NCG590025_Fact Sheet_20190408 (2)

DocuSign Envelope ID: 09F4D88F-8028-41DB-9B04-7748E9805B81
Fact Sheet
NPDES Permit No. COC NCG590025 (formerly NCO088609
Permit Writer/Email Contact: Derek Denard, [e-mail]
Date: 08Apr2019
Division/Branch: NC Division of Water Resources/Water Quality Permitting Section
Compliance & Expediated Permitting Branch
Fact Sheet Template: Version 28Mar2019
Permitting Action:
❑X Renewal
❑ Renewal with Expansion
❑ New Discharge
❑ Modification (Fact Sheet should be tailored to mod request)
[See Attachment A: NCO088609 Renewal Application, FORM C-WTP]
Complete applicable sections below. If not applicable, enter NA.
1. Basic Facility Information
Facility Information
Applicant/Facility Name:
Aqua North Carolina, Inc. / Windgate Subdivision — Well #1 WTP
Applicant Address:
202 Mackenan Ct, Cary, NC 27511
Facility Address:
Simmons Rd, Mt. Airy, NC 27030
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
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 0.018 MGD, a design backwash/reject flow of 0.002 and a maximum, monthly average
wastewater discharge of 0.0014 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. [See Attachment A: NCO088609 Renewal Application, FORM C-WTP]
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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 B: 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 Fisher River
Stream Segment:
12-63-(9)b
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 D: 2016 Final Integrated Report, p.1154
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 0304010107041
USGS Topo Quad:
Dobson, NC
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3. Effluent Data Summary
Effluent data is summarized below for the period May2014 through Oct2018.
Table. Effluent Data Summary
Data
Limits
Parameter
Max Min
Average Count MA DM
PQL UoM
Data Errors
00070 - Turbidity
28
0.25
4.73 104
ntu
no
00076 - Turbidity, HCH
15
9.3
11.5 4
ntu
no
Turbidimiter
00400 - pH
8.5
6
108 Not < 6.0 or > 9.0
su
no
01045 - Iron, Total (as Fe)
18
ug/I
yes
01055 - Manganese, Total
18
ug/I
yes
(as Mn)
50050 - Flow, in conduit or
720
903
mgd
no
thru treatment plant
50060 - Chlorine, Total
106 17
20 ug/I
yes
Residual
C0530 - Solids, Total
15.5
2.5
4.8 108 30 45
2.5 mg/I
no
Suspended - Concentration
MA = monthly average; DM = daily maximum;
PQL = practical quantitation limit; UoM = Unit of Measure
Table. Data Errors
Date Parameter
9/29/2015 01045 - Iron, Total (as Fe)
1/19/2016 50060 - Chlorine, Total Residual
6/7/2016 50060 - Chlorine, Total Residual
8/9/2016 01045 - Iron, Total (as Fe)
8/9/2016 01055 - Manganese, Total (as Mn)
10/11/2016 50060 - Chlorine, Total Residual
11/15/2016 01045 - Iron, Total (as Fe)
11/15/2016 01055 - Manganese, Total (as Mn)
11/15/2016 50060 - Chlorine, Total Residual
2/22/2017 01045 - Iron, Total (as Fe)
2/22/2017 01055 - Manganese, Total (as Mn)
5/9/2017 01045 - Iron, Total (as Fe)
5/9/2017 01055 - Manganese, Total (as Mn)
8/1/2017 50050 - Flow, in conduit or thru treatment plant
8/8/2017 50050 - Flow, in conduit or thru treatment plant
8/15/2017 50050 - Flow, in conduit or thru treatment plant
8/29/2017 50050 - Flow, in conduit or thru treatment plant
4/17/2018 50060 - Chlorine, Total Residual
4. Instream Data Summary
UoM
Value
Comments
ug/I
0.14
UoM mg/L?
ug/I
0
PQL?
ug/I
0
PQL?
ug/I
2.14
UoM mg/L?
ug/I
2.64
UoM mg/L?
ug/I
0
PQL?
ug/I
2.64
UoM mg/L?
ug/I
1.19
UoM mg/L?
ug/I
0
PQL?
ug/I
0.109
UoM mg/L?
ug/I
0.105
UoM mg/L?
ug/I
0.101
UoM mg/L?
ug/I
0.09
UoM mg/L?
mgd
0.00014 decimal place?
mgd
0.00014 decimal place?
mgd
0.00014 decimal place?
mgd
0.00014 decimal place?
ug/I
0
PQL?
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).
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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 E:
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 F:
Inspection Report 11/06/2018, 5 pages.
6. Water Quality -Based Effluent Limitations (WQBELs)
Dilution and Mixin.. Zones
hi accordance with 15A NCAC 2B.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/l (summer) and 1.8 mg/l (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.
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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
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
1 SA NCAC 2H. 0107(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 1 SA NCAC 2B.0226 for this permit renewal: NA.
7. Technology -Based Effluent Limitations (TBELs) — NA.
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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.
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.
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12.Summary of Proposed Permitting Actions:
NC0088609 is to be converted to COC NCG590025. The applicable effluent page is found in Section B.
(L) Greensand WTP Effluent Limitations and Monitoring Requirements — Discharging to Freshwater.
[See Attachment C: General Permit NCG590000, Section C. (1), page 3 of 26.]
The facility map was updated to information found in May 2, 2007 Engineering alternatives analysis
(EAA). See Attachment G: Map page from EAA 05-02-2007.
13. Public Notice Schedule:
Not Applicable for Certificates of Coverage (COCs) Under General Permit NCG590000. The general
permit was submitted to public notice.
See Attachments H, I, J and K for comments and correspondence.
14. Fact Sheet Addendum (if applicable): NA.
15. Fact Sheet Attachments (if applicable):
A. NC0088609 Renewal Application, 20181005, 33 pages.
B. General Permit NCG590000 Section A. Coverage, p. 2 of 26.
C. General Permit NCG590000 Section B. (1), p. 3 of 26.
D. 2016 Final Integrated Report, p.1154.
E. NC0088609 DMR Violations Nov2013 to Oct2018, 1 page.
F. NC0088609 Inspection Report 11/06/2018, 5 pages.
G. Map pages from EAA 05-02-2007, 2 pages.
H. Email to WSRO, 20181206, 2 pages.
1. Email Charles Weaver for conversion to NCG590000, 20190222, 2 pages.
J. Email of DRAFT to Permittee_WSRO_Maureen Kinney, 20190307,1 page.
K. Email to Maureen Kinney, 20190308, 1 page.
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DocuSign Envelope ID: 09F4D88F-8028-41DB-9B04-7748E9805B81
ROY COOPER NORTH CAROLINA
Governor Envfronmental Quality
MICa,kEL S- REGAN
Secretmy
LINDA CULPEPPER
Interim Director
October 05, 2018
Shannon V. Becker, President
c/o Amanda Owens
Aqua North Carolina, Inc.
202 Mackenan Court
Cary, NC 27511
Subject: Permit Renewal
Application No. NCOOSS609
Windgate Subdivision - #1
Surry County
Dear Applicant:
The Water Quality Permitting Section acknowledges the October 5, 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. 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.
ec: WQPS Laserfiche File w/application
Sincerely,
Wren Thedford
Administrative Assistant
Water Quality Permitting Section
e:. e-�Z— I E
0�� Gu61,�
North Carolina Department of Environmental Quality I Division of Water Resources
1617 Mail Service Center I Raleigh, North Carolina 27699-1617
919-807-6300

DocuSign Envelope ID: 09F4D88F-8028-41DB-9B04-7748E9805B81
ROY COOPER NORTH CAROLINA
Governor Environmental Quality
-NUCIiAEL S- REGAN
Secretm-�%+
LINDA CULPEPPER
Interim Director
October 05, 2018
Thomas Roberts
Aqua North Carolina Inc
202 Mackenan Ct
Cary, NC 27511
Subject: Permit Renewal
Application No. NCO088609
Windgate Subdivision - #1
Surry County
Dear Applicant:
The Water Quality Permitting Section acknowledges the October 5, 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. 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://deg.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,
'594AW
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

