NC0069761_Renewal (Application)_20220401

STATE Q;
1r;
ROY COOPER "(
Governor
ELIZABETH S.BISER
Secretary QOAN
RICHARD E.ROGERS,JR. NORTH CAROLINA
Director - -- Environmental Quality
April 04, 2022
Town of Beech Mountain
Attn: Daniel Davis, Utilities Director
510 Beech Mountain Pkwy
Beech Mountain, NC 28604
Subject: Permit Renewal
Application No. NC0069761
Pond Creek WWTP
Watauga County
Dear Applicant:
The Water Quality Permitting Section acknowledges the April 1, 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. 150E-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,
,an
Wren Thedford
Administrative Assistant
Water Quality Permitting Section
ec: WQPS Laserfiche File w/application
E Q1), North Carolina Department of Environmental Quality I Division of Water Resources
Winston-Salem Regional Office 1450 West Nanes Mill Road Sulte 300(Winston-Salem,North Carolina 27105
»+*»* M��^+D 336.776.9800

United States Office of Water EPA Form 3510-2A
Environmental Protection Agency Washington,D.C. Revised March 2019
Water Permits Division
EPA Application Form 2A
New and Existing Publicly
Owned Treatment Works
NPDES Permitting Program
RECEIVED
APR 012022
NCDEQIDWRINPDES
Note: Complete this form if your facility is a new or existing publicly owned treatment works.

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
110069999274 NC0069761 Pond Creek WWTP OMB No.2040-0004
Form U.S.Environmental Protection Agency
2A &EPA Application for NPDES Permit to Discharge Wastewater
NPDES NEW AND EXISTING PUBLICLY OWNED TREATMENT WORKS
SECTION 1.BASIC APPLICATION INFORMATION FOR ALL APPLICANTS(40 CFR 122.21(j)(1)and(9))
1.1 Facility name
Pond Creek Wastewater Treatment Plant
Mailing address(street or P.O.box)
403 Beech Mountain Parkway
City or town State ZIP code
o Beech Mountain North Carolina 28604
Contact name(first and last) Title Phone number Email address
8 Randall Homey Chief Plant Operator [phone] rhorney@townofbeechmount
Location address(street,route number,or other specific identifier) ❑ Same as mailing address
364 Locust Ridge Rd
City or town State ZIP code
Beech Mountain North Carolina 28604
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
Town of Beech Mountain
Applicant address(street or P.O.box)
403 Beech Mountain Parkway
0 City or town State ZIP code
Beech Mountain North Carolina 28604
Contact name(first and last) Title Phone number Email address
Daniel Davis Utilities Director [phone] bmus@townofbeechmountain
1.4 Is the applicant the facility's owner,operator,or both?(Check only one response.)
0 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
water) control)
NC0069761
o ❑ PSD(air emissions) 0 Nonattainment program(CM) 0 NESHAPs(CM)
rn
N ❑ Ocean dumping(MPRSA) 0 Dredge or fill(CWA Section 0 Other(specify)
404)
EPA Form 3510-2A(Revised 3-19) Page 1

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
110069999274 NC0069761 Pond Creek WWTP OMB No.2040-0004
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 ❑ Own ❑ Maintain
13 %Town of Beech 1769 service
a� combined storm and sanitary sewer 0 Own ❑ Maintain
m Mountain connections ❑ Unknown ❑ Own ❑ Maintain
c %separate sanitary sewer ❑ Own El Maintain
o %combined storm and sanitary sewer ❑ Own ❑ Maintain
❑ Unknown 0 Own 0 Maintain
n %separate sanitary sewer CI ❑ Maintain
%combined storm and sanitary sewer ❑ Own ❑ Maintain
'° ❑ Unknown 0 Own ❑ Maintain
E o
/o separate sanitary sewer ❑ Own ❑ Maintain
>, %combined storm and sanitary sewer ❑ Own 0 Maintain
U)
c ❑ Unknown ❑ Own 0 Maintain
g Total
co Population 1769
TD
ci Served
Separate Sanitary Sewer System Combined Storm and
Sanitary Sewer
Total percentage of each type of
sewer line(in miles) 100
?' 1.8 Is the treatment works located in Indian Country?
o ❑ Yes ❑✓ No
U
c 1.9 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
0.400 mgd
= y Annual Average Flow Rates(Actual)
a�a Two Years Ago Last Year This Year
c
Co 0.226 mgd 0.234 mgd 0.193 mgd
c" Maximum Daily Flow Rates(Actual)
o Two Years Ago Last Year This Year
1.027 mgd 2.798 mgd o.s10 mgd
to1.11 Provide the total number of effluent discharge points to waters of the United States by type.
o Total Number of Effluent Discharge Points by Type
a- at Constructed
Treated Effluent Untreated Effluent Combined Sewer
a�H
Bypasses Emergency
U .a Overflows Overflows
u)
1
EPA Form 3510-2A(Revised 3-19) Page 2

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
110069999274 NC0069761 Pond Creek WWTP OMB No.2040-0004
Outfalls Other Than to Waters of the United States
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 United States?
❑ 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 ❑ Intermittent
O Continuous
gpd 0 Intermittent
0 Continuous
tn
gpd ❑ Intermittent
2 1.14 Is wastewater applied to land?
❑ Yes ❑✓ No 4 SKIP to Item 1.16.
0 1.15 Provide the land application site and discharge data requested below.
0 Land Application Site and Discharge Data
o Continuous or
Location Size Average Daily Volume Intermittent
Applied (check one)
acres d ❑ Continuous
o gp 0 Intermittent
d ❑ Continuous
acres
gp 0 Intermittent
-a 0 Continuous
acres gpd ❑ Intermittent
7,3 1.16 Is effluent transported to another facility for treatment prior to discharge?
❑ Yes m 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
EPA Form 3510-2A(Revised 3-19) Page 3

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
110069999274 NC0069761 Pond Creek WWTP OMB No.2040-0004
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
-a Facility name Mailing address(street or P.O.box)
City or town State ZIP code
0
Contact name(first and last) Title
0
Phone number Email address
o0 NPDES number of receiving facility(if any) ❑ None
Average daily flow rate mgd
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 United States(e.g.,underground percolation,underground injection)?
L ElYes ❑✓ No 4 SKIP to Item 1.23.
0 1.22 Provide information in the table below on these other disposal methods.
Information on Other Disposal Methods
oDisposal Location of Size of Annual Average Continuous or Intermittent
Method Disposal Site Disposal Site Daily Discharge (check one)
Description Volume
0 Continuous
acres gpd ❑ Intermittent
0 Continuous
acres gpd ❑ Intermittent
acresgpd ❑ 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.
0 r Consult with your NPDES permitting authority to determine what information needs to be submitted and when.)
❑ Discharges into marine waters(CWA ❑ Water quality related effluent limitation(CWA Section
ca 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
(company name)
Mailing address
(street or P.O.box)
City,state,and ZIP
code
• Contact name(first and
0 last)
Phone number
Email address
Operational and
maintenance
responsibilities of
contractor
EPA Form 3510-2A(Revised 3-19) Page 4

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
110069999274 NC0069761 Pond Creek WTP OMB No.2040-0004
W
SECTION 2.ADDITIONAL INFORMATION(40 CFR 122.21(j)(1)and(2))
c Outfalls to Waters of the United States
2.1 Does the treatment works have a design flow greater than or equal to 0.1 mgd?
❑✓ Yes El 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
.1 and infiltration.
unk gpd
Indicate the steps the facility is taking to minimize inflow and infiltration.
Due to the seasonal nature of the fluctuation of population served by our system,there is no measure in place for
quantifying I&I. We are working to improve I&I within our system by conducting regular camera inspections of sewer
lines as well as State funded collection system infrastructure projects.
s 2.3 Have you attached a topographic map to this application that contains all the required information?(See instructions for
0 Q specific requirements.)
0)
0
ro ❑✓ Yes ❑ No
E 2.4 Have you attached a process flow diagram or schematic to this application that contains all the required information?
0
Es (See instructions for specific requirements.)
" ElYes ❑ No
2.5 Are improvements to the facility scheduled?
❑ Yes ❑✓ No 4 SKIP to Section 3.
Briefly list and describe the scheduled improvements.
0
<NsC
1.
C)
E
0)
2.
E
0
3.
4.
c. 2.6 Provide scheduled or actual dates of completion for improvements.
Scheduled or Actual Dates of Completion for Improvements
°' Affected Attainment of
m 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)
z 1.
a
U 2
cn
3.
4.
2.7 Have appropriate permits/clearances concerning other federal/state requirements been obtained?Briefly explain your
response.
❑ Yes ❑ No ❑ None required or applicable
Explanation:
EPA Form 3510-2A(Revised 3-19) Page 5

