NC0083925_Renewal (Application)_20230623

ROY COOPER
Govemor
ELIZABETH S. BISER
Secretary
RICHARD E. ROGERS, JR.
Director
Aqua North Carolina, Inc.
Attn: Amanda Berger
202 Mackenan Dr
Cary, NC 27511-6447
Subject: Permit Renewal
Application No. NCO083925
Salem Glen Subdivision WWTP
Davidson County
Dear Applicant:
NORTH CAROLINA
Environmental Quality
June 21, 2023
Laserfiche
The Water Quality Permitting Section acknowledges the June 15, 2023, receipt of your permit renewal application and
supporting documentation. Your application will be assigned to a permit writer within the Section's NPDES WW permitting
branch. Per G.S. 150E-3 your current permit does not expire until permit decision on the application is made.
Continuation of the current permit is contingent on timely and sufficient application for renewal of the current permit. The
permit writer will contact you if additional information is required to complete your permit renewal. Please respond in a
timely manner to requests for additional information necessary to allow a complete review of the application and renewal
of the permit.
Information regarding the status of your renewal application can be found online using the Department of Environmental
Quality's Environmental Application Tracker at:
https://dgq.nc.gov/permits-regulations/permit-guidance/environmental-application-tracker
If you have any additional questions about the permit, please contact the primary reviewer of the application using the
links available within the Application Tracker.
ec: WQPS Laserfiche File w/application
ISincerely,
Wren h Ci1
ford
Administrative Assistant
Water Quality Permitting Section
kzV
North Carolina Department of ErMronmenW QLW" I D ybdon of Water Resources
Winston-Salem Regional Office 1 450 Vim Haries MM Road Suhe 300 1 Winston-Salem, North Carolina 27105
336.776,9800

Laserfiche
AQUA-
4 Esserna{
June 15, 2023
RECEIVED
JUN 2 3 2023
NCDEQ/DWR/NPDES
NC Department of Environment and Natural Resources
Division of Water Quality
NPDES Unit
1617 Mail Service Center
Raleigh, NC 27699-1617
Subject: Application for Permit Renewal
Aqua North Carolina, Inc.
Salem Glen Subdivision WWTP
NPDES No. NCO083925
Forsyth County
To Whom It May Concern:
Attached are three (3) copies of the completed application Modification
Application Form 2A, flow diagram, and a topographic map. This letter and
attachments are Aqua North Carolina's request to renew the subject permit.
If you need any additional information or assistance, please feel free to contact
me at [e-mail].
Sincerely,
Amanda Berger
Director, Environmental Compliance

North Carolina
Department of Environmental Quality
Division of Water Resources
Modified Application Form 2A
Revised March 2021
Modified Application
Form 2A
Minor Sewage Facilities < 0.1 MGD
and No Pretreatment Program
NPDES Permitting Program
Note: Complete this form if your facility is a MINOR new or existing publicly owned treatment works.

NPDES Permit Number
Facility Name
Modified Application Form 2A
NCO083925
Salem Glen WWTP
Modified March 2021
Form
NC Department of Environmental Quality - Application for NPDES Permit to Discharge Wastewater
MINOR SEWAGE FACILITIES (Before completing this form, please read the instructions. Failure to follow
NPDES
the instructions nay result in denial of the application.)
SECTION•
1.1
INFORMATION •• r
Facility name
Salem Glen Subdivision WWTP
Mailing address (street or P.O. box)
202 Mackenan Court
City or town
State
ZIP code
o
Cary
NC
27S11
EContact
name (first and last)
Title
Phone number
Email address
w
c
Amanda Berger
Director, Environmental Comr
[phone]
[e-mail]
Location address (street, route number, or other specific identifier) ❑ Same as mailing address
cc
U-
5075 Salem Glen Blvd
City or town
State
ZIP code
Lexington
NC
27292
1.2
Is this application for a facility that has yet to commence discharge?
❑ Yes 4 See instructions on data submission ✓❑ No
requirements for new dischargers.
1.3
Is applicant different from entity listed under Item 1.1 above?
❑ Yes ❑✓ No 4 SKIP to Item 1.4.
Applicant name
Applicant address (street or P.O. box)
0
A
cCity
or town
State
ZIP code
w
c
'
Contact name (first and last)
Title
Phone number
Email address
Q
c
a
1.4
Is the applicant the facility's owner, operator, or both? (Check only one response.)
❑ Owner ❑ Operator Both
1.5
To which entity should the NPDES permitting authority send correspondence? (Check only one response.)
❑ Facility 0 Applicant ❑ Facility and applicant
(they are one and the same)
1.6
Indicate below any existing environmental permits. (Check all that apply and print or type the corresponding permit
number for each.
Existing Environmental Permits
a
✓❑ NPDES (discharges to surface
❑ RCRA (hazardous waste)
❑ UIC (underground injection
c
water)
control)
d
E
c
NCO08392S
o
❑ PSD (air emissions)
❑ Nonattainment program (CAA)
❑ NESHAPs (CAA)
c
uu
rn
y
❑ Ocean dumping (MPRSA)
❑ Dredge or fill (CWA Section
❑ Other (specify)
w
404)
Page 1

NPDES Permit Number
Facility Name
Modified Application Form 2A
NCO083925
Salem Glen WWTP
Modified March 2021
1.7
Provide the collections stem information
requested below for the treatment works.
Municipality
Population
Collection System Type
Ownership Status
Served
Served
indicate ercentage)
371
100 % separate sanitary sewer
E1 Own El Maintain
% combined storm and sanitary sewer
❑ Own ❑ Maintain
d
❑ Unknown
❑ Own ❑ Maintain
co
% separate sanitary sewer
❑ Own ❑ Maintain
% combined storm and sanitary sewer
❑ Own ❑ Maintain
❑ Unknown
❑ Own ❑ Maintain
a%
separate sanitary sewer
❑ Own El Maintain
% combined storm and sanitary sewer
❑ Own ❑ Maintain
❑ Unknown
❑ Own ❑ Maintain
d%
separate sanitary sewer
❑ Own ❑ Maintain
% combined storm and sanitary sewer
❑ Own ❑ Maintain
c
❑ Unknown
❑ Own ❑ Maintain
Total 371
Population
0
Served
Combined Storm and
Separate Sanitary Sewer System
Sanitary Sewer
Total percentage of each type of
100 %
°
sewer line in miles)�0
Z7
1.8
Is the treatment works located in Indian Country?
c
v
❑ Yes El No
0
1.9
Does the facility discharge to a receiving water that flows through Indian Country?
❑ Yes ❑ No
1.10
Provide design and actual flow rates in the designated spaces.
Design Flow Rate
0.1 mgd
Annual Average Flow Rates Actual
y
Two Years Ago
Last Year
This Year
0
0.06 mgd
0.06 mgd
0.06 mgd
U"
Maximum Daily Flow Rates Actual
Two Years Ago
Last Year
This Year
0.01 mgd
0.1 mgd
0.087 mgd
1.11
Provide the total number of effluent discharge points to waters of the State of North Carolina by type.
Total Number of Effluent Dischar a Points by Type
a
Constructed
o,
Treated Effluent
Untreated Effluent
Combined Sewer
Bypasses
Emergency
s
Overflows
Overflows
c
1
Page 2

NPDES Permit Number
Facility Name
Modified Application Form 2A
NCO083925
Salem Glen WWTP
Modified March 2021
Outfalls Other Than to Waters of the State of North Carolina
1.12
Does the POTW discharge wastewater to basins, ponds, or other surface impoundments that do not have outlets
for discharge to waters of the State of North Carolina?
❑ Yes ❑✓ No 4 SKIP to Item 1.14.
1.13
Provide the location of each surface impoundment and associated discharge information in the table below.
Surface Im oundment Location and Dischar a Data
Average Daily Volume
Continuous or Intermittent
Location
Discharged to Surface
(check one)
Impoundment
❑ Continuous
gpd
❑ Intermittent
❑ Continuous
gpd
❑ Intermittent
ElContinuous
gpd
N
❑ Intermittent
s
1.14
Is wastewater applied to land?
❑ Yes No + SKIP to Item 1.16.
1.15
Provide the land application site and discharge data requested below.
C
Land Application Site and Discharge Data
o
0
!
Average Daily Volume
Continuous or
Location
Size
Applied
Intermittent
�,
check one
o
acres
gpd
❑ Continuous
❑ Intermittent
❑ Continuous
c
acres
gpd
❑ Intermittent
acres
❑ Continuous
gpd
❑ Intermittent
1.16
Is effluent transported to another facility for treatment prior to discharge?
o
❑ Yes ElNo + SKIP to Item 1.21.
1.17
Describe the means by which the effluent is transported (e.g., tank truck, pipe).
1.18
Is the effluent transported by a party other than the applicant?
❑ Yes ❑ No + SKIP to Item 1.20.
1.19
Provide information on the transporter below.
Trans orter Data
Entity name
Mailing address (street or P.O. box)
City or town
State
ZIP code
Contact name (first and last)
Title
Phone number
Email address
Page 3

NPDES Permit Number
Facility Name
Modified Application Form 2A
NCO083925
Salem Glen WWTP
Modified March 2021
1.20
In the table below, indicate the name, address, contact information, NPDES number, and average daily flow rate of the
receiving facility.
Receiving F cility Data
7J
Facility name
Mailing address (street or P.O. box)
`
c
City or town
State
ZIP code
0
Contact name (first and last)
Title
rp
Phone number
Email address
NPDES number of receiving facility (if any) ❑ None
Average daily flow rate mgd
c
1.21
Is the wastewater disposed of in a manner other than those already mentioned in Items 1.14 through 1.21 that do
not have outlets to waters of the State of North Carolina (e.g., underground percolation, underground injection)?
❑ Yes ❑✓ No 4 SKIP to Item 1.23.
es
0
1.22
Provide information in the table below on these other disposal methods.
Information on Other Disposal Methods
=
Disposal
Location of
Size of
Annual Average
Continuous or Intermittent
a
a
Method
Disposal Site
Disposal Site
Daily Discharge
(check one)
Description
Volume
acres
gpd
❑ Continuous
❑ Intermittent
acres
gp d
❑ Continuous
❑ Intermittent
acres
gp d
ElContinuous
❑ Intermittent
1.23
Do you intend to request or renew one or more of the variances authorized at 40 CFR 122.21(n)? (Check all that apply.
Consult with your NPDES permitting authority to determine what information needs to be submitted and when.)
w
❑ Discharges into marine waters (CWA El Water quality related effluent limitation (CWA Section
Section 301(h)) 302(b)(2))
�$
Not applicable
1.24
Are any operational or maintenance aspects (related to wastewater treatment and effluent quality) of the treatment works
the responsibility of a contractor?
❑ Yes ❑ No +SKIP to Section 2.
1.25
Provide location and contact information for each contractor in addition to a description of the contractor's operational
and maintenance responsibilities.
Contractor Information
Contractor 1
Contractor 2
Contractor 3
o
Contractor name
(company name
Mailing address
street or P.O. box
City, state, and ZIP
code
c
Contact name (first and
U
last
Phone number
Email address
Operational and
maintenance
responsibilities of
contractor
Page 4

NPDES Permit Number Facility Name Modified Application Form 2A
NCO083925 Salem Glen WWTP Modified March 2021
SECTION11 • •' • 1
o Outfalls to Waters of the State of North Carolina
c
2.1
Does the treatment works have a design flow greater than or equal to 0.1 mgd?
rn
c
✓❑ Yes ❑ No + SKIP to Section 3.
c
2.2
Provide the treatment works' current average daily volume of inflow
Average Daily Volume of Inflow and Infiltration
and infiltration.
N/A gpd
5
Indicate the steps the facility is taking to minimize inflow and infiltration.
RCurrent
peaking factor is < 1 at 0.27
3
0
a=
c
t
2.3
Have you attached a topographic map to this application that contains all the required information? (See instructions for
CL
specific requirements.)
R
o
CL
0 Yes ❑ No
E
2.4
Have you attached a process flow diagram or schematic to this application that contains all the required information?
c o�
(See instructions for specific requirements.)
LL !
c
❑✓ Yes ❑ No
2.5
Are improvements to the facility scheduled?
❑ Yes El No + SKIP to Section 3.
Briefly list and describe the scheduled improvements.
0
c
1.
,r
c
m
E
a
2.
E
w
0
y
3.
m
V
0
w
4.
H
v
2.6
Provide scheduled or actual dates of completion for improvements.
Scheduled or Actual Dates of Completion for Improvements
E
o,
Scheduled
Affected
Begin
End
Begin
Attainment of
>
o
CL
Improvement
Outfalls
(list o
Construction
Construction
Discharge
Operational
Level
E
(from above)
number)
)
(MM/DD/YYYY)
(MM/DD/YYYY)
(MM/DD/YYYY)
MM/DD/YYYY
v
m
v
as
L
N
2.
3.
4.
2.7
Have appropriate permits/clearances concerning other federal/state requirements been obtained? Briefly explain your
response.
❑ Yes ❑ No 21 None required or applicable
Explanation:
Page 5