DocuSign Envelope ID: 09F4D88F-8028-41DB-9B04-7748E9805B81
October 4, 2018
_- Mr. Wren_ Thedford....
NDPES Unit
DWR, NCDEQ
1617 Mail Service Center
Raleigh, NC 27699-1617
RE: Application for Permit Renewal
Aqua North Carolina, Inc.
Windgate Subdivision, Well #1- WTP
NPDES Permit NCO088609
Dear Mr. Thedford:
Enclosed are three (3) copies of the completed application Form C-WTP. This
submittal includes necessary attachments for your office to renew the subject
permit.
Aqua North Carolina, Inc -(AQUA) has reviewed the Division of Water Resource's
General Permit NCG5900000 for Greensand WTP Effluent Limitations and
Monitoring Requirements - Discharging to Freshwater, and AQUA hereby requests
that treated discharge from Windgate - 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 NC0088609.
Best Regards,
AYAA- a/t 6t&, &,LT�
Amanda Berger
Manager, Environmental Compliance
cc: Laurie Ison
Joseph _Pearce
Shannon Becker
RECEIVED/DENR/DWR
OCT o 5 201S
Water Resources
Permitting section
202 MacKenan Court, Cary, NC, 27511 - 919.467.8712 • AquaAmerica.com

DocuSign Envelope ID: 09F4D88F-8028-41DB-9B04-7748E9805B81
NPDES PERMIT APPLICATION - SNORT FORM C - 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 INCO088609
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
Facility Name
Mailing Address
City
State / Zip Code
Telephone Number
Fax Number
e-mail Address
Aqua North Carolina, Inc.
Windgate Subdivision - Well # 1 WTP
202 Mackenan Ct
Cary
NC/27511
[phone]
CaryOfficeEFax@,aquaamerica.com
[e-mail]
2. Location of facility producing discharge:
Check here if same as above ❑
Street Address or State Road Simmons Road
City Mt. Airy
State / Zip Code NC/ 27030
County Surry
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 [e-mail]
Pagel of 3 Version 5/2012

DocuSign Envelope ID: 09F4D88F-8028-41DB-9B04-7748E9805B81
NPDES PERMIT APPLICATION - SHORT FORM C - WTP
For discharges associated with water treatment plants
4. Ownership Status:
Federal ❑ State ❑ Private ® Public ❑
S. Type of treatment plant:
❑ 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 ❑
6. Description of source water(s) (i.e. groundwater, surface water)
Groundwater Well
7. Describe the treatment process(es) for the raw water:
Raw water is treated by greensand filters in series with a 0.0016 MGD discharge of filter
backwash wastewater. Chemicals utilized during this process consist of:
• Potassium Permanganate
• Chlorine
Caustic soda
S. Describe the wastewater and the treatment process(es) for wastewater generated by the
facility:
Wastewater discharge from said treatment works at the location specified on the attached
map into an unnamed tributary to Fisher River, classified C waters in- the Yadkin -Pee Dee
River.
9. Number of separate discharge points: 1
Outfall Identification number(s) 001
10. Frequency of discharge: Continuous ❑ Intermittent
If intermittent:
Days per week discharge occurs: 7 Duration: 100 minutes
11. Plant design potable flow rate 0.018 MGD
Backwash or reject flow 0.002 MGD
r J 12. Name of receiving stream(s) (Provide a map showing the exact location of each outfall, including~
latitude and longitude):
Unnamed Tributary to Fisher River (Yadkin Pee Dee Basin)
13. Please list all water treatment additives, including cleaning chemicals or disinfection
treatments, that have the potential to be discharged.
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NPDES PERMIT APPLICATION,- SNORT FORM C - WTP
For discharges associated with water treatment plants
- Alum [aluminum sulfate .,.-- -•-.. -_ _ Yes No Xn_-
`
Iron sulfate / ferrous sulfate Yes No X
Fluoride Yes No X
Ammonia nitrogen / Chloramines Yes No X
Zinc -orthophosphate or sweetwater CP1236 Yes No X
List any other additives below:
Chlorine -
Potassium Permanganate -
14. Is this facility located on Indian country? (check one)
Yes ❑
15. Additional Information:
➢ Provide a schematic of flow through the facility, include flow volumes at all points in
the water treatment process. The plan should show the point[s] of addition for
chemicals and all discharges routed to an outfall [including stormwater].
➢ Solids Handling Plan
o N/A
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
➢ 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 Berger Manager Environmental Compliance Aqua North Carolina Inc
Pri ted name of Person Signing Title
101q V-A -
-_._._-._Signature of Applicant __ .
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.)
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(SEE NOTE 92)

DocuSign Envelope ID: 09F4D88F-8028-41DB-9B04-7748E9805B81
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f4 f i �' • j
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ro
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' •` .` � ,... �•. t Z '� ! ••-_ter
all
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°•�.• � � �• 4 1 •. `` f.,,, 1, — , ! ��t �
•
1' - -
Aqua North Carolina, Inc. Facility
Windgate Subdivision Well #1 WTP Location
atlttdet 36°24'29" N State Grid: Dobson not to scale
Loagitudc: 80° 40' 43" W Permitted Flow: 0.00168 MGD
Beeeivine Strew: UT to Fisher River Stream Class: - C - - n /off �h NPDES Permit No. NCO088609
Drabaate Bain- Yadkin -Pee Dee River Basin Sub -Basin:- 03-07-02 1 Y Surry County

DocuSign Envelope ID: 09F4D88F-8028-41DB-9B04-7748E9805B81
NPDES PERMIT NO.: NCO088609 PERMIT VERSION: 3.0
FACILITY NAME: Wmdgate Subdivision - n 1 CLASS: PCNC
OWNER NAME: Aqua North Carolina Inc ORC, Not Required
GRADE: PCNC ORC HAS CHANGED. No
eDMR PERIOD: 07-2018 (July 2018) VERSION: 10
PERMIT STATUS: Active
COUNTY: Surry
ORC CERT NUMBER: 995491
STATUS Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
-5O°
0Mrt0
sa s0
coo
o104c
nm5c
au070
ma92
F.SDONK
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2 X month
2 X month
2 X month
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Ouaricrl •
I2 X month
ouarle.arKou>
Gal,
Cah
Grab
Gzb
Gr•4b
Grab
Grab
PII
Cn LORI72E
r35•Gmc
IRON
M1fANG'tESf:
TO RBIPTY
7,INC
240P dock
ifn
240C.1..k
tin
1•/jIm
mFd
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uCR
moil
u•
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1053
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343
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is
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16
17
18
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j
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73
24
1439
0-55
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26
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himthlr Ac gr
00014
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055
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343
04
"" No Reporting Reason- ENFRUSE-No Flow-Reuse/Recycle, ENVWTHR= No Visitation -Adverse Weather, NOFLOW =No Flow. HOLIDAY --No Visitation -Holiday

