NC0065358_Permit Issuance_20110726

I f
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
July 26, 2011
Mr. Peter Placentino
Brown Investment Properties
P.O. Box 930
Greensboro, N.C. 27402-0930
Subject: Issuance of NPDES Permit NCO065358
Hidden Forest Estates WWTP
Randolph County
Dear Mr. Placentino:
Division personnel have reviewed and approved your application for renewal of the subject
permit. Accordingly, we are forwarding the attached NPDES discharge permit. This permit is
issued pursuant to the requirements of North Carolina General Statute 143-215.1 and the
Memorandum of Agreement between North Carolina and the U.S. Environmental Protection
Agency dated October 15, 2007 (or as subsequently amended).
This final permit includes the following significant changes from the draft
permit sent to you on June 9, 2011:
➢ The receiving stream name has been corrected on the permit cover page, Supplement to
Permit Cover page and permit map.
Please note that the Deep River is listed as an impaired waterbody on the North Carolina
303(d) Impaired Waters List. Addressing impaired waters is a high priority with the Division, and
instream data will continue to be evaluated. If there is noncompliance with this permit's effluent
limits and stream impairment can be attributed to your facility, then mitigative measures may be
required.
If any parts, measurement frequencies or sampling requirements contained in this permit
are unacceptable to you, you have the right to an adjudicatory hearing upon written request
within thirty (30) days following receipt of this letter. This request must be in the form of a
written petition, conforming to Chapter 150B of the North Carolina General Statutes, and filed
with the Office of Administrative Hearings (6714 Mail Service Center, Raleigh, North Carolina
27699-6714). Unless such demand is made, this decision shall be final and binding.
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
512 North Salisbury Street, Raleigh, North Carolina 27604
Phone: [phone] / FAX [phone] / http://portal.ncdenr.org/web/wq
An Equal Opportunity/Affirmative Action Employer - 50% Recycled/10% Post Consumer Paper
NoIIrthCarolina
;Vatzmally

Please note that this permit is not transferable except after notice to the Division. The
Division may require modification or revocation and reissuance of the permit. This permit does
not affect the legal requirements to obtain other permits which may be required by the Division of
Water Quality or permits required by the Division of Land Resources, the Coastal Area
Management Act or any other Federal or Local governmental permit that may be required.
If you have any questions concerning this permit, please contact Charles Weaver at
telephone number [phone].
pincerel,
ColH. Sullins
cc: Central Files
Winston-Salem Regional Office/Surface Water Protection
TNPDES Unit

e
Permit NCO065358
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
PERMIT
TO DISCHARGE WASTEWATER UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provisions 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,
SIP Hidden Forest, LLC
is hereby authorized to discharge wastewater from a facility located at the
Hidden Forest Estates WWTP
6602 Holder Inman Road Extension
Randleman
Randolph County ,
to receiving waters designated as an unnamed tributary to Randleman Lake in subbasin 03-06-08 of the
Cape Fear River Basin in accordance with effluent limitations, monitoring requirements, and other
conditions set forth in Parts I, II, III and IV hereof.
This permit shall become effective September 1, 2011.
This permit and authorization to discharge shall expire at midnight on August 31, 2016.
Signed this day July 26, 2011
C Sullins, Director"
Ili' -vision of Water Quality
By Authority of the Environmental Management Commission

Permit NCO065358
SUPPLEMENT TO PERMIT COVER SHEET
All previous NPDES Permits issued to this facility, whether for operation or discharge are hereby revoked, and as of this
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.
SIP Hidden Forest, LLC is hereby authorized to:
1. Continue to operate an existing 0.027 MGD wastewater treatment facility with the following
components:
♦ Influent surge tank with bar screen
♦ Aeration tank
♦ Clarifiers (2)
♦ Chlorine contact tank with tablet chlorination
♦ Aerated sludge holding tank
♦ Phosphorus removal equipment
♦ Tertiary filters
♦ Ultraviolet disinfection unit
♦ Effluent flow measurement
♦ Standby power generator •
This facility is located near Randleman off the Holder Inman Road Extension at the Hidden Forest
Estates WWTP in Randolph County.
2. Discharge from said treatment works at the location specified on the attached map into an unnamed
tributary to Randleman Lake, currently classified WS-IV CA* waters in hydrologic unit 03030003
of the Cape Fear River Basin.

