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HomeMy WebLinkAboutNC0022098_Permit Issuance_20160818PAT MCCRORY („.r,'rum Water Resources ENVIRONMENTAL QUAIJI Y DONALD R. VAN DER VAART S. JAY ZIMMERMAN August 18, 2016 Mr. James Radford III NC Land Lease, LLC P.O. Box 2533 Christiansburg, VA 24068-2533 Subject: Issuance of NPDES Permit NC0022098 Cranbrook Village WWTP Guilford County Class WW-2 Dear Mr. Radford: 0114 for 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). This final permit includes the following changes from the draft permit sent to you on June 29, 2016: ➢ The list of facility components has been corrected. ➢ Sampling for TKN and NO2 + NO3 has been changed to Grab. 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 Charles H. Weaver at telephone number (919) 807-6391. S. Jay Zimmerman, P.G. Director, Division of Water Resources cc: Central Files Winston-Salem Regional Office NPDES Unit State of North Carolina ( Environmental Quality I Water Resources 1617 Mail Service Center 1 Raleigh, NC 27699-1617 919 807 6300 919-807-6389 FAX https://deq. nc. gov/about/divisions/water-resources/water-resources-permits/wastewater-branch/npdes-wastewater-permits Permit NC0022098 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 provisions 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, NC LAND LEASE, LLC is hereby authorized to discharge wastewater from a facility located at the Cranbrook Village WWTP 4309 Old Liberty Place Guilford County to receiving waters designated as Little Alamance Creek in subbasin 03-06-03 of the Cape Fear River Basin in accordance with effluent limits, monitoring requirements, and other conditions set forth in Parts I, II, III and IV hereof. This permit shall become effective October 1, 2016. This permit and authorization to discharge shall expire at midnight on June 30, 2021. Signed this day August 18, 2016 ay Zimmerman, P.G. Director, Division of Water Resources By Authority of the Environmental Management Commission • Page 1 of 6 Permit NC0022098 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. NC LAND LEASE, LLC IS HEREBY AUTHORIZED TO: 1. Continue to operate an existing 0.01 MGD wastewater treatment facility with the following components: • Influent pump station • Aerated digester / sludge holding tank (underground) • Bar screen ♦ Aeration basin ♦ Clarifier • Effluent chlorination with chlorine contact basin • Tablet dechlorination This facility is located southeast of Greensboro at the Cranbrook Village WWTP in Guilford County. 2. Discharge from said treatment works at the location specified on the attached map into Little Alamance Creek, classified WS-IV NSW waters in the Cape Fear River Basin. Page 2 of 6 Permit NC0022098 A. (1) : EFFLUENT LIMITS AND MONITORING REQUIREMENTS [15A NCAC 02B.0400 et seq., 15A NCAC 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 treated wastewater from outfall 001. Such discharges. shall be limited' and monitored by the permittee as specified below: EFFLUENT CHARACTERISTICS Parameter Description ,PCS Code`. 1 . EFFLUENT LIMITS - MONITORING REQUIREMENTS A' - MonthlyDail ,-. -Average ,: .,:'Maxi um' - Unit of ,Measure Measurement Frequency '- Sample Type ,' Sample ;Location Flow - .50650.. 0.01 MGD Weekly Instantaneous Influent or Effluent BOD, 5-Day (20 Deg. C) - 00310 30.0 45.0 mg/L Weekly Grab Effluent Total Suspended Solids - 00530 30.0 45.0 mg/L Weekly Grab Effluent Ammonia Nitrogen (as N) - 00610 (November 1 = March 31) 24.0 35.0 mg/L Weekly Grab i Effluent Ammonia Nitrogen (as N) - 00610 (April 140ctober 31) 3.8 19.0 mg/L Weekly Grab Effluent Fecal Coliform(geometric mean) - 31616 200 400 #/100 ml Weekly Grab Effluent pH - 00400 > 6.0 and < 9.0 standard units s.0 Weekly Grab Effluent Total Residual Chlorine (TRC)2 - 50060 28 pg/L 2 / week Grab Effluent Temperature, °Centigrade - 00010 deg. C Daily -- weekdays Grab Effluent Total Phosphorus (as P) - 00665 mg/L Quarterly Grab Effluent Total Nitrogen (as N)3 - 00600 mg/L Quarterly , Grab Effluent Total Kjeldahl Nitrogen (as N) - 00625 mg/L Quarterly Grab Effluent Nitrite plus Nitrate Total (as N) - 00630 mg/L Quarterly Grab Effluent Footnotes: 1. No later, than December 21, 2016, the permittee shall begin submitting discharge monitoring reports electronically using the Division's eDMR system [see A. (3)]. 2. The facility shall report all effluent TRC values reported by a NC certified laboratory including field certified. However, effluent values < 50 µg/L will be treated as Zero for compliance purposes. 