NCG110103_COMPLETE FILE - HISTORICAL_20190521

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/V C& l I D I O
DOC TYPE
HISTORICAL FILE
❑ MONITORING REPORTS
DOC DATE
o 2olq 05 Zr
YYYYMMDD

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
��J d r7
/V �
DOC TYPE
_9�, HISTORICAL FILE 1
❑ MONITORING REPORTS
DOC DATE
❑ 2bP7 ! 0 2
YYYYM M DD

ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
S. DANIEL SMITH
In terfm Director
Town of Forest City
Attention: Sonny Penson
Post Office Box 728
Forest City, North Carolina 28043
NORTH CAROLINA
Environmental Quality
May 21, 2019
Subject: Compliance Evaluation Inspection
Permit: NCG110000
Certificate of Coverage: NC_GI10103
Rutherford County, North Carolina
Dear Mr. Penson:
Enclosed please find a copy of the Compliance Evaluation Inspection Report for the
inspection I conducted at the subject facility on May 14, 2019.
The report should be self-explanatory; however, should you have any questions
concerning this report, please do not hesitate to contact me at [phone] or by email
at [e-mail].
Sincere
c'� f
Isaiah heed, PSWQ, CEP Cl, MS4CEC1
Environmental Specialist
Land Quality Section
Enclosure: Inspection Report
QNorth.�. Carolina Department of Environmental Quality i Division of Energy, Mineral and Land Resources
CZ EJ�Jj� Asheville Reg'.onal OMce 12090 US. Wlghway 70 I Swannanoa North CaroUna 28T78
ocput-mot � am 820.296.4500

Compliance Inspection Report
Permit: NCG110103 Effective: 06/01/18 Expiration: 05/31/23 owner. Town of Forest City
SOC: Effective: Expiration: Facility: Forest City wwTP
County: Rutherford 397 Riverside far
Region: Asheville
Forest City NC 28043
Contact Person: Sonny Pcnson Title: Phone -828-2h8=5217 _ _ -
directions to Facility: _
System Classifications:
Primary ORC:
Secondary ORC(s):
On -Site Representative(s):
Related Permits:
Inspection Date: 05/14/2019
Primary Inspector: Isaiah L Reed
Secondary Inspector(s):
Certification: Phone:
EntryTime: 10:15AM Exit Time: 11:15AM
Phone: [phone]
Reason for Inspection: Routine Inspection Type: Compliance Evaluation
Permit Inspection Type: Municipal WWfP > tMGD, Stormwater Discharge, COC
Facility Status: Compliant Not Compliant
Question Areas:
storm water
(See attachment summary)
Page 1 of 3

Permit: NCG110103 Owner -Facility: Town of Forest City
Inspection Date: 05/1412019 Inspection Type : Compliance Evaluation Reason for Visit: Routine
Inspection Summary:
On May 14, 2019 this facility was inspected for compliance. I met with Sonney Penson on site. No major issues were
observed, and the issues listed in the previous inspection have been addressed.
E
Thank You.
If you have any questions, please contact this office at [phone]
Page 2 of 3