Latitude: 35°53'53"
Longitude:79"49'22" NCO065358
Stream Class: WS-IV CA* Hidden Forest Estates
Subbasin: 03-06.08 Hydrologic Unit: 03030003 W W rP
Receiving Stream: UT Randleman Lake
USGS Quad: Pleasant Garden, N.C.
Facility
Location
Randolph County
Map not to scale

Permit NCO065358
A. (1) EFFLUENT LIMITATIONS AND MONITORING REQUIREMENTS
During the period beginning on the effective date of the 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:
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Flow
50050
0.027 MGD
Continuous
Recording
Influent or
Effluent
BOD, 5-day (20°C) (April 1— October 31)
C0310
5.0 mg/L
7.5 mg/L
3/Week
Composite
Effluent
BOD, 5-day (20°C) (November 1— March 31)
C0310
10.0 mg/L
15.0 mg/L
3NUeek
Composite
Effluent
Total Suspended Solids
C0530
30.0 mg/L
45.0 mg/L
3/Week
Composite
Effluent
NH3 as N (April 1— October 31)
C0610
2.0 mg/L
10.0 mg/L
3/Week
Composite
Effluent
NH3 as N (November 1— March 31)
C0610
4.0 mg/L
20.0 mg/L
3/Week
Composite
Effluent
Dissolved Oxygen
C0300
Daily average > 6.0 mg/L
3Meek
Grab
Effluent
Fecal Coliform (geometric mean)
31616
200 / 100 ml
400 / 100 ml
3/Week
Grab
Effluent
Total Residual Chlorine (TRC)l
50060
17 Ng/L
3/Week
Grab
Effluent
Temperature (°C)
00010
3/Week
Grab
Effluent
Total Nitrogen (NO2+NO3+TKN)
C0600
Monthly
Composite
Effluent
Total Phosphorus2
C0665
2.0 mg/L Quarterly average
Weekly
Composite
Effluent
pH
00400
> 6.0 and < 9.0 standard units
— —
3/Week
Grab
Effluent
Footnotes:
1. Limit and monitoring requirements apply only if chlorine is added to the treatment system The Permiittee shall report
all effluent TRC values reported by a NC -certified laboratory [including field -certified). Effluent values below 50 µg/L
will be treated as zero for compliance purposes.
2. Compliance shall be based on a quarterly average of weekly samples.
THERE SHALL BE NO DISCHARGE OF FLOATING SOLIDS OR VISIBLE FOAM IN OTHER THAN TRACE AMOUNTS.

Permit NC0065358
A. (2) PERMIT RE -OPENER: NUTRIENT MONITORING
Pursuant to N.C. General Statutes Section 143-215.1 and the implementing rules found in the North
Carolina Administrative Code at 15A NCAC 2H.0112 (b) (1) and 2H.0114 (a) and Part H sections B-
12 and B-13 of this permit, the Director may reopen this permit to require supplemental nutrient
monitoring of the discharge. The purpose of the additional monitoring will be to support water quality
modeling efforts within the Cape Fear River Basin and shall be consistent with a monitoring plan
developed jointly by the Division and affected stakeholders. In addition, the results of water quality
modeling may require that limits for Total Nitrogen and Total Phosphorus be imposed in this permit
upon renewal.

