HomeMy WebLinkAboutNC0064246_Application_20230426Print All Pages
Print Form Only
North Carolina
Department of Environmental Quality
Division of Water Resources
Modified Application Form 2A
Revised March 2021
Modified Application
Form 2A
Minor Sewage Facilities < 0.1 MGD
and No Pretreatment Program
NPDES Permitting Program
Note: Complete this form if your facility is a MINOR new or existing publicly owned treatment works.
NPDES Permit Number
Facility Name
Modified Application Form 2A
NCO064246
PACE MOBILE HOME PARK
Modified March 2021
Form
NC Department of Environmental Quality - Application for NPDES Permit to Discharge Wastewater
MINOR SEWAGE FACILITIES (Before completing this form, please read the instructions. Failure to follow
NPDES
the instructions may result in denial of the application.)
SECTION•N
INFORMATION FOR i
1.1
Facility name
JONES ESTATES PACE LLC
Mailing address (street or P.O. box)
2310 S. MIAMI BLVD SUITE 238
City or town
State
ZIP code
DURHAM
INC
27703
ro
EContact
name (first and last)
Title
Phone number
Email address
.0
c
KELLEN BUSS
DIRECTOR OF INFRASTRUCTUI
(419) 357-9091
KBUSS@RENTSTACKHOUSE.CC
Location address (street, route number, or other specific identifier) ❑ Same as mailing address
R
LL-
15026 BUFFALO ROAD
City or town
State
ZIP code
CLAYTON
NC
27527
1.2
Is this application for a facility that has yet to commence discharge?
❑ Yes -* See instructions on data submission ❑✓ No
requirements for new dischargers.
1.3
Is applicant different from entity listed under Item 1.1 above?
❑ Yes ❑✓ No SKIP to Item 1.4.
Applicant name
Applicant address (street or P.O. box)
0
o
City or town
State
ZIP code
w
r
Contact name (first and last)
Title
Phone number
Email address
.Q
a
1.4
Is the applicant the facility's owner, operator, or both? (Check only one response.)
❑✓ Owner ❑ Operator ❑ Both
1.5
To which entity should the NPDES permitting authority send correspondence? (Check only one response.)
❑ Facility ❑✓ Applicant ❑ Facility and applicant
(they are one and the same)
1.6
Indicate below any existing environmental permits. (Check all that apply and print or type the corresponding permit
number for each.
Existing Environmental Permits
a
✓❑ NPDES (discharges to surface
❑ RCRA (hazardous waste)
❑ UIC (underground injection
R
water)
control)
E
c
NCO064246
❑ PSD (air emissions)
❑ Nonattainment program (CAA)
❑ NESHAPs (CAA)
w
a�
y
❑ Ocean dumping (MPRSA)
❑ Dredge or fill (CWA Section
❑ Other (specify)
w
404)
Page 1
NPDES Permit Number
Facility Name
Modified Application Form 2A
NCO064246
PACE MOBILE HOME PARK
Modified March 2021
1.7
Provide the collections stem information
requested below for the treatment works.
Municipality
Population
Collection System Type
Ownership Status
Served
Served
indicate percentage)
100 % separate sanitary sewer
0 Own 0 Maintain
Archer Lodge
45 lot mhp
% combined storm and sanitary sewer
❑ Own ❑ Maintain
❑ Unknown
❑ Own ❑ Maintain
c%
separate sanitary sewer
El Own IL-1Maintain
R
% combined storm and sanitary sewer
❑ Own ❑ Maintain
❑ Unknown
❑ Own ❑ Maintain
a
% separate sanitary sewer
ElOwn ElMaintain
% combined storm and sanitary sewer
❑ Own ❑ Maintain
❑ Unknown
❑ Own ❑ Maintain
2
%separate sanitary sewer El ❑ Maintain
N%combined
storm and sanitary sewer ❑ Own ❑ Maintain
c
❑ Unknown ❑ Own ❑ Maintain
Total
m
Population 135 number of
C-)
Served persons served
Separate Sanitary Sewer System Combined Storm and
Sanitary Sewer
Total percentage of each type of
sewer line in miles
o 0
100 /0 /o
1.8
Is the treatment works located in Indian Country?
'
0
U
ElYes ✓❑ No
1.9
Does the facility discharge to a receiving water that flows through Indian Country?
c
❑ Yes ❑✓ No
1.10
Provide design and actual flow rates in the designated spaces.
Design Flow Rate
0.015 mgd
= N
Annual Average Flow Rates Actual
Two Years Ago
Last Year
This Year
a 0
0.005 mgd
0.0125 mgd
0.0125 mgd
Maximum Daily Flow Rates Actual
Two Years Ago
Last Year
This Year
o.o10 mgd
0.01454 mgd
0.0148 mgd
1.11
Provide the total number of effluent discharge points to waters of the State of North Carolina by type.
oTotal
Number of Effluent Discharge Points b T pe
a Q-
a'
Combined Sewer
Constructed
Treated Effluent
Untreated Effluent
Overflows
Bypasses
Emergency
Overflows
M
G
1
X
X
X
X
Page 2
NPDES Permit Number
Facility Name
Modified Application Form 2A
NC0064246
PACE MOBILE HOME PARK
Modified March 2021
Outfalls Other Than to Waters of the State of North Carolina
1.12
Does the POTW discharge wastewater to basins, ponds, or other surface impoundments that do not have outlets
for discharge to waters of the State of North Carolina?
❑✓ Yes ❑ No 4 SKIP to Item 1.14.
1.13
Provide the location of each surface impoundment and associated discharge information in the table below.
Surface Im oundment Location and Discharge Data
Average Daily Volume
Continuous or Intermittent
Location
Discharged to Surface
(check one)
Impoundment
BUFFALO CREEK IN SUB -BASIN 03-04-06
14000 gpd
ElContinuous
OF THE NEUSE RIVER BASIN
El Intermittent
ElContinuous
gpd
❑ Intermittent
gpd
ElContinuous
❑ Intermittent
Z
1.14
Is wastewater applied to land?
