NC0056791_Complete File - Historical_20150105

AAA,
NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory Donald van der Vaart
Governor Secretary
January 5, 2015
Mr. Norris Z. Clayton
Hugh Creed Associates, Inc.
P.O. Box 9623
Greensboro, NC 27429-9623
Subject: Rescission of NPDES Permit NC0056791
Horizons Residential Care Center WWTP
Forsyth County
Dear Mr. Clayton: 1
The Division has reviewed your permit rescission request received on
December 5, 2014 . The Division has no objection to your request.
Therefore, NPDES permit NC0056791 is rescinded, effective immediately.
If in the future your organization wishes to discharge .wastewater to
the State' s surface waters, it must first apply 1 for and receive a new
NPDES permit.
If you have any questions concerning this matter, please contact Charles H.
Weaver at (919) 807-6391 or via e-mail [charles [e-mail]] .
inc rely,
G
Thomas A. Reede , Director
Division of Water Resources
cc: Central Files
Winston-Salem Regional Office / Ron Boone
NPDES Unit
Teresa Revis / Budget
1617 Mail Service Center,Raleigh,North Carolina 27699-1617 512 North Salisbury Street,Raleigh,North Carolina 27604
Phone: [phone]/FAX [phone]/Internet:www.ncwaterquality.org
An Equal Opportunity/Affirmative Action Employer-50%Recycled/10%Post Consumer Paper

4
'Weaver, Charles
From: Boone, Ron
Sent: Monday, January 05, 2015 2:29 PM
To: Weaver, Charles
Cc: Basinger, Corey
Subject: RE: NC0056791 rescission request
Yes
Ron Boone
NC DENR Winston-Salem Regional Office
Division of Water Resources, Surface Water Protection
450 West Hanes Mall Road, Suite#300
Winston-Salem, NC 27105-9135
Email: [e-mail]
Office: [phone]
Mobile: [phone]
E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be
disclosed to third parties.
From: Weaver, Charles
Sent: Monday, January 05, 2015 2:25 PM
To: Boone, Ron
Cc: Basinger, Corey
Subject: NC0056791 rescission request
Ron—Hugh Creed &Associates sent a letter requesting rescission of the Horizons Residential Care Center WWTP permit.
They are "currently utilizing a subsurface wastewater disposal system...permitted through the NCDHHS...and the Forsyth
County Health Department."
Can I rescind it?
Thanks,
CHW
1

• Hugh Creed Associates, Inc. P.A.
Consulting Engineers & Land Surveyors
1306 W.WENDOVER AVENUE P.O. BOX 9623
GREENSBORO, N.C. 27408 GREENSBORO,N.C. 27429
TELE: [phone] OR [phone] FAX: [phone]
FIRM LICENSE#C-0551 E-MAIL:[e-mail]
December 2, 2014
NCDENR
Division of Water Quality
Surface Water Protection Section RECEIVED/DENR/DWR
1617 Mail Service Center
Raleigh,NC 27699 DEC - 5 2014
Re: Horizons Residential Care Center WWTP Water Quality
100 Horizons Lane, Forsyth County Permitting Section
NPDES Permit No.: NC0056791
To Whom It May Concern,
I am submitting this letter on behalf of the Horizons Residential Care Center to inform
NCDENR, Division of Water Quality, Surface Water Protection Section that the above
referenced wastewater treatment facility is closed. The facility is currently utilizing a
subsurface wastewater disposal system approved and permitted through the NCDHHS
Water Protection Section and the Forsyth County Health Department.
If there should be any questions, please do not hesitate contacting our office.
Sincerely,
Hugh Creed Associates, Inc., P.A.
Av-24?;
Norris Z. Clayton, P.E., P.L.S.
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December 2, 2014
K:\I-Iorizons Residential Care Center\I-lorizons WW Facility Closed.doc
1

vAid11
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Charles Wakild, P.E. Dee Freeman
Governor Director Secretary
February 17,2012
Mr.T. David Adams,President&CEO
Horizons Residential Care Center
100 Horizons Lane
Rural Hall,NC 27045
Subject: Issuance of NPDES Permit NC0056791
Horizons Residential Care Center WWTP
Forsyth County
Dear Mr.Adams:
Division personnel have reviewed and approved your application for renewal of the subject permit. Accordingly,
we are forwarding the attached NPDES discharge permit. This permit is issued pursuant to the requirements of
North Carolina General Statute 143-215.1 and the Memorandum of Agreement between North Carolina and the
U.S. Environmental Protection Agency dated October 15,2007(or as subsequently amended).
This final permit includes no significant changes from the draft permit sent to you on December 7,2011.
If any parts,measurement frequencies or sampling requirements contained in this permit are unacceptable to you,
you have the right to an adjudicatory hearing upon written request within thirty(30)days following receipt of this
letter. This request must be in the form of a written petition, conforming to Chapter 150B of the North Carolina
General Statutes,and filed with the Office of Administrative Hearings(6714 Mail Service Center, Raleigh,North
Carolina 27699-6714). Unless such demand is made,this decision shall be final and binding.
Please note that this permit is not transferable except after notice to the Division. The Division may require
modification or revocation and reissuance of the permit. This permit does not affect the legal requirements to
obtain other permits which may be required by the Division of Water Quality or permits required by the Division
of Land Resources,the Coastal Area Management Act or any other Federal or Local governmental permit that
may be required.
If you have any questions concerning this permit,please contact Bob Sledge at telephone number(919)807-
6398,or via e-mail at [e-mail].
:racer: y,
'Charles Wakild, P.E.
cc: Central Files
Winston-Salem Regional Office/Surface Water Protection Section
NPDES File
1617 Mail Service Center,Raleigh,North Carolina 27699-1617 One
Location:512 N.Salisbury St Raleigh,North Carolina 27604 North Carolina
Phone: www.ncwaterquality.org
1 FAX:[phone] JV'aturallu
Internet ww.ncwatecwaterquality.org
An Fnual Onnnrtunity 1 Affirmative Action Emnlover

Permit NC0056791
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
PERMIT
TO DISCHARGE WASTEWATER UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provisions of North Carolina General Statute 143-215.1, other lawful standards
and regulations promulgated and adopted by the North Carolina Environmental Management
Commission, and the Federal Water Pollution Control Act, as amended,the
Horizons Residential Care Center
is hereby authorized to discharge wastewater from a facility located at the
Horizons Residential Care Center WWTP
100 Horizons Lane
East of Rural Hall
Forsyth County
to receiving waters designated as Buffalo Creek in the Roanoke River Basin
in accordance with effluent limitations, monitoring requirements, and other conditions set forth in Parts
I, II, III and IV hereof.
This permit shall become effective March 1, 2012.
This permit and authorization to discharge shall expire at midnight on February 28, 2017.
Signed this day February 17, 2012.
C s Wakild, P.E., Director
ision of Water Quality
By Authority of the Environmental Management Commission

V
Permit NC0056791
SUPPLEMENT TO PERMIT COVER SHEET
All previous NPDES permits issued to this facility, whether for operation or discharge are hereby
revoked. As of this permit issuance, any previously issued permit bearing this number is no longer
effective. Therefore,the exclusive authority to operate and discharge from this facility arises under the
permit conditions, requirements,terms, and provisions included herein.
The Horizons Residential Care Center
is hereby authorized to:
1. Continue to operate an existing 0.015 MGD wastewater treatment system with the following
components:
• Septic/Dosing tank with alternating pumps
• Dual alternating surface sandfilters
• Recirculation manhole and pump
• Recirculation sprinkler pump tank
• Tablet chlorination
• Tablet dechlorination
• Post aeration
• Effluent pump station and force main
The facility is located east of Rural Hall, at 100 Horizons Lane, in Forsyth County.
2. Discharge from said treatment works at the location specified on the attached map into Buffalo
Creek, classified C waters in the Roanoke River Basin.

y
Permit NC0056791
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Horizons Residential Care Center
Latitude:36°13'49" Facility
Longitude:80°13'55" Location
Quad# C18NW NPDES Permit
Receiving Stream:Buffalo Creek NC0056791
Stream Class: C Forsyth County
Subbasin:03-02-01
y

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Permit NC0056791
A. (1.) EFFLUENT LIMITATIONS AND MONITORING REQUIREMENTS -FINAL
During the period beginning on the effective date of this permit and lasting until expiration,the
Permittee is authorized to discharge from outfall 001. Such discharges shall be limited and monitored
by the Permittee as specified below:
EFFLUENT CHARACTERISTICS LIMITS MONITORING REQUIREMENTS
Monthly Daily Measurement Sample Type Sample Location
Parameter Code Average Maximum Frequency
Flow 50050 0.015 MGD Weekly Instantaneous Influent or Effluent
BOD,5-day(20°C) C0310 30.0 mg/L 45.0 mg/L 2/Month Grab Effluent
Total Suspended Residue C0530 30.0 mg/L 45.0 mg/L 2/Month Grab Effluent
NH3 as N 16.0 mg/L 35.0 mg/L 2/Month Grab Effluent
(April 1—October 31) C0610
NH3 as N 2/Month Grab Effluent
(November 1—March 31) C0610
Fecal Coliform(geometric mean) 31616 200/100 ml 400/100 ml 2/Month Grab Effluent
Total Residual Chlorine1 50060 28 µg/L Weekly Grab Effluent
Temperature(°C) 00010 Weekly Grab Effluent
pH2 00400 2/Month Grab Effluent
Footnotes:
1. The Division shall consider all effluent TRC values reported below 50 µg/L to be in compliance with the
permit. However, the Permittee shall continue to record and submit all values reported by a North Carolina
certified laboratory(including field certified), even if these values fall below 50 pig/L.
2. The pH shall not be less than 6.0 standard units nor greater than 9.0 standard units.
There shall be no discharge of floating solids or visible foam in other than trace amounts

• 4
Hi Corey&James,
Sledge,Bob
I'm a bit late in getting these out to WSRO and TACU;I apologize for that. We've had trouble scanning since the IT folks
From: Boone,Ron did the data mi ration thin and I dropped the ball instead of finding a workaround. Anyway,these are copies of what
To: Sledge,Bob we sent to the Horizons Residential Care Center in Forsyth County,and Aqua NC's Meadow Ridge S/D WTP in Guilford
Cc: Basinger,Corey County. They're converted from the Word documents and do not include signature on the cover letter.
Subject: RE:Draft NPDES Permits
Please call or reply with any questions or concerns.
Bob, •
Bob
I haste no comments on NC0056791,Horizons Residential Care Center.Feel free to move forward. Bob Sledge
Thanks, Environmental Specialist
Compliance&Expedited Permits Unit
Ron NC Division of Water Quality
[e-mail]
Ron Boone [phone]
NC DENR Winston-Salem Regional Office
Division of Water Quality,Surface Water Protection E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be
585 Waughtown Street disclosed to third parties.
Winston-Salem,NC 27107
Voice:[phone]
FAX:[phone]
E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be
disclosed to third parties.
From:Basinger,Corey
Sent:Wednesday,December 21,2011 1:05 PM
To:Mickey,Mike;Boone,Ron
Subject:RN:Draft NPDES Permits
FYI.•
Please review and provide any comments back to Bob Sledge.
Cc:me on any comments.
Thanks.
CB
W.Corey Basinger
Regional Supervisor
Surface Water Protection Section
Winston-Salem Regional Office
Division of Water Quality
Email:corev.basinger [e-mail]
Phone:[phone]
Fax[phone]
E-mail correspondence to and from this address mcy be subject to the North Carolina Public Records Law and may be disclosed to
third parties. •
From:Sledge,Bob
Sent:Wednesday,December 21,2011 1:01 PM
To:Basinger,Corey;Pugh,James L.
Subject:Draft NPDES Permits
1 2

•
Winston-Salem Journal
Advertising Affidavit Account Number
a 3376309
Winston-Salem Journal
P.O Box 3159 Date
Winston-Salem, NC 27102 December 13,2011
NCDENR/DWQ/POINT SOURCE BRANCH
ATTN:DINA SPRINKLE
1617 MAIL SERVICE CENTER
RALEIGH,NC 27699-1617
Date Category Description Ad Size Total Cost
12/13/2011 Legal Notices PUBLIC NOTICE North Carolina Environmental Managem 1 x 75 L 543.00
PUBLIC NOTICE 1 Media General Operations, Inc.
North Carolina Environmental
Management Commission/NPDES Unit Publisher of the I
1617 Mail Service Center
Raleigh,NC 27699-1617 Winston-Salem Journal
Notice of Intent to Issue a
NPDES Wastewater Permit Forsyth County
The North Carolina Environmental Management
Commission proposes to issue a NPDES wastewa-
ter discharge permit to the person(s)listed below. Before the undersigned,a Notary Public of Forsyth County,North Carolina,duly
Written comments regarding the proposed permit commissioned,qualified,and authorized by law to administer oaths,personally appeared S.
will be accepted until 30 days after the publish A.Bragman,who by being duly sworn deposes and says:that she is the Assistant Controller
date of this notice. The Director of the NC Division
of Water Quality (DWQ) may hold a public hearing I of the Winston-Salem Journal,engaged in the publishing of a newspaper known as
should' there be a significant degree of public in- 1
terest. Please mail comments and/or information Winston-Salem Journal,published,issued and entered as second class mail in the City of
requests to DWQ at the above address. Interested Winston-Salem,in said County and State:that she is authorized to make this affidavit and
persons may visit the DWQ at 512 N. Salisbury
Street, Raleigh, NC to review information on file. sworn statement:that the notice or other legal advertisement,a true copy of which is
Additional information on NPDES permits and this attached hereto,waspublished in the Winston-Salem Journal on the followingdates:
notice may be found on our website: http://portal
ncdenr.or9/web/wq/swp/ps/npdes/calendar, or
by calling(919)807-6304.
12/13/2011
Stokes County Schools requested renewal of per-
mit NC0087980/Pine Hall Elementary School
WWTP. Facility discharges to Eurins Creek/ Roa- and that the said newspaper in which such notice,paper document,or legal advertisement •
noke River Basin. Currently, fecal coliform is wa-
ter quality limited. was published was,at the time of each and every such publication,a newspaper meeting all
Stokes County Sc'hools requested renewal of per- the requirements and qualifications of Section 1-597 of the General Statutes of North
mit NC0044962/North Stokes High School WWTP. Carolina and was a qualified newspaper within the meaning of Section 1-597 of the General
Facility discharges treated wastewater to an un-
named tributary to the Dan River/Roanoke River Statutes of North Carolina.
Basin. Currently, total residual chlorine and fecal
coliform are water quality limited.
Stokes County Schools requested renewal of This 13th day of December,2011
NPDES perrnit NC0044954/South Stokes High
School WWTP. Facility discharges to Little Neat-
man Creek/Roanoke River Basin. Currently, fecal (signature ofp son making affidavit)
coliform and total residual chlorine are water
quality limited.
City of Winston-Salem, Forsyth County, has ap-
plied to renew permit NC0086762 for PW Swain Sworn to and subscribed before me,this 13th day of December,2011
WTP, o✓Tr Ridge Road, discharging (Basin. ck• , --��1 � Q-L
wash to UT Bashavia Creek,Yadkin River Basin.
Carolina Water Service,Inc.NC requested renewal
of permit NC0050461 for Abington Subdivision
WWTP in Forsyth County;this permitted discharge
is treated domestic wastewater to Belews Creek, . MIMALEY JOHNSON
Roanoke River Basin. NOTARY PUBLIC
Horizons Residential Care Center applied for re- My Commission expiresS ,)S 2.01C • FORSYTH COUNTY
newal of NPDES permit NC0056791 for the Hori- 9®®999 STATE OF NORTH CARQLIVVA
zons Residential Care Center WWTP in Forsyth MY COMMISSION EXPIRE�"rLllll//S
I County; this permitted discharge is treated do
mestic wastewater to Buffalo Creek in the Roa- -- - --- e--- »
noke River Basin. THIS IS NOT A BILL. PLEASE PAY FROM INVOICE. THANK YOU
Allegiance Healthcare Investors, LLC requested re-
newal of permit NC0037311/Creekside Manor Rest
. Home/Forsyth County. Facility discharges to an .
unnamed tributary to Belews Creek/Roanoke
River Basin. Currently dissolved oxygen, ammonia
nitrogen, fecal coliform and total residual chlorine
are water quality limited.

