NC0043176_application_20230403

CITY 01
DUNN
PUBLIC UTILITIES
101 E Cleveland St - PO Box 1065 Dunn, North Carolina 28335
[phone] CityofDunn.org
March 30, 2023
NCDEQ
NPDES Permitting Unit
Attn: Emily Richards
1637 Mail Service Center
Raleigh, NC 27609
RECEIVED
APR 0 3 2023
NCDEQ/DWR/NPDES
Re: City of Dunn Black River WWTP NPDES Permit Renewal NCO043176
Ms. Richards,
Enclosed is the permit renewal application and supporting documentation for the renewal of the
WWTP's NPDES permit. During the last permit renewal, Bis (2-ethylhexyl) plithalate was
added to our permit testing requirements. Staff identified the tubing used to collect past priority
pollutant samples inadvertently contaminated the samples. There was a warning label on the
tubing box that stated the tubing contained Bis (2-ethylhexyl) plithalate. After identifying this
interference, the City started using tubing that does not contain this contaminant and did not have
any detects during most recent testing. Therefore, the City would request that Bis (2-ethylhexyl)
plithalate be removed from the new permit.
Please do not hesitate to contact me at [phone] if you need further information in order to
complete your review.
Sincerely,
/(111� 41�
Heather Adams' j
Public Utilities Director
lNere communi� kTins!

Harnett GIS
w
LU
0
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Hospital
Groonw=
-motor
02
Club
Ouffall 001
Black River WWTP
Harnett Cou,nt.Y'GIS, Sources: Esr!, 4TERE, Garmin, Intermap, increment P Corp., OEBCO,USGS,
FAO, NPS,,NRCAN, GeoBase, IGN. Kadaster NL,Ordnance Survey, EsriJapan,;METI, EserChina
(Hong F�069). (c) OpenStneetIvIap contributors, and the G IS User Community
ESurrounding
County
Boundaries MajorRoads Roads N
City Limits
Interstate Railroad w E
County Boundary
NC CapeFearRiver
GIS/E-911 Addressing
us 2,600 5,200
March 27, 2023
Airport
el
1 inch = 3,009 feet

EPA dentification Number
NPDES Permit Number
Facility Name
Form Approved 03105/19
NCO043176
I City of Dunn Black River 7WWTP
OMB No. 2040-0004
Form
U.S. Environmental �rotectlon Agency
2A
%&EFA
Application for NPDES Permit to Discharge Wastewater
NPDES
NEW AND EXISTING PUBLICLY OWNED TREATMENT WORKS
SECTION
1. BASIC
APPLICATION INFORMATION FOR ALL APPLICANTS (40 CFR 122.210)(1) and (9))
acility name
City of Dunn Black River WV%rrP
Mailing address (street or P.O. box)
PO Box 1065
City or town
State
ZIP code
0
Dunn
NC
28335
Contact name (first and last)
Tide
Phone number
Email address
Heather Adams
Director of Public Utilities
[phone]
[e-mail]
Location address (street, route number, or other specific identifier) El Same as mailing address
580JW Edwards Lane
City or town
State--
ZIP code
Dunn
NC
28334
1.2
Is this application for a facility that has yet to commence discharge?
F� Yes -* See instructions on data submission F(J No
requirements for new dischargers.
1.3
Is applicant different from entity listed under Item 1.1 above?
El Yes No 4 SKIP to Item 1.4.
Applicant name
Applicant address (street or P.O. box)
City or town
State
ZIPcode
S
Contact name (first and last)
Title
Phone number
Email address
M
<
1.4
Is the applicant the facility's owner, operator, or both? (Check only one response.)
El owner [I Operator Both
1,5
To which entity should the NPDES permitting authority send correspondence? (Check only one response.)
E] Facility El Applicant Facility and applicant
(they are one and the same)
1.6
Indicate below any existing environmental permits. (Check all that apply and print or type the corresponding permit
number for each.)
Existing Environmental Permits
NPDES (discharges to surface
RCRA (hazardous waste)
E] UIC (underground injection
water)
control)
NCO043176 & NCO078955
2
E] PSD (air emissions)
E] Nonattainment program (CAA)
E] NESHAPs (CAA)
LU
Ocean dumping (MPRSA)
Dredge or fill (CWA Section
E] Other (specify)
404)
EPA Form 3510-2A (Revised 3-19) Page 1

