NCG590024_Fact Sheet_20190321

DocuSign Envelope ID: E8F5795C-4481-4A8B-AA44-8E4885D0731F
Fact Sheet
NPDES Permit No. COC NCG590024 (formerly NCO088498
Permit Writer/Email Contact: Derek Denard, [e-mail]
Date: 21 Mar2019
Division/Branch: NC Division of Water Resources/Water Quality Permitting Section
Compliance & Expediated Permitting Branch
Fact Sheet Template: Version 09Jan2017
Permitting Action:
N Renewal
❑ Renewal with Expansion
❑ New Discharge
❑ Modification (Fact Sheet should be tailored to mod request)
Note: A complete application should include the following:
• For New Dischargers, EPA Form 2A or 2D requirements, Engineering Alternatives Analysis,
Fee.
• For Existing Dischargers (POTW), EPA Form 2A, 3 effluent pollutant scans, 4 2' species WET
tests.
• For Existing Dischargers (Non-POTW), EPA Form 2C with correct analytical requirements based
on industry category.
Complete applicable sections below. If not applicable, enter NA.
1. Basic Facility Information
Facility Information
Applicant/Facility Name:
Aqua North Carolina, Inc. / Mitchell Bluff Subdivision- Well # 1 WTP
Applicant Address:
202 Mackenan Ct, Cary, NC 27511
Facility Address:
Mitchell Cove Rd, Elkin, NC 28621
Permitted Flow:
Not limited
Facility Type/Waste:
MINOR; 100% industrial/ Water Plants and Water Conditioning
Discharge —filter-backwash - Greensand WTP System
Facility Class:
Physical Chemical Not Classified
Treatment Units:
four (4) greensand filters, chemical usage consisting of Potassium
permanganate, Chlorine and caustic soda
Pretreatment Program (Y/N)
No
County:
Surry
Region
Winston-Salem
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Briefly describe the proposed permitting action and facility background: This facility is a greensand
water treatment plant with discharge of wastewaters from media filter backwash, with a design potable
flowrate of 0.05184 MGD, a design backwash/reject flow of 0.00072 and a maximum, monthly average
wastewater discharge of 0.00072 MGD. The facility consists of the following water and wastewater
treatment units: four (4) greensand filters, chemical usage consisting of: Potassium permanganate,
Chlorine and caustic soda.
This facility is eligible for coverage under General Permit NCG590000 for the of discharge backwash
wastewaters from greensand and conventional type water treatment facilities. Eligibility is based on the
following (See Attachment A: General Permit NCG590000 Section A. Coverage, p. 2 of 26).
• The facility is a greensand technology water treatment system.
• There are no toxicity issues (monitoring is not applicable under WTP strategy for greensands).
• There are no WQBELs required for toxicants such as Zinc.
• The discharge is not mixed with other process wastewaters.
• The discharge is not to waters classified as High Quality Waters (HQW) or Outstanding Resource
Waters (ORW).
• The discharge is not from water purification systems using Membrane Treatment (Reverse
Osmosis) or Ion Exchange.
• The discharge would not adversely affect a Federal or State listed endangered or threatened
species or its critical habitat. The discharge is not of pollutants to an impaired waterbody in
excess of the wasteload allocation specified in an EPA -Approved TMDL (Total Maximum Daily
Load).
2. Receiving Waterbody Information:
Receiving Waterbody Information
Outfalls/Receiving Stream(s):
Outfall 001- UT to Mitchell River
Stream Segment:
12-62-(12.5)
Stream Classification:
C
Drainage Area (mi2):
--
Summer 7Q10 (cfs)
0
Winter 7Q 10 (cfs):
0
30Q2 (cfs):
0
Average Flow (cfs):
0
IWC (% effluent):
100%
303(d) listed/parameter:
No — See Attachment C: 2016 Final Integrated Report, p.1169
Subject to TMDL/parameter:
No — 2011 Turbidity TMDLs in the Yadkin River Basin:
Muddy Creek and the Yadkin River. The Mitchell River is
not impaired for Turbidity.
Basin/Subbasin/HUC:
Yadkin -Pee Dee; 03-07-02 [HUC 030401010504]
USGS Topo Quad:
Elkin North, NC
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3. Effluent Data Summary
Effluent data is summarized below for the period May2014 through Oct2018.
Table. Effluent Data
Data
Limits
Parameter
Max
Min
Average
I Count
MA DM
PQL UoM
00070 -
Turbidity
39
_ 0.55
13.881
104
ntu
00076 -
Turbidity, HCH Turbidimiter
21
2.8
11.6
4
ntu
00400 -
pH
8.8
6.7
7.1
108
Not < 6.0 or > 9.0
su
01045 -
Iron, Total (as Fe)
7460
472
2450.5
18
ug/I
01055 -
Manganese, Total (as Mn)
326
70
172.3
18
ug/I
50050 -
Flow, in conduit or thru treatment plant
0.00072
0.00072
0.00072
906
mgd
50060 -
Chlorine, Total Residual
23
0
8.47
108
17
20 ug/I
C0530
- Solids, Total Suspended - Concentration
15.6
2.5
5.3
108
301 45
2.5 mg/I
MA = Monthly Average Limit; DM = Daily Maximum Limit; PQL = Practical Quantitation Limit; UoM = Unit
of Measure
Reporting zero (0) for TRC is not appropriate for no detection. The method PQL
(practical quantitation limit) should be reported instead of zero such as <20 µg/L.
4. Instream Data Summary
Instream monitoring may be required in certain situations, for example: 1) to verify model predictions
when model results for instream DO are within 1 mg/l of instream standard at full permitted flow; 2) to
verify model predictions for outfall diffuser; 3) to provide data for future TMDL; 4) based on other
instream concerns. Instream monitoring may be conducted by the Permittee, and there are also
Monitoring Coalitions established in several basins that conduct instream sampling for the Permittee (in
which case instream monitoring is waived in the permit as long as coalition membership is maintained).
If applicable, summarize any instream data and what instream monitoring will be proposed for this
permit action: NA.
Is this facility a member of a Monitoring Coalition with waived instream monitoring (YIN): NO.
Name of Monitoring Coalition: NA.
5. Compliance Summary
Summarize the compliance record with permit effluent limits (past 5 years): See Attachment D:
Monitoring Report Violations Nov2013 to Oct2018, 1 page. No NOVs or NODS were noted.
Summarize the compliance record with aquatic toxicity test limits and any second species test results
(past 5 years): NA.
Summarize the results from the most recent compliance inspection: The last facility inspection conducted
on 11/06/2018 reported that the facility appeared to be clean and well maintained. See Attachment E:
Inspection Report 11/06/2018, 5 pages.
6. Water Quality -Based Effluent Limitations (WQBELs)
Dilution and Mixin.. Zones
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In accordance with 15A NCAC 213.0206, the following streamflows are used for dilution considerations
for development of WQBELs: 1 Q 10 streamflow (acute Aquatic Life); 7Q 10 streamflow (chronic Aquatic
Life; non -carcinogen HH); 30Q2 streamflow (aesthetics); annual average flow (carcinogen, HH).
If applicable, describe any other dilution factors considered (e.g., based on CORMIX model results): NA.
If applicable, describe any mixing zones established in accordance with 15A NCAC 2B.0204(b): NA.
Oxygen -Consuming Waste Limitations
Limitations for oxygen -consuming waste (e.g., BOD) are generally based on water quality modeling to
ensure protection of the instream dissolved oxygen (DO) water quality standard. Secondary TBEL limits
(e.g., BOD= 30 mg/1 for Municipals) may be appropriate if deemed more stringent based on dilution and
model results.
If permit limits are more stringent than TBELs, describe how limits were developed: NA.
Ammonia and Total Residual Chlorine Limitations
Limitations for ammonia are based on protection of aquatic life utilizing an ammonia chronic criterion of
1.0 mg/1(summer) and 1.8 mg/1(winter). Acute ammonia limits are derived from chronic criteria,
utilizing a multiplication factor of 3 for Municipals and a multiplication factor of 5 for Non -Municipals.
Limitations for Total Residual Chlorine (TRC) are based on the NC water quality standard for protection
of aquatic life (17 µg/1) and capped at 28 µg/1(acute impacts). Due to analytical issues, all TRC values
reported below 50 ug/1 are considered compliant with their permit limit.
Describe any proposed changes to ammonia and/or TRC limits for this permit renewal: There are no
proposed changes. NCG59000 sets the daily maximum limit for TRC at 17 µg/l.
Reasonable Potential Analysis (RPA) for Toxicants — NA.
Toxicity Testing Limitations
Permit limits and monitoring requirements for Whole Effluent Toxicity (WET) have been established in
accordance with Division guidance (per WET Memo, 8/2/1999). Per WET guidance, all NPDES permits
issued to Major facilities or any facility discharging "complex" wastewater (contains anything other than
domestic waste) will contain appropriate WET limits and monitoring requirements, with several
exceptions. The State has received prior EPA approval to use an Alternative WET Test Procedure in
NPDES permits, using single concentration screening tests, with multiple dilution follow-up upon a test
failure.
Describe proposed toxicity test requirement: NA.
Mercury Statewide TMDL Evaluation
There is a statewide TMDL for mercury approved by EPA in 2012. The TMDL target was to comply with
EPA's mercury fish tissue criteria (0.3 mg/kg) for human health protection. The TMDL established a
wasteload allocation for point sources of 37 kg/year (81 lb/year), and is applicable to municipals and
industrial facilities with known mercury discharges. Given the small contribution of mercury from point
sources (-2% of total load), the TMDL emphasizes mercury minimization plans (MMPs) for point source
control. Municipal facilities > 2 MGD and discharging quantifiable levels of mercury (>1 ng/1) will
receive an MMP requirement. Industrials are evaluated on a case -by -case basis, depending if mercury is a
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pollutant of concern. Effluent limits may also be added if annual average effluent concentrations exceed
the WQBEL value (based on the NC WQS of 12 ng/1) and/or if any individual value exceeds a TBEL
value of 47 ng/l.
Describe proposed permit actions based on mercury evaluation: NA.
Other TMDL/Nutrient Management Strategy Considerations
If applicable, describe any other TMDLs/Nutrient Management Strategies and their implementation
within this permit: Under the current general permit NCG590000 nutrient monitoring is not required for
Greensand technology that discharges to freshwater.
Other WQBEL Considerations
If applicable, describe any other parameters of concern evaluated for WQBELs: NA.
If applicable, describe any special actions (HQW or ORW) this receiving stream and classification shall
comply with in order to protect the designated waterbody: NA.
If applicable, describe any compliance schedules proposed for this permit renewal in accordance with
15A NCAC 2H 010 7(c) (2) (B), 40CFR 122.47, and EPA May 2007 Memo: NA.
If applicable, describe any water quality standards variances proposed in accordance with NCGS 143-
215.3(e) and 15A NCAC 2B.0226 for this permit renewal: NA.
7. Technology -Based Effluent Limitations (TBELs) — NA.
8. Antidegradation Review (New/Expanding Discharge)
The objective of an antidegradation review is to ensure that a new or increased pollutant loading will not
degrade water quality. Permitting actions for new or expanding discharges require an antidegradation
review in accordance with 15A NCAC 2B.0201. Each applicant for a new/expanding NPDES permit must
document an effort to consider non -discharge alternatives per 15A NCAC 2H.0105(c)(2). In all cases,
existing instream water uses and the level of water quality necessary to protect the existing use is
maintained and protected.
If applicable, describe the results of the antidegradation review, including the Engineering Alternatives
Analysis (EAA) and any water quality modeling results: NA.
9. Antibacksliding Review
Sections 402(o)(2) and 303(d)(4) of the CWA and federal regulations at 40 CFR 122.44(1) prohibit
backsliding of effluent limitations in NPDES permits. These provisions require effluent limitations in a
reissued permit to be as stringent as those in the previous permit, with some exceptions where limitations
may be relaxed (e.g., based on new information, increases in production may warrant less stringent TBEL
limits, or WQBELs may be less stringent based on updated RPA or dilution).
