NC0068918_Renewal (Application)_20220304

ROY COOPER
Governor 6 i h
ELIZABETH S.BISER ��^
Secretary
S.DANIEL SMITH NORTH CAROLINA
Director Environmental Quality
March 04, 2022
Cedar Hill Property Owners Association, Inc.
Attn: Debby Nussel, CMCA
PO Box 580
Arden, NC 28704
Subject: Permit Renewal
Application No. NC0068918
Cedar Hill WWTP
Jackson County
Dear Applicant:
The Water Quality Permitting Section acknowledges the March 4, 2022 receipt of your permit renewal application and
supporting documentation. Your application will be assigned to a permit writer within the Section's NPDES WW permitting
branch. Per G.S. 150B-3 your current permit does not expire until permit decision on the application is made.
Continuation of the current permit is contingent on timely and sufficient application for renewal of the current permit. The
permit writer will contact you if additional information is required to complete your permit renewal. Please respond in a
timely manner to requests for additional information necessary to allow a complete review of the application and renewal
of the permit.
Information regarding the status of your renewal application can be found online using the Department of Environmental
Quality's Environmental Application Tracker at:
https://deq.nc.gov/permits-regulations/permit-guidance/environmental-application-tracker
If you have any additional questions about the permit, please contact the primary reviewer of the application using the
links available within the Application Tracker.
Sincerely ,vid
Wren Thedford
Administrative Assistant
Water Quality Permitting Section
ec: WQPS Laserfiche File w/application
DE Q North Carolina Department of Environmental Quality I Division of Water Resources
Asheville Regional Office!2090 U.S.Highway 70 Swannanoa.North Carolina 28778
828 296 4500

CEDAR HILL PROPERTY OWNERS ASSOCIATION, INC.
Prafeseionallv Managed By:1PM Corp. - P.O.Box 590 - 2602 Hendersonville Road - Arden,NC 28704
RECEIVED
MAR 0.4 2022
March 1, 2022
NCDEQIDWRINPDES
NCDEQ-Division of Water Quality/NPDES Unit
1617 Mail Service Center
Raleigh, NC 27699-161'7
Re: Cedar Hill WWTP/NC0068918
To Whom It May Concern:
On behalf of Cedar Hill Wastewater Treatment Facility, this letter is to request renewal of
the peiinit NC0068918 for Cedar Hill POA. There have been no changes affecting this
facility.
Thank you,
Debby Nussel, CMCA
Community Association Manager
.L, Uuic ti.v I u-i A TE HERS-NC 28717 F. 828.743 3970 0.828-743.3889
§"' p 1j Fme. 0,90 2602 HENDERSONVILLE RD. ARDEN. NC 28704 INFO;k%IPMHOA.00h1 0.828-650-6875

United States Office of Water EPA Form 3510-1
Environmental Protection Agency Washington, D.C. Revised March 2019
Water Permits Division
Ark
iEPA Application Form 1
General Information
NPDES Permitting Program
Note: All applicants to the National Pollutant Discharge Elimination System (NPDES)permits
program,with the exception of publicly owned treatment works and other treatment works treating
domestic sewage, must complete Form 1.Additionally, all applicants must complete one or more of the
following forms: 2B,2C,2D, 2E, or 2F. To determine the specific forms you must complete, consult the
"General Instructions"for this form.

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
NC0068918 Cedar Hill WWTP OMB No.2040-0004
Form U.S.Environmental Protection Agency
1 IaFEPA Application for NPDES Permit to Discharge Wastewater
NPDES GENERAL INFORMATION
SECTION 1.ACTIVITIES REQUIRING AN NPDES PERMIT(40 CFR 122.21(f)and(f)(1))
1.1 Applicants Not Required to Submit Form 1
Is the facility a new or existing publicly owned Is the facility a new or existing treatment works
1.1.1 12
treatment works? 1. . treating domestic sewage?
If yes, STOP. Do NOT complete D No If yes,STOP. Do NOT 0✓ No
Form 1.Complete Form 2A. complete Form 1.Complete
Form 2S.
1.2 Applicants Required to Submit Form 1
1.2.1 Is the facility a concentrated animal feeding 1.2.2 Is the facility an existing manufacturing,
operation or a concentrated aquatic animal commercial,mining,or silvicultural facility that is
production facility? currently discharging process wastewater?
w ❑ Yes 4 Complete Form 1 ❑✓ No ❑ Yes 4 Complete Form No
a and Form 2B. 1 and Form 2C.
1.2.3 Is the facility a new manufacturing,commercial, 1.2.4 Is the facility a new or existing manufacturing,
0) mining,or silvicultural facility that has not yet commercial, mining,or silvicultural facility that
commenced to discharge? discharges only nonprocess wastewater?
Yes Complete Form 1 El No ❑ Yes 4 Complete Form ❑✓ No
o' and Form 2D. 1 and Form 2E.
°' 1.2.5 Is the facility a new or existing facility whose
'— discharge is composed entirely of stormwater
associated with industrial activity or whose
discharge is composed of both stormwater and
non-stormwater?
Yes 4 Complete Form 1 No
and Form 2F
unless exempted by
40 CFR
122.26(b)(14)(x)or
b 15 .
SECTION 2.NAME,MAILING ADDRESS,AND LOCATION(40 CFR 122.21(f)(2))
2.1 Facility Name
Cedar Hill WWTP
0 2.2 EPA Identification Number
0
J
2.3 Facility Contact
Name(first and last) Title Phone number
Debby Nussel Community Association Manager [phone]
0) Email address
:� [e-mail]
2.4 Facility Mailing Address
Street or P.O.box
P.O.Box 580
City or town State ZIP code
Arden NC 28704
EPA Form 3510-1(revised 3-19) Page 1

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
NC0068918 Cedar Hill WWTP OMB No.2040-0004
la Facility
2.5 Location
N N `
.w Street,route number,or other specific identifier
Q o 1820 US Highway 64
a U
o County name County code(if known)
F. Jackson
£ City or town State ZIP code
z Cashiers NC 28717
SECTION 3.SIC AND NAICS CODES(40 CFR 122.21(f)(3))
3.1 SIC Code(s) Description(optional)
to
N
O
U
U
3.2 NAICS Code(s) Description(optional)
SECTION 4.OPERATOR INFORMATION(40 CFR 122.21(f)(4))
4.1 Name of Operator
RPB Systems,Inc.
0 4.2 Is the name you listed in Item 4.1 also the owner?
❑ Yes ❑✓ No
4.3 Operator Status
❑ Public—federal ✓❑ Public—state ❑ Other public(specify)
o ❑ Private ❑ Other(specify)
4.4 Phone Number of Operator
[phone]
4.5 Operator Address
w Street or P.O. Box
E P.O.Box 1325
O 2
City or town State ZIP code
o �o Asheville NC 28802
co
Q Email address of operator
0 [e-mail]
SECTION 5.INDIAN LAND(40 CFR 122.21(f)(5))
-0 5.1 Is the facility located on Indian Land?
J ❑ Yes ❑✓ No
EPA Form 3510-1(revised 3-19) Page 2

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
NC0068918 Cedar Hill WWTP OMB No.2040-0004
SECTION 6.EXISTING ENVIRONMENTAL PERMITS(40 CFR 122.21(f)(6))
6.1 Existing Environmental Permits(check all that apply and print or type the corresponding permit number for each)
d ❑ NPDES(discharges to surface CIRCRA(hazardous wastes) ❑ UIC(underground injection of
water) fluids)
o --
2 Hosepasture River
w a ❑ PSD(air emissions) ElNonattainment program(CAA) ❑ NESHAPs(CM)
0)
w ❑ Ocean dumping(MPRSA) ❑ Dredge or fill(CWA Section 404) ❑ Other(specify)
SECTION 7.MAP(40 CFR 122.21(f)(7))
7.1 Have you attached a topographic map containing all required information to this application?(See instructions for
specific requirements.)
co
❑✓ Yes ❑ No 0 CAFO—Not Applicable(See requirements in Form 2B.)
SECTION 8.NATURE OF BUSINESS(40 CFR 122.21(f)(8))
8.1 Describe the nature of your business.
POA
U)
U,
.N
m
0
io
SECTION 9.COOLING WATER INTAKE STRUCTURES(40 CFR 122.21(f)(9))
9.1 Does your facility use cooling water?
❑ Yes ❑ No 4 SKIP to Item 10.1.
9.2 Identify the source of cooling water.(Note that facilities that use a cooling water intake structure as described at
; 40 CFR 125,Subparts I and J may have additional application requirements at 40 CFR 122.21(r).Consult with your
NPDES permitting authority to determine what specific information needs to be submitted and when.)
o Q1
O
SECTION 10.VARIANCE REQUESTS(40 CFR 122.21(f)(10))
10.1 Do you intend to request or renew one or more of the variances authorized at 40 CFR 122.21(m)?(Check all that
apply.Consult with your NPDES permitting authority to determine what information needs to be submitted and
when.)
CU
c ❑ Fundamentally different factors(CWA ❑ Water quality related effluent limitations(CWA Section
Section 301(n)) 302(b)(2))
❑ Non-conventional pollutants(CWA ❑ Thermal discharges(CWA Section 316(a))
Section 301(c)and(g))
❑ Not applicable
EPA Form 3510-1(revised 3-19) Page 3

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
NC0068918 Cedar Hill WWTP OMB No.2040-0004
SECTION 11.CHECKLIST AND CERTIFICATION STATEMENT(40 CFR 122.22(a)and(d))
11.1 In Column 1 below, mark the sections of Form 1 that you have completed and are submitting with your application.
For each section,specify in Column 2 any attachments that you are enclosing to alert the permitting authority. Note
that not all applicants are required to provide attachments.
Column 1 Column 2
❑ Section 1:Activities Requiring an NPDES Permit ❑ w/attachments
❑ Section 2: Name,Mailing Address,and Location ❑ w/attachments
❑ Section 3:SIC Codes 0 w/attachments
❑ Section 4:Operator Information 0 w/attachments
❑ Section 5:Indian Land ❑ w/attachments
_ 0 Section 6:Existing Environmental Permits 0 wl attachments
d
E ❑ w/topographic
❑ Section 7:Map map ❑ w/additional attachments
u)
o ❑ Section 8:Nature of Business 0 w/attachments
❑ Section 9:Cooling Water Intake Structures ❑ w/attachments
CU
�' ❑ Section 10:Variance Requests ❑ w/attachments
c
co ❑ Section 11:Checklist and Certification Statement ❑ w/attachments
Y
L., 11.2 Certification Statement
U
I certify under penalty of law that this document and all attachments were prepared under my direction or supervision
in accordance with a system designed to assure that qualified personnel properly gather and evaluate the
information submitted.Based on my inquiry of the person or persons who manage the system,or those persons
directly responsible for gathering the information,the information submitted is,to the best of my knowledge and
belief,true,accurate,and complete. I am aware that there are significant penalties for submitting false information,
including the possibility of fine and imprisonment for knowing violations.
Name(print or type first and last name) Official title •
1 )) b,2\7 1 -1- SSe- COMMUOrry 61t._,
Sig ature ----_ Date signed
24 i 1-? ( Z2-
EPA Form 3510-1(revised 3-19) Page 4

United States Office of Water EPA Form 3510-1
Environmental Protection Agency Washington,D.C. Revised March 2019
Water Permits Division
EPA Application Form 1
General Information
NPDES Permitting Program
Note: All applicants to the National Pollutant Discharge Elimination System (NPDES)permits
program, with the exception of publicly owned treatment works and other treatment works treating
domestic sewage,must complete Form 1. Additionally, all applicants must complete one or more of the
following forms: 2B, 2C, 2D, 2E, or 2F. To determine the specific forms you must complete, consult the
"General Instructions" for this form.
1

