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Mickey, Mike
From: Heather Adams <[e-mail]>
Sent: Thursday, December 17, 2015 10:58 AM
To: SVC_DENR.certadmin; Williamston, Jenee
Cc: Mickey, Mike; Tom Johnson
Subject: Town of Mocksville WWTP ORC Designation Form
Attachments: CCF12172015.pdf
Please see attached for the Town of Mocksville WWTP (Dutchman Creek).
Thanks,
Director of Operations
Envirolink, Inc.
PO Box 670
Bailey, NC 27807
252-235-4900

t
Mickey, Mike
From:
Scott Smart <[e-mail]>
Sent:
Thursday, August 20, 2015 5:26 PM
To:
Mickey, Mike
Cc:
Heather Adams
Subject:
Mocksville NC0021491 Rotary Drum Screen
Attachments:
basketjpg
Mr. Mickey,
In recent weeks, the influent rotary drum screen's motor failed and the unit had to be removed from the influent lift
station. The unit came equipped with a backup screening basket that fits into the drum screen's bracket at the influent
pipe. That basket has been installed, while the repair to the rotary drum screen is being resolved (see attached
picture). Please let us know if you require any additional information.
Scott Smart, PE
Senior Quality Manager
Envirolink Inc.
ssmartCcDenvirolinkinc.com
www.envirolinkinc.com
252-235-4900- Office
252-290-5646 —Mobile
This E-mail (including attachments) is confidential, intended only for the named recipient(s) and may contain confidential or
proprietary information. If you are not the intended recipient(s), you are hereby notified that the dissemination, distribution, or
copying of this message is strictly prohibited. If you receive this message in error, or are not the named recipient(s), please notify the
sender and delete this email from your computer. Thank you.

Mickey, Mike
From: Scott Bryan <[e-mail]>
Sent: Thursday, August 13, 2015 11:49 AM
To: Mickey, Mike
Subject: August 21
Good morning.
Be advised that my final day with Envirolink and at the Town of Mocksville's Dutchman Creek WWTP
will be August 21.
I've enjoyed working with you.
If you have any questions or concerns going forward, contact Heather Adams, Envirolink Director of
Operations, at 252.236.5710.
Many thanks, Mike.
4,
Scott Bryan
Wastewater Specialist
Envirolink Inc
PO Box 670
Bailey NC 27807
704.437.1591
252.235.2132 — Fax
slbryanCaD-road runner. com
ENVIROLINK

Town of Mocksville-Wastewater Annual Report
July 1, 2014-June 30, 2015
The Clean Water Act of 1999, passed by the North Carolina General Assembly, required utilities
like the Town of Mocksville to provide an annual report to their wastewater customers. This
report summarizes the performances of our Wastewater Collection System and Wastewater
Treatment Plant over a 12-month period (July 1, 2014-June 30, 2015).
Each day, we collect and treat an average of 450 thousand gallons of wastewater; about 160
million gallons a year. We are proud of our collection/treatment system and the job we do in
protecting public health and the environment, meeting regulatory requirements and
accommodating the orderly growth of the community.
Our Mission
Overall, there are two key elements in wastewater treatment- the collection system and the
treatment process. Our highly trained, state certified staff does an excellent job with both.
Wastewater collection/treatment is a 24-hour-a-day, 7day-a-week responsibility.
Ultimately, our goal is to protect both the environment and the quality of life not only for the
Town of Mocksville, but for our neighboring communities as well. Each city and town along
Dutchman Creek is affected by the quality of water we discharge from our respective wastewater
treatment plants. Today is more important than ever for all of us to join together to protect the
quality of life that only a clean river can offer.
What is Wastewater Treatment?
Wastewater Treatment is the biological process of removing pollutants from the water so it can
be returned safely to the environment. It is the "last line of defense" against water pollution.
The Town of Mocksville Wastewater Treatment Plant protects the environment from water
which may cause disease -causing bacterial or other pollutants.
Our Community is continuously expanding with the addition of new industries, businesses and
homes. Along with this growth comes added waste to be collected and treated. It is an
enormous task to keep up with this growth and properly manage the increases in wastewater
collection and treatment. The Town of Mocksville accepts this task by planning and upgrading
its wastewater and collection facilities as necessary in order to meet our customers' needs.
About Our Collection System
The Town of Mocksville Utilities Wastewater Collection System includes 81 miles of sanitary
sewer mains (pipes) and 7 pump stations with their associated force mains. These pipes and
pump stations collect and transport an average of 400 thousand gallons of wastewater per day

from homes and businesses in Mocksville and parts of Davie County. Wastewater is collected
through approximately 2500 individual connections to the system and delivered through a
network of pipes ranging from 6" to 1 S" in diameter. The collected wastewater is transported to
the Wastewater Treatment Plant where it is treated prior to being returned to Dutchman Creek.
Overflows Create Problems
Essentially, the collection system is like a transportation system. The pumps and pipes transport
wastewater from our customers to the Wastewater Treatment Plant. We have to do all we can to
make sure "traffic" is not allowed to back up. On the highway it would be called a traffic jam.
In our case, when the "traffic" backs up, it is called a Sanitary Sewer Overflow (SSO). SSOs are
bad for the environment and result in stiff penalties from State Regulators.
SSOs occur when wastewater builds up in the pipe and cannot get out. The water potentially
could seep out of the top of a manhole or cleanout. The majority of overflows on our system are
caused by blockages, which often occur as a result of improper disposal of grease. Some
overflows are caused by excessive inflow and infiltration (I&I) or leaks into the sewer system.
To a lesser extent some problems are caused by tree roots, pipe failure or construction damage,
but most result from grease and/or other debris.
How We Protect the System
We work very hard to protect our system from SSOs in a variety of ways and our record is
excellent. The following is a brief overview of the various ways we try to protect our system and
prevent overflows.
• Pre-treatment Program
There are provisions in our Sanitary Sewer Use Ordinance for pre-treatment of
wastewater, principally by our industrial customers. We issue permits to applicable
industries and they pretreat their wastewater before it is discharged to the Town of
Mocksville.
• Grease Interceptors
Commercial customers that serve food or process meat, etc. are required to have grease
interceptors. These devices are designed to remove grease, a leading cause of sewer line
blockages.
• Inspections
We regularly inspect our sewer lines for obvious problems. We also inspect other
locations such as streams, creek crossings, and outfalls. We inspected over 6,163 feet of
sewer pipe with our sewer camera.

• Pipe Cleaning
This year we cleaned 40,000 feet of sewer pipe with special high pressure equipment
designed to remove grease and other debris from the system. This routine cleaning
program further reduces the potential for system blockages and overflows.
• I&I Investigations
I&I (inflow/infiltration) is extraneous water that gets into the wastewater collection
system; any water other than sewage. We have an extensive program that includes
smoke testing, closed circuit TV inspection and flow monitoring to enable us to identify
areas of extraneous flow. Once we have located problem areas, we take the necessary
steps to remediate the problem.
• Public Education
We are in the process of an educational campaign with our customers involving fliers,
door hangers, newsletters and advertising designed to inform the public on ways they can
help us protect the sanitary sewer system.
What You Can Do
Mocksville Utilities does everything it can to prevent sewer spills, but we cannot do it alone.
You play an important role in helping us maintain an efficient public sanitary sewer system.
Since the majority of overflows are caused by improper disposal of items into the sewer system,
we ask you to be aware of the following guidelines:
• Avoid pouring fats, oils, and grease from cooking down the drain. Instead, collect
them in a container and dispose in the trash.
• Don't use your toilet as a wastebasket. Place a wastebasket in the bathroom to
dispose of items such as disposable diapers and personal hygiene products.
• Unless you have a garbage disposal, please don't use your drain to dispose of
food scraps. Place food scraps in waste containers or garbage bags for disposal or
composting.
• Don't pour hazardous products such as paint, pesticides or herbicides down the
drain.
• If your Business generates waste grease, fats or oils, you should have a grease
interception system that works effectively. A company that recycles fats, oils and
grease should regularly clean out the grease trap. Commercial grease traps are
checked quarterly.

Wastewater Treatment Process and System Performance
Our Wastewater Treatment Plant (WWTP) is responsible for removing debris, solid materials
and pollutants from the water which comes into the facility and then disinfecting the water
before it is returned into Dutchman Creek. The following table is related to Notices of Violations
during the reporting period.
Date
Parameter
Permit Limit
Reported Value
Violation
7/31/14
BOD
5.0 mg/L
6.55 mg/L
Monthly Limit
Exceeded
7/28/14 to
BOD
7.5 mg/L
7.75 mg/L
Weekly Limit
8/ 1 / 14
Exceeded
8/31/14
BOD
5.0 mg/L
5.17 mg/L
Monthly Limit
Exceeded
7/28/14 to
Fecal
400/100 mL
531/100 mL
Weekly Limit
8/1/14
Exceeded
8/4/14 to 8/8/14
Fecal
400/100 mL
965/100 mL
Weekly Limit
Exceeded
10/31/14
BOD
5.0 mg/L
5.28 mg/L
Monthly Limit
Exceeded
1/12/15 to
BOD
15 mg/L
20.2 mg/L
Weekly Limit
1/16/15
Exceeded
2/8/15 to
BOD
15 mg/L
28.3 mg/L
Weekly Limit
2/ 14/ 15
Exceeded
2/8/15 to
TSS
45.0 mg/L
167.9 mg/L
Weekly Limit
2/14/15
Exceeded
2/28/15
BOD
10 mg/L
10.2 mg/L
Monthly Limit
Exceeded
2/28/15 JTSS
30 mg/L
49.0 mg/L
Monthly Limit
Exceeded

Collection System Performance
The North Carolina General Assembly enacted legislation in July 1999, requiring municipalities,
animal operations, industries, and others who operate waste handling facilities to issue news
releases when a wastewater spill of 1,000 or more reaches surface waters. A wastewater spill of
15,000 gallons or more requires a news release as well as a paid public notice. The following
table is related to the Sanitary Sewer Overflows that occurred during the reporting period.
Date
Location
Total Volume
Total Volume
Cause of SSO
(Gallons)
Reaching
Surface
Water
(Gallons)
11/14/14
447 Buck
15,000
0
Broken Force
Seaford Road
Main
1/2/15
Hospital Street
150
150
Debris in Line
Ext.
1/29/15
Behind 127
2,500
1,200
Grease
Wilhaven Drive
2/11/15
Corner of Tot
1,500
750
Debris in Line
Street and
Raymond Street
3/15/15 1
155 Boyce Drive 1
1,800 1
0
Debris in Line
4/6/15
Behind 127
750
0
Grease
Wilhaven Drive
The Town of Mocksville Staff and Employees continue to improve maintenance and pollution
prevention procedures. Please do not hesitate to contact our office if you have any questions
concerning this report.

ATE
NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
May 26, 2015
Ms. Christine Bralley, Manager
Town of Mocksville
171 Clement Street
Mocksville, NC 27028
SUBJECT: Compliance Evaluation Inspection
Mocksville's Dutchman Creek WWTP
NPDES Permit No. NCO021491
Davie County
Dear Ms. Bralley:
Donald van der Vaart
Secretary
On May 21, 2015, Mike Mickey of this office met with Scott Smart and Scott Bryan of Envirolink to
perform a Compliance Evaluation Inspection of the NPDES wastewater discharge from the Dutchman Creek
Wastewater Treatment Plant. The inspection findings are detailed below and an inspection checklist is
attached.
I. Permit
The NPDES was reissued on November 1, 2014. The facility began submitting the monthly monitoring
reports electronically back in April 2014, well ahead of August 1, 2015 deadline established in Condition
A(4) of the permit.
H. Self -Monitoring Program
The monthly Discharge Monitoring Reports (DMRs) were reviewed for the period April 2014 through March
2015. The facility was found to be non -compliant with the effluent limits for BOD, TSS and fecal coliform
in the permit (see data summary attached). These violations have already been addressed in
correspondence from this office. It was noted that the system was compliant in March and April 2015. In
regards to the permit monitoring requirements, all sampling was performed per the frequencies specified in
the permit.
III. Flow Measurement
The NPDES permit requires continuous flow recording and annual calibration of the flow measuring devices.
There are three ultrasonic flow meters with parshall flumes located prior to the aeration basins. Two of these
meters were calibrated by ForTech on January 22, 2015. The third meter was recently replaced and
calibrated. The SCADA system totals the flows from each meter automatically. An additional ultrasonic
flow meter is located at the contact chamber. This meter is connected to the composite sampler so that flow
proportioned composite samples can be collected of the effluent.
IV. Sludee Handline and Disposal
Solids are stored in a 180,000 gallon aerobic digester. Two smaller digesters are also available. Residuals
were recently removed from the digesters by EMA Resources and land applied under non -discharge permit
No. WQ0003351.
450 West Hanes Mill Road, Suite 300, Winston-Salem, NC 27105
Phone: [phone] \ Internet: www.ncwaterguality.org
An Equal Opportunity \ Affirmative Action Employer — Made in part by recycled paper

Ms. Christine Bralley
Page 2
May 26, 2015
V. Operations and Maintenance
Two O&M issues were discussed during the inspection. The first involved the inefficient mixing and oxygen
transfer in the three aeration basins since surface aerators are used. Envirolink has been working to reduce
the MLSS levels in each aeration basin to improve WWTP performance. The second issue noted involved
the deteriorated baffle at the outlet of aeration basin # 1 that was allowing excessive scum to accumulate on
top of clarifier #1. This baffle should be replaced.
VI. Facility Site Review
The existing 0.980 MGD treatment system consists of the following components: influent lift station with
mechanical screening, flow splitter box with chemical feed, three influent flow meters with parshall flumes
(used as passive grit removal), three rectangular aeration basins with two surface aerators each, three circular
secondary clarifiers, gas disinfection, dual contact chambers with post aeration, gas dechlorination and one
large aerobic digester with surface mixer and two smaller digesters.
VII. Records/Reports
A comparison of the March 2015 self -monitoring report with the corresponding operator's records and the
laboratory data sheets from Environment One showed that all values were transcribed onto the DMR
correctly. The operator's records were thorough and complete.
VUL Effluent/Receivine Waters
The system discharges into Dutchman Creek, class "C" waters in the Yadkin -Pee Dee River Basin. The
effluent was clear on the day of inspection.
Should you have any questions concerning this report, please contact Mike Mickey or me at (336)
776-9800.
Sincerely,
4L.-y-, 4141
Sherri V. Knight, PE
Assistant Regional Supervisor
Water Quality Regional Operations
Division of Water Resources
cc: Scott Bryan ([e-mail])
Heather Adams ([e-mail])
Scott Smart ([e-mail])
Central Files
WSRO

Permit: NCO021491 Owner - Facility: Dutchman Creek VWVrP
Inspection Date: 05/21/2015 Inspection Type: Compliance Evaluation
Permit
Yes No NA NE
(If the present permit expires in 6 months or less). Has the permittee submitted a new
❑
❑
0
❑
application?
Is the facility as described in the permit?
M
❑
❑
❑
# Are there any special conditions for the permit?
0
❑
❑
❑
Is access to the plant site restricted to the general public?
M
❑
❑
❑
Is the inspector granted access to all areas for inspection?
0
❑
❑
❑
Comment: A review of the Dutchman Creek monthly Discharge Monitoring Reports (DMRs) for the
period April 2014 through March 2015 noted BOD TSS and fecal coliform effluent limit
violations (see data summary attached). The violations occurred in April, May, June, July,
August October 2014 and January, February 2015. Some contributing factors to
non-compliance were excessive rain SCADA issues causing chemical feed flow pacing
problems high MLSS levels in aeration and inefficient mixing and oxygen transfer with the
surface aerators in each aeration basin.
It was noted that the VWVfP had returned to compliance for the months of March and April
2015.
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: The 0.980 MGD system consists of the following: influent lift station with mechanical
screening flow splitter box with chemical feed three influent flow meters with parshall
flumes three rectangular aeration basins with two surface aerators each, three circular
secondary clarifiers gas disinfection, dual contact chambers with post air, gas dechlor and
aerobic digesters (one large and two small).
It was noted that following two issues mentioned in_previous inspection letters had been
corrected: 1) inoperable SCADA at the VWVfP_and, 2) lack of off -site notification for the
influent pump station had been corrected.
Record Keeping
Yes No NA NE
Are records kept and maintained as required by the permit?
M
❑
❑
❑
Is all required information readily available, complete and current?
M
❑
❑
❑
Are all records maintained for 3 years (lab. reg. required 5 years)?
0
❑
❑
❑
Are analytical results consistent with data reported on DMRs?
M
❑
❑
❑
Is the chain -of -custody complete? M ❑ ❑ ❑
Dates, times and location of sampling
Name of individual performing the sampling
Results of analysis and calibration
Page# 3

Permit: NCO021491
Inspection Date: 05/21/2015
Record Keeping
Dates of analysis
Name of person performing analyses
Transported COCs
Are DMRs complete: do they include all permit parameters?
Owner - Facility: Dutchman Creek wWTP
Inspection Type: Compliance Evaluation
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?
Is the ORC certified at grade equal to or higher than the facility classification?
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?
Facility has copy of previous year's Annual Report on file for review?
Yes No NA NE
■ ❑ ❑ ❑
■ ❑ ❑ ❑
❑ ❑ ■ ❑
■ ❑ ❑ ❑
■ ❑ ❑ ❑
■ ❑ ❑ ❑
■ ❑ ❑ ❑
■ ❑ ❑ ❑
Comment: The facility records were found to be thorough and complete. A comparison of the March
2015 DMR with the corresponding operator's records (temperature, dissolved oxygen,
residual chlorine and PH) and the laboratory data sheets from Environment One found that
all values were transcribed onto the monitoring report correctly.
The annual report for fiscal year 7/1 /13 through 6/30/14 was available on the town's web
site. The report correctly listed the violations that occurred in April, May and June 2014.
Pump Station - Influent
Yes No NA NE
Is the pump wet well free of bypass lines or structures?
❑
❑
❑
Is the wet well free of excessive grease?
❑
❑
❑
M
Are all pumps present?
❑
❑
❑
Are all pumps operable?
❑
❑
❑
Are float controls operable?
❑
❑
❑
Is SCADA telemetry available and operational?
0
❑
❑
❑
Is audible and visual alarm available and operational?
❑
❑
❑
Comment: The influent pump station is maintained by the town's sewer collection system staff. The
unit has three pumps with mechanical screening and an on -site dumpster. The high flow
alarm for the pump station now notifies personell at the WTP.
Flow from the pump station is routed to a splitter box located ahead of the parshall flumes.
Chemical Feed Yes No NA NE
Is containment adequate? 0 ❑ ❑ ❑
Is storage adequate? 0 ❑ ❑ ❑
Page# 4

Permit: NCO021491
Inspection Date: 05/21/2015
Chemical Feed
Are backup pumps available?
Is the site free of excessive leaking?
Owner - Facility: Dutchman Creek WWTP
Inspection Type: Compliance Evaluation
Yes No NA NE
❑ ❑ ❑
❑ ❑ ❑
Comment: Caustic soda is fed prior to the splitter boxes for alkalinity adjustment. The caustic is stored
in double walled tanks.
Bar Screens
Yes No NA NE
Type of bar screen
a.Manual
b.Mechanical
Are the bars adequately screening debris?
❑
❑
❑
Is the screen free of excessive debris?
0
❑
❑
❑
Is disposal of screening in compliance?
0
❑
❑
❑
Is the unit in good condition?
0
❑
❑
❑
Comment: The influent pump station has mechanical screens that remove most of the trash.
In
addition three manual bar screens are located ahead of the parshall flumes to catch large
debris during high flow events.
The flume troughs are also used for passive grit collection and are cleaned approximately
every three months by vac truck with the contents deposited on the old drying
beds.
Flow Measurement - Influent
Yes No NA NE
# Is flow meter used for reporting?
N
❑
❑
❑
Is flow meter calibrated annually?
E
❑
❑
❑
Is the flow meter operational?
0
❑
❑
❑
(if units are separated) Does the chart recorder match the flow meter?
❑
❑
E
❑
Comment: There are three separate ultrasonic flow meters with parshall flumes prior to aeration. The
SCADA system electronically totals the flows from each meter. Two of the meters were last
calibrated by ForTech on January 22 2015. The third meter was recently replaced.
Aeration Basins
Yes No NA NE
Mode of operation
Ext. Air
Type of aeration system
Surface
Is the basin free of dead spots?
❑ N
❑
❑
Are surface aerators and mixers operational?
N ❑
❑
❑
Are the diffusers operational?
❑ ❑
0
❑
Is the foam the proper color for the treatment process?
E ❑
❑
❑
Page# 5

Permit: NCO021491 Owner - Facility: Dutchman Creek WWTP
Inspection Date: 05/2112015 Inspection Type: Compliance Evaluation
Aeration Basins
Yes No NA NE
Does the foam cover less than 25% of the basin's surface?
0
❑ ❑
❑
Is the DO level acceptable?
❑
❑ ❑
Is the DO level acceptable?(1.0 to 3.0 mg/1)
❑
❑ ❑
Comment: Three 340,000 gallon rectangular aeration basins with two surface aerators each.
The
scum baffle at the outlet of aeration basin #1 is deteriorating. The holes that have developed
are allowing excessive scum to accumulate on top of clarifier #1. The baffle should be
replaced.
Secondary Clarifier
Yes No NA NE
Is the clarifier free of black and odorous wastewater?
M
❑
❑
❑
Is the site free of excessive buildup of solids in center well of circular clarifier?
0
❑
❑
❑
Are weirs level?
0
❑
❑
❑
Is the site free of weir blockage?
0
❑
❑
❑
Is the site free of evidence of short-circuiting?
0
❑
❑
❑
Is scum removal adequate?
0
❑
❑
❑
Is the site free of excessive floating sludge?
0
❑
❑
❑
Is the drive unit operational?
M
❑
❑
❑
Is the return rate acceptable (low turbulence)?
0
❑
❑
❑
Is the overflow clear of excessive solids/pin floc?
0
❑
❑
❑
Is the sludge blanket level acceptable? (Approximately 'Y4 of the sidewall depth)
❑
❑
❑
0
Comment: Three circular secondary clarifiers. (Note issue mentioned above with clarifier #1
Aerobic Digester
Yes No NA NE
Is the capacity adequate?
0
❑
❑
❑
Is the mixing adequate?
0
❑
❑
❑
Is the site free of excessive foaming in the tank?
❑
❑
❑
M
# Is the odor acceptable?
0
❑
❑
❑
# Is tankage available for properly waste sludge?
0
❑
❑
❑
Comment: A single 180,000 gallon digester with surface mixer is used for sludge storage. Two smaller
units are also available for storage. Residuals are land applied by EMA Resources under
non -discharge permit No. W00003351.
Disinfection -Gas Yes No NA NE
Are cylinders secured adequately? M ❑ ❑ ❑
Are cylinders protected from direct sunlight? M ❑ ❑ ❑
Page# 6

Permit: NCO021491 Owner -Facility: Dutchman Creek WWTP
Inspection Date: 05/21/2015 Inspection Type: Compliance Evaluation
Disinfection -Gas
Yes No NA NE
Is there adequate reserve supply of disinfectant?
0
❑
❑
❑
Is the level of chlorine residual acceptable?
0
❑
❑
❑
Is the contact chamber free of growth, or sludge buildup?
0
❑
❑
❑
Is there chlorine residual prior to de -chlorination?
E
❑
❑
❑
Does the Stationary Source have more than 2500 Ibs of Chlorine (CAS No. 7782-50-5)?
❑
0
❑
❑
If yes, then is there a Risk Management Plan on site?
❑
❑
0
❑
If yes, then what is the EPA twelve digit ID Number? (1000- -____)
If yes, then when was the RMP last updated?
Comment: Chlorine is fed proportional to flow and is controlled by the ultrasonic flow meter located at
the contact chamber. Both contact chambers are aerated.
De -chlorination
Yes No NA NE
Type of system ?
Gas
Is the feed ratio proportional to chlorine amount (1 to 1)?
N
❑
❑
❑
Is storage appropriate for cylinders?
0
❑
❑
❑
# Is de -chlorination substance stored away from chlorine containers?
0
❑
❑
❑
Are the tablets the proper size and type?
❑
❑
E
❑
Comment: The sulfur dioxide gas is fed proportional to flow at the end of each contact chamber.
Are tablet de -chlorinators operational? ❑ ❑ 0 ❑
Number of tubes in use?
Comment:
Effluent Sampling
Yes No NA NE
Is composite sampling flow proportional?
E
❑
❑
❑
Is sample collected below all treatment units?
N
❑
❑
❑
Is proper volume collected?
❑
❑
❑
Is the tubing clean?
0
❑
❑
❑
# Is proper temperature set for sample storage (kept at less than or equal to 6.0 degrees
E
❑
❑
❑
Celsius)?
Is the facility sampling performed as required by the permit (frequency, sampling type
0
❑
❑
❑
representative)?
Comment: Flow proportioned composite samples are collected from a manhole. The refrigerator
temperature was 1 degrees celcius.
Page# 7

Permit: NCO021491 Owner - Facility:
Dutchman Creek WWTP
Inspection Date: 05/21/2015 Inspection Type:
Compliance Evaluation
Effluent Pipe
Yes No NA NE
Is right of way to the outfall properly maintained?
0
❑
❑
❑
Are the receiving water free of foam other than trace amounts and other debris?
M
❑
❑
❑
If effluent (diffuser pipes are required) are they operating properly?
❑
❑
M
❑
Comment: The effluent at the contact chambers was observed to be clear.
Upstream / Downstream Sampling Yes No NA NE
Is the facility sampling performed as required by the permit (frequency, sampling type, and ❑ ❑ 0 ❑
sampling location)?
Comment: The upstream and downstream monitorina reauirements in the permit are waived since
Mocksville is a member of the Yadkin Pee -Dee River Basin Association.
Standby Power Yes No NA NE
Is automatically activated standby power available? 0 ❑ ❑ ❑
Is the generator tested by interrupting primary power source? 0 ❑ ❑ ❑
Is the generator tested under load?
0
❑
❑
❑
Was generator tested & operational during the inspection?
❑
0
❑
❑
Do the generator(s) have adequate capacity to operate the entire wastewater site?
0
❑
❑
❑
Is there an emergency agreement with a fuel vendor for extended run on back-up power?
❑
❑
❑
Is the generator fuel level monitored?
N
❑
❑
❑
Comment: The 40 kW generator is tested under load periodically by the town staff and
is serviced
2/year. The unit can run the entire WWTP except for post air in the contact chambers.
Page# 8

Data Summary
Mocksville Dutchman Creek WWTP
NPDES Permit No. NCO021491
Self -Monitoring Data Summary
April 2014 - March 2015
Parameters
Monthly Avg.
Permit Limit
Monthly Avg. Limit
Violations per DMR
Weekly Average
Permit Limit
Weekly Avg. Limit
Violations per DMR
Flow (MGD)
0.98
None
-
NA
BOD (mg/L)
(5.0 / 10.0)*
April, May, July, Aug, Oct & Feb.
(7.5 / 15.0)*
April, May, June, August,
January & Feb.
TSS (mg/L)
30.0
February
45.0
February
NH3-N (mg/L)
(2.0 / 4.0)*
None
(6.0 / 12.0)*
None
Fecal (#/100 ml)
200
None
400
August
T. Chlorine (ug/L)
-
NA
28.0**
None
Chronic Toxicity
P/F @ 37%
None
-
NA
Cadmium (ug/L)
7.0
None
15.0***
None
pH (S.U.)
-
NA
(6.0 - 9.0) range****
None
*Summer/Winter Limits.
** Daily max. limit. TRC values reported below 50 ug/L are considered compliant.
* "Daily maximum limit.
****Daily maximum and minimum limit.
Monthly Average Violations:
April 2014 - The BOD monthly average of 6.32 mg/L violated the 5.0 mg/L monthly average limit.
May 2014 - The BOD monthly average of 5.44 mg/L violated the 5.0 mg/L monthly average limit.
July 2014 - The BOD monthly average of 6.55 mg/L violated the 5.0 mg/L monthly average limit.
August 2014 - The BOD monthly average of 5.17 mg/L violated the 5.0 mg/L monthly average limit.
October 2014 - The BOD monthly average of 5.28 mg/L violated the 5.0 mg/L monthly average limit.
February 2015 - The BOD monthly average of 10.22 mg/L violated the 10.0 mg/L monthly average limit.
February 2015 - The TSS monthly average of 49 mg/L violated the 30.0 mg/L monthly average limit.
Weekly Average Violations:
BOD weekly average of 14.1 mg/L for 4/7/14 - 4/11/14 violated the 7.5 weekly average limit.
BOD weekly average of 13.7 mg/L for 5/12 - 5/16 violated the 7.5 weekly average limit.
BOD weekly average of 8.25 mg/L for 6/9 - 6/13 violated the 7.5 weekly average limit.
BOD weekly average of 7.75 mg/L for 7/28 - 8/1 violated the 7.5 weekly average limit.
Fecal C. weekly average of 531/100 ml for 7/28 - 8/1 violated the 400/100 ml weekly average limit.
Fecal C. weekly average of 965/100 ml for 8/4 - 8/8 violated the 400/100 ml weekly average limit.
BOD weekly average of 20.2 mg/L for 1/12/15 - 1/16/15 violated the 15.0 weekly average limit.
BOD weekly average of 28.3 mg/L for 2/9 - 2/13 violated the 15.0 weekly average limit.
TSS weekly average of 167.9 mg/L for 2/9 - 2/13 violated the 45.0 weekly average limit.

Af
RUM
North Carolina Department of Environment and Natural Resources
Pat McCrory Donald van der Vaart
Governor Secretary
May 5, 2015
CERTIFIED MAIL # 7013 1710 0002 1865 6013
RETURN RECEIPT REQUESTED
Ms. Christine W. Bralley, Manager
Town of Mocksville
171 South Clement Street
Mocksville, NC 27028
Subject: Notice of Violation and Recommendafion for Enforcement
NPDES Permit No. NCO021491
Mocksville Dutchman Creek WWTP
Davie County
Dear Ms. Bralley:
A review of the Mocksville Dutchman Creek WWTP monitoring report for February 2015
showed the following effluent limit violations:
Parameter
Date
Limit Value
Reported Value
Limit Type
BOD
2/9 — 2/13/15
15.0 mg/1
28.27 mg/l
Weekly Average Exceeded
BOD
February 2015
10.0
10.22
Monthly Average Exceeded
TSS
2/9 — 2/13/15
45.0
167.93
Weekly Average Exceeded
TSS
February 2015
30.0
49.0
Monthly Average Exceeded
A Notice of Violation/Notice of Recommendation for Enforcement (NOV/NRE) is being
issued for the noted violation of North Carolina General Statute (G.S.) 143-215.1 and NPDES
Permit No. NC0021491. Pursuant to G.S. 143-215.6A, a civil penalty of not more than twenty-five
thousand dollars ($25,000.00) may be assessed against any person who violates or fails to act in
accordance with the terms, conditions, or requirements of any permit issued pursuant to G.S. 143-
215.1. If you wish to provide additional information regarding these violations, request technical
assistance, or discuss overall compliance please respond in writing within ten (10) days after receipt
of this Notice. A review of your response will be considered along with any information provided
on the February 2015 Discharge Monitoring Report. You will then be notified of any civil penalties
that may be assessed regarding the violations. If no response is received in this Office within the
10 day period, a civil penalty assessment may be prepared.
450 West Hanes Mill Road, Suite 300, Winston-Salem, NC 27105
Phone: [phone] \ Internet: www.ncwaterguality.ore
— _ _ . .m_.v-.:.._ . _.:__ r..... I.......— KA,Al ir. mrt K,, rnnirlcrl ...or

Ms. Christine Bralley
Page #2
May 5, 2015
Remedial actions, if not already implemented, should be taken to correct any problems. The
Division of Water Resources may pursue enforcement actions for this and any additional violations.
If the violations are of a continuing nature, not related to operation and/or maintenance problems,
and you anticipate remedial construction activities, then you may wish to consider applying for a
Special Order by Consent.
If you have questions concerning this matter, please do not hesitate to contact Mike Mickey
or me at [phone].
Sincerely,
W. Corey Basinger
Regional Supervisor
Water Quality Regional Operations Section
Division of Water Resources
cc: Scott Bryan ([e-mail])
Heather Adams ([e-mail])
Point Source Branch
SWP — Central Files
WSRO Files

DMR Review Record
Facility: Permit Permit No.: �` ` �'�
�� � Pipe No.: MonthlYear:
Monthly Average Violations
Parameter Permit Limit DMR Value % Over Limit Action
ee *Iv Violations
Date Parameter Permit Limit Limit Type DMR Value % Over Limit Action
?1 7-1
Monitoring Frequency Violations
Date Parameter Permi enc
Other Violations/Staff Remarks:
t
Supervisor Remarks:
Completed by:
Assistant Regional
Supervisor Sign Off: ~� .
Supervisor Sign
Off:
Values Reported # of Violations Action
Date:
Date: 5 S — ► 5
Date: 4- ._l

DR. F. W. SLATE
Mayor
Commissioners:
WILL MARKLIN, Mayor Pro Tern
JOHNNYFRYE
LASH GAITHER SANFORD, JR.
ROB TAYLOR
AMY VAUGHAN-JONES
April 8, 2015
CHRISTINE W. BRALLEY
/ Town Manager
OCR' tl e
INCORPORATED 1839
171 S CLEMENT STREET
MOCKSVILLE, NC 27028
Mr. Cory Basinger, Regional Supervisor
WSRO, WQOS, DWR, NCDENR
450 West Hanes Mill Road Suite 300
Winston-Salem, NC 27105
HENRY R VAN HOY 11
Town Attorney
RECEIVED
N.C.Dept. of ENR
APR 13 2015
Winston-Salem
Regional Office
Subject: Response to the Notice of Violation issued on March 31, 2015 for the Dutchman
Creek WWTP NCO021491
Dear Mr. Basinger:
The Town of Mocksville and Envirolink, Inc. appreciate the opportunity to respond to
the Notice of Violation for exceeding the weekly average permit limit value for BOD at
the WWTP during the week of January 121h.
Envirolink and the Town were able to identify valid reasons for previous violations
such as excessive rain, and issues related to SCADA programming and chemical feed
flow pacing. However, there is belief that the surface aerators are not as efficient as
other forms of aeration at removing BOD and other constituents because of poor
mixing, poor air distribution, and settled older sludge that gets suspended during surge
rain events in the aeration basins. To assist with these issues, Envirolink plans to slowly
lower the Mixed Liquor Suspended Solids (MLSS) in the basins to around 2,200 mg/l.
Based on the recent violations, and February's DMR results, Envirolink welcomes a site
meeting with your technical staff to discuss our plan of action, and get feedback on
some other possible solutions. Envirolink will coordinate with Mr. Mickey to set up
this meeting.
PHONE: [phone] • FAX: [phone]
www.mocksvillenc.org

The Town has expensed significant funds on upgrading the SCADA system, and is
currently budgeting for additional operational maintenance items at the WWTP, and we
respectfully request that the Division not seek any further enforcement action for the
Notice of Violation.
We trust that this letter addresses our response to the Notice of Violation and
demonstrates the Town of Mocksville's commitment to improving the reporting, record
keeping, and overall system condition of the wastewater treatment plant. If the Town
can be of any further assistance or additional information is needed, please do not
hesitate to contact me.
Sincerely,
Christine Bralley
Cc: Mike Meyers
Scott Smart
Heather Adams
Scott Bryan

Ari?2
WNW
North Carolina Department of Environment and Natural Resources
Pat McCrory Donald van der Vaart
Governor Secretary
March 31, 2015
CERTIFIED MAIL # 7013 1710 0002 1865 5979
RETURN RECEIPT REQUESTED
Ms. Christine W. Bralley, Manager
Town of Mocksville
171 South Clement Street
Mocksville, NC 27028
Subject: Notice of Violation and Recommendation for Enforcement
NPDES Permit No. NCO021491
Mocksville Dutchman Creek WWTP
Davie County
Dear Ms. Bralley:
A review of the Mocksville Dutchman Creek WWTP monitoring report for January 2015
showed the following effluent limit violation:
Parameter
Date
Limit Value
Reported Value
Limit Type
BOD
1/12—1/16/15
15.0 mg/1
20.2 mg/1
Weekly Average Exceeded
A Notice of Violation/Notice of Recommendation for Enforcement (NOV/NRE) is being
issued for the noted violation of North Carolina General Statute (G.S.) 143-215.1 and NPDES
Permit No. NC0021491. Pursuant to G.S. 143-215.6A, a civil penalty of not more than twenty-five
thousand dollars ($25,000.00) may be assessed against any person who violates or fails to act in
accordance with the terms, conditions, or requirements of any permit issued pursuant to G.S. 143-
215.1.
In addition, the weekly and/or monthly BOD limit was also violated in April, May, June,
July, August and October 2014. If you wish to provide additional information regarding these
chronic violations, request technical assistance, or discuss overall compliance please respond in
writing within ten (10) days after receipt of this Notice. A review of your response will be
considered along with any information provided on the January 2015 Discharge Monitoring Report.
You will then be notified of any civil penalties that may be assessed regarding the violations. If no
response is received in this Office within the 10 day period, a civil penalty assessment may be
prepared.
450 West Hanes Mill Road, Suite 300, Winston-Salem, NC 27105
Phone: [phone] \ Internet: www.ncwatercLu_ality.org
An Equal Opportunity \ Affirmative Action Employer— Made in part by recycled paper

Ms. Christine Bralley
Page #2
March 31, 2015
Remedial actions, if not already implemented, should be taken to correct any problems. The
Division of Water Resources may pursue enforcement actions for this and any additional violations.
If the violations are of a continuing nature, not related to operation and/or maintenance problems,
and you anticipate remedial construction activities, then you may wish to consider applying for a
Special Order by Consent.
If you have questions concerning this matter, please do not hesitate to contact Mike Mickey
or me at [phone].
Sincerely,
W. Corey Basinger
Regional Supervisor
Water Quality Regional Operations Section
Division of Water Resources
cc: Scott Bryan ([e-mail])
Heather Adams ([e-mail])
Point Source Branch
SWP — Central Files
WSRO Files

Facility: �OchLcdJ �\`QJ
Parameter
Dat
Date
Parameter
Parameter
DMR Review Record
Permit No.: \1�—Q N\M\ Pipe No.: MonthNear: lob S
Monthly Average Violations
mit Limit DMR Value % Over Limit Action
eek h? ' Violations
Permit Limit Limit Type DMR Value % Over Limit Action
Mwitorina Frequency Violations
Permit Fre quenc Values Reported # of Violations Action
Other Violations/Staff Remaa�rks:
AN
Tj
Supervisor Remarks: .
A10 l urn -7b .sue &�- w ALI-- .
36 4-) ss �
Completed by: Date:U' \
Assistant Regional
Supervisor Sign Off: Date:
Regional Supervisor Sign
Off: Date:

NPDES PERMIT NO.: NCO021491 PERMIT VERSION: 4.0 PERMIT STATUS: Active
FACILITY NAME: Dutchman Creek WWTP CLASS: WW-3 COUNTY: Davie
OWNER NAME: Town of Mocksville ORC: Scott Leon Bryan ORC CERT NUMBER: 985581
GRADE: WW-4, ORC HAS CHANGED: No
eDMR PERIOD: 01-2015 (January 2015) VERSION: 1_0 STATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
F
0
50050
00010
00400
50(160
C0310
C0610
C0530
=
E
8
<
F
y
Continuous
5 X week
3 X week
2 X week
3 X week
3 X week
3 X week
m
o
E
U
w
Recorder
Grab
Grab
Grab
Composite
Composite
Composite
A
U
F
O
O
O
Z
FLOW
TEMP-C
PH
CHLORINE
DOD - Cone
NH3-N - Cone
TSS - Cone
2400
Hrs
2400
Hn
YB/N
_
mgd
I dexc
Is.
"./I
.....n
__�
..
'
3
x
0.338
0.395
12.3
4
0.615
5
0153
6.5
Y
0.493
11.7
6
0908
24
0626
6.5
Y
0.513
11.2
7
0636
5
Y
0.429
10.3
8
0954
24
0646
4
Y
0.348
9.6
9
0955
24
0633
5
Y
0.494
7.8
10
0.333
24
0657
0547
6.25
7.25
Y
Y
0.449
0.448
8.1
10.7
0607
6.75
Y
0.421
10.2
24
0606
6.75
Y
0.442
9.8
24
0557
4.25
Y
0.45
9.6
..v
21
- 1
1
U331
0553
/.25
5
Y 1
Y
0.49.8
0.394 8.7
12
1007
24
0553
6
Y
0.381
23
094124
0624
5
Y
0.503 9.1
24
0.847
25
0.5
26
1
0631
6.5
Y
0.442 9.4
27
0907
24
0622
6.75
Y
0.47 9.3
28
0900
24
0618
6.75
Y
0.466 8.2
29
0947
24
0630
4
Y
0.424 7.6
30
0939
24
0634
4
Y
0.448 8
31
0.368
Monthly Average Limit:
0.98
Monthly Average:
0.4435 9.59
Daily Maximum:
0.847 112.3
Dairy Minimum:
Monthly Avg % Removal (85•/.):
0.304 7.6
o.a�
6.85
3Y
2.7
0.12
<2.5
5.5
0.17
6.6
_
4.7
0.08
<25
6.86
53
O.SZ 3
0.64 <2.1
14 140
13
13.1
36
0.24 I3
)5
3.2
0.14
2.5
2.6
0.1
< 2.5
36
<2
2.9
0.11
3.4
5.4
0.06
7.9
10
4
30
36.875
7.28
022
9.58
40
53
0.64
85
31 0
0.06 0
Lt
1_
1©�
I--
1--
1
I --
I-
I®�
RECEIVECI
FEB 2 0 2015
CEiNTf--,,.f`.i.. f=iLE
C,VV R SE r, T,'ON

ZRMIT NO.: NCO021491
PERMIT STATUS: Active
JTY NAME: Dutchman Creek WWTP
NdER NAME: Town of Mocksville
;BADE: WW-4.
eDMR PERIOD: 01-2015 (January 2015)
COMPLIANCE: Nq¢Compliant
PERMIT VERSION: 4.0
CLASS: WW-3
ORC: Scott Leon Bryan
ORC HAS CHANGED: No
VERSION: 1.0
CONTACT PHONE #: [phone]
COUNTY: Davie
ORC CERT NUMBER: 985581
STATUS: Processed
SUBMISSION DATE: 02/12/2015
02/12/2015
ORC/Certifi0kignature: Scott L. Bryan E-Mail:[e-mail] Phone #:[phone] 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 H.E.6 of
the NPDES permit.
COMMENTS: Week #3 non -compliant: BOD - Clarifier drive motor failure on 1/12. Once the motor was replaced, the clarifier began operating normally and effluent limits
were compliant.
02/12/2015
Perm ittee/Submitter Signature:`** Heather Thomas Adams E-Mail:[e-mail] Phone #:[phone] Date
Permittee Address: 295 Garwood Rd Mocksville NC 27028 Permit Expiration Date: 06/30/2019
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: Environment One
CERTIFIED LAB #: 10
PERSON(s) COLLECTING SAMPLES: Operators
CERTIFIED LABORATORIES
PARAMETER CODES
Parameter Codes assistance may be obtained by calling the NPDES Unit [phone] or by visiting the Surface Water Protection Section's web site at
http://portal.ncdenr.org/web/wq/swp and linking to the unit's information pages.
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 document visitation of facility as required 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).

���.V
NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
March 27, 2015
Enviroli@ Inc.
Attn: Ms. Heather Adams
P.O. Box 670
Baily, NC 27807
Subject: Pretreatment Annual Report Review (PAR)
(January 1, 2014 - December 31, 2014)
Town of Mocksville
NPDES Number: NCO021491
Davie County
Dear Ms. Adams:
Donald R. van der Vaart
Secretary
The Winston-Salem Regional Office has reviewed the Pretreatment Annual Report covering January through
December 2014. Our review indicates that the annual report is in good order and satisfies the requirements of
15A NCAC 2H .0908(b) and the Comprehensive Guidance for North Carolina Pretreatment Programs. The
next annual report will be due March 1, 2016.
Thank you for your continued cooperation with the Pretreatment Program. The Town is doing an excellent job
implementing the pretreatment program. If you have any questions or comments, please contact me at (336)
776-9700 femaik [e-mail]].
Sincerely,
George S. Smith, Environmental Chemist
Water Quality Regional Operations Section
Division of Water Resources, NCDENR
ATTACHMENT
cc: PERCS Unit — Monti Hassan
WSRO Files
450 W. Hanes Mill Road, Winston-Salem, North Carolina 27105
Phone: [phone] Internet: www.ncdenr.gov
An Equal Opportunity 1 Affirmative Action Employer — Made in part by recycled paper

Regional Pretreatment Annual Report (PAR) Review
Is the PAR on time? Does it have two copies?
Did they send anv other submissions with it?
Included?
ADEQUATE?
POTW noted Corrections?
MAIs
® YES
❑
NO
❑ NA
® YES
❑
NO
❑ NA
PPS Form
® YES
❑
NO
® YES
NO
y
® YES
❑
NO
® YES
❑
NO
IDSF
❑ YES
❑
NO
® YES
❑
NO
Submitted data
Allocation Table
❑ YES
❑
NO
❑ YES
❑
NO
Waste Reduction Info
❑ YES
❑
NO
[]'YES
❑
NO
❑ YES
❑
NO-®
NA
❑ YES
❑
NO
® NA
'
❑ YES
❑
NO
® NA
❑ YES
❑
NO
® NA
® YES
❑
NO
® YES
❑
NO
[:]YES ® NO
❑ YES
❑
NO
® NA
❑ YES
❑
NO
® NA
❑ YES ❑ NO ® NA
Tf Nn
Regional Office: WSRO
POTW: Town of Mocksville
NPDES Permit No. NCO021491
Report Period: 01/01/2014 - 12/31/201,
❑ Full ® Modified
For modified programs evaluate shaded items
only. A Narrative is required for a modified
program only if there are SIUs in SNC.
1. Have at least 90% of SIU permits been issued within 180
® Yes ❑ No ❑ Not req'd
❑ NOV
LiV/I
❑ QNCR
YG/V lli
❑ NCP
❑ Civil Penalty
days of expiration? See Allocation Table).
Assessment
2. Were at least 80% of SIUs inspected? (See PPS FormT
® Yes ❑ No ❑ Not req'd
❑ NOV
❑ QNCR
❑ NCP
❑ Civil Penalty
Assessment
3. Has effective enforcement been taken against industries in
® Yes ❑ No ❑ NA
❑ NOV
❑ QNCR
❑ NCP
❑ Civil Penalty
SNC, including those causing pass -through or interference? (See
Assessment
Narrative and SNCR Form
4. Does public notice cover all SIUs in SNC?
❑ Yes ❑ No ® NA
❑ NOV
❑QNCR
❑ NCP
❑ Civil Penalty
Assessment
Note: Exceptions should be explained in the comment section below:
Reviewed By: George S. Smith Date: March 27, 2015
Regional Pretreatment Annual Report Review
mocksville form 14.par.docxl2
Fill in Values from PPS Form
data)
SSNC 0
FENF
2
JUDI
0
SVPU
0
IUPN
0
SOCS
0

Mickey, Mike
From: [e-mail]
Sent: Wednesday, February 11, 2015 4:12 PM
To: Mickey, Mike
Subject: Re: November eDMR / Dutchman Creek
I'll fix it.
Thanks
Scott Bryan
Wastewater Services
Envirolink Inc
704.437.1591
[e-mail]
----- Reply message -----
From: "Mickey, Mike" <[e-mail]>
To: "[e-mail]" <slbryan@road runner.com>
Cc: "Heather Adams ([e-mail])" <[e-mail]>
Subject: November eDMR / Dutchman Creek
Date: Wed, Feb 11, 2015 15:56
Scott — The computer is noting two effluent temperature omissions for Thanksgiving week (permit requires 5/week temp
monitoring). Evidently, an "H" needs to be entered in the temperature column for the 27t' and 28`h (see yellow highlight
below from the Helpful Hints document). Can you revise the eDMR and resubmit?
Have yet to see the December and January eDMRs. If sampling did not occur due to the Christmas/New Year's/MLK
holiday's and an "H" was not entered for the parameters not sampled, then those eDMRs will need amending too. Holler
back if any questions. Thanks, Mike.
Topic IS: Reporting for Holidays:
When monitoring is not required due to an official holiday, the following will apply depending on the situation indicated:
• If monitoring is not required for any parameter on a recognized holiday, a selection of "Holiday" can be made
from the drop -down box in the No Flow Reason column, which will apply to all parameters for that day; no
values can be reported for any parameter as long as the No Flow Reason is selected. An alternative method is to
report an "H" as the value for each parameter for that day.
[e-mail]
NC DENR Winston-Salem Regional Office
Division of Water Resources — Water Quality Programs
450 W. Hanes Mill Road, Suite 300, Winston-Salem, NC 27105

Phone: [phone]
E-mail correspondence to and from this address may be subject to the North
Carolina Public Records Law and may be disclosed to third parties.

.,
��
NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
January 20, 2015
Ms. Christine W Bralley, Town
Town of Mocksville
171 South Clement Street
Mocksville, NC 27028
Subject: NOTICE OF VIOLATION
NOV-2015-LV-0015
Permit No. NCO021491
Dutchman Creek WWTP
Davie County
Dear Ms. Bralley:
Donald van der Vaart
Secretary
A review of the Dutchman Creek WWTP monitoring report for October 2014 showed the following violation:
Parameter
Date
Limit Value
Reported Value
Limit Type
BOD
October
5.0 mg/1
5.28 mg/l
Monthly Average Exceeded
Remedial actions, if not already implemented, should be taken to correct the above noncompliance problem.
Please be aware that violations of your NPDES permit could result in enforcement action by the Division of
Water Resources for this and any additional violations of State law.
If you have any questions or require any additional information, please contact Mike Mickey at [phone].
Sincerely,
Sherri V. Knight, PE
Assistant Regional Supervisor
Water Quality Regional Operations Section
Division of Water Resources
cc: Scott Bryan (via email: [e-mail])
Heather Adams (via email: [e-mail])
DWQ Central Files
WSRO
450 West Hanes Mill Road, Suite 300, Winston-Salem, NC 27105
Phone: [phone] \ Internet: www.ncwaterauality.org
An Equal Opportunity \ Affirmative Action Employer— Made in part by recycled paper

DMR Review Record
f Facility: OC�J�SVti�\� a�`� tIpermit No.: Pipe No.: MonthNear: aCy�
U eQc��... G�v.� ZP �
Monthly Average Violations
Parameter Permit Limit DMR Value % Over Limit Action
Weeklv/Daily Violations
Date Parameter Permit Limit Limit a DMR Value % Over Limit Action
'-Monitoring Frequency Violations
iolations
Date Parameter Permit Fro uen Values Reported # of Violations Action
Other Violations/Staff` Remarks:
QC �,V iC,V•� �i��b\S�i,bS�\
supervisor Remarks: , U 0 V
Completed by:�'�
Assistant Regional 1
Supervisor Sign Off:
Regional Supervisor Sign
Off:
Date:
Date:
Date:

1
NPDES PERMIT NO.: NCO021491
PERMIT STATUS: Inactive
FACILITY NAME: Dutchman Creek WWTP
OWNER NAME: Town of Mocksville
GRADE: WW-4.
PERMIT VERSION: 3.0
CLASS: WW-3
ORC: Scott Leon Bryan
ORC HAS CHANGED: No
COUNTY: Davie
ORC CERT NUMBER: 985581
eDMR PERIOD: 10-2014 (October 2014) VERSION: 1_0 STATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
G
13
$
o
U
F
o
E
1
E
F
>
¢
m
6
O
C
E
F
q
6
O
m
U
O 1
a
a
w
Z
50050
00010
00400
50060
C0310
C0610
C0530
31616
00300
Continuous
S X week
3 X week
3 X week
3 X week
3 X week
3 X week
3 X week
3 X week
Recorder
Grab
Grab
Grab
Composite
Composite
Composite
Grab
Grab
FLOW
TEMP-C
PH
CHLORINE
BOD - Cone
NH3-N - Cone
TSS - Cone
FEC COLI
DO
2400
11"
2400
11 s
Y/B/N
mgd
&gc
su
ug/1
mg/1
mg/1
mg/1
#/100m1
mg/l
0606
6
Y
0.392
20.8
45
2
0540
5
Y
0,391
20.1
48
3
0950
24
0547
5
Y
0.43
20.3
6,03
48
4.1
0.13
3
2
7.86
4
0,347
5
0.304
6
I101
0617
6
Y
0.354
15.9
7
0908
24
0546
6
Y
0.376
17.4
6.05
4.l
0.08
3.5
1
8.51
8
0548
6
Y
0.375
18.3
36
9
1006
24
0546
6
Y
0.376
18.7
6.09
29
5.7
<0.04
32
1
8.22
1006
24
0529 16
Y
0.37
19.1
6.37
45
5.6
0.05
4.3 19
8.12
11
0.34
0.325
0555
6
Y
0.384
20.2
r
0910
24
0548
6
Y
"1
20
6.69
4.5
0.1
4.8
3
7.74
0646
4
Y
0.507
21
30
1002
24
0543
6
Y
0.405
19
6.41
32
5.4
0.33
<2.5
5
7.84
17
0938
24
0553
6
Y
0.39
19.7
6.21
34
3.7
0.27
2.9
5
8.02
18
0.353
19
0.305
20
0841
3.5
Y
0.355
15.8
21
0909
24
0611
7
Y
0.372
15.9
25
8.8
0.24
4.6
21
8.62
22
0553
6
Y
0.375
16.2
6.09
23
1007
24
0547
5
Y
0.391
15.2
6.11
34
5.6
0.53
3.6
5
7.56
24
1008
24
0619
4.5
Y
0.373
15.1
6.28
38
3.1
01
2.8
1
8.23
25
0.336
26
0.313
27
0618
4
Y
0,366
16.1
28
0908
24
0545
3.5
Y
0.387
15.3
6.72
44
9.4
0.27
3.8
< 1
9.26
29
0541
4.75
Y
0.413
17.6
30
1005
24
0608
4
Y
0.373
16.2
6.87
36
5
0.21
4.4
1
7.6
31
1008
24
06I0
4
Y
0.367
16.6
6.9
35
3.6
0.23
< 2.5
< 1
8.01
Monthly Average Limit:
0.98
5
2
30
200
Monthly Average:
0.3727
117.8043
6.3708
37.2667
5.28
0.2
3.15
2.49
9.0454
Daily Maximum:
0.507
21
6.9
48
9.4
0.53
4.8
21
8.62
Daily :Minimum:
0.304
15.1
6.03
25
3.1
0
0
0
7.56
Monthly Avg % Removal (85 % ):
RECEIVED
L.. Dept. of ENR
LvVinston-Salem
Regional Offlce
,I D
NOV 2 0 20'14
CENTRAL FILES
DWR SECTION

i .
r
S PERMIT NO.: NCO021491
+CILITY NAME: Dutchman Creek WWTP
OWNER NAME: Town of Mocksville
GRADE: WW-4.
eDMR PERIOD: 10-2014 (October 2014)
COMPLIANCE: Non -Compliant-.,
PERMIT VERSION: 3.0
CLASS: WW-3
ORC: Scott Leon Bryan
ORC HAS CHANGED: No
VERSION: 1.0
CONTACT PHONE #: [phone]
PERMIT STATUS: Inactive
COUNTY: Davie
ORC CERT NUMBER: 985581
STATUS: Processed
SUBMISSION DATE: 11/17/2014
11/17/2014
ORC/Certifier V, nllvture: Scott L. Bryan E-Mail:[e-mail] Phone #:[phone] 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.
14DIENTS: Monthly BOD limit slightly exceeded due to sulfur dioxide overfeed. Since the SCADA system was replaced, we have been working with the Instrumentation
Company to adjust and tweak the flow pacing signals with the chlorine and sulfur dioxide feed rates.
11/17/2014
4Permitte Submitter 4ignature:*** Heather Thomas Adams E-Mail:[e-mail] Phone #:[phone] Date
Permittee Address: 295 Garwood Rd Mocksville NC 27028 Permit Expiration Date: 06/30/2014
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: Environment One
CERTIFIED LAB #: 10
PERSON(s) COLLECTING SAMPLES: Operators
CERTIFIED LABORATORIES
PARAMETER CODES
Parameter Codes assistance may be obtained by calling the NPDES Unit [phone] or by visiting the Surface Water Protection Section's web site at
http://portal.ncdenr.org/web/wq/swp and linking to the units information pages.
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 document visitation of facility as required 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).

DR. F. W. SLATE
Mayor
Commissioners:
WILL MARKLIN, Mayor Pro Tem
JOHNNY FRYE
LASH GAITHER SANFORD, JR.
ROB TAYLOR
AMY VAUGHAN-JONES
December 5, 2014
Jown O
CHRISTINE W. BRALLEY
Town Manager
oc��uc e
W. Corey Basinger INCORPORATED 1639
171 S. CLEMENT STREET
NCDENR MOCKSVILLE, NC 27028
Division of Water Resources
450 W. Hanes Mill Road, Suite 300
Winston Salem, NC 27105
Subject: Response to the Notice of Violation issued on December 2, 2014 for the
Dutchman Creek WWTP NCO021491
Dear Mr. Basinger:
HENRY P. VAN HOY II
Town Attomey
The Town of Mocksville appreciates the opportunity to respond to the Notice of
Violation issued on December 2, 2014. Please find enclosed our response to the Notice
of Violation regarding the Dutchman Creek Wastewater Treatment Plant exceeding the
following parameters: Monthly Average for BOD exceeded on 8/31/14, Weekly Average
for BOD exceeded on 8/1/14 and Fecal Coliform exceeded on 8/1/14 and 8/8/14.
The Town of Mocksville does not dispute that the above mentioned parameters were
exceeded. During the month of July, the SCADA system which controls process
instrumentation and chemical feed addition was replaced at the treatment plant. It was
determined that the chemical flow pacing signals were not set up correctly during the
installation which caused issues with chemical additions.
On July 30, 2014, the operator discovered that the sulfur dioxide was feeding at twice the
rate of the chlorine. It is our past experience with sulfur dioxide, overfeeding will cause
increased levels of BOD in the effluent water quality. The operator immediately called
the SCADA representative and the 4-20 mA signal for the sulfur dioxide flow pacing was
found to need adjusting. It was also noted that the chlorine 4-20 mA flow pacing signal
was adjusted as well.
On August 1, 2014, the operator discovered that the field plug for the #1 aerator in
aeration basin #3 malfunctioned, leaving the entry end of the basin without any mixing or
air. The plug was immediately ordered and was replaced on August 6, 2014. Once the
aerator was returned to service, it took some time before the basin regained its healthy
state. Given the average temperature during that time, all aerators were running 60
minutes on/10 minutes off, so any loss of air capacity was significant. During this same
timeframe, the plant also experienced an increase in flow due to an excess of 1 inch of
rain.
PHONE: [phone] • FAX: [phone]
www.mocksvillenc.org

2
We feel that the issues with the chemical flow pacing signals combined with the aerator
failure and increased flow significantly impacted the treatment plant causing the BOD
and fecal violations. The Town has expensed significant funds to replace the SCADA
system at the WWTP and we respectfully request that the Division not seek any further
enforcement action for the Notice of Violation.
We trust that this letter addresses our response to. the Notice of Violation and
demonstrates the Town of Mocksville's commitment to improving. the reporting, record
[seeping, and overall system condition of the wastewater treatment plant. If the Town can
be of any further assistance or additional information is needed, please do not hesitate to
contact me.
Sincerely,
CSOIN
Christine Bralley
Town Manager
Cc: Heather Adams, Envirolink Inc.
Scott Bryan, Envirolink Inc.
Mike Mickey, NCDENR

Mickey, Mike
From: Christine Bralley <[e-mail]>
Sent: Friday, January 09, 2015 11:14 AM
To: Basinger, Corey
Cc: Mickey, Mike
Subject: Response letter to Nov Dutchman Creek WWTP NC0021491
Attachments: D00010915-01092015102015.pdf
Corey,
I left you a voicemail, which you may disregard. I spoke with Mike Mickey and explained I discovered today, while
updating some other files I did not have a paper copy of this response in my files, which lead me to the conclusion, you
may not have a copy either. I apologize if you have not received this response earlier.
The Town of Mocksville remains respectful of all requirements and regulations and will continue to make improvements
for the overall operations of the Dutchman Creek WWTP.
Sincerely,
Christine Bralley
Christine W. Bralley
Town Manager
Mocksville, NC - "Time Well Spent"
336-753-6701
cbralley@ mocksvillenc.gov

Pat McCrory
Governor
4
NCDENR
North Carolina Department of Environment and Natural Resources
December 2, 2014
CERTIFIED MAIL # 7013 1710 0002 1865 5740
RETURN RECEIPT REQUESTED
Ms. Christine W. Bralley, Manager
Town of Mocksville
171 South Clement Street
Mocksville, NC 27028
Subject: Notice of Violation and Recommendation for Enforcement
NPDES Permit No. NCO021491
Mocksville's Dutchman Creek WWTP
Davie County
Dear Ms. Bralley:
John E. Skvarla, III
Secretary
A review of the Mocksville Dutchman Creek WWTP monitoring report for August 2014
showed the following effluent limit violations:
Parameter
Date
Limit Value
Reported Value
Limit Type
BOD
August 2014
5.0 mg/1
5.17 mg/l
Monthly Average Exceeded
BOD
7/28 — 8/1
7.5 mg/l
7.75 mg/l
Weekly Average Exceeded
Fecal Coliform
7/28 — 8/1
400/100 ml
531
Weekly Average Exceeded
Fecal Coliform
8/4-8/8
400/100 ml
965
Weekly Average Exceeded
A Notice of Violation/Notice of Recommendation for Enforcement (NOV/NRE) is being
issued for the noted violation of North Carolina General Statute (G.S.) 143-215.1 and NPDES
Permit No. NC0021491. Pursuant to G.S. 143-215.6A, a civil penalty of not more than twenty-five
thousand dollars ($25,000.00) may be assessed against any person who violates or fails to act in
accordance with the terms, conditions, or requirements of any permit issued pursuant to G.S. 143-
215.1. If you wish to provide additional information regarding the noted violation, request technical
assistance, or discuss overall compliance please respond in writing within ten (10) days after receipt
of this Notice. A review of your response will be considered along with any information provided
on the August 2014 Discharge Monitoring Report. You will then be notified of any civil penalties
that may be assessed regarding the violations. If no response is received in this Office within the
10 day period, a civil penalty assessment may be prepared.
N.C. Division of Water Resources
450 W. Hanes Mill Road, Suite 300, Winstion-Salem, NC 27105
Phone: [phone] Internet: www.ncwaterquality.org
An Equal Opportunity 1 Affirmative Action Employer — Made in part by recycled paper

Remedial actions, if not already implemented, should be taken to correct any problems. The
Division of Water Resources may pursue enforcement actions for this and any additional violations.
If the violations are of a continuing nature, not related to operation and/or maintenance problems,
and you anticipate remedial construction activities, then you may wish to consider applying for a
Special Order by Consent.
If you have questions concerning this matter, please do not hesitate to contact Mike Mickey
or me at [phone].
Sincerely,
W. Corey Basinger
Regional Supervisor
Water Quality Regional Operations Section
Division of Water Resources
cc: Scott Bryan (via email: [e-mail])
Heather Adams (via email: [e-mail])
Point Source Branch
SWP — Central Files
WSRO Files

DMR Review Record
Facility: • � �1 ��, Permit No.: Pipe No.: MonthNear:
Monthly Average Violations
Parameter g"��
Permit Limit
Date Parameter
N-- e�
H
Date Parameter
Other Violations/Staff Remarks:
Q��.y•.+oa.5 �jtio�c��.ocoS �
Supervisor Remarks:
DMR Value
S'n
eek Daily Violations
Permit Limit Limit Type DMR Value
Freauen
Values Reported
% Over Limit Action
YI c
% Over Limit Action
# of Violations Action
Completed by: Date: ` - )- — \A
Assistant Regional
Supervisor Sign Off: Date:
Regional Supervisor Sign
Off: Date:

NPDES PERMIT NO.: NCO021491
PERMIT VERSION: 3.0
-
PERMIT STATUS: Expired
1I18 _ >I4.i�
FACILITY NAME: Dutchman Creek WWTP
CLASS: WW-3
COUNTY: Davie
OWNER NAME: Town of MocksviUc
ORC: Scott Leon Bryan
ORC CERT NUMBER 985581
1111- 4.4
GRADE: W W-4.
ORC HAS CHANGED: No
eDMR PERIOD: 08-2014 (August 2014) VERSION: 1.0
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.:
STATUS: Processed
001 NO DISCHI*:
lYU` 31•
AContinuous
eU
3
.
1s
A
p,
V
O
Z2
50050
mole
00400
50060
C0310
C0610
C0530
31616
00300
5 X week
3 X week
3 X week
3 X week
3 X week
3 X week
3 X week
3 X week
Recorder
Gist
Grab
Gmb
Co
Co
Composite
crab
Grab
FLOW
TEMP-C
PH
CHLORINE
ROD -Cone
NH3.N-Cone
738-Cone
FECCOLI
DO
2400
Elm
2400 1
Hrs
YBM
mgd
deg c
su
U911
m
-94
Ee
N/1001n1
01811
1
1013
24
0722
4
Y
0.631
21
6.88
50
3.1
0.13
3.6
> 6000
7.22
2
0.393
3
0.344
4
0914
24
0714
55
Y
0357
21.7
_6.99
_48
12
0.92
6.5
>6000
758
5
0910
24
0720 14.5
Y 1
0.383
22.4
6.97
50
4.4
0.27
3.4
500
7.51
6
0728
3
Y
0.385
23.3
7
1000
24
0717
4
Y
1037
22.2
3.8
8
1006
24
0704
3.5
Y
0.377
22.8
6.49
42
42
0.14
2.8
300
729
g
0.365
10
0329
11
0912
24
0721
4
Y
0.413
21.3
41
8
0.51
4.7
2300 17.75
12
0911
24
0714
5
Y
0.446
22.6
6.43
39
32
0.1
3.3
3400
7.64
13
0715
3
Y
0.366
22.7
6A7
14
0719
4
Y
0357
21.9
15
1010
24
0721
3
Y
0.36
21.4
6.91
39
5.5
0.3
4.5
< 1
8.08
16
0.351
17
0324
0903
24
0645
6
Y
0377j
22.6
47
42
0.49
4.3
3
7.24
0907
24
0610
6
Y
039622.7
6226
62
0.11
3.6
7
7.35
r
0612
4
Y
0358 - __23
-
1000
24
- 0615
4
- Y
0.35523.2
6.7
55
22
11011
24
10543
6
Y
0.366
23.4
6.45
49
5
0.3
4.2
5
7.34
23
0357
24
0.378
25
0913
24
0558
725
Y
0.383
22.2
6.59
22
7.8
1.05
3.6
10
735
26
0909
24
0544
7
Y
0379
21.1
6.8
45
2.6
0.09
3.3
3
7.62
27
0540
6
Y
0393
225
28
0552
6.75
Y
0.376
21.6
29
1010
24
0542
5.75
Y
0385
21.8
6.15
49
<2
0.18
4
4
7.4
30
0.341
31
0299
Monthly Average I J
098
5
2
30
200
Monthly Average:
0.3769
22.2571
6.6169
42.0769
.17
0.35
3.98
66.85
Ddiy Maximum:
0.631
23.4
6.99
50
12
1.05
6.5
tv
8.08
Dally mum'
0.289
21
6.15
22
0
0.09
2.8
7.22
Monthly Avg % Removal (85%):
RECEIVED I
N.C.Dept. of ENR
RE
ED
SEP 2 91114 SEP . 2 20',
CENTRAL FILES
Winston-Salem DWR SECTION
Regional Office

DES PERMIT NO.: NCO021491
+ ; ACHdTY NAME: Dutchman Creek WWTP
OWNER NAME: Town of Mocksville
GRADE: WW-4.
eDMR PERIOD: 08-2014 (August 2014)
COMPLIANCE: Non-Comuliant
PERMIT VERSION: 3.0
CLASS: WW-3
ORC: Scott Leon Bryan
ORC HAS CHANGED: No
VERSION: 1.0
CONTACT PHONE #: [phone]
PERMIT STATUS: Expired
COUNTY: Davie
ORC CERT NUMBER: 985581
STATUS: Processed
SUBMISSION DATE: 09/15/2014
09/15/2014
ORC/Certifie Sig%ture: Scott L. Bryan E-Mail:slbryan@roadrunner. corn Phone #:[phone] 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 H.E.6 of
the NPDES permit.
COMMENTS: Non -compliant BOD: Week 1. Non -compliant BOD: Month of August. Non -compliant Fecal Coliform: Weeks 1 and 2. Significant changes in plant yard
piping (increase in service water pressure to chlorination/sulfonation) and the replacement of the plant's SCADA system caused considerable, negative changes in effluent quality
post -clarification. Annual service to the plant's gas systems, and debug of the new SCADA system appear to have resolved effluent quality issues.
09/15/2014
Permittee/Submitter Signature** Heather Thomas Adams E-Mail:[e-mail] Phone #:[phone] Date
Permittee Address: 295 Garwood Rd Mocksville NC 27028 Permit Expiration Date: 06/30/2014
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: Environment One
CERTIFIED LAB #: 10
PERSON(s) COLLECTING SAMPLES: Operators
CERTIFIED LABORATORIES
PARAMETER CODES
Parameter Codes assistance may be obtained by calling the NPDES Unit [phone] or by visiting the Surface Water Protection Section's web site at
http://portal.ncdenr.org/web/wq/swp and linking to the unit's information pages.
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 document visitation of facility as required 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).

Mickey, Mike
From: Mickey, Mike
Sent: Friday, November 21, 2014 2:42 PM
To: 'Scott Bryan'
Cc: Heather Adams ([e-mail])
Subject: RE: Failure to Submit
Scott — When reporting flows on the eDMR, just enter your flow data on the effluent page (even though the actual
readings are influent). No need to enter the same flow values again on the influent page.
This is somewhat confusing since the new eDMR forms do not have an Inf or Eff check box in the flow column like the
paper DMRs.
FYI —Just saw in the database that the Dutchman Creek NPDES permit was reissued 11/1/14. 1 have yet to see a paper
copy though.
Hope this answers your question. If not, holler back. Mike.
[e-mail]
NC DENR Winston-Salem Regional Office
Division of Water Resources — Water Quality Programs
New WSRO Address: 450 W. Hanes Mill Road, Suite 300, Winston-Salem, NC 27105
New WSRO Phone: [phone]
My New Direct Line: [phone]
E-mail correspondence to and from this address may be subject to the North
Carolina Public Records Law and may be disclosed to third parties.
From: Scott Bryan [mailto:[e-mail]]
Sent: Friday, November 21, 2014 2:06 PM
To: Mickey, Mike
Subject: FW: Failure to Submit
Greetings.
Per our conversation just now.
Please copy Heather on any response.
Thank you, sir.
From: Moore, Tom [mailto:[e-mail]]
Sent: Monday, November 17, 2014 4:35 PM
To: Scott Bryan
Subject: RE: Failure to Submit
Are you using the Influent flow to estimate what your effluent flow is? If so, is this a temporary situation? I looked at
the permit and it indicates that the flow should be reported for the Effluent and DMRs before you started using eDMR
indicated the flow reported for the Effluent. The monitoring/reporting requirement for flow is typically on the

Effluent. Permittees may determine their flow on the effluent in various ways but the flow should represent what is
being discharged out the effluent pipe and thus reported as the effluent. After looking at your report, it appears you
reported the same flow data on the effluent and the influent. Reporting the same values for both is unnecessary.
You want to make sure that your data is getting reflected correctly in EPA's system as we transmit your data to EPA. I
would discuss this with the Regional Office to get clarification.
Tom
Thomas F. Moore
Business and Technology Application Analyst
Division of Water Resources / Information Technology Branch
Wilmington Regional Office
1.27 Cardinal Drive Extension
Wilmington, NC 28405
Phone: [phone]
From: Scott Bryan [mailto:slbryan(�)roadrunner.com]
Sent: Monday, November 17, 2014 4:23 PM
To: Moore, Tom
Subject: RE: Failure to Submit
Actually, I need to contact WSRO about that, because our flow is measured from our influent.
Otherwise, I think we're straightened out.
Thanks.
From: Moore, Tom [mailto:tom.f.moorePncdenr.gov]
Sent: Monday, November 17, 2014 4:12 PM
To: Scott Bryan
Subject: RE: Failure to Submit
Do you need to include the Flow parameter in the INFLUENT report? It is not required by your permit.
Thomas F. Moore
Business and Technology Application Analyst

Division of Water Resources / Information Technology Branch
Wilmington Regional Office
1.27 Cardinal Drive Extension
Wilmington, NC 28405
Phone: [phone]
From: Scott Bryan [mailto:slbryanCa)roadrunner.com]
Sent: Monday, November 17, 2014 4:06 PM
To: Moore, Tom
Subject: RE: Failure to Submit
It submitted just fine this time.
This is the second time I've had some units change on me. I have no explanation for it, but from now on, I'll
double check to online dialogue units before I turn it over to my boss.
Thank you, again, sir.
From: Moore, Tom [mailto:[e-mail]]
Sent: Monday, November 17, 2014 3:31 PM
To: Scott Bryan
Subject: RE: Failure to Submit
One way to double check to make sure everything is as it should be before submittal is the print the PDF out before
doing the final certification. if any parameter is missing information, you can manually update it and save the report and
then recheck the PDF to make sure everything looks good. Parameters must have the Units and Sample Type reflected.
We should have a code fix in place by end of the year to address the issue when imported additional parameters. In the
meantime, the above will help prevent this issue.
Tom
Thomas F. Moore
Business and Technology Application Analyst
Division of Water Resources / Information Technology Branch
Wilmington Regional Office
127 Cardinal Drive Extension
Wilmington, NC 28405
Phone: [phone]
From: Scott Bryan [mailto:[e-mail]]
Sent: Monday, November 17, 2014 3:11 PM
To: Moore, Tom
Subject: RE: Failure to Submit

Thanks, Tom.
I have no idea how those units got changed as they weren't that way on the template.
I've done as you've instructed, and will get my boss to submit it again.
slb
From: Moore, Tom [mailto:[e-mail]]
Sent: Monday, November 17, 2014 2:58 PM
To: [e-mail]
Cc: Scott, Michele
Subject: RE: Failure to Submit
Scott,
It appears there is an additional parameter, Flow (50050) included on the Influent and no data is reported. You will note
that the Flow parameter does not have a sample type or unit of measure specified on the printed copy shown below,
which will cause the submittal to reflect a "Failed to Submit" status. If data is not being reported for a parameter, it
should not be included. It appears you are using the import feature and your template should be modified to remove
this parameter on the effluent. Any parameter that does not indicate a frequency will indicate the parameter is not
required by your permit and would be considered a voluntary or additional reported parameter.
You can submit the report as is but you will need to open the report and go to the INFLUENT page. Once on the
INFLUENT data entry screen, you need to only click the SAVE button and this will reset the report status to In
Progress. You will then need to recertify and resubmit the report. The report should submit successfully.
The failure is due to the importing of parameters not required by permit and a software glitch that we are working on
correcting. When additional parameters are imported, you must always click the Save button in the data entry screen
after import to insure all parameter information is saved to database. Otherwise, you will have missing information as
indicated above.

