NC0088765_Renewal (Application)_20230420

ROY COOPER
Governor
ELIZABETH S. BISER
Secretary
RICHARD E. ROGERS, JR.
Director
Wayne Smith
Wayne Smith
51 Bridge St #B
Sylva, NC 28779
Subject: Permit Renewal
Application No. NCO088765
Tuckaseegee RV Resort
Jackson County
Dear Permittee:
NORTH CAROLINA
Environmental Quality
June 22, 2023
The Water Quality Permitting Section acknowledges the April 20, 2023 receipt of your permit renewal application and
supporting documentation. Your application will be assigned to a permit writer within the Section's NPDES WW permitting
branch. Per G.S. 150E-3 your current permit does not expire until permit decision on the application is made.
Continuation of the current permit is contingent on timely and sufficient application for renewal of the current permit. The
permit writer will contact you if additional information is required to complete your permit renewal. Please respond in a
timely manner to requests for additional information necessary to allow a complete review of the application and renewal
of the permit.
Information regarding the status of your renewal application can be found online using the Department of Environmental
Quality's Environmental Application Tracker at:
https•//deq nc gov/permits-regulations/permit-guidance/environmental-application-tracker
If you have any additional questions about the permit, please contact the primary reviewer of the application using the
links available within the Application Tracker.
SSiince�rrglyy, \
Cynthia Demery
Administrative Assistant
Water Quality Permitting Section
ec: WQPS Laserfiche File w/application
North Carolina Departtnent of Environmental Quality I Division of Water Resources
Asheville Regional Office 1 2090 US. Highway 70 1 Swannanoa, North Carolina 28778
�o.w� 828.296.4500

North Carolina
Department of Environmental Quality
Division of Water Resources
Modified Application Form 2A
Revised March 2021
Modified Application
Form 2A y�Yzo�U-5
Minor Sewage Facilities < 0.1 MGD
and No Pretreatment Program
NPDES Permitting Program
Laser fig,
RECEIVED
APR 2 0 2323
NCDEQ/DWR/NPDE
S
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
NCO088765
Tuckaseegee RV Resort
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 ma result in denial of the lication.
SECTION•N
INFORMATION FOR
1.1
Facility name
Tuckaseegee RV Resort
Mailing address (street or P.O. box)
51 Bridge Street #B
City or town
State
ZIP code
o
Sylva
North Carolina
28779
EContact
name (first and last)
Title
Phone number
Email address
12
�
Wayne Smith
y
Owner
[phone]
[e-mail]
Location address (street, route number, or other specific identifier) ❑ Same as mailing address
LL
80 Wilmont Rd
City or town
State
ZIP code
Whittier
North Carolina
28789
1.2
Is this application for a facility that has yet to commence discharge?
❑ Yes 4 See instructions on data submission 0 No
requirements for new dischargers.
1.3
Is applicant different from entity listed under Item 1.1 above?
❑ Yes Q No + SKIP to Item 1.4.
Applicant name
Applicant address (street or P.O. box)
0
R
oCity
or town
State
ZIP code
Contact name (first and last)
Title
Phone number
Email address
.Q
CL
a
1.4
Is the applicant the facility's owner, operator, or both? (Check only one response.)
Z Owner ❑ Operator ❑ Both
1.5
To which entity should the NPDES permitting authority send correspondence? (Check only one response.)
❑ Facility ❑ Applicant 0 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
❑ NPDES (discharges to surface
E]RCRA (hazardous waste)
❑ UIC (underground injection
water)
control)
E
c
NCO088765
o
❑ PSD (air emissions)
❑ Nonattainment program (CAA)
❑ NESHAPs (CAA)
c
w
rn
H
❑ Ocean dumping (MPRSA)
❑ Dredge or fill (CWA Section
❑ Other (specify)
w
404)
Page 1