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
NC0068918 Cedar Hill WWTP OMB No.2040-0004
Form U.S.Environmental Protection Agency
1 — EPA Application for NPDES Permit to Discharge Wastewater
NPDES GENERAL INFORMATION
SECTION 1.ACTIVITIES REQUIRING AN NPDES PERMIT(40 CFR 122.21(f)and(f)(1))
1.1 Applicants Not Required to Submit Form 1
Is the facility a new or existing publicly owned Is the facility a new or existing treatment works
1.1.1 12
treatment works? 1. . treating domestic sewage?
If yes,STOP. Do NOT complete 0 No If yes,STOP.Do NOT 0 No
Form 1.Complete Form 2A. complete Form 1. Complete
Form 2S.
1.2 Applicants Required to Submit Form 1
1.2.1 Is the facility a concentrated animal feeding 1.2.2 Is the facility an existing manufacturing,
operation or a concentrated aquatic animal commercial,mining,or silvicultural facility that is
a. production facility? currently discharging process wastewater?
o Yes 4 Complete Form 1 0 No ❑ Yes 4 Complete Form 0 No
n. and Form 26. 1 and Form 2C.
a1.2.3 Is the facility a new manufacturing,commercial, 1.2.4 Is the facility a new or existing manufacturing,
c mining,or silvicultural facility that has not yet commercial,mining,or silvicultural facility that
commenced to discharge? discharges only nonprocess wastewater?
d0 Yes 4 Complete Form 1 0 No ❑ Yes 4 Complete Form 0 No
ce and Form 2D. 1 and Form 2E.
1.2.5 Is the facility a new or existing facility whose
'— discharge is composed entirely of stormwater
associated with industrial activity or whose
discharge is composed of both stormwater and
non-stormwater?
Yes 4 Complete Form 1 0 No
and Form 2F
unless exempted by
40 CFR
122.26(b)(14)(x)or
b 15 .
SECTION 2.NAME,MAILING ADDRESS,AND LOCATION(40 CFR 122.21(f)(2))
2.1 Facility Name
Cedar Hill WWTP
2.2 EPA Identification Number
0
O
-
-0
2.3 Facility Contact
Name(first and last) Title Phone number
1,2
v Debby Nussel Community Association Manager [phone]
Email address
[e-mail]
2.4 Facility Mailing Address
o Street or P.O.box
P.O.Box 580
City or town State ZIP code
Arden NC 28704
EPA Form 3510-1(revised 3-19) Page 1

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
NC0068918 Cedar Hill WWTP OMB No.2040-0004
d 2.5 Facility Location
wStreet,route number,or other specific identifier
Q v 1820 US Highway 64
o County name County code(if known)
Jackson
City or town State ZIP code
z Cashiers NC 28717
SECTION 3.SIC AND NAICS CODES(40 CFR 122.21(f)(3))
3.1 SIC Code(s) Description(optional)
cu
to
O
U
co
U
3.2 NAICS Code(s) Description(optional)
-o
co
U
SECTION 4.OPERATOR INFORMATION(40 CFR 122.21(f)(4))
4.1 Name of Operator
RPB Systems,Inc.
0 4.2 Is the name you listed in Item 4.1 also the owner?
❑ Yes ❑✓ No
4.3 Operator Status
c ❑ Public—federal ❑✓ Public—state ❑ Other public(specify)
o ❑ Private ❑ Other(specify)
4.4 Phone Number of Operator
[phone]
4.5 Operator Address
✓ Street or P.O. Box
Ia P.O.Box 1325
m
�
City or town State ZIP code
`o 0 Asheville NC 28802
iy
a Email address of operator
0 [e-mail]
SECTION 5.INDIAN LAND(40 CFR 122.21(f)(5))
• c 5.1 Is the facility located on Indian Land?
C —J ❑Yes ❑✓ No
EPA Form 3510-1(revised 3-19) Page 2

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
NC0068918 Cedar Hill WWTP OMB No.2040-0004
SECTION 6.EXISTING ENVIRONMENTAL PERMITS(40 CFR 122.21(f)(6))
6.1 Existing Environmental Permits(check all that apply and print or type the corresponding permit number for each)
d ❑ NPDES(discharges to surface ❑ RCRA(hazardous wastes) ❑ UIC(underground injection of
water) fluids)
o y Hosepasture River
w n ❑ PSD(air emissions) ❑ Nonattainment program(CM) ❑ NESHAPs(CM)
rn
E i
❑ Ocean dumping(MPRSA) ❑ Dredge or fill(CWA Section 404) ❑ Other(specify)
SECTION 7.MAP(40 CFR 122.21(f)(7))
7.1 Have you attached a topographic map containing all required information to this application?(See instructions for
specific requirements.)
❑✓ Yes ❑ No ❑ CAFO—Not Applicable(See requirements in Form 2B.)
SECTION 8.NATURE OF BUSINESS(40 CFR 122.21(f)(8))
8.1 Describe the nature of your business.
POA
N
N
d
C
N
w
O
SECTION 9.COOLING WATER INTAKE STRUCTURES(40 CFR 122.21(f)(9))
9.1 Does your facility use cooling water?
d ❑ Yes ❑ No 4 SKIP to Item 10.1.
9.2 Identify the source of cooling water.(Note that facilities that use a cooling water intake structure as described at
a,w 40 CFR 125,Subparts I and J may have additional application requirements at 40 CFR 122.21(r).Consult with your
o NPDES permitting authority to determine what specific information needs to be submitted and when.)
o is
U C
SECTION 10.VARIANCE REQUESTS(40 CFR 122.21(f)(10))
10.1 Do you intend to request or renew one or more of the variances authorized at 40 CFR 122.21(m)?(Check all that
apply.Consult with your NPDES permitting authority to determine what information needs to be submitted and
when.)
❑ Fundamentally different factors(CWA ❑ Water quality related effluent limitations(CWA Section
Section 301(n)) 302(b)(2))
❑ Non-conventional pollutants(CWA ❑ Thermal discharges(CWA Section 316(a))
Section 301(c)and(g))
❑ Not applicable
EPA Form 3510-1(revised 3-19) Page 3
1

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
NC0068918 Cedar Hill WWTP OMB No.2040-0004
SECTION 11.CHECKLIST AND CERTIFICATION STATEMENT(40 CFR 122.22(a)and(d))
11.1 In Column 1 below,mark the sections of Form 1 that you have completed and are submitting with your application.
For each section,specify in Column 2 any attachments that you are enclosing to alert the permitting authority. Note
that not all applicants are required to provide attachments.
Column 1 Column 2
❑ Section 1:Activities Requiring an NPDES Permit ❑ wl attachments
❑ Section 2:Name, Mailing Address,and Location ❑ wl attachments
❑ Section 3:SIC Codes ❑ w/attachments
❑ Section 4:Operator Information ❑ wl attachments
❑ Section 5: Indian Land ❑ w/attachments
❑ Section 6: Existing Environmental Permits ❑ w/attachments
w/topographic
❑ Section 7:Map ❑ map Liw/additional attachments
o ❑ Section 8:Nature of Business ❑ wl attachments
❑ Section 9:Cooling Water Intake Structures ❑ wl attachments
d
❑ Section 10:Variance Requests ❑ wl attachments
N ❑ Section 11:Checklist and Certification Statement ❑ w/attachments
a 11.2 Certification Statement
c�
I certify under penalty of law that this document and all attachments were prepared under my direction or supervision
in accordance with a system designed to assure that qualified personnel properly gather and evaluate the
information submitted.Based on my inquiry of the person or persons who manage the system,or those persons
directly responsible for gathering the information,the information submitted is,to the best of my knowledge and
belief,true,accurate,and complete. I am aware that there are significant penalties for submitting false information,
including the possibility of fine and imprisonment for knowing violations.
Name(print or type first and last name) Official title
)) 1,j2/ LIGS6. ( Commuod-y 61('
Si ature Date signed
9 9
L ( Z2--
EPA Form 3510-1(revised 3-19) Page 4

United States Office of Water EPA Form 3510-1
Environmental Protection Agency Washington,D.C. Revised March 2019
Water Permits Division
EPA Application Form 1
General Information
NPDES Permitting Program
Note: All applicants to the National Pollutant Discharge Elimination System (NPDES)permits
program,with the exception of publicly owned treatment works and other treatment works treating
domestic sewage, must complete Form 1. Additionally, all applicants must complete one or more of the
following forms: 2B, 2C, 2D, 2E, or 2F. To determine the specific forms you must complete, consult the
"General Instructions" for this form.
i J

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
NC0068918 Cedar Hill WWTP OMB No.2040-0004
Form U.S.Environmental Protection Agency
1 \= EPA Application for NPDES Permit to Discharge Wastewater
NPDES GENERAL INFORMATION
SECTION 1.ACTIVITIES REQUIRING AN NPDES PERMIT(40 CFR 122.21(f)and(f)(1))
1.1 Applicants Not Required to Submit Form 1
Is the facility a new or existing publicly owned Is the facility a new or existing treatment works
1.1.1 treatment works? 1.1.2 treating domestic sewage?
If yes,STOP. Do NOT complete �✓ No If yes,STOP. Do NOT 0✓ No
Form 1.Complete Form 2A. complete Form 1.Complete
Form 2S.
1.2 Applicants Required to Submit Form 1
1.2.1 Is the facility a concentrated animal feeding 1.2.2 Is the facility an existing manufacturing,
operation or a concentrated aquatic animal commercial,mining,or silvicultural facility that is
a production facility? currently discharging process wastewater?
Yes 4 Complete Form 1 ❑✓ No D Yes-4 Complete Form No
a and Form 2B. 1 and Form 2C.
1.2.3 Is the facility a new manufacturing,commercial, 1.2.4 Is the facility a new or existing manufacturing,
mining,or silvicultural facility that has not yet commercial, mining,or silvicultural facility that
commenced to discharge? discharges only nonprocess wastewater?
o ❑ Yes 4 Complete Form 1 No ❑ Yes 4 Complete Form �✓ No
Le and Form 2D. 1 and Form 2E.
N
°' 1.2.5 Is the facility a new or existing facility whose
discharge is composed entirely of stormwater
T."; associated with industrial activity or whose
discharge is composed of both stormwater and
non-stormwater?
❑ Yes 4 Complete Form 1 0✓ No
and Form 2F
unless exempted by
40 CFR
122.26(b)(14)(x)or
b 15 .
SECTION 2.NAME,MAILING ADDRESS,AND LOCATION(40 CFR 122.21(f)(2))
2.1 Facility Name
Cedar Hill WWTP
0 2.2 EPA Identification Number
0
O
0 2.3 Facility Contact
Name(first and last) Title Phone number
v Debby Nussel Community Association Manager [phone]
Email address
[e-mail]
a; 2.4 Facility Mailing Address
Street or P.O.box
P.O.Box 580
City or town State ZIP code
Arden NC 28704
EPA Form 3510-1 (revised 3-19) Page 1

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
NC0068918 Cedar Hill WWTP OMB No.2040-0004
N 2.5 Facility Location
-o Street,route number,or other specific identifier
Q o 1820 US Highway 64
�U
c County name County code(if known)
m Jackson
0
City or town State ZIP code
z Cashiers NC 28717
SECTION 3.SIC AND NAICS CODES(40 CFR 122.21(f)(3))
3.1 SIC Code(s) Description(optional)
0
O
U
En
3.2 NAICS Code(s) Description(optional)
13
SECTION 4.OPERATOR INFORMATION(40 CFR 122.21(f)(4))
4.1 Name of Operator
RPB Systems,Inc.
4.2 Is the name you listed in Item 4.1 also the owner?
:a
€ ❑ Yes ❑✓ No
4.3 Operator Status
❑ Public—federal ❑✓ Public—state ❑ Other public(specify)
o ❑ Private ❑ Other(specify)
4.4 Phone Number of Operator
[phone]
4.5 Operator Address
Street or P.O.Box
P.O.Box 1325
O 7
City or town State ZIP code
0 o Asheville NC 28802
m U
O. Email address of operator
0 [e-mail]
SECTION 5.INDIAN LAND(40 CFR 122.21(f)(5))
0 5.1 Is the facility located on Indian Land?
J ❑Yes ❑✓ No
EPA Form 3510-1(revised 3-19) Page 2