Are any effluent limitations less stringent than previous permit (YES/NO): NO.
If YES, confirm that antibacksliding provisions are not violated: NA.
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10. Monitoring Requirements
Monitoring frequencies for NPDES permitting are established in accordance with the following
regulations and guidance: 1) State Regulation for Surface Water Monitoring, 15A NCAC 2B.0500; 2)
NPDES Guidance, Monitoring Frequency for Toxic Substances (7/15/2010 Memo); 3) NPDES Guidance,
Reduced Monitoring Frequencies for Facilities with Superior Compliance (10/22/2012 Memo); 4) Best
Professional Judgement (BPJ). Per US EPA (Interim Guidance, 1996), monitoring requirements are not
considered effluent limitations under Section 402(o) of the Clean Water Act, and therefore anti -
backsliding prohibitions would not be triggered by reductions in monitoring frequencies.
For instream monitoring, refer to Section 4.
11. Electronic Reporting Requirements
The US EPA NPDES Electronic Reporting Rule was finalized on December 21, 2015. Effective
December 21, 2016, NPDES regulated facilities are required to submit Discharge Monitoring Reports
(DMRs) electronically. Effective December 21, 2020, NPDES regulated facilities will be required to
submit additional NPDES reports electronically. This permit contains the requirements for electronic
reporting, consistent with Federal requirements.
12.Summary of Proposed Permitting Actions:
NC0088498 is to be converted to COC NCG590024. The applicable effluent page is found in Section B.
(L) Greensand WTP Effluent Limitations and Monitoring Requirements — Discharging to Freshwater.
[See Attachment E: General Permit NCG590000, Section B. (L), page 3 of 26.]
Latitude and Longitude were corrected to historical data found in February 27, 2007 Engineering
alternatives analysis (EAA). See Attachment G. Map page from EAA 02-27-2007.
13. Public Notice Schedule:
Not Applicable for Certificates of Coverage (COCs) Under General Permit NCG590000. The general
permit was submitted to public notice.
14. Fact Sheet Addendum (if applicable): NA.
15. Fact Sheet Attachments (if applicable):
A. General Permit NCG590000 Section A. Coverage, p. 2 of 26.
B. General Permit NCG590000 Section B. (1.), p. 3 of 26.
C. 2016 Final Integrated Report, p.1169.
D. Monitoring Report Violations Nov2013 to Oct2018, 1 page.
E. Inspection Report, 11/06/2018, 5 pages.
F. Email to WSRO, 20181206, 2 pages.
G. Email Charles Weaver for conversion to NCG59000, 20190222, 2 pages.
H. Email of DRAFT to Permittee_WSRO_Maureen Kinney, 1 page.
1. Email to Maureen Kinney, 20190309, 1 page.
J. Map pages from EAA 02-27-2007, 2 pages.
K. NC0088498 Renewal Application, 20180709, 7 pages.
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DocuSign Envelope ID: E8F5795C-4481-4A8B-AA44-8E4885D0731F
Permit No. NCG590000
PART 1
A. Coverage
(1.) Eligibility of Coverage
a. Existing Greensand Water Treatment Plants (WTPs) with individual NPDES permits and new facilities seeking a
NPDES permit for a greensand water purification system utilizing Iron and/or Manganese removal systems are
eligible for coverage under this general permit. Backwash wastewaters from similar activities such as sand filtration
or systems utilizing calcite filtration are eligible and covered under the Greensand WTP effluent requirements section
in this general permit.
b. Existing Conventional WTPs with a wastewater discharge resulting from water purification facilities with filter
backwash, sedimentation basin washdown, and decant from water treatment facilities are eligible for coverage under
this general permit.
(2.) Limitations on Coverage
a. Although this general permit does not cover the following types of discharges, other permits such as an
individual NPDES permit, an alternate general permit, or other approval from the Division may be obtained.
This permit does not authorize discharges from Water Treatment Plants with the following:
• Discharges that are mixed with other process wastewaters.
• Discharges to waters classified as High Quality Waters (HQW) or Outstanding Resource
Waters (ORW).
• Discharges from water purification systems using Membrane Treatment (Reverse Osmosis) or
Ion Exchange.
• Discharges that would adversely affect a Federal or State listed endangered or threatened
species or its critical habitat.
• Discharges of pollutants to an impaired waterbody in excess of the wasteload allocation
specified in an EPA -Approved TMDL (Total Maximum Daily Load).
• Discharges from new Conventional WTPs proposing a discharge to surface waters.
b. New Conventional WTPs proposing a discharge to surface waters shall be covered under an individual permit for
at least one permit cycle. Upon permit renewal, if an evaluation of the facility's wastewaters shows no need for
additional limitations or requirements beyond what is contained in this general permit, then the permittee will be
considered for coverage.
c. Conventional WTPs proposing to expand existing facilities shall submit a Notice of Intent (NOI) permit
application with the proposed expansion/treatment details and an Engineering Alternative Analysis for Division
review and approval in order to obtain coverage for the expansion under this permit and receive a revised
Certificate of Coverage (CoC).
d. This permit does not authorize discharges that the Division has determined to be or which may reasonably be
expected to be contributing to a violation of a water quality standard (as defined in the "Red Book" or NC
Administrative Code 15A NCAC 02B .0100, .0200, and .0300).
e. If the Division determines at any time that the discharge is causing or contributing to a violation of water quality
standards or if the Division has any other grounds for modifying or revoking this permit, the Division may require
corrective action or require the discharge be permitted differently in accordance with Part II, Section B of this
permit. The Division may deny coverage under this permit and require submittal of an application for an
individual NPDES permit based on a review of the Notice of Intent (NOI) or other information.
f. Whole Effluent Toxicity (WET) test results for the past three years shall be reviewed for existing or
expanding Conventional WTPs applying for coverage under this general permit. Permittees with WET test
results showing potential for aquatic toxicity may be denied coverage under this general permit which
includes a WET limitation of "Pass".
(3.) Transfer Coverage from Other Permits
Upon issuance of this general permit, all existing and active individual permits for Greensand and
Conventional type WTPs will automatically be considered for coverage under this general permit as
permit renewal applications are received.
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Permit No. NCG590000
B. (L) Greensand WTP Effluent Limitations and Monitoring Requirements — Dischmin2 to Freshwater
a. During the period beginning on the effective date of the permit and lasting until expiration, the Permittee is authorized to discharge
wastewaters from iron and manganese removal type systems for the purpose of water purification to the receiving waters. Such
discharges shall be limited and monitored' by the Permittee as specified below:
PARAMETER
EFFLUENT LIMITS
MONITORING REQUIREMENTS
Monthly Average
Daily MaxinmM2
Measurement
Frequency
Sample
Type
Sample
Location
Flow
Monitor Only (MGD)
Twice per Month
Instantaneous
Or Estimate
Effluent
Total Suspended S0lids4
30.0 mg/1
(Exce tion:Trout Waters)
45.0 mg/L
Exce tion:Trout Waters)
Twice per Month
Grab
Effluent
Total Residual Chlorines
-
17 µg/L
Twice per Month
Grab
Effluent
pH
6.0 < pH < 9.0 s.u.
Monthly
Grab
Effluent
Turbidity6
50 NTU daily maximum
(Exceptions: Trout Waters, Lakes & Reservoirs)
Monthly
Grab
Effluent
Total Manganese'' a
Monitor Only µg/L (Exception: WS Waters)
Quarterly
Grab
Effluent
Total Iron
Monitor Only (µg/L)
Quarterly
Grab
Effluent
Total Zinc9
Monitor Only (µg/L)
Quarterly
Grab
Effluent
Total Fluoride"'
Monitor Only (µg/L)
Quarterly
Grab
Effluent
Fnntnntp.-
1. eDMR: No later than 270 days from the effective date listed on the CoC issued with this permit, begin submitting discharge
monitoring reports electronically using NC DWR's eDMR application system. See Special Condition C.
2. The Daily Maximum limits apply to all permittees. More stringent limitations apply to discharges to Trout and Water Supply (WS)
Waters and Lakes & Reservoirs as noted above and detailed in the footnotes below. Refer to the Certificate of Coverage (CoC) for
receiving stream classifications.
3. For instantaneous flow monitoring, the duration of the discharge must be reported in addition to the total flow.
4. TSS: Permittees discharging to Trout waters shall not exceed a monthly average of 10 mg/L and a daily maximum limit of 15 mg/L.
5. TRC: Limit and monitoring requirements only apply if the facility adds chlorine or chlorine derivatives to water that is eventually
discharged. The Division shall consider all effluent TRC values reported below 50 ug/L to be in compliance with the permit.
However, the Permittee shall continue to record and submit all values reported by a North Carolina certified laboratory (including
field certified), even if these values fall below 50 ug/L.
6. Turbidity: The Turbidity Daily Maximum effluent limit is 10 NTU for Trout waters and 25 NTU for Lakes & Reservoirs not designated
as trout waters.
7. Iron & Manganese: This sampling requirement does not apply to backwash from calcite filtration or similar systems which are not
designed for iron or manganese removal and are not blended with other WTP wastewaters.
8. Total Manganese: Permittees discharging to WS waters shall not exceed the manganese water quality standard defined in
Administrative Code 15A NCAC 2B .0100, .0200, and .0300. Currently the water quality standard for manganese is a daily maximum
limit of 200 lag/L.
9. Zinc: This requirement applies only to wastewater discharges from plants that use water treated with zinc orthophosphate for
backwashing filters.
10. Fluoride: This requirement applies only to wastewater discharges from plants that backwash with fluoridated fmished water.
b. SAMPLES SHALL BE TAKEN AT THE OUTFALL BUT PRIOR TO MIXING WITH THE RECEIVING WATERS
c. THERE SHALL BE NO DISCHARGE OF FLOATING SOLIDS OR FOAM IN OTHER THAN TRACE AMOUNTS.
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K. Final 2016 Integrated Report -All Assessed Waters
EMvirud Yadkin River Headwaters Subbasin Yadkin -Pee Dee River Basin
a+ty
Assessment Unit Name Assessment Unit Description
Assessment Unit Number Water Quality Classification Length/Area Units
Mill Creek
From source to Mitchell River
12-62-4
B;Tr,ORW 3.3
FW Miles
Assessment Criteria Status
Reason for Rating Parameter of Interest
Category
Meeting Criteria
Good -Fair J Benthos (Nar, AL, FW)
1
Mitchell River
From source to mouth of Christian Creek (North Fork Mitchell River)
12-62-(1)
B;Tr,ORW 8.5
FW Miles
Assessment Criteria Status
Reason for Rating Parameter of Interest
Category
Meeting Criteria
Excellent Benthos (Nar, AL, FW)
1 ��
Mitchell River
From South Fork Mitchell River to Yadkin River
12-62-(12.5)
C 6.9
FW Miles
Assessment Criteria Status
Reason for Rating Parameter of Interest
Category
Meeting Criteria
< 10% Water Temperature (292C, AL, MT&UP)
1
Meeting Criteria
< 10% Turbidity (50 NTU, AL, FW miles)
1
Meeting Criteria
< 10% pH (9.0, AL, FW)
1
Meeting Criteria
< 10% pH (6 su, AL, FW)
1
Meeting Criteria
< 10% (Dissolved Oxygen (4 mg/I, AL, FW)
1
Meeting Criteria
Good Benthos (Nar, AL, FW)
1
Meeting Criteria
FCB AP GM<200 and <2*46 [Fecal Coliform (GM 200/400, REC, FW)
1
Moores Fork
From source to Stewarts Creek
12-72-9-5
WS-IV 5.3
FW Miles
Assessment Criteria Status
Reason for Rating Parameter of Interest
Category
Meeting Criteria
Good -Fair Benthos (Nar, AL, FW)
1
Moravian Creek (Yellow Jacket From source to Yadkin River
Lake)
12-39
C 11.4
FW Miles
Assessment Criteria Status
Reason for Rating Parameter of Interest
Category
Meeting Criteria i
Good -Fair Benthos (Nar, AL, FW)
1
4/11/2018 2016 Integrated Report -All Assessed Waters Page 1169 of 1306
Fish tissue assessments for mercury apply to all waters and are not individually listed

