NC0030384_Permit Issuance_20120614

AAA
ICDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Charles Wakild, P. E. Dee Freeman
Governor Director Secretary
June 14, 2012
Mr. James E. Young
Manager of Facilities and Planning
Piedmont Health Services, Inc.
P.O. Box 17179
Chapel Hill, NC 27516
Subject: Issuance of NPDES Permit
Permit No. NC0030384
Moncure Community Health Center
Facility Class I
Chatham County
Dear Mr. Young:
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).
The permit authorizes Piedmont Health Services, Inc. to discharge up to 2,500 GPD of
treated wastewater from Moncure Community Health Center to the Deep River, a class WS-IV
water in the Cape Fear River Basin. The permit includes discharge monitoring requirements
and/or limitations for flow, BOD5, total suspended solids, NH3 as N, fecal coliform, total
residual chlorine, and dissolved oxygen along with other parameters.
Please note that during the public notice period, comments regarding the renewal of the
permit, were received from the North Carolina Wildlife Resources Commission (WRC). The
WRC noted records of an endangered species, the Cape Fear Shiner, in the Deep River. The
comments recommended that the facility replace the chlorination/dechlorination system with
an ultraviolet light or ozone system for the protection of toxicity to aquatic organisms. In
addition, recommendations included increased monitoring frequency for total residual chlorine
and ammonia, and the installation of a standby power system.
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Location: 512 N. Salisbury St. Raleigh, North Carolina 27604
Phone: [phone] FAX: [phone] Customer Service:1-877-623-6748
Internet www.ncwaterauatiiv.orq
NOne C3T011lla
7Vaturaiij
An Equal Opportunity 1 Affirmative Action Employer

Mr. Young
June 14, 2012
Page 2 of 2
The following procedure has been implemented by DWQ: Total residual chlorine (TRC)
compliance level changed to 50 ug/l. Effective March 1, 2008, the Division received EPA
approval to allow a 50 ug/1 TRC compliance level. This change is due to analytical difficulties
with TRC measurements. Facilities will still be required to report actual results on their
monthly discharge monitoring report (DMR) submittals, but for compliance purposes, all TRC
values below 50 ug/1 will be treated as zero. A footnote regarding this change has been added
to the effluent limitations page in the permit.
The following modifications made in the draft permit of April 11, 2012, remain in the
final permit:
• The facility's treatment components have been listed separately on the supplement
to permit cover sheet.
• Special condition A. (4) has been added regarding the possibility of reopening the
permit for supplemental nutrient monitoring for the Cape Fear River modeling
effort.
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 a demand is made, this permit shall be final and binding.
Please take notice that this permit is not transferable. 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, Coastal Area Management Act, or any
other Federal or Local governmental permits may be required.
If you have any questions or need additional information, please contact Ms. Jacquelyn
Nowell at telephone number [phone].
Attachments
cc: Raleigh Regional Office/Surface Water Protection Section (ecopy)
NPDES File
Central Files

Permit NC0030384
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 provisions 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,
Piedmont Health Services, Inc.
is hereby authorized to discharge wastewater from a facility located at the
Moncure Community Health Center WWTP
7228 Pittsboro-Moncure Road
Moncure
Chatham County
to receiving waters designated as the Deep River in 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 July 1, 2012.
This permit and authorization to discharge shall expire at midnight on September 30, 2016.
Signed this day June 14, 2012.
jl harles Wakild, P.E., Director
Division of Water Quality
By Authority of the Environmental Management Commission

Permit NC0030384
SUPPLEMENT TO PERMIT COVER SHEET
All previous NPDES Permits issued to this facility, whether .for operation or discharge are hereby
revoked, and as of this 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.
Piedmont Health Services, Inc. is hereby authorized to:
1. Continue to operate an existing 0.0025 MGD wastewater treatment facility.with the following
components:
• Septic tank
• Dosing siphon distribution box
• Surface sand filters effluent pumps
♦ Tablet chlorination
• Chlorine contact tank
• Dechlorination
♦ Effluent pump
This facility is located at the Moncure Community Health Center WWTP, 7228 Pittsboro-Moncure
Road in Chatham County.
2. Discharge from said treatment works at the location specified on the attached map into the Deep
River, classified WS-1V waters in the Cape Fear River Basin. -

Moncure Community Health Center
WWTP
County: Chatham Stream Class: WS-IV
Receiving Stream: Deep River Sub -Basin: 030611
Latitude: 35° 37' 32" Grid/Quad: E22NE
Longitude: 79° 06' 01" HUC#: 03030003
J IMEN lVII �''
Facility
Location
(not to scale)
NPDES Permit No. NC0030384

