NC0059218_Fact Sheet_20191010

DocuSign Envelope ID: 1879A874-28F7-47C8-944C-93AE2B9C6942
FACT SHEET FOR EXPEDITED PERMIT RENEWALS
This form must be completed by Permit Writers for all expedited permits which do not require full Fact
Sheets. Expedited permits are generally simple 100% domestics (e.g., schools, mobile home parks, etc)
that can be administratively renewed with minor changes, but can include facilities with more complex
issues (Special Conditions, 303(d) listed water, toxicity testing, instream monitoring, compliance
concerns).
Basic Information for Expedited Permit Renewals
Permit Writer/Date
Emily DelDuco 07/10/2019
Permit Number
NCO059218
Facility Name
Captain Stevens WWTP
Basin Name/Sub-basin number
03-07-04
Receiving Stream
UT Reedy Creek
Stream Classification in Permit
WS-IV
Does permit need Daily Max NH3 limits?
N / A
Does permit need TRC limits/language?
No — already resent
Does permit have toxicity testing?
No
Does permit have Special Conditions?
No
Does permit have instream monitoring?
Dissolved Oxygen and Temperature
Is the stream impaired (on 303(d) list)?
No
For whatparameter?
Any obvious compliance concerns?
Current enforcement cases from old violations
(ie: letter sent 4/22/19, penalty assessed
5/19/14)
2019 NOV for frequency violation
2016 series of NOVs for DO
WSRO works closely with this facility due to
past problems. No changes can be made in the
permit to address the maintenance issues at the
site. Owner has done what WSRO has asked
of him and makes earnest effort to keep facility
compliant.
Any permit modifications since last permit?
None.
New expiration date
5/31/2024
Comments on Draft Permit
➢ updated parameter codes.
➢ Added regulatory citations
➢ updated eDMR language (A.(3))
➢ Updated map
➢ Added HUC to outfall description
Instream Monitoring
The current permit requires instream monitoring for dissolved oxygen and temperature. Review
of instream data for the past four years indicates that the dissolved oxygen standard of 5 mg/1 was
maintained, and there were no apparent differences between upstream and downstream stations.
This draft permit maintains the same instream monitoring requirements.

DocuSign Envelope ID: 1879A874-28F7-47C8-944C-93AE2B9C6942
eDMR Summary 07/2015-07/2019
Effluent summary:
Effluent Monitoring Summary July 2015-July
Parameter I Mean
00010 - Temperature, Water Deg. Centigrade 17.52
00300 - Oxygen Dissolved (DO) 8.41
00400 - pH
00556 - Oil & Grease
31616 - Coliform, Fecal MF, MFC Broth, 44.5 C
50050 - Flow, in conduit or thru treatment plant
50060 - Chlorine, Total Residual
C0310 - BOD, 5-Day (20 Deg. C) - Concentration
C0530 - Solids, Total Suspended - Concentration
C0600 - Nitrogen, Total - Concentration
C0610 - Nitrogen, Ammonia Total (as N) - Concentration
C0665 - Phosphorus, Total (as P) - Concentration
Upstream Summary:
Instream monitoring:
Parameter I Mean
00010 - Temperature, Water Deg. Centigrade 15.26
00300 - Oxygen, Dissolved (DO) 9.43
Downstream Summary:
Instream monitoringq: Downstream
Parameter I Mean
00010 - Temperature, Water Deg. Centigrade 15.41
00300 - Oxygen, Dissolved (DO) 9.74
6.17
0.00
12.99
8.52
13.19
16.66
9.81
15.82
2019
Minimum
7.00
2.20
6.20
5.00
1.00
0.00
10.00
2.00
5.00
3.76
0.10
0.83
Maximum
24.00
12.90
8.40
39.70
387.00
0.01
46.00
67.20
89.20
37.70
25.80
37.40
2015-July 2019
Minimum Maximum N
0.30 25.00 160
2.10 14.60 160
r 2015-July 2019
Minimum Maximum N
0.40 26.00 160
6.30 15.10 160
N
196
162
75
75
76
1115
317
76
77
14
75
14

DocuSign Envelope ID: 1879A874-28F7-47C8-944C-93AE2B9C6942
From: man, Jeff
To: DelDuco, Emilv
Cc: Hudson, Eric; Kaufman, Tammv; Brvan, Jeff
Subject: FW: PWS Approval NPDES NCO059218
Date: Tuesday, August 6, 2019 11:55:07 AM
Attachments: imaae001.Dna
NCO059218 Draft 07-2019.Ddf
image003.Dng
Re: Permit Renewal, Captain Stevens Seafood WWTP, 4577 N Highway 150, Lexington, Davidson
County
Hello Emily,
The Public Water Supply Section concurs with issuing the permit provided the permittee properly
operates and maintains the facilities, the stated effluent limits are met, and the discharge does not
contravene the designated water quality standards. Thank you for providing the permit for our
review.
Jeff
Jeff H. Bryan, P.E.
Assistant Regional Engineer
Public Water Supply Section
Department of Environmental Quality
336 776 9663 office
336 403 1092 mobile
aeff. bryan ft_ncdenr.gov
Winston Salem Regional Office
450 W. Hanes Mill Road, Suite 300
Winston Salem, NC 27105
�Noth~ng Compares
AID -
Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties.
From: DelDuco, Emily <[e-mail]>
Sent: Monday, July 22, 2019 4:46 PM
To: Bryan, Jeff <[e-mail]>
Cc: Boone, Ron <[e-mail]>
Subject: PWS Approval
Hi Jeff,

