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HomeMy WebLinkAboutNC0022730_Renewal (Application)_20170519Water Resources ENVIRONMENTAL QUALITY May 19, 2017 Mr. Robert Heaton Town of Beech Mountain 403 Beech Mount Parkway Beech Mountain, NC 28604 Subject: Permit Renewal Application No. NCO022730 Grassy Gap Creek WWTP Watauga County Dear Permittee: ROY COOPER MICHAEL S. REGAN S. JAY ZIMMERMAN The Water Quality Permitting Section acknowledges receipt of your permit application and supporting documentation received on May 19, 2017. The primary reviewer for this renewal application is Charles Weaver. The primary reviewer will review your application, and he will contact you if additional information is required to complete your permit renewal. Per G.S. 150B-3 your current permit does not expire until permit decision on the application is made. Continuation of the current permit is contingent on timely and sufficient application for renewal of the current permit. If you have any additional questions concerning renewal of the subject permit, please contact Charles Weaver at 919-807-6391 or Charles. Weaver@ncdenr.gov. Sincerely, 2 7&fid Wren Thedford Wastewater Branch cc: Central Files NPDES Winston-Salem Regional Office State of North Carolina I Environmental Quality I Water Resources 1617 Mad Service Center I Raleigh, North Carolina 27699-1617 919-807-6300 Council Members E. Rkk' Miller, Mayor Paul Piquet, Vice Mayor Renee Castiglione Wendel Sauer Rick Owen /\N BEECH MOUNTAIN N O R T H C A R d L I N A Eastern Arnerica's Highest Towr: April 26, 2017 U.S. Environmental Protection Agency Atlanta Federal Center 61 Forsyth Street, SW Atlanta, GA 30303-3104 Attention: Permit Contact, Permits Section Dear Permit Reviewer, Town Manager Tim H. Holloman Town Attorne% Stacy C. Eggers IV RECEIVEDUDEUDWR MAY 19 2011 Water Quality Permitting Section On behalf of the Town of Beech Mountain, I respectfully submit to you permit renewal documentation for NPDES Permit No. NC0069761, Pond Creek Wastewater Treatment Plant for your review and approval. Please find enclosed the following: 1. EPA Application Form 1- General Information 2. NPDES Form 2A, Parts Al-Al2 3. NPDES Form 2A, Parts B1 -B6 4. NPDES Form 2A, Part C 5. NPDES Form 2A, Part E 6. Topographic Map Please call me at 828-387-9368 if you have any questions. Thank you. Si cerel , Donald S.. or6e, E.I.T. 403 Beech Mountain Parkway Beech Mountain North Carolina 28604-8012 elephone (828) 387-4236 Fax (828) 387-4862 Please orint or tvoe in the unshaded areas only Form Approved. OMB No. 2040-0086. FORM U.S. ENVIRONMENTAL PROTECTION AGENCY I. EPA I.D. NUMBER 1 GENERAL INFORMATION 5 TA c \=CEPA Consolidated Permits Program F 110069999274 D GENERAL (Read the "General Instructions" before starting.) 1 2 13 10 15 GENERAL INSTRUCTIONS LABEL ITEMS If a preprinted label has been provided, affix it in the designated space. Review the information carefully; if any of it I EPA I.D. NUMBER 110069999274 is incorrect, crass through it and enter the correct data in the appropriate fill-in area below. Also, if any of the preprinted data is absent (the area to the left of the label space lists the III. FACILITY NAME Pond Creek Wastewater Treatment Plant information that should appear), please provide it in the proper filNn area(s) below. If the label is complete and correct, you V. FACILITY MAILING 403 Beech Mountain Parkway, need not complete Items I, III, V, and VI (except Vl-B which ADDRESS must be completed regardless). Complete all items if no label Beech Mountain NC 28604 has been provided. Refer to the instructions for detailed item this VI. FACILITY LOCATION ' descriptions and for the legal authorizations under which Beech Mountain, North Carolina data is collected. II. POLLUTANT CHARACTERIST...., - INSTRUCTIONS: Complete A through J to determine whether you need to submit any permit application forms to the EPA. If you answer "yes" to any questions, you must submit this form and the supplemental form listed in the parenthesis following the question. Mark "X° in the box in the third column if the supplemental form is attached. If you answer "no" to each question, you need not submit any of these forms. You may answer "no" if your activity is excluded from permit requirements; see Section C of the instructions. See also, Section D of the instructions for definitions of bold-faced terms. Mark "X" Mark "X" SPECIFIC QUESTIONS SPECIFIC QUESTIONS YES NO FORM AT YES NO FORM ATTACHED A. Is this facility a publicly owned treatment works which results in a discharge to waters of the U.S.? (FORM 2A) X B. Does or will this facility (either existing or proposed) include a concentrated animal feeding operation or X aquatic animal production facility which results in a 16 17 18 19 26 21 discharge to waters of the U.S.? (FORM 2B) C. Is this a facility which currently results in discharges to�/ X D. Is this a proposed facility (other than those described in A X waters of the U.S. other than those described in A or B or B above) which will result in a discharge to waters of above? (FORM 2C) 22 23 24 the U.S.? (FORM 2D) 25 26 27 E. Does or will this facility treat, store, or dispose of F. Do you or will you inject at this facility industrial or hazardous wastes? (FORM 3) X municipal effluent below the lowermost stratum X containing, within one quarter mile of the well bore, 26 29 W underground sources of drinking water? (FORM 4) 31 32 33 G. Do you or will you inject at this facility any produced water H. Do you or will you inject at this facility fluids for special or other fluids which are brought to the surface in connection with conventional oil or natural gas production, X processes such as mining of sulfur by the Frasch process, solution mining of minerals, in situ combustion of fossil X inject fluids used for enhanced recovery of oil or natural fuel, or recovery of geothermal energy? (FORM 4) gas, or inject fluids for storage of liquid hydrocarbons? (FORM 4) 3d 35 36 37 38 39 I. Is this facility a proposed stationary source which is one J. Is this facility a proposed stationary source which is of the 28 industrial categories listed in the instructions and�/ X NOT one of the 28 industrial categories listed in the �/ X which will potentially emit 100 tons per year of any air instructions and which will potentially emit 250 tons per pollutant regulated under the Clean Air Act and may affect year of any air pollutant regulated under the Clean Air Act °0 °1 d2 43 49 45 or be located in an attainment area? (FORM 5) and may affect or be located in an attainment area? (FORM 5) III. NAME OF FACILITY c SKIP I I I I I 1 I 1 Pond Creek WWTP 15 18 — 29 36-- I 1 IV. FACILITY CONTACT A. NAME & TITLE (last, first, & title) B. PHONE (area code & no.) 1 1 1 I 1 1 I Heaton, Robert, Public Utilities Director ( 2 ) 3 7-9 8 2 V.FACILTY MAILING ADDRESS A. STREET OR P.O. BOX 4(13 BEECH Mountain Parkway 3 5 16 45 B. CITY OR TOWN C. STATE D. ZIP CODE 4 Beech Mountain 15 i6 C 2 6 4 W •4 - 41 5 - VI. FACILITY LOCATION A. STREET, ROUTE NO. OR OTHER SPECIFIC IDENTIFIER 5 3b4 Locust Ridge Roaa s 18 45 B. COUNTY NAME Watauga 1 46 76 C. CITY OR TOWN D. STATE E. ZIP CODE F COUNTY CODE (if known) s B e h M u tai I . C L 2 6 4 is 16 46 41 42 47 51 52 -54 EPA Form 3510-1 (8-90) CONTINUE ON REVERSE EPA Form 3510-1 (8-90) VII. SIC CODES 4-d' it, in order of riori A. FIRST B. SECOND (sped)7 (specify) 7 1E tP 1e 101 C. THIRD D. FOURTH (spec) (speck) J�7t9 15 1E 19 VIII. OPERATOR INFORMATION q. Nq}yE B. Is the name listed In Item i I I I I I I r I I I I I I 1 1 VIII -A also the owner? s Gary Tipton ❑ YES El NO 5 18 55 66 C. STATUS OF OPERATOR (Enter the appropriate letter into the answer box: rf "Other,"specify.) D. PHONE (area code & no.) F =FEDERAL M= PUBLIC (other thanfederalorstate) M (specify) A (828) 387-4724 S=STATE O =OTHER (spec) P = PRIVATE 56 15 6 