NC0065412_Fact Sheet_20211112

FACT SHEET FOR EXPEDITED PERMIT RENEWALS
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, 303(d) listed water, toxicity testing,
instream monitoring, compliance concerns).
Basic Information for Ex edited Permit Renewals
Permit Writer/Date
Emily Richards - July 2021
Permit Number
NC0065412
Facility Name
Pleasant Ridge WWTP
Basin Name/Sub-basin number
Cape Fear / 03-06-01
Receiving Stream
Little Troublesome Creek, Index #16-17-(2)
Stream Classification in Permit
WS-IV; NSW
Does permit need Daily Max NH3 limits?
No - already present for summer
Does permit need TRC limits/language?
No - already present
Does permit have toxicity testing?
No
Does permit have Special Conditions?
Yes, a nutrient reopener
Does permit have instream monitoring?
No
Is the stream impaired (on 303(d) list)?
No. Stream segment 16-17-(2) is not the 2020
303(d) list.
Any obvious compliance concerns?
No. No violations that led to enforcement
during the current permit cycle.
Any permit mods since last permit?
No
New expiration date
4/30/2026
Changes to 2016 permit?
NH3 Limits updated
Compliance
LV-2020-0269 for quarterly average Phosphorous limit violation. A demand letter was sent
3/18/21 demanding payment by 4/19/21. Payment has not yet been received.
9/16/2020 - compliance inspection noted that the WWTP was well maintained and operated.
eDMR Summary
Parameter
Mean Min Max N
00010 - Temperature, Water Deg. Centigrade 16.96 -3.00 30.00 1025
00400 - pH
7.16 6.80 7.40 213
31616 - Coliform, Fecal MF, MFC Broth, 44.5 C
na 1.00 313.00 214
50050 - Flow, in conduit or thru treatment plant 0.01 0.01 0.01 213
50060 - Chlorine, Total Residual 7.48 6.00 10.00 426
C0310 - BOD, 5-Day (20 Deg. C) - Concentration 3.48 2.00 45.00 214
C0530 - Solids, Total Suspended - Concentration 3.29 2.50 26.00 214
C0600 - Nitrogen, Total - Concentration 10.14 0.93 32.10 17
C0610 - Nitrogen, Ammonia Total (as N) - Concentration 1.21 0.02 37.10 214
C0665 - Phosphorus, Total (as P) - Concentration 1.64 0.05 11.00 212

Proposed Changes
The facility's classification was added above the effluent table.
Ammonia Nitrogen (NH3-N) Limits and Monitoring — The current permit
requires weekly monitoring for NH3-N, with effluent limits in place for
summer months only. Recent review by Division staff has noted that 15A
NCAC 2B .0404(c) requires that winter waste load allocations for oxygen
consuming waste be no less stringent than 2 times the summer waste load
limit To meet this rule requirement, winter limits for NH3-N must be added
the permit. The new winter ammonia limits based on current EPA criteria are
35.0 mg/L daily maximum and 14.4 mg/L monthly average.
The language in Section A. (3.) has been updated to be consistent with the
finalization of federal requirements for electronic reporting.

ROY COOPER
Governor
ELIZABETH S. BISER
Secretary
S. DANIEL SMITH
Director
MEMORANDUM
To:
NORTH CAROLINA
Environmental Quality
October 13, 2021
Eric Hudson
NC DEQ / DWR / Public Water Supply
Winston Salem Regional Office
From: Emily Richards
Compliance and Expedited Permitting Unit
Subject: Review of Draft NPDES Permit NC0065412
Pleasant Ridge WWTP
Rockingham County
Please indicate below your agency's position or viewpoint on the draft permit and return this form by
October 27, 2021. If you have any questions on the draft permit, please contact me at 919-707-9125 or
via e-mail [Emily.richardsncdenr.gov].
RESPONSE: (Check one)
Concur with the issuance of this permit provided the facility is operated and maintained properly, the stated
effluent limits are met prior to discharge, and the discharge does not contravene the designated water quality
standards.
Concurs with issuance of the above permit, provided the following conditions are met:
Opposes the issuance of the above permit, based on reasons stated below, or attached:
Signed /�ur� Date: e94-71. ! S 9-0
E
NORTH CAROLINA D. 1
Department of Environmental Duality
North Carolina Department of Environmental Quality I Division of Water Resources
512 North Salisbury Street 11617 Mail Service Center I Raleigh, North Carolina 27699-1617
919.707.9000

