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Home My WebLink AboutNC0007323_Permit (Issuance)_20121220 NPDES DOCUWEMT SCANNIMO COVER SHEET NPDES Permit: NC0007323 Yanceyville WTP Document 'hype: ermit Issuance Waste load Allocation Authorization to Construct (AtC) Permit Modification Speculative Limits Staff Report Instream Assessment (67B) Environmental Assessment (EA) Permit History Document Date: December 20, 2012 WIXIM dog me t Jim prixMted ox%reuse paper-lap ox-e any c0o3Mte3Mt on the re'lreree Mide NCDENR North Carolina Department of Environment and Natural Resources Division of Water Quality Beverly Eaves Perdue Charles Wakild, P.E. Dee'Freeman Governor Director Secretary December 20, 2012 Mr. Haynes M. Brigman, Town Manager Town of Yanceyville P. O. Box 727 Yanceyville,NC 27379 Subject: Issuance of NPDES Permit NCO007323 Town of Yanceyville WTP Caswell County Dear Mr. Brigman: 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 October 15, 2007(or as subsequently amended). This final permit includes no significant changes from the draft permit sent to you on October 24, 2012. 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 Bob Sledge at telephone number(9I9) 807- 6398, or via e-mail at bob.sledge@ncdenr.gov. Sincerely, aha4rlesWaiId, P.E. cc: Central Files Winston-Salem Regional Office/Surface Water Protection Section NPDES File 1617 Mail Service Center,Raleigh,North Carolina 27699-1617 One Location:512 N.Salisbury St.Raleigh,North Carolina 27604 NofthCarolina Phone:919$07-63001 FAX:919.807-6492 Internet:www.n Natnully cwaterquality.orgAn Equal opportunity 1 Affirmative Ac6on Employer Permit NCO007323 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 provisions of North Carolina General Statute 143-215.1, other lawful standards and regulations promulgated and adopted by the North Carolina Environmental Management Commission, and the Federal Water Pollution Control Act, as amended, the Town of Yanceyville is hereby authorized to discharge wastewater from a facility located at the Yanceyville WTP Old Highway 62 Yanceyville Caswell County to receiving waters designated as Fullers Creek in the Roanoke River Basin in accordance with effluent limitations, monitoring requirements, and other conditions set forth in Parts 1, 1I, III and IV hereof. This permit shall become effective February 1, 2013, This permit and authorization to discharge shall expire at midnight on May 31, 2017. Signed this day December 20, 2012. O law Char es WakiId, P.E., Director Division of Water Quality By Authority of the Environmental Management Commission f Permit NCO007323 SUPPLEMENT TO PERMIT COVER SHEET All previous NPDES Pen-nits 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. The Town of Yanceyville is hereby authorized to: 1. Continue to discharge filter backwash water from a conventional water treatment plant,treated through a dual settlement lagoon system. The facility is located southwest of Yanceyville, off of Old Highway 62 in Caswell County. 2. Discharge from said treatment works at the location specified on the attached map into Fullers Creek, classified WS-III CA waters in the Roanoke River Basin. � 4 Permit NC0007323 7 � +•� •:1��-� , � , ,r"�,� ;_ tip., �,ti 749 • ,N �� Jill i �; :� t ,� 5,.� :`rf� 4 }4 �,�:IPA t- ! �. d• c.� y ,WI %� � v � �� '�'�r' 1 I �r^ r fTf. r� + �.—,�. �\�'a•� __ e�rr- I ,��'. �. �_:_ i��• � � � � , � ti r(Jfi��'�{I✓�/J_mil f ,�� ] �_� r� �T�.. r 43�• rn . f � � - _ "' �. fie? coo r as jto -�� 1 � — I F• �'1 r' � � •� .