HomeMy WebLinkAboutNC0086918_Issuance of Permit_20030908 •
\-\OF W ATFR Michael F. Easley
QG +F�►� Governor
NCDENR William G. Ross,Jr., Secretary
] North Carolina Department of Environment and Natural Resources
0 `r Alan W. Klimek, P.E., Director
Division of Water Quality
September 8,2003
Mr.Eddie Coltrain
Eastern Wayne Sanitary District
P.O.Box 1583
Goldsboro,North Carolina 27533
Subject: Issuance of NPDES Permit NC0086918
Rockford Church Road\WTP
Wayne County
Dear Mr.Coltrain:
Division personnel have reviewed and approved your application for renewal of the subject permit. Accordingly,we are
forwarding the attached NPDES discharge permit. This permit is issued pursuant to the requirements of North Carolina General
Statute 143-215.1 and the Memorandum of Agreement between North Carolina and the U.S.Environmental Protection Agency
dated May 9, 1994(or as subsequently amended).
This final permit includes one major change from the draft permit sent to you on July 16,2003:
➢ The monitoring frequencies for Total Nitrogen(TN),TN components and Total Phosphorus have been reduced to
semi-annually,based on your request dated August 18,2003.
• This reduction in sampling frequency makes it imperative that representative samples are collected. Collect the
TN and TP samples on days when flow is monitored.
• Data from the semi-annual samples will be used to calculate the TN load for the facility. The Permittee should
maintain accurate estimates of the total discharge each month (total monthly flow,or TMF). The TMF values
will be multiplied by the TN values for the semi-annual samples to calculate a TN load for the facility.
This permit includes a TRC limit that will take effect on April 1,2005. If you wish to install dechlorination equipment,
the Division has promulgated a simplified approval process for such projects. Guidance for approval of dechlorination projects
is attached.
If any parts,measurement frequencies or sampling requirements contained in this permit are unacceptable to you,you
have the right to an adjudicatory hearing upon written request within thirty(30)days following receipt of this letter. This request
must be in the form of a written petition,conforming to Chapter 150B of the North Carolina General Statutes,and filed with the
Office of Administrative Hearings(6714 Mail Service Center,Raleigh,North Carolina 27699-6714). Unless such demand is
made,this decision shall be final and binding.
Please note that this permit is not transferable except after notice to the Division. The Division may require
modification or revocation and reissuance of the permit. This permit does not affect the legal requirements to obtain other
permits which may be required by the Division of Water Quality or permits required by the Division of Land Resources,the
Coastal Area Management Act or any other Federal or Local governmental permit that may be required. If you have any
questions concerning this permit,please contact Charles Weaver at(919)733-5083,extension 511.
Sincerely,
OTomRIGINAL SIGNED BY
Belnick
A\an\V.Klimek,P.E.
cc: Central Files
Washington Regional Office/Water Quality Section
NPDES Unit
N.C.Division of Water Quality/NPDES Unit Phone:(919)733-5083
1617 Mail Service Center,Raleigh,NC 27699-1617 fax:(919)733-0719
Internet:h2o.enr.state.nc.us DENR Customer Service Center:1 800 623-7748
Permit NC0086918
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
PERMIT
TO DISCHARGE WASTEWATER UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful
standards and regulations promulgated and adopted by the North Carolina Environmental
Management Commission, and the Federal Water Pollution Control Act, as amended, the
Eastern Wayne Sanitary District
is hereby authorized to discharge wastewater from a facility located at the
Rockford Church Road WTP
NCSR 1737 near Seven Springs
Wayne County
to receiving waters designated as an unnamed tributary to the Neuse River in the
Neuse River Basin in accordance with effluent limitations, monitoring requirements,
and other conditions set forth in Parts I, II, III and IV hereof.
This permit shall become effective October 1, 2003.
This permit and authorization to discharge shall expire at midnight on January 31, 2008.
Signed this day September 8, 2003.
