HomeMy WebLinkAboutNC0052043_Permit (Issuance)_20170803ROY COOPER
Governor
Water Resources
ENVIRONMENTAL QUALITY
Ms. Kimberly Oddo, President
Toxaway Falls POA
P.O. Box 0270
Lake Toxaway, NC 28747
Dear Ms. Oddo:
MICHAEL S. REGAN
Secretary
S. JAY ZIMMERMAN
Director
August 3, 2017
Subject: Issuance of NPDES Permit NC0052043
Toxaway Falls WWTP/ Class II
Transylvania County
Division personnel have reviewed and approved your application for renewal of the subject
permit. Accordingly, we are forwarding the attached NPDES discharge permit. This permit is issued
pursuant to the requirements of North Carolina General Statute 143-215.1 and the Memorandum of
Agreement between North Carolina and the U.S. Environmental Protection Agency dated October 15,
2007 (or as subsequently amended).
The final permit includes the following significant changes from the existing permit:
➢ eDMR requirements have been added. See A.(4).
➢ Regulatory Citations have been added.
➢ An updated outfall map had been included.
If any parts, measurement frequencies or sampling requirements contained in this permit are
unacceptable to you, you have the right to an adjudicatory hearing upon written request within thirty
(30) days following receipt of this letter. This request must be in the form of a written petition,
conforming to Chapter 150B of the North Carolina General Statutes, and filed with the Office of
Administrative Hearings (6714 Mail Service Center, Raleigh, North Carolina 27699-6714). Unless
such demand is made, this decision shall be final and binding.
Please note that this permit is not transferable except after notice to the Division. The Division
may require modification or revocation and reissuance of the permit. This permit does not affect the
legal requirements to obtain any other Federal, State, or Local governmental permit that may be
required. If you have any questions concerning this permit, please contact Anjali B. Orlando at
telephone number (919) 807-6388 or anjali.orlando@ncdenr.gov.
S. Jay Zimmerman, P.
Director, Division of Water Resources
cc: Central Files
Asheville Regional Office
NPDES Unit
State of North Carolina I Environmental Quality I Water Resources
1617 Mail Service Center J Raleigh, NC 27699-1617
919 807 6300 919-807-6389 FAX
https: //deq.nc.gov/aboutldivi sions/water-resources/water-resources-permits/wastewater-branch/npdes-wastewater-permits
Permit NC0052043
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF WATER RESOURCES
PERMIT
TO DISCHARGE WASTEWATER UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful
standards and regulations promulgated and adopted by the North Carolina Environmental
Management Commission, and the Federal Water Pollution Control Act, as amended, the
Toxaway Falls POA, Inc.
is hereby authorized to discharge wastewater from a facility located at the
Toxaway Falls WWTP
Toxaway River Rd
Transylvania County
to receiving waters designated as the Toxaway River in subbasin 03-13-02 of the Savannah
River Basin in accordance with effluent limitations, monitoring requirements, and other
conditions set forth in Parts I, II, III and IV hereof.
This permit shall become effective September 1, 2017.
This permit and authorization to discharge shall expire at midnight on June 30, 2022.
Signed this day August 3, 2017.
S. ay Zimmerman, P.G.
irector, Division of Water Resources
By Authority of the Environmental Management Commission
Page 1 of 8
Permit NC0052043
SUPPLEMENT TO PERMIT COVER SHEET
All previous NPDES Permits issued to this facility, whether for operation or discharge are hereby
revoked. As of this permit issuance, any previously issued permit bearing this number is no longer
effective. Therefore, the exclusive authority to operate and discharge from this facility arises under the
permit conditions, requirements, terms, and provisions included herein.
The Toxaway Falls POA is hereby authorized to:
1. Continue to operate an existing 0.010 MGD extended aeration package -type wastewater
treatment system that includes the following components:
• 10,150-gallon aeration basin with dual blowers
• 1685-gallon rectangular clarifier with sludge return
• Ultrasonic flow meter
• Tablet chlorine disinfection
• 260-gallon chlorine contact chamber
• Tablet dechlorination
The facility is located west of Rosman at the Toxaway Falls WWTP off Toxaway River Rd in
Transylvania County.