NPDES PERMIT NO.: NC0021491
FACILITY I+tA.i1tIE: Dutchmm Creek WVrTP
OWNER NAME: Town of MocksWle
PERMIT VERSION: 3.0 PE:
CLASS: WW-3 CO
ORC: Scott Lem Bryan OR
GRADE: WW-4. ORC HAS CHANGED: No
sOMRPERIOD: 10-2014 (October2014) VERSION: 1,0 ST,
SAMPLING LOCATION: INFLUENT DISCHAW
a
sm
cx3u
3Xwftk
246
Ra
240
Rn
TAM
i
0606
6
7
050
s
y
3
4942
24
ow
5
Y
288
Please let me know if you have any further questions or need additional assistance.
Tom
DbAslon of Wabw Resowm
Thomas F. Moore
Business and Technology Application Analyst
Division of Water Resources / Information Technology Branch
Wilmington Regional Office
127 Cardinal Drive Extension
Wilmington, NC 28405
Phone: [phone]
E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be
disclosed to third parties.
From: SVC_DENR.eDMRadmin
Sent: Monday, November 17, 2014 2:41 PM
To: Moore, Tom
Cc: Scott Bryan
Subject: FW: Failure to Submit
Tom,

What would prompt the "failed to submit" message? Thanks in advance.
Michele
From: Scott Bryan [mailto:slbryan(�broadrunner.com]
Sent: Monday, November 17, 2014 2:17 PM
To: SVC DENR.eDMRadmin
Subject: Failure to Submit
Good afternoon.
My boss, for some reason, is unable to submit the October eDMR for the Town of Mocksville
(NC0021491).
It is coming back "Failed to Submit," and she says that it doesn't appear that she is getting the option
to resubmit.
Can you point us in the right direction?
Many thanks.
Scott Bryan
Wastewater Services
Envirolink Inc
PO Box 670
Bailey, NC 27807
Phone: [phone]
Fax: [phone]
slbryan(a-)roadrunner.com

Arjp2
s
WDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
October 7, 2014
Ms. Christine W. Bralley, Manager
Town of Mocksville
171 South Clement Street
Mocksville, NC 27028
Subject: NOTICE OF VIOLATION (# NOV-2014-LV-0440)
NPDES Permit No. NCO021491
Dutchman Creek WWTP
Davie County
Dear Ms. Bralley:
John E. Skvarla, III
Secretary
A review of the Dutchman Creek WWTP monitoring report for July 2014 showed the following
violation:
Parameter
Date
Limit Value
Reported Value
Limit Type
BOD
July 2014
5 mg/l
6.55 mg/1
Monthly Average Exceeded
Remedial actions, if not already implemented, should be taken to correct the above noncompliance
problem. Please be aware that violations of your NPDES permit could result in enforcement action
by the Division of Water Resources for this and any additional violations of State law.
If you should have any questions, please do not hesitate to contact Mike Mickey at [phone].
Sincerely,
Sherri V. Knight, PE
Assistant Regional Supervisor
Water Quality Regional Operations Section
Division of Water Resources
cc: Scott Bryan (via email: [e-mail])
Heather Adams (via email: [e-mail])
Central Files - SWP
N.C. Division of Water Resources
585 Waughtown Street, Winstion-Salem, NC 27107
Phone: [phone]Internet: www.ncwaterquality.org
An Equal Opportunity 1 Affirmative Action Employer— Made in part by recycled paper

DMR Review Record
Facility: fi ���\Q, Permit No.: ���-\yq\ Pipe No.: MonthNear: a•A l ca014
Monthly Average Violations
Parameter
l
Date Parameter
Date Parameter
Other Violations/Staff Remarks:
Supervisor Remarks: IV J
Permit Limit
DMR Value
% Over Limit Action
S.y
Weekly/Daily
Violations
Permit Limit Limit Type
DMR Value
% Over Limit Action
Monitorinq Frequency Violations
Permit Frequency
Values Reported
# of Violations Action
\ NN- �, - 041�0
�, ,Completed by: Date:
Assistant Regional
Supervisor Sign Off: Date:
Regional Supervisor Sign
Off: Date:

I
NPOES PERMIT NO.: NCO021491 PERMIT VERSION: 3.0
FACILITY NAME: Dutchman Creek WWTP CLASS: WW-3
OWNER NAME: Town of Mocksville ORC: Scott Leon Bryan
GRADE: WW-4. ORC HAS CHANGED: No
eDMR PERIOD: 07-2014 (July 2014) VERSION: 1.0
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 00
PERMIT STATUS: Expired °,_
COUNTY: Davie � � . - D
El 'ORC CERT NUMBER: 985581 A U G 2 8 Z 014
STATUS: Processed 0 G
1 NO DISCHARGE*: NO
G
x
8
U
7 m
F
�
$
O
=
�E
v
m
V
O
s
Z
50050
00010
00400
50060
C0310
C0610
C0530
31616
00300
Continuous
5 X week
3 X week
3 X week
3 X week
3 X week
3 X week
3 X week
3 X week
Recorder
Grab
Grab
Grab
Composite
Composite
Composite
Grab
Grab
PLOw
TEMP-C
PH
ICHLORM
ROD - Cone
NH3-N - Cone
TSS - Cone
FEC COLI
DO
2400
Hrs
2400
Hrs
Y/B/N
mgd
deg c
su
u9A
m
m9/1
mg/l
8/looml
mg/t
1
0912
24
0716
4
Y
0327
22.6
6.92
33
5.9
0.12
5.5
3
6.98
2
1018
24
0722
5
Y
0.334
23.7
6.65
40
9.8
0.18
5.7
> 6000
6.98
3
0713
1.5
Y
0.339
24.2
4
10.339
H
H
H
H
H
H
H
H
5
0.339
6
0.278
7
0911
24
0712
5
Y
0.329
21
32
6.2
029
3.7
21
7.5
8
0913
24
0722
525
Y
0.338
22.2
35
33
0.1
3.8
ll
16.66
9
0726
2
Y
0.338
23.7
6
10
10714
3
Y
0.337
22.7
6.47
11
1008
24
0716
4
Y
0.331
22.5
6.54
29
3.6
0.07
4.3
18
7.03
12
0.298
13
0.302
14
0909
24
0714
5.5
Y
0.348
23
6.65
45
6.6
0.12
5.3
14
7.24
15
0911
24
0715
5
Y
0.36
23.5
6.8
39
4.6
0.08
6
26
63
16
0715
5
Y
0.327
23.1
17
0722
5
Y
0.327
21.9
18
1010
24
0808
5
Y
0.345
20.6
6.71
31
4.1
<0.04
4.3
32
6.97
19
0.319
20
0.297
21
0914
24
0646
5
Y
0.352
21.8
6.89
29
9.3
<0.04
<2.5
>6000
6.91
22
0910
24
0722
525
Y
0.372
22.1
6.83
34
6.4
<0.04
<3.9
420
7.2
23
0718
5
Y
0.347
22.7
24
0957
24
0714
5.5
Y
0.375
23.4
5.7
25
1001
24
10714
3
Y
10.347
23.1
6.88
33
7.8
0.13
3.8
1
724
26
0.336
27
0.322
28
0910
24
0720
4.25
Y
0.349
23.2
6.75
40
> l4
0.34
5.1
125
7.09
29
0913
24
0719
5
Y
0.34
22.5
6.71
35
7.5
<0.04
42
200
7.44
30
0717
4.75
Y
0.339
21.1
31
1000
24
0716
5.25
1 Y
1
0.353
21.1
4.4
't Monthly Average Limit:
098
S
2
30
200
Monthly Average:
0.3349
22.5318
6.6769
35
6.55
0.11
3.98
56.13
7.0415
Dilly Maximum:
0.375
24.2
6.92
45
14
0.34
6
6000
7.5
Dally Minimum:
0278
20.6
6
29
3.3
0
0
1
6.3
Monthly Avg % Removal (85 h):
RECEIVED
N.C. Dept of ENR
`- SEP 0 3 MW
WINSTON-SA4EM .
REGIONAL OFFICE

NCO021491
,: Dutchman Creek WWTP
PERMIT VERSION: 3.0
CLASS: WW-3
PERMIT STATUS: Expired
COUNTY: Davie
,E: Town of Mocksville
/W-4.
PERIOD: 07-2014 (July 2014)
AdPLIANCE: Non -Compliant
ORC: Scott Leon Brvan
ORC HAS CHANGED: No
VERSION: 1.0
CONTACT PHONE #: [phone]
ORC CERT NUMBER: 985581
STATUS: Processed
SUBMISSION DATE: 08/18/2014
08/18/2014
ORC/Certifier Sigr�atuXe: Scott L. Bryan E-Mai1:[e-mail] Phone #:[phone] 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 H.E.6 of
the NPDES permit.
COMMENTS: July 2014, BOD: SCADA replacement/upgrade during the last week of June has caused significant instability in chlorine and sulfur dioxide pacing with sulfur
dioxide doubling in flow. It is believed the excess sulfur dioxide (a volatile organic) and its feed location created a significant oxygen demand, elevating BOD past allowable
limits. The Town is currently working with its integrator to correct this problem as quickly as possible.
08/18/2014
Permittee/Submitter Signature:*** Heather Thomas Adams E-Mail:[e-mail] Phone #:[phone] Date
Permittee Address: 295 Garwood Rd Mocksville NC 27028 Permit Expiration Date: 06/30/2014
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: Environment One
CERTIFIED LAB #: 10
PERSON(s) COLLECTING SAMPLES: Operators
CERTIFIED LABORATORIES
PARAMETER CODES
Parameter Codes assistance may be obtained by calling the NPDES Unit [phone] or by visiting the Surface Water Protection Section's web site at
http://portal.ncdenr.org/web/wq/swp and linking to the unit's information pages.
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 document visitation of facility as required 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).

Mickey, Mike
From: Scott Bryan <[e-mail]>
Sent: Friday, September 26, 2014 3:36 PM
To: Mickey, Mike
Subject: RE: Dutchman Creek
Thanks...I guess.
Unfortunately, July and August weren't any better, but we think we've got a handle on things now between
getting the new SCADA system tuned in and getting the gas controls back under... well... control.
September is looking pretty good so far. We could use a winning streak.
Have a good weekend.
From: Mickey, Mike [mailto:[e-mail]]
Sent: Friday, September 26, 2014 12:03 PM
To: Heather Adams ([e-mail]); [e-mail]
Subject: Dutchman Creek
Heather & Scott - Attached is a copy of the letter for the June weekly average BOD violation. Mike.
[e-mail]
Division of Water Resources
585 Waughtown Street
Winston-Salem, NC 27012
Phone: [phone]
Fax: [phone]
E-mail correspondence to and from this address may be subject to the North
Carolina Public Records Law and may be disclosed to third parties.
19-, This email is free from viruses and malware because avast! Antivirus protection is active.
1

&41r,*)
NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
September 23, 2014
Ms. Christine W. Bralley, Manager
Town of Mocksville
171 South Clement Street
Mocksville, NC 27028
Subject: NOTICE OF DEFICIENCY
Mocksville Dutchman Creek WWTP
Permit No. NCO021491
Davie County
Dear Ms. Bralley:
John E. Skvarla, III
Secretary
A review of the June 2014 Discharge Monitoring Report (DMR) revealed a violation of the following
parameter:
Parameter
Date
Reported Value
Permit Limit
Limit Type
BOD
6/9 — 6/13
8.25
7.5
Weekly Average
Remedial actions should be taken to correct the cause(s) of this violation. The violations described above
should be abated immediately and properly resolved. Unresolved violations may lead to the issuance of a
Notice of Violation and/or assessments of civil penalties. Thank you for your attention to this matter.
If you have any questions or require any additional information, please contact Mike Mickey at
[phone].
Sincerely,
Sherri V. Knight, PE
Assistant Regional Supervisor
Water Quality Regional Operations Section
Division of Water Resources
cc: Scott Bryan (via email: [e-mail])
Heather Adams (via email: [e-mail])
DWQ Central Files
VWSRO
N.C. Division of Water Resources
585 Waughtown Street, Winstion-Salem, NC 27107
Phone: [phone]Internet: www.ncwaterquality.org
An Equal Opportunity 1 Affirmative Action Employer — Made in part by recycled paper

UMK Keview Kec®rd
` Facility: Permit No.: C��VIq` Pipe No.: VC)
Parameter Permit Limit
MonthNear: tk
DMR Value % Over Limit Action
(Weekkti-ly Violations
Date Parameter Permit Limit Limit Type DMR Value % Over Limit Action
-A
Moniftina Fre uenc y Violations
Date Parameter Permit Frequency Values Reported # of Violations Action
Other Violations/Staff Remarks:
Supervisor Remarks: N Ub
Completed by: `i^-"X- Date:
Assistant Regional
Supervisor Sign Off: V Date: g
Regional Supervisor Sign
Off: Date:

NPDES PERMIT NO.: NCOO21491 PERMIT VERSION: 3.0 PERMIT STATUS: Active RECEIVED
FACILITY NAME: Dutchman Creek W WTP CLASS: W W-3 COUNTY: Davie J � Ut L 2 4 2014
OWNER NAME: Town ofMocksvillc ORC: Scott Leon Bryan ORC CERT NUMBER: 98558'
GRADE: WWA. ORC HAS CHANGED: No CENTRAL FILES
eDMR PERIOD: 06-2014 (June 2014) VERSION: 1.0 STATUS: Processed DWQ/B V V
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
S
3g
�
e
U
a
V
4
1
<`
9
O
W
C
F5
j
O
m
O
O
a
g
50050
onto
00400
sow
CO310
CO610
CO530
31616
00300
Continuous
5 X week
3 X woek
3 X week
3 X week
3 X week
3 X week
3 X week
3 X wmk
Rcmtder
Grab
Grab
Grab
Comp-
comp-
compostc
Grab
Grab
FLOW
TEMP-C
PH
CHLHUNE
SOD -Cone
NH3-N-Cone
M-Coot
F6CCOL►
DO
2400
1 Hra
2*0
Hro
YAW
deg c
su
u
m911
#/loom)
1
1
0561
2
0910
24
0728
55
Y
0.422
20.6
6.94
0
4.1
024
<2.5
20
726
3
0918-
24
0729
6
Y
OM3
19.9
6.79
111
2.5
0.16
<2.5
4
6.92
4
0729
5
Y
0.492
202
5
0728
55
Y
0.422
121..6
6
1002
24
0728
3
Y
0368 -
215
6.68
7
3A
0.71
39
2
7.09
7
036S
0
0368
9
0913
24
0728
6
Y
0.426
21.8
6.26
23
24
029
3.6
16
7.13
10
0909
24
0727
6.75
Y
0392
21.6
6A5
16
3.2
0.16
<25
25
6.86
11
0726
43
Y
Q387
21-6
12
IWO
24
0718
6
Y
0381 -
20.9
33
13
1015
24 10717
3
Y
1
0339
21.8
6.01
23
2.5
0.13
33
9
655
14
1
0339
is
1
0339
16
0909
24
0719
6 -
Y
0385
21.3
6.1
17
3.8
0.27
4.8
5
7.71
17
0910
24
0719
6
Y
0361
22
6.02
28
23
0.4
4.1
24
676
10
0711
6.5
Y
0369
22.9
6.08
31
7.02
19
072Z
5
Y
0392
23
20
1010
24
0711
5
Y
0-336
23
32
0.15
43
48.
21
0336
22
0336
23
i009
24
0713
6
Y
0355
22.9
35
4.8
0.27
7.3
45
24
1008
24
0701
6
Y 1
0353
23.2
2.7
0.44
6.3
30
6.32
25
1
0656
5
Y
0374
22.5
6.76
39
26
0902
24
0603
6
Y
0375
22.9
721
35
32
6.76
27
IODO
24
0620
6
Y
0358
23
7.16
4.1
022
53
t00
6.42
28
0359
29
124.716
0.298
30
0909
Y
0.318
21.8
6.81
39
5.7
022
72
2
6-03
Monthly Average LirnW.
8.98
5
2
30
200 -
Moathty Average
0377
21.9048
6.5592
233046
4.85
028
3.97
14.13
h.8331
Da0y Masira°rx
0.561
232
T21
39
24
0.71
73
100
7-71
Daily Mialmunc
0298 1
19.9 6-01
0
23 0.13
0
2
6.03
Mao" A.g % R-mal (8554):
N.C.gept. of LNR
AUG 0 4 2014
Winston-Salem

NPDES PERMIT NO.: NCO021491
FACILITY NAME: Dutchman Creek WWTP
OWNER NAME: Town of Mocksville
GRADE: WW4.
eDMR PERIOD: 06-2014 (June 2014)
COMPLIANCE: Non-Cotnoliant
PERMIT VERSION: 3.0
CLASS: WW-3
ORC: Scott Leon Bryan
ORC HAS CHANGED: No
VERSION: 1.0
CONTACT PHONE #: [phone]
PERMIT STATUS: Activ;
COUNTY: Davie
ORC CERT NUMBER: 98558'1
STATUS: Processed
SUBMISSION DATE: 07/14/2014
07/14/2014
ORC/Certifier ignature: Scott L. Bryan E-Mail:[e-mail] Phone #:[phone] 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
he NPDES permit.
COMMENTS: Week #2, 6/8-14: Weekly BOD Exceedance. Blowers tripped out over the weekend of 6/7 and 8.
07/14/2014
Permittee/Submitter Signature:*** Heather Thomas Adams E-Mail:[e-mail] Phone #:[phone] Date
Permittee Address: 295 Garwood Rd Mocksville NC 27028 Permit Expiration Date: 06/30/2014
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: Environment One
CERTIFIED LAB #: 10
PERSON(s) COLLECTING SAMPLES: Operators
PARAMETER CODES
Parameter Codes assistance may be obtained by calling the NPDES Unit [phone] or by visiting the Surface Water Protection Section's web site at
httpJ/portal,ncdcar.org/web/wq/swp and linking to the unit's information pages.
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 document visitation of facility as required 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).

Mickey, Mike
From: [e-mail]
Sent: Tuesday, September 09, 2014 10:11 AM
To: Heather Adams
Cc: [e-mail]; [e-mail]; [e-mail];
[e-mail]; [e-mail]; [e-mail];
[e-mail]; [e-mail]; Mickey, Mike;
[e-mail]
Subject: Phone Number Change
Please change my contact number to 704.437.1591.
Heather/Deborah, I'll send the company phone back to the office when I get a chance.
Thanks
Scott Bryan
Wastewater Services
Envirolink Inc
704.437.1591
[e-mail]

A��
NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
August 5, 2014
Ms. Christine W. Bralley, Manager
Town of Mocksville
171 South Clement Street
Mocksville, NC 27028
Subject: NOTICE OF VIOLATION (# NOV-2014-LV-0377)
NPDES Permit No. NCO021491
Dutchman Creek WWTP
Davie County
Dear Ms Bralley:
John E. Skvarla, III
Secretary
A review of the Dutchman Creek WWTP monitoring report for May 2014 showed the following
violations:
Parameter
Date
Limit Value
Reported Value
Limit Type
BOD
5/12 - 5/16
7.5 mg/1
13.7 mg/1
Weekly Average Exceeded
BOD
May 2014
5 mg/1
5.44 mg/l
Monthly Average Exceeded
Remedial actions, if not already implemented, should be taken to correct the above noncompliance
problem. Please be aware that violations of your NPDES permit could result in enforcement action
by the Division of Water Resources for this and any additional violations of State law.
If you should have any questions, please do not hesitate to contact Mike Mickey at [phone].
Sincerely,
W. Corey Basinger
Regional Supervisor
Water Quality Regional Operations Section
Division of Water Resources
cc: Scott Bryan (via email: [e-mail])
Heather Adams (via email: [e-mail])
Central Files - SWP
WSRO
N.C. Division of Water Resources
585 Waughtown Street, Winstion-Salem, NC 27107
Phone: [phone] Internet: www.ncwaterquality.org
An Equal Opportunity 1 Affirmative Action Employer— Made in part by recycled paper

DMR Review Record
Facility �Gj '� �—
U � 'w, � L � Permit No.:�\�� Pipe No.: Month/Year: ao��
cxrQ�� Monthly Average Violations
Parameter Permit Limit DMR Value % Over Limit Action
eekl Ady Violations
Date Parameter Permit Limit Limit Type DMR Value % Over Limit Action
Monitoring Frequency Violations
Date Parameter Permit Frequency Values Reported # of Violations Action
Other Violations/Staff Remarks:
zi
Supervisor Remarks: q
F�
Completed by:
Assistant Regional
Supervisor Sign Off:
Regional Supervisor Sign
Off:
Date:
Date:
Date: 4- l4"'�

• NPDES PERMIT NO.: NCO021491 PERMIT VERSION: 3.0 PERMIT STATUS: Active
hEGE!VED
FACILITY NAME: Dutchman Creek WWTP CLASS: WW-3 COUNTY: Davie N.C.Dept. of ENR
OWNER NAME: Town of Mocksville ORC: Scott Leon Bryan ORC CERT NUMBER: 985581 p a
GRADE: WW4. ORC HAS CHANGED: No 2019
eDMR PERIOD: 05-2014 (May 2014) VERSION: 1.0 STATUS: Submitted iWinston-SG!em
Regional
_µ Off r;e
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
A
a
U
8
U
F
8
a
O
y
O
O
c
O
c
3
Z
50050
00010
00400
50060
C0310
C0610
C0530
31616
00300
Continuous
S X week
3 X week
3 X week
3 X week
3 X week
3 X week
3 X week
3 X week
Recorder
Grab
Grab
Grab
Composite
Composite
Composite
Grab
Grab
FLOW
TEMP-C
PH
CHLORINE
BOD-Cone
NH3-N-Cone
TSS - Cone
FEC COLI
DO
2400
Iles
2400
Hrs
Y/BIN
mgd
deg c
su
u9/1
mg/1
m8A
mg/l
#/100ml
mgli
i
0700
5.00
B
0.457
17.6
2
1000
24
0700
5A0
B
0.392
17.7
7.01
11
3.2
0.31
4.2
9
7.58
3
0.392
4
0.392
5
0900
24
0730
5.00
Y
0.424
17.5
6.7
7
3.8
0.07
6.1
1
7.33
6
0900
124
0730
6.00
Y
1
10.407
17.9
6.63
10
3.5
0.41
3.3
19
6.94
7
0730
5.00
Y
0.404
18.4
8
0729
6.00
Y
0.425
18.5
9
1000
24
0728
5.00
Y
0.387
19.4
6.66
0
3
0.13
2.9
12
7.42
10
0.387
11
0.387
12
0900
24
0730
6.00
Y
0.416
20.5
6.96
0
4
0.11
2.7
29
7.77
13
0900
24
0730
5.00
1 Y
0.416
20
6.84
0
2.1
0.08
<2.5
5
6.57
14
10730
6.50
Y
0.419
20
15
0900
24
0728
5.50
Y
0.914
21
.;,
16
1000
24
0728
4.00
Y
0.41
20
7.35
5
35
5.03
21
64
6.69
17
0.41
18
0.41
19
0900
24
0704
1.75
Y
0.439
16
7.15
10
2.1
0.09
<2.5
5
821
20
0900
24
0728
5.00
Y 1
0.446
15.9
6.97
0
3.2
0.04
<2.5
6
8.21
21
0729
5.00
Y
0.419
19.8
22
0802
525
Y
0.417
19.3
23
1000
24
0728
3.00
Y
0373
20
6.95
0
2.4
021
<2.5
8
6.62
24
0.373
25
0.373
26
0373
H
H
H
H
H
H
H
H
27
0900
24
0600
5.00
B
0.397
19.7
6.94
0
4.3
0.18
< 2.5
9
7.22
28
0900
24
0630
4.50
B
0.407
20.5
6.93
5
2.7
0.11
<2.5
2
7.19
29
0730
2.00
Y
0.518
21.3
33
30
1000
24
0729
3.00
Y
0.561
21.5
7.06
17
3.5
1.05
<2.5
6
6.28
31
0.561
Monthly Average Limit:
098
5
2
30
200
Monthly Average:
0.4357
19,1667
6.9346
5
5.44
0.6
3.09
7.49
7.2331
Daily Mazimum:
0.914
21.5
7.35
17
35
5.03
21
64
8.21
Daily Minimum:
0.373
15.9
6.63
0
2.l
0.04
0
1
6.28
Monthly Avg % Removal (85%):
jUN 2 0 L014
dY1y1 C.R �.dtlfiLi f T �i~�����

•NPDES PERMIT NO.: NCO021491
+ FACILITY NAME: Dutchman Creek W WTP
OWNER NAME: Town of Mocksville
GRADE: W W-4.
eDMR PERIOD: 05-2014 (May 2014)
COMPLIANCE: Non -Compliant
PERMIT VERSION: 3.0
CLASS: WW-3
ORC: Scott Leon Bryan
ORC HAS CHANGED: No
VERSION: 1.0
CONTACT PHONE #: [phone]
PERMIT STATUS: Active
COUNTY: Davie
ORC CERT NUMBER: 985581
STATUS: Submitted
SUBMISSION DATE: 06/16/2014
06/13/2014
ORC/Certifier Signature: Scott L. Bryan E-Mail:[e-mail] Phone #:[phone] 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 H.E.6 of
the NPDES permit.
COMMENTS: BOD limit exceeded for the week of May 11: 2.6" inches of rain in 18 hours over May 15 and 16 caused a significant BOD excursion. BOD limit exceeded for
the month of May 2014: result of excursion over the week of May 11.
06/ 16/2014
v
Permittee/Submitter Signature:*** Heather Thomas Adams E-Mail:[e-mail] Phone #:[phone] Date
Permittee Address: 295 Garwood Rd Mocksville NC 27028 Permit Expiration Date: 06/30/2014
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: Environment One
CERTIFIED LAB #: 10
PERSON(s) COLLECTING SAMPLES: Operators
CERTIFIED LABORATORIES
PARAMETER CODES
Parameter Codes assistance may be obtained by calling the NPDES Unit [phone] or by visiting the Surface Water Protection Section's web site at
http://portal.ncdenr.org/web/wq/swp and linking to the unit's information pages.
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 document visitation of facility as required 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(bx2)(D).

Pat McCrory
Governor
FOX
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Resources
Water Quality Regional Operations Section
August 1, 2014
Ms. Christine W. Bralley, Town Manager
Town of Mocksville
171 Clement Street
Mocksville, NC 27028
SUBJECT: Pretreatment Compliance Inspection
Town of Mocksville
NPDES #NC0021491
Davie County
Dear Ms. Bralley:
John E. Skvarla, III
Secretary
On July 24, 2014 George Smith, of this office, conducted an inspection of the Town's
pretreatment program. Ms. Heather Adams, Pretreatment Coordinator was present for the
inspection. The purpose of this inspection was to determine the effectiveness of the Town's
pretreatment program by reviewing the files, which include: POTW plant performance, industry
monitoring data, and adherence to the enforcement response plan (ERP).
Background Information
Currently, the Town has 1 significant industrial user (SILT). The House of Raeford (#004) is a
food processor.
POTW Interview
The Town has one WWTP (Dutchman's Creek) on the pretreatment program with a 0.68 MGD
permitted flow.
Program Elements
The Headworks Analysis (HWA) was approved on September 24, 2010. The next HWA is due
September 30, 2015.
The Industrial Waste Survey (IWS) was approved on February 20, 2012. The next IWS is due
December 31, 2014.
The Sewer Use Ordinance (SUO) was approved on June 11, 2014.
The Enforcement Response Plan (ERP) was approved on June 15, 2010.
585 Waughtown Street„ North Carolina 27360
Phone: [phone] Fax: [phone]
Internet:: www.ncwaterauality.org
An C--1 /1nn..e -;hAAlfi.. +;— An+;— Cm ]--

Pretreatment Compliance Inspection
August 1, 2014
Page 2 of 2
a
Long Term Monitoring Plan (LTMP) was approved on July 1, 2010.
File Review
A review of the file for House of Raeford (#004) revealed that the monitoring data was well
organized and compliance evaluation was correctly performed.
A slug control plan is required and kept in a file. The plan was recently updated to show the
latest contacts.
Action Items
The next pretreatment annual report is due on March 1, 2015.
The Interjurisdictional Agreement draft copy was sent to this office, but an approved copy has
not been received. Please insure the agreement is signed by Davie County and Town of
Mocksville before sending us a copy. This is past due since June 16, 2014.
Ms. Adams is doing an excellent job implementing the pretreatment program. Should you have
any questions, please do not hesitate to contact George Smith or me at [phone].
Sincerely,
W. Corey Basinger, Regional Supervisor
Water Quality Regional Operations Section
Division of Water Resources, NCDENR
ATTACHMENT
cc: Heather Adams, P.O. Box 670, Bailey, NC 27807
PERCS Unit — Monti Hassan
WSRO Files

NORTH CAROLINA DIVISION OF WATER QUALITY
PRETREATMENT COMPLIANCE INSPECTION (PCI) REPORT
BACKGROUND INFORMATION 1ComDlete Prior To PCI: Review Program Info Database Sheet(s
1. Control Authority (POTW) Name: TOyVA o R ► /or, kf Vi Ile,
2. Control Authority Representative(s): UG2tti er nja mS
3. Title(s): j�rezrcazrn��Z Coori►.iwr
4. Last Inspection Date: PPri 114 av G Inspection Type (Check One): 9?-PCI ❑ Audit
I
5. Has Program Completed All Requirements from the Previous Inspection and Program Info Sheet(s)? EKES ❑ NO
6. Is POTW under an Order That Includes Pretreatment Conditions? ❑ YES D-90
Order Type, Number, Parameters:
PCS CODING
Trans.Code Main Program Permit Number
IP 1 N I C 1 0 Io I2I1 IYIII/I
Are Milestone Dates Being Met? 0
MM/DD/YY Inspee.Type Inspector Fac. Type
7 lay I tY i P1 l S l
r'ACC)
1 l
(DTIA) ('IYPI) (1NSF)
7. Current Number Of Significant Industrial Users (SIUs)? 1 SIUS
8. Current Number Of Categorical Industrial Users (CIUs)? CIUS
9. Number of SIUs Not Inspected By POTW in the Last Calendar Year?
10. Number of SIUs Not Sampled By POTW in the Last Calendar Year?
11. Enter the Higher Number of 9 or 10 NOIN
12. Number of SIUs With No IUP, or With an Expired 1UP O NOCM
13. Number of SIUs in SNC for Either Reporting or Limits Violations During Either of the Last 2
Semi -Annual Periods (Total Number of SIUs in SNC) PSNC
14. Number of SIUs in SNC For Reporting During Either of the Last 2 Semi -Annual Periods IC7 MSNC
15. Number of SIUs In SNC For Limits Violations During Either of the Last 2 Semi -Annual Periods C SNPS
16. Number of SIUs In SNC For Both Reporting and Limits Violations During Either of the Last 2 b
Semi-annual Periods
POTW INTERVIEW
17. Since the Last PCI, has the POTW had any NPDES Limits Violations?
If Yes, What are the Parameters and How are these Problems Being Addressed?
18. Since the Last PCI, has the POTW had any Problems Related to an Industrial
Discharge (Interference, Pass -Through, Blockage, Citizens' Complaints, Increased
Sludge Production, Etc.)?
If Yes, How are these Problems Being Addressed?
19. Which Industries have been in SNC for Limits or Reporting during SNC for
either of the Last 2 Semi -Annual Periods? Not Been Published for SNC for
Public Notice?(May refer to PAR if Excessive SIUs in SNC) Not Pub
20. Which Industries are on Compliance Schedules or Orders? For all SIUs on an
Order, Has a Signed Copy of the Order been sent to the Division?
21. Are Any Permits Or Civil Penalties Currently Under Adjudication? If Yes, Which
Ones?
YES ❑ NO
�}psT,cr►oas r� lRit�
❑ Y ES O
Limits:
Reporting: /`f `4
dished:
At/A
❑ YES O
LTMP/STMP FILE REVIEW:
22. Is LTMP/STMP Monitoring Being Conducted at Appropriate Locations and Frequencies? [�J YES ❑ NO
23. Are Correct Detection Levels being used for all LTMP/STMP Monitoring? 03YES ❑ NO
24. Is LTMP/STMP Data Maintained in a Table or Equivalent? ❑'rYES ❑ NO Is Table Adequate? [YES ❑ NO
25. All LTMP/STMP effluent data reported on Discharge Monitoring Report? ❑YES [INO DWQ Inspector, please verify
yourself?
26, If NO to 23 - 26, list violations
27. Should any Pollutants of Concern be Eliminated from or Added to LTMP/STMP? DYES NO
If yes, which ones? Eliminated: Added:
NC DWQ Pretreatment Compliance Inspection (PCI) Form Updated 7/25/07 Page 1
POTW INTERVIEW
17. Since the Last PCI, has the POTW had any NPDES Limits Violations?
If Yes, What are the Parameters and How are these Problems Being Addressed?
18. Since the Last PCI, has the POTW had any Problems Related to an Industrial
Discharge (Interference, Pass -Through, Blockage, Citizens' Complaints, Increased
Sludge Production, Etc.)?
If Yes, How are these Problems Being Addressed?
19. Which Industries have been in SNC for Limits or Reporting during SNC for
either of the Last 2 Semi -Annual Periods? Not Been Published for SNC for
Public Notice?(May refer to PAR if Excessive SIUs in SNC) Not Pub
20. Which Industries are on Compliance Schedules or Orders? For all SIUs on an
Order, Has a Signed Copy of the Order been sent to the Division?
21. Are Any Permits Or Civil Penalties Currently Under Adjudication? If Yes, Which
Ones?
YES ❑ NO
�}psT,cr►oas r� lRit�
❑ Y ES O
Limits:
Reporting: /`f `4
dished:
At/A
❑ YES O
LTMP/STMP FILE REVIEW:
22. Is LTMP/STMP Monitoring Being Conducted at Appropriate Locations and Frequencies? [�J YES ❑ NO
23. Are Correct Detection Levels being used for all LTMP/STMP Monitoring? 03YES ❑ NO
24. Is LTMP/STMP Data Maintained in a Table or Equivalent? ❑'rYES ❑ NO Is Table Adequate? [YES ❑ NO
25. All LTMP/STMP effluent data reported on Discharge Monitoring Report? ❑YES [INO DWQ Inspector, please verify
yourself?
26, If NO to 23 - 26, list violations
27. Should any Pollutants of Concern be Eliminated from or Added to LTMP/STMP? DYES NO
If yes, which ones? Eliminated: Added:
NC DWQ Pretreatment Compliance Inspection (PCI) Form Updated 7/25/07 Page 1

28. PRETREATMENT PROGRAM ELEMENTS REVIEW— Please review POTW files, verify POTW has copy of Program
Element in their files, complete with supporting documents and copy of PERCS Approval Letter, and dates consistent with Program Info:
Program Element
Last Submittal
Date In file?
Last Approval
Date In file
Date Next Due,
If Applicable
Headworks Analysis A
❑ Yes ❑ No
/b
D Yes ❑ No
cf 13c, & —
Industrial Waste Survey IWS
❑ Yes ❑
No
Z /
[91fes ❑ No
Sewer Use Ordinance SUO
❑ Yes ❑
No
C u I i
es ❑ No
Enforcement Response Plan (EPP)
Yes ❑
No
G &-1 io
es ❑ No
Long Term Monitoring Plan (LTMP)
❑ Yes ❑
No
7 [t lio
['Yes ❑ No
INDUSTRIAL USER PERMIT (IUP) FILE REVIEW (3 IUP FILE REVIEWS OR 1 FILE REVIEW AND I IU INSPECTION)
29. User Name
1. H;, c �, p� 2.
3.
30. IUP Number
31. Does File Contain Current Permit?
es ❑
No 11
❑ Yes ❑ No
❑ Yes ❑ No
32. Permit Expiration Date
I a — I -17
33. Categorical Standard Applied (I.E. 40 CFR, Etc.) Or N/A
V 1
34. Does File Contain Permit Application Completed Within One Year Prior
DYes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
to Permit Issue Date?
35. Does File Contain an Inspection Completed Within Last Calendar Year?
es ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
36. a. Does the File Contain a Slug/Spill Control Plan?
a. es []No
a. ❑Yes ❑No
a. ❑Yes ❑No
b. If No, is One Needed? (See Inspection Form from POTW)
f}$ �No
b. []Yes []No 11
b. ❑Yes ❑No
37. For 40 CFR 413 and 433 TTO Certification, Does File Contain a Toxic
0Yes0NoMXrA
❑Yes❑No❑N/A
❑Yes❑No❑N/A
Organic Management Plan (TOMP)?
38. a. Does File Contain Original Permit Review Letter from the Division?
a. es ❑No
a. []Yes ❑No
a. ❑Yes ❑No
b. All Issues Resolved?
b.❑Yes❑No /A
b.❑Yes❑No❑N/A I
b.❑Yes❑No❑N/A
39. During the Most Recent Semi -Annual Period, Did the POTW Complete
DYes El No
❑ Yes ❑ No
❑ Yes ❑ No
its Sampling as Required by IUP, including flow?
40. Does File Contain POTW Sampling Chain -Of -Custody Forms?
es U No
❑ Yes ❑ No 11
❑ Yes ❑ No
41. During the Most Recent Semi -Annual Period, Did the SIU Complete its
❑Yes o❑N/A
❑Yes❑No❑N/A
❑Yes❑No❑N/A
Sampling as Required by IUP, including flow?
11
41 b. During the Most Recent Semi -Annual Period, Did SIU submit all reports
es❑No❑N/A
❑Yes❑No❑N/A
Yes❑No❑N/A
on time?
ir
42a. For categorical IUs with Combined Wastestream Formula (CWF), does
❑Yes❑No A
❑Yes❑No❑N/A
❑Yes❑No❑N/A
file includeprocess/dilution flows as Required by IUP?
42b. For categorical IUs with Production based limits, does file include
Yes❑No A
❑Yes❑No❑N/A
❑Yes❑No❑N/A
production rates and/or flows as Required b IUP?
P
43a. During the Most Recent Semi -Annual Period, Did the POTW Identify
Yes ❑ No
❑ Yes No
❑ Yes ❑ No
All Limits Non -Compliance from Both POTW and SIU Sampling?
43b. During the Most Recent Semi -Annual Period, Did the POTW Identify
cs❑No❑N/A
❑Yes❑No❑Ne!'
❑Yes❑No❑N/A
All Reporting Non -Compliance from SIU Sampling?
44. a. Was the POTW Notified by SILT (Within 24 Hours) of All Self-
a. es❑No❑N/A
a.❑Yes❑No❑N/A
a.❑Yes❑No❑N/A
Monitoring Violations?
b.❑Yes❑No /A
b. Did Industry Resample and submit results to POTW Within 30 Days?
b.❑Yes❑No❑N/A
b.❑Yes❑No❑N/A
c. If applicable, Did POTW resample within 30 days of becoming aware
of SIU limit violations in the POTW's sampling of the SIU?
c.❑Yes❑N /A
c.❑Yes❑No❑N/A
c.pYes❑No❑N/A
46. During the Most Recent Semi -Annual Period, Was the SILT in SNC?
❑ s o
11
❑
Yes
❑
No 11
❑ Yes ❑ No
47. During the Most Recent Semi -Annual Period, Was Enforcement Taken
es❑No❑N/A
❑Yes❑No❑N/A
❑Yes❑No❑N/A
as Specified in the POTW's ERP (NOVs, Penalties, timing, etc.)?
11
48. Does the File Contain Penalty Assessment Notices?
FesONoMI11
❑Yes❑No❑N/A
I ❑Yes❑No❑N/A
49. Does The File Contain Proof Of Penalty Collection?
❑Yes❑No /A
11 E]YesoNoo
I ❑Yes❑No❑N/A
50. a. Does the File Contain Any Current Enforcement Orders?
a.❑Yes❑No /�
a.❑Yes❑No❑N/A
a.❑Yes❑No❑N/A
b. Is SIU in Compliance with Order?
�
b.❑Yes❑No❑Ad/
b.❑Yes❑No❑N/A
b.❑Yes❑No❑N/A
51. Did the POTW Representative Have Difficulty in Obtaining Any of This
❑ Yes
No
El ❑ No
Requested Information For You?
71=
NC DWQ Pretreatment Compliance Inspection (PCI) Form Updated 7/25/07 Page 2

FILE REVIEW COMMENTS:
41oyi;td Su© JgIV aDty � J
rt
Hca� htr tqJto►s 5'f �vLlu ra� �f n� �orwc cct
sly{ dlSGit�t�i�n'9 J�rri 1 JY� dalY cn.� a�L I't,^Forr�7 is rctalr�c�
�'nfu►''�c"c.�� NDV�J�r'f-vv 1 J Juk< c9tduJY p.� Cnvtruv ltnl-,
I— NJ
1. Industry Inspected:
2. Industry Address:
3. Type of Industry/Product:
4. Industry
J
7,
tar,
NUV 9-e" 7.41 c J / (-wo'ts C
Main Program Permit Number MM/DD/YY Inspec.Type Inspector Fac.
1 I LJLJL 2 l
(DTIA) (TYPI) SP) (FACC)
Fax:
5. Does the POTW Use the Division Model Inspec ' Form or Equivalent. YES ❑ NO
6. Did the POTW Contact Conduct the FoI ing Parts of the Industrial Inspection oughl;
Comments:
A. Initial Interview YES ❑ NO
B. Plant Tour ❑ YES ❑ NO
C. Pretrea Tour ❑YES ❑ NO
D. Sam ' g Review ❑ YES ❑ NO
E. xit Interview ❑ YES ❑ NO
Indus nsnection Comments:
OVERALL SUMMARY AND COMMENTS:
Comments: CC , lleac-111 AjaMS. PD Q.x 670 oa-,1'�� AIC ,Z7,?07
Requirements: 11AU S-cnj TIrS [-CcTey< T-A(s rro42'h
Recommendations:
NOD: ❑ YES M-1�O
NOV: ❑ YES ❑ NO
QNCR: ❑ YES
POTW Ratin¢:
Satisfactory I Marginal UnSatisfactory
PCI COMPLETED BY:DATE: 7
NC DWQ Pretreatment Compliance Inspection (PCI) Form Updated 7/25/07 Page 3

A AiT4
vv�A*
NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
July 11, 2014
Ms. Christine W. Bralley, Manager
Town of Mocksville
171 South Clement Street
Mocksville, NC 27028
Subject: NOTICE OF VIOLATION (# NOV-2014-LV-0305)
NPDES Permit No. NCO021491
Dutchman Creek WWTP
Davie County
Dear Ms. Bralley:
John E. Skvarla, III
Secretary
A review of the Dutchman Creek WWTP monitoring report for April 2014 showed the following
violations:
Parameter
Date
Limit Value
Reported Value
Limit Type
BOD
4/7 — 4/11
7.5 mg/1
14.1 mg/1
Weekly Average Exceeded
BOD
April 2014
5 mg/1
6.32 mg/1
Monthly Average Exceeded
Remedial actions, if not already implemented, should be taken to correct the above noncompliance
problem. Please be aware that violations of your NPDES permit could result in enforcement action
by the Division of Water Resources for this and any additional violations of State law.
If you should have any questions, please do not hesitate to contact Mike Mickey at [phone].
Sincerely,
Sherri V. Knight, PE
Assistant Regional Supervisor
Water Quality Regional Operations Section
Division of Water Resources
cc: Scott Bryan (via email: [e-mail])
Heather Adams (via email: [e-mail])
Central Files - SWP
WSRO
N.C. Division of Water Resources
585 Waughtown Street, Winstion-Salem, NC 27107
Phone: [phone] Internet: www.ncwaterquality.org
An Equal Opportunity 1 Affirmative Action Employer— Made in part by recycled paper

Facility: Crz& ,A
%u K0 c,ie&.
Parameter
Date Parameter
Date Parameter
DMR Review Record
Permit No.: ��� Pipe No.:
Monthly Average Violations
Permit Limit
Is
Month/Year:
DMR Value % Over Limit Action
.3� o
Weekl y Violations
Permit Limit Limit Type DMR Value % Over Limit Action
Mo 'Orin-brin-q Frequency Violations
Permit Frequency Values Reported # of Violations Action
Other Violations/Staff Remarks`: \
Supervisor Remarks: N V
Completed by: Date: �-
Assistant Regional
Supervisor Sign Off: Date:
Regional Supervisor Sign
Off: Date:

C
NPDES PERMIT NO.: NCO021491
FACILITY NAME: Dutchman Creek WWTP
OWNER NAME: Town of Mocksville
GRADE: WW-4.
PERMIT VERSION: 3.0
CLASS: WW-3
ORC: Scott Leon Bryan
ORC HAS CHANGED: No
PERMIT STATUS: Active
COUNTY: Davie
ORC CERT NUMBER: 985581
eDMR PERIOD: 04-2014 (April 2014) VERSION: 1.0 STATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
O
Em
E
v
a
U
°
F%
E
O
O
O
O
d
a
Z
50050
00010
00400
50060
C0310
C0610
C0530
31616
00300
Continuous
S X week
3 X week
3 X week
3 X week
3 X week
3 X week
3 X week
3 X week
Rewrder
Grab
Grab
Grab
Composite
Composite
Composite
Grab
Grab
FLOW
TEMP-C
PH
CHLORINE
BOD-Cone
NH3-N-Cone
TSS - Cone
FEC COLI
DO
2400
Hrs
2400
Hrs
Y/B/N
mgd
deg c
so
ug/l
mg1l
mg/1
mg/1
#/100ml
mg/1
1
0900
24
0733
5.50
Y
0,439
13.1
7.14
44
5.5
0.09
6.3
< 1
8.31
2
0731
15.50
Y
0.451
118
3
0730
5.50
Y
0.439
14.9
4
1000
24
0731
5.00
Y
0.624
15.6
7.36
22
4.8
0.13
7
1<1
8.14
5
0.624
6
0.624
7
0900
24
0731
5.50
Y
0.624
13.5
7.39
41
3.6
0.1
6.4
I
8.37
8
0900
24
0625
3.00
Y
0.602
15.1
7.28
10
34
4.41
20
1500
6.01
9
0645
1.00
Y
0.602
15.3
10
0731
6.00
Y
0,39
14.2
1 Ali
11
0900
24
0422
8.00
Y
0.415
14.9
7.3
23
4.7
0.33
5
9
8.34
12
0.415
13
0.415
14
0900
24
0730
6.00
Y
0.543
15,9
6.8
9
2.7
U5
5.3
3
7.64
15
0900
24
0730
6.00
Y
1.413
IT9
6.79
24
2.4
10.05
3.2
4
7,01
16
0900
24
0729
6.50
Y
0.713
14.8
7.05
7
14
0.62
14
270
7.82
17
0804
6
Y
0.607
143
181
10.607
H
H
H
H
H
H
H
H
19
0.607
20
0.607
21
0900
24
0727
1.50
Y
0.515
14.6
6
0
2.4
0.06
2.9
< 1
9.73
22
0900
24
0751
1.50
Y
0.516
15
6
12
<2
<0,04
<2.5
3
8.42
23
0751
0.75
Y
0.653
15.3
24
0833
1A0
Y 1
0.232
16.7
25
0900
24
0750
2.50
Y
0.438
14.7
6.48
0
2.6
<0.04
<0
3
7.37
26
0.438
27
0.438
28
0900
24
0732
3
Y
0A46
IT2
6.11
0
3
0.05
<2.5
6
6.82
29
0900
24
0700
5
B
0.453
17.9
6.09
0
2A
0.1
<2.5
4
6.36
30
0700
5 1
B 1
0.457
16
Monthly Average Limit:
0.98
2
30
200
Monthly Average:
0.5449
15.2905
6.7531
14.7692
6.32
0.46
5.39
5.85
7.6415
Daily Msxlmum:
1.413
17.9
7.39
44
34
4.41
20
1500
8.73
Daily Minimum:
0:232
13.1
6
0
0
0
0
0
6.01
Monthly Avg % Removal (85 % ):
RECEIVED
.C.Depi. of ENR
.`
Lj
Re4irJnal u^fire Q A
+VQ/80

NPDES PERMIT NO.: NCO021491
FACILITY NAME: Dutchman Creek W WTP
OWNER NAME: Town of Mocksville
GRADE: W W-4.
eDMR PERIOD: 04-2014 (April 2014)
COMPLIANCE: Non -Compliant
PERMIT VERSION: 3.0
CLASS: WW-3
ORC: Scott Leon Bryan
ORC HAS CHANGED: No
VERSION: 1.0
CONTACT PHONE #: [phone]
PERMIT STATUS: Active
COUNTY: Davie
ORC CERT NUMBER: 985581
STATUS: Processed
SUBMISSION DATE: 05/19/2014
05/19/2014
ORC/Certifier Si n ure: Scott L. Bryan E-Mail:[e-mail] Phone #:[phone] 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 ILE.6 of
the NPDES permit.
COMMENTS: Non -compliant BOD for the week of April 7: heavy rain during the week of April 7 caused a large BOD spike. Non -compliant BOD for April 2014: additional
significant rain during the week of April 14 also caused a BOD spike that pushed the entire month into non-compliance. April 18 was observed as the Good Friday holiday.
05/19/2014
t
Permittee/Submitter Signature:*** Heather Tli mas Adams E-Mail:[e-mail] Phone #:[phone] Date
Permittee Address: 295 Garwood Rd Mocksville NC 27028 Permit Expiration Date: 06/30/2014
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: Environment One
CERTIFIED LAB #: 10
PERSON(s) COLLECTING SAMPLES: Operators
CERTIFIED LABORATORIES
PARAMETER CODES
Parameter Codes assistance may be obtained by calling the NPDES Unit [phone] or by visiting the Surface Water Protection Section's web site at
http://portal.ncdenr.org/web/wq/swp and linking to the unit's information pages.
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 document visitation of facility as required per 15A NCAC 8G .0204.
*** Signature of Pernuttee: 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).

AJ;A
;
NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory John E. Skvarla, III
Governor Secretary
July 1, 2014
Ms. Christine Bralley, Town Manager
Town of Mocksville
171 S. Clement Street
Mocksville, NC 27028
Subject: Pretreatment Review of Industrial User Pretreatment Permit
Program: Town of Mocksville
NPDES Permit Number: NCO021491
Davie County
Dear Ms. Bralley:
RECEIVED
N.O.Dept. of ENR
AIL 0 2 2014
Winston-Salem
r
R ionalOflice
The Pretreatment, Emergency Response, and Collection Systems (PERCS) Unit of the Division of
Water Resources has reviewed the Industrial User Pretreatment Permit (IUP) submitted by Envirolink,
Inc. for the Town of Mocksville for the following Significant Industrial User (SIU). The [UP was initially
received by the Division on June 5, 2014, followed by corrections received on June 30, 2014, via email.
IUP #
SIU
004
House of Raeford Inc. — Mocksville NC
The review indicates that the IUP is adequate and the minimum requirements of 15A NCAC 2H .0905
and .0916 and 40 CFR 403.8(f)(1)(iii) are met.
Thank you for your continued cooperation with the Pretreatment Program. If you have any questions or
comments, please contact Monti Hassan at [phone] [email: Monti. [e-mail]] or
Deborah Gore, Unit Supervisor at [phone] [email: [e-mail]].
S0 cerely,
�omas Ae4�,
Director, Division of Water Resources
MH/mocksville. i up. new. hor.028
cc: Heather Adams, Envirolink, Inc., PO Box 670, Bailey, NC 27807 (email)
Central Files
Monti Hassan, PERCS Unit
George Smith, WSRO
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Location: 512 N. Salisbury St. Raleigh, North Carolina 27604 One
Phone: [phone] FAX: [phone] Customer Service:1-877-623-6748 N-forth C aroliina
Internet:www.nnity www.ncwaterquality.org I,?atf/y+jr/ y
An Equal Opportunity 1 Affirmative Action Employer �/ Y `K` �l"i/

Smith, George
From: Christine Bralley <[e-mail]>
Sent: Tuesday, June 24, 2014 5:24 PM
To: Smith, George
Subject: RE: IJA for Pretreatment
George,
I apologize, the agreement will be presented at our next board meeting July 1st. The board has not met in regular
session since the previous IJA we had submitted for approval is no longer valid. I should have something to you next
week. I-R was scheduled for sampling yesterday or today. I will confirm and reply tomorrow.
I hope all is well with you also.
Thank you,
Christine
Christine W. Bralley
Town Manager
Mocksville, NC - "Time Well Spent"
336-753-6701
[e-mail]
From: Smith, George[mailto:george.smith(cbncdenr.gov]
Sent: Monday, June 23, 2014 2:00 PM
To: Christine Bralley
Subject: IJA for Pretreatment
Christine,
Our PERCS Unit has not received an IJA yet. A deadline of June 16 is past due. Do you have any idea when the agreement
will be signed?
A 6-month sample date for Ingersol Rand is due on June 30, per the pretreatment permit. It is my understanding that a
sample event has not been performed yet.
Hope all is well.
George
George Smith
New email: [e-mail]
NC DENR Winston-Salem Regional Office
Division of Water Resources
585 Waughtown Street
Winston-Salem, NC 27107
Voice: [phone]
1

FAX: [phone]
E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be
disclosed to third parties.

Smith, George
From: Beth Thompson <[e-mail]>
Sent: Monday, July 07, 2014 1:55 PM
To: Smith, George
Cc: Brenda Hunter; Christine Bralley; [e-mail]
Attachments: D00070714-002.pdf
Mr. Smith
Christine Bralley is out of town with a medical emergency and asked that I forward this to you. The agreement was
approved at the July 1, 2014 Mocksville Town Board Meeting with exception of Exhibit A by Commissioner Amy
Vaughan -Jones and seconded by Commissioner Will Marklin and approved by a unanimous vote. Once the minutes are
complete and approved, we will forward a copy to you.
Thank you
Beth N. Thomason
Town of Mocksville

Bear Creek Basin Pretreatment Program Agreement Between
The County of Davie and the Town of Mocksville
This agreement is entered into this 2nd day of June, 2014, between the County of Davie (Davie County) and
the Town of Mocksville (The Town).
RECITALS
A. Davie County owns and operates The Cooleemee wastewater treatment system.
B. The Town currently utilizes this wastewater treatment system to receive wastewater from its Bear Creek
Drainage Basin.
C. Facilities discharging to The Town's Bear Creek Drainage Basin currently include at least one significant
industrial wastewater discharger. These facilities are hereinafter referred to as Significant Industrial Users
(SIUs).
D. Davie County is required to implement and enforce a pretreatment program to control discharges from all
SIUs in accordance with 40 CFR Part 403 [and 15A NCAC 2H .09001.
E. In this Agreement The Town agrees to adopt and maintain a sewer use ordinance that subjects the SIUs
within its boundaries to the necessary pretreatment controls, and Davie County is authorized to implement
and enforce that sewer use ordinance.
AGREEMENT
A. The Town has a local sewer use ordinance no less stringent and as broad in scope as the sewer use
ordinance of Davie County. The Town will, however, forward to Davie County for review a copy of its
sewer use ordinance within 10 days of the date of this Agreement and will adopt any required revisions to
its sewer use ordinance within 45 days of receiving comments from Davie County; provided such
revisions are required by the State to meet State standards.
B. Whenever Davie County revises its sewer use ordinance, it will forward a copy of the revisions to The
Town. The Town will propose revisions to its sewer use ordinance that are at least as stringent as those
adopted by Davie County; provided such revisions are required by the State to meet State standards.
C. . The Town will forward to Davie County for review its proposed revisions within 15 days of receipt of the
Davie County's revisions. The Town will adopt its revisions within 45 days of receiving approval from
Davie County of the content thereof.
D. The Town will adopt pollutant specific local limits which address at least the same pollutant parameters and
are at least as stringent as the local limits enacted by Davie County within 45 days of the date of this
Agreement. If Davie County makes any revisions or additions to its local limits, Davie County will
forward to The Town a copy of such revisions or additions within 10 days of the enactment thereof. The
Town will adopt any such revisions or additions within 45 days of receipt thereof; provided such
revisions are required by the State to meet State standards.

E. The Town designates Davie County as the agent of The Town for the purposes of implementation and
enforcement of The Town's sewer use for any Industrial users discharging to the Town's Bear Creek
Drainage Basin. Davie County may take any action under The Town's sewer use ordinance that could have
been taken by The Town, including enforcement of the ordinance in courts of law.
F. Davie County, on behalf of and as agent for The Town, will perform technical and administrative duties
necessary to implement and enforce The Town's sewer use ordinance. Davie County will: (1) update the
industrial waste survey; (2) issue permits to all industrial users required to obtain a permit; (3) conduct
inspections, sampling, and analysis; (4) take all appropriate enforcement action as outlined in Davie
County's enforcement response plan and provided for in The Town's sewer use ordinance; and (5) perform
any other technical or administrative duties the Parties deem appropriate. In addition, Davie County may, as
agent of The Town, take emergency action to stop or prevent any discharge which presents or may present
an imminent danger to the health or welfare of humans, which reasonably appears to threaten the
environment, or which threatens to cause interference, pass through, or sludge contamination. In any such
event, the County will notify the Town of the event as quickly as is reasonably possible.
G. Before an industrial user located outside the jurisdictional boundaries of The Town discharges into The
Town's sewer system, The Town and Davie County will enter into an agreement with the jurisdiction in
which such industry is located. Such agreement will be substantially equivalent to this Agreement and must
be entered into prior to a discharge from any such industrial user.
H. The Town will reimburse Davie County for all costs incurred in implementing and enforcing The Town's
sewer use ordinance within 30 days of invoicing. Davie County will provide Town of Mocksville with a
detailed accounting of all such costs. The method for calculating such costs shall be as set forth in Exhibit
A attached hereto.
L If any term of this Agreement is held to be invalid in any judicial action, the remaining terms will be
unaffected.
J. The Parties will review and revise this Agreement to ensure compliance with the Federal Clean Water Act
(42 U.S.C. § 1251 et sec .) and rules and regulations (see 40 CFR Part 403) issued thereunder, as necessary,
but at least once every 4 years on a date to be determined by the Parties.
K. Davie County may terminate this Agreement by providing 45 days written notice to Town of Mocksville.
All benefits and obligations under this Agreement will cease following 15 days from receipt of such notice.
L. If the authority of Davie County to act as agent for The Town under this Agreement is questioned by an
industrial user, court of law, or otherwise, The Town will take whatever action is necessary to ensure the
implementation and enforcement of its sewer use ordinance against its industrial users, including, but not
limited to, implementing and enforcing its sewer use ordinance on its own behalf and/or amending this
Agreement to clarify Davie County's authority.

Cecil Wood, Davie County Manager
Christine Bralley, Mocksville Town Manager

A�
J a
NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory John E. Skvarla, III
Governor Secretary
June 11, 2014
FR�egionai
CEIVED
Ms. Christine Bralley, Town Manager
ept. of ENR
Town of Mocksville 13 2a
171 S. Clement Street
Mocksville, NC 27028 Office
Subject: Approval of Draft Sewer Use Ordinance (SUO)
Program: Town of Mocksville
NPDES Permit #: NCO021491
Davie County
Dear Ms. Bralley:
The Pretreatment, Emergency Response, and Collection Systems (PERCS) Unit of the Division of
Water Resources has reviewed the draft Sewer Use Ordinance (SUO) for the Town of Mocksville. The
SUO was submitted by the Envirolink, Inc. and received by the Division on June 11, 2014.
The review indicates that the SUO is adequate and meets the minimum requirements of 15A NCAC 2H
.0900 and 40 CFR 403. Upon adoption please submit copy of the final adopted SUO to the PERCS
Unit, including documentation of adoption, effective date, and the attorney's statement.
Thank you for your continued cooperation with the Pretreatment Program. If you have any questions or
comments, please contact Monti Hassan at [phone] [email: Monti. Hassan(rncdenr.gov] or
Deborah Gore, Unit Supervisor at [phone] [email: [e-mail]].
inc el
homy' as�'Netett
Director, Division of Water Resources
mh/mocksville.suo.2014
cc: Heather Adams, Envirolink, Inc., PO Box 670, Bailey, NC 27807 (email)
Central Files
Monti Hassan, PERCS Unit
George Smith, WSRO
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Location: 512 N. Salisbury St. Raleigh, North Carolina 27604 One
Phone: [phone] FAX: [phone] Customer Service: 1-877-623-6748 NorthCarolina
Internet: www.nnity \ Affirmative
www.ncwaterquality.org
c a%tuyaa//y
An Equal Opportunity 1 AfFrmative Action Employer �/ Y [� L [ i

aReoional
t. of ENR
A�r 6 2014
��-NCDENR n-Salem
North Carolina Department of Environment and Natural Resources Office
Pat McCrory John E. Skvarla, III
Governor Secretary
June 13, 2014
Ms. Christine Bralley, Town Manager
Town of Mocksville
171 S. Clement Street
Mocksville, NC 27028
Subject: Approval of Pretreatment Program Reactivation
Program: Town of Mocksville
NPDES Permit #: NCO021491
Davie County
Dear Ms. Bralley:
The Pretreatment, Emergency Response, and Collection Systems (PERCS) Unit of the Division of
Water Resources has received letter, dated May 19, 2014, from the Town of Mocksville requesting to
re -activate their pretreatment program. The Division approves the pretreatment program reactivation of
the Town of Mocksville with the observation of the required program elements/documents listed below:
1. Sewer Use Ordinance (SUO): Updated draft Sewer Use Ordinance (SUO) was submitted and
approved by the PERCS Unit on June 11, 2014. The Town needs to submit final copy of
adopted SUO including documentation of adoption and attorney's statements.
2. Enforcement Response Plan (ERP): An Enforcement Response Plan (ERP) describes the
required actions in case of a violation by the industry. The ERP was last approved on June 15,
2010 and is still considered adequate.
3. Industrial Waste Survey (IWS): The purpose of an Industrial Waste Survey (IWS) is to identify
any potential significant industrial users. Please review the IWS materials on the "Industrial
Waste Survey" and "Training" pages of the PERCS web -site for IWS requirements. IWS was
last approved on February 20, 2012. Next IWS is due by December 31, 2014.
4. Short Term Monitoring Plan (STMP): Mocksville pretreatment program is considered a modified
program and is required to implement Short Term Monitoring Plan (STMP). The STMP requires
quarterly sampling for 1 year every 5 years. After the industry has been discharging long
enough for the WWTP to become acclimated (usually 3 —4 months), the Town must begin the
STMP monitoring. The STMP was last approved on July 1, 2010 and is still considered
adequate.
5. Industrial User Pretreatment Permit OUP): The Industrial User Pretreatment Permit (IUP) for the
House of Raeford was submitted to the PERCS Unit for approval on June 5, 2014.
6. Headworks Analysis HWA): The Headworks Analysis (HWA) for the Dutchman Creek WWTP
was last approved September 24, 2010. A site -specific HWA must be submitted after 12-month
STMP sampling (July 2014 through June 2015). Next HWA is due by September 30, 2015.
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Location: 512 N. Salisbury St. Raleigh, North Carolina 27604 One
Phone: [phone] FAX: [phone] Customer Service: 1-877-623-6748 NorthCarolina
Internetn
An Equal Opportunity
\ Affirmative
Action Employer %Yatu a//f

Please see our website: http://Portal.ncdenr.org/web/wq/swp/ps/pret, to obtain copies of the documents
referred to above. We look forward to working with the Town of Mocksville in its role as a local Control
Authority of the pretreatment program. Should you require assistance or information regarding the
implementation of your pretreatment program, please contact Monti Hassan at 919-807-6314 [email:
monti.hassan(cD-ncdenr.gov] or me at 919-807-6383 [email: deborah.gore(a)-ncdenr.gov].
S' .�erely, �
Deborah Gore
PERCS Unit Supervisor
mh/mocksville. reactivation. approva1.2014
cc: Heather Adams, Envirolink, Inc., PO Box 670, Bailey, NC 27807 (email)
Central Files
Monti Hassan, PERCS Unit
George Smith, WSRO

A&
CDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
June 11, 2014
Ms. Christine Bralley, Town Manager
Town of Mocksville
171 S. Clement Street
Mocksville, NC 27028
Subject: Approval of Draft Sewer Use Ordinance (SUO)
Program: Town of Mocksville
NPDES Permit #: NCO021491
Davie County
Dear Ms. Bralley:
John E. Skvarla, III
Secretary
The Pretreatment, Emergency Response, and Collection Systems (PERCS) Unit of the Division of
Water Resources has reviewed the draft Sewer Use Ordinance (SUO) for the Town of Mocksville. The
SUO was submitted by the Envirolink, Inc. and received by the Division on June 11, 2014.
The review indicates that the SUO is adequate and meets the minimum requirements of 15A NCAC 2H
.0900 and 40 CFR 403. Upon adoption please submit copy of the final adopted SUO to the PERCS
Unit, including documentation of adoption, effective date, and the attorney's statement.
Thank you for your continued cooperation with the Pretreatment Program. If you have any questions or
comments, please contact Monti Hassan at [phone] [email: Monti. Hassan(CDncdenr.gov] or
Deborah Gore, Unit Supervisor at [phone] [email: Deborah. [e-mail]].
incerely
hom�as A. e`etle�r"
Director, Division of Water Resources
m h/m ocksv i l l e. s u o.2014
cc: Heather Adams, Envirolink, Inc., PO Box 670, Bailey, NC 27807 (email)
Central Files
Monti Hassan, PERCS Unit
George Smith, WSRO
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Location: 512 N. Salisbury St. Raleigh, North Carolina 27604 One
Phone: [phone] FAX: [phone] Customer Service:1-877-623-6748 NorthCarohna
Internet: www.ncwateffirma ive Action
Aahmally
An Equal Opportunity 1 Affirmative Acton Employer

Smith, George
From: Hassan, Monti
Sent: Wednesday, June 11, 2014 3:43 PM
To: Heather Adams
Cc: Smith, George; Christine Bralley; Scott Bryan
Subject: RE: Town of Mocksville SUO
Attachments: mocksville.suo.2014.pdf
Attached please find the copy of SUO approval letter for the Town of Mocksville. Thanks,
From: Heather Adams[mailto:hadams(a)envirolinkinc.com]
Sent: Wednesday, June 11, 2014 8:23 AM
To: Hassan, Monti
Cc: Smith, George; Christine Bralley; Scott Bryan
Subject: Town of Mocksville SUO
Mr. Hassan
Attached is the Town of Mocksville's Draft SUO and checklist in accordance with the new language. The Town's Attorney
had some minor word changes to Section 10 which is included in the attached Draft. We will wait for your approval
before presenting to the Town Council.
Thank You,
'fe4dor Ad4l"
Dareerm 4 6,-bac4tiM4
ENVIROLINK, INC.
PO Box 670
BAILEY, NC 27 807
PHONE: [phone]
FAx: [phone]
hadamsa-envirolinkinc.com

4(oo,el i� Uqvt{ C p.(nc6
Bear Creek Basin Pretreatment Program Agreement between
The County of Davie and the Town of Mocksville
This agreement is entered into this day of , 2013, between the County of Davie
(Davie County) and the Town of Mocksville (The Town).
RECITALS
OkA. Davie County owns and operates The Cooleemee wastewater treatment system.
B. The Town currently utilizes 06'wastewater treatment system to receive wastewater from its Bear Creek
Drainage Basin. ,? C°"tq
(jKC. Facilities discharging to The Town's Bear Creek Drainage Basin currently include at least one significant
industrial wastewater discharger. These facilities are hereinafter referred to as Significant Industrial Users
(SIUs).
ODD. Davie County is required to implement and enforce a pretreatment program to control discharges from all
SIUs in accordance with 40 CFR Part 403 [and 15A NCAC 2H .0900].
E. In this Agreement The Town agrees to adopt and maintain a sewer use ordinance that subjects the SIUs
within its boundaries to the necessary pretreatment controls, and Davie County is authorized to implement
and enforce that sewer use ordinance. 1 1 1,r fw, b""` Fo"c`"y j.ro , k ir- M, f wvnk .
/T :- D-Dial WN�
A. The Town has a local sewer use ordinance no less stringent and as broad in scope as the sewer use
@W ordinance of Davie County. The Town will, however, forward to Davie County for review a copy of its
`i ! sewer use ordinance within 10 days of the date of this Agreement and will adopt any required revisions to P
tr c S Cc" �h J ,C I n t ,
6, S�crc �w its sewer use ordinance within 45 days of receiving comments from Davie County; provided such
rqo� der -,'I revisions are required by the State to meet State standards. s,) 4,r ck st,r k^ lrnwy
caa r�4ld` <r; sG9l�y q�w< ��crl,uc� �cr a,CV(.J rO .cf1fLWr.< 1�r s40.
prr rccw► E (a.r-,,ic
B. Whenever Davie County revises its sewer use ordinance, it will forward a copy of the revisions to The
b k Town. The Town will n ns- u rdin +''g- �*ri +��
- 41tpruv< [)A�! ,Itr rV IM,01c.+.«z Jva w4 1 1 rl, rtV15icns —
provided such revisions are required by the State to meet State standards.
C. . The Town will forward to Davie County for review its proposed revisions within 15 days of receipt of the
Davie County's revisions.Davie County -of the content4hereof- _
T F IX t') 1[n
rl x cr O w ✓1 Ot o,
D. The Town will adopt pollutant specific loc is which address at least the same pollutant parameters and
are at least as stringent as the local limits enacted by Davie County within 45 days of the date of this
Agreement. If Davie County makes any revisions or additions to its local limits, Davie County will
forward to The Town a copy of such revisions or additions within 10 days of the enactment thereof. The
Town will adopt any such revisions or additions within 45 days of receipt thereof ; provided such
revisions are required by the State to meet State standards.
PreC%eec -rh Mun1c1pc1 PVrw - "IT-
C- ,pr.�- .tc� �cl

1«1K Now 11,J5 ro znt,�,t{ j�- 5 f.1A Sac) ro PjArc%e'c �-f t)W4 d,(AC
E. The Town designates Davie County as the agent of The Town for the purposes of implementation and
enforcement of The -ma's sewer use for any Industrial users discharging to the Town's Bear Creek
Drainage Basin. Davie County may take any action under Th�ewn's sewer use ordinance that could have
been taken by The Town, including enforcement of the ordinance in courts of law.
F. Davie County, on behalf of and as agent for The Town, will perform technical and administrative duties
necessary to implement and enforce The Town's sewer use ordinance. Davie County will: (1) update the
industrial waste survey; (2) issue permits to all industrial users required to obtain a permit; (3) conduct
inspections, sampling, and analysis; (4) take all appropriate enforcement action as outlined in Davie
County's enforcement response plan and provided for in The Town's sewer use ordinance; and (5) perform
any other technical or administrative duties the Parties deem appropriate. In addition, Davie County may, as
agent of The Town, take emergency action to stop or prevent any discharge which presents or may present
an imminent danger to the health or welfare of humans, which reasonably appears to threaten the
environment, or which threatens to cause interference, pass through, or sludge contamination. In any such
event, the County will notify the Town of the event as quickly as is reasonably possible.
G. Before an industrial user located outside the jurisdictional boundaries of The Town discharges into The
Town's sewer system, The Town and Davie County will enter into an agreement with the jurisdiction in
which such industry is located. Such agreement will be substantially equivalent to this Agreement and must
be entered into prior to a discharge from any such industrial user.
,K The Town will reimburse Davie County for all costs incurred in implement g and enforci The Town's
iO61,fV111(, sewer use ordinance within 30 days of invoicing. Davie County will provide Town of Mocksville with a
,w;t1 ,+ez
detailed accounting of all such costs. The method for calculating such costs shall be as set forth in Exhibit
A attached hereto.
I. If any term of this Agreement is held to be invalid in any judicial action, the remaining terms will be
unaffected.
Ok_ J. The Parties will review and revise this Agreement to ensure compliance with the Federal Clean Water Act
(42 U.S.C. §1251 et sec .) and rules and regulations (see 40 CFR Part 403) issued thereunder, as necessary,
but at least once every 4 years on a date to be determined by the Parties.
K. P�tie�Cn n� may terminate this Agreement by providing 45 days written notice to f �e.
All benefits and obligations under this Agreement will cease following 15 days from receipt of such notice.
L. If the authority of Davie County to act as agent for The Town under this Agreement is questioned by an
industrial user, court of law, or otherwise, The Town will take whatever action is necessary to ensure the
implementation and enforcement of its sewer use ordinance against its industrial users, including, but not
limited to, implementing and enforcing its sewer use ordinance on its own behalf and/or amending this
Agreement to clarify Davie County's authority.
If= Alf #US Vio(�cc)v ELT' ( /ick� c,, c

Cecil Woods, Davie County Manager Christine Bralley, Mocksville Town Manager

I
- Bear Creek Basin Pretreatment Program Agreement between
The County of Davie and the Town of Mocksville
This agreement is entered into this day of 2014, between the County of Davie
(Davie County) and the Town of Mocksville (The Town).
RECITALS
OkA. Davie County owns and operates The Cooleemee wastewater treatment system.
ak B. The Town currently utilizes the County wastewater treatment system to receive wastewater from its Bear
Creek Drainage Basin.
pk C. Facilities discharging to The Town's Bear Creek Drainage Basin currently include at least one significant
industrial wastewater discharger. These facilities are hereinafter referred to as Significant Industrial Users
(SIUs).
6 k D. Davie County is required to implement and enforce a pretreatment program to control discharges from all
SIUs in accordance with 40 CFR Part 403 [and 15A NCAC 2H .0900].
pcc lj E. In this Agreement The Town agrees to comply with the County's sewer use ordinance that subjects the
wolf� SIUs within its boundaries which are tributary to the County's system.
T,7wq 5Ac,1lj give Qu�t coupo f AQc— crfc1 ru lF ✓rf c (AN c 5at' Wii hin l �tk5b'�(�c �C9r Cr �Yi�rttit
Fox" N DI 040 1 WN 1
OKA. The Town designates Davie County as an agent of The Town for the purposes of implementation and
enforcement of The County's sewer use for any Industrial users discharging to the Town's Bear Creek
Drainage Basin. Davie County may take any action under The County's sewer use ordinance, including
enforcement of such ordinance in courts of law.
B. Davie County, on behalf of and as agent for The Town, will perform technical and administrative duties
I h.s
necessary to implement and enforce The County's sewer use ordinance. Davie County will: (1) update the
industrial waste survey; (2) issue permits to all industrial users required to obtain a permit; (3) conduct
1A, inspections, sampling, and analysis; (4) take all appropriate enforcement action as outlined in Davie
q County's enforcement response plan and provided for in The County's sewer use ordinance; and (5)
perform any other technical or administrative duties the Parties deem appropriate. In addition, Davie
i fUl"c°" County may, as agent of The Town, take emergency action to stop or prevent any discharge which presents
or may present an imminent danger to the health or welfare of humans, which reasonably appears to threaten
the environment, or which threatens to cause interference, pass through, or sludge contamination. In any
such event, the County will notify the Town of the event as quickly as is reasonably possible.
d K_C. If any term of this Agreement is held to be invalid in any judicial action, the remaining terms will be
unaffected.
0 k_ D. The Parties will review and revise this Agreement to ensure compliance with the Federal Clean Water Act
(42 U.S.C. § 1251 et sec..) and rules and regulations (see 40 CFR Part 403) issued thereunder, as necessary,
but at least once every 4 years on a date to be determined by the Parties.
O K_E. Either Parry may terminate this Agreement by providing 45 days written notice to the other Party. All
benefits and obligations under this Agreement will cease following 15 days from receipt of such notice.

