NC0030139_Complete File - Historical_20201105

Date May 3, 1993
STAFF REPORT AND RECOMMENDATIONS
NPDES PERMIT RENEWAL
County —Rutherford
Permit No. NCO030139
PART I - GENERAL INFORMATION
1. Facility and Address: Rutherford County Convalescent Center
Route 2, Box 39-A
Rutherfordton, N. C. 28139
2. Date of Investigation: October 20, 1992
3. Report Prepared By: James R. Reid
4. Persons Contacted and Telephone Number: Steven Nanney
704-286-9001
5. Directions to Site: Facility is located approximately 0.1 mi..
West of the intersection of US 64 and SR 1523 in Rutherford
County.
6. Discharge Point - Latitude: 350 24' 43"
Longitude: 820 55' 37"
Attached a USGS Map Extract and indicate treatment plant site and
discharge point on map.
USGS Quad No. or USGS Quad Name_Rutherfordton North_
7. Size (land available for expansion and upgrading): 1 acre
8. Topography (relationship to flood plain included): 5-10% Slope
above flood plain .
9. Location of nearest dwelling: 300-400 feet.
10. Receiving stream or affected surface waters: UT Cathey's
Creek.
a. Classifications: WS-V
b. River Basin and Subbasin No.: BRD 030802
C. Describe receiving stream .features and pertinent downstream
uses: Wildlife Support, agriculture, recreation

,PART II - DESCRIPTION OF DISCHARGE AND TREATMENT WORKS
1. Type of wastewater: 100 _ % Domestic
% Industrial
a. Volume of Wastewater: 0.015 MGD
b. Types and quantities of industrial wastewater:
C. Prevalent toxic constituents in wastewater:
d. Pretreatment Program (POTWs only)
in development approved _
should be required not needed
2. Production rates (industrial discharges only) in pounds
a. highest month in the last 12 months
b. highest year in last 5 years
3. Description of industrial process (for industries only) and
applicable CFR Part and Subpart:
4. Type of treatment (specify whether proposed or existing):
Existing, extended aeration with surge tank,
and aerated sludge digester.
5. Sludge handling and disposal scheme: Sludge is removed by Ray
Tessner Septic Tank Service and discharged to the Town of
Spindale's WWTP which has an approved, DEM-permitted land
application of sludge system.
6. Treatment plant classification: II
7. SIC Code(s) 8051
Wastewater Code(s) 11
MTU Code: 05007

PART III - OTHER PERTINENT INFORMATION
1. Is this facility being constructed with Construction Grants Funds
(municipals only)?
2. Special monitoring requests:
3. Additional effluent limits requests:
4. Other.
PART IV - EVALUATION AND RECOMMENDATIONS Renewal of the permit is
recommended.
ignature of Report Pr4parer
Water Quality Regional Supervis

1.1 vii ik,r11 ivry Ul 1-/1l,ll 1 111..:;
Name of PIS ;1�`1err"�( (orr
o
Owner or Contact Person:3,�r,,,�/u S, �� s/eaAw-
Mailing Mailing Address.-
--- ------------���Prr��� /uc v2�/��-
Count '------
y
e�7�Yr-c� Telephone:_
70z1- Zf(o- Iva/
NPDES Permit No- NC0036/3'l- Nondisc.
Per. No.
IssueDate: �: c /, / Z5,F6 Expiration
Date:_ it/ov ,� /99,3
Existing Facility_ New Facility
Rated By: &,Cs ,Q ,_;,) Date:
Reviewed (Train. & Cert.) Reg. Office
Reviewed (Train. & Cert.) Central Office
OR C .5:1-e veAj /U. i.v ey Grade
/
Plant Class: (circle one) I II III
IV, Total Points.C�..:.,..:;:,-:..
ITEM POINTS 5 --
{) SECONDARY TREATMENT UNITS
(1) Industrial Pretreatment Units and/or (a)
Carbonaceous=Stage
Industrial Pretreatment Program
(i)Aeration :-. High Purity Oxygen System .... .
(see definition No. 33) 4
(2) DESIGN FLOW OF PLANT IN GPD
Diffused AN System -; . ' ; : -eo
Mechanical Air System
�_
(not applicable to non -contaminated cooling waters, sludge
handling, facilities
(fixed,
floating or rotor)'.
13
for water purification plants, totally
closed•,cycle=systems.(det:f No.:11). and - facilities' -
Separate Sludga' Reaer'ation, •.. - . ;
(il) Tricklingj-Filter
3
consisting only of Item• (4)- (d)' or llems `(4) (d) and -(11) (d))
High Rate
0 20.000 .............
20,001 50,000..........................
Standard Rate .........:`::`:% . •
Packed Tower:::::..'"
5
2
50,001 -- 100,000.......... 3
(iii) Biological•Aerated.Filter"or.,-A*erated--` "•
5
100.001 -- 250,000 ............. 4
Biological Filter ..............
250.001 -- 500.000 . .. .
5
- - • . , . , ,
(iv) Aerated Lagoons .
10
500,001.-1,000,000
..... ;,..::.:::
^...10
..........................
1,000,001--2,000,000.... .:. 8
10
(v) Rotating'Biological Contactors`:.:. _ _ , _ _ ;
10
2,000,001 and u
( p) - rate 1 point additional for each
200,000- gpd capacity up to a
(vi) San1. d-Filte�s-
= maximum of 30
Design Flow (gpd) p0U
intermittent biologlc4al '
recirculatmg116logicai :.
2
(3) PRELIMINARY UNITS (see definrUon no. 32)
:. -
(vii) Stabilization -Lagoons ..............
3
.3
(a) Bar Screens ....
or 1
(viii)Clarifier .:..
(ix) Single - •,,.,.
QD
stage system fog`combined
(b) Mechanical Screens, Static Screens or
carbonaceous reino'val oI BOD 'arid` `
Comminuting Devices ..........: . .
(c) Grit Removal ... 2
nitrogenous i•emovial•-by.'.nil :i�f-iclatiori
(see del: -No_"-12)'(Pom s` fOr, is item-
or 1
(d) Mechanical or Aerated Grit Removal : :
hive to be -iw addilfon" t`o`116ms (5)1' (a)
(i) lhrougti`(5)(a) �:.:: i " ::`°;
- - • 2
(e) Flow Measuring Device .......................
(x) Nutrient- additions to enhance BOD
g
or
(f) Instrumented Flow Measurement
removal :.'.:'......'.:'::`:::':'.: - •'- - .....
(xi) Biological. Culture ('Super Bugs') addition
5
.............. 2
(g) Preaeration ...................
" " " " " " 2 (b)
to enhance organic compound`remoi�af :..:.
.i.-�.Zin+'�;i.f`;vi
Nitrogenous Stage-
5
(h) Influent Flow -Equalization .................. 2
(i) Aeration '= High' Purify Oxygen System `...:.
20
(i) Grease or Oil Separators - Gravity
Diffused Air System .........
10
Mechanical.......... 3
MechVfti&aF Air System (fixed, '
-.•_;
Dissolved Air Flotation. g
Prechlorinalion .............................. �
,,,,-..
floaS-pttng; o.,r'rol'9r.'":. , , , _ , _ •
' a
• e arate Slud`'e Reaertion
g
5
.....
(ii) Trickling Filter"- ` ' ' -
3
(4) PRIMARY TREATMENT UNITS
High Rate ....'....... ...
7
(a) Septic Tank (see definition no. 43) ...... 2
Standard Rate'............
5
(b) Imhoff Tank .... .............................. 5
Pad T k ceower...........
5
(c) Primary Clarifiers ....................... 5
(iil) Biological Aerated Filter or Aerated
(d) Settling Ponds or Settling Tanks for Inorganic
Biological Filler ..........................
10
Non -toxic Materials (sludge handling facilities
(Iv) Rotating Biological Contactors ... .. .....
10
for water purification plants, sand, gravel,
(v) Sand Filter -
stone, and other mining operations except
intermittent biological
2
recreational activities such as gem or gold
recirculating biological . . . . . .. .
3
ruining) ..... 2
.••. ............................
(vi) Clarifier ...
5

•6)-l-ERTIARY
On ADVANCED TREATMENT I
Carbons Beds -
(10) CHEMICAL A01 ! SYST[M (S) (See definition tJo 9)
(a)
net"'aced
w�l}ioul carbon regeneration .... . ............. 5
i (not applicable to chemical additions rated as ile,
wit}1 carbon regeneration _ ......... 1 5
(3) (1). (5) (a) (xi). (6) (a). (6) (b). (7) (b). (7) (e),
(b)
powdered or Granular Activated Carbon Feed
(g) (a). (9) (b), or (9) (c) 5 points each: List:
without carbon regeneration ................. 5
. . . . . • 5
with carbon regeneration ........ . .. . . . 1 5
. . . . „- 5
(c)
Air Stripping .................. . .......... 5
. . . . . . :5
(d)
Denilrificalion Process (separate process) . . . . . 1 0
. . . . . S
(e)
Elecuodialysis ............... . ............ . . 5
(11) MISCELLANEOUS UNITS
(f)
(g)
Foam Separation ............................. 5
ton Exchange ......................... . . ..... 5
(a) Holding Ponds, Holding Tanks or Settling Ponds
(h)
Land Application of Trealed Effluent
for Organic or Toxic Materials including wastes
(see definition no. 22b) (not applicable for
from mining operations containing nitrogen and/or
sand, gravel, stone and other similar mining
phosphorous compounds in amounts significantly
operations)
greater than Is common for domestic wastewater 4
(i) on agriculturally managed sites (See def.
(b) Effluent Flow Equalization (not applicable to storage
No. 4) ............................. 10
basins which are inherent in land application systems). 2
. .....
(ii) by high rate infiltration on non -agriculturally
(c) Stage Discharge (not applicable to storage basins
managed sites (includes rotary distributors
inherent in -land application systems ....................................... 5
d Pumps
and similar fixed nozzle systems) ........... 4
e Stand -By Power Supply
(iii) by subsurface disposal (includes low pressure
(f) Thermal Pollution Control Device ............................................. 3
pipe systems and gravity systems except at
plants consisting of septic tank and nitrifica-
tion lines only) 4
.............................
TOTAL POINTS
(i)
Microscreens.................................. 5
(j)
Phosphorus Remo -/al by Biological Processes
CLASSIFICATION
(See def. No. 26) ............................ 20
(k)
Polishing Ponds - without aeration ....... 2
Class I..................w................... 5 � 25 Points
= with aeration .......... 5
Class II .............:.......................__ .. „ __ 26- 50 Points
(1)
Post Aeration - cascade .............. 0
Class III......................................................:.4 51- 65 Points
diffused or mechanical ... 5
Class IV .................................... __ ._ 66- Up Points
(m) Reverse Osmosis ............................... 5
• .
(n)
Sand or Mixed -Media Filters - low rate ........... 2
Facilities having a rating of one through foul points, inclusive,
high rate .......... 5
do not require a certified operator. . Classification- of all- other
(o)
Treatment processes for removal of metal or
facilities requires a comparable grade operator in' responsible
cyanide ..................................... 15
charge.
(p)
Treatment processes for removal of toxic
materials other than metal or cyanide ......... 15
Facilities having an activated sludge process will be assigned
a minimum classification of Class 11.
SLUDGE TREATMENT
(a) Sludge Digestion Tank - Heated ...............
Facilities having treatment processes for the 'removal of metal
Aerobic ......... . .... . 10
or cyanide will be assigned a minimum classification of Class 11.
Unheated .............. 3
(b) Sludge Stabilization (chemical or thermal) ....... 5
Facilities having treatment processes for the biological removal
(c) Sludge. Drying Beds - . Gravity... ............... 2
of phosphorus will be assigned a minimum classification of Class
111.
Vacuum Assisted ....... 5
(d) Sludge Elutrialion .............................. 5
In -plant processes and related control equipment which are an
(e) Sludge Conditioner (chemical or thermal) ........ 5
integral art of industrial
g p production shall not be considered waste
( f ) Sludge Thickener (gravity) . _ . _ .................. 5
treatment. Likewise, discharges of wastewater from residences
(g) Dissolved .Air, Flotation Unit
having a design flow of 1,000 gpd or less, shall not be subject to
(not applicable to.a unit rates as (3) () ......... 8
rating.
(h) Sludge Gas Utilization (including gas storage) .... 2
(i) Sludge -Holding Tank - : Aerated................ 5
ADDITIONAL COMMENTS
Non -aerated ............ 2
(j) Sludge Incinerator - (not including activated
carbon regeneration) ..... 10
(k) Vacuum, Filler, Centrifuge or ;Filter Press or other
similar dewalering devices ..,_.......,. _ ...:........ 10
(8);. SLUDGE DISPOSAL (including incinerated ash)
(a) Lagoons... ................................. 2
(b) Land Application (surface. and subsurface)
(see de.finiCion 22a)
-where the facility holds the land app. permit ... 10
-by contracting to a land application operator who
holds the land application permit ............... 2O
-land application of sludge by a contractor who does
not hold the permit for the wastewater treatment
facility where the sludge is generated ......... 10
(c) Landfilled (burial) ............................. 5
(0) DISINFECTION
(a) 'Chlorination ...... . . . . .............. ..... 5
(b) Dechlorination ........................ 5
(c) Ozone .............................. 5
(d) Radiation .......................... 5

188 08CAQ JUSTICE ROAD
PUTHEMMMN, NC 28139-9407
White Oak Manor - Qutherfordton FAX [phone]
Providing Ojuity Long Term Care
September 11, 2002
State of North Carolina
Department of Environment
and Natural Resource)
Asheville Regional Office
852 Merrimon.Avenue
Asheville, NC 28804
Dear Sir-
rc,
SEP 1 6 2002
This letter is to confirm that we give authorization for Water Quality Services,
P.O. Box 1102, Banner Elk, NC 28604 to sign the Discharge monitoring
report--bh;dur- behalf
Also please note that we have had a change in administrators. Myself, Jean G.
Carter is administrator at White Oak Manor, Rutherfordton.
Our address at White Oak Manor has also been changed. It is 188 Oscar
Justice Road, Rutherfordton, NC. 28139.
Thank you for your time.
Sincerely,
Jean G. Carter, RN
Admiftistrator-
(828) 2869001

�F WA,T�C9 Michael F. Easley, Governor
William G. Ross Jr., Secretary
7 North Carolina Department of Environment and Natural Resources
r—
_I Coleen H. Sullins, Chairman
pN,
Water Pollution Control System Operators Certification Commission
October, 22 2003
Bettye Cecil
White Oak Manor
188 Oscar Justice Road
Rutherfordton, North Carolina 28139
Subject: IReclas_s_fi_cafiori bf Water -Pollution Control 'System
White Oak Manor -- - C `" _------ -- --- --
Permit No. NCO030139
Rutherford County
Dear Ms. Cecil:
In accordance with North Carolina General Statute § 90A-37, the Water Pollution
Control System Operators Certification Commission is required to classify all water
pollution control systems. The rating scale for classification of Biological Water
Pollution Control Treatment Systems, found at 15A NCAC 8G .0302, was adopted by
the Commission to classify water pollution control systems. The classification of a
facility is determined by the permitted flow, type of treatment and the requirement to
achieve biological nutrient reduction.
The. Water Pollution Control System Operators Certification Commission originally
classified your facility as a Grade 1 Biological Water Pollution Control Treatment
System using a point scale that is no longer used. After being contacted by the
Asheville Regional office of the Division of Water Quality and reviewing your
classification on file, it was apparent that your classification had never been- updated.-_ _
This letter hereby updates your facility classification to a 'Grade_ 2 Biological=Water_ .
IP-ollution-Corit`ro1,Tr_eatment_System-_
As required by 15A NCAC 8G .0202 and your permit, you must designate an Operator
in Responsible Charge (ORC) and Back-up Operator of the appropriate type and grade
for the subject facility. The operator designated as ORC, Mr. Johnny E. Rominger has
not had a valid Wastewater Treatment Operator certificate since 1/1/2003 and as such
has been removed from our system as your ORC. As system owner your are required to
have a qualified operator for both ORC and Back -Up ORC as outlined in 15A NCAC
8G .0201 and .0202 Please use the enclosed designation form to redesignate
immediately since you have exceeded the time limits set forth in the rules mentioned
above. This reclassification does not affect current monitorinlz reauirements for this
facility. A change in monitoring requirements would require a permit modification.
Technical Assistance & Certification Unit
1618 Mail Service Center, Raleigh, NC 27699-1618
DENR Customer Service Center
An Equal Opportunity Action Employer
7lUGE}' R
Internet http://h2o.enr.state.nc.us/tacu
Telephone [phone] Fax [phone]
Telephone [phone]
50% recycled/10% post -consumer paper

4 {e V� A TF Michael F. Easley, Governor
�� 9Q Y7a=xrrjU}?n G.tgss Jr Secretary
\� (� North Carolina Departure t Environment and Natal �2R urce"s,
r Ala W.Lek,,P.F-31".J
tor%Diviati[y,�
. Asheville kegiona�''l'�ffice
SURFACE WATER PROTECTION
January 24, 2007
CERTIFIED MAIL
RETURN RECEIPT REQUESTED 7006 2150 0005 2459 5113
Bettye Cecil
White Oak Manor
188 Oscar Justice Road
Rutherfordton, North Carolina 28139
Subject: NOTICE OF VIOLATION
NOV-2007-LV-0050 ,
Permit No. NC00301,39
White Oak Manor WWTP- Rutherfordton
Rutherford County
Dear Ms. Cecil:
A review of White Oak Manor- Rutherfordton's monitoring report for October 2006 showed
the following violations:
Parameter
Date
Limit Value
Reported Value
Limit Type
Solids, Total Suspended
10/24/06
45 mg/I
48 mg/I
Daily Maximum
Exceeded
Remedial actions should be taken to'correct this problem. The Division of Water Quality may pursue
enforcement action for this and any additional violations of State law.
To prevent further action, carefully review these violations and deficiencies and respond in writing to
this office within 10 working days of receipt of this letter. You should address the causes of non-
compliance and all actions taken to prevent the recurrence of similar situations. If you should have
any questions, please do not hesitate to contact Janet Cantwell at 828/296-4500.
The Asheville Regional Office currently has on staff a Wastewater Treatment Consultant to offer
technical assistance for wastewater treatment plants and collection systems with operational
2090 U.S. Highway70, Swannanoa, N.C. 28778 828/296-4500 (Telephone) 8281299-7043(Fax) Customer Service 877-623-6748 No^rtl�Carolina

Bettye Cecil
January 24, 2007
Page Two -
concerns. This service is free and non -regulatory to assist in the identification and correction of
operational problems. This service can be utilized for' optimization of the operation of wastewater
treatment plants and collection systems. Should you have questions about this service, please
contact Don Price at 828-296-4500, ext. 4656.
Sincerely,
Roger C. Edwards, Regional Supervisor
Surface Water Protection
WQ Central Files
Bob Guerra, Enforcement Files
Joe Simmons, ORCMater Quality Labs & Operations

- - - �'``��`��`��'�'�'`�Gii�li'd'ei6F:aEaslt✓ � vernor
.� W' ' ,Q: Ro e retary
North Carorina De'' of En ro nt and N Res�}urces
Ala e D'rector
Divi3ion-ef-Watep uality
Asheville Regional Office
SURFACE WATER PROTECTION
January 24, 2007
CERTIFIED MAIL
RETURN RECEIPT REQUESTED 7006 2150 0005 2459 5120
Bettye Cecil
White Oak Manor
1-88 Oscar Justice Road
Rutherfordton, North Carolina 28139
Subject: NOTICE OF VIOLATION
NOV-2007-LV-0049
Permit No. NC0030139
White Oak Manor WWT•P- Rutherfordton
Rutherford County
Dear Ms. Cecil:
A review of White Oak Manor- Rutherfordton's monitoring report for May 2006 showed the
following violations:
Parameter
Date
Limit Value
Reported
Limit Type
Value
Coliform, Fecal MF,
05/10/06
400 #/100ml
11,300 #/100ml
Daily Maximum
M-FC, Broth,44.5C
Exceeded
Remedial actions should be taken to correct this problem. The Division of Water Quality may pursue
enforcement action for this and any additional violations of State law.
To prevent further action, carefully review -these violations and deficiencies and respond in writing to
this office within 10 working days of receipt of this letter. You should address the causes of non-
compliance and all actions taken to prevent the recurrence of similar situations. If you should have
any questions, please do not hesitate to contact Janet Cantwell at 828/296-4500.
The Asheville Regional Office currently has on staff a Wastewater Treatment Consultant to offer
technical assistance for wastewater treatment plants and collection systems with operational
concerns. This service is free and non-regulatoryto assist in the identification and correction of
2090 U.S. Highway 70, Swannanoa, N.C. 28778 828/296-4500 (Telephone) 828/299-7043(Fax) Customer Service 877-623-6748 NonihCarol�na

Bettye Cecil
January 24, 2007
Page Two
d, . . '-%.
operational problems. This service can be utilized for optimization of the operation of wastewater
treatment plants and collection systems. Should you have questions about this service, please
contact Don Price at 828-296-4500, ext. 4656.
Sincerely,
1
I
VV-D
Roger C. Edwards, Regional Supervisor
Surface Water Protection
cc:d0sWAF ��vi ; e Ft'il
WQ Central Files
Bob Guerra, Enforcement Files
Joe Simmons, ORC/Water Quality Labs & Operations

\01AT� Michael F. Easley, Governor
©G William G. Ross Jr., Secretary
P North Carolina Department of Environment and Natural Resources
fl �� Coleen H. Sullins, Director
Division of Water Quality
SURFACE WATER PROTECTION SECTION F
September 4, 2007
Mr. Cecil
White Oak Manor
188 Oscar Justice Rd
Rutherfordton, NC 28139
SUBJECT: Wastewater Collection System
Owner & Operator Requirements
White Oak Manor- Rutherfordton
NCO030139
Rutherford County
Dear Mr. Cecil:
I would like to take this opportunity to discuss the requirements for sewerage collection
systems that were first established in 15 NCAC .02H .0200 in March 2000 and are now found in
15 NCAC 2T .0403, Waste Not Discharged to Surface Waters, which became effective
September 1, 2006. These Regulations place significant operation, maintenance and reporting
requirements on those entities that own or operate a wastewater collection system with average
daily flows of less than 200,000 gallons per day.
These regulations are applicable to your facility. This letter is provided as guidance
to assist you in complying with the new reporting and operations and maintenance (O&M)
requirements and to advise you that you are subject to system review, inspections and possible
enforcement, if the system is not in compliance with the regulation.
For your convenience and easy reference, a highlight of these requirements and the
following guidance are offered (see enclosed). You may find the regulations using the following
web site: http://h2o.enr.state.nc.us/peres/Collection%2OSystems/CoIIectionSystemsHome.ht_mI
The Asheville Regional Office will be increasing the level of oversight, compliance
activities and enforcement relating to collections systems, therefore, we wanted to be sure you
are aware of the requirements for these systems. We will be performing, NPDES Wastewater
Collection System inspections sometime in the near future.
NorthCarolina ,
Natzrr rllrm
North Carolina Division of water Quality 2090 US Hwy 70; Swannanoa, NC 28778 Phone [phone]
Internet: www..ncwaterquality.org Customer Service 1-877-623-6748 FAX [phone]
An Equal Opportunity/Affirmative Action Employer — 50% Recycled/10% Post Consumer Paper

September 4, 2007
Page 2 of 2
If this Office has not previously inspected your wastewater collection system and records
of same, you should be prepared to demonstrate compliance with all criteria listed above.
Enclosed is an inspection form that you can use to assemble your records prior to an inspection
by the staff of this office.
This Office has a Wastewater Treatment Plant Consultant on staff to offer assistance to
you in complying with the requirements of these regulations. Should you have questions or
need additional information regarding this issue, please contact Don Price at [phone].
Should you have any other questions .concerning this correspondence or the
requirements relating to collection systems, please contact Roy Davis or Keith Haynes at 828-
296-4500.
Sincerely,
Roger C. Edwards, Supervisor
Surface Water Protection Section
cc: Deborah Gore - PERCS Unit - w/out enclosures
egagiNiolaarl, f stir �= f il e
C� Q PS - centralO ice i es - o t cl5su°re -

ester Quality Lab and Operations, Inc.
P.O. Box 116711522 Tynecastle Highway
Banner Elk, NC 28604
Ph. 828-898-6277Fax [phone]
January 31, 200d
Mr. Roger Edwards, Regional Supervisor
2090 U.S. Highway 70
Swannanoa, N.C. 28778
Phone [phone]
Fax [phone]
Dear Mr, Edwards, -
White Oak WWTP, Permit #NC0030139, exceeded the daily fecal
maximum on May 10, 2006. The chlorine was adjusted after notification of
the exceeded fecal. The samples taken after the adjustment were,`reported
under the daily limits. I feel the adjustment corrected the problem.
If there are any questions concerning this matter arise, please feel free to
contact myself, Jadd Brewer, at Water Quality Lab. and Operations 828-898-
6277.
Thank you for your time and consideration on this matter
Sincerely,
Jadd Brewer
Operations Manager
Water Quality Lab and Operations
p 0 V E
FEB 5 2007'
WATER QUALITY SECTION
ASHEVILLE REGIONAL OFFICE

Vq ATF
Michael F. Easley, Governor
-William G.-Ross Jr., Secretary
North Carolina Department c (ironment and Natural Resources
Coleen H. Sullins, Director _.
Division of Water Quality
Asheville Regional Office_
SURFACE WATER PROTECTION.,
June19 2007
t
1
;
L �a
F
j
Cti&tzacu,.ar,ac�j7aZa,Yt'-:>n;e:
a cvr�"-"
Mr. William David Cable
White Oak Manor
P.O. Box 1167
Banner Elk, North Carolina 28604
r
SUBJECT: Compliance Evaluation Inspection
Status: Compliant
White Oak Manor- Rutherfordton
Wastewater Treatment Facility
Permit No: NCO030139
Rutherford County
Dear Mr. Cable:
Enclosed please find a copy of the Compliance Evaluation Inspection form from
the inspection conducted on June 7, 2007. The facility appeared to be in compliance
with permit NC0030139.
Please refer to the enclosed inspection report for additional observations and
comments. If you or your staff have any questions, please call me at 828-296-4500, Ext.
4667,
Sincerely,
Janet Cantwell ---
Environmental Specialist
Enclosures
s �. I iWe- .le td htt al'
—
WQ Central Files w/ attachments
Ms. Bettye Cecil & Ms. Jean Carter w/ attachments
Joseph Simmons/ ORC w/ attachments
Ono
NortliCarolina
�rricunClJ
2090 U.S. Highway 70, Swannanoa, NC 28778 Telephone: [phone] Fax: [phone] Customer Service 1 877 623-6748

r
United States Environmental Protection Agency
Form Approved.
E p q Washington, D.C. 20460
f�i1
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 NJ 2 15I 31 NCO030139 111 121 07/06/07 117 181 CI j 19I Gi 20Lj
�!
Remarks
211 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 I 1 I 1 1 1 1 1 1 1 1 1 1 1 1 1 I I I I 1 1 1_ I i_ 1 1 1,6
Inspection Work Days Facility Self -Monitoring Evaluation Rating B1 QA ---- --------- ---- Ip ---Reserved-------------------
67I 169 70 U I I 71 I I 72 I N I 73' I 174 !° 751 I I I 11 I 180
u_1 1
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)
White Oak Manor- Rutherfordton •
11:20 AM 07/06/07
05/05/01
1.
Exit Time/Date
Permit Expiration Date
188 Oscar Justice Rd
Rutherfordton NC 28139
12:00 PM 07/0'6/07
08/07/31
Name(s) of Onsite Representative(s)/Titles(s)/Phone and Fax'Number(s)
Other Facility Data
Joseph Carmon Simmons/ORC/828-898-6277/
Name, Address of Responsible OfficiaUTitle/Phone and Fax Number
Contacted
William David Cable,PO Box 1167 Banner Elk NC 28604//828-898-6277/
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
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) AgencylOffice/Phone and Fax Numbers. Date
Janet Cantwell ARO WQ//828-296-4500 Ext.4667/
Signature of Management. Q A Reviewer Agency/Office/Phone and Fax Numbers Date
o JV e
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete.
Page # 1

