NC0046809_Permit Issuance_20110324

ATA
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
March 24, 2011
Mr. Darrell Gaines
Western NC Conference Center
P.O. Box 150
Browns Summit, N.C. 27214-0150
Subject: Issuance of NPDES Permit NC0046809
Cornerstone Conference and Resource Center
Class WW-2
Guilford County
Dear Mr. Gaines:
Division personnel have reviewed and approved your application for renewal of the subject permit.
Accordingly, we are forwarding the attached NPDES discharge permit. This permit is issued pursuant to
the requirements of North Carolina General Statute 143-215.1 and the Memorandum of Agreement between
North Carolina and the U.S. Environmental Protection Agency dated October 15, 2007 (or as subsequently
amended).
This final permit includes one major change from the draft permit sent to you on
February 2, 2011:
A nutrient reopener condition has been added. This reopener may be used by the Division to further
monitor nutrient impacts in the Cape Fear River Basin.
If any parts, measurement frequencies or sampling requirements contained in this permit are
unacceptable to you, you have the right to an adjudicatory hearing upon written request within thirty (30)
days following receipt of this letter. This request must be in the form of a written petition, conforming to
Chapter 150B of the North Carolina General Statutes, and. filed with the Office of Administrative Hearings
(6714 Mail Service Center, Raleigh, North Carolina 27699-6714). Unless such demand is made, this
decision shall be final and binding.
Please note that this permit is not transferable except after notice to the Division. The Division may
require modification or revocation and reissuance of the permit. This permit does not affect the legal
requirements to obtain other permits which may be required by the Division of Water Quality or permits
required by the Division of Land Resources, the Coastal Area Management Act or any other Federal or Local
governmental permit that may be required. If you have any questions concerning this permit, please
contact Charles=Weaver at telephone number [phone].
•
oleen H. Sullins
cc: Central Files Winston-Salem Regional Office/Surface Water Protection
NPDES Unit Aquatic Toxicology Unit
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
512 North Salisbury Street, Raleigh, North Carolina 27604
Phone: [phone] / FAX [phone] / http://portaLrcdenr.org/web/wq
NonrthCarolina
An Equal Opportunity/Affirmative Action Employer - 50%'Recycled/10% Post Consumer Paper

Permit NC0046809
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
PERMIT
TO DISCHARGE WASTEWATER UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful
standards and regulations promulgated and adopted by the North Carolina Environmental
Management Commission, and the Federal Water Pollution Control Act, as amended, the
Western North Carolina Conference Center
is hereby authorized to discharge wastewater from a facility located at the
Cornerstone Conference and Resource Center WWTP
7545 U. S. Highway 29 North
Browns Summit
Guilford County
to receiving waters designated as an unnamed tributary to Benaja Creek in
subbasin 03-06-01 of the Cape Fear River Basin in accordance with effluent
limitations, monitoring requirements, and other conditions set forth in Parts I, II, III
and IV hereof.
This permit shall become effective May 1, 2011.
This permit and authorization to discharge shall expire at midnight on April 30 '201.6.'
Signed this day March 24, 2011
•
2
Col - - H. Sullins, Director
Di - sion of Water Quality
By Authority of the Environmental Management Commission

• Permit NC0046809
SUPPLEMENT TO PERMIT COVER SHEET
All previous NPDES Permits issued to this facility, whether for operation or discharge are hereby revoked.
As of this permit issuance, any previously issued permit bearing this number is no longer effective.
Therefore, the exclusive authority to operate and discharge from this facility arises under the permit
conditions, requirements, terms, and provisions included herein.
The Western North Carolina Conference Center is hereby authorized to:
1. Continue to operate an existing 0.02 MGD wastewater treatment facility with the
following components:
• Splitter box
• Bar screen
• Dual parallel aeration tanks
• Dual parallel clarifiers
• Dual tertiary filters
• Chlorine contact chamber with tablet chlorination
• Tablet dechlorination
• Sludge digester
This facility is located off U.S. Highway 29 North northeast of Browns Summit at
the Cornerstone Conference and Resource Center WWTP in Guilford County.
2. Discharge from said treatment works at the location specified on the attached
map into an unnamed tributary to Benaja Creek, currently classified WS-V NSW
waters in hydrologic unit 03030002 of the Cape Fear River Basin.