Coin
Affidavit of Publication
State of North Carolina,
Randolph County
To Whom It May Concern:
This is to certify the
advertisement attached
hereto has been published
in -
The Courier -Tribune
on the following dates:
,2011
Sworn to on this day
of U 2011
l �' �
Courier -Tribune Representative
Sworn to and Subscribed
Before me this day
Of 2011 0
Notary Public
My Commission Expires
12/13/2012
E
IA B. SHIVER
blic, North Carolina
olph County
mission Expires
13 /Y
Public Notice
North Carolina Environmental
Management Commission/NPDES Unit
1617 Mail Service Center
Raleigh, NC 27699-1617
Notice of Intent to Issue a NPDES Wastewater Permit
The North Carolina Environmental Management Commission
proposes to issue a NPDES wastewater discharge permit to the
person(s) listed below.
Written comments regarding the proposed permit will be accepted
until 30 days after the publish date of this notice. The Director of the
NC Division of Water Quality (DWQ) may hold a public hearing should
there be a significant degree of public interest. Please mail comments
and/or information requests to DWQ at the above address. Interested
persons may visit the DWQ at 512 N. Salisbury Street, Raleigh, NC to
review information on file. Additional information on NPDES permits
and this notice may be found on our website:
http://portal.ncdenr.org/web/wq/swp/ps/npdes/calendar, or by calling
[phone].
SIP Hidden Forest, LLC requested renewal of permit
NC0065358/Hidden Forest MHP WWTP/Randolph County. Facility
discharges treated wastewater to the Deep River/Cape Fear River
Basin. Currently, BOD, ammonia nitrogen, dissolved oxygen, total
phosphorus, fecal coliform and total residual chlorine are water quality
limited.
Aqua North Carolina, Inc. requested renewal of permit NC0050792 for
Melbille Heights WWTP in Randolph County; this permitted discharge
is treated wastewater to Muddy Creek, Cape Fear River Basin.
1 t-6/9/2011

NCDENR
North Carolina Department of Environment and Natural Resources
Division of water Quality
Beverly Eaves Perdue, Governor Coleen H. Sullins, Director Dee Freeman, Secretary
June 10, 2011
MEMORANDUM
To: Lisa Edwards
NC DENR / DEH / Regional Engineer
_ Winston-Salem. Regional ice
i From: Charles H. Weaver, Jr.
NPDES Unit
Subject: Review of Draft NPDZS Permit NCO065358
Hidden Forest WWTP
Randolph Connty
Please indicate ilelow your agency's position or viewpoint on the draft permit and return this
form by duly 12, 2011. If you have any questions on the draft permit, please contact me at
the telephone number or e-mail address listed at the bottom of this page.
i
§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§
RESPONSE: (Check one)
Concur with the issuance of this permit provided the facility is operated and maintained
properly, the stated effluent limits 'axe met prior to discharge, and the discharge does not
contravene the designated water quality standards.
above perAn-2ft-,=pr&vided=tbe4, H., wing
Opposes the issuance of the above permit, based on reasons stated below, or attached.
Si ed - Date:
1617 Mail Sei tce Center, P4ft% , North Cantina 27859 M7 919 807401 (fax) 919 8074M
VisrrusorsTHE I TERW@ HTTHIOzra..H OMORGMSA +a dwdw.weaver§ ncbnrgov
An Equal Opportunity/AfftmeftAdim Employer-80% Ft gdeMO%most ComumerPaper

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Town of Mars Hill
Facility x
Mars Hill WTP
Location
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Latitude: 35' 56' 20.07" N State Grid: Bald Creek
Longitude: 82129' 42.29" W Permitted Flow: N/A
Receiving Stream: Big Laurel Creek Drainage Basin: French Broad Basin
Stream Class: C -Trout ORW Sub-Basin/HU: 04-03-04 / 06010105
not to scale
T 1 NPDES Permit No. NC0083712
L y o rth Madison County

