NC0021491_Permit Issuance_20040528

W AI-E9
0
I.si�`+ 1
� T
Mr. Nick Slogick
Town of Mocksville
171 Clement Street
Mocksville, North Carolina 27028
Dear Mr. Slogick:
Michael F. Easley
Governor
William G. Ross, Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E., Director
Division of Water Quality
May 28, 2004
Subject: Issuance of NPDES Permit NCO021491
Dutchman's Creek WWTP
Davie County
Division personnel have reviewed and approved your application for renewal of the subject permit.
Accordingly, we are forwarding the attached NPDES discharge permit. This permit is issued pursuant to the
requirements of North Carolina General Statute 143-215.1 and the Memorandum of Agreement between North
Carolina and the U.S. Environmental Protection Agency dated May 9, 1994 (or as subsequently amended).
This final permit includes no major changes from the draft permit sent to you on March 31, 2004.
This permit includes a TRC limit that will take effect on January 1, 2006. If you wish to install
dechlorination equipment, the Division has promulgated a simplified approval process for such projects. Guidance
for approval of dechlorination projects is attached.
If any parts, measurement frequencies or sampling requirements contained in this permit are unacceptable to
you, you have the right to an adjudicatory hearing upon written request within thirty (30) days following receipt of
this letter. This request must be in the form of a written petition, conforming to Chapter 150B of the North Carolina
General Statutes, and filed with the Office of Administrative Hearings (6714 Mail Service Center, Raleigh, North
Carolina 27699-6714). Unless such demand is made, this decision shall be final and binding.
Please note that this permit is not transferable except after notice to the Division. The Division may require
modification or revocation and reissuance of the permit. This permit does not affect the legal requirements to obtain
other permits which may be required by the Division of Water Quality or permits required by the Division of Land
Resources, the Coastal Area Management Act or any other Federal or Local governmental permit that may be
required. If you have any questions concerning this permit, please contact Dawn Jeffries at telephone number (919)
733-5083, extension 595.
Sincerely,
ORIGINAL SIGNED BY
Mark McIntire
Alan W. Klimek, P.E.
cc: Central Files
Winston-Salem Regional Office/Water Quality Section
NPDES Unit
Aquatic Toxicology Unit
N. C. Division of Water Quality / NPDES Unit Phone:[phone]
1617 Mail Service Center, Raleigh, NC 27699-1617 fax: [phone]
Internet: h2o.enr.stale.nc.us DENR Customer Service Center..1 800 623-7748

Permit NCO021491
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
PERMIT
TO DISCHARGE WASTEWATER UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the 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
Town of Mocksville
is hereby authorized to discharge wastewater from a facility located at the
Dutchman's Creek WWTP
295 Garwood Road
Mocksville
Davie County
to receiving waters designated as Dutchman's Creek in the Yadkin -Pee Dee River Basin in accordance with effluent
limitations, monitoring requirements, and other conditions set forth in Parts I, II, III, and IV hereof.
The permit shall become effective July 1, 2004.
This permit and the authorization to discharge shall expire at midnight on June 30, 2009.
Signed this day May 28, 2004.
ORIGINAL SIGNED BY
Mark McIntire
Alan W. Klimek, P.E., Director
Division of Water Quality
By Authority of the Environmental Management Commission

Permit NCO021491
SUPPLEMENT TO PERMIT COVER SHEET
All previous NPDFS 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.
The Town of Mocksvil1e is hereby authorized to:
1. Continue to operate and maintain two parallel 0.34 MGD wastewater treatment systems
that include the following components:
➢ Flow sputter box
➢ Two bar screens
➢ Two grit chambers
➢ Flow measurement
➢ Two aeration basins
➢ Two secondary clarifiers
➢ Two disinfection units with aeration
➢ Sludge digester and sludge drying beds
This facility is located at the Dutchman's Creek WWTP (295 Garwood Road,
Mocksville) in Davie County.
2. Discharge from said treatment works at the location specified on the attached map into
Dutchman's Creek, classified C waters in the Yadkin -Pee Dee River Basin.

Q
.0
Town of Mocksville - NCO021491 Facility
Location
USGS Quad Number: D 16 NE Lat.: 35'53'33"
Receiving Stream: Dutchman's Creek Long.: 80'30'07"
Stream Class: C
Subbasin: Yadkin 03-07-05 Aforth Scale 1:24,000

Permit. NCO021491
A. (1.) EFFLUENT LIMITATIONS AND MONITORING REQUIREMENTS
During the period beginning on the effective date of the permit and lasting until expiration, the Permittee is authorized to
discharge from outfall 001. Such discharges shall be limited and monitored by the Permittee as specified below:
EFFLUENT
CHARACTERIS-TICS-
--.
LIMITS
MONITORING RtifRl~NTS
°�y
.:.'average.
V{leekly
Average
Qai�y
A __ ..87r• -
n m
Measurement
Sample .
mp!0_10catiant
Flow
0.68 MGD
Continuous
Recording
Influent or Effluent
BOD, 5 day, 20 °C2
24.0 mg/I
36.0 mg/I
Weekly
Composite
Influent and Effluent
Total Suspended Residue2
30.0 mg/I
45.0 mg/I
Weekly
Composite
Influent and Effluent
Temperature
Daily
Grab
Effluent,
Upstream and Downstream
Dissolved Oxygen3
Weekly
Grab
Effluent,
Up stream and Downstream
Fecal Coliform
(geometric mean
200 / 100 ml
400 / 100 ml
Weekly
Grab
Effluent
NH3 as N
14.0 mg/I
35.0 mg/I
Weekly
Composite
Effluent
Total Nitrogen
(NO2 + NO3 + TKN)
Weekly
Composite
Effluent
Total Phosphorus
Weekly
Composite
Effluent
Total Residual Chlorine4
28jig/I
2/Week
Grab
Effluent
Chronic Toxicity,
Quarterly
Composite
Effluent
Cadmium
Monthly
Composite
Effluent
Chromium
Monthly
Composite
Effluent
Copper
Monthly
Composite
Effluent
Nickel
Monthly
Composite
Effluent
Lead
Monthly
Composite
Effluent
Zinc
Monthly
Composite
Effluent
Cyanide
22.0 ,u /I
2/Month
Grab
Effluent
Silver
Monthly
Composite
Effluent
H
6.0 — 9.0 standard units
Weekly
Grab
Effluent
Notes:
1. Upstream = approximately 100 feet upstream from the outfall. Downstream = approximately 0.5 miles downstream from
the outfall. Upstream and downstream samples shall be grab samples collected 3/week during June, July, August, and
September and once per week during the rest of the year. As a participant in the Yadkin Pee -Dee River Basin association,
the subject facility is not responsible for conducting the instream monitoring requirements as stated above. Should your
membership in the agreement be terminated, you shall notify the Division immediately and the instream monitoring
requirements specified in your permit will be automatically reinstated.
2. The monthly average effluent BOD5 and Total Suspended Residue concentrations shall not exceed 15 percent of the
respective influent value (85% removal).
3. The daily average dissolved oxygen effluent concentration shall not be less than 5.0 mg/l.
4. Limit takes effect January 1, 2006. Until limit takes effect, the permittee shall monitor TRC (with no effluent limit).
5. Chronic Toxicity (Griodaphnia) at 7%: January, April, July, and October (see condition A. (2)).
There shall be no discharge of floating solids or visible foam in other than trace amounts.

Permit NC0021491
A. (2.) CHRONIC TOXICITY PERMIT LIMIT (Quarterly)
The effluent discharge shall at no time exhibit observable inhibition of reproduction or significant mortality to
Ceriodaphnia dubia at an effluent concentration of 7%.
The permit holder shall perform at a minimum, quarterly monitoring using test procedures outlined in the "North
Carolina Ceriodaphnia Chronic Effluent Bioassay Procedure," Revised February 1998, or subsequent versions or "North
Carolina Phase II Chronic Whole Effluent Toxicity Test Procedure" (Revised -February 1998) or subsequent versions.
The tests will be performed during the months of January, April, July, and October. Effluent sampling for this
testing shall be performed at the NPDES permitted final effluent discharge below all treatment processes.
If the test procedure performed as the first test of any single quarter results in a failure or ChV below the permit limit,
then multiple -concentration testing shall be performed at a minimum, in each of the two following months as described
in "North Carolina Phase II Chronic Whole Effluent Toxicity Test Procedure" (Revised -February 1998) or subsequent
versions.
The chronic value for multiple concentration tests will be determined using the geometric mean of the highest
concentration having no detectable impairment of reproduction or survival and the lowest concentration that does have
a detectable impairment of reproduction or survival. The definition of "detectable impairment," collection methods,
exposure regimes, and further statistical methods are specified in the "North Carolina Phase II Chronic Whole Effluent
Toxicity Test Procedure" (Revised -February 1998) or subsequent versions.
All toxicity testing results required as part of this permit condition will be entered on the Effluent Discharge
Monitoring Form (MR-1) for the months in which tests were performed, using the parameter code TGP3B for the
pass/fail results and THP3B for the Chronic Value. Additionally, DWQ Form AT-3 (original) is to be sent to the
following address:
Attention: NC DENR / DWQ / Environmental Sciences Branch
1621 Mail Service Center
Raleigh, North Carolina 27699-1621
Completed Aquatic Toxicity Test Forms shall be filed with the Environmental Sciences Branch no later than 30 days
after the end of the reporting period for which the report is made.
Test data shall be complete, accurate, include all supporting chemical/physical measurements and all
concentration/response data, and be certified by laboratory supervisor and ORC or approved designate signature.
Total residual chlorine of the effluent toxicity sample must be measured and reported if chlorine is employed for
disinfection of the waste stream.
Should there be no discharge of flow from the facility during a month in which toxicity monitoring is required, the
permittee will complete the information located at the top of the aquatic toxicity (AT) test form indicating the facility
name, permit number, pipe number, county, and the month/year of the report with the notation of "No Flow" in the
comment area of the form. The report shall be submitted to the Environmental Sciences Branch at the address cited
above.
Should the permittee fail to monitor during a month in which toxicity monitoring is required, monitoring will be
required during the following month.
Should any test data from this monitoring requirement or tests performed by the North Carolina Division of Water
Quality indicate potential impacts to the receiving stream, this permit may be re -opened and modified to include
alternate monitoring requirements or limits.
NOTE: Failure to achieve test conditions as specified in the cited document, such as minimum control organism survival,
minimum control organism reproduction, and appropriate environmental controls, shall constitute an invalid test and -,vill require
immediate folio-,v-up testing to be completed no later than the last day of the month following the month of the initial monitoring.