NPDES yr/mo/day Inspection Type (cont .) l
3I NC0030139 I11'" 12I 07/06/07 I17 18'_I
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
Joe Simmons/ORC assisted in the inspection of the facility.
A review of the files indicates the permit will expire July 31, 2008.
The Aeration Basin process control data on the day of inspection:
Dissolved Oxygen: 1.09 mg/I
Temperature: 28.5 degrees Celcius
pH: 6.5 units
The Effluent Data on the day of inspection:
Dissolved Oxygen: 1.44 mg/I
Temperature: 28.2 degrees; Celcius
pH: 6.09 units
It is suggested thai the bottom of the shed be secured to prevent access by miscellaneous wildlife for the
safety of the operator.
Page # 2

Permit: NCO030139
Inspection Date: 06/07/2007
Owner - Facility: White Oak Manor- Rutherfordton
Inspection Type: Compliance Evaluation
Permit
Yes
No
NA
NE
(If the present permit expires in 6 months or less). Has the permiftee submitted a new, application?
❑
❑
®
❑
Is the facility as described in the permit?
❑
❑
❑
# Are there any special conditions for the permit?
❑
tq
❑
❑
Is access to the plant site restricted to the general public?
m
❑
❑
❑
Is the inspector granted access to all areas for inspection?
:1
❑
❑
❑
Comment:
r
Record Keeping
Yes
No
NA
NE
Are records kept and maintained as required by the permit?
I
❑
Cl
❑
Is all required information readily available, complete and current?
❑
❑
❑
Are all records maintained for 3 years (lab. reg. required 5 years)?
❑
❑
❑
M
Are analytical results consistent with data reported on DMRs?
❑
r]
❑
m
Is the chain -of -custody complete?
❑
❑
❑
mi
Dates, times and location of sampling
❑
Name of individual performing the sampling
❑
Results of analysis and calibration
❑
Dates of analysis
❑
Name of person performing analyses
❑
Transported COCs
❑
Are DMRs complete: do they include all permit parameters?
❑
❑
❑
Has the facility submitted its annual compliance report to users and DWQ?
❑
❑
❑
S
(If the facility is = or > 5 MGD permitted flow) Do they operate 24/7 with a certified operator on each shift?
❑
❑
M
❑
Is the ORC visitation log available and current?
n
El
❑
0
Is the ORC certified at grade equal to or higher than the facility classification?
I
❑
❑
❑
Is the backup operator certified at one grade less or greater than the facility classification?
❑
❑
❑
Is a copy of the current NPDES permit available on site?
❑
Cl
n
Facility has copy of previous year's Annual Report on file for review?
❑
❑
❑
lm
Comment:
)perations & Maintenance
Yes
No
NA
NE
Is the plant generally clean with acceptable housekeeping?
a
❑
❑
❑
Page # 3

Permit: NCO030139
Inspection Date: 06/07/2007
Owner - Facility: White Oak Manor- Rutherfordton
Inspection Type: Compliance Evaluation
Operations & Maintenance Yes No NA NE
Does the facility analyze process control parameters, for ex: MLSS, MCRT, Settleable Solids, pH, DO, Sludge ■ ❑ ❑ ❑
Judge, and other that are applicable?
Comment:
It is advised to secure the bottom of the shed to prevent access by snakes and other
critters.
V.. Kfn MA AIC
Mode of operation
Type of aeration system
Is the basin free of dead spots?
Are surface aerators and mixers operational?
Are the diffusers operational?
Is the foam the proper color for the treatment process?
Does the foam cover less than 25% of the basin's surface?
Is the DO level acceptable?
Is the DO level acceptable?(1.0 to 3.0 mg/1)
Comment:
The DO was measured at 1.09 mg/I.
Secondary Clarifier
Is the clarifier free of black and odorous wastewater?
Is the site free of excessive buildup of solids in center well of circular clarifier?
Are weirs level?
Is the site free of weir blockage?
Is the site free of evidence of short-circuiting?
Is scurn removal adequate?
Is the site free of excessive floating sludge?
Is the drive unit operational?
Is the return rate acceptable (low turbulence)?
Is the overflow clear of excessive solids/pin floc?
Is the sludge blanket level acceptable? (Approximately % of the sidewall depth)
Comment:
Disinfection -Tablet
Ext. Air
Diffused
■❑❑❑
nn■❑
■n❑❑
■❑00
■❑00
■nnn
■❑❑❑
Page # 4

f It
Permit: NCO030139 Owner - Facility: White Oak Manor- Rutherfordton
Inspection Date: 06/07/2007 Inspection Type: Compliance Evaluation
Disinfection -Tablet Yes No NA NE
Are tablet chlorinators operational?
Are the tablets the proper size and type?
Number of tubes in use?
Is the level of chlorine residual acceptable?
Is the contact chamber free of growth, or sludge buildup?
Is there chlorine residual prior to de -chlorination?
i
Comment:
De -chlorination
Type of system ?
Is the feed ratio proportional to chlorine amount (1 to 1)?
Is storage appropriate for cylinders?
# Is de -chlorination substance stored away from chlorine containers?
Comment:
Are the tablets the proper size and type?
Are tablet de -chlorinators operational?
Number of tubes in use?
Comment:
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:
The last calibration was on 8/10/06.
®❑❑❑
FS000
2
❑❑❑M
®❑❑n
❑❑❑@
Yes No NA NE
Tablet
❑nr❑
®❑ ❑
Yes No NA NE
n n ❑
®❑❑❑
IN 0 El 0
❑nas.❑
Page 4 5

:,
NPDES APPLICATION - FORM D
For privately owned treatment systems treating 100% domestic wastewaters <1.0 MGD
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 C00 "''::j �3
Please print or type.
1. Contact Information:
Owner Name
Facility Name
Mailing Address ���Ql C0'r S-�-C-1— 'RD aci
City. R a*eV4rd�
State / Zip Code NC (:Q g) 3 q
Telephone Number In)
Fax Number
e-mail Address
2. Location of facility producing disc rge:
Check here if same address as above
Street Address or State Road
City
State / Zip Code
County
3. Operator Information:
JAN 1 1 2008
�,�-�
j-
Name of the firm, public organization or other entity that operates the facility. (Note that this is not
referring to the Operator in Responsible Charge or ORC)
Name .e %M'dy17i
Mailing Address �(j�, M-07
City -ETR
State / Zip Code KC a 96 04
Telephone Number 92?) M_
Fax Number ( " )g
1 of 3 Form-D 4/05

c.w
NPDES APPLICATION - FORM D
For privately owned treatment systems treating 100% domestic wastewaters <1.0 MGD
4. Description of wastewater:
Facility Generating Wastewater(check all that apply):
Industrial ❑ Number of Employees
Commercial [ Number of Employees d C1_
Residential. Number of Homes
School ❑ Number of Students/Staff
Other ❑ Explain:
Describe the source(s) of wastewater (example: subdivision, mobile home park, shopping centers,
restaurants, etc.):
Population served: 17
5. Type of collection system
ff'Separate (sanitary sewer only)
❑ Combined (storm sewer and sanitary sewer)
6. Outfall Information:
Number of separate discharge points
Outfall Identification number(s)
Is the outfall equipped with a diffuser? M Yes ' ❑ No
?. Name of receiving stream(s) (Provide a map showing the exact location of each outfallr
8. Frequency of Discharge: Jff— Continuous
If intermittent:
Days per week discharge occurs:
❑ Intermittent
Duration:
9. Describe the treatment system
List all installed components, including capacities, provide design removal for BOD, TSS, nitrogen and
phosphorus. If the space provided is not sufficient, attach the description of the treatment system in a
separate sheet of paper.
9 of 3 Form-D 4105

NPDES APPLICATION - FORM D
For privately owned treatment systems treating 100% domestic wastewaiters <1.0 MGD
10. Flow Information:
Treatment Plant Design flow;, %. MGD
i
Annual Average daily now h MGD (for the previous 3 years)
Maximum daily flow MGD (for the previous 3 years)
11. Is this facility located on Indian country?
❑ YesNo
12. Effluent Data
Provide data for the parameters listed. Fecal Coliform, Temperature and pH shall be grab samples, for all other
parameters 24-hour composite sampling shall be used. If more than one analysis is reported,,, report daily maximum
and monthly average. If only one analysis is reported, report as daily maximum..
Daily
Maximum
Monthly
Average
Units of
Measurement
Parameter
Biochemical Oxygen Demand (BOD5)rr
t
Fecal Coliform -
,; i
E.
e'
Total Suspended Solids".
Temperature (Summer)
{
Hl�
Temperature (Winter)
pH
'� .
13. List all permits, construction approvals and/or applications:
Type Permit Number Type -
Hazardous Waste (RCRA)
UIC (SDWA)
NPDES
NESHAPS (CAA)
Ocean Dumping (MPRSA)
Dredge or fill (Section 404 or CWA)
r
Permit Number
PSD (CAA) Other
a
Non -attainment program (CAA)
14. APPLICANT CERTIFICATION
I certify that I am familiar with the information contained in the application and that to the
d d b lief such information is true, complete, and accurate.
best of my knowle ge an e
crc� rawee, ownper ' lc�� �2ua-��"�
Title
Printed name of Person Signing
S• ature of Applicant LJate
North Carolina General Statute 143-215.6 (b)(2) states: 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 iiiipleiTe� ,ing chat Article, or :�:ho falsifies, tampers with, or knowly 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 1 guilty of a
misdemeanor punishable 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.)
Form-D 4105

t
F A.-
0 4G
r.
o -c
Bettye Cecil
White Oak Manor Management
188 Oscar Justice Road
Rutherfordton, North Carolina 28139
_%.
-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
August,
2008
AUG 1 3 2008 .
WATERQUALITY SECTION
ASHEVILLE REGIONAL OFFICE
Subject:- Issuance of NPDES
- Permit _NC0030139 -
White Oak Manor-Rutherfordton WWTP - -
Rutherford County
Dear Ms. -Cecil:
Division personnel have reviewed and approved your application for renewal of the. subject permit. .
Accordingly, we are forwarding the attached NPDES discharge permit. This permit is issued pursuant to
the requirements of North Carolina General Statute 143-215.1 and the Memorandum of Agreement -
between North Carolina and the U.S. Environmental Protection Agency dated October ,15, 2007 (or as
subsequently amended).
This permit includes no major changes from the draft permit sent to you on May 21, 2008.
If any parts, measurement frequencies or sampling requirements contained in this permit are unacceptable to
you, you have the right to an adjudicatory hearing upon written request within thirty (30) days following receipt of
this letter. This request must be in the form of a written petition, conforming to Chapter 15013-of the North
Carolina General Statutes, and filed with the Office of Administrative Hearings (6714 Mall Service Center,
Raleigh, North Carolina 27699-6714). Unless such demand is made, this decision shall be final and binding. "
Please note that this'permit is not transferable except after notice to the Division. The Division may require
modification -or revocation and reissuance of the permit. This permit does not affect the legal requirements to -- —
obtain other permits which may be required by the Division of Water Quality or permits required by the Division of
Land Resources, the Coastal Area Management Act or any other Federal or Local governmental permit that may _
be required. If you have any questions concerning this permit, please contact Bob- Guerra at telephone number =
[phone].-
Sincerely, _....
Coleen H. Sullins
Enclosure: NPDES Permit NCO030139
cc: Central Files
. s evllle eglorla +:fftce u .ace af+er`Pro echo _
ni
Noj Carolina
Natura!!y
North Carolina Division of Water Quality 1617 Mail Service Center Raleigh, NC 27699-1617 Phone [phone] Customer Service
Internet: www.ncwaterqualitv.ore Location: 512 N. Salisbury St. Raleigh, NC 27604 Fax [phone]
An Equal Opportunity/Affirmative Action Employer — 50% Recycled/100/. Post Consumer Paper

Permit NCO030139
a
STATE OF NORTH 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
White. Oak Manor Management
is -hereby authorized to discharge wastewater from a facility located at the
White Oak Manor - Rutherfordton WWTP
-_ 188 Oscar Justice Road_
= Rutherfordton
_- Rutherford County
:.t.receiving waters designated as an unnamed tributary to Catheys Creek in the.
Broad River Basin
Aaccordance with effluent limitations, monitoring requirements, and other
conditions set forth in Parts I, II, III and IV hereof.
._This permit shall become effective September 1, 2008.
This -permit and authorization to discharge shall expire at midnight on July 31,
2'013.
Signed this day August 6, 2008.
en H. Sullins, Director
rVy
sion of Water Quality
uthority of the Environmental Management Commission

Permit NCO030139
r
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.
White Oak Manor is hereby authorized to:
1. Continue to operate_ an existing 0.015 MGD extended aeration package
wastewater treatment facility with the following components:
• Equalization basin
• Aeration basin
• Clarifier
• Chlorine contact chamber
• Dechlorination
The facility is located at White Oak Manor, 188 Oscar, Justice Road in
Rutherfordton .County.
2. Discharge from said treatment works, through Outfall 001; into an unnamed
tributary to Catheys Creek, classified Class WS-V waters, in the Broad River
Basin, at the location specified on- the attached map.

1
v4
\ r �
22,
e
Zn i , i t � i ! 5 ','' ,•'
j♦
r
t
188 Oscar Justice Road`
,: tI.
-
r
o d
J
HWY 64
White Oak Manor
Facility
White Oak Manor WWTP
Location
Latitude: 35' 24' 43" N State Grid: Rutherdfordton N
not to scale
Longitude: 81° 55' 36" W. Permitted Flow: 0.015 MGD
Receiving Stream: UT Cathey's Creek Drainage Basin: Broad River Basin
]� 1,�
NPDES Permit No. NCO030139
Stream Class: WS-V Sub -Basin: 03-08-02
1 V O rt G
Rutherdford County

Permit NCO030139
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 from outfall 001. Such discharges shall be limited and monitored by the Permittee as
specified below:
rEFFLUENT fsµ"LI
ITS4
* m_MONITQRIN'G Q 1REMENT 4. r
�CHARACi�'ERISTICS�,��'t����
. ,:sv �m s,�-'� � �
1 #
x _... "
MonhlyA�erage
° > .•:.,
Da!IyMax�mum
�..me,. y am "te"Location
rNieasurementAR ;SampleType S p
�t4t�', 'JM1e `h:rXi.sM'"
?�
�h„.:,'ry5; r�.i.
^� Y. f S' i`
l 'ffi ,.n{ ,�3 ., �S,�N ' h
,N`" Sf l +A
...�«h" F ^2y
5 1 fi �'
o"ib 5 �,'ci
Frequer�cyk: �xi:..
�Y�
�$"�>.. 5;€k.�'�w;�}�`-§x�� �'.'kkv-Y',a�"k,3tfx
^�i^���.�x"`�-n°�'.\-.����
��w"td,.'�i>. S��;
ui? uM1���s
Flow
0.015 MGD
Continuous
Instantaneous
Influent or
Effluent
BOD, 5-day (200C)l
30.0 mg/L
45.0 mg/L
Weekly
Composite-
Effluent
Total Suspended
30.0 mg/L
45:0 mg/L
Weekly
Composite
Effluent
Solidsl
NH3 as N
17.0 mg/L
35.0 mg/L
Weekly
Grab
Effluent
(April 1 — Oct 31
NH3 as N
Monitor & Report
Weekly
Grab
Effluent
Nov 1 — March 31
Fecal Coliform
200/ 100 mL
400/ 100 mL
Weekly
Grab
Effluent
(geometric mean
Total Residual
28.0 ug/L =
2/week
Grab
Effluent
Chlorine2
erature
Monitor & Report
WeeklyGrab
Effluent
pTem
H3
Monitor & Report
Weekly
Grab
Effluent
Footnotes:
1. The sampling method has been changed from Grab to Composite sampling. Composite
sampling will become effective 90 days after the permit effective date.
2. TRC - Because low-level TRC is currently difficult to quantify in a wastewater matrix, the
Division shall consider all effluent TRC values reported below 50 µg/L to be "in compliance" with
the permit. However, the Permittee shall continue to record and submit all values reported by
North. Carolina -certified field and lab test methods, even if these values fall below 50 µg/L.
3. The pH shall not be less -than 6.0 standard units nor greater than 9.0 standard units.
There shall be no discharge of floating solids or visible foam in other than trace
amounts.

R
0
North Carolina Department o r
IL Id 'Y
PG
Asheville Regional Office
SURFACE WATER PROTECTION SECTION
July 3, 2008
Mr. William David Cable
White Oak Manor
P.O. Box 1167
Banner Elk, North Carolina 28604-1167
Dear Mr. Cable:
Michael F. Easley, Governor
William G. Ross Jr., Secretary
Ironment and Natural Resources
Coleen H. Sullins, Director
Division of Water Quality
SUBJECT: Compliance Evaluation Inspection
Status: Compliant
White Oak Manor WWTP- Rutherfordton
Permit No: NCO030139
Rutherford County
Enclosed please find a copy of the Compliance Evaluation Inspection form from
the inspection conducted on June 25, 2008. The facility appeared to be yin compliance
with permit NC0030139. The kind assistance of Mr. Jerry Alexander during the inspection
was appreciated. He is doing a find job of operating this facility.
Please refer to the enclosed inspection report for additional observations and
comments. If you or your staff have any questions, please call me at 828-296-4500, Ext.
4667.
Sincerely,
Z7
net tCan well
Environmental Specialist
Enclosure
f aniiiiiiiiiim
DWQ Central Files
Water Quality Lab & Operations/ ORC w/ attachment
G:\WPDATA\DEMWQ\Rutherford\30139 White Oak Manor\30139-CE1.08.doc Noe Carolina
�tura!!y
2090 U.S. Highway 70, Swannanoa, NC 28778 Telephone: [phone] Fax: [phone] Customer Service 1 877 623-6748

United States Environmental Protection Agency
Form Approved.
E p n Washington, D.C. 20460
f—!'�
OMB No. 2040-0057
Water Compliance Inspection Report
Approval expires 8-31-98
Section A: National Data System Coding (i.e., PCS)
Transaction Code NPDES yr/mo/day Inspection Type Inspector Fac Type
1 IN 2 I51 3) NCO030139 I11 12I 08/06/25 117 181rl 19U 201
--' L--' U LJ L!
Remarks
21111111111111111111111111111111111111111111111116
Inspection Work Days Facility Self -Monitoring Evaluation Rating B1 QA ------- —------------------ Reserved ------------- — --- --
67 I 169 70 U 71 U. 721 NJ 73t_U 74 751 I I I I I Li 80
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)
White Oak Manor- Rutherfordton
10:35 AM 08/06/25
05/05/01
Exit Time/Date
Permit Expiration Date
188 Oscar Justice Rd
Rutherfordton NC 28139
12:10 PM 08/06/25
08/07/31
Name(s) of Onsite Representative(s)lTitles(s)/Phone and Fax Number(s)
Other Facility Data
Jerry Ross Alexander/ORC/864-237-1287/
Name, Address of Responsible.Official/Title/Phone and Fax Number
Contacted
William David Cable,PO Box 1167 Banner Elk NC 286041167//828-898-6277_!
rvo
Section C: Areas Evaluated During Inspection (Check only those areas evaluated);.
Permit Flow Measurement Operations & Maintenance E Records/Reports
Self -Monitoring Program Facility Site Review Effluent/Receiving Waters
Section D: 'Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
(See attachment summary)
Name(s) and Signatures) of Inspector(s) Agency/Office/Phone and Fax Numbers Date
Janet Cantwell ARO WQ//828-296-4500 Ext.4667/
t
Signature gf Mana mentiQ A Reviewer Agency/Office/Phone and Fax Numbers Date
22,
EPA Form 3560-3 (Rev 9-94) PrUs editions are obsolete.
Page # 1

NPDES yr/molday Inspection Type 1
3I NC0030139 I11 12I 08/06/25 117 1. UC
Section 0: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
Jerry Alexander/ORC assisted in the inspection of this facility.
The previous compliance evaluation inspection was conducted on 6/7/07.
A review of the files indicates that the permit expires July 31, 2008.
Page # 2

Permit: NCO030139 Owner - Facility: White Oak Manor- Rutherfordton
Inspection Date: 06/25/2008 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?
❑
❑
■ ❑
Is the facility as described in the permit?
®❑
❑ ❑
# Are there any special conditions for the permit?
❑
®❑
❑
Is access to the plant site restricted to the general public?
®❑
❑ ❑
Is the inspector granted access to all areas for inspection?
■
❑
❑
❑
Comment:
Operations & Maintenance
Yes
No
NA
NE
Is the plant generally clean with acceptable housekeeping?
■
❑
❑
❑
Does the facility analyze process control parameters, for ex: MLSS, MCRT, Settleable Solids, pH, DO, Sludge ■
❑
❑
❑
Judge, and other that are applicable?
Comment:
Record Keeping
Yes
No
NA
NE
Are records kept and maintained as required by the permit?
■
❑
❑
❑
Is all required information readily available, complete and current?
■
❑
❑
❑
Are all records maintained for 3 years (lab. reg. required 5 years)?
n
❑
❑
■
Are analytical results consistent with data reported on DMRs?
❑
❑
❑
■
Is the chain -of -custody complete?
❑
❑
❑
■
Dates, times and location of sampling
❑
Name of individual performing the sampling
❑
Results of analysis and calibration
❑
Dates of analysis
❑
Name of person performing analyses
❑
Transported COCs
❑
Are DMRs complete: do they include all permit parameters?
■
❑
❑
❑
Has the facility submitted its annual compliance report to users and DWQ?
Cl
❑
❑
■
(If the facility is = or > 5 MGD permitted flow) Do they operate 24/7 with a certified operator on each shift?
❑
❑
■
❑
Is the ORC visitation log available and current?
■
❑
❑
❑
Is the ORC certified at grade equal to or higher than the facility classification?
■
❑
❑
❑
Is the backup operator certified at one grade less or greater than the facility classification?.
■
❑
❑
❑
Is a copy of the current NPDES permit. available on site?
❑
❑
❑
■
Page # 3

Permit: NCO030139 Owner - Facility: White Oak Manor- Rutherfordton
Inspection Date: 06/25/2008 Inspection Type: Compliance Evaluation
Record Keeping
Yes
No
NA NE
Facility has copy of previous year's Annual Report on file for review?
❑
Q
O ■
Comment:
Aeration Basins
Yes
No
NA NE
Mode of operation
Ext. Air
Type of aeration system
Diffused
Is the basin free of dead spots?
■
❑
0 Q
Are surface aerators and mixers operational?
Q
0
■ Cl
Are the diffusers operational?
®
Q
❑
Is the foam the proper color for the treatment process?
■
❑
D ❑
Does the foam cover less than 25% of the basin's surface?
■
❑
Q 0
Is the DO level acceptable?
❑
b
n ■
Is the DO level acceptable?(1.0 to 3.0 mg/1)
❑
Q
❑ ■
Comment:
Secondary Clarifier
Yes
No
NA NE
Is the clarifier free of black and odorous wastewater?
■
❑
El
Is the site free of excessive buildup of solids in center well of circular clarifier?
❑
0
■ Q
Are weirs level?
■
❑
❑
Is the site free of weir blockage?
■
❑
0 Q
Is the site free of evidence of short-circuiting?
■
11011
Is scum removal adequate?
■
❑
❑ O
Is the site free of excessive floating sludge?
■
❑
Cl
Is the drive unit operational?
—
❑
■ Q
Is the returnrate acceptable (low turbulence)?
■
❑
Cl Q
Is the overflow clear of excessive solids/pin floc?
■
❑
❑ 0
Is the sludge blanket level acceptable? (Approximately'/ of the sidewall depth)
0
Cl
0 ■
Comment:
Flow Measurement - Effluent
Yes
No
NA NE
# Is flow meter used for reporting?
■
❑
Q ❑
Is flow meter calibrated annually?
■
11110
Is the flow meter operational?
■
❑
0 ❑
Page # 4

Permit: NCO030139 Owner - Facility: White Oak Manor- Rutherfordton
Inspection Date: 06/25/2008 Inspection Type: Compliance Evaluation
Flow Measurement - Effluent Yes No NA NE
(If units are separated) Does the chart recorder match the flow meter? ❑ . ❑ ■ ❑
Comment: Last calibration was 8/9/07.
Disinfection -Tablet Yes No NA NE
Are tablet chlorinators operational?
■ ❑
❑
❑
Are the tablets the proper size and type?
■ ❑
❑
❑
Number of tubes in use?
2
Is the level of chlorine residual acceptable?
■ ❑
❑
❑
Is the contact chamber free of growth, or sludge buildup?
■ ❑
❑
❑
Is there chlorine residual prior to de -chlorination?
■ ❑
❑
Cl
Comment:
Type of system ?
Tablet
Is the feed ratio proportional to chlorine amount (1 to 1)?
■
❑
❑
❑
Is storage appropriate for cylinders?
❑
❑
■
❑
# Is de -chlorination substance stored away from chlorine containers?
■
❑
❑
❑
Comment:
Are the tablets the proper size and type?
■
❑
❑
❑
Are tablet de -chlorinators operational?
■
❑
❑
❑
Number of tubes in use?
2
Comment:
Effluent Pipe
Yes
No
NA
NE
Is:�ighfof way to the outfall pioperly 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?
❑
❑
■
Cl
Comment:
Page # 5