Weaver, Charles
From: Mickey, Mike
Sent: Thursday, June 09, 2011 5:29 PM
To: Weaver, Charles
Subject: RE: DRAFT permit renewal for NC0065358 (Hidden Forest WWTP)
Attachments: Paul Smith -Hidden Forest -Downstream 01-10.doc
Charles — Please note the following:
1) The topo map incorrectly locates the discharge point on the east side of Hwy 220. The discharge is actually on the
west side of Hwy 220 below the dam of Glen Stewart's pond (see map below). A previous Hidden Forest owner had to
bore under the hwy and relocate the outfall below Stewart's pond as the result of a penalty settlement.
2) The system discharges into a UT to Randleman Lake. The correct stream classification is class WS-IV, CA* waters.
Please revise the classification on the supplement page and the topo map.
3) WSRO recommends that upstream and downstream monitoring be deleted from the permit. The stream segment
below the outfall is on private property and the ORC is not allowed access. The ORC is currently collecting downstream
samples from Randleman Lake off Adams Farm Road approximately 4,117 ft downstream of the outfall (not even on the
map below). WSRO previously worked with lake authority so the ORC could get access (see attached letter). However,
collecting downstream samples from Randleman Lake simply generates useless data and wastes the permittee's
resources.
Thanks, Mike.
I
N
Glen StewartiIkin
Hidden Forest L
ff I WWTP
Randler� a ~ ++
DischaO
outfall'
c
t
1

Figure 28-4
View of Buckhorn Dam, Mid -River Island, and River Downstream, as seen from the North Abutment of the Dam,
March 29, 2005 (River Discharge about 12,000 cfs)
CM }I:9EN,0DS.W')EiR

FACT SHEET FOR EXPEDITED PERMIT RENEWALS
This form must be completed by Permit Writers for all expedited permits which do not require
fill Fact Sheets. Expedited permits are generally simple 100% domestics (e.g., schools, mobile
home parks, etc) that can be administratively renewed with minor changes, but can include
facilities with more complex issues (Special Conditions, 303(d) listed water, toxicity testing,
instneam monitoring, compliance concerns).
Basic Information for Expedited Permit Renewals
Permit Writer/Date
Charles H. Weaver — 6/2/2011
Permit Number
NCO065358
Facility Name
Hidden Forest Mobile Home Park WWTP
Basin Name/Sub-basin number
Cape Fear / 03-06-08
Receiving Stream
UT to the Deep River
Stream Classification in Permit
C
Does permit need Daily Maximum NH3 limits?
No — already present
Does permit need TRC limits/language?
No — already present
Does permit have toxicity testing?
No
Does permit have Special Conditions?
Yes. This renewal updates the Cape Fear
nutrient reo ener condition.
Does permit have instream monitoring?
Yes
Is the stream impaired on 303(d) list)?
Yes. Standard violations for chloro hvll a.
Any obvious compliance concerns?
No
Any permit mods since lastpermit?
Ownership change mod in 2010.
New expiration date
8/31/2016
Comments received on Draft Permit?
Most Commonly Used Expedited Language:
• 303(d) language for Draft/Final Cover Letters: "Please note that Cane Creek is listed
as an impaired waterbody on the North Carolina 303(d) hnpaired Waters List.
Addressing impaired waters is a high priority with the Division, and instream data will
continue to be evaluated. If there is noncompliance with this permit's effluent limits and
stream impairment can be attributed to your facility, then mitigative measures may be
required".

Sincerely,
RESEAROI & ANALYTICAL LABORATORIES
Dennis J. dodge
Director of Field Services