Draft Permit reviews (3)
Subject: Draft Permit reviews (3)
Date: Mon, 19 Apr 2004 10:38:50 -0400
From: John Giorgino <[e-mail]>
To: Dawn Jeffries <[e-mail]>
Dawn, I have reviewed the following:
NCO055093 - Tobaccoville Facility, no comments concerning tox.
NCO021504 - Biscoe WWTP, page A(2) does not contain the language "If the
test procedure performed as the first test of any single quarter results
in a failure...... then multiple concentration testing....... in each of
the two following months ......... (see 3rd paragraph in A(2) in the other
permits).
N00021491 - Dutchman's Creek WWTP, Supplement To Permit Cover Sheet (2nd
page), has flow @ 0.34 MGD. Is this because there are "two parallel"
treatment systems? PF is 0.68 MGD for the facility.
Thank you for sending me the permits to review.
-John
John Giorgino
Environmental Biologist
North Carolina Division of Water Quality
Aquatic Toxicology Unit
Mailing Address:
1621 MSC
Raleigh, NC 27699-1621
Office: 919 733-2136
Fax: [phone]
Email: [e-mail]
Web Page: http://www.esb.enr.state.nc.us
i off 2 4/20/2004 7:06 AM

FXJVLI v NUTtuc
STATE OF NORTH CAROLINA
ENVIRONMENTAL MANAEMENT
COMMISSION/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 application of NC Gen-
eral Statute 143.21, Public law 92-
500 and other lawful standards and
regulations, the North Carolina En-
vironmental Management Commis-
._, Sion proposes to issue a National
Pollutant Discharge Elimination
System (NPDES) wastewater dis-
charge permit to the person(s) listed
below effective 45 days from the
publish date of this notice:
Written comments regarding the
propsed permit will be accepted
until 30 days after the publish date
of this notice. All comments re-
ceived prior to that date are con-
sidered inthe final determinations
regarding the proposed permit. The
Director of the NC Division of Wa-
ter Quality may decide to hold a
public meeting for the proposed
permit should the Division receive
a significant degree of public inter-
est
Copies of the draft permit and
other supporting information on file
to determine conditions pesent in
the draft permit are available upon
request and payment of the costs
of reproduction. Mail comments
and/or requests for information to
the NC Division of Water Quality at
the above address or call Ms. Valery
Stephens at [phone],exten-
sion 520. Please include the
NPDES permit number (attached)
in any communications. Interested.
persons may also visit the Division
of Water Quality at 512 N. Salisbury
Street, Raleigh, NC 27604-1148
between the hours of 8:00 a.m. and
5:00 p.m. to review information on
file.
Mocksville, N. C_ Q.AQn . D If, 20JEV_
DAVIE COUNTY
=NTEM W '
E�'i�.
NORTH CAROLINA
DAVIE COUNTY AFFIDAVIT OF PUBLICATION
Before the undersigned, a Notary Public of Davie County and North Carolina duly commissioned, qualified and authoriz-
ed [.- to administer oaths, personally appeared Dwight Sparks, who being first duly sworn, deposes and says that
Editor Tin newspaper known as DAVIE COUNTY ENTERPRISE -RECORD, published, issued and entered
as second class mail in the City of Mocksville in Davie County and North Carolina, that he is authorized to nuke this
affidavit and sworn statement, that the notice or other legal advertisement a true copy of which is attached hereto was
published in DAVIE COUNTY ENTERPRISE -RECORD on the following dates.
,V- P-o y
and that the said newspaper in which such notice, paper document or legal
or each and every such publication, a newspaper meeting all of the requir9
the General statutes of North Caroline and was a qualified newspaper within
statutes
or North Caro6m,
ThsQ. ..., .1 f J, .day of. .... G.t.r[].1].(—f!......... . 20J0.4(
Sworn to and subscribed before me
... day
Ff..4o24div! .........:.... oy
"'""""'^"F•,��v..NOTARY PUBLIC
My commission expires .....
ti,,.,...A#..... p 7
seine t was Iffy as, at the time
and 4 C_ROW&r c %an 1-579 of
77 i
ptapr
t: v
{• # v The Davie County WaTer Sys-
• PI tern (261 Chaffin Street, Mocksville,
•• NC 27028) has applied for renewal
Q •••a of NPDES permit NCO024872 for
the Cooleemee/Davie County
"•r,,,, WWTP in Davie County. This per-
mitted facillity discharges treated
wastewater to the South Yadkin
River in the Yadkin Pee -Dee River
Basin. Currently BOD, total sus-
pended soilds, and total residual
chlorine are water quality limited.
This discharge may affect future
allocations in this portion of the
Yadkin Pee -Dee River Basin.
The Town of Mocksville, 171
Clement Street, Mocksville, North
Carolina has applied for renewal of
NPDES permit NCO021491 for its
Dutchman's Creek W WTP in Davie
COunty. This permitted facility dis-
charges treated wastewater to
Dutchman's Creek in the Yadkin -
Pee Dee River Basin. Currently
Bodk, ammonia nitrogren and total
residual chlorine are water quality .
limited. This discharge may affect
future allocations in this portion of
the watershed. W
4-8-1 In

-yr
NORTH CAROLINA
FORSYTH 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 D.H. Stanfield, who being duly sworn, deposes and says: that he is
Controller of the Winston-Salem Journal, engaged in the publishing of a newspaper
known as Winston-Salem Journal, published, issued and entered as second class mail
in the City of Winston-Salem, in said County and State: that he 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 Winston-Salem Journal on
the following dates:
April 3, 2004
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 the requirements and qualifications of Section 1-597 of the
General Statues of North Carolina and was a qualified newspaper within the meaning
of Section 1-597 of the general statues of North Carolina.
This 6th day of April, 2004 1" ZLat a\ 29,
(signature of pers n m k ig affidavit)
Sworn to and subscribed before me, this 6th day of pnlZQ04
I
NotarA P lic
My Commission expires: September 28, 2005
I,e�_ _
.V / ✓ OFFICIAL SEAL
1jp �j Notary Public, North Carolina �
11 COUNTY OF FORSYTH
KI OHf�I$OG
VV f/
- j I ,nmmisston Ex lres es ,J_Y OE
APR 15 2004
Q"/�
" PUBLIC NOTICE
STATE OF NORTH:CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSIONINDES UNIT
t617 MAILSERVICE CENTER
RALEIGH, NO 276 1619
NOTIFICATION OF INTENT TO ISSUEA
NPDES WASTEWATER PERMIT
7M
` heated wastawuter to Outdmads creek in the YadkirrPea Dm Prver
J Basin. CurardlyBDD, ammonia Ntmgen, and tonal residual dhbdne are
water quality limitha& This dscharga may affect future alk rahore in this
potion of thewmershed.
mho CAyal Wlnatan-Salm0. Boc 2511, WlnstonSal m, NO 271 h2J
has apppketl Ior mnmml ofIP.PDES permit NCO050342 for the Muddy
CCreek NAYfP In Forsyth County; Tuts permiAoo msiAy derlmarger treat
j ad waalnwater W the -Yadkin Rarer In 0ae Yadkin Pea -Dee RNer BesN.
CunedhyCSOD, ammora nihagen, and total residual dilormo amewater
gmmkly IimAetl. This d'sdwge may affect futum aloczAcm in INs portion
d Ore Yadkin IM.F.J. Reynolds RNer Rase�urynn
olds North
Carotnain ppFadformnewal oNDESpperma NOo0D55093forits T.
S bamxaAlie Faolily In
frorsylkCouNy. Tiffs permitted facdAy discharggeess
hemetl grow
to Barkers Creek m dp Y=Pge D. RNW Ba
sin. This Mooetor may affect future allocations in this potion olthe wa.
tershed.
WSJ: Aprit B,2004 ._

cc: Central Files
WSRO
To: NPDES Unit
Water Quality Section
Attention: Dawn Jeffries
Date: April 1, 2004
NPDES STAFF RECOMMENDATION
Davie County
Town of Mocksville
Dutchman's Creek WWTP f,PR - 8 2003
Permit No. NC00021491
REGIONAL OFFICE COMMENTS
The Winston-Salem Regional Office recommends approval of this NPDES permit as found in the
draft copy. The significant changes from the current permit for the TRC, NH3-H, and cyanide
limits are acceptable. If you have any questions contact Derek Denard at [phone] Ext-
240.
WSRO Recommendation by: Derek Denard
Signature: dgQ✓en� ofreiDate: ,
WSRO Supervisor: W. Tedder
Signature: -�� ��'� ��iL— Date: / Iz

DENR/DWQ
FACT SHEET FOR NPDES PERMIT DEVELOPMENT
NPDES No. NCO021491
Facility Information
Facility Name:
Town of Mocksville
Permitted Flow:
0.68 MGD
County:
Davie
Facility Class:
III
Regional Office:
Winston-Salem
Facility/Permit Status:
(i.e. New, Modification,
Existing or Renewal)
Existing
(Renewal)
USGS Topo Quad:
D16NE
Stream Characteristics
Receiving Stream:
Dutchman Creek
Stream Classification:
C
Winter 7Q10 (cfs):
26
Subbasin:
03-07-05
30Q2 cfs):
N/A
Drainage Area (mi2):
108
Average Flow (cfs):
108
Summer 7Q 10 (cfs)
15
IWC (%):
7
Summary
The facility has applied for renewal of its permit. This facility discharges into
Dutchman's Creek, classified C waters in the Yadkin -Pee Dee River Basin. The
receiving stream is not listed on the 2003-303(d) list; nor are there any special
considerations for it in the river basin plan. The town is a member of the Yadkin -Pee
Dee River Basin Association (as such, their instream monitoring will continue to be
waived). The town has a modified pretreatment program.
Changes Incorporated into Permit Renewal
• A TRC limit will be added as required by current permitting strategy.
• An ammonia nitrogen weekly average limit will be added as required by
current permitting strategy.
• The cyanide limit will be changed to protect for chronic and acute effects.
Reasonable Potential Analysis:
A reasonable potential analysis was performed using DMR data from 2002-
2003. The results of the analysis are attached to this document. In summary,
Cadmium The maximum predicted concentration was determined to be
less than the allowable concentration. Therefore, no limit will be
included in the renewal. Monitoring only will be included in the permit.
Cyanide The facility exceeded its cyanide limit three times in 2002.
Under current permitting policy, the daily maximum limit of 76.0 14g/1 in
the current permit must be changed to 22.0 µg/1 (1/2 FAV) to protect for
acute effects. This limit would protect for chronic effects also (the

chronic limit is 76µgI1). Therefore no weekly average will be included in
the renewal.
Lead The maximum predicted concentration was determined to be less
than the allowable concentration. Therefore, no limit will be included in
the renewal. Monitoring only will be included in the permit.
Nickel The maximum predicted concentration was determined to be less
than the allowable concentration. Therefore, no limit will be included in
the renewal. Monitoring only will be included in the permit.
Copper The maximum predicted concentration was determined to be
less than the allowable concentration. Therefore, no limit will be
included in the renewal. Monitoring only for copper will remain in the
permit.
Zinc The maximum predicted concentration was determined to be less
than the allowable concentration. Therefore, no limit will be included in
the renewal. Monitoring only will be included in the permit.
Chromium The maximum predicted concentration was determined to be
less than the allowable concentration. Therefore, no limit will be
included in the renewal. Monitoring only will be included in the permit.
Silver Although the maximum predicted concentration is higher than the
allowable concentration, this is an action level parameter. In this case, a
limit is only given if the facility fails a toxicity test and the re -test the
following month (and it is determined that silver may be contributing to
toxicity problems). This facility has not had such problems, so
monitoring only for silver will remain in the permit.
DMR Data (2002-2003) review:
In general, the facility appears to be in compliance with the conditions of the
permit. The following issues were noted in reference to the DMR review.
• The toxicity test was failed in January 2002. The February re -test
passed.
• One flow violation was reported in March 2003. The town indicates
in its application that they have begun the process of requesting an
increase in permitted flow.
• The Daily Maximum limit for Cyanide was exceeded three times:
Feb ' 02, Apr ' 02, and Oct ' 02.
• The weekly average limit for fecal coliform was exceeded twice:
May ' 02 and Nov ' 02.
It is recommended that the permit be renewed as drafted.
Proposed Schedule for Permit Issuance
Draft Permit to Public Notice: 03-31-04
Permit Scheduled to Issue: 05-24-04