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
110069999274 NC0069761 Pond Creek WWTP OMB No.2040-0004
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 North Carolina
H
County Watauga
o City or town Beech Mountain
O"
s Distance from shore ft. ft. ft.
a
d Depth below surface ft. ft. ft.
� I
Average daily flow rate 0.218 mgd mgd mgd
Latitude 36° 12' 49" N °
Longitude 81° 52' 30" W "
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.
23)
3.3 If so,provide the following information for each applicable outfall.
y Outfall Number Outfall Number Outfall Number
0
Number of times per year
s discharge occurs
a Average duration of each
`o discharge(specify units)
Average flow of each
discharge mgd mgd mgd
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.
n.
Outfall Number Outfall Number Outfall Number
N
1-6
ui 3.6 Does the treatment works discharge or plan to discharge wastewater to waters of the United States from one or more
discharge points?
w ❑✓ Yes ❑ No 4SKIP to Section 6.
EPA Form 3510-2A(Revised 3-19) Page 6

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
110069999274 NC0069761 Pond Creek WWTP OMB No.2040-0004
3.7 Provide the receiving water and related information(if known)for each outfall.
Outfall Number 001 Outfall Number Outfall Number
Receiving water name Pond Creek
Name of watershed,river,
a or stream system Beech Creek-Watauga River
E- U.S.Soil Conservation
Service 14-digit watershed
code
0 Name of state
management/river basin Watauga Lake-Watauga River
U.S.Geological Survey
8-digit hydrologic 06010103
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 ❑ Primary ❑ Primary
Treatment(check all that El Equivalent to ❑ Equivalent to ❑ Equivalent to
apply per outfall) secondary secondary secondary
0 Secondary ❑ Secondary ❑ Secondary
❑ Advanced ❑ Advanced ❑ Advanced
El Other(specify) ❑ Other(specify) 0 Other(specify)
0
Design Removal Rates by
U,
Outfall
ok
BOD5 or CBOD5 85
TSS 85 %
F`-
0 Not applicable ❑Not applicable ❑Not applicable
Phosphorus °/o
0 Not applicable 0 Not applicable El Not applicable
Nitrogen
Other(specify) 0 Not applicable ❑ Not applicable El Not applicable
EPA Form 3510-2A(Revised 3-19) Page 7

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
110069999274 NC0069761 Pond Creek WWTP OMB No.2040-0004
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.
Extended aeration with UV disinfection
TRC 28 ug/L on demand
c
Outfall Number UV Outfall Number I Outfall Number
Disinfection type
Ultraviolet Light
v,
Seasons used
All
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?
✓❑ 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 001 Outfall Number Outfall Number
Acute
Acute Chronic Acute Chronic o c Chronic
Number of tests of discharge 20
water
Number of tests of receiving
water
3.13 Does the treatment works have a design flow greater than or equal to 0.1 mgd?
❑✓ Yes ❑ No 4 SKIP to Item 3.16.
0 3.14 Does the POTW use chlorine for disinfection,use chlorine elsewhere in the treatment process,or otherwise have
reasonablepotential to discharge chlorine in its effluent?
9
❑ Yes—) 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?
w ❑✓ Yes ❑ No
3.16 Does one or more of the following conditions apply?
• The facility has a design flow greater than or equal to 1 mgd.
• The POTW has an approved pretreatment program or is required to develop such a program.
• The NPDES permitting authority has informed the POTW that it must sample for the parameters in Table C,must
sample other additional parameters(Table D),or submit the results of WET tests for acute or chronic toxicity for
each of its discharge outfalls(Table E).
❑ Yes 4 Complete Tables C, D,and E as ❑ No SKIP to Section 4.
applicable.
3.17 Have you completed monitoring for all applicable Table C pollutants and attached the results to this application
package?
✓❑ Yes ❑ No
3.18 Have you completed monitoring for all applicable Table D pollutants required by your NPDES permitting authority and
attached the results to this application package?
❑✓ Yes 0 No additional sampling required by NPDES
permitting authority.
EPA Form 3510-2A(Revised 3-19) Page 8

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
110069999274 NC0069761 Pond Creek WWTP OMB No.2040-0004
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?
El 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
(MM/DD/YYYY)
of
c
c
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:
C,
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. authorit .
SECTION 4.INDUSTRIAL DISCHARGES AND HAZARDOUS WASTES(40 CFR 122.21(j)(6)and(7))
4.1 Does the POTW receive discharges from SIUs or NSCIUs?
❑ Yes ❑✓ No- SKIP to Item 4.7.
4.2 Indicate the number of SIUs and NSCIUs that discharge to the POTW.
R Number of SIUs Number of NSCIUs
N
2 4.3 Does the POTW have an approved pretreatment program?
_ ❑ Yes ❑ No
g 4.4 Have you submitted either of the following to the NPDES permitting authority that contains information substantially
identical to that required in Table F:(1)a pretreatment program annual report submitted within one year of the
application or(2)a pretreatment program?
y ❑ Yes ❑ No 4 SKIP to Item 4.6.
o 4.5 Identify the title and date of the annual report or pretreatment program referenced in Item 4.4.SKIP to Item 4.7.
N
c 4.6 Have you completed and attached Table F to this application package?
❑ Yes ❑ No
EPA Form 3510-2A(Revised 3-19) Page 9

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
110069999274 NC0069761 Pond Creek WWTP OMB No.2040-0004
4.7 Does the POTW receive,or has it been notified that it will receive, by truck,rail,or dedicated pipe,any wastes that are
regulated as RCRA hazardous wastes pursuant to 40 CFR 261?
❑ Yes ❑✓ No 4 SKIP to Item 4.9.
4.8 If yes,provide the following information:
Annual
Hazardous Waste Waste Transport Method Amount of Units
Number (check all that apply) Waste
Received
❑ Truck 0 Rail
❑ Dedicated pipe ❑ Other(specify)
0
—
C ❑ Truck 0 Rail
❑ Dedicated pipe ❑ Other(specify)
ro ❑ Truck 0 Rail
_ ❑ Dedicated pipe ❑ Other(specify)
so
L4.9 Does the POTW receive,or has it been notified that it will receive,wastewaters that originate from remedial activities,
including those undertaken pursuant to CERCLA and Sections 3004(7)or 3008(h)of RCRA?
❑ Yes ❑✓ No 4 SKIP to Section 5.
.L
4.10 Does the POTW receive(or expect to receive)less than 15 kilograms per month of non-acute hazardous wastes as
specified in 40 CFR 261.30(d)and 261.33(e)?
❑ Yes 4 SKIP to Section 5. 0 No
4.11 Have you reported the following information in an attachment to this application:identification and description of the
site(s)or facility(ies)at which the wastewater originates;the identities of the wastewater's hazardous constituents;and
the extent of treatment,if any,the wastewater receives or will receive before entering the POTW?
❑ Yes ❑ No
SECTION 5.COMBINED SEWER OVERFLOWS(40 CFR 122.21(j)(8))
5.1 Does the treatment works have a combined sewer system?
a) ❑ Yes ❑✓ No 4SKIP to Section 6.
co
5.2 Have you attached a CSO system map to this application?(See instructions for map requirements.)
c
a ❑ Yes ❑ No
5.3 Have you attached a CSO system diagram to this application?(See instructions for diagram requirements.)
co
o ElYes ❑ No
EPA Form 3510-2A(Revised 3-19) Page 10

