NC0028941_Regional Office Historical File Pre 2018

NPDES PERNIIT NO.: NCO028941
FACILITY NAME: Pine Valley Subdivision WWTP
OWNER NAME: Aqua North Carolina Inc
GRADE: WW-2
eDMR PERIOD: 11-2016 (November 2016)
PERMIT VERSION: 4.0
CLASS: WW-2 CNEE)
ORC: John David Wall ��1 Z017
ORC HAS CHANGED: NoJA1V 8
PERMIT STATUS: Active
COUNTY: Rowan
3
ORC CERT NUMBER: 19% CEIVED/NCDENR/DWR
VERSION: 1_0 CEeIITRA,L F'LES STATUS: Processed JAN 2 3 2017
GWR SECTION
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISC ROS
�1L EGIONAL OFFICE
o'
y
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U
t,,,
B
a
t=
F
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O
-
y
t•
O
O
C
z'
50050
00010
00400
50060
C0310
C0610
C0530
31616
00300
Weekly
5 X week
Weekly
2 X week
Weekly
Weekly
Weekly
Weekly
Weekly
Recorder
Grab
Grab
Grab
Grab
Grab
Gmb
Grab
Grab
FLOW
TEMP-C
PH
CHLORINE
HOD -Cane
NH3-N-Cane
TSS-Cant
FCOLIHR
DO
2400 crock
H.
2400 clock
H.
Y/R/N
mgd
deg c
su
u9/1
m9/1
mg/l
mg/1
#/100m1
mgR
1
24
1146
2.5
Y
0.006
19
<20
2
24
1106
0.465
Y
0.005
19
<2
<0.2
6.2
<I
3
24
1130
2.75
Y
0.003
20
4
24
1239
1.75
Y
0.004
20
5
0.004
6
0.004
7
24
1144
2.5
Y
0.0001
18
7.6
< 20
7.7
8
24
1127
2.75
Y
0.005
18
< 20
9
24
1145
2.5
Y
0.005
18
10
24
1047
0.5
Y
0.003
17
< 2
< 0.2
5.2
8
11
24
1139
2.5
Y
0.003
17
12
0.003
13
0.004
14
24
1152
2.25
Y
0.003
15
6.1
<20
8.9
15
24
1149
2.25
Y
0.003
IS
<20
16
24
1132
2.55
Y
0.003
15
17
24
1102
0.5
Y
0.00279
14
7.4
< 0.2
8
< 1
18
24
1445
1.25
B
0.003
15
19
0.004
20
0.003
21
24
1215
1.0
Y
0.003
14
6.5
<20
9.1
22
1130
24
1118
2.25
Y
0.002
14
<20
23
1130
24
1107
10.5
Y
0.003
13
<2
0.31
6.3
<I
24
25
26
NPHOLIDAY
0.003
27
0.003
28
24
1120
2A$
0.003
14
6.9.
<20
9.3
29
24
1106
2.39
Y0.004
14
< 20
30
24
1121
2.82
IY
0.006
16
Monthly Av,mlle Llmit:
0.025
10
4
30
200
Monthly Average:
0.003496
16.25
0
1.85
0.0775
6.425
1.681793
8.75
Daily Maximum:
0.006
20
7.6
0
7.4
0.31
8
8
9.3
Deily Minimum:
0.0001
13
6.1
0
D
0
5.2 10
7.7
s'•' No Reporting Reason: ENFRUSE = No Flow-Reuse/Recycle; ENV WTHR = No Visitation - Adverse Weather, NOFLOW = No Flow; HOLIDAY = No Visitation - Holiday

NPDES PERMIT NO.: NCO028941 PERMIT VERSION: 4.0 PERMIT STATUS: Active
FACILITY NAME: Pine Valley Subdivision WWTP CLASS: WW-2 COUNTY: Rowan
OWNER NAME: Aqua North Carolina Inc
GRADE: WW-2
eDMR PERIOD: 11-2016 (November 2016)
ORC: John David Wall ORC CERT NUMBER: 19498
ORC HAS CHANGED: No
VERSION: 1.0
STATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO (Continue)
a
.r3
e
u'
fi
F
E
p=
9
F
6
o
e
O
_
O
z
C0600
C0665
Quarterly
Quarterly
Grab
Grab
TOTAL N- Cone
TOTAL P- Cone
2400 clack
Hn
2400 clock
H.
Y/D/N
m9/1
m9/1 -
1
24
1146
2.5
Y
2
24
1106
0.465
Y
3
24
1130
2.75
Y
4
24
1239
1.75
Y
5
6
7
24
1144
2.5
Y
8
24
1127
2.75
Y
9
24
1145
2.5
Y
10
24
1047
0.5
Y
11
1
24
1139
2.5
1 Y
12
13
14
24
1152
2.25
Y
15
24
1149
2.25
Y
16
24
1132
2.55
Y
17
24
1102
0.5
Y
18
24
1445
1.25
B
19
20
21
24
1215
1.0
Y
22
1130
24
1118
2.25
Y
23
1130
24
1107
0.5
Y
24
HOLIDAY
25
HOLIDAY
26
27
28
24
1120
2.49
Y
29
24
1106
2.39
Y
30 1
24
1121
2.82
Y
....ly Avcroge Limo:
Monthly Avernge:
Daffy M.A.—
Dolly Minimum:
`s" No Reporting Reason: ENFRUSE = No Flow-Reuse/Recycle; ENV WTHR = No Visitation — Adverse Weather, NOFLOW = No Flow; HOLIDAY = No Visitation— Holiday

NPDES PERMIT NO.: NCO028941 PERMIT VERSION: 4.0
FACILITY NAME: Pine Valley Subdivision WWTP CLASS: WW-2
OWNER NAME: Aqua North Carolina Inc ORC: John David Wall
GRADE: WW-2 ORC HAS CHANGED: No
eDMR PERIOD: 11-2016 (November 2016) VERSION: 1.0
PERMIT STATUS: Active
COUNTY: Rowan
ORC CERT NUMBER: 19498
STATUS: Processed
SAMPLING LOCATION: DOWNSTREAM DISCHARGE NO.: 001
u
p'
E
F
E
z
C
z°
00010
00300
Weekly
Weekly
Grab
Grab
TEMP-C
DO
2400 clock
deg 0
MgA
1
2
3
4
5'
6
7
1359
15
8.6
8
9
10
11
12
13
14
1239
13
8.9
15
16
17
18
19
20
21
1247
10
9.9
22
23
24
25
26
27
28
1201
10
10.1
29
30
Monthly Average Limit:
Monthly Average:
12
9.375
Doily Madmum:
15 110.1
Dolly Minimum:
10
8.6
ss`sNoReporting Reason: ENFRUSE=No Flow-Reuse/Recycle; ENVWTHR=No Visitation —Adverse Weather, NOFLOW=No Flow; HOLIDAY =NoVisitation —Holiday

NPDES PERMIT NO.: NCO028941 PERMIT VERSION: 4.0 PERMIT STATUS: Active
FACILITY NAME: Pine Valley Subdivision WWTP CLASS: WW-2 COUNTY: Rowan
OWNER NAME: Aqua North Carolina Inc
GRADE: W W-2
eDMR PERIOD: 11-2016 (November 2016)
ORC: John David Wall ORC CERT NUMBER: 19498
ORC HAS CHANGED: No
VERSION: 1.0
STATUS: Processed
SAMPLING LOCATION: UPSTREAM DISCHARGE NO.: 001
=
o
e
f
E
�
Z
00010
OWN
Weekly
Weekly
Grab
Grab
TEMRC
DO
2400 clock
deg c
-9/1
1
2
3
4
5
6
7
1359
15
8.4
8
9
10
11
12
13
14
1239
13
8.9
15
16
17
18
19
20
21
1247
10
9.7
22
23
24
25
26
27
28
1201
11
9.9
29
30
Monthly Average Limit:
Monthly Average:
12.25
9.225
Dolly Maximum:
15
9.9
Daily Minimum:
10
8.4
••**NoReporting Reason: ENFRUSE=No Flow-Reuse/Recycle; ENVWTHR=No Visitation— Adverse Weather, NOFLOW=No Flow; HOLIDAY =NoVisitation —Holiday

NPDES PERMIT NO.: NCO028941
FACILITY NAME: Pine Valley Subdivision WWTP
OWNER NAME: Aqua North Carolina Inc
GRADE: W W-2
eDMR PERIOD: 11-2016 (November 2016)
COMPLIANCE STATUS: Compliant
PERMIT VERSION: 4.0
CLASS: WW-2
ORC: John David Wall
ORC HAS CHANGED: No
VERSION: 1.0
CONTACT PHONE #: [phone]
PERMIT STATUS: Active
COUNTY: Rowan
ORC CERT NUMBER: 19498
STATUS: Processed
SUBMISSION DATE: 12/29/2016
J (i i%x1 12/21/2016
ORC/Certif' r Signature: John David Wall E-Mai1:[e-mail] Phone #:[phone] Date
By this signature, I certify that this report is accurate and complete to the best of my knowledge.
The permittee shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment.
Any information shall be provided orally within 24 hours from the time the permittee became aware of the circumstances. A written submission shall also be
provided within 5 days of the time the permittee becomes aware of the circumstances.
If the facility is noncompliant, please attach a list of corrective actions being taken and a time -table for improvements to be made as required by part H.E.6 of
the NPDES permit. ____2
12/29/2016
Permittee/Submitter Signature:*** Duane Rimmer E-Mail:[e-mail] Phone #:[phone] Date
Permittee Address: NCSR 1802 Salisbury NC 28144 Permit Expiration Date: 03/01/2019
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 managed 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.
CERTIFIED LABORATORIES
LAB NAME: Water Tech
CERTIFIED LAB #: 50
PERSON(s) COLLECTING SAMPLES: David Wall
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit [phone] or by visiting http://portal.ncdenr.org/web/wq/swp/ps/npdes/forms.
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data.
* No Flow/Discharge From Site: Check this box if no discharge occurs and, as a result, there are no data to be entered for all,of the parameters on the DMR
for entire monitoring period.
** ORC on Site?: ORC must visit facility and document visitation of facility as required per 15A NCAC 8G .0204.
*** Signature of Permittee: If signed by other than the permittee, then delegation of the signatory authority must be on file with the state per 15A NCAC 213
.0506(b)(2)(D).

NPDES PERMIT NO.: NC0028941
FACILITY NAME: Pine Valley Subdivision WWTP
OWNER NAME: Aqua North Carolina Inc
GRADE: WW-2
eDMR PERIOD: 11-2016 (November 2016)
Report Comments:
Removes flows from no viisitation Holiday
PERMIT VERSION: 4.0
CLASS: WW-2
ORC: John David Wall
ORC HAS CHANGED: No
VERSION: 1.0
PERMIT STATUS: Active
COUNTY: Rowan
ORC CERT NUMBER: 19498
STATUS: Processed

ES PERMIT NO.: NCO028941
FACILITY NAME: Pine Valley Subdivision WWTP
OWNER NAME: Aqua North Carolina Inc
GRADE: WW-2
eDMR PERIOD: 10-2016 (October 2016)
PERMIT VERSION: 4.0
CLASS: WW-2
ORC: John David Wall
ORC HAS CHANGED: No
VERSION: 1.0
® ®� PERMIT STATUS: Active
RECEi4 B,.N, UNTY: Rowan 3
JAN 11 2017 ORC CERT NUMBER: 14&EIVED/NCDENR/DW8
CENTFZAL RLESSTATUS:Processed JAN 17 2019
DWR SECT ION
WQROS
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHMAMMUN EGIONAL OFFICE
q
6
rn
Ee
fi
U F+
6
"'
F
E
W
a
O
E
O
d
0
09
O
m
C c
z a
50050
00010
00400
50060
C0310
C0610
C0530
31616
00300
Weekly
5 X week
Weekly
2 X week
Weekly
Weekly
Weekly
Weekly
Weekly
Recorder
Gmb
Grab
Grab
Grab
Grab
Grab
Gmb
Grab
FLOW
TEMP-C
pH
CHLORINE
BOD - Cone
NH3-N-Cone
TSS-Cone
FCOLIBR
DO
2400 dock
I Hrs
2400 clock
I 11m
Y/B/N I
mgd Idegc
su
ug/l I
mgll
mgll
mgll I
#/loom)
mg/1
I
0.003
2
0.004
3
24
1136
2.4
Y
0.005
22
6.5
<20
7.5
4
24
1131
2.59
Y
0.004
22 1
<20
5
24
1055
Q41
Y
1
0.004
22
2.2
<0.2
5.3
<1
6
1
24
1152
2.27
Y
0.004
21
7
24
1111
2.99
Y
0.005
21
8
24
0.015
9
24
0.007
10
24
1216
1.71
Y
0.004
20
1
<20
11
1
124
1111
2.31
Y
1
0.004
14
6.8
< 20
7.5
12
24
1231
11.47
Y
0.004
18
13
24
1115
0.4
Y
0.004
18
< 2
0.48
6.5
< 1
14
24
1213
1.78
Y
0.004
119
IS
24
0.007
16
24
1
0.009
17
1
24
11125
2.41
Y
0.008
21
6.8
<20
18.1
IS
24
1057
2.8
Y
0.007
20
<20
19
24
1050
0.49
Y
0.009
20
1
2.4
0.74
a
< 1
20
24
1141
252
Y
0.007
21
21
24
1134
2.53
1 Y
0.007
20
22
24
0.007
23
24
0007
24
24
1152
2.31
Y
0.005
19
16.9
<20
8.2
25
24
1120
2.64
Y
0.005
18
<20
26
1120
24
1050
0.53
1 Y
0.006
17
<2
10.84
7.5
7
27
24
1034
1.27
Y
0.006
17
28
1
124
1035
2.91
Y
0.006
18
29
24
0.006
30
24
0.006
31
24
1131
IZ68
ly
I
0.006
20
6.7
<20
8.2
Monthly Average Limit:
0.025
1
10
2
30
200
Monthly Average:
0.005968
19.428571
1
0
1.15
0.515
6.825
1.626577
7.9
Daily Maximum:
0.015
22
6.9
0
2A
0.84
8
7
18.2
Daily Minimum:
0.003
114
6.5
10
10
10
15.3
10
7.5
..asNoReporting Reason: ENFRUSE=NoFlow-Reuse/Recycle; ENVWTHR=No Visitation -Adverse Weather, NOFLOW=No Flow; HOLIDAY= No Visitation -Holiday

ES PERMM NO.: NCO028941 PERMIT VERSION: 4.0
FACILITY NAME: Pine Valley Subdivision WWTP CLASS: WW-2
OWNER NAME: Aqua North Carolina Inc ORC: John David Wall
GRADE: WW-2 ORC HAS CHANGED: No
eDMR PERIOD: 10-2016 (October 2016) VERSION: 1.0
PERMIT STATUS: Active
COUNTY: Rowan
ORC CERT NUMBER: 19498
STATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO (Continue)
q
c
o
O E
F
6
F
EQ
o
e
E.
E
F
m
e
O
m
q
O
F
e
O
y
Oe
V
O
f:
o
o °o
tk
Z PS
C060D
C0665
Quarterly
Quarterly
Gab
Grab
TOTALN-Conc
TOTAL P-Con:
2400 clock
jHrs
2400 clock
I Hrs
YB/N
I
mgfl
mg/l
r24
r11362.4
Y
24
2.59
Y
5
1
124
1055
0.41
Y
24.4
7.76
6
24
1152
2.27
Y
7
24
1111
2.99
ly
8
24
9
24
10
24
1216
1.71
Y
11
1
24
1111
2.31
Y
12
24
1231
11.47
Y
13
24
1115
0.4
Y
14
24
1213
1.78
Y
is
24
16
1
24
17
24
1125
2.41
Y
18
24
1057
2.8
Y
19
24
1050
0.49
Y
20
24
1141
2.52
Y
21
1
124
1134
2.53
Y
22
24
23
24
24
24
1152
2.31
Y
25
24
1120
2.64
Y
26
11120
24
11050
0.53
Y
27
24
1034
1.27
Y
28
24
1035
2.91
Y
29
24
30
24
31
24
1131
2.68
Y
Monthly Average Limit:
Monthly Average:
..4
7.76
Daily Maximum:
24.4
7.76
Daily Minimum:
24.4
17.76
****No Reporting Reason: ENFRUSE= No Flow-Reuse/Recycle; ENVWTHR=No Visitation —Adverse Weather, NOFLOW=No Flow; HOLIDAY= No Visitation —Holiday

F
PERMIT NO.: NCO028941
ITY NAME: Pine Valley Subdivision WWTP
OWNER NAME: Aqua North Carolina Inc
GRADE: W W-2
eDMR PERIOD: 10-2016 (October 2016)
PERMIT VERSION: 4.0
CLASS: WW-2
ORC: John David Wall
ORC HAS CHANGED: No
VERSION: 1.0
PERMIT STATUS: Active
COUNTY: Rowan
ORC CERT NUMBER: 19498
STATUS: Processed
SAMPLING LOCATION: DOWNSTREAM DISCHARGE NO.: 001
q
a
E�
E
U F+
g
E
o
F
e
a
p
O
1
O
e
F
p
z
O
d
m
G
V
O
S
O
a
1Z 4
00010
00300
Weekly
Weekly
Crab
Grab
TEMP-C
DO
2400 dock
Hrs
2400 dock
Hrs
YB/N
deg c
mg/l
1
2
3
24
1222
0.01
Y
18
7.8
4
5
6
7
8
9
10
24
1146
Q01
Y
14
8.4
12
r1411
13
15
16
17
24
1207
0.03
Y
17
7.9
18
19
20
21
23
r22
24
24
1142
0.003
Y
15
8.5
25
26
27
28
29
30
31
1
124
f1216
0.003
Y
1216
8.3
Monthly Average Limit:
Monthly Average:
16
8.18
Daily Maximum:
1216
18.5
Daily Minimum:
14
7.8
.sssNoReporting Reason: ENFRUSE=NoFlow-Reuse/Recycle; ENVWTHR=No Visitation —Adverse Weather; NOFLOW=No Flow; HOLIDAY= No Visitation —Holiday

F
PERMIT NO.: NCO028941 PERMIT VERSION: 4.0
ITY NAME: Pine Valley Subdivision WWTP CLASS: WW-2
OWNER NAME: Aqua North Carolina Inc ORC: John David Wall
GRADE: W W-2 ORC HAS CHANGED: No
eDMR PERIOD: 10-2016 (October 2016) VERSION: 1.0
PERMIT STATUS: Active
COUNTY: Rowan
ORC CERT NUMBER: 19498
STATUS: Processed
SAMPLING LOCATION: UPSTREAM DISCHARGE NO.: 001
q
c
E
9
O E.
F
8
a
O
y
O
e
O
d
V
O
m
Z tYi
00010
00300
Weekly
weeldy
Grab
Grab
TEMP-C
DO
2400 clock
Hrs
2400 clock
E[n
YB/N
I
deg c
mg/1
1
2
3
24
1219
0.01
Y
18
8
4
6
7
r85
9
10
11
24
1143
0.01
Y
14
8.2
12
13
14
15
17
24
1204
0.03
Y
17
7.8
r16
18
19
20
21
22
23
24
24
1139
0.003
Y
15
8.4
25
26
27
28
29
30
31
1
124
112113,
10,003
16
8.1
Monthly Average Limit:
Monthly Average:
16
81
Daily Maximum:
18
18A
Daily Minimum:
14
7.8
****No Reporting Reason: ENFRUSE=No Flow-Reuse/Recycle; ENVWTHR=No Visitation —Adverse Weather; NOFLOW=No Flow; HOLIDAY=No Visitation —Holiday

ES PERMIT NO.: NCO028941
FACILITY NAME: Pine Valley Subdivision WWTP
OWNER NAME: Aqua North Carolina Inc
GRADE: WW-2
eDMR PERIOD: 10-2016 (October 2016)
COMPLIANCE: Compliant A
PERMIT VERSION: 4.0
CLASS: WW-2
ORC: John David Wall
ORC HAS CHANGED: No
VERSION: 1.0
CONTACT PHONE #: [phone]
PERMIT STATUS: Active
COUNTY: Rowan
ORC CERT NUMBER: 19498
STATUS: Processed
SUBMISSION DATE: 11/23/2016
11/22/2016
ORC/Certifier Signature: John David Wall E-Mail:[e-mail] Phone 4:704-489-9404 Date
By this signature, I certify that this report is accurate and complete to the best of my knowledge.
The permittee shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment.
Any information shall be provided orally within 24 hours from the time the permittee became aware of the circumstances. A written submission shall also be
provided within 5 days of the time the permittee becomes aware of the circumstances.
If the facility is noncompliant, please attach a list of corrective actions being taken and a time -table for improvements to be made as required by part II.E.6 of
the NPDES permit.
11/23/2016
Permittee/Submitter Signature:*** Duane Rimmer E-Mail:[e-mail] Phone #:[phone] Date
Permittee Address: NCSR 1802 Salisbury NC 28144 Permit Expiration Date: 03/01/2019
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 managed 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.
LAB NAME: Water Tech
CERTIFIED LAB #: 50
PERSON(s) COLLECTING SAMPLES: David Wall
CERTIFIED LABORATORIES
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit [phone] or by visiting http://portal.ncdenr.org/web/wq/swp/ps/npdes/forms.
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data.
* No Flow/Discharge From Site: Check this box if no discharge occurs and, as a result, there are no data to be entered for all of the parameters on the DMR
for entire monitoring period.
** ORC on Site?: ORC must visit facility and document visitation of facility as required per 15A NCAC 8G .0204.
*** Signature of Permittee: If signed by other than the permittee, then delegation of the signatory authority must be on file with the state per 15A NCAC 2B
.0506(b)(2)(D).

