NC0070033_Renewal Application_20181214

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M[CHAEL S_REGAN
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LINDA CULPEPPER
Interim Director
January 08, 2019
Rodney Sides
Frog Level Industries Inc
PO Box 208
Lewisville, NC 27023-0208
Subject: Permit Renewal
Application No. NC0070033
Quail Run Mobile Home Park
Davidson County
Dear Applicant:
The Water Quality Permitting Section acknowledges the December 21, 2018 receipt of your permit renewal application
and supporting documentation. Your application will be assigned to a permit writer within the Section's NPDES WW
permitting branch. 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.The
permit writer will contact you if additional information is required to complete your permit renewal. Please respond in a
timely manner to requests for additional information necessary to allow a complete review of the application and renewal
of the permit.
Information regarding the status of your renewal application can be found online using the Department of Environmental
Quality's Environmental Application Tracker at:
https://deq.nc.gov/permits-regulations/permit-guidance/environmental-application-tracker
If you have any additional questions about the permit, please contact the primary reviewer of the application using the
links available within the Application Tracker.
Sincerely,
,SPIAL\
Wren Thedford
Administrative Assistant
Water Quality Permitting Section
ec: WQPS Laserfiche File w/application
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North Carolina Department of Environmental Quality I Division of Water Resources
1617 Mail Service Center I Raleigh,North Carolina 27699-1617
919-807-6300

Frog Level Industries,Inc.
2559 West Clemmonsville Road
Winston-Salem,NC 27127
Mailing Address:
PO Box 208
Lewisville,NC 27023
December 14,2018
Wren Thedford
NC DENR/DWR/NPDES Unit
1617 Mail Service Center
Raleigh,NC 27699-1617
NPDES Permit Renewal for Quail Run Mobile Home Park
Mr. Thedford,
Please fmd attach our completed NPDES Application—Form D for Quail Run Mobile
Home Park and a brief narrative on sludge management. There have been no changes to
the system over the past 5 years. Please let me know if you need any additional
information.
Sincerely,
R-
Rodney R. Sides
Owner

NPDES APPLICATION - FORM D
For privately-owned treatment systems treating 100% domestic wastewaters <1.0 MGD
Mail the complete application to:
NC DEQ / DWR / NPDES
1617 Mail Service Center, Raleigh, NC 27699-1617
NPDES Permit INC0070033
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 Frog Level Industries Inc.
Facility Name Quail Run Mobile Home Park
Mailing Address PO Box 208
City Lewisville
State / Zip Code North Carolina, 27023
Telephone Number [phone]
Fax Number ( )
e-mail Address [e-mail]
2. Location of facility producing discharge:
Check here if same address as above ❑
Street Address or State Road 136 Quail Place Drive
City Winston-Salem
State / Zip Code NC, 27127
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 Luther Leonard
Mailing Address 502 Northside Drive
City Lexington
State / Zip Code NC, 27295 J
Telephone Number [phone]
Fax Number ( )
e-mail Address [e-mail]
1 of 3 Form-D 6/2017

.
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 45
School El 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: 180
5. Type of collection system
X Separate (sanitary sewer only) El Combined (storm sewer and sanitary sewer)
6. Outfall Information:
Number of separate discharge points 1
Outfall Identification number(s) Outfall 1
Is the outfall equipped with a diffuser? El Yes X No
7. Name of receiving stream(s) (NEW applicants:Provide a map showing the exact location of each
outfall):
Miller Creek, currently classified C waters in subbasin 03-07-04 of the Yadkin-Pee Dee River Bas
8. Frequency of Discharge: X Continuous ❑ Intermittent
If intermittent:
Days per week discharge occurs: Duration:
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.
• Two 3,200 gallon septic tanks
• 4,000 gallon septic tank
• Two 4,500 gallon septic tanks
• 8,400 gallon re-circulating dosing tank
• 4,250 square ft recirculating surface sand filter
• Tablet chlorinator
• 350 gallon chlorine contact tank
2 of 3 Form-D 6/2017

•
NPDES APPLICATION - FORM D
For privately-owned treatment systems treating 100% domestic wastewaters <1.0 MGD
10. Flow Information:
Treatment Plant Design flow .017 MGD
Annual Average daily flow .0034 MGD (for the previous 3 years)
Maximum daily flow .0039 MOD (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 permit. Mark other parameters "N/A".
Parameter Daily Monthly Units of
Maximum Average Measurement
Biochemical Oxygen Demand (BOD5) 18.7 7.8 MG/L
Fecal Coliform 19.4 1.82 #/100ML
Total Suspended Solids 13.6 5.8 MG/L
Temperature (Summer) 25 22.5 C
Temperature (Winter) 20 14.5 C
pH 6.8 6.6 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 NC0070033 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.
Rodney R Sides Owner
Printed name of Per.on Signing Title
4.6),/ /Z-ly-G�
Signat re 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 6/2017

s s
Frog Level Industries,Inc.
Quail Run Mobile Home Park
Sludge Management Plan
As part of the waste management system for the mobile home park,we utilize 5 septic tanks to collect
the solids. Those tanks are pumped on a quarterly basis by an independent septic hauler on a quarterly
basis. These solids are then taken to the municipal waste water treatment plant for disposal.