NC0078158_Regional Office Historical File Pre 2016

L
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 Permit NC0078158
If you are completing this form in computer use the TAB key or the up — down arrows to moue 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 OLDE BEAU WWTP iwsion of Water Resources
Mailing Address 202 MACKENAN COURT DEC 1 1 Mis
City CARY
State / Zip Code NC 27511
Telephone Number [phone]
Fax Number [phone]
e-mail Address [e-mail] RECEIVED/DENR/DWR
2. Location of facility producing discharge: DEC 0 2 2015
Check here if same address as above
Water Quality
Street Address or State Road Near 917 County Downs Avenue Permitting Section
City Glade Valley
State / Zip Code NORTH CAROLINA,
County Alleghany
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 AQUA NORTH CAROLINA, INC
Mailing Address 202 MACKENAN COURT
City CARY
State / Zip Code NORTH CAROLINA 27511
Telephone Number [phone]
Fax Number [phone]
N.C.Dept. of ENR
DEC 18 2015
Winston-Salem Form-D 05/08
1 of 4 Regional Office

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 applyr
Industrial
❑
Number of Employees
Commercial
❑
Number of Employees
Residential
®
Number of Homes 149
School
❑
Number of Students/Staff
Other ® Explain: Club
facilities
Describe the source(s) of wastewater (example: subdivision, mobile home park, shopping centers,
restaurants, etc.):
Population served: 149 Single Family Homes, Club House, Pool, & Maintenance Building
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
7. Name of receiving stream(s) (Provide a map showing the exact location of each outfallJ.
To receiving waters designated as Unnamed Tributary to Laurel Branch, classified C-Trout
waters in the New River Basin (see attached map).
S. Frequency of Discharge: ® Continuous ❑ Intermittent
If intermittent:
Days per week discharge occurs: Duration: _
2 of 4 Form-D 05/08

NPDES APPLICATION - FORM D
For privately owned treatment systems treating 100% domestic wastewaters <1.0 MGD
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.
The 0.020 MGD package plant consist of the following:
• Bar screen
• Flow splitter box
• Equalization basin
• Dual Aeration basins
• Dual secondary clarifiers
• Dual aerated sludge holding tanks
• Single tablet chlorinator
• Chlorine contact chamber
• Tablet dechlor unit
• Stevens flow meter
• Effluent pumps
• On -site generator
10. Flow Information:
Treatment Plant Design flow 0.020 MGD
Annual Average daily flow 0.002 MGD (for the previous 3 years) ENTER DATA IN YELLOW
Maximum daily flow 0.011 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 (BOD5)
29.2
10.84
MG/L
Fecal Coliform
145.0
1.9
#/ 100ML
Total Suspended Solids
88.3
15.3
MG/L
Temperature (Summer)
27.0
19.3
'Celsius
Temperature (Winter)
13.0
6.1
° Celsius
pH
8.2
N/A
UNITS
3 of 4 Form-D 05/08

NPDES APPLICATION - FORM D
For privately owned treatment systems treating 100% domestic wastewaters <1.0 MGD
13. List all permits, construction approvals and/or applications:
Type Permit Number Type
Hazardous Waste (RCRA) NESHAPS (CAA)
UIC (SDWA)
NPDES
PSD (CAA)
Non -attainment program (CAA)
NCO078158
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.
X
of
v
Signature of App cant
North Carolina Gene Statute 143-215.6 (b)(2) states: Any person who knowingly makes any false statement representation, or certification in any
application, record, port, 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.)
4 of 4 Form-D 05/08

MMMM
111
r
Discharge point
t
h e
['�Downstrearn Sampling Point �
Gol
Aqua North Carolina. Inc.
Olde Beau Golf Club WWTP
-h ,y'R... z=" 1- rt 4 N 1Location. i
Facility
Latitude: 36° 24' 48 N State Grid:
Glade
not to Scale
Longitude: 80° 58' 59" W Permitted Flow:
0.02 MGD
Receiving Stream: UT to Laurel Branch Stream Class:
GTrout
NPDES
Permit No. NCO078158
Drainage Basin: New River Basin Sub -Basin:
05-07-03
North
Alleghany County

AOUA,
1
SLUDGE MANAGEMENT PLAN
For
Aqua North Carolina, Inc.
No sludge will be treated on any wastewater treatment plant site operated
by Aqua N.C., Western Division
Where practical, sludge removed from a Aqua N.C., Western Division
facility will be transported via a contract hauler to another Aqua N.C.,
Western Division facility for the purpose of "seeding" a new or under
loaded plant.
Unusable (or "dead") sludge will be removed by a contract hauler and
properly disposed of in accordance with NCGS 143-215.1. Contract
haulers used by Aqua N.C., Western Division will be required to
report the quantity of sludge transported and identify the location of
the proposed disposal site if the sludge is not taken to an existing
plant operated by Aqua N.C., Western Division. Aqua N.C., Western
Division has not entered into any agreement to accept sludge into its
facilities from plants not owned by them.
Aqua N.C., Western Division will keep records on the quantity of sludge
removed from each facility, the name of the contract hauler, and the
destination of the sludge (whether used in another plant or disposed of .
The information will be kept on file and will be made available to any
regulatory agency having jurisdiction over sludge treatment or disposal.
Aqua N.C., Western Division includes all of the facilities under the
jurisdiction of the Winston-Salem Regional Office.
202 MacKenan Court, Cary, NC, 27511 919.467.8712 • AquaAmerica.com

Upstream
NPDES Permit No.: NC 0078158 Discharge No.:
Facility Name: Olde Beau Golf Club
Stream: UT to Laurel Branch
Location: 100' above discharge and po
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Stream:
Location:
Downstream
August Year: 2015
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Facility Name: Olde Beau Golf Club
Stream: UT to Laurel Branch
Location: 100' above discharge and po
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Facility Name: Olde Beau Golf Club
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Stream:
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Location:
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NPDES Permit No.: NC 0078158 Discharge No.:
Facility Name: Olde Beau Golf Club
Stream: UT to Laurel Branch
Location: 100' above discharge and po
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RECEIVEDIDENR/DWR
DEC 0 2 2015
Water Quality
rmitting Section
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Upstream
NPDES Permit No.: NC 0078158 Discharge No.: 001 Month:
Facility Name: Olde Beau Golf Club
Stream: UT to Laurel Branch
Location: 100' above discharge and po
Print Stream Sheet: Yes
County:
Stream:
Location:
Downstream
April Year: 2015
Alleghany
UT to Laurel Branch
200' Below the discharge
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I.
NPDES NO: NC 0078158 DISCHARGENO: 001 MONTH: January YEAR: 2015
FACILITY NAME: Olde Beau Golf CIub COUNTY: Allegheny
STREAM: UT to Laurel Branch STREAM: UT to Laurel Branch
LOCATION: 100' ft, Above Discharge &Pond LOCATION: 200' ft. Below Discharge
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Copy DEM Form MR-3 (11/84)

NPDES NO: NC 0078158 DISCHARGE NO: 001 MONTH: December YEAR: 2014
FACILITY NAME: Olde Beau Golf Club COUNTY: Allegheny
i
STREAM: UT to Laurel Branch STREAM: UT to Laurel Branch
LOCATION: 100' ft. Above Discharge & Pond LOCATION: 200' ft. Below Discharge
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Copy DEM Farm MR-3 (11/84)

NPDES NO: NC 0078158 DISCHARGE NO: 001 MONTH: October YEAR: 2014
FACILITY NAME: Olde Beau Golf Club COUNTY: Allegheny
STREAM: UT to Laurel Branch STREAM: UT to Laurel Branch
LOCATION: 100' ft. Above Discharge & Pond LOCATION: 200' ft. Below Discharge
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Copy DEM Form MR-3 (11184)

Water Resources
ENVIRONMENTAL QUALITY
Mr. Thomas J. Roberts, President
Aqua North Carolina, Inc.
Olde Beau Golf Club WWTP
202 Mackenan Court
Cary, NC 27511
Dear Permiee:
RECEIVED
N,C,Dept. of ENR
DEC 112015
Winston-Salem
Re ionalOffice
December 7, 2015
PAT MCCRORY
Go,Krnor
DONALD R. VAN DER VAART
Secretary
S. JAY ZIMMERMAN
Director
Subject: Acknowledgement of Permit Renewal
Application No. NCO078158
Olde Beau Golf Club WWTP
Alleghany County
The Water Quality Permitting Section has received your permit renewal application on December
02, 2015. A member of the NPDES Unit will review your application. They will contact you if additional
information is required to complete your permit renewal. Per G.S. 15OB-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. Please respond in a timely manner to
requests for additional information necessary to complete the permit application.
If you have any additional questions concerning renewal of the subject permit, please contact Wren
Thedford at 919-807-6304 or [e-mail].
Sincerely,
W Ir&o" Tl'.eO(�o of
Wren Thedford
Wastewater Branch
cc: Central Files
Winston Salem Regional Office, Water Quality Regional Operations Section
NPDES Unit
State of North Carolina I Environmental Quality I Water Resources
1617 Mail Service Center I Raleigh, North Carolina 27699-1617
919-807.6300

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Resources
Water Quality Regional Operations Section
Pat McCrory
Governor
June 1, 2015
Thomas J. Roberts, President
Aqua North Carolina Inc
202 Mackenan Ct
Cary NC 27511
Subject: NOTICE OF VIOLATION
NOV-2015-LV-0347
Permit No. NCO078158
Olde Beau Golf Club WWTP
Alleghany County
Dear Mr. Roberts:
Donald R. van der Vaart
A review of Olde Beau Golf Club WWTP's monitoring report for February 2015 showed the following
violations:
Secretary
Parameter
Date
Limit Value
Reported Value
Limit Type
TSS
2/6/2015
45.000 mg/1
88.3 mg/l
Daily Maximum Exceeded
TSS
2/28/2015
30.000 mg/l
58.75 mg/1
Monthly Average Exceeded
Remedial actions, if not already implemented, should be taken to correct the above noncompliance problem.
Please be aware that violations of your NPDES permit could result in enforcement action by the Division of
Water Resources for this and any additional violations of State law. If you should have any questions, please do
not hesitate to contact Gary Hudson at [phone].
cc: SWP — Central Files
WSRO Files
North Carolina Division of Water Resources, Winston-Salem Regional Office
Location: 450 W, Manes Mill Road Suite 300, Winston-Salem, North Carolina 27105
Phone; 336-776-98001, Customer Service;1-877-62M748
Internet: www.ncwater.org
Sincerely,
W. Corey Basinger
Regional Supervisor
Water Quality Regional Operations
Division of Water Resources
NorthCarolina
Iatura!!y
AnEqual Opwrtunity t Affirma*ve ;action _mp ayer

DMR Review Record j
Facility: Otx B/EA Permit No. CX7 9/58 Pipe No.: 60
Monthly Average Violations
MonthlYear. G,7 26/,�—
Permit
Parameter
Limit
DMR Value
% Over Limit Action
L _ Daily iolations,
Date Parameter Permit Limit Limit TVPe
DMR Value
% Over Limit Action
9 y d
Dale Parameter
Permit Frequency
Values Reported
# of Violations Action
Other ViolationslStaff Remarks:
No vt In 5'E)e, 2611 — -r5y— .DR / LV -+ M OA; rHL-Y — �jC):2)
>upervisor Remarks: 'N cv
Completed by: ( , �G/� sQ�I Date: z�? 9 /n/� \/ ,-
Assistant Regional
Supervisor Sign Off: ' r M Date:
Regional Supervisor Sign
Off: Date:

EFFLUENT
NPDES PERMIT NO. NC 0078158 DISCHARGE NO. 001 MONTH February YEAR 2015
FACILITY NAME Olde Beau Golf Club CLASS II COUNTY Allegheny
CERTIFIED LABORATORIES R & A Laboratories, Inc. CERTIFICATION NO. 34
(List additional laboratories on the backside/page 2 of tl is
ED
OPERATOR IN RESPONSIBLE CHARGE (ORC) N or " EIVt� Et4R G DE III CERTIFICATION NO. 992198
PERSON(S) COLLECTING SAMPLES Operator ORC PHONE [phone]
CHECK BOX IF ORC HAS CHANGED APR 0 7 2015 NO FLOW / DISCHARGE FROM SITE * Q
i
Mail ORIGINAL and ONE COPS'` to; , R3 // 7 / 20 !9-
ATTN: CENTRAL FILES
DIVISION OF WATER QUALITY MAR 31 2015 (SIGNATURE OF OPERATOR IN RESPONSIBLE CHARGE) DATE
1617 MAIL SERVICE CENTER BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS _
RALEIGH, NC 27699-1617;IA`"'yrlliz3 LES ACCURATE AND COMPLETE TO THE BEST OF MY I E.
TIRg
j A
50050 00010 00400 1 50060 '00310 00610 00530 31616 00300 00600 0 - 5 1 00556
FLOW y Enter Parameter Code
Above Name And Units
_ O EFF a eo a d a O
is UU F t. °J o U y o�u o Below
Oca
Daily Daily Weekly 2/Week Weekly Weekly Weekly Weekly Weeklyl I Weekly
HRS HRS viam MGDor SU 1 m l m I m l atoo/mt m l m l m 1 nos/c m
2 0950 0.25 Y 0.0001 5.0 7.1 <10
4 1040 0.55 Y 0.0003 2.0
6 0920 0.35 Y 0.0025 0.0 23.8 5.31 88.3 <2 1 13.7 L<5.0
8 0.0011
10 0930 0.30 Y 0.0000 No Discharge ------ ------------ ------ ------------- --- ---- -- _----_---------------------------- - --- --------- - ---- ------- -----
121 0855 1 0.45 1 Y 1 0.0004 1 5.0
14 0.0016
1161 11301 0.50 1 Plant is frozen completely
1181 0930 1 0.50 Y *0.016 Plant is frozen com letely---------------------------------------------- - - -
20 0950 0.25 Y *0.016 Plant is frozen completely -----------------------------------------------------------------------------------------------------------------
22 *0.016 Plant is frozen completely
24I 1 0.0000 lUnable to get to plant due to weather---------------------------------------------------------- -- --- -
26I 1 0.0000 Unable to get to plant due to weather-------------
281 0.0000 IPlant is frozen completely - No Discharge -----__- ---------- -- ------ ------ ----- -_-__-
30
AVERAGE 0.0006 3.2 <10 20.1 1 2.66 1 58.75
MINIMUM 0.0000 0.0 7.1 <10 16.4 1 <0.10 1 29.2
Monthly Limit 0.020 =>6<9 20S/30W 3S/6.9W 30/M 200/M =>5.0 30/M
Daily Limit 28/1) 30S/45W 15S/34.5 45/D I 400/D 60/D
*Inaccurate flow due to Heavy Icin
Copy DWQ Form MR-1 (01/00)

w
y
' RESEARCh & ANA1yTICA1
LAbORATORIES, INC.
Analytical/Process Consultations
Re: Old Beau Golf Club — TSS — February 2015
I had a lot of fines in Effluent due to a frozen return the week prior. I got the
return unclogged and the plant working normal, but even waiting untill Friday to sample,
fines were still present. The following week it seemed to clear up.
-Morgan Turner, ORC
P.O. Box 473. 106 Short Street • Kernersville, North Carolina 27284.336-996-2841 • Fax [phone]
www.randalabs.com

ALF
i y
�
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Resources
Water Quality Regional Operations Section
Pat McCrory
Governor
March 2, 2015
Thomas J Roberts, President
Aqua North Carolina Inc
202 Mackenan Ct
Cary NC 27511
Subject: NOTICE OF DEFICIENCY
NOD-2015-LV-0016
Permit No. NCO078158
Olde Beau Golf Club WWTP
Alleghany County
Dear Mr Roberts:
Donald R. van der Vaart
Secretary
A review of Olde Beau Golf Club WWTP's monitoring report for November 2014 showed the following
deficiencies:
,Parameter
Date
Limit Value
Reported
Value
Limit Type
TSS
11/21/2014
45 mg/l
61 mg/1
Daily Maximum Exceeded
TSS
11/30/2014
3 mg/1
30.9 mg/1
Monthly Average Exceeded
Remedial actions should be taken to correct the cause(s) of these deficiencies. Unresolved deficiencies may
lead to the issuance of a Notice of Violation and/or assessments of civil penalties by the Division of Water
Resources of up to $25,000.00 per day for each violation. Any efforts undertaken to bring the facility back into
compliance are not an admission of culpability. Your response, the degree and extent of harm to the
environment, and the duration and gravity of the deficiency(ies) will be considered in any future actions
undertaken. If you should have any questions, please do not hesitate to contact Gary Hudson at [phone].
cc: SAT — Central Files
WSRO Files
North Carolina Division of Water Resources, Winston-Salem Regional Office
Location: 450 W. Hanes Mill Road, Suite 300, Winston-Salem, North Carolina 27105
Phone: [phone] Customer Service:1-877-623.6748
Internet: www,ncwater.org
Sincerely,
W. Corey Basinger
Regional Supervisor
Water Quality Regional Operations
Division of Water Resources
NorthCarolina
An Equal Opportunity1 Affirmative Action Employer

DMR Review Record
Facility: Q LD E R Ll j j) Permit No&Q 75 / J� �' Pipe No,: n D MonthNear: Ooem 6c
j P 2
I, Monthly Average Violations
ParameterPermit Limit DMR Value %Over Limit Action
T� 3 G�
lam --Violations
Date Parameter Permit Limit Limit Type DMR Value % Over Limit Action
2 j NOVN 71S irJ61 E/
Monitoring Frequency Violations
Date
Parameter Permit Frequency Values Reported # of Violations Action
Other Violations/Staff Remarks:
Supervisor Remarks:
Completed by: r—, '�j F J Date: 2. MAg / -5
Assistant Regional
Supervisor Sign Off: Date:
Regional Supervisor Sign
Off: Date:

