NC0037834_Receipt of Renewal Application w/ Copy_20081230

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DAVID K SAUNDERS PE
DIRECTOR OF UTILITIES
CITY OF WINSTON SALEM
MANSON MEADS COMPLEX
2799 GRIFFITH ROAD
WINSTON SALEM NC 27103
Dear Mr. Saunders:
i
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
December 30, 2008
RECEIVED
N,C, Deot of ENR
DEC 3' 1 2008
Winston-Salem
Regional Office
Subject: Receipt of permit renewal application
NPDES Permit NCO037834
Archie Elledge WWTP
Forsyth County
The NPDES Unit received your permit renewal application on December 30, 2008. 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
Sergei Chernikov at (919), 807-6393.
Sincerely,
Dina Sprinkle
NPDES Unit
cc: CENTRAL FILES
QT_sns. o = �,l-e - : = ` IM-7 Surface Water Protection
NPDES Unit
Mailing Address Phone [phone] Location . OnrthCarolina
1617 Mail Service Center Fax [phone] N. Salisbury St. Natumllb
Raleigh, NC 27699-1617 Raleigh, NC 27604
Internet: www.ncwateraualitv.or¢ Customer Service 1-877-623-6748
An Equal Opportunity/Affirmative Action Employer — 50% Recycled/10% Post Consumer Paper

r
;,.Winston-Salem Forsyth County
, rr, I Y Lounty Utilities
ater a Sewer - Solid Waste Disposal
RECEIVED
'J Deot. of ENR
DEC 3 12008
tvmstonSalem
RLsglonal Office
Manson Meads Complex a 2799 Griffith Road ^ Winston-Salem, NC 27103 ^ Tel [phone] • Fax [phone]
Mrs. Dina Sprinkle
NC DENR / DWQ / Point Source Branch
1617 Mail Service Center
Raleigh, N.C. 27699-1617
Dear Mrs. Sprinkle,
DEC 3 0 2008
DENR < WATER QUALITY
Re: Request for NPDES RenePOI NT SOURCE BRANCH
Archie Elledge WWTP (NC0037834)
City of Winston-Salem
The City of Winston-Salem requests the simple renewal of the NPDES permit for the
Archie Elledge WWTP (NC0037834). The current permit expires on June 30"', 2009.
There is no increase in flow capacity being requested at this time and should remain at
the current 30 MGD limit. The application and supporting documentation requested in
your February 291h, 2008 letter are attached.
There have been a few changes to the Archie Elledge plant since the last renewal in 2004.
Please note the changes listed below;
® A new Dryer Facility built and put online to handle solids from the Archie
Elledge WWTP and the Muddy Creek WWTP.
® A lime/magnesium hydroxide blend is being used for alkalinity in conjunction
with caustic.
® Waste sludge lagoons are being utilized for holding centrate from centrifuges.
0 A 3rd centrifuge was added to existing dewatering facility.

If you or your staff has any questions or comments concerning content of application
please contact Mr. Jon M. Southern at 336-659-4322.
City of Winston-Salem
CC: J, Frank Crump, Plant Superintendant
Jon M. Southern, Plant Supervisor/ORC

Biosolids Disposal Strategy 2008-2012
Winston-Salem/Forsyth County Utility Commission
Archie Elledge WWTP (NPDES Permit NC0037834)
Muddy Creek WWTP (NPDES Permit NC0050342)
Sludges from the Utility Commission's two wastewater treatment plants are anaerobically
digested to meet Class B criteria established by EPA's 40CFR Part 503 Regulations.
Anaerobic digestion occurs by subjecting the sludges to tunes and temperatures that meet
PSRP requirements. Both the Archie Elledge and Muddy Creek plants have lagoons for
storage and dewatering of liquid biosolids to approximately 5.0% solids for land
application. The Commission currently disposes of its Class B biosolids under the North
Carolina Division of Water Quality Land Application of Residuals Permit WQ0000094.
Stabilized biosolids from the anaerobic digestion process at Muddy Creek are now being
pumped 5.2 miles into two blending tanks at Archie Elledge WWTP. Three 8" HDPE
pipe lines are utilized to pump biosolids between each facility. One line is for biosolids
from the Muddy Creek plant to the Elledge plant, the second line brings centrate from
Elledge Plant centrifuges back to Muddy Creek Lagoons, and the third is a spare line.
The Muddy Creek digested biosolids are pumped into the blending tanks along with the
biosolids from Archie Elledge's anaerobic digesters. The blend of biosolids is then
centrifuged into cake biosolids of approximately 22% solids and is available for land
application as a Class B material or for landfill disposal.
The newest addition to the biosolids handing system (3/2008) is the Andritz biosolids
dryer. Cake biosolids from the centrifuges are fed into the dryer to produce a 90-93%
solids dry pellet. This is a Class "EQ" biosolids and is disposed of by land application
through a contractor or may be disposed of by other approved methods. The North
Carolina Division of Water Quality permit number for this facility is WQ0029804.
In summary, there are several biosolids disposal options for Winston-Salem. The
preferred method is distribution of class A pelletized biosolids. The next option would be
to land apply liquid or cake biosolids and the least likely method would be to landfill
cake or pelletized biosolids.
Utilities Division Director
CC: Frank Crump, Superintendent
Jon Southern, Plant Supervisor
Chris Shamel, Plant Supervisor

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
ARCHIE ELLEDGE WWTP,'NC0037834
RENEWAL
YADKIN
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2A
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NPDES
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APPLICATION OVERVIEW
Form 2A has been developed in a modular format and consists of a "Basic Application Information" packet
and a "Supplemental Application Information" packet. The -Basic Application Information packet is divided
into two parts. All applicants must complete Parts A and C. Applicants with a design flow greater than or
equal to 0.1 mgd must also complete Part B. Some applicants must also complete the Supplemental
Application Information packet. The following items explain which parts of Form 2A you must complete.
BASIC APPLICATION INFORMATION:
A. Basic Application Information for all Applicants. All applicants must complete uestiiss r h A r nt works
that discharges effluent to surface waters of the United States must also s r t� n `A? thro
B. Additional Application Information for Applicants with a Design Flo 1 "Alba "fit o tha ave design flows
PP
greater than or equal to 0.1 million gallons per day must complete questions 13.1 through 13.6.
DEC 3 0 2008
C. Certification. All applicants must complete Part C (Certification).
SUPPLEMENTAL APPLICATION INFORMATION: ®ENS ,WATER QUALITY
D. Expanded Effluent Testing Data. A treatment works that discharges effluent to surfa t�rj� f(� Y-�1r� t t�-and meets
f-ll
one or more of the following criteria must complete Part D (Expanded Efflulpff� C 151.
1. Has a design flow rate greater than or equal to 1 mgd,
2. Is required to have a pretreatment program (or has one in place), or
3. Is otherwise required by the permitting authority to provide the information.
E. Toxicity Testing Data. A treatment works that meets one or more of the following criteria must complete Part E (Toxicity Testing
Data):
1. Has a design flow rate greater than or equal to 1 mgd,
2. Is required to have a pretreatment program (or has one in place), or
3. Is otherwise required by the permitting authority to submit results of toxicity testing.
F. Industrial User Discharges and RCRAICERCLA Wastes. A treatment works that accepts process wastewater from any
significant industrial users (SIUs) or receives RCRA or CERCLA wastes must complete Part F (Industrial User Discharges
and RCRA/CERCLA Wastes)_ SIUs are defined as: .
1. All industrial users subject to Categorical Pretreatment Standards under 40 Code of Federal Regulations (CFR) 403.6 and
40 CFR Chapter I, Subchapter N (see instructions); and
2. Any other industrial user that:
a. Discharges an average of 25,000 gallons per day or more of process wastewater to the treatment works (with certain
exclusions); or
b. Contributes a process wastestream that makes up 5 percent or more of the average dry weather hydraulic or organic
capacity of the treatment plant; or
C. Is designated as an SIU by the control authority.
G. Combined Sewer Systems. A treatment works that has a combined sewer system must complete Part G (Combined Sewer
Systems).
ALL`APPLi:CANTS MUST COMPLETE PART C (CERTIFICATION) ..
NPDES FORM 2A Additional Information

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
ARCHIE ELLEDGE WWTP NCO037834
RENEWAL
YADKIN
;BASIC APPLICATION. IN FORMATION
PART,A'.BASIC:APP:LIGATION INFORMATION � ,
N FOR ALL APPLICANTS:
All treatment works must complete questions A.1 through A.8 of this Basic Application Information Packet
A.I. Facility Information.
Facility Name ARCHIE ELLEDGE WASTEWATER TREATMENT PLANT
Mailing Address P.O. BOX 2511
WINSTON-SALEM NC 27102
Contact Person MR. DAVID SAUNDERS
Title DIRECTOR OF UTILITIES
Telephone Number (3360 727-8418
Facility Address 2801 GRIFFITH ROAD
(not P.O. Box) WINSTON-SALEM, NC 27103
A.2. Applicant Information. If the applicant is different from the above, provide the following:
Applicant Name CITY OF WINSTON-SALEM
Mailing Address P.O. BOX 2511
WINSTON-SALEM, NC 27102
Contact Person MR. DAVID SAUNDERS
Title DIRECTOR OF UTILITIES
Telephone Number [phone]
Is the applicant the owner or operator (or both) of the treatment works?
X owner ❑ operator
Indicate whether correspondence regarding this permit should be directed to the facility or the applicant.
❑ facility ® applicant
A.3. Existing Environmental Permits. Provide the permit number of any existing environmental permits that have been issued to the treatment works
(include state -issued permits).
NPDES NC 0037834 DRYER W00029804
UIC Other NON DISCHARGE WQ0000094
RCRA Other AIR QUALITY 00817R4
A.4. Collection System Information. Provide information on municipalities and areas served by the facility. Provide the name and population of each
entity and, if known, provide information on the type of collection system (combined vs_ separate) and its ownership (municipal, private, etc.).
Name Population Served Type of Collection System Ownership
WINSTON-SALEM 95.000 Separate Municipal
KERNERSVILLE 18.000 Municipal
WALKERTOWN 2,100 Municipal
Total population served 115,100
NPDES FORM 2A Additional Information

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
ARCHIE ELLEDGE WVVTP, NCO037834
RENEWAL
YADKIN
NPDES FORM 2A Additional Information

A.5. Indian Country.
a_ Is the treatment works located in Indian Country?
❑ Yes X No
b. Does the treatment works discharge to a receiving water that is either in Indian Country or that is upstream from (and eventually flows
through) Indian Country?
❑ Yes X No
A.6. Flow. Indicate the design flow rate of the treatment plant (i.e., the wastewater flow rate that the plant was built to handle). Also provide the
average daily flow rate and maximum daily flow rate for each of the last three years. Each year's data must be based on a 12-month time period
with the 12th month of "this year" occurring no more than three months prior to this application submittal.
a. Design flow rate 30 mgd
Two Years Ago Last Year This Year
b. Annual average daily flow rate 17.99 MGD 17.96 MGD 17.18 MGD
c_ Maximum daily flow rate 37.72 MGD 43.27 MGD 42.0 MGD
A.7. Collection System. Indicate the type(s) of collection system(s) used by the treatment plant. Check all that apply. Also estimate the percent
contribution (by miles) of each.
® Separate sanitary sewer 100 %
❑ Combined storm and sanitary sewer 0 %
A.8. Discharges and Other Disposal Methods.
a_ Does the treatment works discharge effluent to waters of the U.S.? ® Yes ❑ No
If yes, list how many of each of the following types of discharge points the treatment works uses:
I. Discharges of treated effluent
ii. Discharges of untreated or partially treated effluent
iii. Combined sewer overflow points
iv. Constructed emergency overflows (prior to the headworks)
V. Other u
b. Does the treatment works discharge effluent to basins, ponds, or other surface impoundments
that do not have outlets for discharge to waters of the U.S-? ❑ Yes ® No
If yes, provide the following for each surface impoundment:
Location:
Annual average daily volume discharge to surface impoundment(s)
Is discharge ❑ continuous or ❑ intermittent?
C. Does the treatment works land -apply treated wastewater?
If yes, provide the following for each land application site:
5a
Location:
Number of acres:
mgd
_—r ❑ Yes X No
Annual average daily volume applied to site:
Is land application ❑ continuous or ❑ intermittent?
Does the treatment works discharge or transport treated or untreated wastewater to another
treatment works?
NPDES FORM 2A Additional Information
mgd
X Yes ❑ No

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
ARCHIE ELLEDGE WWTP, NCO037834
RENEWAL
YADKIN
If yes, describe the mean(s) by which the wastewater from the treatment works is discharged or transported to the other treatment works
(e.g., tank truck, pipe).
Muddy Creek digested sludge is pumped to Elledge Plant here it is dewatered and sent to dryer facility, a portion of centrate is pumped back
to Muddy Creek
If transport is by a party other than the applicant, provide:
Transporter Name
Mailing Address
Contact Person
Title
Telephone Number ( )
For each treatment works that receives this discharge, provide the following:
Name Muddy Creek WWTP
Mailing Address 4561 Cooper Rd
Winston-Salem NC
Contact Person Chris Shamel
Title Assistant Plant Superintendent/ORC
Telephone Number (336-765-0130)
If known, provide the NPDES permit number of the treatment works that receives this discharge NCO050342
Provide the average daily flow rate from the treatment works into the receiving facility. .24 mgd
e. Does the treatment works discharge or dispose of its wastewater in a manner not included
in A_8. through A.8.d above (e.g., underground percolation, well injection): ❑ Yes X No
If yes, provide the following for each disposal method:
Description of method (including location and size of site(s) if applicable):
Annual daily volume disposed by this method:
Is disposal through this method ❑ continuous or ❑ intermittent?
NPDES FORM 2A Additional Information

FACILITY NAME AND PERMIT NUMBER: PERIYIIT ACTION REQUESTED: RIVER BASIN:
ARCHIE ELLEDGE WWTP, NCO037834 RENEWAL YADKIN
WASTEWATER DISCHARGES:
If you answered "Yes" to question A.8.a, complete questions A.9 through A.12 once for each outfall (including bypass points) through
which effluent is discharged. Do not include information on combined sewer overflows in this section. If you answered "No" to question
go to Part B, "Additional Application Information for Applicants with a Design Flow Greater than or Equal to 0.1 mgd."
A.9. Description of Outfall.
a. Outfall number 001
b. Location WINSTON-SALEM 27103
(City or town, if applicable) (Zip Code)
FORSYTH NORTH CAROLINA
(County) (State)
N36 DEG. 1.816 MIN. WEST 80 DEGREES 18.868 MIN.
(Latitude)
(Longitude)
C.
Distance from shore (if applicable) NIA
ft.
d_
Depth below surface (if applicable) NIA
ft.
e.
Average daily flow rate 17.18
mgd
f.
Does this outfall have either an intermittent or a periodic discharge? ❑ Yes
X No (go to A.9.g.)
If yes, provide the following information:
Number times per year discharge occurs:
Average duration of each discharge:
Average flow per discharge:
mgd
Months in which discharge occurs:
g.
Is outfall equipped with a diffuser? ❑ Yes
X No
A.10. Description of Receiving Waters.
a.
Name of receiving water SALEM CREEK
b.
Name of watershed (if known)
United States Soil Conservation Service 14-digit watershed code (if known):
C.
Name of State Management/River Basin (if known):
United States Geological Survey 8-digit hydrologic cataloging unit code (if known):
d.
Critical low flow of receiving stream (if applicable) 7 Q10
acute 15 CFS cfs chronic
cis
e.
Total hardness of receiving stream at critical low flow (if applicable): NO DATA AVAILABLE
mg/I of CaCO3
NPDES FORM 2A Additional Information

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
ARCHIE ELLEDGE WWTP, NCO037834
RENEWAL
YADKIN
A.11. Description of Treatment
a. What level of treatment are provided? Check all that apply.
❑ Primary X Secondary
❑ Advanced ❑ Other" Describe:
b. Indicate the following removal rates (as applicable):
Design BOD5 removal or Design CBOD5 removal 98 %
Design SS removal 97 %
Design P removal N/A %
Design N removal N/A %
Other N/A %
c_ What type of disinfection is used for the effluent from this outfall? If disinfection varies by season, please describe:
CHLORINATION USING SODIUM HYPOCHLORITE, NO SEASONAL VARIATION
If disinfection is by chlorination is dechlorinatioh used for this outfall? X Yes ❑ No
Does the treatment plant have post aeration? X Yes ❑ No
A.12 Effluent Testing Information. All Applicants that discharge to waters of the US must provide effluent testing data for the following
parameters. Provide the indicated effluent testing required by the permitting authority for each outfall through which effluent is
discharged. Do not include information on combined sewer overflows in this section. All information reported must be based on data
collected through analysis conducted using 40 CFR Part 136 methods. In addition, this data must comply with QAlQC requirements of
40 CFR Part 136 and other appropriate QA/QC requirements for standard methods for analytes not addressed by,40 CFR Part 136. At a
minimum, effluent testing data must be based on at least three samples and must be no more than four and one-half years apart
Outfall number. 001
MAXIMUM DAILY VALUE
AVERAGE DAILY VALUE.
PARAMETER
Value
Units
Value
Units.
Number ofSamples
pH (Minimum)
6.10
s.u.
pH (Ma)imum)
7.60
s"u.
Flow Rate
89
MGD
17.83
MGD
1115
Temperature (Winter)
21
DEG. C
18
DEG. C
604
Temperature (Summer)
31
DEG, C
25
DEG. C
642
* For pH please report a minimum and a maximum daily value
MAXIMUM DAILY
AVERAGE DAILY DISCHARGE
POLLUTANT
DISCHARGE
ANALYTICAL
ML/MDL
Number of
METHOD
Conc.
Units
Conc.
Units
Samples
CONVENTIONAL AND NON CONVENTIONAL COMPOUNDS
BIOCHEMICAL OXYGEN
BOD5
56
NIG/L
4
MG/L
984
SM5210B
2
CBOD5
DEMAND (Report one)
FECAL COLIFORM
6000
#/1001VIL
36
#110
984
SM9222D
1
TOTAL SUSPENDED SOLIDS (TSS)
31
MG/L
7
MG/L
1422
SM25400
1
NPDES FORM 2A Additional Information

