NC0021491_wasteload allocation_19930429

NPDES DOCUMENT SCANNIN& COVER SHEET
NPDES Permit: NCO021491
Document Type: Permit Issuance
Wasteload Allocation
Authorization to Construct (AtC)
Permit Modification
Engineering Alternatives Analysis
Permit History Date Range:
Correspondence
Document Date: April 29, 1993
THIS DOCYNENT IS PRINTED ON REUSE PAPER - ISHORE ANY CONTENT ON THE
REVERSE SIDE

4 ..
NPDES WASTE LOAD ALLOCATION
PERMIT NO.: NC0021491 Modeler Date Rec. #
PERMITTEE NAME: Town of Mocksville '"
„i ,al ;,
FACILITY NAME: Dutchman's Creek WWTP Drainage Area (mil ) 1 gq Avg. Streamflow (cfs):
Facility Status: Existing 7Q10 (cfs) 15 Winter 7Q10 (cfs) 30Q2 (cfs)
Permit Status: Renewal Toxicity Limits: IWC % Acute/Chronic
Major Minor Instream Monitoring: E/F
Pipe No.: 001 Parameters Tfa4;? Arw2r, -V.O. GEtA cot con7ucr� Ty
Design Capacity: 0.68 MGD Upstream a Location AT CfASr te)o
Domestic (% of Flow): 77 %** Downstream N Location APPY. U• iut L-Es I own�5rnsan
Industrial (% of Flow): 23 %**
Effluent Summer Winter
Comments: Characteristics
**Industrial flow percentage based on permitted flow and reported SIU BOD5 (m ) 2-+ - 2-+
flows from application PIRF has been requested
NH3-N (mg/1)
14 - t4
RECEIVING STREAM:DutchmanCreek
D.O. (mg/1) rj 5
Class: C TSS (mg/1) 50 - 3 o
Sub-Basin: 03-07-05 F. Col. /100 ml
( ) ?� Zvo
Reference USGS Quad: D 16 NE (please attach) pH (SU)
County: Davie - -
Regional Office: Winston-Salem Regional Office " CAD-mI(AM 30 (yAiu4 4 4)( 30
Gi W ): 4,v N,;02 um Rey
PreviousExp. Date: 2/28/93 Treatment Plant Class: II CsPvcn- (µ�L : xwNITaa moNrro2
Classification changes within three miles: " m-1" R
nochanee D (µ}!L) M, ,VfTO(L Ab ITya-
- �Alc Mod qo(� .µ ro2-
_GyAuipE L �l• ?6 CoaI� Max) i6
TD 12_ .tiro iToQ-
Requested by: Charles Lowe Date: 10/27/92
Prepared b
P Y / �1 ido. _ Date: 4 =z 'S 7 Comments:
Reviewed by: Date:

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F�4f1 CI ASSIRCATION
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"IVED
N.C. [),e 3;. of E"s-1l R
FACT SHEET FOR WASTELOAD ALLOCATION
'
Request# 7175 �?,der
Facility Name: Mocksville-Dutchmans Creek WWTP
NPDES No.: NC0021491
Type of Waste: 77% dom/23% ind
Facility Status: Existing
Permit Status: Renewal
Receiving Stream: Dutchmans Creek
Stream Classification: C
Subbasin: 030705
County: Davie Stream Characteristic:
Regional Office: WSRO USGS #
Requestor: C. Lowe Date:
Date of Request: 10/27/92 Drainage Area(mi2): 108
Topo Quad: D16NE Summer 7Q10 (cfs): 15
Winter 7Q10(cfs): 26
Average Flow (cfs): 108
30Q2 (cfs):
IWC (%): 6.55
Wasteload Allocation Summary
(approach taken, correspondence with region, EPA, etc.)
Mocksville is operating well below current limits. The facility has been passing its toxicity test for
the past three years. Staff report indicates that the facility is well maintained, but has VI problems
(although monthly average flow limit has not been violated).
Instream data indicate lower D.O.'s in winter than summer (may be suspect).
Facility will not receive NH3-N/tox choice due to existing stringent NH3-N limit and passing
toxicity test results.
Special Schedule Requirements and additional comments from Reviewers:
Q£su6M I ITA t^
Recommendedby: Date: 3 t
Reviewed by
Instream Assessment: l C / -L( F Dater 1
r,A
-Regional Supervisor: , . P__ Date:
Permits &Engineering: �!� rrT � " — Date: C
i
APR 1993
RETURN TO TECHNICAL SERVICES BY:

• 2.
CONVENTIONAL PARAMETERS
Existing Limits:
Monthly Average
Summer Winter
Wasteflow (MGD): 0.68 0.68
BODS(mg/1): 24 24
NH3N(mg/1): 14 14
DO(mg/1): 5 5
TSS (mg/l): 30 30
Fecal Col. (/100 ml): 1000 1000
pH (SU): 6-9 6-9
Residual Chlorine(µg/1):
Oil&Grease(mg/1):
TP(mg/1): J
TN(mg/1):
Recommended Limits:
Monthly Average
Summer Winter WQ or EL
Wasteflow (MGD): 0.68 0.68
BODS(mg/1): 24 24
NH3N(mg/1): 14 14
DO(mg/1): 5 5
TSS (mg/1): 30 30
Fecal Col. V100 ml): 200 200
pH (SU): 6-9 6-9
Residual Chlorine (µg/1):
Oil&Grease (mg/1):
TP(mg/1):
TN(mg/1):
Limits Changes Due To: Parameter(s) Affected
Change in 7Q10 data
Change in stream classification _
Relocation of discharge
Change in wasteflow
Other(onsite toxicity study,interaction,etc.)
Instream data
New regulations/standards/procedures Fecal coli
New facility information
(explanation of any modifications to past modeling analysis including new flows,rates,field data,
interacting discharges) /
(See page 4 for miscellaneous and special conditions,if applicable)

3
TOMCS/METALS
Type of Toxicity Test: Chronic Quarterly
Existing Limit: Chronic Qtrly P/F at 6.6%
Recommended Limit: Chronic Qtrly P/F at 7%
Monitoring Scheduler Apr, Jul, Oct, Jan
ExistingLimits
imits
Daily Max.
COD (mg/):
Cadmium(ugh): monitor
Chromium(ug/1): monitor
Copper(ug/1): monitor
Nickel(ugh): monitor
Lead(ug/1): monitor
Zinc(ug/1):
Cyanide(ug/1): 76.2
Phenols (ug/1):
Mercury(ug/1):
Silver(ug/1): monitor
Recommended Limits
Daily Max. WQ or EL
COD (mo:
Cadmium(ug/1): 30
Chromium(ug/1): monitor
Copper(ug/1): monitor
Nickel(ug/1): monitor
Lead(ug/1):' monitor
Zinc(ug/1): monitor
Cyanide(ug/1): 76
Phenols (ug/1):
Mercury(ug/1):
Silver(ug/1): monitor
Limits Changes Due To: Parameter(s) Affected
Change in 7Q10 data
Change in stream classification
Relocation of discharge
Change in wasteflow
New pretreatment information Cr,Cu,Ni,Pb,Zn,Ag
Failing toxicity test
Other(onsite toxicity study,interaction,etc.) effluent monitoring data,
Cadmium
_X Parameter(s) are water quality limited. For some parameters,the available load capacity of
the immediate receiving water will be consumed. This may affect future water quality based
effluent limitations for additional dischargers within this portion of the watershed.
OR
No parameters are water quality limited,but this discharge may affect future allocations.