2. After receiving an Authorization to Construct from the Division of Water Quality, construct
and operate a 0.12 MGD wastewater treatment facility.
3. Discharge from said treatment works at the location specified on the attached map into the
Toxaway River (Stream Index 4-(4)), currently classified C waters in hydrologic unit
03060101 of the Savannah River Basin.
Page 2 of 8
Permit NC0052043
Part I.
A. (1) EFFLUENT LIMITATIONS AND MONITORING REQUIREMENTS
[15 NCAC 02B .0400 et seq., 02B .0500 et seq.]
During the period beginning on the effective date of this permit and lasting until expiration, the Permittee
is authorized to discharge from outfall 001. Such discharges shall be limited and monitored1 by the
Permittee as specified below:
PARAMETER
LIMITS
MONITORING REQUIREMENTS
[PCS Code]
Monthly
Average
Daily
Maximum
Measurement
Frequency
Sample
Type
Sample
Location
Flow
[50050]
0.010 MGD
Continuous
Recording
Influent or
Effluent
BOD, 5-day (20°C)
[00310]
30.0 mg/L
45.0 mg/L
Weekly
Grab
Effluent
Total Suspended Solids
[00530]
30.0 mg/L
45.0 mg/L
Weekly
Grab
Effluent
NH3 as N
[00610]
Monitor & Report
2/Month
Grab
Effluent
pH
[00400]
> 6.0 and < 9.0 standard units
— —
Weekly
Grab
Effluent
Fecal Coliform (geometric
mean)
[31616]
200/100 mL
400/100 mL
Weekly
Grab
Effluent
Total Residual Chlorine2
[50060]
28 Og/L
2/Week
Grab
Effluent
Footnotes:
1. The permittee shall submit discharge monitoring reports electronically using the Division's eDMR
system [see A. (4)].
2. The Permittee shall report all effluent TRC values reported by a NC -certified laboratory [including
field -certified]. Effluent values < 50 pug/ L will be treated as zero for compliance purposes.
All samples much be collected from a typical discharge event.
THERE SHALL BE NO DISCHARGE OF FLOATING SOLIDS OR VISIBLE FOAM IN OTHER
THAN TRACE AMOUNTS.
A. (2) PHASED CONSTRUCTION CONDITION
If this facility is built in phases, plans and specifications for the next phase shall be submitted
when the flow to the existing units reaches 80% of the design capacity of the facilities on line.
At no time may the flow tributary to the facility exceed the design capacity of the existing units.
Furthermore, this facility will need to justify the need for specific design flows prior to a request
for expansion.
Page 3 of 8
Permit NC0052043
A. (3) EFFLUENT LIMITATIONS AND MONITORING REQUIREMENTS
[15 NCAC 02B .0400 et seq., 02B .0500 et seq.]
During the period beginning on the effective date of this permit and lasting until expiration, the Permittee
is authorized to discharge from outfall 001. Such discharges shall be limited and monitored' by the
Permittee as specified below:
PARAMETER
LIMITS
MONITORING REQUIREMENTS
[PCS Code]
Monthly
Average
Daily
Maximum
Measurement
Frequency
Sample
Type
Sample
Location
Flow
[50050]
0.12 MGD
Continuous
Recording
Influent or
Effluent
BOD, 5-day (20°C)
[00310]
30.0 mg/L
45.0 mg/L
Weekly
Composite
Effluent
Total Suspended Solids
[00530]
30.0 mg/L
45.0 mg/L
Weekly
Composite
Effluent
NH3 as N (April 1 -October 31)
[00610]
11.0mg/L
35.0 mg/L
Weekly
Composite
Effluent
NH3 as N (November 1 - March
31)
[00610]
22.0 mg/L
35.0 mg/L
Weekly
Composite
Effluent
Fecal Coliform (geometric mean)
[31616]
200/100 m/L
400/100 m/L
Weekly
Grab
Effluent
Total Residual Chlorine2
[50060]
28 Og/L
2/Week
Grab
Effluent
Temperature (°C)
[00010]
Daily
Grab
Effluent
Total Nitrogen (NO2+NO3+TKN)
[00600]
Semi -Annually
Composite
Effluent
Total Phosphorus
[00665]
Semi -Annually
Composite
Effluent
pH
[00400]
> 6.0 and < 9.0 standard units
- -
Weekly
Grab
Effluent
Footnotes:
1. The permittee shall submit discharge monitoring reports electronically using the Division's eDMR
system [see A. (4)].
