NC0068799_Renewal (Application)_20150827

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 NC0068799
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:
Owner Name Greystone Enterprise, Inc.
Facility Name Greystone Subdivision
Mailing Address 9 Greystone Drive RECEIWECJIDENR/DWR
City Hendersonville AUG 2 7 2015
State / Zip Code NC 28792
Water Quality n
Telephone Number 828-693-5534 'ermitting Sego
Fax Number
e-mail Address 9jsi‘e AloSt e SQA • co
2. Location of facility producing discharge:
Check here if same address as above X
Street Address or State Road
City
State / Zip Code
County Henderson
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 Greystone Enterprise, Inc.
Mailing Address 9 Greystone Drive
City Hendersonville
State / Zip Code NC 28792
Telephone Number 828-693-5534
Fax Number I j, I
e-mail Address Ce S 1b�l t vv♦ -1 v tco
1 of 3 Form-D 11112

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 X Number of Homes Gj
School Number of Students/Staff
Other Explain: Nursing Home
Describe the source(s) of wastewater (example: subdivision, mobile home park, shopping centers,
restaurants, etc.):
Subdivision
Number of persons served:
5. Type of collection system
X Separate (sanitary sewer only) ❑ Combined (storm sewer and sanitary sewer)
6. Outfall Information:
Number of separate discharge points 1
Outfall Identification number(s) 001
Is the outfall equipped with a diffuser? ❑ Yes No
7. Name of receiving stream(s) (NEW applicants:Provide a map showing the exact location of each
outfall):
Clear Creek in the French Broad River Basin
8. Frequency of Discharge: X Continuous ❑ Intermittent
If intermittent:
Days per week discharge occurs: Duration:
9. Describe the treatment system
List all installed components, including capacities,provide design removal for BOD, TSS, nitrogen and
phosphorus. If the space provided is not sufficient, attach the description of the treatment system in a
separate sheet of paper.
A 0.0217 MGD facility with bar screen, aeration basin with dual blowers, dual hopper
clarifier with skimmer, sludge return line, effluent weir, sludge holding tank, outfall line.
2 of 3 Form-D 11112

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NPDES APPLICATION - FORM D
For privately-owned treatment systems treating 100% domestic wastewaters <1.0 MGD
10. Flow Information:
Treatment Plant Design flow 0.0217 MGD
Annual Average daily flow 0.0140 MGD (for the previous 3 years)
Maximum daily flow 0.0150 MGD (for the previous 3 years)
11. Is this facility located on Indian country?
❑ Yes X No
12. Effluent Data
NEW APPLICANTS:Provide data for the parameters listed. Fecal Coliform, Temperature and pH shall be grab
samples,for all other parameters 24-hour composite sampling shall be used. If more than one analysis is reported.
report daily maximum and monthly average. If 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 other parameters "N/A".
Parameter Daily Monthly Units of
Maximum Average Measurement
Biochemical Oxygen Demand (BOD;) 11.3 7.1 MG/L
Fecal Coliform 200 4.5 CFU/100ML
Total Suspended Solids 42.1 31.3 MG/L
Temperature (Summer) 25.7 22.5 C
Temperature (Winter) 16.1 11.3 C
pH 7.4 7.0 units
13. List all permits, construction approvals and/or applications:
Type Permit Number Type Permit Number
Hazardous Waste (RCRA) NESHAPS (CAA)
UIC (SDWA) Ocean Dumping(MPRSA)
NPDES NC0068799 Dredge or fill (Section 404 or CWA)
PSD (CAA) Other
Non-attainment program (CAA)
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.
CA04- s Qse
e-eAr, '
Printed name of Person Signing Title
f >!► g -25- 15
Signature of Applicant Date
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.)
3 of 3 Form-D 11112

• A
NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory Donald R. van der Vaart
Governor Secretary
September 04,2015
Charles E. Osteem,President
Greystone Enterprise, Inc.
Greyston Subdivision
9 Greystone Drive
Hendersonville,NC 28792
Subject: Acknowledgement of Permit Renewal
Permit NC0068799
Henderson County
Dear Permittee:
The NPDES Unit received your permit renewal application on August 27, 2015. A member of the
NPDES Unit will review your application. They will contact you if additional information is required to
complete your permit renewal. You should expect to receive a draft permit approximately 30-45 days
before your existing permit expires.
If you have any additional questions concerning renewal of the subject permit, please contact Derek
Denard at(919) 807-6307.
Sincerely,
W re4 Yke of f o-rot,
Wren Thedford
Wastewater Branch
cc: Central Files
Mooresville Regional Office
NPDES Unit
1617 Mail Service Center,Raleigh,North Carolina 27699-1617
Location:512 N.Salisbury St.Raleigh,North Carolina 27604
Phone:[phone] Fax:[phone]/Customer Service:1-877-623-6748
Internet::www.ncwater.orq
An Equal Opportunity'Affirmative Action Employer