EFFLUENT
NPDES PERMIT NO. NC 0078158 DISCHARGE NO. 001 MONTH November YEAR 2014
FACILITY NAME Olde Beau Golf Club CLASS II COUNTY Allegheny
CERTIFIED LABORATORIES R & A Laboratories, Inc. CERTIFICATION NO. 34
(List additional laboratories on the backside/page 2 of this form)
OPERATOR IN RESPONSIBLE CHARGE (ORC) Morgan Turner GRADE III CERTIFICATION NO. 992198
PERSON(S) COLLECTING SAMPLES Operators ORC PHONE [phone]
CHECK BOX IF ORC HAS CHANGED 0 NO FLOW / DISCHARGE FROM SITE
_ RECEIVED
Mail ORIGINAL and ONE - ids I / L N.C. Dept. of ENR
ATTN: CENTRAL FILES DECs� X �2 /� I. 7
DIVISION OF WATER QUALITY EC 3 12
1617 MAIL SERVICE CENTER _
RALEIGH, NC 27699-1617DVIIF
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Copy DWQ Form MR-1 (01/00)

w
` RESEARCh & ANA[yTICA1
LAbORATORIES, INC.
Analytical/Process Consultations
Re: Old Beau Golf Club — TSS — November 21, 2014
Came into plant on Monday, November 17, 2014 and looked terrible. Effluent
was cloudy and had weird foam on Clarifier surface. I hosed down Clarifier and wasted,
added alkalinity to Aeration Basin. All week it stayed cloudy and at end of week I had to
sample. Friday, November 2 1 " it did look better and by Monday, November 24th it had
cleared up.
-Morgan Turner, ORC
a
P.O. Box 473. 106 Short Street • Kernersville, North Carolina 27284.336-996-2841 • Fax [phone]
www.randalabs.com

AQUA,
December 10, 2012
Mr. W. Corey Basinger
Surface Water Regional Supervisor
Winston-Salem Regional Office, DWQ
585 Waughtown Street
Winston-Salem, NC 27107
Aqua North Carolina, Inc
202 MacKenan Court
Cary, NC 27511
Re: Olde Beau WWTP
Notice of Violation and Recommendation for Enforcement
Case No. NOV-2012-MV-0046
Permit No. NCO078158
Dear Mr. Basinger:
RECEIVED
N.C.Dept. of ENR
DEC 13 2012
Winston-Salem
Regional Office
Thomas J. Roberts
President and Chief Operating Officer
T:919.653.5770
F: 919.460.1788
[e-mail]
www.aquanorthcarolina.com
Aqua North Carolina, Inc. (Aqua) offers the following response to the Notice of Violation and
Recommendation for Enforcement, NOV-2012-MV-0046, dated November 28, 2012. This violation was
for measuring frequencies for BOD, fecal coliform, ammonia, oil/grease and TSS on August 4, 2012.
Response:
Each of these samples were collected Tuesday, July 31, 2012; however, the sample results were
inadvertently omitted from the August DMR. An amended DMR for July 2012 has been prepared and
will be submitted by Friday, December 14, 2012.
If you have any questions or comments, please do not hesitate to contact Laurie Ison, Area Manager, at
704-489-9404.
Sincerely,
Thomas J. R erts
President and COO
TJR/rl
cc: Jack Lihvarcik
Michael Melton
Laurie Ison
An Aqua America Company

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Resources
Water Resources Programs
Pat McCrory
Governor
November 10, 2014
Mr. Tom Roberts
Aqua NC, Inc.
202 MacKenan Court
Cary, NC 27511
SUBJECT: Compliance Evaluation Inspection
Olde Beau Golf Club WWTP
NPDES Permit No. NCO078158
Alleghany County
Dear Mr. Roberts:
John E. Skvarla, III
Secretary
On October 30, 2014, Gary Hudson of this office met with Morgan Turner, ORC with R & A Labs, to
perform a Compliance Evaluation Inspection on the wastewater treatment system serving the Olde Beau Golf
Club. This type of inspection consists of two basic parts: an in office file review and an on -site inspection of
the treatment facility. The attached EPA inspection form notes the eight (8) areas that were evaluated for this
inspection. The findings and observations are outlined below:
I. Permit
Ownership of the package plant and collection system has been transferred to Aqua NC. The permit
modification showing ownership change became effective May 1, 2011, and expires on March 31, 2016.
II. Self -Monitoring Program
A review of the monthly self -monitoring reports (DMR's) for the period August 2013 through July 2014 showed
the facility to be in complete compliance with all final NPDES effluent limits for the period.
III. Flow Measurement
A Stevens flow meter is used for continuous flow recording
calibration on 08/09/14.
IV. Sludge Handling and Disposal
North Carolina Division of Water Resources, Winston-Salem Regional Office
Location: 585 Waughtown St. Winston-Salem, North Carolina 27107
Phone: 336-771-WOO \ FAX: [phone] \ Customer Service: 1-877-623.6748
Internet www.ncwaterquality.org
An Equal Opportunity \ Affirmative Action Employer
Horizon Engineering performed the annual
None Carolina
MA M711Y

I
Solids are transferred from the small digester to the unused aeration basin for storage. At this time, no
septage hauler is under contract for regular pumping of the solids
V. Operations and Maintenance
The package plant appeared to be well maintained and operated. No concerns were noted.
VI. Facility Site Review
The 0.020 MGD package plant consists of the following: bar screen, flow splitter box, equalization basin, dual
aeration basins, dual secondary clarifiers, dual aerated sludge holding tanks and a single tablet chlorinator,
contact chamber, tablet dechlor unit, Stevens flow meter, effluent pumps and on -site generator.
VII. Records/Reports
A daily visitation log is kept on site and was available for inspection.
VIII. Effluent/Receiving Waters
The system discharges into a U.T. to Laurel Branch, Class "C-trout' waters. The effluent was crystal clear on
the date of the inspection.
Should you have any questions concerning this report, please contact Gary Hudson or me at (336)
776-9800.
cc: Cliff Cain - R & A Labs
Central Files
WSRO
Sincerely,
W. Corey Basinger
Regional Supervisor
Water Quality Regional Operations
Division of Water Resources

Olde Beau Golf Club WWTP
NPDES Permit No. NCO078158
Self -Monitoring Data Summary
August 2013 - July 2014
Parameters
Monthly Avg.
Permit Limit
Monthly Avg. Limit
Violations per
DMR
Daily Maximum
Permit Limit
Daily Max. Limit
Violations per DMR
Flow (MGD)
0.020
None
-
NA
BOD (mg/1)
(20 / 30)*
None
(30 / 45)*
None
TSS (mg/1)
30.0
None
45.0
None
NH3-N (mg/1)
(3 / 6.9)*
None
(15 / 34.5)*
None
Fecal (#/100 ml)
200
None
400
None
T. Chlorine (ug/1)
-
NA
28
None
Oil & Grease (mg/1)
30
None
60
None
*(Summer/Winter limits)

United States Environmental Protection Agency
Form Approved.
EPA Washington, D.C. 20460
OMB No. 2040-0057
Water Compliance Inspection Report
Approval expires 8-31-98
Section A: National Data System Coding (i.e., PCS)
Transaction Code NPDES ydmo/day Inspection Type Inspector Fac Type
1 2 15 1 3 I NCO078158 I11 12 14/10/30 17 181 r, 1 19 Ls F 20LJ
21111111 111111111 11 I II 1111 1 111111 11111111111 f6
Inspection Work Days Facility Self -Monitoring Evaluation Rating 131 QA ----Reserved — — — — — — —
67
70 L71 ( 72 LNJ 73 L i 74 75 1 1 1 1 1
80
Section B: FacilityData
Name and Location of Facility Inspected (For Industrial Users discharging to POTW, also include
Entry Time/Date
Permit Effective Date
POTW name and NPDES permit Number)
11:00AM 14/10/30
11/05/01
Olds Beau Golf Club WWTP
County Downs Ave
Exit Time/Date
Permit Expiration Date
Roaring Gap NC 28668
12:OOPM 14/10/30
16/03/31
Names) of Onsite Representative(s)/Titles(s)/Phone and Fax Number(s)
Other Facility Data
Morgan Lee Tumer/ORC/336-996-2841/
Name, Address of Responsible Official/Title/Phone and Fax Number
Contacted
Laurie Ison,4163 Sinclair St Denver NC 28037/Westem Area Manager/704-489-9404/
No
Section C: Areas Evaluated During Inspection (Check only those areas evaluated)
Permit 0 Flow Measurement Operations & Maintenance Records/Reports
Self -Monitoring Program 0 Sludge Handling Disposal Facility Site Review Effluent/Receiving Waters
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/H
Signature of Management Q A Reviewer Agency/Office/Phone and Fax Numbers Date
/VG D07Lk - DtfJ4 - tt)540 i d ,coves If —
EPA
Page#

NPDES yr/mo/day Inspection Type 1
31 NCO0781sa I11 12 14/10/30 17 18 ICI
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
Page#

I
Permit NCO078158 Owner - Facility: Olde Beau Golf Club VW TP
Inspection Date: 10/30/2014 Inspection Type: Compliance Evaluation
Operations & Maintenance Yes No NA NE
Is the plant generally clean with acceptable housekeeping? ❑ ❑ ❑
Does the facility analyze process control parameters, for ex: MLSS, MCRT, Settleable 0 ❑ ❑ ❑
Solids, pH, DO, Sludge Judge, and other that are applicable?
Comment:
Permit
Yes No NA NE
(if the present permit expires in 6 months or less). Has the permittee submitted a new
❑
❑
0
❑
application?
Is the facility as described in the permit?
0
❑
❑
❑
# Are there any special conditions for the permit?
❑
0
❑
❑
Is access to the plant site restricted to the general public?
❑
❑
❑
Is the inspector granted access to all areas for inspection?
0
❑
❑
❑
Comment: _
Record Keeping
Yes No NA NE
Are records kept and maintained as required by the permit?
0
❑
110
Is all required information readily available, complete and current?
0
❑
❑
❑
Are all records maintained for 3 years (lab. reg. required 5 years)?
0
❑
❑
❑
Are analytical results consistent with data reported on DM Rs?
0
❑
❑
❑
Is the chain -of -custody complete?
M
❑
❑
❑
Dates, times and location of sampling
Name of individual performing the sampling
Results of analysis and calibration
Dates of analysis
Name of person performing analyses
Transported COCs
M
Are DMRs complete: do they include all permit parameters?
0
❑
❑
❑
Has the facility submitted its annual compliance report to users and DWQ?
M
❑
❑
❑
(If the facility is = or > 5 MGD permitted flow) Do they operate 24/7 with a certified operator
❑
❑
0
❑
on each shift?
Is the ORC visitation log available and current?
M
❑
❑
❑
Is the ORC certified at grade equal to or higher than the facility classification?
0
❑
❑
❑
Is the backup operator certified at one grade less or greater than the facility classification?
M
❑
❑
❑
Is a copy of the current NPDES permit available on site?
0
❑
❑
❑
Page# 3

Permit: NCO078158 Owner - Facility: Olde Beau Golf Club WWTP
Inspection Date: 10/30/2014 Inspection Type: Compliance Evaluation
Record Keepinq Yes No NA NE
Facility has copy of previous year's Annual Report on file for review? 0 ❑ ❑ ❑
Comment:
Aeration Basins
Yes No NA NE
Mode of operation
Ext. Air
Type of aeration system
Diffused
Is the basin free of dead spots?
0 ❑
❑
❑
Are surface aerators and mixers operational?
❑ ❑
0
❑
Are the diffusers operational?
0 ❑
❑
❑
Is the foam the proper color for the treatment process?
0 ❑
❑
❑
Does the foam cover less than 25% of the basin's surface?
N ❑
❑
❑
Is the DO level acceptable?
N ❑
❑
❑
Is the DO level acceptable?(1.0 to 3.0 mg/1)
❑ ❑
❑
Comment:
Disinfection -Tablet
Yes No NA NE
Are tablet chlorinators operational?
❑
❑
❑
Are the tablets the proper size and type?
❑
❑
❑
Number of tubes in use?
Is the level of chlorine residual acceptable?
❑
❑
❑
Is the contact chamber free of growth, or sludge buildup?
0
❑
❑
❑
Is there chlorine residual prior to de -chlorination?
N
❑
❑
❑
Comment:
De -chlorination
Yes No NA NE
Type of system ?
Tablet
Is the feed ratio proportional to chlorine amount (1 to 1)?
N ❑
❑
❑
Is storage appropriate for cylinders?
❑ ❑
S
❑
# Is de -chlorination substance stored away from chlorine containers?
❑ ❑
0
❑
Comment: _
Are the tablets the proper size and type? 0 ❑ ❑ ❑
Are tablet de -chlorinators operational? 0 ❑ ❑ ❑
Number of tubes in use?
Page# 4

Permit: NC0078158
Inspection Date: 10/30/2014
De -chlorination
Comment: _
Owner - Facility: Olde Beau Golf Club WWTP
Inspection Type: Compliance Evaluation
Yes No NA NE
Page#

4
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Resources
Water Resources Programs
Pat McCrory Thomas A. Reeder John E. Skvarla, III
Govemor Director Secretary
October 28, 2013
Mr. Tom Roberts
Aqua NC, Inc.
202 MacKenan Court
Cary, NC 27511
SUBJECT: Compliance Evaluation Inspection
Olde Beau Golf Club WWTP
NPDES Permit No. NCO078158
Alleghany County
Dear Mr. Roberts:
On October 17, 2013, Gary Hudson of this office met with Morgan Turner, ORC with R & A Labs, to
perform a Compliance Evaluation Inspection on the wastewater treatment system serving the Olde Beau Golf
Club. This type of inspection consists of two basic parts: an in office file review and an on -site inspection of
the treatment facility. The attached EPA inspection form notes the eight (8) areas that were evaluated for this
inspection. The findings and observations are outlined below:
I. Permit
Ownership of the package plant and collection system has been transferred to Aqua NC. The permit
modification showing ownership change became effective May 1, 2011, and expires on March 31, 2016.
II. Self -Monitoring Program
A review of the monthly self -monitoring reports (DMR's) for the period March 2012 through February 2013
showed the facility to be in complete compliance with all final NPDES effluent limits for the period. However,
the facility had missed several monitoring frequencies in August of 2012.
III. Flow Measurement
A Stevens flow meter is used for continuous flow recording. Horizon Engineering performed the annual
calibration on 08/09/13.
IV. Sludge Handling and Disposal
North Carolina Division of Water Resources, Winston-Salem Regional Office
Location: 585 Waughtown St Winston-Salem, North Carolina 27107
Phone: [phone] FAX: [phone] Customer Service:1-877-623-6748
Internet www.ncwaterquality.org
An Equal Opportunity l Affirmative Action Employer
ne
cdf Carolina
1atmAdy
v

Solids are transferred from the small digester to the unused aeration basin for storage. At this time, no
septage hauler is under contract for regular pumping of the solids
V. Operations and Maintenance
The package plant appeared to be well maintained and operated. No concerns were noted.
VI. Facility Site Review
The 0.020 MGD package plant consists of the following: bar screen, flow splitter box, equalization basin, dual
aeration basins, dual secondary clarifiers, dual aerated sludge holding tanks and a single tablet chlorinator,
contact chamber, tablet dechlor unit, Stevens flow meter, effluent pumps and on -site generator.
VII. Records/Reports
A daily visitation log is kept on site and was available for inspection.
VIII. Effluent/Receiving Waters
The system discharges into a U.T. to Laurel Branch, Class "C-trout" waters. The effluent was crystal clear on
the date of the inspection.
Should you have any questions concerning this report, please contact Gary Hudson or me at (336)
771-5000.
Sincerely,
C
W. Corey Basinger
Regional Supervisor
Water Quality Regional Operations
Division of Water Resources
cc: Cliff Cain - R & A Labs
Central Files
WSRO

Olde Beau Golf Club WWTP
NPDES Permit No. NCO078158
Self -Monitoring Data Summary
March 2012 — February 2013
Parameters
Monthly Avg.
Permit Limit
Monthly Avg. Limit
Violations per
DMR
Daily Maximum
Permit Limit
Daily Max. Limit
Violations per DMR
Flow (MGD)
0.020
None
-
NA
BOD -(mg/1)
(20 / 30)*
None
(30 / 45)*
None
TSS (mg/I)
30.0
None
45.0
None
NH3-N (mg/1)
(3 / 6.9)*
None
(15 / 34.5)*
None
Fecal (#/100 ml)
200
None
400
None
T. Chlorine (ug/1)
-
NA
28
None
Oil & Grease (mg/1)
30
None
60
None
*(SummerMinter limits)

