NC0088501_Fact Sheet_20200106

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
Fact Sheet
NPDES Permit No. NCO088501
Permit Writer/Email Contact: Derek Denard, [e-mail]
Date: 06Jan2020
Division/Branch: NC Division of Water Resources/Water Quality Permitting Section
Compliance & Expediated Permitting Branch
Fact Sheet Template: Version 28Mar2019
Permitting Action:
❑X Renewal
❑ Renewal with Expansion
❑ New Discharge
❑ Modification (Fact Sheet should be tailored to mod request)
Note: See Attachment A: NCO088501 Renewal Application, FORM C-WTP
Complete applicable sections below. If not applicable, enter NA.
1. Basic Facility Information
Facility Information
Applicant/Facility Name:
Aqua North Carolina, Inc. /Stonington Subdivision — Well 41 WTP
Applicant Address:
202 Mackenan Ct, Cary, NC 27511
Facility Address:
Stonington Way Court, Kernersville, NC 27284
Permitted Flow:
Not limited
Facility Type/Waste:
MINOR; 100% industrial/ Water Plants and Water Conditioning
Discharge —filter-backwash - Greensand WTP System
Facility Class:
Physical Chemical Not Classified
Treatment Units:
greensand filters, chemical usage consisting of Potassium
permanganate, Chlorine and caustic soda
Pretreatment Program (Y/N)
No
County:
Forsyth
Region
Winston-Salem
Briefly describe the proposed permitting action and facility background.- This facility is a greensand
water treatment plant with discharge of wastewaters from media filter backwash, with a design potable
flowrate of 0.02088 MGD, a design backwash/reject flow of 0.00075 and a maximum, monthly average
wastewater discharge of 0.0009 MGD. The facility consists of the following water and wastewater
treatment units: greensand filters, chemical usage consisting of Potassium permanganate, Chlorine and
caustic soda. [See Attachment A: NCO088501 Renewal Application, FORM C-WTP]
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This facility is not eligible for coverage under General Permit NCG590000 for the of discharge backwash
wastewaters from greensand and conventional type water treatment facilities because of the limitation of
Zinc. Eligibility is based on the following (See Attachment B: General Permit NCG590000 Section A.
Coverage, p. 2 of 26).
• The facility is a greensand technology water treatment system.
• There are no toxicity issues (monitoring is not applicable under WTP strategy for greensands).
• There are no WQBELs required for toxicants such as Zinc.
• The discharge is not mixed with other process wastewaters.
• The discharge is not to waters classified as High Quality Waters (HQW) or Outstanding Resource
Waters (ORW).
• The discharge is not from water purification systems using Membrane Treatment (Reverse
Osmosis) or Ion Exchange.
• The discharge would not adversely affect a Federal or State listed endangered or threatened species
or its critical habitat. The discharge is not of pollutants to an impaired waterbody in excess of the
wasteload allocation specified in an EPA -Approved TMDL (Total Maximum Daily Load).
Latitude and Longitude were verified as 36.03473820 N, - 80.07595320 W [entered into BIMS as
360 02' 05" and -800 04' 33"], respectively. See Attachment C: Map pages from EAA 02-19-2007.
Additional information was requested for Hardness data (Attachment D) on May 6, 2019 (due by July 13,
2019). Hardness data was received in response to the additional information request on July 2, 2019
(Attachments E & F).
2. Receiving Waterbody Information:
Receiving Waterbody Information
Outfalls/Receiving Stream(s):
Outfall 001- UT to Abbotts Creek
Stream Segment:
12-119-(1)
Stream Classification:
WS-III
Drainage Area (m12):
--
Summer 7Q10 (cfs)
0
Winter 7Q10 (cfs):
0
30Q2 (cfs):
0
Average Flow (cfs):
0
IWC (% effluent):
100%
303(d) listed/parameter:
Yes — Fish Community — See Attachment G: 2018-NC-303d
List Final, p.243.
Subject to TMDL/parameter:
No — 2011 Turbidity TMDLs in the Yadkin River Basin:
Muddy Creek and the Yadkin River. Abbotts Creek is not
impaired for Turbidity.
Basin/Subbasin4WC:
Yadkin -Pee Dee; 03-07-07 [HUC 030401030202]
USGS Topo Quad:
Kernersville, NC
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3. Effluent Data Summary
Effluent data is summarized below for the period May2014 through Oct2018
Table. Effluent Data Summary
Data
Parameter ,r Max Min Average Count UoM Limits
00070 - Turbidity 5.3 0.045
1.244
94 ntu MA
DM PQL UoM Errors
00076 - Turbidity, HCH Turbidimiter 5.3 0.45
2.875
2 utu
ntu no
00400 - pH 8.03 7.03
113 su
ntu no
00927 - Magnesium, Total (as Mg) 4.56 2.22
3.798
4 ug/I Not < 6.0 or > 9.0
su no
01002 - Arsenic, Total (as As) 0.005 0.005
0.005
4 ug/I
ug/I no
01034 - Chromium, Total (as Cr) 0.005 0.005
0.005
4 ug/I
ug/I no
01042 - Copper, Total (as Cu) 0.005 0.005
0.005
4 ug/I
ug/I no
01045 - Iron, Total (as Fe) 872
50 ug/I
ug/I yes
01055 - Manganese, Total (as Mn) 1440
54 ug/I
ug/I yes
01092 - Zinc, Total (as Zn) 1720 10
423.2
10 ug/I see new see new
ug/I no
50050 - Flow, in conduit or thru treatment plant W0.00031
939 mgd
mgd yes
50060 - Chlorine, Total Residual 47
113 ug/I
17
20 ug/I yes
C0530 - Solids, Total Suspended - Concentration 39 1.8
3.860
108 mg/I
30 45 2.5 mg/I no
MA = monthly average; DM = daily maximum; PQL = practical quantitation limit; UoM = Unit of Measure
Table. Data Reporting Errors
Date Parameter
UoM
Value
Modifier
Comments
6/3/2014 01034 - Chromium, Total (as Cr)
ug/I
0.005
LESSTHAN
UoM mg/L?
8/6/2014 01002 - Arsenic, Total (as As)
ug/I
0.005
LESSTHAN
UoM mg/L?
3/4/2015 50060 - Chlorine, Total Residual
ug/I
0
PQL?
5/6/2015 01055 - Manganese, Total (as Mn)
ug/I
0.057
UoM mg/L?
9/2/2015 01055 - Manganese, Total (as Mn)
ug/I
0.03
UoM mg/L?
10/7/2015 01055 - Manganese, Total (as Mn)
ug/I
0.039
UoM mg/L?
12/2/2015 01055 - Manganese, Total (as Mn)
ug/I
0.005
LESSTHAN
UoM mg/L?
8/3/2016 01055 - Manganese, Total (as Mn)
ug/I
0.01
UoM mg/L?
9/7/2016 01055 - Manganese, Total (as Mn)
ug/I
0.056
UoM mg/L?
10/5/2016 01055 - Manganese, Total (as Mn)
ug/I
0.045
UoM mg/L?
11/2/2016 01055 - Manganese, Total (as Mn)
ug/I
0.044
UoM mg/L?
12/7/2016 01055 - Manganese, Total (as Mn)
ug/I
0.01
UoM mg/L?
1/4/2017 01055 - Manganese, Total (as Mn)
ug/I
0.043
UoM mg/L?
2/1/2017 01045 - Iron, Total (as Fe)
ug/I
0.081
UoM mg/L?
2/1/2017 01055 - Manganese, Total (as Mn)
ug/I
0.076
UoM mg/L?
4/5/2017 01045 - Iron, Total (as Fe)
ug/I
0.243
UoM mg/L?
4/5/2017 50050 - Flow, in conduit or thru treatment plant
mgd
420
UoM gpd?
4/13/2017 50050 - Flow, in conduit or thru treatment plant
mgd
500
UoM gpd?
4/19/2017 50050 - Flow, in conduit or thru treatment plant
mgd
483
UoM gpd?
4/26/2017 50050 - Flow, in conduit or thru treatment plant
mgd
543
UoM gpd?
7/5/2018 01055 - Manganese, Total (as Mn)
ug/I
0.005
LESSTHAN
UoM mg/L?
4. Instream Data Summary
Instream monitoring may be required in certain situations, for example: 1) to verify model predictions
when model results for instream DO are within I mg/l of instream standard at full permitted flow; 2) to
verify model predictions for outfall diffuser; 3) to provide data for future TMDL; 4) based on other
instream concerns. Instream monitoring may be conducted by the Permittee, and there are also
Monitoring Coalitions established in several basins that conduct instream sampling for the Permittee (in
which case instream monitoring is waived in the permit as long as coalition membership is maintained).
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If applicable, summarize any instream data and what instream monitoring will be proposed for this
permit action: Quarterly upstream Hardness monitoring has been added for Outfall 002 to provide a
baseline for establishing limitation of hardness depend metals such as Zinc.
Is this facility a member of a Monitoring Coalition with waived instream monitoring (YIN): NO.
Name of Monitoring Coalition: NA.
5. Compliance Summary
Summarize the compliance record with permit effluent limits (past 5 years): See Attachment H:
Monitoring Report Violations Nov2013 to Oct2018, 1 page. One NOD and two NOVs were issued for
frequency violations in September 2014 (NOD), October 2014, November 2014.
Summarize the compliance record with aquatic toxicity test limits and any second species test results
(past 5 years): NA.
Summarize the results from the most recent compliance inspection: See Attachment L NC0088501
Inspection Report, 02/19/2018, 6 pages.
6. Water Quality -Based Effluent Limitations (WQBELs)
Dilution and Mixing Zones
In accordance with 15A NCAC 213.0206, the following streamflows are used for dilution considerations
for development of WQBELs: 1Q10 streamflow (acute Aquatic Life); 7Q10 streamflow (chronic Aquatic
Life; non -carcinogen W; 30Q2 streamflow (aesthetics); annual average flow (carcinogen, HH).
If applicable, describe any other dilution factors considered (e.g., based on CORMIX model results): NA.
If applicable, describe any mixing zones established in accordance with 15A NCAC 2B. 0204(b): NA.
Oxygen -Consuming Waste Limitations
Limitations for oxygen -consuming waste (e.g., BOD) are generally based on water quality modeling to
ensure protection of the instream dissolved oxygen (DO) water quality standard. Secondary TBEL limits
(e.g., BOD= 30 mg/1 for Municipals) may be appropriate if deemed more stringent based on dilution and
model results.
Ifpermit limits are more stringent than TBELs, describe how limits were developed: NA.
Ammonia and Total Residual Chlorine Limitations
Limitations for ammonia are based on protection of aquatic life utilizing an ammonia chronic criterion of
1.0 mg/1(summer) and 1.8 mg/1(winter). Acute ammonia limits are derived from chronic criteria,
utilizing a multiplication factor of 3 for Municipals and a multiplication factor of 5 for Non -Municipals.
Limitations for Total Residual Chlorine (TRC) are based on the NC water quality standard for protection
of aquatic life (17 µg/1) and capped at 28 µg/1(acute impacts). Due to analytical issues, all TRC values
reported below 50 ug/1 are considered compliant with their permit limit.
Describe any proposed changes to ammonia and/or TRC limits for this permit renewal: Under zero flow
conditions the daily maximum limit for TRC should be 17 µg/l.
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Reasonable Potential Analysis (RPA) for Toxicants
If applicable, conduct RPA analysis and complete information below.
The need for toxicant limits is based upon a demonstration of reasonable potential to exceed water quality
standards, a statistical evaluation that is conducted during every permit renewal utilizing the most recent
effluent data for each outfall. The RPA is conducted in accordance with 40 CFR 122.44 (d) (i). The NC
RPA procedure utilizes the following: 1) 95% Confidence Level/95% Probability; 2) assumption of zero
background; 3) use of/2 detection limit for "less than" values; and 4) streamflows used for dilution
consideration based on 15A NCAC 2B.0206. Effective April 6, 2016, NC began implementation of
dissolved metals criteria in the RPA process in accordance with guidance titled NPDES Implementation of
Instream Dissolved Metals Standards, dated June 10, 2016.
A reasonable potential analysis was conducted on effluent toxicant data collected between May2014 to
Oct2018. Pollutants of concern included toxicants with positive detections and associated water quality
standards/criteria. Based on this analysis, the following permitting actions are proposed for this permit:
• Effluent Limit with Monitoring: The following parameters will receive a water quality -based
effluent limit (WQBEL) since they demonstrated a reasonable potential to exceed applicable
water quality standards/criteria: Total Zinc.
• No Limit or Monitoring: Arsenic, Chromium and Copper were removed from the previous
version (July 14, 2014) of this permit.
• Summary of new limits added based on RPA:
Parameter
Monthly Average Limit
Daily Maximum Limit
Zinc
284.6 µg/L
284.6 µg/L
If applicable, attach a spreadsheet of the RPA results [See Attachment J] as well as a copy of the
Dissolved Metals Implementation Fact Sheet for freshwater/saltwater [See Attachment K] to this Fact
Sheet. Include aprintout of the RPA Dissolved to Total Metal Calculator sheet if this is a Municipality
with a Pretreatment Program.
Toxici . Testing Limitations
Permit limits and monitoring requirements for Whole Effluent Toxicity (WET) have been established in
accordance with Division guidance (per WET Memo, 8/2/1999). Per WET guidance, all NPDES permits
issued to Major facilities or any facility discharging "complex" wastewater (contains anything other than
domestic waste) will contain appropriate WET limits and monitoring requirements, with several
exceptions. The State has received prior EPA approval to use an Alternative WET Test Procedure in
NPDES permits, using single concentration screening tests, with multiple dilution follow-up upon a test
failure.
Describe proposed toxicity test requirement: NA.
Mercury Statewide TMDL Evaluation
There is a statewide TMDL for mercury approved by EPA in 2012. The TMDL target was to comply with
EPA's mercury fish tissue criteria (0.3 mg/kg) for human health protection. The TMDL established a
wasteload allocation for point sources of 37 kg/year (81 lb/year), and is applicable to municipals and
industrial facilities with known mercury discharges. Given the small contribution of mercury from point
sources (-2% of total load), the TMDL emphasizes mercury minimization plans (M1VIPs) for point source
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control. Municipal facilities > 2 MGD and discharging quantifiable levels of mercury (>1 ng/1) will
receive an MMP requirement. Industrials are evaluated on a case -by -case basis, depending if mercury is a
pollutant of concern. Effluent limits may also be added if annual average effluent concentrations exceed
the WQBEL value (based on the NC WQS of 12 ng/1) and/or if any individual value exceeds a TBEL
value of 47 ng/l.
Describe proposed permit actions based on mercury evaluation: NA.
Other TMDL/Nutrient Management Strategy Considerations
If applicable, describe any other TNDDLs/Nutrient Management Strategies and their implementation
within this permit: NA.
Other WQBEL Considerations
If applicable, describe any other parameters of concern evaluated for WQBELs: NA.
If applicable, describe any special actions (HQW or ORW) this receiving stream and classification shall
comply with in order to protect the designated waterbody: NA.
If applicable, describe any compliance schedules proposed for this permit renewal in accordance with
I5A NCAC 2H 0107(c)(2)(B), 40CFR 122.47, and EPA May 2007 Memo: NA.
If applicable, describe any water quality standards variances proposed in accordance with NCGS 143-
215.3(e) and I5A NCAC 2B. 0226 for this permit renewal: NA.
7. Technology -Based Effluent Limitations (TBELs)
Total Suspended Solids (TSS) - TBEL. Secondary treatment standards/40 CFR 133 / 15A NCAC 213 .0406
8. Antidegradation Review (New/Expanding Discharge):
The objective of an antidegradation review is to ensure that a new or increased pollutant loading will not
degrade water quality. Permitting actions for new or expanding discharges require an antidegradation
review in accordance with 15A NCAC 213.0201. Each applicant for a new/expanding NPDES permit must
document an effort to consider non -discharge alternatives per 15A NCAC 2H.0105(c)(2). In all cases,
existing instream water uses and the level of water quality necessary to protect the existing use is
maintained and protected.
If applicable, describe the results of the antidegradation review, including the Engineering Alternatives
Analysis (EAA) and any water quality modeling results: NA.
9. Antibacksliding Review:
Sections 402(o)(2) and 303(d)(4) of the CWA and federal regulations at 40 CFR 122.44(1) prohibit
backsliding of effluent limitations in NPDES permits. These provisions require effluent limitations in a
reissued permit to be as stringent as those in the previous permit, with some exceptions where limitations
may be relaxed (e.g., based on new information, increases in production may warrant less stringent TBEL
limits, or WQBELs may be less stringent based on updated RPA or dilution).
Are any effluent limitations less stringent than previous permit (YESINO): The NC 2007-2014 Water
Quality Standard (WQS) Triennial Review was approved by the US EPA on April 6, 2016 with some
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revisions. The approved WQS no longer includes a standard for Manganese. Therefore, we have removed
the Manganese limit from permit NC0088854.
If YES, confirm that antibacksliding provisions are not violated.- See rationale above.
10. Monitoring Requirements
Monitoring frequencies for NPDES permitting are established in accordance with the following
regulations and guidance: 1) State Regulation for Surface Water Monitoring, 15A NCAC 2B.0500; 2)
NPDES Guidance, Monitoring Frequency for Toxic Substances (7/15/2010 Memo); 3) NPDES Guidance,
Reduced Monitoring Frequencies for Facilities with Superior Compliance (10/22/2012 Memo); 4) Best
Professional Judgement (BPJ). Per US EPA (Interim Guidance, 1996), monitoring requirements are not
considered effluent limitations under Section 402(o) of the Clean Water Act, and therefore anti -
backsliding prohibitions would not be triggered by reductions in monitoring frequencies.
For instream monitoring, refer to Section 4.
11. Electronic Reporting Requirements
The US EPA NPDES Electronic Reporting Rule was finalized on December 21, 2015. Effective
December 21, 2016, NPDES regulated facilities are required to submit Discharge Monitoring Reports
(DMRs) electronically. Effective December 21, 2020, NPDES regulated facilities will be required to
submit additional NPDES reports electronically. This permit contains the requirements for electronic
reporting, consistent with Federal requirements.
12. Summary of Proposed Permitting Actions:
A. Table. Current Permit Conditions and Proposed Changes — Outfall 001
Parameter
Current Permit
Proposed Change
Basis for Condition/Change
Flow
Not limited
No change
15A NCAC 2B .0505. Not limited
per current WTP strategy.
Total Suspended
MA 30 mg/l
No change
TBEL. Secondary treatment
Solids (TSS)
DM 45 mg/l
standards/40 CFR 133 / 15A NCAC
2B .0406
Total Residual
DM 28 µg/L
DM 17 µg/L
WQBEL. State WQ standard, 15A
Chlorine (TRC)
NCAC 2B .0211 (3). Under zero
flow conditions the standard of 17
µg/L applies.
pH
6 — 9 SU
No change
WQBEL. State WQ standard, 15A
NCAC 2B .0211 (14)
Turbidity
Not limited
No change
WQBEL. State WQ standard, 15A
NCAC 2B .0211 (7)
Total Zinc
Not limited
MA 284.6 µg/L
WQBEL. State WQ standard, 15A
DM 284.6 µg/L
NCAC 2B .0211
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Total Hardness
No monitoring
Monitoring added
WQBEL. State WQ standard, 15A
NCAC 213.0211
Total Manganese
200 µg/L limit removed
No change
WTP Strategy parameter of concern
in 08/06/2016 technical
correction.
Total Iron
Not limited
No change
WTP Strategy parameter of concern
MGD — Million gallons per day, MA - Monthly Average, DM — Daily Max
Parameters of concern including measurements frequencies and sample type are in accordance with the
October 14, 2009 WTP Strategy by Julie Grzyb, Table 4.1 for greensand technology (Attachment L) and
Table 5.1 for monitoring frequencies (Attachment M). Sample type as "grab" is also determined by 15A
NCAC 02B .0505 (c)(3).
The permit renewal includes the following significant changes from the existing permit:
1. The facility map has been updated.
2. Regulatory citations have been added.
3. The facility classification Physical Chemical Not Classified WPCS was added to the effluent page.
4. The limit for Total Residual Chlorine (TRC) under zero flow conditions is set at the water quality
standard of 17 ug/1 for Class C waters. Please note that Footnote 2 stipulates the following: The
Division shall consider compliant all TRC effluent values reported below 50 µg/L. However, the
Permittee shall continue to record and submit all values reported by North Carolina -certified
laboratory methods (including field certified), even if these values fall below 50 µg/L.
5. The NC 2007-2014 Water Quality Standard (WQS) Triennial Review was approved by the NC
Environmental Management Committee (EMC) on November 13, 2014. The US EPA subsequently
approved the WQS revisions on April 6, 2016 with some exceptions. The NC Division of Water
Resources is required to implement the new dissolved metal standards in all permits public noticed
after April 6, 2016.
The new standards for most metals include acute standards. Furthermore, the freshwater standards
for several metals are expressed as the dissolved form of the metals, and seven metals have
hardness -dependent equations. As a result, the Division will need site -specific effluent hardness
data and instream hardness data, upstream of the discharge, for each facility monitoring these
metals in order to calculate permit limitations. The metal of concern for this permit renewal is
Zinc.
To evaluate dissolved Zinc, a Reasonable Potential Analysis (RPA) was conducted using data
from DMRs (May2014—Oct2018) [see attached RPA spreadsheets for Outfall 001]. Results
indicated a reasonable potential to exceed the new dissolved metals standard for Zinc.
Consequently, the following daily maximum limits (acute standard) and monthly average limits
(in this case the acute standard) for Total Zinc could be applied for this permit renewal:
Parameter Outfall Monthly Average Limit Daily Maximum Limit
Zinc 001 284.6 µg/L 284.6 µg/L
Please note that the hardness -dependent water quality standard for zinc typically results in a more
stringent permit limit for the acute total allowable metal verses the chronic value. In this situation,
we use the acute total allowable metal concentration (permit limit) as the limitation for both the
Daily Maximum and the Monthly Average.
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Hardness data received on July 2, 2019 was used for the calculation of these limits. Since this
facility discharges under zero flow conditions a value of 0 was entered for all stream flow data.
Please note that under zero flow conditions the RPA defaults to a value of 25 mg/L for the
upstream Total Hardness. Additionally, the maximum monthly average flow of 0.0009 MGD
from November 2015 to October 2018 (3 years) data was used as the effluent flow. For a
summary of this information, please see the attached "Dissolved to Total Metal Calculator".
Please note that monitoring for Zinc is now monthly.
6. A compliance schedule [Section A. (2.)] has been added for Total Zinc limits in found Section A.
(1.). The Total Zinc limits will become effective 60 months from the effective date of the permit
instead of 48 months as drafted.
7. Effluent Hardness Sampling was added with quarterly sampling to maintain a hardness database
for this facility. Please note footnote 5 requires that Effluent hardness sampling be performed in
conjunction with sampling for hardness dependent metals (Zinc).
8. Total Manganese sampling has been reduced to quarterly monitoring. Please note that the NC
2007-2014 Water Quality Standard (WQS) Triennial Review was approved by the US EPA on
April 6, 2016 with some revisions. The approved WQS no longer includes a standard for
Manganese. Therefore, in an August 29, 2016 technical correction to the previous permit, we
have removed the Manganese limit from permit NC0088501.
13. Public Notice Schedule:
Permit to Public Notice: 07/12/2019 [See Attachment N]
Per 15A NCAC 21-1.0109 & .0111, The Division will receive comments for a period of 30 days following
the publication date of the public notice. Any request for a public hearing shall be submitted to the
Director within the 30 days comment period indicating the interest of the party filing such request and the
reasons why a hearing is warranted.
14. Fact Sheet Addendum (if applicable):
Were there any changes made since the Draft Permit was public noticed (Yes/No): Yes.
If Yes, list changes and their basis below: A compliance schedule [Section A. (2.)] has been added for
Total Zinc limits in found Section A. (1.). The Total Zinc limits will become effective 60 months from the
effective date of the permit instead of 48 months as drafted.
15. Fact Sheet Attachments (if applicable):
A. NC0088501 Renewal Application, 20181005, 28 pages.
B. General Permit NCG590000 Section A. Coverage, p. 2 of 26.
C. Map pages from EAA 04-12-2007, 1 page.
D. NC0088501 Additional Information Request 20190506, 19 pages.
E. Additional Information Received 20190702, email 3 pages.
F. Aqua _Hardness Results, 20 pages.
G. 2018-NC-303d List Final, p.243.
H. NC0088501 Monitoring Report Violations Nov2013 to Oct2018, 2 pages.
L NC0088501 Inspection Report, 02/19/2018, 6 pages.
J. NC0088501 001 RPA Spreadsheet Summary 20190703, 8 pages.
K. Dissolved Metals Implementation Freshwater Memo. 4 p.
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L. WTP Strategy revised October 2009, page 9.
M. WTP Strategy revised October 2009, page 10.
N. Affidavit of Publication, Winston-Salem Journal, 20190712, 1 page.
O. Regional Office Comments, Roone Boone, 20181207,2 pages.
P. Permittee Comments, Amanda A Berger, 20191111, 3 pages.
Q. Regional Office Comments, Roone Boone, 20190724, 3 pages.
R. NCO088501 PWSS Review Stonington 20190806, 1 page.
S. Review Checklist 2020
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ROY COOPER NORTH CAROLINA
Governor Environmental Quality
1•ICH AEL S_ REGAN
Secretar,
LINDA CULPEPPER
Interim Director
October 05, 2018
Thomas Roberts
Aqua North Carolina Inc
202 Mackenan Ct
Cary, NC 27511
Subject: Permit Renewal
Application No. NCO088501
Stonington Subdivision - Well #1
Forsyth County
Dear Applicant:
The Water Quality Permitting Section acknowledges the October 5, 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://deg.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.
ec: WQPS Laserfiche File w/application
D_Fm
Sincerely,
�/ILW 04-aw
Wren Thedford
Administrative Assistant
Water Quality Permitting Section
North Carolina Department of Environmental Quality I Division of Water Resources
1617 Mail Service Center I Raleigh, North Carolina 27699-1617
919-807-6300