NPDES Permit Number Facility Name Modified Application Form 2A
NCO083925 Salem Glen WWTP Modified March 2021
SECTION•' • ON • 1
3.1 Provide the following information for each outfall. (Attach additional sheets if you have more than three outfalls.)
Outfall Number 001
Outfall Number
Outfall Number
State
NC
County
Forsyth
C
City or town
Kernersville
0
3
Distance from shore
a
C
Depth below surface
ft.
ft.
ft.
c
Average daily flow rate
0.05 mgd
mgd
mgd
Latitude
35° 98' 58"
°
Longitude
80° 38' 26"
"
3.2
Do any of the outfalls described under Item 3.1 have seasonal or periodic discharges?
9
c
❑ Yes ❑ No 4 SKIP to Item 3.4.
m
3.3
If so, provide the following information for each applicable outfall.
z
a
Outfall Number
Outfall Number
Outfall Number
0
Number of times per year
0
.�
discharge occurs
a
Average duration of each
o
discharge (specify units
cAverage
flow of each
mgd
mgd
mgd
w
discharge
Months in which discharge
occurs
3.4
Are any of the outfalls listed under Item 3.1 equipped with a diffuser?
❑ Yes ❑ No 4 SKIP to Item 3.6.
3.5
Briefly describe the diffuser type at each applicable outfall.
CL
~
Outfall Number
Outfall Number
Outfall Number
d
h
c
3.6
Does the treatment works discharge or plan to discharge wastewater to waters of the State of North Carolina from
In,
one or more discharge points?
L
w
❑ Yes ❑ No 4SKIP to Section 6.
Page 6

NPDES Permit Number
Facility Name
Modified Application Form 2A
NCO083925
Salem Glen WWTP
Modified March 2021
3.7
Provide the receiving water and related information if known for each outfall.
Outfall Number 001
Outfall Number
Outfall Number
Receiving water name
Yadkin PD River Basin
Name of watershed, river,
0
or stream system
Yadkin River
U.S. Soil Conservation
Service 14-digit watershed
o
code
Name of state
3
rn
management/river basin
U.S. Geological Survey
8-digit hydrologic
cataloging unit code
Critical low flow (acute)
cfs
cfs
cfs
Critical low flow (chronic)
cfs
cfs
cfs
Total hardness at critical
mg/L of
mg/L of
mg/L of
low flow
CaCO3
CaCO3
CaCO3
3.8
Provide the following information
describing the treatment pr vided for discharges from each outfall.
Outfall Number 001
Outfall Number
Outfall Number
Highest Level of
❑ Primary
❑ Primary
❑ Primary
Treatment (check all that
❑ Equivalent to
❑ Equivalent to
❑ Equivalent to
apply per outfall)
secondary
secondary
secondary
El Secondary
❑ Secondary
❑ Secondary
❑ Advanced
❑ Advanced
❑ Advanced
❑ Other (specify)
❑ Other (specify)
❑ Other (specify)
0
a
Design Removal Rates by
Outfall
001
N
D1
BOD5 or CBOD5
85 %
%
%
c
d
E
m
TSS
85 %
%
%
• Not applicable
❑ Not applicable
❑ Not applicable
Phosphorus
%
%
%
0 Not applicable
❑ Not applicable
❑ Not applicable
Nitrogen
/o °
° /o
°
/o
Other (specify)
❑ Not applicable
❑ Not applicable
❑ Not applicable
Page 7

NPDES Permit Number
Facility Name
Modified Application Form 2A
NCO083925
Salem Glen WWTP
Modified March 2021
3.9
Describe the type of disinfection used for the effluent from each outfall in the table below. If disinfection varies by
season, describe below.
UV disinfection with tablet chlorination as backup.
I c
� c
Outfall Number 001
Outfall Number
Outfall Number
g
Q
Disinfection type
UV Disinfection with tablet
U
Cn
chlorination/dechlorination
Seasons used
all
E
Dechlorination used?
❑ Not applicable
❑ Not applicable
❑ Not applicable
~
0 Yes
❑ Yes
❑ Yes
❑ No
❑ No
❑ No
3.10
Have you completed monitoring for all Table A parameters and attached the results to the application package?
0 Yes ❑ No
3.11
Have you conducted any WET tests during the 4.5 years prior to the date of the application on any of the facility's
discharges or on any receiving water near the discharge points?
❑ Yes ❑✓ No 4 SKIP to Item 3.13.
3.12
Indicate the number of acute and chronic WET tests conducted since the last permit reissuance of the facility's
discharges by outfall number or of the receiving water near the discharge points.
Outfall Number 001
Outfall Number
Outfall Number
Acute
Chronic
Acute
Chronic
Acute
Chronic
Number of tests of discharge
i
water
Number of tests of receiving
water
d
w
3.14
Does the POTW use chlorine for disinfection, use chlorine elsewhere in the treatment process, or otherwise have
reasonable potential to discharge chlorine in its effluent?
❑� Yes + Complete Table B, including chlorine. ❑ No + Complete Table B, omitting chlorine.
3.15
Have you completed monitoring for all applicable Table B pollutants and attached the results to this application
package?
Z Yes ❑ No
Have you completed monitoring for all applicable Table D pollutants required by your NPDES permitting authority and
3.18
attached the results to this application package?
additional sampling required by NPDES
❑ Yes ID
permitting authority.
Page 8

NPDES Permit Number
Facility Name
Modified Application Form 2A
NCO083925
Salem Glen WWTP
Modified March 2021
3.19
Has the POTW conducted either (1) minimum of four quarterly WET tests for one year preceding this permit application
or (2) at least four annual WET tests in the past 4.5 years?
❑ Yes ❑ No + Complete tests and Table E and SKIP to
Item 3.26.
3.20
Have you previously submitted the results of the above tests to your NPDES permitting authority?
❑ Yes ❑ No 4 Provide results in Table E and SKIP to
Item 3.26.
3.21
Indicate the dates the data were submitted to our NPDES permitting authority and provide a summary of the results.
Date(s) Submitted
Summary of Results
MMIDDNM
v
a
c
c
0
c
3.22
Regardless of how you provided your WET testing data to the NPDES permitting authority, did any of the tests result in
o
toxicity?
❑ Yes ❑ No SKIP to Item 3.26.
3.23
Describe the cause(s) of the toxicity:
c
d
3
LU
W
3.24
Has the treatment works conducted a toxicity reduction evaluation?
❑ Yes r❑ No SKIP to Item 3.26.
3.25
Provide details of any toxicity reduction evaluations conducted.
3.26
Have you completed Table E for all applicable outfalls and attached the results to the application package?
❑ Yes ❑ Not applicable because previously submitted
information to the NPDES permittin authori .
Page 9

NPDES Permit Number Facility Name Modified Application Form to
NCO083925 Salem Glen WWTP Modified March 2021
SECTIONti
6.1
CERTIFICATION STATEMENT (40
In Column 1 below, mark the sections of Form 2A that you have completed and are submitting with your application. For
each section, specify in Column 2 any attachments that you are enclosing to alert the permitting authority. Note that not
all applicants are required to provide attachments.
Column 1
Column 2
❑ Section 1: Basic Application
❑ w/ variance request(s) ❑ w/ additional attachments
Information for All Applicants
❑ Section 2: Additional
✓❑ w/ topographic map ❑ w/ process flow diagram
Information
❑ w/ additional attachments
❑✓ w/ Table A ❑ w/ Table D
❑ Section 3: Information on
✓❑ w/ Table B ❑ w/ additional attachments
Effluent Discharges
E
❑ w/ Table C
d
--
U)
Section 4: Not Applicable
c
0
�a
i=
Section 5: Not Applicable
r
d
v
Section 6: Checklist and
❑
✓❑ w/ attachments
w
Certification Statement
6,2
Certification Statement
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. 1 am aware that there are significant penalties for submitting false information, including the possibility of fine
and imprisonment for knowing violations.
Name (print or type first and last name)
Official title
Amanda Berger
Environmental Compliance Director
Signature
Date signed
—A-P�'Uc&a—
06/15/2023
Page 10

NPDES Permit Number
Facility Name
Outfall Number
NC0083925
Salem Glen WWTP
001
Modified Application Form 2A
Modified March 2021
Pollutant
Maximum Daily Discharge
Average Daily Discharge
Analytical ML or MDL
Method' (include units)
Value
Units
Value
Units
Samb lest
Biochemical oxygen demand
0 BOD5 or ❑ CBOD5
(report one
41.8
mg/L
6.26
mg/L
235
OML
SM5201B 2 O MDL
Fecal coliform
350
#/loom[
42.8
#/loom[
223
SM9222D;Coliert 18 1 OML
p MDL
Design flow rate
0.19
MGD
0.062
MGD
1589
1151
pH (minimum)
7.4
pH (maximum)
7.4
Temperature (winter)
9
Celsius
14
Celsius
Temperature (summer)
30
Celsius
18.7
Celsius
1151
Total suspended solids (TSS)
40
mg/L
6.2
mg/L
235
SM2540D 2 O MDL
' Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter I, subchapter N or 0. See instructions and 40 CFR 122.21(e)(3).
Page 11

DES Permit Number Facility Name Outfall Number Modified Application Form 2A
Salem Glen WWTP Modified March 2021
NCO083925 001
Maximum Daily Discharge Average Daily Discharge
Analytical
ML or MDL
Value
Units
Value
Units
Number
Pollutant
Methods
(Include units)
Samples
Ammonia (as N)
4.88
mg/L
2.5
mg/L
83
ASTMD142608A
OML
0.2 p MDL
Chlorine
total residual, TRC 2
45
ug/L
29.7
ug/L
57
❑ ML
❑ MDL
Dissolved oxygen
N/A
mg/L
N/A
mg/ L
0
❑ MDL
Nitrate/nitrite
37.7
mg/L
14.1
mg/L
53
SM450ONO3E
❑ ML
O MDL
Kjeldahl nitrogen
43.1
mg/L
10.45
mg/L
53
SM4500; EPA 351.2
OML
0.14;0.26 2 MDL
Oil and grease
N/A
OML
❑ MDL
Phosphorus
7.27
mg/L
4.38
mg/L
54
SM4500; EPA 351.2
0.16 OML
O MDL
Total dissolved solids
N/A
❑ ML
❑ MDL
t Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter 1, subchapter N or 0. See instructions and 40 CFR 122.21(e)(3).
2 Facilities that do not use chlorine for disinfection, do not use chlorine elsewhere in the treatment process, and have no reasonable potential to discharge chlorine in their effluent are not
required to report data for chlorine.
EPA Form 3510-2A (Revised 3-19) Page 12

