NC0088609_Permit (Issuance)_20140314

NPDES DOCIMENT SCANNING COVER :SHEET
NPDES Permit:
NC0088609
Windgate Subdivision, Well #1
Document Type:
Permit Issuance
Wasteload Allocation
Authorization to Construct (AtC)
Permit Modification
Complete File - Historical
Engineering Alternatives (EAA)
Correspondence
Instream Assessment (67b)
Speculative Limits
Environmental Assessment (EA)
Permit
History
Document Date:
March 14, 2014
This document is printed on reuse paper - ignore any
content on the reYerse side

ern
F1ENR
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
March 14, 2014
Mr. Thomas J. Roberts, President
Aqua North Carolina, Inc.
Windgate Subdivision Well #1 WTP
202 Mackenan Ct
Cary, North Carolina 27511
Subject: Issuance of NPDES Permit NC0088609
Aqua North Carolina, Inc.
Windgate Subdivision Well #1 WTP
Surry County
Dear Mr. Roberts:
The Division of Water Resources (the Division) hereby issues the attached NPDES permit for
the subject facility. 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.
The changes between this permit and the previous permit include the following:
• Fluoride monitoring will no longer be required.
• Turbidity monitoring twice (2) per month will be added with a limit of 50 NI'U due
impairment of the receiving stream for turbidity.
• Manganese, Zinc and Iron measurement frequency will be reduced to Quarterly.
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.
The requirement to begin reporting discharge monitoring data electronically using the NC
DWR's Electronic Discharge Monitoring Report (eDMR) internet application has been added to
your NPDES permit. [See Special Condition A (3.)] For information on eDMR, registering for
eDMR and obtaining an eDMR user account, please visit the following web page:
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Location: 512 N. Salisbury St Raleigh, North Carolina 27604
Phone: [phone] l Fax: [phone] Customer Service: 1-877-623-6748
Internet: www.ncwatemuality.orq
An Equal OpportunitylAffirmative Action Employer

d
Mr. Roberts
March 14, 2014
Page 2 of 2
http://portal.ncdenr.org/web/wq/admin/bog/ipu/edmr.
For information on EPA's proposed NPDES Electronic Reporting Rule, please visit the
following web site:
http://www2. epa. gov/compliance/proposed-npdes-electronic-reporting-rule.
If any parts, measurement frequencies, or sampling requirements contained in this permit are
unacceptable, you have the right to an adjudicatory hearing, upon written request submitted
within thirty (30) days after receiving this letter. Your request must take the form of a written
petition conforming to Chapter 150B of North Carolina General Statutes, and you must file it
with the Office of Administrative Hearings, 6714 Mail Service Center, Raleigh, North Carolina
27699-6714. Unless such a demand is made, this permit shall remain final and binding.
This permit is not transferable except after notifying the Division of Water Resources. The
Division may require permit modification, or revocation and re -issuance. Please note that this
permit does not affect your legal obligation to obtain other permits required by the Division of
Water Resources, the Division of Land Resources, the Coastal Area Management Act, or other
federal or local governments.
If you have questions, or if we can be of further service, please contact Derek Denard at
[[e-mail]] or call [phone].
Thomas A. Reeder
Enclosure: NPDES Permit NC0088609 (Issuance Final)
hc: Central Files
NPDES Program Files
WSRO Files/ Attn: Corey Basinger
ec: ESS/Aquatic Toxicology Unit, Susan Meadows [[e-mail]]

NPDES Permit NC0088609
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER RESOURCES
PERMIT
TO DISCHARGE WASTEWATER UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
(NPDES)
In compliance with the provisions of North Carolina General Statute 143-215.1, other lawful standards
and regulations promulgated and adopted by the North Carolina Environmental Management
Commission, and the Federal Water Pollution Control Act, as amended, the
Aqua North Carolina, Inc.
is hereby authorized to discharge treated wastewater from a facility known as
Windgate Subdivision Well #1 WTP
Simmons Rd, Mt. Airy, NC 27030
Surry County
to receiving waters designated as an unnamed tributary (UT) to the Fisher River, within the Yadkin -Pee
Dee River Basin, in accordance with effluent limitations, monitoring requirements, and other applicable
conditions set forth in Parts I, II, III, and IV hereof.
The permit shall become effective May 1, 2014.
This permit and the authorization to discharge shall expire at midnight on January 31, 2019.
Signed this day March 14, 2014.
as A. Reeder, Director
ivision of Water Resources
By Authority of the Environmental Management Commission
Page 1 of 5

NPDES Permit NC0088609
SUPPLEMENT TO PERMIT COVER SHEET
All previous NPDES Permits issued to this facility, whether for operation or discharge are hereby
revoked, and as of this issuance, any previously issued permit bearing this number is no longer effective.
Therefore, the exclusive authority to operate and discharge from this facility arises under the permit
conditions, requirements, terms, and provisions described herein.
Aqua North Carolina, Inc.
is hereby authorized to:
1. continue to operate a greensand water treatment plant with discharge of wastewaters from media
filter backwash, with a design potable flowrate of 0.018 MGD and a maximum, monthly average
wastewater discharge of 0.00201 MGD, with water and wastewater treatment consisting of;
• four (4) greensand filters
• chemical usage consisting of:
o Potassium permanganate and
o Chlorine
located at the Windgate Subdivision Well #1 WTP, Simmons Rd, Mt. Airy, NC 27030, Surry County;
and
2. discharge from said treatment works via Outfall 001 at a location specified on the attached map,
into an unnamed tributary (UT) to the Fisher River [Stream Segment 12-63-(9)], currently a
Class C waterbody within Subbasin 03-07-02 of the Yadkin -Pee Dee River Basin.
Page 2 of 5

