NC0040797_Renewal (Application)_20150127

HICKORY
Public Utilities
January 20, 2015
NC Department of Environment and Natural Resources
Division of Water Quality/ Point Source Branch
1617 Mail Service Center
Raleigh NC 27699-1617
RE: NPDES Permit Renewal Application (NPDES # NC0040797)
City of Hickory Henry Fork WWTP
Hickory North Carolina
Dear Sirs:
City of Hickory
Post Office Box 398
Hickory, NC 28603
Phone: [phone]
Fax: [phone]
Email: [e-mail]
RECEIVED/DENR/DWI=
JAN 2 7 2015
Water Quality
Permitting Sectior
Enclosed please find for you review and processing the application package to renew the City of
Hickory's Henry Fork Wastewater Treatment Plant NPDES permit. The application package includes the
following:
• EPA form 2A
■ Part A
■ Part B
• Part C
■ Part D
■ Part E
■ Part F
• Attachment A
• Attachment B
• Attachment C
• Attachment D
• Letter describing the Sludge Management Practices
If additional information is needed, please feel free to contact me at [phone].
Sincerely,
Kevin B. Greer, PE, DS-A, CS -IV
Assistant Public Services Director, Public Utilities
Enclosures
pc: M. Shawn Pennell, Collections Manager
Robert Shaver, Henry Fork WWTP ORC

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
HENRY FORK WWTP, NC 0040797 RENEWAL CATAWBA
FORM
2A
NPDES
APPLICATION OVERVIEW
Form 2A has been developed in a modular format and consists of a "Basic Application Information" packet
and a "Supplemental Application Information" packet. The Basic Application Information packet is divided
into two parts. All applicants must complete Parts A and C. Applicants with a design flow greater than or
equal to 0.1 mgd must also complete Part B. Some applicants must also complete the Supplemental
Application Information packet. The following items explain which parts of Form 2A you must complete.
BASIC APPLICATION INFORMATION:
A. Basic Application Information for all Applicants. All applicants must complete questions A.1 through A.8. A treatment works
that discharges effluent to surface waters of the United States must also answer questions A.9 through A.12.
B. Additional Application Information for Applicants with a Design Flow >_ 0.1 mgd. All treaty ett yl�;ya�icF�l bENRV ,Pws
greater than or equal to 0.1 million gallons per day must complete questions B.1 through 6.6. �t VVCCUUII
C. Certification. All applicants must complete Part C (Certification). JAN 2 7 2015
SUPPLEMENTAL APPLICATION INFORMATION: Water Qua1itY
Permitting Sectlor
D. Expanded Effluent Testing Data. A treatment works that discharges effluent to surface waters of the United States and meets
one or more of the following criteria must complete Part D (Expanded Effluent Testing Data):
1. Has a design flow rate greater than or equal to 1 mgd,
2. Is required to have a pretreatment program (or has one in place), or
3. Is otherwise required by the permitting authority to provide the information.
E. Toxicity Testing Data. A treatment works that meets one or more of the following criteria must complete Part E (Toxicity Testing
Data):
1. Has a design flow rate greater than or equal to 1 mgd,
2. Is required to have a pretreatment program (or has one in place), or
3. Is otherwise required by the permitting authority to submit results of toxicity testing.
Industrial User Discharges and RCRA/CERCLA Wastes. A treatment works that accepts process wastewater from any
significant industrial users (SIUs) or receives RCRA or CERCLA wastes must complete Part F (Industrial User Discharges
and RCRA/CERCLA Wastes). SIUs are defined as:
All industrial users subject to Categorical Pretreatment Standards under 40 Code of Federal Regulations (CFR) 403.6 and
40 CFR Chapter I, Subchapter N (see instructions); and
Any other industrial user that:
a. Discharges an average of 25,000 gallons per day or more of process wastewater to the treatment works (with certain
exclusions); or
b. Contributes a process wastestream that makes up 5 percent or more of the average dry weather hydraulic or organic
capacity of the treatment plant; or
C. Is designated as an SIU by the control authority.
G. Combined Sewer Systems. A treatment works that has a combined sewer system must complete Part G (Combined Sewer
Systems).
ALL APPLICANTS MUST COMPLETE PART C (CERTIFICATION)
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 1 of 22

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
HENRY FORK WWTP, NCO040797
9
RENEWAL
CATAWBA
BASIC APPLICATION INFORMATION
PART A. BASIC APPLICATION INFORMATION FOR ALL APPLICANTS:
All treatment works must complete questions A.1 through A.8 of this Basic Application Information Packet
A.I. Facility Information.
Facility Name CITY OF HICKORY HENRY FORK WASTEWATER TREATMENT PLANT
Mailing Address PO BOX 398
RECEIVEDIDENRIDWR
HICKORY, NC 28603
JAN 2 7 2015
Contact Person ROBERT SHAVER
Title PLANT SUPERINTENDENT, ORC Water.Qualit
ermmiing omuu-
Telephone Number [phone]
Facility Address 4014 RIVER ROAD
(not P.O. Box) HICKORY, NC 28602
A.2. Applicant Information. If the applicant is different from the above, provide the following:
Applicant Name CITY OF HICKORY
Mailing Address PO BOX 398
HICKORY NC 28603
Contact Person MICK W. BERRY
Title CITY MANAGER
Telephone Number [phone]
Is the applicant the owner or operator (or both) of the treatment works?
® owner ® operator
Indicate whether correspondence regarding this permit should be directed to the facility or the applicant.
❑ facility ® applicant
A.3. Existing Environmental Permits. Provide the permit number of any existing environmental permits that have been issued to the treatment works
(include state -Issued permits).
NPDES NCO040797 PSD
UIC Other
RCRA Other
A.4. Collection System information. Provide information on municipalities and areas served by the facility. Provide the name and population of each
entity and, if known, provide information on the type of collection system (combined vs. separate) and its ownership (municipal, private, etc.).
Name Population Served Type of Collection System Ownership
CITY OF HICKORY 16,804 SEPERATE MUNICIPAL
BROOKFORD 382 SEPERATE MUNICIPAL
LONGVIEW 4,871 SEPERATE MUNICIPAL
Total population served 22,057
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 2 of 22