4
INSTREAM MONITORING REQUIREMENTS
Upstream Location: at least 100 It upstream
Downstream Location: at appx. 0.5 miles downstream
Parameters: temperature, D.O., Fecal coliform, conductivity
Special instream monitoring locations or monitoring frequencies:
MISCELLANEOUS INFORMATION &SPECIAL CONDITIONS
AAd quacy of Existing Treatment
Has the facility demonstrated the ability to meet the proposed new limits with existing treatment
facilities? Yes ',-'No
If no, which parameters cannot be met?
Would a "phasing in" of the new limits be appropriate? Yes_ No G-
If yes, please provide a schedule (and basis for that schedule) with the regional
office recommendations:
If no, why not?
Special Instructions or Conditions
Wasteload sent to EPA? (Major)CN�'u' (Y or N)
(If yes, then attach schematic, toxics spreadsheet, copy of model,or, if not modeled, then old
assumptions that were made, and description of how it fits into basinwide plan)
Additional Information attached? —&�c (Y or N) If yes, explain with attachments.

r r
A - - Facility Name
11' nAA�ls Permit# N c'02zl -9 I Pipe#
CHRONIC TOXICITY PASS/FAIL PERMIT LIMIT (QRTRLY)
The effluent discharge shall at no time exhibit chronic toxicity using test procedures outlined in:
1.) The North Carolina Ceriodanhnia chronic effluent bioassay
Procedure-Revised *September 1989)or subsequent version procedure Carolina Chronic Bioassay
The effluent concentration al which there may be no observable inhibition of-reproduction or significant is _96 (defined as treatment two in the North Carolina gnificant mortality
� monitoring using this procedure to establish compliance with document). The permit holder shall perform
Performed after thirty days from the effective date of this permit condition. The first test will be
Permit during the months of
Effluent sampling for this testing shall be Performed at the NPDES
P final effluent discharge below all treatment processes.
All toxicity testing results required as part of this permit condition will be entered on the Effluent Discharge
Monitoring Foam EMR-1)for the month in which it was performed,Additionally,DEM Form AT-1 (original)is to be sent to the followin using the parameter code TGP3B.
g address:
Attention Environmental Sciences Branch
North Carolina Division of
Environmental Management
4401 Reedy Cheek Road
Raleigh, N.C. 27607
Test data shall be complete and accurate and include all s .
association with the toxicity tests, as well"as all dose/response danta.cTo�tal dual chorine of tmeasure�lte effl performed t toxicity
sample must be measured and reported if chlorine is employed for disinfection of the waste stream, ty
Should any single quarterly monitoring indicate a failure to meet
begin immediately until such time that a single test is passed. Upon
limits, then monthly monitoring will
revert to quarterly in the months specified above, P Fen Passing, this monthly test requirement will
Should any test data from this monitoring requirement or tests performed by the North Carolina
Environmental Management indicate potential impacts to the receiving
eceivin s Division of
modified to include alternate monitoring requirements or limits. g �' this permit may be re-opened and
NOTE: Failure to achieve test conditions as specked in the cited document, such as minimum
survival and appropriate environmental controls, shall constitute an invalid test and will mqu control organism
retesting(within 30 days of initial monitoring event). Failure to submit suitable test results will constituteimmediate.
noncompliance with monitoring requirements.
7Q10 I S CA ,
Permitted Flow o,&8 MGD
IWC S5 Recommended by:
Basin & Sub-basin _ oso7O, v��0
Receiving Strom �U- MAr�s
County -ppcdi E Date A b A
QCL P/F Version 9/91

' Oxygen Consuming Waste
1 . WATER QUALITY CRITEIRIA
The North Carolina Administrative Code ( Section 15 NCAC 2B
. 0211 ) requires that a minimum concentration of dissolved oxygen
( DO) be maintained in freshwater systems dependent on stream clas-
sification . -Cf•or designated "trout"waters , DO concentrations
shall not Tall below 6 . 0 mg/l . For non-trout waters , DO concen-trations shall not fall below a daily average of 5 . 0 mg/ 1 nor a
minimum instantaneous value of 4 . 0 mg/ l . Exceptions are made f
designated "swamp" waters , which may have lower values if they
caused by natural conditions .
Per 15 NCAC 2B . 0206 , the governing flow criterion for water
quality standards , including dissolved oxygen, generally shall be
the minimum average flow for a period of seven consecutive days
that has an average recurrence of once in ten years ( i . e . 7Q10 ) .
'However , in cases where the stream flow is regulated , the governing
flow for all standards shall be the instantaneous minimum flow , or
if deemed appropriate by the Environmental Management Commission ,
an alternative flow. Alternative governing flow strategies are
subject to review on a case-by-case basis .
11 . MODEL DESCRIPTION
A modified version of the Streeter - Phelps coupled BOD/DO
equation is used to simulate impacts to dissolved oxygen from oxy-
gen consuming waste . This model assumes that the receiving waters
can be represented by :
a) a one-dimensional system,
b) steady-state conditions , and
c ) advective transport only .
Waste inputs are separated into nitrogenous (NBOD) and carbonaceous
( CBOD) components . The integrated form of the equation is :
-k„x/u K,, -k„x/u -k„x/u k, -k„x/u -k_x/u
D = D„ e + I k„-k,, (e - e ) CBOD + k„-k„ (e e ) NBODI
Where : D = DO deficit at milepoint x (mg/ 1 )
D„ = initial DO deficit (mg/ 1 )
x = distance (mi )
u = velocity (mi/day)
k„ = reaeration rate ( /day)
k,, = CBOD decay rate (/day)
k„ = NBOD decay rate (day)
CBOD = initial CBOD concentration (mg/ 1 )
NBOD = initial NBOD concentration (mg/ 1 )