DocuSign Envelope ID: 1879A874-28F7-47C8-944C-93AE2B9C6942
NCO059218 / Captain Stevens Seafood Restaurant WWTP is a grade I Biological WPCS facility in
Davidson County which discharges into an unnamed tributary to Reedy Creek, currently classified
WS-IV.
Please send me any comments when you are able.
Please note that we're transitioning to paperless communication. As such, NPDES will no longer
send the separate approval memo for PWS comments on this permit draft. The email response from
you (or another PWS contact) will suffice to document the draft permit review by PWS.
Thanks for your help, and let me know if you have any questions.
Emily DelDuco
Division of Water Resources
Department of Environmental Quality
919-707-9125
emily.delduco(@ncdenr.gov
Nothing Compares,
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: 1879A874-28F7-47C8-944C-93AE2B9C6942
42008346 J000647603
AFFIDAVIT OF PUBLICATION
STATE OF NORTH CAROLINA LEXINGTON, NC JULY 26, 2019
DAVIDSON COUNTY
I, ALLISON MYERS OF THE DISPATCH, A NEWSPAPER PUBLISHED IN THE CITY OF LEXINGTON, COUNTY AND
STATE AFORESAID, BEING DULY SWORN, SAYS THE FOREGOING LEGAL OF WHICH THE ATTACHED IS A TRUE
COPY, WAS PUBLISHED IN SAID NEWSPAPER ONCE BEGINNING THE 26TH DAY OF JULY, 2019.
PUBLICATION FEE: $ 94.01
'�5ftilulrrurrr���
(SEAL) \�SA1`t C wp''.,.
5 e
Notary PubliC
Rowan Count
SWORN TO AND SUBSCRIBED BEFORE ME, THIS Z DAY OF
MY COMMISSION EXPIRES
Ad Copy:
Public Notice
North Carolina
Environmental Management
Commission/NPDES Unit
1617 Mail Service Center
Raleigh, NC 27699-1617
Notice of Intent to Issue a
NPDES Wastewater Permit
The North Carolina
Environmental Management
Commission proposes to issue
a NPDES wastewater
discharge permit to the
person(s) listed below. Written
comments regarding the
proposed permit will be
accepted until 30 days after the
publish date of this notice. The
Director of the NC Division of
Water Resources (DWR) may
hold a public hearing should
there be a significant degree of
public interest. Please mail
comments and/or information
requests to DWR at the above
address. Interested persons
may visit the DWR at 512 N.
Salisbury Street, Raleigh, NC
to review information on file.
Additional information on
NPDES permits and this notice
may be found on our website:
http:lldeq. nc. gov/aboutld ivision
slwate r-reso u rceslwate r-
res o u rce s-pe rm its/wa stewate r-
branchln piles -wastewater/
public -notices, or by calling
[phone]. NCO059218:
Steve Pappas requested
renewal of permit for Captain
Stevens Seafood
WWTP/
Davidson County.
Facility
discharges to an
unnamed
tributary to
Reedy
CreeklYadkin-Pee
Dee River
Basin. Currently
dissolved
oxygen, total residual
chlorine,
oil and grease,
and fecal
coliform are water
quality
limited.
July 26, 2019
o
_ Y —
My Conntnissipn Expires
C AR
���rfj j m l i 4 0%\1�

DocuSign Envelope ID: 1879A874-28F7-47C8-944C-93AE2B9C6942
RESEARCh & ANA[YTICA1
LAbORATORfES, INC.
Analytical/Process Consultations
November 21, 2018
Mr. Charles H. Weaver, Jr.
NPDES Unit
Division of Water Quality
1617 Mail Service Center
Raleigh, NC 27699-16I7
RE: Renewal of NPDES Permit No. NCO059218
Captain Stevens Seafood WWTP
Davidson County
Dear Mr. Weaver,
Enclosed is one (1) copy of the NPDES Permit (No.NC0059218) renewal application for Captain
Stevens Seafood WWTP located in Davidson County. If you should have any questions
concerning this information, please so advise.
Sincerely,
Research & Analytical Laboratories, Inc
r'
James M. Cheshire
Authorized Agent
JMC/ jm
Cc. Steve Pappas, Captain Stevens Seafood Restaurant
P 0, Box 473 • 106 Short Street • Kernersville, North Carolina 27264 • 336-996-2841 • Fax [phone]
www.randalabs.com

