NCG590025_Fact Sheet_20190408

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Fact Sheet
NPDES Permit No. COC NCG590025 (formerly NC0088609)

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:
☒ Renewal
☐ Renewal with Expansion
☐ New Discharge
☐ Modification (Fact Sheet should be tailored to mod request)

[See Attachment A: NC0088609 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: NC0088609 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 7Q10 (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 030401010704]
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

Table. Data Errors

4. Instream Data Summary
Instream monitoring may be required in certain situations, for example: 1) to verify model predictions
when model results for instream DO are within 1 mg/l of instream standard at full permitted flow; 2) to
verify model predictions for outfall diffuser; 3) to provide data for future TMDL; 4) based on other
instream concerns. Instream monitoring may be conducted by the Permittee, and there are also
Monitoring Coalitions established in several basins that conduct instream sampling for the Permittee (in
which case instream monitoring is waived in the permit as long as coalition membership is maintained).
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
Turbidimiter
15 9.3 11.5 4 ntu no
00400 - pH 8.5 6 7.0 108 su no
01045 - Iron, Total (as Fe)2640 32 577.1 18 ug/l yes
01055 - Manganese, Total
(as Mn)
2640 28 432.1 18 ug/l yes
50050 - Flow, in conduit or
thru treatment plant
0.0014 0.00096 0.0012 903 mgd no
50060 - Chlorine, Total
Residual
20 0 8.0 106 17 20 ug/l yes
CO530 - Solids, Total
Suspended - Concentration
15.5 2.5 4.8 108 30 45 2.5 mg/l no
MA = monthly average; DM = daily maximum; PQL = practical quantitation limit; UoM = Unit of Measure
Not < 6.0 or > 9.0
Date Parameter UoM Value Comments
9/29/2015 01045 - Iron, Total (as Fe)ug/l 0.14 UoM mg/L?
1/19/2016 50060 - Chlorine, Total Residual ug/l 0 PQL?
6/7/2016 50060 - Chlorine, Total Residual ug/l 0 PQL?
8/9/2016 01045 - Iron, Total (as Fe)ug/l 2.14 UoM mg/L?
8/9/2016 01055 - Manganese, Total (as Mn)ug/l 2.64 UoM mg/L?
10/11/2016 50060 - Chlorine, Total Residual ug/l 0 PQL?
11/15/2016 01045 - Iron, Total (as Fe)ug/l 2.64 UoM mg/L?
11/15/2016 01055 - Manganese, Total (as Mn)ug/l 1.19 UoM mg/L?
11/15/2016 50060 - Chlorine, Total Residual ug/l 0 PQL?
2/22/2017 01045 - Iron, Total (as Fe)ug/l 0.109 UoM mg/L?
2/22/2017 01055 - Manganese, Total (as Mn)ug/l 0.105 UoM mg/L?
5/9/2017 01045 - Iron, Total (as Fe)ug/l 0.101 UoM mg/L?
5/9/2017 01055 - Manganese, Total (as Mn)ug/l 0.09 UoM mg/L?
8/1/2017 50050 - Flow, in conduit or thru treatment plant mgd 0.00014 decimal place?
8/8/2017 50050 - Flow, in conduit or thru treatment plant mgd 0.00014 decimal place?
8/15/2017 50050 - Flow, in conduit or thru treatment plant mgd 0.00014 decimal place?
8/29/2017 50050 - Flow, in conduit or thru treatment plant mgd 0.00014 decimal place?
4/17/2018 50060 - Chlorine, Total Residual ug/l 0 PQL?
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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 (Y/N): 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 Mixing Zones
In accordance with 15A NCAC 2B.0206, the following streamflows are used for dilution considerations
for development of WQBELs: 1Q10 streamflow (acute Aquatic Life); 7Q10 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/l 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/l) and capped at 28 µg/l (acute impacts). Due to analytical issues, all TRC values
reported below 50 ug/l 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/l) 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/l) and/or if any individual value exceeds a TBEL
value of 47 ng/l.
Describe proposed permit actions based on mercury evaluation: NA.
Other TMDL/Nutrient Management Strategy Considerations
If applicable, describe any other TMDLs/Nutrient Management Strategies and their implementation
within this permit: Under the current general permit NCG590000 nutrient monitoring is not required for
Greensand technology that discharges to freshwater.
Other WQBEL Considerations
If applicable, describe any other parameters of concern evaluated for WQBELs: NA.
If applicable, describe any special actions (HQW or ORW) this receiving stream and classification shall
comply with in order to protect the designated waterbody: NA.
If applicable, describe any compliance schedules proposed for this permit renewal in accordance with
15A NCAC 2H.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 15A 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(l) 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.
(1.) 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.
I. 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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ROY COOPER NORTH CAROLINA
Governor Environmental Quality
MICHAEL S_REGAN
Secretary
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. NC0088609
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.
Sincerely,_
XitglAbA
Wren Thedford
Administrative Assistant
Water Quality Permitting Section
ec: WQPS Laserfiche File w/application
DEQ
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
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ROY COOPER NORTH CAROLINA
Gaser740r Environmental Quality
MICHAEL S_BEGAN
SecretWY
LINDA CULPEPPER
Interim Director
October 05, 2018
Thomas Roberts
Aqua North Carolina Inc
202 Mackenan Ct
Cary, NC 27511
Subject: Permit Renewal
Application No. NC0088609
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. 1506-3 your current permit does not expire until permit decision on the application is made.
Continuation of the current permit is contingent on timely and sufficient application for renewal of the current permit.The