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
NC0068918 Cedar Hill WWTP OMB No.2040-0004
SECTION 6.EXISTING ENVIRONMENTAL PERMITS(40 CFR 122.21(f)(6))
6.1 Existing Environmental Permits(check all that apply and print or type the corresponding permit number for each)
NPDES(discharges to surface ❑ RCRA(hazardous wastes) ❑ UIC(underground injection of
a H water) fluids)
Hosepasture River
w a ElPSD(air emissions) 0 Nonattainment program(CAA) 0 NESHAPs(CM)
rn
❑ Ocean dumping(MPRSA) ❑ Dredge or fill(CWA Section 404) 0 Other(specify)
SECTION 7.MAP(40 CFR 122.21(f)(7))
7.1 Have you attached a topographic map containing all required information to this application?(See instructions for
specific requirements.)
❑✓ Yes 0 No 0 CAFO—Not Applicable(See requirements in Form 2B.)
SECTION 8.NATURE OF BUSINESS(40 CFR 122.21(f)(8))
8.1 Describe the nature of your business.
POA
tl7
N
Gl
N
co
"6
d
A
SECTION 9.COOLING WATER INTAKE STRUCTURES(40 CFR 122.21(f)(9))
9.1 Does your facility use cooling water?
❑ Yes ❑ No SKIP to Item 10.1.
9.2 Identify the source of cooling water.(Note that facilities that use a cooling water intake structure as described at
a,w 40 CFR 125,Subparts I and J may have additional application requirements at 40 CFR 122.21(r).Consult with your
'6Y NPDES permitting authority to determine what specific information needs to be submitted and when.)
o ,,
U C
SECTION 10.VARIANCE REQUESTS(40 CFR 122.21(f)(10))
10.1 Do you intend to request or renew one or more of the variances authorized at 40 CFR 122.21(m)?(Check all that
apply.Consult with your NPDES permitting authority to determine what information needs to be submitted and
when.)
d ❑ Fundamentally different factors(CWA ❑ Water quality related effluent limitations(CWA Section
e Section 301(n)) 302(b)(2))
❑ Non-conventional pollutants(CWA ❑ Thermal discharges(CWA Section 316(a))
Section 301(c)and(g))
❑ Not applicable
Pa e3
EPA Form 3510-1(revised 3-19) g

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
NC0068918 Cedar Hill WWTP OMB No.2040-0004
SECTION 11.CHECKLIST AND CERTIFICATION STATEMENT(40 CFR 122.22(a)and(d))
11.1 In Column 1 below,mark the sections of Form 1 that you have completed and are submitting with your application.
For each section,specify in Column 2 any attachments that you are enclosing to alert the permitting authority. Note
that not all applicants are required to provide attachments.
Column 1 Column 2
❑ Section 1:Activities Requiring an NPDES Permit ❑ wl attachments
❑ Section 2: Name, Mailing Address,and Location ❑ wl attachments
❑ Section 3:SIC Codes ❑ w/attachments
❑ Section 4:Operator Information ❑ w/attachments
❑ Section 5: Indian Land ❑ w/attachments
❑ Section 6: Existing Environmental Permits ❑ wl attachments
wl topographic
map
❑ Section 7:Map ❑ ❑ wl additional attachments
c
o ❑ Section 8:Nature of Business ❑ w/attachments
:c.
❑ Section 9:Cooling Water Intake Structures ❑ wl attachments
U ❑ Section 10:Variance Requests 0 wl attachments
-a
0 Section 11:Checklist and Certification Statement ❑ w/attachments
re
a 11.2 Certification Statement
U
I certify under penalty of law that this document and all attachments were prepared under my direction or supervision
in accordance with a system designed to assure that qualified personnel properly gather and evaluate the
information submitted.Based on my inquiry of the person or persons who manage the system,or those persons
directly responsible for gathering the information,the information submitted is, to the best of my knowledge and
belief,true,accurate,and complete.I am aware that there are significant penalties for submitting false information,
including the possibility of fine and imprisonment for knowing violations.
Name(print or type first and last name) Official title
))_eji2y ( f+y
AASOr-
Sigtature. Date signed
2-•/ ( ZZ—
EPA Form 3510-1(revised 3-19) Page 4

North Carolina
Department of Environmental Quality Modified Application Form 2A
Division of Water Resources Revised March 2021
Modified Application
Form 2A
Minor Sewage Facilities < 0.1 MGD
and No Pretreatment Program
NPDES Permitting Program
Note: Complete this form if your facility is a MINOR new or existing publicly owned treatment works.

NPDES Permit Number Facility Name Modified Application Form 2A
NC0068918 Cedar Hill WWTP Modified March 2021
Form NC Department of Environmental Quality-Application for NPDES Permit to Discharge Wastewater
NPDES MINOR SEWAGE FACILITIES(Before completing this form,please read the instructions.Failure to follow
the instructions may result in denial of the application.)
ANT (40 CFR 122.21(j)(1)and
SECTION 1.BASIC APPLICATION INFORMATION FOR ALL APPLICANTS (9))
1.1 Facility name
Cedar Hill WWTP
Mailing address(street or P.O.box)
P.O.Box 580
City or town State ZIP code
o Arden NC 28704
Contact name(first and last) Title Phone number Email address
Debby Nussel Community Association Mana. [phone] [e-mail]
Location address(street,route number,or other specific identifier) ❑ Same as mailing address
m 1820 US Highway 64
City or town State ZIP code
Cashiers NC 28717
1.2 Is this application for a facility that has yet to commence discharge?
❑ Yes 4 See instructions on data submission ❑✓ No
requirements for new dischargers.
1.3 Is applicant different from entity listed under Item 1.1 above?
❑ Yes ❑ No 4 SKIP to Item 1.4.
Applicant name
= Applicant address(street or P.O.box)
0
ca
0 City or town State ZIP code
0
Contact name(first and last) Title Phone number Email address
Q.
1.4 Is the applicant the facility's owner,operator,or both?(Check only one response.)
❑✓ Owner 0 Operator ❑ Both
1.5 To which entity should the NPDES permitting authority send correspondence?(Check only one response.)
El Facility ElApplicant ❑ Facility and applicant
(they are one and the same)
1.6 Indicate below any existing environmental permits.(Check all that apply and print or type the corresponding permit
.E— number for each.)
0 Existing Environmental Permits
a.
❑ (discharges ❑ (hazardouswaste) ❑ (underground 1✓ NPDES dischar es to surface RCRA UIC under round injection
water) control)
Horsepastue River
o ❑ PSD(air emissions) ❑ Nonattainment program(CAA) ❑ NESHAPs(CAA)
0 Ocean dumping(MPRSA) 0 Dredge or fill(CWA Section ❑ Other(specify)
404)
Page 1

NPDES Permit Number Facility Name Modified Application Form 2A
NC0068918 Cedar Hill WWTP Modified March 2021
1.7 Provide the collection system information requested below for the treatment works.
Municipality Population Collection System Type Ownership Status
Served Served (indicate percentage)
100 %separate sanitary sewer 0 Own 0 Maintain
a�i 154 Lots %combined storm and sanitary sewer IDOwn ❑ Maintain
d ❑ Unknown 0 Own 0 Maintain
co
%separate sanitary sewer ❑ Own 0 Maintain
m %combined storm and sanitary sewer 0 Own 0 Maintain
❑ Unknown ❑ Own 0 Maintain
a %separate sanitary sewer 0 Own 0 Maintain
a %combined storm and sanitary sewer ❑ Own ❑ Maintain
a' 0 Unknown 0 Own 0 Maintain
d %separate sanitary sewer ❑ Own ❑ Maintain
co %combined storm and sanitary sewer 0 Own 0 Maintain
❑ Unknown 0 Own ❑ Maintain
r Total
Population 154 Lots
75
of Served
Separate Sanitary Sewer System Combined Storm and
Sanitary Sewer
Total percentage of each type of %°
sewer line(in miles) °
?' 1.8 Is the treatment works located in Indian Country?
o 0 Yes ❑✓ No
c1.9 Does the facility discharge to a receiving water that flows through Indian Country?
c ❑ Yes ❑✓ No
1.10 Provide design and actual flow rates in the designated spaces: Design Flow Rate
0.025 mgd
Ti Annual Average Flow Rates(Actual)
co
a 4,1 Two Years Ago Last Year This Year
13 ce
c o 0.002022 mgd 0.002026 mgd 0.004090 mgd
Maximum Daily Flow Rates(Actual)
o Two Years Ago Last Year This Year
0.034080 mgd 0.013944 mgd 0.06500 mgd
,,, 1.11 Provide the total number of effluent discharge points to waters of the State of North Carolina by type.
o Total Number of Effluent Discharge Points by Type
n- a Constructed
> Combined Sewer
E T Treated Effluent Untreated Effluent Overflows Bypasses Emergency
..c -fl Overflows
0
u)
0 1
Page 2

NPDES Permit Number Facility Name Modified Application Form 2A
NC0068918 Cedar Hill WWTP Modified March 2021
Outfalls Other Than to Waters of the State of North Carolina
1.12 Does the POTW discharge wastewater to basins,ponds,or other surface impoundments that do not have outlets
for discharge to waters of the State of North Carolina?
❑ Yes ❑✓ No 4 SKIP to Item 1.14.
1.13 Provide the location of each surface impoundment and associated discharge information in the table below.
Surface Impoundment Location and Discharge Data
Average Daily Volume Continuous or Intermittent
Location Discharged to Surface (check one)
Impoundment
El Continuous
gpd 0 Intermittent
❑ Continuous
gpd 0 Intermittent
❑ Continuous
gpd 0 Intermittent
w 1.14 Is wastewater applied to land?
2 ❑ Yes ❑✓ No 4 SKIP to Item 1.16.
0 1.15 Provide the land application site and discharge data requested below.
w. Land Application Site and Discharge Data
6 Continuous or
L Average Daily Volume
Location Size Intermittent
En Applied (check one)
h16 0 Continuous
acres gpd ❑ Intermittent
0
acres gpd 0 Continuous
0
0 Intermittent
0 Continuous
acres gpd ❑ Intermittent
1.16 Is effluent transported to another facility for treatment prior to discharge?
❑ Yes
a ❑ No-> SKIP to Item 1.21.
1.17 Describe the means by which the effluent is transported(e.g.,tank truck,pipe).
1.18 Is the effluent transported by a party other than the applicant?
❑ Yes ❑ No 4 SKIP to Item 1.20.
1.19 Provide information on the transporter below.
Transporter Data
Entity name Mailing address(street or P.O.box)
City or town State ZIP code
Contact name(first and last) Title
Phone number Email address
Page 3

NPDES Permit Number Facility Name Modified Application Form 2A
NC0068918 Cedar Hill WWTP Modified March 2021
1.20 In the table below,indicate the name,address,contact information, NPDES number,and average daily flow rate of the
receiving facility.
Receiving Facility Data
0
Facility name Mailing address(street or P.O. box)
City or town State ZIP code
0
aContact name(first and last) Title
0
Phone number Email address
rTs
a NPDES number of receiving facility(if any) ❑None Average daily flow rate mgd
N
1.21 Is the wastewater disposed of in a manner other than those already mentioned in Items 1.14 through 1.21 that do
not have outlets to waters of the State of North Carolina(e.g.,underground percolation,underground injection)?
GJ
❑ Yes ❑✓ No 4 SKIP to Item 1.23.
0 1.22 Provide information in the table below on these other disposal methods.
4.) Information on Other Disposal Methods
o Disposal Location of Size of Annual Average Continuous or Intermittent
-a Method Disposal Site Disposal Site Daily Discharge (check one)
Description Volume
acres gpd ❑ Continuous
❑ Intermittent
0 Continuous
acres gpd ❑ Intermittent
acresgpd 0 Continuous
0 Intermittent
1.23 Do you intend to request or renew one or more of the variances authorized at 40 CFR 122.21(n)?(Check all that apply.
w Consult with your NPDES permitting authority to determine what information needs to be submitted and when.)
4-1
R 3 ❑ Discharges into marine waters(CWA ❑ Water quality related effluent limitation(CWA Section
Section 301(h)) 302(b)(2))
❑✓ Not applicable
1.24 Are any operational or maintenance aspects(related to wastewater treatment and effluent quality)of the treatment works
the responsibility of a contractor?
❑✓ Yes ❑ No+SKIP to Section 2.
1.25 Provide location and contact information for each contractor in addition to a description of the contractor's operational
and maintenance responsibilities.
Contractor Information
Contractor 1 Contractor 2 Contractor 3
o Contractor name
RPB Systems,Inc.
(company name)
o Mailing address P.O.Box 1325
(street or P.O.box)
City,state,and ZIP Asheville,NC 28802
code
Conti last) Robert name(first and Robert P.Barr
Phone number [phone]
Email address [e-mail]
Operational and
maintenance
responsibilities of
contractor
Page 4