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
110069999274 NC0069761 Pond Creek WWTP OMB No.2040-0004
5.4 For each CSO outfall,provide the following information.(Attach additional sheets as necessary.)
CSO Outfall Number_ CSO Outfall Number CSO Outfall Number
City or town
0
State and ZIP code
U
Y/
o County
co
o Latitude " °
0
U
Longitude "
Distance from shore ft. ft. ft.
Depth below surface ft. ft. ft.
5.5 Did the POTW monitor any of the following items in the past year for its CSO outfalls?
CSO Outfall Number CSO Outfall Number CSO Outfall Number
Rainfall 0 Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No
c
`o CSO flow volume ❑ Yes ❑ No ❑ Yes ❑ No 0 Yes ❑ No
ec
CSO pollutant ❑ Yes ❑ No ❑ Yes ❑ No 0 Yes ❑ No
o concentrations
co
0 Receiving water quality ❑ Yes ❑ No ❑ Yes ❑ No 0 Yes ❑ No
CSO frequency ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No
Number of storm events ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No
5.6 Provide the following information for each of your CSO outfalls.
CSO Outfall Number CSO Outfall Number CSO Outfall Number
co
Number of CSO events in events events events
en the past year
a
c Average duration per hours hours hours
event ❑Actual or 0 Estimated 0 Actual or❑Estimated ❑Actual or❑Estimated
N
w'
o Average volume per event million gallons million gallons million gallons
co
c) ❑Actual or 0 Estimated ❑Actual or❑Estimated ❑Actual or❑Estimated
Minimum rainfall causing inches of rainfall inches of rainfall inches of rainfall
a CSO event in last year ❑Actual or❑ Estimated ❑Actual or❑ Estimated ❑Actual or❑ Estimated
EPA Form 3510-2A(Revised 3-19) Page 11

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
110069999274 NC0069761 Pond Creek WWTP OMB No.2040-0004
5.7 Provide the information in the table below for each of your CSO outfalls.
CSO Outfall Number CSO Outfall Number CSO Outfall Number
Receiving water name
Name of watershed/
stream system
U.S.Soil Conservation ❑ Unknown 0 Unknown 0 Unknown
Service 14-digit
watershed code
> (if known)
Name of state
ce management/river basin
co U.S.Geological Survey 0 Unknown 0 Unknown 0 Unknown
8-Digit Hydrologic Unit
Code(if known)
Description of known
water quality impacts on
receiving stream by CSO
(see instructions for
exam.les
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
Information for All Applicants ❑ w/variance request(s) ❑ w/additional attachments
❑ Section 2:Additional ✓❑ w/topographic map ❑✓ w/process flow diagram
Information
❑ w/additional attachments
❑✓ w/Table A ❑ w/Table D
❑ Section 3:Information on ❑ w/Table B ❑✓ w/Table E
Effluent Discharges
E ❑ w/Table C ❑ w/additional attachments
Section 4:Industrial ❑ w/SIU and NSCIU attachments ❑ w/Table F
N ❑ Discharges and Hazardous
s Wastes ❑ w/additional attachments
❑ Section 5:Combined Sewer ❑ w/CSO map ❑ w/additional attachments
Overflows ❑ w/CSO system diagram
❑ Section 6:Checklist and ❑ w/attachments
Certification Statement
Y 6.2 Certification Statement
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. 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
Daniel Davis Director of Utilities
Signature Date signed
/g.17/W 17___
EPA Form 3510-2A(Revised 3-19) Page 12

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
110069999274 NC0069761 Pond Creek WWTP 001 OMB No.2040-0004
TABLE A.EFFLUENT PARAMETERS FOR ALL POTWS
Maximum Daily Discharge Average Daily Discharge Analytical ML or MDL
Pollutant
Value Units Value Units Number of Method' (include units)
Sam.les
Biochemical oxygen demand
©BODS or❑CBOD5 43.3 mg/I 8.13 mg/I 52 SM5210B ❑ML
❑MDL
resort one
Fecal coliform 260 #/100 ml 7.02 #/100 ml 52 SM9222D ❑ML
0 MDL
Design flow rate 0.81 mgd 0.19 mgd 365
pH(minimum) 6.1 su
pH(maximum) 7.1 su
Temperature(winter) 11 Celsius 7.89 Celsius 90
Temperature(summer) 21 Celsius 17.86 Celsius 90
Total suspended solids(TSS) 15 mg/I 3.89 mg/I 52 SM2540D ❑ML
❑MDL
1 Sampling shall be conducted according to sufficiently sensitive test procedures(i.e., methods)approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter I,subchapter N or 0.See instructions and 40 CFR 122.21(e)(3).
EPA Form 3510-2A(Revised 3-19) Page 13

This page intentionally left blank.

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
110069999274 NC0069761 Pond Creek WWTP 1 OMB No.2040-0004
an
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
Value Units Value Units Number of Method1 (include units)
Samples
Ammonia(as N) 3.53 mg/I 2.33 mg/I 3 SM4500CIG-2000 ❑ML
ID MDL
Chlorine
❑ML
(total residual,TRC)2 ❑MDL
Dissolved oxygen 10.3 mg/I 7.76 mg/I 28 YSI550A ID ML
❑MDL
Nitrate/nitrite 13.0 mg/I 7.67 mg/I 3 .100SM4500NO3 ID ML
❑MDL
Kjeldahl nitrogen 23.2 mg/I 10.9 mg/I 3 .140SM4500ORGB ID ML
❑MDL
Oil and grease ID ML
0 MDL
Phosphorus 3.16 mg/I 2.30 mg/I 3 .160SM4500PE ID ML
❑MDL
Total dissolved solids ID 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).
2 Facilities that do not use chlorine for disinfection,do not use chlorine elsewhere in the treatment process,and have no reasonable potential to discharge chlorine in their effluent are not
required to report data for chlorine.
EPA Form 3510-2A(Revised 3-19) Page 15

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
110069999274 NC0069761 Pond Creek WWTP 001 OMB No.2040-0004
TABLE E. EFFLUENT MONITORING FOR WHOLE EFFLUENT TOXICITY
The table provides response space for one whole effluent toxicity sample.Copy the table to report additional test results.
Test Information
Test Number 1 Test Number 1 Test Number 1
Test species Ceriodaphnia dubia Ceriodaphnia dubia Ceriodaphnia dubia
Age at initiation of test <24 hrs <24 hrs <24 hrs
Outfall number 001 001 o01
Date sample collected 04/10/2017 07/10/2017 10/09/2017
Date test started 04/12/2017 07/12/2017 10/11/2017
Duration 24 hours 24 hours 24 hours
Toxicity Test Methods
Test method number 1002.0 1002.0 1002.0
Manual title Short-term methods for estimating the chronic Short-term methods for estimating the chrorp Short-term methods for estimating the chrorp
Edition number and year of publication 4th Edition-2002 4th Edition-2002 4th Edition-2002
Page number(s) 141-189 141-189 141-189
Sample Type
Check one: ❑ Grab ❑ Grab 0 Grab
❑✓ 24-hour composite ❑✓ 24-hour composite ❑✓ 24-hour composite
Sample Location
Check one: 0 Before Disinfection ❑ Before Disinfection ❑ Before disinfection
❑✓ After Disinfection ❑✓ After Disinfection ❑✓ After disinfection
❑ After Dechlorination ❑ After Dechlorination 0 After dechlorination
Point in Treatment Process
Describe the point in the treatment process Effluent Effluent
at which the sample was collected for each Effluent
test.
Toxicity Type
Indicate for each test whether the test was 0 Acute i ❑Acute 0 Acute
performed to asses acute or chronic toxicity, ✓❑ Chronic ❑� Chronic ❑✓ Chronic
or both.(Check one response.)
❑ Both ❑ Both ❑ Both
EPA Form 3510-2A(Revised 3-19) Page 25