❑ Yes ❑✓ No 4 SKIP to Item 1.16.
0
1.15
Provide the land application site and discharge data requested below.
C
Land Application Site and Discharge Data
o
0
Average Daily Volume
Continuous or
a,
Location
Size
Applied
Intermittent
check one
Hacres
d
gpd
❑ Continuous
o
❑ Intermittent
acres
d
gpd
El Continuous
o
ElIntermittent
acres
d
El Continuous
gpd
❑ Intermittent
R
1.16
Is effluent transported to another facility for treatment prior to discharge?
o
❑✓ Yes ElNo -* SKIP to Item 1.21.
1.17
Describe the means by which the effluent is transported (e.g., tank truck, pipe).
Tank Truck
1.18
Is the effluent transported by a party other than the applicant?
✓❑ Yes ❑ No 4 SKIP to Item 1.20.
1.19
Provide information on the transporter below.
Transporter Data
Entity name
Mailing address (street or P.O. box)
Bailey's Septic Tank Service
PO BOX 925
City or town
State
IP code
V545
Knightdale
NC
Contact name (first and last)
Title
Diane Bailey
owner
Phone number
Email address
(919) 821-9850
baileyseptic@gmail.com
Page 3
NPDES Permit Number
Facility Name
Modified Application Form 2A
NCO064246
PACE MOBILE HOME PARK
Modified March 2021
1.20
In the table below, indicate the name, address, contact information, NPDES number, and average daily flow rate of the
receiving facility.
Receiving F cility Data
-a
Facility name
Mailing address (street or P.O. box)
d
City or town
State
ZIP code
0
U
Contact name (first and last)
Title
0
d
Phone number
Email address
c
NPDES number of receiving facility (if any) ❑ None
Average daily flow rate mgd
0.
0
1.21
Is the wastewater disposed of in a manner other than those already mentioned in Items 1.14 through 1.21 that do
0
not have outlets to waters of the State of North Carolina (e.g., underground percolation, underground injection)?
Er
❑ Yes ❑✓ No 4 SKIP to Item 1.23.
0
1.22
Provide information in the table below on these other disposal methods.
Information on Other Disposal Methods
o
Disposal
Location of
Size of
Annual Average
Continuous or Intermittent
Method
Disposal Site
Disposal Site
Daily Discharge
(check one)
Description
Volume
.�
acres
gpd
El
❑ Intermittent
acres
gpd
ElContinuous
❑ Intermittent
acres
gpd
❑ Continuous
❑ Intermittent
1.23
Do you intend to request or renew one or more of the variances authorized at 40 CFR 122.21(n)? (Check all that apply.
ti
Consult with your NPDES permitting authority to determine what information needs to be submitted and when.)
@
El El into marine waters (CWA ElWater quality related effluent limitation (CWA Section
Section 301(h)) 302(b)(2))
❑ Not applicable
1.24
Are any operational or maintenance aspects (related to wastewater treatment and effluent quality) of the treatment works
the responsibility of a contractor?
✓❑ Yes ❑ No 4SKIP to Section 2.
1.25
Provide location and contact information for each contractor in addition to a description of the contractor's operational
and maintenance responsibilities.
Contractor Information
Contractor 1
Contractor 2
Contractor 3
o
Contractor name
compan name
BOONE HILL ENVIRONMENTAL
Mailing address
street or P.O. box
2350 BAKERS CHAPEL RD
r
City, state, and ZIP
codeCon
SMITHFIELD, NC 27577
L
name (first and
c�
last)tact
MATTHEW BAILEY
Phone number
(919) 915-0616
Email address
dmatthewbailey@gmail.com
Operational and
maintenance
WWTP OPERATOR
responsibilities of
contractor
Page 4
NPDES Permit Number Facility Name Modified Application Form 2A
NCO064246 PACE MOBILE HOME PARK Modified March 2021
SECTION11 • •' • I
c Outfalls to Waters of the State of North Carolina
E
2.1
Does the treatment works have a design flow greater than or equal to 0.1 mgd?
LM
c
❑ Yes ❑✓ No 4 SKIP to Section 3.
c
2.2
Provide the treatment works' current average daily volume of inflow
Average Daily Volume of Inflow and Infiltration
;�
r
w
and infiltration.
gpd
=
Indicate the steps the facility is taking to minimize inflow and infiltration.
Smoke Test with Rural Water NC
3
0
2.3
Have you attached a topographic map to this application that contains all the required information? (See instructions for
C
specific requirements.)
a� r
C
0 Yes ❑ No
r°
E
2.4
Have you attached a process flow diagram or schematic to this application that contains all the required information?
c M
(See instructions for specific requirements.)
o
❑✓ Yes ❑ No
2.5
Are improvements to the facility scheduled?
✓❑ Yes ❑ No 4 SKIP to Section 3.
Briefly list and describe the scheduled improvements.
0
1. Repair 2nd treatment train
c
a
E
m
a
2. Purchased new equipment
E
0
0
3. Completed new piping and electrical
m
y4.
Repaired 1st train
R
2.6
Provide scheduled or actual dates of completion for improvements.
Scheduled or Actual Dates of Completion for Improvements
E
a)
Scheduled
Affected
Begin
End
Begin
Attainment of
>
o
Improvement
Outfalls
Construction
Construction
Discharge
Operational
CL E
(from above)
(list o number)
(MM/DD/YYYY)
(MM/DD/YYYY)
(MM/DD/YYYY)
Level
MMIDDIYYYY
1.
a�
2.
3.
4.
2.7
Have appropriate permits/clearances concerning other federal/state requirements been obtained? Briefly explain your
response.