3. TN = TKN + NO3-N + NO2-N, where TN is Total Nitrogen, TKN is Total Kjeldahl Nitrogen, and NO3-N and NO2-N are Nitrate and Nitrite Nitrogen, respectively There shall be no discharge of floating solids or visible foam in other than trace amounts. Page 3 of 6 Permit NC0022098 A. (2) NUTRIENT REOPENER CONDITION [NCGS 143-215.1] Pursuant to N.C. General Statutes Section 143-215.1 and the implementing rules found in the North Carolina Administrative Code at 15A NCAC 2H.0112 (b) (1) and 2H.0114 (a) and Part II sections B-12 and B-13 of this permit, the Director may reopen this permit to require supplemental nutrient monitoring of the discharge. The purpose of the additional monitoring will be to support water quality modeling efforts within the Cape Fear River Basin and shall be consistent with a monitoring plan developed jointly by the Division and affected stakeholders. In addition, the results of water quality modeling may require=that limits for Total Nitrogen and Total Phosphorus be imposed in this permit upon renewal. A. (3) 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 and specify that, if a state does not establish a system to receive such submittals, then permittees must submit monitoring data and reports electronically to the Environmental Protection Agency (EPA) . 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.) Signatory Requirements • Section D. (2.) Reporting • Section D. (6.) Records Retention • Section E. (5.) Monitoring Reports 1. Reporting Requirements [Supersedes Section D. (2.) and Section E. (5.) (a)l Effective December 21, 2016, 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 summarizedfor 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 Page 4 of 6 Permit NC0022098 If a=perniittee 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; • '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 wayers:must be submitted in writing to the Division for written approval at least, sixty (60); flays prior to the date the facility would be required under this permit to. begin Page 5 of 6 Permit NC0022098 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 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 6 of 6 Latitude: 36000'10" Longitude: 79045'08" Chi USGS Quad: Greensboro, N.C. Stream Class: WS-IV NSW Subbasin: 03-06-03 Receiving Stream: Little Alamance Creek Weaver, Charles From: Sent: To: Subject: Weaver, Charles Friday, July 01, 2016 11:16 AM Mickey, Mike RE: DRAFT permit renewal for NC0022098 / Cranbrook Village WWTP Mike — the Supplement and Effluent pages have been corrected. Thanks for catching those errors. CHW From: Mickey, Mike Sent: Friday, July 01, 2016 11:04 AM To: Weaver, Charles <charles.weaver@ncdenr.gov> Subject: RE: DRAFT permit renewal for NC0022098 / Cranbrook Village WWTP Charles - Comments on the supplement page and the limits page. See below: • Do you list the dechlor unit in the system description? If so, can you add "Tablet Dechlorination" after Effluent Chlorination. Also, Vandalia has been absorbed by Greensboro and doesn't exist anymore. Just say SE of Greensboro. 1. Continue to operate an existing 0.01 MGD wastewater treatment facility with the following components: • Influent pump station • Aerated digester / sludge holding tank (underground) • Bar screen • Aeration basin • Clarifier • Effluent chlorination with chlorine contact basin This facility is located southeast of Varsialia off Liberty Road at the Cranbrook Village WWTP in Guilford County. • TRC is listed twice on the effluent limits page. Can you delete the one without the limit? Ammonia Nitrogen (as N) - 00610 (April 1 - October 31) 3-8 19.0 mg/L Weekly Grab Effluent Fecal Coliform (geometric mean) - 31616 200 400 #i10D ml Weekly Grab Effluent pH - 00400 > 6.0 and < 9.0 standard units s.0 Weekly Grab Effluent 2 Yf nets Arel9 GfM'' r T - t-40- Total Residual Chlorine (TRC)2 - 50060 28 pg/L 2 t week Grab Effluent Temperature: °Centigrade - 00010 deg. C Daily -- weekdays Grab Effluent Mike.Mickey@NCDENR.gov NC DEQ Winston-Salem Regional Office Division of Water Resources — Water Quality Programs 450 W. Hanes Mill Road, Suite 300, Winston-Salem, NC 27105 Phone: (336) 776-9697 1 From: Weaver, Charles Sent: Tuesday, June 28, 2016 10:41 AM To: Kinney, Maureen <Maureen.Kinney@ncdenr.gov>; Hudson, Eric <eric.hudsonPncdenr.Rov>; Mickey, Mike <m i ke. m ickey@ n cd e n r.Rov> Cc: smithindustrie@bellsouth.net • Subject: DRAFT permit renewal for NC0022098 / Cranbrook Village WWTP Importance: High This si a class WW-2 facility in Guilford County. Please send me any comments by July 29tn As always, thanks for your help. Charles H. Weaver Environmental Specialist N.C. Division of Water Resources N.C. Department of Environmental Quality 919-807-6391 charles.weaverncdenr.gov (physical address) 512 North Salisbury Street, Raleigh, NC 27604 (mailing address) 1617 Mail Service Center, Raleigh, NC 27699-1617 - 2 Nothing Compares Email correspondence to and from this address is subject to the North Carolina Public Records Law and may be disclosed to third parties. 