NC0021491_Renewal Application_20190102

I
ROY COOPER NORTH CAROLINA
Governor Enybi tmental Qual"
IMICHAEL S- REGAN
Secretcn-
LINDA CULPEPPER
Interim Director
January 02, 2019
Matt Settlemyer, Town Manager
Town of Mocksville
171 Clement St
Mocksville, NC 27028
Subject: Permit Renewal
Application No. NCO021491
Dutchman Creek WWTP
Davie County
Dear Applicant:
The Water Quality Permitting Section acknowledges the January 2, 2019 receipt of your permit renewal application and
supporting documentation. Your application will be assigned to a permit writer within the Section's NPDES WW permitting
branch. Per G.S. 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. The
permit writer will contact you if additional information is required to complete your permit renewal. Please respond in a
timely manner to requests for additional information necessary to allow a complete review of the application and renewal
of the permit.
Information regarding the status of your renewal application can be found online using the Department of Environmental
Quality's Environmental Application Tracker at:
https•//deq nc gov/permits-regulations/permit-guidance/environmental-application-tracker
If you have any additional questions about the permit, please contact the primary reviewer of the application using the
links available within the Application Tracker.
Sincerely,
...%,
Wren Thedford
Administrative Assistant
Water Quality Permitting Section
ec: WQPS Laserfiche File w/application
North Carolina Department of Environmental Quality I Division of Water Resources
1617 Mail Service Center I Raleigh, North Carolina 27699-1617
919-807-6300

12-21-2018
Wren Thedford
NC DENR / DWR / NPDES Unit
1617 Mail Service Center
Raleigh, NC 27699-1617
Subject: NPDES Permit Renewal Application
Permit Number: NCO021491
Dutchman Creek WWTP
Davie County
Mr. Thedford,
RECEIVED/DENR/DWR
JAN 02 2018
Water Resources
Permitting Section
The NPDES permit for the Dutchman Creek wastewater treatment facility, located at 295
Garwood Road in Mocksville, North Carolina, is nearing its expiration on June 30, 2019. Thus,
it is our desire to renew this permit by means of this NPDES permit renewal application package.
This facility, described in Form 2A of this package, has not had any significant upgrades or
changes since the renewal of the current permit.
You will find subsequent to this cover letter an NPDES Form 2A, a topographic map of the
facility, engineering drawings, and a description of the sludge management program currently in
place at this facility. It is our request that this package be processed and our permit to discharge
treated wastewater be renewed following the expiration of the current permit on June 30, 2019.
Thank you for your time.
Sincerely,
Matt Settlemyer
Town Manager
Cc: Michael Myers, Envirolink Inc.
David Strum, Envirolink Inc.
Chris Bitterman, Envirolink Inc.

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
Dutchman Creek WWTP, NCO021491 Renew Yadkin Pee Dee
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 13.1 through 6.6.
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)
JAN 0 2 2018
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Water Resources Page 1 of 39
Permitting Section

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
Dutchman Creek WWTP, NCO021491
Renew
Yadkin Pee Dee
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.1. Facility Information.
Facility Name Dutchman's Creek WWTP
Mailing Address 171 Clement Street
Mocksville NC 27028
Contact Person Chris Bitterman
Title Area Manager
Telephone Number [phone]
Facility Address 295 Garwood Road
(not P.O. Box) Mocksville NC 27028
A.2. Applicant Information. If the applicant is different from the above, provide the following:
Applicant Name Town of Mocksville
Mailing Address 171 Clement Street
Mocksville NC 27028
Contact Person Matt Settlemver
Title Town Manager
Telephone Number [phone]
Is the applicant the owner or operator (or both) of the treatment works?
❑ owner ® operator
Indicate whether correspondence regarding this permit should be directed to the facility or the applicant.
❑ 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 NCO021491 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
Town of Mocksville 5,104 Separate Town of Mocksville
Total population served 5.104
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 2 of 39

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
Dutchman Creek WWTP, NCO021491 Renew I Yadkin Pee Dee
A.5. Indian Country.
a. Is the treatment works located in Indian Country?
❑ Yes ® 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.6. 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 12t" month of "this year" occurring no more than three months prior to this application submittal.
a. Design flow rate 0.98 mgd
Two Years Ago Last Year This Year
b. Annual average daily flow rate .45178 .470488 0.436612
C. Maximum daily flow rate 2.2641 2.294 2.403
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 100 %
❑ Combined storm and sanitary sewer %
A.8. Discharges and Other Disposal Methods.
a. Does the treatment works discharge effluent to waters of the U.S.? ® Yes ❑ No
If yes, list how many of each of the following types of discharge points the treatment works uses:
i. Discharges of treated effluent
J. Discharges of untreated or partially treated effluent
iii. Combined sewer overflow points
iv. Constructed emergency overflows (prior to the headworks)
V. Other
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
If yes, provide the following for each surface impoundment:
Location:
Annual average daily volume discharge to surface impoundment(s)
Is discharge ® continuous or ❑ intermittent?
C. Does the treatment works land -apply treated wastewater?
If yes, provide the following for each land application site:
d.
Location:
Number of acres:
Annual average daily volume applied to site:
Is land application ❑ continuous or ❑ intermittent?
Does the treatment works discharge or transport treated or untreated wastewater to another
treatment works?
1
® No
mgd
❑ Yes ® No
mgd
❑ Yes ® No
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 3 of 39

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
Dutchman Creek WWTP, NCO021491
Renew
Yadkin Pee Dee
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 than 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 ( 1
If known, provide the NPDES 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. 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 site(s) if applicable):
Annual daily volume disposed by this method:
Is disposal through this method ❑ continuous or ❑ intermittent?
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 4 of 39

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
Dutchman Creek WWTP, NCO021491 Renew Yadkin Pee Dee
WASTEWATER DISCHARGES:
If you answered "Yes" to question A.8.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.8.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 001
b. Location Mocksville, NC 27028
(City or town, if applicable) (Zip Code)
(County)
35' 53' 33"
(State)
80' 30' 07"
(Latitude)
(Longitude)
C. Distance from shore (if applicable)
ft.
d. Depth below surface (if applicable)
ft.
e. Average daily flow rate .45296
mgd
f. Does this outfall have either an intermittent or a periodic discharge? ❑ Yes
® No (go to A.9.g.)
If yes, provide the following information:
Number f times per year discharge occurs:
Average duration of each discharge:
Average flow per discharge:
mgd
Months in which discharge occurs:
g. Is outfall equipped with a diffuser? ❑ Yes
® No
A.10. Description of Receiving Waters.
a. Name of receiving water Dutchman Creek
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):
United States Geological Survey 8-digit hydrologic cataloging unit code (if known):
d. Critical low flow of receiving stream (if applicable)
acute cfs chronic cfs
e. Total hardness of receiving stream at critical low flow (if applicable): mg/I of CaCO3
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 5 of 39

