NC0048658_Renewal (Application)_20150422

NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory Donald R. van der Vaart
Governor Secretary
April 29,2015
Audrey L.Deaver,President
A&D Water Service, Inc.
Sherwood Forest WWTP
PO Box 1407
Pisgah Forest,NC 28768
Subject: Acknowledgement of Permit Renewal
Permit NC0048658
Transylvania County
Dear Permittee:
The NPDES Unit received your permit renewal application on April 22, 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 Joe
Corporon(919)807-6394.
Sincerely,
WreAA,T D ro(r
Wren Thedford
Wastewater Branch
cc: Central Files
Asheville 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 OpportunityWfirmative Action Employer

ti
NPDES APPLICATION - FORM D
For privately-owned treatment systems treating 100% domestic wastewaters <1.0 MOD
Mail the complete application to:
N. C. DEIN / Division of Water Quality / NPDES Unit
1617 Mail Service Center, Raleigh, NC 27699-1617
NPDES Permit INC0048658
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 A&D WATER SERVICE, INC.
Facility Name SHERWOOD FOREST WWTP
Mailing Address P. O. BOX 1407
City PISGAH FOREST
State / Zip Code NC 28768
Telephone Number [phone]
Fax Number [phone]
e-mail Address [e-mail]
RECEIVED/DENR/DWR
2. Location of facility producing discharge:
PR 2 2015
Check here if same address as above ❑
Street Address or State Road US Highway 276 Water Quality
Pe,,rtittina Secilor
City Cedar Mountain
State / Zip Code NC
County TRANSYLVANIA
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 A& D WATER SERVICE, INC.
Mailing Address P. O. BOX 1407
City PISGAH FOREST
State / Zip Code NC 28768
Telephone Number [phone]
Fax Number [phone]
e-mail Address [e-mail]
1 of 3 Form-D 11/12

NPDES APPLICATION - FORM D
For privately-owned treatment systems treating 100% domestic wastewaters <1.0 MOD
4. Description of wastewater.
Facility Generating Wastewater(check all that apply):
Industrial 0 Number of Employees
Commercial X Number of Employees 35
Residential X Number of Homes 20
School 0 Number of Students/Staff
Other 0 Explain:
Describe the source(s) of wastewater (example: subdivision, mobile home park, shopping centers,
restaurants, etc.):
SUBDIVISION, ADULT CARE FACILITY
Number of persons served: 70
5. Type of collection system
X Separate (sanitary sewer only) 0 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? 0 Yes X No
7. Name of receiving stream(s) (I EW applicants:Provide a map showing the exact location of each
outfall):
Little River
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.
TYPICAL SAND FILTER
TABLET CHLORINATION
TABLET DE-CHLORINATION
2 of 3 Form-D 11/12

NPDES APPLICATION - FORM D
For privately-owned treatment systems treating 100% domestic wastewaters <1.0 MOD
10. Flow Information:
Treatment Plant Design flow 0.0150 MOD
Annual Average daily flow 0.0068 MOD (for the previous 3 years)
Maximum daily flow 0.0182 MOD (for the previous 3 years)
11. Is this facility located on Indian country?
0 Yes X No
12. Effluent Data
NEW APPLICANTS:Provide darn 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) 22 6 mg/1
Fecal Coliform >600 2 # colonies
Total Suspended Solids 39 6 mg/1
Temperature (Summer) 23 20 C
Temperature (Winter) 17 9 C
pH 7.8 7.0 SU
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 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.
AUBREY L. DEAVER PRESIDENT
Printed name of Person Signing Title
(1) Mar. 9, 2015
Signa re of Applicant Date
North Carolina General Statute 143-215.6 (bX2) 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

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A&D Water Service, Inc. Facility °, z z� .
Location
Sherwood Forest WWTP (not to scale) ==-V14 "
Latitude: 35°08'51"N Longitude: 82°41'05"W
State Grid/USGS Ouad: G 8 NW/Standingstone Mtn. Stream Class: C North NPDES Permit NC0048658
Drainage Basin: French Broad River Basin Sub-Basin: 04-03-02
Receiving Stream: Little River[segment 6-38-(20)] HUC: 06010105 1 Transylvania County