NC0088552_Permit Issuance_20071031

NPDES DOCUMENT SCANNING: COVER SHEET
Permit:
NC0088552
Colonial Woods — Wells 1 & 2 WTP
NPDES
Document Type:
' •
Wasteload Allocation
Authorization to Construct (AtC)
Permit Modification
Complete File - Historical
Engineering Alternatives (EAA)
Report
Instream Assessment (67b)
Speculative Limits
Environmental Assessment (EA)
Document Date:
October 31, 2007
This document is printed on reuse paper - igrnore any
content on the reirerse side

e WA7
o� Qo ern
NCDENR
Gary Moseley, Manager
Aqua North Carolina, Inc.
4163 Sinclair Street
Denver, North Carolina 28037
Dear Mr. Moseley:
Michael F. Easley
Governor
• William G. Ross, Jr., Secretary
North Carolina Department of Environment and Natural Resources
Coleen H. Sullins, Director
Division of Water Quality
October 31, 2007
Subject: Issuance of NPDES Permit NC0088552
Colonial Woods Subdivision — Well #1 and #2
Surry County
Division personnel have reviewed and approved your application for renewal of the subject permit.
Accordingly, we are forwarding the attached NPDES discharge permit. This permit is issued pursuant to the
requirements of North Carolina General Statute 143-215.1 and the Memorandum of Agreement between North
Carolina and the U.S. Environmental Protection Agency dated May 9, 1994 (or as subsequently amended).
This final permit includes the following major changes from the draft permit sent to you on June 20, 2007:
• The NPDES permit for the Colonial Woods Well #1 (Outfall 001) was combined with this permit (Well #2
as Outfall 002) and the compliance schedule for TRC was added to Outfall 001 in accordance with the
existing policy for TRC.
• The flow limit for Outfall 002 was added in accordance with the existing permitting policy.
• Monthly monitoring for fluoride and zinc was eliminated in accordance with the existing permitting policy.
This permit includes a TRC limit that will take effect on June 1, 2009. If you wish to install dechlorination
equipment, the Division has promulgated a simplified approval process for such projects. Guidance for approval of
dechlorination projects is attached.
If any parts, measurement frequencies or sampling requirements contained in this permit are unacceptable to
you, you have the right to an adjudicatory hearing upon written request within thirty (30) days following receipt of
this letter. This request must be in the form of a written petition, conforming to Chapter 150B of the North Carolina
General Statutes, and filed with the Office of Administrative Hearings (6714 Mail Service Center, Raleigh, North
Carolina 27699-6714). Unless such demand is made, this decision shall be final and binding.
Please note that this permit is not transferable except after notice to the Division. The Division may require
modification or revocation and reissuance of the permit. This permit does not affect the legal requirements to obtain
other permits which may be required by the Division of Water Quality or permits required by the Division of Land
Resources, the Coastal Area Management Act or any other Federal or Local governmental permit that may be
required. If you have any questions concerning this permit, please contact Sergei Chernikov at telephone number
[phone], extension 594.
Sincerely,
L
s7
f�
cc: NPDES Files
Winston-Salem Regional Office / Surface Water Protection
J. Thurman. I-Iorne P.E.
Horizon Engineering and Consutling, Inc.
2510 Walker Rd., Mt. Pleasant, N.C. 28124
N. C. Division of Water Quality / NPDES Unit
1617 Mail Service Center, Raleigh, NC 27699-1617
Internet: h2o.enr.state.nc.us
Coleen H. Sullins
Phone: [phone]
fax: [phone]
DENR Customer Service Center: 1 800 623-7748

Permit No. NC0088552
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
PERMIT
TO DISCHARGE WASTEWATER UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1,
other lawful standards and regulations promulgated and adopted by the North Carolina Environmental
Management Commission, and the Federal Water Pollution Control Act, as amended,
Aqua North Carolina, Inc.
is hereby authorized to discharge wastewater from a facility located at
Colonial Woods Subdivision — Well #1 and #2
Atkins Lane
Mt. Airy
Surry County
to receiving waters designated as an unnamed tributary to Bull Creek in the Yadkin -Pee Dee River Basin
in accordance with effluent limitations, monitoring requirements, and other conditions set forth in Parts I, II,
III, and IV hereof.
This permit shall become effective December 1, 2007.
This permit and authorization to discharge shall expire at midnight on February 28, 2009.
Signed this day October 31, 2007.
�S.
Coleen H. Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission

Permit No. NC0088552
SUPPLEMENT TO PERMIT COVER SHEET
All previous NPDES Permits issued to this facility, whether for operation or discharge are hereby revoked. As of this
permit issuance, any previously issued permit bearing this number is no longer effective. Therefore, the exclusive
authority to operate and discharge from this facility arises: under the permit conditions, requirements, terms, and
provisions included herein.
Aqua North Carolina, Inc.
is hereby authorized to: •
1. Continue to operate a water treatment plant with discharge of filter backwash located at the Colonial
Woods Subdivision -- Well #1 and #2, Atkins Lane, Mt. Airy, Surry County.
2. Discharge from said treatment works at the location specified on the attached map into
unnamed tributary to Bull Creek, a class C water in the Yadkin -Pee Dee River Basin.

Colonial Woods Well #1 - NC0088552
USGS Quad Name: Dobson
Receiving Stream: UT to Bull Creek
Stream Class: C
Subbasin: Yadkin Pee Dee - 03 07 03
Lat.: 36°24'40"
Long.: 80°37'29"
Not to SCALE 1

Latitude:
Longitude:
USGS Quad #:
River Basin #:
Receiving Stream:
Stream Class:
36°41' 11"
80° 62' 87"
B 16NE
03-07-03
UT to Bull Creek
C
Nt
Aqua North Carolina, Inc.
Colonial Woods Subdivision —
We11# 2
Water Treatment Plant
Surry County
NC0088552

