NC0088501_Regional Office Historical File Pre 2016

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NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
July 23, 2015
Aqua North Carolina Inc.
Attn: Thomas J. Roberts, President & COO
202 Mackenan Drive
Cary, NC 27511
Subject: Compliance Evaluation Inspection
Permittee: Aqua North Carolina Inc.
Facility: Stonington Subdivision — Well #1
NPDES Permit #: NCO088501
Forsyth County
Dear Mr. Roberts:
Donald R. van der Vaart
Secretary
Ron Boone of the Winston-Salem Regional Office of the NC Division of Water Resources (DWR or the Division)
conducted a compliance evaluation inspection (CEI) of the Stonington Subdivision — Well #1 on July 23, 2015. The
assistance and cooperation of Peter Dealing, system operator, was greatly appreciated. An inspection checklist is
attached for your records and inspection findings are summarized below.
General Information
The Stonington Subdivision — Well #1 is located on the north side of Stonington Subdivision, in Kernersville,
Forsyth County, NC, at approximate coordinates 36.0346720N, 80.0760490W. The permit authorizes Aqua to operate
this 0.0021 MGD facility, which consists of five green sand filters used to treat ground water for use as potable water for
the subdivision. Chemicals used in the water treatment process include Potassium Permanganate, Chlorine, and Caustic
Soda. The permit authorizes Aqua to discharge the filter backwash wastewater from the facility via outfall 001 to an
unnamed tributary of Abbotts Creek, which is currently classified as Class WS-III waters in the Yadkin Pee -Dee river
basin.
Site Review
Mr. Dealing has done a good job operating and maintaining the plant. No discrepancies were found.
Documentation Review
Mr. Boone reviewed all paperwork with Mr. Dealing, including discharge monitoring reports, laboratory result
records and bench sheet, chains of custody, operator visitation logs, operation and maintenance logs, etc. Everything
was in order, complete, and current and no discrepancies were found. Mr. Dealing is doing a great job keeping up with
the required paperwork for the facility.
You are reminded that, in accordance with NC General Statute 143-215.6A, the Director of the Division of
Water Resources may assess civil penalties not to exceed $25,000 per day, per violation, for violations of NCGS 143-
215.1 or the NC0088501 NPDES permit.
450 West Hanes Mill Road, Suite #300, Winston-Salem, North Carolina 27105
Phone: [phone] Internet: www.ncdenr.gov
An Equal Opportunity 1 Affirmative Action Employer— Made in part by recycled paper

If you have any questions regarding the inspection or this letter, please call Mr. Boone or me at [phone].
Thank you for your cooperation in this matter.
Sincerely,
W. Corey Basinger
Regional Supervisor
Water Quality Regional Operations
Division of Water Resources
Attachments:
BIMS Inspection Report
CC: WSRO-SWP
Central Files
NPDES Unit

United States Environmental Protection Agency
Form Approved.
E P /�i1 Washington, D.C. 20460
OMB No. 2040-0057
Water Compliance Inspection Report
Approval expires a-31-98
Section A: National Data System Coding (i.e., PCS)
Transaction Code NPDES yr/mo/day Inspection Type Inspector Fac Type
1 IN 1 2 15 1 3 I NC0088501 I11 12 15/07/23 17 18 ICJ 19 I s j 201
21111111111111111111111111111111111111111111 �6
Inspection
Work Days Facility Self -Monitoring Evaluation Rating B1 QA ----------Reserved ------------
671
72 L,, � 73 I I 174 751 I I I• I I I I80
70 I I 71 � L J I I
LJ
Section B: Facility Data
Name and Location of Facility Inspected (For Industrial Users discharging to POTW, also include
Entry Time/Date
Permit Effective Date
POTW name and NPDES permit Number)
01:OOPM 15/07/23
14/09/01
Stonington Subdivision - Well #1
Exit Time/Date
Permit Expiration Date
Stonington Way Ct
02:0OPM 15/07/23
19/02/28
Kernersville NC 27284
Name(s) of Onsite Representative(s)lritles(s)/Phone and Fax Number(s)
Other Facility Data
Peter Ray Dealing/ORC/336-362-2008/
Name, Address of Responsible Official/Title/Phone and Fax Number
Contacted
Thomas J Roberts,202 Mackenan Ct Cary NC
No
27511/Presidentt919-653-6967/9194661583
Section C: Areas Evaluated During Inspection (Check only those areas evaluated)
Permit 0 Flow Measurement Operations & Maintenance Records/Reports
Self -Monitoring Program N Facility Site Review Effluent/Receiving Waters Laboratory
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
(See attachment summary)
Name(s) and Signature(s) of Inspector(s) Agency/Office/Phone and Fax Numbers Date
Ron Boone WSRO WQ//336-776-9690/
Signature of Management Q A Reviewer Agency/Office/Phone and Fax Numbers Date
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete.
Page#

NPDES yr/mo/day Inspection Type
NCO088501 11 12 15/07/23 17 18 ICI
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
Please refer to the attached inspection summary letter.
Page#

e
Permit: NCO088501 Owner - Facility: Stonington Subdivision - Well #1
Inspection Date: 07/23/2015 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
❑
❑
M
❑
application?
Is the facility as described in the permit?
0
❑
❑
❑
# Are there any special conditions for the permit?
❑
0
❑
❑
Is access to the plant site restricted to the general public?
0
❑
❑
❑
Is the inspector granted access to all areas for inspection?
❑
❑
❑
Comment: None
Record Keeping
Yes No NA NE
Are records kept and maintained as required by the permit?
0
❑
❑
❑
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?
0
❑
❑
❑
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?
M
❑
❑
❑
Has the facility submitted its annual compliance report to users and DWQ?
❑
❑
M
❑
(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?
0
❑
❑
❑
Is the ORC certified at grade equal to or higher than the facility classification?
M
❑
❑
❑
Is the backup operator certified at one grade less or greater than the facility classification?
M
❑
❑
❑
Is a copy of the current NPDES permit available on site?
0
❑
❑
❑
Facility has copy of previous year's Annual Report on file for review?
❑
❑
M
❑
Comment: None
Laboratory Yes No NA NE
Are field parameters performed by certified personnel or laboratory? M ❑ ❑ ❑
Are all other parameters(excluding field parameters) performed by a certified lab? 0 ❑ ❑ ❑
Page# 3

F
Permit: NCO088501 Owner - Facility: Stonington Subdivision - Well #1
Inspection Date: 07/23/2015 Inspection Type: compliance Evaluation
Laboratory
Yes No NA NE
# Is the facility using a contract lab?
M
❑
❑
❑
# Is proper temperature set for sample storage (kept at less than or equal to 6.0 degrees
❑
❑
❑
M
Celsius)?
Incubator (Fecal Coliform) set to 44.5 degrees Celsius+/- 0.2 degrees?
❑
❑
❑
Incubator (BOD) set to 20.0 degrees Celsius +/- 1.0 degrees?
❑
❑
❑
Comment: None
Effluent Sampling
Yes No NA NE
Is composite sampling flow proportional?
❑
❑
0
❑
Is sample collected below all treatment units?
M
❑
❑
❑
Is proper volume collected?
M
❑
❑
❑
Is the tubing clean?
❑
❑
0
❑
# 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
M
❑
❑
❑
representative)?
Comment: None
Flow Measurement- Effluent
Yes No NA NE
# Is flow meter used for reporting?
M
❑
❑
❑
Is flow meter calibrated annually?
M
❑
❑
❑
Is the flow meter operational?
M
❑
❑
❑
(If units are separated) Does the chart recorder match the flow meter?
❑
❑
M
❑
Comment: None
De -chlorination
Yes No NA NE
Type of system ?
Tablet
Is the feed ratio proportional to chlorine amount (1 to 1)?
❑
❑
❑
Is storage appropriate for cylinders?
❑
❑
0
❑
# Is de -chlorination substance stored away from chlorine containers?
0
❑
❑
❑
Are the tablets the proper size and type?
®
❑
❑
❑
Comment: None
Are tablet de -chlorinators operational?
0
❑
❑
❑
Number of tubes in use?
4
Page# 4

x
Permit: NCO088501
Inspection Date: 07/23/2015
De -chlorination
Comment: None
Owner - Facility: Stonington Subdivision - Well #1
Inspection Type: Compliance Evaluation
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?
Comment: None
Operations & Maintenance
Is the plant generally clean with acceptable housekeeping?
Does the facility analyze process control parameters, for ex: MLSS, MCRT, Settleable
Solids, pH, DO, Sludge Judge, and other that are applicable?
Comment: None
Yes No NA NE
Yes No NA NE
M ❑ ❑ ❑
■ ❑ ❑ ❑
❑ ❑ N ❑
Yes No NA NE
■ ❑ ❑ ❑
❑ ❑ ❑
Page# 5

North Carolina Department of Environment and Natural Resources
Pat McCrory Donald R. van der Vaart
Governor Secretary
February 9, 2015
Aqua North Carolina;
Attn: Thomas J. Roberts, President
202 Mackenan Ct
Cary, NC 27511
Subject: NOTICE OF VIOLATION
NOV-2015-MV-0017
Permit No. NCO088501
Stonington Subdivision — Well #1
Forsyth County
Dear Mr. Roberts:
A review of Stonington Subdivision — Well #1's monitoring report for October, 2014 showed the following
violations:
Parameter
Date
Frequency
Values
-Re orted
Number of
Violations
Turbidity
10/31/14
2x month
0
1
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.
450 West Hanes Mill Road, Suite #300, Winston-Salem, NC 27105
Phone: [phone] \ Internet: www.ncdenr.gov
An Equal Opportunity 1 Affirmative Action Employer— Made in part by recycled paper

If you should have any questions, please do not hesitate to contact Ron Boone at [phone].
Sincerely,
- M, - 01-51
W. Corey Basinger
Regional Supervisor
Water Quality Regional Operations
Division of Water Resources
cc: DWR — Central Files
' S- O� IMS

©6�Ii R Review Record
Facility: /o,6U) Permit N..: Pipe No.:
Monthly Average Violations
Parameter Permit Limit DMR Value
If:)z r
MonthNear: /a /
% Over Limit
Weekly/Daily Violations
Date Parameter Permit Limit Limit Type DMR Value % Over Limit
Monitoring Frequency Violations
Date Parameter Permit Frequency Values Reported # of Violations
her Viol ationslStaff Remarks:
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:5e`Jo4 ez4..cC A—.e-,2 s5 z-4 ,-7f 4 NO 7b .
16p 9- Al ,,, &Zd-
Supervisor Remarks:
Kd -- Sec f -- a
Completed by: 14,0 i6e,"9A Date:
Action
Action
Action
d,cV
Assistant Regional
Supervisor Sign Off: Date:
Regional Supervisor Sign
Off: Date: �'�` 20(.r

NDENR'
North Carolina Department of Environment and Natural Resources
Pat McCrory Donald R. van der Vaart
Governor Secretary
February 9, 2015
Aqua North Carolina, Inc.
Attn: Thomas J. Roberts, President
202 Mackenan Ct
Cary, NC 27511
Subject: NOTICE OF VIOLATION
NOV-2015-W-0018
Permit No. NCO088501
Stonington Subdivision — Well #1
Forsyth County .
Dear Mr. Roberts:
A review of Stonington Subdivision — Well #1's monitoring report for November, 2014 showed the
following violations:
Parameter
Date
Frequency
Values
Repo ed
Number of
Violations
Turbidity
11/30/14
2x month
0
1
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.
450 West Hanes Mill Road, Suite #300, Winston-Salem, NC 27105
Phone: [phone] Internet: www.ncdenr.gov
An Equal Opportunity1 Affirmative Action Employer— Made in part by recycled paper

If you should have any questions, please do not hesitate to contact Ron Boone at [phone]. .
Sincerely,
W. Corey Basinger
Regional Supervisor
Water Quality Regional Operations
Division of Water Resources
cc: DWR — Central Files
S'RO+ F'los

Facility: i r�qj
Parameter
DMR Review Record
Permit No.: B 556 / Pipe No.
Monthly Average Violations
Permit Limit DMR Value
Weekly/Daily Violations
6Z9 MonthNear: / J / `f
% Over Limit Action
Date
Parameter
Permit Limit Limit Type
DMR Value
% Over Limit Action
Violations
Monitoring Frequency
Date
Parameter
Permit Frequency
Values Reported
# of Violations Action
Other Violations/Staff Remarks:
tU�v' zUl S"' AMU
Supervisor Remarks:
Y
Completed b :
N
Assistant Regional
Supervisor Sign Off:
Regional Supervisor Sign /S
Off: eJ
Date: '2 15 LI
Date:
Date: ���.f7 ?.v "-3'

Pat McCrory
Governor -
North Carolina Department -of Environment and Natural Resources
December 17, 2014 -
Aqua North Carolina, Inc.
Attn: Thomas I Roberts, President and CEO
202 Mackenan Court
Cary, NC 27511
Subject: NOTICE OF DEFICIENCY
NOD-2014-MV-0063
Permit No. NCO088501
Stonington Subdivision — Well #1
Forsyth County
Dear Mr. Roberts:
John E. Skvarla, III
Secretary
A review of Stonington Subdivision - Well #1's monitoring report for September 2013 showed the
following deficiencies:
Parameter
Date
Frequency
Values Reported
Number of
Violations
Turbidity
09/30/2014
2 x month
0
1
Remedial actions should be taken to correct the cause(s) of these deficiencies. - Unresolved deficiencies may
lead to the issuance of a Notice of Violation -and/or assessments of civil penalties by the Division of Water
Resources of up to $25,000.00 per day for each violation. Your response, the degree and extent of harm to
the environment, and the duration and gravity of the deficiency(ies) will be considered in. any future actions
undertaken.
If you should have any questions, please do not hesitate to contact Ron Boone at [phone].
cc: SWP — Central Files
2 Filler
Sincerely,
W. Corey Basinger
Regional Supervisor
Water Quality Regional Operations
Division of Water Resources
450 West Hanes Mill Road, Suite #300, Winston-Salem, NC 27105
Phone; 336-776-9800 t Internet; www,ncdenr,gov
An Equal Opportunity1 Affirmative Action Employer— Made in part by recycled paper

MIR Review Record
Facility:
5�- I-)
PermitNo.: &S-oJ Pipe No.: Month/Year:
Monthly Average Violations
Parameter
Permit Limit DMR Value
% Over Limit
Action
Weekly/Daily Violations
Date
Parameter
Permit Limit Limit Type DMR Value
% Over Limit
Action
Monitoring Frequency Violations
Date
Parameter
Permit Frequency Values Reported
# of Violations
Action
`l a- iv
1�
Zx tMot7", q1
Other Violations/Staff Remarks:
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IVOD-2 v14'MV -000
Supervisor Remarks: /
Completed by: f6,4 J h e
Assistant Regional
Supervisor Sign Off:
Regional Supervisor Sign
Off:—
•� i �
Date: / 2 — /i j y
Date:
Date: 12- &--f. cjJC.: --..

NOV 6 - 2014
EFFLUENT
Pd� 2014
NPDES PERNvETNO. NC0088501 DischargeNo.: 001 Month:
Facility Name: Stonington Subdivision Well # 1 Class:
Operator in Responsible Charge (ORC): Peter Ray Dealing Grade:
Certified Laboratory (1): Water Tech Labs Inc #50
CHECK BOX IF ORC HAS CHANGED ® PERSON(S) COLLECT
n
September Year: 2014
PC I County: Forte
PC 1 Phone: [phone]
(2)
ING SAMPLES Operators
Mail ORIGINAL and ONE COPY to: X &�
ATTN: CENTRAL FILES (SIGNATURE OF OPE TOR IN RESPONSXLE CHARGE)
DIVISION OF WATER QUALITY BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS
1617 MAIL SERVICE CENTER ACCURATE AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
RALEIGH, NC 27699-1617
50050
00400
50060
00530
01045
01055
00927
01002
01034
01042
01067
71900
01147
61426
<
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FLOW
.
o
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W
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0
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D
W
LLINF tR
W XU F-
W O ZLl
_ :E
EFF
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O
:D
HRS
HRS
Y/B/N
MGD
MIN
UNITS
0 UG/L
MG/L
MG/L
MG/L
MG/L
MG/L
MG/L
MG/L
MG/L
MG/L
MG/L
MOIL
Pass/Fail
1
0.00060
1 60
2
0.00090
90
3
7:26
1
Y
0.00060
60
7.48
9
4.7
0.037
0.118
17.50
4.15
<0.005
<0.005
<0.005
<0.005
<0.0002
<0.005
4
0.00090
90
5
0.00060
60
6
1
0.00090
90
7
0.00060
1 60
8
0.00090
90
9
7:45
1
Y
0.00060
60
7.66
12
Pass
10
0.00090
90
FXML
11
10:55
1
N
0.00060
60
7.53
21
12
0.00090
90
13
0.00060
60
14
0.00090
90
15
0.00060
60
16
0.00090
90
17
7:40
1
Y
0.00060
60
7.42
15
< 2.5
18
1
0.00090
90
19
0.00060
60
20
0.00090
90
21
0.00060
60
22
0.00090
90
N.C.D .
23
0.00060
60
,
24
1
0.00090
90
4
25
0.00060
60
26
0.00090
90
ns o
. _
27
0.00060
60
28
0.00090
90
29
0.00060
60
30
0.00090
90
31
AVERAGE
0.00075
75
14.25
4.70
0.037
0.118
17.50
4.15
0.000
0.000
0.000
0.000
0.0000
0.000
#DIV/0!
MAXIMUM
0.00090
90
7.66
21.00
4.70
0.037
0.118
17.50
4.15
<0.005
<0.005
<0.005
<0.005
<0.000
<0.005
0.0o
MINIMUM
0.00060 1
60
7.42
9.00
<2.5
0.037
0.118
17.50
4.15
<0.005
<0.005
<0.005
<0.005
<0.000
<0.005
o.00
Comp. (C)/Grab (G)
G
G I
G
G I
G I
G
G I
G I
G I
G I
G
G
G
G
Monthly limit
0.0021
NL
NL
NL
30.0
NL
NL
NL
NL
NL I
NL
NL
NL
NL
NL
NL
Daily Maximum
6/9
17*
45.0
NL
NL
NL
NL
NL
NL
NL
NL
NL
NL
NL
as Meurement Frequency
Monthly
2/Nlth
2/Mth
2/Mth
Mthly
Mthly
Mthly
Mthly
Mthly I
Mthly
Mthly
Mthly
Mthly
Mthly
Qrtly
* Limit takes effect June 1, 2009

Stonington WTP NC0088501
Facility Status: (Please check one of the following):
All monitoring data and sampling frequencies meet permit requirements 5z]
Compliant
All monitoring data and sampling frequencies do NOT meet permit requirements El
Noncompliant
If the facility is noncompliant, please comment on corrective actions being taken in respect to equipment, operation, maintenance, etc.
and a time table for improvements to be made.
"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 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 possibility of fines and imprisonment for knowing violations."
Thomas J. Roberts, President, Aqua North Carolina, Inc.
Perm' ee (Please print type),
Signature ofPermittee **
Date
Permittee Address Phone Number Permit Exp. Date
202 MacKenan Court, Cary, NC 27511 919-467-8712 February 28, 2014
00010 Temperature
00076 Turbidity
00080 Color (Pt -Co)
00082 Color (ADMI)
00095 Conductivity
00300 Dissolved Oxygen
00310 BOD5
00340 COD
00400 pH
00530 Total Suspended
Residue
00545 Settable matter
00556 Oil & Grease
00600 Total Nitrogen
00610 Ammonia Nitrogen
00625 Total Kjeldhal
-Nitrogen
00630 Nitrates/Nifrites
00665 Total Phosphorous
00720 Cyanide
00745 Total Sulfide
00927 Total Magnesium
00929 Total Sodium
00940 Total Chloride
PARAMETER CODES
00951 Total Fluoride
01002 Total Arsenic
01027 Cadmium
01032 Hexavalent Chromium
01034 Chromium
01037 Total Cobalt
01042' Copper
01045 Iron
01051 Lead
01055 Manganese
01067 Nickel
01077 Silver
01092 Zinc
01105 Aluminum
01147 Total Selenium
31616 Fecal Coliform
32730 Total Phenolics
34235 Benzene
34481 Toluene
38260 MBAS
39516 PCBs
50050 Flow
50060 Total
Residual
Chlorine
71880 Formaldehyde
71900 Mercury
81551 Xylene
Parameter Code assistance may be obtained by calling the Water Quality Compliance Group at [phone], extension 581 or 534.
The monthly average for fecal coliform is to be reported as a GEOMETRIC mean. Use only units designated in the reporting
facility's permit for reporting data.
* ORC must visit facility and document visitation of facility as required per 15A NCAC 8A.0202 (b) (5) (B).
** If signed by other than the permittee, delegation of signatory authority must be on file with the State per 15A NCAC 213.0506 (b)
(2) (D)•

NC®ENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
July 10, 2014
Aqua North Carolina Inc.
Attn: Thomas J. Roberts, President & COO
202 Mackenan Drive
Cary, NC 27511
Subject: Compliance Evaluation Inspection
Permittee: Aqua North Carolina Inc.
Facility: Stonington Subdivision — Well #1
NPDES Permit #: NCO088501
Forsyth County
Dear Mr. Roberts:
John E. Skvarla, III
Secretary
Ron Boone of the Winston-Salem Regional Office of the NC Division of Water Resources (DWR or the Division)
conducted a compliance evaluation inspection (CEI) of the Stonington Subdivision — Well #1 on July 8, 2014. The
assistance and cooperation of Peter Dealing, system operator, and Billy Young was greatly appreciated. An inspection
checklist is attached for your records and inspection findings are summarized below.
General Information
The Stonington Subdivision — Well #1 is located on the north side of Stonington Subdivision, in Kernersville,
Forsyth County, NC, at approximate coordinates 36.0346720N, 80.0760490W. The permit authorizes Aqua to operate
this 0.0021 MGD facility, which consists of five green sand filters used to treat ground water for use as potable water for
the subdivision. Chemicals used in the water treatment process include Potassium Permanganate, Chlorine, and Caustic
Soda. The permit authorizes Aqua to discharge the filter backwash wastewater from the facility via outfall 001 to an
unnamed tributary of Abbotts Creek, which is currently classified as Class WS-III waters in the Yadkin Pee -Dee river
basin.
Site Review
Mr. Dealing has done a good job operating and maintaining the plant. No discrepancies were found.
Documentation Review
The only issue noted during the inspection concerned the chlorine meter. During the inspection, Mr. Boone was
evaluating paperwork when he noticed the value "<20" being entered the majority of the time for Chlorine Residual on
the discharge monitoring reports. When asked about this Mr. Young stated the 20 pgl is the lowest that their meter could
read down to. This must be corrected. The permit requires the meter to read below the permit limit, which is 17 pgl.
Please respond to this letter in writing within 20 business days of its receipt. Your response should include a
detailed summary of how you plan to address the chlorine meter mentioned above, You are reminded that, in
accordance with NC General Statute 143-215.6A, the Director of the Division of Water Resources may assess civil
penalties not to exceed $25,000 per day, per violation, for violations of NCGS 143-215.1 or the NCO088501 NPDES
permit.
585 Waughtown Street, Winston-Salem, North Carolina 27107
Phone: [phone] Internet: www.ncdenr.gov
An Equal Opportunity1 Affirmative Action Employer— Made in part by recycled paper

0
If you have any questions regarding the inspection or this letter, please call Mr. Boone or me at [phone].
Thank you for your cooperation in this matter.
Sincerely,
W. Corey Basinger
Regional Supervisor
Water Quality Regional Operations
Division of Water Resources
Attachments:
BIMS Inspection Report
CC: ' SR • - �SWP
Central Files
NPDES Unit

I
United States Environmental Protection Agency
Form Approved.
EPA Washington, D.C.20460
OMB No. 2040-0057
Water Compliance Inspection Report
Approval expires8-31-98
Section A: National Data System Coding (i.e., PCS)
Transaction Code NPDES yr/mo/day Inspection Type
Inspector Fac Type
1 2 _I5 1 3 I NCO088501 I11 12 14/07/08 17 18 l,.l
19 I � I 201
21III111 III.IIII1III IIIIIII I I I I I I I I I I
I I I I I I I I f6
Inspection Work Days Facility Self -Monitoring Evaluation Rating B1 QA --------- —Reserved-------
671 701 I 71 I I 72 1 �, 1 731 I 174 761
LJ LJ I I I I I I I I I I80
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)
09:OOAM 14/07/08
09l04l01
Stonington Subdivision - Well #1
Stonington Way Ct
Exit Time/Date
Permit Expiration Date
Kernersville NC 27284
10:OOAM 14/07/08
14/02/28
Name(s) of Onsite Representative(s)fritles(s)/Phone and Fax Number(s)
Other Facility Data
Peter Ray Dealing/ORC/336-362-2008/
Name, Address of Responsible Official/Tifle/Phone and Fax Number
Contacted
Laurie Ison,4163 Sinclair St Denver NC 28037/Western Area Managerf704489-9404/
No -
Section C: Areas Evaluated During Inspection (Check only those areas evaluated)
Permit Flow Measurement Operations & Maintenance Records/Reports
Self -Monitoring Program Facility Site Review Effluent/Receiving Waters Laboratory
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
(See attachment summary)
Name(s) and Signature(s) of Inspector(s) Agency/Office/Phone and Fax Numbers
Date
Ron Boone WSRO WQ//336-7714967/
Signature of Management Q A Reviewer Agency/Office/Phone and Fax Numbers
Date
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete.
Page# 1