United States Environmental Protection Agency
Form Approved.
EPA Washington, D.C. 20460
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 NI 2 1 G 1 3 I NCO078158 111 12I 13/10/17 117 18I r I 19 LI 20IU
LJ J
Remarks
2111111111Jill Jill 11111111111111111111111111111116
Inspection Work Days Facility Self -Monitoring Evaluation Rating B1 QA ------------Reserved---------
67 I 169 70 U 71 U 721 N � 73I I 174 751 I I I I I I 180
—! I_I_I
Section B: Facility Data
Name and Location of Facility Inspected (For Industrial Users discharging to POTW, also include
Entry Time/Date
Permit Effective Date
POTW name and NPDES permit Number)
Olde Beau Goff Club WWTP
10:30 AM 13/10/17
11/05/01
Exit Time/Date
Permit Expiration Date
County Downs Ave
Roaring Gap NC 28668
11:30 AM 13/10/17
16/03/31
Name(s) of Onsite Representative(s)/Tibes(s)/Phone and Fax Number(s)
Other Facility Data
Morgan Lee Turner/ORC/336-996-2841/
Name, Address of Responsible Official/rifle/Phone and Fax Number
Contacted
Laurie Ison,4163 Sinclair St Denver NC 28037/Westem Area Manager/704-489-9404/ Contato
No
Section C: Areas Evaluated During Inspection (Check only those areas evaluated)
Permit 0 Flow Measurement Operations & Maintenance Records/Reports
Self -Monitoring Program 0 Sludge Handling Disposal Facility Site Review Effluent/Receiving Waters
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/H
Go 6C 13
Signature of Management Q A Reviewer AAgen�cy/Offiicce,/�Phhone and Fax Numbers
.�/Date
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete.
Page # 1

NPDES yr/mo/day Inspection Type
3I NCO078158 I" 12I 13/10/17 I �� 18u
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
Page # 2

i
Permit: NCO078158 Owner - Facility: Olde Beau Golf Club WWTP
Inspection Date: 10/17/2013 Inspection Type: Compliance Evaluation
Operations $ Maintenance Yes No NA NE
Is the plant generally clean with acceptable housekeeping? ■ ❑ ❑ ❑
Does the facility analyze process control parameters, for ex: MLSS, MCRT, Settleable Solids, pH, DO, Sludge ■ ❑ ❑ ❑
Judge, and other that are applicable?
Comment:
Permit
Yes
No NA
NE
(If the present permit expires in 6 months or less). Has the permittee submitted a new application?
❑
❑ ■
❑
Is the facility as described in the permit?
0011
❑
# Are there any special conditions for the permit?
❑
■ ❑
❑
Is access to the plant site restricted to the general public?
■
❑ ❑
❑
Is the inspector granted access to all areas for inspection?
01111
❑
Comment:
Record Keeping
Yes
No NA
NE
Are records kept and maintained as required by the permit?
■
❑ ❑
❑
Is all required information readily available, complete and current?
■
❑ ❑
❑
Are all records maintained for 3 years (lab. reg. required 5 years)?
■
❑ ❑
❑
Are analytical results consistent with data reported on DMRs?
■
❑ ❑
❑
Is the chain -of -custody complete?
■
❑ ❑
❑
Dates, times and location of sampling
■
Name of individual performing the sampling
■
Results of analysis and calibration
■
Dates of analysis
■
Name of person performing analyses
■
Transported COCs
■
Are DMRs complete: do they include all permit parameters?
■
❑ ❑
❑
Has the facility submitted its annual compliance report to users and DWQ?
❑
❑ ■
❑
(If the facility is = or > 5 MGD permitted flow) Do they operate 24/7 with a certified operator on each shift?
❑
❑ ■
❑
Is the ORC visitation log available and current?
■
❑ ❑
❑
Is the ORC certified at grade equal to or higher than the facility classification?
■
❑ ❑
❑
Is the backup operator certified at one grade less or greater than the facility classification?
■
❑ ❑
❑
Is a copy of the current NPDES permit available on site?
■
❑ ❑
❑
Page # 3

Permit: NCO078158 Owner - Facility: Olde Beau Golf Club WVVfP
Inspection Date: 10/17/2013 Inspection Type: Compliance Evaluation
Record Keeping Yes No NA NE
Facility has copy of previous year's Annual Report on file for review? 00011
Comment: .
Aeration Basins Yes No NA NE
Mode of operation
Ext. Air
Type of aeration system
Diffused
Is the basin free of dead spots?
■
❑ ❑ ❑
Are surface aerators and mixers operational?
❑
❑ ■ ❑
Are the diffusers operational?
■
❑ ❑ ❑
Is the foam the proper color for the treatment process?
■
n ❑ ❑
Does the foam cover less than 25% of the basin's surface?
■
❑ ❑ ❑
Is the DO level acceptable?
■
❑ Cl ❑
Is the DO level acceptable?(1.0 to 3.0 mg/1)
❑
❑ ❑ ■
Comment: .
Disinfection -Tablet
Yes
No NA NE
Are tablet chlorinators operational?
■
❑ ❑ ❑
Are the tablets the proper size and type?
■
❑ ❑ ❑
Number of tubes in use?
Is the level of chlorine residual acceptable?
❑
❑ ❑ ■
Is the contact chamber free of growth, or sludge buildup?
■
❑ ❑ ❑
Is there chlorine residual prior to de -chlorination?
1300
■
Comment:
n_
V— U- WA WC
Type of system ? Tablet
Is the feed ratio proportional to chlorine amount (1 to 1)? ❑ ❑ ❑ ■
Is storage appropriate for cylinders? ❑ ❑ ■ ❑
# Is de -chlorination substance stored away from chlorine containers? ❑ ❑ ■ ❑
Comment: .
Are the tablets the proper size and type? ■ ❑ ❑ ❑
Are tablet de -chlorinators operational? ■ ❑ ❑ ❑
Number of tubes in use?
Page # 4

Permit: NC0078158
Owner - Facility: Olde Beau Golf Club WWTP
Inspection Date: 10/17/2013 Inspection Type: Compliance Evaluation
De -chlorination
Comment:
Yes No NA NE
Page # 5

A*A
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Resources
Water Quality Programs
Pat McCrory Thomas A. Reeder John E. Skvarla, III
Governor Director Secretary
September 10, 2013
Mr. Tom Roberts
Aqua NC, Inc.
202 MacKenan Court
Cary, NC 27511
Subject: NOTICE OF DEFICIENCY
Olde Beau GC WWTP
NPDES Permit # NCO078158
Alleghany County
Dear Mr. Kilpatrick:
A review of the June 2013 Discharge Monitoring Report (DMR) revealed the following monitoring
violations of the following parameter(s) at Outfall 001:
Parameter
Date
Permit Frequency
Violation
Flow
June 1
Continuous Recording
1
Flow
June 2
Continuous Recording
1
Remedial actions should be taken to correct the cause(s) of this violation. The violations described above
should be abated immediately and properly resolved.
If you have any questions or require any additional information, please contact George Smith at (336)
771-4968, [e-mail], or myself at [phone], [e-mail].
Sincerely,
W. Corey Basinger
Regional Supervisor
Water Quality Section
Division of Water Resources
cc: WSRO File Copy
585 Waughtown Street„ North Carolina 27360
Phone: [phone] Fax: [phone]
Internet:: www.ncwateraualiN.ora

Cover Sheet from
Staff Member to
Regional Supervisor
DMR Review Record
Facility: C Pem-it/Pipe No.: NC007VII-VMonthNear uo a06
Monthly Average Violations
Parameter Permit Limit DMR Value % Over Limit
Weekly �, iolations
Date Parameter Permit Limitfl'vDe DMR Value % Over Limit
Monitoring Frequency Violations
Daate�� Parameeter Permit Frequency / Values Reported # of Violations .
b ` /Dk/
Other Violations
Completed by: �� ��¢� Date:
Regional Water Quality
Supervisor Siznoff: `%� Date:

w
Ame
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Pat McCrory Charles Wakild, P. E. John E. Skvarla, III
Governor Director Secretary
April 10, 2013
Mr. Tom Roberts
Aqua NC, Inc.
202 MacKenan Court
Cary, NC 27511
Subject: NOTICE OF DEFICIENCY
Olde Beau Golf Club WWTP
NPDES Permit # NCO078158
Alleghany County
Dear Mr. Roberts:
A review of the January 2013 Discharge Monitoring Report (DMR) revealed a monitoring violation of the following
parameter(s) at Outfall 001:
Monthly Averaue
Parameter Compliance Level Reported Value
Flow 0.02 MGD 0.048 MGD
Remedial actions should be taken to correct the cause(s) of this violation. The violations described above should be
abated immediately and properly resolved.
If you have any questions or require any additional information, please contact George Smith at [phone],
[e-mail], or myself at [phone], [e-mail].
Sincerely,
W. Corey Basinger
Surface Water Protection Section
WSRO File Copy
rolina Division of Water Quality, Winston-Salem Regional Office
585 Waughtown Street, Winston-Salem, North Carolina 27107
36-771-50001 FAX: [phone]
+uww. ncwateraualitv.ora
)pportunity 1 Affirmative Action Employer
One
NorthCarolina
;VahmalltY

Cover Sheet from
Staff Member to
Regional Supervisor
DMR Review Record
Facility: C G Pernut/Pipe No.: ofC6L'7 LL b' Month/Year Tin �,013
Monthly Average Violations
Parameter Permit Limit DMR Value % Over Limit
``ow'
f—1
Weekly/Daily Violations
Date Parameter Permit Lim� DMR Value % Over Limit
Monitoring Frequency Violations
Date Parameter Permit Frequencv Values Reported # of Violations
Other Violations
�Ct— Ua.0rge-�eN
Completed by: _' �cDate:
Regional Water Quality q,, p
Supervisor SiQnoff: Date:
ok-- A140D 131 5

Beverly Eaves Perdue
Governor
Mr. Tom Roberts
Aqua NC, Inc.
202 MacKenan Court
Cary, NC 27511
A�4
ftl�
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Charles Wakild, P. E.
Director
February 20, 2013
Subject: NOTICE OF DEFICIENCY
Olde Beau Golf Club WWTP
NPDES Permit # NCO078158
Alleghany County
Dear Mr. Roberts:
Dee Freeman
Secretary
A review of the November 2012 Discharge Monitoring Report (DMR) revealed a monitoring violation of the following
parameter(s) at Outfall 001:
Parameter
Date
Permit Frequency
Values Reported
# of Violations
Flow
Nov. 3
Continuous
0
1
Flow
Nov. 4
Continuous
0
1
Flow
Nov.10
Continuous
0
1
Flow
Nov.11
Continuous
0
1
Flow
Nov.17
Continuous
0
1
Flow
Nov.18
Continuous
0
1
Flow
Nov.24
Continuous
0
1
Flow
Nov.25
Continuous
0
1
Remedial actions should be taken to correct the cause(s) of this violation. The violations described above should be
abated immediately and properly resolved.
If you have any questions or require any additional information, please contact George Smith at [phone],
[e-mail], or myself at [phone], [e-mail].
Sincerely,
W. Corey Basinger
Surface Water Protection Section
cc: WSRO File Copy
North Carolina Division of Water Quality, Winston-Salem Regional Office
Location: 585 Waughtown St. Winston-Salem, North Carolina 27107
Phone: [phone] FAX: [phone]
Internet www.ncwaterquality.org
An Equal Opportunity 1 Affirmative Action Employer
ne
NorthCarolina
Natma!!rf

Cover Sheet from
Staff Member to
Regional Supervisor
DMR Review Record
Facility: Permit/Pipe No.: Month/Year
Monthly Average Violations
Parameter Permit Limit DMR Value % Over Limit
Weekly/Daily Violations
Date Parameter Permit Lir hf—Type DMR Value % Over Limit
Monitoring, Frequency Violations
Date Parameter Permit Frequencv Values Reported # of Violations
f 14-3
0
I l�l 0 1
117 tj
!1 l O
it /z1 0 l
c)
Date: - - 1 / / /_ 3
Completed by:
Regional Water Quality
Supervisor Sianoff:
No 0
Date: 70 �" 7�43

IZN
Alleghany
NCO078158 Olde Beau Golf Club WWTP
Monitoring Violation
Frequency
S
Flow, in conduit or thru
Gallons
per
C
Violation
2012
11
001
treatment plant
11-03-2012
Continuous Day
Million
5,J0 Frequency
Flow, in conduit or thru
Gallons
per
Violation
2012
11
001
treatment plant
11-04-2012
Continuous Day
�1"
Million
I Frequency
Flow, in conduit or thru
Gallons
per
Violation
2012
11
001
treatment plant
11-09-2012
Continuous Day
Million
C Frequency
S
Flow, in conduit or thru
Gallons
per
4
Violation
2012
11
001
treatment plant
11-10-2012
Continuous Day
Million
S j,% Frequency
Flow, in conduit or thru
Gallons
per
Violation
2012
11
001
treatment plant
11-11-2012
Continuous Day
5,x C
Million
Frequency
Flow, in conduit or thru
Gallons
per
Violation
2012
11
001
treatment plant
11-17-2012
Continuous Day
Million
;U,t Frequency
Flow, in conduit or thru
Gallons
per
Violation
2012
11
001
treatment plant
11-18-2012
Continuous Day
Million
5•,t C- Frequency
Flow, in conduit or thru
Gallons
per
Violation
2012
11
001
treatment plant
11-24-2012
Continuous Day
Million
S� Frequency
Flow, in conduit or thru
Gallons
per
Violation
2012
11
001
treatment plant
11-28-2012
Continuous Day
`/'ej" c"j di1

North Carolina Emergency Management - EM43 Reporting Page 1 of 3
North Carolina Emergency
Management -
-file Cop.��
EM43 Reporting
Print Return To List
EM Level:
NCEM Edited:
Include in Report:
4
Yes
Yes
Taken by:
Date/Time Reported:
Date/Time Occurred:
R Brown
12/26/2012 10:59:50
12/26/2012 10:59:50
Reported by:
Agency:
Phone:
Michael Melton
Aqua NC
704-489-9404 x57238
County:
City:
Area:
Alleghany
Unknown
11
Street Address:
Zip Code:
Old Beau Wastewater Treatment Plant
Type: Wastewater
Animal Disease Event Type:
Complaint Event Type:
FNF Event Type:
HazMat Event Type:
Homeland Security Event:
Other Event Type:
Transportation Event Type:
Weather Event Type:
State Resource Request
EVENT TYPE
Bomb Threat Event Type:
Fire Event Type:
FNF Class:
HazMat Class:
Non-FNF Event:
SAR Type:
Wastewater Event Type:
Sewage
Weather Event Name:
HazMat Mode:
Non-FNF Event Type:
WMD Event Type:
Event Description:
Aqua North Carolina reported the release of five gallons of sewage to a containment basin
at a wastewater treatment plant due'to heavy rains. No surface water was affected.
Filename:
Deaths: Injuries: Evacuation: Radius:
0 0 0 0
Responsible Party: Responsible Party Phone:
Point of Contact: Point of Contact Phone:
https://www.ncsparta.net/eoc7/boards/board.aspx?tableid=275&viewid=1011&... 12/31/2012

Beverly Eaves Perdue
Governor
Mr. Tom Roberts
Aqua NC, Inc.
202 MacKenan Court
Cary, NC 27511
4
NCDENR
North Carolina Department of Environment and Natural
Division of Water Quality
Charles Wakild, P. E.
Director
January 4, 2013
Subject: NOTICE OF DEFICIENCY
Olde Beau Golf Club WWTP
NPDES Permit # NCO078158
Alleghany County
Dear Mr. Roberts:
Resources
Dee Freeman
Secretary
A review of the September 2012 Discharge Monitoring Report (DMR) revealed a monitoring violation of the
following parameter(s) at Outfall 001:
Parameter
Date
Permit Frequency
Values Reported
# of Violations
Flow
Sept 29
Continuous
28
1
Flow
Sept 30
Continuous
28
1
Remedial actions should be taken to correct the cause(s) of this violation. The violations described above
should be abated immediately and properly resolved.
If you have any questions or require any additional information, please contact George Smith at (336) 771-
4968, [e-mail], or myself at [phone], [e-mail].
Sincerely,
W. Corey Basinger
Surface Water Protection Section
cc: WSRO File Copy
North Carolina Division of Water Quality, Winston-Salem Regional Office
Location: 585 Waughtown St Winston-Salem, North Carolina 27107
Phone: [phone] FAX: [phone]
Internet www.ncwaterquality.org
An Equal Opportunity 1 Affirmative Action Employer
NorthCarolina
NaAmallY

I
Cover Sheet from
Staff Member to
Regional Supervisor
DMR Review Record
Facili `��� Q�� PermitlPipe No.: NC 00 7 ,?I �' Month/Year r SDI
ry:
Monthly Average Violations
Parameter Permit Limit DMR Value % Over Limit
weekly/Daily Violations
Date Parameter Permit Limit1l'vpe DMR Value % Over Limit
Monitoring Frequency Violations
Date Parameter Permit Frequencv Values Reported # of Violations
�A d,On-C1✓1Uoc[
J 1`/ow It 0
Other Violations
ay �-3D Is On �'zD"' (ad
Completed by: _. Date:
Regional Water Quality Z p ( 3
Supervisor Sisnoff: Date:

Aia
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins
Governor Director
October 11, 2012
Mr. Tom Roberts
Aqua NC, Inc.
202 MacKenan Court
Cary, NC 27511
SUBJECT: Compliance Evaluation Inspection
Olde Beau Golf Club WWTP
NPDES Permit # NCO078158
Alleghany County
Dear Mr. Roberts:
Dee Freeman
Secretary
A Compliance Evaluation Inspection was performed by George Smith on October 4, 2012. Mr. Morgan Turner, ORC, was
present for the inspection. The inspection is comprised of an overall evaluation in order to document compliance and
noncompliance of: facilities equipment, capability to meet effluent limits, and terms & conditions with the NPDES permit.
Permit
Your permit became effective May 1, 2011 and expires on March 31, 2016.
Records & Reports
Mr. Turner maintains a daily log that appears to be in good order. The log shows visitation times, process control
(settleability), and observations.
Laboratory data results from Research & Analytical Laboratories (#34) and chain -of -custody forms are kept on file.
Facility Site Review
The aeration basin appeared a brownish color and a good earthy odor with sufficient dissolved oxygen. The bubble
diffusers had a good rolling aeration. There appear to be delivering air very efficiently.
Flow Measurement
Instantaneous flow is measured with a V-notch weir. The flow meter was calibrated by Horizon Engineering Inc. on July
24, 2012. An Isco Model 4210 ultrasonic device is located before the weir.
Laboratory
Research & Analytical Laboratories certified lab (# 34) performs the analytical tests for this facility.
Mr. Turner performs pH, total residual chlorine, temperature; and these tests are recorded on the daily monitoring report
North Carolina Division of Water Quality, Winston-Salem Regional Office
Location: 585 Waughtown St. Winston-Salem, North Carolina 27107 One
Phone: [phone] FAX: [phone] Customer Service: 1-877-623-6748 NorthCarolina
Internet: www.ncwaterquality.org ;Vahan /ly
An Equal Opportunity 1 Affirmative Action Employer `

Compliance Evaluation Inspection
October 11, 2012
Page 2 of 2
The total residual chlorine was performed with a Hach DR2700 spectrophotometer using the DPD colorimetric method.
The annual 5-point calibration was performed on May 17, 2012.
The temperature is recorded against a NIST traceable thermometer.
The pH calibration is performed using a two -point calibration method and a midrange check at 7.0 SU. A calibration log
is recorded.
Effluent/Receiving Waters
The effluent discharges to an UT to Laurel Branch, Class C Trout waters. The effluent from the dechlorinator was clear,
no color, no solids, and no odor was noticed.
Operations & Maintenance
Mr. Morgan Turner, Grade III is the ORC, and Mr. Glen Price is the Back-up ORC, Grade 11.
The aeration basin had a good brown color and course bubble aeration, earthy odor, which indicates satisfactory
operation.
The effluent over weir was clear. Mr. Turner indicated that at times during the winter the plant freezes solid.
The tablet chlorinator used two (2) tubes with Norweco tablets. The tablet dechlorinator used two (2) tubes with Norweco
tablets of Sodium Sulfite.
Self -Monitoring Program
A review of the monthly self -monitoring reports from September 2011 through July 2012 revealed a daily maximum
violation for TSS during February 2012.
The upstream sample is located at the downstream side of a culvert, which is 0.2 miles from Hwy 21. The downstream
sample is located at the service entrance road adjacent to Hwy21.
Sludge Handling Disposal
There is sufficient room in the digester to waste solids. Sludge is removed from the plant by contracting P D Quik Inc.
The compliance evaluation inspection is satisfactory. Mr. Turner operates the facility in an excellent manner. If you have
any questions, please contact this office at [phone].
Sincerely,
W. Corey Basinger
Regional Supervisor
cc: Research & Analytical Laboratories Inc., PO Box 473, Kernersville, NC 27284
WSRO Files

United States Environmental Protection Agency
Form Approved.
EPA Washington, D.C. 20460
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
111 121 12/10/04 117 181 � I 191 c ! I 20 U
1 I NJ 2 I C 1 31 NCO078158 L
J 1=
Remarks
211 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 11 11111 16
Inspection Work Days Facility Self -Monitoring Evaluation Rating B1 QA -----------------Reserved----- --
67 L=! 169 70 711 N I 72 N 73I W I 174 751 I I I I I 11 80
�--� '
Section 13: Facility Data
Name and Location of Facility Inspected (For Industrial Users discharging to POTW, also include
Entry Time/Date
Permit Effective Date
POTW name and NPDES permit Number)
09:20 AM 12/10/04
11/05/01
Olde Beau Golf Club WWTP
Exit Time/Date
Permit Expiration Date
County Downs Ave
Roaring Gap NC 28668
10:05 AM 12/10/04
16/03/31
Name(s) of Onsite Representative(s)/Ttles(s)/Phone and Fax Number(s)
Other Facility Data
Morgan Lee Turner/ORC/336-996-2841/
Name, Address of Responsible Official/Title/Phone and Fax Number
Contacted
Thomas J Roberts,202 Mackenan Ct Cary NC 27511/President/919-467-8712/9194661583 No
Section C: Areas Evaluated During Inspection (Check only those areas evaluated
Permit 0 Flow Measurement Operations & Maintenance Records/Reports
Self -Monitoring Program 0 Facility Site Review Multimedia Effluent/Receiving Waters
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
George S Smith WSRO WQ//336-771-5000/
Signature of Management Q A Reviewer Agency/Office/Phone and Fax Numbers Date
-�idcQ -�✓ l 10 67 vo iz.
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete.
Page # 1

NPDES yr/mo/day Inspection Type
3I NCO078158 I11 12I 12/10/04 17 18"
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
Page # 2

Permit: NCO078158 Owner - Facility: Olde Beau Golf Club WWT•P
Inspection Date: 10/04/2012 Inspection Type: Compliance Evaluation
Operations & Maintenance Yes
No
NA
NE
Is the plant generally clean with acceptable housekeeping?
■
❑
❑
❑
Does the facility analyze process control parameters, for ex: MLSS, MCRT, Settleable Solids, pH, DO, Sludge
■
❑
❑
❑
Judge, and other that are applicable?
Comment:
Permit Yes
No
NA
NE
(If the present permit expires in 6 months or less). Has the permittee submitted a new application?
❑
❑
■
❑
Is the facility as described in the permit?
■
❑
❑
❑
# Are there any special conditions for the permit?
❑
■
❑
❑
Is access to the plant site restricted to the general public?
■
❑
❑
❑
Is the inspector granted access to all areas for inspection?
01111
❑
Comment:
Record Keeping
Yes No
NA
NE
Are records kept and maintained as required by the permit?
■
❑
❑
❑
Is all required information readily available, complete and current?
■
❑
❑
❑
Are all records maintained for 3 years (lab. reg. required 5 years)?
■
❑
❑
❑
Are analytical results consistent with data reported on DMRs?
■
❑
❑
❑
Is the chain -of -custody complete?
■
110
❑
Dates, times and location of sampling
■
Name of individual performing the sampling
■
Results of analysis and calibration
■
Dates of analysis
■
Name of person performing analyses
■
Transported COCs
■
Are DMRs complete: do they include all permit parameters?
■
❑
❑
❑
Has the facility submitted its annual compliance report to users and DWQ?
❑
❑
■
❑
(if the facility is = or > 5 MGD permitted flow) Do they operate 24/7 with a certified operator on each shift?
❑
❑
■
❑
Is the ORC visitation log available and current?
■
❑
❑
❑
Is the ORC certified at grade equal to or higher than the facility classification?
■
❑
❑
❑
Is the backup operator certified at one grade less or greater than the facility classification?
■
❑
❑
❑
Is a copy of the current NPDES permit available on site?
■
❑
❑
❑
Page # 3

Permit: NCO078158
Inspection Date: 10/04/2012
Owner - Facility: Olde Beau Golf Club WWTP
Inspection Type: Compliance Evaluation
Record Keeping
Facility has copy of previous year's Annual Report on file for review?
Comment:
Aeration Basins
Mode of operation
Type of aeration system
Is the basin free of dead spots?
Are surface aerators and mixers operational?
Are the diffusers operational?
Is the foam the proper color for the treatment process?
Does the foam cover less than 25% of the basin's surface?
Is the DO level acceptable?
Is the DO level acceptable?(1.0 to 3.0 mg/1)
Comment:
Disinfection -Tablet
Are tablet chlorinators operational?
Are the tablets the proper size and type?
Number of tubes in use?
Is the level of chlorine residual acceptable?
Is the contact chamber free of growth, or sludge buildup?
Is there chlorine residual prior to de -chlorination?
Comment:
De -chlorination
Type of system ?
Is the feed ratio proportional to chlorine amount (1 to 1)?
Is storage appropriate for cylinders?
# Is de -chlorination substance stored away from chlorine containers?
Comment:
Are the tablets the proper size and type?
Are tablet de -chlorinators operational?
Number of tubes in use?
Yes No NA NE
❑ ❑ ■ ❑
Yes No NA NE
Ext. Air
Diffused
Yes No NA NE
■ ❑ ❑ ❑
■ ❑ ❑ ❑
Yes No NA NE
■ ❑ ❑ ❑
■ ❑ ❑ ❑
Page # 4

Permit: NC0078158
Inspection Date: 10/04/2012
De -chlorination
Comment:
Owner - Facility: Olde Beau Golf Club WWTP
Inspection Type: Compliance Evaluation
Yes No NA NE
Page # 5

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Beverly Eaves Perdue
Governor
Mr. Tom Roberts
Aqua NC, Inc.
202 MacKenan Court
Cary, NC 27511
fi f
rs�®
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Charles Wakild, P. E.
Director
August 10, 2012
Subject: NOTICE OF DEFICIENCY
Olde Beau Golf Club WWTP
NPDES Permit # NCO078158
Alleghany County
Dear Mr. Roberts:
Dee Freeman
Secretary
A review of the May 2012 Discharge Monitoring Report (DMR) revealed a monitoring violation of the
following parameter(s) at Outfall 001:
Parameter
Date ::Efe_r_mit:Frequency
I Values Reported
# of Violations
TRC
May 5
2 x week
1
1
Remedial actions should be taken to correct the cause(s) of this violation. The violations described above
should be abated immediately and properly resolved.
If you have any questions or require any additional information, please contact George Smith at (336) 771-
4968, [e-mail], or myself at [phone], [e-mail].
Sincerely,
W. Corey Basinger
Surface Water Protection Section
cc: WSRO File Copy
North Carolina Division of Water Quality, Winston-Salem Regional Office
Location: 585 Waughtown St. Winston-Salem, North Carolina 27107
Phone: [phone] FAX: [phone]
Internet: www.ncwaterquality.org
An Equal Opportunity 1 Affirmative Action Employer
NonrthCarolina
Natltl'ally

i
Cover Sheet from
Staff Member to
Regional Supervisor
DMR Review Record
Facility: 01J, l.7-(tp C-14 CLAPem-it/Pipe No.: AICDD70—LD?Month/Year 01
Parameter
Date
Date
5-15-
Monthly Average Violations
Permit Limit DMR Value % Over Limit
Weekly/DaiIy Violations
Permit Limitrrvpe DMR Value % Over Limit
Monitoring Frequency Violations
Parameter Permit Frequnc_Values Reported # of Violations
T'f2C
Parameter
Other Violations
Completed by: , Date: r/S 112
Regional Water Quality
Supervisor Signoff: Date: 'I -2-01-�-
hwo

Cover Sheet from
Staff Member to
Regional Supervisor
DNIR Review Record
Facility: Oldz Reag Perrnit/Pipe No.: NBC 00 7FIL Month/Year 5d �-
Monthly Average Violations
Parameter Permit Limit DMR Value % Over Limit
Weekly ail iolations
Date Parameter _Permit Lin-j vDe DMR Value % Over Limit
f TSS L! a, / F.
Monitoring Frequency Violations
Date Parameter Permit Frequency Values Reported # of Violations
Other Violations
Completed by:
Regional Water Quality
Supervisor SiQnoff:
Date: G /it /2oi )
Date: LI
Funs

Beverly Eaves Perdue
Governor
Mr. Tom Roberts
Aqua NC, Inc.
202 MacKenan Court
Cary, NC 27511
Subject:
Dear Mr. Roberts:
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Charles Wakild, P. E.
Director
June 12, 2012
NOTICE OF DEFICIENCY
Olde Beau Golf Club WWTP
NPDES Permit # NCO078158
Alleghany County
Dee Freeman
Secretary
A review of the February 2012 Discharge Monitoring Report (DMR) revealed a violation of the following
parameter(s) at Outfall 001:
Parameter
Date
Reported Value
Permit Limit
TSS
Feb 8
48.6
45
Remedial actions should be taken to correct the cause(s) of this violation. The violations described above
should be abated immediately and properly resolved.
If you have any questions or require any additional information, please contact George Smith at (336) 771-
4968, [e-mail], or myself at [phone], [e-mail].
Sincerely,
W. Corey Basinger
Surface Water Protection Section
cc: WSRO File Copy
DWQ Central Files
North Carolina Division of Water Quality, Winston-Salem Regional Office
Location: 585 Waughtown St. Winston-Salem, North Carolina 27107
Phone: [phone] FAX: [phone]
Internet: www.ncwaterquality.org
An Equal Opportunity 1 Affirmative Action Employer
Nne
orthCarolina
XI&M Illy

k­:'. U A.
January 25, 2012
N.C.Dept. of ENR
JAN 3 0 2012
Winston-Salem
Regional Office
Point Source Branch
Surface Water Protection Section
Division of Water Quality
1617 Mail Service Center
Raleigh, NC 27699-1617
Re: Delegation of Signature Authority
To Whom It May Concern:
Xqua North Carolina, Inc.
202 MacKenan Court
Cary, NC 27511
Thomas J. Roberts
President and Chief Operating Officer
T: 919.653.5770
F: 919.460.1788
[e-mail]
www.aquanorthcarolina.com
By notice of this letter, I hereby delegate signatory authority to each of the following individuals for all
permit applications, discharge monitoring reports, and other information relating to the operations on the
attached list as required by all applicable federal, state, and local environmental agencies specifically with
the requirements for signatory authority as specified in 15A NCAC 213.0506.
Name
Title
Thomas J. Roberts
President and COO
Jack Lihvarcik
Operations Manager
Robert Ashley
Regional Supervisor
Matthew Costner
Regional Supervisor
Larry Finnicum
Area Manager
Michael Melton
Regional Manager of Compliance
Duane Rimmer
Regional Supervisor
If you have any questions regarding this letter, please feel free to contact me at 919-653-5770.
President and COO
cc: Winston Salem Regional Office, DWQ
Mooresville Regional Office, DWQ
An Aqua America Company

Permit No.
Facility
County
NCO028746
Briarwood SD WMP
Stokes
NCO063720
Forsyth
NCO065587
Frye Bridae VWP
Forsyth
NCO078115
Greystone SD WWTP
Forsyth
NCO050792
Melbille Heiahts WP
Rndl h
NCO067091
Mikkola Downs WWTP
Forsyth
NCO078158
Olde Beau GC WVITP
AI hn
NCO055191
Penman Heiahts WP
Rndl h
NCO083925
Salem Glen SD WVffP
Dvdsn
NCO083933
Salem Quaders
Forsyth
NCO083941
Sprina Creek WWTP
Dvdsn
NCO084409
Wellesley Place WMP
Forsyth
NCO034452
Willow Creek WWTP
Dvdsn
NCO088536
Bannerlown Hills W#2
Surry
NCO088552
Surry
NCO088552
Surry
NCO088528
Surry
NCO088498
Surry
NCO088854
Pine Lks W#2
Surry
NCO088633
R yes Wds W #2
Surry
NCO088617
Snow H411 SD
Surry
NCO088501
Forsyth
NCO088625
The Hollows SD
Surry
NCO088609
Ondoate SD
Surry
NCO065749
Ashe Plantation WWTP
Mkl
W00024694
Briahts Crk VMT RWUS
Polk
NCO065684
Country Wood WW7P
Union
NCO063860
Harbor Estates WVff P
Mklbq
NC0063789
Mint Hill FestivalMk1bg
NCO063584
Oxford Glen WWTP
Mklbq
NCO073539
Willowbrook SD WP
Mklb
NCO072061
Fox Run WTP
Gaston
NCO084468
Keltic Meadows WIP #2
Gaston
NCO086193
Madecrest WTPGaston
NCO086142
Oakley Park 1
Gaston
NCO086142
Oakley Park 2
Gaston
NCO069035
Southaate WTP
Gaston
NCO075205
Alexander Island WVff P
Iredell
NCO056154
Bridaeporl WWTP
Iredell
NCO058742
Country Valley WAITP
Catawba
NCO074772
Diamond Head WWTP
Iredell
NCO074900
Hiahway 150 VIMP
Iredell
NCO063355
Killian Xroads WWTP
Catawba
NCO062481
Maliard Head WWTP
Iredell
NCO028941
Pine Valley SD WWTP
Rowan
NCO060593
Soinnaker Bay WWTP
Catawba
NCO080691
Windemere WWTP
Iredell

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins
Governor Director
November 9, 2011
Mr. Tom Roberts
Aqua NC, Inc.
202 MacKenan Court
Cary, NC 27511
SUBJECT: Compliance Evaluation Inspection
Olde Beau Golf Club WWTP
NPDES Permit # NCO078158
Alleghany County
Dear Mr. Roberts:
Dee Freeman
Secretary
A Compliance Evaluation Inspection was performed by George Smith on November 3, 2011. Mr. Joe Baskin, ORC, was
present for the inspection. The inspection is comprised of an overall evaluation in order to document compliance and
noncompliance of facilities equipment, capability to meet effluent limits, and terms & conditions with the NPDES permit.
Permit
Your permit became effective May 1, 2011 and expires on March 31, 2016.
Records & Reports
Mr. Baskin maintains a daily log that appears to be in good order. The log shows visitation times, process control
(settleability), and observations.
Laboratory data results from Research & Analytical Laboratories (#34) and chain -of -custody forms are kept on file.
Facility Site Review
The aeration basin appeared a brownish color and a good earthy odor with sufficient dissolved oxygen. The course bubble
diffusers had a good rolling aeration.
Flow Measurement
Instantaneous flow is measured with a V-notch weir. The flow meter was calibrated by Horizon Engineering Inc. on
October 21, 2011. An Isco Model 4210 ultrasonic device is located before the weir.
Laboratory
Research & Analytical Laboratories certified lab (# 34) performs the analytical tests for this facility.
North Carolina Division of Water Quality, Winston-Salem Regional Office
Location: 585 Waughtown St. Winston-Salem, North Carolina 27107
Phone: [phone] FAX: [phone] \ Customer Service:1-877-623-6748
Internet www.ncwaterquality.org
An Equal Opportunity 1 Affirmative Action Employer
NorthCarolina
Natumily