North Carolina Department c
i
SURFACE WATER PROTECTION SECTION
July 25, 2008
CERTIFIED MAIL
RE' TURN RECEIPT REQUESTED
Ms. Bettye Cecil
White Oak Manor
188 Oscar Justice Road
Rutherfordton, North Carolina 28139
Michael F. Easley, Governor
William G. Ross Jr., Secretary
ironment and Natural Resources
Coleen H. Sullins, Director
Division of Water Quality
Asheville Regional Office
SUBJECT: Notice of Violation and Assessment of Civil Penalty
for Violations of North Carolina General Statute (G.S.) 143-215.1(a)(6) .
and NPDES Permit NCO030139
White Oak ManorWWTP
White Oak Manor- Rutherfordton
Case No. LV-2008-0253
Rutherford County
Dear Ms. Cecil:
This letter transmits a Notice of Violation and assessment of civil penalty in the amount of $265.00
($200.00 civil penalty + $65.06 enforcement costs) against White Oak Manor.
This assessment is based upon the following facts: a review has been conducted of the discharge
monitoring report (DMR) submitted by White Oak Manor for the month of April 2008. This
review has shown the subject facility to be in violation of the discharge limitations and/or ..
monitoring requirements found in NPDES Permit NC0030139. The violations which occurred in
April 2008 are summarized in Attachment A to this letter.
Based upon the above facts, I conclude as a matter of law that White Oak Manor violated the
terms, conditions or requirements of NPDES Permit NCO030139 and G.S. 143-215.1(a)(6) in the
manner and extent shown in Attachment A. In accordance with the maximums established by G.S.
143-215.6A(a)(2), a civil penalty may be assessed against any person who violates the terms,
conditions or requirements of a permit required by G.S. 143-215.1(a).
Based upon the above findings of fact and conclusions of law, and in accordance with authority
provided by the Secretary of the Department of Environment and Natural Resources and the
Director of the Division of Water Quality, I, Roger C. Edwards, Division of Water Quality
Regional Supervisor for the Asheville Region, hereby make the following civil penalty assessment
against White Oak Manor:
No thCarolina
Natumlly
North Carolina Division of Water Quality 2090 U.S. Highway 70 Swannanoa, NC 28778 Phone[phone] Customer Service
Internet: www.ncwaterguality.org FAX [phone] 623-7748

1 of the 1 violations of G.S. 143-215.1(a)(6) and.NPDES Permit No.
$100.00 NC0030139, by discharging waste water into the waters of the State
in violation of the Permit Daily Maximum limit for FEC �COLL
1 of the 1 violations of G.S. 143-215.1(a)(6) and NPDES Permit No.
$100.00 NC0030139, by discharging waste water into the waters of the State
in violation of the Permit Daily Maximum limit for RES/TSS.
$200.00 TOTAL CIVIL PENALTY
$65.00 Enforcement Costs
$265.00 TOTAL AMOUNT DUE
Pursuant to G.S. 143-215.6A(c), in determining the amount of the penalty I have taken into
account the Findings of Fact and Conclusions of Law and the factors set forth at G.S. 143B-
282.1(b), which are:
(1) The degree and extent of harm to the natural resources of the State, to the public health, or
to private property resulting from the violation;
(2) The duration and gravity of the violation;
(3) The effect on ground or surface water quantity or quality or on air quality;
(4) The cost of rectifying the damage;
(5) The amount of money saved by noncompliance;
(6) Whether the violation was committed willfully or intentionally;
(7) The prior record of the violator in complying or failing to comply with programs over
which the Environmental Management Commission has regulatory authority; and
(8) The cost to the State of the enforcement procedures.
Within thirty days of receipt of this notice, you must do one of the following:
Submit payment of the penalty:
Payment should be made directly to the order of the Department of Environment and Natural
Resources (do not include waiver form). Payment of the penalty will not foreclose further
enforcement action for any continuing or new violation(s). Please submit payment to the
attention of:
Point Source Compliance/Enforcement Unit
Division of Water Quality
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
OR
2. Submit a written request for remission or mitigation including a detailed justification
for such request:
Please be aware that a request for remission is limited to consideration of the five factors listed
below as they may relate to the reasonableness of the amount of the civil penalty assessed.
Requesting remission is not the proper procedure for contesting whether the violation(s)
occurred or the accuracy of any of the factual statements contained in the civil penalty
assessment document. Because a remission request forecloses the option of an administrative
hearing, such a request must be accompanied by a waiver of your right to an administrative
hearing and a stipulation and agreement that no factual or legal issues are in dispute. Please

A�
1
prepare a detailed statemen, -.at establishes why you believe the civ.. l ,;nalty should be
remitted, and submit it to the Division of Water Quality at the address listed below. In
determining whether a remission request will be approved, the following factors shall be
considered:'
(1) whether one or more of the civil penalty assessment factors in NCGS 14313-282.1(b)
was wrongfully applied to the detriment of the petitioner;
(2) whether the violator promptly abated continuing environmental damage resulting from
the violation;
(3) whether the violation was inadvertent or a result of an accident;
(4) whether the violator had been assessed civil penalties for any previous violations; or
(5) whether payment of the civil penalty will prevent payment for the remaining necessary
remedial actions.
Please note that all evidence presented in support of your request for remission must be submitted
in writing. The Director of the Division of the Division of Water Quality will review your
evidence and inform you of his decision in the matter of your remission request. The response will
provide details regarding the case status, directions for payment, and provision for further appeal
of the penalty to the Environmental Management Commission's Commmittee on Civil Penalty
Remissions (Committee). Please be advised that the Committee cannot consider information that
was not part of the original remission request considered by the Director. Therefore, it is very
important that you prepare a complete and thorough statement in support of your request for
remission.
In order to request remission, you must complete and submit the enclosed "Request for Remission
of Civil Penalties, Waiver of Right to an Administrative Hearing, and Stipulation of Facts" form
within thirty (30) days of receipt of this notice. The Division of Water Quality also requests that
you complete and submit the enclosed "Justification for Remission Request." Both forms should
be submitted to the following address:
Point Source Compliance/Enforcement Unit
Division of Water Quality
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

3. File a petition for an administrative hearing with the Office of Administrative Hearings:
If you wish to contest any statement in the attached assessment document you must file a petition
for an administrative hearing. You may obtain the petition form from the Office of Administrative
Hearings. You must file the petition with the Office of Administrative Hearings within thirty (30)
days of receipt of this notice. A petition is considered filed when it is received in the Office of
Administrative Hearings during normal office hours. The Office of Administrative Hearings
accepts filings Monday through Friday between the hours of 8:00 a.m. and 5:00 p.m., except for
official state holidays. The original and one (1) copy of the petition must be filed with the Office
of Administrative Hearings. The petition may be faxed - provided the original and one copy of the
document is received in the Office of Administrative Hearings within five (5) business days
following the faxed transmission. The mailing address for the Office of Administrative Hearings
is:
Office of Administrative Hearings
6714 Mail Service Center
Raleigh, North Carolina 27699-6714
Telephone [phone] Facsimile: [phone]
and
Mail or hand -deliver a copy of the petition to
General Counsel
Department of Environment and Natural Resources
1601 Mail Service Center
Raleigh, North Carolina 27699-1601
Please indicate the case number (as found on page one of this letter) on the petition.
Failure to exercise one of the options above within thirty (30) days of receipt of this letter, as
evidenced by an internal date/time received stamp (not a postmark), will result in this matter being
referred to the Attorney General's Office for collection of the penalty through a civil action. Please
be advised that additional penalties may be assessed for violations that occur after the review
period of this assessment.
If you have any questions, please contact Janet Cantwell of the Water Quality staff of the
Asheville Regional Office at 828-296-4500.
Sincerely,
&vaA
Roger C. Edwards, Regional Supervisor
Surface Water Protection Section
Asheville Regional Office
ATTACHMENTS.
fit- hhm - n
DWQ Central Files w/ attachments
Bob Guerra/ DWQ Enforcement File w/ attachments
Water Quality Lab & Operations/ ORC w/ attachments
G:\WPDATA\DEMWQ\Rutherford\30139 White Oak Manor\LV-2008-0253.30139.doc

JUSI __ XATION FOR REMISSION REQ _ ,ST
DWQ Case Number: LV-2008-0253 County: Rutherford
Assessed Party: White Oak Manor WWTP-Rutherfordton
Permit No.: NC00301.39 . Amount Assessed: $265.00
Please use this form when requesting remission of this civil penalty. You must also complete the
"Request For Remission, Waiver of Right to an Administrative Hearing, and Stipulation of Facts"
form to request remission of this civil penalty. You should attach any documents that you. believe
support your request and are necessary for the Director to consider in evaluating your request for
remission. Please be aware that a request for remission is limited to consideration of the five factors
listed below as they may relate to the reasonableness of the amount of the civil penalty assessed.
Requesting remission is not the proper procedure for contesting whether the violation(s) occurred or
the accuracy of any of the factual statements contained in the civil penalty assessment docinnent.
Pursuant to N.C.G.S. § 143B-282.1(c), remission of a civil penalty may be granted only when one or
more of the following five factors applies. Please check each factor that you believe applies to your
case and provide a detailed explanation, including copies of supporting documents, as to why the
factor applies (attach additional pages as needed).
(a) one or more of the civil penalty assessment factors in N.C.G.S. 143B-282.1(b) were
wrongfully applied to the detriment of the petitioner (the assessment factors are listed in the civil
penalty assessment document);
(b) the violator promptly abated continuing environmental damage resulting from the
violation (i. e., explain the steps that you took to correct the violation and prevent future occurrences);
(c) the violation was inadvertent or a result of an accident (i.e., explain why the violation
was unavoidable or something you could not prevent or prepare for);
(d) the violator had not been -assessed civil penalties for any previous violations;
(e) payment of the civil penalty will prevent payment for the remaining necessary remedial
actions (i. e., explain how payment of the civil penalty will prevent you f om performing the activities
necessary to achieve compliance).
]EXPLANATION:

STATE OF NORTH CAROL.. �
COUNTY OF RUTHERFORD
IN THE MATTER OF ASSESSMENT
OF CIVIL PENALTIES AGAINST
WHITE OAK MANOR-RUTHERFORDTON
PERMIT NO. NCO030139
DEPARTn___'1T OF ENVIRONMENT
AND NATURAL RESOURCES
WAIVER. OF FIGHT TO AN
ADMINSTR.ATIVE HEARING AND
STIPULATION OF FACTS
FILE NO. LV-2008-0253
Having been assessed civil penalties totaling $265.00 for violation(s) asset forth in the
assessment document of the Division of Water Quality dated July 25, 2008, the undersigned, desiring
to seek remission of the civil penalty, does hereby waive the right to an administrative hearing in the
above -stated matter and does stipulate that the facts are as alleged in the assessment document. The
undersigned further understands that all evidence presented in support of remission of this civil
penalty must be submitted to the director of the Division of Water Quality within thirty (30) days of
receipt of the notice of assessment. No new evidence in support of a remission request will be allowed
after (30) days from the receipt of the notice of assessment.
This the
day of
:_ I M
TELEPHONE
SIGNATURE
20

ATTACHMENT A
White Oak Manor
CASE NUMBER: LV-2008-0253
PERMIT: N00030139
FACILITY: White Oak Manor- Rutherfordton
COUNTY: Rutherford
REGION: Asheville
Limit Violations
MONITORING OUTFALU
VIOLATION
UNIT OF
CALCULATED % OVER
PENALTY REPORT PPI
LOCATION' PARAMETER DATE FREQUENCY
MEASURE LIMIT
VALUE LIMIT VIOLATION TYPE
$100.00 4-2008 .001
Effluent FEC COLI 04/16/08 Weekly
#/100ml 400
6,000 1,400.00 Daily Maximum Exceeded
$100.00 4-2008 001
Effluent RES/TSS 04/16/08 Weekly
mg/I 45
55 22.22 Daily Maximum Exceeded

EFFLUENT "1 .
NPDES P8Rfl T No. NCO03 9_ DISCHARGE NO. 0 11 MONTH APRIL
FACILITY NAME White Oak CLASS II COUNTY Ruth
FACILITY
OPERATOR IN RESPONSIBLE CHARGE (ORC) J ALEXANDER� GRADE II PHQNE�ri
1
CERTIFIED LABORATORIES (1) Water Quality Lab & Operations, Inc.
CHECK BOX IF ORC HAS CHANGED [ ] PERSON
Mail•ORIGINAL and ONE COPY to: I�4
ATTN: CENTRAL FILEStL
�() x '`
2008
898-6277
LLECTIN ,SAMPLES J ALEXANDER
5`
DIVISION OF WATER QUALITY (S NATURE OF OPERATOR IN RESPONSIBLE CHARGE) (DATE)
1617 MAIL SERVICE CENTER st,11`! 'I.. r;' B THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS
RALEIGH. NC 27699-1617 ACCURATE AND COMPLETE TO THE BEST OF MY KNOWLEDGE
D
A
T
E
O
P A
E R
R I
A V
T A
0 L
R
TIME
2400
O
P
E
R
A
T
0
R
TIME
ON
SITE
O
R
C
/
O%
N
S
I
T
E
I
50050
00010
00400
50060
00310
00610
00530
31616
00300
00900
00665
00076
00095
00558
FLOW
T
E
M C
E L
R S
A I
T U
U S
.R•
E
Ph
I
R C
E H
S L
t o
D R
U.I
A N
L E
I
BOD
20C
-
N
A I
M T
0 R
NO
I G
A E
N
S
U S
o P 0
T E L
AN I
L 0 D
E S
D
C
F O
E L
C F
A 0
L R
GEOMETRIC
MEAN
D
I O
S x
0 Y
LG
V E
E N
D
N
I
T
R
0
G
E
N
Total
P
H
0
S
P
H
O
R
U
S
Total
T
U
B
I
I
I
T
Y
C
0
N
D
U
C
T
I
V&
I.
Y
O G
I R
L E
A
S
E
EFF x
INF
D
A
I
L
Y
R
A
T
E
HRS
HRS
YIN
MGO
C
UNIT
UG/L
MGIL
MG/L
MG/L
cfu1100ML
MG/L
MGIL
MG/L
NTU
umhos/cm
MGIL
1
1015
1.00
Y
2
1500
1.00
Y
0.003
18.5
6.6
<15
< 4.0
0.10
1
< 1
3
944
1.00
Y
4
1700
1.00
Y
<15
-
6
7
1030
1.00
Y
8
800
1.00
Y
9
1145
1.00
Y
10
1100
1.00
Y
0.003
18.1
6.6
<15
6.1
0.23
6
< 1
11
700
1.00
Y
12
is
13
14
1300
1.00
Y
0.003
<16
15
1620
1.00
Y
16
B00
1.00
Y
19.1
7.1
<15
41.0
0.20
55
> 6000
17
1300
1.00
Y
18
1700
1.00
Y
19
20
21
1145
1.00
Y
0.002
<15
22
715
1.00
Y
19.1
6.7
<15
4.0
0.20
.16
< 1
23
1200
1.00
Y
24
1700
1.00
Y
25
900
1.00
Y
26
27
28
1600
1.00
Y
0.004
<15
29
800
1.00
Y
17.9
6.4
<15
10.0
0.36
9
38
30
1800
1.00
Y
31
AVERAGE
1 0.003
19
<15
13.0
0.22
17
12
MAXIMUM
0.004
19
7.1
<15
41.0
0.36
55
6000
MINIMUM
0.002
17.9
6.4
<15
4.0
0.10
•1
1
COMP. C/ GRAB G
G
G
G
G
G
G
G
MONTHLY LIMIT 0.015
s-9
30I45
17.00
30145
2001400

Facility Status: (Please check one of the fol J)
All monitoring data and sampling frequencies meet permit requirements
All monitoring data and sampling frequencies do NOT meet permit requirements X�
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.
One daily non-compliance for fecal coliform and TSS. The solids were wasted to the digester and the chlorine was adjusted and the plant was compliant by the next samples.
= All QC not met I do not feei,that the data was effected.
p = Blank used too much D.O.
9= Seed failed
" = GGA failed
"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 persons 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."
Jadd Brewer
Perm! Please Print or /J
of Permittee)"
(Date)
Rt. 2 Box 39A Rutherfordton, NC 28139 828-286-9001 7/31/2003
Permittee Address Phone Number Permit Exp. Date
PARAMETER CODES
00610 Temperature
00656 Oil and Grease
00960 Dissolved Flouride
01077 Silver
39616 PCP$ -
00065 Steam Stage
00600 Total Nitrogen
01002 Total Arsenic
01087 Total Vanadium
39941 Roundup
00076 Turbidity
00610 Ammonia Nitrogen
01027 Cadmium
01092 Zinc
60047 Maximum Flow during
24-hr. period
00300bissolved Oxygen
00626 Total Kjeldahl Nitrogen
01032 Nexavalent Chromium
01106 Total Aluminum
50084 Minimum flow during
24-hr. period
00310 BOD
00666 Total Phosphorous
01034 Chromium
01147 Total selenium
50050 Flow
00340 COD
00720 Cyanide
01037 Total Cobalt
31504 Total Coliform
60060 Total Residual Chlorine
00400 pH
00745 Total Sulfide
01042 Copper
31614 Fecal Coliform, MPN, Tube
71880 Formaldehyde
00600 Total Solids
00927 Total Magnesium
01046 Total iron
31616 Fecal Coliform
71900 Mercury
00530 TSS
00929 Total Sodium
01061 Lead
32730 Total Phenolics
81318 Ferrocyanides
00546 Settleable Solids
00940 Total Chloride
01067 Nickle
38260 MBAS.
86662 Time
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 requires per 15A NCAC 8A .0202 (b) (6) (B).
"if Signed by other than the permittee, delegation of signatory authority must be on file with the state per 16A NCAC 2B .0506 (b) (2) (0).
R 'Ell
VEF)
►)+ p9 ( mop
informa±iOn f'roo2Ssing Unit
0 WQ/BOG

DIVISION OF WA'---- QUALITY - CIVIL PENALTY ASSL.,.,�VIENT ()FILE)
Violator: White Oak Manor WWTP: NCO030139
County: Rutherford
Case Number: LV-2008-0253
ASSESSMENT FACTORS
As required by G.S. 143-214.6A(c), in determining the amount of the penalty I considered the factors
set out in G.S. 143B-282.1(b), which are:
1) The degree and extent of harm to the natural resources of the State, to the public health, or to
private property resulting from the violation;
All effluent violations are detrimental to the receiving stream.
2) The duration and gravity of the violation;
One Daily Maximum Fecal Coliform exceeded permit limits by 1,400 %.
One Daily Maximum Total Suspended Solids exceeded permit limits by 22.22 %.
3) The effect on ground or surface water quantity or quality or on air quality;
All effluent violations are detrimental to the receiving stream.
4) The cost of rectifying the damage;
It is unknown.
5) The amount of money saved by noncompliance;
It is unknown.
6) Whether the violation was committed willfully or intentionally;
It is unknown.
7) The prior record of the violator in complying or failing to comply with programs over which
the Environmental Management Commission has regulatory authority; and
There have been no enforcements during the past year.
8) The cost to the State of the enforcement procedures.
$65.00.
-7 A- 0
ate wie0c. Edwards, Regional upervisor
Surface Water Protection
Asheville Regional Office

r
RE:
MEMO TO THE FILE
,�
COUNTY:
DATE:
FROM:
NC DIVISION OF WATER QUALITY: WATER QUALITY ;37± C TION

)Water Quality Lab & Operations, Inc.
PO Box 1167, Banner Elk, NC, 28604
Pbone:828-898-6277 Fax:[phone]
White Oak Manor
NPDES # NCO030139
Brenda Price
188 Oscar Justice Rd. �=�� 10
Putherfordton, NC 28139
Here is your ANNUAL WASTEWATER TREATMENT REPORT (AWTR) �al6ri4with
a sample letter that you may send to your customers if you like. You may rewrite the
sample letter to say what you wish to your customers. Please fill out the bold text in the
sample letter if you wish to use it.
A copy of the AWTR has been sent to the state, so you may not modify the AWTR.
Thank you for letting us be of service to you, if you have any questions about the AWTR,
feel free to call me at [phone]. Thank you again for your time.
Sincerely,
Paul Isenhour
Laboratory Supervisor
Water Quality Lab & Operations, Inc.
APR 1 5 2008
WATER QUALITY SECTION
ASHEVILLE REGIONAL OFFICE

Annual Wastewater Treatment Plant]
APB 1 5 2008 3
epor
WATER OUAUTY SECTION
AS; { VII_LE=: REG{CNAL OFFICE
White Oak Manor `.
NPDES #: NCO030139
Date: 2/13/08
+ Y j
s APR 1 o 2008 s '
We are pleased to present to you this year's Annual Wastewater Tie;,afti&ieofihi.keport. i
This report is designed to inform you about the quality of the wastewater we drscharge-to'
the receiving waters every day. Our constant goal is to protect the environmental waters
of North Carolina. We want you to understand the efforts we make to continually
improve the wastewater treatment process and protect our water resources. We are
committed to ensuring the quality of the receiving waters that we discharge to.
If you have any questions about this report or concerning your wastewater utility, please
contact Paul Isenhour at [phone]. We want our valued customers to be informed
about their wastewater utility.
Let us first. take this opportunity to give you a brief description of a Wastewater
Treatment Plant. The waters that go down the drain, follow many different pipes, and
ends up at the treatment plant. The wastewater goes through a bar screen that stops large
particles that are present (i.e., rags and papers). The water then goes to an aeration basin
where air is pumped into the water. This air supplies oxygen to bacteria that feed on the
solids that are in the water. The, water then goes to'the clarifier where the solids settle out.
The solids are pumped back to'the aeration basin to give the bacteria a second chance to
feed. When there are too many solids in the plant, some of the solids are pumped to a
digester tank. In the digester, the bacteria have more time to feed on and reduce the
solids' volume. When the digester gets full, the solids are pumped from the tank and
taken to a larger facility. The clear water from the clarifier then ,goes to a tank for
disinfection. The two most prominent ways to disinfect the wastewater are chlorine and
ultraviolet light. Chlorine can be used as a gas or in solid tablet form. Whenchlorineis
used, there is generally a dechlorinating agent use to remove any excess chlorine from the
wastewater before it goes to the receiving water. When ultraviolet light (UV) is used, the
wastewater flows around the UV bulbs. Bacteria can not live when exposed 'to UV light,
so as the water passes the UV bulbs, the water in disinfected. Finally, after disinfection,
the treated wastewater goes into the receiving waters.

PERFORMANCE
The treatment plant did very well last year. We had no violations -and all samples meet
the permit requirements.
NOTIFICATION
This annual report has been sent to the North Carolina Division of Water Quality and to
the owner of the wastewater system. The wastewater system owner has also been given a
letter that they can easily distribute to all their customers. The letter will inform the
customers that the annual report is available upon request to the owner of the system.
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
as per the NOTIFICATION section above.
2-0
aul Isenhour Date
Laboratory Supervisor
Water Quality Lab & Operations, Inc.

Name of Wastewater System
NPDES# NC0000000
address
city, NC zip
Wastewater system customer
address
city, NC zip
SUBJECT: ANNUAL WASTEWATER TREATMENT REPORT
Dear wastewater customer,
The ANNUAL WASTEWATER TREATMENT REPORT (AWTR) is
completed! The AWTR is a report that lets us, the wastewater treatment provider, tell
you, the user, what has been happening with our wastewater plant in the past year (2006).
In the AWTR, we give you a brief description of the treatment plant, if we had any
violations, and what was done about any violations. If you would like to have a copy of
the AWTR, please call or come by our office, and we will give one to you:
0
Thank you for your time and if you have any questions, feel free to call our office
at 888-888-8888.

�ww� —i
BETTYE CECIL
WHITE OAK MANOR
188 OSCAR JUSTICE RD
RUTHERFORDTON NC 28139
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
August 6 2008
1
' AUG - 8 2008
WATER QUALITY SECTION
ASHEVILLE REGIONAL OFFICE
SUBJECT: Payment Acknowledgment
Civil Penalty Assessment
White Oak Manor- Rutherfordton
Permit Number: NCO030139
Case Number: LV-2008-0253
Rutherford County .
Dear Ms. Cecil:
This letter is to acknowledge receipt of check number 5429 in the amount of $265.00 received
from you dated July 30, 2008. This payment satisfies in full the above civil assessment levied
against the subject facility, and this case has been closed. Payment of this penalty in no way
precludes future action by this Division for additional violations of the applicable Statutes,
Regulations, or Permits.
If you have any questions, please call Bob Guerra at 919-807-6387.
Sincerely,
Dina Sprinkle
cc: Central Files
Wt rslalilRIg opal Office Supervisor
Mailing Address Phone [phone] Location
1617 Mail Service Center Fax [phone] N. Salisbury St.
Raleigh, NC 27699-1617 Raleigh, NC 27604
Ne Carolina
oAw,11WI-V
Internet: www.newaterouality.org Customer Service 1-877-623-6748
An Equal Opportunity/Affirmative Action Employer — 50% Recydedl10% Post Consumer Paper

(i)W4ter Quality Lab & Operations, Inc.
PO Box1167, Banner Elk, NC, 28604
Phone:[phone] Fax:[phone]
White Oak Manor
NPDES #@0001
Brenda Price
188 Oscar Justice Rd.
Putherfordton, NC 28139
Here is your ANNUAL WASTEWATER TREATMENT REPORT (AWTR) along with
a sample letter that you may send to your customers if you like. You may rewrite the
sample letter to say what you wish to your customers. Please fill out the bold text in the
sample letter if you wish to use it.
A copy of the AWTR has been sent to the state, so you may not modify the AWTR.
Thank you for letting us be of service to you, if you have any questions about the AWTR,
feel free to call me at [phone]. Thank you again for your time.
Sincerely,
Paul Isenhour
Laboratory Supervisor
Water Quality Lab & Operations, Inc.
D
`_ 6 2009
MaR
? WATER (QUALITY SFCTIONOFFIC
i? = p,SHEvll G�ONAL
� d M yw �. •V F � .n
MAR 1 0 2009
DENR - DATER QUALITY
'. POINT SOURCE BRANCH

Annual Wastewater Treatment Plant Report
White Oak Manor
NPDES #: NCO030139
Date: 2/11/09
We are pleased to present to you this year's Annual Wastewater Treatment Plant Report.
This report is designed to inform you about the quality of the wastewater we discharge to
the receiving waters every day. Our constant goal is to protect the environmental waters
of North Carolina. We want you to understand the efforts we make to continually
improve the wastewater treatment process and protect our water resources. We are
committed to ensuring the quality of the receiving waters that we discharge to.
If you have any questions about this report or concerning your wastewater utility, please
contact Paul Isenhour at [phone]. We want our valued customers to be informed
about their wastewater utility.
Let us first take this opportunity to give you a brief description of a Wastewater
Treatment Plant. The waters that go down the drain, follow many different pipes, and
ends up at the treatment plant. The wastewater goes through a bar screen that stops large
particles that are present (i.e., rags and papers). The water then goes to an aeration basin
where air is pumped into the water. This air supplies oxygen to bacteria that feed on the
solids that are in the water. The water then goes to the clarifier where the solids settle out.
The solids are pumped back to the aeration basin to give the bacteria a second chance to
feed. When there are too many solids in the plant, some of the solids are pumped to a
digester tank. In the digester, the bacteria have more time to feed on and reduce the
solids' volume. When the digester gets full, the solids are pumped from the tank and
taken to a larger facility. The clear water from the clarifier then goes to a tank for
disinfection. The two most prominent ways to disinfect the wastewater are chlorine and
ultraviolet light. Chlorine can be used as a gas or in solid tablet form. When chlorine is
used, there is generally a dechlorinating agent use to remove any excess chlorine from the
wastewater before it goes to the receiving water. When ultraviolet light (UV) is used, the
wastewater flows around the UV bulbs. Bacteria can not live when exposed to UV light,
so as the water passes the UV bulbs, the water in disinfected. Finally, after disinfection,
the treated wastewater goes into the receiving waters.