EPA Identification Number NPDES Permit Number Facility Name Outfall Number
Modified Application Form 2A
NCO083925 Salem Glen WWTP 001
Modified March 2021
Maximum Daily Discharge Average Daily Discharge
Analytical ML or MDL
Pollutant
rMetals,Cyanide,
Value Units Value Units Number of
Method' (include units)
Samples
and Total Phenols
Hardness (as CaCO3)
❑ ML
Z MDL
❑ ML
Antimony, total recoverable
❑ MDL
Arsenic, total recoverable
❑ ML
❑ MDL
Beryllium, total recoverable
❑ ML
❑ MDL
Cadmium, total recoverable
❑ ML
❑ MDL
Chromium, total recoverable
❑ ML
❑ MDL
Copper, total recoverable
❑ ML
t7 MDL
Lead, total recoverable
❑ ML
t7 MDL
Mercury, total recoverable
❑ ML
❑ MDL
Nickel, total recoverable
❑ ML
❑ MDL
Selenium, total recoverable
❑ ML
❑ MDL
Silver, total recoverable
❑ ML
❑ MDL
Thallium, total recoverable
❑ ML
❑ MDL
Zinc, total recoverable
❑ ML
0 MDL
Cyanide
❑ ML
❑ MDL
Total phenolic compounds
❑ ML
❑ MDL
Volatile Organic Compounds
Acrolein
❑ ML
❑ MDL
Acrylonitrile
_
❑ ML
❑ MDL
--
Benzene
---
-
-
❑ ML
❑ MDL
Bromoform
❑ ML
❑ MDL
EPA Form 3510-2A (Revised 3-19) Page 13

EPA Identification Number NPDES Permit Number Facility Name Outfall Number
Modified Application Form 2A
NC0O83925 Salem Glen WWTP 001
Modified March2021
ASNAWANOSM
Maximum Daily Discharge Average Daily Discharge
Analytical ML or MDL
Pollutant Number of
Method' (include units)
Value Units Value Units
Samples
Carbon tetrachloride
12-chloroethylvinyl
El ML
❑ MDL
Chlorobenzene
❑ ML
❑ MDL
Chlorodibromomethane
❑ ML
❑ MDL
Chloroethane
❑ ML
❑ MDL
ether
0 ML
❑ MDL
Chloroform
El ML
❑ MDL
Dichlorobromomethane
❑ ML
❑ MDL
1, 1 -dichloroethane
❑ MI
❑ MDL
1,2-dichloroethane
❑ ML
❑ MDL
trans-1,2-dichloroethylene
0 ML
❑ MDL
1, 1 -dichloroethylene
0 ML
❑ MDL
1,2-dichloropropane
0 ML
❑ MDL
0 ML
1,3-dichloropropylene
❑ MDL
0 ML
Ethylbenzene
❑ MDL
0 ML
Methyl bromide
❑ MDL
0 MIL
Methyl chloride
❑ MDL
El ML
Methylene chloride
❑ MDL
1,1,2,2-tetrachloroethane
❑ ML
❑ MDL
0 ML
Tetrachloroethylene
❑ MDL
❑ ML
Toluene
❑ MIX
❑ ML
1,1,1-trichloroethane
❑ MDL
❑ ML
1,1,2-trichloroethane
El MDL
EPA Form 3510-2A (Revised 3-19) Page 14

EPA Identification Number
NPDES Permit Number
Facility Name Ouffall Number
Modified Application Form 2A
NCO083925
Salem Glen W WTP 001
Modified March 2021
if • ' it
Maximum Daily Discharge
Average Daily Discharge
Analytical ML or MDL
Pollutant
Number of
Method' (include units)
Value Units
Value Units
Trichloroethylene
- - -
❑ ML
_
❑ MDL
Vinyl chloride
❑ ML
-
— -- —
❑ MDL
Acid -Extractable Compounds
p-chloro-m-cresol
❑ ML
❑ MDL
2-chlorophenol
❑ ML
_
❑ MDL
❑ ML
2,4-dichlorophenol
❑MDL
2,4-dimethylphenol
❑ ML
❑ MDL
4,6-dinitro-o-cresol
❑ ML
❑ MDL
2,4-dinitrophenol
❑ ML
❑ MDL
2-nitrophenol
❑ ML
❑ MDL
4-nitrophenol
❑ ML
❑ MDL
Pentachlorophenol
❑ ML
❑ MDL
Phenol
❑ ML
❑ MDL
2,4,6-trichlorophenol
❑ ML
❑ MDL
Base -Neutral Compounds
Acenaphthene
❑ ML
❑ MDL
Acenaphthylene
❑ ML
❑ MDL
Anthracene
❑ ML
❑ MDL
Benzidine
❑ ML
❑ MDL
Benzo(a)anthracene
❑ ML
❑ MDL
Benzo(a)pyrene
❑ ML
❑ MDL
3,4-benzofluoranthene
❑ ML
❑ MDL
EPA Form 3510-2A (Revised 3-19) Page 15

EPA Identification Number NPDES Permit Number Facility Name Outfall Number
Modified Application Form 2A
NCO083925 Salem Glen WWTP 001
Modified March 2021
Maximum Daily Discharge Average Daily Discharge
Analytical ML or MDL
Pollutant Number of
Method' (include units)
Value Units Value Units
Samples
EJ ML
❑ MDL
Benzo(ghi)perylene
Benzo(k)fluoranthene
0 ML
❑ MDL
Bis (2-chloroethoxy) methane
0 ML
❑ MDL
Bis (2-chloroethyl) ether
0 ML
❑ MDL
Bis (2-chloroisopropyl) ether
11 ML
❑ MDL
Bis (2-ethylhexyl) phthalate
0 ML
❑ MDL
4-bromophenyl phenyl ether
0 ML
❑ MDL
Butyl benzyl phthalate
C1 ML
❑ MDL
2-chloronaphthalene
11 ML
❑ MDL
4-chlorophenyl phenyl ether
❑ ML
❑ MDL
Chrysene
❑ ML
❑ MDL
di-n-butyl phthalate
0 ML
❑ MDL
di-n-octyl phthalate
CIML
❑ MDL
Dibenzo(a,h)anthracene
11 ML
❑ MDL
1,2-dichlorobenzene
❑ ML
❑ MDL
❑ ML
1,3-dichlorobenzene
❑ MDL
❑ ML
1,4-dichlorobenzene
❑ MDL
❑ ML
3,3-dichlorobenzidine
❑ MDL
0 ML
Diethyl phthalate
❑ MDL
Dimethyl phthalate
0 ML
❑ MDL
2,4-dinitrotoluene
❑ ML
❑ MDL
El ML
2,6-dinitrotoluene
❑ MDL
EPA Form 3510-2A (Revised 3-19) Page 16

EPA Identification Number
NPDES Permit Number Facility Name Outfall Number
Modified
Application Form 2A
NC0083925 Salem Glen WWTP 001
Modified March 2021
Maximum Daily Discharge Average Daily Discharge
Analytical
ML or MDL
Pollutant
Number of
Method'
(include units)
Value Units j Value
Units
-
samples
❑ ML
1,2-diphenylhydrazine
❑ MDL
❑ ML
Fluoranthene
—
❑ MDL
Fluorene
❑ ML
❑ MDL
Hexachlorobenzene
0 MIL
❑ MDL
Hexachlorobutadiene
❑ ML
_
❑ MDL
Hexachlorocyclo-pentadiene
❑ ML
❑ MDL
Hexachloroethane
❑ ML
❑ MDL
Indeno(1,2,3 cd)pyrene
❑ ML
❑ MDL
Isophorone
❑ ML❑
MDL
❑ ML
Naphthalene
❑ MDL
Nitrobenzene
❑ ML
❑ MDL
N-nitrosodi-n-propylamine
❑ ML
❑ MDL
N-nitrosodimethylamine
❑ ML
❑ MDL
N-nitrosodiphenylamine
❑ ML
❑ MDL
Phenanthrene
❑ ML
❑ MDL
Pyrene
❑ ML
❑ MDL
1,2,4-trichlorobenzene
❑ ML
❑ MDL
Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR Chapter I, Subchapter N or 0. See instructions and 40 CFR 122.21(e)(3).
EPA Form 3510-2A (Revised 3-19) Page 17

NPDES Permit Number Facility Name Outfall Number
Modified Application Form 2A
NCO083925 Salem Glen WWTP
Modified March 2021
Maximum Dail Dischar a Average Dail Discharge
Pollutant
Analytical ML or MDL
Y
Number of
(list) Value Units Value Units
Method' (include units)
Samples
❑� No additional sampling is required by NPDES permitting authority.
❑ ML
piC/L piC/L Calculated 0.01 p MDL
❑ ML
mg/L
mg/L
DM4500CL-C
1
t7 MDL
❑ ML
piC/L
piC/L
Calculated
0.01 p MDL
piC/L
piC/L
Calculated
❑ ML
0.01 H MDL
piC/L
piC/L
EPA 904
0.01 ❑ ML
17 MDL
❑ ML
piC/L
piC/L
EPA 904
0.01
l7 MDL
piC/L
piC/L
EAP 905; ASTM D581
0.01 ❑ ML
❑ MDL
El ML
piC/L
piC/L
EPA 906
1
17 MDL
ug/L
ug/L
EPA 200.8
0.01 ❑ MO I
MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 GFR 136 for the analysis of pollutants or pollutant parameters or required
under 40 CFR chapter I, subchapter N or 0. See instructions and 40 CFR 122.21(e)(3).
Page 18

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70 70
60 60
HYDRAULIC PROFILE
NO SCuf HORIZONTAL
i' _ IO' VER

AOUA,.
4 Essentta
June 15, 2023
NC Department of Environment and Natural Resources
Division of Water Quality
NPDES Unit
1617 Mail Service Center
Raleigh, NC 27699-1617
Subject: Application for Permit Renewal
Aqua North Carolina, Inc.
Salem Glen Subdivision WWTP
NPDES No. NCO083925
Forsyth County
To Whom It May Concern:
Attached are three (3) copies of the completed application Modification
Application Form 2A, flow diagram, and a topographic map. This letter and
attachments are Aqua North Carolina's request to renew the subject permit.
If you need any additional information or assistance, please feel free to contact
me at [e-mail].
Sincerely,
Amanda Berger
Director, Environmental Compliance

North Carolina
Department of Environmental Quality
Division of Water Resources
Modified Application Form 2A
Revised March 2021
Modified Application
Form 2A
Minor Sewage Facilities < 0.1 MGD
and No Pretreatment Program
NPDES Permitting Program
Note: Complete this form if your facility is a MINOR new or existing publicly owned treatment works.

NPDES Permit Number
Facility Name
Modified Application Form 2A
NCO083925
Salem Glen WWTP
Modified March 2021
Form
NC Department of Environmental Quality - Application for NPDES Permit to Discharge Wastewater
MINOR SEWAGE FACILITIES (Before completing this form, please read the instructions. Failure to follow
NPDES
the instructions may result in denial of the application.)
SECTI•N
1. BASIC
APPLICATION•• • •• r
1.1
Facility name
Salem Glen Subdivision WWTP
Mailing address (street or P.O. box)
202 Mackenan Court
City or town
State
ZIP code
o
Cary
NC
27511
Contact name (first and last)
Title
Phone number
Email address
0
_c
Amanda Berger
Director, Environmental Comr
[phone]
[e-mail]
'
Location address (street, route number, or other specific identifier) ❑ Same as mailing address
m
W
5075 Salem Glen Blvd
City or town
State
ZIP code
Lexington
NC
27292
1.2
Is this application for a facility that has yet to commence discharge?
❑ Yes -* See instructions on data submission ❑ No
requirements for new dischargers.
1.3
Is applicant different from entity listed under Item 1.1 above?
❑ Yes 0 No 4 SKIP to Item 1.4.
Applicant name
Applicant address (street or P.O. box)
0
c
w
City or town
State
ZIP code
w
Contact name (first and last)
Title
Phone number
Email address
.Q
c
a
1.4
Is the applicant the facility's owner, operator, or both? (Check only one response.)
❑ Owner ❑ Operator 0 Both
1.5
To which entity should the NPDES permitting authority send correspondence? (Check only one response.)
❑ Facility El Applicant ❑ Facility and applicant
(they are one and the same)
1.6
Indicate below any existing environmental permits. (Check all that apply and print or type the corresponding permit
number for each.
E
d
Existing Environmental Permits
✓❑ NPDES (discharges to surface
❑ RCRA (hazardous waste)
❑ UIC (underground injection
water)
control)
E
c
NCO083925
❑ PSD (air emissions)
❑ Nonattainment program (CAA)
❑ NESHAPs (CAA)
c
w
rn
y
❑ Ocean dumping (MPRSA)
❑ Dredge or fill (CWA Section
❑ Other (specify)
w
404)
Page 1