NPDES Permit Number Facility Name Modified Application Form 2A
NC0068918 Cedar Hill WWTP Modified March 2021
SECTION 2.ADDITIONAL INFORMATION(40 CFR 122.21(j)(1)and(2))
o Outfalls to Waters of the State of North Carolina
2.1 Does the treatment works have a design flow greater than or equal to 0.1 mgd?
rn
o ❑ Yes ❑✓ No 4 SKIP to Section 3.
0 2.2 Provide the treatment works'current average daily volume of inflow Average Daily Volume of Inflow and Infiltration
.71 and infiltration.
gpd
Indicate the steps the facility is taking to minimize inflow and infiltration.
0
c
2.3 Have you attached a topographic map to this application that contains all the required information?(See instructions for
td 0. specific requirements.)
0
0 ❑ Yes ❑ No
3 E 2.4 Have you attached a process flow diagram or schematic to this application that contains all the required information?
o am (See instructions for specific requirements.)
" as ❑ Yes ❑ No
2.5 Are improvements to the facility scheduled?
❑ Yes ❑ No 4 SKIP to Section 3.
Briefly list and describe the scheduled improvements.
0
1.
c
U
E
a 2.
E
0 0
3.
-a
4.
c 2.6 Provide scheduled or actual dates of completion for improvements.
Scheduled or Actual Dates of Completion for Improvements
Affected Attainment of
Scheduled Begin End Begin
> Outfalls Operational
2 Improvement Construction Construction Discharge
(from above) (list outfall (MM/DD/YYYY) (MM/DD/YYYY) (MM/DD/YYYY) Level
number) (MM/DD/YYYY)
1.
2.
co
3.
4.
2.7 Have appropriate permits/clearances concerning other federal/state requirements been obtained?Briefly explain your
response.
❑ Yes ❑ No ❑ None required or applicable
Explanation:
Page 5

NPDES Permit Number Facility Name Modified Application Form 2A
NC0068918 Cedar Hill WWTP Modified March 2021
SECTION 3.INFORMATION ON EFFLUENT DISCHARGES(40 CFR 122.21(j)(3)to(5))
3.1 Provide the following information for each outfall.(Attach additional sheets if you have more than three outfalls.)
Outfall Number 001 Outfall Number Outfall Number
State NC
N
County Jackson
0 City or town Cashiers
o
g Distance from shore ft. ft. ft.
Depth below surface ft. ft. ft.
Average daily flow rate 0.002713 mgd mgd mgd
Latitude 35° 08' 03"
Longitude 83° 04' 14"
3.2 Do any of the outfalls described under Item 3.1 have seasonal or periodic discharges?
❑ Yes ✓❑ No 4 SKIP to Item 3.4.
3.3 If so,provide the following information for each applicable outfall.
N Outfall Number Outfall Number Outfall Number
Number of times per year
a discharge occurs
a Average duration of each
`o discharge(specify units)
Average flow of each
discharge mgd mgd mgd
03
Months in which discharge
occurs
3.4 Are any of the outfalls listed under Item 3.1 equipped with a diffuser?
❑ Yes ❑✓ No 4 SKIP to Item 3.6.
3.5 Briefly describe the diffuser type at each applicable outfall.
a.
Outfall Number Outfall Number Outfall Number
U)
0
o ui 3.6 Does the treatment works discharge or plan to discharge wastewater to waters of the State of North Carolina from
one or more discharge points?
CD
❑ Yes ❑✓ No-SKIP to Section 6.
Page 6
I _

NPDES Permit Number Facility Name Modified Application Form 2A
NC0068918 Cedar Hill WWTP Modified March 2021
3.7 Provide the receiving water and related information(if known)for each outfall.
Outfall Number 001 Outfall Number Outfall Number
Receiving water name Horsepasture River
Name of watershed,river,
= or stream system Savannah River Basin
0
0- U.S.Soil Conservation
Service 14-digit watershed
o code
Name of state
management/river basin
a)
U.S.Geological Survey
8-digit hydrologic
re cataloging unit code
Critical low flow(acute) cfs cfs cfs
Critical low flow(chronic) cfs cfs cfs
Total hardness at critical mg/L of mg/L of mg/L of
low flow CaCO3 CaCO3 CaCO3
3.8 Provide the following information describing the treatment provided for discharges from each outfall.
Outfall Number 001 Outfall Number Outfall Number
Highest Level of ❑ Primary 0 Primary ❑ Primary
Treatment(check all that 0 Equivalent to ❑ Equivalent to 0 Equivalent to
apply per outfall) secondary secondary secondary
O Secondary 0 Secondary 0 Secondary
❑ Advanced 0 Advanced 0 Advanced
❑ Other(specify) ❑ Other(specify) 0 Other(specify)
C
0
a Design Removal Rates by
.0 Outfall
N
o BOD5 or CBOD5
c°i TSS
I-
❑ Not applicable ❑ Not applicable 0 Not applicable
Phosphorus
❑Not applicable 0 Not applicable 0 Not applicable
Nitrogen
Other(specify) 0 Not applicable ❑ Not applicable 0 Not applicable
Page 7

NPDES Permit Number Facility Name Modified Application Form 2A
NC0068918 Cedar Hill WWTP Modified March 2021
3.9 Describe the type of disinfection used for the effluent from each outfall in the table below.If disinfection varies by
season,describe below.
G
0
Outfall Number onOutfall Number Outfall Number
0
1 Disinfection type
Tablet Chlorine
0
d
Seasons used
Dechlorination used? ❑ Not applicable ❑ Not applicable ❑ Not applicable
❑✓ Yes El Yes ❑ Yes
El No ❑ No ❑ No
3.10 Have you completed monitoring for all Table A parameters and attached the results to the application package?
✓❑ Yes ❑ No
3.11 Have you conducted any WET tests during the 4.5 years prior to the date of the application on any of the facility's
discharges or on any receiving water near the discharge points?
❑ Yes ❑✓ No 4 SKIP to Item 3.13.
3.12 Indicate the number of acute and chronic WET tests conducted since the last permit reissuance of the facility's
discharges by outfall number or of the receiving water near the discharge points.
Outfall Number Outfall Number Outfall Number
Acute Chronic Acute Chronic Acute Chronic
is
rn
Number of tests of discharge
water
Number of tests of receiving
water
3.14 Does the POTW use chlorine for disinfection,use chlorine elsewhere in the treatment process,or otherwise have
reasonable potential to discharge chlorine in its effluent?
❑✓ Yes 4 Complete Table B,including chlorine. ❑ No 4 Complete Table B,omitting chlorine.
3.15 Have you completed monitoring for all applicable Table B pollutants and attached the results to this application
package?
❑✓ Yes ❑ No
Have you completed monitoring for all applicable Table D pollutants required by your NPDES permitting authority and
3.18 attached the results to this application package?
❑✓ Yes ❑ No additional sampling required by NPDES
permitting authority.
Page 8

•
NPDES Permit Number Facility Name Modified Application Form 2A
NC0068918 Cedar Hill WWTP Modified March 2021
3.19 Has the POTW conducted either(1)minimum of four quarterly WET tests for one year preceding this permit application
or(2)at least four annual WET tests in the past 4.5 years?
❑ Yes ❑✓ No 4 Complete tests and Table E and SKIP to
Item 3.26.
3.20 Have you previously submitted the results of the above tests to your NPDES permitting authority?
❑ Yes ❑ No 4 Provide results in Table E and SKIP to
Item 3.26.
3.21 Indicate the dates the data were submitted to your NPDES permitting authority and provide a summary of the results.
Date(s)Submitted Summary of Results
(MM/DD/YYYY)
a
Ua 3.22 Regardless of how you provided your WET testing data to the NPDES permitting authority,did any of the tests result in
toxicity?
❑ Yes ❑✓ No 4 SKIP to Item 3.26.
3.23 Describe the cause(s)of the toxicity:
w
3.24 Has the treatment works conducted a toxicity reduction evaluation?
❑ Yes ❑✓ No 4 SKIP to Item 3.26.
3.25 Provide details of any toxicity reduction evaluations conducted.
3.26 Have you completed Table E for all applicable outfalls and attached the results to the application package?
El Yes ❑ Not applicable because previously submitted
information to the NPDES •ermittin• authori .
Page 9

NPDES Permit Number Facility Name Modified Application Form 2A
NC0068918 Cedar Hill WWTP Modified March 2021
SECTION 6.CHECKLIST AND CERTIFICATION STATEMENT(40 CFR 122.22(a)and(d))
6.1 In Column 1 below,mark the sections of Form 2A that you have completed and are submitting with your application.For
each section,specify in Column 2 any attachments that you are enclosing to alert the permitting authority.Note that not
all applicants are required to provide attachments.
Column 1 Column 2
ID Section 1: Basic Application
Information for All Applicants ❑ wl variance request(s) ❑ wl additional attachments
❑ Section 2:Additional ❑✓ wl topographic map ❑ wl process flow diagram
Information
❑ w/additional attachments
© w/Table A © w/Table D
❑✓ Section 3: Information on 171 w/Table B ❑ w/additional attachments
Effluent Discharges
❑ w/Table C
co
m
Section 4:Not Applicable
0
C,
Section 5:Not Applicable
a�
C)
❑ Section 6:Checklist and ❑ w/attachments
Certification Statement
Se 6.2 Certification Statement
U
1 certify under penalty of law that this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that qualified personnel properly gather and evaluate the information
submitted.Based on my inquiry of the person or persons who manage the system,or those persons directly responsible
for gathering the information,the information submitted is,to the best of my knowledge and belief,true,accurate,and
complete.lam aware that there are significant penalties for submitting false information,including the possibility of fine
and imprisonment for knowing violations.
Name(print or ty a first and last name) Official title
(A GQrr1Ynuo 14- 5t( a:1)Gk
Si turett(-411,4 Date signed NRQ
4- IlX" oZ
Page 10

NPDES Permit Number Facility Name Outfall Number Modified Application Form 2A
NC0068918 Cedar Hill WWTP 001 Modified March 2021
TABLE A.EFFLUENT PARAMETERS FOR ALL POTWS
Maximum Daily Discharge Average Daily Discharge Analytical ML or MDL
Pollutant Number of Methods (include
Value Units Value Units Samples units)
Biochemical oxygen demand
ElBODE or 0 CBODs 52.9 mg/L 9.62 mg/L 156 SM 5210B ❑ML
❑MDL
resort one
Fecal coliform 600 CFU/100mL 4.87 CFU/mL 156 SM 9222D El ML
❑MDL
Design flow rate 0.065000 mgd 0.002713 mgd 1096
pH(minimum) 6.6 su
pH(maximum) 7.4 su
Temperature(winter) 17.0 Deg C 8.2 Deg C 311
Temperature(summer) 22.1 Deg C 15.8 Deg C 449
0 ML
Total suspended solids(TSS) 33.3 mg/L 8.69 mg/L 155 SM 2540D ❑MDL
1 Sampling shall be conducted according to sufficiently sensitive test procedures(i.e.,methods)approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter I,subchapter N or 0.See instructions and 40 CFR 122.21(e)(3).
Page 11