r
1. 11 . MODEIL ( L EIVEL B) INPUT
In the absence of actual stream data Cor model calibration ,
a Level B (desktop) model-ing analysis can be performed . Level B
modeling incorporates the use of empirical model input equations
and DEM procedures to establish model input parameter values .
These empirical equations and procedures are summarized below by
type of input .
a) Model Hydraulics
Model hydraulic considerations include streamflow, runoff ,
stream velocity, channel width and depth, and stream bed gradient
( i . e. slope) . Streamflow and runoff , although not directly dis-
played in the model equation affect 'instream concentrations of DO ,
CBOD, and NBOD.
streamflow -- for free-flowing streams , streamflow estimates
(both upstream and tributary) for average flow, summer (Apr - Oct )
7Q10 , winter .(Nov - Mar) 7Q10 , and 30Q2 conditions are obtained
from the U. S . Geological Survey (USGS) . Regulated streams are
handled on a case-by-case basis .
runoff -- incremental flow is incorporated through calcu-
lation of runoff rates . The difference between upstream and
downstream flows , after subtracting out the flow contributed from
point sources and tributaries , can be divided by the distance
between the two points to arrive at appropriate runoff rates .
Runoff should be calculated for average flow, summer 7Q10 , and
winter 7Q10 conditions .
stream velocity (U) -- in' the absence of instream time-of-
travel data , the empirical regression equation developed by DEM
can be used to predict stream velocity. The equation is based on
a cross-section of data from 125 time-of-travel studies performed
on North Carolina streams , such that :
U = 0 . 124 Qact' - " slope' - 79
Qact' . 3-5
Where : Qact = 7Q10 + wasteflow (cfs)
Qavg = average stream flow (cfs )
slope = stream bed gradient, (fpm)
U = stream velocity (fps)
channel width (W) and depth (H) -- the Level B -model assumes
that stream channel width (W) = 15 depth . Depth (H) is calcu-
lated in the model using this assumption along with the relation-
ship between flow (Q) and instantaneous velocity M :
-2-

V = Q/A
wher.-e . A cross-sectional channel area ( f t' )
therefore : V = _ Q
W H
( 15 '' H) * 1-1
or H = (Q/15V)" - s
slope -- stream bed gradients are calculated from land
elevation data contained on USGS topographical maps . Maps dis-
played on a 72 min. ( 1 : 24000) scale are preferred when available .
Distances along the streambed between contours are measured and
the net elevation changes are divided by the distance to obtain
the slopes . Large differences in streambed slope should be
delineated by individual model reaches .
b) Model Reaction Rates
Model reaction rates include CBOD decay (kc,) , NBOD decay
(kT,) , and reaeration (k„) .
CBOD decay rate , k,i (20'C , base e) -- where field data are
not available for model calibration, DEM employs a modified ver-
sion of the Bosko ( 1966) equation. The method retains the format
of the Bosko equation, but alters the CBOD bottle decay rate (k, )
as a function of instream CBOD concentration. The final. equation
is :
kit = k, + n (V/H)
where : n = coefficient of bed activity
= exp (-2 .8105 + 0 .598 -; In ( slope) )
k, = CBOD bottle decay rate
= 0 . 2/day for instream CBOD <_ 50 mg/1 '
= 0 . 4/day for instream CBOD > 50 mg/l
NBOD decay rate , kT, ( 20'C , base e) -- in the absence of
field-calibrated rates , DEM uses the EPA default values for k_ :
kT, = 0 . 3/day for streams with slope <_ 20 fpm
= 0 .5/day for streams with slope > 20 fpm
reaeration rate , kA ( 20°C , base e) -- reaeration is deter-
mined using the empirical relationships developed by Tsivoglou
( 1976 ) :
-3-

Qact - 10 ct!s ' k,. 1 - 8 s1ope V
10 c [ s < Q:act < 25 cfs , k„ 1 . 3 = s1opo V
Qact- > 2`) cfs , K„ 0 . 88 slope V
Note : the following equations are used by DEN to adjust the re-
action rates to reflect the model design temperature ( T)
k„ (T) k,, ( 200C) a 1 . 047 T
k„ (T) = k„ ( 200C) ;t 1 . 080
k„ (T)  k„ ( 200C) 1 . 022
c ) Model Design Temperature
Model design temperature (T) is based upon the season and
physical location of the stream within the State - Applicable
inputs are summarized below:
Summer Winter
}lydro-Environmental Area IF ( °C ) 'I' ( °C )
Mountains 23
Upper Piedmont 25 14
Middle Piedmont 26 14
Lower Piedmont 26 13
Eastern Piedmont 26 14
Sandhills 27 16
Inner Coastal Plain 27 16
Outer Coastal Plain 28 to _
d ) Background and Boundary Conditions
Headwaters -- headwater or boundary conditions are needed for
CBOD , NBOD, and DO concentrations . Where instream data are not
available.,_ the following default values are assumed :
CBOD = 2 mg/ 1
NBOD = 1 mg/ 1Q" \
DO = 90% saturation at T
Note : DO saturation values are obta-in-ed from the APHA Standard
Methods manual ( 1986 ) -- See Appendix A.
Runoff , Tributaries -- background conditions for runoff and
tributary flow are also needed for CBOD, NBOD , and DO . Where
instream data are not available , the same default values applied
to the headwaters are used .

1V . MODEL OUTPUT
Waste load allocations derived from the model are output in
terms of CBOD and NBOD. For NPDES permit limitations , these
components must be transformed into corresponding values of BOD,
and NH,-N. The NH,-N limit is determined simply by dividing the
allowable NBOD by 4 .5 (approximate stochiometrical ratio) . BOD:, ,
on the other hand , must be calculated using a CBOD/BOD.S ratio that
varies according to type of waste . In the absence of waste-
specific CBOD/BODS data, the following assumptions can be used :
Waste type CBOD/BODS ratio
pure domestic 1 . 5
> 10% industrial 2 . 0
pure industrial 3 . 0
DO can be added to the effluent as a trade-off for either NBOD or
CBOD as long as the instream DO standard is maintained .
V . SPECIAL CONSIDERATIONS
Igor proposed discharges of oxygen-consuming wastewater to
streams with a 7Q10 of 0 . 0 cfs , the following Division procedures
apply:
a) If the 7Q10 = cfs and the 30Q2 > 0 cfs , as
verified by the USGS , the applicant will receive
the following effluent limitations :
Stunmer Winter
BODS (mg/1) 5 10
NH,-N (mg/1) 2 4
DO (mg/1) 6 6
TSS (mg/1) 30 30
However , it there are multiple discharges to the stream
and the model predicts that the above limits will not
protect the DO standard instream, then a discharge will
be prohibited .
b) If the 7Q10 = 0 cfs and the 30Q2 = 0 cfs , as
verified by the USGS , a proposed discharge will
be denied.
Discharges to lakes and estuaries will be handled on a case-
by-case basis . In most situations , the procedures described above
will not apply.
-5 -

, d
References
Bosko , K. 1966 . Advances in Water Pollution Research .
International Association on Water Pollution Research _
Munich .
Tsivoglou, E.C. and L.A. Neal. 1976 . Tracer measurement of
reaeration: predicting the reaeration capacity of inland
streams . Journal WPCF, Vol . 48 , No . 12 .
Other Useful References
USEPA. 1985 . Rates , Constants , and Kinetics : Formulations in
Surface Water Quality Modeling ( 2nd edition) .
EPA/600/3-85/040 .
USEPA. 1983 . Technical Guidance for Performing �Waste Load
Allocations , Book II Streams and River, Chpt . 1 BOD and DO .
EPA-440/4-84-020 .
USEPA. 1980 . Simplified Analytical Method for Determining NPDES
Effluent Limitations for POTWs Discharging into Low Flow
Streams . Monitoring and Data Support Division (WH-553 ) .