•
FACT SHEET FOR EXPEDITED PERMIT RENEWALS
This form must be completed by Permit Writers for all expedited permits which do not require
full Fact Sheets. Expedited permits are generally simple 100%domestics(e.g., schools,mobile
home parks,etc)that can be administratively renewed with minor changes,but can include
facilities with more complex issues(Special Conditions,303(d)listed water,toxicity testing,
instream monitoring,compliance concerns).
Basic Information for Expedited Permit Renewals
Permit Writer/Date Bob Sledge 12/6/11
Permit Number NC0056791
Facility Name Horizons Residential Care Center
Basin Name/Sub-basin number Roanoke 03-02-01
Receiving Stream Buffalo Creek
Stream Classification in Permit C
Does permit need Daily Max NH3 limits? No, summer limits existing
Does permit need TRC limits/language? Existing—added footnote language
Does permit have toxicity testing? No
Does permit have Special Conditions? No
Does permit have instream monitoring? No
Is the stream impaired(on 303(d)list)? No
Any obvious compliance concerns? No
Any permit mods since last permit? Yes,TRE.mon. freq. changed to weekly
Current expiration date 2/29/2012
New expiration date 2/28/2017
Comments received on Draft Permit? Yes No If Yes,discuss response with
Supervisor
Most Commonly Used Expedited Language:
• 303(d)language for Draft/Final Cover Letters: "Please note that the receiving stream
is listed as an impaired waterbody on the North Carolina 303(d)Impaired Waters List.
Addressing impaired waters is a high priority with the Division,and instream data will
continue to be evaluated. If there is noncompliance with permitted effluent limits and
stream impairment can be attributed to your facility,then mitigative measures may be
required".
• TRC language for Compliance Level for Cover Letters/Effluent Sheet Footnote:
"The Division shall consider all effluent TRC values reported below 50 µg/L to be in
compliance with the permit. However,the Permittee shall continue to record and submit
all values reported by a North Carolina certified laboratory(including field certified),
even if these values fall below 50 µg/L."
BIMS Compliance Download: Queries>Reports>Violations>Monitor Report Violations>Limit
Violations for Past 3 Years
Reminder: Permits that are not subject to expedited renewal include the following: 1)Major
Facility(municipal/industrial);2)Minor Municipals with pretreatment program; 3)
Minor Industrials subject to Fed Effluent Guidelines(lb/day limits for BOD,TSS,etc);4)
Limits based on reasonable potential analysis(metals,GW remediation organics);5)
Permitted flow>0.5 MGD(requires full Fact Sheet); 6)permits determined by Supervisor to be
outside expedited process.
Note: This sheet is located on NPDES Server/CurrentVersions/Expedited Fact Sheet May2010

''fir - HORIZONS RESIDENTIAL CARE CENTER
100 Horizons Lane •;• Rural Hall, NC 27045
Phone: [phone] Fax: [phone] ❖ www.horizonscenci,Qpy
r.
August 10, 2011
Mrs. Dina Sprinkle
NCDENR/DWQ/Point Source Branch
1617 Mail Service Center
Raleigh, NC 27699-1617
Dear Mrs.Sprinkle,
Please find enclosed the required items for renewal of our permit for the operation of our privately
owned wastewater treatment center. This letter is our official request for renewal of the permit
NC0056791 which is scheduled to expire on February 29, 2012.
Since the issuance of the current permit,there have been no substantive changes in the facility which
impact the wastewater treatment facility.
The sludge generated by this system is removed by a licensed septic company which pumps the sludge
from the holding tank on a regular schedule, and more often if needed.
Sincerely
0 (A-tj/fiz4/"77)
T. David Adams SEP 2 2011
President&CEO
DENR-WATER QUALITY
POINT SOURCE BRANCH
Horizons Residential Care Center is a rivate non-profit o ani ation which provides,with utmost dignity and respect, compassionate care
p � z
and qualify services appropriate to the needs of individuals with developmental disabilities and their families.

NPDES APPLICATION - FORM D
For privately owned treatment systems treating 100% domestic wastewaters <1.0 MGD
Mail the complete application to:
N. C. DENR / Division of Water Quality / NPDES Unit
1617 Mail Service Center, Raleigh, NC 27699-1617
NPDES Permit NC005.6 Q
If you are completing this form in computer use the TAB key or the up - down arrows to move from one
field to the next. To check the boxes, click your mouse on top of the box. Otherwise,please print or type.
1. Contact Information:Horizons Residential Care Center
Owner Name c/o T. David Adams, President & CEO
Facility Name Horizons Residential Care Center
Mailing Address 100 Horizons Lane
City Rural Hall
State / Zip Code North Carolina 27045
Telephone Number ( 336 ) 767-2411
Fax Number 336 ) 661-2185
e-mail Address [e-mail]
2. Location of facility producing discharge:
Check here if same address as above IT
Street Address or State Road
City
State / Zip Code
County
3. Operator Information:
Name of the firm, public organization or other entity that operates the facility. (Note that this is not
referring to the Operator in Responsible Charge or ORC) M
Name Horizons Residential Care Center D E @ N. 11nn �`l R
r Mailing Address
100 Horizons Lane
City Rural Hall SEA' 2 2011
State / Zip Code North Carolina 27045 DENR-WArERt QUALITY
POINT SOURCE BRANCH
Telephone Number ( 336 ) 767-2411
Fax Number ( 336 ) 661-2185
1 of 3 Forrn-D 05/08

NPDES APPLICATION - FORM D
For privately owned treatment systems treating 100% domestic wastewaters <1.0 MGD
4. Description of wastewater:
Facility Generating Wastewater(check all that apply):
Industrial ❑ Number of Employees
Commercial ❑ Number of Employees
Residential El Number of Homes
School ❑ Number of Students/Staff
Other ® Explain: Residential Center tor Disabled Children
30 Children & 113 Staff
Describe the source(s) of wastewater (example: subdivision, mobile home park, shopping centers,
restaurants, etc.): The source of wastewater is from a Residential Center serving
30 disabled children and an Administrative Office building.
Population served: 30 Disabled Children & 113 Staff/day
5. Type of collection system
[] Separate (sanitary sewer only) ❑ Combined (storm sewer and sanitary sewer)
6. Outfall Information:
Number of separate discharge points 1
Outfall Identification number(s) 001
Is the outfall equipped with a diffuser? ❑ Yes ® No
7. Name of receiving stream(s) (Provide a map showing the exact location of each outfall):
Buffalo Creek
8. Frequency of Discharge: ® Continuous ❑ Intermittent
If intermittent:
Days per week discharge occurs: Duration:
9. Describe the treatment system
List all installed components, including capacities,provide design removal for BOD, TSS, nitrogen and
phosphorus. If the space provided is not sufficient, attach the description of the treatment system in a
separate sheet of paper.
See attached.
2 of 3 Form-D 05/08

•
•
NPDES APPLICATION - FORM D
For privately owned treatment systems treating 100% domestic wastewaters <1.0 MGD
10. Flow Information:
Treatment Plant Design-flow .015 MGD
Annual Average daily flow .0036 MGD (for the previous 3 years)
Maximum daily flow .0043 MGD (for the previous 3 years)
11. Is this facility located on Indian country?
❑ Yes ® No
12. Effluent Data
Provide data for the parameters listed. Fecal Coliform, Temperature and pH shall be grab samples,for all other
parameters 24-hour composite sampling shall be used. If more than one analysis is reported, report daily maximum
and monthly average. If only one analysis is reported, report as daily maximum.
Daily Monthly Units of
Parameter Maximum Average Measurement
Biochemical Oxygen Demand (BOD5)s) 7.23 5.20 mq/1
Fecal Coliform <1 0 #100/m1
Total Suspended Solids 6.67 3.39 mg/1
Temperature (Summer) 23 21 o C
Temperature (Winter) 6.4 o C
P 8
pH 6.63 6.3 SU
13. List all permits, construction approvals and/or applications:
Type Permit Number Type Permit Number
Hazardous Waste (RCRA) NESHAPS (CAA)
UIC (SDWA) Ocean Dumping (MPRSA)
NPDES NC0056791 Dredge or fill (Section 404 or CWA)
PSD (CAA) Other
Non-attainment program (CAA)
14. APPLICANT CERTIFICATION
I certify that I am familiar with the information contained in the application and that to the
best of my knowledge and belief such information is true, complete, and accurate.
T. David Adams President & CEO
Printed name of Person Signing Title
,4/1/ — FJ3/
ll
re of Applicant pplicant Date
North Carolina General Statute 143-215.6 (b)(2) states: Any person who knowingly makes any false statement representation, or certification in any
application, record, report, plan, or other document files or required to be maintained under Article 21 or regulations of the Environmental Management
Commission implementing that Article, or who falsifies, tampers with, or knowingly renders inaccurate any recording or monitoring device or method
required to be operated or maintained under Article 21 or regulations of the Environmental Management Commission implementing that Article,shall be
guilty of a misdemeanor punishable by a fine not to exceed$25,000,or by imprisonment not to exceed six months,or by both. (18 U.S.C.Section 1001
provides a punishment by a fine of not more than$25,000 or imprisonment not more than 5 years,or both,for a similar offense.)
3 of 3 Form-D 05/08

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
May 5, 2011
Mr. David Adams
Horizons Residential Care Center
100 Horizons Lane
Rural Hall,North Carolina 27045
Subject: NPDES Permit Modification
Permit Number NC0056791
Horizons Residential Care Center
Stokes County
Dear Mr. Adams:
Division personnel have reviewed and approved your request for modification of the
subject permit. This permit modification authorizes a change in monitoring frequency for
Total Residual Chlorine from 2/week to weekly.
The attached permit page should be placed in the permit and the old page discarded. This
permit modification 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).
If you have any questions or need additional information, please do not hesitate to
contact Maureen Scardina of my staff at(919) 807-6388.
Sinc ely,
' Coleen H. Sullins
Enclosure
cc: Central Files
NPDES Unit Files
Winston-Salem Regional Office
1617 Mail Service Center,Raleigh,North Carolina 27699-1617
Location:512 N.Salisbury St.Raleigh,North Carolina 27604 One
Phone:[phone] FAX:[phone] Customer Service:1-877-623-6748 NorthCarolina
Internet:www.ncwaterctuality.orq Naturally
An Equal Opportunity\Affirmative Acton Employer

Permit NC0056791 ' •
A. (1.) EFFLUENT LIMITATIONS AND MONITORING REQUIREMENTS
During the period beginning on the effective date of this permit and lasting until
expiration, the Permittee is authorized to discharge from outfall 001. Such discharges
shall be limited and monitored by the Permittee as specified below:
EFFLUENT LIMITS MONITORING REQUIREMENTS
CHARACTERISTICS
Monthly Weekly Daily Measurement Sample Type Sample Location
Average Average Maximum Frequency
Flow 0.015 MGD Weekly Instantaneous Influent or Effluent
BOD, 5-day(20°C) 30.0 mg/L 45.0 mg/L 2/Month Grab Effluent
Total Suspended Residue 30.0 mg/L 45.0 mg/L 2/Month Grab Effluent
NH3 as N 16.0 mg/L 35.0 mg/L 2/Month Grab Effluent
(April 1 —October 31)
NH3 as N 2/Month Grab Effluent
(November 1 —March 31)
Fecal Coliform(geometric mean) 200/100 ml 400/100 ml 2/Month Grab Effluent
Total Residual Chlorine 28 µg/L Weekly Grab Effluent
Temperature(°C) Weekly Grab Effluent
pH1 2/Month Grab Effluent
Footnotes:
1. The pH shall not be less than 6.0 standard units nor greater than 9.0 standard units.
There shall be no discharge of floating solids or visible foam in other than trace amounts

HORIZONS RESIDENTIAL CARE CENTER
100 Horizons Lane ❖ Rural Hall, NC 27045
Phone: [phone] ❖ Fax: [phone] ❖ www.horizonscenter.org
April 26, 2011
Mr. Charles Weaver
Division of Water Quality
Surface Water Protection Section—NPDES
1617 Mail Service Center
Raleigh,NC 27699-1617
Dear Mr. Weaver,
It has come to my attention that we are providing a twice-per-week monitoring for Total
Chlorine Residual (TRC)while, as a grade I treatment facility, we are only required to have our
operator visit and provide reports weekly. Therefore, in compliance with our classification as a
Grade I treatment facility, I request that the twice-per-week monitoring requirement for TRC be
modified to a once-per-week requirement in accordance with our classification.
This change will result in a financial savings for Horizons, a local, non-profit agency which can
benefit from any savings in our expenses. I appreciation your attention to this important matter
and look forward to hearing from you regarding this change.
Sincerely,
T. David Adams
President& CEO
/ 12P, rqrlIV7=
APR 28 n
DEN_" w e_
QUTY
4011
POINT SOURCE
OURE BRAN H
Horizons Residential Care Center is a private, non profit organization which provides, with utmost dignity and respect, compassionate care
and quality services appropriate to the needs of individuals with developmental disabilities and their families.

TEA
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
April 20, 2011
Horizons Residential Care Center
Attn: David Adams
100 Horizons Lane
Rural Hall, NC 27045
Subject: Total Residual Chlorine Monitoring
Permittee: Horizons Residential Care Center
Facility: Horizons Residential Care Center
NPDES Permit#: NC0056791
Forsyth County
Dear Mr. Adams:
It has recently come to our attention that your NPDES wastewater discharge permit has a twice-per-week
monitoring requirement for Total Chlorine Residual (TRC), yet is classified as a grade I treatment facility, which
only requires weekly visitation by the Operator in Responsible Charge (ORC). This somewhat contradictory set of
circumstances forces Horizons to pay their contract operator to come to the plant twice per week just to test the
TRC level in the effluent, despite the fact that the grade of the facility only requires them to visit the plant once per
week. As I am completely unaware of the amount your contract operator charges for such services, I could only
guess at how much reducing his visits to once per week would save Horizons, but I would feel comfortable in
saying it would likely result in a significant savings.
This situation can be easily rectified by your requesting a modification to the permit to reduce the TRC
monitoring requirement from twice per week to once per week. To do so, please send an official letter to the
attention of Mr. Charles Weaver at the following address:
Division of Water Quality
Surface Water Protection Section—NPDES
Attn: Charles Weaver
1617 Mail Service Center
Raleigh, NC 27699-1617
If you have any questions whatsoever or wish to discuss this situation in great detail please do not
hesitate to contact me at 336-771-4963 or corev.basingere.ncdenr.gov, or Ron Boone at 336-771-4967 or
ron.booneencdenr.aov. Thank you for your attention to this matter.
Sincerely,
W. Corey Basinger
Surface Water Regional Supervisor
Winston-Salem Regional Office
Division of Water Quality
CC: WSRO-SWP
Central
PDES Uni
North Carolina Division of Water Quality,Winston-Salem Regional Office
Location:585 Waughtown St.Winston-Salem,North Carolina 27107 One
Phone:[phone] FAX:[phone] t.Customer Service:1-877-623-6748 NorthCarolina
Internet:www.ncwaterquality.org Naturally
An Equal Opportunity\Affirmative Action Employer

•
- Weaver, Charles
From: Boone, Ron
Sent: Wednesday, April 20, 2011 7:55 AM
To: Weaver, Charles
Subject: RE: NC0056791 Horizons Residential Care
Charles,
Is there a particular form the permittee would need to fill out, or should they just send you a letter requesting the
permit mod?
Ron
Ron Boone
NC DENR Winston-Salem Regional Office
Division of Water Quality, Surface Water Protection
585 Waughtown Street
Winston-Salem, NC 27107
Voice: [phone]
FAX: [phone]
E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be
disclosed to third parties.
From: Weaver, Charles
Sent: Tuesday, April 19, 2011 8:51 AM
To: Boone, Ron
Subject: RE: NC0056791 Horizons Residential Care
We can't reopen the permit—only Coleen can authorize that. She usually doesn't.
If the permittee requests a mod to reduce TRC monitoring. I can process it.
CHW
From: Boone, Ron
Sent: Tuesday, April 19, 2011 8:18 AM
To: Weaver, Charles; Basinger, Corey
Subject: RE: NC0056791 Horizons Residential Care
Charles,
Just a quick review of their compliance history in BIMS for TRC over the past year shows that they're, for the most part,
compliant.They're less compliant with the monitoring requirement than the limit. I strongly suggest we somehow
amend this permit to reduce the monitoring requirement to weekly or we will be dealing with frequent monitoring
violations.
Ron
Ron Boone
NC DENR Winston-Salem Regional Office
Division of Water Quality, Surface Water Protection
1

F
• 585 Waughtown Street
" -Winston-Salem, NC 27107
Voice: [phone]
FAX: [phone]
E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be
disclosed to third parties.
From: Weaver, Charles
Sent: Tuesday, April 19, 2011 7:59 AM
To: Boone, Ron
Subject: RE: NC0056791 Horizons Residential Care
If they are compliant with TRC, they could ask us to reduce monitoring to weekly. That would solve it.
CT-lw
•
From: Boone, Ron
Sent: Monday, April 18, 2011 3:43 PM
To: Weaver, Charles
Subject: NC0056791 Horizons Residential Care
Another question for you Sir. BIMS has the subject facility classified as a grade I; it's a sand filter system. But it also
requires them to monitor TRC twice per week. Never showed up till now I guess just because they were taking TRCs
twice per week even though they only have to visit once. What should we do with this one?
Ron Boone
NC DENR Winston-Salem Regional Office
Division of Water Quality,Surface Water Protection
585 Waughtown Street
Winston-Salem, NC 27107
Voice: [phone]
FAX: [phone]
E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be
disclosed to third parties.
2

ADDITIONAL INFORMATION .
City of Claremont- North WWTP
tNC0032662
Outfail 001
Part E-Toxicity Testing Data
Pass/Fail 7 Day Chronic-Ceriodaphnia dubia
Results
L(Monitoring Period CollectionDate Test Date r EPA Lab ID No. NC Cart.No. Test Method Used lir<'C% TM ® �>- <_A-mow �� --•---
•
Groin 120 Mortality Avg. fteprod. %Redo t n ass/Fail
EPAI600/4-91/002 Method 1 ({
1/1/09-3/31/09 1/5/2009 1/7/2009 0004 34 1002.0 NC Modification 13% Control 0.C10°io 22.5C� 4 07% ! PASS
February 1988 j (!
Test 0.00% 21.55�
EPA/E00/4-91/002 Method Control O.CO% 23.0
4/1/09-6/30/09 4/13/2009 4/15/2009 0004 34 1002.0 NC Modification 13% 2.54°•o PASS
February 1988
Test 0.00% 22.42
EPA/600/4-91/002 Method
7/1/09-9/30/09 7/20/2009 7/22/2009 0004 34 1002.0 NC Modification 13% Control 0.00% 24.40 09%0 PASS
February 1988
Test 0.0% 26.50
EPA/600/4-91/002 Method I i
10/1/09-12/31/09 10/19/2009 10/21/2009 0004 34 1002.0 NC Modification 13% Control 0.00°!° 32.50i 1 5% i PASS
February 1988
Test 0.0% 32.00t
Control
Test
—
Control
i
Test
Control
t l
Test
I Control
Test
1