DocuSign Envelope ID: E8F5795C-4481-4A8B-AA44-8E4885D0731F
MONITORING REPORT(MR) VIOLATIONS for:
Report Date:
12/06/18 Page:
1 of 1
Permit: NCO088498
MRS Between 11 - 2013 and 10 - 2018
Region:
%
Violation Category%
Program Category:
Facility Name: %
Param Name %
County:
%
Subbasin:%
Violation Action: %
Major Minor: %
PERMIT: NCO088498
FACILITY:
Aqua North Carolina Inc - Mitchell Bluff Subdivision Well
COUNTY: Surry
REGION: Winston-Salem
#1
Limit Violation
MONITORING OUTFALL/
VIOLATION
UNIT OF
CALCULATED %
REPORT PPS
LOCATION
PARAMETER
DATE
FREQUENCY
MEASURE
LIMIT
VALUE Over
VIOLATION TYPE
VIOLATION ACTION
05 -2018 001
Effluent Chlorine,
Total Residual
05/01/18
2 X month
ug/I
17
23 35.3
Daily Maximum
No Action, BPJ
Exceeded
Monitoring Violation
MONITORING OUTFALL/
VIOLATION
UNIT OF
CALCULATED %
REPORT PPS
LOCATION
PARAMETER
DATE
FREQUENCY
MEASURE
LIMIT
VALUE Over
VIOLATION TYPE
VIOLATION ACTION
08 -2016 001
Effluent
Turbidity
08/31/16
2 X month
ntu
Frequency Violation
No Action, BPJ
10 -2016 001
Effluent
Turbidity
10/31/16
2 X month
ntu
Frequency Violation
No Action, BPJ