�` '`,� `} � I ,O +., �fff �•\_. �.J. I 1 � -�) r Ir _ / l r_` ��/•� �1�/. -5 1 Frf USGS Quad: B21 NE Facility - • `y. w, Latitude:360 23'31"N NCO007323 LocationLongitude:79°20'57"W Stream Class:WS-]ll CA Town of Yanceyrrilfe WTP Subbasi n:03-02-04 Receiving Stream: Fullers Creek North Caswell County f Permit NCO007323 A. (I.) EFFLUENT LIMITATIONS AND MONITORING REQUIREMENTS—FINAL During the period beginning on the effective date of this permit and lasting until expiration, the Permittee is authorized to discharge from outfall 001. Such discharges shall be limited and monitored by the Permittee as specified below: EFFLUENFCHARACTERISTIGS LIMITS'1 MQNITORINGSREQUI REM ENTS Monthly Qaily j Measurement ` Sample ' t iParameterCbde , r ' r.-, - �Sample.Type _ k Average. ;;;Maximum_ Frequency ;_ _,Location:, Flow 50050 Weekly Instantaneous Effluent Total Suspended Solids C0530 30.0 mglL 45.0 mglL 2/Month Grab Effluent pH 00400 ?6.0 s.u.and<_9.0 s.u. 2/Month Grab Effluent Total Residual Chlorines 50060 17 pglL 2/Month Grab Effluent Turbidity 00070 2/Month Grab Effluent Aluminum 01105 Quarterly2 Grab Effluent Total Iron 01045 Quarterly2 Grab Effluent Total Copper 01042 Quarterly2 Grab Effluent Manganese 01055 Quarterly2 Grab Effluent Fluoride 00951 Quarterly2 Grab Effluent Whole Effluent Toxicity Monitoring3 TGP38 Quarterly Grab Effluent Footnotes: 1. .The Division shall consider all effluent TRC values reported below 50 µg/L to be in compliance . with the permit. However, the Permittee shall continue to record and submit all values reported by a North Carolina certified laboratory (including field certified), even if these values fall below 50 la�l-• 2. Monitoring should be performed in conjunction with toxicity testing. 3. Ceriodaphnia dubia 7day pass/fail test @ 90%. See Condition A. (2.) for toxicity testing requirements. Toxicity testing should be performed during the months of January, April, July and October, and sampling should coincide with sampling for parameters covered by footnote 2. All samples must be collected from a typical discharge event. There shall be no discharge of floating solids or visible foam in other than trace amounts. Permit NC0007323 A. (2.) CHRONIC TOXICITY MONITORING (QUARTERLY) The permittee shall conduct quarterly chronic toxicity tests using test procedures outlined in the "North Carolina Ceriodaphnia Chronic Effluent Bioassay Procedure," Revised February 1998, or subsequent versions. The effluent concentration defined as treatment two in the procedure document is 90 %. The testing shall be performed as a Ceriodaphnia duhia May pass/fail test. The tests will be performed during the months of January,April,July and October. Effluent sampling for this testing shall be performed at the NPDES permitted final effluent discharge below all treatment processes. All toxicity testing results required as part of this permit condition will be entered on the Effluent Discharge Monitoring Form (MR-1) for the month in which it was performed, using the parameter code TGP3B. Additionally, DWQ Form AT-1 (original) is to be sent to the following address: Attention: NC DENR/DWQ/Environmental Sciences Section 1621 Mail Service Center Raleigh, N.C. 27699-1621 Completed Aquatic Toxicity Test Forms shall be filed with the Environmental Sciences Section no later than 30 days after the end of the reporting period for which the report is made. Test data shall be complete and accurate and include all supporting chemical/physical measurements performed in association with the toxicity tests, as well as all dose/response data. Total residual chlorine of the effluent toxicity sample must be measured and reported if chlorine is employed for disinfection of the waste stream. Should there be no discharge of flow from the facility during a month in which toxicity monitoring