Permit NC0030384
A. (1.) EFFLUENT LIMITATIONS AND MONITORING REQUIREMENTS -FINAL
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:
EFFLUENT
CHARACTERISTICS
,. LIMITS :
MQNITORINGREQU. REMENTS
Monthly
Average
Daily
Maximum
Measurement
Frequency
Sample Type
Sample Location
Flow
0.0025 MGD
Weekly
Instantaneous
Influent or Effluent
BOD, 5-day (20°C)
30.0 mg/L
45.0 mg/L
2/Month
Grab
Effluent
Total Suspended Solids
30.0 mg/L
45.0 mg/L
2/Month
Grab
Effluent
NH3 as N
2/Month
Grab
Effluent
Dissolved Oxygen'
Weekly
Grab
Effluent
Fecal Coliform (geometric
mean)
200 / 100 ml
400 / 100
ml
2/Month
Grab
Effluent
Total Residual Chlorine2
28 µg/L
Weekly
Grab
Effluent
Temperature (°C)
Daily
Grab
Effluent
pH3
2/Month
Grab
Effluent
Footnotes:
1. The daily average dissolved oxygen effluent concentration shall not be less than 6.0 mg/L.
2. The Division shall consider all effluent total residual chlorine values reported below 50 ug/1 to be
in compliance with the permit. However, the Permittee shall continue to record and submit all
values reported by a North Carolina certified laboratory (including field certified), even if these
values fall below 50 ug/1.
3. The pH shall not be less than 6.0 standard units nor greater than 9.0 standard units.
THERE SHALL BE NO DISCHARGE OF FLOATING SOLIDS OR VISIBLE FOAM IN OTHER THAN TRACE AMOUNTS.
A. (2.) FACILITY OPERATION CONDITIONS
The permittee is required to:
> Operate the wastewater treatment system as efficiently as possible, in a manner that prevents
discharge of excessive pollutants
> Provide an adequate operating staff at all times, duly qualified to perform the necessary
operational, maintenance and testing functions to ensure compliance with the permit.
> Schedule maintenance activities that result in diminished effluent quality during non -critical
water quality periods
> Obtain prior approval from the Division for any maintenance activities that result in diminished
effluent quality
> Have the septic tank pumped at least once each year by a source approved through the local
health department.
> Submit to the Division a copy of the operation and maintenance contract with the certified
operator for the facility.
A. (3.) PESTICIDE CONDITION
Any pesticide discharge from this facility shall be in compliance with the requirements of the Federal
Insecticide, Fungicide and Rodenticide Act (7 USC 136 et seq.). Usage of any pesticides likely to
cause discharge from this facility shall be in a manner consistent with label directions for the pesticide.

Permit NC0030384
A. (4) PERMIT RE -OPENER: SUPPLEMENTARY NUTRIENT MONITORING
Pursuant to N.C. Gen. Stat. Section 143-215.1 and the implementing rules found in Title 15A of the
North Carolina Administrative Code, Subchapter 2H, specifically, 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 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'

North Carolina Wildlife Resources Commission
Gordon Myers, Executive Director
MEMORANDUM
TO: Jackie Nowell, Surface Water Protection Section — Point Source Branch
Division of Water Quality
FROM: Shari L. Bryant, Piedmont Region Coordinator
Habitat Conservation Program
DATE: 4 May 2012
SUBJECT: Draft NPDES Permit for Piedmont Health Services, Inc., Moncure Community Health
Center WWTP, Chatham County, NPDES Permit No. NC0030384
Biologists with the North Carolina Wildlife Resources Commission have reviewed the subject
document. Our comments are provided in accordance with provisions of the Clean Water Act of 1977 (as
amended), Fish and Wildlife Coordination Act (48 Stat. 401, as amended; 16 U.S.C. 661-667e), North
Carolina General Statutes (G.S. 113-131 et seq.), and North Carolina Administrative Code 15A NCAC
10I.0102.
Piedmont Health Services, Inc. has applied for a renewal of their NPDES permit to discharge
0.0025 MGD of wastewater into Deep River in the Cape Fear River basin. The facility uses tablet
chlorination and dechlorination. There are records for the federal and state endangered Cape Fear shiner
(Notropis mekistocholas) in Deep River. Also, the Significant Natural Heritage Area (SNHA) Deep River
Slopes is located adjacent to the discharge site, and the SNHA Lower Rocky River/Lower Deep River
Aquatic Habitat is located in this section of the Deep River.
We reviewed EPA's Enforcement and Compliance History Online (ECHO) and it showed:
• In 2009, this facility had three violations of the limit for BOD, 5-day, 20 deg. C. The
maximum measured in each instance was 138, 144, and 313 mg/L.
• In November 2009, the maximum total residual chlorine was measured at 30,000 µg/L
with an average of 5,000 µg/L.
• From January 2009 to May 2010, average total ammonia -nitrogen (as N) ranged from
1.92 to 44.5 mg/L; the highest concentration measured was 69.0 mg/L.
Chlorine is acutely toxic to aquatic organisms and can form secondary compounds that are
detrimental to aquatic life. Also, fish and mussel species are very sensitive to ammonia. Dwyer et al.
(2005) found that Cape Fear shiners had an IC25 of 8.8 mg/L for ammonia. An IC25 is the level at which
Mailing Address: Division of Inland Fisheries • 1721 Mail Service Center • Raleigh, NC 27699-1721
Telephone: [phone] • Fax: [phone]

