NC0049620_Renewal (Application)_20150407

In accordance with Federal law and U.S.Department of Agriculture policy,this institution is prohibited from discriminating
on the basis of race,color,national origin,age,disability,religion,sex,familial status,sexual orientation,and reprisal(Not all
prohibited bases apply to all programs). To file a complaint of discrimination,write to:
USDA,Assistant Secretary for Civil Rights
Office of the Assistant Secretary for Civil Rights
1400 Independence Avenue,S.W.,Stop 9410
Washington,DC 20250-9410
Or call toll free at(866)632-9992(English)or(800)877-8339(TDD)or(866)377-8642(English Federal-relay)or(800)845-6136
(Spanish Federal-relay). USDA is an equal opportunity provider and employer.
TOWN OF HOT SPRINGS
MAYOR PO BOX 218 ALDERMAN
BRIAN REESE HOT SPRINGS, NC 28743 LEE BARNETT
CLERK PHONE: [phone] JOHNNY LAWSON
NANCY THOMAS FAX: [phone] ABBY GAIL NORTON
March 30,2015 RECEIVED/DENR/DWR
Wren Thedford APR - 7 2(1.;')
NC DENR/DWR/NPDES Unit
1617 Mail Service Center Water Quality
Raleigh,NC 27699 Permitting Sector
Dear Mr.Thedford:
The Town of Hot Springs is requesting renewal of the permit for the Main Sewer Plant, and
the Housing Authority Plant.
There have been no changes since permit issued in 2010.
If we can be of any further service,please contact us.
/ LJQ—
Brihn
pectfully Sub727:402_,
Reese
Mayor,Town of Hot Springs

•
In accordance with Federal law and U.S.Department of Agriculture policy,this institution is prohibited from discriminating
on the basis of race,color,national origin,age,disability,religion,sex,familial status,sexual orientation,and reprisal.(Not all
prohibited bases apply to all programs). To file a complaint of discrimination,write to:
USDA,Assistant Secretary for Civil Rights
Office of the Assistant Secretary for Civil Rights
1400 Independence Avenue,S.W.,Stop 9410
Washington.DC 20250-9410
Or call toll free at(866)632-9992(English)or(800)877-8339(TDD)or(866)377-8642(English Federal-relay)or(800)845-6136
(Spanish Federal-relay). USDA is an equal opportunity provider and employer.
TOWN OF HOT SPRINGS
MAYOR PO BOX 218 ALDERMAN
BRIAN REESE HOT SPRINGS, NC 28743 LEE BARNETT
CLERK PHONE: [phone] JOHNNY LAWSON
NANCY THOMAS FAX: [phone] ABBY GAIL NORTON
March 30,2015
RECEIVED/DENR/DWR
Wren Thedford
NC DENR/DWR/NPDES Unit
APR - '� 201
1617 Mail Service Center
,NC 27699 Water Quality
Raleigh, Permitting Sectior
Dear Mr.Thedford:
In regards to the Sludge Management Plan, the Town of Hot Springs disposes of the sludge on
a"As Needed"Basis.
We are currently using:
Mikes Septic Tank Service
PO Box 968
Leicester,NC 28748
If we can be on any further service,please contact us.
' - I ectfully Submitted,
1 e;:ce
Randy J
,571(
Town o Sp- gs

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 if?61 Q
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 low y) O-F , -Fv`i 149 5
Facility Name 4- 50-4115 1-101,115;
Mailing Address � 3d /� -td-f' 9 r`io HG r7'/3
City � � t � � l R �
f/c f s ?r v�i ECEIVED/DENRIDWR
State / Zip Code N L ,9Z 7 '13 APR - 7 211i5
Telephone Number (Z.7$ (019_9_ _ 15 l
Water Quality
Fax Number In) 622 — -7 (9g Permitting Sectior
e-mail Address tOC,Q>N0010f- D
�f- r I Q�3 ye CI se)vi .
I
2. Location of facility producing discharge:
Check here if same address as above 0 I //��
Street Address or State Road 4/G /3a `( !1/or-t 1 w'Ps, 0-c /IC s
City l/o+ 5Fr 9 Q
State / Zip Code /t/ L 7 Y,
County m a d`5ct.i
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 Vccrt dy
Mailing Address C� -;cl 5-f-,
City D! 5r- Yl
State / Zip Code He- 7 L�
Telephone Number (gig) 5-q-5 - 1z© 1
Fax Number (gam) 6 7 4(0 S
e-mail Address - p C 7 t1 c2 c) egikt erna, 1,, 6011,11
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 X Number of Homes 15 q (,N ;1-9
School ❑ Number of Students/Staff
Other ❑ Explain:
Describe the source(s) of wastewater (example: subdivision, mobile home park, shopping centers,
restaurants, etc.): gel/ �� ho usi✓l? Ani--horc-f�( (,v.-f h 3 c� u /1 � T5
Number of persons served: ijC'— /SU
5. Tyof collection system
Separate (sanitary sewer only) 0 Combined (storm sewer and sanitary sewer)
6. Outfall Information:
Number of separate discharge points ( )NE
Outfall Identification number(s) on
Is the outfall equipped with a diffuser? ❑ Yes A(No
7. Name of receiving stream(s) (NEW applicants:Provide a map showing the exact location of each
outfall): •-5 4 e
�rek�i473rocc� �i Veil �a� , ©rr � t l ,
8. Frequency of Discharge: K 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.
9
/\,/0 A a n 7 e �"o rel t rill 17 O' JD/0
2 of 3 Form-D 9/2013

NPDES APPLICATION FORM D
For privately-owned treatment systems treating 100% domestic wastewaters <1.0 MGD
10. Flow Information:
Treatment Plant Design flow 0 (`?/lGD
Annual Average daily flow e),OC,3 MGD (for the previous 3 years)
Maximum daily flow O LO O 5-MGD (for the previous 3 years)
11. Is this facility located on Indian 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 Measurem nt
Biochemical Oxygen Demand (BODS) �`� 6 . 5
/J
Fecal Coliform 50 L 3 er
Total Suspended Solids /6, 3 6 , o yy�
Temperature (Summer) c-i, c( d c
Temperature (Winter) 6 , 7' gyp, p G
pH le 0 CO, 11 /-c(nolgrd
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 NY
G DO '( C) 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.
d -17;9 2 L 6
Printed name of Person Signing Title
/ (
Signature of Ap . t/ Date
North Carolina Genera• '•3:i Statute 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