NPDES Permit Number
Facility Name
Modified Application Form 2A
NC0083925
Salem Glen WWTP
Modified March 2021
1.7
Provide the collections stem information
requested below for the treatment works.
Municipality
Population
Collection System Type
Ownership Status
Served
Served
indicate percentage)
371
100 % separate sanitary sewer
El Own ❑ Maintain
Z%
combined storm and sanitary sewer
❑ Own El Maintain
d
❑ Unknown
❑ Own ❑ Maintain
% separate sanitary sewer
❑ Own ❑ Maintain
R%
combined storm and sanitary sewer
❑ Own ❑ Maintain
❑ Unknown
❑ Own ❑ Maintain
% separate sanitary sewer
❑ Own ❑ Maintain
ri
% combined storm and sanitary sewer
❑ Own ❑ Maintain
cc
❑ Unknown
❑ Own ❑ Maintain
2
% separate sanitary sewer
❑ Own ❑ Maintain
N%
combined storm and sanitary sewer
❑ Own ❑ Maintain
❑ Unknown
❑ Own ❑ Maintain
0
Total 371
d
Population
L)
Served
Combined Storm and
Separate Sanitary Sewer System
Sanitary Sewer
Total percentage of each type of
100 %
%
sewer line in miles
z'
1.8
Is the treatment works located in Indian Country?
o
❑ Yes 0 No
r—
1.9
Does the facility discharge to a receiving water that flows through Indian Country?
c
❑ Yes 0 No
1.10
Provide design and actual flow rates in the designated spaces.
Design Flow Rate
0.1 mgd
w
Annual Average Flow Rates Actual
Two Years Ago
Last Year
This Year
c o
0.06 mgd
0.06 mgd
0.06 mgd
Ua:Maximum
DailyFlow Rates Actual
in
Two Years Ago
Last Year
This Year
0.01 mgd
0.1 mgd
0.087 mgd
y
1.11
Provide the total number of effluent discharge points to waters of the State of North Carolina by type.
Total Number of Effluent Dischar a Points by Type
a a
Constructed
r=
Treated Effluent
Untreated Effluent
Combined Sewer
Bypasses
Emergency
T
a
Overflows
Overflows
V)
G
1
Page 2

NPDES Permit Number
Facility Name
Modified Application Form 2A
NCO083925
Salem Glen WWTP
Modified March 2021
Outfalls Other Than to Waters of the State of North Carolina
1.12
Does the POTW discharge wastewater to basins, ponds, or other surface impoundments that do not have outlets
for discharge to waters of the State of North Carolina?
❑ Yes ❑✓ No + SKIP to Item 1.14.
1.13
Provide the location of each surface impoundment and associated discharge information in the table below.
Surface Im oundment Location and Dischar a Data
Average Daily Volume
Continuous or Intermittent
Location
Discharged to Surface
(check one)
Impoundment
❑ Continuous
gpd
❑ Intermittent
i
❑ Continuous
gpd
❑ Intermittent
❑ Continuous
gpd
n
❑ Intermittent
r
1.14
Is wastewater applied to land?
j
❑ Yes ❑r No 4 SKIP to Item 1.16.
c1.15
Provide the land application site and discharge data requested below.
Land Application Site and Discharge Data
o
o
Average Daily Volume
Continuous or
Location
Size
Intermittent
d
CD
A lied
Pp
check one
acres
gpd
❑ Continuous
0
❑ Intermittent
r
acres
d
gpd
❑ Continuous
❑ Intermittent
acres
d
❑ Continuous
gpd
❑ Intermittent
1.16
Is effluent transported to another facility for treatment prior to discharge?
o
ElYes ❑ No + SKIP to Item 1.21.
i
I
i
1.17
Describe the means by which the effluent is transported (e.g., tank truck, pipe).
1.18
Is the effluent transported by a party other than the applicant?
❑ Yes ❑ No + SKIP to Item 1.20.
1.19
Provide information on the transporter below.
Trans orter Data
Entity name
Mailing address (street or P.O. box)
City or town
State
ZIP code
Contact name (first and last)
Title
Phone number
Email address
Page 3

NPDES Permit Number
Facility Name
Modified Application Form 2A
NCO083925
Salem Glen WWTP
Modified March 2021
1.20
In the table below, indicate the name, address, contact information, NPDES number, and average daily flow rate of the
receiving facility.
Receiving F cility Data
o
Facility name
Mailing address (street or P.O. box)
d
0
City or town
State
ZIP code
0
U
Contact name (first and last)
Title
0
d
Phone number
Email address
Cn a
NPDES number of receiving facility (if any) ❑ None
Average daily flow rate mgd
0
1.21
Is the wastewater disposed of in a manner other than those already mentioned in Items 1.14 through 1.21 that do
not have outlets to waters of the State of North Carolina (e.g., underground percolation, underground injection)?
s
❑ Yes ❑ No 4 SKIP to Item 1.23.
U
0
1.22
Provide information in the table below on these other disposal methods.
Information on Other Disposal Methods
oDisposal
Location of
Size of
Annual Average
Continuous or Intermittent
r
Method
Disposal Site
Disposal Site
Daily Discharge
(check one)
R
Description
Volume
❑ Continuous
w
acres
gp d
❑ Intermittent
❑ Continuous
acres
gpd
❑ Intermittent
El Continuous
acres
gp d
❑ Intermittent
1.23
Do you intend to request or renew one or more of the variances authorized at 40 CFR 122.21(n)? (Check all that apply.
N
Consult with your NPDES permitting authority to determine what information needs to be submitted and when.)
„
❑ Discharges into marine waters (CWA ❑ Water quality related effluent limitation (CWA Section
Section 301(h)) 302(b)(2))
Not applicable
1.24
Are any operational or maintenance aspects (related to wastewater treatment and effluent quality) of the treatment works
the responsibility of a contractor?
❑ Yes R No +SKIP to Section 2.
1.25
Provide location and contact information for each contractor in addition to a description of the contractor's operational
and maintenance responsibilities.
Contractor Information
Contractor 1 Contractor 2
Contractor 3
�
Contractor name
(company name
I
_
E
Mailing address
street or P.O. box
`o
City, state, and ZIP
Q
code
Contact name (first and
cEZ
c�
last
Phone number
Email address
Operational and
maintenance
responsibilities of
contractor
Page 4

NPDES Permit Number Facility Name Modified Application Form 2A
NCO08392S Salem Glen WWTP Modified March 2021
SECTION1I • •' • 1
0 Outfalls to Waters of the State of North Carolina
=
2.1
Does the treatment works have a design flow greater than or equal to 0.1 mgd?
o
❑✓ Yes ❑ No 4 SKIP to Section 3.
c
2.2
Provide the treatment works' current average daily volume of inflow
Average Daily Volume of Inflow and Infiltration
w
and infiltration.
N/A gpd
5
Indicate the steps the facility is taking to minimize inflow and infiltration.
c
Current peaking factor is < 1 at 0.27
3
0
w
c
L
2.3
Have you attached a topographic map to this application that contains all the required information? (See instructions for
CL
specific requirements.)
0
0
0
0 Yes ❑ No
E
2.4
Have you attached a process flow diagram or schematic to this application that contains all the required information?
3 m
0
(See instructions for specific requirements.)
0n
LL /!
o
❑✓ Yes ❑ No
2.5
Are improvements to the facility scheduled?
❑ Yes ❑ No + SKIP to Section 3.
Briefly list and describe the scheduled improvements.
0
c
m
E
c.
2.
E
0 0
y
3.
d
U
4.
Cn
v
R
2.6
Provide scheduled or actual dates of completion for improvements.
Scheduled or Actual Dates of Completion for Im rovements
E
d
Scheduled
Affected
Begin
End
Begin
Attainment of
>
o
Improvement
Outfalls
Construction
Construction
Discharge
Operational
CL E
(from above)
(list ) I
number)
(MM/DD/YYYY)
(MM/DD/YYYY)
(MM/DD/YYYY)
Level
Level
d
2.
s
3.
4.
—T
—T
2.7
Have appropriate permits/clearances concerning other federal/state requirements been obtained? Briefly explain your
response.
❑ Yes ❑ No El None required or applicable
Explanation:
Page 5

NPDES Permit Number Facility Name Modified Application Form 2A
NCO08392S Salem Glen WWTP Modified March 2021
SECTION•' • ON 1 1
3.1 Provide the following information for each outfall. (Attach additional sheets if you have more than three outfalls.)
Outfall Number 001
Outfall Number
Outfall Number
State
NC
County
Forsyth
w
0
City or town
Kernersville
c
.Q
Distance from shore
ft.
ft.
ft.
Depth below surface
ft.
ft.
ft.
0
Average daily flow rate
0.05 mgd
mgd
mgd
Latitude
35' 98' 58"
Longitude
80' 38' 2611
3.2
Do any of the outfalls described under Item 3.1 have seasonal or periodic discharges?
A
o
❑ Yes No -* SKIP to Item 3.4.
3.3
If so, provide the following information for each applicable outfall.
s
Outfall Number
Outfall Number
Outfall Number
0
a
Number of times per year
0
discharge occurs
a
Average duration of each
o
discharge (specify units
oAverage
flow of each
mgd
mgd
mgd
U)
discharge
M
Months in which discharge
occurs
3.4
Are any of the outfalls listed under Item 3.1 equipped with a diffuser?
❑ Yes ❑✓ No SKIP to Item 3.6.
d
3.5
Briefly describe the diffuser type at each applicable outfall.
Outfall Number
Outfall Number
Outfall Number
0
vi
3 6
Does the treatment works discharge or plan to discharge wastewater to waters of the State of North Carolina from
to
one or more discharge points?
Y
❑ Yes ❑ No 4SKIP to Section 6.
RECEIVED
JUN 2 3 2023
Page 6
N — --'-'-0/DWR/NPDES

NPDES Permit Number
Facility Name
Modified Application Form 2A
NCO083925
Salem Glen WWTP
Modified March 2021
3.7
Provide the receiving water and related information if known for each outfall.
Outfall Number 001
Outfall Number
Outfall Number
Receiving water name
Yadkin PD River Basin
Name of watershed, river,
0
or stream system
Yadkin River
U.S. Soil Conservation
y
Service 14-digit watershed
o
code
Name of state
rn
management/river basin
U.S. Geological Survey
8-digit hydrologic
d
cataloging unit code
Critical low flow (acute)
cfs
cfs
cfs
Critical low flow (chronic)
cfs
cfs
cfs
Total hardness at critical
mg/L of
mg/L of
mg/L of
low flow
CaCO3
CaCO3
CaCO3
3.8
Provide the following information describing the treatment pr vided for discharges from each outfall.
Outfall Number 001
Outfall Number
Outfall Number
Highest Level of
❑ Primary
❑ Primary
❑ Primary
Treatment (check all that
❑ Equivalent to
❑ Equivalent to
❑ Equivalent to
apply per outfall)
secondary
secondary
secondary
El Secondary
❑ Secondary
❑ Secondary
❑ Advanced
❑ Advanced
❑ Advanced
❑ Other (specify)
❑ Other (specify)
❑ Other (specify)
0
Q
Design Removal Rates by
Outfall
ooa
a�
BOD5 or CBOD5
85 %
%
%
c
d
E
m
TSS
85 %
%
%
H
0 Not applicable
❑ Not applicable
❑ Not applicable
Phosphorus
%
%
°
/o
• Not applicable
❑ Not applicable
❑ Not applicable
Nitrogen
%
%
%
Other (specify)
❑ Not applicable
❑ Not applicable
❑ Not applicable
Page 7

