NC0083933_Renewal (Application)_20160909

AQUA,.
September 9, 2016
John Hennessy
Supervisor, Compliance and Expedited Permitting Unit
Division of Water Resources
Department of Environmental Quality
1617 Mail Service Center
Raleigh, NC 27699-1617
Re: Salem Quarters WWTP
Permit Renewal Application
Permit # NCO083933
Forsyth County
Mr. Hennessy:
RECEIVEMCDEQ/ WR
SEP 2 12016
Water Quality
Permitting Section
Enclosed please find our application for renewal of our NPDES Permit and
required documentation.
Aqua North Carolina, Inc. requests the renewal of the current limitations for this
facility as recorded on the previous permit set to expire on February 28, 2017.
If you have questions feel free to contact me at [phone], Extension 57238
or by e-mail at MAMeltona-aguaamerica.com.
Sincerely,
Michael A. Melton
Regional Manager of Compliance
Aqua North Carolina, Inc.
202 MacKenan Court, Cary, NC, 27511 • 919.467.8712 • AquaAmerica.com

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 INCO083933
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:
Owner Name
AQUA NORTH CAROLINA, INC.
Facility Name
SALEM QUARTERS WWTP
Mailing Address
202 MACKENAN COURT
City
CARY
State / Zip Code
NC 27511
Telephone Number
[phone]
Fax Number
[phone]
e-mail Address
[e-mail]
2. Location of facility producing discharge:
Check here if same address as above ❑
Street Address or State Road BELEWS CREEK ROAD
City WALKERTOWN
State / Zip Code NORTH CAROLINA
County FORSYTH
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)
Name AQUA NORTH CAROLINA, INC
Mailing Address 202 MACKENAN COURT
City CARY
State / Zip Code NORTH CAROLINA 27511
Telephone Number [phone]
Fax Number [phone]
1 of 4 Form -D 05108

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 177
School
❑
Number of Students/Staff
Other
❑
Explain:
Describe the source(s) of wastewater (example: subdivision, mobile home park, shopping centers,
restaurants, etc.):
This system serves residential customers only.
Population served: 450
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):
UT TO BELEWS 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.
The 0.06 MGD package plant consist of the following:
• Bar Screen
• Flow Splitter Box
• Equalization Basin
• Dual aeration basins
• Dual clarifiers
• Dual sand filters
• Ultraviolet disinfection system
• Back-up chlorinator, contact basin
• Dechlorinator
2 of 4 Form -D 05/08

NPDES APPLICATION - FORM D
For privately owned treatment systems treating 100% domestic wastewaters <1.0 MGD
• Sludge holding tank
• Stand-by power
10. Flow Information:
Treatment Plant Design flow 0.06 MGD
Annual Average daily flow .026 MGD (for the previous 3 years)
Maximum daily flow .180 MGD (for the previous 3 years)
11. Is this facility located on Indian country?
❑ Yes ® No
12. Effluent Data
Prouide 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.
Parameter
Daily
Maximum
Monthly
Average
Units of
Measurement
Biochemical Oxygen Demand (BODS)
23.7
3.8
MG/L
Fecal Coliform
83
2.1
#/ 100ML
Total Suspended Solids
14.8
4.1
MG/L
Temperature (Summer)
30
23.1
'Celsius
Temperature (Winter)
21
15
° Celsius
pH
7.8
N / A
UNITS
13. List all permits, construction approvals and/or applications:
Type Permit Number Type
Hazardous Waste (RCRA) NESHAPS (CAA)
UIC (SDWA) Ocean Dumping (MPRSA)
NPDES NCO083933 Dredge or fill (Section 404 or CWA)
PSD (CAA) Other
Non -attainment program (CAA)
14. APPLICANT CERTIFICATION
Permit Number
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.
Shannon V. Becker Aqua North Carolina President
Printed name of Person Signing Title
ture of Applicant* 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
3 of 4 Form -D 05108

NPDES APPLICATION - FORM D
For privately owned treatment systems treating 100% domestic wastewaters <1.0 MGD
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.)
4 of 4 Form -D 05108

[s7
17
Aqua North Carolina, Inc.
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Salem Quarters WWTP
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County:
Forsyth Stream Class:
C
Receiving Stream: UT to Belews Creek Sub -Basin:
030201
Latitude:
36° 11' 30" Grid/Quad:
C18NE
Longitude:
800 06' 35" HUC:
03010103
Facility'"`�ziEw
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Location
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(not to scale)
M.
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NORTH
NPDES Permit: NCO083933

Aqua North Carolina, Inc. www.aquaamerica.com
202 MacKenan Court
Cary, NC 27511
SLUDGE MANAGEMENT PLAN
For
Aqua North Carolina, Inc.
No sludge will be treated on any wastewater treatment plant site operated by Aqua
N.C., Western Division
Where practical, sludge removed from a Aqua N.C., Western Division facility will
be transported via a contract hauler to another Aqua N.C., Western Division
facility for the purpose of "seeding" a new or under loaded plant.
Unusable (or "dead") sludge will be removed by a contract hauler and properly
disposed of in accordance with NCGS 143-215.1. Contract haulers used by Aqua
N.C., Western Division will be required to report the quantity of sludge
transported and identify the location of the proposed disposal site if the sludge is
not taken to an existing plant operated by Aqua N.C., Western Division. Aqua
N.C., Western Division has not entered into any agreement to accept sludge into
its facilities from plants not owned by them.
Aqua N.C., Western Division will keep records on the quantity of sludge removed from
each facility, the name of the contract hauler, and the destination of the sludge (whether
used in another plant or disposed of). The information will be kept on file and will be
made available to any regulatory agency having jurisdiction over sludge treatment or
disposal.
Aqua N.C., Western Division includes all of the facilities under the jurisdiction of the
Winston-Salem Regional Office.