EPA Wernfification Number
NPDES Permit Number
Facility Name
Form Approved 03105/19
1
NCO043176
City of Dunn Black River WWTP
OMB No. 204HOO4
1.7
Provide the colle tion system inform tion requested below for the treatment works.
Municipality
Population
Collection System Type
Ownership Status
Served
Served
(indicate percen age)
City of Dunn
12,088
100 % separate sanitary sewer
FI Own El Maintain
% combined storm and sanitary sewer
11 Own 0 Maintain
0 Unknown
El Own 0 Maintain
% separate sanitary sewer
0 Own 0 Maintain
% combined storm and sanitary sewer
11 Own 0 Maintain
73
—
0 Unknown
11 Own 0 Maintain
0
IL
— % separate sanitary sewer
0 Own 0 Maintain
% combined storm and sanitary sewer
0 Own 0 Maintain
m0
Unknown
11 Own 11 Maintain
E
2
% separate sanitary sewer
0 Own 0 Maintain
—0 % combined storm and sanitary sewer
0 Own 0 Maintain
co
Unknown
0 Own 0 Maintain
Total 12,088
Population
0
Served
eparate Sanitary Sewer System
Combined Storm and
Sanita!y Sewer
Total percentage of each type of
sewer line (in miles)
100 %
%
2�
1.8
Is the treatment works located in Indian Country?
C
0
El Yes No
0
C
1.9
Does the facility discharge to a receiving water that flows through Indian Country?
Yes ED No
1.10
Provide design and actual flow rates in the designated spaces.
Design Flow Rate
3.75 mgd
Annual Average Flow Rates (Actual)
Two Years Ago
Last Y ar
This Year
2.83 mgd
1.95 mgd
2.69 mgd
Maximum Daily Flow Rates (Actual)
Two Years Ago
Last Year
This Year
8.55 mgd
6.137 mgd
4.817 mgd
j2
1.11
Provide the total number of effluent discharge points to waters of the United States by type.
.5
Total Number of Effluent Dischar a oints by Type
0
Combined Sewer
Constructed
2ji--
Treated Effluent
Untreated Effluent
Overflows
Bypasses
Emergency
Overflows
1
0
0
0
0
EPA Form 3510-2A (Revised 3-19) Page 2

EPA IdentilICACTINUMEW
[
Facility N,,e
Fom Approved 03/05/19
1 NCO043176
City of Dunn Black River WWTP
OMB No. 2040-0004
Outfa Other Than to Waters of the United States
1.12
Does the POTW discharge wastewater to basins, ponds, or other surface impoundments that do not have outlets for
discharge to waters of the United States?
El Yes El No 4 SKIP to Item 1.14,
1.13
Provide the location of each surface impoundment and associated discharge information in the table below.
Surface I poundment Location and Dischanqe Data
Location
Average Daily Volume
Discharged to Surface
Continuous or Intermittent
Impoundmen
(check one)
0 Continuous
gpd
0 Intermittent
0 Continuous
gpd
0 Intermittent
gpd
0 Continuous
0 Intermittent
0
-q
1.14
Is wastewater applied to land?
El Yes No 4 SKIP to Item 1.16.
1.15
Provide the land application site and discharge data requested below.
Land Application Site
and Discharge Data
0
Location
Size
Average Daily Volume
Continuous or
Intermittent
0
Applied
(check one)
acres
gpd
11 Continuous
0 Intermittent
acres
gpd
0 Continuous
0
Intermittent
acres
gpd
0 Continuous
0 Intermittent
1.16
Is effluent transported to another facility for treatment prior to discharge?
0
El Yes No 4 SKIP to Item 1.21.
1.17
Describe the means by which the effluent is transported (e.g., tank truck, pipe).
1.18
Is the effluent transported by a party other than the applicant?
El Yes 0 No 4 SKIP to Item 1.20.
1.19
Provide information on the transporter below.
Transporter Data
Entity name
Mailing address (street or P.O. box)
City or town
State
code
Contact name (first and last)
Title
Phone number
Email address
EPA Fon 3510-2A (Revised 3�19) Page 3