O�O wAT ) Michael F.Easley,Governor
y William G.Ross Jr.,Secretary
` [ North Carolina Department of Environment and Natural Resources
Coleen H.Sullins,Director
Division of Water Quality
June 14,2007
Mr.Thomas E. Byrd
Executive Director
Horizons Residential Care Center
100 Horizons Lane
Rural Hall,North Carolina 27045
Subject:Issuance of NPDES Permit NC0056791
Horizons Residential Care Center WWTP
Forsyth County
Dear Mr.Byrd:
Division personnel have reviewed and approved your application for renewal of the subject permit.
Accordingly,we are forwarding the attached NPDES discharge permit. This permit is issued pursuant to the
requirements of North Carolina General Statute 143-215.1 and the Memorandum of Agreement between North
Carolina and the U.S.Environmental Protection Agency dated May 9, 1994(or as subsequently amended).
the draftpermit sent toyou on March
This final permit includes no major changes from 28,
2007.
If any parts,measurement frequencies or sampling requirements contained in this permit are
unacceptable to you,you have the right to an adjudicatory hearing upon written request within thirty(30)days
following receipt of this letter. This request must be in the form of a written petition,conforming to Chapter
150B of the North Carolina General Statutes,and filed with the Office of Administrative Hearings (6714 Mail
Service Center,Raleigh,North Carolina 27699-6714). Unless such demand is made,this decision shall be final
and binding.
Please note that this permit is not transferable except after notice to the Division. The Division may
require modification or revocation and reissuance of the permit. This permit does not affect the legal
requirements to obtain other permits which may be required by the Division of Water Quality or permits
required by the Division of Land Resources,the Coastal Area Management Act or any other Federal or Local
governmental permit that may be required. If you have any questions concerning this permit,please contact
Karen Rust at telephone number [phone],extension 361.
Sincerely,
//6/ s.
• Coleen H.Sullins
cc: Central Files
Winston-Salem Regional Office/Surface Water Protection Section
NPDES Files
One
No Carolina
,Naturally
N.C.Division of Water Quality 1617 Mail Service Center Raleigh,North Carolina 27699-1617 Phone: [phone] Customer Service
Internet: httpJ/h2o.enr.state.nc.us 512 N.Salisbury St. Raleigh,NC 27604 Fax: [phone] 1-877-623-6748
An Equal Opportunity/Affirmative Action Employer

O�O� W A T�q�G
Michael F.Easley,Governor
Uj William G.Ross Jr.,Secretary
•
North Carolina Department of Environment and Natural Resources
7-1
O
Coleen H.Sullins,Director
Division of Water Quality
June 14,2007
Mr.Thomas E.Byrd
Executive Director
Horizons Residential Care Center
100 Horizons Lane
Rural Hall,North Carolina 27045
Subject:Issuance of NPDES Permit NC0056791
Horizons Residential Care Center WWTP
Forsyth County
Dear Mr.Byrd:
Division personnel have reviewed and approved your application for renewal of the subject permit.
Accordingly,we are forwarding the attached NPDES discharge permit. This permit is issued pursuant to the
requirements of North Carolina General Statute 143-215.1 and the Memorandum of Agreement between North
Carolina and the U.S.Environmental Protection Agency dated May9 1994(or as subsequently amended).
g cY 9 Y )
This final permit includes no major changes from the draft permit sent to you on March 28,
2007.
If any parts,measurement frequencies or sampling requirements contained in this permit are
unacceptable to you,you have the right to an adjudicatory hearing upon written request within thirty(30)days
following receipt of this letter. This request must be in the form of a written petition,conforming to Chapter
150B of the North Carolina General Statutes,and filed with the Office of Administrative Hearings (6714 Mail
Service Center,Raleigh,North Carolina 27699-6714). Unless such demand is made,this decision shall be final
and binding.
Please note that this permit is not transferable except after notice to the Division. The Division may
require modification or revocation and reissuance of the permit. This permit does not affect the legal
requirements to obtain other permits which may be required by the Division of Water Quality or permits
required by the Division of Land Resources,the Coastal Area Management Act or any other Federal or Local
governmental permit that may be required. If you have any questions concerning this permit,please contact
Karen Rust at telephone number(919) 733-5083,extension 361.
Sincerely,
k///4
4 Coleen H. Sullins
cc: Central Files
Winston-Salem Regional Office/Surface Water Protection Section
NPDES Files
No Carolina
Na`turally
N.C.Division of Water Quality 1617 Mail Service Center Raleigh,North Carolina 27699-1617 Phone: [phone] Customer Service
Internet httpJ/h2o.enr.state.nc.us 512 N.Salisbury St. Raleigh,NC 27604 Fax: [phone] 1-877-623-6748
An Equal Opportunity/Affirmative Action Employer

Permit NC0056791
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
PERMIT
TO DISCHARGE WASTEWATER UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful
standards and regulations promulgated and adopted by the North Carolina Environmental
Management Commission, and the Federal Water Pollution Control Act, as amended, the
Horizons Residential Care Center
is hereby authorized to discharge wastewater from a facility located at the
Horizons Residential Care Center WWTP
100 Horizons Lane
Rural Hall
Forsyth County
to receiving waters designated as Buffalo Creek in the Roanoke River Basin
in accordance with effluent limitations, monitoring requirements, and other
conditions set forth in Parts I, II, III and IV hereof.
This permit shall become effective July 1, 2007.
This permit and authorization to discharge shall expire at midnight on February 29, 2012.
Signed this day June 14, 2007.
Coleen H. Sullins, Direct
Division of Water Quality
By Authority of the Environmental Management Commission

Permit NC0056791
SUPPLEMENT TO PERMIT COVER SHEET
All previous NPDES permits issued to this facility, whether for operation or
discharge are hereby revoked. As of this permit issuance, any previously issued
permit bearing this number is no longer effective. Therefore, the exclusive authority
to operate and discharge from this facility arises under the permit conditions,
requirements, terms, and provisions included herein.
The Horizons Residential Care Center is hereby authorized to:
1. Continue to operate an existing 0.015 MGD wastewater treatment system with
the following components:
• Septic/Dosing tank with alternating pumps
• Dual alternating surface sandfilters
• Recirculation manhole and pump
• Recirculation
P m P
sprinkler u tank
P
• Tablet chlorination
• Tablet dechlorination
• Post aeration
• Effluent pump station and force main
The facility is located in Rural Hall at 100 Horizons Lane in Forsyth County.
2. Discharge from said treatment works at the location specified on the attached
map into Buffalo Creek, classified C waters in the Roanoke River Basin.

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Latitude: 36°13'49" Stream Class: C Facility
,,,,,„Aipp
Longitude: 80°13'55" Subbasin: 030201 Location
Quad # C 18NW
Receiving Stream: Buffalo Creek
NC0056791 - Horizons Residential Care Center
Forsyth County

Permit NCOO56791
A. (1.) EFFLUENT LIMITATIONS AND MONITORING REQUIREMENTS
During the period beginning on the effective date of this permit and lasting until
expiration, the Permittee is authorized to discharge from outfall 001. Such discharges
shall be limited and monitored by the Permittee as specified below:
EFFLUENT LIMITS MONITORING REQUIREMENTS
CHARACTERISTICS
Monthly Weekly Daily Measurement Sample Type Sample Location
Average Average Maximum Frequency
Flow 0.015 MGD Weekly Instantaneous Influent or Effluent
BOD,5-day(20°C) 30.0 mg/L 45.0 mg/L 2/Month Grab Effluent
Total Suspended Residue 30.0 mg/L 45.0 mg/L 2/Month Grab Effluent
6 0 mg
/L as N 1 mg/L 35.0 2/Month Grab Effluent
9
(April 1 —October 31)
NH3 as N 2/Month Grab Effluent
(November 1 —March 31)
Fecal Coliform(geometric mean) 200/100 ml 400/100 ml 2/Month Grab Effluent
Total Residual Chlorine 28 µg/L 2/Week Grab Effluent
Temperature(PC) Weekly Grab Effluent
pH1 2/Month Grab Effluent
Footnotes:
1. The pH shall not be less than 6.0 standard units nor greater than 9.0 standard units.
There shall be no discharge of floating solids or visible foam in other than trace amounts

i
'vv.
1 f a ,<, .
North Carolina Wildlife Resources Commission
Richard B. Hamilton,Executive Director 1 D Q u u -)
MEMORANDUM ct l__ APR 2 2007 i
TO: S Wilson, NPDES Unit
ivision of Water Quality
DER - YYA1c;{ U;;.;ui t
FROM: Ron Linville,Regional Coordinator POINT soI; �!: s ,' -'{_
Habitat Conservation Program
DATE: April 19, 2007
SUBJECT: Wastewater Treatment Plant (WWTP) Permits—Dan/Roanoke River Basin
Biologists with the North Carolina Wildlife Resources Commission (NCWRC) have reviewed
NC Division of Water Quality (DWQ) notices for the proposed issuance of WWTP permits for
potential impacts to fish and wildlife. Biologists with the NCWRC are familiar with habitat
values in the area. The NCWRC is authorized to comment and make recommendations which
relate to the impacts of this permit or project to fish and wildlife pursuant to Clean Water Act of
1977, North Carolina Environmental Policy Act, US National Environmental Policy Act,
Endangered Species Act (16 U. S. C. 1531-1543; 87 Stat 884), the Fish and Wildlife
Coordination Act (48 Stat. 401, as amended; 16 U.S.C. 661-667d) and/or Federal License of
Water Resource Project Act(Federal Power Act-16 U.S.C. 791a et seq.) as applicable.
DWQ is in the process of issuing and/or re-issuing National Pollutant Discharge Elimination
System (NPDES) permits for several WWTPs that discharge into the Dan/Roanoke River basin.
Biologists with the North Carolina Wildlife Resources Commission (NCWRC) have reviewed
the location of these sites and have determined that additional scrutiny is appropriate for
ammonia, chlorine, and copper. The specific NPDES permits we have reviewed are:
• Cains Way Homeowners Association(NC0075027)
• Horizons Residential Care Center(NC0056791)
• Kobe Wieland Copper Products,Inc. (NC0035173)
• Stokes County Board of Education(NC0044954,NC0044962, NC0087980)
• Town of Danbury (NC0043290)
• Twin Lakes Mobile Home Park (NC0057720)
Chlorine & Ammonia Concerns-
Chlorine is acutely toxic to aquatic organisms and forms secondary compounds that are also
detrimental to aquatic life, especially eggs and juveniles. We also have concerns regarding daily
ammonia concentrations. Freshwater mussels are among the most sensitive aquatic organisms
tested for impacts from ammonia, and ammonia may be a significant limiting factor for unionids
Mailing Address: Division of Inland Fisheries • 1721 Mail Service Center • Raleigh,NC 27699-1721
Telephone: [phone] • Fax: [phone]

Dan River NPDES Permits -Page 2- April 19,2007
(Augspurger et al., 2003). Recent research by Augspurger et al. (2003) found that ammonia
concentrations which may be protective of freshwater mussels range from 0.3 to 1.0 mg/L total
ammonia as N at pH 8.
Copper Concerns -
Treated wastewater from Kobe Wieland Copper Products Inc. is discharged to an unnamed
tributary that flows into the lower portion of the Dan River, a Significant Aquatic Resource as
designated by the North Carolina Natural Heritage Program. The Dan River provides diverse
species habitats and harbors several State and Federally listed mussel and fish species, including
the James (River) Spiny Mussel, Pleurobema collina (State Endangered, Federal Endangered).
There are recent records (2001) for the Green floater, Lasmigona subviridis (State Endangered,
Federal Species of Concern) recorded in the NCWRC Aquatics Database. These records are
directly below the confluence of the aforementioned unnamed tributary to the Dan River.
Although the James (River)Spiny Mussel has not been reported in this lower section of the Dan
River, the possibility strongly exists since the Green Floater is a common species associate of the
James (River) Spiny Mussel in the Dan River. The discharge of copper to the unnamed tributary
is an immediate concern for both mussel species. In a 28-day chronic Copper toxicity
experiment, Wang et al. (in press) demonstrated that as little as 12-21 micrograms of copper per
liter of water (0.012-0.021 milligrams/liter) results in an LC-50 (concentration that kills 50% of
the animals in the sample; i.e., Lethal Concentration) for several species of native juvenile
freshwater mussels. This research suggests that mussels are more sensitive to copper pollutants
than other taxa (e.g., fish and microcrustaceans). Monitoring records indicate that on December
31st, 2006 Kobe Wieland Copper Products Inc. discharged an average of 136 micrograms of
copper per liter of water (0.136 milligrams/liter) from pipe 001 and 380 micrograms of copper
per liter of water (0.380 milligrams/liter) from pipe 003 (data extracted from E.P.A. Enviro facts
Data Warehouse). Those discharge concentrations are well above detrimental levels for juvenile
freshwater mussels according to recent research(Wang et al. in press).
The following recommendations should be evaluated and incorporated into these and other
NPDES permits as appropriate to avoid and reduce potential impacts to fish and wildlife
resources, especially in areas known to support listed and highly sensitive species:
1. Only non-chemical disinfection like ultraviolet or ozone should be permitted and used.
Chlorine should be expressly prohibited from any use (including emergency operations)
at the WWTP. This should provide the additional benefit of removing hazardous
materials from the environment and the workplace.
2. Ammonia limits should be reduced to the maximum extent practicable. Ammonia and
pH monitoring should be required daily. Daily composite sampling may be appropriate.
3. If not already in place, we recommend provision of automatic stand-by power generation
to prevent plant emergencies and upsets caused by power outages.
4. If publicly owned collection systems and treatment works (POTW) become available,
these facilities should be required to connect to the POTW without delay.
5. Kobe Wieland Copper Products, Inc. and any other NPDES permits with copper issues
should have reduced copper limits to avoid potential impacts to aquatic species,
especially where federally listed aquatic species are known within the watershed.
Although other factors may also contribute to aquatic habitat degradation, we believe the above
evaluations and prevention measures are appropriate. Limits should protect aquatic habitats

Dan River NPDES Permits -Page 3- April 19,2007
(water quality) and preclude acute or chronic issues from WWTP point source discharges. We
are especially concerned about maintaining aquatic habitat values in the Dan/Roanoke River
basin and similar healthy watersheds. These high value habitats are usually undeveloped
watersheds that need proactive management strategies to preclude impairment from development
as well as from point and non-point issues.
Thank you for the opportunity to provide input during the planning stages for this project. If we
can be of further assistance, please contact me at 336-769-9453. Mr. Robert Nichols, Aquatic
Wildlife Diversity Coordinator is very knowledgeable about the Dan/Roanoke basin's listed
aquatic species as well as the diversity of aquatic species present in the watershed. You may
- - 9. You maycontact Tom Augspurger with the U.S. Fish and
contact Mr.Nichols at 919 786 178
Wildlife Service at 919-856-4520 for additional information concerning toxicity and federally
listed species.
Literature cited:
Augspurger, T., A.E. Keller, M.C. Black, W.G. Cope and F.J. Dwyer. 2003. Water quality
guidance for protection of freshwater mussels (Unionidae) from ammonia exposure.
Environmental Toxicology and Chemistry 22: 2569-2575. (See attached file: Augspurger
et al. Mussel Ammonia Article.ET&C.Nov.2003.pdf)
Wang, N., C.G. Ingersoll, E.I. Greer, D.K. Hardesty, C.D. Ivey, J.L. Kunz, F.J. Dwyer, A.D.
Roberts, T. Auspurger, C.M. Kane, R.J. Neves, and M.C. Barnhart. Assessing
contaminant sensitivity of early life stages of freshwater mussels (Unionidae): Chronic
toxicity testing of juvenile freshwater mussels with copper and ammonia. Environmental
Toxicology and Chemistry. In Press.
Wang, N., C.G. Ingersoll, D.k. Hardesty, C.D. Ivey, J.L. Kunz, T.W. May, F.J. Dwyer, A.D.
Roberts, T. Augspurger, C.M. Kane, R.J. Neves, and M.C. Barnhart. Assessing
contaminant sensitivity of early life stages of freshwater mussels (Unionidae): Acute
toxicity of copper, ammonia, and chlorine to glochidia and juvenile mussels.
Environmental Toxicology and Chemistry. In Press.

