NC0021946_Fact Sheet_20210329

FACT SHEET FOR EXPEDITED PERMIT RENEWALS
This form must be completed by Permit Writers for all expedited permits which do not require
full Fact Sheets. Expedited permits are generally simple 100% domestics (e.g., schools, mobile
home parks, etc) that can be administratively renewed with minor changes, but can include
facilities with more complex issues (Special Conditions, 303(d) listed water, toxicity testing,
instream monitoring, compliance concerns).
Basic Information for Ex edited Permit Renewals
Permit Writer / Date
Brianna Young 3/29/2021
Permit Number
NC0021946
Facility Name / Facility Class
Town of Rosman WWTP / WW-2
Basin Name / Sub -basin number
French Broad / 04-03-01
Receiving Stream / HUC
French Broad River / 060101050105
Stream Classification / Stream Segment
B; Tr / 6-(1)
Does permit need Daily Maximum NH3
N/A
limits?
Does permit need TRC limits/language?
Already present
Does permit have toxicity testing? IWC (%) if
so
No
Does permit have Special Conditions?
Yes —effluent mercury analysis and
temporary means of disinfection
Does permit have instream monitoring?
No
Is the stream impaired (on 303(d) list)?
No
Any obvious compliance concerns?
Yes — See Section 2
Any permit mods since last permit?
No
New expiration date
9/30/2025
Comments on Draft Permit?
No
Section 1. Facility Overview:
The Town of Rosman operates a WWTP with a permitted flow of 0.250 MGD. The
facility serves a population of 780 people. Processed sludge is disposed of at the
Transylvania County landfill site.
Section 2. Compliance History (November 2015 — November 2020):
• 3 NOVs for BOD weekly average exceedances
• 5 CPAs for BOD weekly average exceedances
• 3 CPAs for BOD monthly average exceedances
• 11 CPA for fecal coliform weekly geometric mean exceedances
• 3 CPA for fecal coliform monthly geometric mean exceedances
• 2 NOVs for TSS weekly average exceedances
• 2 CPAs for TSS weekly average exceedances
• 1 CPA for TSS monthly average exceedance
• 3 NOVs for Total Nitrogen frequency violations
• 3 NOVs for Total Phosphorus frequency violations
Page 1 of 7

Section 3. Mercury TMDL:
The TMDL for mercury was run using the permitted flow of 0.250 MGD. The TMDL
found no limit required for mercury. Monitoring will be maintained at once per permit
cycle (per the permitting strategy associated with the 2012 statewide mercury TMDL).
Section 5. Changes from previous permit to draft:
• Updated eDMR footnote in A(1) and language in A(4)
• Updated outfall map
• Updated facility address on Permit Cover Sheet and Supplement to Permit Cover
Sheet
o Address listed was for the Rosman Town Hall, not the facility address
• Added facility grade in A(1)
• Added receiving stream characteristics on the Supplement to Permit Cover Sheet
o Updated stream classification based on surface water quality
classifications website
• Added units of measure in A(1)
Section 6. Changes from draft to final:
• None
Section 7. Comments received on draft permit:
• None
Page 2 of 7

NPDES Implementation of Instream Dissolved Metals Standards - Freshwater
Standards
The NC 2007-2015 Water Quality Standard (WQS) Triennial Review was approved by
the NC Environmental Management Commission (EMC) on November 13, 2014. The
US EPA subsequently approved the WQS revisions on April 6, 2016, with some
exceptions. Therefore, metal limits in draft permits out to public notice after April 6,
2016 must be calculated to protect the new standards - as approved.
Table 1. NC Dissolved Metals Water Quality Standards/Aquatic Life Protection
Parameter
Acute FW, µg/1
(Dissolved)
Chronic FW,
µg/1
(Dissolved)
Acute SW, µg/1
(Dissolved)
Chronic SW,
µg/1
(Dissolved)
Arsenic
340
150
69
36
Beryllium
65
6.5
---
---
Cadmium
Calculation
Calculation
40
8.8
Chromium III
Calculation
Calculation
---
---
Chromium VI
16
11
1100
50
Copper
Calculation
Calculation
4.8
3.1
Lead
Calculation
Calculation
210
8.1
Nickel
Calculation
Calculation
74
8.2
Silver
Calculation
0.06
1.9
0.1
Zinc
Calculation
Calculation
90
81
Table 1 Notes:
1. FW= Freshwater, SW= Saltwater
2. Calculation = Hardness dependent standard
3. Only the aquatic life standards listed above are expressed in dissolved form.
Aquatic life standards for Mercury and selenium are still expressed as Total
Recoverable Metals due to bioaccumulative concerns (as are all human health
standards for all metals). It is still necessary to evaluate total recoverable aquatic
life and human health standards listed in 15A NCAC 2B.0200 (e.g., arsenic at 10
µg/1 for human health protection; cyanide at 5 µg/L and fluoride at 1.8 mg/L for
aquatic life protection).
Table 2. Dissolved Freshwater Standards for Hardness -Dependent Metals
The Water Effects Ratio (WER) is equal to one unless determined otherwise
under 15A NCAC 02B .0211 Subparagraph (11)(d)
Metal
NC Dissolved Standard, µg/1
Cadmium, Acute
WER*{1.136672-[ln hardness](0.041838)} • e^{0.9151 [In hardness]-3.1485}
Cadmium, Acute Trout waters
WER*{1.136672-[In hardness](0.041838)} • e^{0.9151[ln hardness]-3.6236}
Cadmium, Chronic
WER*{1.101672-[ln hardness](0.041838)} • e^{0.7998[ln hardness]-4.4451}
Chromium III, Acute
WER*0.316 • e^{0.8190[ln hardness]+3.7256}
Chromium III, Chronic
WER*0.860 • e^{0.8190[ln hardness]+0.6848}
Page 3 of 7

Copper, Acute
WER*0.960 • e^{0.9422[ln hardness]-1.700}
Copper, Chronic
WER*0.960 • e^{0.8545[ln hardness]-1.702}
Lead, Acute
WER*{1.46203-[ln hardness](0.145712)} • e^{1.273[ln hardness]-1.460}
Lead, Chronic
WER*{1.46203-[ln hardness](0.145712)} • e^{1.273[ln hardness]-4.705}
Nickel, Acute
WER*0.998 • e^{0.8460[ln hardness]+2.255}
Nickel, Chronic
WER*0.997 • e^{0.8460[ln hardness]+0.0584}
Silver, Acute
WER*0.85 • e^{1.72[ln hardness]-6.59}
Silver, Chronic
Not applicable
Zinc, Acute
WER*0.978 • e^{0.8473[ln hardness]+0.884}
Zinc, Chronic
WER*0.986 • e^{0.8473[ln hardness]+0.884}
General Information on the Reasonable Potential Analysis (RPA)
The RPA process itself did not change as the result of the new metals standards.
However, application of the dissolved and hardness -dependent standards requires
additional consideration in order to establish the numeric standard for each metal of
concern of each individual discharge.
The hardness -based standards require some knowledge of the effluent and instream
(upstream) hardness and so must be calculated case -by -case for each discharge.
Metals limits must be expressed as `total recoverable' metals in accordance with 40 CFR
122.45(c). The discharge -specific standards must be converted to the equivalent total
values for use in the RPA calculations. We will generally rely on default translator values
developed for each metal (more on that below), but it is also possible to consider case -
specific translators developed in accordance with established methodology.
RPA Permitting Guidance/WQBELs for Hardness -Dependent Metals - Freshwater
The RPA is designed to predict the maximum likely effluent concentrations for each
metal of concern, based on recent effluent data, and calculate the allowable effluent
concentrations, based on applicable standards and the critical low -flow values for the
receiving stream.
If the maximum predicted value is greater than the maximum allowed value (chronic or
acute), the discharge has reasonable potential to exceed the standard, which warrants a
permit limit in most cases. If monitoring for a particular pollutant indicates that the
pollutant is not present (i.e. consistently below detection level), then the Division may
remove the monitoring requirement in the reissued permit.
1. To perform a RPA on the Freshwater hardness -dependent metals the Permit
Writer compiles the following information:
Page 4 of 7

• Critical low flow of the receiving stream, 7Q10 (the spreadsheet
automatically calculates the 1Q10 using the formula 1Q10 = 0.843
(s7Q10, cfs) 0.993
• Effluent hardness and upstream hardness, site -specific data is preferred
• Permitted flow
• Receiving stream classification
2. In order to establish the numeric standard for each hardness -dependent metal of
concern and for each individual discharge, the Permit Writer must first determine
what effluent and instream (upstream) hardness values to use in the equations.
The permit writer reviews DMR's, Effluent Pollutant Scans, and Toxicity Test
results for any hardness data and contacts the Permittee to see if any additional
data is available for instream hardness values, upstream of the discharge.
If no hardness data is available, the permit writer may choose to do an initial
evaluation using a default hardness of 25 mg/L (CaCO3 or (Ca + Mg)).
Minimum and maximum limits on the hardness value used for water quality
calculations are 25 mg/L and 400 mg/L, respectively.
If the use of a default hardness value results in a hardness -dependent metal
showing reasonable potential, the permit writer contacts the Permittee and
requests 5 site -specific effluent and upstream hardness samples over a period of
one week. The RPA is rerun using the new data.
The overall hardness value used in the water quality calculations is calculated as
follows:
Combined Hardness (chronic)
= (Permitted Flow, cfs *Avg. Effluent Hardness, mg/L) x (s7Q10, cfs *Avg. Upstream
Hardness, mg/L)
(Permitted Flow, cfs + s7Q10, cfs)
The Combined Hardness for acute is the same but the calculation uses the 1Q10
flow.
3. The permit writer converts the numeric standard for each metal of concern to a
total recoverable metal, using the EPA Default Partition Coefficients (DPCs) or
site -specific translators, if any have been developed using federally approved
methodology.
Page 5 of 7

