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HomeMy WebLinkAboutNC0049620_Renewal (Application)_20150407 (2) • 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: (828)622-7591 JOHNNY LAWSON NANCY THOMAS FAX: (828)622-7408 ABBY GAIL NORTON March 30,2015 RECEIVEDIDENRIDWR Wren Thedford APR - 7 2015 NC DENR/DWR/NPDES Unit 1617 Mail Service Center Water Quality Raleigh,NC 27699 Permitting Sectior 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. pectfully Sub,77,1_,612_, Bri 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.D('20250-9410 Or call toll free at(866)632-9992(English)or(800)877-8339 I IDD)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: (828) 622-7591 JOHNNY LAWSON NANCY THOMAS FAX: (828)622-7408 ABBY GAIL NORTON March 30, 2015 Wren Thedford NC DENR/DWR/NPDES Unit 1617 Mail Service Center Raleigh,NC 27699 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. Respectfully Submitted, G�zz 6/ Randy J Town o Sp ngs NPDES APPLICATION - FORM D For privately-owned treatment systems treating 100% domestic wastewaters <1.0 MOD Mail the complete application to: N. C. DENR / Division of Water Resources / NPDES Program 1617 Mail Service Center, Raleigh, NC 27699-1617 NPDES Permit 'NCO() lig 61 (J 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 ✓iCAU f j`T 'i ‘i7 5 Facility Name /lc f" .54i/rf 5 Hr, 05;01 19-41-1,?c�.1-; WttjT? Mailing Address P;C i r3c rcz 1-1e)-1- 9p1- 0015 , !►G v[ 3 City C - . a RJDWR State / Zip Code ,9z ,1 L.( 3 APR 7 2015 Telephone Number ( g2§ (. - tta Fax Number (g ) (4) — /V d Y Perrttlai ting Semon e-mail Address tG cV 1 L,-1 j �,t`i�7T r ar ?, U e r, 2. Location of facility producing discharge: ll Check here if same address as above ❑ Ict7vIc Street Address or State Road G � /3o YNf h tc1'e5I crc. City ff0+ ���>� , 9 State / Zip Code N /< 7 q, County N.2 a Ci` aryl 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 4 GL Yl y 1—C Mailing Address r -�;cJ j) e 5.-f City D/ SFT"i i1 <,, State / Zip Code L J4( l 41 Telephone Number (m) 5-q. -- 1 2- Fax Number 7`IL' Z e-mail Address �- (�i fi ti1711 C 2 y7/7 C(, _J 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 Number of Homes Cf (,0`1 ;15 School ❑ Number of Students/Staff Other ❑ Explain: Describe the source(s) of wastewater (example: subdivision, mobile home park, shopping centers, restaurants, etc.): i c C?" r l o u i ly /1 cc f he r, 1 (,c.,'. -F ii -3 u 4 /If s Number of persons served: / /5c, 5. Tye of collection system jp Separate (sanitary sewer only) E Combined (storm sewer and sanitary sewer) 6. Outfall Information: Number of separate discharge points (IV E Outfall Identification number(s) Or I Is the outfall equipped with a diffuser? ❑ Yes P(No 7. Name of receiving stream(s) (NEW applicants:Provide a map showing theexact location of each outfall): f re-u 6,11 "rc cc.Gle ?it f.''i'r i f f,of r ; 5 C`1 lel f' t/e 8. Frequency of Discharge: K] Continuous ❑ 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. /C) Cl7 6?an - __I T-6 �� fry t� c ,. /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 © , (�IL/MOD Annual Average daily flow 'J &C MGD (for the previous 3 years) Maximum daily flow C 1C. 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 Measuremnt Biochemical Oxygen Demand (BODS) G . 5 Fecal Coliform Z 3 ftecfor?( Total Suspended Solids /�- , -2) Q 11,1 Temperature (Summer) _ r .� 1 9 Y r Temperature (Winter) G, , c C_-- pH pH /, C , �1 f4 VId ct C� 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/L QQYq6�,O 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. 6e:Y. 9 tr.?13 (1)X Printed name of Pierson Signing Title (i12_ Signature of Ap . t Date North Carolina Genera Statute 3-215.6 (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