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HomeMy WebLinkAboutNC0021946_Renewal (Application)_20201008 SfA sJ . ' a 00• " r ifig r 3 r y ROY COOPER - " Governor MICHAEL S. REGAN -' Secretary S. DANIEL SMITH NORTH CAROLINA Director Environmental Quality October 08, 2020 Town of Rosman Attn: Brian Shelton, Mayor PO Box 636 Rosman, NC 28772 Subject: Permit Renewal Application No. NC0021946 Rosman WWTP Transylvania County Dear Applicant: The Water Quality Permitting Section acknowledges the October 5, 2020 receipt of your permit renewal application and supporting documentation. Your application will be assigned to a permit writer within the Section's NPDES WW permitting branch. Per G.S. 150E-3 your current permit does not expire until permit decision on the application is made. Continuation of the current permit is contingent on timely and sufficient application for renewal of the current permit. The permit writer will contact you if additional information is required to complete your permit renewal. Please respond in a timely manner to requests for additional information necessary to allow a complete review of the application and renewal of the permit. Information regarding the status of your renewal application can be found online using the Department of Environmental Quality's Environmental Application Tracker at: https://deq.nc.gov/permits-regulations/permit-guidance/environmental-application-tracker If you have any additional questions about the permit, please contact the primary reviewer of the application using the links available within the Application Tracker. Sincerely, ren Thedford Administrative Assistant Water Quality Permitting Section ec: WQPS Laserfiche File w/application �� North is ro r Deps rtrrent of Envuonmenta'Qua ty I Dyson of W ter Fes:q roes D_E C�, Ash=v ?Raganai DfRoe 12094 U.S.7D►f gtr ay I Spar c anoe,North Ce ro rs i&??a M fYl1 4--- \V/ 828a96-45D:3 TOWN OF ROSMAN MAYOR POST OFFICE BOX 636 ALDERMEN Brian Shelton ROSMAN, NC 28772 Jared Crowe ATTORNEY 828-884-6859 Mark Miller Donald Barton rosmantown@comporium.net Larry Bullock TOWN CLERK Tricia Hendricks Angela Woodson Deedra Shelton September 30, 2020 RECEIVED 0C1 0 5 2020 Ms. Wren Thedford NCDENR/DWR/NPDES Unit NCDSQ/DWR/NPDSS 1617 Mail Service Center Raleigh,NC 27699-1617 Re: Permit Renewal Application—NC0021946 Dear Ms. Thedford, Enclosed,please find the permit renewal application for the Town of Rosman. There have been no changes to the facility since the issuance of our last permit. Therefore I, on behalf of the town, am requesting the renewal of said permit. Furthermore,the town does not have a sludge management plan, all sludge processed is taken to the Transylvania County landfill site for disposal. Sincerely, TOWN OF ROSMAN Brian Shelton Mayor/Town Administrator • EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19 NC0021946 TOWN OF ROSMAN OMB No.2040-0004 Form U.S.Environmental Protection Agency 2A 8 EPA Application for NPDES Permit to Discharge Wastewater NPDES NEW AND EXISTING PUBLICLY OWNED TREATMENT WORKS SECTION 1.BASIC APPLICATION INFORMATION FOR ALL APPLICANTS(40 CFR 122.21(j)(1)and(9)) 1.1 Facility name TOWN OF ROSMAN Mailing address(street or P.O.box) POST OFFICE BOX 636 City or town State ZIP code o ROSMAN NC 28772 Contact name(first and last) Title Phone number Email address c BRIAN SHELTON MAYOR (828)577-1654 rosmantowncomporium.net Location address(street,route number,or other specific identifier) ❑ Same as mailing address 6 MAIN STREET w City or town State ZIP code ROSMAN NC 28772 1.2 Is this application for a facility that has yet to commence discharge? ❑ Yes 4 See instructions on data submission ❑✓ No requirements for new dischargers. 1.3 Is applicant different from entity listed under Item 1.1 above? ❑ Yes ❑✓ No 4 SKIP to Item 1.4. Applicant name Applicant address(street or P.O.box) 0 City or town State ZIP code c Contact name(first and last) Title Phone number Email address .a n. a 1.4 Is the applicant the facility's owner,operator,or both?(Check only one response.) ❑✓ Owner ❑ Operator ❑ Both 1.5 To which entity should the NPDES permitting authority send correspondence?(Check only one response.) El Facility El Applicant ❑ Facility and applicant (they are one and the same) 1.6 Indicate below any existing environmental permits.