Permit: NCG 110103 Owner - Facility: Town of Forest City
Inspoction Date: 05/1412019 Inspection Type : Compliance Fvaluation Reason for Visit: Routine
Stormwator Pollution Prevention Plan
Yes No NA NE
Does the site have a Stormwater Pollution Prevention Plan?
E ❑ ❑ ❑
# Does the Plan include a General Location (USGS) map?
N ❑ ❑ ❑
# Does the Plan include a "Narrative Description of Practices"?
-__ _-00-0 ❑ - -
# Does the Plan Include a detailed site map Including outfatl locations and drainage areas?
®❑ ❑ ❑
# Does the Plan include a list of significant spills occurring during the past 3 years?
❑ ❑ []
Has the facility evaluated feasible alternatives to current practices?
0 ❑ ❑ ❑
# Does the facility provide all necessary secondary containment?
■ ❑ ❑ ❑
# Does the Plan Include a BMP summary?
E ❑ ❑ ❑
# Does the Plan include a Spill Prevention and Response Plan (SPRP)?
❑ ❑ ❑
# Does the Plan include a Preventative Maintenance and Good Housekeeping Plan?
❑ ❑ ❑
# Does the facility provide and document Employee Training?
E ❑ ❑ ❑
# Does the Plan include a list of Responsible Party(s)?
❑ ❑ ❑
# Is the Plan reviewed and updated annually?
■ ❑ ❑ ❑
# Does the Plan include a Stormwater Facility Inspection Program?
■ ❑ ❑ ❑
Has the Stormwater Pollution Prevention Plan been implemented?
E ❑ ❑ ❑
Comment
Qualitative Monitoring
Yes No NA NE
Has the facility conducted its Qualitative Monitoring semi-annually? N ❑ ❑ ❑
Comment:
Analytical Monitoring Yes No NA NE
Has the facility conducted its Analytical monitoring? ❑ ❑ ■ ❑
# Has the facility conducted its Analytical monitoring from Vehicle Maintenance areas? 11110 ❑
Comment:
Permit and Cuffalla Yes No NA NE
# Is a copy of the Permit and the Certificate of Coverage available at the site? N ❑ ❑ ❑
# Were all outfalls observed during the inspection? ■ ❑ ❑ ❑
# If the facility has representative outfall status, is it properly documented by the Division? ❑ ❑ 0 ❑
# Has the facility evaluated all illicit (non stormwater) discharges? 0 ❑ ❑ ❑
Comment:
Page 3 of 3

Compliance Inspection Report
Permit: NCG110103 Effective: 06/01/18 Expiration: 05/31/23 Owner: Town of Forest City
SOC: Effective: Expiration: Facility: Forest City WWTP
County: Rutherford 397 Riverside Dr
Region: Asheville
Forest City NC 28043
Contact Person: Sonny Penson Title: Phone: [phone]
Directions to Facility:
System Classifications:
Primary ORC:
Secondary ORC(s):
On -Site Representative(s):
Related Permits:
Inspection Date: 05/14/2019
Primary Inspector: Isaiah L Reed
Secondary Inspector(s):
Certification:
Phone:
EntryTime: 10:15AM Exit Time: 11:15AM
Phone: [phone]
Reason for Inspection: Routine Inspection Type: Compliance Evaluation
Permit Inspection Type: Municipal WWTP > 1 MGD, Stormwater Discharge, COC
Facility Status: =pliant M Not Compliant
Question Areas:
Storm Water
(See attachment summary)
Page 1 of 3

Permit: NCGI 10103 Owner - Facility: Town of Forest City
Inspection Date. 05/1412019 Inspection Type : Compliance Evaluation Reason for Visit: Routine
Inspection Summary:
On May 14, 2019 this facility was inspected for compliance. I met with Sonney Penson on site. No major issues were
observed, and the issues listed in the previous inspection have been addressed.
Thank You.
If you have any questions, please contact this office at [phone]
Page 2 of 3

Permit: NCG110103 Owner - Facility: Town of Forest City
Inspection Date: 05114/2019 Inspection Type : Compliance Evaluation Reason for Visit: Routine
Stormwater Pollution Prevention Plan
Yes No NA NE
Does the site have a Stormwater Pollution Prevention Plan?
0
❑ ❑ ❑
# Does the Plan include a General Location (USGS) map?
0
❑ ❑ ❑
# Does the Plan include a "Narrative Description of Practices"?
0
❑ ❑ ❑
# Does the Plan include a detailed site map including outfall locations and drainage areas?
®
❑ ❑ ❑
# Does the Plan include a list of significant spills occurring during the past 3 years?
0
❑ ❑ ❑
# Has the facility evaluated feasible alternatives to current practices?
0
❑ ❑ ❑
# Does the facility provide all necessary secondary containment?
❑ ❑ ❑
# Does the Plan include a BMP summary?
❑ ❑ ❑
# Does the Plan include a Spill Prevention and Response Plan (SPRP)?
E
❑ ❑ ❑
# Does the Plan include a Preventative Maintenance and Good Housekeeping Plan?
0
❑ ❑ ❑
# Does the facility provide and document Employee Training?
0
❑ ❑ ❑
# Does the Plan include a list of Responsible Party(s)?
0
❑ ❑ ❑
# Is the Plan reviewed and updated annually?
E
❑ ❑ ❑
# Does the Plan include a Stormwater Facility Inspection Program?
i
❑ ❑ ❑
Has the Stormwater Pollution Prevention Plan been implemented?
0
❑ ❑ ❑
Comment:
Qualitative Monitoring Yes No NA NE
Has the facility conducted its Qualitative Monitoring semi-annually? M ❑ ❑ ❑
Comment:
Analytical Monitoring Yes No NA NE
Has the facility conducted its Analytical monitoring? ❑ ❑ ❑
# Has the facility conducted its Analytical monitoring from Vehicle Maintenance areas? ❑ ❑ 0 ❑
Comment:
Permit and Outfails Yes No NA NE
# Is a copy of the Permit and the Certificate of Coverage available at the site? 0 ❑ ❑ ❑
# Were all outfalls observed during the inspection? ® ❑ ❑ ❑
# If the facility has representative outfall status, is it properly documented by the Division? ❑ ❑ ❑
# Has the facility evaluated all illicit (non stormwater) discharges? N ❑ ❑ ❑
Comment:
Page 3 of 3

