NC0025984_Application_20190205

ROY COOPER
conmor
MICHAEL S. REGAN
Smefury
LINDA CULPEPPER
ofwlor
John Condrey, City Manager
Town of Forest City
1107 Red Hill Church Rd
Dunn, NC 28334
Subject: Permit Renewal
Application No. NCO025984
Forest City WWTP
Rutherford County
Dear Applicant:
NORTH CAROLINA
Ea4 rommrenmiQuaUfy
February 05, 2019
The Water Quality Permitting Section acknowledges the February 4, 2019 receipt of your permit renewal application and
supporting documentation. Your application will be assigned to a permit writer within the Section's NPDES WW permitting
branch. Per G.S. 150E-3 your current permit does not expire until permit decision on the application is made.
Continuation of the current permit is contingent on timely and sufficient application for renewal of the current permit. The
permit writer will contact you if additional information is required to complete your permit renewal. Please respond in a
timely manner to requests for additional information necessary to allow a complete review of the application and renewal
of the permit.
Information regarding the status of your renewal application can be found online using the Department of Environmental
Quality's Environmental Application Tracker at:
httos•//dgq nc govlpermits-regulations/permit-quidance/environmental-aoolication-tracker
If you have any additional questions about the permit, please contact the primary reviewer of the application using the
links available within the Application Tracker.
Sincerely,
M -1 a ter'
Wren Thedford
Administrative Assistant
Water Quality Permitting Section
ec: WQPS Laserfiche File w/application
M North Gmhne Degertmentof En,Afonme to Queldy I Di%0wonof Water Resosmes
Ash@W,* Reganat Office 12090 U.S. 70 Wgh" I Swannenoe, North Ceiowm 28778
'^ 828,2N4500

(9)
January 29, 2019
To: Ms. Wren Thedford
NC DENR/DWR/NPDES
1617 Mail Service Center
Raleigh, NC 27699-1617
From: Jeff Dotson, WRF Superintendent
Town of Forest City WWTP
Town of Forest City
PO BOX 728
Forest City, NC 28043
Cc: John Condrey, City Manager
Subject: Town of Forest City Permit Renewal (NC0025984)
��,ov voxesr�
ors
h ,nn111
RTH CPR�y
The Town of Forest City would like to request the renewal of the Town of Forest City Wastewater Treatment Plant, NPDES Permit
Number NC0025984.The Town of Forest City WWTP has been through some changes since it's last permit renewal. The plant no
longer has a sludge dryer which produced a class A biosolid and given away to residents & farmers. The sludge dryer reached the
end of its estimated 15-year life span and no longer made economic sense to operate. The town removed the sludge dryer in 2015
and reverted to land applying class B cake sludge on local farmlands in 2016. The biosolids are hauled away to local farmers by
Southern Soil Builders. (Permit No. W00037135) for land application.
The town has entered an upgrade phase to one of its existing digesters to increase the mixing and air capabilities of the tank to
better serve with solids handling and treatment. The town has applied and received monies from a community development block
grant that will also improve treatment at the plant in the following areas: Upgrade to the second existing digester, new sludge
thickener, & new loader for the loading of the class B biosolids along with improvements to its Bracket Creek lift station. These
improvements will ensure the town can meet all existing and future permitted requirements for the handling of its biosolids program.
Any questions or comments, please feel free to contact myself or Sonny Penson at 828-248-5217.
Jeff Dotson, Superintendent
own�P of FBrest City W1NTP
ieffdotson@townofforestcity corn
Sonny Penson, (ORC, Chief Operator)
sonnoenson(&townofforestcitv.com
PO Box 728 Forest City, NC 28043 Telephone [phone] Fax [phone]
Email address: [e-mail]
Visit our website
www.townofforestcity.com

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RNER BASIN:
Town of Forest City WWTP, NCO025984 Renewal Broad
FORM
2AFllj�ORM 2A APPLICA ON
NPOES
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.B. 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 2 0.1 mgd. All treatment works that have design flows
greater than or equal to 0.1 million gallons per day must complete questions B.1 through B.6.
C. Certification. All applicants must complete Part C (Certification).
SUPPLEMENTAL APPLICATION INFORMATION:
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.
F. 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 RCRAICERCLA Wastes). SIUs are defined as:
1. 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
2. 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
J. 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. Ila, 1 of 22

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RNER BASIN:
Town of Forest City WWTP, NCO025984
Renewal
Broad
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 Town of Forest City WWTP —_
Mailing Address Post Office Box 728 --
Forest City, North Carolina 28043
Contact Person Jeff Dotson
Title WRF Superintendent
Telephone Number [phone]
Facility Address Riverside Drive
(not P.O. Box) Forest City, North Carolina 28043
A.2. Applicant Information. If the applicant is different from the above, provide the following:
Applicant Name Town of Forest City WWTP
Mailing Address Post Office Box 728
Forest City North Carolina 28043
Contact Person John Condrev
Title City Manager
Telephone Number (828) 2454747
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 NCO025984 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, I 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
Town of Forest City 6,200 Separate Municipal
Rutherford County 100 Separate Municipal
Total population served 6 300
EPA Forth 3510-2A (Rev. 1.99). Replaces EPA farms 7550-5 & 7550-22. Page 2 of 22

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
Town of Forest City WWTP, NCO025984 Renewal Broad
A.5. Indian Country.
a. Is the treatment works located in Indian Country?
❑ Yes ® No
b. Does the treatment works discharge to a receiving water that is either in Indian Country or that is upstream from (and eventually flows
through) Indian Country?
❑ Yes ® No
A.6. Flow. Indicate the design flow rate of the treatment plant (i.e., the wastewater flow rate that the plant was built to handle). Also provide the
average daily flow rate and maximum daily flow rate for each of the last three years. Each years data must be based on a 12-month time period
with the 120 month of "this year' occurring no more than three months prior to this application submittal.
a. Design flow rate 4.95 mgd
Two Years Ago Last Year This Year
b. Annual average daily flow rate 1.087 0.923 1.319
C. Maximum daily flow rate 5.440 3.071 8.099
A.7. Collection System. Indicate the type(s) of collection system(s) used by the treatment plant. Check all that apply. Also estimate the percent
contribution (by miles) of each.
® Separate sanitary sewer 100 %
❑ Combined storm and sanitary sewer %
A.8. Discharges and Other Disposal Methods.
a. Does the treatment works discharge effluent to waters of the U.S.? ® Yes ❑ No
If yes, list how many of each of the following types of discharge points the treatment works uses:
1. Discharges of treated effluent 1
ii. Discharges of untreated or partially treated effluent n/a
III. Combined sewer overflow points n/a
iv. Constructed emergency overflows (prior to the headworks) n/a
V. Other
b. Does the treatment works discharge effluent to basins, ponds, or other surface impoundments
that do not have outlets for discharge to waters of the U.S.? ❑ Yes ® No
If yes, provide the following for each surface impoundment:
Location:
Annual average daily volume discharge to surface impoundment(s) mgd
Is discharge ❑ continuous or ❑ intermittent?
C. Does the treatment works land -apply treated wastewater? ❑ Yes 0 No
It yes, provide the following for each land application she:
Location:
Number of acres:
Annual average daily volume applied to site: mgd
Is land application ❑ continuous or ❑ intermittent?
d. Does the treatment works discharge or transport treated or untreated wastewater to another
treatment works? ❑ Yes ® No
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 8 7550-22. Page 3 of 22

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
Town of Forest City WWTP, NCO025984
Renewal
Broad
If yes, describe the mean(s) by which the wastewater from the treatment works is discharged or transported to the other treatment works
(e.g., tank truck, pipe).
If transport is by a party other than the applicant, provide:
Transporter Name
Mailing Address
Contact Person
Title
Telephone Number 1 )
For each treatment works that receives this discharoe, provide the following:
Name
Mailing Address
Contact Person
Title
Telephone Number 1 1
If known, provide the NPDES permit number of the treatment works that receives this discharge
Provide the average daily flow rate from the treatment works into the receiving facility.
mgd
e. Does the treatment works discharge or dispose of its wastewater in a manner not included
in A.8. through A.8.d above (e.g., underground percolation, well injection): ❑ Yes
® No
If yes, provide the following for each disposal method:
Description of method (including location and size of site(s) If applicable):
Annual daily volume disposed by this method:
Is disposal through this method ❑ continuous or ❑ intermittent?
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 8 7550-22. Page 4 of 22

FACIUTY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
Town of Forest City WWTP, NCO025984 Renewal Broad
WASTEWATER DISCHARGES:
If you answered "Yes" to question A.8.a, complete questions A.9 through A.12 once for each outfall (including bypass points) through
which effluent is discharged. Do not include information on combined sewer overflows in this section. If you answered "No" to question
A.8.a, go to Part B, "Additional Application Information for Applicants with a Design Flow Greater than or Equal to 0.1 mgd."
A.9. Description of Outfall.
a. Outfall number
b. Location Town of Forest City
29043
(City or town, if applicable)
(Zip Code)
Rutherford
North Carolina
(Court)
(State)
35' 19' 35" N
81 ° 50' 24" W
(Latitude)
(Longitude)
C. Distance from shore (If applicable) n/a
fl.
d. Depth below surface (fl applicable) n/a
fl.
e. Average daily flow rate 1.319
mgd
f. Does this outfall have either an intermittent or a periodic discharge? ❑ Yes
® No (go to A.9.g.)
If yes, provide the following information:
Number of times per year discharge occurs:
Average duration of each discharge: n/a
Average flow per discharge: n/a mgd
Months in which discharge occurs: n/a
g. Is outfall equipped with a diffuser9 ❑ Yes ® No
A.10. Description of Receiving Waters.
a. Name of receiving water Second Broad River
b. Name of watershed (if known) Broad
United States Soil Conservation Service 14-digit watershed code (if known): Unknown
C. Name of State Management/River Basin (if known): Broad
United States Geological Survey 8-digit hydrologic cataloging unit code (if known): Unknown
d. Critical low flow of receiving stream (if applicable)
acute n/a cfs chronic n/a cfs
e. Total hardness of receiving stream at critical low flow (if applicable): n/a mg/l of CaCO3
EPA Form 3510-2A (Rev. 1.99). Replaces EPA forms 7550-5 & 7550-22. Page 5 of 22

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
BASIN:
Town of Forest City WWTP, NCO025984
JRWER
Renewal
Broad
A.11. Description of Treatment
a. What level of treatment are provided? Check all that apply.
® Primary ® Secondary
❑ Advanced ❑ Other. Describe:
b. Indicate the following removal rates (as applicable):
Design BOD5 removal or Design CBOD5 removal 85 %
Design SS removal 85 %
Design P removal N/A %
Design N removal N/A %
Other %
C. What type of disinfection is used for the effluent from this outfall? If disinfection varies by season, please describe:
Chlorine
If disinfection is by chlorination is dechlodnation used for this outfall? ® Yes ❑ No
Does the treatment plant have post aeration? ® Yes [3 No
A.12. Effluent Testing Information. All 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 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. At a
minimum, effluent testing data must be based on at least three samples and must be no more than four and one-half years apart.
Outfall number: 1
MAXIMUM DAILY VALUE
AVERAGE DAILY VALUE
PARAMETER
Value
Units
Value
Units
Number of Samples
PH (Minimum)
6.0
S.U.
pH (Maximum)
7.5
S.U.
Flow Rate
8.099
MGD
1.319
MGD
365
Temperature (Winter)
16.2
eC
9.6
°C
59
Temperature (Summer)
26.0
eC
24.4
°C
65
' For PH please report a minimum and a maximum daily value
MAXIMUM DAILY
DISCHARGE
AVERAGE DAILY DISCHARGE
ANALYTICAL
POLLUTANT
METHOD
MLIMDL
Number of
Conic.
Units
Cons.
Units
Samples
CONVENTIONAL AND NON CONVENTIONAL COMPOUNDS
BIOCHEMICAL OXYGEN
SODS
36
m /I
1.08
mail
249
00310
2
DEMAND (Report one)
CB0D5
FECAL COLIFORM
2960
111 ml
8.93
#1m00
248
31616
2
TOTAL SUSPENDED SOLIDS (TSS)
68
m /I
9.12
m /I
249
00530
5
END OF PART A.
REFER TO THE APPLICATION OVERVIEW (PAGE 1) TO DETERMINE WHICH OTHER PARTS
OF FORM 2A YOU MUST COMPLETE
I _
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. ?age 6 cf 22

