NC0030139_Permit Issuance_20040305

Michael F. Easley
Governor
William G. Ross, Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E., Director
Division of Water Quality
March 5, 2004
Mr. Jean G. Carter
White Oak Manor
188 Oscar Justice Road
Rutherfordton, North Carolina 28139
Subject: Issuance of NPDES Permit NCO030139
White Oak Manor
Rutherford County
Dear Ms. Carter:
Division personnel have reviewed and approved your application for renewal of the subject permit.
Accordingly, we are forwarding the attached NPDES discharge permit. This permit is issued pursuant to -the
requirements of North Carolina General Statute 143-215.1 and the Memorandum of Agreement between North
Carolina and the U-S. Environmental Protection Agency dated May 9, 1994 (or as subsequently amended).
This final permit includes no major changes from the draft permit sent to you on January 7, 2004.
This permit includes a TRC limit that will take effect on October 1.2005.
If any parts, measurement frequencies or sampling requirements contained in this permit are unacceptable to
you, you have the right to an adjudicatory hearing upon written request within thirty (30) days following receipt of
this letter. This request must be in the form of a written petition, conforming to Chapter 150B of the North Carolina
General Statutes, and filed with the Office of Administrative Hearings (6714 Mail Service Center, Raleigh, North
Carolina 27699-6714). Unless such demand is made, this decision shall be final and binding.
Please note that this permit is not transferable except after notice to the Division. The Division may require
modification or revocation and reissuance of the permit- This permit does not affect the legal requirements to obtain
other permits which may be required by the Division of Water Quality or permits required by the Division of Land
Resources, the Coastal Area Management Act or any other Federal or Local governmental permit that may be
required. If you have any questions concerning this permit, please contact Dawn Jeffries at telephone number (919)
733-5083, extension 595.
Sincerely,
ORIGINAL SIGNED BY
Mark McIntire
Alan W. Klimek, P.E.
cc: Central Files
Asheville Regional Office/Water Quality Section
NPDES Unit
N. C. Division of Water Quality) NPDES Unit Phone: [phone]
1617 Mail Service Center, Raleigh, NC 27699-1617 fax: [phone]
Internet: h2o. enr. state. nc. us DENR Customer Service Center: i 800 623-7748

Permit No. NCO030139
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
TO DISCHARGE WASTEWATER UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provisions of North Carolina General Statute 143-215.1, other lawful standards
and regulations promulgated and adopted by the North Carolina Environmental Management
Commission, and the Federal Water Pollution Control Act, as amended,
White Oak Manor - Rutherfordton
is hereby authorized to discharge wastewater from a facility located at
White Oak Manor — Rutherfordton
188 Oscar Justice Road
Rutherfordton
Rutherford County
to receiving waters designated as an unnamed tributary to Catheys Creek in the Broad River Basin
in accordance with effluent limitations, monitoring requirements, and other conditions set forth in Parts I,
II, III, and IV hereof.
The permit shall become effective April 1, 2004.
This permit and the authorization to discharge shall expire at midnight on July 31, 2008.
Signed this day March 5, 2004.
ORIGINAL SIGNED BY
Mark McIntire
Alan W. Klimek, P.E., Director
Division of Water Quality
By Authority of the Environmental Management Commission

Permit No. NCO030139
SUPPLEMENT TO PERMIT COVER SHEET
All previous NPDES Permits issued to this facility, whether for operation or discharge are hereby revoked. As of this
permit issuance, any previously issued permit bearing this number is no longer effective. Therefore, the exclusive
authority to operate and discharge from this facility arises under the permit conditions, requirements, terms, and
provisions included herein.
White Oak Manor - Rutherfordton
is hereby authorized to:
Continue to operate a 0.015 MGD extended aeration wastewater treatment facility with the
following components:
• Equalization basin
• Aeration basin
• Clarifier
• Chlorine contact chamber
• Dechlorination
This facility is located at White Oak Manor, 188 Oscar Justice Road in Rutherfordton,
Rutherford County.
2. Discharge from said treatment works at the location specified on the attached map into an
unnamed tributary to Catheys Creek (Class WS-V) in the Broad River Basin.