.�W
ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
S. DANIEL SMITH
Interim Director
Town of Forest City
Attention: Sonny Penson
Post Office Box 728
Forest City, North Carolina 28043
NORTH CAROLINA
Environmental Quality
April 4, 2019
Subject: Compliance Evaluation Inspection
Permit: NCG110000
Certificate of Coverage: NCG110103
Rutherford County, North Carolina
Dear Mr. Penson:
Enclosed please find a copy of the Compliance Evaluation Inspection Report for the
inspection 1 conducted at the subject facility on March 27, 2019.
The report should be self-explanatory; however, should you have any questions
concerning this report, please do not hesitate to contact me at [phone] or by email
at [e-mail].
Since
Isaiah ReeU,-CEPSCI, MiS4CECI
Environmental Specialist
Land Quality Section
Enclosure: Inspection Report
North Carolina Department of Environmental Quality I Division of Energy, Mineral and Land Resources
EQ7> Asheville Regional Office 1 2090 U.S. Highway 70 1 Swannanoa, North Carolina 28778
MKIIc HQUNA
828.296.4500

Compliance Inspection Re ort
Permit: NCG110103' Effective: 06/01/18 Expiration: 05/31/23 Owner: Town of Forest City
SOC: Effective: Expiration: Facility: Forest City WWTP
County: Rutherford 397 Riverside Dr
Region: Asheville
Forest City NC 28043
Contact Person: Sonny Penson Title: Phone: [phone]
Directions to Facility:
System Classifications:
Primary ORC:
Secondary ORC(s):
On -Site Representative(s):
Related Permits:
Inspection Date: 03/27/2019
Primary Inspector: Isaiah L Reed
Secondary [nspector(s):
Certification:
Phone:
EntryTime: 01:OOPM Exit Time: 02:45PM
Phone: [phone]
Reason for Inspection: Routine Inspection Type: Compliance Evaluation
Permit Inspection Type: Municipal WWTP > 1 MGD, Stormwater Discharge, COC
Facility Status: ❑ Compliant ® Not Compliant
Question Areas:
® Storm Water
(See attachment summary)
Page 1 of 3

Permit: NCG1 i0103 Owner - Facility: Town of Forest City
Inspection bate: 03/2712019 Inspection Type : Compliance Evaluation Reason for Visit: Routine
Inspection Summary:
On March 27, 2019 this facility was inspected for compliance. I met with Sonny Person on site. During the inspection, the
following item was noted.
1) The Stormwater Pollution Prevention Plan (SWPPP) has not been maintained and implemented. The permittee is directed
to immediately locate or develop a SWPPP as outlined in Stromwater General Permit NCG110000.
Please give the above your immediate attention. This facility will be re -inspected on or after May 14, 2019. If the above items
have not been addressed, further action will be taken.
If you have any questions, please contact this office at [phone]
Page 2 of 3