0,�—F. If the authority of Davie County to act as agent for The Town under this Agreement is questioned by an
industrial user, court of law, or otherwise, The Town will take whatever action is necessary to ensure the
implementation and enforcement of its sewer use ordinance against its industrial users, including, but not
limited to, implementing and enforcing its sewer use ordinance on its own behalf and/or amending this
Agreement to clarify Davie County's authority.
Cecil Woods, Davie County Manager Christine Bralley, Mocksville Town Manager

4
Smith, George
From: Christine Bralley <[e-mail]>
Sent: Monday, June 02, 2014 12:39 PM
To: Smith, George
Cc: Hank Van Hoy
Subject: revised pretreament agreement
Attachments: Mocksville - Bear Creel Pretreatment Agreement with County, rev. hvh, May 2014.docx
Hello George,
Please advise if this is acceptable for the pretreatment agreement between the town and county. There have been
several changes. We have had input from the management group, the attorney and engineer.
I look forward to your reply.
Thank you,
Christine
Christine W. Bralley
Town Manager
Mocksville, NC - "Time Well Spent"
336-753-6701
[e-mail]
1

INTERLOCAL JOINT 'VENTURE AGREEMENT
This Agreement entered into the 2 day of November , 1998, by and between the
Town of Mocksville ( "Town") and Davie County ("County"). Collectively, the Town and the
County are referred to as the "Venturer(s)."
Purpose. The purpose of this agreement shall be to provide for the efficient and
economical treatment of waste water for the citizens of the Town and County and to do such
other related acts and things as may be agreed on by the Venturers, including the operation and
expansion of the Cooleemee waste water treatment plant (the "Plant").
It is contemplated that the Town will build a waste water pipeline from its current
facilities to the County's Cooleemee waste water treatment plant so that waste water generated
by customers of the Town and the County will be treated at that facility (the "Venture").
T errn. This Agreement is effective the day above written and for twenty-five years
thereafter, except as sooner terminated. This Agreement will automatically renew for two ten
year terms unless objected to in writing three years prior to the termination date.
If there is a breach of the agreement, the non -breaching party will give written notice of
the breach specifying the cause. The breaching party shall have 30 days to commence cure of the
breach, and shall continously work to cure thereafter.
This Agreement may be terminated without cause on three years written notice to the
other Venturer(s). If the County terminates without cause, it will be responsible for remaining
debt service of the waste water pipeline and any funds borrowed to improve the plant as of the
date of termination. If the Town terminated without cause, it will owe the County its share of
remaining debt as of the date of termination. Further, the terminating party shall reimburse the
other for any additional contributions made during the term of this Agreement as set out below.
Requirements of the Town. Once the pipeline is complete, the Plant will accept waste
water from the Town in such amounts as may be required by the Town. However, it is
understood and agreed that during the term of this Agreement that the Town will not construct or
contract for new waste water facilities serving the Bear Creek Watershed, which might divert
flow from the Plant, except as agreed by the Venturers.
ono (vnf.,r .z X,)t 5
Accounting. Each Venturer will keep its own accounts; however, each Venturer shall .
receive all information relating to the operations of the Plant as may be reasonable and desirable.
Operations. The business of the Venture shall be managed by the Venturers, which may
designate a person or entity to be responsible for the day-to-day business of the Plant and the
Venture. Except as set forth herein, the Venturers have no power to contract for the other
Venturers or the Venture, except by unanimous agreement.

The Venturers agrees not to knowingly permit any substance to enter the plant through
their lines which would materially damage the plant or its operations, or cause a violation of any
applicable local, state or federal regulation, including but not limited to, enviromnental and water
quality standards. In the event that such a substance enters the system, the Venturers agree to use
their best efforts to remediate the cause and effect of such substance, including prosecution of
any violation of local, state or federal rules, regulations or statute. The costs of remediation
(including any related fines or penalties) and prosecution shall be charged to the Venturer
violating this section, if any. All Venturers will maintain a pre-treatment program. _.
r
Baseline Flow. The Baseline Flow is defined as the flow related to each Venturer
measured as the average flow from each Venturer for the first six months after the Plant begins
receiving waste water from the Town.
Assignment oflnterest. No Venturer may sell, assign, encumber or convey its interest in
the Plant or the Venture, except with the unanimous written consent of the other Venturers.
Notice. Any notice pursuant to this Agreement shall be in writing and sent to the address
of the parties as shown on Exhibit "A".
Governing Law. This agreement shall be construed according to the laws of the State of
North Carolina.
Rates and Operating Cost. Each Venturer will set its own rates for service to its own
customers. Each Venturer will contribute to the actual cost of operation of the plant in the
proportion to the amount of flow of waste water into the plant by each Venturer, as measured at
an appropriate location to which the Venturers agree.
Initial Contributions. Initially, the County will contribute the Cooleemee waste water
treatment plant and related equipment to the Venture, as is. The Town will contribute the line
connection and related equipment, as is. Neither party will contribute its service lines or any
other property to the Venture, and each remains responsible therefore. Both Venturers will use
their best efforts to prepare for the implementation of the agreement.
Additional Contributions. In the event that it is determined by a unanimous vote of the
Boards of the Venturers that additional funds are necessary or desirable, including but not limited
to funds for capital improvements and replacements, the Venturers will advance funds according
to the proportion that the flow of each venturer has exceeded the Baseline Flow for the previous
six months plus the amount of flow reasonably to be expected by any anticipated major projects
then under construction in the jurisdiction of the Venturer to be charged.
No Venturer shall have the obligation to contribute more than its proportionate share or
its share as compared to the contribution of the other Venturers. No interest shall be paid on any
contribution, and all monies advanced as capital shall be considered to be contributions.

Other Documents. The parties hereto agree that they will execute any further
instruments and perform any acts which may become necessary to effectuate the purposes of this
Agreement. The parties represent that this Agreement has been approved and adopted by all
appropriate boards and authorities. Nothing in this agreement shall affect other valid and binding
agreements between the parties, except as expressly set forth herein.
Integrated Agreement. This Agreement constitutes the final and complete expression of
the agreement between the parties with respect to the subject matter hereof. No modification,
amendment or termination of this agreement shall be valid or enforceable unless in writing and
signed by all of the Venturers.
Neither party shall be responsible for any resulting loss if the fulfillment of any of the
terms or provisions of this agreement is delayed or prevented by force majeure, acts of God or
the state or federal governments.
Other. This Agreement shall not be deemed to create any relationship between the
parties, except as expressed. None of the Venturers may be held liable for the acts or omissions
of the other, except as expressly authorized.
This the 2 day of November ,1998.
ATTEST: COUNTY OF DAVIE
99__�n4
Clerk to the Board ?seph'a?'
g, Chairm
ATTEST:
'L 6X
Clerk to the Board
ATTEST:
Clerk to the Board
TOWN OF. VI TSVILLE
By:
F.W. Slate, Mayor
A
APPROVED AS Y"O FORM:
TOWN ATTORNEY
,THIS INSTRU'VIENT HAS BEEN PRE -AUDITED IN THE MANNER REQUIRED BY THE LOCAL
GOVERNMENT B ET AND FISCAL CONTROL ACT."
jF
CE O ER

EXHIBIT "A"
TOWN OF MOCKSVILLE:
Mr. Terry L. Bralley
Town Manager
171 Clement Street
Mocksville, N.C. 27028
Copy to:
Henry P. Vanhoy, II, Esq.
Town Attorney
10 Court Square
Mocksville, N.C. 27028
COUNTY OF DAVIE:
Mr. Kenneth N. Windley, Jr.
County Manager
123 South Main Street
Mocksville, N.C. 27028
Copy to:
Robert E. Price, Jr., Esq.
County Attorney
3600 Country Club Rd, Suite 101
Winston-Salem, N.C. 27104

LETTER OF TRANSMITTAL
Date: 2/10/15
To: NC Division of Water Resources
PERCS Unit
1617 Mail Service Center
Raleigh, NC 27699-1617
Re: Town of Mocksville Pretreatment Program 2014 PAR
WE ARE SENDING YOU
THE FOLLOWING ITEMS:
Plans X Attached
X Letter Proposal
Other
1
2014 Annual PAR -Town of Mocksville
As Requested
X For Your Use
For Approval
For Review and Comment
Remarks:
COPY TO: File, Christine Bralley, & Scott Bryan
SIGNED:
Heather Adams
Envirolink, Inc.
3rout CPattnet In R/tilit C/ionagqentent
PO Box 670, Bailey, North Carolina 27807
252-235-4900 (phone) 252-235-2132 (fax)
RECEIVED/DENR/DWR
Water Quaiigl
Permittinq Sectior
Submittal
Sample Results

Town of Mocksville, Dutchman Creek WWTP (NC0021491)
2014 Pretreatment Annual Report (PAR)
4)
ENVIROLINK
RECEIVED/DENR/DWR
February 10, 2015 FEB 18 2015
NC Division of Water Resources Water Quality
PERCS Unit Permitting Sectior
1617 Mail Service Center
Raleigh, NC 27699-1617
Re: Town of Mocksville Pretreatment Program 2014 PAR
Enclosed are an original and one copy of the Town of Mocksville's Pretreatment Annual
Report (PAR) for the period of June 13, 2014 through December 31, 2014.
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 gathered and evaluated the information submitted. Based on
my inquiry of the person or persons who manage 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 possibilities of fines and
imprisonment for knowing violations.
If you have any questions concerning this material, please contact me at 252-235-4900.
Sincerely,
Heather Adams
Director of Operations
Envirolink, Inc.
Sfoat p?atl—t (n gild V df-- --t
PO Box 670, Bailey, North Carolina 27807
252-235-4900 (phone) 252-235-2132 (fax)

2
Town of Mocksville, Dutchman Creek WWTP (NC0021491)
2014 Pretreatment Annual Report (PAR)
Narrative
GENERAL INFORMATION:
Contact Information
Town of Mocksville
Ms. Christine Bralley, Town Manager
171 Clement Street
Mocksville, NC 27028
The Acting Pretreatment Coordinator:
Heather Adams, Director of Operations Envirolink, Inc.
PO Box 670
Bailey, NC 27807
General Program Information:
RECEIVED/DENR/DWR
FEB 18 2015
Water Quality
Permiffinq Sectior
➢ The allocation table, short term monitoring plan, head -works analysis, sewer use
ordinance, enforcement response plan, industrial waste surveys, and industrial
user permits are up to date. The next HWA is due September 30, 2015.
➢ All dates on the Division's Database Program Information sheet are correct.
➢ A copy of our Program Information Sheet is enclosed with no corrections.
General Permit Information:
➢ The Townsend Facility was purchased by the House of Raeford and IUP 0004
was issued to the House of Raeford for the period of 2/1/14 through 2/1/17.
SIU Information:
The only SIU discharging to Mocksville's Dutchman Creek WWTP is the House of
Raeford-Mocksville (IUP0004). The House of Raeford facility had 3 daily max
violations for BOD in the second six-month period of 2014 and a Monitoring NOV was
issued on June 6, 2014 to the facility for not sampling in accordance with the industrial
user permit. The House of Raeford immediately took action and began monitoring in
accordance with the permit in June 2014. For the both six month periods in 2014, the
House of Raeford is not in significant non-compliance. A copy of the permit is attached.
Envirolink, Inc.
3roat dlattnet to 9ltztq oNana#ement
PO Box 670, Bailey, North Carolina 27807
252-235-4900 (phone) 2520235-2132 (fax)

House of Raeford Daily Discharge Exceedances
BOD: Daily Max Exceedances
Date
Parameter
Exceeded
Amount of
Exceedance
lbs./da
11/14/14
BOD
20.24
11/25/14
BOD
169.28
12/2/14
BOD
19.34
BOD: Monthly Averages (2014)
Month
Average lbs./da
Exceedance (Y/N
June
99.45
N
July
59.54
N
August
252.86
N
September
197.36
N
October
226.43
N
November
353.02
N
December
330.40
N
TSS: No Exceedances
Oil and Grease: No Exceedances
Summary: June 13, 2014-June 30, 2014
Exceedances
Total
Daily: %
Daily:
Average:
Daily: %
Average:
Measurements
Regular
Chronic
%
TRC
%TRC
Violations>
Violator
Regular
Violations
Violations
66%
(Y/N)
Violations
>33%
>33%
>66%
>66%
Daily
0
4
0
N
0
0
0
BOD
Daily
0
4
0
N
0
0
0
TSS
Daily
0
4
0
N
0
0
0
Oil/grease
Daily
0
21
0
N
0
0
0
Flow
Envirolink, Inc.
3(oat cFattaet to 4%tdlV oYaaa#em f
PO Box 670, Bailey, North Carolina 27807
252-235-4900 (phone) 2520235-2132 (fax)

Summarv: July 1. 2014-Decemher 31. 2(114
Exceedances
Total
Daily: %
Daily:
Average:
Daily: %
Average:
Measurements
Regular
Chronic
%
TRC
%TRC
Violations>
Violator
Regular
Violations
Violations
66%
(Y/1)
Violations
>33%
>33%
>66%
>66%
Daily
3
53
5.66
N
0
0
0
BOD
Daily
0
53
0
N
0
0
0
TSS
Daily
0
53
0
N
0
0
0
Oil/grease
Daily
0
156
0
N
0
0
0
Flow
Envirolink, Inc.
5Coat LFat&wt In 9ffd V o/YaaaPineat
PO Box 670, Bailey, North Carolina 27807
252-235-4900 (phone) 2520235-2132 (fax)

Pretre--t m ( out tPtrogpow %foQa ,— aise printed on: 12/8/2014
for Program Name Mocksville Iwc % at 7Q10 37.39
WWTP Name Dutchman
Program Approval Date 01/14/1985
ow cfs / mgd 2.54
/ 1.64
1Q10 Flow cfs / mgd 2.13
/ 1.37
Pretreatment Status Modified
Stream Classification C
Region WSRO
Basin Number YAD05
County Davie
Receiving Stream Name DUTCHMAN CREEK
NPDES Number NC0021491
NPDES Effective Date Last PAR Rec
11/01/2014
PAR Due Date 03/01/2015
mercury
1631
Current Fiscal
NPDES Expire Date 06/30/2019 Year PCI Done
required
POTW is Primary WWTP TRUE Last Audit on
09/23/2008 Audit Year Next 12/13
yes
Design Flow mgd 0.9800 % Design mgd is SIU permitted
12.24 Permitted SIU flow (mgd) [Pt_SIU)
.12
WWTP SIU's
WWTP CIU's
1
Program SIUs 1
Program CIUs 0ti
LT,IP SUO
;t
0"
date Inactive Date Next Due 09/30/2015�
Date Received by DWQ 1 05/21/2010
05/03/2010 I 02/02/2012 C6/11/2014JI
04/28/2010
Date Approved 1 09/24/2010 1
1 07/01 /2010 02/20/2012 06/11 /2014
06/15/2010
Adopt Date Required
l
Date Adopted
07/01/2014
Pretreat�ir!elf•.RelatetllV��/s frg� DINQ'
4}3
8�24/ft
w
)ttrt aerp,
wa iws
r
r 1:'01
A
h ec)ue IaX_
,Pra yx .._
9 -
yJ1� edge/oorpe p=p 1,
µ
9� 0
. /.
� L
LAP s N�t'i
a'
i
DWQ Central Office Contact JIVIonti Hassan
DWQ Regional Contact lGeorge Smith
1\4 a 1 sip ✓i , !� N C-
C

Chapter 9, PAR Guidance
Pretreatment Performance Summary (PPS)
1.
2.
3.
4.
5.
6.
7.
8.
9.
10
11.
12.
13.
14.
15.
16.
17.
Pretreatment Town Name: Town of Mocksville
"Primary" NPDES Number NCO021491
or Non Discharge Permit # if applicable =>
PAR begin Date, please enter 01/01/yy or 07/01/yy 3. => 06 # 14
PAR end Date, please enter 06/30/yy or 12/31/yy 4. => 12 # 14
Total number of SIUs, includes CIUs 5. => 1
Number of CIUs 6. => 0
Enter the Higher Number, either (7a) or (7b) here => 0
7a. Number of SIUs not sampled by POTW 7a. => 0
7b. Number of SIUs not inspected by POTW 7b. => 0
Number of SIUs with no IUP, or with an expired IUP s. => 0
Total Number of SIUs in SNC due to either IU Reporting violations or
IUP Limit violations. To avoid double counting some SIUs
Enter ( 9a + 9b ) - 9c here => 0
Enter the Number of SIUs in SNC for:
9a. IU Reporting violations
9b. IUP Limit violations
9c. Both IU Reporting & Limit violations
Number of SIUs in SNC due to IU Reporting violations
that were not sampled or inspected by POTW
Number of SIUs in SNC due to violation of
Compliance Schedule due dates
Number NOVs, NNCs, AOs, or similar assesed to SIUs
Number Civil or Criminal Penalties assessed to SIUs
Number of SIUs included in public notice
Number of SIUs from which penalties collected
Total Amount of Civil Penalties Collected 16. => $
Total Number of SIUs on a compliance schedule
Foot Notes: AO Administrative Order
CIU Categorical Industrial User
CO Consent Order
[UP Industrial User Pretreatment Permit
NNC Notice of Non -Compliance
9a. => 0
9b. => 3
9c. => 3
10. => 0
11. => 0
12. =>
2
13. =>
0
14. =>
0
15. =>
0
0
17. => 0
NOV
Notice of Violation
PAR
Pretreatment Annual Report
POTW
Public Operated Treatment Works
SIU
Significant Industrial User
SNC
Significant Non -Compliance, formerly RNC
This Column
for office
use only
EPA
WENDB
PSSD
PSED
SIDS
CIUS
NOIN
NOCM
PSNC
MSNC
SNPS
SNIN
SSNC
FENF
JUDI
SVPU
IUPN
SOCS
Chapter name: PAR Guidance File name: PAR_PPS3dmFmheiram4lfiaiAggG bdptkP9A Section B, Page 5 Blank PPS Form, Copy and use in your PAR

Pretreatment Annual Report (PAR)
Significant Non -Compliance Report (SNCR)
WWTP = Wastewater Treatment Plant, use separate form for each WWTP.
SIU = Significant Industrial User
SNC = Significant Non -Compliance
PAR covers this calendar year =>
Control Authority=Program=Town Name =>
WWTP Name =>
NPDES # =>
A SNCR Form must be submitted with every PAR_ nlense write "Vnne ;f vn„ hart Rrn QTT To ;n QAT!" 4„ ;­ 10. A-- .,
IUP
#
Pipe
#
Industry Name
Parameter
or 'Reporting"
SNC ? ( Yes / No)
for each 6-month period.
Jan. - June
July - Dec.
0004
001
House of Raeford
None
No
No
111.Lawi a %,upy u Li1G 1�1iv,siuli s aius in 3iNk, rilsTorlcal Keport- Ior your FU 1 W's 51Us behind this page.
Is the database correct ? Notify the Division of any errors ! Database indicates SNC history for previous years.
EVERY SNC MUST be explained in the Narrative, How was, is, or will it be resolved?
REPEAT SNCs are serious matters that MUST be explained in the Narrative.
Form name: PAR,SNCR,2001
Date Revised: 1/4/2001
2014
Town of Mocksville
Dutchman Creek
NCO021491

A
NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory John E. Skvarla, III
Governor Secretary
December 9, 2014 RECEIVED--�
N ^ ")a— -NIA,
Ms. Christine Bralley, Town Manager DEC 16 2014
Town of Mocksville
171 Clement St Regional
ice
Mocksville, NC 27028 Re Tonal office
Subject: Pretreatment Review of Industrial Waste Survey
Program: Town of Mocksville
NPDES Permit # NCO021491
Davie County
Dear Ms. Bralley:
The Pretreatment, Emergency Response, and Collection Systems (PERCS) Unit of the Division of
Water Resources has reviewed the Industrial Waste Survey (IWS) for the Town of Mocksville. The
IWS, submitted by Envirolink, Inc., was received by the Division on December 2, 2014.
The review indicates that the IWS is adequate and meets the minimum requirements of 40 CFR
403.8(f)(2). Proper completion of an Industrial Waste Survey is required by Part IV (D) of your NPDES
permit.
Please remember, it is the responsibility of the POTW to continue efforts to ensure that any Significant
Industrial Users (SIUs), as defined by 15A NCAC 02H .0903(b)(33) (A) through (D), are identified and
subsequently added to the town's pretreatment program. This includes evaluation of new IUs before
they commence discharge and evaluation of existing IUs determined to be not SIUs that make changes
to their process.
Next IWS Due Date: The IWS was conducted in 2014. Your next updated. IWS is due on December
31, 2019, unless conditions at the POTW change significantly and thus warrant an earlier submittal.
Thank you for your continued cooperation with the Pretreatment Program. If you have any questions or
comments, please contact Monti Hassan at [phone] [email: Monti. Hassan Q-ncdenr.gov] or
Deborah Gore, Unit Supervisor at [phone] [email: [e-mail]].
Sincerely,
a 64�
�cDirector, Division of Water Resources
m hlmocksville. iws.2014
cc: Heather Adams, Envirolink, Inc. (email)
Central Files
Monti Hassan, PERCS Unit
George Smith, WSRO
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Location: 512 N. Salisbury St. Raleigh, North Carolina 27604 One
Phone: [phone] FAX: [phone] Customer Service:1-877-623-6748 NorthCarolina
Internet) www.ncwaterquali�.org Naturally
An Equal Opportunity 1 Affirmative Action Employer

DR. F. W. SLATE
Mayor
Commissioners:
WILL MARKLIN, Mayor Pro Tern
JOHNNYFRYE
LASH GAITHER SANFORD, JR.
ROB TAYLOR
AMY VAUGHAN-JONES
May 21, 2014
Jown o Pdockville
Sherry V. Knight, PE
Assistant Regional Supervisor
Water Quality Regional Operations
Division of Water Resources
585 Waughtown St.
Winston-Salem, NC 27107
INCORPORATED 1839
171 S. CLEMENT STREET
MOCKSVILLE, NC 27028
Subject: Compliance Evaluation Inspection
Mocksville's Dutchman Creek WWTP
NPDES Permit No. NC 0021491
Davie County
Dear Ms. Knight,
CHRISTINE W. BRALLEY
Town Manager
HENRY P. VAN HOY II
Town Attorney
F
IVED
. of ENR
2 2014
Salem
Regionalofice
During the town's recent compliance evaluation inspection at Dutchman's Creek WWTP, NPDES
Permit No. NC 0021491, two concerns were noted regarding maintenance. The first concern is an
inoperable SCADA system and the second is off -site notification capability for high water levels.
Replacement of the SCADA system was approved and also the of -site notification capability has been
ordered through ForTech Automation Controls and is scheduled to be in place by mid June.
The Town of Mocksville appreciates the competence and facility operations with Envirolink, Inc.
and will continue to maintain compliance as high priority. I will keep you updated with any schedule
changes regarding maintenance concerns. Please contact if you need additional information (336)753-
6701.
cc:
Sincerely,
C lu"�e""� W Lam"����
C
Christine W. Bralley
Town Manager
Heather Adams (via email: [e-mail])
Scott Bryan (via email: [e-mail])
Mike Mikey (via email: [e-mail])
Jon Forest (via email: [e-mail])
PHONE: [phone] • FAX: [phone]
www.mocksvillenc.org

cc: Central Files
WSRO
NPDES STAFF REPORT AND RECOMMENDATION
To: Attention: Tom Belnick
NPDES Complex Permitting Unit
Permit No. NCO021491
County: Davie
PART I - GENERAL INFORMATION
1. Permiee Address: Mrs. Christine Bralley, Manager
Town of Mocksville
171 Clement Street
Mocksville, NC 27028
Facility Address: Mocksville's Dutchman Creek POTW
295 Garwood Road
Mocksville, 27028
2. Date of Investi ation: May 15, 2014
3. Report Prepared by: Mike Mickey, Environmental Program Consultant
4. Contact & Phone #.: Scott Bryan, ORC/Envirolink, Inc, phone: [phone] (cell)
5. Directions to Site: Take Hwy 64 East out of Mocksville. Turn left onto Garwood Road
approximately 0.4 miles before the Hwy 64 bridge over Dutchman Creek. Proceed on
Garwood approximtely 0.4 miles to the end of the road. Turn left onto the gravel drive just
past the mailbox for house number 293. Proceed 0.4 miles to the WWTP.
6. Discharge Point: Latitude: 35' 53' 32" Longitude: 80' 30' 07"
(note: these coordinates were taken at discharge point)
U.S.G.S. Quad Name: Mocksville, NC (D-16-NE)
7. Receiving stream or affected surface waters: Dutchman Creek
a. Classification: C
b. River Basin and Subbasin No.: 03-07-05
C. Describe receiving stream features and pertinent downstream uses: The facility
discharges into Dutchman Creek. The confluence with the Yadkin River is
approximately 8.0 river miles downstream of the outfall.

Part II - DESCRIPTION OF DISCHARGE AND TREATMENT WORKS
1. a. Current permitted/design capacity of the POTW? The permitted flow is 0.98
MGD. A review of the DMRs for calendar year 2013 shows a daily average flow
of 0.413 MGD.
b. Date(s) of construction activities allowed by previous Authorizations to Construct
issued in the previous two years. None in last 5 years.
C. Please provide a description of existing or substantially constructed wastewater
treatment facilities: The 0.98 MGD permitted facility consists of the following:
* Influent lift station with mechanical screening
* Flow splitter box with chemical addition
* three influent flow meters and parshall flumes
* three manual bar screens
* three aeration basins with two surface aerators each
* three secondary clarifiers
* one 180,000 gal. aerobic digester with surface mixer (two other digeseters not used)
* gas disinfection
* two contact chambers
* gas dechlorination
* 400 kW generator
d. Please provide a description of proposed wastewater treatment facilities. N/A
e. Possible toxic impacts to surface waters: None known. The facility has been
compliant with final NPDES effluent limits for the period January 2013 through
March 2014. All chronic toxicity tests of the effluent from 2011 to present have
passed.
f. Pretreatment Program (POTWs only): The Town of Mocksville's pretreatment
program is now active since House of Raeford has started up a chicken processing
operation in the bankrupt Townsend Farms facility.
2. Residuals handlin-g and utilization/disposal scheme: Digested solids from the one aerobic
digester are land applied by EMA Resources on approved fields covered by non -discharge
permit No. WQ0003351.
Page 2

PART III - EVALUATION AND RECOMMENDATIONS
WSRO recommends renewal of the Mocksville Dutchman Creek NPDES permit.
Just FYI -
0 A copy of the May 15, 2014 compliance inspection letter is attached.
s
Report Preparer & Da .
'Y. .: S-/I-/v
Assistant Regional SupervW r & Date
Page 3

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I
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PIT `�- - - "' 10•`. - - " -' ."'�. -' �' ^ .� 10,_ - _ �/ � ( NEW AEROBIC
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Q 968 IwtGO AVG. FLOW APPLICATION
GREY ENGINEERING, INC. T
Civil Design ona Surveying.
P.O. Box 9 Mocksvils. N.C. 27028
[—
DRAM B1f: G BULLARD PRM NQ: 102101.71
DESM BY. & MALARD I DATE to/stAll
VN OF MOCK VILLE
VMTIC FOR STMP lor 1 t

41
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kh",� '���
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--Alnd

A7j?2
®
NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
May 19, 2014
Mrs. Christine Bralley, Manager
Town of Mocksville
171 Clement Street
Mocksville, NC 27028
SUBJECT: Compliance Evaluation Inspection
Mocksville's Dutchman Creek WWTP
NPDES Permit No. NCO021491
Davie County
Dear Mrs. Bralley:
John E. Skvarla, III
Secretary
On May 15, 2014, Mike Mickey of this office met with Scott Bryan, ORC, to perform a Compliance
Evaluation Inspection of the NPDES wastewater discharge from the Mocksville Dutchman Creek Wastewater
Treatment Plant. The treatment system was found to be compliant with all effluent limits and monitoring
requirements of the NPDES permit. The inspection fmdings are detailed below and an inspection checklist is
attached for your records.
I. Permit
The NPDES permit expires on June 30, 2014. The renewal request from the town was received by the
Division on December 2, 2013. Upon expiration, please continue to operate under the current permit until
the next one is issued.
II. Self -Monitoring Program
The monthly self -monitoring reports (DMRs) were reviewed for the period April 2013 through March 2014.
The facility was found to be in compliance with all permit effluent limits (see data summary attached). In
regards to the permit monitoring requirements, it was noted that all sampling was being performed per the
frequencies specified in the permit.
III. Flow Measurement
The NPDES permit requires continuous flow recording and annual calibration of the flow measuring devices.
The three influent Prosonic flow meters with parshall flumes were calibrated by ForTech on March 24, 2014.
At present, however, the SCADA system is currently out of order so the flow values from the three meters
cannot be automatically totaled. The SCADA system needs to be made functional since the facility is
noncompliant with the continuous flow monitoring requirement over the weekends.
Additionally, an ultrasonic flow meter is located at the contact chamber. This meter is connected to the
composite sampler so that flow proportioned composite samples can be collected of the effluent.
IV. Sludge Handling and Disposal
Solids are stored in the single 180,000 gallon aerobic digester. Residuals are periodically removed from the
digester by EMA Resources for land application under non -discharge permit No. WQ0003351.
N.C. Division of Water Resources
585 Waughtown Street, Winstion-Salem, NC 27107
Phone�,336-771-5000 \ Internet: www.ncwaterquality.org --- -
An Equal Opportunity \ Affirmative Action Employer — Made in part by recycled paper

Mrs. Christine Bralley
Page 2
May 19, 2014
V. Operations and Maintenance
The facility appeared to be competently operated. Two concerns were noted regarding maintenance at the
WWTP. The first involves the inoperable SCADA system. The system failed on March 18, 2014 and has
yet to be repaired. The SCADA is necessary for the control and/or monitoring of the surface aerators,
chlorine and dechlor gas feed, solids wasting and influent flow.
The second concern involves the fact that the influent pump station still does not have off -site notification
capability for high water levels should there be a pump failure. This same deficiency was pointed out in the
February 7, 2011 inspection letter.
VI. Facility Site Review
The existing 0.980 MGD treatment system consists of the following components: influent lift station with
mechanical screening, flow splitter box with chemical feed, three influent flow meters and parshall flumes
(used as passive grit removal), three rectangular aeration basins with two surface aerators each, three circular
secondary clarifiers, gas disinfection, dual contact chambers with post aeration, gas dechlorination and a
single aerobic digester.
VIL Records/Reports
A comparison of the February 2014 self -monitoring report with the corresponding operator's records and the
laboratory data sheets from Environment One showed that all values were transcribed onto the DMR
correctly. The operator's records were thorough and complete.
VHL Effluent/Receivina Waters
The system discharges into Dutchman Creek, class "C" waters in the Yadkin -Pee Dee River Basin. The
effluent was clear on the day of inspection.
In regards to the SCADA and pump station issues, it is requested that you respond in writing to our
Winston-Salem Regional Office on or before June 6, 2014, providing an expected date that the SCADA
system will be repaired and the date that the influent pump station will have off -site notification capability.
Our office appreciates your efforts to comply with the NPDES permit. Should you have any
questions concerning this report, please contact Mike Mickey or me at [phone].
Sincerely, / /
3��"' Y a
Sherri V. Knight, PE �'`''
Assistant Regional Supervisor
Water Quality Regional Operations
Division of Water Resources
cc: Scott Bryan (via email: [e-mail])
Heather Adams (via email: [e-mail])
Central Files
WSRO

Data Summary
Mocksville Dutchman Creek WWTP
NPDES Permit No. NCO021491
Self -Monitoring Data Summary
April 2013 — March 2014
Parameters
Monthly Avg.
Permit Limit
Monthly Avg. Limit
Violations per DMR
Weekly Average
Permit Limit
Weekly Avg. Limit
Violations per DMR
Flow (MGD)
0.98
None
-
NA
BOD (mg/L)
(5.0 / 10.0)*
None
(7.5 / 15.0)*
None
TSS (mg/L)
30.0
None
45.0
None
NH3-N (mg/L)
(2.0 / 4.0)*
None
(6.0 / 12.0)*
None
Fecal (#/100 ml)
200
None
400
None
T. Chlorine (ug/L)
-
NA
28.0**
None
Chronic Toxicity
P/F @ 37%
None
-
NA
Cadmium (ug/L)
7.0
None
15.0***
None
pH (S.U.)
-
NA
(6.0-9.0) range****
None
* Summer/Winter Limits.
** Daily max. limit for total residual chlorine (TRC). TRC values reported below 50 ug/L are considered compliant.
***Daily maximum limit.
* * * *Daily maximum and minimum limit.

United States Environmental Protection Agency
Form Approved.
EPA Washington, D.C. 20460
OMB No. 2040-0057
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 INI 2 (s I 31 NCO021491 111 121 14/05/15 117 181 C I 191 c I 201 I
LJ IJ U lJ L_I
Remarks
21111111111111111111111111111111111111111111111116
Inspection Work Days Facility Self -Monitoring Evaluation Rating B1 QA - --- --- --Reserved ------ -
671 69 70 71 U 72 73I I 174 75[ I I I I I I 180
.� t--' W
Section B: FacilityData
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)
Dutchman Creek WWTP
09:30 AM 14/05/15
10/05/01
Exit Time/Date
Permit Expiration Date
295 Garwood Rd
Mocksville NC 27028
11:30 AM 14/05/15
14/06/30
Name(s) of Onsite Representative(s)/Titles(s)/Phone and Fax Number(s)
Other Facility Data
///
Scott Leon Bryan/ORC/704-361-3076/
Name, Address of Responsible Official/Title/Phone and Fax Number
Contacted
Christine W Bralley,171 S Clement St Mocksville NC 27028//336-753-6701/3367519187 Contato
No
Section C: Areas Evaluated During Inspection Check only those areas evaluated)
Permit Flow Measurement Operations & Maintenance Records/Reports
Self -Monitoring Program Sludge Handling Disposal Facility Site Review Effluent/Receiving Waters
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
Michael M Mickey WSRO WQ//336-771-4962/
;pz
Signature of Management Q A Reviewer Agency/Office/Phone and Fax Numbers Date
Att�- �'-' s /I /y
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete.
Page # 1

Permit: NCO021491
Inspection Date: 05/15/2014
Owner - Facility: Dutchman Creek WWTP
Inspection Type: Compliance Evaluation
Permit
(If the present permit expires in 6 months or less). Has the permittee 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: The NPDES permit expires on June 30, 2014. The Division received a
renewal request from the Town of Mocksville on December 2, 2013.
A review of the monthly self -monitoring reports (DMRs) for the period April 2013 through
March 2014 found the Dutchman Creek WWTP to be compliant with the effluent permit
limits.
As you are aware, the new permit will require that Mocksville start submitting DMRs
electronically. It is our understanding that Mocksville will begin using the new eDMR
format starting with submittal of the April 2014 report.
Operations & Maintenance
Is the plant generally clean with acceptable housekeeping?
Yes No NA NE
■ ❑ ❑ ❑
■ ❑ ❑ ❑
❑ ■ ❑ ❑
■ ❑ ❑ ❑
■ ❑ ❑ ❑
V.* N. NA NF
■ N ■,
Does the facility analyze process control parameters, for ex: MLSS, MCRT, Settleable Solids, pH, DO, Sludge ■ ❑ ❑ ❑
Judge, and other that are applicable?
Comment: The operator monitors the sludge blanket levels in the final clarifiers for
solids management.
Once concern noted with the O&M at the WWTP invovles the inoperable SCADA
system. The SCADA system failed on March 18, 2014 and has yet to be repaired. The
operator can no longer automatically control and/or monitor the surface aerator's timing,
chlorine and dechlor gas feed, solids wasting and influent flow meters. The SCADA
system needs to be made functional immediately as the facility is noncompliant with the
continuous flow monitoring requirement over the weekends.
Additionally, the influent pump station still does not have off -site notification capability if
high water levels occur in the wet well. This same deficiency was pointed out in the
February 7, 2011 inspection letter.
Record Keeping
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)?
Yes No NA NE
■ ❑ ❑ ❑
■ ❑ ❑ ❑
■ ❑ ❑ ❑
Page # 3

Permit: NCO021491 Owner - Facility: Dutchman Creek WWTP
Inspection Date: 05/15/2014 Inspection Type: Compliance Evaluation
Record Keeping Yes No NA NE
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
■
Name of person performing analyses
■
Transported COCs
■
Are DMRs complete: do they include all permit parameters?
■ ❑ ❑ ❑
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?
■ ❑ ❑ ❑
Is the ORC certified at grade equal to or higher than the facility classification?
■ ❑ ❑ ❑
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?
■ ❑ ❑ ❑
Facility has copy of previous year's Annual Report on file for review?
■ ❑ ❑ ❑
Comment: The facility records were found to be thorough and complete. A
comparison of the February 2014 DMR with the corresponding operator's records (flow,
temperature, dissolved oxygen, residual chlorine and pH) and the laboratory data
sheets from Environment One found that all values were transcribed onto the monitoring
report correctly.
The Annual Report for fiscal year 7/1/12 - 6/30/13 was available for review. The report
did not list the effluent violations that occurred during the period. Please make sure to
note any permit limit violations in future reports.
Pump Station - Influent Yes No NA NE
Is the pump wet well free of bypass lines or structures? ❑ ❑ ❑ ■
Is the wet well free of excessive grease? ❑ ❑ ❑ ■
Are all pumps present? ■ ❑ ❑ ❑
Are all pumps operable? ■ ❑ ❑ ❑
Are float controls operable? ■ ❑ ❑ ❑
Is SCADA telemetry available and operational? ❑ ■ ❑ ❑
Page # 4

Permit: NCO021491 Owner - Facility: Dutchman Creek WWTP
Inspection Date: 05/15/2014 Inspection Type: Compliance Evaluation
Pump Station - Influent Yes No NA NE
Is audible and visual alarm available and operational? ❑ ❑ ❑ ■
Comment: The influent lift station is maintained by the town's collection system staff.
The station has three pumps along with mechanical screening and an on -site dumpster.
As noted previously, the pump station does not have off -site notification capabilities for
high water levels in the wet well. The failure to respond to an overflow in a timely manor
could subject the town to possible enforcement action by the Division.
Flow from the pump station is routed to a splitter box located ahead of the parshall
flumes. Caustic soda is fed prior to the splitter box for alkalinity adjustment.
Rmr 4rrnnnc Yes No NA NE
Type of bar screen
a.Manual
■
b.Mechanical
■
Are the bars adequately screening debris?
■
❑ ❑
❑
Is the screen free of excessive debris?
■
❑ ❑
❑
Is disposal of screening in compliance?
■
01111
Is the unit in good condition?
■
❑ ❑
❑
Comment: There are three bar screens ahead of the parshall flumes that are capable
of catching large debris during high flow events.
The flume troughs are used for passive grit collection and are cleaned approximately
every three months by vac truck. The grit is placed on the drying beds.
Flow Measurement - Influent
Yes
No NA
NE
# Is flow meter used for reporting?
■
❑ ❑
❑
Is flow meter calibrated annually?
■
❑ ❑
❑
Is the flow meter operational?
■
❑ ❑
❑
(If units are separated) Does the chart recorder match the flow meter?
❑
❑ ■
❑
Comment: There are three separate Prosonic flow meters at the parshall flumes.
When operable, the SCADA system electronically totals the flow from each meter. The
meter was last calibrated by ForTech on March 24, 2014.
Aeration Basins
Yes
No NA
NE
Mode of operation
Ext. Air
Type of aeration system
Surface
Page # 5

Permit: NCO021491 Owner -Facility: Dutchman Creek WWTP
Inspection Date: 05/15/2014 Inspection Type: Compliance Evaluation
Aeration Basins Yes No NA NE
Is the basin free of dead spots? ❑ ❑ ❑ ❑
Are surface aerators and mixers operational? ■ ❑ ❑ ❑
Are the diffusers operational? ❑ ❑ ■ ❑
Is the foam the proper color for the treatment process? ■ ❑ ❑ ❑
Does the foam cover less than 25% of the basin's surface? ■ ❑ ❑ ❑
Is the DO level acceptable? ❑ ❑ ❑ ■
Is the DO level acceptable?(1.0 to 3.0 mg/1) ❑ ❑ ❑ ■
Comment: There are three 340,000 gallon rectangular aeration basins, each with two
surface aerators.
Secondary Clarifier
Yes No NA
NE
Is the clarifier free of black and odorous wastewater?
■ ❑ ❑
❑
Is the site free of excessive buildup of solids in center well of circular clarifier?
❑ ■ ❑
❑
Are weirs level?
■ ❑ ❑
❑
Is the site free of weir blockage?
■ ❑ ❑
❑
Is the site free of evidence of short-circuiting?
■ ❑ ❑
❑
Is scum removal adequate?
■ ❑ ❑
❑
Is the site free of excessive floating sludge?
■ ❑ ❑
❑
Is the drive unit operational?
■ ❑ ❑
❑
Is the return rate acceptable (low turbulence)?
■ ❑ ❑
❑
Is the overflow clear of excessive solids/pin floc?
■ ❑ ❑
❑
Is the sludge blanket level acceptable? (Approximately''% of the sidewall depth)
❑ ❑ ❑
■
Comment: There are three circular secondary clarifiers.
Aerobic Digester
Yes No NA
NE
Is the capacity adequate?
■ ❑ ❑
❑
Is the mixing adequate?
■ ❑ ❑
❑
Is the site free of excessive foaming in the tank?
❑ ❑ ❑
■
# Is the odor acceptable?
■ ❑ ❑
❑
# Is tankage available for properly waste sludge?
■ ❑ ❑
❑
Page # 6

Permit: NCO021491
Inspection Date: 05/15/2014
Owner - Facility: Dutchman Creek WWTP
Inspection Type: Compliance Evaluation
Aerobic Digester Yes No NA NE
Comment: A 180,000 gallon aerobic digester with surface mixer is use for sludge
storage (the two old 28,000 gallon digesters are no longer used). Residuals are land
applied by EMA Resources, Inc, under Nondischarge permit No. WQ0003351
Disinfection -Gas
Yes
No
NA
NE
Are cylinders secured adequately?
■
❑
❑
❑
Are cylinders protected from direct sunlight?
■
❑
❑
❑
Is there adequate reserve supply of disinfectant?
■
❑
❑
❑
Is the level of chlorine residual acceptable?
■
❑
❑
❑
Is the contact chamber free of growth, or sludge buildup?
■
❑
❑
❑
Is there chlorine residual prior to de -chlorination?
■
❑
❑
❑
Does the Stationary Source have more than 2500 Ibs of Chlorine (CAS No. 7782-50-5)?
❑
❑
■
❑
If yes, then is there a Risk Management Plan on site?
❑
❑
■
❑
If yes, then what is the EPA twelve digit ID Number? (1000-
If yes, then when was the RMP last updated?
Comment: Chlorine is fed automatically in proportion to flow using the ultrasonic flow
meter at the contact chamber. In October the chlorine and dechlor systems were
overhauled with replacement of the cylinder scales, tubing and O-rings,
cleaning/replacement of ejectors and re-establisment of the automatic flow pacing.
There are two contact chambers that are aerated.
De -chlorination Yes No NA NE
Type of system ? Gas
Is the feed ratio proportional to chlorine amount (1 to 1)? ■ ❑ ❑ ❑
Is storage appropriate for cylinders? ■ ❑ ❑ ❑
# Is de -chlorination substance stored away from chlorine containers? ■ ❑ ❑ ❑
Are the tablets the proper size and type? ❑ ❑ ■ ❑
Comment: The sulfur dioxide gas is fed proportional to flow.
Are tablet de -chlorinators operational? ❑ ❑ ■ ❑
Number of tubes in use?
Comment:
Effluent Sampling Yes No NA NE
Is composite sampling flow proportional? ■ ❑ ❑ ❑
Page # 7

Permit: NCO021491
Inspection Date: 05/15/2014
Owner - Facility: Dutchman Creek WWTP
Inspection Type: Compliance Evaluation
Effluent Sampling
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 representative)?
Comment: Flow proportioned composite samples are collected as required by the
permit. This sampling occurs from a manhole located at the sampler. The flow from
each contact chamber combines just before the manhole. The sampler is set to collect
at least 100 mis per pull per permit requirements.
Effluent Pipe
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?
Yes No NA NE
M 11 0 0
01100
❑ ❑ ❑ ■
■ ❑ ❑ ❑
■ ❑ ❑ ❑
Yes No NA NE
■ ❑ ❑ ❑
■ ❑ ❑ ❑
❑ ❑ ■ ❑
Comment: The effluent discharge into Dutchman Creek was observed to be clear.
Upstream / Downstream Sampling Yes No NA NE
Is the facility sampling performed as required by the permit (frequency, sampling type, and sampling location)? ■ ❑ ❑ ❑
Comment: The upstream and downstream monitoring requirements in the permit are
currently waived since Mocksville is a member of the Yadkin Pee -Dee River Basin
Association.
Standby Power Yes No NA NE
Is automatically activated standby power available? ■ ❑ ❑ ❑
Is the generator tested by interrupting primary power source? ■ ❑ ❑ ❑
Is the generator tested under load? M ❑ ❑ ❑
Was generator tested & operational during the inspection? ❑ ■ ❑ ❑
Do the generator(s) have adequate capacity to operate the entire wastewater site? ■ ❑ ❑ ❑
Is there an emergency agreement with a fuel vendor for extended run on back-up power? ❑ ❑ ■ ❑
Is the generator fuel level monitored? ■ ❑ ❑ ❑
Comment: The 400 kW generator is tested approximately 1/month by town staff. The
generator can operate the entire facility, except for the post air blowers at the contact
chambers.
Page # 8

Mickey, Mike
From: Heather Adams <[e-mail]>
Sent: Monday, May 19, 2014 9:22 AM
To: Mickey, Mike
Cc: Gore, Deborah; Smith, George; [e-mail]
Subject: RE: Mocksville Pretreatment Program - NCO021491
Hi Deborah
We have been talking with George in the WSRO about the Pre-treatment Program for the Town of Mocksville Dutchman
Creek WWTP. The Town did want to inactivate the program until the House of Raeford came in the picture, the first of
the year. The House of Raeford has moved into the old Townsend Farms Facility and they have the same industrial
process. We have issued the House of Raeford a new permit and we have initiated the STMP at the plant. We are also
in the process of updating their SUO to include the new model language. Please let me know if you have any further
questions.
Thank You,
De=ton 4 6AC=&0'a
ENVIROLINK, INC.
PO Box 670
BAILEY, NC 27807
PHONE: [phone]
FAX: [phone]
hadamsCaD_envirolinkinc.com
ENVIRoL[NK
From: Mickey, Mike [mailto:[e-mail]]
Sent: Thursday, May 15, 2014 2:45 PM
To: Heather Adams ([e-mail])

Cc: Gore, Deborah; Smith, George; [e-mail]
Subject: FW: Mocksville Pretreatment Program - NCO021491
Heather— Mocksville's Pretreatment program is currently listed as inactive per our database (see email below). It is my
understanding that a pretreatment permit was recently issued to House of Raeford (located in the old Townsend Farms
facility) on March 14, 2014, and that the processing operation is now active. Can you please touch base with Deborah
Gore to make sure that our database is updated accordingly? Thanks, Mike.
Mike Mickey
[e-mail]
NC Division of Water Resources
585 Waughtown Street
Winston-Salem, NC 27107
Phone: [phone]
FAX: [phone]
From: Gore, Deborah
Sent: Wednesday, May 14, 2014 11:42 AM
To: Mickey, Mike
Subject: RE: Mocksville - NCO021491
According to our database their program is inactive.
From: Mickey, Mike
Sent: Wednesday, May 14, 2014 9:53 AM
To: Gore, Deborah
Subject: Mocksville - NCO021491
Hi Deborah —Is Mocksville's pretreatment program officially "Active" or "Inactive"? It is my understanding that they no
longer have an active program.
The reason I am asking is that in 2010 their annual fee was upped from $860 to $3,440 since they administered a
pretreatment program. They would revert back to a minor and the lower annual fee if PT is inactive.
Thanks, Mike.
Mike Mickey
[e-mail]
NC Division of Water Resources
585 Waughtown Street
Winston-Salem, NC 27107
Phone: [phone]
FAX: [phone]

"'r
NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
May 15, 2014
Ms. Beth Dirks, County Manager
Davie County
123 South Main Street
Mocksville, NC 27028
Ms. Christine Bralley, Town Manager
Town of Mocksville
171 Clement St
Mocksville, NC 27028
Subject: Interjurisdictional Agreement for Davie County and Town of Mocksville
Program: Davie County
NPDES Permit No: NCO024872
Cooleemee WWTP
Dear Ms. Dirks and Ms. Bralley:
N.C.Dept. of ENR
MAY 2 3 2014
Winston-Salem
Regional of,
ce
John E. Skvarla, III
Secretary
As you are aware, there currently is a situation where a significant industrial user (SIU), Ingersoll
Rand, located within the Town of Mocksville jurisdictional boundaries, discharges their wastewater
to the Davie County Cooleemee WWTP. At this time the Division of Water Resources has not
received a copy of any type of agreement between the two parties granting the County the legal
authority to regulate the SIU.
As required by 40 CFR 403.8 (f) (1), the POTW must have legal authority enforceable in Federal,
State or local courts which enable the POTW to enforce the requirements of the Clean Water Act.
Please provide the PERCS Unit with a copy of the signed agreement between Davie County and the
Town of Mocksville granting that legal authority by June 16, 2014.
If you have any questions or need further assistance, please do not hesitate to contact me at 919-
807-6383 or via email at Deborah.Gore(ancdenr.gov.
Sincerely,
&4'A
Deborah Gore
PERCS Unit Supervisor
Cc: Central Files
George Smith, WSRO
PERCS files
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Phone: [phone] Internet: www.ncwaterquality.org
An Equal Opportunity1 Affirmative Action Employer— Made in part by recycled paper

Operations Report
Town of Mocksville NC
Dutchman Creek Wastewater Treatment Plant
March 2014
Project Manager: Heather Adams, Envirolink Inc.
ORC: Scott Bryan, Envirolink Inc
Operator/Maintenance: John Owens, Envirolink Inc.
February Total Treated Flow: 14.578 MG
February Average Daily Flow: 0.521 MGD*
February Minimum Daily Flow: 0.345 MGD
February Maximum Daily Flow: 0.991 MGD
(*MGD — Million Gallons per Day)
Sludge Handling
No sludge hauled during the reporting period
Chemical Use (2/25/2014 — 3/24/2014)
• Chlorine: 450 Ibs (3 cylinders)
• Sulfur Dioxide: 300 Ibs (2 cylinders)
Operations and Maintenance Summary
• Conducted routine lubrication of treatment equipment
• Passed Q1 chronic toxicity
• Envirolink and Town maintenance staff repaired/refitted caustic delivery
system after determining that existing piping was leaking. Chemical
provider (Amerochem) has been advised that fill delivery piping will always
be emptied when the caustic tank is filled.
• On March 3, experienced elevated fecal coliform and BOD results due to
high flow. No permit limits were exceeded.
• On March 3, discovered a leaking sulfur dioxide cylinder. Leak was
isolated with shipping cap and did not require HAZMAT response.
Envirolink, Inc.
5Coat d'attnet in 4lt14 c11ana#einent
PO Box 670, Bailey, North Carolina 27807
252-235-4900 (phone) 252-235-2132 (fax)

Cylinder was removed the same day by the manufacturer and Amerochem
was advised by Envirolink to issue credit on leaking cylinder.
• On March 5, #1 clarifier sweeper arm wiper fasteners disengaged causing
the wiper to jam on the scum beach. Town maintenance staff refastened
the wiper and returned the clarifier to service without any damage to the
system.
• On March 11, Envirolink site representative (Scott Bryan) met with the
Town Manager regarding eDMR registration. The registration was
submitted to the Division of Water Resources the following day naming the
Town Manager as system owner and Envirolink Project Manager (Heather
Adams) as submitter. Upon return of the registration, the Town Manager
will also be designated as Facility Administrator and Scott Bryan will be
designated as certifier and data entry operator. John Owens will be
designated as backup certifier and Crystal Mullen of Envirolink will be
designated as backup data entry operator.
• Discussed the permit renewal for the WWTP and budgeting a new SCADA
computer for the WWTP.
• On March 14, a pretreatment permit was issued to House of Raeford as a
Significant Industrial User. Initial sampling was conducted March 28.
• On March 18, the SCADA computer for the plant failed. Control is now
limited to turning equipment off and on, and flow is being read from the
mechanical counters located at each grit channel. The Town's integrator,
ForTech, has been advised of the failure. The Town Manager is
coordinating with ForTech.
• On March 24, the ForTech calibrated all flow meters.
• Provided the Town Engineer with the 2013 DMRs in order for the Local
Water Supply Plan to be updated.
Ongoing Activities
• DWQ is currently reviewing the plant discharge renewal application.
Suggested Actions/Projects
• Envirolink continues to recommend the installation of a high water level
monitoring/notification system at the influent wet well due to I&I conditions
and excessive flows during significant rain events. Given recent events
with regard to the SCADA system, it is presumed that this item will be
included within any SCADA replacement.
Envirolink, Inc.
5Coat dfattnet La 9 tdu# o1amVemeat
PO Box 670, Bailey, North Carolina 27807
252-235-4900(phone) 252-235-2132(fax)

Town of Mocksville NC
Dutchman Creek Wastewater Treatment Plant Operations Report
October 2013
Project Manager: Heather Adams, Envirolink Inc.
WWTP ORC: Scott Bryan, Envirolink Inc
WWTP Operator/Maintenance: John Owens, Envirolink Inc.
September Total Treated Flow: 9.782 MG
September Average Daily Flow: 0.326 MGD*
September Minimum Daily Flow: 0.261 MGD
September Maximum Daily Flow: 0.418 MGD
(*MGD — Million Gallons per Day)
Sludge Handling
No sludge hauled during the reporting period
October 2013 Operations and Maintenance Summary
• Replaced worn guide rollers on #3 clarifier
• Operational responsibility for the Dutchman Creek WWTP assumed by
Scott Bryan of Envirolink, Inc. on October 14
• Performed routine lubrication of return pumps and clarifiers
• On October 22, Carolina Technical Services performed annual mechanical
preventative maintenance for WWTP C12 and S02 systems. A
comprehensive overhaul of these systems was also performed. The
detailed service report is attached. Highlights include: replacement of all
cylinder scales, replacement of tubing and O-rings, and cleaning and
replacement of ejectors as needed. Automatic flow pacing for
chlorination/de-chlorination was re-established along with system
coordination with SCADA system
• Collected and submitted 4th quarter chronic toxicity samples
Current Activities
Mentioned as recommended action by Carolina Technical Services, Jim
West Electric is currently evaluating replacement of both exhaust fans in
the chlorination/de-chlorination building.
Envirolink, Inc.
Yout cPattnet In ti%tliq d'ianayemn t
PO Box 670, Bailey, North Carolina 27807
252-235-4900(phone) 252-235-2132(fax)

Current Activities (continued)
Jim West Electric is also currently evaluating several lighting issues.
Evaluating radio frequency and remote access to the facility SCADA
system. It is Envirolink's assumption that the SCADA monitoring was
being displayed at the County's Coolemee WWTP. The Town's SCADA
contractor, FORTECH has been contacted to provide a quote on removing
this access and transferring access back to the Town and Envirolink.
• Working with the Division of Water Quality to re -implement the Town's
Pretreatment Program
Suggested Actions/Projects
• While FORTECH is on -site, a proposal will be provided to the Town
regarding high water level telemetry in the facility's influent pump station
wet well. Currently, there is no alert or alarm mechanism in place for a
high-water condition in the influent wet well. The Town currently is at risk
of significant liability should an overflow/unauthorized discharge event
occur at the influent pump station. Carolina Technical Services will also
be asked to provide a proposal.
• Rebuild #2 clarifier drive. Envirolink will contact Mike West to determine if
the Town can rebuild the drive in house.
• Replace both cut off valves for the C12 vacuum regulators.
Envirolink, Inc.
5%at pPattnet /n Q%tLig management
PO Box 670, Bailey, North Carolina 27807
252-235-4900 (phone) 2520235-2132 (fax)

Mickey, Mike
From: Scott Bryan <[e-mail]>
Sent: Thursday, May 15, 2014 1:52 PM
To: Mickey, Mike
Subject: Mocksville Council Reports
Attachments: October 2013 Report to the Town of Mocksville.doc; March 2014 Report to the Town of
Mocksville.doc
Here are a couple of the monthly reports we discussed.
There is some iteration of the influent wet well telemetry in all of the reports that I have submitted. I
figured I'd let you look at the first one and the one from March regarding the SCADA failure. I've
highlighted the notable information.
I've also highlighted (in blue) a notation regarding the issuing of the pretreatment permit for House of
Raeford in March.
Let me know if you need anything else.
Thanks
Scott Bryan
Wastewater Services
Envirolink Inc
PO Box 670
Bailey, NC 27807
Phone: [phone]
Fax: [phone]
slbryan _roadrunner.com

0 `; This email is free from viruses and malware because avast! Antivirus protection is active.

Mickey, Mike
From: Mickey, Mike
Sent: Thursday, May 15, 2014 2:45 PM
To: Heather Adams ([e-mail])
Cc: Gore, Deborah; Smith, George; [e-mail]
Subject: FW: Mocksville Pretreatment Program - NCO021491
Heather — Mocksville's Pretreatment program is currently listed as inactive per our database (see email below). It is my
understanding that a pretreatment permit was recently issued to House of Raeford (located in the old Townsend Farms
facility) on March 14, 2014, and that the processing operation is now active. Can you please touch base with Deborah
Gore to make sure that our database is updated accordingly? Thanks, Mike.
Mike Mickey
[e-mail]
NC Division of Water Resources
585 Waughtown Street
Winston-Salem, NC 27107
Phone: [phone]
FAX: [phone]
From: Gore, Deborah
Sent: Wednesday, May 14, 2014 11:42 AM
To: Mickey, Mike
Subject: RE: Mocksville - NCO021491
According to our database their program is inactive.
From: Mickey, Mike
Sent: Wednesday, May 14, 2014 9:53 AM
To: Gore, Deborah
Subject: Mocksville - NCO021491
Hi Deborah —Is Mocksville's pretreatment program officially "Active" or "Inactive"? It is my understanding that they no
longer have an active program.
The reason I am asking is that in 2010 their annual fee was upped from $860 to $3,440 since they administered a
pretreatment program. They would revert back to a minor and the lower annual fee if PT is inactive.
Thanks, Mike.
Mike Mickey
[e-mail]
NC Division of Water Resources
585 Waughtown Street
Winston-Salem, NC 27107

Phone: [phone]
FAX: [phone]

Mickey, Mike
From:
Mickey, Mike
Sent:
Thursday, May 15, 2014 2:28 PM
To:
'Heather Adams'
Cc:
Scott Bryan
Subject:
RE: Town of Mocksville Inspection
Attachments:
Annual Report instructions.doc
Thanks Heather. The annual report did not mention the October and November 2012 effluent violations noted
below. Please include any effluent violations on future annual reports per Item II of the attached instructions. Mike.
PERMIT: NCO021491 FACILITY: Town of Mocksville -Dutchman Creek WWfP COUNTY: Davie
Limit Violation
MONITORING OUTFALLJ VIOLATION UNIT OF CALCULATED
REPORT PPI LOCATION PARAMETER DATE FREQUENCY MEASURE LIMIT VALUE % OVER LIMIT
10 -2012 001 Effluent 80D, 5-Day(20 Deg. C)- 1Oil 3A2 3 X meek mgA 7.5 8.93 19.11
Concentration
09-2012 001 Effluent Cadmium, Total (as Cd) 09J3OA2 Monthly
11 -2012 001 Effluent DO, Oxygen, Dissolved
Mike Mickey
Mike. [e-mail]
NC Division of Water Resources
585 Waughtown Street
Winston-Salem, NC 27107
Phone: [phone]
FAX: [phone]
11 J08A 2 3 X week
E-mail correspondence to and from this address may be subject to the North
Carolina Public Records Law and may be disclosed to third parties.
From: Heather Adams[mailto:[e-mail]]
Sent: Thursday, May 15, 2014 1:34 PM
To: Mickey, Mike
Cc: Scott Bryan
Subject: Town of Mocksville Inspection
ugA 7 14 100
mgA 5 3.8 24
Mike,
Scott called me today and said that he was missing the annual report for the Town of Mocksville. Attached is the report
for the 2012-2013 fiscal year. Per the Town, the Customers were notified on their August 2013 utility bill that the report
was available at Town Hall.
1

Thank You,
veweton 4 dAMI&Md
ENVIROLINK, INC.
PO Box 670
BAILEY, NC 27807
PHONE: [phone]
Fax: [phone]
hadams(aD-envirolinkinc.com
ENVI RoLI N K

r
1
DR. F. W. SLATE
Mayor
Commissioners:
WILL MARKLIN, Mayor Pro Tern
JOHNNYFRYE
LASH GAITHER SANFORD, JR.
ROB TAYLOR
AMY VAUGHAN-JONES
Jown o/ mockville
INCORPORATED 1839
171 S. CLEMENT STREET
MOCKSVILLE, NC 27028
January 21, 2014
Point Source Branch
Surface Water Protection Section
Division of Water Quality
1617 Mail Service Center
Raleigh, NC 27699-1617
Subject: Delegation of Signature Authority
Mocksville — Dutchman Creek W WTP
NPDES No. NCO021491
To Whom It May Concern:
CHRISTINE W. BRALLEY
Town Manager
HENRY P. VAN HOY II
N.6.bept. of ENR
JAN 2 2 2014
Winston-Salem
oaninnal Office
By notice of this letter, I hereby delegate signatory authority to each of the following individuals for all
permit applications, discharge monitoring reports, and other information relating to the operations at
Mocksville -Dutchman Creek WWTP as required by all applicable federal, state, and local environmental
agencies specifically with the requirements for signatory authority as specified in 15A NCAC 213.0506.
Name Title
Scott Bryan ORC W WTP
If you have any questions regarding this letter, please feel free to contact me at 336-753-6700.
Sincerely,
G�- vv.
ry
Christine W. Bralley
Town Manager
cc: Winston-Salem Regional Office, Surface Water Protection Section
Technical Assistance and Certification Unit
PHONE: [phone] FAX: [phone]
www.mocksvillene.org

"To preserve. protect
and enhance
-
i
North Carolina's water...
North Carolina (NC) el)\9R Reports
eDMR Registration Form
eDMR is an electronic reporting system, which will provide a facility Owner the ability to submit
discharge monitoring reports via the internet. eDMR is only currently available to facilities that
have an NPDES Wastewater permit issued by the Division of Water Quality. Registration for
eDMR must be completed by the legal Owner of the facility(s), and this legal Owner must be the
same Owner to which the permit(s) have been issued. Once an Owner is registered for eDMR, all
permits held by the Owner will also be registered and able to submit reports via eDMR.
NOTE: Before completing and submitting the registration form, the legal Owners as specified
above should verb the permit facility, Owner, and ORC designations for all permits. This
information can be verified using the eDMR Owner Information Search provided on the
eDMR website. This information is maintained in the DWQ data management system, as
provided by the permittee, and contained in the permit issued to the Owner. Should any
discrepancies with this information be determined, the appropriate DWQ contact should
be notified so information can be corrected prior to registration. It is important that the
Permit information be correct prior to eDMR registration
Please provide all information in Part A, B, C and D. An Owner signature is required for
eDMR registration. Should the registration information be incomplete, the registration
process may be delayed.
Part A: Owner Registration — Permit/Facility Information
Please provide a Permit Number and the associated facility information. Only a single permit
number is needed for registration. If multiple permits are involved, the permit number provided
will be used to identify the Owner and all associated permits. All associated permits issued to the
Owner will be registered for eDMR.
Permit Number:
N 1 C 10101 Z I l l4 1 g l 1 1
Facility Owner:
own of A s&svi Ile,
Facility Name:
J)ktdVV%^A Cnek WWI V
Facility Address:
2q5 Garwood 2d,
Facili City:
t3'•
Moe, ksh 11 G
>�aC 1y Stater
NC
Facility Zip code:
NC eDMR Registration Form (Revision 3) Page i of 4

Part B: Owner Reaistration - Owner User Details:
Please provide the following information which is needed for creating the Facility Owner in
eDMR. The Owner is the legal entity to which the permit(s) have been issued and may be an
organization or individual. For an organization, the information provided for the owner details should
be the official contact person or the person with delegated signatory authority for the Owner.
Last Name:
Middle Name:
V4
First Name:5.�+
Phone Number:
Email:
lip k svi ll m. 6✓
User Id:
(Assigned by DWQ eDMR Administrator)
Part C: User Account Information — Submitters
Please provide the users, in addition to the Owner, who will need Submitter permissions.
Submitter permissions can only be assigned by the DWQ eDMR Administrator. The Owner specified
above will be given full eDMR permissions including Submitter permissions.
The Submitter is equivalent to the individual who signs the certification statement on the back of the
discharge monitoring report. In most cases, the Submitter will be the Owner but may be other
delegated individuals. The Submitter must be an individual with delegated signatory authority. If
individuals other than the duly authorized person for the Owner have been delegated signatory
authority, the Division of Water Quality must be notified in writing of such delegations. A delegation
of authority form is available from the eDMR website.
In addition to the User Details, please specify the permit(s) that each user will be associated with for
eDMR submittal. Should additional space be needed for users and/or permits, please make additional
copies of the Submitter User Details page and complete as needed.
NOTE. The Owner will be responsible for creating all facility users except those with Submitter
permissions.
In addition to the Owner.and Submitter user., there are four additional user types identified
by user permission level: Facility'Administrator, Certifier, Data Entry and View Only.
The Owner and Facility Administrator will have the ability to manage facility users The
Facility User Administration .Guide will provide the appropriate procedures for facility user
management.
NC eDMR Registration Form (Revision 3) Page 2 of 4

Submitter User Details
Permit:No. (s):
�c, oo21yG 1
FirstName:
5c p �--}-
Middle Name:
L ,
LastName:
Y L
Phone Number:
�?_ rJ 03 — Z 3g—S
Email:
51 r 0.r1 o r r
User :
ID
(Assigned by DWQ eDMR Administrator)
Submitter User Details .
Permit No. (s): -T
FirstName•
Middle Name:
Last Name:
Phone. Number:
rE
mail: User ID. .'' (Assigned by DWQ eDMR Administrator)
Submitter User.'Details
Permit No. (s):
First Name•
Middle Name:
Last Name:
Phone Number:
Email: User Mn (Assigned by DWQ eDMR Administrator)
Submitter User Details
Permit No. (s):
First Name:
Middle. Name•
Last Name:
Phone Number:
Email:
User ID:
(Assigned by DWQ eDMR Administrator)
NC eDMR Registration Form (Revision 3) Page 3 of

Part D: Registration Certification:
1 request the facility identified above be allowed to submit DMR data using the NC DWQ eDMR
system.
I understand that electronic submittal of the DMR does notfully satisfy US EPA's electronic signature
requirements and as a result, I understand I will be required to print, sign, and submit hardcopies
(one signed original and a copy) of the eDMR to NC DWQ under the same reporting requirements as
paper -based DMRs as specified in Part II, Condition D(2) of the NPDES Permit.
I agree to protect the security of my user ID and password from compromise and shall take all
necessary steps to prevent its loss, disclosure, modification, or unauthorized use.
C�CiY�IS� 1'ClC'. YV I�YC���•l
Owner (Permittee) Name (type or print)
&. tc Vj W
Owner (Permittee) Signa e
Official Title (type of Print)
1-21- ILI
Date
Please return the comaleted Registration Form to the NC Division of Water Ouali
Fax: or Email: or Mail to:
[phone] eDMRadmin(iDncdenr.gov Information Processing Unit
Attn: eDMR Registration
1617 Mail Service Center
Raleigh, NC 27699-1617
NC eDMR Registration Forth (Revision 3) Page 4 of 4

Town of Mocksville-Wastewater Annual Report
July 1, 2012-June 30, 2013
The Clean Water Act of 1999, passed by the North Carolina General Assembly, required utilities
like the Town of Mocksville to provide an annual report to their wastewater customers. This
report summarizes the performances of our Wastewater Collection System and Wastewater
Treatment Plant over a 12-month period (July 1, 2012-June 30, 2013).
Each day, we collect and treat an average of 350 thousand gallons of wastewater; about 130
million gallons a year. We are proud of our collection/treatment system and the job we do in
protecting public health and the environment, meeting regulatory requirements and
accommodating the orderly growth of the community.
Our Mission
Overall, there are two key elements in wastewater treatment- the collection system and the
treatment process. Our highly trained, state certified staff does an excellent job with both.
Wastewater collection/treatment is a 24-hour-a-day, 7day-a-week responsibility.
Ultimately, our goal is to protect both the environment and the quality of life not only for the
Town of Mocksville, but for our neighboring communities as well. Each city and town along
Dutchman Creek is affected by the quality of water we discharge from our respective wastewater
treatment plants. Today is more important than ever for all of us to join together to protect the
quality of life that only a clean river can offer.
What is Wastewater Treatment?
Wastewater Treatment is the biological process of removing pollutants from the water so it can
be returned safely to the environment. It is the "last line of defense" against water pollution.
The Town of Mocksville Wastewater Treatment Plant protects the environment from water
which may cause disease -causing bacterial or other pollutants.
Our Community is continuously expanding with the addition of new industries, businesses and
homes. Along with this growth comes added waste to be collected and treated. It is an
enormous task to keep up with this growth and properly manage the increases in wastewater
collection and treatment. The Town of Mocksville accepts this task by planning and upgrading
its wastewater and collection facilities as necessary in order to meet our customers' needs.
About Our Collection System
The Town of Mocksville Utilities Wastewater Collection System includes 81 miles of sanitary
sewer mains (pipes) and 7 pump stations with their associated force mains. These pipes and
pump stations collect and transport an average of 450 thousand gallons of wastewater per day

from homes and businesses in Mocksville and parts of Davie County. Wastewater is collected
through approximately 2500 individual connections to the system and delivered through a
network of pipes ranging from 6" to 18" in diameter. The collected wastewater is transported to
the Wastewater Treatment Plant where it is treated prior to being returned to Dutchman Creek.
Overflows Create Problems
Essentially, the collection system is like a transportation system. The pumps and pipes transport
wastewater from our customers to the Wastewater Treatment Plant. We have to do all we can to
make sure "traffic' is not allowed to back up. On the highway it would be called a traffic jam.
In our case, when the "traffic' backs up, it is called a Sanitary Sewer Overflow (SSO). SSOs are
bad for the environment and result in stiff penalties from State Regulators.
SSOs occur when wastewater builds up in the pipe and cannot get out. The water potentially
could seep out of the top of a manhole or cleanout. The majority of overflows on our system are
caused by blockages, which often occur as a result of improper disposal of grease. Some
overflows are caused by excessive inflow and infiltration (I&1) or leaks into the sewer system.
To a lesser extent some problems are caused by tree roots, pipe failure or construction damage,
but most result from grease and/or other debris.
How We Protect the System
We work very hard to protect our system from SSOs in a variety of ways and our record is
excellent. The following is a brief overview of the various ways we try to protect our system and
prevent overflows.
• Pre-treatment Program
There are provisions in our Sanitary Sewer Use Ordinance for pre-treatment of
wastewater, principally by our industrial customers. We issue permits to applicable
industries and they pretreat their wastewater before it is discharged to the Town of
Mocksville.
• Grease Interceptors
Commercial customers that serve food or process meat, etc. are required to have grease
interceptors. These devices are designed to remove grease, a leading cause of sewer line
blockages.
• Inspections
We regularly inspect our sewer lines for obvious problems. We also inspect other
locations such as streams, creek crossings, and outfalls. We inspected over 6,163 feet of
sewer pipe with our sewer camera.