✓❑ Yes ❑ No ❑ None required or applicable
Explanation:
Jones Estates MHP is working with our engineering and contracting firm while in our SOC to complete our repairs and
Page 5
NPDES Permit Number
Facility Name Modified Application Form 2A
NCO064246
PACE MOBILE HOME PARK Modified March 2021
SECTION•'
• ON DISCHARGES
3.1
Provide the following information for each outfall. (Attach additional sheets if you have more than three outfalls.)
Outfall Number 001
Outfall Number
Outfall Number
State
NORTH CAROLINA
w
r
County
JOHNSTON
0
w
City or town
CLAYTON
0
c
Distance from shore
n/a ft.
ft.
ft.
r
n
'i
Depth below surface
n/a ft.
ft.
ft.
c
Average daily flow rate
mgd
mgd
mgd
Latitude
35° 42' 38" N
Longitude
78' 22' 53" W
"
3.2
Do any of the outfalls described under Item 3.1 have seasonal or periodic discharges?
R
o
❑ Yes ✓❑ No 4 SKIP to Item 3.4.
a�
3.3
If so, provide the following information for each applicable outfall.
y
Outfall Number 001
Outfall Number
Outfall Number
0
Number of times per year
L
discharge occurs
a
Average duration of each
o
discharge (specify units
Average flow of each
mgd
mgd
mgd
0
discharge
R
in
Months in which discharge
occurs
3.4
Are any of the outfalls listed under Item 3.1 equipped with a diffuser?
❑ Yes ❑✓ No 4 SKIP to Item 3.6.
3.5
Briefly describe the diffuser t pe at each applicable outfall.
CL
Outfall Number 001
Outfall Number
Outfall Number
d
w
0
vi
3 6
Does the treatment works discharge or plan to discharge wastewater to waters of the State of North Carolina from
12
one or more discharge points?
3::
❑✓ Yes ❑ No 4SKIP to Section 6.
Page 6
NPDES Permit Number
Facility Name
Modified Application Form 2A
NCO064246
PACE MOBILE HOME PARK
Modified March 2021
3.7
Provide the receiving water and related information if known for each outfall.
Outfall Number 001
Outfall Number
Outfall Number
Receiving water name
unnamed tributary to Buffalo
Name of watershed, river,
0
or stream system
Neuse River Basen
•L
U.S. Soil Conservation
N
Service 14-digit watershed
o
code
L
a�
Name of state
management/river basin
North Carolina
U.S. Geological Survey
8-digit hydrologic
cataloging unit code
Critical low flow (acute)
cfs
cfs
cfs
Critical low flow (chronic)
cfs
cfs
cfs
Total hardness at critical
mg/L of
mg/L of
mg/L of
low flow
CaCO3
CaCO3
CaCO3
3.8
Provide the following information
describing the treatment pr vided for discharges from each outfall.
Outfall Number 001
Outfall Number
Outfall Number
Highest Level of
0 Primary
❑ Primary
❑ Primary
Treatment (check all that
❑ Equivalent to
❑ Equivalent to
❑ Equivalent to
apply per outfall)
secondary
secondary
secondary
❑ Secondary
❑ Secondary
❑ Secondary
❑ Advanced
❑ Advanced
❑ Advanced
❑ Other (specify)
❑ Other (specify)
❑ Other (specify)
0
Q
Design Removal Rates by
Outfall
Treated discharge to creek
,
m
BODs or CBODs
%
%
%
c
d
E
d
L
TSS
%
%
%
❑ Not applicable
❑ Not applicable
❑ Not applicable
Phosphorus
%
%
%
❑ Not applicable
❑ Not applicable
❑ Not applicable
Nitrogen
%
%
%
Other (specify)
❑ Not applicable
❑ Not applicable
❑ Not applicable
SEE ATTACHMENT*
Page 7
NPDES Permit Number
Facility Name
Modified Application Form 2A
NCO064246
PACE MOBILE HOME PARK
Modified March 2021
3.9
Describe the type of disinfection used for the effluent from each outfall in the table below. If disinfection varies by
season, describe below.
-a
Dual tablet chlorinator > Tablet Dechlorinator
a>
c
0
U
Outfall Number 001
Outfall Number
Outfall Number
0CL
r
Disinfection type
c.�
TAB CHLORINATION AND
G
DECHLORINATION
y
Seasons used
APRIL - OCTOBER
E
r
Dechlorination used?
❑ Not applicable
❑ Not applicable
❑ Not applicable
❑✓ Yes
❑ Yes
❑ Yes
❑ No
❑ No
❑ No
3.10
Have you completed monitoring for all Table A parameters and attached the results to the application package?
✓❑ Yes ❑ No
3.11
Have you conducted any WET tests during the 4.5 years prior to the date of the application on any of the facility's
discharges or on any receiving water near the discharge points?
❑ Yes ✓❑ No 4 SKIP to Item 3.13.
3.12
Indicate the number of acute and chronic WET tests conducted since the last permit reissuance of the facility's
discharges by outfall number or of the receiving water near the discharge points.
Outfall Number
Outfall Number
Outfall Number
Acute
Chronic
Acute
Chronic
Acute
Chronic
R
Number of tests of discharge
a,
water
Number of tests of receiving
water
d
w
LU
w
3.14
Does the POTW use chlorine for disinfection, use chlorine elsewhere in the treatment process, or otherwise have
reasonable potential to discharge chlorine in its effluent?
❑ Yes 4 Complete Table B, including chlorine. ✓❑ No 4 Complete Table B, omitting chlorine.
3.15
Have you completed monitoring for all applicable Table B pollutants and attached the results to this application
package?
❑✓ Yes ❑ No
Have you completed monitoring for all applicable Table D pollutants required by your NPDES permitting authority and
3.18
attached the results to this application package?
❑ Yes 0 No additional sampling required by NPDES
permitting authority.