(Check all that apply and print or type the corresponding permit number for each.) Existing Environmental Permits ✓❑ NPDES(discharges to surface ❑ RCRA(hazardous waste) ❑ UIC(underground injection water) control) FRENCH BROAD 2 ❑ PSD(air emissions) ❑ Nonattainment program(CAA) 0 NESHAPs(CM) cn ❑ Ocean dumping(MPRSA) ❑ Dredge or fill(CWA Section ❑ Other(specify) 404) EPA Form 3510-2A(Revised 3-19) Page 1 EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19 NC0021946 TOWN OF ROSMAN OMB No.2040-0004 1.7 Provide the collection system information requested below for the treatment works. Municipality Population Collection System Type Served Served (indicate percentage) Ownership Status 75 %separate sanitary sewer 0 Own 0 Maintain ROSMAN 780 %combined storm and sanitary sewer 0 Own 0 Maintain d 0 Unknown 0 Own 0 Maintain Cl) %separate sanitary sewer ❑ Own 0 Maintain %combined storm and sanitary sewer 0 Own 0 Maintain 0 Unknown 0 Own 0 Maintain a %separate sanitary sewer El 0 Maintain _ %combined storm and sanitary sewer 0 Own 0 Maintain t6 0 Unknown 0 Own 0 Maintain E %separate sanitary sewer ❑ Own 0 Maintain %combined storm and sanitary sewer 0 Own 0 Maintain cn c 0 Unknown 0 Own 0 Maintain c Total Population 780 c� Served Separate Sanitary Sewer System Combined Storm and Sanitary Sewer Total percentage of each type of ° ° sewer line(in miles) no /0 o �0 z' 1.8 Is the treatment works located in Indian Country? c o 0 Yes ❑✓ No U c 1.9 Does the facility discharge to a receiving water that flows through Indian Country? c ❑ Yes ❑✓ No 1.10 Provide design and actual flow rates in the designated spaces. Design Flow Rate .250 mgd = Annual Average Flow Rates(Actual) T.; Two Years Ago Last Year This Year ca Ta ce c RI c o .1154 mgd .1029 mgd .101 mgd 7•" Maximum Daily Flow Rates(Actual) rm Two Years Ago Last Year This Year .230 mgd .156 mgd .277 mgd 1 N 1.11 Provide the total number of effluent discharge points to waters of the United States by type. c Total Number of Effluent Discharge Points by Type o a Constructed P.'1— Treated Effluent Untreated Effluent Combined Sewer Bypasses Emergency s .o Overflows Overflows U H b 1 EPA Form 3510-2A(Revised 3-19) Page 2 EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19 NC0021946 TOWN OF ROSMAN OMB No.2040-0004 Outfalls Other Than to Waters of the United States 1.12 Does the POTW discharge wastewater to basins,ponds,or other surface impoundments that do not have outlets for discharge to waters of the United States? ❑ Yes ❑✓ No 4 SKIP to Item 1.14. 1.13 Provide the location of each surface impoundment and associated discharge information in the table below. Surface Impoundment Location and Discharge Data Average Daily Volume Continuous or Intermittent Location Discharged to Surface (check one) Impoundment ❑ Continuous gpd ❑ Intermittent ❑ Continuous gpd 0 Intermittent ❑ Continuous gpd 0 Intermittent .2 1.14 Is wastewater applied to land? ❑ Yes ❑✓ No 4 SKIP to Item 1.16. c 1.15 Provide the land application site and discharge data requested below. Land Application Site and Discharge Data Continuous or Location Size Average Daily Volume Intermittent Applied (check one) acresgpd 0 Continuous y ❑ Intermittent d 0 Continuous acres L g13 0 Intermittent -0 0 Continuous R acres gpd 0 Intermittent Ti 1.16 Is effluent transported to another facility for treatment prior to discharge? ❑ Yes m No 4 SKIP to Item 1.21. 0 1.17 Describe the means by which the effluent is transported(e.g.,tank truck,pipe). 1.18 Is the effluent transported by a party other than the applicant? ❑ Yes ❑ No 4 SKIP to Item 1.20. 1.19 Provide information on the transporter below. Transporter Data Entity name Mailing address(street or P.O.box) City or town State ZIP code Contact name(first and last) Title Phone number Email address EPA Form 3510-2A(Revised 3-19) Page 3 EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19 NC0021946 TOWN OF ROSMAN OMB No.2040-0004 1.20 In the table below,indicate the name,address,contact information, NPDES number,and average daily flow rate of the receiving facility. Receiving Facility Data n Facility name Mailing address(street or P.O.box) °D TOWN OF ROSMAN POST OFFICE BOX 636 City or town State ZIP code o ROSMAN NC 28772 Contact name(first and last) Title o BRIAN SHELTON MAYOR d Phone number Email address (828)577-1654 rosmantown@comporium.net aNPDES number of receiving facility(if any) ❑ None Average daily flow rate 101 mgd 0 1.21 Is the wastewater disposed of in a manner other than those already mentioned in Items 1.14 through 1.21 that do not have outlets to waters of the United States(e.g.,underground percolation,underground injection)? T. ❑ Yes ❑✓ No 4 SKIP to Item 1.23. 0 1.22 Provide information in the table below on these other disposal methods. Information on Other Disposal Methods o Disposal Location of Size of Annual Average Continuous or Intermittent = Method Disposal Site Disposal Site Daily Discharge (check one) 03 Description Volume acres gpd ❑ Continuous 0 Intermittent 0 Continuous acres gpd ❑ Intermittent acres gpd 0 Continuous ❑ Intermittent 1.23 Do you intend to request or renew one or more of the variances authorized at 40 CFR 122.21(n)?