State Contact
If you have any questions on any of the above information or on the attached
permit, please contact Dawn Jeffries at [phone], extension 595.
NPDES Recommendation by:
Regional Office Comments
W5&0 ✓CCO �r5sls
,w, OV'1 I
Regional Recommendation by: �� Date:
�- — zloH
Reviewed By:
Regional Supervisor: / Date: 9 z c f
NPDES Unit: Date:

Facility Nane =
Dutchman's Creek
NPDES # =
NCO021491
Qw (MGD) =
0.68
7QIOs (cjs)=
15
IWC (%) =
6.57 -
FINAL RESULTS
Chromium
Max. Pred C%v 7.6
Allowable Coo 761.6
RESULTS
Std Dev.
0.8609
Mean
2.8
C.V.
0.3046
Number
of data points
23
Mult Factor =
1.52
Max. Value
5.0 µg/I
Max. Pred Cw
7.6 µill
Allowable Cw
761.0 140
Parameter = Chromium
Standard = 50.0 µg/I
n
Date
<
Actual Data
BDL=1/2DL
I
Nov'03
<
5.0
2.5
2
Oet'03
<
5.0
2.5
3
Sep '03
5.0
5.0
4
Aug'03
5.0
5.0
5
Jul'03
<
5.0
2.5
6
Jun '03
<
5.0
2.5
7
May'03
<
5.0
2.5
8
Apr'03
5.0
5.0
9
Mar'03
<
5.0
2.5
IO
Feb'03
<
5.0
2.5
11
Jan'03
<
5.0
2.5
12
Dec'02
<
5.0
2.5
13
Nov'02
<
5.0
2.5
14
Oct'02
<
5.0
2.5
15
Sep'02
<
5.0
2.5
16
Aug'02
<
5.0
2.5
17
Jul'02
<
5.0
2.5
18
Jun'02
<
5.0
2.5
19
May'02
<
5.0
2.5
20
Apr'02
<
5.0
2.5
21
Mar'02
<
5.0
2.5
22
Feb'02
<
5.0
2.5
23
Ian'02
<
5.0
25
24
25
26
27
28
29
30
31

Facility Name =
Dutchman's Creek
NPDES N =
NCO021491
Qw (MGD) =
0.68
7QIOs (cfs)=
15
lWC (%) =
6.57
FINAL RESULTS
Chromium
Max. Pred Cw 7.6
Allowable Cw 761.6
RESULTS
Std Dev.
0.8609
Mean
2.8
C.V.
0.3040
Number
of data points
23
Mull Factor
1.52
Max. Value
5.0 µgll
Max. Pred Cw
7.6 µg/1
Allowable Cw
761.6 µ9/1
Parameter= Chromium
Standard = 50.0 d µg/I
n
Date
<
Actual Data
6DL=1/2DL
l
Nov'03
<
5.0
2.5
2
Oct'03
<
5.0
2.5
3
Sep'03
5.0
5.0
4
Aug'03
5.0
5.0
5
Jul'03
<
5.0
2.5
6
Jun '03
<
5.0
2.5
7
May'03
<
5.0
2.5
8
Apr'03
5.0
5.0
9
Mar'03
<
5.0
2.5
10
Feb'03
<
5.0
2-5
II
Jan'03
<
5.0
2.5
12
Dec'02
<
5.0
2.5
13
Nov'02
<
5.0
2.5
14
Oct'02
<
5.0
2.5
15
Sep'02
<
5.0
2.5
16
Aug'02
<
5,0
25
17
Jul'02
<
5.0
2.5
18
Jun'02
<
5.0
2.5
19
May'02
<
5.0
2.5
20
Apr'02
<
5.0
2.5
21
Mar'02
<
5.0
2.5
22
Feb'02
<
5.0
2.5
23
Jan'02
<
5.0
2.5
24
25
26
27
28
29
30
31

Facility Name =
Dutchman's Creek
NPDES # =
NCO021491
Qw (MGD) =
0.68
7Q10s(cfs)=
15
IWC (%) =
6.57
FINAL RESULTS
Lead
Max. Pred Cw 15.2
Allowable Cw 0.0
RESULTS
Sul Dev.
1.7218
Mean
5.7
C.V.
0.3046
Number
of data points
23
Malt Factor
Max. Value
10.0 µg/1
Max. Pred Cw
15.2 µg/1
Allowable Cw
380.8 µg/1
Parameter = Lead
Standard = 25.0 1 µg/t
n
Date
<
Actual Data
BDL=1/2DL
I
Nov'03
<
10.0
5.0
2
Oct'03
<
10.0
5.0
3
Sep'03
10.0
10.0
4
Aag'03
10.0
10.0
5
Jut'03
<
10.0
5.0
6
Jun'03
<
10.0
5.0
7
May'03
<
10.0
5.0
8
Apr'03
10.0
10.0
9
Mar'03
<
10.0
5.0
10
Feb'03
<
10.0
5.0
11
Jan'03
<
10.0
5.0
12
Dec'02
<
10.0
5.0
13
Nov'02
<
10.0
5.0
14
Oct'02
<
10.0
5.0
15
Sep'02
<
10.0
5.0
16
Aug'02
<
10.0
5.0
17
Jul'02
<
10.0
5.0
18
Jun'02
<
10.0
5.0
19
May'02
<
10.0
5.0
20
Apr'02
<
10.0
5.0
21
Mar'02
<
10.0
5.0
22
Feb'02
<
10.0
5.0
23
Jan'02
<
10.0
5.0
24
25
26
27
28
29
30
31

Facility Name =
Dutchman's Creek
NPDES # =
NCO021491
Qw (MGD) =
0.68
7Q10s (cfs)=
15
lWC(%n)=
6.57
FINAL RESULT'S
Nickel
Max. Pred Cw 15.5
Allowable Cw 1340.4
d Dev. 1.7563
can 5.7
V. 0.3091
of data points
22
HITS
I
Mull Factor =
L55
Max. Value
10.0 µg/I
Max. Pred Cw
15.5 µg/I
Allowable Cw
1340.4 µg/I
Parameter = Nickel
Standard = 88.0 1 µg/l
n
Date
<
Actual Data
1
Nov'03
<
2
Oct'03
<
10.0
3
Sep'03
10.0
4
Aug'03
10.0
5
Jul'03
<
10.0
6
Jun'03
<
10.0
7
May'03
<
10.0
8
Apr'03
10.0
9
Mar'03
<
10.0
10
Feb'03
<
10.0
11
Jan'03
<
10.0
12
Dec'02
<
10.0
13
Nov'02
<
10.0
14
Oct'02
<
10.0
15
Sep'02
<
10.0
16
Aug'02
<
10.0
17
Jul'02
<
10.0
18
Jun'02
<
10.0
19
May'02
<
10.0
20
Apr'02
<
10.0
21
Mar'02
<
10.0
22
Feb'02
<
10.0
23
Jan'02
<
10.0
24
25
26
27
28
29
30
31
BDL=1/2DL
5.0
10.0
10.0
5.0
5.0
5.0
10.0
5.0
5.0
5.0
5.0
5.0
5.0
5.0
5.0
5.0
5.0
5.0
5.0
5.0
5.0
5.0

Facility Name =
Dutchman's Creek
NPDES # =
NCO021491
Qw (MGD) =
0.68
7Q/Os (cfs)=
15
IWC (%) =
6.57
FINAL RESULTS
Cadmium
Max. Pred Cw 3.0
Allowable Cw 30.5
RESULTS
Std Dev.
0.3444
Mean
1.1
C.V.
03046
Number
of data points
23
Mull Factor
Max. Value
2.0 Ag/I
Max. Pred Cw
3.0 µg/I
Allowable Cw
30.5 µg/I
Parameter = Cadmium
Standard = 2.0 d µg/I
n
Date
<
Actual Data
ODL=1/
1
Nov'03
<
2.0
1.0
2
Oct'03
<
2.0
1.0
3
Sep'03
2.0
2.0
4
Aug'03
2.0
2.0
5
Jul'03
<
2.0
1.0
6
Jun'03
<
2.0
1.0
7
May'03
<
2.0
1.0
8
Apr'03
2.0
2.0
9
Mar'03
<
2,0
1.0
10
Feb'03
<
2.0
1.0
11
Jan'03
<
2.0
1.0
12
Dec'02
<
2.0
1.0
13
Nov'02
<
2,0
1.0
14
Oct'02
<
2.0
1.0
15
Sep'02
<
2.0
1.0
16
Aug'02
<
2.0
1.0
17
Jul'02
<
2.0
1.0
18
Jun'02
<
2.0
1.0
19
May'02
<
2.0
1.0
20
Apr'02
<
2.0
1.0
21
Mar'02
<
2.0
1.0
22
Feb'02
<
2.0
1.0
23
Jan'02
<
2.0
1.0
24
25
26
27
28
29
30
31

Facility Name =
NPDES ## =
Qw (MGD) =
7Q10s (cfs)=
IWC (%) =
Dutchman's Creek'
NC0021491
0.68
15
6.57
FINAL RESULTS
Copper
Max. Pred Cw 192
Allowable Cw 1066
RESULTS
Std Dev.
2.6621
Mean
7:8
C.V.
0.3421'
Number
of data points
23
Mult Factor =
1.60
Max. Value
12.0 µgll
Max. Pred Cw
19.2 µgll
Allowable Cw
106.6 µg/l
Parameter = Copper
Standard = 7.0 µg/1
n
Date
< Actual Data
BDL=1/2DL
1
Nov '03
9.0
9.0
2
Oct '03
7.0
7.0
3
Sep '03
9.0
9.0
4
Aug'03
6.0
6.0
5
Jul '03
10.0
'10.0
6
Jun '03
7.0
7.0-
7
May '03
7.0
7.0
8
Apr '03
5.0
5.0
9
Mar'03
6.0
6.0.'
10
Feb '03
6.0
6.0
11
Jan '03
12.0
12.0
12
Dec '02
11.0
11.0
13
Nov '02
9.0
9 0
14
Oct '02
7.0
7'0.
15
Sep '02
3.0
3.0,:
16
Aug '02
9.0
9.0
17
Jul '02
1 1.0
18
Jun '02
7.0
7.0
19
May '02
11.0
11.0
20
Apr '02
1 1.0
11.0
21
Mar '02
5.0
5.0
22
Feb '02
2.0
2.0
23
Jan '02
9.0
9.0
24
25
26
27
28
29
30
31

Facility Name =
NPDES # =
Qw (MGD) =
7Q10s (cfs)=
IWC (%) =
Dutchman's Creek
NCO021491'
0.68
15'
6.57 ':
FINAL RESULTS
Zinc
Max. Pred Cw 345.8
Allowable Cw 761.6
Allowable #/day 0.0
RESULTS
Std Dev. 36.8089
Mean 81.5
C.V. 0.4518
Number
of data points 23
Mult Factor =
1.841
Max. Value
188.0 µg/I
Max. Pred Cw
345.8 µgll
Allowable Cw
761.6 µgll
n
Date
Parameter =
Standard =
< Actual Data
Zinc
50.0µg/l
BDL=1/2DL
1
Nov '03
115.0
A15.0
2
Oct '03
58.0
58.0:,, .
3
Sep '03
56.0
56.0
4
Aug'03
39.0
39.0
5
Jul '03
88.0
88.p.
6
Jun '03
78.0
78.0
7
May '03
50.0
50.0
8
Apr '03
44.0
44.0
9
Mar '03
33.0
33.0.:
10
Feb '03
77.0
77.01.1
11
Jan '03
121.0
1210;..
12
Dec '02
136.0
136.0,
13
Nov '02
65.0
:65.0
14
Oct '02
57.0
57.0
15
Sep '02
33.0
33.0
16
Aug '02
66.0
66.0
17
Jul '02
103.0
103.0
18
Jun '02
106.0
106.0
19
May '02
98.0
98.0
20
Apr '02
188.0
188.0
21
Mar'02
83.0
83.0
22
Feb '02
94.0
94.0
23
Jan '02
86.0
86.0