NPDES Permit NC0088609
PART I
A. (1.) EFFLUENT LIMITATIONS AND MONITORING REQUIREMENTS
During the period beginning on the effective date of this permit and lasting until expiration, the
Permittee is authorized to discharge filter backwash via Outfall 001. Such discharges shall be limited
and monitored' by the Permittee as specified below:
EFFLUENT
CHARACTERISTIC
[PARAMETER CODES] .
LIMITS
MONITORING REQUIREMENTS '1
_
Monthly
Average
" Daily
Maximum
..
Measurement
F recuency y
:'Sample -
rType r ;
Sample
L 'Location
Flow 2 (MGD)50050
Monthly
Instantaneous
or Estimate 2
Effluent
Total Suspended Solids (mg/L)
C0530
30.0 mg/L
45.0 mg/L
2/month
Grab
Effluent
Turbidity (NTU)
00070
50 NTU
2/month
Grab
Effluent
Total Residual Chlorine 3 (µg/L)
50060
17 µg/L 3
2/month
. Grab
Effluent
pH (su)
00400
Not < 6.0 or > 9.0
standard units
2/month
Grab
Effluent
Total Manganese (µg/L)
01055
Quarterly
Grab
Effluent
Total Zinc 4 (µg/L)
01092
Quarterly
Grab
Effluent
Total Iron (µg/L)
01045
Quarterly
Grab
Effluent
Footnotes:
1. No later than January 26, 2015 begin submitting discharge monitoring reports electronically using
NC DWR's eDMR application system. See Special Condition A. (2.).
2. For instantaneous flow monitoring, the duration of the discharge must be reported in addition
to the total flow.
3. The TRC monitoring requirement applies only if the Permittee backwashes with chlorinated
water (and discharges filter backwash). The Division shall consider TRC effluent values
reported below 50 µg/L to be compliant with the permit. However, the Permittee shall continue
to record and submit all values reported by a North Carolina -certified laboratory method
(including field certified), even if these values fall below 50µg/L.
4. Zinc shall be monitored if the Permitee uses any zinc -based additive in the water treatment
process.
Comments:
Samples shall be taken at the outfall but prior to mixing with the receiving waters.
There shall be no discharge of floating solids or foam in other than trace amounts.
Page 3 of 5

NPDES Permit NC0088609 .
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 11 of this
permit (Standard Conditions for NPDES Permits):
• Section B. (11.)
• Section D. (2.)
• Section D. (6.)
• Section E. (5.)
Signatory Requirements
Reporting
Records Retention
Monitoring Reports
1. Reporting [Supersedes Section D. (2.) and Section E. (5.) (a)1
Beginning no later than 270 days from the effective date of this permit, the permittee shall begin
reporting discharge monitoring data electronically using the NC DWR's Electronic Discharge
Monitoring Report (eDMR) internet application.
Monitoring results obtained during the previous month(s) shall be summarized for each month and
submitted electronically using eDMR. The eDMR system 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 / DWR / Information Processing Unit
ATTENTION: Central Files / eDMR
1617 Mail Service Center
Raleigh, North Carolina 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.
Page 4 of 5

NPDES Permit NC0088609
Information on eDMR and application for a temporary waiver from the NPDES electronic reporting
requirements is found on the following web page:
http://portal.ncdenr.org/web/wq/admin/bog/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.
2. Signatory Requirements [Supplements Section B. (11.) (b) and supersedes Section B. (11.) (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/admin/bog/ipu/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:
"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 fines and imprisonment for knowing violations."
3. Records Retention [Supplements Section D. (6.)1
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 122.41].
Page 5 of 5

Aqua North Carolina, Inc.
Windgate Subdivision Well #1 WTP
Receiving Stream: UT to Fisher River Stream Segment: 12-63-(9)
State Grid/USGS Quad: B16NW / Dobson, NC Sub -Basin: 03-07-02
Latitude: 36° 24' 29" N Longitude: 80° 40' 43" W
Stream Class: C HUC: 03040101
Drainage Basin: Yadkin -Pee Dee River Basin
Ill
Facility
Location
Scale 1:24,000
North
NPDES Permit NC0088609
Surry County

NORTH CAROLINA
SURRY COUNTY
AFFIDAVIT OF PUBLICATION
Before the undersigned, a Notary Public of said County and State, duly
commissioned, qualified and authorized by law to administer oaths,
personally appeared Ferris W. Simpson who being first duly
sworn, deposes and says: that he (she) is Business Manager
(Publisher or other officer or employee authorized to make affidavit) of
CIVITAS MEDIA, LLC, engaged in the publication of a newspaper known
as MOUNT AIRY NEWS, published, issued, and entered as periodicals
class mail in the city of Mount Airy in said County and State; that he (she)
is authorized to make this affidavit and sworn statement; that the notice or
other legal advertisement, a true copy of which is attached hereto, was
published in MOUNT AIRY NEWS on the following dates:
� . l (aO f
and that the said newspaper in which such notice, paper, document or
legal advertisement was published was, at the time of each and every
such publication, a newspaper meeting all of the requirements and
qualifications of Section 1-597 of the General Statutes of North Carolina
and was a qualified newspaper within the meaning of Section 1-597 of
the General
Statutes of North Carolina.
This / day of
Swor
4.
Signature of person making affidavit
, 2014
to and subscribed before me, this l day of
2014
Notary Puic
My Commission expires: January 15. 2018
BRIDGET HENDERSON
NOTARY PUBLIC
Yadkin County
North Carolina
My Commission Expires January 15, 2018
'— Raleigh, NC 27699-1617 —
Notice of Intent to Issue a
NPDES Wastewater Permit
The North Carolina Environ-
mental Management Commis-
sion proposes to issue a NP-
DES wastewater discharge
permit to the person(s) listed
below. Written comments re-
garding the proposed permit
will be accepted until 30 days
after the publish date of this
notice. The Director of the NC
Division of Water Resources
(DWR) may hold a public hear-
ing should there be a signific-
ant degree of public interest.
Please mail comments and/or
information requests to DWR
at the above address. Inter-
ested persons may visit the
DWR at 512 N. Salisbury
Street, Raleigh, NC to review
information on file. Additional
information on NPDES per-
mits and this notice may be
found on our website:
http://portal.ncdenr.org/web/wq
/swp/ps/npdes/calendar, or by
calling [phone]. Cent-
ral Care, Inc. requested renew-
al of permit NC0038822 for its
WWTP/Surry County. Facility
discharges to an unnamed trib-
utary to Stewarts
Creek/Yadkin-Pee Dee River
Basin. Currently ammonia ni-
trogen, fecal coliform and total
residual chlorine are water
quality limited. Aqua North
Carolina, Inc. (of Cary 27511)
applied to renew NPDES per-
mit NC0088536 for the Ban-
nertown Subdivision WTP,
Well #2, Town Lane, Mt Airy
27030, discharging to UT to
Faulkner Creek, Yadkin River
Basin, Surry County. Aqua
North Carolina, Inc., Surry
County, has applied to renew
NPDES permit for the Mitchell
Bluff Subdivision Well #1 WTP
INC0088498] discharging filter -
backwash wastewater to
Mitchell River, Yadkin -Pee Dee
River Basin. Aqua North Caro-
lina, Inc., Surry County, has
applied to renew NPDES per-
mit for the Windgate Subdivi-
sion Well #1 WTP
(NC0088609)`discharging filter
backwash wastewater to Fish-
er River, Yadkin-Ree Dee
River Basin. Aqua North Caro-
lina, Inc. (of Cary) applied to
renew NPDES permit
NC0088528 for the Hillcrest
Subdivision WTP, Well #3,
Lynnwood Dr., Mt Airy 27030, ,
discharging to UT to Champ
Creek, Yadkin River Basin,
Surry County. Surry County
Schools requested renewal of
NPDES permit
NC0041947/North Surry High
School WWTP. Facility dis-
charges to Stewarts
CreeklYadkin-Pee Dee River
Basin. Currently fecal coliform
and total residual chlorine are
water quality limited. Surry
County Schools requested re-
newal of NPDES permit
NC0041939/J. Sam Gentry
Middle School WWTP. Facility
discharges to Stewarts
Creek/Yadkin-Pee Dee River
Basin. Currently fecal coliform
and total residual chlorine are
water.quality limited.
Publish February 7, 2014