White Oak manor - NCO030139
U.SGS Quad: Rutherfordton F1 I NW Lat.: 35024'43"
Recelvirt Stream: UT Cathey's Creek Long.: 82055'43"
streawCfass: WS-V
SubbAsin: Broad - 030802
Facility
Location
Not to SCALE

Permit NCO030139
A. (1.) EFFLUENT LIMITATIONS AND MONITORING REQUIREMENTS
During the period beginning on the effective date of this permit and lasting until expiration,
the permittee is authorized to discharge from outfall 001. Such discharges shall be limited
and monitored by the Permittee as specified below:
EFFLUENT
CHARACTERISTICS
LIMITS
MONITORING REQUIREMENTS ;
Monthly
Average
Weekly_
Average
Dally
Maximum
Measurement
Frequency
Sample Type
Sample
Location'`
Flow(MGD)
0.015
Continuous
Recording
I or E
BOD, 5-day, 202 C
30.0 mg/L
45.0 mg/I
Weekly
Grab
E
Total Suspended Solids
30.0 mg/L
45.0 mg/l
Weekly
Grab
E
NH3 as N
(April 1 — October 31)
17.0 mg/l
35.0 mg/l
Weekly
Grab
E
NH3 as N
(November 1 — March 31)
Weekly
Grab
E
Fecal Coliform (geometric mean)
200/100 ml
400/100 ml
Weekly
Grab
E
Total Residual Chlorinez
28Ng/L
2/Week
Grab
E
Temperature (°C)
Weekly
Grab
E
pH
6.0 — 9.0 standard units
Weekly
Grab
E
Footnotes:
1. Sample locations: E-Effluent, I -Influent
2. TRC monitoring and effluent limitations apply only if chlorine is added to disinfect.
Limit takes effect October 1, 2005. Until the limit takes effect, the permittee shall
monitor TRC (with no effluent limit).
There shall be no discharge of floating solids or visible foam in other than trace amounts

Michael F. Easley, Governor
State of North Carolina
William G. Ross, Jr., Secretary
Department of Environment and Natural Resources
Alan W. Klimek, P.E., Director
Division of Water Quality
January 7, 2004
MEMORANDUM v D
To: Jim Adams
FEB 0 6 2004
NC DENR / DEH / Public Water Supply
WLY
Asheville Regional Office
From: Dawn Jeffries
NPDES Unit
Subject: Review of Draft NPDES Permit NCO030139
White Oak Manor
Please indicate below your agency's position or viewpoint on the draft permit and return this form by
February 13, 2004. If you have any questions on the draft permit, please contact me at telephone number
[phone], extension 595 or via e-mail at [e-mail].
RESPONSE: (Check one)
IVIConcur with the issuance of this permit provided the facility is operated and maintained properly, the stated
effluent limits are met prior to discharge, and the discharge does not. contravene the designated water quality
standards.
F-1
Concurs with issuance of the above permit, provided the following conditions are met:
❑ Opposes the issuance of the above permit, based on reasons stated below, or attached:
- ; ""l�t��,, 1 i6 t
_Date:
JAN ] 5 ti'OOZ
1617 MAIL SERVICE CENTER, RALEIGH, NORTH CAROLINA 2 - FCONE 919-733-5083/FAX [phone]
VISIT US ON THE WEB AT http://h2o.enr.state.nc.us/NPDES