NPDES Permit Number
Facility Name
Modified Application Form 2A
NCO088765
Tuckaseegee RV Resort
Modified March 2021
1.7
Provide the collections stem information
requested below for the treatment works.
Municipality
Population
Collection System Type
Served
Served
indicatepercentage)Ownership
Status
-C
Tuckaseegee RV
Private Facility
100 % separate sanitary sewer
El Own ❑ Maintain
�
Resort
% combined storm and sanitary sewer
El Own ❑ Maintain
W
❑ Unknown
❑ Own ❑ Maintain
Cn
c
% separate sanitary sewer
ElOwn ❑ Maintain
% combined storm and sanitary sewer
❑ Own ❑ Maintain
o
ElUnknown
❑ Own ElMaintain
a
% separate sanitary sewer
❑ Own ❑ Maintain
v
% combined storm and sanitary sewer
❑ Own ❑ Maintain
c
❑ Unknown
❑ Own ❑ Maintain
C;
% separate sanitary sewer
❑ Own ❑ Maintain
% combined storm and sanitary sewer
❑ Own ❑ Maintain
rn
c
❑ Unknown
❑ Own ❑ Maintain
o
Total Private Facility
Population
ci
Served
Separate Sanitary Sewer System
Combined Storm and
Sanitary Sewer
Total percentage of each type of
sewer line in miles
100 %
0
Z'
1.8
Is the treatment works located in Indian Country?
c
o
0
U
❑ Yes ❑r No
1.9
Does the facility discharge to a receiving water that flows through Indian Country?
R
=o
❑ Yes No
1.10
Provide design and actual flow rates in the designated spaces.
Design Flow Rate
0.0042 mgd
Annual Average Flow Rates Actual
V All
Two Years Ago
Last Year
This Year
ce-
c
0.0014 mgd
0.0014 mgd
0.0014 mgd
CD
Maximum Daily Flow Rates Actual
Two Years Ago
Last Year
This Year
0.0014 mgd
0.0014 mgd
0.0014 mgd
H
1.11
Provide the total number of effluent discharge points to waters of the State of North Carolina by type
w
c
Total Number of Effluent Discharge Points by Type
a
Constructed
CD
�
Treated Effluent
Untreated Effluent
Combined Sewer
Bypasses
Emergency
t �
Overflows
Overflows
h
C
1
Page 2

NPDES Permit Number
Facility Name
Modified Application Form 2A
NC0088765
Tuckaseegee RV Resort
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 Dischar a Data
Average Daily Volume
Continuous or Intermittent
Location
Discharged to Surface
Impoundment
(check one)
El Continuous
gpd
❑ Intermittent
ElContinuous
gpd
❑ Intermittent
gpd
❑ Continuous
N
❑ Intermittent
L
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.
U)
Land Application Site and Discharge Data
5
0
Average Daily Volume
Continuous or
Location
Size
Applied
Intermittent
check one
n
acres
d
gpd
El Continuous
0
❑ Intermittent
s
acres
gp d
El Continuous
o
❑ Intermittent
acres
gpd
El
y
I ❑ Intermittent
I
1.16
Is effluent transported to another facility for treatment prior to discharge?
o
ElYes ❑✓ No 4 SKIP to Item 1.21.
1.17
Describe the means by which the effluent is transported (e.g., tank truck, pipe).
1.18
Is the effluent transported by a party other than the applicant?
❑ Yes ❑ No + SKIP to Item 1.20.
1.19
Provide information on the transporter below.
Trans orter Data
Entity name
Mailing address (street or P.O. box)
City or town
State
ZIP code
Contact name (first and last)
Title
Phone number
Email address
Page 3