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RNER BASIN:
Town of Forest City WWTP, NCO025984 Renewal Broad
BASIC APPLICATION INFORMATION
PART S. 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 2 0.1 mgd must answer questions BA through B.S. All others go to Part C (Certification).
S.1. Inflow and Infiltration. Estimate the average number of gallons per day that flow into the treatment works from inflow and/or infiltration.
unknown gpd
Briefly explain any steps underway or planned to minimize inflow and Infiltration.
A flow monitoring project is currently underway to determine the location and extent of Ill
13.2. 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''/. 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.
I. 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.
8.3. 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 redundancy 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.
BA. 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
contractor9 ❑ 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:
Mailing Address:
Telephone Number. ( 1
Responsibilities of Contractor:
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 8.5
for each. (If none, go to question B.6.)
a. List the outfall number (assigned in question A9) for each outfall that is covered by this implementation schedule.
Improvements to the digester piping and aeration are currently under design No impact to effluent quality or design
Capacity is anticipated
b. Indicate whetherthe 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 7550-5 S 7550-22. Page 7 of 22

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
BASIN:
Town of Forest City WWTP, NCO025984
JRNER
Renewal
Broad
C. If the answer to 8.5.b is Yes' briefly describe. including new maximum daily inflow rate (if applicable).
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 I l l I
- End Construction
- Begin Discharge
- Attain Operational Level
e. Have appropriate pennits/cleamnoes conceming other Faderel/State requirements been obtained? ❑ Yes ❑ No
Describe briefly:
B.6. 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
QAIQC 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-haM years old.
Outfall Number: 1
MAXIMUM DAILY
AVERAGE DAILY DISCHARGE
POLLUTANT
DISCHARGE
ANALYTICAL
MLIMDL
Number of
METHOD
Coo.
Units
Con,
FUnits
Samples
CONVENTIONAL AND NON CONVENTIONAL COMPOUNDS
AMMONIA (as N)
1.8
mgll
0.665
mgll
4
EPA 350.1,
SM4500NH3D
0.1
CHLORINE (TOTAL
NO
mgn
NO
mgn
4
SM4500CLG
0.02
RESIDUAL, TRC)
DISSOLVED OXYGEN
10.8
mg/I
8.95
mg/1
4
SM4500-OG
6.0
TOTAL KJELDAHL
2.2
MIA1.5
Mg/14
EPA 351.2
0.5.0.24 0.5,1.0
NITROGEN (TKN)
NITRATE PLUS NITRITE
23.6
mall
16.9
mg/I
4
EPA 353.3,
0.2, 1.0, 2.0, 2.0
NITROGEN
SM4500-NO3H
OIL and GREASE
NO
mall
ND
Mgt]
4
EPA 1864A,
EPA7664B
5
PHOSPHORUS (Total)
5.3
mall
41
mall
4
EPA 365.1, EPA
200.7
0.25, 0.04, 0.1,
0.04
TOTAL DISSOLVED SOLIDS
370
mg/1
313.8
mgll
4
SM2540C
25. 10, 10. 10
(TDS)
OTHFR
END OF PART B.
REFER TO THE APPLICATION OVERVIEW (PAGE 1) TO DETERMINE WHICH OTHER PARTS
OF FORM 2A YOU MUST COMPLETE
EPA Foan 3510-2A (Rev. 1-99). Replaces EPA farms 75506 8 7550-22. F'agu a „i 2[

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
Town of Forest City WWTP, NCO025984
Renewal
Broad
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: Biomonhoring Data)
M 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 possibility of fine and imprisonment
for knowing violations.
Name and official title John Condray. Citvana er
Signature
Telephone number 28 24 747
Date signed T` - 1
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 8 7550-22. Page 9 of 22

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RNER BASIN:
Town of Forest City WWTP, NCO025984
Renewal
Broad
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 outfall through which
effluent is discharged. 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 CA/QC requirements of 40 CFR Part 136 and
other appropriate OA/OC 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 form. 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: 1 (Complete once for each outfall discharging effluent to waters of the United States.)
MAXIMUM DAILY DISCHARGE
AVERAGE DAILY DISCHARGE
POLLUTANT
ANALYTICAL
MLlMDL
Number
Coro
Units
Mass
Units
Cone.
Units
Mass
Units
of
METHOD
Samples
METALS (TOTAL RECOVERABLE), CYANIDE, PHENOLS, AND HARDNESS.
0.007
mg/I
0.05
Ibs
0.006
mg/I
0.03
Ibs
3
EPA 200.7,
0.005
ANTIMONY
EPA 200.8,
NO
mg/I
0.00
Ibs
ND
mg1l
0.00
Ibs
4
EPA 200.7,
0.01
ARSENIC
EPA 200.8,
ND
moll
0.00
Ibs
NO
mgA
0.00
Ibs
3
EPA 200.7,
0.001
BERYLLIUM
EPA 200.8,
ND
mg/I
0.00
Ibs
ND
mg/l
0.00
Ibs
4
EPA 200.7,
0.001
CADMIUM
EPA 200.8
ND
mg/I
0.00
Ibs
ND
mgn
0.00
Ibs
4
EPA 200.7,
0.005
CHROMIUM
EPA 200.8
0.012
mg/I
0.02
Ibs
0.009
mg/I
0.01
Ibs
4
EPA 200.7,
0.005,
COPPER
EPA 200.8,
0.001
NO
mg/I
0.00
Ibs
ND
mgn
0.00
Ibs
4
EPA 200.7,
0.005
LEAD
EPA 200.8
11.2
ngA
0.00
Ibs
5.150
ngA
0.00
Ibs
4
EPA 1631,
0.5
MERCURY
EPA 1664A,
EPA 1631 E
ND
ugh
0.00
Ibs
NO
ugll
0.00
Ibs
4
EPA 200.7,
5, 10,
NICKEL
EPA 200.8
0.00001,
0.01
NO
mg/I
0.00
Ibs
ND
mgA
0.00
Ibs
4
EPA 200.7,
0.01
SELENIUM
EPA 200.8
ND
mg/I
0.00
Ibs
ND
mgA
0.00
Ibs
4
EPA 200.7,
0.005
SILVER
EPA 200.8
ND
mgrl
0.00
Ibs
ND
mgrl
0.00
The
3
EPA 200.7,
0.01,
THALLIUM
EPA 200.8
0.0005
0.141
mgVI
0.10
Ibs
0.080
mg/I
0.07
be
4
EPA 200.7,
0.01
ZINC
EPA 200.8
0.015
mgVI
0.05
Ibs
0.009
mgA
0.04
Ibs
4
SM450OCNE
0.008.
CYANIDE
0.005
0.01
mgA
0.05
Ibs
0.007
mgA
0.04
Ibs
4
EPA 420.4,
0.01,
TOTAL PHENOLIC
EPA 420.1
0.005
COMPOUNDS
67.5
mg/I
9.53
Ibs
29.41
mgA
4.94
Ibs
4
SM2340B, EPA
0.662, 1,
HARDNESS (as CaCO3)
200.7
0.001.1
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 forms 7550-6 & 7550-22. Page 10 of 22

FACILITY NAME AND PERMITNUMBER:
PERMIT ACTION REQUESTED:
RNER BASIN:
Town of Forest City WWTP, NCO025984
Renewal
Broad
Outfall number: 1 (Complete once for each outfall discharging effluent to waters of the United States.)
MAXIMUM DAILY DISCHARGE
AVERAGE DAILY DISCHARGE
I
POLLUTANT
ANALYTICAL
MLIMDL
Number
Conc.
Units
Mass
Units
Conc.T
Units
Mass
Units
Of
METHOD
Samples
VOLATILE ORGANIC COMPOUNDS
ND
ug/1
0.00
Ibs
ND
ug/1
0.00
Ibs
4
EPA 624
5
ACROLEIN
NO
ug/1
0.00
Ibs
NO
ugll
0.00
Ibs
4
EPA 624
50, 5, 5, 5
ACRYLONRRILE
ND
Ug/I
0.00
Ibs
ND
Ugll
0.00
Ibs
4
EPA 624
2
BENZENE
ND
Ug/I
0.00
Ibs
NO
Ug/I
0.00
Ibs
4
EPA 624
2
BROMOFORM
NO
Ug/I
0.00
Ibs
NO
uge
0.00
Ibs
4
EPA 624
2
CARBON
TETRACHLORIDE
ND
Ugll
0.00
Ibs
ND
Ugll
0.00
Ibs
4
EPA 624
2
CHLOROBENZENE
ND
Ug/I
0.00
Ibs
NO
UgA
0.00
Ibs
4
EPA 624
2
CHLORODIBROMO-
METHANE
NO
Ug/I
0.00
Ibs
ND
ugA
0.00
Ibs
4
EPA 624
2
CHLOROETHANE
NO
Ugl1
0.00
Ibs
ND
Ug/I
0.00
Ibs
4
EPA 624
5
2-CHLOROETHYLVINYL
ETHER
14.4
Ug/I
0.02
We
8.450
ug0
0.01
Ibs
4
EPA 624
2
CHLOROFORM
2.7
ug/1
0.02
Ibs
2.175
Ugfl
0.01
Ibs
4
EPA 624
2
DICHLOROBROMO-
METHANE
ND
Ug/I
0.00
Ibs
ND
ug/I
0.00
Ibs
4
EPA 624
2
1,1-DICHLOROETHANE
ND
Ug/I
0.00
Ibs
ND
Ug/I
0.00
Ibs
4
EPA 624
2
1,2-DICHLOROETHANE
ND
Ug/I
0.00
Ibs
ND
Ug/I
0.00
Ibs
4
EPA 624
2
TRANS-I,2-DICHLORO-
ETHYLENE
ND
Ug/I
0.00
Ibs
ND
Ug/I
0.00
Ibs
4
EPA 624
2
1,1-DICHLORO-
ETHYLENE
NO
Ug/I
0.00
Ibs
ND
Ugll
0.00
Ibs
4
EPA 624
2
1,2-DICHLOROPROPANE
NO
U9/1
0.00
Ibs
NO
ug/I
0.00
Ibs
4
EPA 624
2, 1, 1, 1
1,3-DICHLORO-
PROPYLENE
ND
ug/1
0.00
Ibs
ND
ugll
0.00
Ibs
4
EPA 624
2
ETHYLBENZENE
NO
Ug/I
0.00
Ibs
ND
ugll
0.00
Ibs
4
EPA 624
2
METHYL BROMIDE
ND
Ug/I
0.00
Ibs
NO
ugll
0.00
Ibs
4
EPA 624
2
METHYL CHLORIDE
NO
Ug/I
0.00
Ibs
NO
ugfl
0.00
Ibs
4
EPA 624
2
METHYLENE CHLORIDE
ND
u9/1
0.00
Ibs
ND
Ugll
0.00
Ibs
4
EPA 624
2
1,1,2,2-TETRA-
CHLOROETHANE
ND
Ug/I
0.00
Ibs
NO
Ugn
0.00
Ibs
4
EPA 624
2
TETRACHLORO-
ETHYLENE
NO
ug/I
0.00
Ibs
ND
ug/I
0.00
Ibs
4
EPA 624
2
TOLUENE
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 11 of 22