Permit NC008855:
A (1). EFFLUENT LIMITATIONS AND MONITORING REQUIREMENTS
During the perio 1 beginning upon the effective date of the permit and lasting until expiration, the
Permittee is authorized to discharge from outfall(s) serial number 001. Such discharges shall be .
limited and monitored by the Permittee as specified below:
Paran eter . ' L
pit
� \ Limits Y
-'f 4` \ .t'
oni 11/Itoring Requirements _ -; «
_. tY -f er2�-: • rt:j }^}.yyij."+.v -t ' r.4 �sri'"i^!" f+f'
x
\ .r} f
`.. . } ✓ ♦T4.
• . c ,.,... _ y y
'' , '
. Monthly
Average -.
Daily' : xy
Maximum.
:. easurement
=fez Ftegi enc •
'yr Sample:,
��� :. Type; ;�'% .
1;Sample > ,Y
- Location e
Flows
0.002 MGD
Monthly
Instantaneous
Effluent
Total Suspended Solids
30.0 mg/L
45.0 mg/L
2/Month
. Grab
Effluent
Total Residual Chlorine2
17 µg/L
2/Month
Grab
Effluent
Total Iron 1
Monthly
Grab
Effluent
^Total Manganese
•
Monthly
Grab
Effluent
pH3
2/Month
Grab
Effluent
Footnotes:
1. For instantaneous flow monitoring, the duration of the discharge must be reported in
addition to the total flow.
2. The limit becomes effective on June 1, 2009.
3. The pH shall not be less than 6.0 standard units nor greater than 9.0 standard units.
The Permittee shall collect all samples from a representative discharge event.
The Permittee shall discharge no floating solids or foam visible in other than trace amounts.

Permit NC0088552
A (2). EFFLUENT LIMITATIONS AND MONITORING REQUIREMENTS
During the period beginning upon the effective date of the permit and lasting until expiration, the
Permittee is authorized to discharge from outfall(s) serial number 002. Such discharges shall be
limited and monitored by the Permittee as specified below:
Parameter' r f• ° z
Litis. f r
Y
t l
ontol'ln
11e'.. Qu r ix 1, '' N
ri�,_s
ti :Ii�,' 7 ,
: .�.wttKeStm�'oI..., e
` . 1
(�.S.
.7 s)t
, ,
'• ►w ,. ,
.ont
Mhl
AversgeMaximuFrequency
"M
cDr
ay
Measurement
q }r
,R
., <•
Sample „3�
j �'
fiSm le
.,
Locatioar,
Flows
0.002 MGD
Monthly.
Instantaneous
Effluent
Total Suspended Solids
30.0 mg/L
45.0 mg/L
2/Month
Grab
Effluent
Total Residual Chlorine2
.17 µg/L
2/Month
Grab
Effluent
Total Iron •
Monthly
Grab
_
Effluent
Total Manganese
Monthly
Grab
Effluent
pH3
2/Month
Grab
Effluent
Footnotes:
1. For instantaneous flow monitoring, the duration of the discharge must be reported in
addition to the total flow.
2. The limit becomes effective on June 1, 2009.
3. The pH shall not be less than 6.0 standard units nor greater than 9.0 standard units.
The Permittee shall collect all samples from a representative discharge event.
The Permittee shall discharge no floating solids or foam visible in other than trace amounts.

DENR/DWQ
FACT SHEET FOR NPDES PERMIT DEVELOPMENT
NPDES No. NC0088552
Facility Information
Applicant/Facility Name:
Aqua North Carolina, Inc/ Colonial Woods Subdivision — Well #2
Applicant Address:
4163 Sinclair Street, Denver NC, 28037
Facility Address:
Atkins Lane, Mt. Airy, North Carolina
Permitted Flow:
N/A
Type of Waste:
Water TreatmentlGreensand filters
Other Permit(s):
N/A
Facility / Permit Status:
Class II/ New
County:
Surry County
Miscellaneous
Receiving Stream:
Stream Classification:
UT to Bull Creek
C
Regional Office:
USGS Topo Quad:
Winston-Salem
B 16NE
303(d) Listed?
Subbasin:
No
03-07-03
Permit Writer:
Date:
Sergei Chernikov
May 15, 2007
Drainage Area (mi2):
Summer 7Q10 (cfs) :
N/A
0
Winter 7Q10 (cfs):
N/A
30Q2 (cfs) :
Average Flow (cfs):
IWC (%):
0
N/A
N/A
AtidallP
Lat. 36° 41' 11" N Long. 80° 62' 87" W
BACKGROUND:
Colonial Woods — Well #2 is a Class If, greensand water treatment plant that provides potable water for
80 customers in the residential subdivision. There are currently 3 greensand filters, the filters are
backwashed approximately once every 2 days. The backwash rate is 1,680 gallons. Well #2 is approved
for 36 gpm, which is sufficient to serve the subdivision. The subdivision is fully developed and there is
no potential for increased flow.
Effluent limitations are implemented based on the new Guidance for Greensand Water Treatment Plants.
The Division has determined that the existing Water Treatment Plant is necessary to accommodate social
and economic growth in the area and that it will not result in contravention of surface water quality
standards or loss of designated uses in the receiving stream.
PROPOSED SCHEDULE FOR PERMIT ISSUANCE:
Draft Permit to Public Notice: June 20, 2007 (est.)
Permit Scheduled to Issue: August 30, 2007 (est.)
NPDES CONTACT:
If you have questions regarding any of the above information or on the attached permit, please contact
Sergei Chernikov at [phone] ext. 594.
CHANGES TO THE FINAL PERMIT:
• The NPDES permit for the Colonial Woods Well #1 (Outfall 001) was combined with this permit
(Outfall 002) and compliance schedule for TRC was added to Outfall 001 in accordance with the
existing policy for TRC.
• Flow limit for Outfall 002 was added in accordance with the existing permitting policy.
• Monthly monitoring for fluoride and zinc was eliminated in accordance with the existing
permitting policy.
Fact Sheet
NPDES NC0088528 Page I