PERFORMANCE
The treatment plant did very well last year. However, in April we had one; daily non-
compliance for fecal coliform and TSS. Solids were wasted to the digester and chlorine
was adjusted. We were back in compliance by next sample.
NOTIFICATION
This annual report has been sent to the North Carolina Division of Water Quality and to
-the owner of the wastewater system. The wastewater system owner has also been given a
letter that they can easily distribute to all their customers. The letter will inform the
customers that the annual report is available upon request to the owner of the system.
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
as per the NOTIFICATION section above.
Paul Isenhour
Laboratory Supervisor
Water Quality Lab & Operations, Inc.
-17=5
Date

Name of Wastewater System
NPDES# NC0000000
address
city, NC zip
Wastewater system customer
address
city, NC zip
SUBJECT: ANNUAL WASTEWATER TREATMENT REPORT
Dear wastewater customer,
The ANNUAL WASTEWATER TREATMENT REPORT (AWTR) is
completed! The AWTR is a report that lets us, the wastewater treatment provider, tell
you, the user, what has been happening with, our wastewater plant in the past year (2006).
In the AWTR, we give you a brief description of the treatment plant, if we had any
violations, and what was done about any violations. If you would like to have a copy of
the AWTR, please call or come by our office, and we will give one to you.;
Thank you for your time and if you have any questions, feel free to call our office
at 888-888-8888.

ii
' awirtrkska+'�w«�ax+x,:;wtiH.:Sfir'"I?3r
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NCDENR
cwv _xPim.i'u7:anaua ursv?taF].rn 9.i#r.q+. y
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North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
Ms. Kally Dotson, Administrator
White Oak Manor
188 Oscar Justice Road
Rutherfordton, NC 28139
Dear Ms. Dotson:
January 14, 2010
Subject: NOTICE OF VIOLATION
NOV-2010-MV-0010
Permit No. NCO030139
White Oak Manor WWTP
Rutherford County
A review of White Oak Manor- Rutherfordton's monitoring report for September 2009 showed
the following violations:
Parameter
Date
Measuring Frequency
Violation
Temperature
08-30 to 09-05
weekly
failure to monitor
pH
08-30 to 09-05
weekly
failure to monitor
Remedial actions, if not already implemented, should be taken to correct any problem.
There were NOT any comments provided on the reverse of the relevant DMR to explain the
violations, nor was the facility status marked as non -compliant.
The Division of Water Quality may pursue enforcement actions for this and any additional
violations. If you should have any questions, please do not hesitate to contact Wanda Frazier 828-
296-4662.
Enclosure
cc: WQ Central Files
s-
s
NOV-2010-MV-0023.White Oak Manor.01-14-10.doc
Sincerely,
L�
Roger C. Edwards, Regional Supervisor
Surface Water Protection Section
NorthCarolina
Nahma!!y
North Carolina Division of Water Quality 2090 U.S. Highway 70 Swannanoa, N.C. 28778 Phone [phone] Customer Service
Internet: www.ncwaterguality.org FAX [phone]

_I
WIWA
Ph
I L
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
SURFACE WATER PROTECTION SECTION
January 29, 2010
Ms. Kally Dotson, Administrator
White Oak Manor
188 Oscar Justice Road
Rutherfordton, NC 28139
SUBJECT: Compliance Evaluation Inspection
White Oak Manor - Rutherfordton WWTP
Permit No: NCO030139
Rutherford County
Dear Ms. Dotson:
Enclosed please find a copy of the Compliance Evaluation Inspection form from the inspection
conducted on January 22, 2010. The facility was found to be in compliance with permit NC0030139.
Please refer to the enclosed inspection report for additional observations and comments. If you or
your staff have any questions, please call me at 828-296-4662.
Sincerely,
/ / C
Wanda P. Frazier
Environmental Specialist
Enclosure
CC' Ce 0traFilers
AsVllleilest,akx.
S:\SWP\Rutherford\Wastewater\Minors\White Oak Manor 30139\CE1.01-29-10.doc
SURFACE WATER PROTECTION —ASHEVILLE REGIONAL OFFICE One
Location: 2090 U.S. Highway 70, Swannanoa, NC 28778 NorthCarolina
Phone: [phone]\FAX: [phone]\Customer Service: 1-877-623-6748 Natllivllly
Internet: www.ncwaterguality.org � J

United States Environmental Protection Agency
Form Approved.
EP Washington, D.C. 20460
�1
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 INI 2 I51 31 N00030139 Ill 121 10/01/22 117 18IcI 19ISI 20I
Remarks
Inspection Work Days Facility Self -Monitoring Evaluation Rating 131 QA --------- —-------- —------ Reserved ----------------------
67 I 1.0 169 701 31 711 I 721 N I 73I I 174 75I I I I I I I i 80
�I
Section B: Facility Data
Name and Location of Facility Inspected (For Industrial Users discharging to POTW, also include
POTW name and NPDES permit Number)
Entry Time/Date
Permit Effective Date
White Oak Manor- Rutherfordton
01:45 PM 10/01/22
08/09/01_
Exit Time/Date
Permit Expiration Date
188 Oscar Justice Rd
Rutherfordton NC 28139
02:45 PM 10/01/22
13/07/31
Name(s) of Onsite Representative(s)/Titles(s)/Phone and Fax Number(s)
Other Facility Data
Jerry Ross Alexander/ORC/864-237-1287/
Name, Address of Responsible Official/Title/Phone and Fax Number
William David Cable,PO Box 1167 Banner'Elk NC 286041167//828-898-6277Wcted
0
Section C: Areas Evaluated During Inspection (Check only those areas evaluated)
Permit Operations & Maintenance 0,1 Records/Reports Facility Site Review
Effluent/Receiving Waters
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
(See attachment summary)
Name(s) and Signature(s) of Inspector(s) Agency/Office/Phone and Fax Numbers Date
Wanda P Frazier ARO WQ//828-296-4500 Ext.4662/
Signature of Management Q A Reviewer Agency/Office hone and Fax Numbers Date
//
Alt
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete.
Page # 1

NPDES yr/mo/day Inspection Type
NCO030139 I11 12I 10/01/22 117 18Icl
(cont.)
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
Please forward a copy of this report to your operator and/or contract operating firm (if applicable).
FACILITY DESCRIPTION:
The White Oak Manor — Rutherfordton WVVTP is a Class II facility rated as a 0.015 MGD extended aeration
package plant with: an equalization basin, with audible and visual alarms (no bar screen); aeration basin,
with blowers providing diffused air; clarifier with sludge return; aerobic digester; tablet chlorinator; chlorine
contact chamber; tablet dechlorinator and a new (in 2009) Isco bubbler 4230 flow meter with battery
back-up.
PERMIT / INSPECTION / LOG:
A review of the files indicates that the last compliance evaluation inspection was conducted on
6-25-2008 by Janet Cantwell.
The permit expires on 7-31-2013. Please request a permit renewal 6 months prior to expiration.
A renewal notice will be mailed as a reminder.
The daily operator log was present on -site and had good notation of daily events, process control and field
testing data.
TREATMENT UNITS / PROCESS CONTROL TESTING DATA:
The activated sludge aeration basin process control data was as follows:
Temperature = 15.0 degrees Celsius
pH = 7.8 units
Dissolved Oxygen = 1.0 to 1.5 mg/I
Tip: The ideal level for dissolved oxygen in the aeration basin is generally 1 to 3 mg/I.
Seasonal. changes in temperature require the adjustment of the aeration timer to achieve ideal
dissolved oxygen levels.
Settleable Solids = 280 ml/I = 28%
Tip: Using the settleability test, the return sludge pumping rate is usually set so that the
flow rate is approximately equal to the percentage volumes occupied by the settleable solids
from the aeration basin after settling for 30 minutes in a settleometer. For example, a
settleability of 30% would generally indicate a recommended return sludge pumping rate of 30%.
Having the percent settleable solids (i.e. 30%) the same as the percent return sludge pumping
rate (i.e. 30%), allows for the solids balance in the plant to be maintained. If the plant
cannot handle that return sludge pumping rate, then wasting is probably recommended, unless the
sludge is too young.
Page # 2

Permit: NCO030139
Inspection Date: 01/22/2010
CLARIFIER:
Owner - Facility: White Oak Manor- Rutherfordton
Inspection Type: Compliance Evaluation
In the summer of 2009, the wooden boards that form the two cone -shape cells in the rectangular clarifier
were replaced, after corrosion caused the metal brackets to break, releasing the boards. The flow level was
taken down by pumping the clarifier. Repairs were completed at an approximate cost of $13,000.
EFFLUENT:
The effluent data was as follows:
pH = 7.0 units
Temperature = 15.0 degrees Celsius
Chlorine = <15 ug/I
FLOW MEASUREMENT:
The facility recently (in 2009) purchased and installed a new Isco bubbler 4230 flow meter with
battery back-up. This meter is calibrated monthly.
The effluent flow was measured at the V-notch weir and compared to the meter, indicating
accuracy.
OPERATIONS AND MAINTENANCE / EFFLUENT / SUMMARY:
Mr. Jerry Alexander, ORC, assisted in the inspection and appears to be operating and maintaining
the facility very well.
The effluent appeared to be in compliance with permit limits.
SYSTEM PERFORMANCE ANNUAL REPORT:
According to the Clean Water Act of 1999 (House Bill 1160), the legal requirement for submittal
of the System Performance Annual Report is as follows:
The owner or operator of any wastewater treatment works or wastewater collection systems that
treats or collects primarily domestic or municipal waste, must provide an Annual Report to its
users or customers and to the Department of Environment and Natural Resources that summarizes
the treatment works' and collection system's performance over a 12 month period.)
The System Performance Annual Performance Report had been filed for the calendar year 2008 by
Water Quality Labs and Operations, Inc.
The System Performance Annual Report, for 2009, is due no later than 60 days of the end of the
reporting period (March 1st).
Report Format:
Page # 3

Permit: NCO030139 Owner - Facility: White Oak Manor- Rutherfordton
Inspection Date: 01/22/2010 Inspection Type: Compliance Evaluation
The following is provided as guidance to assist you in meeting this aspect of the new reporting
requirements. The law states the above mentioned report shall summarize the performance of the
treatment works or collection system and state the extent to which any terms of its permit,
federal laws, or any State laws, regulations or rules related to the protection of water quality
have been violated. In order to meet the spirit of this law, it is strongly suggested that, at
a minimum, the report contain the following information:
I. General Information
• Name of regulated entity and county
• Responsible entity, person or contact with phone number or address
• Listing of applicable permit(s) — NPDES and Collection System permits, etc.
(Note: water plant wastewater dischargers are exempt)
• Description of collection or treatment system or process
II. Performance
• Description of overall 12-month performance, noting highlights and deficiencies.
• By month, list of the number and type of any violations of permit conditions,
environmental regulations or environmental laws, including (but not limited to):
Permit Limit Violations — list by month and type
Monitoring and Reporting Violations — i.e. NOVs and Civil Assessments
(Illegal) Bypass of treatment facilities*
Sanitary Sewer Overflows (SSOs)* - Dates of SSOs*, Press Releases & Public
Notices (*Note the estimated total monthly volumes and locations of events
in which more than 1,000 gallons of waste reached surface waters.
• Description of any known environmental impact of violations
• Description of corrective measures taken to address violations or deficiencies
III. Notification
• Statement as to how users or customers have been provided access to the report.
IV. Certification
• Statement by a responsible official certifying the report is accurate and complete.
It shall be left to the individual applicable, entities to decide both how much detail above
minimum they wish to provide in the report and how they will provide the report to their users
or customers. This law was established to provide a mechanism for public oversight (and
hopefully, to instill public confidence). Those entities that fall under the scope of this part
of the law are encouraged to be forthcoming in their report and they should provide its readers
a contact where .they may view more detailed information.
Submittal:
To satisfy the Departmental reporting requirement, three copies of the report should be
Page # 4

Permit: NC0030139
Inspection Date: 01/22/2010
submitted to the following address:
System Performance Annual Report
North Carolina Division of Water Quality
1617 Mail Service Center
Raleigh, NO 27699-1617
Owner - Facility: White Oak Manor- Rutherfordton
Inspection Type: Compliance Evaluation
Page # 5

k
Permit: NCO030139 Owner - Facility: White Oak Manor- Rutherfordton
Inspection Date: 01/22/2010 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 KE
n
n
n
Judge, and other that are applicable?
Comment:
Permit
Yes
No
NA
NE
(If the present permit expires in 6 months or less). Has the permittee submitted a new application?
n
n
Ig
n
Is the facility as described in the permit?
n
n
n
# Are there any special conditions for the permit?
n
tm
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?
❑
❑
❑
Comment:
Bar Screens
Yes
No
NA
NE
Type of bar screen
n
a. Manual
n
b.Mechanical
Are the bars adequately screening debris?
n
n
n
Is the screen free of excessive debris?
n
n
®
n
Is disposal of screening in compliance?
n
n
®
n
Is the unit in good condition?
n
n
®
n
Comment: This facility does NOT have an influent bar screen. The operator has to
manually remove all debris from the equalization basin.
Aeration Basins
Yes
No
NA
NE
Mode of operation
Ext. Air
Type of aeration system
Diffused
Is the basin free of dead spots?
❑
❑
n
Are surface aerators and mixers operational?
n
n
M
n
Are the diffusers operational?
12
❑
❑
❑
Is the foam the proper color for the treatment process?
R
❑
n
Does the foam cover less than 25% of the basin's surface?
n
n
n
Is the DO level acceptable?
n
n
n
Is the DO level acceptable?(1.0 to 3.0 mg/1)
t
❑
n
❑
Page # 6

Permit: NC0030139 Owner - Facility: White Oak Manor- Rutherfordton
Inspection Date: 01/22/2010 Inspection Type: Compliance Evaluation
Aeration Basins
Yes
No NA NE
Comment:
Secondary Clarifier
Yes
No
NA NE
Is the clarifier free of black and odorous wastewater?
n
n
Is the site free of excessive buildup of solids in center well of circular clarifier?
n
n
lM
n
Are weirs level?
f]
n
n
Is the site free of weir blockage?
n
f1
11
Is the site free of evidence of short-circuiting?
Rg
n
n
n
Is scum removal adequate?
®fl
❑
❑
Is the site free of excessive floating sludge?
0
n
n
n
Is the drive unit operational?
n
n
n
Is the return rate acceptable (low turbulence)?
M
n
n
n
Is the overflow clear of excessive solids/pin floc?
Im
n
n
n
Is the sludge blanket level acceptable? (Approximately'/ of the sidewall depth)
n
n
n
Comment:
Disinfection -Tablet
Yes
No
NA
NE
Are tablet chlorinators operational?
Im
n
n
❑
Are the tablets the proper size and type?
fA
n
00
Number of tubes in use?
2
Is the level of chlorine residual acceptable?
n
00
Is the contact chamber free of growth, or sludge buildup?
n
00
Is there chlorine residual prior to de -chlorination?
®
n
n
n
Comment:
De -chlorination
Yes
No
NA
NE
Type of system ?
Tablet
Is the feed ratio proportional to chlorine amount (1 to 1)?
n
n
I
n
Is storage appropriate for cylinders?
n
n
jg
n
# Is de -chlorination substance stored away from chlorine containers?
n
n
N
n
Comment:
Are the tablets the proper size and type?
M
0
n
n
Are tablet de -chlorinators operational?
®
n
f_1
n
Page # 7

Permit: NC0030139
Inspection Date: 01/22/2010
Owner - Facility: White Oak Manor- Rutherfordton
Inspection Type: Compliance Evaluation
Number of tubes in use?
Comment:
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:
Yes No NA NE
3
Yes No NA NE
�nnn
®nnn
nnM0
Page # 8

NCDENR
North Carolina Department of Environment and Natural Resources
Beverly Eaves Perdue
Governor
Ms. Kally Dotson, Administrator
White Oak Manor
188 Oscar Justice Road
Rutherfordton, North Carolina 28139
Dear Ms. Dotson:
Division of Water Quality
Coleen H. Sullins
Director
November 17, 2010
Dee Freeman
Secretary
Subject: NOTICE OF VIOLATION
NOV-2010-LV-0414
Permit No. NCO030139
White Oak Manor- Rutherfordton WWTP
Rutherford County
A review of White Oak Manor- Rutherfordton's WWTP monitoring report for July 2010 showed the
following violation:
Parameter
Date
Limit Value
Reported Value
Limit Type
Coliform, Fecal MF, M-FC
Broth,44.5C
07/06/2010
400 #/100ml
6,000 #/100ml
Daily Maximum
Exceeded
Remedial actions, if not already implemented, should be taken to correct any problem. Since the
comments section on the reverse of the relevant DMR provided an adequate explanation for the subject
violation, it is not requested that a response be submitted: however, should you have additional information
concerning the violations or comments which you wish to present, please submit them to the attention of Janet
Cantwell.
The Division of Water Quality may pursue enforcement action for this and any additional violations of
State law. If you should have any questions, please do not hesitate to contact Janet Cantwell at
828/296-4500.
Sincerely,
Roger C. Edwards, Regional Supervisor
Surface Water Protection Section
cc: -�DWQ Ash.eville=Files ;_ _,;
DWQ Central- Files
Water Quality Lab & Operations/ ORC
S:\SWP\Rutherford\Wastewater\Minors\White Oak Manor 30139\NOV-2010-LV-0414.doc
Np" Carolina
Ntura!!y
North Carolina Division of Water Quality 2090 U.S. Highway 70 Swannanoa, N.C. 28778 Phone[phone] Customer Service
Internet: www.ncwaterguality.org FAX [phone]

E: UE COPY
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
Ms. Kally Dotson, Administrator
White Oak Manor
188 Oscar Justice Road
Rutherfordton, North Carolina 28139
'Dear Ms. Dotson:
November 17, 2010
Subject: NOTICE OF VIOLATION
NOV-201 0-MV-01 67
Permit No. NCO030139
White Oak Manor- Rutherfordton WWTP
Rutherford County
A review of White Oak Manor- Rutherfordton's WWTP monitoring report for'June 2010 showed the
following violations:
Parameter
Date
Measuring
Frequency
Violation
Temperature
Week ending 06/05/2010
Weekly
Failure to Monitor
pH
Week ending 06/05/2010
Weekly
Failure to Monitor
Total Residual Chlorine
Week ending 06/05/2010
Twice Weekly
Failure to Monitor
It was also noted that the Compliance box on the back of the DMR was marked "Compliant" when in
fact it should have been marked "Non -Compliant" with an explanation for the non-compliance. If the above
parameters were left off inadvertently, please send an amended DMR within 10 business days of
recei t of this letter to Raleigh at the address found on the front page of your'DMR.
Remedial actions should be taken to correct this problem. The Division of Water Quality may pursue
enforcement action for this and any additional violations of State law. If you should have any questions,
please do not hesitate to contact Janet Cantwell at 8281296-4500.
Sincerely,
Roger C. Edwards, Regional Supervisor
Surface Water Protection Section
Asheville Files`
DWQ Central Files
Water Quality Lab & Operations/ ORC
S:1SWP1RutherfordtWastewater\Minors\White Oak Manor 301391NOV-2010-MV-0167.doc I�oe Carolina
Niura!!y
North Carolina Division of Water Quality 2090 U.S. Highway 70 Swannanoa, N.C. 28778. Phone[phone] Customer Service
Internet: www.ncwaterguality.om FAX [phone]

I
U
J
Water Quality L-ab & Operations, Inc.
P6 Box 1167, Banner Elk, NC, 28604
Phone:[phone] Fax: [phone]
RD
NPDES
K -ally Dotson
188 Oscar Justice Rd.
Putherfordton, NC 2 813 9
Here is your ANNUAL WASTEWATER TREATMENT REPORT (AWTR) along with
a sample letter that you may send to your customers if you like. You may rewrite the
sample letter to say what you wish to your customers. Please fill out the bold text in the
sample letter if you wish to use it.
A copy of the AWTR has been sent to the state, so you may not modify the AWTR.
Thank you for letting us be of service to you, if you have any questions about the AWTR,
feel free to call me at [phone]. Thank you again for your time.
Sincerely,
41p�
Paul Isenhour
Laboratory Supervisor
Water Quality Lab & Operations, Inc.
1

Annual Wastewater Treatment:PlantReport
White\,0ak Manor
NPDES #: NCO030139
Date: 3/3/ 10
We are pleased to present to you this year's Annual Wastewater Treatment�Plant Report.
This report is designed to inform you about the quality of the wastewater we discharge to
the receiving waters every day. Our constant goal is to protect the environmental waters
of North Carolina. We want you to understand the efforts we make to continually
improve the wastewater treatment process and protect our water resources. We are
committed to ensuring the quality of the receiving waters that we discharge; to.
If you have any questions about this report or concerning g your wastewater utility, please
contact Paul Isenhour at [phone]. We want our valued customers to be informed
about their wastewater utility.
Let us first take this opportunity to give you a brief description of a Wastewater
Treatment Plant. The waters that go down the drain, follow many different pipes, and
ends up at the treatment plant. The wastewater goes through a bar screen that stops large
particles that are present (i.e., rags and papers). The water then goes to an aeration basin
where air is pumped into the water. This air supplies oxygen to bacteria that feed on the
solids that are in the water. The water then goes to the clarifier where the solids settle out.
The solids are pumped back to the aeration basin to give the bacteria a secorid chance to
feed. When there are too many solids in the plant, some of the solids are pumped to a
digester tank. In the digester, the bacteria have more time to feed on and reduce the
solids' volume. When the digester gets full, the solids are pumped from the tank and
taken to a larger facility. The clear water from the clarifier then goes to a tank for
disinfection. The two most prominent ways to disinfect the wastewater are chlorine and
ultraviolet light. Chlorine can be used as.a gas or in solid tablet form. When::,chlorine is
used, there is generally a dechlorinating agent use, to remove any excess chlorine from the
wastewater before it goes to the receiving water. When ultraviolet light'(UV) is used, the
wastewater flows around the UV bulbs. Bacteria cannot live when exposed to UV light,
so as the water passes the LTV bulbs, the water in disinfected. Finally, after disinfection,
the treated wastewater goes into the receiving waters.

i
PERFORMANCE
The treatment plant did very well last year. There were no violations to report.
NOTIFICATION
This annual report has been sent to the North Carolina Division of Water, Quality and to
the owner of the wastewater system. The wastewater system owner has also been given a
letter that they can easily distribute to all their customers. The letter will inform the
customers that the annual report is available upon request to the owner of the system.
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
as per the NOTIFICATION section above.
Paul Isenhour
Laboratory Supervisor
Water Quality Lab & Operations, Inc.
Date
r

xr a
4'.
400
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Resources
Water Quality Programs
Pat McCrory Thomas A. Reeder
Governor Director
February 20, 2014
Ms. Kally Dotson
White Oak Manor
188 Oscar Justice Road
Rutherfordton, North Carolina 28139
John E. Skvarla, III
Secretary
Subject: NOTICE OF VIOLATION
NOV-2014-MV-0011
Permit No. NCO030139
White Oak Manor WWTP-Rutherfordton
Rutherford County
Dear Ms. Dotson:
A review of White Oak Manor WWTP's monitoring report for October 2013 showed the following
violations:
Parameter
Date
Measuring Frequency
Violation
BOD, 5-Day
10/05/2013
Weekly
Failure to Monitor
Fecal Coliform
10/05/2013
Weekly
Failure to Monitor
Ammonia Nitrogen
10/05/2013
Weekly
Failure to Monitor
Total Suspended Solids
10/05/2013
Weekly
Failure to Monitor
It was also noted that the Compliance box on the back of the DMR was marked "Compliant" when in
fact it should have been marked "Non -Compliant" with an explanation for the non-compliance. If the above
parameters were left off inadvertently, please send an amended DMR within 10 business days of
receipt of this letter to Raleigh at the address found on the front page of your DMR and also a copy to
this office.
Remedial actions should be taken to correct this problem. The Division of Water Resources may
pursue enforcement action for this and any additional violations of State law. If you should have any
questions, please do not hesitate to contact Janet Cantwell or me at 828/296-4500.
Sincerely,
G. Landon Davidson, P.G., Regional Supervisor
Water Quality Regional Operations
_ l�l� tAsheW�ll'e�Fsles
WQ Central Files
Water Quality Lab & Operations/ ORC
G:\WR\WQ\Rutherford\WastewaterWlinors\White Oak Manor 30139\NOV-2014-MV-0011.doc
Water Quality Regional Operations —Asheville Regional Office
2090 U.S. Highway 70, Swannanoa, North Carolina 28778
Phone: [phone] FAX: [phone]
Internet: hUp:Hportal.ncdenr.org/web/wglws
An Equal Opportunity/ Affirmative Action Employer

IF-�' L
NCDENR�
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
Ms. Kally Dotson
White Oak Manor
188 Oscar Justice Road
Rutherfordton, North Carolina 28139
Dear Ms. Dotson:
Division of Water Resources
Water Quality Programs
Thomas A. Reeder
Director
January 15, 2014
John E, Skvarla, III
Secretary
Subject: NOTICE OF VIOLATION
NOV-2014-LV-0012
Permit No. NCO030139
White Oak Manor- Rutherfordton WWTP
Rutherford County
A review of White Oak Manor- Rutherfordton's WWTP monitoring report for September 2013
showed the following violation:
Parameter
Date
Limit Value
Reported Value
Limit Type
Coliform, Fecal MF, M-FC
Broth,44.5C
09/25/2013
400 #/100ml
900 #/100ml
Daily Maximum
Exceeded
Remedial actions, if not already implemented, should be taken to correct any problem. Since the
comments section on the reverse of the relevant DMR provided an adequate explanation for the subject
violation listed above, it is not requested that a response be submitted.
The Division of Water Resources may pursue enforcement action for this and any additional violations
of State law. If you should have any questions, please do not hesitate to contact Janet Cantwell or me
at 828/296-4600.
Sincerely,
G. Landon Davidson, P.G., Regional Supervisor
Water Quality Regional Operations
�c.W�QAsh.euilleFil_es
WQ Central Files
WQ Lab & Operations/ ORC
G:\WQ\SWP\Rutherford\Wastewater\Minors\White Oak Manor 30139\NOV-2014-LV-0012.doc
Water Quality Regional Operations —Asheville Regional Office
2090 U.S. Highway 70, Swannanoa, North Carolina 28778
Phone: [phone] FAX: [phone]
Intemet: hdp://podal.ncdenr.org/web/wglws
An Equal Opportunity/ Affirmative Action Employer