NC0046809
Cornerstone Conference and Resource Center WWTP
Latitude: 36° 13' 45" N USGS Quad: Brownsville, N.C.
Longitude: • - • 79° 41; 29" W Permitted Flow: 0.02•MIGD
Hydrologic Unit: 03030002 Stream Class: WS-V NSW
Receiving Stream: UT Benaja Creek Sub -Basin: 03-06-01
Outfall
001
Guilford County
Map not to scale

• Permit NC0046809
A. (1) EFFLUENT LIMITATIONS AND MONITORING REQUIREMENTS
During the period beginning on the effective date of this permit and lasting until expiration, the Permittee is
authorized to discharge from outfall 001. Such discharges shall be limited and monitored by the Permittee as
specified below:
PARAMETER
[PCS Code]
LIMITS
MONITORING REQUIREMENTS
Monthly
Average
Daily
Maximum
Measurement
Frequency
Sample Type
Sample Location1
Flow
[50050]
0.02 MGD
Weekly
Instantaneous
Influent or Effluent
BOD, 5-day (20°C)
[C0310]
30.0 mg/L
45.0 mg/L
Weekly
Grab
Effluent
Total Suspended Solids
[C0530]
30.0 mg/L
45.0 mg/L
Weekly
Grab
Effluent
NH3 as N
[C0610]
'
2/Month
Grab
Effluent
Dissolved Oxygen
[00300]
Weekly
Grab
Effluent,
U & D
Fecal Coliform (geometric mean)
[31616]
200 / 100 ml
400 / 100 ml
Weekly
Grab
Effluent
Fecal Coliform (geometric mean)
[31616]
Weekly
Grab
U & D
Total Residual Chlorine2
[50060]
28 µg/L
2/week
Grab
Effluent
Temperature (°C)
[00010]
Weekly
Grab
Effluent,
U & D
Oil and Grease
[00556]
Monthly
Grab
Effluent
MBAS
[38260]
Monthly
Grab
_
Effluent
Total Nitrogen (NO2+NO3+TKN)
[C0600]
Quarterly
Grab
Effluent
Total Phosphorus
[C0665]
Quarterly
Grab
Effluent
pH
[00400]
> 6.0 and < 9.0 standard units
Weekly
Grab
Effluent
Chronic Toxicity3
[TGP3B]
Quarterly
Grab
Effluent
"Footnotes:
1. U: at least 100 feet upstream from the outfall. D: at least 100 feet downstream from the outfall.
2. The Permittee shall report all effluent TRC values reported by a NC -certified laboratory [including
field -certified]. Effluent values below 50 µg/L will be treated as zero for compliance purposes.
3. Chronic Toxicity (Ceriodaphnia) P/F at 31%: February, May, August 8s November (see A. (2.)).
There shall be no discharge of floating solids or visible foam in other than trace amounts.