(Check all that apply. w Consult with your NPDES permitting authority to determine what information needs to be submitted and when.) ❑ Discharges into marine waters(CWA ❑ Water quality related effluent limitation(CWA Section ca Section 301(h)) 302(b)(2)) ❑✓ Not applicable 1.24 Are any operational or maintenance aspects(related to wastewater treatment and effluent quality)of the treatment works the responsibility of a contractor? ❑ Yes 0 No+SKIP to Section 2. 1.25 Provide location and contact information for each contractor in addition to a description of the contractor's operational and maintenance responsibilities. Contractor Information Contractor 1 Contractor 2 Contractor 3 o Contractor name (company name) Mailing address (street or P.O. box) City,state,and ZIP code Contact name(first and O last) Phone number Email address Operational and maintenance responsibilities of contractor EPA Form 3510-2A(Revised 3-19) Page 4 r EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19 NC0021946 TOWN OF ROSMAN OMB No.2040-0004 SECTION 2.ADDITIONAL INFORMATION(40 CFR 122.21(j)(1)and(2)) c Outfalls to Waters of the United States 2.1 Does the treatment works have a design flow greater than or equal to 0.1 mgd? as ❑✓ Yes ❑ No 4 SKIP to Section 3. c 2.2 Provide the treatment works'current average daily volume of inflow Average Daily Volume of Inflow and Infiltration and infiltration. 5,000 gpd Indicate the steps the facility is taking to minimize inflow and infiltration. as CORRECT ISSUES AS NEEDED 0 2.3 Have you attached a topographic map to this application that contains all the required information?(See instructions for I a specific requirements.) om a. ❑✓ Yes ❑ No E 2.4 Have you attached a process flow diagram or schematic to this application that contains all the required information? 13 (See instructions for specific requirements.) 0 a, " ❑ Yes ❑✓ No 2.5 Are improvements to the facility scheduled? ❑ Yes ❑ No 4 SKIP to Section 3. Briefly list and describe the scheduled improvements. 0 is 1. d E a, 2. E 0 0 3. a d co 4. -o 2.6 Provide scheduled or actual dates of completion for improvements. Scheduled or Actual Dates of Completion for Improvements Affected Attainment of Scheduled Begin End Begin Outfalls Operational Improvement Construction Construction Discharge a. (from above) (list outtall (MM/DD/YYYY) (MM/DD/YYYY) (MM/DD/YYYY) Level number) (MM/DD/YYYY) 1. 1. d 2. 3. 4. 2.7 Have appropriate permits/clearances concerning other federal/state requirements been obtained?Briefly explain your response. ❑ Yes ❑ No ❑ None required or applicable Explanation: EPA Form 3510-2A(Revised 3-19) Page 5 EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19 NC0021946 TOWN OF ROSMAN OMB No.2040-0004 SECTION 3.INFORMATION ON EFFLUENT DISCHARGES(40 CFR 122.21(j)(3)to(5)) 3.1 Provide the following information for each outfall.(Attach additional sheets if you have more than three outfalls.) Outfall Number o01 Outfall Number Outfall Number State NORTH CAROLINA 1 County TRANSYLVANIA 0 City or town ROSMAN Distance from shore 50 ft. ft. ft. Depth below surface o ft. ft. ft. 0 Average dailyflow rate .101 mgd mgd mgd 9 9 Latitude 35° 08' 10" N ° 0 " Longitude 82° 49' 15" W 3.2 Do any of the outfalls described under Item 3.1 have seasonal or periodic discharges? Fa ❑ Yes ✓❑ No 4 SKIP to Item 3.4. 3.3 If so,provide the following information for each applicable outfall. y Outfall Number Outfall Number Outfall Number Number of times per year 0 discharge occurs a Average duration of each discharge(specify units) c Average flow of each mgd mgd mgd discharge Months in which discharge occurs 3.4 Are any of the outfalls listed under Item 3.1 equipped with a diffuser? ❑ Yes ❑✓ No 4 SKIP to Item 3.6. 3.5 Briefly describe the diffuser type at each applicable outfall. Q Outfall Number Outfall Number Outfall Number c vi 3.6 Does the treatment works discharge or plan to discharge wastewater to waters of the United States from one or more discharge points? 3 ❑ Yes ❑✓ No+SKIP to Section 6. EPA Form 3510-2A(Revised 3-19) Page 6 EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19 NC0021946 TOWN OF ROSMAN OMB No.2040-0004 3.7 Provide the receiving water and related information(if known)for each outfall. Outfall Number 001 Outfall Number Outfall Number Receiving water name FRENCH BROAD Name of watershed,river, FRENCH BROAD BASIN c or stream system U.S.Soil Conservation H Service 14-digit watershed 04-03-01/06010105 code Name of state FRENCH BROAD RIVER management/river basin a U.S.Geological Survey 8-digit hydrologic cc cataloging unit code Critical low flow(acute) N/A cfs cfs cfs Critical low flow(chronic) N/A cfs cfs cfs Total hardness at critical mg/L of mg/L of mg/L of low flow N/A CaCO3 CaCO3 CaCO3 3.8 Provide the following information describing the treatment provided for discharges from each outfall. Outfall Number Outfall Number Outfall Number Highest Level of ❑ Primary ❑ Primary 0 Primary Treatment(check all that 0 Equivalent to ❑ Equivalent to 0 Equivalent to apply per outfall) secondary secondary secondary ❑ Secondary ❑ Secondary 0 Secondary ❑ Advanced ❑ Advanced 0 Advanced O Other(specify) ❑ Other(specify) ❑ Other(specify) 0 Design Removal Rates by a. 