Rockingham Now
Advertising Affidavit
1921 Vance Street
Reidsville, NC 27320
[phone] Fax: [phone]
NCDEQ-DIVISION OF WATER RESOURCES
1617 MAIL SERVICE CENTER
RALEIGH, NC 27699-1617
Account Number
4019534
Date
September 19, 2021
PO Number Order
0000741501
Public Notice
North Carolina Environmental
Management Commission/
NPDES Unit
1617 Mail Service Center
Raleigh, NC 27699-1617
Notice of Intent to Issue a NPDES
Wastewater Permit NC0065412
Pleasant Ridge WWTP
The North Carolina Environmental
Management Commission proposes
to issue a NPDES wastewater dis-
charge permit to the person(s) listed
below. Written comments regarding
the proposed permit will be accept-
ed until 30 days after the publish
date of this notice. The Director of
the NC Division of Water Resources
(DWR) may hold a public hearing
should there be a significant degree
of public interest. Please mail com-
ments and/or information requests
to DWR at the above address. Inter-
ested persons may visit the DWR at
512 N. Salisbury Street, Raleigh, NC
27604 to review information on file.
Additional information on NPDES
permits and this notice may be
found on our website: http.//deq.nc.
gov/abouvdivisions/water-
resources/water-resources-
permits/wastewater-brandt/npdes-
wastewater/public-notices,or by
calling [phone]. NPDES Per-
mit Number NC0065412: T3T Pleas-
ant Ridge, LLC (1150 Hungry Neck
Blvd, Ste C359, Mt Pleasant, SC) has
requested renewal of its for Pleasant
Ridge WWTP in Rockingham County.
This permitted facility discharges
treated wastewater into Little Trou-
blesome Creek in the Cape Fear Riv-
er Basin. Currently ammonia nitro-
gen, fecal coliform, total phospho-
rous and total residual chlorine are
water quality limited. This discharge
may affect future wasteload alloca-
tions in this portion of the Cape Fear
River Basin.
Category
Legal Notices
Description
Public Notice North Carolina Environmental Management Commission! NPDES Unit 1617 Mail
Publisher of the
Rockingham Now
Before the undersigned_ a Notary Public duly commissioned_ qualified_ and authorized by
law to administer oaths. personally appeared the Publishers Representative Who by being
duly sworn deposes and says: that he/she is authorized to make this affidavit and sworn
statement: that the notice or other legal advertisement. a coP) of which is attached hereto.
was published in the Rockingham Now on the lbllow ing dates:
09/1912021
and that the said newspaper in which such notice. paper document. or legal advertisement
was published. was at the time ()leach and every such publication. a newspaper meeting all
the requirements and qualifications of Section 1-597 of the G/ieral Statuttr$ ofl\lorth
Carolina.
Sworn to and subscribed before me the 19th day `v
State of
County of
My commission expires:
v
ember. 2021.
Couo
Billing Representative
(:Aornrr Public)
THIS IS NOT A BILL. PLEASE PAY FROM INVOICE. THANK YOU

ROY COOPER
Governor
DIONNE DELLI-GATTI
Secretory
S. DANIEL SMITH
Director
T3T Cranbrook, LLC.
Attn: Michael Brown, Portfolio Manager
1150 Hungry Neck Blvd Ste C359
Mt Pleasant, SC 29464
Subject: Permit Renewal
Application No. NC0065412
Pleasant Ridge WWTP
Rockingham County
NORTH CAROLINA
Environmental Quality
May 11, 2021
Dear Applicant:
The Water Quality Permitting Section acknowledges the May 6, 2021 receipt of your permit renewal application and
supporting documentation. Your application will be assigned to a permit writer within the Section's NPDES WW permitting
branch. Per G.S. 150B-3 your current permit does not expire until permit decision on the application is made.
Continuation of the current permit is contingent on timely and sufficient application for renewal of the current permit. The
permit writer will contact you if additional information is required to complete your permit renewal. Please respond in a
timely manner to requests for additional information necessary to allow a complete review of the application and renewal
of the permit.
Information regarding the status of your renewal application can be found online using the Department of Environmental
Quality's Environmental Application Tracker at:
https://deq. nc.qov/permits-regulations/permiguidance/environmental-application-tracker
If you have any additional questions about the permit, please contact the primary reviewer of the application using the
links available within the Application Tracker.
cc: Paul Smith, ORC
ec: WQPS Laserfiche File w/application
Sincerely,
Wren The ford
Administrative Assistant
Water Quality Permitting Section
D_ENA
Q�
North Carolina Department of Environmental Quality I Division of Water Resources
Winston-Salem Regional Office 1450 West Hanes Mill Road. Suite 300 I Winston-Salem North Carolina 27105
336.7769800