Denard, Derek
From: Hudson, Gary
Sent: Tuesday, February 04, 2014 3:26 PM
To: Denard, Derek
Cc: Basinger, Corey
Subject: RE: Aqua North Carolina — Windgate Subdivision WTP NPDES # NC0088609
Good Afternoon Derrick,
Our office has no comments or concerns regarding this permit renewal.
Thanks,
Gary
Gary Hudson
NCDENR-Division of Water Resources
Winston-Salem Regional Office
585 Waughtown Street
Winston-Salem, NC 27107
Voice: [phone]
FAX: [phone]
[e-mail]
***********************************************************************
E-mail correspondence to and from this address may be subject to the
North Carolina Public Records Law and may be disclosed to third parties.
***********************************************************************
From: Denard, Derek
Sent: Monday, January 27, 2014 1:24 PM
To: Basinger, Corey; Hudson, Gary; Reid, Steve
Subject: Aqua North Carolina — Windgate Subdivision WTP NPDES # NO0088609
Please find attachments for Aqua North Carolina — Windgate Subdivision WTP NPDES # NC0088609 draft permit and
fact sheet. Please provide your comments, if any, to me via email [[e-mail]] or write to my attention
care of DENR / DWR / NPDES Program no later than March 7, 2014.
Thanks,
Derek
Derek C Denard
Et retfOitfileiltai sppciaist.,
'WINOo6+ oonofw
waterQuairty PeO iitmgsecxn
wit 8m *cb
CoMpriante ac ed Permitting. Unit
gigrIEP,
‘.:Oeiekilerinid@MOMcGov
454*:1?the.0.1it a -jG17
htl�cljp°rs dna;1044 0dsrt:
1

DENR / DWR / NPDES
EXPEDITED FACT SHEET - NPDES PERMIT DEVELOPMENT
NPDES Permit NC0088609
Derek Denard, Compliance & Expedited Permitting Unit / 919-807-6307
22Jan2014
Facility Information
it . ..r.................. ... _..
Applicant/F }cility Name
Aqua North Carolina, Inc.
Windgate Subdivision Well #1
WTP
Applicant Addres
202 Mackenan Ct, Cary, NC 27511
Facility Addkess_ ^ _
Simmons Rd, Mt. Airy, NC 27030
Permitted Flow (MGD)
Not limited
Type of Waste
Water Plants and Water Conditioning Discharge —filter-backwash
- Greensand WTP System
Facility Class .
PCNC
County
Surry
Permit Statu
Renewal
Regional
Office
WSRO
E
i Stream Characteristics
Receiving Stream
UT to the Fisher River
Stream Classification
C
Stream Segn}ent
[12-63-(9)]
Drainage basin
Y
Yadkin -Pee Dee
Summer 7Q10 (cfs)
0.0
Subbasiri
03-07-02
Winter 7Q10 :(Os)
0.0
Use Support
30Q2 (cfs)
0.0
303(d) Listed
Yes, Aquatic Life
Turbidity
Average Flov (cfs)
0.0
State Grid
B 16NW
IWC e/o) 1
100%
USES Topo Quad
Dobson, NC
Facility Summary
This facility is a greensand water treatment plant with discharge of wastewaters from media filter
backwash, with a design potable flowrate of 0.018 MGD and a maximum, monthly average wastewater
discharge of 0.00201 MGD. The facility consists of the following water and wastewater treatment units:
four (4) greensand filters, chemical usage consisting of: Potassium permanganate and Chlorine.
Monthly average FLOW (MGD) — Last 36 months Nov2010-Oct2013:
[Ave 0.00129 MGD; Maximum, Monthly average flow = 0.00201 MGD MGD]
Toxicity — N/A Greensand [per strategy WTP 2009]
Renewal Summary — This permit reflects discharge at Outfall 001. DWR updated the facility description
and Map; added parameter codes to Section A. (1.); added Electronic Reporting - Discharge Monitoring
Reports page; added turbidity with daily maximum limit of 50 NTU because of impairment for Turbidity;
Manganese, Zinc and Iron measurement frequency will be reduced to Quarterly; and removed Fluoride
monitoring.
Stream — Discharge from WTP for outfall 001 is into UT to Fisher River [Stream Segment 12-63-(9)].
The segment from Town of Dobson water supply intake to Yadkin River is currently listed as impaired in
the 2012 North Carolina 303(d) List -Category 5 for Aquatic Life for the parameter Turbidity. Added
Fact Sheet
Renewal 2013 -- NPDES Permit NC0088609
Page 1

turbidity with daily maximum limit of 50 NT due to stream being listed as impaired for Aquatic Life for
Turbidity. Sampling effluent and putting a limit of 50 NTU as a daily maximum is used if zero low -flow.
RPA — A Reasonable Potential Analysis (RPA) was conducted on Zinc, Iron and Fluoride effluent
parameters data because Discharge Monitoring Reports (DMRs) reported concentration above method -
detection levels (MDLs) for the past four and one half (4 1/2) years (Ju1y2009-Sept2013). [See attached
RPA summary sheets.]
• Fluoride did not show reasonable potential to violate state WQS; however, since the predicted
maximum effluent concentration was less than 50% of the allowable concentration no monitoring
will be required. The permitee does not backwash with fluoridated finished water and Fluoride is
not utilized in this facility.
• Zinc showed reasonable potential to violate state water quality standards (WQS). Since Zinc has an
action level standard, quarterly monitoring will be maintained.
• Iron showed reasonable potential to violate state water quality standards (WQS). Since Iron has an
action level standard, quarterly monitoring will be maintained.
Fact Sheet
Renewal -- NPDES NC0088609
Page 2