permit writer will contact you if additional information is required to complete your permit renewal. Please respond in a
timely manner to requests for additional information necessary to allow a complete review of the application and renewal
of the permit.
Information regarding the status of your renewal application can be found online using the Department of Environmental
Quality's Environmental Application Tracker at:
https://deq.nc.gov/permits-regulations/permit-guidance/environmental-application-tracker
If you have any additional questions about the permit, please contact the primary reviewer of the application using the
links available within the Application Tracker.
Sincerely,
iCIght'gtAA
Wren Thedford
Administrative Assistant
Water Quality Permitting Section
ec: WQPS Laserfiche File w/application
DEQ
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
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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 NC0088609
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, CE91/®DENI DWS
L. 2
Amanda BergerPermitting
0 C T 201
Water Resources
ng SectionManager, Environmental Compliance
cc: Laurie Ison _-
Joseph_Pearce
Shannon Becker
202 MacKenan Court,Cary,NC,27511 • 919.467.8712 • AquaAmerica.com
DocuSign Envelope ID: 09F4D88F-8028-41DB-9B04-7748E9805B81
NPDES PERMIT APPLICATION - SHORT 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 NC0088609
If you are completing this form in computer use the TAB key or the up - down arrows to move from one
field to the next. To check the boxes, click your mouse on top of the box. Otherwise,please print or type.
1. Contact Information:
Owner Name Aqua North Carolina, Inc.
Facility Name Windgate Subdivision-Well #1 WTP
Mailing Address 202 Mackenan Ct
City Cary
State / Zip Code NC/27511
Telephone Number 919) 653-6965
Fax Number [e-mail]
e-mail Address [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 704)489-9404
Fax Number [e-mail]
Page 1 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 D State Private N Public
5. 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
8. 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 El
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.
Page 2 of 3 Version 5/2012
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NPDES PERMIT APPLICATION,- SHORT FORM C - WTP
For discharges associated with water treatment plants
Alum /-aluminum sulfate Yes No X _- -- ----- n_-
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 No
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.
Avvt_
ed name of Person Signing Title
an .( / x14112-61E3- -- - -
North North Carolina General Statute 143-215 6(b)(2)provides that:Any person who knowingly makes any false statement representation,or certification in any application,
record,report,plan,or other document files or required to be maintained under Article 21 or regulations of the Environmental Management Commission implementing that
Article,or who falsifies,tampers with,or knowingly renders inaccurate any recording or monitoring device or method required to be operated or maintained under Article 21
or regulations of the Environmental Management Commission implementing that Article,shall be guilty of a misdemeanor punishable by a fine not to exceed$25,000,or by
imprisonment not to exceed six months,or by both. (18 U.S.C.Section 1001 provides a punishment by a fine of not more than$25,000 or imprisonment not more than 5
years,or both,for a similar offense.)
Page 3 of 3 Version 5/2012
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Aqua North Carolina, Inc. Facility
Windgate Subdivision Well #1 WTP Location
at ittdet 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: - Cn Northi NPDES Permit No.NC0088609 --._
Drabaate Bain` Yadkin-Pee Dee River Basin Sub-Basin:_ 03-07-02 1 Y !6 Surry County
DocuSign Envelope ID: 09F4D88F-8028-41DB-9B04-7748E9805B81
NPDES PERMIT NO.:NC0088609 PERMIT VERSION:3.0 PERMIT STATUS:Active
FACILITY NAME:Wtndgate 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:07-2018(July 2018)VERSION:1 0 STATUS Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
50950 00407 50060 C11539 01045 01055 00070 01091
e
s `
s =
s
e. — c
e w Monthly 2 X month 2 X month 2 X month Quarterly `Quarterly 2 X month QuarterlyZ6 ` r
6
3 e 0 o` & Instantaneous Grab Grub Grab Grab I Grab Grab Grab
E e
a•1: u
C 3 A O O 6 >:. FLOW pit cnLORuNC FSS•Cunc moo 61ANG5rOSb TO Rltin7Y 1 ZINC
2409 clock me 2409 clock On WAIN mFd au uc/I mit IV npy I nth 1 os/I
7
a
5
6
7
9
9
10 1053 L.57 Y 0.0014 6,62 14 1<23 419 343 04
17
12
13
14 I
15 i
16
17
18
19 1 1
20 1 1
31
22
13
24 1439 035 Y 00014 665 5 25 4;
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26 1 1
27
36
15 129
31
Menthh Arerepc Ll511
s
130
8I.8h1v Armpr
0 0914 9.5 5 41.9 343 CSS
Dully M.:110010
0.0014 6.62 14C 41.9 34 3 0 7
ll.Ily Minimum Y-
0.0014 6.55 5 0 419 343 04
No Reporting Reason.ENFRUSE—No Flow-Reuse/Recycle, ENVWTIIR=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-#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:07-2018(July 2018)VERSION:1 0 STATUS:Processed
COMPLIANCE STATUS:Compliant CONTACT PHONE it:3369929000 SUBMISSION DATE:08/22/2018
y y. .>. _..«., . ...: fv,,... 0BId.S/2018.,
ORC/Certifier ignature: William Young E-Mail:btyoung rr aquaamerica corn 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 the time the perrn,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 LLE 6 of
the NPDES permit.
Esl•Z 08/22/2018
Permittee/Submitter Signature:*** Dave McDaniel E-Mail:[e-mail] Phone #•336-992-9000 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 gathenng 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,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(919)807-6300 or by visiting http://portal.ncdetir 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:Wlndgate Subdivision-41 CLASS:PCNC COUNTY:Sury • _. - - - -•