'c Outfall N BOD5 or CBOD5 85 ai TSS 85 r= 0 Not applicable ❑Not applicable ❑Not applicable Phosphorus 0 Not applicable ❑Not applicable ❑Not applicable Nitrogen % Other(specify) 0 Not applicable ❑ Not applicable ❑Not applicable EPA Form 3510-2A(Revised 3-19) Page 7 EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19 NC0021946 TOWN OF ROSMAN OMB No.2040-0004 3.9 Describe the type of disinfection used for the effluent from each outfall in the table below.If disinfection varies by season,describe below. d .c 0 Outfall Number o01 Outfall Number Outfall Number 0- Disinfection type 5 uv z Seasons used Tel Dechlorination used? 0 Not applicable 0 Not applicable ❑ Not applicable ❑ Yes 0 Yes 0 Yes ❑ No 0 No 0 No 3.10 Have you completed monitoring for all Table A parameters and attached the results to the application package? ❑ Yes 0 No 3.11 Have you conducted any WET tests during the 4.5 years prior to the date of the application on any of the facility's discharges or on any receiving water near the discharge points? ❑ Yes ❑✓ No 4 SKIP to Item 3.13. 3.12 Indicate the number of acute and chronic WET tests conducted since the last permit reissuance of the facility's discharges by outfall number or of the receiving water near the discharge points. Outfall Number Outfall Number Outfall Number Acute Chronic Acute Chronic Acute Chronic Number of tests of discharge water Number of tests of receiving water 3.13 Does the treatment works have a design flow greater than or equal to 0.1 mgd? 0 Yes ❑ No 4 SKIP to Item 3.16. 0 3.14 Does the POTW use chlorine for disinfection,use chlorine elsewhere in the treatment process,or otherwise have reasonable potential to discharge chlorine in its effluent? ❑ Yes 4 Complete Table B,including chlorine. p No 4 Complete Table B,omitting chlorine. 3.15 Have you completed monitoring for all applicable Table B pollutants and attached the results to this application package? ❑ Yes 0 No 3.16 Does one or more of the following conditions apply? • The facility has a design flow greater than or equal to 1 mgd. • The POTW has an approved pretreatment program or is required to develop such a program. • The NPDES permitting authority has informed the POTW that it must sample for the parameters in Table C,must sample other additional parameters(Table D),or submit the results of WET tests for acute or chronic toxicity for each of its discharge outfalls(Table E). Yes 4 Complete Tables C,D,and E as O applicable. 0No 4 SKIP to Section 4. 3.17 Have you completed monitoring for all applicable Table C pollutants and attached the results to this application package? O Yes ❑ No 3.18 Have you completed monitoring for all applicable Table D pollutants required by your NPDES permitting authority and attached the results to this application package? ❑ Yes ❑ No additional sampling required by NPDES permitting authority. EPA Form 3510-2A(Revised 3-19) Page 8 EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19 NC0021946 TOWN OF ROSMAN OMB No.2040-0004 TABLE A.EFFLUENT PARAMETERS FOR ALL POTWS Maximum Daily Discharge Average Daily Discharge Analytical ML or MDL Pollutant Value Units Value Units Number of Method1 (include units) Samples Biochemical oxygen demand o BOD5 or 0 CBOD5 45 MG/L 30 MG/L 4 SM5210 ©ML ❑MDL (report one) Fecal coliform 400 100ML 200 100ML 4 SM92220 ❑ML 0 MDL Design flow rate .250 MGD pH(minimum) 6 SU pH(maximum) 9 SU Temperature(winter) 13.5 C 6 C 4 Temperature(summer) 22.5 C 21 C 4 Total suspended solids(TSS) 45 MG/L 30 MG/L 4 ❑ML 0 MDL I Sampling shall be conducted according to sufficiently sensitive test procedures(i.e., methods)approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or required under 40 CFR chapter I,subchapter N or O.See instructions and 40 CFR 122.21(e)(3). EPA Form 3510-2A(Revised 3-19) Page 13 L EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19 NC0021946 TOWN OF ROSMAN OMB No.2040-0004 3.19 Has the POTW conducted either(1)minimum of four quarterly WET tests for one year preceding this permit application or(2)at least four annual WET tests in the past 4.5 years? El Yes ❑ No+ Complete tests and Table E and SKIP to Item 3.26. 3.20 Have you previously submitted the results of the above tests to your NPDES permitting authority? ID Yes ❑ No 4 Provide results in Table E and SKIP to Item 3.26. 