FACILITY NAMEAND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RNER BASIN:
Town of Forest City WWTP, NCO025984
Renewal
Broad
Outfall number. 1 (Complete once for each ouffall discharging effluent to waters of the United States.)
MAXIMUM DAILY DISCHARGE
AVERAGE DAILY DI CHARGE
POLLUTANT
MLIMOL
Number
Conc.
Units
Mass
Units
Cone.
Units
Mass
Units
Of
METHOD
sampies
111-
NO
ug/I
0.00
Ibs
NO
ugA
0.00
Ibs
4
EPA 624
2
TRICHLOROETHANE
1 1 2-
NO
ug/I
0.00
We
ND
ugA
0.00
Ibs
4
EPA 624
2
TRICHLOROETHANE
NO
ugA
0.00
Ibs
ND
ugA
0.00
Ibs
4
EPA 624
2
TRICHLOROETHVLENE
ND
ug/I
0.00
Ibs
ND
ug/I
0.00
ibs
4
EPA 624
2
VINYL CHLORIDE
Use this space (or a separate sheet) to provide information on other volatile organic compounds requested by the permit writer
ACI04D(TRACTABLE COMPOUNDS
NO
ug/I
0.00
Ibs
NO
ug/I
0.00
Ibs
4
EPA 625
5
P-CHLOR0.M-CRESOL
NO
ug/I
0.00
Ibs
ND
ug/I
0.00
Ibs
4
EPA 625
5
2-0HLOROPHENOL
NO
ug/I
0.00
Ibs
NO
ug/I
0.00
Ibs
4
EPA 625
5
2,4-DICHLOROPHENOL
NO
ug/I
0.00
Ibs
NO
ug/I
0.00
Ibs
4
EPA 625
10, 5, 5, 5
2,4-DIMETHYLPHENOL
NO
ug/I
0.00
Ibs
ND
ug/I
0.00
Its
4
EPA 625
20, 5, 5, 5
4,6-DINRRO-0-CRESOL
ND
ug/I
0.00
Ibs
ND
ug/I
0.00
Ibs
4
EPA 625
50, 5, 20,
2,4-DINITROPHENOL
10
ND
ug/I
0.00
Ibs
ND
ugA
0.00
Ibs
4
EPA 625
5
2-NITROPHENOL
ND
ug/I
0.00
Ibs
ND
ugA
0.00
We
4
EPA 625
50.5.5.5
4-NITROPHENOL
ND
ug/I
0.00
Ills
ND
ugA
0.00
Ibs
4
EPA 625
10, 5, 10,
PENTACHLOROPHENOL
5
NO
ug/I
0.00
Ibs
ND
u9A
0.00
Ibs
4
EPA 625
5
PHENOL
24 6-
ND
ug/I
0.00
Ibs
ND
ugn
0.00
We
4
EPA 625
10, 5, 5, 5
TRICHLOROPHENOL
Use this space (or a separate sheet) to provide information on other acid4xtractable compounds requested by the permit writer
BASE -NEUTRAL COMPOUNDS
ND
ug/I
0.00
Ibs
ND
ugA
0.00
Ibs
4
EPA 625
5
ACENAPHTHENE
ND
ug/I
0.00
Ibs
ND
ugA
0.00
Ibs
4
EPA 625
5
ACENAPHTHYLENE
NO
ug/I
0.00
Ibs
NO
ugA
0.00
Ibs
4
EPA 625
5
ANTHRACENE
NO
ug/I
0.00
Ibs
NO
ugA
0.00
Its
4
EPA 625
50, 80, 80,
BENZIDINE
80
NO
ug/I
0.00
We
ND
ugA
0.00
We
4
EPA 625
5
BENZO(A)ANTHRACENE
ND
ug/I
0.00
Its
ND
ugA
0.00
Ibs
4
EPA 625
5
BENZO(A)PYRENE
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 12 of 22

FACILITY NAME AND PERMIT NUMBER:
PERMR ACTION REQUESTED:
RIVER BASIN:
Town of Forest City WWTP, NCO025984
Renewal
Broad
Outfall number. 1 (Complete once for each ouffall discharging effluent to haters of the United States.)
MAXIMUM DAILY DISCHARGE
AVERAGE DAILY DISCHARGE
POLLUTANT
ANALYTICAL
MLIMDL
Number
Cone.
Units
Mass
UnNs
Cone.
Units
Mass
Units
of
METHOD
Samples
ND
ug/1
0.00
Ibs
ND
ug/l
0.00
Ibs
4
EPA 625
5
3A BENZO-
FLUORANTHENE
ND
ug/l
0.00
We
ND
ugA
0.00
Ills
4
EPA 625
5
BENZO(GHI)PERYLENE
ND
ug/l
0.00
Ibs
NO
ug/l
0.00
Ibs
4
EPA 625
5
BENZO(K)
FLUORANTHENE
ND
ug/l
0.00
Ibs
NO
ug/l
0.00
Ibs
4
EPA 625
10, 5, 5, 5
BIS (2-CHLOROETHOXY)
METHANE
ND
ug/l
0.00
be
ND
ug/l
0.00
Ibs
4
EPA 625
5
SIS (2-CHLOROETHYL)-
ETHER
ND
ug/l
0.00
Ibs
ND
ugA
0.00
Ibs
4
EPA625
5
BIS (2-CHLOROISO-
PROPYL)ETHER
7.82
ug/l
0.05
Ibs
5.705
ugA
0.03
Ibs
4
EPA625
5
BIS(2-ETHYLHEXYL)
PHTHALATE
ND
ugA
0.00
Ibs
ND
ugA
0.00
Ibs
4
EPA625
5
"ROMOPHENYL
PHENYLETHER
ND
ugh
0.00
Ibs
ND
ugA
0.00
Ibs
4
EPA625
5
BUTYL BENZYL
PHTHALATE
NO
ug/l
0.00
We
ND
ug/l
0.00
Ibs
4
EPA 625
5
2-CHLORO-
NAPHTHALENE
ND
ugA
0.00
Ibs
ND
ug/l
0.00
Ibs
3
EPA 625
5
4-CHLORPHENYL
PHENYL ETHER
ND
ug/l
0.00
Ibs
ND
ugA
0.00
Ibs
4
EPA625
5
CHRYSENE
ND
ug/l
0.00
Ibs
ND
ugA
0.00
Ibs
4
EPA 625
5
DIMI-BUM PHTHALATE
ND
ug/l
0.00
Ibs
ND
ugA
0.00
Ibs
4
EPA625
5
DI-N-OCTYL PHTHALATE
ND
ug/l
0.00
Ibs
ND
ugA
0.00
Ibs
4
EPA625
5
DIBENZO(A,H)
ANTHRACENE
ND
ug/l
0.00
Ibs
ND
ug/l
0.00
Ibs
4
EPA625
2
1,2-DICHLOROBENZENE
NO
ugn
0.00
Ibs
ND
ugA
0.00
Ibs
4
EPA 625
2
1,3-0ICHLOROBENZENE
ND
ug/1
0.00
We
ND
ug/l
0.00
Ibs
4
EPA 625
2
1,4-0ICHLOROBENZENE
ND
ug/l
0.00
Ibs
ND
ugn
0.00
Ibs
4
EPA625
25, 5, 5, 5
3,3-DICHLORO-
BENZIDINE
ND
ug/l
0.00
Ibs
ND
ugA
0.00
Ibs
4
EPA625
5
DIETHYL PHTHALATE
ND
u9/1
0.00
Ibs
ND
ug/I
0.00
Ibs
4
EPA625
5
DIMETHYL PHTHALATE
ND
ug(I
0.00
Ibs
ND
ugA
0.00
Ibs
4
EPA625
5
2,4-DINITROTOLUENE
ND
ugA
0.00
Ibs
ND
ugA
0.00
Ibs
4
EPA625
5
2,6-DINITROTOLUENE
ND
ug/l
0.00
be
ND
ug/I
0.00
Ibs
4
EPA625
5
1,2-0IPHENYL-
HYDRAZINE
EPA Form 3510-2A (Rev. 1.9B). Replaces EPA forms 7550-6 8 7550-22. Page 13 of 22

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
Town of Forest City WWTP, NCO025984
Renewal
Broad
Outfall number. 1 (Complete once for each outfall discharging effluent to waters of the United States.)
MA)(IMUM DAILY DISCHARGE
AVERAGE DAILY DISCHARGE
POLLUTANT
ANALYTICAL
ML/MDL
Number
Caw.
Units
Mass
Units
Cone.
Units
Mass
Units
of
METHOD
Samples
ND
ug/I
0.00
Ibs
ND
ug/I
0.00
Ibs
4
EPA625
5
FLUORANTHENE
NO
ug/I
0.00
Ibs
ND
ug/I
0.00
Ibs
4
EPA 625
5
FLUORENE
NO
ug/I
0.00
Ibs
ND
ug/I
0.00
Ibs
4
EPA 625
5
HEXACHLOROBENZENE
HEXACHLORO-
NO
ug/I
0.00
Ibs
ND
ug/I
0.00
Ibs
4
EPA 625
5
BUTADIENE
HEXACHLOROCYCLO-
NO
ug/I
0.00
Ibs
ND
ug/I
0.00
Ibs
4
EPA 625
10, 10, 5,
PENTADIENE
5
NO
ug/I
0.00
Ibs
ND
ug/I
0.00
Ibs
4
EPA 625
5
HEXACHLOROETHANE
INDENO(1,2,3-CD)
NO
ug/I
0.00
Ibs
ND
ugll
0.00
Ibs
4
EPA 625
5
PYRENE
ND
ug/I
0.00
lbs
ND
u9A
0.00
Ibs
4
EPA 625
10, 5, 5, 5
ISOPHORONE
ND
ug/I
0.00
Ibs
ND
u9/1
0.00
Ibs
4
EPA 625
5
NAPHTHALENE
ND
ug/I
0.00
Ibs
NO
ugfl
0.00
We
4
EPA 625
5
NITROBENZENE
ND
ug/I
0.00
Ibs
ND
ugfl
0.00
Ibs
4
EPA 625
5
N-NRROSODI-N-
PROPYLAMINE
ND
ug/I
0.00
Ibs
NO
ug/I
0.00
Ibs
4
EPA625
5
N-NRROSODI-
METHYLAMINE
ND
ug/I
0.00
Ibs
NO
ugA
0.00
Ibs
4
EPA 625
10,51515
N-NITROSODI-
PHENYLAMINE
ND
ug/I
0.00
Ibs
NO
ug/I
0.00
Ibs
4
EPA625
5
PHENANTHRENE
ND
ug/I
0.00
Ibs
NO
ug/I
0.00
Ibs
4
EPA625
5
PYRENE
ND
ug/I
0.00
Iba
ND
ugll
0.00
Ibs
4
EPA
1 2 4
TRICHLOROBENZENE
Use this space (or a separate sheet) to provide information on other base -neutral compounds requested by the perms writer
Use this specs (or a separate sheet) to provide infonnabon an 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:
RNER BASIN:
Town of Forest City WWTP, NCO025984
Renewal
Broad
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 quarterly 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 OA/QC requirements of 40 CFR Part 136 and other appropriate CA/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 akemate 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 biomonitoring data is required, do not complete Part E. Refer to the Application Overview for directions on which other sections of the forth to
complete.
E.I. Required Tests.
Indicate the number of whole effluent toxicity tests conducted in the past four and one-half years.
® chronic ❑ acute
21 total tests: 10/6/14, 1/28/15, 4/15115, 4/15/15', 7/8/15, 10121/15, 1/25/16, 4/19/16, 7/11/16', 7/12116, 10/11/16, 1/10/17, 4/11/17, 7111117,
10/2/17-, 10/3/17, 1/8/18', 1/9/18, 4/3/18, 7110/18, 1012/18 (' denotes second species)
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 paged more than three tests are being reported.
Test number. Test number. Test number
a. Test information.
Test Species & test method number
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 numbers)
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 Form 3510-2A (Rev. 1-99). Replaces EPA fortes 7550-6 & 7550-22, Page 15 of 22

FACILITY NAME AND PERMIT NUMBER:
Town of Forest City WWTP, NCO025984
PERMIT ACTION REQUESTED:
Renewal
RNER BASIN:
Broad
Test number: t Test number: 2 Test number: 3
e. Describe the point in the treatment process at which the sample was collected.
Sample was collected:
f. For each lest, 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
Static -renewal
Flow -through
It. Source of dilution water. If laboratory water, specify type; if receiving water, specify source.
Laboratory water
Receiving water
i. Type of dilution water. If sab 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
%
%
%
LC,
95% C.I.
%
%
%
Control percent survival
%
%
%
Other (describe)
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550E & 7650-22. Page 16 of 22

FACILITY NAME AND PERMIT NUMBER:
Town of Forest City WWTP, NCO025984
PERMIT ACTION REQUESTED:
Renewal
RNER BASIN:
Broad
Chronic:
NOEC
%
%
%
ICm
%
%
%
Control percent Survival
aka
%
%
Other (describe)
m. Quality Control/Quality Assurance.
Is reference toxicant data available?
Was reference toxicant test vothin
acceptable bounds?
What date was reference toxicant test
run (MM/DDNYYY)?
Other (describe)
E.3. Toxicity Reduction Evaluation. Is the treatment works involved in a Toxicity Reduction Evaluation?
❑ Yes ® No If yes, describe:
EA. Summary of Submitted Biomonitoring 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 vies submitted to the permitting authority and a summary
of the results.
Date submitted: / / (MM/DDM'YY)
Summary of results: (see instructions)
END OF PART E.
REFER TO THE APPLICATION OVERVIEW (PAGE 1) TO DETERMINE WHICH OTHER PARTS
OF FORM 2A YOU MUST COMPLETE.
EPA Forth 3510-2A (Rev. 1-99). Replaces EPA forms 7550-5 & 7550-22. P.+uo 1' of 22

