NCG510002_More Information (Received)_20180308

Ar
NCDENR
North Carolina Department of Environment a«9 kraturan Resoimrces
Division of Water Quality
Pat McCrory Thomas A Reeder
Governor Acting Director
June 21, 2013
Mr. Deryl Bruorton
Blue Ridge Regional Hospital, Inc.
125 Hospital Dr
Spruce Pine, NC 28777
Dear Mr. Bruorton:
•
John E. Skvarla III
Secretary
Subj ect Rescission of Certificate of Coverage
NCG510002
Spruce Pine Hospital
Mitchell County
Division staff has confirmed that the subject Certificate of Coverage (CoC)
is no longer required. Therefore, in accordance with your request, NPDES
CoC NCG5ZL0002 is rescinded, effective immediately.
If in the future your facility wishes to discharge wastewater to the
State' s surface waters, you must first apply for and receive a new
NPDES permit.
If you have any questions concerning this matter, please contact Charles H.
Weaver at [phone] or via e-mail [[e-mail]].
Sincerly,
1
�' ' (9
1%
121/(
r
homas A. Reeder_
cc: Asheville Regional office / Surface dater Protection
NPDES Unit
, j,1,) , t
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 512 North Salisbury Street, Raleigh, North Carolina 27604
Phone: [phone] / FAX [phone] / Internet: www.ncwaterquality.org
An Equal opportunity/Affirmative Action Employer — 50% Recycled/10% Post Consumer Paper

We werr, Charrles
F rc rriai
Scautico)
Siii jen o
Deryl L Bruorton < [e-mail]>
Friday, June 21, 2013 12633 PM
Weaver, Charles
RE NCG510002 is no longer needed
Mr. Weaver
I am in agreement to rescind NCG510002 and understand this will eliminate our annual fee.
Thanks
Deryl Bruorton
VP of Outreach and Service Development
Blue Ridge Regional Hospital
828-766-1803
spcdl b(a�msj .orq
From: Weaver, Charles[mailto:[e-mail]]
Sent: Wednesday, June 19, 2013 10:53 AM
To: Deryl L Bruorton
Cc: [e-mail]
Subject: NCG510002 is no longer needed
Importance: High
Mr. Bruorton:
The UST Supervisor in the NC DENR Asheville Regional Office has notified our Division that the subject Certificate of
Coverage (CoC) is no longer required.
NCG510002 covered a discharge of remediated groundwater from the Spruce Pine Hospital in Mitchell
County. According to the UST Supervisor, this CoC is no longer necessary and all discharge has ceased.
Do you wish to rescind NCG510002? This will eliminate the annual fee of $100.00.
I would appreciate any information you have on this site.
Charles H. Weaver
NPDES Unit
This message and its attachments may contain confidential and/or legally.
sensitive information that is intended for the sole use of the addressee(s). Any unauthorized review, use,
disclosure, or distribution of the information contained in this message and its attachments is prohibited. If you
have received this message or any of its attachments in error, please destroy all originals and copies of the same
p
and notify the sender immediately.
i