3.21 Indicate the dates the data were submitted to your NPDES permitting authority and provide a summary of the results. Date(s)Submitted Summary of Results (MM/DD/YYYY) -a m 3.22 Regardless of how you provided your WET testing data to the NPDES permitting authority,did any of the tests result in o toxicity? ❑ Yes El No 4 SKIP to Item 3.26. F 3.23 Describe the cause(s)of the toxicity: C, a� Ui w 3.24 Has the treatment works conducted a toxicity reduction evaluation? ❑ Yes ❑ No 4 SKIP to Item 3.26. 3.25 Provide details of any toxicity reduction evaluations conducted. 3.26 Have you completed Table E for all applicable outfalls and attached the results to the application package? El Yes ❑ Not applicable because previously submitted information to the NPDES .ermittin. authorit . SECTION 4.INDUSTRIAL DISCHARGES AND HAZARDOUS WASTES(40 CFR 122.21(j)(6)and(7)) 4.1 Does the POTW receive discharges from SIUs or NSCIUs? ❑ Yes ❑✓ No 4 SKIP to Item 4.7. j 4.2 Indicate the number of SIUs and NSCIUs that discharge to the POTW. Number of SIUs Number of NSCIUs 4.3 Does the POTW have an approved pretreatment program? uzi = El Yes ❑ No -a 5 4.4 Have you submitted either of the following to the NPDES permitting authority that contains information substantially d identical to that required in Table F:(1)a pretreatment program annual report submitted within one year of the application or(2)a pretreatment program? ❑ Yes ❑ No 4 SKIP to Item 4.6. o 4.5 Identify the title and date of the annual report or pretreatment program referenced in Item 4.4.SKIP to Item 4.7. -a 4.6 Have you completed and attached Table F to this application package? El Yes ❑ No EPA Form 3510-2A(Revised 3-19) Page 9 EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19 NC0021946 TOWN OF ROSMAN OMB No.2040-0004 4.7 Does the POTW receive,or has it been notified that it will receive,by truck,rail,or dedicated pipe,any wastes that are regulated as RCRA hazardous wastes pursuant to 40 CFR 261? ❑ Yes ❑✓ No 4 SKIP to Item 4.9. 4.8 If yes, provide the following information: Annual Hazardous Waste Waste Transport Method Amount of Units Number (check all that apply) Waste Received ❑ Truck ❑ Rail ❑ Dedicated pipe ❑ Other(specify) O ❑ Truck ❑ Rail ❑ Dedicated pipe ❑ Other(specify) 0 N ❑ Truck ❑ Rail as ❑ Dedicated pipe ❑ Other(specify) as as 4.9 Does the POTW receive,or has it been notified that it will receive,wastewaters that originate from remedial activities, including those undertaken pursuant to CERCLA and Sections 3004(7)or 3008(h)of RCRA? ❑ Yes ❑✓ No-)SKIP to Section 5. y 4.10 Does the POTW receive(or expect to receive)less than 15 kilograms per month of non-acute hazardous wastes as specified in 40 CFR 261.30(d)and 261.33(e)? ❑ Yes 4 SKIP to Section 5. ❑ No 4.11 Have you reported the following information in an attachment to this application:identification and description of the site(s)or facility(ies)at which the wastewater originates;the identities of the wastewater's hazardous constituents;and the extent of treatment,if any,the wastewater receives or will receive before entering the POTW? ❑ Yes ❑ No SECTION 5.COMBINED SEWER OVERFLOWS(40 CFR 122.21(j)(8)) 5.1 Does the treatment works have a combined sewer system? T. El Yes ❑� No+SKIP to Section 6. 03 5.2 Have you attached a CSO system map to this application?(See instructions for map requirements.) 1d ❑ Yes ❑ No a R O 5.3 Have you attached a CSO system diagram to this application?(See instructions for diagram requirements.) ❑ Yes ❑ No EPA Form 3510-2A(Revised 3-19) Page 10 EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19 NC0021946 TOWN OF ROSMAN OMB No.2040-0004 5.4 For each CSO outfall,provide the following information.(Attach additional sheets as necessary.) CSO Outfall Number CSO Outfall Number CSO Outfall Number City or town 0 a State and ZIP code 0 o County 3 Latitude 1 II ° ° 0 II cn Longitude ° Distance from shore ft. ft. ft. Depth below surface ft. ft. ft. 5.5 Did the POTW monitor any of the following items in the past year for its CSO outfalls? CSO Outfall Number CSO Outfall Number CSO Outfall Number Rainfall 0 Yes 0 No ❑ Yes 0 No 0 Yes 0 No 0) 0 CSO flow volume 0 Yes ❑ No ❑ Yes ❑ No ❑ Yes 0 No CSO pollutant 0 Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No o concentrations CO c3 Receiving water quality 0 Yes ❑ No 0 Yes ❑ No ❑ Yes 0 No CSO frequency 0 Yes 0 No ❑ Yes ❑ No 0 Yes 0 No 1 Number of storm events ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑No 5.6 Provide the following information for each of your CSO outfalls. CSO Outfall Number CSO Outfall Number CSO Outfall Number Al Number of CSO events in events events events H the past year a. Average duration per hours hours hours c event ❑Actual or 0 Estimated 0 Actual or 0 Estimated 0 Actual or 0 Estimated m W million gallons million gallons million gallons o Average volume per event co c.) 0 Actual or 0 Estimated 0 Actual or 0 Estimated ❑Actual or 0 Estimated Minimum rainfall causing