2 Weaver, Charles From: Weaver, Charles Sent: Friday, July 01, 2016 9:10 AM To: 'Smithindustrie@bellsouth.net' Subject: RE: DRAFT permit renewal for NC0022098 / Cranbrook Village WWTP Paul — thanks for catching that. The TKN and NO2+NO3 samples will be changed to Grab in the final permit. CHW From: Smithindustrie@bellsouth.net [mailto:Smithindustrie@bellsouth.net] Sent: Thursday, June 30, 2016 1:16 AM To: Weaver, Charles <charles.weaver@ncdenr.gov> Cc: Derek Hinds <derekhinds@gmail.com> Subject: Re: DRAFT permit renewal for NC0022098 / Cranbrook Village WWTP Importance: High Mr Weaver, The TKN and Nitrite & Nitrate samples are listed as a composite samples and the Total Nitrogen is listed as a grab sample. Why are those samples composite samples instead of being grab samples. Paul Smith On Jun 28, 2016, at 10:41 AM, Weaver, Charles <charles.weaver@ncdenr.gov> wrote: 1 \tS 1✓ COI DRIER-TRIBI INE Affidavit of Publication State of North Carolina, Randolph County To Whom It May Concern: This is to certify the advertisement attached hereto has been published in The Courier Tribune on the following dates: Sworn to on th•is , day of , 2016 Courier -Tribune Representative Sworn to and Sub cribed Before me this r6 day of , 2016 ary Public JOSEPHINE VIERA COOPER Notary Public, North Carolina Randolph County My Comnasion Expires -- ��---- PUBLIC NOTICE North Carolina Environmental Management Commission/ NPDES Unit 1617 Mail Service Center Raleigh, NC 27699-1617 Notice of Intent to Issue a NPDES Wastewater Permit The North Carolina Environmental Management Commission 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 to review information on file. Additional information on NPDES permits and this notice may be found on our website: http://deq.nc.gov/about/divisions/water- resources/water-resources-permits/wastewater-branch/npdes-wastewater/public- notices,or by calling (919) 807-6304. NC Land Lease, LLC requested renewal of NPDES permit NC0022098/Cranbrook Village WWTP/Guilford County. Facility discharges to Little Alamance Creek/Cape Fear River Basin. Currently, ammonia nitrogen, fecal coliform, and total residual chlorine are water quality limited. Yes AF Utilities EXP, LLC requested renewal of NPDES permit NC0022691/Autumn Forest WWTP/Guilford County. Facility discharges to an unnamed tributary to Reedy Fork/Cape Fear River Basin. Currently BOD, ammonia nitrogen, dissolved oxygen, fecal coliform, total phosphorus, and total residual chlorine are water quality limited. Quarterstone Farms HOA requested renewal of permit NC0066966/Quarterstone Farm WWTP/Guilford County. Facility discharges treated wastewater to Buffalo Creek/Cape Fear River Basin. Currently ammonia nitrogen, fecal coliform, total nitrogen, and total phosphorus are water quality limited. lt-7/1/2016 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 Charles H. Weaver 6/28/2016 Permit Number NC0022098 Facility Name Cranbrook Village WWTP Basin Name/Sub-basin number Cape Fear/03-06-03 Receiving Stream Little Alamance Creek Stream Classification in Permit WS-IV NSW Does permit need Daily Max NH3 limits? No — already present Does permit need TRC limits/language? No — already present Does permit have toxicity testing? No Does permit have Special Conditions? Cape Fear nutrient reopener Does permit have instream monitoring? No Is the stream impaired (on 303(d) list)? For what parameter? No Any obvious compliance concerns? None. No enforcements since 2009; no violations since 2012. Any permit mods since last permit? Name & Ownership change in 2013 New expiration date _ 06/30/2021 Comments on Draft Permit? Added eDMR requirements Added regulatory citations Most Commonly Used Expedited Language: • 303(d) language for Draft/Final Cover Letters: "Please note that the receiving stream is listed as an impaired waterbody on the North Carolina 303(d) Impaired Waters List. Addressing impaired waters is a high priority with the Division, and instream data will continue to be evaluated. If there is noncompliance with permitted effluent limits and stream impairment can be attributed to your facility, then mitigative measures may be required". • TRC language for Compliance Level for Cover Letters/Effluent Sheet Footnote: "The Division shall consider all effluent TRC values reported below 50 µg/L to be in compliance with the permit. However, the Permittee shall continue to record and submit all values reported by a North Carolina certified laboratory (including field certified), even if these values fall below 50 µg/L." 