NPDES yr/mo/day Inspection Type
31 NCO088501 I11 12 14/07/08 17 18 ICI
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
Please refer to the attached inspection summary letter.
Page#

r
Permit: NCO088501 Owner - Facility: Stonington Subdivision -Well #1
Inspection Date: 07/08/2014 Inspection Type: Compliance Evaluation
Operations $ Maintenance Yes No NA NE
Is the plant generally clean with acceptable housekeeping? 0 ❑ ❑ ❑
Does the facility analyze process control parameters, for ex: MLSS, MCRT, Settleable 0 ❑ ❑ ❑
Solids, pH, DO, Sludge Judge, and other that are applicable?
Comment: None
Permit
Yes No NA NE
(If the present permit expires in 6 months or less). Has the permittee submitted a new
0
❑
❑
❑
application?
Is the facility as described in the permit?
0
❑
❑
❑
# Are there any special conditions for the permit?
❑
0
❑
❑
Is access to the plant site restricted to the general public?
0
❑
❑
❑
Is the inspector granted access to all areas for inspection?
0
❑
❑
❑
Comment: None
Record -Keeping
Yes No NA NE
Are records kept and maintained as required by the permit?
0
❑
❑
❑
Is all required information readily available, complete and current?
0
❑
❑
❑
Are all records maintained for 3 years (lab. reg. required 5 years)?
0
❑
❑
❑
Are analytical results consistent with data reported on DMRs?
0
❑
❑
❑
Is the chain -of -custody complete?
0
❑
❑
❑
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?
0
❑
❑
❑
Has the facility submitted its annual compliance report to users and DWQ?
❑
❑
0
❑
(If the facility is = or > 5 MGD permitted flow) Do they operate 24/7 with a certified operator
❑
❑
0
❑
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?
0
❑
❑
❑
Is the backup operator certified at one grade less or greater than the facility classification?
0
❑
❑
❑
Is a copy of the current NPDES permit available on site?
0
❑
❑
❑
Page# 3

Permit: NCO088601 Owner - Facility: Stonington Subdivision -Well 91
Inspection Date: 07/08/2014 Inspection Type: Compliance Evaluation
Record Keepinq Yes No NA NE
Facility has copy of previous year's Annual Report on file for review? ❑ ❑ 0 ❑
Comment: None
Effluent Pipe Yes No NA NE
Is right of way to the outfall properly maintained? M ❑ ❑ ❑
Are the receiving water free of foam other than trace amounts and other debris? ■ ❑ ❑ ❑
If effluent (diffuser pipes are required) are they operating properly? ❑ ' ❑ M ❑
Comment: None
Flow Measurement - Effluent
Yes No NA NE
# Is flow meter used for reporting?
0
❑
❑
❑
Is flow meter calibrated annually?
❑
❑
0
❑
Is the flow meter operational?
❑
❑
❑
(If units are separated) Does the chart recorder match the flow meter?
❑
❑
❑
Comment: None
Laboratory
Yes No NA NE
Are field parameters performed by certified personnel or laboratory?
M
❑
❑
❑
Are all other parameters(excluding field parameters) performed by a certified lab?
M
❑
❑
❑
# Is the facility using a contract lab?
❑
❑
❑
# Is proper temperature set for sample storage (kept at less than or equal to 6.0 degrees
❑
❑
❑
Celsius)?
Incubator (Fecal Coliform) set to 44.5 degrees Celsius+/- 0.2 degrees?
❑
❑
❑
Incubator (BOD) set to 20.0 degrees Celsius +/- 1.0 degrees?
❑
❑
❑
Comment: None
Effluent Sampling
Yes No NA NE
Is composite sampling flow proportional?
❑
❑
❑
Is sample collected below all treatment units?
M
❑
❑
❑
Is proper volume collected?
M
❑
❑
❑
Is the tubing clean?
❑
❑
M
❑
# Is proper temperature set for sample storage (kept at less than or equal to 6.0 degrees
❑
❑
❑
Celsius)?
Page# 4

FA
Permit: NC0088501 Owner - Facility: Stonington Subdivision - Well #1
Inspection Date: 07/08/2014 Inspection Type: Compliance Evaluation
Effluent Sampling Yes No NA NE
Is the facility sampling performed as required by the permit (frequency, sampling type ® ❑ ❑ ❑
representative)?
Comment: None
Page# 5

AQUA.
July 30, 2014
Mr. W. Corey Basinger
Regional Supervisor
Water Quality Regional Operations
NCDENR, DWR
585 Waughtown Street
Winston Salem, NC 27107
Re: Stonington Subdivision —Well #1
NPDES Permit #NC0088501
Forsyth County
Dear Mr. Basinger:
Aqua North Carolina, Inc.
202 MacKenan Court
Cary, NC 27511
RECEIVED
N.C. Dept. of ENR
AUG 01 2014
WINSTON-SALEM
REGIONAL OFFICE
Thomas J. Roberts
President and Chief Operating Officer
T:919.653.5770
F: 919.460.1788
[e-mail]
www.aquanorthcarolina.com
Aqua North Carolina, ,Inc. (Aqua) offers the following response to the above -referenced Compliance
Evaluation -Inspection conducted on July 8, 2014 by Mr. Ron Boone:
Documentation Review
-During the inspection, Mr. Boone was evaluating paperwork when he noticed the value "<20"
being entered the majority of the time for Chlorine Residual on the discharge monitoring reports.
When asked about this Mr. Young stated the 20 ug/L is the lowest that their meter could read
down to. This must be corrected. The permit requires the meter to read below the permit limit,
which is 17 ug/L.
Aqua's Response
Aqua will make the necessary adjustments to begin reporting the actual Total Residual Chlorine
(TRC) measured. Also, per the permit, we understand that a TRC residual less than 50 ug/L is
considered to be in compliance.
If you have any questions regarding this response, please do not hesitate to contact Laurie Ison at 704-
489-9404, extension 57234.
Sinc el ,
Thomas J. Ro rts _
President an COO
cc: Laurie Ison
Michael Melton _
Moses Thompson
An Aqua America Company

Pat McCrory
Governor
RECENED
=jti=. N.C.Dept. of ENR
JUN 1 1 2014
�ZM® Winston-5a;ern
NCDENRI Regional Office
North Carolina Department of Environment and Natural Resources
John E. Skvarla, III
Secretary
Thomas J. Roberts, President & CEO
Aqua North Carolina, Inc.
202 Mackenan Court
Cary, North Carolina 27511
Dear Mr. Roberts:
June 4, 2014
Subject: NPDES Permit - DRAFT Review
Permit NCO088501
Stonington Subdivision - Well 41 WTP
Stonington Way Court, Kernersville
Forsyth County
Based on your renewal request for the subject site (received October 16, 2013), the Division of
Water Resources (DWR or the Division) hereby transmits a renewal draft for your review and
comment. Please review this draft carefully to ensure your understanding of the limits and
monitoring conditions, and to correct errors, if any.
Concurrent with this notification, the Division will solicit public comment on this draft by
publishing a notice in newspapers having circulation in the general Forsyth County area, as required
by the NPDES Program. Please provide your written comments, if any, to DENR / DWR / NPDES
Program no later July 3, 2014 (approximately 30 days after-Teceiving this document). Your written
comments are welcome, but are not mandatory.
Changes for Renewal. The Division updated your permit in accord with permitting strategies
(amended in 2009) for potable water treatment plants (WTPs) consistent with similar permits
statewide. We have therefore deleted Whole Effluent Toxicity (WET) testing, no longer required of
system utilizing green sand WTP technology. However, effluent data for Total Manganese (Mn)
suggest reasonable potential to exceed its water -quality Standard. Therefore we have added a Mn
permit limit of 200ug/L. Your compliance with this limit will commence 48 months'from the permit
effective date. We have also updated your facility description and site map, adding parameter codes
to permit Section A. (L) for your convenience.
Implementing Electronic Discharge Monitoring Reports (eDMRs). Please be advised that the
Division will implement an electronic Discharge Monitoring Report (eDMR) program, in accord
with pending requirements by the Environmental Protection Agency (EPA). We have included the
details required to implement the eDMR program in this permit [see Special Condition A. (2.)].
1601 Mail Service Center, Raleigh, North Carolina 27699-1601
Phone: [phone] Internet: www.ncdenr,gov
An Equal Opportunity 1 Affirmative Action Employer — Made in part by recycled paper

Proposed federal regulations require electronic submittal of all DMRs and specify that, if North
Carolina does not establish a program to receive such submittals, Permittees must then submit
eDMRs directly to EPA. For more information on eDMRs, registering for eDMR submittal, and
obtaining an eDMR user account, please visit DWR's webpage:
http://portal.nedenr.org/web/wq/admin/bog/l*pu/cdmr.
For information on EPA's proposed NPDES Electronic Reporting Rule, please visit EPA's website:
http://www2.epa. ov/compliance/proposed-npdes-electronic-reporting-rule
Following the mandatory 45-day public comment period, the Division will review all pertinent
comments, if any, and take appropriate action prior to issuing an NPDES permit final.: If you have
questions concerning this draft, please e-mail me [e-mail]]; or call my private line
[phone].
.00
-d Permitting Unit
Enclosure: NPDES Permit NCO08
he.* SRO/ S Supervisor, Corey tlgeri rdraft�p"ermit, Fact Sheet]
NPDES Program Files [draft permit and Fact Sheet]
ec: DWR/WSRO, Corey Basinger [draft permit and Fact Sheet]
Aqua North Carolina, Inc., Thomas J. Roberts [[e-mail]] [draft permit and Fact Sheet]

NPDES Permit NCO088501
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER RESOURCES
PERMIT
TO DISCHARGE WASTEWATER UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
(NPDES)
In compliance with the provisions of North Carolina General Statute 143-215.1, other lawful standards
and regulations promulgated and adopted by the North Carolina Environmental Management
Commission, and the Federal Water Pollution Control�Act, as amended, the
Aqua North Carol
is hereby authorized to discharge
Stonington S
Stonington
to receiving wate s'de 'gr
Basin, in accordance with
Parts I, II, III, and ere
The permit shall become
from afability known as
ivisionW'W' 11 # 1
ille
bbotts Creek in the Yadkin -Pee Dee River
g requirements, and other conditions set forth in
52014.
This permit and the authorization to discharge shall expire at midnight on February 28, 2019.
Signed this day
52014.
Thomas A. Reeder, Director
Division of Water Resources
By Authority of the Environmental Management Commission
Page 1 of 5

NPDES Permit NCO088501
SUPPLEMENT TO PERMIT COVER SHEET
All previous NPDES Permits issued to this facility, whether for operation or discharge are hereby
revoked, and as of this issuance, any previously issued permit bearing this number is no longer effective.
Therefore, the exclusive authority to operate and discharge from this facility arises under the permit
conditions, requirements, terms, and provisions described herein.
Aqua North Carolina, Inc.
is hereby authorized to:
1. continue to operate a filter -backwash treatment system
utilizing green sand treatment technology, including u:
• chlorine
• potassium permanganate
• caustic soda
located at the Stonington Subdivision - W�dl 4'1 St
County; and
potable water production
ay Court, Kernersville, Forsyth
2. discharge from said treatient .W ks via Outfall 001 at a location specified on the attached map, into
an unnamed tributary to Abbotts Creek [Stream Segment 12-119-(1)], a waterbody currently
classified WS-I11 waters within Subbasin 03-07-07 of the Yadkin -Pee Dee River Basin.
Page 2 of 5

NPDES Permit NCO088501
PART I
A. (1.) EFFLUENT LIMITATIONS AND MONITORING REQUIREMENTS
During the period beginning on the effective date of this permit and lasting until expiration, the Permittee is
authorized to discharge filter backwash from Well #1 via Outfall 001. Such discharges shall be limited and
monitored l by the Permittee as specified below:
EFFLUENT ..
:. :-CHARACTERISTIC
,.[PARAIVIETER.:CODES]
.. . . ; ..:...
LIMITS :.
MONITORING; REQUIIEIVIENT 1 : ;
1Vlonthl
Avera 'e
g
Dail
1Vlaxuriuin
Measurement`•
:.Fre ` uency
q
Sam le
`• ' T , e
yP.
Sain',lei
,:.I;ocation;.: ;
-
Flow
50050
Weekly
Estimate
Effluent
Total,Susperided Solids
C0530
30.0 mg/L
45.0 mg/L :
_ 2(menth __
Giab- •.
Effluent
Total Residual Chlorine 2
50060
28 µg/L 2
X/mo th
Grab :- .
Effluent
PH [standard units]
00400
Not < 6.0 or > 9.0
��/nth
Grab
Effluent
Turbidity 3
00070
/
2Ar n\th
Grab
Effluent
Total Manganese
01055
�00�g�/L 4
Monthly
Grab
Effluent
Total Zinc 5
01092
/ uarterly\�
Grab
Effluent
Total Iron
01045
A
%Quarterly
\%Grab
Effluent
Footnotes:
1. Beginning no later than / / \� 2�70 d y?;'fr�tfi fh�e Sc`tfve date of this permit, the
Permittee shall begin repo �g disch7gy mom oring data ekZtronically using the NC DWR s
Electronic Discharge Moni� 1ii0dpoAt (.eDM i ternet application. [See Special Condition A.
(2.) for eDMR str6n4ta. 'eq `re entsj
2. The Divisionka'l, consider c l a t 1 T C effltlr6 t values reported below 50µg/L. However, the
Permittee-shall c, i nue to record nd u� . it all values reported by North Carolina -certified
laboratory method (i�cluding field_ • ert, even if these values fall below 50µg/L.
3. Discharge from this f\d ility shall Vot ause receiving -stream turbidity to exceed 50 NTU. If instream
background conditions e ce�O N U, this discharge shall not cause instream turbidity to increase.
4. Compliance with this perm' im' will commence on , 48 Months from the permit effective date.
5. Total Zinc - monitor only if filters are backwashed with corrosion inhibitor or other containing zinc.
A. (2.) ELECTRONIC REPORTING - DISCHARGE MONITORING REPORTS
Proposed federal regulations require electronic submittal of all discharge monitoring reports (DMRs)
and specify that, if a state does not establish a system to receive such submittals, then Permittees must
submit DMRs electronically to the Environmental Protection Agency (EPA). The Division anticipates
that these regulations will be adopted and will begin implementing this program in 2013.
Page 3 of 5

NPDES Permit NCO088501
NOTE: This special condition supplements or supersedes the following sections within Part II of this
permit (Standard Conditions for NPDES Permits):
• Section B. (11.) Signatory Requirements
• Section D. (2.)
• Section D. (6.)
• Section E. (5.)
Reporting
Records Retention
Monitoring Reports
1. Reportine (Supersedes Section D. (2.) and Section E. (5.) (a)1
Beginning no later than 270 days from the effective date of this permit, the Permittee
shall begin reporting discharge monitoring data electronically using the NC DWR's Electronic
Discharge Monitoring Report (eDMR) internet application.
Monitoring results obtained during the previous month(s) shall be summarized for each month and
submitted electronically using eDMR. The eDMR system allo s pe itted facilities to enter
monitoring data and submit DMRs electronically using the intemd Until such'time that the state's
eDMR application is compliant with EPA's Cross-Media�Elee tr�n: c Reporting Regulation
(CROMERR), Permittees will be required to submi�l�l^di�chargd\ n�nitoring data to the`state
electronically using eDMR and will be required trc plete the el)�VSR�submission by:printing;
signing, and submitting one signed original and � copy of the computer printed eDMR to the
following address: �� 7�
NC DENR / DWR / Information Proc
ATTENTION: Central Files / eDMR
1617 Mail Service Center _�
Raleigh, North Carolina 2, 699 1"6I�7\
If a Permittee is unable to h eVheeMg' systerhdue to a demonstrated hardship, or due to the
facility being physicall'4gca .ar-ea w ere\le�s than 10 percent of the households have
broadband acZss; hen err�po �ary\waiver from t . e NPDES electronic reporting requirements may
be granted an d� charge m `tt\orig ata may be submitted on paper DMR forms (MR l; l:.l, 2, 3)
or alternative f approved by they ector. Duplicate signed copies shall -be submitted to- the
mailing address aiq�q.
Requests for temporar�\Wiv 6 f bm the NPDES electronic reporting requirements must be -
submitted in writing to the �Dil Sion for written approval at least sixty (60) days prior to the date the
facility would be required under this permit to begin using eDMR. Temporary waivers shall be valid
for twelve (12) months and shall thereupon expire. At such time, DMRs shall be submitted
electronically to the Division unless the Permittee re -applies for and is granted a new temporary
waiver by the Division.
Information on eDMR and application for a temporary waiver from the NPDES electronic reporting
requirements is found on the following web page:
http://portal.nedenr.org/web/wq/admin/bojz/ipu/edmr
Page 4 of 5

NPDES Permit NC0088501
Regardless of the submission method, the first DMR is due on the last day of the month following
the issuance of the permit or in the case of a new facility, on the last day of the month following the
commencement of discharge.
2. Signatory Requirements (Supplements Section B. (11.) (b) and supersedes Section B. (11.) (d)1
3.
All eDMRs submitted to the permit issuing authority shall be signed by a person described in Part II,
Section B. (I 1.)(a), or by a duly authorized representative of that person as described in Part II,
Section B. (I 1.)(b). A person, not an assigned position, must be delegated signatory authority for
eDMR reporting purposes.
For eDMR submissions, the. person; signing and submitting the DMR must obtain an eDMR user
account and login credentials to access the eDMR system. For more information on North
Carolina's eDMR system, registering for eDMR and obtaining an eDMR user account, please visit
the following web page:
http://portal.nedenr.org/web/wq/admin/bog/ipu/edmr
Certification. Any'person submitting an electronic D , ��using th state's eDMR system shall make
the following certification [40 CFR 122.221. NO' O �� AT TS OF CERTIFICATION
WILL BE ACCEPTED: �x
7 certify, under penalty of law, that this 5ocument\a*4 al att Mments w�re\nrepared under my
direction or supervision in accordance �v\i system esi , ed to assure that qualified personnel
properly gather and evaluate the informclti s\• itte . &used on my inquiry of the person or
persons who manage the systems those p\\e on fir ctly r�el1�onsible for gathering the information,
the information submitted lie of n'cy�knledg and belief, true, accurate, and complete. I
am aware that there ar=�gnilAi
ant penalties�fo�r s bt�n lse information, including the
possibility offines and mentyo� know ng violation . "
The Permittee hall retain re' rd of� 1' ischarge Monitoring Reports, including eDMR submissions. These
records or copie sh 11 be maiairi dT�� eriod of at least 3 years from the date of the report. This period
may be extended (,request of th\4, D�irectq�r t any time [40 CFR 122.41 ].
Page 5 of 5

)� I Pine Meadows Drive
7
UT to Abbotts Creek
(flow south)
outfall 001 ........
Flows '' 0'
Flows NW
1 %
A
J
NC Hwy 66
Aqua North Carolina, Inc.
Stonington Subdivision Well # 1-WTP
Latitude: 36° 02' 05" N State Grid: Kemersville
Longitude: 80' 040' 32" W Permitted Flow: 0.0021 MGD
Receiving Stream: UT to Abbotts Creek Stream Class: WS-III
Drainage Basin: Yadkin -Pee Dee River Basin Sub -Basin: 03-07-07
-
'and
_\
1 I -74 1
Facility
Location
not to scale
North NPDES Permit NC0088501
Forsyth County

Water Pollution Control System Operator Designation Form
WPCSOCC
NCAC 15A 8G .0201
Permittee Owner/Officer Name:
Mailing Address: 2 0 2 01A C Gl. E A N A lN C d V a T
City: C State: PC Zip: S 11 - Pllone #: (ri tq) V4 9 - 8 i 19
Email address:
Signature:
Date:
Facility Name: _ 4 46,,r_ r. yr `fin..,_ Permit #: N C 00 b_ d1
SUBMIT A SEPARATE FORM FOR EACH TYPE SYSTEM!
Facility Tyne/Grade:
Biological WWTP Surface Irrigation
Physical/Chemical —X— Land Application
Collection System
................................................................................................................................................
Operator in Responsible Charge (ORC)
Print Full Name: _��1 ✓ t� Q �� • , ._
Certificate Type / Grade / Number; ? C ,% IF I? yp t/& Work Phone #: 33c, 13 6 2- — g=;!5c> ,
Signature: 10Date:_ o2 - ZS 7
"I certify that I agree to my designa Zn as the Operator in Responsible Charge for the facility noted. I understand and will abide by the rules
and regulations pertaining to the responsibilities of the ORC as set forth in 15A NCAC 08G .0204 and failing to do so can result in Disciplinary
Actions by the Water Pollution Control System Operators Certification Commission."
.................................................................................................................................................
Back -Up Operator in Responsible Charge (BU ORC)
Print Full Name:. Y-" A� y ,� A
Certificate Type / Grade / Number: '?C_ 2!2 Work Phone #: (3 3()ge) 6 - to 2.2y
Signature: Date:
"I certify that I agree to my designation as a Ba -up Operator in Responsible Charge for the facility noted. I understand and will abide by the
rules and regulations pertaining to the responsibilities of the BU ORC as set forth in 15A NCAC 08G .0205 and failing to do so can result in
Disciplinary Actions by the Water Pollution Control System Operators Certification Commission,"
............ ................................. ... .......................................... ........................................................
,
11,1411, fax or einall the WPCSOCC, 1618 Mail Service Center, Raleigh, NC 27699-1618 Fax: [phone]
original to. Email: certadmin(@ncdcur. eov
Mall or foe a copy to the Asheville
Fayetteville
Mooresville
Raleigh
appropriate Regional Office; 2090 US Hwy 70
225 Green St
610 E Center Ave
3800 Barrett Dr
Swannanoa 28778
Suite 714
Suite 301
Raleigh 27609
Fax: 828.299,7043
Fayetteville 28301-5043
Mooresville 28115
Fax: [phone]
Phone:828,296,4500
Fax:[phone]
Fax:[phone]
Phone: 919,791,4200
Phone:[phone]
Phone:[phone]
Washington
Wilmington
Winston-Salem
943 Washington Sq Mali
127 Cardinal Dr
585 Waughtown St
Washington 27889
Wilmington 28405.2845
Winston-Salem 27107
Fax:[phone]
Fax:[phone]
Fax:336,771,4631
Phone; 252.946.6481
Phone: [phone]
Phone, 336.771.5000
Revised 02-2013

p
A C , A
MT410va
Ap
C®ER
North Carolina Department of Environment and Natural Resources
Division of Water Resources
Water Quality Regional Operations Section
Pat McCrory Thomas A. Reeder
Governor Director
November 7, 2013
Thomas J. Roberts, President
Aqua North Carolina, Inc.
202 Mackenan Ct
Cary, NC 27511
Subject: NOTICE OF VIOLATION
NOV-2013-LV-0684
Permit No. NCO088501
Stonington Subdivision.- Well #1
Forsyth County
Dear Mr. Roberts:
John E. Skvarla, III
Secretary
A review of Stonington Subdivision - Well #1's monitoring report for August 2013 showed the following violations:
Parameter
Date
Limit Value
Reported Value
Limit Type
Solids, Total Suspended - Concentration
08/28/13
45 mg/I
46 mg/I
Daily Maximum
Exceeded
Solids, Total Suspended - Concentration
08/31/13
30 mg/I
43 mg/I
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 Ron Boone at [phone].
cc: SWP — Central Files
IM9,00E—iles"sV
North Carolina Division of Water Resources, Winston-Salem Regional Office
Location: 585 Waughtown St. Winston-Salem, North Carolina 27107
Phone: [phone] FAX: [phone] Customer Service:1-877-623-6748
Internet: wvvw.ncwater.org
Sincerely,
W. Corey Basinger
Regional Supervisor
Water Quality Regional Operations
Division of Water Resources
One
NdithCar®lina
Nata,,rally
An Equal Opportunity 1 Affirmative Action Employer

DMR Review Record
Facility: Stonington Subdivision
Parameter
TSS
Date Parameter
8/28/13 TSS
Date Parameter
Permit No.: 88501 Pipe No.: 001
Monthly Average Violations
Permit Limit DMR Value
30 43
Weekly/Daily Violations
Permit Limit Limit Type DMR Value
45 Daily Max 46
Monitoring Frequency Violations
Permit Frequency Values Reported
Other Violations/Staff Remarks: See attached.
Completed by:
MonthNear: 08/2013
% Over Limit Action
43.33
#DIV/0!
#DIV/0!
#DIV/0!
% Over Limit
2.22
#DIV/0!
#DIV/0!
#DIV/0!
# of Violations
Ron Boone Date: 1IM13
urnena
Failure to monitor parameter with limit: $50
Failure to monitor parameter without limits: $25
Any facility with just a single daily max violation to receive NOV only.
No civil assessment cases for less than $100, not including cost of investigation. NOV only.
Threshold for flow is 10%; threshold for all other. parameters is 20%.
Stipulated demand letters for SOCs..... automatic.
Failure to obtain a permit ..... $4,000.
Action
Action
Multipliers:
Number of assessments for previous 12 months:
0-2 Multiply base penalty by 1.0
3-5 Multiply base penalty by 1.25
6-8 Multiply base penalty by 1.5
9-12 Multiply base penalty by 2.0
Delgated Fast Track Penalties/Base Penalty Amounts:
DMR Monthly Flow Avq
Monthly Average
Weekly Average
Daily Max
50.05 MGD---------
$0-500
$0-200
$0-200
>0.05 but <0.1 MGD
$0-1,000
$0-500
$0-200
2!0.1 but <0.5 MGD
$0-1,500
$0-500
$0-500
>_0.5 but <1.0 MGD
$0-2,000
$0-500
$0-500
>1.0 but <10.0 MGD
$0-3,000
$0-1,000
$0-500
>_10.0 but <25.0 MGD
$0-4,000
$0-1,000
$0-500
>_25.0 MGD
$0-5,000
$0-1,000
$0-500
Supervisor Remarks:
NOU—a013 - LV- 00+
Regional Water Quality rt'
Supervisor Sign Off: o�;YV� � Date: 2A iw

NC0088501
Stonington Subdivision - Well #1
Limit Violation
Chlorine, Total Residual
Solids, Total Suspended - Concentration
Other Violation