Compliance Evaluation Inspection
November 9, 2011
Page 2 of 2
Mr. Baskin performs pH, total residual chlorine, temperature; and these tests are recorded on the daily monitoring report.
The total residual chlorine was performed with a Hach DR2700 spectrophotometer using the DPD colorimetric method.
The temperature is recorded against a NIST traceable thermometer.
The pH calibration is performed using a two -point calibration method and a midrange check at 7.0 SU. A calibration log
is recorded.
Effluent/Receiving Waters
The effluent discharges to an UT to Laurel Branch, Class C Trout waters. The effluent from the dechlorinator was clear,
no color, no solids, and no odor was noticed.
Operations & Maintenance
Mr. Joe Baskin, Grade II is the ORC, and Mr. Glen Price is the Back-up ORC.
The aeration basin had a good brown color and course bubble aeration, earthy odor, which indicates satisfactory
operation.
The effluent over weir was clear. Mr. Baskin indicated that at times during the winter the plant freezes solid.
The tablet chlorinator used two (2) tubes with Norweco tablets. The tablet dechlorinator used two (2) tubes with Norweco
tablets of Sodium Sulfite.
Self -Monitoring Program
A review of the monthly self -monitoring reports from August 2010 through July 2011 revealed a daily maximum
violation for BOD during October 2010.
Sludge Handling Disposal
There is sufficient room in the digester to waste solids. Sludge is removed from the plant by contracting PDQ.
The compliance evaluation inspection is satisfactory. Mr. Baskin operates the facility in a good manner. If you have any
questions, please contact this office at [phone].
Sincerely, <
.J4
W. Corey Basinger
Regional Supervisor
cc: Research & Analytical Laboratories Inc., PO Box 473, Kernersville, NC 27284

United States Environmental Protection Agency
Form Approved.
EPA Washington, D.C. 20460
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 INI 2 15I 31 NCO078158 111 121 11/11/03 117 181 CI 19I S I 20I II
Remarks
211111 1111111 I I III 111111111111 111111111111 11111II6
Inspection Work Days Facility Self -Monitoring Evaluation Rating B1 QA --------------------- ---- Reserved ------------------
67I 169 70131 711 N I 721 NJ 73 L1J 74 751 I( I I I I 180
Section B: Facility Data
Name and Location of Facility Inspected (For Industrial Users discharging to POTW, also include
Entry Time/Date
Permit Effective Date
POTW name and NPDES permit Number)
Olde Beau Golf Club WWTP
10:15 AM 11/11/03
11/05/01
Exit Time/Date
Permit Expiration Date
County Downs Ave
Roaring Gap NC 28668
10:35 AM 11/11/03
16/03/31
Name(s) of Onsite Representative(s)/Titles(s)/Phone and Fax Number(s)
Other Facility Data
///
Joseph Barnard Baskin/ORC/336-996-2841/
Name, Address of Responsible Official/Title/Phone and Fax Number
Contacted
Thomas J Roberts,202 Mackenan Ct Cary NC 27511/President/919-467-8712/9194661583 No
Section C: Areas Evaluated During Inspection (Check only those areas evaluated)
Permit Flow Measurement Operations & Maintenance Records/Reports
Self -Monitoring Program Sludge Handling Disposal Facility Site Review Effluent/Receiving Waters
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
George S Smith WSRO WQ//336-771-5000/
ce(-U
Signature of Management Q A Reviewer Agency/Office/Phone and Fax Numbers Date
! At-j)fFo °'--l�t��j lD Ov ?a q
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete.
Page # 1

NPDES yrfmo/day Inspection Type
3 I N CO078158 ,1 12, 11 /11 /03 17 18 Id
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
Page # 2

Permit: NCO078158 Owner - Facility: Olde Beau Golf Club WWTP
Inspection Date: 11/03/2011 Inspection Type: Compliance Evaluation
Operations & Maintenance Yes No NA NE
Is the plant generally clean with acceptable housekeeping? ■ ❑ ❑ ❑
Does the facility analyze process control parameters, for ex: MLSS, MCRT, Settleable Solids, pH, DO, Sludge ■ n n ❑
Judge, and other that are applicable?
Comment:
Permit
Yes
No
NA
NE
(If the present permit expires in 6 months or less). Has the permittee submitted a new application?
n
ri
■
n
Is the facility as described in the permit?
■
n
n
n
# Are there any special conditions for the permit?
❑
■
Cl
❑
Is access to the plant site restricted to the general public?
■
n
n
n
Is the inspector granted access to all areas for inspection?
■
n
n
n
Comment:
Record Keeping
Yes No
NA
NE
Are records kept and maintained as required by the permit?
■
❑
Cl
❑
Is all required information readily available, complete and current?
■
❑
❑
❑
Are all records maintained for 3 years (lab. reg. required 5 years)?
■
n
❑
❑
Are analytical results consistent with data reported on DMRs?
■
n
❑
❑
Is the chain -of -custody complete?
■
❑
❑
❑
Dates, times and location of sampling
■
Name of individual performing the sampling
■
Results of analysis and calibration
■
Dates of analysis
■
Name of person performing analyses
■
Transported COCs
■
Are DMRs complete: do they include all permit parameters?
■
n
n
❑
Has the facility submitted its annual compliance report to users and DWQ?
❑
❑
■
❑
(If the facility is = or > 5 MGD permitted flow) Do they operate 24/7 with a certified operator on each shift?
❑
❑
■
❑
Is the ORC visitation log available and current?
■
n
n
❑
Is the ORC certified at grade equal to or higher than the facility classification?
■
❑
❑
❑
Is the backup operator certified at one grade less or greater than the facility classification?
■
❑
❑
❑
Is a copy of the current NPDES permit available on site?
❑
n
❑
■
Page # 3

Permit: NCO078158 Owner - Facility:
Olde Beau Golf Club WWTP
Inspection Date: 11/03/2011 Inspection Type:
Compliance Evaluation
Record Keeping
Yes No NA NE
Facility has copy of previous year's Annual Report on file for review?
❑ n ■ n
Comment:
Flow Measurement - Effluent
Yes No NA NE
■ n n o
# Is flow meter used for reporting?
Is flow meter calibrated annually?
■ n n n
Is the flow meter operational?
■ Cl o 0
(If units are separated) Does the chart recorder match the flow meter?
❑ n Q ■
Comment:
Aeration Basins
Yes No NA NE
Ext. Air
Mode of operation
Diffused
Type of aeration system
■ n n o
Is the basin free of dead spots?
0 n ■ n
Are surface aerators and mixers operational?
Are the diffusers operational?
■ n n n
Is the foam the proper color for the treatment process?
■ n Q n
Does the foam cover less than 25% of the basin's surface?
■ n n
■ n n n
Is the DO level acceptable?
Is the DO level acceptable?(1.0 to 3.0 mg/I)
Q n ❑ ■
Comment:
Disinfection -Tablet
Yes No NA NE
■ n n o
Are tablet chlorinators operational?
Are the tablets the proper size and type?
■ n 0 Q
Number of tubes in use?
2
Q ❑ Q ■
Is the level of chlorine residual acceptable?
Is the contact chamber free of growth, or sludge buildup?
■ n n n
Is there chlorine residual prior to de -chlorination?
n n n ■
Comment:
De -chlorination
Yes No NA NE
Type of system ?
Is the feed ratio proportional to chlorine amount (1 to 1)?
Tablet
noon
Page # 4

Permit: NC0078158
Inspection Date: 11/03/2011
Owner - Facility: Olde Beau Golf Club WWTP
Inspection Type: Compliance Evaluation
De -chlorination
Is storage appropriate for cylinders?
# Is de -chlorination substance stored away from chlorine containers?
Comment:
Are the tablets the proper size and type?
Are tablet de -chlorinators operational?
Number of tubes in use?
Comment:
oa■o
nn■n
Page # 5

LT
�a'fflja
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
January 21, 2011
Thomas J Roberts
Aqua North Carolina Inc
202 Mackenan Dr
Cary NC 27511
Subject: NOTICE OF VIOLATION
Permit No. NCO078158
Olde Beau Golf Club WWTP
Alleghany County
Dear Mr Roberts:
A review of Olde Beau Golf Club WWTP's monitoring report for October 2010 showed the
following violations:
Parameter
Date
Limit Value
Reported Value
Limit Type
BOD, 5-Day (20 Deg. C) -
10/06/10
30 mg/l
35.8 mg/1
Daily
Concentration
Maximum
Exceeded
Remedial actions should be taken to correct this problem. The Division of Water Quality may
pursue enforcement action for this and any additional violations of State law.
To prevent further action, carefully review these violations and deficiencies and respond in
writing to this office within 30 working day of receipt of this letter. You should address the
causes of noncompliance and all actions taken to prevent the recurrence of similar situations. If
you should have any questions, please do not hesitate to contact Sue White at 336-771-5000.
Sincerely,
W. Corey Basinger
Interim Surface Water Protection Regional Supervisor
Winston Salem Region
Division of Water Quality
Cc: Central Files —SWP
10WSRO ,
585 Waughtown Street Winston-Salem, NC 27107 336-771-5000 (Telephone) 336-771-4630 (Fax)

L-V_bC).Z� Cover Sheet from
Staff Member to
Regional Supervisor
DNIR Review Record
Facility: Gait= cti)P,_ PermitlPipe No.: kCrxo'78tSB Month/Year td(t(:>
Monthly Average Violations
Parameter Permit Limit DMR Value % Over Limit
Weekl /Daily iolations
Date Parameter Permit Limit/7vpe DMR Value % Over Limit
to IL. 8oc-) 30 3s. S 19.33
Date Parameter
Other Violations
Monitoring Frequency Violations
Permit Frequency Values Reported # of Violations
Completed by: �dm ���� . Date: t (Z C> 1( 1
Regional Water Quality � ��� Date: Z�% �
Supervisor Signoff: �/4�

he ll./ L7! LUlU 10. jo JJO-Doouazo K & H Li-iISUKi-il lJK1GJ riAur- ULI VJ
EFFL ENT
NPDES, PERMIT NO. NC 0078158 DISCHARGE NO.O2- MONTH OctobeC YEAR` 2010
FACILITY NAME Ojde Beau Golf Club CLASS II COUNTY AlleShgu
CERTIFIED LABORATORIES & A Laboratorics. Inc_ CERTIFICATION NO. 34
(List additional laboratories on the backside/page 2 of this form)
OPERATOR IN RESPONSIBLE CHARGE (ORC) Joe Baskin GRADE, 2 CERTIFICATION NO. 989829
PERSONS) COLLECTING SAMPLES 0-perators ORC PHONE [phone]
CHECK BOX IF ORC HAS CHANGED Q NO FLOW I DISCHARGE FROM SITE Q
Mail ORIGMAL and ONE COPY to: � _ I
ATTN= CENTRAL FILES X t
DIVISION OF WATER QUALITY (SIGNATu. . OF OPE..RA l- 1N RESPONSIBLE CHARGE)
1617 MAIL SERVICE CENTER BY TN SIGNATURE. I CERTIFY THAT THIS REPORT IS ryg9 I h ' )�
RAf,F.IG1i, NC 27699-1617 ACCURATE AND COMPLETE TO THE BEST OF MY KNOWIX4 i'' n f,0It
W
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400M
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11/ GJ/ LCI1U 1J. JJ 000-77OUJLo K & is L7AnUKiA I UKILS
Facility Status: (Please check one of the following)
All monitoring data and sampling frequencies meett pennit requirements
(including weekly averages, if applicable)
All monitoring data and sampling frequencies do NOT meet permit requirement,,
r-HUC
Compliant
Iz—
Noncompliant
The permittec 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 permitte became aware of the
circumstances. A written submission shall also be provided within 5 days of the time the permitice 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 111.6 of the NPDES permit.
"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 a qualified personnel properly gather and evaluate the information submitted. Based on my
inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the
In I'onttation submitted is, to the best of my knowledge and belief true. accurate, and complete. I am aware that there arc significant
penalties for submitting false information, including the possibility of tines and imprisonment for knowing violations."
f.
�; n9111►P A PPrne It c#� * Date
iced unless submitted 6i;k-tronie2lly)
202 MacKenan Courts NC 27511 919-467-8712 03/31/2011
Pcrmittee Address Phone Number Permit Gep. Date
ADDITIONAL CERTIFIED )LABORATORIES
Certified Laboratory (2)
Certified Laboratory (3)
Ccnificd Laboratory (4)
Ccrti ficd Laboratory (5)
PARAMETER CODES
Certification No.
Certification No.
Certification No.
Certification No.
Parameter Code assistance may be obtained by calling the NPDES Unit at at [phone], or by visiting the Surface water Protection Section's
wcb site at h2e.cnr.state.nc.us/wos and linking to the Unit's information pages.
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 occurrs and, as a result, there are no data to be entered for all of the
parameters on the DMR for the entire monitoring period.
*� ORC On Site? : ORC must visit facility and document visitation of facility as required per 15ANCAC8G.0204.
'" Signature of Pcrmittee: If signed by other than the permitte, then the delegation of tlhc signirory authoriiy must be on file with the state per
15ANCAC213.0506 (b) (2) (D),
fJJI : J

11/ LJ/ LViV 1J. JJ JJU JJUUJLU
1\ O H L_"Ou R- I uf\1L
l 0-06-10 - High BOD Result
This result was due to high sodium thiosulfate.
-Joe Baskin, ORC

11/ GJI CU1V 1J�JJ JJU JJUUJ LV
rC 61 H LHDUr%H 1 uM1CJ
r HUL VYI VJ
NPDES NO: NC 0078158 DISCHARGE NO:?A—MONTH: Oct er YEA,R: _ 2010
FACILITYNAME: Olcle Beau Golf Club COUNTY: Allegheny
STREAM: UT to Laurel Branch STREAM: Ui to Laurel Branch
LOCATION: 100' ft. Above Qischarae & fond LOCATION: 200' ft. Below Discharge
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MONITORING REPORT(MR) VIOLATIONS for: Report Date 01/18/11 Page: 1 of 5
Permit: % MRs Between: 10 2010 and 10-2010 Region: Winston-Salem Violation Category: Limit Violation Program Category: NPDES WW
Facility Name: `/fl Param Name: % County: % Subbasin: %,, Violation Action: None
Major Minor:
PERMIT: NCO078158
FACILITY: Aqua North Carolina Inc - Olde Beau Golf Club WWTP
COUNTY: Alleghany
REGION: Winston-Salem
Limit Violation
MONITORING OUTFALL /
VIOLATION
UNIT OF
CALCULATED
REPORT PPI
LOCATION PARAMETER
DATE FREQUENCY
MEASURE
LIMIT
VALUE % OVER LIMIT
VIOLATION TYPE VIOLATION ACTION
10 -2010 001
Effluent BOD, 5-Day (20 Deg. C) -
10/06/10 Weekly
mg/I
30
35.8 19.33
Daily Maximum Exceeded None
Concentration
PERMIT: NCO020451
FACILITY: Town of West Jefferson - West Jefferson WWTP
COUNTY: Ashe
REGION: Winston-Salem
Limit Violation
MONITORING OUTFALL /
VIOLATION
UNIT OF
CALCULATED
REPORT PPI
LOCATION PARAMETER
DATE FREQUENCY
MEASURE
LIMIT
VALUE / OVER LIMIT
VIOLATION TYPE VIOLATION ACTION
10 -2010 001
Effluent Cadmium, Total (as Cd)
10/25/10 Weekly
ug/I
2.1
401 18,995.24
Daily Maximum Exceeded None
10 -2010 001
Effluent Cadmium, Total (as Cd)
10/30/10 Weekly
ug/I
0.7
133.67 18,995.24
Weekly Average Exceeded None
PERMIT: NCO026689
FACILITY: Town of Denton - Denton WWTP
COUNTY: Davidson
REGION: Winston-Salem
Limit Violation
MONITORING OUTFALL /
VIOLATION
UNIT OF
CALCULATED
REPORT PPI
LOCATION PARAMETER
DATE FREQUENCY
MEASURE
LIMIT
VALUE / OVER LIMIT
VIOLATION TYPE VIOLATION ACTION
10 -2010 001
Effluent BOD, 5-Day (20 Deg. C) -
10/02/10 3 X week
mg/I
7.5
10.13 35.11
Weekly Average Exceeded None
Concentration