Page 2
4 May 2012
Moncure Community Health WWTP
NPDES Permit No. NC0030384
an organism exhibited a 25 percent reduction in a biological measurement such as reproduction or growth
after a 7-day exposure.
We recognize the discharge is small; however, due to the presence of Cape Fear shiner, it is
imperative the facility operates effectively to prevent excessive discharge of pollutants, particularly
chlorine and ammonia. Should the permit be renewed, we offer the following recommendations to
minimize impacts to aquatic resources.
1. Replace chlorine disinfection systems with ultraviolet light or ozone systems.
2. More frequent monitoring of chlorine and ammonia (e.g., two times per week). We are
concerned the current monitoring schedule is not sufficient for documenting compliance or for
identifying malfunctions in the facility's equipment.
3. If not already in place, we suggest the installation of a stand-by power system.
Thank you for the opportunity to comment on this draft permit. If we can be of further assistance,
please contact our office at [phone] or [e-mail].
Literature cited:
Dwyer, F.J., D.K. Hardesty, C.E. Henke, C.G. Ingersoll, D.W. Whites, T. Augspurger, T.J. Canfield, D.R.
Mount, and F.L. Mayer. 2005. Assessing Contaminant Sensitivity of Endangered and
Threatened Aquatic Species: Part III. Effluent Toxicity Tests. Archives of Environmental
Contamination and Toxicology 48:174-183.
ec: Ryan Heise, NCWRC
Tom Augspurger, USFWS
rit
£d£V7 kill
10.4 • ,t ?? c en) /�f/otte'74-/-ti/

Moncure Comm. Health Center WWTP
Residual Chlorine
7Q10 (CFS) 22.2
DESIGN FLOW (MGD) 0.0025
DESIGN FLOW (CFS) 0.003875
STREAM STD (UG/L) 17.0
UPS BACKGROUND LEVEL (I 0
IWC (%) 0.02
Allowable Concentration (ugi 97410.55
Fecal Limit 200/100m1
Ratio of 5729.0 :1
Ammonia as NH3
(summer)
7010 (CFS)
DESIGN FLOW (MGD)
DESIGN FLOW (CFS)
STREAM STD (MG/L)
22.2
0.0025
0.003875
1.0
UPS BACKGROUND LEVEL (f 0.22
IWC (%) 0.02
Allowable Concentration (Mg 4469.65
Ammonia as NH3
(winter)
7Q10 (CFS) 42.3
DESIGN FLOW (MGD) 0.0025
DESIGN FLOW (CFS) 0.003875
STREAM STD (MG/L) 1.8
UPS BACKGROUND LEVEL (1 0.22
IWC (%) 0.0Th
Allowable Concentration (mg17249.28
_N O1025.542
6/5/2012