CDER
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
May 20, 2013
Aqua North Carolina Inc.
Attn: Thomas J. Roberts, President & COO
202 Mackenan Drive
Cary, NC 27511
Subject: Compliance Evaluation Inspection & Notice of Violation
NOV-2013-PC-0185
Permittee: Aqua North Carolina Inc.
Facility: Stonington Subdivision — Well #1
NPDES Permit #: NC0088501
Forsyth County
Dear Mr. Roberts:
Ron Boone of the Winston-Salem Regional Office of the NC Division of Water Quality (DWQ or the Division)
conducted a compliance evaluation inspection (CEI) of the Stonington Subdivision — Well 41 on May 14, 2013. The
assistance and cooperation of Billy Young, system operator, was greatly appreciated. An inspection checklist is
attached for your records and inspection findings are summarized below.
General Information
The Stonington Subdivision — Well #1 is located on the north side of Stonington Subdivision, in Kernersville,
Forsyth County, NC, at approximate coordinates 36.034672°N, 80.076049°W. The permit authorizes Aqua to
operate this 0.0021 MGD facility, which consists of five green sand filters used to treat ground water for use as
potable water for the subdivision. Chemicals used in the water treatment process include Potassium Permanganate,
Chlorine, and Caustic Soda. The permit authorizes Aqua to discharge the filter backwash wastewater from the facility
via outfall 001 to an unnamed tributary of Abbotts Creek, which is currently classified as Class WS-III waters in the
Yadkin Pee -Dee river basin.
Site Review
Mr. Young has done a good job operating and maintaining the plant. The following issues were also noted:
1. The discharge pipe is 4" black corrugated plastic pipe, which runs down the hill to the north of the facility
and ends within about 20 feet of the receiving stream; it just lays on the ground in a heavily vegetated and
marshy area and does not actually reach the receiving stream. There is a significant amount of black
staining on the ground all around the end of the pipe. It is noted that there is no backwash wastewater
capture facility where the wastewater can be captured, settled, and decanted, therefore, all solids
backwashed from the filters are discharged. The substances that are causing the ground staining are having
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 �7One
An Equal Opportunity l Affirmative Action Employer l� ®rthCarolina

Aqua North Carolina Inc, Attn: Thomas J. Roberts, President and COO
Compliance Evaluation Inspection & NOV-2013-PC-0185
Stonington Subdivision — Well #1, NCO088501
May 17, 2013, Page 2 of 3
an obvious localized impact at the end of the pipe. It is unknown whether or not the substances causing the
staining over actually make it into the receiving stream.
2. It is possible that the discharge may exceed the TSS limit for at least a portion of the backwash/discharge
cycle, i.e. the TSS concentration in the effluent would be significantly higher at the beginning of the
backwash cycle than the end. In a follow-up telephone conversation with Mr. Young on May 17, 2013, he
stated that the actual filter backwash cycle lasts about 10 minutes and that he pulls TSS samples within the
first 2 to 3 minutes; this would appear to be sufficient. The sampling practice employed at the facility was
also mentioned in the Notice of Violation (NOV) that Aqua was issued as a result of the previous inspection
on January 27, 2011 (NOV-2011-PC-0084). Aqua is reminded that Part II, Section D, Paragraph 1 of
NCO088501 states:
Samples collected and measurements taken, as required herein, shall be characteristic of the
volume and nature of the permitted discharge. Samples collected at a frequency less than daily
shall be taken on a day and time that is characteristic of the discharge over the entire period the
sample represents. 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 the approval
of the Permit Issuing Authority [40 CFR 122.41 Q)].
With the current configuration it is difficult to identify a specific point at which the samples would be most
representative. It is noted that a wastewater capturing, settling, and decanting facility would possibly be very
effective at eliminating the loss of solids in the discharge, the ground staining at the end of the discharge
pipe, and would also provide for much more consistent TSS concentration in the discharge.
3. As was also addressed in the NOV Aqua was issued as a result of the 2011 inspection, there still exists an
unauthorized discharge at the facility. There are actually three separate unauthorized discharges from the
facility, as follows:
a. There is a four -inch PVC pipe on the northwest corner of the facility that discharges the drainage
from a floor drain inside the plant. During this inspection, as was also the case during the 2011
inspection, there was a significant amount of spilled Potassium Permanganate on the floor of the
facility, which was flowing into the floor drain and was being discharged from this four -inch PVC
pipe. In its written response to the 2011 NOV, Aqua stated that they would "...evaluate purchasing
spill containment tubs to place under the Potassium Permanganate barrels." At the time of this
inspection, no containment tubs were present.
b. There is a two-inch PVC pipe that comes out the northern wall of the facility, runs parallel to the
buried "authorized" discharge pipe, and ends at the top of the hill. According to Mr. Young this is a
well blowoff.
C. There is another two-inch PVC pipe that, according to Mr. Young, drains a floor drain in the well
head.
These three discharges must either be permitted or eliminated. This office will work with you achieve either
of these options. In order to best advise you, on (b) and (c) above, the Division needs to know exactly what
is discharged from these two pipes and what pollutants may be expected to be in the discharge from these
two pipes.
It is again noted that installation of settling/decanting facilities at this plant may enable Aqua to pipe all three
unauthorized waste streams mentioned above into such facilities and eliminate all three unauthorized
discharges.

Aqua North Carolina Inc, Attn: Thomas J. Roberts, President and COO
Compliance Evaluation Inspection & NOV-2013-PC-0185
Stonington Subdivision — Well #1, NCO088501
May 17, 2013, Page 3 of 3
Documentation Review
All required records were available and in order. No discrepancies were found.
Please respond to this Notice of Violation in writing within 20 business days of its receipt. Your response
must include an action plan and implementation schedule to correct the deficiencies/violations noted above. The
timeliness and content of Aqua's response, as well as the specific actions it takes to remedy the violations noted
above will weigh heavily in our decision of whether to initiate enforcement procedures. You are reminded that, in
accordance with NC General Statute 143-215.6A, the Director of the Division of Water Quality may assess civil
penalties not to exceed $25,000 per day, per violation, for violations of NCGS 143-215.1 or the NCO088501
NPDES permit.
If you have any questions regarding the inspection or this letter, please call Mr. Boone or me at (336) 771-
5000. Thank you for your cooperation in this matter.
Sincerely,
W. Corey Basinger
Surface Water Regional Supervisor
Winston-Salem Regional Office
Division of Water Quality
Attachments:
BIMS Inspection Report
CC: 619MOMWIM
Central Files
NPDES Unit

United States Environmental Protection Agency
Form Approved.
EPA Washington, D.C. 20460 -
OMB No. 2040-0057
Water Crimplianre Inspection Report
Approval expires 8-31-98
Section A: National Data System Coding (i.e., PCS)
Transaction Code NPDES yr/mo/day Inspection Type Inspector Fac Type
1 INI 2 15 I 31 NCO088501 111 121 13/05/14 117 18I r 19I S I 20I I
-!
Remarks
2111111111IIIIIIIIIIIIIIIIIIII IIIIIII1IIIIIIII1116
Inspection Work Days Facility Self -Monitoring Evaluation Rating 131 QA --------------- --------- Reserved —---- _---- __-_----
67I 169 701 I 711 I 72I N I 73' ' 174 751 I I I I I I 180
Section B: Facility Data
Name and Location of Facility Inspected (For Industrial Users discharging to POTW, also include
Entry Time/Date
Permit Effective Date
POTW name and NPDES permit Number)
Stonington Subdivision -Well #1
09:00 AM 13/05/14
09/04/01
Exit Time/Date
Permit Expiration Date
Stonington Way Ct
Kernersville NC 27284
10:00 AM 13/05/14
14/02/28
Name(s) of Onsite Representative(s)/Titles(s)/Phone and Fax Number(s)
Other Facility Data
Not Required/ORC/919-733-0026/
Name, Address of Responsible Official/Title/Phone and Fax Number
Contacted
Laurie Ison,4163 Sinclair St Denver NC 28037/Western Area Manager// Contato
No
Section C: Areas Evaluated During Inspection (Check only those areas evaluated)
Permit 0 Flow Measurement Operations & Maintenance. Records/Reports
Self -Monitoring Program N Facility Site Review Effluent/Receiving Waters Laboratory
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
(See attachment summary)
12-ols
Name(s) and Signature(s) of Inspector(s) Agency/Office/Phone and Fax Numbers Date
Ron Boone WSRO WQ//336-771-4967/
Signature of Management Q A Reviewer Agency/Office/Phone and Fax Numbers' Date
y )
�'I�10 lJt"�:✓'1 �" Y• J'� ����✓{.✓.r.- � ���� ` �JV+fd � �� ���b'<r." -V 6
EPA Form 3560-3 (Rev 9-94)'Previous editions are obsolete.
Page # 1

NPDES yr/mo/day Inspection Type
3I NCO088501 111 12, 13/05/14 . 117
18I d
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
Please refer to the attached inspection summary letter.
Page # 2

Permit: NCO088501 Owner - Facility: Stonington Subdivision - Well #1
Inspection Date: 05/14/2013 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 application? n ONO
Is the facility as described in the permit? ® n n n
# Are there any special conditions for the permit? n ®n
Is access to the plant site restricted to the general public? ® n n n
Is the inspector granted access to all areas for inspection?
■
n
n
n
Comment: Please refer to the attached inspection summary letter.
Record Keeping
Yes
No
NA
NE
Are records kept and maintained as required by the permit?
®
n
n
n
Is all required information readily available, complete and current?
■
❑
n
Are all records maintained for 3 years (lab. reg. required 5 years)?
■
n
n
n
Are analytical results consistent with data reported on DMRs?
®n
n
n
Is the chain -of -custody complete?
®n
n
n
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?
■
n
n
n
Has the facility submitted its annual compliance report to users and DWQ?
n
n
■
n
(If the facility is = or > 5 MGD permitted flow) Do they operate 24/7 with a certified operator on each shift?
n
®
n
n
Is the ORC visitation log available and current?
®
n
n
n
Is the ORC certified at grade equal to or higher than the facility classification?
■
n
n
n
Is the backup operator certified at one grade less or greater than the facility classification?
■
n
n
n
Is a copy of the current NPDES permit available on site?
■
n
n
n
Facility has copy of previous year's Annual Report on file for review?
❑
Q
®
n
Comment: Please refer to the attached inspection .summary letter.
Laboratory Yes No NA NE
Are field parameters performed by certified personnel or laboratory? ® n n n
Page # 3

Permit: NCO088501 Owner - Facility: Stonington Subdivision - Well #1
Inspection Date: 05/14/2013 Inspection Type: Compliance Evaluation
Laboratory
Are all other parameters(excluding field parameters) performed by a certified lab?
# Is the facility using a contract lab?
# Is proper temperature set for sample storage (kept at less than or equal to 6.0 degrees Celsius)?
Incubator (Fecal Coliform) set to 44.5 degrees Celsius+/- 0.2 degrees?
Incubator (BOD) set to 20.0 degrees Celsius +/- 1.0 degrees?
Comment: Please refer to the attached inspection summary letter.
Effluent Sampling
Is composite sampling flow proportional?
Is sample collected below all treatment units?
Is proper volume collected?
Is the tubing clean?
# Is proper temperature set for sample storage (kept at less than or equal to 6.0 degrees Celsius)?
Is the facility sampling performed as required by the permit (frequency, sampling type representative)?
Comment: Please refer to the attached inspection summary letter.
Flow Measurement - Effluent
# 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: 10 GPM flow control valves are used to control effluent flow volume.
Please refer to the attached inspection summary letter.
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?
Comment: Three additional unauthorized discharges are present at the site. This a a
repeat violation. Please refer to the attached inspection summary letter.
Yes No NA NE
®nnn
®nnn
nnn®
0 0 R 0
nn®n
Yes No NA NE
Yes No NA NE
® n n n
nn®n
®nnn
0 0 M 0
Yes No NA NE
Operations & Maintenance Yes No NA NE
Is the plant generally clean with acceptable housekeeping? ® n n n
Does the facility analyze process control parameters, for ex: MLSS, MCRT, Settleable Solids, pH, DO, Sludge n n ® n
Judge, and other that are applicable?
Page # 4

G
Permit: NCO088501 Owner - Facility: Stonington Subdivision - Well #1
Inspection Date: 05/14/2013 Inspection Type: Compliance Evaluation
Operations & Maintenance Yes No NA NE
Comment: Please refer to the attached inspection summary letter.
Page # 5

AQUA.
June 20, 2013
Mr. W. Corey Basinger
Surface Water Regional Supervisor
NCDENR, DWQ
585 Waughtown Street
Winston Salem, NC 27107
Aqua North Carolina, Inc.
202 MacKenan Court
Cary, NC 27511
Re: Stonington Subdivision — Well #1, Forsyth County
Compliance Evaluation Inspection and Notice of Violation
NOV-2013-PC-0185
NPDES Permit # NCO088501
Dear Mr. Basinger:
N.C.Dept. of ENR
JUN 2 4 202
Winston-Salem
Regional Office
Thomas J. Roberts
President and Chief. Operating Officer
T: 919.653.5770
F: 919.460.1788
[e-mail]
www.aquanorthcarolina.com
Aqua North Carolina, Inc. (Aqua) offers the following response for the above -referenced Compliance
Evaluation Inspection and Notice of Violation for the May 14, 2013, inspection.
The discharge pipe is 4" black corrugated plastic pipe, which runs down the hill to the
north of the facility and ends within about 20 feet of the receiving stream; it just lays on
the ground in a heavily vegetated and marshy area and does not actually reach the
receiving stream. There is a significant amount of black staining on the ground all
around the end of the pipe. It is noted that there is no backwash wastewater capture
facility where the wastewater can be captured, settled, and decanted, therefore, all solids
backwashed from the filters are discharged. The substances that are causing the ground
staining are having an obvious localized impact at the end of the pipe. It is unknown
whether or not the substances causing the staining ever actually make it. into the receiving
stream.
Response:
Aqua is following the requirements as specified in the current permit that was issued by
the Division of Water Quality. Dare to the current regulations as codified in Title I5A,
Subchapters 18A and 18C of the North Carolina Administrative Code, Aqua is unable to
install a settling tank for the purpose of removing the expected backwash solids (Fe and
Mn)tithifa�theg1�11Orsiu"� o f ie community wella.
2. It is possible that the discharge, may, exceed_ the TSS limit for at least aportion of the
backwash/discharge cycle, i.e. the TSS concentration in the effluent would be
significantly higher at the beginning of the backwash cycle than the end. In a follow-up
telephone conversation with Mr. Young on May 17, 2013, he stated that the actual filter
backwash cycle lasts about 10 minutes and that lie pulls TSS samples within the first 2 to
3 minutes; this would appear to be sufficient. The sampling practice employed at the
An Aqua America Company

facility was also mentioned in the Notice of Violation (NOV) that Aqua was issued as a
result of the previous inspection on January 27, 2011 (NOV-2011-PC-0084). Aqua is
reminded that Part II, Section D, Paragraph 1 of NC0088501 states:
Samples collected and measurements taken, as required herein, shall be characteristic of
the volume and nature of the permitted discharge. Samples collected at a frequency less
than daily shall be taken on a day and time that is characteristic of the discharge over the
entire period the sample represents. All samples shall betaken at the monitoring points
specified in this permit and, unless otherwise specified, before the effluent joins or is
diluted by any other waste stream, body of water, or substance. Monitoring points shall
not be changed without notification to and the approval of the Permit Issuing Authority
[40 CFR,122.410)J.
With the current configuration it is difficult to identify a specific point at which the
samples would be most representative. It is noted that a wastewater capturing, settling,
and decanting facility would possibly be very effective at eliminating the loss of solids in
the discharge, the ground staining at the end of the discharge pipe, and would also
provide for much more consistent TSS concentration in the discharge.
Response:
Aqua has met with the On -site Water Protection Section and plans to coordinate a
meeting with the Public Water Supply Section and the Division of Water Quality to
discuss the issues that your office has raised. At this time, we will continue to operate the
filters and their respective backwash/sampling as per our current permit.
As was also addressed in the NOV Aqua was issued as a result of the 2011 inspection,
there still exists an unauthorized discharge at the facility. There are actually three
separate unauthorized discharges from the facility, as follows:
a. There is a four -inch PVC pipe on the northwest corner of the facility that
discharges the drainage from a floor drain inside the plant. During this
inspection, as was also the case during the 2011 inspection, there was a
significant amount of spilled Potassium Permanganate on the floor of the facility,
which was flowing into the floor drain and was being discharged from this four -
inch PVC pipe. In its written response to the 2011 NOV, Aqua stated that they
would "...evaluate purchasing spill containment tubs to place under the
Potassium Permanganate barrels." At the time of this inspection, no containment
tubs were present.
b. There is a two-inch PVC pipe that comes out the northern wall of the facility,
runs parallel to the buried "authorized" discharge pipe, and ends at the top of the
hill. According to Mr. Young this is a well blow -off.
C. There is another two-inch PVC pipe that, according to Mr. Young, drains a floor
drain in the well head.
These three discharges must either be permitted or eliminated. This office will work with
you to achieve either of these options. In order to best advise you, on (b) and (c) above,
the Division needs to know exactly what is discharged from these two pipes and what
pollutants may be expected to be in the discharge from these two pipes.
It is again noted that installation of settling/decanting facilities at this plant may enable
Aqua to pipe all three unauthorized waste streams mentioned above into such facilities
and eliminate all three unauthorized discharges.

Response:
(a) Aqua is installing an overflow container to recycle any KA4nO4 that may be lost and,
therefore, it will not be possible to enter the floor drain.
(b) The Public Water Supply Section requires that the site be equipped with a way to
blow -off either the well and/or the water tank. This water is piped away from the well
house to avoid standing water near the well.
(c) The Public Water Supply Section requires that the well house and/or treatment facility
be equipped with a floor drain. Typically, a floor drain(s) is used to allow water to drain
outside of the well house during instances of water sampling and/or clean up of the well
house floor.
If you have any questions or comments, please do not hesitate to contact Laurie Ison at [phone],
Ext. 57234 or Jack Lihvarcik at [phone].
Sine y,
Thomas J. Rob s
President and COO
TJR/rl
cc: Laurie Ison
Michael Melton
Jack Lihvarcik

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Boone, Ron
From: Basinger, Corey
Sent: Monday, July 01, 2013 10:56 AM
To: Boone, Ron
Subject: RE: Stonington Subdivision
I will talk with Lisa Edwards and maybe set up a meeting with them to discuss.
Will keep you posted.
CB
W. Corey Basinger
Regional Supervisor
Surface Water Protection Section
Winston-Salem Regional Office
Division of Water Quality
Email: [e-mail]
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: Boone, Ron
Sent: Monday, July 01, 2013 10:52 AM
To: Basinger, Corey
Subject: FW: Stonington Subdivision
Corey,
Permit expires 2/28/14. Should we wait till rewrite to address these issues, or do we need to get a head start on this?
Since none of the three discharges can be deemed permitted, I see no choice but to permit or eliminate them. I also
think they should have the settling basin/lagoon there, but not sure if/how we can require it, given their historical level
of compliance on the TSS parameter... then again, we know the issue with TSS being higher at the beginning of the
backwash cycle.
In addition to Tammy's statement below, that they can require larger setbacks, Tom told me verbally that they can also
provide special variances to lessen the setback requirements ... it all depends.
Let me know what you think our next step is on this issue. I don't feel comfortable with their response. I think they're
just hoping the issue will just go away.
Ron
Ron Boone
NC DENR Winston-Salem Regional Office
Division of Water Quality, Surface Water Protection
585 Waughtown Street

Winston-Salem, NC 27107
Email: [e-mail]
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: Taylor, Tammy
Sent: Thursday, June 27, 2013 3:45 PM
To: Boone, Ron; Boyd, Tom
Cc: Basinger, Corey; Edwards, Lisa
Subject: RE: Stonington Subdivision
Ro n,
The answer to your questions are as follows:
1) Well site requirements are outlined in 15A NCAC 18C .0203 (copy attached). Normally, the distance
requirements are a 100-foot pollution free radius from the well head. This office can require greater setbacks
depending on different sources of pollution.
2) 1 have not been contacted concerning a meeting with Aqua North Carolina, Incorporated.
3) Floor drains are required as outlined in 15A NCAC 18C .0402 and 15A NCAC 18C .0404 - (copies attached).
4) A waste discharge pipe is required as outlined in 15A NCAC 18C .0402 (copy attached).
I have highlighted the portions of the rules that pertain to your questions. If I can be of further assistance, please
contact me. Thank you!
Tammy Taylor
NC DENR Winston-Salem Regional Office
Division of Water Resources
Public Water Supply Section
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: Boone, Ron
Sent: Thursday, June 27, 2013 7:40 AM
To: Boyd, Tom; Taylor, Tammy
Cc: Basinger, Corey
Subject: RE: Stonington Subdivision
Tammy,
I recently did an inspection at Stonington for their discharge permit. The primary issue(s) are:

1. The discharge of backwash water laden with solids to the stream;
2. An unpermitted discharge pipe connected to a floor drain inside the treatment building (which, at times,
drains spilled potassium permanganate from inside the building);
3. An unpermitted discharge pipe connected to a well blow off,
4. An unpermitted discharge pipe connected to a floor drain inside the well head; and,
5. The timing of the sampling of the effluent— i.e. there are more solids in the effluent at the beginning of the
backwash cycle than at the end.
As harmless as these discharges may appear, the fact is that they are unpermitted and can neither be deemed permitted
in accordance with our rules. Therefore, our letter suggested a settling basin, of some type, to be installed to capture all
these waste streams and at least trap and decant the solids, thereby preventing their discharge to the stream. It was
only a suggestion. In the end, we will have to agree to a long term fix for these issues.
The questions we had for you are:
1. Aqua states in their written response that IAW 15A, Chapters 18A and 18C, they cannot install such a settling
basin within 100' of the well head — can you confirm this requirement;
2. Aqua states in their written response that they will coordinate a meeting between themselves, PWS, and DWQ,
to discuss the matters raised in this latest inspection — have they contacted you about a meeting?
3. Aqua states in their written response that PWS requires the well house and treatment facility to have floor
drains — can you confirm this?
4. Aqua states in their written response that PWS requires that the site be equipped with a way to blow -off either
the well and/or the water tank — can you confirm this?
I am unsure whether a meeting between all of us is required at this time or not. The only way we can address these
issues is to reopen the permit for modification (I think). That doesn't mean that we won't meet with them though, if
they so desire.
If you could just answer the four questions above for now, that would be great! Thanks in advance for your assistance
and for the map you provided.
Regards,
Ron Boone
NC DENR Winston-Salem Regional Office
Division of Water Quality, Surface Water Protection
585 Waughtown Street
Winston-Salem, NC 27107
Email: [e-mail]
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: Boyd, Tom
Sent: Wednesday, June 26, 2013 4:32 PM
To: Taylor, Tammy
Cc: Boone, Ron
Subject: Stonington Subdivision

Tammy,
Ron Boone with DWQ has some questions concerning Stonington Subdivision (NCO234196). Does AQUA own enough
land outside of the 100 foot well buffer to house some type of tank for the greensand filter discharge.
Thanks,
Tom Boyd
Environmental Senior Specialist
NC DENR Winston-Salem Regional Office
Division of Water Resources, Public Water Supply Section
585 Waughtown Street
Winston-Salem, NC 27107
Voice [phone]
FAX [phone]
E-mail correspondence to and from this address is 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.
4

North (,arolina Division of Environmental Health
�l Terry L. Pierce, Director
Public Water Supply Section
Division of
Environmental Health Jessica G. Miles, Section Chief
Mr. Gary Moseley, Regional Manager
Aqua North Carolina
4163 Sinclair Street
Denver, North Carolina 28037
Dear Mr. Moseley:
January 9, 2008
State of North Carolina
Michael F. Easley, Governor
Department of Environment
and Natural Resources
William G. Ross, Secretary
RECE!l'LD
N.C. Dept. of ENE
i k�'`L 4 ff
���: : F ��t9Ct
Frl�insion-saiem
Regiona! Office
Re: Engineering Plans and Specifications Approval
As -Built Plans
Stonington Subdivision Well # 1 Improvements
Forsyth County
I.D. # 02-34-196
This is not an Authorization to Construct
Enclosed please find one copy of the "Application for Approval..." together with one copy of the referenced
engineering as -built plans and specifications bearing the Division of Environmental Health stamp of approval for the
engineeringrpfPrearedproject These as -built plans and specifications are approved under Division of Environmental Health
serial number 07-02191, dated January 4, 2008.
Engineering as -built plans and specifications prepared by William G. Langley, P.E.., depict the installation of a new
well house with five (5) 4 gpm each manganese greensand filters with potassium permanganate feed system, one 5,400 gallon
ASME coded hydropneumatic tank with air compressor and apparatus, liquid chlorine and caustic chemical feed system,
piping, valves and other apparatus at the existing Well # 1. Filters backwash discharge is permitted under NPDES NC
0088501 at a point 100 feet away from the well head.
These plans and specifications in the foregoing application are approved insofar as the protection of public health is
concerned as provided in the rules, standards and criteria adopted under the authority of Chapter 130A-317 of the General Statues.
This approval does not constitute a warranty of the design, construction or future operation of the water system.
One copy of each enclosed document is being forwarded to our Winston-Salem Regional Office. The third copy is
being retained in our permanent files.
If Public Water Supply can be of further service, please call [phone].
Review
Technical Services Branch
TCC/db
Enclosures: Approval Documents
cc: Lee G. Spencer, Regional Engineer
Forsyth County Health Department
William G. Langley, P.E.
Utilities Commission -Water Division
1634 Mail Service Center, Raleigh, North Carolina 27699-1634
Telephone [phone] ♦ Fax [phone] ♦ Lab Form Fax [phone]
http://ncdrinkirigwater.state.nc.us/
NorthCarolina
Natmallrf
An Equal Opportunity / Affirmative Action Employer