OWNER NAME:Aqua North Carolina Inc ORC:Not Required ORC CERT NUMBER:995491
GRADE:PCNC ORC HAS CHANGED:No
eDIvIR PERIOD:06-2018(June 2018)VERSION.1.0 STATUS:Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
50060
i C0530 01040 010.$C11070 01092
a
E
500.0 00402
F E ,
i
m
eA
to y u Monthly 2 X month 12 X month 2 X month Quarterly Quarterly 12 X month Quarterly
C E
S.^
E 6 is Instantaneous IGrab Grab IGrab Grab Grab Grab Grab
f c'
t! 12 o D D L FLOW ,pI1 CIILORRiE TSS-0000 0000 Rih}GhCSE TUROtnTY ZINC
2420 cluck IIrt 2400 dock Ors YJtOIN mod so u411 mit WA ug/1 nlu 09411
1 I
2
3
4
5
6
7 I
9 I 1 I
10
11 I I
12 1445 0 6 Y 0,0014 6.99 12 4.4 4.3
22 I t
14 1
16 I
16
17
18 1 I
19 I
20 I I I
21 1
22
13 I
2`'1 1
25 I
16
27 921 0.62 Y 0 0514 2,03 5 8 o 75
28 I I
29
30 I I
Monthly Avcrngo Limit 30
Monlhll A,N,00.
0.001a 83 62 2.675
Dolly Maumom,
0.00I4 7,03 12 6 n-I-- - 4.6
Dolly hllnlmom' 00014 6,99 5 14.4 0.75
No Reporting Reason'ENFRUSE=No Flow-Reuo&Recycle, ENV WTHR-No V notation-Adverse'Weather, NOFLOW=No Flow: HOLIDAY=No Visitation-Hohday
DocuSign Envelope ID: 09F4D88F-8028-41DB-9B04-7748E9805B81
NPDES PERMIT NO.:NC0088609 PERMIT VERSION:3.0 PERMIT STATUS:Active
FACILITY NAME:W'indgate Subdivision- 1 CLASS:PCNC - COUNTY:Surn .--
OWNER NAME:Aqua North Carolina Inc ORC:Not Required ORC CERT NUMBER:995491
GRADE:PCNC ORC HAS CHANGED:No
eDMR PERIOD:06-2018(lune 2018)VERSION: 1 0 STATUS:Processed
COMPLIANCE STATUS:Compliant CONTACT PHONE#:[phone] SUBMISSION DATE:07/23/2018
07/20/20.18— ...
ORC/Certifier ignatu - William Young 3-Mail:btyoung©aquaamerica.com 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 tune 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.
t,
r `
c 07/23/2018
Permittee/Submitter Signature•*** Dave McDaniel E-Mai1•dtmcdanieleaquaamerica.com 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 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 NODES Unit(919)807-6300 or by visiting http.//portal.ncdenr org/web/we/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 1SA NCAC 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:NC0088609 PERMIT VERSION.3 0 PERMIT STATUS:Active
FACILITY NAME:VJindeate Subdrolslon-hl _ CLASS:PCNC COUNTY:.Sv r -
OWNER NAME:Aqua No-tl1 Carolina Inc ORC:Nol Required ORC CERT NUMBER:995491
GRADE:PCNC ORC HAS CHANGED:No
eDMR PERIOD:05-2018(May 2018)VERSION: 1.0 STATUS:Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
50950 00460 0000 C0530 01045 01055 06070 01092
r C n
e 8'Monthly 2 X month 2 X month 2 X month Quarterlys <` F _
Quarterly 2 X month Quarterly
u -3 0 8 instantaneous Grab Grab Grab Grab I Grab Grab Grab
E n ` e, 4
u t= c o e L FLOA PR C11LOrtivE 7B5•Cone 110016 MAINGNE:.E 1.1R131DTY ZINC
f
2400 clock lin 2400 clerk 11n W0/N mid 511 007 1004 U[ll alit niu u=;0
1 l434 053 B 00014 675 6 6.8 75
5 I
6
7
R
9 I
10
ft Il2 I
13 114 I
15 1443 0.57 B 0,0014 6,94 13 5.3 I 4 5
16
17
16
29
211 I
21
12
23
l4 i
25
26
17
24
29 I
711 I
it
Ir}
Monllhl,,AverageLlmlt I20
Monthly Aeerogq 00014 93 6.05 - 6.15 _
nany nfa;Lmum:
00014 6.94 13 5,8 7.k
Dn11)mtnimam'0l00I4 675 6 5i 4.5
No Reporting Reason.ENFRUSE-No Flow-Reuse/Recycle; ENV3 THR=No Visitation-Adverse Weather; NOFLOW=No now. HOLIDAY=No Vlvtation- Ho'idly
DocuSign Envelope ID: 09F4D88F-8028-41DB-9B04-7748E9805B81
NPDES PERMIT NO.:NC0088609 PERMIT VERSION:3.0 PERMIT STATUS:Active
FACILiTY NAME:W+ndgate Subdivision-#1 CLASS:-FCNC- -- COUNTY:Sunt'
OWNER NAME:Aoua North Carolina Inc ORC:Not Required ORC CERT NUMBER:995491
GRADE:PCNC ORC HAS CHANGED:No
eDMR PERIOD:05-2018(May 2018)VERSION:1.0 STATUS:Processed
COMPLIANCE STATUS:Compliant CONTACT PHONE t:3369929000 SUBMISSION DATE:06/26/2018
06/2.6/2018 •
ORC/Certifier sgnature1W Ilam Young E-Mail:btyoung©r. aquaamerica.com 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 D:rector 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 he
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.
0, C
e 06/26/2018
Permittee/Submitter Signature:*** Dave McDaniel E-Mail.dtmcdaniei@aquaamerica corn 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 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 possibility of fines and imprisonment for
knowing violations.
ZERTIFIED LABORATORIES
LAB NAME:Water Tech/Aqua North Carolina
CERTIFIED LAB rt:50/5035
PERSON(s)COLLECTING SAMPLES:William Young
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit(919)807-6300 or by visiting http.//portal ncdenr.org/web/wq/swp'ps/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 entiremoiiiloringperiod.
ORC on Site?:"ORG_must.visit facility and document-visitation-of facility as required per 15A NCAG8G 0204.1«;., „__X—__ : - ta_
Signature ofPermittee:If signed by other than the permittee,then delegation of the signatory authority must be on file with the state per I5A NCAC 2B
0506(b)(2)(D).
DocuSign Envelope ID: 09F4D88F-8028-41DB-9B04-7748E9805B81
NPDES PERMIT NO:NC0088609 PERMIT VERSION:3.0 PERMIT STATUS:-Ac21ve-, - - -"
FACILITY NAME:Wlndgate Subdivision-in CLASS:PCNC COUNTY:Sony
OWNER NAME:Aqua North Carolina Inc ORC:Not Required ORC CERT NUMBER:995491
GRADE:PCNC ORC HAS CHANGED:No
eDMR PERIOD.04-2018(April 2018) VERSION:3 0 STATUS:Processed
SAMPLING LOCATION: EFFLUENT,-DISCHARGE NO.: 001 .NO DISCHARGE : NO.„ "
50070 150400 40067 C0,411 0104$010.5 001170 01052
E fi
r I I{1. c 6
e s E 1 a Monthly 1 2 X month 2 X month 2 X month Quarterly Quarterly 2 X month Quarterly
E 7. c
l 8 u0 C
E c .Instantaneous IGlab Grao Gala Grab Grab IGrab Ora ,
O E 9 t u a
ii C O 2.FLOW pH CHLORINE T3S.CCM IRON 31ANGNESE TURUOUT' WIC
1450 Noel. lin 2440 dock lin 77050 mod Ell
a
50)1 I11:11 U;n URN non eg/l
1 I I
I
j3 1346 055 B 0.0014 686 8 3.4
y11
4 I f
s
6
F 1 1 I
91 1
10
11
11
13
I I14
IS 1
16
1'1352 0 55 04 0.0214 6.93 0 2.7 252 281 4.2
In
19
20 I 1
11 I
17 1
21
i
24 1 1
25
76 1 I
27
78
29
30
M.nml..lvrr.Re Loon 30
alonlbh Meow 0.0015 4 3.05 202 201 7 6
Welt,"Mmlmvm
00014 693 E 3.4 252 261 111