Pipe Cleaning
This year we cleaned 39,902 feet of sewer pipe with special high pressure equipment
designed to remove grease and other debris from the system. This routine cleaning
program further reduces the potential for system blockages and overflows.
Approximately 1,039 feet of sewer pipe was replaced this past year.
I&I Investigations
I&I (inflow/infiltration) is extraneous water that gets into the wastewater collection
system; any water other than sewage. We have an extensive program that includes
smoke testing, closed circuit TV inspection and flow monitoring to enable us to identify
areas of extraneous flow. Once we have located problem areas, we take the necessary
steps to remediate the problem.
Public Education
We are in the process of an educational campaign with our customers involving fliers,
door hangers, newsletters and advertising designed to inform the public on ways they can
help us protect the sanitary sewer system.
What You Can Do
Mocksville Utilities does everything it can to prevent sewer spills, but we cannot do it alone.
You play an important role in helping us maintain an efficient public sanitary sewer system.
Since the majority of overflows are caused by improper disposal of items into the sewer system,
we ask you to be aware of the following guidelines:
• Avoid pouring fats, oils, and grease from cooking down the drain. Instead, collect
them in a container and dispose in the trash.
• Don't use your toilet as a wastebasket. Place a wastebasket in the bathroom to
dispose of items such as disposable diapers and personal hygiene products.
• Unless you have a garbage disposal, please don't use your drain to dispose of
food scraps. Place food scraps in waste containers or garbage bags for disposal or
composting.
• Don't pour hazardous products such as paint, pesticides or herbicides down the
drain.
• If your Business generates waste grease, fats or oils, you should have a grease
interception system that works effectively. A company that recycles fats, oils and
grease should regularly clean out the grease trap. Commercial grease traps are
checked quarterly.

Wastewater Treatment Process and System Performance
Our Wastewater Treatment Plant (WWTP) is responsible for removing debris, solid materials
and pollutants from the water which comes into the facility and then disinfecting the water
before it is returned into Dutchman Creek.
Collection System Performance
The North Carolina General Assembly enacted legislation in July 1999, requiring municipalities,
animal operations, industries, and others who operate waste handling facilities to issue news
releases when a wastewater spill of 1,000 or more reaches surface waters. A wastewater spill of
15,000 gallons or more requires a news release as well as a paid public notice.
During the past twelve months, there has been 1 overflow in the Town of Mocksville wastewater
system. This overflow was the result of pipe failure (crack in the bell joint). The total estimated
volume from this overflow was 3,000 gallons of wastewater.
The Town of Mocksville Staff and Employees continue to improve maintenance and pollution
prevention procedures. Please do not hesitate to contact our office if you have any questions
concerning this report.

M1ar 17, 2014, 2:49pm EDT I UPDATED: Mar 17, 2014, 3:41pm EDT
Exclusive: Gildan hits unelected
delays with $112M Mocksville plant
project
Katie Arcieri
Reporter -
Triad Business Joumai
Email I Twitter I Google+ I Linr.edln
Canadian sportswear company Gildan
Activewear Inc., which announced plans
late last year for a 500,000-square-foot
yarn -spinning facility in Mocksville that will
create 290 jobs by 2015, has hit some
delays with the project but still expects to
select a site within the next 60 days.
Stephanie Gaucher, a spoKeswoman for
Gildan. said the company has run into
delays because "each step of the process
is taking slightly longer than what we had
initially projected "
Gaucher did not specify the exact cause of
the delays but said that they will have "no
impact on our investment in the county nor
on the number of jobs which will be created
from this investment" and site selection
should be finalized within the next 60 days
Gildan originally announced in October
plans for the Mocksville plant, which is part
of a larger expansion plan to create more
than 500 jobs in North Carolina by the end
of 201 &
Ka; ,e Arc, eri:'The 3,;slness �cLroa;
Chuck ';vard, president of Gildan Yarns, at the October
announcement of the company's new Llacksville facility.
Gildan officials have said that the project has hit some
delays.

In addition to the Mocksville plant. Gildan
also said it would build a yarn -spinning
facility in Salisbury and expand and
renovate a plant in Clarkton in Bladen
County Total investment for the three
projects is estimated at $250 million.
Davie County officials said in late
December that Gildan was about a month
away from selecting a site in Mocksville for
its $112 million yarn -spinning plant.
Terry Bralley, president of the Davie County Economic Development Commission, referred
comments about the plant's timing to Gildan
The Mocksville plant is expected to add significantly to Gildan's Triad presence, which dates
back to October 2000 when the company began operations at its Eden distribution center.
The company has since expanded the Eden distribution center from 325.000 square feet to
more than 950.000 square feet to support the growth of Gildan's printwear business, which
designs. manufactures. and distributes undecorated activewear products primarily to
wholesale distributors in markets located in 30 countries across North America. Europe and
the Asia -Pacific
The company also operates an approximately 380,000-square-foot distribution facility in
Mebane that was bought by Gildan as part of its acquisition of sock -maker Gold Toe.
Gildan has more than 630 workers in the Triad.

Mickey, Mike
From: Gore, Deborah
Sent: Wednesday, May 14, 2014 11:42 AM
To: Mickey, Mike
Subject: RE: Mocksville - NCO021491
According to our database their program is inactive.
From: Mickey, Mike
Sent: Wednesday, May 14, 2014 9:53 AM
To: Gore, Deborah
Subject: Mocksville - NCO021491
Hi Deborah — Is Mocksville's pretreatment program officially "Active" or "Inactive"? It is my understanding that they no
longer have an active program.
The reason I am asking is that in 2010 their annual fee was upped from $860 to $3,440 since they administered a
pretreatment program. They would revert back to a minor and the lower annual fee if PT is inactive.
Thanks, Mike.
Mike Mickey
[e-mail]
NC Division of Water Resources
585 Waughtown Street
Winston-Salem, NC 27107
Phone: [phone]
FAX: [phone]

Mickey, Mike
From:
Sent:
To:
Subject:
Good Friday to you...
Scott Bryan <[e-mail]>
Friday, March 21, 2014 2:22 PM
Mickey, Mike
Mocksville- Dutchman Creek Flow Measurement
I need to give you a heads up on some, somewhat, unexpected changes related to Dutchman
Creek's flow measurement.
On March 18, the plant experienced a catastrophic failure of the SCADA system. The PLC is still in
control of things, but we certainly don't have the control flexibility and data access that we'd like.
To wit:
Flow is now being measured by reading mechanical counters located with each of the three flow
transmitters.
Also, weekend flows for each day (Friday, Saturday, and Sunday) will be shown as the arithmetic
mean of the three days.
The Town of Mocksville is efforting toward a remedy with the appropriate urgency, and I foresee a
return to normal operations within a reasonable time period.
A brief summary of this information will be noted on the compliance declaration of the March DMR.
Please feel free to call me if you have any questions.
Thanks and have a swell weekend.
1
,,-J
Scott Bryan
Wastewater Services
Envirolink Inc
PO Box 670
Bailey, NC 27807
Phone: [phone]
Fax: [phone]
slbryan(a-)roadrunner.com

E Y IROLI N
19-- This email is free from viruses and malware because avast! Antivirus protection is active.

Mickey, Mike
From:
Sent:
To:
Subject:
[e-mail]
[e-mail]
Friday, January 24, 2014 9:27 AM
Mickey, Mike
Re: email address
----- Reply message -----
From: "Mickey, Mike" <[e-mail]>
To: "[e-mail]" <slbrvan@road runner.com>,
<[e-mail]>
Subject: email address
Date: Fri, Jan 24, 2014 9:04 AM
"scottbryan@road run ner.com"
Hi Scott — We have two email addresses for you in our database. Which one is correct? Thanks, Mike.
[e-mail]
[e-mail]
Mike Mickey
[e-mail]
NC Division of Water Resources
585 Waughtown Street
Winston-Salem, NC 27107
Phone: [phone]
FAX: [phone]
E-mail correspondence to and from this address may be subject to the North
Carolina Public Records Law and may be disclosed to third parties.

DR. F. W. SLATE
Mayor
Commissioners:
WILL MARKLIN, Mayor Pro Tem
JOHNNY FRYE
LASH GAITHER SANFORD, JR.
ROB TAYLOR
AMY VAUGHAN-JONES
Jown o woc&vilfe
INCORPORATED 1839
171 S. CLEMENT STREET
MOCKSVILLE, NC 27028
March 11, 2014
Wastewater Branch
Water Quality Permitting Section
Division of Water Resources
1617 Mail Service Center
Raleigh, NC 27699-1617
Subject: Delegation of Signature Authority
Town of Mocksville NC Dutchman Creek WWTP
NPDES Number NCO021491
To Whom It May Concern:
CHRISTINE W. BRALLEY
Town Manager
HENRY P. VAN HOY If
Town Attorney
RECEIVED
N.C. Dept. of ENR
MAR 13 20%
WINSTON-SALEM
REGIONAL OFFICE
By notice of this letter, I hereby delegate signatory authority to the following individual
for submission of electronic discharge monitoring reports at Town of Mocksville, NC
Dutchman Creek WWTP as required by all applicable federal, state, and local
environmental agencies specifically with the requirements for signatory authority as
specified in 15A NCAC 213.0506.
• Heather Adams, Director of Operations Envirolink, Inc.
If you have any questions regarding this letter, please feel free to contact me at 336-753-
6701.
Sincerely,
Christine W. Bralley
Town Manager
cc: Winston Salem Regional Office, Water Quality Permitting Section
PHONE: [phone] • FAX: [phone]
www.mocksvillene.org

Mickey, Mike
From: Scott Bryan <[e-mail]>
Sent: Friday, March 14, 2014 3:35 PM
To: Mickey, Mike
Subject: RE: December 2013 DMR
It'll be in the mail next week.
Thanks
From: Mickey, Mike [mailto:[e-mail]]
Sent: Friday, March 14, 2014 3:31 PM
To: Scott Bryan
Subject: RE: December 2013 DMR
You need to submit an amended DMR to Central Files with just the effluent TRC data. That should solve the
problem. Make sure you note what was amended. Mike.
From: Scott Bryan [mailto:[e-mail]]
Sent: Friday, March 14, 2014 3:23 PM
To: Mickey, Mike
Subject: RE: December 2013 DMR
Truthfully, Mike, that value wasn't even supposed to be entered onto the DMR. It was a process value.
The person in Bailey who does our DMRs did not understand my notations on the operations sheets.
I have since learned not to enter process numbers on the sheets, and I have also taken over DMR production
for Dutchman Creek.
Should I file and amended DMR or is this a done thing?
From: Mickey, Mike [mailto:[e-mail]]
Sent: Friday, March 14, 2014 2:53 PM
To: Scott Bryan
Subject: RE: December 2013 DMR
Scott —The mighty computer shows a total residual chlorine value on the December DMR that was above the
compliance limit of 50 ug/L (see below).
Just wanted to make sure this wasn't a typo since the DMR was checked compliant.
Thanks, Mike.

NCO021491
Limit Violation
Dutchman Creek WWTF
Daily 2013 12 001 Chlorine, Total 12-04-2013 3 X week
Maximum Residual
Exceeded
Mike Mickey
[e-mail]
NC Division of Water Resources
585 Waughtown Street
Winston-Salem, NC 27107
Phone: [phone]
FAX: [phone]
E-mail correspondence to and from this address may be subject to the North
Carolina Public Records Law and may be disclosed to third parties.
From: Scott Bryan [mailto:[e-mail]]
Sent: Friday, March 14, 2014 2:34 PM
To: Mickey, Mike
Subject: RE: Mocksville/Dutchman Creek - NCO021491
Thank you, sir.
Have a swell weekend
From: Mickey, Mike [mailto:[e-mail]]
Sent: Friday, March 14, 2014 2:25 PM
To: [e-mail]
Subject: FW: Mocksville/Dutchman Creek - NCO021491
Scott. Hopefully corrected. Mike.
Mike Mickey
Mike.Mickev[@NCDENR.eov
NC Division of Water Resources
585 Waughtown Street
Winston-Salem, NC 27107
2

Phone: [phone]
FAX: [phone]
From: Buffington, Beth
Sent: Friday, March 14, 2014 2:22 PM
To: Mickey, Mike
Cc: Reid, Steve
Subject: RE: Mocksville/Dutchman Creek - NCO021491
Hi Mike,
I checked the facility's hard file and see that it was reclassified as a Grade III by letter dated 3/3/2010. 1 have just
updated BIMS to reflect the reclassification from a Grade II to a Grade III. Hope this solves the problem.
Thanks! Beth
-------------------------------------
Beth Buffington, Environmental Specialist
NC Division of Water Resources
Phone: [phone]
Fax:[phone]
http: / /portal.ncdenr.org/web/wq/admin/tacu
-------------------------------------
From: Mickey, Mike
Sent: Thursday, March 13, 2014 8:25 AM
To: Buffington, Beth
Subject: FW: Mocksville/Dutchman Creek - NCO021491
Hi Beth —Trying to get the classification corrected in BIMS for the Mocksville/Dutchman Creek WWTP (Grade II to Grade
III). The ORC is trying to register for the e-DMR process. Please see email threads below along with the attached
info. Thanks, Mike.
Mike Mickey
[e-mail]
NC Division of Water Resources
585 Waughtown Street
Winston-Salem, NC 27107
Phone: [phone]
FAX: [phone]
From: Mickey, Mike
Sent: Wednesday, March 12, 2014 2:44 PM
To: Reid, Steve
Subject: FW: Mocksville/Dutchman Creek - NCO021491
Steve — How do we get the database to show Dutchman Creek as a Grade III WWTP? See email from ORC below. Let me
know if you need any additional info from the file. Thanks, Mike.
From: Scott Bryan [mailto:slbryan(�)road run ner.com]
Sent: Wednesday, March 12, 2014 1:09 PM

To: Mickey, Mike
Subject: Mocksville/Dutchman Creek BOD Excursion 3/7
As with the fecal, the BOD for storm day was a little hot. It will still be in for the week.
One other thing...
We are in the process of getting spun up for eDMR.
In the verification portal on the DENR site, Dutchman Creek is shown as a Class II plant when it is, in
fact, a Class III plant.
Is there any way you can get that changed so the universe doesn't blow up when I submit my first
DMR?
Thanks
Scott Bryan
Wastewater Services
Envirolink Inc
PO Box 670
Bailey, NC 27807
Phone: [phone]
Fax: [phone]
sibryan(a)-roadrunner.com
This email is free from viruses and malware because avast! Antivirus protection is active.
This email is free from viruses and malware because avast! Antivirus protection is active.

` \ �y 4\ DMR Review Record
Facility: � ��\�� l�.aY tt�► Permit No.: ` Pipe No.: �.� , MonthNear: c
onthly Average Violations
Parameter Permit L DMR Value % Over Limit Action
Dail Violatio
Date Parameter Permit Limit Limit Type DMR Value % Over Limit Action
Monitorin Fre u nc Violations
Date Parameter Permit Frequency Values Reported # of Violations Action
Other Violation``s``lStaff Remarks:
Supervisor Remarks:
Completed by:
Assistant Regional
Supervisor Sign Off:
Regional Supervisor Sign
Off:
Date: J \� —�
Date:
Date:

-y.
�� �� EFFLUENT i
fE 2014
4 E`D) 49 � e_',.
4
NPDES PERMIT NO. NCO021491 DISCHARGE NO. 001 IMMO+ONTH December YEAR 2013
FACILITY NAME Dutchman Creek WWTP CLASS Y Davie
OPERATOR IN RESPONSIBLE CHARGE (ORC): Scott Brvan GRADE: IV PHONE [phone]
CERTIFIED LABORATORIES: ENVIRONMENT 1
CHECK BOX IF ORC HAS CHANG> "n-a-PER$ON(S) COLLECTING SAMPLES: Scott Bryan
Mail ORIGINAL and ONE CO]
ATTN: CENTRAL FILES
DIV. OF WATER QUALITY
1617 MAIL SERVICE CENT
RALEIGH, NC 27699-1617
N.C.Dept. f ENR
to:
2014X
(SI(
Winston alern BY
JRBqQk OPI TOR IN RESPONSIBLE CHARGE) 'Date
SIGNAT , I CERTIFY THAT THIS REPORT IS
TE AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
50050
00010
00400
5wo
00310
1
005A
31616
00
00665
00625
00630
00600
r
L y
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UG/L
MG/L
MG/L
MG/L
M/100M1/L
MG/L
MG/L
MG/L
MG/L
MG/L
P/P
1
N
0.351
2
0731
6.50
Z'
0.376
M8
6.89
17.0
7.1
0.14
6.4
>6000
7.99
3
0733
3.00
I'
0.383
11.3
6.57
11.0
3.2
0.14
4.2
21
7.92
4
0631
7.79
I'
0.405
13.3
6.78
85.0
7.82
5
0854
4.00
1'
0.401
14.7
7.09
26.0
8.01
6
0855
3.50
I'
0.393
16.6
7.23
12.0
4.2
0.51
4.3
32
7.83
7
N
0.443
8
N
0.383
9
0730
4.00
I'
0.521
12.4
7.23
44.0
2.7
0.05
2.5
4
8.34
io
0732
5.75
Y
0.634
13.2
7.05
48.0
3.4
1.49
2.7
<I
7.53
11
0729
5.00
I'
0.454
13A
6.82
20.0
8.35
12
0730
5.00
1'
0.397
12.2
6.67
20.0
7.84
it
13
0731
6.00
Y
0.377
10.8
7.59
22.0
2.4
0.07
<2.5
8
8.67
14
N
0.553
15
N
0.530
161
0730
6.00
Y
0.430
12.4
6.63
38.0
2.0
0.17
<2.5
<1
8.35
17
0734
5.00
Y
0.420
12.4
6.65
17.0
5.3
0.10
9.6
<1
8.34
i8
0730
5.00
1'
0.394
12.2
6.35
22.0
8.17
i9
0730
5.50
I'
0.391
10.9
6.40
18.0
9.24
20
0732
6.00
I'
0.395
12.5
6.49
18.0
2.3
0.16
4.3
6
8.45
21
N
0.396
22
N
0.696
23
0615
6.50
1'
2.245
16.1
6.29
49.0
27.0
1.00
17.0
5200
5.44
-24
0717
3.00
S'
1.330
15.4
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H
H
H
0.531
H
H
H
H
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H
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0637
5.25
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0.423
11.2
6.92
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5.2
0.13
8.4
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27
0628
6.00
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0.403
113
6.71
23.0
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0.05
5.0
2
8.00
28
N
0.392
N
0.915
t
6306.50
Y
0.568
11.8
6.74
15.0
8.4
0.24
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3.25
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0.481
12.6
6.83
16.0
3.0
0.08
4.0
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7.84
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0.549
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5.6
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8.4
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#DIV/0!
#DIV/0!
#D)V/0!
####
N AXEV"
2.245
16.6
7.59
85.0
27.0
1.49
ITO
>6000
9.2
0.0
0.00
0.00
0.0
mughv"
0.351
10.8
6.29
11.0
2.0
0.05
<2.5
<1
5.4
0.0
0.00
0.00
0.0
Comp. (C)/Grab (G)
G
G
G
C
C
C
G I
G
C
C
C
C
Monthly Limit
0.9800
>6-<9
28.0/D
5S10W I2S10W
I
30/M46W
2001100m1
Continuous
-Daily
3X WEEK
3X WEEK
3X WEEK I
3X WEEK
3X WEEK
3X Week 3X WEEK
Quarter)
Quarter)
TOTAL MONTHLY FLOW-- 17.011
DEM Fo- MR-1 (12/93)

Mickey, Mike
From:
Buffington, Beth
Sent:
Friday, March 14, 2014 2:22 PM
To:
Mickey, Mike
Cc:
Reid, Steve
Subject:
RE: Mocksville/Dutchman Creek - NCO021491
Hi Mike,
I checked the facility's hard file and see that it was reclassified as a Grade III by letter dated 3/3/2010. 1 have just
updated BIMS to reflect the reclassification from a Grade II to a Grade III. Hope this solves the problem.
Thanks! Beth
-------------------------------------
Beth Buffington, Environmental Specialist
NC Division of Water Resources
Phone:[phone]
Fax: [phone]
http://T)ortal.ncdenr.org/web/wq/admin/tacu
-------------------------------------
E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law
and may be disclosed to third parties unless the content is exempt by statute or other regulation.
From: Mickey, Mike
Sent: Thursday, March 13, 2014 8:25 AM
To: Buffington, Beth
Subject: FW: Mocksville/Dutchman Creek - NCO021491
Hi Beth — Is Steve R. still out? Can you help me? Trying to get the classification corrected in BIMS for the
Mocksville/Dutchman Creek WWTP (Grade II to Grade III). The ORC is trying to register for the e-DMR process. Please
see email threads below along with the attached info. Thanks, Mike.
Mike Mickey
Mike. MickevPNCDENR.eov
NC Division of Water Resources
585 Waughtown Street
Winston-Salem, NC 27107
Phone: [phone]
FAX: [phone]
From: Mickey, Mike
Sent: Wednesday, March 12, 2014 2:44 PM
To: Reid, Steve
Subject: FW: Mocksville/Dutchman Creek - NCO021491
Steve — How do we get the database to show Dutchman Creek as a Grade III WWTP? See email from ORC below. Let me
know if you need any additional info from the file. Thanks, Mike.

From: Scott Bryan[mailto:slb[van(d)roadrunner.com]
Sent: Wednesday, March 12, 2014 1:09 PM
To: Mickey, Mike
Subject: Mocksville/Dutchman Creek BOD Excursion 3/7
As with the fecal, the BOD for storm day was a little hot. It will still be in for the week.
One other thing...
We are in the process of getting spun up for eDMR.
In the verification portal on the DENR site, Dutchman Creek is shown as a Class II plant when it is, in
fact, a Class III plant.
Is there any way you can get that changed so the universe doesn't blow up when I submit my first
DMR?
Thanks
4,
Scott Bryan
Wastewater Services
Envirolink Inc
PO Box 670
Bailey, NC 27807
Phone: [phone]
Fax: [phone]
slbryan(o)roadrunner.com

Mickey, Mike
From: Scott Bryan <[e-mail]>
Sent: Monday, March 10, 2014 4:40 PM
To: Mickey, Mike
Subject: RE: NPDES issues from ice storm?
It turns out I had a hot fecal Friday (i.e. >upper threshold), but the week was good. I expect the ammonia,
TSS, and BOD will be elevated but not likely out.
From: Mickey, Mike [mailto:[e-mail]]
Sent: Monday, March 10, 2014 9:57 AM
To: [e-mail]
Subject: RE: NPDES issues from ice storm?
Thanks for the update. Glad it wasn't too bad.
Mike Mickey
[e-mail]
NC Division of Water Resources
585 Waughtown Street
Winston-Salem, NC 27107
Phone: [phone]
FAX: [phone]
E-mail correspondence to and from this address may be subject to the North
Carolina Public Records Law and may be disclosed to third parties.
From: slbr aan(-aroadrunner.com[mailto:slbryan(cbroad run ner.com]
Sent: Monday, March 10, 2014 9:52 AM
To: Mickey, Mike
Subject: Re: NPDES issues from ice storm?
It doesn't look like it, although I haven't got any lab results from the Friday samples, and I didn't notice any
appreciable changes in the effluent quality.
High flow midday Friday through Saturday kinds juiced things up a bit through yesterday morning, but I don't
think a lot kicked out.
Scott Bryan
Wastewater Services
Envirolink Inc
336.503.2383
[e-mail]
----- Reply message -----
From: "Mickey, Mike" <[e-mail]>

To: "[e-mail]" <[e-mail]>
Subject: NPDES issues from ice storm?
Date: Mon, Mar 10, 2014 09:05
Scott —Just checking to see if you had any major issues at the Dutchman Creek WWTP due to the Friday ice
attack? Thanks, Mike.
Mike Mickey
M i ke.. M i c key@ N CD E N R.Rov
NC Division of Water Resources
585 Waughtown Street
Winston-Salem, NC 27107
Phone: [phone]
FAX: [phone]
E-mail correspondence to and from this address may be subject to the North
Carolina Public Records Law and may be disclosed to third parties.
19- This email is free from viruses and malware because avast! Antivirus protection is active.

Mickey, Mike
From: Weaver, Charles
Sent: Wednesday, February 05, 2014 2:27 PM
To: Mickey, Mike
Subject: RE: Mocksville Dutchman Creek - NCO021491
Yes — the application was received on December 2nd
It was assigned to Jackie, but it will get reassigned to someone else.
CHW
From: Mickey, Mike
Sent: Wednesday, February 05, 2014 2:24 PM
To: Weaver, Charles
Subject: Mocksville Dutchman Creek - NCO021491
Charles — Do you know if a renewal has been submitted for the Dutchman Creek WWTP? Thanks, Mike.
Mike Mickey
Mike.Mickev(@NCDENR.eov
NC Division of Water Resources
585 Waughtown Street
Winston-Salem, NC 27107
Phone: [phone]
FAX: [phone]
E-mail correspondence to and from this address may be subject to the North
Carolina Public Records Law and may be disclosed to third parties.

Smith, George
From: Christine Bralley <[e-mail]>
Sent: Monday, October 28, 2013 5:29 PM
To: Smith, George
Subject: RE: Pretreatment Program
George,
We are contracting with Envirolink, Inc. for services. Heather Adam [e-mail] or Mike
Myers [e-mail] are the contact persons 252-235-4900.
Thank you,
Christine
Christine W. Bralley
Town Manager
Mocksville, NC - "Time Well Spent"
336-753-6701
[e-mail]
From: Smith, George[mailto:[e-mail]]
Sent: Monday, October 28, 2013 11:19 AM
To: Christine Bralley
Cc: Gore, Deborah
Subject: Pretreatment Program
Christine,
Ms. Richardson and I spoke this morning. They will probably be using 30,000 gpd of process water from a chicken nugget
process. This will require the completion of the application. I told her that there are no foreseeable issues that will hold-
up this project.
The Town needs to have a pretreatment coordinator/ contractor that will handle the pretreatment program. Please let
us know who that contact will be.
George
George Smith
New email: [e-mail]
NC DENR Winston-Salem Regional Office
Division of Water Resources
585 Waughtown Street
Winston-Salem, NC 27107
Voice: [phone]
FAX: [phone]
1

E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be
disclosed to third parties.

ALVW4,_WY
NCDENR
North Carolina Department of Environment and Natural
Division of Water Quality
Pat McCrory Thomas A. Reeder
Governor Acting Director
July 8, 2013
Ms. Christine W. Bralley, Town Manager
Town of Mocksville
171 Clement Street
Mocksville, NC 27028
Subject: Inactivation of Pretreatment Program
Town of Mocksville (NC0021491)
Davie County
Dear Ms. Bralley:
Resources
John E. Skvarla, III
Secretary
The Pretreatment, Emergency Response and Collection Systems (PERCS) Unit of the Division of Water Quality has
reviewed the status of the Town of Mocksville's Pretreatment Program. As the Town currently has no Significant
Industrial Users (SIUs), by definition, per 15A NCAC 2H .0907 (e) the Pretreatment Program is deemed inactive.
If an SIU proposes to discharge wastewater to your WWTP, you must notify the Division, reactivate your Pretreatment
Program, and update the major Program elements as necessary. Please see Part IV, Section B, 4, of your NPDES permit.
Since you will not be accepting wastewater from any SIUs while your Pretreatment Program is Inactive, and the Town's
NPDES permitted flow is less than 1 MGD, it is PERCS' understanding that the facility can now be reclassified as a
Minor facility. Please contact Charles Weaver of the NPDES staff at 919-807-6391 ([e-mail]) to
discuss this reclassification.
Thank you for your continued cooperation with the Pretreatment Program. If you have any questions or comments, please
contact Monti Hassan at [phone] or Deborah Gore, Unit Supervisor at [phone] [email:
deborah. oregricderingov].
Sincerely,
W. Corey Basinger
Regional Supervisor
Cc: PERCS Unit
WSRO Files
Charles Weaver, NPDES Unit
Fran McPherson, DWQ Budget
North Carolina Division of Water Quality, Winston-Salem Regional Office
Location: 585 Waughtown Street, Winston-Salem, North Carolina 27107
Phone: [phone] FAX: [phone]
Internet: www.ncwaterauality.org
One
NorthCarolina
Natumll#
An Equal Opportunity 1 Affirmative Acton Employer

&Wr
GREY RECEIVED]
of ENR
ENGINEERING, INC.
FRP,aional
UN 14 2012
Winston-Salem
Office
June 13, 2012
Jim Hendrick, Plant Engineer
Omtron USA, LLC
d/b/a Townsends
Post Office Box 709
Siler City, NC 27344
RE: Townsends Facility in Mocksville, NC - pretreatment
Mr. Hendrick:
Please accept this letter as notification on behalf of the Town of Mocksville that the pretreatment
permit issued to Townsends by the Town has expired and the Town intends to request that the
State approve Townsends' removal from its list of Significant Industrial Users.
Should Omtron USA LLC d/b/a Townsends intend to re -open the facility in Mocksville, a new
pretreatment permit application will be required by the Town a minimum of six months prior to
the start of operations.
In your communication dated February 1, 2012 you indicated that the main water valve to the
facility had been closed, and you were in contact with Shamrock Environmental regarding the
required clean up and closure items noted in our annual inspection of the facility in December
2011. Copies of both communications are attached. Please provide us with an update as to the
progress or evidence of completion of these required items.
Thank you for your attention to this matter.
Sincerely,
Grey Engineering, I
( V S \.
Joy Howard for
John C. Grey, Jr. PE
Cc: Christine Bralley, Town of Mocksville
George Smith, NCDENR-DWQ
P.O. Box 9 4 Mocksvilte, NC 27028 . Phone: [phone] . Fax: [phone] . www.greyengineering,com

December 16, 2011
Jim Hendrick
PO Box 709
Siler City, NC 27344
The annual SIU inspection of Townsends (permitted as Omtron USA, d/b/a Townsends) was
performed on December 14, 2011 by John Grey, Acting Pretreatment Coordinator, and Joy
Howard of Grey Engineering on behalf of the Town of Mocksville. Jim Hendrick, Facilities
Manager for Townsends was present to represent the SIU. Our records indicate that production
at the plant ceased on 8/1/2011. In response to the recent shut -down, several items were
discussed:
1. While the production facility seems to be substantially cleaned and properly shut -down,
the wastewater treatment area, including the front pit, two storage tanks behind the
plant, and DAF unit have not been cleaned. These wastewater storage areas contain
deposits of residual oil and grease that must be removed.
2. It is important to insure that stormwater cannot be introduced into the Town's wastewater
collection system. Please construct a system for sealing off the dumpster pad from
wastewater collection.
3. All remaining chemicals, in both full and partial containers, currently stored in the
wastewater treatment facility must be properly disposed of.
4. As long as the Pretreatment Permit remains valid, daily effluent flow reporting is
required. The most recent report contains data through August 26, 2011. Please
provide any interim data available and daily flow data moving forward until permit
termination is accomplished.
5. It is recommended that the current pretreatment permit be closed following satisfactory
completion of wastewater cleanup and stormwater mitigation. A new permit
representing appropriate limits of discharge may be negotiated should the facility be
scheduled to re -open.
6. Please provide contact information (mailing and email addresses) for corporate
ownership for ongoing regulatory communications.
7. Pretreatment records should be accessed from the former safety manager's office and
maintained in accordance with regulatory requirements.
Please address these issues as soon as possible and advise us of a final completion schedule,
but no later than 30 days from the date of this summary.

Joy Howard
From: [e-mail]
Sent: Wednesday, February 01, 2012 3:37 PM
To: Joy Howard
Subject: Re: Summary of Annual pretreatment inspection
Attachments: Wastewater Data.xls
Ms. Howard,
Please find attached the data from the flow meter at the Omtron USA LLC d/b/a Townsends facility at Mocksville that we
reviewed last month. As you can see there is a gap in the data (no paper in the recorder), however we do know the total
flow during this period. Additionally, I now have a supply of chart paper and will be recording these flows on a daily basis.
For the total duration it appears that we have been sending approximately 766 gallons per day to the town of Mocksville.
This is significantly less that the quantity this facility was discharging while processing.
I have continued to work to limit the water going to through the wastewater system. These efforts include, this week,
closing the main water valves that enter the facility - I had been lead to believe this had already occurred. I will keep you
apprised of the efforts in limiting the stormwater that enters the system as this work continues.
I have also been in contact with Shamrock Environmental and we have tentative plans to clean the items enumerated in
you letter from January.
If Mr. Gray of yourself have any questions please contact me via e-mail or my mobile number listed below.
Best Regards,
James (Jim) A. Hendrick, Jr.
Plant Engineer
Omtron USA LLC
d/b/a Townsends
Cell 919-548-4946

Joy Howard
From: John Grey [e-mail]]
Sent: Thursday, November 10, 2011 10:33 AM
To: 'Joy Howard'
Subject: FW: IJA
Attachments: draft IJA Guidance ian-2011.docx
From: Smith, George[maiIto: george.smith(5)ncdenr.gov]
Sent: Friday, August 26, 2011 8:41 AM
To: John Grey
Subject: FW: IJA
John,
Here is the guidance concerning Davie County, Cooleemee. I will include the highlighted portion of this email in the
letter.
Enjoyed the lunch yesterday. Thanks for the advice.
George
George Smith
New email: [e-mail]
NC DENR Winston-Salem Regional Office
Division of Water Quality, Water Quality Section
58S Waughtown Street
Winston-Salem, NC 27107
Voice: [phone]
FAX: [phone]
4/�t � _tj-4
11 d .,-- /1j-,-v" //
! A.
E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be
disclosed to third parties.
From: Gore, Deborah
Sent: Friday, August 26, 2011 8:36 AM
To: Smith, George
Subject: IJA
40 CFR 403.9(b)(3) "If more than one agency is responsible for administration of the Program the responsible agencies
should be identified, their respective responsibilities delineated and their procedures for coordination set forth;"
NCAC 2H .0906 — Submission for Program Approval
(b) In addition to the contents of a control authority pretreatment program submission described in Paragraph (a) of
this Rule, the program submission shall contain:
(1) a sewer use ordinance (SUO) providing the legal authority for implementing the pretreatment program,
along with an attorney's statement, as required by 40 CFR Part 403.8 (f)(1) and Rule .0905 of this
Section. Where the control authority accepts wastewater from one or more satellite POTWs and is the
control authority within the satellite POTW's service area, the attorney's statement for that control
authority shall document the interlocal agreements (ILAs) authorized by G.S. 153A-278 and 160A-460 et
1

seq and SUO sections that establish the control authority's authority for regulation within all satellite
POTW services areas which are tributary to the control authority's POTW. Where a satellite POTW
serves as the control authority within its service area, the attorney's statement for that control authority
shall document the ILAs and SUO sections that establish the satellite POTW's authority for regulation
within its service area and the requirements for the satellite POTW to implement its pretreatment
program in accordance with the downstream POTW's SUO and the ILA. In either case, where the POTW
organizations have other written procedures to outline responsibilities not covered by the ILA or SUO,
the applicable attorney's statements shall also include documentation of these procedures and the
source of their enforceability;
Attached is a Draft IJA guidance. The header says June 2010, but the footer has Jan 2011. They would want to look at
option 2.
A lot going on today because of the hurricane, but if you want to discuss it more next week, let me know.
Deborah
Deborah Gore
PERCS Unit Supervisor
919-807-6383
E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be
disclosed to third parties.
PJ

June 2010 NC Pretreatment Guidance on Intermunicipal Wastewater Arrangements
ments
Increasingly, North Carolina Publicly Owned Treatment Works (POTWs) are working together to solve
wastewater needs. In some cases, this involves wastewater that is generated in the jurisdiction of one
POTW organization being treated at a wastewater treatment plant (WWTP) owned and operated by
another POTW organization. This document will describe options for POTWs with Pretreatment
Programs that have these types of intermunicipal situations, and establish requirements and
recommendations for these options.
In some cases, the POTW organizations establish that the owner of the POTW treatment plant will
administer the Pretreatment Program for the entire service area. In other cases, the POTW organizations
establish that each organization will administer the Pretreatmen#Pam within their own jurisdictions
separately. These options are supported by several NC Generes which are listed at the end of
this document.
In the following discussion, the POTW organization
POTW A. The other POTW organization, a "satell'
that discharges into POTW A's WWTP is referre
P
plant is referred to as
ater collection system
Filename: draft IJA Guidancejan_2011.docx
Revision Date:
Page 1 of 10

June 2010 NC Pretreatment Guidance on Intermunicipal Wastewater Arrangements
Option 1: POTW A is the Pretreatment Program Control Authority (CA) and implements all
Pretreatment Program responsibilities.
In this case, the following requirements and recommendations are provided:
PERCS requests comment on this section. Comment can be consolidated with comments on the last
paragraph of Section 1 of the Divisions Model NC Pretreatment Sewer Use Ordinance (SUO) in the
draft 2011 model SUO.
1)
2)
POTW A must submit a Descri
organization charts. This must
3) If
that
Nis of involvement by POTW B. However, these
o require POTW A to implement any action or decision
es. Nor can they require POTW A to provide prior
her action that would prevent POTW A from being able
to properly iffilknent its Preftment Program. Some examples of potential involvement include:
parties WA
can in no
s�any
ngent
er
Filename: draft IJA Guidancejan_2011.docx Page 2 of 10
Revision Date:

June 2010 NC Pretreatment Guidance on Intermunicipal Wastewater Arrangements
Option 2: Both POTW A and POTW B have their own Division approved Pretreatment Programs and
are CA's within their own jurisdictions and/or sewer service areas.
In this option, it is necessary that there be significant documentation of the details of communication
between the two POTWs regarding Industrial Waste Survey (IWS) activities, pollutants of concern, SIU
determination, IUP limit determination, and documentation that WWTP treatment plant capacity
(Maximum Allowable Headworks Loadings or MAHLs) are not exceeded. Generally, POTW B must
inform POTW A of non -domestic Industrial Discharges, and POTW A must give POTW B enough
information so that POTW B can decide to allow the discharge or not, decide SIU status, and decide if
an IUP limit or monitoring is needed. Without this communicatio TW B will have no guidance on
how much of a pollutant of conce
inadvertently allow an IL
adversely affecting POTW
B's SUO.
The various State Pretreatment Regulations estab
cooperation are listed in Section XXX of this
establish procedures that ensure proper commui
writing and will be part of both POTW's Division
in the ILA, Description of Control A /PO1
separate procedure,
recommendations are designed to
1)
statement from
that establish P
POTW B to im
If the POTWs wil
POTW A of certai
have no violations.
a result, POTW B could
It in POTW B's discharge
with its IUP limit or POTW
gent Program ey may be listed
the SUOs, PO 's SIU IUPs, a
re, the following requirements and
.0906(b)(1), the attorney's
(ILAs) and SUO sections
t, and the requirements for
POTW A's SUO and their
a procedures to outline responsibilities not
shall also include documentation of these
y, if the POTWs have written
treatment arrangement, the C)
and/or conflict with the Des,
PERCS allow POTW B to accept responsibility for notifying
reports, for example routine SIU self -monitoring reports that
3) Description of Control Authority Organization - .0906(b)(9): Each POTW must provide a
Description of the Control Authority Organization administering the Pretreatment Program,
including organization charts. The Descriptions must identify both POTWs as well as any other
satellite POTWs, and clearly identify at least the tasks below. The Description must be consistent
with SUOs, attorney's statements, ILAs, and other written procedures.
a) Which party will receive IU applications for new and changed discharges in which jurisdictions.
b) How the parties will communicate on and make decisions about accepting, denying, or
Filename: draft IJA Guidancejan_2011.docx Page 3 of 10
Revision Date:

June 2010 NC Pretreatment Guidance on Intermunicipal Wastewater Arrangements.
conditioning wastewater discharges, and regulation of all SIUs, including making SIU
determinations and documentation of allocations of flow and pollutant MAHLs.
c) How the parties will communicate on and make decisions about SNC determinations for SNC
criteria in .0903(b)(34) C, D, and H.
4) The POTWs together must develop a general procedure that outlines how the POTWs will work
together to review new/changed dischargers in POTW's jurisdiction, make SIU determinations, and
finalize IUPs that POTW B will then issue, including POC determinations, and also make decisions
on SNC criteria C, D, and H. This procedure may be part of the above mentioned Description of
Control Authority Organization, part of the formal IJA bet; a POTWs, or may be a separate
document. This procedure will be a part of each POTW's D' approved Pretreatment Program.
For any communications where POTW A must
action, specify how much time POTW A will nee
timetable where POTW A must provide a new
new or changed POCs. 4
The general procedures must include the
with before POTW B may take
WNote there may be a different
er appropriate guidance for
A regarding on-gla IWS activities
discharges in particular. For example:
oc� , page 5, 2nd and 3rd bullets, an IUP limit is
Tisch is greater than 5 % of the MARL. However,
's age discharge is greater than 5 %MAHL, an
Was significant available capacity. For BOD, this
is less than 75% of the MAHL, and less than 50 % of
(1 t POTWs wi e PO 's MAHL for the %'s. However, the two POTWs may
e use Jspeci
MAHL if there is one.
The proced aat POTW B mayaddress certain types of SIU or non-SIU changes
on their own roval by POTW A, either with or without a stipulation that POTW
B cc: to POTWdocument.
b) Describe how and w en the POTWs will communicate on POTW A's LTMP/STMP
modifications that add or delete POCs.
i) POTW A must document discussions as to whether new POCs need to be addressed in
POTW B's regulation of its SIUs in their LTMP files.
c) Describe how and when the POTWs will communicate regarding IU compliance status,
especially as relates to POTW problems, including Pass Through, Interference, SNC criteria C,
D, and H. For example:
i) Either POTW can make Pass Through and Interference determinations, as well as SNC criteria C, D,
Filename: draft IJA Guidancejan_201 I.docx Page 4 of 10
Revision Date:

June 2010 NC Pretreatment Guidance on Intermunicipal Wastewater Arrangements
and H determinations.
ii) When POTW A experiences problems with their operation that they believe could be
attributable to POTW B's discharge.
iii) When POTW B discovers any situations at their SIUs or non-SIUs such as slug loads, upsets,
and bypass, especially where these situations could possibly adversely affect POTW A's
operation. This includes all emergency inspections as well as any SIU reports to POTW B
under paragraph 2 of IUP Part II, 30, Potential Problems.
iv) When POTW B identifies any violations by POTW B's IUs, limits or permit conditions, that
could cause POTW B to violate any requirement of their formal IJA, procedures, POTW A's
SUO, or permit issued to POTW B by POTW A. AL
It is strongly recommended that POTW B cc: PI
other violations by POTW B's SIUs that are in SN
Note EPA's IJA Guidance suggests POTW I
SIUs to POTW A monthly.
d)
issued by
5) If (
for
6) It is s
SIUs.
all correspondence related to any
become SNC.
mpliance status reports for all
for with respect to
POTW A's
d on POTW
portion of its flow and pollutant
T along side its own SIU loads.
ss
ant MAHLs in its own AT. SIU IUP flow and pollutant
IJA, in a procedure, or in a permit
POTWs to sample at the connection point
send IDSFs to POTW A from their PAR for all applicable
7) POTW A mayVtoW
POTW B on selected SIU inspections, especially for new SIUs or
SIUs causing pro
a) Note EPA'sso suggests POTW B submit annual schedule of inspections to
POTW A soan to attend if they wish, and that POTW B submit copies of all
inspection re
8) POTW A may wish to "inspect" POTW B annually. Examples can be provided.
9) POTW A may wish to address other reporting issues and/or specify sampling in the formal ILA, in a
procedure, or in a permit issued to POTW B.
Filename: draft IJA Guidancejan_2011.docx Page 5 of 10
Revision Date:

June 2010 NC Pretreatment Guidance on Intermunicipal Wastewater Arrangements
Treating POTW is
Both POTWs are Control
Control Authority
Authorities
15A NCAC
Element/Activity
Treating
Satellite
Treating
Satellite
02H Rule
POTW
POTW
POTW
POTW
POTW Reguirements
.0906(b)(1)
SUO, including
Yes
Yes, probably
Yes
Yes
attorney's statement
one line, at
least for SIUs
.0906(b)(2)
IWS, including SIU
Yes
Participate
Yes,
Yes,
determination
coordinated
coordinated
.0906(b)(9)
POTW Description
Yes
Partic'
Yes,
Yes,
coordinated
coordinated
.0906(b)(10)
Staffing and Funding
Yes
Yes
Yes
.0906(b)(3)
Monitoring Plan
o
otify
No.
-te
Coordinate
'A
'RjjLjjW
POC chang
.0906(b)(4)
HWA
Yes
No
Yes
No
.0906(b)(6)
SILT IUPs, including
No
Yes, in own
Yes,
POC/limits
6.1
service area
coordinated
.0906(b)(8)
SILT compliance
Yes
lated t
Yes
Yes,
including
th tion
coordinated
.0906(b)(8)
Enforc t
Yes, in own
Yes
service area
0908(b)
PAR
Yes
Yes, for own
Yes, for own
service area
service area
.0906
PIX to retre
W6e, but not
Yes, in own
Yes
units
r SIUs in
service area
their service
area
906(b)(5)
ro
liance moni g
nro
IU Requirements
.09080) IU reporting to both N/A Yes Yes
POTWs
Filename: draft IJA Guidancejan_2011.docx Page 6 of 10
Revision Date:

June 2010 NC Pretreatment Guidance on Intermunicipal Wastewater Arrangements
The 2011 Rules revisions included several new or revised conditions that address Interjurisdictional
situations. These include (new wording underlined, wording significant to multiple POTWs situations
highlighted in M
1) Clarify multiple POTWs and which one is the Control Authority:
a) .0902(2) — Scope of Pret. Prog.: „
sources subject to Pretreatment Standards;
b) .0902(b)(26) "POTW', or Publicly Owned Treatment
defined by Section 212 of the Clean Water Act (CW
government organization. This definition includes
treatment, recvcline and reclamation of municipal
which receive wastewater from
s, means a treatment works as
I is owned by a State or local
and systems used in the storage,
lustrial wastes of a liquid nature.
Also see Rule .0402 of Subchapter 02T olMse Rules. term also means the local
government organization, or municipalWe
ned in section L
the CWA, which has
iurisdiction over indirect discharzes toTscbaroes from suc atment works. IM
Filename: draft IJA Guidancejan-2011.docx Page 7 of 10
Revision Date:

June 2010 NC Pretreatment Guidance on Intermunicipal Wastewater Arrangements
a)
b)
c)
d)
e)
ERP - .0903(b)(7)
Headworks Analysis - .0903(b)(10)
"Pollutant of Concern" or "POC" - .0903(b)(25)
"Monitoring Plan"
3) Clarify rights, responsibilities, and authorities of the POTWA#Ijrnot the Control Authority:
Filename: draft IJA Guidancefjan_2011.docx Page 8 of 10
Revision Date:

June 2010 NC Pretreatment Guidance on Intermunicipal Wastewater Arrangements
(2) Criteria D — Endangerment/Emergency Sus ension of Service: in either the MW
exercise of its
emergency authority ...to halt or prevent such a discharge;
(3) Criteria H — Any other violation: ... the determines.
5) Clarify rights, responsibilities, and authorities of POTW B's IUs to each POTW:
a) .0908(h) - In the case where the receiving POTW treatment plant is not owned by the same local
governmental organization as the control authority, all information required to be reported to the
industrial user's control authority by this Section shall also ubmitted to the POTW treatment
plant governmental organization.
Filename: draft IJA Guidancejan-201 I.docx Page 9 of 10
Revision Date:

June 2010 NC Pretreatment Guidance on Intermunicipal Wastewater Arrangements
North Carolina General Statues applicable to Interjurisdictional Issues as related to the Pretreatment
Program.
Cities and Towns
NCGS 160A-312. Authority to operate public enterprises. (b) A city shall have full authority to protect
and regulate any public enterprise system belonging to or operated by it by adequate and reasonable
rules. The rules shall be adopted by ordinance, shall apply to the public enterprise system both within
and outside the corporate limits of the city, and may be enforced with the remedies available under any
provision of law.
NCGS 160A-461. Joint provision of enterprisory services.
and any one or more other units of local government in
permitted by the laws of the other state) may enter into co
to execute any undertaking. Ish.
Counties.
NCGS 153A-275.
reasonable rules to protect and regulate a public
shall be adopted by ordinance, shall apply to the
county, and may be enforced with the Ift9les av
Joint provision of
of local government may cooperate in the
procedures and provisions
Article, the board of cdM
to any part of the county
permit a co nanc
by resolu
NCGS 162A-69(13a) and
to adopt and enforcement
of local government in this State
Dr any other state (to the extent
with each other in order
adopt adequate and
ed by it. The rules
ystem both
provision of law.
and outside the
more counties, cities, or other units
d by this Article according to the
as otherwise provided in this
I ance adopfd pursuant to this Article applicable
the governing board of a city may by resolution
to be applicable within the city. The city may
ce. If it does so, the city shall give written
0 days after the day the county receives this
G.S. 160A-175 to
-81(a) give MSDs the same power as a city under G.S. 160A-175
Filename: draft IJA Guidancejan_2011.docx Page 10 of 10
Revision Date:

Division of Water Quality
May 3, 2013
To: Corey Basinger
Regional Supervisor, Surface ater Protection, WSRD
Through: Cindy A. Moore
Supervisor, Aquatic Toxicology Unit
From: Carol Hollenkamp
Quality Assurance 2fifeer, Aquatic Toxicology Unit
Subject: Whole effluent toxicity test results
Mocksville WWTP
NPDES Permit # NCO021491 /001
Davie County
The aquatic toxicity test using flow -proportional composite samples of effluent discharged from Mocksville
WWTP has been completed. Mocksville WWTP has a permitted effluent discharge that is 0.68 MGD
entering Dutchman's Creek (7Q10 of 2.54 CFS), Whole effluent samples were collected on April 9 and
April I by Jenifer Carter and facility representative Eric Moten for use in a chronic Ceriodaphnia dubia
pass/fail toxicity test. The test using these samples resulted in a pass. Toxicity information follows.
Test Type
Test Concentrations
Test Result
Control Survival
Control Mean Reproduction
Test Treatment Survival
Treatment Mean Reproduction
First Sample pH
First Sample Conductivity
First Sample Total Residual Chlorine
Second Sample pH
Second Sample Conductivity
Second Sample Total Residual Chlorine
3-Brood Ceriodaphnia dubia pass/fail
37 % sample
Pass
100%
28.5
100%
31.2
6.88 SU
490 micromhos/cm
<0.10 mg/L
7.32 SU
524 micromhos/cm
<0.10 mg/L
Test results for the above samples indicate that the effluent would not be predicted to have water quality
impacts on receiving water. These samples were split and tested by Environmental Testing Solutions, Inc.
The chronic Ceriodaphnia dubia pass/fail toxicity test run by Environmental Testing Solutions, Inc. also
resulted in,a pass. Please contact us if further effluent toxicity monitoring is desired. We may be reached at
[phone].
cc; Central Files
Jenifer Carter, WSRO
Aquatic Toxicology Unit Environmental Sciences Section

A ,
Carter, Jenifer
From:
Carter, Jenifer
Sent:
Monday, May 06, 2013 9:24 AM
To:
[e-mail]'
Subject:
FW: Toxicity Test Report
Attachments:
MocksvilleWWTP_0413.pdf
Eric,
I have attached the toxicity test results for the sample we split with you in April. Our test and the Environmental Testing
Solution's test passed.
Thanks for your cooperation.
Have a great week.
Jenifer Carter
A
Before printing this email, prase consider your budget and the environment.
If you must print, please print only what you need and save ink with the free Eco-Font.
NC DENR Winston-Salem Regional Office
Division of Water Quality
585 Waughtown Street
Winston-Salem, NC 27107
Voice: [phone]
FAX: [phone]
E-mail correspondence to and from this address may be subject to the
North Carolina Public Records Law and may be disclosed to third parties.
From: Hollenkamp, Carol
Sent: Friday, May 03, 2013 4:23 PM
To: Basinger, Corey
Cc: Carter, Jenifer; Moore, Cindy; Ventaloro, Christopher
Subject: Toxicity Test Report
Attached is the toxicity test report for Mocksville WWTP. If you have any questions, just let me know.
Thanks,
Carol Hollenkamp
Aquatic Toxicology Unit/Environmental Sciences Section
North Carolina Division of Water quality/DENR
1621 Mail Service Center, Raleigh, NC 27699-1621
Phone: [phone]

Fax: [phone]
Website: htttp://portal.ncdenr.org/web/wq/ess/atu
E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be
disclosed to third parties.

NC DENR - Div. Of Water Quality Reg on
OXICITY SAMPLE COLLECTION FORM page 1 of ARO FRO MRO RRO WaRO WiRO WSRO
Facility/Water Body �(�t 1 C�� %�'�Ci �(���' 1 tqkJ-(T — 7-diw 1 D F %i7OC e511,
NPDES # INC �O�O ( �`tt�q�ljoutfall# U
County D t Y 1 Basin/Sub-basin IIJ s
Receiving Stream RdchfvWs C-.,.-�-e
Collector(s) (print)
Grab Sample ❑ Composite Sample Composite Type:
❑ Constant Time/Constant Volume
low Proportional
`' Sampling Equipment Used: ❑ DWQ Portable Sampler or 2-facility's Sampler
Date
Time
Sampling Site
Description
Da/tee End
samples/hour for hours
Time End
st:
Container: E74 1 gal) PE cubitainer ❑Other (describe) # of containe
Chlorinated: 0 Yes ❑ No Collected on Ice or in Refrigerated Sampler: ❑' es ❑ No Shipped on Ice: es ❑ No
Method of Shipment: Courier ❑✓"'Bus ElStaff ElOther (explain):
Date/time of transfer to shipper or courier box: ' 9112 /
Comments:
P1111"Split" sample, splitting lab name.
Did DWQ staff 2erform. the s lit? t`- / If NO, then did DWQ staff witness the s lit?
� t
Date: N l L
Additional iaffiDle iiandler-Tecords:
Relinquished by:
Received by:
Date:
Time:
Relinquished by:
Received by:
Date:
Time:
Relinquished by:
Received by:
Date:
Time:
Relinquished by:
Received by:
Date:
Time:
DWQ/Environmental Sciences Section
Aquatic Toxicology Unit Use street address only if shipping FedEx or UPS
1621 Mail Service Center Street address: 4401 Reedy Creek Road
Raleigh, NC 27699-1621 Raleigh, NC 27607
ESS Courier #: 520101 phone: [phone]

. NC DVNR - Div. Of Water Quality Re 'on
OXICITY SAMPLE COLLECTION FORM a e 1 of ARO FRO MRO RRO WaRO WiRO
Facility/Water Body
NPDES # NC 0 0 l Outfall #
County lil Vl Basin/Sub-basin
Receiving Stream fi-I ct.'l
Collector(s) (print) �E ( 1 »V C,, 4
Grab Sample ❑ Composite Sample Composite Type:
❑ Constant Time/Constant Volume: samples/hour for
KY Ff ow Proportional
Sampling Equipment Used: ❑ DWQ Portable Sampler or ❑J�PvCclility's Sampler
Date Began Time
Sampling Site
Description
Date End Time End
13
hours
Container: E L (1 gal) PE cubitainer ❑Other (describe) - # of containers_
Chlorinated: ales ❑ No Collected on Ice or in Refrigerated Sampler: r° Yes ❑ No Shipped on Ice: �es ❑ No
Method of Shipment: Courier ❑ Bus ❑ Staff ❑ Other expl • ):
Date/time of transfer to shipper or courier box
Comments: : i
,:.
i t . _:
,J -"
`
`S lit" sample, splitting lab name
b
-_f ; E,
Did DWQ staff perform the split? t >
F i r r
_ ../
C/ If NO, then did DWQ staff witness the s lit?
.w
Collector(s)
Signature:
Date:
ALLLL111V11[ll Jw11
Relinquished by:
Received by:
Date:
Time:
Relinquished by:
Received by:
Date:
Time:
Relinquished by:
Received by:
Date:
Time:
Relinquished b :
Received by:
Date:
Time:
DWQ/Environmental Sciences Section
Aquatic Toxicology Unit
1621 Mail Service Center
Raleigh, NC 27699-1621
ESS Courier #: 520101
Use street address only if shipping FedFx or UPS
Street address: 4401 Reedy Creek Road
Raleigh, NC 27607
phone: [phone]

V��
1__
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Pat McCrory Charles Wakild, P. E. John E. Skvarla, III
Governor Director Secretary
March 26, 2013
Mr. John Grey PE
Grey Engineering, Inc.
P.O. Box 9
Mocksville, NC 27028
Subject: Pretreatment Annual Report (PAR) Review
(January 1, 2012 through December 31, 2012)
Town of Mocksville
NPDES Number: NCO021491
Davie County
Dear Mr. Grey:
The Winston-Salem Regional Office has reviewed the Pretreatment Annual Report covering January through December
2012. Our review indicates that the annual report is in good order and satisfies the requirements of 15A NCAC 2H
.0908(b) and the Comprehensive Guidance for North Carolina Pretreatment Pro ams. The next annual report will be
due March 1, 2014.
Per 15A NCAC 2H .0907 (e) "a pretreatment program is considered inactive when industrial users defined as significant
industrial users (SATs) no longer discharge to the POTW". Please submit a letter to the PERCS Unit indicating the Town
no longer has any SIUs.
Thank you for your continued cooperation with the Pretreatment Program. If you have any questions or comments, please
contact me at [phone] [email: [e-mail]].
Sincerely,
George S. Smith
Environmental Chemist
ATTACHMENT
cc: PERCS Unit
WSRO Files
North Carolina Division of Water Quality, Winston-Salem Regional Office
Location: 585 Waughtown Street, Winston-Salem, North Carolina 27107
Phone: 336-771,50001 FAX: [phone]
Internet: www.ncwatemualitv.om
Nne
orthCarohna
Iatura!!r�
An Equal Opportunity 1 Affirmative Action Employer

Regional Pretreatment Annual Report (PAR) Review
Is the PAR on time? Does it have two copies?
Did thPv cPnri arn/ nthor ci ihmiccinnc %AA4'k R-13
Included?
ADEQUATE?
POTW noted Corrections?
YES
❑
NO
❑ NA
®YES
❑
NO
❑ NA
PPS Form
YES
❑
NO
®YES
❑
NO
❑ YES
®
NO
® YES
NO
IDSF
❑ YES
❑
NO
❑ YES
NO
Allocation Table
Lj YES
❑
NO
❑ YES
❑
NO
Waste Reduction Info
❑ YES
❑
NO
❑ YES
❑
NO
❑ YES
❑
NO
® NA
❑ YES
❑
NO
®NA
❑ YES
❑
NO
® NA
❑ YES
❑
NO
® NA
® YES
❑
NO
® YES
❑
NO
❑ YES ® NO
❑ YES
❑
NO
® NA
❑ YES
❑
NO
® NA
❑ YES ❑ NO ® NA
Ifl
1. Have at least 90% of SIU permits been issued within 180 ❑Yes ❑ No ® Not req'd
days of expiration? See Allocation Table).
2. Were at least 80% of SIUs inspected? (See PPS Form) ❑ Yes ❑ No ®Not req'd
3. Has effective enforcement been taken against industries in 29 Yes ❑ No ❑ NA
SNC, including those causing pass -through or interference? (See
Narrative and SNCR Form
4. Does public notice cover all SIUs in SNC? ❑ Yes ❑ No ® NA
Note: Exceptions should be explained in the comment section below:
SNCR form was not included. There were no SIUs discharging into the POTW.
Reviewed By: George S. Smith
Regional Pretreatment Annual Report Review
mocksville form 12.par12
Date: March 26, 2013
Regional Office: WSRO
POTW: Town of Mocksville
NPDES Permit No. NCO021491
Report Period: 01/01/2012 - 12/31/2a
❑ Full ® Modified
For modified programs evaluate shaded item
only. A Narrative is required for a modified
program only if there are SIUs in SNC.
cfieckrecommendation below,-
] NOV El QNCR ❑ NCP
]-NOV ❑ QNCR ❑ NCP
] NOV JE1 QNCR ❑ NCP
NOV
QNCR ILA NCP
❑ Civil Penalty
Assessment
❑ Civil Penalty
Assessment
❑ Civil Penalty
Assessment
❑ Civil Penalty
Assessment
Fill in Values from
(PCS data)
SSNC
••. •
0
FENF
0
JUDI
0
SVPU
0
IUPN
0
SOCS
0
r

Mocksville Dutchmans Creek WWTP (NC 0021491)
Pretreatment Annual Report (PAR) for Calendar Year 2012
3/15/2013
Narrative
General Information:
Overall Program — Ref. the "Pretreatment Program Info Database Attached"
Contact Information Update:
The Acting Pretreatment Coordinator is Mr. John Grey, PE, Grey
Engineering, Inc., 254 West Water Street. Mocksville, NC 27028,
336-751-2110 (p), 336-751-6348 (f)
Status of Program Elements
HWA — Current (next due 4/1/2015); LTMP — Current (next due 8/1/2013);
IWS — Current (next due 1/30/2017); ERP — Current; PAR (2011)
submitted 3/1/2012; SUO — (submitted, responding to comments)
SIU Information
There were no SIUs discharging to Mocksville's Dutchmans Creek WWTP
in 2012. The Town is considering petitioning for closure of its
pretreatment program related to the Dutchmans Creek facility and
assignment of its Bear Creek drainage basin to Davie County's
Cooleemee wastewater pretreatment program.

printed on: 12/27/2012
for Program Name Moeksville
1WC 96 at TWO 37. 39
WWTP Name Dutchman
Program Approval Date 01/14/1985
c S / mgd 2.54 / 1.64
1010 Flow cfs / mgd 2.13 J 1.37
Pretreatment Status Modified
C
Stream Classification
Region W5R0
Basin Number YAD05
County Davie
Receiving Stream Name DUTCHMAN CRI=EK
NPDES Number NC0021491
NPDES Effective Date 05/01 /2010
Last PAR Rec 03/01/2012 PAR Due Date 03/01/2013 mercury
1631
NPDES Expire Date
p fl6(30/2014
Current Fiscal 04/24/2012 required '
Year PCI Done
POTW is Primary WWTR TRUE
Last Audit on 09/23/2008 Audit Year Next12/13Ir
Design Flow mgd 0.9800
% Design mgd is SIU permitted
12.24
Permitted SIU flow (mgd) [Pt_'SIU) 12
1
WWTP Slu s Program SIUs 11 �
WWTP CIU's Program'CIUsLJ
[late Received by DWQ 05l21!"1010
Adopt Date Required
H c �;'K Vi Ce1

I
Chapter 9, PAR Guidance
Pretreatment Performance Summary (PPS)
1.
Pretreatment Town Name: Mocksville
2.
"Primary" NPDES Number NC00 21 49 1
This Column
for office
or Non Discharge Permit # if applicable =>
use only
EPA
WENDB
3.
PAR begin Date, please enter 01/01/yy or 07/01/yy 3. => I/ 1/ 12
PSSD
4.
PAR end Date, please enter 06/30/yy or 12/31/yy 4. => 12/31/ 12
PSED
5.
Total number of SIUs, includes CIUs 5. =>
0
SIUS
6.
Number of CIUs 6. =>
crus
7.
Enter the Higher Number, either (7a) or (7b) here =>
0
NOIN
7a. Number of SIUs not sampled by POTW 7a. =>
0
7b. Number of SIUs not inspected by POTW 7b. =>
0
8.
Number of SIUs with no IUP, or with an expired IUP 8. =>
0
NOCM
9.
Total Number of SIUs in SNC due to either W Reporting violations or
IUP Limit violations. To avoid double counting some SIUs
Enter ( 9a + 9b) - 9c here =>
0
PSNC
Enter the Number of SIUs in SNC for:
9a. IU Reporting violations 9a. =>
0
MSNC
9b. IUP Limit violations 9b. =>
0
SNPS
9c. Both IU Reporting & Limit violations 9c. =>
0
10.
Number of SIUs in SNC due to IU Reporting violations
that were not sampled or inspected by POTW 10. =>
0
SNIN
11.
Number of SIUs in SNC due to violation of 11. =>
0
SSNC
Compliance Schedule due dates
12.
Number NOVs, NNCs, AOs, or similar assesed to SIUs 12. =>
0
FENF
13.
Number Civil or Criminal Penalties assessed to SIUs 13. =>
0
JUDI
14.
Number of SIUs included in public notice 14. =>
0
SVPU
15.
Number of SIUs from which penalties collected 15. =>
0
IUPN
16.
Total Amount of Civil Penalties Collected 16. => $ 0
17.
Total Number of SIUs on a compliance schedule 17. =>
0
socs
Foot Notes: AO Administrative Order NOV Notice of Violation
CIU Categorical Industrial User PAR Pretreatment Annual Report
CO Consent Order POTW Public Operated Treatment Works
IUP Industrial User Pretreatment Permit SIU Significant Industrial User
NNC Notice of Non -Compliance SNC Significant Non -Compliance,
formerly RNC
Chapter name: PAR Guidance File name: PAR PPS.xls Revision date: August 1, 1994 Comprehensive Guide, Chapter 9, Section B.