Aqua North Carolina, Inc. - Windgate Su IREASONABIEW itannwrIAL ANALYSIS
NC0088609
Qw (MGD) = 0.00
1 Q 10S (cfs) = 0.00
7Q1OS (cfs) = 0.00
7Q1OW (cfs) = 0.00
30Q2 (cfs) = 0.00
Avg. Stream Flow, QA (cfs) = 0.00
Receiving Stream: UT to Fisher River
WWTP/WTP Class: PCNC
IWC @ 1Q10S = 100.00%
IWC @ 7Q1OS = 100.00%
IWC @ 7Q1OW = 100.00%
IWC @ 30Q2 = 100.00%
IWC @ QA = 100.00%
Stream Class: C
Outfall 001
Qw = 0.002013 MGD •
PARAMETER
TYPE
(1)
STANDARDS & CRITERIA (2)
-a
a
t
z
'
REASONABLE POTENTIAL RESULTS
RECOMMENDED ACTION
NC WQS /
Chronic
Applied
Standard
r/2 FAV /
Acute
p
# Det. Max Pred
Allowable Cw
Cw
Fluoride
NC
1800
FW
ug/L
54
54
279.6
Acute: NO WQS
__ ______________
Chronic: 1,800.0
No value > Allowable Cw
_________
No RP, Predicted Max < 50% of Allowable Cw - No
Monitoring required
Zinc (AL)
NC
50
FW
67
ug/L
54
54
5,57I.4
Acute: 67.0
___ _ _______ ____
Chronic: 50.0
23 value(s) > Allowable Cw
_ _ _ _ _ _ _ ___
RP for AL(Cu,Zn,Ag,Fe,CI) - apply Quarterly
Monitoring in conjunction with TOX Test
Iron
NC
1000
FW
pg/L
54
50
48,924.0
Acute: NO WQS
____________________________
Chronic: 1000.0
18 value(s) > Allowable Cw
RP for AL(Cu,Zn,Ag,Fe,CI) - apply Quarterly
Monitoring in conjunction with TOX Test
Page 1 of 1
NC0088609 2012 RPA-FreshwaterREV.xlsm, rpa
1/22/2014

Freshwater RPA
Table 1. Project Information
❑ CHECK if HQW or ORW only
Facility Name
WWTP/WTP Class
NPDES Permit
Outfall
Flow, Qw (MGD)
Receiving Stream
Stream Class
7Q10s (cfs)
7Q10w (cfs)
30Q2 (cfs)
QA (cfs)
1 Q10s (cfs)
Data Source(s)
❑ CHECK for MODEL
Aqua North Carolina, Inc. - Windgale Subdivision - Well #1 WTP
PCNC
NC0088609
001
0.002013
UT to Fisher River
C
0.00
0.00
0.00
0.00
0.00
Follow directions for data entry. In some cases a
comment menu list the available choices or a
dropdown menu will provide a list you may select
from. Error message occur if data entry does not
meet input criteria.
REQUIRED DATA ENTRY
Table 2. Parameters of Concern
Par01
Par02
Par03
Par04
Par05
Par06
Par07
ParOB
Par09
Par10
Par11
Par12
Par13
Par14
Par15
Par16
Par17
Par18
Par19
Par20
Par21
Par22
Name
Type Chronic Modifier
Acute
PQL
Units
h
w
•
■
■
■
■
■
■
■
■
Fluoride
NC
1.800
FW
ugiL
■
■
•
•
•
■
•
Zinc (AL)
NC
50
FW
67
ug%L
■
•
Iron
NC
1000
FW
pg/L
•
•
•
NC0088609 2012 RPA-FreshwaterREV.xlsm, input
1/22/2014

REASONABLE POTENTIAL ANALYSIS
11
Fluoride
Date Data BDL=1/2DL Results
1 2009 143 143 Std Dev. 28.7190
2 2009 146 146 Mean 185.2222
3 2009 191 191 C.V. 0.1551
4 2009 223 223 n 54
5 2009 206 206
6 2009 190 190 Mull Factor = 1.16
7 2009 229 229 Max. Value 241.0 ug/L
8 2009 162 162 Max. Pred Cw 279.6 ug/L
USE ONLY
"PASTE
SPECIAL -
Values" WITH
"COPY"
9 2010 223 223
10 2010 202 202
11 2010 216 216
12 2010 215 215
13 2010 154 154
14 2010 199 199
15 2010 241 241
16 2010 176 176
17 2010 163 163
18 2010 170 170
19 2010 181 181
20 2010 198 198
21 2011 213 213
22 2011 171 171
23 2011 197 197
24 2011 166 166
25 2011 198 198
26 2011 168 168
27 2011 170 170
28 2011 215 215
29 2011 182 182
30 2011 218 218
31 2011 200 200
32 2011 195 195
33 2012 180 180
34 2012 163 163
35 2012 186 186
36 2012 169 169
37 2012 241 241
38 2012 187 187
39 2012 192 192
40 2012 141 141
41 2012 152 152
42 2012 240 240
43 2012 167 167
44 2012 188 188
45 2013 217 217
46 2013 132 132
47 2013 121 121
48 2013 165 165
49 2013 164 164
50 2013 203 203
51 2013 157 157
52 2013 154 154
53 2013 154 154
54 2013 208 208
NC0088609 2012 RPA-FreshwaterREV.xlsm, data
1 1/22/2014

REASONABLE POTENTIAL ANALYSIS
18
Zinc (AL)
Date Data BDL=1/2DL Results
1 2009 45 45 Std Dev. 256.6523
2 2009 270 270 Mean 138.1852
3 2009 313 313 C.V. 1.8573
4 2009 338 338 n 54
5 2009 273 273
6 2009 219 219 Mult Factor = 3.13
7 2009 366 366 Max. Value 1780.0 ug/L
8 2009 246 246 Max. Pred Cw 5571.4 ug/L
USE ONLY
"PASTE
SPECIAL -
Values" WITH
"COPY"
9 2010 189 189
10 2010 1780 1780
11 2010 242 242
12 2010 134 134
13 2010 174 174
14 2010 308 308
15 2010 190 190
16 2010 211 211
17 2010 164 164
18 2010 34 34
19 2010 54 54
20 2010 27 27
21 2011 36 36
22 2011 33 33
23 2011 504 504
24 2011 41 41
25 2011 18 18
26 2011 16 16
27 2011 39 39
28 2011 32 32
29 2011 25 25
30 2011 22 22
31 2011 34 34
32 2011 63 63
33 2012 25 25
34 2012 23 23
35 2012 316 316
36 2012 56 56
37 2012 28 28
38 2012 61 61
39 2012 23 23
40 2012 23 23
41 2012 18 18
42 2012 19 19
43 2012 22 22
44 2012 26 26
45 2013 27 27
46 2013 32 32
47 2013 33 33
48 2013 42 42
49 2013 25 25
50 2013 112 112
51 2013 27 27
52 2013 40 40
53 2013 23 23
54 2013 21 21
NC0088609 2012 RPA-FreshwaterREV.xlsm, data
- 1 - 1/22/2014

