NC0020486_Fact Sheet_20210621

DocuSign Envelope ID: 8BE00C93-912B-4385-A135-7C06232CE562
Fact Sheet
NPDES Permit No. NC0020486
Permit Writer/Email Contact Emily Phillips
Date: February 18, 2021
Division/Branch: NC Division of Water Resources/NPDES Complex Permitting
Fact Sheet Template: Version 09Jan2017
Permitting Action:
© Renewal
❑ Renewal with Expansion
❑ New Discharge
❑ Modification (Fact Sheet should be tailored to mod request)
Note: A complete application should include the following:
• For New Dischargers, EPA Form 2A or 2D requirements, Engineering Alternatives Analysis, Fee
• For Existing Dischargers (POTW), EPA Form 2A, 3 effluent pollutant scans, 4 2nd species WET
tests.
• For Existing Dischargers (Non-POTW), EPA Form 2C with correct analytical requirements based
on industry category.
Complete applicable sections below. If not applicable, enter NA.
1. Basic Facility Information
Facility Information
Applicant/Facility Name:
USDA US Forest Service/North Mills River Recreation Area
Applicant Address:
160 Zillicoa Street, Suite A, Asheville NC 28801
Facility Address:
1040 Shiloh Road, Claremont, NC 28610
Permitted Flow:
0.012 MGD [-40people]
Facility Type/Waste:
Minor Municipal; 100% domestic
Facility Class:
Class II
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Treatment Units:
• Influent pump station
• 7500-gallon flow equalization basin with manual bar screen
• Dual submersible 30-gpm pumps
• Dual high-water alarms
• 40-cfm blower
• Dual 7500-gallon aeration basins with coarse air diffusers and
three 85-scfm blowers
• Dual secondary clarifiers [50 ft2], each with skimmer and air lift
sludge return
• Dual tertiary filters [6.25 ft2], each with 40-scfm scour blower
• Clearwell and mudwell
• 4500-gallon aerobic digester with coarse air diffusers
• Tablet chlorine disinfection
• Chlorine contact basin [417 gallons]
• Tablet dechlorination
• Effluent outfall line [225 linear feet of 6" gravity pipe]
Pretreatment Program (Y/N)
N
County:
Henderson
Region
Asheville
Briefly describe the proposed permitting action and facility background: North Mills River Recreation
Area has applied for an NPDES permit renewal at 0.012 MGD. This facility serves a population of 40
people. The facility has a single Outfall 001.
2. Receiving Waterbodv Information:
Outfalls/Receiving Stream(s):
Outfall 001 — North Fork
Mills River
Stream Segment:
6-54-2-(4)
Stream Classification:
WS-II; Tr, HQW
303(d) listed/parameter:
N/A
Basin/Sub-basin:
French Broad/04-03-03
3. Effluent Data Summary
Table. Effluent Data Summary Outfall 001
See table on following page....
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PARAMETER
[Parameter Code]
LIMITS
MONITORING REQUIREMENTS
Monthly
Average
Daily
Maximum
Measurement
Frequency
Sample Type
Sample
Location
Flow
[50050]
0.012 MGD
Weekly
Instantaneous
Influent or
Effluent
' BOD, 5-day (20°C)
[C0310]
30.0 mg/L
45.0 mg/L
Weekly
Grab
Effluent
Total Suspended Solids
[C0530]
30.0 mg/L
45.0 mg/L
Weekly
Grab
Effluent
NH3 as N
[C0610]
2/Month
Grab
Effluent
Fecal Coliform (geometric mean)
[31616]
200/100 ml
400/100 ml
Weekly
Grab
Effluent
Total Residual Chlorine (TRC)2
[50060]
28 pg/L
2/Week
Grab
Effluent
Temperature (°C)
[00010]
Weekly
Grab
Effluent
pH
[00400]
> 6.0 and < 9.0 standard units
Weekly
Grab
Effluent
4. Instream Data Summary
Instream monitoring may be required in certain situations, for example: 1) to verify model predictions
when model results for instream DO are within 1 mg/1 of instream standard at full permitted flow; 2) to
verify model predictions for outfall diffuser; 3) to provide data for future TMDL; 4) based on other
instream concerns. Instream monitoring may be conducted by the Permittee, and there are also
Monitoring Coalitions established in several basins that conduct instream sampling for the Permittee (in
which case instream monitoring is waived in the permit as long as coalition membership is maintained).