DocuSign Envelope ID: 09F4D88F-8028-41DB-9B04-7748E9805B81
NPDES PERMIT NO.: NC0088609
PERMIT VERSION: 3.0
PERMIT STATUS: Active
FACILITY NAME: Windgate Subdivision - M
CLASS: PCNC
COUNTY: Surry
OWNER NAME: Aqua North Carolina Inc
ORC-.Not Required
ORC CERT NUMBER: 995491
GRADE: PCNC
ORC HAS CHANGED: No
eDMR PERIOD: 07-2018 (July 2019)
VERSION: 1 0
STATUS: Processed
COMPLIANCE STATUS: Compliant
CONTACT PHONE 4: 3369929000
SUBMISSION DATE: 08/22/2018
ORC/Certifies ignature: 'William
Young E-Mail:btyoung rr aquaamenca
com Phone #.[phone] Dale
By this signature, I certify that this report is accurate and complete to the best of my knowledge.
The permittee shall report to the Director or the appropriate Regional. Office any noncompliance that potentially threatens public health or the environment
Any information shall be provided orally within 24 hours from 'he time the pem,ttee became aware of the circumstances. A written submission shall also be
provided within 5 days of the time the permittee becomes aware of the circumstances.
If the facility is noncompliant, please attach a list of corrective actions being taken and a time -table for improvements to be made as required by part ME 6 of
the NPDES permit. tcL 08/22/2018
Permittee/Submitter Signature:*** Dave McDaniel E-h4ail:[e-mail] Phone #•336-992-9000 Date
Permittee Address. 266 Simpson Rd Dobson NC 27017 Penr_it Expiration Date: 01/31/2019
1 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 managed the
system, or those persons directly responsible for gathering the information, the information submitted 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 fines and imprisonment for
knowing violations.
CERTIFIED LABORATORIES
LAD NAME: Water Tech INC, Aqua NC
CERTIFIED LAB #: 50 5035
PERSON(s) COLLECTING SAMPLES: William Young
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit [phone] or by visiting http://portal-ncdeiir org/web/wq/swp/ps/npdes/forms
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data.
* No Flow/Discharge From Site: Check this box if no discharge occurs and, as a result, there are no data to be entered for all of the parameters on the DMR
for entire monitoring period. -
** ORC on Site?: ORC-must visit facility and document visitation of facility as required per 15A NCAC 8G .0204.
*'* Signature of Permittee: If signed by other than the permittee, then delegation of the signatory authority must be on file with the state per 15A NCAC 2B
.0506(b)(2)(D).

DocuSign Envelope ID: 09F4D88F-8028-41DB-9B04-7748E9805B81
NPDES PERMIT NO.: NC0088609
PERMIT VERSION: 3.0
PERMIT STATUS: Active
FACILITY NAME: Windgale Subdivision - 41
CLASS: PCNC
COUNTY: Sury — • _
OWNER NAME: Aqua North Carolina Inc
ORC: Nat Requi:e9
ORC CERT NUMBER: 995491
GRADE: PCNC
ORC HAS CHANGED: No
eDIVIR PERIOD: 06-2018 (.Tune 2018)
VERSION. 1.0
STATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
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01092
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2 X month
2 X mnnm
2 X monib
Otm7erh'
Ouartoly
I2 X month
Ouulvry
lastnntan=ts !Grab
Grub
Grab
Grab
G:aS
Gab
GmF
FLOW
pU
CHLORINE
TSS -Ce+r
fRON
RiA}GhCSE
TURIt1nTY
ZINC
2400 cock
11n
2400 dock
It,,
WRIN
mad
su
urn
mCf
w
rtN
u0/l
1
2
3
4
5
6
7
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9
10
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12
1445
06
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10MI4
6.99
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16
17
18
19
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20
21
22
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*'.* No Repm{mg Reason, F.NFRUSF - No Flow-Reuse/Recycle, ENV WTHR - No V sitatSon - Adverse Weather, NOFLOW = No Flow: 1901-1UAl' = ivo Visitation - nonnay

DocuSign Envelope ID: 09F4D88F-8028-41DB-9B04-7748E9805B81
NPDES PERMIT NO.: NC0088609
-FACILITY NAME: W'indgate Subdivision - f1
OWNER NAME: Aqua North Carolina Inc
GRADE: PCNC
eDMR PERIOD: 06-2018 (June 2018)
COMPLIANCE STATUS: Compliant
PERMIT VERSION: 3.0
CLASS: PCNC
ORC: Not Required
ORC HAS CHANGED: No
VERSION: 10
CONTACT PHONE #: [phone]
PERMIT STATUS: Active
COUNTY: Sur:v, .-- _ _
ORC CERT NUMBER: 995491
STATUS: Processed
SUBMISSION DATE: 07/23/2018
07/20/203 8
ORC/Certifier, ignatuJ 4itiliiam Young 3-Mail:[e-mail] Phone #•704-507-3303 Date
By this signature. I certify that this report is accurate and complete to the best of my knowledge.
The permittee shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment.
Any information shall be provided orally within 24 hours from the time the permittee became aware of the circumstances. A written submission shall also be
provided within 5 days of the time the permittee becomes aware of the circumstances.
If the facility is noncompliant, please attach a list of corrective actions being taken and a time -table for improvements to be made as required by part I1.E.6 of
the NPDES permit.
I t C L—O.—� 07/73/2018
Permittee/Submitter Signature-*** Dave McDaniel E-Mail•[e-mail] Phone 4:336.992-9000 Date
Permittee Address: 266 Simpson Rd Dobson NC 27017 Permit Expiration Date: 01/3112019
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 ofthe person or persons who managed the
system, or those persons directly responsible for gathering the _nfonnation, the information submitted 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 fines and imprisonment for
knowing violations.
CERTIFIED LABORATORIES
LAB NAME: Water Tech INC, Aqua NC
CERTIFIED LAB #: 50 5035
PERSON(s) COLLECTING SAMPLES: William Young
PARAMETER CODES
Parameter Code assistance may be obtained by calling the N`PDES Unit [phone] or by visiting http.//portal.ncdenr org/web/wh/swp/ps/npdes/forms
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data.
* No Flow/Discharge From Site- Check this box if no discharge occurs and, as a result, there are no data to be entered for all of the parameters on the DMR
- for entire monitoring period.-
* ORC on -Site?: ORC must -visit facility and-dtcument visitann of facility as required per 15A NCAC 8G .0204_1,
**" Signature of Permittee: If signed by other than the permittee, then delegation of the signatory authority must be on file with the state per 15A NCAC 2B
.0506(b)(2)(D)

DocuSign Envelope ID: 09F4D88F-8028-41DB-9B04-7748E9805B81
NPDES PERMIT NO : NCO088609
- - FACILITY NAME: Windeate Subdivision - 01
OWNER NAME: Aqua No-tli Carolina Inc
GRADE:PCNC
eDMR PERIOD: 05-2018 (May 2018)
PERMIT VERSION. 3 0
CLASS:PCNC
ORC: Not Required
ORC HAS CHANGED: No
VERSION: LO
PERMIT STATUS: Active
COUNTY, Sorry - --= . - I, --
ORC CERT NUMBER: 995491
STATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
f=
-
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6
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n
-
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u
$
7
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50050
00400
4060
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01045
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or"lu
63092
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2 X month
2 X month
? X month
Ouanerly
Cvartcrly
2Xmonth
Ovx.Rrrry
Instantaneous
Grab
Grab
Grob
Gab
Chat,
Grab
Grab
FLOA
pn
C11LOR]NE
TSS•C—
IRON
M,Ar.GN£6E
TURH113TY
Me
2400 d-k
11.
24000-1,
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m"d
su
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upil
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1434
053
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00014
635
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75
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jj
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7
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9
10
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12
13
14
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1443
0.57
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6,94
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16
17
19
19
20
21
22
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25
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26
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"" No Reporting Reason. ENFRUSE - No I'tow-RcuserRecy c1c; ENV3r7HR= No Vmlatlrn - Adverse Weather; NOFLOW = No Plow, HOLIDAY = No V141tation - Ho'id7y

