NC0077968_Owner Name Change_20091214

A7A
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
December 14, 2009
TIM HORNER
OWNER
HORNERS MOBILE HOME PARK
3073 BEAVER HILL DRIVE
BURLINGTON NC 27215
Subject:
Dear Mr. Homer:
NPDES Permit Modification- Name and/or
Ownership Change
Permit Number NC0077968
Reedy Fork Mobile Home Park
Alamance County
Division personnel have reviewed and approved your request to change the name of the subject permit, received
on November 16, 2009. This permit modification documents the name change.
Please find enclosed the revised permit. All other terms and conditions contained in the original permit remain
unchanged and in full effect. This permit modification is issued under the requirements of North Carolina General
Statutes 143-215.1 and the Memorandum of Agreement between North Carolina and the U.S. Environmental Protection
Agency.
If you have any questions concerning this permit modification, please contact the Point Source Branch at (919)
807-6304.
Sincerely,
Coleen H. Sullins
cc: Central Files
Winston-Salem Regional Office, Surface Water Protection
NPDES Unit File NC0077968
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Location: 512 N. Salisbury St Raleigh, North Carolina 27604
Phone: [phone] FAX: [phone] Customer Service: 1-877-623-6748
Internet www.ncwaterquality.org
NorthCarolina
,7Vaturallu

Permit NC0077968
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
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,
Mr. Tim Horner
is hereby authorized to discharge wastewater from a facility located at the
Reedy Fork Mobile Home Park
3437 Shepard Road
west of Ossipee
Alamance County
to receiving waters designated as Reedy Fork Creek in the Cape Fear 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 December 16, 2009.
This permit and authorization to discharge shall expire at midnight on May 31, 2011.
Signed this day December 16, 2009.
o I een Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission

Permit NC0077968
SUPPLEMENT TO PERMIT COVER SHEET
Mr. Tim Horner is hereby authorized to:
1. Continue to operate an existing 0.040 MGD wastewater treatment system with
the following components:
• Bar screen
• Aerated equalization basin
• Aeration basin
• Clarifier
• Chlorinator and contact basin
• Sludge digestion
• Flow measurement
The facility is located west of Ossipee at Reedy Fork Mobile Home Park at 3437
Shepard Road in Alamance County.
2. Discharge from said treatment works at the location specified on the attached
map into Reedy Fork Creek, classified C-NSW waters in the Cape Fear River
Basin.

Permit NC0077968
A. (1.) EFFLUENT LIMITATIONS AND MONITORING REQUIREMENTS
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:
EFFLUENT
CHARACTERISTICS
LIMITS
MONITORING REQUIREMENTS
Monthly
Average
Weekly
Average
Daily
Maximum
Measurement
Frequency
Sample
Type
Sample Location
Flow
0.040 MGD
Continuous
Recording
Influent or Effluent
BOD, 5-day (20°C)6
30.0 mg/L
45.0 mg/L
Weekly
Composite
Effluent
Total Suspended Solids
30.0 mg/L
45.0 mg/L
Weekly
Composite
Effluent
NH3 as N
2/Month
Composite
Effluent
Total Residual Chlorine3
28 µg/l
2/Weekly
Grab
Effluent
Temperature
Weekly
Grab
Effluent
Total Nitrogen
(NO2+NO3+TKN)
Quarterly
Composite
Effluent
Total Phosphorus1
2.0mg/L
Weekly
Composite
Effluent
pH2 •
Weekly
Grab
Effluent
Footnotes:
1. Compliance shall be based on a quarterly average of weekly samples.
2. The pH shall not be less than 6.0 standard units nor greater than 9.0 standard units.
3. The TRC limit shall become effective 18 months after the permit effective date.
There shall be no discharge of floating solids or visible foam in other than trace amounts