If applicable, summarize any instream data and what instream monitoring will be proposed for this
permit action: N/A
Is this facility a member of a Monitoring Coalition with waived instream monitoring (Y/N): NO
Name of Monitoring Coalition: N/A
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5. Compliance Summary
Summarize the compliance record with permit effluent limits (past 5 years): Monthly average limit
violations in 2015, as well as Insufficient ORC qualifications for O&M. Numerous frequency violations
in 2017, which proceeded to NOVs.
Summarize the compliance record with aquatic toxicity test limits and any second species test results
(past 5 years): N/A
Summarize the results from the most recent compliance inspection: Last inspection occurred July 2020,
with no apparent problems per BIMS.
6. Water Quality -Based Effluent Limitations (WQBELs)
Dilution and Mixing Zones
In accordance with 15A NCAC 2B.0206, the following stream flows are used for dilution considerations
for development of WQBELs: 1 Q 10 streamflow (acute Aquatic Life); 7Q10 streamflow (chronic Aquatic
Life; non -carcinogen HH); 30Q2 streamflow (aesthetics); annual average flow (carcinogen, HH).
If applicable, describe any other dilution factors considered (e.g., based on CORMIX model results): NA
If applicable, describe any mixing zones established in accordance with 15A NCAC 2B.0204(b): NA
Oxygen -Consuming Waste Limitations
Limitations for oxygen -consuming waste (e.g., BOD) are generally based on water quality modeling to
ensure protection of the instream dissolved oxygen (DO) water quality standard. Secondary TBEL limits
(e.g., BOD= 30 mg/1 for Municipals) may be appropriate if deemed more stringent based on dilution and
model results.
If permit limits are more stringent than TBELs, describe how limits were developed: NA
Ammonia and Total Residual Chlorine Limitations
Limitations for ammonia are based on protection of aquatic life utilizing an ammonia chronic criterion of
1.0 mg/1 (summer) and 1.8 mg/1 (winter). Acute ammonia limits are derived from chronic criteria,
utilizing a multiplication factor of 3 for Municipals and a multiplication factor of 5 for Non -Municipals.
Limitations for Total Residual Chlorine (TRC) are based on the NC water quality standard for protection
of aquatic life (17 ug/1) and capped at 28 ug/1(acute impacts). Due to analytical issues, all TRC values
reported below 50 ugh! are considered compliant with their permit limit.
Describe any proposed changes to ammonia and/or TRC limits for this permit renewal: There are no
proposed changes.
Reasonable Potential Analysis (RPA) for Toxicants NA
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If applicable, conduct RPA analysis and complete information below.
The need for toxicant limits is based upon a demonstration of reasonable potential to exceed water quality
standards, a statistical evaluation that is conducted during every permit renewal utilizing the most recent
effluent data for each outfall. The RPA is conducted in accordance with 40 CFR 122.44 (d) (i). The NC
RPA procedure utilizes the following: 1) 95% Confidence Level/95% Probability; 2) assumption of zero
background; 3) use of detection limit for "less than" values; and 4) stream flows used for dilution
consideration based on 15A NCAC 2B.0206. Effective April 6, 2016, NC began implementation of
dissolved metals criteria in the RPA process in accordance with guidance titled NPDES Implementation of
Instream Dissolved Metals Standards, dated June 10, 2016.
A reasonable potential analysis was conducted on effluent toxicant data collected between NA. Pollutants
of concern included toxicants with positive detections and associated water quality standards/criteria.
