NC0038831_owner name change_20170112

ROY COOPER
covemor
S. JAY ZIMMERMAN
Director
Water Resources
ENVIRONMENTAL QUALITY
January 12, 2017
Mr. Matthew Klein
Carolina Water Service, Inc. of North Carolina
PO Box 240908
Charlotte, NC 28224-0908
Subject: Minor modification of NPDES Permit NCO038831
Carolina Trace WWTP
Lee County
Dear Mr. Klein:
The Division has received and approved your request to transfer ownership of the subject permit.
As a result, the Division hereby reissues NC0038831. 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). Insert the
attached page into your permit and discard the old page.
This modified permit includes the following changes from your current permit:
➢ Change of ownership from Carolina Trace Utilities, Inc. to Carolina Water Service, Inc. of North
Carolina.
➢ Section A.(7) has been updated to require electronic submission of effluent data. Federal
regulations require electronic submittal of all discharge monitoring reports (DMRs).
If any parts, measurement frequencies or sampling requirements contained in this modification 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.
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 any other Federal, State, or Local governmental
regulation. If you have any questions concerning this matter, please contact Brianna Young at (919) 807-
6388 or via e-mail [[e-mail]].
r•
Sinc
� C
S. Jay Zimmerman, Dir or
Division of Water Resources
cc: Central Files
Raleigh 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
https:Hdeq. nc.govlabout/divisionslwater-resourceslwater-resources-permits,/wastewater-branchlnpdes-wastewater-permits

ii
Permit NCO038831
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF WATER RESOURCES
PERMIT
TO DISCHARGE WASTEWATER UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other
lawful standards and regulations promulgated and adopted by the North Carolina
Environmental Management Commission, and the Federal Water Pollution. Control Act,
as amended,
Carolina Water Service, Inc. of North Carolina
is hereby authorized to discharge wastewater from a facility located at the
Carolina Trace WWTP
5448 Cox Mill Road
Sanford
Lee County
to receiving waters designated as the Upper Little River in subbasin 03-06-13 of the Cape Fear
River Basin in accordance with effluent ]imitations, monitoring requirements, and other
conditions set forth in Parts I, II, III and IV hereof.
This permit shall become effective January 12, 2017.
This permit and authorization to discharge `shall expire at midnight on September 30, 2021.
Signed this day January 12, 2017.
S J yZimmerman, P.G., Direc
Division of Water Resources
By Authority of the Environmental Management Commission
Page 1 of 11

Permit NCO038831
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 included
herein.
Carolina Water Service, Inc. of North Carolina
is hereby authorized to:
1. Continue to operate an existing 0.675 MGD wastewater treatment facility
consisting of one (1) 0.325 MGD and one (1) 0.350 MGD plant constructed in
parallel with the following components:
♦ Influent pumping station
♦ Bar screen
♦ Splitter box
♦ 2- Diffused aeration basins at 369,395 gallons and 364,326 gallons
♦ 2- 36 foot clarifiers
♦ 2- Aerobic digestors at 78,818 gallons and 78,419 gallons
♦ 2- Traveling bridge filters at 124 square feet each
♦ UV disinfection
♦ Flow measuring device
The facility is located at the Carolina Trace WWTP (5448 Cox Mill Road) in Lee
County.
2. After receiving an Authorization to Construct (ATC) permit from the Division,
construct and operate additional facilities needed to meet the 1.0 MGD flow, final
effluent limitations and conditions in the permit; and after submitting an
engineering authorization (EA) documenting compliance with the ATC.
3. Discharge from said treatment works via Outfall 001, at the location specified on
the attached map into the Upper Little River [18-20-(8)] currently classified C
waters in subbasin 03-06-13 [HUC: 03030002402] of the Cape Fear River Basin.
Page 2 of 11