Petmit NC0046809
A. (2) CHRONIC TOXICITY PERMIT LIMIT (Quarterly)
The effluent discharge shall at no time exhibit observable inhibition of reproduction or significant mortality to
Ceriodaphnia dubia at an effluent concentration of 31%
The permit holder shall perform at a minimum,. quarterly monitoring using test procedures outlined in the "North
Carolina Ceriodaphnia Chronic Effluent Bioassay Procedure," Revised February 1998, or subsequent versions or
"North Carolina Phase II Chronic Whole Effluent Toxicity Test Procedure" (Revised -February 1998) or
subsequent versions. The tests will be performed during the months of February, May, August & November. Effluent
sampling for this testing shall be performed at the NPDES permitted final effluent discharge below all treatment
processes.
If the test procedure performed as the first test of any single quarter results in a failure or ChV below the permit
limit, then multiple -concentration testing shall be performed at a minimum, in each of the two following months as
described in "North Carolina Phase II Chronic Whole Effluent Toxicity Test Procedure" (Revised -February 1998)
or subsequent versions.
The chronic value for multiple concentration tests will be determined using the geometric mean of the highest
concentration having no detectable impairment of reproduction or survival and the lowest concentration that does
have a detectable impairment of reproduction or survival. The definition of "detectable impairment," collection
methods, exposure regimes, and further statistical methods are specified in the "North Carolina Phase II Chronic
Whole Effluent Toxicity Test Procedure" (Revised -February 1998) or subsequent versions.
All toxicity testing results required as part of this permit condition will be entered on the Effluent Discharge
Monitoring Form (MR-1) for the months in which tests were performed, using the parameter code TGP3B for the
pass/fail results and THP3B for the Chronic Value. Additionally, DWQ Form AT-3 (original) is to be sent to the
following address:
NC DENR / DWQ / Environmental Sciences Branch
1621 Mail Service Center
Raleigh, North Carolina 27699-1621
Completed Aquatic Toxicity Test Forms shall be filed with the Environmental Sciences Branch no later than 30
days after the end of the reporting period for which the report is made.
Test data shall be complete, accurate, include all supporting chemical/physical measurements and all
concentration/response data, and be certified by laboratory supervisor and ORC or approved designate signature.
Total residual chlorine of the effluent toxicity sample must be measured and reported if chlorine is employed for
disinfection of the waste stream.
Should there be no discharge of flow from the facility during a month in which toxicity monitoring is required, the
permittee will complete the information located at the top of the aquatic toxicity (Al) test form indicating the
facility name, permit number, pipe number, county, and the month/year of the report with the notation of "No
Flow" in the comment area of the form. The report shall be submitted to the Environmental Sciences Branch at the
address cited above. '
Should the permittee fail to monitor during a month in which toxicity monitoring is required, monitoring will be
required during the following month.
Should any test data from this monitoring requirement or tests performed by the North Carolina Division of Water
Quality indicate potential impacts to the receiving stream, this permit may be re -opened and modified to include
alternate monitoring requirements or limits.
NOTE: Failure to achieve test conditions as specified in the cited document, such as minimum control organism
survival, minimum control organism reproduction, and appropriate environmental controls, shall constitute an
invalid test and will require immediate follow-up testing to be completed no later than the last day of the month
following the month of the initial monitoring.

Permit NC0046809
•
A. (3) NUTRIENT REOPENER CONDITION
Pursuant to N.C. General Statutes Section 143-215.1 and the implementing -rules found in
the North Carolina Administrative Code at 15A NCAC 2H.0112 (b) (1) and 2H.0114 (a) and
Part II sections B-12 and B-13 of this permit, the Director may reopen this permit to
require supplemental nutrient monitoring of the discharge. The purpose of the additional
monitoring will be to support water quality modeling efforts within the Cape Fear River
Basin and shall be consistent with a monitoring plan developed jointly by the Division and
affected stakeholders. In addition, the results of water quality modeling may require that
limits for total nitrogen and total phosphorus be imposed in this permit upon renewal.

Weaver, Charles
From: Weaver, Charles
Sent: Thursday, January 27, 2011 11:13 AM
To: Meadows, Susan; Pugh, James L.; Edwards, Lisa; Basinger, Corey
Subject: DRAFT r,ermit renewal for C0046809 (Cornerstone Conference and Resource Center
WWTP)
Attachments: DEH m: mo.doc; nc0046809 rriap.ppt; 46809box 2011.doc; 46809 draft.doc; 46809 Expedited
Fact Sh-et.doc
Importance: High
Tracking: Recipient Delivery
Meadows, Susa Delivered: 1/27/2011 11:13 AM
Pugh, James L. Delivered: 1/27/2011 11:13 AM
Edwards, Lisa Delivered: 1/27/2011 11:13 AM
Basinger, Corey Delivered: 1/27/2011 11:13 AM
This is a class WW-2 facility in Guilford County.
Please send me any comments by 2/28/2011.
Thanks,
CHW
Messages to and from this address are subject to the N.C. Public Records Law
MCD�J��t�n l� r 7-*V 6�
1