NO '-TRi CA1"OU11NA
CHATTHAM COUNTY
116 Chatit
AFFIDAVIT OF PUBLICATION
Before the undersigned, a Notary Public of said County and State, duly
commissioned, qualified, and authorized by law to administer oaths, person-
ally appeared
Florence Turner
first duly sworn, deposes and says: that he (she) is
Accounts Receivable Clerk
who being
(Owner, partner, publisher, or other officer or employee
authorized to make this affidavit)
of The Chatham News Publishing Co., Inc., engaged in the publication of a
newspaper known as, The Chatham News, published, issued, and entered as
second class mail in the Town of Siler City, in said County and State; that
he (she) is authorized to make this affidavit and sworn statement; that the
notice or legal advertisement, a true copy of which is attached hereto, was
published in The Chatham News on the following dates:
and that the said newspaper in which such notice, paper, document, or
legal advertisement was published was, at the time of each and every such
publication, a newspaper meeting all of the requirements and qualifications
of Section 1-597 of the General Statutes of North Carolina and was a quali-
fied newspaper within the meaning of Section 1-597 of the General Statues
of North Carolina.
This ; i day of
rj
6•
Swto ae sulcribOaoefore me, this
e.t LI ea. (— o
o SOP,'. Z 4
day �2
®, oQuo
C�,Cc IS OOs790A°
�Qe��
(Signature of person making affidavit)
Notary Public
CLIPPING OF LEGAL
ADVERTISEMENT
ATTACHED HERETO
Public Notice
North Carolina Environmental
Management Commission/
NPDES Unit
1617 Mail Service Center
Raleigh, NC 27699-1617
Notice of Intent to Issue a
NPDES Wastewater Permit
The North Carolina Environmental
Management Commission proposes
to issue a NPDES wastewater dis-
charge permit to the person(s) listed
below.
Written comments regarding the pro-
posed permit will be accepted until 30
days after the publish date of this no-
tice. The Director of the NC Division
of Water Quality (DWQ) may hold
a public hearing should there be a
significant degree of public interest.
Please mail comments and/or infor-
mation requests to DWQ at the above
address. Interested persons may visit
the DWQ at 512 N. Salisbury Street.
Raleigh, NC to review information on
file. Additional information on NPDES
permits and this notice may be found
on our website: http://portal.ncdenr.
org/web/wq/swp/psinpdes/calendar,
or by calling [phone].
SS Construction & Rental, Inc. re-
quested renewal of permit NC0038300
for the SS Mobile Horne Park in
Chatham County; this permitted dis-
charge is treated domestic wastewa-
ter to an unnamed tributary to Brush
Creek in the Cape Fear River Basin.
Piedmont Health Services, Inc. re-
quested renewal of permit NC0030384
for Moncure Community Health
Center WWTP in Chatham county;
this permitted discharge is domestic
treated wastewater to Deep River in
the Cape Fear River Basin. A19 1tc
My Commission expires

AwA
APR 1 3 2012 11
NCDENR -
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Charles Wakild, RE. Dee Freeman
Governor Director Secretary
April 11, 2012
MEMORANDUM
'1'0: Micheal Douglas
NC DENR/DWR/Regional Engineer
Raleigh Regional Office
q � M. Nowell
Jacq
uelyn
DWQ/NPDES Complex Permitting Unit
Subject:
Review of NPDES Permit NC0030384
Moncure Community Health Center WWTP
Chatham County
Please indicate below your agency's position or viewpoint on the permit and return this form by April 25, 2012. If
you have any questions on the permit, please contact me at 919-807-6386 or e-mail to jackie.nowellta%ncdenr.gov.
RESPONSE: (Check one)
X
RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR
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.
Concurs with issuance of the above permit, provided the following conditions are met:
Opposes the issuance of the above permit, based on reasons stated below, or attached:
Signed
((a
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Location: 512 N. Salisbury St Raleigh, North Carolina 27604
Phone: [phone] FAX: [phone] \ Customer Service: 1-877-623-6748
Internet: www.ncwaterquality.org
An Equal Opportunity \ Affirmative Action Employer
Date: OLL/14
NonrthCarolina
Naturally

401av //c)hL('
L,J.s/(/ 0foc/r
ifryokkii o yo5 00
U V Zo o U yw4 A -
e Fe s-G 26
uolf
f 4'14 - .at4xC1
Co 779 (r) 7 /f
"Pk„ (/ / )
366
ZS
Z
ZS
bid"."(//- /2/4/Z"6
S,
ef9/Alu
(c
4if" C%/v
lAttetiti
/r i
i
p
ZD/o
/ ,Z�c,L1 a- /J 41 # t1
Gtr 1
?yaw