Page 8
NPDES Permit Number
Facility Name
Modified Application Form 2A
NCO064246
PACE MOBILE HOME PARK
Modified March 2021
3.19
Has the POTW conducted either (1) minimum of four quarterly WET tests for one year preceding this permit application
or (2) at least four annual WET tests in the past 4.5 years?
❑ Yes 0 No + Complete tests and Table E and SKIP to
Item 3.26.
3.20
Have you previously submitted the results of the above tests to your NPDES permitting authority?
❑ Yes 0 No 4 Provide results in Table E and SKIP to
Item 3.26.
3.21
Indicate the dates the data were submitted to our NPDES permitting authority and provide a summary of the results.
Date(s) Submitted
Summary of Results
MM/DD/YYYY
m
c
0
3.22
Regardless of how you provided your WET testing data to the NPDES permitting authority, did any of the tests result in
o
toxicity?
❑ Yes ❑ No 4 SKIP to Item 3.26.
3.23
Describe the cause(s) of the toxicity:
d
w
L
w
3.24
Has the treatment works conducted a toxicity reduction evaluation?
❑ Yes ❑ No 4 SKIP to Item 3.26.
3.25
Provide details of any toxicity reduction evaluations conducted.
3.26
Have you completed Table E for all applicable outfalls and attached the results to the application package?
❑ Yes 0 Not applicable because previously submitted
information to the NPDES permitting authority.
Page 9
NPDES Permit Number
Facility Name Modified Application Form 2A
NCO064246
PACE MOBILE HOME PARK Modified March 2021
SECTION.
CHECKLIST
AND CERTIFICATION STATEMENT (40
6.1
In Column 1 below, mark the sections of Form 2A that you have completed and are submitting with your application. For
each section, specify in Column 2 any attachments that you are enclosing to alert the permitting authority. Note that not
all applicants are required to provide attachments.
Column 1
Column 2
Section 1: Basic Application
wl variance request(s) ❑ wl additional attachments
ElInformation
for All A licants
❑ Section 2: Additional
0 w/ topographic map ❑✓ wl process flow diagram
Information
❑ w/ additional attachments
❑ w/ Table A ❑ wl Table D
Section 3: Information on
❑ w/ Table B ❑ wl additional attachments
Effluent Discharges
E
❑ w/ Table C
d
ca
w.
`o
Section 4: Not Applicable
c
0
Section 5: Not Applicable
d
U
Section 6: Checklist and
❑
❑✓ wl attachments
w
Certification Statement
Y
6.2
Certification Statement
I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that qualified personnel properly gather and evaluate the information
submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible
for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and
complete. I am aware that there are significant penalties for submitting false information, including the possibility of fine
and imprisonment for knowing violations.
Name (print or type first and last name)
Official title
Kellen Buss
Director of Infrastructure
Signature
Date signed
/1 Q•E:L'Q.i1i �GGd�
04/27/2023
Page 10
NPDES Permit Number
Facility Name
Outfall Number
NCO064246
PACE MOBILE HOME PARK
001
Modified Application Form 2A
Modified March 2021
Maximum Daily Discharge
Average Daily Discharge
Pollutant
Analytical ML or MDL
Number
Value Units
Value
Units
Methods (include units)
Sampless
Biochemical oxygen demand
o BOD5 or ❑
13.5
mg/L
9
mg/L
weekly
GRAB El MI
ElCBOD5 MDL
(report one
Fecal coliform
400
mg/L
200
#/100m1
weekly
GRAB ml ❑ MDL
Design flow rate
pH (minimum)
>6.0
pH (maximum)
<9.0
Temperature (winter)
Temperature (summer)
Total suspended solids (TSS)
45
mg/L
30
mg/L
weekly
GRAB ❑ MI
❑ MDL
1 Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter I, subchapter N or 0. See instructions and 40 CFR 122.21(e)(3).
See attachment
Page 11
EPA Identification Number NPDES Permit Number Facility Name Outfall Number
NCO064246 PACE MOBILE HOME PARK
Modified Application Form 2A
Modified March 2021
Maximum Daily Discharge
Average Daily Discharge
Analytical
ML or MDL
Value
Units
Value
Units
Number of
Pollutant
Methods
Include units
( )
Samples
Ammonia (as N)
10
mg/L
2
mg/L
weekly
❑ ML
❑ MDL
Chlorine
17
ug/L
2x week
GRAB
❑ ML
total residual, TRC 2
❑ MDL
Dissolved oxygen
Daily average >5.0
mg/L
Daily average >5.0
mg/L
weekly
GRAB
❑ ML
❑ MDL
Nitrate/nitrite
❑ ML
❑ MDL
Kjeldahl nitrogen
❑ ML
❑ MDL
Oil and grease
❑ ML
❑ MDL
Phosphorus
❑ ML
❑ MDL
Total dissolved solids
❑ ML
❑ MDL
1 Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter I, subchapter N or 0. See instructions and 40 CFR 122.21(e)(3).
2 Facilities that do not use chlorine for disinfection, do not use chlorine elsewhere in the treatment process, and have no reasonable potential to discharge chlorine in their effluent are not
required to report data for chlorine.