NPDES Permit Number
Facility Name
Modified Application Form 2A
NCO088765
Tuckaseegee RV Resort
Modified March 2021
1.20
In the table below, indicate the name, address, contact information, NPDES number, and average daily flow rate of the
receivinq facility.
Renceivina IF cilitv Data
Facility name
Mailing address (street or P.O. box)
City or town
State
ZIP code
0
U
o
Contact name (first and last)
Title
0
s
d
Phone number
Email address
c
NPDES number of receiving facility (if any) ElNone
Average daily flow rate mgd
0.
N
C3
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)?
d
r
❑ Yes ❑r No 4 SKIP to Item 1.23.
c
1.22
Provide information in the table below on these other disposal methods.
Information on Other
Disposal Methods
Disposal
Location of
Size of
Annual Average
Continuous or Intermittent
Method
Disposal Site
Disposal Site
Daily Discharge
(check one)
Description
Volume
H
r
acres
gpd
❑ Continuous
❑ Intermittent
acres
gpd
❑ Continuous
❑ 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.
0 y
Consult with your NPDES permitting authority to determine what information needs to be submitted and when.)
❑ Discharges into marine waters (CWA ❑ Water quality related effluent limitation (CWA Section
Cr
Section 301(h)) 302(b)(2))
Not applicable
1.24Are
any operational or maintenance aspects (related to wastewater treatment and effluent quality) of the treatment works
J❑✓
the responsibility of a contractor?
❑✓ Yes ❑ No +SKIP 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
0
Contractor name
cc
(company name
Environmental, Inc
oMailing
address
p0 BOX 954
c
street or P.O. box
S
City, state, and ZIP
code
Cullowhee, INC 28723
�o
c
Contact name (first and
U
last)g
Mark Teague
Phone number
[phone]
Email address
[e-mail]
Operational and
operations only
maintenance
responsibilities of
contractor
Page 4

NPDES Permit Number Facility Name Modified Application Form 2A
NCO088765 Tuckaseegee RV Resort Modified March 2021
o Outfalls to Waters of the State of North Carolina
2.1
Does the treatment works have a design flow greater than or equal to 0.1 mgd?
T
o
❑ Yes ❑✓ No 4 SKIP to Section 3.
0
2.2
Provide the treatment works' current average daily volume of inflow
Average Daily Volume of Inflow and Infiltration
and infiltration.
gpd
Indicate the steps the facility is taking to minimize inflow and infiltration.
3
0
c
s
2.3
Have you attached a topographic map to this application that contains all the required information? (See instructions for
M C
specific requirements.)
0
C
C
�
❑ Yes ❑ No
E
2.4
Have you attached a process flow diagram or schematic to this application that contains all the required information?
3 R
o
(See instructions for specific requirements.)
rn
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
d
1.
E
Q.
2.
E
6
3.
-n
5
4.
to
a
2.6
Provide scheduled or actual dates of completion for improvements.
Scheduled or Actual Dates of Completion for Im rovements
E
a)
Scheduled
Affected
Outfalls
Begin
End
Begin
Attainment of
Operational
o
CL
Improvement
(list outfall
Construction
Construction
Discharge
Level
E
(from above)
number
(MM(DD/YYYY)
(MM/DD/YYYY)
(MM/DD/YYYY)
MM/DD/YYYY
1.
t
U
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:
Page 5

NPDES Permit Number Facility Name Modified Application Form 2A
NCO088765 Tuckaseegee RV Resort Modified March 2021
SECTION 3. INFORMATION ON EFFLUENT DISCHARGES (40 CFR 122.216)(3) to (5))
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
County
Jackson
City or town
Whittier
0
c
.0
Distance from shore
Q
ch
Depth below surface
ft.
ft.
ft.
0
Average daily flow rate
0.0014 mgd
mgd
mgd
Latitude
35' 24' 12"
"
Longitude
83' 19' 07"
"
3.2
Do any of the outfalls described under Item 3.1 have seasonal or periodic discharges?
o
❑ Yes ❑r No 4 SKIP to Item 3.4.
d
3.3
If so, provide the following information for each applicable outfall.
r
y
Outfall Number
Outfall Number
Outfall Number
0
Number of times per year
discharge occurs
a
Average duration of each
`o
dischar e (specify units
Average flow of each
mgd
mgd
mgd
0
discharge
cn
Months in which discharge
occurs
3.4
Are any of the outfalls listed under Item 3.1 equipped with a diffuser?
❑ Yes ❑r No SKIP to Item 3.6.
3.5
Briefly describe the diffuser t e at each applicable outfall.
Q
Outfall Number
Outfall Number
Outfall Number
0
0
3 6
Does the treatment works discharge or plan to discharge wastewater to waters of the State of North Carolina from
d �
one or more discharge points?
3 w
❑ Yes ❑ No 4SKIP to Section 6.
RECEIVED
APk c 0 2023
Page 6
NCDEQ/DWR/NPDES