is required, the permittee will complete the information located at the top of the aquatic toxicity (AT) test form indicating the facility name, permit number, pipe number, county, and the month/year of the report with the notation of"No Flow" in the comment area of the form. The report shall be submitted to the Environmental Sciences Section at the address cited above. Should the permittee fail to monitor during a month in which toxicity monitoring is required, then monthly monitoring will begin immediately. Upon submission of a valid test,this monthly test requirement will revert to quarterly in the months specified above. Should any test data from this monitoring requirement or tests performed by the North Carolina Division of Water Quality indicate potential impacts to the receiving stream, this permit may be re- opened and modified to include alternate monitoring requirements or limits. If the Permittee monitors any pollutant more frequently then required by this permit, the results of such monitoring shall be included in the calculation & reporting of the data submitted on the DMR&alI AT Forms submitted. NOTE: Failure to achieve test conditions as specified in the cited document, such as minimum control organism survival, minimum control organism reproduction, and appropriate environmental controls, shall constitute an invalid test and will require immediate follow-up testing to be completed no later than the last day of the month following the month of the initial monitoring. I Mom' CCD NR -{ North Carolina Department of Environment and Natural Resources i Division of Water Quality Beverly Eaves Perdue . Charles Wakild, RE, Dee Freeman Governor Director Secretary October 24,2012 MEMORANDUM To: Lisa Edwards,P.E. NC DENR/DWR 1 PWS Regional Engineer Winston-Salem Regional Office From: Bob Sledge Compliance&Expedited Permitting Unit ,Subject: Review of Draft NPDES Permit NCO007323 Town of Yanceyville Water Treatment Plant Caswell County Please indicate below your agency's position or viewpoint on the draft permit and return this form by November 21,2012. If you have any questions on the droLft permit,please contact me at(919) 807- 6398 or via e-mail at bob.sledge@ncdenr.gov. RESPONSE: (Check one) Concur.with the issuance of this permit provided the facility is operated and maintained properly, the stated effluent limits are met prior to discharge, and the discharge does not contravene the designated water quality standards. Concurs with issuance of the above permit,provided the following conditions are met: Opposes the issuance of the above permit,based on reasons stated below, or attached: Signe Date: 1617 Mall Servioe Center,Raleigh,North Carolina 27699-1617 One Location:512 N,Salisbury St.Raleigh,North Carolina 27604 No-thCaxolina Phone:919-307-63001 FAX:919-807-CA92 Internal:www.ncwaterqualk,org atl/r►all�/ An Eaual OwAunity 1 AtfirmaGva Acton Employer Yi[ i �/ Permit Number: �CO4 Q 7 3 ,2 3 Facility Name: la a Type of WTP: Conventional V Greensand Filter Reverse Osmosis i Person Contacted: Date/Time: U A S of J s Chlorine r Fluoride present in water used to backwash filters? Yes No If no what is source water is used? ram. � 3 Does the facility us rthophosphate as a corrosion inhibitor? Yes No /1 zinc Does the facility use chloramines as an alternate form of disinfection? Yes No Highest Reported Monthly Average Flow over past three years: (3• a� MGD Is effluent flow to receiving stream Continuous or Intermittent? How Intermittent? �jl Receiving Stream: �. t r� Cieek �j � 7Q10 Flow: a.a� s7 • a.l �) Source: IWC: Discharge to NSW waters? Yes r '� [y l.ib 3f llh A �ft ., GIa' �'�7c/VJ�I� G [scll�Ilid'7 Cd,r�d �hfYit"!C Discharge to water supply waters. Ye No 61J-/// - .4"a Is the stream impaired/on 303d list? Yes No If yes, for what? /�F L'�-- ' )I.P. }I R lY gx rl 'q/(J1 � 'pLJy fly"- �,�a �✓````7 � c�. 