FCILPERMIT NO.: NCO028941
ITY NAME: Pine Valley Subdivision WWTP
OWNER NAME: Aqua North Carolina Inc
GRADE: WW-2
eDMR PERIOD: 09-2016 (September 2016)
PERMIT VERSION: 4.0
CLASS: WW-2
ORC: John David Wall
ORC HAS CHANGED: No
VERSION: 2_0
PERMIT STATUS: Active
1 1V�OUNTY: Roan y�
ORC CERT NUMBERFjgQAIVED/NCDENR/DWR
FEB 0 9 2017 FEB 13 2017
CEN I iaA,L FILESsTATUS: Processed & Revised
owR sEC 10N WQROS
MOORESVILLE REGIONAL OFFICE
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
F
ti
F
E
O
O
o`
O
1 2�
SM50
00010
00400
50060
C0310
C0610
C0530
31616
00300
Weekly
5 X week
Weekly
2 X week
Weekly
Weekly
Weekly
Weekly
Weekly
Retarder
Grab
Gmb
Grab
Grab
Gmb
Gab
Grab
Gab
FLOW
TEMP-C
PH
CHLORINE
DOD -Cone
NH3-N-Cone
TSS-Con.
FCOLI DR
DO
2400 dodo
H.
2400.1-k
H.
Y/DIN
mgd
deg c
su
119/1
mg/I
mg/l
mg/1
#/loon 1
mg/1
1
24
I125
293
Y
0.003
25
2
24
0704
2.28
Y
0.003
25
3
0.002
4
0.004
5
0004
6
24
1206
2.33
Y
0.004
24
6.5
<20
7.5
7
24
1329
Z42
Y
0003
25
<20
S
1120
24
1055
1.32
Y
0.004
25
<2
<0.2
12
5
9
24
1152
3.23
Y
0.003
26
10
24
13.47
Y
1
0.004
11
24
3.47
Y
0.004
12
24
1136
3.47
Y
0.003
25
7.4
<20
7.7
13
24
1135
1.33
Y
0.004
25
<20
14
24
1308
1.08
Y
0.004
26
IS
1120
124
1054
1.33
1 Y
0.003
26
2.4
< 0.2
18.5
< 1
16
24
1233
Z35
Y
0.003
25
17
24
3.35
Y
0.003
15
24
3.35
Y
0.004
19
24
1127
3.35
Y
0.003
24
7.3
<20
7.4
20
24
1105
3.65
Y
1
0.003
24
<20
21
1120
24
1053
11.38
Y
0.003
24
3.4
0.74
10.7
< 1
22
24
1132
3.33
Y
0.004
124
23
24
1148
0.18
Y
0.003
23
24
24
Z88
Y
0.004
25
24
Z88
Y
0.005
26
24
11151
2.88
Y
O.006
24
7
<20
7.3
27
24
1244
1.4
Y
0.006
24
<20
25
1120
24
1056
1.35
Y
0.004
24
21
< 0.2
72
< 1
29
24
1201
3.12
Y
0.004
24
30
24
1227
267
Y
0.003
24
Mon0ly Awrage Limit
OA25
10
2
30
200
Monthly Average:
0.003667
24.571429
0
1.975
0.185
12.1
1.495349
7.475
Dd19 M-1-
0.006
126
7.4
0
3.4
0.1
18.5
5
7.7
Daily Minim m.
0.002
23
16.5
10
0
0
7.2
0
17.3
****No Reporting Reason: ENFRUSE= No Flow-Reuse/Recycl6; ENVWTHR=No Visitation -Adverse Weather; NOFLOW=No Flow; HOLIDAY= No Visitation -Holiday

FDES PERMIT NO.: NCO028941
FACILITY NAME: Pine Valley Subdivision WWTP
OWNER NAME: Aqua North Carolina Inc
GRADE: WW-2
eDMR PERIOD: 09-2016 (September 2016)
PERMIT VERSION: 4.0
CLASS: WW-2
ORC: John David Wall
ORC HAS CHANGED: No
VERSION: 2.0
PERMIT STATUS: Active
COUNTY: Rowan
ORC CERT NUMBER: 19498
STATUS: Processed & Revised
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO (Continue)
F
..
E
F
F
O
O
o`
O
e
y'
C0600
C0665
Quarterly
Quarterly
Gmb
Gab
TOTAL N-Coat
TOTAL P-Cone
2400 clock
H.
2400 clock
H.
Y/nIN
my/1
mgn
1
24
1125
293
Y
2
24
0704
2.28
Y
3
4
5
6
24
1206
2.33
Y
7
24
1329
Z42
Y
8
1120
24
1055
1.32
Y
9
24
1152
3.23
Y
10
24
3.47
Y
11
24
3.47
Y
12
24
1136
13.47
Y
13
24
1135
1.33
Y
14
24
1308
1.08
Y
15
1120
24
1054
1.33
Y
16
24
1233
235
Y
17
1
24
3.35
Y
18
24
3.35
Y
19
24
1127
3.35
Y
20
24
1105
3.65
Y
21
1120
24
1053
1.38
Y
22
24
1132
13.33
Y
23
24
1148
0.18
Y
24
24
2.88
Y
25
24
2.88
Y
26
24
11151
2.88
Y
27
1
24
1244
1.4
1 Y
2s
1120
24
1056
1.35
Y
29
L2.67
24
12in
3.12
Y
30
24
1227
Y
Monthly Avenge Limit:
Monthly Average.
Daily Maximum:
Daily Minima
asa:No Reporting Reason: ENFRUSE=No Flow-Reuse/Recycle; ENVWTHR=No Visitation— Adverse Weather; NOFLOW=No Flow; HOLIDAY=No Visitation —Holiday

FFA
PERMITNO.: NCO028941
TY NAME: Pine Valley Subdivision WWTP
OWNER NAME: Aqua North Carolina Inc
GRADE: W W-2
PERMIT VERSION: 4.0
CLASS: WW-2
ORC: John David Wall
ORC HAS CHANGED: No
PERMIT STATUS: Active
COUNTY: Rowan
ORC CERT NUMBER: 19498
eDMR PERIOD: 09-2016 (September 2016) VERSION: 2.0 STATUS: Processed & Revised
SAMPLING LOCATION: UPSTREAM DISCHARGE NO.: 001
q
F
_
8
U
9
F
B
F
F
Z
O
w
0
O
_
U
O
n
m
Wy
2
00010
00300
Weekly
Weekly
Grab
Grab
TEMP-C
DO
21DO dock
Hm
2400 dock In.
Y/BIN Ideg
c
-9/1
t
2
3
4
5
6
24
MO
0.02
Y
20
7.9
7
s
9
10
11
12
24
1215
0.03
Y
20
8.4
13
14
15
16
17
18
19
24
1209
0.02
Y
21
8
20
21
22
23
21
25
26
24
1126
0.03
Y
21
7.7
27
28
29
30
MonWiy Average Limit
Mon" Averah .
20.5
8
Daily Maiimum:
21
8.4
Daily Mmimnm:
20
7.7
****No Reporting Reason: ENFRUSE = No Flow-Reuse/Recycle, ENV WTHR = No Visitation— Adverse Weather; NOFLOW = No Flow; HOLIDAY = No Visitation —Holiday

FPERMITNO.: NCO028941
TY NAME: Pine Valley Subdivision WWTP
OWNER NAME: Acua North Carolina Inc
GRADE: W W-2
PERMIT VERSION: 4.0
CLASS: WW-2
ORC: John David Wall
ORC HAS CHANGED: No
PERMIT STATUS: Active
COUNTY: Rowan
ORC CERT NUMBER: 19498
eDMR PERIOD: 09-2016 (September 2016) VERSION: 2.0 STATUS: Processed & Revised
SAMPLING LOCATION: DOWNSTREAM DISCHARGE NO.: 001
q
13
9
e
U
a
S
F'
O
0
3
O
o
O
2
00010
00300
weekly.
weekly
Grab
Grab
TEMRC
DO
2400 clock
H.
2400 clock
H.
YIWN
deg c
mgtl
1
2
3
4
5
6
24
1253
0.02
y
20
8.2
7
8
9
10
11
12
24
1218
.003
y
20
8.1
13
13
is
16
17
18
19
24
1212
0.02
ly
1
20
8.2
20
21
22
23
24
25
26
24
1129
0.03
y
21
7.6
27
28
29
30
Monthly A -rage Limit
'
Monthly Ar 9m -
20.25
8.025
Daily A vm
21
8.2
Daly Mim'mam:
20
17.6
****No Reporting Reason: ENFRUSE = No Flow-Reuse/Recycle; ENV WTHR = No Visitation —Adverse Weather; NOFLOW = No Flow; HOLIDAY = No Visitation —Holiday

F
PERMITNO.: NCO028941
TY NAME: Pine Valley Subdivision WWTP
OWNER NAME: Aqua North Carolina Inc
GRADE: WW-2
eDMR PERIOD: 09-2016 (September 2016)
COMPLIANCE STATUS: Compliant
PERMIT VERSION: 4.0
CLASS: WW-2
ORC: John David Wall
ORC HAS CHANGED: No
VERSION: 2.0
CONTACT PHONE #: [phone]
PERMIT STATUS: Active
COUNTY: Rowan
ORC CERT NUMBER: 19498
STATUS: Processed & Revised
SUBMISSION DATE: 02/02/2017
N_f Lj ULM, 02/02/2017
ORC/Ce ti ier Signature: John David Wall E-Mail:[e-mail] Phone #:[phone] Date
By this signature, I certify that this report is accurate and complete to the best of my knowledge.
The permittee shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment.
Any information shall be provided orally within 24 hours from the time the permittee became aware of the circumstances. A written submission shall also be
provided within 5 days of the time the permittee becomes aware of the circumstances.
If the facility is noncompliant, please attach a list of corrective actions being taken and a time -table for improvements to be made as required by part H.E.6 of
the NPDES permit.
02/02/2017
Permittee/Submitter Signature:*** Duane Rimmer E-Mail:[e-mail] Phone #:[phone] Date
Permittee Address: NCSR 1802 Salisbury NC 28144 Permit Expiration Date: 03/01/2019
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 managed 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.
LAB NAME: Water Tech
CERTIFIED LAB #: 50
PERSON(s) COLLECTING SAMPLES: David Wall
CERTIFIED LABORATORIES
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit [phone] or by visiting http://portal.ncdenr.org/web/wq/swp/ps/npdes/forms.
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data.
* No Flow/Discharge From Site: Check this box if no discharge occurs and, as a result, there are no data to be entered for all of the parameters on the DMR
for entire monitoring period.
** ORC on Site?: ORC must visit facility and document visitation of facility as required per 15A NCAC 8G .0204.
*** Signature of Permittee: If signed by other than the permittee, then delegation of the signatory authority must be on file with the state per 15A NCAC 2B
.0506(b)(2)(D).

DES PERMIT NO.: NCO028941
CILITY NAME: Pine Valley Subdivision WWTP
OWNER NAME: Aqua North Carolina Inc
GRADE: WW-2
eDMR PERIOD: 09-2016 (September 2016)
PERMIT VERSION: 4.0
CLASS: WW-2
ORC: John David Wall
ORC HAS CHANGED: No
VERSION: 1_0
PERMIT STATUS: Active
COUNTY: Rowan
ORC CERT NUMBER: 19498
RECEIVED/NCDENR/DWR
STATUS: Processed N O V 2 9 2016
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCI EY• �J§ROS
GJVfL E EGIONAL OFFICE
q
m
E E
O F
E
fi
F
B
Q`
O
iF
O
U
O
Z
a m
z a 1
50050
00010
00400
50060
C0310
C0610
C0530
31616
00300
Weekly
5Xweek
Weekly
2Xweek
Weekly
Weekly
Weekly
Weekly
Weekly
Recorder
Grab
Grab
Gab
Grab
Grab
Grab
Grab
Grab
FLOW
TEMP-C IPH
CBLORINE
ROD -Cone
NH3-N-Cane
TSS-Cone
FCOLIBR
DO
2400 clock
Hrs
2400 clock
Hrs
YBIN
mgd
deg c
su
u9/1
mg/l
mg/l
m9/1
9/100ml
mg/l
1
24
1125
Z93
Y
0.003
25
2
24
0704
2.28 1
Y
0.003
25
3
0.002
4
0.004
5
0.004+!Pt�
1
.. '
6
24
1206
2.33
Y
0.004
24
7 71I
'+; _,, I '
JJ
;<20
AIM
7
24
1329
2.42
Y
0.003
25
�`
AU
<20
KIM,
8
1120
24
1055
1.32
1 Y
1
0.004
25
R 3 -
1
<2
<0.2
12
5
9
24
1152
3.23
Y
0.003
26
ae
10
24
3.47
Y
0.004,
_
24
3.47
Y
0.004
12
24
1136
3.47
Y
0.003
25
7.4
<20
7.7
r1411
13
24
1135
1.33
Y
0.004
25
<20
24
1308
1.08
Y
0.004
26
15
1120
24
1054
1.33
Y
0.003
26
2.4
< 0.2
18.5
< 1
16
1
124
1233 112.35
Y
1
0.003
25
17
24
3.35
Y
0.003 '
18
24
3.35
Y
0.004
19
24
112
33.35
Y
0.003
24
7.3
<20
7.4
20
24
1105
3.65
Y
10.003
24
<20
21
11120
124
1053
11.38
Y
0.003
24
3.4
0.74
10.7
< 1
22
24
3.33
Y
0.004
24
23
24
0.18
Y
0.003
23
24
242.88
NB12,88
Y
0.004
25
242.88
Y
0.005
26
24
Y
0.006
24
7
<20
7.3
27
24
1244
1.4
Y
0.006
24
<20
0
24
1056
1.35
Y
0.004
24
21
<0.2
72
<124
L
1201
3.12
Y
0.004
24
24
1227
2.67
Y
0.003
24
Monthly Average Limit:
0.025
10
2
30
200
Monthly Average:
0.003667
24.571429
0
1.975
10.185
112.1
11.495349
17.466667
Daily Maximum:
0.006
26
7.4
0
3.4
0.74
18.5
1 5
7.7
Daily Minimum:
0.002
23
7
0
10
0
7.2
0
7.3
****No Reporting Reason: ENFRUSE=No Flow-Reuse/Recycle; ENVWTHR=No Visitation- Adverse Weather; NOFLOW=No Flow; HQ®O®/L�IID�wAY=No Visitation -Holiday
�G® � �d ED
NOV 21 2016
CENTRAL FILES
DV/R SEC7.10 \I

DES PERMIT NO.: NCO028941
CILITY NAME: Pine Valley Subdivision WWTP
OWNER NAME: Aqua North Carolina Inc
GRADE: WW-2
eDMR PERIOD: 09-2016 (September 2016)
PERMIT VERSION: 4.0
CLASS: WW-2
ORC: John David Wall
ORC HAS CHANGED: No
VERSION: 1.0
PERMIT STATUS: Active
COUNTY: Rowan
ORC CERT NUMBER: 19498
STATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO (Continue)
q
s
�'
EU
E
U F7
B
a
5
F'
E
ev
e
O
O
F
o
O
'.���'
O
•S
a c
z a
C0600
C0665
Quarterly
Quarterly
Grab
Grab
TOTAL N-Conc
TOTALP-Conc
2400 clock IHn
Z400 clock
Hrs
Y/B/N
mg/l
mg/1
1
24
1125
Z93
Y
2
24
0704
2.28
Y
3
4
5
6
24
1206
2.33
Y
7
24
1329 12.42
Y
8
1120
24
1055
1.32
Y
9
1
24
1152
3.23
Y
to
24
3.47
Y
11
24
3.47
Y
12
24
11136
3.47
ly
13
24
1135
1.33
Y
14
24
1308
1.08
Y
15
1120
24
1054
1.33
Y
16
24
1233
2.35
Y
17
24
1
3.35
ly
18
24
3.35
Y
19
24
1127
3.35
Y
20
1
24
1105
3.65
Y
21
1120
24
1053
1.38
Y
22
24
11132
3.33
ly
23
24
1148
0.18
Y
24
24
2.88
Y
25
1
24
2.88
Y
26
24
11151
2.88
Y
27
24
11244
1.4
ly
28
1120
24
1056
1.35
Y
29
24
1201
3.12
Y
30
1
24
1227
2.67
Y
Monthly Average Limit:
Monthly Average:
Daily Maximum:
Daily Minimum:
::ssNoReporting Reason: ENFRUSE=No Flow-Reuse/Recycle; ENVWTHR=No Visitation— Adverse Weather; NOFLOW=No Flow; HOLIDAY =No Visitation —Holiday

iCDES PERMIT NO.: NCO028941
ILITY NAME: Pine Valley Subdivision WWTP
OWNER NAME: Aqua North Carolina Inc
GRADE: WW-2
eDMR PERIOD: 09-2016 (September 2016)
PERMIT VERSION: 4.0
CLASS: WW-2
ORC: John David Wall
ORC HAS CHANGED: No
VERSION: 1.0
PERMIT STATUS: Active
COUNTY: Rowan
ORC CERT NUMBER: 19498
STATUS: Processed
SAMPLING LOCATION: UPSTREAM DISCHARGE NO.: 001
q
a
y
ey
E
U E+
E
m
E
F
_
m
O
O
6
o
O
w'
U
O
ec
C q
z
00010
00300
Weekly
Weekly
Gab
Gab
TEMP-C
DO
2400 clock
Hrs
2400 clock
Hrs
YB/N
deg c
mgll
1
2
3
4
6
24
1250
0.02
Y
20
7.9
7
r95
8
10
11
12
24
1215
0.03
Y
20
8.4
13
14
is
16
17
18
19
24
1209
0.02
Y
21
8
20
21
22
23
24
25
26
1
124
1126
0.03
Y
21
7.7
27
28
29
30
Monthly Average Limit:
Monthly Average:
20.5
8
Daily Maximum:
21
8.4
Daily Minimum:
20
17.7
****No Reporting Reason: ENFRUSE =No Flow-Reuse/Recycle; ENVWTHR=No Visitation —Adverse Weather; NOFLOW=No Flow; HOLIDAY= No Visitation —Holiday