` + 9 91a
g
K
Division of
Environmental Health
GARY MOSELEY
4163 SINCLAIR STREET,
DENVER, NC 28037
Dear Applicant:
Division of Environmental Health
Terry L. Pierce, Director
Public Water Supply Section .
Jessica G. Miles, Section Chief
January 8, 2008
State of North Carolina
Michael F. Easley, Governor
Department of Envii'onrnent and
Natural Resources
William G. Ross, Secretary
Re: Authorization to construct L
STONINGTON S/D
STONINGTON S/D
FORSYTH County, NCO234196
Authorization to Construct (This is not a Final Approval) .
N.C. Dept. of ENK
Regional Office
This letter is to confirm that a complete Engineer's Report and a Water System Management Plan have been
received, and that engineering plans and specifications have been approved by the Department for STONINGTON
S/D, DEH Serial No. 07-02191.
The Authorization to Construct is valid for 24 months from the date of this letter. -Authorization to Construct
may be extended if the Rules Governing Public Water Supplies and site conditions have not changed (see Rule
.0305). The Authorization to Construct and the engineering plans and specifications approval letter shall be
posted at the primary entrance of the job site before and during construction.
Upon completion of the construction or modification, and prior to placing the new construction or
modification into service, the applicant must submit an Engineer's Certification and Applicant Certification
directly to TONY CHEN of this office.
Engineer Certification: in accordance with Rule .0303 (a), the applicant shall submit a certification
statement signed and sealed by a registered professional engineer stating that construction was
completed in accordance with approved engineering plans and specifications, including any provisions
stipulated in the Department's engineering plan and specification approval letter.
Applicant Certification: in accordance with Rule .0303 (c), the applicant shall submit a signed
certification statement indicating that the requirements for an Operation and Maintenance Plan and
Emergency Management Plan have been satisfied in accordance with Rule .0307 (d) and (e) and that the
system has a certified operator in accordance with Rule. 1300. The "Applicant Certification" form is
available at h.ttp://www.deh.enr.state.nc.us/pws/ (click on WSMPS, under Plan Review heading).
If this Authorization to Construct is for a new public water system, the owner must submit a completed
application for an Operating Permit and the appropriate fee. For a copy of the application for an Operating
Permit please call [phone].
Once the certifications and permit application and fee, (if applicable), are received and determined adequate,
the Department will issue a Final Approval letter to the applicant. In accordance with Rule .0309 (a), no portion
of this project shall be placed into service until the Department has issued Final Approval.
If we can be of further assistance, please call [phone].
TCC:TCC
cc: LEE G. SPENCER, P.E., Regional Engineer
LANGLEY ENGINEERING PC
Sincerely,
Tony C. Chen, P.E.
Technical Services Branch
Public Water Supply Section
1634 Mail Service Center, Raleigh, North Carolina 27699-1634
Telephone [phone] ♦ Fax [phone] ♦ Lab Form Fax [phone]
http://ncdrinkingwater.state.nc.us/
An EDual ODDortunity / Affirmative Antinn Fmnlnvar
NorthCarohna
vaturalltf

NCDENR
State of North Carolina
Department of Environment and Natural Resources
Division of Environmental Health
Public Water System. Authorization to Construct
Public Water System Name r STONINGTON S/D
and PWS.ID No. (if available): NCO234196
Project Name:
DEH Serial No.
Issue Date:
Expiration Date:
STONINGTON S/D
07-02191
1 /7/2008
24 months after Issue Date
In accordance with NCAC 18C .0305, this Authorization to Construct must be posted for inspection
at the primary entrance to the job site during construction.
North Carolina
Division of
Environmental Health

A -A"
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Environmental Health
Beverly Eaves Perdue Terry L. Pierce Dee Freeman
Governor Director Secretary
March 30, 2009 --
RECEIVED
N.C. Dept. of ENR I
GARY MOSELEY
4163 SINCLAIR STREET I `APR 0 12009
DENVER, NC 28037 j Winston-Salerrr
ii Regional Office J
Re: Final Approval
Final Approval Date: 3/30/2009
STONINGTON S/D
DEH Serial 407-02191
PWSID # NCO234196
FORSYTH COUNTY
Dear Sir/Madam:
The Department received an engineer's certification statement and an applicant's certification statement
concerning the above referenced project. The engineer's certification verifies that the construction of the referenced
project has been completed in accordance with the engineering plans and specifications approved under Department Serial
Number 07-02191. The applicant's certification verifies that an Operation and Maintenance Plan and Emergency
Management Plan have been completed and are accessible to the operator on duty at all times and available to the
Department upon request and that the system will have a certified operator as required by 15A NCAC I8C .1300.
The Department has determined that the requirements specified in 15A NCAC 18C .0303(a) and (c) have been
met and, therefore, issues this Final Approval in accordance with Rule .0309(a).
If Public Water Supply can be of further service, please call [phone].
Eft � wr r14l
Tony C. Chen, P.E.
Technical Services Branch
Public Water Supply Section
TCC:TCC
cc: LEE G. SPENCER, P.E., REGIONAL ENGINEER
FORSYTH COUNTY HEALTH DEPARTMENT
LANGLEY ENGINEERING PC
Public Water Supply Section — Jessica G. Miles, Chief
1634 Mail Service Center, Raleigh, North Carolina 27699-1634
Phone: [phone] FAX: [phone] Lab Form FAX: [phone] Internet: ncdrinkingwater.statanc.us
An Equal Opportunity 1 Affirmative Action Employer
One -
NorthCarolina
Naturally

i
r
October 14, 2013
N.C.Dept. of ENR
3 OCT 14 2013
Ln' Winston-Salem
Reaional Office
Aqua North Carolina,
202 MacKenan Court
Cary, NC 27511
N.C. Department of Environment and Natural Resources
Division of Water Quality / NPDES Unit
1617 Mail Service Center
Raleigh, NC 27699-0167
Re: Application for Permit Renewal
Aqua North Carolina, Inc.
Stonington Subdivision Well #1 WTP
NPDES No. NCO088501
Forsyth County
Gentlemen:
W5 0
Thomas J. Roberts
President and Chief Operating Officer
T:919.653.5770
F: 919.460.1788
[e-mail]
www.aquanoTthcarolina.com
OCT 2 2 2013
NUJ
Enclosed are three (3) copies of the completed application Short Form C-WTP. This submittal includes
the necessary attachments for your office to renew the subject'pennit.
If you need any additional information or assistance, please contact Michael Melton, Regional
Compliance Manager at 704-489-9404, Ext 57238 or email at mameltongaq_uaainerica.corn:
An Aqua America Company

NPDES PERMIT APPLICATION - SNORT FORM C - WTP
For discharges associated with water treatment plants
Mail the complete application to:
N. C. Department of Environment and Natural Resources
Division of Water Quality / NPDES Unit
1617 Mail Service Center, Raleigh, NC 27699-1617
NPDES Permit Number INCO088501
If you are completing this form in computer use the TAB key or the up - down arrows to move from one
field to the next. To check the boxes, click your mouse on top of the box. Otherwise, please print or type.
1. Contact Information:
Owner Name Aqua North Carolina, Inc.
Facility Name Stonington Subdivision - Well # 1 WTP
Mailing Address 202 Mackenan Ct
City Cary
State / Zip Code NC/27511
Telephone Number [phone]
Fax Number [phone]
e-mail Address [e-mail]
2. Location of facility producing discharge:
Check here if same as above ❑
Street Address or State Road Stonington Way Court
City
State / Zip Code
County
Kernersville
NC/ 27284
Forsyth
3. Operator Information:
Name of the firm, consultant or other entity that operates the facility. (Note that this is not referring to the
Operator in Responsible Charge or ORC)
Name Aqua North Carolina, Inc.
Mailing Address 4163 Sinclair Street
City Denver
State / Zip Code NC / 28037
Telephone Number [phone]
Fax Number [phone]
Pagel of 4 Version 5/2012

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

NPDES PERMIT APPLICATION - SHORT FORM C - WT-P
For discharges associated with water treatment plants
13. Please list all water treatment additives, including cleaning chemicals or disinfection
treatments, that have the potential to be discharged.
Alum / aluminum sulfate Yes No X
Iron sulfate / ferrous sulfate Yes No X
Fluoride Yes No X
Ammonia nitrogen / Chloramines Yes No %
Zinc -orthophosphate or sweetwater CP1236 Yes No X
List any other additives below:
Chlorine
Potassium Permanganate
Caustic Soda
14. Is this facility located on Indian country? (check one)
Yes ❑
15. Additional Information:
Provide a schematic of flow through the facility, include flow volumes at all points in
the water treatment process. The plan should show the point[s] of addition for
chemicals and all discharges routed to an outfall [including stormwater].
Solids Handling Plan
16. NEW Applicants
Information needed in addition to items 1-15:
New applicants must contact a permit coordinator with the NCDENR Customer
Service Center.
Was the Customer Service Center contacted? ❑ Yes ❑ No
Analyses of source water collected
Engineering -Alternative Analysis
Discharges from Ion Exchange and Reverse Osmosis plants shall be evaluated using a
water quality model.
17. Applicant Certification
I certify that I am familiar with the information contained in the application and that to the
best of my knowledge and belief such information is true, complete, and accurate.
Aqua North Carolina, Inc.
Signature of
North Carolina General Statute 143-215.6 (b)(2) provides that: Any person who knowingly makes any false statement representation, or certification in any application,
record, report, plan, or other document -files or required to be maintained under Article 21 or regulations of the Environmental Management Commission implementing that
Article, or who falsifies, tampers with, or knowingly renders inaccurate any recording or monitoring device or method required to be operated or maintained under Article 21 or
regulations of the Environmental Management Commission implementing that Article, shall be guilty of a misdemeanor punishable by a fine not to exceed $25,000, or by
Page 3 of 4 Version 5/2012

NPDES PERMIT APPLICATION - SHORT FORM C - WTP
For discharges associated with water treatment plants
imprisonment not to exceed six months, or by both. (18 U.S.C. Section 1001 provides a punishment by a fine of not more than $25,000 or imprisonment not more than 5
years, or both, for a similar offense.)
Page 4 of 4 Version 5/2012

11
Outfall001
•I
I.
n
,
ll• '1
•
I
t1.111••.111 l II- � �` i .. I= . ,_ j. , ..
fir•"-
•
Aqua North Carolina, Inc
Stonington Subdivision Well #1-WTP
Latitude: 36' 02' 05" N State Grid: Kemersville
Longitude: 801040' 32" W -Permitted Flow: 0.0021 MGD
Receiving Stream: UT to Abbotts Creek Stream Class: WS-II I
Drainage Basin: Yadkin -Pee Dee River Basin Sub -Basin: 03.07-07
` Facility
j Location
not to scale
r
North NPDES Permit No. NCOO88501
Forsyth County

Z44242
MCDENR
Forth Carolina Department of.Environment and Natural Resources
Division of Water Resources
Pat McCrory Thomas A. Reeder John E. Skvarla, III
Governor Acting Director Secretary
August 15, 2013
Thomas J. Roberts, President
Aqua North Carolina Inc
202 Mackenan Ct
Cary NC 27511
Subject: NOTICE OF VIOLATION
NOV-2013-LV-0472
Permit No. NCO088501
Stonington Subdivision - Well #1
Forsyth County
Dear Mr. Roberts:
A review of Stonington Subdivision - Well #1's monitoring report for May 2013 showed the following.
violations:
Parameter
Date
Limit Value
Reported Value
Limit Type
Solids, Total Suspended -
05/29/13
45 mg/I
58 mg /I
Daily Maximum
Concentration
Exceeded
Solidsjotal Suspended -
05/31/13
30 mg/I
32.2 mg/1
Monthly Average
Concentration
Exceeded
Remedial actions, if not already implemented, should be taken to correct the above noncompliance
problem(s). Please be aware that violations of your NPDES permit could result in enforcement action by
the Division of Water Quality for this and any additional violations of State law.
If you should have any questions, please do not hesitate to contact Ron Boone at [phone].
Sincerely,
cc: SWP — Central Files
. SRDOO]F'le�_ s�
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
d
W. Corey Basinger
Surface Water Regional Supervisor
Winston-Salem Regional Office
Division of Water Resources
NatmIrmily
One
Noft lCarolina,
An Equal Opportunity \ Affirmative Action Employer

DMR Review Record
Facility: Stonington Subdivision Well #1 Permit No.: 88501 Pipe No.
Monthly Average Violations
Parameter Permit Limit DMR Value
TSS 30 32.2
Date
5/29/13
Parameter
TSS
Date Parameter
Other Violations/Staff Remarks: NONE
1pleted by:
Ron Boone
Weekly/Daily Violations
Permit Limit Limit Type DMR Value
45 Daily Max 58
Monitoring Frequency Violations
Permit Frequency Values Reported
yntena
Failure to monitor parameter with limit: $50
Failure to monitor parameter without limits: $25
Any facility with just a single daily max violation to receive NOV only.
No civil assessment cases for less than $100, not including cost of investigation. NOV only.
Threshold for flow is 10%; threshold for all other parameters is 20%.
Stipulated demand letters for SOCs..... automatic.
Failure to obtain a permit ..... $4,000.
001 MonthNear:
05/2013
% Over Limit
Action
7.33
#DIV/0!
#DIV/0!
#DIV/0!
% Over Limit
Action
28.89
#DIV/0!
#DIV/0!
#DIV/0!
# of Violations
Action
Date
8/14/13
Multipliers:
Number of assessments for previous 12 months:
0-2 Multiply base penalty by 1.0
3-5 Multiply base penalty by 1.25
6-8 Multiply base penalty by 1.5
9-12 Multiply base penalty by 2.0
Delgated Fast Track Penalties/Base Penalty Amounts:
DMR Monthly Flow Avg
Monthly Average
Weekly Average
Daily Max
:50.05 MGD---------
$0-500
$0-200
$0-200
>0.05 but <0.1 MGD
$0-1,000
$0-500
$0-200
>0.1 but <0.5 MGD
$0-1,500
$0-500
$0-500
>_0.5 but <1.0 MGD
$0-2,000
$0-500
$0-500
>1.0 but <10.0 MGD
$0-3,000
$0-1,000
$0-500
>10.0 but <25.0 MGD
$0-4,000
$0-1,000
$0-500
>_25.0 MGD
$0-5,000
$0-1,000
$0-500
Remarks:
ADV-2b16lLU- 0q7,�
Regional Water Quality
Supervisor Sign Off: Date: ,�

U k
January 25, 2012
Point Source Branch
Surface Water Protection Section
Division of Water Quality
1617 Mail Service Center
Raleigh, NC 27699-1617
N.0 Dcpt. ol' 0�'4R
"AN 3 R 201,Z
Nnston-Snlern
i2eaional CmSce
Re: Delegation of Signature Authority
To Whom It May Concern:
Aqua North Carolina, Inc.
202 MacKenan Court
Cary, NC 27511
t
Thomas J. Roberts
President and Chief Operating Officer
T: 919.653.5770
F: 919.460.1788
[e-mail]
www.aquanorthcarolina.com
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 on the
attached list 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
Thomas J. Roberts
President and COO
Jack Lihvarcik
Operations Manager
Robert Ashley
Regional Supervisor
Matthew Costner
Regional Supervisor
Larry Finnicum
Area Manager
Michael Melton
Regional Manager of Compliance
Duane Rimmer
Regional Supervisor
If you have any questions regarding this letter, please feel free to contact me at 919-653-5770.
Sin
Thomas J. R/berts
President and COO
cc: Winston Salem Regional Office, DWQ
Mooresville Regional Office, DWQ
NC60 9,116
Grevsiot�E
NC00( 1'7;ZCt
N C en �, �� r i
rrl i IC Y p! 17 a, ', �.
Q
An Aqua America Company

Permit No.
Facility
County
NC0028746
Briarwood SD WWTP
Stokes
NC00S3720
Forest Ride WWTP
Forsyth
NC0065587
Frye Bride WWTP
Forsyth
NC0078115
Gre stone SD WWTP
Forsyth
NC0050792
Melbille Hei hts WWTP
Rndl h
NC0067091
Mikkola Downs WWTP
Forsyth
NC0078158
Olde Beau GC WWTP
AI hn
NC0055191
Penman Heights WWTP
Rndl h
NC0083925
Salem Glen SD WWTP
Dvdsn
NC0083933
Salem Quarters
Forsyth
NC0083941
Spring Creek WWTP
Dvdsn
NC0084409
Wellesley Place WWTP
Forsyth
NC0034452
Willow Creek WWTP
Dvdsn
NC0088536
Bannertown Hills W#2
Surry
NC0088552
Colonial Wds - W#2
Surr
NC0088552
Colonial Wds-W 1
Surry
NC0088528
H111crest SD - Well #3
Surry
NC0088498
Mitchel Bluff - Well 41
Surry
NC0088854
Pine Lks W 2
Surry
NC0088633
Reeves Wds W #2
Surry
NC0088617
Snow Hill SD
� Sur _
IWCORK-50i1��''S
omi ton SCE - Wel 1
Fors th'w
Surr
NC0088625
The Hollows SD
NC0088609
Wind ate SD
Surry
NC0065749
Ashe Plantation WWTP
Mklb
WQ0024694
Bri h s Crk WWT RWUS
Polk
NC00656B4
Country Wood WWTP
Union
NC0063860
Harbor Estates WW P
Mklb
NC0063789
Mint Hill Festival WWTP
Mklb
NC0063584
Oxford Glen WWTP
Mklb
NC0073539
Willowbrook SD WWTP
Mklb
NC0072061
Fox Run WTP
Gaston
NC0084468
Keltic Meadows WTP #2
Gaston
NC0086193
Ma lecresl WTP
Gaston
NC0086142
-Oaklev Park 1
Gaston
NC0086142
Oakley Park 2
Gaston
NC0069035
South ate WTP
Gaston
NC0075205
Alexander Island WVffP
Iredell
NC0056154
Brid e ort WWTP
Iredell
NC0058742
CotintFv V2118V WWTP
Catawba
NC0074772
Diamond Head WWTP
Iredell
NC0074900
Highway 150 WWTP
Iredell
NC0063355
Killian roads WWTP
Catawba
NC0062481
Mallard Head WWTP
Iredell
NC0028941
Pine V@IIev SD WWTP
Rowan
NC0060593
Spinnaker Bay WWTP
Catawba
NC0080691
Windemere WWTP
Iredell

' 4- -.-!-
O U
I- North Carolina_
February 2, 2011
NC Division of Water Quality
Attn: W. Corey Basinger
Surface Water Protection Section
585 Waughtown St.
Winston-Salem, N.C. 27107
Subject: Compliance Evaluation Inspection (CEI) with
Notice of Violation (NOV)
Stonington Subdivision — Well # 1
Permit No. NCO088401
Forsyth County
Aqua North Carolina, Inc. T: 919.467.8712
202 MacKenan Court F: 919.460.1788
Cary, NC 27519 www.aquanorthcarolina.com
RECEIVED
N.C. Deot. of ENR
MAR 0 t 2011
Winston-Salem
Regional Office
This letter is in response to the Compliance Evaluation Inspection (CEI) performed on January 27, 2011
at the referenced wastewater facility owned by Aqua North Carolina, Inc. (Aqua). The following
addresses the comments of your letter.
Site Review
Mr. Young currently collects the discharge sample out of the de -chlorination box at the point
during backwash events when the least amount of solids is expected. This is not considered
representative as the backwash event actually consists of several cycles during which the levels of
solids in the backwash vary greatly, depending on the particular cycle. The samples being pulled
must be representative of the effluent during the backwash cycle in which the highest
concentration of solids would be expected. This would be representative of the actual pollutants
this system discharges during a backwash event. The current practice is a violation of Part 11,
Section D, of the permit.
Response:
Aqua will begin collecting the sample earlier in the backwash cycle.
2. There are five greensand filters at the plant and there are two backwash cycles that alternate
days; on one day, three of the five backwashes and the next day the remaining two filters
backwash. Backwash flow/volume is controlled via 10 GPM flow restriction valves. According
to the operator, during a single complete backwash cycle, each filter generates 300 gallons of
backwash effluent. So, on the days that three filters backwash, the total flow should be 900
gallons and the days that the two filters backwash the total flow should be 600 gallons. Up to this
point, the flows for these cycles have been reported on discharge monitoring reports (DMR) as
900 (for the three) and 300 (for the two filters). This was discussed with the operator and he
stated he would double check the engineer and begin reporting the correct total daily discharge
flow volumes accordingly. No flow meter is actually used.

r
Response:
Our regional supervisor has spoken to the Facility Operator (FO) about this matter, and he will
correct the reporting on future reports.
There are four containers of approximately 30 gallons of Potassium Permanganate, which is used
to regenerate the filters during a backwash event. Significant leakage from at least one of these
containers was occurring during the inspection and has taken place in the past as evidence by
significant staining of the concrete floor beneath the containers. Chemical leakage goes directly
into a floor drain, which then goes outside and discharges on the hillside going down toward the
stream. There was some staining present on the ground and leaves at the discharge end of the
pipe during the inspection. This is considered an illegal discharge. This office suggests that you
plug the floor drain and/or use spill containment pallets for the Potassium Permanganate, Sodium
Hydroxide, and Caustic Soda. AGAIN WHEN SPILLED CHEMICALS ARE DISCHARGED
VIA THIS FLOOR DRAIN INTO THE ENVIRONMENT, IT IS CONSIDERED AN ILLEGAL
DISCHARGE AND YOU MUST ADDRESS THIS SITUATION IMMEDIATELY.
Response:
Aqua will evaluate purchasing spill containment tubs to place under the potassium permanganate
barrels.
If you have any comments or concerns, please Dennis Francum at [phone], extension 57243.
President and Chief Operating Officer
Aqua North Carolina, Inc.
cc: Michael A. Melton, Aqua NC
Billy Young-ORC, Aqua NC

A4
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
February 9th, 2011
Aqua North Carolina Inc. CERTIFIED MAIL
Attn: Thomas J. Roberts, President RETURN RECEIPT REQUESTED
202 Mackenan Drive 7008-3230-0003-2547-2361
Cary, NC 27511
Subject: Compliance Evaluation Inspection & Notice of Violation
NOV-201 1 -PC-0084
Permittee: Aqua North Carolina Inc.
Facility: Stonington Subdivision — Well #1
NPDES Permit #: NCO088501
Forsyth County
Dear Mr. Roberts:
Mr. Ron Boone of the Winston-Salem Regional Office of the NC Division of Water
Quality (DWQ or the Division) conducted a compliance evaluation inspection (CEI) of the
Stonington Subdivision — Well #1 on January 27th, 2011. The assistance and cooperation of
Mr. Billy Young, system operator, was greatly appreciated. An inspection checklist is attached
for your records and inspection findings are summarized below..
General Information
The Stonington Subdivision — Well #1 is located on the north side of Stonington
Subdivision, in Kernersville, Forsyth County, NC, at approximate coordinates 36.034672°N,
80.0760490W. The permit authorizes you to operate this 0.0021 MGD facility, which consists
of five green sand filters used to treat ground water for use as potable water for the
subdivision. Chemicals used during the process include Potassium Permanganate, Chlorine,
and Caustic Soda. The permit authorizes you to discharge the filter backwash wastewater to
an unnamed tributary to Abbotts Creek, which is currently classified as Class WS-III waters in
the Yadkin Pee Dee River basin via outfall 001.
Site Review
Mr. Young has done a good job operating and maintaining the plant using the resources
that are available to him. However, there are some issues as noted below:
1. Mr. Young currently collects the discharge sample out of the dechlorination box at a
point during backwash events when the least amount of solids are expected. This is not
considered representative as the backwash event actually consists of several cycles
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 yra//'y
atu
An Equal Opportunity \Affirmative Action Employer V i "

Aqua North Carolina Inc.
Attn: Thomas J. Roberts, President
Compliance Evaluation Inspection &
Notice of Violation NOV-201 1 -PC-0084
NC0088501, Stonington Subdivision —Well #1
Page 2 of 3, February 71", 2011
during which the levels of solids in the backwash wastewater vary greatly, depending on
the particular cycle. The samples being pulled must be representative of the effluent
during the backwash cycle in which the highest concentration of solids would be
expected. This would be representative of the actual pollutants this system discharges
during a backwash event. The current practice is a violation of Part Il, Section D, of the
permit.
2. There are five green sand filters at the plant and there are two backwash cycles that
alternate days; on one day, three of the five filters backwash and on the next day the
remaining two filters backwash. Backwash flow/volume is controlled via 10GPM flow
restriction valves. According to the operator, during a single complete backwash cycle,
each filter generates 300 gallons of backwash effluent. So, on the days that three filters
backwash, the total flow should be 900 gallons and on the days that the two filters
backwash the total flow should be 600 gallons. Up to this point, the flows for these
cycles have been reported on discharge monitoring reports (DMR) as 900 (for the three
filters) and 300 (for the two filters). This was discussed with the operator and he stated
he would double check with the engineers and begin reporting the correct total daily
discharge flow volumes accordingly. No flow meter is actually used.
3. There are four containers of approximately 30 gallons of Potassium Permanganate,
which is used to regenerate the filters during a backwash event. Significant leakage
from at least one of these containers was occurring during the inspection and has taken
place in the past as evidenced by significant staining of the concrete floor beneath the
containers. Chemical leakage goes directly into a floor drain, which then goes outside
and discharges on the hillside going down toward the stream. There was some staining
present on the ground and leaves at the discharge end of the pipe during the inspection.
This is considered an illegal discharge. This office suggests that you plug the floor drain
and/or use spill containment pallets for the Potassium Permanganate, Sodium
Hydroxide, and Caustic Soda. AGAIN, WHEN SPILLED CHEMICALS ARE
DISCHARGED VIA THIS FLOOR DRAIN INTO THE ENVIRONMENT, IT IS
CONSIDERED AN ILLEGAL DISCHARGE AND YOU MUST ADDRESS THIS
SITUATION IMMEDIATELY.
Mr. Boone noted no other discrepancies or violations.
Documentation Review
Mr. Young did not have all the required records during the inspection, including a
current copy of the NPDES permit and field lab certification, discharge monitoring reports,
chains of custody, laboratory records, field lab bench sheets, calibration records, and operator
visitation and operation logs. Mr. Boone met with Mr. Young at a later date to review these
records. All required records were reviewed at that time and were found to meet requirements.