END OF'PART-A'
REFER"TO�THE;APPLICATION OVERVIEW (PAGE-1) TO DETERMINE WHICH OTHER,PARTS"
OF FO.RM,2A YOU,MUST COMPLETE:",
NP®ES FORM 2A Additional Information

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
ARCHIE ELLEDGE WWTP, NCO037834
RENEWAL
YAD KIN
BASIC. APPLICATION INFORMATION,- ,r-
:PART,B. ; " "ADDITIONAL APPLICATION INFORIVIATION-,FOR APPLICANTS WITH A DESIGN FLOW .GREATER -THAN OR"
EQUAL TO.0 1 MGD (100 000 gallor►s pe"r day):
All applicants with a design flow rate -a 0.1 mgd must answer questions BA through B.6. All others go to Part C (Certification).
B.I. Inflow and Infiltration. Estimate the average number of gallons per day that flow into the treatment works from inflow and/or infiltration.
—2,000,000 gpd
Briefly explain any steps underway or planned to minimize inflow and infiltration.
REHABILITATION OF SEWER LINES, LINES BEING CLEARED OF ROOTS
B.2. Topographic Map. Attach to this application a topographic map of the area extending at least one mile beyond facility property boundaries. This
map must show the outline of the facility and the following information. (You may submit more than one map if one map does not show the entire
area.)
a- The area surrounding the treatment plant, including all unit processes.
b- The major pipes or other structures through which wastewater enters the treatment works and the pipes or other structures through which
treated wastewater is discharged from the treatment plant_ Include outfalls from bypass piping, if applicable.
c. Each well where wastewater from the treatment plant is injected underground.
d. Wells, springs, other surface water bodies, and drinking water wells that are: 1) within % mile of the property boundaries of the treatment
works, and 2) listed in public record or otherwise known to the applicant.
e. Any areas where the sewage sludge produced by the treatment works is stored, treated, or disposed.
f. If the treatment works receives waste that is classified as hazardous under the Resource Conservation and Recovery Act (RCRA) by truck, rail,
or special pipe, show on the map where the hazardous waste enters the treatment works and where it is treated, stored, and/or disposed.
B.3. Process Flow Diagram or Schematic. Provide a diagram showing the processes of the treatment plant, including all bypass piping and all
backup power sources or redunancy in the system. Also provide a water balance showing all treatment units, including disinfection (e.g.,
chlorination and dechlorination). The water balance must show daily average flow rates at influent and discharge points and approximate daily flow
rates between treatment units- Include a brief narrative description of the diagram.* SEE ATTACHMENT
BA. Operation/Maintenance Performed by Contractor(s).
Are any operational or maintenance aspects (related to wastewater treatment and effluent quality) of the treatment works the responsibility of a
contractor? ❑ Yes ® No
If yes, list the name, address, telephone number, and status of each contractor and describe the contractor's responsibilities (attach additional
pages if necessary).
Name:
Mailing Address:
Telephone Number -
Responsibilities of Contractor.
B.5. Scheduled improvements and Schedules of Implementation. Provide information on any uncompleted implementation schedule or
uncompleted plans for improvements that will affect the wastewater treatment, effluent quality, or design capacity of the treatment works. If the
treatment works has several different implementation schedules or is planning several improvements, submit separate responses to question B.5
for each. (If none, go to question B.6.)
a_ List the outfall number (assigned in question A.9) for each outfall that is covered by this implementation schedule.
DOES NOT APPLY
b. Indicate whether the planned improvements or implementation schedule are required by local, State, or Federal agencies.
❑ Yes X No
NPDES FORM 2A Additional Information

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
ARCHIE ELLEDGE WWTP, NC 0037834
RENEWAL
YADKIN
C. If the answer to B.5.b is "Yes," briefly describe, including new maximum daily inflow rate (If applicable).
d. Provide dates imposed by any compliance schedule or any actual dates of completion for the implementation steps listed below, as
applicable_ For improvements planned independently of local, State, or Federal agencies, indicate planned or actual completion dates, as
applicable_ Indicate dates as accurately as possible.
Schedule Actual Completion
Implementation Stage MMlDD/YYYY MM/DD/YYYY
- Begin Construction November 16, 2008 / NA
- End Construction December 31, 2010/ 1 / / NA
- Begin Discharge / /NA ! / NA
- Attain Operational Level I /NA I / NA
e. Have appropriate permits/clearances concerning other FederaVState requirements been obtained? X Yes ❑ No
Describe briefly: Replacing preliminary and primarV equipment
B.6. EFFLUENT TESTING DATA (GREATER THAN 0.1 MGD ONLY).
Applicants that discharge to waters of the US must provide effluent testing data for the following parameters. Provide the indicated
effluent testing required by the permitting authority for each outfall through which effluent is discharged. Do not include information
on combine sewer overflows in this section. All information reported must be based on data collected through analysis conducted
using 40 CFR Part 136 methods. In addition, this data must comply with QA/QC requirements of 40 CFR Part 136 and other appropriate
QA/QC requirements for standard methods for analytes not addressed by 40 CFR Part 136. At a minimum effluent testing data must be
based on at least three pollutant scans and must be no more than four and on -half years old.
Outfall Number. 001
MAXIMUM DAILY
AVERAGE DAILYDISCHARGE
DISCHARGE
ANALYTICAL
POLLUTANT
METHOD
ML/MDL
Conc.
Units
Conc.
Units
Number of
Samples
CONVENTIONAL AND NON CONVENTIONAL COMPOUNDS
AMMONIA (as N)
11.7
MG/L
.5
MG/L
860
SM4500-NH3F
.5
CHLORINE (TOTAL
20
UGL
<20
UGL
984
HACH10014ULR
20UGL
RESIDUAL, TRC)
DISSOLVED OXYGEN
11
MG/L
8
MG/L
1429
SM4500-OG
1MG/L
TOTAL KJELDAHL
6
MG/L
2
MG/L
208
SM4500NORGB
1MG/L
NITROGEN (TKN)
NITRATE PLUS NITRITE
18.2
MG/L
8.9
MG/L
82
NOTE 1
1 MG/L
NITROGEN
OIL and GREASE
5
MG/L
3.8
MG/L
3
EPA1664A
1 MG/L
PHOSPHORUS (Total)
10.8
MG/L
3.8
MG/L
209
SM4500-PE
.2MG/L
TOTAL DISSOLVED SOLIDS
N/A
(TDS)
OTHER
" END,OF PART-B'..:.
REFER TO. THE APPLICATION OVERVIEW (PAGE 1) TO,.DETERMINE-WHICH OTHER PARTS
OF, FORM 2A YOU MUST.COMPLETE
NPDES FORM 2A Additional Information

FACIUTY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
ARCHIE ELLEDGE WWTP, NCO037834
RENEWAL
YADKIN
BASIC APPLICATION INFORMATION
PART C. -•CERTIFICATIQN ,
All applicants must complete the Certification Section. Refer to instructions to determine who is an officer for the purposes of this
certification. All applicants must complete all applicable sections of Form 2A, as explained in the Application Overview. Indicate below which
parts of Form 2A you have completed and are submitting. By signing this certification statement, applicants confirm that they have reviewed
Form 2A and have completed all sections that apply to the facility for which this application is submitted.
Indicate which parts of Form 2A you have completed and are submitting:
® Basic Application Information packet Supplemental Application Information packet:
x Part D (Expanded Effluent Testing Data)
X Part E (Toxicity Testing: Biomonitoring Data)
X Part F (Industrial User Discharges and RCRA/CERCLA Wastes)
❑ Part G (Combined Sewer Systems)
ALL APPLICANTS'MUST COMPLETE THE FOLLOWING,CERTIFICATION.,.; _ + _
I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system
designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who
manage the system or those persons directly responsible for gathering the information, the information is, to the best of my knowledge and belief, true,
or submitting false information, including the possibility of fine and imprisonment
accurate, and complete. I am aware that th=SAURS,
for knowing violations.
�IIES
Name and official title DAVIR OF U9
Signature
Telephonenumber 336 727-8418
Date signed
Upon request of the permitting authority, you must submit any other information necessary to assure wastewater treatment practices at the treatment
works or identify appropriate permitting requirements.
SEND COMPLETED FORMS TO:
NCDENR/ DWQ
Attn: NPDES Unit
16,17 Mail Service Center
Raleigh, North Carolina 27699-1617
NPDES FORM 2A Additional Information

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
ARCHIE ELLEDGE WWTP, NCO037834
RENEWAL
YADKIN
SUPPLEMENTAL=:APPL`IGQTION 1NFORIULAT!ON.,
PART D:. EX .. :. -,. ,,.,... •,,,-; .. N ,: - ,.,,._
PANDER; EFFLU_ENT:TE$TING'D'ATA,:; . , "' :.".: _ .:. : ? : ," '. , . : ;- •' _
Refer to the directions on the cover page to determine whether this section applies to the treatment works.
Effluent Testing: 1.0 mgd and Pretreatment Works. If the treatment works has a design flow greater than or equal to 1.0 mgd or it has (or is required
to have) a pretreatment program, or is otherwise required by the permitting authority to provide the data, then provide effluent testing data for the following
pollutants_ Provide the indicated effluent testing information and any other information required by the permitting authority for each outfall through which
effluent is discharged_ Do not include information on combined sewer overflows in this section. All information reported must be based on data collected
through analyses conducted using 40 CFR Part 136 methods. In addition, these data must comply with QA/QC requirements of 40 CFR Part 136 and
other appropriate QA/QC requirements for standard methods for analytes not addressed by 40 CFR Part 136. Indicate in the blank rows provided below
any data you may have on pollutants not specifically listed in this form. At a minimum, effluent testing data must be based on at least three pollutant
scans and must be no more than four and one-half years old.
Outfall number. 001 (Complete once for each outfall discharging effluent to waters of the United States.)
MAXIMUM DAILY DISCHARGE
AVERAGE DAILY DISCHARGE
POLLUTANT
ANALYTICAL
MUMDL
Number
Conc.
Units
Mass
Units
Conc..
Units
Mass
Units.
of
METHOD
Samples
METALS (TOTAL RECOVERABLE), CYANIDE, PHENOLS, AND HARDNESS.
5
2.5
3
ANTIMONY
UG/L
UG/L
EPA 204.2
<25
<25
25
<5
<5
5
ARSENIC
UG/L
UG/L
EPA 206.2
<10
<10
10
<1
<1
1
BERYLLIUM
UG/L
UG/L
EPA 200.7
<5
<5
5
<1
<1
1
CADMIUM
UG/L
UG/L
EPA 213.2
<2
<2
2
11
5.5
5
CHROMIUM
UG/L
UG/L
EPA 200.7
<5
<5
5
23
12
10
COPPER
UG/L
UG/L
EPA 220.1
7
6
2
<5
<5
5
LEAD
UG/L
UG/L
EPA 239.2
<10
<10
10
MERCURY
26
NG/L
3.95
NG/L
EPA 1631 E
1.00
<10
<10
10
NICKEL
UG/L
UG/L
EPA 200.7
<10
<10
10
<10
<10
10
SELENIUM
UG/L
UG/L
EPA 270.2
<10
<10
10
<5
<5
5
SILVER
UG/L
UG/L
EPA 200.7
<5
<5
5
<1
<1
1
THALLIUM
UG/L
UG/L
EPA 279.2
<20
<20
20
155
106
ZINC
UG/L
UG/L
EPA 289.1
10
106
94
NPDES FORM 2A Additional Information

.007
.0035
.005 /.005
CYANIDE
MG/L
MG/L
SM450OCN
.007
.0035
<2
<2
2
TOTAL PHENOLIC
UG/L
UG/L
SM510A&B
COMPOUNDS
21
20
10
56
52
HARDNESS (as CaCO3)
MG/L
UG/L
SM2340C
.662
56.6
54.2
Use this space (or a separate sheet) to provide information on other metals requested by the permit writer
NPDES FORM 2A Additional Information

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
ARCHIE ELLEDGE WW fP, NCO037834
RENEWAL
YADKIN
Outfall number: 001 (Complete once for each outfall discharging effluent to waters of the United States.)
MAXIMUM'DAILY-DISCHARGE
` AVERAGE DAILY DISCHARGE
POLLUTANT
ANALYTICAL
ML/MDL
Number
. Conc.
Units
Mass
Units .
Conc.
Units
Mass
Units
of
METHOD
Samples ....
.
VOLATILE ORGANIC COMPOUNDS
<100
<100
100
ACROLEIN
UG/L
UG/L
EPA 624
<50
<50
50
<50
<50
50
ACRYLONITRILE
UGIL
UG/L
EPA 624
<10
<10
10
<5
<5
5
BENZENE
UGIL
UG/L
EPA 624
<1
<1
1
<5
<5
5
BROMOFORM
UG/L
UG/L
EPA 624
3.51
2.37
1
<5
<5
5
CARBON
UGIL
UGIL
EPA 624
TETRACHLORIDE
<1
<1
1
<5
<5
5
CHLOROBENZENE
UGIL
UGIL
EPA 624
<1
<1
1
17
8
5
CHLORODIBROMO-
UG/L
UGlL
EPA 624
METHANE
13.4
9.8
5
<10
<10
10
CHLOROETHANE
UG/L
UGIL
EPA 624
<5
<5
5
<5
<5
5
2-CHLOROETHYLVINYL
UGIL
UGIL
EPA 624
ETHER
<5
<5
5
<5
<5
5
CHLOROFORM
UG/L
UGIL
EPA 624
7.63
7.29
5
DICHLOROBROMO-
18.7
UGIL
9.4
UGIL
EPA 624
5
METHANE
10.7
5.4
1
<5
<5
5
1,1-DICHLOROETHANE
UG/L
UG/L
EPA 624
<1
<1
1
<5
<5
5
1,2-DICHLOROETHANE
UGIL
UG/L
EPA 624
<1
<1
1
TRANS-I,2-DICHLORO-
<5
UGIL
<5
UGIL
EPA 624
5
ETHYLENE
<1
<1
1
9.9
6.0
5
1,1-DICHLORO-
UG/L
UGlL
EPA 624
ETHYLENE
<1
<1
1
<5
<5
5
1,2-DICHLOROPROPANE
UGIL
UG/L
EPA 624
<1
<1
1
1,3-DICHLORO-
<5
UGIL
<5
UGIL
EPA 624
5
PROPYLENE
<1
<1
1
NPDES FORD 2A Additional Information

<5/<1
ETHYLBENZENE
UG/L
<51<1
UG/L
EPA 624
5/1
METHYL BROMIDE
/ <5
UG/L
/ <5
UG/L
EPA 624
Is
METHYL CHLORIDE
/ <5
UG/L
/ <5
UG/L
EPA 624
15
<10
<10
10
METHYLENE CHLORIDE
UG/L
UG/L
EPA 624
<1
<1
1
<5
<5
5
1,1,2,2-TETRA-
UG/L
UG/L
EPA 624
CHLOROETHANE
<1
<1
1
<5
<5
5
TETRACHLORO-
UG1L
UGlL
EPA 624
ETHYLENE
<1
<1
1
<5
<5
5
TOLUENE
UG/L
UG/L
EPA 624
<1
<1
1
NPDES FORM 2A Additional Information

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
ARCHIE ELLEDGE WWTP, NCO037834
RENEWAL
YADKIN
Outfall number. 001 (Complete once for each outfall discharging effluent to waters of the United States.)
MAXIMUM:, DAILY DISCHARGE:
AVERAGE°DAILY, DISCHARGE
POLLUTANT
ANALYTICAL-'
MLIMDL
Number
_
Conc.
Units,
Mass -
Units
Conc:
Units
Mass
Units ,
of
METHOD
Samples
<5
<5
5
1 1 1
UGIL
UG/L
EPA 624
TRICHLOROETHANE
<1
<1
1
<5
<$
5
1,1,2-
UGIL
UGIL
EPA 624
TRICHLOROETHANE
<1
<1
1
<5
<5
5
TRICHLOROETHYLENE
UG/L
UG/L
EPA 624
<1
<1
1
<10
<10
10
VINYL CHLORIDE
UG/L
UGIL
EPA 624
<5
<5
_j
5
Use this space (or a separate sheet) to provide information on other volatile organic compounds requested by the permit writer
ACID -EXTRACTABLE COMPOUNDS
P-CHLORO-M-CRESOL
/ <10
UGIL
/ <10
UGIL
EPA 625
/ 10
<10
<10
10
2-CHLOROPHENOL
UG/L
UG/L
EPA 625
<10
<10
10
<10
<10
10
2,4-DICHLOROPHENOL
UGIL
UG/L
EPA 625
<10
<10
10
<10
<10
10
2,4-DIMETHYLPHENOL
UGIL
UGIL
EPA 625
<10
<10
10
4,6-DINITRO-O-CRESOL
/ <50
UG/L
/ <50
UG/L
EPA 625
/ 50
<50
<50
50
2,4-DINITROPHENOL
UG/L
UG/L
EPA 625
<50
<50
50
<10
<10
10
2-NITROPHENOL
UG/L
UG/L
EPA 625
<10
<10
10
<50
<50
4-NITROPHENOL
UG/L
UGIL
EPA 625
10
<50
<50
<50
<50
50
PENTACHLOROPHENOL
UG/L
UG/L
EPA 625
<50
<50
50
<10
<10
10
PHENOL
UG/L
UG/L
EPA 625
<10
<10
10
2 4 6-
<10
<10
10
TRICHLOROPHENOL
UGIL
UGIL
EPA 625
<10
<10
10
Use this space (or a separate sheet) to provide information on other acid -extractable compounds requested by the permit writer
NPDES FORM 2A Additional Information

BASE -NEUTRAL COMPOUNDS
<10
<10
10
ACENAPHTHENE
UG/L
UG/L
EPA 625
<10
<10
10
<10
<10
10
ACENAPHTHYLENE
UG/L
UG/L
EPA 625
<10
<10
10
<10
<10
10
ANTHRACENE
UG/L
UG/L
EPA 625
<10
<10
10
<100
<100
100
BENZIDINE
UG/L
UG/L
EPA 625
<50
<50
50
<10
<10
10
BENZO(A)ANTHRACENE
UG/L
UG/L
EPA 625
<10
<10
10
<10
<10
10
BENZO(A)PYRENE
UG/L
UG/L
EPA 625
<10
<10
10
NPDES FORM 2A Additional Information