NC®ENR
North Carolina Department of Environment and Natural Resources
Division of Water Resources
Water Quality Programs
Pat McCrory Thomas A. Reeder John E. Skvarla, III
Governor Director Secretary
November 22, 2013
Ms. Kally Dotson
White Oak Manor
188 Oscar Justice Road
Rutherfordton, North Carolina 28139
Subject: NOTICE OF VIOLATION
NOV-2013-LV-0695
Permit No. NCO030139
White Oak Manor- Rutherfordton WWTP
Rutherford County
Dear Ms. Dotson:
A review of White Oak Manor- Rutherfordton's monitoring report for August 2013 showed the
following violation:
Parameter
Date
Limit Value
Reported Value .
Limit Type
Coliform, Fecal MF, M-FC
Broth,44.5C
08/01/2013
400 #/100ml
6,000 #/100mI
Daily Maximum
Exceeded
- Remedial actions,- if not already implemented, should be taken to correct any problem. Since the
comments section on the reverse of the relevant DMR provided an adequate explanation for the subject
violation, it is not requested that a response be submitted.
The Division of Water Resources may pursue enforcement action forthis and any additional violations
of State law. If you should have any questions, please do not hesitate to contact Janet Cantwell or me
at 828/296-4500.
Sincerely,
G. Landon Davidson, P.G., Regiona pervisor
Water Quality Regional Operations
, cc :WAsheville=F les
WQ Central Files
WQ Lab & Operations/ ORC
G:\WQ\SWP\Rutherford\WastewaterWlinors\White Oak Manor 30139\NOV-2013-LV-0695.doc
Water Quality Regional Operations — Asheville Regional Office
2090 U.S. Highway 70, Swannanoa, North Carolina 28778
Phone: [phone] FAX: [phone]
Internet: hftp://portal.ncdenr.org/web/wq/ws
An Equal Opportunity/ Affirmative Action Employer

A7jA rILM
NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
Ms. Kally Dotson
White Oak Manor
188 Oscar Justice Road
Rutherfordton, North Carolina 28139
Dear Ms. Dotson:
Division of Water Resources
Water Quality Programs
Thomas A. Reeder
Director
September 11, 2013
John E. Skvarla, III
Secretary
Subject: NOTICE OF VIOLATION
NOV-2013-LV-0623
Permit No. NCO030139
White Oak Manor- Rutherfordton WWTP
Rutherford County
A review of White Oak Manor- Rutherfordton's WWTP monitoring report for July 2013 showed the
following violation:
Parameter
Date
Limit Value
Reported Value
Limit Type
Coliform, Fecal MF, M-FC
Broth,44.5C
07/02/2013
400 #/100ml
1,000 #/100ml
Daily Maximum
Exceeded
Remedial actions, if not already implemented, should be taken to correct any problem. Since the
comments section on the reverse of the relevant DMR provided an adequate explanation for the subject
violation, it is not requested that a response be submitted.
The Division of Water Resources may pursue enforcement action for this and any additional violations
of State law. If you should have any questions, please do not hesitate to contact Janet Cantwell or me
at 828/296-4500.
Sincerely,
G. Landon Davidson, P.G.
Regional Supervisor
Water Quality Section
cs:IN A .3euil1e�ils
WQ Central Files avow
WQ Lab & Operations/ ORC
G:\WQ\SWP\Rutherford\Wastewater\Minors\White Oak Manor 30139\NOV-2013-LV-0523.doc
WATER QUALITY SECTION
North Carolina Division of Water Resources — Asheville Regional Office Phone (828) 296A500 FAX [phone] Internet: h2o.enr.state.nc.us
2090 U.S. Highway 70, Swannanoa, N.C. 28778 An Equal Opportunity/Affirmative Action Employer

NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
Ms. Bettye Cecil
White Oak Manor
188 Oscar Justice Road
Rutherfordton, North Carolina 28139
Dear Ms. Cecil:
Division of Water Quality
Charles Wakild, P.E.
Director
May 10, 2013
John E. Skvarla, III
Secretary
Subject: NOTICE OF VIOLATION
NOV-2013-LV-0306
Permit No. NCO030139
White Oak Manor- Rutherfordton WWTP
Rutherford County
A review of White Oak Manor- Rutherfordton's WWTP monitoring report for February 2013 showed
the following violation:
Parameter
Date
Limit Value
Reported Value
Limit Type
Coliform, Fecal MF, M-FC
Broth,44.5C
02/26/2013
400 #/100ml
3,700 #/100ml
Daily Maximum
Exceeded
Remedial actions, if not already implemented, should be taken to correct any problem. Since the
comments section on the reverse of the relevant DMR provided an adequate explanation for the subject
violation, it is not requested that a response be submitted.
The Division of Water Quality may pursue enforcement action for this and any additional violations of
State law. It you should have any questions, please do not hesitate to contact Janet Cantwell or me at
828/296-4600.
Sincerely, /'
Chuck Cranford, Regional Supervisor
Surface Water Protection Section
cc: @�'; TK OREM e .ilea
DWQ Central Files
Water Quality Lab & Operations/ ORC
S:\SWP\Rutherford\Wastewater\Minors\White Oak Manor 30139\NOV-2013-LV-0306.doc
NorthCarolina
,A7,qturu11y
North Carolina Division of Water Quality 2090 U.S. Highway 70 Swannanoa, N.C. 28778 Phone[phone]
Internet: www.ncwatercivality.ora FAX [phone]

li{saw
�=AG PA_ F
WDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
Ms. Bettye Cecil
White Oak Manor
188 Oscar Justice Road
Rutherfordton, North Carolina 28139
Dear Ms. Cecil:
Division of Water Quality
Charles Wakild, P.E.
Director
April 25, 2013
John E. Skvarla, III
Secretary
Subject: NOTICE OF VIOLATION
NOV-2013-MV-0062
Permit No. NCO030139
White Oak Manor- Rutherfordton WWTP
Rutherford County
A review of White Oak Manor- Rutherfordton's WWTP monitoring report for January 2013 showed
the following violation:
Parameter
Date
Measuring
Violation
Frequency
Nitrogen, Ammonia Total (as N) -
Week ending
Weekly
Failure to Monitor
Concentration
01/19/2013
It was also noted that the Compliance box on the back of the DMR was marked "Compliant" when in
fact it should have been marked "Non -Compliant" with an explanation for the non-compliance. If the above
parameter was left off inadvertently, please send an amended DMR within 10 business days of receipt
of this letter to Raleigh at the address found on the front page of your DMR and also a copy to this
office.
Remedial actions should be taken to correct this problem. The Division of Water Quality may pursue
enforcement action for this and any additional violations of State law. If you should have any questions,
please do not hesitate to contact Janet Cantwell or me at 828/296-4500.
Sincerely,
Chuck CranVord, Regional Supervisor
Surface Water Protection Section
;ce�U"JQAsheui l leFi le, ,
DWQ Central Files
Water Quality Lab & Operations/ ORC
S:\SWP\Rutherford\Wastewater\Minors\White Oak Manor 30139\NOV-2013-MV-0062.doc
NorthCarolina
N-aturally
North Carolina Division of Water Quality 2090 U.S. Highway 70 Swannanoa, N.C. 28778 Phone[phone]
Internet: www.ncwaterguality.org FAX [phone]

O)Water Quality Lab & Operations, Inc.
PO Box1167, Banner Elk, NC, 28604
Phone:[phone] Fax:[phone]
L
White Oak Manor MAR ® 4 2013
SIP 'y - SOVINC4003Q139— CENTRAL. FILES
Kally Dotson ®WQIB®G
188 Oscar Justice Rd.
Putherfordton, NC 28139
Here is your ANNUAL WASTEWATER TREATMENT REPORT (AWTR) along with
a sample letter that you may send to your customers if you like. You may rewrite the
sample letter to say what you wish to your customers. Please fill out the bold text in the
sample letter if you wish to use it.
A copy of the AWTR has been sent to the state, so you may not modify the AWTR.
Thank you for letting us be of service to you, if you have any questions about the AWTR,
feel free to call me at [phone]. Thank you again for your time.
Sincerely,
Paul Isenhour
Laboratory Supervisor
Water Quality Lab & Operations, Inc.
ECE"'
IVED
APR 1 5 2013
DWQ/Surface Water Protection Section
Asheville Regional Office

Annua7 Wastewater 7VeatmentPrantWeport
RECEIVED
White Oak Manor
NPDES #: NCO030139 ApR 1 5 2013
Date: 2/13/13
DWQ/Surface Water Protection Section
Asheville Regional Office _
We are pleased to present to you this year's Annual Wastewater Treatment Plant Report.
This report is designed to inform you about the quality of the wastewater we discharge to
the receiving waters every day. Our constant goal is to protect the environmental waters
of North Carolina. We want you to understand the efforts we make to continually
improve the wastewater treatment process and protect our water resources. We are
committed to ensuring the quality of the receiving waters that we discharge to.
If you have any questions about this report or concerning your wastewater utility, please
contact Paul Isenhour at [phone]. We want our valued customers to be informed
about their wastewater utility.
Let us first take this opportunity to give you a brief description of a Wastewater
Treatment Plant. The waters that go down the drain, follow many different pipes, and
ends up at the treatment plant. The wastewater goes through a bar screen that stops large
particles that are present (i.e., rags and papers). The water then goes to an aeration basin
where air is pumped into the water. This air supplies oxygen to bacteria that feed on the
solids that are in the water. The water then goes to the clarifier where the solids settle out.
The solids are pumped back to the aeration basin to give the bacteria a second chance to
feed. When there are too many solids in the plant, some of the solids are pumped to a
digester tank. In the digester, the bacteria have more time to feed on and reduce the
solids' volume. When the digester gets full, the solids are pumped from the tank and
taken to a larger facility. The clear water from the clarifier then goes to a tank for
disinfection. The two most prominent ways to disinfect the wastewater are chlorine and
ultraviolet light. Chlorine can be used as a gas or in solid tablet form. When chlorine is
used, there is generally a dechlorinating agent use to remove any excess chlorine from the
wastewater before it goes to the receiving water. When ultraviolet light (UV) is used, the
wastewater flows around the UV bulbs. Bacteria can not live when exposed to UV light,
so as the water passes the UV bulbs, the water in disinfected. Finally, after disinfection,
the treated wastewater goes into the receiving waters.

The treatment plant did very well last year. However, in October the plant had a loss of
solids, and the TSS was out of compliance for a daily max limit.
NOTIFICATION
This annual report has been sent to the North Carolina Division of Water Quality and to
the owner of the wastewater system. The wastewater system owner has also been given a
letter that they can easily distribute to all their customers. The letter will inform the
customers that the annual report is available upon request to the owner of the system.
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
as per the NOTIFICATION section above.
Paul Isenhour
Laboratory Supervisor
Water Quality Lab & Operations, Inc.
Date

NCDENR I LIE
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
Ms. Kally Dotson, Administrator
White Oak Manor
188 Oscar Justice Road
Rutherfordton, North Carolina 28139
Dear Ms. Dotson:
Division of Water Quality
Charles Wakild, P.E.
Director
January 24, 2013
John E. Skvarla, III
Secretary
Subject: NOTICE OF VIOLATION
NOV-2013-LV-0054
Permit No. NCO030139
White Oak Manor- Rutherfordton WWTP
Rutherford County
A review of White Oak Manor- Rutherfordton's WWTP monitoring report for October 2012 showed
the following violations:
Parameter
Date
Limit Value
Reported Value
Limit Type
Solids, Total Suspended -
10/30/2012
45 mg/I
104 mg/I
Daily Maximum
Concentration
Exceeded
pH
10/22/2012
9 su
9.2 su
Daily Maximum
Exceeded
It was also noted that the Compliance box on the back of the DMR was marked "Compliant" when in
fact it should have been marked "Non -Compliant" with an explanation for the non-compliance.
Remedial actions should be taken to correct this problem. The Division of Water Quality may pursue
enforcement action for this and any additional violations of State law. If you should have any questions,
please do not hesitate to contact Janet Cantwell or me at 8281296-4500.
cc�.�DWQ Asheuille_Eiles_r__
DWQ Central Files
WQ Lab & Operations/ ORC
Sincerely, i
Chuck Cranford, Regional Supervisor
Surface Water Protection Section
S:\SWP\Rutherford\Wastewater\Minors\White Oak Manor 30139\NOV-2013-LV-0054.doc
No thCarolina
Naturally
North Carolina Division of Water Quality 2090 U.S. Highway 70 Swannanoa, N.C. 28778 Phone[phone]
Internet: www.ncwaterguality.org FAX [phone]

A74LA..
HCDENR
North Carolina Department of Environment and
Pat McCrory
Governor
Ms. Kally Dotson
White Oak Manor
188 Oscar Justice Rd
Rutherfordton, N.C. 28139
Dear Ms. Dotson:
Division of Water Resources
Thomas A. Reeder
Director
September 11, 2013
Natural Resources
John E. Skvada III
Secretary
Subject: Draft NPDES Permit NCO030139
White Oak Manor - Rutherfordton
Class WW-2
Rutherford County
The Division has reviewed your request to renew the subject permit on behalf of the Permittee. Please
review this draft carefully to ensure your thorough understanding of the information, conditions, and
requirements it contains.
The draft permit includes the following significant changes from the existing permit:
➢ Parameter codes have been added to section A. (1) to simplify data entry on DMR forms.
With this notification, the Division will solicit public comment on this draft permit by publishing a notice in
newspapers having circulation in the general Rutherford County area, per EPA requirements. Please
provide your comments, if any, to me no later than 30 days after receiving this draft permit.
Following the 30-day public comment period, the Division will review all pertinent comments and take
appropriate action prior to issuing a final permit. If you have questions concerning the draft, please contact
me at the telephone number or e-mail address listed at the bottom of this page.
Sincerely,
Charles H. Weaver, Jr.
NPDES Unit
cc: NPDES Unit
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 512 North Salisbury Street, Raleigh, North Carolina 27604
Phone: [phone] / FAX [phone] / Internet: www.ncwaterquality.org
[e-mail]
An Equal Opportunity/Affirmative Action Employer — 50% Recycled/10% Post Consumer Paper

Permit NC0030139
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
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
White Oak Manor
is hereby authorized to discharge wastewater from a facility located; at the
White Oak. Manor - Rutherfordton WWTP
188 Oscar Justice. Road
Rutherfordton
Rutherford County
to receiving waters designated as an unnamed tributary to- Catheys''. Creek in the
Broad River Basin in accordancewith effluent limitations, monitoring requirements,
and other conditions set forth in Parts I, II, III and IV hereof.
This permit shall become effective
This permit and authorization to discharge shall expire at midnight on July 31, 2018.
Signed this day
Thomas A. Reeder, Director
Division of Water Resources
By Authority of the Environmental Management Commission
1 of 3

Permit NCO030139
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.
White Oak Manor is hereby authorized to;
1. Continue to operate an existing 0.015 MGD extended aeration package
wastewater treatment facility with the following components:
• • Equalization basin
• Aeration basin
• Clarifier
• Chlorine contact chamber
• Dechlorination
This facility is located at the White Oak Manor Rutherfordton facility (188.Oscar
Justice Rd, Rutherfordton) in Rutherford County.
2. Discharge from said treatment works via Outfall 001 into an unnamed tributary
to Cathey's Creek, currently classified WS-V waters in the Broad River Basin.
2of3

Permit NCO030139
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 from outfall 001. Such discharges shall be. limited and monitored by the Permittee as
specified below:
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J
Flow
11 1
1 1 i
Influent
003 . , 1 '
11 1
Total Suspended Solids
11 1
111 1
1 .
111 Me J..
11. 1
Monitor & Rep.
..
Fecal • •rm
2001100 mL
[31616]
.
TotalResidual
11.1
Temperature
Monitor & Report
111 1
11,11
• 1 and < • 1 standard units..
Footnotes:
1. Because low-level TRC is currently difficult to quantify in a wastewater matrix, the Division shall
consider all effluent TRC values reported below 50 µg/L to be "in compliance" with the permit..
However, the Permittee shall continue to record and submit all values reported by North
Carolina -certified field and lab test methods, even if these values fall below 50 µg/L.
There shall be no discharge of floating solids or visible foam in other than trace
amounts..
3 of 3

FACT SHL_ S FOR EXPEDITED PERMIZ_..r _ENEWALS
This form must be completed by Permit Writers for all expedited permits which do not require
full Fact Sheets. Expedited permits are generally simple 100% domestics (e.g., schools, mobile
home parks, etc) that can be administratively renewed with minor changes, but can include.
facilities with more complex issues (Special Conditions, .3 03(d) listed water, toxicity testing,
mstream monitoring, compliance concerns).
Basic Information for Exuedited Permit Renewals
Permit Writer/Date
Charles H. Weaver 9/9/2013
Permit Number
NCO030139
Facility Name
White Oak Manor - Rutherfordton WWTP
Basin Name/Sub-basin number
03-08-02
Receiving Stream
UT Cathe 's Creek
Stream Classification in Permit
WS-V
Does permit need Daily Max NH3 limits?
No — already resent
Does permit need TRC limits/language?
No — already resent
Does permit have toxicity testing?
No
Does permit have Special Conditions?
No
Does permit have instream monitoring?
No.
Is the stream impaired (on 303(d) list)?
For whatparameter?
No
Any obvious compliance concerns?
None. No enforcements since 2008.
Any permit modifications since lastpermit?
None.
New expiration date
7/31 /2018
Comments on Draft Permit
Added parameter codes.
No other changes from 2008 renewal.
Most Commonly Used Expedited Language:
• 303(d) language for Draft/Final Cover Letters: "Please note that the receiving stream
is listed as an impaired waterbody on the North Carolina 303(d) Impaired Waters List.
Addressing impaired waters is a high priority with the Division, and instream data will
continue to be evaluated. If there is noncompliance with permitted effluent limits and
stream impairment can be attributed to your facility, then mitigative measures may be
required".
• TRC language for Compliance Level for Cover Letters/Efflaent Sheet Footnote:
"The facility shall report all effluent TRC values reported by a NC certified laboratory
including field certified. However, effluent values < 50 µg/1 will be treated as zero for
compliance purposes."

� S�{+ r• Y
I. C J'y�
P, - :1l
NJI

NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
Ms. Kally Dotson
White Oak Manor
188 Oscar Justice Rd
Rutherfordton, N.C. 28139
Dear Ms. Dotson:
Division of Water Resources
Thomas A. Reeder
Director
November 8, 2013
ARC
John E. Skvarla III
Secretary
Subject: Issuance of NPDES Permit NCO066397
White Oak Manor - Rutherfordton
Rutherford County
Division personnel have reviewed and approved your application for renewal of the subject permit.
Accordingly, we are forwarding the attached NPDES discharge permit. This permit is issued pursuant to
the requirements of North Carolina General Statute 143-215.1 and the Memorandum of Agreement between
North Carolina and the U.S. Environmental Protection Agency dated October 15, 2007 (or as subsequently
amended).
This final permit includes the following major change from the draft permit sent to you
on September 11, 2013.
Section A. (2) has been added to require electronic submission of effluent data. Proposed Federal
regulations require electronic submittal of all discharge monitoring reports (DMRs). The
proposed regulations specify that if a state does not establish a system to receive such
submittals permittees must submit DMRs electronically to the Environmental Protection .
Agency (EPA). Accordingly, NC DENR has established an electronic data -submission system.
Permittees must begin using the system no later than 90 days following the issuance of permit
renewals. In your case, that deadline is March 1, 2014.
If any parts, measurement frequencies or sampling requirements contained in this permit are
unacceptable to you, you have the right to an adjudicatory hearing upon written request within thirty (30)
days following receipt of this letter. This request must be in the form of a written petition, conforming to
Chapter 150B of the North Carolina General Statutes, and filed with the Office of Administrative Hearings
(6714 Mail Service Center, Raleigh, North Carolina 27699-6714). Unless such demand is made, this
decision shall be final and binding.
Please note that this permit is not transferable except after notice to the Division. The Division may
require modification or revocation and reissuance of the permit. This permit does not affect the legal
requirements to obtain other permits which may be required by the Division of Water Quality or permits
required by the Division of Land Resources, the Coastal Area Management Act or any other Federal or Local
governmental permit that may be required. If you have any questions concerning this permit, please
contact Charles Weaver at telephone number [phone].
Sincerely, RECEIVED
Thomas A. Reeder DEC - 5 2013
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 512 North Salisbury Street, Raleigh, North CaAsheville Regional Office
Phone: [phone] / FAX [phone] / http://portal.ncdenr.org/web/wq
An Equal Opportunity/Affirmative Action Employer - 50% Recycled/101/o Post Consumer Paper

Permit NCO030139
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
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
White Oak Manor
is hereby authorized to discharge wastewater from a facility located at the
White Oak Manor - Rutherfordton WWTP
188 Oscar Justice Road
Rutherfordton
Rutherford County
to receiving waters designated as an unnamed tributary to Catheys Creek in the
Broad 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 December 1, 2013.
This permit and authorization to discharge. shall expire at midnight on July 31, 2018.
Signed this day November 8, 2013.
4A/
u =!, e � lk Thomas A. Reeder, Director
"Division of Water Resources
by Authority of the Environmental Management Commission
1 of 5

Permit NC0030139
2. Signatory requirements [Supplements Section B. (11.) (b) and supersedes Section
B. ( I I.) (d)1
All eDMRs submitted to the permit issuing authority shall be signed by a person
described in Part II, Section B. (11.)(a) or by a duly authorized representative of that
person as described in Part II, Section B. (11.)(b). A person, and not a 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.ncdenr.org/web/wq/adminibog/i-pu/edmr
Certification. Any person submitting an electronic DMR using the state's eDMR system
shall make the following certification [40 CFR 122.22]. NO OTHER STATEMENTS OF
CERTIFICATION WILL BE ACCEPTED:
"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."
3. Records Retention [Supplements Section D. (6.)l
The permittee shall retain records of all Discharge Monitoring Reports, including eDMR
submissions. These records or copies shall be maintained for a period of at least 3
years from the date of the report. This period may be extended by request of the
Director at any time [40 CFR 122.411.
5 of 5

Permit NC0030139
• Section D. (2.) Reporting
• Section D. (6.) Records Retention
• Section E. (5.) Monitoring Reports
1. Reporting [Supersedes Section D. (2.) and Section E. (5.) (a)l
Beginning no later than 90 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 allows permitted
facilities to enter monitoring data and submit DMRs electronically using the internet.
Until such time that the state's eDMR application is compliant with EPA's Cross -Media
Electronic Reporting Regulation (CROMERR), permittees will be required to submit all
discharge monitoring data to the state electronically using eDMR and will be required to
complete the eDMR submission by printing, signing, and submitting one signed original
and a copy of the computer printed eDMR to the following address:
NC DENR / Division of Water Resources / Information Processing Unit
ATTENTION: Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
If a permittee is unable to use the eDMR system due to a demonstrated hardship or due
to the facility being physically located in an area where less than 10 percent of the
households have broadband access, then a temporary waiver from the NPDES electronic
reporting requirements may be granted and discharge monitoring data may be .
submitted on paper DMR forms (MR 1, 1. 1, 2, 3) or alternative forms approved by the
Director. Duplicate signed copies shall be submitted to the mailing address above.
Requests for temporary waivers from the NPDES electronic reporting requirements must
be submitted in writing to the Division 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/adminibog/ipu/edmr
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.
4 of 5

Permit NCO030139
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.
White Oak Manor is hereby authorized to:
1. Continue to operate an existing 0.015 MGD extended aeration -package
wastewater treatment facility with the following components:
• Equalization basin
• Aeration basin
• Clarifier
• Chlorine contact chamber
• Dechlorination
This facility is located at the White Oak Manor Rutherfordton facility (188 Oscar
Justice Rd, Rutherfordton) in Rutherford County.
2. Discharge from said treatment works via Outfall 001 into an unnamed tributary
to Cathey's Creek, currently classified WS-V waters in the Broad River Basin.
2 of 5

Permit NCO030139
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 from outfall 001. Such discharges shall be limited and monitored by the Permittee as
specified below:
'PARAMETER
LIMITS
MONITORING REQUIREMENTS
[PCS Code]
'Monthly Average
Daily Maximum
Measurement
Sample Type.
Sample
Frequency
Location
Flow
0.015 MGD
Continuous
Instantaneous
Influent or
50050
Effluent
BOD, 5-day (20°C)
30.0 mg/L
45.0 mg/L
Weekly
Composite
Effluent
00310
Total Suspended Solids
30.0 mg/L
45.0 mg/L
Weekly
Composite
Effluent
00530
NH3 as N [00610]
17.0 mg/L
35.0 mg/L
Weekly
Grab
Effluent
(April 1 — Oct 31
NH3 as N [00610]
Monitor & Report
Weekly
Grab
Effluent
November 1 — March 31
Fecal Coliform (geometric mean)
2001100 mL
400/100 mL
Weekly
Grab
Effluent
31616
Total Residual Chlorine (TRC)l
28 Ng/L
2/week
Grab
Effluent
50060
Temperature
00010
Monitor & Report
Weekly
Grab
Effluent
pH
00400
> 6.0 and < 9.0 standard units
— —
Weekly
Grab
Effluent
Footnotes:
1. No later than March 1, 2014, the permittee shall begin submitting discharge monitoring reports
electronically using the Division's eDMR application system [see A. (2)].
2. Because low-level TRC is currently difficult to quantify in a wastewater matrix, the Division
shall consider all effluent TRC values reported below 50 µg/L to be "in compliance" with the
permit. However, the Permittee shall continue to record and submit all values reported by
North Carolina -certified field and lab test methods, even if these values fall below 50 lug/L.
There shall be no discharge of floating solids or visible foam in other than trace
amounts.
A. (2) ELECTRONIC REPORTING OF 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 is beginning implementation in late 2013.
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
3 of 5

tier Outfall 001
k
� 7 - � Ile"
188 Oscar Justice Road
0
0
�e�brmon,
.1 U.S. Hwy-64
NC0030139 - White Oak Manor WWTP Facility
Latitude: 35' 24'43" N USGS Quad: Rutherfordton, N.C. Location
Longitude: 81' 55' 36" W Sub -Basin: 03-08-02
Stream Class: WS-V
Receiving Stream: UT Cathey's Creek Rutherford County
I Nm& Map not to scale