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
�MyM�
October 4, 2018
Mr. Wren Thedford
NDPES Unit
DWR, NCDEQ
1617 Mail Service Center
Raleigh, NC 27699-1617
RE: Application for Permit Renewal
Aqua North Carolina, Inc.
Stonington Subdivison, Well #1- WTP
NPDES Permit NCO088501
Dear Mr. Thedford:
Enclosed are three (3) copies of the completed application Form C-WWTP. This
submittal includes necessary attachments for your office to renew the subject
permit.
Aqua North Carolina, Inc (AQUA) has reviewed the Division of Water Resource's
General Permit NCG5900000 for Greensand WTP Effluent Limitations and
Monitoring Requirements - Discharging to Freshwater, and AQUA hereby requests
that treated discharge from Stonington - Well #1 be considered for coverage under
this General Permit. AQUA understands that if coverage under a general permit is
granted, the Division will rescind individual NPDES Permit NC0088501.
Best Regards,
RECEIVED/DENR/DWR
A61oA OCT 0 5 2018
Amanda Berger Water Resources
Manager, Environmental Compliance Permitting Section
cc: Laurie Ison
Joseph Pearce -- _
Shannon Becker
202 MacKenan Court, Cary, NC, 27511 919.467.8712 • AquaAmerica.com

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
NPDES PERMIT APPLICATION - SHORT FORM C - WTP
For discharges associated with water treatment plants
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 Number INCO088501
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
Facility Name
Mailing Address
City
State / Zip Code
Telephone Number
Fax Number
e-mail Address
Aqua North Carolina, Inc.
Stonington Subdivision - Well # 1 WTP
202 Mackenan Ct
Cary
NC/27511
[phone]
CaryOfficeEFax@,aquaamerica.com
AAOwcns@,aquaamerica.com
2. Location of facility producing discharge:
Check here if same as above ❑
Street Address or State Road
City
State / Zip Code
County
Stonington Way Court
Kernersville
NC/ 27284
Forsyth
3. Operator Information:
Name of the firm, consultant 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 4163 Sinclair Street_-
City- -
State / Zip Code
Telephone Number
Fax Number
.---,.Denver
NC / 28037
[phone]
DenverEFax@,aquaamerica.com
Page 1 of Version 5/2012

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
NPDES PERMIT APPLICATION - SNORT FORM C - WTP
For discharges associated with water treatment plants
4. Ownership Status:
Federal ❑ State ❑ Private ® Public ❑
5. Type of treatment plant:
❑ Conventional (Includes coagulation, flocculation, and sedimentation, usually followed by
filtration and disinfection)
❑ Ion Exchange (Sodium Cycle Cationic ion exchange)
® Green Sand Filter (No sodium recharge)
❑ Membrane Technology (RO, nanofiltration)
Check here if the treatment process also uses a water softener ❑
6. Description of source water(s) (i.e. groundwater, surface water)
Groundwater Well
7. Describe the treatment process(es) for the raw water:
Raw water is treated by greensand filters in series with a 0.0021 MGD discharge of falter
backwash wastewater. Chemicals utilized during this process consist of:
• Potassium Permanganate
• Chlorine
• Caustic soda
S. Describe the wastewater and the treatment process(es) for wastewater generated by the
facility:
Wastewater discharge from said treatment works at the location specified on the attached
map into an unnamed tributary to Abbotts Creek, classified WS-III waters in the Yadkin -
Pee Dee River Basin.
9. Number of separate discharge points: 1
Outfall Identification number(s) 001
10. Frequency of discharge: Continuous ❑ Intermittent
r
If intermittent:
Days per week discharge occurs: 7 Duration: 75 minutes (average)
11. Plant design potable flow rate 0.02088 MGD
Backwash or reject flow 0.00075 MGD
12. Name of receiving stream(s) (Provide a map showing the exact location of each outfail, including
latitude and longitude):
Unnamed Tributary to Abbotts Creek (Yadkin Pee Dee Basin) -
Page 2 of 4
Version 5/2012

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
NPDES PERMIT APPLICATION - SHORT FORM C - WTP
For discharges associated with water treatment plants
13. Please list all water treatment additives, including cleaning chemicals or disinfection
treatments, that have the potential to be discharged.
Alum / aluminum sulfate Yes No X
Iron sulfate / ferrous sulfate Yes No X
Fluoride Yes NoX
_ Ammonia nitrogen Yes Yes No X
Zinc -orthophosphate or sweetwater CP1236 Yes No
List any other additives below:
Chlorine
Potassium Permanganate
Caustic Soda
14. Is this facility located on Indian country? (check one)
Yes ❑ No
15. Additional Information:
Provide a schematic of flow through the facility, include flow volumes at all points in
the water treatment process The plan should show the point[s] of addition for
chemicals and all discharges routed to an outfall [including stormwater].
Solids Handling Plan
o N/A
16. NEW Applicants
Information needed in addition to items 1-I5:
New applicants must contact a permit coordinator with the NCDENR Customer
Service Center.
Was the Customer Service Center contacted? ❑ Yes ❑ No
Analyses of source water collected
Engineering Alternative Analysis
Discharges from Ion Exchange and Reverse Osmosis plants shall be evaluated using a
water quality model.
17. 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 Berger - Manager Environmental Compliance Aaua.North_Caroli_na
Printed name of Person Signing Title
3A1M .fivt lam• ID [k4 701 b
Signature of Applicant
Date
North Carolina General Statute 143-215.6 (b)(2) provides that 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 iniccurate any f6cording or monitoring de"vice iir"method'�equired 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
Page 3 of 4
Version 5/2012

- DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
NPDES PERMIT APPLICATION - SHO-RT FORM C - WTP
For discharges associated with water treatment plants
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 )
Version 5/2012
Page 4 of 4

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
Aqua North Carolina, Inc. Facility
Location
Stonington Subdivision Well #1-WTP AO not to scale Y
Latitude: 360 02' 05" Stale (;rldQnnd: C18SE/Kernersville
Longitude: 80° 04' 32" IIUC: 03040103 n
ReceivinrStrenm; UT to Abbotts Creek Strenm Chess: WS-111 i North11 NPDES Permit NC0088501
nrninnge Basht: Yadkin -Pee Dee Basin ub-I3nsin: 03-07-07 Forsyth County

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
NPDES PERMIT NO.: NCO098501 PERMIT VERSION: 3 0 PERMIT STATUS: Active
FACILITY NAME: Stonington Subdivision - We11-#) — _CLASS.- PCNC- _ COUNTY: Forsy t- _ - - _ _ _ ,__ •--- •,-
OWNER NAME: Aqua North Carolina Inc ORC: Peter Ray Dealing ORC CERT NUMBER: 994048
GRADE: PC-1 ORC HAS CHANGED: No
eDMR PERIOD: 09-2017 (September 2017) VERSION: 1.0 STATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
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DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
NPDES PERMIT NO.: NIC0088501
FACILITY NAME: Stoningtoo Subdivision - Well P,1
OWNER NAME: Aqua North Carolina inc
GRADE: PC-1
eDMR PERIOD: 09-2017 (September 2017)
PERMIT VERSION: 3.0
- CLASS: PCNC _,
ORC: Peter Ray Dealing
ORC HAS CHANGED: No
VERSION: 1.0
CONTACT PHONE 4: 3369929000
f
PERMIT STATUS: Active
COUNTY: Forsyth .- •-- -_
ORC CERT NUMBER: 994048
STATUS: Processed
SUBMISSION DATE: 10/29/2017
r ` . -
ORC/Certifier Signature Peter y Dealing E-Mail:PRDealingr_q,aquaamerica. Goin Phone #-336-992-9000 Date
By this signature, I certify that this report is accurate and complete to the best of my knowledge.
The permittee shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment.
Any information. shall be provided orally within 24 hours from the time the permittee became aware of the circumstances, A written submission shall also be
provided within 5 days of the time the permittee becomes aware of the circumstances.
If the facility is noncompliant, please attach a list of corrective actions being taken and a time -table for improvements to be made as required by partII.E.6 of
the NPDES permit
0as— t: (�`� C 10/29/2017
Permittee/Submitter Signature*** Dave McDaniel E-Mail-dtmcdaniel@aquaamerica corn Phone 4:336-992-9000 Date
Permittee Address, Stonington Way Ct Kemersville NC 27284 Permit Expiration Date: 02/28/2019
I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision -n accordance with a system designed
to assure that qualified personnel properly gather and evaluate the information submitted, Based on my inquiry of the person or persons who managed the
system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true,
accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for
knowing violations.
CERTIFIED LABORATORIES
LAB NAME: Water Tee lab
CERTIFIED LAB #: 50
PERSON(s) COLLECTING SAMPLES: Peter Dealing
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit [phone] or by visiting http:/Iportal ncdenr org/web/wq/swp/ps/npdes/forms.
FOOTNOTES
Use only units of measurement designated in the reporting facilitys NPDES permit for rcportrng data.
* No Flow/Discharge From Site: Check this box if no discharge occurs and, as a result, there are no data to be entered for all of the parameters on the DMR
for -entire monitoring period. -
__. _ **.:ORC-on.Situ-0RGmust visii:facili_ty arid,dDeumenLvisitattonfacihty as required per_ISf—NCAC BG,_0209._ _ _-„
**" Signature of Permtttee• If signed by other than the permittee, then delegation of the signatory authority must be on file with the state per 15A NCAC 2B
.0506(b)(2)(D).

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
NPDES PERM- IT NO.: NCO088501 PERMIT VERSION- 3 0 PERMIT STATUS: Active
FACILTTY NAME: Stonirigton Subd.vision - Well'#f CLASS: PCNC -
O WNER NAME: Aqua North Carolina Inc ORC: Peter Ray Dealing ORC CERT NUMBER. 994048
GRADE. PC-1 ORC HAS CHANGED, No
eDMR PERIOD: 10-2017 (October 2017) VERSION: 10 STATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
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**** No Reporting Reason- ENFRUSE -No rlow-Rcusr/Rec}cic, ENNWTHR— No Visitation —Adverse Weather, NUI-U)W = Ivn MW, NULAWA-1 7v vrsileuvn— nw,oay

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
NPDES PERMIT NO.: NC0088501
-"FACILITY-NAME.-Stoningror. Subdivision - Well m1
OWNER NAME: Aqua North Carolina Inc
GRADE: PC-1
eDMR PERIOD: 10-2011(October 2017)
COMPLIANCE STATUS: Compliant l�
PERMIT t'ERSION: 3 0
CLASS: PCNC
ORC: Pete- Ray Dealing
ORC HAS CHANGED: No
VERSION: 1.0
CONTACT PHONE 9: 3369929000
PERMIT STATUS: Actire
COUNTY: Forsyth _ ___ -
ORC CERT NUMBER: 994049
STATUS: Processed
SUBMISSION DATE: 11/28/2017
ORC/Certifier Signa re; Peter Ray Dealing ?vfai] FRDealingaaquaamerica.com Phone #:[phone]
By this signature, I certify that this report is accurate and complete to the best of my knowledge
2017__ _-
Date
The permittee shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment
Any information shall be provided orally within 24 hours from the time the permittee became aware of the circumstances A written submission shall also be
provided within 5 days of the time the permittee becomes aware of the circumstances.
Ifthe facility is noncompliant, please attach a list of corrective actions being taken and a time -table for Improvements to be made as required by part II E.6 of
the NPDES permit
6-ca—Y 11/28/2017
Permittee/Submitter Signature-*** Dave MCDani-2l E-Mail:[e-mail] Phone #:[phone] Date
Permittee Address: Stomngtor Way Ct Kemersville NC 27284 Permit Expiration Date- 02/28/2019
I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed
to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who managed the
system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true,
accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for
knowing violations.
CERTIFIED LABORATORIES
LAB NAME- Water Tec Lab
CERTIFIED LAB 9: 50
PERSON(s) COLLECTING SAMPLES: Peter Dealing
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NNPDES Unit [phone] or by visiting http://portal.ncdenr.org/web/ivq/swp/ps/npdes/forrns,
FOOTNOTES
Use only units of measurement designated in the reporting faciliWs NPDES permit for reporting data.
* No Flow!Discharge From Site: Check this box if no discharge occurs and, as a result, there are no data to be entered for all of the parameters on the DMR
- for entire monitoring period. - -
_ _; _ . f ORS ori=5ite7nQRC-must visit facility -and document -visitation of facility as_gquired per 15A NCAC 8G .0204.
*** Signature of Permittee: If signed by other than the permittee, then delegation of the signatory authority must be on file with the state per 15A NCAC 2B
0506(b)(2)(D). ✓

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
NPDES PERMIT NO.: NC0088501 PERMIT VERSION• 3 0
FACILITY NAME: Stonington Subdivision - Well #3 CLASS: PCNC
OWNER NAME: Aqua North Carobra lnc ORC: Peter Ray Dealing
GRADE: PC-] ORC HAS CHANGED: No
eDMR PERIOD: 12-2017 (December 2017) VERSION: 1 0
PERMIT STATUS: Active
COUNTY: Forsyth
ORC CERT NUMLBER: 994048
STATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
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DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
NPDES PERMIT NO.: NCO088501
FACILITY NAME. Stonington Subdivision - Well 91
OWNER NAME: Aqua North Carolina Inc
GRADE: PC -I
eDM'1R PERIOD: 12-2017 (December 2017)
COMPLIANCE STATUS: Compliant
PERMIT VERSION: 3.0
CLASS:PCNC
ORC: Peter Ray Dealing
ORC HAS CHANGED: No
VERSION: 1 0
CONTACT PHONE #: [phone]
PER = STATUS: Active
COUNTY: Forsyth
ORC CERT NUMBER: 994048
STATUS: Processed
SUBMISSION DATE: 0111212018
r_ORC/Certifier Sgature• Peter Ray Dealing�M ail:[e-mail] Phone #:[phone] Eat!
By this signature, I certify that this report is accurate and complete to the best of my knowledge.
The permittee shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment.
Any information shall be provided orally within 24 hours from the time the permittee became aware of the circumstances A written submission shall also be
provided within 5 days of the time the permittee becomes aware of the circumstances ,
If the facility is noncompliant, please attach a list of corrective actions being taken and a time -table for improvements to be made as required by part II.E.6 of
the NPDES puinyt d
1-t-t C'o
Permittee/Submitter Signature:*** Dave MCDai
Permittee Address: Stonington Way Ct Kemersville NC 2729
1 certify, under penalty of law, that this document and all attac
to assure that qualified personnel properly gather and evaluate
system, or those persons directly responsible for gathering the
accurate, and complete. I am aware that there are significant p
knowing violations.
LAB NAME: Water Toe Lab
CERTIFIED LAB #: 50
PERSON(s) COLLECTING SAMPLES: Peter Dealing
Parameter Code assistance may be obtained by calling the
01/12/2018
e1 E-Mail:[e-mail] Phone #:[phone] Date
Permit Expiration Date: 02/2812019
rents were prepared under my direction or supervision in accordance with a system designed
is information submitted. Based on my inquiry of the person or persons who managed the
iformation, the information submitted is, to the best of my knowledge and belief, true,
tallies for submitting false information, including the possibility of fines and imprisonment for
LABORATORIES
PARAMETER CODES
Unit [phone] or by visiting http://portal.ncdeix.org/webiwq/swp/ps/npdes/forms.
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data,
* No Flow/Discharge From Site: Check this box if no discharg occurs and, as a result, there are no data to be entered for all of the parameters on the DMR
for entire monitoring period.
**-ORS on Site?=ORC rtiustdisit facility and=documeittwisita 1`oti of facility as required-pier-15A
*** Signature of Permittee: If signed by other than the permilt e, then delegation of the signatory authority must be on file with the state per 15A NCAC 2B
.0506(b)(2)(D). I

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
NPDES PERMIT 2INO NC0088`01 PERMIT VERSION: 3 0
F4CILITY NAME- Storington Subdivision - We11-1 CLASS: PCNC
OWNER NANTE: Aqua North Carolina Inc ORC- Peer Ray Dealing
GRADE: PC-1 ORC HAS CHANGED: No
eDMR PERIOD: 01-2018 (Januar), 2018) VERSION: 110
PERMIT STATUS: Active
COUNTY: Forsyth
ORC CERT NUMBER, 994048
STATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
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° 1 No Reporting Reason ENFRUSE=No Flow-ReucclRecycle, ENVWTfiR=No Visitaiion—Adverse weetneE,'NVYLVw= iw rmo, nv:_tu., t—,.,,•......... "..1

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
N'PDES PERMIT NO : NCO089501
FACILITY NAME: Stoningion Subdivision - Well el
OWNER NAME. Aqua North Carolina Inc
GRADE: PC-1
eDhIR PERIOD: 01-2019 (January 2018)
COMPLIANCE STATUS: Compliant
PERMIT YERSION:30
CLASS: PCNC
ORC: Peter Ray Dealing
ORC HAS CHANGED: No
VERSION:) 0
CONTACT PHONE #. [phone]
PERMIT STATUS. Active
COUNTY: -Forsyth . . .
ORC CERT NUMBER: 994049
STATUS: Processed
SUBMISSION DATE: 02127/2019
02/02/2018
ORC/Cent°—iffieerr Signature: Peter ay Dealing E-Mai1:PRDealingaaquaamerica.com Phone #:[phone] Date
By this signature, I certif}, that this report is accurate and complete to the best of my knowledge.
The permittee shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environnfent.
Any information shall be provided orally within 24 hours from the time the permittee became aware of the circumstances. A written submission shall also be
provided within 5 days of the time the permittee becomes aware of the circumstances
If the facility is noncompliant, please attach a list of corrective actions being taken and a time -table for improvements to be made as required by part 1LE 6 of
the NPDES permit
(tA oD,_J
02/27/2018
Permittee/Submitter Signature *** Dave McDaniel [e-mail] aquaamerica.com Phone #.[phone] Date
Perm ittee Address. Stonington Way Ct Ker iersville NC 27284 Permit Expiration Date: 02/28/2019
I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed
to assure that qualified personnel properly gather and evaluate the information submitted. Bascd on my inquiry of the person or persons who managed the
system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true,
accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for
knowing violations
LAB NAME: Water Tec Lab
CERTIFIED LAB #: 50
PERSON(s) COLLECCING SAMPLES: Peter Dealing
CERTIFIED LABORATORIES
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit [phone] or by visiting http•//portal ncdenr org/webrwgiswp/ps/npdesiforms
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data
* No Flow/Discharge From Site: Check this box if no discharge occuis and, as a result, there are no data to be entered for all of the parameters on the DMR
for entire monitoring penod. _... _
**-ORC on Site?; ORC'must visit-facilityand-documentwisitation--of facility-as.required-per 15A-NCAC.8G
*** Signature of Permittee• If signed by other than the permittee, then delegation of the signatory authority must be on file with the state per 15A NCAC 2B
.0506(b)(2)(D)

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
NPDES PERMIT NO.; NC0088501 PERMIT VERSION: 3 0
FACILITY NAME: Stonington Subdivision - Well 41 CLASS: PCNC
OWNER NAME: Aaua North Carolina Inc ORC: Peter Rev Dealing
GRADE: PC-1 ORC HAS CHANGED: NO
eDMR PERIOD: 02.2018 (February 2018) VERSION: 1.0
PEMNSIT STATUS; Active
COUNTY, Forsyth
ORC CERT NUMBER; 99404
STATUS. Processed
SAMPLING LOCATION: EFFLUENT DISCEIARGE NO.: 001 NO DISCHARGE*: NO
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"" No Reporting Reason ENFRUSE = No Flow-Reuse/Recycle; ENV WTHR - No Visitation — Adverse Weather, NOFLOW - No Flow; HOLIDAY = No Visitation — Holiday

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
NPDES PERMIT NO.: ^ICO0885CI
FACILITY NAME: Stonington Subdiv:sior - Well #1
OWNER NAME: Aqua Norih Carolina Inc
GRADE: PC-1
eDMR PERIOD: 02-2018 (Februalry 2018)
COMPLIANCE STATUS: Compliant
PERMIT VERSION, 3 0
CLASS: PCNC
ORC: Peter Ray Dealing
ORC HAS CHANGED: No
VERSION: 1 0
CONTACT PHONE #: [phone]
I
PERMIT STATUS: Active
COUNTY: Forsyth
ORC CERT NUMBER: 994048
STATUS: Processed
SUBMISSION DATE: 03/2712018
w. 03/26/2018
ORC/Certifier Signatuk Peter Ray Dealing VE-Mail' Dealing@aqt aamerica.com Phone #,336-992-9000 Date
By this signature, I certify that this report is accurate and complete to the best of my knowledge.
The permittee shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment,
Any information shall be provided orally within 24 hours from the time the permittee became aware of the circumstances. A written submission shall also be
provided within 5 days of the time the permittee becomes aware of the circumstances,
If the facility is noncompliant, please attach a list of corrective actions being taken and a time -table for improvements to be made as required by part II.E.6 of
the NPDES permit.
c�j
03/27/2018
Permittee/Submitter Signature:"** Dave McDaniel E-Mail:dtmcdaniel@aquaamerica,com Phone #.[phone] Date
Pemittee Address. Stonington Way Ct Keinersville NC 27284 Permit Expiration Date: 02/28/2019
1 certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed
to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who managed the
system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true,
accurate, and complete. I am aware that there are significant penalties for submitting false information., including the possibility of fines and imprisonment for
knowing violations.
CERTIFIED LABORATORIES
LAB NAME: Water Tec lab
CERTIFIED LAB #: 50
PERSON(s) COLLECTING SAMPLES: Peter Dealing
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit [phone] or by visiting http://portal.i3cderr.o. glweb/wq/swp/pslnpdes/forms
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data
* No Flow/Discharge From Site: Check this box if no discharge occurs and, as a result, there are no data to be entered for all of the parameters or, the DMR
for entire monitoring period.
must visit facility and document visitation of °zcility as required per 15A NCAC 3G .0204
*** Signature of Permittee: If signed by other than the permittee, then delegation of the signatory authority must be on fle with the state per 15A NCAC 2B
,0506(b)(2)(D).

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
NPDES PERI2IT NO.: 14CO088501
PERMIT VERSION: 3.0
FACILITY NAME: Stontr.,gton Subdt\ Iston - Well 41,
CLASS: PCNC
OWNER NA,iTE: Aqua North Carolina lac
ORC: Peter Rny Dealing
GRADE: PC -I
ORC HAS CHANGED: No
eDNTR PERIOD: 03-2018 (Much 2018)
VERSION: 10
PERMIT STATUS- Active
COUNTY- Forsytb
ORC CERT NUMBER: 994048
STATUS- P*ocessed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
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"*#NoReportingReason ENFRUSE=No Flow-Rcuse(Recycle, ENVWTHR=NoVisdation-AdvctseWeather, NOFLOW=No Flow, HOLIDAY =NoVisitation- Holtr.➢y

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
NPDES PERMIT NO.: NCO08S501
FACILITY NArie : Stonington Subdivision - Well rl
OWNER NAME: Aqua North Car. Tina Iric
GRADE: PC-!
eDMR PERIOD: 03-2018 (March 2019)
COMPLIANCE STATUS: Compliant
PERMIT VERSION: 3.0
CLASS: PCNC
0RC: Peter Ray Dealing
ORC HAS CHAd'GED: No
VERSION: 1 0
CONTACT PHONE 4: 3369929000
PERMIT STATUS: Active
COUNTY: Forsyth
ORC CERT NUMBER: 9940aS
STATUS: Processed
SUBMISSION DATE: 04/27120IS
04/26/2018
ORC/Certifier Signature*- Peter Ray Dealing E-Mai I:[e-mail] Phone #.[phone] Date
By this signature, I certify that this report is accurate and compete to the best of my knowledge
The permittee shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment.
Any information shall be provided orally within 24 hours from the time the pemittee became aware of the circumstances. A written submission shall also be
provided within 5 days of the time the pemittee becomes aware of the circumstances.
If the facility is noncompliant, please attach a list of corrective actions being taken and a time -table for improvements to be made as required by part II E.6 of
the NPDES permt �,j
D-11— ! ( Cca 04/27/2018
PermitteeiSubmitter Signature:*** Dave McDaniel E-Mail:[e-mail] Phone # [phone] Date
Pemittee Address: Stonington Way Ct Kemersville NC 27284 Permit Expiration Date: 02/28/2019
I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed
to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who managed the
system or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true,
accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for
knowing violations.
LAB NAME: WATER TECH LABS INC.
CERTIFIED LAB 0: 50
PERSON(s) COLLECTING SAMPLES; PETER DEALING
CERTIFIED LABORATORIES
PAR4Is4ETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit [phone] or by visiting http://portal nedenr.org/web/wq/svp/ps/iipdes/forms.
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data.
* No Flow/Discharge From Site: Check this box if no discharge occurs and, as a result, there are no data to be entered for all of the parameters on the DiVIR
for entire monitoring period"
�* ORC on Site?: ORC must visit facility and document visitation of facility as requiredper-15A NCAC 8G .0204. —
*** Sienaluie ofPermitte6 If signed by other than -the perniittlse; theirdelegahmrofthzsigaatorq aut'tonty masrtie'on rile with -the -state per-1-5A NC -AG 313----•___ _.
.0506(b)(2)(D).