DocuSign Envelope ID: E8F5795C-4481-4A8B-AA44-8E4885D0731F
United States Environmental Protection Agency
Form Approved.
EPA Washington, D.C. 20460
OMB No. 2040-0057
Water Compliance Inspection Report
Approval expires 8-31-98
Section A: National Data System Coding (i.e., PCS)
Transaction Code NPDES yr/mo/day Inspection Type
Inspector Fac Type
1 IN I 2 IF I 3 I NCO088498 111 12 I 18/11/06 I17
18 I S J
19 L G] 201 I
211111 I I I I I I II I I I I I I I I I I I I I I I I I
I I I I I
I II I I I I I f6
Inspection
Work Days Facility Self -Monitoring Evaluation Rating B1 QA
----------------------
Reserved -------------------
671
70 I I 71 I I 72 I r I
u I�
73 I I 174 751 I I I I I I I80
I I i
Section B: Facility Data
Name and Location of Facility Inspected (For Industrial Users discharging to POTW, also include
Entry Time/Date
Permit Effective Date
POTW name and NPDES oermit Number)
11:00AM 18/11/06
14/05/01
Mitchell Bluff Subdivision Well #1
Mitchell Cove Rd
Exit Time/Date
Permit Expiration Date
Elkin NC 28621
11:30AM 18/11/06
18/12/31
Name(s) of Onsite Representative(s)/Titles(s)/Phone and Fax Number(s)
Other Facility Data
Name, Address of Responsible Official/Title/Phone and Fax Number
Contacted
Joseph R Pearce,202 Mackenan Crt Cary NC 27511/Director of
Operations/919-653-6964/9194601788 No
Section C: Areas Evaluated During Inspection (Check only those areas evaluated)
Other
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
(See attachment summary)
Name(s) and Signature(s) of Inspector(s) Agency/Office/Phone and Fax Numbers
Date
Gary Hudson Division of Water Quality//336-776-9694)
Signature of Management Q A Reviewer Agency/Office/Phone and Fax Numbers
Date
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete.
Page#