't,(j �' �t�^"� �� 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 Expedited Permit Renewals Permit Writer/Date Bob Sledge 12/20/2012 Permit Number NC0007323 Facilit Name Town of Yance ville WTP Basin Name/Sub-basin number Roanoke 03-02-04 Receiving Stream Fullers Creek Stream Classification in Permit WS-III, CA Does permit need Daily Max NH3 limits? No Does permit need TRC limits/language? Added Footnote Does permit have toxicity testing? 7 day chronic ass/fail cerioda hnia added Doespert-nit have Special Conditions? No Doespert-nit have instream monitoring? No Is the stream impaired on 303(d) list)? No Any obvious compliance concerns? No Any permit mods since lastpermit? No Current expiration date 5/31/2012 New expiration date 5/31/2017 Comments received on Draft Permit? No Most Commonly Used Expedited Language: • 303(d) language for Draft/Final Cover Letters: "Please note that the receiving stream is listed as an impaired waterbody on the North Carolina 303(d) Impaired Waters List. Addressing impaired waters is a high priority with the Division, and instream data will continue to be evaluated. If there is noncompliance with permitted effluent limits and stream impairment can be attributed to your facility, then mitigative measures may be required". • TRC lanijuage for Compliance Level for Cover Letters/Effluent Sheet Footnote: "The Division shall consider all effluent TRC values reported below 50 µg/L to be in compliance with the permit. However, the Permittee shall continue to record and submit all values reported by a North Carolina certified laboratory(including field certified), even if these values fall below 50 µg/L." BIMS Compliance Download: Queries>Reports>Violations>Monitor Report Violations>Limit Violations for Past 3 Years Reminder: Permits that are not subject to expedited renewal include the following: 1) Major Facility(municipal/industrial); 2) Minor Municipals with pretreatment program; 3) Minor Industrials subject to Fed Effluent Guidelines(lb/day limits for BOD, TSS, etc); 4) Limits based on reasonable potential analysis (metals, GW remediation organics); 5) Permitted flow> 0.5 MGD(requires full Fact Sheet); b) permits determined by Supervisor to be outside expedited process. Note: This sheet is located on NPDES Server/CurrentVersions/Expedited Fact Sheet May2010 AFFIDAVIT OF INSERTION OF ADVERTISMENT The Times-News Publishing Company Public Notice North Carolina Gnviionmenlal Management Covu6s,lton/ Pf)ES Unit 1617 Mail Service Center Raleigh,INC Z7699.1617 Burlington, NC NaticeoflntenttoIssue a NPI)[S Wastewater Alamance County Permit The North Carolina Envi- rorrnental Management � Commission proposes W 1, Debbie Shue, Legal Advertising Manager of the 'Times-News l ublishing Co., issue a pro waste- do certify that the advertisement of entitled water discharge permit to the persons}listed below. Written comments re- Public Notice North Carolina Environmental Management gautir,g the Imposed per- ms will he accepled until 3C days after the publish dale of this notice.The Di. r0dOr of the NC Division of Measuring 54 Lines appeared in The Times-News, a newspaper published wafer Cnallty cows} may In Alamance County Burlington NC in issues of hold a public hearing > > > should there he a signifi- cant dogree of public inter est.Please mail comments an(/or .information re- luests to l at the October 27, 2012 above adifress. Interested persons may visit the DWO at S17 N. Salisbury Order # 22607779122612281 Sum, Raleigh, NC to re- view infannariorn on flip. Acdilional information on NPIKS permits and this notice miry he found On / ow wehsitu: !