EPA default partition coefficients or the "Fraction Dissolved" converts the
value for dissolved metal at laboratory conditions to total recoverable metal
at in -stream ambient conditions. This factor is calculated using the linear
partition coefficients found in The Metals Translator: Guidance for
Calculating a Total Recoverable Permit Limit from a Dissolved Criterion
(EPA 823-B-96-007, June 1996) and the equation:
Cdiss =
Ctotal
1
1 + { [Kpo] [SSUU+a)] [10-6] }
Where:
ss = in -stream suspended solids concentration [mg/1], minimum of 10 mg/L
used, and
Kpo and a = constants that express the equilibrium relationship between
dissolved and adsorbed forms of metals. A list of constants used for each
hardness -dependent metal can also be found in the RPA program under a
4. The numeric standard for each metal of concern is divided by the default partition
coefficient (or site -specific translator) to obtain a Total Recoverable Metal at
ambient conditions.
In some cases, where an EPA default partition coefficient translator does not exist
(ie. silver), the dissolved numeric standard for each metal of concern is divided by
the EPA conversion factor to obtain a Total Recoverable Metal at ambient
conditions. This method presumes that the metal is dissolved to the same extent as
it was during EPA's criteria development for metals. For more information on
conversion factors see the June, 1996 EPA Translator Guidance Document.
5. The RPA spreadsheet uses a mass balance equation to determine the total
allowable concentration (permit limits) for each pollutant using the following
equation:
Ca = (s7Q10 + Qw) (Cwqs) — (s7Q10) (Cb)
Qw
Where: Ca = allowable effluent concentration (µg/L or mg/L)
Cwqs = NC Water Quality Standard or federal criteria (µg/L or mg/L)
Cb = background concentration: assume zero for all toxicants except NH3*
(µg/L or mg/L)
Qw = permitted effluent flow (cfs, match s7Q10)
s7Q10 = summer low flow used to protect aquatic life from chronic toxicity
and human health through the consumption of water, fish, and shellfish from
noncarcinogens (cfs)
* Discussions are on -going with EPA on how best to address background
concentrations
Flows other than s7Q10 may be incorporated as applicable:
1 Q 10 = used in the equation to protect aquatic life from acute toxicity
Page 6 of 7

QA = used in the equation to protect human health through the
consumption of water, fish, and shellfish from carcinogens
30Q2 = used in the equation to protect aesthetic quality
6. The permit writer enters the most recent 2-3 years of effluent data for each
pollutant of concern. Data entered must have been taken within four and one-half
years prior to the date of the permit application (40 CFR 122.21). The RPA
spreadsheet estimates the 95th percentile upper concentration of each pollutant.
The Predicted Max concentrations are compared to the Total allowable
concentrations to determine if a permit limit is necessary. If the predicted max
exceeds the acute or chronic Total allowable concentrations, the discharge is
considered to show reasonable potential to violate the water quality standard, and
a permit limit (Total allowable concentration) is included in the permit in
accordance with the U.S. EPA Technical Support Document for Water Quality -
Based Toxics Control published in 1991.
7. When appropriate, permit writers develop facility specific compliance schedules
in accordance with the EPA Headquarters Memo dated May 10, 2007 from James
Hanlon to Alexis Strauss on 40 CFR 122.47 Compliance Schedule Requirements.
8. The Total Chromium NC WQS was removed and replaced with trivalent
chromium and hexavalent chromium Water Quality Standards. As a cost savings
measure, total chromium data results may be used as a conservative surrogate in
cases where there are no analytical results based on chromium III or VI. In these
cases, the projected maximum concentration (95th %) for total chromium will be
compared against water quality standards for chromium III and chromium VI.
9. Effluent hardness sampling and instream hardness sampling, upstream of the
discharge, are inserted into all permits with facilities monitoring for hardness -
dependent metals to ensure the accuracy of the permit limits and to build a more
robust hardness dataset.
10. Hardness and flow values used in the Reasonable Potential Analysis for this
permit included:
Parameter
Value
Comments (Data Source)
Average Effluent Hardness
(mg/L)
[Total as, CaCO3 or (Ca+Mg)]
25
Default value (no data
available)
Average Upstream Hardness
(mg/L)
[Total as, CaCO3 or (Ca+Mg)]
25
Default value (no data
available)
7Q10 summer (cfs)
55.5
BIMS
1 Q 10 (cfs)
63.4
RPA spreadsheet
Permitted Flow (MGD)
0.250
Permit
Page 7 of 7

AFFIDAVIT OF PUBLICATION
CLIPPING OF LEGAL ADVERTISING
ATTACHED HERE
North Carolina
Environmental
Management
Commission/NPDES
Unit
1617 Mail Service Center
Raleigh, NC 27699-1617
Notice of Intent to Issue a
NPDES Wastewater
Permit NC0021946
Rosman WWTP
The North Carolina
Environmental
Management Commission
proposes to issue a NPDES
wastewater discharge
permit to the person(s)
listed below. Written
comments regarding the
proposed permit will be
accepted until 30 days after
the publish date of this
notice. The Director of the
NC Division of Water
Resources (DWR) may
hold a public hearing
should there be a significant
degree of public interest.
Please mail comments
and/or information requests
to DWR at the above
address. Interested persons
may visit the DWR at 512
N. Salisbury Street,
Raleigh, NC 27604 to
review information on file.
Additional information on
NPDES permits and this
notice may be found on our
website:
http://deq.nc.gov/about/divisi
ons/water-resources/water-
resources-permits/waste
w ater-branch/npdes-waste
water/public-notices, or by
calling [phone].
The Town of Rosman [PO
Box 636, Rosman, NC
28772-0636] has requested
renewal of permit
NC0021946 for its Rosman
WWTP in Transylvania
County. This permitted
facility discharges treated
domestic wastewater to the
French Broad River in the
French Broad River Basin.
Currently no parameters are
water quality limited. This
discharge may affect future
allocations in this segment
of the French Broad River.
M2/15/1TC-75596
NORTH CAROLINA
TRANSYLVANIA COUNTY
Before the undersigned, a Notary Public of said
County and State, duly commissioned, qualified, and
authorized by law to administer oaths, personally
appeared Sean A. Trapp, who being first duly sworn,
deposes and says: that he is Co -Publisher (Owner,
partner, publisher, or other officer or employee
authorized to make this affidavit) of The
Transylvania Times, published, issued, and entered
as second class mail in the Town of Brevard in said
County and State; that he 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 The Transylvania
Times on the following dates:
February 15,2021
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 I-597 of
the General Statutes of North Carolina and was
qualified newspaper within the meaning of Section
1-597 of the General Statutes of North Carolina.
This � lk day of Fi$2vAY2-( , 2021
(Signature of pe n making affidavit)
subscribed before me, this / a
te,
,2021
Sworn to a
day of (
,,,1$ +,„ /n
\\`\
Notary Public Ste:
TransYlvan,a
Coun
Ay Comm •
06 10-2023 tyExP�Q
0,ck, CAO O\,\��\\
Let& (-14/(eN-
otary Public

Freshwater RPA - 95% Probability/95% Confidence Using Metal Translators
MAXIMUM DATA POINTS = 58
rREQUIRED DATA ENTRY
Table 1. Project Information
Facility Name
WWTP/WTP Class
NPDES Permit
Outfall
Flow, Qw (MGD)
Receiving Stream
HUC Number
Stream Class
❑ CHECK IF HQW OR ORW WQS
Rosman WWTP
WW-2
NC0021946
001
0.250
French Broad
060101050105
❑ Apply WS Hardness WQC
7Q10s (cfs)
7Q1Ow (cfs)
30Q2 (cfs)
QA (cfs)
1Q10s (cfs)
B; Tr
55.50
63.40
240.00
45.49
Effluent Hardness
25 mg/L (Avg)
Upstream Hardness
25 mg/L (Avg)
Combined Hardness Chronic
25 mg/L
Combined Hardness Acute
25 mg/L
Data Source(s)
❑ CHECK TO APPLY MODEL
Table 2. Parameters of Concern
Par01
Par02
Par03
Par04
Par05
Par06
Par07
Par08
Par09
Par10
Par11
Par12
Par13
Par14
Par15
Par16
Par17
Par18
Par19
Par20
Par21
Par22
Par23
Par24
Name
WQS
Type Chronic Modifier
Acute
PQL Units
Arsenic
Aquactic Life
C
150
FW
340
ug/L
Arsenic
Human Health
Water Supply
C
10
HH/WS
N/A
ug/L
Beryllium
Aquatic Life
NC
6.5
FW
65
ug/L
Cadmium
Aquatic Life
NC
0.5899
FW
3.2396
ug/L
Chlorides
Aquatic Life
NC
230
FW
mg/L
Chlorinated Phenolic Compounds
Water Supply
NC
1
A
ug/L
4 Total Phenolic Compounds
Aquatic Life
NC
300
A
ug/L
Chromium III
Aquatic Life
NC
117.7325
FW
905.0818
ug/L
Chromium VI
Aquatic Life
NC
11
FW
16
pg/L
Chromium, Total
Aquatic Life
NC
N/A
FW
N/A
pg/L
Copper
Aquatic Life
NC
7.8806
FW
10.4720
ug/L
Cyanide
Aquatic Life
NC
5
FW
22
10
ug/L
Fluoride
Aquatic Life
NC
1,800
FW
ug/L
Lead
Aquatic Life
NC
2.9416
FW
75.4871
ug/L
Mercury
Aquatic Life
NC
12
FW
0.5
ng/L
Molybdenum
Human Health
NC
2000
HH
ug/L
Nickel
Aquatic Life
NC
37.2313
FW
335.2087
pg/L
Nickel
Water Supply
NC
25.0000
WS
N/A
pg/L
Selenium
Aquatic Life
NC
5
FW
56
ug/L
Silver
Aquatic Life
NC
0.06
FW
0.2964
ug/L
Zinc
Aquatic Life
NC
126.7335
FW
125.7052
ug/L
NC0021946 FW RPA, input
3/29/2021

REASONABLE POTENTIAL ANALYSIS
H1
Effluent Hardness
Date Data BDL=1/2DL Results
1 25 25 Std Dev.
2 Mean
3 C.V.
4 n
5 10th Per value
6 Average Value
7 Max. Value
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
H2
Use "PASTE SPECIAL
Values" then "COPY"
. Maximum data
points = 58
Upstream Hardness
N/A
25.0000
0.0000
1
25.00 mg/L
25.00 mg/L
25.00 mg/L
Date Data BDL=1/2DL Results
1 25 25 Std Dev. N/A
2 Mean 25.0000
3 C.V. 0.0000
4 n 1
5 10th Per value 25.00 mg/L
6 Average Value 25.00 mg/L
7 Max. Value 25.00 mg/L
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
Use "PASTE SPECIAL
Values" then "COPY"
. Maximum data
points = 58
-2-
NC0021946 FW RPA, data
3/29/2021

REASONABLE POTENTIAL ANALYSIS
Par15
Mercury
Date Data BDL=1/2DL Results
1 4.63 4.63 Std Dev.
2 Mean
3 C.V. (default)
4 n
5
6 Mult Factor =
7 Max. Value
8 Max. Pred Cw
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
Use "PASTE SPECIAL
Values" then "COPY"
. Maximum data
points = 58
N/A
4.6300
0.6000
1
6.20
4.6 ng/L
28.7 ng/L
NC0021946 FW RPA, data
- 3 - 3/29/2021

