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HomeMy WebLinkAboutNC0060224_Renewal Application_20141020 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 1NC0060224 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 Jonas Ridge Properties,LLC Facility Name Jonas Ridge Adult Care Facility Mailing Address P 0 Hoz 519 City Newland State / Zip Code NC 28657 Telephone Number 828-733-0141 Fax Number 828-733-9064 e-mail Address sfre com 2. Location of facility producing discharge: Check here if same address as above ❑ Street Address or State Road 9051 Highway 181 RECEIVEDIDENRIDWR City Jonas Ridge OCT 2 0 2014 State / Zip Code NC 28641 Water c.tual' County Burke Permitting Section 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) Jonas Ridge Properties,LLC Name Mailing Address P. O. Boz 519 City Newland State / Zip Code NC 28657 Telephone Number 828-733-0141 Fax Number 828-733-9064 e-mail Address rfrenchigmhstechnologies.com • 1 d 3 Form-011112 NPDEB APPLICATION - FORM D For privately-owned treatment systems treating 100% domestic wastewaters<1.0 MOD 4. Description of wastewater. Facility Generating Wastewater(check all that applyk Industrial ❑ Number of Employees Commercial ❑ Number of Employees Residential Number of Homes School Number of Students/Staff Other x Explain: Nursing Home Describe the source(s) of wastewater (example: subdivision, mobile home park, shopping centers, restaurants, etc.): Nursing home domestic waste Number of persons served: 70 5. Type of collection system X Separate (sanitary sewer only) 0 Combined (storm sewer and sanitary sewer) 6. Outfall Information: Number of separate discharge points_l _l Identification number(s) 001 Is the outfall equipped with a diffuser? ❑ Yes X No 7. Name of receiving stream(s) (NSW applicants:Provide a map showing the exact location of each outfall): Unnamed tributary to Camp Creek 8. Frequency of Discharge: X Continuous 0 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. 0.0075MGD facility with influent bar screen, equalisation basin with two(2) pumps, aeration basin, clarifier, chlorine contact chamber, dechlorination unit, post-aeration tank. 2 of 3 Form-D 11/12 NPDES APPLICATION - FORM D For privately-owned treatment systems treating 100% domestic wastewaters <1.0 MGD 10. Flow Information: Treatment Plant Design flow 0.0075MQD Annual Average daily flow 0.0035 MOD (for the previous 3 years) Maadmum daily flow 0.0098 MGD (for the previous 3 years) 11. Is this facility located on Indian country? ❑ Yes X No 12. Effluent Data NEW APPLTCANPP$:Provide data for the parameters listed.Fecal Coliform, Temperature and pH shall be grub 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/A'. Parameter Daily Monthly Units of >IIsodmsm Average Measurement Biochemical Oxygen Demand (BODS) 50.6 31.5 MG/L Fecal Coliform 23 3.4 CFU/100ML Total Suspended Solids 30 17.1 MG/L Temperature (Summer) 24.5 23.4 C Temperature (Winter) , 9.3 6.5 C pH 9.0 8.1 units 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 NC0060224 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 the best o of my knowledge and belief fssuch information is true, complete, and ' / e. r/ Lill/4e� toe-.-1-/De-it� Printed te of Person Signing Title (&'-q€ SOU . /o - �s- - Signature of Ap licant Date North Cardin General Statute 143-215.6(bM2)states: Any person who knowingly makes any false statement representa ion, a certification in any application,record,report, pian,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 sirdar offense.) 3 of 3 Foran-011/12 iire7A NCDENR North Carolina Department of Environment and Natural Resources Pat McCrory John E. Skvarla, Ill Governor Secretary October 21,2014 George Ware,President Jonas Ridge Properties,LLC PO Box 519 Newland,NC 28657 Subject: Acknowledgement of Permit Renewal Permit NC0060224 Burke County Dear Mr. Ware: The NPDES Unit received your permit renewal application on October.20, 2014. A member of the NPDES Unit will review your application. They will contact you if additional information is required to complete your permit renewal. You should expect to receive a draft permit approximately 30-45 days before your existing permit expires. If you have any additional questions concerning renewal of the subject permit, please contact Charles Weaver(919) 807-6391. Sincerely, W re h•Meobfo-rot, Wren Thedford Wastewater Branch cc: Central Files Asheville Regional Office NPDES Unit 1617 Mail Service Center,Raleigh,North Carolina 27699-1617 Location:512 N.Salisbury St Raleigh,North Carolina 27604 Phone:919-807-63001 Fax:919-807-6492/Customer Service:1-877-623-6748 Internet:www.ncwater.orq An Equal OpportunityV firmative Action Employer