DocuSign Envelope ID: 09F4D88F-8028-41DB-9B04-7748E9805B81
NPDES PERMIT NO.: NC0088609
FACILiTY NAME: W+ndgate Subdivision - #1
O WNF,R NAME: Aoua Norfn Carolina Inc
GRADE:PCNC
eDMR PERIOD: 05-2018 (May 2018)
COMPLIANCE STATUS: Compliant
PERMIT VERSION: 3.0
CLASS:-FCNC -
ORC: Not Required
ORC HAS CHANGED: No
VERSION: 1.0
CONTACT PHONE 9: 3369929000
PERMIT STATUS: Activc
COUNTY: Surry -,---- 0._
ORC CERT NUMBER: 995491
STATUS: Processed
SUBMISSION DATE: 06126/2018
.M .- - I I- - - . 06/2.6/2018
ORC/Certifier rgnature: illiam Young E-Mail:[e-mail] Phone [phone] Date
By this signature, I certify that this report is accurate and complete to the best of my knowledge.
The permitter shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment.
Any information shall be provided orally within 24 hours from the time the permittee became aware of the circumstances A written submission shall also be
provided within 5 days of the time the permittee becomes aware of the circumstances
If the facility is noncompliant, please attach a list of corrective actions being taken and a time -table for improvements to be made as regLired by part II.E.6 of
the NPDES pernit.
C 06/26/2018
Permrttee/Submitter Signature:*** Dave McDaniel E-Mail.dtmcdaniei@aquaamerica com Phone [phone] Date
Permitter Address: 266 Simpson Rd Dobson NC 27017 Permit Expiration Date: 01/31/2019
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 ofthe person or persons who managed the
system, or those persons directly responsible for gathering the information, the information submitted 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 possibiliry of fines and imprisonment for
knowing violations.
CERTIFIED LABORATORIES
LAB NAME: Water Tech / Aqua North Carolina
CERTIFIED LAB #-. 50 / 5035
PERSON(s) COLLECTING SAl\4PLES: William Young
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit [phone] or by visiting http.//portal ncdenr.orgrweb/wq/swpips/npdes/forms.
FOOTNOTES
Use only units of measurement designated in the reporting facil-ty's NPDES permit for reporting data.
* No Flow/Discharge From Site- Check this box if no discharge occurs and, as a result, there are no data to be entered for all of the parameters on the DMR
for entiremoniloring period.-
**-ORC on Site?:"ORGmust.visit facility and document -visitation -of facility as required per 15A NCAC8G 0204. 1
*** Signature of Permrttee: If signed by other than the permittee, their delegation of the signatory authority must be on file with the state per 15A NCAC 2B
0506(b)(2)(D).

DocuSign Envelope ID: 09F4D88F-8028-41DB-9B04-7748E9805B81
NPDES PERMIT NO : NC0088609 —
PERMIT VERSION: 3.0
FACILITY NAME: Wmdgate Subdivlslon -ill
CLASS: PCNC
OWNER NAME: Aqua North Carolina inc
ORC: Not Required
GRADE:PCNC
ORC HAS CHANGED: No
cDMR PERIOD. 04-2018 (April 2018)
VERSION: 3 0
PERMIT STATUS:-Acnv6-
COUNTY: Suny
ORC CERT NUMBER: 995491
STATUS: Processed
- SAMPLING LOCATION: EFFLUENT, DISCHARGE NO.: 001 . NO DISCHARGE*. NO,,,,
I
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E
U'
s
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9
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6
a
-
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L
wu.." I
u..
4067
cn m
mnaa lem•s
oau n
oms:
MUnOily 12
X month
2 X month
2 X month
anal
Quancrly
2 X mm11h
Quart.-dy
Inslanlanwm
Grab
Gran
G-ab
G1ab
G;ab I
AOmb
Orao
FLOW1+11
CHLORINE
769.Cuna
IRON
f1UNGNESE
TURDIDT'
7a14C
:ton deck
11r. 114aa
dock
H.
YRRN I
mcd
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1346
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291
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4.2
••*•NoReportingReason- ENFRUSE-NoFlow-Rcuse/Recycic, ENV \4THR-No Visltaion -AdrelseWeahcr,-NOFL011=NeFlow; HOLIDAI'=NoVlsrta:ion-Holiday_ _` - - - _ __ _,_ _ . ,

DocuSign Envelope ID: 09F4D88F-8028-41DB-9B04-7748E9805B81
---NPDES PERMIT NO.: NC0D88609
PERMIT VERSION: 3.0
FACILITY NAME: WindgalaSubditnsion- 91
CLASS: PCNC
OWNER NAME: Aqua North Carolina Inc
ORC: Not Required
GRADE: PCNC
ORC HAS CHANGED: No
eDMR PERIOD: 04-2018 (April2018)
VERSION: 3.0
,Outrall o0I - Efiiuea Comments: ,
Reason for revision metals reporting wrong
PERMIT STATUS: Active
COUNTY: Surt
ORC CERT NUMBER: 995491
STATUS: Processed

DocuSign Envelope ID: 09F4D88F-8028-41DB-9B04-7748E9805B81
NPDES PERMIT NO.. NIC0088609
FACILITY NAME: Wmdgate Subdivision - 91
OWNER NAME: Aqua North Carolina Inc
GRADE:PCNC
eDMR PERIOD! 04-2018 (April 2018)
COMPLIANCE STATUS: Compliant
PERMIT VERSION. 3.0
CLASS. PCNC
ORC: Not Rcquircd
ORC HAS CHANGED: No
VERSION: 3-0
CONTACT PHONE #: [phone]
PERMIT STATUS: Active
COUNTY: Sunv
ORC CERT NUMBER: 995491
STATUS • Processed
SUBMISSION DATE: 06110/2018
06/08/2018
ORC/Certifier Sig attire= William Young E-Mail:[e-mail] Phone 4:704-507-3303 Date
By this signature, I certify that this report is accurate and complete to the best of my knowledge.
The permittee shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment
Any information shall be provided orally within 24 hours from the time the permittee became aware of the circumstances. A written submission shall also be
provided within � days of the time the permittce becomes aware of the circumstances
If the facility is noncompliant, please attach a list of corrective actions being taken and a time -table for improvements to be made as required by part II.E.6 of
the NPDES permit
06/10/20I8
Permittee/Submitter Signature:*** Dave McDaniel E-Mail-dtmedaniel@aquaametrica corn Phone #.[phone] Date
Permittee Address: 266 Simpson Rd Dobson NC 27017 Permit Expiration Date: 0113 L2019
I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision 1n 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 managed the
system, or those persons directly responsible for gathering the information, the information submitted 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 fines and imprisonment for
]mowing violations.
CERTIFIED LABORATORIES
LAB NAME: Water Tech
CERTIFIED LAB #: 50
PERSON(s) COLLECTING SAMPLES: William Young
PARAMETER CODS
Parameter Code assistance may be obtained by calling the NPDES Unit [phone] or by visiting http://portal.ncdcar.org/web/wq/swp!ps/npdes/forms.
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data.
* No Flow/Discharge From Site: Check this box if no discharge occurs and, as a result, there are no data to be entered for all of the parameters on the DMR
for entire monitoring period._ _
'* ORC on Site?: ORC must visit facility and document visitation of facility as required per 15A NCAC SG .0204.
*** Signature of Permittee: If signed by other than the permtttee, then delegation of the signatory aud.ority must be on file with the state per I SA NCAC 2B u -
.0506(b)(2)(D)

DocuSign Envelope ID: 09F4D88F-8028-41DB-9B04-7748E9805B81
NPDES PERNIIT NO.: NCO089609 PERMIT VERSION: 3.0 PERMIT STATUS: Active
FACILITY NAME: Windeate Subdivision - F1 CLASS: PCNC COUNTY: Su.-ry
` 'NAME:WNER NAME: Aqua North Carolina Inc -ORC: Not Required ORC.CER E � UMBER: 995.491
GRADE: PCNC ORC HAS CHANGED: No
eDNTR PERIOD: 03-2018 (Yfarch 2019) VERSION: 1,0 STATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
o
_
a
-
-
o
O
=
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56M
0940
SI o
C0530
01045
91055
88870
OIUT.
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2 X month
2 X monm
Z X month
oua=)y
Q=erly
2 X munif,
Quarterly
fnstantm=s
Grab
Gmb
Gab I
Gcab
Grab
Grab
Glib
FLOW
pH
CHLORINE
T58-C.n.
IRON
r1wIGNESE
TURnIIITV
ZINC
3400 d-k
a.2406c1-k
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YIh/N
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ug
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I
2 I
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5
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77
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6
7
8
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9
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12
13
1350
24
1-330
0.48
B
0.0014
69
4
43
i 3
14
I
15
16
l5
19
I
1
2C
I
21
i
12
24
25
Z
27
1458
24
1435
057
B
0,0014
693
47
j
I
11
28
29
I
I
30
31
M-1hty Average Lima•
30
Momhly AvsraB-
U014
4
5.65
ll
Ddy Mndmum
0,0014
6.93
4-
il
I
Omy Mlnlmum
0.0014
6.9
4
4.3
I I
No Reporting Reason ENFRUSE=No Flow-Reuse/Recycle; ENVR'THF - No'y mitation'- 4dvclse P✓eathes, IIOFL0IJ =No Flow, HOLIDAY = to Visttahon iiolldz}''