Re: Aqua Draft Permit
Subject: Re: Aqua Draft Permit
From: Mike Mickey <Mike.Mickey @ ncmail.net>
Date: Tue, 04 Sep 2007 12:07:55 -0400
To: Toya Fields <[e-mail]>
Further proof you can't believe everything you read. Works for me. No need to bump the flow up. I
was just trying to make your draft of Colonial Woods #1 similar to Sergi's draft of Colonial Woods #2
(NC0088552) since the permits would be combined. There is no flow limit in Sergi's draft. Maybe he
is going by the old guidance.
Another thought. Just noticed that the footnote for total residual chlorine in Sergi's draft allows the
facility 18 months to comply. A good idea since Aqua will need to add dechlor for both Well #1 and
Well #2 and they are not know for acting fast. Any problem with including that language in the footnote
of your draft for Colonial Woods Well #1?
On 9/4/2007 11:44 AM, Toya Fields wrote:
Hi Mike,
Actually that sentence is a typo. We changed the strategy to require flow limits for all WTP
dischargers, mainly because we wanted to build in some way that they would have to notify us if
there were an iexpansion. If we kept it without a flow limit, and there were ever an increase, there
would be no reason for them to notify us.
But the flow limit isn't meant to be restrictive. Its meant to be a reflection of their actual ability to,
discharge. So we can bump it up if you think they might have trouble meeting that limit.
Toya
Mike Mickey wrote:
Toya - These comments pertain to the draft permits just received for Colonial Woods Well # 1
(NC0088544) and Mitchell Bluff Well # 1 (NC0088498).
Each draft has a flow limit. However, table 4.1 in the _NPDES Permitting Strategies for
Potable WTP's_ states that "A flow limit will not be required for these discharges". Can the
limit be deleted? No real need for it.
Thanks, Mike
Mike Mickey
NC DENR Winston-Salem Regional Office
Division of Water Quality, Water Quality Section
585 Waughtown Street
1 of 2 9/5/2007 1:25 PM

NORTH CAROLINA
SURRY COUNTY
AFFIDAVIT OF PUBLICATION
Before the undersigned, a Notary Public of said County and State, duly
commissioned, qualified and authorized by law to administer oaths,
personally appeared Ferris W. Simpson who being first duly
sworn, deposes and says: that he (she) is Business Manager
(Publisher or other officer or employee authorized to make affidavit) of
MOUNT AIRY NEWSPAPERS, INC.; engaged in the publication of a
newspaper known as MOUNT AIRY NEWS, published, issued, and
entered as periodicals class mail in the city of Mount Airy in said County
and State; that he (she) is authorized to make this affidavit and sworn
statement; that the notice or other legal advertisement, a true copy of
which is attached hereto, was published in MOUNT AIRY NEWS on the
following dates:
6..e, 2, avo9
and that the said newspaper in which such notice, paper, document or
legal advertisement was published was, at the time of each and every
such publication, a newspaper meeting all of the requirements and
qualifications of Section 1-597 of the General Statutes of North Carolina
and was a qualified newspaper within the meaning of Section 1-597 of
the General Statutes of North Carolina.
This I day of O0.40,-e-it, , 2007
Signature of person making affidavit
Sworn to and subscribed before me, this
00-4-0
C fi ate,
aq
, 2007
)(17a-
day of
Notary Public
My Commission expires: May 15, 2010
CLIPPING OF
LEGAL
ADVERTISEMENT
ATTACHED HERE
PUBLIC NOTICE II
STATE OF NORTH
CAROLINA
ENVIRONMENTAL
MANAGEMENT
COMMISSION/
NPDES UNIT
1617 MAIL SERVICE
CENTER
RALEIGH,
NORTH CAROLINA
27699-1617
NOTIFICATION OF
INTENT TO ISSUE A
NPDES
WASTEWATER
PERMIT
•
On the basis of thor-
ough staff review and,
application of NC Gen4
eral Statute 143.21,
Public law 92-500 and
other lawful standards
and regulations, the
North Carolina Environ-
mental Management
Commission proposes
to issue a National Pol-
lutant Discharge Elimi-
nation System (NPDES)
wastewater discharge
permit to the person(s).
listed below effective 45
days from the publish
date of this notice.
Written comments re-
garding the proposed
permit will be accepted
until 30 days after the
publish date of this no-
tice. All comments re-
ceived prior to that date
are considered in the fi-
nal determinations re-
garding the proposed
permit. The Director of
the NC Division of Wa-
ter Quality may decide
to hold a public meeting
for the proposed permit
should the Division re-
ceive a significant de-
gree of public interest.
Copies o the draft per-
mit and other supporting
information on the file
used to determine con-
ditions present in the
draft permit are avail-
able upon request and
payment of the costs of
reproduction. Mail com-
ments and/or requests
for information to the
NC Division of Water
Quality at the above ad-
dress or call the Dina
Sprinkle (919)
733-5083, extension
363 at the Point Source
Branch. Please include
the NPDES permit num-
ber (attached) in any
communication. Inter-
ested persons may also
visit the Division of Wa-
ter Quality at 512 N.
Salisbury Street, Ral-
eigh, NC 27604-1148
between the hours of
8:00 a.m. and 5:00 p.m.
to review information on
file.
Aqua North Carolina,
Inc. (4163 Sinclair
Street, Denver, NC
28037) has applied for a
new NPDES permit
NC0088498 for the
Mitchell Bluff Subdivi-
sion WTP in Surry
County. This permitted
facility discharges
0.0017 MGD treated
wastewater to an un-
named tributary to
Mitchell Creek in the
Yadkin -Pee Dee River
Basin. Currently total
residual chlorine is wa-
ter quality limited. This
discharge may affect fu-
ture allocations in this
portion of the
Yadkin -Pee Dee River
Basin.
Aqua North Carolina,
Inc. (4163 Sinclair
Street, Denver, NC
28037) has applied for
renewal of NPDES per-
mit NC0088544 for the
Colonial Woods Well #1
WTP in Surry County.
This permitted facility
discharges 0.002 MGD
treated wastewater to
an unnamed tributary to
Bull Cree in the
Yadkin -Pee Dee River
Basin. Currently total re-
sidual chlorine is water
quality limited. This dis-
charge may affect future
allocations in this por-
tion of the Yadkin -Pee
Dee River Basin.
Septe. iber 2, 2007