NORTH CAROLINA
t'ORSYTH COUNTY
AFFIDAVIT OF PUBLICATION
Before the undersigned, a Notary Public of said County and State, duly
commissioned, qualified, and authorized by law to administer oaths, personally
appeared D.H. Stanfield, who being duly sworn, deposes and says: that he is
Controller of the Winston-Salem Journal, engaged in the publishing of a newspaper
known as Winston-Salem Journal, published, issued and entered as second class mail
in the City of Winston-Salem, in said County and State: that he is authorized to
make this affidavit and sworn statement: that the notice or other legal advertisement,
a true copy of which is attached hereto, was published in Winston-Salem Journal on
the following dates:
March 31, 2007
and that the said newspaper in which such notice, paper document, or legal
advertisement was published was, at the time of each and every such publication, a
newspaper meeting all the requirements and qualifications of Section 1-597 of the
General Statutes of North Carolina and was a qualified newspaper within the
meaning of Section 1-597 of the General Statutes of North Carolina.
PUBLIC NOTICE
STATE OF NORTH CAROLINA
This 2nd dayof April, 2007 ENVIRONMENTAL MANAGEMENT COMMISSION/
p NPOES UNIT
1617 MAIL SERVICE CENTER
(signature o pers n ak g affidavit) RALEIGH,NC 27699-1617
NOTIFICATION OF INTENT TO ISSUE
A NPOES WASTEWATER PERMIT
Sworn to and subscribed before me, this 2nd day of April, 2007 On the basis l Statute
1h 3 staff review and application
and
of NC General Statute 143.21,Public law 92-500 and
other lawful standards and regulations the North
Carolina Environmental Management Commission
proposes to Issue a National Pollutant Discharge
Elimination System (NPDES) wastewater discharge
permit to person(s)listed below effective 45 days
from the publishublish date of this notice.
Written comments regarding the proposed permit
NOtaQ
lic will be accepted until 30 days after me publish date of
this notice.All comments received prior to that date
are considered in the final determinations regarding
the proposed permit.The Director of the NC Division
f Water Quality may decide to hold a public meeting
My Commission expires: September 28, 2010 for the proposed permit should the Division receive a
significant degree of public interest.
Copies of thedraft permit and other supporting infor-
mation on fl e used to determine conditions present
in the draft permit are available upon request and
payment of the costs of reproduction.Mail comments
and/or requests for information to the NC Division of
Water Quality at the above address or call the Point
Source Branch at(919)733-5083,extension 363.Com-
ments can also be emailed to Qarolvn.Bryantfnc�
KIMALEY JOHNSON et. Please include the NPDES permit number
NOTARY PUBLIC •
(attached)in any communication,interested persons
may also visit the Division of Water Quality at 512 N.
Salisbury Street,Raleigh,NC 27604-1148 between the
FORSYTH COUNTY
STATE OF NORTH CAA! IN; hours of 8:00 a.m.and 5:00 p.m.to review information
d ,'; on file.
MY COMMISSION EXPIRES __c Stokes County Beard of Education(PO Box WOE Lambe-
- — _ rryy,NC 27016)has applied for renewal of NPDES ppermit
o of I
a u,a,• e o•av o,;of v o uv o,a,-` tit0044954 fortheouthStokesHI Sch001 W WTPin
t a.•t i0 o c of 812�11 a° 1}•-`a,i. Stokes County. This permitted acll discharges
F Tcw zaoi=yc� _ Ity3 ro c o ro „ a, of o,,o: 0.0173 MGD treated wastewat r to Little Neatman
_LY�E� So ' w 3SE a '- of
�y o �.!� u gel af•H�;Pell d ;�u�.�c Creek in theRoanoke River ggas n Currently,total re-
MU g 3m•v" 0S'""o 4 a�f o° a c„$„o o a o `b.2a-a E 2 sidual chlorineis water quality l hilted This dischar e
2 �wcw� (]ov�ao.v 0/� c °1 e
ra*E-c:t Kai �� i { ,����gas ��2o may affect future allocations In this portion ofN 5° E fsz X4•c`t o w gy Ez 5,o 2g 9a&or Roanoke River Basin.Y't uofSo'r'- Nc .y -.. a, -y.,v .-IE Stokes County Board of Education(PO Box SS.Danbu-
«.v.u�o w'o�.o s `o c v0 f
v c b.-- -w NC 27016)has applied for renewal of NPD�ESS permit
3 a,v o 't ' =o a,_w •` °" °' o No0044962 for the North Stokes Jr./Sr.High school
t54 O.y OLO+•->OD E cg.z` �- cof� ~ Et c 4ow"-c o WWTP in Stokes County.This permitted facility un-
o_rra, „f E m vim.- om o. otc�a,�•-r charges 0.0115 MGD treated wastewater to an un-
o,u1aY 'i ^NAY cd a named tributary to the Dan River in the Roanoke River
fall,: o o u o vx a: E c a ovf n ro v f, °Basin.Currently,total residual chlorine is water puali-
;t.-«D v- * ,-E .-v af� `ty'limited-This discharge may affect future alloca-
"„ c cL c g cofr t r c a of t tans in this portion o the Roanoke River Basin.
o p a- 3• �. ,^•-oaf ,�,.. u+o._o o E� w
c--t 1ro�~v,2_° rg4•ate,a NoaNaft•- 1
a Ufa a of aym"cal J" ' me aE•. uz g,:_ � Mr. John Henry Splinhom' (PO Box 839 King, NC
o c b o z o-c z c--A�.4 3' 27621 has applied for renewal of NPDES permit
c 3 u c,�L oY b L� o E •-c o� M NC0057720 for the Twin Lakes Mobile Home Park
� •.-a c:e F
c oo•$ , WWTP in Stokes County.This permitted facility dis-
dv •-Ec .a°1e%E_ ag a. -P-$,E`o
a� c �ro o e a a charges 0.04 MGD treated wastewater to an unnamed
3m a.. ,.,�, ,t . a�,`o?2 ; �a�r`�g., tributary to Timmons Creek in the Roanoke River Ba-
• -,g E g d~c lq-§s "—• rana aE�, c eoE "- 3.•c sin.Currently,BOD,ammonia-nitrogen and total re-
gga" $c l> 11a g a.-gala o ivo f ry a IN sldual chlorine are water quality limited. This dis-
p c boa CwiY zvwm 3.. zm am m I charge may affect future allocations in this portion of
1 1 the Roanoke River Basin.

Horizons Residential Care Center
100 HORIZONS LANE•RURAL HALL,NC 27045
PHONE [phone] • FAX [phone]
August 22, 2006
Mrs. Carolyn Bryant
NC DENR/DWQ/ Point Source Branch
1617 Mail Service Center
Raleigh,NC 27699-1617
Subject: Permit Renewal Application
NPDES Permit NC0056791
Horizons Residential Care Center
Forsyth County
Dear Mrs. Bryant:
Enclosed is the completed renewal application for the above referenced waste water
treatment plant. There have been no changes at this facility since the issuance of the last
permit. I am requesting renewal of the permit for this facility.
Thank you for you attention to this request.
Sincerely,
"c5Airrna41 a ler
Thomas E. Byrd
Executive Director

•
NPDES APPLICATION - FORM D
For privately owned treatment systems treating 100% domestic wastewaters <1.0 MGD
Mail the complete application to:
N. C. Department of Environment and Natural Resources
Division of Water Quality / NPDES Unit
1617 Mail Service Center, Raleigh, NC 27699-1617
NPDES Permit INC005-(07
If you are completing this form in computer use the TAB key or the up - down arrows to move from one
field to the next. To check the boxes, click your mouse on top of the box. Otherwise,please print or type.
•
1. Contact Information: I I(J
!ZOIJ s Res'DENT(T( /1 O— Ce_t.yTe.i(
Owner Name CIO Th®mvs E. alga Exec'_QL-nue. Cot Rec,ToQ
Facility Name A[9RIZCNS RI`sI.Der.rn A.4 �Aiz.E.
Mailing Address 100 D 1Z Iz o,J,S L Ate'E
City Ri&aA-i t(
State / Zip Code ;{} OQ.T Ei R D I era. 02 70 4 5-
-Telephone Number (336) 74, 7- a q- (I
Fax Number (33(e) (,,( / .- f gs'
e-mail Address -}• , _ b .lZ J horrnA;` I o
2. Location of facility producing discharge:
Check here if same address as above Lid
Street Address or State Road
City
State / Zip Code
County
3. Operator Information:.
r entity that operates the facility. (Note that this is not
referring to the Operator in Responsible Charge or ORC)
Name I-loaIZ.GN?s R611 oe KrriAI CAVE e.vNrl✓R
Mailing Address i©Oty(,,�ii IZorJS LAIN F
City P.,uIZINI 64Ar 1(
State / Zip Code N D A T I.} C A a o &
Telephone Number (33() '7 (Q°7_ a q (l
Fax Number (33(e) We i s al I S
1 of 2 Form-D 4/05

NPDES APPLICATION - FORM D
For privately owned treatment systems treating 100% domestic wastewaters <1.0 MGD
4. Description of wastewater:
Facility Generating Wastewater(check all that apply)
Industrial ❑ Number of Employees
Commercial ❑ Number of Employees
Residential ❑ Number of Homes
School ❑ Number of Students/Staff
Other [ Explain: Re o tn)riA-1 C,G,h?r'E2 FC!$Z DI SAIN-CD C-h I LDR.6.IJ
Sea Chr Idw.I 766 6TA-f-F
Describe the source(s) of wastewater (example: subdivision, mobile home park, shopping centers,
restaurants, etc.): T 60.A.R.CV. Gc W a,STe,(AlcxTe+R I S c(Lvm a. geSi pg".yrovi
CzKrreg seR -NG 3b c�isetb(e-d c'4 1�.2enD ADO AN Ac a%i1.iter2ATiue
oCc ce bur���,�
Population served: 3© Cris' hk di‘;'(8.- S S' -e i 7it ff dAy
5. Type of collection system
[Separate (sanitary sewer only) ❑ Combined (storm sewer and sanitary sewer)
6. Outfall Information:
Number of separate discharge points (
Outfall Identification number(s) 00 I
Is the outfall equipped with a diffuser? ❑ Yes [ No
7. Name of receiving stream(s) (Provide a map showing the exact location of each outfall)
)kccPfo CQ.t✓E. k
8. Frequency of Discharge: 2 Continuous ❑ Intermittent
If intermittent:
Days per week discharge occurs: Duration:
9. Describe the treatment system
List all installed components, including capacities,provide design removal for BOD, TSS, nitrogen and
phosphorus. If the space provided is not sufficient, attach the description of the treatment system in a
separate sheet of paper.-1 f
SEE. ATTAcHiD
2 of 2 Form-D 4/05

NPDES APPLICATION - FORM D
For privately owned treatment systems treating 100% domestic wastewaters <1.0 MGD
10. Flow Information:
Treatment Plant Design flow •015 MGD
Annual Average daily flow • 00_3 6 MGD (for the previous 3 years)
Maximum daily flow •0043 MGD (for the previous 3 years)
11. Is this facility located on Indian country?
❑ Yes [VNo
12. Effluent Data
Provide data for the parameters listed. Fecal Coliform, Temperature and pH shall be grab samples,fir all other
parameters 24-hour composite sampling shall be used.Effluent testing data must be based on at least three samples
and must be no more than four and one half years old.
Parameter Daily Monthly Units of Number of
Maximum Average Measurement Samples
Biochemical Oxygen Demand
(BOD5) 7, 33 09 m j/ I 3
Fecal Coliform < I © *Joo/lr1 I 3
Total Suspended Solids 4,0 3. 0 m q / 1 3
Temperature (Summer) No• © �4•S' b C 3
Temperature (Winter) f 0, p 8 r 3 �+G 3
pH 6 r 83 +� ..u. -3
13. List all permits, construction approvals and/or applications:
Type Permit Number Type Permit Number
Hazardous Waste (RCRA) NESHAPS (CAA)
UIC (SDWA) Ocean Dumping(MPRSA)
NPDES NscOo5 (,e7 cj / Dredge or fill (Section 404 or CWA)
PSD (CAA) Special Order of Consent (SOC)
Non-attainment program (CAA) Other
14. APPLICANT CERTIFICATION
I certify that I am familiar with the information contained in the application and that to the
best of my knowledge and belief such information is true, complete, and accurate.
—Thor E. B4eCS E xeccrTeve Dtr.ecrb2
Printed name of Person Signing Title
AtellYW E. ee c.c � 02 ,c -v cis V,21 0
I I
Signature of Applica t Date
North Carolina General Statute 143-215.6 (b)(2) states: Any person who knowingly makes any false statement
representation, or certification in any application, record, report, plan, or other document files or required to be
maintained under Article 21 or regulations of the Environmental Management Commission implementing that Article, or
who falsifies, tampers with, or knowly renders inaccurate any recording or monitoring device or method required to be
operated or maintained under Article 21 or regulations of the Environmental Management Commission implementing
that Article, shall be guilty of a misdemeanor punishable by a fine not to exceed $25,000, or by imprisonment not to
exceed six months, or by both. (18 U.S.C. Section 1001 provides a punishment by a fine of not more than $25,000 or
imprisonment not more than 5 years, or both, for a similar offense.)
3 of 3 Form-D 1/06

Horizons Residential Care Center
Waste Water Treatment Plant
North Carolina NPDES No. NC0056791
100 Horizons Lane
Rural Hall, NC 27045
General Description of Elements
• One 10,000 gallon septic tank.
• One 10,000 gallon recirculation sprinkler pump tank with two alternating
discharge pumps, and control float valves.
• Pump control panel with audible and visual trouble alarms.
• Two 40 foot by 40 foot external surface sandfilters each with 9
recirculation heads.
• One manhole tank with recirculation pump and valve.
• One tablet chlorination unit.
• One tablet dechlorination unit.
• One 1,000 gallon aeration tank.
• One manhole discharge tank with two alternating discharge pumps, float
valves and control panel.
• 3 inch underground force main.
Discharges to receiving stream: Buffalo Creek
Sludge management plan: Septic tank sludge is removed by a permitted
commercial septic tank pumping company and delivered to the city of
Winston-Salem's Elledge Wastewater Treatment Plant.
-cfkina4-2, tetixec.Jat.e) auctio' 8/ /o(
Thomas E. Byrd, Executive Director

Horizons Residential Care Center
100 HORIZONS LANE •RURAL HALL,NC 27045
PHONE [phone] • FAX [phone]
Sludge Management Plan
Horizons Residential Care Center
NPDES Permit NC0056791
Forsyth County
Septic tank sludge is removed by a permitted commercial septic tank
pumping company and delivered to the city of Winston-Salem's Elledge
Wastewater Treatment Plant.
IdkOaCt2, . 4(01 AttatbA tatic-tW
Thomas E. Byrd, Executive Director
gio140
Date

FACT SHEET FOR EXPEDITED PERMIT RENEWALS
Basic Information to determine potential for expedited permit renewal
Reviewer/Date ,.i s/2.9
Permit Number /1/e. 0 0
Facility Name /-/ ,-;- ii</e• s;,la
Basin Name/Sub-basin number (-) 1 2 o / CC • ., !<<
Receiving Stream ,
Stream Classification in Permit G o L.. 1' 1
Does permit need NH3 limits? ;t /414x 5-
Does permit need TRC limits? a/,, ,r,s.f..„a
Does permit have toxicity testing? A/o
Does permit have Special Conditions? A/0
Does permit have instream monitoring? n/p
Is the stream impaired (on 303(d) list)? A/o
Any obvious compliance concerns? ,r/c,
Any permit mods since last permit? A/o
Existing expiration date
Reissued permit expiration date / -z.z/t2
Miscellaneous Comments
YES ✓ This is a SIMPLE EXPEDITED permit renewal (administrative
renewal with no changes, or only minor changes such as TRC, NH3,
name/ownership changes). Include conventional WTPs in this group.
YES_ This is a MORE COMPLEX EXPEDITED permit renewal (includes
Special Conditions (such as EAA, Wastewater Management Plan), 303(d)
listed, toxicity testing, instream monitoring, compliance concerns, phased
limits). Basin Coordinator to make case-by-case decision.
YES_ This permit CANNOT BE EXPEDITED for one of the following reasons:
• Major Facility (municipal/industrial)
• Minor Municipals with pretreatment program
• Minor Industrials subject to Fed Effluent Guidelines (lb/day limits for BOD,TSS,
etc)
• Limits based on reasonable potential analysis (metals, GW remediation organics)
• Permitted flow >0.5 MGD (requires full Fact Sheet)
• Permits determined by Basin Coordinator to be outside expedited process
TB Version 8/18/2006 (NPDES Server/Current Versions/Expedited Fact Sheet)

•
State of North Carolina
Department of Environment Alp
• 7A
and Natural Resources
Division of Water Quality — — —
Michael F. Easley, Governor •
William G. Ross, Jr., Secretary NCDENR
Gregory J. Thorpe, Ph.D., Acting Director NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
April 12, 2002
Mr. Thomas E. Byrd, President
Horizons Residential Care Center
100 Horizons Lane
Rural Hall, North Carolina 27045
Subject: Issuance of NPDES Permit NC0056791
Horizons Residential Care WWTP
Forsyth County
Dear Mr. Byrd:
Division personnel have reviewed and approved your application for renewal of the subject
permit. Accordingly, we are forwarding the attached NPDES discharge permit. This permit is
issued pursuant to the requirements of North Carolina General Statute 143-215.1 and the
Memorandum of Agreement between North Carolina and the U.S. Environmental Protection
Agency dated May 9, 1994 (or as subsequently amended).
If any parts, measurement frequencies or sampling requirements contained in this permit are
unacceptable to you, you have the right to an adjudicatory hearing upon written request within
thirty (30) days following receipt of this letter. This request must be in the form of a written
petition, conforming to Chapter 150B of the North Carolina General Statutes, and filed with the
Office of Administrative Hearings (6714 Mail Service Center, Raleigh, North Carolina 27699-
6714). Unless such demand is made, this decision shall be final and binding.
Please note that this permit is not transferable except after notice to the Division. The Division
may require modification or revocation and reissuance of the permit. This permit does not affect
the legal requirements to obtain other permits which may be required by the Division of Water
Quality or permits required by the Division of Land Resources, the Coastal Area Management
Act or any other Federal or Local governmental permit that may be required.
If you have any questions concerning this permit, please contact Christie Jackson at telephone
number [phone], extension 538.
Sincerely,
ORIGINAL SIGNED MMBY
Gre i q.4h' %9 h.D.
cc: Central Files
Winston-Salem Regional Office/Water Quality Section
NPS Unit
Point Source Compliance Enforcement Unit
1617 Mail Service Center,Raleigh,North Carolina 27699-1617 Telephone[phone] FAX[phone]
An Equal Opportunity Affirmative Action Employer Visa US ON THE INTERNET 0 http:/Ih2o.enr.state.nc.us/NPDES

Permit NC0056791
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
PERMIT
TO DISCHARGE WASTEWATER UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful
standards and regulations promulgated and adopted by the North Carolina Environmental
Management Commission, and the Federal Water Pollution Control Act, as amended, the
Horizons Residential Care Center
is hereby authorized to discharge wastewater from a facility located at the
Horizons Residential Care Center WWTP
100 Horizons Lane
Rural Hall
Forsyth County
to receiving waters designated as Buffalo Creek in the Roanoke River Basin
in accordance with effluent limitations, monitoring requirements, and other
conditions set forth in Parts I, II, III and IV hereof.
This permit shall become effective May 1, 2002.
This permit and authorization to discharge shall expire at midnight on February 28, 2007.
Signed this day April 12, 2002.
ORIGINAL SIGNED BY
SUSAN A. WILSON
Gregory J. Thorpe, Ph.D., Acting Director
Division of Water Quality
By Authority of the Environmental Management Commission

Permit NC0056791
SUPPLEMENT TO PERMIT COVER SHEET
The Horizons Residential Care Center is hereby authorized to:
1. Continue to operate an existing 0.015 MGD wastewater treatment system with
the following components:
• Septic/Dosing tank with alternating pumps
• Dual alternating surface sandfilters
• Recirculation manhole and pump
• Recirculation sprinkler pump tank
• Tablet chlorination
• Tablet dechlorination
• Post aeration
• Effluent pump station and force main
The facility is located in Rural Hall at 100 Horizons Lane in Forsyth County.
2. Discharge from said treatment works at the location specified on the attached
map into Buffalo Creek, classified C waters in the Roanoke River Basin.