AM9=
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Charles Wakild, P. E.
Governor Director
Ms. Christine W. Bralley, Town Manager
Town of Mocksville
171 Clement Street
Mocksville, NC 27028
SUBJECT:
Dear Ms. Sanders:
May 1, 2012
Pretreatment Compliance Inspection
Town of Mocksville
NPDES #NC0021491
Davie County
Dee Freeman
Secretary
On April 24, 2012 George Smith, of this office, performed a Pretreatment Compliance Inspection (PCI). Mr.
John Grey and Ms. Joy Howard were present for the inspection. The purpose of this inspection was to determine
the effectiveness of the pretreatment program, which includes: reviewing the files, POTW plant performance,
monitoring data, and adherence to the enforcement response plan (ERP).
Background
The Town has one WWTP (Dutchman's Creek) on the pretreatment program with a 0.68 MGD permitted flow.
POTW Interview
Omtron USA, LLC is doing business as Townsends. The industry is closed. Currently there are zero significant
industrial users on the pretreatment program.
Program Elements
The Headworks Analysis (HWA) was approved on September 24, 2010. The next HWA is due April12015.
The Industrial Waste Survey (IWS) was approved February 20, 2012. The next IWS is due January 30, 2012.
The Sewer Use Ordinance (SUO) was last approved on February 23, 2011. The SUO revision is due December
31, 2012.
The Enforcement Response Plan (ERP) was last approved on June 15, 2010.
Short Term Monitoring Plan (STMP) for the Dutchman's Creek WWTP was approved July 1, 2010. An update
for the STMP is due August 1, 2013.
North Carolina Division of Water Quality, Winston-Salem Regional Office
Location: 585 Waughtown St. Winston-Salem, North Carolina 27107 One
Phone: [phone] FAX: [phone] NorthCarolina
Internet: www.ncwaterquality.org a'ahma li
An Equal Opportunity 1 Affirmative Action Employer An
Bi ``!✓1

Pretreatment Compliance Inspection
May 1, 2012
Page 2 of 2
Industrial User Permit (IUP) File Review
Townsends (#0003) is not operating and no wastewater is being discharged.
Action Items
1. There must be an interjurisdictional agreement (IJA) between Davie County and Town of Mocksville in
order to legally implement the pretreatment program. This must be submitted to Monti Hassan, PERCS
Unit. I forwarded two agreement models via email to you on May 1, 2012. Ms. Beth Dirks also has the
models.
2. Since the Town no longer has any significant industrial users, you may request, in writing, to the PERCS
Unit that the pretreatment program be inactivated. You must include documentation that Townsends no
longer wants the pretreatment permit or demonstrate that the Town made a reasonable effort to contact
the industry.
The pretreatment compliance inspection is considered satisfactory. Mr. John Grey is going a very good job
implementing the pretreatment program. If you have any questions, please contact George Smith or me at (336)
771-5000.
Sincerely,
-24�
W. Corey Basinger
Regional Supervisor
ATTACHMENT
cc: Mr. John Grey, 254 W. Water Street, Mocksville, NC 27028
PERCS Unit — Monti Hassan
WSRO Files

NORTH CAROLINA DIVISION OF WATER QUALITY
PRETREATMENT COMPLIANCE INSPECTION (PCI) REPORT
BACKGROUND INFORMATION 1Comnlete Prior To PCI: Review Program Info Database Sheets
1. Control Authority (POTW) Name: '%pw✓1
2. Control Authority Representative(s): I -oh n Grc,� �ny Clow,r,�d
3. Title(s): r✓�2r,oZrned—Z COWL Arot'
_ 1M�n�3Tr�crv� A,sisre..,c
4. Last Inspection Date: S9125-/// Inspection Type (Check One): ®'*I ❑ Audit
5. Has Program Completed All Requirements from the Previous Inspection and Program Info Sheet(s)? ❑ YES DIN-10
6. Is POTW under an Order That Includes Pretreatment Conditions? ❑ YES �O lud 174
Order Type, Number, Parameters: 1VAre Milestone Dates Being Met? ❑ YES ❑ NO
PCS CODING
Trans.Code Main Program Permit Number MM/DD/YY Inspec.Type Inspector Fac. Type
I—N I I N I C 1 0 to I1I11gI?I l I y Iayl14 1 P 1 J S 1
(DTIA) (TYPI) (INSP)
1 I
(FACC)
7. Current Number Of Significant Industrial Users (SIUs)?
O
SIUS
8. Current Number Of Categorical Industrial Users (CIUs)?
O
CIUS
9. Number of SIUs Not Inspected By POTW in the Last Calendar Year?
Q
10. Number of SIUs Not Sampled By POTW in the Last Calendar Year?
0
11. Enter the Higher Number of 9 or 10
0
NOIN
12. Number of SIUs With No IUP, or With an Expired ]UP TDWAJRAJA
/
NOCM
13. Number of S1Us in SNC for Either Reporting or Limits Violations During Either of the Last 2
Semi -Annual Periods (Total Number of SIUs in SNC)
O
PSNC
14. Number of SIUs in SNC For Reporting During Either of the Last 2 Semi -Annual Periods
1 O
MSNC
15. Number of SIUs In SNC For Limits Violations During Either of the Last 2 Semi -Annual Periods�l
0
SNPS
16. Number of SILTS In SNC For Both Reporting and Limits Violations During Either of the Last 2
Semi-annual Periods
O
POTW INTERVIEW
17. Since the Last PCI, has the POTW had any NPDES Limits Violations?
If Yes, What are the Parameters and How are these Problems Being Addressed?
18. Since the Last PCI, has the POTW had any Problems Related to an Industrial
Discharge (Interference, Pass -Through, Blockage, Citizens' Complaints, Increased
Sludge Production, Etc.)?
If Yes, How are these Problems Being Addressed?
19. Which Industries have been in SNC for Limits or Reporting during SNC for
either of the Last 2 Semi -Annual Periods? Not Been Published for SNC for
Public Notice?(May refer to PAR if Excessive SIUs in SNC) Not Pu
20. Which Industries are on Compliance Schedules or Orders? For all SIUs on an
Order, Has a Signed Copy of the Order been sent to the Division?
21. Are Any Permits Or Civil Penalties Currently Under Adjudication? If Yes, Which
Ones?
El YES O
❑ YES NO
Limits: I
Reporting:
blished:
All
❑ YES O
LTMP/STMP FILE REVIEW:
22. Is LTMP/STMP Monitoring Being Conducted at Appropriate Locations and Frequencies? " YES ❑ NO
23. Are Correct Detection Levels being used for all LTMP/STMP Mon torin[-[Ig? 4ES NO /
24. Is LTMP/STMP Data Maintained in a Table or Equivalent? S El NO Is T ble Adequate? i 'ES ❑ NO
25. All LTMP/STMP effluent data reported on Discharge Monitoring Report'.) YES ❑ NO :DWQ Inspector, please verify
yourself!
26.
27.
If NO to 23 - 26, list violations_ _ _ N /l3
Should any Pollutants of Concern be Eliminated from or Added to LTMP/STMP? ❑ YES 94,
If yes, which ones? Eliminated: Al lt, - Added: w /4
NC DWQ Pretreatment Compliance Inspection (PCI) Form Updated 7/25/07 Page 1

28. PRETREATMENT PROGRAM ELEMENTS REVIEW- Please review POTW files, verify POTW has copy of Program
Element in their files, complete with supporting documents and coax of PERCS Annroval Letter, and dates consistent with Program Info:'
Program Element
Last Submittal
Date In file?
Last Approval
Date In file
Date Next Due,
If Applicable
Headworks Analysis A
❑ Yes ❑ No
Szr 1Y, 1(,10
RYes ❑ No
PPr / , aorS
Industrial Waste Survey S
❑ Yes ❑ No
F-,b • p of
[]"Yes ❑ No
j,.rt 30 ),al
Sewer Use Ordinance SUO
❑ Yes ❑ No
Fb jq,ka
2 Yes ❑ No
tic 9 0(
Enforcement Response Plan RP
❑ Yes ❑ No
vtun /S d010
[]'Yes ❑ No
b _7 Term Monitoring Plan JTMP)
❑ Yes ❑ No
hulk 1 �ol��
Yes ❑ No
INDUSTRIAL USER PERMIT (IUP) FILE REVIEW (3 IUP FILE REVIEWS OR 1 FILE REVIEW AND 1 IU INSPECTION)
29. User Name
1. G ✓42.
3.
30. IUP Number
1 000
31. Does File Contain Current Permit?
I ❑ Yes No
FQ
Yes ❑ No
❑Yes ❑ No
32. Permit Expiration Date
Tin l a 01
33. Categorical Standard Applied (I.E. 40 CFR, Etc.) Or N/A
34. Does File Contain Permit Application Completed Within One Year Prior
❑ Yes No
❑Yes ❑ No
ElYes ElNo-
to Permit Issue Date?
�l/
ll
11
35. Does File Contain an Inspection Completed Within Last Calendar Year?
I��-zNo
❑ Yes ❑ No 11
❑ Yes ❑
No
36. a. Does the File Contain aSlug/Spill. Control Plan?
a. o
a. ❑Yes ❑No
a. ❑Yes ONO
b. If No, is One Needed? (See Inspection Form from POTW)
b. 7OYes o
b. ❑Yes ❑No
b. ❑Yes ❑No
37. For 40 CFR 413 and 433 TTO Certification, Does File Contain a Toxic
❑Yes❑No /AF
❑Yes❑No❑N/A
❑Yes❑No❑N/A
Organic Management Plan (TOMP)?
38. a. Does File Contain Original Permit Review Letter from the Division?
a. ❑Yes ❑No
a. ❑Yes ❑No
a. ❑Yes ❑No
b. All Issues Resolved?
b.❑Yes❑No /A
b.❑Yes❑No❑N/A
b.❑Yes❑No❑N/A
39. During the Most Recent Semi -Annual Period, Did the POTW Complete
o
❑ Yes ❑ No
❑ Yes ❑ No
its Sampling as Required by IUP, including flow?
40. Does File Contain POTW Sampling Chain -Of -Custody Forms?
I-EFYurf3-we-11
❑ Yes ❑ N7ol
❑ Yes ❑ No
41. During the Most Recent Semi -Annual Period, Did the SIU Complete its
❑Yes❑No A
DYesElNoDKI
❑Yes❑No❑N/A
Sampling as Required by IUP, including flow?
41 b. During the Most Recent Semi -Annual Period, Did SIU submit all reports
❑Yes❑No /A
❑Yes❑No❑N/A
❑Yes❑No❑N/A
on time?
42a. For categorical IUs with. Combined Wastestream Formula (CWF), does
❑Yes❑No /A
❑Yes❑No❑N/A
❑Yes❑No❑N/A
file includeprocess/dilution flows as Required by IUP?
42b. For categorical IUs with Production based limits, does file include
❑Yes❑No /A
o❑N/A
production rates and/or flows as Required by IUP?
[❑7o[:]N/A j[-EVTs❑
43a. During the Most Recent Semi -Annual Period, Did the POTW Identify
o
❑ Yes ❑ No
❑ Yes ❑ No
All Limits Non -Compliance from Both POTW and SIU Sampling?
43b. During the Most Recent Semi -Annual Period, Did the POTW Identify
OYesONoU>KA
❑Yes❑No❑N/A
❑Yes❑No❑N/A
All Re m Non -Compliance from SIU Sampling?
44. a. Was the POTW Notified by SIU (Within 24 Hours) of All Self-
a.❑Yes❑No A
a.❑Yes❑No❑N/A
a.❑Yes❑No❑N/A
Monitoring Violations?
b.❑Yes❑NoMN/A
b. Did Industry Resample and submit results to POTW Within 30 Days?
b.❑Yes❑No❑N/A
b.❑YesciNo❑N/A
c. If applicable, Did POTW resample within 30 days of becoming aware
of SIU limit violations in the POTW's sampling of the SIU?
c.❑Yes❑NoaW//A
c.❑Yes❑No❑N/A
c.❑Yes❑No❑N/A
46. During the Most Recent Semi -Annual Period, Was the SIU in SNC?
❑ Yes ❑ No 11
❑ Yes
❑
No
47. During the Most Recent Semi -Annual Period, Was Enforcement Taken
OYesONoW
DYesONoO T111
❑Yes❑No❑N/A
as Specified in the POTW s ERP (NOVs, Penalties, timing, etc.)?
I
48. Does the File Contain Penalty Assessment Notices?
❑Yes❑No /A
I ❑Yes❑No❑N/A
I ❑Yes❑No❑N/A
49. Does The File Contain Proof Of Penalty Collection?
❑Yes❑No A
❑Yes❑No❑N/A 11
❑Yes❑No❑N/A
50. a. Does the File Contain Any Current Enforcement Orders?
a.❑Yes❑No /
❑Yes❑No❑N/A
Fb
a.❑Yes❑No❑N/A
b. Is SIU in Compliance with Order?
b.❑Yes❑No /A
❑Yes❑No❑N/A
b.❑Yes❑No❑N/A
51. Did the POTW Representative Have Difficulty in Obtaining Any of This
❑ Yes o
❑Yes ❑ No
❑ Yes ❑ No
Requested Information For You?
NC DWQ Pretreatment Compliance Inspection (PCI) Form Updated 7/25/07 Page 2

F&E REVIEW COMMENTS:
INDUSTRY INSPECTION PCS CODING:
Trans.Coa&- Main Program Permit Number MM/DD/YY Inspec.Type Inspector Fac. Type
I-N I 1 I 11 1-I l 1 S 2
(DTIA) (TYPI) (INS (FACC)
1. Industry Inspected:
2. Industry Address:
3. Type of Industry/Product:
4. Industry Contact: Title: /
Phone:
5. Does the POTW Use the Division Model Inspection Fo or uivalent? ❑ YES ❑ NO
6. Did the POTW Contact Conduct the Following Parts a In strial Inspection Thoroughly?
Comments:
A. Initial Interview ❑ YES ❑
B. Plant Tour ❑ YES NO
C. Pretreatment Tour ❑ ❑ NO
D. Sampling Review YES ❑ NO
E. Exit Interview ,�� []YES ❑ NO
Industrial Inspection Comments:
OVERALL SUMMARY AND COMMENTS:
Comments: & t kaw< e j T o w ✓t d- d .ti Lei✓n 1- f
Requirements: ConcgcT /niftn 1 to dxrtrmo„4 !i rL.V sod/ w,t„z- a StV igeev,c
Recommendations:
NOD: [—]YES M40
NOV: ❑ YES ENO
QNCR: ❑ YES j' O
POTW Rating:
Satisfactory_ Marginal Unsatisfactory
PCI COMPLETED BY: ��� DATE
NC DWQ Pretreatment Compliance Inspection (PCI) Form Updated 7/25/07 Page 3

Aja
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Charles Wakild, P. E.
Governor Director
April 19, 2012
Grey Engineering, Inc
Attn: John Grey
Town of Mocksville
P. O. Box 9
Mocksville, NC 27028
Subject: Pretreatment Annual Report (PAR) Review
(January 1, 2011 through December 31, 2011)
Town of Mocksville
NPDES Number: NCO021491
Davie County
Dear Mr. Grey:
Dee Freeman
Secretary
The Winston-Salem Regional Office has reviewed the Pretreatment Annual Report covering January through
December 2011. Our review indicates that the annual report is in good order and satisfies the requirements of
15A NCAC 2H .0908(b) and the Comprehensive Guidance for North Carolina Pretreatment Programs. The
next annual report will be due March 1, 2013.
Thank you for your continued cooperation with the Pretreatment Program. If you have any questions or
comments, please contact me at [phone] [email: [e-mail]].
Sincerely,
George S. Smith
Environmental Chemist
ATTACHMENT
cc: PERCS Unit
WSRO Files
North Carolina Division of Water Quality, Winston-Salem Regional Office
Location: 585 Waughtown St. Winston-Salem, North Carolina 27107
Phone: [phone] FAX: [phone]
Internet: www.ncwaterquality.org
An Equal Opportunity 1 Affirmative Action Employer
NorthCarolina
Natura!!'ff

Regional Pretreatment Annual Report (PAR) Review
Is the PAR on time? Does it have two copies?
Did they send any other submissions with it?
Included?
ADEQUATE?
POTW noted Corrections?
® YES
❑
NO
❑ NA
® YES
❑
NO
❑ NA
PPS Form
® YES
❑
NO
® YES
❑
NO
® YES
❑
NO
® YES
❑
NO
IDSF
❑ YES
❑
NO
❑ YES
❑
NO
Allocation Table
❑ YES
❑
NO
❑ YES
❑
NO
Waste Reduction Info
❑ YES
❑
NO
❑ YES
❑
NO
❑ YES
❑
NO
® NA
❑ YES
❑
NO
® NA
❑ YES
❑
NO
® NA
❑ YES
❑
NO
® NA
® YES
❑
NO
® YES
❑
NO
❑ YES ® NO
® YES
❑
NO
❑ NA
® YES
❑
NO
❑ NA
❑ YES ® NO ❑ NA
Regional Office: WSRO
POTW: Town of Mocksville
NPDES Permit No. NCO021491
Report Period: 01/01/2011 - 12/31/201
❑ Full ® Modified
For modified programs evaluate shaded items
only. A Narrative is required for a modified
program only if there are SIUs in SNC.
If No, check recommendation below.-
1. Have at least 90% of SIU permits been issued within 180
❑ Yes ❑ No ® Not req'd
❑ NOV
❑ QNCR
❑ NCP
❑ Civil Penalty
days of expiration? See Allocation Table).
Assessment
2. Were at least 80% of SIUs inspected? (See PPS Form)
❑ Yes ❑ No ® Not req'd
❑ NOV
❑ QNCR
❑ NCP
❑ Civil Penalty
Assessment
3. Has effective enforcement been taken against industries in
® Yes ❑ No El NA
❑ NOV
❑ QNCR
❑ NCP
❑ Civil Penalty
SNC, including those causing pass -through or interference? (See
Assessment
Narrative and SNCR Form
4. Does public notice cover all SIUs in SNC?
❑ Yes ❑ No ® NA
❑ NOV
❑ QNCR
❑ NCP
❑ Civil Penalty
Assessment
(Vote: exceptions Snouia De expiainea in the comment Section Deiow:
Fill in Values frorn
PPS Form
data)
SSNC
0
FENF
1
JUDI
0
SVPU
0
IUPN
0
SOCS
0
Reviewed By: George S. Smith Date: April 19, 2012
Regional Pretreatment Annual Report Review
mocksville form 1 Lpar12

Smith, George
From: Joy Howard [e-mail]]
Sent: Tuesday, March 20, 2012 3:17 PM
To: Hassan, Monti
Cc: Smith, George
Subject: Davie County SIU update
Attachments: Declassification Package 2-29-12.pdf; Non Contact Cooling Water Package 2-29-12.pdf
Hi Monti:
Please see the emails below indicating that Ingersoll Rand, Davie County's only current SIU has proven to us that they no
longer qualify to be classified as a categorical user 433 metal finisher. They have also submitted sufficient evidence that
their non -contact cooling water is acceptable for discharge directly into the sanitary sewer. Copies of both submissions
are attached for your records.
We believe that due to the process changes at Ingersoll Rand and significantly reduced flow that they may be producing
wastewater that on a mass basis no longer requires them to be regulated by pretreatment rules. Please direct me to
any updated standards that are available for review to determine the need for their continued participation in the
program.
As of now, they continue to capture and remove all wastewater via Shamrock environmental until further testing of
pretreatment processes and determination of requirements are complete.
Thank you.
jh
Job toward
projectAdwi.inv strator
C.,re1J. E-neiweeriwe, Inc.
336-751-2110
From: Annie, Christin [mailto:[e-mail]]
Sent: Tuesday, March 20, 2012 8:17 AM
To: John Grey
Cc: Christine Bralley; Joy Howard
Subject: RE: RE:
Thank you for that clarification!
From: John Grey [mailto:[e-mail]]
Sent: Tuesday, March 20, 2012 8:16 AM
To: Annie, Christin
Cc: Christine Bralley; Joy Howard
Subject: Re: RE:
Thanks Christin.

By the way, there is a critical typo in my previous email to you that you probably noticed. You may not
discharge "stormwater" but may instead discharge properly regulated "non -contact cooling water". Sorry for
any confusion.
John
On Mar 20, 2012, at 7:31 AM, "Annie, Christin" <CANNIEr?irco.com> wrote:
John and Joy,
This is wonderful news. Thanks to you both for all the hard work and effort in assisting us through the
process!
From: John Grey [mailto:[e-mail]]
Sent: Monday, March 19, 2012 3:34 PM
To: Annie, Christin
Cc: Christine Bralley
Subject:
Christin,
We have reviewed your submission with respect to Categorical declassification and agree that you are no
longer a Categorical discharger.
We have further reviewed your process work and revisions aimed at allowing direct discharge of your non
contact cooling water to the Town's sewer system. You have satisfied our requirements and the
discharge may proceed with our approval.
We will redraft your pretreatment permit to reflect the above referenced changes and delete extraneous
testing.
You may discharge stormwater in accordance with the limits proposed in your communication while we
complete final permit revision which should be in place by the end of next week.
Thanks for your environmental awareness and proactive attitude. You are an inspiration.
John
John Grey
Grey Engineering, Inc.
Phone: [phone]
Fax: [phone]
The information contained in this message is privileged and intended only for the recipients named. If the reader is not a representative of the
intended recipient, any review, dissemination or copying of this message or the information it contains is prohibited. If you have received this
message in error.. please immediately notify the sender. and delete the original message and attachments.

The information contained in this message is privileged and intended only for the recipients named. If the reader is not a representative of the intended recipient.
any review, dissemination or copying of this message or the information it contains is prohibited. If you have received this message in error, please immediately
notify the sender, and delete the original message and attachments.

Mocksville Operations
501 Sanford Avenue
Mocksville, NC 27028
Tel [phone]
February 29 1h 2012
John Grey, PE
Town of Mocksville Pretreatment Coordinator
171 Clement Street
Mocksville, North Carolina 27028
Reference: Non -Contact Cooling Water Re-routing Project
Dear Grey Engineering,
Please find the attached requested information for the non -contact cooling water rerouting
project at Ingersoll Rand - Mocksville. Included in this package is a description of how the
system functions, maximum limits for various constituents, and flow diagram.
Please let us know the next step(s) in pursuit of this request. Feel free to contact Christin Annie
(EHS Manager) at 336-751-6895 or [e-mail].
Thank you,
Christin Annie
EHS Manager

> Ingersoll band
Industrial Technologies
Mocksville Operations
501 Sanford Avenue
Mocksville, NC 27028
Tel [phone]
Our proposed non -contact cooling water management program is a three layered
approach, which will ensure acceptable limits are maintained with the Town of Mocksville while
reducing waste water treatment costs for Ingersoll Rand in an environmentally responsible
manner.
1. Existing cooling tower systems have been upgraded with the following:
a. Upgraded controls
b. Mechanical improvements
c. Passivation
d. Remote monitoring integration allowing greater control of chemistry programs
and minimizing the introduction of dissolved metals (Zn) into the bulk water
2. Aqualine's formula 4800IP has been modified to 4800IP-G-Mo. The new formula
contains approximately 93% less phosphate and all Molybedenum has been removed.
3. The bleed fora all cooling towers is being routed through the AX Water Management
Center for monitoring and disinfection. The center will monitor:
a. Discharge water volume
b. Conductivity
c. pH
d. Total Cl-
Discharge limits based on these parameters have been established with the Town of
Mocksville during previous communications and are the following:
• Total Cl- (3 ppm)
• Phosphate — (10 ppm) monitored and trended on a monthly basis
• Flow — (10,000 gallons per day)
• All other limits will remain below the parameters set forth by the Town of
Mocksville as shown below:
Parameter
m 1
BOD
250
TSS
250
Ammonia
17
Arsenic
0.003
Cadmium
0.003
Chromium
0.05
Copper
0.061
Cyanide
0.041
Lead
0.049
Mercury
0.0003
Molybdenum
0.0031
Nickel
0.021
Selenium
0.005
Silver
0.005
Zinc
0.9551
2

d)ln ers ll Rand
Industrial Technologies
Mockaville Operations
501 Sanford Avenue
Mocksville, NC 27028
Tel [phone]
Additionally, the control center has been has been programmed to automatically stop
discharges to sanitary before it exceeds the discharge limits. The system is also capable
of providing retrievable data and trend analysis.
Field testing will be required once permission is gained to place the new system on-line
to establish set points. The phosphate will be controlled by bleeding the cooling towers before
they cycle the incoming phosphate above the field verified level. This will be done by
monitoring each tower's conductivity and controlling inhibitor feed based on make-up.
Additionally, the combined discharges will be monitored by the water management center
conductivity and monthly verification of Phosphate levels. It would require a triple failure in the
program to violate the discharge limit. Should this method of controlling Phosphate not meet
standards, additional chemical changes and phosphorus monitoring methods are available and
reserved as a back-up to this plan.
The total daily water discharged will not be allowed to exceed 1.0,000 gallons per day via
a daily totalizer on the water management center. Finally, in the event of a loss of power to the
controller the discharge valve fails shut. Any overflow or water that does not meet limits can be
directed to the waste water treatment building.
Please find included in this package the drawings to include:
• Flow diagram
• Skid design layout

1. CHEMISTRY: New Green Inhibit reduced Phosphate by 93% all Molybdenum Removed
2. COOLING TOWER MAINT: Cooling Towers are tested monthly, pacified and or coated to minindm Zinc
3. COOLING TOWER CONTROLS: Monitor pH, Cond. ORP, MN Water Meters and Bised Water Meters.
A. BLEED: Bleed set point will be set to prevert exceeding PO4 limit.
5. COMBINED SUMP: Broad from all cooling towers Is routed to the combined sump. Overflow goes to on
aite waste water beet, ent
6. HOLDING TANK: Water in holding tank is circulated through AX Water Management Center for monitoring
and disinfection.
7. AX WATER MANAGEMENT CENTER: monitors discharge water volume, concludvity, pH, and Total Ci-.
Control canter programmed to autornatfcaly atop discharges to sanitary before exceeding discharge emits.
OVERFLOW
WASTE
TO COMBINED SUMP WATER
TREATMENT
COMBINED SUMP PUMP AND HOLDING TANK BY OTHERS
COOLING TOWERS
2'-6-
3
0
le
4
w
1RC TO DAY TANK
t>r
TCLSAMPLE RETURN II <
TO SANITARY
TAG DESCRIPTION
1 #1 SS BAG FILTER
2 ULTRAVIOLET DISINFECTION
3 pH SENSOR
4 CONDUCTIVITY SENSOR
5 TOTAL CL- SENSOR
6 3-WAY VALVE 1-1/2" CISTERN RECIRC
7 THROTTLE VALVE
8 WATER METER
9 POWER CABINET
10 CONTROLS CABINET
lTT1TTTT
0

ol
I 1 /2"RECIRC TO DAY TANK
1-1/2" INLET
FROM DAY TANK 3/4!
T Cl- SAMPLE RETURN
"
7
1 1 /2".OUTLET
TO SANITARY
t
2' - 6'�
3
AY TANK
5
9
10
S`
MECHANICAL
TAGDESCRIPTION
QTY.
j
Mkt SS BAG FILTER
IB

Mocksville Dutchmans Creek WWTP (NC 0021491)
Pretreatment Annual Report (PAR) for Calendar Year 2011
3/1 /2012
Narrative
General Information:
Overall Program — Ref. the "Pretreatment Program Info Database Attached"
Contact Information Update:
The Acting Pretreatment Coordinator is Mr. John Grey, PE, Grey
Engineering, Inc., 254 West Water Street. Mocksville, NC 27028,
336-751-2110 (p), 336-751-6348 (f)
Status of Program Elements
HWA — Current (next due 4/1/2015); LTMP — Current (next due 8/1/2013);
IWS — Current (next due 1/30/2017); ERP — Current; PAR (2010)
submitted 2/23/2011; SUO — Current (next due 12/31/2012)
SIU Information
The Town of Mocksville's only SIU, Omtron USA, LLC d/b/a Townsends
(formerly known as Crestwood Farms) ceased production on 8/1 /2011.
Since that date, there has been no process water discharged to the Town
of Mocksville's Dutchmans Creek WWTP. Flow and sampling records
from January 1 — July 28, as well as Compliance Judgment Worksheets
for January 1-June 30 and July 1 — July 28 indicate that the SIU was not in
SNC during 2011. There were a total of 13 limit violations for BOD (25%).

Pretreatment Program Info Database printed on: 1 /25/2012
for Program Name MockSVllle
IWC % at 7010 37.39
WWTP Name Dutchman
.,.,� cFs /mgd 2.54 / 1.64
Program Approval Date 01/14/1985
1 Q10 Flow cfs / mgd 2.13 / 1.37
Pretreatment Status Modified
Stream Classification C
Region WSRO
Basin Number YAD05
County Davie
Receiving Stream Name DUTCHMAN CREEK
NPDES Number NCO021491 .
Last PAR Rec
PAR Due Date 03/01/2012 � mercury
NPDES Effective Date 05/01/2010
1931
NPDES Expire Date 06/30/2014
Current Fiscal
Year PCI Done
required
y�
POTW is Primary WWTP TRUE
Last Audit on
09/23/2008 Audit Year Next12/13
Design Flow mgd 0-9W)0 % Design mgd is SIU permitted
12.24
Permitted SIU flow (mgd) [Pt SIU) ..12
WWTP SIU's 1 Program SIUs 1
g
0
� � ;. R.. .
::x .:.::.::,x ; x
WWTP CIU's Program CIUs
4.
::....
date Inactive , b t ,l eitt Ciu
i7 10 t/2015
Q8/01fY43 f�1f3 I/Z012 :; I2/3 f}12:..
Date Received by DWQ
05/21/2010
05/03/2010 01/23t2007 01/31/2007 04/28/2010
Appf
`t9t24Q1U:.%;>:.
:.::.:.::.::....:...... ......
07/011t#/3112007 U2/1f200T 06/15F2Q�b
Adopt Date Required
:.
°doled
DWQ Central Office Contact Monti Hassan
DWQ Regional Contact f5eorge Smith

Chapter 9, PAR Guidance
Pretreatment Performance Summary (PPS)
1. Pretreatment Town Name: Mocksville
2. "Primary" NPDES Number NC00 21 49 1 This for office Column
or Non Discharge Permit # if applicable => use only
EPA
WENDB
3. PAR begin Date, please enter 01/01/yy or 07/01/yy 3. => 1/ 1/ 11 PSSD
4. PAR end Date, please enter 06/30/yy or 12/31/yy 4. => 12/31/ 11 PSED
5. Total number of SNs, includes CIUs 5. => 1 SIUS
6. Number of CIUs 6. => CIUS
7. Enter the Higher Number, either (7a) or (7b) here => 0 NOIN
7a. Number of SIUs not sampled by POTW 7a. => 0
7b. Number of SIUs not inspected by POTW 7b. => 0
8. Number of SIUs with no IUP, or with an expired IUP 8. => 0 NOCM
9. Total Number of SIUs in SNC due to either N Reporting violations or
IUP Limit violations. To avoid double counting some SIUs
Enter ( 9a + 9b) - 9c here => 0 PSNC
Enter the Number of SIUs in SNC for
9a. IU Reporting violations 9a. => 0 MSNC
9b. IUP Limit violations 9b. => 0 SNPS
9c. Both IU Reporting & Limit violations 9c. => 0
10. Number of SIUs in SNC due to IU Reporting violations
that were not sampled or inspected by POTW 10. => 0 SNIN
11. Number of SNs in SNC due to violation of 11. => 0 SSNC
Compliance Schedule due dates
12. Number NOVs, NNCs, AOs, or similar assesed to SIUs 12. => 1 FENF
13. Number Civil or Criminal Penalties assessed to SIUs 13. => 0 JUDI
14. Number of SIUs included in public notice 14. => 0 SVPU
15. Number of SNs from which penalties collected 15. => 0 IUPN
16. Total Amount of Civil Penalties Collected 16. => $ 0
17. Total Number of SIUs on a compliance schedule 17. => 0 SOCS
of Notes: AO Administrative Order NOV Notice of Violation
CIU Categorical Industrial User PAR Pretreatment Annual Report
CO Consent Order POTW Public Operated Treatment Works
IUP Industrial User Pretreatment Permit SIU Significant Industrial User
NNC Notice of Non-ConlDliance SNC Sienificant Non -Compliance. formerlv RNC
Chapter name: PAR Guidance File name: PAR PPS.xls Revision date: August 1, 1994 Comprehensive Guide, Chapter 9, Section B.

GREY
ENGINEERING, INC.
Omtron dba Crestwood Farms LLC
Mr, Jim Harrison, Plant Manager
254 Eaton Road
Mocksville, NC 27028
Re: Notice of Violation — Significant Non Compliance
Wastewater Pretreatment Program
Town of Mocksville
Rear J im:
3/ 13/2011
This is a Notice of Violation required under the Town's Wastewater Pretreatment Program for January 1,
2011 through February 17, 2011.
Daily BOD Limit: 650 Ibs
Date BOD Exceedence in lbs.
6-Jan-2011
298.68
13-Jan-2011
596.65
20-Jan-2011
314.85
1-Feb-2011
881.87
3-Feb-2011
747.56
10-Feb-2011
508.41
These exceedences (43% of values in excess of 140% of the BOD limit) place Crestwood in a
compliance category entitled SIGNFICANT NON COMPLIANCE.
l (John Grey) met with you (Jim Harrison) and Eric Ivey on Thursday, December 23, 2010 and again on
Thursday, December 30, 2011 to discuss a variety of issues regarding Crestwood discharges; especially
the need to remain compliant while the Town seeks to support Crestwood in its expansion plans. These
discussions appear to have failed to move Crestwood toward compliance.
The Town is required by State and Federal regulations to take necessary steps to bring Crestwood into
compliance and to avoid pass through of pollutants into Dutchmans Creek. Lacking other effective
actions to regulate Crestwood's discharges, the Town is required to eliminate the discharge by
terminating water service to Crestwood.
Until Crestwood becomes compliant, you are required to provide sampling results for ail parameters every
two weeks. If Crestwood remains in Significant Non Compliance, water service will be terminated.
Sincerely,
John Grey, PE
Grey Engineering, Inc.
Cc: Hank Van Hoy, Mocksville Attorney
David Purtle
Eric Ivey
C�i
Christine Bralley
Mocksville Town Manager
-7c4 coAS - ..-•n.,r..,,,nnninaorinn rnm

GREY
ENGINEERING, INC.
Omtron USA LLC
d/b/a Townsends
22855 DuPont Blvd.
Georgetown, DE 19947
Re: Crestwood Farms Wastewater Discharges
Dear Mr. Purtle:
3/13/2011
As you confront the other challenges of completing the acquisition of Townsends, Inc.
please be aware that the Crestwood Farms Mocksville facility is facing both an
opportunity and a significant challenge.
The opportunity is to benefit from approximately $750,000 in grant funding to.support
wastewater pretreatment enhancements. The enhancements include a new pump
station to transfer Crestwood wastewater to a different treatment facility that can support
higher discharge limits and delivery and installation of a larger DAF treatment module.
The challenge is represented in the included Notices of Violation that indicate that the
Crestwood facility was.reasonably compliant in 2010 by has been significantly non
compliant in 2011. The Town's wastewater pretreatment program is a state mandated
program operating under federal guidelines. State and Federal rules will require that the
Town take extraordinary actions to remove Crestwood from significant non compliance.
The Town has arranged to expedite installation of the larger DAF unit and an additional
point of solids disposal. Delivery and installation of that system can be accomplished
approximately 4 weeks after order and will require a weekend shutdown. Construction
of the pump station will take approximately 6 to 9 months.
I called your office and requested that you contact me regarding this situation but have
not heard from you. I hope that I.can brief you more fully on the situation here and that
the Town can support rather than inhibit Crestwood's growth.
Please understand that the Town is required to execute its responsibilities under the
Pretreatment program.
Sincerely,
John Gre , PE
Pretreatment Coordinator
Cc: Hank Van Hoy, Town Attorney
Jim Harrison
Eric Ivey
rX4
Christine Brall y
Town Manager
11n M-.. h AA..-1.«.::IFS klrl ML--_.. lnn11%'7 A IAAn _ VA nnAm .._._.. ._..«....�- .:.... ...�.�.+

Compliance Judgement Worksheet For SNC With Limits
Use separate sheets for each Industry SNC determination for Flow optional, see Section 7-E Use separate sheets for each Pollutant
SIU Name: Crestwood Farms
IUP Number: 0003
1 Pipe Number: 01
Parameter: BOD
Six Month SNC Determination Period: 1/1/11-6/30/11
See next page for definitions
Daily Max. and IUP Limit * TRC criteria = TRC Limit Circle which units apply
Ave. Limits Circle 1.4 For TRC for BOD, TSS, oil, fat, grease; Circle 1.2 for all other pollutants to Limits
from IUP TRC compliance judgement not required for H:
Daily Maximum Limit: 650 * 1.2 or 1.4 = TRC Daily Limit: 910 mg/1 or lbs/day
Average Limit: * 1.2 or 1.4 = TRC Avg. Limit: mg/1 or lbs/day
Column 1: I - Industry self P-POTW A - Average
Column 5: Use only if IUP has (monthly, or other?) average limit. Average values of all sampling events collected wtihin the
"average" period (for example, for a monthly average limit, use all values collected within a calendar month) and enter
this average in column 5. Treat this average as another CJP. Compare this average to the appropriate average IUP limit
or TRC limit.
Column 6: Use only if IUP has daily limits in lbs/day. Formula to use is ( mgd * mg/1 * 8.34 = lbs/day ).
Column 7: Use only if IUP has (monthly?) average limits in lbs/day. Use ( mgd * mg/1 * 8.34 = lbs/day ).
Column 8: Put "1" for each daily maximum or average value, tally up at bottom as "A."
Column 9: Compare daily and average values to IUP limits above,put "0" if at or below limit, "1" if above, tally at bottom as "B."
Column 10: Compare daily and average values to TRC limits above,put "0" if below limit, "1" if at or above, tally at bottom as "C."
Col. 1:
From
IDMRs
From
IDMRs
From
IDMRs
Col. 5:
Col 6:
Col 7:
Col 8:
Col 9:
Col 10:
Sample or
CJP Type
Sample
Date
Daily
Flow, mgd
Daily
Conc. mg/1
Avg Conc.
mg/l
Daily
Load
lbs/day
Avg. Load
lbs/day
CJP
Count
Regular
Violation
?
TRC
Violation
?
I
1/4/11
0.089050
660
490.17
1
0
0
I
1/6/11
0.103410
1100
948.68
1
1
1
I
1/11/11
0.062340
860
447.13
1
0
0
I
1113111
0.116780
1280
124665
1
1
1
I
1118111
0.113700
560
531.02
1
0
0
I
1120111
0.111240
1040
964.85
1
1
1
I
1125111
0.039440
560
184.20
1
0
0
I
1/27/11
0.099380
500
414.41
1
0
0
I
211111
0.139150
1320
1531.87
1
1
1
I
2/3/11
0.135140
1240
1397.56
1
1
1
I
2/8/11
0.079580
460
305.30
1
0
0
I
2110111
0.117710
1180
1158.41
1
1
1
I
2115111
0.090800
720
545.24
1
0
0
I
2117111
0.092840
520
402.63
1
0
0
I
2122111
0.097300
820
665.42
1
1
0
I
2124111
0.067760
334
188.75
1
0
0
I
311/11
0.120070
650
650.90
1
1
0
1
3/3/11
0.161990
1100
1486.10
1
1
1
Title: SNC With Limits Compliance Judgement Worksheet
File name: Compliance Judge Janll.doc
Revision date: 1/5/01

Compliance Judgement Worksheet For SNC With Limits
Use separate sheets for each Industry SNC determination for Flow optional, see Section 7-E Use separate sheets for each Pollutant
SIU Name: Crestwood Farms
IUP Number: 0003 1
Pipe Number: 01
Parameter: BOD
I Six Month SNC Determination Period: 1/1/11-6/30/11
Col. 1:
From
IDMRs
From
IDMRs
From
IDMRs
Col. 5:
Col 6:
Col 7:
Col 8:
Col 9:
Col 10:
Sample or
CJP Type
Sample
Date
Daily
Flow, mgd
Daily
Conc. mg/1
Avg Conc.
mg/l
Daily
Load
lbs/day
Avg. Load
lbs/day
CJP
Count
Regular
Violation
TRC
Violation
1
318111
.115010
820
786.53
1
1
0
1
3110111
.139480
450
523.47
1
0
0
1
3115111
0.067510
580
326.56
1
0
0
1
3117111
0.095630
460
366.87
1
0
0
1
3122111
0.081100
280
189.38
1
0
0
1
3124111
0.096510
400
321.96
1
0
0
1
3129111
0.067620
540
304.53
1
0
0
1
3131111
0.064320
500
268.21
1
0
0
1
415111
0.044530
640
237.68
1
0
0
1
417111
0.070500
640
376.30
1
0
0
1
4112111
0.070500
640
376.3
1
0
0
1
4114111
0.062600
520
271.48
1
0
0
1
4119111
0.066530
630
349.56
1
0
0
1
4121111
0.083480
590
410.77
1
0
0
1
4126111
0.083460
630
438.52
1
0
0
1
4128111
0.72280
1320
795.72
1
1
0
1
513111
0.66500
580
321.67
1
0
0
1
5110111
0.82410
620
426.13
1
0
0
1
5112111
0.90750
600
454.11
1
0
0
1
5117111
0.71250
800
475.38
1
0
0
1
5119111
0.53310
560
248.98
1
0
0
1
5124111
0.80930
560
377.98
1
0
0
1
5126111
0.87120
480
348.76
1
0
0
P
5131111
0.16760
540
75.48
1
0
0
1
612111
0,66590
880
488.72
1
0
0
1
617111
0.62950
620
325.50
1
0
0
1
619111
0.88890
1280
948.92
1
1
1
1
6114111
0.61020
530
269.72
1
0
0
1
6116111
0.99040
800
660.79
1
1
0
Title: SNC With Limits Compliance Judgement Worksheet
File name: Compliance Judge Janll.doc
Revision date: 1/5/01

Compliance Judgement Worksheet For SNC With Limits
Use separate sheets for each Industry SNC determination for Flow optional, see Section 7-E Use separate sheets for each Pollutant
SIU Name: Crestwood Farms
IUP Number: 0003
Pipe Number: 01
Parameter: BOD
Six Month SNC Determination Period: 1/1/11-6/30/11
Col. 1:
From
IDMRs
From
IDMRs
From
IDMRs
Col. 5:
Col 6:
Col 7:
Col 8:
Col 9:
Col 10:
Sample or
CJP Type
Sample
Date
Daily
Flow, mgd
Daily
Conc. mg/l
Avg Conc.
mg/I
Daily
Load
lbs/day
Avg. Load
lbs/day
CJP
Count
Regular
Violation
TRC
Violation
I
6121111
0.82080
840
575.02
1
0
0
1
6123111
0.88060
500
367.21
1
0
0
1
6128111
0.83610
320
223.14
1
0
0
1
6130111
0.79510
640
424.39
1
0
0
1
List these Totals on next page =>
A=51
B=13
C=8
Title: SNC With Limits Compliance Judgement Worksheet
File name: Compliance Judge Janll.doc
Revision date: 1/5/O1

Compliance Judgement Worksheet For SNC With Limits
Use separate sheets for each Industry SNC determination for Flow optional, see Section 7-E Use separate sheets for each Pollutant
SIU Name: Crestwood Farms
IUP Number: 0003
1 Pipe Number: 01
Parameter: BOD
I Six Month SNC Determination Period: 1/1/11-6/30/11
SIGNIFICANT NON-COMPLIANCE (SNC) LIMITS DETERMINATION Calculate % and Circle Answers
1)
Calculate the % of Regular violations: B/A = 0.25
2)
Is B/A greater than or equal to 0.66 (or 66 %) ? Chronic violator?
Yes / ®o
3)
Calculate the % of TRC Violations: C/A = 0.16
4)
Is C/A greater than or equal to 0.33 (or 33 %) ? TRC Violator?
Yes / ®o
5)
Did any violation, alone or in combination with other discharges, cause pass -through
or interference at the POTW, or endanger the health of POTW workers or the public?
Yes /
6)
Did any violation cause imminent endangerment to human health / welfare or to the
environment or has resulted in the POTW's exercise of its emergency authority to halt
or prevent such discharge?
Yes /
7) If the answer to any of these questions is yes, the SIU is in Signficant Non -Compliance (SNC) for this
parameter. They must be listed on the Significant Non -Compliance Report (SNCR) form in the Pretreatment
Annual Report (PAR), described in the PAR narrative (including parameter, period, and POTW actions), and
the POTW must take adequate enforcement as outlined in its Enforcement Responce Plan (ERP).
Is the SIU in SNC for this six month period? CIRCLE ONE: YES ®O
Was the SIU in SNC for THE SAME PARAMETER in the previous six month compliance
period? CIRCLE ONE: YES ®O
If YES to EITHER question, DESCRIBE IN NARRATIVE.
Please note if SIU was in SNC for the previous six month compliance period and is also in SNC for this six month
compliance period, escalated enforcement actions must be taken as soon as possible, preferably before the end
of the second consecutive period. Failure to take the action within 2 months after the end of the second
consecutive period will subject the POTW to enforcement by the Division. The options are:
Consent Order with Enforceable schedule;
Administrative Order with Enforceable schedule;
Formal notice to comply issued, or
Permit modification.
See Chapter 9 - Pretreatment Annual Reports, Chapter 8 - Enforcement, and the POTW's Enforcement Response
Plan (ERP).
Definitions:
CJP Compliance Judgement Point, The number of daily sample data values plus the number of average of
sampling events used for checking compliance with average limits.
TRC Technical Review Criteria, Multiply the actual IUP limits by the proper TRC Criteria value to get a
TRC Limit:
TRC Criteria = 1.4 for BOD, TSS, oil, fat, grease
TRC Criteria = 1.2 for all other pollutants
Not required to perform TRC compliance judge ment for pH.
SNCR Significant Non -Compliance Report
SNC Significant Non -Compliance (formerly called Reportable Non -Compliance or RNC)
Title: SNC With Limits Compliance Judgement Worksheet
File name: Compliance Judge Janll.doc
Revision date: 1/5/01

Compliance Judgement Worksheet For SNC With Limits
Use separate sheets for each Industry SNC determination for Flow optional, see Section 7-E Use separate sheets for each Pollutant
SIU Name: Crestwood Farms
IUP Number: 0003
1 Pipe Number: 01
Parameter: BOD
Six Month SNC Determination Period: 7/1/11-12/31/11
See next page for definitions
Daily Max. and IUP Limit * TRC criteria = TRC Limit Circle which units apply
Ave. Limits Circle 1.4 For TRC for BOD, TSS, oil, fat, grease; Circle 1.2 for all other pollutants to Limits
from IUP TRC compliance judgement not required for H:
Daily Maximum Limit: 650 * 1.2 or 1.4 = TRC Daily Limit: 910 mg/l or lbs/day
Average Limit: * 1.2 or 1.4 = TRC Avg. Limit: mg/l or lbs/day
Column 1: I - Industry self P-POTW A - Average
Column 5: Use only if IUP has (monthly, or other?) average limit. Average values of all sampling events collected wtihin the
"average" period (for example, for a monthly average limit, use all values collected within a calendar month) and enter
this average in column 5. Treat this average as another CJP. Compare this average to the appropriate average IUP limit
or TRC limit.
Column 6: Use only if IUP has daily limits in Ibs/day. Formula to use is ( mgd * mg/1 * 8.34 = Ibs/day ).
Column 7: Use only if IUP has (monthly?) average limits in lbs/day. Use ( mgd * mg/1 * 8.34 = lbs/day ).
Column 8: Put "1" for each daily maximum or average value, tally up at bottom as "A."
Column 9: Compare daily and average values to IUP limits above,put "0" if at or below limit, "1" if above, tally at bottom as'B."
Column 10: Compare daily and average values to TRC limits above,put "0" if below limit, "1" if at or above, tally at bottom as "C."
Col. 1:
From
IDMRs
From
IDMRs
From
IDMRs
Col. 5:
Col 6:
Col 7:
Col 8:
Col 9:
Col 10:
Sample or
CJP Type
Sample
Date
Daily
Flow, mgd
Daily
Conc. mg/l
Avg Conc.
mg/l
Daily
Load
Ibs/day
Avg. Load
lbs/day
CJP
Count
Regular
Violation
TRC
Violation
1
715111
0.20880
580
101
1
0
0
I
717111
0.83910
510
356.90
1
0
0
I
7112111
0.91170
580
441.01
1
0
0
1
7114111
0.79390
960
635.63
1
0
0
1
7119111
0.70000
560
326.93
1
0
0
1
7121111
0.70000
620
361.96
1
0
0
1
7126111
0.85879
880
630.28
1
0
0
1
7128111
0.31179
280
72.81
1
0
0
I
I
List these Totals on next page =>
A
B=0
C=0
i
Title: SNC With Limits Compliance Judgement Worksheet
File name: Compliance Judge Julll.doc
Revision date: 1/5/01

Compliance Judgement Worksheet For SNC With Limits
Use separate sheets for each Industry SNC determination for Flow optional, see Section 7-E Use separate sheets for each Pollutant
SIU Name: Crestwood Farms
IUP Number: 0003
1 Pipe Number: 01
Parameter: BOD
Six Month SNC Determination Period: 7/1/11-12/31/11
SIGNIFICANT NON-COMPLIANCE (SNC) LIMITS DETERMINATION Calculate % and Circle Answers
1) Calculate the % of Regular violations:
2) Is B/A greater than or equal to 0.66 (or 66 %) ?
3) Calculate the % of TRC Violations:
4) Is C/A greater than or equal to 0.33 (or 33 %) ?
B/A = 0.00
Chronic violator? Yes /
C/A = 0.00
TRC Violator? Yes /
5) Did any violation, alone or in combination with other discharges, cause pass -through
or interference at the POTW, or endanger the health of POTW workers or the public? Yes / ®o
6) Did any violation cause imminent endangerment to human health / welfare or to the
environment or has resulted in the POTW's exercise of its emergency authority to halt
or prevent such discharge? Yes /
7) If the answer to any of these questions isles, the SIU is in Signficant Non -Compliance (SNC) for this
parameter. They must be listed on the Significant Non -Compliance Report (SNCR) form in the Pretreatment
Annual Report (PAR), described in the PAR narrative (including parameter, period, and POTW actions), and
the POTW must take adequate enforcement as outlined in its Enforcement Responce Plan (ERP).
Is the SIU in SNC for this six month period? CIRCLE ONE: YES ®O
Was the SIU in SNC for THE SAME PARAMETER in the previous six month compliance
period? CIRCLE ONE: YES ®O
If YES to EITHER question, DESCRIBE IN NARRATIVE.
Please note if SIU was in SNC for the previous six month compliance period and is also in SNC for this six month
compliance period, escalated enforcement actions must be taken as soon as possible, preferably before the end
of the second consecutive period. Failure to take the action within 2 months after the end of the second
consecutive period will subject the POTW to enforcement by the Division. The options are:
Consent Order with Enforceable schedule;
Administrative Order with Enforceable schedule;
Formal notice to comply issued, or
Permit modification.
See Chapter 9 - Pretreatment Annual Reports, Chapter 8 - Enforcement, and the POTW's Enforcement Response
Plan (ERP).
Definitions:
CJP Compliance Judgement Point, The number of daily sample data values plus the number of average of
sampling events used for checking compliance with average limits.
TRC Technical Review Criteria, Multiply the actual IUP limits by the proper TRC Criteria value to get a
TRC Limit:
TRC Criteria = 1.4 for BOD, TSS, oil, fat, grease
TRC Criteria = 1.2 for all other pollutants
Not required to perform TRC compliance judge ment for pH.
SNCR Significant Non -Compliance Report
SNC Significant Non -Compliance (formerly called Reportable Non -Compliance or RNC)
Title: SNC With Limits Compliance Judgement Worksheet
File name: Compliance Judge Julll.doc
Revision date: 1/5/01

SIU INSPECTION FORM
Name Of Industry: Crestwood Farms IUP # 003
Address Of Industry: 254 Eaton Road IUP Expiration Date: 01 /01 /12
Mocksville. NC 27028
Industry Representatives: Title
Jim Hendrick Facilities Manager
POTW Representatives:
John Grey
Date Of Inspection: 12/14/11
Purpose of Inspection: Annual X Other (Describe)
POTW to which IU discharges Dutchmans Creek
Is SIU currently in SNC? NO If yes, for what?
Title
Acting Pretreatment Coordinator
Time Of Inspection: 10:00 Rpm
NPDES # NCO021491
PART I - INITIAL INTERVIEW
Has anything changed since the last inspection or IUP application in the following:
COMMENTS
Product / NO Production shut down
Raw materials used E / NO ,Nq new raw materials entering facility due to shut down
Manufacturing processes S / NO All processes shut d wn at present
Categorical, if applicable YES / NO
Production rate / NO shut down 0% production
Number of employees MINO 500 + laid off
Number of shifts S NO All production shifts .stopped
Comments:
PART II - PLANT TOUR - Visit all areas where wastewater is generated or where there are
drains to the POTW.
Plant Tour Section A - PRODUCTION AND STORAGE AREAS
1. Are there floor drains in the production area? fVKS] / NO Where do they go? Wastewater
2. Are production areas diked, contained, or otherwise constructed in such a way as to prevent harm to the WWTP,
especially from spills or slugs? 0 / NO Comments:
3_ Are there floor drains in the storage area? ©E / NO Where do they go? Wastewater
4. Are storage tanks and areas diked, contained, or otherwise constructed in such a way as to prevent harm to the
W WTP, especially from spills or slugs? © / NO Comments:
5. Are process and storage tanks and pipes labeled? / NO If hazardous
6. How are off -spec raw materials, and products disposed of? Placed in dumosters and hauled to landfill
7. When is the production area cleaned?
8. Is the wastewater from cleaning the production area discharged to the POTW? ©/ NO
9. What non -process wastewaters are discharged to POTW? Domestic
Comments:
Title: SIU Inpsection Form
File name: COMPINSP App 7-D
Revision data: August 1, 1994 Page 1

SIU INSPECTION FORM
PART II - Plant Tour Section B - PRETREATMENT SYSTEM
Ask the operator to describe pretreatment system.
1. Does operator seem knowledgeable about the system? ©/ NO Comments:
2.
3.
4.
5.
Are all units operational? YES / NO
How often does operator/maintenance person check system?
Is there an operator for each shift? YES / NO
How and when is sludge disposed of?
6. Is there a schedule for preventative maintenance? YES
Comments:
PART II - Plant Tour Section C - SAMPLING POINT(S) AND FLOW MEASUREMENT
(Collect a sample if desired.)
1. Does an outside lab complete sampling? YES / NO If yes, name of lab.
2. If industry completes sampling, ask the industry representative to describe sampling procedures. Comments:
3. Is flow measurement equipment operational? YES / NO Comments:
4. Is there a calibration log for the flow met / NO Comments:
Comments:
PART III - EXIT INTERVI
Review monitoring records and ogr
SIU records required by IUP.
1. Are files well organized? / NO Comments:
2. Are sample collection / cha' -of-custody forms filled out properly? ag/ NO Comments:
3. Do results in files agree th reports sent to POTW? ES / NO Comments:
4. Who has authorityt shut down production should a spill or slug discharge occur?
5. How does SIU ' orm employees of whom to call at POTW in case of spill/slug?
If slug/spill plan ' already required by POTW, review procedures.
6. Is SIU imp menting slug/spill plan? YES / NO Comments:
Comments
INSP CTION RESULTS
Slug/S ill Control Plan Needed? YES / NO
Comments, Required Or Recommended Actions:
Signature Of Inspector(s) Date: z�y,I14
Date:
Title: SIU iapsection Form
Filename: COM P.INSP App 7-D
Revision data: August 1, 1994 Page 2

Joy Howard
From: Joy Howard [e-mail]]
Sent: Friday, December 16, 2011 3:37 PM
To: '[e-mail]'
Cc: 'John Grey'; '[e-mail]; 'Hassan, Monti'
Subject: Summary of Annual pretreatment inspection
Attachments: 2011 Annual inspection.docx
Jim:
Please see the attached summary of the Annual Pretreatment inspection of Townsends Mocksville facility.
Feel free to contact either John or me if you have questions regarding any of the items on the summary.
Thanks for your attention to these details,
jh
Job FtowArd
project AoI vKI Kv strator
creU EK.giweeri-wg, +wo.
336-751-2110

December 16, 2011
Jim Hendrick
PO Box 709
Slier City, NC 27344
The annual SIU inspection of Townsends (permitted as Omtron USA, d/b/a Townsends) was
performed on December 14, 2011 by John Grey, Acting Pretreatment Coordinator, and Joy
Howard of Grey Engineering on behalf of the Town of Mocksville. Jim Hendrick, Facilities
Manager for Townsends was present to represent the SIU. Our records indicate that production
at the plant ceased on 811/2011. In response to the recent shut -down, several items were
discussed:
1. While the production facility seems to be substantially cleaned and properly shut -down,
the wastewater treatment area, including the front pit, two storage tanks behind the
plant, and DAF unit have not been cleaned. These wastewater storage areas contain
deposits of residual oil and grease that must be removed.
2. It is important to insure that stormwater cannot be introduced into the Town's wastewater
collection system. Please construct a system for sealing off the dumpster pad from
wastewater collection.
3. All remaining chemicals, in both full and partial containers, currently stored in the
wastewater treatment facility must be properly disposed of.
4. As long as the Pretreatment Permit remains valid, daily effluent flow reporting is
required. The most recent report contains data through August 26, 2011. Please
provide any interim data available and daily flow data moving forward until permit
termination is accomplished.
5. It is recommended that the current pretreatment permit be closed following satisfactory
completion of wastewater cleanup and stormwater mitigation. A new permit
representing appropriate limits of discharge may be negotiated should the facility be
scheduled to re -open.
6. Please provide contact information (mailing and email addresses) for corporate
ownership for ongoing regulatory communications.
7. Pretreatment records should be accessed from the former safety manager's office and
maintained in accordance with regulatory requirements.
Please address these issues as soon as possible and advise us of a final completion schedule,
but no later than 30 days from the date of this summary.

GREY
ENGINEERING, INC.
Ms. Christine Bralley, Manager 8/9/2011
Town of Mocksville
171 Clement St.
Mocksville, NC 27028
Re: Townsends (Crestwood) Shut Down Concerns
Dear Christine:
Confirming my conversation with you and Terry this morning, I am very concerned about
environmental risk that may be generated by improperly shutting down the above referenced
industrial facility. These risks surround proper disposal of dangerous chemicals at the facility
including: sulfuric acid, sodium hydroxide, various polymers and additives, liquid and
gaseous ammonia and various cleaning supplies. Waste products that must be properly
processed and disposed of include: waste sludges, oils, greases and food products.
Additionally, drainage from the dumpster pad area now routed to the pretreatment facility must be
modified so that stormwater is not routed to the pretreatment area. Further, all vessels,
machinery and pumping systems used to convey, treat or store wastewaters or sludges must be
properly cleaned in order to avoid odors and unsanitary conditions.
Townsends operates under a wastewater pretreatment permit issued by the Town and is
responsible to the Town for proper operation and maintenance of the facility. Townsends has
been operating under temporary permit limits while grant funded pretreatment and pumping
facilities were designed and constructed. These pumping facilities would convey the wastewater
away from the Town's Dutchmans Creek treatment facility and to Davie County's (larger)
Cooleemee wastewater treatment facility. Should the processing plant be reactivated without the
required pumping system, final pretreatment limits will be governed by the long term capacity of
the Dutchmans Creek wastewater treatment plant and will likely be sharply reduced. The
necessary reduction in pretreatment limits (both for flow and BOD) will result in greatly
reduced plant production.
I am informed that production ceased as of Monday 8/1/11 and that the remaining staff is
proceeding to do what it can to act responsibly in these matters. However, there seems to be a
distinct lack of corporate leadership and funding for the required work.
I, therefore, suggest that you request Corey Basinger, NCDENR Water Quality Supervisor for our
region, to commission Mike Mickey and other regulatory officials to examine this situation and
correspond with financially responsible individuals under all pertinent State, local and Federal
regulations. This situation must be contained in order to protect the health, safety and welfare of
our citizens and the environment.
Very Truly Yours,
Grey Engineering, Inc.
CAgO�i
?hnrey, PE
Grey Engineering, Inc.
01
Cc: Corey Basinger (corey.basingerna.ncdenr) �� O of �•
Mike Mickey (mike. mickey@ ncdenr ov) ��•
P.4. Box 9 • Mocksville, NC 27028 • Phone: [phone] • Fax: [phone] www,greyengineering.com

Joy Howard
From:
John Grey [e-mail]]
sent:
-ruesaay, August 09, z011 1:29 PM
To:
Joy Howard
Subject:
Fwd: Wastewater Issues
Begin forwarded message:
From: eiveyOkownsends.com
Date: August 9, 2011 11:27:33 AM GMT-04:00
To: iRTey@Lzreyengineerinp,.com
Subject: Wastewater Issues
John,
As previously discussed, the plant has not run production since 8/1 /11. We have not run any process
water at all since completion of the sanitation shift on the morning of &2/11. The last sampling that went
out to Tri-test was the morning of 8011. Our average daily flow since 813/11 has been a little over 2,600
gallons a day, with reduced BOD loading due to the fact that we are not running process water. Our
current flow consists mostly of stormwater run-off, and some residual flow inside the plant. This morning
we ran fresh water through the system in order to clear out and pre -treat what was left to turn septic. I'm
not yet sure of the amount. I won't be able to get a printout until the end of the shift I have spoken to
Harcros, and they will be here to discuss chemicals. I have already informed them that we will need their
chemicals, and I have an update on the manner in which they will be paid_ I will continue to do all I can to
ensure compliance. Please let me know if I have overlooked anything. I will keep you posted as
information becomes available.
Best Regards
Eric L. Ivey
�atetyrovaste water Manager a waM Coorainator
Omtron USA LLC, d/b/a Townsends
Mocksville Plant
[phone] x409
c : [phone]
"Production First, Safety Always"

10ingersoll Rand
Industrial 70chnologies
February 29 1h 2012
John Grey, PE
Town of Mocksville Pretreatment Coordinator
171 Clement Street
Mocksville, North Carolina 27028
Reference: Part 433 Declassification
1UP Number: 0004
Dear Grey Engineering,
Mocksville Operations
501 Sanford Avenue
Mocksville, NG 27028
Tel [phone]
Please find the attached "Verification of Applicable Standards and Reporting Requirements for
Electroplaters and Metal Finishers" signed documentation as we have discussed in reference to
our request for a Part 433 Declassification. Please also find the subsequent documentation to
support this declassification as part of this package.
Please let us know the next step(s) in pursuit of this request. Feel free to contact Christin Annie
(EHS Manager) at 336-751-6895 or [e-mail].
Thank you,
V4001
Christin Annie
EHS Manager

I Ingersoll Rand
1�
industrial Technologies
Mocksville Operations
501 Sanford Avenue
Mocksville, NC 27028
Tel [phone]
Ingersoll Rand, Mocksville has gone through a substantial transformation in the past
three years with respect to the type of manufacturing and assembled products that we offer. In
2009, the portable compressor business was sold to Doosan, which meant that a number of
processes ceased at that time. One of the processes that went away was the zinc phosphate paint
process, which was the sole reason Ingersoll Rand - Mocksville met the 433 metal finisher
classification. Since this change, we currently have no processes which meet the definitions of
the 433 metal finishing category.
During 2011, we experienced a positive cyanide result from our lab. After numerous
samples taken, researching of the topic, and discussions with subject matter experts, it was
determined that the positive cyanide result was a result of interference. We have provided the
Town of Mocksville with numerous updates throughout this determination. Please see the
attached TCLP results for the raw, untreated waste from our manhole at the chip recovery pad
where all of our wastes converge prior to being sent to our waste water treatment plant. As you
can see from the results, there was no evidence of cyanide in this sample.
Ingersoll Rand — Mocksville will also be the recipient of work from the Louisville, GA
facility. This will create approximately 150,000 gal/month additional waste water from a washer
and vibratory finishing machines. Neither of these operations meets the 433 metal finisher
classification. We have included a sample report of bench testing results from a treated sample
of the Louisville, GA waste water that the Mocksville facility will be receiving.
Based on the attached information, the Ingersoll Rand — Mocksville facility would like to
respectfully request a change in permit status from categorical to general.
Please feel free to contact us for any additional information or questions related to this
request.
Enclosures): Analytical results from: 1. Certification A: Metal Finishing Exemption, 2. TCLP
Manhole Chip Recovery 3. Georgia Waste Water

CERTIFICATION A
ELECTROPLATING/METAL FINISHING EXEMPTION
I have personally examined and familiar with the operations
performed at this facility and with the wastewaters discharged
from these operations. I certify that this facility does not
perform any of the six operations listed below. I am aware that
there are significant penalties for submitting false information.
1. Electroplating
2. Electroless Plating
3. Anodizing
4. Coatings
5. Chemical Etching and Milling
6. Printing Circuit Board Manufacturing
�Z
Authorized Representative DaYe
414f
Title .1

4
Verification of Applicable Standards and Reporting
Requirements for Electroplaters and Metal Finishers
Wastewater being discharged into publicly owned treatment 1
works (POTWs)from the first six metal finishing operations
have been subject to federal electroplating (Part 413)
pretreatment standards since either April 27 or June 30,
1984_ Wastewaters from all forty-six metal finishing
operations are now (as of February 15, 1986) regulated by the
more stringent federal metal finishing (Part 433) pretreatment
standards for existing or for new sources, unless the
facilities generating these wastewaters fall into one of
two specific categories, in which case they will remain
subject only to Part 413 standards.
1 a. Does your facility perform any of the first six metal
finishing operations? X
YES NO
If yes, go'to 1 b. If no, have an authorized representative
of your facility sign and submit Certification A, then go to
10.
1 b. Does your facility discharge from any of the 46 metal
finishing operations?
YES NO
If yes, go to 2. If no, have an authorized representarive2
of your facility sign and submit Certification E, then go to
10.
2. Did your facility begin operation before September 1, 19827,
YES NO
If yes, please have an authorized representative of your
facility sign and submit Certification B, then go to 3. If
no, go to 6.
1Throughout these instructions, metal finishing
operations refers to the forty-six unit operations listed
in Table 1. The first sir, metal finishing operations means
operations 1-6 in Table 1.
2An authorized representative as a minimum shall be
a vice president --level individual if your facility is a
corporation; a general partner or proprietor if your
facility is a partnership or sole proprietorship,
respectively; or any other representative if that
representative is responsible for your facility's
operations.

4,.
3. Does your facility own, in a calendar year, less than
50% (area basis) of the materials which undergo those of the
forty-six metal finishing operations which are performed at
your facility?
YES NO
If yes, please have an authcrized representative of your
facility sign and submit Certification C, then go to 5. If
no, go to 4.
4. Is your facility an independent printed circuit board
manufacturer (does it manufacture printed circuit boards
principally for sale to other companies)?
YES NO
if yes, please have an authorized representative of your
facility sign and submit Certification D, then go to 5. If
no, go to 6.
5. All wastewaters which your facility discharges from any
of the first six metal finishing operations are subject to
electroplating (Part 413) pretreatment standards. Has your
facility submitted an electroplating 90-day compliance
report?
`:F.S NO
If yes, go to S. If no, go to 7.
6. All wastewaters which your facility discharges from any
of the forty-six metal finishing operations are subject to
metal finishing (Part 433) pretreatment standards. Your
facility must submit a metal finishing 90-day compliance
report by May 15, 1986. Sampling results for each regulated
pollutant, representative of the monthly discharge from your
f acilty, are required to complete the report. A minimum of
one production week's worth of 24-hour composite.sampling
results for each regulated pollutant is recommended.
The maximum daily value of each regulated pollutant is to be
reported in the daily maximum column of Form G, and the
average value of each regulated pollutant for all daily
samples is to be reported in the maximum monthly average
column. If you answered yes to question 2, complete the
upper portion of Form G. If you answered no to question 2,
complete the lower portion of Form G. Go to 9.
7. Submit -an electroplating 90-day compliance report as
soon as possible. The results of four consecutive 24--hour
composite samples for each regulated pollutant are necessary
to complete the report. The maximum daily value of each
regulated pollutant is to be reported in the daily maximum
column of Form G, and the average value of each regulated
pollutant for the four daily samples is to be reported in
the four -day average column. If your facility discharges

less than 10,000 gallons per day of wastewater from the
first 6 metal finishing operations, complete the upper
portion of Form G. If your facility discharges 10,000
gallons or more per day of wastewater from the first six
metal finishing operations, complete the lower portion of
Form G. The electroplating (Part 413) TTO compliance date
is not until July 15, 1986-, so a TTO sampling result does
not have to be submitted until October 15, 1986, but you may
co ahead and submit one now and not have to do so later. Go
to 8.
8. Four consecutive 24-hour composite samples must be taken
and reported for all regulated pollutants every six months
for continued compliance reporting. Go to 11.
9. Sampling results representative of your facility's
monthly discharge, must be taken and reported for all
regulated pollutants (except TTO, which may be certified
for, provided the TTO sampling 'result in the 90-day
compliance report shows compliance with the TTO standard and
a toxic organic management plan has been submitted by your
facility) every six months for continued compliance
reporting. A minimum of one production week's worth of
24-hour composite samples is recommended. Go to 11.
10. Wastestreams from your facility are not regulated by
electroplating (Part 413) or meta_ finishing (Part 433)
pretreatment standards. Go to 11.
11. Verification of the applicable standards and reporting
recuirements for your facility is now complete. Please
submit any and all reports and monitoring results requested.
3

laceAnal�/tical®
J`
!. iympacelabs com
Pace Analytical Services, Inc.
205 East Meadow Road - Suite
Eden, NC 27288
Pace Analytical Services, Inc.
2225 Riverside Dr.
Asheville, NC 28804
Pace Analytical Services, Inc.
9800 Kincey Ave. Suite 100
Huntersvilte, NC 28078
July 19, 2011
Ms. Christin Annie
Ingersoll Mocksville
[phone]
RE: Project: TCLP MANHOLE CHIP RECOVERY
Pace Project No.: 9297660
Dear Ms. Annie:
[phone]
Enclosed are the analytical results for sample(s) received by the laboratory on July 06, 2011. The
results relate only to the samples included in this report. Results reported herein conform to the
most current TN1 standards, where applicable, unless otherwise narrated in the body of the report.
Analyses were performed at the Pace Analytical Services location indicated on the sample analyte
page for analysis unless otherwise footnoted.
If you have any questions concerning this report, please feel free to contact me.
Sincerely,
Renee Spencer
[e-mail]
Project Manager
Enclosures
cc: Mr. Jerry Lakey, Ingersoll Mocksville
�Q pGCRF�-
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc..
[phone]
Page 1 of 12

® Pace Analytical Services, Inc. Pace Analytical Services, Inc.
/71aceAnalXical 205 East Meadow Road - Suite 2225 Riverside Dr.
www,pacelaus.com Eden, NC 27288 Asheville, NC 28804
[phone] [phone]
CERTIFICATIONS
Project: TCLP MANHOLE CHIP RECOVERY
Pace Project No.: 9297660
Ormond Beach Certification IDs
8 East Tower Circle, Ormond Beach, FL 32174
Alabama Certification M 41320
Arizona Certification #: AZO735
Colorado Certification: FL NELAC Reciprocity
Connecticut Certification #- PH 0216
Florida Certification #: E83079
Georgia Certification #: 955
Guam Certification: FL NELAC Reciprocity
Hawaii Certification: FL NELAC Reciprocity
Kansas Certification #: E-10383
Kentucky Certification #: 90050
Louisiana Certification #- LA090012
Louisiana Environmental Certificate* 05007
Maine Certification #: FL1264
Massachusetts Certification #- M-FL1264
Charlotte Certification IDs
9800 Kincey Ave. Ste 100, Huntersville, NC 28078
Louisiana/LELAP Certification #: 04034
New Jersey Certification * NCO12
North Carolina Drinking Water Certification #: 37706
North Carolina Field Services Certification #: 5342
North Carolina Wastewater Certification #: 12
Pennsylvania Certification #: 68-00784
South Carolina Certification #: 99006001
Asheville Certification IDs
2225 Riverside Dr., Asheville, NC 28804
Connecticut Certification #: PH-0106
Florida/NELAP Certification #: E87648
Massachusetts Certification #: M-NC030
New Jersey Certification #: NC011
North Carolina Bioassay Certification M 9
North Carolina Drinking Water Certification * 37712
Michigan Certification #: 9911
Mississippi Certification: FL NELAC Reciprocity
Montana Certification #: Cert 0074
Nevada Certification: FL NELAC Reciprocity
New Hampshire Certification #: 2958
New Jersey Certification #: FL765
New York Certification #: 11608
North Carolina Environmental Certificate #: 667
North Carolina Certification #: 12710
Pennsylvania Certification #: 68-547
Puerto Rico Certification #: FLO1264
Tennessee Certification #: TN02974
Texas Certcation: FL NELAC Reciprocity
Virginia Certification #: 00432
Wyoming Certification: FL NELAC Reciprocity
South Carolina Drinking Water Cert. #: 99006003
Virginia Drinking Water Certification #: 00213
Connecticut Certification * PH-0104
Florida/NELAP Certification #: E87627
Kentucky UST Certification #: 84
Louisiana DHH Drinking Water # LA 100031
West Virginia Certification #: 357
Virginia/VELAP Certification #: 460144
North Carolina Wastewater Certification #: 40
Pennsylvania Certification #: 68-03578
South Carolina Bioassay Certification #: 99030002
South Carolina Certification M 99030001
Virginia Certification #: 00072
West Virginia Certification #: 356
Virgina/VELAP Certification #: 460147
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc..
Pace Analytical Services, In%
9800 KinceyAve. Suite 100
Huntersville, NC 28076
[phone]
Page 2 of 12

® Pace Analytical Services, Inc. Pace Analytical Services, Inc.
aceAnalytica! 205 East Meadow Road - Suite A 2225 Riverside Dr.
www.pacetabs.com Eden, NC 27288 Asheville, NC 28804
[phone] [phone]
SAMPLE ANALYTE COUNT
Project: TCLP MANHOLE CHIP RECOVERY
Pace Project No.: 9297660
Pace Analytical Services, Inc.
9800 KinceyAve. Suite 100
Huntersvitle, NC 28078
[phone]
Lab ID Sample ID Method
Analysts
Analytes
Reported
Laboratory
9297660001 SLUDGE WASH PIT EPA 8081
BAG
9
PASI-0
EPA 8082
RES
8
PASI-C
EPA 8270
Bpi
18
PASI-C
EPA 8260
TLS
15
PASI-C
EPA 9045
SAJ
1
PASI-A
REPORT OF LABORATORY ANALYSIS Page 3 of 12
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc..