Aqua North Carolina Inc.
Attn: Thomas J. Roberts, President
Compliance Evaluation Inspection &
Notice of Violation NOV. 2011 -PC-0084
NC0088501, Stonington Subdivision —Well #1
Page 3 of 3, February 71h, 2011
Please respond to this letter in writing within 20 days of receiving it. Your response
must include an action plan and implementation schedule to correct all the
deficiencies/violations noted above in the enumerated paragraphs 1 through 3. Failure to
respond as required within this specified timeframe will likely result in further enforcement
actions.
You are reminded that, in accordance with NC General Statute 143-215.6A, the Director
of the Division of Water Quality may assess civil penalties not to exceed $25,000 per day, per
violation, for violations of the NCO088501 NPDES permit. If you have any questions
regarding the inspection or this letter, please call Mr. Boone or me at [phone]. Thank
you for your cooperation in this matter.
Sincerely,
W. Corey Basinger
Interim Regional Supervisor
Surface Water Protection Section
Attachments:
1. BIMS Inspection Report
CC: WS.RO®S_WP
Central Files
NPDES Unit

United States Environmental Protection Agency
Form Approved.
EPA Washington, D.C. 20460
OMB No. 2040-0057
Water Compliance Inspection Report
Approval expires8-31-98
Section A: National Data System Coding (i.e., PCS)
Transaction Code NPDES yr/mo/day Inspection Type Inspector Fac Type
1 I NI 2 15I 31 N00088501 111 121 11/01/27 117 18I CI 191 SI 20I II
Remarks
2111111111111111111111111111111111111111111III1116
Inspection Work Days Facility Self -Monitoring Evaluation Rating B1 QP --- - —Reserved----- --
671 169 701 I 711 I 72 I N I 73 I I 174 751 I I I I I I 180
W
Section B: Facility Data
Name and Location of Facility Inspected (For Industrial Users discharging to POTW, also include
Entry Time/Date
Permit Effective Date
POTW name and NPDES permit Number)
02:30 PM 11/01/27
09/04/01
Stonington Subdivision - Well #1
Exit Time/Date
Permit Expiration Date
Stonington Way Ct
Kernersville NC 27284
03.30 PM 11/01/27
14/02/28
Name(s) of Onsite Representative (s)/Titles(s)/Phone and Fax Number(s)
Other Facility Data
Name, Address of Responsible Official/Title/Phone and Fax Number
Thomas J Roberts,202 Mackenan Dr Cary NC Contacted
27511/President/919-467-8712/9194661583 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
Laboratory
Section D: Summary of Finding/Comments Attach additional sheets of narrative and checklists as necessary)
(See attachment summary)
Name(s) and Signature(s) of Inspector(s) Agency/Office/Phone and Fax Numbers Date
Ron Boo WSRO WQ//704-663-1699 Ext.2202/
Signature of M naa�g}ement A Reviewer Agency/Office/Phone and Fax Numbers Date
EPA Form 3560-3 (Re j9-94) Previo s editions are obsolete.
Page # 1

NPDES yr/mo/day Inspection Type
3I NCO088501 I11 12I 11/01/27 117 18ICI
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
Please refer to the attached inspection summary letter.
Page # 2

Permit: NCO088501
Inspection Date: 01/27/2011
Owner - Facility: Stonington Subdivision - Well #1
Inspection Type: Compliance Evaluation
Permit
Yes
No
NA N
(If the present permit expires in 6 months or less). Has the permittee submitted a new application?
n
n
■ n
Is the facility as described in the permit?
■
n
n n
# Are there any special conditions for the permit?
❑
■
n n
Is access to the plant site restricted to the general public?
■
n
n n
Is the inspector granted access to all areas for inspection?
®n
n
Comment: Please refer to the attached inspection summary letter.
Record Keeping
Yes
No
NA
NE
Are records kept and maintained as required by the permit?
■
n
n
n
Is all required information readily available, complete and current?
■
n
n
n
Are all records maintained for 3 years (lab. reg. required 5 years)?
■
n
n
n
Are analytical results consistent with data reported on DMRs?
■
n
n
n
Is the chain -of -custody complete?
■
❑
n
n
Dates, times and location of sampling. o
■
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?
■
n
n
n
Has the facility submitted its annual compliance report to users and DWQ?
n
❑
■
n
(If the facility is = or > 5 MGD permitted flow) Do they operate 24/7 with a certified operator on each shift?
❑
■
n
n
Is the ORC visitation log available and current?
■
n
n
n
Is the ORC certified at grade equal to or higher than the facility classification?
■
n
n
n
Is the backup operator certified at one grade less or greater than the facility classification?
■
n
n
Cl
Is a copy of the current NPDES permit available on site?
n
■
o
o
Facility has copy of previous year's Annual Report on file for review?
n
n
■
n
Comment: Not all of the required documentation was available during the inspection.
Please refer to the attached inspection summary letter.
Laboratory
Yes
No
NA
NE
Are field parameters performed by certified personnel or laboratory?
■
n
n
El
Page # 3

t
Permit: NCO088501 Owner - Facility: Stonington Subdivision - Well #1
Inspection Date: 01/27/2011 Inspection Type: Compliance Evaluation
Laboratory
Yes No NA NE
Are all other parameters(excluding field parameters) performed by a certified lab?
■ n n n
# Is the facility using a contract lab?
Is n n n
# Is proper temperature set for sample storage (kept at less than or equal to 6.0 degrees Celsius)?
n n n ■
Incubator (Fecal Coliform) set to 44.5 degrees Celsius+/- 0.2 degrees?
n ❑ ■ ❑
Incubator (BOD) set to 20.0 degrees Celsius +/-1.0 degrees?
n n ■ n
Comment: Please refer to the attached inspection summary letter.
Effluent Sampling
Yes No NA NE
Is composite sampling flow proportional?
❑ n ■ ❑
Is sample collected below all treatment units?
■ n n n
Is proper volume collected?
Is n n n
Is the tubing clean?
n n ■ n
# Is proper temperature set for sample storage (kept at less than or equal to 6.0 degrees Celsius)?
n n ■ n
Is the facility sampling performed as required by the permit (frequency, sampling type representative)?
n ■ n .n
Comment: According to the operator, he pulls the effluent samples at a point during
the backwash cycle when the least amount of contaminants are expected to be in the
discharge. Samples should be pulled at a point during the backwash cycle when the
discharge contains an amount of contaminants representative of the worst possible
discharge from the facility.
Flow Measurement - Influent
Yes No NA NE
# Is flow meter used for reporting?
n n ■ n
Is flow meter calibrated annually?
n n ■ n
Is the flow meter operational?
n n ■ n
(If units are separated) Does the chart recorder match the flow meter?
n n ■ n
Comment: There are five green sand filters at the site which treat ground water. There
are two backwash cycles that alternate days; on one day, three of the five filters
backwash and on the next day the remaining two filters backwash. Backwash
flow/volume is controlled via 10GPM flow restriction valves. According to the operator,
during a single complete backwash cycle, each filter generates 300 gallons of backwash
effluent. So, on the days that three filters backwash, the total flow shoud be 900 gallons
and on the days that the two filters backwash the total flow should be 600 gallons. Up to
this point, the flows for these cycles have been reported as 900 (for the three filters) and
300 (for the two filters). This was discussed with the operator and he stated he would
double check with their engineers and begin reporting the correct total daily volumes.
No flow meter is actually used.
Filtration (High Rate Tertiary)
V— Mn NA NF
Page # 4

Permit: NCO088501
Inspection Date: 01/27/2011
Filtration (High Rate Tertiary)
Type of operation:
Is the filter media present?
Is the filter surface free of clogging?
Is the filter free of growth?
Is the air scour operational?
Is the scouring acceptable?
Is the clear well free of excessive solids and filter media?
Owner - Facility: Stonington Subdivision - Well #1
Inspection Type: Compliance Evaluation
Yes No NA NE
Up flow
■ n n n
nn■n
nn■0
nn■o
nn■n
nn■n
Comment: Filters are green sand filters; they all seem to be operating properly. Please
refer to the attached inspection summary letter.
Chemical Feed
Yes No NA NE
Is containment adequate?
n ■ n n
Is storage adequate?
n n n n
Are backup pumps available?
n n n ■
Is the site free of excessive leaking?
n ■ n n
Comment: There are four containers of approximately 30 gallons of Potassium
Permanganate that is used to regenerate the filters during backwash. Significant
leakage from these containers was occurring during the inspection and had taken place
in the past as evidenced by staining on the concrete floor around the floor drain.
Leakage of the chemicals goes into the floor drain which then goes outside and
discharges on the hillside going down toward the stream. This is considered an illegal
discharge. This office suggests that you plug the floor drain and/or use spill containment
pallets for the Potassium Permanganate, Sodium Hydroxide, and Caustic Soda. AGAIN,
DISCHARGE OF SPILLED CHEMICALS FROM THE FACILITY INTO THE
ENVIRONMENT IS CONSIDERED AN ILLEGAL DISCHARGE AND YOU MUST
ADDRESS THIS SITUATION IMMEDIATELY.
De -chlorination
res
NO
NA
NI
Type of system ?
Tablet
Is the feed ratio proportional to chlorine amount (1 to 1)?
n
n
n
■
Is storage appropriate for cylinders?
n
n
■
n
# Is de -chlorination substance stored away from chlorine containers?
■
n
n
n
Are the tablets the proper size and type?
❑
n
n
■
Comment: Please refer to the attached inspection summary letter.
Are tablet de -chlorinators operational?
■
n
Cl
n
Number of tubes in use?
4
Page # 5

Permit: NCO088501
Inspection Date: 01/27/2011
no-rhlnrinnfinn
Owner - Facility: Stonington Subdivision - Well #1
Inspection Type: Compliance Evaluation
Comment: Please refer to the attached inspection summary letter.
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?
Comment: There is significant staining of the ground, leaves and other matter on the
ground around the end of the discharge pipe. There is a large (approx 20' diameter)
black stain on the ground at the very end of the discharge pipe where it is obvious that
the solids that are in the filter backwash discharge settle on the ground, leaves and
other organic matter, while the supernate or water soaks into the ground or actually
flows down into the stream. There is also a slight indication of some of the backwash
solids in the stream also. Please refer to the attached inspection summary letter.
Operations & Maintenance
Is the plant generally clean with acceptable housekeeping?
Yes No NA NE
Yes No NA NE
■nnn
■nnn
nn■n
V— Pln AIA PIC
■nnn
Does the facility analyze process control parameters, for ex: MLSS, MCRT, Settleable Solids, pH, DO, Sludge ■ ❑ n n
Judge, and other that are applicable?
Comment: Please refer to the attached inspection summary letter.
Page # 6

41,.
Cover Sheet from
Staff Member to
Regional Supervisor
DNIR Review Record
ry
Facili : Permit/Pipe No.: 1&WMQ\ Month/Year
Monthly Average Violations
Parameter Permit Limit DIAR Value % Over Limit
Wee y/Daily Violations
Date Parameter Permit imit/Tv e DMR Value % Over Limit
Monitori Q Frequency Violations
Date Parameter Permit e uencv Values ReTorted # of Violations
Other Violations
N awe F -
Completed by: / Date:
Regional Water Quality �
Supervisor Sianoff: Date:
p �fiJ7

EFFLUENT
NPDES PERMIT NO. FP;IG0088504` Discharge No.: 001 Month
Facility Name: Stonington'Subdiv'ision-Class:
Operator in Responsible Charge (ORC): _ William T. Young Grade:
Certified Laboratory (1): Water Tech Labs Inc 950
CHECK BOX IF ORC HAS CHANGED ® PFyRWN(S) COL)(
Mail ORIGINAL and ONE COPY to: X
ATTN: CENTRAL FILES
DIVISION OF WATER QUALITY
1617 MAIL SERVICE CENTER
RALEIGH, NC 27699-1617
i
f .
! ���iU OA
EC County nrsyth`
PC 1 Phone: [phone] x 57232
(2)
ING SAMPLES Operators
(SIGNATURE OF,9ARATOR IN&�'E-§PONSIBLE CHARGE)
BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS
ACCURATE AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
DATE
50050
00400
50060
00530
01045
01055
00916
00927
01002
01034
01042
11
01067 1909dO
u
''(M4
� a
GP36
w�¢O--
e
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A¢oE Q
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FLOW
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H
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7
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F
wzuw
U OEFFE
za0i
W O z
y F
3
INF ❑
H
7-
H
o
HRS
HRS
Y/BM
MGD
MIN
UNITS
UG/L
MG/L
MG/L
MG/L
MG/L
MG/L
MG/L
MG/L
MG/L
MG/L
MG L
MG/L
Pass/Fail
1
0.000301
60
2
0.00090
90
3
0.00030
60
4
1
0.00090
90
5
0.00030
60
6
0.00090
90
7
1
0.000301
60
8
0.00090
90
911:25
0.50
Y
0.00090
60
8.8
<20
r36-71
0.025
10.7
16.10
4.05
<.005
0.007
<.005
<.005
<0002
0.012
10
0.00090
90
11
0.00030
60
12
0.00090
90
P
13
0.000301-
60
14
0.000901
90
15
0.000301
60
16
0.0oogol
90
17
0.00030
60
18
0.00090
90
19
0.00030
60
20
0.00090
90
21
0.00030
60
22
0.00090
90
23
0.4
0.33
Y
0.00030
60
8.7
<20
1 26.0
24
0.00090
90
25
0.00030
60
26
0.00090
90
27
1
0.00030
60
28
0.00090
90
29
0.00030
60
30
0.00090
90
31
0.00030
60
ce_
AVERAGE
0.00061
75
O
`3�44 ]
0.025
10.700
16.10
4.05
0.000
O.ODO
0.000
0.000
0.0000
0.012
MAXIMUM
0.00090
90
8.8
<20
361.7
0.025
10.700
16.10
4.05
<.005
1 <.005
<.005
<.005
<.0002
0.012
MINIMUM
0.00030
60
8.7
<20
26.0
0.025
10.700
16.10
4.05
<.005
<.005
<.005
<.005
<.0002
0.012
Comp. (C)/Grab (G)
G
G
G
G
G
I G
G
G
G
G
G
G
G
G
Monthly limit
0.0021
NL
NL
NL
30.0
NL
NL
NL
NL
NL
NL
NL
NL
NL
NL
NL
Daily Maximum
6/9
17'
45.0
NL
NL
NL
NL
NL
NL
NL
NL
NL NL
NL
Measurement Frequency
Monthly
2/Mth
2/Mth
I 2/Mth
Mthly
Mthly
Mthly
Mthly
Mthly
Mthly
Mthly
Mthly
Mthly Mthly
Mthly
* Limit takes effect June 1. 2009

Y
Stonington WTP NCO088501 r.
Facility Status: (Please check one of the following): n
All monitoring data and sampling frequencies meet permit requirements {7
Compliant
All monitoring data and sampling frequencies do NOT meet permit requirements
Noncompliant
If the facility is noncompliant, please comment on corrective actions being taken in respect to equipment, operation, maintenance, etc.
and a time table for improvements to be made.
T T
"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 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 possibility of fines and imprisonment for knowing violations."
Thomas J. Roberts, President, Aqua North Carolina, Inc.
Permittee,( ,Y1 ' e p ' or type)
Signature of Permittee ** Date
Permittee Address
Phone Number
Permit Exp. Date
202 MacKenan Court, Cary, NC 27511
919-467-8712
February 28, 2014
PARAMETER CODES
00010 Temperature
00556 Oil & Grease
00951 Total Fluoride
01055 Manganese
50050 Flow
00076 Turbidity
00600 Total Nitrogen
01002 Total Arsenic
01067 Nickel
00080 Color (Pt -Co)
00610 Ammonia Nitrogen
01077 Silver
00082 Color (ADMI)
00625 Total Kjeldhal
01027 Cadmium
01092 Zinc
50060 Total
Nitrogen
61105 Aluminum
Residual
00095 Conductivity
00630 Nitrates/Nitrites
01032 Hexavalent Chromium
Chlorine
00300 Dissolved Oxygen
01034 Chromium
01147 Total Selenium
00310 BOD5
00665 Total Phosphorous
31616 Fecal Coliform
71880 Formaldehyde
00340 COD
00720 Cyanide
01037 Total Cobalt
32730 Total Phenolics
71900 Mercury
00400 pH
00745 Total Sulfide
01042 Copper
34235 Benzene
81551 Xylene
00530 Total Suspended
00927 Total Magnesium
34481 Toluene
Residue
00929 Total Sodium
01045 Iron
38260 MBAS
00545 Settable matter
00940 Total Chloride
01051 Lead
39516 PCBs
Parameter Code assistance may be obtained by calling the Water Quality Compliance Group at [phone], extension 581 or 534.
The monthly average for fecal coliform is to be reported as a GEOMETRIC mean. Use only units designated in the reporting
facility's permit for reporting data.
* ORC must visit facility and document visitation of facility as required per 1YA NCA(Nk0202 (b) (5) (B).
** If signed by other than the permittee, delegation of signatory authority rimust'be,ori,fle4itfi,1 e State per 15A NCAC 2B.0506 (b)
(2) (D). -

A. (1.) EFFLUENT LIMITATIONS AND MONITORING REQUIREMENTS
During the period beginning on the effective date of this permit and lasting until expiration, the Permittee is
authorized to discharge filter backwash from outfall 001. Such discharges shall be limited and monitored by the
Permittee as specified below:
EF LU
K .._v.
'�.,<
MONITORING"RE UIREME'NTS;'::,..�
Q ,<
STIGS
CHARACTERISTICS.
.. ,,
Monthl y..
.,Dail .Mazi'mumF��
>Me asur'ement"
,�'. •fir
Sam "le.:
..p
Sam le. _
$r,. p_
...... _.. .... s
��r':gr..,. ".
r 9
-
�Fi' q
_
,p t r,
Flow'
0.0021 MGD
2/Month
Instantaneous
Effluent
Total Suspended
30.0 mg/L
45.0 mg/L
21Month
Grab
Effluent
Solids
Total Residual
17 ug/L
2/Month
Grab
Effluent
Chlorine '
Fluoride
Monthly
Grab
Effluent
Total Iron
Monthly
Grab
Effluent
Total Zinc5
Monthly
Grab
Effluent
Total Arsenic
Monthly
Grab
Effluent
Chromium
Monthly
Grab
Effluent
Total Copper
Monthly
Grab
Effluent
Magnesium
Monthly
Grab
Effluent
Total Manganese
Monthly
Grab
Effluent
pH
6.0 — 9.0 s.u.
2/Month
Grab
Effluent
Whole Efflsuent Toxicity
Quarterly
Grab
Effluent
Monitorin
Footnotes:
1. For instantaneous flow monitoring, the duration of the discharge must be reported in addition to the total
flow.
2. The TRC monitoring requirement applies only if the Permittee backwashes with chlorine or chlorine
derivatives. This limit will become effective on June 1, 2009.
3. The Division shall consider all effluent TRC values reported below 50 ug/I to be in compliance with the
permit. However, the Permittee shall continue to record -and submit all values reported by a North
Carolina certified laboratory (including field certified), even if these values fall below 50 ug/I.
4. Fluoride should be monitored if the permittee backwashes with fluoridated finished water.
5. Zinc shall be monitored if the Permittee uses any zinc -based additive in the water treatment process.
6. See Attachment A. (2).
All samples collected should be from a representative discharge event.
There shall be no discharge of floating solids or visible foam in other than trace
amounts.

RECEIVED
J N.C. Deot. of EN"
APR
Performance Annual Report - �ot�
Winston-Salem
on -Salem
Regional Office
I. General Information
Facility/System Name
Responsible Entity:
Person in Charge/Contact:
Applicable Permit (s):
Stonington-Well # 1
Aqua North Carolina, Inc
Torn Roberts
NC O.S.8S0�
Description of Collection System or Treatment Process:
This facili1y discharges the backwash water from iron removal filters
serving this community water system. TRC limit of 17 ug/L became
effective in June 2009.
II. Performance
Text Summary of System Performance for Calendar Year 2009
This water treatment plant performed well and generally met the
discharge limits.
List (by month) any violations of permit conditions or other environmental
regulations. Monthly lists should include discussion of any environmental
impacts and corrective measures taken to address violations.
January Compliant
February Compliant
March Compliant
April Compliant
May Compliant

'' . ,
June The daily maximum for Total Residual Chlorine was
exceeded. De -chlorination facilities had not been
installed as of yet.
July The daily maximum for Total Residual Chlorine was
exceeded. De -chlorination facilities were installed within
30 days.
August Compliant
September Compliant
October Compliant
November Compliant
December Compliant
III. Notification
Our customers will receive a letter regarding the availability of this report
upon request. These reports will also be available for review with the
customer at Aqua's Southern Call Center.
IV. Certification
I certify under penalty of law that this report is complete and accurate to the
best of my knowledge. I further certify that this report has been made
available to the users or customers of the named system and that those users
have been notified of its availability.
v Date: 02/26/2010
Respo ible Person
Title: Regional Compliance Manager
Entity: Aqua North Carolina, Inc.

U A -
Aqua North Carolina, Inc.
202 MacKenan Court
Cary, NC 27511
October 20, 2009
Mr. Steve W. Tedder
Surface Water Regional Supervisor
Winston-Salem Regional Office
Division of Water Quality
585 Waughtown Street
Winston Salem, NC 27107
Dear Mr. Tedder:
RECEIVED
DHDL of ENR
X 0
T2 5 209
Win -'ton -Salem
Regicnal a ice
Thomas J. Roberts
President and Chief
Operating Officer
T: 919.653.5770
F: 919.460.1788
[e-mail]
www.aquanorthcarolina.com
Recently three Notice of Violations and Assessment of Civil Penalties were sent to Gary Moseley
with Aqua North Carolina at 4163 Sinclair Street, Denver, NC.
Please be advised that Gary Moseley is no longer with Aqua North Carolina. Please send all
future Notice of Violations, Assessment of Civil Penalties and Compliance Inspections to the attention of:
Thomas J. Roberts, President and COO
Aqua North Carolina, Inc.
202 MacKenan Court
Cary, NC 27511
If you need any further information you may contact me at 919-653-5771.
Sincerely,
Robyn L. Thomas
Executive Assistant to Thomas J. Roberts
An Aqua America Company

•
�® RECETT
NC®ENR N.C. bent o4 eNet ;
North Carolina Department of Environment and Natural Resou ces JUL 2 9 2009
Division of Water Quality Winston-Salem I
Regl al office
Beverly Eaves Perdue Coleen H. Sullins Beereetan—
Governor Director Secretary
July 16, 2009
Mr. Scott Smart, P:E.
Aqua North Carolina, Inc.
202 MacKenan Court
Cary, North Carolina 27511
SUBJECT: Authorization to Construct
A to C No. 088501A01
Aqua North Carolina, Inc.
Stonington Subdivision Well #1
Dechlorination Facilities
Forsyth County
Dear Mr. Smart:
A fast track application for Authorization to Construct dechlorination facilities was
received on June 30, 2009, by the Division of Water Quality (Division). Authorization is hereby
granted for the construction of modifications to the existing Stonington Subdivision Well #1,
with discharge of backwash effluent into an unnamed tributary to Abbotts Creek in the
Yadkin -Pee Dee River Basin.
This authorization results in no increase in design or permitted capacity and is awarded
for the construction of the following specific modifications:
Installation of a dechlorination system, utilizing sodium sulfite pursuant to the fast
track application received on June 30, 2009, and in conformity with the Minimum
Design Criteria for Dechlorination Facilities.
This Authorization to Construct is issued in accordance with Part III, Paragraph A of
NPDES Permit No. NCO088501 issued March 12, 2009, and shall be subject to revocation unless
the wastewater treatment facilities are constructed in accordance with the conditions and
limitations specified in Permit No. NC0088501.
In the event that the facilities fail to perform satisfactorily, including the creation of
nuisance conditions, the Permittee shall take immediate corrective action, including those as may
be required by this Division, such as the construction of additional or replacement wastewater
treatment or disposal facilities.
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 - One
Location: 512 N. Salisbury St. Raleigh, North Carolina 27604 NorthCarolina
Phone: [phone] \ FAX: [phone] \ Customer Service:1-877-623-6748
Internet: www.ncwaterquality.org A�tmall f
An Equal Opportunity \ Affirmative Action Employer fff�//�

Mr. Smart
July 16, 2009
Page 2
The Winston-Salem Regional Office, telephone number [phone] shall be notifi
at least forty-eight (48) hours in advance of operation of the installed facilities so that an on sit
inspection can be made. Such notification to the regional supervisor shall be made during the
normal office hours from 8:00 a.m. until 5:00 p.m. on Monday through Friday, excluding Stati
Holidays.
Upon completion of construction and prior to operation of these permitted facilities,
attached Engineer's Certification form must be received from a professional engineer certif
that the permitted facility has been installed in accordance with the NPDES Permit and this
Authorization to Construct. Mail the Certification to: Construction Grants & Loans,
DWQ/DENR, 1633 Mail Service Center, Raleigh, NC 27699-1633.
Upon classification of the facility by the Certification Commission, the Permittee sh
employ a certified wastewater treatment plant operator to be in responsible charge (ORC) of
wastewater treatment facilities. The operator must hold a certificate of the type and grade at
equivalent to or greater than the classification assigned to the wastewater treatment facilities
the Certification Commission.
The Permittee must also employ a certified back-up operator of the appropriate type
grade to comply with the conditions of T15A:8G.0202. The ORC of the facility must visit i
Class I facility at least weekly and each Class II, I1I and IV facility at least daily, excluding
weekends and holidays, must properly manage the facility, must document daily operation
maintenance of the facility, and must comply with all other conditions of T 15A:8G.0202.
A copy of the approved plans and specifications shall be maintained on file by the
Permittee for the life of the facility.
During the construction of the proposed additions/modifications, the permittee shall
continue to properly maintain and operate the existing wastewater treatment facilities at all tin
and in such a manner, as necessary to comply with the effluent limits specified in the NPDES
Permit.
You are reminded that it is mandatory for the project to be constructed in accordance
with the North Carolina Sedimentation Pollution Control Act, and, when applicable, the Nortt}
Carolina Dam Safety Act. In addition, the specifications must clearly state what the contractor's
responsibilities shall be in complying with these Acts.
Prior to entering into any contract(s) for construction, the recipient must have obtaineall
applicable permits from the State.
Failure to abide by the requirements contained in this Authorization to Construct may
subject the Permittee to an enforcement action by the Division in accordance with North
Carolina General Statute 143-215.6A to 143-215.6C.