Weaver, Charles
From:
Sent:
To:
Subject:
Attachments:
Wiggs Linda
Tuesday, June 18, 2013 11:01 AM
Weaver, Charles
RE: NPDES General Permit NCG510000 renewal notices - UST sites
Copy of NCG510 March 2011.xts
Hi Charles,
I had Jan Andersen (Supervisor of UST in ARO) go through these and give me a response.
She said none of the ones listed here in yellow in the ARO need our NPDES permit anymore,,,they no longer discharge.
Linda
Linda Wiggs - [e-mail]
North Carolina Dept. of Environment and Natural Resources
Asheville Regional Office
Division of Water Quality - Water Quality Section
2090 U.S. 70 Highway
Swannanoa, NC 28778
Tel: [phone]
Fax: [phone]
Link to Division of Water Quality Home Page
http•//portal.ncdenr.org/web/wq
Notice: E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and
therefore may be disclosed to third parties.
From: Weaver, Charles
Sent: Monday, June 17, 2013
To: Wiggs, Linda
Subject' FW NPDES General
Many of these were resolved.
CHW
3'23 PM
Permit NCG510000 renewal notices - UST sites
Any CoC that's expired in BIMS remains unresolved.
From: Weaver, Charles
Sent: Thursday, March 10, 2011 10:31 AM
To: Andersen, Jan; Bullock, Scott; Jackson, Gene; Rintoul, Cindy; Taraban, Ron; Harmon, Karen
Cc: Edwards, Roger; Krebs, Rob, Smith, Danny, Thorpe, Roger; Shiver, Rick; Basinger, Corey, Hennessy, John
Subject: NPDES General Permit NCG510000 renewal notices - UST sites
I'm currently sending out renewal notices to Certificate of Coverage (CoC) holders under the subject
General Permit. These CoCs were issued to UST cleanup sites which discharge remediated
groundwater. I've attached the database of current CoC holders showing the progress thus far in
contacting them. I've also attached the renewal form being sent to the CoC holders.
UST personnel:
1. The database is FYI in case your contacts at these sites ask why they are receiving the notice.
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NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue, Governor Coleen H. Sullins, Director Dee Freeman, Secretary
October 18, 2011
Mr. Deryl L. Bruorton
Blue Ridge Regional Hospital, Inc.
125 Hospital Dr
Spruce Pine, NC 28777
Subject: NPDES General Permit NCG510000
Certificate of Coverage (CoC) NCG510002
Spruce Pine Hospital
Mitchell County
Dear Permittee:
The Division received your request for renewal of NCG510002 on April 4, 2011. The revised General
Permit was signed on September 20th, 2011 and took effect October 1, 2011. This renewed CoC is issued
pursuant to the requirements of North Carolina General Statute 143-215.1 and the Memorandum of
Agreement between North Carohna and the US Environmental Protection agency dated October 15, 2007 [or
as subsequently amended].
A copy of the NCG510000 is enclosed, as well as an updated Technical Bulletin. The Technical
Bulletin summarizes the changes from the previous version of NCG510000. If any parts, measurement
frequencies or sampling requirements contained in this permit are unacceptable to you, you have the right to
request an individual permit by submitting an individual permit application. Unless such demand is made,
this CoC shall be final and binding.
The CoC is not transferable except after notice to the Division. You must notify the Division if you sell
or otherwise transfer ownership of the permitted facility. The Division may require modification or reissuance
of the CoC.
If your facility ceases discharge of wastewater before the expiration date of this permit, contact the
Regional Office listed below. Once discharge from your facility has ceased, this CoC may be rescinded. This
permit does not affect the legal requirements to obtain other permits which may be required by the Division of
Water Quality, the Division of Land Resources, Coastal Area Management Act or any other Federal or Local
government. If you have any questions concerning this permit, please contact Charles H. Weaver at the
telephone number or e-mail address listed below.
cc: Asheville Regional Office — Surface Water Protection
NPDES file
CI
71f:
Coleen H. Sullins V.
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
512 North Salisbury Street, Raleigh, North Carolina 27604
Internet: www,ncwaterquality,org
Phone: [phone] / FAX [phone]
charles.weaver@ncdenr,gov
NorthCarolina
Naturally
An Equal Opportunity/Affirmative Action Employer — 50% Recycled/10% Post Consumer Paper
•

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NCG510000
CERTIFICATE OF COVERAGE NCG510002
TO DISCHARGE PETROLEUM CONTAMINATED GROUNDWATER AND SIMILAR WASTEWATERS
UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards and
regulations promulgated and adopted by the North Carolina Environmental Management Commission, and
the Federal Water Pollution Control Act, as amended,
Blue Ridge Regional Hospital, Inc.
is hereby authorized to operate a groundwater remediation system for petroleum -contaminated groundwater
or similar waste streams that will discharge treated wastewater from the
Spruce Pine Hospital
125 Hospital Dr
Spruce Pine
Mitchell County
to receiving waters designated as an unnamed tributary to Beaver Creek, a class C-Trout stream in
subbasin 04 03-06 of the French Broad River Basin.
All discharges shall be in accordance with the effluent limitations, monitoring requirements, and
other conditions set forth in Parts I, II, III and IV of General Permit NCG510000 as attached.
This Certificate of Coverage shall take effect on October 18, 2011.
This Certificate of Coverage shall expire on September 30, 2016.
Signed this day, October 18, 2011
/
for Cole° . . Sulhns, Director
Dfiision of Water Quality
By Authority of the Environmental Management Commission

NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
NC DENR / DWQ / Water Quality Section
National Pollutant Discharge Elimination System
NCG510000
RENEWAL application for coverage under General Permit NCG510000
[remediation projects treating petroleum -contaminated groundwater]
(Please print or type) Certificate of Coverage number: NCG510002
1) Mailing address of site Owner:
Company Name: Blue Ridge Regional Hospital, Inc. (formerly, Spruce Pine Hospital)
Company Contact: Deryl L Bruorton
Street Address:
City*
Telephone No.:
e-mail address:
125 Hospital Drive
Spruce Pine
State: NC ZIP Code: 28777
828-766-1803 Fax:
[e-mail]
2) Location of remediation site producing discharge:
Facility Name:
Facility Contact:
Street Address:
City:
County:
Telephone No.:
e-mail address:
Spruce Pine Hospital
Deryl Bruorton
125 Hospital Drive
Spruce Pine State: NC ZIP Code: 28777
Mitchell
828-766-1803 Fax:
[e-mail]
3) System operator / Consultant ID [if different from Owner] :
Company Name: S&MEEK, Inc. (under contract with the NCDENR, DWM, UST Section, State Lead)
Company Contact: Al Quarles (operator David Reames)
Street Address: 9751 Southern Pine Blvd.
City Charlotte
Telephone No.: 704 523-4726
e-mail address: [e-mail] (dreames a smeinc.com)
State: NC ZIP Code: 28273
Fax: [phone]
4) Site ranking & ID:
GW incident # 3659
Site Ranking [if available] :1125D
Date of most i ecent discharge: Currently Discharging
Additional data required:
a) A site map clearly showing the path of the remediation system effluent from the site to its
discharge point.
b) If this application is being submitted by a consulting engineer (or engineering firm), include
documentation from the current permittee showing that the person[s] submitting the
application has been designated an Authorized Representative.
Page 1 of 2