18 19 2122 26 E. STREET OR P.O. BOX G 3641 Locust Ridge Rd 26 5 F. CITY OR TOWN G. STATE H. ZIP CODE IX. INDIAN LAND C i Is the facility located on indian ianas? B Beech Mountain NC 28604 ❑ YES © NO 52 15 Ila 10 it w•: a'7 - 51 X. EXISTING ENVIRONMENTAL PERMITS A.NPDES Discha es toSuriaceWater D. PSD AirEmtsstons(romP7,2T Sources C T I C T g N NCO069761 91P 151 16 1 17 118 30 15 16 17 B.UIC (Undergproundlm'ectiono1Fluids' E. OTHER s��eci,. C T I I C T I 9 /Spec fy) 91U1 15 18 17 18 30 15 16 17 18 30 C. RCRA Hazardous Wastes) E. OTHER ci C T I I C T I (spec �) 9 R 9 15 16 17 18 30 15 1 16 1 17 116 30 XI. MAP Attach to this application a topographic map of the area extending to at least one mile beyond property boundaries. The map must show the outline of the facility, the location of each of its existing and proposed intake and discharge structures, each of its hazardous waste treatment, storage, or disposal facilities, and each well where it injects fluids underground. Include all springs, rivers, and other surface water bodies in the map area. See instructions for precise requirements. XII. NATURE OF BUSINESS (provide a brief description) Treatment of Municiple waste via a wastewater treatment plant discharging effluent into Pond Creek. XIII. CERTIFICATION (see instructions) 1 certify under penalty of law that I have personally examined and am familiar with the information submitted in this application and all attachments and that, based on my inquiry of those persons immediately responsible for obtaining the information contained in the application, I believe that the information is true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibifite Ane a monsonment. A. NAME & OFFICIAL TITLE (type orprint) B. SIGNATURE C. DATE SIGNE Tim H. Holloman, Town Manager h {/ COMMENTS FOR OFFICIAL USE ONLY 11 I I I I C 15 116 Y EPA Form 3510-1 (8-90) FACILITY NAME AND PERMIT NUMBER: Form Approved 1/14W Pond Creek WWTP, NCO069761 OMB Number 2040-M6 FORM 2A NPDES FORM 2A APPLICATION OVERVIEW NPDES APPLICATION OVERVIEW Form 2A has been developed in a modular format and consists of a 'Basic Application Information" packet and a "Supplemental Application Information" packet. The Basic Application Information packet is divided into two parts. All applicants must complete Parts A and C. Applicants with a design flow greater than or equal to 0.1 mgd must also complete Part B. Some applicants must also complete the Supplemental Application Information packet. The following items explain which parts of Form 2A you must complete. BASIC APPLICATION INFORMATION: A. Basic Application Information for all Applicants. All applicants must complete questions A.1 through A.8. A treatment works that discharges effluent to surface waters of the United States must also answer questions A.9 through A.12. B. Additional Application Information for Applicants with a Design Flow > 0.1 mgd. All treatment works that have design flows greater than or equal to 0.1 million gallons per day must complete questions B.1 through B.6. C. Certification. All applicants must complete Part C (Certification). SUPPLEMENTAL APPLICATION INFORMATION: D. Expanded Effluent Testing Data. A treatment works that discharges effluent to surface waters of the United States and meets one or more of the following criteria must complete Part D (Expanded Effluent Testing Data): 1. Has a design flow rate greater than or equal to 1 mgd, 2. Is required to have a pretreatment program (or has one in place), or 3. Is otherwise required by the permitting authority to provide the information. E. Toxicity Testing Data. A treatment works that meets one or more of the following criteria must complete Part E (Toxicity Testing Data): 1. Has a design flow rate greater than or equal to 1 mgd, 2. Is required to have a pretreatment program (or has one in place), or 3. Is otherwise required by the permitting authority to submit results of toxicity testing. F. Industrial User Discharges and RCRA/CERCLA Wastes. A treatment works that accepts process wastewater from any significant industrial users (SIUs) or receives RCRA or CERCLA wastes must complete Part F (industrial User Discharges and RCRA/CERCLA Wastes). SIUs are defined as: 1. All industrial users subject to Categorical Pretreatment Standards under 40 Code of Federal Regulations (CFR) 403.6 and 40 CFR Chapter I, Subchapter N (see instructions); and 2. Any other industrial user that: a. Discharges an average of 25,000 gallons per day or more of process wastewater to the treatment works (with certain exclusions); or b. Contributes a process wastestream that makes up 5 percent or more of the average dry weather hydraulic or organic capacity of the treatment plant; or c. Is designated as an SIU by the control authority. G. Combined Sewer Systems. A treatment works that has a combined sewer system must complete Part G (Combined Sewer Systems). ALL APPLICANTS MUST COMPLETE PART C (CERTIFICATION) EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 1 of 21 FACILITY NAME AND PERMIT NUMBER:I OMS Number 20440086 Form Approved 1/14V9 Pond Creek WWTP, NC0069761 BASIC APPLICATION INFORMATION PART A. BASIC APPLICATION INFORMATION FOR ALL APPLICANTS: All treatment works must complete questions A.1 through A.8 of this Basic Application Information packet A.I. Facility Information. Facility name Pond Creek WWTP Mailing Address 403 Beech Mountain Parkway. Beech Mountain. NC 28604 Contact person Title Public Willies Director Telephone number (828).387-9282 Facility Address 364 Locust Ridge Road. Beech Mountain. NC 28604 (not P.O. Box) A.2. Applicant Informatlon. If the applicant Is different from the above, provide the following: Applicant name Town Of Beech Mountain Mailing Address 403 8eerh Mountain Parkway�$earh Mountain. NC 28804 Contact person Title Town Mana er Telephone number (8281 387-423 Is the applicant the owner or operator (or both) of the treatment works? V/ owner operator • Indicate whether correspondence regarding this permit should be directed to the facility or the applicant. V/ facility applicant A.3. Existing Environmental Permits. Provide the permit number of any existing environmental permits that have been issued to the treatment works (include state -issued permits). NPDES NCO069761 PSD UIC Other RCRA Other A.4. Collection System Information. Provide information on municipalities and areas served by the facility. Provide the name and population of each entity and, if known, provide information on the type of collection system (combined vs. separate) and its ownership (municipal, private, etc.). Name Population Served Type of Collection System Ownership Total population served 2640 EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 8 7550-22, Page 2 of 21 FACILITY NAME AND PERMIT NUMBER: Pond Creek WWTP, NCO069761 A.S. Indian Country. a. Is the treatment works located in Indian Country? Form Approved 1/14198 OMB Number 2040.0088 Yes V( No b. Does the treatment works discharge to a receiving water that is either in Indian Country or that is upstream from (and eventually flows through) Indian Country? Yes ✓ No A.S. Flow. Indicate the design flow rate of the treatment plant (i.e., the wastewater flow rate that the plant was built to handle). Also provide the average daily flow rate and maximum daily flow rate for each of the last three years. Each year's data must be based on a 12 -month time period with the 12th month of "this year" occurring no more than three months prior to this application submittal. a. Design flow rate _ 0.40 mgd Two Years Aoo Last Year This Year b. Annual average daily flow rate 0.15 0.10 0.23 mgd c. Maximum daily flow rate 1 15 0.89 0.23 mgd A.7. Collection System. Indicate the type(s) of collection system(s) used by the treatment plant. Check all that apply. Also estimate the percent contribution (by miles) of each. ✓ Separate sanitary sewer Combined storm and sanitary sewer A.S. Discharges and Other Disposal Methods. 