NPDES Permit Number
Facility Name
Modified Application Form 2A
NCO088765
Tuckaseegee RV Resort
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
Tuckasegee River
Name of watershed, river,
0
or stream system
Little Tennessee River Basin
a
U.S. Soil Conservation
Service 14-digit watershed
In
code
='
3
CD
Name of state
management/river basin
Little Tennessee River Basin
U.S. Geological Survey
8-digit hydrologic
06010202
W
cataloqinq unit code
Critical low flow (acute)
cfs
cfs
cfs
Critical low flow (chronic)
cfs
cfs
cfs
Total hardness at critical
mg/L of
TCaCO3
mg/L of
mg/L of
low flow
CaCO3
CaCO3
3.8
Provide the following information
describing the treatment provided for discharges from each outfall.
Outfall Number
Outfall Number
Outfall Number
Highest Level of
❑ 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)
c
n0
Design Removal Rates by
Outfall
H
N
Y
BOD5 or CBOD5
%
%
%
C
d
E
Y
TSS
%
%
%
❑ Not applicable
❑ Not applicable
❑ Not applicable
Phosphorus
a
�o
o
�o
0
�o
❑ Not applicable
❑ Not applicable
❑ Not applicable
Nitrogen
%
%
%
Other (specify)
❑ Not applicable
❑ Not applicable
❑ Not applicable
%
%
%
Page 7

NPDES Permit Number
Facility Name
Modified Application Form 2A
NCO088765
Tuckaseegee RV Resort
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.
v
d
c
c
0
t)
`o
Outfall Number 001
Outfall Number
Outfall Number
w
•�
Disinfection type
YP
Calcium Hypochlorite
c�
N
d
Seasons used
Year Round
d
E
r
Dechlorination used?
❑ Not applicable
❑ Not applicable
❑ Not applicable
❑r 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?
El 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 0 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
R
Number of tests of discharge
water
FNumber
of tests of receiving
water
d
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. 0 No -* 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 ❑� No additional sampling required by NPDES
permitting authority.
Page 8

NPDES Permit Number
Facility Name
Modified Application Form 2A
NCO088765
Tuckaseegee RV Resort
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 4 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 ❑ 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/DDNYYY
7E
c
c
0
w3.22
Regardless of how you provided your WET testing data to the NPDES permitting authority, did any of the tests result in
o
toxicity?
CM
c
❑ Yes ❑ No 4 SKIP to Item 3.26.
U)
3.23
Describe the cause(s) of the toxicity:
c
d
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 ❑ Not applicable because previously submitted
information to the NPDES permittinq authorit .
Page 9

NPDES Permit Number
Facility Name
Outfall Number
NCO088765
Tuckaseegee RV Resort
Modified Application Form 2A
Modified March 2021
•• ••
Maximum Daily Discharge
Average Daily Discharge
Pollutant
Analytical ML or MDL
Number of
Value Units
Value Units Method' (include units)
Samples
Biochemical oxygen demand
❑ BODs or ❑ CBOD5
57
mg/L
18.23
mg/L
52 sm5210B-2011 ❑ ML
(report one
o MDL
Fecal coliform
1200
#100 ml
8.4
#100 ml
52 sm9222D-1997 ❑ ML
O MDL
Design flow rate
0.0014
mgd
0.0014
mgd
52
pH (minimum)
6.4
su
pH (maximum)
7.7
su
Temperature (winter)
21
Celcius
14.16
Celcius
26
Temperature (summer)
24.9
Celcius
20.91
Celcius
26
Total suspended solids (TSS)
26
mg/L
5.9
mg/L
52 sm2540D
O MDL
I 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 11