NCG510000 renewal application
CERTIFICATION:
I certify that I am familiar with the information contained in this application and
that to the best of my knowledge and belief such information is true, complete, and
accurate.
Printed Name of Person Signing: Deryl L Bruorton
Title: Vice ,'re Bidet
if
ia/J/r
y 02 0 0
(SignatureApplicant)
(Date Signed)
North Carolina General Statute 143-215.6 B (i) provides that:
Any person who knowingly makes any false statement, representation, or certification in any
application, record, report, plan or other document filed 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 $10, 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 S 10,000 or imprisonment not more than 5 years, or both, for a similar offense.)
DJVQDWQDWQDWQDWQDWQDWQDWQDWQD VQDWQDnIQ
Mail THIS COMPLETED FORM to:
Mr. Charles H. Weaver
NC DENR / DWQ / NPDES
1617 Mail Service Center
Raleigh, North Caroiina 27699-1617
NPDESNPDESNPDESNPDESNPDESN PDESN PDESNPDESNPDES
For electronic copies of this form or the NCG510000 Fact Sheet, send a request to:
charles.weaver@ncdenr. gov
Page 2 of 2

Discharge
from
Remediation
System
MMm
•
•
•
•
•
•
•
Underground
Piping
Figure from S&ME's October 1998 Site Map for Engineering Drawings
Scale: Shown
Checked by:
Drawn by: WAQ
Date: 03-31-2011
ENGINEERING TESTING
ENVIRONMENTAL SERVICES
•
Remediation System
Site Aerial Map — Discharge Path
Blue Ridge Reg Hosp (Spruce Pine Hosp)
NCG510002, 125 Hospit'tl Dr
Spruce Pine, North Carolina
Job No.: 1354-09-212D
•
Figure No.
1

s
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
May 18, 2009
Transmitted via FAX - 1 page total
MEMORANDUM
To: Keith Holtsclaw / Spruce Pine Community Hospital
From: Charles H. Weaver, Jr. / NPDES Unit
Subject: Contact for status of remediation project covered by NCG510002
Mr. Holtsclaw: the person to contact regarding the current status of groundwater
oundwater
your
remediation project is Mr. Scott Ryals at 919 733- 431.8. Mr. Ryals is with the State Trust Fund
group within the Underground Storage Tank program; he can answer your questions regarding
payment of the annual fee.
If Mr. Ryais informs you that remediation is no longer necessary at your site, you request
may
rescission of your Certificate of Coverage. Simply contact me with the information from Mr.
Ryais, should you wish to rescind.
If you have any additional questions regarding the permit rescission [or renewal] process, contact
me at the telephone number or address listed below.
5e4) glo ei6 r/Se'd2L/
•
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 919 807-6391 (fax) 919 807-6495
VISIT US ON THE INTERNET Q© http://www.ncwaterquality,org charles.weaver aC ncdenr.gov
An Equal Opportunity/Affirmative Action Employer — 50% Recycled/10% Post Consumer Paper

Weaver, Charles
From:
Sent:
To:
Subject:
Haynes, Keith
Tuesday, May 12, 2009 2:50 PM
Weaver, Charles; Edwards, Roger
RE: NCG510002 - status?
Charles, a county or a facility name would have been nice! This is a State Trust Fund site, so they need to contact Scot:.
Ryals at 919-733-1318. He should take of the billing issue by contacting the engineering firm. The site is still active.
Keith Haynes - [e-mail]
North Carolina Dept. of Environment and Natural Resources
Asheville Regional Office
Division of Water Quality - Surface Water Protection
2090 U.S. 70 Highway
Swannanoa, NC 28778
Tel: [phone]
Fax: [phone]
Notice• E-mail correspondence to and from this address may be subject to the NC Public Records Law and may be
disclosed to third parties.
From: Weaver, Charles
Sent: Tuesday, May 12, 2009 2:14 PM
To: Edwards, Roger
Cc: Haynes, Keith
Subject: NCG510002 status?
Keith Holtsclaw from this facility called today, after his maintenance man called yesterday. Theyhave the an
nual Y a Waal fee
invoice for the CoC and no longer have an engineering firm to whom they can send it.
The system is [apparently] shut down. No one at the hospital knows much about it.
PLEASE have someone from UST contact them [or me] and determine if this CoC is still necessary. Also, whey
Ydo they
send the bill?
Thanks,
CHW
1