Ir
NCDENR
North Carolina Department of Environment and Natural Resources
Beverly Eaves Perdue
Governor
Thomas J. Roberts, President & COO
Aqua North Carolina, Inc.
202 Mackenan Court
Cary, NC 27511
Dear Mr. Roberts:
Division of Water Quality
Coleen H. Sullins Dee Freeman
Director Secretary
January 19, 2011
Subject: Draft NPDES Permit No. NC0078158
Old Beau Golf Club VVVVTP
Alleghany County
Enclosed with this letter is a copy of the draft permit for your facility. Please review the draft very carefully to ensure
thorough understanding of the conditions and requirements it contains. The following procedure has been recently
implemented by DWQ: Total residual chlorine (TRC) compliance level changed to 50ug/L. Effective March 1, 2008,
the Division received EPA approval to allow a 50 ug/L TRC compliance level. A footnote regarding this change has
been added to the effluent limitations page in the draft permit.
This draft permit contains the following changes from your existing permit:
• Footnote #1 has been revised with the following additional Total Residual Chlorine Language: "The facility shall
report all effluent TRC values reported by a NC certified laboratory including field certified. However, effluent
values below 50 ug/I will be treated as zero for compliance purposes."
• "Total Suspended Residue" has been changed to "Total Suspended Solids"
• The site map has been updated to reflect lat & long values, sampling points and the VVVVTP location.
• Parameter codes have been added to the effluent page.
Concurrent with this transmittal, the Division will solicit public comment on this draft as required by the EPA by
publishing a notice in newspapers having circulation in the general Alleghany County area. Following the 30-day
public comment period, the Division will review all pertinent comments and take appropriate action prior to issuing a
final NPDES permit. Should you wish to correct errors or provide comments regarding this draft please contact the
DENR / DWQ / NPDES Program no later than 30 days after receiving this document. If you have questions
concerning the draft permit for your facility, please contact me by e-mail (bob.guerra .ncdenr.gov) or at (919) 807-
6387.
Respectfully,
Bob Guerra
1617 Man Service :;enter. Raieigh North Caro'ira 27699 111317
Location 512 N Salisbury St Raleigh North Carolina 276G4
Phone 1.9- �,-a.1.,-7 ; FAX 919-8u; -64J51 Customer 5ervioe 1,-577-623-6748
Inter ei Mlp 'p it nr rier r , ovet!wct/norne
NorthCarohna
An Eq 3 G ppor, y "+f`'wratV8 yen �-1010/e,

Compliance & Expedited Permits Unit
Enclosure: NPDES Permit NCO078156 (DRAFT)
cc: NPDES Unit
Winston Salem Regional Office / Surface Water Protection (Corey. Basinger) (ecopy)
Technical and Assistance Certification Unit — James Pugh (iames.pugh(Dncdenr.gov) (ecopy)
1617 Mail Service Center. Raleigh, North Carolina 27699-1617
Location 512 N. Salisbury St. Raleigh, North Carolina 27604 One
Phone. [phone] FAX: [phone] � Customer Service 1-877-623-6748 NorthCarolina
Internet: httpa/portal ncdenr.orglweblwgJhorne ���������
An Equal Opportunity', Affirmative.Action Employer

Permit NCO078158
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
PERMIT
TO DISCHARGE WASTEWATER UNDER THE
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,
Aqua North Carolina, Inc.
is hereby authorized to discharge wastewater from a facility located at the
Olde Beau Golf Club WWTP
Near 917 County Downs Avenue
Glade Valley
Alleghany County
to receiving waters designated as an Unnamed Tributary to Laurel Branch in the New River
Basin
in accordance with effluent limitations, monitoring requirements, and other conditions set
forth in Parts I, II, III and IV hereof.
This permit shall become effective xxxx xx, 2011
This permit and authorization to discharge shall expire at midnight on March 31, 2016.
Signed this day xxxx xx, 2011.
Coleen H. Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission

Permit NCO078158
SUPPLEMENT TO PERMIT COVER SHEET
All previous NPDES Permits issued to this facility, whether for operation or discharge are
hereby revoked. As of this permit issuance, any previously issued permit bearing this number
is no longer effective. Therefore, the exclusive authority to operate and discharge from this
facility arises under the permit conditions, requirements, terms, and provisions included
herein.
Aqua North Carolina, Inc is hereby authorized to:
1. Continue to operate an existing 0.020
system with the following components:
♦ Bar screen
♦ Flow splitter box
♦ Equalization basin
♦ Dual Aeration basins
♦ Dual secondary clarifiers
♦ Dual aerated sludge holding tanks
♦ Single tablet chlorinator
♦ Chlorine contact chamber
♦ Tablet dechlor unit
♦ Stevens flow meter
♦ Effluent pumps, and
♦ On -site generator
MGD extended aeration wastewater treatment
The facility is located at the Olde Beau Golf Club, near 917 Country Downs Avenue,
Glade Valley in Alleghany County.
2. Discharge from said treatment works at the location specified on the attached map into an
Unnamed Tributary to Laurel Branch, classified C-Trout waters in the New River Basin.

Permit NCO078158
A. (1.) EFFLUENT LIMITATIONS AND MONITORING REQUIREMENTS
During the period beginning on the effective date of this permit and lasting until expiration,
the Permittee is authorized to discharge from outfall 001. Such discharges shall be limited
and monitored by the Permittee as specified below:
EFFLUENT
CHARACTERISTICS
LIMITS
MONITORING REQUIREMENTS
Monthly
Daily
Measurement
Sample
Sample
Average
Maximum
Frequency
Type
Location'
50050 - Flow
0.020 MGD
Continuous
Recording
Influent or Effluent
00310 - BOD, 5-day (20°C)
20.0 mg/L
30.0 mg/L
Weekly
Grab
Effluent
(April 1 — October 31)
00310 - BOD, 5-day (20°C)
30.0 mg/L
45.0 mg/L
Weekly
Grab
Effluent
(November 1 — March 31)
00530 - Total Suspended
Solids
30.0 mg/L
45.0 mg/L
Weekly
Grab
Effluent
00610 - NH3 as N
(April 1 — October 31)
3.0 mg/L
15.0 mg/L
Weekly
Grab
Effluent
00610 - NH3 as N
(November 1 — March 31)
6.9 mg/L
34.5 mg/L
Weekly
Grab
Effluent
Effluent,
00300 - Dissolved Oxygen 2
Weekly
Grab
Upstream &
Downstream
31616 - Fecal Coliform
(geometric mean)
200/100 ml
400/100 ml
Weekly
Grab
Effluent,
Upstream &
Downstream
50060 - s otal Residual
28 ug/L
2/Week
Grab
Effluent
Chlorine
Temperature (°C)
Daily
Grab
Effluent
Temperature (°C)
Weekly
Grab
Upstream &
Downstream
00556 - Oil and Grease
30.0 mg/L
60.0 mg/L
Weekly
Grab
Effluent
00400 — pH
Weekly
Grab
Effluent
Footnotes:
1. Upstream = approximately 50 feet above outfall
Downstream = at mouth of the unnamed tributary
2. The daily average dissolved oxygen effluent concentration shall not be less than 5.0 mg/L.
3. The facility shall report all effluent TRC values reported by a NC certified laboratory including field certified.
However, effluent values below 50 ug/I will be treated as zero for compliance purposes.
4. The pH shall not be less than 6.0 standard units nor greater than 9.0 standard units.
There shall be no discharge of floating solids or visible foam in other than trace amounts

FACT SHEET
COMPLEX EXPEDITED PERMIT RENEWAL
Permit Writer/Date
Bob Guerra / 1-12-11
Permit Number
NCO078158
Name
Olde Beau Golf Club WWTP
-Facility
Basin Name/Sub-basin number
New River / 05-07-02
Stream
UT to Laurel Branch
-Receiving
Stream Classification in Permit
C-Trout
Does permit need Daily Max NH3
limits?
No
Does permit need TRC limits/language?
Needs new language
Does permit have toxicity testing?
No
Does permit have Special Conditions?
No
Does permit have instream monitoring?
Yes
Is the stream impaired on 303 d list)?
No
obvious compliance concerns?
No — see Attached enforcement history
-Any
Any permit mods since last permit?
Yes — Permit Ownership change to Aqua North Carolina,
Inc 7-3-2007
Current expiration date
3-31-2011
New expiration date
3-31-2016
Comments received on Draft Permit?
Yes No If Yes, discuss response with Supervisor
Chancres to the Previous Permit:
• Updated map for renewal
• Added new TRC language
• Changed "Total Suspended Residue" language to "Total Suspended Solids"
• Added parameter codes to Effluent Table, A. (1.). None
BIMS Downloads:
• Permit enforcement history:
c None during existing permit cycle
• NOV'S issued limit exceedances:
o FC (4), BOD (1) and TSS (1)
• Instream data review
o No attributable facility impacts
DMR Parameter Values Export: (2006 — 2010)
FLOW
BODS
TSS
NH3
O&G
DO
FECAL
TRC
Monthly
0.021 MGD
Summer 6.45 mg/L
11.43 mg/L
Summer 19.00 mg/L
2.61 mg/L
Average
Winter 6.65 mg/L
Winter 11.00 mg/L
Daily
Summer 5.89 mg/L
11.94 mg/L
Summer 0.14 mg/L
5.62 mg/L
8.88 mg/L
33.84 / #100
12.89 ug/L
Average
Winter 6.90 mg/L
Winter 0.13 mg/L

M
27C8
i
Discharge
point
fr
r !r t
r.
n
111 i
i
l
,. County Do,tins Avenue
Downstream Sampling Point
y
/ J w
F ,
Upstream Sampling Point��� 5
Golf COUfsra
:
.
r
TPA
lip
Aqua North Carolina. Inc.
Facility
Olde Beau Golf Club WWTP
Location
Latitude: 36' 24' 48 N State Grid: Glade
not to Scale
Longitude: 80' 58' 59" W Permitted Flow: 0.02 MGD
Receiving Stream: UT to Laurel Branch Stream Class: C-Trout
]� NPDES Permit No. NC0078158
Drainage Basin: New River Basin Sub -Basin : 05-07-03
North orth Alleghany County

Mickey, Mike
From:
Tedder, Steve
Sent:
Friday, October 22, 2010 7:07 AM
To:
White, Sue
Cc:
Mickey, Mike
Subject:
FW: Old Beau Dam
E-mail correspondence to and from this address
may be subject to the North Carolina Public Records
Law and may be disclosed to third parties.
Steve Tedder
Steve.Tedder@ NCDEN R.eov
NC DENR Division of Water Quality
585 Waughtown Street
Winston-Salem, NC 27107
(336)-771-4950
Fax [phone]
From: Tedder, Steve
Sent: Friday, October 22, 2010 7:07 AM
To: Gantt, Matt; McEvoy, Steve
Cc: Poling, Matt; Nevils, Mell; Wakild, Chuck
Subject: RE: Old Beau Dam
The minimum release is a condition enforced by the Division of LQ as part of the Dam permit for Roaring Gap.. The
condition is based upon conditions to support aquatic fauna downstream from the regulated structure. Normally Water
Resources in conjunction with Wildlife establishes this number for the permit and from a WQ perspective we often use
that number in lieu of 7Q10 for NPDES permitting purposes. There is an NPDES discharge just below the Old Beau
ponds.
Three days of no flow to the stream below the ponds would probably not be a good think for the aquatic life.
I think the minimum release is 1.4 cfs from Roaring Gap. I would not see a problem with this as long as the stream
below Old Beau sees "approximately" 1.4 cfs being released from the lower pond. I think even the toe leakage at
Roaring gap is some 0.3 cfs.
Old Beau should be able to continue the release of the 1.4 cfs downsteam while they are making the repairs even if
Roaring Gap holds some back.
My only concern is that the stream below Old Beau receives some flow during these three days. No concern of the area
between Roaring Gap dam and the lower pond dam on Old Beau.
Tedder
E-mail correspondence to and from this address
may be subject to the North Carolina Public Records
Law and may be disclosed to third parties.
Steve Tedder

Steve.Tedder@ NCDEN R.Ro
NC DENR Division of Water Quality
585 Waughtown Street
Winston-Salem, NC 27107
(336)-771-4950
Fax [phone]
From: Gantt, Matt
Sent: Thursday, October 21, 2010 3:18 PM
To: McEvoy, Steve; Tedder, Steve
Cc: Poling, Matt; Nevils, Mell
Subject: Old Beau Dam
Steve and Steve,
Please see the attached letter from Mr. Billy Packer regarding his dam at Old Beau. The dam is not regulated by the Dam
Safety Act. I spoke to Mr. Packer last week concerning the proposed modifications to his dam.
The riser for the dam has been leaking and they wish to fill it with concrete. They will then allow the emergency spillway
to serve as the principal spillway.
Mr. Packer wishes to have the minimum flow requirement coming from Roaring Gap Dam suspended so he can repair
his dam.
Who would have the authority to suspend the minimum flow requirement for the three day period to allow this work to
be completed?
Please let me know and I will respond to Mr. Packer.
Thanks,
Matt
Matthew E. Gantt, P.E.
NC DENR Winston-Salem Regional Office
Land Quality
585 Waughtown Street
Winston-Salem, NC 27107
Voice: [phone]
FAX: [phone]
***************
E-mail correspondence to and from this address may be subject to the
North Carolina Public Records Law and may be disclosed to third parties.
***************
2

IMIT111 . S
Beverly Eaves Perdue
Governor
THOMAS J ROBERTS
PRESIDENT AND COO
AQUA NORTH CAROLINA, INC
202 MACKENAN COURT
CARY NC 27511
Dear Mr. Roberts:
DivisionNCDEN
Department of Environment and Natural Resources
Coleen H. Sullins
Director
October 1, 2010
RECEIVED
N.C. Deot. ct p
OCT 0 5 2010
Winston-So,F
Regional lit`-ce
Dee Freeman
Secretary
Subject: Receipt of permit renewal application
NPDES Permit NCO078158
Olde Beau Gold Court WWTP
Alleghany County
The NPDES Unit received your permit renewal application on September 29, 2010. A member of the
NPDES Unit will review your application. They will contact you if additional information is required to complete
your permit renewal. You should expect to receive a draft permit approximately 30-45 days before your existing
permit expires.
If you have any additional questions concerning renewal of the subject permit, please contact Jeff Poupart at
[phone].
Sincerely,
Dina Sprinkle
Point Source Branch
cc: CENTRAL FILES
Winston-Salem Regional Office/Surface Water Protection
NPDES Unit
1617 Mail Service Center, Ralegh, North Carolina 27699-1617
Location: 512 N. Salisbury St. Raleigh, North Carolina 27604 One
Phone: [phone] FAX: 91H07-64921 Customer Service: 1-877-623-6748 NorthCarohna
Internet: www.ncwaterqualq.org 'J\ ������l//�
An Equal Opportunity 1 Affirmative Action Employer � �/

AQUA.
North Carolina
Aqua North Carolina, Inc.
4163 Sinclair Street F: 704.489.9409
Denver, NC 28037 www.aquanorthcarolina.com
September 24, 2010
NC Department of Environment and Natural Resources
Division of Water Quality
NPDES Unit
1617 Mail Service Center
Raleigh, NC 27699-1617
Subject: Application for Permit Renewal
Aqua North Carolina, Inc.
Olde Beau Subdivision WWTP
NPDES No. NCO078158
Alleghany County
Gentlemen:
Attached are three (3) copies of the completed application Form D — WWTP, and
a location map. This letter, the attachments, and our Sludge Management Plan
are our request to renew the subject permit.
If you need any additional information or assistance, please feel free to contact
our Regional Compliance Manager, Michael Melton @ 704-489-9404 ext. 57238
or by e-mail at MAMelton a,aguaamerica.com.
�crel,
Thomas J. oberts
Presiden & COO
Enc
An Aqua America Company

t
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 Permit �NC0078158�
If you are completing this forrn 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. Othenuise, please pant or type.
1. Contact Information:
Owner Name
Facility Name
Mailing Address
City
State / Zip Code
Telephone Number
Fax Number
e-mail Address
AQUA NORTH CAROLINA, INC.
OLDS BEAU
202 MACKENAN COURT
CARY
NC 27511
[phone]
[phone]
tjrobe rt s y aquaamerica.com
2. Location of facility producing discharge:
Check here if same address as above ❑
Street Address or State Road COUNTY DOWNS AVENUE
City ROARING GAP
State / Zip Code North Carolina 28668
County ALLEGIIANY COUNTY
3. Operator Information:
Name of the finn, public organization or other entity that operates the facility
referring to the Operator in Responsible Charge or ORC)
Name AQUA NORTH CAROUNA, INC
Mailing Address 202 MACKENAN COURT
City CARY
State / 'lip Code NC 27511
Telephone Number [phone]
Fax Number [phone]
We a]
(Note that this is not
Form-D 05l08

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
Residential
®
Number of Homes 77
School
❑
Number of Students/Staff
Other
®
Explain: Club
Describe the source(s) of wastewater (example: subdivision, mobile home park, shopping centers,
restaurants, etc.):
Single family residences, Golf Course, Club House, and Lodge.
Population served: 196
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
7. Name of receiving stream(s) (Provide a ►nap showing the exact location of each outfall):
LAUREL BRANCH IN THE NEW RIVER BASIN
8. Frequency of Discharge:
If intermittent:
Days per week discharge occurs:
9. Describe the treatment system
Continuous ❑ Intermittent
Duration:
The 0.020 MGD package plant consist of the following: bar screen, flow splitter box,
equalization basin, dual aeration basins, dual secondary clarifiers, dual aerated sludge
holding tanks and a single tablet chlorinator, contact chamber, tablet dechlor unit,
Stevens flow meter, effluent pumps and on -site generator.
Sludge from the Olde Beau Golf and Country Club wastewater treatment plant is disposed
of in the following manner:
Solids are collected in the sludge holding tank and digested aerobically. The excess
solids are periodically pumped and hauled by a licensed septic pumper contractor and
disposed of at the city of Elkin wastewater plant.
Flow Information:
Treatment Plant Design flow 0.020MGD
Annual Average daily flow .0025 MGD (for the previoi:is 3 years)
Maximum daily flow .0044 ,________MGD (for the previous 3 years)
2of3
Form-D 05/08