ORIGINAL SIGNED BY
Tom Beinick
Alan W. Klimek, P.E., Director
Division of Water Quality
By Authority of the Environmental Management Commission
Permit NC0086918
SUPPLEMENT TO PERMIT COVER SHEET
All previous NPDES Permits issued to this facility,whether for operation or discharge are hereby revoked. As of
this permit issuance, any previously issued permit bearing this number is no longer effective.Therefore, the
exclusive authority to operate and discharge from this facility arises under the permit conditions, requirements,
terms,and provisions included herein.
The Eastern Wayne Sanitary District is hereby authorized to:
1. Continue to operate a drinking-water treatment plant with a discharge of filter-
backwash wastewater. This facility is located at the Rockford Church Road WTP
off NCSR 1737 near Seven Springs in Wayne County.
2. Discharge from said treatment works at the location specified on the attached
map into an unnamed tributary to the Neuse River, classified C-NSW waters in
the Neuse River Basin.
t
•
- 1 u
`x. • w *• I
•
- I li y' -I £W< :; • '1 4-a rip yi��'b y '! —
" `, . - `6g1`' d - �`;ISI
, :::
7.
:„....,......„...„...7,,, ,....,..i_
:::-:-..-:
„„ , . . •. ...,_ ....,..„.„.„
I ,....„
....„..4=....„.„- .
(1
, ..,.., _ ......,„ , .••• .... .., ..„,... , , . ., 1. „. 0 ....
_ ....__
,___„ .........
..._
/ '-� ------ ---------r t t ' �=�" ,_.,_f ,7•3,\----,_ • r / % / °t h _
t . _ .
-_,,,::
RodcEpfd
-•
J -'av � -
:-.) .4- i ' f.'LCINits4 1", „....- ..1.-...-...r---_,-----. - .. .
..,....
_ n-. f` 13 t emir Bridge- --- ��-,-;:-
r
y.-L. 'mss may. 'A it aH . c '4 - ..
,,...� j "1�.-•-�...t.,,•— =r i' _ / s'Y' l F' 'O, fes. _-_
bz - € ,_ - -
739 r •'®I� 1F-'e: • r-,` '�` •-_- -�. ` _
4',..---C.,� -v-';'-'-'----• t I -4-.- 1 IV lam: f - - • 1 ., 3 -� �'
•
p , ilu ... a;- E _
....
____.
�,,l ., ` 738 .i •_--J • ___.•'� _ -----
�-: / ..��t -- - Batt •:• .� 14.
• 37.4 Vii- ! -
- -...t-- 1
T4s Y / t-1 j i r'�� \\,14 S 1, . 'r ( ti. % / _ `' ' it 4 t
•
r ,
', -'4r.}I.-1 i 1 F •- ",,'.rrr ';m + _- �t\ — yaw• - •'��,-t_:
a _. 9 ..„2,-..__,,,_. �!y i ate. ___ .„- i �' 4
pp/
41
t /%- •meq 'f`•fr!�;r,i,, " !f „ \ . ,t1 Y -
e..7.-:,#--
_.'7 Fill 0-1 ` a r,� 1�{ � i •Ir•� = iI. 1 NI v / -:243-:-J:077
y
1}q 1, t'�4. s .! A:ii / - ; 1 •
. 'ice. i' .';',-,..17:',---:-----, ---.
� �! 4 7� F
-16
'•'� � � I j!� J// V.
1, f ,� �\• N °\ 4,+Yr /
v` 1 \
ass
... t!,2. e../- 7-- i ; .,;-..-7-N,•:.--.%,,:,/.7-(, .