NCDENR/DWQ
FACT SHEET FOR NPDES PERMIT DEVELOPMENT
Aqua NC, Inc.
Colonial Woods Subdivision- Well #1
NC0088544
Facility,-Inf ` rmafion..-.:
(1.) Facility Name: Colonial Woods Subdivision — Well #1
_
(2.) Permitted Flow MGD):
.
0.002 1
I 1
(6.) Count___.__._._._..........._._........_._._._.__-_TSurry
(7.) Regional Office:
Winston-Salem
(3.) Facility Class:
(4.) Pretreatment Program: N/A 1
(8.) USGS Topo Quad: j B16NE
(5.) Permit Status: New 1
(9.) USGS Quad Name: . Dobson, NC
r Stream Ch acieristics.
(1.) Receiving Stream:
UT to Bull Creek (7:) Draina_ge Area (mi2):
03-07-03 1 (8.) Summer 7Q10 (cfs):
�: ._..._
(2.) Sub-basin
0
(3.) Stream Assessment Unit:
12-72-15 (9.) Winter 7Q10 (cfs):
(4.) Stream Classification:
C
(10.) 30Q2 (cfs): ; 0
(5.) 303(d) Status:
Not listed
(11.) Average Flow (cfs):
(6.) 305(b) Status:
N/A
(12.) IWC %: 100%
I. Summary
Aqua NC currently owns and operates and existing well water system serving Colonial Woods
Subdivision located south of Mt. Airy in Surry County. Well #1 of the water system uses an assembly of
green sand filters in the treatment of groundwater prior to distribution to the Colonial Woods
community. These filters are backwashed, using potable water, approximately once every two days.
This facility is an existing, unpermitted discharge that falls under the greensand WTP permitting strategy
The applicant did not obtain streamflow data from USGS, however they indicate that the receiving
stream is intermittent and estimate that both 7Q10 and 30Q2 are zero. Since filter backwash is not
considered to be an oxygen consuming wastewater, this discharge is not prohibited by state regulations.
II. Proposed Schedule for Permit Issuance
Draft Permit to Public Notice: August 29, 2007
Permit Scheduled to Issue: November 1, 2007
III. State Contact Information
Ifyou have anyquestions on anyof the above information or on the attached permit,please
contact Toya Fields at [phone], extension 551.
Copies of the following are attached to provide further information on the permit development:
• Draft permit

cc: Central Files
WSRO
NPDES STAFF REPORT AND RECOMMENDATION
Application # NC0088552
To: Point Source Branch - SWP--------
Attention: Sergei Chernikov, Ph.D. I n E
Date: June 26, 2007
JUNJ 2 9 2007
County: Surry
PART I - GENERAL INFORMATION
1. Permittee Address: Aqua NC, Inc.
Colonial Woods Subdivision — Well #2 (located on Atkins Lane)
4163 Sinclair Street
Denver, NC 28037
2. Date of Investigation: June 26, 2007
3. Report Prepared by: Mike Mickey, Environmental Specialist
4. Persons Contacted and Telephone Number: No one present.
5. Directions to Site: Colonial Woods Subdivision is on Atkins Lane, which is located off
Siloam Road between Dobson and Mount Airy. To access well #2 take the gravel driveway
just before 298 Atkins Lane.
6. Discharge Points(s), List for all discharge points:
Latitude: 36° 24' 40" Longitude: 80° 37' 44"
U.S.G.S. Quad No. B-16-NW U.S.G.S. Quad Name Dobson, NC
7. Site size and expansion area consistent with application? Well # 2 is located on Parcel No.
5927-17-02-6432 and consists of 1.15 acres.
8. Topography: The filter backwash is discharged onto the ground 10 ft from the well house
where it flows through the woods in leaf litter towards the U.T.
9. Location of nearest dwelling: Well # 2 is located behind house numbers 318 and 326.

10. Receiving stream or affected surface waters: U.T. to Bull Creek.
a. Classification: C
b. River Basin and Subbasin No.: 03-07-03
c. Describe receiving stream features and pertinent downstream uses: The filter
backwash is discharged through a 2" pipe into leaf litter 10 ft from the well house
(see attached picture).
Part II - DESCRIPTION OF DISCHARGE AND TREATMENT WORKS
1. a. Volume of Wastewater to be permitted: The system is backwashed approximately
once every two days with an estimated flow of 1,680 GPD.
b. What is the permitted capacity of the well system? The Colonial Woods water
system serves 80 customers and is approved for 36 gpm (maximum yield) by the
Public Water Supply Section.
c. j Actual treatment capacity of the current facility? See above.
d. Date(s)of AtC s issued in theprevious two years. NA.
e. Please provide a description of existing or substantially constructed wastewater
II treatment facilities: There is no treatment. The discharge is generated when the
green sand filters (4) are backwashed with potable water.
f. Please provide a description of proposed wastewater treatment facilities. N/A
g•
Possible toxic impacts to surface waters: The following chemicals are used:
Potassium Permanganate (for iron and manganese removal), chlorine (for
disinfection) and caustic soda (for pH adjustment).
h. Pretreatment Program (POTWs only): NA
2. Residuals handling and utilization/disposal scheme: None generated.
PART III - OTHER PERTINENT INFORMATION
1. Is this facility being constructed with Construction Grant Funds (municipals only)? NA.
2. Special monitoring or limitations (including toxicity) requests: NA.
3. Important SOC, JOC or Compliance Schedule dates: NA.
NPDES Permit Staff Report
Version 10/92
Page 2

4. Alternative Analysis Evaluation: No other disposal options available for this type of
operation.
PART IV - EVALUATION AND RECOMMENDATIONS
WSRO recommends issuance of the permit for the de minimis discharge created from
backwashing of the green sand filters at Well # 2 serving the Colonial Woods Subdivision. In
addition, this permit should also include a separate outfall for the discharge from Well # 1 at
Colonial Woods (and not a separate permit).
Report Preparer & Da
://l/.'/07
S W P Regional Supervisor & Date
NPDES Permit Staff Report
Version 10/92
Page 3

Four Existing
Potassium
Permanganate
Feed Tanks
(One each to each
green sand filter)
To Storage Tank and Colonial Woods Subdivision Water System
E=J
Four Existing Green Sand
Filters
(In parallel)
fi
Chlorine & Caustic
Addition
fi
Well Water
==>
Backwash
Discharge to
unnamed tributary
to UT to Bull
Creek
Colonial Woods Subdivision — Well # 2
Existing well System - Process Flow Diagram
Mt. Airy, NC Scale: NTS
Horizon Engineering & Consulting, Inc.
2510 Walker Road
Mt. Pleasant, N.C. 28124 March 7, 2007
1