NPDES APPLICATION - FORM D
For privately owned treatment systems treating 100% domestic wastewaters <1.0 MGD
11. Is this facility located on Indian country?
❑ Yes ® No
12. Effluent Data
Yrvuide data for the pc�rarneters listed. Fecal ColiJbrrn, Temperature and pII shall be grab samples, for all other
parameters 24-hour composite sarrrpling shall be used. 1J'more than one analysis is reported, report daily maximum
and rrton.thly average. 1f only one analysis is reported, report as daily maximum.
Parameter
Daily
Maximum
Monthly
Units of
Measurement
Biochemical Oxygen Demand (BODs)
11.6
__Average_
6.7
mg/ L
Fecal Coliform
17.0
3.8
# 100 / ml
Total Suspended Solids
17.8
11.7
Mg/ L
Temperature (Summer)
25.0
21.4
° C
Temperature (Winter)
8.7
3.9
° C
pH
7.3
7.15
SU
13. List all permits, construction approvals and/or applications:
Type Permit Number Type
Hazardous Waste (RCRA)
UIC (SDWA)
NPDES NCOO78158
PSD (CAA)
Non -attainment program (CAA)
14. APPLICANT CERTIFICATION
NESHAPS (CAA)
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.
North 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.)
3of3
Form-D 05/08

�. � -
j %-: �-

Norte Carohrla
Aqua North Carolina, Inc.
41-Ii8 Sinclair Street F: 704.489.940!1
Deriver, NC 48087 www.aquanorthcarulina.com
SLUDGE MANAGEMENT PLAN
For
Aqua North Carolina, Inc.
No sludge will be treated on any wastewater treatment plant site operated
by Aqua N.C., Western Division
Where practical, sludge removed fi-orn a Aqua N.C., Western Division
facility will be transported via a contract hauler to another Aqua N.C.,
Western Division facility for the purpose of "seeding" a new or under
loaded plant.
Unusable (or- "dead") sludge will be removed by a contract hauler and
properly disposed of in accordance with NCGS 14,3-315.1. Contract
haulers used by Aqua N.C., Western Division will be reCluired to report the
quantity of sludge transported and identify the location of the proposed
disposal site if the sludge is not taken to an existing plant operated by Aqua
N.C., Western Division. AgUia N.C., Western Division has not entered into
any agreement to accept sludge into its facilities from plants not owned by
them.
Aqua N.C., Western Division will keep records on the quantity of sludge
removed from each facility, the name of the contract hauler, and the
destination of the sludge (whether used in another plant or disposed Cif).
-File information will be kept on file and will be made available to any
regulatory agency having jurisdiction over sludge treatment or disposal.
Aqua N.C., Western Division includes all of the facilities Under the
jurisdiction of the Mooresville Regional Office.

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
May 7, 2010
Mr. Tom Roberts
Aqua NC, Inc.
202 MacKenan Court
Cary, NC 27511
SUBJECT: Compliance Evaluation Inspection
Olde Beau Golf Club WWTP
NPDES Permit No. NCO078158
Alleghany County
Dear Mr. Roberts:
On April 15, 2010, Gary Hudson of this office met with Joe Baskin, ORC with R & A Labs, to perform a
Compliance Evaluation Inspection on the wastewater treatment system serving the Olde Beau Golf Club. This
type of inspection consists of two basic parts: an in office file review and an on -site inspection of the treatment
facility. The attached EPA inspection form notes the eight (8) areas that were evaluated for this inspection.
The findings and observations are outlined below:
I. Permit
Ownership of the package plant and collection system has been transferred to Aqua NC. The permit
modification showing ownership change became effective July 3, 2007, and expires on March 31, 2011.
II. Self -Monitoring Program
A review of the monthly self -monitoring reports (DMR's) for the period March 2009 through February 2010
showed the facility to be in complete compliance with all final NPDES effluent limits for the period with the
exception of a fecal coliform violation on 8/19/09. In addition, all monitoring was performed and recorded per
the frequencies specified in the permit.
III. Flow Measurement
A Stevens flow meter is used for continuous flow recording
calibration on 10/14/09.
IV. Sludge Handling and Disposal
North Carolina Division of Water Quality, Winston-Salem Regional Office
Location: 585 Waughtown St. Winston-Salem, North Carolina 27107
Phone: [phone] FAX: [phone] \ Customer Service: 1-877.623-6748
Internet: www.ncwaterquality.org
An Equal Opportunity 1 Affirmative Action Employer
Horizon Engineering performed the annual
Nne
orthCarolina
Natumlly

Solids are transferred from the small digester to the unused aeration basin for storage. At this time, no
septage hauler is under contract for regular pumping of the solids
V. Operations and Maintenance
The package plant appeared to be well maintained and operated. No concerns were noted.
VI. Facility Site Review
The 0.020 MGD package plant consists of the following: bar screen, flow splitter box, equalization basin, dual
aeration basins, dual secondary clarifiers, dual aerated sludge holding tanks and a single tablet chlorinator,
contact chamber, tablet dechlor unit, Stevens flow meter, effluent pumps and on -site generator.
VII. Records/Reports
A daily visitation log is kept on site and was available for inspection.
VIII. Effluent/Receiving Waters
The system discharges into a U.T. to Laurel Branch, Class "C-trout" waters. The effluent was crystal clear on
the date of the inspection.
Should you have any questions concerning this report, please contact Gary Hudson or me at (336)
771-5000.
Sincerely,
00,
oe,-��r--
Steve W. Tedder
Water Quality Regional Supervisor
cc: Cliff Cain - R & A Labs
Central Files
WSRO

Olde Beau Golf Club WWTP
NPDES Permit No. NCO078158
Self -Monitoring Data Summary
March 2009 — February 2010
Parameters
Monthly Avg.
Permit Limit
Monthly Avg. Limit
Violations per
DMR
Daily Maximum
Permit Limit
Daily Max. Limit
Violations per DMR
Flow (MGD)
0.020
None
-
NA
BOD (mg/1)
(20 / 30)'
None
(30 / 45)*
None
TSS (mg/1)
30.0
None
45.0
None
NH3-N (mg/1)
(3 / 6.9)*
None
(15 / 34.5)*
None
Fecal (#/100 MI)
200
None
400
8/19/09
T. Chlorine (ug/1)
-
NA
28
None
Oil & Grease (mg/1)
30
None
60
None
*(Summer/Winter limits)

United States Environmental Protection Agency
Form Approved.
EPA Washington, D.C. 20460
OMB No. 2040-0057
Water Compliance Inspection Report
Approval expires 8-31-98
Section A: National Data System Coding (i.e., PCS)
Transaction Code NPDES yr/mo/day Inspection Type Inspector Fac Type
1 I NI 2 15I 31 NCO078158 111 121 10/04/15 117 181 CI 19I SI 20I I1
Remarks
211111111111111111I1111I11 llll IIII IIII IIII III1I1_]6
Inspection Work Days Facility Self -Monitoring Evaluation Rating 131 QA --------------------------- Reserved ----------------------
67I 169 701 I 711 I 72 I N I 73 L U 74 751 I I I I I I 180
Section B: Facility Data
Name and Location of Facility Inspected (For Industrial Users discharging to POTW, also include
Entry Time/Date
Permit Effective Date
POTW name and NPDES permit Number)
11:00 AM 10/04/15
06/04/01
Olde Beau Golf Club WWTP
Exit Time/Date
Permit Expiration Date
County Downs Ave
Roaring Gap NC 28668
12:30 PM 10/04/15
11/03/31
Name(s) of Onsite Representative (s)ITitles(s)/Phone and Fax Number(s)
Other Facility Data
Joseph Barnard Baskin/ORC/336-996-2841/
Name, Address of Responsible Official/Title/Phone and Fax Number
Thomas J Roberts,202 Mackenan Court Cary NC Contacted
27511/President/919-467-8712/9194661583 No
Section C: Areas Evaluated During Inspection (Check only those areas evaluated)
Permit N Flow Measurement Operations & Maintenance Records/Reports
Self -Monitoring Program E Sludge Handling Disposal Facility Site Review Effluent/Receiving Waters
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
(See attachment summary)
�. • 7/s�t�y r d
Name(s) and Signature(s) of Inspector(s) Agency/Office/Phone and Fax Numbers Date
Gary Hudson WSRO WQ///
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

NPDES yr/mo/day Inspection Type
3I NCO078158 I11 121 10/04/15 117 18ICI
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
Page # 2

Permit: NCO078158 Owner - Facility: Olde Beau Golf Club WWTP
Inspection Date: 04/15/2010 Inspection Type: Compliance Evaluation
Operations & Maintenance
Yes
No
NA
NE
Is the plant generally clean with acceptable housekeeping?
■
❑
n
n
Does the facility analyze process control parameters, for ex: MLSS, MCRT, Settleable Solids, pH, DO, Sludge ■
n
n
n
Judge, and other that are applicable?
Comment:
Permit
Yes
No
NA
NE
(If the present permit expires in 6 months or less). Has the permittee submitted a new application?
n
n
■
n
Is the facility as described in the permit?
■
n
n
n
# Are there any special conditions for the permit?
n
■
n
n
Is access to the plant site restricted to the general public?
■
n
n
n
Is the inspector granted access to all areas for inspection?
■
n
n
n
Comment: .
Record Keeping
Yes
No
NA
NE
Are records kept and maintained as required by the permit?
■
n
n
n
Is all required information readily available, complete and current?
■
n
n
n
Are all records maintained for 3 years (lab. reg. required 5 years)?
■
n
n
n
Are analytical results consistent with data reported on DMRs?
■
n
n
n
Is the chain -of -custody complete?
■
n
n
n
Dates, times and location of sampling
■
Name of individual performing the sampling
■
Results of analysis and calibration
■
Dates of analysis
■
Name of person performing analyses
■
Transported COCs
■
Are DMRs complete: do they include all permit parameters?
■
n
n
n
Has the facility submitted its annual compliance report to users and DWQ?
■
n
n
n
(If the facility is = or > 5 MGD permitted flow) Do they operate 24/7 with a certified operator on each shift?
n
n
■
n
Is the ORC visitation log available and current?
■
n
In
n
Is the ORC certified at grade equal to or higher than the facility classification?
■
n
n
n
Is the backup operator certified at one grade less or greater than the facility classification?
■
n
n
n
Is a copy of the current NPDES permit available on site?
■
n
n
n
Page # 3

4
Permit: NCO078158 Owner - Facility: Olde Beau Golf Club VWVT'P
Inspection Date: 04/15/2010 Inspection Type: Compliance Evaluation
Record Keeping
Yes No
NA
NE
Facility has copy of previous year's Annual Report on file for reviev✓.
■
n
Comment:
Bar Screens
Yes
No
NA
NE
Type of bar screen
a.Manual
■
b. Mechanical
Are the bars adequately screening debris?
■
n
n
n
Is the screen free of excessive debris?
■
n
n
n
Is disposal of screening in compliance?
■
n
n
n
Is the unit in good condition?
■
n
n
n
Comment: .
Equalization Basins
Yes
No
NA
NE
Is the basin aerated?
■
n
n
n
Is the basin free of bypass lines or structures to the natural environment?
■
n
00
Is the basin free of excessive grease?
■
n
n
n
Are all pumps present?
■
n
n
n
Are all pumps operable?
■
❑
n
Are float controls operable?
■
n
n
n
Are audible and visual alarms operable?
■
n
n
n
# Is basin size/volume adequate?
■
❑
❑
❑
Comment:
Aeration Basins
Yes
No
NA
NE
Mode of operation
Ext. Air
Type of aeration system
Diffused
Is the basin free of dead spots?
■
n
n
n
Are surface aerators and mixers operational?
n
n
n
■
Are the diffusers operational?
■
n
n
n
Is the foam the proper color for the treatment process?
■
n
n
n
Does the foam cover less than 25% of the basin's surface?
■
n
n
n
Is the DO level acceptable?
■
❑
n
❑
Page
# 4

Permit: NCO078158 Owner - Facility: Olde Beau Golf Club WVVTP
Inspection Date: 04/15/2010 Inspection Type: Compliance Evaluation
Aeration Basins
Yes
No
NA
NE
Is the DO level acceptable?(1.0 to 3.0 mg/1)
■
❑
Q
n
Comment: .
Secondary Clarifier
Yes
No
NA
NE
Is the clarifier free of black and odorous wastewater?
■
n
n
n
Is the site free of excessive buildup of solids in center well of circular clarifier?
n
n
■
n
Are weirs level?
■
n
n
n
Is the site free of weir blockage?
■
n
n
n
Is the site free of evidence of short-circuiting?
■
n
n
n
Is scum removal adequate?
■
n
n
n
Is the site free of excessive floating sludge?
■
n
n
n
Is the drive unit operational?
n
n
■
o
Is the return rate acceptable (low turbulence)?
■
n
n
n
Is the overflow clear of excessive solids/pin floc?
■
n
n
n
Is the sludge blanket level acceptable? (Approximately '/< of the sidewall depth)
■
n
n
n
Comment: .
Aerobic Digester
Yes
No
NA
NE
Is the capacity adequate?
■
In
n
n
Is the mixing adequate?
■
n
n
n
Is the site free of excessive foaming in the tank?
■
n
n
n
# Is the odor acceptable?
■
n
n
n
# Is tankage available for properly waste sludge?
■
n
n
n
Comment: .
Disinfection -Tablet
Yes
No
NA
NE
Are tablet chlorinators operational?
■
n
n
n
Are the tablets the proper size and type?
■
n
n
n
Number of tubes in use?
2
Is the level of chlorine residual acceptable? ■ n n n
Is the contact chamber free of growth, or sludge buildup? ■ n n n
Is there chlorine residual prior to de -chlorination? ■ n n n
Comment: .
Page # 5

Permit: NC0078158 Owner - Facility: Olde Beau Golf Club WVVTP
Inspection Date: 04/15/2010 Inspection Type: Compliance Evaluation
De -chlorination
Yes No
NA
NE
Type of system ?
Tablet
Is the feed ratio proportional to chlorine amount (1 to 1)?
n
n
■
o
Is storage appropriate for cylinders?
n
n
■
o
# Is de -chlorination substance stored away from chlorine containers?
n
n
■
n
Comment: .
Are the tablets the proper size and type?
■
❑
n
n
Are tablet de -chlorinators operational?
■
n
n
n
Number of tubes in use?
3
Comment: .
Flow Measurement - Effluent
Yes
No
NA
NE
# Is flow meter used for reporting?
■
n
❑
n
Is flow meter calibrated annually?
■
n
n
n
Is the flow meter operational?
■
n
n
n
(If units are separated) Does the chart recorder match the flow meter?
Cl
n
■
n
Comment: .
Pump Station - Effluent
Yes
No
NA
NE
Is the pump wet well free of bypass lines or structures?
■
n
n
n
Are all pumps present?
■
n
n
n
Are all pumps operable?
■
n
n
n
Are float controls operable?
■
n
n
n
Is SCADA telemetry available and operational?
n
n
■
n
Is audible and visual alarm available and operational?
■
n
n
n
Comment:
Effluent Pipe
Yes
No
NA NE
Is right of way to the outfall properly maintained?
■
n
n
n
Are the receiving water free of foam other than trace amounts and other debris?
■
n
n
n
If effluent (diffuser pipes are required) are they operating properly?
n
n
■
n
Comment: .
Page # 6

0-14 fvW�� 657
I
Performance Annual Report
General Information
Facility/System Name: Olde Beau Golf Club
Responsible Entity: Aqua North Carolina
Person in Charge/Contact: Tom Roberts
Applicable Permit (s):NC0078158
Description of Collection System or Treatment Process:
RecE,ivE_
N.C. Dan!
APR 16 2010
Wrist,
Regicnai
MAR 042010 `i
This 0.02 MGD aeration treatmentsystem berates with a flow snlitter box, bar screen,
an aeration chamber, chlorine basin and a de -chlorination tank.
II. Performance
Text Summary of System Performance for Calendar Year 2009
This plant is operated by Research and Analytical Laboratories out of Kemersville, NC. They
function as Aqua's contract operator for Olde Beau Overall the plant performed well and it
generally met all of the discharge permit limits.
List (by month) any violation of the permit conditions or other environmental regulations.
Monthly lists should include discussion of any environmental impacts and corrective measures
taken to address violations.
January Compliant
February Compliant
March Compliant
April Compliant
May Compliant - -
June Compliant
July Compliant
August The daily maximum for fecal was exceeded. The operator cleaned out the
chlorine contact chamber.