4-
Permit NCO038831
Part I
A. (1) EFFLUENT LIMITATIONS AND MONITORING REQUIREMENTS (0.675
MGD)
[15A NCAC 02B.0400 et seq., 15A NCAC 02B.0500 et seq.]
Beginning with the effective date of this permit and lasting until expansion above 0.675 MGD or
expiration, whichever is sooner, the Permittee is authorized to discharge treated wastewater from Outfall
001. Such discharges shall be limited and monitored' by the Permittee as specified below:
EFFLUENT CHARACTERISTICS
Parameter Code
_.
'EFFLUENT. LIMITATIONS . , '
MONITORING REQUIREMENTS
Monthly Average
-Daily Maximum
Measurement
frequency'
Sample
Type ,
. .
..Sample
Location .
Flow 50050
0.676 MGD
Continuous
Recording
Influent or Effluent
BOD, 5-day, (20°C) - Summer* C0310
5.0 mg/L
7.5 mg/L
3Meek
Composite
Effluent
BOD, 5-day, (20°C) - Winter* C0310
10.0 mg/L
15.0 mg/L
3Mleek
Composite
Effluent
Total Suspended Solids C0530
30.0 mg/L
45.0 mg/L
3M/eek
Composite
Effluent
NH3 as N - Summer* C0610
2.0 mg/L
10.0 mg/L
3M/eek
Composite
Effluent
NH3 as N - Winter* C0610
4.0 mg/L
20.0 mg/L
3M/eek
Composite
Effluent
Dissolved Oxygen 00300
Daily average > 5.0 mg/L
3Mleek
Grab
Effluent
Fecal Coliform 31616
(geometric mean)
200/100 ml
400/100 ml
3M/eek
Grab
Effluent
Total Residual Chlorine 3 50060
22 Ng/L
3M/eek
Grab
Effluent
Temperature (*C) 00010
Daily
Grab
Effluent
pH 00400
> 6.0 and < 9.0 standard units
3M/eek
Grab
Effluent
Total Nitrogen C0600
(NO2+NO3+TKN)
Quarterly
Composite
Effluent
Total Phosphorus C0655
Quarterly
Composite
Effluent
Chronic Toxicity 4 TGP38
Quarterly
Composite
Effluent
Fecal Coliform 31616
(geometric mean)
Variable 5
Grab
Upstream &
Downstream 2
Temperature (*C) 00010
Variable 5
Grab
Upstream &
Downstream 2
Dissolved Oxygen 00300
Variable 5
Grab
Upstream &
Downstream 2
*Summer. April 1- October 31
*Winter. November 1- March 31
Footnotes:
1. The permittee shall submit discharge monitoring reports electronically using the NC DWR's eDMR application .
system [see A. (7)].
2. Upstream = at least 100 feet above the outfall. Downstream = at NCSR 1222. Carolina Trace WWTP is a
participant of the Middle Cape Fear Basin Association and thus instream monitoring requirements as specified
in this permit are waived. Should the Carolina Trace WWTP's membership in the association be terminated for
any reason, the Permittee shall notify the Division in writing, and immediately resume instream monitoring
and sampling according to this permit.
3. Limit and monitoring requirements apply only if chlorine is used for disinfection. The facility shall report all
effluent TRC values reported by a NC certified laboratory including field certified. However, effluent values
below 50 µg/L will be treated as zero for compliance purposes.
4. See section A. (4).
5. Variable: instream samples shall be collected 3/week during the summer months of June, July, August,
and September; samples shall be collected weekly during the rest of the year.
Page 3 of 11