NPDES Permit Number
NC. C'o6'S `i 12
Facility Name
plea Sir'}` R+1e,w%00
Modified Application Form 2A
Modified March 2021
►P
Form
NPDES
NC Department of Environmental Quality - Application for NPDES Permit to Discharge Wastewater
MINOR SEWAGE FACILITIES (Before completing this form, please read the instructions. Failure to follow
the instructions may result in denial of the application.)
cn
Facility Information
0
N 1. BASIC
APPLICATION
INFORMATION FOR ALL APPLICANTS (40 CFR 122.21(j)(1) and (9))
1.1
Facility name
p\e.a5a,,N-- Ricage wuk-)TP
Mailing
address (street or P.O. box)
1 H 5 o H o v ry nec.8 /vc. 5 --V e. C. - 3 5 9
City or town
M-V P1eaSc v 4
State
3G
ZIP code
2.q`14`i
Contact name (first and last)
Bro�r�
Michaelv
Title
Phone number Email address
�1
So`20I 33Zz,'i ke. e.-�rub;ij
Location address (street, route number, or other specific identifier)
rog.,Same as mailing address
City or town
State ZIP code
1.2
Is this application for a facility that has yet to commence discharge? C
❑ Yes 4 See instructions on data submission K No
requirements for new dischargers.
E I VE D
2021
Applicant Information
1.3
Is applicant different from entity listed under Item 1.1 above? NCD5Q/DWRINPDES
451 Yes ❑ No 3 SKIP to Item
Applicant name
Pa3 ( 5nel't IA ---
Applicant address (street or P.O. box)
pc 'w)01 z,q
City or town
1Re4A5J►.11e_
State
/1C_
ZIP code
273/3
Contact name (firs and last)
�JISw.;- .
Title
DG3C_-
Phone number
336S3a93Y7
Email address o�
.1ts'0%-3.K..��
1.4
Is the applicant the facility's owner, operator. or both? (Check only one response.)
❑ Owner N Operator ❑ Both
1.5
To which entity should the NPDES permitting authority send correspondence? (Check only one response.)
151( Facility ❑ Applicant ❑ Facility and applicant
(they are one and the same)
Existing Environmental Permits
1.6
Indicate below any existing environmental permits. (Check ail that apply and print or type the corresponding permit
number for each.)
Existing Environmental Permits
a NPDES (discharges to surface
water)
NC006511/Z
❑ RCRA (hazardous waste)
❑ UIC (underground injection
control)
❑ PSD (air emissions)
❑ Nonattainment program (CAA)
❑ NESHAPs (CAA)
❑ Ocean dumping (MPRSA)
❑ Dredge or fill (CWA Section
404)
❑ Other (specify)
Page 1

NPDES Permit Number Facility Name RAn is i 4nnlirn}inn Fnrtn �A
AFL oo652 Peeg,s•- a,ew ,P
Collection System and Population Served
c
0
0
V
c
c
cn
m
ce
c o
W
a)
0
1.7
1.8
Provide the collection system information requested below for the treatment works.
Municipality
Served
Population
Served
220
Collection System Type
(indicate percentage)
/ OCi % separate sanitary sewer
% combined storm and sanitary sewer
0 Unknown
Modified March 2021
Ownership Status
l . Own 0 Maintain
❑ Own 0 Maintain
❑ Own 0 Maintain
% separate sanitary sewer
% combined storm and sanitary sewer
Unknown
❑ Own 0 Maintain
❑ Own 0 Maintain
❑ Own 0 Maintain
% separate sanitary sewer
% combined storm and sanitary sewer
Unknown
❑ Own
❑ Own
❑ Own
❑ Maintain
❑ Maintain
O Maintain
Total
Population
Served
220
Total percentage of each type of
sewer line (in miles)
% separate sanitary sewer
% combined storm and sanitary sewer
Unknown
❑ Own
❑ Own
❑ Own
O Maintain
❑ Maintain
Maintain
0
Separate Sanitary Sewer System
) O O
Is the treatment works located in Indian Country?
❑ Yes P.R No
Combined Storm and
Sanitary Sewer
%
1.9
1.10
Does the facility discharge to a receiving water that flows through Indian Country?
❑ Yes pl No
Provide design and actual flow rates in the designated spaces.
Design Flow Rate
mgd
Two Years Ago
Annual Average Flow Rates (Actual)
Last Year
This Year
0,008 mgd
O.OQ9 mgd
©,O /O mgd
Two Years Ago
Maximum Daily Flow Rates (Actual)
Last Year
This Year
o O F`-/ mgd
d . ob mgd
0, 0 / 3 mgd
Provide the total number of effluent discharge points to waters of the State of North Carolina by type
Treated Effluent
Total Number of Effluent Discharge Points by Type
Untreated Effluent
Combined Sewer
Overflows
Bypasses
Constructed
Emergency
Overflows
Pjge2

NPDES Permit Number
NC o O/ L i-I 1 1
Facilibi Name
P kcq,5q i W
Modified Application Form 2A
W I P Modified March 2021
Outfalis and Other Discharge or Disposal Methods
Outfalls Other Than to Waters of the State of North Carolina
1.12
Does the POTW discharge wastewater to basins, ponds, or other surface impoundments that do not have outlets
for discharge to waters of the State of North Carolina?
❑ Yes Es, No 4 SKIP to Item 1.14.
1.13
Provide the location of each surface impoundment and associated discharge information in the table below.
Surface Impoundment Location and Discharge Data
Location
Average Daily Volume
Discharged to Surface
Impoundment
Continuous or Intermittent
(check one)
gpd
❑ Continuous
❑ Intermittent
gpd
❑ Continuous
❑ Intermittent
gpd
0 Continuous
0 Intermittent
1.14
Is wastewater applied to land?
❑ Yes (21
No -4 SKIP to Item 1.16.
1.15
Provide the land application site and discharge data requested below.
Land Application Site and Discharge Data
Location
Size
Average Daily Volume
Applied
Continuous or
Intermittent
(check one)
acres
gp d
❑ Continuous
❑ Intermittent
acres
gp d
❑ Continuous
❑ Intermittent
acres
gpd
0 Continuous
❑ Intermittent
1.16
Is effluent transported to another facility for treatment rior to discharge?
❑ Yes ( No 4 SKIP to Item 1.21.
1.17
Describe the means by which the effluent is transported (e.g., tank truck, pipe).
1.18
Is the effluent transported by a party other than the applicant?
❑ Yes ,� No 4 SKIP to Item 1.20.
1.19
Provide information on the transporter below.
Transporter Data
Entity name Mailing address (street or P.O. box)
City or town
State
ZIP code
Contact name (first and last)
Title
Phone number
Email address
Page 3