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Modified Application Form 2A
NC0068918 Cedar Hill WWTP 001 Modified March 2021
TABLE B.EFFLUENT PARAMETERS FOR ALL POTWS WITH A FLOW EQUAL TO OR GREATER THAN 0.1 MGD
Maximum Daily Discharge Average Daily Discharge Analytical ML or MDL
Pollutant Number Value Units Value Units Samplest Methods (include units)
Ammonia(as N) 26 mg/L 2.15 mg/L 158 EPA 350.1 ❑ML
❑MDL
Chlorine ❑ML
(total residual,TRC)2 19.9 ug/L 12.35 ug/L 310 ❑MDL
Dissolved oxygen ❑ML
0 MDL
Nitrate/nitrite ❑ML
❑MDL
Kjeldahl nitrogen 0 ML
0 MDL
Oil and grease ❑ML
❑MDL
Phosphorus 5.5 mg/L 3.6 mg/L 7 EPA 365.1 Rev 2.0 0 ML
❑MDL
Total dissolved solids 0 ML
0 MDL
1 Sampling shall be conducted according to sufficiently sensitive test procedures(i.e., methods)approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter I,subchapter N or 0.See instructions and 40 CFR 122.21(e)(3).
2 Facilities that do not use chlorine for disinfection,do not use chlorine elsewhere in the treatment process,and have no reasonable potential to discharge chlorine in their effluent are not
required to report data for chlorine.
•
EPA Form 3510-2A(Revised 3-19) Page 12

NPDES Permit Number Facility Name Outfall Number Modified Application Form 2A
NC0068918 Cedar Hill WWTP 001 Modified March 2021
TABLE D.ADDITIONAL POLLUTANTS AS REQUIRED BY NPDES PERMITTING AUTHORITY
Maximum Daily Discharge Average Daily Dischar e
Pollutant Analytical ML or MDL
(list) Value Units Value Units Number of Method1 (include units)
Samples
❑ No additional sampling is required by NPDES permitting authority.
Total Nitrogen 30.0 mg/L 20.91 mg/L 7 TKN+NO3+NO2 Calci ❑ML
❑MDL
❑ML
❑MDL
❑ML
❑MDL
❑ML
❑MDL
❑ML
❑MDL
❑ML
❑MDL
❑ML
❑MDL
❑ML
❑MDL
0 ML
❑MDL
❑ML
❑MDL
❑ML
0 MDL
❑ML
❑MDL
❑ML
❑MDL
❑ML
❑MDL
❑ML
❑MDL
❑ML
❑MDL
❑ML
❑MDL
1 Sampling shall be conducted according to sufficiently sensitive test procedures(i.e.,methods)approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or required
under 40 CFR chapter I,subchapter N or 0.See instructions and 40 CFR 122.21(e)(3).
Page 18

North Carolina
Department of Environmental Quality Modified Application Form 2A
Division of Water Resources Revised March 2021
Modified Application
Form 2A
Minor Sewage Facilities < 0. 1 MGD
and No Pretreatment Program
NPDES Permitting Program
Note: Complete this form if your facility is a MINOR new or existing publicly owned treatment works.

NPDES Permit Number Facility Name Modified Application Form 2A
NC0068918 Cedar Hill WWTP Modified March 2021
Form NC Department of Environmental Quality-Application for NPDES Permit to Discharge Wastewater
NPDES MINOR SEWAGE FACILITIES(Before completing this form,please read the instructions.Failure to follow
the instructions may result in denial of the application.)
SECTION 1.BASIC APPLICATION INFORMATION FOR ALL APPLICANTS(40 CFR 122.21(j)(1)and(9))
1.1 Facility name
Cedar Hill WWTP
Mailing address(street or P.O.box)
P.O.Box 580
City or town State ZIP code
0 Arden NC 28704
Contact name(first and last) Title Phone number Email address
0 Debby Nussel Community Association Mana, [phone] [e-mail] Location address(street,route number,or other specific identifier) ❑ Same as mailing address
co 1820 US Highway 64
ur
City or town State ZIP code
Cashiers NC 28717
1.2 Is this application for a facility that has yet to commence discharge?
❑ Yes 4 See instructions on data submission ✓❑ No
requirements for new dischargers.
1.3 Is applicant different from entity listed under Item 1.1 above?
❑ Yes ❑ No 4 SKIP to Item 1.4.
Applicant name
= Applicant address(street or P.O.box)
0
City or town State ZIP code
Contact name(first and last) Title Phone number Email address
Q
0.
1.4 Is the applicant the facility's owner,operator,or both?(Check only one response.)
❑✓ Owner ❑ Operator ❑ Both
1.5 To which entity should the NPDES permitting authority send correspondence?(Check only one response.)
❑ Facility ❑✓ Applicant ElFacility and applicant
(they are one and the same)
1.6 Indicate below any existing environmental permits.(Check all that apply and print or type the corresponding permit
number for each.)
a) Existing Environmental Permits
a_
❑✓ NPDES(discharges to surface ❑ RCRA(hazardous waste) ❑ UIC(underground injection
water) control)
Horsepastue River
o ❑ PSD(air emissions) ❑ Nonattainment program(CAA) ❑ NESHAPs(CAA)
C
w
rn
to ❑ Ocean dumping(MPRSA) ❑ Dredge or fill(CWA Section ❑ Other(specify)
404)
Page 1

NPDES Permit Number Facility Name Modified Application Form 2A
NC0068918 Cedar Hill WWTP Modified March 2021
1.7 Provide the collection system information requested below for the treatment works.
Municipality Population Collection System Type
Served Served (indicate percentage) Ownership Status
100 %separate sanitary sewer 0 Own 0 Maintain
Z154 Lots %combined storm and sanitary sewer 0 Own 0 Maintain
c) 0 Unknown 0 Own 0 Maintain
co %separate sanitary sewer 0 Own 0 Maintain
:Li %combined storm and sanitary sewer ❑ Own 0 Maintain
c ❑ Unknown 0 Own 0 Maintain
a %separate sanitary sewer ❑ Own 0 Maintain
-o %combined storm and sanitary sewer ❑ Own 0 Maintain
m ❑ Unknown 0 Own 0 Maintain
d %separate sanitary sewer 0 Own 0 Maintain
%combined storm and sanitary sewer 0 Own 0 Maintain
co
c ❑ Unknown 0 Own 0 Maintain
:. Total
d Population 154 Lots
o Served
Separate Sanitary Sewer System Combined Storm and
Sanitary Sewer
Total percentage of each type of
sewer line(in miles)
z' 1.8 Is the treatment works located in Indian Country?
c
o ❑ Yes ❑✓ No
U
A 1.9 Does the facility discharge to a receiving water that flows through Indian Country?
c 0 Yes ❑✓ No
1.10 Provide design and actual flow rates in the designated spaces: Design Flow Rate
0.025 mgd
73
y Annual Average Flow Rates(Actual)
a Two Years Ago Last Year This Year
03
-0w
COC
RI
0.002022 mgd 0.002026 mgd 0.004090 mgd
w`L Maximum Daily Flow Rates(Actual)
o Two Years Ago Last Year This Year
0.034080 mgd 0.013944 mgd 0.06500 mgd
N 1.11 Provide the total number of effluent discharge points to waters of the State of North Carolina by type.
C Total Number of Effluent Discharge Points by Type
a. aa.s Constructed
Combined Sewer
s a Treated Effluent Untreated Effluent Overflows Bypasses Emergency
Overflows
N_
in 1
Page 2

NPDES Permit Number Facility Name Modified Application Form 2A
NC0068918 Cedar Hill WWTP Modified March 2021
Outfalls Other Than to Waters of the State of North Carolina
1.12 Does the POTW discharge wastewater to basins,ponds,or other surface impoundments that do not have outlets
for discharge to waters of the State of North Carolina?
❑ Yes ❑✓ No 4 SKIP to Item 1.14.
1.13 Provide the location of each surface impoundment and associated discharge information in the table below.
Surface Impoundment Location and Discharge Data
Average Daily Volume Continuous or Intermittent
Location Discharged to Surface (check one)
Impoundment
O Continuous
gpd ❑ Intermittent
O Continuous
gpd 0 Intermittent
❑ Continuous
gpd ❑ Intermittent
w 1.14 Is wastewater applied to land?
❑ Yes ❑✓ No 4 SKIP to Item 1.16.
O 1.15 Provide the land application site and discharge data requested below.
Land Application Site and Discharge Data
o Continuous or
Location Size Average Daily Volume Intermittent
Applied (check one)
•
acresgpd ElContinuous
y ❑ Intermittent
0
acresgpd ❑ Continuous
❑ Intermittent
5
0 Continuous
acres gpd ❑ Intermittent
73 1.16 Is effluent transported to another facility for treatment prior to discharge?
o ❑ Yes No-) SKIP to Item 1.21.
1.17 Describe the means by which the effluent is transported(e.g.,tank truck,pipe).
1.18 Is the effluent transported by a party other than the applicant?
❑ Yes ❑ No 4 SKIP to Item 1.20.
1.19 Provide information on the transporter below.
Transporter Data
Entity name Mailing address(street or P.O.box)
City or town State ZIP code
Contact name(first and last) Title
Phone number Email address
Page 3

NPDES Permit Number Facility Name Modified Application Form 2A
NC0068918 Cedar Hill WWTP Modified March 2021
1.20 In the table below,indicate the name,address,contact information, NPDES number,and average daily flow rate of the
receiving facility.
Receiving Facility Data
d Facility name Mailing address(street or P.O.box)
City or town State ZIP code
0
toContact name(first and last) Title
0
Phone number Email address
00
.
NPDES number of receiving facility(if any) 0 None Average daily flow rate mgd
N
0 1.21 Is the wastewater disposed of in a manner other than those already mentioned in Items 1.14 through 1.21 that do
not have outlets to waters of the State of North Carolina(e.g.,underground percolation,underground injection)?
❑ Yes ❑✓ No 4 SKIP to Item 1.23.
U
O 1.22 Provide information in the table below on these other disposal methods.
Information on Other Disposal Methods
o Disposal Location of Size of Annual Average Continuous or Intermittent
o Method Disposal Site Disposal Site Daily Discharge (check one)
Description Volume
to
0 Continuous
acres gpd 0 Intermittent
acresgpd 0 Continuous
❑ Intermittent
acresgpd ❑ Continuous
❑ Intermittent
1.23 Do you intend to request or renew one or more of the variances authorized at 40 CFR 122.21(n)?(Check all that apply.
h Consult with your NPDES permitting authority to determine what information needs to be submitted and when.)
C c ❑ Discharges into marine waters(CWA ❑ Water quality related effluent limitation(CWA Section
rr Section 301(h)) 302(b)(2))
❑✓ Not applicable
1.24 Are any operational or maintenance aspects(related to wastewater treatment and effluent quality)of the treatment works
the responsibility of a contractor?
❑✓ Yes ❑ No+SKIP to Section 2.
1.25 Provide location and contact information for each contractor in addition to a description of the contractor's operational
and maintenance responsibilities.
Contractor Information
Contractor 1 Contractor 2 Contractor 3
o Contractor name
47- RPB Systems,Inc.
(company name)
Mailing address P.O.Box 1325
E (street or P.O.box)
City,state,and ZIP Asheville,NC 28802
CO code
Conc�i last) Robert name(first and Robert P.Barr
Phone number [phone]
Email address [e-mail]
Operational and
maintenance
responsibilities of
contractor
Page 4