DocuSign Envelope ID: 09F4D88F-8028-41DB-9B04-7748E9805B81
NPDES PERMIT NO : NC0088609
FACILITY NAME: Wmdgate Subdivision - 91
O WNER NAR'IE: Aqua North Carolina Inc - — —
GRADE:PCNC
eDMR PERIOD: 03-20I8 (March 2018)
CO.N,LPLIANCE STATUS: Compliant
PERMIT VERSION: 3 0
CLASS: PCNC
ORC: Not Required
0RC HAS CHANGED: No
VERSION: 1 0
CON FACT PHONE #: [phone]
PERMIT STATUS: Active
COUNTY: Surry
ORC CERT-NUMBER,.995491
STATUS: Processed
SUBMISSION DATE: 04/25/2018
04/1912018
ORC/Certifie-• •ig r nature: Milani Youfig-E-Mail:[e-mail] Phone Y:704-50?-3303 Date
By this signature, I certify that this report is accurate and complete to the best of my knowledge.
The permittee shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment
Any information shall be provided orally within 24 hours from the time the permittee became aware of the circumstances. A written submission shall also be
provided within 5 days of the time the permittee becomes aware of the circumstances.
If the facility is noncompliant, please attach a list of corrective actions being taken and a time -table for improvements to be made as required by part II.E 6 of
the NPDES permit
) tl'tl sc � 11-2 04/25/2018
Permittee/Submitter Signature-.' Dave McDaniel E-Mail:[e-mail] Phone #:[phone] Date
Permmittee Address: 266 Simpson Rd Dobson NC 27017 Permit Expiration Date: 01/31/2019
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 managed the
system, or those persons directly responsible for gathering the information, the information submitted 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 fines and unprisonment for
knowing violations.
CERTIFIED LABORATORIES
LAB NAME: Water Tech INC
CERTIFIED LAB #: 50
PERSON(s) COLLECTING SAMPLES: William Young
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit [phone] or by visiting http://portal.ncdenr.org/web/wq/swp/ps/npdes/forms.
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data
* No Flow/Discharge From Site: Check this box if no discharge occurs and, as a result, there are no data to be entered for all of the parameters on the DMR
for entire monitoring period.
--- - ** ORC-on Site?.-ORC-must visit facility and document visitation of facility as required per-15A NCAC 8G .0204. - -
***-Sienatute of Pennittee Yf signed -by -other than'theypermittee, then -delegation of -the signatory authority must be onsfrle with the state —per 15A,NCAC.2B _��_
.0506(b)(2)(D).

DocuSign Envelope ID: 09F4D88F-8028-41DB-9B04-7748E9805B81
NPDES PERMIT NO.: NCO099609 PERMIT VERSION: 3.0 PERMIT STATUS: Active
FACILITY NAME:_Wmdgate Subdivision - #1 CLASS:_PCNC COUNTY: SutTy
OWNER NAME: Aqua North Carolina Inc ORC: Not Required ORC CERT NUMBER: 995491
GRADE: PCNC ORC HAS CHANGED: No
eDMR PERIOD: 02-2018 (February 2018) VERSION: 1.0 STATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
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_A4tt No Reporting Reason ENFRUSE=No Flow-Reuse(Recycle; EN-v. - HR—No VlsitBtlo:1—Advcm WeHiller, NOFLOW=No Flow, HOLIDAY=NoymL2Gon—Holiday y

DocuSign Envelope ID: 09F4D88F-8028-41DB-9B04-7748E9805B81
NPDES PERMIT NO.: NCO088609
FACILITY NAME: Windgate Subdivision - #1
OWNER NAME: Aqua North Carolim Inc
GRADE:PCNC
eDMR PERIOD: 02-2018 (February 2018)
COMPLIANCE STATUS: Compliant
PERMIT VERSION: 3.0
- CLASS: PCNC
ORC: Not Required
ORC HAS CHANGED: No
VERSION: l 0
CONTACT PHONE #: [phone]
PERMIT STATUS: Active
COUNTY: Surry - - -
ORC CERT NUMBER: 995491
STATUS- Processed
SUBMISSION DATE: 03/2712018
ORC/Certifio�Signature tiilliam Young E-Mail:btyoung@aquaamerica con Phone #:70a-507-3303
By this signature, I certify that this report is accurate and complete to the best of my knowledge.
03 / 14/2018
Date
The permittee shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment.
Any information shall be provided orally within 24 hours from the time the permittee became aware of the circumstances A written submission shall also be
provided within 5 days of the time the permittee becomes aware of the circumstances
If the facility is noncompliant, please attach a list of corrective actions being taken and a time -table for improvements to be made as required by part U.E 6 of
the NPDES permit
0
03/27/2018
Permittee/Submitter Signature:*** Dave McDaniel E-Mail:[e-mail] Phone #.[phone] Date
Permittee Address. 266 Simpson Rd Dobson NC 27017 Permit Expiration Date: 01/31/2019
1 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 managed the
system, or those persons directly responsible for gathering the information, the information submitted 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 fines and imprisonment for
knowing violations.
CERTIFIED LABORATORIES
LAB NAME- Water Tech
CERTIFIED LAB #: 50
PERSON(s) COLLECTING SAMPLES: William Young
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit [phone] or by visiting http://portal.ncdenr.org/web/wq/swp/ps/npd,-s/forms.
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data.
* No Flow/Discharge From Site: Check this box if no discharge occurs and, as a result, there are no data to be entered for all of the parameters on the DMR
for entire monitoring period.
*-ORC of Site?:'ORC must visit facility and document visitation, of facility -as required.per.l5A NGAG 8G
*** Signature of Permittee: If signed by other than the permittee, then delegation of the signatory authority must be on file with the state per 15A NCAC 2B
.0506(b)(2)(D).

DocuSign Envelope ID: 09F4D88F-8028-41DB-9B04-7748E9805B81
NPDES PERMIT NO.: N00088609 PERMIT VERSION: 3.0
FACII,IT,Y NAME: Windgalc Subdivision - kl CLASS• PCNC
OWNER NAME: Aqua North Carolina Inc ORC: Not Required
GRADE: PCNC ORC HAS CHANGED: No
eDMR PERIOD: 01-2018 (January 2018) VERSION: 1.0
PERMIT STATUS- Active
COUNTY: Surry
ORC CERT NUMBER: 995491
STATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
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DocuSign Envelope ID: 09F4D88F-8028-41DB-9B04-7748E9805B81
NPDES PERMIT NO.: NCO088609
- — FACILITY NAME: Windgate Subdivision - #4
OWNER NAME: Aqua North Carolina Inc
GRADE: PCNC
eDMR PERIOD: 01-2018 (January 2018)
COMPLIANCE STATUS: Compliant
PERYIIT VERSION: 3 0
CLASS: PCNC
ORC: Not Required
ORC HAS CHANGED: No
VERSION: 10
CONTACT PHONE #: [phone]
PERMIT STATUS: Active
_ COUNTY: -Surry_--
ORC CERT NUMBER: 995491
STATUS: Processed
SUBMISSION DATE: 02/2712018
02/15/2018
ORC/Certifier Signature. William Young E-Mail:[e-mail] Phone #:[phone] Date
By this signature, I certify that this report is accurate and complete to the best of my knowled-ge
The permittee shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment.
Any information shall be provided orally within 24 hours from the time the permittee became aware of the circumstances. A written submission shall also be
provided within 5 days of the time the permittee becomes aware of the circumstances.
If the facility is noncompliant, please attach a list of corrective actions being taken and a time -table for improvements to be made as regwred by part II.E.6 of
the NPDES permit.
C� 02/27/2018
Permittee/Submitter Signature:*** Dave McDaniel E-Marl. [e-mail] Phone #:[phone] Date
Permittee Address 266 Simpson Rd Dobson NC 27017 Permit Expiration Date: 01/31/2019
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 managed the
system, or those persons directly responsible for gathering the information, the information submitted 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 fines and imprisonment for
knowing violations.
CERTIFIED LABORATORIES
LAB NAME: Water Tcch INC
CERTIFIED LAB #: 50
PERSON(s) COLLECTING SAMPLES: William Young
PARAMETER CODES
Parameter Codc assistance may be obtained by calling the NPDES Unit [phone] or by visiting http:i/portal.ncdenr org/web/wq/swp/ps/npdcs/forms.
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data.
* No Flow/Discharge From Site- Check this box if no discharge occurs and, as a result, there are no data to be entered for all of the parameters on the DMR
for entire monitoring period. - —
__,_-__-.__** ORC on Site: ORC must visit facility and document visitation of facilty,as-regwred per i5A NCAC 8G .0204.
*** Signature of Permittee: If signed by other than the permittee, then delegation of the signatory authority must be on file with the state per 15A NCAC 2B
.0506(b)(2)(D).