PUBLIC NOTICE
STATE of NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT
COMM ISSION/NPDES UNIT
1617 MAIL SERVICE CENTER
RALEIGH, NC 27699-1617
NOTIFICATION OF INTENT TO ISSUE
A NPUES WASTEWATER PERMIT
On the basis of thorough staff review and
application of NC General Statute 145.21, Public
law 92.500 and other lawful standards and
regulations, the North Carolina Environmental
Management Commission proposes to issue a
National Pollutant Discharge Elimination System
(NPDES) wastewater discharge permit to the
person(s) listed below effective 45 days from the
publish date of this notice.
Written comments regarding the proposed
permit will be accepted until 30 daysafter the
publish date of this notice. All comments
received prior to that date are considered in the
final determinations regarding the proposed
permit. The Director of the NC Division of Water
Quality may decide to hold a public meeting for
the proposed permit should the Division receive
a significant degree of public interest.
Copies of the draft permit and other supporting
information on fife used to determine conditions
present in the draft permit are available
upon request and payment of the costs of
reproduction. Mail comments and/or requests
for information to the NC Division of Water
Quality at the above address or call Ms. Vatery
Stephens at [phone], extension 520.
Please include the NPDES permit number
(attached) in any communication. Interested
persons may also visit the Division of Water
Quality at 512 N Salisbury Street Raleigh, NC
27604-1.14Sbetween-jihe hours of 8:00 a_m: and
5:00 p.m to review information on fife.
White Oak Manor. 188 Oscar Justice Road,
Rutherfordton, NC has applied for rAnewal of
NPDES permit NCO030139 for its White Oak
Manor Wastewater Trealment Plant in Rutherford
County_ This permitted facifity discharges treated
wastewater to.an Ainnamed tributary to Cathys
Creek in the Broad River Basin; Currerrtty, arnmo-
NP, nitrogen and total residual chlorine are water
quality iimited. This discharge may affect future
allocations in the portion of the watershed.
AFFIDAVIT OF PUBLICATION
STATE OF NORTH CAROLINA
RUTHERFORD COUNTY
j fore the undersigned, a Notary Public of said County and State,
y commissioned, qualified, and authorized by law to administer
hs, personally appeared
Susie Sisk
being first duly sworn, deposes and says: that they are
Classified Advertising Represent itive
Goner, partner, publisher, or other officer or, employee authorized to
eke this affidavit) of THE DAILY COURIER, a newspaper
blished, issued and entered as second class mail In the town of
)REST CITY, In said County and State; that they are authorized to
ke this affidavit and sworn statement; that the notice or other legal
vertisement, a true copy of which is attached hereto, was published
THE DAILY COURIER on the following dates:
January 8, 2004
II that said newspaper in which such notice., paper, document, or
!al advertisement was published was, at the time of each and every
It publication, a newspaper meeting all of the requirements and
�Alifications of Section 1-597 of the General Statutes of North
rolina and was a qualified newspaper within the meaning of Section
97 of the General Statutes of North Carolina.
S the 12th day of January, 2004.
i
i
at Susie Sisk, Classified Advertising Representitive
corn to and subscribed before me this the 12th day of January,
04.
J A N 2 2 2004
'-A(Heather D. Rhodes, otary Pubf c}
My commission expires: August 21, 2008

Re: White Oak Manor
Subject: Re: White Oak Manor
Date: Mon, 29 Dec 2003 14:08:48 -0500
From: Roger Edwards <[e-mail]>
Organization: NC DENR - Asheville Regional Office
To: Dawn Jeffries <[e-mail]>
Dawn,
Thank you ---hope your Christmas was enjoyable as well.
The requirement for a flow meter will me an improvement that will give us
more leverage in future inspections (I think all facilities should have flow
measurement). At present, White Oak does not have a permit limit for TRC.
I assume they will get the 28 ug/1 limit in their renewal.. I feel the reason
that DMR's do not indicate a TSS problem is that samples are collected early
A.M. prior to heavy flows entering the treatment facility. On two separated
visits around noon, I observed the clarifier loosing solids which leads me
to believed this is not an unusual occurrence and is the reason I requested
composite sampling.
I have been working with the contract operator and permittee to make changes
is water usage in the care facility, which seems to have made some
improvement. I is d-o what we gaii to hold them accountable €or tbi�r
effluent discFiarge in the peririt renewal wifh reasonable- regairb'monts fdf`
data recotdfhg.
If you have any questions or if you need additional information let me know.
R. Edwards
Dawn Jeffries wrote:
> Roger,
> Hope your Christmas was nice...
> I finally received the application for renewal for NC0030139,White Oak
> Manor in Rutherfordton so I have taken a look at it.
> I see an October email here from you expressing some concern about their
> TSS levels. You wanted to require them to collect composite samples?
> instead of grab.
> I've reviewed the DMR's, and they do not indicate a problem. However,
> your inspection there on October 22, 2003 contradicts this. Given this,
> I don't see how I can change the sampling to composite...
> If we could establish a reasonable case that there might actually be a
> problem (and the data on the DMR's is faulty), that might change
> things. Right now though, we have years of data showing no problems and
> one sample showing a problem.
> When a facilty is 10,000 GPD, we can require continuous flow monitoring
> rather than instantaneous (as White Oak Manor now has) so I could
> justify that ahange;.but composite samples (rather than grab) aren't
> required until 30,00 GPD (go figure??) .
> Just out of curiosity, do you think the data regularly collected is
> wrong? Could it maybe be a problem with the lab? The reason I ask is
> that another thing I noticed in them was that very frequently, TRC is
> reported as zero (not less than detect, but zero) even though the
> facility has chlorination but no dechlorination. in addition, with the
1 of 2 12/30/2003 11:13 AM