D.Is Minimum:
00014 6 96 - __- D-- - -2.7 252 281 - 14,2
NoReporting Reason'ENFRUSE-NoHow-Reuse/Recycle,ENV WTHR=No Visitation-Adverse Weather,-NOFLOW=No Flow; HOLIDAY=No Vlsta:ion-Holiday_
DocuSign Envelope ID: 09F4D88F-8028-41DB-9B04-7748E9805B81
NPDES PERMIT NO.:NCOD886O9 _.__ PERMIT VERSION:3.0 PERMIT STATUS_Active
FACILITY NAME:Windgele Subdivision-fit 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:04-2018(April2018) VERSION:3.0 STATUS:Processed
Outfall 001-Effluent Comments:
Reason for revision metals reporting wrong
DocuSign Envelope ID: 09F4D88F-8028-41DB-9B04-7748E9805B81
NPDES PERMIT NO..NC0088609 PERMIT VERSION.3.0 PERMIT STATUS:Active
FACILITY NAME:Wmdgate Subdivision-1/1 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:04-2018(April 2018) VERSION:3.0 STATUS•Processed
COMPLIANCE STATUS:Compliant CONTACT PHONE#:[phone] SUBMISSION DATE:06/10/2018
06/08/2018
ORC/Certifier Sig attire: Yr1Iliani 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 wntten 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 ILE.6 of
the NPDES permit
e
61CC
06/10/2018
Permittee/Submitter Signature:*** Dave McDaniel E-Mail-dtmedaniel@aquaalnerica corn 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
CERTIFIED LAB#:50
PERSON(s)COLLECTING SAMPLES:William Young
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit(919)807-6300 or by visiting http://portal.ncdenr.org/web/wq/swp!ps/npdes/forrus•
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 Permitter:If signed by other than the permrttce,then delegation of the signatory authority must be on file with the state per-15A NCAC 2B u -
0506(b)(2)(D)
DocuSign Envelope ID: 09F4D88F-8028-41DB-9B04-7748E9805B81
NPDES PERMIT NO.:NC0088609 PERMIT VERSION:10 PERMIT STATUS:Active
FACILITY NAME:Windeate Subdivision-#1 CLASS:PCNC COUNTY:Su.-ry
OWNER NAME:Aqua North Carolina Inc - ' •-ORC:Not Required ORC.CERT NUMBR:995.491 _ __ ___
GRADE:PCNC ORC HAS CHANGED:No
eDMR PERIOD:03-2018(YTar1r 2018) VERSION:1,0 STATUS:Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
50051 00400 50060 C0930 01045 01055 00070 ,. 01092
i e n
1° p o
o°I.a S. m Monthly 2 X month 12 X month 2 X month Quarterly Quarterly 2 X month Quarterly
59 r.
I5i -F Instantaaxus Grab Grab Grab I Gab Grab Grab Grab
1a
C o 5 i FLOW pH CHLORINE 755-Croy TR6N MJ.NGItlESE 7'ORDm7Y ZINC
2400 dock Ore 241/6 clock Are YIMM I mgd I SU an/l mg/I n0.4 usli ala uyal
1 I
2 I I
3
37
5 I i
6
8 I
9
10 1
11
12
13 1350 24 1330 0.48 B 0.0014 6 9 4 43 II
14 I
15
10
I7
LB I
19I
I
I
2C
21 I
22 1
I
0
25
27 1458 24 1435 0.57 B 0.0014 6.93 4 7 1 11
28 I
29 I 1
30 1
31 I
Monlhly Avernae Lima` 30
Monthly Aver,0r 0D014 4 5.65 11
Dnly Mnzimum_
0,0014 6.93 14- 1 11
Dolly Minimum
0.0014 6.9 14 43 1 I
t_---s.. _. s.... . . ..:_
k"No Reporting Reason ENFRUSE=Pdc Flow-Aeuse/Rccycle; F,;VR'THF=No Gsitetion'—4dvcrsc Woxthe,I4OFL01%J=No Flow, HOLIDAY `.oto Visltahori=iioLdz}
DocuSign Envelope ID: 09F4D88F-8028-41DB-9B04-7748E9805B81
NPDES PERMIT NO:NC0088509 PERMIT VERSION:3 0 PERMIT STATUS:Active
FACILITY NAME:Windgate Subdivision-#1 CLASS:PCNC COUNTY:Surry
O WNER NAME:Aqua North Carolina Inc — —-- ORC:Not Required ORC CERT-NUMBER095491 , - - - - - _-. --
GRADE:PCNC ORC HAS CHANGED:No
eDMR PERIOD:03-2018(March 2018) VERSION:1 0 STATUS:Processed
COMPLIANCE STATUS:Compliant CON FACT PHONE#:[phone] SUBMISSION DATE:04/25/2018
t'
04/19/2018
ORCr//
Certtiifiet -' •ig niture: `Vd/tlltam Young -E-Mail:[e-mail] Phone 4:704-507-33-03, -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.
C'(04/25/2018
Permittee/Submitter Signature:*** Dave McDaniel E-Maii:[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(919)807-6300 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.
ORCon Site?-ORC must visit facility and document visitation of facility as required per-ISA NCAC 8G.0204. --- - -- - -
Sienatute bf Pertnttee If signed-by other thari'the permittee;then-delegation of-the signatory-authority must-be onsfrle:with the state_per 15A,NrCAC.2B
0506(b)(2)(D).
DocuSign Envelope ID: 09F4D88F-8028-41DB-9B04-7748E9805B81
NPDES PERMIT NO.:N00088609 PERMIT VERSION:10 PERMIT STATUS:Active
FACILITY NAME:_Wmdgate Subdivision-#1 CLASS:_PCNC COUNTY:Sutry
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
50050 00400 50060 C0530 01045 01055 001070 01092
8 Monthly 2 X month 2 X month 2 X month Ouarterty 10uarterly 2X month Quartrly
o u` E c° E Instantaneous Grab Grab Grab Gab Cttah Grab Grab
a a
o U
H
C C O ,-
Go
FLOSS p0 CHLORINE 75S-Cont 0009 MANG\ESE TURamTS ZINC
2400aloek Hrs 2400 clock 11rc YAWN gond an uc/I mall upll Ur/ 1n aryl
I I
2
3 I I
4
5
6 I I I
a I4
10
u
12
13 953 0.77 B 9.0314 730 6 3.6 1 1.B
14 I
15i I
16 I 1+ I
I7
16
19 I I
20
21
22
J
33
24
25 I
26 1
27 1510 0 62 113 0,0314 6.61 5 7 19 I
26
Monthly A.eresc Limit. 30 1
Monthly Arrregc;
3,0014 53 5 3 10.4
TMIb A4eTlmuv'
0 0014 7 39 6 7 19
Drill Minimum:
0.0014 6 61 5 13 6 I 1.6
r*No Reporting Reason ENFRUSE=No Flow-Reuse/Recycle; ENVWrBR-NoVisitation—Advers-eWeather, NOFLOW=NoFlow:HOLIDAY=No Visitation—Holiday
y
DocuSign Envelope ID: 09F4D88F-8028-41DB-9B04-7748E9805B81
NPDES PERMIT NO.:NC0088609 PERMIT VERSION:3.0 PERMIT STATUS:Active
FACILITY NAME:Windgate 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:02-2018(February 2018) VERSION:1 0 STATUS.Processed
COMPLIANCE STATUS:Compliant CONTACT PHONE#:[phone] SUBMISSION DATE:03/27/2018
f-x""
4.'• ''--,--_ -l
03/14/2018
ORC/Certifte Signature: 'William Young E-Mail:btyoung@aquaamerica corn 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 perrnittee 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
C1--e (1 C.l 1i 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
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
CERTIFIED LAB#:50
PERSON(s)COLLECTING SAMPLES:William Young
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit(919)807-6300 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 facilityas required.per.15A N IAC 80.0204.