Based on this analysis, the following permitting actions are proposed for this permit:
• Effluent Limit with Monitoring. The following parameters will receive a water quality -based
effluent limit (WQBEL) since they demonstrated a reasonable potential to exceed applicable
water quality standards/criteria: NA
• Monitoring Only. The following parameters will receive a monitor -only requirement since they
did not demonstrate reasonable potential to exceed applicable water quality standards/criteria,
but the maximum predicted concentration was >50% of the allowable concentration: NA
• No Limit or Monitoring: The following parameters will not receive a limit or monitoring, since
they did not demonstrate reasonable potential to exceed applicable water quality
standards/criteria and the maximum predicted concentration was <50% of the allowable
concentration: NA
• POTW Effluent Pollutant Scan Review: Three effluent pollutant scans were evaluated for
additional pollutants of concern.
o The following parameter(s) will receive a water quality -based effluent limit (WQBEL)
with monitoring, since as part of a limited data set, two samples exceeded the allowable
discharge concentration: NA
o The following parameter(s) will receive a monitor -only requirement, since as part of a
limited data set, one sample exceeded the allowable discharge concentration: NA
If applicable, attach a spreadsheet of the RPA results as well as a copy of the Dissolved Metals
Implementation Fact Sheet for freshwater/saltwater to this Fact Sheet. Include a printout of the RPA
Dissolved to Total Metal Calculator sheet if this is a Municipality with a Pretreatment Program.
Toxicity Testing Limitations
Permit limits and monitoring requirements for Whole Effluent Toxicity (WET) have been established in
accordance with Division guidance (per WET Memo, 8/2/1999). Per WET guidance, all NPDES permits
issued to Major facilities or any facility discharging "complex" wastewater (contains anything other than
domestic waste) will contain appropriate WET limits and monitoring requirements, with several
exceptions. The State has received prior EPA approval to use an Alternative WET Test Procedure in
NPDES permits, using single concentration screening tests, with multiple dilution follow-up upon a test
failure.
Describe proposed toxicity test requirement: NA
Mercury Statewide TMDL Evaluation
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There is a statewide TMDL for mercury approved by EPA in 2012. The TMDL target was to comply
with EPA's mercury fish tissue criteria (0.3 mg/kg) for human health protection. The TMDL established a
wasteload allocation for point sources of 37 kg/year (81 lb/year), and is applicable to municipals and
industrial facilities with known mercury discharges. Given the small contribution of mercury from point
sources (-2% of total load), the TMDL emphasizes mercury minimization plans (MMPs) for point source
control. Municipal facilities > 2 MGD and discharging quantifiable levels of mercury (>1 ng/l) will
receive an MMP requirement. Industrials are evaluated on a case -by -case basis, depending if mercury is a
pollutant of concern. Effluent limits may also be added if annual average effluent concentrations exceed
the WQBEL value (based on the NC WQS of 12 ng/l) and/or if any individual value exceeds a TBEL
value of 47 ng/1
NA Table. Mercury Effluent Data Summary
# of Samples
Annual Average Conc. ng/L
Maximum Conc., ng/L
TBEL, ng/L
WQBEL, ng/L
Describe proposed permit actions based on mercury evaluation: NA
Other TMDL/Nutrient Management Strategy Considerations
If applicable, describe any other TMDLs/Nutrient Management Strategies and their implementation
within this permit: NA
Other WQBEL Considerations
If applicable, describe any other parameters of concern evaluated for WQBELs: NA
If applicable, describe any special actions (HQW or ORW) this receiving stream and classification shall
comply with in order to protect the designated waterbody: NA
If applicable, describe any compliance schedules proposed for this permit renewal in accordance with
15A NCAC 2H 0107(c)(2)(B), 40CFR 122.47, and EPA May 2007 Memo: NA
If applicable, describe any water quality standards variances proposed in accordance with NCGS 143-
215.3(e) and 15A NCAC 2B.0226for this permit renewal: NA
7. Technology -Based Effluent Limitations (TBELs)
Municipals (if not applicable, delete and skip to Industrials)
Are concentration limits in the permit at least as stringent as secondary treatment requirements (30 mg/l
BOD5/TSS for Monthly Average, and 45 mg/l for BOD5/TSS for Weekly Average). YES