: .1: .--,1:,:,‘-..._. i
.1 ,.,- Tower / . ,- , , : •--- . ' ir• --/ ;.'"(:
-ti • I 4.4141(f/.—__\ t , (j a,i i", r / r f %,�`
-1 i.-_ (-----,,. ,f, . //. l'; .---k , i4 ,/, • , ....._,....„._ ., ,
,_. ,
1 It 1 ./ ! • "sir /
i� ° I 148 \\ �-'-''is'-'_ J ,` ;/t/::- l
Rockford Church Road WTP Facility
Eastern Wayne Sanitary District Location
Latitude: 35° 14'03" N State Grid/Quad: G 27 NE/Seven Springs not to scale
Longitude: 77°49.43•" W Permitted Flow: Not Limited NPDES Permit No. NC0086918
Receiving Stream: UT of Neuse River Drainage Basin: Neuse River Basin North
Stream Class: C-NSW Sub-Basin: 03-04.05 Wayne County
. Permit 'NC0086918
A. (1) EFFLUENT LIMITATIONS AND MONITORING REQUIREMENTS
During the period beginning on the effective date of this permit and lasting until expiration. the Permittee is
authorized to discharge filter backwash from outfall 001. Such discharges shall be limited and monitored by
the Permittee as specified below:
EFFLUENT LIMITS MONITORING REQUIREMENTS
CHARACTERISTICS
Monthly Daily Measurement Sample Type Sample Locations
Average Maximum Frequency
Flow Weekly Estimate Effluent
Total Suspended Solids 30.0 mg/L 45.0 mg/L 2/Month Grab Effluent
Settleable Solids 0.1 ml/L 0.2 ml/L Weekly Grab Effluent
Iron Weekly Grab Effluent
Total Residual Chlorine2 17 pg/L Weekly Grab Effluent
Turbidity3 Weekly Grab Upstream&Downstream
Total Monthly Flow 4 Monitor&Report Monthly Calculated Effluent
(million gallons/month)
Total Nitrogen(TN)4 Monitor&Report(mg/L) Semi-annually Grab Effluent
Nitrate/Nitrite Nitrogen' Monitor&Report(mg/L) Semi-annually Grab Effluent
(NO2+NO3)
Total Kjeldahl Nitrogen(TKN)4 Monitor&Report(mg/L) Semi-annually Grab Effluent
TN load(pounds/month)4 Monitor&Report Monthly Calculated Effluent
(pounds per month)
TN load(pounds/year)4 Monitor&Report Annually Calculated Effluent
(pounds per year)
Total Phosphorus Monitor&Report(mg/L) Semi-annually Grab Effluent
Footnotes:
1. Upstream = at least 50 feet upstream from the outfall. Downstream = at least 50 feet downstream from the
outfall.
2. Limit takes effect April 1, 2005. Limits and monitoring apply only if chlorinated water is used to backwash
filters.
3. The discharge from this facility shall not cause turbidity in the receiving stream to exceed 50 NTU. If the
instream turbidity exceeds 50 NTU due to natural background conditions, the discharge cannot cause
turbidity to increase in the receiving stream.
4. See A. (2) for Total Nitrogen monitoring and reporting requirements.
All samples collected should be from a representative discharge event.
There shall be no discharge of floating solids or visible foam in other than trace amounts.
Permit NC0086918
A. (2) CALCULATION OF TOTAL NITROGEN LOADS
a. The Permittee shall calculate monthly and annual TN Loads as follows:
i. Monthly TN Load (pounds/month) = TN x TMF x 8.34
where:
TN= TN concentration(mg/L)of the sample collected during the semi-annual monitoring event. Use the
TN value for the month in which the sample was taken and successive months until another TN
sample is collected.
TMF= Total Monthly Flow of wastewater discharged during the month(MG/month). If all discharges are not
recorded at the facility,document the calculation(s)used to determine total monthly flow.
8.34= conversion factor,from(mg/L x MG)to pounds
ii. Annual TN Load (pounds/year) = Sum of the 12 Monthly TN Loads for the
calendar year
h. The Permittee shall report the semi-annual Total Nitrogen results in the discharge
monitoring report (DMR) for that month. The calculated pounds of TN load per month
will be reported on each month's DMR. The Permittee shall report each year's annual
results (pounds per year) on the December DMR.
r : .
astern Wayne Sanitary Distric
1111111111111111►►►►►II1111II1111111111IIIII1►►i►Iiiiii;11111111I►1►1►II►II
P.O.Box 1583•Goldsboro,N.C.27533• (919)731.2310 1111
,39 360554 feyUeS /-
August 18, 2003 14/7A4 ,
I/V1( S�fnos Ail
Charles Weaver, Jr.
NPDES Permit Unit a 7-4/fr Conee/'/1.
