NC0066249_Renewal (Application)_20200529 (2)

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GOVPrO91 �5, ;At-., ,'7 -
MICHAEL S.REGAN `. �*•«�* .
Secretary
S.DANIEL SMITH NORTH CAROL INA
Director Environmental Quality
June 04, 2020
Country Acres Mobile Home Park
Attn: John Edmundson
25 Keith Memorial Dr
Mills River, NC 28759-2522
Subject: Permit Renewal
Application No. NC0066249
Country Acres MHP WWTP
Henderson County
Dear Applicant:
The Water Quality Permitting Section acknowledges the May 29, 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. 150E-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:J/deq.nc.gov/permits-requlations[permit-guidanceLenvironmental-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.
Sincerely,
Wren Thedford
Administrative Assistant
Water Quality Permitting Section
ec: WQPS Laserfiche File w/application
DE North Carolina Depsrtnrent of Env;ron meets'Qua ty I D vson of Water Resod roes
Ast ev,le Regan*Offoe 12090 U.S.70 H hwsy I SWannaros, North Cery re 28779
,....... ..,—.�.�.-..... 828-296-45D0

NPDES APPLICATION - FORM D
For privately-owned treatment systems treating 100% domestic wastewaters <1.0 MOD
Mail the complete application to:
N. C. DENR / Division of Water Quality / NPDES Unit
1617 Mail Service Center, Raleigh, NC 27699-1617
NPDES Permit INCOO to(01 ti 9
If you are completing this form in computer use the TAB key or the up - down arrows to move fro!1 one
field to the next. To check the boxes, click your mouse on top of the box. Otherwise,please print or tt pe.
1. Contact Information:
Owner Name JOwA..1
Facility Name �s/ � � /)0-glee
Mailing Address es 7C /T1/ l76A'42�L?G�
City /27/6 `72/
State / Zip Code /VC v2 0 75-9
Telephone Number
Fax Number ( )
e-mail Address J( G"�/Js'I cJ/v�$o� ��- S Oc-f%/'
2. Location of facility producing dis_ch/ar1e:
Check here if same address as above I�
Street Address or State Road C E \I ED
City
MAY 2 9 2020
State / Zip Code
County SO/L.) NCDEQ/DWR/NPDES
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 j'1/tAgk o NIL S
Mailing Address -is- \ 2G6 n 1- 0--
City
State / Zip Code r L 281,3
Telephone Number (ISZS ) 273 - 0 7(Q
Fax Number ( )
e-mail Address c(LS br-0.:L; a) 5,v.Cti) _
1 of 3 Form-)11/12

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 ❑ Explain:
Describe the source(s) of wastewater (example: subdivision, mobile home park, shopping centers,
restaurants, etc.):
M
Number of persons served: 2�
5. Type of collection system
Separate (sanitary sewer only) ❑ Combined (storm sewer and sanitary sewer)
6. Outfall Information:
Number of separate discharge points
Outfall Identification number(s) 00�^
Is the outfall equipped with a diffuser? 0 Yes ,❑ No
7. Name of receiving stream(s) (NEW applicants:Provide a map showing the exact location of each
outfall):
l�0wetl G2.cC=
8. Frequency of Discharge: 2 Continuous ❑ Intermittent
If intermittent: Z y �/,�� (�
Days per week discharge occurs: 7 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 iit a
separate sheet of paper.
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2 of 3 I VJa h\ Form-)11/12
36-

NPDES APPLICATION - FORM D
For privately-owned treatment systems treating 100% domestic wastewaters <1.0 MOD
10. Flow Information:
Treatment Plant Design flow •U 0(c, MOD
Annual Average daily flow • 0 O Zy 1 MOD (for the previous 3 years)
Maaimnm daily flow 00 3 MOD (for the previous 3 years)
11. Is this facility located on Indian country?
❑ Yes 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 your permit Mark other parameters `N/AD.
Daily Monthly Units of
Parameter Maximum Average Measurement
Biochemical Oxygen Demand (BOD5) 9 S,`�3j] en,)
Fecal Coliform j C.SL? LG c3 ' 7 7. //CCO r� j
Total Suspended Solids 2 2 . 8 7o 0 5 wt l
Temperature (Summer) "A Cv [-
Temperature (Winter) I 8 I S cos 7 G
pH 7,y U 8 1 e/ 5 N
13. List all permits, construction approvals and/or applications:
Type Permit Number Type Permit Number
Hazardous Waste (RCRA) NESHAPS(CAA) _
UIC (SDWA) Ocean Dumping(MPRSA)
NPDES Dredge or fill(Section 404 or CWA) _
PSD (CAA) Other
—
Non-attainment program (CAA)
14. APPLICANT CERTIFICATION
I certify that I am familiar with the information contained in the application and that to tho best
of my knowledge and
belief such information is true, complete, and accurate.
Printed name of Person Signing Title
Si tore of Applicant Date
North Carolina General Statute 143-215.6(b)(2)states:Any person who knowingly makes any false statement representation,or certificaticn in any
application,record,report,plan,or other document files or required to be maintained under Article 21 or regulations of the Environmental Mar agement
Commission inplementing that Article,or who falsifies,tampers with,or knowingly renders inaccurate any recording or monitoring device or methoc required
to be operated or maintained under Article 21 or regulations of the Environmental Management Commission implementing that Article,shall be r oilty of a
misdemeanor purishable 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 pevides a
punishment by a fine of not more than$25,000 or imprisonment not more than 5 yeas,or both,for a similar offense.)
3 of 3 Form-I)11/12