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RNER BASIN:
Town of Forest City WWTP, NCO025984
Renewal
Broad
SUPPLEMENTAL APPLICATION INFORMATION
PART F.INDUSTRIAL USER DISCHARGES AND RCRAICERCLA 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.I. 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. 3
b. Number of CIUs. 2
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: Everest Textiles
Mailing Address: 1331 West Main Street
Forest City, NC 26043
FA. Industrial Processes. Des :nbe all the industrial processes that affect or contribute to the SIU's discharge.
Weaving. knitting finishing. nomrmanmade fibers & sewing
F.S. Principal Producible) and Raw Materialist). Describe all of the principal processes and raw materials that affect or contribute to the SIU's
discharge.
Principal product(s): synthetic (non -cotton) fabrics & aarments
Raw matenal(s): drains cloth dyes finishing chemicals synthetic yams
F.6. Flow Rate.
a. Process wastewater flow rate. Indicate the average daity volume of process wastewater discharge into the collection system in gallons per
day (gpd) and whether the discharge is continuous or intemlittent.
880,000 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
55,000 gpd (X 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?
n/a
EPA Forth 3510-2A (Rev. 1-99). Replaces EPA forms 7550E & 7550-22. Page 18 of 22

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
R BASIN:
Town of Forest City WWTP, NCO025984
Renewal
I!!
Broad
F.B.
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.
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: Valley Fine Foods
Mailing Address: 212 Nip Way Parkin Road
Forest City. NC 28043
FAL
Industrial Processes. Describe all the industrial processes that affect or contribute to the SIU's discharge.
Processing of paste sauces, and prepared meals cleanup
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 pmduct(s): food processing company
Raw material(s): eggs dairy, wheatvegetables herbs spices
F.B.
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.
5,000 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.
15 300 gpd (X 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?
nia
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.
EPA Forth 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7660-22, Pop 19 M 22

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:
Mailing Address:
Forest City, NC 28043
F.4. Industrial Processes. Describe all the industrial processes that affect or contribute to the SIU's discharge.
Rubber extrusion braiding and vulcanization
F.S. Principal Product(s) and Raw Material(s). Describe all of the principal processes and raw matenals that affect or contribute to the SIU's
discharge.
Principal product(s):
Raw material(s): Synthetic rubber, textile wire processing aids mold release inks and dyes lubricants
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 (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 (X 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?
F.B. 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.
EPA Forth 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 8 7550-22. Page 20 of 22

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. Parker Hanni n
Mailing Address: PO Box 429 Pine Street
Forest City, NC 28043
FA.
Industrial Processes. Describe all the industrial processes that affect or contribute to the SIU's discharge.
Machining assembly, Pressure testing metal finishing
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): hydraulic valves
Raw material(s): cast iron ductile iron extrusions steel aluminum
F.6.
Flow Rate.
a.Process wastewater flow rate. Indicate the average dairy volume of process wastewater discharge into the collection system in gallons per
day (gpd) and whether the discharge is continuous or intermittent.
10,000 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.
900 gpd (X continuous or intermittent)
F.7.
Pretreatment Standards. Indicate whether the SIU is subject to the following:
a. Local limits ID Yes ❑ No
It. Categorical pretreatment standards ® Yes ❑ No
If subject to categorical pretreatment standards, which category and subcategory?
433.17
FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
Town of Forest City WWTP, NCO025984
Renewal
Broad
F.B.
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.
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 21 of 22

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: West Rock
Mailing Address: 376 Pine Street
Forest City, NC 28043
FA.
Industrial Processes. Describe all the industrial processes that affect or contribute to the SIU's discharge.
Manufactures Purchase displays from wood metal and plastic
F.5.
Principal Products) and Raw Material(s). Describe all of the principal processes and raw materials that affect or contribute to the SIU's
discharge.
Principal preduct(s): Purchase displays
Raw material(s): wood laminates metal sheet plastic Paint (powder coal water, and solvent -based), iron Phosphate pretreatment
chemicals and water -based contact adhesives
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.
10,000 gpd (X continuous or intermittent)
b. Nan -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.
2.670 gpd (X 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?
433 463
FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
Town of Forest City VVVi NCO025984
Renewal
Broad
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
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 22 of 22

CERCLA (SUPERFUND) WASTEWATER, RCRA REM EDIATIONICORRECTIVE ACTION
WASTEWATER, AND OTHER REMEDIAL ACTIVITY WASTEWATER:
F.12. Remedlation 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 originate 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 tl 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 A9). Replaces EPA forms 7550-6 & 7550-22. Page 23 of 22

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
BASIN:
Town of Forest City WWTP, NCO025984
JIUNER
Renewal
Broad
SUPPLEMENTAL APPLICATION INFORMATION
PART G. COMBINED SEWER SYSTEMS
If the treatment works has a combined sewer system, complete Part G.
G.1. 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 G.1 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 GA once for each CSO discharge Point
G.3. Description of Outfall.
a. Outfall number
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 dte following were monitored during the last year for this CSO?
❑ Rainfall ❑ CSO pollutant concentrations ❑ CSO frequency
❑ CEO flow volume ❑ Receiving water quality
f. How many storm events were monitored during the last year?
GA. CSO Events.
a. Give the number of CSO events in the last year.
events (p actual or ❑ approx.)
b. Give the average duration per CSO event.
hours (I] actual or ❑ approx.)
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-5 & 7550-22. Page 24 of 22

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
Town of Forest City WWTP, NCO025984 Renewal Broad
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.5. Description of Receiving Waters.
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-digit hydrologic cataloging unit code (if known):
G.B. CSO Operations.
Describe any known inter 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 Forth 3510-2A (Rev. 1-99). Replaces EPA forme 7550E & 7550-22. 6°aya 21, e( 22

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Residuals Management Plan
Town of Forest City Wastewater Treatment Plant
The Town of Forest City Wastewater Treatment Plant (WWTP) wastes residual solids to a 45'
diameter, 18' depth (214,140 gallons total volume) aerobic digester (Digester 1) for pre -thickening
by means of decanting. Pre -thickened sludge is then pumped to a 1-meter belt thickener where it
is thickened from to an average of 3% solids and discharged to a 55' diameter, approximately 25'
depth (441,680 gallons total volume) aerobic digester (Digester 2) to reduce volatile solids by at
least 38% to meet USEPA vector attraction reduction requirements for Class B biosolids before
discharge to a 2-meter belt filter press and storage building. The biosolids are hauled away by
Southern Soil Builders (Permit No. WQ0037135) for land application.
Per 15A NCAC 02H a minimum of 30 days of solids storage is required. Solids will be produced
at a rate of 4,462 lbs/day based on a design flow of 4.95 MGD and historic average of 0.901 dry
lbs pounds solids per 1,000 gallons of wastewater (4,950,000 aay x 0.9011,0 o gat = 4,462 aQy).
Assuming a typical reported 3% solids concentration from the belt thickener, approximately
[4,462 aay _ �8.34lbsa`ter x 1.045(SG, 3% sludge) x 3%), x 30 days = 512,000 gallons
of sludge will be produced.
Digester 2 has sufficient capacity for only 26 days of sludge storage at 3% solids. However,
scheduled improvements to the solids handling train, including replacement of the thickener, are
anticipated to further reduce the sludge volume requiring storage and increase the total number of
days of sludge storage available. If sludge thickening can be improved to at least 3.1% solids, 30
days of combined storage will be available in the two digesters. Sludge thickening to at least 3.5%
solids will permit Digester 2 alone to store 30 days of thickened sludge.
If additional storage is needed as the WWTP approaches design capacity, the installation of an
additional pump or piping modifications to permit the transfer of thickened sludge to Digester 1
will be considered.
City Manager
Date
Page I of 1

Permit No. NCO025984 Annual Monitoring and Pollutant Scan Month APdI
Outfall 001 Year 2015
Facility Name Town of Forest City W WTP ORC Barnard Norris Penson, Jr.
Date of sampling April 15, 2015
Analytical Laboratory Pace Analytical Services, INC.
Phone [phone])
parameter
Sample
Type
Analytical
Method
Quantitation
Level
Sample
Result
Units of
Measurement
Number of
samples
Ammonia (as N)
Composite
EPA 350.1
0.10
0.48
mg/I
1
Dissolved oxygen
Grab
SM 4500-OG
6.0
7.9
mg/1
1
Nitrate/Nitrite
Composite
EPA 353.3
0.2
22.9
mg/I
1
Total Kjeldahl nitrogen
Composite
EPA 351.2
0.5
2.2
mg/I
1
Total Phosphorus
Composite
EPA 365.1
0.3 15.3
1
mg/1
1
Total dissolved solids
Composite
SM2540C
25.0
301
mg/l
1
Hardness
Composite
SM2340B
662.0
67500
ug/I
1
Chlorine (total residual, TRC)
Grab
SM4500-C
20.0
< 20.0
ug/1
1
Oil and grease
Grab
EPA 1664A
5.0
< 5.0
mg/1
1
Metals (total recoverable), cyanide and total phenols
Antimony
Composite
EPA 200.7
5.0
< 5.0
ug/1
1
Arsenic
Composite
EPA 200.7
10.0
< 10.0
ug/l
1
Beryllium
Composite
EPA 200.7
1.0
< 1.0
ug/l
Cadmium
Composite
EPA 200.7
1.0
< 1.0
ug/I
Chromium
Composite
EPA 200.7
5.0
< 5.0
ug/I
Copper
Composite
EPA 200.7
5.0
9.1
ug/I
Lead
Composite
EPA 200.7
5.0
< 5.0
ug/l
Mercury
Composite
EPA 1631
0.5
11.2
ng/1
1
Nickel
Composite
EPA 200.7
5.0
< 5.0
ug/1
1
Selenium
Composite
EPA 200.7
10.0
< 10.0
ug/1
Silver
Composite
EPA 200.7
5.0
< 5.0
ug/1
Thallium
Composite
EPA 200.7
10.0
< 10.0
ug/1
1
Zinc
Composite
EPA 200.7
10.0
1 141
ug/1
1
Cyanide
Grab
ISM450OCNEI
8.0
1 < 8.0
1 ug/l
1
Total phenolic compounds
Grab
EPA 420.4
0.010
< .010
1 mg/1
1
Volatile organic compounds
Acrolein
Grab
EPA 624
5.0
< 5.0
ug/1
1
Acrylonitrile
Grab
EPA 624
50.0
< 50.0
ug/I
1
Benzene
Grab
EPA 624
2.0
< 2.0
ug/1
1
Bromoform
Grab
EPA 624
2.0
< 2.0
ug/l
1
Carbon tetrachloride
Grab
EPA 624
2.0
< 2.0
ug/1
1
Chlorobenzene
Grab
EPA 624
2.0
< 2.0
ug/l
1
Chlorodibromomethane
Grab
EPA 624
2.0
< 2.0
ug/l
1
Chloroethane
Grab
EPA 624
2.0
< 2.0
ug/l
1
2-chloroethylvinyl ether
Grab
EPA 624
5.0
< 5.0
ug/1
1
Chloroform
Grab
EPA 624
2.0
3.9
ug/l
Dichlorobromomethane
Grab
EPA 624
2.0
< 2.0
ug/I
1
1,1-dichloroethane
Grab
EPA 624
2.0
< 2.0
ug/1
1
1,2-dichloroethane
Grab
EPA 624
2.0
< 2.0
ug/l
1
Trans-1,2-dichloroethylene
Grab
EPA 624
2.0
< 2.0
ug/l
Form - DMR- PPA-1 Page 1