News & Record
Name
Published by
News & Record, Inc.
Greensboro, North Carolina
AFFIDAVIT OF
North Carolina, Guilford County
Before the undersigned, a Notary Public of said County and State, duly commissioned, qualified and authorized by law to
administer oaths, personally appeared the Publisher's Representative who being first duly sworn, deposed and says:
1. That he/she is the Publisher's Representative of the Greensboro News & Record, Inc. a corporation, engaged in the
publication of newspapers known as "News & Record", published, issued and entered as second class mail in the City of
Greensboro in said County and State.
2. That he/she is authorized to make this affidavit and sworn statement; that the notice or other legal advertisement,
a copy of which is attached hereto, was published in the News & Record on the dates listed below.
3. That the said newspaper (or newspapers) in which such notice, paper, document, or legal advertisement was published
was, at the time of each and every such publication, a newspaper meeting all of the requirements and qualifications of
Section 1-597 of the General Statutes of North (;prolina and was a,gtialified new paper within the meaning of Section 1-59;
of the General Statutes of North Carolina.
Publisher's Representative
Sworn to and subscribed before me, this
Notary Public
` day of
Ad # Date Edition Class PO Ad Copv
tow tits/0/i
\‘` 0.1 NE 44/
v OTA Ry ��
My Comm. Exp.
6/1 S/2014
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NCDENR DWQ NPDES 34141982 02/04/11 News & Record 400 Cornerstone Public NoticeNorth Carolina Environmenta

Ad ID
34141982
Date
02/02/2011
Time
3:23 PM
Public Notice
North Carolina Environrrental
Managerrent Connission'
NPDB Unit
1617 Mail Service Center
Ralegh, NC 27699-1617
Notice of inert to Issue a NPDB
Wastewater Permit
The North Carolina Environmental
Manager nt Conmssbn proposes
to issue a NPDESwastewater
discharge perrrit tothe person(s)
listed below
Written comrrents regarding the
proposed perrrit wil be accepted
until 30 days after the pub is h date of
this notice. The Diector of the NC
Division of Water Quality (DW) may
hold a pubk hearing should there be
a significant degree of pubk interest
Phase rrai corrrrents and'or
information requests to DWQ at the
abose address. Interested persons
may vet the DWQ at 512 N. Salisbury
Street, Raleigh, NC to review
information on file. Additional
information on NPDB permits and
this notice may be found on our
website:
http//portaincdencorgiweb/wgiswpip
s/npdes/calendar, or by calling (919)
807-6304
Western NC Conference Center has
requested renewal of NPDES perrrrt
Nc00468090, Cornerstone Conference
and Resource CenterWWTAGuiiord
County. This permitted facility
discharges treated westewaterto
Benaja CreeldCape Fear River Basin
Currently fecal coliformard total
residual chlorine are water quaky
lirrited
Oak Ridge Miitary Ataderry requested
renewal of perrrit NC0046043 for its
WWTPinGufffordCounty. This
permitted facility discharges treated
wastewater to the Haw River/Cape
Fear Ricer Basin Currently BOD,
arrrronia nitrogen dissolved orgrgen,
fecal coliform and total residual
chbrine are water quality lirited.
Ad shown is not actual print size

Weaver, Charles
From: Basinger, Corey
Sent: Thursday, January 27, 2011 1:41 PM
To: Weaver, Charles
Subject: RE: DRAFT permit renewal for NC0046809 (Cornerstone Conference and Resource Center
WWTP)
This permit looks good to me.
CB
Corey Basinger
Interim Regional Supervisor
Surface Water Protection Section
[e-mail]
NC DENR Division of Water Quality
585 Waughtown Street
Winston-Salem, NC 27107
[phone]
Fax [phone]
E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be
disclosed to third parties.
From: Weaver, Charles
Sent: Thursday, January 27, 2011 11:13 AM
To: Meadows, Susan; Pugh, James L.; Edwards, Lisa; Basinger, Corey
Subject: DRAFT permit renewal for NC0046809 (Cornerstone Conference and Resource Center WWTP)
Importance: High
This is a class WW-2 facility in Guilford County.
Please send me any comments by 2/28/2011.
Thanks,
CHW
Messages to and from this address are subject to the N.C. Public Records Law.
1

