NC0059421_Renewal (Application)_20170327

4
Water Resources
ENVIRONMENTAL QUALITY
March 27, 2017
Mr. Aubrey Deaver, President
A&D Water Services, Inc.
PO Box 1407
Pisgah Forest, NC 28768
Subject: Permit Renewal
Application No. NCO059421
Sapphine Lake WWTP #1
Transylvania County
Dear Mr. Deaver:
ROY COOPER
Governor
MICHAEL S. REGAN
Secrelmy
S. JAY ZIMMERMAN
Director
The Water Quality Permitting Section acknowledges receipt of your permit application and
supporting documentation received on March 27, 2017. The primary reviewer for this renewal
application is Sarah Phillips.
The primary reviewer will review your application, and she • 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 Sarah Phillips at 919-807-6479 or [e-mail].
cc: Central Files
NPDES
Asheville Regional Office
Sincerely,
?A" %Ciec#vn
Wren Thedford
Wastewater Branch
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. Department of Environment and Natural Resources
Division of Water Quality / NPDES Unit
1617 Mail Service Center, Raleigh, NC 27699-1617
NPDES Permit XPP059421
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
A & D Water Service, Inc.
Facility Name
Sapphire Lakes WWTP #1
Mailing Address
P.O. Box 1407
City
Pisgah Forest
State / Zip Code
N.C. 28768
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 Off US 64 at Sapphire Lakes Subdivision
City Sapphire
State / Zip Code N.C. 28774
County Transylvania
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 A & D Maintenance , Inc.
Mailing Address P.O. Box 1407
City Pisgah Forest
State / Zip Code N.C. 28768
Telephone Number [phone]
Fax Number [phone]
1 of 4 Form -D 1106

NPDES APPLICATION - FORM D
For privately -owned treatment systems treating 100% domestic wastewaters <1-0 MGD
4. Description of wastewater:
Facilitv Generating Wastewater(check all that applyJ:
Industrial
❑
Number of Employees f
Commercial
❑
Number of Employees
Residential
X
Number of Homes 74
School
❑
Number of Students/ Staff l
Other
❑
Explain:
Describe the source(s) of wastewater (example: subdivision, mobile home park, shopping centers,
restaurants, etc.): j
Residential Subdivision
. j
Number of persons served: 108
5. Type of collection system 1
X Separate (sanitary sewer only) ❑ Combined (storm sewer and sanitary sewer) }
i
6. Outfall Information: j
Number of separate discharge points 1
Outfall Identification number(s) 001
Is the outfall equipped with a diffuser? ❑ Yes X No
7. Name of receiving stream(s) (NEW applicants: Provide a map showing the exact location of each
outfall):
Horsepasture River
S. Frequency of Discharge: X Continuous ❑ Intermittent
If intermittent:
Days per week discharge occurs: Duration:
9. Describe the treatment system 1 .
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. i
Eq basin, conventional activated sludge, chlorination, chlorine contact chamber, dechlor
and flow metering basin. f
2 of 3 i Form -011112

NPDES APPLICATION - FORM D
;_ ► For privately -owned treatment systems treating 100% domestic wastewaters <1.0 MGD
10. Flow Information:
Treatment Plant Design flow 0.025 MGD
Annual Average daily now 0.0047 MGD (for the previous 3 years)
Maximum daily flow 0.0162 MGD (for the previous 3 years)
11. Is this facility located on Indian country?
❑ Yes X No
12. Effluent Data
11EW 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 uour permit_ Mark nthor nnrnmAtorc anriA-'
Parameter
Daily
Maximum
Monthly
Average
Units of
Measurement
Biochemical Oxygen Demand (BODS)
9.5
4.7
rng/l
Fecal Coliform
34
3.5
/ 100 ml
Total Suspended Solids
33
21
mg/l
Temperature (Summer)
23
N/A
c
Temperature (Winter)
N/A
N/A
c
pH
7.0
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)
NCO059421
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.
Aubrey Deaver President
Printed name of Person Signing Title
Applicant
111?5
Date
FIVA
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