�Lk. �(,�� hltp:7/P��rhal.ncclenr.ory�w chlwq/swp/ps/npdes/cafe Legal Advertising Manager oche, Of by calling (919( BD7-8394. the Town of Yanceyviile ' requested renewal of per- roit, NCOOD7373 for the Yanceyville WTP.in Caswell County;this permitted dis / charge is lilter backwash Sworn to and��Vhscj}bed before me this 1 day of(t(�J , 2012 water to Fullers Creek in the Roanoke River Basin, i I � Z r ? W Angelia Ross Little o) = C. o G ��1f1411� ary Public My commission expires: January 20, 2015 Yanceyville WTP REASONABLE POTENTIAL ANALYSIS Outfall 001 NCO007323 Ow=0.04 MGD Qa(51t 1111= 0.04 WWI I'Ak7 PU.ss PC-1 IV luh'mf,l-0.04 lu'C Sri IQ lus- 60.75% 7(;hisldsl- 0.06 lukc SQlu f7s- 66.36% 7Q.uW{clyl- 0 06 [%k C.-11 7Q01W- 66.34% 114)2 ufs1- 0.06 M'c Z 3(.p- 66.36% Acg Sl,.m F'lou,QA(cf.)=0.05 IN'C^a QA- 66.36% Rcccirinp%Irnm'.fullers.C—k slrc.m Cl—448 III,CA PARAMETER TYPE STANDARM A CWTEM(2) REASONAOLE POTENTIAL RESULTS RECOMMENOEOACMN (11 NL'VL'Qs 1 A1,1+ned ry F'AV! S A Ikl. Nh`Ihcd A!1„xahlc Cu cl—ie st.nd.ld A-le 11 Cx Aoulc: No WQ5 A....i. c in FW(7Q111a) vµA, u N WA - - _ ---- - A—k C 10 NIIM's(t)..µ1 uFAl 0 U NIA [luohrc:- - IA I "•-•"•^•__ _ _ _-_-_ _ _ Acute: NI I WQs S.ryawrrl NC 6.5 F 7QI(Isl ,FA. 11 n NIA _ II.7__ _-_-_-_-_._._-_-_-_-_-_-_-_ Aclus: 24.7 C.emlum NO 2 1'WQ1)pisl 15 upA, u u WA ._ -_-_- _. ._.--_._. Ch... _ ;.f_-_ _ -`_ - Acura: NO WO, ChkrM..(AL) Nc 230 FW'(7QI0al mgrl, n (1 N1A Acme Nt)WQS - ChN,0nw.EPh—ft Conpo". Nc I A(110)2) '41L 0 0 NIA Clmmic: A vm; NO 1 Wt75 Td.l Pn.nmk cwnPxuna. Nc 11A1 A(nu1A -11, 11 0 N(n _-_-_-_ ._-_----.-.-. Cluhnic: 541.9 A.ule; 16A1.5 Ch-4— Nc 50 FW(7QIOs) 1022 .0, 0 0 N(A Acute; 120 c ppw(ALy Nc 7 FW[7QIW 7 upA, P 0 N!A Ac111c: 16.2 cym1M. Nc 5 YW(A111d! 22 10 �gA. 0 0 WA l'luuni.; y[1 ._ _-_-_---_-_-_-_.____ __._ NC00073212011 RPAFr.. .M,r Pap.1 0!2 12/20m 12 YanceyAIIe WTP REASONABLE POTENTIAL ANALYSIS Outfall 001 NC0007323 Ow=0.04 MGD Acute, N(1u'Qs Fl—id. NC 19W FW(7QIN) W. 7% 7A 1.946.0 ....... _ _ _ __ _ __ Cl.—':-- -1,_'il4 No RP,Pntl�tlM..150%alPMwahle Qx- - N—lue-All—bin CN •PP110--y MoMwrp A—: 55.6 L.W NC 25 FW(7Q0,M i}.A ugA. 0 0 Aoh Nu WQti ... ..... . Maury NC 12 F'W(7Q10a1 C5 0,;A. U (1 NIA Acme: Molyw-um NC 26(10 NN(7QI(a) ugA. 0 0 NIA - ._-_._-_-_---_-_._-_._-_- Am, 429.4 NkkN NC Ax Flt'17Q1na1 2w ugA. fl D NIA _ _ _ - _ _ --.-,-.-.----------------- Am,: Is Zi '11.1 a.knwm NC 5 FW(7010.) 56 u9/1. 0 n NIA _ ._ -_-_._._-_---_-_._._-_-_- Chrunu._ - -_ _ _ 90 Acme: 2.024 6W.r(ALI Ne 0.06 FW(7QIW 1.23 upA. 0 (1 NIA _ - --'-'-'-------------•-•-• Ctuhllu-- --aloe-- - - ncwe: uu.2 . Zinc JAL) Nc 50 FW'(7Q[nal 67 ueA 0 0 NIA _ -_ -------- ---- Acute_ NI I WQs Iron NC 1000 F14'(7Q i0a1 PO7i Si 2,026.12(N10 _ _ _ _ _ _ _ _ _ _ Ch—c:- 1%n6 1591A Nn aaluea Alk,xANe Cx Q-(�1f'f 4¢l TCI A,w� d�'A 5 Acuk: / 0 0 NIA CM,ni - -- -__ -_-_._,_-___-_ _ _-_-_---_ A-1, ... 0 0 NIA Ch--- _-_-_-_-_ _-_-_._._ _,_ _-_-_-_-_-_-_ Acuk: 0 0 NIA _ _ ChrnnK'._._-_-_-_ ------- *---------- --------- Nc00074232011 RPA.Frea 1.,10p. Pap.2.12 12120r20'2 ENVIRoLINK November 28, 2011 NCDENR—DWQ—NPDES Section 1617 Mail Service Center Raleigh, NC 27699-1617 Subject: Town of Yanceyville Water Plant Discharge Permit Renewal NC0007323 Town of Yanceyville Wastewater Treatment Plant Discharge Permit Renewal NCO040011 Enclosed please find the water treatment plant renewal application Short Form C —WTP and the wastewater treatment plant renewal application NPDES Form 2A. The following items are included: 1. Discharge location maps for both facilities. 