REASONABLE POTENTIAL ANALYSIS
20
Iron
Date Data BDL=1/2DL Results
1 2009 1060 1060 Std Dev. 2377.0999
2 2009 2400 2400 Mean 1204.4815
3 2009 2420 2420 C.V. 1.9735
4 2009 3980 3980 n 54
5 2009 3980 3980
6 2009 1110 1110 Mull Factor = 3.24
7 2009 3250 3250 Max. Value 15100.0 Ng/L
8 2009 2220 2220 Max. Pred Cw 48924.0 Ng/L
USE ONLY
"PASTE
SPECIAL -
Values" WITH
"COPY"
9 2010 2340 2340
10 2010 15100 15100
11 2010 2600 2600
12 2010 1110 1110
13 2010 1900 1900
14 2010 981 981
15 2010 3090 3090
16 2010 3170 3170
17 2010 1100 1100
18 2010 220 220
19 2010 474 474
20 2010 241 241
21 2011 172 172
22 2011 82 82
23 2011 6660 6660
24 2011 65 65
25 2011 < 25 12.5
26 2011 33 33
27 2011 34 34
28 2011 43 43
29 2011 41 41
30 2011 34 34
31 2011 < 25 12.5
32 2011 244 244
33 2012 < 25 12.5
34 2012 < 25 12.5
35 2012 2040 2040
36 2012 296 296
37 2012 103 103
38 2012 263 263
39 2012 25 25
40 2012 59 59
41 2012 30 30
42 2012 26 26
43 2012 21 21
44 2012 71 71
45 2013 224 224
46 2013 298 298
47 2013 132 132
48 2013 142 142
49 2013 92 92
50 2013 674 674
51 2013 58 58
52 2013 207 207
53 2013 41 41
54 2013 36 36
NC0088609 2012 RPA-FreshwaterREV.xlsm, data
- 1 - 1/22/2014

IWC Calculations
Facility: Aqua North Carolina, Inc. - Windgate Subdivision - Well #1 WTP
NC0088609
Prepared By: Derek Denard
Enter Design Flow (MGD):
Enter s7Q10 (cfs):
Enter w7Q10 (cfs):
0.00201
0
0
Total Residual Chlorine (TRC)
Daily Maximum Limit (ug/I)
s7Q10 (CFS)
DESIGN FLOW (MGD)
DESIGN FLOW (CFS)
STREAM STD (UG/L)
Upstream Bkgd (ug/1)
IWC (%)
Allowable Conc. (ug/I)
Fecal Coliform
Monthly Average Limit:
(If DF >331; Monitor)
(If DF<331; Limit)
Dilution Factor (DF)
0
0.002013
0.00312
17.0
0
100.00
17
Ammonia (Summer)
Monthly Average Limit (mg NH3-N/I)
s7Q10 (CFS)
DESIGN FLOW (MGD)
DESIGN FLOW (CFS)
STREAM STD (MG/L)
Upstream Bkgd (mg/I)
IWC (%)
Allowable Conc. (mg/I)
Ammonia (Winter)
Monthly Average Limit (mg NH3-N/I)
w7Q10 (CFS)
200/100mI DESIGN FLOW (MGD)
DESIGN FLOW (CFS)
STREAM STD (MG/L)
1.00 Upstream Bkgd (mg/I)
IWC (%)
Allowable Conc. (mg/I)
Total Residual Chlorine
1. Cap Daily Max limit at 28 ug/I to protect for acute toxicity
Ammonia (as NH3-N)
1. If Allowable Conc > 35 mg/I, Monitor Only
2. Monthly Avg limit x 3 = Weekly Avg limit (Municipals); capped at 35 mg/I
3. Monthly Avg limit x 5 = Daily Max limit (Non-Munis); capped at 35 mg/I
4. BAT for Minor Domestics: 2 mg/I (summer) and 4 mg/I (winter)
5. BAT for Major Municipals: 1 mg/I (year-round)
0
0.00201
0.00312
1.0
0.22
100.00
1.0
0
0.00201
0.00312
1.8
0.22
100.00
1.8
Fecal Coliform
1. Monthly Avg limit x 2 = 400/100 ml = Weekly Avg limit (Municipals) = Daily Max limit (Non -Muni)
NPDES Server/Current Versions/WLA; TB 1/16/2009

2012 North Carolina 303(d) List -Category 5
Yadkin -Pee Dee River Basin
> AU Number Name
10-digit Watershed 0304010106
Description
Elkin Creek -Yadkin River
Length or Area Units Classification Catug ory
Category Rating Use
Reason for Rating
Parameter
Year
> 12-(53)
YADKIN RIVER
From a point 0.3 mile upstream of the mouth to Elkin Creek (River) to a 24.7
point 0.3 mile upstream of Ararat River
FW Miles C
5 Impaired Aquatic Life Standard Violation Turbidity
2012
5
Yadkin -Pee Dee River Basin
10-digit Watershed 0304010108
12-digit Subwatershed 030401010807
Upper Ararat River
Faukner Creek -Ararat Rive
> 12-72-8-(3)
Lovills Creek (Lovell
Creek)
From Town of Mount Airy Water Supply Dam to Ararat River
4.2 FW Miles C
5 Impaired Aquatic Life Fair Bioclassification Ecological/biological Integrity Benthos 1998
5
Yadkin -Pee Dee River Basin
10-digit Watershed 0304010109
12-digit Subwatershed
030401010902
Ararat River
Toms Creek
> 12-72-14-5b Heatherly Creek
From NC 268 to Toms Creek
1.4 FW Miles C 5
Impaired Aquatic Life Fair Bioclassification Ecological/biological Integrity Benthos 1998
Yadkin -Pee Dee River Basin
10-digit Watershed 0304010110 Little Yadkin River -Yadkin River
12-digit 5ubwatershed
030401011001
Double Creek -Yadkin Rive
> 12-63-(9)
Fisher River
From Town of Dobson water supply intake to Yadkin River
21.2
FW Miles C
5 Impaired Aquatic Life
Standard Violation Turbidity
2012
> 12-67
East Double Creek
From source to Yadkin River
5.4
FW Miles
5
C 5
5 Impaired
Recreation
Standard Violation Fecal Coliform (recreation)
2012
Yadkin -Pee Dee River Basin
10-digit Watershed 0304010111
12-digit Subwatershed 030401011102
Deep Creek
North Deep Creel
> 12-84-1-(0.5)
North Deep Creek
From source to a point 1.0 mile downstream of Yadkin County SR 1515 17.3
FW Miles
c
5 Impaired Aquatic Life Standard Violation Turbidity
2012
5
Friday, August 24, 2012
Approved by EPA August 10, 2012
Page 153 of 170