Facility Nave =
Dutchman's Creek
NPDES N =
NCO021491
Qw (MGD) =
0.68
7Ql0s
is
/WC(`#,)=
6.57
FINAL RESULTS
Silver
Max. Pred Cw 7.62
Allowable Cw 0.91
RESULTS
Std Dev.
0.8609
Mean
2.8
C.V.
0.3046
Number
of data points
23
Mull Factor =
L52
Max. Value
5.00 µgo
Max. Pred Cw
7.62 µg/I
Allowable Cw
0.91 µg/l
Paramenv= Silrcr
Standard = 0.0G µg/I
n
Date
<
Actual Data
BDL=1/2DL
I
Nov '03
<
5.0
2.5
2
Oct'03
<
5.0
2.5
3
Sep'03
5.0
5.0
4
Aug'03
5.0
5.0
5
Jul '03
<
5.0
2.5
6
Jun '03
<
5.0
2.5
7
May'03
<
5.0
2.5
8
Apr'03
5.0
5.0
9
Mar'03
<
5.0
2.5
10
Peb '03
<
5.0
2.5
II
Jan'03
<
5.0
2.5
12
Dec'02
<
5.0
2.5
13
Nov'02
<
5.0
2.5
14
Det'02
<
5.0
2.5
15
Sep'02
<
5.0
2.5
16
Aug'02
<
5.0
2.5
17
Jul'02
<
5.0
2.5
18
Jun'02
<
5.0
2.5
19
May'02
<
5.0
2.5
20
Apr'02
<
5.0
2.5
21
Mar'02
<
5.0
2.5
22
Feb'02
<
5.0
2.5
23
Jan'02
<
5.0
2.5

Whole Effluent Toxicity Testing Self -Monitoring Summary
January 15, 2004
FACILITY REQUIREMENT
YEAR JAN
FEE
MAR APR
MAY
JUN
JUL AUG
SEP OCT
NOV
DEC
M.rion-Corpening Cr. WWTP chr him: 67%
2000-
Pass
- -
Pass
-
- Pass
- -
Pass
-
NCM31g99N0I Begin l/IROM FrequencyQ Feb May Aug Nov NonComp Single
2001 -
Pass
- -
Fail
>90
>90 Pass
- -
Pass
-
Coanty:McDowell Region: ARO Subbaslm CFB30
2002 -
Pass
- -
Pas.
-
- Pas:
-- -
Pas.
-
PF: 3.0 Strait
2003 -
Pass
- -
Pa..
-
- P.-
- -
Pass
9Q10: 2.3 IWC(%:66.9
2004
Marshall WWTP 24hr p/fac lim: 90% (Fathead)
2000-
Pa..
- -
Pess
-
- Pass
- -
Pass
-
NCO021]33/001 Begin6/1/2002 Frequency + Feb May Aug Nov + NonComp Single
2001 -
P...
- -
Pass
-
- Pass
- -
Pass
-
Connty:Mudum Region: ARO Subluem: FUN
2002 -
Pass
- -
Pas.
-
- Pass
- -
Pass
-
PF: 0,40 "osi
2003 -
P...
- -
Pass
-
- Pas
- -
Pass
7QI0: 535 IWC(%;0.12
2004
Mryoden VuVTP cIm hot fiG ifpf>L25/9%if4.5.MGD
20W Pass
-
List. Fail
8.5
19
- -
Pa.s -
-
Pa..
NCO0218731001 Regina/120o) Frequency + Mar Jun Sup Dec NonComp Single
2001 -
-
Pess -
-
Pass
- -
Pas. -
-
Pao
County: Rockingham Region: WSRO Sudd in: ROA02
2002 -
-
Pa.. -
-
Pass
- -
Pa.. -
-
Fail
PF: 3.0 sprdd
2W3 >24
a24
Pan -
-
Pass
- -
Pas. -
-
Pass
]QIO: 95 IWC(%;6
2006
Me lndustrin-001 241rp/f ac lim: 90% food
Y2"-
-
Paws -
-
Pass
- -
NRSawwa -
-
In...
NOW00311,001 Begio:5/laWl Frequency + Mar Jun Scp Dee + NonComp Sln8le
2001 -
-
Pass -
-
P...
- -
NR1Pess -
-
NRJPass
Counry:Tramylvania Region: ARO Subbssm: FRBW
2002 -
-
NRoaass -
-
P...
- -
Pass - -
-
Pass
PF: 0.030 special
2003 -
_
Pa.. -
-
Fail
Pass -
Pas. -
-
]QI0:2'1.9 IWC(%:0.11
20N
MB ladaetres-003 chr him: 0.55%(grab)
2000-
-
-
-
-
-
-
-
-
-
-
-
NC0000311/003 Begin:5/I/2001 Frequency Mar Jun Sep Dec
+ NonComp Single
2001 -
-
-
-
-
H
-
-
NR/lnvalid
-
-
NWInvalid
County: Transylvania Region: ARO Subbasim FBR01
2002 -
-
NRllnvalid
-
-
InvaOd
-
Pass
Pees
-
-
Pas.
PF: 0.10 Stood
2003 -
-
Pass
-
-
Paes
-
-
Pass
-
-
]Q10:21.9 IWC(%;0.55
2004
McMurray Fsbricalamesaille Inc. 24hrpIf sc him: 90% Pool
2000-
-
P.n,>90
-
-
Pass
-
-
Pen
-
-
Pe.s.a90
KW2371WO01 Begin:Nl/1991 Frequency + Mar Jun Sep Dec
+ NonComp Single
2001 -
-
Pasn,>90
-
-
Pass.>90
-
-
Pass>90
-
-
Pass?90
Co..": Martin Be,.: WARD Subbawn: ROA09
2002 -
-
Pas.,>90
-
-
Pa.s?100
-
-
Posa>lw
-
-
Fml.53.8
PF: 0.45 Special
2003 "to
Fail
Fail
Pass.>W
-
Pan.>t00
-
-
FailA6.5
Pass.>100
-
Fail,a12.5
7QIO: 1200 IWCP%/ 0.06
2004
MebaneW VrP chr lim: 90%
V Zaino Pass
-
-
Pass
-
-
Pass
-
-
Pas.
-
-
NCW214/4/001 Begm9/Ii7x2 Frequency Jan Apr Jul Oct
+ NonComp Single
2001 Paas
-
-
Pass
-
-
Pass
-
-
Pass
-
-
Coumy:Alamancc Raglan: WSRO Subbasim CPF02
2002 Pout
-
-
Paas
-
-
Pas.
-
-
Fail
>100
1100
Pf: 2.5 spiral
2003 Paes
-
-
Pass
-
-
Pass
-
-
Pass
-
yQIO: 0.0 IWC(%; Ion
2004
Miller Brewlsg Co. chr lim: 2.10/4
2000 -
Pat.
-
-
Pa..
-
-
Invalid
-
Pass
Pass
-
NCO0299SOM01 Begin:9/I0003 FrequencyQ PIP + Feb May Aug Nov
+ NonComp Smdc
2001 -
Pat.
-
-
is...
-
-
Pan
-
-
Pass
-
County:Rockingham Region: WSRO Subbusin: ROA03
2002 -
Paas
-
-
Pess
-
-
Pass
-
-
Pass
-
PF: 5.2 Special
2003 -
Pas.
-
-
p...
-
-
Pass
-
-
Pass
7010: 313 IWC(%]2.51
2004
MockavllleW PBe.r Creek chr him: 37%
y 2000-
Pass
-
-
P...
-
-
Pas.
-
-
NR
Pes.
NOWS090]NM Begia9/1/2003 Frequency Q PIP Feb May Aug Nov
' NunCOmp Single
2001 NR
Pan
-
-
Pass
-
-
<10'Fall
NR
e10.136
136
F.II.P.s.
Co..":Dvie Region: WSRO Subbssim YAD06
2W2 NRrFail
13,6
C0
�10
-10
>100
866
Fail
.100
>100
Pass
-
PF: 0.25 s'osl
2003 -
Pa..
-
-
Pass
-
-
Pass
-
-
Pass
1Q10: 0.65 1 WC(%:31
2004
MocWrite 3VWFP Dutchman's Ce. the him: 7%
Y 2000 Pass
-
-
Pass
-
-
Pass
-
-
Pas.
-
-
NC0021491/001 Bcgin:3/1/2001 Frequency Jan Apr Jul Oct
+ NonComp Single
2001 Pass
-
-
Pass
-
-
Pass
-
-
Pau
-
-
County:Davie Region: WSRO Subbour: YAD05
2002 Fail
>213
9.00
Pass
-
-
Pass
-
-
Pass
-
-
PF: 0.68 Smrisl
2003 Pass
-
-
Pass
-
-
Pass
-
-
Pass
-
0QW: 15.0 IWC(%:6.5]
2004
Monarch Hmlery, 24hr p/for him: 90%
M 2000 -
-
Pass
-
-
Pas.
-
-
NR/Pnss
-
-
Pas.
NC0001210MI BeginAl/l/2002 FrequencyQ + Mar Jun Sep Dec
NonComp Single
2001 -
-
Pa..
-
-
Pass
-
-
Pas.
-
-
Fail
County: Aluai Region: WSRO Subboim CPF02
2002 Fail
Pa..
Paes
-
-
Pas.
-
-
H
-
-
H
Pp: 0.05 special
2003 H
-
-
-
-
H
-
-
H
-
-
0QW: 47.8 IWC(%;0.16
20M
LEGEND:
PERM -Permit Requiremcnl LET- Administrative Lenet-Targct Frequency- Monitoring ftrqucncy Q. Quarterly; M. Monthly: BM- Bimonthly; SA. Semiannually: A.Annually;OWD. Only when discharurts: D. Dtscumtnued monitorng ra,uncearm
Begin- First month required OQIO- Receiving stream low Bow criterion(cfs +- quarterly monitoring Increases to monthly upon failure orN Months that taring must occur- ex. Jon, Apr, Jul, Oct NonComp- Curren Compliance Requirement
PF=Permuted ROw(MGD) IWC%-Inmmati streawa.eoneentP/F-Pass/Failmsl AC=Acute CHR- Chmnie
Data Nolatlon: f- Fathead Minnow; --Ceriodaphnia V, my - Mysid shrimp; ChV - Chronic volue; P - Mortality ofsumd percentage at highest concentration; at - Performed by D WQ Aquatic Tax Unit: bt- Bad tut
Repotting Natation:--= Dma ram mquimd; NR - Nat rcymde Facility Activity Status: I - Inactive,N - Newly lssued(To canslmct):H- Active but not discharging;t-Mom data available for month in question- = ORC signature needed
29