Permit NC0038831
THERE SHALL BE NO DISCHARGE OF FLOATING SOLIDS OR VISIBLE FOAM IN OTHER THAN TRACE
AMOUNTS.
A. (2) EFFLUENT LIMITATIONS AND MONITORIING REQUIREMENTS (1.0 MGD)
[15A NCAC 02B.0400 et seq., 15A NCAC 02B.0500 et seq.]
During the period beginning after expansion above 0.675 MGD and lasting until expiration, the
Permittee is authorized to discharge treated wastewater from Outfall 001. Such discharges shall be
limited and .monitored' by the Permittee as specified below:
EFFLUENT CHARACTERISTICS . :4
Parameter Code
:,
EFFLUENT LIMITATIONS
MQNITORING REQUIREMENTS
Monthly Average
i
'Daily Maximum-
Measurement` "
Frequency.
Sample , ^
Type.;
.. - -Sample'',.:
Ao6aflon
Flow 50050
1.0 MGD
Continuous
Recording
Influent or Effluent
BOD, 5-day, (20°C) - Summer* C0310
5.0 mg/L
7.5 mg/L
3Meek
Composite
Effluent
BOD, 5-day, (20°C) - Winter* C0310
10.0 mg/L
15.0 mg/L
3Meek
Composite
Effluent
Total Suspended Solids C0530
30.0 mg/L
45.0 mg/L
3/Week
Composite
Effluent
NH3 as N - Summer* C0610
2.0 mg/L
10.0 mg/L
3/Week
Composite
Effluent
'NH3 as N - Winter* C0610
4.0 mg/L
20.0 mg/L
'3/Week
Composite
Effluent
Dissolved Oxygen 00300
Daily average > 5.0 mg/L
3Meek
Grab
Effluent
Fecal Coliform 31616
(geometric mean)
200/100 ml
400/100 ml
3Meek
Grab
Effluent
Total Residual Chlorine 3 50060
22 Ng/L
3Meek
Grab
Effluent
Temperature (*C) 00010
Daily
Grab
Effluent
pH 00400
> 6.0 and < 9.0 standard units
3Meek
Grab
Effluent
Total Nitrogen
(NO2+NO3+TKN) C0600
Monthly
Composite
Effluent
Total Phosphorus C0655
Monthly
Composite
Effluent
Chronic Toxicity 4 TGP38
Quarterly
Composite
Effluent
Fecal Coliform
(geometric mean) 31616
Variable a
Grab
Upstream &
Downstream 2
Temperature (°C) 00010
Variable 5
Grab
Upstream &Z
Downstream
Dissolved Oxygen 00300
Variable 5
Grab
Upstream &z
Downstream
*Summer. April 1- October 31
*Winter. November 1- March 31
Footnotes:
1. The permittee shall submit' discharge monitoring reports electronically using the NC DWR's eDMR application
system [see A. (7)].
2. Upstream = at least 100 feet above the outfall. Downstream = at NCSR 1222. Carolina Trace WWTP is a
participant of the Middle Cape Fear Basin Association and thus instream monitoring requirements as specified
in this permit are waived. Should the Carolina Trace WWTP's membership in the association be terminated for
any reason, the Permittee shall notify the Division in writing, and immediately resume instream monitoring
and sampling according to this permit.
3. Limit and monitoring requirements apply only if chlorine is used for disinfection. The facility shall report all
effluent TRC values reported by a NC certified laboratory including field certified. However, effluent values
below 50 µg/L will be treated as zero for compliance purposes.
4. See section A. (5).
5. Variable: instream samples shall be collected 3/week during the summer months of June, July, August,
and September; samples shall be collected weekly during the rest of the year.
THERE SHALL BE NO DISCHARGE OF FLOATING SOLIDS OR VISIBLE FOAM IN OTHER THAN TRACE
Page 4 of 11

r
Permit NCO038831
AMOUNTS.
A. (4) CHRONIC TOXICITY PERMIT LIMIT (QUARTERLY) - (0.675 MGD)
[15A NCAC 02B.0200 et seq.]
The effluent discharge shall at no time exhibit observable inhibition of reproduction or
significant mortality to Ceriodaphnia dubia at an effluent concentration of 67%.
The permit holder shall perform at a minimum, quarterlu monitoring using test
procedures outlined in the "North Carolina Ceriodaphnia Chronic Effluent Bioassay
Procedure," Revised December 2010, or subsequent versions or "North Carolina Phase II
Chronic Whole Effluent Toxicity Test Procedure" (Revised- December 2010) or
subsequent versions. The tests will be performed during the months of January, April,
July and October. These months signify the first month of each three-month toxicity
testing quarter assigned to the.facility. Effluent sampling for this testing must be
obtained during representative effluent discharge and 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 -
December 2010) 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, DWR Form AT-3 (original) is to be sent to the following
address:
Attention: North Carolina Division of Water Resources
Water Sciences Section/Aquatic Toxicology Branch
1623 Mail Service Center
Raleigh, NC 27699-1623
Completed Aquatic Toxicity Test Forms shall be filed with the Water Sciences Section 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
Page 5 of 11