-WDES Permit Standard Conditions
Page 1 of 18
PART II
STANDARD CONDITIONS FOR NPDES PERMITS
Section A. Definitions
2/Month
Samples are collected twice per month with at least ten calendar days between sampling events. These samples shall be
representative of the wastewater discharged during the sample period.
3/Week
Samples are collected three times per week on three separate calendar days. These samples shall be representative of
the wastewater discharged during the sample period.
Act or "the Act"
The Federal Water Pollution Control Act, also known as the Clean Water Act (CWA), as amended, 33 USC 1251, et.
seq.
Annual Average
The arithmetic mean of all "daily discharges" of a pollutant measured during -the calendar yea. In the case of fecal
coliform, the geometric mean of such discharges. '
Arithmetic Mean
The summation of the individual values divided by the number of individual values.
Bypass
The known diversion of waste streams from any portion of a treatment facility including the collection system, which is
not a designed or established or operating mode for the facility.
Calendar Day ;
The.period from midnight of one day until midnight of the next day. However, for purposes of this permit, any
consecutive 24-hour period that reasonably represents the calendar day may be used for sampling.
Calendar Week
The period from Sunday through the following Saturday.
Calendar Quarter
One of the following distinct periods: January through March, April through June, July through September, and
October through December.
Composite Sample
A sample collected over a 24-hour period by continuous'sampling or combining grab samples1'of at least 100 mL in
such a manner as to result in a total sample representative of the wastewater discharge during the sample period. The
Director may designate the most appropriate method (specific number and size of aliquots necessary, the time interval
between grab samples, etc.) on a case -by -case basis. Samples may be collected manually or automatically. Composite
samples may be obtained by the following methods:
(1) Continuous: a single, continuous sample collected over a 24-hour period proportionaL,to the rate of flow.
(2) Constant time/variable volume: a series of grab samples collected at equal time intervals over a 24 hour period
of discharge and combined proportional to the rate of flow measured at the time of individual sample
collection, or
(3) Variable time/constant volume: a series of grab samples of equal volume collected over a 24 hour period with
the time intervals between samples determined by a preset number of gallons passing. the sampling point. Flow
measurement between sample intervals shall be determined by use of a flow recorderiand totalizer, and the
preset gallon interval between sample collection fixed at no greater than 1/24 of the expected total daily flow at
the treatment system; or
Version 1110912011

DES Permit Standard Conditions'
Page 2 of 18
(4) Constant time/constant volume: a series of grab samples of equal volume collected over a 24-hour period at a
constant time interval. Use of this method requires prior approval by the Director. This method may only be
used in situations where effluent flow rates vary less than 15 percent. The following restrictions also apply:
➢ Influent and effluent grab samples shall be of equal size and of no less than 100 milliliters
➢ Influent samples shall not be collected more than once per hour:
Permittees with wastewater treatment systems whose detention time < 24 hours shall collect effluent grab
samples at intervals of no greater than 20 minutes apart during any 24-hour period.
➢ Permittees with wastewater treatment systems whose detention time exceeds 24 hours shall collect effluent
grab samples at least every six hours; there must be a minimum of four samples during a 24-hour sampling
period.
Continuous flow measurement
Flow monitoring that occurs without interruption throughout the operating hours of the facility. Flow shall be
monitored continually except for the infrequent times when there may be no flow or for infrequent maintenance
activities on the flow device.
Daily Discharge
The discharge of a pollutant measured during a calendar day or any 24-hour period that reasonably represents the
calendar day for purposes of sampling. For pollutants measured in units of mass, the "daily discharge" is calculated as
the total mass of the pollutant discharged over the day. For pollutants expressed in other units of measurement, the
"daily discharge" is calculated as the average measurement of the pollutant over the day. (40 CFR 122.2; see also
"Composite Sample," above.)
Daily Maximum
The highest "daily discharge" during the calendar month.
Daily Sampling
Parameters requiring daily sampling shall be sampled 5 out of every 7 days per week unless otherwise specified in the
permit. Sampling shall be conducted on weekdays except where holidays or other disruptions of normal operations
prevent weekday sampling. If sampling is required for all seven days of the week for any permit parameter(s), that
requirement will be so noted on the Effluent Limitations and Monitoring Page(s).
DWQ or "the Division"
The Division of Water Quality, Department of Environment and Natural Resources.
Effluent
Wastewater discharged following all treatment processes from a water pollution control facility or other point source
whether treated or untreated.
EMC
The North Carolina Environmental Management Commission
EPA
The United States Environmental Protection Agency
Facility Closure
Cessation of all activities that require coverage under this NPDES permit. Completion of facility closure will allow this
permit to be rescinded.
Geometric Mean
The Nth root of the product of the individual values where N = the number of individual values. For purposes of
calculating the geometric mean, values of "0" (or "< [detection level]") shall be considered = 1.
Grab Sample
Individual samples of at least 100 mL collected over a period of time not exceeding 15 minutes. Grab samples can be
collected manually. Grab samples must be representative of the discharge (or the receiving stream, for instream
samples).
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1PDES Permit Standard Conditions
Page 3 of 18
Hazardous Substance
Any substance designated under 40 CFR Part 116 pursuant to Section 311 of the CWA.
Instantaneous flow measurement
The flow measured during the minimum time required for the flow measuring device or method to produce a result in
that instance. To the extent practical, instantaneous flow measurements coincide with the collection of any grab
samples required for the same sampling period so that together the samples and flow are representative of the discharge
during that sampling period.
Monthly Average (concentration limit)
The arithmetic mean of all "daily discharges" of a pollutant measured during the calendar month. In the case of fecal
coliform or other bacterial parameters or indicators, the geometric mean of such discharges.
Permit Issuing Authority .
The Director of the Division of Water Quality.
Quarterly Average (concentration limit)
The arithmetic mean of all samples taken over a calendar quarter.
Severe property damage
Substantial physical damage to property, damage to the treatment facilities which causes them to become inoperable, or
substantial and permanent loss of natural resources which can reasonably be expected to occur in the absence of a
bypass. Severe property damage excludes economic loss caused by delays in production.
Toxic Pollutant:
Any pollutant listed as toxic under Section 307(a)(1) of the CWA.
Upset
An incident beyond the reasonable control of the Permittee causing unintentional and temporary noncompliance with
permit effluent limitations and/or monitoring requirements. An upset does not include noncompliance caused by
operational error, improperly designed treatment facilities, inadequate treatment facilities, lack of preventive
maintenance, or careless or improper operation.
Weekly Average (concentration limit)
The arithmetic mean of all "daily discharges" of a pollutant measured during the calendar week. In the case of fecal
coliform or other bacterial parameters or indicators, the geometric mean of such discharges.
Section B. General Conditions
1. Duty to Comply
The Permittee must comply with all conditions of this permit. Any permit noncompliance, constitutes a violation of
the CWA and is grounds for enforcement action; for permit termination, revocation and reissuance, or
modification; or denial of a permit renewal application [40 CFR 122.41].
a. The Permittee shall comply with effluent standards or prohibitions established under section 307(a) of the
CWA for toxic pollutants and with standards for sewage sludge use or disposal established under section
405(d) of the CWA within the time provided in the regulations that establish these standards or prohibitions or
standards for sewage sludge use or disposal, even if the permit has not yet been modified to incorporate the
requirement.
b. The CWA provides that any person who violates section[s] 301, 302, 306, 307, 308, 318 or 405 of the Act, or
any permit condition or limitation implementing any such sections in a permit issued under section 402, or any
requirement imposed in a pretreatment program approved under sections 402(a)(3) of 402(b)(8) of the Act, is
subject to a civil penalty not to exceed $37,500 per day for each violation. [33 USC 1319(d) and 40 CFR
122.41(a)(2)]
c. The CWA provides that any person who negligently violates sections 301, 302, 306, 307, 308, 318, or 405 of
the Act, or any condition or limitation implementing any of such sections in a permit issued under section 402
of the Act, or any requirement imposed in a pretreatment program approved undersection 402(a)(3) or
402(b)(8) of the Act, is subject to criminal penalties of $2,500 to $25,000 per day of violation, or
Version 1110912011

DES Permit Standard Conditions
Page 4 of 18
imprisonment of not more than 1 year, or both. In the case of a second or subsequent conviction for a negligent
violation, a person shall be subject to criminal penalties of not more than $50,000 per day of violation, or by
imprisonment of not more than 2 years, or both. [33 USC 1319(c)(1) and 40 CFR 122.41(a)(2)]
d. Any person who knowingly violates such sections, or such conditions or limitations is subject to criminal
penalties of $5,000 to $50,000 per day of violation, or imprisonment for not more than 3 years, or both. In the
case of a second or subsequent conviction for a knowing violation, a person shall be subject to criminal
penalties of not more than $100,000 per day of violation, or imprisonment of not more than 6 years, or both.
[33 USC 1319(c)(2) and 40 CFR 122.41(a)(2)]
e. Any person who knowingly violates section 301, 302, 303, 306, 307, 308, 318 or 405 of the Act, or any permit
condition or limitation implementing any of such sections in a permit issued under section 402 of the Act, and
who knows at that time that he thereby places another person in imminent danger of death or serious bodily
injury, shall, upon conviction, be subject to a fine of not more than $250,000 or imprisonment of not more than
15 years, or both. In the case of a second or subsequent conviction for a knowing endangerment violation, a
person shall be subject to a fine of not more than $500,000 or by imprisonment of not more than 30 years, or
both. An organization, as defined in section 309(c)(3)(B)(iii) of the CWA, shall, upon conviction of violating
the imminent danger provision, be subject to a fine of not more than $1,000,000 and can be fined up to
$2,000,000 for second or subsequent convictions. [40 CFR 122.41(a)(2)]
f. Under state law, a civil penalty of not more than $25,000 per violation may be assessed against any person
who violates or fails to act in accordance with the terms, conditions, or requirements of a permit. [North
Carolina General Statutes § 143-215.6A]
g. Any person may be assessed an administrative penalty by the Administrator for violating section 301, 302,
306, 307, 308, 318 or 405 of this Act, or any permit condition or limitation implementing any of such sections
in a permit issued under section 402 of this Act. Administrative penalties for Class I violations are not to
exceed $16,000 per violation, with the maximum amount of any Class I penalty assessed not to exceed
$37,500. Penalties for Class 11 violations are not to exceed $16,000 per day for each day during which the
violation continues, with the maximum amount of any Class II penalty not to exceed $177,500. [33 USC
1319(g)(2) and 40 CFR 122.41(a)(3)]
2. Duty to Mitigate
The Permittee shall take all reasonable steps to minimize or prevent any discharge or sludge use or disposal in
violation of this permit with a reasonable likelihood of adversely affecting human health or the environment [40
CFR 122.41(d)].
3. Civil and Criminal Liability
Except as provided in permit .conditions on 'Bypassing" (Part II.C.4), "Upsets" (Part II.C.5) and 'Power Failures"
(Part II.C.7), nothing in this permit shall be construed to relieve the Permittee from any responsibilities, liabilities,
or penalties for noncompliance pursuant to NCGS 143-215.3, 143-215.6 or Section 309 of the Federal Act, 33 USC
1319. Furthermore, the Permittee is responsible for consequential damages, such as fish kills, even though the
responsibility for effective compliance may be temporarily suspended.
4. Oil and Hazardous Substance Liability
Nothing in this permit shall be construed to preclude the institution of any legal action or relieve the Permittee
from any responsibilities, liabilities, or penalties to which the Permittee is or may be subject to under NCGS 143-
215.75 et seq. or Section 311 of the Federal Act, 33 USG 1321. Furthermore, the Permittee is responsible for
consequential damages, such as fish kills, even though the responsibility for effective compliance may be
temporarily suspended.
5. Property Rights
The issuance of this permit does not convey any property rights iri either real or personal property, or any exclusive
privileges, nor does it authorize any injury to private property or any invasion of personal rights, nor any
infringement of Federal, State or local laws or regulations [40 CFR 122.41(g)].
6. Onshore or Offshore Construction
This permit does not authorize or approve the construction of any onshore or offshore physical structures or
facilities or the undertaking of any work in any navigable waters.
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[PDES Permit Standard Conditions
Page 5 of 18
7. Severability
The provisions of this permit are severable. If any provision of this permit, or the application of any provision of
this permit to any circumstances, is held invalid, the application of such provision to other circumstances, and the
remainder of this permit, shall not be affected thereby [NCGS 15013-23].
8. Duty to Provide Information
The Permittee shall furnish to the Permit Issuing Authority, within a reasonable time, any; information which the
Permit Issuing Authority may request to determine whether cause exists for modifying, revoking and reissuing, or
terminating this permit or to determine compliance with this permit. The Permittee shall also furnish to the Permit
Issuing Authority upon request, copies of records required by this permit [40 CFR 122.41(h)].
9. Duty to Reapply
If the Permittee wishes to continue an activity regulated by this permit after the expiration date of this permit, the
Permittee must apply for and obtain anew permit [40 CFR 122.41(b)].
10. Expiration of Permit
The Permittee is not authorized to discharge after the expiration date. In order to receive automatic authorization to
discharge beyond the expiration date, the Permittee shall submit such information, forms,and fees as are required
by the agency authorized to issue permits no later than 180 days prior to the expiration date unless permission for a
later date has been granted by the Director. (The Director shall not grant permission for applications to be
submitted later than the expiration date of the existing permit.) [40 CFR 122.21(d)] Any Permittee that has not
requested renewal at least 180 days prior to expiration, or any Permittee that does not have a permit after the
expiration and has not requested renewal at least 180 days prior to expiration, will subject the Permittee to
enforcement procedures as provided in NCGS 143-215.6 and 33 USC 1251 et. seq.
11. Signatory Requirements
All applications, reports, or information submitted to the Permit Issuing Authority shall be signed and certified [40
CFR 122.41(k)].
a. All permit applications shall be signed as follows:
(1) For a corporation: by a responsible corporate officer. For the purpose of this Section, a responsible
corporate officer means: (a) a president, secretary, treasurer or vice president of the corporation in charge
of a principal business function, or any other person who performs similar policy or decision making
functions for the corporation, or (b) the manager of one or more manufacturing, production, or operating.
facilities, provided, the manager is authorized to make management decisions which govern the operation
of the regulated facility including having the explicit or implicit duty of making major capital investment
recommendations, and initiating and directing other comprehensive measures to assure long term
environmental compliance with environmental laws and regulations; the manager can ensure that the
necessary systems are established or actions taken to gather complete and accurate information for permit
application requirements; and where authority to sign documents has been assigned or delegated to the
manager in accordance with corporate procedures.
(2) For a partnership or sole proprietorship: by a general partner or the proprietor, respectively; or
(3) For a municipality, State, Federal, or other public agency: by either a principal executive officer or
ranking elected official [40 CFR 122.22].
b. All reports required by the permit and other information requested by the Permit Issuing Authority shall be
signed by a person described in paragraph a. above or by a duly authorized representative of that person. A
person is a duly authorized representative only if:
(1) The authorization is made in writing by a person described above;
(2) The authorization specified either an individual or a position having responsibility for the overall operation
of the regulated facility or activity, such as the position of plant manager, operator of a well or well field,
superintendent, a position of equivalent responsibility, or an individual or position having overall
responsibility for environmental matters for the company. (A duly authorized representative may thus be
either a named individual or any individual occupying a named position.); and
(3) The written authorization is submitted to the Permit Issuing Authority [40 CFR 122.22]
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c. Changes to authorization: If an authorization under paragraph (b) of this section is no longer accurate because
a different individual or position has responsibility for the overall operation of the facility, a new authorization
satisfying the requirements of paragraph (b) of this section must be submitted to the Director prior to or
together with any reports, information, or applications to be signed by an authorized representative [40 CFR
122.22]
d. Certification. Any person signing a document under paragraphs a. or b. of this section shall make the following
certification [40 CFR 122.22]. NO OTHER STATEMENTS OF CERTIFICATION WILL BE ACCEPTED:
7 certify, underpenalty 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. "
12. Permit Actions
This permit may be modified, revoked and reissued, or terminated for cause. The filing of a request by the
Permittee for a permit modification, revocation and reissuance, or termination, or a notification of planned changes
or anticipated noncompliance does not stay any permit condition [40 CFR 122.41(f)].
13. Permit Modification, Revocation and Reissuance, or Ternunation
The issuance of this permit does not prohibit the permit issuing authority from reopening and modifying the permit,
revoking and reissuing the permit, or terminating the permit as allowed by the laws, rules, and regulations
contained in Title 40, Code of Federal Regulations, Parts 122 and 123; Title 15A of the North Carolina
Administrative Code, Subchapter 02H .0100; and North Carolina General Statute 143.215.1 et. al.
14. Annual Administering and Compliance Monitoring Fee Requirements
The Permittee must pay the annual administering and compliance monitoring fee within thirty days after being
billed by the Division. Failure to pay the fee in a timely manner in accordance with 15A NCAC 02H .0105(b)(2)
may cause this Division to initiate action to revoke the permit.
Section C. Operation and Maintenance of Pollution Controls
1. Certified Operator
Owners of classified water pollution control systems must designate operators, certified by the. Water Pollution
Control System Operators Certification Commission (WPCSOCC), of the appropriate type and grade for the
system, and, for each classification must [T15A NCAC 08G .0201]:
a. designate one Operator In Responsible Charge (ORC) who possesses a valid certificate of the type and grade at
least equivalent to the type and grade of the system;
b. designate one or more Back-up Operator(s) in Responsible Charge (Back-up ORCs) who possesses a valid
certificate of the type of the system and no more than one grade less than the grade of the system, with the
exception of no backup operator in responsible charge is required for systems whose minimum visitation
requirements are twice per year; and
c. submit a signed completed "Water Pollution Control System Operator Designation Form" to the Commission
(or to the local health department for owners of subsurface systems) countersigned by the designated certified
operators, designating the Operator in Responsible Charge (ORC) and the Back-up Operator in Responsible
Charge (Back-up ORC):
(1) 60 calendar days prior to wastewater or residuals being introduced into a new system; or
(2) within 120 calendar days following:
receiving notification of a change -in the classification of the system requiring the designation of a new
Operator in Responsible Charge (ORC) and Back-up Operator in Responsible Charge (Back-up ORC)
of the proper type and grade; or
➢ a vacancy in the position of Operator in Responsible Charge (ORC) or Back-up Operator in
Responsible Charge (Back. -up ORC).
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(3) within seven calendar days of vacancies in both ORC and Back-up ORC positions replacing or designating
at least one of the responsibilities.
The ORC of each Class I facility (or the Back-up ORC, when acting as surrogate for the ORC) must:
➢ Visit the facility as often as is necessary to insure proper operation of the treatment system; the treatment
facility must be visited at least weekly
➢ Comply with all other conditions of 15A NCAC 08G .0204.
The ORC of each Class II, III and IV facility (or the Back-up ORC, when acting, as surrogate for the ORC) must:
➢ Visit the facility as often as is necessary to insure proper operation of the treatment system; the treatment
facility must be visited at least five days per week, excluding holidays
➢ Properly manage and document daily operation and maintenance of the facility
➢ Comply with all other conditions of 15A NCAC 08G .0204.
2. Proper Operation and Maintenance
The Permittee shall at all times properly operate and maintain all facilities and systems of;treatment and control
(and related appurtenances) which are installed or used by the Permittee to achieve compliance with the conditions
of this permit. Proper operation and maintenance also includes adequate laboratory controls and appropriate quality
assurance procedures. This provision requires the Permittee to install and operate backup or auxiliary facilities only
when necessary to achieve compliance with the conditions of the permit [40 CFR 122.41(e)].
NOTE: Properly and officially designated operators are fully responsible for all proper operation and maintenance
of the facility, and all documentation required thereof, whether acting as a contract operator [subcontractor] or a
member of the Permittee's staff..
3. Need to Halt or Reduce not a Defense
It shall not be a defense for a Permittee in an enforcement action that it would have been necessary to halt or
reduce the permitted activity in order to maintain compliance with the condition of this permit [40 CFR 122.41(c)].
4. Bypassing of Treatment Facilities
a. Bypass not exceeding limitations [40 CFR 122.41(m)(2)]
The Permittee may allow any bypass to occur which does not cause effluent limitations to be exceeded, but
only if it also is for essential maintenance to assure efficient operation. These bypasses are not subject to the
provisions of Paragraphs b. and c. of this section.
b. Notice [40 CFR 122.41(m)(3)]
(1) Anticipated bypass. If the Permittee knows in advance of the need for a bypass, it shall submit prior notice,
if possible at least ten days before the date of the bypass; including an evaluation''of the anticipated quality
and effect of the bypass.
(2) Unanticipated bypass. The Permittee shall submit notice of an unanticipated bypass as required in Part
II.E.6. (24-hour notice).
c. Prohibition of Bypass
(1) Bypass from the treatment facility is prohibited and the Permit Issuing Authoritymay take enforcement
action against a Permittee for bypass, unless:
(A) Bypass was unavoidable to prevent loss of life, personal injury or severe property damage;
(B) There were no feasible alternatives to the bypass, such as the use of auxiliarytreatment facilities,
retention of untreated wastes or maintenance during normal periods of equipment downtime.. This
condition is not satisfied if adequate backup equipment should have been installed in the exercise of
reasonable engineering judgment to prevent a bypass which occurred during normal periods of
equipment downtime or preventive maintenance; and
(C) The Permittee submitted notices as required under Paragraph b, of this section.
(2) Bypass from the collection system is prohibited and the Permit Issuing Authority may take enforcement
action against a Permittee for a bypass as provided in any current or future system -wide collection system
permit associated with the treatment facility.
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(3) The Permit Issuing Authority may approve an anticipated bypass, after considering its adverse effects, if
the Permit Issuing Authority determines that it will meet the three conditions listed above in Paragraph c.
(1) of this section.
Upsets
a. Effect of an upset [40 CFR 122.4'1(n)(2)]: An upset constitutes an affirmative defense to an action brought for
noncompliance with such technology based permit effluent limitations if the requirements of paragraph b. of
this condition are met. No determination made during administrative review of claims that noncompliance was
caused by upset, and before an action for noncompliance, is final administrative action subject to judicial
review.
b. Conditions necessary for a demonstration of upset: Any Permittee who wishes to establish the affirmative
defense of upset shall demonstrate, through properly signed, contemporaneous operating logs, or other relevant
evidence that:
(1) An upset occurred and that the Permittee can identify the cause(s) of the upset;
(2) The Permittee facility was at the time being properly operated; and
(3) The Permittee submitted notice of the upset as required in Part II.E.6.(b) of this permit.
(4) The Permittee complied with any remedial measures required under Part II.B.2. of this permit.
c. Burden of proof [40 CFR 122.41(n)(4)]: The Permittee seeking to establish the occurrence of an upset has
the burden of proof in any enforcement proceeding.
6. Removed Substances
Solids, sludges, filter backwash, or other pollutants removed in the course of treatment or control of wastewaters
shall be utilized/disposed of in accordance with NCGS 143-215.1 and in a manner such as to prevent any pollutant
from such materials from entering waters of the State or navigable waters of the United States except as permitted
by -die Commission. The Permittee shall comply with all applicable state and Federal regulations governing the
disposal of sewage sludge, including 40 CFR 503,. Standards for the Use and Disposal of Sewage Sludge; 40 CFR
Part 258, Criteria For Municipal Solid Waste Landfills; and 15A NCAC Subchapter 2T, Waste Not Discharged To
Surface Waters. The Permittee shall notify the Permit Issuing Authority of any significant change in its sludge use
or disposal practices.
7. Power Failures
The Permittee is responsible for maintaining adequate safeguards (as required by 15A NCAC 02H .0124) to
prevent the discharge of untreated or inadequately treated wastes during electrical power failures either by means
of alternate power sources, standby generators or retention of inadequately treated effluent.
Section D. Monitoring and Records
1. Representative Sampling
Samples collected and measurements taken, as required herein, shall be representative of the permitted discharge.
Samples collected at a frequency less than daily shall be taken on a day and time that is representative of the
discharge for the 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 122.410)].
2. Reporting
Monitoring results obtained during the previous month(s) shall be summarized for each month and reported on a
monthly Discharge Monitoring Report (DMR) Form (MR 1, 1. 1, 2, 3) or alternative forms approved by the
Director, postmarked no later than the last calendar day of the month following the completed reporting period.
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. Duplicate signed copies of these,
and all other reports required herein, shall be submitted to the following address:
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NC DENR / Division of Water Quality / Surface Water Protection Section
ATTENTION: Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
3. Flow Measurements
Appropriate flow measurement devices and methods consistent with accepted scientific practices shall be selected
and used to ensure the accuracy and reliability of measurements of the volume of monitored discharges. The
devices shall be installed, calibrated and maintained to ensure that the accuracy of the measurements is consistent
with the accepted capability of that type of device. Devices selected shall be capable of measuring flows with a
maximum deviation of less than 10% from the true discharge rates throughout the range of expected discharge
volumes. Flow measurement devices shall be accurately calibrated at a minimum of once per year and maintained
to ensure that the accuracy of the measurements is consistent with the accepted capability'of that type of device.
The Director shall approve the flow measurement device and monitoring location prior to"°installation.
Once -through condenser cooling water flow monitored by pump logs, or pump hour meters as specified in Part'I of
this permit and based on the manufacturer's pump curves shall not be subject to this requirement.
4. Test Procedures
Laboratories used for sample analysis must be certified by the Division. Permittees should contact the Division's
Laboratory Certification Section (919 733-3908 or http://portal.ncdenr.org/web/wq/lab/cert) for information
regarding laboratory certifications.
Facilities whose personnel are conducting testing of field -certified parameters only must Hold the appropriate field
parameter laboratory certifications.
Test procedures for the analysis of pollutants shall conform to the EMC regulations (published pursuant to NCGS
143-215.63 et. seq.), the Water and Air Quality Reporting Acts, and to regulations published pursuant to Section
304(g), 33 USC 1314, of the CWA (as amended), and 40 CFR 136; or in the case of sludge use or disposal,
approved under 40 CFR 136, unless otherwise specified in 40 CFR 503, unless other test procedures have been
specified in this permit [40 CFR 122.41].
To meet the intent of the monitoring required by this permit, all test procedures must produce minimum detection
and reporting levels that are below the permit discharge requirements and all data generated must be reported down
to the minimum detection or lower reporting level of the procedure. If no approved methods are determined
capable of achieving minimum detection and reporting levels below permit discharge requirements, then the most
sensitive (method with the lowest possible detection and reporting level) approved method must be used.
Penalties for Tampering
The CWA provides that any person who falsifies, tampers with, or knowingly renders inaccurate, any monitoring
device or method required to be maintained under this permit shall, upon conviction, be punished by a fine of not
more than $10,000 per violation, or by imprisonment for not more than two years per violation, or by both: If a
conviction of a person is for a violation committed after a first conviction of such person under this paragraph,
punishment is a fine of not more than $20,000 per day of violation, or by imprisonment of not more than 4 years,
or both [40 CFR 122.41].
6. Records Retention
Except for records of monitoring information required by this permit related to the Permitfee's sewage sludge use
and disposal activities, which shall be retained for a period of at least five years (or longer" required by 40 CFR
503), the Permittee shall retain records of all monitoring information, including:
➢ all calibration and maintenance records
➢ all original strip chart recordings for continuous monitoring instrumentation
➢ copies of all reports required by this permit .
➢ copies of all data used to complete the application for this permit
These records or copies shall be maintained for a period of at least 3 years from the date of the sample, '
measurement, report or application. This period may be extended by request of the Director at any time [40 CFR
122.41].
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7. Recording Results
For each measurement or sample taken pursuant to the requirements of this permit, the Permittee shall record the
following information [40 CFR 122.41]:
a. The date, exact place, and time of sampling or measurements;
b. The individual(s) who performed the sampling or measurements;
c. The date(s) analyses were performed;
d. The individual(s) who performed the analyses;
e. The analytical techniques or methods used; and
f. The results of such analyses.
8. Inspection and Entry
The Permittee shall allow the Director, or an authorized representative (including an authorized contractor acting as
a representative of the Director), upon the presentation of credentials and other documents as may be required by
law, to;
a. Enter, at reasonable times, upon the Permittee's premises where a regulated facility or activity is located or
conducted, or where records must be kept under the conditions of this permit;
b. Have access to and copy, at reasonable times, any records that must be kept under the conditions of this permit;
c. Inspect at reasonable times any facilities, equipment (including monitoring and control equipment), practices,
. or operations regulated or required under this permit; and
d. Sample or monitor at reasonable times, for the purposes of assuring permit compliance or as otherwise
authorized by the CWA, any substances or parameters at any location [40 CFR 122.41(i)].
Section E Reporting Requirements
1. Change in Discharge
All discharges authorized herein shall be consistent with the terms and conditions of this permit. The discharge of
any pollutant identified in this permit more frequently than or at a level in excess of that authorized shall constitute
a violation of the permit.
2. Planned Changes
The Permittee shall give notice to the Director as soon as possible of any planned physical alterations or additions
to the permitted facility [40 CFR 122.41(1)]. Notice is required only when:
a. The alteration or addition to a permitted facility may meet one of the criteria for new sources at 40 CFR
122.29(b); or
b. The alteration or addition could significantly change the nature or increase the quantity of pollutants
discharged. This notification applies to pollutants subject neither to effluent limitations in the permit, nor to
notification requirements under 40 CFR 122.42(a)(1); or
c. The alteration or addition results in a significant change in the Permittee's sludge use or disposal practices, and
such alteration, addition or change may justify the application of permit conditions that are different from or
absent in the existing permit, including notification of additional use or disposal sites not reported during the
permit application process or not reported pursuant to an approved land application plan.
3. Anticipated Noncompliance
The Permittee shall give advance notice to the Director of any planned changes to the permitted facility or other
activities that might result in noncompliance with the permit [40 CFR 122.41(1)(2)].
4. Transfers
This permit is not transferable to any person without prior written notice to and approval from the Director in
accordance with 40 CFR 122.61. The Director may condition approval in accordance with NCGS 143-215.1, in
particular NCGS 143-215. 1 (b)(4)b.2., and may require modification or revocation and reissuance of the permit, or
a minor modification, to identify the new permittee and incorporate such other requirements as may be necessary
under the CWA [40 CFR 122.41(1)(3), 122.61] or state statute.
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5. Monitoring Reports
Monitoring results shall be reported at the intervals specified elsewhere in this permit [40 ,CFR 122.41(1)(4)].
a. Monitoring results must be reported on a Discharge Monitoring Report (DMR) (See Part H.D.2) or forms
provided by the Director for reporting results of monitoring of sludge use or disposal'practices.
b. If the Permittee monitors any pollutant more frequently than required by this permit using test procedures
approved under 40 CFR Part 136 and at a sampling location specified in this permit or other appropriate
instrument governing the discharge, the results of such monitoring shall be included in the calculation and
reporting of 'the data submitted on the DMR.
6. Twenty-four Hour Reporting
a. The Permittee shall report to the Director or the appropriate Regional Office any noncompliance that
potentially threatens public health or the environment. Any information shall be provided orally within 24
hours from the time the Permittee became aware of the circumstances. A written submission shall also be
provided within 5 days of the time the Permittee becomes aware of the circumstances. The written submission
shall contain a description of the noncompliance, and its cause; the period of noncompliance, including exact
dates and times, and if the noncompliance has not been corrected, the anticipated time it is expected to
continue; and steps taken or planned to reduce, eliminate, and prevent reoccurrence of the noncompliance [40
CFR 122.41(1)(6)].
b. The Director may waive the written report on a case -by -case basis for reports under this section if the oral
report has been received within 24 hours.
c. Occurrences outside normal business hours may also be reported to the Division's Emergency Response
personnel at [phone], [phone] or [phone].
7. Other Noncompliance
The Permittee, shall report all instances of noncompliance not reported under Part H.E.5 and 6. of this permit at the
time monitoring reports are submitted. The reports shall contain the information listed in Part II.E.6. of this permit
[40 CFR 122.41(1)(7)].
8. Other Information
Where the Permittee becomes aware that it failed to submit any relevant facts in a permit application, or submitted
incorrect information in a permit application or in any report to the Director, it shall promptly submit such facts or
information [40 CFR 122.41(1)(8)].
9. Noncompliance Notification
The Permittee shall report by telephone to either the central office or the appropriate regional office of the Division
as soon as possible, but in no case more than 24 hours or on the next working day following the occurrence or first
knowledge of the occurrence of any of the following:
a. Any occurrence at the water pollution control facility which results in the discharge of significant amounts of
wastes which are abnormal in quantity or characteristic, such as the dumping of the contents of a sludge
digester; the known passage of a slug of hazardous substance through the facility; or any other unusual
circumstances.
b. Any process unit failure, due to known or unknown reasons, that render the facility incapable of adequate
wastewater treatment such as mechanical or electrical failures of pumps, aerators, compressors, etc.
c. Any failure of a pumping station, sewer line, or treatment facility resulting in a by-pass without treatment of all
or any portion of the influent to such station or facility.
Persons reporting such occurrences by telephone shall also file a written report within 5 days following first
knowledge of the occurrence. Also see reporting requirements for municipalities in Part IV.C.2.c. of this permit.
10. Availability of Reports
Except for data determined to be confidential under NCGS 143-215.3 (a)(2) or Section 308 of the Federal Act, 33
USC 1318, all reports prepared in accordance with the terms shall be available for public inspection at the offices
of the Division. As required by the Act, effluent data shall not be considered confidential. Knowingly making any
false statement on any such report may result in the imposition of criminal penalties as provided for in NCGS 143-
215.1(b)(2) or in Section 309 of the Federal Act.
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11. Penalties for Falsification of Reports
The CWA provides that any person who knowingly makes any false statement, representation, or certification in
any record or other document submitted or required to be maintained under this permit, including monitoring
reports or reports of compliance or noncompliance shall, upon conviction, be punished by a fine of not more than
$25,000 per violation, or by imprisonment for not more than two years per violation, or by both [40 CFR 122.41].
12. Annual Performance Reports .
Permittees who own or operate facilities that collect or treat municipal or domestic waste shall provide an annual
report to the Permit Issuing Authority and to the users/customers served by the Permittee (NCGS 143-215.1 C). The
report shall summarize the performance of the collection or treatment system, as well as the extent to which the
facility was compliant with applicable Federal or State laws, regulations and rules pertaining to water quality. The
report shall be provided no later than sixty days after the end of the calendar or fiscal year, depending upon which
annual period is used for evaluation.
The report shall be sent to:
NC DENR / Division of Water Quality / Surface Water Protection Section
ATTENTION: Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
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PART III .
OTHER REQUIREMENTS
Section A. Construction
a. The Permittee shall not commence construction of wastewater treatment facilities, nor add to the planfs treatment
capacity, nor change the treatment process(es) utilized at the treatment plant unless (1) the Division has issued an
Authorization to Construct (AtC) permit or (2) the Permittee is exempted from such AtC permit requirements
under Item b. of this Section.
b. In accordance with NCGS 143-2.15.1(a5) [SL 2011-394], no permit shall be required to enter into a contract for the
construction, installation, or alteration of any treatment work or disposal. system or to construct, install, or alter any
treatment works or disposal system within the State when the system's or work's principle function is to conduct,
treat, equalize, neutralize, stabilize, recycle, or dispose of industrial waste or sewage from an industrial facility and
the discharge of the industrial waste or sewage is authorized under a permit issued for the' discharge of the
industrial waste or sewage into the waters of the State. Notwithstanding the above, the permit issued for the
discharge may be modified if required by federal regulation.
c. Issuance of an AtC will not occur until Final Plans and Specifications for the proposed construction have been
submitted by the Permittee and approved by the Division.
Section B. Groundwater Monitoring
The Permittee shall, upon written notice from the Director, conduct groundwater monitoring as may be required to
determine the compliance of this NPDES permitted facility with the current groundwater standards.
Section C. Changes in Discharges of Toxic Substances
The. Permittee shall notify the Permit Issuing Authority as soon as it knows or has reason to believe (40 CFR 122.42):
a. That any activity has occurred or will occur which would result in the discharge, on a routine or frequent basis, of
any toxic pollutant which is not limited in the permit, if that discharge will exceed the highest of the following
"notification levels'
(1) One hundred micrograms per liter (100 µg/L);
(2) Two hundred micrograms per liter (200 µg/L) for acrolein and acrylonitrile; five hundred micrograms per liter
(500 µg/L) for 2,4-dinitrophenol and for 2-methyl-4,6-dinitrophenol; and one milligram per liter (1 mg/L) for
antimony;
(3) Five times the maximum concentration value reported for that pollutant in the permit. application.
b. That any activity has occurred or will occur which would result in any discharge, on a non -routine or infrequent
basis, of a toxic pollutant which is not limited in the permit, if that discharge will exceed the highest of the
following "notification levels';
(1) Five hundred micrograms per liter (500 µg/L);
(2) One milligram per liter (1 mg/L) for antimony;
(3) Ten times the maximum concentration value reported for that pollutant in the permit application.
Section D. Facility Closure Requirements
The Permittee must notify the Division at least 90 days prior to the closure of any wastewater treatment system covered
by this permit. The Division may require specific measures during deactivation of the system to prevent adverse
impacts to waters of the State. This permit cannot be rescinded while any activities requiring this permit continue at the
permitted facility.
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PART IV
SPECIAL CONDITIONS FOR MUNICIPAL FACILITIES
Section A. Definitions '
In addition to the definitions in Part H of this permit, the following definitions apply to municipal facilities:
Indirect Discharge or Industrial User
Any non -domestic source that discharges wastewater containing pollutants into a POTW regulated under section
307(b), (c) or (d) of the CWA. [40 CFR 403.3 (i) and 0) and 15A NCAC 02H .0903(b)(I1)]
Interference
Inhibition or disruption of the POTW treatment processes; operations; or its sludge process, use, or disposal which
causes or contributes to a violation of any requirement of the Permittee's (or any satellite POTW's if different from the
Permittee) NPDES, collection system, or non -discharge permit or prevents sewage sludge use or disposal in
compliance with specified applicable State and Federal statutes, regulations, or permits. [I5A NCAC 02H
.0903(b)(14)]
Pass Through
A discharge which exits the POTW into waters of the State in quantities or concentrations which, alone or with
discharges from other sources, causes a violation, including an increase in the magnitude or duration of a violation, of
the Permittee's (or any satellite POTW's, if different from the Permittee) NPDES, collection system, or non -discharge
permit. [15A NCAC 02H .0903(b)(23)]
Publicly Owned Treatment Works (POTW)
A treatment works as defined by Section 212 of the CWA, which is owned by a State or local government organization.
This definition includes any devices and systems used in the storage, treatment, recycling and reclamation of municipal
sewage or industrial wastes of a liquid nature. It also includes the collection system, as defined in 15A NCAC 2T
.0402, only if it conveys wastewater to a POTW treatment plant. The term also means the local government
organization, or municipality, as defined in section 502(4) of the CWA, which has jurisdiction over indirect discharges
to and the discharges from such a treatment works. In this context, the organization may be the owner of the POTW
treatment plant or the owner of the collection system into which an indirect discharger discharges. This second type of
POTW maybe referred to as a "satellite POTW organization." [15A NCAC 02H .0903(b)(26)]
"Significant Industrial User" or "SIU"
An Industrial User that discharges wastewater into a publicly owned treatment works and that [15A NCAC 02H
.0903(b)(33)1:
1: Discharges an average of 25,000 gallons per day or more of process wastewater to the POTW (excluding sanitary,
noncontact cooling and boiler blowdown wastewaters); or
2. Contributes process wastewater which makes up five percent or more of the NPDES or non -discharge permitted
flow limit or organic capacity of the POTW treatment plant. In this context, organic capacity refers to BOD, TSS
and ammonia; or
3. Is subject to categorical standards under 40 CFR Part 403.6 and 40 CFR Parts 405-471; or
4. Is designated as such by the Permittee on the basis that the Industrial User has a reasonable potential for adversely
affecting the POTW's operation or for violating any pretreatment standard or requirement, or the POTW's effluent
limitations and conditions in its NPDES or non -discharge permit, or to limit the POTW's sludge disposal options;
5. Subject to approval under 15A NCAC 02H .0907(b), the Permittee may determine that an Industrial User meeting
the criteria in paragraphs 1 or 2 of this definition above has no reasonable potential for adversely affecting the
POTW's operation or for violating any pretreatment standard or requirement, the POTW's effluent limitations and
conditions in its NPDES or non -discharge permit, or to limit the POTW's sludge disposal options, and thus is not a
Significant Industrial User (SIU); or
6. Subject to approval under 15A NCAC 02H .0907(b), the Permittee may determine that an Industrial User meeting
the criteria in paragraph 3 of this definition above meets the requirements of 40 CFR Part 403.3(v)(2) and thus is a
non -significant categorical Industrial User.
Section B. Publicly Owned Treatment Works (POTWs)
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WDES Permit Standard Conditions
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All POTWs must provide adequate notice to the Director of the following [40 CFR 122.42(b)]:
1. Any new introduction of pollutants into the POTW from an indirect discharger, regardless of the means of
transport, which would be subject to section 301 or 306 of CWA if it were directly discharging those pollutants;
and
2. Any substantial change in the volume or character of pollutants being introduced by an indirect discharger as
influent to that POTW at the time of issuance of the permit.
3. For purposes of this paragraph, adequate notice shall include information on (1) the quality and quantity of effluent
introduced into the POTW, and (2) any anticipated impact that may result from the change of the quantity or
quality of effluent to be discharged from the POTW.
Section C. Municipal Control of Pollutants from Industrial Users.
1. Effluent limitations are listed in Part I of this permit. Other pollutants attributable to inputs from Industrial Users
discharging to the POTW may be present in the Permittee's discharge. At such time as sufficient information
becomes available to establish limitations for such pollutants, this permit may be revised .to specify effluent
limitations for any or all of such other pollutants in accordance with best practicable technology or water quality
standards.
2. Prohibited Discharges
a. The Permittee shall develop and enforce their Pretreatment Program to implement the prohibition against the
introduction of pollutants or discharges into the waste treatment system or waste collection system which
cause or contribute to Pass Through or Interference as defined in 15A NCAC 02H .600 and 40 CFR 403. [40
CFR 403.5(a)(1)]
b. The Permittee shall develop and enforce their Pretreatment Program to. implement the prohibitions against the
introduction of the following wastes in the waste treatment or waste collection system [40 CFR 403.5(b)]:
(1) Pollutants which create a fire or explosion hazard in the POTW, including, but not limited to,
wastestreams with a closed cup flashpoint of less than 140 degrees Fahrenheit or:60 degrees Centigrade
using the test methods specified in 40 CFR 261.21;
(2) Pollutants which cause corrosive structural damage to the POTW, but in no case discharges with pH lower
than 5.0, unless the works is specifically designed to accommodate such discharges;
(3) Solid or viscous pollutants in amounts which cause obstruction to the flow in the' POTW resulting in
Interference;
(4) Any pollutant, including oxygen demanding pollutants (BOD, etc.) released in a Discharge at a flow rate
and/or pollutant concentration which will cause Interference with the POTW;
(5) Heat in amounts which will inhibit biological activity in the POTW resulting in Interference, but in no
case heat in such quantities that the temperature at the POTW Treatment Plant exceeds 40°C (104°F)
unless the Division, upon request of the POTW, approves alternate temperature limits;
(6) Petroleum oil, non -biodegradable cutting oil, or products of mineral oil origin in amounts that wi11. cause
Interference or Pass Through;
(7) Pollutants which result in the presence of toxic gases, vapors, or fumes within the POTW in a quantity that
may cause acute worker health and safety problems; or
(8) Any trucked or hauled pollutants, except at discharge points designated by the.POTW.
c. The Permittee shall investigate the source of all discharges into the POTW, including;slug loads and other
unusual discharges, which have the potential to adversely impact the Permittee's Pretreatment Program and/or
the operation of the POTW.
The Permittee shall report such discharges into the POTW to the Director or the appropriate Regional Office.
Any information shall be provided orally within 24 hours from the time the Permittee'�became aware of the
circumstances. A written submission shall also be provided within 5 days of the time the Permittee becomes
aware of the circumstances. The written submission shall contain a description of the discharge; the
investigation into possible sources; the period of the discharge, including exact dates and times; if the
discharge has not ceased, the anticipated time it is expected to continue; and steps taken or planned to reduce,
eliminate, and prevent reoccurrence of the noncompliance,
Version 1110912011