NC 2010 Integrated Report Categories 4 and 5 Impaired Waters
All 13,123 Waters in NC are in Category 5-303(d) List for Mercury due to statewide fish consumption advice for several fish species
AU Number AU Name AU_Description LengthArea
AU —Units Classification
Category Parameter
Reason for Rating Use Category
Collection Year
303(d)year
Cape Fear River Basin
Headwaters Deep River Watershed 0303000301
Cape Fear River Basin
Deep River Subbasin
03030003
Capepe Fear River Basin
Headwaters Deep River Watershed 0303000301
17-(10.5)dl DEEP RIVER
From Haskett Creek to Gabriels Creek
2.7 FWMiles
C,
( 5 Chlorophyll a
Standard Violation Aquatic Life
2008
2008
Q' 17-(4)a DEEP RIVER
From dam at Oakdale Cotton Mills, Inc. to
2.0 FW Miles
WS-IV;CA:*
SR 1113
5 Low DismAyed Oxygen
Standard Violation Aquatic Life
2008
2010
17-(1) DEEP RIVER(including
From source in backwaters of High Point 263.3 FW Acres
WS-IV;CA:*
High Point Lake at
Lake to dam at High Point Lake(City of High
normalpool
Point water supply intake)
elevation)
5 Chlorophyll a
Standard Violation Aquatic Life
2008
2006
Q 17-2-(0.3)a East Fork Deep River
From source to Thatcher Road
1.9 FW Miles
WS-IV:*
4t Fecal Conform (recreation)
Standard Violation Recreation
2008
1998
4t Turbidity
Standard Violation Aquatic Life
2008
1998
Q 17-2-(0.3)b East Fork Deep River
From Thatcher Road to a point 0.4 mile
4.8 FW Mlles
WS-IV:*
downstream of Guilford County SR 1541
4t Fecal California (recreation)
Standard Violation Recreation
2008
1998
4t Turbidity
Standard Violation Aquatic Life
2008
1998
17-2-(0.7) East Fork Deep River
From a point 0.4 mile downstream of
0.8 FW Miles
WS-IV;CA:*
Guilford County SR 1541 to High Point Lake,
Deep River
4t Fecal Coliform(recreation)
Standard Violation Recreation
2008
1998
4t Turbidity
Standard Violation Aquatic Life
2008
1998
Q* 17-12a Haskett Creek
From source to SR 2149
6.3 FW Miles
C
4s Ecological/biological Integrity Benthos
Fair Bioclassification Aquatic Life
2003
1998
5 Low Dissolved Oxygen
Standard Violation Aquatic Life
2008
2010
0 17-121b Haskett Creek
From SR 2149 to Deep River
1.3 FW Miles
C
5 Copper
Standard Violation Aquatic Life
2008
2008
4s EcologicaUhlological Integrity Benthus
Poor Bioclassification Aquatic Life
2003
2008
5 Turbidity
Standard Violation Aquatic Life
2008
2008
Qa 17-8-2 Jenny Branch
From source to Reddicks Creek
3.2 FW Miles
WS-IV:*
5 Ecological/biological Integrity Bentlros
Fair Bioclassification Aquatic life
2003
2010
NC 2010 Integrated Report Category 4 and 5 303(d) List EPA Approved Aug 31, 201 9/20/2010 Page 10 of 145
6 fv I. daed e•1 ✓1.4`h to bb0((2.LUJ 4)Un-UU ti✓ul-bl Ubbt1XJ .td1L✓dll `Y -10*[Id .Ua4✓ UU4"rV

WASTEWATER SYSTEM
PERFORMANCE ANNUAL REPORT
2006
I. General Information
Facility Name:
Responsible Entity:
Contact Person:
11.
Pine Hall Elementary School
Stokes County Board of Education
Dennis J. Hodge
Applicable Permit (s): NPDES Permit No. NCO087980
Description of collection system or process:
The system consists of a 0.004 million gallon per day (MGD) wastewater treatment plant
With the following components: septic/dosing tank, recirculation system, surface sand filter, and
ultraviolet disinfection.
Performance
Summary of system performance for calendar year 2006:
April 2006
System start-up. Compliant with all effluent limitations
May 2006
Compliant with all effluent permit limitations
June 2006
Compliant with all effluent permit limitations
July 2006
Compliant with all effluent permit limitations
August 2006
Exceeded maximum weekly and average monthly limitation for fecal
coliform. Workers repaired problem with ultraviolet disinfection
system. There have been no further exceedences.
September 2006
Compliant with all effluent permit limitations
October 2006
Compliant with all effluent permit limitations
November 2006
Compliant with all effluent permit limitations
December 2006
Compliant with all effluent permit limitations
III. Notification
Annual notice posted at school.