Signature of Permittee:If signed by other than the permittee,then delegation of the signatory authority must be on file with the state per l 5A NCAC 213
0506(b)(2)(D).
DocuSign Envelope ID: 09F4D88F-8028-41DB-9B04-7748E9805B81
NPDES PERMIT NO.:N00088609 PERMIT VERSION:3.0 PERMIT STATUS.Active
FACIIJTY NAME:Windgalc Subdivision-#1 CLASS PCNC COUNTY:Sony
OWNER NAME:Aqua North Carolina Inc ORC:Not Required ORC CERT NUMBER:995491
GRADE:PCNC ORC HAS CHANGED:No
eDMR PERIOD:01-2018(January 2018) VERSION:1.0 STATUS:Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
I " _
6 E .. - -
50050 00400 50060 C0530 01045 01055 1011070 01092
E. h
F ^cz
s t.Sonthly 2 X month 2X month 2 X month Quertorly _Quarterly 2 X month Quartet
a o u,
8 8 8 1Inatantaneoam Grab Grab Grab Grab Grab Grab Grab
a b 5 a
c :.J F O G 5 I.I FLOW pit CHLORINE 17FC-Cone IOWa if4xh Gh E.SE 'i'l1RnIn7Y ZINC
2400 el.d. 11ln 2401)Noel On YRLN I • 51. ugI rng4 og4 00/1nv 00A
1. -----*--H
2 I I I f
3 I I
4 1
5
6
8
1553 032 B 0.0014 7.12 8 3.5 103 32 1,3
10 111
12
13
14
15
16
17
18 I
19
20
21 I
22
23 1359 043 B 0.0014 749 20 4 24
24
1
25
6I
22
28
29
30
31
Monthly Arer.gn1,bnItl 30
hinmMi Anm.ae`
0.0014 14 3 75 103 32 - 195
n.II Mnalnam
0.0014 749 20 4 103 32 26
No Reporting Reason-ENFRUSE=No Flow-Reuse/Reeycle: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-#+ CLASS-PCNC COUNT:Surry
OWNER NAME:Aqua North Carolina Inc CRC:Not Required ORC CERT NUMBER:995491
GRADE:PCNC ORC HAS CHANGED:No
eDMR PERIOD:01-2018(January 2018) VERSION:1 0 STATUS:Processed
COMPLIANCE STATUS:Compliant CONTACT PHONE#:[phone] SUBMISSION DATE:02/27/2018
l<
J
02/15/2018
ORC/Certifier Signature. William Young E-Mail:btyoungcraquaamerica.com 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.
r t OJ 02/27/2018
Permittee/Submitter Signature:*** Dave McDaniel E-Mail.dtmcdaniel®aquaamerica.com 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 Codc assistance may be obtained by calling the NPDES Unit(919)807-6300 or by visiting httpi/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 paiameters on the DMR
for entire monitoring period.
ORC on,Site9: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: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
eDMR PERIOD:12-2017(December 2017) VERSION:1 0 STATUS:Processed
SAMPLING LOCATION:EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
g/094 00400 90060 C0e30 01049 01850 Deem 01092
s e y
C a I
E Monthly 2 X month : month 12 Y,month 011anely Quarterly 2 X month Quarterly
e 2 F = G i
g tnslanlanwas Grab Grab Grab Grab GmI1 Grab Grab
0 a
c'
E.
O Z FLOW pH CHLORINE 'MS•Cog IRON StAN°NESE TUR0IDTY ZINC
2400 a/nek Del 2400<tnck W. YIBIN mad Su IV MO aerI 111 Inm uart
1
2 I
3
41
5 1
6 I
1
8
9 I
10 1
11 1
12 1
13 124 857 0.45 0 I 41.0014 7.56 4 3.6 035
14 1
IA I
16 1
17 1
In
19
20
21 1 1 i
22 1
23 1
24
25
26 I 1
Z7
28 24 1227 0 43 B 1 0 0014 7.28 4 3 4 0,0
29
30
it
Month11 Average LIm14 10
L__
e innlhllArerene
low 4- 4 3S 0575
5.11)Mexlmum
0A014 756 4 3 6 04
116118atlnto
9.0014 7 28 4 3,9
c
035- _--1-
No Reporting Reason:ENFRUSE=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 PERMIT NO.:NC0088609 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:TIo
eDMR PERIOD:12-2017(December 2017) VERSION:1.0 STATUS;Processed
COMPLIANCE STATUS:Compliant CONTACT PHONE#:[phone] SUBMISSION DATE.01/12/2018
17 01/10/2018 •-
s
ORC/Certifier . nature: William Young E-Mail:btyoung®aquaamerica.coni 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.
y6".„.....i 1" 0 1/1 2/201 8
Permittee/Submitter Signature:*** Dave McDaniel E-Mai1•[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(919)807-6300 or by visiting httpJ/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 facilityand-document visitation of facility as required per 15A NCAC 80.0204.
t___ ,•,
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.Windgato Subdivision-#1 CLASS:PNC COUNTY Suny
OWNER NAME:Aqua North Carolina Inc ORC:Not Required ORC CERT NUMBER:995491
GRADE:PCNC ORC HAS CHANGED:No
eDMR PERIOD.11-2017(November 2017) VEERSION:1.0 STATUS:Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
e
50050 00400 50060 C0530 01045 00059 00070 01042
I
Fav611
e F Monthly 2 X month 2 X mnntF 12 X month Quarterly 0uz-lerly 2 X monthOuarted-v
S !°,, G In.StantanOn5 Grab IGab Grab Grab IGrab Grab Grab
T. 11f a
q V h O G o 2 MOW PH CHLORINE ISS-Cone IRON MANONESE I771RDID7Y ZINC
3400 clock ur, 2400 clock Io-, Y111ra1 mad ea oy l marl I ay7 alt ntu uo/I
1
I
3
4 I I I ,..
S
6 1 I 1(
7 1413 0.52 E 00014 71'1 ID 3.5 045
R
9 I
10 I l a I
11
12
13
14
1
IS f
16
17
1S 1-
19 i 1
s0
21 1231 0 53 9 00014 7.38 5 5.8 32 28 1
22
23 1
24
25
26
27
26
29
30
Monthly Average LW! 30
Monthly Avrregr.
c 0014 7.5 4.60 32 20 0.025
D--Maolmum;
0.0014 738 10 _ _. _ 5,8 __ - 32 28___ ____ 1.2 I
1---_ - --
Dolly Minimum'
00014 7.17 5 3.5 _ 32 28 045 1
f 0t No Reporting Reason.ENFRUSE=No Flow-Reuse/Recycle,ENVWFH R=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:Wmdeate 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:Compliant CONTACT PHONE#•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 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.
JC'
g---- / 12/22/2017
Permittee/Submitter Signature•*** Dave McDaniel E-Mail:[e-mail] Phone #:[phone] Date
Permittee Address:266 Simpson Rd Dobson NC 27017 Permit Expiration Date:01/3I/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
k nowingviolations.
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(919)807-6300 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 I5A NCAC 2B
0506(b)(2)(D).
DocuSign Envelope ID: 09F4D88F-8028-41DB-9B04-7748E9805B81
NPDES PERMIT NO.:NC0038609 PERMIT VERSION 13.0 PERMIT STATUS:Active
FACILITY NAME:Wlndgate Subdlyision-RI CLASS:PCNC COUNTY:Surly
OWNER NAME:Aqua North Carolina Inc ORC:Not Required ORC CERT NUMBER'9954-91