Aqua North Carolina, Inc.
202 MacKenan Court
Cary, NC 27511
October 14, 2013
N.C. Department of Environment and Natural Resources
Division of Water Quality / NPDES Unit
1617 Mail Service Center
Raleigh, NC 27699-0167
Re: Application for Permit Renewal
Aqua North Carolina, Inc.
Windgate Subdivision Well41 WTP
NPDES No. NC0088609
Surry County
Gentlemen:
Thomas J. Roberts
President and Chief Operating Officer
T: 919.653.5770
F: 919.460.1788
[e-mail]
www.aquanorthcarolina.com
Enclosed are three (3) copies of the completed application Short Form C-WTP. This submittal includes
the necessary attachments for your office to renew the subject permit.
If you need any additional information or assistance, please contact Michael Melton, Regional
Compliance Manager at 704-489-9404, Ext 57238 or email at mamelton(iaquaamerica.com.
Sii r' ly,
J
Thomas J. Ro. -rts
President and COO
An Aqua America Company

0
NPDES PERMIT APPLICATION - SHORT FORM C - WTP
For discharges associated with water treatment plants
Mail the complete application to:
N. C. Department of Environment and Natural Resources
Division of Water Quality / NPDES Unit
1617 Mail Service Center, Raleigh, NC 27699-1617
NPDES Permit Number
NC0088609
If you are completing this form in computer use the TAB key or the up — down arrows to move from one
field to the next. To check the boxes, click your mouse on top of the box. Otherwise, please print or type.
1. Contact Information:
Owner Name Aqua North Carolina, Inc.
Facility Name Windgate Subdivision — Well # 1 WTP
Mailing Address 202 Mackenan Ct
City Cary
State / Zip Code NC/27511
Telephone Number [phone]
Fax Number [phone]
e-mail Address TJRoberts®aquaamerica.com
2. Location of facility producing discharge:
Check here if same as above ❑
Street Address or State Road Simmons Road
City
State / Zip Code
County
Mt. Airy
NC/ 27030
Surry
3. Operator Information:
Name of the firm, consultant or other entity that operates the facility. (Note that this is not referring to the
Operator in Responsible Charge or ORC)
Name Aqua North Carolina, Inc.
Mailing Address 4163 Sinclair Street
_
City Denver
State / Zip Code NC / 28037
Telephone Number [phone]
Fax Number [phone]
Page 1 of 4 Version 5/2012

NPDES PERMIT APPLICATION - SHORT FORM C - WTP
For discharges associated with water treatment plants
4. Ownership Status:
Federal ❑ State ❑ Private ® Public ❑
5. Type of treatment plant:
❑ . Conventional (Includes coagulation, flocculation, and sedimentation, uually_ followed by
filtration and disinfection)
❑ Ion Exchange (Sodium Cycle Cationic ion exchange)
® Green Sand Filter (No sodium recharge)
❑ Membrane Technology (RO, nanofiltration)
Check here if the treatment process also.uses a water softener
6. Description of source water(s) (Le. groundwater, surface water)
Groundwater Well
7. Describe the treatment process(es) for the raw water:
Raw water is treated by greensand filters in series with a 0.0016 MGD discharge of filter
backwash wastewater. Chemicals utilized during this process consist of:
• Potassium Permanganate
• Chlorine
• Caustic soda
8. Describe the wastewater and the treatment process(es) for wastewater generated by the
facility:
Wastewater discharge from said treatment works at the location specified on the
attached map into an unnamed tributary to Fisher River, classified C waters in the
Yadkin -Pee Dee River.
9. Number of separate discharge points: 1
Outfall Identification number(s) 001
10. Frequency of discharge:
Continuous ❑ Intermittent
If intermittent:
Days per week discharge occurs: 7 Duration: 100 minutes
11. Plant design potable flow rate "0:018 MGD
Backwash or reject flow 0.002 MGD
12. Name of receiving stream(s) (Provide a map showing the exact location of each outfall, including
latitude and longitude):
Unnamed Tributary to Fisher River (Yadkin Pee Dee Basin)
Page 2 of 4 Version 5/2012

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

ATA
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
Gary Moseley
Aqua North Carolina, Inc.
4163 Sinclair Street
Denver, North Carolina 28037
February 26, 2009
Subject: Issuance of NPDES
Permit NC0088609
Windgate Subdivision — Well #1 WTP
Surry County
Dear Mr. Moseley:
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 contains no changes from the draft
permit mailed to you on December 17, 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 150E 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 Bob Guerra at telephone number [phone].
Coleen H. Sullins
Enclosure: NPDES Permit NC0088609
cc: Winston-Salem Regional Office / Surface Water Protection
NPDES Unit
Central Files
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Location: 512 N. Salisbury St. Raleigh, North Carolina 27604
Phone: [phone] FAX: [phone] \ Customer Service: 1-877-623-6748
Internet: www.ncwaterquality.org
An Equal Opportunity \ Affirmative Action Employer
One
NorthCarolina
Naturally

Permit NC0088609
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
PERMIT
TO DISCHARGE WASTEWATER UNDER THE
NATIONAL POLLUTANT DISCHARGE ELINIINATION 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,
Aqua North Carolina, Inc.
is hereby authorized to discharge wastewater from a facility located at the
Windgate Subdivision - Well #1
Simmons Road
Dobson
Surry County
to receiving waters designated as an unnamed tributary to the Fisher River in the
Yadkin -Pee Dee River
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 April 1, 2009.
This permit and authorization to discharge shall expire at midnight on January 31,
2014.
Signed this day February 26, 2009.
f
oleen H. Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission

