NC0033251_Renewal (Application)_20160313

JONES ENVIRONMENTAL
Mark Jones
45 Pleasant Ct
Flat Rock NC 28731
828-273-0760
March 21,2016
Permit Renewal Request
To Whom It May Concern
Please fine enclosed a permit Renewal package for Camp Highlander(NPDES/NC 0033251).
This filtration system is not operational at this time,however the Owner would request the renewal. We
respectfully request this permit to be renewed. We also hope you find this package in order.
If we may be of further assistance please do not hesitate to call or correspond
Sincerely
)1
./ /
Marky)ot16s
Operartor in Resportsble Charge

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4.1
JONES ENVIRONMENTAL
March 21,2016
Signatory Authority/Authorized Representative
For the purpose of this permit renewal for Camp Highlander Sand Filtration System:
NPDES/NC0033251 evidenced by the signatures below.
•
X ' •
Mark l#Jones
Operator in Responsible`Charge
Karl T Alexander
Owner

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 Resources / NPDES Program
1617 Mail Service Center, Raleigh, NC 27699-1617
NPDES Permit NC0033251
If you are completing this form in computer use the TAB key or the up - down arrows to moue 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 Karl T Alexander
Facility Name Camp Highlander RECEIVEDNCL. FQ; ?'.'vR
Mailing Address 42 Dalton Road
APR 0 7 2:1t
City Horse Shoe
1"/atsr 0,1ality
State / Zip Code NC 28742 Perri;itt;rci Section
Telephone Number 828-891-7721
Fax Number 828-891-1960
e-mail Address
2. Location of facility producing discharge:
Check here if same address as above 0
Street Address or State Road
City
State / Zip Code
County
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 Mark B Jones
Mailing Address 45 Pleasant Court
City Flat Rock
State / Zip Code NC 28731
Telephone Number 828-273-0760
Fax Number None
Jonesenvironmentyahoo.com*
e-mail Address
Please note change in email address
1 of 4 Form-D 9/2013

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 0 Number of Employees
Commercial 0 Number of Employees
Residential ❑ Number of Homes
School ❑ Number of Students/Staff
Other ❑ Explain: Camp seasonal
Describe the source(s) of wastewater (example: subdivision, mobile home park, shopping centers,
restaurants, etc.):
Sporting and Recreational camp
Number of persons served:
5. Type of collection system
0 Separate (sanitary sewer only) 0 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
outfalls
South Fork Mills River, classified WS-II- Trout HQW waters in the French Broad River Basin
8. Frequency of Discharge: ❑ Continuous 0 Intermittent
If intermittent:
Days per week discharge occurs: No Flow Duration: No Flow
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.
2 of 4 Form-D 9/2013

NPDES APPLICATION - FORM D
For privately-owned treatment systems treating 100% domestic wastewaters <1.0 MGD
(2) 3500 gallons septic tanks
Dosing tanks
Parallel surface sand filters
Tablet chlorination
Tablet dechlorination
3 of 4 Form-D 9/2013

NPDES APPLICATION - FORM D
For privately-owned treatment systems treating 100% domestic wastewaters <1.0 MGD
10. Flow Information:
Treatment Plant Design flow .0074 MGD
Annual Average daily flow NA=Not operational MGD (for the previous 3 years)
Maximum daily flow NA- Not operational MOD (for the previous 3 years)
11. Is this facility located on Indian country?
❑ Yes ❑ 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;) 45 30 Mg/1
Fecal Coliform 400/100 200/100 M1
Total Suspended Solids 45 30 Mg/1
Temperature (Summer) 20 20 C°
Temperature (Winter) 20 20 C°
pH <6 to >9 <6 to >9 Su
*These are permit listed readings due to plant being not operational
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 NC0033251 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 i�nf�rmation contained in the application and that to the
best of my knowledge and be of such information is true, complete, and accurate.
Karl T Alexander /---- - / 7 Owner
P . e n;01e of P on fling --"7-
Title
-3/2. 1 / 1 L-
Signature of Applicant Date
_f
North Carolina General Statute 143-215.8(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.)
4 of 4 Form-0 9/2013

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Karl T. and Shelley McCoy Alexander Facilityr , ,� , .:.,
Camp Highlander WWTP J '- � '
Location ' ”
Latitude:• 35°22'28" N Stream Class: WS-1I Trout HQW, not to scale
_: Lon eituile:_82°-3b.5 :W.-_ :--.)VrainaeeBisin:-:.French.Broad River Basin
State Grid: Horseshoe Receiving Stream: UT to S Fork of Mills River North
Camp Highlander NC0033251
Sub-Basin: 04-03-03 06010105 Permitted Flow: 0.0074 MGD 1 Y iflrt/L Henderson County

PAT MCCRORY
DONALD R. VAN DER VAART
^ - Seen°rnr
S. JAY ZIMMERMAN
Water Resources
ENVIRONMENTAL QUALITY
April 13, 2016
Karl T. Alexander
Camp Highlander
42 Dalton Road
Horse Shoe,NC 28742
Subject: Acknowledgement of Permit Renewal
Application No. NC0033251
Camp Highlander
Henderson County
Dear Permittee:
The Water Quality Permitting Section has received your permit renewal application on April 7,
2016. A member of the NPDES Unit will review your application. They will contact you if additional
information is required to complete your permit renewal. Per G.S. 150B-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. Please respond in a timely manner to
requests for additional information necessary to complete the permit application.
If you have any additional questions concerning renewal of the subject permit, please contact Joe
Corporon at 919-807-6394 or [e-mail].
Sincerely,
WreAtt,TIAzoLf o-Iro(,
Wren Thedford
Wastewater Branch •
cc: Central Files
NPDES
Asheville Regional Office
•State of North Carolina I Environmental Quality I Water Resources
1617 Mail Service Center Raleigh,North Carolina 27699-1617
919-807-6300