_7ilaceAnaly4ical
ffmpacebbs.can
i
Pace Analytical Services, Inc.
205 East Meadow Road - Suite
Eden, NC 27288
[phone]
Project: TCLP MANHOLE CHIP RECOVERY
Pace Project No.: 9297660
Pace Analytical Services, Inc.
2225 Riverside Or.
Asheville, NC 28804
[phone]
ANALYTICAL RESULTS
Pace Analytical Services, In%
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Sample: SLUDGE WASH PIT Lab ID: 9297660001 Collected: 07/05/11 10:00
Results reported on a "wet -weight" basis
Parameters Results Units Report Limit OF
Received: 07/06/11 16:20 Matrix: Solid
Prepared Analyzed CAS No. Qual
8081 GCS Pesticides, TCLP
Analytical Method: EPA 8081
gamma-BHC (Lindane)
NO mg/L
0.0010
1
07/13/11 14:23
07/14/11 01:16
58-89-9
Chlordane (Technical)
NO mg/L
0.0050
1
07/13/11 14:23
07/14/11 01:16
57-74-9
Endrin
ND mg/L
0.0010
1
07/13/11 14:23
07/14/11 01:16
72-20-8
Heptachlor
ND mg/L
0.0010
1
07/13/11 14:23
07/14/11 01:16
76-44-8
Heptachlor epoxide
NO mg1L
0.0010
1
07/13/11 14:23
07/14/11 01:16
1024-57-3
Methoxychlor
NO mg/L
0.0010
1
07/13/11 14:23
07/14/11 01:16
72-43-5
Toxaphene
ND mg/L
0,0050
1
07/13/11 14:23
07/14/11 01:16
8001-35-2
Decachlorobiphenyl (S)
82 %
70-130
1
07/13/11 14:23
07/14/11 01:16
2051-24-3
Tetrachloro-m-xylene (S)
94 %
70-130
1
07/13/11 14:23
07/14/11 01:16
877-09-8
8082 GCS PCBs, TCLP SPE
Analytical Method: EPA 8082 Preparation Method:
EPA 3535
Leachate Method/Date: EPA 1311; 07/12/11 15:30
PCB-1016 (Aroclor 1016)
NO ug/L
1000
1
07/14/11 15:00
07/16/11 01:42
12674-11-2
PCB-1221 (Aroclor 1221)
NO ug/L
1000
1
07/14/11 15:00
07/16/11 01:42
11104-28-2
PCB-1232 (Aroclor 1232)
ND ug/L
1000
1
07/14/11 15:00
07/16/11 01:42
11141-16-5
PCB-1242 (Aroclor 1242)
ND ug/L
1000
1
07114/11 15:00
07/16/11 01:42
53469-21-9
PCB-1248 (Aroclor 1248)
ND ug/L
1000
1
07/14/11 15:00
07/16/11 01:42
12672-29-6
PCB-1254 (Aroclor 1254)
ND ug/L
1000
1
07/14/11 15:00
07/16/11 01:42
11097-69-1
PCB-1260 (Aroclor 1260)
ND ug/L
1000
1
07/14/11 15:00
07/16/11 01:42
11096-82-5
Decachlorobiphenyl (S)
84 %
10-132
1
07/14111 15:00
07/16/11 01:42
2051-24-3
8270 MSSV TCLP Sep Funnel
Analytical Method: EPA 8270 Preparation Method: EPA 3510
Leachate Method/Date: EPA 1311; 07/12/11 15:30
1,4-Dichlorobenzene
NO ug/L
50.0
1
07/12/11 09:00
07/15/11 21:16
106-46-7
2,4-Dinitrotcluene
NO ug/L
%0
1
07/12/11 09:00
07/15/11 21:16
121-14-2
Hexachloro-1,3-butadiene
NO ug/L
50.0
1
07/12/11 09:00
07/15/11 21:16
87-68-3
Hexachlorobenzene
NO uglL
50.0
1
07/12/11 09:00
07/15/11 21:16
118-74-1
Hexachloroethane
ND ug/L
50.0
1
07/12/11 09:00
07/15/11 21:16
67-72-1
2-Methylphenol(o-Cresol)
NO ug/L
50.0
1
07/12/11 09:00
07/15/11 21:16
95-48-7
3&4-Methylphenol(m&p Cresol)
NO ug/L
50.0
1
07/12/11 09:00
07/16/11 21:16
Nitrobenzene
NO ug/L
50.0
1
07/12/11 09:00
07/15/11 21:16
98-95-3
Pentachlorophenol
NO ug/L
100
1
07/12/11 09:00
07/15/11 21:16
87-86-5
Pyridine
364 ug/L
50.0
1
07/12/11 09:00
07/15/11 21:16
110-86-1
2,4,5-Trichlorophenol
NO ug/L
50.0
1
07/12/11 09:00
07/15111 21:16
95-95-4
2,4,6-Trichlorophenol
ND ug/L
50.0
1
07/12/11 09:00
07/15/11 21:16
88-06-2
Nitrobenzene-d5(S)
87 %
12-102
1
07/12/11 09:00
07115/1121A6
4165-60-0
2-Fluorobiphenyl (S)
84 %
13-107
1
07/12/11 09:00
07115/11 21:16
321-60-8
Terpheny1-d14 (S)
88 %
21-132
1
07/12/11 09:00
07/15/11 21:16
1718-51-0
Phenol-dB(S)
30 %
10-110
1
07/12/11 09:00
07/15/11 21:16
13127-88-3
2-Fluorophenol (S)
46 %
10-110
1
07/12/11 09:00
07/15/11 21:16
367-12-4
2,4,6-Tribromophenol (S)
84 %
27-108
1
07/12/11 09:00
07/15/11 21:16
118-79-6
8260 MSV TCLP
Analytical Method: EPA 8260
Benzene
ND ug/L
100
20
07/11/11 20,30
71-43-2
2-Butanone (MEK)
NO ug/L
200
20
07/11/11 20:30
78-93-3
Date: 07/19/2011 11:06AM REPORT OF LABORATORY ANALYSIS Page 4 of 12
This report shall not be reproduced, except In full,
without the written consent of Pace Analytical Services, Inc.

®
Pace Analytical Services, Inc. Pace Analytical Services, Inc.
Pace Analytical Services, Inc.
/7,Pa-lceAnalytical
205 East Meadow Road - Suite
2225 Riverside Dr.
9800 KinceyAve. Suite 100
wvmpacelabacom
Eden, NC 27288
Asheville, NC 28804
Huntersville, NC 28078
po
[phone]
[phone]
[phone]
ANALYTICAL RESULTS
Project TCLP MANHOLE
CHIP RECOVERY
Pace Project No.: 9297660
Sample: SLUDGE WASH PIT
Lab ID: 9297660001 Collected: 07/05/11 10:00
Received: 07/06/11 16:20
Matrix: Solid
Results reported on a "wet -weight" basis
Parameters
Results Units
8260 MSV TCLP
Analytical Method: EPA 8260
Carbon tetrachloride
ND ug/L
Chlorobenzene
ND ug/L
Chloroform
ND ug/L
1,4-Dichlorobenzene
ND ug/L
1,2-Dichloroethane
ND ug/L
1,1-Dichloroethene
ND ug/L
Tetrachloroethene
ND ug/L
Trichloroethene
ND ug/L
Vinyl chloride
ND ug/L
1,2-Dic4iloroethane-d4 (S)
106 %
Toluene-d8 (S)
96 %
4-Bromofluorobenzene (S)
96 %
Dibromofluoromethane (S)
103 %
9045 pH Soil Analytical Method: EPA 9045
pH at 25 Degrees C 8.8 Std. Units
Report Limit DF Prepared Analyzed CAS No. Quaff
100
20
0711111120:30
56-23-5
100
20
07111/1120:30
108-90-7
100
20
07111/1120:30
67-66-3
100
20
07111/1120:30
106-46-7
100
20
07/1111120:30
107-06-2
100
20
07/11/11 20:30
75-35-4
100
20
07/1111120:30
127-18-4
100
20
07/11/1120:30
79-01-6
100
20
07/1111120:30
75-01-4
70-130
20
07/11/1120:30
17060-07-0
67-135
20
07111/1120:30
2037-26-6
70-130
20
07/11/11 20:30
460-00-4
70-130
20
07/1111120:30
1868-53-7
0.10
1
07/13/11 12:58
Date: 07/19/2011 11:06AM REPORT OF LABORATORY ANALYSIS Page 5 of 12
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc..

d Pace Analytical Services, Inc. Pace Analytical Services, Inc.
/�aceAnalj4ical 205 East Meadow Road - SuiteA 2225 Riverside Dr.
ry�y pp�y� y Eden, NC 27288 Asheville, NC 28804
[phone] [phone]
QUALITY CONTROL DATA
Project: TCLP MANHOLE CHIP RECOVERY
Pace Project No.: 9297660
QC Batch: GCSV/5144
QC Batch Method: EPA 8081
Associated Lab Samples: 9297660001
METHOD BLANK: 222481
Associated Lab Samples: 9297660001
Parameter
Units
Chlordane (Technical)
mg/L
Endrin
mg/L
gamma-BHC (Lindane)
mg/L
Heptachlor
mg/L
Heptachlor epoxide
mg/L
Methoxychlor
mg/L
Toxaphene
mg/L
DecachlorobiphenylIS)
%
Tetrachloro-m-xylene IS)
%
Analysis Method: EPA 8081
Analysis Description: 8081 GCS TCLP Pesticides
Matrix: Water
Blank
Result
Reporting
Limit
Analyzed Qualifiers
ND
0.0050
07/1311120:50
ND
0.0010
07113/1120:50
ND
0.0010
07/13/1120:50
ND
0.0010
07/1311120:50
ND
0.0010
07/13/1120:50
ND
0.0010
07/13/1120:50
ND
0.0050
07/13/1120:50
115
70-130
07/13/1120:50
90
70-130
07/13/1120:50
LABORATORY CONTROL SAMPLE:
Parameter
222482
Units
Spike
Conc.
LCS
Resutt
LCS
% Rec
% Rec
Limits
Endrin
mg/L
.005
0.0048
95
70-130
gamma-BHC (Lindane)
mg/L
.005
0.0045
91
70-130
Heptachlor
mg/L
.005
0.0045
90
70-130
Heptachlor epoxide
mg/L
.005
0.0049
98
70-130
Methoxychlor
mg/L
.005
0.0053
106
70-130
DecachlorobiphenylIS)
%
116
70-130
Tetrachloro-m-xylene (S)
%
97
70-130
Pace Analytical Services, Ind
9800 IGncey Ave. Suite 100
Huntersville, NC 28078
[phone]
Qualifiers
MATRIX SPIKE 8 MATRIX SPIKE DUPLICATE:
222651
222652
MS
MSD
9297590005
Spike
Spike
MS
MSD
MS
MSD
% Rec
Parameter
Units
Result
Conc.
Conc.
Result
Result
% Rec
% Rec
Limits
RPD Qual
Endrin
mg/L
ND
.005
.005
0.0051
0.0051
103
102
70-130
.7
gamma-BHC (Lindane)
mg/L
ND
.005
.005
0.0047
0.0047
85
86
70-130
.4
Heptachlor
mg/L
ND
.005
.005
0.0052
0.0052
104
104
70-130
.4
Heptachlor epoxide
mg/L
ND
.005
.005
0.0061
0.0062
122
124
70-130
2
Methoxychlor
mg/L
ND
.005
.005
0.0063
0.0062
127
123
70-130
3
Decachlorobiphenyl (S)
%
111
108
70-130
Tetrachloro-m-xylene (S)
%
101
102
70-130
Date: 07/19/2011 11:06 AM REPORT OF LABORATORY ANALYSIS Page 6 of 12
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc..

® Pace Analytical Services, Inc. Pace Analytical Services, Inc.
7-ralceAnalXical 205 East Meadow Road - Suite A 2225 Riverside Dr.
www.pacelabs.com Eden. NC 27288 Asheville, NC 28804
[phone] [phone]
QUALITY CONTROL DATA
Project: TCLP MANHOLE CHIP RECOVERY
Pace Project No.. 9297660
QC Batch: OEXT/14216
QC Batch Method: EPA 3535
Associated Lab Samples: 9297660001
METHOD BLANK: 633975
Associated Lab Samples: 9297660001
Parameter
Units
PCB-1016 (Aroclor 1016)
ug/L
PCB-1221 (Aroclor 1221)
ug/L
PCB-1232 (Aroclor 1232)
ug/L
PCB-1242 (Aroclor 1242)
ug/L
PCB-1248 (Aroclor 1248)
ug/L
PCB-1254 (Aroclor 1254)
ug/L
PCB-1260 (Aroclor 1260)
ug/L
Decachlorobiphenyl (S)
%
Analysis Method: EPA 8082
Analysis Description: 8082 GCS PCB TCLP
Matrix: Water
Blank
Reporting
Result
Limit
Analyzed
ND
1000
07116/1100:42
ND
1000
07116/1100:42
ND
1000
07/16/1100:42
ND
1000
07/16/1100:42
ND
1000
07/1611100:42
ND
1000
07/16/1100:42
ND
1000
07116/1100:42
81
10-132
07/16/1100:42
Qualifiers
Pace Analytical Services, Inc.
9800 Kncey Ave. Suite 100
Huntersvilie, NC 28078
[phone]
LABORATORY CONTROL SAMPLE & LCSD: 633976
633977
Spike LCS LCSD
LCS
LCSD
% Rec Max
Parameter Units
Conc. Result Result
% Rec
% Rec
Limits RPD, RPD Qualifiers
PCB-1016 (Aroclor 1016) ug/L
25 ND ND
52
53
38-113 30
PCB-1260 (Aroclor 1260) ug/L
25 ND ND
57
55
35-120 30
Decachlorobiphenyl (S) %
81
80
10-132
Date: 07/19/2011 11:06 AM REPORT OF LABORATORY ANALYSIS Page 7 of 12
This report shall not be reproduced, except in full.
without the written consent of Pace Analytical Services, Inc..

laceAnalytical
f WWM!f18Cei8i)SCORI
Pace Analytical Services, Inc.
205 East Meadow Road - Suite
Eden, NC 27288
[phone]
Project: TCLP MANHOLE CHIP RECOVERY
Pace Project No.: 9297660
Pace Analytical Services, Inc.
2225 Riverside Dr.
Asheville, NC 28804
[phone]
QUALITY CONTROL DATA
QC Batch: OEXT/14185 Analysis Method: EPA 8270
QC Batch Method: EPA 3510 Analysis Description: 8270 TCLP MSSV
Associated Lab Samples: 9297660001
METHOD BLANK: 632233 Matrix: Water
Associated Lab Samples: 9297660001
Parameter
Units
Blank
Result
Reporting
Limit
Analyzed
1,4-Dichlorobenzene
ug/L
ND
50.0
07/13/11 11:58
2,4,5-Trichlorophenol
ug/L
ND
50.0
07/13/11 11:58
2,4,6-Trichlorophenol
ug/L
ND
50.0
07/1311111:58
2,4-Dinitrotoluene
ug/L
ND
50.0
07/13/11 11:58
2-Methylphenot(o-Cresol)
ug/L
ND
50.0
07/13/11 11:58
3&4-Methylphenol(m&p Cresol)
ug/L
ND
50.0
07/13/11 11:58
Hexachloro-1,3-butadiene
ug/L
ND
50.0
07113/1111:58
Hexachlorobenzene
ug/L
ND
50.0
07/13/11 11:58
Hexachloroethane
ug/L
ND
50.0
07/1311111:58
Nitrobenzene
ug/L
ND
50.0
07/13/11 11:58
Pentachlorophenol
ug/L
ND
100
07/13/11 11:58
Pyridine
ug/L
ND
50.0
07/1311111:58
2,4,6-Tribromophenol (S)
%
58
27-108
07/13/11 11:58
2-Fluorobiphenyl (S)
%
57
13-107
07/13/11 11:58
2-Fluorophenol (S)
%
29
10-110
07/13/11 11:58
Nitrobenzene-d5 (S)
%
61
12-102
07/13/11 11:58
Phenol-d6 (S)
%
18
10-110
07/13/11 11:58
Terphenyl-d14 (S)
%
69
21-132
07/13/11 11:58
LABORATORY CONTROL SAMPLE: 632234
Parameter
1,4-Dichlorobenzene
ug/L
2,4,5-Trichlorophenol
ug/L
2,4,6-Tdchlorophenot
ug/L
2,4-Dinitrotoluene
ug/L
2-Methyiphenol(o-Cresol)
ug/L
3&4-Methylphenol(m&p Cresol)
ug/L
Hexachloro-1,3-butadiene
ug/L
Hexachlorobenzene
ug/L
Hexachloroethane
ug/L
Nitrobenzene
ug/L
Pentachiorophenol
ug/L
Pyridine
ug/L
2,4,6-Tribromophenol (S)
%
2-Fluorobiphenyl (S)
%
2-Fluorophenol(S)
%
Nitrobenzene-d5 (S)
%
Phenol-d6 (S)
%
Terphenyl-d14 (S)
%
Spike
Units Conc.
LCS
Result
500
212
500
316
500
285
500
282
500
230
500
205
500
238
500
301
500
195
500
293
1000
337
500
167
LCS
% Rec
Qualifiers -
% Rec
Limits
42 10-110
63 39-108
57 40-104
56 42-109
46 31-110
41 30-110
48 10-110
60 39-121
39 10-110
59 32-101
34 18-108
33 10-110
48 27-108
58 13-107
22 10-110
61 12-102
14 10-110
67 21-132
Pace Analytical Services, roar
9800 KinceyAve. Suite 100
Huntersville, NC 28078
[phone]
Qualifiers
Date: 07/19/2011 11:06 AM REPORT OF LABORATORY ANALYSIS Page 8 of 12
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc..
•

/71aceAnalyfical"
wwwpacela6s.com
Pace Analytical Services, Inc.
205 East Meadow Road - Suite A
Eden, NC 27288
[phone]
Project: TCLP MANHOLE CHIP RECOVERY
Pace Project No.: 9297660
MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 632235
Pace Analytical Services, Inc.
2225 Riverside Dr.
Asheville, NC 28804
[phone]
QUALITY CONTROL DATA
MS
9297739001
Spike
Parameter
Units
Result
Conc.
1,4-Dichlorobenzene
ug/L
ND
500
2,4,5-Trichlorophenol
ug/L
NO
500
2,4,6-Trich loro phenol
ug/L
ND
500
2,4-Dinitrotoluene
ug/L
ND
500
2-Methylphenol(o-Cresol)
ug/L
ND
500
3&4-Methylphenol(m&p
ug/L
ND
500
Cresol)
Hexachloro-1,3-butadiene
ug/L
ND
500
Hexachlorobenzene
ug/L
ND
500
Hexachloroethane
ug1L
ND
500
Nitrobenzene
ug/L
ND
500
Pentachlorophenol
ug/L
ND
1000
Pyridine
ug/L
ND
500
2,4,6-Tribromophenol (S)
%
2-Fluorobiphenyl (S)
%
2-Fluorophenol (S)
%
Nitrobenzene-d5 (S)
%
Phenol-d6 (S)
%
Terphenyl-d14 (S)
%
Pace Analytical Services, Inc.
9800 KinceyAve. Suite 100
Huntersville, NC 28078
[phone]
632236
MSD
Spike
MS
MSD
MS
MSD
% Rec
Cone.
Result
Result
% Rec
% Rec
Limits
RPD
500
256
250
51
50
30-150
2
500
396
361
79
72
30-150
9
500
350
327
70
65
30-150
7
500
349
323
70
65
30-150
B
500
281
290
56
58
30-160
3
500
255
266
51
53
30-150
4
500
295
293
59
59
30-150
0
500
373
328
75
66
30-150
13
500
249
243
50
49
30-150
2
500
357
356
71
71
30-150
0
1000
493
415
49
41
30-150
17
500
211
199
42
40
30-150
6
60
53
27-108
69
66
13-107
26
26
10-110
70
69
12-102
17
17
10-110
78
72
21-132
Qual
Date: 07/19/2011 11:06 AM REPORT OF LABORATORY ANALYSIS Page 9 of 12
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc..

._ �aceAnalytical
w wpace4bscom
Pace Analytical Services, Inc.
205 East Meadow Road - Suite A
Eden, NC 27288
[phone]
Project: TCLP MANHOLE CHIP RECOVERY
Pace Project No-: 9297660
Pace Analytical Services, Inc.
2225 Riverside Dr.
Asheville, NC 28804
[phone]
QUALITY CONTROL DATA
QC Batch: MSVA 5956 Analysis Method: EPA 8260
QC Batch Method: EPA 8260 Analysis Description: 8260 MSV TCLP
Associated Lab Samples: 9297660001
METHOD BLANK: 631353
Associated Lab Samples:
Parameter
9297660001
Units
Matrix: Water
Blank Reporting
Result Limit
Analyzed
1,1-Dichloroethene
ug/L
NO
5.0
07111/1118:05
1,2-Dichloroethane
ug/L
ND
5.0
07/1111118:05
1,4-Dichlorobenzene
ug/L
NO
5.0
07/11/11 18:05
2-Butanone (MEK)
ug/L
ND
10.0
07/11/11 18:05
Benzene
ug/L
ND
5.0
07111/1118:05
Carbon tetrachloride
ug/L
ND
5.0
07/11/11 18:05
Chlorobenzene
ug/L
ND
5.0
07/11/11 18:05
Chloroform
ug/L
ND
5.0
07/11/11 18:05
Tetrachloroethene
ug/L
ND
5.0
07111/1118:05
Trichloroethene
ug/L
ND
5.0
07111/1118:05
Vinyl chloride
ug/L
ND
5.0
07/11/11 18:05
1,2-Dichloroethane-d4 (S)
%
121
70-130
07/11/11 18:05
4-Bromofluorobenzene (S)
%
101
70-130
07/11/11 18:05
Dibromofluoromethane (S)
%
105
70-130
07/11/11 18:05
Toluene-d8 (S)
%
102
67-135
07/11/11 18:05
LABORATORY CONTROL SAMPLE: 631354
Parameter
1,1-Dichloroethene
ug/L
1,2-Dichloroethane
ug/L
1,4-Dichlorobenzene
ug/L
2-Butanone (MEK)
ug/L
Benzene
ug/L
Carbon tetrachloride
ug/L
Chlorobenzene
ug/L
Chloroform
ug/L
Tetrachloroethene
ug/L
Trichloroethene
ug/L
Vinyl chloride
ug/L
1,2-Dichloroethane-d4 (S)
%
4-Bromofluorobenzene (S)
%
Dibromofluoro methane (S)
%
Toluene-d8 (S)
%
Spike
Units Conc.
LCS
Result
50
43.6
50
46.3
50
47.0
100
83.2
50
47.6
50
50.4
50
52.0
50
49.2
50
53.4
50
51.1
50
48.1
LCS
% Rec
Qualifiers
% Rec
Limits
87 70-141
93 70-139
94 70-141
83 63-150
95 70-132
101 70-150
104 70-134
98 70-130
107 70-137
102 70-131
96 56-144
89 70-130
103 70-130
95 70-130
102 67-135
Pace Analytical Services, In&
9800 KinceyAve. Suite 100
Huntersville, NC 28078
[phone]
Qualifiers
Date: 07/19/2011 11:06 AM REPORT OF LABORATORY ANALYSIS Page 10 of 12
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc..

7Pa eAnalytical
i www.pacelabs.com
Pace Analytical Services, Inc.
205 East Meadow Road - Suite A
Eden, NC 27288
[phone]
Project TCLP MANHOLE CHIP RECOVERY
Pace Project No.: 9297660
Pace Analytical Services, Inc.
2225 Riverside Dr.
Asheville, NC 28804
[phone]
QUALITY CONTROL DATA
QC Batch: WETM7122 Analysis Method: EPA 9045
QC Batch Method: EPA 9045 Analysis Description: 9045 pH
Associated Lab Samples: 9297660001
SAMPLE DUPLICATE: 632756
Parameter
pH at 25 Degrees C
9297643025 Dup
Units Result Result
Std. Units 4.3 4.3
RPD Qualifiers
0
Pace Analytical Services, Inc.
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Date:07/19/2011 11:06AM REPORT OF LABORATORY ANALYSIS Pagel of12
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc..

e
Pace Analytical Services, Inc.
Pace Analytical Services, Inc.
Pace Analytical Services, I11�nd,
aceAnalyiical
205 East Meadow Road - Suite A
2225 Riverside Dr.
9800 KinceyAve. Suite 100
www.pacelabs.com
Eden, NC 27288
Asheville, NC 28804
Huntersville, NC 28078
[phone]
[phone]
[phone]
QUALIFIERS
Project: TCLP MANHOLE CHIP RECOVERY
Pace Project No.: 9297660
DEFINITIONS
DF - Dilution Factor, if reported, represents the factor applied to the reported data due to changes in sample preparation, dilution of
the sample aliquot, or moisture content.
ND - Not Detected at or above adjusted reporting limit.
J - Estimated concentration above the adjusted method detection limit and below the adjusted reporting limit.
MDL -Adjusted Method Detection Limit.
S - Surrogate
1,2-Diphenylhydrazine (8270 listed analyte) decomposes toAzobenzene.
Consistent with EPA guidelines, unrounded data are displayed and have been used to calculate % recovery and RPD values.
LCS(D) - Laboratory Control Sample (Duplicate)
MS(D) - Matrix Spike (Duplicate)
DUP - Sample Duplicate
RPD - Relative Percent Difference
NC - Not Calculable.
SG - Silica Gel - Clean -Up
U - Indicates the compound was analyzed for, but not detected.
N-Nitrosodiphenyla mine decomposes and cannot be separated from Diphenylamine using Method 8270. The result reported for
each analyte is a combined concentration.
Pace Analytical is TNI accredited. Contact your Pace PM for the current list of accredited analytes.
LABORATORIES
PASI-A Pace Analytical Services -Asheville
PASI-C Pace Analytical Services - Charlotte
PAST-O Pace Analytical Services - Ormond Beach
Date: 07/19/2011 11:06AM REPORT OF LABORATORY ANALYSIS Page 12 of 12
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc..

'll'll l►li l('`! Ill if
Order ID: 1113710 DOC
,' vnwyu;.W.Gs.own
Workorder: 9297660 Workorder Name: TCLP MANHOLE CHIP RECOVERY (Results Requested 7/18/2011
Report I Invoice To Subcontract To
'~
a uested.Ariat sis
Renee Spencer
Pace
i
Analytical Charlolte P.O.
9800 Kincey Ave. Suite 100
Huntersville, NC
28078
Phone (704)87b-9092 �� E�
Email: [e-mail]
PruSerVe..B.Centainsrs
I
;
colfett
€
m
t
item ,
Sample i0 -' „, a
DatelFime:
Lab.11) ,, -
ylatnx .
LAS USE ONLY
1
SLUDGE WASH PIT
7/5/2011 10:00
9297660001
Solid
I
2
3
4
—
-
- —!
I
5
I
7 Comments -
Transfers
Rete ed By
Daterrime
Received By
Datemme
Pb , 0, 1
I
-84
'
(i/L kt4lk S
3
4
VVednesday, July Oci, 2011 3 c0.47 PM -- -- �— ~ --- !— FM1IT-AI_I_-C-002rev.00 24N1arch2009 — Page 1 of

0
IF
Summit Environmental Technologies, Inc.
Cooler Receipt Form
Order ID: 1113710 COOLER
1
,33
Client:
II
Order ID:
Log in Initials:
Date Received: t Time Received: C,/ Date &P_enedt/
Number of ol�s/boxes:
,-
N/A Unpacked by:
Shipper: F UPS
DHL_-_q•��bome US Postal Walk-in '4`-� n Pickup Other:
Packaging: Peanuts
rBubble Wrap/ Paper Foam None Other.
Tape on cooler/box:
—
N N/A
i'Y
Custody Seals intact
/Y N N/A
C-O-C in plastic
Y N N/A
Coolant iced Blue ice
,Water _None i Sample Temperature ? 'C
C-O-C filled out properly
Y' N NIA
Samples in separate bags rY N N/A
L'
Sample containers intact Y . N N/A
'If no, list broken sample(s):
Sample label(s) complete (ID, date, etc)
Y..
N
N/A
Label(s) agree with C-O-C
N
NIA
Correct containers used
(`Y •
N
NIA
Sufficient sample received
'Y
N
N/A
Samples at correct pH? (list below)
Y
N
NA'
Bubbles absent from 40 mL vials"
Y
N
N/A
t
" Samples with bubbles less than the size of a pea are acceptable.
Client contact:
Date/Time:
Comments:

Approved By:
IN
r.iJV!#iWOU, EN"I'ilL TECHNOLOGIES. INC,
3��tfjFit;.:'al hlt#.>C�ftcnt;c''
In
as r • r Lr —_.r. r
Client
Pace Analytical Services Inc
9800 Kincey Avenue Suite 100
Huntersville, NC 28078
Order Number
1113710
Project Number
TCLP Manhole Chip Recovery
Issued
Monday, July 18, 2011
Total Number of (Pages
5 (excluding C.O.C. and cooler receipt form)
N•
NELAC Accreditation #E87688
"Amlytical Integrity" • EPA certified
:3311# vUi:; Strea • Cuyai-{oga i ells, Oleic 4 223 � Phone: [phone] . Fax: [phone]

}
I ENVIRONMENTAL TECHNOLOGIES, INC.
Analytical Labow+tot•ie5s
Client: Pace Anal tical Services Inc
Order Number: 1113710
Laboratory ID Client ID
1113-110-01
Sample Summary
Matrix
9297660001 Solid
2
Sampling Date
7/5/2011
"rinalytical integrity". - EPA Certified NE. LAP C 7t LI IE
srijin cJ,!•na.t;-ails, Ohio 4 422 ; - Phone: 330-253,8211 f-ax: 330-253-11.4189
+Neil Site' .vvvw Fottek.com

^� ✓
t i # t
s'idVii'tONiViCNTAL. TECH INIO LOGIES. INC.
.... i7: lylit;al La?Jt3r�?to -h- S
Report Narrative
Client: Pace Analytical Services Inc
Order Number: 1113710
3
Solid sample results are reported on a wet weight basis except as noted.
No problems were encountered during analysis of this order number, except as noted.
Data Qualifiers:
B = Analyte found in the method blank
J = Estimated concentration of analyte between MDL (LOD) and Reporting Limit (LOQ)
C = Analyte has been confirmed by another instrument or method
E = Analyte exceeds the upper limit of the calibration curve.
D = Sample or extract was analyzed at a higher dilution
X = User defined data qualifier.
S = Surrogate out of control limits
U = Undetected
a = Not Accredited by NELAC
ND = Non Detected at LOQ
DF = Dilution Factor
Limit Of Quantitation (LOQ) = Laboratory Reporting Limit (not adjusted for dilution factor)
Limit Of Detection (LOD) = Laboratory Detection Limit
Estimated uncertainty values are available upon request.
Matrices:
A=Air
C = Cream
DW = Drinking Water
L = Liquid
O = Oil
SL = Sludge
SO = Soil
S = Solid
T = Tablet
TC = TCLP Extract
WW = Waste Water
W = Wipe
The test results meet the requirements of the NELAC standard, except where noted. The information contained in
this analytical report is the sole property of Summit Environmental Technologies, Inc. and that of the client. It cannot
be reproduced in any form without the consent of Summit Environmental Technologies, Inc. or the client for which this
report was issued. The results contained in this report are only representative of the samples received. Conditions
can vary at different times and at different sampling conditions. Summit Environmental Technologies, Inc. Is not
responsible for use or interpretation of the data included herein.
"Analytical Integrity" . ERA Certified - NF, W Certifi x:
us l 1 �1�ttt1 ` t t?Es Cuylahoqa h -lls, Ohio 44223 8 Phone: 330-253 t3?11 ;=ax: 330-253-4E3`.3
Weis Sito tmv-s641ok.com

J
-i\lVII3ONIViCNTA1.TCC,,1INOLOCIFS,
INC.
July 18,2011
r w;'•l dIn t;ytit:al Mal oratories.
Client: Pace Analytical Services Inc
Address: 9800 Kinecy Avenue Suite
I00
Huntersville, NC 28078
Received: 7/8/2011
Project #: TCLP Manhole Chip Recovery
TCLP Metals
Client ID #
Lab 1D#
Collected Analvte
Rep Lmt
Elg1k
lkil§Z tix Method
DF
Re t-vl
Run Analyst
9297660001
1113710-01
05-Jut-11 Lead
0.5
ND
mg/I S 1311
1
5
18-Jul-11 VVK
9297660001
1113710-01
05-Jul-11 Cadmium
0.1
ND
mg/I S 1311
1
1
18-Jul-11 VVK
9297660001
1113710-01
05-Jul-11 Chromium
0.2
ND
mg/I S 1311
1
5
18-Jul-11 VVK
9297660001
1113710-01
05-Jul-11 Silver
0.5
ND
mg/I S 1311
1
5
18-Jul-11 VVK
9297660001
1113710-01
05-Jul-11 Mercury
0.002
ND
mg/I S 1311
1
0.2
18-3ul-11 VVK
9297660001
1113710-01
05-JUI-11 Barium
5
ND
mg/I S 1311
1
100
18-Jul-11 VVK
9297660001
1113710-01
05-Jul-11 Arsenic
0.5
ND
mg/I S 1311
1
5
18-Jul-11 VVK
9297660001
1113710-01
05-Jul-11 Selenium
0.5
ND
mg/l S 1311
1
1
18-Jul-11 VVK
Client ID#
Lab lD#
Cp1lected Anala
Result
flails Mntrix Me ad
DF
LOQ
Run Analyst.
9297660001
1113710-01
05-Jul-11 Cadmium
ND
mg/Kg S 6010
1
0.5
18-Jul-11 VVK
Client ID#
Lab ID#
Collected Anal
Rgi!!h
Units Matrix Method
DF
LOQ
Run galvst
9297660001
1113710-01
05_Jul-11 Chromium
28.0
mg/Kg S 6010
1
2.5
18-Jul li VVK
tent Ill#
Lab ID#
Collected Angl3ne
Result
Uttits Matrix Medit,a
DF
LOCI
Run Analv,t
9297660001
1113710-01
OS-Jul-11 Copper
370.0
mg/Kg S 6010
1
2.5
18-Jul-11 WK
Client lD#.
Lab IQ#
Collceted Analyto
Result
nits hiairiN Medtod
DF
LOQ
Run Analyst
9297660001
1113710-01
05-Jul-11 Lead
18.0
mg/Kg S 6010
1
5
18-Jul-11 VVK
Client ID#
LahIDI
Collect AnalLn
Result
Units Ma rix Method
DF
LOQ
Run Ana)W
9297660001
1113710-01
05 Jul-11 Mercury
ND
mg/kg S 7471A
1
0.2
13-Jul-11 VVK
Client 11)#
lab ID#
Collecteci Analvte
Result
Units Matrix Method
Dr
LOQ
Ran Analyst
9297660001
1113710-01
05-Jul-11 Nickel _ _
_
27.0
mg/Kg S 6010
1
2.5
18-Jul-11 VVK
Client ID #
l-ab ID#
Collceled al to
Result
li its Matrix Method
DF
LOQ
1 a Anal yst
9297660001
1113710-01
05-Jul-11 Silver
_
ND
mg/Kg S 6010
1
2.5
18-Jul-11 VVK
Client ID#
Lib 1D#
Collected Analyte
Result
Units Manix Method
DF
LOB(
Run Analyst
9297660001
1113710-01
05_Jul-11 Zinc _
70.0
_ mg/Kg S _6010
1
2_5
18-Jul-11 VVK
Page 4
"Annlytical lntergrity" - r-PA Certified - 'NEL P? Oert4ffc-t
3310 Win Stroor Cuyahogii 1-,alls, Ohio 41,122" - ,'hone: 330-253-8211 t'ax: 330-253-4489
(�,�i-.'h �1tE'. 41'vt•t4.SNltt'Ii.ClJ111

h jF =l
s } r N1 HONNIENTAt. TECHNOLOGIES, INC.
Aimlyticat f tJor'afort%S
Client ID Lab IN Collected �-I t-ee
9297660001 1113710-01 05-Jul-11 Cyanide, Total
Client ID Lab IN Collectet] nalvte
9297660001 1113710-01 05-Jul-11 Oil & Grease
July 18, 2011
Client: Pace Analytical Services Inc
Address: 9800 Kincey Avenue Suite 100
Huntersville, NC 28078
Received: 7/8/2011
Project #l: TCLP Manhole Chip Recovery
Result
(.lads
Matrix Method
DF
LOQ
Run Analyg
<0.5
mg/Kg
S SW-846
1
0.5
12-Jul-11 TIR
9010
mod.
Result
1kiiia
Matrix Method
U
LOO
Run Analyst
220950.0
mg/kg
S 1664
1
1000
15-Jul-11 SRA
Page 5
alrzaiVfiCW Integrity" • EPA Certified ldl-:i.�fr t';t=rti i
`tt. c:i C'Uy_ hoga Falls, 01-do 44223 a 1lhone: 330-253-8211 Fax: [phone]
VYeb Site: tvww.settc�lc.rc�r7t

PaceAr igytical'
,
CHAIN -OF -CUSTODY / Analytical Request Document
The Chain -of -Custody is a LEGAL DOCUMENT. Alf relevant fields must be completed accurately.
^^
Page. of
Section A Section B Section C
Required Client Information: Required Project Inkxmatlon: Invoice Information:
Report To: Attention:
147617 1
!Compan `� v /
Addro
Copy To:
Company Name:
REGULATORY AGENCY
Address:
r— NPDES r— GROUND WATER i— DRINKING WATER
r- UST C— RCRA i^ OTHER
Email To:
Purchase Order No.:
Pace Quote
Reference:
P•
Fax:
Project Name:�.� �
4,44er•
Pace Project
Site Location
STATE:
Ale —
�—
DueDaterrAT:
Project ti
o"ProlFeA:
Requested
Requested
Analysis
Filtered
(YIN)
�
Section D MaWxCodes
z
Requiredckaximwmosoe tNATRrx r eooE
COLLECTED
Preservatives
>`
Drinking Wafer aw
Water WT
a
o
Wastewater WW
(a
c3TMrre
c�W
V
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1
f�Ui� A-`` i`
Product P
SdUSaNd SL
SAMPLE ID wipe wa
w
a
m
7 ycu e�+N
iAz.
ag/;) Alr AR
Sample IDs MUST DE UNIQUE Tissue TS
O
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Q
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0
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a
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O
r/j
a7
IVOther
O
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S,LU
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=
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DATE
TIME
DATE
TIME
#
Z
Z
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Pace Project No./ Lab I.D.
1
C4 P D; ese
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C
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3
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4
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11
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ADDITIONAL COMMENTS
RELINQUISHED BY I AFFILIATION
TIME
ACCEP
D BY!
TION
D
TIME
SAMPLE CONDITIONS
71,44
/
yI
62�
t
Ib�o
3•Lt
SAMPLER NAME AND SIGNATURE
O
T b
ORIGINAL
=_
PRINT Name of SAMPLER:
0
DATESigned /y
31r3NA7URE of SAMPLER: IMMIDDNY):

1 Sample-Condit'lon..Receipt
4ceAnalytical' Client Name: Project
t1Cl
r
Vhere Received: Huntersville ❑ Asheville ❑ Eden
:ourier: ❑Fed Ex El UPS ❑ USPS [I Client ❑Commercial Pace Other 0 ptiohai:�
Proj°.�Dij�`OateT�'� �,� ,y.
:ustody Seal on Cooler/Box Present: ❑ yes no Seals intact: ❑ yes ❑ no
pe.gj? DWQ x _
lacking Material: ❑ Bubble Wrap ubble Bags ❑ None [I Other
'hermometer Used: IR Gun: T1102 Type of Ice: et Blue None Samples on ice, cooling process has begun
:orrected Cooler Temp.: C
Biological Tissue is Frozen: Yes No
Date and initials of person examining
contents:
amp should be above freezing to 6•C
Comments:
:hain of Custody Present:
114es ❑No
❑N/A
1.
;hain of Custody Filled Out:
es tia�lo'
❑N/A
2. r.
< <
:hain of Custody Relinquished:
es ❑No
❑NIA
3.41'�
,ampler Name & Signature on COC:
2" es ONo
❑N/A
4.
,amples Arrived within Hold Time:
[IN.
❑NIA
5.
short Hold Time Analysis (<72hr):
❑Yes to
ON/A
6.
,ush Turn Around Time Requested:
OYes boo —❑NIA
7.
sufficient Volume:
Pfe—s ONo
❑N/A
8.
:orrect Containers Used:
es ❑No
❑NIA
g.
-Pace Containers Used:
IRres ON.
❑NIA
:ontainers Intact:f�Yes'❑No
❑NIA
10.
iltered volume received for Dissolved tests
❑Yes ONo
/A
11.
:ample Labels match COC:
OIL- ❑No
❑N/A
12,
-Includes date/timellD/Anal sis Matrix:
ll containers needing preservation have been checked.
[]Yes ❑No
ErNIA
13.
,11 containers needing preservation are found to be in
ompliance with EPA recommendation.
❑Yes ONo
/A
xceptions: VOA, coluorm, TOC, O&O, WI-DRO (water)
Dyes []No
Initial when completed
lam les checked for dechlorination:
OYes ONo
ENW
14.
leadspace in VOA Vials (>6mm):
OYes ONo
N/A
15.
-rip Blank Present:
❑Yes ONo
0VA
16.
rip Blank Custody Seals Present
❑Yes ONo
N/A
pace Trio Blank Lot # (if purchased):
-lient Notification/ Resolution: Field Data Required? Y / N
Person Contacted: Daterrime:
Comments/ Resolution:
SCURF Review: r'`'� )Date: II G SRF Review:) Date: [ _T 7"I
Note: Whenever there is a discrepancy affecting North Carolina compliance samples, a copy of this form will be sent to the North Carolina DEHNR
Certification Office ( Le out of hold, incorrect preservative, out of temp, incorrect containers)
�m
F-CHR-CS-003-rev.04 27Jun2011

Ap
Analytical
WWWPACaMLWM
Pace Analytical Services, Inc.
205 East Meadow Road - Suite A
Eden, NC 27288
[phone]
February 09, 2012
Ms. Christin Annie
Ingersoll Mocksville
501 Sanford Avenue
Mocksville, NC 27028
RE: Project: Georgia Waste Water
Pace Project No.: 92111364
Dear Ms. Annie:
Pau Analytical Services, Inc.
2225 Riverside Dr.
Asheville, NC 28804
[phone]
Pau Analytical Services, Inc.
98001Gncey Ave. Suite 100
Huntersville, NC 28078
(704W5.9092
Enclosed are the analytical results for sample(s) received by the laboratory on February 02, 2012.
The results relate only to the samples included in this report. Results reported herein conform to the
most current TNI standards and the laboratory's Quality Assurance Manual, where applicable, unless
otherwise noted in the body of the report.
Analyses were performed at the Pace Analytical Services location indicated on the sample analyte
page for analysis unless otherwise footnoted.
If you have any questions concerning this report, please feel free to contact me.
Sincerely,
Renee Spencer
[e-mail]
Project Manager
Enclosures
cc: Mr. Jerry Lakey, Ingersoll Mocksville
Mr. Jahn Young, Ingersoll Mocksville
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pau Analytical Services, Inc.,
1of16
Page 1 of U

acmnalXical
wxw.pacelabs.com
Project: Georgia Waste Water
Pace Project No.: 92111364
Pace Analytical Services, Inc.
205 East Meadow Road - Suite A
Eden, NC 27288
[phone]
Pace Analytical Services, Inc.
2225 Riverside Dr.
Asheville, NC 28804
[phone]
CERTIFICATIONS
Pace Analytical Services, Inc.
98001CnceyAve. Suite 100
Huntersville, NC 28078
[phone]
Asheville Certification IDs
2225 Riverside Dr., Asheville, NC 28804
South Carolina Certification M 99030001
Florida/NELAP Certification #: E87648
Virginia Certification #: 00072
Massachusetts Certification #: M-NC030
West Virginia Certification #: 356
North Carolina Drinking Water Certification #: 37712
Virgina/VELAP Certification M 460147
North Carolina Wastewater Certification #: 40
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except In full,
without the written consent of Pace Analytical Services, Inc..
Page 2 of 14
2of16

acanalytical e
www.Pacdabs.corn
Project: Georgia Waste Water
Pace Project No.: 92111364
Pace Analytical Services, Inc.
205 East Meadow Road - Suite A
Eden, NC 27288
[phone]
Lab ID Sample ID
92111364001 Shaker/Washer/Georgia #1
92111364002 Shaker/Washer/Georgia #2
Pace Analytical Services, Inc.
2225 Riverside Dr.
Asheville, NC 28804
[phone]
SAMPLE ANALYTE COUNT
Method
EPA 200.7
EPA 245.1
SM 2540D
SM 5210B
SM 4500-CN-E
EPA 200.7
EPA 245.1
SM 2540D
SM 5210B
SM 4500-CN-E
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc..
Pace Analytical Services, Inc.
9800 IGncey Ave. Suite 100
Huntersvlle, NC 28078
[phone]
Analytes
Analysts Reported Laboratory
JMW
7
PASI-A
DMB
1
PASI-A
SMW
1
PASI-A
SDH
1
PASI-A
JDA
t
PASI-A
JMW
7
PASI-A
DMB
1
PASI-A
SMW
1
PASI-A
SDH
1
PASI-A
JDA
1
PASI-A
Page 3 of 14
46
3of16

aceAnaiytical
www.pacw8ftcom
Project: Georgia Waste Water
Pace Project No.: 92111364
Pace Analytical Services, Inc.
205 East Meadow Road -Suite A
Eden, NC 27288
[phone]
Pace Analytical Services, Inc.
2225 Riverside Dr.
Asheville, NC 28804
[phone]
ANALYTICAL RESULTS
Pace Analytical Services, Inc.
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Sample: Shaker/Washer/Georgia #1
Parameters
Lab ID; 92111364001 Collected: 02/01/12 13:30
Results Units Report Limit OF
Received: 02/02/12 12:05 Matrix: Water
Prepared Analyzed CAS No. Qual
200.7 MET ICP
Analytical Method: EPA200.7 Preparation
Method: EPA200.7
Cadmium
NO ug/L
1.0
1
02/06/12 11:05
02/07/12 21:50 7440-43-9
Chromium
NO ug/L
5.0
1
02/06/12 11:05
02107/12 21:50 7440-47-3
Copper
56.9 ug/L
5.0
1
02/06/12 11:05
02/07/12 21:50 7440-50-8
Lead
NO ug/L
5.0
1
02/06/12 11:05
02/07/12 21:50 7439-92-1
Nickel
ND ug/L
5.0
1
021D6M211:05
0210711221:50 7440-02-0
Silver
ND ug/L
5.0
1
02/06/12 11:05
02107/12 21:50 7440-22-4
Zinc
14.4 ug/L
10.0
1
02/06/12 11:05
02/07/12 21:50 7440-66-6
245.1 Mercury
Analytical Method: EPA245.1 Preparation Method: EPA245.1
Mercury
NO ug/L
0,20
1
02/06/12 15:05
02/07/1211:51 7439-97-6
2540D Total Suspended Solids
Analytical Method: SM 2540D
Total Suspended Solids
10 mg/L
8.3
1
02/07112 08:56
521013 BOD, 5 day
Analytical Method: SM 5210B
BOD, 5 day
30.0 mg/L
2.0
1
02/03/12 12.42
02/08/12 16:08 82
450OCNE Cyanide, Total
Analytical Method: SM 4500-CN-E
Cyanide
ND mg/L
0.0050
1
02/07/12 16:01 57-12-5
Date: 02/09/2012 04:35 PM
REPORT OF LABORATORY ANALYSIS
This report shell not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc..
Page 4 of 14
4of16

lceAnalytical
www.pacNebaeom
Project: Georgia Waste Water
Pace Project No.: 92111364
Pace Analytical Services, Inc.
205 East Meadow Road - Suite A
Eden, NC 27288
[phone]
Pace Analytical Services, Inc.
2225 Riverside Dr.
Asheville, NC 28804
[phone]
ANALYTICAL RESULTS
A
Pace Analytical Services, Inc.
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Sample: ShakerlWasher/Georgla #2 Lab 1D: 92111364002 Collected: 02/0111213:30 Received: 02/02/1212:05 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
200.7 MET ICP
Analytical Method: EPA 200.7 Preparation Method: EPA 200.7
Cadmium
ND ug/L
1.0
1
02/06/12 11:05
02/07/12 21:57 7440- 43-9
Chromium
ND ug/L
5.0
1
02/06/12 11:05
02/07/12 21:57 7440-47-3
Copper
56.7 ug/L
5.0
1
02/06/12 11:05
02/07/12 21:57 7440-50-8
Lead
ND ug/L
5.0
1
02/06/12 11:05
02/07/12 21:57 7439-92-1
Nickel
ND ug/L
5.0
1
02/06/12 11:05
02/07/12 21:57 7440-02-0
Silver
ND ug/L
5.0
1
02/06/12 11:05
02/07/12 21:57 7440-22-4
Zinc
ND ug/L
10.0
1
02/06/12 11:05
02/07/12 21:57 7440-66-6
245.1 Mercury
Analytical Method: EPA245.1 Preparation Method: EPA245.1
Mercury
ND ugfL
0.20
1
02/06/12 15:05
02/07/12 11:54 7439-97-6
2540D Total Suspended Solids
Analytical Method: SM 25400
Total Suspended Solids
12.0 mg/L
8.3
1
02107/1210:20
5210E BOD, 5 day
Analytical Method: SM 52108
BOD, 5 day
ND mg/L
2.0
1
02/03/12 12:42
02108/1216:0B
450OCNE Cyanide, Total
Analytical Method: SM 4500-CN-E
Cyanide
ND mg/L
0.0050
1
02/07/12 16:04 57-12-5
Date: 02/09/2012 04:35 PM REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc..
B2
Page 5 of 14
5of16

® Pace Analytical Services, Inc. Pace Analytical Services, Inc. Pace Analytical Services, Inc.
aceMalXical 205 East Meadow Road - Suite 2225 Riverside Dr. 9800 Kincey Ave. Suite 100
www.peceleba.cam Eden, NC 27288 Asheville, NC 28804 Huntersville, NC 28078
[phone] [phone] [phone]
QUALITY CONTROL DATA
Project: Georgia Waste Water
Pace Project No.: 92111364
QC Batch: MERP/4025
Analysis Method: EPA 245.1
QC Batch Method: EPA 245.1
Analysis Description: 245.1 Mercury
Associated Lab Samples: 92111364001, 92111364002
METHOD BLANK: 718270
Matrix: Water
Associated Lab Samples: 92111364001, 92111364002
Blank Reporting
Parameter
Units
Result Limit
Analyzed
Qualifiers
Mercury
ug/L
NO 0.20
02/07/1211:09
LABORATORY CONTROL SAMPLE:
718271
Spike LCS
LCS
% Rec
Parameter
Units
Conc. Result
% Rec
Limits Qualifiers
Mercury
ug/L
2.5 2.4
94
85-115
MATRIX SPIKE SAMPLE:
718272
92110587001 Spike
MS
MS
% Rec
Parameter
Units
Result Conc.
Result
% Rec
Limits Qualifiers
Mercury
ug/L
ND 2.5
2.7
107
70-130
MATRIX SPIKE SAMPLE:
718274
92111327003 Spike
MS
MS
% Rec
Parameter
Units
Result Conc.
Result
% Rec
Limits Qualifiers
Mercury
uglL
ND 2.5
1.9
70
70-130
SAMPLE DUPLICATE: 718273
92111276001 Dup
Parameter
Units
Result Result
RPD
Qualifiers
Mercury
ug/L
0.89 0.76
16
SAMPLE DUPLICATE: 718275
92111327004 Dup
Parameter
Units
Result Result
RPD
Qualifiers
Mercury
ug/L
ND .191
Date: 02/09/2012 04:35 PM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, Ina.
Page 6 of 14
6of16

aceAnalytical"
m�w.pecWahscam
Project: Georgia Waste Water
Pace Project No.: 92111364
Pace Analytical Services, Inc.
205 East Meadow Road - Suite
Eden, NC 27288
[phone]
QC Balch: MPRP/9845
QC Batch Method: EPA 200.7
Associated Lab Samples: 92111364001, 92111364002
METHOD BLANK: 717756
Associated Lab Samples: 92111364001, 92111364002
Parameter
Units
Cadmium
ug/L
Chromium
ug/L
Copper
ug/L
Lead
ug/L
Nickel
ug/L
Silver
ug1L
Zinc
ug1L
Pace Analytical Services, Inc.
2225 Riverside Dr.
Asheville, NC 28804
[phone]
QUALITY CONTROL DATA
Analysis Method:
EPA 200.7
Analysis Description:
200.7 MET
Matrix: Water
Blank Reporting
Result Limit
Analyzed
NO
1.0
02/07/12 21:36
NO
5.0
02/07/12 21:36
NO
5.0
02/07/12 21:36
NO
5.0
02/07/12 21:36
NO
5.0
02/07/12 21:36
NO
5.0
02/07/12 21:36
ND
10.0
02/07/12 21:36
Qualifiers
Pace Analytical Services, Inc.
9800 Kincey Ave. Suite 100 ;
Hunlersville, NC 28078
[phone]
LABORATORY CONTROL SAMPLE:
Parameter
717757
Units
Spike
Conc.
LCS
Result
LCS
% Rec
% Rec
Limits Qualifiers
Cadmium
ug/L
500
462
92
85-115
Chromium
ug/L
500
472
94
85-115
Copper
ug/L
500
456
91
85-115
Lead
ug/L
500
459
92
85-115
Nickel
ug/L
500
460
92
85-115
Silver
ug/L
250
236
94
85-115
Zinc
ug/L
500
464
93
85-115
MATRIX SPIKE SAMPLE:
717758
92111362001
Spike
MS
MS
% Rec
Parameter
Units
Result
Conc.
Result
% Rec
Limits Qualifiers
Cadmium
ug/L
NO
500
454
91
70-130
Chromium
ug1L
11.3
500
479
94
70-130
Copper
ug/L
434
500
895
92
70-130
Lead
ug/L
NO
500
444
89
70-130
Nickel
ug/L
5.7
500
455
90
70-130
Silver
ug/L
ND
250
235
94
70-130
Zinc
ug/L
238
500
700
92
70-130
MATRIX SPIKE SAMPLE:
717760
92111381004
Spike
MS
MS
% Rec
Parameter
Units
Result
Conc.
Result
% Rec
Limits Qualifiers
Cadmium
ug/L
1.2
500
429
86
70-130
Chromium
ug/L
88.6
500
554
93
70-130
Copper
ug/L
1780
500
2300
104
70-130
Lead
ug/L
NO
500
386
77
70-130
Nickel
ug/L
227
500
635
82
70-130
Date: 02/09/2012 04:35 PM
REPORT OF LABORATORY ANALYSIS
Page 7 of 14
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc..
7of16

- aceAnalytical
wwwpacOsUcom
Project: Georgia Waste Water
Pace Project No.: 92111364
Pace Analytical Services, Inc. Pace Analytical Services, Inc. Pace Analytical Services, Inc.
205 East Meadow Road - Suite 2225 Riverside Dr. 9800 Kincey Ave. Suite 100
Eden, NC 27288 Asheville, NC 28804 Huntersville, NC 28078
[phone] [phone] [phone]
QUALITY CONTROL DATA
MATRIX SPIKE SAMPLE: 717760
92111381004 Spike MS MS % Rec
Parameter Units Result Conc. Result % Rec Limits Qualifiers
Silver ug/L ND 250 285 114 70-130
Zinc ug/L 19.4 500 550 106 70-130
SAMPLE DUPLICATE: 717761
Parameter
Units
Cadmium
ug/L
Chromium
ug/L
Copper
ug/L
Lead
ug/L
Nickel
ug/L
Silver
ug/L
Zinc
ug/L
SAMPLE DUPLICATE: 718303
Parameter
Units
Cadmium
ug/L
Chromium
ug/L
Copper
ug/L
Lead
ug/L
Nickel
ug/L
Silver
ug/L
Zinc
ug/L
t
Date: 02/09/2012 04:35 PM
92111426001
Result
Dup
Result RPD Qualifiers
ND
ND
ND
5.3
7.8
9.8 23 D6
5.3
6.4 19
ND
4.7J
ND
.18J
204
223 9
92111364001
Result
Dup
Result RPD
ND
ND
ND
1.4.11
56.9
56.0 2
ND
ND
ND
2.5J
ND
ND
14.4
11.0 27 D6
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc,.
Qualifiers
Page 8 of 14
8of16

aceAnalytical"
f wwwpaeNebtcom
t
Project: Georgia Waste Water
Pace Project No.: 92111364
Pace Analytical Services, Inc. Pace Analytical Services, Inc.
205 East Meadow Road - Suite A 2225 Riverside Dr.
Eden, NC 27288 Asheville, NC 28804
[phone] [phone]
QUALITY CONTROL DATA
QC Batch: WET/19593 Analysis Method: SM 2540D
QC Balch Method: SM 2540D Analysis Description: 2540D Total Suspended Solids
Associated Lab Samples: 92111364001
METHOD BLANK: 718509
Associated Lab Samples: 92111364001
Parameter Units
Total Suspended Solids mg/L
LABORATORY CONTROL SAMPLE: 718510
Parameter Units
Total Suspended Solids mg/L
SAMPLE DUPLICATE: 718511
Parameter
Total Suspended Solids
SAMPLE DUPLICATE: 718512
Parameter
Total Suspended Solids
Date: 02/0912012 04:35 PM
Pace Analytical Services, lnc.
9800 Kincey Ave. Suite 100
Hunlersville, NC 28078
[phone]
Matrix: Water
Blank Reporting
Result Limit Analyzed Qualifiers
ND 2.5 02/07/12 08:49
Spike LCS LCS % Rec
Conc. Result % Rec Limits Qualifiers
250 276 110 80-120
92111513001 Dup
Units Result Result
mg/L 285 274
92111307001 Dup
Units Result Result
mg/L 33.0 44.7
RPD Qualifiers
4
RPD Qualifiers
3006
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services. Inc..
Page 9 of 14
9 of 16

aceAnalytical
wwvw.pacelabacan
Project: Georgia Waste Water
Pace Project No.: 92111364
Pace Analytical Services, Inc. Pace Analytical Services, Inc. Pace Analytical Services, Inc.
205 East Meadow Road - Suite A 2225 Riverside Dr. 9800 Kincey Ave. Suite 100
Eden, NC 27288 Asheville, NC 28804 Huntersville, NC 28078
[phone] [phone] [phone]
QC Batch: WET/19594
QC Batch Method: SM 2540D
Associated Lab Samples: 92111364002
METHOD BLANK: 718528
Associated Lab Samples: 92111364002
Parameter
Units
Total Suspended Solids
mg/L
LABORATORY CONTROL SAMPLE:
718529
Parameter
Units
Total Suspended Solids
mg/L
SAMPLE DUPLICATE: 718530
Parameter
Units
Total Suspended Solids
mg/L
SAMPLE DUPLICATE: 718531
Parameter Units
Total Suspended Solids mg/L
Date: 02/09/2012 04.35 PM
QUALITY CONTROL DATA
Analysis Method: SM 2540D
Analysis Description: 2540D Total Suspended Solids
Matrix: Water
Blank Reporting
Result Limit Analyzed Qualifiers
ND 2.5 02/07/1210:19
Spike LCS
Conc. Result
250 272
92111364002 Dup
Result Result
12.0 13.7
92111547002 Dup
Result Result
24.3 23.7
LCS % Rec
% Rec Limits Qualifiers
109 80-120
RPD Qualifiers
13 D6
RPD Qualifiers
3
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc.,
Page 10 of 14
10 of 16

ace Analytical
( wew.pacekbs.can
I
Project: Georgia Waste Water
Pace Project No.: 92111364
Pace Analytical Services, Inc.
205 East Meadow Road - Suite A
Eden, NC 27288
[phone]
Pace Analytical Services, Inc.
2225 Riverside Dr.
Asheville, NC 28804
[phone]
QUALITY CONTROL DATA
QC Batch: WET/19573 Analysis Method: SM 521013
QC Batch Method: SM 5210B Analysis Description: 5210E BOD, 5 day
Associated Lab Samples: 92111364001, 92111364002
METHOD BLANK: 717569
Associated Lab Samples: 92111364001, 92111364002
Parameter
Units
BOD, 5 day
mg/L
LABORATORY CONTROL SAMPLE:
717570
Parameter
Units
BOD, 5 day
mg/L
SAMPLE DUPLICATE: 717571
Parameter
Units
BOD, 5 day
mg/L
Date: 02/09/2012 04:35 PM
•
Pace Analytical Services, Inc.
9800 KlnceyAve. Suite 100 a
Huntersville, NC 28078
[phone]
Matrix: Water
Blank Reporting
Result Limit Analyzed Qualifiers
ND 2.0 02/08/1216:08
Spike LCS LCS % Rec
Cone. Result % Rec Limits Qualifiers
198 220 111 84-115
92111364001 Dup
Result Result RPD Qualifiers
30.0 ND 82
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc..
Page 11 of 14
11 of 16

y • Pace Analytical Services, Inc. Pace Analytical Services, Inc. Pace Analytical Services, Inc.
64 acemalXical 205 East Meadow Road - Suite A 2225 Riverside Dr. 9800 Kincey Ave. Suits 100
www.pacelab&cam Eden, NC 27288 Asheville, NC 28804 Huatersville, NC 28078
[phone] [phone] [phone]
QUALITY CONTROL DATA
Project: Georgia Waste Water
Pace Project No.: 92111364
QC Batch: WETA/11453 Analysis Method: SM 4500-CN-E
QC Batch Method: SM 4500-CN-E Analysis Description: 450OCNE Cyanide, Total
Associated Lab Samples: 92111364001, 92111364002
METHOD BLANK: 718148 Matrix: Water
Associated Lab Samples: 92111364001, 92111364002
Blank Reporting
Parameter Units Result Limit Analyzed Qualifiers
Cyanide mg/L ND 0.0050 02/07/1215:53
LABORATORY CONTROL SAMPLE: 718149
Parameter Units
Cyanide mg/L
MATRIX SPIKE SAMPLE: 718150
Parameter Units
Cyanide mg/L
SAMPLE DUPLICATE: 718151
Parameter
Cyanide
Date: 02/09/2012 04:35 PM
Units
mg/L
Spike LCS LCS % Rec
Cone. Result % Rec Limits Qualifiers
1 0.11 106 80-120
92110953002 Spike MS MS % Rec
Result Conc. Result % Rec Limits Qualifiers
ND .1 0A1 103 75-125
92110955001 Dup
Result Result RPD Qualifiers
ND ND
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services. Inc..
Page 12 of 14
12 of 16

aceAnalytical
www.pacWebs.com
Project: Georgia Waste Water
Pace Project No.: 92111364
DEFINITIONS
Pace Analytical Services, Inc.
205 East Meadow Road - Suite A
Eden, NO 27288
[phone]
QUALIFIERS
Pace Analytical Services, Inc.
2225 Riverside Dr.
Asheville, NO 28804
[phone]
Pace Analytical Services, Inc.
98DO Kincey Ave. Suite 100
Huntersville, NO 28078
OF - Dilution Factor, if reported, represents the factor applied to the reported data due to changes in sample preparation, dilution of
the sample aliquot, or moisture content.
NO - Not Detected at or above adjusted reporting limit.
J - Estimated concentration above the adjusted method detection limit and below the adjusted reporting limit.
MDL -Adjusted Method Detection Limit.
S - Surrogate
1,2-Diphenylhydrazine (8270 listed analyte) decomposes to Azobenzene.
Consistent with EPA guidelines, unrounded data are displayed and have been used to calculate % recovery and RPD values.
LCS(D) - Laboratory Control Sample (Duplicate)
MS(D) - Matrix Spike (Duplicate)
DUP - Sample Duplicate
RPD - Relative Percent Difference
NC - Not Calculable.
SG - Silica Gel - Clean -Up
U - Indicates the compound was analyzed for, but not detected.
N-Nitrosodiphenylamine decomposes and cannot be separated from Diphenylamine using Method 8270. The result reported for
each analyte is a combined concentration.
Acid preservation may not be appropriate for 2-Chloroethylvinyl ether, Styrene, and Vinyl chloride.
Pace Analytical is TNI accredited. Contact your Pace PM for the current list of accredited analytes.
LABORATORIES
PASI-A Pace Analytical Services - Asheville
ANALYTE QUALIFIERS
B2 Oxygen usage is less than 2.0 for all dilutions set. The reported value is an estimated less than value and is calculated
for the dilution using the most amount of sample.
D6 The relative percent difference (RPD) between the sample and sample duplicate exceeded laboratory control limits.
Date: 02/09/2012 04:35 PM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc..
[phone]
Page 13 of 14
13 of 16

Pace Analytical Services, Inc. Pace Analytical Services, Inc.
aceAnalytical 205 East Meadow Road - Suite 2225 Riverside Dr.
www.pacw8ftcom Eden, NC 27288 Asheville, NC 28804
[phone] [phone]
QUALITY CONTROL DATA CROSS REFERENCE TABLE
Project: Georgia Waste Water
Pace Project No.: 92111364
Pace Analytical Services, Inc.
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Lab ID
Sample ID
QC Batch Method
QC Batch
Analytical Method
92111364001
Shaker/Washer/Georgia #1
EPA 200.7
MPRP/9845
EPA 200.7
92111364002
Shaker/Washer/Georgia #2
EPA 200.7
MPRP/9845
EPA 200.7
92111364001
Shaker/Washer/Georgia#1
EPA245.1
MERP/4025
EPA245.1
92111364002
ShakerMasher/Georgia#2
EPA245.1
MERP/4025
EPA245.1
92111364001
ShakerMasher/Georgia #1
SM 2540D
WET119593
92111364002
Shaker/Washer/Georgia #2
SM 2540D
WET/19594
92111364001
Shaker/Washer/Georgia #1
SM 5210E
WET/19573
SM 5210B
92111364002
Shaker/Washer/Georgia #2
SM 5210B
WET/19573
SM 5210B
92111364001
Shaker/Washer/Georgia #1
SM 4500-CN-E
WETA111453
92111364002
Shaker/Washer/Georgia #2
SM 4500-CN-E
WETA/11453
Date: 02/09/2012 04:35 PM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of PaceAnalyticat Services, Inc..
Analytical
Batch
ICP/9084
ICP/9084
MERC/3953
MERC/3953
WET/19575
WET/19575
Page 14 of 14
14 of 16

A
FlaiceAna/ytical"
wvrw.paalshl.eots
CHAIN -OF -CUSTODY / Analytical Request Document
The Chain -of -Custody is a LEGAL DOCUMENT. All relevant Wide must be completed accurately.
Section A Section B Section C
Page: of %
Required Client Information: Required Project Information; Invoice information:
Company. -•- R"0" T- Attention:
1127585
C rlS-Akl
Address:
Copy To:
Company Name:
REGULATORY AGENCY
Address;
r NPDES i- GROUNDWATER s DRINKING WATER
I- UST (" RCRA OTHER
E it TO:
Purchase Order No.-
Pace Ouvte
Reference:
�� Fax:
Project Name: e'1/ /✓
Paw Project
Site LOCaiIOn
f
/ /f V{,�q.( '�I
Manager.
SrATE:
. A/C
Ra ostad Due Date/TAT:
Project Number:
Pace Profile d:
Requested
Analysis
Filtered
(YIN)
Section D Matrix Codes
~
Z
Required Client Information MATRIX I CODE
8
O
COLLECTED
Preservatives
>
Ddriking Water DW
g
U
Water WT
'
O
OZ
wastewater WW
Product P
.YY
cornrostTs
START
COMPOSITE
ErmvoRAe
�-
1
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adlSOlid SQL
SAMPLE ID
-
U
In
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d
Wipe WIR
(A,Z. f}e 1:) Air AR
W
a
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?
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°i
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Sample IDs MUST BE UNIQUE Tissue TS
O
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Other OT
X
a.
ZO
w
a.
tL
O
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O
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c
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MC
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DATE
TIME
DATE
TIME
sa
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Pace Project No./ Lab I.D.
; JLLll
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2
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3
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5
6
7
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11
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12
ADDITIONAL COMMENTS
RELINQUISHE BY IAFFILP
,71ON
PATE
TIME
C
TED B AF ATION
A7
TIME
SAMPLE CONDfT10N5
19
+ 1
c
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SAMPLER NAME AND SIGNATURE
U
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ORIGINAL PRINT Name of SAMPLER:
E
"
04
n
DATE Signed
SIGNATURE of SAMPLER:
~
"
Ga�� {MMIoD/YY)•
-important Note. By tugning thta form you are accepting Paee`$ NET 30 day payment terms and agreeing to tote charges of 1 S% per monthfof any InvOic in, not paid within 3o days. / / F-ALL-0-020rev.07. 15-May-2007

i
l*,2ceAnalyfical'
Document Name:
Sample Condition Upon Receipt (SCURI
Document Revised: January 30, 2012
Page 1 of 2
Document Number:
Issuing Authority:
F-CHR-CS-03-rev.06
Pace Huntersville Quality Office
Client Name: Project # ol113rn)
Where Received: Huntersville ❑ Asheville El Eden
Courier: ❑ Fed Ex ❑ UPS❑ USPS❑ Client❑ CommercialLE,Pace Other O tional
CustodySeal on Cooler/Box Present. ❑ yes [ /no Seals intact: ❑ yes ❑ no Prof Due,Date:;,'
ProfNaios";' r{
Packing Material: ❑ Bubble Wrap ❑ Bubble Bags ErNone ❑ Other
Thermometer Used: IR Gun T1101 T1102 Type of Ice: 8
Blue None Ersamples on ice, cooling process has begun
Tamn rnrmetinn Factnr T1101- Nn CnrrAnttnn T1102- Subtract 12'C
Corrected Cooler Temp.: 1 • ' C
Biological Tissue is Frozen: Yes No N/A
Date and Initials of pers n e ramining
_
contents:
Temp should be above freezing to 6°C
Comments:
Chain of Custody Present:
Yes ONO
❑NIA
1.
Chain of Custody Filled Out:
E5Yes ONO
❑MIA
2.
Chain of Custody Relinquished:
Yes ❑No
❑NIA
3.
Sampler Name & Signature on COC:
Yes ONO
❑NIA
4.
Samples Arrived within Hold Time:
es ONO
❑NIA
5.
Short Hold Time Analysis <72hr :
9Yes ONO
❑N/A
6.
Rush Turn Around Time Requested:
❑Yes eNo
❑N/A
7.
Sufficient Volume:
Yes ON.
❑NIA
8.
Correct Containers Used:
Ys ONO
ON/A
9.
-Pace Containers Used:
MYY�ees ONO
❑MIA
Containers Intact:
L Yes ONO
ONIA
10.
Filtered volume received for Dissolved tests
❑Yes ONO
1241A
11.
Sample Labels match COC:
❑Yes ffNo
❑N/A
12. RD 4ABrie- Ott 5 dM&— ,ck)dS
-Includes date/time/ID/Analysis Matrix:
All containers needing preservation have been checked.
Yes ❑No
ONlA
13.
All containers needing preservation are found to be in
compliance wllh EPA recommendation.
Yes ONO
❑NIA
exceptions: VOA, coliform. T00, O&G, WI-DRO (water)
OYe ONO
Initial when completed
Samples checked for dechlorination:
Yes ONO
❑NIA
14.
Headspace in VOA Vials >6mm):
❑Yes ONO
04NIA
15.
Trip Blank Present:
❑Yes ONO
ON/A
A 6.
Trip Blank Custody Seals Present
❑Yes ONO
ZTNIA
Pace Trip Blank Lot # if purchased):
Client Notification/ Resolution:
Person Contacted: DatelTime:
Comments/ Resolution:
Field Data Required? Y / N
SCURF Review:l Wj mate: ii:�= ( - SRF Review:) -r W JDate:
Note: Whenever there is a discrepancy affecting North Carolina compliance samples, a copy of this fora will be sent to the Nord
Certification Office ( t.e out of hold, incorrect preservative, out of temp, incorrect containers)

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Charles Wakild, P.E. Dee Freeman
Governor Director Secretary
February 20, 2012
RECEIVED
Ms. Christine Bralley, Town Manager N.c.Dept. of ENR
Town of Mocksville FEB 2 3 2012
171 Clement St
Mocksville, NC 27028 Winston
Regional
Office
Subject: Pretreatment Review of Industrial Waste Survey (IWS)
Program: Town of Mocksville (NPDES #: NC0021491)
Davie County
Dear Ms. Bralley:
The Pretreatment, Emergency Response, and Collection Systems (PERCS) Unit of the Division of
Water Quality has reviewed the Industrial Waste Survey (IWS) for the Town of Mocksville. The IWS,
submitted by the Grey Engineering, was received by the Division on February 2, 2012.
The review indicates that the IWS is adequate and meets the minimum requirements of 40 CFR
403.8(f)(2). Proper completion of an Industrial Waste Survey is required by Part IV (D) of your NPDES
permit.
Please remember, it is the responsibility of the POTW to continue efforts to ensure that any Significant
Industrial Users (SIUs), as defined by 15A NCAC 02H .0903(b)(33) (A) through (D), are identified and
subsequently added to the town's pretreatment program. This includes evaluation of new IUs before
they commence discharge and evaluation of existing IUs determined to be not SIUs that make changes
to their process.
Next IWS Due Date: Your next updated IWS is due on January 30, 2017, unless conditions at the
POTW change significantly and thus warrant an earlier submittal.
Thank you for your continued cooperation with the Pretreatment Program. If you have any questions or
comments, please contact Monti Hassan at [phone] [email: Monti. Hassan(a)_ncdenr.govl or
Deborah Gore, Unit Supervisor at [phone] [email: [e-mail]].
incerely,
(—
mh/mocksville. iws.2012
cc: John Grey, Grey Engineering, Inc., P.O. Box 9, Mocksville, NC 27028
Central Files
Monti Hassan, PERCS Unit
George Smith, WSRO
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Location: 512 N. Salisbury St. Raleigh, North Carolina 27604 One -
Phone: [phone] \ FAX: [phone] \ Customer Service: 1-877-623-6748 NorthCarolina
Internet: ppo tncwater Affirmative
Action
Natitrally
An Equal Opporfunity'�, Affirmative Action Employer

December 16, 2011
Jim Hendrick
PO Box 709
Siler City, NC 27344
The annual SIU inspection of Townsends (permitted as Omtron USA, d/b/a Townsends) was
performed on December 14, 2011 by John Grey, Acting Pretreatment Coordinator, and Joy
Howard of Grey Engineering on behalf of the Town of Mocksville: Jim Hendrick, Facilities
Manager for Townsends was present to represent the SIU. Our records indicate that production
at the plant ceased on 8/1/2011. In response to the recent shut -down, several items were
discussed:
1. While the production facility seems to be substantially cleaned and properly shut -down,
the wastewater treatment area, including the front pit, two storage tanks behind the
plant, and DAF unit have not been cleaned. These wastewater storage areas contain
deposits of residual oil and grease that must be removed.
2. It is important to insure that stormwater cannot be introduced into the Town's wastewater
collection system. Please construct a system for sealing off the dumpster pad from
wastewater collection.
3. All remaining chemicals, in both full and partial containers, currently stored in the
wastewater treatment facility must be properly disposed of.
4. As long as the Pretreatment Permit remains valid, daily effluent flow reporting is
required. The most recent report contains data through August 26, 2011. Please
provide any interim data available and daily flow data moving forward until permit
termination is accomplished.
5. It is recommended that the current pretreatment permit be closed following satisfactory
completion of wastewater cleanup and stormwater mitigation. A new permit
representing appropriate limits of discharge may be negotiated should the facility be
scheduled to re -open.
6. Please provide contact information (mailing and email addresses) for corporate
ownership for ongoing regulatory communications.
7. Pretreatment records should be accessed from the former safety manager's office and
maintained in accordance with regulatory requirements.
Please address these issues as soon as possible and advise us of a final completion schedule,
but no later than 30 days from the date of this summary.