Permit NC0088609
SUPPLEMENT TO PERMIT COVER SHEET
All previous NPDES Permits issued to this facility, whether for operation or discharge are
hereby revoked. As of this permit issuance, any previously issued permit bearing this
number is no longer effective. Therefore, the exclusive authority to operate and discharge
from this facility arises under the permit conditions, requirements, terms, and provisions
included herein.
Aqua North Carolina, Inc. is hereby authorized to:
1. Continue to operate an existing 0.00168 MGD greensand water treatment
system with a discharge of filter backwash utilizing the following
components/processes:
a. Four (4) greensand filters,
b. Chemical usage consisting of:
o Potassium permanganate and
o Chlorine
2. The facility is at the Windgate Subdivision - Well #1 located on Simmons
Road, Dobson, in Surry County.
3. Discharge from said treatment works at the location specified on the attached
map into an unnamed tributary to the Fisher River, classified as C waters .in
the Yadkin -Pee Dee River Basin.

Aqua North Carolina, Inc.
Windgate Subdivision Well #1 WTP
Latitude: 36° 24' 29" N State Grid: Dobson
Longitude: 80° 40' 43" W Permitted Flow: 0.00168 MGD
Receiving Stream: UT to Fisher River Stream Class: C
Drainage Basin: Yadkin -Pee Dee River Basin Sub -Basin: 03-07-02
North
NPDES Permit No. NC0088609
Surry County

Permit NC0088609
A. {1.) EFFLUENT LIMITATIONS AND MONITORING REQUIREMENTS
During the period beginning on the effective date of this permit and lasting until expiration, the Permittee is
authorized to discharge filter backwash from outfall 001. Such discharges shall be limited and monitored by the
Permittee as specified below:
EFFLUENT
CHARACTERISTICS
LIMITS
MONITORING REQUIREMENTS
Monthly
Average
Daily Maximum
Measurement
Frequency
Sample
Type
Sample
Location
Flow'
0.00168 MGD
Monthly
Instantaneous
Effluent
Total Suspended
Solids
30.0 mg/L
45.0 mg/L
2/Month
Grab
Effluent
Total Residual
Chlorine
17 ug/L
2/Month
Grab
Effluent
Fluorides
Monthly
Grab
Effluent
Total Iron
Monthly
Grab
Effluent
Total Zincs
Monthly
Grab
Effluent
Total Manganese
Monthly
Grab
Effluent
pH
6.0 — 9.0 s.u.
2/Month
Grab
Effluent
Footnotes:
1. For instantaneous flow monitoring, the duration of the discharge must be reported in addition to the
total flow.
2. Limit takes effect May 1.2009. Until then, the permittee shall monitor TRC (with no effluent limit). This
time period is allowed in order for the facility to budget and design/construct dechlorination and / or an
alternative disinfection system.
3. The TRC monitoring requirement applies only if the Permittee backwashes with chlorinated water (and
discharges filter backwash).
4. The Division shall consider all effluent TRC values reported below 50 ug/l to be in compliance with the
permit. However, the Permittee shall continue to record and submit all values reported by a North
Carolina certified laboratory (including field certified), even if these values fall below 50 ug/I.
5. Fluoride should be monitored if the permittee backwashes with fluoridated finished water.
6. Zinc shall be monitored if the Permittee uses any zinc -based additive in the water treatment process
All samples collected should be from a representative discharge event.
There shall be no discharge of floating solids or visible foam in other than trace amounts.

NORTH CAROLINA
SURRY COUNTY
AFFIDAVIT OF PUBLICATION
Before the undersigned, a Notary Public of said County and State, duly
commissioned, qualified and authorized by law to administer oaths,
personally appeared Ferris W. Simpson who being first duly
sworn, deposes and says: that he (she) is Business Manager
(Publisher or other officer or employee authorized to make affidavit) of
HEARTLAND PUBLICATIONS, LLC, engaged in the publication of a
newspaper known as MOUNT AIRY NEWS, published, issued, and
entered as periodicals class mail in the city of Mount Airy in said County
and State; that he (she) is authorized to make this affidavit and sworn
statement; that the notice or other legal advertisement, a true copy of
which is attached hereto, was published in MOUNT AIRY NEWS on the
following dates:
atl MT) b01 161 nOCT
and that the said newspaper in which such notice, paper, document or
legal advertisement was published was, at the time of each and every
such publication, a newspaper meeting all of the requirements and
qualifications of Section 1-597 of the General Statutes of North Carolina
and was a qualified newspaper within the meaning of Section 1-597 of
the General of North Carolina.
This Qt�" day of ORiCJ nh('r
Signature of person making affidavit
, 2008
Sworn to and subscribed before me, this t'1J —' day of
De0etY1bet
Notary Public
My Commission expires:
, 2008
November 27. 2012
Notary Public
Surry County, North Carolina
Sandra F. Boles
My Commission Expires
PUBLIC NOTICE
STATE OF NORTH
CAROLINA
ENVIRONMENTAL
MANAGEMENT COM-
MISSION/NPDES UNIT
1617 MAIL SERVICE
CENTER
RALEIGH, NC
27699-1617
NOTIFICATION OF
INTENT TO ISSUE A
NPDES WASTEWATER
PERMIT
On the basis of thorough
staff review and applica-
tion of NC General Stat-
ute i43.215.1 and 15A
NCAC 02H.0109 and
other lawful standards
and regulations, the
North Carolina Environ-
mental Management
Commission proposes to
issue a National Pollut-
ant Discharge Elimina-
tion System (NPDES)
wastewater discharge
permit to the person(s)
listed below effective 45
days from the publish
date of this notico.
Written comments re-
garding the proposed
permit will be accepted
until 30 days after the
- publish date of this no-
tice. All comments re-
ceived prior to that date
are considered in the fi-
nal determinations re-
garding the proposed
permit. The Director of
the NC Division of Water
Quality may decide to
hold a public meeting for
the proposed permit,
should the Division re-
ceive a significant de-
gree of public interest.
Copies of the draft permit Aqua North Carolina, Inc.
and other supporting(4163 Sinclair Street,
in- Denver, NC 28037) has
formation on file used to applied for renewal of ex -
determine conditions isting NPDES permit
present in the draft per- NC0088609 for the
mit are available upon Windgate Subdivision request and payment of
the costs of reproduction. TWell permitted1 in Surry County.w
Mail comments and/or discharge
facility will
requests for information treated filer
to
to the NC Division of Wa- backwashisherRivertoitheUYad-
ter Quality at the above kin -Pee
in si.
address or call Dina Currently
e t Dee tRotal
Basin.
Sprinkle [phone] Currently total total the• Point Source r e ideaded solids and total
Branch. Please include ter
esiqual chlorine are wa-
his
the NPDES permit num- is chqarge limited. This
ber (below) in any com- discharge may innct fu-
ber
munication. Interested lure allocations the
persons may also visit portion of the
the Division of Water Yadkin -Pee Dee River
Quality at 512 N. Salis- Basin.
bury Street, Raleigh, NC Publish:
27604-1148 between the 2008
hours of 8:00 a.m. and
5:00 p.m. to review infor-
mation on file.
December 19,