See attachment
EPA Form 3510-2A (Revised 3-19) Page 12
EPA Identification Number NPDES Permit Number Facility Name Outfall Number
Modified Application Form 2A
NCO064246 PACE MOBILE HOME PARK
Modified March 2021
•- •�
Maximum Daily Discharge Average Daily Discharge
Analytical ML or MDL
Pollutant
Number of
Method' (include units)
Value Units Value Units
Samples
Metals, Cyanide, and Total Phenols
Hardness (as CaCO3)
❑ ML
❑ MDL
Antimony, total recoverable
❑ ML
❑ MDL
Arsenic, total recoverable
❑ ML
❑ MDL
Beryllium, total recoverable
❑ ML
❑ MDL
Cadmium, total recoverable
❑ ML
❑ MDL
Chromium, total recoverable
❑ ML
❑ MDL
Copper, total recoverable
❑ ML
❑ MDL
Lead, total recoverable
❑ ML
❑ MDL
Mercury, total recoverable
❑ ML
❑ MDL
Nickel, total recoverable
❑ ML
❑ MDL
Selenium, total recoverable
El M
El MI
MDL
Silver, total recoverable
❑ ML
❑ MDL
Thallium, total recoverable
❑ ML
❑ MDL
Zinc, total recoverable
❑ ML
❑ MDL
Cyanide
❑ ML
❑ MDL
Total phenolic compounds
❑ ML
❑ MDL
Volatile Organic Compounds
Acrolein
❑ ML
❑ MDL
Acrylonitrile
❑ ML
❑ MDL
Benzene
❑ ML
❑ MDL
Bromoform
❑ ML
❑ MDL
EPA Form 3510-2A (Revised 3-19) Page 13
EPA Identification Number NPDES Permit Number Facility Name Outfall Number
Modified Application Form 2A
NCO064246 PACE MOBILE HOME PARK
Modified March2021
= ••
Maximum Daily Discharge Average Daily Discharge
Analytical ML or MDL
Pollutant Number of
Method' (include units)
Value Units Value Units
Samples
Carbon tetrachloride
❑ ML
❑ MDL
Chlorobenzene
❑ ML
❑ MDL
Chlorodibromomethane
❑ ML
❑ MDL
Chloroethane
❑ ML
❑ MDL
2-chloroethylvinyl ether
❑ ML
❑ MDL
Chloroform
❑ ML
❑ MDL
Dichlorobromomethane
❑ ML
❑ MDL
1,1-dichloroethane
❑ ML
❑ MDL
1,2-dichloroethane
❑ ML
❑ MDL
trans- 1,2-dichloroethylene
❑ ML
❑ MDL
1,1-dichloroethylene
❑ ML
❑ MDL
1,2-dichloropropane
❑ ML
❑ MDL
1,3-dichloropropylene
❑ ML
❑ MDL
Ethylbenzene
❑ ML
❑ MDL
Methyl bromide
❑ ML
❑ MDL
Methyl chloride
❑ ML
❑ MDL
Methylene chloride
❑ ML
❑ MDL
1,1,2,2-tetrachloroethane
❑ ML
❑ MDL
Tetrachloroethylene
❑ ML
❑ MDL
Toluene
❑ ML
❑ MDL
1,1,1-trichloroethane
❑ ML
❑ MDL
1,1,2-trichloroethane
❑ ML
❑ MDL
EPA Form 3510-2A (Revised 3-19) Page 14
EPA Identification Number NPDES Permit Number Facility Name Outfall Number
Modified Application Form 2A
NCO064246 PACE MOBILE HOME PARK
Modified March2021
= ••
Maximum Daily Discharge Average Daily Discharge
Analytical ML or MDL
Pollutant Number of
Method' (include units)
Value Units Value Units
Samples
Trichloroethylene
❑ ML
❑ MDL
Vinyl chloride
❑ ML
❑ MDL
Acid -Extractable Compounds
p-chloro-m-cresol
❑ ML
❑ MDL
2-chlorophenol
❑ ML
❑ MDL
2,4-dichlorophenol
❑ ML
❑ MDL
2,4-dimethyl phenol
❑ ML
❑ MDL
4,6-dinitro-o-cresol
❑ ML
❑ MDL
2,4-dinitrophenol
❑ ML
❑ MDL
2-nitrophenol
❑ ML
❑ MDL
4-nitrophenol
❑ ML
❑ MDL
Pentachlorophenol
❑ ML
❑ MDL
Phenol
❑ ML
❑ MDL
2,4,6-trichlorophenol
❑ ML
❑ MDL
Base -Neutral Compounds
Acenaphthene
❑ ML
❑ MDL
Acenaphthylene
❑ ML
❑ MDL
Anthracene
❑ ML
❑ MDL
Benzidine
❑ ML
❑ MDL
Benzo(a)anthracene
❑ ML
❑ MDL
Benzo(a)pyrene
❑ ML
❑ MDL
3,4-benzofluoranthene
❑ ML
❑ MDL
EPA Form 3510-2A (Revised 3-19) Page 15
EPA Identification Number NPDES Permit Number Facility Name Outfall Number
Modified Application Form 2A
NCO064246 PACE MOBILE HOME PARK
Modified March2021
= ••
Maximum Daily Discharge Average Daily Discharge
Analytical ML or MDL
Pollutant Number of
Method' (include units)
Value Units Value Units
Samples
Benzo(ghi)perylene
❑ ML
❑ MDL
Benzo(k)fluoranthene
❑ ML
❑ MDL
Bis (2-chloroethoxy) methane
❑ ML
❑ MDL
Bis (2-chloroethyl) ether
❑ ML
❑ MDL
Bis (2-chloroisopropyl) ether
❑ ML
❑ MDL
Bis (2-ethylhexyl) phthalate
❑ ML
❑ MDL
4-bromophenyl phenyl ether
❑ ML
❑ MDL
Butyl benzyl phthalate
❑ ML
❑ MDL
2-chloronaphthalene
❑ ML
❑ MDL
4-chlorophenyl phenyl ether
❑ ML
❑ MDL
Chrysene
❑ ML
❑ MDL
di-n-butyl phthalate
❑ ML
❑ MDL
di-n-octyl phthalate
❑ ML
❑ MDL
Dibenzo(a,h)anthracene
❑ ML
❑ MDL
1,2-dichlorobenzene
❑ ML
❑ MDL
1,3-dichlorobenzene
❑ ML
❑ MDL
1,4-dichlorobenzene
❑ ML
❑ MDL
3,3-dichlorobenzidine
❑ ML
❑ MDL
Diethyl phthalate
❑ ML
❑ MDL
Dimethyl phthalate
❑ ML
❑ MDL
2,4-dinitrotoluene
❑ ML
❑ MDL
2,6-dinitrotoluene
❑ ML
❑ MIDI
EPA Form 3510-2A (Revised 3-19) Page 16
EPA Identification Number NPDES Permit Number Facility Name Outfall Number
Modified Application Form 2A
NCO064246 PACE MOBILE HOME PARK
Modified March2021
= ••
Maximum Daily Discharge Average Daily Discharge
Analytical ML or MDL
Pollutant Number of
Method' (include units)
Value Units Value Units
Samples
1,2-diphenylhydrazine
❑ ML
❑ MDL
Fluoranthene
❑ ML
❑ MDL
Fluorene
❑ ML
❑ MDL
Hexachlorobenzene
❑ ML
❑ MDL
Hexachlorobutadiene
❑ ML
❑ MDL
Hexachlorocyclo-pentadiene
❑ ML
❑ MDL
Hexachloroethane
❑ ML
❑ MDL
Indeno(1,2,3-cd)pyrene
❑ ML
❑ MDL
Isophorone
❑ ML
❑ MDL
Naphthalene
❑ ML
❑ MDL
Nitrobenzene
❑ ML
❑ MDL
N-nitrosodi-n-propylamine
❑ ML
❑ MDL
N-nitrosodimethylamine
❑ ML
❑ MDL
N-nitrosodiphenylamine
❑ ML
❑ MDL
Phenanthrene
❑ ML
❑ MDL
Pyrene
❑ ML
❑ MDL
1,2,4-trichlorobenzene
❑ ML
❑ MDL
1 Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR Chapter I, Subchapter N or 0. See instructions and 40 CFR 122.21(e)(3).