If NO, provide a justification for alternative limitations (e.g., waste stabilization pond). NA
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Are 85% removal requirements for BOD5/TSS included in the permit? NA
If NO, provide a justification (e.g., waste stabilization pond). NA
Industrials (if not applicable, delete and skip to next Section) NA
Describe what this facility produces:
List the federal effluent limitations guideline (ELG) for this facility:
If the ELG is based on production or flow, document how the average production/flow value was
calculated:
For ELG limits, document the calculations used to develop TBEL limits:
Table. TBEL Development per NA
Pollutant
Daily Maximum
BPT/BAT
(lb/1000 lb)
Daily Maximum
Monthly Average
BPT/BAT
(lb/1000 lb)
Monthly Average
Limit
(lb/d)
Limit
(lb /d)
If any limits are based on best professional judgement (BPJ), describe development: NA
Document any TBELs that are more stringent than WQBELs: NA
Document any TBELs that are less stringent than previous permit: NA
8. Antidegradation Review (New/Expanding Discharge):
The objective of an anti -degradation review is to ensure that a new or increased pollutant loading will not
degrade water quality. Permitting actions for new or expanding discharges require an anti -degradation
review in accordance with 15A NCAC 2B.0201. Each applicant for a new/expanding NPDES permit
must document an effort to consider non -discharge alternatives per 15A NCAC 2H.0105 (c)(2). In all
cases, existing instream water uses and the level of water quality necessary to protect the existing use is
maintained and protected.
If applicable, describe the results of the antidegradation review, including the Engineering Alternatives
Analysis (EAA) and any water quality modeling results: NA
9. Antibacksliding Review:
Sections 402(o)(2) and 303(d)(4) of the CWA and federal regulations at 40 CFR 122.44(1) prohibit
backsliding of effluent limitations in NPDES permits. These provisions require effluent limitations in a
reissued permit to be as stringent as those in the previous permit, with some exceptions where limitations
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may be relaxed (e.g., based on new information, increases in production may warrant less stringent TBEL
limits, or WQBELs may be less stringent based on updated RPA or dilution).
Are any effluent limitations less stringent than previous permit (YES/NO): NO
If YES, confirm that antibacksliding provisions are not violated: NA
10. Monitoring Requirements
Monitoring frequencies for NPDES permitting are established in accordance with the following
regulations and guidance: 1) State Regulation for Surface Water Monitoring, 15A NCAC 2B.0500; 2)
NPDES Guidance, Monitoring Frequency for Toxic Substances (7/15/2010 Memo); 3) NPDES Guidance,
Reduced Monitoring Frequencies for Facilities with Superior Compliance (10/22/2012 Memo); 4) Best
Professional Judgement (BPJ). Per US EPA (Interim Guidance, 1996), monitoring requirements are not
considered effluent limitations under Section 402(o) of the Clean Water Act, and therefore anti -
backsliding prohibitions would not be triggered by reductions in monitoring frequencies.
For instream monitoring, refer to Section 4.
11. Electronic Reporting Requirements
The US EPA NPDES Electronic Reporting Rule was finalized on December 21, 2015. Effective
December 21, 2016, NPDES regulated facilities are required to submit Discharge Monitoring Reports
(DMRs) electronically. Effective December 21, 2020, NPDES regulated facilities will be required to
submit additional NPDES reports electronically. This permit contains the requirements for electronic
reporting, consistent with Federal requirements.
12.Summary of Proposed Permitting Actions:
A. Table. Current Permit Conditions and Proposed Changes NA
Parameter
Current Permit
Proposed Change
Basis for Condition/Change
NA
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MGD — Million gallons per day, MA - Monthly Average, WA — Weekly Average, DM — Daily Max
B. Table. it Conditions and Proposed Changes NA
Parameter
Current Permit
Proposed Change
Basis for Condition/Change
NA
MGD — Million gallons per day, MA - Monthly Average, WA — Weekly Average, DM — Daily Max
13. Public Notice Schedule:
Permit to Public Notice: 3/23/2021
Per 15A NCAC 2H .0109 & .0111, The Division will receive comments for a period of 30 days following
the publication date of the public notice. Any request for a public hearing shall be submitted to the
Director within the 30 days comment period indicating the interest of the party filing such request and the
reasons why a hearing is warranted.