Rosman WWTP
NC0021946
Freshwater RPA
Qw (MGD) = 0.2500
1Q10S (cfs) = 45.49
7Q1OS (cfs) = 55.50
7Q1OW (cfs) = 63.40
30Q2 (cfs) = NO 30Q2 DATA
Avg. Stream Flow, QA (cfs) = 240.00
Receiving Stream: French Broad HUC
- 95% Probability/95% Confidence Using Metal Translators
MAXIMUM DATA POINTS = 58
WWTP/WTP Class: WW-2
IWC% @ 1Q10S = 0.844640619
IWC% @ 7Q1OS = 0.693357191
IWC% @ 7Q1OW = 0.607485793
IWC% @ 30Q2 = N/A
IW%C @ QA = 0.161198066
060101050105 Stream Class: B; Tr
Outfall 001
Qw = 0.25 MGD
COMBINED HARDNESS (mg/L)
Acute = 25 mg/L
Chronic = 25 mg/L
PARAMETER
TYPE
NC STANDARDS OR EPA CRITERIA
Chronic
Applied
Standard
Acute
0.
a
1
z
REASONABLE POTENTIAL RESULTS
ri # Det.
Mercury
NC
12 FW(7Q10s)
0.5
ng/L
1 1
Note: n < 9
Limited data set
Max Pred Cw
28.7
C.V. (default)
Allowable Cw
Acute: NO WQS
Chronic: — — 1,730.7 --
No value > Allowable Cw
RECOMMENDED ACTION
No RP, Predicted Max < 50% of Allowable Cw
Page 4 of 49
NC0021946 FW RPA, rpa
3/29/2021

:ETS
•
•
•
Environmental Testing Solutions, Inc. Certificate of Analysis
Project name: Town Of Rosman
Collection date: 1-Dec-20
Date received: 1-Dec-20
Sample identification: Effluent - Composite
PO Box 7565
Asheville, NC 28802
Phone: [phone]
Fax: [phone]
Project number: 201201.539
Sample number: 207138
Parameter
Method Result RL Units Date Analyst Footnotes
Analyzed
BOD, 5 day SM 5210 B 20 2.0 mg/L 2-Dec-20 KEK
Solids, Total Suspended SM 2540 D <5.0 5.0 mg/L 2-Dec-20 KEK 2
Ammonia Nitrogen SM 4500 NH3 D 11 0.20 mg/L 3-Dec-20 KEK
Sample identification: Effluent - Grab
Sample number: 207139
• Parameter
te
Method Result RL Units Anaald Analyst Footnotes
Bacteria, Fecal Coliform
SM 9222 D <2 1 covlooml 1-Dec-20 TS
Sample identification: Effluent - Grab
Sample number: 207140
Parameter
Method Result RL Units Anaalyzed Analyst Footnotes
Mercury
1631 4.63 0.500 ng/L 9-Dec-20 BCD1 1
Sample identification: Field Blank
Sample number: 207141
Parameter
te
Method Result RL Units A uaald Analyst Footnotes
Mercury
1631 <0.500 0.500 ng/L 9-Dec-20 BCD1 1
Footnotes:
RL = Reporting Limit. Values are reported down to the Reporting Limit only.
1. Sample analzyed by Gel Labortories, LLC.
2. Duplicate was outside established limits. Validity of data is not affected.
Date reviewed:
Data reviewed by:
Signature:
Kelley E. Keenan
NC Certification Number: 600
SC Certification Number: 99053
NC Drinking Water Certification Number: 37786
This report should not be reproduced, exept in its entirety, without the written consent of Environmental Testing Solutions, Inc.
The results in this report relate only to the samples submitted for analysis.

DocuSign Envelope ID: F84FEE9B-0A31 -4A79-BE9D-B077C0951 438
ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
S. DANIEL SMITH
Director
CERTIFIED MAIL #:
RETURN RECEIPT REQUESTED
Mayor Brian Shelton
Town of Rosman
PO Box 636
Rosman, NC 28772-0636
Dear Permittee:
NORTH CAROLINA
Environmental Quality
10/7/2020
Subject: Notice of Violation — Notice of Intent
NOV-2020-RV-0001
Failure to Submit Permit Renewal Application
NPDES Permit NC0021946
Rosman WWTP
Transylvania County
The subject permit was issued to you on September 16, 2015 and expired on September 30, 2020.
Federal [40 CFR 122.41(b)] and state [15A NCAC 02H .0105(e)] regulations require that permit
renewal applications be filed at least 180 days prior to expiration of the current permit. The renewal
application was due to the Division no later than April 3, 2020.
To date, the Division has not received a renewal application. This is a violation of your permit per
Part II. B. 10., which states "Any Permittee that has not requested renewal at least 180 days prior to
expiration, or any Permittee that does not have a permit after the expiration and has not requested
renewal at least 180 days prior to expiration, will subject the Permittee to enforcement procedures as
provided in NCGS 143-215.6 and 33 USC 1251 et. seq." Pursuant to 143-215.1(a)(1) and 143-
215.1(a)(2), you are now in violation of making an outlet to waters of the State and operating a
treatment works without a permit.
In order to prevent an assessment of civil penalties, you must respond to the Division within 10 days
of receipt of this notification. The required NPDES permit application forms can be found online at
https://deq .nc.gov/about/divisions/water-resources/water-quality-permitting/npdes-wastewater/npdes-
permitting-process.
If you have questions, please contact Brianna Young of my staff at 919-707-3619, or via e-mail
[[e-mail]].
cc: NPDES Files
Asheville Regional Office
NORTH
D_E
ro CAROLINA
nepanene Di enwmnmentai uuaory
Sincerely,
DocuSigned/by:
8328B44CE9EB4A1...
S. Daniel Smith, Director
Division of Water Resources
North Carolina Department of Environmental Quality I Division of Water Resources
512 North Salisbury Street 1617 Mail Service Center I Raleigh, North Carolina 27699-1617
919.707.9000

i
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9590 9402 3950 8060 7367 97
United S
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• Send
First -Class Mail
Postage & Fees Paid
USPS
Permit No. G-10
NCDEQ/DWR/NPDES
Attn: Wren Thedford
1617 Mail Service Center
Raleigh, NC 27699-1617
SA.
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'his box•
t1ttit i b111t 11113110 ittt11}11i1ti\ MI511[i1\111 i
SENDER: COMPLETE THIS SECTION
■ Complete Items 1, 2, and 3.
• Print your name and address on the reverse
so that we can return the card to you.
IN Attach this card to the back of the mailpiece,
or on the front if space permits.
Town of Rosman
Attn: Brian Shelton, Mayor
PO Box 636
Rosman, NC 28772
IIIIIIIII III
11111
IIIII
IIII
III III
1111
9590 9402 3950 8060 7367 97
COMPLETE THIS SECTION ON DELIVERY
D.
Sig ture
J. / 19-1 Addressee
ived by (Printed Name) C. Date of Delivery
,0d2,t/L"
1S delivery address different from item 1? Yes
If YES, enter delivery address below:
2. Article Number (Transfer from service label)
PS Form 3811, July 2015 PSN 7530-02-000-9053
3. Service Type
❑ Adult Signature
❑ Adult Signature Restricted Delivery
❑ Certified Mail®
0 Certified Mail Restricted Delivery
0 Collect on Delivery
❑ Collect on Delivery Restricted Delivery
0 Insured Mail
❑ Insured Mail Restricted Delivery
(over$500)
0 Priority Mail Express®
0 Registered MaiITM
0 Registered Mail Restricted
Delivery
❑ Return Receipt for
Merchandise
❑ Signature ConfirmationTM
O Signature Confirmation
Restricted Delivery
Domestic Return Receipt

MONITORING REPORT(MR) VIOLATIONS for:
Report Date: 11/16/20 Page 1 01 3
Permit: nc0021946
Facility Name:
Major Minor: %
MRs Betweei 11 - 2015 and11 - 2020 Region: %
Param Nam( % County: %
Violation Category:%
Subbasin:%
Program Category:
Violation Action: %
PERMIT: NC0021946
FACILITY: Town of Rosman - Rosman WWTP
COUNTY: Transylvania
REGION: Asheville
Limit Violation
MONITORING OUTFACE
REPORT
LOCATION
PARAMETER
VIOLATION
DATE FREQUENCY MEASURE
UNIT OF
LIMIT
CALCULATED
VALUE
Over
VIOLATION TYPE VIOLATION ACTION
11-2017 001
03-2018 001
03-2018 001
04-2018 001
05-2018 001
05-2018 001
05-2018 001
08-2018 001
08-2018 001
08-2018 001
02-2019 001
03-2018 001
03-2018 001
03-2018 001
05-2018 001
Effluent BOD, 5-Day (20 Deg. C) - 11/25/17 Weekly
Concentration
Effluent BOD, 5-Day (20 Deg. C) - 03/17/18 Weekly
Concentration
Effluent BOD, 5-Day (20 Deg. C) - 03/31/18 Weekly
Concentration
Effluent BOD, 5-Day (20 Deg. C) - 04/28/18 Weekly
Concentration
Effluent BOD, 5-Day (20 Deg. C) - 05/05/18 Weekly
Concentration
Effluent BOD, 5-Day (20 Deg. C) - 05/19/18 Weekly
Concentration
Effluent BOD, 5-Day (20 Deg. C) - 05/31/18 Weekly
Concentration
Effluent BOD, 5-Day (20 Deg. C) - 08/11/18 Weekly
Concentration
Effluent BOD, 5-Day (20 Deg. C) - 08/18/18 Weekly
Concentration
Effluent BOD, 5-Day (20 Deg. C) - 08/31/18 Weekly
Concentration
Effluent BOD, 5-Day (20 Deg. C) - 02/23/19 Weekly
Concentration
Effluent Coliform, Fecal MF, MFC 03/10/18 Weekly
Broth, 44.5 C
Effluent Coliform, Fecal MF, MFC 03/17/18 Weekly
Broth, 44.5 C
Effluent Coliform, Fecal MF, MFC 03/31/18 Weekly
Broth, 44.5 C
Effluent Coliform, Fecal MF, MFC 05/19/18 Weekly
Broth, 44.5 C
mg/I
mg/I
mg/I
mg/I
mg/I
mg/I
mg/1
mg/I
mg/I
mg/1
mg/I
#/100m1
#/100m1
#/100m1
#/100m1
45 47 4.4 Weekly Average
Exceeded
45 74 64.4 Weekly Average
Exceeded
30 38.63 28.8 Monthly Average
Exceeded
45 47 4.4 Weekly Average
Exceeded
45 62 37.8 Weekly Average
Exceeded
45 132 193.3 Weekly Average
Exceeded
30 62 106.7 Monthly Average
Exceeded
45 57.6 28 Weekly Average
Exceeded
45 58 28.9 Weekly Average
Exceeded
30 42.78 42.6 Monthly Average
Exceeded
45 55 22.2 Weekly Average
Exceeded
400 1,200 200 Weekly Geometric Mean
Exceeded
400 1,200 200 Weekly Geometric Mean
Exceeded
200 253.4 26.7 Monthly Geometric Mean
Exceeded
400 1,200 200 Weekly Geometric Mean
Exceeded
Proceed to NOV
Proceed to
Enforcement Case
Proceed to
Enforcement Case
Proceed to NOV
Proceed to
Enforcement Case
Proceed to
Enforcement Case
Proceed to
Enforcement Case
Proceed to
Enforcement Case
Proceed to
Enforcement Case
Proceed to
Enforcement Case
Proceed to NOV
Proceed to
Enforcement Case
Proceed to
Enforcement Case
Proceed to
Enforcement Case
Proceed to
Enforcement Case