inches of rainfall inches of rainfall , inches of rainfall a CSO event in last year 0 Actual or 0 Estimated 0 Actual or 0 Estimated 0 Actual or 0 Estimated EPA Form 3510-2A(Revised 3-19) Page 11 EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19 NC0021946 TOWN OF ROSMAN OMB No.2040-0004 5.7 Provide the information in the table below for each of your CSO outfalls. CSO Outfall Number_ CSO Outfall Number_ CSO Outfall Number Receiving water name Name of watershed/ y stream system U.S.Soil Conservation ❑Unknown ❑Unknown ❑ Unknown Service 14-digit watershed code '> (if known) Name of state management/river basin U.S.Geological Survey 0 Unknown 0 Unknown 0 Unknown 8-Digit Hydrologic Unit Code(if known) Description of known water quality impacts on receiving stream by CSO (see instructions for exam i les SECTION 6.CHECKLIST AND CERTIFICATION STATEMENT(40 CFR 122.22(a)and(d)) 6.1 In Column 1 below,mark the sections of Form 2A that you have completed and are submitting with your application.For each section,specify in Column 2 any attachments that you are enclosing to alert the permitting authority.Note that not all applicants are required to provide attachments. Column 1 Column 2 ❑ Section 1: Basic Application ❑ w/variance request(s) ❑ w/additional attachments Information for All Applicants ❑ Section 2:Additional ❑ w/topographic map ❑ w/process flow diagram Information ❑ w/additional attachments ❑ w/Table A ❑ w/Table D ❑ Section 3: Information on ❑ w/Table B ❑ w/Table E • Effluent Discharges ❑ w/Table C ❑ w/additional attachments w Section 4: Industrial ❑ w/SIU and NSCIU attachments ❑ w/Table F ❑ Discharges and Hazardous s Wastes ❑ w/additional attachments Section 5:Combined Sewer ❑ wl CSO map ❑ w/additional attachments ❑ Overflows ❑ w/CSO system diagram ❑ Section 6:Checklist and ❑ w/attachments Certification Statement Y 6.2 Certification Statement cu 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 submitted is,to the best of my knowledge and belief,true,accurate,and complete.I am aware that there are significant penalties for submitting false information,including the possibility of fine and imprisonment for knowing violations. Name(print or type first and last name) Official title BRIAN SHELTON MAYOR Signature Date signed 09/30/2020 EPA Form 3510-2A(Revised 3-19) Page 12 1 This page intentionally left blank. EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19 NC0021946 TOWN OF ROSMAN OMB No.2040-0004 TABLE B.EFFLUENT PARAMETERS FOR ALL POTWS WITH A FLOW EQUAL TO OR GREATER THAN 0.1 MGD Maximum Daily Discharge Average Daily Discharge Analytical ML or MDL Pollutant Number of Methods (include Value Units Value Units Samples units) 0 ML Ammonia(as N) 6.3 MG/L 4.5 MG/L 4 SM4500NH 3-F 0 MDL Chlorine ❑ML (total residual,TRC)2 ❑MDL 0 ML Dissolved oxygen ❑MDL Nitrate/nitrite 22 MG/L 19 MG/L 2 EPA353.2 ❑ML ❑MDL 0 ML Kjeldahl nitrogen 1.0 MG/L 1.0 MG/L 2 EPA351.2 0 MDL 0 ML Oil and grease ❑MDL ❑ML Phosphorus 4 MG/L 4 MG/L 2 EPA365.1 0 MDL Total dissolved solids ❑ML ❑MDL I Sampling shall be conducted according to sufficiently sensitive test procedures(i.e.,methods)approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or required under 40 CFR chapter I,subchapter N or 0.See instructions and 40 CFR 122.21(e)(3). 2 Facilities that do not use chlorine for disinfection,do not use chlorine elsewhere in the treatment process,and have no reasonable potential to discharge chlorine in their effluent are not required to report data for chlorine. EPA Form 3510-2A(Revised 3-19) Page 15 This page intentionally left blank. EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19 NC0021946 TOWN OF ROSMAN OMB No.2040-0004 TABLE C. EFFLUENT PARAMETERS FOR SELECTED POTWS Maximum Daily Discharge Average Daily Discharge Analytical ML or MDL Pollutant Number of Method1 (include units) Value Units Value Units Samples Metals,Cyanide,and Total Phenols o ML Hardness(as CaCO3) ❑MDL 0 ML Antimony,total recoverable ❑MDL Arsenic,total recoverable ❑ML ❑MDL 0 ML Beryllium,total recoverable ❑MDL Cadmium,total recoverable ❑ML ❑MDL Chromium,total recoverable ❑ML ❑MDLML Copper,total recoverable ❑MDL Lead,total recoverable ❑ML ❑MDL 0 ML Mercury,total recoverable ❑MDL Nickel,total recoverable ❑ML _ ❑MDL Selenium,total recoverable ❑ML ❑MDL Silver,total recoverable ❑ML ❑MDL Thallium,total recoverable ❑ML ❑MDL Zinc,total recoverable ❑ML ❑MDL ❑ML Cyanide ❑MDL ❑ML Total phenolic compounds ❑MDL Volatile Organic Compounds Acrolein ❑ML _ ❑MDL 0 ML Acrylonitrile ❑MDL Benzene 0 ML ❑MDL Bromoform ❑ML ❑MDL EPA Form 3510-2A(Revised 3-19) Page 17 EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19 NC0021946 TOWN OF ROSMAN OMB No.2040-0004 TABLE C.EFFLUENT PARAMETERS FOR SELECTED POTWS Maximum Daily Discharge Average Daily Discharge Analytical ML or MDL Pollutant