NPDES Permit Number
MC 006.5 9 / 2
Facility Name
p64:4)w04- I.acr, W co
Modified Application Form 2A
1P Modified March 2021
Outfails and Other Discharge or Disposal Methods Continued
1.20
In the table below, indicate the name, address, contact information, NPDES number, and average daily flow rate of the
receiving facility.
Receiving Facility Data
Facility name
Mailing address (street or P.O. box)
City or town
State
ZIP code
Contact name (first and last)
Title
Phone number
Email address
NPDES number of receiving facility (if any) 0 None
Average daily flow rate mgd
1.21
Is the wastewater disposed of in a manner other than those a ready mentioned in Items 1.14 through 1.21 that do
not have outlets to waters of the State of North Carolina (e.g., underground percolation, underground injection)?
❑ Yes No 4 SKIP to Item 1.23.
1.22
Provide information in the table below on these other disposal methods.
Information on -Other Disposal Methods
Disposal
Method
Description)
Location of
Disposal Site
Size of
Disposal Site
Annual Average
Daily Discharge
Volume
Continuous or Intermittent
(check one)
acres
gpd
❑ Continuous
❑ Intermittent
acresgpd
❑ Continuous
❑ Intermittent
acres
gpd
❑ Continuous
❑ Intermittent
Variance
Requests
1.23
Do you intend to request or renew one or more of the variances authorized at 40 CFR 122.21(n)? (Check all that apply.
Consult with your NPDES permitting authority to determine what information needs to be submitted and when.)
❑ Discharges into marine waters (CWA ❑ Water quality related effluent limitation (CWA Section
Section 301(h)) 302(b)(2))
Not applicable
Contractor Information
1.24
Are any operational or maintenance aspects (related to wastewater treatment and effluent quality) of the treatment works
the responsibility of a contractor?
Z. Yes ❑ No 4SKIP to Section 2.
1.25
Provide location and contact information for each contractor in addition to a description of the contractor's operational
and maintenance responsibilities.
Contractor Information
C ntractor 1
Contractor 2
Contractor 3
Contractor name
(company name)
T,, dv S r ; e. 5
Mailing address
(street or P.O. box)
PO box 2.69
City, state, and ZIP
code
p e, a 5 d ill e_ AL
2_-7 3 2.3
Contact name (first and
last)
r� 1 C, l
� J 71�
Phone number
33 6 9.32 9 31-0
Email address
SM' fir.-+A.tv5 }ri e.
bt1ISou
Operational and
maintenance
responsibilities of
contractor
tt,.,
rc.pa't c- t-�a c..�
D
nr•c6 ". a i" pomp S'
et ¢.reA-e r .5
Page 4

NPDES Permit Number
NC-o e.)6 5't- J 2.Pie
Facility Namen .
a t i'f . g„r► i v
Modified Application Form 2A
IA'�� Modified March 2021
SECTION
2. ADDITIONAL INFORMATION
Outfatls to Waters of
(40 CFR 122.21(j)(1) and (2))
the State of North Carolina
a)
o
2.1
Does the treatment works have a design flow greater than or equal to 0.1 mgd?
❑ Yes '4 No 4 SKIP to Section 3.
0
2.2
Provide the treatment works' current average daily volume of inflow
Average Daily Volume of Inflow and Infiltration
.R
and infiltration.
gpd
-
'a
c
co
0
0
c
c
Indicate the steps the facility is taking to minimize inflow and infiltration.
Scheduled Improvements and Schedules of Implementation i p FlowamMap
Topographic
g
2.3
Have you attached a topographic map to this application that contains all the required information? (See instructions for
specific requirements.)
❑ Yes ❑ No
2.4
Have you attached a process flow diagram or schematic to this application that contains all the required information?
(See instructions for specific requirements.)
❑ Yes ❑ No
2.5
Are improvements to the facility scheduled?
❑ Yes ❑ No 4 SKIP to Section 3.
Briefly list and describe the scheduled improvements.
1.
2.
3.
4.
2.6
Provide scheduled or actual dates of completion for improvements.
Scheduled or Actual Dates of Completion for Improvements
Scheduled
Improvement
(from above)(list
Affected
Outfalls
outfall
number}
Begin
Construction
(MM/DD/YYYY)
End
Construction
(MM/DD/YYYY)
Begin
Discharge
(MM/DD/YYYY)
Attainment of
Operational
Level
MM/DD/YYY i
2.
3.
4.
2.7
Have appropriate permits/clearances concerning other federal/state
response.
❑ Yes ❑ No
requirements been
❑
obtained? Briefly
None required or
explain your
applicable
Explanation:
Page 5