Permit No. NCO025984 Annual Monitoring and Pollutant Scan
n-+t ,n nni
Month Aoril
Vear gnl q
Parameter
Sample
Type
Analytical
Method
Quantitation
Level
Sample
Result
Units of
Measurement
Number of
samples
Volatile organic compounds (Cont.)
1, 1 -dichloroethylene
Grab
EPA 624
2.0
< 2.0
ug/1
1
1,2-dichloropmpane
Grab
EPA 624
2.0
< 2.0
ug/I
1,3-dichloropropylene
Grab
EPA 624
2.0
< 2.0
ug/1
Ethyibenzene
Grab
EPA 624
2.0
< 2.0
ug/1
Methyl bromide
Grab
EPA 624
2.0
< 2.0
ug/1
1
Methyl chloride
Grab
EPA 624
2.0
< 2.0
ug/1
1
Methylene chloride
Grab
EPA 624
2.0
< 2.0
ug/1
1
1,1,2,2-tetracbloroethane
Grab
EPA 624
2.0
< 2.0
ug/l
1
Tetrachloroethylene
Grab
EPA 624
2.0
< 2.0
ug/l
1
Toluene
Grab
EPA 624
2.0
< 2.0
ug/1
1
1,1,1-trichloroethane
Grab
EPA 624
2.0
< 2.0
ug/l
1
1,1,2-trichloroethane
Grab
EPA 624
2.0
< 2.0
ug/1
1
Trichloroethylene
Grab
EPA 624
2.0
< 2.0
ug/I
1
Vinyl chloride
Grab
EPA 624
2.0
< 2.0
ug/1
1
Acid -extractable compounds
P-chloro-m-creso
Grab
EPA 625
5.0
< 5.0
ug/1
1
2-chlomphenol
Grab
EPA 625
5.0
< 5.0
ug/l
1
2,4-dichlorophenol
Grab
EPA 625
5.0
< 5.0
ug/1
1
2,4-dimethylphenol
Grab
EPA 625
10.0
< 10.0
ug/I
1
4,6-dimtro-o-cresol
Grab
EPA 625
20.0
< 20.0
ug/I
1
2,4-dinitrophenol
Grab
EPA 625
50.0
< 50.0
ug/I
1
2-nitrophenol
Grab
EPA 625
5.0
< 5.0
ug/I
1
4-nitrophenol
Grab
EPA 625
50.0
< 50.0
ug/1
1
Pentachlorophenol
Grab
EPA 625
10.0
< 10.0
ug/I
1
Phenol
Grab
EPA 625
5.0
< 5.0
ug/I
1
2,4,6-trichlorophenol
Grab
EPA 625
10.0
< 10.0
ug/I
1
Base -neutral compounds
Acenaphthene
Grab
EPA 625
5.0
< 5.0
ug/1
1
Acenaphthylene
Grab
EPA 625
5.0
< 5.0
ug/I
1
Anthracene
Grab
EPA 625
5.0
< 5.0
ug/I
Benzidine
Grab
EPA 625
50.0
< 50.0
ug/l
1
Benzo(a)anthracene
Grab
EPA 625
5.0
< 5.0
ug/1
Benzo(a)pyrene
Grab
EPA 625
5.0
< 5.0
ug/1
3,4 benzofluoranthene
Grab
EPA 625
5.0
< 5.0
ug/1
Benzo(ghi)perylene
Grab
EPA 625
5.0
< 5.0
ug/I
Benzo(k)fluoranthene
Grab
EPA 625
5.0
< 5.0
ug/I
Bis (2-chloroethoxy) methane
Grab
EPA 625
10.0
< 10.0
ug/l
Bis (2-chloroethyl) ether
Grab
EPA 625
5.0
< 5.0
ug/I
1
Bis (2-chloroisopropyi) ether
Grab
EPA 625
5.0
< 5.0
ug/I
1
Bis (2-ethylhexyl) phthalate
Grab
EPA 625
5.0
< 5.0
ug/I
1
4-bromophenyl phenyl ether
Grab
EPA 625
5.0
< 5.0
ug/I
1
Butyl benzyl phthalate
Grab
EPA 625
5.0
< 5.0
ug/I
1
2-chloronaphthalene
Grab
EPA 625
5.0
< 5.0
ug/I
1
4-chlorophenyl phenyl ether
Grab
EPA 625
5.0
< 5.0
ug/I
1
Form - DMR- PPA-1 Page 2

Permit No. NCO025984 Annual Monitoring and Pollutant Scan
n,.+F�n nm
Month April
Year 2015
Parameter
Sample
Type
Analytical
Method
Quantitation
Level
Sample
Result
Units of
Measurement
Number of
samples
Base -neutral compounds (coat.)
Chrysene
Grab
EPA 625
5.0
< 5.0
ug/1
1
Di-n-butyl phthalate
Grab
EPA 625
5.0
< 5.0
ug/1
1
Di-n-octyl phthalate
Grab
EPA 625
5.0
< 5.0
ug/l
1
Dibenzo(a,h)anthracene
Grab
EPA 625
5.0
< 5.0
ug/1
1
1,2-dichlorobenvme
Grab
EPA 625
2.0
< 2.0
ug/1
1
1,3-dichlorobenzene
Grab
EPA 625
2.0
< 2.0
ug/l
1
1,4-dichlorobenzene
Grab
EPA 625
2.0
< 2.0
1 ug/1
1
3,3-dichlorobenzidine
Grab
EPA 625
25.0
< 5.0
ug/1
Diethyl phthalate
Grab
EPA 625
5.0
< 5.0
ug/1
1
Dimethyl phthalate
Grab
EPA 625
5.0
< 5.0
ug/1
1
2,4-dinitrotoluene
Grab
EPA 625
5.0
< 5.0
ug/1
1
2,6-dinitmtoluene
Grab
EPA 625
5.0
< 5.0
ug/1
I
1,2-diphenylhydrazine
Grab
EPA 625
5.0
< 5.0
ug/1
1
Fluoranthene
Grab
EPA 625
5.0
< 5.0
ug/1
1
Fluorene
Grab
EPA 625
5.0
< 5.0
ug/1
1
Hexachlorobenzene
Grab
EPA 625
5.0
< 5.0
ug/1
1
Hexachlorobutadiene
Grab
EPA 625
5.0
< 5.0
ug/1
1
Hexachlorocyclo-pentadiene
Grab
EPA 625
10.0
< 10.0
ug/1
1
Hexachloroethane
Grab
EPA 625
5.0
< 5.0
ug/1
1
Indeno(1,2,3-cd)pyrene
Grab
EPA 625
5.0
< 5.0
1 ug/1
1
Isophorone
Grab
EPA 625
10.0
< 10.0
ug/1
1
Naphthalene
Grab
EPA 625
5.0
< 5.0
ug/1
1
Nitrobenzene
Grab
EPA 625
5.0
< 5.0
ug/l
1
N-nitrosodi-n-propylamine
Grab
EPA 625
5.0
< 5.0
ug/1
1
N-nitrosodimethylamine
Grab
EPA 625
5.0
< 5.0
ug/1
1
N-nitrosodiphenylamine
Grab
EPA 625
10.0
< 10.0
ug/1
1
Phenanthrene
Grab
EPA 625
5.0
< 5.0
ug/l
1
Pyrene
Grab
EPA 625
5.0
< 5.0
ug/1
1
1,2,4,-trichlorobenzene
Grab
EPA 625
5.0
< 5.0
ug/1
1
"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 managed the system, or those persons directly responsible for gathering the information, the information
submitted is, to the best of my knowledge and belief, tale, accurate, and complete. I am aware that there are significant penalties for
submitting false information, including the possibility of fines and imprisonment for knowing violations."
Authorized Representative name
Signature
Date
Form - DMR- PPA-1 Page 3

Permit No. NCO025984 Annual Monitoring and Pollutant Scan Month July
Outfall 001 Year 2016
Facility Name Town of Forest City WWTP ORC Bamard Norris Penson. Jr.
Date of sampling July 12, 2016
Analytical laboratory Pace Analytical Services. INC.
Phone f828-248-5217)
Parameter
Sample
Type
Analytical
Method
Quantitation
Level
Sample
Result
Units of
Measurement
Number of
samples
Ammonia (as N)
Composite
SM4500 NH30
0.10
0.28
mg/I
1
Dissolved oxygen
Grab
SM 4500-OG
6.0
7.7
mg/l
I
Nitrate/Nitrite
Composite
SM4500-NO31i
1.0
21.4
mg/1
1
Total Kjeldahl nitrogen
Composite
EPA 351.2
0.2
0.70
mg/I
1
Total Phosphorus
Composite
EPA 200.7
1 0.040
5.0
1 mg/I
t
Total dissolved solids
Composite
SM2540C
10.0
350
mg/1
t
Hardness
Composite
EPA 200.7
1.0
50
mg/1
l
Chlorine (total residual, TRCI
Grab
SM4500-C
20.0
< 20.0
ug/1
1
Oil and grease
Grab
EPA 1664A
5.0
< 5.0
mg/ l
Metals (total recoverable), cyanide and total
phenols
Antimony
Composite
EPA 200.8
0.005
0.005
mg/l
Arsenic
Composite
EPA 200.8
0.010
< .010
mg/1
Beryllium
Composite
EPA 200.8
0.001
< .010
mg/1
1
Cadmium
Composite
EPA 200.8
0.001
< .001
mg/1
1
Chromium
Composite
EPA 200.8
0.005
< .005
mg/1
1
Copper
Composite
EPA 200.8
0.001
0.012
mg/1
1
Lead
Composite
EPA 200.8
0.005
< .005
mg/1
Mercury
Composite
EPA 1664A
0.500
5.05
ng/1
Nickel
Composite
EPA 200.8
0.010
< .010
mg/1
Selenium
Composite
EPA 200.8
0.010
< .010
mg/1
Silver
Composite
EPA 200.8
0.005
< .005
mg/l
1
Thallium
Composite
EPA 200.8
0.0005
< .0005
mg/1
1
Zinc
Composite
EPA 200.8
0.010
0.054
mg/1
1
Cyanide
Grab
SM450OCNE
0.005
0.006
mg/1
1
Total phenolic compounds
Grab
EPA 420.1
0.005
0.006
mg/I
1
Volatile organic compounds
Acrolein
Grab
EPA 624
5.0
< 5.0
ug/I
Acrylonitrile
Grab
EPA 624
5.0
< 5.0
ug/1
Benzene
Grab
EPA 624
2.0
< 2.0
ug/l
Bromoform
Grab
EPA 624
2.0
< 2.0
ug/1
1
Carbon tetrachloride
Grab
EPA 624
2.0
< 2.0
ug/1
1
Chlorobenzene
Grab
EPA 624
2.0
< 2.0
ug/l
1
Chlorodibromomethane
Grab
EPA 624
2.0
< 2.0
ug/1
1
Chloroethane
Grab
EPA 624
2.0
< 2.0
ug/1
I
2-chloroethylvinyl ether
Grab
EPA 624
5.0
< 5.0
ug/1
I
Chloroform
Grab
EPA 624
2.0
13.5
ug/1
1
Dichlorobromomethane
Grab
EPA 624
2.0
2.7
ug/l
1
1,1-dichloroethane
Grab
EPA 624
2.0
< 2.0
ug/1
1
1,2-dichloroethane
Grab
EPA 624
2.0
< 2.0
ug/1
1
Trans-1,2-dichloroethylene
Grab
EPA 624
2.0
< 2.0
ug/1
1
Form - DMR- PPA-1 Page 1