2. A copy of the sludge disposal permits for both facilities. 3. Flow diagram for the wastewater treatment facility. Please contact Envirolink, Inc. at the number below, should you have any questions. DEC - 2 2011 DENR•WATER QUALITY POINT SOURCE SRANCF4 Envirolink,Inc. Your Partner in Utility Management PO Box 670, Bailey,North Carolina 27807 252-235-4900(phone) 2520235-2132(fax) � 4 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 NC0007323 If you are completing this form in computer use the TAB key or the up — down arrows to moue 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 Town of Yanceyville Facility Name Yanceyville Water Treatment Facility Mailing Address PO Box 727 City Yanceyville State / Zip Code NC 27379 Telephone Number (336)694-5431 Fax Number (336)694-1499 e-mail Address yanceyville@cnvirolinkinc.com cnvirolinkinc.com 2. Location of facility producing discharge: Check here if same as above ❑ Street Address or State Road Old Highway 62 City Yanceyville State / Zip Code NC 27379 County Caswell 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 Envirolink, Inc. Mailing Address PO Box 67010 City Bailey State / Zip Code NC 27807 Telephone Number (252)235-4900 DE R WATERPOINI QUqLI Fax Number (252)235-2132 CN 4. Ownership Status: Federal ❑ State ❑ Private ❑ Public 5. Type of treatment plant: Page l of 3 C-WTP 03/05 NPDES PERMIT APPLICATION - SHORT FORM C - WTP For discharges associated with water treatment plants ® Conventional (Includes coagulation, flocculation, and sedimentation, usually followed by filtration and disinfection) ❑ 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 ❑ 6. Description of source water(s) (i.e. groundwater, surface water) Surface Water Withdrawn from Farmer Lake in Caswell County 7. Describe the treatment processes) for the raw water: Conventional water treatment facility ( permanganate feed followed by coagulation, flocculation, sedimenation and filtration) 8. Describe the wastewater and the treatment process(es) for wastewater generated by the facility: Decanted filter backwash through a dual settlement lagoon system. 9. Number of separate discharge points: 1 Outfall Identification number(s) 001 10. Frequency of discharge: Continuous ❑ Intermittent If intermittent: Days per week discharge occurs: 4 Duration: 1 hour 11. Plant design potable flowrate 1 MGD Backwash or reject flow .004 MGD 12. Name of receiving stream(s) (Provide a map showing the exact location of each outfall, including latitude and longitude): Fullers Creek 13. Please list all water treatment additives, including cleaning chemicals or disinfection treatments, that have the potential to be discharged. Page 2 of 3 C-WTP 03105 NPDES PERMIT APPLICATION - SHORT FORM C - WTP For discharges associated with water treatment plants 13. Please list all water treatment additives, including cleaning chemicals or disinfection treatments, that have the potential to be discharged. Aluminum Sulfate Caustic Soda Chlorine Potassium Permanganate 14. Is this facility located on Indian country? (check one) 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. > SoIids Handling Plan 16. NEW Applicants Information needed in addition to items 1-I5: > New applicants must contact a permit coordinator with the NCDENR Customer Service Center. Was the Customer Service Center contacted? ❑ Yes ❑ No Analyses of source water collected > Engineering Alternative Analysis Discharges 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. a nP- . zf( an -To uh Mmo, e)( Print nAme of Person Si ing Title a, Th4kQ�� Il 21 (A Signatu t f Applicant 0 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.) Pnge 3 of 3 C-W'rP 03105