NPDES Permit Number Facility Name Modified Application Form 2A
NCO088765 Tuckaseegee RV Resort Modified March 2021
SECTIONI
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
❑
❑ w/ variance request(s) El w/ additional attachments
Information for All Applicants
❑ Section 2: Additional
❑ w/ topographic map ❑ w/ process flow diagram
Information
❑ w/ additional attachments
❑✓ w/ Table A ❑ w/ Table D
❑ Section 3: Information on
❑ w/ Table B ❑ w/ additional attachments
Effluent Discharges
E
❑ w/ Table C
d
0
w
`n
Section 4: Not Applicable
c
0
.Y
m
Section 5: Not Applicable
d
U
a
Section 6: Checklist and
❑
w/attachments
_c
Certification Statement
H
Y
6.2
Certification Statement
d
1 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. 1 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
nf�ne- Sm
Signature
Date signed
Page 10

North Carolina
Department of Environmental Quality
Division of Water Resources
Modified Application Form 2A
Revised March 2021
Modified Application
Form 2A
Minor Sewage Facilities < o.1 MGD
and No Pretreatment Program
NPDES Permitting Program
RECEIVED
APR 2 0 2023
NCDEQ/DWR/NPDES
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
NCO088765
Tuckaseegee RV Resort
Modified March 2021
Form
NC Department of Environmental Quality - Application for NPDES Permit to Discharge Wastewater
NPDES
MINOR SEWAGE FACILITIES (Before completing this form, please read the instructions. Failure to follow
the instructions mgy result in denial of the lication.
SECTIONmmmw
•N INFORMATION FOR t
1.1
Facility name
Tuckaseegee RV Resort
Mailing address (street or P.O. box)
51 Bridge Street #B
City or town
State
ZIP code
Sylva
North Carolina
28779
€
Contact name (first and last)
Title
Phone number
Email address
Wayne Smith
Owner
[phone]
[e-mail]
Location address (street, route number, or other specific identifier) ❑ Same as mailing address
A
LL
80 Wilmont Rd
City or town
State
ZIP code
Whittier
North Carolina
28759
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 4 SKIP to Item 1.4.
Applicant name
Applicant address (street or P.O. box)
0
o
City or town
State
ZIP code
5
i
Contact name (first and last)
Title
Phone number
Email address
a
1.4
Is the applicant the facility's owner, operator, or both? (Check only one response.)
0 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.
dExisting
Environmental Permits
✓❑ NPDES (discharges to surface
water)
❑ RCRA (hazardous waste)
❑ UIC (underground injection
control)
E
NCO088765
t?
❑ PSD (air emissions)
❑ Nonattainment program (CAA)
❑ NESHAPs (CAA)
a
W
❑ Ocean dumping (MPRSA)
❑ Dredge or fill (CWA Section
❑ Other (specify)
404)
Page 1