100.00 % %C a. Does the treatment works discharge effluent to waters of the U.S.? VL Yes No If yes, list how many of each of the following types of discharge points the treatment works uses: 1. Discharges of treated effluent 1 Ii. Discharges of untreated or partially treated effluent 0 iii. Combined sewer overflow points 0 Iv. Constructed emergency overflows (prior to the headworks) 0 v. Other 0 b. Does the treatment works discharge effluent to basins, ponds, or other surface Impoundments that do not have outlets for discharge to waters of the U.S.? Yes ✓ No If yes, provide the following for each surface impoundment: Location: r1l,cl Annual average daily volume discharged to surface impoundment(s) „ oa mgd Is discharge continuous or intermittent? c. Does the treatment works land -apply treated wastewater? Yes ✓ No If yes, provide the following for each land application site: Location: Number of acres: Annual average daily volume applied to site: Mgd Is land application continuous or intermittent? d. Does the treatment works discharge or transport treated or untreated wastewater to another treatment works? Yes ✓ No EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 3 of 21 FACILITY NAME AND PERMIT NUMBER: Pond Creek WWTP, NCO069761 Form Appmved 1/1489 OMS Number 2040.0085 If yes, describe the mean(s) by which the wastewater from the treatment works is discharged or transported to the other treatment works (e.g., tank truck, pipe). If transport is by a party other then the applicant, provide: Transporter name: Mailing Address: Contact person: Title: Telephone number: For each treatment works that receives this discharge, provide the following: Name: Mailing Address: Contact person: Title: Telephone number: If known, provide the NPOES permit number of the treatment works that receives this discharge. Provide the average daily flow rate from the treatment works into the receiving facility. mgd e. Does the treatment works discharge or dispose of its wastewater in a manner not included in A.8.a through A.8.d above (e.g., underground percolation, well injection)? Yes No If yes, provide the following for each disposal method: Description of method (including location and size of ske(s) if applicable): Annual daily volume disposed of by this method: Is disposal through this method continuous or intermittent? EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-8 & 7550-22. Page 4 of 21 FACILITY NAME AND PERMIT NUMBER: Pond Creek WWTP, NCO069761 Form Approved 1/14199 OMB Number 20400086 WASTEWATER DISCHARGES: If you answered "yes" to question A.B.a, complete questions A.9 through A.12 once for each outfall (including bypass points) through which effluent is discharged. Do not Include information on combined sewer overflows in this section. If you answered "no" to question A.B.a, go to Part B, `Additional Application Information for Applicants with a Design Flow Greater than or Equal to 0.1 mgd.' A.9. Description of Outfall. a. Outfall number b. Location 001 or town, IIounry) state) 3 degrees, 12 Min, 49 Sec North 81 Degrees, 52 Min. 30 Sec. West (Latitude) c. Distance from shore (if applicable) d. Depth below surface (if applicable) e. Average daily flow rate I. Does this outfall have either an intermittent or a periodic discharge? If yes, provide the following Information: Number of times per year discharge occurs: Average duration of each discharge: Average flow per discharge: Months in which discharge occurs: g. Is outfall equipped with a diffuser? A.10. Description of Receiving Waters. a. Name of receiving water Pond Creek Yes ff. fl. mgd VF No (go to A.9.g.) b. Name of watershed (if known) United States Soil Conservation Service 14 -digit watershed code (if known): c. Name of State Management/River Basin (if known): Watauga River Basin United States Geological Survey 8 -digit hydrologic cataloging unit code (if known): d. Critical low flow of receiving stream (if applicable): acute cls chronic cfs e. Total hardness of receiving stream at critical low flow (if applicable): mgN of CaCO3 EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 5 of 21 mgd Yes No b. Name of watershed (if known) United States Soil Conservation Service 14 -digit watershed code (if known): c. Name of State Management/River Basin (if known): Watauga River Basin United States Geological Survey 8 -digit hydrologic cataloging unit code (if known): d. Critical low flow of receiving stream (if applicable): acute cls chronic cfs e. Total hardness of receiving stream at critical low flow (if applicable): mgN of CaCO3 EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 5 of 21 FACILITY NAME AND PERMIT NUMBER: Form Approved 1/14x99 Pond Creek WWTP, NCO069761 OMB Number 2040-0086 A.11. Description of Treatment a. What levels of treatment are provided? Check all that apply. V* Primary Secondary Advanced Other. Describe: b. Indicate the following removal rates (as applicable): Design BODE removal or Design CBODS removal 85.00 % Design SS removal 85.00 % Design P removal % Design N removal Other % c. What type of disinfection is used for the effluent from this outfall? If disinfection varies by season, please describe. Ultra Violet Lights If disinfection is by chlorination, is dechlorination used for this outfall? Yes V/ No d. Does the treatment plant have post aeration? V/ Yes No A.12. Effluent Testing Information. All Applicants that discharge to waters of the US must provide effluent testing data for the following parameters. Provide the indicated effluent testing required by the permitting authority for each outfall through which effluent Is discharged. Do not Include Information on combined sewer overflows In this section. All Information reported must be based on date collected through analysis conducted using 40 CFR Part 136 methods. In addition, this data must comply with QAfQC requirements of 40 CFR Part 136 and other appropriate QAIQC requirements for standard methods for analytes not addressed by 40 CFR Part 136. At a minimum, effluent testing data must be based on at least three samples and must be no more than four and one-half years apart. Outfall number: 001 PARAMETER MAXIMUM DAILY VALUE AVERAGE DAILY VALUE Value Units Value Units Number of Samples H Minimum 6.10 S.U. H (Ma)imum 7.40 s,u - Flow Rate 0.89 mgd 0.10 mgd Temperature winter 14.00 degree C 10.00 degree C Temperature (Summen 121.00Idegree C 16.00 degree C " For pH please report a minimum and a maximum daily value POLLUTANT MAXIMUM DAILY AVERAGE DAILY DISCHARGE ANALYTICAL ML ! MDL DISCHARGE METHOD Conc. Units Cone. Units Number of Samples CONVENTIONAL AND NONCONVENTIONAL COMPOUNDS. BIOCHEMICAL OXYGEN BOD -5 20.90 mg/I 4.50 mg/I 52.00 CBOD-5 DEMAND (Re ort one) FECAL COLIFORM 29.00 /100 mgl 2.10 / 100 mgl 52.00 TOTAL SUSPENDED SOLIDS (TSS) 26.00 / 100 mgl 11.10 / 100 mgl, END OF PART A. REFER TO THE APPLICATION OVERVIEW TO DETERMINE WHICH OTHER PARTS OF FORM 2A YOU MUST COMPLETE EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 6 of 21 FACILITY NAME AND PERMIT NUMBER: Form Approved 1/14/39 Pond Creek WWTP, NCO069761 O&M Numbar 204"086 BASIC APPLICATION INFORMATION PART B. ADDITIONAL APPLICATION INFORMATION FOR APPLICANTS WITH A DESIGN FLOW GREATER THAN OR EQUAL TO 0.1 MGD (100,000 gallons per day). All applicants with a design flow rate > 0.1 mgd must answer questions B.1 through B.6. All others go to Part C (Certification). B.1. Inflow and Infiltration. Estimate the average number of gallons per day that flow into the treatment works from Inflow and/or infiltration. 