Permit NCO038831
comment area of the form. The report shall be submitted to the Water Sciences Section
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. Assessment of toxicity
compliance is based on the toxicity testing quarter, which is the three month time
interval that begins on the first day of the month in which toxicity testing is required by
this permit and continues until the final day of the third month.
Should any test data from this monitoring requirement or tests performed by the North
Carolina Division of Water Resources 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 will require
immediate follow-up testing to be completed no later than the last day of the month
following the month of the initial monitoring.
A. (5) CHRONIC TOXICITY PERMIT LIMIT (QUARTERLY) - (1.0 MGD)
[15A NCAC 0213.0200 et seq.]
The effluent discharge shall at no time exhibit observable inhibition of reproduction or
significant mortality to Ceriodaphnia dubia at an effluent concentration of 76%.
The permit holder shall perform at a minimum, quarferlu monitoring using test
procedures outlined in the "North Carolina Ceriodaphnia Chronic Effluent Bioassay
Procedure," Revised December 2010, or subsequent versions' or "North Carolina Phase II
Chronic Whole Effluent Toxicity Test Procedure" (Revised- December 2010) or
subsequent versions: The tests will be performed during the months of January, April,
July and October. These months signify the first month of each three-month toxicity
testing quarter assigned to the facility. Effluent sampling for this testing must be
obtained during representative effluent discharge and 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 -
December 2010) 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, DWR Form AT-3 (original) is to be sent to the following
address:
Attention: North Carolina Division of Water Resources
Page 6 of 11

Permit NCO038831
Water Sciences Section/Aquatic Toxicology Branch
1623 Mail Service ' Center
Raleigh, NC 27699-1623
Completed Aquatic Toxicity Test Forms shall be filed with the Water Sciences Section 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 Water Sciences Section
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. Assessment of toxicity
compliance is based on the toxicity testing quarter, which is the three month time
interval that begins on the first day of the month in which toxicity testing is required by
this permit and continues until the final day of the third month.
Should any test data from this monitoring requirement or tests performed by the North .
Carolina Division of Water Resources 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 will require
immediate follow-up testing to be completed no later than the last day of the month
following the month of the initial monitoring.
A. (6) NUTRIENT REOPENER CONDITION
[NCGS 143-215.1 (b)]
Pursuant to N.C. General Statutes Section 143-215.1 and the implementing rules found
in the North Carolina Administrative Code at 15A NCAC 2H.0112 (b) (1) and 2H.0114 (a)
and Part II sections B-12 and B-13 of this permit, the Director may reopen this permit to
require supplemental nutrient monitoring of the discharge. The purpose of the additional
monitoring will be to support water quality modeling efforts within the Cape Fear River
Basin and shall be consistent with a monitoring plan developed jointly by the Division and
affected stakeholders. In addition, the results of water quality modeling may require that
limits for total nitrogen and total phosphorus be imposed in this permit upon renewal.
Page 7 of 11

Permit NCO038831
A. (7) ELECTRONIC REPORTING OF MONITORING REPORTS
[NCGS 143-215.1 (b)]
Federal regulations require electronic submittal of all discharge monitoring reports
(DMRs) and program reports. The final NPDES Electronic Reporting Rule was adopted
and became effective on December 21, 2015.
NOTE: This special condition supplements or supersedes the following sections within
Part II of this permit (Standard Conditions for NPDES Permits):
• Section B. (11.) Signatory Requirements
• Section D. (2.) Reporting
• Section D. (6.) Records Retention
• Section E. '(5.) Monitoring Reports
1. Reporting Requirements [Supersedes Section D. (2.) and Section E. (5.1 (all
The permittee shall report 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 DEQ / Division of Water Resources / Water Quality Permitting Section
ATTENTION: Central Files
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. See "How to
Request a Waiver from Electronic Reporting" section below.
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.
Starting on December 21, 2020, the permittee must electronically report the following
compliance monitoring data and reports, when applicable:
Page 8 of 11

Permit NCO038831
• Sewer Overflow/Bypass Event Reports;
• Pretreatment Program Annual Reports; and
• Clean Water Act (CWA) Section 316(b) Annual Reports.
The permittee may seek an electronic reporting waiver from the Division (see "How to
Request a Waiver from Electronic Reporting" section below).
2. Electronic Submissions
In accordance with 40 CFR 122.41(1)(9), the permittee must identify the initial recipient
at the time of each electronic submission. The permittee should use the EPA's website
resources to identify the initial recipient for the electronic submission.
Initial recipient of electronic NPDES information from NPDES-regulated facilities means
the entity (EPA or the state authorized by EPA to implement the NPDES program) that is
the designated entity for receiving electronic NPDES data [see 40 CFR 127.2(b)].
EPA plans to establish a website that will also link to the appropriate electronic reporting
tool for each type of electronic submission and for each state. Instructions on how to
access and use the appropriate electronic reporting tool will be available as well.
Information on EPA's NPDES Electronic Reporting Rule is found at:
http: / /www2.epa.gov/compliance/final-national-pollutant-discharge-elimination-
system-npdes-electronic-reporting-rule:
Electronic submissions must start by the dates listed in the "Reporting Requirements"
section above.
3. How to Request a Waiver from Electronic Reporting
The permittee may seek a temporary electronic reporting waiver from the Division. To'
obtain an electronic reporting waiver, a permittee must first submit an electronic
reporting waiver request to the Division. Requests for temporary electronic reporting
waivers 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
submitting monitoring data and reports. The duration of a temporary waiver shall not
exceed 5 years and shall thereupon expire. At such time, monitoring data and reports
shall be submitted electronically to the Division unless the permittee re -applies for and is
granted a new temporary electronic reporting waiver by the, Division. Approved electronic
reporting waivers are not transferrable. Only permittees with an approved reporting
waiver request may submit monitoring data and reports on paper to the Division for the
period that the approved reporting waiver request is effective.
Information on eDMR and the application for a temporary electronic reporting waiver are
found on the following web page:
http: / / deq.nc. gov/ about/ divisions /water -resources /edmr
4. 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
Page 9 of 11