DocuSign Envelope ID: 1879A874-28F7-47C8-944C-93AE2B9C6942
NPDES APPLICATION - FORM D
For privately owned treatment systems treating 100% domestic wastewaters <1.0 MGD
Mail the complete application to:
N. C. DENR / Division of Water Quality / NPDES Unit
1617 Mail Service Center, Raleigh, NC 27699-1617
NPDES Permi NCO059218
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
Steve Pappas
Facility Name
Captain Stevens Seafood WWTP
Mailing Address
4577 NC Highway 150
City
Lexington
State / Zip Code
NC / 27292
Telephone Number
(336) 731 - 8470
Fax Number
N/A
e-mail Address
2. Location of facility producing discharge:
Check here if same address as above
Street Address or State Road
City
State / Zip Code
County
3. Operator Information:
Name of the firm, public organization or other entity that operates the facility. (Note that this is not
referring to the Operator in Responsible Charge or ORC)
Name Research & Analytical Laboratories, Inc.
Mailing Address 106 Short Street
City Kernersville
State / Zip Code NC / 27284
Telephone Number [phone]
Fax Number [phone]
1 of 3 Form-D 05/08

DocuSign Envelope ID: 1879A874-28F7-47C8-944C-93AE2B9C6942
NPDES APPLICATION - FORM D
For privately owned treatment systems treating 100% domestic wastewaters <1.0 MGD
4. Description of wastewater:
Facility Generating Wastewater(check all that apply):
Industrial
❑
Number of Employees
Commercial
®
Number of Employees 20 (part time)
Residential
❑
Number of Homes
School
❑
Number of Students/Staff
Other
❑
Explain:
Describe the source(s) of wastewater (example: subdivision, mobile home park, shopping centers,
restaurants, etc.):
Restaurant
Population served: _200 Seats (open at night only
5. Type of collection system
® Separate (sanitary sewer only) ❑ Combined (storm sewer and sanitary sewer)
6. Outfall Information:
Number of separate discharge points _1
Outfall Identification number(s) 001
Is the outfall equipped with a diffuser? ❑ Yes ® No (step aeration)
7. Name of receiving stream(s) (Provide a map showing the exact location of each outfall):
Unnamed Tributary to Reedy Creek
8. Frequency of Discharge: ❑ Continuous ® Intermittent
If intermittent:
Days per week discharge occurs: Random Duration: Random
9. Describe the treatment system
List all installed components, including capacities, provide design removal for BOD, TSS, nitrogen and
phosphorus. If the space provided is not sufficient, attach the description of the treatment system in a
separate sheet of paper.
0.0025 Wastewater Facility consisting of the following:
• Grease Trap # 1 . Primary Filter
• Grease Trap #2 (In Series)
• Septic Tank (12,000 gallons)
• Pump Tank (Manhole, 30 gallons)
• Primary Holding Tank (1,500 gallons)
• Secondary Holding Tank (1,500 gallons)
• Recirculation Tank (1,500 gallons)
• Effluent Dosing Tank
• Secondary Filter
• Chlorine Contact Tank
• Dechlor Contact Tank
• Step Aeration
2 of 3 Form-D 05108

DocuSign Envelope ID: 1879A874-28F7-47C8-944C-93AE2B9C6942
NPDES APPLICATION - FORM D
For privately owned treatment systems treating 100% domestic wastewaters <1.0 MGD
Flow Information:
Treatment Plant Design flow 0.0025 MGD
Annual Average daily flow 0.0010 MGD (for the previous 3 years)
Maximum daily flow 0,007 MGD (for the previous 3 years)
11. Is this facility located on Indian country?
❑ Yes ® No
12. Effluent Data*
Provide data for the parameters listed. Fecal Coliform, Temperature and pH shall be grab samples, for all other
parameters 24-hour composite sampling shall be used. If more than one analysis is reported, report daily maximum
and monthly average. If only one analysis is reported, report as daily maximum.
Parameter
Daily
Maximum
Monthly
Average
Units of
Measurement
Biochemical Oxygen Demand (BODs)
67.2
8.40
MG/L
Fecal Coliform
59
1.10
Col/ 100ml
Total Suspended Solids
89.2
13.3
MG/L
Temperature (Summer)
42
19.59
oC
Temperature (Winter)
20
13.01
OC
pH
8.4
N/A
SU
13. List all permits, construction approvals and/or applications:
Type Permit Number Type
Hazardous Waste (RCRA) -- NESHAPS (CAA)
UIC (SDWA)
NPDES NCO059218
PSD (CAA) --
Non-attainment program (CAA) --
14. APPLICANT CERTIFICATION
Ocean Dumping (MPRSA)
Dredge or fill (Section 404 or CWA)
Other
Permit Number
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.
James M. Cheshire Authorized Agent
Printed name of Person Signing Title
ture of Appli
Date
Morth Carolina General Statute 143-215.6 (b)(2) states: 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.)
3 of 3 Form-D 05/08