NPDES Permit Number
Facility Name
Modified Application Form 2A
NCO083925
Salem Glen WWTP
Modified March 2021
3.9
Describe the type of disinfection used for the effluent from each outfall in the table below. If disinfection varies by
season, describe below.
UV disinfection with tablet chlorination as backup.
a
_
.c
0
U
=
Outfall Number 001
Outfall Number
Outfall Number
ZL
Disinfection type
UV Disinfection with tablet
U
chlorination/dechlorination
0
Seasons used
All
d
E
Dechlorination used?
❑ Not applicable
❑ Not applicable
❑ Not applicable
~
0 Yes
❑ Yes
❑ Yes
❑ No
❑ No
❑ No
3.10
Have you completed monitoring for all Table A parameters and attached the results to the application package?
0 Yes ❑ No
3.11
Have you conducted any WET tests during the 4.5 years prior to the date of the application on any of the facility's
discharges or on any receiving water near the discharge points?
❑ Yes ❑✓ No 4 SKIP to Item 3.13.
3.12
Indicate the number of acute and chronic WET tests conducted since the last permit reissuance of the facility's
discharges by outfall number or of the receiving water near the discharge points.
Outfall Number 001
Outfall Number
Outfall Number
Acute
Chronic
Acute
Chronic
Acute
Chronic
is
Number of tests of discharge
water
Number of tests of receiving
water
d
w
3.14
Does the POTW use chlorine for disinfection, use chlorine elsewhere in the treatment process, or otherwise have
reasonable potential to discharge chlorine in its effluent?
❑� Yes + Complete Table B, including chlorine. ❑ No 4 Complete Table B, omitting chlorine.
3.15
Have you completed monitoring for all applicable Table B pollutants and attached the results to this application
package?
❑✓ Yes ❑ No
Have you completed monitoring for all applicable Table D pollutants required by your NPDES permitting authority and
3.18
attached the results to this application package?
❑ Yes O No additional sampling required by NPDES
permitting authority.
Page 8

NPDES Permit Number
Facility Name
Modified Application Form 2A
NCO083925
Salem Glen WWTP
Modified March 2021
3.19
Has the POTW conducted either (1) minimum of four quarterly WET tests for one year preceding this permit application
or (2) at least four annual WET tests in the past 4.5 years?
❑ Yes ❑ No 4 Complete tests and Table E and SKIP to
Item 3.26.
3.20
Have you previously submitted the results of the above tests to your NPDES permitting authority?
❑ Yes 0 No 4 Provide results in Table E and SKIP to
Item 3.26.
3.21
Indicate the dates the data were submitted to our NPDES permitting authority and provide a summary of the results.
Date(s) Submitted
Summary of Results
MWDDNYYY
c
c
0
3.22
Regardless of how you provided your WET testing data to the NPDES permitting authority, did any of the tests result in
o
toxicity?
c
❑ Yes ❑ No 4 SKIP to Item 3.26.
3.23
Describe the cause(s) of the toxicity:
d
w
3.24
Has the treatment works conducted a toxicity reduction evaluation?
❑ Yes r❑ No 4 SKIP to Item 3.26.
I�
3.25
Provide details of any toxicity reduction evaluations conducted.
3.26
Have you completed Table E for all applicable outfalls and attached the results to the application package?
❑ Yes El Not applicable because previously submitted
information to the NPDES permittinq authority.
Page 9

NPDES Permit Number
Facility Name Modified Application Form 2A
NCO083925
Salem Glen WWTP Modified March 2021
SECTION. CHECKLIST
AND CERTIFICATION STATEMENT (40
6.1
In Column 1 below, mark the sections of Form 2A that you have completed and are submitting with your application. For
each section, specify in Column 2 any attachments that you are enclosing to alert the permitting authority. Note that not
all applicants are required to provide attachments.
Column 1
Column 2
Section 1: Basic Application
w/ variance request(s) El w/ additional attachments
Informationforfor All A licants
❑ Section 2: Additional
✓❑ w/ topographic map ❑ w/ process flow diagram
Information
❑ w/ additional attachments
✓❑ w/ Table A ❑ w/ Table D
❑ Section 3: Information on
✓❑ w/ Table B ❑ w/ additional attachments
Effluent Discharges
E
❑ w/ Table C
d
io
Section 4: Not Applicable
0
R
Section 5: Not Applicable
,C
m
c�
❑ Section 6: Checklist and
❑ w/ attachments
�?
Certification Statement
Y
6.2
Certification Statement
1 certify under penalty of law that this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that qualified personnel properly gather and evaluate the information
submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible
for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and
complete. I am aware that there are significant penalties for submitting false information, including the possibility of fine
and imprisonment for knowing violations.
Name (print or type first and last name)
Official title
Amanda Berger
Environmental Compliance Director
Signature
Date signed
C(iLcf?A 9� i�v2J
06/15/2023
Page 10

NPDES Permit Number
Facility Name
Outfall Number
NCO083925
Salem Glen WWTP
001
Modified Application Form 2A
Modified March 2021
Maximum Daily Discharge
Average Daily Discharge Analytical ML or MDL
Value
Units
Pollutant
Numbers Method' (include units )
Value Units
Samples _
Biochemical oxygen demand
O BOD5 or ❑ CBOD5
41.8
mg/L
OML
6.26 mg/L 235 SM5201B 2 O MDL
(report one
Fecal coliform
350
#/100ml
42.8
#/100ml
223 SM9222D;Coliert 18 1 OML
O MDL
Design flow rate
0.19
MGD
0.062
MGD
1589
pH (minimum)
7.4
pH (maximum)
7.4
Temperature (winter)
9
Celsius
14
Celsius
1151
Temperature (summer)
30
Celsius
18.7
Celsius
1151
Total suspended solids (TSS)
40
mg/L
6.2
mg/L
235 SM2540D
2 OML
O MDL
Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter I, subchapter N or 0. See instructions and 40 CFR 122.21(e)(3).
Page 11

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Modified Application Form 2A
NCO083925 I Salem Glen WWTP 001 Modified March 2021
•• '• • •
• •' 1 1
Maximum Daily Discharge
Average Daily Discharge
Analytical
ML or MDL
Value
Units
Number of
Pollutant
Value Units
Method'
(include units)
Samples
Ammonia (as N)
4.88
mg/L
2.5
mg/L
83
ASTMD142608A
0 ML
0.2 Z MDL
Chlorine
El ML
total residual, TRC 2
45
ug/L
29.7
ug/L
57
❑ MDL
Dissolved oxygen
N/A
mg/L
N/A
mg/ L
0
DMIL
❑ MDL
Nitrate/nitrite
37.7
mg/L
14.1
mg/L
53
SM450ONO3E
OML
O MDL
Kjeldahl nitrogen
43.1
mg/L
10.45
mg/L
53
SM4500; EPA 351.2
OML
0.14;0.26 21 MDL
❑ ML
Oil and grease
N/A
❑ MDL
Phosphorus
7.27
mg/L
4.38
mg/L
54
SM4500; EPA 351.2
-F
0.16 OML
MDL
❑ ML
Total dissolved solids
N/A
I
❑ MDL
I Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter I, subchapter N or 0. See instructions and 40 CFR 122.21(e)(3).
2 Facilities that do not use chlorine for disinfection, do not use chlorine elsewhere in the treatment process, and have no reasonable potential to discharge chlorine in their effluent are not
required to report data for chlorine.
EPA Form 3510-2A (Revised 3-19) Page 12

EPA Identification Number
NPDES Permit Number Facility Name Outfall Number
Modified Application Form 2A
NC0083925 Salem Glen WWTP 001
Modified March 2021
Maximum Daily Discharge Average Daily Discharge
Pollutant
Analytical ML or MDL
Value
Units Value
Units
Number of
Method' (include units)
Samples
Metals, Cyanide, and Total Phenols
Hardness (as CaCO3)
�—
❑ ML
0 MDL
Antimony, total recoverable
❑ ML
❑ MDL
Arsenic, total recoverable
❑ ML
❑ MDL
Beryllium, total recoverable
❑ ML
❑ MDL
Cadmium, total recoverable
❑ ML
❑ MDL
Chromium, total recoverable
❑ ML
❑ MDL
Copper, total recoverable
❑ ML
0 MDL
Lead, total recoverable
❑ ML
O MDL
Mercury, total recoverable
❑ ML
❑ MDL
Nickel, total recoverable
❑ ML
❑ MDL
Selenium, total recoverable
❑ ML
❑ MDL
Silver, total recoverable
❑ ML
❑ MDL
Thallium, total recoverable
❑ ML
❑ MDL
Zinc, total recoverable
❑ ML
O MDL
Cyanide
❑ ML
❑ MDL
Total phenolic compounds
El ML
❑ MDL
Volatile Organic Compounds
Acrolein
❑ ML
❑ MDL
Acrylonitrile
❑ ML
❑ MDL
Benzene
❑ ML
❑ MDL
Bromoform
❑ ML
❑ MDL
EPA Form 3510-2A (Revised 3-19) Page 13

EPA Identification Number
NPDES Permit Number Facility Name Outfall Number
Modified Application Form 2A
NCO083925 Salem Glen WWTP 001
Modified March 2021
Maximum Daily Discharge Average Daily Discharge
Analytical ML or MDL
Pollutant
Method' (include units)
Number of
Value
Units
Value
Units
Samples
Carbon tetrachloride
El ML
❑ MDL
Chlorobenzene
❑ ML
❑ MDL
Chlorodibromomethane
❑ ML
❑ MDL
❑ ML
Chloroethane
❑ MDL
0 ML
2-chloroethylvinyl ether
❑ MDL
❑ ML
Chloroform
❑ MDL
❑ ML
Dichlorobromomethane
❑ MDL
1, 1 -dichloroethane
❑ ML
❑ MDL
❑ ML
1,2-dichloroethane
❑ MDL
0 ML
trans-1,2-dichloroethylene
❑ MDL
0 ML
1,1-dichloroethylene
❑ MDL
❑ ML
1,2-dichloropropane
❑ MDL
El ML
1,3-dichloropropylene
❑ MDL
0 ML
Ethylbenzene
❑ MDL
❑ ML
Methyl bromide
❑ MDL
0 ML
Methyl chloride
❑ MDL
0 ML
Methylene chloride
❑ MDL
❑ ML
1,1,2,2-tetrachloroethane
❑ MDL
❑ ML
Tetrachloroethylene
❑ MDL
❑ ML
Toluene
❑ MDL
❑ ML
1, 1,1 -trichloroethane
❑ MDL
❑ ML
1,1,2-trichloroethane
❑ MDL
EPA Form 3510-2A (Revised 3-19) Page 14

EPA Identification Number
NPDES Permit Number Facility Name Outfall Number
Modified Application Form 2A
NCO083925 Salem Glen WWTP 001
Modified March 2021
Maximum Daily Discharge Average Daily Discharge
Analytical ML or MDL
Pollutant
Value
Units
Value
Units
Number of
Method' (include units)
❑ ML
Trichloroethylene
_Samples.—
— - —�
❑ MDL
Vinyl chloride
❑ ML
L
❑ MDL
_
Acid -Extractable Compounds
p-chloro-m-cresol ❑ ML
❑ MDL
2-chlorophenol
❑ ML
❑ MDL
2,4-dichlorophenol
❑ ML
❑ MDL
2,4-dimethylphenol
❑ ML
❑ MDL
4,6-dinitro o-cresol
❑ ML
❑ MDL
2,4-dinitrophenol
❑ ML
❑ MDL
2-nitrophenol
❑ ML
❑ MDL
4 nitrophenol
❑ ML
❑ MDL
Pentachlorophenol
❑ ML
❑ MDL
Phenol
❑ ML
❑ MDL
2,4,6-trichlorophenol
El ML
❑ MDL
Base -Neutral Compounds
Acenaphthene
❑ ML
❑ MDL
Acenaphthylene
❑ ML❑
MDL
Anthracene
❑ ML❑
MDL
Benzidine
❑ ML
❑ MDL
Benzo(a)anthracene
❑ ML
❑ MDL
Benzo(a)pyrene
❑ ML
❑ MDL
3,4-benzofluoranthene
❑ ML
❑ MDL
EPA Form 3510-2A (Revised 3-19) Page 15