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
HENRY FORK WWTP, NCO040797
RENEWAL
CATAWBA
BASIC APPLICATION INFORMATION
PART B. ADDITIONAL APPLICATION INFORMATION FOR APPLICANTS WITH A DESIGN FLOW GREATER THAN OR
EQUAL TO 0.1 MGD (100,000 gallons per day).
All applicants with a design flow rate t 0.1 mgd must answer questions BA through B.S. All others go to Part C (Certification).
B.I. Inflow and Infiltration. Estimate the average number of gallons per day that flow into the treatment works from inflow and/or infiltration.
118,350 gpd
Briefly explain any steps underway or planned to minimize inflow and infiltration.
The City of Hickory currently utilizes surveillance of pipes and manhole rehabilitation, as needed, to control inflow
and infiltration.
B.2. Topographic Map. Attach to this application a topographic map of the area extending at least one mile beyond facility property boundaries. This
map must show the outline of the facility and the following information. (You may submit more than one map if one map does not show the entire
area.)
a. The area surrounding the treatment plant, including all unit processes.
b. The major pipes or other structures through which wastewater enters the treatment works and the pipes or other structures through which
treated wastewater Is discharged from the treatment plant. Include outfalls from bypass piping, if applicable.
c. Each well where wastewater from the treatment plant is injected underground.
d. Wells, springs, other surface water bodies, and drinking water wells that are: 1) within 1% mile of the property boundaries of the treatment
works, and 2) listed in public record or otherwise known to the applicant.
e. Any areas where the sewage sludge produced by the treatment works is stored, treated, or disposed.
f. If the treatment works receives waste that is classified as hazardous under the Resource Conservation and Recovery Act (RCRA) by truck, rail,
or special pipe, show on the map where the hazardous waste enters the treatment works and where it is treated, stored, and/or disposed.
B.3. Process Flow Diagram or Schematic. Provide a diagram showing the processes of the treatment plant, including all bypass piping and all
backup power sources or redunancy in the system. Also provide a water balance showing all treatment units, including disinfection (e.g.,
chlorination and dechlorination). The water balance must show daily average flow rates at influent and discharge points and approximate daily flow
rates between treatment units. Include a brief narrative description of the diagram.
B.4. Operation/Maintenance Performed by Contractor(s).
Are any operational or maintenance aspects (related to wastewater treatment and effluent quality) of the treatment works the responsibility of a
contractor? ❑ Yes ® No
If yes, list the name, address, telephone number, and status of each contractor and describe the contractor's responsibilities (attach additional
pages If necessary).
Name: N/A
Mailing Address: N/A
Telephone Number. ( )
Responsibilities of Contractor. N/A
B.S. Scheduled Improvements and Schedules of Implementation. Provide information on any uncompleted implementation schedule or
uncompleted plans for improvements that will affect the wastewater treatment, effluent quality, or design capacity of the treatment works. If the
treatment works has several different implementation schedules or is planning several improvements, submit separate responses to question 13.5
for each. (If none, go to question 13.6.)
a. List the outfall number (assigned in question A.9) for each outfall that is covered by this implementation schedule.
N/A
b. Indicate whether the planned improvements or implementation schedule are required by local, State, or Federal agencies.
❑ Yes ❑ No
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 6 7550-22. Page 7 of 22

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
HENRY FORK WWTP, NCO040797
RENEWAL
CATAWBA
C. If the answer to B.5.b is "Yes," briefly describe, including new maximum daily inflow rate (if applicable).
N/A
d. Provide dates Imposed by any compliance schedule or any actual dates of completion for the implementation steps listed below, as
applicable. For improvements planned independently of local, State, or Federal agencies, indicate planned or actual completion dates, as
applicable. Indicate dates as accurately as possible.
Schedule Actual Completion
Implementation Stage MM/DD/YYYY MM/DD/YYYY
- Begin Construction
- End Construction
- Begin Discharge
- Attain Operational Level / /
e. Have appropriate permits/clearances concerning other Federal/State requirements been obtained? ❑ Yes ❑ No
Describe briefly:
B.S. EFFLUENT TESTING DATA (GREATER THAN 0.1 MGD ONLY).
Applicants that discharge to waters of the US must provide effluent testing data for the following parameters. Provide the indicated
effluent testing required by the permitting authority for each outfall through which effluent Is discharged. Do not Include Information
on combine sewer overflows In this section. All Information reported must be based on data collected through analysis conducted
using 40 CFR Part 136 methods. In addition, this data must comply with QA/QC requirements of 40 CFR Part 136 and other appropriate
QA/QC requirements for standard methods for analytes not addressed by 40 CFR Part 136. At a minimum effluent testing data must be
based on at least three pollutant scans and must be no more than four and on -half years old.
Outfali Number. 001
MAXIMUM DAILY
DISCHARGE
AVERAGE DAILY DISCHARGE
POLLUTANT
ANALYTICAL
ML/MDL
Conc.
Units
Conc.
Units
Number of
METHOD
Samples
CONVENTIONAL AND NON CONVENTIONAL COMPOUNDS
AMMONIA (as N)
21.0
mg/L
0.72
mg/L
983
4500NH3 D-1997
0.10
CHLORINE (TOTAL
RESIDUAL, TRC)
48
ug/L
<20
ug/L
980
4500CI G-2000
20
DISSOLVED OXYGEN
8.4
mg/L
6.8
mg/L
980
45000 G-2000
0.10
TOTAL KJELDAHL
NITROGEN (TKN)
103
mg/L
6.9
mg/L
50
351.2 (1993)
0.50
NITRATE PLUS NITRITE
NITROGEN
29.0
mg/L
14.9
mg/L
So
353.2 (1978)
0.10
OIL and GREASE
<5
mg/L
<5
mg/L
3
1664B
5.0
PHOSPHORUS (Total)
5.1
mg/L
2.9
mg/L
50
365.3 (1978)
0.30
TOTAL DISSOLVED SOLIDS
(TDS)
594
mg/L
418
mg/L
3
2640 C-1997
25.0
OTHER
END OF PART B.
REFER TO THE APPLICATION OVERVIEW (PAGE 1) TO DETERMINE WHICH OTHER PARTS
OF FORM 2A YOU MUST COMPLETE
EPA Form 3510-2A (Rev. 1-99). Replaces EPA fortes 7550-6 & 7550-22. Page 8 of 22

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
HENRY FORK WWTP, NCO040797
RENEWAL
CATAWBA
BASIC APPLICATION INFORMATION
PART C. CERTIFICATION
All applicants must complete the Certification Section. Refer to Instructions to determine who is an officer for the purposes of this
certification. All applicants must complete all applicable sections of Form 2A, as explained in the Application Overview. Indicate below which
parts of Form 2A you have completed and are submitting. By signing this certification statement, applicants confirm that they have reviewed
Form 2A and have completed all sections that apply to the facility for which this application is submitted.
Indicate which parts of Form 2A you have completed and are submitting:
® Basic Application Information packet Supplemental Application Information packet:
® Part D (Expanded Effluent Testing Data)
® Part E (Toxicity Testing: Biomonitoring Data)
® Part F (Industrial User Discharges and RCRA/CERCLA Wastes)
❑ Part G (Combined Sewer Systems)
ALL APPLICANTS MUST COMPLETE THE FOLLOWING CERTIFICATION.
I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system
designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who
manage the system or those persons directly responsible for gathering the information, the information 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 fine imprisonment
possibility of and
for knowing violations.
Name and official title MICK W. BERRY, CITY MANAGER
Signature
v
Telephone number [phone]
Date signed
Upon request of the permitting authority, you must submit any other information necessary to assure wastewater treatment practices at the treatment
works or identify appropriate permitting requirements.
SEND COMPLETED FORMS TO:
NCDENR/ DWQ
Attn: NPDES Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 9 of 22