GRADE:PCNC ORC HAS CHANGED:No
eDMR PERIOD:10-2017(October 2017) VERSION:1.0 STATUS:Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
50090 011410 50060 C0510 01045 01055 4#0.70 01092
1 E ,S /f,
C -.
1,
C
K
E. t
Fg
Mnntnly 2 X month 2 h month 12 X month Quarterly 9ua.-terly "2 X month Quarterly
SE)
v, ot
G o` E- Ustantanmis Grab Grab Grab Grab Grab Grab Grab
5 a u C
w
z FLOW 411 CHLORINE 1300-Cone IRON MANGNESE TURDin rY DNC
a J r ,i O O Z
A
24110,loci, (Ors 2400 clock Hr. 0/a/N mgd 80 ug/1 marl alit lug/1 non WI
1 1
2I
3 1404 0.68 0 0 0014 6.92 8 I<2.5 05
4
5
1
e I
9
10
11 I I
12 1
13 1 I
14 I
1
15
116 I
17
18 1
19 1
211 I
11
22
23
24
ss 1226 047 B 100014 702 5 2.5 05
20 1
27 1
211 1
29 1
30
31
a 1
Momhh Average Llmh, S0
h'"'thl Avero6o.
0.001465 0 0.5
Denr M.nlmnm
OWt4 7.02 •8 0 OS
Dolly Allnlmum: P0014 6-52 9 0 05
r''No Reporting Reason.ENFRUSF.=No Flow-Reuse/Recycle, ENVWVTHR=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:Wmdgate Subdivision-frl CLASS:PCNL COUNTY:Surry
w,- ___
OWNER NAME:Aqua North Carolina Inc ORC:Not Required ORC CERT NUMBER:995491
GRADE:PCNC ORC HAS CHANGED:No
eDMR PERIOD:10-2017(October 2017) VERSION:1.0 STATUS:Processed
COMPLIANCE STATUS:Compliant CONTACT PHONE#:[phone] SUBMISSION DATE:11/28/2017
6(
1
d_ 11/20/2017
ORC/Certifi 1Signature: Allam Young E-Mail:[e-mail] Phone 0:704-507-3303 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 II.E.6 of
the NPDES permit.
711 C(Cij 11/28/2017
Permittee/Submitter Signature:*** Dave McDaniel E-ivlail:[e-mail] Phone #:[phone] Date
Permittee Address:266 Simpson Rd Dobson NC 2701'T 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 impnsonment for
knowing violations.
CERTIFIED LABORATORIES
LAB NAME:Water Tech INC
CERTIFIED LAB#:50
PERSON(s)COLLECTING SAMPLES:William Young
PARAMETER CODES
Parameter Code assistance maybe obtained by calling the NPDES Unit(919)807-6300 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 authonty 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:Wjndgate Subdlvlsioz-4'1 CLASS:?CNC COUNTY:Surry
OWNER NAME:Aqua North Carolina Inc ORC:Not Reoulred ORC CERT NUMBER:995491
GRADE:PCNC ORC HAS CHANGED:No
eDMR PERIOD:09-2017(September 2017) VERSION:1.0 STATUS:Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
sass__ -.n_. ..
Srpor.00400 89069 C0036 01019 01055 00100 10)090
F 6 fi w e
l
u It O
y e FIn Monthly 2 X month 2 X month 2 X month Quarterly Ouertcrly 12 X month Quarterly
e'
g. vCT. C o -
e
Insla.tainous Grab Grab Grab Grab Grab Cab Grab
o
6
fO O CC 2 FLOW p11 1CHLORINE TSS•Conc iMON MANGNESE 211RDIDTY ZINC
2400 clock Iles 7400 dock lin YAM mod su WI mill ulr. ug/1 mu oWl
I.
7 1
13I
4 1 1
5 I
6 1
7
9 I
10 1
11
12 1257 9.62 B 0.0014 7.36 4 23 035
13
14
15 1
16 1
17 1
16
09
20"
21 I
u 1
73 I
24
29
76 1217 105 B D 0014 7 D8 6 3,1 10 65
27
J
20 1
29 1
30
Monthly Average Limb. 30
Monthly Areroke.
5,0014 5 135 0.65
15.11y M.r1 mum
00014 736 6 3J 065
Dully Mlnlmum
0.0014 758 4 I 0-65
000No Reporting Reason CNFRUSE=NoFlow-Reuse/Recycle;•ENVWTIIR=No Vlsitahon_Advers Weather NOFLOW=No Flow, HOLIDAY_=_NoNOstlation=Holiday _-__ „_-,:-:.__,_,__:_„:-
DocuSign Envelope ID: 09F4D88F-8028-41DB-9B04-7748E9805B81
NPDES PERMIT NO.:NC0088609 PERMIT VERSION:3 0 PERMIT STATUS:Active
FACILITY NAME:Wmdgate Subdivision- CLASS:PCNC COUNTY:Surry
OWNER NAME:Aqua North Carolina Inc ORC:Not Required ORC CERT NUMBER:99549I
GRADE:PCNC ORC HAS CHANGED:No
eDMR PERIOD:09-2017(September 2017) VERSION:1 0 STATUS:Processed
COMPLIANCE STATUS:Compliant CONTACT PHONE#:[phone] SUBMISSION DATE:10/29/2017
I0/23/2017,
ORC/Certifier Sigr.a ure: Wham Young E-Mail:btyoung@aquaamerica corn 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 II.E.6 of
the NPDES permit
Le itjVC00-110/29/2017
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 Bather 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 arc 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(919)807-6300 or by visiting httpi/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•l5A NCAC 80.0204.
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:Windgate Subdivision-#1 CLASS:PCNC COUNTY:Sorry
OWNER NAME:Aqua North Caroitna Inc ORC:No:Required ORC CERT NUMBER:995491
GRADE:PCNC ORC HAS CHANGED:No
eDMR PERIOD:08-2017(August 2017) VERSION:1 0 STATUS:Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
t
50050 - - 110600
s
50060 : 00530 01845 01055 100070 01092
EF E C
m
y
E -
y '[g _ g Armagh' 12 X month 2 X montn 2 X month Quarterly Qnertcrly I2 X month Quarterly r
At E < L
u E c" 8 lnstartar.mus Grab Crab Grab Grab Grab Grab Grab
Y. E u C
A 0 4 o &- o z FLOW pit CHLORINE 756-Cone IIRoh MANCNCSE _ITURBTDTY ZINC
2400 clock 'lira 17400 e1ock Ilra Y/BIN mgd 511 nal mg/1 ug/1 ug/1 otu ur/I
t I 0 00014
2 I
3 I
4 f
5 I I I 1
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9
10
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17 I
15 I I I
19 I 4
10 I I
21
22 1306 0.48 Y 0.0014 6.95 8 3.9 87 49 035
23
24 I
25
26
2?1 I
25
29 0 00014
30
11 I
1 4
Monthly Avcrap.Llmll. 30
Monthly Average.
0,000392 i 1.95 87 29 0375
Dat0 974410004.
0 00I4 I i 08 8 3.9 87 49 OA
s.....7;"•—•:..Ag-11 Minimam•
0.0-0314- 6 93---- - 6 - 0 S7 "49
No Reporting Reason.ENFRUSE No Flow-Rcnse/Recycle; ENVWTHR=NoVtsaation—AdverseWeather,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-Pi 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:08-2017(August 2017) VERSION:1 0 STATUS:Processed
COMPLIANCE STATUS;Compliant CONTACT PHONE#:[phone] SUBMISSION DATE:09/25/2017
09/19/2017
ORC/Certifier Signature: iliiam Young E-Mail:btyoung@aquaamerica corn 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 ILE.6 of
the NPDES permit
CCal 09/25/2017aP
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(919)807-6300 or by visiting http://portal.ncdenr.org/webiwq/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 1SA 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

