NC0037311_Permit Issuance_19970103

State of North Carolina
Department of Environment,
Health and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
A. Preston Howard, Jr., P.E., Director
Mr. James M. Cheshire
Pierce Management Company
6206 Reidsville Road
Kernersville, North Carolina 27284
Dear Mr. Cheshire:
Aj
C)iEHNFI
January 3,1997
Subject: NPDES Permit Issuance
Permit No. NCO037311
Creekside Manor Rest Home W WTP
Forsyth County
In accordance with the application for a discharge permit received on August 1, 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 US
Environmental Protection Agency dated December 6,1983.
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 notice this permit is not transferable. Part II, EA. 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, 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 Susan Robson at telephone number (919)
733-5093, extension 551.
Sincerely,
Original Signed By
David A. Goodrich
A. Preston Howard, Jr., P.E.
cc: Central Files
Winston-Salem Regional Office
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. NCO037311
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT, HEALTH, AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
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,
Pierce Management Company
is hereby authorized to discharge wastewater from a facility located at
Creekside Manor Rest Home WWTP
intersection of Highway 158 and NCSR 1971
Kernersville
Forsyth County
to receiving waters designated as an unnamed tributary to Belews 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 February 1, 1997
This permit and authorization to discharge shall expire at midnight on January 31, 2002
Signed this day January 3, 1997
Original Signed By
David A. Goodrich
A. Preston Howard, Jr., P.E., Director
Division of Water Quality
By Authority of the Environmental Management Commission

Permit No. NC0037311
SUPPLEMENT TO PERMIT COVER SHEET
Pierce Management Company
is hereby authorized to:
I. Continue to operate a 0.01 MGD extended aeration wastewater treatment facility consisting of
bar screen, aeration basin, secondary clarifier, aerobic digester, and chlorination located at
Creekside Manor Rest Home WWTP, intersection of Highway 158, and NC State Road 1971
Kernersville, Forsyth County (See Part III of this Permit), and
2. Discharge from said treatment works at the location specified on the attached map into an
unnamed tributary to Belews Creek which is classified Class C waters in the Roanoke River
Basin.

ROAD CLASSIFICATION
PRIMARY HIGHWAY iMpRMOVEDSRFACE ��
HARD SURFACE
SECOND
HARD SURACE HIG"WAC=3019= UNIMPROVED ROAD - -
Latitude 36012'49"
Mtp # C18NE
Longitude 80003'49"
Sub -basin 030201
Stream Class C
Discharae Class 11
ng Stream UT to Belews Creek
0 0.01 MGD Permit expires 1/31/02
SCALE 1:24 000
0 1 MILE
0 7000 FEET
1 0 1 KILOMETER
CONTOUR INTERVAL 10 FEET
QUAD LOCATION Creekside Manor Rest Home
NCO037311
% Forsyth County
WWTP

A. (). EFFLUENT LIMITATIONS AND MONITORING REQUIREMENTS SUMMER (April 1 - October 31) Permit No. NCO037311
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
Flow
BOD, 5 day, 200C
Total Suspended Residue
NH3 as N
Dissolved Oxygen"
Fecal Coliform (geometric mean)
Temperature
Temperature
Conductivity
Total Residual Chlorine
Discharge Limitations
Monitoring
Requirements
Measurement
Sample
*Sample
Monthly Avg. Weekly Avg.
Daily Max
Frequency
Type
Location
0.010 IVIGD
Weekly
Instantaneous
I or E
30.0 mg/I
45.0 mg/I
Weekly
Grab
E
30.0 mg/I
45.0 mg/I
Weekly
Grab
E
2.0 mg/I
Weekly
Grab
E
Weekly
Grab
E, U, D
200.0 /100 ml
400.0 /100 ml
Weekly
Grab
E, U, D
Daily
Grab
E
Weekly
Grab
U, D
Weekly
Grab
E,U,D
2/Week
Grab
E
* Sample locations: E - Effluent, I - Influent, U - Upstream approximately 100 feet above outfall, D - Downstream approximately 300 feet
below outfall.
Stream samples shall be grab samples and shall be conducted weekly.
** The daily average dissolved oxygen effluent concentration shall not be less than 5.0 mg/l.
The pH shall not be less than 6.0 standard units nor greater than 9.0 standard units and shall be monitored weekly at the effluent by grab
sample.
There shall be no discharge of floating solids or visible foam in other than trace amounts.