DocuSign Envelope ID: E8F5795C-4481-4A8B-AA44-8E4885D0731F
NPDES yr/mo/day Inspection Type (Cont.)
NCO088498 I11 121 18/11/06 117 18 JCJ
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
November 26, 2018
Shannon V. Becker, President
Aqua NC, Inc.
202 MacKenan Court
Cary, NC 27511
Subject: Compliance Evaluation Inspection
Nine Greensand Filtration Water Treatment Systems
NPDES Permit No. NC0088536, NC0088552, NC0088528, NC0088625, NC0088498, NC0088633,
NC0088617, NC0088609, NC0088854.
Dear Mr. Becker:
On November 6, 2018, Gary Hudson of this office met with William Young, ORC of Aqua NC, to
perform a Compliance Evaluation Inspection on the nine NPDES permitted greensand water filtration
plants located throughout Surry County. This type of inspection consists of two basic parts: an
in -office file review and an on -site inspection of the treatment facility. The findings and observations
are outlined below:
Bannertown Hills Subdivision Well # 2 — NC0088536
Location: Town Lane, Mount Airy, NC 27030
Permitted Flow: 0.0016 MGD
Discharge Point: Discharges into a flexible black plastic pipe that runs 100' downhill to the west of the
plant, and eventually into an unnamed tributary to Faulkner Creek in the Yadkin -Pee Dee River Basin.
Colonial Woods Subdivision — Wells 1 & 2 — NC0088552
Location: Atkins Lane, Mount Airy, NC 27030
Permitted Flow: 0.002 MGD
Discharge Point: Discharges into a drain pipe that runs 100' downhill to the north of the plant, and
eventually into an unnamed tributary to Bull Creek, a class "C" water in the Yadkin — Pee Dee River
Basin.
Hillcrest Subdivision — Well # 3 — NC0088528
Location: Lynnewood Drive, Mount Airy, NC 27030
Permitted Flow: 0.00168 MGD
Discharge Point: Discharges under pressure into an underground gravel pit approximately 50'
northwest of the water plant, and eventually into an unnamed tributary to Champ Creek, a class "C"
water in the Yadkin -Pee Dee River Basin.
Page# 2

DocuSign Envelope ID: E8F5795C-4481-4A8B-AA44-8E4885D0731F
Permit: NCO088498 Owner - Facility: Mitchell Bluff Subdivision Well #1
Inspection Date: 11/06/2018 Inspection Type: Compliance Evaluation
The Hollows Subdivision — Well # 1 — NCO088625
Location: Lois Lane, Mount Airy, NC 27030
Permitted Flow: 0.002 MGD
Discharge Point: Approximately 100' southwest of water plant, and eventually into an unnamed
tributary to Stewarts Creek, class "C" waters in the Yadkin — Pee Dee River Basin.
Mitchell Bluff Subdivision — Well # 1 — NCO088498
Location: Mitchell Cove Road, Elkin, NC 28621
Permitted Flow: 0.00168MGD
Discharge Point: Into a PVC pipe that runs 100' to the west of the water plant, and eventually into an
unnamed tributary to the Mitchell River in the Yadkin — Pee Dee River Basin.
Reeves Woods Subdivision — Well # 2 — NCO088633
Location: Reeves Mill Road, Mount Airy, NC 27030
Permitted Flow: 0.002 MGD
Discharge Point: 100' east of the water plant at the tree line, and eventually into an unnamed tributary
to Rutledge Creek in the Yadkin — Pee Dee River Basin.
Snow Hill Subdivision — Well # 1 — NCO088617
Location: Snow Hill Drive, Dobson, NC 27017
Permitted Flow: 0.00252 MGD
Discharge Point: Approximately 100' south of the water plant into a field, and eventually into an
unnamed tributary to Cody Creek, class "C" waters in the Yadkin — Pee Dee River Basin.
Windgate Subdivision — Well # 1 — NCO088609
Location: Simmons Road, Dobson, NC 27017
Permitted Flow: 0.00168 MGD
Discharge Point: 100' southwest of the water plant, and eventually into an unnamed tributary to the
Fisher River, class "C" waters in the Yadkin — Pee Dee River Basin.
Pine Lakes Subdivision — Well # 2 — NCO088854
Location: Gloria Road, Mount Airy, NC 27030
Permitted Flow: 0.002 MGD
Discharge Point: The equipment for the greensand filtration has recently been installed.
All of these sites appeared to be clean and well maintained. No problems or concerns were
noted.Should you have any questions concerning this report, please contact Gary Hudson or me at
[phone].
Sincerely,
Sherri V. Knight, P.E.
Regional Supervisor
Page# 3