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
110069999274 NC0069761 Pond Creek WWTP 001 OMB No.2040-0004
TABLE E.EFFLUENT MONITORING FOR WHOLE EFFLUENT TOXICITY
The table provides response space for one whole effluent toxicity sample.Copy the table to report additional test results.
Test Number 1 Test Number 1 Test Number 1
Test Type
Indicate the type of test performed.(check one ❑ Static ❑ Static 0 Static
response.)
❑✓ Static-renewal ❑✓ Static-renewal ❑✓ Static-renewal
❑ Flow-through 0 Flow-through 0 Flow-through
Source of Dilution Water
Indicate the source of dilution water.(check ❑✓ Laboratory water 0 Laboratory water ❑✓ Laboratory water
one response.)
❑ Receiving water 0 Receiving water 0 Receiving water
If laboratory water,specify type.
If receiving water,specify source.
Type of Dilution Water
Indicate the type of dilution water. If salt ❑✓ Fresh water ❑✓ Fresh water ❑✓ Fresh water
water,specify"natural"or type of artificial
sea salts or brine used. ElSalt water(specify) ElSalt water(specify) ❑ Salt water(specify)
Percentage Effluent Used
Specify the percentage effluent used for all
concentrations in the test series. 51% 51% 51%
Parameters Tested
Check the parameters tested. 0 pH ❑ Ammonia ❑✓ pH 0 Ammonia 0 pH 0 Ammonia
0 Salinity 0 Dissolved oxygen 0 Salinity 0 Dissolved oxygen 0 Salinity 0 Dissolved oxygen
❑ Temperature 0 Temperature ❑ Temperature
Acute Test Results
Percent survival in 100%effluent N/A % N/A % N/A To
LC5o N/A N/A N/A
95%confidence interval N/A % N/A % N/A %
Control percent survival N/A % N/A % N/A %
EPA Form 3510-2A(Revised 3-19) Page 26

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
110069999274 NC0069761 Pond Creek WWTP 001 OMB No.2040-0004
TABLE E.EFFLUENT MONITORING FOR WHOLE EFFLUENT TOXICITY
The table provides response space for one whole effluent toxicity sample.Copy the table to report additional test results.
Test Number 1 Test Number 1 Test Number 1
Acute Test Results Continued
Other(describe) N/A N/A N/A
Chronic Test Results
NOEC >iwc % >iwc % >IWC %
IC25 % % %
Control percent survival 10o % 100 % 100 %
Other(describe)
Pass Pass Pass
Quality ControllQuality Assurance
Is reference toxicant data available? ❑✓ Yes ❑ No 0 Yes 0 No 0 Yes 0 No
Was reference toxicant test within
acceptable bounds? 0 Yes 0 No ❑✓ Yes ElNo 0 Yes 0 No
What date was reference toxicant test run
(MM/DD/YYYY)?
Other(describe)
Within two weeks of test Within two weeks of test Within two weeks of test
EPA Form 3510-2A(Revised 3-19) Page 27

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
110069999274 NC0069761 Pond Creek WWTP 001 0MBNo.2040-0004
TABLE E.EFFLUENT MONITORING FOR WHOLE EFFLUENT TOXICITY
The table provides response space for one whole effluent toxicity sample.Copy the table to report additional test results.
Test Information
Test Number 1 Test Number 1 Test Number 1
Test species Ceriodaphnia dubia Ceriodaphnia dubia Ceriodaphnia dubia
Age at initiation of test <24 hrs <24 hrs <24 hrs
Outfall number 00i 001 001
Date sample collected 04/02/2018 07/16/2018 10/08/2018
Date test started 04/04/2018 07/18/2018 10/10/2018
Duration 24 hours 24 hours 24 hours
Toxicity Test Methods
Test method number 1002.0 1002.0 1002.0
Manual title Short-term methods for estimating the chronic Short-term methods for estimating the chror0 Short-term methods for estimating the chrorE
Edition number and year of publication 4th Edition-2002 4th Edition-2002 4th Edition-2002
Page number(s) 141-189 141-189 141-189
Sample Type
Check one: 0 Grab ❑ Grab 0 Grab
❑✓ 24-hour composite ❑✓ 24-hour composite 0 24-hour composite
Sample Location
Check one: ❑ Before Disinfection ❑ Before Disinfection ❑ Before disinfection
❑✓ After Disinfection ❑✓ After Disinfection ❑✓ After disinfection
❑ After Dechlorination ❑ After Dechlorination 0 After dechlorination
Point in Treatment Process
Describe the point in the treatment process Effluent Effluent Effluent
at which the sample was collected for each
test.
Toxicity Type
Indicate for each test whether the test was ❑Acute 0 Acute 0 Acute
performed to asses acute or chronic toxicity,
or both.(Check one response.) ❑✓ Chronic 0Chronic 0 Chronic
❑ Both 0 Both 0 Both
EPA Form 3510-2A(Revised 3-19) Page 25

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
110069999274 NC0069761 Pond Creek WWTP 001 OMB No.2040-0004
TABLE E.EFFLUENT MONITORING FOR WHOLE EFFLUENT TOXICITY
The table provides response space for one whole effluent toxicity sample.Copy the table to report additional test results.
Test Number 1 Test Number 1 Test Number 1
Test Type
Indicate the type of test performed.(Check one ❑ Static 0 Static ❑ Static
response.)
❑✓ Static-renewal ❑✓ Static-renewal ❑✓ Static-renewal
❑ Flow-through 0 Flow-through ❑ Flow-through
Source of Dilution Water
Indicate the source of dilution water.(Check ❑✓ Laboratory water ❑✓ Laboratory water ❑✓ Laboratory water
one response.)
❑ Receiving water ❑ Receiving water 0 Receiving water
If laboratory water,specify type.
If receiving water,specify source.
Type of Dilution Water •
Indicate the type of dilution water. If salt ❑✓ Fresh water ❑✓ Fresh water ❑✓ Fresh water
water,specify"natural"or type of artificial
sea salts or brine used. ❑ Salt water(specify) ❑ Salt water(specify) ElSalt water(specify)
Percentage Effluent Used
Specify the percentage effluent used for all
concentrations in the test series. 51% 51% 51%
Parameters Tested
Check the parameters tested. ❑✓ pH 0 Ammonia ❑✓ pH 0 Ammonia ❑✓ pH 0 Ammonia
❑ Salinity 0 Dissolved oxygen 0 Salinity 0 Dissolved oxygen 0 Salinity 0 Dissolved oxygen
0 Temperature 0 Temperature 0 Temperature
Acute Test Results
Percent survival in 100%effluent N/A % N/A % N/A %
LC5o N/A N/A N/A
95%confidence interval N/A % N/A % N/A %
Control percent survival N/A % N/A % N/A %
EPA Form 3510-2A(Revised 3-19) Page 26

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
110069999274 NC0069761 Pond Creek WWTP 001 OMB No.2040-0004
TABLE E.EFFLUENT MONITORING FOR WHOLE EFFLUENT TOXICITY
The table provides response space for one whole effluent toxicity sample.Copy the table to report additional test results.
Test Number 1 Test Number 1 Test Number 1
Acute Test Results Continued
Other(describe)
N/A N/A N/A
Chronic Test Results
NOEC >IWC % >iwc % >IWC
IC25 % % %
Control percent survival 100 % 100 % 100 %
Other(describe)
Pass Pass Pass
Quality ControllQuality Assurance
Is reference toxicant data available? ❑✓ Yes ❑ No ❑ Yes 0 No 0 Yes 0 No
Was reference toxicant test within ❑✓ Yes ❑ No ❑✓ Yes 0 No ❑✓ Yes 0 No
acceptable bounds?
What date was reference toxicant test run
(MM/DD/YYYY)?
Other(describe)
Within two weeks of test Within two weeks of test Within two weeks of test
EPA Form 3510-2A(Revised 3-19) Page 27

