NC0088528_Permit (Issuance)_20090312

NPDES DOCUMENT SCANNING COVER :MEET
NC0088528
Hillcrest Subdivision, Well #3
NPDES Permit:
Document Type:
Permit Issuance
Wasteload Allocation
Authorization to Construct (AtC)
Permit Modification
Complete File - Historical
Engineering Alternatives (EAA)
Correspondence
Instream Assessment (67b)
Speculative Limits
Environmental Assessment (EA)
Permit
History
Document Date:
March 12, 2009
This document is printed on reuiae paper - ignore any
content on the rezrerse side

AVA
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
March 12, 2009
Thomas Roberts, President
Aqua North Carolina, Inc.
202 Mackenan Court
Cary, North Carolina 27511
Subject: Issuance of NPDES
Permit NC0088528
Hillcrest Subdivision Well #3 WTP
Surry County
Dear Mr. Roberts:
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).
Please be advised that Permit Condition A. (2.) requires compliance within thirty (30) days after issuance of this
final permit.
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 150E 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 Guerra at telephone number [phone].
Sincerely
Coleen H. Sullins
Enclosure: NPDES Permit C0088528
cc: Winston-Salem Regional Office / Surface Water Protection
NPDES Unit
Central Files
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Location: 512 N. Salisbury St. Raleigh, North Carolina 27604
Phone: [phone] FAX: [phone] \ Customer Service: 1-877-623-6748
Internet: www.ncwaterquality.org
An Equal Opportunity l Affirmative Action Employer
NorthCarolina
Naturally

Permit NC0088528
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
PERMIT
TO DISCHARGE WASTEWATER UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful
standards and regulations promulgated and adopted by the North Carolina Environmental
Management Commission, and the Federal Water Pollution Control Act, as amended,
Aqua North Carolina, Inc.
is hereby authorized to discharge wastewater from a facility located at the
Hillcrest Subdivision Well #3
Lynnewood Drive
Mt. Airy
Surry County
to receiving waters designated as an unnamed tributary to the Champ Creek in the
Yadkin -Pee Dee River,
in accordance with effluent limitations, monitoring requirements, and other
conditions set forth in Parts I, II, III and IV hereof.
This permit shall become effective April 1, 2009.
This permit and authorization to discharge shall expire at midnight on February 28,
2014.
Signed this day March 12, 2009.
j
Coleen H. Sullins, Director
Division of Water Quality
ty
By Authority of the Environmental Management Commission

Permit NC0088528
SUPPLEMENT TO PERMIT COVER SHEET
All previous NPDES Permits issued to this facility, whether for operation or discharge are
hereby revoked. As of this permit issuance, any previously issued permit bearing this
number is no longer effective. Therefore, the exclusive authority to operate and discharge
from this facility arises under the permit conditions, requirements, terms, and provisions
included herein.
Aqua North Carolina, Inc. is hereby authorized to:
1. Continue to operate an existing 0.002 MGD greensand water treatment
system with a discharge of filter backwash utilizing the following
components/ processes:
a. Three (3) Greensand filters operated in parallel,
b. Chemical usage consisting of:
o Potassium permanganate
o Caustic soda and
o Chlorine
2. The facility is at the Hillcrest Subdivision — Well #3 located on Lynnewood
Drive, Mt. Airy, in Surry County.
3. Discharge from said treatment works at the location specified on the attached
map into an unnamed tributary to Champ Creek, classified as C waters in the
Yadkin -Pee Dee River Basin.

Aqua North Carolina, Inc.
Hillcrest Subdivision Well # 3 WTP
Latitude:
Longitude:
Receiving Stream:
Drainage Basin:
36° 31' 49" N
80° 34' 16" W
UT to Champ Creek
Yadkin -Pee Dee River Basin
State Grid: Mt. Airy N
Permitted Flow: 0.002 MGD
Stream Class: C
Sub -Basin: 03-07-03
NPDES Permit No. NC0088528
Surry County