DocuSign Envelope ID: 1879A874-28F7-47C8-944C-93AE2B9C6942
RESEARCh & ANA1yTICAL
LABORATORIES, INC.
Analytical/Process Consultations
SLUDGE MANAGEMENT PLAN
CAPTAIN STEVENS SEAFOOD RESTAURANT
WASTEWATER TREAMENT PLANT
NPDES PERMIT NO. NCO059218
Sludge from the Captain Stevens Seafood Restaurant wastewater treatment plant is disposed
of in the following way:
Captain Stevens Seafood WWTP consists of a documented sludge hauling subcontractor
(Forsyth Rooter Services 336-768-8494) who periodically removes digested sludge from
septic tank and delivers waste sludge to a documented or approved wastewater treatment
facility. Information found in documented log includes date, time, volume of sludge
removed and location, date and time sludge transported to final destination. The
designated ORC coordinates the frequency in which digested sludge is removed.
P 0 Box 473 • 106 Short Street • Kernersville, North Carolina 27284 • 336-996-PB41 • Fax [phone]
www.randalabs.com

DocuSign Envelope ID: 1879A874-28F7-47C8-944C-93AE2B9C6942
J.
�J 1NIN
54
"i' �l~'�, t � 1- J_ •, :� ,,�` � � � >>� • �f � j� � l `w� �� ;•, ., err , •' .` IF
_ --t
=. .,f^ I'; ,•`'`1 / !: �'`' � ( �Sp II�\• I I "1 � •5�'�.J•tl; �{• :; )�: • �•�; "`I � c� �.
'�L f � �t•r . ���� .�\,.f j /�l`�'sil� � � . i ' � Z • � / 'i3: �i L1� -L'I 4-'1.rJ j "i 4 ^��,.,"��ij
Ilk t✓ ••/ �\\ ;y'
`t f _• "11 'tj �i ' ` �:1 tti\ 1 l V R,_ J
','--,Creek
��'',,`a. `i}aL.' _'Jr,..•1.`�)p`.. �j���.;:4J 1 Ouifall 001 �;.��';'- -•� �,,
� 'II ��� � r't�+�?'Jf .?�'c-_ `'f •, 9rt ;1'f \�� �(- . �� =�"-' �: ^•.• ! 1 .!�jl�•-�-�t�; • 1't.+'m.yfill
�;�� *.
r�
!
', d „ •'�� � "pl ;� , .a. Ji 'mac-, ;-mil � 1 1 l^�: � f �• ` I �� .. / ! '��`•.'' •%
1 ,!� rp �w . �+ r ^ ti� /i i- _�_ /� L' ff 1 tit • ,� `i� h/ '•
,. l' '� � � , fJ% ; i ham. �•�..,' �'� � � � (�th, � �� �?; 4,
, � , `\•'� ' _ a� fl %,
ll�•��VI� f'i `l ��•`i � fig SZ:1`> �1:R`� '� ,��/�-�':?�.`� (`�-�� � �`� 1 � �k-� � �
Lnyv
41
YIN
''ti ', l `�y , /,_''\ •� ` 4 �-- .••--�---•. �" 1. 1r r ��` I
��\q 1� t ,,. •; � �.sr;`�.l yJ`'!^��a` 1..� C/� ����5;11 ���)+' }1'1 ��'.� �11 �`, pl ,r�( S '—`••�J•"� , J���J�`'��y �� {
� `� 1 f ;� i�=� r%;�r�`„ �i :;�r"�d���` r���1,J \�. '``�``l!`.'' `\'1 �^�`J`. �f.•/ - y�'1 -'"'.1 ?,� � �!
(.;i a\, {'.S�q�D `� � y�'J!i t �.'1� ��'1������ ��. 1 .'� ' i1r • ! •:%1 \ �� i��,/ • � '•� � I f�
1 l
y�J. �y _•�, I!. ice;,, !;( � + `/ � `/�'�!/' 1 � �\ � i'• •//.�f:
Z I l / .fir ♦ //� _ 41� '%�K
Ij.� , .0 :�ll� i//S_
if �� FF r�~ti� ��.: Ir
­ J �,
-S /
/.�\\l
1.•.: -.- )}� /irk �,r�(� `\„� ""- .sf• � ; �. � '}n• \� r.; / l /'� + �"� �I�.•t 11 9 c•�`�'
..� •/ �`... •'- �- •,sf — ��, i\\�C�� �! r������ acx�e�� � r r/ � �il� f: r' a .• •-, .
//'�[c,•�lc—ti0�, �":��v\� �\`�—=f� •` ^�`'n� f—f`.I�J�� I�� ` t—� ,f� r7 /`:• � i.�� "'n}�.� ` i��`.'•�' �
--���� \1(. 1 �� r Ifl.l yr_ i ' fia �_� ram=
d�N
NCO059218
Captain Stevens Seafood Restaurant
Latitude: 350 54' 38" N USGS Quad: Welcome
Longitude: 800 19' 37" W Sub -Basin: 03-07-04
Receiving Stream: UT to Reedy Creek
Stream CIass: WS-IV
Facility
Location
Davidson County
.JV[1Ut(�L Map not to scale