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
110069999274 NC0069761 Pond Creek WWTP 001 OMB No.2040-0004
TABLE E. EFFLUENT MONITORING FOR WHOLE EFFLUENT TOXICITY
The table provides response space for one whole effluent toxicity sample.Copy the table to report additional test results.
Test Information
Test Number 1 Test Number 1 Test Number 1
Test species Ceriodaphnia dubia Ceriodaphnia dubia Ceriodaphnia dubia
Age at initiation of test <24 hrs <24 hrs <24 hrs
Outfall number 001 o01 o01
Date sample collected 01/07/2019 04/01/2019 07/15/2019
Date test started 01/09/2019 04/03/2019 07/17/2019
Duration 24 hours 24 hours 24 hours
Toxicity Test Methods
Test method number 1002.0 1002.0 1002.0
Manual title Short-term methods for estimating the chronic Short-term methods for estimating the chror0 Short-term methods for estimating the chror0
Edition number and year of publication 4th Edition-2002 4th Edition-2002 4th Edition-2002
Page number(s) 141-189 141-189 141-189
Sample Type
Check one: ' 0 Grab ❑ Grab ❑ Grab
❑✓ 24-hour composite 0 24-hour composite 0 24-hour composite
Sample Location
Check one: 0 Before Disinfection ❑ Before Disinfection 0 Before disinfection
0 After Disinfection 0 After Disinfection 0 After disinfection
❑ After Dechlorination ❑ After Dechlorination ❑ After dechlorination
Point in Treatment Process
Describe the point in the treatment process Effluent Effluent
at which the sample was collected for each Effluent
test.
Toxicity Type
Indicate for each test whether the test was ❑Acute 0 Acute 0 Acute
performed to asses acute or chronic toxicity,
or both.(Check one response.) ❑✓ Chronic ❑✓ Chronic 0 Chronic
❑ Both 0 Both 0 Both
EPA Form 3510-2A(Revised 3-19) Page 25

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
110069999274 NC0069761 Pond Creek WWTP 001 OMB No.2040-0004
TABLE E.EFFLUENT MONITORING FOR WHOLE EFFLUENT TOXICITY
The table provides response space for one whole effluent toxicity sample. Copy the table to report additional test results.
Test Number 1 Test Number 1 Test Number 1
Test Type
Indicate the type of test performed.(Check one ❑ Static ❑ Static 0 Static
response.)
❑✓ Static-renewal ❑✓ Static-renewal ❑✓ Static-renewal
❑ Flow-through ❑ Flow-through ❑ Flow-through
Source of Dilution Water
Indicate the source of dilution water.(Check ❑✓ Laboratory water ❑✓ Laboratory water ❑✓ Laboratory water
one response.)
❑ Receiving water ❑ Receiving water ❑ Receiving water
If laboratory water,specify type.
If receiving water,specify source.
Type of Dilution Water
Indicate the type of dilution water. If salt ❑✓ Fresh water ❑✓ Fresh water ❑✓ Fresh water
water,specify"natural"or type of artificial
sea salts or brine used. 0 Salt water(specify) 0 Salt water(specify) ElSalt water(specify)
Percentage Effluent Used
Specify the percentage effluent used for all
concentrations in the test series. 51% 51% 51%
Parameters Tested
Check the parameters tested. ❑✓ pH 0 Ammonia ❑✓ pH ❑ Ammonia ❑✓ pH ❑ Ammonia
❑ Salinity ❑ Dissolved oxygen ❑ Salinity ❑ Dissolved oxygen ❑ Salinity ❑ Dissolved oxygen
❑ Temperature ❑ Temperature ❑ Temperature
Acute Test Results
Percent survival in 100%effluent N/A % N/A % N/A
LC5o N/A N/A N/A
95%confidence interval N/A % N/A % N/A %
Control percent survival N/A % N/A % N/A %
EPA Form 3510-2A(Revised 3-19) Page 26

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
110069999274 NC0069761 Pond Creek WWTP 001 OMB No.2040-0004
TABLE E.EFFLUENT MONITORING FOR WHOLE EFFLUENT TOXICITY
The table provides response space for one whole effluent toxicity sample.Copy the table to report additional test results.
Test Number 1 Test Number 1 Test Number 1
Acute Test Results Continued
Other(describe) N/A N/A N/A
Chronic Test Results
NOEC >IWC % >IWC % >IWC %
IC25 % % %
Control percent survival 100 % 100 % 10o %
Other(describe)
Pass Pass Pass
Quality Control/Quality Assurance
Is reference toxicant data available? 0 Yes ❑ No ❑ Yes ❑ No ❑ Yes 0 No
Was reference toxicant test within
acceptable bounds? El Yes ❑ No 0 Yes 0 No 0 Yes 0 No
What date was reference toxicant test run
(MM/DD/YYYY)? _
Other(describe)
Within two weeks of test Within two weeks of test Within two weeks of test
EPA Form 3510-2A(Revised 3-19) Page 27

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
110069999274 NCO069761 Pond Creek WWTP 001 OMB No 2040-0004
TABLE E.EFFLUENT MONITORING FOR WHOLE EFFLUENT TOXICITY
The table provides response space for one whole effluent toxicity sample.Copy the table to report additional test results.
Test Information
Test Number 1 Test Number 1 Test Number 1
Test species Ceriodaphnia dubia Ceriodaphnia dubia Ceriodaphnia dubia
Age at initiation of test <24 hrs <24 hrs <24 hrs
Outfall number 001 001 001
Date sample collected 04/06/2020 07/06/2020 10/05/2020
Date test started 04/08/2020 07/08/2020 10/07/2020
Duration 24 hours 24 hours 24 hours
Toxicity Test Methods
Test method number 1002.0 1002.0 1002.0
Manual title Short-term methods for estimating the chronic Short-term methods for estimating the chronD Short-term methods for estimating the chrorp
Edition number and year of publication 4th Edition-2002 4th Edition-2002 4th Edition-2002
Page number(s) 141-189 141-189 141-189
Sample Type
Check one: ❑ Grab 0 Grab 0 Grab
❑✓ 24-hour composite ❑✓ 24-hour composite ❑✓ 24-hour composite
Sample Location
Check one: ❑ Before Disinfection 0 Before Disinfection ❑ Before disinfection
❑✓ After Disinfection ❑✓ After Disinfection ❑✓ After disinfection
❑ After Dechlorination 0 After Dechlorination ❑ After dechlorination
Point in Treatment Process
Describe the point in the treatment process Effluent Effluent
at which the sample was collected for each Effluent
test.
Toxicity Type
Indicate for each test whether the test was 0 Acute 0 Acute ❑ Acute
performed to asses acute or chronic toxicity,
or both.(Check one response.) ❑✓ Chronic 0 Chronic ❑✓ Chronic
0 Both 0 Both 0 Both
EPA Form 3510-2A(Revised 3-19) Page 25

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
110069999274 NC0069761 Pond Creek WWTP 001 OMB No.2040-0004
TABLE E. EFFLUENT MONITORING FOR WHOLE EFFLUENT TOXICITY
The table provides response space for one whole effluent toxicity sample.Copy the table to report additional test results.
Test Number 1 Test Number 1 Test Number 1
Test Type
Indicate the type of test performed.(Check one ❑ Static 0 Static 0 Static
response.)
O Static-renewal 0 Static-renewal ❑✓ Static-renewal
❑ Flow-through 0 Flow-through 0 Flow-through
Source of Dilution Water
Indicate the source of dilution water.(Check 0 Laboratory water 0 Laboratory water ❑✓ Laboratory water
one response.)
❑ Receiving water 0 Receiving water _ 0 Receiving water
If laboratory water,specify type.
If receiving water,specify source.
Type of Dilution Water
Indicate the type of dilution water. If salt ❑✓ Fresh water ❑✓ Fresh water El Fresh water
water,specify"natural"or type of artificial
sea salts or brine used. 0 Salt water(specify) 0 Salt water(specify) 0 Salt water(specify)
Percentage Effluent Used
Specify the percentage effluent used for all
concentrations in the test series. 51% 51% 51%
Parameters Tested
Check the parameters tested. ❑✓ pH 0 Ammonia ElpH 0 Ammonia ❑✓ pH ❑ Ammonia
❑ Salinity 0 Dissolved oxygen ❑ Salinity 0 Dissolved oxygen 0 Salinity ❑ Dissolved oxygen
❑ Temperature ❑ Temperature ❑ Temperature
Acute Test Results
Percent survival in 100%effluent N/A % N/A % N/A
LC5o _ N/A N/A N/A
95%confidence interval N/A % _ N/A % N/A %
Control percent survival N/A % N/A % N/A %
EPA Form 3510-2A(Revised 3-19) Page 26