Ambient Monitoring System Station Summaries
NCDENR, Division of Water Quality
Basinwide Assessment Report
Location: DEEP RIV AT SR 1011 OLD US 1 NR MONCURE
Station #: B6040300 Hydrologic Unit Code: 03030003
Latitude: 35.61759 Longitude: -79.09119 Stream class: WS-IV
Agency: UCFRBA NC stream index: 17-(43.5)
Time period: 01/30/2004 to 12/15/2008
# # Results not meeting EL Percentiles
results ND EL # % %Conf Min 10th 25th 50th 75th 90th Max
Field
D.O. (mg/L) 60 0 <4 0 0 5.5 6.6 7.6 9.1 11.3 13 13.5
60 0 <5 0 0 5.5 6.6 7.6 9.1 11.3 13 13.5
pH (SU) 60 0 <6 0 0 6.2 6.8 7 7.2 7.4 7.6 7.9
60 0 >9 0 0 6.2 6.8 7 7.2 7.4 7.6 7.9
Spec. conductance 60 1 N/A 64 91 106 143 174 251 339
(umhos/cm at 25°C)
Water Temperature (°C) 60 0 >32 0 0 3 5.8 9.8 18.1 25.3 28.2 31
Other
TSS (mg/L) 60 7 N/A 1 1 2 5 9 32 200
Turbidity (NTU) 60 0 >50 3 5 1.5 3.3 4.9 9.9 23.8 43.5 211
Nutrients (mg/L)
NH3 as N 59 24 N/A 0.02 0.02 0.02 0.02 0.05 0.14 0.39
NO2 + NO3 as N 60 I >10 0 0 0.02 0.54 0.67 0.89 1.02 1.21 2.74
TKN as N 59 I N/A 0.2 0.4 0.42 0.53 0.82 1.3 14
Total Phosphorus 60 0 N/A 0.02 0.09 0.12 0.19 0.28 0.37 0.58
Metals (ug/L)
Aluminum, total (Al) 25 0 N/A 70 133 198 456 768 1148 3470
Arsenic, total (As) 25 25 >10 0 0 5 5 5 10 10 10 10
Cadmium, total (Cd) 25 25 >2 0 0 0.5 0.5 1 2 2 2 2
Chromium, total (Cr) 25 24 >50 0 0 5 5 5 5 10 10 10
Copper, total (Cu) 25 7 >7 2 8 2 2 2 3 5 8 16
Iron, total (Fe) 25 0 >1000 10 40 100 351 568 810 918 1345 2194 3030
Lead,total(Pb) 25 24 >25 0 0 2 2 10 10 10 10 10
Manganese, total (Mn) 25 0 >200 l 4 19 22 31 46 88 118 352
Mercury, total (Hg) 25 16 >0.012 0 0 0.002 0.002 0.004 0.2 0.2 0.2 0.2
Nickel, total (Ni) 25 25 >25 0 0 5 5 5 10 10 10 10
Zinc, total (Zn) 25 17 >50 I 4 10 10 10 10 18 25 105
Fecal Coliform Screening(#/100mL)
# results: Geomean # > 400: % > 400: %Conf:
60 70 10 17
Key:
# result number of observations
# ND: number of observations reported to be below detection level (non -detect)
EL: Evaluation Level; applicable numeric or narrative water quality standard or action level
Results not meeting EL: number and percentages of observations not meeting evaluation level
%Conf : States the percent statistical confidence that the actual percentage of exceedances is at least 10% (20% for Fecal Coliform)
Stations with less than 10 results for a given parameter were not evaluated for statistical confidence
NCDENR, Division of Water Quality
Ambient Monitoring System Report
Cape Fear River Basin -August 2009
AMS-132

Ambient Monitoring System Station Summaries
NCDENR, Division of Water Quality
Basinwide Assessment Report
Location: DEEP RIV AT SR 1011 OLD US 1 NR MONCURE
Station #: B6040300 Hydrologic Unit Code: 03030003
Latitude: 35.61759 Longitude: -79.09119 Stream class: WS-IV
Agency: NCAMBNT NC stream index: 17-(43.5)
Time period: 01/28/2004 to 12/01/2008
# # Results not meeting EL Percentiles
results ND EL # % %Conf Min 10th 25th 50th 75th 90th Max
Field
D.O. (mg/L) 50 0 <4 1 2 2.5 5.9 6.5 8.7 10.6 12.2 13.9
50 0 <5 2 4 2.5 5.9 6.5 8.7 10.6 12.2 13.9
pH (SU) 54 0 <6 0 0 6 6.5 6.6 6.8 7.3 7.5 8.5
54 0 >9 0 0 6 6.5 6.6 6.8 7.3 7.5 8.5
Salinity (ppt) 21 0 N/A 0 0.02 0.1 0.1 0.1 0.1 0.1
Spec. conductance 53 0 N/A 75 91 113 133 168 222 341
(umhos/cm at 25°C)
Water Temperature (°C) 54 0 >32 0 0 1 7 10.1 19 25.8 27.6 29.9
Other
TSS (mg/L) 20 3 N/A 2.5 2.6 5.3 6.8 11.2 36.8 163
Turbidity (NTU) 54 0 >50 1.9 3.8 5.2 9.7 20 35 150
Metals (ug/L)
Aluminum, total (Al) 13 0 N/A 170 174 255 420 680 5280 8000
Arsenic, total (As) 13 13 >10 0 0 5 5 5 5 5 10 10
Cadmium, total (Cd) 13 13 >2 0 0 1 1.4 2 2 2 2 2
Chromium, total (Cr) 13 13 >50 0 0 10 16 25 25 25 25 25
Copper, total (Cu) 13 0 >7 I 7.7 2 2 2 2 3 7 10
Iron, total (Fe) 13 0 >1000 5 38.5 380 476 765 880 1450 4840 6800
Lead, total (Pb) 13 13 >25 0 0 10 10 10 10 10 10 10
Manganese, total (Mn) 13 0 >200 I 7.7 23 24 39 53 96 274 390
Mercury, total (Hg) 12 12 >0.012 0 0 0.2 0.2 0.2 0.2 0.2 0.2 0.2
Nickel, total (Ni) 13 13 >25 0 0 10 10 10 10 10 10 10
Zinc, total (Zn) 13 8 >50 0 0 10 10 10 10 17 29 31
3 5.6
99.9
Fecal Coliform Screening(#/100mL)
# results: Geomean # > 400: %> 400: %Conf:
54 41 3 6
Kev:
# result: number of observations
# NO: number of observations reported to be below detection level (non -detect)
EL: Evaluation Level; applicable numeric or narrative water quality standard or action level
Results not meeting EL: number and percentages of observations not meeting evaluation level
%Conf : States the percent statistical confidence that the actual percentage of exceedances is at least 10% (20% for Fecal Coliform)
Stations with Tess than 10 results for a given parameter were not evaluated for statistical confidence
NCDENR, Division of Water Quality
Ambient Monitoring System Report
Cape Fear River Basin - August 2009
AMS-131