Keith Holtsclaw
Spruce Pine Community
P.O. Box 9
Spruce Pine, NC
Hospital
28777
Michael F Hasley
Governor
William G. Ross, Jr., Secretary
North Carolina Department of I--K;nvironment and Natural Resources
Alan W Klimek, P.R., Director
Division of Water Quality
September 29, 2006
Dear Permittee:
Subject: General Permit NCG510000
Certificate of Coverage NCG510002
Spruce Pine Community Hospital
Mitchell County
The Division received your request for renewal of the subject Certificate of Coverage (CoC) on June
19, 2006. The revised General Permit was signed on September 20th, 2006 and takes effect October 1, 2006.
Accordingly, we are forwarding the attached CoC to discharge under NCG510000. This CoC is issued
pursuant to the requirements of North Carolina General Statute 143-215.1 and the Memorandum of
Agreement between North Carolina and the US Environmental Protection agency dated May 9, 1994.
A copy of the renewed General Permit is enclosed, as well as an updated Technical Bulletin. The
Technical Bulletin summarizes the changes from the previous version of NCG510000. If any parts,
measurement frequencies or sampling requirements contained in this permit are unacceptable to you, you
have the right to request an individual permit by submitting an individual permit application. Unless such
demand is made, this Certificate of Coverage shall be final and binding.
The CoC is not transferable except after notice to the Division. You must notify the Division if you
sell or otherwise transfer ownership of the permitted facility. The Division may require modification or
reissuance of the CoC.
If your facility ceases discharge of wastewater before the expiration date of this permit, contact the
Regional Office listed below. Once discharge from your facility has ceased, this permit may be rescinded.
This permit does not affect the legal requirements to obtain other permits which may be required by the
Division of Water Quality, the Division of Land Resources, Coastal Area Management Act or any other
Federal or Local government. If you have any questions concerning this permit, please contact Charles
Weaver at the telephone number or e-mail address listed below.
Sincerely,
L,c72
for Alan W. Klimek
cc: Central Files
Asheville Regional Office — Surface Water Protection
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 919 733-5083, extension 511 (fax) 919 733-0719
An Equal Opportunity Affirmative Action Employer e-mail: [e-mail]

0EPARTME1N
S 'ATE OF NORTH CA_ OL NA
OF n/IRONME-NT AND NAITURAL RESOURCES
DIVISION OF WATER QUALITY
GENE I"AL P ERIV_7I" N (CG511 00QD0
C__ EFHCATE OF C OV 11:dL1LAGE NcO cG5:
02
TO DISCHARGE PETROLEUM CON TAMI \ ATED GROUNDWATER AND SIMILAR WASTEWATERS
•
UNIT KR THE
NATIONAL POIf LUTAIVT T ►ISC TIGE
N L IINATMX SYS nEIV.:
in compliance with the provision of North Carolina General Statute 143-215.1, other lawful
standards and regulations promulgated and adopted by the North Carolina Environmental
Management Commission, and the Federal Water Pollution Control Act, as amended,
Spruce Pine CUorrrmunL -y Hospital
is hereby authorized to operate a groundwater remediation system for petroleum -contaminated groundwater
or similar waste streams that will discharge treated wastewater from the
Spruce Pine Community lF ospital
Mitchell County
to receiving waters designated as an unnamed tributary to Beaver Creek, a class C-Trout stream
in subbasin 40306 of the French Broad River Basin.
All discharges shall be in accordance with the effluent limitations, monitoring requirements, and
other conditions set forth in Parts I, II, III and IV of General Permit N CG510000 as attached.
This certificate of coverage shall become effective October 1, 2006.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day, September 29, 2006.
for Alan W. Klimek, P.E., Director
Division of Water Quality
By Authority of the Environmental Management Commission

AVA
NCDENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
4'270 DO �
NC 1) ENRMo 1 Water Quality Section
National Pollutant Discharge Elimination System
NiCosS)51DLIOD
RENEWAL application for coverage under General Permit NCC 510000
[remediation projects treating petroleum -contaminated groundwater]
(Please print or type)
1) Mailing address of site Owner:
Company Name -
Company Contact:
Street Address:
City:
Telephone No.:
e-mail address:
Certificate of Coverage number: ti C. Ci 510 001.
K6\w HDLLsL/av4
P to. bog. 9
5 P c pi a�ib
t41ix
2) Location of remediation site producing discharge:
Facility Name:
Facility Contact:
Street Address:
City:
County:
Telephone No.:
e-mail address:
State: Nit ZIP Code: 2W7--7
Fax: 6263
S?2Wc SN6 Go MAYT Sputau
i 2s He5in TAL- 0(2,
State: FJC ZIP Code: ` e rr7
Fax: E528 4.7C5 v&2.4
3) System operator / Consultant ID [if different from Owner]:
Company Name*
Company Contact:
Street Address:
City:
County:
Telephone No.:
e-mail address:
tYkt MAW-5 � pA s-Lif 1wc-.
cN aN aPAIpN�
ill M p t\a
State: NIZ., ZIP Code: 2-15I
6119 ;39 520'2 Fax: S I9 535 qS 5
doo aiiilicketervertei own
4) Site ranking & ID:
GW incident #: 3G59
Site Ranking (A - E)- t+AtTo o,9A%
Date of most recent site ranking: 1998
Date of most recent discharge: 2-00H
•
Additional data required:
a) A site map clearly showing the path of the remediation system effluent from the site to its
discharge point.
b) If this application is being submitted by a consulting engineer (or engineering firm), include
documentation from the current permittee showing that the persons] submitting the
application has been designated an Authorized Representative.
Page I of 2