Bnowm JmvcSTMENT
PROPERTIES
ESTABLISHED • N60
February 28, 2011
Mrs. Dina Sprinkle
NC DENR/DWQ/Point Source Branch
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
RE: NPDES Permit NCO065358
Hidden Forest Mobile Home Park WWTP
Randolph County
Dear Ms. Sprinkle
This letter is to request renewal of the above -referenced NPDES permit. NPDES Application
Form D and required copies are enclosed.
Hidden Forest Mobile Home Park is now owned by SIP Hidden Forest LLC. Brown Investment
Properties, Inc. is the managing agent. An excerpt from the current management agreement is
enclosed.
Please note that no changes have been made to this facility since the issuance of the last permit
The operator continues to be Paul Smith of Smith Industries, Reidsville, North Carolina.
Please change the contact information for Hidden Forest Mobile Home Park as follows:
Hidden Forest Mobile Home Park
c/o Brown Investment Properties, Inc.
Post Office Box 930 (440 West Market Street)
Greensboro, North Carolina 24702 (27401)
Attention: Peter Placentino
Very truly yours,
B. Obi I P OPERTIES, INC.
i /
Peter Placentino, CPM
Senior Vice President
Agent for SIP Hidden Forest
PP/mh
Enclosures
440 West Market St. (27401) 0 P.O. Box 930 • Greensboro, NC 27402 0 336-379-8771 • Fax: [phone] www.bipinc.com

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 Quality / NPDES Unit
1617 Mail Service Center, Raleigh, NC 27699-1617
NPDES Permit NCO065358
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.
I. Contact Information:
Owner Name
SIP Hidden Forest LLC
Facility Name
Hidden Forest Mobile Home Park WWTP
Mailing Address
c/o Brown Investment Properties, Inc. PO Box 930
City
Greensboro
State / Zip Code
North Carolina 27402
Telephone Number
336 379 8771
Fax Number
336 274 9305
e-mail Address
[e-mail]
2. Location of facility producing discharge:
Check here if same address as above ❑
Street Address or State Road 6602 Holder Inman Road Extension
City Randleman
State / Zip Code North Carolina 27317
County Randolph
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 Paul Smith, Smith Industries
Mailing Address 235 Richardson Road
City
State / Zip Code
Telephone Number
Fax Number
Reidsville
North. Carolina 27320
336 932 9347 MAR 4 2011
1 of 3
Form-D 05/08

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
p
Number of Homes 197
School
❑
Number of Students/ Staff
Other
❑
Explain:
Describe the source(s) of wastewater (example: subdivision, mobile home park, shopping centers,
restaurants, etc.):
Mobile home park
Population served: 396
S. Type of collection system
0 Separate (sanitary sewer only)
6. Outfall Information:
❑ Combined (storm sewer and sanitary sewer)
Number of separate discharge points 1
Outfall Identification number(s) Op 1
Is the outfall equipped with a diffuser? ❑ Yes D No
7. Name of receiving stream(s) (Provide a map showing the exact location of each outfall):
Unnamed tributary to Randleman Reservoir
S. Frequency of Discharge: 0 Continuous ❑ Intermittent
If intermittent:
Days per week discharge occurs: Duration:
9. Describe the treatment system
Influent tank, sludge digester, aeration tank, tertiary hitters, bar screen, two clarifiers, UV
disinfection, effluent flow measurement, standby generator.
2of3
Form-D 05108

NPDES APPLICATION - FORM D
For privately owned treatment systems treating 100% domestic wastewaters <1.0 MGD
10. Flow Information:
Treatment Plant Design flow 0.027 MGD
Annual Average daily now 0.0159 MGD (for the previous 3 years)
Maximum daily flow 0.0258 MGD (for the previous 3 years)
11. Is this facility located on Indian country?
❑ Yes El No
12. Effluent Data
Provide data for the parameters listed. Fecal Coliform, Temperature and pH shall be grab samples, for all other
parameters 24-hour composite andsampling shall be used. If more than one analysis is reported; report daily,, maxi.;�µ�;;�
�-, &W wy uU�, age. jj oruy one analysis is reported, report as daily maximum.
Parameter
Biochemical Oxygen Demand (BODS)
Fecal Coliform
Total Suspended Solids
Temperature (Summer)
Temperature (Winter)
pH
Daily Monthly Units of
Maximum Average Measurement
18.0 3.5 MG/L
30.0
7.0
28.0
10.0
7.6
13. List all permits, construction approvals and/or applications:
Type Permit Number Type
Hazardous Waste (RCRA) NESHAPS (CAA)
UIC (SDWA
2.0
1 200/ 100 ML
3.0
MG/L
2.2
C
5.0
C
7.3
SU
(C NC 00Ocean Dumping (MPRSA)
NPD 65358 Dredge or fill (Section 404 or CWA)
PSD (CAA) Other
Non -attainment program (CAA)
14. APPLICANT CERTIFICATION
Permit Number
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.
North Carolina General Statute 143-215.6 (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.)
3of3
Form-D 05/08