Permit: NCGI 10103 Owner - Facility: Town of Forest City
Inspection Date: 0312712019 Inspection Type : Compliance Evaluation Reason for Visit: Routine
Stormwater Pollution Prevention Plan
Yes No NA NE
I Does the site have a Stormwater Pollution Prevention Plan?
❑
®❑ ❑
# Does the Plan include a General Location (USGS) map?
i
❑
®❑ ❑
# Does the Plan include a "Narrative Description of Practices'?
❑
®❑ ❑
?------# Does the Plan include a'detailed-site map'including outfah locations and"cirairiage areas? - -- ----
-
'
# Does the Plan include a list of significant spills occurring during the past 3 years?
❑
®❑ ❑
# Has the facility evaluated feasible alternatives to current practices?
❑
®❑ ❑
# Does the facility provide all necessary secondary containment?
❑
®❑ ❑
# Does the Plan include a BMP summary?
❑
®❑ ❑
# Does the Plan include a Spill Prevention and Response Plan (SPRP)?
❑
19 ❑ ❑
# Does the Plan include a Preventative Maintenance and Good Housekeeping Plan?
❑
®❑ ❑
# Does the facility provide and document Fmployee Training?
❑
®❑ ❑
# Does the Plan include a list of Responsible Party(s)?
❑
®❑ ❑
# Is the Plan reviewed and updated annually?
❑
®❑ ❑
# Does the Plan include a Stormwater Facility Inspection Program?
❑
11 ❑ ❑
Has the Stormwater Pollution Prevention Plan been implemented?
❑
E ❑ ❑
Comment: See summary for more information
Qualitative Monitoring
Yes No NA NE
Has the facility conducted its Qualitative Monitoring semi-annually? ❑ ®❑ ❑
Comment: See summary for more information
Permit and Outfalls Yes No NA NE
# Is a copy of the Permit and the Certificate of Coverage available at the site? ❑ ®❑ ❑
# Were all outfalls observed during the inspection? ❑ ®❑ ❑
# If the facility has representative outfall status, is it properly documented by the Division? ❑ ❑ ® ❑
# Has the facility evaluated all illicit (non stormwater) discharges? ❑ ®❑ ❑
Comment:
Page 3 of 3

Compliance Inspection Report
Permit: NCG110103
SOC:
County: Rutherford
Region: Asheville
Effective: 06701/18 Expiration: 05/31/23 Owner: Town of Forest City '
Effective: Expiration: Facility: Forest City WWTP
397 Riverside Dr
Contact Person: Sonny Penson Title:
Directions to Facility:
System Classifications:
Primary ORC:
Secondary ORC(s):
On -Site Representative(s):
Related Permits:
Inspection Date: 03/27/2019 Entry Time: 01:OOPM
Primary Inspector: Isaiah L Reed
Secondary Inspector(s):
Certification:
Forest City NC 28043
Phone: [phone]
Phone:
Exit Time: 02:45PM
Phone: [phone]
Reason for Inspection: Routine ' Inspection Type: Compliance Evaluation
Permit Inspection Type: Municipal WWTP > 1 MGD, Stormwater Discharge, COG
Facility Status: L^_i comp4ant Not Compliant
Question Areas:
Storm Water
(See attachment summary)
Page 1 of 3

Permit: NCG110103 Owner - Facility: Town of Forest City
Inspection Date: 03/27/2019 Inspection Type : Compliance Evaluation Reason for Visit: Routine
Inspection Summary:
On March 27, 2019 this facility was inspected for compliance. I met with Sonny Penson on site. During the inspection, the
following item was noted.
1) The Stormwater Pollution Prevention Plan (SWPPP) has not been maintained and implemented. The permittee is directed
to immediately locate or develop a SWPPP as outlined in Stromwater General Permit NCG110000.
Please give the above your immediate attention. This facility will be re -inspected on or after May 14, 2019. If the above items
have not been addressed, further action will be taken.
If you have any questions, please contact this office at [phone]
Page 2 of 3