I
DES PERMIT NO.: NCO028941 PERMIT VERSION: 4.0
CILITY NAME: Pine Valley Subdivision WWTP CLASS: WW-2
OWNER NAME: Aqua North Carolina Inc ORC: John David Wall
GRADE: W W-2 ORC HAS CHANGED: No
eDMR PERIOD: 09-2016 (September 2016) VERSION: 1.0
PERMIT STATUS: Active
COUNTY: Rowan
ORC CERT NUMBER: 19498
STATUS: Processed
SAMPLING LOCATION: DOWNSTREAM DISCHARGE NO.: 001
A
a
6 s
U P
9
a
F
E
e
a
O
O
O
,—`Z
C
U
O
•g
C x
a
z 94
00010
00300
Weekly
Weekly
Grab
Grab
TEMP-C
DO
2400 clock I
Hrs
2400 dock
Hrs
YB/N
deg c
ma,Jl
1
2
3
4
5
6
24
1253
0.02
y
20
82
7
8
9
to
11
12
1
24
1218
.003
1 y
1
20
8.1
14
r1613
15
17
18
19
24
1212
0.02
y
20
8.2
20
r21
22
23
24
25
26
24
1129
0.03
y
21
7.6
27
28
29
30
Monthly Average Limit:
Monthly Average:
20.25
8.025
Daily Maximum:
21
8.2
Daily Minimum:
20
17.6
****No Reporting Reason: ENFRUSE = No Flow-Reuse/Recycle; ENV WTHR = No Visitation —Adverse Weather; NOFLOW = No Flow; HOLIDAY = No Visitation —Holiday

I
DES PERMIT NO.: NCO028941
CILITY NAME: Pine Valley Subdivision WWTP
OWNER NAME: Aqua North Carolina Inc
GRADE: W W-2
eDMR PERIOD: 09-2016 (September 2016)
PERMIT VERSION: 4.0
CLASS: WW-2
ORC: John David Wall
ORC HAS CHANGED: No
VERSION: 1.0
CONTACT PHONE #: [phone]
PERMIT STATUS: Active
COUNTY: Rowan
ORC CERT NUMBER: 19498
STATUS: Processed
SUBMISSION DATE: 10/27/2016
4--/ yn. / cz" 10/27/2016
ORC/Certifier Signature: John David Wall E-Mail:[e-mail] Phone #:[phone] Date
By this signature, I certify that this report is accurate and complete to the best of my knowledge.
The permittee shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment.
Any information shall be provided orally within 24 hours from the time the permittee became aware of the circumstances. A written submission shall also be
provided within 5 days of the time the permittee becomes aware of the circumstances.
If the facility is noncompliant, please attach a list of corrective actions being taken and a time -table for improvements to be made as required by part H.E.6 of
the NPDES permit.
10/27/2016
1 ermittee/Submitt�ignature:*** Duane Rimmer E-Mail:[e-mail] Phone #:[phone] Date
Permittee Address: NCSR 1802 Salisbury NC 28144 Permit Expiration Date: 03/01/2019
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 managed 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.
LAB NAME: Water Tech
CERTIFIED LAB #: 50
PERSON(s) COLLECTING SAMPLES: David Wall
CERTIFIED LABORATORIES
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit [phone] or by visiting http://portal.ncdenr.org/web/wq/swp/ps/npdes/forms.
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data.
* No Flow/Discharge From Site: Check this box if no discharge occurs and, as a result, there are no data to be entered for all of the parameters on the DMR
for entire monitoring period.
** ORC on Site?: ORC must visit facility and document visitation of facility as required per 15A NCAC 8G .0204.
*** Signature of Penmittee: If signed by other than the permittee, then delegation of the signatory authority must be on file with the state per 15A NCAC 2B
.0506(b)(2)(D).

U
S PERMIT NO.: NCO028941
ITY NAME: Pine Valley Subdivision WWTP
R NAME: Aqua North Carolina Inc
E: W W-2
eDMR PERIOD: 08-2016 (August 2016)
PERMIT VERSION: 4.0
CLASS: W W-2
ORC: John David Wall
ORC HAS CHANGED: No
VERSION: 1_0
PERMIT STATUS: Active
COUNTY: Rowan
ORC CERT NUMBER: 19498
RECEIVED/NCDENR/DWR
STATUS: Processed O C T 2 4 2016
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DI Pl-V
.1 SILLE REGIONAL OFFICE
q
c
e
e
U A
E
i
E
E.
1
F
iv
O
in
o
O
E
O
U
O 1z
t
a
a
50050
00010
00400
50060
C0310
C0610
C0530
31616
00300
Weekly
5 X week
Weekly
2 X week
Weekly
Weekly
Weekly
Weekly
Weekly
order
Gmb
Gmb
Gmb
Gmb
Gmb
Gmb
Crab
Gmb
FLOW
TEMP-C
pH
CHLORINE
ROD -Cone
NH3-N-Cone
TSS-Cone
FCOLIBR
DO
2400 dock
Hrs
2400 clock
Hrs
YA%N
mgd
deg c
so
u9/1
mg/l
mg/l
m9/1
9/100m1
mg/l
1
24
1115
3.08333
Y
0.00517
26
7.7
<20
7.6
2
24
1054
3.28333
Y
0.00517
26
<20
3
1120
24
1005
1.25
Y
0.00342
26
2.2
<0.2
5.8
7
4
24
1025
3.73333
Y
0.00398
25
5 1
124
1027
3.31666
Y
0.00355
25
6
24
N
0.00298
7
24
N
0.0034
8
24
1046
3.25
Y
0.00406
26
7.6
<20
7.2
9
24
1107
2.65
Y
0.0037
26
<20
10
24
1111
3.05
Y
0.00362
26
11
11120
124
1003
1.29333
Y
0.00319
26
1
22
<0.2
T2
<1
12
24
1108
1.1
B
0.00401
26
13
24
N
0.0039
14
24
N
0.0039
15
24
1202
2.11666
Y
0.0039
27
7.3
<20
6.6
16
1
124
1227
1.6
Y
1
0.00496
127
<20
17
24
1112
3.01666
Y
0.00367
27
18
1120
24
1002
1.3
Y
0.00366
27
<2
<0.2
5.8
32
19
24
1115
278333
Y
0.00365
27
20
24
N
0.00409
21
24
N
0.00365
22
24
11135
2.38333
Y
1
0.00365
26
7.4
1<20
1
17.5
23
24
1043
3.28333
Y
0.00378
25
<20
24
1120
24
1000
1.31666
Y
0.00519
25
< 2
< 0.2
4.7
4
25
24
1052
3.08333
Y
0.00562
25
26
1
24
1111
2.78333
Y
0.00517
26
27
-
24
N
0.00361
28
24
N
0.00401
29
24
1031
3.43333
Y
0.00439
25
7.4
<20
7.5
30
24
1018
1.71666
Y
Q00356
25
<20
31
11120
24
1049
.5
Y
0.004
25
<2
< 0.2
9.3
< 1
Monthly Average Limit:
0.025
10
2
30
200
Monthly Average:
0.004M
25.869565
0
10.88
10
6.56
3.894589
17.28
Daily Maximum:
0.00562
27
7.7
0
2.2
0
9.3
32
7.6
Daily Minimum:
0.00298
25
7.3
0
0
0
4.7
0
6.6
****No Reporting Reason: ENFRUSE = No Flow-Reuse/Recycle; ENV WTHR = No Visitation -Adverse Weather; NOFLOW = No Flow; HOLIDAY = No Visitation -Holiday
ICI®
OCT 17 2016
CENTRAL FILES
DWR SECTION

NPDES PERMIT NO.: NCO028941
FACILITY NAME: Pine Valley Subdivision WWTP
OWNER NAME: Aqua North Carolina Inc
GRADE: W W-2
eDMR PERIOD: 08-2016 (August 2016)
PERMIT VERSION: 4.0
CLASS: WW-2
ORC: John David Wall
ORC HAS CHANGED: No
VERSION: 1.0
PERMIT STATUS: Active
COUNTY: Rowan
ORC CERT NUMBER: 19498
STATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO (Continue)
q
s
6
E
U F+
E
EF
c
4
F
fi
w
o
L
O
O
e
O
m
ri
O
t
Z X
C0600
C0665
Quarterly
Quarterly
Crab
Crab
TOTAL N-Cane
TOTAL P-Cone
2400 dock
Hrs
2400 dock lHrs
YB/N 1
m9/1
mgA
1
24
1115
3.08333
Y
2
24
1054
3.28333
Y
3
1120
24
1005
1.25
Y
4
24
1025
3.73333
Y
5 1
24
1027 13.31666
Y
6
2r4
N
7
24
N
8
24
1046
3.25
Y
9
24
1107
2.65
Y
10
24
1111
3.05
Y
11
11120
124
1003
1.28333
Y
12
24
1108
1.1
13
24
14
24
rN_
is
24
1202
2.11666
16
24
1227
1.6
17
1
124
1112
3.01666
Y
18
1120
24
1002
1.3
Y
19
24
1115
179333
Y
20
24
N
21
24
N
22
24
1135
Z.38333
Y
23
1
24
1043
3.28333
Y
24
1120
24
1000
1.31666
Y
25
24
1052
3.08333
Y
26
24
1111
2.78333
Y
27
24
N
28
24
N
29
24
1031
3.43333
Y
3
L�120024
24
1018
1.71666
Y
31
1049
1.5
Y
Monthly Average Limit:
MenthlyAverage:
Daily Mavmum•
Daily Minimum:
****No Reporting Reason: ENFRUSE = No Flow-Reuse/Recycle; ENV WTHR = No Visitation —Adverse Weather; NOFLOW = No Flow; HOLIDAY = No Visitation —Holiday

NPDES PERMIT NO.: NCO028941
FACILITY NAME: Pine Valley Subdivision WWTP
OWNER NAME: Aqua North Carolina Inc
GRADE: W W-2
eDMR PERIOD: 08-2016 (August 2016)
PERMIT VERSION: 4.0
CLASS: WW-2
ORC: John David Wall
ORC HAS CHANGED: No
VERSION: 1.0
PERMIT STATUS: Active
COUNTY: Rowan
ORC CERT NUMBER: 19498
STATUS: Processed
SAMPLING LOCATION: UPSTREAM DISCHARGE NO.: 001
A
a
$
E
O E.
E
U
5
E4
E
z
o
O
rn
O
e
z
O
d
O
U
O
�' o
a d
z Ci
00010
00300
Weekly
Wcckly
Grab
Grab
TEMRC
DO
2400 clock
Hn
2400 clock
Eln
Y/B/N
deg c
mg/l
1
1245
.5
Y
21
81
2
3
4
5
6
7
8
1211
.5
ly
1
21
8
9
10
11
12
13
14
15
1332
.5
Y
1332
7.1
16
17
18
19
20
21
22
1
1320
.5
Y
1320
8.3
23
24
25
26
27
28
29
1209
.5
Y
1209
7.9
30
31
Monthly Average Limit:
Monthly Average:
780.6
7.88
Daily Maximum:
1332
8.3
Daily Minimum:
21
17.1
**** No Reporting Reason: ENFRUSE = No Flow-Reuse/Recycle; ENVWTHR=No Visitation— Adverse Weather; NOFLOW=No Flow; HOLIDAY =NoVisitation —Holiday

NPDES PERMIT NO.: NCO028941
FACILITY NAME: Pine Valley Subdivision WWTP
OWNER NAME: Aqua North Carolina Inc
GRADE: W W-2
eDMR PERIOD: 08-2016 (August 2016)
PERMIT VERSION: 4.0
CLASS: WW-2
ORC: John David Wall
ORC HAS CHANGED: No
VERSION- 1.0
PERMIT STATUS: Active
COUNTY: Rowan
ORC CERT NUMBER: 19498
STATUS: Processed
SAMPLING LOCATION: DOWNSTREAM DISCHARGE NO.: 001
A
EU
U E+
6
BEF
F
E
H
13
h
e
8
O
u
rn
O
en
i
sx
z a
00010
00300
Weekly
Weekly
Grab
Grab
TEMP-C
DO
2400 dock
Hm
2400 dock
Elm
YB/N
deg c
m9/1
1
1248
.5
Y
21
8.4
2
3
4
5
6
7
8
1
1214
.5
Y
21
8.3
9
10
11
12
13
14
is
1335
.5
Y
23
7.3
16
17
18
19
20
21
22
1323
.5
Y
21
8A
23
24
25
26
27
28
29
1
1212
1.5
1 Y
1
21
82
30
31
Monthly Average Limit:
Monthly Average:
21.4
8.12
Daily Mavmum:
23
8.4
Daly Nrm®um:
21
7.3
****No Reporting Reason: ENFRUSE = No Flow-Rcuse/Recycle; ENV WTHR = No Visitation —Adverse Weather; NOFLOW = No Flow; HOLIDAY = No Visitation —Holiday

DES PERMIT NO.: NCO028941 PERMIT VERSION: 4.0
FACILITY NAME: Pine Valley Subdivision WWTP CLASS: WW-2
OWNER NAME: Aqua North Carolina Inc ORC: John David Wall
GRADE: WW-2 ORC HAS CHANGED: No
eDMR PERIOD: 08-2016 (August 2016) VERSION: 1.0
COMPLIANCE-fCompliant CONTACT PHONE #: [phone]
PERMIT STATUS: Active
COUNTY: Rowan
ORC CERT NUMBER: 19498
STATUS: Processed
SUBMISSION DATE: 09/28/2016
11 / (A � J (J" 09/28/2016
ORC/Certifier Signature: John David Wall E-Mail:[e-mail] Phone #:[phone] Date
By this signature, I certify that this report is accurate and complete to the best of my knowledge.
The permittee shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment.
Any information shall be provided orally within 24 hours from the time the permittee became aware of the circumstances. A written submission shall also be
provided within 5 days of the time the permittee becomes aware of the circumstances.
If the facility is noncompliant, please attach a list of corrective actions being taken and a time -table for improvements to be made as required by part H.E.6 of
the NPDES permit.
09/28/2016
Term ittee/Submitter Signature:*** Duane Rimmer E-Mail:[e-mail] Phone #:[phone] Date
Permittee Address: NCSR 1802 Salisbury NC 28144 Permit Expiration Date: 03/01/2019
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 managed 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.
LAB NAME: Water Tech
CERTIFIED LAB #: 50
PERSON(s) COLLECTING SAMPLES: David Wall
CERTIFIED LABORATORIES
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit [phone] or by visiting http://portal.ncdenr.org/web/wq/swp/ps/npdes/forms.
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data.
* No Flow/Discharge From Site: Check this box if no discharge occurs and, as a result, there are no data to be entered for all of the parameters on the DMR
for entire monitoring period.
** ORC on Site?: ORC must visit facility and document visitation of facility as required per 15A NCAC 8G .0204.
*** Signature of Permittee: If signed by other than the permittee, then delegation of the signatory authority must be on file with the state per 15A NCAC 2B
.0506(b)(2)(D).

IF MIT
NO.: NCO028941
FACILITY NAME: Pine Valley Subdivision WWTP
OWNER NAME: Aqua North Carolina Inc
GRADE: W W-2
eDMR PERIOD: 07-2016 (July 2016)
PERMIT VERSION: 4.0
CLASS: WW-2
ORC: John David Wall
ORC HAS CHANGED: No
VERSION: 1.0
PERMIT STATUS: Active
COUNTY: Rowan
ORC CERT NUMBER: 19498
STATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001
RECEIVED/NCDENR/DWR
NOV 16 2016
NO DISCHARGF3loNO
MOORESVILLE REGIONAL OFRCE
s
E
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6
i
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E
a
F
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F
>
G
O
in
e
O
F
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U
O
a° "
o
m
Z a
50050
00010
00400
50060
C0310
C0610
C0530
31616
00300
Weekly
5 X week
Weekly
2 X week
Weekly
Weekly
Weekly
Weekly
Weekly
Instantaneous
Grab
Grab
Grab
Composite
Composite
Composite
Grab
Grab
FLOW
TEMP-C
pH
CHLORINE
BOD - Conc
NH3-N - Cone
TSS - Conc
FCOLI BR
IDO
2400 clock
Hrs
2400 clock
Hrs
YB/N
mgd
deg c
su
ug/1
mg/I
mg/I
mg/1
#/100m1
mgQ
1
11:44
2.25
Y
0.003
24
2
3
4
HOLIDAY
5
11:48
24
11:48
1.5
Y
0.003
25
7.5
<20
7.3
6
11:00
0.5
Y
0.004
24
< 2
0.74
4.8
< 1
7
11:35
2.25
Y
0.004
25
<20
8
11:39
225
Y
0.004
25
9
10
11
12:23
1.25
Y
0.005
25
7.6
<20
7.4
12
12:05
2
Y
0.006
25
<20
13
11:33
24
11:33
10.5
Y
0.006
25
14
11:15
0.5
Y
0.007
26
<2
<0.2
11
<1
15
11:25
2.5
Y
0.003
26
16
17
18
12:20
1.75
Y
0.003
25
7.4
<20
7.9
19
1
12:27 11.75
Y
0.003
26
1
<20
20
14:15 _ -
24
14:15
0.25--
Y
0.003_ _-�
26�-
_
21
10:59
0.50
Y
0.004
26
< 2
< 02
7.3
< 1
22
11:13
2.75
Y
0.004
26
23
24
25
13:01
1.25
Y
0.004
27
7.7
<20
7.3
26
12:07
2.25
12:07
2.25
Y
0.003
27
<20
27
11:15
0.50
Y
0.003
27
2.1
0.51
4.5
4
28
12:51
1.50
Y
0.004
27
29
11:57 12.25
Y
0.004 127
30
31
Monthly Average Limit:
0.025
10
2
30
200
Monthly Average:
0.0114
25.7
0
0.525
0.3125
6.9
1.414214
7.475
Daily Maximum:
0.007
27
7.7
0
2.1
0.74 ill
4
7.9
Daily Minimum:
0.003 124
7.4 10
0
0
4.5
0
7.3
****No Reporting Reason: ENFRUSE=NoFlow-Reuse/Recycle; ENVWTHR=No Visitation -Adverse Weather, NOFLOW=No Flow; HOLIDAY=NoVisitation- Holiday
RECEIVED
Nov 0 9 2016
CENTRAL FILES
DWR SECTION