Number of Method' (include units) Value Units Value Units Samples Carbon tetrachloride ❑ML _ ❑MDL Chlorobenzene ❑ML 0 MDL Chlorodibromomethane ❑ML ❑MDL Chloroethane El ML ❑MDL ML 2-chloroethylvinyl ether ❑MDL Chloroform 0 ML ❑MDL Dichlorobromomethane ❑ML ❑MDL 1,1-dichloroethane ❑ML ❑MDL 1,2-dichloroethane ❑ML ❑MDL 0 ML trans-1,2-dichloroethylene 0 MDL ML 1,1-dichloroethylene ❑MDL 0 ML 1,2-dichloropropane ❑MDL ML 1,3-dichloropropylene 0 MDL ML Ethylbenzene 0 MDL ML Methyl bromide ❑MDL ML Methyl chloride ❑MDL 0 ML Methylene chloride ❑MDL 1,1,2,2-tetrachloroethane ❑ML ❑MDL El ML Tetrachloroethylene ❑MDL Toluene ❑ML ❑MDL 1,1,1-trichloroethane ❑ML ❑MDL 1,1,2-trichloroethane ❑ML ❑MDL EPA Form 3510-2A(Revised 3-19) Page 18 EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19 NC0021946 TOWN OF ROSMAN OMB No.2040-0004 TABLE C.EFFLUENT PARAMETERS FOR SELECTED POTWS Maximum Daily Discharge Average Daily Discharge Analytical ML or MDL Pollutant Number of Method' (include units) Value Units Value Units Samples ML Trichloroethylene 0 MDL ML Vinyl chloride ❑MDL Acid-Extractable Compounds ML p-chloro-m-cresol ❑MDL 0 ML 2-chlorophenol ❑MDL 0 ML 2,4-dichlorophenol ❑MDL 0 ML 2,4-dimethylphenol 0 MDL 4,6-dinitro-o-cresol ❑ML ❑MDL 0 ML 2,4-dinitrophenol ❑MDL 0 ML 2-nitrophenol ❑MDL ❑ML 4-nitrophenol ❑MDL 0 ML Pentachlorophenol ❑MDL Phenol ❑ML ❑MDL 0 ML 2,4,6-trichlorophenol ❑MDL Base-Neutral Compounds ML Acenaphthene o MDL ML Acenaphthylene ❑MDL Anthracene ❑ML ❑MDL Benzidine ❑ML ❑MDL 0 ML Benzo(a)anthracene ❑MDL 0 ML Benzo(a)pyrene ❑MDL 3,4-benzofluoranthene ❑ML ❑MDL EPA Form 3510-2A(Revised 3-19) Page 19 EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19 NC0021946 TOWN OF ROSMAN OMB No.2040-0004 TABLE C.EFFLUENT PARAMETERS FOR SELECTED POTWS Maximum Daily Discharge Average Daily Discharge Analytical ML or MDL Pollutant Number of Method' (include units) Value Units Value Units Samples ID ML Benzo(ghi)perylene 0 MDL 0 ML Benzo(k)fluoranthene ❑MDL 0 ML Bis(2-chloroethoxy)methane ❑MDL 0 ML Bis(2-chloroethyl)ether ❑MDL 0 ML Bis(2-chloroisopropyl)ether ❑MDL 0 ML Bis(2-ethylhexyl)phthalate 0 MDL 0 ML 4-bromophenyl phenyl ether ❑MDL 0 ML Butyl benzyl phthalate 0 MDL 0 ML 2-chloronaphthalene ❑MDL 0 ML 4-chlorophenyl phenyl ether ❑MDL 0 ML Chrysene ❑MDL 0 ML di-n-butyl phthalate ❑MDL 0 ML di-n-octyl phthalate 0 MDL ❑ML Dibenzo(a,h)anthracene ❑MDL 1,2-dichlorobenzene ❑ML ❑MDL 1,3-dichlorobenzene ID ML ❑MDL 1,4-dichlorobenzene ID ML ❑MDL 3,3-dichlorobenzidine ID ML ❑MDL 0 ML Diethyl phthalate ❑MDL ID ML Dimethyl phthalate ❑MDL 2,4-dinitrotoluene ❑ML ❑MDL 2,6-dinitrotoluene ID ML ❑MDL EPA Form 3510-2A(Revised 3-19) Page 20 EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19 NC0021946 TOWN OF ROSMAN OMB No.2040-0004 TABLE C.EFFLUENT PARAMETERS FOR SELECTED POTWS Maximum Daily Discharge Average Daily Discharge Analytical ML or MDL Pollutant Number of Method1 (include units) Value Units Value Units Samples o ML 1,2-diphenylhydrazine ❑MDL Fluoranthene ❑ML ❑MDL Fluorene ❑ML ❑MDL Hexachlorobenzene ❑ML ❑MDL Hexachlorobutadiene ❑ML ❑MDL ML Hexachlorocyclo-pentadiene ❑MDL Hexachloroethane El ML ❑MDL ML Indeno(1,2,3-cd)pyrene o MDL ML Isophorone ❑MDL ML Naphthalene ❑MDL Nitrobenzene ❑ML ❑MDL 0 ML N-nitrosodi-n-propylamine 0 MDL 0 ML N-nitrosodimethylamine ❑MDL ML N-nitrosodiphenylamine ❑MDL Phenanthrene ❑ML ❑MDL 0 ML Pyrene ❑MDL 1,2,4-trichlorobenzene ❑ML ❑MDL 1 Sampling shall be conducted according to sufficiently sensitive test procedures(i.e.,methods)approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or required under 40 CFR Chapter I,Subchapter N or 0.See instructions and 40 CFR 122.21(e)(3). EPA Form 3510-2A(Revised 3-19) Page 21 This page intentionally left blank. EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03105/19 NC0021946 TOWN OF ROSMAN OMB No.2040-0004 TABLE D.ADDITIONAL POLLUTANTS AS REQUIRED BY NPDES PERMITTING AUTHORITY Maximum Daily Discharge Average Daily Dischar e Pollutant Analytical ML or MDL (list) Value Units Value Units Number of Method1 (include units) Samples ❑ No additional sampling is required by NPDES permitting authority. o ML ❑MDL ❑ML ❑MDL ❑ML ❑MDL ❑ML ❑MDL ❑ML ❑MDL ❑ML ❑MDL ❑ML ❑MDL ❑ML ❑MDL ❑ML ❑MDL ❑ML ❑MDL ❑ML ❑MDL ❑ML ❑MDL ❑ML ❑MDL ❑ML ❑MDL ❑ML ❑MDL ❑ML ❑MDL ❑ML ❑MDL I Sampling shall be conducted according to sufficiently sensitive test procedures(i.e.,methods)approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or required under 40 CFR chapter I,subchapter N or 0.See instructions and 40 CFR 122.21(e)(3). EPA Form 3510-2A(Revised 3-19) Page 23 This page intentionally left blank. EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19 NC0021946 TOWN OF ROSMAN OMB No.2040-0004 TABLE E.EFFLUENT MONITORING FOR WHOLE EFFLUENT TOXICITY The table provides response space for one whole