DocuSign Envelope ID: E8F5795C-4481-4A8B-AA44-8E4885D0731F
Permit: NCO088498 Owner - Facility: Mitchell Bluff Subdivision Well #1
Inspection Date: 11/06/2018 Inspection Type: Compliance Evaluation
Water Quality Regional Operations
Division of Water Resources
cc: Central Files
WSRO
Page#

DocuSign Envelope ID: E8F5795C-4481-4A8B-AA44-8E4885D0731F
Permit: NCO088498
Inspection Date: 11/06/2018
Other
Comment: See Summary
Owner - Facility: Mitchell Bluff Subdivision Well #1
Inspection Type: Compliance Evaluation
Yes No NA NE
Page#

DocuSign Envelope ID: E8F5795C-4481-4A8B-AA44-8E4885D0731F
Denard, Derek
From: Denard, Derek
Sent: Thursday, December 06, 2018 11:28 AM
To: Hudson, Gary; Boone, Ron
Cc: Knight, Sherri
Subject: Aqua North Carolina Inc. - Greensand WTP Renewals/Transfers to coverage under NCG590000
Gary & Ron,
The following is a list of Aqua greensand WTP permits that are up for renewal:
Permit
Owner
Facility
County
Expires
NCO088498
Aqua North Carolina, Inc.
Mitchell Bluff - Well #1
Surry
12/31/2018
NCO088609
Aqua North Carolina, Inc.
Windgate Subdivision
Surry
1/31/2019
NCO088528
Aqua North Carolina, Inc.
Hillcrest Subdivision - Well #3
Surry
12/31/2018
NCO088536
Aqua North Carolina, Inc.
Bannertown Hills Subdivision - Well #2
Surry
12/31/2018
Colonial Woods Subdivision - Wells 1
NCO088552
Aqua North Carolina, Inc.
and 2
Surry
1/31/2019
NCO088854
Aqua North Carolina, Inc.
Pine Lakes Subdivision - Well #2
Surry
1/31/2019
NCO088617
Aqua North Carolina, Inc.
Snow Hill subdivision
Surry
2/28/2019
NCO088625
Aqua North Carolina, Inc.
The Hollows subdivision
Surry
2/28/2019
NCO088633
Aqua North Carolina, Inc.
Reeves Woods Subdivision Well #2
Surry
2/28/2019
NCO088501
Aqua North Carolina, Inc.
Stonington Subdivision - Well #1
Forsyth
2/28/2019
Aqua has indicated that they would like to have coverage under the general permit for these. Most likely all of them will
be converted to General Permit NCG590000. Please note that conversion to the general permit will not require public
notice. We should be able to process these renewals/conversions in a couple of week instead of months. I would like to
knock out the 3 that expire this month by December 31. Please let me know if you have any comments or staff reports
(e-mail is fine) for any of these facilities.
Thanks,
Derek C Denard
Environmental Specialist
Compliance & Expedited Permitting Unit
N.C. Division of Water Resources
N.C. Department of Environmental Quality
919 707 3618 office
919 707 9000 main DWR
[e-mail]
N. C. Division of Water Resources
Water Quality Permitting Section - NPDES
1617 Mail Service Center
Raleigh, NC 27699-1617
Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties.
1

DocuSign Envelope ID: E8F5795C-4481-4A8B-AA44-8E4885D0731F

DocuSign Envelope ID: E8F5795C-4481-4A8B-AA44-8E4885D0731F
Denard, Derek
From: Weaver, Charles
Sent: Friday, February 22, 2019 10:28 AM
To: Denard, Derek
Subject: RE: Aqua Greensands to convert to NCG59 in BIMS
See details below
From: Denard, Derek
Sent: Thursday, February 21, 2019 12:16 PM
To: Weaver, Charles <[e-mail]>
Subject: Aqua Greensands to convert to NCG59 in BIMS
Charles,
Below is a list of greensands that can be converted to NCG59.
NC0088498
Aqua North Carolina, Inc.
NC0088609
Aqua North Carolina, Inc.
NC0088528
Aqua North Carolina, Inc.
NC0088536
Aqua North Carolina, Inc.
NC0088552
Aqua North Carolina, Inc.
NC0088617
Aqua North Carolina, Inc.
NC0088625
Aqua North Carolina, Inc.
NC0088633
Aqua North Carolina, Inc.
Mitchell Bluff - Well #1-> NCG590024
Windgate Subdivision -> NCG590025
Hillcrest Subdivision - Well #3 -> NCG590026
Bannertown Hills Subdivision - Well #2 -> NCG590027
Colonial Woods Subdivision - Wells 1 and 2 -> NCG590028
Snow Hill subdivision -> NCG590029
The Hollows subdivision -> NCG590030
Reeves Woods Subdivision Well #2 -> NCG590031
Please let me know what the COC numbers are.
By the way, I have two others that may end up as individual permits because of a possible Zinc limit.
Thanks,
Derek C Denard
Environmental Specialist
Compliance & Expedited Permitting Unit
N.C. Division of Water Resources
N.C. Department of Environmental Quality
919 707 3618 office
919 707 9000 main DWR
derek.denard(aD_ncdenr.gov
N. C. Division of Water Resources
Water Quality Permitting Section - NPDES
1617 Mail Service Center
Raleigh, NC 27699-1617
Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties.
1

DocuSign Envelope ID: E8F5795C-4481-4A8B-AA44-8E4885D0731F

DocuSign Envelope ID: E8F5795C-4481-4A8B-AA44-8E4885D0731F
Denard, Derek
From: Denard, Derek
Sent: Monday, February 25, 2019 11:10 AM
To: '[e-mail]'
Cc: Hudson, Gary; Kinney, Maureen
Subject: DRAFT COC NCG590024 Aqua, Inc. -Mitchell Bluff -Well #1
Attachments: NCG590024 Mitchell Bluff -Well 1 COC 2019.pdf
Ms. Owens,
Please find the attached draft of certification of coverage (COC) NCG590024 for Aqua, Inc. -Mitchell Bluff -Well #1. Please
review this document to assure your understanding of the permit limits and monitoring conditions, and to correct
errors, if any. Please provide any comments to me via email [[e-mail]] or write to my attention care of
DEQ/ DWR / NPDES Program no later than March 11, 2019.
Sincerely,
Derek C Denard
Environmental Specialist
Compliance & Expedited Permitting Unit
N.C. Division of Water Resources
N.C. Department of Environmental Quality
919 707 3618 office
919 707 9000 main DWR
derek.denard(a_ncdenr.gov
N. C. Division of Water Resources
Water Quality Permitting Section - NPDES
1617 Mail Service Center
Raleigh, NC 27699-1617
Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties.