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
110069999274 NC0069761 Pond Creek WWTP 001 OMB No.2040-0004
TABLE E.EFFLUENT MONITORING FOR WHOLE EFFLUENT TOXICITY
The table provides response space for one whole effluent toxicity sample.Copy the table to report additional test results.
Test Number 1 Test Number 1 Test Number 1
Acute Test Results Continued
Other(describe) N/A N/A N/A
Chronic Test Results
NOEC >IWC % >iwc % >IWC
IC25 % % %
Control percent survival 100 % 100 % 100 %
Other(describe)
Pass Pass Pass
Quality ControUQuality Assurance
Is reference toxicant data available? ❑✓ Yes _ ❑ No ❑ Yes _ ❑ No ❑ Yes _ ❑ No
Was reference toxicant test within ❑✓ Yes ❑ No ❑✓ Yes ❑ No 0 Yes ❑ No
acceptable bounds?
What date was reference toxicant test run
(MM/DD/YYYY)?
Other(describe)
Within two weeks of test Within two weeks of test Within two weeks of test
EPA Form 3510-2A(Revised 3-19) Page 27

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
110069999274 NC0069761 Pond Creek WWTP 001 OMB No.2040-0004
TABLE E.EFFLUENT MONITORING FOR WHOLE EFFLUENT TOXICITY
The table provides response space for one whole effluent toxicity sample.Copy the table to report additional test results.
Test Information
Test Number 1 Test Number 1 Test Number 1
Test species Ceriodaphnia dubia Ceriodaphnia dubia Ceriodaphnia dubia
Age at initiation of test <24 hrs <24 hrs <24 hrs
Outfall number o01 001 001
Date sample collected 04/19/2021 07/26/2021 10/18/2021
Date test started 04/21/2021 07/28/2021 10/20/2021
Duration 24 hours 24 hours 24 hours
Toxicity Test Methods
Test method number 1002.0 1002.0 1002.0
Manual title - Short-term methods for estimating the chronic Short-term methods for estimating the chrorp Short-term methods for estimating the chror©
Edition number and year of publication 4th Edition-2002 4th Edition-2002 4th Edition-2002
Page number(s) 141-189 141-189 141-189
Sample Type
Check one: ❑ Grab 0 Grab 0 Grab
❑✓ 24-hour composite ❑✓ 24-hour composite ❑✓ 24-hour composite
Sample Location
Check one: ❑ Before Disinfection ❑ Before Disinfection ❑ Before disinfection
❑✓ After Disinfection ❑✓ After Disinfection ❑✓ After disinfection
❑ After Dechlorination ❑ After Dechlorination 0 After dechlorination
Point in Treatment Process
Describe the point in the treatment process Effluent Effluent
at which the sample was collected for each Effluent
test.
Toxicity Type
Indicate for each test whether the test was 0 Acute ❑Acute ❑ Acute
performed to asses acute or chronic toxicity,
or both.(Check one response.) ❑✓ Chronic ❑✓ Chronic ❑✓ Chronic
❑ Both ❑ Both ❑ Both
EPA Form 3510-2A(Revised 3-19) Page 25

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
110069999274 NC0069761 Pond Creek WWTP 001 OMB No.2040-0004
TABLE E.EFFLUENT MONITORING FOR WHOLE EFFLUENT TOXICITY
The table provides response space for one whole effluent toxicity sample.Copy the table to report additional test results.
Test Number 1 Test Number 1 Test Number 1
Test Type
Indicate the type of test performed.(check one ❑ Static ❑ Static ❑ Static
response.)
❑✓ Static-renewal ❑✓ Static-renewal ❑✓ Static-renewal
❑ Flow-through ❑ Flow-through 0 Flow-through
Source of Dilution Water
Indicate the source of dilution water.(check ❑✓ Laboratory water ❑✓ Laboratory water 0 Laboratory water
one response.)
❑ Receiving water 0 Receiving water ❑ Receiving water
If laboratory water,specify type.
If receiving water,specify source.
Type of Dilution Water
Indicate the type of dilution water. If salt ✓❑ Fresh water 0 Fresh water ❑✓ Fresh water
water,specify"natural"or type of artificial
sea salts or brine used. ❑ Salt water(specify) ❑ Salt water(specify) ❑ Salt water(specify)
Percentage Effluent Used
Specify the percentage effluent used for all
concentrations in the test series. 51% 51% 51%
Parameters Tested
Check the parameters tested. ❑✓ pH ❑ Ammonia 0 pH ❑ Ammonia 0 pH ❑ Ammonia
❑ Salinity ❑ Dissolved oxygen ❑ Salinity ❑ Dissolved oxygen ❑ Salinity ❑ Dissolved oxygen
❑ Temperature ❑ Temperature ❑ Temperature
Acute Test Results
Percent survival in 100%effluent N/A % N/A % N/A %
LC50 N/A N/A N/A
95%confidence interval N/A % N/A % N/A
Control percent survival N/A % N/A % N/A
EPA Form 3510-2A(Revised 3-19) Page 26

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
110069999274 NC0069761 Pond Creek WWTP 001 OMB No.2040-0004
TABLE E.EFFLUENT MONITORING FOR WHOLE EFFLUENT TOXICITY
The table provides response space for one whole effluent toxicity sample.Copy the table to report additional test results.
Test Number 1 Test Number 1 Test Number 1
Acute Test Results Continued
Other(describe) N/A N/A N/A
Chronic Test Results
NOEC >iwc % >IWC % >IWC %
IC25 %
Control percent survival 100 % 100 % 100 %
Other(describe)
Pass Pass Pass
Quality Control/Quality Assurance
Is reference toxicant data available? ❑✓ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No
•
Was reference toxicant test within
acceptable bounds? ❑✓ Yes ❑ No ❑✓ Yes ❑ No El Yes ❑ No
•
What date was reference toxicant test run
(MM/DD/YYYY)?
Other(describe)
Within two weeks of test Within two weeks of test Within two weeks of test
EPA Form 3510-2A(Revised 3-19) Page 27

Pond Creek Wastewater Treatment Plant Process Schematic
Influent
Bar screen/solids removal
, --
Aeration tank
Primary Secondary
Clarifier Clarifier
UV
disinfection
Sedimentation
tank/digester
Effluent
discharged
•
to stream
Sludge
pressing