NCG510000 renewal application
(Signature of Applicant)
CERTIFICATION:
I certify that I am familiar with the information contained in this application and
that to the best of my knowledge and belief such information is true, complete, and
accurate.
Printed Name of Person Signing: C Gist i5.-1 3 p r r i p, e,
Title: OAStAAWe- 6 }.tlitt\(g v •- N CPiti UST SSGLOJ crAr6 t.Wr,o GaN`t'lapc,'C ---
(Date Signed)
North Carolina General Statute 143-215.6 B (i) provides that:
Any person who knowingly makes any false statement, representation, or certification in any
application, record, report, plan or other document filed 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 $10,000, 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 $10,000 or imprisonment not more than 5 years, or both, for a similar offense.)
DWODWel0We11We11Wel1Wel0WellWGI/WG11WGIIWGIDWe
Mail THIS COMPLETED FORM to:
Mr. Charles H. Weaver, Jr.
NC DENR / DWQ / NPDES
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
►!U1= SMFDES 11,10E KIPDE \!111:S\!DFS\PDESKI_III . \_ ES
For electronic copies of this form or the NCG510000 Fact Sheet, send a request to:
[e-mail]
Page 2 of 2

r
•
WITHERS SC RAVENEL
ENGINEERS 1 PLANNERS I SURVEYORS
111 Mackenm !hive Cay, North Carotins 27511 onremitiersravenel.cam
tat 919-460-5006 far 919-535-454.5
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GENERAL LOCATION MAP
SPRUCE PINE COMMUNITY HOSPITA;
125 HOSPITAL DRIVE
SPRUCE PINE, NORTH CAROLINA
USGS SPRUCE PINE, NC
7.5 min Quadrangle
i
DRAIhN BY:
SKP
SCAT F
1 "=2000'
APPROVED BY:
` CCB
DATE:
02/23/05
FIGURE NO.
1
JOB NO:
` 099715.01

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rich Car.lna .f [nvkcnnnt Natura Resources
DMMosaor .f Water Q udity
Michael F. Easley, Governor William G. Ross, Jr., Secretary
Alan W. Klimek, P.E., Director
CER T. IVIED MA- 1
RE l URN RECEIPT
EqQ ESJLIHD
Keith Holtsclaw
Spruce Pine Community Hospital
P.O. Box 9
Spruce P1ne, I\ C 28777
Dear Permittee:
ACrol---Jj• ri
`y=
June 5, 2006
Subject: Notice of Violation
�I'ailure to Submit Permit Renewal Application
Certificate of Coverage NCG510002
Spruce Pine Community Hospital
Mitchell County
NPDES General Permit NCG510000, under which the subject facility is covered, expires on
September 30, 2006. North Carolina Administrative Code (15A NCAC 2H.0105(e)) requires that an
application for permit renewal be filed at least 180 days prior to expiration of the current permit. To satisfy
this requirement, your renewal package should have been sent to the Division postmarked no later than
April 39 2006.
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The Division has not received a renewal request for the subject CoC. This is a violation of your
permit at Part II. B. 10, which states "Any permittee that 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.".
To prevent an assessment of civil penalties you must submit a completed permit application (see
enclosed forms) no later than June 19, 2006. If the system is inactive due to lack of trust fund payments,
but the remedlation equipment is still on site, the CoC should be renewed.
If all rem ediation discharge from this facility has ceased and you wish to rescind this CoC [or if you
have any other questions], contact Charles Weaver of my staff. Mr. Weaver's telephone number, fax number
and e-mail address are listed at the bottom of this page.
•
cc: Central Files
Asheville Regional Office / Surface Water Protection
NPDES File
Sincerely,
\ n
cPiA(MY1
l _ y1�1,
Alan"W. Klimek, P.E
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 919 733-5083, extension 511 (fax) 919 733-0719
VISIT US ON THE INTERNET @ http://h2o enr,state.nc,us/NPDES e-mail: [e-mail]

41;+IIo)
COMPETE S SECTION
Complete items 12 2, and S. Also complete
item 4 if Restricted Delivery is do sired°
Print your name and ac`dress on the reverse
so that we can return the card to you.
Attach this card to the back of the mailpiece,
or on the front if space permits.
:i Article Addressed to:
COMPLETE THIS SECTION ON DELIVERY
A Sign- - f
d by (Pnn e • ame)
1] Agent
Addressee
11
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D. Is delivery address different frorn item 'l
LI la
Keith Holtsclaw
Spruce Pine Community Hospital
PO Box 9
Spruce Pine, X C 28777
2. Article Number f
(transfer from service label) I76 Lt w� ?C) fl Qbq
€5
PS Form 381 F August 2001
If YES, enter delivery address below:
/O�O2-
. pate o : Delivery
�, - -�
0 Yes
No
I-d
Service, Type
Express Mail
Li Registered ICI Return Receipt for Merchandise
Insured Mail ® C.O.D.
Certified Mail
. Restricted Delivery? (En`& Fee)
Domestic Return Receipt
N-1
102595-02=MIa1540