NC Division of Water Quality
1617 Mail Service Center
e/4(-- /pria/
Raleigh, NC 27699-1617 v '�e �ii___ .
x'1O4, (t .
SUBJECT: Monitoring Requirements
Draft NPDES Permit No. NC0086918
Eastern Wayne Sanitary District
Wayne County, NC
Dear Mr. Weaver:
Monitoring requirements for nutrients appear excessive in subject draft NPDES Permit inasmuch
as the effluent is treated filter backwash from a potable water treatment plant with groundwater
supply. Numerous wells are in the area with a history of data indicating low nitrogen levels (see
attached sample reports). There are no additives involving nitrogen in the water treatment process.
A polyphosphate is added in the treatment process (maintained less than 1 mg/I) and is monitored
daily with field test kits. A written record of phosphate levels is maintained by the Sanitary District.
Inasmuch as nitrogen is present only at low background levels it is recommended the frequency
be revised to once per year. More frequent monitoring of phosphorous maybe justified due to the
addition of phosphate in the treatment process; however, semi-annual sampling of phosphorous is
believed adequate since daily sampling and records are maintained for the addition of phosphate.
Your consideration and approval of this request will be appreciated. If you have any questions,
please do not hesitate to contact me.
Sincerely,
EASTERN WAYNE S ITARY DISTRICT
Eddie Coltrain
District Manager
Attachments
cc: McDavid Associates, Goldsboro (w/attach)
\\G-PC 1\D805\FTL\20031EWSDMREQ.LTR 1
EWSD-MONITORING-REQ-NPDES.LTR 030818
NORTH CAROLINA
C)-'°/
WAYNE COUNTY.
AFFIDAVIT OF PUBLICATION CLIPPING OF LEGAL
ADVERTISEMENT
Before the undersigned, a Notary Public of said County and State, ATTACHED HERE
duly commissioned,qualified,and authorized by law to administer oaths, PUBLIC NOTICE
STATE OF NORTH CAROLINA
ENVIRONMENTAL
personally appeared MNIIAMIIENf
COMMISSION/NPDES UNIT
Cynthia Foye 1617 MAIL SERVICE CENTER
RALEIGH,NC 27699-1617
who being first duly sworn, deposes and says: that he (she) is NOTIFICATION OF INTENT TO
ISSUE A NPDES
WASTEWATER PERMIT
Legal Clerk On the basis of thorough staff
review and application of NC
(Publisher, or other officer or employee authorized to make affidavit) General Statute 143.21,Public
law 92-500 and other lawful
of WAYNE PRINTING COMPANY,INC., engaged in the publication of standards and regulations,the
a newspaper known as GOLDSBORO NEWS-ARGUS: published, North Carolina Environmental
Management Commission pro-
issued, and entered as second class mail in the city of Goldsboro in said poses to issue a National Pollu-
Countyand State; that he (she) is authorized to make this affidavit and tart Discharge Elimination Sys- -
tem(NPDES)wastewater dis-
sworn statement; that the notice or other legal advertisement, a true charge permit to the person(s)
copy of which is attached hereto, was published in GOLDSBORO listed below effective 45 daysfrom the publish date of this
NEWS-ARGUS on the following dates: notice.
Written comments regarding
the proposed permit will be ac-
cepted until 30 days after the
publish date of this notice.All
comments received prior to
July 21, 2003 ,that date are considered in the
final determinations regarding
the proposed permit The Direc-
tor of the NC Division of Water
Quality may decide to hold a
and that the said newspaper in which such notice, paper, document, or public meeting foe the proposed
permit should the Division re-
legal advertisement was published was, at the time of each, and every 1 terve a significant degree of
such publication, a newspaper meeting all of the requirements and public interest
Copies of the draft permit and
qualifications of Section 1-597 of the General Statutes of North Carolina other supporting information on
and was a qualified newspaper within the meaning of Section 1-597 of the file used to determine condi-
tions present in the draft permit
General Statutes of North Carolina. are available upon request and
i payment of the costs of
033 repro-
July ' duction.Mail comments and/or
This 31 day of ,20 requests for information to the
n NC Division of Water Quality at
-�. the above address or call Ms.