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
NPDES PERMIT NO ' 1JC0088501 PERA11IT VERSION: 3.0 PERN4IT STATUS: Active
FACILITY NAME: Stnninglor Subdiviston - Well ki CLASS: PCNC COUNTY. Forsyth
OWNER NAME: Aqua North Carolina Inc ORC: Peter Ray Dealing ORC CERT NUMBER: 994048
GRADE: PC-1 ORC HAS CHANGED: No
eDMR PERIOD. 04-2018 (April 2018) VERSION: 1_0 T S'rATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
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DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
NPDES PERMIT NO. - NCO088501 PERMIT VERSION: ? 0 PERMIT STATUS: Active
- " - FACILITY NAME: Sionington Subev�issor, -Well #i - CLASS: PCNC - COUNTY: Forsyth- - - -
OWNER NAME: Aqua North Carolina Inc ORC- Peter Ray Dealing ORC CERT NL:4IBER: 99d048
GRADE: PC-1 ORC HAS CHANGED: No
eDMR PERIOD: 04-2018 (.Ap-il2018) VERSION: 1 0 STATUS: Processed
COMPLIANCE STATUS: Comatiari CONTACT PHONE #: [phone]D SUBMISSION DATE: 05/23/2018
ORC/Certifier Signature: Peter Ray Dealing E-Mail.PRDealrngcJaouaamerica.com Phone #:[phone] Date
By this signature, I certify that this report is accurate and complete to the best of my knowledge.
The permitiee shali report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment,
Any :nformation shall be provided orally within 24 hours from the time the per-nittee became aware of the circumstances A written submission shall also be
provided within 5 days of the time the permittee becomes aware of the circumstances.
If the facility is noncompliant, please attach a list of corrective actions being taken and a time -table for improvements to be made as required by part ME 6 of
the NPDES permit
f,-q 'ID05/23/2018
Permittee/Submitter Signature:**" Dave McDaniel E-Mail.dtmcdaniel cr aquaamerica com Phone #.[phone] Date
Permittee Address: Stonington Way Ct Kemersville NC 27284 Permit Expiration Date, 02/28/2019
I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision i i accordance wi£n a system designed
to assure that qualified personnel properly gather and evaluate he information submitted. Based on my inquiry of the person or persons who managed the
system, or tnose persons directly responsible for gathering the mformation, the information submitted is, to the best of my knowledge and belief, true,
accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for
knowing violations
CERTIFIED LABORATORIES
LAB NAME: )iiater Tec Lab
CERTIFIED LAB #: 50
PERSON(s) COLLECTING SAMPLES: Peter Dealing
PARAMETER CODES
Parameter Code assistance :nay be obtained by calling the NPDES Unit [phone] or by visiting http://portal.ncdenr.oralweblwq/swp/ps/npdes/forms.
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data,
* No Flow/Discharge From Site. Check this box if no discharge occurs and, as a result, there are no data to be entered for ail of the parameters on the DIAR
Tor entire mgnitonng-period_ - - -
_:�._;____---*�-ORCo>sSite�'URGmustuisitfaci,Stu-anddocumentvisitaton•o-f-facilit3ras-required.par--iS�I�CAC�$G..0244.,e«_--,�c�.�•:v�.,s�_-__.-�"=•--- "--�,S Wk..=__�,...-�
** Signature of Permittee- If signed by other than the pemiiltee, then delegation of the signatory authority must be on file with the state ,per 15A NCAC 2B
0506(b)(2)(D)

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
NPDES PERA•fIT NO.: NCO088501 PERMIT VERSION: 3.0
FACILITY NAME: Stomngton Subdivision - Well ri CLASS- PCNC
OWNER NAME: Aqua North Carolina Inc ORC: Peter Ray Dealing
GRADE: PC-1 ORC HAS CHANGED: No
eDMR PERIOD: 05-2018 (N4ay 2018) VERSION. 1 0
PERMIT STATUS: Active
COUNTY: Forsyth
ORC CERT NUMBER: 994048
STATUS- Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
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No Reporting Reason Fi;FRUSF. = Na : Iew-Reuse(P.ecycle; cl ..= No ISLa Ion- t - — ""

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
NPDES PERMIT NO.: NC0088501
FACILITY NAME: Stonington Sabdwision - Well nl
OWNER NAME: Aqua North Carolina lnc
GRADE: PC-i
eDMR PERIOD: 05-2018 (May 2018)
COMPLIANCE STATUS: Compliant
PERMIT VERSION: 3.0
CLASS•PCNC
ORC: Peter Ray Dealing
ORC TTAS CHANGED: No
VERSION: 1 0
CONTACT PHONE #: [phone]
ORC/Certifier Signature: Peter Ray D
PERMIT STATUS: Active
COUNTY- Forsyth
ORC CERT NUMBER: 99d048
STATUS: Processed
SUBMISSION DATE: 06/262019
_� .. 06/2612019
g E-Mail:[e-mail] Phone #:[phone] Date
By (his signature, I certify that this report is accurate and complete to the best of my knowledge.
The permittee shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment.
Any information shall be provided orally wittun 24 hours from the time the permmttee became aware of the circumstances. A written submission shall also be
provided -.vithin 5 days of the time the permittee becomes'aware of the circumstances.
If the facility is noncompliant, please attach a list of corrective actions being taken and a time -table for improvements to be made as required by part ME 6 of
the NPDES permit.
�J 06/26/2018
Permittee/Submitter Signature:*** Dave McDaniel E-Mail [e-mail] Phone #:[phone] Date
Permittee Address, Stonington Way Ct Kernersville NC 27284 Permit Expiration Date: 02/28/2019
I certify, under penalty of law. that this document and all attachments were prepared under my direction or supervision in accordance with a system designed
to assure that qualified personnel properly gather and evaluate the information submitted Based on my inquiry of the person or persons who managed the
system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true,
accurate, and complete I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for
knowing violations
CERTIFIED LABORATORIES
LAB NAME: Water Tee Lab
CERTIFIED LAB #: 50
PERSON(s) COLLECTING SAMPLES: Peter Dealing
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit [phone] or by visiting http•//portal ncdenr org/webhvq/swpips/npdes/forms.
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data
* No Flow/Discharge From Site Check this box if no discharge occurs and, as a result, there are no data to be entered for all of the parameters on the DMR
for entire monitoring period.
**-ORCbnSite?:ORCiiiust-visit•facili"d-docofnent-visitatian,opl€iei?ity=-as-requited=per15ANCAC--8G,020ks,�,
*** Signature of Permittee: If signed by other than the permittee, then delegation of the signatory authority must be on file with the state per 15A NCAC 2B
.0506(b)(2)(D).

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
NPDES PE2MIT NO.: NCO088501
PERMIT VERSION: 3 0
FACILITY NANITE: Stomngion Su"Aivismn- Well 91
-CLASS. PCNC
OWNER NAME: Aqua North Carolina Inc
ORC: Peter Ray Dealing
GRADE: l'C-t
ORC HAS CIIANGED. No
eDMR. PERIOD: 06-201 8(June 2C18)
VERSION: 1 0
PERMIT STATUS: Active
COUN'-IY:-Forsvth — -
ORC CERT NUMBER: 994048
STATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE': NO
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DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
NPDES PERMIT NO.- NC0088501
FACILITY-NAhfE:-Stonington Subdivision-1�'ell #t
OWNER NAME- Aqua Nortb Carolina Inc
GRADE: PC-1
eDMR PERIOD: 06-2018 (June 20I8)
COMPLIANCE STATUS: Compliant
ORC/Certifier Signature- Peter Ray
PERMIT VERSION: 3 0
CLASS: PCNC
ORC: Peter Ray Dealing
ORC HAS CHANGED: No
VERSION: 1.0
CONTACT PHONE #: [phone]
r
ling
PERMIT STATUS: Active
COUNTY: Fo;syth
ORC CERT NUMBER: 99a048
STATUS: Processed
SUBMISSION DATE: 08/01/2018
E-lvlaii:[e-mail] Phone #.[phone] Date
By this signature. I certify that this report is accurate and complete to the best of my knowledge.
The pemmittee shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment
Any information shall be provided orally within 24 hours from the time the permiteee became aware of the circumstances A written submission shall also be
provided within 5 days of the time the permittee becomes aware of the circumstances.
If the facility is noncompliant, please attach a list of corrective actions being taken and a time -table for improvements to be made as required by part II.E.6 of
the NPDES permit. e
rc,,,_C 08/01 /2018
Permittee/Submitter Signature:*** Dave McDaniel E-h4ail:dtmcdaniel@acuaamerica com Phone #:[phone] Date
Permittee Address: Stonington Way Ct Kernersville NC 27284 Permit Expiration Date: 02128,12019
I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed
to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who managed the
system, or those persons directly responsible for gathering the infntation, the information submitted is, to the best of my knowledge and belief, true,
accurate, and complete I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for
knowing violations.
CERTIFIED LABORATORIES
LAB NAME: Water Tec Lab
CERTIFIED LAB #: 50
PERSON(s) COLLECTING SAMPLES: Peter Dealing
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit [phone] or by visiting http://portal.nedenr org/webhvq/swp/ps/npdes/forms
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data.
* No Flow/Discharge From Site: Check this box if no discharge occurs and, as a result, there are no data to be entered for all of the parameters on the DMR
--- - - for entire monitoring period.-
_- sust_v�sit facilfta and document visitation offacility as required per 15A NCAC 8G .0204,
- -ion — -
*** Signature of Permittee: If signed by other than the permittee. then delegation of the signatory authonty must be on file with the state per 15A NCAC 2B
0506(b)(2)(D),

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
NPDrS PERMIT NO.: NC0088501 PERMIT VERSIOIN: 3 0
-- - FACILITY�NAME: Sloning'or Subdivision-- Well-Ki CLASS: PCNC
OWNER :NAME: Aqua North Carolina Inc ORC: Peter Ray Dealing
GRADE' PC-1 ORC HAS CHANGED: No
eDrYTR PERIOD: 07 2018 (July 2019) VERSION: 1.0
PERMIT STATUS: Active
COUNTY:-Forsyui, _ _ -
ORC CERT NUMBER: 994049
STATUS: Processed
SAMIPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
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****No Reporting Reason E-NCRLISE - \o FIO v-Reuse:Recycle, F.NVGVTIIR - No Visitation-- Acvc7c Weatiicr, NOFLOW = No F10 , r.0 1u�r = No vlslanon - ncli6ay
P

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
NPDES PERMIT NO.: NCO088501
FACILIg1' NAA4E: Stonmgton Subdivision - Well 'l
OWNER NAME: Aqua North Carolina Inc
GRADE: PC-1
eDMR PERIOD: 07-2018 (July 2018)
COMPLIANCE STATUS. Compliant
PERMIT VERSION: 3 0
CLASS: PCNC
ORC: Peter Ray Dealing
ORC HAS CHANGED- No
VERSION: 1 0
CONTACT PHONE #: [phone]
PERMIT STATUS: Active
COUNTY: Forsyth,
ORC CERT NUMBER- 99an48
STATUS: Processcd
SUBMISSION DATE: 08/22/2018
ORC/Certifier Signature. Pete Ray Dealing [e-mail] Phone 11:336-992-9000 Date
By this signature, I certify that this report is accurate and complete to the best of my knowledge.
The permittee shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment.
Any information shall be provided orally within 24 hours from the time the permittee became aware of the circumstances. A written submission shall alsc be
provided within 5 days of the time the perimttee becomes aware of the circumstances.
If the facility is noncomplianF please attach a list of corrective actions being taken and a time -table for improvements to be made as required by part ILE 6 of
the NPDES permit.
J,
C 08/22/2018
Permittee/Submitter Signature:` Dave McDaniel E-Mail:[e-mail] Phone #.[phone] Date
Permtttee Address: Stonmgton Way Ct Kemersville NC 27284 Permit Expiration Date: 02/28/2019
I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed
to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who managed the
system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true,
accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for
knowing violations.
CERTIFIED LABORATORIES
LAB NAME: Water Tec Lab
CERTIFIED LAB 9: 50
PERSON(s) COLLECTING SAMPLES: Peter Dealing
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit [phone] or by visiting httpJ/portal ncdenr.org/web/wq/sw•p/ps/npdes/forrrs.
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data
* No Flow/Discharge From Site: Check this box if no discharge occurs and; as a result, there are no data to be entered for all of the parameters on the DMR
----for entire monitoring period.
** ORC on Site?: ORC must visit facility and documeniyisdation of facility as-req-utred per_15A NCAC 8G- 0204.
*" Signature of Permittee: If signed by other than the permittee, then delegation of the signatory authority must be on file with the state per 15A NCAC 2B
.0506(b)(2)(D).

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
Permit No. NCG590000
PART 1
A. Coverage
(L) Eligibility of Coverage
a. Existing Greensand Water Treatment Plants (WTPs) with individual NPDES permits and new facilities seeking a
NPDES permit for a geensand water purification system utilizing Iron and/or Manganese removal systems are
eligible for coverage under this general permit. Backwash wastewaters from similar activities such as sand filtration
or systems utilizing calcite filtration are eligible and covered under the Greensand WTP effluent requirements section
in this general permit.
b. Existing Conventional WTPs with a wastewater discharge resulting from water purification facilities with filter
backwash, sedimentation basin washdown, and decant from water treatment facilities are eligible for coverage under
this general permit.
(2.) Limitations on Coverage
a. Although this general permit does not cover the following types of discharges, other permits such as an
individual NPDES permit, an alternate general permit, or other approval from the Division may be obtained.
This permit does not authorize discharges from Water Treatment Plants with the following:
• Discharges that are mixed with other process wastewaters.
• Discharges to waters classified as High Quality Waters (HQW) or Outstanding Resource
Waters (ORW).
• Discharges from water purification systems using Membrane Treatment (Reverse Osmosis) or
Ion Exchange.
• Discharges that would adversely affect a Federal or State listed endangered or threatened
species or its critical habitat.
• Discharges of pollutants to an impaired waterbody in excess of the wasteload allocation
specified in an EPA -Approved TMDL (Total Maximum Daily Load).
• Discharges from new Conventional WTPs proposing a discharge to surface waters.
b. New Conventional WTPs proposing a discharge to surface waters shall be covered under an individual permit for
at least one permit cycle. Upon permit renewal, if an evaluation of the facility's wastewaters shows no need for
additional limitations or requirements beyond what is contained in this general permit, then the permittee will be
considered for coverage.
c. Conventional WTPs proposing to expand existing facilities shall submit a Notice of Intent (NOI) permit
application with the proposed expansion/treatment details and an Engineering Alternative Analysis for Division
review and approval in order to obtain coverage for the expansion under this permit and receive a revised
Certificate of Coverage (CoC).
d. This permit does not authorize discharges that the Division has determined to be or which may reasonably be
expected to be contributing to a violation of a water quality standard (as defined in the "Red Book" or NC
Administrative Code 15A NCAC 02B .0100, .0200, and .0300).
e. If the Division determines at any time that the discharge is causing or contributing to a violation of water quality
standards or if the Division has any other grounds for modifying or revoking this permit, the Division may require
corrective action or require the discharge be permitted differently in accordance with Part II, Section B of this
permit. The Division may deny coverage under this permit and require submittal of an application for an
individual NPDES permit based on a review of the Notice of Intent (NOI) or other information.
f. Whole Effluent Toxicity (WET) test results for the past three years shall be reviewed for existing or
expanding Conventional WTPs applying for coverage under this general permit. Permittees with WET test
results showing potential for aquatic toxicity may be denied coverage under this general permit which
includes a WET limitation of "Pass".
(3.) Transfer Coverage from Other Permits
Upon issuance of this general permit, all existing and active individual permits for Greensand and
Conventional type WTPs will automatically be considered for coverage under this general permit as
permit renewal applications are received.
Page 2 of 26

ID:3B1E5887-A307-4BE8-894A-D63642356695
Map for GIS User
Location of My Location
rk
" �,v±". E`er" ,€'"�A ,•`yF �.,. ,,1"''' "�' "'"' ""` ---•w d^•�'� ::,t'
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lLongitude:-80.0759532 W
Latitude: 36.0347382 N
' wT ; ✓w : 16" pew all
Q..
,q,�° f�
' Exist. well
S
1:11,954
_F;
to 'Jill rd
Kernersville IDA ids n:1.•
7.5-minute Quadrangle
Index map
North
Stonington Subdivison - Well # 1 Horizon EngineeringEngineerLng & Consulting, Inc.
USGS Map - Existing Well Location 2510 Walker Road
Kernersville, N.C. Scale: l: 11,954 1
Mt. Pleasant, N.C. 28124 February 19, 2007

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
LINDA CULPEPPER
Director
NORTH CAROLINA
Environmental Quality
May 6, 2019
CERTIFIED MAIL 7016 2140 0000 4371 1179
RETURN RECEIPT REQUESTED
Mr. Shannon V. Becker, President
c/o Amanda Berger
Aqua North Carolina, Inc.
202 Mackenan Court
Cary, North Carolina 27511
Subject: Request for Additional Information
Renewal Application
Stonington Subdivision - Well 91
NPDES permit NCO088501
Forsyth County
Dear Mr. Becker:
The Division has reviewed your application, received on October 5, 2018, for renewal of NPDES permit
NC0088501. To enable us complete our review in accordance with N.C.G.S. 143-215.1 and 15A NCAC
2H.0105, please provide additional or revised information to address the following comments:
1. Please provide five (5) days of Total Hardness (CaCO3 or (Ca + Mg)) data for the effluent at
Outfall 001.
2. Please note the attached data reporting errors form May2014 to October 2018 for permit
NCO088501 and others. Many errors involved reporting the incorrect unit of measure (UoM) such
as mg/L verses µg/L. Another error noted was reporting a value of zero (0) for "no detection" for
Total Residual Chorine (TRC) results instead of reporting the method practical quantitation limit
(PQL) such as < 20 µg/L. If these are indeed errors, please correct DMRs accordingly. Please note
you may want to review and correct DMRs since October 2018 as well.
The NC 2007-2014 Water Quality Standard (WQS) Triennial Review was approved by the NC
Environmental Management Committee (EMC) on November 13, 2014. The US EPA subsequently
approved the WQS revisions on April 6, 2016 with some exceptions. The NC Division of Water
Resources is required to implement the new dissolved metal standards in all permits public noticed after
Apri16, 2016.
The new standards for most metals include acute standards. Furthermore, the freshwater standards for
several metals are expressed as the dissolved form of the metals, and seven metals have hardness -
dependent equations. As a result, the Division will need site -specific effluent hardness data and instream
hardness data, upstream of the discharge, for each facility monitoring these metals in order to calculate
permit limitations. The metal of concern for this permit renewal is Zinc.
To evaluate dissolved Zinc, a Reasonable Potential Analysis (RPA) was conducted using data from
DMRs (May2014—Oct2018) [see attached RPA spreadsheets for Outfall 001]. Results indicated a
reasonable potential to exceed the new dissolved metals standard for Zinc. Consequently, the following
D EQ �� North Carolina Department of Environmental Quality Division of Water Resources
512 North Salisbury Street 1 1617 Mail Service Center I Raleigh, North Carolina 27699-1617
NORTH CAROLINA
oePenmamorenmonmameiaueiz /� 919.707.9000

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
lYL. LVV11Vl
May 6, 2019
Page 2 of 2
daily maximum limits (acute standard) and monthly average limits (in this case the acute standard) for
Total Zinc could be applied for this permit renewal:
Parameter Outfall Monthly Average Limit Daily Maximum Limit
Zinc 001 125.7 µg/L 125.7 µg/L
Please note that the hardness -dependent water quality standard for zinc typically results in a more
stringent permit limit for the acute total allowable metal verses the chronic value. In this situation, we use
the acute total allowable metal concentration (permit limit) as the limitation for both the Daily Maximum
and the Monthly Average.
To calculate these limits a default hardness of 25 mg/L was entered for both the effluent and upstream
values. Since this facility discharges under zero flow conditions a value of 0 was entered for all stream
flow data. Please note that under zero flow conditions the default value of 25 mg/L will be using for the
upstream Total Hardness. Additionally, the maximum monthly average flow of 0.0009 MGD from
November 2015 to October 2018 (3 years) data was used as the effluent flow. For a summary of this
information, please see the attached "Dissolved to Total Metal Calculator".
If no response is received within 60 calendar days [per 15A NCAC 2H.0107(b)], the permit will be
renewed without the benefit of the requested additional information. Therefore, a default effluent
hardness of 25 mg/L will be used to calculate effluent limits for Zinc as indicated above.
Please submit the additional information requested by one of the following:
Electronically: [e-mail]
Address For LISPS:
Attention: Derek Denard
Division of Water Resources
WQ Permitting Section — NPDES
1617 Mail Service Center
Raleigh, NC 27699-1617
Physical Address For parcel packages:
Attention: Wren Tredford
Division of Water Resources
WQ Permitting Section — NPDES
512 N. Salisbury Street
(9th Floor -Archdale Bldg)
Raleigh, NC 27604
If you have any questions, please contact Derek Denard at 919-807-6307 or email at
derekdenardkncdenr.gov.
Sincerely,
Derek Denard, Environmental Specialist
Compliance & Expedited Permitting Unit
Division of Water Resources, NCDEQ
hc: Central Files
ec: Laserfiche
DWR/WSRO, Boone, Ron [ron.boonegancdenr.gov]
Amanda Berger [aaowensgaaquaamerica.com]

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
Freshwater RPA - 95% Probability/95% Confidence Using Metal Translators
MAXIMUM DATA POINTS = 58
REQUIRED DATA ENTRY
Table 1. Project Information
❑CHECK IF HQW OR ORW WQS
Facility Name Stonington Subdivision - Well #1
WWTP/WTP Class PCNC
NPDES Permit NCO088501
Outfall 001
Flow, Qw (MGD) 0.001
Receiving Stream UT to Abbotts Creek
HUC Number 030401030202
Stream Class
WS-11
❑✓ Apply WS Hardness WQC
7Q10s (cfs)
0.00
0.00
7Q10w (cfs)
30Q2 (cfs)
0.00
0.00
QA (cfs)
0.00
1Q10s (cfs)
Effluent Hardness
25 mg/L (Avg)
Upstream Hardness
25 mg/L (Avg)
--------------------
Combined Hardness Chronic
25 mg/L
Combined Hardness Acute
25 mg/L
BIMS Data May2014 to Oct2018; flow data Nov2015
to Oct2018; default hardness
Data Source(s)
❑CHECK TO APPLY MODEL
Follow directions for data entry. In some cases a
comment menu list the available choices or a
dropdown menu will provide a list you may select
from. Error message occur if data entry does not
meet input criteria.
Par01
Par02
Par03
Par04
Par05
Par06E
Par07
Par08
Par09
Par10
Par11
Par12
Par13
Par14
Par15
Par16
Par17
Par18
Par19
Par20
Par21
Par22
Par23
Par24
Par25
Table 2. Parameters of Concern
Name wQs Type Chronic Modifier Acute PCL Units
Arsenic
Aquactic Life
C
150
FW
340
5
ug/L
Arsenic
Human Health
Water Supply
C
10
HH/WS
N/A
5
ug/L
Beryllium
Aquatic Life
NC
6.5
FW
65
ug/L
Cadmium
Aquatic Life
NC
0.5899
FW
3.2396
ug/L
Chlorides
Aquatic Life
NC
230
FW
Chlorinated Phenolic Compounds
Water Supply
NC
1
A
ug/L
Total Phenolic Compounds
Aquatic Life
NC
300
A
ug/L
Chromium III
Aquatic Life
NC
117.7325
FW
905.0818
ug/L
Chromium VI
Aquatic Life
NC
11
FW
16
pg/L
Chromium, Total
Aquatic Life
NC
N/A
FW
N/A
5
pg/L
Copper
Aquatic Life
NC
7.8806
FW
10.4720
5
ug/L
Cyanide
Aquatic Life
NC
5
FW
22
10
ug/L
Fluoride
Aquatic Life
NCI
1,800
FW
ug/L
Lead
Aquatic Life
NC
2.9416
FW
75.4871
ug/L
Mercury
Aquatic Life
NC
12
FW
0.5
ng/L
Molybdenum
Human Health
NC
2000
HH
ug/L
Nickel
Aquatic Life
NC
37.2313
FW
335.2087
pg/L
Nickel
Water Supply
NC
25.0000
WS
N/A
pg/L
Selenium
Aquatic Life
NC
5
FW
56
ug/L
Silver
Aquatic Life
NC
0.06
FW
0.2964
ug/L
Zinc
Aquatic Life
NC
126.7335
FW
125.7052
10
ug/L
NCO088501 001 RPA 2019, input
5/6/2019

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
REASONABLE POTENTIAL ANALYSIS
H1
H2
Use "PASTE SPECIAL
Use "PASTE SPECIAL
Effluent Hardness
Values" then "COPY"
Upstream Hardness
Values" then "COPY"
. Maximum data
. Maximum data
points = 58
points = 58
Date Data BDL=1/2DL Results
Date Data BDL=1/2DL Results
1
25 25 Std Dev.
N/A
1
25 25 Std Dev.
N/A
2
Mean
25.0000
2
Mean
25.0000
3
C.V.
0.0000
3
C.V.
0.0000
4
n
1
4
n
1
5
10th Per value
25.00 mg/L
5
10th Per value
25.00 mg/L
6
Average Value
25.00 mg/L
6
Average Value
25.00 mg/L
7
Max. Value
25.00 mg/L
7
Max. Value
25.00 mg/L
8
8
9
9
10
10
11
11
12
12
13
13
14
14
15
15
16
16
17
17
18
18
19
19
20
20
21
21
22
22
23
23
24
24
25
25
26
26
27
27
28
28
29
29
30
30
31
31
32
32
33
33
34
34
35
35
36
36
37
37
38
38
39
39
40
40
41
41
42
42
43
43
44
44
45
45
46
46
47
47
48
48
49
49
50
50
51
51
52
52
53
53
54
54
55
55
56
56
57
57
58
58
NCO088501 001 RPA 2019, data
2- 5/6/2019

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
REASONABLE POTENTIAL ANALYSIS
Par01 & Par02
Use "PASTE SPECIAL
Arsenic
Values" then "COPY"
. Maximum data
points = 58
Date
Data
BDL=1/2DL
Results
1
5/7/2014
<
5
2.5
Std Dev.
0.0000
2
6/3/2014
<
5
2.5
Mean
2.5000
3
7/2/2014
<
5
2.5
C.V.
0.0000
4
8/6/2014
<
5
2.5
n
4
5
6
Mult Factor =
1.00
7
Max. Value
2.5 ug/L
8
Max. Pred Cw
O DETECTS ug/L
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
NCO088501 001 RPA 2019, data
3 - 5/6/2019