v
APPENDIX A.
TABLE 421:1. SOLUBILITY Of OXYGEN IN WATER EXPOSED TO WATER-SATURATED AIR AT
ATMOSPHERIC PRESSURE(101.3) KPA'
Oxygen Solubility
mg/L
Temperature
.0 Chlorinity:0 5.0 10.0 15.0 20.0 23.0
0.0 14.621 13.728 12.888 12.097 11.355 10.657
1.0 14.216 13.356 12.545 11.793 11.066 10.392
2.0 13.929 13.000 12.21E 11.483 10.790 10.139
3.0 13.460 12.660 11.906 11.195 10.526 9.897
4.0 13.107 12.335 11.607 10.920 10.273 9.664
5.0 12.770 12.024 11.320 10.656 10.031 _ 9.441
6.0 12.447 11.727 11.046 10.404 9.799 9.22E
7.0 12.139 11.442 10.783 10.162 9.576 9.023
8.0 11.943 11.169 10.531 9.930 9.362 8.826
9.0 11.559 10.907 10.290 9.707 9.156 9.636
10.0 11.28E 10.656 10.05E 9.493 9.959 9.454
11.0 11.027 10.415 9.835 9.287 8.769 8.279
12.0 10.777 10.193 9.621 9.089 8.586 8.111
13.0 10.537 9.%1 9.416 9.899 9.411 7.949
14.0 10.306 9.747 9.218 8.716 9.242 7.792
15.0 10.094 9.541 9.027 8.540 9.079 7.642
16.0 9.970 9.344 8.9" 9.370 7.922 7.4%
17.0 9.665 9.153 8.667 8-207 7.770 7.356
18.0 9.467 9.969 8.497 8.049 7.624 7.221
19.0 9.276 9.792 9.333 7.8% 7.483 7.090
20.0 9.092 8.621 8.174 7.749 7.346 6.964
21.0 8.915 8.456 8.021 7.607 7.214 6.942
22.0 8.743 9.297 7.873 7.470 7.087 6.723
23.0 8.57E 8.143 7.730 7.337 6.%3 6.609
24.0 9.418 7.994 7.591 7.208 6.9" 6.498
25.0 8.263 7.850 7.457 7.083 6.728 6.390
26.0 8.113 7.711 7.327 6.962 6.615 6.285
27.0 7.968 7.575 7.201 6.945 6.506 6.194
28.0 7.827 7.444 7.079 6.731 6.400 6.085
29.0 7.691 7.317 6.%1 6.621 6.297 5.990
30•0 7.559 7.194 6.845 6.513 6.197 5.8%
31.0 7.430 7.073 6.733 6.409 6.100 5.806
32.0 7.305 6.957 6.624 6.307 6.005 5.717
33.0 7.193 6.843 6.518 6.208 5.912 5.631
34.0 7.065 6.732 6.415 6.111 5.922 5.546
35.0 6.950 6.624 6.314 6.017 5.734 5.464
36.0 6.837 6.519 6.215 5.925 5.64E 5.384
37.0 6.727 6.416 6.119 5.835 5.564 5.305
38.0 6.620 6.316 6.025 5.747 5.481 5.228
39.0 6.515 6.217 5.932 5.660 5.400 5.152
40.0 6.412 6.121 5.842 5.576 5.321 5.07E
41.0 6.312 6.026 5.753 5.493 5.243 5.005
42.0 6.213 5.934 5.667 5.411 5.167 4.933
43.0 6.116 5.943 5.581 5.331 5.091 4.862
44•0 6.021 5.753 5.497 5.252 5.017 4.793
45.0 5.927 5.665 5.414 S.'174 4.944 4.724
46.0 5.835 5.578 5.333 5.097 4.872 4.656
47.0 5.744 5.493 5.252 5.021 4.801 4.589
48.0 5.654 5.40E 5.172 4.947 4.730 4.523
49.0 5.565 5.324 5.094 4.972 4.660 4.457
50•0 5.477 5.242 5.016 4.799 4.591 4.392
From: Standard Methods for the Examination of Water and
Wastewater. Sixteenth Edition. American Public Health
Association. ' 1985.

k. EFFLUENT LIMITATIONS AND MONITORING REQUIREMENTS - Final
qn, aD/ `
During the period beginning on the effective date of the permit and lasting until expiration
the permittee is authorized to discharge from outfall serial number - 001 .
Such discharges shall be limited and monitored by the permittee as specified below:
l
fluent Characteristics Discharge Limitations Monitoring Requirements
Kg/day (lbs/day) Other Units (Specify) Measurement Sample Sample*
Monthly Avg. Weekl Av . Monthly Avg . Weekly Avg . Frequency :Type Location
low 0. 68 MGD Continuous Recording I or E
OD,5Day, 20'OC** 24.0 mg/1 36. 0 mg/l 2/Month Composite E, I
otal Suspended Residue** 30. 0 mg/l 45 . 0 mg/l 2/Month Composite E,I
as N 14. 0 mg/1 21 . 0 mg/1 2/Month Composite E
i'ssolved -Oxygen (minimum) 5 . 0 mg/l 5 . 0 mg/l Weekly Grab E,U,D
ecal Coliform (geometric mean) 1000. 0/100 ml 2000.0/100 ml 2/Month Grab E,U,D
esidual Chlorine Daily Grab E
empe•rature Weekly Grab E,U,D
otal Nitrogen (NO2 + NO3 + TKN) Quarterly Composite E
otal Phosphorus Quarterly Composite E
oxicity *** *** Quarterly Composite E
y.anide Tao 0.0762 mg/l **** 2/Month Grab E
otal CadmiumI6�1 Monthly Composite E
otal Chromium103' Monthly Composite E
otal Nickel ►b6i Monthly Composite E
otal Lead 1b51 Monthly Composite E
'otal Silveri0T1 Monthly Composite E
'otal Copper ibU'- Monthly Composite E
'onductivity. Weekly Grab U,D
Z 8V,�/��`
r,zj` fir' C) m
r,
0
i�Y Y
-
As--
'he pH shall iiot 79e;'�11 ess than 6 .0 standard units nor greater than 9 . 0 standard units
ind shall be ' 4'n•itor*ed ?/Month at the effluent by grab samples .
Chere shall ben scharge of floating solids or visible foam in. other than trace amounts .