2. The Permittee shall report all effluent TRC values reported by a NC -certified laboratory [including
field -certified]. Effluent values < 50 µg/ L will be treated as zero for compliance purposes.
All samples much be collected from a typical discharge event.
THERE SHALL BE NO DISCHARGE OF FLOATING SOLIDS OR VISIBLE FOAM IN OTHER
THAN TRACE AMOUNTS.
Page 4 of 8
Permit NC0052043
A. (4) ELECTRONIC REPORTING OF DISCHARGE MONITORING REPORTS
[NCGS 143-215.1 (b)]
Federal regulations require electronic submittal of all discharge monitoring reports (DMRs)
and program reports. The final NPDES Electronic Reporting Rule was adopted and became
effective on December 21, 2015.
NOTE: This special condition supplements or supersedes the following sections within Part II
of this permit (Standard Conditions for NPDES Permits):
• Section B. (11.)
• Section D. (2.)
• Section D. (6.)
• Section E. (5.)
Signatory Requirements
Reporting
Records Retention
Monitoring Reports
1. Reporting Requirements [Supersedes Section D. (2.) and Section E. (5.) (a)]
The permittee shall report discharge monitoring data electronically using the NC DWR's
Electronic Discharge Monitoring Report (eDMR) internet application.
Monitoring results obtained during the previous month(s) shall be summarized for each
month and submitted electronically using eDMR. The eDMR system allows permitted
facilities to enter monitoring data and submit DMRs electronically using the internet.
Until such time that the state's eDMR application is compliant with EPA's Cross -Media
Electronic Reporting Regulation (CROMERR), permittees will be required to submit all
discharge monitoring data to the state electronically using eDMR and will be required to
complete the eDMR submission by printing, signing, and submitting one signed original
and a copy of the computer printed eDMR to the following address:
NC DENR / Division of Water Resources / Water Quality Permitting Section
ATTENTION: Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
If a permittee is unable to use the eDMR system due to a demonstrated hardship or due
to the facility being physically located in an area where less than 10 percent of the
households have broadband access, then a temporary waiver from the NPDES electronic
reporting requirements may be granted and discharge monitoring data may be submitted
on paper DMR forms (MR 1, 1.1, 2, 3) or alternative forms approved by the Director.
Duplicate signed copies shall be submitted to the mailing address above. See "How to
Request a Waiver from Electronic Reporting" section below.
Regardless of the submission method, the first DMR is due on the last day of the month
following the issuance of the permit or in the case of a new facility, on the last day of the
month following the commencement of discharge.
Starting on December 21, 2020, the permittee must electronically report the following
compliance monitoring data and reports, when applicable:
• Sewer Overflow/Bypass Event Reports;
Page 5 of 8
Permit NC0052043
• Pretreatment Program Annual Reports; and
• Clean Water Act (CWA) Section 316(b) Annual Reports.
The permittee may seek an electronic reporting waiver from the Division (see "How to
Request a Waiver from Electronic Reporting" section below).
2. Electronic Submissions
In accordance with 40 CFR 122.41(1)(9), the permittee must identify the initial recipient at
the time of each electronic submission. The permittee should use the EPA's website
resources to identify the initial recipient for the electronic submission.