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
Dutchman Creek WWTP, NCO021491
Renew
Yadkin Pee Dee
A.11. Description of Treatment
a. What level of treatment are provided? Check all that apply.
❑ Primary ❑ Secondary
❑ Advanced ❑ Other. Describe:
b. Indicate the following removal rates (as applicable):
Design BOD5 removal or Design CBOD5 removal 98 %
Design SS removal 88 %
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:
Chlorine gas
If disinfection is by chlorination is dechlorination used for this outfall? ® Yes ❑ No
Does the treatment plant have post aeration? ® 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 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. 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
MAXIMUM DAILY VALUE
AVERAGE DAILY VALUE
PARAMETER
Value
Units
Value
Units
Number of Samples
pH (Minimum)
6.00
s.u.
pH (Maximum)
7.99
S.U.
Flow Rate
2.403
MGD
0.45296
MGD
Continuous
Temperature (Winter)
20.2
-C
11.59
° C
5/week
Temperature (Summer)
26.7
° C
20.45
° CI
5/week
' For pH please report a minimum and a maximum daily value
MAXIMUM DAILY
AVERAGE DAILY DISCHARGE
DISCHARGE
ANALYTICAL
POLLUTANT
METHOD
ML/MDL
Conc.
Units
Conc.
Units
Number of
Samples
CONVENTIONAL AND NON CONVENTIONAL COMPOUNDS
BIOCHEMICAL OXYGEN
BODS
64
m /L
4.443
m /L
3/week
DEMAND (Report one)
CBOD5
FECAL COLIFORM
6000
100 mL
6.871
100 mL
3/week
TOTAL SUSPENDED SOLIDS (TSS)
1 128 1
m /L
5.708
m /L
3/week
END OF PART A.
REFER TO THE APPLICATION OVERVIEW (PAGE 1) TO DETERMINE WHICH OTHER PARTS
OF FORM 2A YOU MUST COMPLETE
EPA Form 3510-2A (Rev. 1-99), Replaces EPA forms 7550-6 8 7550-22. Page 6 of 39

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
Dutchman Creek WWTP, NCO021491
Renew
Yadkin Pee Dee
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 2 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.
40,000 gpd
Briefly explain any steps underway or planned to minimize inflow and infiltration.
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/< 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 the hazardous waste enters the treatment works and where it is treated, stored, and/or disposed.
B.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 redunancy 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. Operation/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: Envirolink Inc.
Mailing Address: 4700 Homewood Ct, Suite 108
Raleigh, NC 27609
Telephone Number: [phone]
Responsibilities of Contractor: Provide ORC and cover daily operations and basic maintenance of WWTP.
B.5. 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.
001
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 39

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
Dutchman Creek WWTP, NCO021491
Renew
Yadkin Pee Dee
C. If the answer to B.5.b is "Yes," briefly describe, including new maximum daily inflow rate (if applicable).
Plans have been made to add new headworks and screening, new clarifiers and a new digester/thickener.
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/DD/YYYY
Begin Construction 3/1/2019
End Construction
Begin Discharge
Attain Operational Level
e. Have appropriate permits/clearances concerning other Federal/State requirements been obtained? ® Yes ❑ No
Describe briefly: All improvements have been approved by appropriate -governing agencies
B.6. 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 effluent is discharged. Do not include information
on combine 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. At a minimum effluent testing data must be
based on at least three pollutant scans and must be no more than four and on -half years old.
Outfall Number: 001
MAXIMUM DAILY
AVERAGE DAILY DISCHARGE
DISCHARGE
ANALYTICAL
ML/MDL
Number of
POLLUTANT
METHOD
Conc.
Units
Con,.
Units
Samples
CONVENTIONAL AND NON CONVENTIONAL COMPOUNDS
AMMONIA (as N)
11.12
mg/L
0.363
mg/L
3/week
CHLORINE (TOTAL
44
pg/L
14.387
pg/L
2/week
RESIDUAL, TRC)
DISSOLVED OXYGEN
14.94
mg/L
8.142
mg/L
3/week
TOTAL NITROGEN
42.29
mg/L
20.833
mg/L
1/quarter
NITRATE PLUS NITRITE
NITROGEN
OIL and GREASE
PHOSPHORUS (Total)
15
mg/L
6.985
mg/L
1/quarter
TOTAL DISSOLVED SOLIDS
(TDS)
OTHER
END OF PART B.
REFER TO THE APPLICATION OVERVIEW (PAGE 1) 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 39

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
Dutchman Creek WWTP, NCO021491
Renew
Yadkin Pee Dee
BASIC APPLICATION INFORMATION
PART C. CERTIFICATION
All 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 apply 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 Matt Settlem er Town Manager
Signature _
o �
Telephone number [phone]
Date signed 12-28-2018
Upon request of the permitting authority, you must submit any other information necessary to assure wastewater treatment practices at the treatment
works or identify appropriate permitting requirements.
SEND COMPLETED FORMS TO:
NCDENR/ DWQ
Attn: NPDES Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 9 of 39

FACILITY NAME AND PERMIT NUMBER:
Dutchman Creek WWTP, NCO021491
PERMIT ACTION REQUESTED:
Renew
RIVER BASIN:
Yadkin Pee Dee
SUPPLEMENTAL APPLICATION INFORMATION
PART D. EXPANDED EFFLUENT TESTING DATA
Refer to the directions on the cover page to determine whether this section applies to the treatment works.
Effluent Testing: 1.0 mgd and Pretreatment Works. If the treatment works has a design flow greater than or equal to 1.0 mgd or it has (or is required
to have) a pretreatment program, or is otherwise required by the permitting authority to provide the data, then provide effluent testing data for the following
pollutants. Provide the indicated effluent testing information and any other information 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 data collected
through analyses conducted using 40 CFR Part 136 methods. In addition, these 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. Indicate in the blank rows provided below
any data you may have on pollutants not specifically listed in this form. At a minimum, effluent testing data must be based on at least three pollutant
scans and must be no more than four and one-half years old.
Outfall number: 001 (Complete once for each outfall discharging effluent to waters of the United States.)
POLLUTANT
MAXIMUM DAILY DISCHARGE
AVERAGE DAILY DISCHARGE
ANALYTICAL
METHOD
ML/MDL
Conc.
Units
Mass
Units
Conc.
Units
Mass
Units
Number
of
Samples
METALS (TOTAL RECOVERABLE), CYANIDE, PHENOLS, AND HARDNESS.
ANTIMONY
<3
pg/L
1
ARSENIC
<5
pg/L
1
BERYLLIUM
<1
pg/L
1
CADMIUM
<1
pg/L
1
CHROMIUM
<5
pg/L
1
COPPER
13
pg/L
1
LEAD
<5
Ng/L
1
MERCURY
<1
pg/L
1
NICKEL
<10
pg/L
1
SELENIUM
<10
pg/L
1
SILVER
<5
pg/L
1
THALLIUM
<1
pg/L
1
ZINC
50
Ng/L
1
CYANIDE
<5
pg/L
1
TOTAL PHENOLIC
COMPOUNDS
<5
pg/L
1
__F
(as CaCO3)
�HARDNESS
48
mg/L
1
Use this space (or a separate sheet) to provide information on other metals requested by the permit writer
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 10 of 39

FACILITY NAME AND PERMIT NUMBER:
Dutchman Creek WWTP, NCO021491
PERMIT ACTION REQUESTED:
Renew
RIVER BASIN:
Yadkin Pee Dee
Outfall number: 001 (Complete once for each outfall discharging effluent to waters of the United States.)
POLLUTANT
MAXIMUM DAILY DISCHARGE
AVERAGE DAILY DISCHARGE
ANALYTICAL
METHOD
ML/MDL
Conc.
Units
Mass
Units
Conc.
Units
Mass
Units
Number
of
Samples
VOLATILE ORGANIC COMPOUNDS
ACROLEIN
<100
pg/L
1
ACRYLONITRILE
<50
pg/L
1
BENZENE
<5
pg/L
1
BROMOFORM
<5
pg/L
1
CARBON
TETRACHLORIDE
<5
pg/L
1
CHLOROBENZENE
<5
pg/L
1
CHLORODIBROMO-
METHANE
<5
pg/L
1
CHLOROETHANE
<10
pg/L
1
2-CHLOROETHYLVINYL
ETHER
<5
pg/L
1
CHLOROFORM
6.2
pg/L
1
DICHLOROBROMO-
METHANE
<5
pg/L
1
1,1-DICHLOROETHANE
<5
pg/L
1
1,2-DICHLOROETHANE
<5
pg/L
1
TRANS-1,2-DICHLORO-
ETHYLENE
<5
pg/L
1
1,1-DICHLORO-
ETHYLENE
<5
pg/L
1
1,2-DICHLOROPROPANE
<5
pg/L
1
1,3-DICHLORO-
PROPYLENE
<5
pg/L
1
ETHYLBENZENE
<5
pg/L
1
METHYL BROMIDE
<10
pg/L
1
METHYL CHLORIDE
<10
pg/L
1
METHYLENE CHLORIDE
<10
pg/L
1
1,1,2,2-TETRA-
CHLOROETHANE
<5
p9/L
1
TETRACHLORO-
ETHYLENE
<5
pg/L
1
TOLUENE
<5
pg/L
1
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 11 of 39