Valery Stephens at(919)733-
: 5083,extension 520.Please in-
.ignature of person 14 ing affidavit) elude the NPDES permit num-
ber(attached)in any communi-
cation.Interested persons may'
Sworn to and subscribed before me,this 3 I day of also visit the Division of Water
Quality at 512 N. Salisbury
Street Raleigh,NC 27604-1148
July 20 03 , between the hours of 8:00 a.m.
.m.
and 5:00 e nw infor-
mation on file.
The Northwestern Wayne
Sanitary District has applied for
tar Public i renewal of NPDES permit
Y ..4bc).? I NC0086959 for its memorial
Church Road WTP.This permit-
ted facility discharges filter-
My Commission expires: �� ' backwash wastewater to Great
Swamp in the Neuse River Ba-—�
sin.Currently the total residual
chlorine is water quality limit-
ed.This discharge may affect
future allocations in this portion
of Great Swamp.
The Eastern Wayne Sanitary
District has applied for renewal
of NPDES permit NC0086918
for its Rockfor Church Road
WTP.This permitted facility dls-j
charges filter-backwash waste-
water to an unnamed tributary r
to the Neuse River in the Neuse
River Basin.Currently total re-
sidual chlorine is water quality
limited.This discharge may at-
fect future allocations in this
portion of the Neuse River.
Legal#895
July21,2003
`a,
I
- . r_ j
Aug 18 03 03: 18p McDAVID ASSOCIATES, INC. 919-735-7351 p. 2
astern Wayne Sanitary Distric
IiIIIIIIIIIIIililli;lllllllll llllllllllllllllllll IIIIIIIIIIlIlI1111i11i1111
P.O.sox 1513-Goldsboro,N.C.27S23•(919)731-2310 IIII
August 18, 2003
Charles Weaver. Jr.
NPDES Permit Unit
NC Division of Water Quality
1617 Mail Service Center
Raleigh, NC 27699-1617
SUBJECT: Monitoring Requirements
Draft NPDES Permit No. NC0086918
Eastern Wayne Sanitary District
Wayne County, NC
Dear Mr. Weaver:
Monitoring requirements for nutrients appear excessive in subject draft NPDES Permit inasmuch
as the effluent is treated filter backwash from a potable water treatment plant with groundwater
supply. Numerous wells are in the area with a history of data indicating low nitrogen levels (see
attached sample reports). There are no additives involving nitrogen in the water treatment process.
A polyphosphate is added in the treatment process (maintained less than 1 mg/I) and is monitored
daily with field test kits. A written record of phosphate levels is maintained by the Sanitary District.
Inasmuch as nitrogen is present only at low background levels it is recommended the frequency
be revised to once per year. More frequent monitoring of phosphorous maybe justified due to the
addition of phosphate in the treatment process; however, semi-annual sampling of phosphorous is
believed adequate since daily sampling and records are maintained for the addition of phosphate.
Your consideration and approval of this request will be appreciated. If you have any questions,
please do not hesitate to contact me.
Sincerely,
EASTERN WAYNE SANITARY DISTRICT
,,-------------
144.1 44
Eddie Coltrain
District Manager
Attachments
cc: McDavid Associates, Goldsboro (w/attach)
\\G-PC 11D8051Ff L120031EWS DIv1R EQ.LTR 1
030818
EW S D-MONITORING-REQ-N PD ES.LTR
t--
• r
SOC PRIORITY PROJECT: YESNO_X_
IF YES,SOC NO.
To: Permits and Engineering Unit
Water Quality Section 10)
Attn: Charles Weaver SEP - 4 2002 1-1:Jj
Date: August 20, 2002 CENR - WATER QUALITY
POINT SOURCE BRANCH
NPDES STAFF REPORT AND RECOMMENDATION
Eastern Wayne Sanitary District
Rockford Church Road Water Treatment Plant
Permit No. NC0086918
PART I—GENERAL INFORMATION
1. Facility and Address: Eastern Wayne Sanitary District
Rockford Church Road Water Treatment Plant
Wayne County
P.O.Box 1583
Goldsboro,NC 27533
2. Date of Investigation: July 31, 2002
3. Report Prepared by: Kristin Jarman
4. Person(s) contacted and telephone number(s):
Joey Threewitts- Operations Manager
919-731-2310
5. Directions to Site: Located on the North side of SR 1737 Approximately .25 miles
west of its intersection with SR 1736
6. Discharge Point:
001-- Latitude: 35° 14' 03"N Longitude: 77°49'43" W
Attach a USGS map extract and indicate treatment facility site and discharge
point on map.