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
ARCHIE ELLEDGE WWTP, NCO037834
RENEWAL
YADKIN
Outfall number. 001 (Complete once for each outfall discharging effluent to waters of the United States.)
MAXIMUM:DAILY
DISCHARGE
AVERAGE, DAILY DISCHARGE`"_
POLLUTANT
ANALYTICAL
ML/MDL
Number
Cor-c.'
Units.
. Mass
Units
Conc.
:,Units'
Mass
Units.
of
METHOD
Samples
<10
<10
10
3,4 BENZO-
UG/L
UG,L
EPA 625
FLUORANTHENE
<10
<10
10
<10
<10
10
BENZO(GHI)PERYLENE
UG/L
UG/L
EPA 625
<10
<10
10
<10
<10
10
BENZOIC
UG/L
UG/L
EPA 625
FLUORANTHENE
<10
<10
10
< 10
<10
10
BIS (2-CHLOROETHOXY)
UG/L
UG/L
EPA 625
METHANE
<10
<10
10
<10
<10
10
BIS (2-CHLOROETHYL)-
UG/L
UG/L
EPA 625
ETHER
<10
<10
10
<10
<10
10
BIS (2-CHLOROISO-
UG/L
UG/L
EPA 625
PROPYL) ETHER
<10
<10
10
<20
<20
20
BIS (2-ETHYLHEXYL)
UG/L
UG/L
EPA 625
PHTHALATE
11.7
5.8
10
<10
<10
10
4-BROMOPHENYL
<10
UG/L
UG/L
EPA 625
PHENYL ETHER
<10
10
<10
<10
10
BUTYL BENZYL
UG/L
UG/L
EPA 625
PHTHALATE
<10
<10
10
<10
<10
10
2-CHLORO-
UG/L
UG/L
EPA 625
NAPHTHALENE
<10
<10
10
4-CHLORPHENYL
<10
UG/L
<10
UG/L
EPA 625
10
PHENYL ETHER
<10
<10
10
<10
<10
10
CHRYSENE
UG/L
UG/L
EPA 625
<10
<10
10
<10
<10
10
DI-N-BUTYL PHTHALATE
UGL
UG/L
EPA 625
<10
<10
10
<10
<10
10
DI-N-OCTYL PHTHALATE
UG/L
UG/L
EPA 625
<10
<10
10
<10
<10
10
DIBENZO(A,H)
UG/L
UG/L
EPA 625
ANTHRACENE
<10
<10
10
<10
<10
10
1,2-DICHLOROBENZENE
UG/L
UG?L
EPA 625
<10
<10
10
<10
<10
10
1,3-DICHLOROBENZENE
UG/L
UG/L
EPA 625
<10
<10
10
NPDES FORM 2A Additional Information

<10
<10
10
1,4-DICHLOROBENZENE
UG/L
UG/L
EPA 625
<10
<10
10
3,3-DICHLORO-
<10
<10
10
UG/L
UG/L
EPA 625
BENZIDINE
<50
<50
50
<10
<10
10
DIETHYL PHTHALATE
UG/L
UG/L
EPA 625
<10
<10
10
<10
<10
10
DIMETHYL PHTHALATE
UG/L
UG/L
EPA 625
<10
<10
10
<10
<10
10
2,4-DINITROTOLUENE
UG/L
UG/L
EPA 625
<10
<10
10
<10
<10
10
2,6-DINITROTOLUENE
UG/L
UG/L
EPA 625 '
<10
<10
10
<10
<10
10
1,2-DIPHENYL-
UG/L
UG/L
EPA 625
HYDRAZINE
<10
<10
10
NPDES FORM 2A Additional Information

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
ARCHIE ELLEDGE WWTP, 37834
RENEWAL
YADKIN
Outfall number. 001 (Complete once for each outfall discharging effluent to waters of the United States.)
MAXfmUM.DAILY :DISCHARGE ,
AV,ERQGE DAILY DIS,CHARGE.,
POLLUTANT
ANALYTICAL
METHOD
ML/MDL
Number
Conc.:Units
MassUnits
'Con
Units
Mass
Units
of
Samples-,
<10
<10
10
FLUORANTHENE
UG/L
UGIL
EPA 625
<10
<10
10
<10
<10
10
FLUORENE
UG/L
UGIL
EPA 625
<10
<10
10
<10
<10
10
HEXACHLOROBENZENE
UG/L
UG/L
EPA 625
<10
<10
10
<10
<10
10
HEXACHLORO-
UGIL
UGIL
EPA 625
BUTADIENE
<10
<10
10
<10
<10
10
HEXACHLOROCYCLO-
UGIL
UGIL
EPQ 625
PENTADIENE
<50
<50
50
<10
<10
10
HEXACHLOROETHANE
UGIL
UGIL
EPA 625
<10
<10
10
<10
<10
10
INDENO(1,2,3-CD)
UG/L
UG/L
EPA 625
PYRENE
<10
<10
10
<10
<10
10
ISOPHORONE
UG/L
UG/L
EPA 625
<10
<10
10
<10
<10
10
NAPHTHALENE
UG/L
UG/L
EPA 625
<10
<10
10
<10
<10
10
NITROBENZENE
UGIL
UG/L
EPA 625
<10
<10
10
<10
<10
10
N-NITROSODI-N-
UGIL
UGIL
EPA 625
PROPYLAMINE
<1D
<70
10
<10
<10
10
N-NITROSODI-
UGIL
UGIL
EPA 625
METHYLAMINE
<10
<10
10
<10
<10
10
N-NITROSODI-
UGIL
UGIL
EPA 625
PHENYLAMINE
<10
<10
10
<10
<10
10
PHENANTHRENE
UGIL
UG/L
EPA 625
<10
<10
10
<10
<10
10
PYRENE
UGIL
UG/L
EPA 625
<10
<10
10
<10
<10
10
1,2,4-
UG/L
UGIL
EPA 625
TRICHLOROBENZENE
c10
<10
10
Use this space (or a separate sheet) to provide information on other base -neutral compounds requested by the permit writer
Use this space (or a separate sheet) to provide information on other pollutants (e.g., pesticides) requested by the permit writer
NPDES FORM 2A Additional Information

:END OF PART"D.
REFER TO THE.APPLICATION 1O EAVIEW (PAGE..1) TO-DETERMINE'WHICH'OTHER PARTS
OF'FOKW2AYOU MUST;C"OMPLETE
NPDES FORM 2A Additional Information

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
ARCHIE ELLEDGE WWTP, NCO037834
RENEWAL
YADKIN
SUPPLEMENTAL APPLICATION INFORMATION,
.;PART E TOXICITYTESTING. DATA
POTWs meeting one or more of the following criteria must provide the results of whole effluent toxicity tests for acute or chronic toxicity for each of the
facility's discharge points: 1) POTWs with a design flow rate greater than or equal to 1.0 mgd; 2) POTWs with a pretreatment program (or those that are
required to have one under 40 CFR Part 403); or 3) POTWs required by the permitting authority to submit data for these parameters.
• At a minimum, these results must include quarterly testing for a 12-month period within the past 1 year using multiple species (minimum of two
species), or the results from four tests performed at least annually in the four and one-half years prior to the application, provided the results
show no appreciable toxicity, and testing for acute and/or chronic toxicity, depending on the range of receiving water dilution. Do not include
information on combined sewer overflows in this section. All information reported must be based on data collected through analysis conducted
using 40 CFR Part 136 methods. In addition, this data must comply with QA/QC requirements of 40 CFR Part 136 and other appropriate QA/QC
requirements for standard methods for analytes not addressed by 40 CFR Part 136.
• In addition, submit the results of any other whole effluent toxicity tests from the past four and one-half years. If a whole effluent toxicity test
conducted during the past four and one-half years revealed toxicity, provide any information on the cause of the toxicity or any results of a
toxicity reduction evaluation, if one was conducted.
• If you have already submitted any of the information requested in Part E, you need not submit it again. Rather, provide the information
requested in question EA for previously submitted information. If EPA methods were not used, report the reasons for using alternate methods.
Iftest summaries are available that contain all ofthe information requested below, they may be submitted in place of Part E.
If no biomonitoring data is required, do not complete Part E. Refer to the Application Overview for directions on which other sections of the form to
complete.
E.I. Required Tests.
Indicate the number of whole effluent toxicity tests conducted in the past four and one-half years.
❑ chronic ❑ acute
E.2. Individual Test Data. Complete the following chart for each whole effluent toxicity test conducted in the last four and one-half years. Allow one
column per test (where each species constitutes a test). Copy this page if more than three tests are being reported.
Test number: Test number: Test number:
a. Test information.
Test Species & test method number
Age at initiation of test
Outfall number
Dates sample collected
Date test started
Duration
b_ Give toxicity test methods followed.
Manual title
Edition number and year of publication
Page number(s)
c. Give the sample collection method(s) used. For multiple grab samples, indicate the number of grab samples used.
24-Hour composite
Grab
d_ Indicate where the sample was taken in relation to disinfection. (Check all that apply for each.
Before disinfection
After disinfection
NPDES FORM 2A Additional Information

After dechlodnation
NPDES FORM 2A Additional Information.

FACILITY NAME AND PERMIT NUMBER:
ARCHIE ELLEDGE WWTP, NCO037834
PERMIT ACTION REQUESTED:
RENEWAL
RIVER BASIN:
YAMN
Test number: Test number: Test number:
e. Describe the point in the treatment process at which the sample was collected.
Sample was collected:
f. For each test, include whether the test was intended to assess chronic toxicity, acute toxicity, or both
Chronic toxicity
Acute toxicity
g. Provide the type of test performed.
Static
Static -renewal
Flow -through
h. Source of dilution water. If laboratory water, specify type; if receiving water, specify source.
Laboratory water
Receiving water
i. Type of dilution water_ If salt water, specify "natural' or type of artificial sea salts or brine used.
Fresh water
Salt water
j_ Give the percentage effluent used for all concentrations in the test series.
k. Parameters measured during the test. (State whether parameter meets test method specifications)
pH
Salinity
Temperature
Ammonia
Dissolved oxygen
I. Test Results.
Acute:
Percent survival in 100%
effluent
%
oho
LCso
95% C.I.
%
%
%
Control percent survival
%
ova
NPDFS FORM 2A Additional Information

Other (describe)
NPDES FORM 2A Additional Information

FACILITY NAME AND PERMIT NUMBER:
ARCHIE ELLEDGE 1AJWTP, NCO037834
PERMIT ACTION REQUESTED:
RENEWAL
RIVER BASIN:
YADKIN
Chronic:
NOEC
%
%
%
IC25
%
%
%
Control percent survival
%
%
%
Other (describe)
m. Quality Control/Quality Assurance.
Is reference toxicant data available?
Was reference toxicant test within
acceptable bounds?
What date was reference toxicant test
run (MM/DD/YYYY)?
Other (describe)
E.3. Toxicity Reduction Evaluation. Is the treatment works involved in a Toxicity Reduction Evaluation?
❑ Yes ❑ No If yes, describe:
EA. Summary of Submitted Biomonitoring Test Information. If you have submitted biomonitoring test information, or information regarding the
cause of toxicity, within the past four and one-half years, provide the dates the information was submitted to the permitting authority and a summary
of the results.
Date submitted: / / (MM/DD/YYYY)
Summary of results: (see instructions)
Quarterly, as required by the permit. All passed except for July, 2007 ( result was 42.7 ). When retested both passed.
.:-END,OpPARTE�'. .
REFER"TO THE_.APPLICATION OVERVIEW -(PAGE 1) TO DETERMINE WHICH OTHER. PARTS
OF FORM 2A YOU MUST COMPLETE.
NPDES FORM 2A Additional Information

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
ARCHIE ELLEDGE WWTP, NCO037834
RENEWAL
YADKIN
PP.LEMENTAL APFL'ICATION,INFORMATION '
PART F IN17lfSTRIAL USER DISCHARGES AND RCRAlCERCLA WASTES
All treatment works receiving discharges from significant industrial users or which receive RCRA,CERCLA, or other remedial wastes must
complete part F.
GENERAL INFORMATION:
F.I. Pretreatment program. Does the treatment works have, or is subject ot, an approved pretreatment program?
X Yes ❑ No
F.2. Number of Significant Industrial Users (SIUs) and Categorical Industrial Users (CIUs). Provide the number of each of the following types of
industrial users that discharge to the treatment works.
a. Number of non -categorical SIUs. 21
b. Number of Cl Us. 11
SIGNIFICANT INDUSTRIAL. USER INFORMATION:
Supply the following information for each SIU. If more than one SIU discharges to the treatment works, copy questions F.3 through F.8 and
provide the information requested for each SIU.
F.3. Significant Industrial User Information. Provide the name and address of each SIU discharging to the treatment works. Submit additional pages
as necessary.
Name: ADELE KNITS
Mailing Address: 3304 OLD LEXINGTON ROAD
WINSTON-SALEM NC 27107
F.4. Industrial Processes. Describe all the industrial processes that affect or contribute to the SIU's discharge.
TEXTILE
F.5. Principal Product(s) and Raw Material(s). Describe all of the principal processes and raw materials that affect or contribute to the SIU's
discharge.
Principal product(s): KNIT DYE
Raw material(s): POLYESTER, NYLON, DYESTUFF
F.6. Flow Fate.
a. Process wastewater flow rate. indicate the average daily volume of process wastewater discharge into the collection system in gallons per
day (gpd) and whether the discharge is continuous or intermittent
100,000 gpd ( X continuous or intermittent)
b. Non -process wastewater flow rate. Indicate the average daily volume of non -process wastewater flow discharged into the collection system
in gallons per day (gpd) and whether the discharge is continuous or intermittent.
20,000 gpd ( X continuous or intermittent)
F.7. Pretreatment Standards. Indicate whether the SIU is subject to the following:
a_ Local limits X Yes ❑ No
b. Categorical pretreatment standards ❑ Yes X No
If subject to categorical pretreatment standards, which category and subcategory?
NPDES FORM 2A Additional Information

FACILITY'NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
ARCHIE ELLEDGE WWTP, N00037834
RENEWAL
YADKIN
F.8. Problems at the Treatment Works Attributed to Waste Discharge by the SIU. Has the SIU caused or contributed to any problems (e.g.,
upsets, interference) at the treatment works in the past three years?
❑ Yes X No if yes, describe each episode.
ADELE KNITS.
RCRA HAZARDOUS WASTE RECEIVED BY TRUCK, RAIL, OR DEDICATED PIPELINE:
F.9. RCRA Waste. Does the treatment works receive or has it in the past three years received RCRA hazardous waste by truck, rail or dedicated pipe?
❑ Yes ® No (go to F.12)
F.10. Waste transport. Method by which RCRA waste is received (check all that apply):
❑ Truck ❑ Rail ❑ Dedicated Pipe
F.11. Waste Description. Give EPA hazardous waste number and amount (volume or mass, specify units).
EPA Hazardous Waste Number Amount Units
CERCLA (SUPERFUND) WASTEWATER, RCRA REMEDIATION/CORRECTIVE ACTION
WASTEWATER, AND OTHER REMEDIAL ACTIVITY WASTEWATER:
F.12. Remediation Waste. Does the treatment works currently (or has it been notified that it will) receive waste from remedial activities?
❑ Yes (complete F.13 through F.15.) X No
F.13. Waste Origin. Describe the site and type of facility at which the CERCLA/RCRA/or other remedial waste originates (or is excepted to origniate in
the next five years).
F.14. Pollutants. List the hazardous constituents that are received (or are expected to be received). Include data on volume and concentration, if
known. (Attach additional sheets if necessary.)
F.15. Waste Treatment
a_ Is this waste treated (or will be treated) prior to entering the treatment works?
❑ Yes ❑ No
If yes, describe the treatment (provide information about the removal efficiency):
b. Is the discharge (or will the discharge be) continuous or intermittent?
❑ Continuous ❑ Intermittent If intermittent, describe discharge schedule.
EN D' O-F PART
REFER TO; THE.APPLICATION OVERVIEW (PAGE .1-YW DETERMINE WHICH OTHER PARTS
'Of- FORM 2A YOU 'MUS-T COMPLETE
NPDES FORM 2A Additional Information

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
ARCHIE ELLEDGE WVVTP, NCO037834
RENEWAL
YADKIN
SUPPLEINENTAL APPLICATIQK INFORMATION ,
PART F INDUSTRIAL USER DISCHARGES AND, RCRA/CERCLA WASTES
7
All treatment works receiving discharges from significant industrial users or which receive RCRA,CERCLA, or other remedial wastes must
complete part F.
GENERAL INFORMATION:
F.I. Pretreatment program. Does the treatment works have, or is subject ot, an approved pretreatment program?
X Yes ❑ No
F.2. Number of Significant Industrial Users (SIUs) and Categorical Industrial Users (CIUs). Provide the number of each of the following types of
industrial users that discharge to the treatment works.
G. Number of non -categorical SIUs. 21
d. Number of CIUs. 11
SIGNIFICANT INDUSTRIAL USER INFORMATION:
Supply the following information for each SIU. If more than one SIU discharges to the treatment works, copy questions F.3 through F.8 and
provide the information requested for each SIU.
F.3. Significant Industrial User Information. Provide the name and address of each SIU discharging to the treatment works. Submit additional pages
as necessary.
Name: B/E AEROSPACE
Mailing Address: 1455 FAIRCHILD ROAD
WINSTON-SALEM, NC 27105
FA. Industrial Processes. Describe -all the industrial processes that affect or contribute to the SIU's discharge.
METAL FABRICATION
F.S. Principal Product(s) and Raw Material(s). Describe all of the principal processes and raw materials that affect or contribute to the SIU's
discharge.
Principal product(ss AIRLINE SEATING
Raw material(s): ALUM, STEEL, PLASTICS
F.6. Flow Rate.
C. Process wastewater flow rate. Indicate the average daily volume of process wastewater discharge into the collection system in gallons per
day (gpd) and whether the discharge is continuous or intermittent.
8,000 gpd ( continuous or X intermittent)
d. Non -process wastewater flow rate_ indicate the average daily volume of non -process wastewater flow discharged into the collection system
in gallons per day (gpd) and whether the discharge is continuous or intermittent_
2,000 gpd ( continuous or X intermittent)
F.7. Pretreatment Standards. Indicate whether the SIU is subject to the following:
a. Local limits X Yes ❑ No
b. Categorical pretreatment standards X Yes No
If subject to categorical pretreatment standards, which category and subcategory?
433 SUB A
NPDES FORM 2A Additional Information