Re: White Oak Manor
> zero TRC in the effluent, fecal coliform levels are <1 (in a facility
> where all the waste is domestic).
> Let me know what you think...
> Sincerely,
> Dawn Jeffries
> NPDES Unit
Roger Edwards - [e-mail]
North Carolina Dept. of Environment and Natural Resources
Asheville Regional Office
Division of Water Quality - Water Quality Section
59 Woodfin Place
Asheville, NC 28801
Tel: [phone]
Fax: [phone]
Roger Edwards <Roger.Edwards @ ncmail.neb
NC DENR - Asheville Regional Office
Division of Water Quality -Water Quality Section
2 of 2 12/30/2003 11:13 AM

Re: White Oak Manor
Subject: Re: White Oak Manor
Date: Thu, 23 Oct 2003 16:48:45 -0400
From: Roger Edwards <[e-mail]>
Organization: NC DENR - Asheville Regional Office
To: Susan A Wilson <[e-mail]>
CC: Dawn Jeffries <[e-mail]>,
Forrest Westall <[e-mail]>
Dawn,
L'314-% 0/ K' rn
0C,603013 q
10-28 113
,1'17.t -9`-ti 'fir `f c�:� w r'i' ill( 1PV r
t,3 j- - "k, s K tea; t mrr l -
I would like to require composite sampling at White Oak WWTP. By using this
requirement they will have to install a flow meter, so sampling will be flow
proportional. This will give us much needed information to put pressure on
the permittee to make up -grades to the WWTP. Ideally, a new WWTP would be
installed, but up -grades will help. Let me know what you think.
Thanks,
R. Edwards
Susan A Wilson wrote:
> Dawn,
> Looks like this one was assigned to you? (NC0030139). Roger (who works
> in ARO) wanted to know if we could add more frequent testing to this
> facility (he said it is very old and not so good). I told him I didn't
> think Dave would be too inclined to do that unless there were well
> documented compliance problems with the facility (meaning comp. problems
> and enforcement actions). I told him we could like put in some special
> condition language (like the wastewater management plan) and modify that
> as needed. He's especially concerned about issues with solids.
> Anyway...you guys can work out the specifics when you draft it.
> Susan
Roger Edwards - [e-mail]
North Carolina Dept. of Environment and Natural Resources
Asheville Regional Office
Division of Water Quality - Water Quality Section
59 Woodfin Place
Asheville, NC 28801
Tel: [phone]
Fax: [phone]
[Roger Edwards <[e-mail]>
NC DENR - Asheville Regional Office
Division of Water Quality - Water Quality Section
1 of 2 10/24/2003 11:02 AM