State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
Michael F. Easley, Governor
William G. Ross Jr , Secretary
Gregory J. Thorpe, Ph.D , Acting Director
J D BARKER
SPRUCE PINE COMM HOSPITAL
111 MACKENAN DR
CARY, NC 27511
Dear Permittee:
September 26, 2001
Styli
NCDENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
Subject: Reissue - NPDES Wastewater Discharge Permit
Spruce Pine Comm Hospital
COC Number NCG510002
Mitchell County
In response to your renewal application for continued coverage under general permit NCG510000, the Division of
Water Quality (DWQ) is forwarding herewith the reissued wastewater general permit Certificate of Coverage
(COC). This COC is reissued pursuant to the requirements of North Carolina General Statute 143-215.1 and the
Memorandum of Agreement between the state of North Carolina and the U.S. Environmental Protection Agency,
dated May 9, 1994 (or as subsquently amended).
The following information is included with your permit package:
* A copy of the Certificate of Coverage for your treatment facility
* A copy of General Wastewater Discharge Permit NCG510000
* A copy of a Technical Bulletin for General Wastewater Discharge Permit NCG510000
Your coverage under this general permit is not transferable except after notice to DWQ. The Division may require
modification or revocation and reissuance of the Certificate of Coverage. This permit does not affect the legal
requirements to obtain other permits which may be required by DENR or relieve the permittee from responsibility
for compliance with any other applicable federal, state or local law rule, standard, ordinance, order, judgment, or
decree.
If you have any questions regarding this permit package please contact Bill Mills of the Central Office Stormwater
and General Permits Unit at [phone], ext. 548
Sincerely,
for Gregory J. Thorpe, Ph.D
cc: Central Files
Stormwater & General Permits Unit Files
Asheville Regional Office
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIROI\NT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PE IT NO. NCG510000
CERTIFICATE OF COVERAGE No, NCG510002
TO DISCHARGE PETROLEUM CONTAMINATED GROUNDWATER AND SIMILAR
WASTEWATERS UNDER THE
NATIONAL POLLUTANT DISC RGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards and
regulations promulgated and adopted by the North Carolina Environmental Management Commission, and the
Federal Water Pollution Control Act, as amended,
SPRUCE PINE COMM HOSPITAL
is hereby authorized to construct and operate or continue operation of a groundwater treatment system for
petroleum contaminated groundwater or similar waste streams with the discharge of treated wastewater from a
facility located at
SPRUCE PINE COMM HOSPITAL
NCSR 1121
SPRUCE PINE
MITCHELL COUNTY
to receiving waters designated as the North Toe River, a class WS IV Tr stream, in the French Broad River Basin
in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts I, II,
III, IV, V, and VI of General Permit No. NCG510000 as attached.
This certificate of coverage shall become effective October 1, 2001.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day September 28, 2001.
for Gregory J. Thorpe, Acting Director
Division of Water Quality
By Authority of the Environmental Management Commission

State of North Carolina
Department of Environment,
Health and Natural Resources
Division of Water duality
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
A. Preston Howard, Jr., P.E., Director
Keith Holtsclaw
Spruce Pine Community Hospital
P.O. Box 9
Spruce Pine, NC 28777
Y
April 25, 1997
Subject: Renewal of NPDES Permit No. NCG510002
Mitchell County
Dear Permittee:
Ai;
S 11-1 NI Fl
In accordance with your application for permit renewal, the Division is forwardingthe subject NPDES
general
permit for petroleum contaminated groundwater remediation systems. This General Permit is issued ur u p s ant to the
requirements of North Carolina General Statute 143-215.1 and the Memorandum of Agreement between North
orth
Carolina and the US Environmental Protection Agency dated December 6, 1983 and as subsequently
q y amended.
The Certificate of Coverage previously issued to your facility is now valid under the revised General Pe
rmit al Permit for
discharges associated with groundwater remediation systems (NCG510000 - issued August 22, gu1996). The new General
Permit is more comprehensive, in that it covers remediation of groundwater contaminated with heavier
eav2er fuels (such as
diesel, fuel oil, and kerosene) as well as gasoline contamination. Please note that the permit has s three effluent
limitations pages. The type of contamination at your site (gasoline only, heavy fuels only, or ga
soline and heavy
fuels) will determine the effluent limitations for your discharge.
If any parts, measurement frequencies or sampling requirements contained in this permit are unacceptable
cceptable to you, you
have the right to request an individual permit by submitting an individual permit application.
pp Please take notice
that the previously issued Certificate of Coverage is not transferable except after notice to the Division p ivision of Water
Quality. The Division of Water Quality may require modification or revocation and reissuance' of the Certificate of
Coverage.
This permit does not affect the legal requirements to obtain other permits which maybe required Division q by the Division of
Water Quality or permits required by the Division of Land Resources, the Division of Coastal Mana
gement, or any
other Federal or Local governmental permit that may be required.
If you have any questions or need additional information, please contact Charles Weaver at tele
phone number (919)
733-5083, extension 511.
4
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Respectfully,
e , t
r_`'•4• ns-tf1;
t
A. Preston Howard, Jr., P.E
cc: Central Files
Asheville Regional Office
Permits & Engineering Unit
Facility Assessment Unit

