WQ0002829_Other_20100322

PROCEDURE 4 REQUEST FORM
SURFACE WATER PROTECTION SECTION
WASHINGTON REGIONAL OFFICE
TO David May - Washington Aquifer Regional Supervisor Date: 3119/10
FROM Thom Edgerton
252-948-3955
252-946-9215 (FAX)
thom.ed4ertonancdenr.Qov
Application Number:
Applicant
Project Name:
Project Type:
Flow Type
County: Dare
KDHVWYTP, LLC
Colony IV Motel, ON Trading Corp. Sewer
Fast -Track ® Pressure Sewer ❑ Name Change ❑
Change of Ownership ❑
Pump Station/Force Main ® Vacuum Sewer ❑
Gravity Sewer ❑
DOM ® COM ❑ IND ❑
Receiving Facility: KDHWVVTP, LLC
Receiving Facility Permit WO0002829
Flow Volume (GPD): 10,770 GPD Engineer: Michael W. Robinson, PE (Michael W.
Robinson, PE, PO Box 2852 (104 Jester Court), Kill Devil Hills, NC 27948) [phone]
SOC Project?
❑ YES
NO
❑
SEPA Project
❑ YES
NO
❑ FONSI Issued? ❑ YES ❑ NO
Pretreatment Program?
❑ YES
NO
❑ Other Issues:
..................................................................
WWTP Approval:
-RrYES ❑ NO
Disp. Method (Spray, Drip, etc.) Approval: ❑ YES ❑ NO ❑N/A
Comments:
Regional Office Signature: 3�,��