September Compliant
October Compliant
November Compliant
December Compliant
III. Notification
Our customers will receive a letter regarding the availability of this report upon request. These
reports will also be available for review with the customer at Aqua's Southern Call Center.
IV. Certification
I certify under penalty of law that this report is complete and accurate to the best of my
knowledge. I further certify that this report has been made available to the users or customers of
the named system and that those users have been notified of its availability.
2/26/2010
Responsible Person Date
Title: Regional Compliance Manager
Entity: Aqua North Carolina

"4y . H
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Coleen H. Sullins, Director
Division of Water Quality
November 13, 2009
Thomas J Roberts
Aqua North Carolina Inc
202 Mackenan Court
Cary, NC 27511
Subject: NOTICE OF VIOLATION
NPDES Permit No. NCO078158
Olde Beau Golf Club WWTP
Alleghany County
Dear Mr Roberts:
A review of Olde Beau Golf Club WWTP's monitoring report for August 2009 showed the
following violations:
Parameter
Date
Limit Value
Reported Value
Limit Type
Fecal Coliform
08/19/09
400 #/100ml
680 #/100m1
Daily Maximum Exceeded
Remedial actions, if not already implemented, should be taken to correct the above
noncompliance problem. Please be aware that violations of your NPDES permit could result in
enforcement action by the Division of Water Quality for this and any additional violations of
State law. If you should have any questions, please do not hesitate to contact Gary Hudson at
[phone].
Sincerely,
Steve W. Tedder
Water Quality Regional Supervisor
Region
Division of Water Quality
Cc: Central Files - SWP
W SRO
NorthCarolina
Naturally
N.C. Division of Water Quality 585 Waughtown Street Winston-Salem, NC 27107 [phone] Customer Sei Ywo
1(800)623-7748
An Equal Opportunity/Affirmative Action Employer— 50% Recycled/10% Post Consumer Paper

�f q. Cover Sheet from
b -- 2�� 1a " L V f -! S Staff Member to
Regional Supervisor
DMR Review Record
Facility: OL-D HEAU Permit/Pipe No.: HC0o7815R Month/Year i12D©q
(Tay F Cw8 440rP
Monthly Average Violations
Parameter
Permit Limit DMR Value
Weekly/Daily Violations
Date Parameter Permit Limit/Tvpe DMR Value % Over Limit
19,406 FEC4 L 6W. 70 6/o
Monitoring Frequency Violations
Date Parameter Permit Frequency Values Reported # of Violations
Other Violations
Na G,jr02CC-^EAJrS 1,✓ 4A
Completed by: Date: 0V0
Regional Water Quality
Supervisor SiQnoff: Date:
.t/v✓

�- Facility Status: (Please check one of the following)
• All monitoring data and sampling frequencies meet permit requirements
(including weekly averages, if applicable) Compliant
All monitoring data and sampling frequencies do NOT meet permit requirements
Noncompliant
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 permitte 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.
PUmfed 60t CJ&V_irt¢ (6"'�Ct_d k��a�K a�I� ()-Ca> WA
dP CAA1 6 CiY\W 6Y% b 11k
"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 a qualified personnel properly gather and evaluate the information submitted. Based on my
inquiry of the person or persons who manage 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."
Tom Roberts
Permitt print or type)
Si at a of ermitee*** Date
(Required unless submitted electronically)
202 MacKenan Court Cary NC 27511 919-467-8712 03/31/2011
Permittee Address Phone Number Permit Exp. Date
Certified Laboratory (2)
Certified Laboratory (3)
Certified Laboratory (4)
Certified Laboratory (5)
ADDITIONAL CERTIFIED LABORATORIES
PARAMETER CODES
Certification No.
Certification No.
Certification No.
Certification No.
Parameter Code assistance may be obtained by calling the NPDES Unit at at [phone], or by visiting the Surface Water Protection Section's
web site at h2o.enr.state.nc.us/was and linking to the Unit's information pages.
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 occurrs and, as a result, there are no data to be entered for all of the
parameters on the DMR for the entire monitoring period.
°c* ORC On Site?: ORC must visit facility and document visitation of facility at;.equred per} 45ANCAC8G.0204.
*** Signature of Permittee: If signed by other than the permitte, then the delegation of the signatory authority must be on file with the state per
15ANCAC2B.0506 (b) (2) (D). _.

EFFLNT
n,.n
NPDES PERMIT NO. NC 0078158 DISCHARGE NO.001 MONTH August YEAR 2009
FACILITY NAME Olde Beau Golf Club CLASS II COUNTY Allegheny
CERTIFIED LABORATORIES R & A Laboratories Inc. CERTIFICATION NO. 34
(List additional laboratories on the backside/page 2 of this form)
OPERATOR IN RESPONSIBLE CHARGE (ORC) Joe Baskin GRADE II CERTIFICATION NO. 989829
PERSON(S) COLLECTING SAMPLES Operators ORC PHONE [phone]
CHECK BOX IF ORC HAS CHANGED NO FLOW / ISCHARGE FROM SITE * Q
Mail ORIGINAL and ONE COPY to: " `' v�r' " - 9
ATTN: CENTRAL, FILES AI�1
DIVISION OF P,'ATER QUALITY ' l ' �'1(SIGNAT F OPERATOR IN RESPONSIBLE CHARGE) D7k
1617 MAIL SERVICE CENTER 'NV nstc r BY THIS GNATURE, I CERTIFY THAT THIS REPORT IS CT 16 ' Reyicn RALEIGH, NC 27699-1617 - - -- - ACCURATE AND COMPLETE TO THE BEST OF MY KNOWLEDGE. 2009
TO
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Copy DWQ Form MR -I (01/00)

��
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
July 14, 2009
Mr. Tom Roberts
Aqua NC, Inc.
4163 Sinclair Street
Denver, NC 28037
SUBJECT: Compliance Evaluation Inspection
Olde Beau Golf Club WWTP
NPDES Permit No. NCO078158
Alleghany County
Dear Mr. Roberts:
On July 9, 2009, Gary Hudson of this office met with Joe Baskin, ORC with R & A Labs, to perform a
Compliance Evaluation Inspection on the wastewater treatment system serving the Olde Beau Golf Club. This
type of inspection consists of two basic parts: an in office file review and an on -site inspection of the treatment
facility. The attached EPA inspection form notes the eight (8) areas that were evaluated for this inspection.
The findings and observations are outlined below:
I. Permit
Ownership of the package plant and collection system has been transferred to Aqua NC. The permit
modification showing ownership change became effective July 3, 2007, and expires on March 31, 2011.
II. Self -Monitoring Program
A review of the monthly self -monitoring reports (DMR's) for the period May 2008 through April 2009 showed
the facility to be in complete compliance with all final NPDES effluent limits for the period with the exception of
a fecal coliform violation on 7/2/08, and 8/14/08. In addition, all monitoring was performed and recorded per
the frequencies specified in the permit.
III. Flow Measurement
A Stevens flow meter is used for continuous flow recording
calibration on 10/14/08.
North Carolina Division of Water Quality, Winston-Salem Regional Office
Location: 585 Waughtown St. Winston-Salem, North Carolina 27107
Phone: [phone] FAX: [phone] Customer Service: 1-877-623-6748
Internet: www.ncwaterquality.org
Horizon Engineering performed the annual
Nne
orthCarolina
Natmally
An Equal Opportunity 1 Affirmative Action Employer

Mr. Tom Roberts
Page 3
July 14, 2009
IV. Sludge Handling and Disposal
Solids are transferred from the small digester to the unused aeration basin for storage. At this time, no
septage hauler is under contract for regular pumping of the solids
V. Operations and Maintenance
The package plant appeared to be well maintained and operated. No concerns were noted.
VI. Facility Site Review
The 0.020 MGD package plant consists of the following: bar screen, flow splitter box, equalization basin, dual
aeration basins, dual secondary clarifiers, dual aerated sludge holding tanks and a single tablet chlorinator,
contact chamber, tablet dechlor unit, Stevens flow meter, effluent pumps and on -site generator.
VII. Records/Reports
A daily visitation log is kept on site and was available for inspection.
VIII. Effluent/Receiving Waters
The system discharges into a U.T. to Laurel Branch, Class "C-trout' waters. The effluent was crystal clear on
the date of the inspection.
Should you have any questions concerning this report, please contact Gary Hudson or me at (336)
771-5000.
Sincerely,
4.�eJ_1--
Steve W. Tedder
Water Quality Regional Supervisor
cc: Cliff Cain - R & A Labs
Central Files
WSRO

Mr. Tom Roberts
Page 3
July 14, 2009
Olde Beau Golf Club WWTP
NPDES Permit No. NCO078158
Self -Monitoring Data Summary
May 2008 — April 2009
Parameters
Monthly Avg.
Permit Limit
Monthly Avg. Limit
Violations per
DMR
Daily Maximum
Permit Limit
Daily Max. Limit
Violations per DMR
Flow (MGD)
0.020
None
-
NA
BOD (mg/1)
(20 / 30)*
None
(30 / 45)*
None
TSS (mg/1)
30.0
None
45.0
None
NH3-N (mg/1)
(3 / 6.9)-
None
(15 / 34.5)'
None
Fecal (#/100 ml)
200
None
400
7/2/09, 8/14/09
T. Chlorine (ug/1)
-
NA
28
None
Oil & Grease (mg/I)
30
None
60
None
*(Summer/Winter limits)

United States Environmental Protection Agency
Form Approved.
EPA Washington, D.C. 20460
OMB No. 2040-0057
Water Compliance Inspection Report
Approval expires 8-31-98
Section A: National Data System Coding (i.e., PCS)
Transaction Code NPDES yr/mo/day Inspection Type Inspector Fac Type
1 I NI 2 15I 31 N00078158 111 121 09/07/09 117 18I CI 191 sI 20I II
Remarks
211IIIIIIIIIIIIII1111111111111IIIIIIII IIIIIIII1_LJ6
Inspection Work Days Facility Self -Monitoring Evaluation Rating B1 QA --------------------- ----- Reserved ----------------- ----
67 I 169 701 I 711 I 721 NJ 73I I 174 751 I I I I I I 180
u_1
Section B: Facility Data
Name and Location of Facility Inspected (For Industrial Users discharging to POTW, also include
Entry Time/Date
Permit Effective Date
POTW name and NPDES permit Number)
10:00 AM 09/07/09
06/04/01
Olde Beau Golf Club WWTP
Exit Time/Date
Permit Expiration Date
County Downs Ave
Roaring Gap NC 28668
12:00 PM 09/07/09
11/03/31
Name(s) of Onsite Representative (s)lritles(s)/Phone and Fax Number(s)
Other Facility Data
Joseph Barnard Baskin/ORC/336-996-2841/
Name, Address of Responsible Official/Title/Phone and Fax Number
Contacted
Thomas J Roberts,202 Mackenan Court Cary NC
No
27511/President/919-467-8712/9194661583
Section C: Areas Evaluated During Inspection (Check only those areas evaluated)
Permit 0 Flow Measurement Operations & Maintenance Records/Reports
Self -Monitoring Program 0 Sludge Handling Disposal Facility Site Review Effluent/Receiving Waters
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
(See attachment summary)
/�J-C o
ke((s)anYSignature('s)
Na of Inspector(s) Agency/Office/Phone and Fax Numbers Date
Gary Hudson WSRO WQ///
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

NPDES yr/mo/day Inspection Type
3I NCO078158 1
11 121
09/07/09 117 18ICI
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
Page # 2

Permit: NCO078158
Inspection Date: 07/09/2009
Owner - Facility: Olde Beau Golf Club VWVTP
Inspection Type: Compliance Evaluation
Operations & Maintenance Yes No NA NE
Is the plant generally clean with acceptable housekeeping? ■ n n n
Does the facility analyze process control parameters, for ex: MLSS, MCRT, Settleable Solids, pH, DO, Sludge ■ n n n
Judge, and other that are applicable?
Comment:
— _ Yes No NA NE
(If the present permit expires in 6 months or less). Has the permittee submitted a new application?
n
n
■
n
Is the facility as described in the permit?
■
n
n
n
# Are there any special conditions for the permit?
n
■
n
n
Is access to the plant site restricted to the general public?
■
n
n
n
Is the inspector granted access to all areas for inspection?
■
n
n
n
Comment: .
Record Keeping
Yes
No
NA
NE
Are records kept and maintained as required by the permit?
■
n
In
n
Is all required information readily available, complete and current?
■
n
n
n
Are all records maintained for 3 years (lab. reg. required 5 years)?
■
n
n
n
Are analytical results consistent with data reported on DMRs?
■
n
n
n
Is the chain -of -custody complete?
■
n
n
n
Dates, times and location of sampling
■
Name of individual performing the sampling
■
Results of analysis and calibration
■
Dates of analysis
■
Name of person performing analyses
■
Transported COCs
■
Are DMRs complete: do they include all permit parameters?
■
n
n
n
Has the facility submitted its annual compliance report to users and DWQ?
■
n
n
n
(If the facility is = or > 5 MGD permitted flow) Do they operate 24/7 with a certified operator on each shift?
n
❑
■
n
Is the ORC visitation log available and current?
■
n
In
n
Is the ORC certified at grade equal to or higher than the facility classification?
■
n
n
n
Is the backup operator certified at one grade less or greater than the facility classification?
■
n
In
n
Is a copy of the current NPDES permit available on site?
■
n
n
In
Page # 3

Permit: NCO078158 Owner - Facility:
Inspection Date: 07/09/2009 Inspection Type:
Olde Beau Golf Club WVVrP
Compliance Evaluation
Record Keeping
Yes
No
NA NE
Facility has copy of previous year's Annual Report on file for review?
■
❑
❑
❑
Comment:
Bar Screens
Yes
No
NA NE
Type of bar screen
a.Manual
■
b. Mechanical
n
Are the bars adequately screening debris?
■
n
n
n
Is the screen free of excessive debris?
■
n
n
n
Is disposal of screening in compliance?
■
o
n
n
Is the unit in good condition?
■
n
n
n
Comment: .
Equalization Basins
Yes
No
NA
NE
Is the basin aerated?
■
n
n
n
Is the basin free of bypass lines or structures to the natural environment?
■
n
n
n
Is the basin free of excessive grease?
■
n
n
n
Are all pumps present?
■
n
n
n
Are all pumps operable?
■
o
n
n
Are float controls operable?
■
o
n
n
Are audible and visual alarms operable?
■
n
n
n
# Is basin size/volume adequate?
■
n
n
n
Comment: .
Aeration Basins
Yes
No
NA
NE
Mode of operation
Ext.
Air
Type of aeration system
Diffused
Is the basin free of dead spots?
■
n
n
In
Are surface aerators and mixers operational?
n
n
■
n
Are the diffusers operational?
■
o
n
n
Is the foam the proper color for the treatment process?
■
o
n
n
Does the foam cover less than 25% of the basin's surface?
■
n
n
n
Is the DO level acceptable?
■
n
n
n
Page
# 4

Permit: NCO078158 Owner - Facility: Olde Beau Golf Club WWTP
Inspection Date: 07/09/2009 Inspection Type: Compliance Evaluation
Aeration Basins
Yes
No
NA
NE
Is the DO level acceptable?(1.0 to 3.0 mg/1)
■
n
❑
n
Comment: .
Secondary Clarifier
Yes
No
NA
NE
Is the clarifier free of black and odorous wastewater?
■
n
n
n
Is the site free of excessive buildup of solids in center well of circular clarifier?
n
n
■
n
Are weirs level?
■
o
n
n
Is the site free of weir blockage?
■
n
n
n
Is the site free of evidence of short-circuiting?
■
n
n
n
Is scum removal adequate?
■
n
n
n
Is the site free of excessive floating sludge?
■
n
n
n
Is the drive unit operational?
n
n
■
n
Is the return rate acceptable (low turbulence)?
■
n
n
n
Is the overflow clear of excessive solids/pin floc?
■
o
n
n
Is the sludge blanket level acceptable? (Approximately '/< of the sidewall depth)
■
n
n
n
Comment: .
Aerobic Digester
Yes
No
NA
NE
Is the capacity adequate?
■
o
n
n
Is the mixing adequate?
■
n
n
n
Is the site free of excessive foaming in the tank?
■
n
n
n
# Is the odor acceptable?
■
n
n
n
# Is tankage available for properly waste sludge?
■
o
n
n
Comment: .
Disinfection -Tablet
Yes
No
NA
NE
Are tablet chlorinators operational?
■
o
n
n
Are the tablets the proper size and type?
■
n
n
n
Number of tubes in use?
2
Is the level of chlorine residual acceptable?
■
n
n
n
Is the contact chamber free of growth, or sludge buildup?
■
n
n
n
Is there chlorine residual prior to de -chlorination?
■
o
n
n
Comment: .
Page # 5

Permit: NCO078158 Owner - Facility: Olde Beau Golf Club WWTP
Inspection Date: 07/09/2009 Inspection Type: Compliance Evaluation
De -chlorination
Yes
No
NA NE
Type of system ?
Tablet
Is the feed ratio proportional to chlorine amount (1 to 1)?
n
n
■
n
Is storage appropriate for cylinders?
F1
n
■
n
# Is de -chlorination substance stored away from chlorine containers?
n
❑
■
n
Comment: .
Are the tablets the proper size and type?
■
n
n
n
Are tablet de -chlorinators operational?
■
n
n
n
Number of tubes in use?
3
Comment: .
Flow Measurement - Effluent
Yes
No
NA
NE
# Is flow meter used for reporting?
■
o
n
n
Is flow meter calibrated annually?
■
n
n
n
Is the flow meter operational?
■
n
n
n
(If units are separated) Does the chart recorder match the flow meter?
n
n
■
n
Comment: The flow meter was last calibrated on 140CT08 by Horizon Engineering.
Pump Station - Effluent
Yes
No
NA
NE
Is the pump wet well free of bypass lines or structures?
■
n
n
n
Are all pumps present?
■
n
n
n
Are all pumps operable?
■
o
n
n
Are float controls operable?
■
n
n
n
Is SCADA telemetry available and operational?
n
n
■
n
Is audible and visual alarm available and operational?
■
o
n
n
Comment:
Effluent Pipe
Yes
No
NA
NE
Is right of way to the outfall properly maintained?
■
n
n
n
Are the receiving water free of foam other than trace amounts and other debris?
■
n
n
n
If effluent (diffuser pipes are required) are they operating properly?
n
n
■
❑
Comment
Page # 6