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Facility �` „ •
Latitude: 36°13'49" Stream Class: C '- t
Longitude: 80°13'55" Subbasin: 030201 Location {y ;-;:
Quad # C 18NW s.
Receiving Stream: Buffalo Creek
NC0056791 - Horizons Residential Care Center
Forsyth County

Permit NC0056791
A. (1.) EFFLUENT LIMITATIONS AND MONITORING REQUIREMENTS - FINAL
During the period beginning on the effective date of this permit and lasting until
expiration, the Permittee is authorized to discharge from outfall 001. Such discharges
shall be limited and monitored by the Permittee as specified below:
EFFLUENT LIMITS MONITORING REQUIREMENTS
CHARACTERISTICS
Monthly Weekly Daily Measurement Sample Type Sample Location
Average Average Maximum Frequency
Flow 0.015 MGD Weekly Instantaneous Influent or Effluent
BOD,5-day(20°C) 30.0 mg/L 45.0 mg/L 2/Month Grab Effluent
Total Suspended Residue 30.0 mg/L 45.0 mg/L 2/Month Grab Effluent
NH3 as N 16.0 mg/L ( 2/Month Grab Effluent
(April 1 -October 31) � � '
NH3 as N 2/Month Grab Effluent
(November 1 —March 31)
Fecal Coliform (geometric mean) 200/100 ml 400/100 ml 2/Month Grab Effluent
Total Residual Chlorine 28 µg/L 2/Week Grab Effluent
Temperature(9C) Weekly Grab Effluent
pH1 2/Month Grab Effluent
Footnotes:
1. The pH shall not be less than 6.0 standard units nor greater than 9.0 standard units.
There shall be no discharge of floating solids or visible foam in other than trace amounts

i
S 0
NORTH CAROLINA 0( G
r �FORSYTI LCOUNTY �
AFFIDAVIT OF PUBLICATION
Before the undersigned, a Notary Public of said County and State, duly
commissioned, qualified, and authorized by law to administer oaths, personally
appeared D.H. Stanfield, who being duly sworn, deposes and says: that he is
Controller of the Winston-Salem Journal, engaged in the publishing of a newspaper
known as Winston-Salem Journal, published, issued and entered as second class mail
in the City of Winston-Salem, in said county and State: that he is authorized to
make this affidavit and sworn statement: that the notice or other legal advertisement,
a true copy of which is attached hereto, was published in Winston-Salem Journal on
the following dates:
February 24, 2002
IEand that the said newspaper in which such notice, paper document, or le V
PP
advertisement was published was, at the time of each and every such publicatio
newspaper meeting all the requirements and qualifications of Section 1-597 of _ •.,.f 7
General Statues of North Carolina and was a qualified newspaper within the meani V .l~, - •
of Section 1-597 of the general statues of North Carolina.
nn ,,� I DENR WATER Q�Ar11Y
This 25th day of February, 2002 L f. i �)Nt �ouRCE E?I a+cN
(signature of pers..aking affidavit)
Sworn to and subscribed before me, this 25th da of Feb . y, 2002
•
I
...
, .
Notary Public
PUBLIC NOTICE
STATE OF NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION/NPDES UNIT
My Commission expires: September 28, 2005 1617 MAIL SERVICE CENTER
RALEIG ,NOTIFICATIONN NC
709-161 7 'ISSUE
NPDES WASTEWATER PERMIT •
On the basis of thorough staff review and application of NC General Stat-
ute 143.21,Public Law 62500 and other lawful standards and regule-
lions,the North Carolina Environmental Management Commission pro-
poses to issue a National Pollutant Discharge Elimination System
(NPDES)wastewater discharge permit to the person(s)listed below ef-
fective 46 days from the publish date of this notice.
Written comments regarding the proposed permit will be accepted unit
30 days after the publish date of this notice.All comments received prior
- t to that date are considered in the final determinations regarding the pro-
OFFICIAL SEAL posed ermit.The Director of the NC Division of Water Quality may de-
r cide to hold a public meeting for the proposed permit should the Division
• . Notary Public,North Carolina receive a significant degree of public interest.
��d COUNTY OF FORSYTH Copies of the draft permit and other supporting information on file used
•4q ito determine conditions present in the draft permit are available upon re-
K I MAL EY O�'(�S jnwN^ , quest and payment of the costs of reproduction.Mail comments and/or
i. M Commission Expires 7. I -OW r/ requests for information to the NC Division of Water Quality at the above
y P address or cat Ms.Christie Jackson at(919)733-5083,extension 538.
Please include the NPDES permit number(attached)in any communica-
tion.Interested persons may also visit the Division of Water Quality at
512 N.Salisbury Street,Raleigh,NC 27604-1148 between the hours of
9:00 a.m.and 5:00 p m.to review information on file.
NPDES Permit Number NC0056791,Horizons Residential Care Center,
100 Horizons Lane,Rural Hall,NC 27045 has applied for a permit re-
newal for a facility located in Forsyth County discharging treated waste-
water into Buffalo Creek in the Roanoke River Basin.Currently ammonia
&total residual chlorine are water quality Smiled.This discharge may af-
fect future allocations in this portion of the receiving stream.
NPDES Permit Number 11C0075027,Caine Way Mobile Home Park,
P.O.Box 846,Watkertown,NC 27051 has applied for a permit renewal
for a facility located in Forsyth County discharging treated wastewater
into Ader Creek in the Roanoke River Basin.Currently BOD&ammonia
are water quality limited.This discharge may affect future allocations in
this portion of the receiving stream.
WSJ:February 24,2002

Horizons Residential Care Center, Inc.
100 HORIZONS LANE • RURAL HALL,N.C. 27045
PHONE[phone] • FAX[phone]
•
July 11, 2001 r_
I _, :,a
Mr. Charles H. Weaver, Jr. „ }
NCDENR/Water Quality/NPDES Unit ,,
1617 Mail Service Center
Raleigh, NC. 27699-1617
Subject: Permit Renewal Application
Horizons Residential Care Center WWTP
NPDES Permit NC0056791
Forsyth County
Dear Mr. Weaver:
Enclosed is the completed renewal application for the above referenced WWTP. There
have been no changes at the facility since the issuance of the last permit. I am requesting
renewal of the permit for this facility.
Thank you for your attention to this request.
Sincerely,
'\--Stethen;e. 4,e
Thomas E. Byrd
President & CEO

r '
Horizons Residential Care Center
Waste Water Treatment Plant
North Carolina NPDES No. NC0056791
100 Horizons Lane
Rural Hall, NC 27045
Sludge Management Plan
Septic tank sludge is removed by a permitted commercial septic tank
pumping company and delivered to the City of Winston-Salem's Elledge
Wastewater Treatment Plant for treatment and disposal.
'J-
`i�hL*4 E. '! £ !t,.200 I
Thomas E. Byrd Date
President & CEO

V
Attachment to Renewal Application
For Item No. 4
Horizons Residential Care Center
Waste Water Treatment Plant
North Carolina NPDES No. NC0056791
100 Horizons Lane
Rural Hall, NC 27045
Forsyth County
Description of Existing Treatment Facility's Installed Components
• One 10,000 gallon septic tank.
• One 10,000 gallon recirculation sprinkler pump tank with two alternating
discharge pumps, and control float valves.
• Pump control panel with audible and visual trouble alarms.
• Two 40 foot by 40 foot external surface sandfilters each with 9
recirculation heads.
• One manhole tank with recirculation pump and valve.
• One tablet chlorination unit.
• One tablet dechlorination unit.
• One 1,000 gallon aeration tank.
• One manhole discharge tank with two alternating discharge pumps, float
valves and control panel.
• 3 inch underground force main.
75/471)44 Zcr jai, doo I
Thomas E. Byrd Date
President& CEO

State of North Carolina
Department of Environment,
• Health and Natural Resources ATICIPriA
Division of Environmental Management
James B. Hunt, Jr., Governor Adaminswillk
Jonathan B. Howes, Secretary E H N R
A. Preston Howard, Jr., P.E., Director
January 19, 1996
Mr. Thomas Byrd
Horizons Residential Care Center
100 Horizons Lane
Rural Hall, North Carolina 27045
Subject: Permit No. NC0056791
Authorization to Construct
Horizons Residential Care Center
WWTP Modifications
Forsyth County
Dear Mr. Byrd:
A letter of request for an Authorization to Construct was received on October 31, 1995 by
the Division and final plans and specifications for the subject project have been reviewed and found
to be satisfactory. Authorization is hereby granted for the construction of a WWTP upgrade
including the following new components with final discharge of treated wastewater into Buffalo
Creek.
• 10,000 gallon precast concrete recirculation tank and pumps
• Piping and sprinkler system at the existing two sand beds with nine distribution nozzles per bed
• Recirculation manhole and pump
• Dechlorinator and vault
• Effluent discharge pump in the existing post aeration tank
• Discharge force main with relocation of discharge to Buffalo Creek
• Associated pumps,piping, and other appurtenances
This Authorization to Construct is issued in accordance with Part III, Paragraph A of
NPDES Permit No. NC0056791 issued October 16, 1995 and shall be subject to revocation unless
the wastewater treatment facilities are constructed in accordance with the conditions and limitations
specified in Permit No. NC0056791.
The sludge generated from these treatment facilities must be disposed of in accordance with
G.S. 143-215.1 and in a manner approved by the North Carolina Division of Environmental
Management.
In the event that the facilities fail to perform satisfactorily, including the creation of
nuisance conditions,the Petmittee shall take immediate corrective action,including those as may be
required by this Division, such as the construction of additional or replacement wastewater
treatment or disposal facilities.
The Winston-Salem Regional Office, telephone number(910)771-4600 shall be notified at
least forty-eight (48) hours in advance of operation of the installed facilities so that an in-place
inspection can be made. Such notification to the regional supervisor shall be made during the
P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50%recycled/10% post-consumer paper

Permit No. NC0056791
Authorization to Construct
Horizons Residential Care Center
January 19, 1996
Page 2
normal office hours from 8:00 a.m. until 5:00 p.m. on Monday through Friday, excluding State
Holidays.
Upon completion of construction and prior to operation of this permitted facility, a
certification must be received from a professional engineer certifying that the permitted facility has
been installed in accordance with the NPDES Permit, this Authorization to Construct and the
approved plans and specifications. Mail the Certification to the Permits and Engineering Unit,
P.O. Box 29535, Raleigh, NC 27626-0535.
Upon classification of the facility by the Certification Commission, the Permittee shall
employ a certified wastewater treatment plant operator to be in responsible charge (ORC) of the
wastewater treatment facilities. The operator must hold a certificate of the type and grade at least
equivalent to or greater than the classification assigned to the wastewater treatment facilities by the
Certification Commission. The Permittee must also employ a certified back-up operator of the
appropriate type and grade to comply with the conditions of Title 15A, Chapter 8A, .0202. The
ORC of the facility must visit each Class I facility at least weekly and each Class II, III, and IV
facility at least daily, excluding weekends and holidays, and must properly manage and document
daily operation and maintenance of the facility and must comply with all other conditions of Title
15A, Chapter 8A, .0202. Once the facility is classified, the Permittee must submit a letter to the
Certification Commission which designates the operator in responsible charge within thirty days
after the wastewater treatment facilities are 50% complete.
A copy of the approved plans and specifications shall be maintained on file by the Permittee
for the life of the facility.
Failure to abide by the requirements contained in this Authorization to Construct may
subject the Permittee to an enforcement action by the Division of Environmental Management in
accordance with North Carolina General Statute 143-215.6A to 143-215.6C.
The issuance of this Authorization to Construct does not preclude the Permittee from
complying with any and all statutes, rules, regulations, or ordinances which may be imposed by
other government agencies (local, state, and federal) which have jurisdiction.
One (1) set of approvedplans and specifications is beingforwarded toyou. If you have
PP P
any questions or need additional information,please contact Jeanette Powell at telephone number
[phone], extension 537.
Sincerely,
�ull/2L .
A. Preston Howard, Jr., P.E.
cc: Forsyth County Health Department
Winston-Salem Regional Office,Water Quality Section
Training and Certification Unit
Facilities Assessment Unit
Phil Shu

I
re odo
State of North Carolina
Department of Natural Resources and Community Development
Division of Environmental Management
512 North Salisbury Street • Raleigh, North Carolina 27611
James G. Martin, Governor R. Paul Wilms
S. Thomas Rhodes, Secretary March 10, 1986 Director
Mr. Thomas E. Byrd, Executive Director
Horizons Residential Care Center, Inc.
2835 Memorial Industrial School Road
Rural Hall, N. C. 27045
SUBJECT: Permit No. NC0056791
Authorization to Construct
Horizons Residential Care Center, Inc.
Wastewater Treatment Facility Improvement
Forsyth County
Dear Mr. Byrd:
A letter of request for Authorization to Construct was received January 29,
1986, by the Division and final plans and specifications for the subject project have
been reviewed and found to be satisfactory. Authorization is herebygranted for the
addition of a 2,000 gallon baffled chlorine contact chamber with tablet-type chlorinator
to the existing wastewater treatment facilites serving Horizons Residential Care
Center.
This Authorization to Construct is issued in accordance with Part III paragraph
B of NPDES Permit No. NC0056791 issued November 11, 1983, and shall be subject
to revocation unless the wastewater treatment facilities are constructed in
accordance with the conditions and limitations specified in Permit No. NC0056791 .
The Permittee must employ a certified wastewater operator in accordance with Part
III paragraph D of the referenced permit.
The sludge generated from these treatment facilities must be disposed of in accordance
with G. S. 143-215. 1 and in a manner approvable by the North Carolina Division of
Environmental Management.
The Winston-Salem Regional Office, telephone number 919/761-2351 shall be
notified at least twenty-four (24) hours in advance of start up of the installed chlorina-
tion system so that an in-place inspection can be made of said system prior to operation.
Such notification to the Regional Supervisor shall be made during the normal office
hours from 8:00 a.m. until 5:00 p.m. on Monday through Friday, excluding State
Holidays.
Cont'd. Pollution Prevention Pays
P.O. Box 27687, Raleigh, North Carolina 27611-7687 Telephone [phone]
An Equal Opportunity Affirmative Action Employer

Permit No. NC0056791
Page 2
In event the facilities fail to perform satisfactorily in meeting its
NPDES permit effluent limits, the Permittee shall take such
immediate corrective action as may be required by this Division, including the
construction of additional wastewater treatment and disposal facilities.
One (1) set of approved plans and specifications is being forwarded to you. If
you have any questions or need additional information, please contact Mr. Robert
Teulings, telephone number 919/733-5083, ext. 121.
Sincerely yours,
7C1R. Paul Wilms
Director
cc: Forsyth County Health Department
Mr. Jeffrey D. Rawls, P. E.
Winston-Salem Regional Office
Mr. Dennis R. Ramsey
RT/jp

r
r 1 - 05
Staff Review and Evaluation
NPDES Wastewater Permit
FACILITY INFORMATION
Facility Horizons Residential Care Center
NPDES No. NC0056791
Design Flow (MGD) 0.015 MGD
Facility Class I
STREAM CHARACTERISTICS
Stream Name Buffalo Creek
Stream Class C
Sub-basin 030201
Drainage Area (mi2) 4.6
S7Q10 (cfs) 0.44
W7Q10 (cfs) 0.90
30Q2 (cfs) 1.12
IWC (%) 5.02%
Proposed Changes Parameters Affected Basis for change(s)
none
Compliance Schedule: NA
Special Condition(s): NA
Permits&Engineering Comments:
1. Compliance data was evaluated for the period July 1994 -July 1996. The facility appears to have
regular problems with meeting BOD limit.
2. Permit does not require instream monitoring,but instream monitoring conducted during the period
January through October 1994 indicate the stream is not adversely impacted by the wastewater
discharge from Horizons Residential Care Center. The lowest instream dissolved oxygen concentration
was 7.3 mg/1 measured at the upstream station(8/94).
Prepared by: _ � 6 di- 9 0
C
Regional Office Evaluation and Recommendations:
5LC- w- s0v ►, i
(I'yv1i-t Fay . . - 12c-7

State of North Carolina
Department of Environment,
Health and Natural Resources ATIPirigrADivision of Water Quality
JamesB. Hunt, Jr., Governorp E H N F{.
S
Jonathan B. Howes, Secretary
A. Preston Howard, Jr., P.E., Director
December 23, 1996
Mr.Thomas Byrd
Horizons Residential Care Center,Inc.
100 Horizons Lane
Rural Hall,North Carolina 27045
Subject: NPDES Permit Issuance
Permit No. NC0056791
Horizons Residential Care Center
Forsyth County
Dear Mr.Byrd:
In accordance with the application for a discharge permit received on July 8, 1996, the Division is
forwarding herewith the subject NPDES permit. This permit is issued pursuant to the requirements of North
Carolina General Statute 143-215.1 and the Memorandum of Agreement between North Carolina and the
U.S.Environmental Protection Agency dated December 6, 1983.
There were two errors in the draft permit that have been changed. The limits for BOD, TSS, and
fecal coliform have been changed from weekly averages to daily maximums and footnote reference no.2 has
been eliminated from BOD and TSS because there is no corresponding footnote.
If any parts, measurement frequencies or sampling requirements contained in this permit are
unacceptable to you, you have the right to an adjudicatory hearing upon written request within thirty (30)
days following receipt of this letter. This request must be in the form of a written petition, conforming to
Chapter 150B of the North Carolina General Statutes,and filed with the Office of Administrative Hearings,
Post Office Drawer 27447, Raleigh, North Carolina 27611-7447. Unless such demand is made, this
decision shall be final and binding.
Please take note that this permit is not transferable. Part II,E.4. addresses the requirements to be
followed in case of change in ownership or control of this discharge.
This permit does not affect the legal requirements to obtain other permits which may be required by
the Division of Water Quality or permits required by the Division of Land Resources or any other Federal or
Local governmental permit that may be required.
If you have any questions concerning this permit,please contact Paul B. Clark at telephone number
[phone],extension 580.
sinelv
Or>igiinai Signed By
David A. Goodrich
A. Preston Howard, Jr., P.E.
Enclosures
cc: Central Files
Winston-Salem Regional Office,Water Quality Section
Mr.Roosevelt Childress,EPA
Permits and Engineering Unit
Facility Assessment Unit
P.O.Box 29535,Raleigh,North Carolina 27626-0535 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50%recycled/10%post-consumer paper

Permit No. NC0056791
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT, HEALTH, AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
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,
Horizons Residential Care Center, Inc.
is hereby authorized to discharge wastewater from a facility located at
Horizons Residential Care Center Wastewater Treatment Plant
on Memorial Industrial School Road
in Rural Hall
Forsyth County
to receiving waters designated as Buffalo Creek in the Roanoke River Basin
in accordance with effluent limitations, monitoring requirements, and other conditions set forth in Parts I,
II, III, and IV hereof.
The permit shall become effective February 1, 1997
This permit and the authorization to discharge shall expire at midnight on January 31, 2002
Signed this day December 23, 1996
Original Signed By
David A. Goodrich
A. Preston Howard, Jr., P.E.,Director
Division of Water Quality
By Authority of the Environmental Management Commission

S
Permit No. NC0056791
SUPPLEMENT TO PERMIT COVER SHEET
Horizons Residential Care Center, Inc.
is hereby authorized to:
1. Continue to operate an existing 0.015 MGD wastewater treatment facility consisting of a
10,000 gallon septic/dosing tank with alternating pumps, dual alternating surface sandfilters,
recirculation manhole and pump, 10,000 gallon recirculation sprinkler pump tank, tablet
chlorinator, dechlorination unit, post aeration, and discharge pump located at Horizons
Residential Care Center WWTP, on Memorial Industrial School Road, in Rural Hall,
Forsyth County (See Part III of this permit), and
2. Discharge wastewater from said treatment works at the location specified on the attached
map into Buffalo Creek which is classified Class C waters in the Roanoke River Basin.