T NO.: NCO028941
FACILITY NAME: Pine Valley Subdivision WWTP
OWNER NAME: Aqua North Carolina Inc
GRADE: WW-2
eDMR PERIOD: 07-2016 (July 2016)
PERMIT VERSION: 4.0
CLASS: WW-2
ORC: John David Wall
ORC HAS CHANGED: No
VERSION: 1.0
PERMIT STATUS: Active
COUNTY: Rowan
ORC CERT NUMBER: 19498
STATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO (Continue)
a
q
c
E
a
E
o f
U C-
E
is
o
a
o
F
E
F
a
t
c
O
y
e
O
E
Y
.a.
a
1 O
u
U
C
O
o0
i
a o
o
z x"
C0600
C0665
Quarterly
Quarterly
Composite
Composite
TOTAL N- Cone
TOTAL P- Cone
2400 dock
Hrs
2400 clock
Hrs
YB/N
mg/1
mg/l
1
11:44
2.25
Y
2
3
4
HOLIDAY
5
11:48
24
11:48
1.5
Y
6
11:00
0.5
Y
5.78
5.12
7
11:35
2.25
Y
8
11:39
2.25
Y
9
10
I1
12:23
1.25
Y
12
12:05
2
Y
13
11:33
24
11:33
0.5
Y
14
11:15
0.5
Y
15
11:25
12.5
Y
16
17
18
12:20
1.75
Y
19
12:27
1.75
Y
20
14:15
24
14:15
0.25-
21
10:59 10.50
Y
22 1
11:13
2.75
Y
23
24
25--1
13:01- _
1.25
Y
- -
26
12:07
2.25
12:07
2.25
Y
27
11:15
0.50
Y
28
12:51
1.50
Y
29
11:57
2.25
Y
30
31
Monthly Average Limit:
Monthly Average:
5.78
5.12
Daily Maximum:
5.78
5.12
Daily Minimum:
5.78
5.12
**** No Reporting Reason: ENFRUSE = No Flow-Reuse/Recycle; ENVWTHR=No Visitation— Adverse Weather; NOFLOW=No Flow; HOLIDAY=NoVisitation— Holiday

WL
T NO.: NCO028941 PERMIT VERSION: 4.0
FACILITY NAME: Pine Valley Subdivision WWTP CLASS: WW-2
OWNER NAME: Aqua North Carolina Inc ORC: John David Wall
GRADE: WW-2 ORC HAS CHANGED: No
eDMR PERIOD: 07-2016 (July 2016) VERSION: 1.0
SAMPLING LOCATION: UPSTREAM
PERMIT STATUS: Active
COUNTY: Rowan
ORC CERT NUMBER: 19498
STATUS: Processed
DISCHARGE NO.: 001
L1
E
o f
U E-
fi
u
o
F
E
a
P,
O
h
O
e
P
a
1 O
t
In
O
U
C
O
m
o s
C o
o u
Z 0.'
00010
00300
Weekly
Weekly
Grab
Grab
TEM -C
DO
2400 clock
Hrs
2400 clock
-firs
YB/N
deg c
mg/l
I
2
3
4
1
1
HOLIDAY
5
---
-
12:29 —
Y
20
7.3
6
7
8
9
10
11
13:09
ly
21
8
12
13
14
15
16
17
18
12:58
Y
21
7.9
19 -
-
-
-- -
--
- - -
21
22
23
24
25
-- _
—
-13:43 --
— --
Y
-----
22
7.4
26
27
28
29
30
31
Monthly Average Limit:
-
Monthly Average:
21
7.65
` Daily Maximum:
22
8
Daily Minimum:
20
7.3 '
**** No Reporting Reason: ENFRUSE = No Flow-Reuse/Recycle; ENV WTHR = No Visitation — Adverse Weather; NOFLOW = No Flow; HOLIDAY = No Visitation — Holiday

T NO.: NCO028941
PERMIT STATUS: Active
FACILITY NAME: Pine Valley Subdivision WWTP
OWNER NAME: Aqua North Carolina Inc
GRADE: WW-2
eDMR PERIOD: 07-2016 (July 2016)
PERMIT VERSION: 4.0
CLASS: WW-2
ORC: John David Wall
ORC HAS CHANGED: No
VERSION: 1.0
COUNTY: Rowan
ORC CERT NUMBER: 19498
STATUS: Processed
SAMPLING LOCATION: DOWNSTREAM DISCHARGE NO.: 001
O
E
m
a
E E
U E-
E
-
V
a
F
2
'6'
O
y
'-
1 O
O
U
O
d o
o: w
Z tz
00010
00300
Weekly
Weekly
Grab
Grab
TEMP-C
DO
2400 clock
firs
2400 clock
firs
YB/N
deg c
m9/1
1
2
3
4
5
12:32
Y
21
7.2
6
7
8
9
10
11
13:12
Y
21
7.7 '
12
13
14
15
16
17
18
13:01
Y
21
7.7
19
20
--
- "--
- - i
- -- '---- - --
- - --
21
22
23
24
25
-- -
13:46—
Y - -
22 - - -
7.5
26
27
28
29
30
31
Monthly Average Limit:
Monthly Average:
2125
7.525
Daily Maximum:
22
7.7
Daily Minimum:
21
72
****No Reporting Reason: ENFRUSE = No Flow-Reuse/Recycle; ENV WTHR = No Visitation -Adverse Weather; NOFLOW = No Flow; HOLIDAY = No Visitation -Holiday

WL
T NO.: NCO028941 PERMIT VERSION: 4.0 PERMIT STATUS: Active
FACILITY NAME: Pine Valley Subdivision WWTP CLASS: WW-2 COUNTY: Rowan
OWNER NAME: Aqua North Carolina Inc ORC: John David Wall ORC CERT NUMBER: 19498
GRADE: WW-2 ORC HAS CHANGED: No
eDMR PERIOD: 07-2016 (July 2016) VERSION: 1.0 STATUS: Processed
COMPLIANCE: Compliant C ACT PHONE #: [phone] SUBMISSION DATE: 08/30/2016
%J�,h L 08/30/2016
V CA
ORC/Certifi r Signature: Michael A Melton E-Mail:[e-mail] Phone #:[phone] Date
By this signature, I certify that this report is �ccurate and complete to the best of my knowledge.
The permittee shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment.
Any information shall.be provided orally within 24 hours from the time the permittee became aware of the circumstances. A written submission shall also be
provided within 5 days of the time the permittee becomes aware of the circumstances.
If the facility is noncompliant, please attach a list of corrective actions being taken and a time -table for improvements to be made as required by part II.E.6 of
the NPDES permit.
08/30/2016
Permittee/Submitter Suture:*** Michael A Melton E-Mail:[e-mail] Phone #:[phone] Date
Permittee Address: NCSR 1802 Salisbury NC 28144 Permit Expiration Date: 03/01/2019
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 managed 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.
CERTIFIED LABORATORIES -
LAB NAME: Water Tech Labs
CERTIFIED LAB #: 50
PERSON(s) COLLECTING SAMPLES: John Wall
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit [phone] or by visiting http://portal.ncdenr.org/web/wq/swp/ps/npdes/forms.
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data.
* No Flow/Discharge From Site: Check this box if no discharge occurs and, as a result, there are no data to be entered for all of the parameters on the DMR
for entire monitoring period.
** ORC on Site?: ORC must visit facility and document visitation of facility as required per 15A NCAC 8G .0204.
*** Signature of Permittee: If signed by other than the permittee, then delegation of the signatory authority must be on file with the state per 15A NCAC 2B
.0506(b)(2)(D).

Effluent
,3
NPDES PERMIT NO. NCO028941
Discharge No.: 001 Month: June
Year:
2016
Facility Name: Pine Valley S/D WWTP Class:
If County:
Rowan
Operator in Responsible Charge (ORC):
David Wall Grade:
II Phone: [phone]
Certified Laboratory (1): Water Tech Labs Inc (2)
CHECK BOX IF ORC HAS CHANGED
PER O S) COL CTING S
MPLES Operators
/
7(Lf
Mail ORIGINAL and ONE COPY to:
X
b
ATTN: CENTRAL FILES
(SIGNATURE O ERA OR IN
SPONSIBLE CHARGE)
ATE
DIVISION OF WATER QUALITY
BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS
RECEIVED/NCDENR/DWR
1617 MAIL SERVICE CENTER
ACCURATE AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
RALEIGH, NC 27699-1617
1-'
AUG 0 q 2016
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0,i-
�U
C
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$�
m
y 0
0 CL
O
0
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50050
00010
00400
50060
00310
00610
00530
31616
00300
00600
00665
FLOW
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p a
~0
ENTER PARAMETER CODE ABOVE
NAME AND UNITS BELOW
EFF■
INF ❑
�w
0
HRS
HIRS
Y/B/N
MGD
OC
UNITS
UG/L
MG/L
MG/L I
MG/L
#/100ML
MG/L
MG/L
MG/L
1
1105
0.5
Y
0.003
21
7.4
<0.2
1 7.0
6
2
1119
2.75
Y
0.004
22
<20
gg q�
C ..
3
1125
2.5
Y
0.004
22
4
1
0.005
1
G U
5
0.006
6
1309
0.75
Y
0.004
23
7.5
<20
7.4
i CE
7
1132
2
Y
0.004
23
<20
8
1057
0.5
Y
0.002
22
7.2
<0.2
6.4
5
9
1231
1
Y
0.003
22
10
1252
1.25
Y
0.002
22
11
0.004
12
0.004
13
1245
1.5
Y
0.003
23
14
1050
0.75
Y
0.003
23
7.4
<20
7.6
016
15
1150
2.25
Y
0.003
24
<20
16
1120
0.5
Y
0.004
24
1
1 5.2
0.73
4.7
3
17
1345
0.5
Y
0.003
25
18
0.004
19
0.003
20
1156
2
Y
0.003
22
7.6
<20
7.8
21
1215
2
Y
0.004
23
<20
22
1118
0.5
Y
0.004
23 .
8.2
<0.2
4.4
34
r.
23
1118
2.75
Y
0.003
24
24
1137
2.5
Y
0.003
24
25
0.003
26
0.003
27
1132
2.5
Y
0.003
24
7.7
<20
7.3
28
1122
2.5
Y
0.003
24
<20
29
1058
0.5
Y
0.003
24
3.9
<0.2
8.2
8
30
1138
2.25
Y
0.003
24
31
AVERAGE
0.003
23
0
6.4
0.15
6.1
8
7.5
MAXIMUM
0.006
25
7.7
<20
8.2
0.73
8.2
34
7.8
MINIMUM
0.002
21
7.4
<20
3.9
<0.2
4.4
3
7.3
Comp. (C)/Grab (G)
G
G
G
C
C
C
G
G
C
C
Monthly limit
0.0250
NL
6/9
10.0
F 2.0
30.0
200
NL
NL
Daily Maximum
1
1 17
1 15.0
1 10.0
45.0
400
>6.0
OFFICE
i�J

Facility Status: (Please check one of the following):
All monitoring data and sampling frequencies meet permit requirements IZI
Compliant
All monitoring data and sampling frequencies do NOT meet permit requirements D
Noncompliant
If the facility is noncompliant, please comment on corrective actions being taken in respect to equipment, operation, maintenance, etc.
and a time table for improvements to be made.
"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 fines and imprisonment for knowing violations."
Thomas J. Roberts, President, Aqua North Carolina, Inc.
itee (Please print o e)
Signature of ermittee ** Date
Permittee Address Phone Number Permit Exp. Date
202 MacKenan Court, Cary, NC 27511 704-489-9404 March 31, 2019
00010 Temperature
00076 Turbidity
00080 Color (Pt -Co)
00082 Color (ADMI)
00095 Conductivity
00300 Dissolved Oxygen
00310 BOD5
00340 COD
00400 pH
00530 Total Suspended
Residue
00545 Settable matter
00556 Oil & Grease
00600 Total Nitrogen
00610 Ammonia Nitrogen
00625 Total Kjeldhal
Nitrogen
00630 Nitrates/Nitrites
00665 Total Phosphorous
00720 Cyanide
00745 Total Sulfide
00927 Total Magnesium
00929 Total Sodium
00940 Total Chloride
PARAMETER CODES
00951 Total Fluoride
01002 Total Arsenic
01027 Cadmium
01032 Hexavalent Chromium
01034 Chromium
01037 Total Cobalt
01042 Copper
01045 Iron
01051 Lead
01067 Nickel
01077 Silver
01092 Zinc
01105 Aluminum
01147 Total Selenium
31616 Fecal Coliform
32730 Total Phenolics
34235 Benzene
34481 Toluene
38260 MBAS
39516 PCBs
50050 Flow
50060 Total
Residual
Chlorine
71880 Formaldehyde
71900 Mercury
81551 Xylene
Parameter Code assistance may be obtained by calling the Water Quality Compliance Group at [phone], extension 581 or 534.
The monthly average for fecal coliform is to be reported as a GEOMETRIC mean. Use only units designated in the reporting
facility's permit for reporting data.
* ORC must visit facility and document visitation of facility as required per 15A NCAC 8A.0202 (b) (5) (B).
** If signed by other than the permittee, delegation of signatory authority must be on file with the State per 15A NCAC 2B.0506 (b)
(2) (D). Pine Valley NC0028941

■
Upstream
NPDES Permit No.: NCO028941 Discharge No
Facility Name: Pine Valley S/D WWTP
Stream: Setman Branch
Location: 100 ft. upstream
Yadkin Pee -Dee RB
Downstream
001 Month: June Year: 2016
County: Rowan
Stream: Setman Branch
Location: 20 ft downstream
Yadkin Pee -Dee RB

w
Effluent
NPDES PERMIT NO. NCO028941 Discharge No.: 001 Month: May Year: 2016
II
Facility Name: Pine Valley S/D WWTP Class: County: Rowan
Operator in Responsible Charge (ORC): David Wall Grade: II Phone: [phone]
Certified Laboratory (1): Water Tech Labs Inc (2)
CHECK BOX IF ORC HAS CHANGED PE S N(S)AOI- f CTING SAMPLES Operators
Mail ORIGINAL and ONE COPY to: X I\jw.-Y u / �V (! 1 14 ) zV 16
ATTN: CENTRAL FILES (SIGNATURE OF OPERATCTR IN RESPONSIBLE CHARGE) DA ERECEIVEDINCDENP,/DWFi
DIVISION OF WATER QUALITY BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS 6� C
1617 MAIL SERVICE CENTER ACCURATE AND COMPLETE TO THE BEST OF MY KNOWLEDGE. ,� U L 12 Z O 16
RALEIGH, NC 27699-1617
WQROS
hfic)r)Dr: I G _GIONAL OFF'.
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❑
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00400
50060
00310
00610
00530
31616
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00600
00665
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PARAMETER CODE ABOVEE
NAME AND UNITS BELOW
EFF■
INF ❑
r w
��
o�a
HRS
HRS
Y/B/N
MGD
OC
UNITS
UG/L
MG/L
MG/L
MG/L
#/100ML
MG/L
MG/L
MG/L
1
2
1106
2.5
Y
20
7.5
<20
7.9
3
1113
2.75
Y
20
<20
4
1056
0.5
Y
20
2.2
0.52
5.0
<1
5
1130
2
Y
18
6
1039
3.25
Y
0.004
17
7
P9
8
1147
2.25
Y
18
<20
10
1114
2.25
Y
19
7.6
<20
7.8
11
1123
0.5
Y
20
12
1105
0.5
Y
0.004
20
<2.0
0.37
4.0
<1
13
1126
2.5
Y
0.005
20
14
0.004
15
0.003
16
1130
2
Y
0.003
18
1 7.6
<20
8.3
17
1137
2
Y
0.003
17
<20
18
1200
1
Y
0.003
18
19
1057
0.5
Y
0.003
18
<2.0
0.76
5.2
<1
20
1108
0.5
B
0.005
19
21
0.004
22
0.003
23
1151
2
Y
0.003
18
7.7
<20
8.6
24
1021
0.75
Y
0.003
18
<20
25
1053
0.5
Y
0.004
18
4.7
<0.2
6.5
3
26
1112
0.5
Y
0.003
19
27
1108
1.25
Y
0.003
19
28
0.003
29
0.005
30
Holiday
H
0.004
31
1 1147
1.5
Y
0.004
22
7.2
<20
7.3
AVERAGE
0.004
19
0
1.7
0.41
5.2
1
7.9
MAXIMUM
0.005
22
7.7
<20
4.7
0.76
6.5
3
8.6
MINIMUM
0.003
17
7.2
<20
<2.0
<0.2
4.0
<1
7.3
Comp. (C)/Grab (G)
G
G
G
C
C
C
G
G
C
C
limit
0.0250
NL
6/9
10.0
2.0
30.0
200
NL
NL
PLMonthly
Daily Maximum
1
17
15.0
10.0
1 45.0
1 400
>6.0
fV
[ 2016
FILE$
CTION

ow
Facility Status: (Please check one of the following):
All monitoring data and sampling frequencies meet permit requirements
All monitoring data and sampling frequencies do NOT meet permit requirements
I-]
Compliant
Noncompliant
If the facility is noncompliant, please comment on corrective actions being taken in respect to equipment, operation, maintenance, etc.
and a time table for improvements to be made.
"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 fines and imprisonment for knowing violations."
Thomas J. Roberts, President, Aqua North Carolina, Inc.
Permittee (Please print o pe)
Signature of Permittee ** Date
Permittee Address Phone Number Permit Exp. Date
202 MacKenan Court, Cary, NC 27511 704-489-9404 March 31, 2019
00010 Temperature 00556 Oil & Grease
00076 Turbidity 00600 Total Nitrogen
00080 Color (Pt -Co) 00610 Ammonia Nitrogen
00082 Color (ADMI) 00625 Total Kjeldhal
Nitrogen
00095 Conductivity 00630 Nitrates/Nitrites
00300 Dissolved Oxygen
00310 BOD5 00665 Total Phosphorous
00340 COD 00720 Cyanide
00400 pH 00745 Total Sulfide
0053.0 Total Suspended 00927 Total Magnesium
Residue 00929 Total Sodium
00545 Settable matter 00940 Total Chloride
PARAMETER CODES
00951 Total Fluoride
01002 Total Arsenic
01027 Cadmium
01032 Hexavalent Chromium
01034 Chromium
01037 Total Cobalt
01042 Copper
01045 Iron
01051 Lead
01067 Nickel
01077 Silver
01092 Zinc
01105 Aluminum
01147 Total Selenium
31616 Fecal Coliform
32730 Total Phenolics
34235 Benzene
34481 Toluene
38260 MBAS
39516 PCBs
50050 Flow
50060 Total
Residual
Chlorine
71880 Formaldehyde
71900 Mercury
81551 Xylene
Parameter Code assistance may be obtained by calling the Water Quality Compliance Group at [phone], extension 581 or 534.
The monthly average for fecal coliform is to be reported as a GEOMETRIC mean. Use only units designated in the reporting
facility's permit for reporting data.
* ORC must visit facility and document visitation of facility as required per 15A NCAC 8A.0202 (b) (5) (B).
** If signed by other than the permittee, delegation of signatory authority must be on file with the State per 15A NCAC 2B.0506 (b)
(2) (D). Pine Valley NCO028941

Upstream
NPDES Permit No.: NCO028941 Discharge No.
Facility Name: Pine Valley S/D VVVVTP
Stream: Setman Branch
Location: 100 ft. upstream
Yadkin Pee -Dee RB
Downstream
001 Month: May Year: 2016
County: Rowan
Stream: Setman Branch
Location: 20 ft downstream
Yadkin Pee -Dee RB