Permit No. NCO025984 Annual Monitoring and Pollutant Scan
n„tr-,n nni
Month July
Year 2016
Parameter
Sample
Type
Analytical
Method
Quantitation
Level
Sample
Result
Units of
Measurement
Number of
samples
Volatile organic compounds (Cont.)
1,1-dichloroethylene
Grab
EPA 624
2.0
< 2.0
ug/1
I
1,2-dichloropropane
Grab
EPA 624
2.0
< 2.0
ug/1
1
1,3-dichloropropylene
Grab
EPA 624
1.0
< 1.0
ug/1
1
Ethylbenzene
Grab
EPA 624
2.0
< 2.0
ug/1
I
Methyl bromide
Grab
EPA 624
2.0
< 2.0
ug/1
I
Methyl chloride
Grab
EPA 624
2.0
< 2.0
ug/1
1
Methylene chloride
Grab
EPA 624
2.0
< 2.0
ug/1
1
1,1,2,2-tetrachloroethane
Grab
EPA 624
2.0
< 2.0
ug/1
1
Tetrachloroethylene
Grab
EPA 624
2.0
< 2.0
ug/1
1
Toluene
Grab
EPA 624
2.0
< 2.0
ug/1
1
1,1,1-trichloroethane
Grab
EPA 624
2.0
< 2.0
ug/1
1
1,1,2-trichloroethane
Grab
EPA 624
2.0
< 2.0
ug/1
1
Trichloroethylene
Grab
EPA 624
2.0
< 2.0
ug/1
1
Vinyl chloride
Grab
EPA 624
2.0
< 2.0
ug/1
Acid -extractable compounds
P-chloro-m-creso
Grab
EPA 625
5.00
< 5.00
ug/1
2-chlorophenol
Grab
EPA 625
5.00
< 5.00
ug/1
1
2,4-dichlorophenol
Grab
EPA 625
5.00
< 5.00
ug/1
1
2,4-dimethylphenol
Grab
EPA 625
5.00
< 5.00
ug/1
1
4,6-dinitro-o-cresol
Grab
EPA 625
5.00
< 5.00
ug/1
I
2,4-dinitrophenol
Grab
EPA 625
5.00
< 5.00
ug/l
1
2-nitrophenol
Grab
EPA 625
5.00
< 5.00
ug/l
1
4-nitrophenol
Grab
EPA 625
< 5.00
ug/1
1
Pentachlorophenol
Grab
EPA 625
< 10.0
ug/1
1
Phenol
Grab
EPA 625
M5.00
< 5.00
ug/12,4,6-trichlorophenol
Grab
EPA 625
< 5.00
ug/1
1
Base -neutral compounds
Acenaphthene
Grab
EPA 625
5.00
< 5.00
ug/1
Acenaphthylene
Grab
EPA 625
5.00
< 5.00
ug/1
1
Anthracene
Grab
EPA 625
5.00
< 5.00
ug/1
1
Benmdme
Grab
EPA 625
80.0
< 80.0
ug/1
1
Benzo(a)anthracene
Grab
EPA 625
5.00
< 5.0
ug/1
1
Benzo(a)pyrene
Grab
EPA 625
5.00
< 5.00
ug/l
3,4 benzolluoranthene
Grab
EPA 625
5.00
< 5.00
ug/1
Benzo(ghi)perylene
Grab
EPA 625
5.00
< 5.00
ug/1
Benzo(k)ffuoranthene
Grab
EPA 625
5.00
< 5.00
ug/1
I
Bis (2-chloroethoxy) methane
Grab
EPA 625
5.00
< 5.00
ug/1
Bis (2-chloroethyl) ether
Grab
EPA 625
5.00
< 5.00
ug/1
1
Bis (2-chloroisopropyl) ether
Grab
EPA 625
5.00
< 5.00
ug/I
1
Bis (2-ethylhexyl) phthalate
Grab
EPA 625
5.00
7.82
ug/I
1
4-bromophenyl phenyl ether
Grab
EPA 625
5.00
< 5.00
ug/1
I
Butyl benzyl phthalate
Grab
EPA 625
5.00
< 5.00
ug/1
1
2-chloronaphthalene
Grab
EPA 625
5.00
< 5.00
ug/1
1
4-chlorophenyl phenyl ether
Grab
EPA 625
5.00
< 5.00
ug/1
1
Form - DMR- PPA-1 Page 2

Permit No. NCO025984 Annual Monitoring and Pollutant Scan
.,...r,.11 nA,
Month July
v�a,)nIF
Parameter
Sample
Type
Analytical
Method
Quantitation
Level
Sample
Result
Units of
Measurement
Number of
samples
Base -neutral compounds (coat.)
Chrysene
Grab
EPA 625
5.00
< 5.00
ug/I
Di-n-butyl phthalate
Grab
EPA 625
5.00
< 5.00
ug/I
Di-n-octyl phthalate
Grab
EPA 625
5.00
< 5.00
ug/I
I
Dibenzo(a,h)anthracene
Grab
EPA 625
5.00
< 5.00
ug/1
1
1,2-dichlorobenzene
Grab
EPA 625
2.0
< 2.0
ug/I
1
1,3-dichlorobenzene
Grab
EPA 625
2.0
< 2.0
ug/1
1
1,4-dichlorobenzene
Grab
EPA 625
2.0
< 2.0
ug/1
1
3,3-dichlorobenzidine
Grab
EPA 625
5.00
< 5.00
ug/1
1
Diethyl phthalate
Grab
EPA 625
5.00
< 5.00
ug/1
1
Dimethyl phthalate
Grab
EPA 625
5.00
< 5.00
ug/1
1
2,4-dinitrotoluene
Grab
EPA 625
5.00
< 5.00
ug/1
1
2,6-dinitrotoluene
Grab
EPA 625
5.00
< 5.00
ug/1
1
1,2-diphenylhydrazine
Grab
EPA 625
5.00
< 5.00
ug/I
I
Fluoranthene
Grab
EPA 625
5.00
< 5.00
ug/1
1
Fluorene
Grab
EPA 625
5.00
< 5.00
ug/l
1
Hexachlorobenzene
Grab
EPA 625
5.00
< 5.00
ug/1
I
Hexachlorobutsdiene
Grab
EPA 625
5.00
< 5.00
ug/I
1
Hexachlorocyclo-pentadiene
Grab
EPA 625
10.0
< 5.00
ug/l
1
Hexachloroethane
Grab
EPA 625
5.00
< 5.0
ug/1
1
Indeno(1,2,3-cd)pyrene
Grab
EPA 625
5.00
< 5.00
ug/1
Isophorone
Grab
EPA 625
3.00
< 5.00
ug/1
Naphthalene
Grab
EPA 625
5.00
1 < 5.00
ug/1
Nitrobenzene
Grab
EPA 625
5.00
< 5.00
ug/I
N-nitrosodi-n-propylamine
Grab
EPA 625
5.00
< 5.00
ug/I
N-nitrosodimethylamine
Grab
EPA 625
5.00
< 5.00
ug/k
N-nitrosodiphenylamine
Grab
EPA 625
5.00
< 5.00
ug/1
Phenanthrene
Grab
EPA 625
5.00
< 5.00
ug/1
Pyrene
Grab
EPA 625
5.00
< 5.00
ug/I
1,2,4,-trichlorobenzene
Grab
EPA 625
2.0
< 2.0
ug/I
I
"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 managed the system, or those persons directly responsible for gathering the information, the information
submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for
submitting false information, including the possibility of fines and imprisonment for knowing violations."
Authorized Representative name
Signature
Date
Form - DMR- PPA-1 Page 3

Permit No. NCO025984 Annual Monitoring and Pollutant Scan Month OCTOBER
Outfall 001 Year 2017
Facility Name Town of Forest City W WTP ORC Barnard Norris Penson, Jr.
Date of sampling October 5 2017 Phone [phone]
Analytical Laboratory Environmental Testing Solutions, Inc.
Parameter
Sample
Type
Analytical
Method
Quantitation
Level
Sample
Result
Units of
Measurement
Number of
samples
Ammonia (as N)
Composite
SM4500NH31)
0.1
0.1
mg/l
1
Dissolved oxygen
Grab
SM 4500-OG
6.0
9.4
mg/l
1
Nitrate/Nitrite
Composite
sM 4500-No3 H
2.0
23.6
mg/1
1
Total Kjeldahl nitrogen
Composite
EPA 351.2
0.5
1.25
mg/l
1
Total Phosphorus
Composite I
EPA 200.7
1 0.1
1 3.6
mg/l
1
Total dissolved solids
Composite
SM2540C
10.0
370.0
mg/l
1
Hardness
Composite
EPA 200.7
1.0
1 98.0
ug/1
1
Chlorine (total residual, TRC)
Grab
SM4500-C
20.0
< 20.0
ug/l
1
Oil and grease
Grab I
EPA 1664B
5.0
< 5.0
mg/l
1
Metals (total recoverablel, cyanide and total
phenols
Antimony
Composite
EPA 200.8
mg/l
1
Arsenic
Composite
EPA 200.8
0.010
< 0.010
mg/l
Beryllium
Composite
EPA 200.8
mg/1
1
Cadmium
Composite
EPA 200.8
0.001
< 0.001
mg/1
1
Chromium
Composite
EPA 200.8
0.005
< 0.005
mg/l
1
Copper
Composite
EPA 200.8
0.001
0.007
mg/l
1
Lead
Composite
EPA 200.8
0.005
< 0.005
mg/1
1
Mercury
Composite
EPA 1631 E
0.500
1.53
ng/l
1
Nickel
Composite
EPA 200.8
0.010
< 0.010
rig/l
1
Selenium
Composite
EPA 200.8
0.010
< 0.010
mg/l
1
Silver
Composite
EPA 200.8
0.005
< 0.005
mg/l
Thallium
Composite
EPA 200.8
mg/l
1
Zinc
Composite
EPA 200.8
0.010
0.036
mg/l
Cyanide
Grab
SM450OCNE
0.005
0.015
mg/l
1
Total phenolic compounds
Grab
EPA 420.1
0.005
< .005
mg/l
1
Volatile organic compounds
Acrolein
Grab
EPA 624
5.0
< 5.0
ug/1
1
Acrylonitrile
Grab
EPA 624
5.0
< 5.0
ug/1
1
Benzene
Grab
EPA 624
2.0
< 2.0
ug/l
1
Bromoform
Grab
EPA 624
2.0
< 2.0
ug/l
1
Carbon tetrachloride
Grab
EPA 624
2.0
< 2.0
ug/l
1
Chlorobenzene
Grab
EPA 624
2.0
< 2.0
ug/1
1
Chlorodibromomethane
Grab
EPA 624
2.0
< 2.0
ug/1
1
Chloroethane
Grab
EPA 624
2.0
< 2.0
ug/l
1
2-chloroethylvinyl ether
Grab
EPA 624
5.0
< 5.0
ug/l
1
Chloroform
Grab
EPA 624
2.0
14.4
ug/l
1
Dichlorobromomethane
Grab
EPA 624
2.0
< 2.0
ug/1
1
1,1-dichloroethane
Grab
EPA 624
2.0
< 2.0
ug/1
1
1,2-dichloroethane
Grab
EPA 624
2.0
< 2.0
ug/1
1
7'rans-1,2-dichloroethylene
Grab
EPA 624
2.0
< 2.0
ug/l
1
Form - DMR- PPA-1 Page 1

Permit No. NC0025984 Annual Monitoring and Pollutant Scan Month OCTOBER
Outfall 001 Year 2017
Parameter
Sample
Type
Analytical
Method
Quantitation
Level
Sample
Result
Units of
Measurement
Number of
samples
Volatile organic compounds (Cont.)
1,1-dichloroethylene
Grab
EPA 624
2.0
< 2.0
ug/l
1
1,2-dichloropropane
Grab
EPA 624
2.0
< 2.0
ug/l
1
1,3-dichloropropylene
Grab
EPA 624
1.0
< 1.0
ug/l
1
Ethylbenzene
Grab
EPA 624
2.0
< 2.0
ug/l
1
Methyl bromide
Grab
EPA 624
2.0
< 2.0
ug/l
1
Methyl chloride
Grab
EPA 624
2.0
< 2.0
ug/l
1
Methylene chloride
Grab
EPA 624
2.0
< 2.0
ug/l
1
1,1,2,2-tetrachloroethane
Grab
EPA 624
2.0
< 2.0
ug/1
1
Tetrachloroethylene
Grab
EPA 624
2.0
< 2.0
ug/1
1
Toluene
Grab
EPA 624
2.0
< 2.0
ug/l
1
1,1,1-trichloroethane
Grab
EPA 624
2.0
< 2.0
ug/l
1
1,1,2-trichloroethane
Grab
EPA 624
2.0
< 2.0
ug/l
1
Trichloroethylene
Grab
EPA 624
2.0
< 2.0
ug/l
1
Vinyl chloride
Grab
EPA 624
2.0
< 2.0
ug/l
Add-eztsaetable compounds
P-chloro-m-creso
Grab
EPA 625
5.00
< 5.00
ug/l
2-chlorophenol
Grab
EPA 625
5.00
< 5.00
ug/l
2,4-dichlorophenol
Grab
EPA 625
5.00
< 5.00
ug/1
2,4-dimethylphenol
Grab
EPA 625
5.00
< 5.00
ug/l
4,6-dinitro-o-cresol
Grab
EPA 625
5.00
< 5.00
ug/1
2,4-dinitrophenol
Grab
EPA 625
20.00
< 20.00
ug/1
2-nitrophenol
Grab
EPA 625
5.00
< 5.00
ug/l
4-nitrophenol
Grab
EPA 625
5.00
< 5.00
ug/1
Pentachlorophenol
Grab
EPA 625
10.0
< 10.00
ug/l
Phenol
Grab
EPA 625
5.00
< 5.00
ug/l
2,4,6-trichlorophenol
Grab
EPA 625
5.00
< 5.00
ug/1
Base -neutral compounds
Acenaphthene
Grab
EPA 625
5.00
< 5.00
ug/I
Acenaphthylene
Grab
EPA 625
5.00
< 5.00
ug/l
Anthracene
Grab
EPA 625
5.00
< 5.00
ug/l
Benzidine
Grab
EPA 625
80.00
< 80.00
ug/l
Benzo(a)anthracene
Grab
EPA 625
5.00
< 5.00
ug/l
Benzo(a)pyrene
Grab
EPA 625
5.00
< 5.00
ug/1
3,4 benzofluoranthene
Grab
EPA 625
5.00
< 5.00
ug/l
Benzo(ghi)perylene
Grab
EPA 625
5.00
< 5.00
ug/l
1
Benzo(k)fluoranthene
Grab
EPA 625
5.00
< 5.00
ug/l
1
Bis (2-chloroethoxy) methane
Grab
EPA 625
5.00
< 5.00
ug/l
1
Bis (2-chloroethyl) ether
Grab
EPA 625
5.00
< 5.00
ug/l
1
Bis (2-chloroisopropyl) ether
Grab
EPA 625
5.00
< 5.00
ug/l
1
Bis (2-ethylhexyl) phthalate
Grab
EPA 625
5.00
< 5.00
ug/l
4-bromophenyl phenyl ether
Grab
EPA 625
5.00
< 5.00
ug/l
Butyl benzyl phthalate
Grab
EPA 625
5.00
< 5.00
ug/1
2-chloronaphthalene
Grab
EPA 625
5.00
< 5.00
ug/1
Form - DMR- PPA-1 Page 2