Colonial Woods Well # 2
Well house
Outfall location

cc: Central Files
Sergei Chernikov
WSRO
NPDES STAFF REPORT AND RECOMMENDATION
Application # NC0088544
To: Point Source Branch - SWP
Attention: Toya Fields
Date: June 29, 2007
County: Surry
PART I - GENERAL INFORMATION
rIll
,;E I JUL - 3 2007 I
L
I. Permittee Address: Aqua NC, Inc.
Colonial Woods Subdivision — Well #1
4163 Sinclair Street
Denver, NC 28037
2. Date of Investigation: June 26, 2007
3. Report Prepared by: Mike Mickey, Environmental Specialist
4. Persons Contacted and Telephone Number: No one present.
5. Directions to Site: Colonial Woods Subdivision is located off Siloam Road between Dobson
and Mount Airy. To access well #1 turn onto Atkins Lane and then take the gravel driveway
leading to the well house just after 218 Atkins Lane.
6. Discharge Points(s), List for all discharge points:
Latitude: 36° 24' 40" Longitude: 80° 37' 29"
U.S.G.S. Quad No. B-16-NW U.S.G.S. Quad Name Dobson, NC
7. Site size and expansion area consistent with application? Well # 1 is located on Parcel No.
5927-17-12-7332 and consists of 1.1 acres.
8. Topography: The well house is situated in a small ravine.
9. Location of nearest dwelling: Well # 1 is located approximately 300 feet behind house
number 218.

10. Receiving stream or affected surface waters: U.T. to Bull Creek.
a. Classification: C
b. River Basin and Subbasin No.: 03-07-03
c. Describe receiving stream features and pertinent downstream uses: The exact
location of the discharge into the dry ditch could not be located.
Part II - DESCRIPTION OF DISCHARGE AND TREATMENT WORKS
1. a. Volume of Wastewater to be permitted: The system is backwashed approximately
once every two days with an estimated flow of 2,000 GPD.
b. What is the permitted capacity of the well system? The Colonial Woods water
system (Well #1 & Well #2) currently serves 80 customers and Well # 1 is approved
for 200 gpm (maximum yield) by the Public Water Supply Section.
c. Actual treatment capacity of the current facility? See above.
d. Date(s) of AtC s issued in the previous two years. NA.
e. Please provide a description of existing or substantially constructed wastewater
treatment facilities: There is no treatment. The discharge from Well # 1 is generated
when the green sand filters (2) are backwashed with potable water.
f. Please provide a description of proposed wastewater treatment facilities. N/A
g.
h.
Possible toxic impacts to surface waters: The following chemicals are used:
Potassium Permanganate (for iron and manganese removal), chlorine (for
disinfection) and caustic soda (for pH adjustment).
Pretreatment Program (POTWs only): NA
2. Residuals handling and utilization/disposal scheme: None generated.
PART III - OTHER PERTINENT INFORMATION
1. Is this facility being constructed with Construction Grant Funds (municipals only)? NA.
2. Special monitoring or limitations (including toxicity) requests: NA.
3. Important SOC, JOC or Compliance Schedule dates: NA.
NPDES Permit Staff Report
Version 10/92
Page 2

4. Alternative Analysis Evaluation: No other disposal options available for this type of
operation.
PART IV - EVALUATION AND RECOMMENDATIONS
WSRO recommends issuance of the permit for the de minimis discharge created from
backwashing of the green sand filters at Well # 1 serving the Colonial Woods Subdivision. Please
combine Well # 1 (NC0088544) and Well # 2 (NC0088552) into one permit with two outfalls. No
need for two separate permits.
Report Preparer & Date
SWP'Regional Supervisor & Date
NPDES Permit Staff Report
Version 10/92
Page 3

Surry CO., NC -- Printable Map
http://arcims.webgis.net/nc/surry/printable.asp?process=id&x2=152...
\
arcel ID: 5927-17-12-73
Owner:
HEATER UTILTIES INC
4168 SINCLAIR ST
PO BOX 859
DENVER,NC 280370859
Deed Book: 0736 Pg: 0684
Plat Book: 7 Pg: 37
Fire Districts:
Surry Co., NC
Parcels
Subdivision: COLONIAL WOODS
Township: ELDORA
Calculated Acreage: 1.10AC
Building Value: $0
Outbuildings Value: $350
Land Value: $11,500
Deferred Value: $0
Assessed value: $11,850
Other Attributes
at point 1521830, 972398
School Districts:
DISCLAIMER: The information contained on this page is NOT to be construed or used as a "legal description". Map
information is believed to be accurate but accuracy is not guaranteed.
http://www.webgis.net Anderson & Associates, Inc. http://www.andassoc.com
1 of 1 6/29/2007 12:43 PM

Horizon Engineering & Consulting, Inc.
Ms. Susan Wilson
Supervisor, Western NPDES Program
Division of Water Quality
NPDES Unit
1617 Mail Service Center
Raleigh, N.C. 27699 - 1617
Subject:
NPDES Permit Application
Well Backwash Discharge
Well No. 1
Aqua, North Carolina, Inc.
Colonial Woods Subdivision
Surry County
Dear Ms. Wilson:
2510 Walker Road
Mt. Pleasant, N.C. 28124-8567
704-788-4455
Fax: [phone]
March 12, 2007
NPDES Permit Application Existing
Existing Well Backwash Discharge
Well No. 2
Aqua, North Carolina, Inc.
Colonial Woods Subdivision
Surry County
Attached are four (4) copies of each of two (2) applications for NPDES permits signed by Aqua
North Carolina, Inc., four (4) copies of each of two (2) of the Engineering Alternatives Analysis
(EAA) and two (2) checks for $ 715 (application fees.) These applications are for permits for the
continued discharge of backwash from existing green sand filters installed on two (2) potable
wells which serve the Colonial Woods Subdivision, located outside Mount Airy, N.C. The EAA's
contain maps which indicate the existing locations.
These are existing groundwater wells that filter water through a series of green sand filters before
the water is distributed to the Colonial Woods community. The filters are "backwashed" with
water approximately once every two (2) days and approximately 2,000 gallons of water is then
discharged into the nearby stream from Well No. 1 and approximately 1,680 gallons of water is
then discharged into the nearby stream from Well No.2.
These have been in service for a number of years and we are not aware of any environmental
concerns over these discharges.
We appreciate your consideration of our application for permit. If you have any questions or if
there is anything we need to discuss, please call me (704-788-4455.)
C: Tamara S. Taylor (NC Public Water Supply Section)
Gary Moseley
Mike Melton