Effluent
ES PERMIT NO. NCO028941 Discharge No.: 001
ity Name: Pine Valley S/D WWTP
ilrator
in Responsible Charge (ORC): David Wall
Certified Laboratory (1): Water Tech Labs Inc
CHECK BOX IF ORC HAS CHANGED 1=1 PER ON(
Mail ORIGINAL and ONE COPY to: X
ATTN: CENTRAL FILES
DIVISION OF WATER QUALITY
1617 MAIL SERVICE CENTER
RALEIGH, NC 27699-1617
Month: April Year: 2016
Class: If County: Rnwan
Grade: II Phone: [phone]
(2)
;OL CTIN SAMPLES Operators
OPERATORIN
BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS
ACCURATE AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
3
ENR/DWR
JUN 14 2016
WQROS
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31616
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00665
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ENTER PARAMETER CODE ABOVE
NAME AND UNITS BELOW
EFF
INF ❑
J W
o�Uj
HRS
HRS
Y/B/N
MGD
OC
UNITS
UG/L
MG/L
MG/L
MG/L
#/100ML
MG/L
MG/L
MG/L
1
1125
2.5
Y
0.004
17
2
3
4
1130
2.25
Y
17
7.6
<20
8.7
5
1108
2
Y
16
<20
6
1053
0.5
Y
14
<2.0
<0.2
4.0
<1
14.32
4.50
7
1115
2.75
Y
15
8
1049
3
Y
0.004
15
9
10
11
1718
0.25
Y
17
12
1256
1
Y
17
it R
13
1134
2.25
Y
15
7.6
<20
9.7
14
1057
0.5
Y
15
<2.0 -
0 229
4.5
<1
15
1105
2.75
Y
0.004
16
<20
16
17
18
1116
2.75
Y
17
7,3
<20
8.4
19
1102
3
Y
17
20
1055
0.5
Y
18
<2.0
0.31
6.7
<1
21
1114
0.5
Y
19
<20
22
1127
0.5
Y
0.004
19
23
24
v
25
1140
2.25
Y
20
7.6
<20
8.2
26
1137
2.25
Y
20
<20 -
27
1050
0.5
Y
20
6.4
1.01
3.4
<1
28
1109
2.75
Y
20
29
1118
2.75
Y
0.004
20
30
31
AVERAGE
0.004
17
0
1.6
0.27
3.7
1
8.8
14.32
4.50
MAXIMUM
0.004
20
7.6
<20
6.4
1.01
6.7
<1
9.7
14.32
4.50
MINIMUM
0.004
14
7.3
<20
<2.0
<0.2
3.4
<1
8.2
14.32
4.50
Comp. (C)/Grab I
G
G
G
C
C
C
G
G
C
C
Monthly limit
0.0250
NL
6/9
10.0
2.0
30.0
200
NL
NL
Daily Maximum
17
15.0
10.0
45.0
400
>6.0
AL OFFICE
,-0
2016
ILES
ION

Facility Status: (Please check one of the following):
All monitoring data and sampling frequencies meet permit requirements 1Z
Compliant
All monitoring data and sampling frequencies do NOT meet permit requirements E]
Noncompliant
If the facility is noncompliant, please comment on corrective actions being taken in respect to equipment, operation, maintenance, etc.
and a time table for improvements to be made.
"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 fines and imprisonment for knowing violations."
Thomas J. Roberts, President, Aqua North Carolina, Inc.
Permittee (Please print o e)
Signature of Permittee ** Date
Permittee Address
Phone Number
Permit Exp, Date
202 MacKenan Court, Cary, NC 27511
704-489-9404
March 31, 2019
PARAMETER CODES
00010 Temperature
00556 Oil & Grease
00951 Total Fluoride
01067 Nickel
50060 Total
00076 Turbidity
00600 Total Nitrogen
01002 Total Arsenic
01077 Silver
Residual
00080 Color (Pt -Co)
00610 Ammonia Nitrogen
01092 Zinc
Chlorine
00082 Color (ADMI)
00625 Total Kjeldhal
01027 Cadmium
01105 Aluminum
Nitrogen
00095 Conductivity
00630 Nitrates/Nitrites
01032 Hexavalent Chromium 01147 Total Selenium
71880 Formaldehyde
00300 Dissolved Oxygen
01034 Chromium
31616 Fecal Coliform
71900 Mercury
00310 BOD5
00665 Total Phosphorous
32730 Total Phenolics
81551 Xylene
00340 COD
00720 Cyanide
01037 Total Cobalt
34235 Benzene
00400 pH
00745 Total Sulfide
01042 Copper
34481 Toluene
00530 Total Suspended
00927 Total Magnesium
38260 MBAS
Residue
00929 Total Sodium
01045 Iron
39516 PCBs
00545 Settable matter
00940 Total Chloride
01051 Lead
50050 Flow
Parameter Code assistance may be obtained by calling the Water Quality Compliance Group at [phone], extension 581 or 534.
The monthly average for fecal coliform is to be reported as a GEOMETRIC mean. Use only units designated in the reporting
facility's permit for reporting data.
* ORC must visit facility and document visitation of facility as required per 15A NCAC 8A.0202 (b) (5) (B).
** If signed by other than the permittee, delegation of signatory authority must be on file with the State per 15A NCAC 213.0506 (b)
(2) (D). Pine Valley NCO028941

Upstream
ES Permit No.: NCO028941
Discharge No.: 001 Month:
ility Name: Pine Valley S/D WWTP
County:
Downstream
April Year: 2016
Rowan
Stream: Setman Branch Stream: Setman Branch
Location: 100 ft. upstream Location: 20 ft downstream
Yadkin Pee -Dee RB Yadkin Pee -Dee RB

Effluent _13
NPDES PERMIT NO. NCO028941
Discharge No.: 001
Month: March Year:
2016 . -
Facility Name: Pine Valley S/D WWTP
Class: 1 II -. County:
-- Rowan
Operator in Responsible Charge (ORC):
David Wall
Grade: II Phone:
704-489-9404
Certified Laboratory (1): Water Tech Labs Inc
(2)
CHECK BOX IF ORC HAS CHANGED
® . PE S N(S)
LL TING SAMPLES Operators
Mail ORIGINAL and ONE COPY to:
X
z �'
ATTN: CENTRAL FILES
(SIGNATURE OF
ERA R IN RESPONSIBLE CHARGE)
DAT
DIVISION OF WATER QUALITY
BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS
1617 MAIL SERVICE CENTER
RALEIGH, NO 27699-1617
ACCURATE AND COMPLETE TO THE BEST OF -MY KNOWLEDGE.
MAY 1 8 2016
FE
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titG�MIVtU UD
/N2C42016
EFF■
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0 of0
HRS
HRS
Y/B/N
MGD
°C
UNITS
UG/L
MG/L
MG/L
MG/L
#/100ML
MG/L
MG/L
MG/L
1
1118
2.75
Y
16
<20
t
•'I
2
1050
0.5
Y
12
<2.0
<0.2
3.9
6
3
1050
2.5
Y
11
4
1108
2.5
Y
0.004
11
5
6�6%It-BX
7
1128
2.25
Y
13
6.4
<20
9.3.
a aB_Ka>
--I; q7
8
1115
2.5
Y
13
<20
9
1052
0.5
Y
14
2.8
<0.2
5.6
2
10 '
1152
2
Y
15
PrfT.(4')
11
1058
2.75
Y
0.004
17
.�
12
13',
14
1204
2
Y
18
7.7
<20
8.4
15
1024
2
Y
17
16
1132
2.5
Y .
18
<20
17
1 1053
1 0.5
Y
17
3.6
<0.2
5.8
<1
18 .
1129
2.5
Y
0.004
17
19
20
21
1153
1.75
Y
13
7.3
<20
9.3
22
1105
2.5
Y
13
<20
23
1051
0.5
Y
14
<2.0
<0.2
4.7
<1
24
1148
2.25
Y
16
25
1055
2.75
Y
o.b04
17
26
27
28
1053
3
Y
17
7.5
<20
7.8
29
1059
2.5
Y
16
<20
30 '
1052
0.5
Y
15
2.7
<0.2
4.1
<1
31
1118
2.75
Y
17
: AVERAGE
0.004
15
M
0
1.8
0.00
4.8
2
8.7
MAXIMUM
0.004
18
7.7
<20
3.6
<0.2
5.8
6
9.3
MINIMUM'
0.004
11
6.4
<20
<2.0
<0.2
3.9
<1
7.8
Comp. (C)/Grab (G)
G
G
G
C
C
C
G
G
C
C
Monthly limit
0.0250
NL
6/9
10.0
4.0
30.0
200
NL
NL
Daily Maximum
17
15.0
20.0
45.0
1 400
>6.0
F
OFFICE

Facility Status: (Please check one of the following):
All monitoring data and sampling frequencies meet permit requirements F
Compliant
All monitoring data and sampling frequencies do NOT meet permit requirements D
Noncompliant
If the facility is noncompliant, please comment on corrective actions being taken in respect to equipment, operation, maintenance, etc.
and a time table for improvements to be made.
"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 fines and imprisonment for knowing violations."
Thomas J. Roberts, President, Aqua North Carolina, Inc.
P 'ttee (Please print
Signature of Permittee **
Date
Permittee Address Phone Number Permit Exp. Date
202 MacKenan Court, Cary, NC 27511 704-489-9404 March 31, 2019
PARAMETER CODES
00010 Temperature
00556 Oil & Grease
00951 Total Fluoride
01067 Nickel
00076 Turbidity
00600 Total Nitrogen
01002 Total Arsenic
01077 Silver
00080 Color (Pt -Co)
00610 Ammonia Nitrogen
01092 Zinc
00082 Color (ADMI)
00625 Total Kjeldhal
01027 Cadmium
01105 Aluminum
Nitrogen
00095 Conductivity
00630 Nitrates/Nitrites
01032 Hexavalent Chromium 01147 Total Selenium
00300 Dissolved Oxygen
01034 Chromium
31616 Fecal Coliform
00310 BOD5
00665 Total Phosphorous
32730 Total Phenolics
00340 COD
00720 Cyanide
01037 Total Cobalt
34235 Benzene
00400 pH
00745 Total Sulfide
01042 Copper
34481 Toluene
00530 Total Suspended
00927 Total Magnesium
38260 MBAS
Residue
00929 Total Sodium
01045 Iron
39516 PCBs
00545 Settable matter
00940 Total Chloride
01051 Lead
50050 Flow
50060 Total
Residual
Chlorine
71880 Formaldehyde
71900 Mercury
81551 Xylene
Parameter Code assistance may be obtained by calling the Water Quality Compliance Group at [phone], extension 581 or 534.
The monthly average for fecal coliform is to be reported as a GEOMETRIC mean. Use only units designated in the reporting
facility's permit for reporting data.
* ORC must visit facility and document visitation of facility as required per 15A NCAC 8A.0202 (b) (5) (B).
** If signed by other than the permittee, delegation of signatory authority must be on file with the State per 15A NCAC 2B.0506 (b)
(2) (D). Pine Valley NC0028941

Upstream
NPDES Permit No.: NCO028941 Discharge No.:
Facility Name: Pine Valley S/D WWTP
Stream: Setman Branch
Location: 100 ft. upstream
Yadkin Pee -Dee RB
7M
Downstream
001 Month: March Year: 2016
County: Rowan
Stream: Setman Branch
Location: 20 ft downstream
Yadkin Pee -Dee RB

Effluent
3
NPDES PERMIT NO. NCO028941 Discharge No.: 001 Month: February Year: 2016
Facility Name: Pine Valley S/D WWTP Class: ll County: Rowan
Operator in Responsible Charge (ORC): David Wall Grade: II Phone: [phone]
Certified Laboratory (1): Water Tech Labs Inc
CHECK BOX IF ORC HAS CHANGED PE"ON(S) nL
Mail ORIGINAL and ONE COPY to: X
ATTN: CENTRAL FILES
DIVISION OF WATER QUALITY
1617 MAIL SERVICE CENTER
RALEIGH, NC 27699-1617
(2)
:TING SAMPLES Operators
,,3
►R I �� RESPONSIBLE CHARGE) DATE
�,�
BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS
ACCURATE AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
W
FQ
u0
Ev
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mN
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50050
00010
00400
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00610
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00665
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SC�O�EDLE�ABOVE
/
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2Ojm
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HRS
1 RS
Y/B/N
MGD
OC
UNITS
UG/L
MG/L
MG/L
MG/L
I #/100ML
MG/L
MG/L
MG/L
1
1203
1.5
Y
13
7.4
<20
9.1
2
1206
0.75
Y
13
<20
3
1025
0.5
B
13
<2.0
<0.2
7.8
<1
4
1122
2.5
Y
14
5
1144
2.25
Y
0.004
12
6
7
CEN
8
1139
2
Y
11
6.5
<20
10.2
Dw
9
1209
2
Y
10
<20
10
1051
0.5
Y
8
2.8
<0.2
12.4
4
11
1124
0.5
Y
7
12
1110
2.75
Y
0.004
7
13
LIJ
14
15
1111
0.75
Y
7
PR
2mr.
16
1130
2.5
Y
8
7.6
<20
9.7
17
1135
2.5
Y
10
<20
18
1051
0.5
Y
9
<2.0
<0.2
6.2
3
19
1113
2.75
Y
0.004
9
20
21
22
1150
2
Y
13
6.9
<20
9.3
23
1128
2.5
Y
12
<20
24
1100
0.5
Y
13
.2.2
<0.2
10.4
<1
25
1054
2.75
Y
12
26
1141
2
Y
0.004
12
27
28
29
Y
14
7.2
<20
8.9
30
31
AAVERAGE
0.004
11
0
1.3
0.00
9.2
2
9.4
0.004
14
7.6
<20
2.8
<0.2
12.4
4
10.2
MINIMUM
0.004
7
6.5
<20
<2.0
<0.2
6.2
<1
1 8.9
Comp. (C)/Grab (G)
G
G
G
C
C
C
G
G
C
C
Monthly limit
0.0250
NL
6/9
10.0
4.0
30.0
200
NL
NL
Daily Maximum
17
15.0
20.0
45.0
400
>6.0
M
OFFICE
rLj
016
LES
ON

Facility Status: (Please check one of the following):
All monitoring data and sampling frequencies meet permit requirements
Compliant
All monitoring data and sampling frequencies do NOT meet permit requirements E:1
Noncompliant
If the facility is noncompliant, please comment on corrective actions being taken in respect to equipment, operation, maintenance, etc.
and a time table for improvements to be made.
"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 fines and imprisonment for knowing violations."
Thomas J. Roberts, President, Aqua North Carolina, Inc.
Permittee (Plea=pre)
Signature of Permittee ** Date
Permittee Address Phone Number Permit Exp. Date
202 MacKenan Court, Cary, NC 27511 704-489-9404 March 31, 2019
PARAMETER CODES
00010 Temperature
00556 Oil & Grease
00951 Total Fluoride
01067 Nickel
00076 Turbidity
00600 Total Nitrogen
01002 Total Arsenic
01077 Silver
00080 Color (Pt -Co)
00610 Ammonia Nitrogen
01092 Zinc
00082 Color (ADMI)
00625 Total Kjeldhal
01027 Cadmium
01105 Aluminum
Nitrogen
00095 Conductivity
00630 Nitrates/Nitrites
01032 Hexavalent Chromium 01147 Total Selenium
00300 Dissolved Oxygen
01034 Chromium
31616 Fecal Coliform
00310 BOD5
00665 Total Phosphorous
32730 Total Phenolics
00340 COD
00720 Cyanide
01037 Total Cobalt
34235 Benzene
00400 pH
00745 Total Sulfide
01042 Copper
34481 Toluene
00530 Total Suspended
00927 Total Magnesium
38260 MBAS
Residue
00929 Total Sodium
01045 Iron
39516 PCBs
00545 Settable matter
00940 Total Chloride
01051 Lead
50050 Flow
50060 Total
Residual
Chlorine
71880 Formaldehyde
71900 Mercury
81551 Xylene
Parameter Code assistance may be obtained by calling the Water Quality Compliance Group at [phone], extension 581 or 534.
The monthly average for fecal coliform is to be reported as a GEOMETRIC mean. Use only units designated in the reporting
facility's permit for reporting data.
* ORC must visit facility and document visitation of facility as required per 15A NCAC 8A.0202 (b) (5) (B).
** If signed by other than the permittee, delegation of signatory authority must be on file with the State per 15A NCAC 2B.0506 (b)
(2) (D). Pine Valley NCO028941

� Upstream
NPDES Permit No.: NCO028941 Discharge No.:
Facility Name: Pine Valley SO WWTP
Stream: Setman Branch
Location: 100 ft. upstream
Yadkin Pee -Dee RB
Downstream
001 Month: February Year: 2016
County: Rowan
Stream: Setman Branch
Location: 20 ft downstream
Yadkin Pee -Dee RB

Effluent
a
S PERMIT NO. NCO028941 Discharge No.: 001
Name: Pine Valley S/D WWTO
Operator in Responsible Charge (ORC): David Wall
Certified Laboratory (1): Water Tech Labs Inc
CHECK BOX IF ORC HAS CHANGED r-1 PERSON S
Month: January Year: 2016
Class: It County: Rowan
Grade: II Phone: [phone]
Operators
Mail ORIGINAL and ONE COPY to: X A ) C,[-,
ATTN: CENTRAL FILES (SIGNATURE O PERATOR IN RESPONSIBLE Cl
DIVISION OF WATER QUALITY BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS
1617 MAIL SERVICE CENTER ACCURATE AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
RALEIGH, NC 27699-1617
v 1 1 b
DATE
ERL'e'4 -
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NAME AND UNITS BELOW
EFF ■
INF ❑
I
R O
WQROS
>-W
J
S
Y/B/N
MGD
OC
UNITS
UG/L
MG/L
MG/L
MG/L
#/100ML
MG/L
MG/L
MG/L
1
Holiday
H
2
3
4
1219
1.5
Y
10
CENT
5
1120
1.75
Y
9
6.5
<20
10.4
DVVR
U
6
1051
0.5
Y
8
2.6
0.47
5.0
<1
22.0
4.63
7
1101
3
Y
8
<20
8
1104
3
Y
0.004
9
9
10
11
1150
2
Y
10
6.9
<20
10.0
12
1114
0.5
Y
8
<20
13
1057
0.5
Y
8
3.9
<0.2
4.8
<1
14
1230
1.75
Y
9
15
1031
3.5
Y
0.004
9
16
17
18
1102
2
Y
9
6.8
<20
1
10.3
19
1136
2.5
Y
7
<20
20
1052
0.5
Y
7
<2.0
<0.2
14.3
7
21
1058
2.5
Y
7
a1 ry
22
1103
0.25
B
0.004
6
23
24
25
1136
1
Y
a
6.6
<20
11.0
26
1142
0.75
Y
8
<20
27
1040
3
Y
9
4.4
<0.2
4.0
79
28
1052
0.5
Y
8
29
1158
2
Y
0.040
9
30
31
AVERAGE
0.004
8
0
2.7
0.12
7.0
22
8.2
22.00
4.63
MAXIMUM
0.004
10
6.9
<20
4.4
0.47
14.3
79
11.0
22.00
4.63
MINIMUM
0.004
6
6.5
<20
<2.0
<0.2
4.0
<1
10.0
22.00
4.63
Comp. (C)/Grab (G)
G
G
G
C
C
C
G
G
C
C
Monthly limit
0.0250
NL
6/9
10.0
4.0
30.0
200
NL
NI -
Daily Maximum
17
15.0
20.0
45.0
400
>6.0
NR/DWR
?016
MI, L OFFICE