FACILITY NAME AND PERMIT NUMBER:
HENRY FORK WWTP, NCO040797
9.
PERMIT ACTION REOUFST61
RENEWAL
RIVER BASIN:
CATAWBA
SUPPLEMENTAL APPLICATION INFORMATION
PART D. EXPANDED EFFLUENT TESTING DATA
Refer to the directions on the cover page to determine whether this section applies to the treatment works.
Effluent Testing: 1.0 mgd and Pretreatment Works. If the treatment works has a design flow greater than or equal to 1.0 mgd or it has (or is required to
have) a pretreatment program, or Is otherwise required by the permitting authority to provide the data, then provide effluent testing data for the following
pollutants. Provide the Indicated effluent testing information and any other information required by the permitting authority for each oulfall through which
effluent is dischamed. Do not include information on combined sewer overflows in this section. All information reported must be based on data collected
through analyses conducted using 40 CFR Part 136 methods. In addition, these data must comply with QA/QC requirements of 40 CFR Part 136 and other
appropriate QA/QC requirements. for standard methods for analyses not addressed by 40 CFR Part 136. Indicate in the blank rows provided below any data
you may have on pollutants not specifically listed in this forth. At a minimum, effluent testing data must be based on at least three pollutant scans and must
be no more than four and one-half years old.
Outfall number. 001 (Complete once for each outfall discharging effluent to waters of the United States.)
POLLUTANT
MAXIMUM DAILY DISCHARGE
AVERAGE DAILY DISCHARGE
ANALYTICAL
METHOD
ML/f4�bl.
Conc.
Units
Mass
Units
Conc.
Units
Mass
Units
Number
of
Samples
METALS (TOTAL RECOVERABLE), CYANIDE, PHENOLS, AND HARDNESS.
ANTIMONY
<5
ug/L
<0.10
Ibs
<5
ug/L
<0.10
Ibs
3
200.7
5ug/L
ARSENIC
<10
ug/L
<0.21
Ibs
<10
ug/L
<0.21
Ibs
3
200.7
10ug/L
BERYLLIUM
<1
ug/L
<0.02
Ibs
<1
ug/L
<0.02
Ibs
3
200.7
1ug/L
CADMIUM
<1
ug/L
<0.02
Ibs
<1
ug/L
<0.02
Ibs
3
200.7
1 ug/L
CHROMIUM
<5
ug/L
<0.10
Ibs
<5
ug/L
<0.10
Ibs
3
200.7
5ug/L
COPPER
15.6
ug/L
0.33
Ibs
11.8
ug/L
0.25
Ibs
3
200.8
0.5ug/L
LEAD
0.82
ug/L
0.017
Ibs
0.38
ug/L
0.008
Ibs
3
200.8
0.1ug/L
MERCURY
<0.2
ug/L
<.004
Ibs
<0.2
ug/L
<.004
Ibs
3
245.1
0.2ug/L
NICKEL
<5
ug/L
<0.10
Ibs
<5
ug/L
<0.10
Ibs
3
200.7
5ug/L
SELENIUM
<10
ug/L
<0.21
Ibs
<10
ug/L
<0.21
Ibs
3
200.7
10ug/L
SILVER
<5
ug/L
<0.10
Ibs
<5
ug/L
<0.10
Ibs
3
200.7
5ug/L
THALLIUM
<10
ug/L
<0.21
Ibs
<10
ug/L
<0.21
Ibs
3
200.7
10ug/L
ZINC
168
ug/L
3.50
Ibs
67.1
ug/L
1.40
Ibs
3
200.7
10ug/L
CYANIDE
0.013
mg/L
0.27
Ibs
0.010
mg/L
.21
Ibs
3
450OCN E-1999
0.005mg/L
TOTAL
COMPOUNDS PHENOLIC
0.033
mg/L
.69
Ibs
0.017
mg/L
0.35
Ibs
3
420.4
0.005mg/L
HARDNESS (as CaCO3)
58.0
mg/L
1209
Ibs
35.0
mg/L
730
Ibs
3
2340 B-1997
0.662mg/L
Use this space (or a separate sheet) to provide Information on other metals requested by the permit writer
EPA Form 3510-2A (Rev. 1-99). Replaces EPA fortes 7550-6 & 7550-22. Page 10 of 22

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
HENRY FORK WWTP, NCO040797
RENEWAL
CATAWBA
Outfall number. 001 (Complete once for each outfall discharging effluent to waters of the United States.)
MAXIMUM DAILY DISCHARGE
AVERAGE DAILY DISCHARGE
POLLUTANT
ANALYTICAL
MUMDL
Number
Conc.
Units
Mass
Units
Conc.
Units
Mass
Units
of
METHOD
Samples ,
VOLATILE ORGANIC COMPOUNDS
ACROLEIN
<100
ug/L
<2.09
Ibs
<100
ug/L
<2.09
Ibs
3
624
100ug/L
ACRYLONITRILE
<60
ug/L
<1.04
Ibs
<50
ug/L
<1.04
Ibs
3
624
50ug/L
BENZENE
<5
ug/L
<0.10
Ibs
<5
ug/L
<0.10
Ibs
3
624
Sug/L
BROMOFORM
<5
ug/L
<0.10
Ibs
<5
ug/L
<0.10
Ibs
3
624
5ug/L
CA R�ACHLORIDE
<5
ug/L
<0.10
Ibs
<5
ug/L
<0.10
Ibs
3
624
Sug/L
CHLOROBENZENE
<5
ug/L
<0.10
Ibs
<5
uglL
<0.10
Ibs
3
624
Sug/L
CHLORODIBROMO-
METHANE
<5.
ug/L
<0.10
Ibs
<5
ug/L
<0.10
Ibs
3
624
5ug/L
CHLOROETHANE
<5
ug/L
<0.10
Ibs
<5
ug/L
<0.10
Ibs
3
624
Sug/L
HLOROETHYLVINYL
ET
ETHER
<10
ug/L
<0.21
Ibs
<10
ug/L
<0.21
Ibs
3
624
10ug/L
CHLOROFORM
11.7
ug/L
0.24
The
7.0
ug/L
0.16
Ibs
3
624
Sug/L
METHANE BROMO-
3.6
ug/L
0.08
Ibs
1.2
ug/L
0.03
Ibs
3
624
Sug/L
1,1-DICHLOROETHANE
<5
ug/L
<0.10
Ibs
<5
ug/L
<0.10
Ibs
3
624
5ug/L
1,2-DICHLOROETHANE
<5
ug/L
<0.10
Ibs
<5
ug/L
<0.00
The
3
624
Sug/L
TRANS-I,2-DICHLORO-
ETHYLENE
<5
ug/L
<0.10
Ibs
<5
ug/L
<0.10
Ibs
3
624
Sug/L
1,1-DIETHYENE RO-
<5
ug/L
<0.10
Ibs
<5
ug/L
<0.10
Ibs
3
624
Sug/L
1,2-DICHLOROPROPANE
<5
ug/L
<0.10
Ibs
<5
ug/L
<0.10
The
3
624
Sug/L
PROPYLENEa
<5
ug/L
<0.10
Ibs
<5
ug/L
<0.10
Ibs
3
624
Sug/L
ETHYLBENZENE
<5
ug/L
<0.10
Ibs
<5
ug/L
<0.10
Ibs
3
624
Sug/L
METHYL BROMIDE
<10
ug/L
<0.21
The
<10
ug/L
<0.21
Ibs
3
624
10ug/L
METHYL CHLORIDE
<5
ug/L
<0.10
Ibs
<5
ug/L
<0.10
Ibs
3
624
Sug/L
METHYLENE CHLORIDE
<5
ug/L
<0.10
The
<5
ug/L
<0.10
We
3
624
5ug/L
CHLOROETHANE
<5
ug/L
<0.10
Ibs
<5
ug/L
<0.10
Ibs
3
624
Sug/L
ETHYLENEORO-
<5
ug/L
<0.10
Ibs
<5
ug/L
<0.10
Ibs
3
624
5ug/L
TOLUENE
<5
ug/L
<0.10
Ibs
<5
ug/L
<0.10
Ibs
3
624
Sug/L
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 11 of 22