34.000.00 _•.ipd Briefly explain any steps underway or planned to minimize Inflow and infiltration. Pian to replace 2000 feet of existing sewer line bi-yearly. B.2. Topographic Map. Attach to this application a topographic map of the area extending at least one mile beyond facility property boundaries. This map must show the outline of the facility and the following Information. (You may submit more than one map if one map does not show the entire area.) a. The area surrounding the treatment plant, including all unit processes. b. The major pipes or other structures through which wastewater enters the treatment works and the pipes or other structures through which treated wastewater is discharged from the treatment plant. Include outfalls from bypass piping, if applicable. c. Each well where wastewater from the treatment plant is injected underground. d. Wells, springs, other surface water bodies, and drinking water wells that are: 1) within 1/4 mile of the property boundaries of the treatment works, and 2) listed in public record or otherwise known to the applicant. e. Any areas where the sewage sludge produced by the treatment works is stored, treated, or disposed. f. If the treatment works receives waste that is classified as hazardous under the Resource Conservation and Recovery Act (RCRA) by truck, rail, or special pipe, show on the map where that hazardous waste enters the treatment works and where It is treated, stored, and/or disposed. 8.3. Process Flow Diagram or Schematic. Provide a diagram showing the processes of the treatment plant, including all bypass piping and all backup power sources or redundancy in the system. Also provide a water balance showing all treatment units, including disinfection (e.g, chlorination and dechlorination). The water balance must show daily average flow rates at influent and discharge points and approximate daily flow rates between treatment units. Include a brief narrative description of the diagram. B.4. Operstlon/MaIntenance Performed by Contractor(s). Are any operational or maintenance aspects (related to wastewater treatment and effluent quality) of the treatment works the responsibility of a contractor? _Yes ✓ No If yes, list the name, address, telephone number, and status of each contractor and describe the contractor's responsibilities (attach additional pages if necessary). Name: Mailing Address: Telephone Number: Responsibilities of Contractor: B.B. Scheduled Improvements and Schedules of Implementation. Provide information on any uncompleted implementation schedule or uncompleted plans for Improvements that will affect the wastewater treatment, effluent quality, or design capacity of the treatment works. If the treatment works has several different implementation schedules or is planning several improvements, submit separate responses to question B.5 for each. (If none, go to question B.6.) a. List the outfall number (assigned in question A.9) for each outfall that Is covered by this implementation schedule. b. Indicate whether the planned improvements or implementation schedule are required by local, State, or Federal agencies. Yes No EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 7 of 21 FACILITY NAME AND PERMIT NUMBER: Form Approved 1/14/99 Pond Creek WWTR NCO069761 OMB Number 2040-0096 c If the answer to B.5.b Is "Yes," briefly describe, Including new maximum daily inflow rate (if applicable). d. Provide dates imposed by any compliance schedule or any actual dates of completion for the implementation steps listed below, as applicable. For Improvements planned independently of local, State, or Federal agencies, indicate planned or actual completion dates, as applicable. Indicate dates as accurately as possible. Schedule Actual Completion Implementation Stage MM / DD / YYYY MM / DO / YYYY –Beginconstruction _/_/ _/—/ – End construction l 1 I l – Begin discharge –Attain operational level —/—I— /_/ a. e. Have appropriate permits/clearances concerning other Federal/State requirements been obtained? _Yes No Describe briefly: B.S. EFFLUENT TESTING DATA (GREATER THAN 0.1 MGD ONLY). Applicants that discharge to waters of the US must provide effluent testing data for the following parameters. Provide the indicated effluent testing required by the permitting authority for each outfall through which effl+lent i¢ ttt 2r ared. Do not Include information on combined sewer overflows in this seetion. All information reported must be based on data collected through analysis conducted using 40 CFR Part 136 methods. In addition, this data must comply with QAIQC requirements of 40 CFR Part 136 and other appropriate QAlQC requirements for standard methods for analytes not addressed by 40 CFR Part 136. At a minimum, effluent testing data must be based on at least three pollutant scans and must be no more than Tour and one-half years old. Outfall Number: 001 POLLUTANT MAXIMUM DAILY AVERAGE DAILY DISCHARGE DISCHARGE Conc. Units Conc. Units Number of ANALYTICAL ML / MDL Samples METHOD CONVENTIONAL AND NONCONVENTIONAL COMPOUNDS. AMMONIA (as N) 4.80 mg/I 2.60 mg/I 52.00 CHLORINE (TOTAL RESIDUAL, TRC) 0.00 mg/I 0.00 mg/l 3.00 sm4500cig-2000 DISSOLVED OXYGEN 10.70 mg/I 9.70 mgll 210.00 ysi550a TOTALNE T TKNHL NITROGEN j 13.70 mg/I 9.70 mg/I 3.00 .140sm4500o b � NITRATE PLUS NITRITE NITROGEN 9.90 mg/I 7.20 mg/I 3.00 .100sm4500no3 OIL and GREASE PHOSPHORUS (Total) 4.14 mg/I 2.60 mg/I 3.00 .160sm4500pe TOTAL DISSOLVED SOLIDS (TDS) OTHER END OF PART B. REFER TO THE APPLICATION OVERVIEW TO DETERMINE WHICH OTHER PARTS OF FORM 2A YOU MUST COMPLETE EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 8 of 21 FACILITY NAME AND PERMIT NUMBER: Foran Approved 1/1499 Pond Creek WWTP, NCO069761 ME Number 2040.0088 BASIC APPLICATION INFORMATION PART C. CERTIFICATION Ali applicants must complete the Certification Section. Refer to Instructions to determine who is an officer for the purposes of this certification. All applicants must complete all applicable sections of Form 2A, as explained in the Application Overview. Indicate below which parts of Form 2A you have completed and are submitting. By signing this certification statement, applicants confirm that they have reviewed Form 2A and have completed all sections that avp� to the facility for which this application is submitted. Indicate which parts of Form 2A you have completed and are submitting: ✓ Basic Application Information packet Supplemental Application Information packet: Part D (Expanded Effluent Testing Data) ✓ Part E (Toxicity Testing: Biomonitoring Data) Part F (Industrial User Discharges and RCRA/CERCLA Wastes) Part G (Combined Sewer Systems) ALL APPLICANTS MUST COMPLETE THE FOLLOWING CERTIFICATION. I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the Information submitted. Based on my Inquiry of the person or persons who manage the system or those persons directly responsible for gathering the information, the Information is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for knowing violations. Name and official title Tim H. Hollomarl, Tow 4,ana, er Signature Telephone number (828) 387-q282 Date signed 6 Upon request of the permitting authority, you must submit any other Information necessary to assess wastewater treatment practices at the treatment works or identify appropriate permitting requirements. SEND COMPLETED FORMS TO: EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 9 of 21 FACILITY NAME AND PERMIT NUMBER: Pond Creek WWTP, NCO069761 Form Approved 1/14189 OMB Number 2040.0086 SUPPLEMENTAL APPLICATION INFORMATION PART E. TOXICITY TESTING DATA POTWs meeting one or more of the following criteria must provide the results of whole effluent toxicity tests for acute or chronic toxicity for each of the facility's discharge points: 1) POTWs with a design flow rate greater than or equal to 1.0 mgd; 2) POTWs with a pretreatment program (or those that are required to have one under 40 GFR Part 403); or 3) POTWs required by the permitting authority to submit data for these parameters. • At a minimum, these results must Include quarterly testing for a 12 -month period