DocuSign Envelope ID: 1879A874-28F7-47C8-944C-93AE2B9C6942
MONITORING REPORT(MR) VIOLATIONS for:
Permit: NCO059218 MRs Between 7 - 2015 and 7 - 2019 Region: %
Facility Name: % Param Name % County: %
Major Minor: %
Report Date: 07/10/19 Page: 1 of 6
Violation Category% Program Category:
Subbasin:% Violation Action: %
PERMIT: NCO059218
FACILITY: Steve Pappas - Captain Stevens Seafood WWTP
COUNTY: Davidson
REGION: Winston-Salem
Limit Violation
MONITORING
VIOLATION
UNIT OF
CALCULATED
%
REPORT
OUTFALL
LOCATION
PARAMETER
DATE
FREQUENCY
MEASURE
LIMIT
VALUE
Over
VIOLATION TYPE
VIOLATION ACTION
02 -2018
001
Effluent
BOD, 5-Day (20 Deg. C) -
02/26/18
2 X month
mg/I
45
67.2
49.3
Daily Maximum
Proceed to NOD
Concentration
Exceeded
02 -2018
001
Effluent
BOD, 5-Day (20 Deg. C) -
02/28/18
2 X month
mg/I
30
33.6
12
Monthly Average
Proceed to NOD
Concentration
Exceeded
08 -2015
001
Effluent
Chlorine, Total Residual
08/20/15
2 X week
ug/I
28
37
32.1
Daily Maximum
No Action, BPJ
Exceeded
09 -2015
001
Effluent
Chlorine, Total Residual
09/15/15
2 X week
ug/I
28
38
35.7
Daily Maximum
No Action, BPJ
Exceeded
10 -2015
001
Effluent
Chlorine, Total Residual
10/06/15
2 X week
ug/I
28
29
3.6
Daily Maximum
No Action, BPJ
Exceeded
11 - 2015
001
Effluent
Chlorine, Total Residual
11/13/15
2 X week
ug/I
28
30
7.1
Daily Maximum
No Action, BPJ
Exceeded
12 - 2015
001
Effluent
Chlorine, Total Residual
12/01/15
2 X week
ug/I
28
30
7.1
Daily Maximum
No Action, BPJ
Exceeded
08 - 2017
001
Effluent
Chlorine, Total Residual
08/14/17
2 X week
ug/I
28
39
39.3
Daily Maximum
No Action, BPJ
Exceeded
03 - 2018
001
Effluent
Chlorine, Total Residual
03/26/18
2 X week
ug/I
28
29
3.6
Daily Maximum
No Action, BPJ
Exceeded
06 - 2018
001
Effluent
Chlorine, Total Residual
06/25/18
2 X week
ug/I
28
46
64.3
Daily Maximum
No Action, BPJ
Exceeded
07 - 2018
001
Effluent
Chlorine, Total Residual
07/06/18
2 X week
ug/I
28
39
39.3
Daily Maximum
No Action, BPJ
Exceeded
07 -2018
001
Effluent
Chlorine, Total Residual
07/09/18
2 X week
ug/I
28
44
57.1
Daily Maximum
No Action, BPJ
Exceeded
08 -2018
001
Effluent
Chlorine, Total Residual
08/13/18
2 X week
ug/I
28
44
57.1
Daily Maximum
No Action, BPJ
Exceeded
08 - 2018
001
Effluent
Chlorine, Total Residual
08/20/18
2 X week
ug/I
28
34
21.4
Daily Maximum
No Action, BPJ
Exceeded
08 - 2018
001
Effluent
Chlorine, Total Residual
08/27/18
2 X week
ug/I
28
33
17.9
Daily Maximum
No Action, BPJ
Exceeded
09 - 2018
001
Effluent
Chlorine, Total Residual
09/14/18
2 X week
ug/I
28
41
46.4
Daily Maximum
No Action, BPJ
Exceeded