DocuSign Envelope ID: 09F4D88F-8028-41DB-9B04-7748E9805B81
NPDES PERMIT NO.: NCO088609 PERMIT VERSION: 3.0 PERMIT STATUS: Active
FACILITY NAME: WindgaleSubdivision -#1 CLASS: PCNC COUNTY:Surry
OWNER NAME: Aqua North Carolina Inc ORC: Not Required ORC CERT NUMBER- 995491
GRADE: PCNC ORC HAS CHANGED: No
eDM?i PERIOD: 12-2017 (Dccclnber 2017) VERSION: 1 0 STATUS: Processed
S AMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
OA014 -
"'* No Reporting Reason: ENFRUSF. = No Flow-Rcusc/Recycle, ENVWTHR -No Visitation -Adverse Weather; NOFLOW - No Flow; HOLIDAY - No Visitation - Holiday

DocuSign Envelope ID: 09F4D88F-8028-41DB-9B04-7748E9805B81
NPDES PERItUT NO.: NCO088609 PERVLIT VERSION: 3 0 PERMIT STATUS: Active
-- - -FACILITY NAME: Wmdgate Subdivision - 91 CLASS: PCNC - COUNTY:-Surry
OWNER NAME: Aqua North Carolina Inc ORC: Not Required ORC CERT NUMBER: 995491
GRADE: PCNC ORC HAS CHANGED: -No
eDMR PERIOD: 12-2017 (December 2017) VERSION: 1.0 STATUS; Processed
COMPLIANCE STATUS: Compliant CONTACT PHONE 9: 3369929000 SUBMISSION DATE. 01/12/2018
s
ORC/Certifier nature: William Young E-Mail:[e-mail] Phone #:[phone] Date
By this signature, I certify that this report is accurate and complete to the best of my knowledge.
The permittee shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment.
Any information shall be provided orally within 24 hours from the time the permittee became aware of the circumstances. A written submission shall also be
provided within 5 days of the time the permittee becomes aware of the circumstances.
If the facility is noncompliant, please attach a list of corrective actions being taken and a time -table for improvements to be made as required by part II.E 6 of
the NPDES permit.
-�, - / i 1 11--y 01/12/2018
Permittee/Submitter Signature:*** Dave McDaniel E-Mail•[e-mail] Phone #:[phone] Date
Perrnittee Address. 266 Simpson Rd Dobson NC 27017 Permit Expiration Date: 01/31/2019
I certify, under penalty of law, that this document and all attachments were prepared under my direction or supen,sioo 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 managed the
system, or those persons directly responsible for gathering the information, the information submitted 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 fines and imprisonment for
knowing violations.
CERTIFIED LABORATORIES
LAB NAME: Water Tech INC
CERTIFIED LAB n: 50
PERSON(s) COLLECTING SAMPLES: William Young
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit [phone] orby visiting httpJ/portal ncdenr.org/Nveb/wq/swp/ps/npdes/forms.
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data
* No Flow/Discharge From Site: Check this box if no discharge occurs and, as a result, there are no data to be entered for all of the parameters on the DMR
fo"r entire monitoring period.
**_ORC on Site?: ORC must -visit facility -and -document visitation of facility as required per 15A NCAC 8G .020¢.
*** Signature of Permittee: If signed by other than the permittee, then delegation of the signatory authority must be on file with the state per 15A NCAC 2B
.0506(b)(2)(D).

DocuSign Envelope ID: 09F4D88F-8028-41DB-9B04-7748E9805B81
NPDES PERMIT NO.: NCO088609 PERMIT VERSION: 3.0
FACILITY NAME. Windgate subdivision - #1 CLASS: P::NC
OWNER NAME: Aqua North Carolina Inc ORC: Not Required
GRADE: PCNC ORC HAS CHANGED: No
eDhIR PERIOD- 11-2017 (November 2017) VEERSION: 1.0
PERMIT STATUS: Active
--COUNTY-,Suiry
ORC CERT NUMBER: 995491
STATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
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'••` No Reporting Reason. ENFRUSE = No Flow-ReustfRccycic, ENVINfH R -No Visitation— Adverse Weather. NOFLOW = No Flow; HOLIDAY = No Visitation = Hoiiday-

DocuSign Envelope ID: 09F4D88F-8028-41DB-9B04-7748E9805B81
NPDES PERMIT NO.: NCO088609
PERMIT VERSION: 3 0
PERMIT STATUS: Active
FACILITY NAME: Wmdgate Subdivision - #1
CLASS: PCNC
_ COUNTY: Surry
OWNER NAME: Aqua North Carolina Inc
ORC: Not Required
ORC CERT NUMBER: 995491
GRADE: PCNC
ORC HAS CHANGED: No
eDMR PERIOD.- 11-2017 (November 201 7)
VERSION: 1.0
STATUS: Processed
COMPLIANCE STATUS: Comphant
CONTACT PIiONE 9- 3369929000
SUBMISSION DATE: 12/22./2017
- -
12/21/2017
ORC/Certifier Signature: illram
Young E-Mail:[e-mail] Phone #:[phone] Date
By this signature, I certify that this report is accurate and complete to the best of my knowledge.
The permittee shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment.
Any information shall be provided orally within 24 hours from the time the permittee became aware ofthe circumstances. A written submission shall also be
provided within 5 days of the time the permittee becomes aware of the circumstances.
If the facility is noncompliant, please attach a list of corrective actions being taken and a time -table for improvements to be made as required by part H E.6 of
the N-PDES permit.
�iJ C' ,
/ i 12/22/2017
Perm ittee/Submitter Signature-*** Dave McDaniel E-Mail:[e-mail] Phone #:[phone] Date
Permittee Address: 266 Simpson Rd Dobson NC 27017 Permit Expiration Date: 01/3Ii2019
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 managed the
system, or those persons directly responsible for gathering the information, the information submitted 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 fines and imprisonment for
knowing violations.
CERTIFIED LABORATORIES
LAB NAME: Water Tech INC
CERTIFIED LAB #: 50
PERSON(s) COLLECTING SAMPLES: William Young
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit [phone] or by visiting http://portal ncdenr.org/web/wq/swp/ps/npdes/forms.
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data.
* No Flow/Discharge From Site: Check this box if no discharge occurs and, as a result, there are no data to be entered for all of the parameters on the DMR
- - —for-entire monitoring period.. _ --- - - - _ - - - - - -- - _ ---- - --- --- _
** ORC on Site?: ORC must visit facility and document visitation of facility as required per 15A NCAC 8G 0204.
*** Signature of Permittee. If signed by other than the permittee, then delegation of the signatory authority must be on file with the state per 15A NCAC 213
.0506(b)(2)(D).

