NC0074110_Permit Issuance_20151207

le v a ter Resources
ENVIRONMENTAL QUALITY
PAT MCCRORY
C;nvvrnM4
DONALD K. VAN DER VAART
secraro,},
S, JAY ZIMMERMAN
Dire aln,.
December 73 2015
Mr. Robert Crummie, Administrator
Mizpah Healthcare, Inc.
P.O. Box 1029
Marion, NC 28752
Subject: Issuance of NPDES Permit NC0074110
Mountain View Assisted Living WWTP
238 Brookside Camp Road, Hendersonville 28792
Henderson County
Dear Mr. Crummie:
The Division of Water Resources (the Division) hereby issues the attached NPDES permit for the subject
facility. 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 October 15, 2007, or as subsequently amended.
The Division understands that you have made no significant changes to your facility the last permit
renewal. We have made the following updates to your previous permit:
• updated the facility description (see supplement to cover sheet) and map
• updated parameter codes in Section A. (L)
• the coordinates for the Outfall 001 were adjusted to the following as indicated on the facility map
attached to the application:
Latitude: 35' 22' 56" Longitude: 82' 28' 04"
• added the limit for DO to the effluent table and removed footnote
• updated Total Residual Chlorine (TRC) limit to 17 µg/L because of zero summer 7Q 10; however,
The Division shall consider all effluent TRC values reported below 50 µg/L to be in compliance with
the permit [see footnote 3]
• added Electronic Reporting , Discharge Monitoring Reports page [Section A. (2.)].
Proposed federal regulations require electronic submittal of all discharge monitoring reports (DMRs) and
specify that, if a state does not establish a system to receive such submittals, then permittees must submit
DMRs electronically to the Environmental Protection Agency (EPA). The Division anticipates that these
regulations will be adopted and is beginning implementation.
The requirement to begin reporting discharge monitoring data electronically using the NC DWR's
Electronic Discharge Monitoring Report (eDMR) Internet application has been added to your NPDES
permit. [See Special Condition A. (2.)] For information on eDMR, registering for eDMR and obtaining
an eDMR user account, please visit the following web page:
http://portal.ncdenr.org/web/wq/admin/bog/ipu/edmr.
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Phone: [phone] \ Litemet: tvww.ncwaterquality.org
An Equal Opporhurity \ Affu-mative Action Employer —Made nr part by recycled paper

Mr. Crummie
December 7, 2015
Page 2 of 2
For information on EPA proposed NPDES Electronic Reporting Rule, please visit the following web
site:
http://www2. epa. gov/compliance/proposed.npdes-electronic-reporting-rule.
If any parts, measurement fiequencies, or sampling requirements contained in this permit are
unacceptable, you have the right to an adjudicatory hearing, upon written request submitted within thirty
(30) days after receiving this letter. Your request must take the form of a written petition conforming to
Chapter 150B of North Carolina General Statutes, and you must file it with the Office of Administrative
Hearings, 6714 Mail Service Center, Raleigh, North Carolina 27699-6714. Unless such a demand is
made, this permit shall remain 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 Resources or any
other Federal, State, or Local governmental permits that may be required.
If you have questions, or if we can be of further service, please contact Derek Denard at
[derek.denard@ncdem•.gov] or call [phone].
�c5pe � iry,
S. Jay Zimmerman, P.G r or
Division of Water Resources, NCDEQ
Enclosure: NPDES Permit NC0074110 (Issuance Final)
hc: Central Files
NPDES Program Files
ARO Files/ Attn: Landon Davidson

NP )ES Permit NCO074110
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF WATER RESOURCES
TO DISCHARGE WASTEWATER UNDER THE
TIONAL POLLUTANT DISCHARGE ELIMINATION S
(NPDES)
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards
and regulations promulgated and adopted by the North Carolina Environmental Management
Commission, and the Federal Water Pollution Control Act, as amended,
Mizpah Healthcare, Inc.
is hereby authorized to discharge wastewater from a facility located at the
Mountain View Assisted Living WWTP
238 Brookside Camp Road, Hendersonville 28792
Henderson County
to receiving waters designated as an unnamed tributary to Featherstone Creek in the French Broad
River Basin, in accordance with effluent limits, monitoring requirements, and other conditions set forth
in Parts I, II, III and IV hereof.
This permit shall become effective JariUary 1, 2016.
This permit and authorization to discharge shall expire at midnight onNOVe111ber 30, 2020.
Signed this day December 7, 2015.
S Zimmerman, P.G., Director
I�fvision of Water Resources
By Authority of the Environmental Management Commission
Page 1 of 5