NPDES PERMIT APPLICATION - SHORT FORM C - WTP
For discharges associated with water treatment plants
Mail the complete application to:
N. C. Department of Environment and Natural Resources
Division of Water Quality / NPDES Unit
1617 Mail Service Center, Raleigh, NC 27699-1617
NPDES Permit Number
Ncoogo+{ Lk
If you are completing this form in computer use the TAB key or the up - down arrows to move from one
field to the next. To check the boxes, click your mouse on top of the box. Otherwise, please print or type.
1. Contact Information:
Owner Name Aqua North Carolina, Inc.
Facility Name Colonial Woods Subdivision - Well # 1
Mailing Address 4163 Sinclair Street
City Denver
State / Zip Code NC/28037
Telephone Number [phone]
Fax Number [phone]
e-mail Address [e-mail]
2. Location of facility producing discharge:
Check here if same as above El
Street Address or State Road
City
State / Zip Code
County
Atkins Lane
Mt. Airy
NC/27030
Surry
3. Operator Information:
Name of the firm, consultant or other entity that operates the facility. (Note that this is not referring to the
Operator in Responsible Charge or ORC)
Name
Mailing Address
City
State / Zip Code
Telephone Number
Fax Number
4. Ownership Status:
Aqua North Carolina, Inc.
4163 Sinclair Street
Denver
NC/28037
[phone]
[phone]
Federal ❑ State ❑
Private ® Public ❑
Page 1 of 3 C-WTP 03/05

NPDES PERMIT APPLICATION - SHORT FORM C - WTP
For discharges associated with water treatment plants
5. Type of treatment plant:
0 Conventional (Includes coagulation, flocculation, and sedimentation, usually followed by
filtration and disinfection)
O Ion Exchange (Sodium Cycle Cationic ion exchange)
® Green Sand Filter (No sodium recharge)
❑ Membrane Technology (RO, nanofiltration)
Check here if the treatment process also uses a water softener
El
6. Description of source water(s) (i.e. groundwater, surface water)
Groundwater well
7. Describe the treatment process(es) for the raw water:
Green sand filtration using potassium permanganate. Chlorine added for disinfection.
Caustic soda added for pH adjustment.
8. Describe the wastewater and the treatment process(es) for wastewater generated by the
facility:
Wastewater discharge is the backwash of the green sand filters. Discharge rate is
approximately 2,000 gallons, once every two days.
9. Number of separate discharge points: 1
Outfall Identification number(s) 001
10. Frequency of discharge:
Continuous ❑ Intermittent ED
If intermittent:
Days per week discharge occurs: 2 Duration: approx. 20 min.
11. Plant design potable flowrate 0.288 (Max. well yield) MGD
Backwash or reject flow 0.002 MGD
12. Name of receiving stream(s) (Provide a map showing the exact location of each outfall, including
latitude and longitude):
an unnamed tributary to Bull Creek (Yadkin River Basin)
Page 2 of 3 C-WTP 03/05

NPDES PERMIT APPLICATION - SHORT FORM C - WTP
For discharges associated with water treatment plants
13. Please list all water treatment additives, including cleaning chemicals, that have the
potential to be discharged.
potassium permanganate
chlorine
caustic soda
14. Is this facility located on Indian country? (check one)
II
Yes ❑ No
15. Additional Information:
• Provide a schematic of flow through the facility, include flow volumes at all points in
the treatment process, and point of addition of chemicals.
• Solids Handling Plan
16. NEW Applicants
Information needed in addition to items 1-15:
• New applicants must contact the NCDENR Customer Service Center.
Was the Customer Service Center contacted? ® Yes 0 No
• Analyses of source water collected
• Engineering Alternative Analysis
• Discharges from
g o Ion Exchange and Reverse Osmosis plants shall be evaluated using a
water quality model.
17. Applicant Certification
I certify that I am familiar with the information contained in the application and that to the
best of my knowledge and belief such information is true, complete, and accurate.
Gary Moseley Manager, Western N. C.
Printed name of Person Signing Title
Signature of Applicant Date
North Carolina General Statute 143-215.6 bprovides that: Anyper
son )(2j p son who knowingly makes any false
statement representation, or certification in any application, record, report, plan, or other document files or
required to be maintained under Article 21 or regulations of the Environmental Management Commission
implementing that'' Article, or who falsifies, tampers with, or knowingly renders inaccurate any recording or
monitoring device or method required to be operated or maintained under Article 21 or regulations of the
Environmental Management Commission implementing that Article, shall be guilty of a misdemeanor punishable
by a fine not to exceed $25,000, or by imprisonment not to exceed six months, or by both. (18 U.S.C. Section
1001 provides a punishment by a fine of not more than $25,000 or imprisonment not more than 5 years, or both,
for a similar offense.)
Page 3 of 3 C-WTP 03/05

NPDES PERMIT APPLICATION - SHORT FORM C - WTP
For discharges associated with water treatment plants
Mail the complete application to:
N. C. Department of Environment and Natural Resources
Division of Water Quality / NPDES Unit
1617 Mail Service Center, Raleigh, NC 27699-1617
NPDES Permit Number
,NC00
If you are completing this form in computer use the TAB key or the up — down arrows to move from one
field to the next. To check the boxes, click your mouse on top of the box. Otherwise, please print or type.
1. Contact Information:
Owner Name Aqua North Carolina, Inc.
Facility Name Colonial Woods Subdivision - Well # 2
Mailing Address 4163 Sinclair Street
City Denver
State / Zip Code NC/28037
Telephone Number [phone]
Fax Number [phone]
e-mail Address [e-mail]
2. Location of facility producing discharge:
Check here if same as above ❑
Street Address or State Road
City
State / Zip Code
County
Atkins Lane
Mt. Airy
NC/27030
Surry
3. Operator Information:
Name of the firm, consultant or other entity that operates the facility. (Note that this is not referring to the
Operator in Responsible Charge or ORC)
Name Aqua North Carolina, Inc.
Mailing Address 4163 Sinclair Street
City Denver
State / Zip Code NC/28037
Telephone Number [phone]
Fax Number [phone]
4. Ownership Status:
Federal ❑ State ❑
Private ® Public El
Page I of 3 C-WTP 03/05