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14. Fact Sheet Addendum (if applicable):
Were there any changes made since the Draft Permit was public noticed (Yes/No): NO
If Yes, list changes and their basis below: NA
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LOCALiQ
StarNews The Dispatch PO Box 631245 Cincinnati, OH 45263-1245
Times -News
PROOF OF PUBLICATION
Wren Thedford
Ncdenr/Div Waste Mngmt
jfer7ME MAIL SERVICE CTR
!` RALEIGH NC 27699
STATE OF NORTH CAROLINA, COUNTY OF HENDERSON
The Hendersonville Times -News, a newspaper printed and
published in the city of Gastonia, and of general circulation in the
County of Henderson, State of North Carolina, and personal
knowledge of the facts herein state and that the notice hereto
annexed was Published in said newspapers in the issue:
03/27/2021
and that the fees charged are legal.
Sworn to and subscribed before on 03/27/2021
Legal Clerk
Notary, State of WI, ounty of Br:
My commision expires
Publication Cost: $85.68
Order No: 5703572
Customer No: 488566
PO #:
TIIJS (S NOT AN INVO!C.I !
Please do not we this fin -m fi r payment remittnce.
# of Copies:
1
VICKY FELTY
Notary Public
State of Wisconsin
Public Notice
North Carolina Environmental
Management Commis-
sion/NPDES Unit
1617 Mail Service Center
Raleigh, NC 27699-1617
Notice of Intent to Issue a
NPDES Wastewater Permit
NC0020486 North Mills River
Recreation Area
The North Carolina Environ-
mental Management Commis-
sion proposes to issue a
NPDES wastewater discharge
permit to the person(s) listed
below. Written comments
regarding the proposed permit
will be accepted until 30 days
after the publish date of this
notice. The Director of the NC
Division of Water Resources
(DWR) may hold a public
hearing should there be a
significant degree of public
interest. Please mail
comments and/or information
requests to DWR at the above
address. Interested persons
may visit the DWR at 512 N.
Salisbury Street, Raleigh, NC
27604 to review information on
file. Additional information on
NPDES permits and this notice
may be found on our website:
http://deq.nc.gov/about/division
s/water-resources/water-
resou rces-perm i is/wastewate r-
branch/npdes-waste-
water/public-notices,or by call-
ing [phone]. The U.S.
Forest Service (160 Zillicoa St,
Suite A, Asheville, NC 28801-
1082) has requested renewal of
NPDES permit NC0020486 for
the North Mills River Recre-
ation Area WWTP in Hender-
son County. This permitted
facility discharges treated
wastewater to the North Fork
Mills River in the French
Broad River Basin. Currently,
total residual chlorine and
fecal coliform are water qual-
ity limited. This discharge may
affect future allocations in this
portion of the watershed.
3/27/2021 5703572
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ROY COOPER
Cove, nor
MICHAEL S. REGAN
Secretory
S. DANIEL SMITH
Director
USDA
Attn: Huston Nicholas, Forest Supervisor
160A Zillicoa St
Asheville, NC 28801
Subject: Permit Renewal
Application No. NC0020486
North Mills River Recreation Area
Henderson County
Dear Applicant:
., _....
ca�tQUA µ .:.`
NORTH CAROLINA
Environmental Quality
August 17, 2020
The Water Quality Permitting Section acknowledges the August 12, 2020 receipt of your permit renewal application and
supporting documentation. Your application will be assigned to a permit writer within the Section's NPDES WW permitting
branch. Per G.S. 150B-3 your current permit does not expire until permit decision on the application is made.
Continuation of the current permit is contingent on timely and sufficient application for renewal of the current permit. The
permit writer will contact you if additional information is required to complete your permit renewal. Please respond in a
timely manner to requests for additional information necessary to allow a complete review of the application and renewal
of the permit.