within the past 1 year using multiple species (minimum of two species), or the results from four tests performed at least annually in the four and one-half years prior to the application, provided the results show no appreciable toxicity, and testing for acute and/or chronic toxicity, depending on the range of receiving water dilution. Do not include information on combined sewer overflows in this section. All information reported must be based on data collected through analysis conducted using 40 CFR Part 136 methods. In addition, this data must comply with QA/QC requirements of 40 CFR Part 136 and other appropriate QA/QC requirements for standard methods for analytes not addressed by 40 CFR Part 136. • In addition, submit the results of any other whole effluent toxWty tests from the past four and one-half years. If a whole effluent toxicity test conducted during the past four and one-half years revealed toxicity, provide army information on the cause of the toxicity or any results of a toxicity reduction evaluation, if one was conducted. • If you have already submitted any of the information requested in Part E, you need not submit it again. Rather, provide the information requested in question EA for previously submitted information. If EPA methods were not used, report the reasons for using alternate methods. If test summaries are available that contain all of the information requested below, they may be submitted in place of Part E. If no biomonitoring data is required, do not complete Part E. Refer to the Application Overview for directions on which other sections of the form to complete. E.I. Required Tests. Indicate the number of whole effluent toxicity tests conducted in the past four and one-half years. ✓ chronic acute E.2. Individual Test Date. Complete the following chart for each whole effluent toxicity test conducted in the last four and one-half years. Allow one column per test (where each species constitutes a test). Copy this page if more than three tests are being reported. Test number: Test number: Test number: a. Test information. Test species 8 test method number Ceriodaphnia dubia Ceriodaphnia dubia Ceriodaphnia dubie Age at initiation of test < 24 Hours < 24 Hours < 24 Hours Outfall number 001 001 001 Dates sample collected 01/09/2017 10/24/2016 07/11/2016 Date test started 01/11/2017 10/26/2016 07/13/2016 Duration 24 hours 24 hours 24 hours b. Give toxicity test methods followed. Manual title Estimating Chronic Toxicity Estimating Chronic Toxicity Estimating Chronic Toxicity Edition number and year of publication Fourth edition, 2002 Fourth edition, 2002 Fourth edition, 2002 Page number(s) 3-49, 141-189 3-49, 141-189 3-49, 141-189 c. Give the sample collection method(s) used. For multiple grab samples, indicate the number of grab samples used. 24 -Hour composite Yes Yes Yes Grab d. Indicate where the sample was taken in relation to disinfection. (Check all that apply for each) Before disinfection After disinfection Yes Yes Yes After dechlorination EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550.22. Page 15 of 21 FACILITY NAME AND PERMIT NUMBER: Pond Creek WWTP, NCO069761 Form Approved 1/14189 OMB Number 20440086 Test number. Test number. Test number: e. Describe the point in the treatment process at which the sample was collected. Sample was collected: I Effluent Effluent f. For each test, include whether the test was intended to assess chronic toxicity, acute toxicity, or both. I Chronic toxicity Yes Yes Yes Acute toxicity Yes Yes Yes g. Provide the type of test performed. Static Laboratory water Statio-renewal Yes Yes Yes Flow-through I. Type of dilution water. It salt water, specify 'natural' or type of artificial sea salts or brine used. Fresh water Yes h. Source of dilution water. If laboratory water, specify type; if receiving water, specify source. Laboratory water Receiving water I. Type of dilution water. It salt water, specify 'natural' or type of artificial sea salts or brine used. Fresh water Yes Yes Yes SaR water J. Give the percentage effluent used for all concentrations in the test series. 51% 51% 51% k. Parameters measured during the test. (State whether parameter meets test method specifications) pH 7.04 7.09 7.01 Salinity Temperature 3.1 2.4 1.90 Ammonia Dissolved oxygen 8.6 8.3 8.2 I. Test Results. Acute: Percent survival In 100% effluent oda LCoo 95% C.I. % % % Control percent survival % % % Other (describe) EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 16 of 21 FACILITY NAME AND PERMIT NUMBER: Form Approved 1/14/99 Pond Creek WWTP, NCO069761 OMS Number 2040-0066 SUPPLEMENTAL APPLICATION INFORMATION PART E. TOXICITY TESTING DATA POTWs meeting one or more of the following criteria must provide the results of whole effluent toxicity tests for acute or chronic toxicity for each of the facility's discharge points: 1) POTWs with a design flow rate greater than or equal to 1.0 mgd; 2) POTWs with a pretreatment program (or those that are required to have one under 40 CFR Part 403); or 3) POTWs required by the permitting authority to submit data for these parameters. • At a minimum, these results must Include quarterly testing for a 12-month period within the past 1 year using multiple species (minimum of two species), or the results from four tests performed at least annually in the four and one-half years prior to the application, provided the results show no appreciable toxicity, and testing for acute and/or chronic toxicity, depending on the range of receiving water dilution. Do not include Information on combined sewer overflows in this section. All information reported must be based on data collected through analysis conducted using 40 CFR Part 136 methods. In addition, this data must comply with QAJQC requirements of 40 CFR Part 136 and other appropriate QA/QC requirements for standard methods for analytes not addressed by 40 CFR Part 136. • In addition, submit the results of any other whole effluent toxicity tests from the past four and one-half years. If a whole effluent toxicity test conducted during the past four and one-half years revealed toxicity, provide any information on the cause of the toxicity or any results of a toxicity reduction evaluation, if one was conducted. • If you have already submitted any of the information requested in Part E, you need not submit it again. Rather, provide the information requested in question EA for previously submitted information. If EPA methods were not used, report the reasons for using alternate methods. If test summaries are available that contain all of the information requested below, they may be submitted In place of Part E. If no biomonitoring data is required, do not complete Part E. Refer to the Application Overview for directions on which other sections of the form to complete. EA. Required Tests. Indicate the number of whole effluent toxicity tests conducted in the past four and one-half years. ✓ chronic acute E.2. Individual Test Data. Complete the following chart for each whole effluent toxicity test conducted in the last four and one-half years. Allow one column per test (where each species constitutes a test). Copy this page If more than three tests are being reported. Test number: Test number: Test number: a. Test information. Test species & test method number Ceriodaphnia dubia Ceriodaphnia dubia Ceriodaphnia dubia Age at initiation of test < 24 Hours < 24 Hours < 24 Hours Outfall number 001 001 001 Dates sample collected 04/18/2016 01/11/2016 10/12/2015 Date test started 04/20/2016 01/13/2016 10/14/2015 Duration 24 hours 24 hours 24 hours b. Give toxicity test methods followed. Manual title Estimating Chronic Toxicity Estimating Chronic Toxicity Estimating Chronic Toxicity Edition number and year of publication Fourth edition, 2002 Fourth edition, 2002 Fourth edition, 2002 Page number(s) 3-49, 141-189 3-49, 