Facility Name
NPDES Permit Number
PtectSQ R nct. LAT ty
rp
Modified Application Form 2A
Modified March 2021
SECTION 3. INFORMATION ON EFFLUENT DISCHARGES (40 CFR 122.21(j)(3) to (5))
3.1
Provide the following information for each outfall. (Attach additional
sheets if you have more than three outfalls.)
Outfall Number t O1
Outfall Number
Outfall Number
State
N C ..
6
County
o
0
City or town
RQ, t c.5).' ) 1 e_
c
Distance from shore
3 ft.
ft.
ft.
Q
d
Depth below surface
Z ft.
ft.
ft.
n
Average daily flow rate
() , 010 mgd
mgd
mgd
Latitude
° ' N or
° " N or
° ' " N of
Longitude
" N or
° " N of
"
co
>
3.2
Do any of the outfalls described under Item 3.1 have seasona
❑ Yes
or periodic discharges?
IA No 4 SKIP to Item 3.4.
a'
3.3
If so, provide the following information for each applicable outfall.
Outfall Number
Outfall Number
Outfall Number
en
Et
c
Number of times per year
discharge occurs
15
a.
o
Average duration of each
discharge (specify units)
c
u)
Average flow of each
discharge
mgd
mgd
mgd
cn
Months in which discharge
occurs
Waters of Diffuser Type
the U.S,
3.4
Are any of the outfalls listed under Item 3.1 equipped with a diffuser?
❑ Yes rgiNo 4 SKIP to Item 3.6.
3.5
Briefly describe the diffuser type at each applicable outfall.
Outfall Number
Outfall Number
Outfall Number
3.6
Does the treatment works discharge or plan to discharge wastewater to waters of the State of North Carolina from
one or more discharge points?
IK Yes ❑ No 3SKIP to Section 6.
Page 6

NPDES Permit Number
/V c 00 6 3 `i .) 2
Facility Name
P\e -W it.w u, ip
Modified Application Form 2A
Modified March 2021
Receiving Water Description
3.7
Provide the receiving water and related information (if known) for each outfali.
Outfall Number 0° 1
Outfall Number
Outfall Number
Receiving water name
L' ++\ e_ Tr0`43 (cs�
-c
Name of watershed, river,
or stream system
Hqv. R 'Not (—
U.S. Soil Conservation
Service 14-digit watershed
code
Name of state
management/riverbasin
Cce.Pe- Peck r
4E,r B4 S;
U.S. Geological Survey
8-digit hydrologic
cataloging unit code
Critical low flow (acute)
cfs
cfs
cfs
Critical low flow (chronic)
cfs
cfs
cfs
Total hardness at critical
low flow
mg/L of
CaCO3
mg/L of
CaCO3
mg/L of
CaCO3
Treatment Description
3.8
Provide the following information
describing the treatment provided for discharges from each outfall.
Outfall Number 00 a♦
Outfall Number
Outfall Number
Highest Level of
Treatment (check all that
apply per outfall)
0 Primary
(j Equivalent to
secondary
❑ Secondary
0 Advanced
❑ Other (specify)
0 Primary
0 Equivalent to
secondary
0 Secondary
0 Advanced
0 Other (specify)
0 Primary
0 Equivalent to
secondary
0 Secondary
❑ Advanced
❑ Other (specify)
Design Removal Rates by
Outfall
BOD5 or CBOD5
%
%
%
TSS
%
%
%
Phosphorus
8�] Not applicable
%
0 Not applicable
%
0 Not applicable
%
Nitrogen
N Not applicable
%
0 Not applicable
%
0 Not applicable
%
Other (specify)
Not applicable
%
0 Not applicable
0 Not applicable
Page 7

NPDES Permit Number
/1/C oo65LiJ 2
Facility Name
Pec 40P., w0l��
Modified Application Form 2A
Modified March 2021
Treatment Description Continued
3.9
Describe the type of disinfection used for the effluent from each Qutfall in the table below. If disiniection varies by
season, describe below. G�\d,- , ,' -�—c,` 2t5 �„_,; 8 e c or � 61 e+5
Outfall Number
00
Outfall Number
Outfall Number
Disinfection type
L,rAer r-i n.0-
'f„b12. -5
Seasons used
A 11 r
Dechlorination used?
❑ Not applicable
Eg, Yes
❑ No
❑ Not applicable
❑ Yes
❑ No
❑ Not applicable
❑ Yes
❑ No
Effluent Testing Data
3.10
Have you completed monitoring for all Table A parameters and attached the results to the app ication package?
Yes ❑ No
3.11
Have you conducted any WET tests during the 4.5 years prior to the date of the application on any of the facility's
discharges or on any receiving water near the discharge points?
❑ Yes No 4 SKIP to Item 3.13.
3.12
Indicate the number of acute and chronic WET tests conducted since the last permit reissuance of the facility's
discharges by outfall number or of the receiving water near the discharge points.
Outfall Number
Outfall Number
Outfali Number
Acute
Chronic
Acute
Chronic
Acute
Chronic
Number of tests of discharge
water
Number of tests of receiving
water
3.14
Does the POTW use chlorine for disinfection, use chlorine elsewhere in the treatment process, or otherwise have
reasonable potential to discharge chlorine in its effluent?
ILL Yes 4 Complete Table B, including chlorine. ❑ No -4 Complete Table B, omitting chlorine.
3.15
Have you completed monitoring for all applicable Table B pollutants and attached the results to this application
package?
Iti Yes ❑ No
3.18
Have you completed monitoring for all applicable Table D pollutants required by your NPDES permitting authority and
attached the results to this application package?
❑ Yes g4 No additional sampling required by NPDES
permitting authority.
Page 8