Information regarding the status of your renewal application can be found online using the Department of Environmental
Quality's Environmental Application Tracker at:
https://deq. nc.gov/permits-regulations/permit-guidance/environmental-application-tracker
If you have any additional questions about the permit, please contact the primary reviewer of the application using the
links available within the Application Tracker.
Sincere!
ren Thedford
Administrative Assistant
Water Quality Permitting Section
ec: WQPS Laserfiche File w/application
North Ca ro re Depa rtrrent of Environmental Quality I Division of Water Res roes
Ashev.:e Fegora Off oe 12090 U.S. 70 Hg w.ay I Swannenos, North Caro ra 26778
828 298.45DD

DocuSign Envelope ID: 8BE00C93-912B-4385-A135-7C06232CE562
USDA United States
-WeldDepartment of
Agriculture
Forest National Forests in North Carolina
Service
160A Zillicoa Street
Asheville, NC 28801
828-257-4200
Fax: [phone]
File Code:
Date:
Wren Thedford
NC DENR / DWR / NPDES Unit
1617 Mail Service Center
Raleigh, NC 27699-1617
7100
August 4, 2020
Subject: Draft NPDES Permit
Permit NC0020486
USDA Forest Service, North Mills River Recreation Area
Recreation Area WWTP Facility Rating: WW-2
Henderson County
Dear Ms. Thedford:
RECEIVED
AUG 12 2020
NCDEQ/DWR/NPDES
Enclosed is the permit renewal application for North Mills River Recreation Area Wastewater
Treatment Plant.
Please contact Karl Buchholz, Forest Facilities Engineer at 828-443-1581 with questions and
concerns.
HURSTON A. NICHOLAS
Forest Supervisor
cc: Karl Buchholz, Barry Jones
Caring for the Land and Serving People
.Printed on Recycled Paper

DocuSign Envelope ID: 8BE00C93-912B-4385-A135-7C06232CE562
NPDES APPLICATION - FORM D
For privately -owned treatment systems treating 100% domestic wastewaters <1.0 MGD
Mail the complete application to:
N. C. DENR / Division of Water Quality / NPDES Unit
1617 Mail Service Center, Raleigh, NC 27699-1617
NPDES Permit
INC0020486
If you are completing this form in computer use the TAB key or the up - down arrows to move from one
field to the next. To check the boxes, click your mouse on top of the box. Otherwise, please print or type.
1. Contact Information:
Owner Name USDA - US Forest Service
Facility Name North Mills River Recreation Area
Mailing Address 160 Zillicoa Street, Suite A
City Asheville
RECEIVED
AUG 12 7117q
NCfFQ/DWR/NPDES
State / Zip Code NC 28801-1082
Telephone Number 828-257-4200
Fax Number 828-257-4884
e-mail Address [e-mail]
2. Location of facility producing discharge:
Check here if same address as above ❑
Street Address or State Road NCSR 1345 NW of Mills River
City
State / Zip Code
County
Mills River
NC
Henderson
3. Operator Information:
Name of the firm, public organization or other entity that operates the facility. (Note that this is not
referring to the Operator in Responsible Charge or ORC)
Name
Mailing Address
City
State / Zip Code
Telephone Number
Fax Number
e-mail Address
USDA - US Forest Service
160 Zillicoa Street, Suite A
Asheville
NC 28801-1082
828-257-4200
828-257-4884
[e-mail]
1 of 3 Form-D 11 /12

DocuSign Envelope ID: 8BE00C93-912B-4385-A135-7C06232CE562
NPDES APPLICATION - FORM D
For privately -owned treatment systems treating 100% domestic wastewaters <1.0 MGD
4. Description of wastewater:
Facility Generating Wastewater(check all that apply):
Industrial Number of Employees
Commercial Number of Employees
Residential Number of Homes
School Number of Students/Staff
Other x Explain: Recreation Area
4
Describe the source(s) of wastewater (example: subdivision, mobile home park, shopping centers,
restaurants, etc.):
Domestic waste from community showers, dump station and full hook up sites
Number of persons served: 40
5. Type of collection system
X Separate (sanitary sewer only) ❑ Combined (storm sewer and sanitary sewer)
6. Outfall Information:
Number of separate discharge points 1
Outfall Identification number(s) 001
Is the outfall equipped with a diffuser? ❑ Yes X No
7. Name of receiving stream(s) (NEW applicants: Provide a map showing the exact location of each
outfall):
North Fork Mills River
8. Frequency of Discharge: X Continuous ❑ Intermittent
If intermittent:
Days per week discharge occurs: Duration:
9. Describe the treatment system
List all installed components, including capacities, provide design removal for BOD, TSS, nitrogen and
phosphorus. If the space provided is not sufficient, attach the description of the treatment system in a
separate sheet of paper.