A. EFFLUENT LIMITATIONS AND MONITORING REQUIREMENTS - Final _
During the period beginning on the effective date of the permit and lasting until expiration,
the permittee is authorized to discharge from outfall serial number ' - 001 .
Such discharges shall be limited and monitored by the' permittee as specified below:
fluent Characteristics Discharge Limitations Monitoring Requirements
. Kg/day (lbs/day) Other Units (Specify) Measurement Sample Sample
Monthly Avg_ Weekly__Avg Monthly_Avg .. Weeks Ayl_ Frequency. TyEe Location
*Sample locations : E - Effluent, I - Influent , U - Upstream, D - Downstream
Upstream and downstream samples shall be grab samples .
**The monthly average effluent BOD5 and Total Suspended Residue concentrations shall
not exceed 15% of the respective influent values (85% removal) .
***See Part III, Condition No. I .
****Daily Maximum Limitation

Part III
• Permit No . NC0021491
I. Toxicity Testing Requirement
The effluent discharge shall at no time exhibit chronic toxicity
using test procedures outlined in:
1 . The North Carolina Ceriodaphnia chronic effluent bioassay
procedure (North Carolina Chronic Bioassay Procedure - Revised
*February 1987) or subsequent versions .
The effluent concentration at which there may be no observable
inhibition of reproduction or significant mortality is 6.6% (defined
as treatment two in the North Carolina procedure document) . The
permit holder shall perform quarterly monitoring using this
procedure to establish compliance with the permit condition. The
first test will be performed within thirty days from issuance of
this permit. . Effluent sampling for this testing shall be performed
at the NPDES permitted final effluent discharge below all treatment
processes .
All toxicity testing results required as part of, this permit
condition will be entered on the Effluent Discharge Monitoring Form
(MR-1) for the month in which it was performed, using the
appropriate parameter code. Additionally, DEM Form AT-1 (original)
is to be sent to the following address :
Technical Services Branch
North Carolina Division of Environmental Management
PO Box 27687
Raleigh, North Carolina 27611-7687
Test data shall be complete and accurate and include all supporting
chemical/physical measurements performed in association with the
toxicity tests, as well as all dose/response .data. Total residual
chlorine must be measured and reported if employed for disinfection
of the waste stream.
Should any test data from this -monitoring requirement or tests
performed by the North Carolina Division of Environmental Management
indicate potential impacts to the receiving stream, this permit may
be reopened and modified to include alternate monitoring
requirements or limitations.
Note: Failure to achieve test conditions as specifi ' ,�in the cad
document, such as minimum control organism survival n'd ay"ipp6iate
- J C � C�
environmental controls, shall constitute an invalid est an�`_wi116=
require immediate retesting. Failure to submit sui bl �ti..
results will constitute a failure of permit conditio�s . 3uy U� ^�' �L
FILE 4

NOXnl CAROLLiA DEPT. OF NATUi2AL RESOURCES AND COMMUNITY DEVEL
ENVIRONMENTAL MANAGEMENT CnMMISSInN FOR AGENCY VSE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
APPLICATION FOR PERMIT TO DISCHARGE WASTEWATER
�b o0
STANDARD FORM A — MUNICIPAL
`IS �yC�u
SECTION L APPLICANT AND FACILITY DESCRIPTION
Unless otne,wlse apa,,med on this form all Items are to be completed. It an Item Is not applicable indicate'NA.'
ADDITIONAL INSTRUCTIONS FOR SELECTED ITEMS APPEAR IN SEPARATE INSTRUCTION BOOKLET AS INDICATED. REFER TO
BOOKLET BEFORE FILLING OUT THESE ITEMS.
Please Print or Type
1. Cobh Name of Applicant 101
Town of Mocksville
(see Instructions)
d. Mailing Address of Applicant
(see Instructions 1 7 1 Clement St . ._
Number 6 Street 102a --
Mocksville
City 10=a
North Carolina
Stan 1024
27028
Zip Code 1024
0. Applicant',Authorized Agent
Isae instructions) Terry B r a l l e y
Name and Title 1030
Town Manager _.
Number 6 Street
103a 171 Clement St .
Mocksville
City 103C '—
North Carolina
State - 103d
27028
Zip Code 103a
704 634-2259
Twephone 1031
Ana Number
a. Previous Application Coo.
II a previous appllcatl.h for a per-
mit under the National Pollutant
Discharge Elimination System has
been made,give the date of --—
application. 104 YR MO DAY
I certify that I am familiar with the Information contained In this application and that to the past of my knowledge and belief such Information
Is true,complete.and accurate.
Terry L . Bralley _ 102e Town Manager
Printed Name of Person Signing Title
92 9 29
1021 YR MO DAY
SI nature of Applicant or Authorie• nl Data Application Signed
Nur L'❑ 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 wit:),
or knowingly renders inaccurate any recording or monitoring device or method required to be
operated or maintained under Article 21 or regulations of the Environmental Management
Commission implementing that Article, shall be guilty or a misdemeanor punishable by a fine
not to exceed $10,000, or by imprisonment not to exceed six months, or by both. (18 U.S.C.
Section l001 provides a punishment by a fine or not more than $10,000 or imprisonment not
more than 5 years, or both, for a similar offense.)

FOR AGENCY USE
S. Facllity.(see instructions)
Givrthe name,ownership,and physi-
cal location of the plant or other
operating facility where discharge($)
presently occur(s)or will occur. x ::. N D u t c h m a n s Creek' W W T P
Name �`
Ownership(Public,Private or
Both Public and Prlvab). ❑PUB ❑PRV ❑BPP
CMck block If a Federal facility aQiO '❑FED
and give GSA Inventory Control'
Number
Location: O f f N C S R 1605 _.
Number i Street
City
A�o��: near Mocksvi l l e _
County 101</''.
'DaVie County _.
':. North Carolina _.
State iglr>
i. Discharge to Another Municipal
Facility(see instructions)
a. Indicate If part of your dischargeOiiA. ❑Yes ❑No
Is Into a municipal waste trans•
port system under another re-
sponsible organization. If yes,
complete the rest of this Item
and continue with Item 7. If no,
go directly to Item 7.
b. Responsible Organization
Receiving Discharge
Name '10ip
Number&Street fOto
City
State
Zip Code tOfif
c. Facility Which Receives Discharge IDoi.
Give the name of the facility
(waste treatment plant!which►r
calves and Is ultimately respon-
sible for treatment of the discharge
from your facility.
d. Average Dally Flow to Facility TO{h' mod
(mod) Give your average daily ,
flow Into the receiving facility.
7. Facility Discharges,Number and
Discharge Volume (see Instructions)
Specify the number of discharges' '
described In this application and the
volume of water discharged or lost
to each of the categories below.
Estimate average volume per day In
Million gallons per day. Do not In-
elude Intermittent of noneontinuou$.
overflows,bypasses or seasonal dis-
charges from lagoons,holding
ponds,eta
I-2

FOR AGENCY USE
Number of Total volume Discharged, '
Discharge Points million Gallons'ar Day
1o7at 1 0 . 3 2-
To: Surface Water �87'
Surface impoundment with
no Effluent 1070,.1' ilb{OY
Underground Percolation 10701'' Isli4
6:Q
Well(Infection) 1070;. r1Q71
t0ya:. :i;,Tj
Other '::�•�Ryr;
Total Item 7 107f1 1 =
If'other'Is specified,describe 107l1:'
ray,if any any of the discharges from this
facility are Intermittent,such as from
overflow or bypass points, or are
seasonal or periodic from lagoons,
holding ponds,etc.,complete Item S.
0. Intermittent Discharges
a. Facility bypass points
Indicate the number of bypass loss::,
points for the facility that are
discharge points.(see Instructions)
b. Facility Overflow Points _
Indicate the number of overflow 10Jti.,
points to a surface water for the
facility(see Instructions).
c. Seasonal or Periodic Discharge _
Points Indicate the number of 101110
points where seasonal discharges
occur from holding ponds,
lagoons,etc.
9. Collection System Type
Indicate the type and length(In to♦as
miles)of the collection system used
by this facility. (see Instructions)
Separate Storm ❑SST
Separate Sanitary [/SAN
Combined Sanitary and Storm ❑CSS
Both Separate Sanitary and
Combined Sewer Systems ❑BSC
Both Separate Storm an-, 10�.
Combined Sewer Systems ❑SSC
Length 3 6 Mlles
10. Municipalities or Areas Served Actual Population
(see Instructions) Name Served
1t0, _Greater Mocksville 3 ,000
%tioe
/Y
11 t►a 11 Ob
t
Total Population Served 1'1 '
I-3