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
ARCHIE ELLEDGE WWTP, NCO037834
RENEWAL
YAMN
F.8. Problems at the Treatment Works Attributed to Waste Discharge by the SIU. Has the SIU caused or contributed to any problems (e.g.,
upsets, interference) at the treatment works in the past three years?
❑ Yes X No If yes, describe each episode.
B/E AEROSPACE
RCRA HAZARDOUS WASTE RECEIVED BY TRUCK, RAIL, OR DEDICATED PIPELINE:
F.9.. RCRA Waste. Does the treatment works receive or has it in the past three years received RCRA hazardous waste by truck, rail or dedicated pipe?
❑ Yes X No (go to F.12)
F.10. Waste transport Method by which RCRA waste is received (check all that apply):
❑ Truck ❑ Rail ❑ Dedicated Pipe
F.11. Waste Description. Give EPA hazardous waste number and amount (volume or mass, specify units).
EPA Hazardous Waste Number Amount Units
CERCLA (SUPERFUND) WASTEWATER, RCRA REMEDIATION/CORRECTIVE ACTION
WASTEWATER, AND OTHER REMEDIAL ACTIVITY WASTEWATER:
F.12. Remediation Waste. Does the treatment works currently (or has it been notified that it will) receive waste from remedial activities?
❑ Yes (complete F_13 through F.15.) X No
F.13. Waste Origin. Describe the site and type of facility at which the CERCLA/P,CRA/or other remedial waste originates (or is excepted to origniate in
the next five years).
F.14. Pollutants. List the hazardous constituents that are received (or are expected to be received). Include data on volume and concentration, if
known. (Attach additional sheets if necessary.)
F.15. Waste Treatment
C. Is this waste treated (or will be treated) prior to entering the treatment works?
❑ Yes ❑ No
If yes, describe the treatment (provide information about the removal efficiency):
d. Is the discharge (or will the discharge be) continuous or intermittent?
❑ Continuous ❑ Intermittent If intermittent, describe discharge schedule.
END -OF; PART F:-=
REFER TO: THE AP:PLI'CATION OVERVIEW:.(PAGE.1) TO DETERMINE WHICH •OTHER PARTS:.
.-OF FORM 2A'YO.U:;MUST,COMPLETE .
NPDES FORM 2A Additional Information

FACILITY NAME AND PERMIT NUMBER"
PERMIT ACTION REQUESTED:
RIVER BASIN:
ARCHIE ELLEDGE WWTP, NCO037834
RENEWAL
YADKIN
SUPPLEMENTAL P 0
UP
IN WASTES
pp
All treatment works receiving disc . harges from significant industrial users or which receive RGRACERCLA, or other remedial wastes must
complete part F.
GENERAL INFORMATION:
F.1. Pretreatment program. Does the treatment works have, or is subject ot, an approved pretreatment program?
X Yes F-1 No
F.2. Number of Significant Industrial Users (SlUs) and Categorical Industrial Users (ClUs). Provide the number of each of the following types of
industrial users that discharge to the treatment works.
e. Number of non -categorical Sl Us. 21
f. Number of ClUs. 11
SIGNIFICANT INDUSTRIAL USER INFORMATION:
Supply the following information for each SIU. If more than one SIU discharges to the treatment works, copy questions F.3 through F.8 and
provide the information requested for each SIU.
F.3. . Significant Industrial User Information. Provide the name and address of each SIU discharging to the treatment works. Submit additional pages
as necessary.
Name: BEKAERT TEXTILES
Mailing Address: 240 BUSINESS PARK DRIVE
WINSTON-SALEM NC 27107
F.4. Industrial Processes. Describe all the industrial processes that affect or contribute to the SIU's discharge.
TEXTILE
F.S. Principal Product(s) and Raw Material(s). Describe all of the principal processes and raw materials that affect or contribute to the SI U's
discharge.
Principal product(s): WOVEN AND KNIT FABRICS
Raw material(s): POLYESTER. NYLON, BINDERS
F.G. Flow Rate.
e. Process wastewater flow rate. Indicate the average daily volume of process wastewater discharge into the collection system in gallons per
day (gpd) and whether the discharge is continuous or intermittent.
10.000 gpd X continuous or intermittent)
f. Non -process wastewater flow rate. Indicate the average daily volume of non -process wastewater flow discharged into the collection system
in gallons per day (gpd) and whether the discharge is continuous or intermittent.
20,000 gpd X continuous or intermittent)
F.7. Pretreatment Standards. Indicate whether the SIU is subject to the following:
a. Local limits X Yes F1 No
b. Categorical pretreatment standards ❑ Yes X No
If subject to categorical pretreatment standards, which category and subcategory?
NPDES FORM 2A Additional Information

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED-
RIVER BASIN:
ARCHIE ELLEDGE WWTP, NCO037834
RENEWAL
YADKIN
F.O. Problems at the Treatment Works Attributed to Waste Discharge by the Sift. Has the SIU caused or contributed to any problems (e.g.,
upsets, interference) at the treatment works in the past three years?
❑ Yes X No If yes, describe each episode.
BEKAERT TEXTILES
RCRA HAZARDOUS WASTE RECEIVED BY TRUCK, RAIL, OR DEDICATED PIPELIN
F.9. RCRA Waste. Does the treatment works receive or has it in the past three years received RCRA hazardous waste by truck, rail or dedicated pipe?
❑ Yes X No (go to FA 2)
F.10. Waste transport. Method by which RCRA waste is received (check all that apply):
❑ Truck ❑ Rail ❑ Dedicated Pipe
FA 1. Waste Description. Give EPA hazardous waste number and amount (volume or mass, specify units).
EPA Hazardous Waste Number Amount Units
CERCLA (SUPERFUND) WASTEWATER, RCRA REMEDIATION/CORRECTIVE ACTION
WASTEWATER, AND OTHER REMEDIAL ACTIVITY WASTEWATER:
F.12. Remediation Waste. Does the treatment works currently (or has it been notified that it will) receive waste from remedial activities?
❑, Yes (complete F-13 through F.15.) X No
F.13. Waste Origin. Describe the site and type of facility at which the CERCLA/RCRA/or other remedial waste originates (or is excepted to origniate in
the next five years).
F.14. Pollutants. List the hazardous constituents that are received (or are expected to be received). Include data on volume and concentration, if
known. (Attach additional sheets if necessary.)
F.15. Waste Treatment
e. Is this waste treated (or will be treated) prior to entering the treatment works?
❑ Yes ❑ No
If yes, describe the treatment (provide information about the removal efficiency):
f. Is the discharge (or will the discharge be) continuous or intermittent?
❑ Continuous ❑ Intermittent If intermittent, describe discharge schedule.
END OF PART F, ,
REF:ER.TO"THE APPLICATION'OVERVIEW "(PAGE 1),TO:DETERMINE WHICH .OTHER- PARTS
OF FORM 2A YOU; MUST COMPLETE =
NPDES FORM 2A Additional Information

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
ARCHIE ELLEDGE WVVTP, NCO037834
RENEWAL
YADKIN
SUPPLEMENTAL AFFLICAT�ION INFORMATION
PART FRIAL USER DISCHARGES
All treatment works receiving discharges from significant industrial users or which receive RCRA,CERCLA, or other remedial wastes must
complete part F.
GENERAL INFORMATION:
F.I. Pretreatment program. Does the treatment works have,or is subject ot, an approved pretreatment program?
X Yes ❑ No
F.2. Number of Significant Industrial Users (SlUs) and Categorical Industrial Users (ClUs). Provide the number of each of the following types of
industrial users that discharge to the treatment works.
g. Number of non -categorical SlUs. 21
h. Number ofClUs. 11
SIGNIFICANT INDUSTRIAL USER INFORMATION:
Supply the following information for each SIU. If more than one SIU discharges to the treatment works, copy questions F.3 through F.8 and
provide the information requested for each SIU.
F.3. Significant Industrial User Information. Provide the name and address of each SIU discharging to the treatment works. Submit additional pages
as necessary.
Name: CORN PRODUCTS CO.
Mailifig Address: P.O. BOX
WINSTON-SALEM, NC 27285
FA. Industrial Processes. Describe all the industrial processes that affect or contribute to the SIU's discharge.
CORN MILLING
F.5. Principal Product(s) and Raw Material(s). Describe all of the principal processes and raw materials that affect or contribute to the SIU's
discharge.
Principal product(s): CORN ,FRUTOSE,DEXTROSE
Raw material(s): CORN. SURFACTANTS, ACIDS
F.6. Flow Rate.
g- Process wastewater flow rate- Indicate the average daily volume of process wastewater discharge into the collection system in gallons per
day (gpd) and whether the discharge is continuous or intermittent.
700,000 gpd X continuous or intermittent)
h. Non -process wastewater flow rate. Indicate the average daily volume of non -process wastewater flow discharged. into the collection system
in gallons per day (gpd) and whether the discharge is continuous or intermittent_
1000,000 gpd X continuous or intermittent)
F.7. Pretreatment Standards. Indicate whether the SIU is subject to the following:
a. Local limits X Yes ❑ No
b. Categorical pretreatment standards ❑ Yes X No
If subject to categorical pretreatment standards, which category and subcategory?
NPDES FORM 2A Additional Information

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
ARCHIE ELLEDGE WWTP, NCO037834
RENEWAL
YADKIN
F.8. Problems at the Treatment Works Attributed to Waste Discharge by the SIU. Has the SIU caused or contributed to any problems (e.g.,
upsets, interference) at the treatment works in the past three years?
❑ Yes No If yes, describe each episode.
CORN PRODUCTS CO.
RCRA HAZARDOUS WASTE RECEIVED BY TRUCK, RAIL, OR DEDICATED PIPELINE:
F.9. RCRA Waste. Does the treatment works receive or has it in the past three years received RCRA hazardous waste by truck, rail or dedicated pipe?
❑ Yes X No (go to FA2)
FA0. Waste transport Method by which RCRA waste is received (check all that apply):
❑ Truck ❑ Rail ❑ Dedicated Pipe
F.11. Waste Description. Give EPA hazardous waste number and amount (volume or mass, specify units).
EPA Hazardous Waste Number Amount Units
CERCLA (SUPERFUND) WASTEWATER, RCRA REMEDIATION/CORRECTIVE ACTION
WASTEWATER,- AND OTHER REMEDIAL ACTIVITY WASTEWATER:
F.12. Remediation Waste. Does the treatment works currently (or has it been notified that it will) receive waste from remedial activities?
❑ Yes (complete F.13 through F.15_) X No
F.13. Waste Origin. Describe the site and type of facility at which the CERCLA/RCRA/or other remedial waste originates (or is excepted to origniate in
the next five years).
F.14. Pollutants. List the hazardous constituents that are received (or are expected to be received). Include data on volume and concentration, if
known. (Attach additional sheets if necessary.)
F.15. Waste Treatment.
g. Is this waste treated (or will be treated) prior to entering the treatment works?
❑ Yes ❑ No
If yes, describe the treatment (provide information about the removal efficiency):
h. Is the discharge (or will the discharge be) continuous or intermittent?
❑ Continuous ❑ Intermittent If intermittent, describe discharge schedule.
END `.OF: PART F ..
REFER TO -THE APPLICATION=OUERVIEW (PAGED TO DETERMINE.WHICH OTHER PARTS,
OF FORM;3A YOU: MUST COMPLETE : -
NPDES FORM 2A Additional Information

FACILITY NAME AND PERMIT NUMBER:
ERMIT ACTION REQUESTED:
RIVER BASIN:
EME
51
All treatment works receiving discharges from significant industrial users or which receive RCRACERCLA, or other remedial wastes must
pomplete part F.
GENERAL INFORMATION:
F.I. Pretreat ment program. Does the treatment works have, or is subject ot, an approved pretreatment program?
X Yes F1 No
F.2. Number of Significant Industrial Users (SlUs) and Categorical Industrial Users (ClUs). Provide the number of each of the following types of
industrial users that discharge to the treatment works.
SIGNIFICANT INDUSTRIAL USER INFORMATIO
Supply the following information for each SIU. If more than one SIU discharges to the treatment works, copy questions F.3 through F.8 and
provide the information requested for each SIU.
F.3. Significant Industrial User Information. Provide the name and address of each SIU discharging to the treatment works. Submit additional pages
as necessary.
Name: DAIRY FRESH
Mailing Address: P.O. BOX 4009
FA. Industrial Processes. Describe all the industrial processes that affect or contribute to the SILl's discharge.
DAIRY
F.S. Principal PrGduct(s) and Raw Material(s). Describe all of the principal processes and raw materials that affect or contribute to the SILI's
Principal product(s): MILK, ICE CREAM, FRUIT DRINKS
Raw material(s): MILK. CORN SYRUP, SANITIZERS
F.S. Flow Rate.
L Process wastewater flow rate. Indicate the average daily volume of process wastewater discharge into the collection system in gallons per
day (gpd) and whether the discharge is continuous or intermittent
j. Non -process wastewater flow rate. Indicate the average daily volume of non -process wastewater flow discharged into the collection system
in gallons per day (gpd) and whether the discharge is continuous or intermittent.
F.7. Pretreatinent Standards. Indicate whether the SILI is subject to the following:
a. Local limits X Yes F1 No
b. Categorical pretreatment standards n Yes X No
If subject to categorical pretreatment standards, which category and subcategory?
NPDESFORM 2AAdditional Information

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
ARCHIE ELLEDGE WWTP, NCO037834
RENEWAL
YADKIN
F.S. Problems at the Treatment Works Attributed to Waste Discharge by the SIU. Has the SIU caused or contributed to any problems (e.g.,
upsets, interference) at the treatment works in the past three years?
❑ Yes X No If yes, describe each episode.
DAIRY FRESH
RCRA HAZARDOUS WASTE RECEIVED BY TRUCK, RAIL, OR DEDICATED. PIPELINE:
F.9. RCRA Waste. Does the treatment works receive or has it in the past three years received RCRA hazardous waste by truck, rail or dedicated pipe?
❑ Yes ® No (go to F.12)
F.10. Taste transport Method by which RCRA waste is received (check all that apply):
❑ Truck ❑ Rail ❑ Dedicated Pipe
FA 1. Waste Description. Give EPA hazardous waste number and amount (volume or mass, specify units).
EPA Hazardous Waste Number Amount Units
CERCLA (SUPERFUND) WASTEWATER, RCRA REMEDIATIONICORRECTIVE ACTION
WASTEWATER, ARID OTHER REMEDIAL ACTIVITY WASTEWATER:
F.12. Remediation Waste. Does the treatment works currently (or has it been notified that it will) receive waste from remedial activities?
❑ Yes (complete F.13 through F_15_) X No
F.13. Waste Origin. Describe the site and type of facility at which the CERCLA/RCRA/or other remedial waste originates (or is excepted to origniate in
the next five years).
F.14. Pollutants. List the hazardous constituents that are received (or are expected to be received). Include data on volume and concentration, if
known. (Attach additional sheets if necessary.)
F.15. Waste Treatment
I. Is this waste treated (or will be treated) prior to entering the treatment works?
❑ Yes ❑ No
If yes, describe the treatment (provide information about the removal efficiency):
j. Is the discharge (or will the discharge be) continuous or intermittent?
❑ Continuous ❑ Intermittent If intermittent, describe discharge schedule.
E .. D "O.F ;PORT
REFER .TQ THE AP.PLICATION,OVERVIEW (PAGE 1),TQ.DETERMINEWHlCH OTHER PARTS
OF. FORM 2A YOU. MUST. COMPLETE,
NPDES FORM 2A Additional Information

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED'
RIVER BASIN:
ARCHIE ELLEDGE WV\FFP, NCO037834
RENEWAL.
YADKIN
­--APPLI' INFORMATION` M "
'1§00 -fL",EN, E TA '
D",
KART F INDUSTRIAL USER DISCHARGES _AERCLA WASTES
All treatment works receiving discharges from significant industrial users or which receive RCRA,CERCLA, or other remedial wastes must
complete part F.
GENERAL INFORMATION:
FA. Pretreatment program. Does the treatment works have, or is subject ot, an approved pretreatment program?
X Yes ❑ No
F.2. Number of Significant Industrial Users (SlUs) and Categorical Industrial Users (ClUs). Provide the number of each of the following types of
industrial users that discharge to the treatment works.
k. Number of non -categorical SlUs. 21
1. Number of ClUs. 11
SIGNIFICANT INDUSTRIAL USER INFORMATION:
Supply the following information for each SIU. If more than one SIU discharges to the treatment works, copy questions F..3 through F.8 and
provide the information requested for each SIU.
F.3. Significant Industrial User Information. Provide the name and address of each SIU discharging to the treatment works. Submit additional pages
as necessary.
Name: DEERE-HITACHI CONSTRUCTION
Mailing Address: P.O. BOX 1187
KERNERSVILLE, NC 27285
FA. Industrial Processes. Describe all the industrial processes that affect or contribute to the SIU's discharge.
METAL FABRICATION
F.5. Principal Product(s) and Raw Material(s). Describe all of the principal processes and raw materials that affect or contribute to the SIU's
discharge.
Principal product(s): HYDRAULIC EXCAVATORS
Raw material(s): STEEL, PAINT, DETERGENTS
F.G. Flow Rate.
k. Process wastewater flow rate. Indicate the average daily volume of process wastewater discharge into the collection system in gallons per
day (gpd) and whether the discharge is continuous or intermittent.
2,000 gpd continuous or X intermittent)
I. Non -process wastewater flow rate. Indicate the average daily volume of non -process wastewater flow discharged into the collection system
in gallons per day (gpd) and whether the discharge is continuous or intermittent.
1,000 gpd continuous or X intermittent)
F.7. Pretreatment Standards. Indicate whether the SIU is subject to the following:
a- Local limits X Yes F1 No
b. Categorical pretreatment standards X Yes No
If subject to categorical pretreatment standards, which category and subcategory?
433 SUB A
NPDES FORM 2A Additional Information,