MONITORING REPORT(MR) VIOLATIONS for:
Report Date: 11/16/20 Page 2 of 3
Permit: nc0021946 MRs Betweei 11 - 2015 and11 - 2020
Facility Name: % Param Nam( %
Major Minor: %
Region:
County: %
Violation Category:%
Subbasin:%
Program Category: %
Violation Action: %
PERMIT: NC0021946
FACILITY: Town of Rosman - Rosman WWTP
COUNTY: Transylvania
REGION: Asheville
Limit Violation
MONITORING OUTFACE
REPORT
LOCATION
PARAMETER
VIOLATION
FREQUENCY UNIT OF
DATE MEASURE
LIMIT
CALCULATED
VALUE
Over
VIOLATION TYPE
VIOLATION ACTION
05-2018 001
05-2018 001
06-2018 001
06-2018 001
07-2018 001
08-2018 001
08-2018 001
08-2018 001
08-2018 001
09-2018 001
11-2017 001
05-2018 001
05-2018 001
08-2018 001
02-2019 001
Monitoring Violation
Effluent
Effluent
Effluent
Effluent
Effluent
Effluent
Effluent
Effluent
Effluent
Effluent
Effluent
Effluent
Effluent
Effluent
Effluent
Coliform, Fecal MF, MFC
Broth, 44.5 C
Coliform, Fecal MF, MFC
Broth, 44.5 C
Coliform, Fecal MF, MFC
Broth, 44.5 C
Coliform, Fecal MF, MFC
Broth, 44.5 C
Coliform, Fecal MF, MFC
Broth, 44.5 C
Coliform, Fecal MF, MFC
Broth, 44.5 C
Coliform, Fecal MF, MFC
Broth, 44.5 C
Coliform, Fecal MF, MFC
Broth, 44.5 C
Coliform, Fecal MF, MFC
Broth, 44.5 C
Coliform, Fecal MF, MFC
Broth, 44.5 C
Solids, Total Suspended -
Concentration
Solids, Total Suspended -
Concentration
Solids, Total Suspended -
Concentration
Solids, Total Suspended -
Concentration
Solids, Total Suspended -
Concentration
05/26/18 Weekly #/100m1
05/31/18 Weekly #/100m1
06/02/18 Weekly #/100m1
06/23/18 Weekly #/100m1
07/28/18 Weekly #/100m1
08/04/18 Weekly #/100m1
08/11/18 Weekly #/100m1
08/25/18 Weekly #/100m1
08/31/18 Weekly #/100m1
09/01/18 Weekly #/100m1
11/25/17 Weekly mg/1
05/05/18 Weekly mg/I
05/31/18 Weekly mg/1
08/11/18 Weekly mg/I
02/23/19 Weekly mg/I
400 1,200 200 Weekly Geometric Mean
Exceeded
200 482.92 141.5 Monthly Geometric Mean
Exceeded
400 1,200 200 Weekly Geometric Mean
Exceeded
400 1,200 200 Weekly Geometric Mean
Exceeded
400 1,200 200 Weekly Geometric Mean
Exceeded
400 1,200 200 Weekly Geometric Mean
Exceeded
400 1,200 200 Weekly Geometric Mean
Exceeded
400 1,200 200 Weekly Geometric Mean
Exceeded
200 538.09 169.0 Monthly Geometric Mean
Exceeded
400 820 105.0 Weekly Geometric Mean
Exceeded
45 52 15.6 Weekly Average
Exceeded
45 61.5 36.7 Weekly Average
Exceeded
30 38.98 29.9 Monthly Average
Exceeded
45 58 28.9 Weekly Average
Exceeded
45 58.5 30 Weekly Average
Exceeded
Proceed to
Enforcement Case
Proceed to
Enforcement Case
Proceed to
Enforcement Case
Proceed to
Enforcement Case
Proceed to
Enforcement Case
Proceed to
Enforcement Case
Proceed to
Enforcement Case
Proceed to
Enforcement Case
Proceed to
Enforcement Case
Proceed to
Enforcement Case
Proceed to NOV
Proceed to
Enforcement Case
Proceed to
Enforcement Case
Proceed to
Enforcement Case
Proceed to NOV

MONITORING REPORT(MR) VIOLATIONS for:
Report Date: 11/16/20 Page 3 of 3
Permit: nc0021946 MRs Betweei I - 2015 and11 - 2020 Region: % Violation Category:% Program Category: %
Facility Name: % Param Nam(% County: % Subbasin:% Violation Action: %
Major Minor: %
PERMIT: NC0021946
FACILITY: Town of Rosman - Rosman WWTP
COUNTY: Transylvania REGION: Asheville
MONITORING UNIT OF
OUTFALL LOCATION PARAMETER VIOLATION FREQUENCY
REPORT DATE MEASURE
LIMIT
CALCULATED %
VALUE Over
VIOLATION TYPE VIOLATION ACTION
12-2015 001
12-2016 001
12-2018 001
12-2015 001
12-2016 001
12-2018 001
Reporting Violation
Effluent
Effluent
Effluent
Effluent
Effluent
Effluent
Nitrogen, Total - 12/31/15 Semi-annuall mg/I
Concentration
Nitrogen, Total - 12/31/16 Semi-annuall mg/I
Concentration
Nitrogen, Total - 12/31/18 Semi-annuall mg/I
Concentration
Phosphorus, Total (as P) - 12/31/15 Semi-annuall mg/I
Concentration
Phosphorus, Total (as P) - 12/31/16 Semi-annuall mg/I
Concentration
Phosphorus, Total (as P) - 12/31/18 Semi-annuall mg/I
Concentration
MONITORING UNIT OF
OUTFALL LOCATION PARAMETER VIOLATION FREQUENCY
REPORT DATE MEASURE
LIMIT
CALCULATED
VALUE Over
Frequency Violation Proceed to NOV
Frequency Violation Proceed to NOV
Frequency Violation Proceed to NOV
Frequency Violation Proceed to NOV
Frequency Violation Proceed to NOV
Frequency Violation Proceed to NOV
VIOLATION TYPE VIOLATION ACTION
06-2016 001
Effluent Mercury, Total (as Hg) - 06/30/16 See Permit ug/I
Concentration
Parameter Missing No Action, BPJ

ROY COOPER
Governor
MICHAEL S. REGAN
Secretory
S. DANIEL SMITH
Director
Town of Rosman
Attn: Brian Shelton, Mayor
PO Box 636
Rosman, NC 28772
Subject: Permit Renewal
Application No. NC0021946
Rosman WWTP
Transylvania County
Dear Applicant:
NORTH CAROLINA
Environmental Quality
October 08, 2020
The Water Quality Permitting Section acknowledges the October 5, 2020 receipt of your permit renewal application and
supporting documentation. Your application will be assigned to a permit writer within the Section's NPDES WW permitting
branch. Per G.S. 150B-3 your current permit does not expire until permit decision on the application is made.
Continuation of the current permit is contingent on timely and sufficient application for renewal of the current permit. The
permit writer will contact you if additional information is required to complete your permit renewal. Please respond in a
timely manner to requests for additional information necessary to allow a complete review of the application and renewal
of the permit.
Information regarding the status of your renewal application can be found online using the Department of Environmental
Quality's Environmental Application Tracker at:
https://deq.nc.gov/permits-regulations/permit-guidance/environmental-application-tracker
If you have any additional questions about the permit, please contact the primary reviewer of the application using the
links available within the Application Tracker.
ec: WQPS Laserfiche File w/application
EtECV
Sincerely,
ren Thedford
Administrative Assistant
Water Quality Permitting Section
North Caroins Department of Environments' Qua rty I D vson of Water Resoi, roes
Ashev eRegone1Offioe 12090U.S.70►fghg.ay 1 SAar ranos, North Carora 28778
828 2a6.45D0

MAYOR
Brian Shelton
ATTORNEY
Donald Barton
TOWN CLERK
Angela Woodson
September 30, 2020
Ms. Wren Thedford
NCDENR/DWR/NPDES Unit
1617 Mail Service Center
Raleigh, NC 27699-1617
TOWN OF ROSMAN
POST OFFICE BOX 636
ROSMAN, NC 28772
828-884-6859
[e-mail]
Re: Permit Renewal Application — NC0021946
Dear Ms. Thedford,
Enclosed, please find the permit renewal application for the Town o
There have been no changes to the facility since the issuance of our
behalf of the town, am requesting the renewal of said permit.
Furthermore, the town does not have a sludge management plan, all
the Transylvania County landfill site for disposal.
Sincerely,
TOWN OF ROSMAN
7f/(--
Brian Shelton
Mayor/Town Admini strator
ALDERMEN
Jared Crowe
Mark Miller
Larry Bullock
Tricia Hendricks
Deedra Shelton
RECEIVED
0C1 0 5 2020
NCDEQ/DWR/NPDES
f Rosman.
last permit. Therefore I, on
sludge processed is taken to