FOR AGENCY USE
11. Average Daily Industrial Flow 3,rrva Q� (2E1 mgd
Total estimated average daily waste tI O
flow from all Industrial sources. `'"'ts
Note: All major Industries(as defined In Section IV)
discharging to the municipal system must be
listed In Section IV.
12. Permits,Licenses and Applications
List all existing, pending or denied permits, licenses and applications related to discharges from this facllity.(see Instructions)
For Date Date Date Expirat-o-
Agency Use Type of Permit ID Number Flied Issued Denied Date
Issuing Agency or License YR/MO/DA YR/MO/DA YR/M /OA YR/MO/DA
�:�< �:_:,�•.��: �,;, p�.S NL o021491 3/ i 88 2 28 13
2.
#zt
<`•
13. Maps and Drawings
Attach all required maps and drawings to the back of this application. (see Instructions)
14. Additional Information
Item Information
Number

I -
I
I - .
POST AERATION AND
I CHLORINE CONTACT TANK
I Chforine
I
Contact Y
I,1 Control �--- W
Bldg
1 / elkU
I
I � N
Flour — Settling Tank I Q
Splatter ^+ — _ O° O° Sludge
Sch Chamber 9 ParsAaU F Drying
Beds =
1
1 Sludge i Aeration Basin 6`
HoldMq
v Tk.
XISTING 6 scum Sludge DIGESTED SLUDGE TO SANQ BEDS
SLUDGF. WASTING 4 —_� RECIR.
— --Sam„—s Muge _
- ���_^•
r _ SLUDGE
. I WASTING
I ,,hope � I
1 Holding SAND
r Tk. ; 4- BEDS
Setting Tank
Grit Chamber fi Porti`all Flit I
/ L
Aeration Basin PUMP i /4~ - I I
STATION--,,,,.
4` F.M.
TO LAND CLZ
I
DISPOSAL BLOC. \
t
-' EO:AE AMIN ACTr .
'DOWN OF MOCKSVILLE, NC
DUIYHIIANS CREEK WWPP
PROCESS SCRcMA%IC
PAGx6 2 o F 2

STANDARD FORM A—MUNICIPAL FOR AGE CV USE
SECTION IL BASIC DISCHARGE DESCRIPTION TTI I I
Complete this section for each present or p►oposod oischarge indicated In Section I,Items 7 and e,that Is to surface waters. This Includes
discharges
Discharges to wellsrage mustybeems In described Ich the waste here there areter does not also dischargers torsurface waters from this fach&treatment works ility.to being
discharged to
descriptions of each discharge are required even If several discharges originate In the same facility. All values for an existing discharge should
be representative of the twelve previous months of operation. If this Is a proposed discharge,values should reflect best engineering estimates.
ADDITIONAL INSTRUCTIONS FOR SELECTED ITEMS APPEAR IN SEPARATE INSTRUCTION BOOKLET AS INDICATED. REFER TO
BOOKLET BEFORE FILLING OUT THESE ITEMS.
1. Discharge Serial No.and Name 001
a. Discharge Serial No. =41�•,
(see Instructions) ,
Dutchmans Creek Discharge s
b. Discharge Name 201b'
Give name of discharge,If any
(see Instructions) 001
c. Previous Discharge Serial No 2010.
If a previous NPDES Permlt
application was made for this dls-
charge(Item 4,Section 1)provide
previous discharge serial number.
2. Discharge Operating Dates `�'.. ]2 6
a. Discharge to Bsgin Date Me. ---
If the discharge has never YR MO
occurred but is planned for some
future date,give the date the
discharge will begin.
N/A
b. Discharge to End Date I/the tlls- 202b -- '
charge is scheduled to be dlscon- YR MO
tinued'wlthln the next 5 years,
give the date(within best estimate)
the discharge will end. Give rea-
son for discontinuing this discharge
in Item 17.
3. Discharge Location Name the
polltical.boundarles within which Agency Use
the point of discharge Is located:
North Carolina �
State 2038
Davie
County sa�b
,
(If applicable) City or Town 203c
4. Discharge Point Description
(see Instructions)
Discharge Is Into(check one)
Stream(includes ditches,arroyos, 2q." UTR
and other watercourses)
Estuary ❑EST
Lake ❑LKE
Ocean ❑OCE
Well (Injection) ❑WEL
Other ❑OTH
If'other'Is checked,specify type S"b
S. Discharge Point—Lat/Long.
State the precise location of the
point of discharge to the nearest
second. (see Instructions)
Latitude :os 3 5 DEG. 5 3 MIN. 3 2 SEC
Longitude late 80 DEG 3 DO MIN• 0 8 SEC
II-I This section contains 8 pages.

DISCHARGE SERIAL NUMBER FOR AGENCY USE
DO(
6. .Discharge Receiving Water Name D u t c h m a n s Creek
Name the waterway at the point of �Ilit.
dlscharge.(ses Instructions)
..:. :.:
For Agency Use :%'':>°:r For Agency Use
Minor 303e
If the discharge Is through an out.
fall that extends beyond the shoreline
or Is below the mean low water line,
complete Item 7.
7. Offshore Discharge N/A
a. Discharge Distance from Shore17i feet
b. Discharge Depth Below Water N/A
Surface tt@7b feet
If discharge Is from a bypass or an overflow point or Is a seasonal discharge from a lagoon,holding pond,etc.,complete Items 8,9 or 10.
as applicable,and continue with Item 11.
S. Bypass Discharge (see Instructions)
a. Bypass Occurrence
Check.when bypass occurs /
Wet weather tt0lat. ❑Yes Ltd No
Dry weather 20tliZ.: ❑Yes' Fkr<o
b. Bypass Frequency Give the
actual or approximate number
of bypass Incidents per year.
Wet Weather- ibt 0 'times per year
Dry weather ttttttt. D times per year
c. Bypass Duration Give the
average bypass duration In hours.
Wet weather :mat D hours
Dry weatherO1ai. 0—hours
d.. Bypass Volume Give the
average volume per bypass Incident,
In thousand gallons. N/A
Wet weather ` thousand gallons per Incident
N/A Dry weather k
thousand gallons per Incident
i ,
ce.
a. Bypass Reasons Give reasons N/A
why bypass occurs. i.20N>
Proceed to Item 11.
9. Overflow Discharge(see Instructions)
a. Overflow Occurrence Check
when overflow occurs. '.:•.`,
Wet weather xOfa't ❑Yes [04[,/No
Dry weather tQFi! ❑Yes VNo
b. Overflow Frequency Give the
actual or approximate Incidents
per year.
Wet weather t•'Out: 10 times per year
Dry weather ( '' �1—times per year