NPDES Permit NCO074110
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.
Mizpah Healthcare, Inc.
is hereby authorized to:
1. continue to operate an existing 0.005 MGD wastewater treatment system with the following
components;
• extended aeration basin with gravity flow
• 5000-gallon treatment system with grease trap and bar screen
• clarifier
• sludge holding basin
• dual blowers
• tertiary filter
• tablet -feed chlorinator
• chlorine -contact chamber
• tablet dechlorinator
• post aeration tank
• effluent discharge line
located at the Mountain View Assisted Living WWTP, 238 Brookside Camp Road,
Hendersonville, Henderson County,
2. discharge from said treatment works at the location specified on the attached map into an unnamed
tributary to Featherstone Creek [6-55-12], a waterbody classified C located within Subbasin
04-03-02 [HUC: 060101050303] of the French Broad River Basin,
Page 2 of 5

NPDES Permit NCO074110
PART I
EFFLUENT LIMITATIONS AND MONITORING REQUIREMENTS
[15A NCAC 02B .0400 et seq., 02B .0500 et seq.]
During the period beginning on'the effective date
Permittee is authorized to discharge from outfall 001
reported' by the Permittee as specified below:
of this pC1111it and lasting until expiration, the
Such discharges shall be limited, monitored and
EFFLUENT
CHARACTERISTICS
[Parameter Codes]
LIMITS
MONITORING
REQUIREMENTS)
Monthly
Average
Daily
Maximum
Measurement
Frequency
Sample
Type''
Sample
Location2
Flow (MGD)
50050
0.005 MGD
Continuous
Recording
I or E
Temperature (°C)
00010
Daily
Grab
E
Total Residual Chlorine (TRC) 3 (µg/L)
50060
17 µg/L 3
2/Week
Grab
E
Dissolved Oxygen (mg/L)
00300
6.0 mg/L
Weekly
Grab
E
pH (su)
00400
> 6.0 and < 9.0 standard units
Weekly
Grab
E
BOD, 5-day (20°C) (mg/L)
(April 1-October 31
C0310
5.0 in
7.5 mg/L
Weekly
Composite
E
BOD,
201C)
(Nov 5-day (Marc 31)
(November 1-March 31
C0310
10.0 mg/L
15.0 mg/L
Weekly
Composite
E
Total Suspended Solids (TSS) (mg/L)
C0530
30.0 mg/L
45.0 mg/L
Weekly
Composite
E
N1-13-N (April 1-October 31) (mg/L)
C0610
2.0 mg/L
10.0 mg/L
Weekly
Composite
E
NH3-N (November 1-March 31) (mg/L)
C0610
4.0 mg/L
20.0 mg/L
Weekly
Composite
E
Fecal Coliform (#/100ml) 4
31616
200/100 ml
400/100 ml
Weekly
Grab
E
Temperature (°C)
00010
Weekly
Grab
U & D
Dissolved Oxygen (mg/L,)
00300
Weekly
Grab
U & D
Fecal Coliform (#/100m1) 4
31616
Weekly
Grab
U & D
Footnotes:
1. No later than 270 days from the effective date of this permit, begin submitting discharge monitoring
reports electronically using NC DWR's eDMR application system. See Special Condition A. (2.).
2. E = Effluent; I = Influent; U = Upstream; and D = Downstream.
3. The Division shall consider all effluent TRC values reported below 50 µg/L to be in compliance with
the permit. However, the Permittee shall continue to record and submit all values reported by North
Carolina certified test methods (including field certified), even if these values fall below 50 µg/L.
4. Fecal Coliform shall be calculated using the geometric mean, according to the procedure detailed in
Part 11. Section A.
Conditions:
• There shall be no discharge of floating solids or foam visible in other than trace amounts.
Page 3 of 5