NPDES PERMIT APPLICATION - SHORT FORM C - WTP
For discharges associated with water treatment plants
5. Type of trea�ment plant:
❑ Cony ntional (Includes coagulation, flocculation, and sedimentation, usually followed by
filtration and disinfection)
❑ Ion Exchange (Sodium Cycle Cationic ion exchange)
® Green Sand Filter (No sodium recharge)
0 Membrane Technology (RO, nanofiltration)
Check here if the treatment process also uses a water softener
6. Description of source water(s) (i.e. groundwater, surface water)
Groundwater well
7. Describe the treatment process(es) for the raw water:
Green sand filtration using potassium permanganate. Chlorine added for disinfection.
Caustic soda added for pH adjustment.
8. Describe the wastewater and the treatment process(es) for wastewater generated by the
facility:
Wastewater discharge is the backwash of the green sand filters. Discharge rate is
approximately 1,680 gallons, once every two days.
9. Number of separate discharge points: 1
Outfall Identification number(s) 001
10. Frequency of discharge: Continuous 0 Intermittent
If intermittent:
Days per week discharge occurs: 2 Duration: approx. 20 min.
11. Plant design potable flowrate 0.0518 (Max. well yield) MGD
Backwashor reject flow 0.00168 MGD
12. Name of receiving stream(s) (Provide a map showing the exact location of each outfall, including
latitude and longitude):
an unnamed tributary to Bull Creek (Yadkin River Basin)
Page 2 of 3 C-WTP 03/05

NPDES PERMIT APPLICATION - SHORT FORM C - WTP
For discharges associated with water treatment plants
13. Please list all water treatment additives, including cleaning chemicals, that have the
potential to be discharged.
potassium permanganate
chlorine
caustic soda
14. Is this facility located on Indian country? (check one)
Yes ❑ No Egi
15. Additional Information:
• Provide a schematic of flow through the facility, include flow volumes at all points in
the treatment process, and point of addition of chemicals.
Solids Handling Plan
16. NEW Applicants
Information needed in addition to items 1-15:
• New applicants must contact the NCDENR Customer Service Center.
Was the Customer Service Center contacted? ® Yes ❑ No
Analyses of source water collected
• Engineering Alternative Analysis
• Dischares from Ion Exchange and Reverse Osmosis plants shall be evaluated using a
water (quality model.
17. Applicant Certification
I certify that I am familiar with the information contained in the application and that to the
best of my knowledge and belief such information is true, complete, and accurate.
Gary Moseley Manager. Western N. C.
Printed name of Person Signing Title
Signature of Applicant Date
North Carolina General Statute 143-215.6 (b)(2) provides that: Any person who knowingly makes any false
statement representation, or certification in any application, record, report, plan, or other document files or
required to be maintained under Article 21 or regulations of the Environmental Management Commission
implementing that Article, or who falsifies, tampers with, or knowingly renders inaccurate any recording or
monitoring device or method required to be operated or maintained under Article 21 or regulations of the
Environmental Management Commission implementing that Article, shall be guilty of a misdemeanor punishable
by a fine not to exceed $25,000, or by imprisonment not to exceed six months, or by both. (18 U.S.C. Section
1001 provides a punishment by a fine of not more than $25,000 or imprisonment not more than 5 years, or both,
for a similar offense.)
Page 3 of 3 C-WTP 03/05

Horizon Engineering & Consulting, Inc.
Mr. Macon C. Sammons, Jr.
County Manager
Surry County
118 Hamby Road
Dobson, NC 27017
Subject: Request for Local Government Review
NPDES Permit Applications
Wells No. 1 & 2
Existing Well Backwash Discharges
Colonial Woods Subdivision
Surly County
Dear Mr. Sammons:
2510 Walker Road
Mt. Pleasant, N.C. 28124-8567
704-788-4455
Fax: [phone]
March 12, 2007
Hui J U N - 6 2007
C. - I IAi;:� c':.'.1.I1Y
Attached are copies of two (2) applications for permits signed by Aqua North Carolina, Inc.
These applications are for permits for the continued discharge of backwash from filters installed
on two (2) existing potable wells which serve the Colonial Woods Subdivision, located outside
Mt. Airy off Siloam Road. I have also attached a map to indicate the existing locations.
As part of the application process, the state requires that we notify the local government and ask
that they complete the attached forms which indicates whether the local government has a zoning
or subdivision ordinance and whether the continued discharges are consistent with that
ordinance.
These are existing groundwater wells that filter water through a series of filters before the water
is distributed to the Colonial Woods community. The filters are "backwashed" with water
approximately once every two (2) days and approximately 2,000 gallons of water is then
discharged into the nearby stream from Well No. 1 and approximately 1,680 gallons of water is
then discharged into the nearby stream from Well No.2.
These have been in service for a number of years and we are not aware of any environmental
concerns over these discharges, other than that the state has advised that we must apply for
permits.
As the state has instructed, we are trying to file these applications as soon as possible. If you
could complete, sign and return these forms, it will be very helpful.
We apologize for the necessity to ask for this assistance but I hope that you can appreciate our
dilemma. If you have any questions or if there is anything we need to discuss, please call me
(704-788-4455.)
C: Gary Mosely
NC DENR
3*.