FACILITY NAME AND PERMIT NUMBER:
Dutchman Creek WWTP, NCO021491
PERMIT ACTION REQUESTED:
Renew
RIVER BASIN:
Yadkin Pee Dee
Outfall number: 001 (Complete once for each outfall discharging effluent to waters of the United States.)
POLLUTANT
MAXIMUM DAILY DISCHARGE
AVERAGE DAILY DISCHARGE
ANALYTICAL
METHOD
ML/MDL
Cone.
Units
Mass
Units
Cone.
Units
Mass
Units
Number
of
Samples
TRICHLOROETHANE
<5
pg/L
1
1,1,2-
TRICHLOROETHANE
<5
Ng/L
1
TRICHLOROFTHYLENE
<5
pg/L
1
VINYL CHLORIDE
<10
ug/L
1
Use this space (or a separate sheet) to provide information on other volatile organic compounds requested by the permit writer
ACID -EXTRACTABLE COMPOUNDS
P-CHLORO-M-CRESOL
<20
Ng/L
1
2-CHLOROPHFNOL
<10
Ng/L
1
2,4-DICHLOROPHENOL
<10
Ng/L
1
2,4-DIMETHYLPHLNOL
<10
Ng/L
1
4,6-DINITRO-0-CRESOL
<50
Ng/L
1
2,4-DINITROPHENOL
<50
pg/L
1
2-NITROPHENOL
<10
pg/L
1
4-NITROPHENOL
<50
Ng/L
1
PENTACHLOROPHENOL
<50
Ng/L
1
PHENOL
<10
pg/L
1
2.4,6
TRICHLOROPHENOL
<10
Ng/L
1
Use this space (or a separate sheet) to provide information on other acid -extractable compounds requested by the permit writer
BASE -NEUTRAL COMPOUNDS
ACENAPHTHENE
<10
pg/L
1
ACENAPHTHYLENE
<10
Ng/L
1
ANTHRACENE
<10
Ng/L
1
BENZIDINF
<100
Ng/L
1
BENZO(A)ANTHRACENE
<10
Ng/L
1
BENZO(A)NYRENE
<10
Ng/L
1
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 12 of 39

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
Dutchman Creek WWTP, NCO021491
Renew
Yadkin Pee Dee
Outfall number: 001 (Complete once for each outfall discharging effluent to waters of the United States.)
MAXIMUM DAILY DISCHARGE
AVERAGE DAILY DISCHARGE
POLLUTANT
ANALYTICAL
ML/MDL
Number
Conc.
Units
Mass
Units
Conc.
Units
Mass
Units
of
METHOD
Samples
3.4 BENZO-
<10
pg/L
1
FLUORANTHENE
BENZO(CHI)PERYLENE
<10
pg/L
1
BENZO(K)
<10
pg/L
1
FLUORANTHENE
BIS (2-CHI-OROETHOXY)
<10
pg/L
1
METHANE
BIS (2-CHLOROETHYL)-
<10
pg/L
1
ETHER
BIS (2-CHLOROISO-
<10
pg/L
1
PROPYL)ETHER
BIS (2-ETFIYLHEXYL)
<20
pg/L
1
PHTHALATE
4-BROMOPHENYL
<10
pg/L
1
PHENYI. ETHER
BUTYLBFNZYL
<10
pg/L
1
PHTHALATE
2-CHLORO-
<10
pg/L
1
NAPHIHALENE
4-CHLORPHENYL
<10
pg/L
1
PHENYL ETHER
CHRY SENE
<10
pg/L
1
DI-N-RUTYL PHTHALATE
<10
pg/L
1
DI-N-OC I YL PHTHALATE
<10
pg/L
1
DIBEN/O(A,H)
<10
pg/L
1
ANTHRACENE
1,2-DICHLOROBENZENE
<10
pg/L
1
1,3-DICIIIOROBENZFNE
<10
pg/L
1
1,4-DI0 I[ OROBENZFNE
<10
pg/L
1
3,3-DICIILORO-
<10
pg /L
1
BENZIUINE
DIETHYL PHTHALATE
<10
pg/L
1
DIMETHYL PHTHALATE
<10
pg/L
1
2,4-DINITROTOLUENF_
<10
pg/L
1
2,6-DIIJ T ROTOLUENF
<10
pg/L
1
1,2-DIRHENYL-
<10
pg/L
1
HYDRAZINE
EPA Forn 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 13 of 39

FACILITY NAME AND PERMIT NUMBER:
Dutchman Creek WWTP, NCO021491
PERMIT ACTION REQUESTED:
Renew
RIVER BASIN:
Yadkin Pee Dee
Outfall number: 001 (Complete once for each outfall discharging effluent to waters of the United States.)
POLLUTANT
MAXIMUM DAILY DISCHARGE
AVERAGE DAILY DISCHARGE
ANALYTICAL
METHOD
ML/MDL
Conc.
Units
Mass
Units
Conc.
Units
Mass
Units
Number
of
Samples
FLUORANTHENE
<10
pg/L
1
FLUOkENE
<10
pg/L
1
HEXACHLOROBENZENE
<10
pg/L
1
HEXACHLORO-
BUTAPIENE
<10
p9/L
1
HEXACHLOROCYCLO-
PENTADIENE
<10
pg/L
1
HEXACHLOROETHANE
<10
pg/L
1
INDENO(1,2,3-CD)
PYRENE
<10
pg/L
1
ISOPI !ORONE
<10
pg/L
1
NAPH:"HALENE
<10
pg/L
1
NITROBENZENE
<10
pg/L
1
N-NI I ROSODI-N-
PROPYLAMINE
<10
p9/L
1
N-NITk0S0DI-
METHYLAMINE
<10
pg/L
1
N-NITNOSODI-
PHENYLAMINE
<10
pg/L
1
PHENANTHRENE
<10
pg/L
1
PYRENE
<10
pg/L
1
TRIClHLOROBENZENE
<10
p9/L
1
Use th s space (or a separate sheet) to provide information on other base -neutral compounds requested by the permit writer
Use th s space (or a separate sheet) to provide information on other pollutants (e.g., pesticides) requested by the permit writer
END OF PART D.
REFER TO "HE APPLICATION OVERVIEW (PAGE 1) TO DETERMINE WHICH OTHER PARTS
OF FORM 2A YOU MUST COMPLETE
EPA Foi n 3510-7A (R r . 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 14 of 39