EPA Identification Number
NPDES Permit Number Facility Name Outfall Number
Modified Application Form 2A
NC0O8392S Salem Glen WWTP 001
Modified March 2021
Maximum Daily Discharge Average Daily Discharge
Analytical ML or MDL
Pollutant
Method' (include units)
Number of
Value
Units
Value
Units
Samples
Benzo(ghi)perylene
❑ ML
❑ MDL
Benzo(k)fluoranthene
0 ML
❑ MDL
Bis (2-chloroethoxy) methane
El ML
❑ MDL
Bis (2-chloroethyl) ether
0 ML
❑ MDL
Bis (2-chloroisopropyl) ether
0 ML
❑ MDL
Bis (2-ethylhexyl) phthalate
0 MIL
❑ MDL
4-bromophenyl phenyl ether
0 ML
❑ MDL
Butyl benzyl phthalate
0 ML
❑ MDL
2-chloronaphthalene
0 ML
❑ MDL
4-chlorophenyl phenyl ether
0 ML
❑ MDL
Chrysene
❑ ML
❑ MDL
di-n-butyl phthalate
❑ MDL
di-n-octyl phthalate
❑ MDL
Dibenzo(a,h)anthracene
0 ML
❑ MDL
1,2-dichlorobenzene
❑ ML
❑ MDL
1,3-dichlorobenzene
❑ ML
❑ MDL
1,4-dichlorobenzene
❑ ML
❑ MDL
3,3-dichlorobenzidine
❑ ML
❑ MDL
Diethyl phthalate
0 ML
❑ MDL
Dimethyl phthalate
El ML
❑ MDL
2,4-dinitrotoluene
❑ ML
❑ MDL
2,6-dinitrotoluene
❑ ML
❑ MDL
EPA Form 3510-2A (Revised 3-19) Page 16

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Modified Application Form 2A
NCO083925 Salem Glen WWTP 001 Modified March 202'
•- Q -9
Maximum Daily Discharge Average Daily Discharge Analytical ML or MDL
Pollutant
Number of Method' (include units)
Value Units Value Units
Samples
1,2-diphenylhydrazine ❑ ML
❑ MDL
❑ MI
Fluoranthene ❑ MDL
Fluorene
❑ ML
❑ MDL
Hexachlorobenzene
El ML
❑MDL
Hexachlorobutadiene
_
❑ ML
❑ MDL
Hexachlorocyclo-pentadiene
❑ ML
❑ MDL
Hexachloroethane
❑ ML
❑ MDL
Indeno(1,2,3-cd)pyrene
❑ ML
❑ MDL
Isophorone
❑ ML
❑ MDL
Naphthalene
❑ ML
❑ MDL
Nitrobenzene
❑ ML
❑ MDL
N-nitrosodi-n-propylamine
❑ ML
❑ MDL
N-nitrosodimethylamine
❑ ML
❑ MDL
N-nitrosodiphenylamine
❑ ML
❑ MDL
Phenanthrene
❑ ML
❑ MDL
Pyrene
❑ ML
❑ MDL
0 1,2,4 trichlorobenzene
❑ ML
❑ MDL
' Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR Chapter I, Subchapter N or 0. See instructions and 40 CFR 122.21(e)(3).
EPA Form 3510-2A (Revised 3-19) Page 17

NPDES Permit Number Facility Name Outfall Number
Modified Application Form 2A
NCO083925 Salem Glen W WTP
Modified March 2021
Maximum Dail Dischar a Avera a Dail Discharge
Pollutant
Anal tical ML or MDL
y
Number of
(list) Value Units Value Units
Method' (include units)
Samples
❑� No additional sampling is required by NPDES permitting authority.
❑ ML
piC/L
piC/L
Calculated
0.01 p MDL
El ML
mg/L
mg/L
DM4500CL-C
1
0 MDL
❑ ML
piC/L
piC/L
Calculated
0.01 17 MDL
❑ ML
piC/L
piC/L
Calculated
0.01 O MDL
piC/L
piC/L
EPA 904
0.01 ML
0 MDL
❑ ML
piC/L
piC/L
EPA 904
0.01 l7 MDL
piC/L
piC/L
EAP 905; ASTM D581
0.01 ❑ ML
❑ MDL
El ML
piC/L
piC/L
EPA 906
1
[7 MDL
ug/L
ug/L
EPA 200.8
0.01 ❑ ML
!7 MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
I Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or requlreo
under 40 CFR chapter I, subchapter N or 0. See instructions and 40 CFR 122.21(e)(3).
Page 18

6LAti FLAN VIEW
S U, 3/16-- 1 D-
!Q M N]s
110 6. rvNr amn a Im.» v o1mEx wrw _ - 110
or ■eIYFASUPEWMT 90X
x
- j !cPWRAnw L � _ Sa11R'Al.! { UV ObWfECi10N - - - SNI[.9LY - —
.� � E,8
100 �nn.ti zaK 1 :oc x. x 1 . _ . 9➢.Ie 100
L�
O bT
_� EfTLUEM
_--{.. _.- - ,..�... 6 1••' WV W➢I.SJ w.. OUT 97.S5
90 �. om�.v-' -- °B �-- wa^rJ__P61,Li!90
1
x�
80
70 70
60 _ 60
HYDRAULIC PROFILE
NO SLUE N RI20NTU
1- 10' V RTIGL

AOUA-
4 _. ,..e. t;a
June 15, 2023
NC Department of Environment and Natural Resources
Division of Water Quality
NPDES Unit
1617 Mail Service Center
Raleigh, NC 27699-1617
Subject: Application for Permit Renewal
Aqua North Carolina, Inc.
Salem Glen Subdivision WWTP
NPDES No. NCO083925
Forsyth County
To Whom It May Concern:
Attached are three (3) copies of the completed application Modification
Application Form 2A, flow diagram, and a topographic map. This letter and
attachments are Aqua North Carolina's request to renew the subject permit.
If you need any additional information or assistance, please feel free to contact
me at [e-mail].
Sincerely,
A4tCGLA 94' I�,'
Amanda Berger
Director, Environmental Compliance

North Carolina
Department of Environmental Quality
Division of Water Resources
Modified Application Form 2A
Revised March 2021
Modified Application
Form 2A
Minor Sewage Facilities < 0.1 MGD
and No Pretreatment Program
NPDES Permitting Program
Note: Complete this form if your facility is a MINOR new or existing publicly owned treatment works.

NPDES Permit Number
Facility Name
Modified Application Form 2A
NCO083925
Salem Glen WWTP
Modified March 2021
Form
NC Department of Environmental Quality - Application for NPDES Permit to Discharge Wastewater
MINOR SEWAGE FACILITIES (Before completing this form, please read the instructions. Failure to follow
NPDES
the instructions may result in denial of the application.)
SECTION•N
INFORMATION FOR r
Facility name
1.1
Salem Glen Subdivision WWTP
Mailing address (street or P.O. box)
202 Mackenan Court
City or town
State
ZIP code
o
Cary
NC
27511
EContact
name (first and last)
Title
Phone number
Email address
c
Amanda Berger
Director, Environmental Comr
[phone]
[e-mail]
Location address (street, route number, or other specific identifier) ❑ Same as mailing address
R
LL
5075 Salem Glen Blvd
City or town
State
ZIP code
Lexington
NC
27292
1.2
Is this application for a facility that has yet to commence discharge?
❑ Yes 4 See instructions on data submission ❑ No
requirements for new dischargers.
1.3
Is applicant different from entity listed under Item 1.1 above?
❑ Yes ❑ No + SKIP to Item 1.4.
Applicant name
Applicant address (street or P.O. box)
.Q
A
€
City or town
State
ZIP code
w
c
y
c�
Contact name (first and last)
Title
Phone number
Email address
a
1.4
Is the applicant the facility's owner, operator, or both? (Check only one response.)
❑ Owner ❑ Operator Both
1.5
To which entity should the NPDES permitting authority send correspondence? (Check only one response.)
❑ Facility 0 Applicant ❑ Facility and applicant
(they are one and the same)
1.6
Indicate below any existing environmental permits. (Check all that apply and print or type the corresponding permit
number for each.
E
W
Existing Environmental Permits
a
r❑ NPDES (discharges to surface
❑ RCRA (hazardous waste)
❑ UIC (underground injection
water)
control)
NCO083925
c
o
❑ PSD (air emissions)
❑ Nonattainment program (CAA)
❑ NESHAPs (CAA)
w
rn
y
❑ Ocean dumping (MPRSA)
❑ Dredge or fill (CWA Section
E] Other (specify)
w
404)
Page 1

NPDES Permit Number
Facility Name
Modified Application Form 2A
NCO083925
Salem Glen WWTP
Modified March 2021
1.7
Provide the collections stem information
requested below for the treatment works.
Municipality
Population
Collection System Type
Ownership Status
Served
Served
indicate percentage)
100 % separate sanitary sewer
Il Own ❑ Maintain
d
371
% combined storm and sanitary sewer
❑ Own ❑ Maintain
Z
d
❑ Unknown
❑ Own ❑ Maintain
_
% separate sanitary sewer
❑ Own ❑ Maintain
w
% combined storm and sanitary sewer
❑ Own ❑ Maintain
❑ Unknown
❑ Own ❑ Maintain
a%
separate sanitary sewer
❑ Own ❑ Maintain
combined storm and sanitary sewer
❑ Own ❑ Maintain
❑ Unknown
❑ Own ❑ Maintain
d%
separate sanitary sewer
❑ Own ❑ Maintain
>,
% combined storm and sanitary sewer
❑ Own ❑ Maintain
❑ Unknown
❑ Own ❑ Maintain
Total 371
Population
ci
Served
Combined Storm and
Separate Sanitary Sewer System
. Sanitary Sewer
Total percentage of each type of
100 %
° /�
sewer line in miles)
Z'
1.8
Is the treatment works located in Indian Country?
c
c
❑ ❑ Yes No
R1.9
Does the facility discharge to a receiving water that flows through Indian Country?
E
❑ Yes El No
1.10
Provide design and actual flow rates in the designated spaces.
Design Flow Rate
0.1 mgd
Annual Average Flow Rates Actual
Two Years Ago
Last Year
This Year
c o
0.06 mgd
0.06 mgd0.06
mgd
a� U-
y
Maximum Daily Flow Rates Actual
d
Two Years Ago
Last Year
This Year
0.01 mgd
0.1 mgd
0.087 mgd
1.11
Provide the total number of effluent discharge points to waters of the State of North Carolina by type.
a
Total Number of Effluent Discharge Points by Type
a
Constructed
LM F
Treated Effluent
Untreated Effluent
Combined Sewer
Overflows
Bypasses
Emergency
_
Overflows
G
1
Page 2

NPDES Permit Number
Facility Name
Modified Application Form 2A
NCO083925
Salem Glen WWTP
Modified March2021
Outfalls Other Than to Waters of the State of North Carolina
1.12
Does the POTW discharge wastewater to basins, ponds, or other surface impoundments that do not have outlets
for discharge to waters of the State of North Carolina?
❑ Yes 0 No 4 SKIP to Item 1.14.
1.13
Provide the location of each surface impoundment and associated discharge information in the table below.
Surface Im oundment Location and Dischar a Data
Average Daily Volume
Continuous or Intermittent
Location
Discharged to Surface
(check one)
Impoundment
❑ Continuous
gp d
❑ Intermittent
❑ Continuous
gpd
❑ Intermittent
ElContinuous
gpd
0
❑ Intermittent
s
1.14
Is wastewater applied to land?
M
❑ Yes No SKIP to Item 1.16.
c1.15
Provide the land application site and discharge data requested below.
C
Land Application Site and Discharge Data
in
0
Average Daily Volume
Continuous or
Location
Size
Intermittent
a,
Applied
check one
y
acres
9p d
❑ Continuous
0
❑ Intermittent
acres
gp d
El
o
❑ Intermittent
-0
acres
gp d
❑ Continuous
cc
❑ Intermittent
1.16
Is effluent transported to another facility for treatment prior to discharge?
o
❑ Yes ❑ No -* SKIP to Item 1.21.
1.17
Describe the means by which the effluent is transported (e.g., tank truck, pipe).
1.18
Is the effluent transported by a party other than the applicant?
❑ Yes 0 No + SKIP to Item 1.20.
1.19
Provide information on the transporter below.
Transporter Data
Entity name
Mailing address (street or P.O. box)
City or town
State
ZIP code
Contact name (first and last)
Title
Phone number
Email address
Page 3