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Henderson's Assisted Lmng
Henderson's Assisted Living
LV-2007-0424 !NC0071897
Henderson's Assisted Living
Henderson's Assisted Living
LV-20D9-0128 NC0071897
Henderson'sAssisted Living
Henderson's Assisted Lmng
LV-2009-0237 NC0071897
Henderson'sAssisted Living
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AVA
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue, Governor Coleen H. Sullins, Director Dee Freeman, Secretary
January 27, 2011
MEMORANDUM
To: Lisa Edwards
NC DENR / DEH / Regional Engineer
Winston-Salem Regional Office
From: Charles H. Weaver, Jr.
NPDES Unit
Subject: Review of Draft NPDES Permit NC0O468O9
Cornerstone Conference and Resource Center WWTP
Guilford County
Please indicate below your agency's position or viewpoint on the draft permit and return this
form by February 28, 2011. If you have any questions on the draft permit, please contact
me at the telephone number or e-mail address listed at the bottom of this page.
RESPONSE: (Check one)
Concur with the issuance of this permit provided the facility is operated and maintained
properly, the stated effluent limits are met prior to discharge, and ' the discharge does not
contravene the designated water quality standards.
LilConcurs with issuance of the above permit, provided the following conditions are met:
ElOpposes the issuance of the above permit, based on reasons stated below, or attached
Signed
Date: l/
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 919 807.6391 (fax) 919 807-6496
Visa us ON THE INTERNET ta Iffir /PORTM..NCDENR.ORGANEBIWQ chartes,weavertgi nodenr.gov
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file ras
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Select Enforcement Case
Case g
Permit
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Facility! Incident Location
Owner
LM,2010.0015
NCO083313
Brookside Village WTP
Brookside Village Association
LV-2007.0397
NC0083313
Brookside VillageWWrP
Brookside Village Association
LV-2007-0422
NC0083313
Brookside Village WNW
Brookside Village Association
LV-2010-0122
NC0083313
iBrookside Village W,VrP
Brookside Village Association
LV-2010-0128
NC0083313
iBrookside Village W,VrP
Brookside Village Association
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ornerstone
Conference and ',Resource Center
International Pentecostal Holiness Church
Mailing Address:
PO Box 150
Browns Summit, NC 27214
"Equipping For Excellence JriMinistry"
October 28, 2010
N.C. DENR/Division of Water Quality
NPDES Unit
1617 Mail Service Center
Raleigh, NC 27699-1617
Enclosed you will find our request for renewal of our NPDES wastewater discharge permit. The
only addition to the Waste Water Treatment Plant since issuance of the last permit was a tablet
dechlorinator installed after the chlorine contact chamber. If you have any other questions
concerning this please feel free to call me at 336-656-7936 ext 121 or you may email me at
dgainesc ccrdc.org.
Darrell Gaines
Office Manager
OCT 29Z010
DENR-WA. T ER QUALrrV
POINT SOURCE BRANCH
7545 Highway 29
Browns Summit, INC 27214
Phone [phone] Fax [phone]

•
NPDES APPLICATION - FORM D
For privately owned treatment systems treating 100% domestic wastewaters <1.0 MGD
Mail the complete application to:
N. C. DENR / Division of Water Quality / NPDES Unit
1617 Mail Service Center, Raleigh, NC 27699-1617
NPDES Permit
INC00 4 to $3a q
If you are completing this form in computer use the TAB key or the up - down arrows to move from one
field to the next. To check the boxes, click your mouse on top of the box. Otherwise, please print or type.
1. Contact Information:
Owner Name
Facility Name
Mailing Address
City
State / Zip Code
Telephone Number
Fax. Number
e-mail Address
UkSvr\ Noel, Cu a4 ry i ti i (y '
tiirt" Ki0r ". (-4)16 inn- Cc trrZ4n . (1, c.i• /AIL CO r '-i%xn-
Pc 1 x rs'
f YO L)1" 5 5 lti ry, n.r ; -i-
(336) VS" --1'i 3t
( 33 b) 155 1/4I
d Cc rcl c , o r9
2. Location of facility producing discharge:
Check here if same address as above
Street Address or State Road
City
State / Zip Code
County
CitLi
3. Operator Information:
Name of the firm, public organization or other entity that operates the facility. (Note that this is not
referring to the Operator in Responsible Charge or ORC)
Name
Mailing Address
City
State / Zip Code
Telephone Number
Fax Number
W sus -4(;-ln Nam• C w �an�t �.�.
P O 1.oX I "So
Jc a1)IL(
(3 cam) tof Lo - 1134,
(336) 65 6- ')S S
1 of 3 Form-D 05108