EPA Form 3510-2A (Revised 3-19) Page 17
NPDES Permit Number Facility Name Outfall Number
Modified Application Form 2A
NCO064246 PACE MOBILE HOME PARK
Modified March2021
1111111 1111111311
Maximum Dail Discharge Average Dail Discharge
Pollutant
Analytical ML or MDL
Number
ist)
(l�
Value
Units Value
Units
d Metho(include units)
Samples
s
❑ No additional sampling is required by NPDES permitting authority.
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or required
under 40 CFR chapter I, subchapter N or 0. See instructions and 40 CFR 122.21(e)(3).
Page 18
z� r
spy- 1 r rf
Discharge Point
M
NCO064246 - Pace Mobile Home Park
latitude: 35°42-,18.1(r Sub-13asm. 01-0 t-06
Longitude 78°22'53.27" Stream Class. C-NSW
USGS Ouad. Clayton. N.C.
Receiving Siroam: UT to Buffalo Creel:
�r
Facilitv
Location
tloiinstan County
Map not to wale
DocuSign Envelope ID: AD6A3D86-FD68-4C8E-8CO8-CCOA0806FC4C
Permit NCO064246
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF WATER RESOURCES
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,
Jones Estates Pace LLC
is hereby authorized to discharge wastewater from a facility located at the
Pace Mobile Home Park WWTP
15026 Buffalo Road
Clayton
Johnston County
to receiving waters designated as an unnamed tributary (UT) to Buffalo Creek in sub -basin 03-04-06 of the Neuse
River Basin in accordance with effluent limitations, monitoring requirements, and other conditions set forth in
Parts I, H, III, and IV hereof.
This permit modification is effective April 1, 2020.
This permit and authorization to discharge shall expire at midnight on April 30, 2023.
Signed this day 3/20/2020 DOCUSigned by:
E�8328B44CEKB4A1 .
for S. Daniel Smith, Director
Director, Division of Water Resources
By Authority of the Environmental Management Commission
Page 1 of 8
DocuSign Envelope ID: AD6A3D86-FD68-4C8E-8CO8-CCOA0806FC4C
Permit NCO064246
SUPPLEMENT TO PERMIT COVER SHEET
Allprevious NPDES Permits issued to this facility, whether for operation or discharge are hereby revoked. As of
this permit issuance, any previously issued permit bearing this number is no longer effective. Therefore, the
exclusive authority to operate and discharge from this facility arises under the permit conditions, requirements,
terms, and provisions included herein.
Jones Estates Pace LLC is hereby authorized to:
1. Continue to operate an existing 0.015 MGD wastewater treatment system that includes the following
components:
♦ Continuous flow meter system
♦ Manual bar screen
♦ Equalization tank
♦ Dual aeration chambers
♦ Dual clarifiers
♦ Aerated sludge holding tank
♦ Dual air blowers
♦ Dual tablet chlorinator
♦ Tablet de -chlorinator
♦ Audible visual alarms
♦ Electrical hook-up for portable generator
♦ Portable generator (kept off -site)
This Class WW-2 facility is located at the Pace Mobile Home Park WWTP (15026 Buffalo Road) in
Johnston County.
2. Discharge from said treatment works via Outfall 001 at the location specified on the attached map into an
unnamed tributary to Buffalo Creek (Stream Index 27-57-16-(3)), a waterbody currently classified C-NSW
waters in sub -basin 03-04-06 (HUC 0302020115) of the Neuse River Basin.
Page 2 of 8
DocuSign Envelope ID: AD6A3D86-FD68-4C8E-8CO8-CCOA0806FC4C
Permit NCO064246
Part I.
A. (L) EFFLUENT LIMITATIONS AND MONITORING REQUIREMENTS
[15A NCAC 0213.0400 et seq., 02B.0500 et seq.]