DISCHARGE SERIAL NUMBER OR AO[NCV Uti[
Q 0( i<
C. Overflow Duration Give the
average overflow duration In
hours.
Wet weather ; 01i1. 0 hours
Dry weather w '.; O Hour
d. Overflow•Volums Give the
average volume per overflow
Incident In thousand gallons.
•xs N/A
Wet weather dY:'• thousand gallons per Incident
.a:
N/A
Dry weather 4140! thousand gallons per Incident
r
L'r�ck�4.
Proceed to Item 11 :p
.-AK
10. Sessonal/Psrl odic Discharges
a. Seasonal/Periodic Discharge N/A
Frequency If discharge Is Inter- �lOtt' times per year
mittent from a holding pond, % 's":•i:
lagoon,etc.,give the actual or
approximate number of times
this discharge occurs per year. `^<
b. Seasonal/Periodic Discharge "a:,, N/A
Volume Give the average .: Air;' thousand gallons per discharge occurrence
volume per discharge occurrence
In thousand gallons.
c Seasonal(Periodic Discharge t``""''' N/-A
Duration Give the average dura 10 days
tlon of each discharge occurrence
In days. f
N/A
d. Seasonal/Periodic Discharge
Occurrence—Months Check the t.1.Otk.< ❑JAN ❑FEB ❑MAR
months during the year when
the discharge normally occurs. s`;<.,;, ❑APR ❑MAY ❑JUN
>N% %S
❑JUL ❑AUG ❑SEP
❑OCT ❑NOV ❑DEC
11. Discharge Treatment
a. Discharge Treatment Description
Describe waste abatement prac-
tices used on this discharge with
a brief narrative. (See lnstruc• x" ' Treatment consists of : Screening & Grit
ss::.:k::.•
tions) 1:1�<:
removal , followed by activated sludge
treatment followed by final setting :
waste sludge goes to a
holding tank , then sand beds , then land
application . Clarifier effluent passes
through clorination�aeration prior to
discharge .
U-3

DISCHARGE SERIAL-NUMBER FOR AGENCY USE
001
b. Discharge Treatment Codes S , M , G , A S E , N , PG
Using the codes listed In Table 1 211*::
of the Instruction Booklet.
describe the waste abatement B H X
processes applied to this dis-
charge In the order In which
they occur.If possible.
Separate all codes with Commas
except where slashes are used
to designate parallel operations.
If this discharge Is from a municipal waste
treatment plant(not an overflow or
bypass).complete Items 12 and 13
12. Plant Design and Operation Manuals
Check which of the following are
currently available
a. Engineering Design Report
b. Operation and Maintenance
Manual
13. Plant Design Data(see Instructions) sfi
a. Plant Design Flow (mgd:)
0 . 6 8. mgd
b. Plant Dmlgn BOO Removal (%) =t !; 95 %
c. Plant Design N Removal (%) t111►{! 95 %
d. Pliant Design P Removal(%) 2/3a M1 N A %
e. Plant Design SS Removal(%) 2134 95 %
f. Plant Began Operation (year) 2131
1972 .
g. Plant Last Ma)or Revision(Year) .2.134 .
1984

DISCHARGE SERIAL NUMBER
001
FOR AGENCY UfE
14. Description of Influent and Effluent(see Instructions)
Influent Effluent
9 0
Parameter and Code ° 7 0
< < >
X> y
o ,
.� ' e '
< > Z y
(1) (2) (3) (4) (5) (6) (7)
Flow
Million gallons per day �
50050 0 . 318 0 . 318 0 . 237 0 . 382 Cont . 365 N/A':
pH
Units
00400 6 . 9 7 . 0 1/7 52 G
Temperature(winter) !
`F
74028 55 : 4 55 . 4 55 . 4 57 . 2 1/7 52 G
Temperature(summer)
cF
74027 62 . 2 62 . 2 59 66 . 2 1 1/7 52 G
Fecal Streptococci Bacteria
Number/100 ml
74054
(Provide if available) X X. XN/A N/A
Fecal Coliform Bacteria
Number/100 ml
74055
(Provide if available) 346 2/3 0 24 G
>7<X
Total Collform Bacteria
Number/100 ml.
74056
(Provide if available) XX N/A _N/A
BOD 5-day
mI
00 10 129 3 . 7 1• 7 2/30 24 G
Chemical Oxygen Demand(COD)
mg/I
00340
(Provide if available)
N/A N/A' N/A N/A N/A N/A
OR
Total Organic Carbon(TOC)
mg/1
00680
(Provide if available)
(Either analysis is acceptable) N/A N/A N/A N/A N/A N/A
Chlorine—Total Residual
mg/1
50060 N/A 0 . 56 0 . 44' 0 . 70 7/7 365 G
A-S

DISCHARGE SERIAL NUMBER FOR AGENCY USE
14. Description of Influent and Effluent(s"Instructions) (Continued)
Influent Effluent
Parameter and Code
o
> e> ee w` < z �
(1) (2) (3) (4) (5) (6) (7)
Total Solids
mg/l
00500 N/A
Total Dissolved Solids
mg/l
70300 N/A
Total Suspended Solids
mg/l
00530 144 6 . 6 1 25 2/30 24 G
Settleable Matter(Residue)
ml/l
00545 N/A _ -
Ammonia(as N)
mg/l
00610
(Provide if available) N/A 0 . 825 0 . 2 2 . 3 2/3 0 24 G
Kicidahl Nitrogen
mg/l
00625
(Provide if available) N/A 2 . 63 -2 . 4 2 . 9 1/9 0 4 G
Nitrate(as N)
mg/l
00620
el rovide if available) N/A 1 . 73 2 . 2 2 . 5 1/9 0 4 G
Nitrite(as N)
mg/l
00615
(Provide if available) N/A . 07 . 05 0 . 12 1/9 0 4 G
Phosphorus Total(as P)
mg/1
00665
(Provide if available) N/A 2 . 17 1 . 9 2 . 3 1 /9 0 4 G
Dissolved Oxygen(DO)
mg/l
00300
8 . 3 .7:8 , 9 . 13 1/7 52 G
n-6

FOR AGENCY USE
DISCHARGE SERIAL NUMBER
001
IS.Additional Wastewater Characteristics
Cherie the box next to each parameter If It Is present In the effluent.(see Instructions)
fL
Parameter Parameter y
51
a (215) 2 (215)
a
Bromide Cobalt Thallium
71870 01037 01059
Chloride Chromium Titanium
00940 01034 01152
Cyanide Copper Tin
00720 X 01042 X 01102
Fluoride Iron Zinc
00951 01045 01092 X
Sulfide Lead Algicidese
00745 01051 X 74051
Aluminum Manganese Chlorinated organic compounds'
01105 01055 74052
Antimony Mercury 00,and grease
01097 71900 00550
Arsenic Molybdenum Pesticides*
01002 01062 74053
Beryllium Nickel Phenols
01012 01067 X 32730
Barium Selenium Surfactants
01007 01147 38260
Boron Silver Radioactivity*
01022 01077 74050
i Cadmium
` 01027
*Provide specific compound and/or element in Item 17,if known:
Pesticides(Insecticides,fungicides,and rodenticides)must be reported in terms of the acceptable common names specified in Acceptable Com-
mon Names and Chemical Names for the Ingredient Statement on Pesticide Labels, 2nd Edition,Environmental Protection Agency,Washington,
D.C. 20250,June 1972,as required by Subsection 162.7(b)of the Regulations for the Enforcement of the Federal Insecticide,Fungicide,and
Rodenticide Act.
II.7