A 0.012 MGD dual -train extended aeration package system with influent pump station,
7500-gallon flow equalization basin with manual bar screen, dual submersible 30-gpm
pumps, dual high-water alarms, 40-cfm blower, dual 7500-gallon aeration basins with
coarse air diffusers and 3 85-scfm blowers, dual secondary clarifiers, each with skimmer
and air lift sludge return, dual tertiary filers each with 40-scfm scour blower, clearwell
and mudwell, 4500 gallon aerobic digester with coarse air diffusers, tablet chlorine
disinfection, chlorine contact basin (417 gallons), tablet dechlorination, effluent outfall
line (225 linear feet of 6" gravity pipe)
2 of 3 Form-D 11/12

DocuSign Envelope ID: 8BE00C93-912B-4385-A135-7C06232CE562
Type
Hazardous Waste (RCRA)
UIC (SDWA)
NPDES
PSD (CAA)
Non -attainment program (CAA)
NPDES APPLICATION - FORM D
For privately -owned treatment systems treating 100% domestic wastewaters <1.0 MGD
10. Flow Information:
Treatment Plant Design flow 0.012 MGD
Annual Average daily flow .0017 MGD (for the previous 3 years)
Maximum daily flow MGD 0.009 (for the previous 3 years)
11. Is this facility located on Indian country?
❑ Yes X No
12. Effluent Data
NEW APPLICANTS: Provide data for the parameters listed. Fecal Coliform, Temperature and pH shall be grab
samples, for all other parameters 24-hour composite sampling shall be used. If more than one analysis is reported,
report daily maximum and monthly average. If only one analysis is reported, report as daily maximum.
RENEWAL APPLICANTS: Provide the highest single reading (Daily Maximum) and Monthly Average
over the past 36 months for parameters currently in our permit. Mark other parameters "N/A".
Parameter
Daily
Maximum
Monthly
Average
Units of
Measurement
Biochemical Oxygen Demand (BOD5)
12.8
7.8
MG/L
Fecal Coliform
<4
2.4
CFU/ 100ML
Total Suspended Solids
39.0
23.6
MG/L
Temperature (Summer)
24.5
22.9
C
Temperature (Winter)
CLOSED
CLOSED
C
pH
7.9
7.6
units
13. List all permits, construction approvals and/or applications:
Permit Number Type
NESHAPS (CAA)
Ocean Dumping (MPRSA)
NC0020486 Dredge or fill (Section 404 or CWA)
Other
14. APPLICANT CERTIFICATION
Permit Number
I certify that I am familiar with the information contained in the application and that to the
best of my knowledge and belief such information is true, complete, and accurate.
pplicant Date
North Carolina General Statute 143-215.6 (b)(2) states: Any person who knowingly makes any false statement representation, or certification in any
application, record, report, plan, or other document files or required to be maintained under Article 21 or regulations of the Environmental Management
Commission implementing that Article, or who falsifies, tampers with, or knowingly renders inaccurate any recording or monitoring device or method
required to be operated or maintained under Article 21 or regulations of the Environmental Management Commission implementing that Article, shall be
guilty of a misdemeanor punishable by a fine not to exceed $25,000, or by imprisonment not to exceed six months, or by both. (18 U.S.C. Section 1001
provides a punishment by a fine of not more than $25,000 or imprisonment not more than 5 years, or both, for a similar offense.)
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Form-D 11/12