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
ARCHIE ELLEDGE WW-FP, NCO037834
RENEWAL
YADKIN
F.S. Problems at the Treatment Works Attributed to Waste Discharge by the SIU. Has the SIU caused or contributed to any problems (e.g.,
upsets, interference) at the treatment works in the past three years?
❑ Yes X No If yes, describe each episode.
DEERE-HITACHI CONSTRUCTION
RCRA HAZARDOUS WASTE RECEIVED BY TRUCK, RAIL, OR DEDICATED PIPELINE:
F.S. RCRA Waste. Does the treatment works receive or has it in the past three years received RCRA hazardous waste by truck, rail or dedicated pipe?
❑ Yes ® No (go to F.12)
F.10. Waste transport. Method by which RCRA waste is received (check all that apply):
❑ Truck ❑ Rail ❑ Dedicated Pipe
FA 1. Waste Description. Give EPA hazardous waste number and amount (volume or mass, specify units).
EPA Hazardous Waste Number Amount Units
CERCLA (SUPERFUND) WASTEWATER, RCRA REMEDIATION/CORRECTIVE ACTION
WASTEWATER, AND OTHER REMEDIAL ACTIVITY WASTEWATER:
F.12. Remediation Waste. Does the treatment works currently (or has it been notified that it will) receive waste from remedial activities?
❑ Yes (complete F.13 through F.15.) X No
F.13. Waste Origin. Describe the site and type of facility at which the CERCLA/RCRA/or other remedial waste originates (or is excepted to origniate in
the next five years).
F.14. Pollutants. List the hazardous constituents that are received (or are expected to be received). Include data on volume and concentration, if
known. (Attach additional sheets if necessary.)
F.13. Taste Treatment
k. Is this waste treated (or will be treated) prior to entering the treatment works?
❑ Yes ❑ No
If yes, describe the treatment (provide information about the removal efficiency):
I. Is the discharge (or will the discharge be) continuous or intermittent?
❑ Continuous ❑ Intermittent If intermittent, describe discharge schedule.
END,':OF PART'F,:. .
REFER, TO THE., APP,LICATION:OVERVIEW'(PAGE 1),TO;;DETERMINEWHIGH OTHER PARTS
_ OF FORM 2A YOU.MUS1.COM,PI_ETE
NPDES FORM 2A Additional Information

FACILITY NAME AND PERMIT NUMBER:
ERMIT ACTION REQUESTED:
RIVER BASIN:
MAT 0
vv
All treatmentworks receiving discharges from significant industrial users orwhich receive RCRACERCLA, or other remedial wastes must
complete part F.
GENERAL INFORMATION:
F.I. Pretreatment program. Does the treatment works have, or is subject ot, an approved pretreatment program?
F.2. Number of Significant Industrial Users (SlUs) and Categorical Industrial Users (ClUs). Provide the number of each of the following types of
industrial users that discharge to the treatment works.
SIGNIFICANT INDUSTRIAL USER INFORMATION:
Supply the following information for each ' SIU. If more than one SIU discharges to the treatment works, copy questions F.3 through F.8 and
provide the information requested for each SIU.
F.3. Significant Industrial User Information. Provide the name and address of each SIU discharging to the treatment works. Submit additional pages
as necessary.
Mailing Address: P.O. BOX 12159
FA. Industrial Processes. Describe all the industrial processes that affect or contribute to the SIU's discharge-
BATFERY
F.S. Principal Product(s) and Raw Material(s). Describe all of the principal processes and raw materials that affect or contribute to the SI U's
Principal product(sy: INDUSTRIAL, LEAD, ACID
Raw material(s): LEAD, SULFURIC ACID, ZINC
F.6. Flow Rate.
M. Process wastewater flow rate. Indicate the average daily volume of process wastewater discharge into the collection system in gallons per
day (gpd) and whether the discharge is continuous or intermittent.
n. Non -process wastewater flow rate. Indicate the average daily volume of non -process wastewater flow discharged into the collection System
in gallons per day (gpd) and whether the discharge is continuous or intermittent.
F.7. Pretreatment Standards. Indicate whether the SIU is subject to the fbilowing:
a. Local limits X Yes EJ No
b. Categorical pretreatment standards X Yes No
If subject to categorical pretreatment standards, which category and subcategory?
NPDESFORM 2AAdditional Information

FACILITY NAME AND PERMIT'NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
ARCHIE ELLEDGE WWTP, NCO037834
RENEWAL
YADKIN
F.S. Problems at the Treatment Works Attributed to Waste Discharge by the SIU. Has the SIU caused or contributed to any problems (e.g.,
upsets, interference) at the treatment works in the past three years?
❑ Yes X No If yes, describe each episode.
DOUGLAS BATTERY
RCRA HAZARDOUS WASTE RECEIVED BY TRUCK, RAIL, OR DEDICATED PIPELINE:
F.9. RCRA Waste. Does the treatment works receive or has it in the past three years received RCRA hazardous waste by truck, rail or dedicated pipe?
❑ Yes ® No (go to F.12)
F.10. Waste transport Method by which RCRA waste is received (check all that apply):
❑ Truck ❑ Rail ❑ Dedicated Pipe
FA 1. Waste Description. Give EPA hazardous waste number and amount (volume or mass, specify units)_
EPA Hazardous Waste Number Amount Units
CERCLA (SUPERFUND) WASTEWATER, RCRA REMEDIATIONICORRECTIVE ACTION
WASTEWATER, AND OTHER REMEDIAL ACTIVITY WASTEWATER:
F.12. Remediation Waste. Does the treatment works currently (or has it been noted that it will) receive waste from remedial activities?
❑ Yes (complete F.13 through F_15.) X No
F.13. Waste Origin. Describe the site and type of facility at which the CERCLA/RCRA/or other remedial waste originates (or is excepted to origniate in
the next five years).
F.14. Pollutants. List the hazardous constituents that are received (or are expected to be received). Include data on volume and concentration, if
known. (Attach additional sheets if necessary.)
F.15. Waste Treatment
m_ Is this waste treated (or will be treated) prior to entering the treatment works?
❑ Yes ❑ No
If yes, describe the treatment (provide information about the removal efficiency):
n. Is the discharge (or will the discharge be) continuous or intermittent?
❑ Continuous ❑ Intermittent If intermittent, describe discharge schedule.
END OF PART F
REFER TO THE' APPLICATION OVERVIEW (PAGE 1);TO DETERMINE WHICH OTHER PARTS
OF FORM 2A YOU;;,MUSTCOMP�ETE:
NPDES FORM 2A Additional Information

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
ARCHIE ELLEDGE VWvTP, NCO037834
RENEWAL
YADKIN
DIS
PART IND WASTES
F;.,
All treatment works receiving discharges from significant industrial users or which receive RCRA,CERCLA, or other remedial wastes must
complete part F.
GENERAL INFORMATION:
F.I. Pretreatment program. Does the treatment works have, or is subject ot, an approved pretreatment program?
X Yes F1 No
F.2. Number of Significant Industrial Users (SlUs) and.Categorical Industrial Users (ClUs). Provide the number of each of the following types of
industrial users that discharge to the treatment works.
0. Number of non -categorical SlUs- 21
p. Number of ClUs. 11
SIGNIFICANT INDUSTRIAL USER INFORMATION:
Supply the following information for each SIU. If more than one SIU discharges to the treatment works, copy questions F.3 through F.8 and
provide the information requested for each SIU..
F.3. Significant Industrial User Information. Provide the name and address of each SIU discharging to the treatment works. Submit additional pages
as necessary.
Name: GRASS AMERICA
Mailing Address: P.O. BOX 1019
KERNERSVILLE, NC 27285
F.A. Industrial Processes. Describe all the industrial processes that affect or contribute to the SIU's discharge.
METAL FABRICATION
F.S. Principal Product(s) and Raw Material(s). Describe all of the principal processes and raw materials that affect or contribute to the SIU's
discharge.
Principal product(s): FURNITURE HINGES
Raw material(s): STEEL, POWDER COATING
F.6. Flow Rate.
0. Process wastewater flow rate. Indicate the average daily volume of process wastewater discharge into the collection system in gallons per
day (gpd) and whether the discharge is continuous or intermittent
2,000 gpd continuous or X intermittent)
p. Non -process wastewater flow rate. Indicate the average daily volume of non -process wastewater flow discharged into the collection system
in gallons per day (gpd) and whether the discharge is continuous or intermittent.
1,000 gpd continuous or X intermittent)
F.7. Pretreatment Standards. Indicate whether the SIU is subject to the following:
a- Local limits X Yes No
b. Categorical pretreatment standards X Yes No
If subject to categorical pretreatment standards, which category and subcategory?
433 SUB A
NPDES FORM 2A Additional- Information

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
ARCHIE ELLEDGE WWTR, NCO037834
RENEWAL
YADKIN
F.S. Problems at the Teeatment Works Attributed to Waste Discharge by the SIU. Has the SIU caused or contributed to any problems (e.g.,
upsets, interference) at the treatment works in the past three years?
❑ Yes X No If yes, describe each episode.
GRASS AMERICA
RCRA HAZARDOUS WASTE RECEIVED BY TRUCK, RAIL, OR DEDICATED PIPELINE:
F.9. RCRA Waste. Does the treatment works receive or has it in the past three years received RCRA hazardous waste by truck, rail or dedicated pipe?
❑ Yes ® No (go to F.12)
F.10. Waste transport Method by which RCRA waste is received (check all that apply):
❑ Truck ❑ Rail ❑ Dedicated Pipe
F.11. Waste Description. Give EPA hazardous waste number and amount (volume or mass, specify units).
EPA Hazardous Waste Number Amount Units
CERCLA (SUPERFUND) WASTEWATER, RCRA REMEDIATION/CORRECTIVE ACTION
WASTEWATER, AND OTHER REMEDIAL ACTIVITY WASTEWATER:
FA 2. Rernediation Waste. Does the treatment works currently (or has it been notified that it will) receive waste from remedial activities?
❑ Yes (complete F.13 through F.15.) X No
F.13. Waste Origin. Describe the site and type of facility at which the CERCLA/RCRAIor other remedial waste originates (or is excepted to origniate in
the next five years).
F.14. Pollutants. List the hazardous constituents that are received (or are expected to be received). Include data on volume and concentration, if
known. (Attach additional sheets if necessary.)
F.15. Waste Treatment
o_ Is this waste treated (or will be treated) prior to entering the treatment works?
❑ Yes ❑ No
If yes, describe the treatment (provide information about the removal efficiency):
p. Is the discharge (or will the discharge be) continuous or intermittent?
❑ Continuous ❑ Intermittent If intermittent, describe discharge schedule.
END OF PAR"
:REFER TO THE APPLICATION OVERVIEW (PAGE �) yT0 DETERMINE . HICK,0THER PARTS
OF FORM 2A'YOU MUST:COMPLETE
NPDES FORM 2A Additional Information

FACILITY NAME AND PERMIT NUMBER-
ERMIT ACTION REQUESTED:
RIVER BASIN:
All treatment works receivingdischarges from significant industrial users or which receive RCRACERCLA, or other remedial wastes must
complete part F.
GENERAL INFORMATION:
F.I. Pretreatment program. Does the treatment works have, or is subject ot, an approved pretreatment program?
X Yes El No
F.2. Number of Significant Industrial Users (SlUs) and Categorical Industrial Users (ClUs). Provide the number of each of the following types of
industrial users that discharge to the treatment works.
q. Number of non -categorical Sl Us. 21
SIGNIFICANT INDUSTRIAL USER INFORMATI
Supply the following information for each SIU. If more than one SIU discharges to the treatment works, copy questions F.3 through F.8 and
provide the information requested for each SIU.
F.3. Significant Industrial User Information. Provide the name and address of each SIU discharging to the treatment works- Submit additional pages
as necessary.
Name: HANES DYE & FINISHING
Mailing Address: P.OBOX 202
F.4. Industrial Processes. Describe all the industrial processes that affect or contribute to the SIU's discharge.
TEXTILE
F.5. Principal Pr.oduct(s) and Raw Material(s). Describe all of the principal processes and raw materials that affect or contribute to the SIU's
Principal product(s): DYEING AND FINISHING
Raw material(s): DYESTUFF, ACID , CAUSTICS
F.6. Flow Rate.
q- Process wastewater flow rate- Indicate the average daily volume of process wastewater discharge into the collection system in gallons per
day (gpd) and whether the discharge is continuous or intermittent.
r. Non -process wastewater flow rate. Indicate the average daily volume of non -process wastewater flow discharged into the collection system
in gallons per day (gpd) and whether the discharge is continuous or intermittent
75,000 gpd continuous or intermittent)
F.7. Pretreatment Standards. Indicate whether the SIU is subject to the following:
a- Local limits X Yes n No
b. Categorical pretreatment standards El Yes X No
If subject to categorical pretreatment standards, which category and subcategory?
NPDESFORM &4Additional knfnnnoUnn

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN: -
ARCHIE ELLEDGE WWTP, NCO037834
RENEWAL
YADKIN
F.8. Problems at the Treatment Works Attributed to Waste Discharge by the SIU. Has the SIU caused or contributed to any problems (e.g.,
upsets, interference) at the treatment works in the past three years?
❑ Yes X No If yes, describe each episode.
HANES DYE & FINISHING
RCRA HAZARDOUS WASTE RECEIVED BY TRUCK, RAIL, OR DEDICATED PIPELINE:
F.9. RCRA !Haste. Does the treatment works receive or has it in the past three years received RCRA hazardous waste by truck, rail or dedicated pipe?
❑ Yes X No (go to F.12)
F.10. !Haste transport. Method by which RCRA waste is received (check all that apply):
❑ Truck ❑ Rail ❑ Dedicated Pipe
F.11. Waste Description. Give EPA hazardous waste number and amount (volume or mass, specify units).
EPA Hazardous Waste Number Amount Units
CERCLA (SUPERFUND) WASTEWATER, RCRA REMEDIATIONICORRECTIVE ACTION
WASTEWATER, AND OTHER REMEDIAL ACTIVITY WASTEWATER:
FA2. Remediation Waste. Does the treatment works currently (or has it been notified that it will) receive waste from remedial activities?
❑ Yes (complete F.13 through F.15.) X No
F.13. !Haste Origin. Describe the site and type of facility at which the CERCLA/RCRA/or other remedial waste originates (or is excepted to origniate in
the next five years).
F.14. Pollutants. List the hazardous constituents that are received (or are expected to be received). Include data on volume and concentration, if
known. (Attach additional sheets if. necessary.)
F.15. Waste Treatment
q. Is this waste treated (or will be treated) prior to entering the treatment works?
❑ Yes ❑ No
If yes, describe the treatment (provide information about the removal efficiency):
r. Is the discharge (or will the discharge be) continuous or intermittent?
❑ Continuous ❑ Intermittent If intermittent, describe discharge schedule.
,END OF PART F
REFER TO THE APPLICATION OUERUIEW (PAGE 1) TO DrETERMINE WHICH OTHER PARTS
,
OF FORM 2A.YOU MUST COMPLETE"
NPDES FORM 2A Additional Information

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
ARCHIE ELLEDGE WVV-FP, NCO037834
RENEWAL
YADKIN
7
SUPPLEMENTALON] RMATIOW-
; -l"A A
PART ,F7IN,PYS,T USER AN WASTES
All treatment works receiving discharges from significant industrial users or which receive RCRA,CERCLA, or other remedial wastes must
complete part F.
GENERAL INFORMATION:
F.I. Pretreatment program. Does the treatment works have, or is subject ot, an approved pretreatment program?
X Yes [I No
F.2. Number of Significant Industrial Users (SlUs) and Categorical Industrial Users (ClUs). Provide the number of each of the following types of
industrial users that discharge to the treatment works.
S. Number of non -categorical StUs. 21
t. Number ofClUs. 11
SIGNIFICANT INDUSTRIAL USER INFORMATION:
Supply the following information for each SIU. If more than one SIU discharges to the treatment works, copy questions F.3 through F.8 and
provide the information requested for each SIU.
F.3. Significant Industrial User Information. Provide the name and address of each SIU discharging to the treatment works. Submit additional pages
as necessary.
Name: HIGHLAND INDUSTRIES
Mailing Address: 215 DRUMMOND STREET
KERNERSVILLE, NC 27285
FA. Industrial Processes. Describe all the industrial processes that affect or contribute to the SIU's discharge.
TEXTILE COATING
F.S. Principal Product(s) and Raw Material(s). Describe all of the principal processes and raw materials that affect or contribute to the Sl U's
discharge.
Principal product(s): FABRIC FOR AIRBAGS
Raw material(s): TIECOATS. NEOPRENE. SILICONE
F.6. Flow Rate.
S. Process wastewater flow rate. Indicate the average daily volume of process wastewater discharge into the collection system in gallons per
day (gpd) and whether the discharge is continuous or intermittent
8,000 gpd continuous or X intermittent)
t. Non -process wastewater flow- rate- Indicate the average daily volume of non -process wastewater flow discharged into the collection system
in gallons per day (gpd) and whether the discharge is continuous or intermittent.
2,000 gpd continuous or X intermittent)
F.7. Pretreatment Standards. Indicate whether the SIU is subject to the following:
a- Local limits X Yes E] No
b. Categorical pretreatment standards El Yes X No
If subject to categorical pretreatment standards, which category and subcategory?
NPDES FORM 2A Additional Information