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i
NPDES APPLiCATION FOR PERMIT RENEWAL- SHORT FORM D
To be filed only by privately -owned dischargers of 100% domestic wastewater (< 1 MGD flow)
N. C. Department of Environment and Natural Reaowrcee
Division of Water Quality / NPDES Unit
1617 Mail Service Center, Raleigh, NC 27699-1617
http-./ /h2o.enr.state.nc-ua/NPDES/
North Carolina NPDES Pcrmit Number jNC00,3GjjSq
Please print or type
I. Contact Information_
Facility Name _
Q GZ�O i' itAe /6rcl iozI
Owner Name
.� ��1��{nor
Street Address
�
/ 8 8 6SO-ar Ta SHee
city
_
:R0hedO rdty ry A/a g) 3
State /Zip Code
.
Nam , [� ralr'na, �/3_rj'
Telephone Number (
_
8) dln _ 9, 0 0 /
Fax Number (
) c2 4, - O D
e-mail Address
Operator Name
r j �`ci lvt Uble,
Street Address
p px / (o `%
City —Banner6
1 k
State / Zip Code
County
A Je r OV 1 3 -2003
Telephone Number
2. Location of facility producing discharge:
Check here if same as above 9
Facility Name (If different from above)
Street Address or Statc Road
City
State / Zip Code
County
3. Reason for application:
Expansion/ModificationExisting Unpermitted Discharge
Renewal New Facility
` Please provide a description of the cxpansi.on/modification:
Nign 1 of 3
Verslon 12102

I v • JUl7C00007YJ I U
NPDES APPLICATION FOR PERMIT RENEWAL- SHORT FORM D
To be filed only by privately -owned dischargers of 100% domestic wastewater (<1 MGU flow)
4. Description of the existing treatment facilities (list all installed components with
capaafies):
Ca ] are-{L vm s4-& i,ULt.4 r `i-t,Pli lymPy'f % Llay7)- nn ►, c i c 'n.4 n t
S. Description of wastewater (check all that apply):
Tpe of Facility Genorgtinr Wastewater
Industrial Number of Employees
Commercial Number of Employees f09
Residential Number of Homes
School Number of Students/Staff
Other -- z --
Describe the source(s) of wastewater (example: subdivision, mobile home park, ctc.):
6. List all permits, construction Approval■ and/or applications (check all that apply):
T"T
RCRA
UIC
NPDES
PS D
NESHAPS
Permit Number
NC_ a03D13q
TVPC
Non -Attainment
Ocean Dumping
Dredp_,e/rill Permits
Other
1'eSmit Number
T. Number of separate Wastewater discharge pipes (Wastewater outfaIls):
8. if the facility has multiple discharge outfs2s, record the source(s) of Wastewater for each
outfall:
not Tplr'r�.b!
13
Page 2 of 3 Version 12102

iU-'7bt]Ct,=0b7YJr10 t .4'4
NPDES "PLIC.ATION FOR PERMIT RENEWAL- SHORT FORM D
To be filed only by privately -owned dischargers of 100% domestic wastewater (c 1 MGD flow)
9. Name of receiving st reAm(s) (Provide a reap showing the exact location of each ourfallp
0— -�(1-b 1A Le D 's Cr e
10. Is this facility located on Natiwe American lauds? (check one)
YES ❑ NO
I certify that I am familiar aritlr the information contained in the application and that to
the beet of my knowledge and belief such information is true, complete, and accurate.
Jean G. Ca,,der
Printed Name of Person Signing
A- d M i rn is +ra+n r
Title
Si lureAplicant Date Signed
North Carolina General Statute 143-215.8(b)(2) provides that: Any person who movdngly makes any falso statement representation, or
certlflcatlon in any sppllcallon, record, report, plan, or other document files or required to be maintained under Article 21 or regulations of the
Envionmental Management Commission implementing that Article, or who falsifies, tampers Will, or knowingly renders inaccuralo any
recording or monitoring device or method required to he operated or maintained under Article 21 or regulations of the Environmental
Management Commission Implementing that Article, shall bn guilty of a misdemeanor punishable by a fine not to exceed $10,000, or by
imprisonment not to exceed six months, or by both. (18 U.S.C. Section 1001 provides a punishment by a fine of not more than 210,000 or
Imprisonment not more than 5 years, or both for a similar offense.)
Per 3 of 3
version 12102