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
Dutchman Creek WWTP, NCO021491
Renew
Yadkin Pee Dee
SUPPLEMENTAL APPLICATION INFORMATION
PART E. TOXICITY TESTING DATA
PO-1 �s 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 CA/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 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 b omonitoring 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.1. Required Tests.
Indicate the number of whole effluent toxicity tests conducted in the past four and one-half years.
E) chronic D acute
E.2. Individual Test Data. Complete the following chart for each whole effluent toxicity test conducted in the last four and one-half Vears. 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 inic:^nation.
Test Species & tosi number
Ceriodaphnia Dubia
Ceriodaphnia Dubia
Ceriodaphnia Dubia
Age at initiation
Outfall number
001
001
001
Dates sample collected
10-8-2018; 10-10-2018
7-10-2018; 7-12-2018
4-10-2018; 4-12-2018
Date test started
10-10-2018
7-11-2018
4-11-2018
Duration
7 Days
7 Days
7 Days
b. Give toxidry test methods followed.
Short-term Methods for
Short-term Methods for
Short-term Methods for
Estimating the Chronic Toxicity
Estimating the Chronic
Estimating the Chronic
Manu,:l title
of Effluents and Receiving
Toxicity of Effluents and
Toxicity of Effluents and
Waters to Freshwater
Receiving Waters to
Receiving Waters to
Organisms
Freshwater Organisms
Freshwater Organisms
Edition number and year of publication
4th Edition, 2002
4th Edition, 2002
4th Edition, 2002
Pago number(s)
c. Give the r:, nple collection method(s) used. For multiple grab samples, indicate the number of grab samples used.
24-1 to jr composite
X
X
X
Grab
d. Indicate where the sample was taken in relation to disinfection. (Check all that apply for each.
Before disinfection
After disinfection
X
X
X
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 15 of 39

After dechlorination X X X
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22, Page 16 of 39

FACILITY NAME AND PERMIT NUMBER:
Dutchman Creek WWTP, NCO021491
PERMIT ACTION REQUESTED:
Renew
RIVER BASIN:
Yadkin Pee Dee
Test number: Test number: Test number:
e. Describe the point in the treatment process at which the sample was collected.
Sample was collected:
Effluent
Effluent
Effluent
f. For each test, include whether the test was intended to assess chronic toxicity, acute toxicity, or both
Chronic toxicity
X
X
X
Acute toxicity
g. Provide the type of test performed.
Static
Static -renewal
X
X
X
Flow -through
h. Source of dilution water. If laboratory water, specify type; if receiving water, specify source.
Laboratory water
Soft Synthetic
Receiving water
Lake Brandt
Lake Brandt
i. Type of dilution water. If salt water, specify "natural" or type of artificial sea salts or brine used.
Fresh water
X
X
X
Salt water
j. Give the percentage effluent used for all concentrations in the test series.
37%
37%
37%
k. Parameters measured during the test. (State whether parameter meets test method specifications)
pH
7.67
7.34
Salinity
Temperature
24.6
24.9
Ammonia
Dissolved oxygen
7.81
8.2
1. Test Results.
Acute:
Percent survival in 100%
%
%
%effluent
LC,,j
951% C.I.
%
%
%
Control percent survival
%
%
%
Other(describe)
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 17 of 39

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
Dutchnla:i Creek WWTP, NCO021491
Renew
Yadkin Pee Dee
Chronic:
NOEL
37 %
37 %
37% %
IC2s
%
%
%
Control percent survival
100 %
100 %
100 %
Other (describe)
m. Quality Control/Quality Assurance.
Is reference toxicant data available?
Yes
Yes
No
Was reference toxicant lest within
Yes
Yes
acceptable bow
What date was re(crcnco toxicant test
/
07/10/2018
/ /
run (MM/DD/YYYY)7
Other (describe)
E.3. Toxicity Reduction Evaluation. Is the treatment works involved in a Toxicity Reduction Evaluation?
D Yc: Ti No If yes, describe:
E4. Summar; ied Biomonitoring Test Information. If you have submitted biomonitoring test information, or information regarding the
cause o` t, i In the past four and one-half years, provide the dates the information was submitted to the permitting authority and a summary
of the result
Date subrnit'.c,i: / / (MM/DD/YYYY)
Summary c .;su!.s: (see instructions)
END OF PART E.
REFER: L APPLICATION OVERVIEW (PAGE 1) TO DETERMINE WHICH OTHER PARTS
OF FORM 2A YOU MUST COMPLETE.
EPA Form 3510-7/n r w. 1 ' i. Replaces EPA forms 7550-6 & 7550-22. Page 18 of 39

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
Dutchman Creek WWTP, NCO021491 Renew Yadkin Pee Dee
SUPPLEMENTAL APPLICATION INFORMATION
PART E. TOXICITY TESTING DATA
F10 FVVs meeting on,� 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
requironn^ is for standard methods for analytes not addressed by 40 CFR Part 136.
• In addition, sirhrnit the results of any other whole effluent toxicity tests from the past four and one-half years. If a whole effluent toxicity test
conducted cT.rr!r,g the past four and one-half years revealed toxicity, provide any information on the cause of the toxicity or any results of a
toxicity wouctcm 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 S: r rnnrie5 are available that contain all of the information requested below, they may be submitted in place of Part E.
If no biomonitoring ,I,rta is required, do not complete Part E. Refer to the Application Overview for directions on which other sections of the form to
complete.
E.1. Required Ir.•sts.
Indicate the rural cr of whole effluent toxicity tests conducted in the past four and one-half years.
[: cfi ; ❑ acute
E.2. Individual T, st '; aln. Complete the following chart for each whole effluent toxicity test conducted in the last four and one-half years. Allow one
column per : -t (.ehere each species constitutes a test). Copy this page if more than three tests are being reported.
Test number: Test number: Test number:
a. Test n-n'jn.
Test Species mr 1 number
Ceriodaphnia Dubia
Ceriodaphnia Dubia
Ceriodaphnia Dubia
Age at initiation; ,,
<24 hours
<24 hours
001
001
001
Outfall number
Dates sample colk, ;
1-22-2018; 1-24-2018
10-3-2017; 10-5-2017
7-18-2017; 7-20-2017
Date test started
1-24-2018
10-4-2017
7-19-2017
Duration
7 Days
7 Days
7 Days
b. G, 1 methods followed.
Short-term Methods for
Short-term Methods for
Short-term Methods for
Estimating the Chronic Toxicity
Estimating the Chronic
Estimating the Chronic
Manual title
of Effluents and Receiving
Toxicity of Effluents and
Toxicity of Effluents and
Waters to Freshwater
Receiving Waters to
Receiving Waters to
Organisms
Freshwater Organisms
Freshwater Organisms
4th Edition, 2002
41h Edition, 2002
4th Edition, 2002
Fdition number a:,J yc, r ci publication
Page number(s)
c. Give the s.: : collection method(s) used. For multiple grab samples, indicate the number of grab samples used.
24-Hour composite
X
X
X
Grab
d. Indicate wh, : the sample was taken in relation to disinfection. (Check all that apply for each.
Before disinfection
After disinfection
X
X
X
EPA Form 3510-2A (Rev. 1 - +9J. Replaces EPA forms 7550-6 & 7550-22. Page 19 of 39

After dechlorination X X X
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 20 of 39