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 LIMITS
MONITORING REQUIREMENTS
PARAMETER
Monthly
Daily
Unit of
Measurement
Sample
Sample
[eDMR Code]
Average
Maximum
Measure
Frequency
Type
Location2
Flow
0.015
MGD
Continuous
Recorder
Influent or
[50050]
Effluent
Total Monthly Flow
MG/month
Monthly
Recorder or
Influent or
[82220]
Calculated
Effluent
BOD, 5-Day (20 Deg. C)
9
13.5
mg/L
Weekly
Grab
Effluent
[C0310 ]
Total Suspended Solids
30
45
mg/L
Weekly
Grab
Effluent
[C0530]
Ammonia Nitrogen (as N)
[C0610]
2
10
mg/L
Weekly
Grab
Effluent
(April 1 -October 31)
Ammonia Nitrogen (as N)
[C0610]
4
20
mg/L
Weekly
Grab
Effluent
(November 1 - March 31)
Fecal Coliform (geometric mean)
200
400
#/100ml
Weekly
Grab
Effluent
[31616]
Total Residual Chlorine (TRC) 3
17
pg/L
2 X week
Grab
Effluent
[50060]
Temperature
degrees C
Weekly
Grab
Effluent
[00010]
Dissolved Oxygen
Daily average > 5.0 mg/L
mg/L
Weekly
Grab
Effluent
[00300]
Total Phosphorus (as P)
mg/L
Monthly
Grab
Effluent
[C0665]
Total Nitrogen4 (as N)
mg/L
Monthly
Grab
Effluent
[C0600]
[QM600]
pounds/month
Monthly
Calculated
Effluent
Total Nitrogen Loads
[QY600]
pounds/year
Annually
Calculated
Effluent
Total Kjeldahl Nitrogen (as N)
mg/L
Monthly
Grab
Effluent
[00625]
NO2 +NO3 (as N)
mg/L
Monthly
Grab
Effluent
[00630]
pH
[00400]
> 6.0 and < 9.0
standard units
Weekly
Grab
Effluent
Temperature
[00010]
degrees C
Weekly
Grab
U & D
Dissolved Oxygen
mg/L
Weekly
Grab
U & D
[00300]
Page 3 of 8
DocuSign Envelope ID: AD6A3D86-FD68-4C8E-8CO8-CCOA0806FC4C
Permit NCO064246
Footnotes:
1. The Permittee shall submit discharge monitoring reports electronically using the Division's eDMR system
[see A. (5)].
2. U: at least 100 feet upstream from the outfall. D: at least 300 feet downstream from the outfall.
3. The facility shall report all effluent TRC values reported by a North Carolina certified laboratory including field
certified. However, effluent values < 50 µg/L will be treated as zero for compliance purposes.
4. For a given wastewater sample, TN = TKN + NO3-N + NO2-N, where TN is Total Nitrogen, TKN is Total
Kjeldahl Nitrogen, and NO3-N and NO2-N are Nitrate and Nitrite Nitrogen, respectively.
5. TN Load is the mass quantity of Total Nitrogen discharged [see A. (2)].
There shall be no discharge offloating solids or visible foam in other than trace amounts.
Page 4 of 8
DocuSign Envelope ID: AD6A3D86-FD68-4C8E-8CO8-CCOA0806FC4C
Permit NCO064246
A. (2.) CALCULATION OF TOTAL NITROGEN LOADS
[NCGS 143-215.1 (b)]
a. The Permittee shall calculate monthly and annual TN Loads as follows:
(1) Monthly TN Load (pounds/month) = TN x TMF x 8.34
where:
TN = the average Total Nitrogen concentration (mg/L) of the composite samples
collected during the month
TMF = the Total Monthly Flow of wastewater discharged during the month
(MG/month)
8.34 = conversion factor, from (mg/L x MG) to pounds
(2) Annual TN Load (pounds/year) = Sum of the 12 Monthly TN Loads for the calendar year
b. The Permittee shall report monthly Total Nitrogen results (mg/L and pounds/month) in the appropriate
discharge monitoring report for each month and shall report each year's annual results (pounds/year) with
the December report for that year.
A. (3.) TOTAL NITROGEN ALLOCATIONS
[NCGS 143-215.1 (b)]
The following table lists the Total Nitrogen (TN) allocation(s) assigned to, acquired by, or transferred to the
Permittee in accordance with the Neuse River nutrient management rule (T15A NCAC 02B.0234) and the
status of each as of permit issuance. For compliance purposes, this table does not supercede any TN limit(s)
established elsewhere in this permit or in the NPDES permit of a compliance association of which the
Permittee is a Co-Permittee Member.
ALLOCATION
TYPE
SOURCE
DATE
ALLOCATION AMOUNT (1)
STATUS
Estuary
Discharge
(pounds/year)
(pounds/year)
Base
Assigned by Rule
1217/1997;
152
303
Active
(T15A NCAC 026 .0234)
411/2003
Footnote:
1. Transport Factor = 50%
Page 5 of 8
DocuSign Envelope ID: AD6A3D86-FD68-4C8E-8CO8-CCOA0806FC4C
Permit NCO064246
A. (4.) OUTFALL SIGNAGE
[G.S. 143-215.1 (b)]
The permittee shall maintain permanent signage identifying outfall 001 as a wastewater discharge point. Unless
otherwise approved in writing by the Director, the signage shall conform to the following specifications:
1. It shall be located in reasonable proximity to the outfall.
2. It shall be clearly visible to persons on the adjoining property and in or near the surrounding waters and,
toward that end, shall:
• be two-sided
• be located at least 3 feet above ground level
• at least two feet by two feet (2 ft x 2 ft) in size
• consist of black letters on a white field; the word "notice" to be at least 3 inches tall and the remaining
words to be at least 2 1/4 inches tall
3. The signage shall contain, at a minimum, the following information:
NOTICE
TyIS IS A WASTEWATER DISCHARGE POINT
PACE MOBILE HOME PARK
WASTEWATER TREATMENT PLANT
NPDES PERMIT NCO064246
< local contact number for the facility >
NORTH CAROLINA
DIVISION OF WATER RESOURCES
RALEIGH REGIONAL OFFICE
919-791-4200
A. (5.) ELECTRONIC REPORTING - DISCHARGE MONITORING REPORTS
[G.S. 143-215.1 (b)]
Federal regulations require electronic submittal of all discharge monitoring reports (DMRs) and program reports.