MONITORING REPORT(MR) VIOLATIONS for:
Report Date: 01/22/04 Page: 1 of 1 ,
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PERMIT: NCO021491 FACILITY: Town of Mocksville - Dutchman's Creek WWTP COUNTY: Davie
REGION: Winston-Salem
Limit Violation
MONITORING OUTFALL
VIOLATION
UNIT OF
CALCULATED
REPORT / PPI
LOCATION
PARAMETER
DATE
FREQUENCY
MEASURE
LIMIT
VALUE
VIOLATION TYPE
VIOLATION ACTION
05 - 2002 001
Effluent
Coliform, Fecal MF, M-FC
05/04/02
Weekly
#/100ml
400
600
Weekly Geometric Mean
DMR conversion
Broth,44.5C
Exceeded
history
11 - 2002 001
Effluent
Coliform, Fecal MF, M-FC
11/16/02
Weekly
#/100ml
400
600
Weekly Geometric Mean
Proceed to
Broth,44.5C
Exceeded
Enforcement Case
02 - 2002 001
Effluent
Cyanide, Total (as Cn)
02/06/02
2 X month
ug/I
76
86
Daily Maximum Exceeded
BIMS
Pre -Production
03- zoaZ ab t
6 •
TsG
�
lod
�•�i�Y Est x Exce�d��
Violation
04 - 2002 001
Effluent
Cyanide, Total (as Cn)
04/02/02
2 X month
ug/l
76
1,050
Daily Maximum Exceeded
Proceed to
Enforcement Case
10 - 2002 001
Effluent
Cyanide, Total (as Cn)
10/01/02
2 X month
ug/l
76
89
Daily Maximum Exceeded
Proceed to NOV
03 - 2003 001
Effluent
Flow, in conduit or thru treatment
03/31/03
Continuous
mgd
0.68
0.73
Monthly Average Exceeded
Proceed to NOV
plant
Monitoring Violation
MONITORING OUTFALL
VIOLATION
UNIT OF
CALCULATED
REPORT / PPI
LOCATION
PARAMETER
DATE
FREQUENCY
MEASURE
LIMIT
VALUE
VIOLATION TYPE
VIOLATION ACTION
07 - 2003 001
Effluent
Chlorine, Total Residual
07/05/03
2 X week
mg/l
Frequency Violation
None
08 - 2003 001
Effluent
Chlorine, Total Residual
08/02/03
2 X week
mg/I
Frequency Violation
None
01 - 2002 001
Effluent
DO, Oxygen, Dissolved
01/12/02
Weekly
mg/l
Frequency Violation
BIMS
Pre -Production
Violation
Reporting Violation
MONITORING OUTFALL
VIOLATION
UNIT OF
CALCULATED
REPORT / PPI
LOCATION
PARAMETER
DATE
FREQUENCY
MEASURE
LIMIT
VALUE
VIOLATION TYPE
VIOLATION ACTION
05 - 2003
07/01/03
Late/Missing DMR
None

NPDES/Non-Discharge Permitting Unit Pretreatment Information Request Form
OR NONDISCHARGE PERMITTING UNIT COMPLETES THIS PART:
Date of Request 1/21/2004
lFacility,
Mocksville
Permit #
NC0021491 — o cco
Region
Winston-Salem
Re uestor
Dawn Jeffries-NP DES
Pretreatment A-F Towns- Dana Folley (ext. 523)
Contact G-M Towns- Jon Risgaard (ext. 580)
N-Z Towns- Deborah Gore (ext. 593)
PRETREATMENT UNIT COMPLETES THIS PART:
Status of Pretreatment Program (circle all that apply)
1) the facility has no SW's and does have a Division approved Pretreatment Program that is INACTIVE
2) the facility has no SIU's and does not have a Division approved Pretreatment Program
3) the facility has (or is developing) a Pretreatment o ram
3a) is Full Program with LTMP or 3b) is Motlifietl Program with STMP
4) the facility MUST develop a Pretreatment Program -
u Modified
5) additional conditions regarding Pretreatment attached or listed below
Flaw
Permitted MGD Actual MGD
STMP time frame:
most recent 7/00— yb�ol
Industrial
(J,OTS (i041
Domestic
O, 6 g 0,44
next cycle toes
Pollutant
L
Check List
POC due to
(a)
NPDEVNoo-
STMP
LTMP
T
Discharge
Required
Required by
Frequency at
Frequency at
MP
Permit Limit
by EPA'
503 Sludge"
POC due to SIU•^
Site specific POC Provide Explanallon)"
effluent
effluent
BOD
X
4
QM
TSS
X
4
Q M
NH3
4
M
Arsenic
4
M
Cadmium
4
M
Chromium
4
M
Copper
4
Cyanide
X
4
Q M
Lead
4
0
Mercury
4
M
Molybdenum
4
M
Nickel
4
TIT —
Silver
4
Q M
Selenium
X
4
Q
Zinc
J
4
4
M
4
0
4
Q
4
4
Q
a
M
'Always in the LTMP
ail LTMP/STMP effluent data
"Only in the LTMP it the POTW land applies •x_:d
"'Only in LTMP while the SIU is comiecied i, ^ r 11TW
on Di
"' Only in LTMP when the
pollutant �s a spc,,, rem to the POTW (ex -Chlorides for a POTW who accepts Textile waste) Yes
M=Month) Quarterly
Y
_
No (attach data)
Comments:
available in spreadsheet?
Yes No
version IWWD3
NPDES Pretreetmanl.request..form.03t on0Lr
Revised: August 4,2000

Re: Town of Mocksville
Subject: Re: Town of Mocksville
Date: Tue, 17 Feb 2004 08:11:01 -0500
From: Jon Risgaard <[e-mail]>
To: Dawn Jeffries <dawn [e-mail]>
Dawn,
There are two facilities in Mocksville. I assume you are talking about
the Dutchman's Creek facility.
Currently neither of the industries have a cyanide limited, but if they
did the facility will still have just under 90% of there allocation
available using the 22 ug/l limit.
I did not find any indication that the previous high cyanide sampling
results caused the Town to investigate cyanide as a problem.
Jon
Dawn Jeffries wrote:
>Jon,
>I'm finishing up the draft renewal for the Town of Mocksville. In it
>therr daily max limit for cyanide is being reduced from 76µg/1 to
>22µg/1. I notice that they violated the limit three times in 2002 (but
>none in 2003). Was there a problem there that was identified and
>solved, or do you think the new lower limit might be a considerable
>problem?
>Dawn Jeffries
>NPDES Unit
1 of 1 �� 2/ 17/2004 8:19 AM

DR. F. W. SLATE
Mayor
Commissioners:
J.C.'BUSTER` CLEARY, Mayor Pro Tom
RICHARD BROADWAY
WILLIAM L. (BILL) FOSTER
LASH GAITHER SANFORD, JR.
VERNON THOMPSON
CHRISTINE W. SANDERS
Town Manager
owan. o/ MocLville
.. 'iNOORPORATED1929
To Mrs. Valery Stephens,
DANIEL L. SMITH
Director of Public Works
171 CLEMENT STREET
MOCKSVILLE, NC 27026 December 21, 2003
The Town of Mocksville is requesting the renewal of Permit #NC0021491 for the
Dutchman's Creek Wastewater Treatment Plant located in Davie County, NC. There
have been no physical changes to the facility since the last permit renewal. The only
structural change was the rebuilding of a clarifier in September of this year. Please call
Nick Slogick, WWTP ORC with any questions at [phone].
oku J Vr
Christine W. Sanders
Town Manager
JACK KELLER
Chief of Pol'we
PHILCROWE
Fire Chief
HENRY P, VAN HOY II
Town Attorney
PHONE [phone] FAX [phone]
E-MAIL lownhall0mooksvllle.con
www.nocksvillenc.org

USGS MAP = MOCKSVILLE, N.C.
USGS MAP = ADVANCE, N.C.
0 2000 4000 6000
SCALE: 1"=2000' CONTOURS AT 10'
GREY ENGINEERING, INc.
TOWN
OF
MOCKSVILLE
Civil Design and Surveying
P.O.Box 9 Mocksville.
P.O.
SHEET
gineering.com 36)751-211028
DUTCHMANS
WWTP
VICINITY MAP
DRAWN BY: G. BULLARD
PROJ. NO.: 102.101.GE
ONE MILE RADIUS
DESIGN 8Y: G. BULLARD
DATE: 12 17 03
OF 1

Sludge Management Plan for Dutchman's Creek Wastewater Plant
The Town of Mocksville currently uses the bio-solids handling company Synagro, Inc. to
handle all of its generated sludge. Synagro, Inc. comes to Dutchman's Creek WWTP
every quarter and land applies the solids on approved sites throughout Davie County.
Synagro, Inc. does a turn -key operation, this includes all testing of the solids, pH
adjustment, and land application. Synagro, Inc. then gives the results to the Town of
Mocksville every quarter and issues a full year report, which is signed by the Town of
Mocksville representative, and distributed to the EPA and State of NC as required.
Nicholas D. Slogick
Dutchman's Creek ORC

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POST AEJA4ACT
a
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TOWN OF MOCKSVILLE, NC
CREEK WWI?
P�oc-rss SCREMArIC
2:

NAME AND PERMIT NUMBER:
FORM
2A
NPDES
APPLICATION OVERVIEW
PERMIT ACTION REQQ/�U/ESTED: RIVEERR/BASIN-
Form 2A has been developed in a modular format and consists of a "Basic Application Information" packet
and a "Supplemental Application Information" packet. The Basic Application Information packet is divided
into two parts. All applicants must complete Parts A and C. Applicants with a design flow greater than or
equal to 0.1 mgd must also complete Part B. Some applicants must also complete the Supplemental
Application Information packet. The following items explain which parts of Form 2A you must complete.
BASIC APPLICATION INFORMATION:
A. Basic Application Information for all Applicants. All applicants must complete questions A.1 through A.B. A treatment works
that discharges effluent to surface waters of the United States must also answer questions A.9 through A.12.
B. Additional Application Information for Applicants with a Design Flow t 0.1 mgd. All treatment works that have design flows
greater than or equal to 0.1 million gallons per day must complete questions B.1 through B.6.
C. Certification. All applicants must complete Part C (Certification).
SUPPLEMENTAL APPLICATION INFORMATION:
D. Expanded Effluent Testing Data. A treatment works that discharges effluent to surface waters of the United States and meets
one or more of the following criteria must complete Part D (Expanded Effluent Testing Data):
1. Has a design flow rate greater than or equal to 1 mgd,
2. Is required to have a pretreatment program (or has one in place), or
3. Is otherwise required by the permitting authority to provide the information.
E. Toxicity Testing Data. A treatment works that meets one or more of the following criteria must complete Part E (Toxicity Testing
Data):
1. Has a design flow rate greater than or equal to 1 mgd,
2. Is required to have a pretreatment program (or has one in place), or
3. Is otherwise required by the permitting authority to submit results of toxicity testing.
F. Industrial User Discharges and RCRA/CERCLA Wastes. A treatment works that accepts process wastewater from any
significant industrial users (SIUs) or receives RCRA or CERCLA wastes must complete Part F (Industrial User Discharges
and RCRA/CERCLA Wastes). SIUs are defined as:
1. All industrial users subject to Categorical Pretreatment Standards under 40 Code of Federal Regulations (CFR) 403.6 and
40 CFR Chapter I, Subchapter N (see instructions); and
2. Any other industrial user that:
a. Discharges an average of 25,000 gallons per day or more of process wastewater to the treatment works (with certain
exclusions); or
b. Contributes a process wastestream that makes up 5 percent or more of the average dry weather hydraulic or organic
capacity of the treatment plant; or
C. Is designated as an SIU by the control authority.
G. Combined Sewer Systems. A treatment works that has a combined sewer system must complete Part G (Combined Sewer
Systems).
ALL APPLICANTS MUST COMPLETE PART C (CERTIFICATION)
EPA Form 3510-2A (Rev.1-99). Replaces EPA lorrns 7550-6 & 7550-22. Pagel 022