EPA Identification Number
NPDES Permit Number
Facility Name
Form Approved 03/05/19
1 NCO043176
I City of Dunn Black River VVVVTP
OMB No. 2040-0004
1.20
In the table below, indicate the name, address, contact information, NPIDES number, and average daily flow rate of the
receiving facility,
Receiving F chilly, Data
Facility name
Mailing address (street or P.O. box)
City or town
State
P code
Contact name (first and last)
Title
0
Z
Phone number
Email address
0
NPIDES number of receiving facility (if any) EI None
Average daily flow rate mgd
0
1.21
Is the wastewater disposed of in a manner otherthan those already mentioned in Items 1.14 through 1.21 that do not
0
have outlets to waters of the United States (e.g., underground percolation, underground injecflon)?
0
IT
El Yes No -+ SKIP to Item 1.23.
1.22
Provide information in the table below on these other disposal methods.
Information on Other Disposal Methods
;5
Disposal
Location of
Size of
Annual Average
Continuous or Intermittent
Method
Disposal Site
Disposal Site
Daily Discharge
(check one)
Description
Volume
acres
gpd
0 Continuous
0 Intermittent
0
acres
gpd
El Continuous
0 Intermittent
acres
gpd
0 Continuous
0 Intermittent
1.23
Do you intend to request or renew one or more of the variances authorized at 40 CFR 122.21 (n)? (Check all that apply.
Consult with your NPDES permitting authority to determine what information needs to be submitted and when.)
Discharges into marine waters (CWA Water quality related effluent limitation (CWA Section
El
Section 301 (h)) 302(b)(2))
El Not applicable
1.24
Are any operational or maintenance aspects (related to wastewater treatment and effluent quality) of the treatment works
the responsibility of a contractor?
El Yes 21 No 4SKIP to Section 2.
1.25
Provide location and contact information for each contractor in addition to a description of the contractor's operational
and maintenance responsibilities.
Contractor Information
Contractor I
Contractor 2
Contractor 3
0
Contractor name
7M
(company name)
Mailing address
(street or P.O. box)
City, state, and ZIP
code
Contact name (first and
U
last)
Phone number
Email address
Operational and
maintenance
responsibilities of
contractor
EPA Form 3510-2A (Revised M9) Page 4

EPA Idenlificalion Number NPDES Permit Number Facility Name Form Approved 03/05/19
P .2040-0004
NCO043176 City of Dunn Black River VVVVT 01VIBNo
SECTION 2. AD ITIONAL INFORMATION (40 CFR `122.2110)(1) and (2))
.2 1 u a to aters of the United States
2.1
Does the treatment works have a design flow greater than or equal to 0. 1 mgd?
Yes E] No 4 SKIP to Section 3.
2.2
Provide the treatment works' current average daily volume of inflow
Average Daily Volume of Inflow and Infiltration
.0
and infiltration.
750,000 gpd
Indicate the steps the facility is taking to m nimize inflow and infiltration.
C
The system currently has a SOC agreement with the State and has several rehab projects included in the agreement to
assist with minimizing the W coming into the treatment plant. The City also has an ATC to make improvements to the
treatment plant in order to process additional peak flow through the treatment plant.
2.3
Have you attached a topographic map to this application that contains all the required information? (See instructions for
specific requirements.)
0
Yes El No
E
2.4
Have you attached a process flow diagram or schematic to this application that contains all the required information?
(See instructions for specific requirements.)
Yes E] No
2.5
Are improvements to the facility scheduled?
El Yes 0 No 4 SKIP to Section 3.
Briefly list and describe the scheduled improvements.
0
ATC 043176AO5 Clarifier and chlorine contact basin improvements, chemical feed, RAS control, and internal piping
E
'&
2. In design -install new 36-inch effluent force main to Cape Fear River
E
i
3.
4.
0
2.6
Provide scheduled or actual dates of completion for improvements.
Scheduled or Actual Dates of Completion for Imp vements
Scheduled
Affected
Begin
End
Begin
Attainment of
Improvement
Outfalls
(list ouffall
Construction
Construction
Disch arge
Operational
eve
E
(from above)
number)
(MM/DDNYYY)
(MM/DD/YYYY)
(MM/DD/YYYY)
(MMIDDNYYY)
001
04/17/2023
04/17/2024
2.
001
03/01/2024
12/01/2025
3.
4.
2.7
Have appropriate permits/clearances concerning other federal/state requirements been obtained? Briefly explain your
response.
[Z] Yes No None required or applicable
Explanation:
Permits have been obtained on #1. Project #2 is still in design phase.
EPA Form 3510-2A (Revised 3-19) Page 5