DocuSign Envelope ID: 1879A874-28F7-47C8-944C-93AE2B9C6942
MONITORING REPORT(MR) VIOLATIONS for:
Permit: NCO059218 MRS Between 7 - 2015 and 7 - 2019 Region: %
Facility Name: % Param Name % County: %
Major Minor: %
Report Date: 07/10/19 Page: 2 of 6
Violation Category:% Program Category: %
Subbasin:% Iq
Violation Action:
PERMIT: NCO059218
FACILITY:
Steve Pappas - Captain Stevens Seafood WWTP
COUNTY: Davidson
REGION: Winston-Salem
Limit Violation
MONITORING
VIOLATION
UNIT OF
CALCULATED
%
REPORT
OUTFALL
LOCATION
PARAMETER
DATE
FREQUENCY
MEASURE
LIMIT
VALUE
Over
VIOLATION TYPE
VIOLATION ACTION
09 -2018
001
Effluent
Chlorine, Total Residual
09/21/18
2 X week
ug/I
28
42
50
Daily Maximum
No Action, BPJ
Exceeded
10 - 2018
001
Effluent
Chlorine, Total Residual
10/19/18
2 X week
ug/I
28
37
32.1
Daily Maximum
No Action, BPJ
Exceeded
10 - 2018
001
Effluent
Chlorine, Total Residual
10/22/18
2 X week
ug/I
28
41
46.4
Daily Maximum
No Action, BPJ
Exceeded
11 - 2018
001
Effluent
Chlorine, Total Residual
11/30/18
2 X week
ug/I
28
42
50
Daily Maximum
No Action, BPJ
Exceeded
12 - 2018
001
Effluent
Chlorine, Total Residual
12/13/18
2 X week
ug/I
28
30
7.1
Daily Maximum
No Action, BPJ
Exceeded
12 - 2018
001
Effluent
Chlorine, Total Residual
12/17/18
2 X week
ug/I
28
29
3.6
Daily Maximum
No Action, BPJ
Exceeded
07 - 2015
001
Effluent
Oxygen, Dissolved (DO)
07/02/15
Weekly
mg/I
5
2.2
56.0
Daily Minimum Not
Proceed to
Reached
Enforcement Case
07 - 2015
001
Effluent
Oxygen, Dissolved (DO)
07/11/15
Weekly
mg/I
5
3.2
36
Daily Minimum Not
Proceed to
Reached
Enforcement Case
07 - 2015
001
Effluent
Oxygen, Dissolved (DO)
07/17/15
Weekly
mg/I
5
3.6
28
Daily Minimum Not
Proceed to
Reached
Enforcement Case
07 - 2015
001
Effluent
Oxygen, Dissolved (DO)
07/24/15
Weekly
mg/I
5
3.1
38
Daily Minimum Not
Proceed to
Reached
Enforcement Case
07 - 2015
001
Effluent
Oxygen, Dissolved (DO)
07/31/15
Weekly
mg/I
5
3.5
30
Daily Minimum Not
Proceed to
Reached
Enforcement Case
08 - 2015
001
Effluent
Oxygen, Dissolved (DO)
08/07/15
Weekly
mg/I
5
4.1
18
Daily Minimum Not
Proceed to
Reached
Enforcement Case
08 - 2015
001
Effluent
Oxygen, Dissolved (DO)
08/14/15
Weekly
mg/I
5
3.8
24
Daily Minimum Not
Proceed to
Reached
Enforcement Case
08 - 2015
001
Effluent
Oxygen, Dissolved (DO)
08/20/15
Weekly
mg/I
5
2.6
48
Daily Minimum Not
Proceed to
Reached
Enforcement Case
08 - 2015
001
Effluent
Oxygen, Dissolved (DO)
08/26/15
Weekly
mg/I
5
2.8
44.0
Daily Minimum Not
Proceed to
Reached
Enforcement Case
09 - 2015
001
Effluent
Oxygen, Dissolved (DO)
09/02/15
Weekly
mg/I
5
3.3
34
Daily Minimum Not
Proceed to NOV
Reached

DocuSign Envelope ID: 1879A874-28F7-47C8-944C-93AE2B9C6942
MONITORING REPORT(MR) VIOLATIONS for:
Permit: NCO059218 MRS Between 7 - 2015 and 7 - 2019 Region: %
Facility Name: % Param Name % County: %
Major Minor: %
Report Date: 07/10/19 Page: 3 of 6
Violation Category:% Program Category: %
Subbasin:% Iq
Violation Action:
PERMIT: NCO059218
FACILITY: Steve Pappas - Captain Stevens Seafood WWTP
COUNTY: Davidson
REGION: Winston-Salem
Limit Violation
MONITORING
VIOLATION
UNIT OF
CALCULATED
%
REPORT
OUTFALL
LOCATION
PARAMETER
DATE
FREQUENCY
MEASURE
LIMIT
VALUE
Over
VIOLATION TYPE
VIOLATION ACTION
09 -2015
001
Effluent
Oxygen, Dissolved (DO)
09/09/15
Weekly
mg/I
5
3.5
30
Daily Minimum Not
Proceed to NOV
Reached
09 -2015
001
Effluent
Oxygen, Dissolved (DO)
09/15/15
Weekly
mg/I
5
4.1
18
Daily Minimum Not
Proceed to NOV
Reached
09 -2015
001
Effluent
Oxygen, Dissolved (DO)
09/23/15
Weekly
mg/I
5
4.5
10
Daily Minimum Not
Proceed to NOV
Reached
09 - 2015
001
Effluent
Oxygen, Dissolved (DO)
09/28/15
Weekly
mg/I
5
3.4
32
Daily Minimum Not
Proceed to NOV
Reached
10 - 2015
001
Effluent
Oxygen, Dissolved (DO)
10/06/15
Weekly
mg/I
5
4.5
10
Daily Minimum Not
Proceed to NOV
Reached
10 - 2015
001
Effluent
Oxygen, Dissolved (DO)
10/15/15
Weekly
mg/I
5
4.9
2.0
Daily Minimum Not
Proceed to NOV
Reached
10 - 2015
001
Effluent
Oxygen, Dissolved (DO)
10/20/15
Weekly
mg/I
5
4.1
18
Daily Minimum Not
Proceed to NOV
Reached
10 - 2015
001
Effluent
Oxygen, Dissolved (DO)
10/30/15
Weekly
mg/I
5
4.2
16.0
Daily Minimum Not
Proceed to NOV
Reached
11 -2015
001
Effluent
Oxygen, Dissolved (DO)
11/06/15
Weekly
mg/I
5
3.7
26
Daily Minimum Not
Proceed to NOV
Reached
11 -2015
001
Effluent
Oxygen, Dissolved (DO)
11/13/15
Weekly
mg/I
5
3.9
22
Daily Minimum Not
Proceed to NOV
Reached
11 -2015
001
Effluent
Oxygen, Dissolved (DO)
11/17/15
Weekly
mg/I
5
3.4
32
Daily Minimum Not
Proceed to NOV
Reached
12 - 2015
001
Effluent
Oxygen, Dissolved (DO)
12/01/15
Weekly
mg/I
5
4.7
6
Daily Minimum Not
Proceed to NOV
Reached
12 - 2015
001
Effluent
Oxygen, Dissolved (DO)
12/10/15
Weekly
mg/I
5
4.8
4
Daily Minimum Not
Proceed to NOV
Reached
12 - 2015
001
Effluent
Oxygen, Dissolved (DO)
12/23/15
Weekly
mg/I
5
4.9
2.0
Daily Minimum Not
Proceed to NOV
Reached
12 - 2015
001
Effluent
Oxygen, Dissolved (DO)
12/28/15
Weekly
mg/I
5
4.1
18
Daily Minimum Not
Proceed to NOV
Reached
03 - 2017
001
Effluent
Solids, Total Suspended -
03/20/17
2 X month
mg/I
45
48
6.7
Daily Maximum
Proceed to NOD
Concentration
Exceeded