Beverly Eaves Perdue, Governor
Dee Freeman, Secretary
North Carolina Department of Environment and Natural Resources
Coleen H. Sullins, Director
Division of Water Quality
SURFACE WATER PRO'
CTION SECTION
GE FORM
I.
II.
b. Person legally responsible for permit: 7 iyi
RECEIVED
NOV 1 6 2009
DEN RFac' 1 T (Q1 1Y
POINT slouReEs SBRAN CH
Please enter the permit number for which the change is requested.
NPDES Permit
N
C
0
1
7
9
(or)
Certificate of Coverage
C G
5',
Permit status prior, to status change.
a. Permit issued to (company name): #0 ((le C S ifl ah(./e // in
t/orner
First
MI
Last
Title
S4 4-3 &au er 1,41/ /Or; JE
Permit Holder Mailing Address
rCit/IAqtcr, A g7-2/
City State Zip
(33 fo ) A2z -8-6 s Z ( )
Phone Fax
fQe.dy f ck /)'l06t/p / 4e payL
5't 5 4- Sot e pur J e-SL
Address
Os 5'. OK_ ekic-- a 7-,q,-f
City p State Zip
e. Facility contact person: J /I1gr a 4;ce- (SS (4 ) 58A(-39 0
First / MI / Last Phone
III. Please provide the following for the requested change (revised permit).
a. Request for change is a result of: ❑ Change in ownership of the facility
❑ Name change of the facility or owner 1
If other please explain: 7 cd f red /Ae p- P 1I/Y/ dr- ,pe-4, i 'r
b. Permit issued to (company name): Aritr5 11 bht/e we A,L
c. Person legally responsible for permit: 7i A.._ ,4"d rA {
d. Facility name (discharge):
e. Facility address:
f. Facility contact person:
First MI Last
Title
3�1-3 Beau er f•lul A:Je
jj Permit Holder Mailing Address
r I it OC 7,2/�
City State Zip
(53(P ) 1.22 a gZ
Phone E-mail Address
Q ej( Ark ,ii / Idle
3q - So) e poti est_
Address
dsspP- 'VC- 2.y4.1
City State Zip
GU' Ulc.iv- 6.- 4,
First MI Last
(g56 ) 5 4(-53? b eul(io/r.4e , 6eisou/,Z, ne
Phone E-mail Address
Revised 1/2009

PERMIT NAME/OWNERSHIP CHANGE FORM
Page 2 of 2
IV. Permit contact information (if different from the person legally responsible for the permit)
Permit contact:
V.
VI.
First
MI Last
Title
Mailing Address
City State Zip
( )
Phone E-mail Address
Will the permitted facility continue to conduct the same industrial activities conducted prior
tot is ownership or name change?
Yes
n No (please explain)
Required Items: THIS APPLICATION WILL BE RETURNED UNPROCESSED IF ITEMS
ARE INCOMPLETE OR MISSING:
111 This completed application is required for both name change and/or ownership change
requests.
❑ Legal documentation of the transfer of ownership (such as relevant pages of a contract deed,
or a bill of sale) is required for an ownership change request. Articles of incorporation are
not sufficient for an ownership change.
The certifications below must be completed and signed by both the permit holder prior to the change, and
the new applicant in the case of an ownership change request. For a name change request, the signed
Applicant's Certification is sufficient.
PERMITTEE CERTIFICATION (Permit holder prior to ownership change):
I, , attest that this application for a name/ownership change has been reviewed and is accurate and
complete to the best of my knowledge. I understand that if all required parts of this application are not
completed and that if all required supporting information is not included, this application package will be
returned as incomplete.
Signature Date
APPLICANT CERTIFICATION
I, , attest that this application for a name/ownership change has been reviewed and is accurate and
complete to the best of my knowledge. I understand that if all required parts of this application are not
completed and that if all required supporting information is not included, this application package will be
returned as incomplete.
w- r
Signature
(Vc (///4.4-
Date
i/urnP�- PLEASE SEND THE COMPLETE APPLICATION PACKAGE TO:
l7 Division of Water Quality
Surface Water Protection Section
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Revised 1/2009