AQUA.
Aqua North Carolina, Inc.
202 MacKenan Court
Cary, NC 27511
July 30, 2008
Ms. Dina Sprinkle
NC DENR/DWQ/Point Source Branch
1617 Mail Service Center
Raleigh, NC 27699-1677
SUBJECT: NPDES Renewal Application
Wingate Subdivision, Well #1
NPDES Permit No. NC0088609
Surry County, NC
Dear Ms. Sprinkle:
Thomas J. Roberts
President and Chief
Operating Officer
T: 919.467.8712 ext. 30
F: 919.460.1788
[e-mail]
www.aquanorthcarolina.com
Transmitted herewith are the completed/signed original and two copies of the subject NPDES
permit application and two copies of this cover letter. Since this facility does not generate any
sludge, no sludge management plan is necessary. There have been no modifications since the
last permit was issued.
It is my understanding that no filing fee is required for this renewal.
If you have any questions regarding this application, please do not hesitate to contact me.
Sincere
Thomas J. oberts
President and COO
TJR/rt
Enclosure
An Aqua America Company

NPDES PERMIT APPLICATION - SHORT FORM C - WTP
For discharges associated with water treatment plants
Mail the complete application to:
N. C. Department of Environment and Natural Resources
Division of Water Quality / NPDES Unit
1617 Mail Service Center, Raleigh, NC 27699-1617
NPDES Permit Number
NC0088609
• If you are completing this form in computer use the TAB key or the up - down arrows to moue from one
field to the next. To check the boxes, click your mouse on top of the box. Otherwise, please print or type.
.. .1. Contact_Information:
Owner Name Aqua North Carolina, Inc
Facility Name Windgate Subdivision --Well # 1
Mailing Address 202 Mackenan
City Cary
State ./ Zip Code NC/27511
. Telephone Number [phone]
Fax Number [phone]
e-mail Address TRobertsjaquaamerica.com
2. Location of facility producing discharge:
Check here if sameas above .❑
Street Address or State Road
Simmons Road
City Dobson
State / Zip Code
County
NC/27017
Surry
3. Operator Information:
Name of the firm, consultant or other entity that operates the facility. (Note that this is not referring to the
Operator in Responsible Charge or ORC)
Name Aqua North Carolina, Inc
Mailing Address 4163 Sinclair Street
City Denver
State / Zip Code NC/28037
Telephone Number [phone]
Fax Number [phone]
4. Ownership Status:

NPDES PERMIT APPLICATION - SHORT FORM C - WTP
For discharges associated with water treatment plants
Federal ❑ State ❑ Private ® Public 0
5. Type of treatment plant:
0 Conventional (Includes coagulation, flocculation, and sedimentation, usually followed by
filtration and disinfection)
❑ Ion Exchange (Sodium Cycle Cationic ion exchange)
® Green Sand Filter (No sodium recharge)
❑ Membrane Technology (RO, nanofiltration)
Check here if the treatment process also uses a water softener
6. Description of source water(s) (Le. groundwater, surface water)
Groundwater well
7. Describe the treatment process(es) for the raw water:
Green sand filtration using potassium permanganate. Chlorine added for disinfection.
8. Describe the wastewater and the treatment process(es) for wastewater generated by the
facility:
Wastewater discharge is the backwash of the green sand filters. Discharge rate is
approximately 1680 gallons, once every day.
9. Number of separate discharge points: 1
Outfall Identification number(s) 001
10. Frequency of discharge:
Continuous ❑ Intermittent Ej
If intermittent:
Days per week discharge occurs: 7 Duration: Approx. 20 minutes
11. Plant design potable flowrate 0.1224 (Max. well yield) MGD
Backwash or reject flow 0.00168 MGD
12. Name of receiving stream(s) (Provide a rnap showing the exact location of each outfall, including
latitude and longitude
Unnamed tributary to Fisher River (Yakdin River Basin)

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

FACT SHEET FOR EXPEDITED PERMIT RENEWALS
Basic Information to determine potential for expedited permit renewal
Reviewer/Date -
eA
Permit Number
00 V V k J)
Facility Name
U✓; pg A c.{t- S.„ t of! 1+ a )(V - fit/
Basin Name/Sub-basin number
!V / D - p4 -- J?--
Receiving Stream
Ur to C- is s `f --i' v - --
Stream Classification in Permit
Does permit need NH3 limits?
/1P
Does permit need TRC limits?
/A
Does permit have toxicity testing?
Ai
Does permit have Special Conditions?
AP
Does permit have instream monitoring?
AN
Is the stream impaired (on 303(d) list)?
_
Aft
Any obvious compliance concerns?
Aio
Any permit mods since last permit?
AP
Existing expiration date
t) 4-- 31—
New expiration date
u 4 --' -f --- .13
New permit effective date
Miscellaneous Comments
YES This is a SIMPLE EXPEDITED permit renewal (administrative
renewal with no changes, or only minor changes such as TRC, NH3,
name/ownership changes). Include conventional WTPs in this group.
YES_ This is a MORE COMPLEX EXPEDITED permit renewal (includes
Special Conditions (such as EAA, Wastewater Management Plan), 303(d)
listed, toxicity testing, instream monitoring, compliance concerns, phased
limits). Basin Coordinator to make case -by -case decision.
YES This permit CANNOT BE EXPEDITED for one of the following reasons:
• Major Facility (municipal/industrial)
• Minor Municipals with pretreatment program
• Minor Industrials subject to Fed Effluent Guidelines (lb/day limits for BOD, TSS,
etc)
• Limits based on reasonable potential analysis (metals, GW remediation organics)
• Permitted flow > 0.5 MGD (requires full Fact Sheet)
• Permits determined by Basin Coordinator to be outside expedited process
TB Version 8/18/2006 (NPDES Server/Current Versions/Expedited Fact Sheet)