141-189 3-49, 141-189 c. Give the sample collection method(s) used. For multiple grab samples, indicate the number of grab samples used. 24-Hour composite Yes Yes Yes Grab d. Indicate where the sample was taken in relation to disinfection. (Check all that apply for each) Before disinfection After disinfection Yes Yes Yes After dechlorination EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 15 of 21 FACILITY NAME AND PERMIT NUMBER: Form Appmved 114/99 Pond Creek WWTP, NCO069761 oMBNumber 2040.0086 Test number. Test number. Test number: I e. Describe the point in the treatment process at which the sample was collected. Sample was collected: I Effluent I Effluent Effluent f. For each test, include whether the test was Intended to assess chronic toxicity, acute toxicity, or both. Chronic toxicity Yes Yes Yes Acute toxicity Static -renewal Yes Yes g. Provide the type of test performed. Static Static -renewal Yes Yes Yes Flow-through h. Source of dilution water. If laboratory water, specify type; If receiving water, specify source. Laboratory water Receiving water 1. Type of dilution water. It salt water, specify "natural" or type of artificial sea salts or brine used. Fresh water Yes Yes Yes Salt water j. Give the percentage effluent used for all concentrations in the test series. --"51% 51% 51% k. Parameters measured during the test. (State whether parameter meets test method specifications) pH 6.00 6.74 6.65 Salinity Temperature 1.9 2.1 3.1 Ammonia Dissolved oxygen 8.3 8.3 8.3 I. Test Results. Acute: Percent survival in 100% effluent % % % LC5o 95% C.I. % % % Control percent survival % % % Other (describe) EPA Form 3510-2A (Rev. 1-99), Replaces EPA forms 7550-6 & 7550-22. Page 16 of 21 FACILITY NAME AND PERMIT NUMBER: Form Approved 1114r89 Pond Creek WWTP, NC0069781 OMB Number 2040.0086 SUPPLEMENTAL APPLICATION INFORMATION PART E. TOXICITY TESTING DATA POTWs meeting one or more of the following criteria must provide the results of whole effluent toxicity tests for acute or chronic toxicity for each of the facility's discharge points: 1) POTWs with a design flow rate greater than or equal to 1.0 mgd; 2) POTWs with a pretreatment program (or those that are required to have one under 40 CFR Part 403); or 3) POTWs required by the permitting authority to submit data for these parameters. • At a minimum, these results must include quarterly testing for a 12-month period within the past 1 year using multiple species (minimum of two spades), or the results from four tests performed at least annually in the four and one-half years prior to the application, provided the results show no appreciable toxicity, and testing for acute and/or chronic toxicity, depending on the range of receiving water dilution. Do not include information on combined sewer overflows in this section. All information reported must be based on data collected through analysis conducted using 40 CFR Part 136 methods. In addition, this data must comply with QA/QC requirements of 40 CFR Part 136 and other appropriate QA/QC requirements for standard methods for analytes not addressed by 40 CFR Part 136. • In addition, submit the results of any other whole effluent toxicity tests from the past four and one-half years. If a whole effluent toxicity test conducted during the past four and one-haft years revealed toxicity, provide any information on the cause of the toxicity or any results of a toxicity reduction evaluation, if one was conducted. • If you have already submitted any of the information requested in Part E, you need not submit it again. Rather, provide the information requested in question EA for previously submitted information. If EPA methods were not used, report the reasons for using alternate methods. If test summaries are available that contain all of the information requested below, they may be submitted in place of Part E. If no biomonitoring data is required, do not complete Part E. Refer to the Application Overview for directions on which other sections of the forth to complete. E.I. Required Tests. Indicate the number of whole effluent toxicity tests conducted in the past four and one-half years. ✓ chronic acute E.2. Individual Test Data. Complete the following chart for each whole effluent toxicity test conducted in the last four and one-half years. Allow one column per test (where each species constitutes a test). Copy this page if more than three tests are being reported. Test number. Test number: Test number: a. Test information. Test species & test method number Ceriodaphnia dubia Ceriodaphnia dubia Ceriodaphnia dubfa Age at initiation of test < 24 Hours < 24 Hours < 24 Hours Outfall number 001 001 001 Dates sample collected 07/13/2015 04/13/2015 01/12/2015 Date test started 07/15/2015 04/15/2015 01/14/2015 Duration 24 hours 24 hours 24 hours b. Give toxicity test methods followed. Manual title Estimating Chronic Toxicity Estimating Chronic Toxicity Estimating Chronic Toxicity Edition number and year of publication Fourth edition, 2002 Fourth edition, 2002 Fourth edition, 2002 Page number(s) 3-49, 141-189 3-49, 141-189 3-49, 141-189 c. Give the sample collection method(s) used. For multiple grab samples, Indicate the number of grab samples used. 24-Hour composite Yes Yes Yes Grab d. Indicate where the sample was taken in relation to disinfection. (Check all that apply for each) Before disinfection After disinfection Yes Yes Yes After dechlorination EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 15 of 21 FACILITY NAME AND PERMIT NUMBER: Pond Creek WWTP, NCO069761 Form Approved 1/14/99 OMB Number 20440086 G Test number. Test number. Test number: e. Describe the point in the treatment process at which the sample was collected. Sample was collected: I Effluent Effluent Effluent I f. For each test, include whether the test was intended to assess chronic toxicity, acute toxicity, or both. I Chronic toxicity Yes r Yes Yes Acute toxicity Static -renewal Yes Yes g. Provide the type of test performed. Static Static -renewal Yes Yes Yes Flow-through h. Source of dilution water. If laboratory water, specify type; if receiving water, specify source. Laboratory water Receiving water I. Type of dilution water. It salt water, specify "natural" or type of artificial sea salts or brine used. Fresh water Yes Yes Yes Salt water j. Give the percentage effluent used for all concentrations in the test series. -51% 51% 51% k. Parameters measured during the test. (State whether parameter meets test method specifications) pH 7.07 7.21 6.65 Salinity Temperature 2.3 1.9 3.5 Ammonia Dissolved oxygen 8.4 8.3 8.3 1. Test Results. Acute: Percent survival in 100% effluent % % % LC5o 95% C. I. % % % Control percent survival % % % Other (describe) EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 16 of 21 FACILITY NAME AND PERMIT NUMBER: Form Approved 1/14/99 Pond Creek WWTP, NCO069761 OMS Number 20440086 SUPPLEMENTAL APPLICATION INFORMATION PART E. TOXICITY TESTING DATA POTM meeting one or more of the following criteria must provide the results of whole effluent toxicity tests for acute or chronic toxicity for each of the facility's discharge points: 1) POTWs with a design flow rate greater than or equal to 1.0 mgd; 2) POTWs with a pretreatment program (or those that are required to have one under 40 CFR Part 403); or 3) POTWs required by the permitting authority to submit data for these parameters. • At a minimum, these results must include quarterly testing for a 12-month period within the past 1 year using multiple species (minimum of two species), or the results from four tests performed at least annually in the four and one-half years prior to the application, provided the results show no appreciable toxicity, and testing far acute and/or chronic toxicity, depending on the range of receiving water dilution. Do not include information on combined sewer overflows in