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVf R BASIN: '
Cxak plc o 1119/����-P��
BASIC APPLICATION INFORMATION
PART A. BASIC APPLICATION INFORMATION FOR ALL APPLICANTS: .. -
All treatment works must complete questions A.1 through A.8 of this Basic Application Information Packet.
A.I. Facility Information.
�Gi..Q� `t/ P
Facility Name I t/U[ /Yi%LVR.0 1 W
�JI
~
I • I �-�/N.
V!
Mailing Address ;
Contact Person Al, a C/o a i-o
�r
Title iVk/ IT /-/3 /C C 0.
Telephone Number (356, IX51 - a6-a
/J
(J � Kook
9A o��/f/t
Facility Address voo�c/-e
,�/�
(not P.O. Box)
A.2. Applicant Information. If the applicant is different from the above, provide the following:
Applicant Name l CC�^L� U -
DCiy -
rO
I ry /
Mailing Address l�K/N'/,.,I—
7'd�� 0 C/4L '-&0 2� N.
//
Contact Person Ali (° K ,� lo7liLk
W,
{/�'�
Title %LP 0. �.
'f_
r�
Telephone Number (336) / S / "
Is the applicant the owner or operator (or both) of the treatment works?
owner 9 operator
Indicate whether correspondence regarding this permit should be directed to the facility or the applicant.
❑ facility applicant
A.3. Existing Environmental Permits. Provide the permit number of any existing environmental pennits that have been issued to the treatment works
(include state -issued permits).
�1
NPDES Ale OO d I 11 c%1 PSD
UIC Other
RCRA Other
A.4. Collection System Information. Provide information on municipalities and areas served by the facility. Provide the name and population of each
entity and, if known, provide information on the type of collection system (combined vs. separate) and Its ownership (municipal, private, etc.).
Name Population Served Type of Collection System Ownership
Z12
l e)Q, flocks(-.c%& 90
Total population served
EPA Forte 3510-2A (Rev. 1-99). Replaces EPA fortes 7550.E & 7550-22. Page 2 of 22

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
a.,k & 00;a / q q/ 11_Wngzu a� 1 -, P. &Q-
A.S. Indian Country.
a. Is the treatment works located in Indian Country?
❑ Yes WNo
b. Does the treatment works discharge to a receiving water that is either in Indian Country or that is upstream from (and eventually flows
through) Indian Country?
❑ Yes WNo
A.6. Flow. Indicate the design flow rate of the treatment plant (i.e., the wastewater flow rate that the plant was built to handle). Also provide the
average daily flow rate and maximum daily flow rate for each of the last three years. Each year's data must be based on a 12-month time period
with the 12'' month of "this year
//occurring no more than three months prior to this application submittal.
a. Design flow rate 0. (v 90 mgd
Two Years AQo Last Year This Year
b. Annual average daily flow rate �� 7 �� 50 S c �- So 3
C. Maximum daily flow rate �.. 15 r!'! 000
A.7. Collection System. Indicate the type(s) of collection system(s) used by the treatment plant. Check all that apply. Also estimate the percent
contribution (by Iles) of each.
Separate sanitary sewer / 00 %
❑ Combined storm and sanitary sewer %
A.B. Discharges and Other Disposal Methods.
a. Does the treatment works discharge effluent to waters of the U.S.? Oyes
If yes, list how many of each of the following types of discharge points the treatment works uses:
I. Discharges of treated effluent
ii. Discharges of untreated or partially treated effluent
iii. Combined sewer overflow points
iv. Constructed emergency overflows (prior to the headworks)
V. Other
b. Does the treatment works discharge effluent to basins, ponds, or other surface Impoundments
that do not have outlets for discharge to waters of the U.S.? ❑ Yes
If yes, provide the following for each surface impoundment:
Location:
Annual average daily volume discharge to surface impoundment(s)
Is discharge ❑ continuous or ❑ intermittent?
C. Does the treatment works land -apply treated wastewater?
If yes, provide the following for each land application site:
d.
Location:
Number of acres:
Annual average daily volume applied to site:
Is land application ❑ continuous or ❑ intermittent?
Does the treatment works discharge or transport treated or untreated wastewater to another
treatment works?
❑ No
WNo
mgd
❑ Yes X No
mgd
❑ Yes No
EPA Form 3510-2A (Rev.1-99). Replaces EPA forms 7550-6 & 7550-22. Page 3 of 22

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
;fel'mac� LeL /V e 00 4 r-VO�L-
If yes. describe the mean(s) by which the wastewater from the treatment works is discharged or transported to the other treatment works
(e.g., tank truck, pipe).
If transport is by a party other than the applicant, provide:
Transporter Name
Mailing Address
Contact Person
Title
Telephone Number { }
For each treatment works that receives this discharge, provide the following:
Name
Mailing Address
Contact Person
Title
Telephone Number { )
If known, provide the NPDES permit number of the treatment works that receives this discharge
Provide the average daily flow rate from the treatment works into the receiving facility. mgd
e. Does the treatment works discharge or dispose of its wastewater in a manner not included
in A.S. through A.8.d above (e.g., underground percolation, well injection): ❑ Yes X No
If yes, provide the following for each disposal method:
Description of method (including location and size of site(s) if applicable):
Annual daily volume disposed by this method:
Is disposal through this method ❑ continuous
or ❑ intermittent?
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 4 of 22

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
1_-`)It &11» I c c_h CLO'cl, /U ('oc) l'-/ q I I CC u,, l,,a— Poq�,-.-
WASTEWATER DISCHARGES:
If you answered "Yes" to question A.8.acomplete questions A.9 through A.12 once for each outfail (including bypass points) through
which effluent is discharged. Do not Include information on combined sewer overflows in this section. If you answered "No" to question
Aj& go to Part B, "Additional Application Information for Applicants with a Design Flow Greater than or Equal to 0.1 mgd."
A.9. Description of Outfall.
a. Outfall number
b. Location /"/ o t" k .S cu "Ile
c1 10 a{ x
(City or town, If applicable)
(Zip Code)
A/ C
(County)
(State)
35°53'.33
8003v'07"
(Latitude)
(Longitude)
C. Distance from shore (if applicable)
A/4 ft.
d. Depth below surface (if applicable)
& A ft.
e. Average daily flow rate
, S v2.3 177 JCL mgd
f. Does this outfall have either an Intermittent or a periodic discharge?
❑ Yes 5<0No (go to A.9.g.)
If yes, provide the following Information:
Number f times per year discharge occurs:
Average duration of each discharge:
Average flow per discharge:
Months in which discharge occurs:
g. Is outfali equipped with a diffuser?
I A.10. Description of Receiving Waters.
a. Name of receiving water
❑ Yes X No
_[�:)/" �C aQx ce e-ek
Name of watershed (if known)
United States Soil Conservation Service 14-digit watershed code (if known):
Name of State Management/River Basin (if known)-
United States Geological Survey 8-digit hydrologic cataloging unit code (if known):
Critical low flow of receiving stream (if applicable)
acute
cfs
e. Total hardness of receiving stream at critical low flow (If applicable):
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-2-2.
chronic
mgd
cis
mgA of CaCO3
Page 5 of 22

FACILITY NAME AND NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
ok
//PERMIT
J(✓�
/ L2.•��e
A.11. Description of Treatment
a. What level of treatment are provid ? Check all that apply.
Primary Secondary
❑ Advanced ❑ Other. Describe:
b. Indicate the following removal rates (as applicable):
Design BODS emoval or Design CBOD5 removal 75
Design SS removal 5 %
p1
/ Design P removal v fi
5
Design N removal %
Other
C. What type of disinfection is used for the effluent from this outfall? If disinfection varies by season, please describe:
C/
Q a,
N
If disinfection is by IvIorinalion is dechiorination used for this outfall? ❑ Yes }zj No
(❑
Does the treatment plant have post aeration? Y& Yes No
A.12. Effluent Testing Information. All Applicants that discharge to waters of the US must provide effluent testing data for the following
parameters. Provide the indicated effluent testing required by the permitting authority for each outfall through which effluent is
discharged. Do not include Information on combined sewer overflows in this section. All Information reported must be based on data
collected through analysis conducted using 40 CFR Part 136 methods. In addition, this data must comply with OA/OC requirements of
40 CFR Part 136 and other appropriate OA1QC requirements for standard methods for analytes not addressed by 40 CFR Part 136. At a
minimum, effluent testing data must be based on at least three samples and must be no more than four and one-half years apart.
Outfall number. 0 0'
PARAMETER
MAXIMUM DAILY VALUE
AVERAGE DAILY VALUE
Value
Units
Value
Units
Number of Samples.
_
PH (Minimum)
SM.
PH (Maximum)
s.u.
Flow Rate
Temperature (Winter)
'/°
0C
8O
° C_
300
Temperature (Summer)
a5'
cc
'� a- °
C..
For pH please report a minimum
and a maximum dailv value
MAXIMUM DAILY
DISCHARGE
1. AVERAGE DAILY DISCHARGE
-
ANALYTICAL
POLLUTANT
' METHOD
ML/MDL
Nurr f
- Conc.
Units
Cond.
Units
Samples.
CONVENTIONAL AND NON CONVENTIONAL COMPOUNDS
BIOCHEMICAL OXYGEN
GODS
S. j r1
177,5 �L
3. 7 I
m %L
N
sm sa i 0 %3
-,`/ 36
DEMAND (Report one)
CBODS
FECAL COLIFORM
t � o
ryf /G
7 o
/Y1, A
14 $
Sm V)a b
0-00 Z/00
TOTAL SUSPENDED SOLIDS (TSS)
(� . O
%i •� /L
j 'f
�+7) /C
7{^S
[ P; 2 Q, a
30 lYS
END OF PART A.
REFER TO THE APPLICATION OVERVIEW (PAGE 1) TO DETERMINE WHICH OTHER PARTS
OF FORM 2A YOU MUST COMPLETE
EPA Form 3510-2A (Rev. 1.99). Replaces EPA fortes 7550-6 & 7550.22. Page 6 of 22

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
r���Q�
��.
Q
a�,
--per � —
C! kylOW, W*­i4l�"�
-APPL1Cq9N-INF RMt
FORA WITHA _
ITIONALGREATER APP
qA,TION.INFORM ATION
ESIGN* FLOW THAN tA L,1
wD
Q (190,"9alonSrperCa j.ay,
All applicants with a design flow rate 2: 0.1 mgd must answer questions B.1 through B.6. All others go to Part C (Certification).
B.I. Inflow and Infiltration. Estimate the average number of gallons per day that flow into the treatment works from inflow and/or infiltration.
0) 000 gpd
inflow infiltration.
Briefly explain �an steps underway or I nned.to min?iZlq
C?UA'k_ Ck Q-* "I" gL24
P 4C-
8.2. Topographic Map. Attach to this application a topographic map of the area extending at least one mile beyond facility property boundaries. This
map must show the outline of the facility and the following information. (You may submit more than one map if one map does not show the entire
area.)
a. The area surrounding the treatment plant, including all unit processes.
b. The major pipes or other structures through which wastewater enters the treatment works and the pipes or other structures through which
treated wastewater is discharged from the treatment plant. Include outfalls from bypass piping, if applicable.
c. Each well where wastewater from the treatment plant is injected underground.
d. Wells, springs, other surface water bodies, and drinking water wells that are: 1) within % mile of the property boundaries of the treatment
works. and 2) listed In public record or otherwise known to the applicant.
e. Any areas where the sewage sludge produced by the treatment works is stored, treated, or disposed.
f. If the treatment works receives waste that is classified as hazardous under the Resource Conservation and Recovery Act (RCRA) by truck, rail,
or special pipe, show on the map where the hazardous waste enters the treatment works and where It is treated, stored, and/or disposed.
B.& Process Flow Diagram or Schematic. Provide a diagram showing the processes of the treatment plant, including all bypass piping and all
backup power sources or redunancy in the system. Also provide a water balance showing -all treatment units, including disinfection (e.g.,
chlorination and dechlodnation). The water balance must show daily average flow rates at influent and discharge points and approximate daily flow
rates between treatment units. Include a brief narrative description of the diagram.
8.4. Operation/Maintenance Performed by Contractor(s).
Are any operational or maintenance aspects (Z%tpd to wastewater treatment and effluent quality) of the treatment works the responsibility of a
contractor? [3 Yes )�� No
It yes, list the name, address, telephone number, and status of each contractor and describe the contractor's responsibilities (attach additional
pages if necessary).
Name:
Mailing Address:
Telephone Number.
Responsibilities of Contractor.
B.5. Scheduled Improvements and Schedules of Implementation. Provide Information on any uncompleted implementation schedule or
uncompleted plans for improvements that will affect the wastewater treatment, effluent quality, or design capacity of the treatment works. If the
treatment works has several different implementation schedules or is planning several improvements, submit separate responses to question B.5
for each. (If none, go to question B.6.)
List the outfall number (assigned in question A .9) for each outfall that is covered by this implementation schedule.
rb Indicate whether the planned Improvements or implementation schedule are required by local, State, or Federal agencies.
0 Yes [I No
rdo_
0_44-
0. OLG t�6(
EPA Forrn 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 7 of 22