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
REASONABLE POTENTIAL ANALYSIS
Paf08
Par09
Use "PASTE SPECIAL
Use "PASTE SPECIAL
Chromium III
Values" then "COPY"
Chromium VI
Values"then "COPY"
. Maximum data
. Maximum data
points = 58
points = 58
Date
Data BDL=1/2DL Results
Date
Data BDL=1/2DL Results
1
Std Dev.
NO DATA
1
Std Dev.
NO DATA
2
Mean
NO DATA
2
Mean
NO DATA
3
C.V.
NO DATA
3
C.V.
NO DATA
4
n
0
4
n
0
5
5
6
Mult Factor =
N/A
6
Mult Factor =
N/A
7
Max. Value
N/A Ng/L
7
Max. Value
N/A Ng/L
8
Max. Pred Cw
N/A Ng/L
8
Max. Pred Cw
N/A Ng/L
9
9
10
10
11
11
12
12
13
13
14
14
15
15
16
16
17
17
18
18
19
19
20
20
21
21
22
22
23
23
24
24
25
25
26
26
27
27
28
28
29
29
30
30
31
31
32
32
33
33
34
34
35
35
36
36
37
37
38
38
39
39
40
40
41
41
42
42
43
43
44
44
45
45
46
46
47
47
48
48
49
49
50
50
51
51
52
52
53
53
54
54
55
55
56
56
57
57
58
58
NCO088501 001 RPA 2019, data
4- 5/6/2019

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
REASONABLE POTENTIAL ANALYSIS
0
Date Data
1 5/7/2014 <
2 6/3/2014 <
3 7/2/2014 <
4 8/6/2014 <
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
5R
Use "PASTE SPECIAL Pa11
Chromium, Total
values then COPY
. Maximum data
points = 58
BDL=1/2DL
Results
5
2.5
Std Dev.
0.0000
5
2.5
Mean
2.5000
5
2.5
C.V.
0.0000
5
2.5
n
4
Mult Factor =
1.00
Max. Value
2.5 Ng/L
Max. Pred Cw O DETECTS Ng/L
Date Data
1 5/7/2014 <
2 6/3/2014 <
3 7/2/2014 <
4 8/6/2014 <
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
5R
Use "PASTE SPECIAL
Copper
Values" then "COPY"
. Maximum data
points = 58
BDL=1/2DL
Results
5 2.5
Std Dev.
0.0000
5 2.5
Mean
2.5000
5 2.5
C.V.
0.0000
5 2.5
n
4
Mult Factor =
1.00
Max. Value
2.50 ug/L
Max. Pred Cw
O DETECTS ug/L
NCO088501 001 RPA 2019, data
5- 5/6/2019

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
REASONABLE POTENTIAL ANALYSIS
Par21
Use "PASTE SPECIAL
Zinc
Values" then "COPY"
. Maximum data
points = 58
Date
Data
BDL=1/2DL
Results
1
9/6/2017
693
693
Std Dev.
612.4562
2
10/4/2017
1290
1290
Mean
422.6900
3
11/1/2017
1720
1720
C.V.
1.4489
4
12/6/2017
< 10
5
n
10
5
2/7/2018
92.2
92.2
6
3/7/2018
183
183
Mult Factor =
2.89
7
4/4/2018
99.7
99.7
Max. Value
1720.0 ug/L
8
5/2/2018
64
64
Max. Pred Cw
4970.8 ug/L
9
6/6/2018
57.2
57.2
10
7/5/2018
22.8
22.8
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
NCO088501 001 RPA 2019, data
6 - 5/6/2019

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
Stonington Subdivision - Well #1
NCO088501 Freshwater RPA - 95% Probability/95% Confidence Using Metal Translators
MAXIMUM DATA POINTS = 58
Qw (MGD) =
0.00
WWTP/WTP Class:
PCNC
1Q10S(cfs)=
0.00
IWC% @ 1Q10S =
100
7Q10S (cfs) =
0.00
IWC% @ 7Q10S =
100
7Q10W (cfs) =
0.00
IWC% @ 7Q10W =
100
30Q2 (cfs) =
0.00
IWC% @ 30Q2 =
100
Avg. Stream Flow, QA (cfs) =
0.00
IW%C @ QA =
100
Receiving Stream: UT to Abbotts Creek HUC 030401030202 Stream Class:
WS-II
Outfall 001
Qw = 0.0009 MGD
COMBINED HARDNESS (mg/L)
Acute = 25 mg/L
Chronic = 25 mg/L
YOU HAVE DESIGNATED THIS RECEIVING
STREAM AS WATER SUPPLY
Effluent Hard: 0 value > 100 mg/L
Effluent Hard Avg = 25 mg/L
PARAMETER
NC STANDARDS OR EPA CRITERIA
y
REASONABLE POTENTIAL RESULTS
RECOMMENDED ACTION
TYPE
(t)
a
a
t
�
Chronic Applied
Acute
n # Det. Max Pred Cv Allowable Cw
Standard
Acute (FW): 340.0
Arsenic
C
150 FW 340
5
ug/L
No detects
4 0 NO DETECTS
Chronic (FW): 150.0
Max MDL —5
No detects
Arsenic
C
10 F[H/WS
5
ug/L
Note: n < 9
Chronic (HH): 10.0
Limited data set
Max MDL = 5
No detects
Acute: 905.1
Chromium III
NC
117.7325 FW 905.0818
µg/L
0 0
N/A
_
--Chronic-----117.7 -
---------------------------
Acute: 16.0
Chromium VI
NC
11 FW 16
µg/L
0 0
N/A
_
-- Chronic. 11.0—
---------------
Chromium, Total
NC
5
µg/L
4 0 NO DETECTS
a: No monitoring required if all Total Chromium
samples are < 5 pg/L or Pred. max for Total Cr is <
Note: n < 9
allowable Cw for Cr VI.
Limited data set
Max MDL = 5
Acute: 10.47
No detects
Copper
NC
7.8806 FW 10.4720
5
ug/L
4 0 NO DETECTS
Note: n < 9
_ _ _ _ _ _
Chronic: 7.88
_ _ _ _ _ _ _ _ _ _ _ _ _
No detects
Limited data set
Max MDL = 5
Acute: 125.7
RP shown - apply Monthly Monitoring with Limit
Zinc
NC
126.7335 FW 125.7052
10
ug/L
10 9
4,970.8
_ _ _ _
---- -
-- Chronic—126.7
---------------------------
RP shown - apply Monthly Monitoring with Limit
4 values > Allowable Cv
NCO088501 001 RPA 2019, rpa
Page 7 of 8 5/6/2019

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
Date: 5/6/2019
FACILITY: Stonington Subdivision - Well #1 Outfall 001
NPDES PERMIT: NC0088501 Dissolved to Total Metal Calculator
In accordance with Federal Regulations, permit limitations must be written as Total Metals per 40 CFR 122.45(c)
Receiving
Receiving
Rec. Stream
NPDES Total Suspended
Combined
Combined
nstream
Instream
Effluent
Stream
Stream
Solids
Hardness
Hardness
Wastewater
Wastewater
Upstream
Hardness
summer
summer7Q10
1Q10
Flow Limit
-Fixed Value-
chronic
Acute
Concentration
Concentration
Hardness
Average
7Q10 (CFS)
(MGD)
[MGD]
[MGD] (mg/L)
(mg/L)
(mg/L)
(Chronic)
(Acute)
Average (mg/L)
(mg/L)
0.0000
1 0.0000
0.0000
0.0009 10
25.000
25.000
100.0000
100.0000
25
25
Upstream Hard Avg (mg/L) = 25
EFF Hard Avg (mg/L) = 25
ENTS (identify parameters to PERCS Branch to maintain in facility's LTMP/STMP):
PARAMETER
Dissolved Metals
Translators- using
Default Partition
Coefficients
(streams)
(MAEC) as a Total Metal
=Dissolved Metal Translator
Chronic
Acute
Chronic
Acute
u
u /I
u /I
rug/I]
Cadmium (d)
0.15
0.82
0.252
0.59
3.24
Cd -Trout streams
0.15
0.51
0.252
0.59
2.01
Chromium III (d)(h)
24
183
0202.
117.73
905.08
Chromium VI (d)
11
16
1.000
11.00
16.00
Chromium, Total (t)
N/A
N/A
Copper (d)(h)
2.7
3.6
0.348
7.88
10.47
Lead (d)(h)
0.54
14
0.184
2.94
75.49
Nickel (d)(h)
16
145
0.432
37.23
335.21
Ni - WS streams (t)
5 N/A
Silver(d)(h,acute)
0.06
0.301
1.000
0.06 0.30
Zinc (d)(h)
36
361
0.288
126.73 125.71
Beryllium 1 6.51
1.0001
6.51
65
Arsenic (d) 1501
1 1 1.0001
0 1501
0 340
(d) = dissolved metal standard. See 15A NCAC 02B .0211 for more information.
(h) = hardness -dependent dissolved metal standard. See 15A NCAC 02B .0211 for more information.
(t) = based upon measurement of total recoveable metal. See 15A NCAC 02B .0211 for more information.
The Human Health standard for Nickel in Water Supply Streams is 25 mg/L which is Total Recoverable metal standard
The Human Health standard for Arsenic is 10 µg/L which is Total Recoverable metal standard.

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
A
C
F
G
H
I
K
N
O
P
T I U
1
Permit
Facility
Outfall
Month
Day
Year
Parameter
UoM
Value
Modifier
Comments
NCO088498
Aqua North Carolina Inc - Mitchell Bluff
001
6
2
2015
01045 - Iron, Total (as Fe)
ug/I
2.66
UoM mg/L?
2
Subdivision Well #1
NCO088498
Aqua North Carolina Inc - Mitchell Bluff
001
6
2
2015
01055 - Manganese, Total (as Mn)
ug/I
0.238
UoM mg/L?
3
Subdivision Well #1
NCO088498
Aqua North Carolina Inc - Mitchell Bluff
001
10
27
2015
50060 - Chlorine, Total Residual
ug/I
0
PQL?
4
Subdivision Well #1
NCO088498
Aqua North Carolina Inc - Mitchell Bluff
001
8
9
2016
01045 - Iron, Total (as Fe)
ug/I
3.07
UoM mg/L?
5
Subdivision Well #1
NCO088498
Aqua North Carolina Inc - Mitchell Bluff
001
8
9
2016
01055 - Manganese, Total (as Mn)
ug/I
0.23
UoM mg/L?
6
Subdivision Well #1
NCO088498
Aqua North Carolina Inc - Mitchell Bluff
001
8
9
2016
50050 - Flow, in conduit orthru
mgd
0.0072
decimal place?
7
Subdivision Well #1
treatment plant
NCO088498
Aqua North Carolina Inc - Mitchell Bluff
001
8
23
2016
50050 - Flow, in conduit orthru
mgd
0.0072
decimal place?
8
Subdivision Well #1
treatment plant
NCO088498
Aqua North Carolina Inc - Mitchell Bluff
001
10
1
2016
50050 - Flow, in conduit orthru
mgd
0.0072
decimal place?
9
Subdivision Well #1
treatment plant
NCO088498
Aqua North Carolina Inc - Mitchell Bluff
001
10
4
2016
50050 - Flow, in conduit orthru
mgd
0.0072
decimal place?
10
Subdivision Well #1
treatment plant
NCO088498
Aqua North Carolina Inc - Mitchell Bluff
001
10
10
2016
50050 - Flow, in conduit orthru
mgd
0.0072
decimal place?
11
Subdivision Well #1
treatment plant
NCO088498
Aqua North Carolina Inc - Mitchell Bluff
001
10
18
2016
50050 - Flow, in conduit orthru
mgd
0.0072
decimal place?
12
Subdivision Well #1
treatment plant
NCO088498
Aqua North Carolina Inc - Mitchell Bluff
001
10
24
2016
50050 - Flow, in conduit orthru
mgd
0.0072
decimal place?
13
Subdivision Well #1
treatment plant
NCO088498
Aqua North Carolina Inc - Mitchell Bluff
001
10
31
2016
50050 - Flow, in conduit orthru
mgd
0.0072
decimal place?
14
Subdivision Well #1
treatment plant
NCO088498
Aqua North Carolina Inc - Mitchell Bluff
001
11
15
2016
01045 - Iron, Total (as Fe)
ug/I
4.53
UoM mg/L?
151
Subdivision Well #1
NCO088498
Aqua North Carolina Inc - Mitchell Bluff
001
11
15
2016
01055 - Manganese, Total (as Mn)
ug/I
0.192
UoM mg/L?
16
Subdivision Well #1
NCO088498
Aqua North Carolina Inc - Mitchell Bluff
001
12
6
2016
50050 - Flow, in conduit orthru
mgd
0.0072
decimal place?
17
Subdivision Well #1
treatment plant
NCO088498
Aqua North Carolina Inc - Mitchell Bluff
001
12
20
2016
50050 - Flow, in conduit orthru
mgd
0.0072
decimal place?
18
Subdivision Well #1
treatment plant
NCO088498
Aqua North Carolina Inc - Mitchell Bluff
001
2
22
2017
01045 - Iron, Total (as Fe)
ug/I
0.472
UoM mg/L?
19
Subdivision Well #1
NCO088498
Aqua North Carolina Inc - Mitchell Bluff
001
2
22
2017
01055 - Manganese, Total (as Mn)
ug/I
0.071
UoM mg/L?
20
Subdivision Well #1
NCO088498
Aqua North Carolina Inc - Mitchell Bluff
001
5
10
2017
01045 - Iron, Total (as Fe)
ug/I
0.687
UoM mg/L?
21
1
ISubdivision Well #1

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
A
C
F
G
H
I
K
N
O
P
T I U
1
Permit
Facility
Outfall
Month
Day
Year
Parameter
UoM
Value
Modifier
Comments
NCO088498
Aqua North Carolina Inc - Mitchell Bluff
001
5
10
2017
01055 - Manganese, Total (as Mn)
ug/I
0.118
UoM mg/L?
22
Subdivision Well #1
NCO088501
Aqua North Carolina Inc - Stonington
001
6
3
2014
01034 - Chromium, Total (as Cr)
ug/I
0.005
LESSTHAN
UoM mg/L?
23
Subdivision - Well #1
NCO088501
Aqua North Carolina Inc - Stonington
001
8
6
2014
01002 - Arsenic, Total (as As)
ug/I
0.005
LESSTHAN
UoM mg/L?
24
Subdivision - Well #1
NCO088501
Aqua North Carolina Inc - Stonington
001
3
4
2015
50060 - Chlorine, Total Residual
ug/I
0
PQL?
25
Subdivision - Well #1
NCO088501
Aqua North Carolina Inc - Stonington
001
5
6
2015
01055 - Manganese, Total (as Mn)
ug/I
0.057
UoM mg/L?
26
Subdivision - Well #1
NCO088501
Aqua North Carolina Inc - Stonington
001
9
2
2015
01055 - Manganese, Total (as Mn)
ug/I
0.03
UoM mg/L?
27
Subdivision - Well #1
NCO088501
Aqua North Carolina Inc - Stonington
001
10
7
2015
01055 - Manganese, Total (as Mn)
ug/I
0.039
UoM mg/L?
28
Subdivision - Well #1
NCO088501
Aqua North Carolina Inc - Stonington
001
12
2
2015
01055 - Manganese, Total (as Mn)
ug/I
0.005
LESSTHAN
UoM mg/L?
29
Subdivision - Well #1
NCO088501
Aqua North Carolina Inc - Stonington
001
8
3
2016
01055 - Manganese, Total (as Mn)
ug/I
0.01
UoM mg/L?
30
Subdivision - Well #1
NCO088501
Aqua North Carolina Inc - Stonington
001
9
7
2016
01055 - Manganese, Total (as Mn)
ug/I
0.056
UoM mg/L?
31
Subdivision - Well #1
NCO088501
Aqua North Carolina Inc - Stonington
001
10
5
2016
01055 - Manganese, Total (as Mn)
ug/I
0.045
UoM mg/L?
32
Subdivision - Well #1
NCO088501
Aqua North Carolina Inc - Stonington
001
11
2
2016
01055 - Manganese, Total (as Mn)
ug/I
0.044
UoM mg/L?
33
Subdivision - Well #1
NCO088501
Aqua North Carolina Inc - Stonington
001
12
7
2016
01055 - Manganese, Total (as Mn)
ug/I
0.01
UoM mg/L?
34
Subdivision - Well #1
NCO088501
Aqua North Carolina Inc - Stonington
001
1
4
2017
01055 - Manganese, Total (as Mn)
ug/I
0.043
UoM mg/L?
35
Subdivision - Well #1
NCO088501
Aqua North Carolina Inc - Stonington
001
2
1
2017
01045 - Iron, Total (as Fe)
ug/I
0.081
UoM mg/L?
361
Subdivision - Well #1
NCO088501
Aqua North Carolina Inc - Stonington
001
2
1
2017
01055 - Manganese, Total (as Mn)
ug/I
0.076
UoM mg/L?
37
Subdivision - Well #1
NCO088501
Aqua North Carolina Inc - Stonington
001
4
5
2017
01045 - Iron, Total (as Fe)
ug/I
0.243
UoM mg/L?
38
Subdivision - Well #1
NCO088501
Aqua North Carolina Inc - Stonington
001
4
5
2017
50050 - Flow, in conduit orthru
mgd
420
UoM gpd?
39
Subdivision - Well #1
treatment plant
NCO088501
Aqua North Carolina Inc - Stonington
001
4
13
2017
50050 - Flow, in conduit orthru
mgd
500
UoM gpd?
40
Subdivision - Well #1
treatment plant
NCO088501
Aqua North Carolina Inc - Stonington
001
4
19
2017
50050 - Flow, in conduit orthru
mgd
483
UoM gpd?
41
Subdivision - Well #1
treatment plant

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
A
C
F
G
H
I
K
N
O
P
T
U
1
Permit
Facility
Outfall
Month
Day
Year
Parameter
UoM
Value
Modifier
Comments
NCO088501
Aqua North Carolina Inc - Stonington
001
4
26
2017
50050 - Flow, in conduit orthru
mgd
543
UoM gpd?
42
Subdivision - Well #1
treatment plant
NCO088501
Aqua North Carolina Inc - Stonington
001
7
5
2018
01055 - Manganese, Total (as Mn)
ug/I
0.005
LESSTHAN
UoM mg/L?
43
Subdivision - Well #1
NCO088528
Aqua North Carolina Inc - Hillcrest
001
5
27
2015
50060 - Chlorine, Total Residual
ug/I
0
PQL?
44
Subdivision- Well #3
NCO088528
Aqua North Carolina Inc - Hillcrest
001
4
12
2016
50060 - Chlorine, Total Residual
ug/I
0
PQL?
45
Subdivision- Well #3
NCO088528
Aqua North Carolina Inc - Hillcrest
001
8
9
2016
01045 - Iron, Total (as Fe)
ug/I
0.13
UoM mg/I?
46
Subdivision- Well #3
NCO088528
Aqua North Carolina Inc - Hillcrest
001
8
9
2016
01055 - Manganese, Total (as Mn)
ug/I
0.08
UoM mg/I?
47
Subdivision- Well #3
NCO088528
Aqua North Carolina Inc - Hillcrest
001
9
13
2016
01055 - Manganese, Total (as Mn)
ug/I
1.5
UoM mg/I?
48
Subdivision- Well #3
NCO088528
Aqua North Carolina Inc - Hillcrest
001
9
28
2016
01055 - Manganese, Total (as Mn)
ug/I
3.1
UoM mg/I?
49
Subdivision- Well #3
NCO088528
Aqua North Carolina Inc - Hillcrest
001
11
15
2016
01055 - Manganese, Total (as Mn)
ug/I
0.078
UoM mg/I?
50
Subdivision- Well #3
NCO088528
Aqua North Carolina Inc - Hillcrest
001
2
22
2017
01045 - Iron, Total (as Fe)
ug/I
0.117
UoM mg/I?
51
Subdivision- Well #3
NCO088528
Aqua North Carolina Inc - Hillcrest
001
2
22
2017
01055 - Manganese, Total (as Mn)
ug/I
0.037
UoM mg/I?
52
Subdivision- Well #3
NCO088528
Aqua North Carolina Inc - Hillcrest
001
5
9
2017
01045 - Iron, Total (as Fe)
ug/I
0.093
UoM mg/I?
53
Subdivision- Well #3
NCO088528
Aqua North Carolina Inc - Hillcrest
001
5
9
2017
01055 - Manganese, Total (as Mn)
ug/I
0.044
UoM mg/I?
54
Subdivision- Well #3
NCO088536
Aqua North Carolina Inc - Bannertown Hills
001
1
5
2016
50060 - Chlorine, Total Residual
ug/I
0
PQL?
55
Subdivision - Well #2
NCO088536
Aqua North Carolina Inc - Bannertown Hills
001
6
7
2016
50060 - Chlorine, Total Residual
ug/I
0
PQL?
56
Subdivision - Well #2
NCO088536
Aqua North Carolina Inc - Bannertown Hills
001
7
26
2016
50060 - Chlorine, Total Residual
ug/I
0
PQL?
57
Subdivision - Well #2
NCO088536
Aqua North Carolina Inc - Bannertown Hills
001
8
9
2016
01045 - Iron, Total (as Fe)
ug/I
0.75
UoM mg/L?
58
Subdivision - Well #2
NCO088536
Aqua North Carolina Inc - Bannertown Hills
001
8
9
2016
01055 - Manganese, Total (as Mn)
ug/I
0.09
UoM mg/L?
59
Subdivision - Well #2
NCO088536
Aqua North Carolina Inc - Bannertown Hills
001
11
15
2016
01055 - Manganese, Total (as Mn)
ug/I
0.114
UoM mg/L?
60
Subdivision - Well #2
NCO088536
Aqua North Carolina Inc - Bannertown Hills
001
1
11
2017
50060 - Chlorine, Total Residual
ug/I
0
PQL?
61
ISubdivision - Well #2

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
A
C
F
G
H
I
K
N
O
P
T I U
1
Permit
Facility
Outfall
Month
Day
Year
Parameter
UoM
Value
Modifier
Comments
NCO088536
Aqua North Carolina Inc - Bannertown Hills
001
2
22
2017
01045 - Iron, Total (as Fe)
ug/I
0.46
UoM mg/L?
62
Subdivision - Well #2
NCO088536
Aqua North Carolina Inc - Bannertown Hills
001
2
22
2017
01055 - Manganese, Total (as Mn)
ug/I
0.081
UoM mg/L?
63
Subdivision - Well #2
NCO088536
Aqua North Carolina Inc - Bannertown Hills
001
5
9
2017
01055 - Manganese, Total (as Mn)
ug/I
0.45
UoM mg/L?
64
Subdivision - Well #2
NCO088552
Aqua North Carolina Inc - Colonial Woods
001
2
24
2015
01055 - Manganese, Total (as Mn)
ug/I
0.0116
UoM mg/L?
65
Subdivision - Wells #1 & #2
NCO088552
Aqua North Carolina Inc - Colonial Woods
001
6
16
2015
50060 - Chlorine, Total Residual
ug/I
0
PQL?
66
Subdivision - Wells #1 & #2
NCO088552
Aqua North Carolina Inc - Colonial Woods
001
6
28
2016
50060 - Chlorine, Total Residual
ug/I
0
PQL?
67
Subdivision - Wells #1 & #2
NCO088552
Aqua North Carolina Inc - Colonial Woods
002
6
28
2016
50060 - Chlorine, Total Residual
ug/I
0
PQL?
68
Subdivision - Wells #1 & #2
NCO088552
Aqua North Carolina Inc - Colonial Woods
001
8
9
2016
01055 - Manganese, Total (as Mn)
ug/I
0.019
UoM mg/L?
69
Subdivision - Wells #1 & #2
NCO088552
Aqua North Carolina Inc - Colonial Woods
001
11
15
2016
01055 - Manganese, Total (as Mn)
ug/I
0.028
UoM mg/L?
70
Subdivision - Wells #1 & #2
NCO088552
Aqua North Carolina Inc - Colonial Woods
002
11
15
2016
01055 - Manganese, Total (as Mn)
ug/I
1.22
UoM mg/L?
71
Subdivision - Wells #1 & #2
NCO088552
Aqua North Carolina Inc - Colonial Woods
002
12
6
2016
50060 - Chlorine, Total Residual
ug/I
0
PQL?
72
Subdivision - Wells #1 & #2
NCO088552
Aqua North Carolina Inc - Colonial Woods
001
2
22
2017
01045 - Iron, Total (as Fe)
ug/I
0.048
UoM mg/L?
73
Subdivision - Wells #1 & #2
NCO088552
Aqua North Carolina Inc - Colonial Woods
001
2
22
2017
01055 - Manganese, Total (as Mn)
ug/I
0.03
UoM mg/L?
74
Subdivision - Wells #1 & #2
NCO088552
Aqua North Carolina Inc - Colonial Woods
001
2
22
2017
01092 - Zinc, Total (as Zn)
ug/I
0.053
UoM mg/L?
75
Subdivision - Wells #1 & #2
NCO088552
Aqua North Carolina Inc - Colonial Woods
002
2
22
2017
01045 - Iron, Total (as Fe)
ug/I
0.556
UoM mg/L?
76
Subdivision - Wells #1 & #2
NCO088552
Aqua North Carolina Inc - Colonial Woods
002
2
22
2017
01055 - Manganese, Total (as Mn)
ug/I
1.13
UoM mg/L?
77
Subdivision - Wells #1 & #2
NCO088552
Aqua North Carolina Inc - Colonial Woods
002
2
22
2017
01092 - Zinc, Total (as Zn)
ug/I
0.035
UoM mg/L?
78
Subdivision - Wells #1 & #2
NCO088552
Aqua North Carolina Inc - Colonial Woods
001
5
9
2017
01045 - Iron, Total (as Fe)
ug/I
0.163
UoM mg/L?
79
Subdivision - Wells #1 & #2
NCO088552
Aqua North Carolina Inc - Colonial Woods
001
5
9
2017
01055 - Manganese, Total (as Mn)
ug/I
0.018
UoM mg/L?
80
Subdivision - Wells #1 & #2
NCO088552
Aqua North Carolina Inc - Colonial Woods
001
5
9
2017
01092 - Zinc, Total (as Zn)
ug/I
0.01
LESSTHAN
UoM mg/L?
81
Subdivision - Wells #1 & #2