USGS Quad. No. USGS Quad Name: Seven Springs
7. Site size and expansion area consistent with application?
X Yes No If No, explain:
8. Topography(relationship to flood plain Included) : Flat with elevation of approx.
16 meters
9. Location of nearest dwelling: Greater than 500 feet
10. Receiving stream or affected surface waters: UT to Neuse River
a. Classification: C-NSW
b. River Basin and Subbasin No. : 03-04-05
c. Describe receiving stream features and pertinent downstream uses:
Drainage
PART II—DESCRIPTION OF DISCARGE AND TREATMENT WORKS
1. a. Volume of Wastewater to be permitted: NA
b. What is the current permitted capacity of the Wastewater Treatment
facility?NA
c. Actual treatment capacity of the current facility(current design capacity)?
NA
d. Date(s) and construction activities allowed by previous Authorizations to
Construct issued in the previous two years: NA(new facility)
e. Please provide a description of existing or substantially constructed
wastewater treatment facilities: NA(Not yet constructed)
f. Please provide a description of proposed wastewater treatment facilities:
40' x 40' (67.000 gallon) concrete settling basin
g. Possible toxic impacts to surface waters: Chlorine
h. Pretreatment Program(POTWs only): NA
2. Residuals handling and utilization/disposal scheme:
a. If residuals are being land applied, please specify DWQ permit
no.
Residuals Contractor
Telephone No.
b. Residuals stabilization: PSRP PFRP Other
c. Landfill: x
d. Other disposal/utilization scheme (Specify):
Treatment plant classification(attach completed rating sheet): Grade 1
Y '
4. SIC Code: 4941
Wastewater Code of actual wastewater,not particular facilities.
001-- Primary_22_ Secondary
Main Treatment Unit Code: 5 0 0 1
PART III—OTHER PERTINTENT INFORMATION
1. Is this facility being constructed with Construction Grant Funds or are any public
monies involved?(municipals only) No
2. Special monitoring or limitations(including toxicity) requests:NA
3. Additional effluent limits requested: None
4. Other: None
PART IV—EVALUATION AND RECOMMENDATION
This proposed discharge will result from the backwash of filters for iron removal.
Softeners are not proposed therefore chlorides are not expected to be a problem The
Washington Regional Office recommends that this permit be reissued at the same
location.
moi_ - ►� L","4
Signature yipr'eport Preparer
)—Water Quality Regional Supervisor
i 2/GZ--
Date
astern Wayne Sanitary District
IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIINIIIiIIIIIIIIIIIIIIUIIIIIIIIIIiiIIIIIiI
P.O. Box 1583•Goldsboro,N.C.27533•(919)731-2310 1W
June 27, 2002 RE C E
JUL _ 2 2002
Mr. Charles H. Weaver, Jr.
NPDES Unit
Division of Water DENA-WATER QUALITY
Q ty POINT SOURCE BRANCH
uali
1617 Mail Service Center
Raleigh, NC 27699-1617
SUBJECT: Request for Permit Renewal
NPDES Permit NC 0086918
Eastern Wayne Sanitary District
Wayne County, NC
Dear Mr. Weaver:
Attached please find one signed original and two copies of each of the following:
1. Cover Letter
2. Application Form
Wastewater discharged via this Permit is backwash and rinse water from water filters treating
potable water. Solids retained (iron residual) are anticipated to be removed on an annual basis (less
than 3000 lbs) and be transported to the Wayne County landfill for disposal.
If you have any questions concerning this, please do not hesitate to contact me.