NPDES Permit Number
Facility Name
Modified Application Form 2A
NCO083925
Salem Glen WWTP
Modified March 2021
1.20
In the table below, indicate the name, address, contact information, NPDES number, and average daily flow rate of the
receiving facility.
Receivinq F cilitv Data
o
Facility name
Mailing address (street or P.O. box)
City or town
State
ZIP code
0
U
Contact name (first and last)
Title
0
Phone number
Email address
M
cNPDES
number of receiving facility (if any) ❑ None
Average daily flow rate mgd
2
0
1.21
Is the wastewater disposed of in a manner other than those already mentioned in Items 1.14 through 1.21 that do
0
not have outlets to waters of the State of North Carolina (e.g., underground percolation, underground injection)?
s
❑ Yes ❑ No 4 SKIP to Item 1.23.
U
0
1.22
Provide information in the table below on these other disposal methods.
Information on Other Disposal Methods
oDisposal
Location of
Size of
Annual Average
Continuous or Intermittent
Method
Disposal Site
Disposal Site
Daily Discharge
(check one)
R
Description
Volume
❑ Continuous
w
acres
9P d
❑ Intermittent
0
❑ Continuous
acres
gpd
❑ Intermittent
❑ Continuous
acres
gp d
❑ Intermittent
1.23
Do you intend to request or renew one or more of the variances authorized at 40 CFR 122.21(n)? (Check all that apply.
Consult with your NPDES permitting authority to determine what information needs to be submitted and when.)
,�
❑ Discharges into marine waters (CWA ❑ Water quality related effluent limitation (CWA Section
Section 301(h)) 302(b)(2))
Not applicable
1.24
Are any operational or maintenance aspects (related to wastewater treatment and effluent quality) of the treatment works
the responsibility of a contractor?
❑ Yes No +SKIP to Section 2.
1.25
Provide location and contact information for each contractor in addition to a description of the contractor's operational
and maintenance responsibilities.
Contractor Information
Contractor 1
Contractor 2
Contractor 3
o
Contractor name
j
(company name
Mailing address
c
street or P.O. box
c
City, state, and ZIP
code
Contact name (first and
0
last
Phone number
Email address
Operational and
maintenance
responsibilities of
contractor
Page 4

NPDES Permit Number Facility Name Modified Application Form 2A
NCO083925 Salem Glen WWTP Modified March 2021
SECTIONDD• •R•
c Outfalls to Waters of the State of North Carolina
2.1
Does the treatment works have a design flow greater than or equal to 0.1 mgd?
rn
c
❑ Yes ❑ No + SKIP to Section 3.
2.2
Provide the treatment works' current average daily volume of inflow
Average Dally Volume of Inflow and Infiltration
c
and infiltration.
N/A gpd
5
Indicate the steps the facility is taking to minimize inflow and infiltration.
Current peaking factor is < 1 at 0.27
3
0
c
t
2.3
Have you attached a topographic map to this application that contains all the required information? (See instructions for
CL
specific requirements.)
A
rn�
C
Yes ❑ No
Fo
E
2.4
Have you attached a process flow diagram or schematic to this application that contains all the required information?
c 2
(See instructions for specific requirements.)
_ rn
X ,R
c
0 Yes ❑ No
2.5
Are improvements to the facility scheduled?
❑ Yes 0 No 4 SKIP to Section 3.
Briefly list and describe the scheduled improvements.
=
0
1.
c
m
E
!
a
2.
E
w
0
0
d
3.
d
rn
4.
v
A
2.6
Provide scheduled or actual dates of completion for improvements.
=
Scheduled or Actual Dates of Completion for Improvements
m
Scheduled
Affected
Begin
End
Begin
Attainment of
>
o
Improvement
Outfalls
(list outfall
Construction
Construction
Discharge
Operational
Level
(from above)
number
(MM/DD/YYYY)
(MM/DD/YYYY)
(MM/DD/YYYY)
MM/DD/YYYY
-o
m
v
1.
m
s
2.
3.
4.
2.7
Have appropriate permits/clearances concerning other federal/state requirements been obtained? Briefly explain your
response.
❑ Yes ❑ No 0 None required or applicable
Explanation:
Page 5

NPDES Permit Number Facility Name Modified Application Form 2A
NCO083925 Salem Glen WWTP Modified March 2021
SECTION•' • ON 1 1
3.1 Provide the following information for each outfall. (Attach additional sheets if you have more than three outfalls.)
Outfall Number _ 001
Outfall Number
Outfall Number
State
NC
County
Forsyth
O
w
0
City or town
Kernersville
s .
Distance from shore
ft.
ft.
ft.
Q
U)
Depth below surface
d
0
Average daily flow rate
0.05 mgd
mgd
mgd
Latitude
35° 98' 58"
Longitude
80 38' 26"
°
3.2
Do any of the outfalls described under Item 3.1 have seasonal or periodic discharges?
o
o
❑ Yes 0 No 4 SKIP to Item 3.4.
3.3
If so. provide the following information for each applicable outfall.
s
y
Outfall Number
Outfall Number
Outfall Number
0
Number of times per year
0
discharge occurs
a
Average duration of each
-
o
discharge (specify units
Q
Average flow of each
mgd
mgd
mgd
discharge
M
a)
Months in which discharge
occurs
3.4
Are any of the outfalls listed under Item 3.1 equipped with a diffuser?
❑ Yes ❑✓ No 4 SKIP to Item 3.6.
m
3.5
Briefly describe the diffuser type at each applicable outfall.
�
Outfall Number
Outfall Number
Outfall Number
L
b
Does the treatment works discharge or plan to discharge wastewater to waters of the State of North Carolina from
vi
0
3.6
one or more discharge points?
w
❑ Yes 0 No +SKIP to Section 6.
Page 6

NPDES Permit Number
Facility Name
Modified Application Form 2A
NCO083925
Salem Glen WWTP
Modified March 2021
3.7
Provide the receiving water and related information if known for each outfall.
Outfall Number 001
Outfall Number
Outfall Number
Receiving water name
Yadkin PD River Basin
Name of watershed, river,
c
or stream system
Yadkin River
a
U.S. Soil Conservation
y
Service 14-digit watershed
o
code
cc
Name of state
3
managemenUriver basin
U.S. Geological Survey
8-digit hydrologic
W
cataloging unit code
Critical low flow (acute)
cfs
cfs
cfs
Critical low flow (chronic)
cfs
cfs
cfs
Total hardness at critical
mg/L of
mg/L of
mg/L of
low flow
CaCO3
CaCO3
CaCO3
3.8
Provide the following information
describing the treatment pr vided for discharges from each outfall.
Outfall Number 001
Outfall Number
Outfall Number
Highest Level of
❑ Primary
❑ Primary
❑ Primary
Treatment (check all that
❑ Equivalent to
❑ Equivalent to
❑ Equivalent to
apply per outfall)
secondary
secondary
secondary
El Secondary
❑ Secondary
❑ Secondary
❑ Advanced
❑ Advanced
❑ Advanced
❑ Other (specify)
❑ Other (specify)
❑ Other (specify)
c
0
'a
Design Removal Rates by
U
Outfall
Do>
d
BOD5 or C6OD5
85 %
%
%
c
d
E
m
TSS
85 %
%
%
H
• Not applicable
❑ Not applicable
❑ Not applicable
Phosphorus
%
%
%
0 Not applicable
❑ Not applicable
❑ Not applicable
Nitrogen
/o o
0 /o
/o
%
Other (specify)
❑ Not applicable
❑ Not applicable
❑ Not applicable
Page 7

NPDES Permit Number
Facility Name
Modified Application Form 2A
NCO083925
Salem Glen WWTP
Modified March 2021
3.9
Describe the type of disinfection used for the effluent from each outfall in the table below. If disinfection varies by
season, describe below.
UV disinfection with tablet chlorination as backup.
v
m
c
c
0
U
c
Outfall Number 001
Outfall Number
Outfall Number
Disinfection type
UV Disinfection with tablet
u
H
a�
chlorination/dechlorination
G
=
Seasons used
All
d
E
Dechlorination used?
❑ Not applicable
❑ Not applicable
❑ Not applicable
0 Yes
❑ Yes
❑ Yes
❑ No
❑ No
❑ No
3.10
Have you completed monitoring for all Table A parameters and attached the results to the application package?
0 Yes ❑ No
3.11
Have you conducted any WET tests during the 4.5 years prior to the date of the application on any of the facility's
discharges or on any receiving water near the discharge points?
❑ Yes 0 No 4 SKIP to Item 3.13.
3.12
Indicate the number of acute and chronic WET tests conducted since the last permit reissuance of the facility's
discharges by outfall number or of the receiving water near the discharge points.
Outfall Number 001
Outfall Number
Outfall Number
Acute
Chronic
Acute
Chronic
Acute
Chronic
Number of tests of discharge
water
Number of tests of receiving
water
d
E
W
3.14
Does the POTW use chlorine for disinfection, use chlorine elsewhere in the treatment process, or otherwise have
reasonable potential to discharge chlorine in its effluent?
0 Yes + Complete Table B, including chlorine. ❑ No -* Complete Table B, omitting chlorine.
3.15
Have you completed monitoring for all applicable Table B pollutants and attached the results to this application
package?
❑✓ Yes ❑ No
Have you completed monitoring for all applicable Table D pollutants required by your NPDES permitting authority and
3.18
attached the results to this application package?
No additional sampling required by NPDES
El Yes ❑
permitting authority.
Page 8

NPDES Permit Number
Facility Name
Modified Application Form 2A
NCO083925
Salem Glen WWTP
Modified March 2021
3.19
Has the POTW conducted either (1) minimum of four quarterly WET tests for one year preceding this permit application
or (2) at least four annual WET tests in the past 4.5 years?
❑ Yes ❑ No + Complete tests and Table E and SKIP to
Item 3.26.
3.20
Have you previously submitted the results of the above tests to your NPDES permitting authority?
❑ Yes ❑ No + Provide results in Table E and SKIP to
Item 3.26.
3.21
Indicate the dates the data were submitted to our NPDES permitting authority and provide a summary of the results.
Date(s) Submitted
Summary of Results
MMIDD/YYYY
v
m
c
c
0
3.22
Regardless of how you provided your WET testing data to the NPDES permitting authority, did any of the tests result in
o
toxicity?
❑ Yes ❑ No + SKIP to Item 3.26.
3.23
Describe the cause(s) of the toxicity:
c
a>
3
iU
w
3.24
Has the treatment works conducted a toxicity reduction evaluation?
❑ Yes r❑ No + SKIP to Item 3.26.
3.25
Provide details of any toxicity reduction evaluations conducted.
3.26
Have you completed Table E for all applicable outfalls and attached the results to the application package?
❑ Yes Not applicable because previously submitted
information to the NPDES permittinq authority.
Page 9

NPDES Permit Number Facility Name Modified Application Form 2A
NCO083925 Salem Glen WWTP Modified March 2021
SECTION•
CERTIFICATION STATEMENT (40
In Column 1 below, mark the sections of Form 2A that you have completed and are submitting with your application. For
6.1
each section, specify in Column 2 any attachments that you are enclosing to alert the permitting authority. Note that not
all applicants are required to provide attachments.
Column 1
Column 2
❑ Section 1: Basic Application
❑ w/ variance request(s) ❑ w/ additional attachments
Information for All Applicants
__
El Section 2: Additional
El w/ topographic map ❑ w/ process flow diagram
Information
❑ w/ additional attachments
❑� w/ Table A ❑ w/ Table D
❑ Section 3: Information on
✓❑ w/ Table B ❑ w/ additional attachments
Effluent Discharges
E
❑ w/ Table C
d
is
N
Section 4: Not Applicable
c
0
R
Section 5: Not Applicable
r
d
U
v
Section 6: Checklist and
0
❑ w/ attachments
Certification Statement
Y
6.2
Certification Statement
1 certify under penalty of law that this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that qualified personnel properly gather and evaluate the information
submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible
for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and
complete. 1 am aware that there are significant penalties for submitting false information, including the possibility of fine
and imprisonment for knowing violations.
Name (print or type first and last name)
Official title
Amanda Berger
Environmental Compliance Director
Signature
Date signed
06/15/2023
Page 10

