NC0083925_Renewal Application_20180625

As. U
A.
----„....„
June 25,2018
Mr. John Hennessy, Supervisor RECEIVED/DENR/DWR
Compliance and Expedited Permitting Unit
DWR,NCDEQ JUL 16 2018
1617 Mail Service Center
Raleigh,NC 27699-1617 Water Resources
Permitting Section
Re: Application for Permit Renewal
Aqua North Carolina,Inc.
Salem Glenn Subdivision WWTP
NPDES Permit NC0083925
Dear Mr. Hennessy:
Enclosed are three (3) copies of the completed application Form D-WWTP. This submittal includes the
necessary attachments for your office to renew the subject permit.
If there are any questions or concerns with our request,please do not hesitate to contact me at
aaowens(aiaquaamerica.com or 919-653-6965.
Best regards,
JA(V1A-JaA-ail.-- 124/1/4"----Y
Amanda Owens
Manager,Environmental Compliance
cc: Laurie Ison
Joseph Pearce
Shannon Becker

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 NC0083925
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 AQUA NORTH CAROLINA, INC.
Facility Name SALEM GLEN SUBDIVISION WWTP
Mailing Address 202 MACKENAN COURT
City CARY
State / Zip Code NC 27511
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 Dock Davis Road
City CLEMMONS
State / Zip Code NORTH CAROLINA
County DAVIDSON
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 AQUA NORTH CAROLINA, INC
Mailing Address 202 MACKENAN COURT
City CARY
State / Zip Code NORTH CAROLINA 27511
Telephone Number [phone]
Fax Number [phone]
1 of 1 Form-D 05/08

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 ® Number of Homes 303
School ❑ Number of Students/Staff
Other ❑ Explain:
Descnbe_the source(s) of wastewater (example: subdivision, mobile home park, shopping centers,
restaurants, etc.):
This system serves residential customers only.
Population served: 770
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 0 No
7. Name of receiving stream(s) (Provide a map showing the exact location of each outfall):
Yadkin River, classified class WS-IV waters in the Yadkin-Pee Dee River Basin
8. Frequency of Discharge: ►1 Continuous ❑ Intermittent
If intermittent:
Days per week discharge occurs: Duration:
9.
10.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.
The 0.10 MGD extended-aeration package WW plant consist of the following:
• An effluent flow control chamber with bar screen
• A flow equalization tank
• Two (2) 50,000 gallon aeration basins with coarse air bubblers
• Two (2) rectangular clarifiers with air sludge wasting and return
• UV disinfection with backup tablet chlorination/declorination
• Effluent clear well
• Effluent pump station
• Flow measuring device
• Stationary Generator at the plant for backup power
2 of 2 Form-D 05/08

NPDES APPLICATION - FORM D
For privately owned treatment systems treating 100% domestic wastewaters<1.0 MGD
11. Flow Information:
Treatment Plant Design flow 0.10 MGD
Annual Average daily flow 0.059 MGD (for the-previous 3 years)
Maximum daily flow 0.30 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 shalLbe used. If more than one analysis is reported, report daily maximum
and monthly average. If only one analysis is reported, report as daily maximum.
Daily Monthly Units of
Parameter
Maximum Average Measurement
Biochemical Oxygen Demand (BODS) 28.9 14.96 MG/L
Fecal Coliform N/A N/A #/100ML
Total Suspended Solids 18.0 7.6 MG/L
Temperature (Summer) 27.3 23.6 °Celsius
Temperature (Winter) 20.0 14.4 ° Celsius
pH 7.6 N/A UNITS
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 N00083925 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 information_ contained in the application and that to the
best of my knowledge and belief such information is true, complete, and accurate.
Amanda A. Owens Manager, Environmental Compliance
Printed name of Person Signing Title
CE12—clig
Signature of Applicant Date
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 05/08