4
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ROAD CLASSIFICATION SCALE 1 :24 000
PRIMARY HIGHWAY LIGHT-DUTY ROAD,HARD OR 0 1 MILE
HARD SURFACE a ROVED SURFACE •�;�__.y- b._ '. i
0 7000 FEET
SECONDARY HIGHWAY
HARD SURFACE UNIMPROVED ROAD === . . .MEM- ,. ,
1 0 1 KILOMETER •
Latitude 36°13'49" Longitude 60°13'55" ® i I
Map# C18NW Sub-basin 030201 CONTOUR INTERVAL 10 FEET
Stream Class C QUAD LOCATION
Discharge Class 11 Horizons Residential Care Center
NC0056791
Receiving Stream Buffalo Creek Forsyth County ]
Design 0 9400 GPD Permit expires 1/31/02

A. EFFLUENT LIMITATIONS AND MONITORING REQUIREMENTS Permit No. NC0056791•
During the period beginning on the effective date of the permit and lasting until expiration, the Permittee is authorized to discharge from outfall(s) serial number
001. Such discharges shall be limited and monitored by the Permittee as specified below:
EFFLUENT CHARACTERISTICS LIMITS MONITORING REQUIREMENTS
Monthly Weekly Daily Measurement Sample Sample
Average Average Maximum Frequency Type Location'
IFlow 0.015 MGD Weekly Instantaneous I or E
BOD, 5-day, 20 C 30.0 mg/I 45.0 mg/1 2/month Grab E
TSS 30.0 mg/I 45.0 mg/I 2/month Grab E
NH3-N (April 1 - October 31) 16.0 mg/I 2/month Grab E
NH3-N (November 1 - March 31) 2/month _ Grab E
Fecal Coliform (geometric mean) 200/100 ml 400/100 ml 2/month Grab E
Total Residual Chlorine 28,0 ug/I 2/week Grab E
Temperature Weekly Grab E
Notes:
' Sample locations: E - Effluent, I - Influent.
The pH shall not be less than 6.0 standard units nor greater than 9.0 standard units and shall be monitored 2/month at the effluent by grab sample.
There shall be no discharge of floating solids or visible foam in other than trace amounts.

NPDES WASTE LOAD ALLOCATION - . 4
•
PERMIT NO.:
NC0056791 Modeler Date Rec. # .. O.
Horizons Residential Care Center,Inc. FK 7�Sf 9S 8 3 z
F NAME: Horizons Residential Care Center WWTP Drainage Area(mi ) 4. . Avg. Streamflow(cfs): g.2.A
FACILITY I E NAME: 2
Facility Status: Existing 7Q10(cfs) 0.44 Winter 7Q10(cfs) 0.10 30Q2 (cfs) I.(z.
Permit Status: Modification Toxicity Limits:IWC % Acute/Chronic
Major Minor q Instream Monitoring:
Pipe No.: 001 Parameters
.rFr-
Design Capacity: 0.0094 MGD so. osseca�er Upstream Notvr Location
Domestic (% of Flow): 100 % Downstream ,jra v,asd Location
Industrial (% of Flow):
Effluent Summer Winter
Comments: Characteristics
Alternatives Analysis is moving outfall from UT to Buffalo to Buffalo BOD5 (mg/1) 30 30
Creek proper. NH -N(mg/1)
3 tb , MONftoft
RECEIVING STREAM.
Buffalo Creek D.O. (mg/1) — —
TSS m
Class: C i;�) 3 c 3 o
Sub-Basin: 03-02-01 F. Col. (/100 ml) .Zoo Z-oo
Reference USGS Quad: C 18 NW (please attach)
County: Forsyth pH (SU)
6 -ct 6 .
Regional Office: Winston-Salem Regional Office V. t elvAt
Previous Exp. Date: 1/31/97 Treatment Plant Class: I
Tct mite rung('C moN rt'on_ Mon t-i-m_
Classification changes within three miles:
_ Refer : Basinwide / Streamline WLA File
Completed By Permits & Engineering
k - At Front Of Subbasin
Requested by: Charles lvarez Date: 7/3/95 I I
Prepared by: Date: a tl '`f Comments: -, las et',vf. `.;.-
Reviewed by: Date: $ r7/q5
FA), 11} / 135 )___=___p/ • S
.I,ct_- ° -C-L

FACT SHEET FOR WASTELOAD ALLOCATION
Request# 8321
Facility Name: Horizons Residential Care Center r, - ; .�. I V ED
NPDES No.: NC0056791 ! '�
Type of Waste: Domestic - 100% N.C. L`e;A. of EHNR
Facility Status: Existing Permit Status: Relocation/e y jt V15.‘0 v' J U L 2 7 13 5
Receiving Stream: Buffalo Creek
Stream Classification: C W!'{StQf-Sa{f m
Subbasin: 03-02-01 Regional Office
County: Forsyth Stream Characteristic:
Regional Office: Winston-Salem USGS # Open Report
Requestor: Alvarez Date: 1995
Date of Request: 7/5/95 Drainage Area(mi2): 4.60
Topo Quad: C 18 NW Summer 7Q10(cfs): 0.44
Winter 7Q10(cfs): 0.90
Average Flow (cfs): 5.29
30Q2 (cfs): 1.12
1WC(%): 5.0 %
Wasteload Allocation Summary
(approach taken,correspondence with region,EPA,etc.)
Relocation was modeled with no violation of stream standard predicted. Modelling analysis was
done with 0.015 mgd discharge. e,{5-I'i 7 permit',i c d-hgto- a.6064 yykc,1
Facility currently under SOC for BOD violations.
Special Schedule Requirements and additionali comments from Reviewers:
� ,W:w+.,Q,+_ ~CV.L. \\,..\ Nv� �t+,t�dw� 4.. c,_&.4t �r�.\ —�\-ss,,
I\ r ,
'6 ' . - CJ1
= L
co siy 15 5 r,':
d i -T
Recommended by:� Kflh _ Date:apt ,j,.LC , 1.115 3C
Reviewed by ( L/,h4(JL' -VLasessment: Date: 7 a�,��5 r-a
--Regional Supervisor: Z). £ Date: 7 2 8- � cji --4
Permits&Engineering: 4a/7,1,__.1
,11� Date: r//��
RETURN TO TECHNICAL SUPPORT BY: AUG 2 4 t995
S (* ' 1 t47 : i(o bt 01 . � 1. - l

.
2
PARAMETERS
Existing Limits for discharge to unnamed tributary to Buffalo Creek:
Monthly Average
Wasteflow (MGD): 0.0094
BOD5 (mg/1): 17
NH3N (mg/I): 12
DO(mg/1): 6
TSS (mg/1): 30
Fecal Col. (/100 ml): 200
pH (SU): 6- 9
Residual Chlorine (14/1): monitor
TP(mg/1): not required
TN(mg/1): not required
Temperature(°C): monitor
There shall be no discharge of floating solids or visible foam in other than trace amounts.
Recommended Limits for discharge to Buffalo Creek:
Monthly Average
„L/pan.s,'o rt Summer Winter WQ or EL
Wasteflow(MGD): 0.015 0.015
BOD5 (mg/1): 30 30 EL
NH3N (mg/1): 15cAt Ict, monitor WQ/EL
DO(mg/1): not required not required
TSS (mg/1): 30 30
Fecal Col. (/100 ml): 200 200
pH (SU): 6 -9 6 - 9
Residual Chlorine (14/1): 28.0 * 28.0 * WQ
TP(mg/1): not required not required
TN(mg/1): not required not required
Temperature(°C): monitor monitor
There shall be no discharge of floating solids or visible foam in other than trace amounts.
* Request Region comment as to whether residual chlorine limit needs to be phased-in.
—
Parameter(s)affected: Limits Changes Due To:
BOD5 , NH3N,DO, Residual Chlorine relocation of outfall
_x_ Parameter(s) are water quality limited. For some parameters,the available load capacity of
the immediate receiving water will be consumed. This may affect future water quality based
effluent limitations for additional dischargers within this portion of the watershed.
OR
No parameters are water quality limited,but this discharge may affect future allocations.

•
INSTREAM MONITORING REQUIREMENTS
Upstream Location: not required
Downstream Location: not required
Parameters:
Special instream monitoring locations or monitoring frequencies:
MISCELLANEOUS INFORMATION&SPECIAL CONDITIONS
Adequacy of Existing Treatment
Has the facility demonstrated the ability to meet the proposed new limits with existing treatment
facilities? Yes No V
If no,which parameters cannot be met? 71ko\ %RA-44 C
Would a "phasing in" of the new limits be appropriate? Yes No
If yes, please provide a schedule (and basis for that schedule) with the regional
office recommendations: ``W�
W\\\Q. C� < 6 Ai• RA3414.41,6ZA `N
CNA4 \\(\ • ttL \�+' � p42,WMQ- S:c% •re-- "��\-V• `b . .1 \
V` V D�
� e \\ti;\� �peLa^\e, Q.`kQ.VNIa V.+r�!VK �(�Q SO(..
If no, why not?
Special Instructions or Conditions
Wasteload sent to EPA? (Major) (Y or N)
(If yes,then attach schematic, toxics spreadsheet, copy of model,or, if not modeled, then old
assumptions that were made, and description of how it fits into basinwide plan)
Additional Information attached? (Y or N) If yes,explain with attachments.

•
- • Request# 8321
Facility Name: Horizons Residential Care Center
NPDES No.: NC0056791
Type of Waste: 100 % Domestic
Facility Status: Existing
Permit Status: Relocation Stream Characteristic:
Receiving Stream: Buffalo Creek USGS#
Stream Classification: C Date: 1995
Subbasin: 03-02-01 Drainage Area(mi2): 4.6
County: Forsyth Summer 7Q10(cfs): 0.44
Regional Office: Winston-Salem Winter 7Q10 (cfs): 0.9
Requestor: Alvarez Average Flow(cfs): 5.29
Date of Request: 7/5/95 3002(cfs): 1.12
Topo Quad: C 18 NW IWC(%): 5.0%
Existing WLA checked: x
Staff Report: x
Topo checked: x
USGS Flows confirmed: x
IWC Spreadsheet: x
Stream Classification: x
Nutrient Sensitivity: nr
Instream Data: x not useful for this review
Facility was discharging into unnamed tributary to Buffalo Creek and had a zero s7Q10. They were required to do an Alternative
Analysis during this renewal. Both the Staff Report and information from the Engineer indicates that relocation is the most economical
Alternative available to them.
They are under an SOC due BOD violations and this relocation is in hopes of better limits.
pMmprJ%1 toxy_xtv1
5�b1113' 0.1414 cV�
IWC= 5 ,(7 1 /�
IiIIOWAbIC = 5 My�L
uR- O= Q.° C5S
IWC. : 5 '/e
Allow : 63-6 .-1 (S2.—

slope change slope change- Tickum Creek Rough creek Cummulative '
Segment/Reach S1 R1 S1 R2 S1 R3 S1 R4 S1 R5 Distance Elevation Slope Distance Comments
Length 0.05 0.05 0.2 1.9 0.3 0 710
Qw . 0.015 0.2 700 50 0.2
CBOD 45 0.8 690 12.5 • 1 Tick-urn Creek Rough Fork unnamed roads
NBOD 71.55 0.7 680 14.3 • 1.7 SR 1918
DO 1 670 10 ' 2.7 unnamed road Fish Hatchery
f�Citfll�>:z>:::�3::>�:•`•::::E:::::>E::>:«:»�::?:�»%>�?:::::::::::::::.:: :.;...::::::,�.•.•::::.:::::s::»»»»»:<.:<�s>:�>::::>:>:<::::.......... 0.3 660 33 3 at mouth of Buffalo Creek
-- ... ., - --� ..........:................................................... Hwy 65
s 7010 0•1 0.0f 0,9 O.66 0.6C
W 7010 0.4 O•I- 0•R 0.9 0.9 'These three will be added together and averaged over reaches 3 and 4.
Oave 0.0 O.0 O•() 3 3 Ruufor F t
..... ;-..::..........:.:g.�::.,..:,...::::.::.;.: :::::::::::: :: ::.; $IQt- 5t23 54410'• 0.9ci-0.2.8-0•51)!•0.3 t 01
S 7010 0.28 0.43 coliain:( 1-56- o.M5- 0.91)}f03_ 0 7-
w7Q10 0.45 0.88 0,4vc:(6"z.5 -Z.21- 5.23,}/0.3, Ec1Z04-, 1444_HAI° is tkc 3
Qave 2.21 5.11 5'e,f-5,Q3 54Q,D•.(Z-11- - 0.43-o-99)/Z-2 10.6c 4'oe- Skts nnarw)
Slope 50 12.5 12.3 12.3 33.3 w4g10:( '1.41- 0.88- t-5G)(1,•- t O AO
QAve- •
la- .5.11- 6.Z. 1)/z.L c 3
Rouon Cec-cu mouth
Teak•Ine C.4o4K . ' ran:4.44m.i
On I.yzmz 5'Ra0; o.YSc1.5
5341 0-D.2--Z js Tick-urn Creek Rough Creek eAQN'0'2?Os But�pa--o688 9l00 a.oggtp;0.45 cA, 4ravc c 5•ItCF3 QQE: Z-iI J3 Dc%IS ntlz
V
6u1Fat0 Ce.sr.% K m c.a 34Qq=1•81-d3 3
Do:5•24.Iz it
3 Io.Ji111�S wiQtO.Y•'Ircr Sad
�
te Io% I-56 G.cs QI\ €. 4$Cf"3 is
Qom.: C.zq'3 Buffalo Creek t
Sod IZ.gi It.3 �.,, uuaF,med e_opd-3 SR%°I3 lZ 3 Fp►. ouNpmMFdrtaxl rt . 6
o-05M.t¢S o'os es.\Gs o•z ^,.IGS I.o. wel 3"3 mete ,
S1 R1 S1 R2 S1 RS 0.4 gaup 0,7 melts t•3n..t- S1 R4 Ih I.etey Trout Farm Si R5
Horizons Residential Care Center beln'^I dasarwe 13Z11:4°a,luwaya oesek, no longer exists
NC0056791 deswuie
Qw-0.015n�rd
tor,: Lt6 r►t,'t
�Q10 a L 1 i, Flows-
w trlt0: o•gac•cp3 The discharge itself falls on the line between HA9 and HA10:with everything upstream of the discharge being HA9 and everything downstream of the discharge being HA10.
GtAk6. 5-23 C43 After a quick discussion with Steve Bevington,I will determine the flows at the flows at the discharge location using HA9 statistics and the other flows,(below the discharge)
will be determined using HA10 statistics.
Two tributaries were large enough to include near the head of the model and therefc e two sets c runoff calculations were necessary.
The first reach is tiny,but had such a large slope incomparison with the other reaches I left it at 0.05 miles. Reaches 3 and 4 have an average of their slopes as an input.