effluent toxicity sample.Copy the table to report additional test results. Test Information Test Number Test Number Test Number Test species Age at initiation of test Outfall number Date sample collected Date test started Duration Toxicity Test Methods Test method number Manual title Edition number and year of publication Page number(s) Sample Type Check one: ❑ Grab ❑ Grab 0 Grab ❑ 24-hour composite ❑ 24-hour composite ❑ 24-hour composite Sample Location Check one: ❑ Before Disinfection 0 Before Disinfection ❑ Before disinfection ❑After Disinfection 0 After Disinfection 0 After disinfection ❑ After Dechlorination 0 After Dechlorination 0 After dechlorination Point in Treatment Process Describe the point in the treatment process at which the sample was collected for each test. Toxicity Type Indicate for each test whether the test was 0 Acute 0 Acute 0 Acute performed to asses acute or chronic toxicity, or both.(Check one response.) ❑ Chronic ❑ Chronic El Chronic O Both ❑ Both 0 Both EPA Form 3510-2A(Revised 3-19) Page 25 EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19 OMB No.2040-0004 NC0021946 TOWN OF ROSMAN TABLE E. EFFLUENT MONITORING FOR WHOLE EFFLUENT TOXICITY The table provides response space for one whole effluent toxicity sample.Copy the table to report additional test results. Test Number Test Number Test Number Test Type Indicate the type of test performed.(Check one ❑ Static 0 Static ❑ Static response.) ❑ Static-renewal ❑ Static-renewal ❑ Static-renewal ❑ Flow-through ❑ Flow-through ❑ Flow-through Source of Dilution Water Indicate the source of dilution water.(Check ❑ Laboratory water ❑ Laboratory water ❑ Laboratory water one response.) ❑ Receiving water 0 Receiving water ❑ Receiving water If laboratory water,specify type. If receiving water,specify source. Type of Dilution Water Indicate the type of dilution water.If salt 0 Fresh water ❑ Fresh water ❑ Fresh water water,specify"natural"or type of artificial sea salts or brine used. 0 Salt water(specify) ElSalt water(specify) ❑ Salt water(specify) Percentage Effluent Used Specify the percentage effluent used for all concentrations in the test series. Parameters Tested Check the parameters tested. ❑ pH ❑ Ammonia 0 pH ❑ Ammonia 0 pH 0 Ammonia ❑ Salinity ❑ Dissolved oxygen 0 Salinity ❑ Dissolved oxygen ❑ Salinity 0 Dissolved oxygen ❑ Temperature ❑ Temperature ❑ Temperature Acute Test Results Percent survival in 100%effluent LCso 95%confidence interval Control percent survival EPA Form 3510-2A(Revised 3-19) Page 26 EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19 NC0021946 TOWN OF ROSMAN OMB No.2040-0004 TABLE E.EFFLUENT MONITORING FOR WHOLE EFFLUENT TOXICITY The table provides response space for one whole effluent toxicity sample.Copy the table to report additional test results. Test Number Test Number Test Number Acute Test Results Continued Other(describe) Chronic Test Results NOEC IC25 % % Control percent survival % Other(describe) • Quality ControllQuality Assurance Is reference toxicant data available? ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No Was reference toxicant test within acceptable bounds? El Yes El No El Yes El No ❑ Yes ❑ No What date was reference toxicant test run (MM/DD/YYYY)? Other(describe) EPA Form 3510-2A(Revised 3-19) Page 27 This page intentionally left blank. EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19 NC0021946 TOWN OF ROSMAN OMB No.2040-0004 TABLE F.INDUSTRIAL DISCHARGE INFORMATION Response space is provided for three SIUs.Copy the table to report information for additional SIUs. SIU_ SIU SIU Name of SIU Mailing address(street or P.O.box) City,state,and ZIP code Description of all industrial processes that affect or contribute to the discharge. List the principal products and raw materials that affect or contribute to the SIU's discharge. Indicate the average daily volume of wastewater discharged by the SIU. gpd gpd gpd How much of the average daily volume is attributable to process flow? gpd gpd gpd How much of the average daily volume is attributable to non-process flow? gpd gpd gpd Is the SIU subject to local limits? ❑ Yes ❑ No 0 Yes 0 No 0 Yes 0 No Is the SIU subject to categorical standards? 0 Yes 0 No 0 Yes ❑ No 0 Yes 0 No EPA Form 3510-2A(Revised 3-19) Page 29 EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19 NC0021946 TOWN OF ROSMAN OMB No.2040-0004 TABLE F.INDUSTRIAL DISCHARGE INFORMATION Response space is provided for three SIUs.Copy the table to report information for additional SIUs. SIU SIU_ SIU Under what categories and subcategories is the SIU subject? Has the POTW experienced problems(e.g., upsets,pass-through interferences)in the past 4.5 0 Yes 0 No ❑ Yes ❑ No ❑ Yes 0 No years that are attributable to the SIU? If yes,describe. EPA Form 3510-2A(Revised 3-19) Page 30