DES Permit Standard Conditions
Page 16 of 18
3. With regard to the effluent requirements listed in Part I of this permit, it may be necessary for the Permittee to
supplement the requirements of the Federal Pretreatment Standards (40 CFR, Part 403) to ensure compliance by
the Permittee with all applicable effluent limitations. Such actions by the Permittee may be necessary regarding
some or all of the industries discharging to the municipal system.
4. The Permittee shall require any Industrial User (IU) discharging to the POTW to meet Federal Pretreatment
Standards developed under Section 307(b) of the Act as amended (which includes categorical standards and
specific local limits, best management practices and narrative requirements). Prior to accepting wastewater from
any Significant Industrial User (SIU), the Permittee shall either develop and submit to the Division a new
Pretreatment Program or, as necessary, a modification of an existing Pretreatment Program, for approval as
required under section D below as well as 15A NCAC 02H .0907(a) and (b). [40 CFR 122.440)(2)]
5. This permit shall be modified, or alternatively, revoked and reissued, to incorporate or modify an approved POTW
Pretreatment Program or to include a compliance schedule for the development of a POTW Pretreatment Program
as required under Section 402 (b)(8) of the CWA and implementing regulations or by the requirements of the
approved State pretreatment program, as appropriate.
Section D., Pretreatment Programs
Under authority of sections 307 (b) and (c) and 402(b)(8) of the CWA and implementing regulations 40 CFR 403,
North Carolina General Statute 143-215.3(14) and implementing regulations 15A NCAC .02H .0900, and in accordance
with the approved pretreatment program, all provisions and regulations contained and referenced in the pretreatment
program submittal are an enforceable part of this permit. [40 CFR 122.440)(2)]
The Permittee shall operate its approved pretreatment program in accordance with Section 402(b)(8) of the CWA, 40
CFR 403, 15A NCAC 02H .0900, and the legal authorities, policies, procedures, and financial provisions contained in
its pretreatment program submission and Division approved modifications thereof. Such operation shall include but is
not limited to the implementation of the following conditions and requirements. Terms not defined in Part 11 or Part IV
of this permit are as defined in 15A NCAC 02H .0903 and 40 CFR 403.3.
1. Sewer Use Ordinance (SUO)
The Permittee shall maintain adequate legal authority to implement its approved pretreatment program. [I5A
NCAC 02H .0903 (b)(32),.0905 and .0906(b)(1); 40 CFR 403.8(f)(1) and 403.9(b)(1) and (2)]
Industrial Waste Survey (IWS)
The Permittee shall implement an IWS consisting of the survey of users of the POTW collection system or
treatment plant, as required by 40 CFR 403.8(f)(2)(i-iii) and 15A NCAC 02H .0905 [also 40 CFR 122.440)(1)],
including identification of all Industrial Users that may have an impact on the POTW and the character and amount
of pollutants contributed to the POTW by these Industrial Users and identification of those Industrial Users
meeting the definition of SIU. Where the Permittee accepts wastewater from one or more satellite POTWs, the
IWS for the Permittee shall address all satellite POTW services areas, unless the pretreatment program in those
satellite service areas is administered by a separate Permittee with an approved Pretreatment Program. The
Permittee shall submit a summary of its IWS activities to the Division at least once every five years, and as
required by the Division. The IWS submission shall include a summary of any investigations conducted under
paragraph C.2.c. of this Part. [15A NCAC 02H .0903 (b)(1 3),.0905 and .0906(b)(2); 40 CFR 403'.8(f)(2) and 403.91
3. Monitoring Plan
The Permittee shall implement a Division -approved Monitoring Plan for the collection of facility specific data to
be used in a wastewater treatment plant Headworks Analysis (HWA) for the development of specific pretreatment
local limits. Effluent data from the Plan shall be reported on the DMRs (as required by Parts H.D and II.E.5.). [15A
NCAC 02H .0903(b)(16), .0906(b)(3) and .0905]
4. Headworks Analysis (HWA) and Local Limits
The Permittee shall obtain Division approval of a HWA at least once every five years, and as required by the
Division. Within 180 days of the effective date of this permit (or any subsequent permit modification) the
Permittee shall submit to the Division a written technical evaluation of the need to revise local limits (i.e., an
updated HWA or documentation of why one is not needed) [40 CFR 122.44]. The Permittee shall develop, in
accordance with 40 CFR 403.5(c) and 15A NCAC 02H .0909, specific Local Limits to implement the prohibitions
listed in 40 CFR 403.5(a) and (b) and 15A NCAC 02H .0909. Pursuant to 40 CFR 403.5, local limits are
Version 1110912011

f_PDE_S Permit ,Standard, Conditions
Page 17 of 1.8
enforceable Pretreatment Standards as defined by 40 CFR 403.3(1). [15A NCAC 02H .0903(b)(10), .0905„ and
.0906(b)(4)]
5. Industrial User Pretreatment Permits (IUP) & Allocation Tables
In accordance with NCGS 143-215.1, the Permittee shall issue to all Significant Industrial Users, permits for
operation of pretreatment equipment and discharge to the Permitte. e's collection system or treatment works. These
permits shall contain limitations, sampling protocols, reporting requirements, appropriate standard and special
conditions; and compliance schedules as necessaryfor the installation, of treatment,and control technologies to
assure that their wastewater discharge will meet all applicable pretreatment standards and requirements. The
Permittee shall maintain a current Allocation Table (AT) which summarizes the results of the HWA and the limits
from all IUPs. Permitted _IUP loadings for each parameter cannot exceed the treatment capacity of the POT W as
determined by the HWA. [15A NCAC 02H .0906(b)(6), .0909, .091,6, and .0917; 40 CFR403.5, 403.8(f)(1)(iii);
NCGS 143-215.67(a)j
6. Authorization to Construct (AtC)
The, Permittee shall ensure that an Authorization to Construct permit (AtC) is issued to all applicable Industrial
Users for the construction or modification of any pretreatment facility. Prior to the issuance of an AtC, the
proposed pretreatment facility and treatment process must be evaluated for its capacity to Comply with all
Industrial_ User Pretreatment Permit (IUP) limitations. ;[15A NCAC 02H .0906(b)(7) and .0:905; NCGS 143-
215.1(a)(8)]
7. POTW Inspection & Monitoring of their lUs
The Permittee shall conduct inspection, surveillance, and monitoring activities as described in its Division
approved pretreatment program in order to determine; independent of information supplied by Industrial Users,
compliance with, applicable pretreatment standards. [I5A NCAC 02H .0908(e); 40 CFR 403.8(0(2)(v)] The
Permittee must;
a. Inspect all Significant Industrial Users (SIUs) at least once per calendar year;
b. Sample all Significant Industrial Users .(SIUs) at least once per calendar year for all S1U permit -limited
parameters including flow, except as allowed under 15A NCAC 0908(e); and
e. At least once per year, document an evaluation of any non -significant categorical Industrial User for
compliance with the requirements in 40 CFR 403:3(v)(2), and either continue or revoke the designation as non-
significant.
8. IU Self Monitoringand nd Reporting
The Permittee shall require all Industrial Users to comply with the applicable monitoring and reporting
requirements outlined in the Division -approved pretreatment program, the industry's pretreatment permit,. or in 15A
NCAC 02'H .0908. [15A NCAC 02R .0906(b)(5) and .0905; 40 CFR 403.8(f)(1)(v) and (2)(iii); 40''CFR
1.22.440)(2) and 40 CFR 403.12]
9. Enforcement Response Plan (ERP)
The Permittee shall enforce and obtain appropriate remedies for violations of all ,pretreatment standards
promulgated pursuant to section 307(b) and (c) of the CWA (40 CFR 405 et. seq.), prohibitive discharge standards
as set forth in 40 CFR 403.5 and 15A NCAC 02H .0909, specific local limitations; and other pretreatment
requirements. All remedies, enforcement actions and other, shall be consistent with the Enforcement Response;
Plan (ERP) approved by the Division. [15A NCAC 02H .0903(b)(7), .0906(b)(8) and .0905; 40 CFR 403.8(f)(5)]
10., Pretreatment Annual Reports (PAR)
The Permittee shall report to the Division in accordance with 1.5A NCAC 02H .0908, In lieu of submitting annual
reports, Modified. Pretreatment Programs developed under 15A NCAC 02H 0904 (b) may be required to submit a
partial annual report or to meet with Division personnel periodically to discuss enforcement of pretreatment
requirements and other pretreatment implementation issues.
For all other active pretreatment programs, the Permittee shall submit .two copies of a Pretreatment. Annual Report.
(PAR) describing its pretreatment activities over the previous calendar year to the Division at the ,following
address:,
Version 11,10912011