Mr. Smart
July 16, 2009
Page 3
The issuance of this Authorization to Construct does not preclude the Permittee from
complying with any and all statutes, rules, regulations, or ordinances which may be imposed by
other government agencies (local, state, and federal) which have jurisdiction.
If you have any questions or need additional information, please do not hesitate to contact
Seth Robertson, P.E. at telephone number [phone].
Sincerely,
C�/ r-
01 Coleen H. Sullins
swc/sr
cc: James Thurman Horne, P.E., Horizon Engineering & Consulting, Inc., 2510 Walker Rd.,
Mount Pleasant, NC 28124
Forsyth County Health Department
anst�n Salem egional�CFffice;�5;urface i�'-ater ;l�rc�t.t���a
Technical Assistance and Certification Unit
Point Source Branch, NPDES Program
Steve Coffey, P.E.
ATC File 088501A01

Aqua North Carolina, Inc.
A To C No. 088501AOI
Issued July 16, 2009
Engineer's Certification
I, , as a duly registered Professional Enginee in
the State of North Carolina, having been authorized to observe (periodically/weekly/full time)
the construction of the modifications and improvements to the Stonington Subdivision Well #II
located on Stonington Way Court in Forsyth County for Aqua North Carolina, Inc., hereby state
that, to the best of my abilities, due care and diligence was used in the observation of the
following construction:
Installation of a dechlorination system utilizing sodium sulfite pursuant to the fast
track application received on June 30, 2009, and in conformity with the Minimum
Design Criteria for Dechlorination Facilities.
I certify that the construction of the above referenced project was observed to be boil
within substantial compliance and intent of the approved plans and specifications.
Signature
Date
Registration No
Send to: Construction Grants & Loans
DENR/DWQ
1633 Mail Service Center
Raleigh, NC 27699-1633

Ira .
RUNNR
North Carolina Department of Environment and Natural Resou
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins
Governor Director
June 17, 20.09
Mr. Scott Smart, P.E.
Aqua North'Carolina, Inc. .
202 MacKenan Court
Cary, NC 27571
�.�. bznt. ©f Efvht
JUN -2 21009
Winston-Salem'
Regional Office
Dee. Freeman.
Secretary
Subject: Request for TRC Compliance Schedule Extension
NPDES Permits
Surry and Forsyth Counties
Dear Mr. Smart:
The Division does not concur with your request for a. 4-month extension to the TRC compliance deadline for several Aqua
NC facilities. Your email request was received after the compliance schedule had expired for four of the facilities, and the
original 18-month compliance schedule should have provided more. than sufficient time to plan/implement Fast Track
dechlorination activities despite recent organizational changes. Based on permit file reviews, the Division did discover an
error in the TRC compliance schedule in the 3/12/2009 permit reissuance for NCO088633 (Reeves Woods Subdivision);
therefore, the TRC effective date for this facility will be changed from.5/l/2009 back to 10/l/2009. In summary, the TRC
effluent limit becomes effective on the following dates:
Perm_ it.#...:..
_ __ ..
- Facility;,;:.. ,. -. ". .: ` :
TRC: Limit Effective Date'
*I
_ao
Sub_ No-1 . e_
_ 009"=.tonigtai�-
NC0088625
The Hollows Subdivision Well
June 1, 2009
NCO088536
Bannerton Hills Subdivision Well No. 2
June-1, 2009
NCO088552
Colonial Woods Subdivision Wells No. 1&2
June 1; 2009
NCO088617
Snow Hill Subdivision Well No. 1
September 1, 2009
NCO088633
Reeves Woods Subdivision Well No. 2
October 1, 2009
NCO088498
Mitchell Bluff Subdivision Well No. 1
November 1, 2009
Please call me at 919-807-63.90 with any questions on this permit requirement.
Sincerely,
�1 .0
om Belnick
Supervisor, NPDES West Program
Cc: WSRO SWPS; NPDES Files
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Location: 512 N. Salisbury St. Raleigh, North Carolina 27604 1�7One 1 7
Phone: [phone] FAX: [phone] Customer Service: 1-877-623-6748 1 V ofth Quolina
Internet: www.ncwaterquality.org
An Equal Opportunity 1 Affirmative Action Employer "

Pruitt, Rose
From: Tedder, Steve
Sent: Thursday, June 18, 2009 7:25 AM
To: Hudson, Gary; Pruitt, Rose
Subject: FW: Request for Residual Chlorine Compliance Extension- Surry and Forsyth Counties
fyi
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.
Steve Tedder
Steve.Tedder(@NCDENR.eov
NC DENR Division of Water Quality
585 Waughtown Street
Winston-Salem, NC 27107
(336)-771-4950
Fax [phone] -
From: Belnick, Tom [mailto:[e-mail]]
Sent: Wednesday, June 17, 2009 3:12 PM
To: Smart, Scott
Cc: Charles; [e-mail]; Schlobohm, David G.; Melton, Michael A.; Roberts, Tom; Poupart, Jeff
Subject: RE: Request for Residual Chlorine Compliance Extension- Surry and Forsyth Counties
Scott- The Division does not concur with your request for a 4-month extension to the TRC compliance deadlinefor
several Aqua NC facilities. Your email request was received after the compliance schedule had expired for four of the
facilities, and the original 18-month compliance schedule should have provided more than sufficient time to
plan/implement Fast Track dechlorination activities despite recent organizational changes. Based on permit file reviews,
the Division did discover an error in the TRC compliance schedule in the 3/12/2009 permit reissuance for NC0088663
(Reeves Woods Subdivision); therefore, the TRC effective date for this facility will be changed from 5/1/2009 back to
10/1/2009. In summary, the TRC effluent limit becomes effective on the following dates:
TRC limit effective June 1, 2009
• NC0088501-Stonington;Subdivi"sion`...WelI-No,-7 ,�--
• NC0088625- The Hollows Subdivision Well- ---
• NC0088536- Bannerton Hills Subdivision Well No. 2
• NC0088552- Colonial Woods Subdivision Wells No. 1&2
TRC limit effective September 1, 2009
• NC0088617- Snow Hill Subdivision Well No. 1
TRC limit effective October 1, 2009
• NC0088633- Reeves Woods Subdivision Well No. 2 (permit to be corrected)
TRC limit effective November 1, 2009
0 NC0088498- Mitchell Bluff Subdivision Well No. 1

Let me know if you have any questions on this permit requirement.
Tom Belnick
Supervisor, NPDES West Program
NC DENR/Division of Water Quality
1617 Mail Service Center, Raleigh, NC 27699-1617
[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: Smart, Scott [mailto:[e-mail]]
Sent: Tuesday, June 02, 2009 9:04 AM
To: [e-mail]
Cc: Charles; [e-mail]; Schlobohm, David G.; Melton, Michael A.; Roberts, Tom
Subject: Request for Residual Chlorine Compliance Extension- Surry and Forsyth Counties
Mr. Belnick,
Aqua North Carolina, Inc. regrets that we must ask for your indulgence to grant us an extension of the deadline
for complying with residual chlorine limits at the facilities listed in the attached letter. This problem has
occurred as a consequence of some organizational changes Aqua North Carolina, Inc. has experienced in the
last several months. As a result, we have discovered that efforts to prepare and submit plans and specifications
with requests for Authorization to Construct (ATC), fell off schedule.
Attached is a scanned letter making this request. We appreciate your consideration of our request for this
extension. If you have any questions or if there is anything we need to discuss, please contact me at 919-653-
6989 or via email at rssmartckaquaamerica.com.
Scott Smart, P.E.
Engineering Manager
Aqua North Carolina, Inc.
919-653-6989
Email correspondence to and from this sender is subject to the N.C. Public Records Law and may be disclosed to third parties.

Aqua North Carolina, Inc
A To C No. 60501A01
Issued July 16, 2009
RECEIVED
N.C. Dept of ENR
AUG - I '
Winston-Salem
Roglonai Office
Engineer's Certification
I, %, /f?Iit /� _, as a duly registered Professional Engineer in
the State of North Carolina, having been authorized to observe (periodically/weekly/full time)
the construction of the modifications and improvements to Stonington Subdivision Well #l, .
located on $tonington' W-- ay Court in Surry County for Aqua North Carolina; Inc., hereby state
that, to the nest of my abilities, due care and diligence was used in the observation of the
following construction:
Installation of a dechlorination system utilizing sodium sulfite pursuant to the fast
track application received on June 30, 2009, and in conformity with the Minimum
Design Criteria for Dechlorination Facilities.
I certify that the construction of the above referenced project was observed to be built
within substantial compliance and intent of the approved plans and specifications.
' I
Signature;,'i � Registration No.
Date 0/ ✓� a
Send to: Construction Grants & Loans
DENRIDWQ
1633 Mail Service Center
Raleigh, NC 27699-1633

O�O�WAT4919
r
o. �
Thomas Roberts, President
Aqua North Carolina, Inc.
202 Mackenan Court
Cary, N C 27511
Dear Mr. Roberts: -
Beverly Eaves Perdue, Governor
Dee Freeman, Secretary
North Carolina Department of Environment and Natural Resources
January 14, 2009
Coleen H. Sullins, Director
Division of Water Quality
RECEIVED
N.C. Dept of ENR
i
4Ninston-Salem
Regional Office
Subject: Draft NPDES Permit NCO088501
Stonington Subdivision Well #1 WTP
Forsyth County
Enclosed with this letter is a copy of the draft permit for your facility. Please review the draft very carefully to
ensure thorough understanding of the conditions and requirements it contains.
The draft permit contains the following changes from your current permit as required by the attached "DWQ- NPDES
Permitting Strategies for Potable Water Treatment Plants:
➢ Monitoring deletions
o Total Nickel, Total Selenium and Total Mercury
➢ Notations added
o TRC footnote added
Since this permit uses water softeners, the requirements for this facility are more stringent than many of the other
Aqua facilities that have been recently permitted. Your facility utilizes both Greensand and Ion exchange process
which warrant additional monitoring for additional Pollutants of Concern. You may request re-evaluation of these
requirements after 12 consecutive months of data have been submitted that do not demonstrate reasonable
potential to cause an exceedence of water quality standards. The Whole Effluent Toxicity monitoring requirement
will not be able to be removed from the permit.
Concurrent with this transmittal, the Division will solicit public comment on this draft as required by the EPA by
publishing a notice in newspapers having circulation in the general Surry County area. Please review this draft
carefully to ensure thorough understanding of the information, conditions, and requirements contained therein.
Should you wish to correct errors or provide comments regarding this draft please contact the DENR / DWQ /
NPDES Program no later than 30 days after receiving this document.
Following the 30-day public comment period, the Division will review all pertinent comments and take
appropriate action prior to issuing a final NPDES permit. If you have questions concerning the draft permit for
your facility, please contact me by e-mail ([e-mail]) or call me at [phone].
Respect,
Bob Guerra
NPDES Unit, Western Program
Enclosure: NPDES Permit NCO088501 (DRAFT)
Water Treatment Strategies Policy Document
cc: Winston-Salem- Regional -.Office / Surface Water Protection
Winston Salem Regional Office / DEH
Aquatic Toxicology Unit
NPDES Unit
North Carolina Division of Water Quality 1617 Mail Service Center Raleigh, NC 27699-1617 Phone [phone]
Internet: www.ncwaterqualiiy.org Location: 512 N. SalisburySt. Raleigh, NC 27604 Fax [phone]
oe Carolina
NNaturally
Customer Service
1-877-623-6748
An Equal Opportunity/AffirmatNe Action Employer— 50% Recycled/10% Post Consumer Paper

Permit NCO088501
STATE OF NOR T H CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER (QUALITY
PERMIT
TO DISCHARGE WASTEWATER UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful
standards and regulations promulgated and adopted by the North Carolina Environmental
Management Commission, and the Federal Water Pollution Control Act, as amended, the
- Aqua North ,Carolina;- Inc. - --
is hereby authorized to .discharge wastewater'from`�.a facility located at the
j st®nington Subdivision'':— Well ##1 (WTP)
\Sfoningt®n Way Court
Kernersville
Forsyth County
to receiving waters designated as an unnamed tributary to Abbotts Creek in the Yadkin -Pee
Dee River Basin
in accordance with effluent limitations, monitoring requirements, and other conditions set forth
in Parts I, II, III and IV hereof.
This permit shall become effective xxxx, 09.
This permit and authorization to discharge shall expire at midnight on xxx, 2014.
Signed this day xxx, 09.
DRAFT
Coleen H. Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission

Permit NC0088501
SUPPLEMENT TO PERMIT COVER SHEET
All previous NPDES Permits issued to this facility, whether for operation or discharge are
hereby revoked. As of this permit issuance, any previously issued permit bearing this number
is no longer effective. Therefore, the exclusive authority to operate and discharge from this
facility arises under the permit conditions, requirements, terms, and provisions included herein.
Aqua North Carolina, Inc. is hereby authorized to:
Continue to operate an existing greensand water treatment system utilizingg-greensand
filters in series with a 0.0021 MGD discharge of filter backwash wastewater. Chemicals
utilized during the process consist of:
• Potassium Permanganate
• Chlorine and
• Caustic soda
2. This facility is located at the Stonington Subdivision Well #1 located on Stonington Way
Court, Kernersville in Forsyth County.
3. Discharge from said treatment works at the location specified on the attached map into an
unnamed tributary to Abbotis Creek; classified W8-III waters in the Yadkin -Pee Dee River
Basin.

Aqua North Carolina,
Inc
Stonington Subdivision Well #1-WTP
Latitude: 36' 02' 05" N State Grid: Kernersville
Longitude: 801040' 32" W Permitted Flow:
0.0021 MGD
Receiving Stream: UT to Abbotts Creek Stream Class:
WS-III
Drainage Basin: Yadkin -Pee Dee River Basin Sub -Basin:
03-07-07
IFacility x
Location
not to scale
North T
NPDES Permit No. NC0088501
Forsyth County

Permit NC0088501
A.(I.) EFFLUENTLIMITATIONSAND MONITORING REQUIREMENTS
During the period beginning on the effective date of this permit and lasting until expiration, the Permittee is
authorized to discharge filter backwash from outfall 001. Such discharges shall be limited and monitored by the
Permittee as specified below:
';EFFLUENT
w -.fix IMITS`'`
: M,ONI,TORING-REQUIREIVIIE
G HARAGTERISTICS
:Monthl`
'imumhr
ax
-
-Measurement
Sa m
_
Sam
<F ;
r`
'�Fre `ue
,p
yp.
<Locatio n> .
Flow'
0.0021 MGD
2/Month
Instantaneous
Effluent
Total Suspended
30.0 mg/L
45.0 mg/L
2/Month
Grab
Effluent
Solids
Total Residual
17 ug/L
2/Month
Grab
Effluent
Chlorine
Fluoride
Monthly
Grab
Effluent
Total Iron
Monthly
Grab
Effluent
Total Zinc5
Monthly
Grab
Effluent
Total Arsenic
Monthly
Grab
Effluent
Chromium
Monthly
Grab
Effluent
Total Copper
Monthly
Grab
Effluent
Magnesium
Monthly
Grab
Effluent
Total Manganese
_
Monthly
Grab
Effluent
pH
6.0 - 9.0 s.u.
2/Month
Grab
Effluent
Whole Effl�uent Toxicity
Quarterly
Grab
Effluent
Monitorin
Footnotes:
1. For instantaneous flow monitoring, the duration of the discharge must be reported in addition to the total
flow.
2. The TRC monitoring requirement applies only if the Permittee backwashes with chlorine_ or chlorine
derivatives. ;This hiiit_will become effective'on June 1, 2000.
3. The Division shall -.consider all effluent TRC values reported below-50-ug/i to -be -in compliance
with the permit. However, the Permittee:,shall continue`;to record and submit all values reported
laboratory (including field certified), even if these values fall below
by a North Carolina certified labor
50 ug/I.
4. Fluoride should be. monitored if the permittee backwashes with fluoridated finished water.
5. Zinc shall be monitored if;the Permittee-uses.any zing -based additive in the water treatment process.
6. See Attachment A. (2). !
All samples collected. -should be from a representative discharge event.
There shall be no discharge of floating solids or visible foam in other than trace
amounts.

Permit NCO088501
A. (2.) CHRONIC TOXICITY MONITORING (QRTRLY)
The permittee shall conduct quarterly chronic toxicity tests using test procedures outlined in the "North
Carolina Ceriodaphnia Chronic Effluent Bioassay Procedure," Revised February 1998, or subsequent .
versions.
The effluent concentration defined as treatment two in the procedure document is 90%. The testing shall be
performed as a Ceriodaphnia dubia 7day pass/fail test. The tests will be performed during the months of
March, June, September and December. Effluent sampling for this testing shall be performed at the NPDES
Permitted final effluent discharge below all treatment processes.
All toxicity testing results required as part of this permit condition will be entered on the Effluent Discharge
Monitoring Form (MR-1) for the month in which it was performed, using the parameter code TGP313.
Additionally, DWQ Form AT-1 (original) is to be sent to the following address:
Attention: North Carolina Division of Water Quality
Environmental Sciences Section
1621 Mail Service Center
Raleigh—N,.C. 27699-162-1; --� i ---- - --i
Completed Aquatic Toxicity Test Forms shall be filed with the Environmental Sciences-Section-no.later-.--- --.
than 30 days after the end of the. reportir'g period for,which the report. is made.
Test data shall be complete and accurate and include all supporting chemical/physical measurements performed
in association with the toxicity tests, as well as all dose/response! data. Total residual chlorine of the effluent
toxicity sample must i emeasured;and reported if:chloeine is employed`.for disinfection of -the waste stream.
Should there be no discharge of flow from Ehb-facility during a month in which toxicity monitoring is required, the
permittee will complete the information located at'the.top of the aquatic toxicity (AT) test form indicating the facility
name, permit number, pipe number,.*county, and the month/year of thereport with the notation of "NoTlovv' in the
comment area of the form. The report s�all be submitted to the Environmental Sciences Section at the address
cited above.
Should the permittee fail to monitor during a month in'whic'h toxicity monitoring is required, then monthly
monitoring will begin immediately. Upon submission of a valid test, this monthly test requirement will revert to
quarterly in the months specified above.
Should any test data from this monitoring requirement or tests performed by the North Carolina Division of Water
Quality indicate potential impacts to the receiving stream, this permit may be re -opened and modified to include
alternate monitoring requirements or limits.
If the, Permittee monitors any pollutant more frequently then required by this permit, the results of such monitoring
shall be included in the calculation & reporting of the data submitted on the DMR & all AT Forms submitted.
NOTE: Failure to achieve test conditions as specified in the cited document, such as minimum
control organism survival, minimum control organism reproduction, and appropriate
environmental controls, shall constitute an invalid test and will require immediate follow-up
testing to be completed no later than the last day of the month following the month of the initial
monitoring.

Aqua North Carolina, ^Inc. WWW� Fiquanorthcarolina.C&I,
U "A 202 MacKena'n'Cour( Phone:, .919=467-8712;
. Cary, NC 275.11 Fax: [phone]&
A rt[h- Ca.: r1[irl a,,TM,
.June 2, 2009
Mr, Tom Relnick
Supervisor, Western NPDES Program
Division of Water' Quality, — NPDES Unit
1617 Mail Service. Center
Ralelgh,N.C.. 2,7699 - 1617
Subject:= Request for'Residual: Chlorine Compliance Extension,
NPDES 'Permits
Aqua, North Carolina, Inc.
Surry and Forsyth. Counties
Dear,,Mr.'Belnick:
Aqua North Carolina, Inc. regrets that we must ask for your indulgence to :grant us an extension
of the deadline.for complying with residual chlorine limits at.the facilities listed below. This,
:problem has occurred as a. consequence of some organizational changes Aqua North Carolina,
Inc. has experienced in the last several months. As a result, we have discovered that efforts to
prepare and submit plans and. specifications with requests for Authorization to Construct (ATC),.
;fell off:schedule. ,
We have corrected, this problem and have an.engineer Working on he submissions. These are all
'Fast Track applications and: We Will have all .of these submitted and installed. as soon. as
possible. We have prepared and, will submit our plans and specifications for ATC's for the
proposed dechlorination.facilities to serve Bannertown Hills Well No. 1, .Reeves Woods Well
No: 2 and Colonial Woods Well No. L These will 'be 'installed as soon as possible after: receiving
the ATC but, obviously, even. these, yvill, be :after the, current -compliance deadlines.
We'will have all of, the remaining plans and specifications submitted with requests for ATC's'by
no later than July 31, 2009.
Therefore, we are, as for a four. (4) month. extension of the current deadlines for complying
with residual :chlorine limits in thefollowing permits:
Mitchel .Bluff Subdivision Well No:1
Reeves Woods Subdivision Well No-.2
Snow Hill Subdivision' Well No. l
'The Hollows Subdivision Well
Bannertown Hills Subdivision Well No.2
Colonial Woods. Subdivision Well No.1 &
NCO.Q8850=1::
NC.0088498
NC0088633:
NC008861'7
NCO088625
NC0088536
No.2. NC0088552
Page; 1 ,of 2
An Aqua Amb`_ a'Company

Mr. Tom Belnick
Supervisor, Western NPDES Program
Request, for Residual Chlorine :Compliance Extension
Juho 2, 2009
We appreciate your consideration of our request for this extension. If you have any ,questions or
if there is anything we! need to discuss, please contact meat 919-653-6989 or via email at
[e-mail].
Sincerely,,
la,
Scott Smart, P.E.
.Engineering Manager
Aqua North Carolina, Inc.
CC: Aqua NC Compliance
Aqua NC Deriver Operations.
WSRO-:Surface Water.P.rotection Section
An Aqua America Company
Page 2 of 2

NC®ENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director . Secretary
June 1, 2009
Thomas Roberts
Aqua North Carolina, Inc
202 Mackenan Ct
Cary, NC 27511
Subject: Continuing NOTICE OF VIOLATION
Compliance Evaluation Inspection
Stonington Subdivision Well #1 WTP
NPDES Permit No. NCO088501
Forsyth County
Dear Mr Roberts:
A follow up Complianco1valuation Inspection (CEI) was performed on the Stonington Subdivision Well #1 WTP on May 12, 2009
by Rose Pruitt and Marc Stokes with the Division of Water Quality, Winston-Salem Regional Office. Billy Young with Aqua NC was
present for the inspection.
The treatment facility was found to still be in violation of permit NCO088501:
As noted during the previous inspection:
• There were no flow meter calibration records available at the inspection. The Division will accept the estimation of
instantaneous flow for this system based on the manufacturers specifications for this system. Be prepared to supply this
information to the Division.'
• There was no spill response plan available. The Division strongly recommends a spill response plan for this facility.
During the inspection it was noted. that two large containers with sodium hypochlorite and caustic sodium are maintained at
the facility and would flow to a central floor drain that empties just outside the building.
• Operations records were incomplete and did not include all sample analyses and process control tests that were
performed in January and February 2008. Thank you for supplying the missing records, see below.
• There were no chain of custody forms available for January or February 2008. The inspector has reviewed the chain of
custody forms you sUplied and noted that some required signatures are missing from these documents. Please discuss the
importance of completing these forms properly with the lab and operators.
The Division of Water Quality greatly appreciates your continued oversight at this facility. The Division encourages you to continue
to be proactive in your efforts to maintain compliance. Please refer to the enclosed inspection report for additional observations and
comments. If you or your staff have any questions, please call Rose Pruitt at 336-771-5000.
Sincerely,
Steve W. Tedder
Water Quality Regional Supervisor
Winston-Salem Regional Office
Division of Water Quality
cc: Central Files
'i�SFCI
North Carolina Division of Water Quality, Winston-Salem Regional Office
Location: 585 Waughtown St. Winston-Salem, North Carolina 27107 One.
Phone: [phone] FAX: 336-771A630l Customer Service:1-877-623-6748 NorthCarolina
Internet: www.ncwaterquality.org Naturally
atu ra. ly
An Equal Opportunity 1 Affirmative Action Employer �Zd $`