NPDES Permit Number
/V C 6-5y' 2
Facility Name
pi 1 _ R ;
Modified Application Form 2A
Modified March 2021
Effluent Testing Data Continued
3.19
Has the POTW conducted either (1) minimum of four quarterly WET tests for one year preceding this permit application
or (2) at least four annual WET tests in the past 4.5 years?
❑ Yes ❑ No 4 Complete tests and Table E and SKIP to
Item 3.26.
3.20
Have you previously submitted the results of the above tests to your NPDES permitting authority?
❑ Yes ❑ No 4 Provide results in Table E and SKIP to
Item 3.26.
3.21
Indicate the dates the data were submitted to our NPDES permitting authority and provide a summary of the results.
Date(s) Submitted
(MfuUDDNYYY)
Summary of Results
3.22
Regardless of how you provided your WET testing data to the NPDES permitting authority, did any of the tests result in
toxicity?
❑ Yes ❑ No 4 SKIP to Item 3.26.
3.23
Describe the cause(s) of the toxicity:
3.24
Has the treatment works conducted a toxicity reduction evaluation?
❑ Yes ❑ No 4 SKIP to Item 3.26.
3.25
Provide details of any toxicity reduction evaluations conducted.
3.26
Have you completed Table E for all applicable ouffalls and attached the results to the application package?
❑ Yes ❑ Not applicable because previously submitted
information to the NPDES •ermittin• authorit .
Page 9

NPDES Permit Number
NC_, o06 S L112
Facility Name
JP
Modred Application Form 2A
Modified March 2021
SECTION 6. CHECKLIST AND CERTIFICATION STATEMENT (40 CFR 122.22(a) and (d))
submitting with your application. For
permitting authority. Note that not
Checklist and Certification Statement
6.1
In Column 1 below, mark the sections of Form 2A that you have completed and are
each section, specify in Column 2 any attachments that you are enclosing to alert the
at applicants are required to provide attachments.
Column 1 "
Column 2
xiSection 1: Basic Application
Information for All Applicants
❑ w/ variance request(s) ❑ w/ additional attachments
❑ Section 2: Additional
Information
❑ w/ topographic map ❑ w/ process flow diagram
❑ w/ additional attachments
❑ Section 3: Information on
Effluent Discharges
tI w/ Table A ❑ w/ Table D
R w/ Table B ❑ w/ additional attachments
❑ w/ Table C
Section 4: Not Applicable
Section 5: Not Applicable
Section 6: Checklist and
® Certification Statement
❑ w/ attachments
6.2
Certification Statement
1 certify under penalty of law that this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that qualified personnel properly gather and evaluate the information
submitted. Based on my inquiry of the person or persons who 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 fine
and imprisonment for knowing violations.
Name (print or type first and last name)
kJ 5, ., "
Official title
y-z9.2.1
Signature
R�
Date signed
y‘297‘a/
Page 10

NPDES Permit Number
NC. oo6.5H J 2
Facility Name
f et 54w'�-tR�+9t.
OC)
Outfall Number
Modified Application Form 2A
Modified March 2021
TABLE A. EFFLUENT PARAMETERS
FOR ALL POTWS
Maximum Daily Discharge
Average Daily Discharge
Analytical
Method1
ML or MDL
(include units)
Pollutant
Value
Units
Value
Units
Number of
Sam . Ies
Biochemical oxygen demand
❑ BOD5 or o CBOD5
report one
2 0
/ L
W.�
5
I L
''�'j
) e,r toc.e
P
M 5Z1 0 8
2011
Z. 0 L MDL
Fecal coliform
'1 CO
11‘04/,..)
(-)
NIP»/ )
/. r- v- c.ek
Col', er}-) $
) �iQ ML
MDL
Design flow rate
o, o/ S
/M 6 0
0, 0 l D
M C.
we,ck\c
pH (minimum)
6 . S
5 (j
/ 0
C.,
a; 1
pH (maximum)
7. 5
/ S
5 v
G.
Temperature (winter)
Temperature (summer)
Z 8
G
2 3
C_.
oA. \
Total suspended solids (TSS)
2. o
rig /L
5
r$ 9 /L
/P_r w►tc s
SM 2 01 • • 2. 5 mil- D MDu
Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter I, subchapter N or 0. See instructions and 40 CFR 122.21(e)(3).
Page 11

