NC0024805_Renewal (Application)_20150806

NPDES APPLICATION FOR PERMIT RENEWAL - FORM D
For privately owned treatment systems treating 100% domestic wastewaters <0.1 MGD --
Mail the complete application to:
N. C. Department of Environment and Natural Resources
Division of Water Quality / NPDES Unit
1617 Mail Service Center, Raleigh, NC 27699-1617
NPDES Permit NC0024805
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:
RECEIVED/DENR/DWR
Owner Name NC DOT Roadside Environmental Unit AUG ' 2015
Facility Name NC DOT Welcome Center/Rest Area Water Quality
Permitting Sectior
Mailing Address 253 Webster Rd.
City Sylva
State / Zip Code NC 28779
Telephone Number [phone]
Fax Number [phone]
e-mail Address [e-mail]
2. Location of facility producing discharge:
Check here if same address as above ❑
Street Address or State Road NC DOT Welcome Center/Rest Area
City Off of I-40 EB MM 10
State / Zip Code North of Walters Lake
County Haywood
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 NC DOT Roadside Environmental Unit
Mailing Address 253 Webster Rd.
City Sylva
State / Zip Code NC 28779
Telephone Number [phone]
Fax Number [phone]
1 of 4 Form-D 1/06
1

NPDES APPLICATION FOR PERMIT RENEWAL - FORM D
For privately.owned treatment systems treating 100% domestic wastewaters <0.1 MGD
4. Description of wastewater:
Facility Generating Wastewater(check all that apply):
Industrial ❑ Number of Employees
Commercial ❑ Number of Employees
Residential ❑ Number of Homes
School ❑ Number of Students/Staff
Other ® Explain: Rest Area
Describe the source(s) of wastewater (example: subdivision, mobile home park, shopping centers,
restaurants, etc.):
NC DOT Welcome Center/Rest Area
Population served:
5. Type of collection system
® 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) (Provide a map showing the exact location of each outfall):
Pigeon River in the French Broad River Basin. Doesn't discharge directly into stream.
8. Frequency of Discharge: ® Continuous ❑ Intermittent
If intermittent:
Days per week discharge occurs: Duration:
9. Describe the treatment system
List all installed components, including capacity,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.
Dual Unit Extended Aireation Type Secondary Plant of.026 GPD with
Flow Equalization Tank & Sludge Holding Tank
2 of 4 Form-D 1/06

NPDES APPLICATION FOR PERMIT RENEWAL - FORM D
For privately owned treatment systems treating 100% domestic-wastewaters <0.1 MGD
10. Flow Information:
• Treatment Plant Design flow .026 MGD •
Annual Average daily flow .010 MGD (for the previous 3 years)
Maximum daily flow .021 MGD (for the previous 3 years)
11. Is this facility located on Indian country?
❑ Yes ® 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 sampling shall be used. Effluent testing data must be based on at least three samples
and must be no more than four and one half years old.
Parameter Daily Monthly Units of Number of
Maximum Average Measurement Samples
Biochemical Oxygen Demand 45 30 mg/1 2/Month
(BODS)
Fecal Coliform NA NA NA NA
Total Suspended Solids 45 30 mg/1 2/Month
Temperature (Summer) NL NL C Weekly
•
Temperature (Winter) NL NL C Weekly
pH NA NA NA NA
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 NC0024805 Dredge or fill (Section 404 or CWA)
PSD (CAA) Special Order of Consent (SOC) •
Non-attainment program (CAA) Other
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.A�
Itiv
Printed name of Person Signing Title
3 of 4 Form-D 1/06

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NPDES APPLICATION FOR PERMIT RENEWAL - FORM D
For privately owned treatment systems treating 100% domestic wastewaters <0.1 MGD ---
��iw T
ignat of Applicant ate
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 knowly 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.)
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4 of 4 Form-D 1/06

NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory Donald R. van der Vaart
• Governor Secretary
August 10, 2015
Alan James
NC DOT
NC DOT Welcome Center/Rest Area •
253 Webster Rd.
Sylva,NC 28779
Subject: Acknowledgement of Permit Renewal
Permit NC0024805
Haywood County
Dear Permittee:
The NPDES Unit received your permit renewal application on August 6, 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 Maureen
Kinney at(919) 807-6388. •
•
Sincerely,
W re vv T -€4f oro1
Wren Thedford
Wastewater Branch
cc: Central Files
Asheville 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 Opportunity1Afrirmative Action Employer