SUMMER
•
RELOCATION / EXPANSION
MODEL RESULTS
Discharger : HORIZONS RESIDENTIAL CARE CENTER
Receiving Stream : BUFFALO CREEK
The End D .O . is 8 . 08 mg/l .
The End CBOD is 1 . 86 mg/l .
The End NBOD is 1 . 07 mg/l .
WLA WLA WLA
DO Min CBOD NBOD DO Waste Flo
(mg/1) Milepoint Reach # (mg/1) (mg/1) (mg/1) (mgd)
Segment 1 7 . 07 0 . 00 1
Reach 1 45 . 00 71 . 55 0 . 00 0 . 01500
Reach 2 0 . 00 0 . 00 0 . 00 0 . 00000
Reach 3 0 . 00 0 . 00 0 . 00 0 . 00000
Reach 4 0 . 00 0 . 00 0 . 00 0 . 00000
Reach 5 0 . 00 0 . 00 0 . 00 0 . 00000

r I
.4
2e F . -
CA i S 4
a v,
(D (D S
W i--4H1-11-41--' 1--‘ 1✓ - I-' 1-11-1F4I-4r 1--, 1-, 1--' I-41-41-` 1-41-1F- -
40 40
7d 7d
(D (D
a a
O UIUlUlU1 .A .A .A .A .A W W WNNNNNNI•--, I--, I--' I--' I-' I-, 0
.7 ►7
4o
U1 co
(D N N N N N 1'-' I--H F-H Co 0 0 0 0 Co O 0 O Co Co 0 O 0 O 0 (D
• CFI a. W NNOo .A001 W NF--, H 00000000000
' . 00000Na . cyNco [OOOO IO OD �1d1U1Cn aAW N1--' O 'X
Imo- H-
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I
O OD co co J J J J J J 4,3 J J J J J J J —.] J J —] J J J 0 ..
O▪ 0 0 O IO ID CO CO J OI .A%.A .A W C. W W W W W W N N F-' 1--' 0 0
• COU10NNloU100J JOo .Al00oCoJJJ01•001NJ NJ •
.
o C)
Cb F--H1--1HHF-' F-� NNNNNNNNNWW W W,W W .A .A .A .A �
p • . • • . • • • . . . . 0
C5 CO CO CO VO VD %.0 0I-4W .A01C -J ko '.o0000;.o 'O00I-, H0
01001DI-, I-` 'DODOD0 (.7lOJ01 -] Oo0Fa W .A•;W J1--' O1I-' 01
Z Z
CO 1-' 1-1 F-' 1--' 1-' H H I-, 1--' H N N N'N N N N N N .A .A ;IN A. .A .A CO CA
p . . . . . . . • . • • • • . . . . . . . 0 C
l7OOI-' HI-' N Lk) . 01 --] O1--1N01O101O101JF--' NW W at. U10 L- R
JlOI-' .p .A N N .p IDOO1.-' ICAO N .AOIIDF-4U1 N00001a. 0
C) to
— — 7zi
t H
I-I
I-r1 r'] O
1-4 I-' Z
O W W W W W N N N N H F--` 1-4 I-, O O O O O 0 0 0 0 0 O O
• UNI—, I� F-' 0001Lk) 1-103 .A W Nl0101Dl0wW01Ut .A .IN .A .A
W0110W LA) OOWJNJ .AU101 JJ01U1 at. I-, OlD0oJ01 t=]
Af r-g iv
A
t
R v a s c 0
.d• A a \./ Z+I 3 40 I9
U }4 o
a) ' 0 a -o
Doi W $ r F
c 4. 2

*** MODEL SUMMARY DATA ***
Discharger : HORIZONS RESIDENTIAL CARE CENTER Subbasin : 0302
. Receiving Stream : BUFFALO CREEK Stream Class : C
Summer 7Q10 : 0 .44 Winter 7Q10 : 0 . 9
Design Temperature: 25 . 0
ILENGTHI SLOPE' VELOCITY I DEPTHI Kd I Kd I Ka I Ka I KN I KN I KNR I KNR I SOD I SOD I
1 mile I ft/mil fps I ft 'design l @20 'design l @20 'design' @20 'design' @20 'design' @20 I
I I I I I I I I I I I I I I I
Segment 1 1 0.051 50.001 0.125 1 0.51 1 0.44 1 0.35 112.57 111.271 0.73 1 0.50 1 0.73 1 0.00 1 0.00 1 0.00 I
Reach 1 1 I I I I I I I I I I I I
I I I I I I I I I I I I I I I
Segment 1 I 0.051 12.501 0.110 1 0.76 1 0.30 1 0.24 12.77 1 2.981 0.49 1 0.30 1 0.44 1 0.00 1 0.00 1 0.00
Reach 2 1 I I I I I I I I I I I I
I I I I I I 1 I I I I I I I I
Segment 1 I 0.201 12.301 0.133 1 0.82 1 0.30 1 0.29 13.27 I 2.941 0.44 1 0.30 10.44 1 0.00 1 0.00 1 0.00 I
Reach 3 I I I I I I I I I I I I I
I I I I I I I I I I I I I I I
Segment 1 I 1.901 12.301 0.177 10.97 1 0.31 1 0.25 14.37 I 3.921 0.44 1 0.30 1 0.49 1 0.00 1 0.00 1 0.00 I
Reach 4 I I I I I I I I I I I I I
I I I I I I I I I I I I I I I
Segment 1 I 0.301 33.301 0.272 1 0.89 1 0.93 1 0.34 118.16 116.291 0.73 1 0.50 1 0.73 1 0.00 1 0.00 1 0.00 I
Reach 5 I I I I I I I I I I I I I
Flow I CBOD I NBOD I D.O. I
i cfs I mg/1 I mg/1 I mg/1 I
Segment 1 Reach 1
Waste I 0 . 023 145 . 000 171 .550 I 0 . 000
Headwaters ) 0 .440 I 2 . 000 I 1 . 000 I 7 .440
Tributary I 0 . 000 I 2 . 000 I 1 . 000 I 7 .440
* Runoff I 0 . 900 I 2 .000 I 1 . 000 I 7 .440
Segment 1 Reach 2
Waste I 0 . 000 I 0 . 000 I 0 . 000 I 0 .000
Tributary I 0 . 430 I 2 . 000 I 1 . 000 I 7 .440
* Runoff I 0 . 900 I 2 . 000 I 1 . 000 I 7 .440
Segment 1 Reach 3
Waste I 0 . 000 I 0 . 000 I 0 . 000 I 0 . 000
Tributary I 0 .280 I 2 . 000 I 1 . 000 I 7 . 440
* Runoff I 0 . 900 i 2 . 000 I 1 . 000 I 7 . 440
Segment 1 Reach 4
Waste I 0 . 000 I 0 . 000 I 0 . 000 ) 0 . 000

Tributary 0 .430 I 2 . 000 I 1 . 000 I 7 . 440
' * Runoff I 0 . 660 I 2 . 000 I 1 . 000 I 7 .440
Segment 1 Reach 5
Waste I 0 . 000 I 0 . 000 I 0 .000 I 0 . 000
Tributary I 0 .000 I 2 .000 I 1 .000 I 7 .440
* Runoff I 0 . 660 I 2 . 000 I 1 . 000 I 7 .440 1
* Runoff flow is in cfs/mile

Facility: Horizons Residential Care Center
NPDES#: NC0056791
Receiving Stream: Buffalo Creek
Comment(s): relocation - end of model is in an HA10
Low Flow Record Station Number:
Hydrologic Area Number: HA9
Drainage Area Low Flow Record Station:
Mean Annual Runoff:
Qave Low Flow Record Station: 0.00 cfs
s7Q1 0 Low Flow Record Station:
w7Q10 Low Flow Record Station:
30Q2 Low Flow Record Station:
must be<400 sq.miles
Drainage Area New Site: 4.60 sq.miles
MAR New Site: 1.2 cfs/miles squared
Qave per Report Equation: 5.29 cfs
s7Q1 0 per Report Equation: 0.44 cfs
w7Q10 per Report Equation: 0.90 cfs
30Q2 per Report Equation: 1.12 cfs
Continue
Drainage Area Ratio: #DIV/0!
[new DA/Da at gage] #DIV/0!
Weighted Ratio: #DIV/0!
Over-ride Inappropriate Site (y):
Drainage Area New Site: 4.60 miles squared
MAR New Site: 1.2 cfs/miles squared
Weighted Qave per Report Equation: #DIV/0!
Weighted s7Q10 per Report Equation: no input from above
Weighted w7Q10 per Report Equation: no input from above
Weighted 30Q2 per Report Equation: no input from above

•
Facility:
NPDES#:
Receiving Stream: Tick-urn Creek
Comment(s): for the Horizons Residential Care Center model
on Buffalo Creek--->Town Fork Creek
Low Flow Record Station Number:
Hydrologic Area Number: HA9
Drainage Area Low Flow Record Station:
Mean Annual Runoff:
Qave Low Flow Record Station: 0.00 cfs
s701 0 Low Flow Record Station:
w7Q10 Low Flow Record Station:
30Q2 Low Flow Record Station:
must be<400 sq.miles
Drainage Area New Site: 1.92 sq.miles
MAR New Site: 1.2 cfs/miles squared
Qave per Report Equation: 2.21 cfs
s7Q10 per Report Equation: 0.28 cfs
w7Q10 per Report Equation: 0.45 cfs
30Q2 per Report Equation: 0.54 cfs
Continue
Drainage Area Ratio: #DIV/0!
i new DA/Da at gage] #DIV/0!
Weighted Ratio: #DIV/0!
Over-ride Inappropriate Site (y):
Drainage Area New Site: 1.92 miles squared
MAR New Site: 1.2 cfs/miles squared
Weighted Qave per Report Equation: #DIV/0l
Weighted s7Q10 per Report Equation: no input from above
Weighted w7Q10 per Report Equation: no input from above
Weighted 3002 per Report Equation: no input from above

Facility:
NPDES#:
Receiving Stream: Rough Fork
Comment(s): for the Horizons Residential Care Center model
on Buffalo Creek--->Towne Fork Creek
Low Flow Record Station Number:
Hydrologic Area Number: HA9
Drainage Area Low Flow Record Station:
Mean Annual Runoff:
Qave Low Flow Record Station: 0.00 cfs
s7010 Low Flow Record Station:
w7Q10 Low Flow Record Station:
30Q2 Low Flow Record Station:
must be<400 sq.miles
Drainage Area New Site: 4.44 sq.miles
MAR New Site: 1.2 cfs/miles squared
Qave per Report Equation: 5.11 cfs
s7Q10 per Report Equation: 0.43 cfs
w7Q10 per Report Equation: 0.88 cfs
30Q2 per Report Equation: 1.09 cfs
Continue
Drainage Area Ratio: #DIV/0!
[new DA/Da at gage I #DIV/0!
Weighted Ratio: #DIV/0!
Over-ride Inappropriate Site (y):
Drainage Area New Site: 4.44 miles squared
MAR New Site: 1.2 cfs/miles squared
Weighted Qave per Report Equation: #DIV/01
Weighted s7Q10 per Report Equation: no input from above
Weighted w7Q10 per Report Equation: no input from above
Weighted 3002 per Report Equation: no input from above

Fadlity:
NPDES#:
Receiving Stream: Buffalo Creek
Comment(s): at confluence with Rough Creek
Low Flow Record Station Number:
Hydrologic Area Number: HA10
Drainage Area Low Flow Record Station:
Mean Annual Runoff:
Qave Low Flow Record Station: 0.00 cfs
s7Q10 Low Flow Record Station:
w7Q10 Low Flow Record Station:
30Q2 Low Flow Record Station:
must be<400 sq.miles
Drainage Area New Site: 5.24 sq.miles
MAR New Site: 1.2 cfs/miles squared
Qave per Report Equation: 6.29 cfs
s7Q10 per Report Equation: 0.99 cfs
w7Q10 per Report Equation: 1.56 cfs
3002 per Report Equation: 2.16 cfs
Continue
Drainage Area Ratio: #DIV/0!
[new DA/Da at gage] #DIV/0!
Weighted Ratio: #DIV/01
Over-ride Inappropriate Site (y):
Drainage Area New Site: 5.24 miles squared
MAR New Site: 1.2 cfs/miles squared
Weighted Qave per Report Equation: #DIV/01
Weighted s7Q10 per Report Equation: no input from above
Weighted w7Q10 per Report Equation: no input from above
Weighted 30Q2 per Report Equation: no input from above

Facility:
NPDES#:
Receiving Stream: Buffalo Creek \
Comment(s): for the Horizons Residential Care Center model i ,y v `n L
Low Flow Record Station Number: 02.0688.9100 �tJ`C)I\
1`
Hydrologic Area Number: HA10
Drainage Area Low Flow Record Station:
Mean Annual Runoff:
Qave Low Flow Record Station: 0.00 cfs
s7Q1 0 Low Flow Record Station:
w7Q10 Low Flow Record Station:
3002 Low Flow Record Station:
must be<400 sq.miles
Drainage Area New Site: 15.00 sq. miles
MAR New Site: 1.2 cfs/miles squared
Qave per Report Equation: 18.00 cfs
s7Q1 0 per Report Equation: 2.87 cfs
w7Q10 per Report Equation: 4.41 cfs
30Q2 per Report Equation: 6.19 cfs
Continue
Drainage Area Ratio: #DIV/01
[new DA/Da at gage] #DIV/0l
Weighted Ratio: #DIV/0l
Over-ride Inappropriate Site (y):
Drainage Area New Site: 15.00 miles squared
MAR New Site: 1.2 cfs/miles squared
Weighted Qave per Report Equation: #DIV/0!
Weighted s7Q10 per Report Equation: no input from above
Weighted w7Q10 per Report Equation: no input from above
Weighted 3002 per Report Equation: no input from above

r
I •
Permits and Engineering
Technical Support Branch
County Health Dept.
Central Files
WSRO
SOC PRIORITY PROJECT: Yes X - SOC No. 94-20
To: Permits and Engineering Unit
Water Quality Section
Attention: Charles Alvarez
Date: July 5, 1995
NPDES STAFF REPORT AND RECOMMENDATION
County Forsyth
Permit No. NC0056791
PART I - GENERAL INFORMATION
1. Facility and Address: Horizons Residential Care Center
Mr. Thomas E Byrd, Executive Director
100 Horizons Lane
Rural Hall, N.C. 27045
2. Date of Investigation: June 26, 1995
3. Report Prepared by: Mike Mickey, Environmental Specialist II
4. Persons Contacted and Telephone Number: Mr. Phil Shu, Consulting Engineer,
1-800-219-4074.
5. Directions to Site: Take Hwy 8 north out of Winston-Salem. After crossing Hwy
66, travel 2.4 miles and turn right onto Memorial Industrial School Road (SR 1920).
Continue 1.1 mile to the entrance drive (Horizon Lane) on the left.
6. Discharge Points(s), List for all discharge points:
Latitude: 36° 13' 40" Longitude: 80° 14' 38"
U.S.G.S. Quad No. C-18-NW U.S.G.S. Quad Name Walkertown
7. Site size and expansion area consistent with application? X Yes
8. Topography (relationship to flood plain): The system is located above the flood plain.

•
•
9. Location of nearest dwelling: No dwellings located within 500 feet of the sandfilter
system. The Horizon property is surrounded by county owned land/park.
10. Receiving stream or affected surface waters: Buffalo Creek (proposed relocation site)
U.T. to Buffalo Creek (current discharge site).
a. Classification C
b. River Basin and Subbasin No.: 03-02-01
c. Describe receiving stream features and pertinent downstream uses: Currently
the WWTP discharges to the U.T. to Buffalo Creek which has a 7Q 10=0.
The facility is proposing to relocate the discharge to Buffalo Creek in order to
have a positive flow and more favorable limits.
Part II - DESCRIPTION OF DISCHARGE AND TREATMENT WORKS
1. a. Volume of Wastewater to be permitted: Design 0.015 MGD (Ultimate
Capacity).
b. What is the current permitted capacity of the WWTP? 0.0094.
The Horizons Residential Care Center is a non profit facility designed to care
for 35 severely retarded and/or handicapped residents. A 24 hour staff of 110
works at the site.
c. Actual treatment capacity of the current facility (current design capacity)?
9735 gpd (2830 sq.ft. x 3.44 gpd/ft).
d. Date(s) and construction activities allowed by previous Authorizations to
Construct issued in the previous two years. NA
e. Please provide a description of existing or substantially constructed wastewater
treatment facilities; The existing system consists of a 8,089 gallon septic tank,
dosing tank with dual alternating 130 gpm pumps, dual alternating surface
sandfilters (1,415 sq ft each), tablet chlorinator and post air chamber.
f. Please provide a description of proposed wastewater treatment facilities.
Although no plans have been submitted, it is expected that a 3000 gallon
influent septic tank will be added along with an effluent pump station and 3500
LF of force main.
g. Possible toxic impacts to surface waters: None known.
h. Pretreatment Program (POTWs only): NA
NPDES Permit Staff Report
Version 10/92
Page 2

2. Residuals handlingand utilization/disposal osal scheme:
P
a. Other disposal/utilization scheme (Specify): Solids are removed by a licensed
pumper for disposal in the nearest POTW.
3. Treatment plant classification (See attached rating sheet). Class I (15 points)
4. SIC Code(s): 8051
Primary 11 Main Treatment Unit Code: 4 6 0 X 7
PART III - OTHER PERTINENT INFORMATION
1. Is this facility being constructed with Grant Funds or are any public monies involved.
(municipals only)? NA
2. Special monitoring or limitations (including toxicity) requests: None
3. Important SOC, JOC or Compliance Schedule dates: (Please indicate)
Date
Submission of Plans and Specifications 10-31-95
Begin Construction 3-31-95
Complete Construction 7-31-96
4. Alternative Analysis Evaluation: Has the facility evaluated all of the non-discharge
options available. Please provide regional perspective for each option evaluated. The
region concurs with the Central Office's recommendation (after review of the
Alternatives Analysis) that moving the discharge to Buffalo Creek at Memorial
Industrial School Road is the best available environmental option which is
economically reasonable. This will eliminate the current discharge into a zero flow
stream.
Spray Irrigation: Insufficient land available and adjoining land owned by County
Parks and Recreation Department cannot be used.
Connection to Regional Sewer System: Existing Winston-Salem sewer lines are
located approximately 4.7 miles from Horizons. The estimated cost is $300,000.
Subsurface: A subsurface system would require 5.1 acres (w/repair and buffers) with
an estimated cost of $120,000. This option is not feasible since the Forsyth County
Parks and Recreation Director has recommended against using county land for
subsurface disposal (See 1-26-95 letter with application).
NPDES Permit Staff Report
Version 10/92
Page 3