EPA Identification Number
NPDES Permit Number
NC- 006 5 Li 12
Facility Name
Outfall Number
CI 0
Modified Application Form 2A
Modified March 2021
TABLE B. EFFLUENT PARAMETERS
Pollutant
FOR ALL POTWS WITH A FLOW EQUAL
Maximum Daily Discharge
TO OR GREATER THAN 0.1 MGD
Average Daily Discharge
Analytical
Methods
ML or MDL
(include units)
Value
Units
Value
Units
Number of
Samples
Ammonia as NEo%�
( )
/0
/1...
(', 5
r,,.9 /L
��cr �¢ck
350 ,
Rev 20(993
❑ ML
v, 17,- MDL
Chlorine
(total residual, TRC)2
C�
Vg / L-
< /
v
uj /L
2per Week
40
C.i L 20 I 1
0 ML
6 05 IL MDL
Dissolved oxygen
❑ ML
❑ MDL
Nitrate/nitrite
45
1r,,, 1 L
✓
1�
p��,
J
ci var}'cr��
E P 3"53' a
K¢v 2, D
d,oy ❑ML
�y /L IR MDL
Kjeldahl nitrogen
q 0
O '
rIN ) L.
G / �-^
✓
5
I
Y�nq / L
J
' +',
ci Uar leek `)
g-Pl'r 351.2
QQs/ 2.014 f 3
0. ❑ ML
y L ❑ MDL
Oil and grease
/
❑ ML
0 MDL
Phosphorus
6
tr- / L
1, -.6
r I L
1 Per'c.e k
EP J 3Z. 6 ,1'1°r3
rti,Jc /L IerMDL
Total dissolved solids
❑ ML
0 MDL
Sampling shall be conducted according to suffntly sensitive test procedures (l.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under40 CFR chapter I, subchapter N or 0. See instructions and 40 CFR 122.21(e)(3).
2 Facilities that do not use chlorine for disinfection, do not use chlorine elsewhere in the treatment process, and have no reasonable potential to discharge chlorine in their effluent are not
required to report data for chlorine.
EPA Form 3510-2A (Revised 3-19)
Page 12

aceAnalytical
Pace Analytical Services, LLC
205 East Meadow Road - Suite A
Eden, NC 27288
[phone]
www.pacalabs.cam
Project: Pleasant Ridge 2/25
Pace Project No.: 92524339
ANALYTICAL RESULTS
Sample: Effluent
Parameters
Lab ID: 92524339001
Results
Collected: 02/25/21 14:05 Received: 02/25/21 16:35 Matrix: Water
Units Report Limit DF Prepared Analyzed
CAS No. Qual
2540D Total Suspended Solids
Total Suspended Solids
350.1 Ammonia EDN
Nitrogen, Ammonia
5210B BOD, 5 day EDN
BOD, 5 day
Colilert-18 Fecal Coliform EDN
Fecal Coliforms
365.1 Phosphorus, Total
Phosphorus
Date: 03/04/2021 11:18 AM
Analytical Method: SM 2540D-2011
Pace Analytical Services - Eden
ND mg/L 2.6 1 02/26/21 08:59
Analytical Method: EPA 350.1 Rev 2.0 1993
Pace Analytical Services - Eden
0.68 mg/L 0.10 1 03/01/21 13:25 7664-41-7
Analytical Method: SM 5210B-2011 Preparation Method: SM 5210B-2011
Pace Analytical Services - Eden
ND mg/L 2.0 1 02/26/21 11:33 03/03/21 10:23
Analytical Method: Colilert-18 Preparation Method: Colilert-18
Pace Analytical Services - Eden
27.9 MPN/100mL 1.0 1 02/25/21 18:26 02/26/21 13:00
Analytical Method: EPA 365.1 Rev 2.0 1993 Preparation Method: EPA 365.1 Rev 2.0 1993
Pace Analytical Services - Asheville
0.46 mg/L
0.050 1 03/03/21 22:25 03/04/21 09:44 7723-14-0
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
Page 4 of 11

a
www.pacelabs.com
ANALYTICAL RESULTS
Project: Pleasant Ridge
Pace Project No.: 92514026
Pace Analytical Services, LLC
205 East Meadow Road - Suite A
Eden, NC 27288
[phone]
Sample: Effluent Lab ID: 92514026001 Collected: 12/29/20 13:30 Received: 12/29/20 14:00 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
2540D Total Suspended Solids
Total Suspended Solids
Analytical Method: SM 2540D-2011
Pace Analytical Services - Eden
ND mg/L 2.5 1 12/30/20 08:40
5210E BOD, 5 day EDN Analytical Method: SM 5210B-2011 Preparation Method: SM 5210B-2011
Pace Analytical Services - Eden
BOD, 5 day 2.1 mg/L
2.0 1 12/30/20 12:10 01/04/21 15:14
Colilert-18 Fecal Coliform EDN Analytical Method: Colilert-18 Preparation Method: Colilert-18
Pace Analytical Services - Eden
Fecal Coliforms 8.6 MPN/100mL 1.0 1 12/29/20 15:47 12/30/20 10:50
350.1 Ammonia Analytical Method: EPA 350.1 Rev 2.0 1993
Pace Analytical Services - Asheville
Nitrogen, Ammonia ND mg/L 0.10 1 01/06/21 14:57 7664-41-7
365.1 Phosphorus, Total Analytical Method: EPA 365.1 Rev 2.0 1993 Preparation Method: EPA 365.1 Rev 2.0 1993
Pace Analytical Services - Asheville
Phosphorus 0.43 mg/L 0.050 1 01/04/21 18:12 01/05/21 15:58 7723-14-0
Date: 01/07/2021 02:09 AM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
Page 4 of 11