FACILITY NAME AND PERMIT NUMBER:
HENRY FORK WWTP, NCO040797
PERMIT ACTION REQUESTED:
RENEWAL
RIVER BASIN:
CATAWBA
Outfall number. 001 (Complete once for each outfall discharging effluent to waters of the United States.)
POLLUTANT
MAXIMUM DAILY DISCHARGE
AVERAGE DAILY DISCHARGE
ANALYTICAL
METHOD
ML/MDL
Cone.
Units
Mass
Units
Cone.
Units
Mass
Units
Number
of
Sam es
1,1,1
TRICHLOROETHANE
<5
ug/L
<0.10
Ibs
<5
ug/L
<0.10
Ibs
3
624
Sug/L
1'1'2-
TRICHLOROETHANE
<5
ug/L
<0.10
Ibs
<5
ug/L
<0.10
Ibs
3
624
Sug/L
TRICHLOROETHYLENE
<5
ug/L
<0.10
Ibs
<5
ug/L
<0.10
Ibs
3
624
5ug1L
VINYL CHLORIDE
<5
ug/L
<0.10
Ibs
<5
ug/L
<0.10
Ibs
3
624
SuglL
Use this space (or a separate sheet) to provide information on other volatile organic compounds requested by the permit writer
ACID*EXTRACTABLE COMPOUNDS
P-CHLORO-M-CRESOL
<10
ug/L
<0.21
Ibs
<10
ug/L
<0.21
Ibs
3
625
10ug/L
2-CHLOROPHENOL
<5
ug/L
<0.10
Ibs
<5
ug/L
<0.10
Ibs
3
625
Sug/L
4,4-DICHLOROPHENOL
<5
ug/L
<0.10
Ibs
<5
ug/L
<0.10
Ibs
3
625
Sug/L
2,4-DIMETHYLPHENOL
<10
ug/L
<0.21
Ibs
<10
ug/L
<0.21
Ibs
3
625
10ug/L
4,6-0INITRO-0-CRESOL
<20
ug/L
<0.42
Ibs
<20
ug/L
<0.42
The
3
625
20ug/L
2,4-DINITROPHENOL
<50
ug/L
<1.04
Ibs
<50
ug/L
<1.04
Ibs
3
625
50ug/L
2-NITROPHENOL
<5
ug/L
<0.10
Ibs
<5
ug/L
<0.10
Ibs
3
625
5ug/L
4-NITROPHENOL
<50
ug/L
<1.04
Ibs
<50
ug/L
<1.04
Ibs
3
625
50ug/L
PENTACHLOROPHENOL
<25
ug/L
<0.52
Ibs
<25
ug/L
<0.52
Ibs
3
625
25ug/L
PHENOL
<5
ug/L
<0.10
Ibs
<5
ug/L
<0.10
Ibs
3
625
Sug/L
2.4,6TRIO - OROPHENOL
<10
ug/L
<0.21
Ibs
<10
ug/L
<0.21
Ibs
3
625
10ug/L
Use this space (or a separate sheet) to provide inkm nallon on other acid -extractable compounds requested by the permit writer
BASE -NEUTRAL COMPOUNDS
ACENAPHTHENE
<5
ug/L
<0.10
Ibs
<5
ug/L
40.10
Ibs
3
625
Sug/L
ACENAPHTHYLENE
<5
ug/L
<0.10
Ibs
<5
ug/L
<0.10
Ibs
3
625
Sug/L
ANTHRACENE
<5
ug/L
<0.10
Ibs
<5
ug/L
<0.10
Ibs
3
625
Sug/L
BENZIDINE
<50
ug/L
<1.04
Ibs
<50
ug/L
<1.04
Ibs
3
625
50ug/L
BENZO(A)ANTHRACENE
<5
ug/L
<0.10
Ibs
<5
ug/L
<0.10
Ibs
3
625
5ug/L
BENZO(A)PYRENE
<5
ug/L
<0.10
Ibs
<5
ug/L
<0.10
Ibs
3
625
Sug/L
EPA Forth 3510-2A (Rev.1-99). Replaces EPA tonne 7550-6 & 7550-22. Page 12 of 22

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
HENRY FORK WWTP, NCO040797
RENEWAL
CATAWBA .
Outfall number. 001 (Complete once for each outfall discharging effluent to waters of the United States.)
M _ �IMUMI AI[IV D CHARGE
AVERAGE DAILY DISCH RGE
POLLUTANT
ANALYTICAL
ML/MDL
Number
Conc.
Units
Mass
Units
Conc.
Units
Mass
Units
of
METHOD
S e.
rr
FLUORANTHENE
<5
ug/L
<0.10
Ibs
<5
ug/L
<0.10
Ibs
3
625
5ug/L
BENZO(GHQPERYLENE
<5
ug/L
<0.10
Ibs
<5
ug/L
<0.10
Ibs
3
625
5ugIL
F UOROANTHENE
<5
ug/L
<0.10
Ibs
<5
ug/L
<0.10
Ibs
3
625
5ug/L
MN (ETHANE OROETHOXY)
<10
ug/L
<0.21
Ibs
<10
ug/L
<0.21
Ibs
3
625
10ug/L
BETHIS ER HLOROETHYQ-
<5
ug/L
<0.10
Ibs
<5
ug/L
<0.10
Ibs
3
625
5ugIL
PROPYL ETHER O-
<5
ug/L
<0.10
Ibs
<5
ug/L
<0.10
Ibs
3
625
5ugIL
SIS (2-ETHYLHEXYL)
PHTHALATE
<5
ug/L
g
<0.10
Ibs
< 5
ug/L
<0.10
Ibs
3
625
5ug/L
PHENYL ETHER L
<5
ug/L
<0.10
Ibs
<5
ug/L
<0.10
Ibs
3
625
5ug/L
BPUTY�B THE YL
<5
ug/L
<0.10
Ibs
<5
ug/L
<0.10
Ibs
3
625
5ug/L
2-CHLORO-
NAPHTHALENE
<5
ug/L
<0.10
Ibs
<5
ug/L
<0.10
Ibs
3
625
5ug/L
4-CHLORPHENYL
PHENYLETHER
<5
ug/L
<0.10
Ibs
<5
ug/L
<0.10
Ibs
3
625
5ug/L
CHRYSENE
<5
ug/L
<0.10
Ibs
<5
ug/L
<0.10
Ibs
3
625
5ug/L
DI -NI -BUTYL PHTHALATE
<5
ug/L
<0.10
Ibs
<5
ug/L
<0.10
Ibs
3
625
5ug/L
DI-N-OCTYL PHTHALATE
<5
ug/L
<0.10
Ibs
<5
ug/L
<0.10
Ibs
3
625
5ug/L
DIBENZO(A,H)
ANTHRACENE
<5
ug/L
<0.10
Ibs
<5
ug/L
<0.10
Ibs
3
625
5ug/L
1,2-DICHLOROBENZENE
<5
ug/L
<0.10
Ibs
<5
ug/L
<0.10
Ibs
3
625
5ug/L
1,3-DICHLOROBENZENE
<5
ug/L
<0.10
Ibs
<5
ug/L
<0.10
Ibs
3
625
5ug/L
1,4-DICHLOROBENZENE
<5
ug/L
<0.10
Ibs
<5
ug/L
<0.10
Ibs
3
625
5ug/L
BENZID NERD
<25
ug/L
<0.52
Ibs
<25
ug/L
<0.52
Ibs
3
625
25ug/L
DIETHYL PHTHALATE
<5
ug/L
<0.10
Ibs
<5
ug/L
<0.10
Ibs
3
625
5ug/L
DIMETHYL PHTHALATE
<5
ug/L
<0.10
Ibs
<5
ug/L
<0.10
Ibs
3
625
5ugIL
2,4-DINITROTOLUENE
<5
ug/L
<0.10
Ibs
<5
ug/L
<0.10
Ibs
3
625
5ugIL
2,6-0INITROTOLUENE
<5
ug/L
<0.10
Ibs
<5
ug/L
<0.10
Ibs
3
625
5ug/L
1,ENYL-
HYDRAZYDRAZINE
<5
ug/L
<0.10
Ibs
<5
ug/L
<0.10
Ibs
3
625
5ug/L
EPA Form 3510-2A (Rev. 1-99). Replaces EPA fortes 7550-e & 7550-22. Page 13 of 22

