NC0073571_Authorization to Construct_19890623

State of North Carolina
Department of Natural Resources and Community Development
Division of Environmental Management
512 North Salisbury Street • Raleigh, North Carolina 27611
James G. Martin, Governor
William W. Cobey, Jr., Secretary
June 23, 1989
Dr. Mervyn R. King, Owner
Countryside Village
7700 US HWY 158
Stokesdale, N. C. 27357
R. Paul Wilms
Direct
Subject: Permit No. NCO073571
Authorization to Construct
Countryside Village Retirement Center
Wastewater Treatment Facilities
Guilford County
Dear Dr. King:
� A letter of request for an Authorization to Construct was received on May 9, 1989, by the
Division and final plans and specifications for the subject project have been reviewed and found to
be satisfactory. Authorization is hereby granted for the construction of a 15,000 GPD wastewater
treatment facility which consists of a bar screen, a 7035 gallon aerated equalization tank, a 17, 772
gallon aeration tank, a 5686 gallon clarifier, a 4070 gallon sludge holding tank, a sludge air lift,
dual 95 CFM blowers, a tablet chlorinator and chlorine contact tank with thirty minutes detention,
an alum chemical feed system for phosphorus removal, an effluent step aerator (paved flume with
rip rap set in concrete), approximately 1034 linear feet of 6-inch gravity sewer line, and all other
appurtenances to serve the Countryside Village Retirement Center with the discharge of treated
wastewater into Troublesome Creek.
This Authorization to Construct is issued in accordance with Part III, paragraph B of
NPDES Permit No. N00073571, which became effective on March 1, 1989, and shall be subject
to revocation unless the wastewater treatment facilities are constructed in accordance with the
conditions and limitations specified in Permit No. NCO073571.
The Permittee shall employ a certified wastewater treatment plant operator to be in
responsible charge of the wastewater treatment facilities. Such operator must hold a certificate of
the grade at least equivalent to the classification assigned to the wastewater treatment facilities by
the Certification Commission. Within thirty days after the wastewater treatment facilities are 50
percent complete, the owner must submit a letter to the Certification Commission which designates
the operator in responsible charge. Questions regarding operator certification should be directed to
Mr. John Campbell at 919 / 733-5083.
Pollution Prevention Pays
P.O. Box 27687, Raleigh, North Carolina 27611-7687 Telephone [phone]
An Equal Opportunity Affirmative Action Employer

The sludge generated from these treatment facilities must be disposed of in accordance with
G.S. 143-215.1 and in a manner approvable by the North Carolina Division of Environmental
Management.
The Winston-Salem Regional Office, telephone number 919 / 761-2351 shall be notified at
least forty-eight (48) hours in advance of operation of the installed facilities. Such notification to
the Regional Supervisor shall be made during the normal office hours from 8:00 a.m. until 5:00
p.m. on Monday through Friday, excluding State holidays.
In the event that the facilities fail to perform satisfactorily in meeting its NPDES permit
effluent limits, the permittee shall take such immediate corrective action as may be required by this
Division, including the construction of additional wastewater treatment and disposal facilities.
Upon completion of construction and prior to operation of this permitted facility, a
certification must be received from a professional engineer certifying that the permitted facility has
been installed in accordance with the approved plans and specifications. Mail the Certification to
the Permits and Engineering Unit, P.O. Box 27687, Raleigh, NC 27611-7687.
A copy of the approved plans and specifications shall be maintained on file by the
Pemuttee for the life of the permit.
One (1) set of approved plans and specifications is being forwarded to you. If you have
any questions or need additional information, please contact Randy Jones, telephone number
919/733-5083.
Sincerely,
. Pain
cc: Guilford County Health Department
Winston-Salem Regional Office
WM. F. Freeman Assoc.
John Campbell
Permit No. NC0073571
Engineer's Certification
I, , as a duly registered Professional Engineer in the State of North
Carolina, having been authorized to observe (periodically, weekly, full time) the construction of the
project, for the
Project Name or Location
Perrnittee hereby state that, to the best of my abilities, due care and diligence was used in the
observation of the construction such that the construction was observed to be built within substantial
compliance and intent of the approved plans and specifications.
Signature Registration
OOON Date