A�
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins
Governor Director
August 26, 2011
Ms. Christine Sanders, Town Manager
Town of Mocksville
171 Clement Street
Mocksville, NC 27028
SUBJECT: Pretreatment Compliance Inspection
Town of Mocksville
NPDES #NC0021491
Davie County
Dear Ms. Sanders:
Dee Freeman
Secretary
On August 25, 2011 George Smith, of this office, performed a Pretreatment Compliance Inspection (PCI). Mr.
John Grey and Ms. Joy Howard were present for the inspection. The purpose of this inspection was to determine
the effectiveness of the pretreatment program, which includes: reviewing the files, POTW plant performance,
industry monitoring data, and adherence to the enforcement response plan (ERP).
Background
The Town has one WWTP (Dutchman's Creek) on the pretreatment program with a 0.68 MGD permitted flow.
POTW Interview
The significant industrial user Omtron USA, LLC is doing business as Townsends.
Program Elements
The Headworks Analysis (HWA) was approved on September 24, 2010. The next HWA is due April 1, 2015.
The Industrial Waste Survey (IWS) is due January 30, 2012.
The Sewer Use Ordinance (SUO) was last approved on February 14, 2007.
The Enforcement Response Plan (ERP) was last approved on June 15, 2010.
Short Term Monitoring Plan (STMP) for the Dutchman's Creek WWTP was approved July 1, 2010. An update
for the STMP is due August 1, 2013.
North Carolina Division of Water Quality Winston-Salem Regional Office
Location: 585 Waughtown St. Winston-Salem, North Carolina 27107 One
Phone: [phone] FAX: [phone] Customer Service:1-877-623-6748 NorthCarolina
Internet: www.ncwaterquality.org v � to rally
An Equal Opportunity 1 Affirmative Action Employer �/ ` i

Pretreatment Compliance Inspection
August 26, 2011
Page 2 of 2
Industrial User Permit (IUP) File Review
A review of the file for Townsends (#0003) revealed that the monitoring data was well organized and correctly
judged for compliance.
All sampling is performed as required per the permit and chain of custody forms are on file.
Industrial Inspection
On August 11, 2011 the Town requested a multi -media inspection in order to determine possible environmental
hazards. The industry was purchased by a foreign owner from the Ukraine, and it was selling the assets with
possibility of the closing the facility.
Those present at the inspection were: John Grey, Town Engineer; Steve Barron, Hazard Waste Section; Mike
Mickey, Surface Water Protection (Stormwater); George Smith, Surface Water Protection (Pretreatment). Also
present, representing Townsends were: Mr. Eric Ivey, Safety & Environmental Manager; and Mr. David Purtle,
CEO.
There were some stormwater and pretreatment issues that need attention. There are numerous outside storage of
chemicals that need to be removed from the elements. In addition, the pretreatment facility needs to have spill
containment measures installed inside the building to keep chemicals from entering the wastewater pit. Mr. Ivey
and Mr. Purtle assured us that all these environmental concerns will be addressed.
Currently, the facility is not operating and no wastewater is being discharged.
The pretreatment compliance inspection is considered satisfactory. Mr. John Grey is going a very good job
implementing the pretreatment program. If you have any questions, please contact George Smith or me at (336)
771-5000.
Sincerely,
JWJ_,/�
W. Corey Basinger
Regional Supervisor
ATTACHMENT
M. Mr. John Grey, 254 W. Water Street, Mocksville, NC 27028
PERCS Unit — Monti Hassan
WSRO Files

NORTH CAROLINA DIVISION OF WATER QUALITY
PRETREATMENT COMPLIANCE INSPECTION (PCI) REPORT
BACKGROUND INFORMATION [Complete Prior To PCI; Review Program Info Database Sheet(s
1. Control Authority (POTW) Name: Town of MoekS 0lle,
2. Control Authority Representatiive(s): Tbhn Greg rfoy Nowd"i
3. Title(s): : rCTxAMg rE L oo0AW' ur dmare'r•Cl;,c sre
4. Last Inspection Date: q-/� - /b Inspection Type (Check One): [ PCI ❑ Audit
5. Has Program Completed All Requirements from the Previous Inspection and Program Info Sheet(s)? E3-YES ❑ NO
6. Is POTW under an Order That Includes Pretreatment Conditions? ❑ YES 21G0
Order Type, Number, Parameters: /l/A Are Milestone Dates Being Met? ❑ YES ❑ NO
PCS CODING
Trans.Code Main Program Permit Number MM/DD/YY Inspec.Type Inspector Fac. Type
Nl INICL0 Io 1�_III`IIqIIOF1951//1 1-R-1 L.s1 1 1 l
(DTIA) (TYPI) (INSP) (FACC)
7. Current Number Of Significant Industrial Users (SIUs)?
!
SILTS
8. Current Number Of Categorical Industrial Users (CIUs)?
O
CIUS
9. Number of SNs Not Inspected By POTW in the Last Calendar Year?
10. Number of SNs Not Sampled By POTW in the Last Calendar Year?
11. Enter the Higher Number of 9 or 10
O
NOIN
12. Number of SNs With No ]UP, or With an Expired IUP
p
NOCM
13. Number of SNs in SNC for Either Reporting or Limits Violations During Either of the Last 2
Semi -Annual Periods (Total Number of SNs in SNC)
O
PSNC
14. Number of SNs in SNC For Reporting During Either of the Last 2 Semi -Annual Periods
4 __JJ
MSNC
15. Number of SNs In SNC For Limits Violations During Either of the Last 2 Semi -Annual Periods
0
SNPS
16. Number of SIUs In SNC For Both Reporting and Limits Violations During Either of the Last 2
Semi-annual Periods
v
POTW INTERVIEW
17. Since the Last PCI, has the POTW had any NPDES Limits Violations?
If Yes, What are the Parameters and How Ore these Problems Being Addressed?
14,9 aolo - Nffs , moos &f. a./My/G hi6t- X
18. Since the Last PCI, has the POTW had any Problems Related to an Industrial
Discharge (Interference, Pass -Through, Blockage, Citizens' Complaints, Increased
Sludge Production, Etc.)?
If Yes, How are these Problems Being Addressed?
19. Which Industries have been in SNC for Limits or Reporting during SNC for
either of the Last 2 Semi -Annual Periods? Not Been Published for SNC for
Public Notice?(May refer to PAR if Excessive SNs in SNC) Not Put
20. Which Industries are on Compliance Schedules or Orders? For all SNs on an
Order, Has a Signed Copy of the Order been sent to the Division?
21. Are Any Permits Or Civil Penalties Currently Under Adjudication? If Yes, Which
Ones?
❑ YES O
[:]YES [LJfi 0
Pn 6/t 5PA411 slogs f-or to
pro0z-1 we ni etluK
Limits.
Reporting: f /
)Iished:
,AV on I(
❑ YES PSO
LTMP/STMP FILE REVIEW:
22. Is16 /STMP Monitoring Being Conducted at Appropriate Locations and Frequencies? [I�'f�'ES ❑ NO
23. Are Correct Detection Levels being used for all LTMP/STMP Monitoring? U`fES ❑ NO
24. Is LTMP/STMP Data Maintained in a Table or Equivalent? 0"hS ❑ NO Is Table Adequate? [ YES ❑ NO
25. All LTMP/STMP effluent data reported on Discharge Monitoring Report? [-YES ❑ NO DWQ Inspector, please verify
yourself!
26. If NO to 23 - 26, list violations tV �)9
27. Should any Pollutants of Concern be Eliminated from or Added to LTMP/STMP? ❑ YES ❑ NO
If yes, which ones? Eliminated: N/14 Added:
NC DWQ Pretreatment Compliance Inspection (PCI) Form Updated 7/25/07 Page 1

28. PRETREATMENT PROGRAM ELEMENTS REVIEW- Please review POTW files, verify POTW has copy of Program
Flement in their files_ complete with sunnortin¢ documents and coov of PERCS Aonroval Letter, and dates consistent with Program Info:
Program Element
Last Submittal
Date In file?
Last Approval
Date In file
Date Next Due,
If Applicable
Headworks Analysis A
❑ Yes ❑ No
2 y - 0
es No
y— / - /,-
Industrial Waste Survey WS
❑ Yes ❑ No
- 3/-o7
Yes ❑ No
/- 30-/,t
Sewer Use Ordinance SUO
❑ Yes ❑ No
- l -o
❑ Yes ❑ No
Enforcement Response Plan RP
❑ Yes ❑ No
16 _ 1 - /O
M' Yes ❑ No
Long Term Monitoring Plan VMP)
❑ Yes ❑ No
7 _ 1 - 10
®'Yes ❑ No
g _ 1-13
J
INDUSTRIAL USER PERMIT (IUP) FILE REVIEW (3 IUP FILE REVIEWS OR 1 FILE REVIEW AND 1 IU INSPECTION)
29. User Name
1. n 2.
3.
30. IUP Number
000
31. Does File Contain Current Permit?
KJYes ❑ No
I❑ Yes ❑
No I
❑ Yes ❑ No
32. Permit Expiration Date
an 1
33. Categorical Standard Applied (I.E. 40 CFR, Etc.) Or N/A
t.
34. Does File Contain Permit Application Completed Within One Year Prior
es ❑ No JrD
Yes ❑ No 11
❑ Yes ❑ No
to Permit Issue Date?
❑ Yes ❑ No
35. Does File Contain an Inspection Completed Within Last Calendar Year?
es ❑ No
❑ Yes ❑ No 11
36. a. Does the File Contain a Slug/Spill Control Plan?
a. es ❑No
a. ❑Yes ❑No
a. ❑Yes ❑No
b. If No, is One Needed? (See Inspection Form from POTW)
h_Eifes$Idn
b. ❑Yes ❑No
b. ❑Yes ❑No
37. For 40 CFR 413 and 433 TTO Certification, Does File Contain a Toxic
❑Yes❑No /A
❑Yes❑No❑N/A
❑Yes❑No❑N/A
Organic Management Plan (TOMP)?
38. a. Does File Contain Original Permit Review Letter from the Division?
a. ElYeS❑No
a. [:]Yes []No
a. []Yes❑No
I
b. All Issues Resolved?
b.❑Yes❑No /A
b.❑Yes❑No❑N/A
b.❑Yes❑No❑N/A
39. During the Most Recent Semi -Annual Period, Did the POTW Complete
es ❑ No
IF
❑ Yes ❑ No
❑ Yes ❑ No
1
its Sampling as Required b IUP, includin flow?
40. Does File Contain POTW Sampling Chain -Of -Custody Forms?
es
❑ No 11
[:]Yes ❑ NoI
[:]Yes ❑ No
41. During the Most Recent Semi -Annual Period, Did the SIU Complete its
es❑No❑N/A
❑Yes❑No❑N/A
❑Yes❑No❑N/A
Sampling as Required by LUP, including flow?
41b. During the Most Recent Semi -Annual Period, Did SIU submit all reports
es❑No❑N/A
❑Yes❑No❑N/A
❑Yes❑No❑N/A
on time?
42a. For categorical Ns with Combined Wastestream Formula (CWF), does
❑Yes❑NoTWA
❑Yes❑No❑N/A
❑Yes❑No❑N/A
file includeprocess/dilution flows as Required by IUP?
42b. For categorical [Us with Production based limits, does file include
0Yes0NoVW1A
❑Yes❑No❑l,4
❑Yes❑No❑N/A
production rates and/or flows as Required by IUP?
43a. During the Most Recent Semi -Annual Period, Did the POTW Identify
Eilles ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
All Limits Non -Compliance from Both POTW and SIU Sampling?
43b. During the Most Recent Semi -Annual Period, Did the POTW Identify
❑Yes❑No /A
❑YesONo❑N/A
❑Yes❑No❑N/A
All Re ortm Non -Compliance from SIU Sampling?
44. a. Was the POTW Notified by SIU (Within 24 Hours) of All Self-
a. es❑No❑N/A
a.❑Yes❑No❑N/A
a.❑Yes❑No❑N/A
Monitoring Violations?
b.
b. Did Industry Resample and submit results to POTW Within 30 Days?
b.❑Yes❑No❑N/A
b.❑Yes❑No❑N/A
c. If applicable, Did POTW resample within 30 days of becoming aware
r#1es❑No❑N/A�
c.❑Yes❑NoC1A
c.❑Yes❑No❑N/A
c.❑Yes❑No❑N/A
of SIU limit violations in the POTW's sampling of the SIU?
46. During the Most Recent Semi -Annual Period, Was the SILT in SNC?
I
❑ Yes 7 �oj
❑
Yes
❑ No
11
❑
Yes
❑ No
47. During the Most Recent Semi -Annual Period, Was Enforcement Taken
❑Yes❑No A
❑Yes❑No❑N/A
❑Yes❑No❑N/A
as Specified in the POTW's ERP (NOVs, Penalties, timing, etc.)?
48. Does the File Contain Penalty Assessment Notices?
oYes❑No A
❑Yes❑No❑N/A
❑Yes❑No❑N/A
49. Does The File Contain Proof Of Penalty Collection?
❑Yes❑No /A
❑Yes❑No❑N/A
❑Yes❑No❑N/A
50. a. Does the File Contain Any Current Enforcement Orders?
a.❑Yes❑No /
a.❑Yes❑No❑N/A
a.❑Yes❑No❑N/A
b. Is SIU in Compliance with Order?
b.❑Yes❑No
b.❑Yes❑No❑N/A
b.❑Yes❑No❑N/A
51. Did the POTW Representative Have Difficulty in Obtaining Any of This
❑ Yes No
❑ Yes ❑ No
❑ Yes ❑ No
Requested Information For You?
NC DWQ Pretreatment Compliance Inspection (PCI) Form Updated 7/25/07 Page 2

FILE REVIEW COMMENTS:
OMt1ro►) (/511 , Gj6 J l d �, T6wn su s
INDUSTRY INSPECTION PCS CODING:
Trans.Code Main Program Permit Number MM/DD/YY
11 l��l C,l010 I I I YI 0g,Ia I�) l
(DTIA)
1. Industry Inspected: % OWnu✓I j
2. Industry Address:
3. Type of Industry/Product: . ki',Jrc ",ckcn)
4. Industry Contact: &,',4 TV,% V►r;) PVaz/( Title
Phone:
Fax:
Inspec.Type Inspector Fac. Type
1 1 l L S--j U
(TYPI) (INSP) (FACC)
WW
5. Does the POTW Use the Division Model Inspection Form or Equivalent? UAES ❑ NO
6. Did the POTW Contact Conduct the Following Parts of the Industrial Inspection Thoroughly?
Comments:
A. Initial Interview Wt
NO
B. Plant Tour
❑ NO
C. Pretreatment Tour ❑ NO
D. Sampling Review S ❑ NO
E. Exit Interview �ES ❑ NO
Indu trial Inspection Comm +
AV
OVERALL SUMMARY
Comments:
Requirements:
Recommendations:
NOD: ❑ YES E NO
NOV: ❑ YES EqNO
QNCR: ❑ YES U?1�0
POTW Rating:
Satisfactory_LIZ," Marginal Unsatisfactory /
PCI COMPLETED BY: DATE:
NC DWQ Pretreatment Compliance Inspection (PCI) Form Updated 7/25/07 Page 3

r
• *rVatmtut program Info ` e
for Program Name Mocksville
WWTP Name Dutchman {
Program Approval Date
01/14/1985
Pretreatment Status
Modified
Region
WSRO
County
Davie
printed on: 8/24/2011
IWC % at 7Q10 37.39
ow cfs /mgd
2.54 / 1.64
1 Q10 Flow cfs / mgd
2.13 / 1.37
Stream Classification
C
Basin Number
YAD05
Receiving Stream Name
DUTCHMAN CREEK
DWQ Central Office Contact JIVIonti Hassan
DWQ Regional Contact George Smith

A�
NCDENR
North Carolina Department of Environment and Natura
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins
Governor Director
April 1, 2011
Grey Engineering, Inc
Attn: John Grey
Town of Mocksville
P. O. Box 9
Mocksville, NC 27028
Subject: Pretreatment Annual Report (PAR) Review
(January 1, 2010 through December 31, 2010)
Town of Mocksville
NPDES Number: NCO021491
Davie County
Dear Mr. Grey:
Resources
Dee Freeman
Secretary
The Winston-Salem Regional Office has reviewed the Pretreatment Annual Report covering January through
December 2010. Our review indicates that the annual report is in good order and satisfies the requirements of
15A NCAC 2H .0908(b) and the Comprehensive Guidance for North Carolina Pretreatment Programs. The
next annual report will be due March 1, 2012.
Thank you for your continued cooperation with the Pretreatment Program. If you have any questions or
comments, please contact me at [phone] [email: [e-mail]].
Sincerely,
George S. Smith
Environmental Chemist
cc: PERCS Unit
WSRO Files
North Carolina Division of Water Quality, Winston-Salem Regional Office
Location: 585 Waughtown St. Winston-Salem, North Carolina 27107
Phone: [phone] FAX: [phone] Customer Service: 1-877-623-6748
Internet: www.ncwaterqual4.org
An Equal Opportunity 1 Affirmative Action Employer
Nne
orthCarolina
Satz rall

Regional Pretreatment Annual Report (PAR) Review
Included?
ADEQUATE ?
POTW noted Corrections?
Narrative
®
YES
❑
NO ❑ NA
®
YES
❑
NO ❑ NA
PPS Form
❑
YES
❑
NO
❑
YES
❑
NO
SO t"
®
YES
❑
NO
®
YES
❑
NO
IDSF
❑
YES
❑
NO
❑
YES
❑
NO
Allocation Table
❑
YES
❑
NO
❑
YES
❑
NO
Waste Reduction Info
❑
YES
❑
NO
❑
YES
❑
NO
Corn' Iiance Schedule
❑
YES
❑
NO ® NA
❑
YES
❑
NO ® NA
RUblc Notice
Pro ram Tnformatior
HistonCal SNC
❑
®
❑
YES
YES
YES
❑
❑
❑
NO ® NA
NO
NO ® NA
❑YES
®
❑
YES
YES
❑
❑
❑
NO ® NA
NO
NO ® NA
❑ YES ® NO
❑ YES ❑ NO ® NA
Regional Office: WSRO
POTW: Town of Mocksville
NPDES Permit No. NCO021491
Report Period: 1/1/2010 - 12/31/2010
❑ Full ® Modified
For modified programs evaluate shaded
items only. A Narrative is required for a
modified program only if there are SIUs
in SNC.
If No check recommendation below;
1. Have at least 90% of SIU permits been issued within 180
El ❑ No ®Not req'd
❑ NOV
❑ QNCR
❑ NCP
❑ Civil Penalty
days of expiration? See Allocation Table).
2. Were at least 80% of SIUs inspected? (See PPS Form)
® Yes ❑ No ❑ Not req'd
❑ NOV
❑ QNCR
❑ NCP
Assessment
❑ Civil Penalty
Assessment
3. Has effective enforcement been taken against industries in
❑ Yes ❑ No ® NA
❑ NOV
❑ QNCR
❑ NCP
❑ Civil Penalty
SNC, including those causing pass -through or interference? (See
Assessment
Narrative and SNCR Form
4. Does public notice cover all SIUs in SNC?
❑Yes ❑ No ®NA
❑ NOV
❑ QNCR
❑ NCP
❑ Civil Penalty
Assessment
Note: Exceptions should be explained in the comment section beiow:
Reviewed By: George Smith Date: April 1, 2011
Regional Pretreatment Annual Report Review
PAR review form 2007
FULL PROGRAMS ONLY -Fill in
Values from PPS Form (PCS data)
•
* Alternatively, attach PPS page from PAR

RECEIVED
N.C. Dept of ENR
I
MAR 1 5.2011
Mocksville Dutchmans Creek WWTP (NC 0021491) Fwins Winston-
Mocksville
Pretreatment Annual Report (PAR) for Calendar Year 2010 1 Regional office
2/23/2011
Narrative
General Information:
Overall Program — Ref. the "Pretreatment Program Info Database Attached"
Contact Information Update:
The Mocksville Town Manager is Mrs. Christine Bralley (same address);
The Acting Pretreatment Coordinator is Mr. John Grey, PE, Grey
Engineering, Inc., 254 West Water Street. Mocksville, NC 27028, 336-751-
2110 (p), 336-751-6348 (f)
Status of Program Elements
HWA — Current (Submitted to DWQ 5/21/10, Approved 9/24/10); LTMP —
Current (Received by DWQ 5/3/10); IWS — Current; ERP — Current
(Received by DWQ 4/28/10); PAR (2009) submitted 4/16/2010
SIU Information
The only SIU discharging to the Dutchmans Creek WWTP is the
Crestwood Farms facility (IUP 003). The facility is not SNC but has 20 limit
violations (19%) for BOD 2010 (Compliance Judgement Worksheets are
included). The permit is scheduled for renewal on 1/1/12. A copy of the
site inspection performed 12/23/2010 is attached.
e I
t.
PIN
rEg 2 8 2011

1 02/23/2011 14:51 19197330059
PERCS PAGE 01/02
Pretreatment ]grogram Info Database
printed on: 2/2312011
for Program Name MocksVille15
" IWC %at7010 37.39
WWTP Name Dutchman
ow :::: " mgd 2.64 / 1.64
'/
Program Approval Date 01/14/1985
1 Q10 Flow cis / mgd 2.13 J 1.37
Pretreatment Status Modified
stream Classification C
Region WSRO
Basin Number YAD05
County Davie
Receiving Stream Name DUTCHMAN CREEK
NPDES Number NCO021491
Last PAR Rae
PAR. Due Date 03/01/2011 mercury
NPDES Effective Date 05101/2010
Current Fiscal
1631
required
NPDES Expire Date 06/30/2014
Year PCI Done
es
POTW is Primary WWTP TRUE
Last Audit on 09/23/2008 Audit Year Next12/13
SIU flow [Pt SIU) 12
Design Flow mgd 0.9800 % Design mgd is SIU permitted r--12-2-4-1 Permitted (mgd)
1 1
WWTPSIUs Program5lUs
WWTP CIU's Program C IUS
r,rrwMi.. ...---"!n . �.;(•.n1(1MF'11�•. ...
..��.,,,,,,,,,,,,,,.,.,..� ,. .•:,...
,,::,. ..,„,,,... LIMP- _ •j°�ffJ;7I,. !(r
,... IiWI!Y':i...,'::�:;:; .
"7'I:w..,,;-,•.,,,L;,,•.. ,:;..,:.•. ",.'rfl;'I+:�%zaG.ib'v.i
date inactive Date Next Due
04/01/2016
08/01/2013 ' ..01/30/2012
Date Received by DWQ
05/21/2010
05/03/2010 01/23/2007 01/31/2007 04/28/2010
Date Approved
.09/24/2010
07/01 /2010 01 I31 /2007 02/14/2007 06/15/2010
Adopt Date Required
Date Adapted
Info in_tfis Box from' Pt' Contacts
PT Prb
Formal Name g.Prime Phonel
Mr. John Grey, Jr., PE Prim 336-751-2110
[e-mail]
Ms. Christine Bralley . Prim [phone]
[e-mail] .
Pmtrieatment Related NOVs from DWQ
6/24/1993 Itmp, h%iW erp, !Ws
9/23/1993 late SAR -
$19/1994 NCP 94-01
9/29/1984 program inadequate, late SAR
pate .: 'Date Date
Attended. Attended Attended .
ext Fax HWA Wksp IUP Wksp I m Wksp
1 336-751'-6348 I, V24/2001.:1 J.'1/23/2001 1
Town
751-9187
IUPs, comp jddgelenforce, pub not; 9/00 PCI
enforce, imple stmp.yrom respon to 3129 nov)
failure to issue IUPs
NOV-NOI for failure to submit PAR 2009 -
NOv-NOI For PT elements (HWA, ERP., STMP) . '

retreatment Annual Report (PAR)
Slgnlficaht Non-Cornpllance. Report {SNCR)
WWTP = Wastewater Treatment Plant, use separate form for each WWTP.
SIU = Significant Industrial User
SNC = Significant Non -Compliance
PAR covers this calendar year => 2010
Control Authority=Program=Town Name => Mocksville
WWTP Name => Dutchmans Creek
NPDES # _> NC 0021491
A SNCR Form must be submitted with every PAR, please write "None " if you had No SIUs in SNC during calendar vear
IUP
#
Pipe
#
Industry Name
Parameter
or "Reporting"
SNC? (Yes/No,)
for each 6-month period.
Jan. - June
July - Dec.
31
1
Crestwood Farms Industrial WW
None
None
Attach a copy of the Division's "SIUs in SNC Historical Report" for your POTW s SATs behind this page .
Is the database correct ? Notify the Division of any errors ! Database indicates SNC history for previous years.
EVERY SNC MUST be explained in the Narrative, How was, is, or will it be resolved?
REPEAT SNCs are serious matters that MUST be explained in the Narrative.
Form name: PAR,SNCR,2001
Date Revised: 1/4/2001

Compliance Judgement Worksheet For SNC With Limits
Use separate sheets for each Industry SNC determination for Flow optional, see Section 7-E Use separate sheets for each Pollutant
SIU Name: Crestwood Farms
IUP Number: 0003
Pipe Number: 01
Parameter: BOD
Six Month SNC Determination Period: 1/1/10-6/30/10
See next page for definitions
Daily Max. and IUP Limit * TRC criteria = TRC Limit Circle which units apply
_ Ave. Limits Circle 1.4 For. TRC for BOD, TSS, oil, fat, grease; Circle 1.2 for all other pollutants to Limits
from IUP TRC compliance judgement not required for H:
Daily Maximum Limit: 650 * 1.2 or 1.4 = TRC Daily Limit: 910 mg/1 or lbs/day
Average Limit: * 1.2 or 1.4 = TRC Avg. Limit: mg/1 or lbs/day
Column 1: I - Industry self P-POTW A - Average
Column 5: Use only if IUP has (monthly, or other?) average limit. Average values of all sampling events collected wtihin the
"average" period (for example, for a monthly average limit, use all values collected within a calendar month) and enter
this average in column 5. Treat this average as another CJP. Compare this average to the appropriate average IUP limit
or TRC limit.
Column 6: Use only if IUP has daily limits in lbs/day. Formula to use is ( mgd * mg/I * 8.34 = lbs/day ).
Column 7: Use only if IUP has (monthly?) average limits in lbs/day. Use ( mgd * mg/l * 8.34 = lbs/day ).
Column 8: Put "1" for each daily maximum or average value, tally up at bottom as "A."
Column 9: Compare daily and average values to IUP limits above,put "0" if at or below limit, "1" if above, tally at bottom as'B."
Column 10: Compare daily and average values to TRC limits above,put "0" if below limit, "1" if at or above, tally at bottom as "C."
Col. 1:
From
IDMRs
From
IDMRs
From
IDMRs
Col. 5:
Col 6:
Col 7:
Col8:
Col9:
Col 10:
Sample or
CJP Type
Sample
Date
Daily
Flow, mgd
Daily
Conc. mg/1
Avg Conc.
mg/l
Daily
Load
lbs/day
Avg. Load
lbs/day
CJP
Count
Regular
Violation
?
TRC
Violation
?
1
115110
.08587
540
386.72
1
0
0
1
1/7/10
.06629
480 _
265.37
1.
0
0
1
1112110
.124
630
651.52
1
1
0
1
1114110
.09019
300
225.66
1
0
0
1
1119110
.05706
670
318.84
1
0
0
1
1121110
.05812
620
300.53
1
0
0
1
1126110
.10613
620
548.78
1
0
0
1
1128110
.12794
460
490.83
1
0
0
1
212110
.13134
330
361.47
1
0
0
1
214110
.06515
580
315.14
1
0
0
1
219110
.12198
336
335.71
1
0
0
1
2111110
.06199
610
315.37
1
0
0
1
2116110
.09509
1240
983.38
1
1
1
1
2118110
.10409
960
833.39
1
1
0
1
2/23/10
.12035
293
294.09
1
0
0
1
2/25/10
.10707
780
696.51
1
1
0
1
3/2/10
.07662
340
217.26
1
0
0
1
3/4/10
.08077
530
357.02
1
0
0
Title: SNC With Limits Compliance Judgement Worksheet
File name: Compliance Judge JanlO.doc
Revision date: 1/5/01

Compliance Judgement Worksheet For SNC With Limits
Use separate sheets for each Industry SNC determination for Flow optional, see Section 7-E Use separate sheets for each Pollutant
SILT Name: Crestwood Farms
IUP Number: 0003
Pipe Number: 01
Parameter: BOD
Six Month SNC Determination Period: 1/1/10-6/30/10
Col. 1:
From
IDMRs
From
IDMRs
From
IDMRs
Col. 5:
Col 6:
Col 7:
Col 8:
Col9:
Col 10:
Sample or
CJP Type
Sample
Date
Daily
Flow, mgd
Daily
Conc. mg/l
Avg Conc.
mg/l
Daily
Load
lbs/day
Avg. Load
lbs/day
CJP
Count
Regular
Violation
?
TRC
Violation
1
3/9/10
.12837
570
610.25
1
0
0
1
3/11/10
.10813
630
568.14
1
0
0
1
3/16/10
.07998
330
220.12
1
0
0
1
3/18/10
.08133
600
406.98
1
0
0
1
3/23/10
.06464
610
328.85
1
0
0
1
3/25/10
.07361
197
120.94
1
0
0
1
3/30/10
.07812
590
384.40
1
0
0
1
4/1/10
.06789
580
328.40
1
0
0
1
4/6/10
.07653
570
363.81
1
0
0
1
4/8/10
.09893
560
462.04
1
0
0
1
4/13/10
.07568
1200
757.41
1
1
0
1
4/15/10
.08608
1140
818.41
1
1
0
1
4/20/10
.05939
354
175.34
1
0
0
1
4/22/10
.08037
1180
790.94
1
1
0
1
4/27/10
.09371
517
404.06
1
0
0
1
4/29/10
.08015
1260
842.25
1
1
0
1
5/4/10
.09625
1140
915.11
1
1
1
1
5/6/10
.07909
1200
791.53
1
1
0
1
5111110
.0817
667
454.48
1
0
0
1
5/13/10
.07475
1100
685.76
1
1
0
1
5/18/10
.06439
610
327.58
1
0
0
1
5/20/10
.08852
590
435.57
1
0
0
P
5/21/10
.08776
570
417.19
1
0
0
1
5/25/10
.09133
450
342.76
1
0
0
1
5/27/10
.07936
510
337.55
1
0
0
1
6/1/10
.07305
620
377.73
1
0
0
1
6/3/10
.08167
520
345.19
1
0
0
1
6/8/10
.09418
510
400.59
1
0
0
1
6/10/10
.09198
560
429.34
1
0
0
Title: SNC With Limits Compliance Judgement Worksheet
File name: Compliance Judge Jan1O.doc
Revision date: 1/5/01

Compliance Judgement Worksheet For SNC With Limits
Use separate sheets for each Industry SNC determination for Flow optional, see Section 7-E Use separate sheets for each Pollutant
SIU Name: Crestwood Farms
IUP Number: 0003
Pipe Number: 01
Parameter: BOD
Six Month SNC Determination Period: 1/1/10-6/30/10
Col. 1:
From
IDMRs
From
IDMRs
From
IDMRs
Col. 5:
Col6:
Coll:
Col 8:
Col9:
Col 10:
Sample or
CJP Type
Sample
Date
Daily
Flow, mgd
Daily
Conc. mg/1
Avg Conc.
mg/I
Daily
Load
lbs/day
Avg. Load
lbs/day
CJP
Count
Regular
Violation
?
TRC
Violation
?
1
6/15/10
.10044
540
452.34
1
0
0
1
6/17/10
.08072
580
390.46
1
0
0
1
6/22/10
.09126
560
426.22
1
0
0.
1
6/24/10
.06057
570
287.94
1
0
0
1
6/29/10
.05042
270
113.54
1
0
0
List these Totals on next page =>
A =52
B= l l
C= 2
Title: SNC With Limits Compliance Judgement Worksheet
File name: Compliance Judge Jan10.doc
Revision date: 1/5/01

Compliance Judgement Worksheet For SNC With Limits
Use separate sheets for each Industry SNC determination for Flow optional, see Section 7-E Use separate sheets for each Pollutant
SILT Name: Crestwood Farms
IUP Number: 0003
1 Pipe Number: 01
Parameter: BOD
Six Month SNC Determination Period: 1/1/10-6/30/10
SIGNIFICANT NON-COMPLIANCE (SNC) LIMITS DETERMINATION Calculate % and Circle Answers
1) Calculate the % of Regular violations: B/A = 11/52 = .21
2) Is B/A greater than or equal to 0.66 (or 66 %) ? Chronic violator? Yes /
3) Calculate the % of TRC Violations: C/A = 2/52 = .04
4) Is C/A greater than or equal to 0.33 (or 33 %) ? TRC Violator? Yes /
5) Did any violation, alone or in combination with other discharges, cause pass -through
or interference at the POTW, or endanger the health of POTW workers or the public? Yes /
6) Did any violation cause imminent endangerment to human health / welfare or to the
environment or has resulted in the POTW s exercise of its emergency authority to halt
or prevent such discharge? Yes /
7) If the answer to any of these questions isles, the SIU is in Signficant Non -Compliance (SNC) for this
parameter. They must be listed on the Significant Non -Compliance Report (SNCR) form in the Pretreatment
Annual Report (PAR), described in the PAR narrative (including parameter, period, and POTW actions), and
the POTW must take adequate enforcement as outlined in its Enforcement Responce Plan (ERP).
Is the SIU in SNC for this six month period? CIRCLE ONE: YES
Was the SIU in SNC for THE SAME PARAMETER in the previous six month compliance
period? CIRCLE ONE: YES
If YES to EITHER question, DESCRIBE IN NARRATIVE.
Please note if SILT was in SNC for the previous six month compliance period and is also in SNC for this six month
compliance period, escalated enforcement actions must be taken as soon as possible, preferably before the end
of the second consecutive period. Failure to take the action within 2 months after the end of the second
consecutive period will subject the POTW to enforcement by the Division. The options are:
Consent Order with Enforceable schedule;
Administrative Order with Enforceable schedule;
Formal notice to comply issued, or
Permit modification.
See Chapter 9 - Pretreatment Annual Reports, Chapter 8 - Enforcement, and the POTW's Enforcement Response
Plan (ERP).
Definitions:
CJP Compliance Judgement Point, The number of daily sample data values plus the number of average of
sampling events used for checking compliance with average limits.
TRC Technical Review Criteria, Multiply the actual IUP limits by the proper TRC Criteria value to get a
TRC Limit:
TRC Criteria = 1.4 for BOD, TSS, oil, fat, grease
TRC Criteria = 1.2 for all other pollutants
Not required to perform TRC compliance judge ment for pH.
SNCR Significant Non -Compliance Report
SNC Significant Non -Compliance (formerly called Reportable Non -Compliance or RNC)
Title: SNC With Limits Compliance Judgement Worksheet
File name: Compliance Judge Jan10.doc
Revision date: 1/5/01

Compliance Judgement Worksheet For SNC With Limits
Use separate sheets for each Industry SNC determination for Flow optional, see Section 7-E Use separate sheets for each Pollutant
SIU Name: Crestwood Farms
IUP Number: 0003
1 Pipe Number: 01
Parameter: BOD
Six Month SNC Determination Period: 7/1/10-12/31/10
See next page for definitions
Daily Max. and IUP Limit * TRC criteria = TRC Limit Circle which units apply
_ Ave. Limits Circle 1.4 For TRC for BOD, TSS, oil, fat, grease; Circle 1.2 for all other pollutants to Limits
from IUP TRC compliance judgement not required for H: i
Daily Maximum Limit: 650 * 1.2 or 1.4 = TRC Daily Limit: 910 mg/1 or lbs/day
Average Limit: * 1.2 or 1.4 = TRC Avg. Limit: mg/l or lbs/day
Column 1: I - Industry self P-POTW A - Average
Column 5: Use only if IUP has (monthly, or other?) average limit. Average values of all sampling events collected wtihin the
"average" period (for example, for a monthly average limit, use all values collected within a calendar month) and enter
this average in column 5. Treat this average as another CJP. Compare this average to the appropriate average IUP limit
or TRC limit.
Column 6: Use only if IUP has daily limits in lbs/day. Formula to use is ( mgd * mg/I * 8.34 = lbs/day ).
Column 7: Use only if IUP has (monthly?) average limits in lbs/day. Use ( mgd * mg/I * 8.34 = lbs/day ).
Column 8: Put "1" for each daily maximum or average value, tally up at bottom as "A."
Column 9: Compare daily and average values to IUP limits above,put "0" if at or below limit, "1" if above, tally at bottom as "B."
Column 10: Compare daily and average values to TRC limits above,put "0" if below limit, "1" if at or above, tally at bottom as "C."
Col 1:
From
IDMRs
From
IDMRs
From
IDMRs
Col. 5:
Col6:
Col 7:
Col 8:
Col9:
Col 10:
Sample or
CJP Type
Sample
Date
Daily
Flow, mgd
Daily
Conc. mg/1
Avg Conc.
mg/1
Daily
Load
lbs/day
Avg. Load
lbs/day
CJP
Count
Regular
Violation
?
TRC
Violation
?
1
7/1/10
.04548
280
106.20
1
0
0
1
7/6/ 10
.08665
580
419.14
1
0
0
1
7/8/10
.08966
560
418.75
1
0
0
1
7/13/10
.05304
550
243.29
1
0
0
1
7/15/10
.07415
610
377.23
1
0
0
1
7/20/10
.07337
580
354.91
1
0
0
1
7/22/10
.07497
570
356.39
1
0
0
1
7/27/10
.06499
1180
639.58
1
0
0
1
7/29/10
.08193
480
327.98
1
0
0
1
8/3/10
.09015
1080
812.00
1
1
0
1
8/5/10
.12313
720
739.37
1
1
0
1
8/10/10
.09192
1100
843.27
1
1
0
1
8/12/10
.05082
850
360.26
1
0
0
1
8/17/10
.08123
785
531.80
1
0
0
1
8/19/10
.08204
1180
807.37
1
1
0
1
8/24/10
.11776
590
579.45
1
0
0
1
8/26/10
.07376
640
393.7
1
0
0
1
8/31/10
.08336
980
r681 32
1
1
0
Title: SNC With Limits Compliance Judgement Worksheet
File name: Compliance Judge Ju110.doc
Revision date: 1/5/01

Compliance Judgement Worksheet For SNC With Limits
Use separate sheets for each hidustry SNC determination for Flow optional, see Section 7-E Use separate sheets for each Pollutant
SIU Name: Crestwood Farms IUP Number: 0003 Pipe Number: 01
Parameter. BOD Six Month SNC Determination Period: 7/1/10-12/31/10
Col. 1:
From
IDMRs
From
IDMRs
From
IDMRs
Col. 5:
Col6:
Coll:
Col8:
Col9:
Col 10:
Sample or
CJP Type
Sample
Date
Daily
Flow, mgd
Daily
Conc. mg/1
Avg Conc.
mg/1
Daily
Load
lbs/day
Avg. Load
lbs/day
CJP
Count
Regular
Violation
TRC
Violation
1
9/2/10
.08086
800
539.50
1
0
0
1
9/7/10
.07178
390
233.47
1
0
0
1
9/9/10
.09184
1180
903.82
1
1
0
1
9/14/10
.08665
640
462.50
1
0
0'
1
9/16/10
.08522
1020
724.95
1
1
0
I
9/21/10
.06152
327
167.78
1
0
0
1
9/23/10
.08427
1160
815.26
1
1
0
1
9/28/10
.06565
180
98.55
1
0
0
1
9/30/10
.05950
334
165.74
1
0
0
1
1015110
.07468
600
373.70
1
0
0
1
10/7/10
.09166
1220
932.62
-1
1
1
1
10/12/10
.08438
337
237.16
1
0
0
1
10/14/10
.07560
680
428.74
1
0
0
'1
10/19/10
.04667
420
163.48
1
0
0
1
10/21/10
.11198
600
560.35
1
0
0
1
10/26/10
.08557
420
299.73
1
0
0
1
10/28/10
.08547
570
406.31
1
0
0
1
11/2/10
.08951
440
328.47
1
0
0
1
11/4/10
.09247
410
316.19
1
0
0
1
11/9/10
.05422
570
257.75
1
0
0
1
11/11/10
.11247
620
581.56
1
0
0
1
11/16/10
.05039
360
151.29
1
0
0
1
11/18/10
.114954
630
603.99
1
0
0
1
11/23/10
.04896
300
122.50
1
0
0
1
11%30/10
.10901
630
572.76
1
0
0
1
12/2/10
.09796
530
433
1
0
0
1
12nlio
.12010
630
631.03
1
0
0
1
12/9/10
.10952
480
438.43
1.
0
0
1
12/14/10
.10820
630
568.50
1
0
0
Title: SNC With Limits Compliance Judgement Worksheet
File name: Compliance Judge JullO.doc
Revision date: 1/5/01

Compliance Judgement Worksheet For SNC With Limits
Use separate sheets for each Industry SNC detennination for Flow optional, see Section 7-E Use separate sheets for each Pollutant
SIU Name: Crestwood Farms
IUP Number: 0003
1 Pipe Number: 01
Parameter: BOD
Six Month SNC Determination Period: 7/1/10-12/31/10
Col. 1:
From
IDMRs
From
IDMRs
From
IDMRs
Col. 5:
Col6:
Coll:
Col 8:
Col9:
Col 10:
Sample or
CJP Type
Sample
Date
Daily
Flow, mgd
Daily
Conc. mg/1
Avg Conc.
mg/1
Daily
Load
lbs/day
Avg. Load
lbs/day
CJP
Count
Regular
Violation
?
TRC
Violation
?
I
12/16/10
.09587
520
415.77
1
0
0
I
j 12/21/10
.10150
630
533.30
1
0
0
P
12/21/10
.10150
600
507.91
1
0
0
I
12/23/10
.11600
630
609.49
1
0
0
I
12/28/10
.09533
570
453.18
1
0
0
I
12/30/10
.09284
640
495.54
1
0
0
List these Totals on next page =>
A =53
B = 9
C= 1
Title: SNC With Limits Compliance Judgement Worksheet
File name: Compliance Judge Ju110.doc
Revision date: 1/5/01

Compliance Judgement Worksheet For SNC With Limits
Use separate sheets for each Industry SNC determination for Flow optional, see Section 7-E Use crate sheets for each Pollutant
SIU Name: Crestwood Farms IUP Number: 0003 1 Pipe Number: 01
Parameter. BOD Six Month SNC Determination Period: 7/1/10-12/31/10
SIGNIFICANT NON-COMPLIANCE (SNC) LIMITS DETERMINATION Calculate % and Circle Answers
1) Calculate the % of Regular violations: B/A = 9/53 = .17
2) Is B/A greater than or equal to 0.66 (or 66 %) ? Chronic violator? Yes /
3) Calculate the % of TRC Violations: - C/A = 1/53 = .02
4) Is C/A greater than or equal to 0.33 (or 33 %) ? TRC Violator? Yes /
5) Did any violation, alone or in combination with other discharges, cause pass -through
or interference at the POTW, or endanger the health of POTW workers or the public? Yes /
6) Did any violation cause imminent endangerment to human health / welfare or to the
environment or has resulted in the POTW s exercise of its emergency authority to halt
or prevent such discharge? Yes /
7) If the answer to any of these questions is yes, the SIU is in Signficant Non -Compliance (SNC) for this
parameter. They must be listed on the Significant Non -Compliance Report (SNCR) form in the Pretreatment
Annual Report (PAR), described in the PAR narrative (including parameter, period, and POTW actions), and
the POTW must take adequate enforcement as outlined in its Enforcement Responce Plan (ERP).
Is the SIU in SNC for this six month period? CIRCLE ONE: YES
Was the SIU in SNC for THE SAME PARAMETER in the previous six month compliance
period? CIRCLE ONE: YES KO
If YES to EITHER question, DESCRIBE IN NARRATIVE.
Please note if SIU was in SNC for the previous six month compliance period and is also in SNC for this six month
compliance period, escalated enforcement actions must be taken as soon as possible, preferably before the end
of the second consecutive period. Failure to take the action within 2 months after the end of the second
consecutive period will subject the POTW to enforcement by the Division. The options are:
Consent Order with Enforceable schedule;
Administrative Order with Enforceable schedule;
Formal notice to comply issued, or
Permit modification.
See Chapter 9 - Pretreatment Annual Reports, Chapter 8 - Enforcement, and the POTW's Enforcement Response
Plan (ERP).
Definitions:
CJP Compliance Judgement Point, The number of daily sample data values plus the number of average of
sampling events used for checking compliance with average limits.
TRC Technical Review Criteria, Multiply the actual IUP limits by the proper TRC Criteria value to get a
TRC Limit:
TRC Criteria = 1.4 for BOD, TSS, oil, fat, grease
TRC Criteria = 1.2 for all other pollutants
Not required to perform TRC compliance judge ment for pH.
SNCR Significant Non -Compliance Report
SNC Significant Non -Compliance (formerly called Reportable Non -Compliance or RNC)
Title: SNC With Limits Compliance Judgement Worksheet
File name: Compliance Judge Ju110.doc
Revision date: 1/5/01

SIU INSPECTION FORM
Name Of Industry: Crestwood Farms IUP # 003
Address Of Industry: 254 Eaton Road IIJP Expiration Date: 01 /01 /12
Mocksville. NC 27028
Industry Representatives: Title
Eric Ivey Safety and WW Manager
POTW Representatives:
John Grey
Date Of Inspection: 12/23/10
Purpose of Inspection: Annual X Other (Describe)
POTW to which IU discharges Dutchmans Creek
Is SIU currently in SNC? NO If yes, for -what?
Title
Acting Pretreatment Coordinator
Time Of Inspection: 11:00 ERpm
NPDES # NCO021491
PART I - INITIAL INTERVIEW
Has anything changed since the last inspection or IUP application in the following:
COMMENTS
Product MSINO
/NO Production increased by 20-30%
Raw materials used / NO Raw Materials increased accordingly with production
Manufacturing processes Added new production line (see comment below)
Categorical, if applicable YES / NO
Production rate / NO
Number of employees WS / NO
Number of shifts YES /
Increased by 20-30%
Added 50 new employees
Comments: New production line is similar to other processes. Cooked poultry products with slight
variations in marinade mix..
PART II - PLANT TOUR - Visit all areas where wastewater is generated or where there are
drains to the POTW.
Plant Tour Section A - PRODUCTION AND STORAGE AREAS
1 Are there floor.drains in the production area? WSJ / NO Where do they go? Wastewater
2. Are production areas diked, contained, or otherwise constructed in such a way as to prevent harm to the WWTP,
especially from spills or slugs? ©S / NO Comments:
3. Are there floor drains in the storage area? 0 / NO Where do they go? Wastewater
4. Are storage tanks and areas diked, contained, or otherwise constructed in such a way as to prevent harm to the
WWTP, especially from spills or slugs? © / NO Comments:
5. Are process and storage tanks and pipes labeled? / NO If hazardous
6. How are off -spec raw materials, and products disposed of? Placed in dumpsters and hauled to landfill
7. When is the production area cleaned? Nightly
8. Is the wastewater from cleaning the production area discharged to the POTW? / NO
9. What non -process wastewaters are discharged to POTW? Domestic
Comments:
Title: SIU Inpsection Form
File name: COMP.INSP App 7-1)
Revision data: August 1, 1994 Page 1

SIU INSPECTION FORM
PART II - Plant Tour Section B - PRETREATMENT SYSTEM
Ask the operator to describe pretreatment system.
1. Does operator seem knowledgeable about the system? ES / NO Comments:
2. Are all units operational? 0 / NO
3. How often does operator/maintenance pSrson check system? Continuously
4. Is there an operator for each shift? YES / NO
5. How and when is sludge disposed of? Dumpster to landfill 3 times per week
6. Is there a schedule for preventative maintenance? YES /
Comments:
PART II - Plant Tour Section C - SAMPLING POINTS) AND FLOW MEASUREMENT
(Collect a sample if desired.)
1. Does an outside lab complete sampling? WSJ / NO . If yes, name of lab. Tritest
2. If industry completes sampling, ask the industry representative to describe sampling procedures. Comments:
24 hour composite 2 times per week: Tritest picks u
3. Is flow measurement equipment operational? / NO Comments:
4. Is there a calibration log for the flow meter? ©S / NO Comments:
Comments:
PART III - EXIT INTERVIEW
Review monitoring records and other SIU records required by IUP.
1. Are files well organized? [ffSj / NO Comments:
2. Are sample collection / chain -of -custody forms filled out properly? ©S / NO Comments:
3. Do results in files agree with reports sent to POTW? 0 / NO Comments:
4. Who has authority to shut down production should a spill or slug discharge occur? Production Manager on
5. How does SIU inform employees of whom to call at POTW in case of spill/slug? Wastewater manager has
If slug/spill plan is already required by POTW, review procedures.
6. Is SIU implementing slug/spill plan? ©S / NO Comments:
Comments:
INSPECTION RESULTS
Slug/Spill Control Plan Needed? YES / NO
Comments, Required Or Recommended Actions: See 2009 Inspection. Have requested updated version.
Signature Of Inspector(s)
Date: iz-23—ifl
Date:
Title: SIU Inpsection Form
File name: COMP.INSP App 7-D
Revision data: August 1, 1994 Page 2

Y� a�
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins
RECEIVED T
N.C. Dept. of ENR
SEP 3 0 2010
Winston-Salem
Regional oucP
Dee Freeman
Governor Director Secretary
September 24, 2010
Ms. Christine Bralley, Town Manager
Town of Mocksville
171 Clement St
Mocksville, NC 27028
Subject: Pretreatment Review of Headworks Analysis - Approved
Dutchman Creek WWTP (NPDES #: NC0021491)
Program: Town of Mocksville
Davie County
Dear Ms. Bralley:
The Pretreatment, Emergency Response, and Collection Systems (PERCS) Unit of the Division of
Water Quality has reviewed the Headworks Analysis (HWA) for the Dutchman Creek WWTP. The
HWA, submitted by the Grey Engineering, was initially received by the Division on May 21, 2010,
followed by several revisions received on different dates since then.
The Division concurs with the HWA calculations for all pollutants of concern, with the corrections
outlined below. These approved Maximum Allowable Headworks Loadings (MAHLs), Maximum
Allowable Industrial Loadings (MAILs), and the basis for these values are found on the last page of the
enclosed HWA spreadsheet, which has the corrections marked. The results of the HWA are also listed
in the bottom section of the enclosed Allocation Table.
The following observations were noted during the review of the HWA:
1) Changes to the HWA Approved Today: Please feel free to contact PERCS if you have any
questions about the changes outlined below. All corrected spreadsheets were emailed to you for
your files, and other corrected documents were faxed. Please ensure the POTW's paper and
electronic HWA, AT, and other supporting documents contain these corrected documents,
especially the Allocation Table. As needed, please mark any original documents as "replaced" or
"voided."
a) 7Q10 Stream Flow: 7Q10 stream flow was corrected to 1.64 MGD per NPDES permit (summer
7Q10 flow, 2.54 CFS*0.646).
b) Sludge to Disposal Flow: Sludge flow to disposal was recalculated using only the gallons
generated by the Dutchman Creek WWTP.
c) Cadmium stream standard: Removed cadmium water quality standard from the stream
standard column since POTW has NPDES limit on cadmium.
d) Action Level Parameters: Copper, silver, and zinc are action level parameters; only required to
use in HWA if failing whole effluent toxicity due to these POCs.
e) Removal Rates Spreadsheet: Various corrections were made on effluent data summaries.
Removal rates for copper and zinc were recalculated using site specific data. Chose to use
literature removal rate for nickel.
f) Inhibition Loading Calculations: Corrected literature activated sludge/nitrification values for
several parameters.
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Location: 512 N. Salisbury St. Raleigh, North Carolina 27604 One
Phone: [phone] FAX: 91M07-64921 Customer Service: 1-877-623-6748 NorthCarolina
Internet: ppotncwaterqualtiveAg Nahl ra lY
An Equal Opportunity 1 Affirmative Action Employer j

g) Allocation Table: Updated allocation table per current Crestwood farms IUP. AT needs be
updated every time the IUP is modified or renewed.
2) Resubmit DMRs: While reviewing HWA data summaries, we noticed that STMP effluent data were
not included on the DMRs. Effluent STMP data shall be reported on the DMRs per your NPDES
permit (Part IV, Section D). Also, the reported below detections (BDLs) for the metals including
cyanide on the DMRs are incorrect. Per my discussion with John Grey, the amended DMRs
starting January 2008 to -date need to be resubmitted to the Division (regular DMR submission
address) by October 31, 2010. Please send a confirmatory email to the PERCS.
3) HWA Due Date: The HWA approved today is primarily based on DMR/STMP data for the period
November 2008 through October 2009. Unless conditions at the POTW change significantly and
thus warrant an earlier submittal (see Comprehensive Guide, Section 8), the POTW must meet the
followings:
a) Submit an updated STMP by August 1, 2013, to prepare for the next STMP cycle.
b) Collect STMP data in 2014.
c) Submit an updated HWA using this site -specific data on or before April 1, 2015.
Thank you for your continued cooperation with the Pretreatment Program. If you have any questions or
comments, please contact Monti Hassan at (010) w7-63i-At 'eiiiaii. ivionti.Hassanwricdenr.yUyj Vr
Deborah Gore, Unit Supervisor at [phone] [email: Deborah. [e-mail]].
Sincerely,
Coleen H. Sullins
mh/mocksville.dutchmann. HWA.2010
Enclosures: HWA-AT, mass balance, removal rate spreadsheets
cc: John Grey, Grey Engineering, Inc., P.O. BOX 9, Mocksville, NC 27028
Central,f tl'§ a
Mont�lassan, PERCS Unit
George Smith, WSRO

North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
September 22, 2010
Ms. Christine Sanders, Town Manager
Town of Mocksville
171 Clement Street
Mocksville, NC 27028
SUBJECT: Pretreatment Compliance Inspection
Town of Mocksville
NPDES #NC0021491
Davie County
Dear Ms. Sanders:
On September 16, 2010 George Smith, of this office, performed a Pretreatment Compliance Inspection (PCI).
Mr. John Grey and Ms. Joy Howard were present for the inspection. The purpose of this inspection was to
determine the effectiveness of the pretreatment program, which includes: reviewing the files, POTW plant
performance, industry monitoring data, and adherence to the enforcement response plan (ERP).
Background
The pretreatment program has one WWTP, which is NCO021491 (Dutchman's Creek) with a 0.68 MGD
permitted flow.
POTW Interview
Mr. Grey procured some continuous monitoring pH probes and strategically placed them in manholes. There is
a documented slug every 4 to 6 weeks showing a pH of 1.6 SU. Hopefully the discharger will be identified
soon.
Program Elements
The Headworks Analysis (HWA) for Dutchman's Creek WWTP was submitted to PERCS on May 28, 2010.
The HWA was not yet approved by PERCS.
The Industrial Waste Survey (IWS) is due January 30, 2012.
The Sewer Use Ordinance (SUO) was last approved on February 14, 2007.
The Enforcement Response Plan (ERP) was last approved on June 15, 2010.
Short Term Monitoring Plan (STMP) for the Dutchman's Creek WWTP was approved July 1, 2010.
North Carolina Division of Water Quality, Winston-Salem Regional Office
Location: 585 Waughtown St. Winston-Salem, North Carolina 27107 One
Phone: [phone] FAX: [phone] Customer Service: 1-877-623-6748 NorthCarolina
Internet: www.ncwaterquality.org �/ ►/ �'jwwra y
An Equal Opportunity 1 Affirmative Action Employer "

fl
Pretreatment Compliance Inspection
September 22, 2010
Page 2 of 2
Industrial User Permit (IUP) File Review
A review of the file for Crestwood (#0003) revealed that the monitoring data was well organized and correctly
judged for compliance.
The pretreatment compliance inspection is considered satisfactory. Mr. John Grey is going a very good job
implementing the pretreatment program. If you have any questions, please contact George Smith or me at (336)
771-5000.
Sincerely,
Al
Steve W. Tedder
Regional Supervisor
cc: Mr. John Grey, 254 W. Water Street, Mocksville, NC 27028
PERCS Unit — Monti Hassan
WSRO Files

NORTH CAROLINA DIVISION OF WATER QUALITY
PRETREATMENT COMPLIANCE INSPECTION (PCI) REPORT
BACKGROUND INFORMATION (Complete Prior To PCI; Review Program Info Database Sheet(s)1
1. Control Authority (POTW) Name: T wf) o-F nowil LIL
2. Control Authority Representative(s):
3. Title(s):
4. Last Inspection Date: _A _f lispection Type (Check One): 024CI ❑ Audit
5. Has Program Completed All Requirements from the Previous Inspection and Program Info Sheet(s)? ❑ YES ❑ NO
6. Is POTW under an Order That Includes Pretreatment Conditions? ❑ YES ❑-1 0
Order Type, Number, Parameters: 'y/* Are Milestone Dates Being Met? ❑ YES ❑ NO
PCS CODING
Trans.Code Main Program Permit Number MM/DD/YY Inspec.Type Inspector Fac. Type
N1 I N I C 1 0 10 12-1/IgIgI II 1 91161lot 1 PJ 1 S I l-1_J
(DTIA) (TYPI) (INSP) (FACC)
7. Current Number Of Significant Industrial Users (SIUs)?
/
SIUS
8. Current Number Of Categorical Industrial Users (CIUs)?
©
CIUS
9. Number of SIUs Not Inspected By POTW in the Last Calendar Year?
10. Number of SIUs Not Sampled By POTW in the Last Calendar Year?
Q
11. Enter the Higher Number of 9 or 10
Q
NOIN
12. Number of SIUs With No IUP, or With an Expired IUP
O
NOCM
13. Number of SIUs in SNC for Either Reporting or Limits Violations During Either of the Last 2
Semi -Annual Periods (Total Number of SIUs in SNC) 11
4
PSNC
14. Number of SIUs in SNC For Reporting During Either of the Last 2 Semi -Annual Periods
I C
MSNC
15. Number of SIUs In SNC For Limits Violations During Either of the Last 2 Semi -Annual Periods
0
SNPS
16. Number of SIUs In SNC For Both Reporting and Limits Violations During Either of the Last 2
Semi-annual Periods
D
POTW INTERVIEW
17. Since the Last PCI, has the POTW had any NPDES Limits Violations?
If Yes, What are the Parameters and How are these Problems Being Addressed?
' roX IGit-y N (o r,dM j 'ro 4101.11"«r0t
18. Since the Last PCI, has the POTW had any Problems Related to an Industrial
Discharge (Interference, Pass -Through, Blockage, Citizens' Complaints, Increased
Sludge Production, Etc.)?
If Yes, How are these Problems Being Addressed?
19. Which Industries have been in SNC for Limits or Reporting during SNC for
either of the Last 2 Semi -Annual Periods? Not Been Published for SNC for
Public Notice?(May refer to PAR if Excessive SIUs in SNC) Not Pu
20. Which Industries are on Compliance Schedules or Orders? For all SIUs on an
Order, Has a Signed Copy of the Order been sent to the Division?
21. Are Any Permits Or Civil Penalties Currently Under Adjudication? If Yes, Which
Ones?
[g"YFS [:1 NO
[:1[ YES INS O
Limits:
Reporting:
blished:
❑ YES [D-_'O
LTMP/STMP FILE REVIEW:
22. Is LTMP/STMP Monitoring Being Conducted at Appropriate Locations and Frequencies? YES ❑ NO
23. Are Correct Detection Levels being used for all LTMP/STMP Monitoring? EglliS ❑ NO
24. Is LTMP/STMP Data Maintained in a Table or Equivalent? OaTES ❑ NO Is Table Adequate? Q5*ES ❑ NO
25. All LTMP/STMP effluent data reported on Discharge Monitoring Report? G21*S'ES ❑ NO DWQ Inspector, please verify
yourself!
26. If NO to 23 - 26, list violations sonz- J 4T-L is mrJA
27. Should any Pollutants of Concern be Eliminated from or Added to LTMP/STMP? ❑ Y ES UQO
If yes, which ones? Eliminated: Added:
NC DWQ Pretreatment Compliance Inspection (PCI) Form Updated 7/25/07 Page 1

28. PRETREATMENT PROGRAM ELEMENTS REVIEW- Please review POTW files, verify POTW has copy of Program
Element in their files co m fete with su orting documents and coDv of PERCS Approval Letter, and dates consistent with Program Info:
Program Element
Last Submittal
Date In file?
Last Approval
Date In file
Date Next Due,
If Applicable
Headworks Analysis A
-a F- to
es ❑ No
Lj Yes ❑ No
s
Industrial Waste Survey IWS
❑ Yes ❑ No
-D
❑- es ❑ No
/- go - i
Sewer Use Ordinance SUO
❑ Yes ❑ No
1 - lY-o 7
Yes ❑ No
Enforcement Response Plan (ERP)
❑ Yes ❑ No
6-16---io
Q'Yes ❑ No
Long Term Monitoring Plan (LTMP)
❑ Yes ❑ No
- / - Io
21es ❑ No
T1Vn-rjQT1DTA1. ITSER PERMIT RITPI FILL REVIEW (3 IUP FILE REVIEWS OR 1 FILE REVIEW AND 1 IU INSPECTION)
29.
User Name
1 Cry �'tw ,n S 2 3.
30.
IUP Number
Ioeo 3
31.
Does File Contain Current Permit? I
Zyes ❑ No ❑ Yes ❑ No]I El Yes ❑ No
32.
Permit Expiration Date
' ! -
33.
Categorical Standard Applied (I.E. 40 CFR, Etc.) Or N/A I
N
34.
Does File Contain Permit Application Completed Within One Year Prior
[-Yes ElNo ElYes ❑ No ❑ Yes ❑ No
35.
to Permit Issue Date?
Does File Contain an Inspection Completed Within Last Calendar Year?
es ❑ No ❑ Yes ❑ No ❑ Yes ❑ No
36.
a. Does the File Contain a Slug/Spill Control Plan?
a. 9Jfes ON a. ❑Yes ❑No a. ❑Yes ❑No
b. ❑Yes ❑No b. ❑Yes ❑No
b. If No, is One Needed? (See Inspection Form from POTW)
b. ❑Yes ❑N
37.
For 40 CFR 413 and 433 TTO Certification, Does File Contain a Toxic
❑Yes❑NoC4rt1 ❑Yes❑No❑N/A ❑Yes❑No❑N/A
Organic Management Plan (TOMP)?
38.
a. Does File Contain Original Permit Review Letter from the Division?
a. Erqes [IN a. ❑Yes ❑No a. oyes ❑No
b. All Issues Resolved?
b.❑Yes❑No Fd/A b.❑Yes❑No❑N/A b.❑Yes❑No❑N/A
39.
During the Most Recent Semi -Annual Period, Did the POTW Complete
Pfes ❑ No ❑ Yes FYes ❑ fl
its Sampling as Required by IUP, including flow?
40.
Does File Contain POTW Sampling Chain -Of -Custody Forms?
EFfes ❑ No IF
❑ Yes I ❑ Yes ❑ No
41.
During the Most Recent Semi -Annual Period, Did the SIU Complete its
es❑No❑N/A
❑Yes❑No❑N/A
❑Yes❑No❑N/A
Sampling as Required by IUP, including flow?
41b. During the Most Recent Semi -Annual Period, Did SIU submit all reports
es❑No❑N/A
❑Yes❑No❑N/A
❑Yes❑No❑N/A
on time?
42a. For categorical fUs with Combined Wastestream Formula (CWF), does
❑Yes❑Noq?f/A
❑Yes❑No❑N/A
❑Yes❑No❑N/A
file include process/dilution flows as Required b IUP?
42b. For categorical IUs with Production based limits, does file include
❑Yes❑No /A
❑YespNo❑N/A
❑Yes❑No❑N/A
production rates and/or flows as Required b IUP?
43a.
During the Most Recent Semi -Annual Period, Did the POTW Identify
es ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
All Limits Non -Compliance from Both POTW and SIU Sampling?
43b. During the Most Recent Semi -Annual Period, Did the POTW Identify
es❑No❑N/A
❑YespNo❑N/A
❑Yes❑No❑N/A
All Re ortin Non-Com liance from SIU Sampling?
44.
a. Was the POTW Notified by SILT (Within 24 Hours) of All Self-
a. es❑No❑N/A
a.❑Yes❑No❑N/A
a.❑Yes❑No❑N/A
Monitoring Violations?
b. Did Industry Resample and submit results to POTW Within 30 Days9
�
b.®'Yes❑No❑N/A
b.❑Yes❑No❑N/A
b.❑Yes❑No❑N/A
c. If applicable, Did POTW resample within 30 days of becoming aware
C. es❑No❑N/A
c.❑Yes❑No❑N/A
c.❑Yes❑No❑N/A
of SIU limit violations in the POTW's sampling of the SIU?
46.
During the Most Recent Semi -Annual Period, Was the SIU in SNC?
I ❑
Yes No
11
❑
Yes
❑
No
❑
Yes ❑
No
47.
During the Most Recent Semi -Annual Period, Was Enforcement Taken
gKesON77N
❑Yes❑No❑N/A
❑YespNo❑N/A
as Specified in the POTW's ERP (NOVs, Penalties, timing, etc.)?
❑Yes❑No /A
❑Yes❑No❑N/A
48. Does the File Contain Penalty Assessment Notices?
❑Yes❑No❑N/A
49.
Does The File Contain Proof Of Penalty Collection?
❑Yes❑NoOKA
❑Yes❑No❑N/A
❑Yes❑No❑N/A
50.
a. Does the File Contain Any Current Enforcement Orders?
a.❑Yes❑NoWN/A
a.❑Yes❑No❑N/A
a.❑Yes❑No❑N/A
b. Is SIU in Compliance with Order?
b.❑Yes❑No�/A
b.❑Yes❑No❑N/A
b.❑Yes❑No❑N/A
51.
Did the POTW Representative Have Difficulty in Obtaining Any of This
❑ Yes o
❑ Yes ❑ No
❑ Yes ❑ No
Requested Information For You?
NC DWQ Pretreatment Compliance Inspection (PCI) Form Updated 7/25/07 Page 2

FILE REVIEW COMMENTS:
INDUSTRY INSPECTION PCS CODING:
Trans.Code Main Program Permit Number
I-N I 1 I I I I
1. Industry Inspected:
2. Industry Address:
3. Type of Industry/Product:
4. Industry Contact:
Phone:
5. Does the POTW Use the Division Model Inspecti=of
6. Did the POTW Contact Conduct the Follow
Comments:
A. Initial Interview ❑ Y NO
B. Plant Tour ES ❑ NO
C. Pretreatment T ❑ YES ❑ .NO
D. Sampling view ❑ YES ❑ NO
E. Exit erview ❑ YES ❑ NO
Industrial Ins tion Comments:
OVERALL SUMMARY AND COMMENTS:
Comments: RWS k e-dh e'/'c�r%�n 6
Requirements:
Recommendations:
MM/DD/YY Inspec.Type
L I 1 L I1
(DTIA) (TYPI)
Fax:
ent? ❑ YES ❑ NO
Inspection Thoroughly?
Inspector Fac. Type
f SJ 1 2 l
(6W— (FACC)
NOD: [:IV ES U-NO
NOV: ❑ YES EO
QNCR: ❑ YES NO
POTW Rating:
Satisfactory—L�Marginal UnSatisfactory
PCI COMPLETED BY:�4 "r- DATE: . i _ 0/0
NC DWQ Pretreatment Compliance Inspection (PCI) Form Updated 7/25/07 Page 3

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
July 1, 2010 N.C. Dept.vof ENR
Ms. Christine Bralley, Town Manager JUL O 2 1OtO
Town of Mocksville
171 Clement St. Winston-Salem
Regional Office i
Mocksville, NC 27028 S T1^t f'
Subject: Pretreatment Review of Heaa s Short Term Monitoring Plan — Approved
Dutchman Creek WWTP (NPDES #: NC0021491)
Program: Town of Mocksville
Davie County
Dear Ms. Bralley:
The Pretreatment, Emergency Response, and Collection Systems (PERCS) Unit of the Division of
Water Quality has reviewed the Short Term Monitoring Plan (STMP) for the Town of Mocksville. The
STMP was submitted in response to the Division's Pretreatment Program Review letter, dated April 19,
2010. The STMP was initially received by the Division on May 3, 2010, followed by corrections
received on June 29, 2010.
The review indicates that with the revisions included in the recent submission, the STMP is adequate
and meets the requirements needed to establish a site -specific Headworks Analysis (HWA). Proper
implementation of an LTMP is also required by Part IV (C) of your NPDES permit.
1. STMP Data Summary: Comprehensive Guide, Appendix 4-B. Sample collection and laboratory
analysis must be done as outlined in this STMP. It is also very important to organize and
summarize your data. Example STMP data summary forms can be found on our website (web
address listed in footer of this letter) or on disc by request, and also in the Comprehensive Guide.
2. Division Review of Data: As your STMP data is accumulated, organized, and analyzed, the
Division may request to review tabulated data and to see chain of custody forms and laboratory
data sheets.
3. STMP Modifications: Interpretation of monitoring data or changes in operation at your POTW may
indicate that the STMP needs to be modified; however, please be aware that modifications to your
STMP must be approved by the Division.
Thank you for your continued cooperation with the Pretreatment Program. If you have any questions or
comments, please contact Monti Hassan at [phone] [email: Monti. Hassan(cDncdenr.gov] or
Deborah Gore, Unit Supervisor at [phone] [email: Deborah. [e-mail]].
Sincerely,
K+4-4Gt,Q'b a,
+- Coleen H. Sullins
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Location: 512 N. Salisbury St. Raleigh, North Carolina 27604 One
Phone: [phone] \ FAX: [phone] \ Customer Service: 1-877-623-6748 NorthCarolina
Internet: www.unity \ rqualtive Action
Naturally
An Equal Opportunity \Affirmative Action Employer �/ Y it l

m h/mocksville.stmp.2010
cc: Mr. John Gre - 254 W. Water Street, Mocksville, NC 27028
ral Files
Monti Ftassan, PER S Unit
George Smith, O