NPDES Permit NCO074110
A. (2.) ELECTRONIC REPORTING OF DISCHARGE MONITORING REPORTS
[G.S. 143-215.1(b)]
Proposed federal regulations require electronic submittal of all discharge monitoring reports (DMRs)
and specify that, if a state does not establish a system to receive such submittals, then permittees must
submit DMRs electronically to the Environmental Protection Agency (EPA). The Division adopted
these regulations in 2013.
NOTE: This special condition supplements or supersedes the following sections within Part II of this
permit (Standard Conditions for NPDES Permits):
• Section B. (11.) Signatory Requirements
• Section D. (2.) Reporting
• Section D. (6.) Records Retention
• Section E. (5.) Monitoring Reports
1. Reporting [Supersedes Section D. (2.) and Section E. (5) (a)1
Beginning no later than 270 days from the effective date of this permit, the permittee shall report
discharge monitoring data electronically using the NC DWR's Electronic Discharge Monitoring
Report (eDMR) inter -net application.
Monitoring results obtained during the previous months) shall be summarized for each month and
submitted electronically using eDMR. The eDMR system allows permitted facilities to enter
monitoring data and submit DMRs electronically using the internet, Until such time that the state's
eDMR application is compliant with EPA's Cross -Media Electronic Reporting Regulation
(CROMERR), permittees will be required to submit all discharge monitoring data to the state
electronically using eDMR and will be required to complete the eDMR submission by printing,
signing, and submitting one signed original and a copy of the computer printed eDMR to the
following address:
NC DEQ / DWR /Information Processing Unit
ATTENTION: Central Files /eDMR
1617 Mail Service Center
Raleigh, North Carolina 276994 617
If a permittee is unable to use the eDMR system due to a demonstrated hardship or due to the
facility being physically located in an area where less than 10 percent of the households have
broadband access, then a temporary waiver from the NPDES electronic reporting requirements may
be granted and discharge monitoring data may be submitted on paper DMR forms (MR 1, 1.1, 2, 3)
or alternative forms approved by the Director. Duplicate signed copies shall be submitted to the
mailing address above.
Requests for temporary waivers from the NPDES electronic reporting requirements must be
submitted in writing to the Division for written approval at least sixty (60) days prior to the date the
facility would be required under this permit to begin using eDMR. Temporary waivers shall be
valid for twelve (12) months and shall thereupon expire. At such time, DMRs shall be submitted

NP )ES Permit NCO074110
2.
electronically to the Division unless the permittee re -applies for and is granted a new temporary
waiver by the Division.
Information on eDMR and application for a temporary waiver from the NPDES electronic reporting
requirements is found on the following web page:
http://portal.ncdenr. or6/web/wq/admin/bog/ipu/edmr
Regardless of the submission method, the first DMR is due on the last day of the month following
the issuance of the permit or in the case of a new facility, on the last day of the month following the
commencement of discharge.
All eDMRs submitted to the permit issuing authority shall be signed by a person described m Part
Il, Section B. (11.)(a) or by a duly authorized representative of that person as described in Part Il,
Section B. (I 1.)(b). A person, and not a position, must be delegated signatory authority for eDMR
reporting purposes.
For eDMR submissions, the person signing and submitting the DMR must obtain an eDMR user
account and login credentials to access the eDMR system. For more information on North
Carolina's eDMR system, registering for eDMR and obtaining an eDMR user account, please visit
the following web page:
http ://p ortal.ncdenr. org/web/wq/admin/bo �/ipu/edmr
Certification. Any person submitting an electronic DMR using the state's eDMR system shall
make the following certification [40 CFR 122.22]. NO OTHER STATEMENTS OF
CERTIFICATION WILL BE ACCEPTED:
"I certify, under° penalty of law, that this document and all attachments were prepay°ed under my
diT°ection oN super°vision 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 fines and imprisonment for knowing violations. "
3. Records Retention [Supplements Section D. (6.)]
The permittee shall retain records of all Discharge Monitoring Reports, including eDMR submissions.
These records or copies shall be maintained for a period of at least 3 years from the date of the report. This
period may be extended by request of the Director at any time [40 CFR 122.41].
Page 5 of 5

Mizpah Healthcare, Inc.
Mountain View Assisted Living WWTP
238 Brookside Camp Road, Hendersonville 28792
Receivine Stream: UT to Featherstone Creek Stream Class: C
Stream Seement: 6-55-12 Sub -Basin: 04-03-02
Drainage Basin: French Broad HUC: 060101050303
Latitude: 350 22' 56" Loneitude: g2° 28' 04"
State Grid/LTSGS Ouad0 F9NW / Fruitland, NC
Facility
Location
Scale 1:24,000
NPDES Permit NC0074ll0
NOY'tI2 Henderson County