NPDES APPLICATION - FORM D
For privately owned treatment systems treating 100% domestic wastewaters <1.0 MGD
4. Description of wastewater:
Facility Generating Wastewater(check all that apply)
Industrial
Commercial
Residential
School
Other
Number of Employees
Number of Employees
Number of Homes
Number of Students/Staff
Explain:
Describe the source(s) of wastewater (example: subdivision, mobile home park, shopping centers,
restaurants, etc.) : oak)
_k) ri,1 _ (or eeA G' re _ `e r
ff �,r,� g 1 Q9 or-+ toe'
Population served: 1 0 'I�.Z�-�
5. Type .of collection system
Separate (sanitary sewer only) ❑ Combined (storm sewer and sanitary sewer)
6. Outfall Information:
Number of separate discharge points
Outfall Identification number(s) C O 1
Is the outfall equipped with a diffuser? ❑ Yes a No
7. Name of receiving stream(s) (Provide a map showing the exact location of each outfall):
Un�,a1neL- 4 L+ o 4 Ben
8. Frequency of Discharge: Continuous ❑ Intermittent
If intermittent:
Days per week discharge occurs: Duration:
9. Describe the treatment system
List all installed components, including capacities, provide design removal for BOD, TSS, nitrogen and
phosphorus. If the space provided is not sufficient, attach the description of the treatment system in a
separate sheet of paper.
Sp\
far ccre-er
ttQa
�aL {\`..m•ctilt1 Glc,r‘TrerS
c ,,r,m_ (4 A;-4G+ G\A.aA t21' 14.+ CI) ) )0r.nc.4soi
. ahk c -c lac; Aa-for
S1ve5t_ e,tts-\vr
2 of 3 Form-D 05/08

NPDES APPLICATION - FORM D
For privately owned treatment systems treating 100% domestic wastewaters <1.0 MGD
10. Flow Information:
Treatment Plant Design flow 0. 0 vZ MGD
Annual Average daily flow Q . 0d 1 MGD (for the previous 3 years)
Maximum daily flow O. O t C? MGD (for the previous 3 years)
11. Is this facility located on Indian country?
❑ Yes � No
12. Effluent Data
Provide data for the parameters listed. Fecal Coliform, Temperature and pH shall be grab samples, for all other
parameters 24-hour composite sampling shall be used. If more than one analysis is reported, report daily maximum
and monthly average. If only one analysis is reported, report as daily maximum.
Parameter
Daily
Maximum
Monthly
Average
Units of
Measurement
Biochemical Oxygen Demand (SODS)
S Q, .1
d g
ins j L
Fecal Coliform
) (zoo
a
a
cos ! j oo
L
Total Suspended Solids
S?) 3
l c .
!h g I L.
Temperature (Summer)
? 7
c of
© G.
Temperature (Winter)
1 6
j I
0 C.
pH
—I.I
6.%
sv
13. List all permits, construction approvals and/or applications:
Type Permit Number Type
Hazardous Waste (RCRA) NESHAPS (CAA)
UIC (SDWA)
NPDES
PSD (CAA)
Non -attainment program (CAA)
Ocean Dumping (MPRSA)
N L 004 6 6047 Dredge or fill (Section 404 or CWA)
14. APPLICANT CERTIFICATION
Other
Permit Number
I certify that I am familiar with the information contained in the application and that to the
best of my knowledge and belief such information is true, complete, and accurate.
04-0.447._ aCt EcAl
a c-1ce ikAtuutiaty
Printed name of Person Signing Title
10 1.Z/ 1,,)
Signature of Applicant Date
North Carolina General Statute 143-215.6 (b)(2) states: Any person who knowingly makes any false statement representation, or certification in any
application, record, report, plan, or other document files or required to be maintained under Article 21 or regulations of the Environmental Management
Commission implementing that Artide, or who falsifies, tampers with, or knowingly renders inaccurate any recording or monitoring device or method
required to be operated or maintained under Artide 21 or regulations of the Environmental Management Commission implementing that Artide, shall be
guilty of a misdemeanor punishable by a fine not to exceed $25,000, or by imprisonment not to exceed six months, or by both. (18 U.S.C. Section 1001
provides a punishment by a fine of not more than $25,000 or imprisonment not more than 5 years, or both, for a similar offense.)
3 of 3 Form-D 05l08

ornerstone
Conference and W,esoirrce Cen ter
international Pentecostal Holiness Church
Mailing Address:
PO Box 150
Browns Summit, NC 27214
"Equipping For Excellence /n ) finistn, "
MEMO
October 28, 2010
To: N.C. DENR/Division of Water Quality
NPDES Unit
From: Darrell Gaines, Office Manager
RE: Sludge Management Plan
Sludge is wasted into the digestor by the operator as needed. Once the digestor has reached its
capacity the operator calls a septic hauling company (currently Billingsly Septic in Reidsville,
NC), to remove and dispose of the waste sludge. The amount of sludge removed is recorded and
the billing and receipts for the hauling are kept in the main office.
Darrell Gaines
Office Manager
7545 Highway 29
Browns Summit, NC 27214
Phone [phone] • Fax [phone]