Permit: NCGlIO103 Owner -Facility: Town of Forest City
Inspection Date: 03127/2019 Inspection Type : Compliance Evaluation Reason for Visit: Routine
Stormwater Pollution Prevention Plan
Yes No NA NE
Does the site have a Stormwater Pollution Prevention Plan?
❑
®❑ ❑
# Does the Plan include a General Location (USGS) map?
❑
®❑ ❑
# Does the Plan include a "Narrative Description of Practices"?
❑
®❑ ❑
# Does the Plan include a detailed site map including outfall locations and drainage areas?
❑
®❑ ❑
# Does the Plan include a list of significant spills occurring during the past 3 years?
❑
® ❑ ❑
# Has the facility evaluated feasible alternatives to current practices?
❑
® ❑ ❑
# Does the facility provide all necessary secondary containment?
❑
® ❑ ❑
# Does the Plan include a BMP summary?
❑
® ❑ ❑
# Does the Plan include a Spill Prevention and Response Plan (SPRP)?
❑
®❑ ❑
# Does the Plan include a Preventative Maintenance and Good Housekeeping Plan?
❑
®❑ ❑
# Does the facility provide and document Employee Training?
❑
®❑ ❑
# Does the Plan include a list of Responsible Party(s)?
❑
®❑ ❑
# Is the Plan reviewed and updated annually?
❑
® ❑ ❑
# Does the Plan include a Stormwater Facility Inspection Program?
❑
® ❑ ❑
Has the Stormwater Pollution Prevention Plan been implemented?
❑
® ❑ ❑
Comment: See summary for more information
Qualitative Monitorin
Has the facility conducted its Qualitative Monitoring semi-annually?
Comment: See summary for more information
Yes No NA NE
❑®❑❑
Permit and Outfalls
v" u.. A!8 A1F
# Is a copy of the Permit and the Certificate of Coverage available at the site? ❑ ® ❑ ❑
# Were all outfalls observed during the inspection? ❑ ® ❑ ❑
# If the facility has representative outfall status, is it properly documented by the Division? ❑ ❑ ® ❑
# Has the facility evaluated all illidt (non stormwater) discharges? ❑ ®❑ ❑
Comment:
Page 3 of 3

TOR $Src'
gown Of 70TF-1t city
FNAL
+ 1)DCQ. Eox 72-S7' CAa����13o¢esi City, CNo¢E�i C�awfCnQ 2S0¢3 SECTION OFFICE {
January 7, 2008
Mr. Bradley Bennett
Supervisor, Stormwater & General Permit Unit
North Carolina Department of Environment
And Natural Resources
Division of Water quality
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
RE: NPDES Stormwater Permit NCG110103
Forest City Water Reclamation Facility
Renewal Application
Dear Mr. Bennett:
Please find enclosed for your use and processing three (3) copies of the Renewal
Application Form for the NPDES Stormwater General Permit NCG110000 for
Our wastewater treatment plant.
If there are any questions please let me know.
Sincerely,
Charles R. Summey, 1I
Manager
CC: Roger Edwards w/enclosure
Mike Wall w/enclosures
Scott Hoyle w/enclosures
Keith Webb w/enclosures

of WADES Perr verage
�K Renewal A,_ dcation Form
National Pollutant Discharge Elimination System Certificate of Coverage Number
Stormwater General Permit NCG110000 NCGI10103
The following is the information currently in our database for your facility. Please review this information carefully and make all
corrections/ additions as necessary in the space provided to the right of the current information.
Owner Affiliation Information
Owner / Organization Name:
Owner Contact:
Mailing Address:
Phone Number:
Fax Number:
E-mail address:
Facility Contact Information
* Reissued Permit will be mailed to the owner address
Town of Forest City
Charles R Surnmey, II
Forest City, NC 28043
Facility Name: Forest City Water Reclamation Facility
Facility Physical Address: Riverside Dr
Forest City, NC 28043
Facility Contact: rZ W AI
Mailing Address: PO Box 728
r
Phone Number: )5 1 p 828-248-5217 Ext. _
Fax Number: _
E-mail address:
Permit Contact Information
Permit Contact:
Mailing Address:
Phone Number:
Fax Number:
E-mail address:
Discharge_ Information
Receiving Stream:
Stream Class: `
Basin:
Sub -Basin:
Number of Outfalls:
Second Broad River
03-08-02
Ill 11 k �T��-•?nn�,�i
i
WATER QUALITY SECTION
ASNEVILLE REGIONAL OFFi^F
Impaired WaterslTMDL: Does this facility discharge to waters listed as impaired or waters with a finalized TMDL? ❑ Yes ❑ No
( for information on these waters refer to http.;111720.enr.state.nc.us/sullmpairett-Waters-77LfD41)
FacilitylActivity Change Please describe below any changes to your facility or activities since issuance of your. permit. Attached a
separate sheet if necessary.
CERTIFICA
I certify that
such interrm
Sig
i familiar with the information contained in the application and that to the best of my knowledge and belief
is true, complete and accurate.
S Date
Print or type name of person
ng above
Title
Please return this completed renewal application form to: 5W General Permit Coverage RenewalStormwater Permitting Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