Attachment A. Local Government Review For
rn
Ge zl Statu e • .. North Carolina General Statute 143-215.1 (c)(6) allows input from local governments
of NPDES Permits for non -municipal domestic wastewater treatment facilities. Specifically, the g s in the issuance
Commission (EMC) may not act on an application for a new non -municipal domesc wastater Environmental
discharge nfay; Management
received a written statement from each city and county government having jurisdiction over any part of the lands facilityuntilit has
proposed facility and its appurtenances are to be located. The written statement shall document whether the cityor county
which the
zoning or subdivision ordinance in effect and (if such an ordinance is in effect) whether the proposed facility is consistent withhas e
ordinance. The EMC shall not approve a permit application for any facility which a cityor countyty zt o the
inconsistent with zoning or subdivision ordinances unless the approval of such application is determined has
todeterminedaystatewide
to be
significance and is in the best interest of the State. ed have statewide
Instructions to the Applicant: Prior to submitting an application for a NPDES Permit for a proposed facility, th
shall request that boi the nearby city and county government complete this form. The applicant must: ty' a applicant
• Submit a copy of the permit application (with a written request for this form to be completed) to the clerk of the ci
the county by certified mail, return receipt requested. h' and
If either (or both) local government(s) fail(s) to mail the completed form, as evidenced by the
•
mail card(s), within 15 days after receiving and signing for the certified mail, the applicant may postmarkthe othe certified
the NPDES Unit. PP y submit application to
• As evidence to the Commission that the local government(s) failed to respond within 15 days, the applicant shall submit a
copy of the'Icertified mail card along with a notarized letter stating that the local governments) failed to respond within the
15-day period.
p
Instructions to the Local Government: The nearby city and/or county government which may have or has jurisdiction
over
any part of the land on which the proposed facility or its appurtenances are to be located is required to corn lete and return this
form to the applicant, within 15 days of receipt The form must be signed and notarized. p
Name of local government
Does the city/coup have'jurisdiction over any part of the land on which the proposed facility
located? Yes [/j' o [� lino,please signthis form, P p �h' and its appurtenances are to be
have it notarized, and return it to the applicant.
Does the city/county have in effect a zoning or subdivision ordinance? Yes [/f No [ ]
•
plan fo
is the a zoning or subdivision ordinance in effect
If re 's , r the proposed facility consistent with the ordinance? Yes
No the {/[ )
Date 541-
State of
46 Ca f fla
rfh
r1
On this l414'
name C - -- . —• --
to me known and known to me to be the person'desctibed ;m
and who .executed the foregoing cument and he (or she) acknowledged '
e) executed the same and being duly sworn
by me, made oath that the statements in the foregoing document are true.
My Commission expires 5 /5 4'o // of No .(Signaturetart' Public) %t
, County of
Signature
(City Manager/County Manager)
44111
OFFICIAI, SEAL
DEANNA D. HENDERSON
NptaryPublla•North Carolina
s SURRY COUNTY
My CamnID Expires
day of rat-- Ep7, personally appeared before me, the said
Notary Public 'i fficial Seal)
EAA Guidance Document Version: June 23, 2005
Pane Rfir R

. Connection to POTW
Prop. Force Main
Exist. Well
,vo, /
Colonial Woods Subdivision - Well # 1
Possible Route for Connection to POTW
North
Horizon Engineering & Consulting, Inc.
2510 Walker Road
Mt. Pleasant, N.C. 28124 March 3, 2007
Mt. Airy, N.C. Scale: 1" = 2,000'

My Commission expire
Attachment A. Local Government Review Form
General Statute Ov�rview: North Carolina General Statute 143-215.1 (c)(6) allows input from Local
of NPDES Permits for non -municipal domestic wastewater treatment facilities. Specifically, the
P governments in the issuance
Commission (EMC) may not act on an application for a new non -municipal domesc wastewater EnvironmentalfManagement
received a written statement from each city and county gOVernment having jurisdiction over an part discharge facility until it has
proposed facility andiits appurtenances are to be located. The written statement shall document whether
y of the lands on which the
zoning or subdivision ordinance in effect and (if such an ordinance is in effect) whetter the proposed facility co city si county has a
ordinance. The ElvC shall not approve a permit application for any facilitywhich a cityP cihh' is consistent witho the
inconsistent with zoning or subdivision ordinances unless the approval of such application or county has determined to be
significance and is in the best interest of the State. PP n is determined to have statewide
Instructions to the Applicant: Prior to submitting an application for a NPDES Permit for a proposed
shall request that both the nearby city and county government complete this form. The applicant must: set facility, the applicant
• Submit a copy of the permit application (with a written request for this form to be corn let
the county by certified mail, return receipt requested. p ed) to the clerk of the city and
• If either (or both) local government(s) fail(s) to mail the completed for
m, as evidenced by mail card(s), within 15 days after receiving and signing for the certified mail, the applicant ae mart
on the certifiedthe NPDES Unit. y submi t t the application to
• As evidence to the Commission that the local government(s) failed to respond within 15 days, the applicant
copy of the certified mail card along with a notarized letter statingthat the local y PP t shall submit a
15-day period, government(s) failed to respond within the
Instructions to the Local Governnttenl: The nearbycity
cty and/or county government which may have or has jurisdiction over
any part of the land on which the proposed facility or its appurtenances are to be located is required to corn lete and return to the applicant within 15 days of receipt. The form must be signed and notarized. P this
Name of local governiihen
Does the city/county have jurisdiction ov an a (City/County)
located? Yes o If no, please sign this form, have it notarized and return it
proposed facility and its appurtenances are to be
[�N [ storm ito the applicant.
Does the city/county have in effect a zoning or subdivision ordinance? Yes No
C]
• If there is a zoning or subdivision ordinance in effect, is the plan for the proposed facility consistent with the a ordinance? Yes [ ]
Date
State of
On this
name
C
day of
Signature
, County of
(City Manager County Manager)
impersonally appeared before me, the said
and who exec ted the foregoing docu to me known and known to me to be the person `described in
g g t and he (or she) acknowledged that he (or she) executed the same and bein dui sworn
by me, made oath that the statements in the foregoing document are true. g y
k4i741)//
.(Signature of Notary Public)
Notary
OFFICIAL SEAL
DEANNA D. HENDERSON
Notary Public -North Carolina
SURRY COUNTY
My Comm rExpires
atO
EAA Guidance Document Version: June 23, 2005
Poop R nf'R
ffici . I Seal)

Prop. Connection to POTW
9
Prop. Force Main
Exist. Well
Ate Z
s( i
Colonial Woods Subdivision - Well # 2
Possible Route for Connection to POTW
A
r
North
Horizon Engineering & Consulting, Inc.
2510 Walker Road
Mt. Pleasant, N.C. 28124 March 3, 2007
Mt. Airy, N.C. Scale: 1" = 2,000'