DES Permit StandardConditions
Page 18 of 18
NC DENR / Division of Water Quality / Surface Water Protection Section
Pretreatment, Emergency Response; and Collection Systems (PERCS) unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
These reports shall be submitted by March 1 of each year and shall contain the following:
a. Narrative
A narrative summary detailing actions taken, or proposed', by the Permittee to correct significant non-
compliance. and to ensure compliance with pretreatment requirements;
b. Pretreatment Program Summary (PPS)
A pretreatment program summary (PPS) on forms or in a format provided by the Division;
c. Significant Non -Compliance Keport (SNCR)
A list of Industrial Users (IUs) in significant noncompliance (SNC) with pretreatment requirements, and the
nature of the violations on forms or in a format provided by the Division;
d. Industrial Data Summary Forms IDSF)
Monitoring data from samples collected by both the POTW and the Significant Industrial Users (SIUs). These
analytical results must be reported on Industrial Data Summary Forms (1DSF) or on other forms or in a format,
provided by the Division;
e. Other Information
Copies of the POTW's allocation table, new or modified enforcement compliance schedules, public notice of
IUs in SNC, a summary of data or other information related to significant noncompliance determinations for
lUs that are not considered•SIUs, and any other information, upon request, which in the opinion of the Director
is needed to determine compliance with the pretreatment implementation requirements of this permit;
11. Public Notice
The Permittee shall publish annually a list of Industrial Users (1Us) that were in significant noncompliance (SNC):
as defined in the Permittee's Division -approved Sewer Use Ordinance with applicable pretreatment :requirements.
and standards during the previous twelve month ;period. This list shall be published within four months of the
applicable twelve-month period. [15A NCAC 02H .0903(b)(34), .0908(b)(5) and .0905 and 40 CFR
403.8(f)(2)(viii))
12. Record Keeping
The Permittee shall retain for a minimum of three years records of monitoring activities and results, along with
support information including general records, water, qualityrecords, and records of industrial impact on the
POTW and shall' retain all other Pretreatment Program, records as required by 15A NCAC 02H .0908(f). [15A
NCAC 02H .0908(f); 40 CFR 403.12(6)].
1.3. Pretreatment Progr, am Resources
The Permittee shall maintain adequate funding; and qualified personnel to accomplish the objectives of its approved
pretreatment program. and retain a written description of those current levels of inspection. [I 5A NCAC 02H
.0906(b)(9) and (10) and .0905; 40 CFR 403.8(f)(3), 403.9(b)(3)]
14. Modification to Pretreatment Programs
Modifications to the approved pretreatment program including but not limited to local limits modifications, POTW
monitoring of their Significant Industrial Users (SIUs), and Monitoring Plan modifications, shall be, considered,a
permit modification and shall be governed by 40 CFR 403-18, 15 NCAC 02H .0114 and 15A NCAC 0211.0907.
Version 111091201'1

a ®®
a'r
MCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
Ms. Kally Dotson
White Oak Manor
188 Oscar Justice Road
Rutherfordton, North Carolina 28139
Dear Ms. Dotson:
John E. Skvarla, III
Secretary
July 25, 2014
Subject: NOTICE OF VIOLATION
NOV-2014-LV-0346
Permit No. NCO030139
White Oak Manor- Rutherfordton WWTP
Rutherford County
A review of White Oak Manor- Rutherfordton's WWTP monitoring report for April 2014 showed the
following violation:
Parameter
Date
Limit Value
Reported Value
Limit Type
Coliform, Fecal MF, M-FC
Broth,44.5C
04/29/2014
400 #/100ml
3,550 #/100ml
Daily Maximum
Exceeded
Remedial actions, if not already implemented, should be taken to correct any problem. Since the
comments section on the reverse of the relevant DMR provided an adequate explanation for the subject
violation, it is not requested that a response be submitted.
The Division of Water Resources may pursue enforcement action for this and any additional violations
of State law. If you should have any questions, please do not hesitate to contact Janet Cantwell or me
at 828/296-4600.
Sincerely, _
G. Landon Davidson, P.G., Regional Supervisor
Water Quality Regional Operations, NCDENR
Asheville Regional Office
c v-T!QyAfshevi#ieMRiles
MSC 1617-Central Files -Basement
WQ Lab & Operations/ ORC
GtFb`/Ri:'1Q4rufher?or:i1`v'•Jasf2:vater,YtinorsiLlRti!e Oak P,lanor 30139NOV-2014-LV-034s.doo
Water Quality Regional Operations — Asheville Regional Office
2090 U.S. Highway 70, Swannanoa, North Carolina 28778
Phone: [phone] FAX: [phone]
Internet: http://portal.nodenr.org/web/wq
An Equal Opportunity/ Affinnative Action Employer

Cantwell, Janet
From:
Menzel, Jeff
Sent:
Friday, August 08, 2014 12:32 PM
To:
[e-mail]; [e-mail]
Cc:
Cantwell, Janet
Subject:
eDMR submittal White Oak WWTP
Ms. Chapman
The U.S. EPA recently proposed a rule that will require NPDES permittees to electronically submit required
NPDES reports instead of written reports. This will include Discharge Monitoring Reports (DMRs). In addition,
the proposed federal regulations specify that if the state does not have at least 90% of its regulated users
reporting electronically, then NPDES permittees will be required to submit data electronically to the EPA. The
Division anticipates that these regulations will be adopted and is beginning implementation to meet the
proposed federal requirements. Electronic reporting creates efficiency and saves time and money.
I have spoken with Water Quality Labs and it will take some time for the contract operators in the Asheville
Region to register this program and become familiar with it. Because of that reason lam attaching a link to so
that you would be able request a waiver to delay this requirement. I would recommend that you fill this form
out and mail it in at your earlier convenience.
Temporary Waiver Application;
http://portal.ncdenr.org/web/wq/admin/bog/ipu/edmrforms
To get more familiar with this requirement I am also sending a Link to our eDMR page.
http://portal.ncdenr.org/web/wq/admin/bog/ipu/edmr
Please review and let me know if you have question or concerns.
Regards,
Jeff
Jeff Menzel - [e-mail]
North. Carolina Dept. of Environment and Natural Resources
Pwo Di
of Water Resources
NCDENR Asheville Water Quality Regional Operations Section
2090 U.S. 70 Highway
Swannanoa, NC 28778
Tel: [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.

Cantwell, Janet
From: Water Quality Labs <[e-mail]>
Sent: Tuesday, December 02, 2014 5:02 PM
To: Cantwell, Janet
Subject: White Oak
Hello Ms. Cantwell,
Jadd Brewer would like to know -if you have a current copy of the Effluent Limitations and Monitoring
Requirements for White Oak Permit # NC0030139.
If so, would you please send a copy to us?
Thank you,
Ruth 011is
Administrative Assistant
Water Quality Lab & Operations, Inc.
PO BOX 1167/1522 Tynecastle Hwy.
Banner Elk, North Carolina 28604
Phone-[phone]
Fax- [phone]
1

Nor' . arolina. Department of EnVironment(` aalit
F [ 0_1
L
Donald R.' van der Vaart
- Secretary
November 20, 2015
9s. Kally Dotson
Vhite Oak Manor
88 Oscar'Justice Road
;utherfordton, North Carolina .28139
Subject: NOTICE OF VIOLATION
NOV-2015-LV-0756
Permit No. NC0030139
White Oak Manor WWTP
Rutherford County
Dear Ms. Dotson:
A review of White Oak Manor WWTP monitoring report for July 2015 showed the following
violation:
Parameter
Date
Limit Value
Reported Value
Limit Type '
Coliform, Fecal MF, M-FC.
Broth,44.5C
07/07/2015
400.00
#/100ml
-6,000.00
#/100ml
Daily Maximum
Exceeded
Remedial actions, if not already implemented, should be taken to correct any problem. Since the
comments section on the'reveme of the relevant DMR provided an adequate explanation for the subject
violation, it is not requested that a response be submitted. The Division of Water Resources may pursue enforcement action for this and any additional
violations of State law. If you should have any questions, please do not hesitate to contact Janet
Cantwell or me at 828/296-4500.
Sincerely,-
G. Landon Davi son, P.G., Regional Supervisor
Water Quality Regional Operations, NCDEQ
Asheville Regional Office
MSC 1617-Central Files -Basement
WQ .Lab &Operations/ ORC
G:lWR1WQIRutherfordlWastewaterlMinors\White Oak Manor 3013MNOV-2015-LV-0756.docx
Water Quality Regional Operations -Asheville Regional Office
2090 U.S. Highway 70, Swannanoa, North Carolina 28778
Phone: [phone] Fax: [phone]
Internet: http://portal.ncdenr:org/web/wq
An Equal Opportunity/ Affirmative Action Employer

Aye '
NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
Ms. Kally Dotson
White Oak Manor
188 Oscar JusticeRoad
Rutherfordton, North Carolina 28139
Dear Ms. Dotson:
Donald R. van der Vaart
Secretary
January 26, 2015
Subject: NOTICE OF VIOLATION
NOV-2016-LV-0030
Permit No. NCO030139
White Oak Manor- Rutherfordton WWTP
Rutherford County
A review of White Oak Manor- Rutherfordton's WWTP monitoring report for July 2014 showed the
following violation:
Parameter
Date .
Limit Value
Reported Value
Limit Type
Coliform, Fecal MF, M-FC
Broth,44.5C
07/16/2014
400.000
#/100ml
6,000.000
#/I ooml
Daily Maximum
Exceeded
Remedial actions, if not already implemented, should be taken to correct any problem. Since the
comments section on the reverse of the relevant DMR provided an adequate explanation for the subject
violation, it is not requested that a response be submitted.
The Division of Water Resources may pursue enforcement action forthis and any additional violations
of State law., If you should have any questions, please do not hesitate to contact Janet Cantwell or me
at 8281296-4500.
Sincerely,
G. Landon Davidson, P.G., Regional Supervisor
Water Quality Regional Operations, NCDENR
Asheville Regional Office
�ccsWQAAshevill� �Ftle_
MSC 1617-Central-hles-Basement
WQ Lab & Operations Inc] ORC
G:\WR1WQ\Rutheriortl\Waste,HaterlMinorslVVhite Oak Manor 30139\NOV-2015-LV-0030.doc
Water Quality Regional Operations —Asheville Regional Office
2090 U.S. Highway 70, Swannanoa, North Carolina 28778
Phone: [phone] Fax: [phone]
Internet: hftp://portal,ncdenr.org/web/wq
An Equal Opportunity/ Affirmative Action Employer

f
Afim
NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
Ms. Kally Dotson
White Oak Manor
188 Oscar Justice Road
Rutherfordton, North Carolina 28139
Dear Ms. Dotson:
Donald R. van der Vaart
Secretary
March 24, 2015
Subject: NOTICE OF VIOLATION
NOV-2016-LV-0209
Permit No. NCO030139
White Oak Manor- Rutherfordton WWTP.
Rutherford County
A review of White Oak Manor- Rutherfordton's WWTP monitoring report for December 2014
showed the following violation:
Parameter
Date
Limit Value
Reported Value
Limit Type
Coliform, Fecal MF, M-FC
Broth,44.50
12/03/2014
400.00
#/100ml
6,000.00
#/100m1.
Daily Maximum
Exceeded
Remedial actions, if not.already implemented, should be taken to correct any problem. Since the
comments section on the reverse of the relevant DMR provided an adequate explanation for the subject
violation, it is not requested that a response be submitted.
The Division of Water Resources may pursue enforcement action for this and any additional violations
of State law. If you should have any questions, please do not hesitate to contact Janet Cantwell or me
at 828/296-4500. J
Sincerely,
G. Landon Davidson, P.G.,.Regional Supervisor
Water Quality Regional Operations, NCDENR
Asheville Regional Office
MSC 1617-Central Files -Basement.
WQ Lab & Operations/ ORC
G:\WR\W01RutherfordwVasiewater\Minors\White Oak Manor 301391NOV-2015-LV-0209.doc
Water Quality Regional Operations — Asheville Regional Office
2090 U.S. Highway 70, Swannanoa, North Carolina 28778
Phone: [phone] Fax: [phone]
Internet: http://portal.ncdenr.org/webfwq .
An Equal Opportunity/ Affirmative Action Employer .

�ea+rs>xtrhi�Ya�L �a1.E?� ,
Ranita Chapman
White Oak Manor
188 Oscar Justice Rd
Rutherfordton, NC 28139
J 'J
T Tti+I CRC3RY
-;tatns�r:3v
January 27, 2016
SUBJECT: NOTICE OF VIOLATION
Tracking Number: NOV-2016-LV-0062
Permit No. NCO030139
White Oak Manor WWTP
Rutherford County
Dear Permittee:
A review of the October 2015 Discharge Monitoring Report (DMR) for the subject facility revealed the violation(s)
indicated below:
Limit Exceedance Violation(s):
Sample Limit Reported
Location Parameter Date Value Value Type of Violation
001 Effluent Coliform, Fecal MF, M-FC 10/6/2015 400 900 Daily Maximum Exceeded
Broth,44.5C (31616)
Remedial actions, if not already implemented, should be taken to correct any noted problems. The Division of
Water Resources may pursue enforcement actions for thi's and any additional violations.
If you have any questions concerning this matter, please contact Janet Cantwell of the Asheville Regional
Office at 828-296-4500.
Sincerely,
G. Landon Davidson, P.G., Regional Supervisor
Water Quality Regional Operations Section
Asheville Regional Office
Division of Water Resources, NCDEQ
WQS AshevilTRegloal ,icifat�cernentil
NPDES Compliance/Enforcement Unit - Enforcement File
WQ Lab & Operations/ ORC
G:,WR\WQ\Rutherford\Wastewater\Minors\White Oak (Manor 30139\NOV-2016-LV-0062.rtf
State of North Carolina I Environmental Quality I Water Resources
2090 U.S. 70 Highway, Swannanoa, NC 28778
828-296-4500

L,4
f.
'a'erR�r
February 10, 2016
Ranita Chapman
White Oak Manor
188 Oscar Justice Rd
Rutherfordton, NC 28139
SUBJECT: Compliance Evaluation Inspection
White Oak Manor WWTP
Permit No: NCO030139
Rutherford County
Dear Ms. Chapman:
C*(1'LP�t?7
L
Ei�'
AL�3:�..ir��
J4Y ZdTtII Itl,A
�esFos
Enclosed please find a copy of the Compliance Evaluation Inspection conducted on February 9, 2016. The
facility appeared well maintained and operated and was found to be in compliance with permit N_ C0030139 for
the White Oak Manor Wastewater Treatment Plant.
The following additional items were noted during the inspection.
• The ORC noted that during large rain events, it is suspected that rainwater is entering the collection
system and may be disrupting treatment, at the plant. Consider identifying and eliminating the pathway
by which this is occurring.
Please refer to the enclosed inspection report for additional observations and comments. The assistance
provided by Jacob Hodge, ORC and Mike Pcenicni during the inspection was greatly appreciated. If you or
your staff have any questions, please call me at 828-296-4500.
Sincerely,
o�
Tim Heim, P.E.
Environmental Engineer
Enc.
cc: Jacob Hodge, ORC — WQ Lab & Operations
MSC 1617-Central Files -Basement
A hevh'e F l'es ` z
G:\WR\WQ\Rutherford\Wastewater\Minors\White Oak Manor 30139\CEI letter 02-09-2016.doc
State of North Carolina I Environmental Quality I Water Resources
2090 U.S. 70 Highway, Swannanoa, NC 28778
828-296-4500

United States Environmental Protection Agency
Form Approved.
/�
EPA Washington, D.C.20460
OMB No. 2040-0057
Water Compliance Inspection Report
Approval expires 8-31-98
Section A: National Data System Coding (i.e., PCS)
Transaction Code NPDES yr/mo/day Inspection Type Inspector Fac Type
1 IN 2 15 1 3 1 NCO030139 111 12 16/02/09 17 18 1, 1 19 L G j 20 Ll
211. 1 1 1 1 1 1 1 1 11 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 11 1 11 1 t66
Ins�pecUon Work Days Facility Self -Monitoring Evaluation Rating B1 QA ---------------Reserved
671 70 u 71 IJ 72 LL J N 73 I I 174 751 III 1 1 1 180
I I I
Section B: Facility Data
Name and Location of Facility Inspected (For Industrial Users discharging to POTW, also include
Entry Time/Date
Permit Effective Date
POTW name and NPDES permit Number)
10:OOAM 16/02/09
13/12/01
White Oak Manor- Rutherfordton
188 Oscar Justice Rd
Exit Time/Date
Permit Expiration Date
Rutherfordton NC 28139
12:00PM 16/02/09
18/07/31
Name(s) of Onsite Representative(s)fTitles(s)/Phone and Fax Number(s)
Other Facility Data
///
Jacob William Hodge/ORC/828-248-5217/
Name, Address of Responsible Official/Title/Phone and Fax Number
Contacted
William David Cable,PO Box 1167 Banner Elk NC'286041167//828-898-6277/
No
Section C: Areas Evaluated During Inspection (Check only those areas evaluated)
Flow Measurement ® Operations & Maintenance E Records/Reports Facility Site Review
Effluent/Receiving Waters
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
(See attachment summary)
Name(s) and Signature(s) of Inspector(s) Agency/Office/Phone and Fax Numbers Date
Timothy H Heim ' ARO WQ//828-296-4665/ a
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
31 Nc0030139 I11 12 16/02/09 17 18
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
Tim Heim of the Asheville Regional Office performed a Compliance Evaluation Inspection on February
9th, 2016. Jacob Hodge (ORC) and Mike Pcenicni of White Oak Manor were present during the
inspection.
The WWTP was well maintained and appeared to be in compliance at the time of the inspection.
Page#

Permit: NCO030139 Owner - Facility: White Oak Manor- Rutherfordton
Inspection Date: 02/09/2016 Inspection Type: Compliance Evaluation
Aeration Basins
Yes No NA NE
Mode of operation
Ext. Air
Type of aeration system
Diffused
Is the basin free of dead spots?
0 ❑
❑
❑
Are surface aerators and mixers operational?
® ❑
❑
❑
Are the diffusers operational?
0 ❑
❑
❑
Is the foam the proper color for the treatment process?
0 ❑
❑
❑
Does the foam cover less than 25% of the basin's surface?
0 ❑
❑
❑
Is the DO level acceptable?
❑ ❑
❑
N
Is the DO level acceptable?(1.0 to 3.0 mg/1)
❑ ❑
❑
Comment:
Secondary Clarifier
Yes No NA NE
Is the clarifier free of black and odorous wastewater?
S
❑
❑
❑
Is the site free of excessive buildup of solids in center well of circular clarifier?
E
❑
❑
❑
Are weirs level?
❑
❑
❑
Is the site free of weir blockage?
0
❑
❑
❑
Is the site free of evidence of short-circuiting?
0
❑
❑
❑
Is scum removal adequate?
0
❑
❑
❑
Is the site free of excessive floating sludge?
0
❑
❑
❑
Is the drive unit operational?
❑
❑
0.0
Is the return rate acceptable (low turbulence)?
N
❑
❑
❑
Is the overflow clear of excessive solids/pin floc?
■
❑
❑
❑
Is the sludge blanket level acceptable? (Approximately %4 of the sidewall depth)
❑
❑
❑
Comment:
Disinfection -Tablet
Yes No NA NE
Are tablet chlorinators operational?
N
❑
❑
❑
Are the tablets the proper size and type?
0
❑
❑
❑
Number of tubes in use?
2
Is the level of chlorine residual acceptable?
❑
❑
❑
Is the contact chamber free of growth, or sludge buildup?
0
❑
❑
❑
Is there chlorine residual prior to de -chlorination?
❑
❑
❑
Comment:
Page# 3

Permit: NCO030139 Owner - Facility: White Oak Manor- Rutherfordton
Inspection Date: 02/09/2016 Inspection Type: Compliance Evaluation
Disinfection -Tablet Yes No NA NE
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:
Yes No NA NE
® ❑ ❑ ❑
® ❑ ❑ ❑
Page# 4

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Certified Mail # 7012 1010 00021965'5129
Return Receipt Requested
April 26, 2016
Kally Dotson
White Oak Manor
188 Oscar Justice Rd
Rutherfordton, NC 28139
SUBJECT: NOTICE OF VIOLATION
Tracking Number: NOV-2016-MV-0060
Permit No. NC0030139
White Oak Manor WWTP
Rutherford County
Dear Permittee:
1'rT C_44I
Y r :'� {ifJ'i91,7if3T
1. 011
A review of the December 2015 Discharge Monitoring Report (DMR) for the subject facility revealed the
violation(s) indicated below:
Monitoringa Violation(s):
Sample
Location parameter
Monitoring
Date Frequency Type of Violation
001 Effluent pH (00400) 12/5/2015 Weekly Frequency Violation
001 Effluent Temperature, Water Deg. 12/5/2015 Weekly Frequency Violation
Centigrade (00010)
Remedial actions, if not already implemented, should be taken to correct any noted problems. The Division of
Water Resources may pursue enforcement actions for this and any additional violations.
If the above parameters were left off inadvertently, please send amended DMRs within 10 business days of receipt
of this letter to Raleigh at the address found on the front page of your DMR and also a copy to this office.
State of North Carolina I Environmental Quality I Water Resources
2090 U.S. 70 Highway, Swannanoa, NC 28778
828-296-4500

If you have any questions concerning this matter, please contact Janet Cantwell of the Asheville Regional
Office at 828-296-4500.
Sincerely,
G. Landon Davidson, P.G., Regional Supervisor
Water Quality Regional Operations Section
Asheville Regional Office
Division of Water Resources, NCDEQ
Cc:
NPDES Compliance/Enforcement Unit - Enforcement File
WQ Lab & Operations/ ORC
G:\4VR\WQ\Rutherford\Wastewater\Minors\White Oak Manor 30139\NOV-2016-MV-0060.rtf

Certified Mail # 7016 1370.000165719109
Return Receipt Requested
May 16, 2017
Renita G Chapman
White -Oak Manor
188 Oscar Justice Rd
Rutherfordton, NC 28139
SUBJECT: NOTICE OF VIOLATION & INTENT TO ASSESS CIVIL PENALTY
Tracking Number: NOV-2017-LV-0344
Permit No. NCO030139
White Oak Manor- Rutherfordton
Rutherford County
Dear Permittee:
A review of the February 2017 Discharge Monitoring Report (DMR) for the subject facility revealed the
violation(s) indicated below:
Limit Exceedance Violation(s)-
Sample Limit Reported
Location Parameter Date Value • Value Type of Violation
001 Effluent Flow, in conduit or thru 2/28/2017 0.015 0.0437 Monthly Average Exceeded
treatment plant (50050)
A Notice of Violation/Intent to Issue Civil Penalty is being issued for, the notedviolationof North Carolina General
Statute (G.S.) 143-215.1 and the facility's NPDES Permit. Pursuant to G.S. 143-215.6A, a civil penalty of not
more than twenty-five thousand dollars ($25,000.00) may be assessed against any person who violates or fails
to act in accordance with the terms, conditions, or requirements of any permit issued pursuant to G.S.
143-215.1.
If you wish to provide additional information regarding the noted violation, request technical assistance, or
discuss overall compliance please respond in writing within ten (10) business days after receipt of this Notice. A
review of your response will be considered along with any information provided on the'submitted Discharge
Monitoring Report(s). You will then be notified of any civil penalties that may be assessed regarding the
violations. If no response is received in this Office within the 10-day period, a civil penalty
assessment may be prepared.
State of North Carolina I Environmental Quality I Water Resources
2090 U.S. 70 Highway, Swannanoa, NC 28778
13 828-296-4500

Remedial actions should have already been taken to correct this problem and prevent further occurrences in the
future. The Division of Water Resources may pursue enforcement action for this and any additional violations of
State law. If the violations are of a continuing nature, not related to operation and/or maintenance problems,
and you anticipate remedial construction activities, then you may wish to consider applying for a Special Order by
Consent.
Reminder: Pursuant to Permit Condition 6 in Section E, the Permittee is required to verbally notify the Regional
Office as soon as possible, not to exceed 24 hours, from first knowledge of any non-compliance at
the facility including limit violations, bypasses of, or failure of a treatment unit. A written report may
be required within 5 days if directed by Division staff. Prior notice should be given for anticipated or
potential problems due to planned maintenance activities, taking units off-line, etc.
Additionally and if you have not already done so, you may wish to consider registering to use the Division's new
e-DMR system for the completion and electronic submittal of monthly Discharge Monitoring Reports (DMRs).
For more information, please visit the eDMR Website at the following address:
http://portal.ncdenr.org/web/wq/admin/boq/ipu/edmr.
If you have any questions. concerning this matter or to apply for an SOC, please contact Timothy Heim of the
Asheville Regional Office at 828-296-4500.
Sincerely,
G. Landon Davidson, .fig'ionall Supervisor
Water Quality Regional Operations Sec
Asheville Regional Office
Division of Water Resources, NCDEQ
NPDES Compliance/Enforcement Unit — Enforcement Fi
G:\WR\WQ\Rutherford\Wastewater\Minors\White Oak Manor 30139\NOV-NOI-2017-LV-0344.Docx
State of North Carolina I Environmental Quality I Water Resources
2090 U.S. 70 Highway, Swannanoa, NC 28778
828-296-4500

Certified Mail # 7016 1370 000165717211
Return Receipt Requested
August 14, 2017
Renita G Chapman
White Oak Manor
188 Oscar Justice Rd
Rutherfordton, NC 28139
SUBJECT: NOTICEOF VIOLATION
Tracking Number: NOV-2017-LV-0559
Permit No. NCO030139
White Oak Manor- WWTP (Rutherfordton)
Rutherford County
Dear Permittee:
A review of the May 2017 Discharge Monitoring Report (DMR) for the subject facility. 'revealed the violation(s)
indicated below:
Limit Exceedance Violation(s):
Sample
Location Parameter
Limit Reported
Date . Value Value Type of Violation
001 Effluent Coliform, Fecal MF, MFC Broth, 5/24/2017 400 2,500 Daily -'Maximum Exceeded
44.5 C (31616)
Remedial actions, if not already implemented, should be taken to correct any noted problems. The Division of
Water Resources may pursue enforcement actions for this and any additional violations.
If you have any questions concerning this matter, please contact Janet Cantwell of the Asheville Regional
Office at 828-296-4500.
Sincerely,
.4u, I �r�
0
G. Landon Davidson, P.G., Regional Supervisor
Water Quality Regional Operations Section
Asheville Regional Office
Division of Water Resources, -NCDEQ
Ec: WQS Asheville Regional Office - Enforcement File•
NPDES Compliance/Enforcement Unit - Enforcement File
G:\WR\WQ\Rutherford\Wastewater\Minors\White Oak Manor 30139\NOV-2017-LV-0559.rtf
State of North Carolina I Environmental Quality I Water Resources
2090 U.S. 70 Highway, Swannanoa, NC 28778
828-296-4500

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UNITED STATES
0 Sender: Please print your name, address, and ZIP+4 in this box 0
VELL
JANET CANT
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MCDENR-DWQ-SWp
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2090 U.S. HIGHWAY 70
SWANNANOA NC 28778

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Renita G. Chapman
White-Dak Manor ;_
188 OscarJustice Road
Rutherfordton, North Carolina 28139
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Ranita Chapman
White Oak Manor
188 Oscar Justice Road
Rutherfordton, NC 28139
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