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT, HEALTH, AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG510000
CERTIFICATE OF COVERAGE NO. NCG510002
TO DISCHARGE PETROLEUM -CONTAMINATED GROUNDWATER AND
SIMILAR WASTEWATERS UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolma 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,
Spruce Pine Community Hospital
is hereby authorized to discharge treated wastewater from a groundwater remediation system
from a facility located at
Spruce Pine Community Hospital
NCSR 1121
Spruce Pine
Mitchell County
to receiving waters designated as subbasm 40306 m the French Broad River Basin
in accordance with the effluent limitations, monitoring requirements, and other conditions set forth
in Parts I, II, III and IV of General Permit No. NCG510000 as attached.
This certificate of coverage shall become effective April 25, 1997.
This certificate of coverage shall remain in effect for the duration of the General Permit.
Signed this day April 25, 1997.
/,),,,n4",
•
A. Preston Howard" Jr., P.E , Director
Division of Water Quality
By Authority of the Environmental Management Commission

1
DIVISION OF WATER QUALITY
July 8, 1996
MEMORANDUM
To: Mike Parker
Asheville Regional Office
From: Greg Nizich `? 5 L`
NPDES Permits Unit
Subject: Permit Renewal
NPDES Permit #NC0082333
Spruce Pine Communtiy Hospital
Mitchell County
As we discussed previously, the individual permit was reinstated for this facilityon Jul
29, 1994 since the groundwater remediationfacilitiesy • General Permit was not suitable for
treating contamination from No. 2 fuel oil. Since that General Permit is currentlyin the
final stages of revision and will take effect
g in August or September, it will be appropriate
to cover this discharge under that revised General Permit and rescind the individual
permit at that time. A streamline package will not be submitted for this permit.
cc: Permit File
trogreglI
y •
•
4.
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CWT_ ,.� ,
•

Page 1
From:
ate:
cr
Note for Marcia folerAcCullen
Susan Robson
Mon, Jul 28, 1997 2:02 PM
RE: NC0082333
Marcia Toler-McCullen
Sorry for this delay o 0 0 0 0 only NCGS 10002 is valid....
From: Marcia Toler:McCullen on WedJul 23, 1997 3:24 PM
Subject: NC0082333
To: Susan Robson
Spruce Pine Community Hospital has an NPDES permit under NC0082333. rll-'hen,1 have a
permit map for the same facility under a General Permit number NCG5100020
Did this facility go from an NPDES permit to a General Permit? Or does it have two permits?
Thanks for you help 9 9 ?

State of North Carolina
Department .f Hnvironment,
Health and Natural Resources
Division of Environmental Management
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
A. Preston Howard, Jr., P.J ., Director
July 299 1994
Mr. Keith Holtsclaw
Spruce Pine Community Hospital
PO ox 9
Spruce Pine, NC 28777
Dear Mr. Holtsclaw:
Subject: Permit No. NC0082333
Authorization to Construct
Spruce Pine Community Hospital
Groundwater Treatment Facility
Mitchell County
A letter of request for an Authorization to Construct was received December 23, 1993 by the
Division and final plans and specifications for the subject project have been reviewed and found to be
satisfactory. Authorization is hereby granted for the construction of a groundwater remediation system
consisting of recovery wells, an oil/water separator with 1000 gallon oil holding tank, sump tank with
pump, low profile air diffuser, particulate filters and dual carbon cannisters in series with discharge of
treated wastewater into an unnamed tributary to Beaver Creek.
This Authorization to Construct is issued in accordance with Part III, Paragraph A of NPDES
Permit No. NC0082333 issued July 29, 1994, and shall be subject to revocation unless the wastewater
treatment facilities are constructed in accordance with the conditions and limitations specified in Permit No.
NC0082333.
The sludge generated from these treatment facilities must be disposed of in accordance with G.S.
143-215.1 and in a manner approved by the North Carolina Division of Environmental Management.
In the event that the facilities fail to perform satisfactorily, including the creation of nuisance
conditions, the Permittee shall take immediate corrective action, including those as may be required by this
Division, such as the construction of additional or replacement wastewater treatment or disposal facilities.
The Asheville Regional Office, telephone number 704/251-6208, shall be notified at least forty-
eight (48) hours in advance of operation of the installed facilities so that an in -place inspection can be
made. Such notification to the regional supervisor shall be made during the normal office hours from 8:00
a.m. until 5:00 p.m. on Monday through Friday, excluding State Holidays.
Upon completion of construction and prior to operation of this permitted facility, a certification
must be received from a professional engineer certifying that the permitted facility has been installed in
accordance with the NPDES Permit, this Authorization to Construct and the approved plans and
specifications. Mail the Certification to the Permits and Engineering Unit, P.O. Box 29535, Raleigh, NC
27626-0535.
P.O. Box 29535, Raleigh, North Carolina 27626=0535 Telephone 919=73307015 FAX 919n733o2a96
An Equal Opportunity Affirmative Action Employer 50% recycledl 10% postoconsumer paper