DocuSign Envelope ID: 09F4D88F-8028-41DB-9B04-7748E9805B81
NPDES PERMIT NO.: NCO099609 PERMIT VERSION; 3.0
FACILITY NAME: Wmdgate Subdivision - RI CLASS: PCNC
OWNER NAME: Aqua Nortb Carolina Inc ORC: Not Required
GRADE: PCNC ORC IiAS CUANGED: No
eDNIR PERIOD: 10-2017 (October 2017) VERSION: 1.0
PERMIT STATUS: Active
COUNTY: Surly
ORC CERT NUMBER' 995,191
STATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
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**'*No Reporting Reason. ENFRUSF. = No Flew-Rcuse/Recycle, ENVW7HR = No Visitation —Adverse Weather, NOFLOW = No Flow, HOLIDAY = No Visitation— Holiday

DocuSign Envelope ID: 09F4D88F-8028-41DB-9B04-7748E9805B81
NPDES PERMIT NO.: NC0088609
FACILITY NAME: Wmdgate Subdivision - 61
OWNER ?LAME: Aqua North Carolina Inc
GRADE:PCNC
eDMR PERIOD: 10-2017 (October 2017)
COMPLIANCE STATUS: Compliant
ORC/Certifi."A41gnat ure
PERMIT VERSION: 3 0
CLASS: PCNC
ORC: Not Required
ORC HAS CHANGED: No
VERSION: 1.0
CONTACT PHONE #: [phone]
PERMIT STATUS: Active
COUNTY: Surry _ _ --
ORC CERT NUMBER: 995491
STATUS: Processed
SUBMISSION DATE: 11/28/2017
illiam Young E-Mail:[e-mail] Phone 0:704-507-3303
By this signature, I certify that this report is accurate and complete to the best of my knowledge.-
11 /20/2017
Date
The permittee shall report to the Director or the appropriate Regional Office any noncompliance that -potentially threatens public health or the environment.
Any information shall be provided orally within 24 hours from the time the permittee became aware of the circumstances. A written submission shall also be
provided within 5 days of the time the permittee becomes aware of the circumstances.
If the facility is noncompliant, please attach a list of corrective actions being taken and a time -table for improvements to be made as required by part II.E.6 of
the NPDES permit.
�1_ cfloj 11/28/2017
Permittee/Submitter Signature:*** Dave McDaniel E-Mail:[e-mail] Phone #:[phone] Date
Permittee Address: 266 Simpson Rd Dobson NC 27017- Permit Expiration Date: 01/31/2019
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 managed the
system, or those persons directly responsible for gathering the information, the information submitted 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 fines and imprisonment for
knowing violations.
CERTIFIED LABORATORIES
LAB NAME: Water Tech INC
CERTIFIED LAB #: 50
PERSON(s) COLLECTING SAMPLES: William Young
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES lint [phone] or by visiting http://portal.ncdenr org/web/wq/swp/ps/npdes/forms.
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES pennit for reporting data.
* No Flow/Discharge From Site: Check this box if no discharge occurs and, as a result, there are no data to be entered for all of the parameters on the DMR
— --,for entire monitoring -period. - - -- --
_--** ORC on Site?: ORC must visit facility and document visitation of facility as required per 15A NCAC 8G_0204."
*** Signature of Permittee: If signed by other than the permittee, then delegation of the signatory authority must be on file with the state per 15A NCAC 2B
.0506(b)(2)(D).

DocuSign Envelope ID: 09F4D88F-8028-41DB-9B04-7748E9805B81
NPDES PERMIT NO.: NC0099609
PERMIT VERSION: 3.0
FACILITY NAME: Windgate Subdivision - n1
CLASS: ?CNC
OWNER NAME: Aqua Nor'-b Carolina Inc
ORC: Not Reoured
GRADE. PCNC
ORC HAS CHANGED: No
eDMR PERIOD: 09-2017 (September 2017)
VERSION: 1.0
PERMIT STATUS: Active
COUNTY: Surry
ORC CERT NUMBER: 995491
STATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
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' No Reporting Reason ENFRUSE=No Flow-ReuseJRecycle;• ENVWTIIR= No Visitation_ Adverse Weather NOFLOW =No Flow, HOLIDAY_=_No Vlstladon =Holiday— __ ­- --

DocuSign Envelope ID: 09F4D88F-8028-41DB-9B04-7748E9805B81
NPDES PERMIT NO.: NCO088609
FACILITY NAME: Windgate Subdivision - 41
OWNER NAME: Aqua North Carolina Inc
GRADE:PCNC
eDMR PERIOD: 09-2017 (Seotember2017)
COMPLIANCE STATUS: Compliant
PERMTI' VERSION: 3 0
CLASS:PCNC
ORC: Not Requ;rcd
ORC HAS CHANGED: No
VERSION: 10
CONTACT PHONE #: [phone]
PERMIT STATUS: Active
COUNTY: Surry
ORC CERT NUMBER: 99549I
STATUS: Processed
SUBMISSION DATE: 10/2912017
ORC/Certifier Sigr.a ure: Wfff_7_am Young E-Mail:btyoung@aquaamerica com Phone #•704-507-3303
By this signature, I certify that this report is accurate and complete to the best of my knowledge
I0/23/2017
Date
The permittee shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment.
Any information shall be provided orally within 24 hours from the time the permittee became aware of the circumstances A written submission shall also be
provided within 5 days of the time the permittee becomes aware of the circumstances.
If the facility is noncompliant, please attach a list of corrective actions being taken and a time -table for improvements to be made as required by part II.E.6 of
the NPDES permit
cc ­P_ / u Cco10/29/2017
Permittee/Submitter Signature:*** Dave McDaniel E-h4ail:[e-mail] Phone 4:336-992-9000 Date
Permittee Address: 266 Simpson Rd Dobson NC 27017 Permit Expiration Date: 01/31/2019
1 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 managed the
system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true,
accurate, and complete. 1 am aware that there are significant penalties for submitting false information, including fhe possibility of fines and imprisonment for
knowing violations.
LAB NAME: Water Tech INC
CERTIFIED LAB #: 50
PERSON(s) COLLECTING SAMPLES: William Young
CERTIFIED LABORATORIES
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit [phone] or by visiting httpJ/portal.ncdenr org/web/,4,q/swp/ps/ni)des/forTns
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data.
* No Flow/Discharge From Site- Check this box if no discharge occurs and, as a result, there are no data to be entered for all of the parameters on the DMR
for entire monitoring period
** ORC on Site?: ORC must visit facility and document visitation of facility as required per. I5A NCAC 8G .0204.
*** Signature of Pemiittee: If signed by other than the permittee, then delegation of the signatory authority must be on file with the state per 15A NCAC 2B
.0506(b)(2)(D).

DocuSign Envelope ID: 09F4D88F-8028-41DB-9B04-7748E9805B81
NPDES PERMIT NO.: NCO098609
'PERMIT VERSION: 3 0
FACILITY NAME: Windgate Subdivision - # I
CLASS: PCNC
OWNER NAME: Aqua NfirtF. Carolina Inc
ORC: No_ Required
GRADE: PCNC
ORC HAS CHANGED: No
eDMR PERIOD: 08-2017 (August 2017)
VERSION: I 0
PERMIT STATUS: Active
COUNTY: Sutry
ORC CERT NUMBER: 995491
STATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
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—*NoRepordngReason.ENFRUSE=No Flow-RcusdRecycle; ENVWTHR=NoVis;tation—AdyerseWeather; NOFLOW=No Flow, HOLIDAY =NoVisitation —Holiday