The final NPDES Electronic Reporting Rule was adopted and became effective on December 21, 2015.
NOTE: This special condition supplements or supersedes the following sections within Part II of this permit
(Standard Conditions for NPDES Permits):
• Section B. (11.)
• Section D. (2.)
• Section D. (6.)
• Section E. (5.)
Signatory Requirements
Reporting
Records Retention
Monitoring Reports
1. Reporting Requirements [Supersedes Section D. (2.) and Section E. (5.) (a)l
Page 6 of 8
DocuSign Envelope ID: AD6A3D86-FD68-4C8E-8CO8-CCOA0806FC4C
Permit NCO064246
The permittee shall report discharge monitoring data electronically using the NC DWR's Electronic
Discharge Monitoring Report (eDMR) internet application.
Monitoring results obtained during the previous month(s) shall be summarized for each month and submitted
electronically using eDMR. The eDMR system allows permitted facilities to enter monitoring data and
submit DMRs electronically using the internet. The eDMR system may be accessed at:
hllps://deq.nc.gov/about/divisions/water-resources/edmr.
If a permittee is unable to use the eDMR system due to a demonstrated hardship or due to the facility being
physically located in an area where less than 10 percent of the households have broadband access, then a
temporary waiver from the NPDES electronic reporting requirements may be granted and discharge
monitoring data may be submitted on paper DMR forms (MR 1, 1.1, 2, 3) or alternative forms approved by
the Director. Duplicate signed copies shall be submitted to the following address:
NC DEQ / Division of Water Resources / Water Quality Permitting Section
ATTENTION: Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
See "How to Request a Waiver from Electronic Reporting" section below.
Regardless of the submission method, the first DMR is due on the last day of the month following the
issuance of the permit or in the case of a new facility, on the last day of the month following the
commencement of discharge.
Starting on December 21, 2020, the permittee must electronically report the following compliance
monitoring data and reports, when applicable:
• Sewer Overflow/Bypass Event Reports;
• Pretreatment Program Annual Reports; and
• Clean Water Act (CWA) Section 316(b) Annual Reports.
The permittee may seek an electronic reporting waiver from the Division (see "How to Request a Waiver
from Electronic Reporting" section below).
2. Electronic Submissions
hi accordance with 40 CFR 122.41(1)(9), the permittee must identify the initial recipient at the time of each
electronic submission. The permittee should use the EPA's website resources to identify the initial recipient
for the electronic submission.
Initial recipient of electronic NPDES information from NPDES-regulated facilities means the entity (EPA or
the state authorized by EPA to implement the NPDES program) that is the designated entity for receiving
electronic NPDES data [see 40 CFR 127.2(b)].
EPA plans to establish a website that will also link to the appropriate electronic reporting tool for each type
of electronic submission and for each state. Instructions on how to access and use the appropriate electronic
reporting tool will be available as well. Information on EPA's NPDES Electronic Reporting Rule is found at:
https://www.federalre ig ster.gov/documents/2015/10/22/2015-24954/national-pollutant-discharge-
elimination-system-npdes-elelectronic-reporting rule
Electronic submissions must start by the dates listed in the "Reporting Requirements" section above.
Page 7 of 8
DocuSign Envelope ID: AD6A3D86-FD68-4C8E-8C08-CCOA0806FC4C
Permit NCO064246
3. How to Request a Waiver from Electronic Reporting
The permittee may seek a temporary electronic reporting waiver from the Division. To obtain an electronic
reporting waiver, a permittee must first submit an electronic reporting waiver request to the Division.
Requests for temporary electronic reporting waivers must be submitted in writing to the Division for written
approval at least sixty (60) days prior to the date the facility would be required under this permit to begin
submitting monitoring data and reports. The duration of a temporary waiver shall not exceed 5 years and
shall thereupon expire. At such time, monitoring data and reports shall be submitted electronically to the
Division unless the permittee re -applies for and is granted a new temporary electronic reporting waiver by the
Division. Approved electronic reporting waivers are not transferrable. Only permittees with an approved
reporting waiver request may submit monitoring data and reports on paper to the Division for the period that
the approved reporting waiver request is effective.
Information on eDMR and the application for a temporary electronic reporting waiver are found on the
following web page:
hllp://deq.nc. gov/about/divisions/water-resources/edmr
4. Signatory Requirements [Supplements Section B. (11.) (b) and Supersedes Section B. (11.) (d)]
All eDMRs submitted to the permit issuing authority shall be signed by a person described in Part II, Section
B. (I 1.)(a) or by a duly authorized representative of that person as described in Part If, Section B. (I 1.)(b). A
person, and not a position, must be delegated signatory authority for eDMR reporting purposes.
For eDMR submissions, the person signing and submitting the DMR must obtain an eDMR user account and
login credentials to access the eDMR system. For more information on North Carolina's eDMR system,
registering for eDMR and obtaining an eDMR user account, please visit the following web page:
httn://dea.nc. L,ov/about/divisions/water-resources/edmr
Certification. Any person submitting an electronic DMR using the state's eDMR system shall make the
following certification [40 CFR 122.22]. NO OTHER STATEMENTS OF CERTIFICATION WILL BE
ACCEPTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that qualified personnel properly gather and
evaluate the information submitted. Based on my inquiry of the person orpersons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of
my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for
submitting false information, including the possibility of fines and imprisonment for knowing violations. "
5. Records Retention [Supplements Section D. (6.)l
The permittee shall retain records of all Discharge Monitoring Reports, including eDMR
submissions. These records or copies shall be maintained for a period of at least 3 years from the
date of the report. This period may be extended by request of the Director at any time [40 CFR
122.41].
Page 8 of 8