NC0075353_Renewal (Application)_20190313

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ROY COOPER ( --.0)"
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Governor 5o t r
MICHAEL S.REGAN - •,„,, . I
Secretary a ,.
LINDA CULPEPPER NORTH CAROLINA
Director Environmental-Quality
April 08, 2019
Linda Isaacs
McDowell Assisted Living LLC
PO Box 909
Marion, NC 28752-0909
Subject: Permit Renewal
Application No. NC0075353
McDowell Assisted Living WWTP
McDowell County
Dear Applicant:
The Water Quality Permitting Section acknowledges the March 13, 2019 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://dea.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,Si(
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Wren Thedford
Administrative Assistant
Water Quality Permitting Section
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James & James Environmental Management, Inc.
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RECE1VED/DENR/DWR
MAR132019
Water Reeourcea
Permitting Section
McDowell Assisted Living
NC0075353
Enclosed you will find your permit renewal. It is due to the state by 04/15/2019.
There are a couple of items that you will need to put on the form:
Section 1 &3 —fax number and email address if needed
Section 4—fill in number of employees, and the number of persons served
Section 13 —Print name&Title, sign& date
Original and 2 copies of everything enclosed needs to be sent to the address at the top of the lst
page of the Application Renewal. I have also included a letter requesting that the peiinit be
renewed, one letter stating the sludge removal plan and a map of the Outfall. These 2 letters can
be adapted if you would like to do your own. If there are changes that you would like me to
make, I can do that and email the corrected form back to you.
This packet needs to be mailed to the State as soon as possible. We do recommend that you mail
it Certified with Return Receipt requested. Also,please email or mail us a copy of the completed
application for our records. It will be several months before you receive your new permit from
the State. Once you receive the new permit,please send us a copy for our records as we do not
receive one from the State.
If you have questions,please give me a call at the number below.
Thank you,
aokuji, 090_2
Ashley Ogle
Administrative Assistant
James &James Environmental Management, Inc.
[e-mail]
828.697.0063
828.697.0065 -Fax

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 NC0075353
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 McDowell Assisted Living, LLC
Facility Name McDowell Assisted Living
Mailing Address P. O. Box 909
City Marion
State / Zip Code NC 28752
Telephone Number 828-652-3033
Fax Number [phone]
e-mail Address [e-mail]
2. Location of facility producing discharge:
Check here if same address as above 0
Street Address or State Road 5235 NC Highway 226 5o
City Marion
State / Zip Code NI 0•C6 i7 5 2
County McDowell
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 McDowell Assisted Living, LLC
Mailing Address P. O. Box 909
City Marion
State / Zip Code NC 28752
Telephone Number 828-652-3033
Fax Number [phone]
e-mail Address [e-mail]
1 of 3 Form-D 11/12

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 X Number of Employees aeo
Residential Number of Homes
School Number of Students/Staff
Other X Explain: Residents 4-9
Describe the source(s) of wastewater (example: subdivision, mobile home park, shopping centers,
restaurants, etc.):
Assisted Living Home
Number of persons served:
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? ❑ Yes X No
7. Name of receiving stream(s) (NEW applicants:Provide a map showing the exact location of each
outfall):
North Muddy Creek in Catawba River Basin •
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.
0.010 MGD facility with extended aeration basin, clarifier, chlorination equipment and
sludge digester
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 0.010 MGD
Annual Average daily flow 0.0014 MGD (for the previous 3 years)
Maximum daily flow 0.007 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 permit. Mark other parameters "N/A".
Parameter Daily Monthly Units of
Maximum Average Measurement
Biochemical Oxygen Demand (BOD5) 22.3 12.7 MG/L
Fecal Coliform 102 2.5 CFU/100ML
Total Suspended Solids 36.7 21.6 MG/L
Temperature (Summer) 27.1 24.9 C
Temperature (Winter) 14.0 13.0 C
pH 8.1 7.6 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 NC0075353 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.
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Printed name of Person Signing Title
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Signature of Applicant ate
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