FACILITY NAME AND PERMIT NUMBER:
HENRY FORK WWTP, NCO040797
PERMIT ACTION REQUESTED:
RENEWAL
RIVER BASIN:
CATAWBA
Outfall number. 001 (Complete once for each outfall discharging effluent to waters of the United States.)
POLLUTANT
MAXIMUM DAILY DISCHARGE
AVERAGE DAILY DISCHARGE
ANALYTICAL
METHOD
MUMDL
Conc.
Units
Mass
Units
Conc.
Units
Mass
Units
Number
of
Samples
FLUORANTHENE
<S
ug/L
<0.10
Ibs
<5
ug/L
<0.10
Ibs
3
625
Sug/L
FLUORENE
<5
ug/L
<0.10
Ibs
<5
ug/L
<0.10
Ibs
3
625
5ug/L
HEXACHLOROBENZENE
<5
ug/L
<0.10
Ibs
<5
ug1L
<0.10
Ibs
3
625
5ug/L
HEXACHLORO-
BUTADIENE
HEXACHLOROCYCLO-
PENTADIENE
<10
ug1L
<0.21
Ibs
<10
ug/L
<0.21
Ibs
3
625
10ug/L
HEXACHLOROETHANE
<5
ug/L
<0.10
Ibs
<5
ug/L
<0.10
Ibs
3
625
Sug/L
INDENO(1,2,3-CD)
PYRENE
<5
ug/L
<0.10
Ibs
<5
ug/L
<0.10
Ibs
3
625
Sug/L
ISOPHORONE
<10
ug/L
<0.21
Ibs
<10
ug/L
<0.21
Ibs
3
625
10ug/L
NAPHTHALENE
<5
ug/L
<0.10
Ibs
<5
ug/L
<0.10
Ibs
3
625
5ug/L
NITROBENZENE
<5
ug/L
<0.10
Ibs
<5
ug/L
<0.10
Ibs
3
625
Sug/L
N-NITROSODI-N-
PROPYLAMINE
<5
ug/L
<0.10
Ibs
<5
ug/L
<0.10
We
3
625
Sug/L
N-NITROSODI-
METHYLAMINE
<5
ug/L
<0.10
Ibs
<5
ug/L
<0.10
Ibs
3
625
5ug/L
N-NITROSODI-
PHENYLAMINE
<10
ug/L
<0.21
Ibs
<10
ug1L
<0.21
Ibs
3
625
10ug/L
PHENANTHRENE
<5
ug/L
<0.10
Ibs
<5
ug/L
<0.10
Ibs
3
625
5ug/L
PYRENE
<5
ug/L
<0.10
Ibs
<5
ug/L
<0.10
Ibs
3
625
5ug/L
1,2,4-
TRICHLOROBENZENE
<5
ug/L
<0.10
Ibs
<5
ug/L
11 <0.10
Ibs
3
625
Sug1L
Use this space (or a separate sheet) to provide information on other base -neutral compounds requested by the permit writer
Use this space (or a separate sheet) to provide information on other pollutants (e.g., pesticides) requested by the permit writer
END OF PART D.
REFER TO THE APPLICATION OVERVIEW (PAGE 1) TO DETERMINE WHICH OTHER PARTS
OF FORM 2A YOU MUST COMPLETE
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 $ 7550-22. Page 14 of 22

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
HENRY FORK WWTP, NCO040797
RENEWAL
CATAWBA
.
SUPPLEMENTAL APPLICATION INFORMATION
PART E. TOXICITY TESTING DATA
POTWs meeting one or more of the following criteria must provide the results of whole effluent toxicity tests for acute or chronic toxicity for each of the
facility's discharge points: 1) POTWs with a design flow rate greater than or equal to 1.0 mgd; 2) POTWs with a pretreatment program (or those that are
required to have one under 40 CFR Part 403); or 3) POTWs required by the permitting authority to submit data for these parameters.
• At a minimum, these results must include quarterty testing for a 12-month period within the past 1 year using multiple species (minimum of two
species), or the results from four tests performed at least annually in the four and one-half years prior to the application, provided the results
show no appreciable toxicity, and testing for acute and/or chronic toxicity, depending on the range of receiving water dilution. Do not include
information on combined sewer overflows in this section. All information reported must be based on data collected through analysis conducted
using 40 CFR Part 136 methods. in addition, this data must comply with QA/QC requirements of 40 CFR Part 136 and other appropriate QA/QC
requirements for standard methods for analytes not addressed by 40 CFR Part 136.
• In addition, submit the results of any other whole effluent toxicity tests from the past four and one-half years. If a whole effluent toxicity test
conducted during the past four and one-half years revealed toxicity, provide any information on the cause of the toxicity or any results of a
toxicity reduction evaluation, if one was conducted.
• If you have already submitted any of the information requested in Part E, you need not submit it again. Rather, provide the information
requested In question EA for previously submitted information. If EPA methods were not used, report the reasons for using alternate methods.
If test summaries are available that contain all of the information requested below, they may be submitted in place of Part E.
If no biomonkoring data is required, do not complete Part E. Refer to the Application Overview for directions on which other sections of the form to
corn late.
E.7. Required Tests.
Indicate the number of whole effluent toxicity tests conducted in the past four and one-half years.
® chronic ❑ acute
E.2. Individual Test Data. Complete the following chart for each whole effluent toxicity test conducted in the last four and one-half years. Allow one
column per test (where each species constitutes a test). Copy this page if more than three tests are being reported.
Test number. Test number. Test number.
a. Test information.
Test Species & test method number
SEE ATTACHMENT FOR
TOXICITY TEST RESULTS
Age at initiation of test
Outfall number
Dates sample collected
Date test started
Duration
b. Give toxicity test methods followed.
Manual title
Edition number and year of publication
Page number(s)
c. Give the sample collection method(s) used. For multiple grab samples, indicate the number of grab samples used.
24-Hour composite
Grab
d. Indicate where the sample was taken in relation to disinfection. (Check all that apply for each.
Before disinfection
After disinfection
After dechlorination
EPA Forth 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 15 of 22

FACILITY NAME AND PERMIT NUMBER:
jiENRY FORK WWTP, NCO040797
PERMIT ACTION REQUESTED:
RENEWAL
RIVER BASIN:
CATAWBA
Test number: Test number: Test number.
e. Describe the point In the treatment process at which the sample was collected.
Sample was collected:
f. For each test, include whether the test was Intended to assess chronic toxicity, acute toxicity, or both
Chronic toxicity
Acute toxicity
g. Provide the type of test performed.
static
Statio•renewal
Flo"rough
h. Source of dilution water. If laboratory water, specify type; If receiving water, specify source.
Laboratory water
Receiving water
1. Type of dilution water. If salt water, specify 'natural' or type of artificial sea salts or brine used.
Fresh water
Salt water
J. Give the percentage effluent used for all concentrations in the test series.
k. Parameters measured during the test. (State whether parameter meets test method specifications)
pH
Salinity
Temperature
Ammonia
Dissolved oxygen
I. Test Results.
Acute:
Percent survival In 100%
effluent
%
%
%
LC50
95% C.I.
%
%
%
Control percent survival
%
%
%
Other (describe)
EPA Form 3510-2A (Rev. 1-99). Replaces EPA fors 7550-6 & 7550-22, Page 16 of 22