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
ARCHIE ELLEDGE WWTP, NCO037834
RENEWAL
YAMN
F.8. Problems at the Treatment Works Attributed to Waste Discharge by the SIU. Has the SIU caused or contributed to any problems (e.g.,
upsets, interference) at the treatment works in the past three years?
❑ Yes X No If yes, describe each episode.
HIGHLAND INDUSTRIES
RCRA HAZARDOUS WASTE RECEIVED BY TRUCK, RAIL, OR DEDICATED PIPELINE:
F.9. RCRA Waste. Does the treatment works receive or has it in the past three years received RCRA hazardous waste by truck, rail or dedicated pipe?
❑ Yes X No (go to FA2)
F.10. Waste transport Method by which RCRA waste is received (check all that apply):
❑ Truck ❑ Rail ❑ Dedicated Pipe
F.11. Waste Description. Give EPA hazardous waste number and amount (volume or mass, specify units).
EPA Hazardous Waste Number Amount Units
CERCLA (SUPERFUND) WASTEWATER, RCRA REMEDIATIONICORRECTIVE ACTION
WASTEWATER, AND OTHER REMEDIAL ACTIVITY WASTEWATER: .
F.12. Remediation'Waste. Does the treatment works currently (or has it been notified that it will) receive waste from remedial activities?
❑ Yes (complete F_13 through F.15.) X No
F.13. baste Origin. Describe the site and type of facility at which the CERCLA/RCRA/or other remedial waste originates (or is excepted to origniate in
the next five years).
F.14. Pollutants. List the hazardous constituents that are received (or are expected to be received). Include data on volume and concentration, if
known. (Attach additional sheets if necessary.)
F.18. Waste Treatment.
S. Is this waste treated (or will be treated) prior to entering the treatment works?
❑ Yes ❑ No
If yes, describe the treatment (provide information about the removal efnciency):
t. Is the discharge (or will the discharge be) continuous or intermittent?
❑ Continuous ❑ Intermittent If intermittent, describe discharge schedule.
END:DF PART:F
-.-
. ,( ,
REFER TO-TH,E APPLICATION OVE RVIEW-;(PAGE 1) TO,.DETERMINE:WHICH OTHER.PARTS .
.:.AF FORIVI2A,YOU'IVI�USTCOMPLETE° :. .
NPDES FORM 2A Additional Information

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
ARCHIE ELLEDGE W\/\TFP, NCO037834
RENEWAL
YADKIN
.10
SUPPLEMENTAL-APPILI-CAT APPLICATION' INFORMATION
USER DISCHARGESANDJRCRA/CERCLA WASTES
All treatment works receiving discharges from significant industrial users or which receive RCRACERCLA, or other remedial wastes must
complete part F.
GENERAL INFORMATION:
F.1. Pretreatment program. Does the treatment works have, or is subject ot, an approved pretreatment program?
X Yes r-1 No
F.2., Number of Significant Industrial Users (SlUs) and Categorical Industrial Users.(ClUs). Provide the number of each of the following types of
industrial users that discharge to the treatment works.
U. Number of non -categorical SlUs. 21
V. Number of Cl Us. 11
SIGNIFICANT INDUSTRIAL USER INFORMATION:
Supply the following information for each SIU. If more than one SIU discharges to the treatment works, copy questions F.3 through F.8 and
provide the information requested for each SIU.
F.3. Significant Industrial User Information. Provide the name and address of each SIU discharging to the treatment works. Submit additional pages
as necessary.
Name: HOH CORPORATION
Mailing Address: 1701 VARGRAVE STREET
WINSTON-SALEM, NC 27107
FA. Industrial Processes. Describe all the industrial processes that affect or contribute to the SIU's discharge_
WASTETREATMENT
F.S. Principal Product(s) and Raw Material(s). Describe all of the principal processes and raw materials that affect or contribute to the St U's
discharge.
Principal product(s): NON -HAZARDOUS
Raw mate.rial(s): POYMERS, SAWDUST, CARBON
F.6. Flow Rate.
u- Process wastewater flow rate- Indicate the average daily volume of process wastewater discharge into the collection system in gallons per
day (gpd) and whether the discharge is continuous or intermittent-
15,000 god continuous or X intermittent)
V. Non -process wastewater flow rate. indicate the average daily volume of non -process wastewater flow discharged into the collection system
in gallons per day (gpd) and whether the discharge is continuous or intermittent.
200 gpd continuous or X intermittent)
F.7. Pretreatment Standards. Indicate whether the SIU is subject to the following:
a. Local limits X Yes F] No
b. Categorical pretreatment standards X Yes No
If subject to categorical pretreatment standards, which category and subcategory?
437 SUB D
NPOES FORM2A Additional Information

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN.
ARCHIE ELLEDGE WVVTP, NCO037834 (
RENEWAL
YADKIN
F.8. Problems at the Treatment Works Attributed to Waste Discharge by the SIU. Has the SIU caused or contributed to any problems (e.g.,
upsets, interference) at the treatment works in the past three years?
❑ Yes X No If yes, describe each episode.
HOH CORPORATION
RCRA HAZARDOUS WASTE RECEIVED BY TRUCK, RAIL, OR DEDICATED PIPELINE:
F.9. RCRA Waste. Does the treatment works receive or has it in the past three years received RCRA hazardous waste by truck, rail or dedicated pipe?
❑ Yes X No (go to F.12)
F.10. Waste transport. Method by which RCRA waste is received (check all that apply):
❑ Truck ❑ Rail ❑ Dedicated Pipe
F.11. Waste Description. Give EPA hazardous waste number and amount (volume or mass, specify units).
EPA Hazardous Waste Number Amount Units
CERCLA (SUPERFUND) WASTEWATER, RCRA REMEDIATIONICORRECTIVE ACTION
WASTEWATER, ARID OTHER REMEDIAL ACTIVITY WASTEWATER.
F.12. Remediation Waste. Does the treatment works currently (or has it been notified that it will) receive waste from remedial activities?
❑ Yes (complete F.13 through F.15.) X No
F.13. Waste Origin. Describe the site and type of facility at which the CERCLA/RCRA/or other remedial waste originates (or is excepted to origniate in
the next five years).
F.14. Pollutants. List the hazardous constituents that are received (or are expected to be received). Include data on volume and concentration, if
known. (Attach additional sheets if necessary.)
F.15. Waste Treatment.
U. Is this waste treated (or will be treated) prior to entering the treatment works?
❑ Yes ❑ No
If yes, describe the treatment (provide information about the removal, efficiency):
V. Is the discharge (or will the discharge be) continuous or intermittent?
❑ Continuous ❑ Intermittent If intermittent, describe discharge schedule.
END OF PART F
REFER TO.THE APPLICATION OVERVIEW (PAGE 1) TO DETERMINE WHICH=OTHER PARTS
q FORM 2A YOU'MUST COMPLETE=
NPDES FORM 2A Additional Information

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN.
ARCHIE -ELLEDGE WVVTP, NCO037834
RENEWAL
YADKIN
SUPPLEMENTAL APPLICATION INFQRMATION
PART F-INDUSTRIAL USER 1R C
All treatment works receiving discharges from significant industrial users or which receive RCRA,CERCLA, or other remedial wastes must
complete part F.
GENERAL INFORMATION:
F.1. Pretreatment program. Does the treatment works have, or is subject ot, an approved pretreatment program?
X Yes ❑ No
F.2. Number of Significant Industrial Users (SIUs) and Categorical Industrial Users (ClUs). Provide the number of each of the following types of
industrial users that discharge to the treatment works.
W. Number of non -categorical SlUs. 21
X_ Number of Cl Us. 11
SIGNIFICANT INDUSTRIAL USER INFORMATION:
Supply the following information for each SIU. If more than one SIU discharges to the treatment works, copy questions F.3 through F.8 and
provide the information requested for each SIU.
F.3. Significant Industrial User Information. Provide the name and address of each SIU discharging to the treatment works. Submit additional pages
as necessary_
Name: JOHNSON CONTROLS BATTERY
Mailing Address: P.O. BOX 1867
KERNERSVILLE, NC 27285
FA. Industrial Processes. Describe all the industrial processes that affect or contribute to the SIU's discharge.
BATTERY
F.6. Principal Product(s) and Raw Material(s). Describe all of the principal processes and raw materials that affect or contribute to the SIU's
discharge.
Principal product(s): INDUSTRIAL LEAD. ACID'
Raw material(s): LEAD. SULFURIC ACID, ZINC
F.6. Flow Rate.
W. Process wastewater -flow rate. Indicate the average daily volume of process wastewater discharge into the collection system in gallons per
day (gpd) and whether the discharge is continuous or intermittent.
8,000 gpd X continuous or intermittent)
X. Non -process wastewater flow rate. Indicate the average daily volume of non -process wastewater flow discharged into the collection system
in gallons per day (gpd) and whether the discharge is continuous or intermittent.
15,000 — gpd continuous or, intermittent)
F.7. Pretreatment Standards. Indicate whether the SIU is subject to the following:
a. Local limits X Yes R.No
b. Categorical pretreatment standards X Yes No
If subject to categorical pretreatment standards, which category and subcategory?
461 SUB G
NPDES FORM 2A Additional Information

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
.ARCHIE ELLEDGE WVVTP, NCO037834
RENEWAL
YADKIN
SUPPLEMENTAL APPLICATION LNFORMATION
R F INDUSTRIAL USER DISCHARGES AND RCRA/CERCLA WASTES
.ART
4_1
All treatment works receiving discharges from significant industrial users or which receive RCRA,CERCLA, or other remedial wastes must
complete part F.
GENERAL INFORMATION:
FA. Pretreatment program. Does the treatment works have, or is subject ot, an approved pretreatment program?
X Yes ❑ No
F.2. Number ofSignificant Industrial Users (SlUs) and Categorical Industrial Users (ClUs). Provide the number of each of the following types of
industrial users that discharge to the treatment works.
y_ Number of non -categorical SlUs_ 21
f. Number of ClUs. 11
SIGNIFICANT INDUSTRIAL USER INFORMATION:
Supply the following information for each SIU. If more than one SIU discharges to the treatment works, copy questions F.3 through F.8 and
provide the information requested for each SIU.
F.3. Significant Industrial User Information. Provide the name and address of each SIU discharging to the treatment works. Submit additional pages
as necessary.
Name: KASA ILCO CORP.
Mailing Address: 2941 INDIANA AVE.
WINSTON-SALEM, NC 27105
FA. Industrial Processes. Describe all the industrial processes that affect or contribute to the SIU's discharge.
DIECASTING METAL FABRICATION
F.S. Principal Product(s) and Raw Material(s). Describe all of the principal processes and raw materials that affect or contribute to the SIU's
discharge.
Principal produGt(s): LOCKS
Raw material(s): ZINC, BRIGHTNERS, ACIDS
F.6. Flow Rate.
y. Process wastewater flow rate. Indicate the average daily volume of process wastewater discharge into the collection system in gallons per
day (gpd) and whether the discharge is continuous or intermittent.
20.000 gpd X continuous or intermittent)
Z. Non -process wastewater flow rate- Indicate the average daily volume of non -process wastewater flow discharged into the collection system
in gallons per day (gpd) and whether the discharge is continuous or intermittent-
6,000 gpd X continuous or intermittent)
F.7. Pretreatment Standards. Indicate whether the SIU is subject to the following:
a. Local limits X Yes ❑ No
b- Categorical pretreatment standards X Yes No
If subject to categorical pretreatment standards, which category and subcategory?
433 SUB A
NPDES FORM 2A Additional Information

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
ARCHIE ELLEIDGE WWTP, NCO037834
RENEWAL
YADKIN
F.8. Problems at the Treatment Works Attributed to Waste Discharge by the SIU. Has the SIU caused or contributed to any problems (e.g.,
upsets, interference) at the treatment works in the past three years?
❑ Yes X No If yes, describe each episode.
KABA ILCO CORP.
RCRA HAZARDOUS TASTE RECEIVED BY TRUCK, RAIL., OR DEDICATED PIPELINE:
F.9. RCRA Waste. Does the treatment works receive or has it in the past three years received RCRA hazardous waste by truck, rail or dedicated pipe?
❑ Yes X No (go to F.12)
F.10. Waste transport Method by which RCRA waste is received (check all that apply):
❑ Truck ❑ Rail ❑ ' Dedicated Pipe
FA 1. Waste Description. Give EPA hazardous waste number and amount (volume or mass, specify units).
EPA Hazardous Waste Number Amount Units
CERCLA (SUPERFUND) WASTEWATER, RCRA REMEDiATION/CORRECTIVE ACTION
WASTEWATER, AND OTHER REMEDIAL ACTIVITY WASTEWATER:
F.12. Remediation Waste. Does the treatment works currently (or has it been notified that it will) receive waste from remedial activities?
❑ Yes (complete F.13 through F.15.) X No
F.13. Waste Origin. Describe the site and type of facility at which the CERCLA/RCRA/or other remedial waste originates (or is excepted to origniate in
the next -five years).
F.14. Pollutants. List the hazardous constituents that are received (or are expected to be received). Include data on volume and concentration, if
known. (Attach additional sheets if necessary_)
F.15. Waste Treatment.
y. Is this waste treated (or will be treated) prior to entering the treatment works?
❑ Yes ❑ No
If yes, describe the treatment (provide information about the removal efficiency):
Z. Is the discharge (or will the discharge be) continuous or intermittent?
❑ Continuous ❑ Intermittent If intermittent, describe discharge schedule.
END OF -PART F �: ;
REFER TO;TH;1AP, PLICATION OVERVIEW (PAGE 1) TO DETERMINE WHICH' OTHER PARTS
OF FORM 2A YOU :MUST:'COMPLETE
NPDES FORM 2A Additional Inibrrnation

FACILITY NAME AND PEFZMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
ARCHIE ELLEDGE WWTP, NCO037834
RENEWAL
YADKIN
$UPPLEIVIENTAL APPLICATION
r. J,
PART F. 'IN _4USTRIAL USHER 3ES--AND,;RCR CEWASTES
All treatment works receiving discharges from significant industrial users or which receive RCRACERCLA, or other remedial wastes must
complete part F.
GENERAL INFORMATION:
F.1. Pretreatment program. Does the treatment works have, or is subject ot, an approved pretreatment program?.
X Yes F1 No
F.2. Number of Significant Industrial Users (SIUs) and Categorical Industrial Users (ClUs). Provide the number of each of the following types of
industrial users that discharge to the treatment works.
aa. Number of non -categorical SlUs. 21
bb. Number of ClUs. 11
SIGNIFICANT INDUSTRIAL USER INFORMATION:
Supply the following information for each SIU. If more than one SIU discharges to the treatment works, copy questions F.3 through F.8 and
provide the information requested for each SIU.
F.3. Significant Industrial User Information. Provide the name and address of each SIU discharging to the treatment works. Submit additional pages
as necessary.
Name: MICROFIBERS INC.
Mailing Address: 3821 KIMWELL DRIVE
WINSTON-SALEM, NC 27103
FA. Industrial Processes. Describe all the industrial processes that affect or contribute to the SIU's discharge.
TEXTILE
F.& Principal Product(s) and Raw Material(s). Describe all of the principal processes and raw materials that affect or contribute to the SIU's
discharge.
Principal product(s): UPHOLSTRY FABRIC
Raw material(s): DYESTUFF, POLYESTER, COTTON
F.6. Flow Rate.
aa. Process wastewater flow rate. Indicate the average daily volume of process wastewater discharge into the collection system in gallons per
day (gpd) and whether the discharge is continuous or intermittent.
400,000 gpd X continuous or intermittent)
bb. Non -process wastewater flow rate. Indicate the average daily volume of non -process wastewater flow discharged into the collection system
in gallons per day (gpd) and whether the discharge is continuous or intermittent
100,000 'gpd X continuous or intermittent)
F.7. Pretreatment Standards. Indicate whether the SIU is subject to the following:
a- Local limits X Yes nNo
b. Categorical pretreatment standards n Yes X No
If subject to categorical pretreatment standards, which category and subcategory?
NPDES FORM 2A Additional Information

FACILITY NARRE AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
ARCHIE ELLEDGE WWTP, NCO037834
RENEWAL
YADKIN
F.B. Problems at the Treatment Works Attributed to Waste Discharge by the SIU. Has the SIU caused or contributed to any problems (e.g.,
upsets, interference) at the treatment works in the past three years?
❑ Yes X No If yes, describe each episode.
MICROFIBERS INC.
RCRA HAZARDOUS WASTE RECEIVED BY TRUCK, RAIL, OR DEDICATED PIPELINE:
F.9. RCRA Waste. Does the treatment works receive or has it in the past three years received RCRA hazardous waste by truck, rail or dedicated pipe?
❑ Yes X No (go to FA2)
F.10. Waste transport Method by which RCRA waste is received (check all that apply):
❑ Truck ❑ Rail ❑ Dedicated Pipe
F.11. Waste Description. Give EPA hazardous waste number and amount (volume or mass, specify units).
EPA Hazardous Waste Number Amount Units
CERCLA (SUPERFUND) WASTEWATER, RCRA REMEDIATION/CORRECTIVE ACTION
WASTEWATER, AND OTHER REMEDIAL ACTIVITY WASTEWATER:
F.12. Remediation Waste. Does the treatment works currently (or has it been notified that it will) receive waste from remedial activities?
❑ Yes (complete F.13 through F.15.) X No
F.13. Waste Origin. Describe the site and type of facility at which the CERCLA/RCRA/or other remedial waste originates (or is excepted to origniate in
the next five years).
F.14. Pollutants. List the hazardous constituents that are received (or are expected to be received). Include data on volume and concentration, if
known. (Attach additional sheets if necessary.)
F.15. "Taste Treatment
aa. Is this waste treated (or will be treated) prior to entering the treatment works?
❑ Yes ❑ No
If yes, describe the treatment (provide information about the removal efficiency):
bb. Is the discharge (or will the discharge be) continuous or intermittent?
❑ Continuous ❑ Intermittent If intermittent, describe discharge schedule.
:END OF PART:F:,,'.
REFER TO;;THE APPLICATION'.QVE-RVfEW`(PAG;E 1) TO DETERMINE WHICH.OTHERPARTS
QF FORM 2A YOU:.MUSI'COMPLETE
NPDES FORM 2A Additional Information