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
A
C
F
G
H
I
K
N
O
P
T I U
1
Permit
Facility
Outfall
Month
Day
Year
Parameter
UOM
Value
Modifier
Comments
NCO088552
Aqua North Carolina Inc - Colonial Woods
002
5
9
2017
01092 - Zinc, Total (as Zn)
ug/I
0.03
UoM mg/L?
82
Subdivision - Wells #1 & #2
NCO088552
Aqua North Carolina Inc - Colonial Woods
002
6
26
2018
50060 - Chlorine, Total Residual
ug/I
0
PQL?
83
Subdivision - Wells #1 & #2
NCO088609
Aqua North Carolina Inc - Windgate
001
9
29
2015
01045 - Iron, Total (as Fe)
ug/I
0.14
UoM mg/L?
84
Subdivision - #1
NCO088609
Aqua North Carolina Inc - Windgate
001
1
19
2016
50060 - Chlorine, Total Residual
ug/I
0
PQL?
85
Subdivision - #1
NCO088609
Aqua North Carolina Inc - Windgate
001
6
7
2016
50060 - Chlorine, Total Residual
ug/I
0
PQL?
86
Subdivision - #1
NCO088609
Aqua North Carolina Inc - Windgate
001
8
9
2016
01045 - Iron, Total (as Fe)
ug/I
2.14
UoM mg/L?
87
Subdivision - #1
NCO088609
Aqua North Carolina Inc - Windgate
001
8
9
2016
01055 - Manganese, Total (as Mn)
ug/I
2.64
UoM mg/L?
88
Subdivision - #1
NCO088609
Aqua North Carolina Inc - Windgate
001
10
11
2016
50060 - Chlorine, Total Residual
ug/I
0
PQL?
89
Subdivision - #1
NCO088609
Aqua North Carolina Inc - Windgate
001
11
15
2016
01045 - Iron, Total (as Fe)
ug/I
2.64
UoM mg/L?
90
Subdivision - #1
NCO088609
Aqua North Carolina Inc - Windgate
001
11
15
2016
01055 - Manganese, Total (as Mn)
ug/I
1.19
UoM mg/L?
91
Subdivision - #1
NCO088609
Aqua North Carolina Inc - Windgate
001
11
15
2016
50060 - Chlorine, Total Residual
ug/I
0
PQL?
92
Subdivision - #1
NCO088609
Aqua North Carolina Inc - Windgate
001
2
22
2017
01045 - Iron, Total (as Fe)
ug/I
0.109
UoM mg/L?
93
Subdivision - #1
NCO088609
Aqua North Carolina Inc - Windgate
001
2
22
2017
01055 - Manganese, Total (as Mn)
ug/I
0.105
UoM mg/L?
94
Subdivision - #1
NCO088609
Aqua North Carolina Inc - Windgate
001
5
9
2017
01045 - Iron, Total (as Fe)
ug/I
0.101
UoM mg/L?
95
Subdivision - #1
NCO088609
Aqua North Carolina Inc - Windgate
001
5
9
2017
01055 - Manganese, Total (as Mn)
ug/I
0.09
UoM mg/L?
96
Subdivision - #1
NCO088609
Aqua North Carolina Inc - Windgate
001
8
1
2017
50050 - Flow, in conduit orthru
mgd
0.00014
decimal place?
97
Subdivision - #1
treatment plant
NCO088609
Aqua North Carolina Inc - Windgate
001
8
8
2017
50050 - Flow, in conduit orthru
mgd
0.00014
decimal place?
98
Subdivision - #1
treatment plant
NCO088609
Aqua North Carolina Inc - Windgate
001
8
15
2017
50050 - Flow, in conduit orthru
mgd
0.00014
decimal place?
99
Subdivision - #1
treatment plant
NCO088609
Aqua North Carolina Inc - Windgate
001
8
29
2017
50050 - Flow, in conduit orthru
mgd
0.00014
decimal place?
100
Subdivision - #1
treatment plant
NCO088609
Aqua North Carolina Inc - Windgate
001
4
17
2018
50060 - Chlorine, Total Residual
ug/I
0
PQL?
11011
1 Subdivision - #1

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
A
C
F
G
H
I
K
N
O
P
T I U
1
Permit
Facility
Outfall
Month
Day
Year
Parameter
UOM
Value
Modifier
Comments
NCO088617
Aqua North Carolina Inc - Snow Hill
001
8
9
2016
01045 - Iron, Total (as Fe)
ug/I
0.18
UoM mg/L?
102
Subdivision
NCO088617
Aqua North Carolina Inc - Snow Hill
001
8
9
2016
01055 - Manganese, Total (as Mn)
ug/I
0.01
UoM mg/L?
103
Subdivision
NCO088617
Aqua North Carolina Inc - Snow Hill
001
10
25
2016
50060 - Chlorine, Total Residual
ug/I
0
PQL?
104
Subdivision
NCO088617
Aqua North Carolina Inc - Snow Hill
001
11
15
2016
01045 - Iron, Total (as Fe)
ug/I
1.45
UoM mg/L?
105
Subdivision
NCO088617
Aqua North Carolina Inc - Snow Hill
001
11
15
2016
01055 - Manganese, Total (as Mn)
ug/I
0.033
UoM mg/L?
1061
Subdivision
NCO088617
Aqua North Carolina Inc - Snow Hill
001
2
22
2017
01045 - Iron, Total (as Fe)
ug/I
1.48
UoM mg/L?
107
Subdivision
NCO088617
Aqua North Carolina Inc - Snow Hill
001
2
22
2017
01055 - Manganese, Total (as Mn)
ug/I
0.038
UoM mg/L?
108
Subdivision
NCO088617
Aqua North Carolina Inc - Snow Hill
001
5
9
2017
01045 - Iron, Total (as Fe)
ug/I
2.37
UoM mg/L?
1091
Subdivision
NCO088617
Aqua North Carolina Inc - Snow Hill
001
5
9
2017
01055 - Manganese, Total (as Mn)
ug/I
0.062
UoM mg/L?
110
Subdivision
NCO088625
Aqua North Carolina Inc -The Hollows
001
10
28
2015
01055 - Manganese, Total (as Mn)
ug/I
0.016
UoM mg/L?
111
Subdivision
NCO088625
Aqua North Carolina Inc -The Hollows
001
8
9
2016
01045 - Iron, Total (as Fe)
ug/I
3.6
UoM mg/L?
1121
Subdivision
NCO088625
Aqua North Carolina Inc -The Hollows
001
8
9
2016
01055 - Manganese, Total (as Mn)
ug/I
1.63
UoM mg/L?
113
Subdivision
NCO088625
Aqua North Carolina Inc -The Hollows
001
9
28
2016
01055 - Manganese, Total (as Mn)
ug/I
0.036
UoM mg/L?
114
Subdivision
NCO088625
Aqua North Carolina Inc -The Hollows
001
10
12
2016
01055 - Manganese, Total (as Mn)
ug/I
0.166
UoM mg/L?
1151
Subdivision
NCO088625
Aqua North Carolina Inc -The Hollows
001
11
15
2016
01055 - Manganese, Total (as Mn)
ug/I
0.078
UoM mg/L?
116
Subdivision
NCO088625
Aqua North Carolina Inc -The Hollows
001
2
22
2017
01045 - Iron, Total (as Fe)
ug/I
0.0675
UoM mg/L?
117
Subdivision
NCO088625
Aqua North Carolina Inc -The Hollows
001
2
22
2017
01055 - Manganese, Total (as Mn)
ug/I
0.497
UoM mg/L?
1181
Subdivision
NCO088625
Aqua North Carolina Inc -The Hollows
001
2
7
2017
50060 - Chlorine, Total Residual
ug/I
0
PQL?
119
Subdivision
NCO088625
Aqua North Carolina Inc -The Hollows
001
4
12
2017
01045 - Iron, Total (as Fe)
ug/I
0.163
UoM mg/L?
120
Subdivision
NCO088625
Aqua North Carolina Inc -The Hollows
001
4
12
2017
01055 - Manganese, Total (as Mn)
ug/I
0.392
UoM mg/L?
11211
ISubdivision

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
A
C
F
G
H
I
K
N
O
P
T I U
1
Permit
Facility
Outfall
Month
Day
Year
Parameter
UoM
Value
Modifier
Comments
NCO088625
Aqua North Carolina Inc -The Hollows
001
5
10
2017
01045 - Iron, Total (as Fe)
ug/I
0.208
UoM mg/L?
122
Subdivision
NCO088625
Aqua North Carolina Inc -The Hollows
001
5
10
2017
01055 - Manganese, Total (as Mn)
ug/I
0.309
UoM mg/L?
123
Subdivision
NCO088625
Aqua North Carolina Inc -The Hollows
001
11
21
2017
01055 - Manganese, Total (as Mn)
ug/I
7
UoM mg/L?
124
Subdivision
NCO088625
Aqua North Carolina Inc -The Hollows
001
12
12
2017
01045 - Iron, Total (as Fe)
ug/I
0.282
UoM mg/L?
125
Subdivision
NCO088625
Aqua North Carolina Inc -The Hollows
001
12
12
2017
01055 - Manganese, Total (as Mn)
ug/I
0.313
UoM mg/L?
1261
Subdivision
NCO088633
Aqua North Carolina Inc - Reeves Woods
001
9
29
2015
01055 - Manganese, Total (as Mn)
ug/I
0.709
UoM mg/L?
127
Subdivision Well #2
NCO088633
Aqua North Carolina Inc - Reeves Woods
001
8
9
2016
01045 - Iron, Total (as Fe)
ug/I
2.3
UoM mg/L?
128
Subdivision Well #2
NCO088633
Aqua North Carolina Inc - Reeves Woods
001
8
9
2016
01055 - Manganese, Total (as Mn)
ug/I
0.77
UoM mg/L?
1291
Subdivision Well #2
NCO088633
Aqua North Carolina Inc - Reeves Woods
001
10
25
2016
50060 - Chlorine, Total Residual
ug/I
0
PQL?
130
Subdivision Well #2
NCO088633
Aqua North Carolina Inc - Reeves Woods
001
11
15
2016
01055 - Manganese, Total (as Mn)
ug/I
4
UoM mg/L?
131
Subdivision Well #2
NCO088633
Aqua North Carolina Inc - Reeves Woods
001
12
6
2016
50060 - Chlorine, Total Residual
ug/I
0
PQL?
1321
Subdivision Well #2
NCO088633
Aqua North Carolina Inc - Reeves Woods
001
2
22
2017
01045 - Iron, Total (as Fe)
ug/I
6.79
UoM mg/L?
133
Subdivision Well #2
NCO088633
Aqua North Carolina Inc - Reeves Woods
001
2
22
2017
01055 - Manganese, Total (as Mn)
ug/I
1.33
UoM mg/L?
134
Subdivision Well #2
NCO088633
Aqua North Carolina Inc - Reeves Woods
001
5
9
2017
01045 - Iron, Total (as Fe)
ug/I
1.27
UoM mg/L?
1351
Subdivision Well #2
NCO088633
Aqua North Carolina Inc - Reeves Woods
001
5
9
2017
01055 - Manganese, Total (as Mn)
ug/I
0.274
UoM mg/L?
136
Subdivision Well #2
NCO088854
Aqua North Carolina Inc - Pine Lakes
001
4
28
2015
50060 - Chlorine, Total Residual
ug/I
0
PQL?
137
Subdivision - Well # 2
NCO088854
Aqua North Carolina Inc - Pine Lakes
001
12
15
2015
50060 - Chlorine, Total Residual
ug/I
0
PQL?
1381
Subdivision - Well # 2
NCO088854
Aqua North Carolina Inc - Pine Lakes
001
8
9
2016
01055 - Manganese, Total (as Mn)
ug/I
0.026
UoM mg/L?
139
Subdivision - Well # 2
NCO088854
Aqua North Carolina Inc - Pine Lakes
001
8
9
2016
01092 - Zinc, Total (as Zn)
ug/I
0.176
UoM mg/L?
140
Subdivision - Well # 2
NCO088854
Aqua North Carolina Inc - Pine Lakes
001
9
13
2016
01055 - Manganese, Total (as Mn)
ug/I
0.02
UoM mg/L?
11411
ISubdivision - Well # 2

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
A
C
F
G
H
I
K
N
O
P
T I U
1
Permit
Facility
Outfall
Month
Day
Year
Parameter
UoM
Value
Modifier
Comments
NCO088854
Aqua North Carolina Inc - Pine Lakes
001
11
15
2016
01055 - Manganese, Total (as Mn)
ug/I
0.009
UoM mg/L?
142
Subdivision - Well # 2
NCO088854
Aqua North Carolina Inc - Pine Lakes
001
11
15
2016
01092 - Zinc, Total (as Zn)
ug/I
0.213
UoM mg/L?
143
Subdivision - Well # 2
NCO088854
Aqua North Carolina Inc - Pine Lakes
001
2
22
2017
01055 - Manganese, Total (as Mn)
ug/I
0.005
LESSTHAN
UoM mg/L?
144
Subdivision - Well # 2
NCO088854
Aqua North Carolina Inc - Pine Lakes
001
5
10
2017
01045 - Iron, Total (as Fe)
ug/I
0.025
LESSTHAN
UoM mg/L?
145
Subdivision - Well # 2
NCO088854
Aqua North Carolina Inc - Pine Lakes
001
5
10
2017
01055 - Manganese, Total (as Mn)
ug/I
0.006
UoM mg/L?
146
Subdivision - Well # 2
NCO088854
Aqua North Carolina Inc - Pine Lakes
001
5
10
2017
01092 - Zinc, Total (as Zn)
ug/I
0.101
UoM mg/L?
147
Subdivision - Well # 2

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece
or on the front if space permits.
Shannon V. Becker, President
c/o Amanda Berger
Aqua North Carolina, Inc.
202 Mackenan Court
Cary NC 27511
A. Signat ft3)
X C Agent
❑ Addressee
S. Received fa me) C. Date of Deliver
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m
$
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Shannon V. Becker, President
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Aqua North Carolina, Inc.
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202 Mackenan Court--
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Cary, NC 27511
PS Form 3800, April 2015 PSN 7630-02-000-9047 See
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Reverse for

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
Denard, Derek
From: Berger, Amanda A <[e-mail]>
Sent: Tuesday, July 02, 2019 3:13 PM
To: Denard, Derek
Cc: Hudson, Gary; Pearce, Joseph R; Ison, Laurie T; McDaniel, David T; Boone, Ron
Subject: [External] RE: Request for Additional Information -NPDES permit NC0088552; NC0088501; NC088854
Attachments: Request for Additional Information - Aqua - Stonington Subdivision - Well #1 - NPDES permit
NC0088501; Request for Additional Information - Aqua - Pine Lakes Subdivision - Well #2 WTP -
NPDES permit NC0088854; Aqua_Hardness Results.pdf
EExternal email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
�
Hi Derek,
We have received the hardness results requested for Stonington (NC0088501), Pine Lakes (NC0088854), and Colonial
Woods (NC0088552).
The lab sent them in one file; therefore, I am including the entire set for all three permits listed (attached).
If you have any questions, please contact me.
Thank you,
0i� ¢rN
A. O E
Amanda Berger
Director of Environmental Compliance
Aqua North Carolina
202 MacKenan Ct; Cary, NC 27511
0:919.653.6965 M:910.773.0406
From: Denard, Derek <[e-mail]>
Sent: Monday, May 06, 2019 5:57 PM
To: Berger, Amanda A <[e-mail]>
Cc: Hudson, Gary <[e-mail]>
Subject: Request for Additional Information - Aqua - Colonial Woods Subdivision — Wells #1 & #2 WTP - NPDES permit
NCO088552
Dear Ms. Berger:
The Division has reviewed your application, received on July 6, 2018, for renewal of NPDES permit NC0088552. To
enable us complete our review in accordance with N.C.G.S. 143-215.1 and 15A NCAC 2H.0105, please provide additional
or revised information to address the following comments:

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
1. Please provide five (5) days of Total Hardness (CaCO3 or (Ca + Mg)) data for the effluent at Outfalls 001 and 002.
2. Please note the attached data reporting errors form May2014 to October 2018 for permit NCO088552 and
others. The data for Zinc is of most importance for this additional information request. Many errors involved
reporting the incorrect unit of measure (UoM) such as mg/L verses µg/L. Another error noted was reporting a
value of zero (0) for "no detection" for Total Residual Chorine (TRC) results instead of reporting the method
practical quantitation limit (PQL) such as < 20 µg/L. If these are indeed errors, please correct DMRs accordingly.
Please note you may want to review and correct DMRs since October 2018 as well.
The NC 2007-2014 Water Quality Standard (WQS) Triennial Review was approved by the NC Environmental
Management Committee (EMC) on November 13, 2014. The US EPA subsequently approved the WQS revisions on April
6, 2016 with some exceptions. The NC Division of Water Resources is required to implement the new dissolved metal
standards in all permits public noticed after April 6, 2016.
The new standards for most metals include acute standards. Furthermore, the freshwater standards for several metals
are expressed as the dissolved form of the metals, and seven metals have hardness -dependent equations. As a result,
the Division will need site -specific effluent hardness data and instream hardness data, upstream of the discharge, for
each facility monitoring these metals in order to calculate permit limitations. The metal of concern for this permit
renewal is Zinc.
To evaluate dissolved Zinc, a Reasonable Potential Analysis (RPA) was conducted using data from DMRs (May2014—
Oct2018) [see attached RPA spreadsheets for Outfalls 001 & 002]. Results indicated a reasonable potential to exceed the
new dissolved metals standard for Zinc. Consequently, the following daily maximum limits (acute standard) and monthly
average limits (in this case the acute standard) for Total Zinc could be applied for this permit renewal:
Parameter
Outfall
Monthly Average
Daily Maximum
Zinc
001
No Limit
No Limit
Zinc
002
125.7 µg/L
125.7 µg/L
Please note that the hardness -dependent water quality standard for zinc typically results in a more stringent permit limit
for the acute total allowable metal verses the chronic value. In this situation, we use the acute total allowable metal
concentration (permit limit) as the limitation for both the Daily Maximum and the Monthly Average.
To calculate these limits a default hardness of 25 mg/L was entered for both the effluent and upstream values. Since this
facility discharges under zero flow conditions a value of 0 was entered for all stream flow data for both Oufalls 001 &
002. Please note that under zero flow conditions the default value of 25 mg/L will be using for the upstream Total
Hardness. Additionally, the maximum monthly average flows of 0.001 MGD for Outfall 001 and 0.001239 MGD for
Outfall 002 from November 2015 to October 2018 (3 years) data was used as the effluent flow. For a summary of this
information, please see the attached "Dissolved to Total Metal Calculator".
If no response is received within 60 calendar days [per 15A NCAC 2H.0107(b)], the permit will be renewed without the
benefit of the requested additional information. Therefore, a default effluent hardness of 25 mg/L will be used to
calculate effluent limits for Zinc as indicated above.
Please submit the additional information requested by one of the following:
Electronically: [e-mail]
Address For USPS:
Attention: Derek Denard
Division of Water Resources
WQ Permitting Section — NPDES
1617 Mail Service Center
Raleigh, NC 27699-1617
Physical Address For parcel packages:
Attention: Wren Tredford
Division of Water Resources
WQ Permitting Section — NPDES
512 N. Salisbury Street
(9th Floor -Archdale Bldg)

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
Raleigh, NC 27604
If you have any questions, please contact Derek Denard at 919-807-6307 or email [e-mail].
Sincerely,
Derek C Denard
Environmental Specialist
Compliance & Expedited Permitting Unit
N.C. Division of Water Resources
N.C. Department of Environmental Quality
919 707 3618 office
919 707 9000 main DWR
derek.denard(a)-ncdenr.gov
N. C. Division of Water Resources
Water Quality Permitting Section - NPDES
1617 Mail Service Center
Raleigh, NC 27699-1617
Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties.

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
RESEARCh & ANALYTICAL Report of Analysis
LA o RATO Ri ES, INC. 7/2/2019
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Lab Sample ID: 68549-01
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Parameter
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Rev Limit Analyst Analysis DaterrTime
Hardness, Total
SM 2340 C-1997
25.2
mg/L
1 AB 7/1/2019
Client Sample ID:
Site:
Stonington Effluent
Aqua NC - Kville
Lab Sample ID: 68549-02
Collection Date: 6/24/2019 16:15
Parameter
Method
Result
Units
Rea Limit Analyst Analysis DatefTime
Hardness, Total
SM 2340 C-1997
66.9
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Client Sample ID:
Site:
Stonington Upstream
Aqua NC - Kville
Lab Sample ID: 68549-03
Collection Date: 6/25/2019 7:00
Parameter
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Hardness, Total
SM 2340 C-1997
25.2
mg1L
1 AB 7/1/2019
Client Sample ID:
Site:
Stonington Effluent
Aqua NC - Kville
Lab Sample ID: 68549-04
Collection Date: 6/25/2019 7:20
Parameter
Method
Result
Units
Rep Limit Analyst Analysis Dateaime
Hardness, Total
SM 2340 C-1997
63.1
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NA = not analyzed
P.O. Box 473 106 Short Street Kernersville, North Carolina 27284 Tel: [phone] Fax: [phone] www.randalabs.com Page 1

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
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RESEARCh & ANALYTICAL
L.AWRATORIES, INC.
For: Aqua NC -Kville
152 B Furlong Ind Drive
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Client Sample ID: Stonington Effluent Lab Sample ID: 68597-02
Site: Aqua NC - Kville Collection Date: 6/26/2019 7:15
Parameter Method Result Units Rep Limit Analys Analysis Datealme
Hardness, Total SM 2340 C-1997 66.0 mg/L 1 AB 7/1/2019
NA = not analyzed
P.O. Box 473 106 Short Street Kernersville, North Carolina 27284 Tel, 336-996-2841 Fax: [phone] www.randalabs.com Page 1

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RESEARCh & ANA1yTICA1
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Client Sample ID: Stonington Effluent Lab Sample ID: 68669-02
Site: Aqua NC - Kville Collection Date: 6/27/2019 7:25
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Hardness, Total SM 2340 C-1997 64.0 mg/L 1 AB 7/1/2019
NA = not onalyzed
P.O. Box 473 106 Short Street Kernersville, North Carolina 27284 TeL [phone] Fax [phone] www.randalabs.com Page 1

DocuSign Envelope
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DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
RESEARCh & ANALYTICAL
LAbORATORI ESP I NC.
For: Aqua NC-Kville
152 B Furlong Ind Drive
Kernersville, NC
Attn: Dave McDaniel
Client Sample ID: Stonington Upstream
Site: Aqua NC - Kville
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Client Sample ID: Stonington Effluent Lab Sample ID: 68719-02
Site: Aqua NC - Kville Collection Date: 6/28/2019 7:45
Parameter Method Result Units Rep Limit Anal Analysis DaterTime
Hardness, Total SM 2340 C-1997 67.9 mg/L 1 AB 7/1/2019
NA = not analyzed
P.O. Box 473 106 Short Street Kernersville, North Carolina 27284 Tel: [phone] Fax: [phone] www.randalabs.com Page 1

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
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RESEARCh & ANA YTiCAI
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For: Aqua NC -Kville
152 B Furlong Ind Drive
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Site: Aqua NC - Kville
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DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
InRESEARCh & ANALyT1CAL
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For: Aqua NC -Kville
152 B Furlong Ind Drive
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Client Sample ID: Colonial Woods Upstream Lab Sample ID: 68754-01
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Hardness, Total SM 2340 C-1997 9.70 mg/L 1 AB 7/1/2019
Client Sample ID: Colonial Woods #1 Effluent Lab Sample ID: 68754-02
Site: Aqua NC - Kville Collection Date: 6/24/2019 13:50
Parameter Method Result Units Rea Limit Analyst Analysis DatelTime
Hardness, Total SM 2340 C-1997 45.6 mglL 1 AB 7/1/2019
Client Sample ID: Colonial Woods #2 Effluent Lab Sample ID: 68754-03
Site: Aqua NC - Kville Collection Date: 6/24/2019 14:22
Parameter Method Result Units Rea Limit Analyst Analysis Date/Time
Hardness, Total SM 2340 C-1997 39.7 mg1L 1 AB 7/1/2019
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DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
RESEARCh & ANA[YTICA[
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152 B Furlong Ind Drive
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P.O. Box 473 106 Short Street Kernersville, North Carolina 27284 Tel; 336-996-2841 Fax: [phone] www,randalabs.com Page 1

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
RESEARCh & ANALyT1CAL
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For: Aqua NC -Kville
152 B Furlong Ind Drive
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Hardness, Total SM 2340 C-1997 8.73 mglL 1 AB 7/1/2019
Client Sample 1D: Colonial Woods Effluent 1 Lab Sample ID: 68756-02
Site: Aqua NC - Kville Collection Date: 6/25/2019 16:00
Parameter Method Result Units Rep Limit Analyst Analysis DateMme
Hardness, Total SM 2340 C-1997 45.6 mglL 1 AB 7/1/2019
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Hardness, Total SM 2340 C-1997 39.8 mglL 1 AB 7/1/2019
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P.O. Box 473 106 Short Street Kernersville, North Carolina 27284 Tel: [phone] Fax: [phone] www.randalabs.corn Page 1
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DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
RESEARCH & ANAtyTICAL
LAbORATORIES, INC.
For: Aqua NC -Kville
152 B Furlong Ind Drive
Kernersville, NC
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Client Sample ID: Pinelakes Upstream
Site: Aqua NC - Kville
Report of Analysis
7/2/2019
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Parameter Method Result Units Rep Lirnit Analyst Analysis DatelTime
Hardness, Total SM 2340 C-1997 27.2 mg/L 1 AB 7/1/2019
NA = not analyzed
P.O. Box 473 106 Short Street Kernersville, North Carolina 27284 Tel: [phone] Fax: [phone] www.randalabs.com Page 1