FACILITY NAME AND PERMIT NUMBER:
HENRY FORK WWTP, NCO040797
PERMIT ACTION REQUESTED:
RENEWAL
RIVER BASIN:
CATAWBA ,
Chronic:
NOEC
%
%
%
ICzr
%
%
%
Control percent survival
%
%
%
Other (describe)
M. Quality Control/Quality, Assurance.
Is reference toxicant data available?
Was reference toxicant test within
acceptable bounds?
What date was reference toxicant test
run (MM/DD/YYYY)?
Other (describe)
E.3. Toxicity Reduction Evaluation. Is the treatment works involved in a Toxicity Reduction Evaluation?
❑ Yes N No If yes, describe:
EA. Summary of Submitted Blomonkoring Test Information. If you have submitted biomonitoring test information, or information regarding the
cause of toxicity, within the past four and one-half years, provide the dates the information was submitted to the permitting authority and a summary
of the results.
Date submitted: / / (MM/DD/YYYY)
Summary of results: (see instructions)
Over the oast 4'/2 years, the Henry Fork POTW has submitted 21 chronic toxicity tests on a quarterly basis All but 1
Passed and the follow up test Passed. SEE ATTACHMENT— D.
END OF PART E.
REFER TO THE APPLICATION OVERVIEW (PAGE 1) TO DETERMINE WHICH OTHER PARTS
OF FORM 2A YOU MUST COMPLETE.
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 17 of 22

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
HENRY FORK WWTP, NCO040797
RENEWAL
CATAWBA
SUPPLEMENTAL APPLICATION INFORMATION
PART F.INDUSTRIAL USER DISCHARGES AND RCRA/CERCLA WASTES
All treatment works receiving discharges from significant industrial users or which receive RCRA,CERCLA, or other remedial wastes must
complete part F.
GENERAL INFORMATION:
F.1. Pretreatment program. Does the treatment works have, or is subject ot, an approved pretreatment program?
® Yes ❑ No
F.2. Number of Significant Industrial Users (SIUs) and Categorical Industrial Users (CIUs). Provide the number of each of the following types of
industrial users that discharge to the treatment works.
a. Number of non -categorical SIUs. 10
b. Number of CIUs. 0
SIGNIFICANT INDUSTRIAL USER INFORMATION:
Supply the following information for each SIU. If more than one SIU discharges to the treatment works, copy questions F.3 through F.8 and
provide the information requested for each SIU.
F.3. Significant Industrial User Information. Provide the name and address of each SIU discharging to the treatment works. Submit additional pages
as necessary.
Name: PLEASE SEE ATTACHED SHEETS.
Mailing Address:
F.4. Industrial Processes. Describe all the industrial processes that affect or contribute to the SIU's discharge.
F.5. Principal Product(s) and Raw Material(s). Describe all of the principal processes and raw materials that affect or contribute to the SIU's
discharge.
Principal product(s):
Raw material(s):
F.6. Flow Rate.
a. Process wastewater flow rate. Indicate the average daily volume of process wastewater discharge into the collection system in gallons per
day (gpd) and whether the discharge is continuous or intermittent.
gpd ( continuous or intermittent)
b. Non -process wastewater flow rate. Indicate the average daily volume of non -process wastewater flow discharged into the collection system
in gallons per day (gpd) and whether the discharge is continuous or intermittent.
gpd ( continuous or __ intermittent)
F.7. Pretreatment Standards. Indicate whether the SIU is subject to the following:
a. Local limits ❑ Yes ❑ No
b. Categorical pretreatment standards ❑ Yes ❑ No
If subject to categorical pretreatment standards, which category and subcategory?
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 18 of 22

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
HENRY FORK WWTP, NCO040797
RENEWAL
CATAWBA
F.8. Problems at the Treatment Works Attributed to Waste Discharge by the SIU. Has the SIU caused or contributed to any problems (e.g.,
upsets, interference) at the treatment works in the past three years?
❑ Yes ❑ No If yes, describe each episode.
RCRA HAZARDOUS WASTE RECEIVED BY TRUCK, RAIL, OR DEDICATED PIPELINE:
F.9. RCRA Waste. Does the treatment works receive or has it in the past three years received RCRA hazardous waste by truck, rail or dedicated pipe?
❑ Yes ❑ No (go to F.12)
F.10. Waste transport Method by which RCRA waste is received (check all that apply):
❑ Truck ❑ Rail ❑ Dedicated Pipe
F.11. Waste Description. Give EPA hazardous waste number and amount (volume or mass, specify units).
EPA Hazardous Waste Number Amount Units
CERCLA (SUPERFUND) WASTEWATER, RCRA REMEDIATION/CORRECTIVE ACTION
WASTEWATER, AND OTHER REMEDIAL ACTIVITY WASTEWATER:
F.12. Remediation Waste. Does the treatment works currently (or has it been notified that it will) receive waste from remedial activities?
❑ Yes (complete F.13 through F.15.) ❑ No
F.13. Waste Origin. Describe the site and type of facility at which the CERCLA/RCRA/or other remedial waste originates (or is excepted to origniate in
the next five years).
F.14. Pollutants. List the hazardous constituents that are received (or are expected to be received). Include data on volume and concentration, if
known. (Attach additional sheets if necessary.)
F.15. Waste Treatment
a. Is this waste treated (or will be treated) prior to entering the treatment works?
❑ Yes ❑ No
If yes, describe the treatment (provide information about the removal efficiency):
b. Is the discharge (or will the discharge be) continuous or intermittent?
❑ Continuous ❑ Intermittent If intermittent, describe discharge schedule.
END OF PART F.
REFER TO THE APPLICATION OVERVIEW (PAGE 1) TO DETERMINE WHICH OTHER PARTS
OF FORM 2A YOU MUST COMPLETE
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 19 of 22

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
.HENRY FORK WWTP, NCO040797
RENEWAL
CATAWBA
SUPPLEMENTAL APPLICATION INFORMATION
PART G. COMBINED SEWER SYSTEMS
If the treatment works has a combined sewer system, complete Part G.
G.I. System Map. Provide a map indicating the following: (may be included with Basic Application Information)
a. All CSO discharge points.
b. Sensitive use areas potentially affected by CSOs (e.g., beaches, drinking water supplies, shellfish beds, sensitive aquatic ecosystems, and
outstanding natural resource waters).
C. Waters that support threatened and endangered species potentially affected by CSOs.
G.2. System Diagram. Provide a diagram, either in the map provided in GA or on a separate drawing, of the combined sewer collection system that
includes the following information.
a. Location of major sewer trunk lines, both combined and separate sanitary.
b. Locations of points where separate sanitary sewers feed into the combined sewer system.
C. Locations of in -line and off-line storage structures.
d. Locations of flow -regulating devices.
e. Locations of pump stations.
CSO OUTFALLS:
Complete questions G.3 through G.6 once for each CSO discharge point.
G.3. Description of Outfall.
a. Outfall number N/A
b. Location
(City or town, if applicable) (Zip Code)
(County) (State)
(Latitude) (Longitude)
C. Distance from shore (if applicable) ft.
d. Depth below surface (if applicable) ft.
e. Which of the following were monitored during the last year for this CSO?
❑ Rainfall ❑ CSO pollutant concentrations ❑ CSO frequency
❑ CSO flow volume ❑ Receiving water quality
f. How many storm events were monitored during the last year?
G.4. CSO Events.
a. Give the number of CSO events in the last year.
events (❑ actual or ❑ approx.)
b. Give the average duration per CSO event.
hours (❑ actual or ❑ approx.)
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 20 of 22