Alo et a /
6ov,-u- // 2-606 ims 1 ceo a .-7wv
O fr 3 (5)9 /4 / 09G 5441-04'5
re6 8 / /, f� o Zoo y� �v 2o/
/i6V /VL,), 2C/c);1'4,,,f, , Zoe) g .Xceze&.0 / 24
,lU/k)
51 a //e41,-/— el (fie-6
a4-htiv,A0 AAV,
c`rit�jJ/v� / 7 1 �Z1 f_ / �C
L
404 AlkS a)C1/4 Ao /-74,641 e4,^ 2,063 /Y 20(> (//r)
zo S (x/ ZOO l( LX
/t/, ZED 2
01,04.j) c,3, 1 11- /
w/ v 1,k 1�//(/ -)
i
26 ci/

❑ Submitted to
NPDES PERMIT RENEWAL
DRAFT & FINAL
CHECK LIST
FILE CONTENTS: Facility i v> N eA 3 -ex-vi' es
Permit No. P C 40 J Cr S
Left side:
O BIMS Tracking Slip
Right side:
❑ Streamline Package Sheet
❑ Draft Permit Cover Letter.
❑ Draft Permit
❑ Facility Map
❑ Fact Sheet
❑ Permit Writer's Notes
❑ Staff Report from Region
❑ Old Permit
❑ Permit Application.
❑ Acknowledgement Letter
❑ Permittee Responses
❑ Waste Load Allocation
NPDES Permit Writer: (41/ '2
(to region, only if streamlined)
(add new policy text; summarize major changes to permit)
(order: cover, supplement, map, effluent sheets, special conditions)
(E-Map: include facility Outfalls; U and D sample locations)
(documents permit writer's issues and re -issue logic)
(if not in Facts Sheet -- chronology, strategy, DMR Review, RPA, etc.)
(as appropriate -- not needed if streamlined)
(Text, Effluent Sheets and Special Conditions)
(New Permit or Renewal; any additional permittee correspondence)
(NPDES Unit written response to Renewal Application)
(to acknowledgement letter, if any)
(reference date; notes if recalculated for current action)
Note: Italics indicate special conditions not always required or applicable.
P.
! for Peer Review: Date
❑ Peer Review completed by Date
❑ Updated Public Notice System [date]
Admin cutoff date
. Updated BIMS Events: [date]
O Submitted for Public Notice on Y 4 =' / ` Newspaper Notice Received . Actual Notice date(s)
iLtat- it /7Zv/ Z �
O Draft Permit [Mailed f Maile o (Regional Staff) by i� ° Date `f
Cl Regional Office Reviewed /Approved by . Received on [Date]
❑ Additional Review by [TO t S�9 / /ti• iZ
initiated by
Vj Date !/l/Zd l7i
u Additional ReviewiApprovai by Date
O EPA Review - Draft sent to initiated by
Date
O EPA Reviewed /Approved [mail / E-mail] by Date Received
O FINAL to John / Jeff / Mike / Matt / for signature on [date] � Letter Dated
❑ Additional Review (other] ljt vim d t 1 %u4 '1 3 v 3" /l ir� / 611/M a i
❑ Final Files transferred to Server (Permits Folder) . BIMS Final Updates: Events Limits
❑ Emailed FINAL to Kim Colson (CG&L) [Date]
Version 25May2011