United States Environmental Protection Agency
Form Approved.
EPA Washington, D.C. 20460
OMB No. 2040-0057
Water Compliance Inspection Report
Approval expires 8-31-98
Section A: National Data System Coding (i.e., PCS)
Transaction Code NPDES yr/mo/day Inspection Type Inspector Fac Type
1 I NI 2 15I 31 NCO088501 Ill 121 09/05/12 117 18I CI 19I SI 20III
Remarks
21111111111111111111111111111111111111111111111116
Inspection Work Days Facility Self -Monitoring Evaluation Rating B1 QA Reserved----------
671 i 69 701 I 711 I 721 NJ 73I I W 174 751 I I I I I Li
Section B: Facility Data
Name and Location of Facility Inspected (For Industrial Users discharging to POTW, also include
Entry Time/Date
Permit Effective Date
POTW name and NPDES permit Number)
09:00 AM 09/05/12
09/04/01
Stonington Subdivision - Well #1
Exit Time/Date
Permit Expiration Date
Stonington Way Ct
Kernersville NC 27284
09:30 AM 09/05/12
14/02/28
Name(s) of Onsite Rep resentative(s)/Titles(s)/Phone and Fax Number(s)
Other Facility Data
Name, Address of Responsible Official/Title/Phone and Fax Number
Contacted
Gary Mosel.ey,4163 Sinclair'St Denver NC 28037//704-489-9404/70448994�.
Section C: Areas Evaluated During Inspection (Check only those areas evaluated)
Records/Reports Facility Site Review
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
Marc Stokes WSRO WQ//336-771-5000/
Rose Pruitt // n /% WSRO WQ//336-771-5000/ �r 0'5�
Signature of Mana ment Q A Revi er Agency/Office/Phone and Fax Numbers Date
0//
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete.
Page # 1

v
NPDES yr/mo/day Inspection Type
3I NCO088501 I11 12I 09/05/12 I17 18ICI
(cont.) 1
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
The inspectors were met at the facility by Billy Young, ORC. This facility has not yet been rated so no
certified ORC is required at this time.
The inspectors noted 2 large chemical containers of approx 50 gallons each containing sodium hypochlorite
and caustic sodium would flow to a floor drain that discharges directly outside the building. A spill response
plan is needed.
The inspector noted that chain of custody documents provided by the facility were not signed properly by
either the permitee or the lab.
Page # 2

AQUA.
RECEIVED
N,C. Deot. of ENR
MAY 0 4 2000
,1:r"ton•Salem
R,gional Office
Aqua North Carolina, Inc.
202 MacKenan Court
Cary, NC 27511
May 1, 2009
Mr. Steve Tedder
Water Quality Regional Supervisor
NC DENR-DWQ
585 Waughtown Street
Winston-Salem, North Carolina 27107
Re: Notice of Violation (NOV)
Compliance Evaluation Inspection
Stonington Subdivision Well #1 WTP
NPDES Permit No. NCO088501
Forsyth County
Dear Mr. Tedder:
Thomas J. Roberts
President and Chief
Operating Officer
T: 919.653.5770
F: 919.460.1788
[e-mail]
www.aquanorthcarolina.com
This letter is in response to the referenced NOV at Stonington Subdivision in Forsyth County,
North Carolina. Aqua North Carolina, Inc. (Aqua) offers the following comments to Ms. Rose
Pruitt's inspection findings:
• "There were 'no flow meter calibration records available at the inspection."
Response: The five greensand filters present do not utilize a flow meter, but do contain
flow restrictors. The frequency and the amount of discharge from the greensand filters is
based on timer, and each filter backwashes with a predelertnined volume of 400
gallons/day including regeneration and the rinse cycles. Since there is not a need for a
flow meter, there are no calibration records.
• "There was no spill response plan."
Response: Since the filter and the media within are used in conjunction with water
treatment and the material removed is a naturally occurring mineral, Aqua does not
understand the intent of needing a spill response plan. We would be glad to discuss this
with you further.
An Aqua America Company

Page Two
Mr. Steve Tedder
May 1, 2009
• "Operation records were incomplete and did not include all sample analyses and
process control tests that were performed in January and February 2008."
Response: The sample analyses results for January and February 2008 are attached.
• There were no chain of custody forms available for January or February 2008."
Response: The missing chain of custody forms are attached.
If you have any questions concerning the inspection and Aqua's responses, please contact Cheri
Spencer at [phone].
Sincer y,
Thomas J. erts
President and COO

A°R-30-2009 THU 09:25 AM WATER TECH LABS, INC, FAX NO. 8283965761 P, 02
61117CR47KCH LRDS-I ic. _
POST OFFICE BOX 1056 • #5 PINEWOOD PLAZA DR.
GRANITE FALLS, NORTH CAROLINA 28630
[phone]
SAMPLE: Stonington #1 COLLECTION DATE: 1 /14/2008
PERMIT #: COLLECTION TIME: 1544
ADDRESS: Aqua North Carolina RECEIVED DATE: 1/15/2008
P.O. Box 859 RECEIVEI) TIME: 1300
Denver, NC 28037
REPORTED: 2/14/2008
ANALYSIS
Err
UNITS.
DATE
ANALYST
TSS
<2.0
mg/L
1116/03
Jrfl
A,senic
<0.010
mg/L
1/181013
Calcium
39.3
mg/L
1/18/0B
Chromium
0.007
mg/L
1/22/08
lag
Copper
0.011
mg/L
1I22/08
lag
Magnesium
4.40
mg/L
1/18/C8
Nickel
<0.005
mg/L
1/22/C18
lag
Iron
0,266
mg/L
1/22/08
lag
Selenium
<0.010
mg/L
1/181:�8
Manganese
0.211
mg/L
1122)08
lag
LOG ID: 0801-212 REPORTED BY: NC CERTIFIED LAB # 50
filw6off
'Tony Gragg, Lab Supervisor

APR-30-2009 THU 09:25 AM WATER TECH LABS, INC. FAX N0, 8283965761 F. 03
— ANYTE1 4r9CH DRIPS -Inc.
POST OFFICE BOX 1056 • #5 PINEWOOD PU%ZA DR, ^• ;:
GRANITE FALLS, NORTH CAROLINA 28630:: = -•=
[phone]
SAMPLE., Stonington 01 COLLECTION DATE: 1129/2008
PERMIT #: COLLECTION TIME; 1210
ADDRESS: Aqua North Carolina RECEIVi°D DATE: 1/29/2008
P.O. Box 859 RECEIVED TIME: 1420
Denver, NC 28037
REPORTED: 2/20/2008
ANALYSIS EFF UNITS DATE' ANALYST
TS8 <2.0 mg1L 1/30108 jY9
Mercury <0.0002 mg/L 211I013
LOG ID: 0801-422 REPORTED BY: NC CERTIFIED LAB # SO
f�*
Pony Gmgg, Lab Supervisor

AFR-30-2009 THU 09:25 AM WATER TECH LABS, INC. FAX NO. 8283965761 P. 04
1dIwrrRirZCH LROVinc.
POST OFFICE BOX 1066 • #5 PINEWOOD PLAZA DR.
GRANITE FALLS. NORTH CAROLINA 2863D
[phone]
SAMPLE: Stonington #1 COLLECTION DATE: 2/11/2008
PFRM/T #: COLLECTION TIME: 1067
ADDRESS: Aqua North Carolina RECEIVED DATE; 2/12/2008
P.O. Box 869 RECEIVFD TIME: 1430
Denver, NC 28037
REPORTED: 3/7/2008
lALY�I�:`
.:ANALYSIS: '
EFF
.• UNI•T5 •
DA' . E •
' --ANALYST
TSS
<2.0
mg/L
2/13/013
jrg
Arsenic
<0.010
mg/L
2/1510B
Calcium
1.71
mg/L
2/15108
Chromium
-co.020
mg/L
2/19/08
lag
Copper
<0.020
mg/L
2/19A)B
lag
Magnesium
0.194
mg/L
2/15/oB
Mercury
.40.0002
mg/L
2/15/08
Nickel
<0.010
mg/L
2/19/08
lag
Iron
<0.050
mg/L
2/19N8
lag
Selenium
4.010
mg/L
2/1508
Manganese
0.048
mg/L
2/1SMS
lag
LOG ID; 0802-162 REPORTED BY: NC CERTIFIED LAB # 50
f4
Tony Gragg, Lab Supervisor

4PR-30-2009 THU 09:25 AM WATER TECH LABS, INC. FAX NO. 8283965761
POST OFFICE BOX 1056 • #5 PINEWOOD PLAZA PR_
GRANITE FAILS, WORTH CAROL-INA 28630
(828) 3984444
SAMPLE: Stonington #1 COLLECTION DATE: 2/29/2008
PERMIT #_ COLLECTION TIME: 1363
ADDRESS., Aqua North Carolina RECEIVED DATE: 2/29/2008
P.O, Box 859 RECEIVED TIME. 1546
Denver, NC 28037
REPORTED: 3/6/2008
... Y. -
x:
S
�..
A Is •..
>a:�Y:sr��� `E�F��t unrirs " �� � `- � . �► �.
TSS
<2,0 ►,1g/L 3/5/0e
ire
LOG ID: 0802-440 REPORTED BY: NC CERTIFIED LAB # 50
f6lik
7'iany Gragg, Lab Supervisor
P, 05

APR-30-2009 THU 09:53 AM WATER TECH LABS, INC. FAX NO, 8283965761
q 1
5 Pinewood Plaza DCive - P.O.ox 10,18
Granite- Falls, NC 28630
Phone [phone] - Fax [phone]
CLIENT: Aqua North Carolina PHONE: [phone]
P.O. Box 859 TYPt; SAMPLE: Backwash
Denver, NC 28037 No. LOCATIONS: 4
SAMPLER NAME:
SAMPLE COLLECTION SIUMPIZ- TYPE CONTAINERS
SAMPLE LOCATION C�R� ! PLASTC f
FACILITY NAME DATE TIME TEMP "C coNNPOSrrE NO. Cu►Ss ANALYSIS 1
c TSS,
Q 12; A) 4 SITE I �
Stanln on #1 F
SS,® COY'The Hollows#1 ;�� 3COMPOSITE �s.ram, SS, I�e,�11Arr,-�n
19. .
Reeve / �
s woods #2 1'%'�� J7 COMPOSITE `�a5s
.3 c. 4L6=t , f TSS, Ca; -Mg; T-e
Bannertown #2 COMPOSITE GLASS
RELINQUISHED BY: DATE: TIME-- RECEIVED BY: DA TIME
> �y �L
RELINQUISHED BY: DATE: TIME: RECEI ATE: DIME
PRESER
[ _ pH<2 wt HNO3- Metals
-!::;�[ one -Fluoride
Sample Tempemture at Lab (®C) `
NC CERTIFIED LAB # 50
P. 01

APR-30-2009 THU 09:53 AM WATER TECH LABS, INC. FAX N0, 8283965761 P. 02
wil T_ei�'
5 Pinewood Plaza Drive - P.O. ox 10513
Granite Falls, NC 28630
Phone [phone] - Fax [phone]'61
CLIENT,
PHONE:
/ 1
�a=�►'►..rs�i ��r `/�'��^J
TYPE SAMPLE:
.
No. LOCATIONS:
tP )
SAMPLER NAME:
01,
SAMPLE COLLECTION
SAMPLE TYPE
CONTAINERS
SAMPLE L,OCATIOl4
FACILITY NAME
DATE
TIME
TEMP OC
GRAB I
COMPOSITE
PIASTIS /
NO. GLASS
ANALYSIS REQUIRED
��y
3 y
�•
COM OS1TE GRAB I!
LASTIC
PGLASS I
-1—S �riiao�l�
-jtorf�;.>�flr+
C<, 4i
GRAB /
COMPOSITE
PLASTIC /
GLASS
�l N' • Fe , S /A„
GRAB /
PLASTIC /
COMPOSITE
GLASS
GRAB /
PLASTIC I
COMPOSITE
GLASS
GRAB /
PLASTIC /
COMPOSITE
GLASS
GRAB /
-PLASTIC I
COMPOSITE
GLASS
GRAB /
PLASTIC 1
COMPOSITE
GLASS
GRgBT\
P TIC /
PR�51C Tt:
Gool 4°C - BO TS onductfvity, MBAS, Color, Alkalinity, Cr,VI, Turbidity
j ] Cool 40C - SO4 - NH3, NO2 - NO3, TKN, Oil & Grease, TOC, COD, Hardness, Phenolics, T. Phosphorus
[ o C - pH<2 w/ HNO3 - Metals except Or, VI
[ ] None -Chloride, pH, Fluoride
OTHER: 1 2 s
[ ] Cool 4°C - N82S203 - Coliform Bacteria, NH3, T.N. T. PO4
j ] Cool 4`C - pH > 12 w/ NaOH, 0.6 gm. Ascorbic Acid - Cyanide
[ ] Cool 49C - pH > 9 w/ NaOH, ZnOAc-Suffide
[ ] Per Analyzing Lab - Organics
Sample Temperature at Lab (°C)
1 - Chlorine Residual mg/I
2 - Chlorine Residual mgll NC CERTIFIED LAB # 50
3 - Chlorine Residual mg/l

APR-30-2009 THU 09:53 AM WATER TECH LABS, INC, FAX NO, 8283965761
5 Pinewood Plaza' Drive . P.O. gnx 10513
Granite Fail--, NC 286530
Phone [phone] * Fax [phone]
CLIENT: Aqua North Carolina PHONE: [phone]
P.O. Box 859 TYPE SAMPLE: Backwash
Denver, NC 28037 No. LOCA11ONS.' 4
SAMPLER NAME:
SAMPLE LOCATION
Stonington #1
The Hollows #1
Reaves Wood-
aj
:33
.it
Cool 4*C -TS8
Cool 40C -PH<2w/HNO3- Metals
None -Fluoride
Sample Temperature at Lab (OC)
cc
GLASS
PLASTIC I
GLASS
PLASTIC I
GLASS
PLASTIC I
GLASS
PLASTIC I
GLASS
Mn
a,Cr,r'V,
Mg, Fe,
Fe, Mn, Zn
Ca, Mg, Fe,
NC CERTIFIED LAB# 50
P. 03

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
March 30, 2009
Thomas Roberts
Aqua North Carolina, Inc
202 Mackenan Ct
Cary, NC 27511
Subject: NOTICE OF VIOLATION
Compliance Evaluation Inspection
Stonington Subdivision Well #1 WTP
NPDES Permit No. NC0088501
Forsyth County
Dear Mr Roberts:
A Compliance Evaluation Inspection (CEI) was performed on the Stonington Subdivision Well #1 WTP on Thursday, March 12, 2009
by Rose Pruitt with the Division of Water Quality, Winston-Salem Regional Office. Billy Young and Pete Dealing with Aqua NC
were also present for the inspection.
The inspection consisted of two parts: an on -site inspection of the treatment facility and a file review. The following are the findings
from the subject inspection.
The treatment facility was found to be in violation of permit NC0088501:
I. Permit
The NPDES permit for the Stonington Subdivision Well #1 WTP became effective January 1, 2008 and expires on February 28, 2009.
The permit renewal for this facility was still in review at the time of the inspection. This facility is permitted to discharge 0.0021
MGD backwash wastewater from an existing greensand filtration water treatment system utilizing greensand filters in series and
chemicals; potassium permanganate, chlorine and caustic soda. The Stonington Subdivision Well #1 WTP is located at Stonington
way Court, Kernersville in Forsyth County North Carolina.. The facility is authorized to discharge from the above treatment works
into an unnamed tributary to Abbotts Creek, a class WS-III water in the Yadkin Pee Dee River Basin.
H. Records/Reports
The ORC's daily logbook was evaluated and found to be satisfactory. DMR's were available for the period requested. A complete
copy of the NPDES permit was on site. The daily operator and maintenance logs were on site. Emergency contact information was
posted on the gate. An annual report for the year 2008 was available at the inspection.
The following deficiencies and violations were noted during the inspection and require your immediate attention:
• There were no flow meter .calibration records available at the inspection.
• There was no spill response plan available.
• Operations records were incomplete and did not include all sample analyses and process control tests that were
performed in January and February 2008.
• There were no chain of custody forms available for January or February 2008.
III. Facility Site Review . - -
The facility site review indicated that the 0.0021 MGD greensand water treatment system is consistent with the permitted components.
The actual permitted treatment system consists of greensand filters in series utilizing the following chemicals; potassium
permanganate, chlorine and caustic soda.
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
Nne
®rthCarolina
An Equal Opportunity 1 Affirmative Action Employer

IV. Effluent / Receiving Stream
The WTP discharges to an unnamed tributary to Abbots Creek, which is a classified WS-III water in the Yadkin Pee Dee River Basin.
The discharge pipe stops short of the stream. There was no effluent on the date of inspection. The receiving stream was free of solids,
foam and debris.
V. Flow Measurement
• There were no flow meter calibration records available at the inspection.
VI. Self -Monitoring Program
A review of the discharge monitoring reports (DMRs) for the time period of January 2008 through December 2008 demonstrated that
the Stonington Subdivision Well #1 WTP had no permit limit violations for 2008. An NOV was issued for a late or missing DMR for
January 2008.
VII. Laboratory
Sample analyses are conducted by Watertech and R&A Labs. The laboratory was not reviewed at the time of the subject inspection.
• Chain of custody forms were missing for January and February 2008.
VIII.Operation and Maintenance
Operation and maintenance at the time of the subject inspection were deemed satisfactory.
The Division of Water Quality will greatly appreciate your prompt attention to the non-compliance issues noted in this inspection.
Your permit is very specific about the types of reports and records that must be retained, the length of time they must be retained and
your responsibility to furnish them on request. This office faxed a request for information related to the inspection that should have
been be available at the inspection to Michael Melton before the inspection. These complete records were still not made available to
the inspector.
You are required to respond to this office, in writing, stating how the non-compliance issues will be addressed.
a) All calibration records for flow measurement for the past year.
b) Lab Data per DMR dates (from a certified lab) for the January and February of 2008.
c) Chain of custody forms (per DMR dates) for lab data for January and February of 2008.
d) A spill response plan with updated emergency numbers for this facility.
The report and all supporting documentation must be received in this Office no later than 30 days from receipt of this letter. You
should be aware that until full compliance is achieved with all Division regulations and permit conditions, the subject facility will be
considered to be in violation and could be subject to the possible assessment of civil penalties of up to $25,000 per day, per violation.
The Division of Water Quality greatly appreciates your continued oversight at this facility. The Division encourages you to continue
to be proactive in your efforts to maintain compliance.
Please refer to the enclosed inspection report for additional observations and comments. If you or your staff have any questions,
please call Rose Pruitt at 336-771-5000.
Sincerely,
l�
Steve W. Tedder
Water Quality Regional Supervisor
Winston-Salem Regional Office
Division of Water Quality
cc: Central Files
4#WViSR®

United States Environmental Protection Agency
Approved.
EPA Washington, D.C. 20460
OMB No. 2040-0057
OMB
Water Compliance Inspection Report
Approval expires 8 31-98
Section A: National Data System Coding (i.e., PCS)
Transaction Code NPDES yr/mo/day Inspection Type Inspector Fac Type
1 I NI 2 15I 3I N0O088501 111 121 09/03/12 117 181 CI 191 SI 20III
Remarks
211111111111111111 11111111111111111111111111111116
Inspection Work Days Facility Self -Monitoring Evaluation Rating B1 . QA -- ---- - --Reserved----- -- --
671 169 701 I 711 I 721 NJ 73 I I 174 751 I I I E I I 180
W
Section B: Facility Data
Name and Location of Facility Inspected (For Industrial Users discharging to POTW, also include
Entry Time/Date
Permit Effective Date
POTW name and NPDES permit Number)
08:30 AM 09/03/12
08/01/01
Stonington Subdivision - Well #11
Exit Time/Date
Permit Expiration Date
Stonington Way Ct.
Kernersville NC 27284
09:30 AM 09/03/12
09/02/28
Nand(s) of Onsite Representative(s)/Titles(s)/Phone and Fax Number(s)
Other Facility Data
Name, Address of Responsible Official/Title/Phone and Fax Number
Contacted
Gary Moseley,4163 Sinclair St Denver NC 28037//704-489-9404/7044899ff0
Section C: Areas Evaluated During Inspection (Check only those areas evaluated)
Permit Flow Measurement Operations & Maintenance 0 Records/Reports
Self -Monitoring Program Facility Site Review ® Ef luent/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
Rose Pruitt WSRO WQ//336-771-5000/
�o
Signature of Manage t Q A Review Agency/Office/Phone and Fax Numbers Date
' V
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete.
Page # 1

NPDES yr/mo/day Inspection Type 1
3I NCO088501 I11 12I 09/03/12 I17 18ICI
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
The inspector met Billy Young (ORC) and Pete Dealing (back up ORC) at the facility. Lab data and chain of
custody forms for January and February 2008 were not available. There was no spill response plan
available. There were no flow meter calibration records available.
The effluent pipe stops short of the stream.
Page # 2

Permit: NCO088501
Inspection Date: 03/12/2009
Owner - Facility: Stonington Subdivision - Well #1
Inspection Type: Compliance Evaluation
Operations & Maintenance Yes No NA NE
Is the plant generally clean with acceptable housekeeping? ■ n n n
Does the facility analyze process control parameters, for ex: MLSS, MCRT, Settleable Solids, pH, DO, Sludge ■ n n n
Judge, and other that are applicable?
Comment:
,� vex u„ ue u❑
.(If the present permit expires in 6 months or less). Has the permittee submitted a new.application?
■ n
110
Is the facility as described in the permit?
■ ❑
n
n
# Are there any special conditions for the permit?
n n
■
n
Is access to the plant site restricted to the general public?
■ n
n
n
Is, the inspector granted access to all areas for inspection? -
■ n
n
n
Comment:
Record Keeping
Yes No
NA
NE
Are records kept and maintained as required by the permit?
n ■
n
n
Is all required information readily available, complete and current?
n ■
n
n
Are all records maintained for 3 years (lab. reg. required 5 years)?
n n
n
■
Are analytical results consistent with data reported on DMRs?
■ n
n
n
Is the chain -of -custody complete?
n ■
n
n
Dates, times and location of sampling
n
Name of individual performing the sampling
n
Results of analysis and calibration
Dates of analysis
n
Name of person performing analyses
n .
Transported COCs
n
Are DMRs complete: do they include all permit parameters?
■ n
n
❑
Has the facility submitted its annual compliance report to users and DWQ?
■ n
n
n
(If the facility is = or > 5 MGD permitted flow) Do they operate 24/7 with a certified operator on each shift?
n ❑
■
n
Is the ORC visitation log available and current?
■ n
n
n
Is the ORC certified at grade equal to or higher than the facility classification?
n n
■
n
Is the backup operator certified at one grade less or greater than the facility classification?
n n
■
n
Is a copy of the current NPDES permit available on site?
■ n
n
n
Page # 3

Permit: NC0088501
Inspection Date: 03/12/2009
Owner -Facility: Stonington Subdivision -Well #1
Inspection Type: Compliance Evaluation
Record Keeping
Facility has copy of previous year's Annual Report on file for review?
Comment: January & February chain of custody forms and lab records missing.
No spill response plan available
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?
Comment: Effluent pipe stops short of stream
Flow Measurement - Effluent
# 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: No calibration.records for flow meter
Effluent Sampling
Is composite sampling flow proportional?
Is sample collected below all treatment units?
Is proper volume collected?
Is the tubing clean?
# Is proper temperature set for sample storage (kept at less than or equal to 6.0 degrees Celsius)?
Is the facility sampling performed as required by the permit (frequency, sampling type representative)?
Comment: grab samples .
Yes No NA NE
❑ ❑ ■ ❑
Yes No NA NE
■ n n n
■nnn
nn■o
nn■n
■nnn
n n n ■
nn■n
nn■n
■ n n n
Page # 4

Faxed To: Aqua- Michael Melton
Fax #: [phone] Phone [phone]
WWTP Annual Inspection Checklist
This information should be available to the inspector at inspection time.
Facility: Stonin_gton Well #1 NPDES: NC0088501
Permit Effective Dates: January 1, 2008 to February 28, 2009 (In Review)
Inspection Date: March 92, 2009 Inspection Time: 8:30 am
�1) DMRs January 2008 t i December 200
(Dates: n
Lab Data (per DMR dates)'
Laboratories for & #'s
used analysis certification
Chain of Custody forms (per DMR dates)
✓5) Complete NPDES
copy of current permit
__&)-�tus of SOC or Moratorium issuance (if applicable)
✓�� 1eel
7) ORC and Back-up ORC current certification g
�/8) Wastewater Annual Report (fiscal or calendar year - if applicable)
Daily Operator's log / ORC visitation log
10) Maintenance log - PW
Process control data (which includes field parameters tested and equipment
calibrations)
v12) Field Parameter certification (if applicable)
Flow meter calibration records (if applicable) •
and/or effluent samplers
15) Fln e_rha tts (if applicably
16) Generator Inspection / under load checks
17) Spill Response Plan (with current emergency contact numbers)
�1 1 rec rds (if applicable)
�9) Plant visual inspection of treatment units J
20) Stream accessible for insp Sction (at effluent discharge pipe)
l
Please call with questions:
o Rose Pruitt
NC Department of Environment & Natural Resources
N Division of Water Quality
Winston-Salem Regional Office
�.� [phone]
Fax: (3�6) 77 1 -4630 I
W

MONITORING REPORT(MR) VIOLATIONS for:
Report Date: 03/30/09 Page: 3 of 3
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a.,
Perrrilt` nc0088S01 w,, , ; MRs=Between 1;2008 'and I2�2pQ8 y; Region::% Ylolation Category °!o 'ProgramMCategory, °1° I
pttF¢':Faclll Name °I° }� : , � � Param:Nairie % � " ,`r � • •.Couritt:-0/Q � "= d Stitibasm °° - i Violation n:
E;,'1 ri. .. k7� .i , 6 r+ .�:.. .,.x "�� ` n .� r s y • i. ,,.,� a �s- y ,1, ,.;s� � ' � " .� $"- y� iui.. .�;r, . r ! :,k t . '"�:�,x;,: ' ff 1�, n,"Si t
�
.�
i ; is k , i Y ','F Ihy . � r,�.' ' [ "� :',ti =r'' ' �i e�, � � .E '.�' �'�r^# t� fi k ..� ��o�n# �'e• � a „i }r'" iF��7`; r .. ,��."'� ' '� . i t � _'' � '�" .'k',. I "�- "" ..ia; "" ,e�='` ' k . tfr- t w i� t',
r z
PERMIT: NCO088501 FACILITY: Aqua North Carolina Inc - Stonington Subdivision - Well #1 COUNTY: Forsyth REGION: Winston-Salem
Monitoring Violation
MONITORING OUTFALL /
VIOLATION
UNIT OF
CALCULATED
REPORT PPI LOCATION
PARAMETER
DATE FREQUENCY
MEASURE
LIMIT VALUE
VIOLATION TYPE
VIOLATION ACTION
12 -2008 001 Effluent
Flow, in conduit or thru
12/27/08 Weekly
mgd
Frequency Violation
None
treatment plant
Reporting Violation
MONITORING OUTFALL/
VIOLATION
UNIT OF
CALCULATED
REPORT PPI LOCATION
PARAMETER
DATE FREQUENCY
MEASURE
LIMIT VALUE
VIOLATION TYPE
VIOLATION ACTION
01 -2008
03/02/08
Late/Missing DMR
Proceed to NOV
05 -2008
07/01/08
Late/Missing DMR
No Action, BPJ