this section. All information reported must be based on data collected through analysis conducted using 40 CFR Part 136 methods. In addition, this data must comply with QA/QC requirements of 40 CFR Part 136 and other appropriate QA/QC requirements for standard methods for analytes not addressed by 40 CFR Part 136. • In addition, submit the results of any other whole effluent toxicity tests from the past four and one-half years. If a whole effluent toxicity test conducted during the past four and one-half years revealed toxicity, provide any information on the cause of the toxicity or any results of a toxicity reduction evaluation, if one was conducted. • If you have already submitted any of the information requested In Part E, you need not submit it again. Rather, provide the Infornation requested In question EA for previously submitted Information. If EPA methods were not used, report the reasons for using altemate methods. If test summaries are available that contain all of the Information requested below, they may be submitted In place of Part E. If no bfomonitoring data Is required, do not complete Part E. Refer m the Application Overview for directions on which other sections of the form to complete. E.I. Required Teats. Indicate the number of whole effluent toxicity tests conducted in the past four and one-half years. ✓ chronic acute E.2. Individual Test Date. Complete the following chart for each whole effluent toxicity test conducted in the last four and one-half years. Allow one column per test (where each species constitutes a test). Copy this page if more than three tests are being reported. Test number: Test number: Test number: a. Test information. Test species & test method number Ceriodaphnia dubia Ceriodaphnia dubia Ceriodaphnia dubia Age at initiation of test < 24 Hours < 24 Hours < 24 Hours Outfall number 001 001 001 Dates sample collected 10/06/2014 07/14/2014 04/07/2014 Date test started 10/08/2014 07/16/2014 04/09/2014 Duration 24 hours 24 hours 24 hours b. Give toxicity test methods followed, Manual title Estimating Chronic Toxicity Estimating Chronic Toxicity Estimating Chronic Toxicity Edition number and year of publication Fourth edition, 2002 Fourth edition, 2002 Fourth edition, 2002 Page number(s) 3-49, 141-189 3-49, 141-189 3-49, 141-189 c. Give the sample collection method(s) used. For multiple grab samples, Indicate the number of grab samples used. 24-Hour composite Yes Yes Yes Grab d. Indicate where the sample was taken In relation to disinfection. (Check all that apply for each) Before disinfection After disinfection Yes Yes Yes After dechlorination EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 15 of 21 FACILITY NAME AND PERMIT NUMBER:I OMS Number 2040-0088 Form Approved 1114199 Pond Creek WWTP, NC0069761 I Test number. Test number. Test number: f e. Describe the point in the treatment process at which the sample was collected. Sample was collected: I Effluent Effluent Effluent f. For each test, include whether the test was intended to assess chronic toxicity, acute toxicity, or both. Chronic toxicity Yes Yes Yes Acute toxicity Yes Yes Yes g. Provide the type of test performed. Static Laboratory water Static -renewal Yes Yes Yes Flow-through 1. Type of dilution water. It salt water, specify "natural" or type of artificial sea salts or brine used. Fresh water Yes h. Source of dilution water. If laboratory water, specify type; if receiving water, specify source. Laboratory water Receiving water 1. Type of dilution water. It salt water, specify "natural" or type of artificial sea salts or brine used. Fresh water Yes Yes Yes Salt water J. Give the percentage effluent used for all concentrations in the test series. 51% 51% 51% k. Parameters measured during the test. (State whether parameter meets test method specifications) pH 7.10 6.83 7.05 Salinity Temperature 2.6 3.1 3.6 Ammonia Dissolved oxygen 8.1 8.2 8.2 1. Test Results. Acute: Percent survival in 100% effluent % % % LC50 95% C.I. % % % Control percent survival % % % Other (describe) EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-e $ 7550-22, Page 1e of 21 FACILITY NAME AND PERMIT NUMBER: Form Approved 1/14169 OMB Number 2040-0086 Pond Creek WWTP, NCO069761 SUPPLEMENTAL APPLICATION INFORMATION PART E. TOXICITY TESTING DATA POTWs meeting one or more of the following criteria must provide the results of whole effluent toxicity tests for acute or chronic toxicity for each of the facility's discharge points: 1) POTWs with a design flow rate greater than or equal to 1.0 mgd; 2) POTWs with a pretreatment program (or those that are required to have one under 40 CFR Part 403); or 3) POTWs required by the permitting authority to submit date for these parameters. • At a minimum, these results must include quarterly testing for a 12 -month period within the past 1 year using multiple species (minimum of two species), or the results from four tests performed at least annually in the four and one-half years prior to the application, provided the results show no appreciable toxicity, and testing for acute and/or chronic toxicity, depending on the range of receiving water dilution. Do not include information on combined sewer overflows in this section. All information reported must be based on data collected through analysis conducted using 40 CFR Part 136 methods. In addition, this data must comply with QA/QC requirements of 40 CFR Part 138 and other appropriate QA/QC requirements for standard methods for analytes not addressed by 40 CFR Part 136. • In addition, submit the results of any other whole effluent toxicity tests from the past fair and one-half years. If a whole effluent toxicity test conducted during the past four and one-half years revealed toxicity, provide any information on the cause of the toxicity or any results of a toxicity reduction evaluation, if one was conducted. • If you have already submitted any of the information requested in Part E, you need not submit it again. Rather, provide the information requested in question EA for previously submitted Information. If EPA methods were not used, report the reasons for using altemate methods. If test summaries are available that contain all of the information requested below, they may be submitted in place of Part E. if no biomonitoring data is required, do not complete Part E. Refer to the Application Overview for directions on which other sections of the form to com lete. E.I. Required Tests. Indicate the number of whole effluent toxicity tests conducted In the past four and one-half years. ✓ chronic acute E.2. Individual Test Data. Complete the following chart for each whole effluent toxicity test conducted in the last four and one-half years. Allow one column per test (where each species constitutes a test). Copy this page if more than three tests are being reported. Test number: Test number. Test number: a. Test information. Test species & test method number Ceriodaphnia dubia Ceriodaphnia dubia Ceriodaphnia dubia Age at initiation of test < 24 Hours < 24 Hours < 24 Hours Outfall number 001 001 001 Dates sample collected 01/13/2014 10/14/2013 07/15/2013 Date test started 01/15/2014 10/16/2013 07/17/2013 Duration 24 hours 24 hours 24 hours b. Give toxicity test methods followed. Manual title Estimating Chronic Toxicity Estimating Chronic Toxicity Estimating Chronic Toxicity Edition number and year of publication Fourth edition, 2002 Fourth edition, 2002 Fourth edition, 2002 Page number(s) 3-49, 141-189 3-49, 141-189 3-49, 141-189 c. Give the sample collection method(s) used. For multiple grab samples, indicate the number of grab samples used. 24 -Hour composite Yes Yes Yes Grab d. Indicate where the sample was taken in relation to disinfection. (Check all that apply for each) Before disinfection After disinfection Yes Yes Yes After dechlorination EPA Fonn 3510-2A (Rev. 