Initial recipient of electronic NPDES information from NPDES-regulated facilities means
the entity (EPA or the state authorized by EPA to implement the NPDES program) that is
the designated entity for receiving electronic NPDES data [see 40 CFR 127.2(b)].
EPA plans to establish a website that will also link to the appropriate electronic reporting
tool for each type of electronic submission and for each state. Instructions on how to
access and use the appropriate electronic reporting tool will be available as well.
Information on EPA's NPDES Electronic Reporting Rule is found at:
http: / /www2.epa.gov/compliance/final-national-pollutant-discharge-elimination-system-
npdes-electronic-reporting-rule.
Electronic submissions must start by the dates listed in the "Reporting Requirements"
section above.
3. How to Request a Waiver from Electronic Reporting
The permittee may seek a temporary electronic reporting waiver from the Division. To
obtain an electronic reporting waiver, a permittee must first submit an electronic
reporting waiver request to the Division. Requests for temporary electronic reporting
waivers must be submitted in writing to the Division for written approval at least sixty
(60) days prior to the date the facility would be required under this permit to begin
submitting monitoring data and reports. The duration of a temporary waiver shall not
exceed 5 years and shall thereupon expire. At such time, monitoring data and reports
shall be submitted electronically to the Division unless the permittee re -applies for and is
granted a new temporary electronic reporting waiver by the Division. Approved electronic
reporting waivers are not transferrable. Only permittees with an approved reporting
waiver request may submit monitoring data and reports on paper to the Division for the
period that the approved reporting waiver request is effective.
Information on eDMR and the application for a temporary electronic reporting waiver are
found on the following web page:
http: / /deq.nc.gov/about/divisions/water-resources/edmr
Page 6 of 8
Permit NC0052043
4. Signatory Requirements [Supplements Section B. (11.) (b) and Supersedes Section B.
(11.) (d)]
All eDMRs submitted to the permit issuing authority shall be signed by a person
described in Part II, Section B. (11.)(a) or by a duly authorized representative of that
person as described in Part II, Section B. (11.)(b). A person, and not a position, must be
delegated signatory authority for eDMR reporting purposes.
For eDMR submissions, the person signing and submitting the DMR must obtain an
eDMR user account and login credentials to access the eDMR system. For more
information on North Carolina's eDMR system, registering for eDMR and obtaining an
eDMR user account, please visit the following web page:
http://deq.nc.gov/about/divisions/water-resources/edmr
Certification. Any person submitting an electronic DMR using the state's eDMR system
shall make the following certification [40 CFR 122.22]. NO OTHER STATEMENTS OF
CERTIFICATION WILL BE ACCEPTED:
"I certify, under penalty of law, that this document and all attachments were prepared
under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gather and evaluate the information submitted. Based on my
inquiry of the person or persons who manage the system, or those persons directly
responsible for gathering the information, the information submitted is, to the best of my
knowledge and belief, true, accurate, and complete. I am aware that there are significant
penalties for submitting false information, including the possibility of fines and
imprisonment for knowing violations."
5. Records Retention [Supplements Section D. (6.)1
The permittee shall retain records of all Discharge Monitoring Reports, including eDMR
submissions. These records or copies shall be maintained for a period of at least 3 years
from the date of the report. This period may be extended by request of the Director at any
time [40 CFR 122.41].
Page 7 of 8
Permit NC0052043
NPDES Permit NC0052043
Toxaway Fans WWTP
Rec&ving Stre am :Toxaway Rver
Stream Segment: 4-14)
River Basn: Savannah
County: Transyivan6a
Stream Cass: C
Sub -Basin #: 03-13-02
HUC: 0306010/
SCALE
1:24,03,
Facity Location
LakeToxaway, NC
USGS Q uad: Reid, NC
Page 8 of 8
FACT SHEET FOR EXPEDITED PERMIT RENEWALS
This form must be completed by Permit Writers for all expedited permits which do not
require full Fact Sheets. Expedited permits are generally simple 100% domestics (e.g.,
schools, mobile home parks, etc) that can be administratively renewed with minor
changes, but can include facilities with more complex issues (Special Conditions, 303(d)
listed water, toxicity testing, instream monitoring, compliance concerns).