Permit NC0038831
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: / /deq.nc.gov./about/divisions/water-resources/edmr
Certification. Any person submitting an electronic DMR using the state's eDMR system
shall make the following certification [40 CFR 122.221. NO OTHER STATEMENTS OF
CERTIFICATION WILL BE ACCEPTED:
"I certify, under penalty of law, that this document and all attachments were prepared
under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gather and evaluate the information submitted. Based on my
inquiry of the person or persons who manage the system, or those persons directly
responsible for gathering the information, the information submitted is, to the best of my
knowledge and belief, true, accurate, and complete. I am aware that there are significant
penalties for submitting false information, including the possibility of fines and
imprisonment for knowing violations."
5. Records Retention [Supplements Section D. (6.11
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 10 of 11

Permit NCO038831
Carolina Water Service, Inc. of North Carolina
Carolina Trace WWTP
NPDES Permit NCO038831
Receiving Stream: Upper Little River Stream Class: C
Stream Segment: 18-20-(8) Sub -Basin M 03-06-13
River Basin: Cape Fear HUC: 0303000402
County: Lee
N
A
SCALE
1:30,000
Page 11 of 11
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•

1
UtilitiEs, Inc
December 28, 2016
NC DEQ — Division of Water Resources
Water Quality Permitting Section
1617 Mail Service Center
Raleigh NC 27699-1617
Re: Ownership Name Change Request
NCO064734
— Bradfield Farms
NCO058378
— Elk River
NCO038831—
Carolina Trace
NCO024295
— Connestee Falls No. 1
NCO088943
— Connestee Falls No. 2
NCO033111—
Fairfield Harbour
NCO022985
— Fairfield Sapphire
To Whom It Will Concern,
RECEIVEDUDEUDWR
DEC 29 ' 016
Water Quality
Permitting Section
Please find enclosed Permit Ownership change request forms for the above referenced NPDES discharge
facilities. There is a name change of the owner due to a merger consolidation of our smaller affiliates into Carolina
Water Service, Inc. of North Carolina. Proof of merger documentation filed with the NC Dept. of the Secretary of
State is affixed to each request.
If you should have any questions or need any additional information, please feel free to contact me at 704-319-0517
or by email at [e-mail].
Thank you for your attention.
Sinc
Aly,
Martin Lashua
Vice President of Operations
AUbhes, Inc. comMy Carolina Water Service, Inc. of North Carolina
P.O. Box 240908 • Charlotte, NC 28224 • P: 704-525-7990 • F: 704-525-8174
5701 Westpark Dr., Suite 101 • Charlotte, NC 28217 • www.uiwater.com