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
All treatment works receiving discharges from significant industrial users or which receive RCRA,CERCLA, or other remedial wastes must
complete part F.
GENERAL INFORMATION:
F.1- Pretreatment program. Does the treatment works have, or is subject ot, an approved pretreatment program?
X Yes n No
F.2. Number of Significant Industrial Users (SlUs) and Categorical Industrial Users (ClUs). Provide the number of each of the following types of
industrial users that discharge to the treatment works.
dd. Number of ClUs. 11
SIGNIFICANT INDUSTRIAL USER INFORMATION:
Supply the following information for each SIU. If more than one SIU discharges to the treatment works, copy questions F.3 through F.8 and
provide the information requested for each SIU.
F.3. Significant Industrial User Information. Provide the name and address of each SIU discharging to the treatment works. Submit additional pages
as necessary.
Name: PEPSI BOTTLING
Mailing Address: 3425 MYER LEE DRIVE
WI NSTON-SALEM, NC 27101
FA. Industrial Processes. Describe all the industrial processes that affect or contribute to the SIU's discharge.
SOFT DRINK
F.S. Principal Product(s) and Raw Material(s). Describe all of the principal processes and raw materials that affect or contribute to the SIU's
Principal product(s): CARBONATED AND NON CARBONATED
Raw material(sj: WATER, NITROGEN, CITRIC ACID
F.6. Flow Rate.
cc. Process wastewater flow rate. Indicate the average daily volume of process wastewater discharge into the collection system in gallons per
day (gpd) and whether the discharge is continuous or intermittent.
dd. Non -process wastewater flow rate- Indicate the average daily volume of non -process wastewater flow discharged into the collection system
in gallons per day (gpd) and whether the discharge is continuous or intermittent.
F.7. Pretreatment Standards. Indicate whether the SILI is subject to the following:
a- Local limits X Yes 0 No
b. Categorical pretreatment standards f_1 Yes X No
If subject to categorical pretreatment standards, which category and subcategory?
NPDESFORM 2AAdditionuInformation

FACILITY NAME AN® PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIOTER BASIN:
ARCHIE ELLEDGE WWTP, NCO037834
RENEWAL
YADKIN
F.8. Problems at the Treatment Works Attributed to Waste Discharge by the SIU. Has the SIU caused or contributed to any problems (e.g.,
upsets, interference) at the treatment works in the past three years?
❑ Yes X No If yes, describe each episode.
PEPSI BOTTLING
RCRA HAZARDOUS WASTE RECEIVED BY TRUCK, RAIL, OR DEDICATED PIPELINE:
F.9. RCRA Waste. Does the treatment works receive or has it in the past three years received RCRA hazardous waste by truck, rail or dedicated pipe?
❑ Yes X No (go to FA 2)
F.10. Waste transport. Method by which RCRA.waste is received (check all that apply):
❑ Truck ❑ Rail ❑ Dedicated Pipe
FA 1. Waste Description. Give EPA hazardous waste number and amount (volume or mass, specify units).
EPA Hazardous Waste Number Amount Units
CERCLA (SUPERFUND) WASTEWATER, RCRA REMEDIATION/CORRECTIVE ACTION
WASTEWATER, AND OTHER REMEDIAL ACTIVITY WASTEWATER:
F.12. Remediation Waste. Does the treatment works currently (or has it been notified that it will) receive waste from remedial activities?
❑ Yes (complete F.13 through F.15.) X No
F.13. Waste Origin. Describe the site and type of facility at which the CERCLA/RCRAtor other remedial waste originates (or is excepted to origniate in.
the next five years).
F.14. Pollutants. List the hazardous constituents that are received (or are expected to be received). Include data on volume and concentration, if
known_ (Attach additional sheets if necessary.)
F.15. Waste Treatment
GC. Is this waste treated (or will be treated) prior to entering the treatment works?
❑ Yes ❑ No
If yes, describe the treatment (provide information about the removal efficiency):
dd. Is the discharge (or will the discharge be) continuous or intermittent?
❑ Continuous ❑ Intermittent If intermittent, describe discharge schedule.
END OF PART F
-REFER TO THE APPLICATIO,N`OVERVIEW (PAGE1) TO DETERMINE WHICH OTHER PARTS
OF FORM 2A YOU MUST:COMPLETE
NPDES FORM 2A Additional Information

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
It LA
All treatmentworks receiving discharges from significant industrial users orwhich receive RCRA,CERCLA, or other remedial wastes must
complete part F.
GENERAL INFORMATION:
F.I. Pretreatment program. Does the treatment works have, or is subject ot, an approved pretreatment program?
X Yes n No
F.2. Number of Significant Industrial Users (SlUs) and Categorical Industrial Users (ClUs). Provide the number of each of the following types of
industrial users that discharge to the treatment works.
ff. NumberofClUs.
SIGNIFICANT INDUSTRIAL USER INFORMATION:
Supply the following information for each SIU. If more than one SIU discharges to the treatment works, copy questions F.3 through F.8 and
provide the information requested for each SIU.
F.3. Significant Industrial User Information.- Provide the name and address of each SIU discharging to the treatment works. Submit additional pages
as necessary.
Name: PIEDMONT AVIATION
Mailing Address: 3817 N. LIBERTY STREET
FA. Industrial Processes. Describe all the industrial processes that affect or contribute to the SIU's discharge.
METAL FABRICATION
F.S. Principal Product(s) and Raw Material(s). Describe all ofthe principal processes and raw materials that affect or contribute to the SIU's
Principal product(s): AVIATION REPAIR
Raw material(s): CHROME. NICKEL, CAUSTICS
F.6. Flow Rate.
ee. Process wastewater flow rate. Indicate the average daily volume of process wastewater discharge into the collection system in gallons per
day (gpd) and whether the discharge is continuous or intermittent.
ff. Non -process wastewater flow rate. Indicate the average daily volume of non -process wastewater flow discharged into the collection system
in gallons per day (gpd) and whether the discharge is continuous or intermittent-
F.7. Pretreatment Standards. Indicate whether the SIU is subject to the following:
a- Local limits X Yes EI'No
b. Categorical pretreatment standards X Yes No
If subject to categorical pretreatment standards, which category and subcategory?
NPDESFORM 2AAdditional Infonnotiun

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
ARCHIE ELLEDGE WWI P, NCO037834
RENEWAL
YADKIN
F.8. Problems at the Treatment Works Attributed to Waste Discharge by the SIU. Has the SIU caused or contributed to any problems (e.g.,
upsets, interference) at the treatment works in the past three years?
❑ Yes X No If yes, describe each episode.
PIEDMONT AVIATION
RCRA HAZARDOUS WASTE RECEIVED BY TRUCK, RAIL, OR DEDICATED PIPELINE:
F.9. RCRA Waste. Does the treatment works receive or has it in the past three years received RCRA hazardous waste by truck, rail or dedicated pipe?
❑ Yes X No (go to F.12)
F.10. Waste transport Method by which RCRA waste is received (check all that apply):
❑ Truck ❑ Rail ❑ Dedicated Pipe
F.11. Waste Description. Give EPA hazardous waste number and amount (volume or mass, specify units).
EPA Hazardous Waste Number Amount Units
CERCLA (SUPERFUND) WASTEWATER, RCRA REMEDIATIONICORRECTIVE ACTION
WASTEWATER, ARID OTHER REMEDIAL ACTIVITY WASTEWATER:
F.12. Remediation Waste. Does the treatment works currently (or has it been notified that it will) receive waste from remedial activities?
❑ Yes (complete F.13 through F.15.) X No
F.13. Waste Origin. Describe the site and type of facility at which the CERCLA/RCRA/or other remedial waste originates (or is excepted to origniate in
the next five years).
FA4. Pollutants. List the hazardous constituents that are received (or are expected to be received). Include data on volume and concentration, if
known. (Attach additional sheets if necessary.)
F.15. 'Taste Treatment
ee_ Is this waste treated (or will be treated) prior to entering the treatment works?
❑ Yes ❑ No
If yes, describe the treatment (provide information about the removal efficiency):
ff_ Is the discharge (or will the discharge be) continuous or intermittent?
❑ Continuous ❑ Intermittent If intermittent, describe discharge schedule.
END:pF; RARTF
REFER: TO.�THE'APPLIPATION'OVERVIE:W (PAGE, ,1):TO DETERMINE -WHICH
WHICH_ OTHER PARTS
OF FORD 2A,Y0U 'MUST COMPLETE` .
NPDES FORM 2A Additional Information

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
ARCHIE ELLEDGE WWTP, NCO037834
RENEWAL
YADKIN
SUPPLEMENTAL PLIC-ATIO 'INFORMATION
FART IN IA USER,�DISCHARGES ��CkR A§TES
All treatment works receiving discharges from significant industrial users or which receive RCRA,CERCLA, or other remedial wastes must
complete part F.
GENERAL INFORMATION:
F.I. Pretreatment program. Does the treatment works have, or is subject ot, an approved pretreatment program?
X Yes 1­1 No
F.2. Number of Significant Industrial Users (SIUs) and Categorical Industrial Users (ClUs). Provide the number of each of the following types of
industrial users that discharge to the treatment works.
gg. Number of non -categorical SlUs. 21
hh. Number of ClUs. 11
SIGNIFICANT INDUSTRIAL USER INFORMATION:
Supply the following information for each SIU. If more than one SIU discharges to the treatment works, copy questions F.3 through F.8 and
provide the information requested for each SIU.
F.3. Significant Industrial User Information. Provide the name and address of each SIU discharging to the treatment works. Submit additional pages
as necessary.
Name: REXAM BEVERAGE CAN
Mailing Address: 4000 OLD MILWAUKEE LANE
WINSTON-SALEM, NC 27117
FA. Industrial Processes. -Describe all the industrial processes that affect or contribute to the SIU's discharge.
CAN MAKING
F.S. Principal Product(s) and Raw Material(s). Describe all of the principal processes and raw materials that affect or contribute to the SI U's
discharge.
Principal product(s): ALUMINUM BEVERAGE CAN
Raw material(s): ALUMINUM, INKS, ACIDS
F.S. Flow Rate.
gg. Process wastewater flow rate. Indicate the average daily volume of process wastewater discharge into the collection system in gallons per
day (gpd) and whether the discharge is continuous or intermittent.
120,000 gpd X continuous or intermittent)
hh. Non -process wastewater flow rate. Indicate the average daily volume of non -process wastewater flow discharged into the collection system
in gallons per day (gpd) and whether the discharge is continuous or intermittent.
180,000 _ gpd X continuous or intermittent)
F.7. Pretreatment Standards. Indicate whether the SIU is subject to the following:
a. Local limits X Yes El No
b. Categorical pretreatment standards X Yes No
If subject to categorical pretreatment standards, which category and subcategory?
465 SUB D
NPDES FORM 2A Additional Information

FACILITY NAME ARID PEROT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
ARCHIE ELLEDGE WWTP, NCO037834
RENEWAL
YADKIN
F.8. Problems at the Treatment Works Attributed to Waste Discharge by the SIU. Has the SIU caused or contributed to any problems (e.g.,
upsets, interference) at the treatment works in the past three years?
❑ Yes X No If yes, describe each episode.
REXAM BEVERAGE CAN
RCRA HAZARDOUS WASTE RECEIVED BY TRUCK(, RAIL, OR DEDICATED PIPELINE:
F.9. RCRA Waste. Does the treatment works receive or has it in the past three years received RCRA hazardous waste by truck, rail or dedicated pipe?
❑ Yes X No (go to FA 2)
F.10. Waste transport Method by which RCRA waste is received (check all that apply):
❑ Truck ❑ Rail ❑ Dedicated Pipe
FA1. Waste Description. Give EPA hazardous waste number and amount (volume or mass, specify units).
EPA Hazardous Waste Number Amount Units
CERCLA (SUPERFUND) WASTEWATER, RCRA REMEDIATIONICORRECTIVE ACTION
WASTEWATER, AND OTHER REMEDIAL ACTIVITY WASTEWATER:
F.12. Remediation Waste. Does the treatment works currently (or has it been notified that it will) receive waste from remedial activities?
❑ Yes (complete F_13 through F.15.) X No
F.13. Waste Origin. Describe the site and type of facility at which the CERCLA/RCRA/or other remedial waste originates (or is excepted to origniate in
the next five years).
F.14. Pollutants. List the hazardous constituents that are received (or are expected to be received). Include data on volume and concentration, if
known. (Attach additional sheets if necessary.)
F.15. Waste Treatment
gg. Is this waste treated (or will be treated) prior to entering the treatment works?
❑ Yes ❑ No
If yes, describe the treatment (provide information about the removal efficiency):
hh. Is the discharge (or will the discharge be) continuous or intermittent?
❑ Continuous ❑ Intermittent If intermittent, describe discharge schedule.
END.OF,PART f';.',`
`. -REFER:T.O THE."APPLI'CATION-OVERVIEW:(PAGE-,1) TO'DETERMINE WHICH -OTHER -PARTS ,
OF FORMA 2A YOU"'MUST .COMPLETE
NPDES FORM 2A Additional Information

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
ARCHIE ELLEDGE WVVTP, NCO037834
RENEWAL
YADKIN
INFORMAT10'N
ION �..WPPLEIVIEN,
APPLICATION
;PART ��EWDISP G ES�RCR ERdL`
All treatment works receiving discharges from significant industrial users or which receive RCRA,CERCLA, or other remedial wastes must
complete part F.
GENERAL INFORMATION:
F.1. Pretreatment program. Does the treatment works have, or is subject ot, an approved pretreatment program?
X Yes F1 No
F.2. Number of Significant Industrial Users (SlUs) and Categorical Industrial Users (ClUs). Provide the number of each of the following types of
industrial users that discharge to the treatment works-
iL Number of non -categorical SlUs. 21
Number of ClUs. 11
SIGNIFICANT INDUSTRIAL USER INFORMATION:
Supply the following information for each SIU. If more than one SIU discharges to the treatment works, copy questions F.3 through F.8 and
provide the information requested for each SIU.
F.3. Significant Industrial User Information. Provide the name and address of each SIU discharging to the treatment works.. Submit additional pages
as necessary_
Name: SLINOCO CORFLEX
Mailing Address: P.O. BOX 12669
WINSTON-SALEM, NC 27117
F.4. industrial Processes. Describe all the industrial processes that affect or contribute to the SILI's discharge.
CORRUGATED BOXES
F.S. Principal Product(s) and Raw Material(s). Describe all ofthe principal processes and raw materials that affect or contribute to the SIU's
discharge.
Principal product(s): DISPLAYS AND PACKAGING
Raw material(s): PAPER, STARCH, CAUSTIC
F.6. Flow Rate.
ii. Process wastewater flow rate. Indicate the average daily volume of process wastewater discharge into the collection system in gallons per
day (gpd) and whether the discharge is continuous or intermittent
20,000 gpd X continuous or intermittent)
Non -process wastewater flow rate. Indicate the average daily volume of non -process wastewater flow discharged into the collection system
in gallons per day (gpd) and whether the discharge is continuous or intermittent.
3,000 gpd X continuous or intermittent)
F.7. Pretreatment Standards. Indicate whether the SIU is subject to the following:
a. Local limits X Yes F1 No
b.' Categorical pretreatment standards F1 Yes X No
If subject to categorical pretreatment standards, which category -and subcategory?
NPDES FORM 2A Additional Information

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
ARCHIE ELLEDGE WWTP, NCO037834
RENEWAL
YADKIN
F.9. Problems at the Treatment Works Attributed to Waste Discharge by the SIU. Has the SIU caused or contributed to any problems (e.g.,
upsets, interference) at the treatment works in the past three years?
❑ Yes X No If yes, describe each episode.
SUNOCO CORFLEX
RCRA HAZARDOUS WASTE DECEIVED BY TRUCK, RAIL, OR DEDICATED PIPELINE:
F.9. RCRA Waste. Does the treatment works receive or has it in the past three years received RCRA hazardous waste by truck, rail or dedicated pipe?
❑ Yes X No (go to F.12)
F.10. Waste transport Method by which RCRA waste is received (check all that apply):
❑ Truck ❑ Rail ❑ Dedicated Pipe
F.11. Waste Description. Give EPA hazardous waste number and amount (volume or mass, specify units)_
EPA Hazardous Waste Number Amount Units
CERCLA (SUPERFUND) WASTEWATER, RCRA REMEDIATION/CORRECTIVE ACTION
WASTEWATER, AND OTHER REMEDIAL ACTIVITY WASTEWATER:
F.12. Remediation Waste. Does the treatment works currently (or has it been notified that it will) receive waste from remedial activities?
❑ Yes (complete F.13 through F.15.) X No
F.13. Waste Origin. Describe the site and type of facility at which the CERCLA/RCRA/or other remedial waste originates (or is excepted to origniate in
the next five years).
F.14. Pollutants. List the hazardous constituents that are received (or are expected to be received). Include data on volume and concentration, if
known. (Attach additional sheets if necessary.)
F.15. Waste Treatment.
ii. Is this waste treated (or will be treated) prior to entering the treatment works?
❑ Yes ❑ No
If yes, describe the treatment (provide information about the removal efficiency):
ll. Is the discharge (or will the discharge be) continuous or intermittent?
❑ Continuous ❑ Intermittent If intermittent, describe discharge schedule.
- END
REFER TO THSAPPLI�ATION OVERVIEW (PAGE L) TO DETERMINE WHIEH :OTHER PARTS
OF FORM 2A~YOU MUST COMPLETE
NPDES FORM 2A Additional Information