p.2
BROWN INVESTMENT PROPERTIES
ACANAGEMENT AGREEMENT
AGREEMENT made the FIRST day of OCTOBEW, 2010, between BROWN R�VESTMM, NT
-PROPE RTIES, INC. ("AGENT"), a North Carolina coloration u�th its l.�riaci al office in
Carolina; and SIP HIDDEN FOREST I,I,C (��ay�NE�,►�. P Greensboro, North
RECJTALS:
WHEREAS, OWNER is the fee owner of improved real property (the "property")1aiown as
HIDDEN FOREST ESTATES MOBILE HoNVm PA
rvmr: kT01 1%.1 ► �.-- RIB, located at Ft;n iarrl�r nEIi I`:"Xn 1 TO" <� „u=vty, R ti1�Lt:l1 AN, NORT73 CAROLINA;
WIIEREAS, OWNER desires to engage AGENT to be OWNER's AGENT for the management
operation of the Property, and AGENT has agreed to perform such services, all upon the terms nt and
hereinafter set forth: Po aid conditions
NOW, THEREFORE, in consideration of the premises, the covenants and conditions herei
contained, the parties hereto agree as follows: Wafter
1. Tenn of the Agreement.
The OWNER hereby employs the AGENT exclusively to manage the Propel ► Yereinalter
"Premises") known as Hidden Forest Estates Mobile $omC Park upon the terms hereinafter called the
tern of this agreement shall be fox a one (1) year r set forth. The
201Z and thereafter for monthlyPeriod be ing October 1, 2010 through September 30,
of any calendar month, either periods from time to time, Mess on or before sixty (60) days prior to the end
party hereto shall notify the other in writing that it elects to teirninate Plus
agreement, in which case this agreement shall be terminated at the end of said period. Provided however,
OWNER may terminate this agreement wiita � er,
misfeasance or � ��` (30} days Prior written nonce for reasons of malfeasance:
gross negligence, or any material breach of material duty by AGENT under this Agreement, or
at termination of Ownership.
Upon the expiration of this Agreement, however caused, the AGENT shall vacate the Property
tttru over to the QWNER all books and records in AGENT's possession which are the property of the and shall
or which OWNER (or new AGENT) will reasonably require for the contauued operation of the PropertyOWNER
records may be provided by true copies thereof). Promptly after such expiration or termination NE (which
an
AGENT A;dll account to each other for amotmts due hereunder from one to OWNER and
furnish the AG ENT security, satisfactory to file AGENT against the other, and the OWNER Shall
which the AGENT may have incurred hereunder. Further, both t parties agr��ug obligations, or liabilities
termination procedures outlined elsewhere in this Agreement, and thereupon, ee after the completion tions of the
accounting the net stull then due from OWNER to AGEN T or AGENT to OWNER, as the case may be shall
paid. y be
OdZes I'MIManrgement Agreement 7 empluteMIDDF. N FOREST MjgP MARCH 201 l,doc t

Me
IN WITNESS WHEREGF, the parties hereto have affixed or caused to be affixed their respective signatures
and seats.
AGENT
CPDES ROPERTIES, INC.
(SEAL)
nioeter lacen,CPM,
Vice Presid.nt
Date: 16 / �.0 /0
OWNER 4,
(SEAL)
even C. Sack
SIP Hidden Forest LLC
Date:
-S-
1:%Res PMWanagetnent Ag..=mattTattplat:s%141DDEN FORESTMI-1P MARCH 201 l.doex