NPDES Permit Number
Facility Name
Modified Application Form 2A
NCOOE&766
Tuckaseegee RV Resort
Modified March 2021
1.7
Provide the collections stem information requested below for the treatment works.
Municipality
Population
Collection System Type
Served
Served
indicate percentage)
Ownership Status
-o
Tuckaseegee RV
Private Facility
100 %separate sanitary sewer
O Own ❑ Maintain
Z
Resort
% combined storm and sanitary sewer
❑ Own ❑ Maintain
❑ Unknown
❑ Own ❑ Maintain
`o
% separate sanitary sewer
❑ Own ❑ Maintain
'A
% combined storm and sanitary sewer
❑ Own ❑ Maintain
o
❑ Unknown
❑ Own ❑ Maintain
a°
% separate sanitary sewer
❑ Own ❑ Maintain
_ % combined storm and sanitary sewer
❑ Own ❑ Maintain
E
❑ Unknown
❑ Own ElMaintain
2
% separate sanitary sewer ❑ Own ❑ Maintain
rn
% combined storm and sanitary sewer ❑ Own ❑ Maintain
o`
ElUnknown ElOwn ❑ Maintain
Total Private Facility
Population
0
Served
Separate Sanitary Sewer System Combined Storm and
Sanita Sewer
Total percentage of each type of
sewer line in miles
100 %
o
2
1.8
Is the treatment works located in Indian Country?
c
o'
ca
❑ Yes 21 No
1.9
Does the facility discharge to a receiving water that flows through Indian Country?
v
c
❑ Yes No
1.10
Provide design and actual flow rates in the designated spaces.
Design Flow Rate
0.0042 mgd
m
aAnnual
Average Flow Rates Actual
e
Two Years Ago
Last Year
This Year
c
u
0.0014 mgd
o.00la mgd
0.0014 mgd
d
Maximum Daily Flow Rates Actual
Two Years Ago
Last Year
This Year
0.0014 mgd
0.0014 mgd
0.0014 mgd
1.11
Provide the total number of effluent discharge points to waters of the State of North Carolina by type.
g
Total Number of Effluent Discharge Points by Type
d
Combined Sewer
Constructed
El
Treated Effluent
Untreated Effluent
Overflows
Bypasses
YP
Emergency
9 Y
u '
Overflows
a
'0
1
Page 2

NPDES Permit Number
Facility Name
Madded Application Form 2A
NCO088765
Tuckaseegee RV Resort
Modified March 2021
Outfalls Other Than to Waters of the State of North Carolina
1.12
Does the POTIN 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 Impoundment Location and Discharge
Data
Location
Average Daily Volume
Discharged to Surface
Continuous or Intermittent
Impoundment
check one)
(
❑ Continuous
gpd
❑ Intermittent
❑ Continuous
gpd
❑ Intermittent
gpd
ElContinuous
v
❑ Intermittent
1.14
Is wastewater applied to land?
g
❑ Yes ❑✓ No 4 SKIP to Item 1.16.
c
1.15
Provide the land application site and discharge data requested below.
2
Land Application Site and Discharge Data
IS
Location
Size
Average Daily Volume
Continuous or
Intermittent
0
La
Applied
check one
a
acres
9p d
❑ Continuous
c
❑ Intermittent
d
acres
gpd
❑ Continuous
❑ Intermittent
°
acres
gpd
❑ Continuous
❑ Intermittent
1.16
Is effluent transported to another facility for treatment prior to discharge?
o'
❑ Yes No 4 SKIP to Item 1.21.
1.17
Describe the means by which the effluent is transported (e.g., tank truck, pipe).
1.18
Is the effluent transported by a party other than the applicant?
❑ Yes ❑ No + SKIP to Item 1.20.
1.19
Provide information on the transporter below.
Trans orter Data
Entity name
Mailing address (street or P.O. box)
City or town
State
ZIP code
Contact name (first and last)
Title
Phone number
Email address
Page 3

NPDES Permit Number
Facility Name
Modified Application Form 2A
NC0088765
Tuckaseegee RV Resort
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.
Recelvina Facilltv Data
Facility name
Mailing address (street or P.O. box)
Z
City or town
State
ZlPcode
0
c.�
Contact name (first and last)
Title
0
s
Phone number
Email address
"g
NPDES number of receiving facility (if any) ❑ None
Average daily flow rate mgd
w
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
not have outlets to waters of the State of North Carolina (e.g., underground percolation, underground injection)?
LM
M
❑ Yes ❑ No 4 SKIP to Item 1.23.
0
—"
0
1.22
Provide information in the table below on these other disposal methods.
ffi
Information on Other Dis osal Methods
SDisposal
v
Method
Location of
Size of
Annual Average
Daily Discharge
Continuous or Intermittent
V
Descriion
Disposal Site
Disposal Site
Volume
(check one)
s
acres
gpd❑
❑ Continuous
o
Intermittent
acres
gpd
❑ Continuous
❑ 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.
Consult with your NPDES permitting authority to determine what information needs to be submitted and when.)
W
❑ Discharges into marine waters (CWA ❑ Water 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 +SKIP 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
V
wm an name
Environmental, Inc
€
Mailing address
`c
street or P.O. box
PO BOX 954
City, state, and ZIP
7oi
Code
Cullowhee, NC 28723
o0
Contact name (first and
last
Mark Tea ue
g
Phone number
[phone]
Email address
[e-mail]
Operational and
Operations Only
maintenance
responsibilities of
contractor
Page 4