DocuSign Envelope ID: 1879A874-28F7-47C8-944C-93AE2B9C6942
MONITORING REPORT(MR) VIOLATIONS for:
Permit: NCO059218 MRS Between 7 - 2015 and 7 - 2019 Region: %
Facility Name: % Param Name % County: %
Major Minor: %
Report Date: 07/10/19 Page: 4 of 6
Violation Category:% Program Category: %
Subbasin:% Iq
Violation Action:
PERMIT: NCO059218 FACILITY: Steve Pappas - Captain Stevens Seafood WWTP COUNTY: Davidson REGION: Winston-Salem
Limit Violation
MONITORING VIOLATION UNIT OF CALCULATED %
REPORT OUTFALL LOCATION PARAMETER DATE FREQUENCY MEASURE LIMIT VALUE Over VIOLATION TYPE VIOLATION ACTION
03 -2017 001
02 - 2018 001
02 - 2018 001
Monitoring Violation
MONITORING
REPORT OUTFALL
Effluent
Effluent
Effluent
LOCATION
Solids, Total Suspended -
Concentration
Solids, Total Suspended -
Concentration
Solids, Total Suspended -
Concentration
PARAMETER
03/31/17
02/26/18
02/28/18
VIOLATION
DATE
2 X month
2 X month
2 X month
FREQUENCY
mg/I
mg/I
mg/I
UNIT OF
MEASURE
30 35.2 17.3
45 89.2 98.2
30 51.6 72
CALCULATED %
LIMIT VALUE Over
Monthly Average
Exceeded
Daily Maximum
Exceeded
Monthly Average
Exceeded
VIOLATION TYPE
Proceed to NOD
Proceed to NOD
Proceed to NOD
VIOLATION ACTION
01-2019
001
Effluent
BOD, 5-Day (20 Deg. C) -
01/31/19
2 X month
mg/I
Frequency Violation
Proceed to NOV
Concentration
04 - 2016
001
Effluent
Chlorine, Total Residual
04/23/16
2 X week
ug/I
Frequency Violation
No Action, BPJ
04 - 2016
001
Effluent
Chlorine, Total Residual
04/30/16
2 X week
ug/I
Frequency Violation
No Action, BPJ
10 - 2016
001
Effluent
Chlorine, Total Residual
10/01/16
2 X week
ug/I
Frequency Violation
No Action, BPJ
01 -2019
001
Effluent
Chlorine, Total Residual
01/05/19
2 X week
ug/I
Frequency Violation
Proceed to NOV
01 -2019
001
Effluent
Chlorine, Total Residual
01/12/19
2 X week
ug/I
Frequency Violation
Proceed to NOV
01 -2019
001
Effluent
Chlorine, Total Residual
01/19/19
2 X week
ug/I
Frequency Violation
Proceed to NOV
01 -2019
001
Effluent
Chlorine, Total Residual
01/26/19
2 X week
ug/I
Frequency Violation
Proceed to NOV
01 -2019
001
Effluent
Coliform, Fecal MF, MFC
01/31/19
2 X month
#/100ml
Frequency Violation
Proceed to NOV
Broth, 44.5 C
01 -2019
001
Effluent
Flow, in conduit or thru
01/12/19
Weekly
mgd
Frequency Violation
Proceed to NOV
treatment plant
01 -2019
001
Effluent
Flow, in conduit or thru
01/19/19
Weekly
mgd
Frequency Violation
Proceed to NOV
treatment plant
01 -2019
001
Effluent
Flow, in conduit or thru
01/26/19
Weekly
mgd
Frequency Violation
Proceed to NOV
treatment plant