eixt
CORPORATE OFFICE
299 Lloyd Street
Carrboro, NC 27510
[phone]
FAX [phone]
CARRBORO COMMUNITY
HEALTH CENTER
301 Lloyd Street
Carrboro, NC 275to
[phone]
FAX [phone]
Pakh Ser\ices. Inc.
IEDMON
CHARLES DREW COMMUNITY
HEALTH CENTER
221 N. Graham Hopedale Road
Burlington, NC 27217-2971
[phone]
FAX (336) 570-I215
MONCURE COMMUNITY HEALTH
CENTER
PO Box 319
7228 Pittsboro-Moncure Road
Moncure, NC 27559
[phone]
FAX [phone]
PROSPECT HILL COMMUNITY
HEALTH CENTER
PO Box 4
140 Main Street
Prospect Hill, NC 27314
[phone]
FAX [phone]
TOLL FREE [phone]
ScoTT CLINIC
5270 Union Ridge Road
Burlington, NC 27217
[phone]
FAX [phone]
Sn.ER CrrY CoMMUNrrr
HEALTH CENTER
PO Box 83r
224 South loth Avenue
Siler City NC 27344
[phone]
FAX [phone]
March 30, 2011
MAILING ADDRESS
PO Box 17179
Chapel Hill, NC 27516-7179
[phone]
FAX [phone]
Mrs. Dina Sprinkle
NC DENR / DWQ / Point Source Branch
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Subject: Renewal Application
Dear Mrs. Sprinkle,
Please accept this letter as our request to renew the NPDES Wastewater Permit
for our Moncure Community Health Center WWTP in Chatham County.
Since our last Permit there have been no changes to our system.
If there are any questions or concerns, please do not hesitate to call or e-mail.
Thank You,
im You
Manager of Facilities & Planning
Piedmont Health Services, Inc.
919-428-8764 Cell
[e-mail]
Orfg_41ROY§
APR 0 4 2011
DENR-WATER QUALITY
POD SOURCE BRANCH
D
"People Caring for People since 1970"

04-01-'11 10:07 FPOM-
T-630 P0002/0005 F-461
NC DENR / IDWQ / NPDES
RenewalA.pplicatIon Checldiat
The following items axe REOWRED for all renewal packages:
O A cover letter requesting renewal of the permit and documenting any changes at the facility since
issuance of the last permit. Submit one signed original and two copies.
•
0 The completed application form (copir attached), signed by the permittee or an Authorized
Representative. Submit one signed 'original and two copies.
C' If an Authorized Representative (such as a consulting engineer oz environmental consultant) prepares
die renewal package, written documentation must be provided showing the authority delegated to the
Authorized Representative (see Part II.B.11.b of the existing NPDES parrot).
El A narrative description of the sludge management plan for the facility. Describe how sludge (or other
solids) generated during wastewater treatment ate handled and disposed. If your facility has no such
plan (or the permitted facility does not generate any solids), explain this in writing Submit one signed
original and two copies.
The facility at Moisture is equipped with a dual septic tank holding all solids and
keeping any sludge from the treatment system. These tanks arc pumped twice a
year by Clark Septic of Slier City.
The following items ran be submitted, by a y Municipal or xneiusttial fa ' 'ties _e chafing
procOR artist water:
0 Industtiai facilities classified as Primary Industries (sec Appendices A-D to Title 40 of the Code of
Federal Reguladons, Part 122) and ALL Municipal facilities with a permitted flow 1.0 MGT) must
submit a Priority Pollutant Analysis (PPA) in accordance with 40 CPR. Part 122.21.
The above teguiremeot does NOT appf v to non-induatnalfacilities.
Send the completed renewal package to:
Mrs. Oita Sprinkle
NC DENR / DWQ / Point Source Branch
1617 Mail Service Center
Raleigh, NC 276994617
[phone]

Name
Mailing Address
City
State / Zip Code
Telephone Number
Fax Number
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
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
Y'.-ec%}ranf /i %I/ e''GcSf
#TCyrc #6.2<7.4 C. eMZcr
01 ,e/07,/ //Sf
oZ7576
(9/9) 933- 8.419c 6xe. /4 84
( 9i9) 933- 9,261
!�°urt�,✓ a,oied„rontftea/ i. or�
2. Location of facility producing discharge:
Check here if same address as above ❑
Street Address or State Road
City
State / Zip Code
County
7.2 28 ? zlztsI�ry -ea we're
leOga/
/t/- C. 02 76-5
e cz
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 oraORC)
e d/r/on C /l"a/17/ Services, .L.rc.
a9 L/oyJ
/ J
/(7: 027576
(9/9) 933 - o 1/44/ &X Z. /84
(giq.) 9'33 - 9,2a/
OMR
I
AHK u 4 20ii
DENR-WATER QUALITY
POINT SOURCE BRANCH
1 of 3 Form-D 05/08

