NC0059251_Renewal (Application)_20170220

Y
r.
Water Resources
ENVIRONMENTAL QUALITY
February 20, 2017
Mr. Lee Simaan
Quail Acres Mobile Home Parke
PO Box 549
Summerfield, NC 27358
Subject: Permit Renewal
Application No. NCO059251
Quail Acres Mobile Home Park
Rockingham County
Dear Mr. Simaan:
ROY COOPER
Governor
MICHAEL S. REGAN
secretory
S. JAY ZIMMERMAN
Director
The Water Quality Permitting Section acknowledges receipt of your permit application and
supporting documentation received on February 17, 2017. The primary reviewer for this renewal application
is John Hennessy.
The primary reviewer will review your application, and he 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 Mr. Hennessy at 919-807-6377 or [e-mail].
Sincerely,
Wren Thedford
Wastewater Branch
cc: Central Files
NPDES
Winston-Salem Regional Office
State of North Carolina I Environmental Quality I Water Resources
1617 Mail Service Center I Raleigh, North Carolina 27699-1617
919-807-6300

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 C0059251
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 Lee Simaan
Facility Name Quail Acres Mobile Home Park
Mailing Address PO box 549
City Summerfield
State / Zip Code NC 27358®�R
Telephone Number (336-382-6783)
Fax Number NA 7 2017
e-mail Address [e-mail]8 81111
vormittitlq sedo11
2. Location of facility producing discharge:
Check here if same address as above ❑
Street Address or State Road Quail Acres Dr.
City Stokesdale
State / Zip Code
County
NC
Rockingham
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 Meritech Inc.
Mailing Address
PO Box 27
City
Reidsville
State / Zip Code
NC 27323
Telephone Number
336-342-4748
Fax Number
336-342-1522
e-mail Address
[e-mail]
1 of 3
Form -D 11/12

u 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 72
School
❑
Number of Students/Staff
Other
❑
Explain:
Describe the source(s) of wastewater (example: subdivision, mobile home park, shopping centers,
restaurants, etc.):
Mobile Home Park
Number of persons served: 300
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? X Yes ❑ No
7. Name of receiving stream(s) (NEW applicants: Provide a map showing the exact location of each
outfall):
Unnamed tributary to Hogan's Creek in the Roanoke River Basin
S. Frequency of Discharge: ❑ Continuous X Intermittent
If intermittent:
Days per week discharge occurs: 7 Duration:. as pumps run
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.
WWTP Design consists of a series'of septic tanks gravity fed to a 15000 gallon dosing
tank.
From there influent is moved with 2 rotating submersible pumps to a 60 X 80 sand filter.
effluent is passed through tablet chlorination, through a diffused air contact chamber,
then through de -chlorination to the discharge, 001
2 of 3 Form -D 11/12

NPDES APPLICATION - FORM D
For privately -owned treatment systems treating 100% domestic wastewaters <1.0 MGD
10. Flow Information:
Treatment Plant Design flow 0.018 MGD
Annual Average daily flow 0.012 MGD (for the previous 3 years)
Maximum daily flow 0.026 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 nerm.it_ Mark other narnmetere "AT/ A"
Parameter
Daily
Maximum
Monthly
Average
Units of
Measurement
Biochemical Oxygen Demand (BODS)
27.3
3.28
Mg/1
Fecal Coliform
9.0
<1
#/ 100 ml
Total Suspended'Solids
18.0
2.2
Mg/1
Temperature (Summer)
28
23
Degrees C
Temperature (Winter)
18
11
Degrees C
pH
7.2
4.9 min
1-14 SU
13. List all permits, construction approvals and/or. applications:
Type Permit Number Type
Hazardous Waste (RCRA)
UIC (SDWA)
NPDES
PSD (CAA)
Non -attainment program (CAA)
NCO059251
14. APPLICANT CERTIFICATION
NESHAPS (CAA)
Ocean Dumping (MPRSA)
Dredge or fill (Section 404 or CWA)
Other
Permit Number
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.
David Merritt (for Lee Simaan/Ouail Acres) Vice President Meritech Inc
Printed name of Person Signing Title
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 11/12