April 20, 2007
Mr, Charles R. Summey, Il
Town of Forest City
P.O. BOX 728
Forest City, NC 28043
ac.r.[-fta
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Q Alan 4W. Klimcl
D V D visu
APR 2 6 2007
WATER QUALITY SECTION
ASHEVILLE REGIONAL OFFICE
Subject: General Permit No. NCGI 10000
Forest City Water Reclamation Facility
COC No. NCG110103
Rutherford County
Dear Mr. Summey:
In accordance with your application for a discharge permit received on January 16, 2007
we are forwarding herewith the subject certificate of coverage (COC) to discharge under the
subject state — NPDES general permit. This permit is issued pursuant'to the requirements of
North Carolina General Statute 143-215.1 and the Memorandum of Agreement between North
Carolina and the US Environmental Protection Agency dated May 9, 1994 (or as subsequently
amended).
If any parts, measurement frequencies, or sampling requirements contained in this permit
are unacceptable to you, you have the right to request an individual permit by submitting an
individual permit application. Unless such demand is made, this certificate of coverage shall be
final and binding.
Please take notice that this certificate of coverage is not transferable except after notice to
the Division of Water Quality. The Division of Water Quality may require modification or
revocation and reissuance of the certificate of coverage. This permit does not affect the legal
requirements to obtain other permits which may be required by the Division of Water Quality or
permits required by the Division of Land Resources, Coastal Area Management Act or any other
federal or local governmental permit that may be required.
If you have any questions concerning this permit please contact Aisha Lau at telephone
number [phone] ext. 578. _
SQRUS Alt_ SIGNED BY
BRADI EY BENNETf
Alan W. Klimek, P.E.
cc: Asheville.Regional--Gffice
i�
Central Files
Stormwater Permitting Unit Files
Attachments
.E. Director
iter Quality
NorthCarolina
Naturally
North Carolina Division of water Quality 1617 Mail service Center Raleigh, NC 27699-1617
Internet: h2o.enr.state.nc.us 512 N. Salishury St. Ralci_,h. NC 27604
An Equal Opportunity/Affirmative Action Employer — 50% Recycled110% Post Consumer Paper
Phone [phone] Customer Service
FAX [phone]

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG110000
CERTIFICATE OF COVERAGE No. NCGI10103
STORMWATER DISCHARGES
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards and
regulations promulgated and adopted by the North Carolina Environmental Management Commission, and the
Federal Water Pollution Control Act, as amended,
Town of Forest City
is hereby authorized to discharge stormwater from a facility located at
Forest City Water Reclamation Facility
Riverside Drive
Forest City
Rutherford County
to receiving waters designated as the Second Broad River, class WS IV water, in the Broad River, Basin in
accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts I, I1, II1, IV,
V and VI of General Permit No. NCG 110000 as attached.
This certificate of coverage shall become effective April 20, 2007.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day April 20, 2007.
ORIGINAL. SIGNED BY
E ADI EY EENNE`!7
Alan W. Klimek, Director
Division of Water Quality
By Authority of the Environmental Management Commission

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Latitude: 35°19'37"
Longitude: 81°50'26" NCG 110103 Facility
County: Cherokee Forest City Water Location
tY _.
Stream Class: WS INT Reclamation Facility
Receiving Stream: Broad River
Sub -basin: 03-08-02 (Broad River Basin) Not scaled