• r
Ar
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Resources
Pat McCrory
Governor WATER QUALITY PERMITTING SECTION
John E. Skvarla, III
Secretary
PERMIT NAME/OWNERSHIP CHANGE REQUEST
This form is for ownership changes or name changes of NPDES wastewater permits.
• "Permittee" references the existing permit holder
• "Applicant" references the entity applying for the ownership/name change.
I. NPDES Permit No. (for which the change is requested: N C 0 0 3 8 8 3 1
or
Certificate of Coverage #: N C G 5
II. Existing Permittee Information:
a. Permit issued to (company name):
Carolina Trace Utilities, Inc.
b. Person legally responsible for permit:
Matthew Klein
First MI Last
President
RECEIVEDINCDEUDWR
Title
PO Box 240908
DEC 2 9 2016
Permit Holder Mailing Address
Charlotte NC 28227-0908
Water Quality
City State Zip
Permitting Section
[phone] [phone]
Phone Fax
c. Facility name:
Carolina Trace Wastewater Treatment Plant
d. Facility's physical address:
5448 Cox Mill Road
Address
Sanford NC 27332-
City State Zip
e. Facility contact person:
Danny Lassiter [phone]
First / MI / Last Phone
III. Applicant Information:
a. Request for change is a result of:
❑ Change in ownership of the facility
® Name change of t4&4acility-Browner
If other please explain: Name change
of owner due to merger consolidation
b. Permit issued to (company name):
Carolina Water Service, Inc. of North Carolina
c. Person legally responsible for permit:
Matthew Klein
First MI Last
President
Title
PO Box 240908
Permit Holder Mailing Address
Charlotte NC 28224-0908
City State Zip
[phone] [e-mail]
Phone E-mail Address
Page t of 2 Revised 710112014

', d. Facility name:
e. Facility's physical address:
f. Facility contact person:
Address
City State Zip
First MI Last
Title
Phone E-mail Address
IV. Will the permitted facility continue to conduct the same commercial/industrial activities conducted prior to
this ownership or name change?
® Yes
❑ No (please explain)
If applicable, the applicant shall submit a major permit modification request to DWR. A major modification shall be
defined as one that increases the volume, increases the pollutant load, results in a significant relocation of the
discharge point, or results in a change in the characteristics of the waste generated.
V. Required Items: THIS APPLICATION WILL BE RETURNED UNPROCESSED IF ITEMS ARE
INCOMPLETE OR MISSING:
1. This completed application is required for both name change and/or ownership change requests.
2. Legal documentation of the transfer of ownership (such as relevant pages of a contract deed, or a bill of sale) is
required for an ownership change request. Articles of incorporation are not sufficient for an ownership change.
Applicable regulations: 40 CFR 122.41, 40 CFR 122.61 and 15A NCAC 02H .0114
...................................................................................................................
The certifications below must be completed and signed by both the permit holder prior to the change (Permittee), and the
new applicant in the case of an ownership change request. For a name change request, the signed Applicant's Certification
is sufficient.
PERMITTEE CERTIFICATION (Permit holder prior to ownership change):
I, Martin Lashua, attest that this application for a name/ownership change has been reviewed and is accurate and complete
to the best of my knowledge. I understand that if all required parts of this application are not completed and that if all
r quir d su portin formation is not included, this application package will be returned as incomplete.
Lit W, 12/28/2016
Signature Date
APPLICANT CERTIFICATION
I, Martin Lashua, attest that this application for a name/ownership change has been reviewed and is accurate and complete
to the best f my knowled e. I u erstand that if all required parts of this application are not completed and that if all
require s porti infor atio is of included, this application package will be returned as incomplete.
jhA
l cPPr
Q Sjn�
12/28/2016
Signature
Date
PLEASE SEND THE COMPLETE APPLICATION PACKAGE TO:
Division of Water Resources
Water Quality Permitting Section
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
NPDES PERMIT NAME/OWNERSHIP CHANGE REQUEST
Page 2 of 2 Revised 710112014

Z,: NORTH CAROLINA
e Department of the Secretary of State
To all whom these presents shall come, Greetings:
I, ELAINE F. MARSHALL, Secretary of - State of the State of. North .
Carolina, do hereby certify the following and hereto attached to be a true copy of
ARTICLES .OF MERGER
OF
BRADFIELD FARMS WATER COMPANY
CAROLINA TRACE - UTILITIES, INC.
CWS SYSTEMS, INC.
ELK RIVER UTILITIES, INC.
TRANSYLVANIA UTILITIES, INC.
INTO
CAROLINA WATER SERVICE, INC. OF NORTH CAROLINA
the original of which was filed in this office on the :30th day of August; 2016.
,o►+�,� i IN WITNESS WHEREOF, I have hereunto set
w my hand and affixed my official seal at the City
t�. of Raleigh,- this 31 st day of August, 2016.
�
4*C M"" Scan to verify online.
-Certification# C201624300754-1 Reference#.C201624300754-1 Secretary Of State
Verify this certificate online at http://www.sosno;govlverification