Permit NC0088528
A. (1.) EFFLUENT LIMITATIONS AND MONITORING REQUIREMENTS
During the period beginning on the effective date of this permit and lasting until expiration, the Permittee is
authorized to discharge filter backwash from outfall 001. Such discharges shall be limited and monitored by the
Permittee as specified below:
} ��,+r . .
EF.SFLU N _ �4
CHARACTERIS; ICS;
I
`{( �. 1 K',,.. W +'' { 1.•
� :- LIMx : 'r �'uM
r wF "'x. 7,P+ .-.4'.!: - ilf••-
ONIT01N9 IIE! �
: �` .. "-" '�. � .
x r� l3jPj
. ... ; 7 . -';.&!,
Monthly :',
_.Average
•: Dai axe .`�y`� ,7,
_ , ; 24 t
r asuremert
-Frequency '
Y ampi =
t.
-,4' Tyype 5 .
; - a le
L • canon
Flow'
0.002 MGD
Monthly
Instantaneous
Effluent
Total Suspended
Solids
30.0 mg/L
45.0 mg/L
2/Month
Grab
Effluent
Total Res id4ual
Chlorine
17 ug/L
2/Month
Grab
Effluent
Fluorides
Monthly
Grab
Effluent
Total Iron
•
Monthly
Grab
Effluent
Total Zincs
Monthly
Grab
Effluent
Total Manganese
Monthly
Grab
Effluent
pH
6.0 — 9.0 s.u.
2/Month
Grab
Effluent
Footnotes:
1. For instantaneous flow monitoring, the duration of the discharge must be reported in addition to the
total flow.
2. Limit takes effect May 1.2009. Until then, the permittee shall monitor TRC (with no effluent limit).
3. The TRC monitoring requirement applies only if the facility backwashes with chlorinated water (and
discharges filter backwash).
4. The Division shall consider all effluent TRC values reported below 50 ugll 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 ug/I.
5. Fluoride should be monitored if the facility backwashes with fluoridated finished water.
6. Zinc shall be monitored if the facility uses any zinc -based additive in the water treatment process
All samples collected should be from a representative discharge event.
There shall be no discharge of floating solids or visible foam in other than trace amounts.

Permit NC0088528
A. (2.) PROCESS SCHEMATIC FLOW DIAGRAM
The Permittee shall submit a Process schematic flow diagram within 30 days from issuance
of permit. This submittal shall include:
• Components utilized in treatment process and
• Size of process components in treatment process

