NC0070289_Renewal (Application)_20190731

NPDES APPLICATION - FORM D
For privately -owned treatment systems treating 100 % domestic wastewaters <1.0 MOD
Mail the complete application to:
N. C. DENR / Division of Water Quality / NPDES Unit
1617 Mail Service Center, Raleigh, NC 27699-1617
NPDES Permit NCO070289
If you are completing this form in computer use the TAB key or the up - down arrows to moue from one
field to the next. To check the boxes, click your mouse on top of the bar. Otherwise, please print or type.
1. Contact Infernuatiom
Owner Name
Stones Throw HOA (Wayne Huntley)
Facility Name
Ridgewood Farms at Stones Throw
Mailing Address
PO Hoe 690725
City
Charlotte
State / Zip Code
NC/28227
Telephone Number
704-607-3506 (Verlene)
Fax Number
704-545-3374
e-mail Address
[e-mail]
2. Location of facility producing discharge:
Check here if same address as above ❑
Street Address or State Road Olde Creek Trail end of cul-de-sac
City Concord
State / Zip Code NC/28025
County Cabarrus
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 Environmental Process Solutions PLLC
Mailing Address 7000 Stinson Hartis Rd, Suite F
City Indian Trail
State / Zip Code NC/28079
Telephone Number [phone]
Fax Number (none)
e-mail Address [e-mail]
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NPDES APPLICATION - FORM D
For privately -owned treatment systems treating 100% domestic wastewaters s l.0 MGD
4. Description of wastewater:
Facility Generating Wastevrater(check all that applyk
Industrial
❑
Number of Employees
Commercial
❑
Number of Employees
Residential
E
Number of Homes 1 5
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 subdivision
Number of persons served: 170
S. Type of collection system
N Separate )sanitary sewer only) ❑ Combined (storm sewer and sanitary sewer)
6. Outfall Information:
Number of separate discharge points 1
Outfall Identification numbers) 001
Is the outfall equipped with a diffuser? ❑ Yes E No
7. Name of receiving stream(s) (NEW applicants: Provide a map showing the exact location of each
outfall}.
Caldwell Creek which flows into Rocky River
S. Frequency of Discharge: N Continuous ❑ Intermittent
If intermittent:
Days per week discharge occurs: Duration: _
9. Describe the treatment system
List all installed components, including capacities, provide design removal far 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.
Duplex influent pump station
Narsereen
Aerobic sludge holding/thickening tank with pumped decant
Extended aeration
Clarifier
Tablet chlorination/dechlorination
Post treatment reaeration to comply with effluent DO
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NPDES APPLICATION - FORM D
For privately -owned treatment systems treating 100% domestic wastewaters <1.0 MOD
10. Flow Information:
Treatment Plant Design floor 0.05 MOD
Annual Average daily floor 0.025 MOD (for the previous 3 years)
Maximum daily floor 0.264 MOD (for the previous 3 years)
11. Is this facility located on Indian country?
❑ Yes M No
12. Effluent Data
NEW APPLfCAMS: Provide data for the parameters baled Fecal Cohforrn, 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 anst 36 months for Parameters currently in uour Permit. Mark other parameters "NIA'.
Parameter
Daily
Maximum
Monthly
Average
Anita of
Measurement
Biochemical Oxygen Demand (HODS)
48
17
mg/L
Fecal Coliform
925
52
N/ 100ml
Total Suspended Solids
243
68
rag/L
Temperature (Summer)
30
23.5
C
Temperature (Winter)
24
17.7
C
pH
8.3
N/A
SU
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 NCO070289 Dredge or fdi (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
beet of my knowledge and belief such information is true, complete, and accurate.
2 tea name of
Signature of Apt
North Carolina General Statute 143-215.6 (b)(2) states'. Any pamn who knawingly makes any Islas statement representation, or certification in any
appkation, record, report plan, a other document files or requited to be mantained under Article 21 m regulations of the Environmental Management
Commission imptarrentlng that Ancle, or who falsifies, tampers War, a knowingly renders inaccurate any iexceling a monilanng device or method
required to be cleated or maintained under Artois 21 or regulations of the Environmental Management Canmisson implementing that Article, shall be
guilty of a misdemeanor punishable by a fine not to exceed $25,000, a by imprisonment not to exceed six months, a by both. (18 U.S.C. Secton 1001
provides a punishment by a fine of not more than $25,000 or impnsarnment not more than 5 years, or both, for a similar offense.)
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