FACILITY NAME AND PERMIT `�NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
ct Ma.Jh 6wj- , W C-ood i'M
r�
1C6LP e_e 12 e
C. If the answer to B.5.b is Wes," briefly describe, including new maximum daily inflow rate (if applicable).
d. Provide dates imposed by any compliance schedule or any actual dates of completion for the implementation steps listed below, as
applicable. For improvements planned independently of local, State, or Federal agencies, indicate planned or actual completion dates, as
applicable. Indicate dates as accurately as possible.
Schedule Actual Completion
Implementation Stage MM/DD/YYYY MM/DD/YYYY
- Begin Construction
- End Construction
- Begin Discharge
- Attain Operational Level /
e. Have appropriate permits/clearances concerning other Federal/State requirements been obtained? ❑ Yes ❑ No
Describe briefly:
B.6. EFFLUENT TESTING DATA (GREATER THAN 0.1 MGD ONLY).
Applicants that discharge to waters of the US must provide effluent testing data for the following parameters. Provide the indicated
effluent testing required by the permitting authority for each outfall through which effluent Is discharged. Do not Include information
on combine sewer overflows In this section. All information reported must be based on data collected through analysis conducted
using 40 CFR Part 136 methods. In addition, this data must comply with QA/QC requirements of 40 CFR Part 136 and other appropriate
QA/QC requirements for standard methods for analytes not addressed by 40 CFR Part 136. At a minimum effluent testing data must be
based on at least three pollutant scans and must be no more than four and on -halt years old.
Outfall Number: 001
MAXIMUM DAILY
DISCHARGE
AVERAGE DAILY DISCHARGE
POLLUTANT
-
ANALYTICAL
METHOD
MUMDL
Conc,
Units
Conc.
Units
of
ber Smples
' Samples
CONVENTIONAL AND NON CONVENTIONAL COMPOUNDS
AMMONIA (as N)
[/0 10
n l.5
0.37
iqJ L
o"i y
E p,4 3 50. 1
i-i
CHLORINE (TOTAL
RESIDUAL, TRC)
/r 3a
/7JJ/[,
0. "�
/Y/5/L
�-��
/j/
'Vo%e
DISSOLVED OXYGEN
C D 0
7.7 a
m• l[
'a. H
5.0
TOTAL KJELDAHL
NITROGEN (TKN)
t/
/" (
A_0.'1
q
1
{» k
EPA351 i
NITRATE PLUS NITRITE
NITROGEN
,,QQ
?77
6. q D-
m S`L
�.
EP,435 3.-1
OIL and GREASE
PHOSPHORUS (Total)
S 6
&
2
M :J �[
PPR 365. a-
,1d
N ,
TOTAL DISSOLVED SOLIDS
(TDS)
OTHER Te,-f,,l N.+r_'r"
�y.
/>I /C
7.3/
'nJ L
2
N..L
END OF PART B.
REFER TO THE APPLICATION OVERVIEW (PAGE 1) TO DETERMINE WHICH OTHER PARTS
OF FORM 2A YOU MUST COMPLETE
a�
n
EPA Form 3510.2A (Rev. 1-99). Replaces EPA forms 7550-6& 7550-22. Page 8 of 22

OACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
Oy /iiQ/
BASIC APPLICATION INFORMATION
PART C. CERTIFICATION " •r - �' - }
1 „ 'AAnw
All applicants must complete the Certification Section. Refer to instructions to determine who is an officer for the purposes of this
certification. All applicants must complete all applicable sections of Form 2A, as explained in the Application Overview. Indicate below which
parts of Form 2A you have completed and are submitting. By signing this certification statement, applicants confirm that they have reviewed
Form 2A and have completed all sections that apply to the facility for which this application is submitted.
which parts of Form 2A you have completed and are submitting:
-IndiiYate
17 Basic Application Information packet Suppl mental Application Information packet:
TTTSSS Pan D (Expanded Effluent Testing Data)
Part E (Toxicity Testing: Biomonitoring Data)
Part F (Industrial User Discharges and RCRAICERCLA Wastes)
❑ Part G (Combined Sewer Systems)
ALL APPLICANTS MUST COMPLETE THE FOLLOWING CERTIFICATION. .
I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system
designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who
manage the system or those persons directly responsible for gathering the information, the information 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.
(l t� rl-44'ir �cVirs i at:n AAar]
Name and official title xQr
tIw, ,t
/`� ✓V t &r4tt� Cj
Signature \
Telephone number (33L) -z 51 - 22S 9
Date signed 12� 3 t 1133
Upon request of the permitting authority, you must submit any other information necessary to assure wastewater treatment practices at the treatment
works or Identify appropriate permitting requirements.
SEND COMPLETED FORMS TO:
NCDENR/ DWO
Attn: NPDES Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 9 of 22

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
(fir
LU&6'�710"eb 6LQ24/� �/�00Xq1
1Qx&v6L
! �lZk� zC.!Pe,4_2%.
rs �i-ly ..? - .- •- t a 7 ! �j r.. tom. ,,� _ -- ut �e :�..�� �.r - LA. • � �.r. .
SUPPLEMENT�AyA P 1G�A 14 INFORlIIIATIOr`i=$td{6t4�,,*µ�crA:��yR lijr•�Y+f �-
?4 ♦ T f {�:.i'3
r Y '{ i-yyqQj i S'Y T
PART D.. EXPANDE METTESTING DATA ==�;:��?"` t�, "� x'♦ ,-�
Cr
-I.. �.:
rJ• Q-YY7:S/.l' • ';.,R. Nr .r:.4 :.- �•�! i4:YK''. �t.T-..it tF .
Refer to the directions on the cover page to determine whether this section applies to the treatment works.
Effluent Testing: 1.0 mgd and Pretreatment Works. If the treatment works has a design flow greater than or equal to 1.0 mgd or it has (or is required
to have) a pretreatment program, or is otherwise required by the permitting authority to provide the data, then provide effluent testing data for the following
pollutants. Provide the indicated effluent testing information and any other information required by the permitting authority for each outfall through which
effluent is discharged. Do not include information on combined sewer overflows in this section. All information reported must be based on data collected
through analyses conducted using 40 CFR Part 136 methods. In addition, these data must comply with 0A10C requirements of 40 CFR Part 136 and
other appropriate 0A10C requirements for standard methods for analytes not addressed by 40 CFR Part 136. Indicate in the blank rows provided below
any data you may have on pollutants not specifically listed in this form. At a minimum, effluent testing data must be based on at least three pollutant
scans and must be no more than four and one-half years old.
Outfall number: 0 0/ (Complete once for each outfall discharging effluent to waters of the United States.)
MAXIMUM DAILY DISCHARGE:-
= AVERAGE DAILY DISCHARGE
POLLUTANT t
r
ANALYTICAL
METHOD
�?�yi+✓�r'y: t
MUMDL
,, �
Conc
r -
Units'
Mass
Units :
�:
Conc.
. ,
, Units;
Mass
4 3
Units ,
Nui be '
x ,�- �•
.f $
1�tgo
es
,y
METALS (TOTAL RECOVERABLE), CYANIDE, PHENOLS, AND HARDNESS.
ANTIMONY
ARSENIC
BERYLLIUM
CADMIUM
;20670d
'u°JlL
<j'000
t ?6-
GP,4Doc).7
�V ► L
CHROMIUM
,ter,
uJ %L
15.VC0
a.
C p11 900# 7
Al I.
COPPER
0.04P
►y79�L
CI.OG�%
m��L
LEAD
/O,D
At /L
E-pl)a ov . v
// .
MERCURY
NICKEL
t0V
•Ll /c.
/o, o
SELENIUM
SILVER
0.00 Sr
#uk
<O.CbS
Y25k
� o�
�/ �� o7m. 7'
THALLIUM
ZINC
, I a 1
In
A, 06�
m 5 IL
! a-
� �A a:C�, i
/
CYANIDE
C p
/
E/ 11 3 35, of
'76.0 aV
TOTAL PHENOLIC
COMPOUNDS
HARDNESS (as CaCO3)
Use this space (or a separate sheet) to provide information on other metals requested by the permit writer
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 10 of 22

FACILITY NAME AND PERMIT NUMBER:
L f I4 Ve v')rv9
PERMIT ACTION REQUESTED:
RIVER BASIN:
Chronic:
NOEC
%
%
IC2s
%
%
%
Control percent survival
%
%
%
Other(describe)
m. Quality Control/Quality Assurance.
Is reference toxicant data available?
Was reference toxicant test within
acceptable bounds?
What date was reference toxicant test
run (MMIDD/YYYY)?
Other(describe)
E.3. Toxicity Reduction Evaluation. Is the treatment works involved in a Toxicity Reduction Evaluation?
Yes If yes, describe:
EA. Summary of Submitted Biomonitoring Test Information. If you have submitted biomonitoring test information, or information regarding the
cause of toxicity, within the past four and one-half years, provide the dates the information was submitted to the permitting authority and a summary
of the results.
Date submitted: / / (MMIDDIYYYY)
Summary of results: (see instructions)
END OF PART E.
REFER TO THE APPLICATION OVERVIEW (PAGE 1) TO DETERMINE WHICH OTHER PARTS
OF FORM 2A YOU MUST COMPLETE.
EPA Form 3510-2A (Rev. 1.99). Replaces EPA forms 7550-6 & 7550-22. Page 17 of 22