Sincerely,
EASTERN WAYNE SANITARY DISTRICT
jai: dit ---
Eddie Coltrain
District Manager
\\G-PC 1\D805\FTL\2002
EWSD-DWQ-NPDES-PERMIT-RENEWAL.wpd 1 020627
NPDES PERMIT APPLICATION - SHORT FORM C
For manufacturing or commercial facilities with a discharge <1 MGD (or WTPs)
N. C. Department of Environment and Natural Resources
Division of Water Quality/ NPDES Unit
1617 Mail Service Center, Raleigh, NC 27699-1617
North Carolina NPDES Permit Number NC00 86918
Please print or type
1. Applicant and facility producing discharge
•
A. Name Eastern Wayne Sanitary District
B. Mailing address of applicant:
•
Street address P.O. Box 1583
City Goldsboro County Wayne
•
State NC Zip Code 27533
Telephone Number ( 919 ) 731-2310
Fax Number ( 919 ) 734-5994
e-mail address N/A
C. Location of facility:
Street Rockford Church
City Seven Springs County Wayne
State NC Zip Code 27858
Telephone Number ( )
2. Standard Industrial Classification (SIC) code(s):
3. Number of employees: 15
4. Principal product(s) produced: Potable water
Principal raw material(s) consumed: Groundwater
5. Principal process(es): Potable water system
6. Amount of rrincipal DrnriIJct producAd or raw material consumed
(List specific amounts consumed and/or units of production)
Product Produced or Raw Material Consumed Product Produced or Raw Material Consumed
(AVERAGE) (PEAK)
per Day 1,000,000 GPD 1.000.000 GPD
per Month
per Year
7. Check here if discharge occurs all year E , or
Circle the month(s) in which discharge occurs: January February March April
May June July August September October November December
Days per week discharge occurs: 7 days/week
NOTE: If the facility has separate discharge points(outfalls)or multiple industrial processes, include a schematic diagram
of wastewater flow at the facility.
Page 1 of 2 Version-11/2000
NPDES PERMIT APPLICATION - SHORT FORM C
For manufacturing or commercial facilities with a discharge <1 MGD (or WTPs)
8. Types of wastewater discharged to surface waters only (check as applicable).
Discharge per operating day Flow Volume treated before discharging
(GALLONS PER OPERATING DAY) (PERCENT)
Sanitary - daily average
Cooling water, etc. - daily average
Process water - daily average
33,000 GPD
Maximum per operating day for
total discharge (all types) 66,000 GPD
9. If any of the types of wastewater identified in item 8 (either treated or untreated) are discharged to places
other than surface waters, record the amount(s) discharged below:
A. Municipal sewer system gpd
B. Underground well gpd
C. Septic tank gpd Sanitary wastewater disposed
on—site via septic system
D. Evaporation lagoon or pond gpd
E. Other, specify gpd
10. Number of separate discharge points:
11. Name of receiving stream(s):
12. Does your discharge contain or is it possible for your discharge to contain one or more of the following
substances added as a result of your operations, activities, or processes? Circle all that apply:
aluminum ammonia beryllium cadmium chromium chlorine (residual)
copper cyanide lead mercury nickel oil and grease
- phenols selenium zinc None of the above
I certify that I am familiar with the information contained in the application and that to the best of my
knowledge and belief such information is true, complete, and accurate.
Eddie Coltrain District Manager
Printed name of Person Signing Title
l ibtre iLfrittef 4/2/ -f,
Signature of Applicant Date
North Carolina General Statute 143-215.68(i)provides that:Any person who knowingly makes any false statement representation,or certification in any
application,record,report,plan,or other document files or required to be maintained under Article 21 or regulations of the Environmental Management
Commission implementing that Article,or who falsifies,tampers with,or knowingly renders inaccurate any recording or monitoring device or method
required to be operated or maintained under Article 21 or regulations of the Environmental Management Commission implementing that Article,shall be
guilty of a misdemeanor punishable by a fine not to exceed$10,000,or by imprisonment not to exceed six months,or by both.
(18 U.S.C.Section 1001 provides a punishment by a fine of not more than$10,000 or imprisonment not more than 5 years,or both,for a similar offense.)
Page 2 of 2 Version—11/2000