Facility Status: (Please check one of the following):
All monitoring data and sampling frequencies meet permit requirements
Compliant
All monitoring data and sampling frequencies do NOT meet permit requirements El
Noncompliant
If the facility is noncompliant, please comment on corrective actions being taken in respect to equipment, operation, maintenance, etc.
and a time table for improvements to be made.
"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 fines and imprisonment for knowing violations."
Thomas J. Roberts, President, Aqua North Carolina, Inc.
KIittee (P ease or type)
1161
Signature ofPermittee ** Date
Permittee Address Phone Number Permit Exp. Date
202 MacKenan Court, Cary, NC 27511 704-489-9404 March 31, 2019
PARAMETER CODES
00010 Temperature
00556 Oil & Grease
00951 Total Fluoride
01067 Nickel
00076 Turbidity
00600 Total Nitrogen
01002 Total Arsenic
01077 Silver
00080 Color (Pt -Co)
00610 Ammonia Nitrogen
01092 Zinc
00082 Color (ADMI)
00625 Total Kjeldhal
01027 Cadmium
01105 Aluminum
Nitrogen
00095 Conductivity
00630 Nitrates/Nitrites
01032 Hexavalent Chromium 01147 Total Selenium
00300 Dissolved Oxygen
01034 Chromium
31616 Fecal Coliform
00310 BOD5
00665 Total Phosphorous
32730 Total Phenolics
00340 COD
00720 Cyanide
01037 Total Cobalt
34235 Benzene
00400 pH
00745 Total Sulfide
01042 Copper
34481 Toluene
00530 .Total Suspended
00927 Total Magnesium
38260 MBAS
Residue
00929 Total Sodium
01045 Iron
39516 PCBs
00545 Settable matter
00940 Total Chloride
01051 Lead
50050 Flow
50060 Total
Residual
Chlorine
71880 Formaldehyde
71900 Mercury
81551 Xylene
Parameter Code assistance may be obtained by calling the Water Quality Compliance Group at [phone], extension 581 or 534.
The monthly average for fecal coliform is to be reported as a GEOMETRIC mean. Use only units designated in the reporting
facility's permit for reporting data.
* ORC must visit facility and document visitation of facility as required per 15A NCAC 8A.0202 (b) (5) (B).
** If signed by other than the permittee, delegation of signatory authority must be on file with the State per 15A NCAC 213.0506 (b)
(2) (D). Pine Valley NCO028941

Upstream
ES Permit No.: NCO028941
Discharge No.: 001 Month
Facility Name: Pine Valley SID VVWTP
County:
Downstream
January Year: 2016
Rowan
Stream: Setman Branch Stream: Setman Branch
Location: 100 ft. upstream Location: 20 ft downstream
Yadkin Pee -Dee RB Yadkin Pee -Dee RB

0--
Effluent
NPDES PERMIT NO. NCO028941 Discharge No.: 001
Facility Name: Pine Valley S/D WWTP
Operator in Responsible Charge (ORC): David Wall
Certified Laboratory (1): Water Tech Labs Inc
CHECK BOX IF ORC HAS CHANGED M P (S)
Mail ORIGINAL and ONE COPY to: X
ATTN: CENTRAL FILES
DIVISION OF WATER QUALITY
1617 MAIL SERVICE CENTER
RALEIGH, INC 27699-1617
Month: December Year: 2015
Class: II County: Row n
Grade: II Phone: [phone]
_ (2)
,04CTINC�SAMPLES Operators
BLE CHARGE)
BY THIS SIGNATURE, I CERTIFY THAT THISAtRD1;!?' IS
ACCURATE AND COMPLETE TO T STOF gY}(bjtLEDGE.
3
CDENR/DWR
ELC
FEB 17 2016
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NAME AND UNITS BELOW
EFF
INF
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HRS
HRS
Y/B/N
MGD
OC
UNITS
UG/L
MG/L
MG/L
I MG/L
#/100ML
MG/L
MG/L
MG/L
1
0945
0.25
B
15
2
1314
0.75
B
0.004
17
6.5
<20
8.2
3
0730
2
B
17
1
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8.5
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16.5
6
4
1133
0.5
1 B
15
5
6
7
1126
2.25
Y
12
7.0
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9.9
8
1148
2
Y
13
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9
1059
0.5
Y
12
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<0.2
12.8
6
10
1036
1.5
Y
13
11
1148
2
Y
0.004
15
12
13
14
1120
2.5
Y
17
7.2
<20
8.7
15
1354
0.5
Y
16
<20
3.1
<0.2
8.8
4
16
1 1059
0.5
Y
16
17
1354
0.5
Y
15
18
1203
2
Y
0.004
15
19
20
21
1115
2.25
Y
12
6.7
<20
10.1
22
1113
2.75
Y
12
<20
23
1052
0.5
Y
12
4.2
<0.2
18.0
48
24
1159
1
Y
0.004
16
25
Holiday
H
26
27
28
1117
2.5
Y
19
7.1
<20
8.0
29
1125
2
Y
15
<20
30
1056
0.5
Y
15
2.0
<0.2
4.7
<1
31
1148
2
Y
0.004
17
AVERAGE
0.004
114
0
3.6
0.00
15.5
13
9.0
MAXIMUM
0.004
19
7.2
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8.5
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18.0
48
10.1
MINIMUM
0.004
12
6.5
<20
<2.5
<0.2
4.7
<1
8.0
Comp. (C)/Grab (G)
G
G
G
C
C
C
G
G
C
C
Monthly limit
0.0250
NL
6/9
10.0
4.0
30.0
200
NL
NL
Daily Maximum
17
15.0
20.0
45.0
400
1 >6.0
WIN
.ES
,N

Facility Status: (Please check one of the following):
All monitoring data and sampling frequencies meet permit requirements
Compliant
All monitoring data and sampling frequencies do NOT meet permit requirements El
Noncompliant
If the facility is noncompliant, please comment on corrective actions being taken in respect to equipment, operation, maintenance, etc.
and a time table for improvements to be made.
"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 fines and imprisonment for knowing violations."
Thomas J. Roberts, President, Aqua North Carolina, Inc.
P ittee (Please prin type)
Signature ofPermittee ** Date
Permittee Address Phone Number Permit Exp. Date
202 MacKenan Court, Cary, NC 27511 704-489-9404 March 31, 2019
PARAMETER CODES
00010 Temperature 00556 Oil & Grease 00951 Total Fluoride 01067 Nickel 50060 Total
00076 Turbidity 00600 Total Nitrogen 01002 Total Arsenic 01077 Silver Residual
00080 Color (Pt -Co) 00610 Ammonia Nitrogen 01092 Zinc Chlorine
00082 Color (ADMI) 00625 Total Kjeldhal 01027 Cadmium 01105 Aluminum
Nitrogen
00095 Conductivity 00630 Nitrates/Nitrites 01032 Hexavalent Chromium 01147 Total Selenium 71880 Formaldehyde
00300 Dissolved Oxygen 01034 Chromium 31616 Fecal Coliform 71900 Mercury
00310 BOD5 00665 Total Phosphorous 32730 Total Phenolics 81551 Xylene
00340 COD 00720 Cyanide 01037 Total Cobalt 34235 Benzene
00400 pH 00745 Total Sulfide 01042 Copper 34481 Toluene
00530 Total Suspended 00927 Total Magnesium 38260 MBAS
Residue 00929 Total Sodium 01045 Iron 39516 PCBs
00545 Settable matter 00940 Total Chloride 01051 Lead 50050 Flow
Parameter Code assistance may be obtained by calling the Water Quality Compliance Group at [phone], extension 581 or 534.
The monthly average for fecal coliform is to be reported as a GEOMETRIC mean. Use only units designated in the reporting
facility's permit for reporting data.
* ORC must visit facility and document visitation of facility as required per 15A NCAC 8A.0202 (b) (5) (B).
* * If signed by other than the permittee, delegation of signatory authority must be on file with the State per 15A NCAC 2B.0506 (b)
(2) (D). Pine Valley NCO028941

Upstream
RES Permit No.: NCO028941 Discharge No
Facility Name: Pine Valley S/D WWTP
Stream: Setman Branch
Location: 100 ft. upstream
Yadkin Pee -Dee RB
Downstream
001 Month: December Year: 2012
County: Rowan
Stream: Setman Branch
Location: 20 ft downstream
Yadkin Pee -Dee RB

Effluent
IDES PERMIT NO. NCO028941 Discharge No.: 001 Month: November Year: 2942- /
Facility Name: Pine Valley SID WWTP Class: Il County: RnWan
Operator in Responsible Charge (ORC): David Wall Grade: II Phone: [phone]
Certified Laboratory (1): Water Tech Labs Inc (2)
CHECK BOX IF ORC HAS CHANGED 1=1 P ON( OLL TING SAMPLES Operators
Mail ORIGINAL and ONE COPY to: X
ATTN: CENTRAL FILES
DIVISION OF WATER QUALITY
1617 MAIL SERVICE CENTER
RALEIGH, NC 27699-1617
,-A )aU ),cjA
TS-IGNA-TME OF CIPERATOR IN RESPONSIBLE CHARGE) DATE
BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS
ACCURATE AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
JAN I A 2016
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NAME AND UNITS BELOW
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HRS
HRS
Y/B/N
MGD
OC
UNITS
UG/L
MG/L
MG/L
MG/L
#/100ML
MG/L
MG/L
MG/L
1141
2.5
Y
18
6.7
<20
7.41146
E52
2.5
Y
18
<20
1100
0.5
Y
18
2.6
0.70
9.2
33
Q
1149
2.25
Y
19
6
1132
2.5
Y
0.004
19
CENTRAL
FIL
7
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S- I It
8
9
1120
2.25
Y
17
6.7
<20
8.6
10
1129
2.5
Y
17
<20
11
1053
0.5
Y
16
2.5
<0.2
4.3
12
12
1402
0.25
Y
16
13
1122
0.25
B
0.004
16
14
ECEIV
INCDEP
R/DWR
15
16
1205
1.75
Y
15
6.7
<20
9.7
A
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6
17
1207
2
Y
15
<20
18
1054
0.5
Y
15
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5.8
8
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VQROS
19
1202
2
Y
17
O
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20
1107
3
Y
0.004
17
21
22
23
1140
2
Y
13
6.9
<20
9.9
24
1055
0.5
Y
12
<2.0
0.84
12.8
<1
25
1103
2.75
Y
0.004
12
<20
AN
2nic
26
Holiday
H
Lj
27
Holiday
H
28
29
30
1241
0.25
B
15
31
AVERAGE
0.004
16
0
1.3
0.39
8.0
13
8.9
MAXIMUM
0.004
19
6.9
<20
2.6
0.84
12.8
33
9.9
MINIMUM
0.004
12
6.7
<20
<2.0
<0.2
4.3
<1
7.4
Comp. (C)/Grab (G)
G
G
G
C
C
C
G
G
C
C
Monthly limit
0.0250
NL
6/9
10.0
4.0
30.0
200
NL
NL
Daily Maximum
17
15.0
20.0 1
45.0
400
>6.0
6
rS
�N
:E

Facility Status: (Please check one of the following):
All monitoring data and sampling frequencies meet permit requirements 21
Compliant
All monitoring data and sampling frequencies do NOT meet permit requirements El
Noncompliant
If the facility is noncompliant, please comment on corrective actions being taken in respect to equipment, operation, maintenance, etc.
and a time table for improvements to be made.
"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 fines and imprisonment for knowing violations."
Thomas J. Roberts, President, Aqua North Carolina, Inc.
P -ttee (Please print or type
Signature of Permittee * * Date
Permittee Address Phone Number Permit Exp. Date
202 MacKenan Court, Cary, NC 27511 704-489-9404 March 31, 2019
PARAMETER CODES
00010 Temperature
00556 Oil & Grease
00951 Total Fluoride
01067 Nickel
00076 Turbidity
00600 Total Nitrogen
01002 Total Arsenic
01077 Silver
00080 Color (Pt -Co)
00610 Ammonia Nitrogen
01092 Zinc
00082 Color (ADMI)
00625 Total Kjeldhal
01027 Cadmium
01105 Aluminum
Nitrogen
00095 Conductivity
00630 Nitrates/Nitrites
01032 Hexavalent Chromium
01147 Total Selenium
00300 Dissolved Oxygen
01034 Chromium
31616 Fecal Coliform
00310 BOD5
00665 Total Phosphorous
32730 Total Phenolics
00340 COD
00720 Cyanide
01037 Total Cobalt
34235 Benzene
00400 pH
00745 Total Sulfide
01042 Copper
34481 Toluene
00530 Total Suspended
00927 Total Magnesium
38260 MBAS
Residue
00929 Total Sodium
01045 Iron
39516 PCBs
00545 Settable matter
00940 Total Chloride
01051 Lead
50050 Flow
50060 Total
Residual
Chlorine
71880 Formaldehyde
71900 Mercury
81551 Xylene
Parameter Code assistance may be obtained by calling the Water Quality Compliance Group at [phone], extension 581 or 534.
The monthly average for fecal coliform is to be reported as a GEOMETRIC mean. Use only units designated in the reporting
facility's permit for reporting data.
* ORC must visit facility and document visitation of facility as required per 15A NCAC 8A.0202 (b) (5) (B).
** If signed by other than the permittee, delegation of signatory authority must be on file with the State per 15A NCAC 2B.0506 (b)
(2) (D). Pine Valley NCO028941

Upstream
IDES Permit No.: NCO028941 Discharge No.
Facility Name: Pine Valley S/D WWTP
Stream: Setman Branch
Location: 100 ft. upstream
Yadkin Pee -Dee RB
Downstream 21
vl0
001 Month: November Year: 2692
County: Rowan
Stream: Setman Branch
Location: 20 ft downstream
Yadkin Pee -Dee RB

Effluent
NPDES PERMIT NO. NCO028941
Facility Name: Pine Valley
Operator in Responsible Charge (ORC):
Certified Laboratory (1): Water Tech
CHECK BOX IF ORC HAS CHANGED
_ Discharge No.: 001 Month:
S/D WWTP Class:
David Wall Grade:
n
Mail ORIGINAL and ONE COPY to: X
ATTN: CENTRAL FILES
DIVISION OF WATER QUALITY
1617 MAIL SERVICE CENTER
RALEIGH, NC 27699-1617
October Year: 2015
lL County: Rnwan
II Phone: [phone]
(2)
:TING SAMPLES Operators
BY THIS SIGNATURE, I CERTIFY THAT THI1RffU'tft79b/NCDENR/DWR
ACCURATE AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
DEC 15 2015
tn/nanc
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NAME AND UNITS BELOW
EFF�
INF O
� r
Q
HRS
HRS
Y/B/N
MGD
OC
UNITS
UG/L
MG/L
MG/L
MG/L
#/100ML
MG/L
MG/L
MG/L
1
1139
2.75
Y
20
2
1101
3
Y
0.004
20
3
4
'
L FILE
5
1135
2.5
Y
16
6.9
<20
8.9
WR $
CTIQ
6
1141
2.25
Y
18
<20
7
1053
0.5
Y
18
<2.0
0.37
11.0
12
16.40
4.79
8
1057
1.5
Y
19
9
1038
3.5
Y
0.004
20
10
11
12
1141
1.75
Y
19
7.2
<20
8.1
13
1013
2.5
Y
19
<20
14
1057
0.5
Y
18
2.9
<0.2
7.3
<1
15
1158
2.25
Y
19
16
1101
3.25
Y
0.004
18
17
18
19
1145
2.25
Y
15
6.7
<20
9.3
20
1147
2.25
Y
15
<20
21
1058
0.5
Y
15
4.9
0.70
7.0
6
22
1212
2.25
Y
16
23
1158
2.25
Y
0.004
16
24
25
26
1149
2
Y
19
7.0
<20
8.3
27
1122
2.75
Y
17
<20
28
1054
0.5
Y
16
3.1
0.38
8.5
6
29
1130
2.5
Y
17
30
1143
2.25
Y
0.004
17
31
AVERAGE
0.004
18
0
2.7
0.36
8.5
6
8.7
16.40
4.79
MAXIMUM
0.004
20
7.2
<20
4.9
0.70
11.0
12
9.3
16.40
4.79
MINIMUM
0.004
15
6.7
<20
<2.0
<0.2
7.0
<1
8.1
16.40
4.79
Comp. (C)/Grab (G)
G
G
G
C
C
C
G
G
C
C
limit
0.0250
NL
6/9
10.0
2.0
30.0
200
NL
NL
F:]Monthly
Daily Maximum
17
15.0
10.0
1 45.0
400
>6.0

Facility Status: (Please check one of the following):
All monitoring data and sampling frequencies meet permit requirements IZI
Compliant
All monitoring data and sampling frequencies do NOT meet permit requirements E]
Noncompliant
If the facility is noncompliant, please comment on corrective actions being taken in respect to equipment, operation, maintenance, etc.
and a time table for improvements to be made.
"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 fines and imprisonment for knowing violations."
Thomas J. Roberts, President, Aqua North Carolina, Inc.
Pe ittee (Pleas int or
Signature of Pen ittee ** Date
Permittee Address
Phone Number
Permit Exp. Date
202 MacKenan Court, Cary, NC 27511
704-489-9404
March 31, 2019
PARAMETER CODES
00010 Temperature
00556 Oil & Grease
00951 Total Fluoride
01067 Nickel
50060 Total
00076 Turbidity
00600 Total Nitrogen
01002 Total Arsenic
01077 Silver
Residual
00080 Color (Pt -Co)
00610 Ammonia Nitrogen
01092 Zinc
Chlorine
00082 Color (ADMI)
00625 Total Kjeldhal
01027 Cadmium
01105 Aluminum
Nitrogen
00095 Conductivity
00630 Nitrates/Nitrites
01032 Hexavalent Chromium 01147 Total Selenium
71880 Formaldehyde
00300 Dissolved Oxygen
01034 Chromium
31616 Fecal Coliform
71900 Mercury
00310 BOD5
00665 Total Phosphorous
32730 Total Phenolics
81551 Xylene
00340 COD
00720 Cyanide
01037 Total Cobalt
34235 Benzene
00400 pH
00745 Total Sulfide
01042 Copper
34481 Toluene
00530 Total Suspended
00927 Total Magnesium
38260 MBAS
Residue
00929 Total Sodium
01045 Iron
39516 PCBs
00545 Settable matter
00940 Total Chloride
01051 Lead
50050 Flow
Parameter Code assistance may be obtained by calling the Water Quality Compliance Group at [phone], extension 581 or 534.
The monthly average for fecal coliform is to be reported as a GEOMETRIC mean. Use only units designated in the reporting
facility's permit for reporting data.
* ORC must visit facility and document visitation of facility as required per 15A NCAC 8A.0202 (b) (5) (B).
** If signed by other than the permittee, delegation of signatory authority must be on file with the State per 15A NCAC 2B.0506 (b)
(2) (D). Pine Valley NCO028941

Upstream
NPDES Permit No.: NC0028941
Discharge No.: 001 Month
-Facility Name: Pine Valley S/D WWTP
County:
Downstream
October Year: 2015
Rowan
Stream: Setman Branch Stream: Setman Branch
Location: 100 ft. upstream Location: 20 ft downstream
Yadkin Pee -Dee RB Yadkin Pee -Dee RB