I
NCDENR
Fkwrw w:: ovr — w
ew,+ec .oar Kwi tt�
Division of Water Quality / Water Quality Section
National Pollutant Discharge Elimination System
NCG110000
FOR AGENCY USE ONLY
Date Received
Year I Month Da
Certcate o iFf Covera e
C eck fI tat[
Permit Assigned to
NOTICE OF INTENT
National Pollutant Discharge Elimination System application for coverage under General Permit
NCGl I0000:
STORMWATER DISCHARGES associated with activities classified as:
Treatment Works treating domestic sewage or any other sewage sludge or wastewater treatm
10
device or system, used in the storage, treatment, recycling, and reclamation of municipal y ,�
domestic sewage, with a design flow of 1.0 million gallons per day or more, or required to have
approved pretreatment program under Title 40 Code of Federal Regulations (CFR) Part 40 0 �.
including lands dedicated to the disposal of sewage sludge that is located within the confines CD
the facility.
(Please print or type)
1 } Mailing address of ownerloperator:
Name Town of Forest City
Street Address 12 No t-h PnwPll Rtrepr P n n„x 7')n
City Forest City State ^Nr ZIPCode 2804,-
Telephone No. 828 248-5203 Fax: 828 „-,247-8,956 r
Address to which all permit correspondence wit) be mailed
2) Location of facility producing discharge:
Facility Name Forest CityKater Reclamin
Facility Contact Jeff Dodson
Street Address Riverside Drive
City Fnres t Cj f- y State pNr: ZIP Code 28041
Cour•ty
Telephone No. R 2 R 248 6217 Fax:
3) Physical Location Information:
Please provide a narrative description of how to get to the facility (use street names, state road numbers, and
distance and direction from a roadway intersection). US 74
west on Old Caroleen Rd to Riverside Dr, right onto Riverside Dr.
(A copy of a county map or USGS quad sheet with facility dearly located on the map Is required to be submitted with this application) Plant on
4) This NPDES Permit Application applies to which of the following: right approx . 300 yards.
❑ New or Proposed Facility Date operation is to begin
Q Existing
5) Standard Industrial Classification:
Provide the 4 digit Standard Industrial Classification Code (SIC Code) that describes the primary industrial
activity at this facility
S 1 C Code: 9 2 9 9_
SWU-226-101701
Page 1 of 3

NCG110000 N.O.I.
6) Provide a brief narrative description of the types of industrial activities and products manufactured at
this facility: 4.95 MGD WWTP Raw wastewater flows into facility and is
treated tb secondary limits using a suspended growth, activated
sludge process. Wastewater residuals are heat dried prior to
_ distribution.
7) Discharge points / Receiving waters:
How many discharge points (ditches, pipes, channels, etc.) convey stormwater from the property? 3
What is the name of the body or bodies of water (creek, stream, river, lake, etc.) that the facility stormwater
discharges end up in? Second Broad River
If the site stormwater discharges to a separate storm sewer system, name the operator of the separate storm
sewer system (e.g. City of Raleigh municipal storm sewer). N/A _ ..
8) Does this facility have any other NPDES permits?
❑ No
Q Yes
If yes, list the permit numbers for all current NPDES permits for this facility:
NC 0025984
9) Does this facility have any Non -Discharge permits (ex: recycle permits)?
E5: No
❑ Yes
If yes, list the permit numbers for all current Non -Discharge permits for this facility:
10) Does this facility employ any best management practices for stormwater control?
❑ No
Q Yes
If yes, please briefly describe: crood on—sitt-
11) Does this facility have a Stormwater Pollution Prevention Plan?
El No
❑ Yes
If yes, when was it implemented?
12) Are vehicle maintenance activities occurring at this facility?
ER No ❑ Yes
13) Hazardous Waste:
a) is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility?
0 No ❑ Yes
b) Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste generated per month) of
hazardous waste?
W No Cl Yes
c) Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste generated per month) of
hazardous waste?
R1 No ❑ Yes
d) If you answered yes to questions b. or c., please provide the following information:
Page 2 of 3
SWU-226-101701

NCG110000 N.O.I.
Type(s) of waste:
How is material stared:
Where is material stored.
How many disposal shipments per year:
Name of transport ! disposal vendor:_
Vendor address:
14) Certification:
North Carolina General Statute 143-215.6 b (i) provides that:
Any person who knowingly makes any false statement, representation, or certification in any application, record, report,
plan or other document filed 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, shah be guilty of a misdemeanor punishable by a
fine not to exceed $10,000. 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 $1 D,000 or Imprisonment not more than 5 years, or both, ror a similar offense.)
I hereby request coverage under the referenced General Permit. I understand that coverage under this permit
will constitute the permit requirements for the discharge(s) and is enforceable in the same manner as an
individual permit.
I certify 96t I am f�niliar with the information contained in this application and that to the best of my knowledge
and betkf such infqkmation is true, complete, and accurate.
of Person Signing:
n Manager
of Applicant)
Charles R. Summey, II
(Date Signed)
iJOH-ce of Irient must w4 zaccornpArticd by a chocn ormoney Order for $80.00 .-trade payabla to:
NCDENR
Final Checklist
This application will be returned as incomplete unless all of the following items have been included:
Check for $80 made payable to NCDENR
This completed application and all supporting documents
Copy of county map or USGS quad sheet with location of facility clearly marked on map
Mail the entire package to:
Stormwater and General Permits Unit
Division of Water Quality
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Note
Page 3of3
SW U-226-101701