EPA dentification Number NPDES Permit Number Facility Name Form Approved ON05119
I NCO043176 I City of Dunn Black River WVVTP1 OMB No. 204NO04
SECTION 3. INFORMATION ON EFFLUENT DISCHARGES (40 CFR 122.216)(3) to (5))
3.1 Provide the following information for each outfall. (Attach additional sheets if you have more than three oulfialls.)
Outfall Number 001
Cluffall Number
Ouffall Number
state
NC
County
Harnett
4!
0
City or town
Ervvin
Distance from shore
ft.
ft.
Depth below surface
ft.
ft.
Average daily flow rate
2.49 mgd
mgd
mgd
Latitude
35, ly 31!' NE9
Longitude
79' 4f 09" V3
3.2
Do any of the ouffalls described under Item 3.1 have seasonal or periodic discharges?
Yes El No 4 SKIP to Item 3.4.
3.3
If so, provide the following information for each applicable outfall.
Outfall Number
Outfall Number
Outfall Number
Number of times per year
0
discharge occurs
W
Average duration of each
t
0
discharge (specify units)
-a
a
0
Average flow of each
mgd
mgd
mgd
discharge
Months in which discharge
occurs
3.4
Are any of the ouffalls listed under Item 3.1 equipped with a diffuser?
El Yes No + SKIP to Item 3.6.
3.5
Briefly describe the diffuser type at each applicable ouffall.
Outfall Number—
Cuffall Number
Outfall Number
Does the treatment works discharge or plan to discharge wastewater to waters of the United States from one or more
discharge points?
ED Yes El No 4 SKIP to Section 6.
EPA Form 3510-2A (Revised 3-19) Page 6

E denfification Numb�r
NPDES Permit Number
Facility Name
Form Approved 03/05/19
NCO043176
City of Dunn Black River vvvvTPI
DIMS No. 2040-0004
3.7
Provide the receiving water nd related information (if kno for each outfall.
Ouffall Number 00,
Ouffall Number
Outfall Number
Receiving water name
Cape Fear River
Name of watershed, river,
0
or stream system
Cape Fear River Basin
U.S. Soil Conservation
Service 14-digit watershed
in
code
Name of state
mariagementIriver basin
Cape Fear
U.S. Geological Survey
8-digit hydrologic
03030004
cataloging unit code
Critical low flow (acute)
cfs
cfs
cis
Critical low flow (chronic)
GfS
cis
cfs
Total hardness at critical
mg/L of
mg/L of
mg/L of
low flow
CaCO3
CaCO3
CaCO3
3.8
Provide the following inform ion describing the treatment p vided for discharges from eac outfall.
Outfall Number 001
Outfall Number
Ouffall Number —
Highest Level of
El Primary
0 Primary
0 Primary
Treatment (check all that
0 Equivalent to
0 Equivalent to
0 Equivalent to
apply per outfall)
secondary
secondary
secondary
* Secondary
0 Secondary
0 Secondary
* Advanced
0 Advanced
0 Advanced
0 Other (specify)
0 Other (specify)
0 Other (specify)
,a
Design Removal Rates by
.1
U
Outfall
49
BOD5 or CBOD5
90 %
%
%
E
ZZ
TSS
90 %
%
%
0 Not applicable
0 Not applicable
El Not applicable
Phosphorus
%
%
%
0 Not applicable
0 Not applicable
0 Not applicable
Nitrogen
%
%
%
Other (specify)
0 Not applicable
0 Not applicable
11 Rot applicable
%
%
%
EPA Form 3510-2A (Revised 3-19) Page 7