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
HENRY FORK WWTP, NCO040797
RENEWAL
CATAWBA ,
C. Give the average volume per CSO event.
million gallons (0 actual or ❑ approx.)
d. Give the minimum rainfall that caused a CSO event in the last year
Inches of rainfall
G.S. Description of Receiving Wate?s.
a. Name of receiving water.
b. Name of watershed/river/stream system:
United State Soil Conservation Service 14-digit watershed code (if known):
C. Name of State Management/River Basin:
United States Geological Survey 8-dlgit hydrologic cataloging unit code (if known):
G.S. CSO Operations.
Describe any known water quality impacts on the receiving water caused by this CSO (e.g., permanent or intermittent beach closings, permanent or
intermittent shell fish bed closings, fish kills, fish advisories, other recreational loss, or violation of any applicable State water quality standard).
END OF PART G.
REFER TO THE APPLICATION OVERVIEW (PAGE 1) TO DETERMINE WHICH OTHER PARTS
OF FORM 2A YOU MUST COMPLETE.
EPA Form 3510-2A (Rev. 1-99). Replaces EPA fortes 7550-6 & 7550-22. Page 21 of 22

Attachment A- B82

F`.

IF
;,- Xv�vl �i
lk
1,
1
L{'A_

Attachment B- B83

Attachment C-E.2

ADDITIONAL IWORMATION
City of Hickory - Henry Fork POTW
NCO040797
Outfall 001
Part E - Toxicity Testing Data
Pass/Fail 7 Day Chronic - Ceriodaphnia dubia
Results
Monitoring Period
CollectionDate
Test Date
EPA Lab ID No.
NC Cert. No.
Test Method Used
IWC%
Group
% Mortality
Avg. Reprod.
% Reduction
Pass/Fail
EPA1600/4-91/002 Method
111/10 - 3/31/10
2/1/2010
2/3/2010
NC0030
9
1002.0 NC Modification
34%
Control 8.30% 21.80
0
P
February 1988
Test 0.0% 27.90
EPA/600/4-91/002 Method
4/1/10 - 6/30/10
5/3/2010
5/5/2010
NCO030
9
1002.0 NC Modification
34%
Control 0.00% 17.70
0
P
February 1988
Test 8.3% 19.00
EPA/600/4-91/002 Method
7/1/10 - 9/30/10
8/2/2010
8/4/2010
NCO030
9
1002.0 NC Modification
34%
Control 0.00% 26.30
4.1
P
February 1988
Test 9.1 % 25.20
EPA/600/4-91/002 Method
10/1/10-12/31/10
11/1/2010
11/3/2010
NCO030
9
1002.0 NC Modification
34%
Control 0.00% 25.80
6.2
P
February 1988
Test 0.0% 24.20
EPA 821-R-02-013
1/1/11 - 3/31/11
1/31/2011
2/2/2011
NCO030
16
Method 1002.0
34%
Control 8.33% 15.33
-26.09
P
4th Edition 2002
Test 0.00% 19.33.
EPA 821-R-02-013
411111 - 6/30/11
5/2/2011
5/4/2011
NCO030
16
Method 1002.0
34%
Control 8.33% 21.50
-7.36
P
4th Edition 2002
Test 0.00% 23.08
EPA 821-R-02-013
7/1 /11 - 9/30/11
1 /1 /1900
8/3/2011
NCO030
16
Method 1002.0
34%
Control 0.00% 26.25
-1.90
P
4th Edition 2002
Test 0.00% 26.75
EPA 821-R-02-013
10/1/11 - 12/31/11
10/31/2011
11/2/2011
NCO030
16
Method 1002.0
34%
Control 0.00% 26.58
16.93
P
4th Edition 2002
Test 0.00% .22.08

ADDITIONAL INFORMATION
City of Hickory - Henry Fork POTW
NCO040797
Outfall 001
Part E - Toxicity Testing Data
Pass/Fail 7 Day Chronic - Ceriodaphnia dubia
Monitoring Period
CollectionDate
Test Date
EPA Lab ID No.
NC Cart. No.
Test Method Used
IWC%
Results
Group
I % Mortality
Avg. Reprod.
% Reduction
Pass/Fail
1/1/2012 - 3/31/12
2/6/2012
2/8/2012
NCO030
16
EPA 821-R-02-013
Method 1002.0
34%
Control 0.00% 25.33
6.25
p
4th Edition 2002
Test 0.00%• 23.75
4/1112 - 6/30/12
5/7/2012
5/9/2012
NCO030
16
EPA 821-R-02-013
Method 1002.0
34%
Control 0.00% 2100
.
-7.54
p
4th Edition 2002
Test 0.00% 22.58
7/1/12 - 9130/12
8/6/2012
8/8/2012
NCO030
16
EPA 821-R-02-013
Method 1002.0
34%
Control 0.00% 25.75
-7.77
P
4th Edition 2002
Test 0.00% 27.75
10/1/12-12131/12
11/12/2012
11/14/2012
NCO030
16
EPA 821-R-02-013
Method 1002.0
34%
Control 0.00% 22.75
64.84
F
4th Edition 2002
Test 9.09% 8.00
10/1/12 - 12/31/12
12/10/2012
12/12/2012
NCO030
16
EPA 821-R-02-013
Method 1002.0
17% - 68%
Control 0% 25
-3.20
>68%
4th Edition 2002
Test 0% 25.8
1/1/13 - 3/31/13
1/7/2013
1/9/2013
NCO030
16
EPA 821-R-02-013
Method 1002.0
17% - 68%
Control 0% 26.7
3.75
>68%
4th Edition 2002
Test 0% 25.7
1/1/13 - 3/31 /13
2/4/2013
2/6/2013
NCO030
16
EPA 821-R-02-013
Method 1002.0
34%
Control 0.00% 26.25
-9 84
P
4th Edition 2002
Test 0.00% 28.83
4/1/13 - 9/30/13
6/13/2013
5/15/2013
NCO030
16
EPA 821-R-02-013
Method 1002.0
4th Edition 2002
34%
Control 8.33% 35.42
0.94
P
Test 0.00% 35.08

ADDITIONAL INFORMATION
City of Hickory - Henry Fork POTW
NCO040797
Outfall 001 .
Part E - Toxicity Testing Data
Pass/Fail 7 Day Chronic - Ceriodaphnia dubia
Monitoring Period
CollectionDate
Test Date
EPA Lab ID No.
NC Cart. No.
Test Method Used
IWC%
Results
GMup
I % Mortality
Avg. Reprod..
% Reduction
Pass/Fail
7/1/13 - 9/30/13
8/5/2013
8/17/2013
NCO030
16
EPA 821-R-02-013
Method 1002.0
4th Edition 2002
34%
Control 0.00% 24.42
-4.44
p
Test 0.00% 25.5
10/1/13 - 12/31-13
11/18/2013
11/20/2013
NCO030
16
EPA 821-R-02-013
Method 1002.0
4th Edition 2002
34%
,Control 0.00% 28.17
1.48
P
Test 0.00% 27.75
1/1/14 - 3/31/14
2/17/2014
2/19/2014
NCO030
16
EPA 821-R-02-013
Method 1002.0
4th Edition 2002
34%
Control 0.00% 29.25
5.98
P
Test 0.00% 27.5
4/1 /14 - 6/30/14
5/12/2014
5/14/2014
NCO030
16
EPA 821-R-02-013
Method 1002.0
4th Edition 2002
34%
Control 0.00% 28.67
-8.72
p
Test 0.00% 31.17
7/1/14 - 9/30/14
8/18/2014
8/20/2014
NCO030
16
EPA 821-R-02-013
Method 1002.0
4th Edition 2002
34%
Control 0.00% 26.42
3.79
P
Test 0.00% 25.42