Basic Information for Expedited Permit Renewals
Permit Writer/Date
Anjali Orlando 05 / 03 / 2017
Permit Number
NC0052043
Facility Name
Toxaway Falls WWTP
Basin Name/Sub-basin number
Savannah River/03060101
Receiving Stream
Toxaway River
Stream Classification in Permit
C
Does permit need Daily Max NH3
limits?
No
Does permit need TRC
limits/language?
No
Does permit have toxicity testing?
No
Does permit have Special Conditions?
Yes -Phased Construction Condition
Does permit have instream
monitoring?
No
Is the stream impaired (on 303(d)
list)?
No
Any obvious compliance concerns?
Yes- 1 NOV in 2017;2 NOV in 2016; 2
NOV in 2015
Any permit mods since last permit?
No
New expiration date
6 / 30 / 2022
Changes to Draft Permit?
Yes
• eDMR requirements have
been added (See A.(4)).
• An updated outfall map
included
• Regulatory citations added
Comments received on Draft Permit?
No
Orlando, Anjali
From: Heim, Tim
Sent: Wednesday, June 21, 2017 10:29 AM
To: Orlando, Anjali
Subject: FW: Emailing - 52043 draft permit 2017.pdf
Attachments: 52043 draft permit 2017.pdf
Anjali,
I have reviewed this and have no additional comments.
-Tim
From: Davidson, Landon
Sent: Wednesday, June 07, 2017 10:46 AM
To: Heim, Tim <Tim.Heim@ncdenr.gov>
Subject: FW: Emailing - 52043 draft permit 2017.pdf
fyi
G. Landon Davidson, P.G.
Regional Supervisor — Asheville Regional Office
Water Quality Regional Operations Section
NCDEQ — Division of Water Resources
828 296 4680 office
828 230 4057 mobile
Landon.Davidson(a�ncdenr.gov
2090 U.S. Hwy. 70
Swannanoa, N.C. 28711
Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties.
From: Orlando, Anjali
Sent: Wednesday, June 07, 2017 10:21 AM
To: Davidson, Landon <Iandon.davidson@ncdenr.gov>; Price, Zan (George) <Zan.Price@ncdenr.gov>
Subject: Emailing - 52043 draft permit 2017.pdf
Good morning
Please see draft permit NC0052043 Toxaway Falls WWTP
for review.
We are still waiting for the affidavit from Transylvania Times,
so the 30 day comment period has not run as yet but
I thought I would send it to you anyway.
Thanks
Anjali
Anjali Orlando
Environmental Specialist
Compliance and Expedited Permitting Unit
Division of Water Resources
N.C. Department of Environmental Quality
Office: 919-807-6388
anjali.orlando@ncdenr.gov
Mailing address:
1617 Mail Service Center
Raleigh, NC 27699-1617
Email correspondence to and from this address is subject to the North Carolina Public Records Law and may be disclosed
to third parties.
2
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 Resources / NPDES Unit
1617 Mail Service Center, Raleigh, NC 27699-1617
NPDES Permit
C0052043
If you are completing this form in computer use the TAB key or the up -- down arrows to moue from one
_field to the next. To check the boxes, click your mouse on top of the box. Otherwise, please print or tape.