EPA Identification Number
NPDES Permit Number
NC0021946
Facility Name
TOWN OF ROSMAN
Form Approved 03/05/19
OMB No. 2040-0004
Form
2A &EPA
NPDES
U.S. Environmental Protection Agency
Application for NPDES Permit to Discharge Wastewater
NEW AND EXISTING PUBLICLY OWNED TREATMENT WORKS
Facility Information
N 1. BASIC
1.1
APPLICATION INFORMATION FOR ALL APPLICANTS (40 CFR 122.21(j)(1) and (9))
Facility name
TOWN OF ROSMAN
Mailing address (street or P.O. box)
POST OFFICE BOX 636
City or town
ROSMAN
State
NC
ZIP code
28772
Contact name (first and last)
BRIAN SHELTON
Title
MAYOR
Phone number
[phone]
Email address
rosmantowncomporium.net
Location address (street, route number, or other specific identifier)
6 MAIN STREET
• Same as
mailing address
City or town
ROSMAN
State
NC
ZIP code
28772
1.2
Is this application for a facility that has yet to commence
❑ Yes 4 See instructions on data submission
requirements for new dischargers.
discharge?
✓ No
Applicant Information
1.3
Is applicant different from entity listed under Item
❑ Yes
1.1 above?
Item 1.4.
✓ No 4 SKIP to
Applicant name
Applicant address (street or P.O. box)
City or town
State
ZIP code
Contact name (first and last)
Title
Phone number
Email address
1.4
Is the applicant
the facility's owner, operator,
or both?
(Check only one response.)
❑ Both
0 Owner
■ Operator
1.5
To which entity
should the NPDES permitting
authority
send correspondence? (Check
Applicant
only
one response.)
Facility and applicant
(they are one and the same)
• Facility
NI
•
Existing Environmental Permits
1.6
Indicate below any existing environmental permits. (Check all that apply and print or type the corresponding permit
number for each.)
Existing Environmental Permits
p NPDES
(discharges to surface
BROAD
•
RCRA (hazardous waste)
•
UIC (underground injection
control)
water)
FRENCH
• PSD (air
emissions)
•
Nonattainment program (CAA)
•
NESHAPs (CAA)
• Ocean
dumping (MPRSA)
ii
Dredge or fill (CWA Section
404)
•
Other (specify)
EPA Form 3510-2A (Revised 3-19)
Page 1

EPA Identification Number
NPDES Permit Number
NC0021946
Facility Name
TOWN OF ROSMAN
Form Approved 03/05/19
OMB No. 2040-0004
Collection System and Population Served
1.7
Provide the collection system information requested below for the treatment works.
Municipality
Served
Population
Served
Collection System Type
(indicate percentage)
Ownership Status
75 %separate sanitary sewer
0 Own t] Maintain
ROSMAN
780
% combined storm and sanitary sewer
❑ Own 0 Maintain
0 Unknown
❑ Own 0 Maintain
% separate sanitary sewer
0 Own 0 Maintain
% combined storm and sanitary sewer
0 Own 0 Maintain
0 Unknown
0 Own 0 Maintain
% separate sanitary sewer
0 Own 0 Maintain
% combined storm and sanitary sewer
0 Own ❑ Maintain
0 Unknown
0 Own 0 Maintain
% separate sanitary sewer
0 Own 0 Maintain
% combined storm and sanitary sewer
0 Own 0 Maintain
0 Unknown
0 Own 0 Maintain
Total
Population
Served
780
Separate Sanitary Sewer System
Combined Storm and
Sanitary Sewer
Total percentage of each type of
sewer line (in miles)
0
100 /0
°
0 �0
Indian Country
1.8
Is the
•
treatment works located in Indian
Yes
Country?
0
No
1.9
Does
•
the facility discharge to a receiving
Yes
water that flows through
0
Indian Country?
No
Design and Actual
Flow Rates
1.10
Provide design and actual flow rates
in the designated spaces.
Design Flow Rate
.250 mgd
Annual Average Flow Rates (Actual)
Two Years Ago
Last Year
This Year
.1154 mgd
.1029 mgd
.101 mgd
Maximum Daily Flow Rates (Actual)
Two Years Ago
Last Year
This Year
.230 mgd
.156 mgd
.277 mgd
Discharge Points
by Type
1.11
Provide the total number of effluent discharge points to waters of the United States by type.
Total Number of Effluent Discharge Points by Type
Treated Effluent
Untreated Effluent
Combined Sewer
Overflows
Bypasses
Constructed
Emergency
Overflows
1
EPA Form 3510-2A (Revised 3-19)
Page 2

EPA Identification Number
NPDES Permit Number
NC0021946
Facility Name
TOWN OF ROSMAN
Form Approved 03/05/19
OMB No. 2040-0004
Outfalls and Other Discharge or Disposal Methods
Outfalls Other Than to Waters of the United States
1.12
Does the POTW
discharge to waters
discharge wastewater to basins, ponds,
of the United States?
or other
surface impoundments that do not have outlets for
4 SKIP to Item 1.14.
■ Yes
0 No
1.13
Provide the location of each surface impoundment and associated discharge information in the table below.
Surface Impoundment Location and Discharge Data
Location
Average Daily Volume
Discharged to Surface
Impoundment
Continuous or Intermittent
(check one)
gpd
❑ Continuous
❑ Intermittent
gpd
❑ Continuous
❑ Intermittent
gpd
❑ Continuous
❑ Intermittent
1.14
Is wastewater
applied to land?
4 SKIP to Item 1.16.
■ Yes
0 No
1.15
Provide the land application site and discharge data requested below.
Land Application Site and Discharge Data
Location
Size
Average Daily Volume
Applied
Continuous or
Intermittent
(check one)
acres
gp d
0 Continuous
❑ Intermittent
acres
g13 d
0 Continuous
❑ Intermittent
acres
gp d
0 Continuous
❑ Intermittent
1.16
Is effluent transported
to another facility for treatment
prior to discharge?
• Yes
FA No4SKIPtoItem1.21.
1.17
Describe the means by which the effluent is transported (e.g., tank truck, pipe).
1.18
Is the effluent
transported by a party other
than the applicant?
4 SKIP to Item 1.20.
• Yes
■
No
1.19
Provide information on the transporter below.
Transporter Data
Entity name
Mailing address (street or P.O. box)
City or town
State
ZIP code
Contact name (first and last)
Title
Phone number
Email address
EPA Form 3510-2A (Revised 3-19)
Page 3

EPA Identification Number
NPDES Permit Number
NC0021946
Facility Name
TOWN OF ROSMAN
Form Approved 03/05/19
OMB No. 2040-0004
Outfalls and Other Discharge or Disposal Methods Continued
1.20
In the table below, indicate the name, address, contact information, NPDES number, and average daily flow rate of the
receiving facility.
Receiving Facility Data
Facility name
TOWN OF ROSMAN
Mailing address (street or P.O. box)
POST OFFICE BOX 636
City or town
ROSMAN
State
NC
ZIP code
28772
Contact name (first and last)
BRIAN SHELTON
Title
MAYOR
Phone number
[phone]
Email address
[e-mail]
NPDES number of receiving facility (if any) ❑ None
Average daily flow rate .101 mgd
1.21
Is the
have
■
wastewater disposed of in a manner other than
outlets to waters of the United States (e.g., underground
Yes 12
those already mentioned in Items 1.14 through 1.21 that do not
percolation, underground injection)?
No 4 SKIP to Item 1.23.
1.22
Provide
information in the table below on these other disposal methods.
Information on Other Disposal Methods
Disposal
Method
Description
Location of
Disposal Site
Size of
Disposal Site
Annual Average
Daily Discharge
Volume
Continuous or Intermittent
(check one)
acres
gp d
❑ Continuous
❑ Intermittent
acresgpd
❑ Continuous
❑ Intermittent
acres
0 Continuous
gpd❑ Intermittent
Variance
Requests
1.23
Do
Consult
A
you intend to request or renew one or more of the
with your NPDES permitting authority to determine
Discharges into marine waters (CWA
Section 301(h))
Not applicable
variances authorized at 40 CFR 122.21(n)? (Check all that apply.
what information needs to be submitted and when.)
Water quality related effluent limitation (CWA Section
302(b)(2))
Contractor Information
1.24
Are
the
•
any operational or maintenance aspects (related to
responsibility of a contractor?
Yes IN
wastewater treatment and effluent quality) of the treatment works
No +SKIP to Section 2.
1.25
Provide location and contact information for each contractor in addition to a description of the contractor's operational
and maintenance responsibilities.
Contractor Information
Contractor 1
Contractor 2
Contractor 3
Contractor name
(company name)
Mailing address
(street or P.O. box)
City, state, and ZIP
code
Contact name (first and
last)
Phone number
Email address
Operational and
maintenance
responsibilities of
contractor
EPA Form 3510-2A (Revised 3-19)
Page 4

EPA Identification Number
NPDES Permit Number
NC0021946
Facility Name
TOWN OF ROSMAN
Form Approved 03/05/19
OMB No. 2040-0004
SECTION 2. ADDITIONAL INFORMATION (40 CFR 122.21(j)(1) and (2))
LL
• N
d
Outfalls to Waters of the United States
2.1
Does the treatment works have a design flow greater than or equal to 0.1 mgd?
❑✓ Yes
❑ No 4 SKIP to Section 3.
Inflow and Infiltration
2.2
Provide the treatment works' current average daily volume of inflow
and infiltration.
Average Daily Volume of Inflow and Infiltration
5,000 gpd
Indicate the steps the facility is taking to minimize inflow and infiltration.
CORRECT ISSUES AS NEEDED
Scheduled Improvements and Schedules of Implementation
2.3
Have you attached a topographic map to this application that contains all the required information? (See instructions for
specific requirements.)
❑✓ Yes ❑ No
2.4
Have you attached a process flow diagram or schematic to this application that contains all the required information?
(See instructions for specific requirements.)
❑ Yes ❑✓ No
2.5
Are improvements to the facility scheduled?
❑ Yes ❑ No 4 SKIP to Section 3.
Briefly list and describe the scheduled improvements.
1.
2.
3.
4.
2.6
Provide scheduled or actual dates of completion for improvements.
Scheduled
Improvement
(from above)
1.
Scheduled or Actual Dates of Completion for Improvements
Affected
Outfalls
(list outfall
number)
Begin
Construction
(MM/DD/YYYY)
End
Construction
(MM/DD/YYYY)
Begin
Discharge
(MM/DD/YYYY)
Attainment of
Operational
Level
(MM/DD/YYYY)
2.
3.
4.
2.7
Have appropriate permits/clearances concerning other federal/state requirements been obtained? Briefly explain your
response.
❑ Yes ❑ No ❑ None required or applicable
Explanation:
EPA Form 3510-2A (Revised 3-19) Page 5

EPA Identification Number
NPDES Permit Number
NC0021946
Facility Name
TOWN OF ROSMAN
Form Approved 03/05/19
OMB No. 2040-0004
SECTION 3. INFORMATION
ON EFFLUENT DISCHARGES (40 CFR 122.21(j)(3) to (5))
Description of Outfalls
3.1
Provide the following information for each outfall. (Attach additional sheets if you have more than three outfalls.)
Outfall Number °01
Outfall Number
Outfall Number
State
NORTH CAROLINA
County
TRANSYLVANIA
City or town
ROSMAN
Distance from shore
50 ft.
ft.
ft.
Depth below surface
o ft.
ft.
ft.
Average daily flow rate
.101 mgd
mgd
mgd
Latitude
35° 08' 10" N
°
° "
Longitude
82° 49' 15" W
IIII
Seasonal or Periodic Discharge Data
3.2
Do
•
any of the outfalls described
Yes
under Item 3.1 have seasonal or
periodic
IJ
discharges?
No 4 SKIP to Item 3.4.
3.3
If so,
provide the following information
for each applicable outfall.
Outfall Number
Outfall Number
Outfall Number
Number
discharge
of times per year
occurs
Average
discharge
duration of each
(specify units)
Average
discharge
flow of each
mgd
mgd
mgd
Months
occurs
in which discharge
Diffuser Type
3.4
Are
•
any of the outfalls listed under Item 3.1 equipped with a diffuser?
Yes
12
No 4 SKIP to Item 3.6.
3.5
Briefly
describe the diffuser type at each applicable outfall.
Outfall Number
Outfall Number
Outfall Number
Waters of
the U.S.
3.6
Does
discharge
•
the treatment works discharge or plan to discharge wastewater
points?
Yes
151
to waters of the United States from one or more
No 4SKIP to Section 6.
EPA Form 3510-2A (Revised 3-19)
Page 6