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
RESEARCh & ANA1yTICAL
LAbORATORIESF INC.
For: Aqua NC -Kville
152 B Furlong Ind Drive
Kernersville, NC
Attn: Dave McDaniel
Client Sample ID: Colonial Woods Upstream
Site: Aqua NC - Kville
Report of Analysis
7/2/2019
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Site: Aqua NC - Kville
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Hardness, Total SM 2340 C-1997
Client Sample ID: Colonial Woods Effluent 2
Site: Aqua NC - Kville
Parameter Method
Hardness, Total SM 2340 C-1997
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Collection Date: 6/26/2019 11:52
Result Units Rep Limit Analys Analysis DatelTime
48.5 mg/L 1 AB 7/1/2019
Lab Sample ID: 68758-03
Collection Date: 6/26/2019 12:25
Result Units Rep Limit Analyst Analysis Date/Time
41.7 mg/L 1 AB 7/1/2019
NA = not analyzed
P.O. Box 473 106 Short Street Kernersville, North Carolina 27284 Tel: [phone] Fax: [phone] www.randalabs.com Page 1

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
RESEARCH & ANAlyTICAI
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REttNn AY

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
RESEARCh & ANA[yTICAL
LAbORATORIESF INC.
For: Aqua NC -Kville
152 B Furlong Ind Drive
Kemersville, NC
Attn: Dave McDaniel
Report of Analysis
7/2/2019
` ,s14t:1111jeri
� Gib
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ttp�
Lp NC #34 Z�
! NC #37701
Client Sample ID: Pinelakes Effluent Lab Sample ID: 68759-01
Site: Aqua NC - Kville Collection Date: 6/27/2019 8:38
Parameter Method Result Units Rep Limit Analy Analysis Date/Time
Hardness, Total SM 2340 C-1997 26.2 mg/L 1 AB 7/1/2019
Client Sample ID: Pinelakes Upstream Lab Samp[e ID: 68759-02
Site: Aqua NC - Kville Collection Date: 6/27/2019 9:20
Parameter Method Result Units Rep Limit Analyst Anal sis DatelTime
Hardness, Total SM 2340 C-1997 13.6 mg/L 1 AB 7/1/2019
NA = not analyzed
P.O. Box 473 106 Short Street Kernersville, North Carolina 27284 Tel: [phone] Fax: [phone] www.randalabs.com Page 1

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
RESEARCIi El ANA[yTICAL
LAbORATORIESill" INC.
For: Aqua NC -Kville
152 B Furlong Ind Drive
Kernersville, NC
Attn: Dave McDaniel
Client Sample ID: Colonial Woods Upstream
Site: Aqua NC - KviUe
Kaameter Method
Hardness, Total SM 2340 C-1997
Client Sample ID: Colonial Woods Effluent 1
Site: Aqua NC - KviUe
Parameter Method
Hardness, Total SM 2340 C-1997
Report of Analysis
7/2/2019
�� Q``1 + •• ••+,• Nil,
:+� A
00 NC #34 7� w
S NC#3770I i
, ,
Lab Sample ID: 68760-01
Collection Date: 6/27/2019 14:50
Result lJnits Rep Limit An st Analysis Date/Time
7.76 mglL 1 AB 7/1/2019
Lab Sample ID: 68760-02
Collection Date: 6/27/2019 15:02
Result Units Rem Analyst Analysis Date/Time
47Z mglL 1 AB 7/1/2019
Client Sample ID: Colonial Woods Effluent 2 Lab Sample ID: 68760-03
Site: Aqua NC - Kville Collection Date: 6/27/2019 15:12
Parameter Method Result Units Rep Limit Analyst Analysis ❑atefrime
Hardness, Total SM 2340 C-1997 38.8 mglL 1 AB 7/1/2019
NA = not analyzed
P.O. Box 473 106 Short Street Kernersville, North Carolina 27284 TeL [phone] Fax: [phone] www.randalabs.com Page 1
rai coo oa�c : id

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
RESEARCh & ANA1YTICAL
LAboRATORIES, INC.
For: Aqua NC -Kville
152 B Furlong Ind Drive
Kernersville, NC
Attn: Dave McDaniel
Report of Analysis
7/2/2019
AMLi
IwoaD NC #34
>� S NC#37701
ED
Client Sample ID: Pinelakes Effluent Lab Sample ID: 68761-01
Site: Aqua NC - Kville Collection Date: 6/28/2019 8:15
Parameter Method Result Units Rep Limit Analyst Anal sis Date/Time
Hardness, Total SM 2340 C-1997 272 mg/L 1 AB 7/1/2019
Client Sample ID: Pinelakes Upstream Lab Sample ID: 68761-02
Site: Aqua NC - Kville Collection Date: 6/28/2019 8:05
rParameter Method Result Units Rep Limit Analyst Analysis Date/Time
l_ _ ...- -.-...- -
Hardness, Total SM 2340 C-1997 11 B mg/L 1 AB 7/1/2019
NA = not analyzed
P.O. Box 473 106 Short Street Kernersville, North Carolina 27284 Tel: [phone] Fax: [phone] www.randalabs.com Page 1
Fr,i I `aria v a

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
RESEARCh & ANA[YTICA[
LABORATORIES, INC.
For: Aqua NC -Kville
152 B Furlong Ind Drive
Kernersville, NC
Attn: Dave McDaniel
Report of Analysis
7/2/2D19
ANAL
r�ssrerrrrrirs
M NC#34 Z�N:
NC #37701
• otSlist
Client Sample ID: Colonial Woods Upstream Lab Sample ID: 68762-01
Site: Aqua NC - Kville Collection Date: 6/28/2019 11:00
Parameter Method Result Units Rep Limit Analyst Analysis Date/Time
Hardness, Total SM 2340 C-1997 6.80 mg/L 1 AB 7/1/2019
Client Sample ID: Colonial Woods Effluent 1 Lab Sample ID: 68762-02
Site: Aqua NC - Kville Collection Date: 6/28/2019 11:12
Parameter Method Result Units Rep Limit Analy Analysis DatelTime
Hardness, Total SM 2340 C-1997 46.6 mg/L 1 AB 7/1/2019
Client Sample ID: Colonial Woods Effluent 2 Lab Sample ID: 68762-03
Site: Aqua NC - Kville Collection Date: 6/28/2019 11:25
Parameter Method Result Units Rep Limit Analyst Analysis Date/Time
Hardness, Total SM 2340 C-1997 40.7 mg/L 1 AB 7/1/2019
NA _ not onolyzed
P.O. Box 473 106 Short Street Kernersville, North Carolina 27284 Tel: [phone] Fax: [phone] www.randalabs.com Page 1
ral

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
RESEARCh & ANA1yTiCA1
UbORATORIES, INC.
Analytical / Process Consultations
Phone [phone]
CHAIN OF CUSTODY RECORD
COMPANY � t
JOB NO.
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STREETADDRESS Af
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SAMPLER NAME (PLEASE PRINT)
CONTACT PHONE
ILI-
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(LAB USE ONLY!
TIME
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RELINQUISHED BY
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REMARKS:
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RELINQUISHED BY
DATEMME
RECEIVED BY

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
2018 NC Category 5 Assessments "303(d) List" Final
Yadkin -Pee Dee River Basin
12-108-11-3
iPatterson Creek
b_Es}
South Yadkin Subbasin 03040102
From source to Rocky Creek
Classification C Length or Area 11 Units FW Miles Previous AU Number
4ssessment Criteria Status Reason for Rating Parameter of Inter Category
Exceeding Criteria Fair Benthos (Nar, AL, FW) �5
12-108-9-(0.6) 1 ISnow Creek
From a point 1.1 miles upstream of Iredell County SR 1614 to South Yadkin River
Classification WS-IV Length or Area 13 Units FW Miles Previous AU Number
essrnt Criteria Status Reason for Rating Parameter of Interest Category
Exceeding Criteria Fair Fish Community (Nar, AL, FW) 5
Lower Yadkin Subbasin 03040103
12-119-(1) bA Botts Creek
From source to a point 0.5 mile upstream of Davidson County SR 1810
Classification WS-III Length or Area 19 Units FW Miles Previous AU Number
12-119-(6)b
or Rating -
Exceeding Criteria Fair Fish Community (Nar, AL, FW)
botts Creek
From SR1243 to185
Classification
Length or Area 2 Units FW Miles Previous AU Number C
Assessment Criteria Status
Reason for Rating
rameter of Inter
Category
Exceeding Criteria
Fair
Benthos (Nar, AL, FW)
5
6/3/2019 2018 NC Category 5 Assessments "303(d) List" Approved by EPA May 22,2019 Page 243 of 262

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
MONITORING REPORT(MR) VIOLATIONS for:
Report Date:
12/06/18 Page:
1 of 2
Permit:
NCO088501
MRs Between 11 -
2013 and 10 - 2018
Region:
%
Violation Category:%
Program Category:
Facility Name:
%
Param Name %
County:
%
Subbasin:%
Violation Action:
Major Minor:
%
PERMIT: NCO088501
FACILITY:
Aqua North Carolina Inc - Stonington Subdivision -Well
COUNTY: Forsyth
REGION: Winston-Salem
#1
Limit Violation
MONITORING
OUTFALL/
VIOLATION
UNIT OF
CALCULATED
%
REPORT
PPI
LOCATION
PARAMETER
DATE
FREQUENCY
MEASURE
LIMIT
VALUE
Over
VIOLATION TYPE
VIOLATION ACTION
11 -2013
001
Effluent
Chlorine, Total Residual
11/13/13
2 X month
ug/I
17
21
23.5
Daily Maximum
No Action, BPJ
Exceeded
01 -2014
001
Effluent
Chlorine, Total Residual
01/08/14
2 X month
ug/I
17
21
23.5
Daily Maximum
No Action, BPJ
Exceeded
11 -2014
001
Effluent
Chlorine, Total Residual
11/19/14
2 X month
ug/I
28
43
53.6
Daily Maximum
No Action, BPJ
Exceeded
02-2015
001
Effluent
Chlorine, Total Residual
02/02/15
2 X month
ug/I
28
37
32.1
Daily Maximum
No Action, BPJ
Exceeded
06-2015
001
Effluent
Chlorine, Total Residual
06/17/15
2 X month
ug/I
28
44
57.1
Daily Maximum
No Action, BPJ
Exceeded
07-2015
001
Effluent
Chlorine, Total Residual
07/15/15
2 X month
ug/I
28
33
17.9
Daily Maximum
No Action, BPJ
Exceeded
05-2016
001
Effluent
Chlorine, Total Residual
05/18/16
2 X month
ug/I
28
29
3.6
Daily Maximum
No Action, BPJ
Exceeded
06-2016
001
Effluent
Chlorine, Total Residual
06/01/16
2 X month
ug/I
28
32
14.3
Daily Maximum
No Action, BPJ
Exceeded
06-2016
001
Effluent
Chlorine, Total Residual
06/15/16
2 X month
ug/I
28
33
17.9
Daily Maximum
No Action, BPJ
Exceeded
07-2016
001
Effluent
Chlorine, Total Residual
07/06/16
2 X month
ug/I
28
47
67.9
Daily Maximum
No Action, BPJ
Exceeded
07-2016
001
Effluent
Chlorine, Total Residual
07/20/16
2 X month
ug/I
28
33
17.9
Daily Maximum
No Action, BPJ
Exceeded
09-2016
001
Effluent
Chlorine, Total Residual
09/07/16
2 X month
ug/I
28
44
57.1
Daily Maximum
No Action, BPJ
Exceeded
10-2016
001
Effluent
Chlorine, Total Residual
10/05/16
2 X month
ug/I
28
37
32.1
Daily Maximum
No Action, BPJ
Exceeded
12-2016
001
Effluent
Chlorine, Total Residual
12/21/16
2 X month
ug/I
28
31
10.7
Daily Maximum
No Action, BPJ
Exceeded
01 -2017
001
Effluent
Chlorine, Total Residual
01/04/17
2 X month
ug/I
28
29
3.6
Daily Maximum
No Action, BPJ
Exceeded

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
MONITORING REPORT(MR) VIOLATIONS for:
W Permit: NCO088501 %Rs Between 11 - 2013 and 10 - 2018 Region: %
Facility Name: % am Name % County: %
Major Minor: %
PERMIT: NCO088501 FACILITY: Aqua North Carolina Inc -Stonington Subdivision -Well
#1
Report Date: 12/06/18 Page: 2 of 2
Violation Category:% IN Program Category: ./o
Subbasin:% Violation Action: ./o
Ir
COUNTY: Forsyth REGION: Winston-Salem
Limit Violation
MONITORING
OUTFALL/
VIOLATION
UNIT OF
CALCULATED
%
REPORT
PPI
LOCATION
PARAMETER
DATE
FREQUENCY
MEASURE
LIMIT VALUE
Over
VIOLATION TYPE
VIOLATION ACTION
07-2017
001
Effluent
Chlorine, Total Residual
07/19/17
2 X month
ug/I
28 33
17.9
Daily Maximum
No Action, BPJ
Exceeded
Monitoring Violation
MONITORING
OUTFALL/
VIOLATION
UNIT OF
CALCULATED
%
REPORT
PPI
LOCATION
PARAMETER
DATE
FREQUENCY
MEASURE
LIMIT VALUE
Over
VIOLATION TYPE
VIOLATION ACTION
09-2014
001
Effluent
Turbidity
09/30/14
2 X month
ntu
Frequency Violation
Proceed to NOD
10-2014
001
Effluent
Turbidity
10/31/14
2 X month
ntu
Frequency Violation
Proceed to NOV
11 - 2014
001
Effluent
Turbidity
11/30/14
2 X month
ntu
Frequency Violation
Proceed to NOV

r
DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
Water Resources
ENVIRONMENTAL QUALITY
February 19, 2016
Aqua North Carolina Inc.
Attn: Thomas J. Roberts, President & COO
202 Mackenan Drive
Cary, NC 27511
Subject: Compliance Evaluation Inspection
Permittee: Aqua North Carolina Inc.
Facility: Stonington Subdivision — Well #1
NPDES Permit #: NCO088501
Forsyth County
Dear Mr. Roberts:
PAT MCCRORY
Govemor
DONALD R. VAN DER VAART
Secretary
S. JAY ZIMMERMAN
RECEIVED/NCDEQ/DWR
FEB 2 9 2016'
Water Quelity
Permitting Section
Director
Ron Boone of the Winston-Salem Regional Office of the NC Division of Water Resources (DWR or the
Division) conducted a compliance evaluation inspection (CEI) of the Stonington Subdivision — Well #1 on February 11,
2016. The assistance and cooperation of Peter Dealing, system operator, was greatly appreciated. An inspection
checklist is attached for your records and inspection findings are summarized below.
General Information
The Stonington Subdivision — Well #1 is located on the north side of Stonington Subdivision, in Kernersville,
Forsyth County, NC, at approximate coordinates 36.034672°N, 80.076049°W. The permit authorizes Aqua to operate
this 0.0021 MGD facility, which consists of five green sand filters used to treat ground water for use as potable water
for the subdivision. Chemicals used in the water treatment process include Potassium Permanganate, Chlorine, and
Caustic Soda. The permit authorizes Aqua to discharge the filter backwash wastewater from the facility via outfall 001
to an unnamed tributary of Abbotts Creek, which is currently classified as Class WS-III waters in the Yadkin Pee -Dee
river basin.
Site Review
Mr. Dealing has done a good job operating and maintaining the plant. No discrepancies were found.
Documentation Review
Mr. Boone reviewed all paperwork with Mr. Dealing, including discharge monitoring reports, laboratory result
records and bench sheets, chains of custody, operator visitation logs, operation and maintenance logs, etc. Everything
was in order, complete, and current and no discrepancies were found. Mr. Dealing is doing a great job keeping up with
the required paperwork for the facility.
You are reminded that, in accordance with NC General Statute 143-215.6A, the Director of the Division of
Water Resources may assess civil penalties not to exceed $25,000 per day, per violation, for violations of NCGS
143-215.1 or the NCO088501 NPDES permit.
State of North Carolma I Environmental Quality I Water Resources
450 West Hanes Mill Road, Suite 300 1 Winston-Salem, North Carolina 27105
336 776 9800

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
33
If you have any questions regarding the inspection or this letter, please call Mr. Boone or me at (336) 776-
9800. Thank you for your cooperation in this matter.
Sincerely,
Sherri V. Knight, PE
Regional Supervisor
Water Quality Regional Operations
Division of Water Resources
Attachments:
BIMS Inspection Report
CC: WSRO-SWP
Central Files
NPDES Unit 4

`DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
United States Environmental Protection Agency
Form Approved
EPA Washington, D C 20460
OMB No 2040-0057
Water Compliance Inspection Report
Approval expires 8-31-98
Section A National Data System Coding (i e., PCS)
Transaction Code NPDES yr/mo/day Inspection Type
Inspector _ Fac Type
1 IN 1 2 15 1 3 I NCO088501 I11 12 I 16/02/11 I17 18 L l
19 L G j 201 I
2111111111111111111111111111111,1111111111111
�6
Inspection
Work Days Facility Self -Monitoring Evaluation Rating 81 QA —------- —-------- Reserved -------------
67
701_J 72
NJ 73I 74 75I III I I I (8071 JL
Section B. Facility Data
Name and Location of Facility Inspected (For Industrial Users discharging to POTW, also include
Entry Time/Date
Permit Effective Date
POTW name and NPDES permit Number)
10 OOAM 16/02/11
14/09/01
Stonington Subdivision - Well #1
Stonington Way Ct
Exit Time/Date
Permit Expiration Date
Kernersville NC 27284
11 OOAM 16/02/11
19/02/28
Name(s) of Onsite Representative(s)/Titles(s)/Phone and Fax Number(s)
Other Facility Data
Peter Ray Deal ing/ORC/336-362-2008/
Name, Address of Responsible Official/Title/Phone and Fax Number
Contacted
Thomas J Roberts,202 Mackenan Ct Cary NC
No
2751 1/President/919-653-6967/9194661583
Section C Areas Evaluated During Inspection (Check only those areas evaluated)
Permit ® Flow Measurement Operations & Maintenance ® Records/Reports
Self -Monitoring Program E Facility Site Review ® Effluent/Receiving Waters ® Laboratory
Section D- Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
(See attachment summary)
Name(s) and Signature(s) of Inspector(s) Agency/Office/Phone and Fax Numbers
Date
Ron WSRO WQ//336-776-9690/
Signature of Management Q A Reviewer Agency/Office/Phone and Fax Numbers
Date
4"Y I
?,//9/1(r
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete
Page#

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
NPDES yr/mo/day Inspection Type
31 NCO088501 I11 12 16/02/11 17 18 ICI
Section D Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
Please refer to the attached inspection summary letter.
Page#

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
if
Permit: NCO088501 Owner - Facility: Stonington Subdivision - Well #1
Inspection Date: 02/11/2016 Inspection Type: Compliance Evaluation
Operations & Maintenance
Yes No NA NE
Is the plant generally clean with acceptable housekeeping?
®
❑
❑
❑
Does the facility analyze process control parameters, for ex- MLSS, MCRT, Settleable
®
❑
❑
❑
Solids, pH, DO, Sludge Judge, and other that are applicable?
Comment: None
Permit
Yes No NA NE
(If the present permit expires In 6 months or less). Has the permlttee submitted a new
❑
❑
®
❑
application?
Is the facility as described in the permit?
®
❑
❑
❑
# Are there any special conditions for the permit?
❑
®
❑
❑
Is access to the plant site restricted to the general public?
®
❑
❑
❑
Is the inspector granted access to all areas for inspection?
®
❑
❑
❑
Comment: None
Record Keeping
Yes No NA NE
Are records kept and maintained as required by the permit?
®
❑
❑
❑
Is all required information readily available, complete and current?
®
❑
❑
❑
Are all records maintained for 3 years (lab. reg required 5 years)?
®
❑
❑
❑
Are analytical results consistent with data reported on DMRs?
®
❑
❑
❑
Is the chain -of -custody complete?
®
❑
❑
❑
Dates, times and location of sampling
Name of individual performing the sampling
Results of analysis and calibration
Dates of analysis
0
Name of person performing analyses
Transported COCs
Are DMRS complete: do they include all permit parameters?
M
❑
❑
❑
Has the facility submitted its annual compliance report to users and DWQ?
❑
❑
■
❑
(If the facility is = or > 5 MGD permitted flow) Do they operate 24/7 with a certified operator
❑
❑
■
❑
on each shift?
Is the ORC visitation log available and current?
i
❑
❑
❑
Is the ORC certified at grade equal to or higher than the facility classification?
M
❑
❑
❑
Is the backup operator certified at one grade,less or greater than the facility classification?
■
❑
❑
❑
Is a copy of the current NPDES permit available on site?
■
❑
❑
❑
Page# 3

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
Permit: NCO088501 Owner - Facility: Stonington Subdivision - Well #1
Inspection Date: 02/11/2016 Inspection Type: Compliance Evaluation
Record Keeping Yes No NA NE
Facility has copy of previous year's Annual Report on file for review? ❑ ❑ ® ❑
Comment: None
Effluent Pipe Yes No NA NE
Is right of way to the outfall properly maintained? ® ❑ ❑ ❑
Are the receiving water free'of foam other than trace amounts and other debris? ® ❑ ❑ ❑
If effluent (diffuser pipes are required) are they operating properly? ❑ ❑ ® ❑
Comment: None
Laboratory
Yes No NA NE
Are field parameters performed by certified personnel or laboratory?
®
❑
❑
❑
Are all other parameters(excluding field parameters) performed by a certified lab?
®
❑
❑
❑
# Is the facility using a contract lab?
®
❑
❑
❑
# Is proper temperature set for sample storage (kept at less than or equal to 6 0 degrees
❑
❑
❑
Celsius)?
Incubator (Fecal Coliform) set to 44 5 degrees Celsius+/- 0 2 degrees?
❑
❑
®
❑
Incubator (BOD) set to 20 0 degrees Celsius +/- 1.0 degrees?
❑
❑
®
❑
Comment: None
Effluent Sampling
Yes No NA NE
Is composite sampling flow proportional'?
❑
❑
■
❑
Is sample collected below all treatment units
®
❑
❑
❑
Is proper volume collected?
®
❑
❑
❑
Is the tubing clean?
❑
❑
®
❑
# Is proper temperature set for sample storage (kept at less than or equal to 6 0 degrees
❑
❑
❑
Celsius)?
Is the facility sampling performed as required by the permit (frequency, sampling type
0
❑
❑
❑
representative)?
Comment: None
Page# 4

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
Freshwater RPA - 95% Probability/95% Confidence Using Metal Translators
MAXIMUM DATA POINTS = 58
REQUIRED DATA ENTRY
Table 1. Project Information
❑ CHECK IF HQW OR ORW WQS
Facility Name Stonington Subdivision - Well #1
WWTP/WTP Class PCNC
NPDES Permit NCO088501
Outfall 001
Flow, Qw (MGD) 0.001
Receiving Stream UT to Abbotts Creek
HUC Number 030401030202
Stream Class
WS-11
❑ Apply WS Hardness WQC
7Q10s (cfs)
0.00
7Q10w (cfs)
0.00
0.00
30Q2 (cfs)
0.00
QA (cfs)
1Q10s (cfs)
0.00
Effluent Hardness
65.58 mg/L (Avg)
Upstream Hardness
25.6 mg/L (Avg)
Combined Hardness Chronic
65.58 mg/L
Combined Hardness Acute
65.58 mg/L
BIMS Data May2014 to Oct2018; flow data Nov2015
to Oct2018. Effluent and upstream Hardness data
for 06/24/2019 to 06/28/2019 received from Aqua on
Data Source(s)
❑ CHECK TO APPLY MODEL
July 2, 2019.
Follow directions for data entry. In some cases a
comment menu list the available choices or a
dropdown menu will provide a list you may select
from. Error message occur if data entry does not
meet input criteria.
Par01
Par02
Par03
Par04
Par05
Par06E
Par07
Par08
Par09
Par10
Par11
Par12
Par13
Par14
Par15
Par16
Par17
Par18
Par19
Par20
Par21
Par22
Par23
Par24
Par25
Table 2. Parameters of Concern
Name wQs Type Chronic Modifier Acute PCL Units
Arsenic
Aquactic Life
C
150
FW
340
5
ug/L
Arsenic
Human Health
Water Supply
C
10
HH/WS
N/A
5
ug/L
Beryllium
Aquatic Life
NC
6.5
FW
65
ug/L
Cadmium
Aquatic Life
NC
1.2225
FW
7.5148
ug/L
Chlorides
Aquatic Life
NC
230
FW
Chlorinated Phenolic Compounds
Water Supply
NC
1
A
ug/L
Total Phenolic Compounds
Aquatic Life
NC
300
A
ug/L
Chromium III
Aquatic Life
NC
259.3698
FW
1993.9338
ug/L
Chromium VI
Aquatic Life
NC
11
FW
16
pg/L
Chromium, Total
Aquatic Life
NC
N/A
FW
N/A
5
pg/L
Copper
Aquatic Life
NC
17.9661
FW
25.9808
5
ug/L
Cyanide
Aquatic Life
NC
5
FW
22
10
ug/L
Fluoride
Aquatic Life
NCI
1,800
FW
ug/L
Lead
Aquatic Life
NC
8.6197
FW
221.1965
ug/L
Mercury
Aquatic Life
NC
12
FW
0.5
ng/L
Molybdenum
Human Health
NC
2000
HH
ug/L
Nickel
Aquatic Life
NC
84.1860
FW
757.9606
pg/L
Nickel
Water Supply
NCI
25.0000
WS
N/A
pg/L
Selenium
Aquatic Life
NC
5
FW
56
ug/L
Silver
Aquatic Life
NC
0.06
FW
1.5569
ug/L
Zinc
Aquatic Life
NC
286.9242
FW
284.5962
10
ug/L
NCO088501 001 RPA 2019, input
7/9/2019