Effluent
NPDES PERMIT NO. NCO028941 Discharge No.: 001
Facility Name: Pine Valley S/D WWTP
Operator in Responsible Charge (ORC): David Wall
Certified Laboratory (1): Water Tech Labs Inc
CHECK BOX IF ORC HAS CHANGED r-1 PERSO (S)
Mail ORIGINAL and ONE COPY to: X
ATTN: CENTRAL FILES
DIVISION OF WATER QUALITY
1617 MAIL SERVICE CENTER
RALEIGH, NC 27699-1617
Month: September Year: 2015
Class: II County: Rnwan
Grade: II Phone: [phone]
NG b1'4MPLES Operators
(SIGNATURE OF OPERATOR IN RESPONSIBLE CHARGE)
BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS
ACCURATE AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
3
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NAME ARE@iV9/CDE
EFF
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v 2j 4
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Y/B/N
MGD
OC
UNITS
UG/L
MG/L
MG/L
MG/L
#/100ML
MG/L
MG/L
MG/L
_
11
1152
2.25
Y
24
<20
V 1-
2
1054
0.5
Y
24
2.5
0.58
11.6
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3
1058
3
Y
25
4
1135
2.5
Y
0.004
25
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5
6
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FILES
7
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8
1125
2
Y
24
7.5
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7.5
9
1050
0.5
Y
24
3.3
0.43
5.4
27
10
1150
3.25
Y
24
11
1134
2.75
Y
0.004
24
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12
13
14
1154
2
Y
21
7.4
<20
8.4
15
1133
2.5
Y
21
<20
16
1100
0.5
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22
3.4
<0.2
12.4
6
17
1147
2.25
Y
0.004
22
18
N
19
20
21
1128
2.5
Y
22
6.7
<20
8.2
22
1131
2.5
Y
22
<20
23
1058
0.5
Y
21
3.0
1.12
10.3
22
24
1103
3
Y
21
25
1048
3
Y
0.004
20
26 "
27
28
1137
2
Y
21
7.5
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8.3
29
1101
3
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<20
30
1059
0.5
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<2.0
<0.2
12.0
7
31
AVERAGE
0.004
g25
0
2.4
0.24
10.3
12
8.1
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DAM4
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<20
3.4
1.12
12.4
27
8.4
MINIMUM
0.004
6.7
<20
<2.0
<0.2
5.4
<1
7.5
Comp. (C)/Grab (G)
G
G
G
C
C
C
G
G
C
C
Monthly limit
0.0250
NL
6/9
10.0
2.0
30.0
200
NL
NL
Daily Maximum
17
15.0
10.0
45.0
1 400
>6.0
AMR
MR
NAL OFFICE

Facility Status: (Please check one of the following):
All monitoring data and sampling frequencies meet permit requirements El
Compliant
All monitoring data and sampling frequencies do NOT meet permit requirements 1Z
Noncompliant
If the facility is noncompliant, please comment on corrective actions being taken in respect to equipment, operation, maintenance, etc.
and a time table for improvements to be made.
Required Visit missed on 9/18/2015. ORC was on an approved vacation day and no one was assigned to visit Plant.
"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 fines and imprisonment for knowing violations."
Permittee Address
202 MacKenan Court, Cary, NC 27511
00010 Temperature 00556 Oil & Grease
00076 Turbidity 00600 Total Nitrogen
00080 Color (Pt -Co) 00610 Ammonia Nitrogen
00082 Color (ADMI) 00625 Total Kjeldhal
Nitrogen
00095 Conductivity 00630 Nitrates/Nitrites
00300 Dissolved Oxygen
00310 BOD5 00665 Total Phosphorous
00340 COD 00720 Cyanide
00400 pH 00745 Total Sulfide
00530 Total Suspended 00927 Total Magnesium
Residue 00929 Total Sodium
00545 Settable matter 00940 Total Chloride
Thomas J. Roberts, President, Aqua North Carolina, Inc.
Permittee (Please print or
Signature of Permittee * * Date
Phone Number
704-489-9404
PARAMETER CODES
00951 Total Fluoride
01002 Total Arsenic
01027 Cadmium
01032 Hexavalent Chromium
01034 Chromium
01037 Total Cobalt
01042 Copper
01045 Iron
01051 Lead
Permit Exp. Date
March 31, 2019
01067 Nickel
01077 Silver
01092 Zinc
01105 Aluminum
01147 Total Selenium
31616 Fecal Coliform
32730 Total Phenolics
34235 Benzene
34481 Toluene
38260 MBAS
39516 PCBs
50050 Flow
50060 Total
Residual
Chlorine
71880 Formaldehyde
71900 Mercury
81551 Xylene
Parameter Code assistance may be obtained by calling the Water Quality Compliance Group at [phone], extension 581 or 534.
The monthly average for fecal coliform is to be reported as a GEOMETRIC mean. Use only units designated in the reporting
facility's permit for reporting data.
* ORC must visit facility and document visitation of facility as required per 15A NCAC 8A.0202 (b) (5) (B).
** If signed by other than the permittee, delegation of signatory authority must be on file with the State per 15A NCAC 213.0506 (b)
(2) (D). Pine Valley NCO028941

Upstream
NPDES Permit No.: NCO028941
Discharge No.: 001 Month:
Facility Name: Pine Valley S/D WWTP
County:
Downstream
September Year: 2015
Rowan
Stream: Setman Branch Stream: Setman Branch
Location: 100 ft. upstream Location: 20 ft downstream
Yadkin Pee -Dee RB Yadkin Pee -Dee RB

Effluent
game:
ERMIT NO. NC0028941 Discharge No.: 001
Pine Valley S/D WWTP
Operator in Responsible Charge (ORC): David Wall
Certified Laboratory (1): Water Tech Labs Inc
CHECK BOX IF ORC HAS CHANGED M PER O S)
Month: Auqust Year: 2015
Class: If County: Rowan
Grade: II Phone: [phone]
(2)
SAMPLES Operators
Mail ORIGINAL and ONE COPY to: X \` ) "._ = 1 &'t/\
ATTN: CENTRAL FILES (SIGNATUR OPERATOR IN RESPONSIBLE CI
DIVISION OF WATER QUALITY BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS
1617 MAIL SERVICE CENTER I ACCURATE AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
RALEIGH, NC 27699-1617 LC
_. nr19C.
OCT 2 4 2015
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EFF ■
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2
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1159
2.25
Y
25
7.6
<20
7.6
4
1149
1
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26
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5
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0.5
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26
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0.64
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26
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9
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7.5
11
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12
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0.5
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0.47
7.3
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13
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25
14
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3.25
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0.004
24
15
16
17
1159
1.75
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25
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18
1153
1.5
Y
25
7.4
<20
7.6
19
1059
0.5
Y
24
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<0.2
5.8
6
20
1150
2.25
Y
25
21
1 1024
3.5
Y
0.004
25
22
23
24
1119
2.75
Y
25
7.5
<20
7.7
25
1142
2.25
Y
25
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26
1052
0.5
Y
24
3.5
0.57
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27
1130
2.25
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23
28
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1 2
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7.4
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5.3
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Comp. (C)/Gr
G
G
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C
C
G
G
C
C
Monthly limit0.
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6/9
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30.0
200
NL
NDaily
Maximu
1
1 17
15.0
10.0
45.0
400
>6.0
AL OFFICE

Facility Status: (Please check one of the following):
All monitoring data and sampling frequencies meet permit requirements El
0. Compliant
All monitoring data and sampling frequencies do NOT meet permit requirements El
Noncompliant
If the facility is noncompliant, please comment on corrective actions being taken in respect to equipment, operation, maintenance, etc.
and a time table for improvements to be made.
"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 fines and imprisonment for knowing violations."
Thomas J. Roberts, President, Aqua North Carolina, Inc.
Permittee (Please print or )
Signature of Permittee ** Date
Permittee Address Phone Number Permit Exp. Date
202 MacKenan Court, Cary, NC 27511 704-489-9404 March 31, 2019
PARAMETER CODES
00010 Temperature
00556 Oil & Grease
00951 Total Fluoride
01067 Nickel
00076 Turbidity
00600 Total Nitrogen
01002 Total Arsenic
01077 Silver
00080 Color (Pt -Co)
00610 Ammonia Nitrogen
01092 Zinc
00082 Color (ADMI)
00625 Total Kjeldhal
01027 Cadmium
01105 Aluminum
Nitrogen
00095 Conductivity
00630 Nitrates/Nitrites
01032 Hexavalent Chromium 01147 Total Selenium
00300 Dissolved Oxygen
01034 Chromium
31616 Fecal Coliform
00310 BOD5
00665 Total Phosphorous
32730 Total Phenolics
00340 COD
00720 Cyanide
01037 Total Cobalt
34235 Benzene
00400 pH
00745 Total Sulfide
01042 Copper
34481 Toluene
00530 Total Suspended
00927 Total Magnesium
38260 MBAS
Residue
00929 Total Sodium
01045 Iron
39516 PCBs
00545 Settable matter
00940 Total Chloride
01051 Lead
50050 Flow
50060 Total
Residual
Chlorine
71880 Formaldehyde
71900 Mercury
81551 Xylene
Parameter Code assistance may be obtained by calling the Water Quality Compliance Group at [phone], extension 581 or 534.
The monthly average for fecal coliform is to be reported as a GEOMETRIC mean. Use only units designated in the reporting
facility's permit for reporting data.
* ORC must visit facility and document visitation of facility as required per 15A NCAC 8A.0202 (b) (5) (B).
** If signed by other than the permittee, delegation of signatory authority must be on file with the State per 15A NCAC 213.0506 (b)
(2) (D). Pine Valley NCO028941

Upstream Downstream
NPDES Permit No.: NCO028941 Discharge No.: 001 Month: August Year: 2015
Facility Name: Pine Valley S/D WWTP County: Rowan
Stream: Setman Branch Stream: Setman Branch
Location: 100 ft. upstream Location: 20 ft downstream
Yadkin Pee -Dee RB Yadkin Pee -Dee RB

Effluent
3
NPDES PERMIT NO. NCO028941 Discharge No.: 001 Month: July Year: 2015
Facility Name: Pine Valley S/D WWTP Class: ll County: Rowan
Operator in Responsible Charge (ORC): David Wall Grade: II Phone: [phone]
Certified Laboratory (1): Water Tech Labs Inc (2)
CHECK BOX IF ORC HAS CHANGED 0 NPERSON(� COL^CTII
Mail ORIGINAL and ONE COPY to: X
ATTN: CENTRAL FILES (S
DIVISION OF WATER QUALITY BY
1617 MAIL SERVICE CENTER AC
RALEIGH, NC 27699-1617
SAMPLES Operators
JRE OF OPERATOR IN RESPONSIBLE C1
!NATURE, I CERTIFY THAT THIS REPORT IS
AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
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MG/L
MG/L
1
1058
0.5
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24
3.7
0.82
12.7
7
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2.75
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8
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5
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9
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2.5
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10
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2
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27
11
12
13
1157
2
Y
25
7.4
<20
7.3
14
1154
1.5
Y
25
<20
15
1053
0.5
Y
25
2.3
0.97
4.8
63
16
1226
1.75
Y
26
e
17
1042
3.75
Y
0.004
26
18
19
20
1259
0.75
Y
26
21
1216
1.75
Y
26
7.8
<20
7.2
22
1228
1.25
Y
26
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23
1055
0.5
Y
26
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0.78
12.3
<1
24
1132
2.5
Y
0.004
26
25
26
27
1256
1.5
Y
25
7.3
<20
7.6
28
1201
2.5
Y
26
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29
1229
2
Y
27
30
1107
0.5
Y
26
<2.0
0.68
3.6
21
31
1228
1.75
Y
0.004
26
AVERAGE
0.004
25
0
1.2
0.84
8.8
21
7.4
2.88
5.77
MAXIMUM
0.004
27
7.8
<20
3.7
0.97
12.7
63
7.6
2.88
5.77
MINIMUM
0.004
24
7.3
<20
<2.0
0.68
3.6
<1
7.2
2.88
5.77
Comp. (C)/Grab (G)
G
G
G
C
C
C
G
G
C
C
Monthly limit
0.0250
NL
6/9
10.0
2.0
30.0
200
NL
NL
Daily Maximum
17
15.0
10.0
45.0
400
>6.0
t/DWR
15
U5 ICE
015
I LES
ION

Facility Status: (Please check one of the following):
All monitoring data and sampling frequencies meet permit requirements IZI
Compliant
All monitoring data and sampling frequencies do NOT meet permit requirements E]
Noncompliant
If the facility is noncompliant, please comment on corrective actions being taken in respect to equipment, operation, maintenance, etc.
and a time table for improvements to be made.
"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 fines and imprisonment for knowing violations."
Thomas J. Roberts, President, Acitia North Carolina, Inc.
Permittee (Ple �®r��
Signature of Permittee **
Date
Permittee Address Phone Number Permit Exp. Date
202 MacKenan Court, Cary, NC 27511 704-489-9404 March 31, 2019
PARAMETER CODES
00010 Temperature
00556 Oil & Grease
00951 Total Fluoride
01067 Nickel
00076 Turbidity
00600 Total Nitrogen
01002 Total Arsenic
01077 Silver
00080 Color (Pt -Co)
00610 Ammonia Nitrogen
01092 Zinc
00082 Color (ADMI)
00625 Total Kjeldhal
01027 Cadmium
01105 Aluminum
Nitrogen
00095 Conductivity
00630 Nitrates/Nitrites
01032 Hexavalent Chromium 01147 Total Selenium
00300 Dissolved Oxygen
01034 Chromium
31616 Fecal Coliform
00310 BOD5
00665 Total Phosphorous
32730 Total Phenolics
00340 COD
00720 Cyanide
01037 Total Cobalt
34235 Benzene
00400 pH
00745 Total Sulfide
01042 Copper
34481 Toluene
00530 Total Suspended
00927 Total Magnesium
38260 MBAS
Residue
00929 Total Sodium
01045 Iron
39516 PCBs
00545 Settable matter
00940 Total Chloride
01051 Lead
50050 Flow
50060 Total
Residual
Chlorine
71880 Formaldehyde
71900 Mercury
81551 Xylene
Parameter Code assistance may be obtained by calling the Water Quality Compliance Group at [phone], extension 581 or 534.
The monthly average for fecal coliform is to be reported as a GEOMETRIC mean. Use only units designated in the reporting
facility's permit for reporting data.
* ORC must visit facility and document visitation of facility as required per 15A NCAC 8A.0202 (b) (5) (B).
** If signed by other than the permittee, delegation of signatory authority must be on file with the State per 15A NCAC 213.0506 (b)
(2) (D). Pine Valley NC0028941

Upstream
NPDES Permit No.: NCO028941 Discharge No.
Facility Name: Pine Valley S/D WWTP
Stream: Setman Branch
Location: 100 ft. upstream
Yadkin Pee -Dee RB
Downstream
001 Month:
July Year: 2015
County:
Rowan
Stream:
Setman Branch
Location:
20 ft downstream
Yadkin Pee -Dee RB

Effluent
NES PERMIT NO. NCO028941 Discharge No.: 001 Month:
Facility Name: Pine Valley S/D WWTP Class:
Operator in Responsible Charge (ORC): David Wall Grade:
Certified Laboratory (1): Water Tech Labs Inc
CHECK BOX IF ORC HAS CHANGED PETSON(S) LLEI
Mail ORIGINAL and ONE COPY to: X
ATTN: CENTRAL FILES
DIVISION OF WATER QUALITY
1617 MAIL SERVICE CENTER
RALEIGH, NC 27699-1617
Year: 2015
County: Rowan
Phone: [phone]
(2)
TING SAMPLES Operators
(SIGNATURE OF OPERATOF"N RESPONSIBLE CHARGE)
BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS
ACCURATE AND COMPLETE TO THE BEST OF MY KNO E.
AUG 0 4 2015
JUL 3 1 2019
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5
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9
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10
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6
11
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0.25
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22
12
1116
3.25
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0.004
23
13
14
15
1159
2.75
Y
24
7.4
<20
1
7.5
16
1213
2.25
Y
25
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17
1055
0.5
Y
25
4.0
0.81
5.2
220
18
1150
3
Y
26
19
1209
1.75
Y
0.004
27
20
21
22
1131
2
Y
25
7.8
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7.9
23
1058
2.75
Y
26
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24
1052
2
Y
27
4.8
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3.7
6
25
1233
1.5
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27
26
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0.75
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0.004
26
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28
29
1119
1 2.75
Y
23
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8.1
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1159
1.75
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24
1
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31
AVERAGE
0.004
23
0
3.6
0.47
7.2
64
7.9
MAXIMUM
0.004
27
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4.8
0.81
16.0
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8.1
MINIMUM
0.004
19
7.4
<20
2.0
<0.2
3.7
6
7.5
Comp. (C)/Grab (G)
G
G
G
C
C
C
G
G
C
C
Monthly limit
0.0250
NL
6/9
10.0
2.0
30.0
200
NL
NL
Daily Maximum
1
1 17
1 15.0
10.0
45.0
400
>6.0
wil
DFFICE

Facility Status: (Please check one of the following):
All monitoring data and sampling frequencies meet permit requirements 1Z
Compliant
All monitoring data and sampling frequencies do NOT meet permit requirements F-1
Noncompliant
If the facility is noncompliant, please comment on corrective actions being taken in respect to equipment, operation, maintenance, etc.
and a time table for improvements to be made.
"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 fines and imprisonment for knowing violations."
Thomas J. Roberts, President, Aqua North Carolina, Inc.
Permittee (Please print or e
Signature of Permittee * * Date
Permittee Address Phone Number Permit Exp. Date
202 MacKenan Court, Cary, NC 27511 704-489-9404 March 31, 2019
PARAMETER CODES
00010 Temperature
00556 Oil & Grease
00951 Total Fluoride
01067 Nickel
00076 Turbidity
00600 Total Nitrogen
01002 Total Arsenic
01077 Silver
00080 Color (Pt -Co)
00610 Ammonia Nitrogen
01092 Zinc
00082 Color (ADMI)
00625 Total Kjeldhal
01027 Cadmium
01105 Aluminum
Nitrogen
00095 Conductivity
00630 Nitrates/Nitrites
01032 Hexavalent Chromium 01147 Total Selenium
00300 Dissolved Oxygen
01034 Chromium
31616 Fecal Coliform
00310 BOD5
00665 Total Phosphorous
32730 Total Phenolics
00340 COD
00720 Cyanide
01037 Total Cobalt
34235 Benzene
00400 pH
00745 Total Sulfide
01042 Copper
34481 Toluene
00530 Total Suspended
00927 Total Magnesium
38260 MBAS
Residue
00929 Total Sodium
01045 Iron
39516 PCBs
00545 Settable matter
00940 Total Chloride
01051 Lead
50050 Flow
50060 Total
Residual
Chlorine
71880 Formaldehyde
71900 Mercury
81551 Xylene
Parameter Code assistance may be obtained by calling the Water Quality Compliance Group at [phone], extension 581 or 534.
The monthly average for fecal coliform is to be reported as a GEOMETRIC mean. Use only units designated in the reporting
facility's permit for reporting data.
* ORC must visit facility and document visitation of facility as required per 15A NCAC 8A.0202 (b) (5) (B).
** If signed by other than the permittee, delegation of signatory authority must be on file with the State per 15A NCAC 2B.0506 (b)
(2) (D). Pine Valley NCO028941

Upstream
NES Permit No.: NCO028941 Discharge No.:
Facility Name: Pine Valley S/D WWTP
Stream: Setman Branch
Location: 100 ft. upstream
Yadkin Pee -Dee RB
Downstream
001 Month: June Year: 2015
County: Rowan
Stream: Setman Branch
Location: 20 ft downstream
Yadkin Pee -Dee RB