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
ARCHIE ELLEDGE WVVTP, NCO037834
RENEWAL
YADKIN
SUPPLEMENTAL APPLICATION INFQRMATION
FART F INDUSTRIAL USER DISCHARGES AND RCRA/CERCLA WASTES
All treatment works receiving discharges from significant industrial users or which receive RCRA,CERCLA, or other remedial wastes must
complete part F.
GENERAL INFORMATION:
F.1. Pretreatment program. Does the treatment works have, or is subject ot, an approved pretreatment program?
® Yes ❑ No
F.2. Number of Significant Industrial Users (SIUs) and Categorical Industrial Users (CIUs). Provide the number of each of the following types of
industrial users that discharge to the treatment works.
kk. Number of non -categorical SIUs. 21
II_ Number of CIUs. 11
SIGNIFICANT INDUSTRIAL USER INFORhflATION:
Supply the following information for each SIU. If more than one SIU discharges to the treatment works, copy questions F.3 through F.8 and
provide the information requested for each SIU.
F.3. Significant Industrial User Information. Provide the name and address of each SIU discharging to the treatment works. Submit additional pages
as necessary.
Name: STRATFORD METAL FINISHING
Mailing Address: 807 SOUTH STRATFORD ROAD
WINSTON-SALEM NC 27101
FA. Industrial Processes. Describe all the industrial processes that affect or contribute to the SIU's discharge.
METAL FINISHING
F.S. Principal Product(s) and Raw Material(s). Describe all of the principal processes and raw materials that affect or contribute to the SIU's
discharge.
Principal product(s): FURNITURE HARDWARE
Raw material(s): NICKEL CADMIUM ZINC
F.S. Flow Rate.
kk. Process wastewater flow rate. Indicate the average daily volume of process wastewater discharge into the collection system in gallons per
day (gpd) and whether the discharge is continuous or intermittent.
5,000 gpd ( continuous or X intermittent)
II. Non -process wastewater flow rate. Indicate the average daily volume of non -process wastewater flow discharged into the collection system
in gallons per day (gpd) and whether the discharge is continuous or intermittent:
500 gpd ( continuous or X intermittent)
F.7. Pretreatment Standards. Indicate whether the SIU is subject to the following:
a. Local limits X Yes ❑ No
b_ Categorical pretreatment standards X Yes No
If subject to categorical pretreatment standards, which category and subcategory?
433 SUB A
NPDES FORM 2A Additional Information

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
ARCHIE ELLEDGE WW i P, NCO037834
RENEWAL
YADKIN
F.8. Problems at the Treatment Works Attributed to Waste Discharge by the SIU. Has the SIU caused or.contributed to any problems (e.g.,
upsets, interference) at the treatment works in the past three years?
❑ Yes X No If yes, describe each episode.
STRATFORD METAL FINISHING
RCRA HAZARDOUS WASTE RECEIVED BY TRUCK, RAIL, OR DEDICATED PIPELINE:
F.9. RCRA Waste. Does the treatment works receive or has it in the past three years received RCRA hazardous waste by truck, rail or dedicated pipe?
❑ Yes X No (go to F.12)
F.10. Waste transport Method by which RCRA waste is received (check all that apply):
❑ Truck ❑ Rail ❑ Dedicated Pipe
F.11. Waste Description. Give EPA hazardous waste number and amount (volume or mass, specify units).
EPA Hazardous Waste Number Amount Units
CERCLA (SUPERFUND) WASTEWATER, RCRA REAEDIATIONICORRECTIVE ACTION
WASTEWATER, AND OTHER REMEDIAL ACTIVITY WASTEWATER:
F.12. Remediation Waste. Does the treatment works currently (or has it been notified that it will) receive waste from remedial activities?
❑ Yes (complete F.13 through F.15.) X No
F.13. Waste Origin. Describe the site and type of facility at which the CERCLA/RCRA/or other remedial waste originates (or is excepted to origniate in
the next five years).
F.14. Pollutants. List the hazardous constituents that are received (or are expected to be received). Include data on volume and concentration, if
known. (Attach additional sheets if necessary.)
F.15. Waste Treatment_
kk. Is this waste treated (or will be treated) prior to entering the treatment works?
❑ Yes ❑ No
If yes, describe the treatment (provide information about the removal efficiency):
11. Is the discharge (or will the discharge be) continuous or intermittent?
❑ Continuous ❑ Intermittent If intermittent, describe discharge schedule.
_,.._.. END OF:PARTF:
.REFER TO THE APPLICATION, OVERVIEW, :(PAGEllTO:DETERMINE WHICH. OTHER. PARTS
OF FORM 2A YOU MUST ;COML?LETE `
NPDES FOR1ii 2A Additional Information

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
ARCHIE ELLEDGE WV\ITP, NCO037834•
RENEWAL
YADKIN
'SUPPLEMENTAL APPLICATION INFORMATION
PART F INDUSTRIAL USER ND`RGRAICERCLA WASTES
All treatment works receiving discharges from significant industrial users or which receive RCRACERCLA, or other remedial wastes must
complete part F.
GENERAL INFORMATION:
F.I. Pretreatment program. Does the treatment works have, or is subject ot, an approved pretreatment program?
X Yes ❑ No
F.2. Number of Significant Industrial Users (SlUs) and Categorical Industrial Users (ClUs). Provide the number of each of the following types of
industrial users that discharge to the treatment works.
mm. Number of non -categorical SlUs. 21
nn. Number ofClUs. 11
SIGNIFICANT INDUSTRIAL USER INFORMATION:
Supply the following information for each SIU. If more than one SIU discharges to the treatment works, copy questions F.3 through F.8 and
provide the information requested for each SIU.
F.3. Significant Industrial User Information. Provide the name and address of each SIU discharging to the treatment works. Submit additional pages
as necessary.
Name: TYCO ELECTRONICS
Mailing Address: 3900 REIDSVILLE ROAD
WI NSTON-SALEM, NC 27101
F.4. Industrial Processes. Describe all the industrial processes that affect or contribute to the SIU's discharge.
METAL FABRICATION
F.S. Principal Product(s) and Raw Material(s). Describe all of the principal processes and raw materials that affect or contribute to the SILI's
discharge.
Principal product(s): ELECTRICAL CONNECTORS
Raw material(s): COPPER, NICKEL, TIN
F.6. Flow Rate.
mm. Process wastewater flow rate. Indicate the average daily volume of process wastewater discharge into the collection system in gallons per
day (gpd) and whether the discharge is continuous or intermittent.
15,000 gpd X continuous or intermittent)
nn. Non -process wastewater flow rate- Indicate the average daily volume of non -process wastewater flow discharged into the collection system
in gallons per day (gpd) and whether the discharge is continuous or intermittent.
3,000 gpd X continuous or intermittent)
F.7. Pretreatment Standards. Indicate whether the SIU is subject to the following:
a. Local limits X Yes ❑ No
b. Categorical pretreatment standards X Yes No
If subject to categorical pretreatment standards, which category and subcategory?
433 SUB A
NPDES FORM 2A Additional Information.

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
ARCHIE ELLEDGE WWTP, NCO037834
RENEWAL
YADKIN
F.8. Problems at the Treatment Works Attributed to Waste Discharge by the SIU. Has the SIU caused or contributed to any problems (e.g.,
upsets, interference) at the treatment works in the past three years?
❑ Yes X No If yes, describe each episode.
TYCO ELECTRONICS
RCRA HAZARDOUS WASTE RECEIVED BY TRUCK, RAIL, OR DEDICATED PIPELINE:
F.9. RCRA Waste. Does the treatment works receive or has it in the past three years received RCRA hazardous waste by truck, rail or dedicated pipe?
❑ Yes X No (go to F.12)
F.10. Waste transporL Method by which RCRA waste is received (check all that apply):
❑ Truck ❑ Rail ❑ Dedicated Pipe
F.11. Waste Description. Give EPA hazardous waste number and amount (volume or mass, specify units).
EPA Hazardous Waste Number Amount Units
CERCLA (SUPERFUND) WASTEWATER, RCRA REMEDIATION/CORRECTIVE ACTION
WASTEWATER, AND OTHER REMEDIAL ACTIVITY WASTEWATER:
F.12. Remediation Waste. Does the treatment works currently (or has it been notified that it will) receive waste from remedial activities?
❑ Yes (complete F.13 through F.15.) X No
i .13. Waste Origin. Describe the site and type of facility at which the CERCLA/RCRA/or other remedial waste originates (or is excepted to origniate in
the next five years).
F.14. Pollutants. List the hazardous constituents that are received (or are expected to be received). Include data on volume and concentration, if
known. (Attach additional sheets if necessary.)
FA S. Waste Treatment
mm. Is this waste treated (or will be treated) prior to entering the treatment works?
❑ Yes ❑ No
If yes, describe the treatment (provide information about the removal efficiency):
nn_ Is the discharge (or will the discharge be) continuous or intermittent?
❑ Continuous ❑ Intermittent If intermittent, describe discharge schedule.
ENDOF� PART F:
REFER TO THE APPLICATIQN. OVERVIEW"(PAGE=1)-TO-DETERMINE ,WHICH OTHER -;PARTS" -
.OF: FORM.'2A YOU :MUST COMPLETE .,
NPDES FORM 2A Additional Information

FACILITY NAME AND -PERMIT NUMBER:
PERMIt ACTION REQUESTED-
RIVER BASIN:
ARCHIE ELLEDGE WWTP, NCO037834
RENEWAL
YADKIN
AlLiOW INFORMATION AL�-_APPLIC
DISCHARGES DR
All treatment works receiving discharges from significant industrial users or which receive RCRA,CERCLA, or other remedial Wastes must
complete part F.
GENERAL INFORMATION:
F.I. Pretreatment program. Does the treatment works have, or is subject ot, an approved pretreatment program?
X Yes n No
F.2. Number of Significant Industrial Users (SIUs) and Categorical Industrial Users (ClUs). Provide the number of each of the following types of
industrial users that discharge to the treatment works.
00. Number of non -categorical SlUs. 21
pp. Number of ClUs. 11
SIGNIFICANT INDUSTRIAL USER INFORMATION:
Supply the following information for each SIU. If more than one SIU discharges to the treatment works, copy questions F.3 through F.8 and
provide the information requested for each SIU.
F.3. Significant Industrial User Information. Provide the name and address of each SIU discharging to the treatment works. Submit additional pages
as necessary.
Name: UNIFIRST CORP.
Mailing Address: P.O. BOX 684
KERNERSVILLE, NC 27285
FA. Industrial Processes. Describe all the industrial processes that affect or contribute to the SIU's discharge.
INDUSTRIAL LAUNDRY
F.S. Principal Product(s) and Raw Material(s). Describe all of the principal processes and raw materials that affect or contribute to the SIU's
discharge.
Principal product(s): UNIFORMS, SHOP TOWELS
Raw material(s): DETERGENTS, DEGREASER, CAUSTIC
F.S. Flow Rate.
oo. Process wastewater flow rate. Indicate the average daily volume of process wastewater discharge into the collection system in gallons per
day (gpd) and whether the discharge is continuous or intermittent.
20,000 gpd X continuous or intermittent)
pp. Non -process wastewater flow rate. Indicate the average daily volume of non -process wastewater flow discharged into the collection system
in gallons per day (gpd) and whether the discharge is continuous or intermittent.
10,000 gpd X continuous or intermittent)
F.7. Pretreatment Standards. Indicate whether the SIU is subject to the following:
a. Local limits X Yes El No
b. Categorical pretreatment standards El Yes X No
If subject to categorical pretreatment standards, which category and subcategory?
NPDES FORM 2A Additional Information

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
ARCHIE ELLEDGE VWVFP, NCO037834
RENEWAL
YADKIN
F.8. Problems at the Treatment Works Attributed to Waste Discharge by the SIU. Has the SIU caused or contributed to any problems (e.g.,
upsets, interference) at the treatment works in the past three years?
❑ Yes X No If yes, describe each episode.
UNIFIRST CORP.
RCRA HAZARDOUS WASTE RECEIVED BY TRUCK, RAIL, OR DEDICATED PIPELINE:
F.9. RCRA Waste. Does the treatment works receive or has it in the past three years received RCRA hazardous waste by truck, rail or dedicated pipe?
❑ Yes X No (go to F-12)
F.10. Waste transport Method by which RCRA waste is received (check all that apply):
❑ Truck ❑ Rail ❑ Dedicated Pipe
F.11. Waste Description. Give EPA hazardous waste number and amount (volume or mass, specify units).
EPA Hazardous Waste Number Amount Units
CERCLA (SUPERFUND) WASTEWATER, RCRA REMEDIATIONOCORRECTIVE ACTION
WASTEWATER, AND OTHER REMEDIAL ACTIVITY WASTEWATER:
F.12. Remediation Waste. Does the treatment works currently (or has it been noted that it will) receive waste from remedial activities?
❑ Yes (complete F.13 through F.15.) X No
F.13. Waste Origin. Describe the site and type of facility at which the CERCLA/RCRA/or other remedial waste originates (or is excepted to origniate in
the next five years).
F.14. Pollutants. List the hazardous constituents that are received (or are expected to be received). Include data on volume and concentration, if
known (Attach additional sheets if necessary.)
FAA. Waste Treatment
oo. Is this waste treated (or will be treated) prior to entering the treatment works?
❑ Yes ❑ No
If yes, describe the treatment (provide information about the removal efficiency):
pp. Is the discharge (or will the discharge be) continuous or intermittent?
❑ Continuous ❑ Intermittent If intermittent, describe discharge schedule.
END OF PART F
REFER TO'xTHE APPLICATION OVERVIEW (PAGE ,1) TO DETERMINE WHICH OTHER PARTS
OF FORM 2A:YOU MUST COMPLETE .
iVPDES FORM 2A Additional Information

'FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
ARCHIE ELLEDGE WWTP-, NCO037834
RENEWAL
YADKIN
SUPPLEMENTAL APPLICATION !,14FORMATIO
c.
PART KINDUSTRIAL USER DISFHARGE&ANDRCRAfCERCLA'WASTES
All treatment works receiving discharges from significant industrial users or which receive -RCRACERCLA, or other remedial wastes must
complete part F.
GENERAL INFORMATION:
F.I. Pretreatment program.* Does the treatment works have, or is subject ot, an approved pretreatment program?
Yes F1 No
F.2. Number of Significant Industrial Users (SlUs) and Categorical Industrial Users (ClUs). Provide the number of each of the following types of
industrial users that discharge to the treatment works.
qq. Number of non -categorical SlUs. 21
rr. Number of ClUs. 11
SIGNIFICANT INDUSTRIAL USER INFORMATION:
Supply the following information for each SIU. Of more than one SIU discharges to the treatment works, copy questions F.3 through F.8 and
provide the information requested for each SIU.
F.3. Significant Industrial User Information. Provide the name and address of each SIU discharging to the treatment works. Submit additional pages
as necessary.
Name: UNIFIRST CORP.
Mailing Address: P.O. BOX 684
KERNERSVILLE, NC 27285
FA. Industrial Processes. Describe all the industrial processes that affect or contribute to the SIU's discharge-
-INDUSTRIAL LAUNDRY
F.5. Principal Product(s) and Raw Material(s). Describe all of the principal processes and raw materials that affect or contribute to the SILI's
discharge.
Principal produGt(s): UNIFORMS, SHOP TOWELS
Raw material(s): DETERGENTS, DEGREASER, CAUSTIC
F.6. Flow Rate.
qq. Process wastewater flow rate. Indicate the average daily volume of process wastewater discharge into the collection system in gallons per
day (gpd) and whether the discharge is continuous or intermittent.
20,000 gpd continuous or intermittent)
Fr. Non -process wastewater flow rate. Indicate the average daily volume of non -process wastewater flow discharged into the collection system
in gallons per day (gpd) and whether the discharge is continuous or intermittent.
10,000 gpd X continuous or intermittent)
F.7. Pretreatment Standards. Indicate whether the SIU is subject to the following:
a. Local limits IR Yes F] No
b. Categorical pretreatment standards ❑ Yes E No
If subject to categorical pretreatment standards, which category and subcategory?
NPDES FORM 2A Additional Information

FACILITY NAME AND PERMIT NUMBER-
PERMIT ACTION REQUESTEb:
RIVER BASIN:
ARCHIE ELLEDGE WWTP, NCO037834
RENEWAL
'YADKIN
SUPPLEMENTAL APPLICATION'1NFORMATfON
PART G COMBINED E*O*SYST
If the treatment works has a combined sewer system, complete Part G.
G.I. System Map. Provide a map indicating the following: (may be included with Basic Application Information)
a- All CSO discharge points_
b. Sensitive use areas potentially affected by CSOs (e-g., beaches, drinking water supplies, shellfish beds, sensitive aquatic ecosystems, and
outstanding natural resource waters).
G. Waters that support threatened and endangered species potentially affected by CSOs.
G.2. System Diagram. Provide a diagram, either in the map provided in G. 1 or on a separate drawing, of the combined sewer collection system that
includes the following information.
a- Location of major sewer trunk lines, both combined and separate sanitary.
b- Locations of points where separate sanitary sewers feed into the combined sewer system.
G. Locations of in -line and off -fine storage structures.
d- Locations of flow -regulating devices.
e. Locations of pump stations.
CSO OUTFALLS:
Complete questions G.3 through GA once for each CSO discharge point
G.3. Description of Outfall.
a- Oulfall number
b. Location
(City or town, if applicable) (Zip Code)
(County) (State)
(Latitude) (Longitude)
C. Distance from shore (if applicable)
d. Depth below surface (if applicable)
e. Which of the following were monitored during the last year for this CSO?
❑ Rainfall ❑ CSO pollutant concentrations ❑ CSO frequency
❑ CSO flow volume ❑ Receiving water quality
f. How many storm events were monitored during the last year?
GA. CSO Events.
a. Give the number of CSO events in the last year.
events (❑ actual or ❑ approx.)
b. Give the average duration per CSO event.
hours (❑ actual or ❑ approx.)

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
C. Give the average volume per CSO event. _
million gallons (El actual or ❑ approx.)
d. Give the minimum rainfall that caused a CSO event in the last year
Inches of rainfall
G.S. Description of Receiving Waters.
a. Name of receiving water.
b. Name of watershed/river/stream system:
United State Soil Conservation Service 14-digit watershed code (if known):
C. Name of State Management/River Basin:
United States Geological Survey 8-digit hydrologic cataloging unit code (if known):
G.6. CSO Operations.
Describe any known water quality impacts on the receiving water caused by this CSO (e.g., permanent or intermittent beach closings, permanent or
intermittent shell fish bed closings, fish kills, fish advisories, other recreational loss, or violation of any applicable State water quality standard).
END OF PART G
REFER TO THE APPLICATION OVERVIEW (PAGE 1) TO DETERMINE WHICH OTHER PARTS;
OF FORM 2A'YOU1MUST COMP.LETE.=
x