NPDES Permit Number Facility Name Modified Application Form 2A
NC0068918 Cedar Hill WWTP Modified March 2021
SECTION 2.ADDITIONAL INFORMATION(40 CFR 122.21(j)(1)and(2))
o Outfalls to Waters of the State of North Carolina
c 2.1 Does the treatment works have a design flow greater than or equal to 0.1 mgd?
rn
o ❑ Yes ❑✓ No 4 SKIP to Section 3.
0 2.2 Provide the treatment works'current average daily volume of inflow Average Daily Volume of Inflow and Infiltration
and infiltration. gpd
Indicate the steps the facility is taking to minimize inflow and infiltration.
0
s 2.3 Have you attached a topographic map to this application that contains all the required information?(See instructions for
a. C specific requirements.)
o
0
0 ElYes ❑ No
E 2.4 Have you attached a process flow diagram or schematic to this application that contains all the required information?
3
O ca (See instructions for specific requirements.)
LL Cv
o ❑ Yes ❑ No
2.5 Are improvements to the facility scheduled?
❑ Yes ❑ No 4 SKIP to Section 3.
Briefly list and describe the scheduled improvements.
0
1.
v
E
a 2.
E
0
3.
a
m
co
4.
a
gi 2.6 Provide scheduled or actual dates of completion for improvements.
CO
Scheduled or Actual Dates of Completion for Improvements
E Affected Attainment of
Scheduled Begin End Begin
> Outfalls Operational
o Improvement Construction Construction Discharge
(from above) (list outfall (MM/DD/YYYY) (MM/DD/YYYY) (MM/DD/YYYY) Level
number) (MM/DD/YYYY)
1.
2.
3.
4.
2.7 Have appropriate permits/clearances concerning other federal/state requirements been obtained?Briefly explain your
response.
❑ Yes ❑ No ❑ None required or applicable
Explanation:
Page 5

NPDES Permit Number Facility Name Modified Application Form 2A
NC0068918 Cedar Hill WWTP Modified March 2021
SECTION 3.INFORMATION ON EFFLUENT DISCHARGES(40 CFR 122.21(j)(3)to(5))
3.1 Provide the following information for each outfall.(Attach additional sheets if you have more than three outfalls.)
Outfall Number o01 Outfall Number Outfall Number
State NC
(71 County Jackson
0 City or town Cashiers
0
Q Distance from shore ft. ft. ft.
Depth below surface ft. ft. ft.
0
Average daily flow rate 0.002713 mgd mgd mgd
Latitude 35° 08' 03"
Longitude 83° 04' 14"
3.2 Do any of the outfalls described under Item 3.1 have seasonal or periodic discharges?
El Yes ❑✓ No 4 SKIP to Item 3.4.
R 3.3 If so,provide the following information for each applicable outfall.
Outfall Number Outfall Number Outfall Number
Number of times per year
0 discharge occurs
a Average duration of each
`o discharge(specify units)
aAverage flow of each mgd mgd mgd
discharge
co
Months in which discharge
occurs
3.4 Are any of the outfalls listed under Item 3.1 equipped with a diffuser?
❑ Yes ❑✓ No 4 SKIP to Item 3.6.
3.5 Briefly describe the diffuser type at each applicable outfall.
a
F— Outfall Number Outfall Number Outfall Number
U)
N
o cri 3.6 Does the treatment works discharge or plan to discharge wastewater to waters of the State of North Carolina from
one or more discharge points?
❑ Yes ❑✓ No 4SKIP to Section 6.
Page 6

NPDES Permit Number Facility Name Modified Application Form 2A
Modified March 2021
NC0068918 Cedar Hill WWTP
3.7 Provide the receiving water and related information(if known)for each outfall.
Outfall Number 001 Outfall Number Outfall Number
Receiving water name Horsepasture River
Name of watershed,river,
0
Savannah River Basin
or stream system
U.S.Soil Conservation
N Service 14-digit watershed
o code
Name of state
management/river basin
U.S.Geological Survey
8-digit hydrologic
cataloging unit code
Critical low flow(acute) cfs cfs cfs
Critical low flow(chronic) cfs cfs cfs
Total hardness at critical mg/L of mg/L of mg/L of
low flow CaCO3 CaCO3 CaCO3
3.8 Provide the following information describing the treatment provided for discharges from each outfall.
Outfall Number 001 Outfall Number Outfall Number
Highest Level of 0 Primary ❑ Primary 0 Primary
Treatment(check all that 0 Equivalent to 0 Equivalent to 0 Equivalent to
apply per outfall) secondary secondary secondary
O Secondary 0 Secondary ❑ Secondary
❑ Advanced 0 Advanced 0 Advanced
❑ Other(specify) 0 Other(specify) 0 Other(specify)
C
0
a Design Removal Rates by
Outfall
BODs or CBODs
TSS
❑Not applicable 0 Not applicable 0 Not applicable
Phosphorus
0 Not applicable 0 Not applicable ❑Not applicable
Nitrogen
Other(specify) 0 Not applicable ❑ Not applicable 0 Not applicable
Page 7

NPDES Permit Number Facility Name Modified Application Form 2A
NC0068918 Cedar Hill WWTP Modified March 2021
3.9 Describe the type of disinfection used for the effluent from each outfall in the table below. If disinfection varies by
season,describe below.
-o
d
_
0
Outfall Number 001 Outfall Number Outfall Number
0
Disinfection type Tablet Chlorine
c)
a)
G)
Seasons used
co
E
Dechlorination used? ❑ Not applicable ❑ Not applicable ❑ Not applicable
❑✓ Yes ❑ Yes ❑ Yes
❑ No ❑ No ❑ No
3.10 Have you completed monitoring for all Table A parameters and attached the results to the application package?
E Yes ❑ No
3.11 Have you conducted any WET tests during the 4.5 years prior to the date of the application on any of the facility's
discharges or on any receiving water near the discharge points?
❑ Yes ❑✓ No 4 SKIP to Item 3.13.
3.12 Indicate the number of acute and chronic WET tests conducted since the last permit reissuance of the facility's
discharges by outfall number or of the receiving water near the discharge points.
Outfall Number Outfall Number Outfall Number
Acute Chronic Acute Chronic Acute Chronic
0)
Number of tests of discharge
= water
Number of tests of receiving
water
d
3.14 Does the POTW use chlorine for disinfection,use chlorine elsewhere in the treatment process,or otherwise have
reasonable potential to discharge chlorine in its effluent?
❑✓ Yes 4 Complete Table B,including chlorine. ❑ No 4 Complete Table B,omitting chlorine.
3.15 Have you completed monitoring for all applicable Table B pollutants and attached the results to this application
package?
❑✓ Yes ❑ No
Have you completed monitoring for all applicable Table D pollutants required by your NPDES permitting authority and
3.18 attached the results to this application package?
❑✓ Yes ❑ No additional sampling required by NPDES
permitting authority.
Page 8

NPDES Permit Number Facility Name Modified Application Form 2A
NC0068918 Cedar Hill WWTP
Modified March 2021
3.19 Has the POTW conducted either(1)minimum of four quarterly WET tests for one year preceding this permit application
or(2)at least four annual WET tests in the past 4.5 years?
❑ Yes ❑✓ No 4 Complete tests and Table E and SKIP to
Item 3.26.
3.20 Have you previously submitted the results of the above tests to your NPDES permitting authority?
El Yes ❑ No 4 Provide results in Table E and SKIP to
Item 3.26.
3.21 Indicate the dates the data were submitted to your NPDES permitting authority and provide a summary of the results.
Date(s)Submitted Summary of Results
(MWDDNYYY)
a
Y
0
w3.22 Regardless of how you provided your WET testing data to the NPDES permitting authority,did any of the tests result in
toxicity?
❑ Yes ❑✓ No 4 SKIP to Item 3.26.
3.23 Describe the cause(s)of the toxicity:
m
3
Ui
W
3.24 Has the treatment works conducted a toxicity reduction evaluation?
❑ Yes ❑✓ No 4 SKIP to Item 3.26.
3.25 Provide details of any toxicity reduction evaluations conducted.
3.26 Have you completed Table E for all applicable outfalls and attached the results to the application package?
❑ Yes ❑ Not applicable because previously submitted
information to the NPDES ermittin authori .
•
Page 9

NPDES Permit Number Facility Name Modified Application Form 2A
NC0068918 Cedar Hill WWTP Modified March 2021
SECTION 6.CHECKLIST AND CERTIFICATION STATEMENT(40 CFR 122.22(a)and(d))
6.1 In Column 1 below,mark the sections of Form 2A that you have completed and are submitting with your application.For
each section,specify in Column 2 any attachments that you are enclosing to alert the permitting authority. Note that not
all applicants are required to provide attachments.
Column 1 Column 2
❑ Section 1: Basic Application ❑ w/variance request(s) ❑ wl additional attachments
Information for All Applicants
❑ Section 2:Additional ✓❑ wl topographic map ❑ wl process flow diagram
Information
❑ wl additional attachments
© w/Table A © w/Table D
❑✓ Section 3: Information on © w/Table B 0 wl additional attachments
c Effluent Discharges
E ❑ wl Table C
d
co
c Section 4: Not Applicable
c
0
co
Section 5:Not Applicable
co
U
❑ Section 6: Checklist and 0 w/attachments
co
Certification Statement
S.
N
Y 6.2 Certification Statement
V
I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that qualified personnel properly gather and evaluate the information
submitted. Based on my inquiry of the person or persons who manage the system,or those persons directly responsible
for gathering the information,the information submitted is,to the best of my knowledge and belief, true,accurate,and
complete.I am aware that there are significant penalties for submitting false information,including the possibility of fine
and imprisonment for knowing violations.
Name(print or type first and last name) Official title
`bet2 2 y e I C+�I nrnuo l 5z 4 h o�
Si ature A C x� � �jv�Date signed N �
(
Page 10

NPDES Permit Number Facility Name Outfall Number Modified Applicafion Form 2A
NC0068918 Cedar Hill WWTP 001 Modified March 2021
TABLE A.EFFLUENT PARAMETERS FOR ALL POTWS
Maximum Daily Discharge Average Daily Discharge Analytical ML or MDL
Pollutant
Value Units Value Units Number of Method1 (include units)
Samples
Biochemical oxygen demand ❑ML
o BOD5 or 0 CBOD5 52.9 mg/L 9.62 mg/L 156 SM 5210B ❑MDL
(report one)
Fecal coliform 600 CFU/100mL 4.87 CFU/mL 156 SM 9222D ❑ML
❑MDL
Design flow rate 0.065000 mgd 0.002713 mgd 1096
pH(minimum) 6.6 su
pH(maximum) 7.4 su
Temperature(winter) 17.0 Deg C 8.2 Deg C 311
Temperature(summer) 22.1 Deg C 15.8 Deg C 449
Total suspended solids(TSS) 33.3 mg/L 8.69 mg/L 155 SM 2540D ❑ML
❑MDL
1 Sampling shall be conducted according to sufficiently sensitive test procedures(i.e.,methods)approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter I,subchapter N or 0. See instructions and 40 CFR 122.21(e)(3).
Page 11

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Modified Application Form 2A
NC0068918 Cedar Hill WWTP 001 Modified March 2021
TABLE B.EFFLUENT PARAMETERS FOR ALL POTWS WITH A FLOW EQUAL TO OR GREATER THAN 0.1 MOD
Maximum Daily Discharge Average Daily Discharge Analytical ML or MDL
Pollutant Number of
Value Units Value Units Methods (include units)
Samples
Ammonia(as N) 26 mg/L 2.15 mg/L 158 EPA 350.1 ❑ML
❑MDL
Chlorine 19.9 ug/L 12.35 ug/L 310 CI ML
(total residual,TRC)2 g g ❑MDL
Dissolved oxygen ❑ML
0 MDL
Nitrate/nitrite 0 ML
0 MDL
Kjeldahl nitrogen ❑ML
❑MDL
Oil and grease ❑ML
0 MDL
Phosphorus 5.5 mg/L 3.6 mg/L 7 EPA 365.1 Rev 2.0 0 ML
❑MDL
Total dissolved solids ❑ML
0 MDL
I Sampling shall be conducted according to sufficiently sensitive test procedures(i.e., methods)approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter I,subchapter N or 0.See instructions and 40 CFR 122.21(e)(3).
2 Facilities that do not use chlorine for disinfection,do not use chlorine elsewhere in the treatment process,and have no reasonable potential to discharge chlorine in their effluent are not
required to report data for chlorine.
EPA Form 3510-2A(Revised 3-19) Page 12
L

NPDES Permit Number Facility Name Outfall Number Modified Application Form 2A
NC0068918 Cedar Hill WWTP 001 Modified March 2021
TABLE D.ADDITIONAL POLLUTANTS AS REQUIRED BY NPDES PERMITTING AUTHORITY
Maximum Daily Discharge Average Daily Dischar e
Pollutant r Analytical ML or MDL
(list) Value Units Value Units Number of Method1 (include units)
Samples
❑ No additional sampling is required by NPDES permitting authority.
Total Nitrogen 30.0 mg/L 20.91 mg/L 7 TKN+NO3+NO2 Calct ❑ML
❑MDL
❑ML
❑MDL
❑ML
❑MDL
❑ML
❑MDL
❑ML
❑MDL
❑ML
0 MDL
❑ML
❑MDL
0 ML
❑MDL
❑ML
❑MDL
❑ML
❑MDL
❑M
❑MLDL
❑ML
❑MDL
❑ML
❑MDL
❑ML
❑MDL
❑ML
❑MDL
❑ML
❑MDL
❑ML
❑MDL
1 Sampling shall be conducted according to sufficiently sensitive test procedures(i.e., methods)approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or required
under 40 CFR chapter I,subchapter N or 0.See instructions and 40 CFR 122.21(e)(3).
Page 18
L_

North Carolina
Department of Environmental Quality Modified Application Form 2A
Division of Water Resources Revised March 2021
Modified Application
Form 2A
Minor Sewage Facilities < 0.1 MGD
and No Pretreatment Program
NPDES Permitting Program
Note: Complete this form if your facility is a MINOR new or existing publicly owned treatment works.