NORTH CAROLINA
SURRY COUNTY
AFFIDAVIT OF PUBLICATION
Before the undersigned, a Notary Public of said County and State, duly
commissioned, qualified and authorized by law to administer oaths,
personally appeared Ferris W. Simpson who being first duly
sworn, deposes and says: that he (she) is Business Manager
(Publisher or other officer or employee authorized to make affidavit) of
HEARTLAND PUBLICATIONS, LLC, engaged in the publication of a
newspaper known as MOUNT AIRY NEWS, published, issued, and
entered as periodicals class mail in the city of Mount Airy in said County
and State; that he (she) is authorized to make this affidavit and sworn
statement; that the notice or other legal advertisement, a true copy of
which is attached hereto, was published in MOUNT AIRY NEWS on the
following dates:
-��nuUly 1(p aooi
and that the said newspaper in which such notice, paper, document or
legal advertisement was published was, at the time of each and every
such publication, a newspaper meeting all of the requirements and
qualifications of Section 1-597 of the General Statutes of North Carolina
and was a qualified newspaper within the meaning of Section 1-597 of
the General Statutes of North Carolina.
This
day of re 1 r / r l , 2009
Signature of person making affidavit
Sworn to and subscribed before me, this /Q -- 6 day of
, 2009
rebt(Aar/
Notary Public
My Commission expires: November 27, 2012
Notary Public
Surry County, North Carolina
Sandra F. Boles
My Commission Expires__
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Aqua North Carolina, Inc.
(Town Lane, Mt. Airy,
North Carolina) has ap-
plied for renewal of
NPDES Permit
NC0088536 for the Ban-
nertown Hills Subdivision
- Well #2 in Surry
County. This permitted
facility discharges 1600
gallons per day of green-
-. sand filter backwash wa-
ter to an unnamed tribu-
tary to Faulker Creek
within the Yadkin -Pee
Dee River Basin. Total
Suspended Solids (TSS)
and total residual chlo-
rine are currently water
quality limited. This dis-
charge may affect future
allocations in this portion
of the Faulkner Creek.
Aqua North Carolina, Inc.
(Lois Lane, Mt. Airy,
North Carolina) has ap-
plied for renewal of
NPDES Permit
NC0088625 for the Hol-
lows Sub.division - Well
#1 in Surry County. This
permitted facility dis-
charges 2000 gallons per
day of greensand filter
backwash water to an
unnamed tributary to
Stewarts Creek within
the Yadkin -Pee Dee
River Basin. Total Sus-
pended Solids (TSS) and
total residual chlorine are
currently water quality
limited. This discharge
may affect future alloca-
tions in this portion of the
Stewarts Creek.
Aqua North Carolina, Inc.
(4163 Sinclair Street,
Denver, NC, 28037) has
applied for renewal of
NPDES. permit
NC0088552 for the Colo-
nial Woods Subdivision
Well #2 in Surry County.
This permitted facility will
discharge treated filter
backwash to UT to Bull
Creek in the Yadkin -Pee
Dee River Basin. Cur-
rently total suspended
solids and total residual
chlorine are water quality
limited. This discharge
may affect future alloca-
tions in this portion of the
Yadkin -Pee Dee River
Basin.
Aqua North Carolina, Inc.
(4163 Sinclair Street,
Denver, NC, 28037) has
applied for renewal of
NPDES permit
NC0088528 for the Hill -
crest Subdivision Well #3
in Surry County. This
permitted facility will dis-
charge treated filter
backwash to- UT' - to
Champ Creek in the
Yadkin -Pee Dee River
Basin. Currently
total
suspended solids and to-
tal residual chlorine are
water quality limited.
This discharge may af-
fect future allocations
in
this portion of the'
Yad-
kin -Pee Dee River Basin.
Aqua NC, Inc. (4163 Sin-
clair Street, Denver,
NC,
28037) has applied for
renewal of NPDES per-
mit NC0088617 for the
Snow Hill Subdivision
Well #1 in Surry County.
This permitted facility
discharges 0.0026 MGD
of treated wastewater to
an unnamed
tributary to Cody Creek
in the Yadkin -Pee Dee
River Basin. Currently .
total residual chlorine is
water quality limited.
This discharge may af-
fect future allocations in
this portion of the Yad-
kin -Pee Dee River Basin.
Central Care, Inc. [139
Apex Lane, Mount Airy,
NC, 270301 has applied
for renewal of permit
NC0038822 for its
WWTP in Surry County.
This permitted facility
discharges treated do-
mestic wastewater to an
unnamed tributary to
Stewarts Creek in the
Yadkin -Pee Dee River
Basin. Currently ammo-
nia nitrogen, fecal coil -
form and total residual
chlorine are water quality
limited. This discharge
may affect future alloca-
tions in this portion of
Stewarts Creek
Aqua North Carolina, Inc.
has applied for renewal
of NPDES permit, num-
ber NC0088633, for the
Reeves Woods Subdivi-
sion Well #2 WTP near
Mount Airy ' in Surry
ccha ges filterf backwdis-
ash
water into an unnamed
tributary in the Yadkin
River Basin. The new
permit sets TSS, Total
Residual Chlorine, and
pH as water quality lim-
ited parameters. This
discharge may effect fu-
ture allocations in this
portion of the Yadkin
River Basin.
Publish: January 16,
2nnn