DocuSign Envelope ID: 1879A874-28F7-47C8-944C-93AE2B9C6942
MONITORING REPORT(MR) VIOLATIONS for:
Permit: NCO059218 MRS Between 7 - 2015 and 7 - 2019 Region: %
Facility Name: % Param Name % County: %
Major Minor: %
Report Date: 07/10/19 Page: 5 of 6
Violation Category:% Program Category: %
Subbasin:% Iq
Violation Action:
PERMIT: NCO059218
FACILITY: Steve Pappas - Captain Stevens Seafood WWTP
COUNTY: Davidson REGION: Winston-Salem
Monitoring Violation
MONITORING
VIOLATION
UNIT OF
CALCULATED
REPORT
OUTFALL
LOCATION
PARAMETER
DATE
FREQUENCY
MEASURE
LIMIT VALUE Over VIOLATION TYPE
VIOLATION ACTION
01-2019
001
Effluent
Nitrogen, Ammonia Total (as
01/31/19
2 X month
mg/I
Frequency Violation
Proceed to NOV
N) - Concentration
01 _2019
001
Effluent
Oil & Grease
01/31/19
2 X month
mg/I
Frequency Violation
Proceed to NOV
04 -2016
001
Effluent
Oxygen, Dissolved (DO)
04/30/16
Weekly
mg/I
Frequency Violation
No Action, BPJ
10 -2016
001
Effluent
Oxygen, Dissolved (DO)
10/01/16
Weekly
mg/I
Frequency Violation
No Action, BPJ
03 - 2018
001
Effluent
Oxygen, Dissolved (DO)
03/03/18
Weekly
mg/I
Frequency Violation
No Action, Facility
Reporting Error
01 -2019
001
Effluent
Oxygen, Dissolved (DO)
01/05/19
Weekly
mg/I
Frequency Violation
Proceed to NOV
01 -2019
001
Effluent
Oxygen, Dissolved (DO)
01/12/19
Weekly
mg/I
Frequency Violation
Proceed to NOV
01 -2019
001
Effluent
Oxygen, Dissolved (DO)
01/19/19
Weekly
mg/I
Frequency Violation
Proceed to NOV
01 -2019
001
Effluent
Oxygen, Dissolved (DO)
01/26/19
Weekly
mg/I
Frequency Violation
Proceed to NOV
01 -2019
001
Effluent
pH
01/31/19
2 X month
su
Frequency Violation
Proceed to NOV
01-2019
001
Effluent
Solids, Total Suspended -
01/31/19
2 X month
mg/I
Frequency Violation
Proceed to NOV
Concentration
04 - 2016
001
Effluent
Temperature, Water Deg.
04/30/16
Weekly
deg c
Frequency Violation
No Action, BPJ
Centigrade
10 - 2016
001
Effluent
Temperature, Water Deg.
10/01/16
Weekly
deg c
Frequency Violation
No Action, BPJ
Centigrade
01 -2019
001
Effluent
Temperature, Water Deg.
01/05/19
Weekly
deg c
Frequency Violation
Proceed to NOV
Centigrade
01 -2019
001
Effluent
Temperature, Water Deg.
01/12/19
Weekly
deg c
Frequency Violation
Proceed to NOV
Centigrade
01 -2019
001
Effluent
Temperature, Water Deg.
01/19/19
Weekly
deg c
Frequency Violation
Proceed to NOV
Centigrade
01 -2019
001
Effluent
Temperature, Water Deg.
01/26/19
Weekly
deg c
Frequency Violation
Proceed to NOV
Centigrade
Reporting Violation

DocuSign Envelope ID: 1879A874-28F7-47C8-944C-93AE2B9C6942
MONITORING REPORT(MR) VIOLATIONS for:
Report Date:
07/10/19 Page:
6 of 6
Permit: NCO059218
MRS Between 7 - 2015 and 7 - 2019 Region: %
Violation Category:%
Program Category:
Facility Name: %
Param Name oho
County: %
Subbasin:%
Violation Action: %
Major Minor: %
PERMIT: NCO059218
FACILITY:
Steve Pappas - Captain Stevens Seafood WWTP
COUNTY: Davidson
REGION: Winston-Salem
MONITORING
VIOLATION
UNIT OF CALCULATED %
REPORT OUTFALL
LOCATION
PARAMETER DATE FREQUENCY
MEASURE LIMIT VALUE Over
VIOLATION TYPE
VIOLATION ACTION
02-2019
03/31/19
Late/Missing DMR
None
03-2019
05/01/19
Late/Missing DMR
None
04-2019
05/31/19
Late/Missing DMR
None