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
REASONABLE POTENTIAL ANALYSIS
H1 H2
Use "PASTE SPECIAL
Effluent Hardness Values" then "COPY"
. Maximum data
points = 58
Date
Data
BDL=1/2DL
Results
1
6/24/2019
66.9
66.9
Std Dev.
2
6/25/2019
63.1
63.1
Mean
3
6/26/2019
66.0
66
C.V. (default)
4
6/27/2019
64.0
64
n
5
6/28/2019
67.9
67.9
10th Per value
6
Average Value
7
Max. Value
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
Use "PASTE SPECIAL
Upstream Hardness Values" then "COPY"
. Maximum data
points = 58
Date
Data
BDL=1/2DL
Results
1.9967
1
6/24/2019
25.2
25.2
Std Dev.
0.5477
65.5800
2
6/25/2019
25.2
25.2
Mean
25.6000
0.6000
3
6/26/2019
26.2
26.2
C.V. (default)
0.6000
5
4
6/27/2019
26.2
26.2
n
5
63.46 mg/L
5
6/28/2019
25.2
25.2
10th Per value
25.20 mg/L
65.58 mg/L
6
Average Value
25.60 mg/L
67.90 mg/L
7
Max. Value
26.20 mg/L
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
NCO088501 001 RPA 2019, data
2- 7/9/2019

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
REASONABLE POTENTIAL ANALYSIS
Par01 & Par02
Use "PASTE SPECIAL
Arsenic
Values" then "COPY"
. Maximum data
points = 58
Date
Data
BDL=1/2DL
Results
1
5/7/2014
<
5
2.5
Std Dev.
0.0000
2
6/3/2014
<
5
2.5
Mean
2.5000
3
7/2/2014
<
5
2.5
C.V.
0.0000
4
8/6/2014
<
5
2.5
n
4
5
6
Mult Factor =
1.00
7
Max. Value
2.5 ug/L
8
Max. Pred Cw
O DETECTS ug/L
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
NCO088501 001 RPA 2019, data
3 - 7/9/2019

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
REASONABLE POTENTIAL ANALYSIS
Paf08
Par09
Use "PASTE SPECIAL
Use "PASTE SPECIAL
Chromium III
Values" then "COPY"
Chromium VI
Values"then "COPY"
. Maximum data
. Maximum data
points = 58
points = 58
Date
Data BDL=1/2DL Results
Date
Data BDL=1/2DL Results
1
Std Dev.
NO DATA
1
Std Dev.
NO DATA
2
Mean
NO DATA
2
Mean
NO DATA
3
C.V.
NO DATA
3
C.V.
NO DATA
4
n
0
4
n
0
5
5
6
Mult Factor =
N/A
6
Mult Factor =
N/A
7
Max. Value
N/A Ng/L
7
Max. Value
N/A Ng/L
8
Max. Pred Cw
N/A Ng/L
8
Max. Pred Cw
N/A Ng/L
9
9
10
10
11
11
12
12
13
13
14
14
15
15
16
16
17
17
18
18
19
19
20
20
21
21
22
22
23
23
24
24
25
25
26
26
27
27
28
28
29
29
30
30
31
31
32
32
33
33
34
34
35
35
36
36
37
37
38
38
39
39
40
40
41
41
42
42
43
43
44
44
45
45
46
46
47
47
48
48
49
49
50
50
51
51
52
52
53
53
54
54
55
55
56
56
57
57
58
58
NCO088501 001 RPA 2019, data
4- 7/9/2019

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
REASONABLE POTENTIAL ANALYSIS
0
Date Data
1 5/7/2014 <
2 6/3/2014 <
3 7/2/2014 <
4 8/6/2014 <
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
5R
Use "PASTE SPECIAL Pa11
Chromium, Total
values then COPY
. Maximum data
points = 58
BDL=1/2DL
Results
5
2.5
Std Dev.
0.0000
5
2.5
Mean
2.5000
5
2.5
C.V.
0.0000
5
2.5
n
4
Mult Factor =
1.00
Max. Value
2.5 Ng/L
Max. Pred Cw O DETECTS Ng/L
Date Data
1 5/7/2014 <
2 6/3/2014 <
3 7/2/2014 <
4 8/6/2014 <
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
5R
Use "PASTE SPECIAL
Copper
Values" then "COPY"
. Maximum data
points = 58
BDL=1/2DL
Results
5 2.5
Std Dev.
0.0000
5 2.5
Mean
2.5000
5 2.5
C.V.
0.0000
5 2.5
n
4
Mult Factor =
1.00
Max. Value
2.50 ug/L
Max. Pred Cw
O DETECTS ug/L
NCO088501 001 RPA 2019, data
5- 7/9/2019

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
REASONABLE POTENTIAL ANALYSIS
Par21
Use "PASTE SPECIAL
Zinc
Values" then "COPY"
. Maximum data
points = 58
Date
Data
BDL=1/2DL
Results
1
9/6/2017
693
693
Std Dev.
612.4562
2
10/4/2017
1290
1290
Mean
422.6900
3
11/1/2017
1720
1720
C.V.
1.4489
4
12/6/2017
< 10
5
n
10
5
2/7/2018
92.2
92.2
6
3/7/2018
183
183
Mult Factor =
2.89
7
4/4/2018
99.7
99.7
Max. Value
1720.0 ug/L
8
5/2/2018
64
64
Max. Pred Cw
4970.8 ug/L
9
6/6/2018
57.2
57.2
10
7/5/2018
22.8
22.8
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
NCO088501 001 RPA 2019, data
6 - 7/9/2019

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
Stonington Subdivision - Well #1
NCO088501 Freshwater RPA - 95% Probability/95% Confidence Using Metal Translators
MAXIMUM DATA POINTS = 58
Qw (MGD) =
0.00
WWTP/WTP Class:
PCNC
1Q10S(cfs)=
0.00
IWC% @ 1Q10S =
100
7Q10S (cfs) =
0.00
IWC% @ 7Q10S =
100
7Q10W (cfs) =
0.00
IWC% @ 7Q10W =
100
30Q2 (cfs) =
0.00
IWC% @ 30Q2 =
100
Avg. Stream Flow, QA (cfs) =
0.00
IW%C @ QA =
100
Receiving Stream: UT to Abbotts Creek HUC 030401030202 Stream Class:
WS-II
Outfall 001
Qw = 0.0009 MGD
COMBINED HARDNESS (mg/L)
Acute = 65.58 mg/L
Chronic = 65.58 mg/L
YOU HAVE DESIGNATED THIS RECEIVING
STREAM AS WATER SUPPLY
Effluent Hard: 0 value > 100 mg/L
Effluent Hard Avg = 65.58 mg/L
PARAMETER
NC STANDARDS OR EPA CRITERIA
y
REASONABLE POTENTIAL RESULTS
RECOMMENDED ACTION
TYPE
(t)
a
a
t
�
Chronic Applied
Acute
n # Det. Max Pred Cv Allowable Cw
Standard
Acute (FW): 340.0
Arsenic
C
150 FW 340
5
ug/L
No detects
4 0 NO DETECTS
Chronic (FW): 150.0
Max MDL —5
No detects
Arsenic
C
10 F[H/WS
5
ug/L
Note: n < 9
Chronic (HH): 10.0
Limited data set
Max MDL = 5
No detects
Acute: 1,993.9
Chromium III
NC
259.3698 FW 1993.9338
µg/L
0 0
N/A
_
--Chronic-----259.4 -
---------------------------
Acute: 16.0
Chromium VI
NC
11 FW 16
µg/L
0 0
N/A
_
-- Chronic. 11.0—
---------------
Chromium, Total
NC
5
µg/L
4 0 NO DETECTS
a: No monitoring required if all Total Chromium
samples are < 5 pg/L or Pred. max for Total Cr is <
Note: n < 9
allowable Cw for Cr VI.
Limited data set
Max MDL = 5
Acute: 25.98
No detects
Copper
NC
17.9661 FW 25.9808
5
ug/L
4 0 NO DETECTS
Note: n < 9
_ _ _ _ _ _
Chronic: 17.97
_ _ _ _ _ _ _ _ _ _ _ _ _
No detects
Limited data set
Max MDL = 5
Acute: 284.6
RP shown - apply Monthly Monitoring with Limit
Zinc
NC
286.9242 FW 284.5962
10
ug/L
10 9
4,970.8
_ _ _ _ _ _ _ _ _ _
Chronic 286.9
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _
RP shown - apply Monthly Monitoring with Limit
3 values > Allowable Cw
NCO088501 001 RPA 2019, rpa
Page 7 of 8 7/9/2019

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
Date: 7/9/2019
FACILITY: Stonington Subdivision - Well #1 Outfall 001
NPDES PERMIT: NC0088501 Dissolved to Total Metal Calculator
In accordance with Federal Regulations, permit limitations must be written as Total Metals per 40 CFR 122.45(c)
Receiving
Receiving
Rec. Stream
NPDES Total Suspended
Combined
nstream
Instream
Effluent
Stream
Stream
Solids
Hardness
Wastewater
Wastewater
Upstream
Hardness
summer
summer7Q10
1Q10
Flow Limit
-Fixed Value-
chronicConcentration
M
Concentration
Hardness
Average
7Q10 (CFS)
(MGD)
[MGD]
[MGD] (mg/L)
(mg/L)
(Chronic)
(Acute)
Average (mg/L)
(mg/L)
0.0000
0.0000
0.0000
0.0009 10
65.580
65.580
100.0000
100.0000
25.6
65.58
Upstream Hard Avg (mg/L) = 25.6
EFF Hard Avg (mg/L) = 65.58
ENTS (identify parameters to PERCS Branch to maintain in facility's LTMP/STMP):
PARAMETER
Dissolved Metals
Translators- using
Default Partition
Coefficients
(streams)
(MAEC) as a Total Metal
=Dissolved Metal Translator
Chronic
Acute
Chronic
Acute
u
u /I
u /I
u /I
Cadmium (d)
0.31
1.90
0.252
1.22
7.51
Cd -Trout streams
0.31
1.18
0.252
1.22
4.67
Chromium III (d)(h)
52
403
0.202
259.37
1993.93
Chromium VI (d)
11
16
1.000
11.00
16.00
Chromium, Total (t)
N/A
N/A
Copper (d)(h)
6.2
9.0
0.348
17.97
25.98
Lead (d)(h)
1.59
41
0.184
8.62
221.20
Nickel (d)(h)
36
328
0.432
84.19
757.96
Ni - WS streams (t)
WIA
Silver(d)(h,acute)
1 0.061
1.561
1.0001
0.06 1.56
Zinc (d)(h)
1 83
821
0.2881
286.92 284.60
Beryllium 1 6.51
1.0001
6.51
65
Arsenic (d) 1501
1 1 1.0001
0 1501
0 340
(d) = dissolved metal standard. See 15A NCAC 02B .0211 for more information.
(h) = hardness -dependent dissolved metal standard. See 15A NCAC 02B .0211 for more information.
(t) = based upon measurement of total recoveable metal. See 15A NCAC 02B .0211 for more information.
The Human Health standard for Nickel in Water Supply Streams is 25 mg/L which is Total Recoverable metal standard
The Human Health standard for Arsenic is 10 µg/L which is Total Recoverable metal standard.

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
Permit No. NC0088501
NPDES Implementation of Instream Dissolved Metals Standards - Freshwater Standards
The NC 2007-2015 Water Quality Standard (WQS) Triennial Review was approved by the NC
Environmental Management Commission (EMC) on November 13, 2014. The US EPA subsequently
approved the WQS revisions on April 6, 2016, with some exceptions. Therefore, metal limits in draft
permits out to public notice after April 6, 2016 must be calculated to protect the new standards - as
approved.
Table 1. NC Dissolved Metals Water Q ality Standards/A uatic Life Protection
Parameter
Acute FW, µg/1
(Dissolved)
Chronic FW, µg/1
(Dissolved)
Acute SW, µg/1
(Dissolved)
Chronic SW, µg/1
(Dissolved)
Arsenic
340
150
69
36
Beryllium
65
6.5
---
---
Cadmium
Calculation
Calculation
40
8.8
Chromium III
Calculation
Calculation
---
---
Chromium VI
16
11
1100
50
Copper
Calculation
Calculation
4.8
3.1
Lead
Calculation
Calculation
210
8.1
Nickel
Calculation
Calculation
74
8.2
Silver
Calculation
0.06
1.9
0.1
Zinc
Calculation
Calculation
90
81
Table 1 Notes:
1. FW= Freshwater, SW= Saltwater
2. Calculation = Hardness dependent standard
3. Only the aquatic life standards listed above are expressed in dissolved form. Aquatic life
standards for Mercury and selenium are still expressed as Total Recoverable Metals due to
bioaccumulative concerns (as are all human health standards for all metals). It is still necessary
to evaluate total recoverable aquatic life and human health standards listed in 15A NCAC
213.0200 (e.g., arsenic at 10 µg/1 for human health protection; cyanide at 5 µg/L and fluoride at
1.8 mg/L for aquatic life protection).
Table 2. Dissolved Freshwater Standards for Hardness -Dependent Metals
The Water Effects Ratio (WER) is equal to one unless determined otherwise under 15A
NCAC 02B .0211 Subparagraph (11)(d)
Metal
NC Dissolved Standard, µg/1
Cadmium, Acute
WER*{1.136672-[ln hardness](0.041838)} - e^{0.9151 [In hardness]-3.14851
Cadmium, Acute Trout waters
WER*{1.136672-[ln hardness](0.041838)1 - e^{0.9151[In hardness]-3.6236}
Cadmium, Chronic
WER* { 1.101672-[ln hardness](0.041838)1 - of 0.7998[ln hardness]-4.4451 }
Chromium III, Acute
WER*0.316 eA fO.8190[ln hardness]+3.7256}
Chromium III, Chronic
WER*0.860 e^{0.8190[ln hardness]+0.6848}
Copper, Acute
WER*0.960 eA fO.9422[ln hardness]- 1. 7001
Copper, Chronic
WER*0.960 eA fO.8545[ln hardness]-1.7021
Lead, Acute
WER*{1.46203-[ln hardness](0.145712)1 • of 1.273[ln hardness]-1.4601
Lead, Chronic
WER*{1.46203-[ln hardness](0.145712)1 • of 1.273[ln hardness]-4.7051
Nickel, Acute
WER*0.998 eA fO.8460[ln hardness]+2.255}
Nickel, Chronic
WER*0.997 eA10.8460[ln hardness]+0.0584}
Page 1 of 4

DocuSign Envelope ID: 3B 1 E5887-A307-4BE8-894A-D63642356695
Permit No. NCO088501
Silver, Acute
WER*0.85 • e^{1.72[ln hardness]-6.59}
Silver, Chronic
Not applicable
Zinc, Acute
WER*0.978 eA10.8473[ln hardness]+0.8841
Zinc, Chronic
WER*0.986 eA10.8473[ln hardness]+0.8841
General Information on the Reasonable Potential Analysis (RPA)
The RPA process itself did not change as the result of the new metals standards. However, application of
the dissolved and hardness -dependent standards requires additional consideration in order to establish the
numeric standard for each metal of concern of each individual discharge.
The hardness -based standards require some knowledge of the effluent and instream (upstream) hardness
and so must be calculated case -by -case for each discharge.
Metals limits must be expressed as `total recoverable' metals in accordance with 40 CFR 122.45(c). The
discharge -specific standards must be converted to the equivalent total values for use in the RPA
calculations. We will generally rely on default translator values developed for each metal (more on that
below), but it is also possible to consider case -specific translators developed in accordance with
established methodology.
RPA Permitting Guidance/WOBELs for Hardness -Dependent Metals - Freshwater
The RPA is designed to predict the maximum likely effluent concentrations for each metal of concern,
based on recent effluent data, and calculate the allowable effluent concentrations, based on applicable
standards and the critical low -flow values for the receiving stream.
If the maximum predicted value is greater than the maximum allowed value (chronic or acute), the
discharge has reasonable potential to exceed the standard, which warrants a permit limit in most cases. If
monitoring for a particular pollutant indicates that the pollutant is not present (i.e. consistently below
detection level), then the Division may remove the monitoring requirement in the reissued permit.
To perform a RPA on the Freshwater hardness -dependent metals the Permit Writer compiles the
following information:
• Critical low flow of the receiving stream, 7Q10 (the spreadsheet automatically calculates
the 1 Q 10 using the formula 1 Q 10 = 0.843 (s7Q 10, CA) 0.993
• Effluent hardness and upstream hardness, site -specific data is preferred
• Permitted flow
• Receiving stream classification
In order to establish the numeric standard for each hardness -dependent metal of concern and for
each individual discharge, the Permit Writer must first determine what effluent and instream
(upstream) hardness values to use in the equations.
The permit writer reviews DMR's, Effluent Pollutant Scans, and Toxicity Test results for any
hardness data and contacts the Permittee to see if any additional data is available for instream
hardness values, upstream of the discharge.
If no hardness data is available, the permit writer may choose to do an initial evaluation using a
default hardness of 25 mg/L (CaCO3 or (Ca + Mg)). Minimum and maximum limits on the
hardness value used for water quality calculations are 25 mg/L and 400 mg/L, respectively.
If the use of a default hardness value results in a hardness -dependent metal showing reasonable
potential, the permit writer contacts the Permittee and requests 5 site -specific effluent and
upstream hardness samples over a period of one week. The RPA is rerun using the new data.
Page 2 of 4

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
Permit No. NCO088501
The overall hardness value used in the water quality calculations is calculated as follows:
Combined Hardness (chronic)
_ (Permitted Flow, cfs *Avg. Effluent Hardness, mg/L) + (s7Q10, cfs *Avg. Upstream Hardness, mg/L)
(Permitted Flow, cfs + s7Q10, cfs)
The Combined Hardness for acute is the same but the calculation uses the 1Q10 flow.
3. The permit writer converts the numeric standard for each metal of concern to a total recoverable
metal, using the EPA Default Partition Coefficients (DPCs) or site -specific translators, if any
have been developed using federally approved methodology.
EPA default partition coefficients or the "Fraction Dissolved" converts the value for
dissolved metal at laboratory conditions to total recoverable metal at in -stream
ambient conditions. This factor is calculated using the linear partition coefficients
found in The Metals Translator: Guidance for Calculating a Total Recoverable
Permit Limit from a Dissolved Criterion (EPA 823-B-96-007, June 1996) and the
equation:
Cdiss - 1
Ctotal I + { [KPO] [SS(I+a)] [10-6] i
Where:
ss = in -stream suspended solids concentration [mg/1], minimum of 10 mg/L used,
and
Kpo and a = constants that express the equilibrium relationship between dissolved
and adsorbed forms of metals. A list of constants used for each hardness -dependent
metal can also be found in the RPA program under a sheet labeled DPCs.
4. The numeric standard for each metal of concern is divided by the default partition coefficient (or
site -specific translator) to obtain a Total Recoverable Metal at ambient conditions.
In some cases, where an EPA default partition coefficient translator does not exist (le. silver), the
dissolved numeric standard for each metal of concern is divided by the EPA conversion factor to
obtain a Total Recoverable Metal at ambient conditions. This method presumes that the metal is
dissolved to the same extent as it was during EPA's criteria development for metals. For more
information on conversion factors see the June, 1996 EPA Translator Guidance Document.
5. The RPA spreadsheet uses a mass balance equation to determine the total allowable concentration
(permit limits) for each pollutant using the following equation:
Ca = (s7Q10 + Qw) (Cwgs) — (s7Q10) (Cb)
Qw
Where: Ca = allowable effluent concentration (µg/L or mg/L)
Cwqs = NC Water Quality Standard or federal criteria (µg/L or mg/L)
Cb = background concentration: assume zero for all toxicants except NH3* (µg/L or mg/L)
Qw = permitted effluent flow (cfs, match s7Q10)
s7Q10 = summer low flow used to protect aquatic life from chronic toxicity and human
health through the consumption of water, fish, and shellfish from noncarcinogens (cfs)
* Discussions are on -going with EPA on how best to address background concentrations
Flows other than s7Q10 may be incorporated as applicable:
1Q10 = used in the equation to protect aquatic life from acute toxicity
Page 3 of 4

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
Permit No. NC0088501
QA = used in the equation to protect human health through the consumption of water,
fish, and shellfish from carcinogens
30Q2 = used in the equation to protect aesthetic quality
The permit writer enters the most recent 2-3 years of effluent data for each pollutant of concern.
Data entered must have been taken within four and one-half years prior to the date of the permit
application (40 CFR 122.21). The RPA spreadsheet estimates the 95th percentile upper
concentration of each pollutant. The Predicted Max concentrations are compared to the Total
allowable concentrations to determine if a permit limit is necessary. If the predicted max exceeds
the acute or chronic Total allowable concentrations, the discharge is considered to show
reasonable potential to violate the water quality standard, and a permit limit (Total allowable
concentration) is included in the permit in accordance with the U.S. EPA Technical Support
Document for Water Quality -Based Toxics Control published in 1991.
7. When appropriate, permit writers develop facility specific compliance schedules in accordance
with the EPA Headquarters Memo dated May 10, 2007 from James Hanlon to Alexis Strauss on
40 CFR 122.47 Compliance Schedule Requirements.
The Total Chromium NC WQS was removed and replaced with trivalent chromium and
hexavalent chromium Water Quality Standards. As a cost savings measure, total chromium data
results may be used as a conservative surrogate in cases where there are no analytical results
based on chromium III or VI. In these cases, the projected maximum concentration (95th %) for
total chromium will be compared against water quality standards for chromium III and
chromium VI.
9. Effluent hardness sampling and instream hardness sampling, upstream of the discharge, are
inserted into all permits with facilities monitoring for hardness -dependent metals to ensure the
accuracy of the permit limits and to build a more robust hardness dataset.
10. Hardness and flow values used in the Reasonable Potential Analysis for this permit included:
Parameter
Value
Comments (Data Source)
Average Effluent Hardness
65.58 mg/1
Effluent and upstream Hardness data for
(mg/L)
06/24/2019 to 06/28/2019 received
[Total as, CaCO3 or (Ca+Mg)]
from Aqua on July 2, 2019.
Average Upstream Hardness
25.6 mg/1
Effluent and upstream Hardness data for
(mg/L)
06/24/2019 to 06/28/2019 received
[Total as, CaCO3 or (Ca+Mg)]
from Aqua on July 2, 2019.
7Q10 summer (cfs)
0
BIMS, NPDES Permit Files
1Q10 (cfs)
0
BIMS, NPDES Permit Files
Permitted Flow (MGD)
Not Limited
Used maximum monthly average of
0.0009 MGD (Nov2015 to Oct2OI8)
Date: July 9, 2019
Permit Writer: Derek Denard
Page 4 of 4

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
IV PER-HUDE1,TLOPMENT FOR GREENSAND F"TER TREATM ENT PLANTS
4.1 Background
The following penrutting strategy applies to new and existing water treatment plants using greensand filtration to generate
potable water from groundwater. This categorization would also include many community well systems, "iron filters", and
"manganese filters" as long as they do not back -wash filters with a sodium solution. The permit writer should contact the facility to
verify that there is not a briny discharge. This permitting strategy does not apply to any other kind of cationic exchange unit used
in water treatment. If any portion of the water treatment process includes an ion exchange/water softener unit, then the RO-IE
Permitting Strategy will apply as well.
Typically, a greensand filtration unit is preceded by the use of an aeration tower along with potassium permanganate to
oxidize dissolved iron in the ground water. The particulate ferric hydroxide (and some minor quantities of soluble ferrous material) is
then removed. via filtration through a manganese based greensand media. Greensand is a proprietary material that does not require
sodium cycle regeneration, only backwash with finished (potable) water. Since the discharge from such a facility is not as saline as
that :from a sodium cycle cationic exchange unit, this may be considered a more erivironinentally friendly technology for the treatment
of groundwater. For that reason, unlike other types of ion exchange systems, non -discharge options are sometimes an alternative and
should be explored for new permits. Filter backwash water is usually collected in a settling basin, and the supernatant is then
discharged to surface waters or a. regional treatment works.
4.2 Pollutants of Concern
Typical chemical additives to such treatment systems are an anti-scalant (such as zinc orthophosphate), fluoride, chlorine
and potassium permanganate.
lame 4.1:.cuonitortne Keauirements -ror (Yreensana wiry
The monitoring requirements included below identify various pollutants of concern including conventional parameters, nutrients,
and toxicants. A brief rationale for the inclusion of these contaminants can be found in Appendix A. Other toxicants were not
included because they were either not detected or rarely detected in the effluent data surveyed. However, if a pollutant specific
problem is detected in the receiving stream, effluent, or source water then a monitoring requirement may be added for that parameter.
Likewise, if data indicate that a pollutant is not present in the facility's discharge, that parameter may be dropped from the
requirements. Limits should be added if the facility shows reasonable potential to exceed water quality standards for toxicants. New
facilities should monitor for pollutants of concerns regardless of whether or not there is a water quality standard. Monitoring
requirements can be re-evaluated during subsequent renewals.
EFFLUENT
CHARACTERISTICS
LIMITS
MONITORING REQ1111ZEMENTS
nthly
Monthly
Averaage,
S
D
Daily Maximum
Measurement
e uenvy
Sample
Tvp.-
Sample
Location
Flow
See footnote
Instantaneous
or Estimate
Effluent
Total Suspended Solids
30.0 mg/L
45.0 mg/L
See footnote'
Grab
Effluent
pH
Freshwater: 6.0 - 9.0 s,u,
Saltwater: 6.8 - 8.5 s.u.
See footnote'
Grab
Effluent
Total Residual Chlorine2
Freshwaters: 17- 28 pg/L
Saltwater: 13 L!E�L
See footnote-3
Grab
Effluent
Turbidity4
See footnote'
Grab
Effluent
Fluoride'
Limit based on potential
Quarterly
Grab
Effluent
Total Iron
Limit based on potential
Quarterly
Grab
Effluent
Total Zinc6
Limit based on potential
Quarterly
Grab
Effluent
Total Manganese
Limit based on potential
Quarterly
Grab
Effluent
Notes to permit writers:
1. For instantaneous flow monitoring, the duration of the discharge must be reported in addition to the total flow. The
monitoring frequency for flow should be as frequent as the minimum frequency of monitoring for any parameter listed.
2. Footnote for permit: Limit and monitor only if the facility adds chlorine or chlorine derivatives to water that is eventually
discharged. The Division shall consider all effluent TRC values reported below 50 ug/I to be in compliance with the permit.
However, the Permittee shall continue to record and submit all values reported by a North Carolina certified laboratory (including
field certified), even if these values fall below 50 ug/l.
S. Monitor 2/month if discharge is < 0.5 MGD and monitor weekly if discharge is >0-5 MGD
4. If the receiving stream is impaired for turbidity a daily maximum limit should be given. See Appendix A for limit and footnote.
5. Fluoride should be monitored if the Permittee backwashes with fluoridated finished water.
6. Zinc should be monitored if the Permittee adds zinc orthophosphate as a corrosion inhibitor prior to backwashing.
-7-