.• - Other disposal options: NA
5. Other Special Items: None.
PART IV - EVALUATION AND RECOMMENDATIONS
The Horizon Residential Care Center has submitted a permit modification request for
outfall relocation. The facility is proposing to move the discharge point from the U.T. to
Buffalo Creek (7Q10=0) to Buffalo Creek at Memorial Industrial School Road. This will
require an effluent pump station and 3500 LF of new outfall line. This option is alternative
#3 as outlined in the Alternatives Analysis submitted 3-21-95.
Currently, the facility is noncompliant with BOD. A SOC has been drafted requiring
plans and specifications by 10-31-95, and final compliance by 7-31-96. The draft permit for
this modification request needs to be sent to public notice prior to 10-31-95, so that DEM
will accept Horizons A/C request.
The permit modification also involves increasing the permitted flow from 0.0094
MGD to 0.015 MGD. Although actual water meter readings show an average daily usage of
5587 gpd, flow monitoring of the effluent (conducted from 11/10/94 - 11/16/94) showed an
average effluent flow of 15,000 gpd. The engineer attributes the discrepancy in the values to
an I/I problem with the probability of spring water entering the system through the sand
beds. In addition, it was deemed more economical to increase the permitted flow than to
remove the groundwater source.
WSRO recommends approval of the modification request.
— t
Signature of report preparer
Water Quality Regional S pervisor
(-f
Date
NPDES Permit Staff Report -
Version 10/92
Page 4

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NPDES WASTE LOAD ALLOCATION
NC0056791 Modeler Date Rec. #
PERMIT NO.: - .
FK 11' `e1Z '1Z4
PERMITTEE NAME: Horizons Residential Care Center,Inc.
FACILITY NAME:
Horizons Residential Care Center Inc. Drainage Area(mil ) Avg. Streamflow (cfs):
Facility Status: Existing 7Q10 (cfs) 0.0 Winter 7Q10 (cfs) 0.0 30Q2 (cfs) 0.0
Permit Status: Renewal Toxicity Limits: IWC % Acute/Chronic •
Major Minor Instream Monitoring: •
/�
Pipe No.: 001 Parameters 1ei✓32pvtdvi-; 1)4 ea , ( 9'nC)Oc V IT
Design Capacity: 0.0094 MGD Upstream / Location Lo Ad a
Domestic (% of Flow): 100 % Downstream y Locatio K nv lY/ a•J '
Industrial (% of Flow): -). 5[,i. .
Effluent Summer Winter
Comments: Characteristics
BOD5 (mg/1) 1-4.p
NH _
3-N (mg/1) ►z o •
D.O. (mg/1)
RECEIVING STREAM:an unnamed tributary to Buffalo Creek 6.O
Class: C TSS (mg/1)
30
Sub-Basin: 03-02-01 F. Col. (/100 ml)
LOU
Reference USGS Quad: C 18 NW (please attach) pH (SU)
County: Forsyth 6-g
Regional Office: Winston-Salem Regional Office
ibsitom C RiptEto5/4 rno„"tnr2.
Previous Exp.Date: 7/31/93 Treatment Plant Class:
Classification changes within three miles: The facility discharges into a stream with 7Q10/30Q2=0 cfs. Removal of the
no change discharge will be required if a more environmentally sound alternative is
available. An engineering report evaluating alternatives to discharge is due
i pLo piED 180 days prior to permit expiration along with the permit renewal
application. As part of the report,the cost of constructing a treatment facility
Requested by: Charle$,Lowe Date: 11/23/92 to meet limits of 5 mg/I BOD5, 2 mg/1 NH3,6 mg/1 dissolved oxygen, and
17 ug/1 chlorine must also be included if there are no alternatives to a surface
Prepared by: — Date: z 3 (discharge. Upon review of the results of the engineering report, the Division
may reopen and modify this NPDES permit to require removal of the
Reviewed by: Date: afidischarge, modified treatment designs, and/or revised effluent limitations
-501)Li, g_ l 3 within a specified time schedule.

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• ` RECEIVED
N.C. Dept. of EHNR
FACT SHEET FOR WASTELOAD ALLOCATION J A N 2 2 1993
Request# 7245 Winston-Salem
Facility Name: Horizons Residential Care Center, Inc. Regional Office
NPDES No.: NC0056791
Type of Waste: Domestic - 100% ,,
Facility Status: Existing
Permit Status: Renewal
Receiving Stream: unnamed tributary to Buffalo Creek
Stream Classification: C
Subbasin: 03-02-01
County: Forsyth Stream Characteristic:
Regional Office: Winston-Salem USGS #
Requestor: Lowe Date:
Date of Request: 12/1/92 Drainage Area(mi2):
Topo Quad: C 18 NW Summer 7Q10 (cfs): 0.0
Winter 7Q10 (cfs): 0.0
Average Flow (cfs):
30Q2 (cfs): 0.0
IWC (%): 100 %
Wasteload Allocation Summary
(approach taken,correspondence with region,EPA,etc.)
The facility discharges into a stream with 7Q10/30Q2=0 cfs. Removal of the discharge will be
required if a more environmentally sound alternative is available. An engineering report evaluating
alternatives to discharge is due 180 days prior to permit expiration along with the permit renewal
application. As part of the report,the cost of constructing a treatment plant at the discharge point to
meet limits of 5 mg/l BOD5, 2 mg/1 NH3, 6 mg/1 DO, and 17 µg/1 chlorine should also be included j
if there are no alternatives to a surface discharge. Upon review of the results of the engineering 1
report,the Division'nay reopen and modify this NPDES permit to require removal of the
discharge,modify treatment designs and/or revise effluent limitations within a specified time
schedule.
Request Region input as to economic viabilities of above. Instream data suspect. r ;
Special Schedule Requirements and additional comments from Reviewers:
Rec>,0�.,A,.- oft L lc Cop-vie,' Al 1,/5 nn�C/z>' .J,4cL. (7IL,QtVrel A
1/aS A SAtAL L "pitt ,T Cof TLD , 5c4 6sL(,cAcL ///f/os.4 5//OKLt, at iVALuAsi'TLDI
,lrcr- li7e/. rAL. ..Z,-,.e1Ac7— ry S-rtze_.,:-7 /5 Nv4 - X/5rf,vT. �j
,� coriele/i,d A ,-t, 7- ,4 _ IeLI? Sc(t /=o.& Yt445, I? / Bssl4L4.. A
Recommended by: l - — — Date: ► ►3/53
Farrell Keough
Reviewed by I
i
Instream Assessment: Date: /q-3 I
Regional Supervisor: ,f_hrzyt."-No /� L.- Date: /— 2 S 3
Permits&Engineering: �-� Date:
RETURN TO TECHNICAL SERVICES BY: FEB 1 7 1993

2
CONVENTIONAL PARAMETERS
Existing Limits:
Monthly Average
Summer Winter
Wasteflow (MGD): 0.0094
BOD5 (mg/1): 17.0
NH3N (mg/1): 12.0
DO(mg/1): 6.0
TSS (mg/1): 30
Fecal Col. (/100 ml): 1000
pH (SU): 6-9
Residual Chlorine (41): monitor
Oil&Grease (mg/1):
TP(mg/1):
TN(mg/1):
Recommended Limits:
Monthly Average
Summer Winter WQ or EL
Wasteflow (MGD): 0.0094
BOD5 (mg/1): 17.0 WQ
NH3N (mg/1): 12.0 WQ
DO(mg/1): 6.0 WQ DO
TSS (mg/1): 30
Fecal Col. (/100 ml): 200
pH (SU): 6-9
Residual Chlorine (µg/1): monitor
Oil&Grease (mg/1):
TP(mg/1):
TN(mg/1):
Limits Changes Due To: Parameter(s) Affected
Change in 7Q10 data
Change in stream classification
Relocation of discharge
Change in wasteflow
Other(onsite toxicity study,interaction,etc.)
Instream data
New regulations/standards/procedures x Fecal Coliform
New facility information
_x_ Parameter(s) are water quality limited. For some parameters, the available load capacity of the
immediate receiving water will be consumed. This may affect future water quality based effluent
limitations for additional dischargers within this portion of the watershed.
OR
No parameters are water quality limited, but this discharge may affect future allocations.

•
INSTREAM MONITORING REQUIREMENTS
Upstream Location: upstream fire discharge
Downstream Location: at unnamed road 0.5 mile downstream from discharge point
Parameters: Temperature,DO,Fecal Coliform, Conductivity
Special instream monitoring locations or monitoring frequencies:
weekly in summer[April- October] - monthly in winter[November- March]
MISCELLANEOUS INFORMATION&SPECIAL CONDITIONS
Adequacy of Existing Treatment
Has the facility demonstrated the ability to meet the proposed new limits with existing treatment
facilities? Yes 1/ No
If no, which parameters cannot be met?
Would a "phasing in"of the new limits be appropriate? Yes No ✓
If yes,please provide a schedule (and basis for that schedule) with the regional
office recommendations:
If no, why not?
Special Instructions or Conditions
Wasteload sent to EPA? (Major) (Y or N)
(If yes,then attach schematic, toxics spreadsheet, copy of model,or, if not modeled, then old
assumptions that were made, and description of how it fits into basinwide plan)
Additional Information attached? (Y or N) If yes,explain with attachments.

Facility4Name: ; 5AQk,,kr% tE,toEnntW„ CAM& c nnm ING
?ermit number: mc_cos& 1
Subasin: t -o 1 a , ° r 1a Cvs
Request number: 41y3 1T (%j, t
Comments
Request Logged-in
Existing WLA File checked
Topo-map checked
USGS Flows checked 7 PLEV1003 W1,41 cr vc W 9 a In /3o aZ t b dt t, () c,c
IWC spreadsheet }�0,U5 'R� t city Arc* s-r -4+t5 —cie,� u1c �c-
Nutrient Sensitivity Bocvati c. v dh,€t. i 1ptth Oi�Y pccc�rl
v
Stream classification
Instream Data
History: 't' nt. timees : Bu®: 11.0
N H3•N: rt.a
Tsy :30
00 : 6.0
Fcuat. ' 1004)
• OMR ; 00 VRIt►E.S pl Wiop jtlai aq pw„A 6.+ (19 Z. 4 v r algtl zn) ill-1?i'
• Vc-ol- "IC' ...V N2 b"p Du VA21 nil oIQ 1 ") 1N6t2C-Jort.` cootq
5+i eft'. -VAc.1,i-d WE.II MAl'-tntiv /o'JO Q�wav
-- FAcA r 1,A5 V up y a./44--ct dObatANtiAII s hnce. 1.986 _ 'DPW- clrott Plcxts DO
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Horizons Residential Care Center NC0056791
UPSTREAM DOWNSTREAM
MONTH Temp DO Saturation Fecal Conductivity Temp DO Saturation Fecal Conductivity
Oct-92 8 7.2 61% 33 149 9 7.6 66% 45 163
Sep-92 17 6.9 71% 127 203 18 7 74% 140 186
Aug-92 18 6.9 73% 145 189 19 7.3 79% 159 206
Jul-92 10 6.6 59% 27 188 11 6.6 60% 20 172
Jun-92 9 6.8 59% 23 185 10 6.9 61% 11 188
May-92 9 7.1 61% 5 188 10 7.2 64% 6 181
Apr-92 9 7.2 62% 262 152 10 7.2 64% 145 286 •
Mar-92 8 7.3 61% 13 144 8 7.2 61% 15 147
Feb-92 7 7.2 59% 4 190 7 7.5 61% 4 185
Jan-92 7 7.3 60% 12 173 6 7.4 59% <4 171
Dec-91 7 7.2 59% 38 151 7 7.6 62% 6 181
Nov-92 8 7.5 63% 8 171 8 7.7 65% <4 246
1 2/4/9 2

Horizons Residential Care - Allowable Waste Concentrations
SUMMER
Residual Chlorine Ammonia as NH3
7010 (CFS) 0 7Q10 (CFS) 0
DESIGN FLOW (MGD) 0.0094 DESIGN FLOW (MGD) 0.0094
DESIGN FLOW (CFS) 0.01457 DESIGN FLOW (CFS) 0.01457
STREAM STD (UG/L) 17.0 STREAM STD (MG/L) 1.0
UPS BACKGROUND LEVEL (UG/L) 0 UPS BACKGROUND LEVEL (MG/L) 0.22
IWC (%) 100.00 IWC (%) 100.00
Allowable Concentration (ug/I) 17.00 Allowable Concentration (mg/I) 1.00
WINTER
Ammonia as NH3
7010 (CFS) 0.075
Fecal Limit 200 mg/I DESIGN FLOW (MGD) 0.0094
(based on 331 : 1) DESIGN FLOW (CFS) 0.01457
STREAM STD (MG/L) 1.8
UPS BACKGROUND LEVEL (MG/L) 0.22
IWC (%) 16.27
Allowable Concentration (mg/I) 9.93
NC0056791 FK $d

NPDES WASTE LOAD ALLOCATION
Modeler Date Rec. #
PERMIT NO.: NCOO 711
. 17/////gS iA6-,q 5— *
FACILITY NAME: \\oft - - 4rs�0&•k AL clka,E c- "1 4
Drainage Area (mi2) Avg. Streamflow (cfs):
Facility Status: (- 10 PROPOSED
(circle one) 7Q10 (cfs) O'U Winter 7Q10 (cfs) " - 30Q2 (cfs) O.b
Permit Status: RENEWAL) MODIFICATION UNPEKMrITED NEW
(cireie one) Toxicity Limits: IWC % (circle one) Acute / Chronic
Major Minor, \/
Instream Monitoring:
Pipe No: ,-'� I Design Capacity (MGD): . ©o94 Parameters -Temp era'turt ) -DO , cenJ :r u,471 -tr
eca( cols,corr-,
Domestic (% of Flow): 1(S) Upstream Location uesErtar', oC -';r,&.l A: chary. !of,
Industrial (7r of Flow): n/ra • Downstream '7 Location M4" UnAamtcl coco,‘ ,S' rr1,(t dow/--
Comments: sir es,,,,, 'r on, 41naI et,'s c-ho,c L po.n{`r
frercf,1 : wae.kiy ;n kbv. surytin.cr (Ap,:l- Oc+)
MunlY ;n +hc w.nqer (rJoup- Mir
)
Effluent Summer Winter ` ,
Characteristics
RECEIVING STREAM: v T To ' v) Togo cc K BOD5 (mg/I) 17
Class: — NHS N (mg/1) 12.
Sub-Basin: c) s- o.-- 0 1 D.O. (mg/1) 6
Reference USGS Quad: ' Nw (please attach) TSS (mg/1) 30
County: =-o�LsyTH
F. Col. (/100m1) 1000
Regional Office: As Fa Mo Ra Wa WI cWS
(circle ewe) pH (SU) 6-q
Requested By: n`� ,o T� -1-€a_ Date: Lk—Li'E53
/f -(l.isE ace_ 1�n exi ci ty l:r+4,-(s .
Prepared By: Scd�(' qote: tiiirgt
Reviewed By t"I-) (f)21,,:_ `-p
nate: _( n
j ft; Comments: 'ec�olMenci. removal aC elisckary.e a5 coon is M
al+tena-Vitt ottifloc� d( -wask clIsPasot( can be J4ound, t ;nsir-eaM
rito+lc(-d<<nq requtctr,vii5 vw,(l 6 el,'pPtlr os s-oo/1 .is('s[y& Cac4.1(I'�-y
os)r et-s, ,n I.. (, l Al , ¢o, . S'Ju,tut -`'ac r�erneuki O,C cPt GYIA'o -

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/ -------�- � - -~~~
`
w ^
' Reque �
�
------------------ WASTELOAD ALLOCATION APPROVAL FORM
Facility Name: HORI7ONS RESIDENTIAL CARE CENT
.ftZAi
fttA
NPDES No . : NC0056791 -- ���—�----
Type of Waste: DOMESTIC
Status: EXISTING
Receiving Stream: UT TO BUFFALO CREEK
Classification: C
Subbasin: O3O201 Drainage area: 0.240 sq mi
County: FORSYTH Summer 7Q10: 0.00 cfs
Regional Office: WINGTON-SALEM Winter 7Q10: 0.075 cfs
Requestor : DAVID FOSTER Average flow: 0.300 cfs
Date of Request : 4/4/88 30Q2: 0.075 cf c-
ad
: C18NW
� -------------------- RECOMMENDED EFFLUENT LIMITS ...-.........-.........................................-.......
--------
Wasteflow (mgd ) :
BOD5 (mg/I ) : 17
NH3N (mg/l ) : 12 (Existing Limits >
DO (mg/ l ) : 6
TSS (mg/l ) : 30
Fecal coliform (#/ 100ml ) : 1000
� \ (
Toxicity Testing Req . : �r�� � � mp��^~°�
Cl-
Upstream (Y/N) : Y Location: UPSTREAM OF FINAL DISCHARGE POINT
Downstream (Y/N> : Y Location: AT UNNAMED ROAD .5 MILE DOWNSTREAM
FROM FINAL DISCHARGE SITE.
--------------- --------- COMMENTS ---------- -----------------------
RECOMMEND REMOVAL OF DISCHARGE AS SOON AS AN ALTERNATIVE METHOD OF
WASTE DISPOSAL CAN BE F*OVNn' F()CILITY HAS NOT BEEN MONITORING IN-STREAM
BECAUSE OF NO FLOW / ' �-5t(-,e«�w^ u4 t" DISCHARGE. INSTREAM MONITORING SITES `
v - �`
HA BEE T TO FACIL H ITATE TE INSTREAM MONITORING REQUIREMENT �� ���o�i
MONITORING REQUIREMENT WILL BE DROPPED AS /
SO�N AS THE FACILITY AGREES IN WRITING TO A SCHEDULE OF REMOVAL OF DISCHARGE .
............ _________............................... __ _______....................... __.......__.....................______ ____ ____________ .............
_
Recommended by : �� �� Date:
Reviewed by
Tech Support Supervisor : ' _ ...........____ Date:
Regional Supervisor : _\] ________ Date:
Permits & Engineering : ___ 44,1. _________ Date:
RETURN TO TECHNICAL SERVICES BY : UUU 8� 1���
----�=r�",-`���-="��----
� �