ADDITIONAL INFORMATION
City of Hickory - Henry Fork VVWTP
NCO040797
Outfall 001
Part E - Toxicity Testing Data
Pimephales Promelas
CollectionDate
Test Start Date
EPA Lab ID
No.
NC Cart. No.
Test Method Used
RESULTS
Group
7-Day Survival
Average Growth
per Larvae
Avg WPer
Sury Coo ntrol
NOEC
LOEC
,
11/17/2013
11/19/2013
NCO030
16
EPA 821-R-02-013
Method 1000.0
4th Edition 2002
Control
100.0
0.749
0.749
68
>68
17%
97.5
0.688
25.5%
100.0
0.662
34%
100.0
0.753
51 %
100.0
0.724
68%
100.0
0.683
2/16/2014
2/18/2014
NCO030
16
EPA 821-R-02-013
Method 1000.0
4th Edition 2002
Control
100.0
0.716
0.716
68
>68
17%
100.0
0.766
25.5%
100.0
0.734
34%
100.0
0.724
51 %
100.0
0.693
68%
100.0
0.764
5/11/2014
5/13/2014
NCO030
16
EPA 821-R-02-013
Method 1000.0
4th Edition 2002
Control
100.0
0.363
0.363
68
>68
17%
100.0
0.331
25 5%
97.5
0.352
34%
97.5
0.366
51%
100.0
0.334
68%
100.0
6.47
8/17/2014
8/19/2014
NCO030
16
EPA 821-R-02-013
Method 1000.0
4th Edition 2002
Control
100.0
0. 82
0.582
68
>68
17%
97.5
0. 5
25.5%
97.5
0.580
34%
97.5
0.630
51 %
97.5
0.633
68%
100.0
0.649

Attachment D-F.3

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
HENRY FORK WWTP, NCO040797
RENEWAL
CATAWBA
SUPPLEMENTAL APPLICATION INFORMATION
PART F.INDUSTRIAL USER DISCHARGES AND RCRA/CERCLA WASTES
All treatment works receiving discharges from significant industrial users or which receive RCRA,CERCLA, or other remedial wastes must
complete part F.
GENERAL INFORMATION:
F.1. Pretreatment program. Does the treatment works have, or is subject ot, an approved pretreatment program?
M Yes ❑ No
F.2. Number of Significant Industrial Users (SIUs) and Categorical Industrial Users (CIUs). Provide the number of each of the following types of
industrial users that discharge to the treatment works.
a. Number of non -categorical SIUs. 10
b. Number of CIUs. 0
SIGNIFICANT INDUSTRIAL USER INFORMATION:
Supply the following information for each SIU. If more than one SIU discharges to the treatment works, copy questions F.3 through F.8 and
provide the information requested for each SIU.
F.3. Significant Industrial User Information. Provide the name and address of each SIU discharging to the treatment works. Submit additional pages
as necessary.
Name: CATAWBA MEMORIAL HOSPITAL
Mailing Address: 810 FAIRGROVE CHURCH ROAD
HICKORY NC 28602
F.4. Industrial Processes. Describe all the industrial processes that affect or contribute to the SIU's discharge.
F.S. Principal Product(s) and Raw Material(s). Describe all of the principal processes and raw materials that affect or contribute to the SIU's
discharge.
Principal product(s): HEALTH CARE
Raw materlal(s): BOILER WATER TO PRODUCE STEAM USED FOR HEATING COOKING HUMIDIFYING AND STERILIZING INSTRUMENTS
F.6. Flow Rate.
a. Process wastewater flow rate. Indicate the average daily volume of process wastewater discharge into the collection system in gallons per
day (gpd) and whether the discharge is continuous or intermittent.
71,750 gpd ( X continuous or intermittent)
b. Non -process wastewater flow rate. Indicate the average daily volume of non -process wastewater flow discharged into the collection system
in gallons per day (gpd) and whether the discharge is continuous or intermittent.
gpd ( continuous or intermittent)
F.7. Pretreatment Standards. Indicate whether the SIU is subject to the following:
a. Local limits M Yes ❑ No
b. Categorical pretreatment standards ❑ Yes ® No
If subject to categorical pretreatment standards, which category and subcategory?

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
HENRY FORK WWTP, NCO040797
RENEWAL
CATAWBA
F.8. Problems at the Treatment Works Attributed to Waste Discharge by the SIU. Has the SIU caused or contributed to any problems (e.g.,
upsets, interference) at the treatment works in the past three years?
❑ Yes ® No If yes, describe each episode.
RCRA HAZARDOUS WASTE RECEIVED BY TRUCK, RAIL, OR DEDICATED PIPELINE:
F.9. RCRA Waste. Does the treatment works receive or has it in the past three years received RCRA hazardous waste by truck, rail or dedicated pipe?
❑ Yes ❑ No (go to F.12)
F.10. Waste transport Method by which RCRA waste is received (check all that apply):
❑ Truck ❑ Rail ❑ Dedicated Pipe
F.11. Waste Description. Give EPA hazardous waste number and amount (volume or mass, specify units).
EPA Hazardous Waste Number Amount Units
CERCLA (SUPERFUND) WASTEWATER, RCRA REM EDIATION/CORRECTIVE ACTION
WASTEWATER, AND OTHER REMEDIAL ACTIVITY WASTEWATER:
F.12. Remediation Waste. Does the treatment works currently (or has it been notified that it will) receive waste from remedial activities?
❑ Yes (complete F.13 through F.15.) ❑ No
F.13. Waste Origin. Describe the site and type of facility at which the CERCLA/RCRA/or other remedial waste originates (or is excepted to origniate in
the next five years).
F.14. Pollutants. List the hazardous constituents that are received (or are expected to be received). Include data on volume and concentration, if
known. (Attach additional sheets if necessary.)
F.15. Waste Treatment
a. Is this waste treated (or will be treated) prior to entering the treatment works?
❑ Yes ❑ No
If yes, describe the treatment (provide information about the removal efficiency):
b. is the discharge (or will the discharge be) continuous or intermittent?
❑ Continuous ❑ Intermittent If intermittent, describe discharge schedule.
END OF PART F.
REFER TO THE APPLICATION OVERVIEW (PAGE 1) TO DETERMINE WHICH OTHER PARTS
OF FORM 2A YOU MUST COMPLETE

A�
NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
Mick W. Berry, City Manager
City of Hickory
PO Box 398
Hickory, NC 28601
Dear Mr. Berry:
Donald R. van der Vaart
Secretary
January 27, 2015
Subject: Acknowledgement of Permit Renewal
Permit NCO040797
Catawba County
The NPDES Unit received your permit renewal application on January 27, 2015. A member of the
NPDES Unit will review your application. They will contact you if additional information is required to
complete your permit renewal. You should expect to receive a draft permit approximately 30-45 days
before your existing permit expires.
If you have any additional questions concerning renewal of the subject permit, please contact Julie
Grzyb (919) 807-63 89.
Sincerely,
W rem Tkeolfo-rd.
Wren Thedford
Wastewater Branch
cc: Central Files
Mooresville Regional Office
NPDES Unit
1617 Mail Service Center, Ralegh, 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.ncwater.orq
An Equal 0pportunily%ftinnative Action Employer