OF Wg7-fio Michael F. Easley
Governor
ip NCDENR William G. Ross, Jr., Secretary
y f r North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E., Director
Division of Water Quality
November 14, 2003
CERTIFIED MAIL
RETURN RECEIPT REQUESTED
Bettye Cecil
White Oak Manor
188 Oscar Justice Road
Rutherfordton, NC 28139
Subject: Notice of Violation
Failure to Submit Renewal Application
NPDES Permit NCO030139
White Oak Manor- Rutherfordton
Rutherford County
Dear Permittee:
The subject permit's expiration date is July 31, 2003. Federal [40 CFR 1221 and state (15A NCAC
2H.0105(e)) requires that an application for permit renewal be filed at least 180 days prior to expiration of the current
permit. To satisfy this requirement, your renewal package should have been sent to the Division postmarked no later
than February 1, 2003.
As of this date, the Division has not received your renewal application. This is a violation of Part Il. B. 10.
of your permit, which states "Any permittee that has not requested renewal at least 180 days prior to expiration... will
subject the permittee to enforcement procedures as provided in NCGS 143-215.6 and 33 USC 1251 et. seq.".
To prevent an assessment of civil penalties you must submit a completed permit application (see enclosed
forms) within 10 days of your receipt of this letter. Submit the completed application package to the address listed at
the bottom of this page.
If all wastewater discharge from your facility has ceased and you wish to rescind this permit, contact Robert
Farmer of the Division's Compliance Enforcement Unit at [phone], extension 531. You may also contact the
Asheville Regional Office at [phone] to begin the rescission process.
Use the enclosed checklist to complete your renewal package. The checklist identifies the items N*ou must
submit with the permit renewal application. If you have any questions, please contact Valery Stephens of my staff.
Mrs. Stephens' telephone number, fax number and e-mail address are listed at the bottom of this page.
Sincerely,
ORIGINAL SIGNED BY
Charles H. Weaver Jr.
Alan W. Klimek, P.E.
cc: Central Files
Asheville Regional Office, Witer Quality Section
NPDES File
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 919 733-5083, extension 520 (fax) 919 733-0719
VisirusoNrHEirrrERNET@http://h2o.enr.state.nc.us/NPDES e-mail: [e-mail]

NPDES Permit NCO030139
White Oak Manor
Rutherford County
The following items are REQUIRED for all renewal packages:
❑ A cover letter requesting renewal of the permit and documenting any changes at the facility since
issuance of the last permit. Submit one signed original and two copies.
❑ The completed application form (copy attached), signed by the permittee or an Authorized
Representative. Submit one signed original and two copies.
❑ If an Authorized Representative (such as a consulting engineer or environmental consultant) prepares
the renewal package, submit written documentation showing the authority delegated to any such
Authorized Representative (see Part II.B.11.b of the existing NPDES permit).
❑ A narrative description of the sludge management plan for the facility. Describe how sludge (or other
solids) generated during wastewater treatment are handled and disposed. If your facility has no such
plan (or the permitted facility does not generate any solids), explain this in writing. Submit one signed
original and two copies.
The following item must be submitted by Industrial facilities discharL ng_process wastewater
and Municipal WWTPs with a jlermitted flow of 1.0 MGD or greater:
❑ Industrial facilities classified as Primary Industries (see Appendices A-D to Title 40 of the Code of
Federal Regulations, Part 122) and municipal W�VTPs with a permitted flow of 1.0 MGD or greater
must submit a Priority Pollutant Analysis (PPA) in accordance with 40 CFR Part 122.21. If the PPA
cannot be completed by the time you complete your application package, submit the application
package without the PPA. Submit the PPA as soon as possible -after you receive the completed analyses.
The above requirement does NOT apply to nonindustrial facilities or municipal
WWTPs with permitted flows <1.0 MGD.
PLEASE NOTE:
Due to a change in fees effective January 1, 1999, there is no renewal fee required with your
application package.
Send-the4cornpleted renewal package to:
Mrs. Valery Stephens
NC DENR / Water Quality / NPDES Unit
1617 Mail Service Center
Raleigh, NC 27699-1617