04-01-' 11 10:08 FFOM-
T-630 P000410005 F-461
NPDES APPLICATION - FORM D
For privately owned treatment systems treating 100% domestic wastewaters <1.0 MOD
4. Description of wastewater;
FaciXi v Generati Wi tg vate3r(check di that applgj:
Industrial ❑ Number of Employees
Commercial Number of Employees
Residential • 0 Number of Homes
School ❑ Number of Students/Staff
• Other ❑ Explain:
Describe the source(s) of Wastearater (example: subdivision, mobile home park, shopping centers.
restaurants, etc.):
�6<n.1-r�•�i' z�� /V .7/14 KPH
Population semen: G
5. Type et collection system
1 Separate (sanitary sewer only)
❑ Combined (storm sewer and sanitary sewer)
6. Outfail Information:
Number of separate discharge points 1
Outfall Identification number(s) 001
Is the outfall equipped with a diffuser? ❑ Yes EI No
7. Name of receiving etz eam(s) (Provide a map showing the exact location of each outfa[i):
Deep River
8. Frequency of Discharge; ❑ Continuous �,]x` Intermittent
If intermittent: /
Days per week discharge occurs; , a Duration: %`ram c
G. Describe the treatment system
Ltst oil thstailed components, incluoltruj cupardies, provide design removal. for DOD. TS.S, nitrogen and
phosphorus. If the space provided is net sufficient; attach the deSeriptton of the treats/tentsystem in a
separate Sheet ofp=
Influent is received into the system from a duel septic tank allowing liquid only to pass through to the treatment
system. Influent then enters a 1S,00t) gallon bolding tank where it is then pumped to a Dosing siphon
distribution box where it is then dosed into alternating sarrote sand filters. From the filter, two-tbirds of the
wastewstetr its recycled back to the holding tank wbiia the remaining third passes through tablet chlorination
and into a Chlorine contact chamber. From here the effluent passes through tablet decbloriaatfon and into an
grated wet -well where it is then pumped out otthe plant to the receiving stream.
2 eta ' Form•D OS/08
•

04-01-'11 10:08 FROM-
T-630 P0005/0005 F-461
IMES APPLICATION - FORM D
For privately owned teatment systems treating 100% domestic wastewaters <1.0 MGD
XQ. Flow Information:
Treatment Plant Design flow .0025 MGD
Annual Average daily flow .0007 MGD {for the previous 3 years)
Maximum daily Bow .0012 MGD (for the previous 3 years)
11. • is this facility located on Indian country?
QYes IJNo
12. Effluent Data
Ptoutde dabafor the parameter* listed Feorg Calfform. Temperature andpII shalt b€9rab sorrcplss, for all other
paro peters 24-hour composite sampUfnp shall be used. if more ttwn one analysis is report report daffy rnaxinwn
and monthly avera9 . rattly one analysis is reported, report as datly maximum
Parameter
Maximum
maximum
Monthly
Airtraaa
Units of
Measurement
Biochemical Oxygen Demand 0B0D5)
313
24.4
mg/L
Fecal Conform
>6000
49.9
col/100mL
Total Suspended Solids
21
5.3
mg/L
Temperature (Summer)
34.8
23.5
Celsius
Temperature (Winter)
28.3
11.8
Celsius
pH
10.40 --
7.4
Std. Units - _
13. Dist all permits. construction approvals and/or applications:
Typo Permit Number Type
Hazardous Waste (RCM) NEsHAPS (CAA)
DiC (SDWAJ - Ocean Dumping (1v1Pit2SA)
NPDES NC0030384 Dredge or fill (Section 404 Or CWA)
PSD (CAA) Other
KOn-attathment Pram (CAA)
Permit Number
14. APPLICANT CCRT`Il#a`IQATION
I certify► that 1 am familiar with the information contained in the application and that to the
best of my Inowiedge and belief such information is true, complete. and accurate.
•
iz ,r/� /1: 8 l/� / ///sii'se
V C7 r1i t° s L. i / G� LJ 1�% � .�i=�.i-%i:i`AJ ��p�%% 291i� � - � � /�S `/.
Printed name of Person S$gr ng Ztde
Daf�e
oat Carolina General e 143-215.0 (b 2) states: Any person who knowirgy makes any false statement representation. or certification to any
application, rowed, report, pram or other document fifes or required to be maintained under Article 21 or regulations d the Environmental Management
Commission ptetnerit ng that Article,or who falsi!ies, tampers with, or knowingly renders inscaate any recording or moto'todng devisee or method
required to be operated or maintained under Article 21 or regulations of cite Environmental Management Commission implementing that Artide, sbalJ be
guilty of a rrasdemeaaor punishable by a fine net to exceed $25,000, or by imprlsonmenI not to exceed abc months, or by both. (18 U.S.C. Section 1001
provides a punishment byatine of not more than $25,000 or imprisonment not more than 5 years. or both, fora similar offense,)
3013
Form•D O5fOB