NCG500651_Permit (Issuance)_20160426

PAT MCCRORY
Water Resources
ENVIRONMEN1 AL OU 1L?1 Y
DONALD R. VAN DER VAART
S. JAY ZIMMERMAN
April 26, 2016
Mr. Charles Mullis
Moses Cone Health System
618 S Main St
Reidsville, NC 27320
Subject: Renewal of General Permit NCG500000
Annie Penn Hospital
Certificate of Coverage NCG500651
Rockingham County
Dear Permittee:
The Division hereby reissues Certificate of Coverage (CoC) NCG500651 under General Permit '
NCG500000. It is issued pursuant to the requirements of North Carolina General Statue 143-215.1 and the
Memorandum of Agreement between North Carolina and the US Environmental Protection agency dated
October 15, 2007 [or as subsequently amended].
If any parts, measurement frequencies or sampling requirements contained in this General Permit
are unacceptable to you, you have the right to request an individual permit by submitting an individual
permit application. Unless such demand is made, the certificate of coverage shall be final and binding.
Please take notice that this Certificate of Coverage is not transferable except after notice to the
Division. The Division may require modification or revocation and reissuance of the certificate of coverage.
Contact the Winston-Salem Regional Office prior to any sale or transfer of the permitted facility.
Regional Office staff will assist you in documenting the transfer of this CoC.
This permit does not affect the legal requirements to obtain any other State, Federal, or Local
governmental permit that may be required. If you have any questions concerning the requirements of the
General Permit, please contact Charles Weaver of the NPDES staff [919 807-6391 or
charles. weaver@ncdenr. gov] .
rely,
for S. Jay Zimmerman, Director
Division of Water Resources
cc: Winston-Salem Regional Office
NPDES file
State of North Carolina I Environmental Quality I Water Resources
1617 Mail Service Center I Raleigh, NC 27699-1617
919 807 6300 919-807-6389 FAX
hops://deq.nc.gov/about/divisions/water-resources/water-resources-pern its/wastewater-branch/npdes-wastewater-permits

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF WATER RESOURCES
GENERAL PERMIT NCG500000
CERTIFICATE OF COVERAGE NCG500651
DISCHARGE OF NON -CONTACT COOLING WATER, COOLING TOWER AND BOILER
BLOWDOWN, CONDENSATE, EXEMPT STORMWATER, COOLING WATERS ASSOCIATED
WITH HYDROELECTRIC OPERATIONS, AND SIMILAR WASTEWATERS 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
Moses Cone Health System
is hereby authorized to discharge from a facility located at the
Annie Penn Hospital
618 S Main St
Reidsville
Rockingham County
to receiving waters designated as Troublesome Creek, a class WS-III NSW stream in subbasin 03-
06-01 of the Cape Fear River Basin in accordance with the effluent limitations; monitoring
requirements, and other conditions set forth in Parts I, II, III and IV hereof.
This certificate of coverage takes effect April 26, 2016.
This Certificate of Coverage shall remain valid for the duration of the General Permit.
Signed this day April 26, 2016
for ay Zimmerman, P.G., IZor `-
Division of Water Resources
By Authority of the Environmental Management Commission