FACILITY NAME AND PERMIT NUMBER:
Dutchman Creek WWTP, NCO021491
PERMIT ACTION REQUESTED:
Renew
RIVER BASIN:
Yadkin Pee Dee
Test number: Test number: Test number:
e. Describe the point in the treatment process at which the sample was collected.
Sample was collected:
Effluent
Effluent
Effluent
f. For each tar include whether the test was intended to assess chronic toxicity, acute toxicity, or both
Chronic toxicity
X
X
X
Acute toxicity
g. Provide the !vpo of test performed.
Static
Static -renewal
X
X
X
Flow -through
h. Source of dilution water. If laboratory water, specify type; if receiving water, specify source.
Laboratory water
Soft Synthetic
Soft Synthetic
Receiving water
Lake Brandt
i. Type of dilution water. If salt water, specify "natural" or type of artificial sea salts or brine used.
Fresh water
X
X
X
Salt water
j. Give the perccntage effluent used for all concentrations in the test series.
37%
67%
37%
k. Parameters rrens,red during the test. (State whether parameter meets test method specifications)
pH
7.33
6.92
7.37
Salinity
Temperature
24.8
24.7
24.2
Ammonia
Dissolved oxygen
8.0
8.0
8.0
I. Test Resuli,
Acute:
Percent survival in 100%
effluent
%
%
"fin
LC,0
95% C.I.
%
%
%
Control percent survival
%
%
%
Other (descrue)
EPA Form 3510-7A (Rev. 1-b9). Replaces FPA forms 7550-6 & 7550-22. Page 21 of 39

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
Dutchman Creek WWTP, NCO021491
Renew
Yadkin Pee Dee
Chronic:
NOEL <37 % 37 % 37 %
IC25
25 %
25 %
%
Control r.:• survival
100 %
100 %
100 %
Other (d(:,,
M. Quality Control/Quality Assurance.
Is reference toxicant data available?
Yes
No
No
Was reference toxicant test within
Yes
acceptable bound::?
What date was rc6;rr.n; c toxicant test
1/9/2018
run (MM/DD/YYYY 1
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 s,,bmitted Biomonitoring Test Information. If you have submitted biomonitoring test information, or information regarding the
caus.: thin the past four and one-half years, provide the dates the information was submitted to the permitting authority and a summary
of the
Date s / (MM/DD/YYYY)
Sumr (see inslrucrnns)
END OF PART E.
REF - ATION OVERVIEW (PAGE 1) TO DETERMINE WHICH OTHER PARTS
OF FORM 2A YOU MUST COMPLETE.
EPA Form 3510-2A (, i. 1-99). Replaces IPA forms 7550-6 & 7550-22. Page 22 of 39

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
Dutchman Creek WWTP, NCO021491
Renew
Yadkin Pee Dee
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 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.1. 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
Outfall number
001
001
001
Dates sample collected
4-11-2017; 4-13-2017
12-13-2016; 12-15-2016
11-8-2016; 11-10-2016
Date test started
4-12-2017
12-14-2016
11-9-2016
Duration
7 Days
7 Days
7 Days
b. Give toxicity test methods followed.
Short-term Methods for
Short-term Methods for
Short-term Methods for
Estimating the Chronic Toxicity
Estimating the Chronic
Estimating the Chronic
Manual title
of Effluents and Receiving
Toxicity of Effluents and
Toxicity of Effluents and
Waters to Freshwater
Receiving Waters to
Receiving Waters to
Organisms
Freshwater Organisms
Freshwater Organisms
Edition number and year of publication
4th Edition, 2002
4th Edition, 2002
41h Edition, 2002
Page number(s)
c. Give the sample collection method(s) used. For multiple grab samples, indicate the number of grab samples used.
24-Hour composite
X
X
X
Grab
d. Indicate where the sample was taken in relation to disinfection. (Check all that apply for each.
Before disinfection
After disinfection
X
X
X
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 23 of 39

After dechlorination X X X
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 24 of 39

FACILITY NAME AND PERMIT NUMBER:
Dutchman Creek WWTP, NCO021491
PERMIT ACTION REQUESTED:
Renew
RIVER BASIN:
Yadkin Pee Dee
Test number: Test number: Test number:
e. Describe the point in the treatment process at which the sample was collected.
Sample was collected:
Effluent
Effluent
Effluent
f. For each test, include whether the test was intended to assess chronic toxicity, acute toxicity, or both
Chronic toxicity
X
X
X
Acute toxicity
g. Provide the type of test performed.
Static
Static -renewal
X
X
X
Flow -through
h. Source of dilution water. If laboratory water, specify type; if receiving water, specify source.
Laboratory water
Receiving water
Lake Brandt
Lake Brandt
Lake Brandt
i. Type of dilution water. If salt water, specify "natural" or type of artificial sea salts or brine used.
Fresh water
X
X
X
Salt water
j. Give the percentage effluent used for all concentrations in the test series.
37%
27.75%
27.75%
37%
37%
55.5%
55.5%
k. Parameters measured during the test. (State whether parameter meets test method specifications)
pH
7.66
7.44
7.58
Salinity
Temperature
24.6
24.4
25.0
Ammonia
Dissolved oxygen
8.08
7.87
8.23
I. 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 7550-6 & 7550-22.
Page 25 of 39

FACILITY NAME AND PERMIT NUMBER:
Dutchman Creek WWTP, NCO021491
PERMIT ACTION REQUESTED:
Renew
RIVER BASIN:
Yadkin Pee Dee
Chronic:
NOEL
37 %
74 %
74 %
IC25
Control percent survival
100 %
100 %
100 %
Other (describe)
m. Quality Control/Quality Assurance.
Is reference toxicant data available?
No
No
NO
Was reference toxicant test within
acceptable bounds?
What date was reference toxicant test
run (MM/DD/YYYY)?
/
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 Biomonitoring 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 (PAGE 1) 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 26 of 39

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
Dutchman Creek WWTP, NCO021491
Renew
Yadkin Pee Dee
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 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.1. 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
Outfall number
001
001
001
Dates sample collected
7-19-2016; 7-21-2016
1-12-2016; 1-14-2016
7-14-2015; 7-16-2015
Date test started
7-20-2016
1-13-2016
7-15-2015
Duration
7 Days
7 Days
7 Days
b. Give toxicity test methods followed.
Short-term Methods for
Short-term Methods for
Short-term Methods for
Estimating the Chronic Toxicity
Estimating the Chronic
Estimating the Chronic
Manual title
of Effluents and Receiving
Toxicity of Effluents and
Toxicity of Effluents and
Waters to Freshwater
Receiving Waters to
Receiving Waters to
Organisms
Freshwater Organisms
Freshwater Organisms
Edition number and year of publication
4th Edition, 2002
4th Edition, 2002
41h Edition, 2002
Page number(s)
c. Give the sample collection method(s) used. For multiple grab samples, indicate the number of grab samples used.
24-Hour composite
X
X
X
Grab
d. Indicate where the sample was taken in relation to disinfection. (Check all that apply for each.
Before disinfection
After disinfection
X
X
X
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 27 of 39

After dechlorination X X X
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 28 of 39

FACILITY NAME AND PERMIT NUMBER:
Dutchman Creek WWTP, NCO021491
PERMIT ACTION REQUESTED:
Renew
RIVER BASIN:
Yadkin Pee Dee
Test number: Test number: Test number:
e. Describe the point in the treatment process at which the sample was collected.
Sample was collected:
Effluent
Effluent
Effluent
f. For each test, include whether the test was intended to assess chronic toxicity, acute toxicity, or both
Chronic toxicity
X
X
X
Acute toxicity
g. Provide the type of test performed.
Static
Static -renewal
X
X
X
Flow -through
h. Source of dilution water. If laboratory water, specify type; if receiving water, specify source.
Laboratory water
Receiving water
Lake Brandt
Lake Brandt
Lake Brandt
i. Type of dilution water. If salt water, specify "natural" or type of artificial sea salts or brine used.
Fresh water
X
X
X
Salt water
j. Give the percentage effluent used for all concentrations in the test series.
37%
37%
37%
k. Parameters measured during the test. (State whether parameter meets test method specifications)
pH
7.89
7.64
7.6
Salinity
Temperature
22.42
24.7
25.7
Ammonia
Dissolved oxygen
8.26
8.18
8.23
I. Test Results.
Acute:
Percent survival in 100%
,%
%
%effluent
LC+5o
95% C.I.
%
%
%
Control percent survival
%
%
%
Other (describe)
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 29 of 39