NPDES Permit Number Facility Name Modified Application Form 2A
NCO088765 Tuckaseegee RV Resort Modified March 2021
SECTION 2. ADDITIONAL INFORMATION (40 CFR 122.210)(1) and (2))
c Outfalls to Waters of the State of North Carolina
2.1
Does the treatment works have a design flow greater than or equal to 0.1 mgd?
❑ 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
a
and infiltration.
gpd
c
Indicate the steps the facility is taking to minimize inflow and infiltration.
v
C
W
3
0
c
c
L
2.3
Have you attached a topographic map to this application that contains all the required information? (See instructions for
A A
specific requirements.)
o �
c
�
❑ Yes ❑ No
A
2.4
Have you attached a process flow diagram or schematic to this application that contains all the required information?
0
(See instructions for specific requirements.)
LL m
c
❑ Yes ❑ No
2.5
Are improvements to the facility scheduled?
❑ Yes ❑ No + SKIP to Section 3.
Briefly list and describe the scheduled improvements.
0
A
1.
c
m
E
n
E
2.
O
d
3.
H
4.
9
`m
2.6
Provide scheduled or actual dates of com letion for improvements.
Scheduled or Actual Dates of Completion for Improvements
Scheduled
Affected d
OudQ
Begin
End
Begin
Attainment of
Operational
0
Improvement
(list l
Construction
Construction
Discha a
�rn
Level
E
.�
from above
( )
number
bee)
(MM/DD/YYYY)
(MM/DD/YYYY)
(MM/DD/YY
MMIDD/YYY
v
m
u
y
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:
Page 5

¢o remm numuer raauty Name Modified Application Form 2A
NCO088765 I Tuckaseegee RV Resort Modified March 2021
SECTION•'
• ON r 1
m77
rovide the following information for each ouffall. (Attach additional sheets if you have more than three outalls.)
Outfall Number 001
Outfall Number _
Outfall Number
State
North Carolina
County
Jackson
O
`o
City or town
Whittier
c
Distance from shore
ft.
ft.
ft.
n
.c
Depth below surface
ft.
ft.
ft
0
Average daily flow rate
0.0014 mgd
mgd
mgd
Latitude
35° 24' 12"
"
Longitude
83` 19, 07"
"
3.2
Do any of the ouffalls described under Item 3.1 have seasonal or periodic discharges?
W
0
❑ Yes ❑� No + SKIP to Item 3.4.
m
t3.3
If so, provide the following information for each applicable ouffall.
u
3
Outfall Number_
Outfall Number_
Outfall Number_
Number of times per year
C
discharge occurs
a
Average duration of each
o`
discharge (specify units
Average flow of each
W
dischar a
an g d
mgd
g
mgd
an
h
Months in which discharge
occurs
3.4
Are any of the outalls listed under Item 3.1 equipped with a diffuser?
❑ Yes 0 No + SKIP to Item 3.6.
3.5
Briefly describe the diffuser I pe at each aotolicable ouffall.
n
Outfall Number_
Outfall Number_
Outfall Number
m
'o
ui
3.6
Does the treatment works discharge or plan to discharge wastewater to waters of the State of North Carolina from
m
one or more discharge points?
3
H Yes ❑ No +SKIP to Section 6.
RECEIVE®
APR 10 2023
Page 6
NCDEQ/DWR/NPDES