�0F W ATF9p Michael F. Easley
�► Governor
y WC-bFNR William G. Ross, Jr., Secretary
] r North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E., Director
Division of Water Quality
January 3, 2003
Bettye Cecil
White Oak Manor
188 OscarJustice Road
Rutherfordton, NC 28139
Subject: Renewal Notice
NPDES Permit NCO030139
White Oak Manor- Rutherfordton
Rutherford County
Dear Permittee:
The subject permit expires on July 31, 2003. North Carolina Administrative Code (15A NCAC 2H.0105(e)) requires that
an application for permit renewal be filed at least 180 days prior to expiration of the current permit. If you have already mailed
your renewal application, you may disregard this notice.
To satisfy this requirement, your renewal package must be sent to the Division postmarked no later than February 1,
2003. Failure to request renewal of the permit by this date may result in a civil assessment of at least $500.00. Larger penalties
may be assessed depending upon the delinquency of the request.
If any wastewater discharge will occur after July 31, 2003 (or if continuation of the permit is desired), the current permit
must be renewed. Discharge of wastewater without a valid permit would violate North Carolina General Statute 143-215.1 and
could result in assessment of civil penalties of up to $25,000 per day.
If all wastewater discharge has ceased at your facility and you wish to rescind this permit, contact Robert Farmer of the
Division's Compliance Enforcement Unit at [phone], extension 531. You may also contact the Asheville Regional Office
at [phone] to begin the rescission process.
Use the enclosed checklist to complete your renewal package. The checklist identifies the items you must submit with
the permit renewal application. If you have any questions, please contact Valery Stephens at [phone], extension 520.
Sincerely,
Charles H. Weaver, Jr.
NPDES Unit
cc: Central Files
Asheville Regional Office, Water Quality Section
NPDES File
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 919 733-5083, extension 520 (fax) 919 733-0719
VISIT us ON THE INTERNET @ http://h2o.enr.state.nc.us/NPDES e-mail: [e-mail]

NPDES Permit NCO030139
White Oak Manor- Rutherfordton
Rutherford County
The following items are REQUIRED for all renewal packages:
❑ A cover letter requesting renewal of the permit and documenting any changes at the facility since
issuance of the last permit. Submit one signed original and two copies.
-❑ The completed application form (copy attached), signed by the permittee or an Authorized
Representative. Submit one signed original and two copies.
❑ If an Authorized Representative (such as a consulting engineer or environmental consultant) prepares
the renewal package, written documentation must be provided showing the authority delegated to any
such Authorized Representative (see Part II.B.11.b of the existing NPDES permit).
❑ A narrative description of the sludge management plan for the facility. Describe how sludge (or other
solids) generated during wastewater treatment are handled and disposed. If your facility has no such
plan (or the permitted facility does not generate any solids), explain this in writing. Submit one signed
original and two copies.
The following items must be submitted by any Municipal or Industrial facilities discharging
process wastewater:
Industrial facilities classified as Primary Industries (see Appendices A-D to Title 40 of the Code of Federal
Regulations, Part 122) and ALL Municipal facilities with a permitted flow >_ 1.0 MGD must submit a
Priority Pollutant Analysis (PPA) in accordance with 40 CFR Part 122.21.
The above requirement does NOT apply to privately owned facilities treating 100%
domestic wastewater, or facilities which discharge non process wastewater (cooling
water, filter backwash, etc.)
PLEASE NOTE:
Due to a change in fees effective January 1, 1999, there is no renewal fee required with your
application package.
Send the completed renewal package to:
Mrs. Valery Stephens
NC DENR / Water Quality / Point Source Branch
1617 Mail Service Center
Raleigh, NC 27699-1617