Permit No. NC0082333
Authorization to Construct
Spruce Pine Community Hospital
July 29, 1994
Page 2
Upon classification of the facility by the Certification Commission, the Permittee shall employ plant operator P Y a
certified wastewater treatment
pe ator to be in responsible charge (ORC) of the wastewater treatment
facilities. The operator must hold a certificate of the type and grade at leastequivalent to or greater than the
classification assigned to the wastewater treatment facilities by the Certification Commission. The
Permittee must also employ a certified back-up operator of the appropriate type andgrade to comply with
the conditions of Title � p �t e 15A, Chapter 8A, .0202. The ORC of the facility must visit each Class I facilityat
least weeklyand each Class II III and IV facility
� 9 at least daily, excluding weekends and holidays, and
must properly manage and document daily operation and maintenance of the facility and must comply with
all other conditions of Title 15A, Chapter8 P y
8A, .0202.
A copy of the approved plans and specifications shall be maintained on file by the Permittee for the
life of the facility.
Failure to abide by the requirements contained in this Authorization to Construct may subject •ect the
Permittee to an enforcement action by the Division of Environmental Management in accordance with
North Carolina General Statute 143=215.6A to 1430215.6C.
The issuance of this Authorization to Construct does not preclude the Permittee from complying
with any and all statutes, rules, regulations, or ordinances which may be by imposed other government
agencies (local, state, and federal) which have jurisdiction.
P
One (1) set of approved plans and specifications is being forwarded to you. If you have any
Y
questions or need additional information, please contact Mr. Charles Alvarez, telephone number 919/733-
5083.
Sincerely,
f-A. Preston ard, Jr., P.E
Division of Environmental Management
cc: Mitchell County Health Department
Asheville Regional Office, Water Quality
Training and Certification Unit

State of North Carolina
Department of Environment,
Health and Natural Resources
Division of Environmental Management
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
A. Preston Howard, Jr., P.E., Director
Mr. Keith Holtsclaw
P.O. Box 9
Spruce Pine, NC 28777
Dear Mr. Holtsclaw:
AI A
wki rrtah.
taws _a
Co 1-1 NI Fl
July 29, 1994
Subject: Permit No. NC0082333
Spruce Pine Community Hospital
Mitchell County
In accordance with your application for discharge permit received on December 28, 1993
1993, we are forwarding herewith the subject state - NPDES 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 US Environmental Protection
agency dated December 6, 1983.
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, Post Office Drawer 27447, Raleigh, North
Carolina 27611 -7447. Unless such demand is made, this decision shall be final and binding.
Please take notice this permit is not transferable. Part II, E 4 addresses the requirements
to be followed in case of change in ownership or control of this discharge.
This permit does not affect the legal requirements to obtain other permits which may be
required by the Division of Environmental Management or permits required by the Division of
Land Resources, 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 Mr. Charlez Alvarez at
telephone number 919/733-5083.
Sincerely,
Original Signed y
David A. Goodrich
A. Preston Howard, Jr.
cc: Mr. Jim Patrick, EPA
Asheville Regional Office
P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper

Permit No. NC0082333
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT, HEALTH, AND NATURAL RESOURCES
DIVISION OF ENVIRONMENTAL MANAGEMENT
PERMIT
TO DISCHARGE WASTEWATER UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1,
other lawful standards and regulations promulgated and adopted by the North Carolina Environmental
Management Commission, and the Federal Water Pollution Control Act, as amended,
Spruce Pine Community Hospital
is hereby authorized to discharge wastewater from a facility located at
Spruce Pine Community Hospital
Hospital Drive
Spruce Pine
Mitchell County
•
to receiving waters designated as an unnamed tributary to Beaver Creek in the French Broad River
Basin
in accordance with effluent limitations, monitoring requirements, and other conditions set forth in
Parts I, II, and III hereof.
This permit shall become effective July 29, 1994
•
This permit and the authorization to discharge shall expire at midnight on December 31, 1996
Signed this day July 29, 1994
Ori ina, Signed y
avid d Goodrich
•
A. Preston Howard, Jr., P.E., Director
Division of Environmental Management
By Authority of the Environmental Management Commission

Permit No. NC0082333
SUPPLEMENT TO PERMIT COVER SHEET
Spruce Pine Community Hospital
is hereby authorized to:
1. Enter into a contract for construction of a wastewater treatment facility, and
2. Make an outlet into an unnamed tributary to Beaver Creek, and
3. After receiving an Authorization to Construct from the Division of Environmental
Management, construct and operate a 0.072 MGD wastewater treatment facility located at
Spruce Pine Community Hospital, Hospital Drive, Spruce Pine, Mitchell County (See
Part III of this Permit), and
4. Discharge from said treatment works at the location specified on the attached map into an
unnamed tnbutary to Beaver Creek which is classified class C-Trout waters in the French
Broad River Basin.

Permit No. NC0082333
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Part III Permit No. NC0082333
E Toxicity Reopener Condition
This permit shall be modified, or revoked and reissued to incorporate toxicity limitations and
monitoring requirements in the event toxicity testing or other studies conducted on the effluent or
receiving stream indicate that detrimental effects may be expected in the receiving stream as a result
of this discharge.