FACILITY NAME AND PERMIT NUMBER:
Dutchman Creek WWTP, NCO021491
PERMIT ACTION REQUESTED:
Renew
RIVER BASIN:
Yadkin Pee Dee
Chronic:
NOEL
37 %
37 %
37 %
IC25
%
%
%
Control percent survival
100 %
100 %
100 %
Other (describe)
m. Quality Control/Quality Assurance.
Is reference toxicant data available?
No
No
No
Was reference toxicant test within
acceptable bounds?
What date was reference toxicant test
run (MM/DD/YYYY)?
Other (describe)
E.3. Toxicity Reduction Evaluation. Is the treatment works involved in a Toxicity Reduction Evaluation?
O Yes ® No If yes, describe:
EA. Summary of Submitted Biomonitoring 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 (PAGE 1) 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 30 of 39

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
Dutchman Creek WWTP, NCO021491
Renew
Yadkin Pee Dee
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 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 O 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
Outfall number
001
001
001
Dates sample collected
4-14-2015; 4-16-2015
1-27-2015; 1-29-2015
10-14-2014; 10-16-2014
Date test started
4-15-2015
1-28-2015
10-15-2014
Duration
7 Days
7 Days
7 Days
b. Give toxicity test methods followed.
Short-term Methods for
Short-term Methods for
Short-term Methods for
Estimating the Chronic Toxicity
Estimating the Chronic
Estimating the Chronic
Manual title
of Effluents and Receiving
Toxicity of Effluents and
Toxicity of Effluents and
Waters to Freshwater
Receiving Waters to
Receiving Waters to
Organisms
Freshwater Organisms
Freshwater Organisms
Edition number and year of publication
4th Edition, 2002
4th Edition, 2002
41h Edition, 2002
Page number(s)
c. Give the sample collection method(s) used. For multiple grab samples, indicate the number of grab samples used.
24-Hour composite
X
X
X
Grab
d. Indicate where the sample was taken in relation to disinfection. (Check all that apply for each.
Before disinfection
After disinfection
X
X
X
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 31 of 39

After dechlorination X X X
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 32 of 39

FACILITY NAME AND PERMIT NUMBER:
Dutchman Creek WWTP, NCO021491
PERMIT ACTION REQUESTED:
Renew
RIVER BASIN:
Yadkin Pee Dee
Test number: Test number: Test number:
e. Describe the point in the treatment process at which the sample was collected.
Sample was collected:
Effluent
Effluent
Effluent
I. For each test, include whether the test was intended to assess chronic toxicity, acute toxicity, or both
Chronic toxicity
X
X
X
Acute toxicity
g. Provide the type of test performed.
Static
Static -renewal
X
X
X
Flow -through
h. Source of dilution water. If laboratory water, specify type; if receiving water, specify source.
Laboratory water
Receiving water
Lake Brandt
Lake Brandt
Lake Brandt
i. Type of dilution water. If salt water, specify "natural' or type of artificial sea salts or brine used.
Fresh water
X
X
X
Salt water
j. Give the percentage effluent used for all concentrations in the test series.
37%
37%
37%
k. Parameters measured during the test. (State whether parameter meets test method specifications)
pH
7.65
7.64
7.46
Salinity
Temperature
24.3
24.5
25.0
Ammonia
Dissolved oxygen
8.05
7.86
7.78
I. Test Results.
Acute:
Percent survival in 100%
effluent
%
%
%
Lcso
95% C.I.
%
%
%
Control percent survival
%
%
Other (describe)
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 33 of 39

FACILITY NAME AND PERMIT NUMBER:
Dutchman Creek WWTP, NCO021491
PERMIT ACTION REQUESTED:
Renew
RIVER BASIN:
Yadkin Pee Dee
Chronic:
NOEC
37 %
37 %
37 %
IC25
%
%
%
Control percent survival
100 %
92 %
100 %
Other (describe)
m. Quality Control/Quality Assurance.
Is reference toxicant data available?
No
No
NO
Was reference toxicant test within
acceptable bounds?
What date was reference toxicant test
run (MM/DD/YYYY)?
/
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 Biomonitoring 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 (PAGE 1) TO DETERMINE WHICH OTHER PARTS
OF FORM 2A YOU MUST COMPLETE.
FACILITY NAME AND PERMIT NUMBER:
Dutchman Creek WWTP, NCO021491
PERMIT ACTION REQUESTED:
Renew
RIVER BASIN:
Yadkin Pee Dee
SUPPLEMENTAL APPLICATION INFORMATION
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 34 of 39

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 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.1. 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
Age at initiation of test
Outfall number
001
Dates sample collected
7-15-2014; 7-17-2014
Date test started
7-16-2014
Duration
7 Days
b. Give toxicity test methods followed.
Short-term Methods for
Estimating the Chronic Toxicity
Manual title
of Effluents and Receiving
Waters to Freshwater
Organisms
Edition number and year of publication
4ch Edition, 2002
Page number(s)
c. Give the sample collection method(s) used. For multiple grab samples, indicate the number of grab samples used.
24-Hour composite
X
Grab
d. Indicate where the sample was taken in relation to disinfection. (Check all that apply for each.
Before disinfection
After disinfection
X
After dechlorination
X
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 35 of 39

FACILITY NAME AND PERMIT NUMBER:
Dutchman Creek WWTP, NCO021491
PERMIT ACTION REQUESTED:
Renew
RIVER BASIN:
Yadkin Pee Dee
Test number: Test number: Test number:
e. Describe the point in the treatment process at which the sample was collected.
Sample was collected:
Effluent
f. For each test, include whether the test was intended to assess chronic toxicity, acute toxicity, or both
Chronic toxicity
X
Acute toxicity
g. Provide the type of test performed.
Static
Static -renewal
X
Flow -through
h. Source of dilution water. If laboratory water, specify type; if receiving water, specify source.
Laboratory water
Receiving water
Lake Brandt
i. Type of dilution water. If salt water, specify "natural" or type of artificial sea salts or brine used.
Fresh water
X
Salt water
j. Give the percentage effluent used for all concentrations in the test series.
37%
k. Parameters measured during the test. (State whether parameter meets test method specifications)
pH
7.78
Salinity
Temperature
24.2
Ammonia
Dissolved oxygen
7.9
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 36 of 39

FACILITY NAME AND PERMIT NUMBER:
Dutchman Creek WWTP, NCO021491
PERMIT ACTION REQUESTED:
Renew
RIVER BASIN:
Yadkin Pee Dee
Chronic:
NOEC
37% %
%
%
IC25
%
%
%
Control percent survival
100 %
%
%
Other (describe)
m. Quality Control/Quality Assurance.
Is reference toxicant data available?
No
Was reference toxicant test within
acceptable bounds?
What date was reference toxicant test
run (MM/DD/YYYY)?
/
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 Biomonitoring 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)
j END OF PART E.
REFER TO THE APPLICATION OVERVIEW (PAGE 1) 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 37 of 39