Beverly Eaves Perdue, Governor
Dee Freeman, Secretary
North Carolina Department of Environment and Natural Resources
Coleen H. Sullins, Director
Division of Water Quality
January 14, 2009
Thomas Roberts, President
Aqua North Carolina, Inc.
202 Mackenan Court
Cary, NC 27511
Subject: Draft NPDES Permit NC0088528
Hillcrest Subdivision Well # 3 WTP
Surry County
Dear Mr. Roberts,
Enclosed with this letter is a copy of the draft permit for your facility. Please review the draft very carefully to
ensure thorough understanding of the conditions and requirements it contains.
This draft permit has the following significant change from your existing permit. Please see the attached
document "Permitting Strategy for Potable Water Treatment Plants, September 2007' for more
information. •
> Permit additions
o Total Residual Chlorine (TRC) footnote added
o Zinc footnote added
o Fluoride footnote added
> Permit condition added
o A. (2.) Submittal of process flow schematic
Concurrent with this transmittal, the Division will solicit public comment on this draft as required by the EPA by
publishing a notice in newspapers having circulation in the general Surry County area. Should you wish to
correct errors or provide comments regarding this draft please contact the DENR / DWQ / NPDES Program no
later than 30 days after receiving this document.
Please review this draft carefully to ensure thorough understanding of the information, conditions, and
requirements contained therein. Following the 30-day public comment period, the Division will review all
pertinent comments and take appropriate action prior to issuing a final NPDES permit. If you have questions
concerning the draft permit for your facility, please contact me by e-mail ([e-mail]) or call me at
[phone].
Respectfully,
Robert L. Guerra
NPDES Unit, Westem Program
Enclosure: NPDES Permit NC0088528 (DRAFT)
Water Treatment Strategies Policy Document
cc: Winston Salem Regional Office / Surface Water Protection
NPDES Unit
N Carolina
Naaturally
North Carolina Division of Water Quality 1617 Mail Service Center Raleigh, NC 27699-1617 Phone [phone] Customer Service
Internet: www.ncwaterquality.org Location: 512 N. Salisbury St. Raleigh, NC 27604 Fax [phone]
An Equal Opportunity/Affirmative Action Employer — 50% Recyc€ed/10% Post Consumer Paper

Permit NC0088528
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
PERMIT
TO DISCHARGE WASTEWATER UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful
standards and regulations promulgated and adopted by the North Carolina Environmental
Management Commission, and the Federal Water Pollution Control Act, as amended,
Aqua North Carolina, Inc.
is hereby authorized to discharge wastewater from a facility lo ted at the
Hillcrest Subdivision Well
Lynnewood Drive
Mt. Airy
Surry County
to receiving waters designated as an unnamed tributary to the Champ Creek in the
Yadkin -Pee Dee River,
in accordance with effluent limitations, monitoring requirements, and other
conditions set forth in Parts I, II, III and IV hereof.
This permit shall become effective xxxx, 2009.
This permit and authorization to discharge shall expire at midnight on xxxx, 2014.
Signed this day xxxx, 2009.
DRAFT
Coleen H. Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission

Permit NC0088528
SUPPLEMENT TO PERMIT COVER SHEET
All previous NPDES Permits issued to this facility, whether for operation or discharge are
hereby revoked. As of this permit issuance, any previously issued permit bearing this
number is no longer effective. Therefore, the exclusive authority to operate and discharge
from this facility arises under the permit conditions, requirements, terms, and provisions
included herein.
Aqua North Carolina, Inc. is hereby authorized to:
1. Continue to operate an existing 0.002 MGD greensand water treatment
system with a discharge of filter backwash utilizing the following
components/processes:
a. Three (3) Greensand filters operated in parallel,
b. Chemical usage consisting of:
o Potassium permanganate
o Caustic soda and
o Chlorine
2. The facility is at the Hillcrest, Subdivision — Well #3 located on Lynnewood
Drive, Mt. Airy, in Slurry County.
3. Discharge from said treatment works at the Iodation specified on the attached
map into an unnamed tributary to Champ Creek, classified as C waters in the
Yadkin -Pee Dee River Basin.
I

Aqua North Carolina, Inc.
Hillcrest Subdivision Well # 3 WTP)
Latitude: 36° 31' 49" N State Grid: Mt. Airy ‘.
Longitude: 80° 34' 16" W Permitted Flow: 0.002 MGD
Receiving Stream: UT to Champ Creek Stream Class: C
Drainage Basin: Yadkin -Pee Dee River Basin Sub -Basin: 03-07-03
Facility
Location
not to scale
44411F
North
NPDES Permit No. NC0088528
Surry County

