NC0071862_Renewal (Application)_20150519

RECEIVED/DENRIDWR
May 14, 2015
MAY 192015
Water Qual'
Permitting Section
Dear Mr. Thedford,
Thank you for your attention to this permit #NC0071862.
Enclosed you will find the necessary paperwork for the request
of renewal of our permit.
There have been no changes to the facility from the date of the
last permit.
If you have any questions regarding the permit renewal please
contact us at [phone] or email us at
[e-mail]. Again thank you for
handling the renewal request.
Sincerely,
Henry K. Odom
Magnolia Place MHP
1 Ariel Loop
Hendersonville, NC 28792
[phone]

NPDES APPLICATION - FORM D
For privately-owned treatment systems treating 100% domestic wastewaters<1.0 MGD
Mall the complete application to:
N.C.DENR/Division of Water Resources/NPDES Program
1617 Mail Service Center, Raleigh, NC 27699-1617
NPDES Permit[NC00 ?/I40071
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: A10/1/1
/ile/V
Owner Name )e/ 7 L i 610/0l1/)
Facility Name ilL nl2li 1Z Race i')oLi'/e //�m,� p
Mailing Address
firJI'e l Lnp ut IVED/DENR/DWR
City /len c/{ ()l V,'l 1,, KAY 1 9 2015
State/Zip Code C
g :
Telephone Number ( 82,2) 685- 9 h .2� Permitting Section
Fax Number (g2 ) �y d5 9520
e-mail Address /na jtho /y)/L/[Q re-/i'rell ien-yo rk 9 ivI o i 1.en rn
2. Location of facility producing discharge:
Check here if same address as above 0
Street Address or State Road I //,4rj t/ Loop NC 5/2 /5S,Z
City I fnde(striv%II&
State/Zip Code C /29 9.2
County / PY)derion 61,111,1y
3. Operator Information: f
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/4nry'
ORC)
Name -(ei.A (/ow
Mailing Address ( 4 i e I L
City 142.1 C CSonVi I k,
State/Zip Code !v lam ' .g 7 92
Telephone Number (gam) 6 8'5-9?,2 0
Fax Number (gZl)625- 9520
e-mail Address /y16q/?O/i�tP/ace,rei re nenilt2Ik Uq iai . c &
1 of 4 Form-D 9/2013
- - '1

NPDES APPLICATION - FORM D
For privately-owned treatment systems treating 100%domestic wastewaters<1.0 MGD
10. Flow Information:
Treatment Plant Design flow • 030 MGD
Annual Average daily flow 0037 MGD (for the previous 3 years)
Maximum daily flow 0039 MGD(for the previous 3 years)
11. Is this facility located on Indian country?
0 Yes [rNo
12. Effluent Data
NEW APPLICANTS:Provide data for the parameters listed.Fecal Collfomi, Temperature and pH shall be grab samples, for
all other parameters 24-hour composite sampling shall be used. N more than one analysis is reported,report daily maximum
and monthly average. tf 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 otherparameters "N/A"
Parameter Daily Monthly Units of
Maximum Average Measurement
Biochemical Oxygen Demand(BOD,) ,2an /O /Y7( /L
Fecal Coliform 4 ,SO /no/r)L
Total Suspended Solids /,?0 S m C/
Temperature(Summer) a,tf, / a0. 0
Temperature(Winter) 020,0 i,. 5 oC
pH 7, 5
13. List all permits,construction approvals and/or applications:
Type Permit Number Type Permit Number
Hazardous Waste(RCRA) ^//A NESHAPS(CAA) AVA
UIC(SDWA) 6/ _ 415 _i 7 a, Ocean Dumping(MPRSA) 1109
NPDES ^//11 Dredge or fill(Section 404 or CWA) n/�4
PSD(CAA) n/l4 Other 4///1
Non-attainment program(CAA) N/A
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.
///nr Od 1iy) O hI1W,r
Printed name . rson Signi Title
— 5"- /g
ignature of Applicant Date
North Carolina General Statute 143-215.6(bX2)states: My person who knowingly makes any false statement representation, or certification in any
application,record,report,plan,or other document ices or required to be maintained under Artide 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 4 Form-0 9/2013

May 14, 2015
Sludge Management Plan
Magnolia Place MHP
Permit #NC0071862
When sludge accumulates at the wastewater plant, a septic
pumping company is called and they remove sludge with the
proper equipment and truck.
The current company I am using is "Mike's Septic". Once
sludge is removed it is transported to Brevard City Facility and
properly treated there.

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Facility Information Facility
Latitude: 35°22'06" Sub-Basin: 04-03-02 Location r
Longitude: 82°25'15"
Quad Name: Hendersonville
Stream Class: C
Receiving Stream: Clear Creek Henry Keith Odom-Na 0o71 P612ce Mobile Home Park
torth Henderson County