EPA Identification Number
NPDES Permit Number
NC0021946
Facility Name
TOWN OF ROSMAN
Form Approved 03/05/19
OMB No. 2040-0004
Receiving Water Description
3.7
Provide the receiving water and related information (if known) for each outfall.
Outfall Number 001 Outfall Number
Outfall Number
Receiving water name
FRENCH BROAD
Name of watershed, river,
or stream system
FRENCH BROAD BASIN
U.S. Soil Conservation
Service 14-digit watershed
code
04-03-01/06010105
Name of state
management/river basin
FRENCH BROAD RIVER
U.S. Geological Survey
8-digit hydrologic
cataloging unit code
Critical low flow (acute)
N/A cfs
cfs
cfs
Critical low flow (chronic)
N/A cfs
cfs
cfs
Total hardness at critical
low flow
mg/L of
N/A CaCO3
mg/L of
CaCO3
mg/L of
CaCO3
Treatment Description
3.8
Provide the following information describing the treatment provided for discharges from each outfall.
Outfall Number Outfall Number
Outfall Number
Highest Level of
Treatment (check all that
apply per outfall)
❑ Primary
0 Equivalent to
secondary
0 Secondary
0 Advanced
0 Other (specify)
0 Primary
0 Equivalent to
secondary
0 Secondary
0 Advanced
0 Other (specify)
0 Primary
0 Equivalent to
secondary
0 Secondary
0 Advanced
0 Other (specify)
Design Removal Rates by
Outfall
BOD5 or CBOD5
85
TSS
85
Phosphorus
I Not applicable
0 Not applicable
❑ Not applicable
Nitrogen
m Not applicable
%
❑ Not applicable
%
❑ Not applicable
°
/o
Other (specify)
0 Not applicable
0 Not applicable
0 Not applicable
EPA Form 3510-2A (Revised 3-19)
Page 7

EPA Identification Number
NPDES Permit Number
NC0021946
Facility Name
TOWN OF ROSMAN
Form Approved 03/05/19
OMB No. 2040-0004
Effluent Testing Data Treatment Description Continued
3.9
Describe the type of disinfection used for the effluent from each outfall in the table below. If disinfection varies by
season, describe below.
Outfall Number
o01
Outfall Number
Outfall Number
Disinfection type
uv
Seasons used
Dechlorination used?
■ Not applicable
■ Not applicable
■ Not applicable
•
Yes
• Yes
• Yes
•
No
• No
• No
3.10
Have you completed monitoring for all Table A parameters and attached the results to the app
ication package?
• Yes
• No
3.11
Have you conducted any WET tests during the 4.5 years prior to the date of the application on any of the facility's
discharges or on any receiving water near the discharge points?
■ Yes
1A No 4 SKIP to Item 3.13.
3.12
Indicate the number of acute and chronic WET tests conducted since the last permit reissuance of the facility's
discharges by outfall number or of the receiving water near the discharge points.
Outfall Number
Outfall Number
Outfall Number
Acute
Chronic
Acute
Chronic
Acute
Chronic
Number of tests of discharge
water
Number of tests of receiving
water
3.13
Does the treatment works have a design flow greater than or equal to 0.1 mgd?
A Yes
■ No 4 SKIP to Item 3.16.
3.14
Does the POTW use chlorine for disinfection, use chlorine elsewhere in the treatment process, or otherwise have
reasonable potential to discharge chlorine in its effluent?
• Yes 4 Complete Table B, including chlorine.
5I No 4 Complete Table B, omitting chlorine.
3.15
Have you completed monitoring for all applicable Table B pollutants and attached the results to this application
package?
■ Yes
• No
3.16
Does one or more of the following conditions apply?
• The facility has a design flow greater than or equal to 1 mgd.
• The POTW has an approved pretreatment program or is required to develop such a program.
• The NPDES permitting authority has informed the POTW that it must sample for the parameters in Table C, must
sample other additional parameters (Table D), or submit the results of WET tests for acute or chronic toxicity for
each of its discharge outfalls (Table E).
Yes
4 Complete Tables C, D, and E as
applicable.
SKIP to Section 4.
p No 4
3.17
Have you completed monitoring for all applicable Table C pollutants and attached the results to this application
package?
• Yes
• No
3.18
Have you completed monitoring for all applicable Table D pollutants required by your NPDES permitting authority and
attached the results to this application package?
No
sampling required by NPDES
authority.
■ Yes
additional
•
permitting
EPA Form 3510-2A (Revised 3-19)
Page 8

EPA Identification Number
NPDES Permit Number
Facility Name
Outfall Number
NC0021946
TOWN OF ROSMAN
Form Approved 03/05/19
OMB No. 2040-0004
TABLE
A. EFFLUENT PARAMETERS FOR ALL POTWS
Discharge
Average Daily Discharge
Analytical
Method1
ML or MDL
(include units)
Pollutant
Maximum Daily
Value
Units
Value
Units
Number of
Samples
Biochemical oxygen demand
0 BODs or ❑ CBOD5
(report one)
45
MG/L
30
MG/L
4
SM5210
10 ML
MDL
Fecal coliform
400
100ML
200
100ML
4
SM92220
❑ ML
0 MDL
Design flow rate
.250
MGD
pH (minimum)
pH (maximum)
Temperature (winter)
6
SU
9
SU
13.5
C
6
C
4
Temperature (summer)
22.5
C
21
C
4
Total suspended solids (TSS)
45
MG/L
30
MG/L
4 ❑ ML
0 MDL
Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter I, subchapter N or 0. See instructions and 40 CFR 122.21(e)(3).
EPA Form 3510-2A (Revised 3-19)
Page 13

EPA Identification Number
NPDES Permit Number
NC0021946
Facility Name
TOWN OF ROSMAN
Form Approved 03/05/19
OMB No. 2040-0004
Industrial Discharges and Hazardous Wastes Effluent Testing Data Continued
3.19
Has the POTW
or (2) at least
conducted either (1) minimum of four quarterly
four annual WET tests in the past 4.5 years?
WET tests for one year
+ Complete
preceding this permit application
tests and Table E and SKIP to
■ Yes
INNo
Item 3.26.
3.20
Have you previously
submitted the results of the above tests to
your NPDES permitting
No 4 Provide
authority?
results in Table E and SKIP to
MI Yes
■
Item 3.26.
3.21
Indicate the dates the data were submitted to your NPDES permitting authority and provide a summary of the results.
Date(s) Submitted
(MM/DD/YYYY)
Summary of Results
3.22
Regardless of
toxicity?
how you provided your WET testing data to the
NPDES permitting authority,
did any of the tests result in
Item 3.26.
■ Yes
■ No 4 SKIP to
3.23
Describe the cause(s) of the toxicity:
3.24
Has the treatment
works conducted a toxicity reduction evaluation?
Item 3.26.
• Yes
• No 4 SKIP to
3.25
Provide details of any toxicity reduction evaluations conducted.
3.26
Have you completed
Table E for all applicable outfalls and attached
the results to the application
Not
package?
because previously submitted
• Yes
• applicable
information to the NPDES •ermittin4 authori .
4. INDUSTRIAL
DISCHARGES AND HAZARDOUS WASTES (40 CFR 122.21(j)(6) and (7))
4.1
Does the POTW
receive discharges from SIUs or NSCIUs?
4.7.
■ Yes
■ No 4 SKIP to Item
4.2
Indicate the number of SIUs and NSCIUs that discharge to the POTW.
Number of SIUs
Number of NSCIUs
4.3
Does the POTW
have an approved pretreatment program?
• Yes
• No
4.4
Have you submitted
identical to that
application or
either of the following to the NPDES permitting
required in Table F: (1) a pretreatment program
(2) a pretreatment program?
authority that contains
annual report submitted
information substantially
within one year of the
4.6.
IN Yes
■ No 4 SKIP to Item
4.5
Identify the title and date of the annual report or pretreatment program referenced in Item 4.4. SKIP to Item 4.7.
4.6
Have you completed
and attached Table F to this application
package?
• Yes
• No
EPA Form 3510-2A (Revised 3-19)
Page 9

EPA Identification Number
NPDES Permit Number
NC0021946
Facility Name
TOWN OF ROSMAN
Form Approved 03/05/19
OMB No. 2040-0004
fldustriaI Discharges and Hazardous Wastes Continued
4.7
Does
regulated
•
the POTW receive, or has it been notified that it will receive,
as RCRA hazardous wastes pursuant to 40 CFR 261?
Yes
12
by truck, rail, or dedicated pipe, any wastes that are
No 4 SKIP to Item 4.9.
4.8
If yes,
provide the following information:
Hazardous
Waste
Number
Waste Transport Method
(check all that apply)
Annual
Amount of
Waste
Received
Units
❑
•
Truck
Dedicated pipe
•
•
Rail
Other (specify)
■
•
Truck
Dedicated pipe
IN
•
Rail
Other (specify)
■
IN
Truck
Dedicated pipe
•
Rail
Other (specify)
Does
including
•
the POTW receive, or has it been notified that it will receive,
those undertaken pursuant to CERCLA and Sections 3004(7)
Yes 151
wastewaters that originate from remedial activities,
or 3008(h) of RCRA?
No 4 SKIP to Section 5.
4.9
4.10
Does
specified
•
the POTW receive (or expect to receive) less than 15 kilograms
in 40 CFR 261.30(d) and 261.33(e)?
Yes 4 SKIP to Section 5.
•
per month of non -acute hazardous wastes as
No
4.11
Have
site(s)
the
•
you reported the following information in an attachment to
or facility(ies) at which the wastewater originates; the identities
extent of treatment, if any, the wastewater receives or will receive
Yes
this application: identification and description of the
of the wastewater's hazardous constituents; and
before entering the POTW?
❑ No
N 5. COMBINED
SEWER OVERFLOWS (40 CFR 122.21(j)(8))
CSO Map and Diagram
5.1
Does
•
the treatment works have a combined sewer system?
Yes
0
No 4SKIP to Section 6.
5.2
Have
•
you attached a CSO system map to this application? (See
Yes
instructions
■
for map requirements.)
No
5.3
Have
IN
you attached a CSO system diagram to this application? (See
Yes
•
instructions for diagram requirements.)
No
EPA Form 3510-2A (Revised 3-19)
Page 10