FACILITY NAME AND PERMIT UMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
N 0 0 02 /1-12L
SUPPLEMENTAL APPLICATION INFORMATION ,
PART F.INDUSTRIAL USER DISCHARGES AND RCRA/CERCLA-WASTES
All treatment works receiving discharges from significant industrial users or which receive RCRA,CERCLA, or other remedial wastes must
complete part F.
GENERAL INFORMATION:
F.1. Pretreatment program. Does the treatment works have, or is subject ot, an approved pretreatment program?
AYes ❑ No
F.2. Number of Significant Industrial Users (SIUs) and Categorical Industrial Users (CIUs). Provide the number of each of the following types of
Industrial users that discharge to the treatment works.
a. Number of non -categorical SIUs.
b. Number of CIUs. 1
SIGNIFICANT INDUSTRIAL USER INFORMATION:
Supply the following information for each SIU. If more than one SIU discharges to the treatment works, copy questions F.3 through F.8 and
provide the Information requested for each SIU.
F.3. Significant Industrial User Information. Provide the name and address of each SIU discharging to the treatment works. Submit additional pages
as necessary.
Name: ayC
Mailing Address: J -� / o4 k
Iq O W<;b 0 C.E 6 71 e.
F.4. Industrial Processes. Describe all the industrial processes that affect or contribute to the SIU's discharge.
LL&d,-
fs
%...' U
F.S. Principal Product(s) and Raw Material(s). Describe all of the principal processes and raw materials that affect or contribute to the SIU's
discharge. ! o, ,, /'
e V G-K.�//
Principal Q�G( G c l.w` C•
product(s): c� �i/"t.�
r
Raw material(s):
F.6. Flow Rate.
a. Process wastewater flow rate. Indicate the average daily volume of process wastewater discharge into the collection system In gallons per
day (gpd) and whether the discharge is continuous or intermittent.
7 ✓+ (90 gpd ( continuous or intermittent)
b. Non -process wastewater flow rate. Indicate the average daily volume of non -process wastewater flow discharged into the collection system
In gallons per day (gpd) and whether the discharge is continuous or intermittent.
gpd ( continuous or _A"' intermittent)
F.7. Pretreatment Standards. Indicate whether the SIU is subject to the following:
a. Local limits 'WYes ❑ No
b. Categorical pretreatment standards ❑ Yes W'No
If subject to categorical pretreatment standards, which category and subcategory?
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 1S of 22

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN;
, x
y�' ,
c-o
rQ
I Q-C-- J114212-
F.B. Problems at the Treatment Works Attributed to Waste Discharge by the SIU. Has the SIU caused or contributed to any problems (e.g.,
upsets, Interference) at the Ir ment works in the past three years?
❑ Yes No it yes, describe each episode.
RCRA HAZARDOUS WASTE RECEIVED BY TRUCK, RAIL, OR DEDICATED PIPELINE:
F.9. RCRA Waste. Does the treatment works receive or has it in the past three years received RCRA hazardous waste by truck, rail or dedicated pipe?
❑ Yes XNo (go to F.12)
F.10. Waste transport. Method by which RCRA waste is received (check all that apply):
❑ Truck ❑ Rail ❑ Dedicated Pipe
F.11. Waste Description. Give EPA hazardous waste number and amount (volume or mass, specify units).
EPA Hazardous Waste Number Amount Units
CERCLA (SUPERFUND) WASTEWATER, RCRA REMEDIATIOWCORRECTIVE ACTION
WASTEWATER, AND OTHER REMEDIAL ACTIVITY WASTEWATER:
F.12. Remedlation Waste. Does the treatment works currently (or has it been notified that h will) receive waste from remedial activities?
❑ Yes (complete F.13 through F.15.) �No
F.13. Waste Origin. Describe the site and type of facility at which the CERCLAIRCRAfor other remedial waste onginates (or Is excepted to origniate in
the nerd live years).
F.14. Pollutants. List the hazardous constituents that are received (or are expected to be received). Include data on volume and concentration. If
known. (Attach additional sheets if necessary.)
F.15. Wasle Treatment.
a. Is this waste treated (or will be treated) prior to entering the treatment works?
❑ Yes ❑ No
If yes, describe the treatment (provide information about the removal efficiency):
b. Is the discharge (or will the discharge be) continuous or intermitten17
❑ Continuous ❑ Intermittent If intermittent, describe discharge schedule.
Page 19 of 22
EPA Farts 35107A (Rev. 1.99). Replaces EPA forma 755n•68 7550.22.

'FACILITY NAME AND PERMIT UMBER: q PERMIT ACTION REOUESTED: RIVER BASIN:
lOzxeic -
-SUPPL€MENTAL APPLECATION INF©RMATIQN
ARTS IN )USTRIALUS40 MSCHARC�ES-
All treatment works receiving discharges from signiRcant Industrial users or which receive RCRA.CERCLA, or other remedial wastes must
complete part F.
GENERAL INFORMATION:
F.I. Pretreatment program. Does the treatment works have, or is subject of, an approved pretreatment program?
Yes ❑ No
F.2- Number of Significant Industrial Users (SIUs) and Categorical Industrial Users (CIUs). Provide the number of each of the following types of
industrial users that discharge to the treatment works.
a. Number of non -categorical SIUs.
b. Number of CIUs.
SIGNIFICANT INDUSTRIAL USER INFORMATION:
Supply the following information for each SIU. If more than one SIU discharges to the treatment works, copy questions F.3 through F.B and
provide the information requested for each SIU.
F.3. Significant Industrial User Information. Provide the name and address of each SIU discharging to the treatment works. Submit additional pages
as necessary. {/n
Name:J/Yi _ /l. ollvl1
Mailing j �eA r,Q
F.A. Industrial Processes. Describe all the industrial processes that affect or contribute to the SII,U''s- discharge. wp� Ti (tir Ce It ^ Gy� ✓( iN N 04)1 4,6 Gc* to e� , �d,�) 4"!C .
F.S. Principal Product(s) and Raw Material(s). Describe all of the principal processes and raw materials that affect or contribute to the SIU's
discharge.
Principal product(s): 11- ,, %
Raw materiels) rYYt.P.i� %JQy,�.c.'6 /( r1-..er•e-u UQc. ck,FJ�) Tve /J C<,+ s
F.B. Flow Rate.
a. Process wastewater flow rate. Indicate Ih0 average daily volume of process wastewater discharge into the collection system In gallons per
day (gpd) and whether the discharge Is continuous or Intermittent.
(20O OBb god ( continuous or �_ intermittent)
b. Non -process wastewater flow rate. Indicate the average daily volume of non -process wastewater flow discharged into the collection system
in gallons per day -(gpd) and whether the discharge is continuous or Intermittent.
gpd ( continuous or / Intermittent)
F.7. Pretreatment Standards. Indicate whether the SIU is subject to the following;
I a. Local limits IVYes ❑ No
b. Categorical pretreatment standards xYes ❑ No
If subject to categorical pretreatment standards, which category and subcategory?
!!2o o Fh Li33. 5- j
EPA Form 3510.2A (Rev. 149). Replaces EPA forms 7550-6 & 7550.22. Page 18 of 22

FACILITY NAME AND PERMIT NUMBER:
e c.d, if/e x I
PERMIT ACTION REQUESTED:
RIVER BASIN: n(�
�w 't J-e-r' ee
F.B. Problems at the Treatment Works Attributed to Waste Discharge by the SIU. Has the SIU caused or contributed to any problems (e.g.,
upsets, interference) at the treatment works in the past three years?
❑ Yes �SNo If yes, describe each episode.
RCRA HAZARDOUS WASTE RECEIVED BY TRUCK, RAIL, OR DEDICATED PIPELINE:
F.B. RCRA Waste. Does the treatment works receive or has it in the past three years received RCRA hazardous waste by truck, rail or dedicated pipe?
❑ Yes X No (go to F.12)
F.10. Waste transport. Method by which RCRA waste is received (check all that apply):
❑ Truck ❑ Rail ❑ Dedicated Pipe
F.11. Waste Description. Give EPA hazardous waste number and amount (volume or mass, specify units).
EPA Hazardous Waste Number Amount Units
CERCLA (SUPERFUND) WASTEWATER, RCRA REMEDIATION/CORRECTIVE ACTION
WASTEWATER, AND OTHER REMEDIAL ACTIVITY WASTEWATER:
F.12. Remedlatlon Waste. Does the treatment works currently (or has it been notified that it will) receive waste from remedial activities?
❑ Yes (complete F.13 through F.15.) XNo
F.13. Waste Origin. Describe the site and type of facility at which the CERCLAIRCRAtor other remedial waste originates (or is excepted to origniate in
the next five years).
F.14. Pollutants. List the hazardous constituents that are received (or are expected to be received). Include data on volume and concentration, if
known. (Attach additional sheets If necessary.)
F.15. Waste Treatment.
a. Is this waste treated (or will be treated) prior to entering the treatment works?
❑ Yes Aj No
If yes, describe the treatment (provide information about the removal efficiency):
b. Is the discharge (or will the discharge be) continuous or intermittent?
❑ Continuous ❑ Intermittent If intermittent, describe discharge schedule.
END OF PART F.
REFER TO THE APPLICATION OVERVIEW (PAGE 1) TO DETERMINE WHICH OTHER PARTS
OF FORM 2A YOU MUST COMPLETE
EPA Form 3510.2A (Rev. 1-99). Replaces EPA fors 7550-6 & 7550-22.
Page 19 of 22

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
A'(!00a1qq1_.rt
Moak
Q % • e
SUPPLEMENTAL APPLICATION INFORMATION -�
PART G. COMBINED SEWERZYSTEMS �
z ..1 .di3 cT.. .e-• .1� 1. -�. t.. N.-. ;. .N}- .aA!`.r aFa'Q
If the treatment works has a combined sewer system, complete Part G.
G.I. System Map. Provide a map indicating the following: (may be included with Basic Application Information)
a. All CSO discharge points.
b. Sensitive use areas potentially affected by CSOs (e.g., beaches, drinking water supplies, shellfish beds, sensitive aquatic ecosystems, and
outstanding natural resource waters).
C. Waters that support threatened and endangered species potentially affected by CSOs.
G.2. System Diagram. Provide a diagram, either in the map provided in G.1 or on a separate drawing, of the combined sewer collection system that
includes the following information.
a. Location of major sewer trunk lines, both combined and separate sanitary.
b. Locations of points where separate sanitary sewers feed into the combined sewer system.
C. Locations of in -line and off-line storage structures.
d. Locations of flow -regulating devices.
e. Locations of pump stations.
CSO OUTFALLS:
Complete questions G.3 through G.6 once for each CSO discharge point.
G.3. Description of Outfall.
a. Outfall number
b. Location
(City or town, if applicable) (Zip Code)
(County) (State)
(Latitude) (Longitude)
C. Distance from shore (if applicable) ft.
d. Depth below surface (if applicable) ft.
e. Which of the following were monitored during the last year for this CSO?
❑ Rainfall ❑ CSO pollutant concentrations ❑ CSO frequency
❑ CSO flow volume ❑ Receiving water quality
f. How many storm events were monitored during the last year?
GA. CSO Events.
a. Give the number of CSO events in the last year.
events (❑ actual or ❑ approx.)
b. Give the average duration per CSO event.
hours (❑ actual or ❑ approx.)
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 20 of 22

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
C. Give the average volume per CSO event.
million gallons (❑ actual or ❑ approx.)
d. Give the minimum rainfall that caused a CSO event in the last year
Inches of rainfall
G.5. Description of Receiving Waters.
a. Name of receiving water:
b. Name of watershed/river/stream system:
United State Soil Conservation Service 14-digit watershed code (if known):
C. Name of State Management/River Basin:
United States Geological Survey 8-digit hydrologic cataloging unit code (if known):
G.6. CSO Operations.
Describe any known water quality impacts on the receiving water caused by this CSO (e.g., permanent or intermittent beach closings, permanent or
intermittent shell fish bed closings, fish kills, fish advisories, other recreational loss, or violation of any applicable State water quality standard).
TI END OF PART G.
REFER TO -THE APPLICATION OVERVIEW (PAGE`1) TO DETERMINE WHICH OTHER PARTS
OF FORM 2A YOU MUST COMPLETE.'
EPA Form 3510-2A (Rev. 1-99). Replaces EPA tons 7550-6 8 7550-22. Page 21 of 22