FACT SHEET FOR EXPEDITED PERMIT RENEWALS
This form must be completed by Permit Writers for all expedited permits which do not require
full Fact Sheets. Expedited permits are generally simple 100% domestics (e.g., schools, mobile
home parks, etc) that can be administratively renewed with minor changes, but can include
facilities with more complex issues (Special Conditions, 303(d) listed water, toxicity testing,
instream monitoring, compliance concerns).
Basic Information for Expedited Permit Renewals
Permit Writer/Date
Charles H. Weaver — 1/27/2011
Permit Number
N00046809
Facility Name
Western NC Conference Center WWTP
Basin Name/Sub-basin number
Cape Fear / 03-06-01
Receiving Stream
An unnamed tributary to Benaja Creek
Stream Classification in Permit
WS-V NSW
Does permit need Daily Maximum NH, limits?
N/A
Does permit need TRC limits/language'?
No — already present
Does permit have toxicity testing?
Yes
Does permit have Special Conditions?
No
Does permit have instream monitoring'?
Yes
Is the stream impaired (on 303(d) list)'?
No
Any obvious compliance concerns'?
No
Any permit mods since last permit?
No
New expiration date
4/30/2016
Comments received on Draft Permit?
Most Commonly Used Expedited Language:
• 303(d) language for Draft/Final Cover Letters: "Please note that Cane Creek is listed
as an impaired waterbody on the North Carolina 303(d) Impaired Waters List.
Addressing impaired waters is a high priority with the Division. and instream data will
continue to be evaluated. If there is noncompliance with this permits effluent limits and
stream impairment can be attributed to your facility. then mitigative measures may be
required'.
• TRC Ian2uage for Compliance Level for Cover Letters/Effluent Sheet Footnote:
"The facility shall report all effluent TRC values reported by a NC certified laboratory
including field certified. However, effluent values below 50 1.ig/1 will be treated as zero
for compliance purposes."

Physical 0
Hazard
Personal X
protection
History
Date of issue . 03/29/2006.
Date of previous issue 03/27/2006.
Prepared by Product Stewardship
Notice to reader
Inventories AUSTRALIAN INVENTORY (AICS): In compliance.
CANADA INVENTORY (DSL): In compliance.
CHINKINVENTORY (IECS): Not determined.
EC INVENTORY (EINECS/ELINCS): In compliance. ,
JAPAN INVENTORY (ENCS): Not determined.
KOREA INVENTORY (ECL): In compliance.
PHILIPPINE INVENTORY (PICCS): In compliance.
16. Other information
Label requirements DANGER!
FLAMMABLE LIQUID AND VAPOR.
VAPOR MAY CAUSE FLASH FIRE.
HARMFUL IF SWALLOWED.
ASPIRATION HAZARD.
HARMFUL OR FATAL IF LIQUID 1S ASPIRATED INTO LUNGS.
HARMFUL IF INHALED.
INHALATION CAUSES HEADACHES, DIZZINESS, DROWSINESS, AND NAUSEA, AND MAY
LEAD TO UNCONSCIOUSNESS.
MAY CAUSE EYE IRRITATION.
MAY CAUSE RESPIRATORY TRACT IRRITATION.
HMIS® Rating : Health 1 * National Fire
Flammability 3 Protection
Association
(U.S.A.)
Health
Fire hazard
instability
Specific hazard
NOTICE : This Material Safety Data Sheet is based upon data considered to be accurate at the time of its. preparation. Despite
our efforts, it may not be up to date or applicable to the circumstances of any particular case. We are not responsible for any
damage or injury resulting from abnormal use, from any failure to follow appropriate practices or from hazards inherent in the
nature of the product. ,
Product ETHANOL, DENATURED (FUEL GRADE)
name
Version 1 Date of issue 03/29/2006.
MSDS # 0000003552 Page: 8/8
Format US -COMP
Build 4.2.7
Language ENGLISH.
( ENGLISH )