1.89). Replaces EPA forms 7550-8 & 7550-22. Page 15 of 21 FACILITY NAME AND PERMIT NUMBER:I OhM Number 2040-0086 Form Approved 1/14189 Pond Creek WWTP, NC0069761 Test number; Test number. Test number: f e. Describe the point in the treatment process at which the sample was collected. Sample was collected: I Effluent I Effluent Effluent f. For each test, include whether the test was intended to assess chronic toxicity, acute toxicity, or both. Chronic toxicity Yes Yes Yes Acute toxicity Yes Yes Yes g. Provide the type of test performed. Static Laboratory water Static -renewal Yes Yes Yes Flow-through i. Type of dilution water. It salt water, specify *natural" ar type of artlfciai sea salts or bFine used Fresh water Yes h. Source of dilution water. If laboratory water, specify type; if receiving water, specify source. Laboratory water Receiving water i. Type of dilution water. It salt water, specify *natural" ar type of artlfciai sea salts or bFine used Fresh water Yes Yes Yes Salt water j. Give the percentage effluent used for all concentrations In the test series. _ 51% 51% 51% k. Parameters measured during the test. (State whether parameter meets test method specifications) pH 6.90 6.96 7.38 Salinity Temperature 4.0 24.8 25.1 Ammonia Dissolved oxygen 8.2 '8.0 8.0 I. Test Results. Acute: Percent survival in 100% effluent % % % LC6o 950/0 C.I. % % % Control percent survival % % % Other (describe) EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 16 of 21 FACILITY NAME AND PERMIT NUMBER: FonnApproved 1/14199 Pond Creek WWTP, NCO069761 OMB Number 2040-MO SUPPLEMENTAL APPLICATION INFORMATION PART E. TOXICITY TESTING DATA POTWs meeting one or more of the following criteria must provide the results of whole effluent toxicity tests for acute or chronic toxicity for each of the facility's discharge points: 1) POTWs with a design flow rate greater than or equal to 1.0 mgd; 2) POTWs with a pretreatment program (or those that are required to have one under 40 CFR Part 403); or 3) POTWs required by the permitting authority to submit data for these parameters. • At a minimum, these results must include quarterly testing for a 12-month period within the past 1 year using multiple species (minimum of two species), or the results from four tests performed at least annually in the four and one-half years prior to the application, provided the results show no appreciable toxicity, and testing for acute and/or chronic toxicity, depending on the range of receiving water dilution. Do not Include information on combined sewer overflows in this section. All information reported must be based on data collected through analysis conducted using 40 CFR Part 136 methods. In addition, this data must comply with QA/QC requirements of 40 CFR Part 136 and other appropriate QA/QC requirements for standard methods for analytes not addressed by 40 CFR Part 136. • In addition, submit the results of any other whole effluent toxicity tests from the past four and one-half years. If a whole effluent toxicity test conducted during the past four and one-half years revealed toxicity, provide any information on the cause of the toxicity or any results of a toxicity reduction evaluation, if one was conducted. • If you have already submitted any of the information requested in Part E, you need not submit it again. Rather, provide the information requested in question EA for previously submitted Information. If EPA methods were not used, report the reasons for using aflemate methods. If test summaries are available that contain all of the information requested below, they may be submitted in place of Part E. If no biomonitoring data is required, do not complete Part E. Refer to the Application Overview for directions on which other sections of the form to complete. E.I. Required Tests. Indicate the number of whole effluent toxicity tests conducted in the past four and one-half years. ✓ chronic _acute E.2. Individual Test Data. Complete the following chart for each whole effluent toxicity test conducted in the last four and one-half years. Allow one column per test (where each species constitutes a test). Copy this page if more than three tests are being reported. Test number. Test number: Test number: a. Test information. Test species & test method number Ceriodaphnia dubia Ceriodaphnia dubia Ceriodaphnia dubia Age at initiation of test < 24 Hours < 24 Hours < 24 Hours Outfall number 001 001 001 Dates sample collected 04/01/2013 01/14/2013 10/08/2012 Date test started 04/03/2013 01/16/2013 10/12/2012 Duration 24 hours 24 hours 24 hours b. Give toxicity test methods followed. Manual title Estimating Chronic Toxicity Estimating Chronic Toxicity Estimating Chronic Toxicity Edition number and year of publication Fourth edition, 2002 Fourth edition, 2002 Fourth edition, 2002 Page number(s) 3-49, 141-189 3-49, 141-189 3-49, 141-189 c. Give the sample collection method(s) used. For multiple grab samples, indicate the number of grab samples used. 24-Hour composite Yes Yes Yes Grab d. Indicate where the sample was taken in relation to disinfection. (Check all that apply for each) Before disinfection After disinfection Yes Yes Yes After dechlorination EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 16 of 21 FACILITY NAME AND PERMIT NUMBER:I Form Approved 1/14199 Pond Creek WWTP, NCO069761 OMS Number 2040-0086 Test number Test number. Test number: e. Describe the point in the treatment process at which the sample was collected. Sample was collected: I Effluent I Effluent Effluent f. For each test, include whether the test was Intended to assess chronic toxicity, acute toxicity, or both. Chronic toxicity Yes Yes Yes Acute toxicity Static -renewal Yes Yes g. Provide the type of test performed. Static Static -renewal Yes Yes Yes Flow-through h. Source of dilution water. If laboratory water, specify type; If receiving water, specify source. Laboratory water Receiving water I. Type of dilution water. It salt water, specify "natural" or type of artificial sea salts or brine used. Fresh water Yes Yes Yes Salt water j. Give the percentage effluent used for all concentrations In the test series. 51% 51% 51% k. Parameters measured during the test. (State whether parameter meets test method specifications) pH 7.46 7.20 7.20 Salinity Temperature 25.2 24.8 24.9 Ammonia Dissolved oxygen 8.1 8.0 7.8 t. Test Results. Acute: Percent survival in 100% effluent % % % LCm 95% C.I. % % % Control percent survival % % % Other (describe) EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 16 of 21 FACILITY NAME AND PERMIT NUMBER: Forth Approved 1/14199 Pond Creek WWTP, NC0069761 OMB Number 2040.0086 Chronic: NOEC % % % IC25 % % % Control percent survival % % % Other (describe) m. Quality Control/Quality Assurance. Is reference toxicant data available? Was reference toxicant test within acceptable bounds? What date was reference toxicant test run (MM/DP=? Other (describe) E.3. Toxicity Reduction Evaluation. Is the treatment works involved in a Toxicity Reduction Evaluation? _Yes_No If yes, describe: EA. Summary of Submitted Blomonitoring Test Information. If you have submitted biomonitoring test information, or information regarding the cause of toxicity, within the past four and one-half years, provide the dates the information was submitted to the permitting authority and a summary of the results. Date submitted: (MM/DD/YYYY) Summary of results: (see Instructions) END OF PART E. REFER TO THE APPLICATION OVERVIEW TO DETERMINE WHICH OTHER PARTS OF FORM 2A YOU MUST COMPLETE. EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 17 of 21 sown or Deem muun Lam Pond Creek WWTP State Grid/Quad: C11NE Receiving Stream= Pond Creep Latitude: 36° 12'49" N Stream Class C -Tr oat Longitude_ 31° 52'30" W 8 -Di it HUC: 06010103 Drainage Basin: Watauga River Basin Sub -Basin: 04-02-01 Outfall 001 f, VAJI � — a �wl 0 1,