Permit No. NCG590000
Page 2 of 26

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 conta ined 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 applica tion 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.

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

Permit No. NCG590000
Page 3 of 26

B. (1.) Greensand WTP Effluent Limitations and Monitoring Requirements – Discharging 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 monitored1 by the Permittee as specified below:

PARAMETER EFFLUENT LIMITS MONITORING REQUIREMENTS
Monthly Average Daily Maximum2 Measurement
Frequency
Sample
Type
Sample
Location
Flow3 Monitor Only (MGD) Twice per Month Instantaneous
Or Estimate Effluent
Total Suspended Solids4 30.0 mg/l
(Exception:Trout Waters)
45.0 mg/L
(Exception:Trout Waters) Twice per Month Grab Effluent
Total Residual Chlorine5 - 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 Manganese7, 8 Monitor Only µg/L (Exception: WS Waters) Quarterly Grab Effluent
Total Iron7 Monitor Only (µg/L) Quarterly Grab Effluent
Total Zinc9 Monitor Only (µg/L) Quarterly Grab Effluent
Total Fluoride10 Monitor Only (µg/L) Quarterly Grab Effluent

Footnotes:
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 & R eservoirs not designated
as trout waters.
7. Iron & Manganese: This sampling requirement does not apply to b ackwash 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 maxim um
limit of 200 µg/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 finished 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.