EPA Identification Number
NPDES Permit Number
NC0021946
Facility Name
TOWN OF ROSMAN
Form Approved 03/05/19
OMB No. 2040-0004
CSO Outfall Description
5.4
For each CSO outfall, provide the following information. (Attach additional sheets as necessary.)
CSO Outfall Number
CSO Outfall Number
CSO Outfall Number
City or town
State and ZIP code
County
Latitude
0 "
°
°
LongitudeII
°
Distance from shore
ft.
ft.
ft.
Depth below surface
ft.
ft.
ft.
CSO Monitoring
5.5
Did the POTW monitor any of the following items in the past year for its CSO outfalls?
CSO Outfall Number
CSO Outfall Number
CSO Outfall Number
Rainfall
• Yes • No
■ Yes • No
• Yes • No
CSO flow volume
• Yes ■ No
• Yes • No
• Yes • No
CSO pollutant
concentrations
• Yes • No
■ Yes ■ No
• Yes • No
Receiving water quality
■ Yes • No
• Yes • No
• Yes • No
CSO frequency
• Yes • No
• Yes • No
• Yes • No
Number of storm events
• Yes • No
• Yes • No
• Yes ■ No
CSO Events in Past Year
5.6
Provide the following information for each of your CSO outfalls.
CSO Outfall Number
CSO Outfall Number
CSO Outfall Number
Number of CSO events in
the past year
events
events
events
Average duration per
event
hours
❑ Actual or 0 Estimated
hours
0 Actual or 0 Estimated
hours
0 Actual or ❑ Estimated
Average volume per event
million gallons
0 Actual or 0 Estimated
million gallons
0 Actual or 0 Estimated
million gallons
0 Actual or 0 Estimated
Minimum rainfall causing
a CSO event in last year
inches of rainfall
0 Actual or 0 Estimated
inches of rainfall
0 Actual or 0 Estimated
inches of rainfall
0 Actual or 0 Estimated
EPA Form 3510-2A (Revised 3-19)
Page 11

EPA Identification Number
NPDES Permit Number
NC0021946
Facility Name
TOWN OF ROSMAN
Form Approved 03/05/19
OMB No. 2040-0004
CSO Receiving Waters
5.7
Provide the information in the table below for each of your CSO outfalls.
CSO Outfall Number_
CSO Outfall Number
CSO Outfall Number
Receiving water name
Name of watershed/
stream system
U.S. Soil Conservation
❑ Unknown
❑ Unknown
0 Unknown
Service 14-digit
watershed code
(if known)
Name of state
management/river basin
U.S. Geological Survey
0 Unknown
0 Unknown
0 Unknown
8-Digit Hydrologic Unit
Code (if known)
Description of known
water quality impacts on
receiving stream by CSO
(see instructions for
les
exam i
SECTION
6. CHECKLIST
AND CERTIFICATION
STATEMENT (40 CFR 122.22(a) and (d))
Checklist and Certification Statement
6.1
In Column 1 below, mark the
sections of Form 2A that you have completed and are submitting
with your application. For
each section, specify in Column 2 any attachments that you are enclosing to alert the permitting authority. Note that not
all applicants are required to provide attachments.
Column 1
Column 2
1: Basic Application
request(s)
Section
w/ variance
■
w/ additional attachments
for All Applicants
Information
Section
2: Additional
• w/ topographic
map
attachments
•
w/ process flow diagram
IN
Information
• w/ additional
• w/ Table A ■
w/ Table D
3: Information on
Discharges
B
II Section
1 w/ Table
•
w/ Table E
Effluent
• w/ Table C ■
w/ additional attachments
Section 4: Industrial
• w/ SIU and NSCIU attachments ■
w/ Table F
• Discharges and Hazardous
Wastes
■ w/ additional
attachments
Section
5: Combined Sewer
■ w/ CSO
map
system diagram
•
w/ additional attachments
•
Overflows
• w/ CSO
6: Checklist andIN
Statement
Section
• w/ attachments
Certification
6.2
Certification Statement
I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that qualified personnel properly gather and evaluate the information
submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible
for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and
complete. I am aware that there are significant penalties for submitting false information, including the possibility of fine
and imprisonment for knowing violations.
Name (print or type first and last name)
Official title
BRIAN SHELTON
MAYOR
Signature
Date signed
S A `
09/30/2020
EPA Form 3510-2A (Revised 3-19)
Page 12

This page intentionally left blank.

EPA Identification Number
NPDES Permit Number
NC0021946
Facility Name
TOWN OF ROSMAN
Outfall Number
Form Approved 03/05/19
OMB No. 2040-0004
TABLE B. EFFLUENT PARAMETERS
FOR ALL POTWS WITH A FLOW EQUAL TO OR GREATER
THAN 0.1 MGD
Daily Discharge
Analytical
Methods
Methods(
ML or MDL
Include units )
Pollutant
Maximum Daily Discharge
Average
Value
Units
Value
Units
Number of
Samples
Ammonia (as N)
6.3
MG/L
4.5
MG/L
4
SM450ONH
0 ML
3-F ❑ MDL
Chlorine
(total residual, TRC)2
❑ ML
❑ MDL
Dissolved oxygen
D ML
❑ MDL
Nitrate/nitrite
22
MG/L
19
MG/L
2
EPA353.2
❑ ML
❑ MDL
Kjeldahl nitrogen
1.0
MG/L
1.0
MG/L
2
EPA351.2
0 ML
0 MDL
Oil and grease
0 ML
❑ MDL
Phosphorus
4
MG/L
4
MG/L
2
EPA365.1
❑ ML
❑ MDL
Total dissolved solids
0 ML
❑ MDL
I Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter I, subchapter N or 0. See instructions and 40 CFR 122.21(e)(3).
2 Facilities that do not use chlorine for disinfection, do not use chlorine elsewhere in the treatment process, and have no reasonable potential to discharge chlorine in their effluent are not
required to report data for chlorine.
EPA Form 3510-2A (Revised 3-19)
Page 15

This page intentionally left blank.

EPA Identification Number
TABLE C. EFFLUENT PARAMETERS
Pollutant
NPDES Permit Number
NC0021946
FOR SELECTED POTWS
Facility Name
TOWN OF ROSMAN
Outfall Number
Analytical
Method1
Form Approved 03/05/19
OMB No.2040-0004
ML or MDL
(include units)
Maximum Daily Discharge
Average Daily Discharge
Value
Units
Value
Units
Number of
Samples
Metals, Cyanide, and Total Phenols
Hardness (as CaCO3)
o ML
0 MDL
Antimony, total recoverable
0 ML
0 MDL
Arsenic, total recoverable
❑ ML
❑ MDL
Beryllium, total recoverable
0 ML
❑ MDL
Cadmium, total recoverable
❑ ML
❑ MDL
Chromium, total recoverable
❑ ML
❑ MDL
Copper, total recoverable
0 ML
0 MDL
Lead, total recoverable
❑ ML
❑ MDL
Mercury, total recoverable
0 ML
❑ MDL
Nickel, total recoverable
❑ ML
❑ MDL
Selenium, total recoverable
❑ ML
❑ MDL
Silver, total recoverable
❑ ML
❑ MDL
Thallium, total recoverable
❑ ML
❑ MDL
Zinc, total recoverable
❑ ML
❑ MDL
Cyanide
❑ ML
0 MDL
Total phenolic compounds
❑ ML
0 MDL
Volatile
Organic Compounds
Acrolein
❑ ML
0 MDL
Acrylonitrile
0 ML
❑ MDL
Benzene
❑ ML
❑ MDL
Bromoform
❑ ML
❑ MDL
EPA Form 3510-2A (Revised 3-19)
Page 17

EPA Identification Number
TABLE C. EFFLUENT PARAMETERS
Pollutant
NPDES Permit Number
NC0021946
FOR SELECTED POTWS
Maximum Daily Discharge
Facility Name
TOWN OF ROSMAN
Average
Outfall Number
Daily Discharge
Analytical
Method,
Form Approved 03/05/19
OMB No. 2040-0004
ML or MDL
(include units)
Value
Units
Value
Units
Number of
Samples
Carbon tetrachloride
CI ML
❑ MDL
Chlorobenzene
El ML
❑ MDL
Chlorodibromomethane
❑ ML
❑ MDL
Chloroethane
El ML
❑ MDL
2-chloroethylvinyl ether
0 ML
❑ MDL
Chloroform
❑ ML
❑ MDL
Dichlorobromomethane
❑ ML
❑ MDL
1,1-dichloroethane
❑ ML
❑ MDL
1,2-dichloroethane
❑ ML
❑ MDL
trans-1,2-dichloroethylene
0 ML
0 MDL
1,1-dichloroethylene
0 ML
❑ MDL
1,2-dichloropropane
0 ML
❑ MDL
1,3-dichloropropylene
0 ML
0 MDL
Ethylbenzene
0 ML
0 MDL
Methyl bromide
D ML
❑ MDL
Methyl chloride
0 ML
0 MDL
Methylene chloride
0 ML
❑ MDL
1,1,2,2-tetrachloroethane
❑ ML
❑ MDL
Tetrachloroethylene
0 ML
0 MDL
Toluene
❑ ML
❑ MDL
1,1,1-trichloroethane
❑ ML
❑ MDL
1,1,2-trichloroethane
❑ ML
❑ MDL
EPA Form 3510-2A (Revised 3-19)
Page 18

EPA Identification Number
TABLE C. EFFLUENT PARAMETERS
Pollutant
NPDES Permit Number
NC0021946
FOR SELECTED POTWS
Maximum Daily Discharge
Facility Name
TOWN OF ROSMAN
Average
Outfall Number
Daily Discharge
Analytical
Method'
Form Approved 03/05/19
OMB No.2040-0004
ML or MDL
(include units)
Value
Units
Value
Units
Number of
Samples
Trichloroethylene
o ML
0 MDL
Vinyl chloride
0 ML
0 MDL
Acid -Extractable Compounds
p-chloro-m-cresol
o ML
❑ MDL
2-chlorophenol
0 ML
❑ MDL
2,4-dichlorophenol
0 ML
❑ MDL
2,4-dimethylphenol
0 ML
0 MDL
4,6-dinitro-o-cresol
❑ ML
❑ MDL
2,4-dinitrophenol
0 ML
❑ MDL
2-nitrophenol
0 ML
0 MDL
4-nitrophenol
❑ ML
❑ MDL
Pentachlorophenol
0 ML
❑ MDL
Phenol
El ML
❑ MDL
2,4,6-trichlorophenol
0 ML
❑ MDL
Base -Neutral Compounds
Acenaphthene
0 ML
❑ MDL
Acenaphthylene
0 ML
0 MDL
Anthracene
❑ ML
❑ MDL
Benzidine
❑ ML
❑ MDL
Benzo(a)anthracene
0 ML
❑ MDL
Benzo(a)pyrene
0 ML
❑ MDL
3,4-benzofluoranthene
❑ ML
❑ MDL
EPA Form 3510-2A (Revised 3-19)
Page 19