NPDES Permit Number Facility Name Modified Application Form 2A
NC0068918 Cedar Hill WWTP Modified March 2021
Form NC Department of Environmental Quality-Application for NPDES Permit to Discharge Wastewater
NPDES MINOR SEWAGE FACILITIES(Before completing this form,please read the instructions.Failure to follow
the instructions may result in denial of the application.)
SECTION 1.BASIC APPLICATION INFORMATION FOR ALL APPLICANTS(40 CFR 122.21(j)(1)and(9))
1.1 Facility name
Cedar Hill WWTP
Mailing address(street or P.O.box)
P.O.Box 580
City or town State ZIP code
0 Arden NC 28704
47.
Contact name(first and last) Title Phone number Email address
Debby Nussel Community Association Mana; [phone] [e-mail]
Location address(street,route number,or other specific identifier) ❑ Same as mailing address
1820 US Highway 64
u_
City or town State ZIP code
Cashiers NC 28717
1.2 Is this application for a facility that has yet to commence discharge?
❑ Yes 4 See instructions on data submission ❑✓ No
requirements for new dischargers.
1.3 Is applicant different from entity listed under Item 1.1 above?
❑ Yes ❑ No 4 SKIP to Item 1.4.
Applicant name
Applicant address(street or P.O.box)
0
City or town State ZIP code
Contact name(first and last) Title Phone number Email address
0.
a
1.4 Is the applicant the facility's owner,operator,or both?(Check only one response.)
❑✓ Owner ❑ Operator ❑ Both
1.5 To which entity should the NPDES permitting authority send correspondence?(Check only one response.)
❑ Facility ❑✓ Applicant ❑ Facility and applicant
(they are one and the same)
1.6 Indicate below any existing environmental permits.(Check all that apply and print or type the corresponding permit
number for each.)
Existing Environmental Permits
❑✓ NPDES(discharges to surface ❑ RCRA(hazardous waste) ❑ UIC(underground injection
dwater) control)
E Horsepastue River
❑ PSD(air emissions) ❑ Nonattainment program(CAA) ❑ NESHAPs(CAA)
rn
❑ Ocean dumping(MPRSA) ❑ Dredge or fill(CWA Section ❑ Other(specify)
404)
Page 1

NPDES Permit Number Facility Name Modified Application Form 2A
NC0068918 Cedar Hill WWTP Modified March 2021
1.7 Provide the collection system information requested below for the treatment works.
Municipality Population Collection System Type Ownership Status
Served Served (indicate percentage)
100 %separate sanitary sewer 0 Own 0 Maintain
154 Lots %combined storm and sanitary sewer 0 Own 0 Maintain
d 0 Unknown ❑ Own 0 Maintain
c %separate sanitary sewer 0 Own ❑ Maintain
%combined storm and sanitary sewer ❑ Own 0 Maintain
a ❑ Unknown 0 Own 0 Maintain
a %separate sanitary sewer 0 Own 0 Maintain
-o %combined storm and sanitary sewer ❑ Own 0 Maintain
0 Unknown ❑ Own ❑ Maintain
E %separate sanitary sewer 0 Own 0 Maintain
ta
> %combined storm and sanitary sewer ❑ Own 0 Maintain
c 0 Unknown 0 Own 0 Maintain
w Total
Population 154 Lots
75
o Served
Separate Sanitary Sewer System Combined Storm and
Sanitary Sewer
Total percentage of each type of
sewer line(in miles)
?' 1.8 Is the treatment works located in Indian Country?
c
o El Yes ❑✓ No
0
U
c 1.9 Does the facility discharge to a receiving water that flows through Indian Country?
cu
iFs
❑ Yes ❑✓ No
1.10 Provide design and actual flow rates in the designated spaces: Design Flow Rate
0.025 mgd
To
Annual Average Flow Rates(Actual)
a -2 Two Years Ago Last Year This Year
COci
0.002022 mgd 0.002026 mgd 0.004090 mgd
`i" Maximum Daily Flow Rates(Actual)
o Two Years Ago Last Year This Year
0.034080 mgd 0.013944 mgd 0.06500 mgd
y 1.11 Provide the total number of effluent discharge points to waters of the State of North Carolina by type.
o Total Number of Effluent Discharge Points by Type
a. a. Constructed
Combined Sewer
Treated Effluent Untreated Effluent Bypasses Emergency
s1 _c � ver Oflows Overflows
U
_N
0 1
Page 2
i

NPDES Permit Number Facility Name Modified Application Form 2A
NC0068918 Cedar Hill WWTP Modified March 2021
Outfalls Other Than to Waters of the State of North Carolina
1.12 Does the POTW discharge wastewater to basins,ponds,or other surface impoundments that do not have outlets
for discharge to waters of the State of North Carolina?
❑ Yes ❑✓ No 4 SKIP to Item 1.14.
1.13 Provide the location of each surface impoundment and associated discharge information in the table below.
Surface Impoundment Location and Discharge Data
Average Daily Volume Continuous or Intermittent
Location Discharged to Surface (check one)
Impoundment
❑ Continuous
gpd 0 Intermittent
❑ Continuous
gpd 0 Intermittent
❑ Continuous
gpd 0 Intermittent
a
2 1.14 Is wastewater applied to land?
co
❑ Yes ❑✓ No-4 SKIP to Item 1.16.
o 1.15 Provide the land application site and discharge data requested below.
ca. Land Application Site and Discharge Data
Continuous or
8 Location Size Average Daily Volume Intermittent
CD Applied (check one)
acresgpd 0 Continuous
N ❑ Intermittent
0
d acres gpd 0 Continuous
0 Intermittent
0 Continuous
acres gpd 0 Intermittent
7, 1.16 Is effluent transported to another facility for treatment prior to discharge?
0
❑ Yes E1 No 4 SKIP to Item 1.21.
1.17 Describe the means by which the effluent is transported(e.g.,tank truck,pipe).
1.18 Is the effluent transported by a party other than the applicant?
❑ Yes ❑ No 4 SKIP to Item 1.20.
1.19 Provide information on the transporter below.
Transporter Data
Entity name Mailing address(street or P.O.box)
City or town State ZIP code
Contact name(first and last) Title
Phone number Email address
Page 3

NPDES Permit Number Facility Name Modified Application Form 2A
NC0068918 Cedar Hill WWTP Modified March 2021
1.20 In the table below,indicate the name,address,contact information, NPDES number,and average daily flow rate of the
receiving facility.
Receiving Facility Data
-0 Facility name Mailing address(street or P.O.box)
a)
City or town State ZIP code
0
C.)
Contact name(first and last) Title
0
Phone number Email address
aNPDES number of receiving facility(if any) ❑ None Average daily flow rate mgd
w
0 1.21 Is the wastewater disposed of in a manner other than those already mentioned in Items 1.14 through 1.21 that do
not have outlets to waters of the State of North Carolina(e.g.,underground percolation,underground injection)?
❑ Yes ❑✓ No SKIP to Item 1.23.
0 1.22 Provide information in the table below on these other disposal methods.
CI) Information on Other Disposal Methods
o Disposal Location of Size of Annual Average Continuous or Intermittent
-a Method Disposal Site Disposal Site Daily Discharge (check one)
co Description Volume
acres gpd ❑ Continuous
0 Intermittent
0 Continuous
acres gpd 0 Intermittent
acresgpd 0 Continuous
0 Intermittent
1.23 Do you intend to request or renew one or more of the variances authorized at 40 CFR 122.21(n)?(Check all that apply.
4.3
• N Consult with your NPDES permitting authority to determine what information needs to be submitted and when.)
o 0 Discharges into marine waters(CWA Water quality related effluent limitation(CWA Section
▪ cu ❑ Section 301(h)) ❑ 302(b)(2))
❑✓ Not applicable
1.24 Are any operational or maintenance aspects(related to wastewater treatment and effluent quality)of the treatment works
the responsibility of a contractor?
❑✓ Yes ❑ No+SKIP to Section 2.
1.25 Provide location and contact information for each contractor in addition to a description of the contractor's operational
and maintenance responsibilities.
Contractor Information
Contractor 1 Contractor 2 Contractor 3
c Contractor name
(company name) RPB Systems,Inc.
Mailing address P.O.Box 1325
(street or P.O.box)
City,state,and ZIP Asheville,NC 28802
code
<� Contact name(first and Robert P.Barr
last)
Phone number [phone]
Email address [e-mail]
Operational and
maintenance
responsibilities of
contractor
Page 4

NPDES Permit Number Facility Name Modified Application Form 2A
NC0068918 Cedar Hill WWTP Modified March 2021
SECTION 2.ADDITIONAL INFORMATION(40 CFR 122.21(j)(1)and(2))
Outfalls to Waters of the State of North Carolina
2.1 Does the treatment works have a design flow greater than or equal to 0.1 mgd?
rn
o ❑ Yes ❑✓ No SKIP to Section 3.
O 2.2 Provide the treatment works'current average daily volume of inflow Average Daily Volume of Inflow and Infiltration
and infiltration.
:° gpd
Indicate the steps the facility is taking to minimize inflow and infiltration.
co
co
0
0
2.3 Have you attached a topographic map to this application that contains all the required information?(See instructions for
0. 0. specific requirements.)
rn�
❑ Yes ❑ No
E 2.4 Have you attached a process flow diagram or schematic to this application that contains all the required information?
oco (See instructions for specific requirements.)
rn
" o ❑ Yes ❑ No
2.5 Are improvements to the facility scheduled?
❑ Yes ❑ No+ SKIP to Section 3.
= Briefly list and describe the scheduled improvements.
0
C
1.
d
E
w
2.
E
0 0
3.
w
d
co
4.
co 2.6 Provide scheduled or actual dates of completion for improvements.
Cfl
Scheduled or Actual Dates of Completion for Improvements
Affected Attainment of
Scheduled Begin End Begin
Outfalls Operational
o Improvement Construction Construction Discharge
(from above) (list outfall Level
(MM/DD/YYYY) (MM/DD/YYYY) (MM/DD/YYYY)
number) (MM/DD/YYYY)
1.
s
2.
3.
4.
2.7 Have appropriate permits/clearances concerning other federal/state requirements been obtained?Briefly explain your
response.
❑ Yes ❑ No ❑ None required or applicable
Explanation:
Page 5