Permit No. NC0025984 Annual Monitoring and Pollutant Scan Month OCTOBER
Outfall 001 Year 2017
4-chlorophenyl phenyl ether
I Grab
IEPA 625
Parameter
Sample
Type
Analytical
Method
Quantitation
Level
Sample
Result
Units of
Measurement
Number of
samples
Base -neutral compounds (coat.(
Chrysene
Grab
EPA 625
5.00
< 5.00
ug/1
1
Di-n-butyl phthalate
Grab
EPA 625
5.00
< 5.00
ug/I
Di-n-octyl phthalate
Grab
EPA 625
5.00
< 5.00
ug/l
Dibenzo(a,h)anthracene
Grab
EPA 625
5.00
< 5.00
ug/l
1
1,2-dichlorobenzene
Grab
EPA 625
2.00
< 2.00
ug/l
1
1,3-dichlorobenzene
Grab
EPA 625
2.00
< 2.00
ug/1
1
1,4-dichlorobenzene
Grab
EPA 625
2.00
< 2.00
ug/1
I
3,3-dichlorobenzidine
Grab
EPA 625
5.00
< 5.00
ug/1
1
Diethyl phthalate
Grab
EPA 625
5.00
< 5.00
ug/1
1
Dimethyl phthalate
Grab
EPA 625
5.00
< 5.00
ug/l
1
2,4-dinitrotoluene
Grab
EPA 625
5.00
< 5.00
ug/l
1
2,6-dinitrotoluene
Grab
EPA 625
5.00
< 5.00
ug/l
1
1,2-diphenylhydrazine
Grab
EPA 625
5.00
< 5.00
ug/l
1
Fluoranthene
Grab
EPA 625
5.00
< 5.00
ug/1
1
Fluorene
Grab
EPA 625
5.00
< 5.00
ug/I
1
Hexachlorobenzene
Grab
EPA 625
5.00
< 5.00
ug/l
1
Hexachlorobutadiene
Grab
EPA 625
5.00
< 5.00
ug/I
1
Hexachlorocyclo-pentadiene
Grab
EPA 625
5.00
< 5.00
ug/l
1
Hexachloroethane
Grab
EPA 625
5.00
< 5.00
ug/l
1
Indeno(1,2,3-cd)pyrene
Grab
EPA 625
5.00
< 5.00
ug/l
1
Isophorone
Grab
EPA 625
5.00
< 5.00
ug/l
1
Naphthalene
Grab
EPA 625
5.00
< 5.00
ug/I
1
Nitrobenzene
Grab
EPA 625
5.00
< 5.00
ug/I
1
N-nitrosodi-n-propylamine
Grab
EPA 625
5.00
< 5.00
ug/1
1
N-nitrosodimethylamine
Grab
EPA 625
5.00
< 5.00
ug/I
1
N-nitrosodiphenylamine
Grab
EPA 625
5.00
< 5.00
ug/1
1
Phenanthrene
Grab
EPA 625
5.00
< 5.00
ug/1
1
Pyrene
Grab
EPA 625
5.00 1
< 5.00
ug/I
I
1,2,4,-trichlorobenzene IGrab
EPA 625
2.00 1
< 2.00
ug/l
1
"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 managed the system, or those persons directly responsible for gathering the information, the information
submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for
submitting false information, including the possibility of fines and imprisonment for knowing violations."
Authorized Representative name
Signature
Date
Form - DMR- PPA-I Page 3

Permit No. NCO025984 Annual Monitoring and Pollutant Scan Month January
Outfall 001 Year 2018
Facility Name Town of Forest City W WTP ORC Barnard Norris Penson. Jr.
Date of sampling January 9. 2018 Phone [phone]
Analytical Laboratory Environmental Testing Solutions, Inc.
Parameter
Sample
Type
Analytical
Method
Quantitation
Level
Sample
Result
Units of
Measurement
Number of
samples
Ammonia (as N)
Composite
SM4500NH3D
0.1
1.8
mg/1
1
Dissolved oxygen
Grab
SM 4500-OG
6.0
10.8
mg/l
1
Nitrate/Nitrite
Composite
SM4500-NO3H
2.0
7.54
mg/I
1
Total Kjeldahl nitrogen
Composite
EPA 351.2
1.0
2.01
mg/l
1
Total Phosphorus
Composite
EPA 200.7
1 0.040
1 2.8
1 mg/1
1
Total dissolved solids
Composite
SM2540C
10.0
230.0
mg/l
1
Hardness
Composite
EPA 200.7
1.0
37.0
ug/l
1
Chlorine (total residual, TRC)
Grab
SM4500-C
20.0
1 < 20.0
1 ug/1
I L
Oil and grease
Grab
EPA 1664B
1 5.0
15.0
mg/1
Metals (total recoverable), cyanide and total
phenols
Antimony
Composite
EPA 200.8
0.005
0.007
mg/1
1
Arsenic
Composite
EPA 200.8
0.010
< 0.010
mg/l
1
Beryllium
Composite
EPA 200.8
0.001
< 0.001
mg/l
1
Cadmium
Composite
EPA 200.8
0.001
< 0.001
mg/1
1
Chromium
Composite
EPA 200.8
0.005
< 0.005
mg/l
1
Copper
Composite
EPA 200.8
0.001
0.008
mg/l
1
Lead
Composite
EPA 200.8
0.005
< 0.005
mg/l
1
Mercury
Composite
EPA 1631 E
0.500
2.82
ng/I
Nickel
Composite
EPA 200.8
0.010
< 0.010
ng/l
Selenium
Composite
EPA 200.8
0.010
< 0.010
mg/l
Silver
Composite
EPA 200.8
0.005
< 0.005
mg/l
Thallium
Composite
EPA 200.8
0.001
< 0.001
mg/l
Zinc
Composite
EPA 200.8
0.010
0.088
mg/l
1
Cyanide
Grab
SM4500CNE
0.005
< 0.005
mg/l
1
Total phenolic compounds
Grab
EPA 420.1
0.005
< 0.005
mg/l
Volatile organic compounds
Acrolein
Grab
EPA 624
5.0
< 5.0
ug/I
Acrylonitrile
Grab
EPA 624
5.0
< 5.0
ug/l
Benzene
Grab
EPA 624
2.0
< 2.0
ug/l
Bromoform
Grab
EPA 624
2.0
< 2.0
ug/l
Carbon tetrachloride
Grab
EPA 624
2.0
< 2.0
ug/1
1
Chlorobenzene
Grab
EPA 624
2.0
< 2.0
ug/L
1
Chlorodibromomethane
Grab
EPA 624
2.0
< 2.0
ug/l
Chloroethane
Grab
EPA 624
2.0
< 2.0
ug/l
2-chloroethylvinyl ether
Grab
EPA 624
5.0
< 5.0
ug/l
Chloroform
Grab
EPA 624
2.0
< 2.0
ug/l
Dichlorobromomethane
Grab
EPA 624
2.0
< 2.0
ug/l
1,1-dichloroethane
Grab
EPA 624
2.0
< 2.0
ug/I
1
1,2-dichloroethane
Grab
EPA 624
2.0
< 2.0
ug/l
Trans-1,2-dichloroethylene
Grab
EPA 624
2.0
< 2.0
ug/1
1
Form - DMR- PPA-1 Page 1

Permit No. NC0025984 Annual Monitoring and Pollutant Scan Month January
Outfall 001 Year 2018
Parameter
Sample
Type
Analytical
Method
Quantitation
Level
Sample
Result
Units of
Measurement
Number of
samples
Volatile organic compounds (Cont.)
1, 1 -dichloroethylene
Grab
EPA 624
2.0
< 2.0
ug/l
1
1,2-dichloropropane
Grab
EPA 624
2.0
< 2.0
ug/l
1
1,3-dichloropropylene
Grab
EPA 624
1.0
< 1.0
ug/l
1
Ethylbenzene
Grab
EPA 624
2.0
< 2.0
ug/l
1
Methyl bromide
Grab
EPA 624
2.0
< 2.0
ug/l
1
Methyl chloride
Grab
EPA 624
2.0
< 2.0
ug/ 1
I
Methylene chloride
Grab
EPA 624
2.0
< 2.0
ug/1
1
1,1,2,2-tetrachloroethane
Grab
EPA 624
2.0
< 2.0
ug/1
1
Tetrachloroethylene
Grab
EPA 624
2.0
< 2.0
ug/1
1
Toluene
Grab
EPA 624
2.0
< 2.0
ug/1
1
1, 1, 1 -trichloroethane
Grab
EPA 624
2.0
< 2.0
ug/l
1
1,1,2-trichloroethane
Grab
EPA 624
2.0
< 2.0
ug/l
1
Trichloroethylene
Grab
EPA 624
2.0
< 2.0
ug/1
1
Vinyl chloride
Grab
EPA 624
2.0
< 2.0
ug/l
1
Acid -extractable compounds
P-chloro-m-creso
Grab
EPA 625
5.00
< 5.00
ug/l
1
2-chlorophenol
Grab
EPA 625
5.00
< 5.00
ug/l
1
2,4-dichlorophenol
Grab
EPA 625
5.00
< 5.00
ug/1
1
2,4-dimethylphenol
Grab
EPA 625
5.00
< 5.00
ug/1
1
4,6-dinitro-o-cresol
Grab
EPA 625
5.00
< 5.00
ug/1
1
2,4-dinitrophenol
Grab
EPA 625
10.00
< 10.00
ug/1
1
2-nitrophenol
Grab
EPA 625
5.00
< 5.00
ug/1
1
4-nitrophenol
Grab
EPA 625
5.00
< 5.00
ug/1
1
Pentachlorophenol
Grab
EPA 625
5.0
< 5.00
ug/1
1
Phenol
Grab
EPA 625
5.00
< 5.00
ug/1
1
2,4,6-trichlorophenol
Grab
EPA 625
5.00
< 5.00
ug/I
1
Base -neutral compoanda
Acenaphthene
Grab
EPA 625
5.00
< 5.00
ug/I
Acenaphthylene
Grab
EPA 625
5.00
< 5.00
ug/I
1
Anthracene
Grab
EPA 625
5.00
< 5.00
ug/1
1
Benzidine
Grab
EPA 625
80.00
< 80.00
ug/1
1
Benzo(a)anthracene
Grab
EPA 625
5.00
< 5.00
ug/1
1
Benzo(a)pyrene
Grab
EPA 625
5.00
< 5.00
ug/1
1
3,4 benzofluoranthene
Grab
EPA 625
5.00
< 5.00
ug/1
1
Benzo(ghi)perylene
Grab
EPA 625
5.00
< 5.00
ug/l
1
Benzo(k)fluoranthene
Grab
EPA 625
5.00
< 5.00
ug/1
1
His (2-chloroethoxy) methane
Grab
EPA 625
5.00
< 5.00
ug/1
1
Bis (2-chloroethyl) ether
Grab
EPA 625
5.00
< 5.00
ug/1
1
Bis (2-chloroisopropyl) ether
Grab
EPA 625
5.00
< 5.00
ug/1
1
Bis (2-ethylhexyl) phthalate
Grab
EPA 625
5.00
< 5.00
ug/1
1
4-bromophenyl phenyl ether
Grab
EPA 625
5.00
< 5.00
ug/1
1
Butyl benzyl phthalate
Grab
EPA 625
5.00
< 5.00
ug/1
1
2-chloronaphthalene
Grab
EPA 625
5.00
< 5.00
ug/1
1
Form - DMR- PPA-1 Page 2