Permit NC0088528
A. (2.) EFFLUENT LIMITATIONS AND MONITORING REQUIREMENTS
During the period beginning on the effective date of this permit and lasting until expiration, the Permittee is
authorized to discharge filter backwash from outfall 001. Such discharges shall be limited and monitored by the
Permittee as specified below:
EFFLUENT ,- ` ;, `
CHARACTERISTICS
''E,. o - ;
.
° LIMITS . Y "•_.>
.r
MONITORING REQUIREMENTS .
`' ' _ s :. > : ,w
Monthly
Average
' Daily Maximum`°
' ,Y ,, -
•
Measurement
Frequency.
Sample, x
,"-.-firph
'• Sample, f.
Li cationi
Flow'
0.002 MGD
Monthly
Instantaneous
Effluent
Total Suspended
Solids
30.0 mg/L
45.0 mg/L
2/Month
Grab
Effluent
Total Residual
Chlorine
17 ug/L
2/Month
Grab
Effluent
Fluorides
Monthly
Grab
Effluent
Total Iron
Monthly
Grab
Effluent
Total Zinc'
Monthly
Grab
Effluent
Total Manganese
Monthly
Grab
Effluent
pH
6.0 — 9.0 s.u.
2/Month
Grab
Effluent
Footnotes:
1. For instantaneous flow monitoring, the duration of the discharge must be reported in addition to the
total flow.
2. Limit takes effect May 1.2009. Until then, the permittee shall monitor TRC (with no effluent limit).
3. The TRC monitoring requirement applies only if the facility backwashes with chlorinated water (and
dischar es_filter_backwash .
9 �.
4. The Division shall consider all effluent TRC values reported below 50 ug/I to be in compliance with the
permit. However; -the Permittee shall continue to record and submit all values reported by 6 North
Carolina certified laboratory (including field certified), even if these values fall below 50 ugjl.
5. Fluoride should be monitored; if the facility; backwashes with fluoridated finished water.
6. Zinc shall be monitored if the facility uses any zinc -based additive in the water treatment process
All samples collected should be from a representative. discharge event.
There shall b7 rio discharge of floating solids or visible foam in other than trace
-- i
amounts.
A. (2.) PROCESS SCHEMATIC FLOW DIAGRAM
The Permittee shall submit a Process schematic flow diagram within 30 days from issuance
of permit. This submittal shall include:
• Components utilized in treatment process and
• Size of process components in treatment process

AQUA.
Aqua North Carolina, Inc.
202 MacKenan Court
Cary, NC 27511
July 30, 2008
Ms. Dina Sprinkle
NC DENR/DWQ/Point Source Branch
1617 Mail Service Center
Raleigh, NC 27699-1677
SUBJECT: NPDES Renewal Application
Hillcrest. Subdivision, Well #3
NPDES Permit No. NC0088528
Surry County, NC
Dear Ms. Sprinkle:
Thomas J. Roberts
President and Chief
Operating Officer
T: 919.467.8712 ext. 30
F: 919.460.1788
[e-mail]
www.aquanorthcarolina.com
Transmitted herewith are the completed/signed original and two copies of the subject NPDES
permit application and two copies of this cover letter. Since this facility does not generate any
sludge, no sludge management plan is necessary. There have been no modifications since the
last permit was issued.
It is my understanding that no filing fee is required for this renewal.
If you have any questions regarding this application, please do not hesitate to contact me.
Sinc
. Thomas J. Roberts
President and COO
TJR/rt
Enclosure
An Aqua America Company

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
,NC0088528
If you are completing this form in computer use the TAB key or the up - down arrows to move from one
field to the next. To check the boxes, click your mouse on top of the box. Otherwise, please print or type.
1. Contact Information:
Owner Name Aqua North Carolina, Inc
Facility Name Hillcrest Subdivision --Well #3
MailingAddress 202 Mackenan
City Cary
State / Zip Code NC/27511
Telephone Number [phone]
Fax Number [phone]
e-mail Address [e-mail]
2. Location of facility producing discharge:
Check here if same as above ❑
Street Address or State Road
City
State / Zip Code
County
Lynnwood Drive
Mt. Airy
NC/27030
Surry
3. Operator Information:
Name of the firm, consultant or other entity that operates the facility. (Note that this is not referring to the
Operator in Responsible Charge or ORC)
Name Aqua North Carolina, Inc
Mailing Address 4163 Sinclair Street
City Denver
State / Zip Code NC/28037
Telephone Number [phone]
Fax Number [phone]
4. Ownership Status:

NPDES PERMIT APPLICATION - SHORT FORM C - WTP
For discharges associated with water treatment plants
Federal ❑ State ❑ Private ® Public 0
5. Type of treatment plant: •
❑ 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)
Groundwater well
7. Describe the treatment process(es) for the raw water:
Green sand filtration using potassium permanganate. Chlorine added for disinfection and
caustic soda added for pH adjustment.
8. Describe the wastewater and the treatment process(es) for wastewater generated by the
facility:
Wastewater discharge is the backwash of the green sand filters. Discharge rate is
approximately 1680 gallons, once every three(3) days.
9. Number of separate discharge points: 1
Outfall Identification number(s) 001
10. Frequency of discharge:
Continuous ❑ Intermittent Eg
If intermittent:
Days per week discharge occurs: 2-3 Duration: Approx. 20 minutes
11. Plant design potable flowrate 0.046 (Max. well yield) MGD
Backwash or reject flow 0.00168 MGD
12. Name of receiving streams) Provide a map showing the exact location of each outfall, including
latitude and longitude):
Unnamed tributary to Champ Creek (Yakdin River Basin)

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.
Potassium permanganate
Chlorine
Caustic soda
14. Is this facility located on Indian country? (check one)
Yes ❑ No El
15. Additional Information:
➢ Provide a schematic of flow through the facility, include flow volumes at all points in
the treatment process, and point of addition of chemicals.
➢ Solids Handy 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.
Thomas Roberts
President
Signature of Applicant bate
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

FACT SHEET FOR EXPEDITED PERMIT RENEWALS
Basic Information to determine potential for expedited permit renewal
Reviewer/Date
S .6',
Permit Number
, , /l/'J O tiS S, 2-2 ..
Facility Name
k ; I c,Vu i— S t Lt).a! ,' ,/ ; ,` )iti — w e,, E
Basin Name/Sub-basin number
Yam.) k-if 'V / 0 3— 01-- o
Receiving Stream
' 14`j -} ('i rd^60 (', k
Stream Classification in Permit
U
Does permit need NH3 limits?
mt2
Does permit need TRC limits?
A1A7
Does permit have toxicity testing?
NO
Does permit have Special Conditions?
/ }
Does permit have instream monitoring?
N)
Is the stream impaired (on 303(d) list)?
A/ J
Any obvious compliance concerns?
i1i0
Any permit mods since last permit?
qO / '/ 2 s • 51-
Existing expiration date
0 2' 2 ? 0 9
New expiration date
0 2 - 'a - 4 9
New permit effective date
i
Miscellaneous Comments
YES
This is a SIMPLE EXPEDITED permit renewal (administrative
renewal with no changes, or only minor changes such as TRC, NH3,
name/ownership changes). Include conventional WTPs in this group.
YES_ This is a MORE COMPLEX EXPEDITED permit renewal (includes
Special Conditions (such as EAA, Wastewater Management Plan), 303(d)
listed, toxicity testing, instream monitoring, compliance concerns, phased
limits). Basin Coordinator to make case -by -case decision.
YESThis permit CANNOT BE EXPEDITED for one of the following reasons:
• Major Facility (municipal/industrial)
• Minor Municipals with pretreatment program
• Minor Industrials subject to Fed Effluent Guidelines (lb/day limits for BOD, TSS,
etc)
• Limits based on reasonable potential analysis (metals, GW remediation organics)
• Permitted flow > 0.5 MGD (requires full Fact Sheet)
• Permits determined by Basin Coordinator to be outside expedited process
TB Version 8/18/2006 (NPDES Server/Current Versions/Expedited Fact Sheet)