A. (). EFFLUENT LIMITATIONS AND MONITORING REQUIREMENTS WINTER (November I - March 31) Permit No. NCO037311
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
Flow
BOD, 5 day, 200C
Total Suspended Residue
NH3 as N
Dissolved Oxygen"
Fecal Coliform (geometric mean)
Temperature
Temperature
Conductivity
Total Residual Chlorine
Discharge Limitations
Monitoring
Requirements
Measurement
Sample
*Sample
Monthly Avg. Weekly Avg.
Daily Max
Frequency
Type
Location
0.010 MGD
Weekly
Instantaneous
I or E
30.0 mg/I
45.0 mg/I
Weekly
Grab
E
30.0 mg/I
45.0 mg/I
Weekly
Grab
E
4.0 mg/I
Weekly
Grab
E
Weekly
Grab
E, U, D
200.0 /100 ml
400.0 /100 ml
Weekly
Grab
E, U, D
Daily
Grab
E
Weekly
Grab
U, D
Weekly
Grab
E,U,D
2/Week
Grab
E
* Sample locations: E - Effluent, I - Influent, U - Upstream approximately 100 feet above outfall, D - Downstream approximately 300 feet
below outfall.
Stream samples shall be grab samples and shall be conducted weekly.
** The daily average dissolved oxygen effluent concentration shall not be less than 5.0 mg/l.
The pH shall not be less than 6.0 standard units nor greater than 9.0 standard units and shall be monitored weekly at the effluent by grab
sample.
There shall be no discharge of floating solids or visible foam in other than trace amounts.

Staff Review and Evaluation
NPDES��Wastewater Permit
FACILITY INFORMATION
Facility TTi--CfiyHaven WWTP
NPDES No. NC0037311
Design Flow (MGD) 0.01
Facility Class II
STREAM CHARACTERISTICS
Stream Name
Stream Class
Sub -basin
Drainage Area (mil)
S7Q10 (cfs)
W7Q10 (cfs)
30Q2 (cfs)
IWC (%)
UT Belews Creek
C
030201
0.3
0.0
0.06
0.06
100
Proposed Changes
Parameters Affected
Basis for change(s)
monitoring frequencies
BOD5,TSS,NH3-N,Fecal„Tem
2B .0500's
limit
NH3-N
DEM policy 2/4
monitoring implementation
residual chlorine
consistent with all facilities
chlorinating (this is already
being conducted)
limit
DO
DO limit changed from 3 mg/1 to
5 mg/l, which is consistent with
WQ limited facilities
Compliance Schedule:
Special Condition(s):
Permits & Engineering Comments:
This facility has been in compliance with the existing limits for the past 2 years. Instream
monitoring does not indicate any DO's less than 5 mg/1 in the past 2 years. Monitoring
frequencies will be changed based on Class II facility. The monthly average NH3-N limit has
been modified to 2 mg/I & 4 mg/1(sum & win), consistent with DIM policy for minimum NH3-N
limits. The effluent dissolved oxygen limit has been raised from 3 mg/I to 5 mg/l (which is
consistent with WQ limited facilities). Total residual chlorine has been added as a monitoring
requirement (which the facility has been reporting on their DMR's). No other changes are
recommended by P&E. Facility has had one TSS violation during the past year. No instream
monitoring is required at this facility:
Prepared by:
Regional Office Evaluation and Recommendations:

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