p.2
BROWN INVESTMENT PROPERTIES
XANAGEN.1ENT AGREEMENT
AGREEMENT made the FIRST day of OCTOBER, 2010, between BROWN INVESTMENT
PROPERTIES, INC. ("AGENT"), a North Carolina corporation with its principal office in Greensboro, North
Carolina; and SIP HIDDEN FOREST LLC ("OWNER").
RECITALS:
WHEREAS, OWNER is the fee owner of improved real property (the "Property") Known as
HIDDEN FOREST ESTATES MOBILE HOME PARK, located at 6602 HOLDER ENMAN ROAD
EXTENSION, RANDLEMAN, NORTH CAROLINA;
WHEREAS, OWNER desires to engage AGENT to be OV/NER`s AGENT for the management and
operation of the Property, and AGENT has agreed to perform such services, all upon the terms and conditions
hereinafter set forth:
NOW, THEREFORE, in consideration of the premises, the covenants and conditions hereinafter
contained, the parties hereto agree as follows:
1. Term of the Agreement.
The OWNER hereby employs the AGENT exclusively to manage the Property(hereinafter called the
"Premises") known as Hidden Forest Estates IMobile Home Park upon the terms hereinafter set forth. The
term of this agreement shall be for a one (1) year period begriming October 1, 2010 through September 30,
2011 and thereafter for monthly periods from time to time, unless on or before sixty (60) days prior to the end
of any calendar month, either party hereto shall notify the other in writing that it elects to terairiate this
agreement, in which case this agreement shall be terminated at the end of said period. Provided, however,
OWNER may terminate this agreement with thirty (30) days prior written notice for reasons of malfeasance_
misfeasance or gross negligence, or any material breach of a material duty by AGENT under this Agreement, or
at termination of Ownership.
Upon the expiration of this Agreement, however caused, the AGENT shall vacate the Property and shall
turn over to the OWNER all books and records in AGENT`s possession which are the property of the OWNER
or which OWNER (or new AGENT) will reasonably require for the continued operation of the Property (which
records may be provided by true copies thereof). Promptly after such expiration or termination, OWNER and
AGENT «rill account to each other for amounts due hereunder from one to the other, and the OWNER shall
Atmish the AGENT security, satisfactory to the AGENT, against any outstanding obligations, or liabilities
which the AGENT may have incurred hereunder. Further, both parties agree to the conditions of the
termination procedures outlined elsewhere in this Agreement, and thereupon, after the completion of such
accounting the net sum then due from OWNER to AGENT or AGENT to OWNER, as the case may be, shall be
paid.
-1-
1ARes PA4MEnimement Agreunent ranptatesff DDEN FOREST MHP MARCH 201 Ldoca

IN 'FITNESS WHEREOF. the parties hereto have affixed or caused to be affixed their respective signatures
and seats.
AGENT
t
ES ,N ROPERTIES, INC.
(SEAL)
eter Ptacentino, CPM, Vice Presid-.nt
Date: 16 ! lt:kl Q /v
OWNER
(SEAL)
even C. Sack
SIP Hidden Forest LLC
Date:
-8-
1:%Res PMlManagranc:itAgrocmauTanplai;sllilDDEN FORESTMMP MARCH 2O1I.ducx

�e
BROWN INVESTMENT
PROPER7IES
February 28, 2011
North Carolina Department of Environment
and Natural Resources
Division of Water Quality/NPDES Unit
1617 Mail Service Center
Raleigh, North Carolina 2769U_1616
RE: Renewal Notice
NPDES Permit NCO065358
Hidden Forest Mobile Home Park WWTP
Randolph County
Sludge Management
The sludge management plan and policy for this plant is as follows:
Solids are removed from the WWTP as necessary by Carolina Septic, a licensed contract hauler, and
disposed of properly
Very truly yours,
BRQVVW-1NVM T PROP TI S, INC.
Peter PTacentino, CPM
Senior Vice President
Agent for SIP Hidden Forest LLC
PP/mh
enclosures
440 West Market St. (27401) 0 P.O. Box 930 0 Greensboro, NC 27402 • 336-379-8771 • Fax: [phone] www.bipinc.com