DocuSign Envelope ID: 09F4D88F-8028-41DB-9B04-7748E9805B81
NPDES PERMIT NO.: NCO098609
FACILITY NAME: WindgateSubdivision -#i
OWNER NAME: Aqua North Carolina Inc
GRADE:PCNC
eDMR PERIOD: 08-2017 (August 2017)
COMPLIANCE STATUS: Compliant
PERMIT VERSION: 3.0
CLASS:PCNC
ORC: Not Required
ORC HAS CHANGED: No
VERSION: 1 0
CONTACT PHONE #: [phone]
PERMIT STATUS: Active
COUNTY: Surly
ORC CERT NUiMBER: 995491
STATUS: Processed
SUBMISSION DATE: 09/25/2017
ORC/Certifier Signature: - iliiam Young E-Mail:btyoung@aquaamerica com Phone #:[phone]
By this signature. I certify tI:at this report is accurate and complete to the best of my knowledge
09/19/2017
Date
The permittee shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment
Any information shall be provided orally within 24 hours from the time the permittee became aware of the circumstances. A written submission shall also be
provided within 5 days of the time the permittee becomes aware of the circumstances.
If the facility is noncompliant, please attach a list of corrective actions being taken and a time -table for improvements to be made as required by part II.E.6 of
the NPDES permit
cc l C 1
..� 09/25/201 7
Permittee/Submitter Signature:*** Dave McDaniel E-Mail:[e-mail] Phone [phone] Date
Permittee Address: 266 Simpson Rd Dobson NC 27017 Permit Expiration Date, 01/31/2019
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 managed the
system, or those persons directly responsible for gathering the information, the information submitted 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 fines and imprisonment for
knowing violations,
CERTIFIED LABORATORIES
LAB NAME: Water Tech INC
CERTIFIED LAB #: 50
PERSON(s) COLLECTING SAMPLES: William Young
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit [phone] or by visiting http://portal.ncdenr.org/iveb/wq/swp/ps/npdes/for-ms.
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data.
* No Flow/Discharge From Site- Check this box if no discharge occurs and, as a result, there are no data to be entered for all of the parameters on the DMR
for entire monitoring period.
** ORC on Site?: ORC must visit facility and document visitation of facility as required per 15A NCAC 8G .0204. _
*** Signature of Permittee: If signed by other than the permittec, then delegation of the signatory authority must be on file with the state per 15A NCAC 2B
0506(b)(2)(D).

DocuSign Envelope ID: 09F4D88F-8028-41DB-9B04-7748E9805B81
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.
Page 2 of 26

DocuSign Envelope ID: 09F4D88F-8028-41DB-9B04-7748E9805B81
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.
Page 3 of 26

Dii n Envelope ID: 09F4D88F-8028-41 DB-9B04-7748E9805B81
Final 2016 Integrated Report -All Assessed Waters
EMvirud Yadkin River Headwaters Subbasin Yadkin -Pee Dee River Basin
a+tr
Assessment Unit Name Assessment Unit Description
Assessment Unit Number Water Quality Classification Length/Area Units
Fisher River From Little Fisher Creek to Yadkin River
12-63-(9)b
18.8 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% Dissolved Oxygen (4 mg/I, AL, FW) 1
Meeting Criteria < 10% pH (6 su, AL, FW) 1
Meeting Criteria < 10% Turbidity (50 NTU, AL, FW miles) 1
Meeting Criteria < 10% pH (9.0, AL, FW) 1
Meeting Criteria Excellent Benthos (Nar, AL, FW) 1
Meeting Criteria FCB AP GM<200 and <20% [Fecal Coliform (GM 200/400, REC, FW) 1
C
4/11/2018 2016 Integrated Report -All Assessed Waters Page 1154 of 1306
Fish tissue assessments for mercury apply to all waters and are not individually listed

DocuSign Envelope ID: 09F4D88F-8028-41DB-9B04-7748E9805B81
MONITORING REPORT(MR) VIOLATIONS for:
Permit: NCO088609 MRS Between 11 - 2013 and 10 - 2018 Region: %
Facility Name: % Param Name % County: %
Major Minor: %
Report Date: 12/06/18 Page: 1 of 1
Violation Category% Program Category:
Subbasin:% Violation Action: %
PERMIT: NCO088609
FACILITY:
Aqua North Carolina Inc - Windgate Subdivision - #1
COUNTY: Surry
REGION: Winston-Salem
Limit Violation
MONITORING OUTFALU
VIOLATION
UNIT OF
CALCULATED
%
REPORT PPI
LOCATION
PARAMETER
DATE
FREQUENCY
MEASURE
LIMIT VALUE
Over
VIOLATION TYPE
VIOLATION ACTION
01 -2018 001
Effluent
Chlorine, Total Residual
01/23/18
2 X month
ug/I
17 20
17.6
Daily Maximum
No Action, BPJ
Exceeded
Monitoring Violation
MONITORING OUTFALL/
VIOLATION
UNIT OF
CALCULATED
%
REPORT PPI
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: 09F4D88F-8028-41 DB-91304-7748E98051381
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 NCO088609 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 131 QA
---------------------- Reserved -------------------
671
70 I I 71 I I 72 I r I
u I�
73 I I 74 75I I I I I I I I80
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)
01:00PM 18/11/06
14/05/01
Windgate Subdivision - #1
266 Simpson Rd
Exit Time/Date
Permit Expiration Date
Dobson NC 27017
01:30PM 18/11/06
19/01/31
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
Gary Moseley,4163 Sinclair St Denver NC 28037//704-489-9404/7044899409
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: 09F4D88F-8028-41 DB-9B04-7748E9805B81
NPDES yr/mo/day Inspection Type (Cont.)
NCO088609 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: 09F4D88F-8028-41 DB-9B04-7748E9805B81
Permit: NCO088609 Owner - Facility: windgate Subdivision - #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: 09F4D88F-8028-41 DB-9B04-7748E9805B81
Permit: NCO088609 Owner - Facility: Windgate Subdivision - #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: 09F4D88F-8028-41 DB-9B04-7748E9805B81
Permit: NCO088609
Inspection Date: 11/06/2018
Other
Comment: See Summary
Owner - Facility: Windgate Subdivision - #1
Inspection Type: Compliance Evaluation
Yes No NA NE
Page#

DocuSign Envelope ID: 09F4D88F-8028-41 DB-9B04-7748E9805B81
7
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Longitude: -80 deg. 40 min. 43 sec. W
Latitude 36 deg 24 min. 29 sec N
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0 0.3 0.6 0.9 1.2 1.5 km r
0 0.2 0.4 0.6 0.8 1 mi
360 24.49'N, 800 40.72'W (NAD27)
USGS Dobson (NC) Quadrangle [1=-7.517
Projection is UTM Zone 17 NAD83 Datum G=O.191
Wind -ate Subdivision -Well # 1 Horizon Engineering & Consulting, Inc.
USGS Location Map 2510 Walker Road
Mt. Pleasant, N.C. 28124 May 2, 2007
Dobson, N.C. Scale: 1" = 1,600'

DocuSign Envelope ID: 09F4D88F-8028-41 DB-91304-7748E98051381
Windgate Subdivision - Well # 1
Aerial Photo - Location Map
North
Horizon Eagineerima & Consulting, Inc.
2510 Walker Road
Mt. Pleasant, N.C. 28124 May 2, 2007
Dobson, N.C. Scale: V = 330'

DocuSign Envelope ID: 09F4D88F-8028-41 DB-9B04-7748E9805B81
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: 09F4D88F-8028-41 DB-9B04-7748E9805B81

DocuSign Envelope ID: 09F4D88F-8028-41 DB-9B04-7748E9805B81
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: 09F4D88F-8028-41 DB-9B04-7748E9805B81

DocuSign Envelope ID: 09F4D88F-8028-41 DB-9B04-7748E9805B81
Denard, Derek
From: Denard, Derek
Sent: Thursday, March 07, 2019 5:43 PM
To: '[e-mail]'
Cc: Hudson, Gary; Kinney, Maureen
Subject: DRAFT COC NCG590025 Aqua North Carolina, Inc. - Windgate Subdivision - Well #1
Attachments: NCG590025 Aqua-Windgate COC 2019 DRAFT.pdf
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.denard(@_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: 09F4D88F-8028-41 DB-9B04-7748E9805B81
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: 09F4D88F-8028-41 DB-9B04-7748E9805B81
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.