NPDES Permit Number
Facility Name
Outfall Number
NCO083925
Salem Glen WWTP
001
Modified Application Form 2A
Modified March 2021
Ig-1.1surg 4 agel
Maximum Daily Discharge
Pollutant
Value Units
Average Daily Discharge
Analytical ML or MDL
Method' (include units)
Value
Units
NSam lesuert
Biochemical oxygen demand
O BOD5 or ❑ CBODS
(report one
41.8
mg/L
6.26
mg/L
235
OML
SM5201B 2 O MDL
Fecal coliform
350
#/100ml
42.8
#/100ml
223
1589
SM9222D;Coliert 18 1 OML
O MDL
Design flow rate
0.19
MGD
0.062
MGD
pH (minimum)
7.4
1151
pH (maximum)
7.4
Temperature (winter)
9
Celsius
14
Celsius
Temperature (summer)
30
Celsius
18.E
Celsius
1151
Total suspended solids (TSS)
40
mg/L
6.2
mg/L
235
SM2540D
2 OML
O MDL
I Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter I, subchapter N or 0. See instructions and 40 CFR 122.21(e)(3).
Page 11

EPA Identification Number I NPDES Permit Number Facility Name Outfall Number Modified Application Form 2A
NCO083925 Salem Glen WWTP 001 Modified March 2021
Maximum Daily Discharge Average Daily Discharge
Analytical
ML or MDL
Pollutant Number of
Value Units Value Units
Method'
(include units)
es
Sams
Ammonia (as N)
4.88
mg/L
2.5
mg/L
83
ASTMD142608A
OML
0.2 O MDL
Chlorine
❑ ML
total residual, TRC z
45
ug/L
29.7
ug/L
57
❑ MDL
Dissolved oxygen
N/A
mg/L
N/A
mg/L
0
OML
❑ MDL
Nitrate/nitrite
37.7
mg/L
14.1
mg/L
53
SM450ONO3E
El ML
21 MDL
Kjeldahl nitrogen
43.1
mg/L
10.45
mg/L
53
SM4500; EPA 351.2
0 ML
0.14;0.26 O MDL
Oil and grease
N/A
OML
❑ MDL
Phosphorus
7.27
mg/L
4.38
mg/L
54
SM4500; EPA 351.2
0.16 OML
O MDL
Total dissolved solids
N/A
❑ ML
❑ MDL
Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter I, subchapter N or 0. See instructions and 40 CFR 122.21(e)(3).
2 Facilities that do not use chlorine for disinfection, do not use chlorine elsewhere in the treatment process, and have no reasonable potential to discharge chlorine in their effluent are not
required to report data for chlorine.
EPA Form 3510-2A (Revised 3-19) Page 12

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Modified Application Form 2A
NC0083925 Salem Glen WWTP 001 Modified March 2021
Maximum Daily Discharge Average Daily Discharge Analytical ML or MDL
Pollutant
Number of Method' (include units)
Value Units Value Units
Samples
Metals, Cyanide, and Total Phenols
Hardness (as CaCO3) ❑ ML
O MDL
El ML
Antimony, total recoverable ❑ MDL
Arsenic, total recoverable ❑ ML
❑ MDL
Beryllium, total recoverable
❑ ML
❑ MDL
Cadmium, total recoverable
❑ ML
❑ MDL
Chromium, total recoverable
❑ ML
❑ MDL
Copper, total recoverable
❑ ML
O MDL
Lead, total recoverable
❑ ML
O MDL
Mercury, total recoverable
❑ ML
❑ MDL
Nickel, total recoverable
❑ ML
❑ MDL
Selenium, total recoverable
❑ ML
❑ MDL
Silver, total recoverable
❑ ML
❑ MDL
Thallium, total recoverable
❑ ML
❑ MDL
Zinc, total recoverable
❑ ML
0 MDL
Cyanide
❑ ML
❑ MDL
Total phenolic compounds
❑ ML
❑ MDL
Volatile Organic Compounds
Acrolein
❑ ML
❑ MDL
Acrylonitrile
El ML
❑ MDL
Benzene
❑ ML
❑ MDL
Bromoform
❑ ML
❑ MDL
EPA Form 3510-2A (Revised 3-19) Page 13

EPA Identification Number
NPDES Permit Number
Facility Name Outfall Number
Modified
Application Form 2A
NCO083925
Salem Glen WWTP 001
Modified March 2021
Maximum Daily Discharge
Average Daily Discharge
Analytical
ML or MDL
Pollutant
Method'
(include units)
Number of
Value
Units
Value
Units
Samples
Carbon tetrachloride
❑ ML
❑MDL
Chlorobenzene
❑ ML
❑ MDL
Chlorodibromomethane
_
❑ ML
❑MDL
Chloroethane
_
❑ ML
❑MDL
0 ML
2-chloroethylvinyl ether
❑ MDL
Chloroform
_ _
❑ ML
❑MDL
❑ ML
Dichlorobromomethane
❑ MDL
❑ ML
1, 1 -dichloroethane
❑ MDL
1,2-dichloroethane
❑ ML
❑ MDL
0 ML
trans- 1, 2-dichloroethylene
❑ MDL
0 ML
1, 1 -dichloroethylene
❑ MDL
11 ML
1,2-dichloropropane
❑ MDL
❑ ML
1,3-dichloropropylene
❑ MDL
❑ ML
Ethylbenzene
❑ MDL
❑ ML
Methyl bromide
❑ MDL
❑ ML
Methyl chloride
❑ MDL
❑ ML
Methylene chloride
❑ MDL
❑ ML
1,1,2,2-tetrachloroethane
❑ MDL
0 ML
Tetrachloroethylene
❑ MDL
❑ ML
Toluene
❑ MDL
❑ ML
1, 1,1 -trichloroethane
❑ MDL
❑ ML
1,1,2-trichloroethane
❑ MDL
EPA Form 3510-2A (Revised 3-19) Page 14

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Modified Application Form 2A
NC008392S Salem Glen WWTP 001 Modified March 2021
Maximum Daily Discharge Average Daily Discharge
Analytical ML or MDL
Pollutant
Number of Method' (include units)
Value Units Value Units
Samples
Trichloroethylene ❑ ML
❑ MDL
Vinyl chloride ❑ ML
❑ MDL
Acid -Extractable Compounds
p-chloro-m-cresol ❑ ML
❑ MDL
2-chlorophenol
❑ ML
❑ MDL
2,4-dichlorophenol
❑ ML
❑ MDL
2,4-dimethylphenol
❑ ML
❑ MDL
4,6-dinitro-o-cresol
❑ ML
❑ MDL
2,4-dinitrophenol
❑ ML
❑ MDL
2-nitrophenol
❑ ML
❑ MDL
4-nitrophenol
❑ ML
❑ MDL
Pentachlorophenol
❑ ML
❑ MDL
Phenol
❑ ML
❑ MDL
2,4,6-trichlorophenol
❑ ML
❑ MDL
Base-Moutrai Compounds
Acenaphthene
❑ ML
❑ MDL
Acenaphthylene
❑ ML
❑ MDL
Anthracene
❑ ML
❑ MDL
Benzidine
❑ ML
❑ MDL
Benzo(a)anthracene
❑ ML
❑ MDL
Benzo(a)pyrene
❑ ML
❑ MDL
3,4-benzofluoranthene
❑ ML
❑ MDL
EPA Form 3510-2A (Revised 3-19) Page 15

EPA Identification Number NPDES Permit Number Facility Name Outfall Number
Modified Application Form 2A
NCOO8392S Salem Glen WWTP 001
Modified March 2021
Maximum Daily Discharge Average Daily Discharge
Analytical ML or MDL
Pollutant Number of
Method' (include units)
Value Units Value Units
Samples
0 ML
❑ MDL
11 ML
❑ MDL
Benzo(ghi)perylene
Benzo(k)fluoranthene
Bis (2-chloroethoxy) methane
0 ML
❑ MDL
0 ML
Bis (2-chloroethyl) ether
❑ MDL
0 ML
Bis (2-chloroisopropyl) ether
❑ MDL
Bis (2-ethylhexyl) phthalate
0 MIL
❑ MDL
0 ML
4-bromophenyl phenyl ether
❑ MDL
❑ ML
Butyl benzyl phthalate
❑ MDL
❑ ML
2-chloronaphthalene
❑ MDL
❑ ML
4-chlorophenyl phenyl ether
❑ MDL
❑ ML
Chrysene
❑ MDL
❑ ML
di-n-butyl phthalate
❑ MDL
❑ ML
di-n-octyl phthalate
❑ MDL
❑ ML
Dibenzo(a,h)anthracene
❑ MDL
❑ ML
1,2-dichlorobenzene
❑ MDL
❑ ML
1,3-dichlorobenzene
❑ MDL
❑ ML
1,4-dichlorobenzene
❑ MDL
❑ ML
3,3-dichlorobenzidine
❑ MDL
❑ ML
Diethyl phthalate
❑ MDL
❑ ML
Dimethyl phthalate
❑ MDL
❑ ML
2,4-dinitrotoluene
❑ MDL
❑ ML
2,6-dinitrotoluene
❑ MDL
EPA Form 3510-2A (Revised 3-19) Page 16

EPA Identification Number
NPDES Permit Number Facility Name Outfall Number
Modified Application Form 2A
NC0083925 Salem Glen WWTP 001
Modified March 2021
Maximum Daily Discharge Average Daily Discharge
Analytical ML or MDL
Pollutant
Number of
Method' (include units)
Value
Units
Value
Units
Samples_____
1,2-diphenylhydrazine
❑ ML
❑ MDL
Fluoranthene
❑ ML
❑ MDL
Fluorene
❑ ML
❑ MDL
Hexachlorobenzene
❑ ML
❑ MDL
Hexachlorobutadiene
❑ ML
❑ MDL
Hexachlorocyclo-pentadiene
❑ ML
❑ MDL
Hexachloroethane
❑ ML
❑ MDL
Indeno(1,2,3-cd)pyrene
❑ ML
❑ MDL
Isophorone
❑ ML
❑ MDL
Naphthalene
❑ ML
❑ MDL
Nitrobenzene
❑ ML
❑ MDL
N-nitrosodi-n-propylamine
❑ ML
❑ MDL
N-nitrosodimethylamine
❑ ML
❑ MDL
N-nitrosodiphenylamine
❑ ML
❑ MDL
Phenanthrene
❑ ML
OM L
Pyrene
❑ ML
❑ MDL
0 1,2,4-trichlorobenzene
❑ ML
❑ MDL
' Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR Chapter I, Subchapter N or 0. See instructions and 40 CFR 122.21(e)(3).
EPA Form 3510-2A (Revised 3-19) Page 17

NPDES Permit Number Facility Name Outfall Number
Modified Application Form 2A
NCOO83925 Salem Glen WWTP
Modified March2021
tip � '• � � �
Dail DiAvera a Dail Dischar aAnal
7�'Maximum
Pollutant
7ae
tical ML or MDL
Y(list)
Value Value Units Numbers
Method' (include units)
Samples
No additional sampling is required
by NPDES permitting authority.
❑ ML
piC/L piC/L Calculated 0.01 O MDL
❑ ML
mg/L mg/L DM45O0CL-C 1 2 MDL
❑ ML
piC/L
piC/L
Calculated
0.01 O MDL
❑ ML
piC/L
piC/L
Calculated
0.01 2 MDL
p iC/L
piC/L
EPA 904
0.01 ❑ ML
O MDL
❑ ML
piC/L
piC/L
EPA 904
0.01
2 MDL
❑ ML
piC/L
piC/L
EAP 905; ASTM D58]
0.01
❑ MDL
ML
piC/L
piC/L
EPA 906
1 p MDL
ug/L
ug/L
EPA 200.8
0.01 ❑ ML
O MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
' Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or requlreo
under 40 CFR chapter I, subchapter N or 0. See instructions and 40 CFR 122.21(e)(3).
Page 18

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Salem glen Subdivision WWTP
NPDES Permit NCO083925
Receiving Stc�:ao. Yadkin River Stre r i Class: WS-V
Stream Segmet 12-(93.5) Sub -Basin #: 03-07-02
River Basin: Yadkin -Pee Dee HUC: 030401011501
County: Davidson
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