FOR AGENCY USE
STANDARD FORM A-MUNICIPAL
SECTION III. SCHEDULED(IMPROVEMENTS AND SCHEDULES OF IMPLEMENTATION
This section requires Information on any uncomlDeSsed implementationd Dy loCal,Stat orlFederah agen IC es has nor Dy court actionfor s IFIon of waste treatment
YOU ARE SUBJECT TO
facilities. Requirement schedules may have been
SEVERAL DIFFERENT IMPLEMENTATION SCHEDULES, EITHER BECAUSE OF DIFFERENT LEVELS OF AUTHORITY IMPOSING
DIFFERENT SCHEDULES(ITEM lb)AND/OR STAGED CONSTRUCTION OF SEPARATE OPERATIONAL UNITS(ITEM 1c),SUBMIT A
SEPARATE SECTION III FOR EACH ONE.
FOR AGENCY USE
1. Improvements Required 4'
a. Discharge Serial Number
Affected List the discharge
serial numbers,assigned In Sec.
tlon 11.that are covered by this
Implementation schedule
ti. Authority Imposing Requirement
Check the appropriate Item Indl-
cating the authority for the Irn,- _^x;
plementation schedule. If the.
Identical Implementation sched-
ule has been ordered by more
than one authority,check the '
appropriate Items. (seeln-
structlons) .•:;:��'s
❑LOC
Locally developed Plan ❑ARE
Areawlds Plan ❑SAS
Basin Plan
State approved Implementation ❑SQS
schedule
Federal approved water quality ❑Was
standards Implementation plan
Federal enforcement procedure ❑ENF' .
or action ❑CRT
State court order ❑FED
Federal court order
c. Improvement Description Specify the 3-character code for the
General Action Description In Table II that best describes the
improvements required by the Implementation schedule. If more
than one schedule applies to the faelllty because of a staged con-
struction schedule,state the stage of construction being described
here with the appropriate general action code. submN a seParats
Section III for each stage of construction planned. Also,list ell
the 3-character(Specific Action)codes which describe ln•more
detail the pollution abatement practices that the Implementation
schedule requires.
3-character general action
description
3-character speclfic•action
descriptions 301d
2• Implementation Schedule and 3. Actual Completion Dates
Provide dates imposed by schedule and any actual dates of completion for Implementation steps
listed below. Indicate Well as accurately as possible. (see Instructions)
Implementation Steps 2. Schedule(Yr/Mo/Day) 3. Actual Completion(Yr/Mo/Day)
a. Preliminary plan complete 302•
b. Final plan complete .
c. Financing complete 6 contract
awarded
d. Site acquired 302 -/-/- '0z -/-/-
e. Bog in
I r,or.etructlon
f. End construction 30V -/-/- -/-/-
g. Begin Discharge
h. Operational level attained 302�? -/'-�
This section contains 1 page.
Ill-1 .
GPO 865.707

FOR AGENCY USE.
STANDARD FORM A—MUNICIPAL .1 H iTM
SECTION 17. INDUSTRIAL WASTE CONTRIBUTION TO MUNICIPAL SYSTEM
Submit a description of each major Industrial facility discharging to the municipal system,using a separate Section IV for each facility descrlp-
tion. Indicate the 4 digit Standard Industrial Classification(SIC)Code for the Industry,the major product or raw material,the flow(in thrn;-
sand gallons per day),and the characteristics of the wastewater discharged from the Industrial facility Into the municipal system. Consult :3ble
III for standard measures of products or raw materials. (see Instructions)
1. Major Contributing Facility _
(toe Instructions)Name 401a LEmuc-axat J f up-w I,-rpPr- L t oos T21ES
Number&Street 401b —
city
401e ���'
County 401d —
State 4010 lV Qi2'('N AROLI N A — —
Zip Code 401;
2. Primary Standard Industrial 402
Classification Code (Sae
Instructions)
Units(See
Quantity Table I11)
3. Principal Product or Raw
Material (see Instructions)
Product
403a ®O� I�QN l rV Zt %48k:t 4034
Raw Material 403b �1 l►J I S N�I?S 42dA 402f.
4. Flow Indicate the volume of water 't
discharged Into the municipal sys- 404a 3or�y thousand gallons per day
tam In thousand gallons per day
and whether this discharge Is Inter- 404b Intermittent lint)[:)Continuous(con)
mittent or continuous. ��
S. Pretreatment Provided Indicate If 405 ❑Yes &.N*o
Pretreatment is provided prior to
entering the municipal system
6. Characteristics of Wastewater
(see instructions)
Parameter
�""• Name
4o63 ParametNumber
er �0/2 rJ t9O �
406b Value' l�0 S4 —74P 29O
TV-I This section contains ! page.
GPO 065.706

FOR AGENCY USE.
STANDARD FORM A—MUNICIPAL
SECTION 17. INDUSTRIAL WASTE CONTRIBUTION TO MUNICIPAL SYSTEM
Submit a description
of each major Industrial
alif naic to the municipal
system. separate h iv for l,ch tlt
descrip-
tion. Indcatithe 4digit SUd srial classification Code for theIndustry, he major product or rawmateriathe flow(In thn,;-
sand gallons per day).and the characteristics of the wastewater discharged from the Industrial facility Into the municipal system. Consult :3bie
III for standard measures of products or raw materials. (see Instructions)
1. Major Contributing Facility
(see Instructions) ROt,.� �I
Name 401a
Number&Street 401 b
City 4014 M
County 401d 1�Au 1
State 4019,
Zip Code
401; 28
_, Primary Standard Industrial 402
251?
Classification Code (see
Instructions) Units(See
Quantity Table 111
3. Principal Product or Raw
• Materlr,t• ..!see Instructions)
Product
Raw Material 407b EP_806 R D
� t=1 1.11 s l-1�S •
4. Flow Indicate the volume of water 125,���
discharged into the municipal syh 404a thousand gallons per day
tam In thousand gallons per day
and whether this discharge Is Inter. 404b I]Intermittent lint)aiContinuous(con)
mittent or continuous.
5. Pretreatment Provided Indicate If 405 2(Yes ❑No
pretreatment Is provided prior to
entering the municipal system
i. Characteristics of Wastewater
(see Instructions)
Parameter �00 SS K o
Name
Parameter
4063 Number fD0'3l0 00530 000OZ5
so0ti Value' 170 2GO 54- 450 O•oo4-
TV-I This section contains I page.
GPO $65.706