Permit No. NC0025984 Annual Monitoring and Pollutant Scan Month January
Outfall 001 Year 2018
4-chlorophenyl phenyl ether
Grab
EPA 625
Parameter
Sample
Type
Analytical
Method
Quantitation
Level
Sample
Result
Units of
Measurement
Number of
samples
Base -neutral compounds (coat.)
Chrysene
Grab
EPA 625
5.00
< 5.00
1
Di-n-butyl phthalate
Grab
EPA 625
5.00
< 5.00
ug/I
1
Di-n-octyl phthalate
Grab
EPA 625
5.00
< 5.00
ug/l
1
Dibenzo(a,h)anthracene
Grab
EPA 625
5.00
< 5.00
ug/1
1
1,2-dichlorobenzene
Grab
EPA 625
2.00
< 2.00
ug/l
1
1,3-dichlorobenzene
Grab
EPA 625
2.00
< 2.00
ug/1
1
1,4-dichlorobenzene
Grab
EPA 625
2.00
< 2.00
ug/l
3,3-dichlorobenzidine
Grab
EPA 625
5.00
< 5.00
ug/1
Diethyl phthalate
Grab
EPA 625
5.00
< 5.00
ug/1
Dimethyl phthalate
Grab
EPA 625
5.00
< 5.00
ug/l
2,4-dinitrotoluene
Grab
EPA 625
5.00
< 5.00
ug/l
2,6-dinitrotoluene
Grab
EPA 625
5.00
< 5.00
ug/1
1
1,2-diphenylhydrazine
Grab
EPA 625
5.00
< 5.00
ug/l
1
Fluoranthene
Grab
EPA 625
5.00
< 5.00
ug/l
1
Fluorene
Grab
EPA 625
5.00
< 5.00
ug/1
1
Hexachlorobenzene
Grab
EPA 625
5.00
< 5.00
ug/1
1
Hexachlorobutadiene
Grab
EPA 625
5.00
< 5.00
ug/1
1
Hexachlorocyclo-pentadiene
Grab
EPA 625
5.00
< 5.00
ug/1
1
Hexachloroethane
Grab
EPA 625
5.00
< 5.00
1 ug/l
1
Indeno(1,2,3-cd)pyrene
Grab
EPA 625
5.00
< 5.00
ug/l
1
Isophorone
Grab
EPA 625
5.00
< 5.00
ug/l
1
Naphthalene
Grab
EPA 625
5.00
< 5.00
ug/l
1
Nitrobenzene
Grab
EPA 625
5.00
< 5.00
ug/1
1
N-nitrosodi-n-propylamine
Grab
EPA 625
5.00
< 5.00
ug/l
1
N-nitrosodimethylamine
Grab
EPA 625
5.00
< 5.00
ug/1
1
N-nitrosodiphenylamine
Grab
EPA 625
5.00
< 5.00
ug/1
1
Phenanthrene
Grab
EPA 625
5.00
< 5.00
ug/1
1
Pyrene
Grab
EPA 625
5.00
< 5.00
ug/l
1
1,2,4,-trichlorobenzene
Grab
EPA 625
2.00
< 2.00
ug/1
1
"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 managed the system, or those persons directly responsible for gathering the information, the information
submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for
submitting false information, including the possibility of fines and imprisonment for knowing violations."
Authorized Representative name
Signature
Date
Form - DMR- PPA-1 Page 3

/ ceftlyUcale
/ wwnAamfaLscmr
Mr. Jeff Dotson
Forest City W WTP
P.O. Box 728
397 Riverside Drive
Forest City, NC 28043
Project: BIOASSAY041142015
Pace Project No.: 92245853
Sample: PIPE 001
Pace Analytical Services, Inc.
9800 Kincey, Ave. Suite 100
Nunter6Hlle, NC 28078
[phone]
Page 1 of 1
\ � J
, Laboratory Report �A `4 (P 5� JL l x5
U / Report Date: 04/17/2015
Date Received: 04/152015
Lab ID: 92245853001 Collected: 04/1411508:56 Matrix: Water
Parameters Results Units Report Limit Analysed Qualifiers
P.promelas Full -range Chronic Pass % 04115/15 00:00
Reviewed by:
Stacy Tarle
stacy.tarte®pacelabs.com
Raleigh Certification IDs
5701 Conference Drive, Raleigh, NC 27507
North Carolina Wastewater Certlficallon IY: 67
North Carolina Bloassay Certification it: 16
North Carolina Drinking Water Certifica0on IX: 37731
Page 1 of 2

C 6�
Effluent Aquatic Toxicity Report Form - Acute Pass/Fail Date
T -�d NPDES#NC I Pipe # j Count
iin Test t�n� _ D (1 r�Q 11 d�(1g�_
FCcimmert�s
r in Resppppnsible,Ch rge
MAIL ORIGINAL TO' Div. Water Q Qu
ality
es8ranch
N.C.DENR
1621 Mail Service Center
CaKOHAa Acute Pass/Fatl Toxicity Test Raleigh, North Carolina 27699-1621
Collection Date: 4-14-15 Organism Tested
Collection Time: 4
Test Start Date: Ili' I� tNS , ��l
SamoleTvpe'Duration
Control
Grab Com ,Duration pry
mil' o o Treatment ,a1c
E x
o t e
3 t
a n
d
Hardness(mgrl r
t
Spec.Corid.(umhos ControlM
Chlorine(m .O.Treatment
Sample temp. at receip
Mortality
Treatment 1 (Control)
Treatment 2 (Exposure)
Concentration Ez
Tested
Replicate Mean Mortality
A B C D
r
A B C n
% % % R
C l p C
(NOTE: If mean control mortality exceeds10%, the test is considered invalid)
Calculate using
Arc -Sine Calculated Student'st PASS
Square Root
transformed Tabular Students t FAIL
data (ONE TAILED) `
If the absolute value of the calculated t is less than or equal
to the absolute value of the tabular t, check PASS.
If the absolute value of the calculated t is greater than the
absolute value of the tabular t, check FAIL.
If all vessels within each treatment have the same response
but the treatment two response is greater than the control, check FAIL.
DWQ farm AT-2 (&VI)

Effluent
Facility
-aboratory Performing Test.
Form - Acute Pass/Fail Date .
Pipe N- County
MAIL ORIGINAL TO;
Collection Date:
Collection Time:
Test Start Date:
R�mnleTvnn/ni iroKnn
Grab
Comp,jDuratlon
Sample temp. at
Mortality
Treatment 1 (Control)
r�
gm
N
Comments
Environmental Sciences Branch
Div. of Water Quality
N.C.DENR
1621 Mail Service Center
Raleigh, North Carolina 27699-1621
Organism Tested
Control
pH
Treatment
s e
t n
I
d
r
t
Control g
D.O.
Treatment
Replicate
A B C D
Treatment 2 (Expos re) A B C D
Concentration /� O o% o I Oo 0 0
Tested l
(NOTE: If mean control mortality exceeds10%a, the test is considered invalid)
Calculate using
Arc -Sine Calculated Student's t PASS :;
Square Root
transformed Tabular Student's t FAIL
data (ONE TAILED)
If the absolute value of the calculated t is less than or equal
to the absolute value of the tabular t, check PASS.
If the absolute value of the calculated t is greater than the
absolute value of the tabular t, check FAIL.
If all vessels within each treatment have the same response
but the treatment two response is greater than the control, check FAIL.
Mean Mortality
G
DWQ form AT-2 (8/91)

Pace Analytical
Data Sheet for Acute Pass/Fail Test — Fathead minnow Pimephales promelas
Client: r Y ` NPDES #: NCReviewed by: cS�
Test Organism:;Treatment:
S ''LMrklSQrganism Born (Date)Time)r / Age of Organism: .3 Time Fed: : a0 --
# Replicates perrr�- Total Organisms per Vessel: _LQ_ Test Vessel Size: �? m� - VolumeJVessel:<`) +fr,,
Dilution Water Batch: I F-6 Temperature: 2-S. o Randomized: \;r- Incubator:
StartDate:4-1,6-1$' Time:5"�(D
End Date: 1 - S Time: 3' �a
Analyst.
Analyst: t-T
# Organisms
# Alive after 24hrs
D.O.
Temp.
pH
Conductivity
exposed
M
Ots/cm)
Concentration
A B C D
A B C D
Total
0 24
0 24
0 24
0 24
Chlorine Total
(mg/L) Hardness
Control
to :10 10 to
10 IQ 101 10
' 4b
7ao
90
io i0 9 j1C
3q
-49
Comments:
100% Sample:
pH- ( �2• (0 D
conductivity (AS/cm) - - -.

start uate: 4110rzu10 i est tu: forest sampie w:
End Date: 4/16/2015 Lab ID: PACE -Raleigh #016 Sample Type:
Sample Date: Protocol: EPAF 91-EPA Freshwater Test Species: PP-Pimephales promelas
rot f.uuvu i.uuuu t.uuuv t.uuvu
90 1.0000 1.0000 0.9000 1.0000
transform: Aresm aquas Root: Rang t-tauaa
Conc-% Mean N-Mean Mean Min Max CV% N Sum Critical
control 1.0000 1.0000 1.4120 1.4120 1.4120 0.000 4
90 0.9750 0.9750 1.3713 1.2490 1.4120 5.942 4 16.00 9.00
non -normal distribution (p <=
Wilcoxon Two -Sample Test Indicates no significant differences
Dose -Response Plot
1
0.9
0.8
0.7
m
? 0.6
2
y 0.5
e 0.4
N
0.3
0.2
0.1
0
Q
e
8
0
m
Pace 1 TOXCalaV5.023 Reviewed by:?�

Document Name:
Date ReNZl June 22. 2012
- AlxlAcd1
-...Btoassay of Custody
Page 1 of 1
Dooumeht Numoar
Issuing AWwrily:
...-HbkLCS-007-rev.01
Pace Cantinas Quality Office
Facility Name:
Bioassay Chain of Custody Form
g•,4s14 Cy,, flu; 1(
Address: .?(3"2 %'iuP/SltJf e/
.iR rf 01 r tiL
County : �yf% Pi hcid
% Effluent Dilution (IWC):ITI? �.
Plant Flow.
P.O. Box: /
Phone # : _(�W S»
Contact: Te-1r '0 4r
NPDFS permR#: pipe: (X/
Test Method:
Sample Collector: Print ��+ Sa—
Signature.
Sample Type: _
Composite
Date Started y'/T'� ; , Jlt;; ;: /.G,y rpm
Date Ended li-i5;rsr �T OfrfG or PM
Samples per Hr
Grab
Date: Time: AM or PM
Sample Volume — ne<[ t r No
MMMM
~ '
\MIs'i�i/,/l't'
lit
_
Comments:
Pace Work Order Number:
Receiving Temperature:
Received By.
Pace Analytical Services, Inc Address: 6701 Conference Dr., Raleigh, NC 27607 Phone: [phone]

PO Box 7565
Asheville, NC 28802
Phone: [phone]
Fax: [phone]
N
Environmental Testing Solutions, Inc.
August 05, 2016
Mr. Jeff Dotson
Forest City
PO Box 728
Forest City, NC 28043
RE: ETS PROJECT NUMBER: 11559
Dear Mr. Dotson:
Enclosed are toxicity test results for samples from the Forest City WWTP received by
Environmental Testing Solutions, Inc. July 11 through July 15, 2016.
Parameter Test Procedure EPA Method Final Result
Code Number
THP6C Fathead Minnow (Pinrephales promelas) Larval EPA-821-R-02-013 ChV > 72%
Survival and Growth, Test Method 1000.0
Note: ChV = Chronic Value. A numeric value representing the geometric mean of the highest concentration having no
detectable impairment of survival or growth and the lowest concentration that does have a detectable impairment of survival or
growth.
If this test was performed as an NPDES requirement or by Administrative Letter, please enter the
ChV value >72% on the Effluent Discharge Monitoring Form (MR-1) for the collection date
July 11, 2016 using the parameter code THP6C.
Additionally, please sign and submit the original DWQ Aquatic Toxicity Form (AT-5) by
August 31, 2016.
If you have any questions concerning these results, please feel free to contact me.
Sincerely,
Oimter*
Laboratory Director
This report should not be reproduced, except in its entirety. without the written consent of Environmental Testing Solutions, Inc.
The results in this report relate only to the samples submitted for analysis.
North Carolina
rificate Numbers: Biological Analyses: 37, Drinking Water: 37786, Wastewater:
South Carolina Certificate Number: Clean Water Act: 99053-001