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
V. LUPLEMENTA TION
5.1. Monitoring Frequency
In order to be consistent with the monitoring guidance employed for other permits across the state, monitoring
Z:>
frequencies will be based on the flow divisions used to define facility class in the 15A NCAC 08C .0302 regulations.
Requirements described in 15A NCAC 2B .0508(d) for water supply plants were used as guidance. Table 5 summarizes
the monitoring requirements. After sufficient data have been collected (eight to 12 data points over at least one year) the
permittee may petition for a reduction in monitoring.
Table 5.1: WTP Monitoring Requirements
If a parameter is not currently limited hut requires a limitation based on potential, increase sainplingftequeney by one
degree. (Quarterly — Monthly, Monthly— 2 Month)
Conventional Parameters (except flow)
Facility Class
and Toxicants
(Effluent and Instream)
Permitted Flow < 0.5 MGD
If limited - 2/Month
Not limited - Monthly
Permitted Flow --> 0.5 MGD
If limited - Weekly
Not limited - 2/Month
5.2. Wiole Effluent Toxicity Testing
Membrane, ion exchange, and conventional WTPs should be required to conduct quarterly WET tests for monitoring
purposes. Eventually, the Division may choose to use this data to develop additional policy. The type of WET test
conducted will vary depending on receiving stream characteristics. In addition, the level of available dilution and tidal
effects will determine whether the facility should perform an acute or chronic test, while the type of water (freshwater or
saltwater) will determine which organism should be used. Table I summarizes WET -testing requirements. Appendix A
includes sample WET language.
Z�
Greensand filter systems will not be required to monitor whole effluent toxicity.
7
7777777777,11,
Dilution IWC < 0.25%
Acute 24-hour Pass/Fail at 90%
IWC �! 0.25%
-
Chronic test at JWC (maximum 90%)
Tidal Effects I Modeled Tidal discharge
Chronic test at chronic mixing zone characteristics
Tidal Discharge- not modeled,
Acute 24-hour Pass/Fail at 90%
Freshwater
Acute test organism: Fathel7d ininnoW
Chronic test organism: Ceriodaphnia dubs
Water Type
Acute test organism: Fathead Minnow OR tv�tlsid Shrimp
Saltwater
OR Silverside Minnow (permittee's choice)
Chronic test organism: Kysid shrifnp -2
Notes:
1. Applies to existing dischargers only.
2. Permittee may choose to conduct comparison studies showing Ceriodaphnia dubia to be greater than or equal to Alsid Shriinp in
degree of sensitivity to the facility's, effluent.
-8-

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
Winston-Salem Journal
Advertising Affidavit
NCDENR/DWQ/POINT SOURCE BRANCH
1617 MAIL SERVICE CENTER
RALEIGH, NC 27699-1617
PO Number Order
public notice 0000580526
Category
Legal Notices
PtjMLItC N41:31-r04CIlE
North Carotiina Environmentall
Management Commission/
NPDES Unit
1617 Mail Service Center
RaiBIqft_ TIC 27699-i617
NPUES Wastewater Permit
The North Caronna Environmental
Management Commission proposes
It. Issue a NPDES wastewater dis-
charge permit to the person<s3 listed
below_ written comments regarding
the proposed permit will be accept-
ed until 30 days after the publish
date of this notice_ The Director of
the NC Division of Water Resources
(UWR) may hold a public hearing
should there be a significant degree
of public _ terest_ Please mail com-
ment; andZor information requests
to UWR at the above address_ Inter-
ested persons may visit the oWR at
512 N_ -Salisbury Street, Raleigh, NC
to review Information on file. Addi-
tional information on NPU ES permits
and this notice may be found on aur
webslte http_//d.q.nc_gov/ab..tldi
visions/w ate r-resou rc es/water-
resources-perm iYs/wastewater-
bra
nch/npdes-wastewater/public-
notices.or by calling <9193 707-3601.
Aqua North Carolina. Inc. applied to
anew NPDES permit NC0088501 for
the Stonington Subdivision. Well Y11
WTP. Stonington Way Court. Ker-
ersville. Forsyth County, discharg-
ing filter backwash to Abbott.
Creek, Yadkin -Pee Uee River Basin_
WSJ: JrNy 12, 2019
P.O Box 3159
Winston-Salem, NC 27102
Description
Account Number
3376309
Date
July 12, 2019
PUBLIC NOTICE North Carolina Environmental Management Commission/ NPDES Unit 1617
Publisher of the
Winston-Salem Journal
Before the undersigned, a Notary Public of Guilford, North Carolina, duly commissioned,
qualified, and authorized by law to administer oaths, personally appeared the Publisher
Representative who by being duly sworn deposes and says: that he/she is the Publisher's
Representative of the Winston-Salem Journal, engaged in the publishing of a newspaper
known as Winston-Salem Journal, published, issued and entered as second class mail in the
City of Winston-Salem, in said County and State: that he/she is authorized to make this
affidavit and sworn statement: that the notice or other legal advertisement, a copy of which
is attached hereto, was published in the Winston-Salem Journal on the following dates:
07/12/2019
and that the said newspaper in which such notice, paper document, or legal advertisement
was published was, at the time of each and every such publication, a newspaper meeting all
the requirements and qualifications of Secti 1-597 of the General Statutes of North
Carolina and was a qualified newspaper wit a meaning of Section 1-597 of th leneral
Statutes of North Carolina. f
A' r
ofperson making q(]idavit)
Sworn to and subscribed before me the 12 day of July, 2019
LEA ANNE LAMB - �Maj"�_ to W`
NOTARY PUBLIC (Notary Public)
GUILFORD COUNTY, NC
My Commission Expires June 15, 2024
THIS IS NOT A BILL. PLEASE PAY FROM INVOICE. THANK YOU

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
Denard, Derek
From: Boone, Ron
Sent: Friday, December 07, 2018 11:32 AM
To: Denard, Derek; Hudson, Gary
Cc: Knight, Sherri
Subject: RE: Aqua North Carolina Inc. - Greensand WTP Renewals/Transfers to coverage under NCG590000
I don't have a problem with Stonington getting the GP and have no comments about its renewal as such.
I can't speak for the Surry facilities. Those are Gary's.
Ron
Best Regards,
Ronald C. Boone, Environmental Program Consultant
NC Department of Environmental Quality, Division of Water Resources, Water Quality Regional Operations Section,
Winston-Salem Regional Office
450 West Hanes Mill Road, Suite 300
Winston-Salem, NC 27105
Main: 336-776-9800
Direct: 336-776-9690
Mobile 1: 336-341-3568
Mobile 2: 336-686-4921
Fax [phone]
[e-mail]
http://deg.nc.gov/about/divisions/water-resources
From: Denard, Derek
Sent: Thursday, December 6, 2018 11:28 AM
To: Hudson, Gary <[e-mail]>; Boone, Ron <[e-mail]>
Cc: Knight, Sherri <[e-mail]>
Subject: Aqua North Carolina Inc. - Greensand WTP Renewals/Transfers to coverage under NCG590000
Gary & Ron,
The following is a list of Aqua greensand WTP permits that are up for renewal:
Permit
Owner
Facility
County
Expires
NCO088498
Aqua North Carolina, Inc.
Mitchell Bluff - Well #1
Surry
12/31/2018
NCO088609
Aqua North Carolina, Inc.
Windgate Subdivision
Surry
1/31/2019
NCO088528
Aqua North Carolina, Inc.
Hillcrest Subdivision - Well #3
Surry
12/31/2018
NCO088536
Aqua North Carolina, Inc.
Bannertown Hills Subdivision - Well #2
Surry
12/31/2018
Colonial Woods Subdivision - Wells 1
NCO088552
Aqua North Carolina, Inc.
and 2
Surry
1/31/2019
NCO088854
Aqua North Carolina, Inc.
Pine Lakes Subdivision - Well #2
Surry
1/31/2019
NCO088617
Aqua North Carolina, Inc.
Snow Hill subdivision
Surry
2/28/2019
NCO088625
Aqua North Carolina, Inc.
The Hollows subdivision
Surry
2/28/2019
NCO088633
Aqua North Carolina, Inc.
Reeves Woods Subdivision Well #2
Surry
2/28/2019
1

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
NCO088501 Aqua North Carolina, Inc. Stonington Subdivision - Well #1 Forsyth 2/28/2019
Aqua has indicated that they would like to have coverage under the general permit for these. Most likely all of them will
be converted to General Permit NCG590000. Please note that conversion to the general permit will not require public
notice. We should be able to process these renewals/conversions in a couple of week instead of months. I would like to
knock out the 3 that expire this month by December 31. Please let me know if you have any comments or staff reports
(e-mail is fine) for any of these facilities.
Thanks,
Derek C Denard
Environmental Specialist
Compliance & Expedited Permitting Unit
N.C. Division of Water Resources
N.C. Department of Environmental Quality
919 707 3618 office
919 707 9000 main DWR
derek.denard aancdenr clov
N. C. Division of Water Resources
Water Quality Permitting Section - NPDES
1617 Mail Service Center
Raleigh, INC 27699-1617
Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties.

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
Denard, Derek
From: Berger, Amanda A <[e-mail]>
Sent: Monday, November 11, 2019 1:22 PM
To: Denard, Derek
Cc: Ison, Laurie T; Pearce, Joseph R; McDaniel, David T; Hennessy, John; Boone, Ron; Graznak, Jenny;
Snider, Lon
Subject: RE: [EXTERNAL] 90 day extension request for NC0088501, NC0088552, NCO088854
M�Gernal email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
r
Good afternoon Derek,
Apologies for the late response. We have not had an opportunity to visit these sites and I do not wish to hold you up
from your review. Please go ahead and begin working on these permits.
Aqua did investigate the source of the zinc and determined that its source was the polyphosphate. Aqua is no longer
utilizing this version of poly. The current polyphosphate formulation should not contain zinc.
Let me know if you have any questions, and once again may apologies.
Best regards,
Amanda Berger
Director of Environmental Compliance
Aqua North Carolina
202 MacKenan Ct; Cary, NC 27511
0:919.653.6965 M:910.773.0406
0
From: Denard, Derek <[e-mail]>
Sent: Thursday, November 07, 2019 10:58 AM
To: Berger, Amanda A <[e-mail]>
Cc: Ison, Laurie T <[e-mail]>; Pearce, Joseph R <[e-mail]>; McDaniel, David T
<[e-mail]>; Hennessy, John <[e-mail]>; Boone, Ron
<[e-mail]>; Graznak, Jenny <[e-mail]>; Snider, Lon <[e-mail]>
Subject: [EXTERNAL] 90 day extension request for NC0088501, NC0088552, NCO088854
CAUTION: This email originated from outside of the organization. Do not click links or open attachments unless you recognize the
sender and know the content is safe.
Amanda,

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
I wanted to reach out you about the status of these permit renewals. We are past the 90 day extension
request for issuance of these permits. Unless there is information you would like to add for my review, I would
like to start working on these again for issuance. Please note the compliance schedules contained within the
draft permits give you adequate time to resolve any issues with meeting the new metals limits. If you have any
questions, please let me know.
Sincerely,
Derek Denard
Environmental Specialist
N.C. Division of Water Resources
N.C. Department of Environmental Quality
919 707 3618 office
919 707 9000 main DWR
derek.denard(a)ncdenr.aov
1617 Mail Service Center
Raleigh, NC 27699-1617
Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties.
From: Berger, Amanda A <[e-mail]>
Sent: Monday, July 22, 2019 4:25 PM
To: Denard, Derek <[e-mail]>; Hennessy, John <[e-mail]>
Cc: Kinney, Maureen <[e-mail]>; Boone, Ron <[e-mail]>; Ison, Laurie T
<[e-mail]>; Pearce, Joseph R <[e-mail]>; McDaniel, David T
<DTMcDaniel @aguaamerica.com>
Subject: [External] Draft Permit(s) - Comment/Request NC0088501, NC0088552, NCO088854
CAUTION:ks or open attachments unless you verify. Send all suspicious email as an attachment to
rr anV
Hi John and Derek,
Aqua respectfully requests a 90 day extension on permit issuance for Stonington WTP (NC 0088501), Pine Lakes WTP
(NC0088554), and Colonial Woods WTP (NC 0088552) to allow us time to investigate if these sites meet the conditions of
the NPDES program. This will require inspection and visitation by not only Aqua staff but also the Winston Salem
Regional Office. Aqua would also like to utilize this time to investigate the source of zinc that was previously reported in
2017 DMRs.
We appreciate your time and consideration on this request. If you have any questions or concerns, please do not
hesitate to contact me.
Best regards,

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
Amanda Berger
Director of Environmental Compliance
Aqua North Carolina
202 MacKenan Ct; Cary, NC 27511
0:919.653.6965 M:910.773.0406

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
Denard, Derek
From: Boone, Ron
Sent: Wednesday, July 24, 2019 9:42 AM
To: Pearce, Joseph R; Berger, Amanda A; Denard, Derek; Hennessy, John
Cc: Kinney, Maureen; Ison, Laurie T; McDaniel, David T
Subject: RE: [External] Draft Permit(s) - Comment/Request NC0088501, NC0088552, NC0088854
That's exactly why I was questioning the intent here.
Stonington has had a NPDES permit (88501) since approximately 2007 for discharge of water conditioning wastewater to
Abbott's Creek. What's changed? Has the discharge been eliminated? If not, what's the purpose of revisiting, "...if these
sites meet the conditions of the NPDES program"? If the discharge hasn't been eliminated, then obviously they meet the
conditions and the permit is still required.
As for the other two facilities in question, Pine Lakes WTP (88854) and Colonial Woods WTP (88552), 1 have never
inspected those facilities but I am the NPDES program consultant in the Winston-Salem Regional Office and have not
been made aware of the elimination of either of those discharges.
Best Regards,
Ronald C. Boone, Environmental Program Consultant
NC Department of Environmental Quality, Division of Water Resources, Water Quality Regional Operations Section,
Winston-Salem Regional Office
450 West Hanes Mill Road, Suite 300
Winston-Salem, NC 27105
Main: 336-776-9800
Direct: 336-776-9690
Mobile 1: 336-341-3568
Mobile 2: 336-686-4921
Fax [phone]
[e-mail]
http://deg.nc.gov/about/divisions/water-resources
From: Pearce, Joseph R <[e-mail]>
Sent: Wednesday, July 24, 2019 8:55 AM
To: Boone, Ron <ron.boon [e-mail]>; Berger, Amanda A <[e-mail]>; Denard, Derek
<[e-mail]>; Hennessy, John <[e-mail]>
Cc: Kinney, Maureen <[e-mail]>; Ison, Laurie T <[e-mail]>; McDaniel, David T
<DTMcDaniel @aquaamerica.com>
Subject: RE: [External] Draft Permit(s) - Comment/Request NC0088501, NC0088552, NC0088854
• External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
Ron,
NPDES is for discharge to WOTUS, Waters of the United States. If the systems do not discharge to WOTUS, then NPDES
is not the appropriate permit.
Joe

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
AL 40 AL
f#rr L ► i�,w
Joseph Pearce PE CFM
Director of Operations
Aqua North Carolina, Inc.
202 MacKenan Court
Cary, North Carolina 27511
0:919.653.6964 F:919.460.1788
From: Boone, Ron <[e-mail]>
Sent: Wednesday, July 24, 2019 8:25 AM
To: Berger, Amanda A <[e-mail]>; Denard, Derek <[e-mail]>; Hennessy, John
<iohn.hennessy@ncdenr.�ov>
Cc: Kinney, Maureen <[e-mail]>; Ison, Laurie T <[e-mail]>; Pearce, Joseph R
<[e-mail]>; McDaniel, David T <[e-mail]>
Subject: RE: [External] Draft Permit(s) - Comment/Request NC0088501, NC0088552, NCO088854
CAUTION: This email originated from outside of the organization. Do not click links or open attachments unless you recognize the
sender and know the content is safe.
Hello All,
What exactly does it mean, "...if these sites meet the conditions of the NPDES program"? If the facilities discharge then
they still require a permit. The only way to eliminate the permit is to first eliminate the discharge...
Am I missing something here?
Thanks,
Ron
Best Regards,
Ronald C. Boone, Environmental Program Consultant
NC Department of Environmental Quality, Division of Water Resources, Water Quality Regional Operations Section,
Winston-Salem Regional Office
450 West Hanes Mill Road, Suite 300
Winston-Salem, NC 27105
Main: 336-776-9800
Direct: 336-776-9690
Mobile 1: 336-341-3568
Mobile 2: 336-686-4921
Fax [phone]
[e-mail]
http://deg.nc.gov/about/divisions/water-resources

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
From: Berger, Amanda A <[e-mail]>
Sent: Monday, July 22, 2019 4:26 PM
To: Denard, Derek <[e-mail]>; Hennessy, John <[e-mail]>
Cc: Kinney, Maureen <[e-mail]>; Boone, Ron <[e-mail]>; Ison, Laurie T
<[e-mail]>; Pearce, Joseph R <[e-mail]>; McDaniel, David T
<DTMcDaniel @aguaamerica.com>
Subject: [External] Draft Permit(s) - Comment/Request NC0088501, NC0088552, NCO088854
External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
report.spam@nc or —
Hi John and Derek,
Aqua respectfully requests a 90 day extension on permit issuance for Stonington WTP (NC 0088501), Pine Lakes WTP
(NC0088554), and Colonial Woods WTP (NC 0088552) to allow us time to investigate if these sites meet the conditions of
the NPDES program. This will require inspection and visitation by not only Aqua staff but also the Winston Salem
Regional Office. Aqua would also like to utilize this time to investigate the source of zinc that was previously reported in
2017 DMRs.
We appreciate your time and consideration on this request. If you have any questions or concerns, please do not
hesitate to contact me.
Best regards,
■ Dfi
-, L4t�'
Amanda Berger
Director of Environmental Compliance
Aqua North Carolina
202 MacKenan Ct; Cary, NC 27511
0:919.653.6965 M:910.773.0406

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
LINDA CULPEPPER
Director
MEMORANDUM
NORTH CAROLINA
Environmental Quality
July 12, 2019
To: Jeff Bryan [[e-mail]]
NC DEQ / DWR / PWS Regional Engineer
Winston-Salem Regional Office
From: Derek C. Denard, Environmental Specialist
DWR / NPDES / Expedited and Compliance Permitting
Central Office, Raleigh (919-707-3618)
Subject: Review of Discharge to Surface Waters Designated Water Supply (WS)
■ UT to Abbotts Creek [12-119-(1)]], WS- III,
03-07-07 [HUC: 030401030202] Yadkin -Pee Dee;
■ greensand water treatment facility filter backwash
for: Renewal of NPDES Permit NCO088501
Aqua North Carolina, Inc. — Stonington Subdivision —Well # 1 WTP
Forsyth County
Please provide your comments by August 9, 2019 [email OK]
REST PONE:
I concur with the issuance of this pennit provided the Permittee properly operates and
maintains the facility; the Permittee meets the stated effluent limits prior to discharge; and the
discharge does not contravene the designated water quality standards.
I concur with issuance of the above permit provided the following conditions are met:
I oppose the issuance of the above permit based on reasons stated below, or attached:
Signed: > `A ' ''
15-k F-AQPEI
cc: file
r
NORTH CAROL INA
0o rbmo of Emhwononkl Walia
North Carolina Department of Environmental Quality I Division of Water Resources
512 North Salisbury Street 1 1617 Mail Service Center I Raleigh, North Carolina 27699-1617
919.707.9000 .

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
NPDES PERMIT NEW / RENEWAL
DRAFT / FINAL
CHECK LIST
Permittee
Aqua North Carolina, Inc.
Facility
Pine Lakes Subdivision - Well #2 WTP
Permit No.
NCO088854
Stream Class
WS-IV
Regional Office
WSRO
Permit Writer
Derek Denard
Permit Drafting Initiated [BIMS Events] (review application for completeness)
12/06/2018
RO staff report requested [BIMS Events], sent email to:
To: Hudson, Gary <gary.hudson(ancdenr.gov>; Boone, Ron <[e-mail]>
Cc: Knight, Sherri <sherri.kni ht ncdenr. ov>
12/06/2018
RO staff report received [BIMS Events]
Boone, Ron <ron.boone ncdenr. ov>
12/07/2018
EAA Review (new or expanding)
NA
Draft Permit
-------------
Create/Edit GIS Map
07/19/2019(ed)
Update/ Create Permit Outfall (Lat/Lon, HUC code, etc.)
NA
Data/RPA Review
05/06/2019
Add. Info. Requested [BIMS Events]
05/14/2019
Add. Info. Received [BIMS Events]
07/13/2019
Complete Draft Permit
07/08/2019
Draft Fact Sheet & Fact Sheet Binder
12/17/2019
Draft Cover Letter
12/17/2019
Proof Read for Peer Review
07/12/2019
Submit Cover, Permit, Map, Factsheet Binder (including Application, Add. Info.) for Peer Review
by Emily Phillips
07/12/2019
Peer Review Completed: Emily Phillips
07/17/2019
Proof Read Draft for Public Notice
07/08/2019
Prepare Public Notice Statement
07/08/2019
Updated Public Notice System
07/08/2019
Submitted for Public Notice on
07/10/2019
Region comments on draft requested to (see draft to whom list):
Boone, Ron <ron.boone ncdenr. ov>
07/12/2019
Region comments on draft received from:
Boone, Ron <ron.boone ncdenr. ov>
07/24/2019
Draft to additional reviewers ATB [BIMS Events]:
hannah.headrick ncdenr. oy; cind .a.moore ncdenr. ov
NA
Draft from additional reviewers ATB [BIMS Events] :
NA
Draft to additional reviewers WOCG [BIMS Events]:
Maureen.KinneykncdenL.gov
07/12/2019
Draft from additional reviewers WOCG [BIMS Events]:
Maureen.Kinneykncdenr.gQv
None
If stream class WS, Draft to additional reviewers PWS (see draft to whom list) [BIMS Events]:
Jeff B ran
07/12/2019
If stream class WS, Draft form additional reviewers PWS [BIMS Events]:
Jeff Bryan
08/06/2019
Other agency comments re uested(see draft to whom list, for S —DMF / Shellfish)[BIMS Events]:
NA
NA
Other agency comments received [BIMS Events]:
NA
NA
Newspaper Notice Received add to factsheet binder
--------------

DocuSign Envelope ID: 3B1E5887-A307-4BE8-894A-D63642356695
Public notice published [BIMS Events] 07/14/2019
BIMS Scheduled Issuance Date [BIMS Events - automatic]
08/28/2019
Permit Effective Date for Final
02/01/2020
Expiration Date
O1/31/2025
Prepare Final Permit
01/08/2020
Finalize Factsheet & Binder
01/08/2020
Prepare Final Cover Letter
01/08/2020
Final to DocuSign (proof read):
01/08/2020
Add (3) Document packages to the Envelope Page to send to John- Please upload in the following order:
1. Cover Letter, Draft Permit, Map (combined into one file), Boilerplate
2. Fact Sheet, plus supporting documents in one file (called "Fact Sheet Binder"):
i. PDF copy of Application
11 RPA and supporting data sheet (see Tips section)
iii. All calculations for limits
iv. Emails (see Tips section)
V. Any comments received
vi. Affidavit of Publication (scanned copy)
vii. WET testing and Monitoring summary
viii. Compliance Summary
ix. Any other pertinent information supervisor needs to look at
3. Copy of Previous Effective Permit (also include necessary versions)
After signinE•
1. Permit writer receives an email from DocuSign that states the Document has been completed.
2. Click View Completed Documents.
3. While viewing the documents in DocuSign, click Download icon which appears above the
document. Download as separate PDFs to your personal permit file folder on the H drive or OneDrive.
4. Permit writer prints and sends out 3 copies:
a. To Permittee: permit, cover letter, map, boilerplate
b. To NPDES File Room: cover letter, permit, map, fact sheet
c. To Central Files: cover letter, permit, map, boilerplate, fact sheet
5. Permit writer imports e-copy of cover letter and final permit (signed) to Laserfiche.
6. Permit writer imports e-copy of Fact Sheet (i.e. all documents) to Laserfiche.
7. Permit writer imports WORD version of Final Permit into Sharepoint or the S: Drive under SWP-Point
Source>NPDES>Permit Files> (find permit number, import your files as a file folder labeled as
"permit number year", or create a file for the current renewal year and import your files into that folder)
8. Permit writer imports WORD version of Fact Sheet into Sharepoint or S: Drive. (same instructions as 97)
9. Charles processes permits as usual and puts a stapled Permittee copy in the mail basket "Already scanned
in Laserfiche". Also, if stapled, Wren knows it has already been put in Laserfiche.
10. Charles puts NPDES File Room copy in the NPDES File Room. Charles gives Central Files copy of
the permit to permit writer after updating BIMS to QA/QC.
11. To QA/QC:
-Once Charles issues the permit in BIMS, then Permit Writer goes into BIMS>Tasks>Maintain
Permit>Input Permit Number>Outfall>Highlight outfall>Select Maintain>Limits>Check that limits match
what is in the permit
12. Permit writer responds via email to Charles Weaver that QA/QC is completed.
13. Permit writer puts hard copy of permit in Central Files basket at end of hall to send to Central Files.
Email Final to the followinE recipients:
cc: Central Files
ec: NPDES Files [Laserfiche]
Jenny Graznak benny.graznak&cdenr.gov]
Amanda Berger [aaowensgaaquaamerica.com]