DocuSign Envelope ID: E8F5795C-4481-4A8B-AA44-8E4885D0731F
Denard, Derek
From: Denard, Derek
Sent: Friday, March 08, 2019 11:42 AM
To: Kinney, Maureen
Subject: RE: DRAFT COC NCG590025 Aqua North Carolina, Inc. - Windgate Subdivision - Well #1
Maureen,
Yes, this one is being converted to coverage under the general permit for water treatment plants. Did you see the one
from a couple of weeks ago? It was NCG590024. Should these be PC-1 or PCNC? They are greensand water treatment
systems. By the way, I will be copying you on 6 others that are being converted to the general permit.
Thanks,
Derek C Denard
Environmental Specialist
Compliance & Expedited Permitting Unit
N.C. Division of Water Resources
N.C. Department of Environmental Quality
919 707 3618 office
919 707 9000 main DWR
derek.denardCcDncdenr.aov
N. C. Division of Water Resources
Water Quality Permitting Section - NPDES
1617 Mail Service Center
Raleigh, NC 27699-1617
Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties.
From: Kinney, Maureen
Sent: Friday, March 08, 2019 8:55 AM
To: Denard, Derek <[e-mail]>
Subject: RE: DRAFT COC NCG590025 Aqua North Carolina, Inc. - Windgate Subdivision - Well #1
Is this replacing an old NC00 permit?
Thanks!
Maureen
From: Denard, Derek
Sent: Thursday, March 07, 2019 5:43 PM
To: [e-mail]
Cc: Hudson, Gary <[e-mail]>; Kinney, Maureen <[e-mail]>
Subject: DRAFT COC NCG590025 Aqua North Carolina, Inc. - Windgate Subdivision - Well #1

DocuSign Envelope ID: E8F5795C-4481-4A8B-AA44-8E4885D0731F
Ms. Owens,
Please find the attached draft of certification of coverage (COC) NCG590025 Aqua North Carolina, Inc. - Windgate
Subdivision - Well #1. Please review this document to assure your understanding of the permit limits and monitoring
conditions, and to correct errors, if any. Please provide any comments to me via email [[e-mail]] or
write to my attention care of DEQ / DWR / NPDES Program no later than March 21, 2019.
Sincerely,
Derek C Denard
Environmental Specialist
Compliance & Expedited Permitting Unit
N.C. Division of Water Resources
N.C. Department of Environmental Quality
919 707 3618 office
919 707 9000 main DWR
derek.denardancdenr.aov
N. C. Division of Water Resources
Water Quality Permitting Section - NPDES
1617 Mail Service Center
Raleigh, NC 27699-1617
Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties.

PP DocuSign Envelope ID: E8F5795C-4481-4A8B-AA44-8E4885D0731F
1:12,000
Elkin North
7.5-minute Quadrangle
urry
OR, n
Index map
Mitchell Bluff Subdivison - Well # 1 Horizon Engineering & Consulting, Inc.
USGS Map - Existing Well Location 2510 Walker Road
Mt. Pleasant, N.C. 28124 February 27, 2007
Elkin, N.C. Scale: 1:12,000

DocuSi n Envelope ID: E8F5795C-4481-4A8B-AA44-8E4885D0731F
Mitchell Bluff Subdivison - Well # 1
Aerial Photo
North
Horizon Ekqineerin-q & Consulting, Inc.
2510 Walker Road
Mt. Pleasant, N.C. 28124 February 27, 2007
Scale: 1" = 450'

DocuSign Envelope ID: E8F5795C-4481-4A8B-AA44-8E4885D0731F
Water Resources
UNWRONMENCAL QUALITY
July 09, 2018
Shannon V. Becker, President
Aqua North Carolina Inc
202 Mackenan Ct
Cary, NC 27511
Subject: Permit Renewal
Application No. NCO088498
Mitchell Bluff Subdivision Well #1
Surry County
Dear Applicant:
ROY COOPER
G�m�sr,�r
A4IICHAEL 8- REGAIN
secrekz
LINDA CULPEPPER
Alerhn Dirsclor
The Water Quality Permitting Section acknowledges the July 6, 2018 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. 150E-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,
1L
Wren Thed ord
Administrative Assistant
Water Quality Permitting Section
ec: WQPS Laserfiche File w/application(WSRO)
State of North Carolina I Environmental Quality I Water Resources
1617 Mail Service Center I Raleigh, North Carolina 27699-1617
919-807-6300

DocuSign Envelope ID: E8F5795C-4481-4A8B-AA44-8E4885D0731F
June 25, 2018
Mr. Wren Thedford
Compliance and Expedited Permitting Unit
DWR, NCDEQ
1617 Mail Service Center
Raleigh, NC 27699-1617
Re: Application for Permit Renewal
Aqua North Carolina, Inc.
Mitchell Bluff Subdivision, Well #1 - WTP
NPDES Permit NCO088498
Dear Mr. Thedford:
RECEIVED/DENR/DWR
JUL 0 6 2018
Water Resources
Permitting Section
Enclosed are three (3) copies of the completed application Form D-WWTP. This submittal includes the
necessary attachments for your office to renew the subject permit.
Aqua of North Carolina, Inc. (AQUA) has also reviewed the Division of Water Resource's General
Permit NCG5900000 for Greensand WTP Effluent Limitations and Monitoring Requirements -
Discharging to Freshwater, and AQUA hereby request that treated discharge from Mitchell Bluff
Subdivision — Well #1 be considered for coverage under this General Permit. AQUA understands that if
Coverage under a General Permit is granted, the Division will rescind individual NPDES Permit
NC0088498.
If there are any questions or concerns with our request, please do not hesitate to contact me at
aaowensp,aquaamerica.com or 919-653-6965.
Best regards,
Ama da Owens
Manager, Environmental Compliance
cc: Laurie Ison
Joseph Pearce
Shannon Becker