, -
d
o
a,
---.
1 ..y- • 1• 7. ,r--- •.-1 r fr r,.- —I:j f \- c .—t .,,,,..,-;11....; !Alt / ‘... ,... ..."N-Af
."
,tilt—e'''...\ ::" "•,' rb ' ‘• ' )c'' 4.--,ks ',,, ..---1.."' ; , __-'1. 'NZ' 1 7/ , pi •1 i: .---.. t..
,0 -
• ts\-, ., 1 \ c <*- ----- "'.------" ;,-- ff"1/1///-.----'• . -
---..-;,;;;;-..;,,p,....",:-----. - ' ' ''''' \ \\•\ t ( ( -.----‘../,,,---,_,_-%.1,•-----1.111;:i. '..--N::,_
*---\
...5.1...-::::=4:Y : ....„,) 1 i V. '`."------,,..--Z-_-:.--, 4 \\*':, ‘N C:"-:-.:,_?-7.....-%1/4..----.,,-. 4.‘,s7-',.. L'fir___/:„......._.- •,..;:z_....7./.
.n „,\ , ,,, „..... ',.7,.\, "' ,.i, \ ) r,-..-:-.4'...et.'•.4.' -
i".---.6‘.1, ' $:'.' ' ' \-.::.,..'‘`‘,. .-`k---,, ,
C:' / !, 4 P 1-N ,...e:-..-Idi 1. .,--7.
( ..• ,,,,
1 ( if,. _.)Ize. ,•.' !Lim, 1 , _.4,.;"./:.." s\r% 0, \ -‘, .NA .....) tt. (
‘ \\:%\\\\ \ .• •-
'''•.‘ \ 't.' ' C \1 ' \ t..-- 1 1 C/..e•--I sk`-.. k \\ \\ \-t---. ,..----s:4is'77:"1•5-:::-- -•-•.1%
\t • '. 1 • \ , 1 \ i . v , ,_ _., -:,,,,,- ,,,o. ••\\.,,,, \ \\ \ -.•:•A"----______,_—_.,. r.ovi ,
•, i , 0, 1
N r(
r ••• ,.,v, -, \\.)A i.1 )). ------:`- ~-,\\ ) ' 1 i':, -- :. ,--,‘,. .-'4, ' - ' \\. -2_,./- ___,--,)
. ..... % . ' i
\ .. , • ,k,
',....*\."•••• 1\N.1 •,.%,,,,\,...t..:t. ‘.\\,....:x. .,,,,.,
i\ \............,(\::\
•••17.sk.,,,,n , . , t ....,,....... . ...".".%s. \\,% ....\ 1 ."..,,,..\\.•-: '0,i,\,,,..,..\\. '...\,....:\:,......... a'rs.:..,......... ,*".................. ..........,:\ \
I -• -
...N.‘—c)
. *.• ••• ' -.. —.*`,..1 .7.\\ :1••,\\\ \\\•\\ (L.:(...) . \.; — - - '7 \
.--
11
(
... it ti,,' '.. i:-.'.I • ' .•‘J. • " " \ ii
Outfall 001
_ ,.. •,.
j 1 ••"' r 1 ..—...4 S ',., ‘,4,, , ,1%4 . ‘ 1
‘,. ... .
(/--- t 4 . A. % -- s i 1 . 1 ) , Ir
, ... J.. • , , I , . / .4,„,... .....\\-...-'.„4::-......------ ...„,- i )
A N.
1 i 4; ,.......1 I ; . 10. t ‘ ,% . _ i 1 1 ; •/ , •, "..... i C --
, •,,.,0.1.1 i t -...,__ ---' ......c ... ‘ `• 1
( 1 LLIS \e.' ..' v 1 I'':\ \V, \ ''''.'• i ! •
..- .% •, i • i n„ /7 ---____.....
. ..,,, .‘,..-i:-..,.---1•:._=%, , , ik;„ '.1 s 1 ' 1 C , .
....r \1 41, .,,,,---'-t.'-'-- --\ \\,-- .--,:-. '• . i ,—....„_••-- ,,- 1 f, ...---__ -.---...,
' . 11' ...."7"::-...'":27-e•s" . ' ' '1:, ,'''' s.."--‘7.4C- ‘\ .(' ,II, ° A '-- "----__
1 \ ' \ .....--T.:'"---------::::-.-.. ../1k• ,:-..„,_, \ et.,; '1: 1\4......1.--..--N,44 ‘‘,,,s‘ ,,,;),
ti ' ss ‘.
..
---...-N.
":„z„....,..-... .% k •
%, I el ‘ Ns::\, ... •
i) \\ \._ ..., • , \ \ •.
\
: \.,\ .. . \ • .-••••.. " ,-- \ .,.,- ,,,,
\ k I
\ \
s.• "74.. ‹.:" \ \ ; •••,. __. , \ \ \ - % \ i 1k, ' NI
. --.. -----
_-z•\
---'\
-4.0 • --.. ‘'. '" \"
i it./ /' - \* •`'''•-• - N. .• \\ 'f' ..----"-`' j )
.• •••• . ... -..,, 1 . 'r r ---- \
kk--.... -;,-.. --•\ \ "iciil _----,--- ;,•_.
"-- --...,...„ .,,,...00, _ P .-\ _-, .1
A I • ,
. oi...••••:'.:':. •• i , ..... i .,
• ' 4')1. (•.^..:,
-% Grassy .f. . ) , s L, • ,-...-__ ,
, • „.. --„ ....
...._ . , • e :„..
..._ , • ,----
)4:',,\. \ --..'%c,&'i-.•.;,,,,, .. C i.* . ,• „.... ,.
.....
,,-;-....-...P , . .....„..... .. ,,.. _, \ •. ,,--.. ...-
_
c . .....r
,....: .\\,,............„ ‘, , e• I \. f' - ""--.......77 • i
. \ .• .. I N I - ! . i
...._. ,
I. .A1' '''' '''' • %.-.-N ' ., i ) 2 '.\._ .\. ' . 1 C. ' ,I \ ‘1'• - )
e,ii. I 4 1 i ‘ 1 . --,\.,-, ,ii, •,Ni•Li i #(.." / 1 '. 4.--1 ,
• L, 14----Ak,r, .._,.; f, ,„,..„:4
, ...t...‘ .:•%.,‘‘t , i 1., I ,,,, /-•,...,_ ••••.\.; , -„, ..,,,\
/ • -.-_,... / ,„."
•i,fli; !li , I , . ., %',.*II 1 •r' \ • ,. 14kt --
---,' :? • • • '- t a 1 ., \\ .4-- ---- r-N., ' '' A_.
----
Town of Beech Mountain Facility ... _, .._. _. ,.. .
Pond Creek VVVVTP
- 0 Location --:-.1. •
State Grid/Quad: CIINE Receiving Stream: Pond Creek
J,atittirler 36° 12' 49- N Stream Class: C-Trout not to scale
Longitude: 81°52'30- W 8-Digit HUC: 06010103 I NPDES Permit No. NC0069761
Drainage Basin: Watauga River Basin 1 North
Sub-Basin: 04-02-01 Watauga County _, 1
1

GEL LABORATORIES LLC •
2040 Savage Road Charleston SC 29407-[phone] -www.gel.com
Certificate of Analysis
Report Date: March 4,2022
Company: Water Tech Laboratories
Address: P.O. Box 1056
Granite Falls,North Carolina 28630
Contact: Mr.Tony Gragg
Project: Routine Analysis
Client Sample ID: Town of Beech MTN Pondcreek Eff Project: WATR00101
Sample ID: 571055001 Client ID: WATR001
Matrix: Waste Water
Collect Date: 15-FEB-22 08:30
Receive Date: • 21-FEB-22
Collector: Client
Parameter Qualifier Result DL RL Units PF DF Analyst Date Time Batch Method
Mercury Analysis-CVAA
EPA 1631 Low Level Mercury Analysis"As Received"
Mercury 2.59 0.200 0.500 ng/L I BCDI 03/03/22 1027 2236202 1
The following Analytical Methods were performed:
Method Description Analyst Comments
1 EPA 1631 E
Notes:
Column headers are defined as follows:
DF: Dilution Factor Lc/LC:Critical Level
DL:Detection Limit PF:Prep Factor
MDA:Minimum Detectable Activity RL: Reporting Limit
MDC:Minimum Detectable Concentration SQL: Sample Quantitation Limit
•
Page 3 of 12 SDG: 571055

GEL LABORATORIES LLC
2040 Savage Road Charleston SC 29407-[phone] -w w.gel.com
Certificate of Analysis
Report Date: March 4,2022
Company: Water Tech Laboratories
Address: P.O.Box 1056
Granite Falls,North Carolina 28630
Contact: Mr.Tony Gragg
Project: Routine Analysis
Client Sample ID: Eff.Duplicate Project: WATR00101
Sample ID: 571055002 -Client ID: WATR001
Matrix: Waste Water
Collect Date: 15-FEB-22 08:30
Receive Date: 21-FEB-22
Collector: Client
Parameter Qualifier Result DL RL Units PF DF Analyst Date Time Batch Method
Mercury Analysis-CVAA
EPA 1631 Low Level Mercury Analysis"As Received"
Mercury 2.54 0.200 0.500 ng/L 1 BCD! 03/03/22 1031 2236202
The following Analytical Methods were performed:
Method Description Analyst Comments
1 EPA 1631 E
Notes:
Column headers are defined as follows:
DF: Dilution Factor Lc/LC:Critical Level
DL:Detection Limit PF:Prep Factor
MDA:Minimum Detectable Activity RL:Reporting Limit
MDC:Minimum Detectable Concentration SQL: Sample Quantitation Limit
•
Page 4 of 12 SDG: 571055