R�utIVED
JUN 1.7 1010
..= IL
NCDENR
Reg1onal Office
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
June 15, 2010
Ms. Christine Bralley, Town Manager
Town of Mocksville
171 Clement St.
Mocksville, NC 27028
Subject: Pretreatment Review of Enforcement Response Plan
Program: Town of Mocksville
NPDES: NCO021491
Davie County
Dear Ms. Bralley:
The Pretreatment, Emergency Response, and Collection Systems (PERCS) Unit of the Division of
Water Quality has reviewed the Enforcement Response Plan (ERP) for the Town of Mocksville. The
ERP was received by the Division on April 28, 2010.
The review indicates that overall the ERP is adequate and meets the requirements of 15A NCAC 02H
.0905 and 40 CFR 403.8 (f)(5). Proper implementation of an ERP is also required by Section IV, C, 9,
of your NPDES permit. Please refer to the Comprehensive Guidance for North Carolina Pretreatment
Programs (Comprehensive Guide) for additional information and examples.
The Division expects you to follow this approved ERP for all enforcement actions. Modifications to this
ERP must be approved by the Division.
Thank you for your continued cooperation with the Pretreatment Program. If you have any questions or
comments, please contact Monti Hassan at [phone] [email: Monti. Hassan(@,ncdenr.gov] or
Deborah Gore, Unit Supervisor at [phone] [email: [e-mail]].
Sincerely,
Coleen H. Sullins
mh/mocksville.erp.2010
cc: Mr. John Grey - 254 W. Water Street, Mocksville, INC 27028
Central Files
Monti Hassan, PERCS Unit
George Smith, WSRO
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Location: 512 N. Salisbury St. Raleigh, North Carolina 27604 One
Phone: [phone] FAX: [phone] Customer Service: 1-877-623-6748 North Carob n a
Internet: www.unity \ r Affirmative
Action
�/�!lIt1Cl alli/
An Eaual O000rtunity 1 AfFrmative Action Emolover j tL

Apaa --
FRECEfVED
N.C. Gert. o"
NCDENR MAY 2 5 2010
North Carolina Department of Environment and Natural Resources
Division of Water Qualit winstorr5ary
y i L _ RegionalOffiee _-
Beverly Eaves Perdue Coleen H. Sullins ee reeman
Governor Director Secretary
May 20, 2010
Ms. Christine Bralley, Town Manager
Town of Mocksville
171 Clement Street
Mocksville, NC 27028
Subject: Pretreatment Review of Industrial User Pretreatment Permit
Program: Town of Mocksville (NPDES#: NC0021491)
Davie County
Dear Ms. Bralley:
The Pretreatment, Emergency Response, and Collection Systems (PERCS) Unit of the Division of
Water Quality has reviewed the Industrial User Pretreatment Permit (IUP) renewal issued by the Town
of Mocksville for the following Significant Industrial User (SIU). The IUP was initially received by the
Division on April 28, 2010 followed by permit application submitted on May 3, 2010.
IUP #
SIU
40 CFR
0003
Crestwood Farms
N/A
The review indicates that with the observation below, the IUP is adequate and the minimum
requirements of 15A NCAC 2H .0905 and .0916 and 40 CFR 403.8(f) (1) (iii) are met.
1) IUP History: The last entry in the IUP History says "IUP Modification". The next time this IUP is
modified, please correct the typo so it would say "IUP Renewal."
2) Wastewater Pollutant Checklist: We noticed in the permit application that the pollutants that are
checked as absent at the facility do not provide any indication as to whether the pollutants are
present or absent in the discharge. We assume in fact the POCs are absent in the discharge. If
that's not the case please let us know promptly. Please insure all future permit applications have
this wastewater Pollutant checklist section filled out completely.
Thank you for your continued cooperation with the Pretreatment Program. If you have any questions or
comments, please contact Monti Hassan at [phone] [email: Monti. Hassan(,a-)ncdenr.gov] or
Deborah Gore, Unit Supervisor at [phone] [email: Deborah. [e-mail]].
Sincerely,
mh/mocksvi Ile. crestwood. renewal
cc: Mr. John Grey - 254 W. Water Street, Mocksville, NC 27028
Central Files
Mo a assan, RCS Unit
George Smith SRO
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Location: 512 N. Salisbury St. Raleigh, North Carolina 27604 One
Phone: [phone] FAX: [phone] Customer Service: 1-877-623-6748 North Carolina
Internet) www.nnity \ Affirmative
rg
Action
Naturally
An Equal Opportunity 1 Affirmative Action Employer 1

4
A&MA
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins
Governor Director
May 5, 2010
Grey Engineering, Inc
Attn: John Grey
Town of Mocksville
P. O. Box 9
Mocksville, NC 27028
Subject: Pretreatment Annual Report (PAR) Review
(January 1 through December 31, 2009)
Town of Mocksville
NPDES Number: NCO021491
Davie County
Dear Mr. Grey:
Dee Freeman
Secretary
The Winston-Salem Regional Office has reviewed the Pretreatment Annual Report covering January through
December 2009. Our review indicates that the annual report is in good order and satisfies the requirements of
15A NCAC 2H .0908(b) and the Comprehensive Guidance for North Carolina Pretreatment Pro rams. The
next annual report will be due March 1, 2011.
The next PAR must include the Historical SNC.
Thank you for your continued cooperation with the Pretreatment Program. If you have any questions or
comments, please contact me at [phone] [email: [e-mail]].
Sincerely,
George S. Smith
Environmental Chemist
cc: PERCS Unit
WSRO Files
North Carolina Division of Water Quality, Winston-Salem Regional Office
Location: 585 Waughtown St. Winston-Salem, North Carolina 27107
Phone: [phone] FAX: [phone] Customer Service: 1-877-623-6748
Internet: www.newaterquality.org
Nne
OrthCarolina
An Equal Opportunity 1 Affirmative Action Employer

Regional Pretreatment Annual Report (PAR) Review
Included in
PAR
Adequate
Narrative
®
YES
❑
NO ❑ NA
®
YES
❑
NO ❑ NA
PPS Form
❑
YES
❑
NO
❑
YES
❑
NO
SNCR
®
YES
❑
NO
®
YES
❑
NO
IDSF
❑
YES
❑
NO
❑
YES
❑
NO
Allocation Table
❑
YES
❑
NO
❑
YES
❑
NO
Waste Reduction Info
❑
YES
❑
NO
❑
YES
❑
NO
Compliance Schedules
❑
YES
❑
NO ® NA
❑
YES
❑
NO ® NA
Public Notice
❑
YES
❑
NO ® NA
❑
YES
❑
NO ® NA
Program Information
®
YES
❑
NO
®
YES
❑
NO
Historical SNC
❑
YES
®
NO
®
YES
❑
NO
Regional Office: Winston-Salem
POTW: Mocksville
NPDES Permit No. NCO021491
Report Period: 1/1/09 to 12/31/09
❑ Full Program ® Modified Program
rf No, check recommendation below:
1. Have at least 90% of SIU permits been issued within 180
❑ Yes ❑ No ® Not Required
❑ NOV
❑ QNCR
❑ NCP
❑ Civil Penalty
days of expiration? See Allocation Table).
Assessment
2. Were at least 80% of SIUs inspected? (See PPS Page)
❑ Yes ❑ No ® Not Required
❑ NOV
❑ QNCR
❑ NCP
❑ Civil Penalty
Assessment
3. Has effective enforcement been taken against industries in
❑ Yes ❑ No ® NA
❑ NOV
❑ QNCR
❑ NCP
❑ Civil Penalty
SNC, including those causing pass -through or interference? (See
Assessment
SNCR Form
4. Does public notice cover all SIUs in SNC?
❑ Yes ❑ No ® NA
❑ NOV
❑ QNCR
❑ NCP
❑ Civil Penalty
Assessment
Note: Exceptions should be explained in the comment section Deiow_
There are no SIUs in significant noncompliance. The next PAR must include the
Historical SNC.
Reviewed By: George Smith
Regional Pretreatment Annual Report Review
mocksville form.par
Date: May 5, 2010
Fill in Values from PPS Form
SSNC 0
FENF 0
JUDI 0
SVPU 0
IUPN 0
SOCS 0
* Alternatively attach PPS page from PAR

GREY
ENGINEERING, INC.
E N V I R O N M E N T A L A N D C I V I L
5/3/2010
Deborah Gore
Supervisor, PERCS Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Via: Priority Mail Return Receipt Requested
Re: Notice of Violation NOV-2010-LV-0130
Town of Mocksville (NPDES #NC0021491)
Dear Ms. Gore:
D E S I G N
RECEIVED
N.C. Dept, of ENR
I
MAY 0 5 2010 j
Winston-Salem
Regional ice
This letter is in response to your Notice of Violation dated April 19, 2010 and
received April 26, 2010.
Grey Engineering, Inc. was delayed in completing and submitting the items listed
in the NOV (STMP, ERP and HWA) while it vigorously supported the Town in
obtaining approximately $3 million dollars in economic development grants to
upgrade the Town's water and sewer infrastructure and the industry's wastewater
pretreatment facility. The industry has agreed to provide over 100 new jobs to the
community. This successful effort was complex and involved many organizations
working together to bring new jobs to the community.
It is my understanding that the Town's Dutchmans Creek WWTP remained in
compliance with all of its discharge parameters during this period.
It is true that we were late in providing you with the required elements but I trust
that you can keep the infraction in perspective with the accomplishment of
acquiring the funding to further support the infrastructure and employment needs
of this Town.
Very Truly Yours,
Grey ngineering, Inc
John C. Grey, Jr., PE
Cc: Steve Tedder - WSRO
The Town of Mocksville
Christine Bralley, Manager
P.O. Box 9 • Mocksville, NC 27028 • Phone: [phone] • Fax: [phone] . wv vw.greyengineering.cor-,-i

4n. �*
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
April 19, 2010
CERTIFIED MAIL
RETURN RECEIPT REQUESTED
Ms. Christine Bralley, Town Manager
Town of Mocksville
171 Clement Street
Mocksville, NC 27028
Subject: Notice of Violation: NOV-2010-LV-0130
Notice of Intent to Recommend Assessment of Penalties
Pretreatment Program Review
Program: Town of Mocksville (NPDES #NC0021491)
Davie County
Dear Ms. Bralley:
This letter is to transmit a Notice of Violation against the Town of Mocksville. This assessment
is based upon the following facts: A review has been conducted of the Town's approved
Industrial Pretreatment Program. This review has shown the subject facility to be in violation of
NCGS 143-215.1 (a), NCGS 143-215.3(14), 15A NCAC 2H .0900 and NPDES Permit number
NC0021491. The violations are summarized below.
1. The POTW was found to have violated Part IV, C, 4, of its NPDES permit for failure
to submit a Headworks Analysis (HWA). The HWA was due to the PERCS Unit by
September 30, 2009. This was communicated via conference call with Mr. John Grey
and followed up with email dated June 16, 2009. The due date to submit HWA was
later extended until December 31, 2009 during Pretreatment Compliance Inspection
2009. The HWA is over three months late.
2. The POTW was found to have violated Part IV, C, 9, of its NPDES permit for failure
to have an adequate Enforcement Response Plan (ERP). An updated Enforcement
Response Plan (ERP) was due December 31, 2009. This was communicated with Mr.
John Grey through email dated June 16, 2009. The ERP is over three months late.
3. The POTW was found to have violated Part IV, C, 3, of its NPDES permit for failure
to submit Short Term Monitoring Plan (STMP). An updated Short Term Monitoring
Plan (STMP) was due December 31, 2009. This was communicated with Mr. John
Grey through email dated June 16, 2009. The STMP is over three months late.
1617 Mail Service Center, Ra"h, North Carolina 27699-1617 One
Location: 512 N. Salisbury St Ra"h, North Carolina 27604
Phone: [phone] FAX: [phone] Customer Service:1-877-623-6748 North Carolina
Internet: www.ncwaterquality.org Natu'rallYAn Equal opportunity 1 Affirmative Action Employer

The Town is required to submit the items mentioned above according to the following
schedules. If these items are not submitted at the requested time, please submit a schedule
of dates by which the Town will submit these requested items.
1. STMP: Submit an updated STMP by April 30, 2010.
2. ERP: Submit an updated ERP by April 30, 2010.
3. HWA: Submit a Headworks Analysis using 2009 DMR and STMP data by May 215t,
2010.
The Central Office is considering recommending to the Director that further enforcement
actions be taken, including penalty assessments. If you have any supporting documents as to
why further actions should not be taken, please provide the information to our office and the
Regional Office at the addresses listed below along with the other items requesting in this
letter within 14 days of the receipt of this letter.
Steve W. Tedder Deborah Gore
Water Quality Regional Office Supervisor Unit Supervisor, PERCS Unit
NC DWQ Winston-Salem Regional Office NC DWQ
585 Waughtown Street 1617 Mail Service Center
Winston-Salem, NC 27107 Raleigh, NC 27699-1617
Thank you for your continued cooperation with the Pretreatment Program. If you have any
questions or comments, please contact Monti Hassan at [phone] [email:
Monti. Hassan(c-)-ncdenr.gov] or Deborah Gore, Unit Supervisor at [phone] [email:
Deborah. [e-mail]].
ncerely,
Deborah Gore
Supervisor, PERCS Unit
mh/Mocksville_nov_2010
cc: Mr. John Grey - 254 W. Water Street, Mocksville, NC 27028
Central Reg—
Molnti Hassan, PERCS Unit
eor ie Smith'*SRO
—. _-
RECRIY��
N.C. Dept, of ENR
APR 2 g 2010
WInstonaalem
Regional Office

04/16/2010 17:23 3367516348 GREY PAGE 01/02
GREY
ENGINEERING, INC.
E N V I R 0 N M E N T A L A N D C I V I L D E S I G N
4/16/2010
Mr. Steve Tedder
Regional Water Quality Supervisor
NCDENR — WSRO
585 Waughtown St.
Winston-Salem, NC 27107
Re: Notice of Violation with Intent to Enforce
Town of Mocksville — Dutchmans Creek WWTP (NC0021491)
Pretreatment Annual Report
Via Fax to: 336 771 4630 (hard copy by USPS)
Dear Steve:
The Pretreatment Annual Report referenced in your Notice of Violation dated
April 9, 2010 has been submitted to Monti Hassan by certified mail today. Our
transmittal record is attached hereto. The PAR recognizes that Crestwood Farms
is participating with the Town of Mocksville in obtaining more that $2 million of
grant funding to upgrade the Crestwood Farms pretreatment facility and the
Mocksville water treatment plant.
Failure to submit the report by March first was an oversight on our part as we
transition from submitting semi-annual reports to annual reports.
Thank you for your consideration in this matter.
Sincerely,
Grey Engineering, Inc.
'000qe�
John C. Grey, Jr., PE
President
Cc: Beth Dirks
P.O- Box 9 - Mocksville, NC 27028 - Phone: [phone] - Fay- «-Ati) 7C7_r_z ea

04/16/2010 17:23 3367516348 GREY PAGE 02/02
LETTER OF TRANSMITTAL
Date: 4/16/2010 GREY ENGINEERING, INC
254 West Water Street
P. O. Box 9
To: Monti Hassan Mocksville, NC 27028
NC DWQ-PERCS Telephone [phone]
1617 Mail Service Center Fax: [phone]
Raleigh, NC 27699-1617
Job #
Re: Town of Mocksville - Dutchmans Creek
WE ARE SENDING YOU: X Attached Under separate cover via
the following items: Copy of letter Submittal
Prints Plans Samples
Change order Other
vuanuty uescriptlon
1 Copy of PAR for 2009 with Attachments
As requested
X For your use
For approval
For review and comment
Resubmit copies for approval
Remarks:
Approved as submitted
Approved as noted
Returned f. corrections
Return corrected prints
Submit copies for distribution
COPY T0: SIGNED Q
If enclosures are not as noted, kindly notify us at once

GREY
ENGINEERING, INC.
ENVI RON MENTAL A N D C I V I L
4/16/2010
Mr. Steve Tedder
Regional Water Quality Supervisor
NCDENR — WSRO
585 Waughtown St.
Winston-Salem, NC 27107
RECEIVED
N.C. Dept of ENR
D E S I G N
APR 2 0 20M
Winston-Salem
Regional Office
Re: Notice of Violation with Intent to Enforce
Town of Mocksville — Dutchmans Creek WWTP (NC0021491)
Pretreatment Annual Report
Via Fax to: 336 771 4630 (hard copy by USPS)
Dear Steve:
The Pretreatment Annual Report referenced in your Notice of Violation dated
April 9, 2010 has been submitted to Monti Hassan by certified mail today. Our
transmittal record is attached hereto. The PAR recognizes that Crestwood Farms
is participating with the Town of Mocksville in obtaining more that $2 million of
grant funding to upgrade the Crestwood Farms pretreatment facility and the
Mocksville water treatment plant.
Failure to submit the report by March first was an oversight on our part as we
transition from submitting semi-annual reports to annual reports.
Thank you for your consideration in this matter.
Sincerely,
Grey Engineering, Inc.
John C. Grey, Jr., PE
President
Cc: Christine Bralley
P.O. Box 9 • Mocksville, NC 27028 • Phone: [phone] • Fax: [phone] • www.greyengineering.com

LETTER OF TRANSMITTAL
Date: 4/16/2010 GREY ENGINEERING, INC
254 West Water Street
P. 0. Box 9
To: Monti Hassan Mocksville, NC 27028
NC DWQ-PERCS Telephone [phone]
1617 Mail Service Center Fax: [phone]
Raleigh, NC 27699-1617
Job #
Re: Town of Mocksville - Dutchmans Creek
WE ARE SENDING YOU: X Attached Under separate cover via
the following items: Copy of letter Submittal
Prints Plans Samples
Change order Other
uuantity uescription
1 Copy of PAR for 2009 with Attachments
As requested
X For your use
For approval
For review and comment
Resubmit copies for approval
Remarks:
COPY TO:
Approved as submitted
Approved as noted
Returned f. corrections
Return corrected prints
Submit copies for distribution
SIGNED I Io QQQ�
If enclosures are not as noted, kindly notify us at once

RECEIVED
N.C. D�eo of;�10R
LETTER OF TRANSMITTAL APR 1
Winston-Salem
Regional Office
Date: 4/20/2010 GREY ENGINEERING, INC
254 West Water Street
P. O. Box 9
To: eorge Smit Mocksville, NC 27028
N`CD�WQ Telephone [phone]
585 Waughtown Street Fax: [phone]
Winston-Salem, NC 27107
Job #
Re: Town of Mocksville Dutchmans Creek
WE ARE SENDING YOU: X Attached Under separate cover via
the following items: Copy of letter Submittal
Prints Plans Samples
Change order X Other
uuantlty uescrlptlon
11 Copy of PAR for 2009 with attachments
X As requested
X For your use
For approval
For review and comment
Resubmit copies for approval
Remarks:
COPY TO:
Approved as submitted
Approved as noted
Returned f. corrections
Return corrected prints
Submit copies for distribution
SIGNED -31�_)��
If enclosures are not as noted, kindly notify us at once

Town of Mocksville, Dutchmans Creek WWTP (NC 0021491)
Pretreatment Annual Report (PAR) for Calendar Year 2009
4/16/2010
Narrative
General Information:
Overall Program — Ref. the "Pretreatment Program Info Database Attached"
Contact Information Update
The Mocksville Town Manager is Mrs. Christine Bralley (same address);
The Acting Pretreatment Coordinator is Mr. John Grey PE, Grey
Engineering, Inc, 254 West Water St., Mocksville, NC 27028, 336 751-
2110 (p), 336 751 6348 (f)
Status of Program Elements
HWA — 12/31/09 (will be submitted by 4/23/10); LTMP — 12/31/09 (will be
submitted by 4/23/10); IWS —due 1/23/2012; ERP —due 12/31/09 (will be
submitted by 4/23/10)
General Permit Information
The Crestwood Farms Permit (#003) was reissued for the period January
1, 2009 through January 1, 2012. Several limits were increased to cover a
period of construction in which the existing pretreatment facility will be
upgraded. Crestwood has participated with the Town of Mocksville in an
economic development project which is bringing over 100 jobs to the
community and resulting in more than $2 million dollars in grant funding to
support improvements at Crestwood and at Mocksville's Water treatment
plant.
SIU Information
The only SIU discharging to the Mocksville's Dutchmans Creek WWTP is
the lagersol Rand facility (IUP-DG&). The facility is not SNC but has 17
C� violations for BOD in 2009 (17%). A copy of the permit is attached. The
rx-Sz' w' Permit was scheduled for renewal on 3/19/2010. A copy of the permit
application will be forwarded by April 23. A copy of the site inspection
performed 12/29/2009 is attached.

Crestwood Farms Daily Discharge Exceedences
Date:
Area of Exceedence: Amt of Exceedence:
Monthly
Avg BOD:
Ibs/day
No Exceedences
6e00 AP/04Y
BOD
/
12/31/2009
59
Dec
440.84lbs
11/12/2009
23
Nov
407.31 Ibs
9/29/2009
210
Oct
318.06lbs
9/17/2009
44
Sept
523.44lbs
8/20/2009
229
Aug
478.5lbs
7/30/2009
53
July
570.57lbs
7/16/2009
7
June
527.89lbs
7/14/2009
102
May
575.31 Ibs
6/23/2009
50
April
581.97 Ibs
6/4/2009
76
Mar
368.99lbs
5/28/2009
37
Feb
353.66lbs
5/12/2009
95
Jan
375.61lbs
5/7/2009
99
5/5/2009
96
4/30/2009
170
4/16/2009
254
4/14/2009
96
TSS
No Exceedences
Summary of Exceedences
>140/o=snc
(910)=0
Exceedences:
Total # Meas
Total Exc > 140%
% of Total
Daily BOD:
17
101
0
0.00%
Monthly BOD:
0
12
0
0.00%
TSS :
0
101
0
0.00%
Flow:
0
240
0
0.00%
Town Sample:
0
2
0
Total :
17
0

printed on: 4/14/2010
Pretreatment Program Info Database
for Program Name Mocksville
WWTP Name Dutchman
Program Approval Date
01/14/1985
Pretreatment Status
Modified
Region
WSRO
County
Davie
NPDES Number
Stream Information
IWC % at 7Q10 9.19
7Q10 Flow cfs / mgd
15 / 9.69
1 Q10 Flow cfs / mgd
12.41 / 8.02
Stream Classification
C
Basin Number
YAD05
Receiving Stream Name
DUTCHMAN CREEK
NC0021491
NPDES Effective Date 08/01 /2005
Last PAR Rec
PAR Due Date 03/01/2010
mercury
1631
Expire Date 06/30/2009
Current Fiscal
Year PCI Done
requiredNPDES
yes
POTW is Primary WWTP TRUE
Last Audit on 09/23/2008
Audit Year Next12/13
Design Flow mgd 0.9810 % Design mgd is SIU permitted 16.31
Permitted SIU flow (mgd) [Pt_SIU) 16
WWTP SIU's
2
Program SIUs 2
WWTP CIU's
11
Program CIUsIJ
HWA
LTMP
IWS SUO
ERP
date Inactive Date Next Due
12/31 /2009
12/31 /2009
01 /23/2012
12/31 /2009
Date Received by DWQ
05/02/2002
06/14/1999
01/23/2007 01/31/2007
08/16/1993
Date Approved
02/26/2003
06/27/2000
01 /31 /2007 02/14/2007
11 /02/1993
Adopt Date Required
Date Adopted
Info in this Box from Pt Contacts
PT Pro
Formal Name 9-Prime Phone1 ext Fax
Mr. John Grey, Jr., PE I II336-751-2110 I 1336-751-6348
[e-mail] I President
Ms. Christine Sanders I II(336) 751-2259 I I(336) 751-9187
[e-mail] I Town Manager
6/24/1993
Itmp, hwa, erp, iws
9/23/1993
late SAR
3/9/1994
NCP 94-01
9/29/1994
program inadequate, late SAR
10/7/1996
late SAR
3/29/2001
IUPs, comp judge/enforce, pub not; 9/00 PC[
9/21/2001
enforce, imple stmp (from respon to 3/29 nov)
3/5/2003
failure to issue IUPs
Date Date Date
Attended Attended Attended
HWA Wksp IUP Wksp PAR Wksp
1 /24/2001 1 1 1 /23/2001
PO Box 9
1 1
171 Clement Street
DWQ Central Office Contact IMonti Hassan
DWQ Regional Contact lGeorge Smith

U
Mocksville, NC
Control Authority and/or Municipality
PERMIT
Industrial User Pretreatment Permit (IUP)
To Discharge Wastewater Under the
Industrial Pretreatment Program
0003
IUP Number
N/A
40 CFR Category(if Applicable)
In compliance with the provisions of North Carolina General Statute 143-215.1, any
applicable federal categorical pretreatment regulations, all other lawful standards and
regulations promulgated and adopted by the North Carolina Environmental Management
Commission, and the Control Authority and/or Municipality Sewer Use Ordinance. The
followine Industrv. hereafter referred to by name or as the nermittee:
Industry name, permittee:
Crestwood Farms
Facility Located at Street Address
254 Eaton Road
city
Mocksville
State, Zip
NC, 27028
is hereby authorized to discharge wastewater from the facility located at the above listed
address into the sanitary sewer collection system and the wastewater treatment facility of
the Control Authority and/or Municipality listed below:
IUP Control Authority and/or Municipality WWTP name:
Dutchmans Creek WWTP
NPDES Number:
NCO021491
WWTP Address:
171 Clement St
City, State, Zip
Mocksville, NC 27028
in accordance with effluent limitations, monitoring requirements, and all other conditions
set forth in Parts I, II, and III of this Industrial User Pretreatment Permit (IUP).
Effective date, this permit and the authorization to discharge shall become
effective at midnight on this date:.
Janualy 1, 2009
Expiration date, this permit and the authorization to discharge shall expire at
midnight on this date:
January 1, 2012
Date signed John C Grey E.
Acting Pretreat t Coordinator

Industrial User Pretreatment Permit (IUP)
PART I
Specific Conditions
IUP, PART I, OUTLINE:
A.) IUP Basic Information
B.) IUP Modification History
C.) Authorization Statement
D.) Description of Discharges
E.) Schematic and Monitoring Locations
F.) Effluent Limits & Monitoring Requirements
G.) Definitions and Limit Page(s) notes
A. IUP Basic Information:
Receiving Control Authority & WWTP name:
POTW NPDES # :
Dutchmans Creek WWTP
NCO021491
IUP Name:
IUP Number:
Crestwood Farms
0003
IUP Effective date:
Pipe Numbers, list all regulated pipes:
January 1, 2009
01
IUP Expiration date:
IUP 40 CFR # (if applicable), or N/A:
January 1, 2012
N/A
B. IUP History. A Complete Permit History is required):
Effective Renewal or Description of changes over previous IUP.
Date Modification
3/20/97 Initial Permit
8/98 Verbal approval given to sample at pretreatment discharge
9/30/98 Special Order By Consent to Correct Violations
12/23/99 Current Permit Replacing Special Order. Listed new treatment
units, clarified description of discharge, included map of
sample locations, raised limits, increased monitoring, added
flow requirements, other special conditions.
1/28/99 Modification to require monthly sampling by the permittee and
not the Town (see page 5 of 13)
7/6/99 Permit was modified to require twice monthly sampling by the
permitee. This will be a composite sample being taken on M/T
and W/Th. John Grey working as consultant to the Town
verbally requested the sample point for all future sampling be
done at the parshall fume.
2
IUP No. 003
Crestwood Farms

Industrial User Pretreatment Permit (IUP)
PART I
Specific Conditions
9/15/99 Permit was modified to show an increase in Crestwood's flow
from 60,000 gpd to 65,000 gpd. 11
11/10/99
Modification torespond to State comments issued 3/30/99 and
6/10/99. Flow limit increased to 0.065 mgd
9/6/01
IUP Related
A 10 ft3 filter press was installed in the Crestwood
Event
pretreatment unit.
10/1/01
IUP Related
All Crestwood lab results go directly to Nick Slogick.
Event
3/19/02
IUP Renewal
Expires 3/19/05. All sampling done by Crestwood per IUP
guidelines will be performed inside their pretreatment unit
before the waste goes through the parshall fume. Twice
weekly sampling indicated in permit.
5/29/03
IUP
Modification
Crestwood Farms requested an increase in their flow from
65,000 gal. to 75,000 gal, due to plant expansion
IUP
6/21 /04
Modification
Crestwood Farms requested an increase in their flow from
75,000 gal. to 100,000 gal. due to plant expansion. Updated
limits page.
3/19/05
IUP Renewal
Expires 3/19/10. There are no changes to the permit.
I/l/09
Limits revised to accommodate construction period. Permit
IUP
renewal date 1/l/12.
Modification
Kj
IUP No. 003
Crestwood Farms

Industrial User Pretreatment Permit (IUP)
PART I
ecific Conditions
C.) Authorization Statement:
1.) The Permittee is hereby authorized to discharge wastewater in accordance
with the effluent limitations, monitoring requirements, and all other conditions
set forth in this Industrial User Pretreatment Permit (IUP) into the sewer
collection system and wastewater treatment facility of the Control Authority
and/or Municipality.
2.) The Permittee is hereby authorized to continue operation of and discharge
wastewater from the following treatment or pretreatment facilities. These
facilities must correspond to the treatment units listed on both the application
nd inspection torms.
II IU Treatment Units II
List all Treatment Units: Descriptions:
Micro Screening,
Polymer Mixing,
Dissolved Air Floatation,
Solids Pressing,
pH Correction,
Recirculation
3.) The Permittee is hereby authorized to, if required by the Control Authority
and/or Municipality and after receiving Authorization to Construct (A to C)
from the Control Authority and/or Municipality, construct and operate
additional pretreatment units as needed to meet final effluent limitations.
D.) Description of IUP Discharge(s):
1. Describe the discharge(s) from all regulated pipes.
Pipe # 01 , Description of Discharge:
Wastewater resulting from the breading, marinating and preparation of chicken
parts for sale and distribution. Small amounts of stormwater from loading dock.
Cooling system blow down. Wash down and floor drains.
4
IUP No. 003
Crestwood Farms

r
Industrial User Pretreatment Permit (IUP)
PART I
Specific Conditions
E.) Schematic and Monitoring Locations:
Quality: The pretreatment unit is located in a dedicated building to the rear
of the manufacturing facility. Sample the dissolved air flotation effluent
after pH neutralization. See sketch. Flow: Parshall flume located between
the manufacturing building and Eaton Street, upstream of the raw waste
pumping station and receiving no domestic wastewater.
OtMMPST£R 0~$7m TO
11
FL 11
1. .1
951 rj
/ EFFLUENT Per I FROM PUMP 3TAmP4
TO PARSHALL FLUME
CXSC34ARCE TO TOWN
5
IUP No.003
Crestwood Fauns

IUP, Part 1 Section F:
Effluent Limits and Monitoring Requirements
The Permittee may discharge from this specific
Pipe number according to these specific dates,
effluent limits, and monitoring requirements
Receiving POTW name =>
Receiving POTW NPDES # _>
Effective date for these Limits =>
Expiration date for these Limits =>
Dutchman Creek
IU name =>
NC0021491
IUP # _>
January 1, 2009
Pipe # _>
January 1, 2012
40 CFR # _>
THE LIMITS ON THIS PAGE ARE, (Check one below):
LIMITS for ENTIRE permit period => X
INTERIM Limits for period # 1 =>
INTERIM Limits for period # 2 =>
FINAL Limits Page =>
Crestwood Farms
0003
01
N/A
if not applicable put N/A
Concentration Limits
Mass Limits
Monitorin Frequency
Dail Max
Monthly
Average
Units
Daily Max
Monthly
Average
Units
By Industry
By POTW
Sample
Collection
Method
(C or G)
Required
Laboratory
Detection
Level
1
Flow
.14
.12
MGD
Continuous and
daily reported
monthly.
Every sample
continuous
2
BOD
m 1
650
600
lbs/day
Twice weekly
1 each 6 months
c
2
3
TSS
300
250
lbs/day
Twice weekly
1 each 6 months
c
2
4
Temperature
5
PH
7-10
Twice weekly
1 each 6 months
0.1
OTHER PARAMETERS; Please List Al habeticall
6
1 Oil and Grease
30
20
lbs/day
Twice weekly
1 each 6 months
9
1
7
8
9
10
fUP No. 003
Crestwood Farms
0
rJ

Industrial User Pretreatment Permit (IUP)
PART I
Specific Conditions
G.) Definitions and Limit Page(s) notes:
In addition to the definitions in the Town of Mocksville Sewer Use Ordinance the
following definitions and requirements apply:
1. Composite Sample:
Unless defined differently below, a composite sample for the monitoring
requirements of this IUP, is defined as the automatic or manual collection
of one grab sample of constant volume, not less than 100 ml, collected
every hour during the entire discharge period on the sampling day.
Sampling day shall be a typical production, and discharge day.
2. Composite Sample, alternative definition: N/A
A composite sample for the monitoring requirements of this IUP is the
same as described above unless specifically defined below as the
automatic or manual collection of constant volume and constant time grab
samples collected and composited according to the following criteria:
specific volume of each grab sample =
specific time interval between samples
total duration of sample collection period =
Total number of grab samples to be composited =
3. Daily Monitoring Frequency
Milliliters
Hours
Hours
Samples
Daily Monitoring Frequency as specified in this IUP shall mean each day
of discharge.
4. Grab Sample
Grab sample for the monitoring requirements of this IUP, is defined as a
single "dip and take" sample collected at a representative point in the
discharge stream.
5. Instantaneous measurement
An Instantaneous measurement for the monitoring requirements of this
IUP is defined as a single reading, observation, or measurement.
7
IUP No. 003
Crestwood Fanns

ri
Industrial User Pretreatment Permit (IUP)
PART II
General Conditions
Outline of PART II,
1. Representative Sampling 16. Federal and/or State Laws
2. Reporting 17. Penalties
3.
Test Procedures
18.
Need to Halt or Reduce
4.
Additional Monitoring by
19.
Transferability
Permittee
5.
Duty to comply
20.
Property Rights
6.
Duty to Mitigate
21.
Severability
7.
Facilities Operation, Bypass
22.
Modification, Revocation,
Termination
8.
Removed substances
23.
Reapplication
9.
Upset Conditions
24.
Dilution Prohibition
10.
Right of Entry
25.
Reports of Changed Conditions
11.
Availability of Records
26.
Construction of pretreatment
facilities
12.
Duty to provide information
27.
Reopener
13.
Signatory Requirements
28.
Categorical Reopener
14.
Toxic Pollutants
29.
General Prohibitive Standards
15.
Civil and Criminal Liability
30.
Reports of Potential Problems
1. Representative Sampling
Samples and measurements taken as required herein shall be representative of the volume and
nature of the monitored discharge. All samples shall be taken at the monitoring points specified in
this permit and, unless otherwise specified, before the effluent joins or is diluted by any other
wastestream, body of water, or substance. Monitoring points shall not be changed without
notification to, and approval by, the permit issuing authority.
2. Reporting
a.) Monitoring results obtained by the permittee shall be reported on forms specified by the
Town of Mocksville, postmarked no later than the twentieth day of the month following
the month in which the samples were taken. If no discharge occurs during a reporting
period (herein defined as each calendar month) in which a sampling event was to have
occurred, a form with the phrase "no discharge" shall be submitted. Copies of these and
all other reports required herein shall be submitted to the Control Authority and/or
Municipality and shall be emailed to the following address: jgrey@ rg even ineering com
or physically posted to (emailed spreadsheets are preferred):
John Grey, PE
Acting Pretreatment Coordinator
Town of Mocksville
171 Clement Street
Mocksville, NC 27028
8
IUP No. 003
Crestwood Farms

Industrial User Pretreatment Permit (IUP)
PART II
General Conditions
b.) If the sampling performed by the permittee indicates a violation, the permittee shall notify the
Control Authority and/or Municipality within 24 hours of becoming aware of the violation.
The permittee shall also repeat the sampling and analysis and submit the results of the repeat
analysis to the Control Authority and/or Municipality within 30 days after becoming aware of
the violation.
3. Test Procedures
Test procedures for the analysis of pollutants shall be performed in accordance with the techniques
prescribed in 40 CFR part 136 and amendments thereto unless specified otherwise in the
monitoring conditions of this permit.
4. Additional Monitoring by Permittee
If the permittee monitors any pollutant at the location(s) designated herein more frequently than
required by this permit, using approved analytical methods as specified above, the results of such
monitoring shall be submitted to the Control Authority and/or Municipality. The Control
Authority and/or Municipality may require more frequent monitoring or the monitoring of other
pollutants not required in this permit by written notification.
5. Duty to Comply
The permittee must comply with all conditions of this permit. Any permit noncompliance
constitutes a violation of the Control Authority and/or Municipality Sewer Use Ordinance and is
grounds for possible enforcement action.
6. Duty to Mitigate - Prevention of Adverse Impact
The permittee shall take all reasonable steps to minimize or prevent any discharge in violation of
this permit which has a reasonable likelihood of adversely affecting human health, the POTW, the
waters receiving the POTW's discharge, or the environment.
7. Facilities Operation, Bypass
The permittee shall at all times maintain in good working order and operate as efficiently as
possible, all control facilities or systems installed or used by the permittee to achieve compliance
with the terms and conditions of this permit. Bypass of treatment facilities is prohibited except
when approved in advance by the Control Authority and/or Municipality. Bypass approval shall
be given only when such bypass is in compliance with 40 CFR 403.17.
8. Removed Substances
Solids, sludges, filter backwash, or other pollutants removed in the course of treatment or control
of wastewaters shall be disposed of in a manner such as to prevent any pollutants from such
materials from entering the sewer system. The permittee is responsible for assuring its compliance
with any requirements regarding the generation, treatment, storage, and/or disposal of "Hazardous
waste" as defined under the Federal Resource Conservation and Recovery Act.
9. Upset Conditions
An "upset" means an exceptional incident in which there is an unintentional and temporary
noncompliance with the effluent limitations of this permit because of factors beyond the reasonable
control of the permittee. An upset does not include noncompliance to the extent caused by
9
IUP No. 003
Crestwood Farms

Industrial User Pretreatment Permit (IUP)
PART II
General Conditions
operational error, improperly designed or inadequate treatment facilities, lack of preventative
maintenance, or careless or improper operations.
An upset may constitute an affirmative defense for action brought for the noncompliance. The
permittee has the burden of proof to provide evidence and demonstrate that none of the factors
specifically listed above were responsible for the noncompliance.
10. Right of Entry
The permittee shall allow the staff of the State of North Carolina Department of Environment and
Natural Resources, Division of Water Quality, the Regional Administrator of the Environmental
Protection Agency, the Control Authority and/or Municipality, and/or their authorized
representatives, upon the presentation of credentials:
1. To enter upon the permittee's premises where a real or potential discharge is located or
in which records are required to be kept under the terms and conditions of this permit;
and
2. At reasonable times to have access to and copy records required to be kept under the
terms and conditions of this permit; to inspect any monitoring equipment or monitoring
method required in this permit; and to sample any discharge of pollutants.
11. Availability of Records and Reports
The permittee shall retain records of all monitoring information, including all calibration and
maintenance records as well as copies of reports and information used to complete the application
for this permit for at least three years. All records that pertain to matters that are subject to any
type of enforcement action shall be retained and preserved by the permittee until all enforcement
activities have concluded and all periods of limitation with respect to any and all appeals have
expired.
Except for data determined to be confidential under the Sewer Use Ordinance, all reports prepared
in accordance with terms of this permit shall be available for public inspection at the Control
Authority and/or Municipality. As required by the Sewer Use, Ordinance, effluent data shall not be
considered confidential.
12. Duty to Provide Information
The permittee shall furnish to the Director of Public Works or his/her designees, within a
reasonable time, any information which the Director, his/her designee, or the Division of Water
Quality may request to determine whether cause exists for modifying, revoking and reissuing, or
terminating this permit or to determine compliance with this permit. The permittee shall also
furnish, upon request, copies of records required to be kept by this permit.
13. Signatory Requirements
All reports or information submitted pursuant to the requirements of this permit must be signed and
certified by the Authorized Representative as defined under the Sewer Use Ordinance. If the
designation of an Authorized Representative is no longer accurate because a different individual or
position has responsibility for the overall operation of the facility, or overall responsibility for
environmental matters for the company, a new authorization satisfying the requirements of this
section must be submitted to the Town Manager prior to or together with any reports to be signed
by an authorized representative.
10
[UP No. 003
Crestwood Farms

Industrial User Pretreatment Permit (IUP)
PART II
General Conditions
14. Toxic Pollutants
If a toxic effluent standard or prohibition (including any schedule of compliance specified in such
effluent standard or prohibition) is established under Section 307(a) of the Federal Clean Water
Act for a toxic pollutant which is present in the discharge and such standard or prohibition is more
stringent than any limitation for such pollutant in this permit, this permit may be revised or
modified in accordance with the toxic effluent standard or prohibition and the permittee so
notified.
15. Civil and Criminal Liability
Nothing in this permit shall be construed to relieve the permittee from civil or criminal penalties
for noncompliance.
16. Federal and/or State Laws
Nothing in this permit shall be construed to preclude the institution, of any legal action or relieve
the permittee from any responsibilities, liabilities, or penalties established pursuant to any
applicable Federal and/or State law or regulation.
17. Penalties
The Sewer Use Ordinance of the Control Authority and/or Municipality provides that any person
who violates a permit condition is subject to a civil penalty not to exceed $25,000 dollars per day
of such violation.
Under state law, (NCGS 143-215.613), under certain circumstances it is a crime to violate terms,
conditions, or requirements of pretreatment permits. It is a crime to knowingly make any false
statement, representation, or certification in any record or other document submitted or required to
be maintained under this permit, including monitoring reports or reports of compliance or
noncompliance. These crimes are enforced at the prosecutorial discretion of the local District
Attorney.
18. Need to Halt or Reduce not a Defense
It shall not be a defense for a permittee in an enforcement action that it would have been necessary
to halt or reduce the permitted activity to maintain compliance with the conditions of the permit.
19. Transferability
This permit shall not be reassigned or transferred or sold to a new owner, new user, different
premises, or a new or changed operation without approval of the Town.
20. Property Rights
This permit does not convey any property rights in either real or personal property, or any
exclusive privileges, nor does it authorize any injury to private property or any invasion of
personal rights, nor any infringement of Federal, State or local laws or regulations.
21. Severability
The provisions of this permit are severable and, if any provision of this permit or the application of
any provision of this permit to any circumstance is held invalid, the application of such provision
to other circumstances and the remainder of this permit shall not be affected thereby.
11
IUP No. 003
Crestwood Farms

i
Industrial User Pretreatment Permit (IUP)
PART II
General Conditions
22. Permit Modification, Revocation, Termination
This permit may be modified, revoked and reissued or terminated with cause in accordance to the
requirements of the Control Authority and/or Municipality Sewer Use Ordinance and North
Carolina General Statute or implementing regulations.
23. Re -Application for Permit Renewal
The permittee is responsible for filing an application for reissuance of this permit at least 180 days
prior to its expiration date.
24. Dilution Prohibition
The permittee shall not increase the use of potable or process water or in any other way attempt to
dilute the discharge as a partial or complete substitute for adequate treatment to achieve
compliance with the limitations contained in this permit.
25. Reports of Changed Conditions
The permittee shall give notice to the Control Authority and/or Municipality of any planned
significant changes to the permittee's operations or system which might alter the nature, quality, or
volume of its wastewater at least 180 days before the change. The permittee shall not begin the
changes until receiving written approval from the Control Authority and/or Municipality. Also see
Part II, 30 below for additional reporting requirements for spill/slug issues.
Significant changes may include but are not limited to
(a) increases or decreases to production;
(b) increases in discharge of previously reported pollutants;
(c) discharge of pollutants not previously reported to the Control Authority and/or
Municipality;
(d) new or changed product lines;
(e) new or changed manufacturing processes and/or chemicals
26. Construction
No construction of pretreatment facilities or additions thereto shall be begun until Final Plans and
Specifications have been submitted to the Control Authority and/or Municipality and written
approval and an Authorization to Construct (A to C) have been issued.
27. Reopener
The permit shall be modified or, alternatively, revoked and reissued to comply with any applicable
effluent standard or limitation for the control of any pollutant shown to contribute to toxicity of the
WWTP effluent or any pollutant that is otherwise limited by the POTW discharge permit. The
permit as modified or reissued under this paragraph may also contain any other requirements of
State or Federal pretreatment regulations then applicable.
12
W No. 003
Crestwood Farms

Industrial User Pretreatment Permit (IUP)
PART II
General Conditions
28. Categorical Reopener
This permit shall be modified, or alternatively, revoked and reissued, to comply with any
applicable effluent standard or limitation issued or approved under Sections 302(b)(2)(C) and (D),
304(b)(2), and 307(a)(2) of the Clean Water Act, if the effluent standard or limitation so issued or
approved:
1.) contains different conditions or is otherwise more stringent than any effluent
limitation in this permit; or
2.) controls any pollutant not limited in this permit.
The permit as modified or reissued under this paragraph shall also contain any other requirements
of the Act then applicable.
29. General Prohibitive Standards
The permittee shall comply with the general prohibitive discharge standards in 40 CFR 403.5 (a)
and (b) of the Federal pretreatment regulations.
30. Potential Problems
The permittee shall provide protection from accidental and slug discharges of prohibited materials
and other substances regulated by this permit. The permittee shall also notify the POTW
immediately of any changes at its facility affecting the potential for spills and other accidental
discharge, discharge of a non -routine, episodic nature, a non -customary batch discharge, or a slug
load as defined in the Sewer Use Ordinance.
Additionally, the permittee shall notify by telephone the Control Authority and/or Municipality
immediately of all discharges that could cause problems to the POTW including any slug loadings
as defined in the Sewer Use Ordinance. If the permittee experiences such a discharge, they, shall
inform the Control Authority and/or Municipality immediately upon the first awareness of the
commencement of the discharge. Notification shall include location of the discharge, type of
waste, concentration and volume if known and corrective actions taken by the permittee. A written
follow-up report thereof shall be filed by the permittee within five (5) days, unless waived by the
Control Authority and/or Municipality.
13
IUP No. 003
Crestwood Farms

Industrial User Pretreatment Permit (IUP)
PART III
Not Applicable
IUP No. 003
Crestwood Farms
Special Conditions
14

IUP Synopsis
A. IUP Basic Information
Receiving POTW name:
POTW NPDES#:
Town of Mocksville
NCO021491
IUP name:
IUP Number:
Crestwood International
0003
IUP Effective date:
Pipe Numbers, list all regulated pipes:
January 1, 2009
01
Ii.TP expiration date:
IUP 40 CFR#, if applicable:
January 1, 2012
N/A
B. IUP Survey & Application form
See Attached
C. IU Inspection form
See Attached
D. RATIONALE FOR LIMITATIONS:
As listed on the IUP Limits Page(s), PART I, Section F of the IUP.
RATIONALE #1:
Review of IU Monitoring Data, with no Over Allocation situation:
The following pollutants were assigned numerical limits in this IUP based
on a review of monitoring data for the permittee to determine what ranges of
concentrations are currently being discharged. To account for sample
variability a factor was applied to the monitoring data to determine the
permit limit.
BOD, TSS, Oil & Grease
15

Pretreatment Annual Report (PAR)
Significant Non -Compliance Report (SNCR)
WWTP = Wastewater Treatment Plant, use separate form for each WWTP.
SIU = Significant Industrial User
SNC = Significant Non -Compliance
PAR covers this calendar year =>
Control Authority=Program=Town Name =>
WWTP Name =>
NPDES # _>
A SNCR Form must be submitted with every PAR, please write "None " if you had No SIUs in SNC during calendar year
IUP
#
Pipe
#
Industry Name
Parameter
or "Reporting"
SNC? ( Yes / No)
for each 6-month period.
Jan. - June
July - Dec.
3
1
Crestwood Farms
none
none
Attach a copy of the Division's "SIUs in SNC Historical Report" for your POTW's SIUs behind this page.
Is the database correct ? Notify the Division of any errors ! Database indicates SNC history for previous years.
EVERY SNC MUST be explained in the Narrative, How was, is, or will it be resolved?
REPEAT SNCs are serious matters that MUST be explained in the Narrative.
Fonn name: PAR,SNCR, 2001
Date Revised: 1/4/2001
2009
Town of Mocksville
Dutchmans Creek
NC 0021491

SIU INSPECTION FORM
Name Of Industry: Crestwood Farms IUP # 003
Address Of Industry: 254 Eaton Road IUP Expiration Date: I 1 '201-'
Mocksville NC 27028
Industry Repre,entati%e,: Title
Eric Ivey _ Safety and W W Manager
POJ W Represcntatn e,:
Date Of Inspection: 12/29/09
Purpose of Inspection: Annual X Other (Describe)
POTW to which IU discharge, Dutchmans Creek
Is SIU currently in SNC? No Ifyes, for what?
Title
Pretreatment Coordinator
Time 01' Inspection: 11:00 anu 'pm
NI'DFS � NCO021491
PART I - INITIAL INTERVIEW
Has anything changed since the last inspection or IUP application in the following:
COMMENTS
Product YES / NO More wings with sweet marinades / sauces
Raw materials used YES / 0
Manufacturing processes YE5T NO New cook line in full production
Categorical, if applicable YES / �O _
Production rate ES / NO Increased by 25-30'4,
Number of employees YES / NO
Number of shifts YES i O
Comments: Increases in soluble BOD due to sweet marinades on wings.
PART II - PLANT TOUR - Visit all areas where wastewater is generated or where there are
drains to the POTW.
Plant Tour Section A - PRODUCTION AND STORAGE AREAS
1. Are there floor drains in the production area? YES / NO Where do they go'? wastewater
2. Are production areas diked. contained, or otherwise constructed in such a way as to prevent harm to the WWTP.
especially from spills or slugs'? YES / NO Conuents:
3. Are there floor drains in the storage area'? 'ES / NO Where do they go? wastewater
4. Are storage tanks and areas diked. contained. or otherwise constructed in such a way as to prevent harm to the
WWTP. especially from spills or ,lugs? N 'ES l NO Comments:
Arc process and storage tanks and pipes labeled" LI S NO
How are off -spec raw materials. and products disposed of? Dumpster and landfill
7. 'Mien is the production area cleaned'.' nightly _
8. Is the wastewater from cleaning the production area discharged to the POTW? 'ES NO
9. What non -process wastewaters are discharged to POTW? domestic
Comments:
Title: StU lnpsection Form
File name: COMP.IN'SP App 7-1)
Re% ision data: August I. 1994 Pagc I

SIU INSPECTION FORM
PART II - Plant "Tour Section B - PRETREAT,'\IENT SYSTEM
Ask the operator to describe pretreatment ,%stem.
I. Does operator,eem knu��ied table about the ,%stem:' S_ - NO Comments:
?. Are all units operational.' YL
3. How often doe; operatormaintcnance per,on check ,vstem:' Each shift
4. Is there an operator br each ,hi ft`' [' NO
5. llow and when is slue disposed of Dumpster to landfill 3 times tier
6. Is there a schedule for pre%cmatiNe maintenance:' YES /
Comments:
PART II - Plant Tour Section C - SAMPLING POINT(S) AND FLOW MEASUREMENT
(Collect a sample if desired.)
1. Does an outside lab complete sampling? YES / NO If yes, name of lab. J ritest
?. If industry completes sampling, ask the industry representative to describe sampling procedures. Comments:
'14 hour composite sample twice weekly_ Tritest picks up
3. Is flow measurement equipment operational'? YES / NO Comments:
4. Is there a calibration log for the flow meter? YES / NO Comments:
Comments:
PART III - EXIT INTERVIEW
Review monitoring records and other SIU records required by IUP.
1. Are files well organized? YES / NO Comments:
?. Are sample collection / chain -of -custody forms filled out properly? YES / NO Continents:
3. Do results in files agree with reports sent to POTW? YES / NO Continents:
4. Who has authority to shut down production should a spill or slug discharge occur'? Production manager on
5. How does SIU inform employees of whom to call at POTW in case of spill/slug:' Wastewater manager has a
If slug/spill plan is already required by POTW. review procedures.
6. Is SIU implementing slugr'spill plan? YES / NO Comments:
Comments:
INSPECTION RESULTS
Slug'Spill Control Plan Needed? NO
Continents. Required Or Recommended Actions: 2005 plan is on file: request updated version
Signature Of Inspector(s)
Title: SIU Inpsection FoIT11
Filename: COMP.INSP App 7-D
Revision data: Aueust I. 1994
Date: 1 r- 2`Tlo?
Date:
Page 2

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins
Governor Director
April 9, 2010
Certified Mail No. 7008 1140 0003 8505 6345
Return Receipt Requested
Ms. Christine Sanders, Town Manager
Town of Mocksville
171 Clement Street
Mocksville, NC 27028
Dee Freeman
Secretary
SUBJECT: Notice of Violation with Intent to Enforce
Town of Mocksville - Failure to Submit a Pretreatment Annual Report (PAR)
NPDES #NC0021491
Davie County
Dear Ms. Sanders:
POTWs with an active approved pretreatment program shall submit a pretreatment annual report once a year
describing its pretreatment activities over the previous 12 months. This report is required to be submitted to
NCDENR, DWQ, PERCS Unit, 1617 Mail Service Center, Raleigh, NC 27699-1617. This report was due on
March 1, 2010 for the pretreatment activities during 2009. The report was not received. The Town is in
violation with 15A NCAC 2H .0908 (b), and a NPDES permit violation per Part IV, Section C 10.
Please be advised, these violations and any future violations are subject to civil penalty assessment of up
to $25,000.00 per day, per violation, as well as other actions by the Division of Water Quality.
In order to avoid escalating actions by the Division, the following measures must be taken:
1. Submit a Pretreatment Annual Report (2 copies) to the PERCS Unit at the address described in the
above paragraph.
2. The Pretreatment Annual Report must contain the elements as described in your NPDES Permit, Part
IV, Section C 10.
North Carolina Division of Water Quality, Winston-Salem Regional Office
Location: 585 Waughtown St. Winston-Salem, North Carolina 27107
Phone: [phone] FAX: [phone] Customer Service:1-877-623-6748
Internet: www.ncwaterquality.org
An Equal Opportunity 1 Affirmative Action Employer
ne
NorthCarolina
NaturallY

NOV
April 9, 2010
Page 2 of 2
Please respond to me, in writing, within ten (1 O) dgys following receipt of this Notice. The response must
include the reason wh. the he report was not submitted, and the date ,you intend to submit the report to the PERCS
Unit.
If you have any questions, please contact Monti Hassan at 919-807-6314, George Smith or me at (336) 771-
5000.
Sincerely,
Steve W. Tedder
Regional Supervisor
cc: Mr. John Grey - 254 W. Water Street, Mocksville, NC 27028
PERCS Unit — Monti Hassan
WSRO Files

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins
Governor Director
October 1, 2009
Ms. Christine Sanders, Town Manager
Town of Mocksville
171 Clement Street
Mocksville, NC 27028
SUBJECT: Pretreatment Compliance Inspection
Town of Mocksville
NPDES #NC0021491
Davie County
Dear Ms. Sanders:
Dee Freeman
Secretary
On September 29, 2009 George Smith, of this office, performed a Pretreatment Compliance Inspection (PCI).
Mr. John Grey was present for the inspection. The purpose of this inspection was to determine the effectiveness
of the pretreatment program, which includes:. reviewing the files, POTW plant performance, industry
monitoring data, and adherence to the enforcement response plan (ERP).
Background
The pretreatment program has one WWTP, which is NCO021491 (Dutchman's Creek) with a 0.68 MGD
permitted flow.
Bear Creek WWTP, NCO050903 does not exist. It was demolished.
POTW Interview
During October 2008 NCO021491 (Dutchman's Creek) recorded a pH violation. Mr. Grey procured some
continuous monitoring pH probes and strategically placed them in manhole 33 and a few others. The analysis
showed that the pH problem was not Crestwood International, Inc.
Crestwood International, Inc. is in significant noncompliance for BOD during January through June 2009. They
will be published by the end of the year.
Program Elements
The Headworks Analysis (HWA) for Dutchman's Creek WWTP was changed from September 30, 2009, and is
due December 31. 2009.
The Industrial Waste Survey (IWS) is due January 23, 2012.
North Carolina Division of Water Quality, Winston-Salem Regional Office
Location: 585 Waughtown St. Winston-Salem, North Carolina 27107
Phone: [phone] FAX: [phone] Customer Service:1-877-623-6748
Internet: www.ncwaterquality.org
An Equal Opportunity 1 Affirmative Action Employer
NorthCarohna
Naturally

Pretreatment Compliance Inspection
October 1, 2009
Page 2 of 3
The Sewer Use Ordinance (SUO) was last approved on February 14, 2007.
The Enforcement Response Plan (ERP) was last approved on February 14, 2007.
Short Term Monitoring Plan (STMP) for the Dutchman's Creek WWTP is due December 31, 2009.
Industrial User Permit (IUP) File Review
A review of the file for Crestwood (#0003) revealed that the monitoring data was well organized and correctly
judged for compliance. The industry is in significant noncompliance for BOD for the first half of 2009.
Action Items
Method 1631 for Mercury must be performed at the effluent. The STMP must show the correct detection level
for Mercury, which is 0.001 ug/L (1 ng/L).
The HWA and supporting documents for Dutchman's Creek WWTP must be submitted to the PERCS Unit on
or before December 31, 2009.
Collect four (4) Mercury samples at the Effluent using Method 1631. Also, you must have a total of four metal
sample events at the Influent. Make sure you have the conventional parameters sampled for at Influent (four
data sets).
The pretreatment compliance inspection is considered satisfactory. If you have any questions, please contact
George Smith or me at [phone].
Sincerely,
Steve W. Tedder
Regional Supervisor
cc: Mr. John Grey, 254 W. Water Street, Mocksville, NC 27028
PERCS Unit — Monti Hassan
WSRO Files

NORTH CAROLINA DIVISION OF WATER QUALITY
PRETREATMENT COMPLIANCE INSPECTION (PCI) REPORT
BACKGROUND INFORMATION [Complete Prior To PCI• Review Program Info Database Sheets
1. Control Authority (POTW) Name: JG wf)
2. Control Authority Representative(s): ,J o k„
t� 7
3. Title(s): (blvyl � A.c tr
4. Last Inspection Date: q-13- 0 V Inspection Type (Check One): ❑ PCI [g-'Audit
5. Has Program Completed All Requirements from the Previous Inspection and Program Info Sheet(s)? �ES ❑ NO
6. Is POTW under an Order That Includes Pretreatment Conditions? ❑ YES M40
Order Type, Number, Parameters: Al A Are Milestone Dates Being Met? ❑ YES ❑ NO
PCS CODING
Trans.Code Main Program Permit Number MM/DD/YY Inspec.Type Inspector Fac. Type
IP INIC1010I1l11'1111/I o��ayay 1 P1 LA-1 1 11
(DTIA) (TYPI) (INSP) (FACC)
7. Current Number Of Significant Industrial Users (SIUs)?
SIUS
8. Current Number Of Categorical Industrial Users (CIUs)?
CIUS
9. Number of SIUs Not Inspected By POTW in the Last Calendar Year?
10. Number of SIUs Not Sampled By POTW in the Last Calendar Year?
C-5
11. Enter the Higher Number of 9 or 10
0
NOIN
12. Number of SIUs With No IUP, or With an Expired IUP
NOCM
13. Number of SIUs in SNC for Either Reporting or Limits Violations During Either of the Last 2
Semi -Annual Periods (Total Number of SIUs in SNC)
PSNC
14. Number of SIUs in SNC For Reporting During Either of the Last 2 Semi- Annual Periods
©
MSNC
15. Number of SIUs In SNC For Limits Violations During Either of the Last 2 Semi -Annual Periods
l
SNPS
16. Number of SIUs In SNC For Both Reporting and Limits Violations During Either of the Last 2
Semi-annual Periods
POTW INTERVIEW
17. Since the Last PCI, has the POTW had any NPDES Limits Violations?
If Yes, What are the Parameters and How are these Problems Being Addressed?
ve—, of 0 -N PrvAs 1we-AA- 4
18. Since the Last PCI, has the POTW had any Problems Related to an Industrial
Discharge (Interference, Pass -Through, Blockage, Citizens' Complaints, Increased
Sludge Production, Etc.)?
If Yes, How are these Problems Being Addressed?
19. Which Industries have been in SNC for Limits or Reporting during SNC for
either of the Last 2 Semi -Annual Periods? Not Been Published for SNC for
Public Notice?(May refer to PAR if Excessive SIUs in SNC) Not Pu
20. Which Industries are on Compliance Schedules or Orders? For all SIUs on an
Order, Has a Signed Copy of the Order been sent to the Division?
21. Are Any Permits Or Civil Penalties Currently Under Adjudication? If Yes, Which
Ones?
RYES []NO
EO-VES ❑ NO
Gr/_szuvid Poo orvk c.as
Limits: eri.)rwr;d I919-0
Reporting:
blished: �w,(/ be V, /�rl, G
fV �
❑ YES i `0
LTMP/STMP FILE REVIEW:
22. Is LTMP/STMP Monitoring Being Conducted at Appropriate Locations and Frequencies? RYES ❑ NO
23. Are Correct Detection Levels being used for all LTMP/STMP Monitoring? 5c'ES �10 Aeriel 1671 #j
24. Is LTMP/STMP Data Maintained in a Table or Equivalent? N_ YES ❑ NO Is Table Adequate? DYES ❑ NO
25. All LIMP/STMP effluent data reported. on Discharge Monitoring Report? ❑ VES ❑ NO DWQ Inspector, please verify yourself?
26. If NO to 23 - 26, List violations Olke ;uS
27. Should any Pollutants of Concern be Eliminated from or Added to LTMP/STMP? ❑ YES a"NO
If yes, which ones? Eliminated: Added:
NC DWQ Pretreatment Compliance Inspection (PCI) Form tpdated 7/25/07 Page 1

28. PRETREAT NIENT PROGRAM ELEitiIENTS REVIENN - Please revie%v PO I'��' tiles, verity POTW has copy of Program Element in
their files complete with sunnortina clocuments and co of PERCS A roval Letter. and dates consistent with Program Info:
Program Element
Last Submittal
Date In file`'
Last Approval
Date In file
Date Next Due,
If Applicable
Headworks Analysis (HWA)
❑ Yes ❑ No
1-16 -o
es ❑ No
!
Industrial Waste Survey IWS
❑ Yes ❑ No
1- 31-0'
Yes ❑ No
x 3
Sewer Use Ordinance (SUO)
❑ Yes ❑ No
1-11-07
9Yes ❑ No
Enforcement Response Plan (ERP
❑ Yes ❑ No
_ a 3
[2Yes ❑ No
111,11 d
Long Term Monitoring Plan (LTMP)
[]Yes ❑ No
I/._ 1-0 7
Yes ❑ No
� ��� G
INDUSTRIAL USER PERMIT (IUP) FILE REVIEW (3 IUP FILE REVIEWS OR 1 FILE REVIEW AND 1 IU INSPECTION)
131/0`1
29. User Name
1. G t `�� i„�,
2• 3•
30. IUP Number
6003
31. Does File Contain Current Permit? I
52"Yes ❑ Noj
❑ Yes ❑ No 11
❑ Yes ❑ No
32. Permit Expiration Date 1
3111110
33. Categorical Standard Applied (I.E. 40 CFR, Etc.) Or N/A
IVfi
34. Does File Contain Permit Application Completed Within One Year Prior
es ❑ !]j ❑ Yes ❑ No
❑ Yes , ❑ No
to Permit Issue Date?
35. Does File Contain an Inspection Completed Within Last Calendar Year?
02'Yes ❑ No
❑Yes
❑ No
El Yes El No
36. a. Does the File Contain a Slug,/Spill Control Plan?
a. [des ❑No a. ❑Yes ❑No
11
a. ❑Yes ❑No
b. If No, is One Needed? (See Inspection Form from POTW)
b. es ❑No b. ❑Yes ❑No
b. ❑Yes ❑No
37. For 40 CFR 413 and 433 TTO Certification, Does File Contain a Toxic
❑Yes❑No /A
❑Yes❑No❑N/A
❑Yes❑No❑N/A
Organic Management Plan (TOMP)?
38. a. Does File Contain Original Permit Review Letter from the Division?
a. fifes ❑No a. ❑Yes ❑No
11
a. ❑Yes ❑No
b. All Issues Resolved?
b.❑Yes❑Nob.❑Yes❑No❑N/A
b.❑Yes❑No❑N/A
39. During the Most Recent Semi -Annual Period, Did the POTW Complete
[Yes ❑ No ❑ Yes ❑ No ir
El Yes ❑ No
its Sampling as Required b IUP, including flow?
40. Does File Contain POTW Sampling Chain-Of-Custod Forms?
es ❑ No 11
[]Yes
❑
Yes ❑ No
41. During the Most Recent Semi -Annual Period, Did the SIU Complete its
es❑No❑N/A
❑Yes❑No❑N/A
❑Yes❑No❑N/A
Sampling as Required b IUP, including flow?
41b. During the Most Recent Semi -Annual Period, Did SIU submit all reports
es❑No❑N/A
❑Yes❑No❑N/A
❑Yes❑No❑N/A
on time`?
42a. For categorical IUs with Combined Wastestream Formula (CWF), does
❑Yes❑No /A
❑Yes❑No❑N/A
❑Yes❑No❑N/A
File include process/dilution flows as Required b IUP?
42b. For cate<0orical IUs with Production based limits, does file include
❑Yes❑No /A
❑Yes❑No❑N/A
❑Yes❑No❑N/A
production rates and/or flows as Required by IUP?
43a. During the Most Recent Semi -Annual Period, Did the POTW Identify
es ❑ No
El Yes El No
El Yes ❑ No
All Limits Non -Compliance from Both POTW and SIU Sampling?
43b. During the Most Recent Semi -Annual Period, Did the POTW Identify
es❑No❑N/A
❑Yes❑No❑N/A
❑Yes❑No❑N.'A
ling?
All Re ortina Non -Compliance from SIU Sampling?
44. a. Was the POTW Notified by SIU (Within 24 Hours) of All Self-
a. es❑No❑N/A
a.❑Yes❑No❑N/A
a.❑Yes❑No❑N/A
Monitoring Violations?
b. Did Industry Resample and submit results to POTW Within 30 Days?
b. es❑No❑N/A
b.❑Yes❑No❑N/A
b.❑Yes❑No❑N/A
c. If applicable, Did POTW resample within 30 days of becoming aware
c.EYes❑No❑N/A
c.❑Yes❑No❑N/A
c.❑Yes❑No❑N/A
of SIU limit violations in the POTW's sampling of the SIU?
46. Duringthe Most Recent Semi -Annual Period, Was the SIU in SNC?
es El
No
[:]Yes
❑
No
❑Yes
❑
No
47. During the Most Recent Semi -Annual Period, Was Enforcement Taken
es❑No❑N/A
❑Yes❑No❑N/A
❑Yes❑No❑N/A
as Specified in the POTW's ERP (NOVs, Penalties, timing, etc.)?
48. Does the File Contain Penalty Assessment Notices?
es❑No❑N/A
11 ❑Yes❑No❑N/A
❑Yes❑No❑N/A
49. Does The File Contain Proof Of Penal Collection?
es❑No❑N/A
❑Yes❑No❑N/A
❑Yes❑No❑N/A
50. a. Does the File Contain Any Current Enforcement Orders?
a.❑Yes❑No //A
a.❑Yes❑No❑N/A
a.❑Yes❑No❑N/A
b. Is SIU in Compliance with Order?
b.OYesoNo 1A,
b.❑Yes❑No❑N/A
b.❑Yes❑No❑N/A
51. Did the POTW Representative Have Difficulty in Obtaining Any of This
❑ Yes EFKo
❑ Yes ❑ No
❑ Yes ❑ No
Requested Information For You?
NC DWQ Pretreatment Compliance Inspection (PCI) Form Updated 7/25/07 Page 2

FILE REVIEW COMMENTS: }
r4rrev"'.l 1.�" 5� 0 T,1k 3, 1007 tJvPw l
V',4 fv`tiii 4 A,,& _� P— .3 /) 'Zug
INDUSTRY INSPECTION PCS CODING:
Trans.Code Main Program Permit Number
1. Industry Inspected:
2. Industry Address:
3. Type of Industry/Product:
4. Industry Contact:
Phone:
5. Does the POTW Use the Division Model
6. Did the POTW Contact Conduct the Fo
Comments:
MM/DD/YY Inspec.Type
Inspector
Fac. Type
L 1 1 LI l
1 S-j
1? 1
(DTIA) (TYYN-�
(INSP)
(FACC)
Title:
Fax
'on Form or Equival
Parts of the Industrial
A. Initial Interview,-❑ YES ❑ NO
B. Plant Tour / ❑ YES ❑ NO
C. Pretreatment Tour ❑ YES ❑ NO
D, pling Review ❑ YES ❑ NO
Exit Interview ❑ YES ❑ NO
Industrial Inspection Comments:
OVERALL SUMMARY AND COMMENTS:
Comments:
Requirements:
Recommendations:
❑ YES ❑ NO
ct Thoroughly?
NOD: ❑ YES 0 1 0
NOV: ❑ YES 0 NO
QNCR: ❑ YES E lO
POTW Rating:
Satisfactoryy Marginal UnSatisfactory
PCI COMPLETED BY:
� -%� DATE: Y /a `t©a `1
NC DWQ Pretreatment Compliance Inspection (PCI) Form Updated 7/2.07 Page 3

UNITED STATES POSTAL SERVICE First -Class Mail
Postage & Fees Paid
USPS
Permit No. G-10
• Sender: Please print your name, address, and ZIP+4 in this box •
Surface Water Protection Section
N.C. Dept. of Environment and Natural Resources
Hay, & U 40i , Sic 3c _
Wi n5ttn --Se Y nX- a71LY7

■ 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.
1. Article Addressed to:
Ms. Christine W. Bralley, Manager
Town of Moc(sville
171 S. Clement Street
Mocksville, NC 27028
A.
X
Printed Name) ' I C. Date of Delivery
D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
3. SServiicc Type
Ed'Certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
7013 1710 0002 1865 6013IS 1JD U

UNITED STATE$.' , CE
First -Class Mail
Postage & Fees Paid
USPS
Permit No. G-10
• Sender: Please print your name, address, and ZIP+4® in
NCDENR-tOivisiolll of Vti Wier Resources
450 W. Hanes Mil! 1%oad, Suite 300
Winston-Salem, NC 27105
is box•L
` n E
ow N
W • U, o
J r• C ,
W
U ® �C
u' C �a

Complete items 1, 2, and 3. Also complete A. Signature
item 4 if Restricted Delivery is desired. X
Print your name and address on the reverse V-ic
so that we can return the card to you. eived
i Attach this card to the back of the mailpiece, 0k
or on the front if space permits.
Article Addressed to:
Ms. Christine Bralley, Manager
Town of Mocksville
171 South Clement Street
Mocksville, NC 27028
Is delivery
If YES, eG(
Type
" ❑ Agent
❑ Addressee
me)
C. Date of Delivery
,,,
L-�-V
different
om item 1? ❑ Yes
pry addre
below: ❑ No
o�
drilfiKm Priority Mail Express'"
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ Collect on Delivery
4. Restricted Delivery? (Extra Fee) ❑ Yes
7013 1710 0002 1865 5979 361 Ajov e-e

UNITED STATES POSTAL SERVICE First -Class Mail
Postage & Fees Paid
USPS
Permit No. G-10
• Sender: Please print your name, address, and ZIP+4 in this box •
DIVISION OF WATER RESOURCES
Water Quality Regional ';aerations
450 West Hanes Mill R •.jd, Suite 300
Winston-Salem, NC 27105

■ Complete items 1, 21* ed 5.W!§o cofnpiete
item 4 if Restricted D6HW .Wdeshieif.
■ 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.
Article Addressed to:
Ms. Christine Bralley, Manager
Town of Mocksville
171 South Clement Street
Mocksville, NC 27028
C
u
�j ReceNed"Wr riled NBrribJ. C. Date of D, very
D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
3. Service Type
Zledvi�ertified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
7013 1710 0002 1865 5740
IS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-154(

UNITED STATESIpGh"OZ66E"%""
Fftt-class Mau.
PoSta46'wF"A alcl''
USPS
Permit No. G-10
0 Sender: Please print your name, address, and ZIP+4 in this box 0
NCDENR-Division of Water Quality
585 Waughtown Street
Winston-Salem, NC 27107

■ Complete items 1, 2, and 3. Also complete A. Sig ure
item 4 if Restricted Delivery is desired. / Agent
■ Print your name and address on the reverse X / / atddresseE
so that we can return the card to you. B. ei e by ( ted Name) C. Date f Delivery
■ Attach this card to the back of the mailpiece, / ` `; 1 J i
or on the front if space permits. %
D. Is delivery address differ t from item 1? El Yes
1. Article Addressed to: If YES, enter delivery address below: ❑ No
Ms. Christine Sanders, Manager
Town of Mocksville
171 Clement Street
Mocksville, NC 27028
3 Service Type
Certified Mail ❑ Express Mail
Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
7008 1140 0003 8505 6345 � ti N N
'S Form 3811. February 2004 Domestic Retum Recelot A 14 1 f) 102595-02-M-154i