www.pacelabs.com
Pace Analytical Services, LLC
205 East Meadow Road - Suite A
Eden, NC 27288
[phone]
ANALYTICAL RESULTS
Project: Pleasant Ridge 12/8
Pace Project No.: 92510356
Sample: Effluent Lab ID: 92510356001 Collected: 12/08/20 15:05 Received: 12/08/20 16:05 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
2540D Total Suspended Solids Analytical Method: SM 2540D-2011
Pace Analytical Services - Eden
Total Suspended Solids 3.6 mg/L 2.8 1 12/09/20 11:00
5210B BOD, 5 day EDN Analytical Method: SM 5210B-2011 Preparation Method: SM 5210B-2011
Pace Analytical Services - Eden
BOD, 5 day
ND mg/L 2.0 1 12/09/20 15:42 12/14/20 11:30 B2
Colilert-18 Fecal Coliform EDN Analytical Method: Colilert-18 Preparation Method: Colilert-18
Pace Analytical Services - Eden
Fecal Coliforms
ND MPN/100mL 1.0 1 12/08/20 17:25 12/09/20 11:53
350.1 Ammonia Analytical Method: EPA 350.1 Rev 2.0 1993
Pace Analytical Services - Asheville
Nitrogen, Ammonia 0.45 mg/L 0.10 1 12/15/20 13:38 7664-41-7
365.1 Phosphorus, Total Analytical Method: EPA 365.1 Rev 2.0 1993 Preparation Method: EPA 365.1 Rev 2.0 1993
Pace Analytical Services - Asheville
Phosphorus 0.68 mg/L
0.050 1 12/14/20 21:00 12/15/20 19:55 7723-14-0
REPORT OF LABORATORY ANALYSIS
Date: 12/16/2020 11:38 AM
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC. Page 4 of 11

Facility Name: Pleasant Ridge
Permit #: NC0065412
County : Rockingham
Month/Year DF_Lz- otr
•solved Oxygen SM 4500 0 G-2011
Temperature SM 2550 B 2U1u pis
1
Effluent
Meter
Reading
Effluent
Flow
MGD
Temp
Collected/
Analyzed
Temp
Celsius
DO
Adjusted
Air
Calibration
DO
Calibration
Time
DO
Reading
mg/L
DO
Sample
Analysis
Time
Signature
Date
1
Iyv
P 1 C�, 1�
2
0,0 /0
;VOL
3
1720
5
p-+' 5,
if
c�u►Qg. "`i,
4
q 06
5
6
r
7
1y `10
5
8
o,vjo
cS03
q
P
9
3
9..114
10
1337
l335
if
P Q__
11
II ..3.S
S
f)Q^.Q�,w-
12
13
14
I Jr- 20
b
-Rj
15
15/D
2-
f)
16
O. 0(0
5S-
14
)3
17
/`106
5
e..,,,,a,s
3
cv .
18
/�3
19
20
21
9 v 6
g
P-
22
o.vo$
13 5 4
i?
c�����
23
1`ir22
7
���
24
IH2u
7
25
/4-f4
26
27
P,,
28
1520
g
29
0;0/1
133q
‘
p
30
lL-12°
q
"Q'
31
/ 0 55
4
`>

Facility Name: Pleasant Ridge
Permit #: NC0065412
County : Rockingham
pH SM 4500 H+B-2011
Month/Year c v p bcr Ze 0
Total Residual Chlorine SM 4500 CI C2011
Date
pH
Sample
Analysis
in -situ
Time
pH
Result
Buffer
Check
value
CI Daily
Check
Standard
ug/L
Time CL
daily
Check
Standard
Analyzed
Chlorine
Sample
Analysis
Time
TRC
Result
ug/L
Signature
1
56
700
) yzo
c 6,
WOO /. a
2 .
/LI I S
7, 3
7.
pyi3
to
7vc)
0 z5
HD /,0 '
3
i7/SPA S A-
4
5a 5 P�S.---P\---
5
6
7
l y 3
8
e
1.512
l r LI
(51t)
h Li
L b)
J2-3
`
A
9
5 c7
Zcb
13 ,-f,,
10
'I33 �P
11
I y Q 0-.Q S-
12
13
14
1 �1S 75
�J�
15
5
7�
152 a
6
�s"
16
A
v
<
lyay
c 6
l3rt5 (9,7S
! `1 "Q ��
17
18
%530 0.7
19
T
20
21
F°'-
23
5o 1700
1 g 3 Z
.G i
Pit5p o
24
/L/ . o
25
26
27
28
i �� P_
29
131-`I
7 2.70'
4.2
so
-TOO
/4.32_
..6
/33o 0.
30
5o
100
jy3LJ
<�.
4ts5p�,,9i5s5
31
�&
j
�P�e��,