1. Contact Information:
Owner Name
Facility Name
Mailing Address
City
State / Zip Code
Telephone Number
Fax Number
e-mail Address
TOXAWAY FALLS POA C/O KIMBERLY ODDO (PRESIDENT)
TOXAWAY FALL WWTP
PO BOX 270
LAKE TOXAWAY
NC 28747
(828)883-9059
(828)883-9077
KimOddo.23ru; omail.com - accrnmtantsWccm porium.net
2. Location of facility producing discharge:
Check here if same address as above ❑
Street Address or State Road TOXAWAY FALLS RIVER RD
City LAKE TOXAWAY
State / Zip Code
County
NC 28747
TRANSYLVANIA
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
1 of 4
WILLIAM WESLEY ROYAL
PO BOX 778
PISGAH FOREST
NC 28768
(828)506-5572
( )
WESROYAL{ir HOTMAII,.coM
Form-D 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 0
Commercial X❑ Number of Employees 4
Residential X❑ Number of Homes 27
School ❑ Number of Students/Staff 0
Other ❑ Explain: 0
Describe the source(s) of wastewater (example: subdivision, mobile home park, shopping centers,
restaurants, etc.):
ONE RESTAURNAT 4 CONDOS WITH 23 UNITS AND 2 HOMES
Number of persons served: 50
5. Type of collection system
X❑ Separate (sanitary sewer only) ❑ Combined (storm sewer and sanitary sewer)
6. Outfall Information:
Number of separate discharge points 001
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
ou tfa ll):
TOXAWAY RIVER
8. Frequency of Discharge: X❑ Continuous
❑ Intermittent
If intermittent:
Days per week discharge occurs: 7 Duration: 365
9. Describe the treatment system
List all installed components, including capacities, provide design removal for ROD, TSS, nitrogen and
phosphorus. If the space provided is not sufficient, attach the description of the treatment system in a
separate sheet of paper.
THE PLANT IS A .010 MGD EXTENDED AIR PACKAGE PLANT. HAS A CONINUED FLOW
METER. CHLORINE TABLET FEEDER WITH A CONTACT CHAMBER AND A DECLOR
TABLET FEEDER. WE WORK WITH LOCAL PUMP AND HALL TRUCKS FOR SLUDGE
REMOVAL AS NEEDED, AND DUMPED AT CITY OF BREVARD WWTP.
2 of 4 Form-D 11/12
Parameter Daily
Maximum
Monthly
Average
r
Biochemical Oxygen Demand (BOD-,)
17.2
9.4
Mg
GE
Mg
Fecal Coliform
1.7
1.4
Total Suspended Solids
21.3
17.6
Temperature (Summer)
19.4
16.2
c
Temperature (Winter)
11.2
9.3
c
p11
7.1
7.0
SU
13. List all permits, construction approvals and/or applications:
Type
Permit Number Type
NPDES APPLICATION - FORM D
For privately -owned treatment systems treating 100% domestic wastewaters <1.0 MGD
10. Flow Information:
Treatment Plant Design flow .010 MGD
Annual Average daily flow .003 MGD (for the previous 3 years)
Maximum daily flow .006 MGD (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 pF1 shall he ctirih
samples, for all other parameters 24-hour composite sampling shall he used, If more than one analysis is reported.
report daily maximum and monthly average. If only one analysis is reported. report os daily maximum.
RENEWAL APPLICANTS: Provide the highest single reading (Daily Maximum) and Monthly Average
over the past 36 monthssfor parameters currently in yourrntit Mark otF
r aramet�s-c "N/A ".
Units of
easurement
/1
OMEAN
/1
Permit Number
Hazardous Waste (RCRA) NA NESIIAPS (CAA) NA
UIC (SDWA) NA ocean Dumping (MPRSA) NA
NPDES NA Dredge or fill (Section 404 or CWA) NA
PSD (CAA) NA Other NA
Non -attainment program (CAA) NA
14. APPLICANT CERTIFICATION
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.
WILLIAM WESLEY ROYAL ORC
Printed name of Person Signing Title
1i
Signature of Applican
1 A)1
Date 7
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
3 of 4 Form-D 11/12
NPDES APPLICATION - FORM D
For privately -owned treatment systems treating 100% domestic wastewaters <1.0 MGD
guilty of a misdemeanor punishable by a fine not to exceed $25,000, or by imprisonment not to exceed six months, or by both (1811 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 )
4 of 4
Form-D 11/12