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
Dutchman Creek WWTP, NCO021491
Renew
Yadkin Pee Dee
SUPPLEMENTAL APPLICATION INFORMATION
PART F.INDUSTRIAL USER DISCHARGES AND RCRA/CERCLA WASTES
All treatment works receiving discharges from significant industrial users or which receive RCRA,CERCLA, or other remedial wastes must
complete part F.
GENERAL INFORMATION:
F.I. Pretreatment program. Does the treatment works have, or is subject ot, an approved pretreatment program?
® Yes ❑ No
F.2. Number of Significant Industrial Users (SIUs) and Categorical Industrial Users (CIUs). Provide the number of each of the following types of
industrial users that discharge to the treatment works.
a. Number of non -categorical SIUs. 1
b. Number of CIUs. 0
SIGNIFICANT INDUSTRIAL USER INFORMATION:
Supply the following information for each SIU. If more than one SIU discharges to the treatment works, copy questions F.3 through F.8 and
provide the information requested for each SIU.
F.3. Significant Industrial User Information. Provide the name and address of each SIU discharging to the treatment works. Submit additional pages
as necessary.
Name: Brakebush Brothers Inc.
Mailing Address: 251 Eaton Road
Mocksville, NC 27028
FA. Industrial Processes. Describe all the industrial processes that affect or contribute to the SIU's discharge.
Processing of chicken to produce ready to eat chicken food products.
F.5. Principal Product(s) and Raw Material(s). Describe all of the principal processes and raw materials that affect or contribute to the SIU's
discharge.
Principal product(s): Ready to eat chicken food products
Raw material(s): Unprocessed chicken
F.6. Flow Rate.
a. Process wastewater flow rate. Indicate the average daily volume of process wastewater discharge into the collection system in gallons per
day (gpd) and whether the discharge is continuous or intermittent.
89,035.5 gpd (X continuous or intermittent)
b. Non -process wastewater flow rate. Indicate the average daily volume of non -process wastewater flow discharged into the collection system
in gallons per day (gpd) and whether the discharge is continuous or intermittent.
gpd ( continuous or intermittent)
F.7. Pretreatment Standards. Indicate whether the SIU is subject to the following:
a. Local limits ❑ Yes (D No
b. Categorical pretreatment standards ® Yes ❑ No
If subject to categorical pretreatment standards, which category and subcategory?
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 38 of 39

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
Dutchman Creek WWTP, NCO021491
Renew
Yadkin Pee Dee
F.8. Problems at the Treatment Works Attributed to Waste Discharge by the SIU. Has the SIU caused or contributed to any problems (e.g.,
upsets, interference) at the treatment works in the past three years?
❑ Yes ® No If yes, describe each episode.
RCRA HAZARDOUS WASTE RECEIVED BY TRUCK, RAIL, OR DEDICATED PIPELINE:
F.9. RCRA Waste. Does the treatment works receive or has it in the past three years received RCRA hazardous waste by truck, rail or dedicated pipe?
❑ Yes ® No (go to F.12)
F.10. Waste transport. Method by which RCRA waste is received (check all that apply):
❑ Truck ❑ Rail ❑ Dedicated Pipe
FA 1. Waste Description. Give EPA hazardous waste number and amount (volume or mass, specify units).
EPA Hazardous Waste Number Amount Units
CERCLA (SUPERFUND) WASTEWATER, RCRA REMEDIATION/CORRECTIVE ACTION
WASTEWATER, AND OTHER REMEDIAL ACTIVITY WASTEWATER:
F.12. Remediation Waste. Does the treatment works currently (or has it been notified that it will) receive waste from remedial activities?
❑ Yes (complete F.13 through F.15.) ® No
F.13. Waste Origin. Describe the site and type of facility at which the CERCLA/RCRA/or other remedial waste originates (or is excepted to origniate in
the next five years).
F.14. Pollutants. List the hazardous constituents that are received (or are expected to be received). Include data on volume and concentration, if
known. (Attach additional sheets if necessary.)
FA5. Waste Treatment.
a. Is this waste treated (or will be treated) prior to entering the treatment works?
❑ Yes ❑ No
If yes, describe the treatment (provide information about the removal efficiency):
b. Is the discharge (or will the discharge be) continuous or intermittent?
❑ Continuous ❑ Intermittent If intermittent, describe discharge schedule.
END OF PART F.
REFER TO THE APPLICATION OVERVIEW (PAGE 1) 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 39 of 39

Sludge Management Plan for Dutchman Creek
WWTP (Town of Mocksville)
The Dutchman Creek WWTP in Mocksville is a WW-3 plant that serves the population within
the town limits of Mocksville, North Carolina. Currently, sludge and solids produced at this
facility are pumped on an as -needed basis by EMA Resources, a company based in Mocksville.
This typically occurs every two to three months, depending on accumulation of solids in the
digester and weather conditions that would prohibit solids from being disposed of via land
application.
REGENEDIDENRONR
J AN, 0 2 2M
Water Re Section
urces
Permitting
Name (Print)
Signature
Title
Date

4
Town of Mocksville - NCO021491
U"GS t: uad Numder. G 16 NE
Receiving Stream: Dutchman Creek.
Stream Class: C
Subbasin: Yadkin 03-07-05
Page 8 of 8
a a .." 411 vUU41 Y'Yl
Facility Location
Lat.: 35' 53' 33" Long.: 80° 30' 07'

I
y MANHOLE O.
CO 'C�RRETE NOTE;
-,/-)' P�a-1 t!i I "'• � � • re sv,u.�e mbrtrt•�uew.,w,•e an
9 ;'� -o e;a.•stib..u+u:+eai:•.ir« Isu.s.•�a• y .,�I�..
/, ,� Y 6 sReoar wr a •, +,us
//� ---."�"'--.'- r-----' '-----•c _ it • 'RD4' c..,w V-.. s,m we•e ..o eo•re :•w. R .c. r. ux r ..e
Y
' �� , loeoa n i n .w .a .ccaw:o.ox,s s¢ km w s,a °� aSPHALT PAS SfE�S,
ifs �]F
I mere K,
; / •:a Me:n - �i j --`_ rr � it c,wr, ea_ a o. ew. ea °o e..
/ it l / :FrP:r?4• j ` � •`� % 1 \ :3 •.°..cllw x° a,s. .w r., ,w
' / $ �.o.s , � ,..a+rt .wla, ,.•sll�.s .ems.
,,,'1 i � � +/ ' � � '�"•� _ i • -� -`` a '`, ,, •g
-- —•--- - apt .� 11 � � � I � , ; i i i i i w �
1 ` 1 1 `• O R I e 0 :f e
l\ 11 �•• Itl i /
.nu
z �3 � 111 • "�
r1
I �`� 1`3 � 1 � l•1rl.:': II 1 'eTs e1`. /r
L2=
'I
r
e •' 1� I �II'I�'Ir 3
i • I•'ti 11, TOWN OF MOCKSVILLE
j --• \ DUTCH AN CREEK
1 • 1 '� \�,° j ,I .•',`�'�,WWASTEWATER TREATMENT PLANT UPGRADE_
•'I. `�-!,•uanv�•"`" $ 1 sK E%ISTNG OVERALL SITE PLAN
RNGiNC.QREYENGINE,E2
.
or

777
--- ---------------
,o
----------- -------
... ...........
... . . ......... R'
-----------
D4
...... ..... .
4
-7-
it
yt r.
Mb I N.
iN
7. 3,
t
ST1., t
V).
-------- --
. . . . . . . .
T . .
411
N it
ot, it
it
m000
BMW=
mm
M
IMM30
lm�
=wwo
(=FM
IM
MMMMIMIM
sawmnnomm
E,"
r
v
El
1.7m
PROFILE V—V BETWEEN AERATION BASIN 02 #3
.16
TOWN OF MOCKSViLLE
DUTCHMANS CREEK
WASTEWATER TREATMENT PLANT UPGRADE
PROPOSED OVERALL SITE PLAN
Oaf
iA GREY ENGINEERING, INC