NPDES Permit Number Facility Name Modified Application Form 2A
NC0068918 Cedar Hill WWTP Modified March 2021
SECTION 3.INFORMATION ON EFFLUENT DISCHARGES(40 CFR 122.21(j)(3)to(5))
3.1 Provide the following information for each outfall.(Attach additional sheets if you have more than three outfalls.)
Outfall Number an Outfall Number Outfall Number
State NC
County Jackson
'
0 City or town Cashiers
0
c Distance from shore ft. ft. ft.
a.
d Depth below surface ft. ft. ft.
0
Average daily flow rate 0.002713 mgd mgd mgd
Latitude 35° 08' 03" ° ° '
Longitude 83° 04' 14" ° ° "
3.2 Do any of the outfalls described under Item 3.1 have seasonal or periodic discharges?
o ❑ Yes ❑✓ No 4 SKIP to Item 3.4.
d
r 3.3 If so,provide the following information for each applicable outfall.
s
w Outfall Number Outfall Number Outfall Number
Number of times per year
0 discharge occurs
a Average duration of each
`o discharge(specify units) I
oAverage flow of each mgd mgd mgd
en discharge
in Months in which discharge
occurs
3.4 Are any of the outfalls listed under Item 3.1 equipped with a diffuser?
❑ Yes ❑✓ No-4 SKIP to Item 3.6.
a, 3.5 Briefly describe the diffuser taupe at each applicable outfall.
,T Outfall Number Outfall Number Outfall Number
ao
co
t, vi 3.6 Does the treatment works discharge or plan to discharge wastewater to waters of the State of North Carolina from
m one or more discharge points?
`" r ❑ Yes ❑✓ No-SKIP to Section 6.
Page 6

NPDES Permit Number Facility Name Modified Application Form 2A
NC0068918 Cedar Hill WWTP Modified March 2021
3.7 Provide the receiving water and related information(if known)for each outfall.
Outfall Number 001 Outfall Number Outfall Number
Receiving water name Horsepasture River
Name of watershed,river,
0
or stream system Savannah River Basin
E. U.S.Soil Conservation
N Service 14-digit watershed
a) code
R Name of state
management/river basin
co
c U.S.Geological Survey
a 8-digit hydrologic
ce cataloging unit code
Critical low flow(acute) cfs cfs cfs
Critical low flow(chronic) cfs cfs cfs
Total hardness at critical mg/L of mg/L of mg/L of
low flow CaCO3 CaCO3 CaCO3
3.8 Provide the following information describing the treatment provided for discharges from each outfall.
Outfall Number 001 Outfall Number Outfall Number
Highest Level of 0 Primary 0 Primary ❑ Primary
Treatment(check all that 0 Equivalent to 0 Equivalent to 0 Equivalent to
apply per outfall) secondary secondary secondary
O Secondary 0 Secondary 0 Secondary
❑ Advanced 0 Advanced 0 Advanced
❑ Other(specify) 0 Other(specify) 0 Other(specify)
c
'a Design Removal Rates by
O Outfall
N
G)
o BOD5 or CBOD5
d 1
co
CI) TSS % % %
it
❑ Not applicable 0 Not applicable 0 Not applicable
Phosphorus %
0 Not applicable 0 Not applicable 0 Not applicable
Nitrogen aka
Other(specify) 0 Not applicable 0 Not applicable 0 Not applicable
Page 7

NPDES Permit Number Facility Name Modified Application Form 2A
NC0068918 Cedar Hill WWTP Modified March 2021
3.9 Describe the type of disinfection used for the effluent from each outfall in the table below. If disinfection varies by
season,describe below.
v
w
0
Outfall Number Doi Outfall Number Outfall Number
0
Disinfection type Tablet Chlorine
N
N
Seasons used
d
Dechlorination used? ❑ Not applicable El Not applicable ❑ Not applicable
❑✓ Yes El Yes El Yes
El No El No El No
3.10 Have you completed monitoring for all Table A parameters and attached the results to the application package?
✓❑ Yes El No
3.11 Have you conducted any WET tests during the 4.5 years prior to the date of the application on any of the facility's
discharges or on any receiving water near the discharge points?
El Yes ❑✓ No 4 SKIP to Item 3.13.
3.12 Indicate the number of acute and chronic WET tests conducted since the last permit reissuance of the facility's
discharges by outfall number or of the receiving water near the discharge points.
Outfall Number Outfall Number Outfall Number
Acute Chronic Acute Chronic Acute Chronic
ro
rn
Number of tests of discharge
water
Number of tests of receiving
water
d
3.14 Does the POTW use chlorine for disinfection,use chlorine elsewhere in the treatment process,or otherwise have
reasonable potential to discharge chlorine in its effluent?
❑✓ Yes 4 Complete Table B,including chlorine. El No 4 Complete Table B,omitting chlorine.
3.15 Have you completed monitoring for all applicable Table B pollutants and attached the results to this application
package?
❑✓ Yes El No
Have you completed monitoring for all applicable Table D pollutants required by your NPDES permitting authority and
3.18 attached the results to this application package?
❑✓ Yes ❑ No additional sampling required by NPDES
permitting authority.
Page 8

NPDES Permit Number Facility Name Modified Application Form 2A
NC0068918 Cedar Hill WWTP Modified March 2021
3.19 Has the POTW conducted either(1)minimum of four quarterly WET tests for one year preceding this permit application
or(2)at least four annual WET tests in the past 4.5 years?
❑ Yes ❑ No 4 Complete tests and Table E and SKIP to
Item 3.26.
3.20 Haveyou previouslysubmitted the results of the above tests to your NPDES permitting authority?
El Yes ❑ No 4 Provide results in Table E and SKIP to
Item 3.26.
3.21 Indicate the dates the data were submitted to
your NPDES permitting authority and provide a summary of the results.
Date(s)Submitted
(MMIDDIYYYY) Summary of Results
-a
c
.0
0
w 3.22 Regardless of how you provided your WET testing data to the NPDES permitting authority,did any of the tests result in
toxicity?
❑ Yes ❑✓ No-4 SKIP to Item 3.26.
3.23 Describe the cause(s)of the toxicity:
d
w
3.24 Has the treatment works conducted a toxicity reduction evaluation?
❑ Yes ❑✓ No 4 SKIP to Item 3.26.
3.25 Provide details of any toxicity reduction evaluations conducted.
3,26 Have you completed Table E for all applicable outfalls and attached the results to the application package?
❑ Yes ❑ Not applicable because previously submitted
information to the NPDES ermittin authori .
•
Page 9

•
NPDES Permit Number Facility Name Modified Application Form 2A
NC0068918 Cedar Hill WWTP Modified March 2021
SECTION 6.CI ECKLIST AND CERTIFICATION STATEMENT(40 CFR 122.22(a)and(d))
6.1 In Column 1 below,mark the sections of Form 2A that you have completed and are submitting with your application. For
each section,specify in Column 2 any attachments that you are enclosing to alert the permitting authority.Note that not
all applicants are required to provide attachments.
Column 1 Column 2
❑ Section 1: Basic Application ❑ wl variance request(s) 0 w/additional attachments
Information for All Applicants
❑ Section 2:Additional ❑✓ w/topographic map ❑ w/process flow diagram
Information
0 wl additional attachments
© w/Table A 0 wl Table D
❑✓ Section 3:Information on © w/Table B 0 wl additional attachments
d Effluent Discharges
1 0 w/Table C
CU
55 Section 4:Not Applicable
c
0
is
Section 5:Not Applicable
0
U
❑✓ Section 6:Checklist andc ❑ w/attachments
w
Certification Statement
H
.Y 6.2 Certification Statement
0
di
/certify under penalty of law that this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that qualified personnel properly gather and evaluate the information
submitted.Based on my inquiry of the person or persons who manage the system,or those persons directly responsible
for gathering the information,the information submitted is,to the best of my knowledge and belief,true,accurate,and
complete.I am aware that there are significant penalties for submitting false information,including the possibility of fine
and imprisonment for knowing violations.
Name(print or t\y��e first and last name) Official title
'belkySi ture Date signed f'k, 5 Ra �/RP
Page 10

NPDES Permit Number Facility Name Outfall Number Modified Application Form 2A
Modified March 2021
NC0068918 Cedar Hill WWTP 001
TABLE A.EFFLUENT PARAMETERS FOR ALL POTWS
Maximum Daily Discharge Average Daily Discharge Analytical ML or MDL
Pollutant Number of Methods include units
Value Units Value Units Samples Methods (
)
Biochemical oxygen demand
ii BODs or❑CBODs 52.9 mg/L 9.62 mg/L 156 SM 5210B ❑ML
❑MDL
(report one)
Fecal coliform 600 CFU/100mL 4.87 CFU/mL 156 SM 9222D ❑ML
0 MDL
Design flow rate 0.065000 mgd 0.002713 mgd 1096
pH(minimum) 6.6 su
pH(maximum) 7.4 su
Temperature(winter) 17.0 Deg C 8.2 Deg C 311
Temperature(summer) 22.1 Deg C 15.8 Deg C 449
Total suspended solids(TSS) 33.3 mg/L 8.69 mg/L 155 SM 2540D ❑ML
❑MDL
1 Sampling shall be conducted according to sufficiently sensitive test procedures(i.e.,methods)approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter I,subchapter N or 0.See instructions and 40 CFR 122.21(e)(3).
Page 11

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Modified Application Form 2A
NC0068918 Cedar Hill WWTP 001 Modified March 2021
TABLE B.EFFLUENT PARAMETERS FOR ALL POTWS WITH A FLOW EQUAL TO OR GREATER THAN 0.1 MGD
Maximum Daily Discharge Average Daily Discharge Analytical ML or MDL
Pollutant Number of
Value Units Value Units Method"' (include units)
Samples
Ammonia(as N) 26 mg/L 2.15 mg/L 158 EPA 350.1 ID ML
❑MDL
Chlorine 0 ML
(total residual,TRC)2 19.9 ug/L 12.35 ug/L 310 ❑MDL
Dissolved oxygen 0 ML
0 MDL
Nitrate/nitrite 0 ML
❑MDL
Kjeldahl nitrogen ❑ML
0 MDL
Oil and grease 0 ML
❑MDL
Phosphorus 5.5 mg/L 3.6 mg/L 7 EPA 365.1 Rev 2.0 ❑ML
❑MDL
Total dissolved solids ❑ML
0 MDL
1 Sampling shall be conducted according to sufficiently sensitive test procedures(i.e.,methods)approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter I,subchapter N or 0. See instructions and 40 CFR 122.21(e)(3).
2 Facilities that do not use chlorine for disinfection,do not use chlorine elsewhere in the treatment process,and have no reasonable potential to discharge chlorine in their effluent are not
required to report data for chlorine.
•
EPA Form 3510-2A(Revised 3-19) Page 12

NPDES Permit Number Facility Name Outfall Number Modified Application Form 2A
NC0068918 Modified March 2021
Cedar Hill WWTP 001
TABLE D.ADDITIONAL POLLUTANTS AS REQUIRED BY NPDES PERMITTING AUTHORITY
Maximum Daily Discharge Average Daily Dischar e
Pollutant Analytical ML or MDL
(list) Value Units Value Units Number of Method"' (include units)
Samples
❑ No additional sampling is required by NPDES permitting authority.
Total Nitrogen 30.0 mg/L 20.91 mg/L 7 TKN+NO3+NO2 Calci ❑ML
❑MDL
❑ML
❑MDL
0 ML
❑MDL
❑ML
❑MDL
•
❑ML
0 MDL
0 ML
❑MDL
❑ML
❑MDL
0 ML
❑MDL
❑ML
❑MDL
❑ML
❑MDL
❑ML
❑MDL
0 ML
❑MDL
❑ML
❑MDL
❑ML
❑MDL
0 ML
❑MDL
❑ML
❑MDL
❑ML
❑MDL
I Sampling shall be conducted according to sufficiently sensitive test procedures(i.e.,methods)approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or required
under 40 CFR chapter I,subchapter N or 0.See instructions and 40 CFR 122.21(e)(3).
Page 18