MONITORING REPORT(MR) VIOLATIONS for: Report Date: 03/30/09 Page: 1 of 3
T Permit., nc008850i` M j' MRs Between. "�+`�1-2008 ,-and; °•12-2008 Region: °I° " ° Violation Category:_.% 'grogram Category,:'%.s`
:lunty% Subbasin`
Facility -Name: Param NameViolation Action:% { S6° Maaor Minor % r
t......t.._...a.,-.�.�.w..�—.u.... �b R '
PERMIT: NCO088501 FACILITY: Aqua North Carolina Inc - Stonington Subdivision - Well #1 COUNTY: Forsyth REGION: Winston-Salem
Monitoring Violation
MONITORING OUTFALL/
VIOLATION
UNIT OF CALCULATED
REPORT
PPI
LOCATION
PARAMETER
DATE
FREQUENCY
MEASURE LIMIT VALUE
01 -2008
001
Effluent
Flow, in conduit or thru
01/05/08
Weekly
mgd
treatment plant
01 -2008
001
Effluent
Flow, in conduit or thru
01/12/08
Weekly
mgd
treatment plant
01 -2008
001
Effluent
Flow, in conduit or thru
01/26/08
Weekly
mgd
treatment plant
02 -2008
001
Effluent
Flow, in conduit or thru
02/09/08
Weekly
mgd
treatment plant
02 -2008
001
Effluent
Flow, in conduit or thru
02/23/08
Weekly
mgd
treatment plant
03 -2008
001
Effluent
Flow, in conduit or thru
03/08/08
Weekly
mgd
treatment plant
03 -2008
001
Effluent
Flow, in conduit or thru
03/22/08
Weekly
mgd
treatment plant
04 -2008
001
Effluent
Flow, in conduit or thru
04/12/08
Weekly
mgd
treatment plant
04 -2008
001
Effluent
Flow, in conduit or thru
04/26/08
Weekly
-mgd
treatment plant
05 -2008
001
Effluent
Flow, in conduit or thru
05/03/08
Weekly
mgd
treatment plant
05 -2008
001
Effluent
Flow, in conduit or thru
05/10/08
Weekly
mgd
treatment plant
05 -2008
001
Effluent
Flow, in conduit or thru
05/24/08
Weekly
mgd
treatment plant
06 -2008
001
Effluent
Flow, in conduit or thru
06/07/08
Weekly
mgd
treatment plant
06-2008
001
Effluent
Flow, in conduit or thru
06/21/08
Weekly
mgd
treatment plant
VIOLATION TYPE
VIOLATION ACTION
Frequency Violation
None
Frequency Violation
None
Frequency Violation
None
Frequency Violation
None
Frequency Violation
None
Frequency Violation
None
Frequency Violation
None
Frequency Violation
None
Frequency Violation
None
Frequency Violation
None
Frequency Violation
None
Frequency Violation
None
Frequency Violation
None
Frequency Violation
None

MONITORING REPORT(MR) VIOLATIONS for: Report Date: 03/30/09 Page: 2 of 3
Permit: nc0088501 MRs Between:'' 1-2008 and' .12-2608 - Region; % Violation Category: % Program. Category:' %,
Facility Name: % Param Name: % County: % Subbasin: % Violation Action:% ,
!,,Major Minor: °/a .
PERMIT: NCO088501 FACILITY: Aqua North Carolina Inc - Stonington Subdivision - Well #1 COUNTY: Forsyth REGION: Winston-Salem
Monitoring Violation
MONITORING OUTFALLI
VIOLATION
UNIT OF CALCULATED
REPORT
PPI
LOCATION
PARAMETER
DATE
FREQUENCY
MEASURE LIMIT VALUE
07 -2008
001
Effluent
Flow, in conduit or thru
07/05/08
Weekly
mgd
treatment plant
07 -2008
001
Effluent
Flow, in conduit or thru
07/19/08
Weekly
-mgd
treatment plant
08 -2008
001
Effluent
Flow, in conduit or thru
08/02/08
Weekly
mgd
treatment plant
08 -2008
001
Effluent
Flow, in conduit or thru
08/09/08
Weekly
mgd
treatment plant
08 -2008
001
Effluent
Flow, in conduit or thru
08/23/08
Weekly
mgd
treatment plant
09 -2008
001
Effluent
Flow, in conduit or thru
09/06/08
Weekly
mgd
treatment plant
09 -2008
001
Effluent
Flow, in conduit or thru
09/20/08
Weekly
mgd
treatment plant
10 -2008
001
Effluent
Flow, in conduit or thru
10/04/08
Weekly
mgd
treatment plant
10 -2008
001
Effluent
Flow, in conduit or thru
10/18/08
Weekly
mgd
treatment plant
11 -2008
001
Effluent
Flow, in conduit or thru
11/01/08
Weekly
mgd
treatment plant
11 -2008
001
Effluent
Flow, in conduit or thru
11/15/08
Weekly
mgd
treatment plant
11 -2008
001
Effluent
Flow, in conduit or thru
11/29/08
Weekly
mgd
treatment plant
12 -2008
001
Effluent
Flow, in conduit or thru
12/06/08
Weekly
mgd
treatment plant
12 -2008
001
Effluent
Flow, in conduit or thru
12/20/08
Weekly
mgd
treatment plant
VIOLATION TYPE
VIOLATION ACTION
Frequency Violation
None
Frequency Violation
None _
Frequency Violation
None
Frequency Violation
None
Frequency Violation
None
Frequency Violation
None
Frequency Violation
None
Frequency Violation
None
Frequency Violation
None
Frequency Violation
None
Frequency Violation
None
Frequency Violation
None
Frequency Violation
None
Frequency Violation
None

i
Performance Annual Deport
I. General Information
Facility/System Name: Stonington-Well #1
Responsible Entity: Aqua North Carolina, Inc.
Person in Charge/Contact: Tom Roberts D EN R ' WATER QUALITY
V I I I SOURCE BIZ-' NCH
Applicable Permit (s): T77 2K j p f
Description of Collection System or Treatment Process:
This facility discharges the backwash water from iron removal filters
serving this community water system. TRC limit of 17 ug/L will become
effective in June 2009
II. Performance
Text Summary of System Performance for Calendar Year 2008
The water treatment plant performed well and consistently met the
discharge limits.
List (by month) any violations of permit conditions or other environmental
regulations. Monthly lists should include discussion of any environmental
impacts and corrective measures taken to address violations.
January Compliant
February Compliant
March Compliant
April Compliant
May . Compliant
"r'.C. UaLL j`�n'.7
Winston-Salem
_Regional office

June Compliant
July
Compliant
August
Compliant
September
Compliant
October
Compliant
November
Compliant
December Compliant
III. Notification
Our customers will receive a message on their bills regarding the availability
of this report upon request and a notebook containing these reports is located
in our Customer Service office.
IV. Certification
I certify under penalty of law that this report is complete and accurate to the
best of my knowledge. I further certify that this report has been made
available to the users or customers of the named system and that those users
have been notified of its availability.
AA cuf-rt6' Date: 02/28/09
Responsible Person
Title: Regional Compliance Manager
Entity: Aqua North Carolina, Inc.

AkINEIFWAL
A WMAI
- NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Michael F. Easley, Governor
June 2, 2008
Gary R. Moseley
Aqua.North Carolina, Inc.
4163 Sinclair St
Denver, NC 28037
William-G. Ross, Jr.,
RI= 55-hiin H. ,Sulk s,
N.C. Dept. of ENR
JUN. 0 4 2000
Wipston•Salem
Regional QfFce
Subject: Renewal Notice
NPDES Permit NCO088501
Stonington Subdivision - Well #1
Forsyth County
Dear Permittee:
secretary
Director
Your NPDES permit expires on'February 28, 2009. Federal (40 CFR 122.41) and North Carolina
(15A NCAC 2H.0105 (e)) regulations state that permit renewal applications must be filed at least 180 days
prior to expiration of the current permit. If you have .already mailed your renewal application, you
may disregard this notice.
. Your renewal package must be sent to the Division postmarked no later than September 1, 2008.
Failure to request renewal by this date may result'in a civil penalty assessment. Larger penalties may be
assessed depending upon the delinquency. of the request.
If any wastewater discharge will occur after February 28, 2009, the current permit must be renewed.
Discharge of wastewater without a valid permit would violate 'North Carolina General Statute 143-215.1;
unpermitted discharges of wastewater may be, assessed civil penalties of up to $25,000 per day.
If all wastewater discharge has ceased at your facility and you wish to rescind this permit, contact
me at the telephone number or address listed below.
. Use -the enclosed checklist to complete your renewal package. The checklist identifies the items you
must submit with the permit renewal application. ' If you have any questions, please contact me at the
telephone number or e-mail address listed below.
Sincerely,
Charles H., Weaver, Jr.
NPDES Unit
cc: Central Files
NPDES File
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 One 1
512 North Salisbury Street, Raleigh; North Carolina 27604 NofthCarollna
Phone: [phone], extension 511 / FAX [phone] / [e-mail] ;atul
��rt�jr/�An Equal Oppounity/Affirmative Action Employer — 50% Recycled/10% Post Consumer Paper V [ L"

NPDES PERMIT NC0088501
STONINGTON SUBDIVISION - WELL #1
FORSYTH COUNTY
The following items are REQUIRED for all renewal packages:
➢ A cover letter requesting renewal of the permit and documenting any changes at the facility since
issuance of the last permit. Submit one signed original and two copies.
➢ The completed application form (copy attached), signed by the permittee or an Authorized
Representative. Submit one signed original and two copies.
➢ If an Authorized Representative (such as a consulting engineer or environmental consultant) prepares
the renewal package, written documentation must be provided showing the authority delegated to any
such Authorized Representative (see Part II.B.1 Lb of the existing NPDES permit).
➢ A narrative description of .the sludge management plan for the facility. Describe how sludge (or other
solids) generated during wastewater treatment are -handled and disposed. If your facility has no- such
plan (or the permitted facility does not generate any solids), explain this in writing. Submit one signed
original and two copies.
The following items must be submitted by and Municipal or Industrial facilities discharging
process wastewater:
Industrial facilities classified as Primary Industries (see Appendices A-D to Title 40 of the Code of Federal
Regulations, Part 122) and ALL Municipal facilities with a permitted flow >_ 1.0 MGD must submit a
Priority Pollutant Analysis (PPA) in accordance with 40 CFR Part 122.21.
The above requirement does NOT apply to privately owned facilities treating 100%
domestic wastewater, or facilities which, discharge non process wastewater (cooling
water, filter backwash, etc.)
Send the completed renewal package to:
Mrs. Dina Sprinkle
NC DENR / DWQ / Point Source Branch
_ 1617 Mail Service Center
Raleigh, NC 27699-1617

NPDES REGIONAL WATER QUALITY
STAFF REPORT AND RECOMMENDATIONS
(This form is best filled out on computer, rather than hard copy)
Date: 68/15/2007 County: Forsyth
To: NPDES Discharye Permitting Unit Permitee: Aqua North Carolina
Attn. NPDES Reviewer: Agyeman Adu-Poku Application/ Permit No.: NCO088501
Staff Report Prepared By: Rose Pruitt
Project Name: Stonington Subdivision Well 41
SOC Priority Project? (Y/N) N If Yes, SOC No.
A. GENERAL INFORMATION
1. This application is (check an that apply): ® New ❑ Renewal
❑ Modification
2. Was a site visit conducted in order to prepare this report? Z Yes or ❑ No.
a. Date of site visit: 06/26/2007
b. Person contacted and telephone number:
c. Site visit conducted by: Rose Pruitt
d. Inspection Report Attached: ❑ Yes or ® No.
3. Keeping BIMS Accurate: Is the following BIMS information (a. through e. below) correct?
® Yes or ® No. If No, please either indicate that it is correct on the current application or the
existing permit or provide the details. If none can be supplied, please explain:
Discharize Point: (Fill this section only if BIMS or Application Info, is incorrect or missing)
(If there is more than one discharge pipe, put the others on the last page of this form.)
a. Location OK on Application ❑,
OK on Existing Permit ❑, or provide Location:
b. Driving Directions OK on Application ❑,
OK on Existing Permit ❑, or provide Driving Directions (please be accurate):
c. USGS Quadrangle Map name and number OK on Application ❑,
OK on Existing Permit ❑, or provide USGS Quadrangle Map name and number:
d. Latitude/Longitude OK on Application ❑, (check at http://www.topozone.com These are often
inaccurate) OK on Existing Permit ❑, or provide Latitude: Longitude:
e. Receiving Stream OK on Application ❑,
OK on Existing Permit ❑, or provide Receiving Stream or affected waters:
a. Stream Classification:
b. River Basin and Sub basin No.:
c. Describe receiving stream features and downstream uses:
For NEW FACILITIES Proceed to Section C, Evaluation and Recommendations
(For renewals or modifications continue to section B)

a
w •
NPDES REGIONAL WATER QUALITY � 1
STAFF REPORT AND RECOMMENDATIONS
B. DESCRIPTION OF FACILITIES AND WASTE(S) (renewals and modifications only)
1. Describe the existing treatment facility:
2. Are there appropriately certified ORCs for the facilities? ❑ Yes or ❑ No.
Operator in Charge: Certificate # (Available in BIMS or Certification Website)
Back- Operator in Charge: Certificate #
3. Does the facility have operational or compliance problems? Please comment:
Summarize your BIMS review of monitoring data (Notice(s) of violation within the last permit cycle;
Current enforcement action(s)):
Are they currently under SOC, ❑ Currently under JOC, ❑ Currently under moratorium ❑? Have
all compliance dates/conditions in the existing pennit, SOC, JOC, etc. been complied with? ❑ Yes
or ❑ No. If no, please explain:
4. Residuals Treatment: PSRP ❑ (Process to Significantly Reduce Pathogens, Class B) or
PFRP ❑ (Process to Further Reduce Pathogens, Class A)?
Are they liquid or dewatered to a cake?
Land Applied? Yes ❑ No ❑ If so, list Non -Discharge Permit No.
Contractor Used:
Landfilled? Yes ❑ No❑ If yes, where?
Other?
Adequate Digester Capacity? Yes ❑ No ❑ Sludge Storage Capacity? Yes ❑ No ❑
Please comment on current operational practices:
5. Are there any issues related to compliance/enforcement that should be resolved before issuing this
permit? ❑ Yes or ❑ No. If yes, please explain:
C. EVAL UATIONAND RECOMMENDATIONS
1. Alternative Analysis Evaluation: has the facility evaluated the non -discharge options available? Give
regional perspective for each option evaluated:
Spray Irrigation:
Connect to Regional Sewer System: Not available
Subsurface:
Other Disposal Options:
2. Provide any additional narrative regarding your review of the application: NOI is for an existing
discharge and to bring facility into compliance
FORM: NPDES-RRO 06/03, 9/03 2

ly
NPDES REGIONAL WATER QUALITY
STAFF REPORT AND RECOMMENDATIONS
3. List any items that you would like NPDES Unit to obtain through an additional information
request. Make sure that you provide a reason for each item:
Recommended Additional Information I Reason
4. List specific Permit requirements that you recommend to be removed from the permit when
issued. Make sure that you provide a reason for each condition:
Recommended Removal Reason
5. List specific special requirements or compliance schedules that you recommend to be included in
the permit when issued. Make sure that you provide a reason for each special condition:
Recommended Addition Reason
6. Recommendation: ❑ Hold, pending receipt and review of additional information by regional office;
❑ Hold, pending review and approval of required additional' information by NPDI S permitting
office; ® Issue; ❑ Deny. If deny, please state reasons:
7
Reminder: attach inspection report if Yes was the ked for 2 d.
Signature of report preparers
Signature of WQS regional supervisor:
Date: � /& `o
FORM: NPDES-RRO 06/03, 9/03 3

:4U
ry*
C
y

e0Yz__
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
August 8, 2008
THOMAS ROBERTS
PRESIDENT AND COO
AQUA NORTH CAROLINA INC
202 MACKENAN COURT
CARY NC 27511
Coleen H. Sullins, Director
Division of Water Quality
RECEIVED
N.C. 000t, of ENR
AUG f 12008
Winston-Salem
Regional Office
Subject Receipt of permit renewal application
NPDES Permit NCO088501
Stonington Subdivision - Well #1
Forsyth County
Dear Mr. Roberts:
The NPDES Unit received your permit renewal application on August 5, 2008. A member
of the NPDES Unit will review your application. They will contact you if additional information is
required to complete your permit renewal. You should expect to receive a draft permit
approximately 30-45 days before your existing permit expires.
If you have any additional questions concerning renewal of the subject permit, please contact
Robert Guerra at [phone].
Sincerely,
MINIM 3/1
Dina Sprinkle
NPDES Unit
cc: CENTRAL FILES
m stagy Sal �I?y g-nall '* Surface Water Protection
NPDES Unit
Mailing Address Phone [phone] Location NorthCarol—
1617 Mail Service Center Fax [phone] N. Salisbury St. QtlllYt��
Raleigh, NC 27699-1617 Raleigh, NC 27604
Internet: www.newateroualitv.ors Customer Service 1-877-623-6748
An Equal Opportunity/Affirmative Action Employer — 50% Recycled/10% Post Consumer Paper

AQUA.
Aqua North Carolina, Inc.
202 MacKenan Court
Cary, NC 27511
July 30, 2008
Ms: Dina Sprinkle .
NC DENRIDWQ/Point Source Branch
1617 Mail Service Center
Raleigh, NC 27699-1671
SUBJECT. NPDES Renewal Application
Stonington Subdivision, Well #1
NPDES Permit No. NCO088501
Surry County, NC
Dear Ms. Sprinkle:
Thomas J. Roberts
President and Chief
Operating Officer
T: 919.467.8712 ext. 30
F: 919.460.1788
[e-mail]
www.aquanorthcarolina.com
Transmitted herewith are the completed/signed original and two copies of the subject NPDES
permit application and two copies of this cover letter. Since this facility does not generate any
sludge, no sludge management plan is necessary. There have been no modifications since the
last permit was issued.
It is my understanding that no filing fee is required for this renewal
If you have any questions regarding this application, please do not hesitate to contact me.
Sine ely
Thomas . Roberts
President and COO
1
Enclosure
An Aqua America Company

Short Form C - WTP
NPDES PENT: APPLICATION` - SHORT FORM C WTP .
- For discharges. associated with water treatment plants
Federal Q State Q Priyate JA Public Q., -
5. Type of treatment plantc
Q Conventional (Includes coagulation, flocculation, and -sedimentation, usually followed by
filtration and disinfection)
Q Ion Exchange ,(Sodiuin Cycle Cationic ion exchange)
Green Sand Filter JNo sodium recharge)
1wembrane Technology (RO,, nano filtration).
Check here if the treatment process. -also uses a water softener Q
6. Descripti(in.of source_ water(s) (i.e. groundwater, surface' water)
Groundwater. well
7. Describe the treatment process(es.) for the raw water:
Green- sand: filtration, using. potassium permanganate.' Chlorine added for disinfection.and.
Caustic`soda.addedfour pMadjustment. "
S: Describe the wastewater and the treatment process(es) for wastewater generated by the
facility:
Wastewater discharge is the backwash of the green sand ,filters. Discharge rate. is
approximately 2100 gallons, once every two(2) days.
9. Number of separate discharge points: 1
Outfall Identification number(s) 001
10. Frequency of discharge: Continuous ❑ Intermittent
If intermittent:
Days per week discharge occurs: 3 Duration: Approx. 20 minutes
11. Plant design potable flowrate 0.0619 (Max. well yield) MGD
Backwash or reject flow 0.0021 MGD
12. Name of 'receiving stream(s) (Provide a map showing the exact location -of each outfall, including
latitude and longitudes
Unnamed tributary to Abbotts Creek (Yakdiu River Basin)

Ti PDES PERMIT APPLICATION - SHORT FORM C - WTP
For discharges associated with water treatment plants
13: Meaffm Hat an Water treatment addit P -cl i me cleaming chomicau or disbdaction
t t entjj4 that have the potential to be discharged.
Potassium permanganate
Chlorine
Caustic soda
14. Is this facility located on Indian country? (check one)
Yes ❑ No
15. Additional Information:
➢ Provide a schematic of flog through the facility, include flow volumes at all points in
the treatment process, and point of addition of chemicals.
- Solids Handling Plan
16. NEW Applicants
Information needed in addition to items 1-15:
➢ New applicants must contact a permit coordinator with the NCDENR Customer
Service Center.
Was the Customer Service Center contacted? ❑ Yes ❑ No
Analyses of source water collected
➢ Engineering Alternative Analysis
➢ Discharges from Ion Exchange and Reverse Osmosis plants shall be evaluated using a
water quality model.
17. Applicant Certification
I certify that I am familiar with the information contained in the application and that to the
best of my knowledge and belief such information is true, complete, and accurate.
North Carolina General Statute 143-215.6 (b)(2) provides that: Any person who knowingly makes any false
statement representation, or certification in any application, record, report, plan, or .other document files or
required to. be maintained under Article 21 or regulations of the Environmental Management Commission
implementing that Article, or who falsifies, tampers with, or knowingly renders inaccurate any recording or
monitoring device or method required to be operated or maintained under Article 21 or regulations of the
Environmental Management Commission implementing that Article, shall be guilty of a misdemeanor punishable

NPDES PERMIT APPLICATION - SHORT FORM C - WTP
For discharges associated with water treatment plants
by a fine not to exceed $25,000, or by imprisonment not to exceed six months, or by both. (18 U.S.C. Section
1001 provides a punishment by a fine of not more than $25,000 or imprisonment not more than 5 years, or both,
for a similar offense.)

�p
f3sc
kV
9
Stoninorton Subdivision Well #1
Receiving Stream: 12T to AMOLS Creek Subbasin: 03-07-07
Drainaee Basin: Yadkin -Pee Dee River Basin Latitude: 36' 02' 55- N
Loneitude: 80' 04' 32" 'A Permitted Flow: 0.0021 MGD
Stream Class: 'A'S-111 Grid/Quad: C IS SE. Kernersville
Facility
m 'M' W
Location,
. -ii
not to scale
m-
Nth
Nr PDES Permit No. NCO088501
Forsvth County

Michael F. Easley
Governor
William G. Ross, Jr., Secretary
North Carolina Department of Environment and Natural Resources
Coleen H. Sullins, Director
Division of Water Quality
March 26, 2008
CERTIFIED MAIL 7002-2410-0000-5757-1755
RETURN RECEIPT REQUESTED
Mr. Gary Moseley
Aqua North Carolina, Inc.
4163 Sinclair Street
Denver, North Carolina 28037
Subject: NOTICE OF VIOLATION
Stonington Subdivision Well #1
NPDES Permit NCO088501
Forsyth County
NOV-2008-LR-0017
Dear Mr. Moseley:
This is to inform you that the Division of Water Quality has not received your monthly
monitoring report for January 2008. This is in violation of Part II, Condition D(2) of the NPDES permit,
as well as 15A NCAC 2B .506(a), which requires the submittal of Discharge Monitoring Reports no later
than the thirtieth (30'') day following the reporting period. Failure to submit reports as required will
subject the violator to the assessment of a civil penalty of up to $25,000 per violation. You will be
considered noncompliant with the self -monitoring requirements of your NPDES permit until the report
has been submitted.
To prevent further action, please submit said report within fifteen (15) days of receipt of this
notice.
The Division must take these steps because timely submittal of discharge monitoring reports is
essential to the efficient operation of our water quality programs. We appreciate your assistance in this
matter. If you have any questions about this letter or Discharge Monitoring Reports, please contact
Maureen Crawford at 919-733-5083, extension 538.
Sincerely,
M ur en Crawford Val
cc: Maureen Crawford, NPDES Unit_
�_ _DWQ_W_ inston_Salem Regional Office Supervisor
Central Files
No ehCarolina
aturally
North Carolina Division of Water Quality 1617 Mail Service Center Raleigh, NC 27699-1617 Phone [phone] Customer Service
Internet: h2o.ennstate.nc.us 512 N. Salisbury St. Raleigh, NC 27604 FAX [phone]
An Fniial rinnnrfunifv/Affirmafiva Artinn Fmnlnvar_ 5no/ Porvr1aH11nW/ Pnct nnnenmor Pnnor

■ 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:
;sR
Mr. Thomas J. R
President
Aqua North Carole , a., �.
:202 Mackenan D%sv� �<
Cary, NC _ 27511 : z sC z 7� .
kv
❑ Agent
❑ Addresses
Deceived by (Pri ed Name) ate of a ever
�c / ✓{� /M
D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
f `3. Service Type
certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number twv
(Transfer fromservice 7008 3230 0003 2547 2361 a 9
PS Form 3811 - Fahri mry grand nnmaatir•. Ratnrn Raraint 7_ / L i� 1 mFas_n�.nn_ue

UNITED STATES POSTAL SERVICE
First -Class Mail
Postage & Fees Paid
LISPS
Permit No. G-10
• Sender: Please print your name, address, and ZIP+4 in this box •
NCDENR - Water Quality Section
�Orl �oO�sz
585 Waughtown Street
Winston-Salem, NC 27107