NC0071528_Acknowledgement of Permit Renewal_20150122

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NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory Donald R. van der Vaart
Governor Secretary
January 22,2015
Dale H.Norman
Lake Norman Woods WWTP
PO Box 321
Sherrills Ford,NC 28673
Subject: Acknowledgement of Permit Renewal
Permit NC0071528
Catawba County
Dear Mr.Norman:
The NPDES Unit received your permit renewal application on January 21, 2015. 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 Maureen
Kinney(919)807-6388.
Sincerely,
W tr2.vv 714Z0VerrOG
Wren Thedford
Wastewater Branch
cc: Central Files
Mooresville Regional Office
NPDES Unit
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.ncwater.orq
An Equal OpportunityWffimrative Action Employer

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 Program
1617 Mail Service Center, Raleigh, NC 27699-1617
NPDES Permit INCOO r1\'S DCB
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 I.-6<e- kbieiy1Qn Lel AJC 7 H©6
Facility Name �e Nor av‘ 1 , Jvy,V✓C i i i e
Mailing Address �O (3x 3)\
City rr1 1 S 3iV"V
State / Zip Code ll ll C � �►?� � RECEIVEDIDENRIDWR
!v � JAN 2 0 2015
Telephone Number (33047 -3g101
qty
Fax Number (3-10 37,4-5055 Pg Water fling Section
e-mail Address no r v -O l \104/65 I CO Wl
2. Location of facility producing discharge:
Check here if same address as above ❑
Street Address or State Road YMarLa n C.- RECEIVED/DENR/DWR
City
CLQ�t.o JAN .1 1 26,5
State / Zip Code �SCUll nJ
County Water Quality
Cal-Gt l� �. Permitting Seer
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 o;RC)
Name •.• ,
Mailing Address ' _ Qv;
�+ NiCity ' G j.S�/ ► \,� V\L �`��2 l
State / Zip Code
Telephone Number (r1�\k) 4 3r-'\ ac\ %
Fax Number (10A) J iat-17 I
e-mail Address • - _ • .
LiJkfl
1 of 3 Form-D 9/2013

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 2 Number of Homes 1-1(
School ❑ Number of Students/Staff
Other ❑ Explain:
Describe the source(s) of wastewater (example: subdivision, mobile home park, shopping centers,
restaurants, etc.):
Number of persons served: 5
5. Ty of collection system
Separate (sanitary sewer only) ❑ Combined (storm sewer and sanitary sewer)
6. Outfall Information: I
Number of separate discharge points 1
Outfall Identification number(s) �1,
Is the outfall equipped with a diffuser? ❑ YesNo
7. Name of receiving stream(s) (NEW applicants:Provide a map showing the exact location of each
outfalls
C CL-4-Cit-GU boL ?-? ( ve,v }0--d _ 51-r)
8. Frequency of Discharge: [Continuous ❑ Intermittent
If intermittent: �f
Days per week discharge occurs: I Duration: /' Li
9. Describe the treatment system 9eJf oyr' .e.g.,b\-1),-. b ,O -S 1\1\610 �
List all installed components, including capacities,provide design removal f r 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. r .c,\ • W .�t'a�t \\ tt1�����1 DIn c1r
, 1 ID
- 1.-,ociLie4,4-
- Oair 6ffeen .
r efoj(DO ba0 i K)
- 0 1Tuseol, -a-ICiari-P ( ser
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2 of 3 CO ^ B L i t J^ Form-D 912013
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NPDES APPLICATION - FORM D
For privately-owned treatment systems treating 100% domestic wastewaters <1.0 MGD
10. Flow Information:
Treatment Plant Design flow 0.a
)7 MGD
Annual Average daily flow D. MOD (for the previous 3 years)
Maximum daily flow D• D' MGD (for the previous 3 years)
11. Is this facility located on In#kn 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/A".
Parameter Daily Monthly Units of
Maximum Average Measurement
Biochemical Oxygen Demand (BODS) � 11 l 'g r(11 \
Fecal Coliform 1--1 O
Total Suspended Solids 111
Temperature (Summer) DI
Temperature (Winter) rj ` ` b C
pH f �J
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 r b''1 v5a$ 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 of my knowledge and belief such information is true, complete, and accurate.
1jc&e , 1\k7rman 516or i-
Printed name of Person Signing Title
/AQIIItiLe1 " I /i 5 Ai 5
Signature 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 9/2013

Dale Norman
President
Lake Norman Woods HOA
PO Box 321
Sherrills Ford, NC 28673
Attention Wren Theford,
I request renewal of Lake Norman Woods WWTP permit operating under the
current permit NC0071528. There have been no changes at the facility since the
issuance of the last permit.
Sincerely,
)26-7C0/6/AAA-e-- __
Dale H. Norman
President HOA RECEIVEDIDENRIDWR
JAN 2 0 2015
Water Quality
Permitting Section

Sludge management plan
Sludge generated at the Lake Norman Woods WWTP is removed by Lake Norman
Sewer and Septic [phone] and transported to Black Gold in Charlotte, NC.
Prepared by: `r ///:5/.6-
Dale H. Norman Date
RECEIVED/DENR/DWR
JAN 2 0 2015
Water Quality
Permitting Sectior