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 INC0022098 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 Facility Name Mailing Address City State / Zip Code Telephone Number Fax Number e-mail Address NC Land Lease, LLC Cranbrook Village PO BOX 2533 Christiansburg VA / 24068 (540)552-3034 (540)552-5528 info@radfordcompaniesinc.com RECEIVED/NCDEQ/DWR 2. Location of facility producing discharge: Check here if same address as above ❑ Street Address or State Road 4309 Old Liberty Place City State / Zip Code County FEB 052016 Water Quality Permitting Section Greensboro NC / 27406 Guilford County 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 Paul Smith Mailing Address City State / Zip Code Telephone Number Fax Number e-mail Address PO BOX 269 Reidsville NC / 27323 (336)932-9347 ( ) smithindustrie@bellsouth.net 1 of 3 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 Commercial ❑ Number of Employees Residential X Number of Homes School ❑ Number of Students/Staff Other E Explain: 75 Describe the source(s) of wastewater (example: subdivision, mobile home park, shopping centers, restaurants, etc.): Mobile home park Number of persons served: 150 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? 11 Yes X No 7. Name of receiving stream(s) (NEW applicants: Provide a map showing the exact location of each outfall): Little Alamance Creek 8. Frequency of Discharge: X Continuous ❑ Intermittent If intermittent: Days per week discharge occurs: 7 Duration: 24 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. Influent pump station, sludge holding tank, bar screen, aeration basin, clarifier, effluent chlorine disinfection and contact basin, tablet dechlorination and 22.5 degree V notch weir 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 .010 MGD Annual Average daily flow .007 MGD (for the previous 3 years) Maximum daily flow .010 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 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 currentlq in our permit. Mark other parameters "N/A". Parameter Daily Maximum Monthly Average Units of Measurement Biochemical Oxygen Demand (BOD5) 20 4 Mg/1 Fecal Coliform 50 10 200/ 100 ml Total Suspended Solids 24 10 mg/1 Temperature (Summer) 28 25 C Temperature (Winter) 7 18 16 C pH 7.3 N/A SU 13. List all permits, construction approvals and/or applications: Type Permit Number Type Hazardous Waste (RCRA) UIC (SDWA) NPDES PSD (CAA) Non -attainment program (CAA) NC002098 14. APPLICANT CERTIFICATION NESHAPS (CAA) Ocean Dumping (MPRSA) Dredge or fill (Section 404 or CWA) Other 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. James Radford III Managing Member Printed name of Person Signing Title Q-2-16 Sim ature of Applicant 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.) 3 of 3 Form-D 11/12 N.C. Land Lease, LLC Cranbrook Village Mobile Home Community ^w 2/2/2016 James Radford I11 N.C. Land Lease, LLC Cranbrook Village Mobile Home Community PO BOX 2533 Christiansburg, VA 24068 Ms. Wren Thedford NC DEQ/ DWR / NPDES 1617 Mail Service Center Raleigh, NC 27699-1617 Sludge Management Plan: The sludge is removed as needed from a holding tank. The removal is done by a pumping company. We are currently using Carolina Septic Inc. Thank you, James Radford III Managing Member N.C. Land Lease, LLC Cranbrook Village Mobile Home Community * 2/2/2016 James Radford III N.C. Land Lease, LLC Cranbrook Village Mobile Home Community PO BOX 2533 Christiansburg, VA 24068 Ms. Wren Thedford NC DEQ/ DWR / NPDES 1617 Mail Service Center Raleigh, NC 27699-1617 Greetings, NC Land Lease, LLC is requesting renewal of the permit for the Cranbrook Village Mobile Home Community. Which is a mobile home park located at 4309 Old Liberty Place, Greensboro, NC 27406. There have been no changes to the facility since the issuance of the last permit. Thank you, es Radford III Managing Member