a
7005 0390'0001 3553 1572
5 9!
AGRA7
NCDENR
CH RSUMME 11
,-",�ZLFS y
TOWN . MANAGER
OF FOREST CITY
POST 0 F F-I C E BOX 72 8
FOREST OTv 14C ?8043

■ Olitemsete 1, 2, and 3. Also complete A.
if Restricted Delivery is desired.
■ Pnnt your name and address on the reverse
so that we can return the card to you. B.
■ ettarh thic real to thw hank of the mailniece,
North C�rbli
t + + e
�Environment and n,
f A-2090 U.S. Nior1wn '70, 1 1wQnn
ARLES R SUMMEY ��� CH�.1'°
i OWN MANAGi:T, 1� 3j
TOWS OF FOREST C9T'!," �a �
PCriT OFFICE BOX 728�4 i
FOREST CITY HC 28043 4.
72Q5 0390 0001 3553 1572
3d Name} • .`' ` C. Date' o`f Del
liffene fro @e s
add
12 2D46
QUAL17Y
E5+Wg"—M Return Receipt
❑ Insured Mail .O. .
�es"trlcted Deliveryl7 (Fxha fee}
E
❑ Yes'^_'�
PS Form 3811, February 2004 Domestic Retum Receipt
10259-W2-M-1540

UNITED STATES POSTAL SERVICE
First -Class Mail
Postage & FeeUSPS
Permit No. G-1
• Sender: Please print your name, address, and ZIP+4 in this box •
R. KH IIH HAVNEN
N'f.I AFT R-Jmvt)..SWP
DMI (T.t. LIICi1RS1�''0
l NVtiANNANI),XNc zY�x
MEMMMWWWWWIMBIffififfliff

O� 0A 7n.�r,:.
RQG ti tic rskey, Governor
y 'IV Ili, osI7r., Secretary
North Car in a artnie of virunrn Nadir k Resources
O C .j1' 3iNk P.E, Director
f�ivisionofWaterQuality
SURFACE WATER PROTECTION
December 07, 2006
CERTIFIED MAIL
RETRUN RECEIPT REQUESTED 7005 0390 00013553 1572
Mr. Charles Summey
Town of Forest City
Post Office Box 728
Forest City, North Carolina 28043-0728
Subject: Stormwater Permitting for Treatment Works
Forest City WV1lTP
General Permit Number NCG110000
Rutherford County
Dear Mr. Summey:
The Division several years ago developed General Stormwater Permit No. NCG110000, it is
applicable to owners or operators of stormwater point source discharges associated with activities
classified as Treatment Works. Treatment Works are defined as those facilities treating municipal or
domestic sewage with a design flow of 1.0 million gallons per day or more, or facilities, which are
required to have an approved pretreatment program.
A review of the Division's records indicates that the Town does not have a permit, has not
submitted a Notice of Intent (NOI) or has not submitted a No Exposure Certification for the Forest City
WWTP, in accordance with North Carolina General Statutes 143-214.7 and 143-215.1. I have
enclosed a copy of the NOI and a copy of the Technical Bulletin for Stormwater General Permits,
which contains links for cn!ine information. You are iequesied to fill out the attached NOI completely
(see the final checklist on page 3) and return it to the address on the form.
Please understand that operating your WWTP without the appropriate Stormwater permit
constitutes a violation of North Carolina General Statute (NCGS) 143-215.1; enforceable under
provisions of NCGS 143-215.6A as administered by this Agency.
If you or your staff should have any questions regarding this matter you may contact Mr. Keith
Haynes or me at [phone].
Sincerely,
r
L ry Frost
nvironmental Engineer
ne
Enclosure Nc°thCarolina
�1 atlljvlljl
North Carolina Division of Water Quality 2090 U.S. Highway 70 Swannanoa, NC 29778 Phone [phone] Customer Semite
Internet: www.ncwaterquality.org FAX [phone]a3 1-877-623-6748
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