Effluent
DES PERMIT NO. NCO028941
Discharge No.: 001
Month: May
Year: 2015
ility Name: Pine Valley
S/D WWTP
Class: II
County: Rnwnn
Operator in Responsible Charge (ORC):
David Wall
Grade: II
Phone: [phone]
Certified Laboratory (1): Water Tech Labs Inc
(2)
CHECK BOX IF ORC HAS CHANGED
=1 E�SO
(
COLL CTING SAMPLES
Operators
Mail ORIGINAL and ONE COPY to: X I Z
ATTN: CENTRAL FILES (SIGNATURE OP -OPERATOR IN RESPONSIBLE CHARGE) AT
DIVISION OF WATER QUALITY BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS RECEIVEDINCDENR/DWR
1617 MAIL SERVICE CENTER EACCURATE AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
RALEIGH, NC 27699-1617 JUL 2 9 2015 '-" L
JUL 10 2015
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1
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2.5
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9
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21
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17
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2.75
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2.5
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0.5
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0.69
3.6
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1047
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20
22
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2.75
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0.004
19
23
24
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H
26
1119
2
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21
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8.2
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29
28
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2.25
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29
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B
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31
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7.8
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8.3
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7.5
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4.2
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10.8
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8.6
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0.004
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<2.0
<0.2
3.6
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8.1
Comp. (C)/Grab (G)
G
G
G
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C
C
G
G
C
C
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0.0250
NL
6/9
10.0
2.0
30.0
200
NL
NL
Daily Maximum
17
15.0
10.0
45.0
400
>6.0
)FFICE

Facility Status: (Please check one of the following):
All monitoring data and sampling frequencies meet permit requirements 2]
Compliant
All monitoring data and sampling frequencies do NOT meet permit requirements El
Noncompliant
If the facility is noncompliant, please comment on corrective actions being taken in respect to equipment, operation, maintenance, etc.
and a time table for improvements to be made.
"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 fines and imprisonment for knowing violations."
Thomas J. Roberts, President, Aqua North Carolina, Inc.
P ittee (Please print o
Signature of Permittee * *
Date
Permittee Address Phone Number Permit Exp. Date
202 MacKenan Court, Cary, NC 27511 704-489-9404 March 31, 2019
00010 Temperature 00556 Oil & Grease
00076 Turbidity
00600 Total Nitrogen
00080 Color (Pt -Co)
00610 Ammonia Nitrogen
00082 Color (ADMI)
00625 Total Kjeldhal
Nitrogen
00095 Conductivity
00630 Nitrates/Nitrites
00300 Dissolved Oxygen
00310 BOD5
00665 Total Phosphorous
00340 COD
00720 Cyanide
00400 pH
00745 Total Sulfide
00530 Total Suspended
00927 Total Magnesium
Residue
00929 Total Sodium
00545 Settable matter
00940 Total Chloride
PARAMETER CODES
00951 Total Fluoride
01002 Total Arsenic
01027 Cadmium
01032 Hexavalent Chromium
01034 Chromium
01037 Total Cobalt
01042 Copper
01045 Iron
01051 Lead
01067 Nickel
01077 Silver
01092 Zinc
01105 Aluminum
01147 Total Selenium
31616 Fecal Coliform
32730 Total Phenolics
34235 Benzene
34481 Toluene
38260 MBAS
39516 PCBs
50050 Flow
50060 Total
Residual
Chlorine
71880 Formaldehyde
71900 Mercury
81551 Xylene
Parameter Code assistance may be obtained by calling the Water Quality Compliance Group at [phone], extension 581 or 534.
The monthly average for fecal coliform is to be reported as a GEOMETRIC mean. Use only units designated in the reporting
facility's permit for reporting data.
* ORC must visit facility and document visitation of facility as required per 15A NCAC 8A.0202 (b) (5) (B).
** If signed by other than the permittee, delegation of signatory authority must be on file with the State per 15A NCAC 213.0506 (b)
(2) (D). Pine Valley NCO028941

Upstream
DES Permit No.: NCO028941 Discharge No.
Facility Name: Pine Valley S/D WWTP
Stream: Setman Branch
Location: 100 ft. upstream
Yadkin Pee -Dee RB
Downstream
001 Month: May Year: 2015
County: Rowan
Stream: Setman Branch
Location: 20 ft downstream
Yadkin Pee -Dee RB

Effluent
WNPDS PERMIT NO. NCO028941 Discharge No.: 001
Facility Name: Pine Valley S/D WWTP
Operator in Responsible Charge (ORC): David Wall
Certified Laboratory (1): Water Tech Labs Inc
CHECK BOX IF ORC HAS CHANGED PEREPN,,(S)
Mail ORIGINAL and ONE COPY to- X
ATTN: CENTRAL FILES
DIVISION OF WATER QUALITY
1617 MAIL SERVICE CENTER j1 IA' 0 2�1�
RALEIGH, NC 27699-1617 J U IV
3
Month: April Year: 2015
Class: II County: RnWan
Grade: II Phone: [phone]
NG SAMPLES Operators
IN RESPONSIBLE CHARGE)
BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS
ACCURATE AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
1120=0 LC
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1
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0.5
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13
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14.5
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9
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16
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1.5
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15
17
1106
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16
18
19
20
1109
2.75
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18
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8.0
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22
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2
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16
24
1138
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16
25
26
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8.9
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1121
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13
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29
1051
0.5
Y
13
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6.4
36
30
1107
3
Y
13
31
AVERAGE
0.004
16
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1.7
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8.9
23
8.8
9.80
4.99
MAXIMUM
0.004
19
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14.5
65
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4.99
MINIMUM
0.004
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4.99
Comp. (C)/Grab (G)
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G
G
C
C
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0.0250
NL
6/9
100
.
2.0
30.0
200
NL
NL
Daily Maximum
17
15.0
1 10.0
45.0
400
1 >6.0
DWR
L OFFICE
D

Facility Status: (Please check one of the following):
All monitoring data and sampling frequencies meet permit requirements
Compliant
All monitoring data and sampling frequencies do NOT meet permit requirements El
Noncompliant
If the facility is noncompliant, please comment on corrective actions being taken in respect to equipment, operation, maintenance, etc.
and a time table for improvements to be made.
"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 fines and imprisonment for knowing violations."
Permittee Address
202 MacKenan Court, Cary, NC 27511
Thomas J. Roberts, President, Aqua North Carolina, Inc.
P ittee (Please print or
Signature of Permittee * *
Phone Number
704-489-9404
PARAMETER CODES
Date
Permit Exp. Date
March 31, 2019
00010 Temperature
00556 Oil & Grease
00951 Total Fluoride
01067 Nickel
00076 Turbidity
00600 Total Nitrogen
01002 Total Arsenic
01077 Silver
00080 Color (Pt -Co)
00610 Ammonia Nitrogen
01092 Zinc
00082 Color (ADMI)
00625 Total Kjeldhal
01027 Cadmium
01105 Aluminum
Nitrogen
00095 Conductivity
00630 Nitrates/Nitrites
01032 Hexavalent Chromium 01147 Total Selenium
00300 Dissolved Oxygen
01034 Chromium
31616 Fecal Coliform
00310 BOD5
00665 Total Phosphorous
32730 Total Phenolics
00340 COD
00720 Cyanide
01037 Total Cobalt
34235 Benzene
00400 pH
00745 Total Sulfide
01042 Copper
34481 Toluene
00530 Total Suspended
00927 Total Magnesium
38260 MBAS
Residue
00929 Total Sodium
01045 Iron
39516 PCBs
00545 Settable matter
00940 Total Chloride
01051 Lead
50050 Flow
50060 Total
Residual
Chlorine
71880 Formaldehyde
71900 Mercury
81551 Xylene
Parameter Code assistance may be obtained by calling the Water Quality Compliance Group at [phone], extension 581 or 534.
The monthly average for fecal coliform is to be reported as a GEOMETRIC mean. Use only units designated in the reporting
facility's permit for reporting data.
* ORC must visit facility and document visitation of facility as required per 15A NCAC 8A.0202 (b) (5) (B).
** If signed by other than the permittee, delegation of signatory authority must be on file with the State per 15A NCAC 2B.0506 (b)
(2) (D). Pine Valley NCO028941

Upstream Downstream
NPDES Permit No.: NCO028941 Discharge No.: 001 Month: April Year: 2015
Facility Name: Pine Valley S/D WWTP County: Rowan
Stream: Setman Branch Stream: Setman Branch
Location: 100 ft. upstream Location: 20 ft downstream
Yadkin Pee -Dee RB Yadkin Pee -Dee RB

Effluent
PERMIT NO. NCO028941 Discharge No.: 001
Name: Pine Valley S/D WWTP
t in Responsible Charge (ORC): David Wall
Certified Laboratory (1): Water Tech Labs Inc
CHECK BOX IF ORC HAS CHANGED =1 PE SOI�(S)
Mail ORIGINAL and ONE COPY to: X
ATTN: CENTRAL FILES
DIVISION OF WATER QUALITY
1617 MAIL SERVICE CENTER
RALEIGH, NC 27699-1617
Month: March Year: 2015
Class: II County: Rnwna
Grade: II Phone: [phone]
(2)
,OLLftCTING SAMPLES Operators
(SIGNATORE OF OPERATOR IN RESPONSIBLE CHARGE) DATI£
BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS
ACCURATE AND COMPLETE TO THE BEST OF MY KNOWLEDGE. ELC
MAY 14 2015
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17
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11
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21
22
23
1133
2.75
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14
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8.8
24
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26
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29
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0.004
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<ZO
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Comp. (C)/Grab (G)
G
G
G
C
C
C
G
G
C
C
Monthly limit
0.0250
NL
6/9
10.0
4.0
30.0
200
NL
NL
Daily Maximum
17
15.0
20.0
45.0
400
>6.0
I/M
15
kL OFFICE

Facility Status: (Please check one of the following):
All monitoring data and sampling frequencies meet permit requirements E2
Compliant
All monitoring data and sampling frequencies do NOT meet permit requirements El
Noncompliant
If the facility is noncompliant, please comment on corrective actions being taken in respect to equipment, operation, maintenance, etc.
and a time table for improvements to be made.
"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 fines and imprisonment for knowing violations."
Thomas J. Roberts, President, Aqua North Carolina, Inc.
Permittee (Plea print e)
i
Signature of Permittee ** Date
Permittee Address
Phone Number
Permit Exp. Date
202 MacKenan Court, Cary, NC 27511
704-489-9404
March 31, 2019
PARAMETER CODES
00010 Temperature
00556 Oil & Grease
00951 Total Fluoride
01067 Nickel
50060 Total
00076 Turbidity
00600 Total Nitrogen
01002 Total Arsenic
01077 Silver
Residual
00080 Color (Pt -Co)
00610 Ammonia Nitrogen
01092 Zinc
Chlorine
00082 Color (ADMI)
00625 Total Kjeldhal
01027 Cadmium
01105 Aluminum
Nitrogen
00095 Conductivity
00630 Nitrates/Nitrites
01032 Hexavalent Chromium 01147 Total Selenium
71880 Formaldehyde
00300 Dissolved Oxygen
01034 Chromium
31616 Fecal Coliform
71900 Mercury
00310 BOD5
00665 Total Phosphorous
32730 Total Phenolics
81551 Xylene
00340 COD
00720 Cyanide
01037 Total Cobalt
34235 Benzene
00400 pH
00745 Total Sulfide
01042 Copper
34481 Toluene
00530 Total Suspended
00927 Total Magnesium
38260 MBAS
Residue
00929 Total Sodium
01045 Iron
39516 PCBs
00545 Settable matter
00940 Total Chloride
01051 Lead
50050 Flow
Parameter Code assistance may be obtained by calling the Water Quality Compliance Group at [phone], extension 581 or 534.
The monthly average for fecal coliform is to be reported as a GEOMETRIC mean. Use only units designated in the reporting
facility's permit for reporting data.
* ORC must visit facility and document visitation of facility as required per 15A NCAC 8A.0202 (b) (5) (B).
** If signed by other than the permittee, delegation of signatory authority must be on file with the State per 15A NCAC 213.0506 (b)
(2)(1)). Pine Valley NCO028941

Upstream
Permit No.: NCO028941
Discharge No.: 001 Month:
_ame: Pine Valley S/D WWTP
County:
Downstream
March Year: 2015
Rowan
Stream: Setman Branch Stream: Setman Branch
Location: 100 ft. upstream Location: 20 ft downstream
Yadkin Pee -Dee RB Yadkin Pee -Dee RB

OEffluent
PERMIT NO. NC0028941 Discharge No.: 001
Facility Name: Pine Valley S/D WWTP
Operator in Responsible Charge (ORC): David Wall
Certified Laboratory (1): Water Tech Labs Inc
CHECK BOX IF ORC HAS CHANGED r1 PER O )
Month: February Year: 2015
Class: . II County: Rrnlan
Grade: II Phone: [phone]
PILES
Mail ORIGINAL and ONE COPY to: X \ J W
ATTN: CENTRAL FILES (SIGNATURE OF OPE TOR IN RESPONSIBLE Cl
DIVISION OF WATER QUALITY BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS
1617 MAIL SERVICE CENTER ACCURATE AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
RALEIGH, NC 27699-1617
©m®
APR 1 2015
3
=NAME
AND UNITS BELOW
--
®
-
o0000000�®®�-
NR/DWR
INAL OFFICE

Facility Status: (Please check one of the following):
All monitoring data and sampling frequencies meet permit requirements
0 Compliant
All monitoring data and sampling frequencies do NOT meet permit requirements E-1
Noncompliant
If the facility is noncompliant, please comment on corrective actions being taken in respect to equipment, operation, maintenance, etc.
and a time table for improvements to be made.
"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 fines and imprisonment for knowing violations."
Thomas J. Roberts, President, Aqua North Carolina, Inc.
Permittee (Please print or type
Signature of Permittee **
Date
Permittee Address Phone Number Permit Exp. Date
202 MacKenan Court, Cary, NC 27511 704-489-9404 March 31, 2019
00010 Temperature 00556 Oil & Grease
00076 Turbidity 00600 Total Nitrogen
00080 Color (Pt -Co) 00610 Ammonia Nitrogen
00082 Color (ADMI) 00625 Total Kjeldhal
Nitrogen
00095 Conductivity 00630 Nitrates/Nitrites
00300 Dissolved Oxygen
00310 BOD5 00665 Total Phosphorous
00340 COD 00720 Cyanide
00400 pH 00745 Total Sulfide
00530 Total Suspended 00927 Total Magnesium
Residue 00929 Total Sodium
00545 Settable matter 00940 Total Chloride
PARAMETER CODES
00951 Total Fluoride
01002 Total Arsenic
01027 Cadmium
01032 Hexavalent Chromium
01034 Chromium
01037 Total Cobalt
01042 Copper
01045 Iron
01051 Lead
01067 Nickel
01077 Silver
01092 Zinc
01105 Aluminum
01147 Total Selenium
31616 Fecal Coliform
32730 Total Phenolics
34235 Benzene
34481 Toluene
38260 MBAS
39516 PCBs
50050 Flow
50060 Total
Residual
Chlorine
71880 Formaldehyde
71900 Mercury
81551 Xylene
Parameter Code assistance may be obtained by calling the Water Quality Compliance Group at [phone], extension 581 or 534.
The monthly average for fecal coliform is to be reported as a GEOMETRIC mean. Use only units designated in the reporting
facility's permit for reporting data.
* ORC must visit facility and document visitation of facility as required per 15A NCAC 8A.0202 (b) (5) (B).
* * If signed by other than the permittee, delegation of signatory authority must be on file with the State per 15A NCAC 213.0506 (b)
(2) (D). Pine Valley NC0028941

Upstream
Permit No.: NCO028941 Discharge No.:
Facility Name: Pine Valley S/D VVMP
Stream: Setman Branch
Location: 100 ft. upstream
Yadkin Pee -Dee RB
Downstream
001 Month: February Year: 2015
County: Rowan
Stream: Setman Branch
Location: 20 ft downstream
Yadkin Pee -Dee RB
L

Effluent
NPDES PERMIT NO. NCO028941 Discharge No.: 001
Facility Name: Pine Valley SID WWTP
Operator in Responsible Charge (ORC): David Wall
Certified Laboratory (1): Water Tech Labs Inc
CHECK BOX IF ORC HAS CHANGED F-1 PR(S)
Mail ORIGINAL and ONE COPY to: X
ATTN: CENTRAL FILES (SIGNATI)RE$F OPERATOR IN RESPONSIBLE CI
DIVISION OF WATER QUALITY BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS
1617 MAIL SERVICE CENTER ACCURATE AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
RALEIGH, NC 27699-1617
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Month: January Year: 2015
Class: Il County: Rowan
Grade: II Phone: [phone]
SAMPLES Operators,
MAR 8 2015
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Facility Status: (Please check one of the following):
All monitoring data and sampling frequencies meet permit requirements Fl/Compliant
All monitoring data and sampling frequencies do NOT meet permit requirements F]
Noncompliant
If the facility is noncompliant, please comment on corrective actions being taken in respect to equipment, operation, maintenance, etc.
and a time table for improvements to be made.
"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 fines and imprisonment for knowing violations."
Thomas J. Roberts, President, Aqua North Carolina, Inc.
Permittee (Please print or
Signature of Permittee ** Date
Permittee Address Phone Number Permit Exp. Date
202 MacKenan Court, Cary, NC 27511 704-489-9404 March 31, 2019
PARAMETER CODES
00010 Temperature
00556 Oil & Grease
00951 Total Fluoride
01067 Nickel
00076 Turbidity
00600 Total Nitrogen
01002 Total Arsenic
01077 Silver
00080 Color (Pt -Co)
00610 Ammonia Nitrogen
01092 Zinc
00082 Color (ADMI)
00625 Total Kjeldhal
01027 Cadmium
01105 Aluminum
Nitrogen
00095 Conductivity
00630 Nitrates/Nitrites
01032 Hexavalent Chromium 01147 Total Selenium
00300 Dissolved Oxygen
01034 Chromium
31616 Fecal Coliform
00310 BOD5
00665 Total Phosphorous
32730 Total Phenolics
00340 COD
00720 Cyanide
01037 Total Cobalt
34235 Benzene
00400 pH
00745 Total Sulfide
01042 Copper
34481 Toluene
00530 Total Suspended
00927 Total Magnesium
38260 MBAS
Residue
00929 Total Sodium
01045 Iron
39516 PCBs
00545 Settable matter
00940 Total Chloride
01051 Lead
50050 Flow
50060 Total
Residual
Chlorine
71880 Formaldehyde
71900 Mercury
81551 Xylene
Parameter Code assistance may be obtained by calling the Water Quality Compliance Group at [phone], extension 581 or 534.
The monthly average for fecal coliform is to be reported as a GEOMETRIC mean. Use only units designated in the reporting
facility's permit for reporting data.
* ORC must visit facility and document visitation of facility as required per 15A NCAC 8A.0202 (b) (5) (B).
** If signed by other than the permittee, delegation of signatory authority must be on file with the State per 15A NCAC 213.0506 (b)
(2) (D). Pine Valley NC0028941

Upstream Downstream
NPDES Permit No.: NCO028941 Discharge No.: 001 Month: January Year: 2015
Facility Name: Pine Valley S/D VVWTP County: Rowan
Stream: Setman Branch Stream: Setman Branch
Location: 100 ft. upstream Location: 20 ft downstream
Yadkin Pee -Dee RB Yadkin Pee -Dee RB