GEL LABORATORIES LLC
2040 Savage Road Charleston SC 29407-[phone] -www.gel com
Certificate of Analysis
Report Date: March 4,2022
Company: Water Tech Laboratories
Address: P.O.Box 1056
Granite Falls,North Carolina 28630
Contact: Mr.Tony Gragg
Project: Routine Analysis
Client Sample ID: Field Blank Project: WATR00I01
Sample ID: 571055003 Client ID: WATR001
Matrix: BLANK
Collect Date: 15-FEB-22 08:30
Receive Date: '21-FEB-22
Collector: Client
Parameter Qualifier Result DL RL Units PF DF Analyst Date Time Batch Method
Mercury Analysis-CVAA
EPA 1631 Low Level Mercury Analysis"As Received"
Mercury J 0.25 0.200 0.500 ng([. 1 BCD' 03/03/22 1008 2236202
The follow
ing Analytical Methods were performed:
Method Description
1 EPA 1631E Analyst Comments
Notes:
Column headers are defined as follows:
DF:Dilution Factor Lc/LC:Critical Level
DL:Detection Limit PF:Prep Factor
MDA:Minimum Detectable Activity RL:Reporting Limit
MDC:Minimum Detectable Concentration SQL: Sample Quantitation Limit
•
Page 5 of 12 SDG: 571055

GEL LABORATORIES LLC
2040 Savage Road Charleston SC 29407-[phone] -www.gel.com
Certificate of Analysis
Report Date: March 4,2022
Company: Water Tech Laboratories
Address: P.O.Box 1056
Granite Falls,North Carolina 28630
Contact: Mr.Tony Gragg
Project: Routine Analysis
Client Sample ID: Trip Blank Project: WATR00101
Sample ID: 571055004 Client ID: WATR001
Matrix: BLANK
Collect Date: 15-FEB-22 08:30
Receive Date: 21-FEB-22
Collector: Client
Parameter Qualifier Result DL RL Units PF DF Analyst Date Time Batch Method
Mercury Analysis-CVAA
EPA 1631 Low Level Mercury Analysis"As Received"
Mercury J 0.25 0.200 0.500 ng/L 1 BCD' 03/03/22 1013 2236202
The following Analytical Methods were performed:
Method Description Analyst Comments
I EPA 163I E
Notes:
Column headers are defined as follows:
DF: Dilution Factor Lc/LC:Critical Level
DL:Detection Limit PF:Prep Factor
MDA:Minimum Detectable Activity RL: Reporting Limit
MDC:Minimum Detectable Concentration SQL:Sample Quantitation Limit
•
Page 6 of 12 SDG: 571055

toe: I of I
GEL laboratories-LLC
tl0'ro;ect# GEL Laboratories l LC - , --) 1 0 55 2040 Savage Road
r'GEL Quote ar. GELP19-1669 om corr. Chemistry)Hadochermtry I Radinbioassav 1 Snecialtv Analytivs. Charleston.SC 29407
c OC Number(I):__ Chain of Custody and Analytical Request Phone:[phone])
'O Number: GEL Work Order Number: GEL Project Manager:Samuel Hogan 1=as:[phone]
'`"t h LaLIN
Ehent Name. an.-
-
t•h +'! BOX 1(155 i'hg g 3 t�-`f`f`(f Sample Analysis Requested(5) (Fill in the number of containers for each test)
C/Nro)ect/Site Name ,wood Plaza Drive Pas k'
� Should this <--Preservative Type(6)
( 'ddress G• rrt1to Falls, INC: Z863U sample be EI
`` n,
,,J considered:
ollected By: f��vi4J _l"J��t3 { Send Results To:�„ ,^���� (• _ _S • - ^ Comments
i f 1 ]/ /Yt" 4R-K _ - a, y Note:extra sample is
CZ
*Time _ c ti .- '--" -
'Date Collected Collected QC Field Sample = -r' -' - c q 1
required for sample
Sample ID (Military) Code Filtered Matrix o c o X - : u Specific QC
* For composites/ -indicate�y� start and stop date/time (mm-dd•yy) thhmnt) (2) (3) (4) " _ F-
�l C l &c'di AVI.) -ti^iderec4 i a-i .,? .-'30 (U wiv Au_ ( .21,J 4 A)C.oO6
cf . p(.t p l�ke--)7Lr_ 0-/sue-2), 1.3o N w('�% t' L -ak �p 6
r I �4 l� 1
....i.,i,,
Chain of Custody Signatures TAT Requested: Normal: Rush:-__ Specify:
Relinquished l3v(Signed) Dale 'lime Received be(signed) Date Time
� J / Fax Results: ( (1'es No
__y 41 {^• • `/5-�' , 3C' I� / .? lYL2_ / CSC Select Deliverable:[ J C of [ 1 QC Summarylevel 1 ( 1 Level_ [ J Level 3 ( [Level 4
� 'z� Additional Remarks:200572
' 3 For Lab Receiving Use Only:Custody Seal Intact?l /Yes l l No Cooler Te,np.11.&C
>For sample shipping and deliver)•details,see Sample Receipt&Review form(SRR.) -Sample Collection'lime Zone:Kamm [ J Pacific ( J Central [ J Mountain ( J Oilier.
I)Chain Custody Number Client Dcmmmncd ���� ���� ��
'_)QC Codes:
es: N u Normal Sample,TB=Trip Blank,FD-Field Duplicate.EftEquipment Blank, MS_Harris Spike Sample.MSD a Matrix Spike Duplicate Sample,G Grab,C Composite {-{
3)Field Filtered. For liquid matrices,indicate with a-V-for yes the sample was field filtered or•N•for sample was not field filtered r RESERVED
41 Al atria Codes.D\\'uDrinkmy water,Gl\'-GuniJoamr,SW-Surface Water.R'\\=�\l'ute Water.\V \Valet.Ml.=-\hsc Liquid,50-Soil.SU-Scdinient,St.>Sludee,SS SolWaste,6,O11,F.1-alter.F'-K'rp� ! - - ,s i
ime:
s)Sample Analysis Requested Analytical method requested(I e.8260B,60 1 013 174 7 0A)and number of containers provided for each ti e 8260B- a01013l7470A-I).
Analyst:
6)Preservative Type F IA-Hydrochloric Acid,NI.Nitric Acid,514 Sodium Hydroxide,SA=Sulfuric Acid,AA=Ascorbic Acid,HX=Hexane,ST.Sodium Thiosutfate.IC no preservative is adr.V. d h cliave fiel , _ (J „/'y
7.)KNOWN ON PUtiS1aLE HAZARDS IClu+rtuacrixtie.Ilaiards I Listed 1Vtiste J 'Outer •---�J 1 a n—�-- - Please provide1''vi�any additional details
OT=Other/Unknown VOiUI.tE.:_� L,
1�L=Flammable/lgnitrblc L,51'=Listed Waste —= -'l�c7r7its'rug ltrrYThrg7fii7r71rng and/or disposal
RCRA Metals CO=Corrosive (!?K.Y and U-listed wastes.) (i.e.:High/low pit,asbestos,heryllhrnr,irritants,other concerns.(i.e.:Origin ofsample(s),type
As=Arsenic big=Mercury RE=Reactive Waste code(s): misc.health ha=m'ds,etc.) of site collected from.odd matrices,etc)
Ba=Barium Se=Selenium Description:
Cd=Cadmium Ag=Silver TSCA Regulated
Cr=Chromium MR=Misc.RCRA metals PCB=Polychlorinated
Pb=lead biphenyls