DocuSign Envelope ID: E8F5795C-4481-4A8B-AA44-8E4885D0731F
NPDES PERMIT APPLICATION a SHORT FORM O - WTP
For discharges associated with water treatment plants
Mail the complete application to:
N. C. Department of Environment and Natural Resources
Division of Water Quality / NPDES Unit
1617 Mail Service Center, Raleigh, NC 27699-1617
NPDES Permit Number INCO088498
If you are completing this form in computer use the TAB key or the up — down arrows to move from one
field to the next. To check the boxes, click your mouse on top of the box. Otherwise, please print or type.
1. Contact Information:
Owner Name Aqua North Carolina, Inc.
Facility Name Mitchell Bluff Subdivision- Well #1
Mailing Address 202 Mackenan Ct
City
State / Zip Code
Telephone Number
Fax Number
e-mail Address
Cary
NC / 27511
[phone]
[phone] RECEIVE®/nNR/®WR
[e-mail] 018
2. Location of facility producing discharge:
Check here if same as above ❑
Street Address or State Road
City
State / Zip Code
County
Mitchell Cove Road
Elkin
NC / 28621
Surry
Water Resources
Permitting Section
3. Operator Information:
Name of the firm, consultant or other entity that operates the facility. (Note that this is not referring to the
Operator in Responsible Charge or ORC)
Name Aqua North Carolina, Inc.
Mailing Address 4163 Sinclair Street
City Denver
State / Zip Code NC / 28037
Telephone Number [phone]
Fax Number [phone]
4. Ownership Status:
Federal ❑ State ❑
5. Type of treatment plant:
Private
Public ❑
Pagel of 3 C-WTP 03/05

DocuSign Envelope ID: E8F5795C-4481-4A8B-AA44-8E4885D0731F
IMP DES PERMIT APPLICATION ® SHORT FORM O m WTP
For discharges associated with water treatment plants
❑ Conventional (Includes coagulation, flocculation, and sedimentation, usually followed by
filtration and disinfection)
❑ Ion Exchange (Sodium Cycle Cationic ion exchange)
® Green Sand Filter (No sodium recharge)
❑ Membrane Technology (RO, nanofiltration)
Check here if the treatment process also uses a water softener ❑
b. Description of source water(s) (i.e. groundwater, surface water)
Groundwater well
7. Describe the treatment process(es) for the raw water:
Greensand filtration using potassium permanganate. Chlorine added for disinfection and
caustic soda added for pH adjustment.
S. Describe the wastewater and the treatment process(es) for wastewater generated by the
facility:
Wastewater discharge is the backwash of the green sand filters. Discharge rate is
approximately 720 gallons per day.
9. Number of separate discharge points: 1
Outfall Identification number(s) 001
10. Frequency of discharge: Continuous ❑ Intermittent IK
If intermittent:
Days per week discharge occurs: 4 Duration: Approx. 20 minutes
11. Plant design potable flowrate .05184 MGD
Backwash or reject flow 0.00072 MGD
12. Name of receiving stream(s) (Provide a map showing the exact location of each outfall, including
latitude and longitude): j
Unamed tributary to Mitchell River ( Yadkin- Pee Dee River Basin) j
13. Please list all water treatment additives, including cleaning chemicals or disinfection
treatments, that have the potential to be discharged. i
Page 2 of 3 C-WTP 03/05

DocuSign Envelope ID: E8F5795C-4481-4A8B-AA44-8E4885D0731F
NPDEB PERMIT APPLICATION e SHORT FORM C - WTP
For discharges associated with water treatment plants
Potassium permanganate
Chlorine
Caustic soda
14. Is this facility located on Indian country? (check one)
Yes ❑ No
15. Additional Information:
e Provide a schematic of flow through the facility, include flour volumes at all points in
the treatment process, and point of addition of chemicals.
Solids Handling Plan
16. NEW Applicants
Information needed in addition to items 1-15:
New applicants must contact a permit coordinator with the NCDENR Customer
Service Center.
Was the Customer Service Center contacted? ❑ Yes ❑ No
D Analyses of source water collected
Engineering Alternative Analysis
Discharges from -Ion Exchange and Reverse Osmosis plants shall be evaluated using a
water quality model.
17. Applicant Certification
I certify that I am familiar with the information contained in the application and that to the
best of my knowledge and belief such information is true, complete, and accurate.
Amanda A. Owens Mgr,Environmental Compliance
Prir4ed name of Person Signin Title
, 0WA aAAYA (-.,o �z �—// b
of Applicant
Date
North Carolina General Statute 143-215.6 (b)(2) provides that: Any person who knowingly makes any false
statement representation, or certification in any application, record, report, plan, or other document files or
required to be maintained under Article 21 or regulations of the Environmental Management Commission
implementing that Article, or who falsifies, tampers with, or knowingly renders inaccurate any recording or
monitoring device or method required to be operated or maintained under Article 21 or regulations of the
Environmental Management Commission implementing that Article, shall be guilty of a misdemeanor punishable
by a fine not to exceed $25,000, or by imprisonment not to exceed six months, or by both. (18 U.S.C. Section
1001 provides a punishment by a fine of not more than $25,000 or imprisonment not more than 5 years, or both,
for a similar offense.)
Page 3 of 3 C-WTP 03/05

DocuSign Envelope ID: E8F5795C-4481-4A8B-AA44-8E4885D0731F
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qua
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Mitchell Bluff Subdivision W
atitude 3601T Ol'.' N State Grid: Ellin NQrdi
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onettud80"'47,05" W PernuttedFlow; 00068iv16D
Stream Class: C NPD Perm No NC 088495
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Iraina a Basins Yadkin•Pec Dee River Basin 9uh Aatitn: 03-07.0

DocuSign Envelope ID: E8F5795C-4481-4A8B-AA44-8E4885D0731F
AQUA..
SLUDGE MANAGEMENT PLAN
For
Aqua North Carolina, Inc.
No sludge will be treated on any wastewater treatment plant site operated
by Aqua N.C., Western Division
Where practical, sludge removed from a Aqua N.C., Western Division
facility will be transported via a contract hauler to another Aqua N.C.,
Western Division facility for the purpose of "seeding" a new or under
loaded plant.
Unusable (or "dead") sludge will be removed by a contract hauler and
properly disposed of in accordance with NCGS 143-215.1. Contract
haulers used by Aqua N.C., Western Division will be required to
report the quantity of sludge transported and identify the location of
the proposed disposal site if the sludge is not taken to an existing
plant operated by Aqua N.C., Western Division. Aqua N.C., Western
Division has not entered into any agreement to accept sludge into its
facilities from plants not owned by them.
Aqua N.C., Western Division will keep records on the quantity of sludge
removed from each facility, the name of the contract hauler, and the
destination of the sludge (whether used in another plant or disposed of).
The information will be kept on file and will be made available to any
regulatory agency having jurisdiction over sludge treatment or disposal.
Aqua N.C., Western Division includes all of the facilities under the
jurisdiction of the Winston-Salem Regional Office.
202 MacKenan Court, Cary, NC, 27511 • 919.467.8712 • AquaAmerica.com