EPA Identification Number
TABLE C. EFFLUENT PARAMETERS
NPDES Permit Number
NC0021946
FOR SELECTED POTWS
Maximum Daily Discharge
Facility Name
TOWN OF ROSMAN
Average
Outfall Number
Daily Discharge
Analytical
Method'
Form Approved 03/05/19
OMB No. 2040-0004
ML or MDL
(include units)
Pollutant
Value
Units
Value
Units
Number of
Samples
Benzo(ghi)perylene
0 ML
❑ MDL
Benzo(k)fluoranthene
0 ML
❑ MDL
Bis (2-chloroethoxy) methane
0 ML
❑ MDL
Bis (2-chloroethyl) ether
0 ML
❑ MDL
Bis (2-chloroisopropyl) ether
0 ML
❑ MDL
Bis (2-ethylhexyl) phthalate
0 ML
0 MDL
4-bromophenyl phenyl ether
0 ML
❑ MDL
Butyl benzyl phthalate
0 ML
❑ MDL
2-chloronaphthalene
0 ML
❑ MDL
4-chlorophenyl phenyl ether
0 ML
❑ MDL
Chrysene
0 ML
❑ MDL
di-n-butyl phthalate
0 ML
❑ MDL
di-n-octyl phthalate
0 ML
0 MDL
Dibenzo(a,h)anthracene
0 ML
❑ MDL
1,2-dichlorobenzene
0 ML
❑ MDL
1,3-dichlorobenzene
❑ ML
❑ MDL
1,4-dichlorobenzene
ID ML
❑ MDL
3,3-dichlorobenzidine
❑ ML
❑ MDL
Diethyl phthalate
0 ML
❑ MDL
Dimethyl phthalate
0 ML
❑ MDL
2,4-dinitrotoluene
❑ ML
❑ MDL
2,6-dinitrotoluene
ID ML
❑ MDL
EPA Form 3510-2A (Revised 3-19)
Page 20

EPA Identification Number
TABLE C. EFFLUENT PARAMETERS
NPDES Permit Number
NC0021946
FOR SELECTED
POTWS
Discharge
Facility Name
TOWN OF ROSMAN
Average
Outfall Number
Daily Discharge
Analytical
Method1
Form Approved 03/05/19
OMB No. 2040-0004
ML or MDL
(include units)
Pollutant
Maximum Daily
Value
Units
Value
Units
Number of
Samples
1,2-diphenylhydrazine
o ML
❑ MDL
Fluoranthene
❑ ML
❑ MDL
Fluorene
❑ ML
❑ MDL
Hexachlorobenzene
El ML
❑ MDL
Hexachlorobutadiene
❑ ML
❑ MDL
Hexachlorocyclo-pentadiene
0 ML
❑ MDL
Hexachloroethane
El ML
❑ MDL
Indeno(1,2,3-cd)pyrene
0 ML
0 MDL
Isophorone
0 ML
0 MDL
Naphthalene
0 ML
❑ MDL
Nitrobenzene
❑ ML
❑ MDL
N-nitrosodi-n-propylamine
0 ML
0 MDL
N-nitrosodimethylamine
0 ML
❑ MDL
N-nitrosodiphenylamine
El ML
❑ MDL
Phenanthrene
❑ ML
❑ MDL
Pyrene
0 ML
0 MDL
1,2,4-trichlorobenzene
❑ ML
❑ MDL
1 Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR Chapter I, Subchapter N or 0. See instructions and 40 CFR 122.21(e)(3).
EPA Form 3510-2A (Revised 3-19)
Page 21

This page intentionally left blank.

EPA Identification Number
TABLE D. ADDITIONAL POLLUTANTS
NPDES Permit Number
NC0021946
AS REQUIRED BY NPDES PERMITTING
Maximum Daily Discharge
Facility Name
TOWN OF ROSMAN
AUTHORITY
Average
Outfall
Daily Dischar
Number
e
Analytical
Method1
Form Approved 03/05/19
OMB No. 2040-0004
ML or MDL
(include units)
Pollutant
(list) Value
Units Value
Units
Number of
Samples
•
No additional sampling is required by NPDES permitting authority.
o ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
I Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or required
under 40 CFR chapter I, subchapter N or 0. See instructions and 40 CFR 122.21(e)(3).
EPA Form 3510-2A (Revised 3-19)
Page 23

This page intentionally left blank.

EPA Identification Number
NPDES Permit Number
NC0021946
Facility Name
TOWN OF ROSMAN
Outfall Number
Form Approved 03/05/19
OMB No. 2040-0004
TABLE E. EFFLUENT MONITORING
FOR WHOLE EFFLUENT TOXICITY
for one whole effluent toxicity sample. Copy the table to report additional test results.
The table provides response space
Test Information
Test Number
Test
Number
Test Number
Test species
Age at initiation of test
Outfall number
Date sample collected
Date test started
Duration
Toxicity Test Methods
Test method number
Manual title
Edition number and year of publication
Page number(s)
Sample Type
Check one:
• Grab
• Grab
composite
• Grab
• 24-hour composite
• 24-hour
• 24-hour composite
Sample Location
Check one:
• Before Disinfection
• Before Disinfection
• Before disinfection
• After Disinfection
• After Disinfection
• After disinfection
• After Dechlorination
• After Dechlorination
• After dechlorination
Point in Treatment Process
Describe the point in the treatment process
at which the sample was collected for each
test.
Toxicity Type
Indicate for each test whether the test was
performed to asses acute or chronic toxicity,
or both. (Check one response.)
■ Acute
• Acute
• Acute
• Chronic
• Chronic
• Chronic
• Both
• Both
• Both
EPA Form 3510-2A (Revised 3-19)
Page 25

EPA Identification Number
NPDES Permit Number
NC0021946
Facility Name
TOWN OF ROSMAN
Outfall Number
Form Approved 03/05/19
OMB No.2040-0004
TABLE E. EFFLUENT MONITORING
FOR WHOLE EFFLUENT TOXICITY
The table provides response space for one whole effluent toxicity sample. Copy the table to report additional test results.
Test Number
Test Number
Test Number
Test Type
Indicate the type of test performed. (Check one
response.)
• Static
• Static
•
Static
• Static -renewal
• Static -renewal
•
Static -renewal
• Flow -through
• Flow -through
•
Flow -through
Source of Dilution Water
Indicate the source of dilution water. (Check
one response.)
■ Laboratory water
• Laboratory
water
water
• Laboratory water
• Receiving water
• Receiving
• Receiving water
If laboratory water, specify type.
If receiving water, specify source.
Type of Dilution Water
Indicate the type of dilution water. If salt
water, specify "natural" or type of artificial
sea salts or brine used.
• Fresh water
• Fresh water
(specify)
• Fresh water
• Salt water (specify)
• Salt water
• Salt water (specify)
Percentage Effluent Used
Specify the percentage effluent used for all
concentrations in the test series.
Parameters Tested
Check the parameters tested.
• pH
■
Ammonia
• pH
• Ammonia
■ pH
• Ammonia
• Salinity
•
Dissolved oxygen
• Salinity
• Dissolved oxygen
• Salinity
• Dissolved oxygen
• Temperature
• Temperature
• Temperature
Acute Test Results
Percent survival in 100% effluent
%
%
%
LC50
95% confidence interval
%
%
%
Control percent survival
%
%
%
EPA Form 3510-2A (Revised 3-19)
Page 26

EPA Identification Number
TABLE E. EFFLUENT MONITORING
The table provides response space
NPDES Permit Number
NC0021946
FOR WHOLE EFFLUENT TOXICITY
for one whole effluent toxicity sample.
Facility Name
TOWN OF ROSMAN
Copy the table to report additional
Outfall Number
test results.
Form Approved 03/05/19
OMB No. 2040-0004
Test Number
Test Number
Test Number
Acute Test Results Continued
Other (describe)
Chronic Test Results
NOEC
%
%
%
IC25
%
%
%
Control percent survival
%
Other (describe)
Quality Control/Quality Assurance
Is reference toxicant data available?
•
Yes
•
No
•
Yes
•
No
•
Yes
•
No
Was reference toxicant test within
acceptable bounds?
•
Yes
•
No
•
Yes
■
No
•
Yes
•
No
What date was reference toxicant test run
(MM/DD/YYYY)?
Other (describe)
EPA Form 3510-2A (Revised 3-19)
Page 27

This page intentionally left blank.

EPA Identification Number
NPDES Permit Number
NC0021946
Facility Name
TOWN OF ROSMAN
Form Approved 03/05/19
OMB No. 2040-0004
TABLE F. INDUSTRIAL DISCHARGE INFORMATION
Response space is provided for three SIUs. Copy the table to report information for additional SIUs.
SIU
SIU
SIU
Name of SIU
Mailing address (street or P.O. box)
City, state, and ZIP code
Description of all industrial processes that affect
or contribute to the discharge.
List the principal products and raw materials that
affect or contribute to the SIU's discharge.
Indicate the average daily volume of wastewater
discharged by the SIU.
gpd
gpd
gpd
How much of the average daily volume is
attributable to process flow?
gpd
gpd
gpd
How much of the average daily volume is
attributable to non -process flow?
gpd
gpd
gpd
Is the SIU subject to local limits?
Yes
No
Yes
No
• Yes • No
•
•
•
•
Is the SIU subject to categorical standards?
Yes
No
Yes
No
• Yes • No
•
•
•
■
EPA Form 3510-2A (Revised 3-19)
Page 29

EPA Identification Number
NPDES Permit Number
NC0021946
Facility Name
TOWN OF ROSMAN
Form Approved 03/05/19
OMB No. 2040-0004
TABLE F. INDUSTRIAL DISCHARGE INFORMATION
Response space is provided for three SIUs. Copy the table to report information for additional SIUs.
SIU
SIU
SIU
_
Under what categories and subcategories is the
SIU subject?
Has the POTW experienced problems (e.g.,
upsets, pass -through interferences) in the past 4.5
years that are attributable to the SIU?
•
Yes
•
No
•
Yes
•
No
■ Yes ❑ No
If yes, describe.
EPA Form 3510-2A (Revised 3-19)
Page 30