DocuSign Envelope ID: 09F4D88F-8028-41DB-9B04-7748E9805B81
Final 2016 Integrated Report-All Assessed Waters
Yadkin River Headwaters Subbasin Yadkin-Pee Dee River Basin
Assessment Unit Name
Assessment Unit Number
Assessment Unit Description
Water Quality Classification Length/Area Units
Fisher River From Little Fisher Creek to Yadkin River
18.8 FW MilesC12-63-(9)b
Assessment Criteria Status Reason for Rating Parameter of Interest Category
Meeting Criteria < 10%Water Temperature (29ºC, AL, MT&UP)1
Meeting Criteria < 10%Dissolved Oxygen (4 mg/l, 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
Page 1154 of 13064/11/2018 2016 Integrated Report -All Assessed Waters
Fish tissue assessments for mercury apply to all waters and are not individually listed
DocuSign Envelope ID: 09F4D88F-8028-41DB-9B04-7748E9805B81
MRs Between and Violation Category:Program Category:
Param Name County:Subbasin:%Violation Action:
Major Minor:%
Permit:
Facility Name:
Region:--NC0088609
%%
%
%
%%
%
11 2013 10 2018
MONITORING REPORT(MR) VIOLATIONS for:12/06/18Report Date:1Page:of 1
PERMIT:NC0088609 FACILITY:Aqua North Carolina Inc - Windgate Subdivision - #1 COUNTY:Surry REGION:Winston-Salem
%
Over
UNIT OF
MEASURE VIOLATION ACTIONVIOLATION TYPECALCULATED
VALUELIMITFREQUENCYVIOLATION
DATEPARAMETERLOCATIONOUTFALL/
PPI
MONITORING
REPORT
Limit Violation
01 - 2018 001 Effluent Chlorine, Total Residual 01/23/18 2 X month Daily Maximum
Exceeded
No Action, BPJ2017ug/l 17.6
%
Over
UNIT OF
MEASURE VIOLATION ACTIONVIOLATION TYPECALCULATED
VALUELIMITFREQUENCYVIOLATION
DATEPARAMETERLOCATIONOUTFALL/
PPI
MONITORING
REPORT
Monitoring Violation
08 - 2016 001 Effluent Turbidity 08/31/16 2 X month Frequency Violation No Action, BPJntu
10 - 2016 001 Effluent Turbidity 10/31/16 2 X month Frequency Violation No Action, BPJntu
DocuSign Envelope ID: 09F4D88F-8028-41DB-9B04-7748E9805B81
EPA
United States Environmental Protection Agency
Washington, D.C. 20460
Water Compliance Inspection Report
Form Approved.
OMB No. 2040-0057
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 N 52 NC0088609 18/11/06 C S31112171819 20
21 66
Inspection Work Days Facility Self-Monitoring Evaluation Rating B1 QA ----------------------Reserved-------------------
N67707172 73 74 75 80
Section B: Facility Data
Name and Location of Facility Inspected (For Industrial Users discharging to POTW, also include
POTW name and NPDES permit Number)
Windgate Subdivision - #1
266 Simpson Rd
Dobson NC 27017
Entry Time/Date Permit Effective Date
Exit Time/Date Permit Expiration Date
01:00PM 18/11/06 14/05/01
Name(s) of Onsite Representative(s)/Titles(s)/Phone and Fax Number(s)
///
Other Facility Data
01:30PM 18/11/06 19/01/31
Name, Address of Responsible Official/Title/Phone and Fax Number
Gary Moseley,4163 Sinclair St Denver NC 28037//704-489-9404/7044899409 Contacted
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#1
DocuSign Envelope ID: 09F4D88F-8028-41DB-9B04-7748E9805B81
NPDES yr/mo/day
18/11/06
Inspection Type
C3111218
1
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.
NC0088609 17 (Cont.)
Page#2
DocuSign Envelope ID: 09F4D88F-8028-41DB-9B04-7748E9805B81
Permit:NC0088609
Inspection Date:11/06/2018
Owner - Facility:
Inspection Type:
Windgate Subdivision - #1
Compliance Evaluation
The Hollows Subdivision – Well # 1 – NC0088625
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 – NC0088498
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 – NC0088633
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 – NC0088617
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 – NC0088609
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 – NC0088854
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-8028-41DB-9B04-7748E9805B81
Permit:NC0088609
Inspection Date:11/06/2018
Owner - Facility:
Inspection Type:
Windgate Subdivision - #1
Compliance Evaluation
Water Quality Regional Operations
Division of Water Resources
cc:Central Files
WSRO
Page#4
DocuSign Envelope ID: 09F4D88F-8028-41DB-9B04-7748E9805B81
Permit:NC0088609
Inspection Date:11/06/2018
Owner - Facility:
Inspection Type:
Windgate Subdivision - #1
Compliance Evaluation
Other Yes No NA NE
See SummaryComment:
Page#5
DocuSign Envelope ID: 09F4D88F-8028-41DB-9B04-7748E9805B81
DocuSign Envelope ID: 09F4D88F-8028-41DB-9B04-7748E9805B81
DocuSign Envelope ID: 09F4D88F-8028-41DB-9B04-7748E9805B81
1
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
NC0088498 Aqua North Carolina, Inc. Mitchell Bluff - Well #1 Surry 12/31/2018
NC0088609 Aqua North Carolina, Inc. Windgate Subdivision Surry 1/31/2019
NC0088528 Aqua North Carolina, Inc. Hillcrest Subdivision - Well #3 Surry 12/31/2018
NC0088536 Aqua North Carolina, Inc. Bannertown Hills Subdivision - Well #2 Surry 12/31/2018
NC0088552 Aqua North Carolina, Inc.
Colonial Woods Subdivision - Wells 1
and 2 Surry 1/31/2019
NC0088854 Aqua North Carolina, Inc. Pine Lakes Subdivision - Well #2 Surry 1/31/2019
NC0088617 Aqua North Carolina, Inc. Snow Hill subdivision Surry 2/28/2019
NC0088625 Aqua North Carolina, Inc. The Hollows subdivision Surry 2/28/2019
NC0088633 Aqua North Carolina, Inc. Reeves Woods Subdivision Well #2 Surry 2/28/2019
NC0088501 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.

DocuSign Envelope ID: 09F4D88F-8028-41DB-9B04-7748E9805B81
2

DocuSign Envelope ID: 09F4D88F-8028-41DB-9B04-7748E9805B81
1
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. Mitchell Bluff ‐ Well #1 ‐> NCG590024 
NC0088609 Aqua North Carolina, Inc. Windgate Subdivision ‐> NCG590025 
NC0088528 Aqua North Carolina, Inc. Hillcrest Subdivision ‐ Well #3 ‐> NCG590026 
NC0088536 Aqua North Carolina, Inc. Bannertown Hills Subdivision ‐ Well #2 ‐> NCG590027 
NC0088552 Aqua North Carolina, Inc. Colonial Woods Subdivision ‐ Wells 1 and 2 ‐> NCG590028 
NC0088617 Aqua North Carolina, Inc. Snow Hill subdivision ‐> NCG590029 
NC0088625 Aqua North Carolina, Inc. The Hollows subdivision ‐> NCG590030 
NC0088633 Aqua North Carolina, Inc. 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
[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.

DocuSign Envelope ID: 09F4D88F-8028-41DB-9B04-7748E9805B81
2

DocuSign Envelope ID: 09F4D88F-8028-41DB-9B04-7748E9805B81
1
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
[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.

DocuSign Envelope ID: 09F4D88F-8028-41DB-9B04-7748E9805B81
1
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
[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.

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-8028-41DB-9B04-7748E9805B81
2

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
[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.

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