1�
A
A
Tft-
PIPE/GUIDE RAIL SUPPORT, PLAN
--LJ
;R�,FR CTURAL PLAN
TOP GUIDE RAILS SUPPORT DETAIL
---------- ------ -
�� INTERMEDIATE GUIDE
RAILS SUPPORT DETAIL
----- -----
IL
- ---------
14M 4 GRATE WA I I SUPPO L-qu*
GRATING NOTj,$;-
-- ------It
d
AS CRANE NOTE
------ - ...
------------
-----
+
I
%
N
---------- J--
----------- - - - - - - - 7
:7= ----'7—:-
;CRIEEN GRATE & SUIPPOF PI
TOWN OF MOCKSVILLE
OUTCHMANS CREEK
WASTEWATER TREATMENT PLANT UPGRADE
50-NiN ,
No INFLUENT PUMP srATIGN RENOVATIONS
PLAN, SECTION 11 DETAILS
13RI;,Y ENGINEERING,INC

wEa
A I
i.rhi uc w mbpl �ft5
PLAN BASE,
9 i .
i u •r
SECTION D—D
suac: t4'-t'-o' f
PARTIAL WEIR PLATE DETA
WEIR PLATE SECTION
wxIXR
eax r„Ou
m.�: �y.r-o• s YW..-
Mrt
a. N iT.v�i POaa%xixwM e0tn al
- ofY ,-lP _ na huge �2vwuw�ua act
1C a ,a• � c. 5[l roa »xW
r. olv�9d9 d &'u Lwr•.Ai nl
xsp[ caIX rs rv:E.
nn j----------
--_ 1 f—}III—ICI} 6.0 ftm_v'-rt eF o.prto xa ulw.3M'
rntnraf,.w'�" �:nr..ksaa f«Ect .a
w h'•Y ears
SECTION C-C ---
mx.�i v.-.,._o.
TOWN OF MOCKSVILLE
DUTCHMANS CREEK
WASTEWATER TREATMENT PLANT UPGRADE
.'
NEW SPUTTER PLAN. SECTIONS k DETAILS
yyc. �•"
GREY ENGINEERING. INC.
7

s
—
ftDL— .—I K
A
----------- -
EAKHALL—E-WIRL BAR SCREEN & GRIT H'.MBER PLAN
10
. ..... . ....
I I
ly r
SECTION A -A
BAR SCREEN PLAN
Tr
FRONT
STOP GATE STOP GATE
GUIDEDETAILDETAIL
BAR SCREEN SECTION
swc —1 -1 (2 —.)
SECTION B=a
T F MOCKSVILLE
fissYr
,,,Rt�,,q,EEK
WASTEWATER TREATMENT
PLANT UPGRADE
NEW PARSHALL FLUME, BAR SCREEN & GRIT
CHAMBER 13 PLAN. SECTION &DETAILS
CIREY ENGINEERING, INC

I'A'-!-I'
---- -------------- ---- - ------------------------
. . . . . . . . . . . .. . . . . ......... =:=T ... . . . . ............ .....
B'j
-------- - ---- ---- -- --
PLAN
. ol
SECTION A -A
\t-4
1\ 14
BOTTOM WALL DETAIL
NOTE5,
KEYNOTESII
ELECTRICAL
TROUGH SECTION
HANDRAIL POST
i Mom. DERAIL
M, 10M
ft7
SUPPORT POST
MOORINGCABLE
IT-
0---. It
pitSECTION B-B
�T 1�
------ BASIN TOP EDGE &
SIDEWALK SECTION
-
-----------------
OWN OF MOCKSVILLE
CHEMICAL . . ...........
4; N UTOHMANS CREEK
FEED INJECTOR
WASTEWATER TREATMENT PLANT UPGRADE
NEW AERATION BASIN #3
PLAN. SECTION & DETAILS
GREY ENGINEERING, INC.

7mm
- �- - --
d aRIFI� IFI yg�'
Y
m ') �. tuuu cwmr.,w w=u wowX raxw(it ww, uw
• 1�` tear. w,sn[ saa •-x[xx c'o,rm+env ro awn+rt
'r�, x. +u (aw„xr vx:«r �; 3r •+,w�r,u, (wrvx(xr ac`a .' • •• i � $
a +a,:ws[axa�o,atzux...n(a a•>:w.xo a
t
in(Yt(aY I
m cx
m�h'Ea+vt
,+tieie�o�i< v/
�I
PIER CENTER PLAN
��i I w+"anx k„n,u,•,r a/o, .ow. "°� 33 TYP. BASIN
\\ .t r v+cu w�r_a•�•6 H ORAIa POST
SECTION 8-8
-,.
TOWN OF MOCKSVILLE
c q`��'+�,�,�,
OUTCHMANS CREEK
WASTEWATER TREATMENT PLANT UPGRADE
€
NEW CLARIFIER rJ
PLAN, SECTION AND OETALS
GREY
.ENGINEERING . INC.
1O

NMH-3
--------------------
w.- 00
F
-
i
�
■®emu
�� ,
®�uu(--_•
��
i
I'�
�N�
��C1,loci
Ul
oil
0
PLAN OF NEW MANHOLE 93
If
NMH-3
G
-91 4�tl
jECTION Of NEW MANHOLE Q W 11 1 -T I I -t Hl lag
SECTION A -A
KEYNOTES
==1 ITT-.
(D
4
5:=
<
ko«P
I Ti� I Tu!
M�®
17l
TYP. BASIN
WOR-L
�OST
TOWN OF MOCKSVILLE
DUTCHMANS CREEK
I. WASTEWATER TREATMENT PLANT UPGRADE
DECHOR NEW CHLQFVNE CONTACT BASIN
SECTION SECTION ELEVATION FEED PIPE PLAS1. SECTM AM OETALS
SECTION 19
16/ 43FIEY ENGINEERING, INC
Al SUPPORT AIR LINE SUPPORT #4 SUPPORT DETAIL A
,,,YNE PPORT #1 'PORT J2

i
it
:�., w.min awn n
-- ------
auuv n
---
./W,w
—
------------------
�I
LAN r _r
SECTION A —A
r./ PLKua1 n.s�W
I
SECTION 'B'
SECTION 'C'
DFGN 91 • FOR N000
A. ♦ Y51=BF
B. M 4B R zDrn.c x nK aM.r, eu.o.c coot
GN
a�[,Ic�vv[v�ic�m. �ooc�Wssn cad' n .K Mae�^+�w
c._
p �Nas az 'nn M,=v-
D. TIMBER RF I MMM' uo cm
E. MWI fA) R . M ua5-
F. BRA ;JNG AND BRIDCINGy
G
N

J
e
—_— � i rnw rou..msroar a � '�" ' §� ��"�•� * oJC°l'^✓`
�N 44M1L Iyt.w ...r �xN
W N::
.P
PLAN
--__ �------rj
EXTERIOR STEPS & PLATFORM ELEVATION C—C
\ 0 �� avtiC
or
1
TOWN OF MOCKSVILLE
♦/"`'�. DUTCHMANS CREEK
ek ,-"I WASTEW_TER TREATMENT PLANT UPGRADE _
ifj\ NEW AERDBIC DIC
MA
PLAN, SECTIDN k DETARS
ENGINEERING, INC. 13
..ny....y,.