NPDES Permit Number
Facility Name
Modred Application Form 2A
NCO088765
Tuckaseegee RV Resort
Modred 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
Tuckasegee River
Name of watershed, river,
g
or stream system
Little Tennessee River Basin
U.S. Soil Conservation
Servicel4-digit watershed
o
code
3
rn
Name of state
management/river basin
Little Tennessee River Basin
U.S. Geological Survey
8-digit hydrologic
06010202
cataloging unit code
Critical low flow (acute)
cis
cis
cfs
Critical low flow (chronic)
cfs
cfs
cfs
Total hardness at critical
mglL of
mg/L of
mglL of
low flow
CaCO3
CaCO3
CaCO3
3.8
Provide the following information describing the treatment provided for discharges from each outfall.
Outfall Number_
Outfall Number
Outfall Number_
Highest Level of
❑ 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)
C
O
'n
Design Removal Rates by
Outfall
w
w
BODs or CBODs
%
%
%
c
E
E
TSS
%
%
%
❑ Not applicable
❑ Not applicable
❑ Not applicable
Phosphorus
%
%
%
❑ Not applicable
❑ Not applicable
❑ Not applicable
Nitrogen
%
"fie
%
Other (specify)
❑ Not applicable
❑ Not applicable
❑ Not applicable
%
%
Page 7

NPDES Permit Number
Facility Name
Modified Application Fun 2A
NCOOSS765
Tuckaseegee RV Resort
Modified March 2021
3.9
Describe the type of disinfection used for the effluent from each ouffall in the table below. If disinfection varies by
season, describe below.
v
d
c
c
0
U
S
Outfall Number 001
Outfall Number_
Outfall Number_
n
Disinfection type
Calcium H ypochlorite
U
N
m
Seasons used
Year Round
E
E
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 ouffall number or of the receiving water near the discharge points.
Outfall Number_
Outfall Number_
Outfall Number_
Acute 7Chronic
Acute
Chronic
Acute
Chronic
A
A
Number of tests of discharge
rn
water
F
Number of tests of receiving
water
a
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 + 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 No additional sampling required by NPDES
permittingauthority.
Page 8

NPDES Perron Number
Facility Name
Modred Application Form 2A
NCO088765
Tuckaseegee RV Resort
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 ❑ 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?
4 Provide results in Table E and SKIP to
❑ Yes El
Item 3.26.
Item
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/DDIYYYY
c
E
0
�
3.22
Regardless of how you provided our WET testing data to the NPDES permitting authority, did an of the tests result in
9 Y P Y 9 P 9 Y� Y
$
toxicity?
c
❑ Yes ❑ No + SKIP to Item 3.26.
F
3.23
Describe the cause(s) of the toxicity:
d
w
3.24
Has the treatment works conducted a toxicity reduction evaluation?
❑ Yes ❑ No + 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 ❑ Not applicable because previously submitted
information to the NPDES Dermittina authority.
Page 9

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NPDES Permit Number Facility Name Modified Application Form 2A
NC0088765 Tuckaseegee RV Resort Modified March 2021
SECTION1
CERTIFICATION STATEMENT 140 and r
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
❑ w/variance request(s) Elw/additional attachments
Information for All A licants
0 Section 2: Additional
❑ w/ topographic map ❑ w/ process flow diagram
Information
❑ w/ additional attachments
❑✓ w/ Table A ❑ w/ Table D
O Section 3: Information on
❑ w/ Table B ❑ w/ additional attachments
Effluent Discharges
E
❑ w/ Table C
d
Section 4: Not Applicable
c
0
=
Section 5: Not Applicable
r
m
v
A
Section 6: Checklist and
w/attachments
CertificationStatement
,Z
6.2
Certification Statement
ci
d
�
1 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
Signature
Date signed
'
y I5Ia3
Page 10