EPA denfificabon Number
NPOES Permit Number
Facility Name
Form Approved 03/05/19
NCO043176
City of Dunn Black River WWTP
OMB No. 2040-0004
3.9
Describe the type of disinfection used for the effluent from each outfall in the table below. If disinfection vades by
season, describe below.
Sodium hypochlorite solution
U
Outfall Number 001
Cutfall Number
Outfall Number
Disinfection type
Chlorine
ti
Seasons used
4
V
Dechlorination used?
El Not applicable
Not applicable
El Not applicable
0 Yes
El Yes
Yes
[I No
El No
No
3.10
Have you completed monitoring for all Table A parameters and attached the results to the application package?
[Z] Yes El No
3.11
Have you conducted any WET tests during the 4.5 years prior to the date of the application on any of the facility's
discharges or on any receiving water near the discharge points?
ED Yes El No 4 SKIP to Item 3.13.
3.12
Indicate the number of acute and chronic WET tests conducted since the last permit reissuance of the facility's
discharges by ouffall number or of the receiving water near the dischame point .
Ouffall Number 001
Ouffall Number
Ouffall Number
Acute ]
Chronic
Acute
Chronic
Acute
Chronic
Number of tests of discharge
water
4
4
Number of tests of receiving
water
0
0
3.13
Does the treatment works have a design flow greater than or equal to 0.1 mgd?
0 Yes No 4 SKIP to Item 3.16.
3.14
Does the POTW use chlorine for disinfection, use chlorine elsewhere in the treatment process, or otherwise have
reasonable potential to discharge chlorine in its effluent?
Yes 4 Complete Table 13, including chlorine. No 4 Complete Table B, omitting chlorine.
3.15
Have you completed monitoring for all applicable Table B pollutants and attached the results to this application
package?
Q Yes El No
3.16
Does one or more of the following conditions apply?
• The facility has a design flow greater than or equal to 1 mgd.
• The POTW has an approved pretreatment program or is required to develop such a program.
• The NPIDES permitting authority has informed the POTW that it must sample for the parameters in Table C, must
sample other additional parameters (Table D), or submit the results of WET tests for acute or chronic toxicity for
each of its discharge outfalls (Table E).
IZI Yes 4 Complete Tables C, D, and E as 0 No 4 SKIP to Section 4.
applicable.
3.17
Have you completed monitoring for all applicable Table C pollutants and attached the results to this application
package?
0 Yes El No
3.18
Have you completed monitoring for all applicable Table D pollutants required by your NPIDES permitting authority and
attached the results to this application package?
Yes No additional sampling required by NPIDES
permitting authority.
EPA Form 3510-2A (Revised 3-19) Page 8

EPA dentilicaflon Number
NPODES Permit Number
Facility Name
Form Approved 03/05/19
NCO043176
City of Dunn Black River WWTP
OMB No. 2040-0004
3.19
Has the POTW conducted either (1) minimum of four quarterly WET tests for one year preceding this permit application
or (2) at least four annual WET tests in the past 4.5 years?
No 4 Complete tests and Table E and SKIP to
Yes El
Item 3.26.
3.20
Have you previously submitted the results of the above tests to your NPIDES permitting authority?
Yes No 4 Provide results in Table E and SKIP to
Item 3.26.
3.21
Indicate the dates the data were submitted to your NPIDES permittinci authority and provide a summary of the results.
Date(s) Submitted
Summary of Results
(MM/DDNYYY)
0q/70/X&'-&
March 2022 Pass
D -711 3/-102-2-
June 2022 Pass
2-7—
IV / 2.)l 7
September2022 Pass
_D
0 11041 ZOX3
December 2022 Pass
0
,2
3.22
Regardless of howyou provided your WET testing data to the NPDES permitting authority, did any of the tests result in
0
toxicity?
El Yes ED No 4 SKIP to Item 3.26.
3.23
Describe the cause(s) of the toxicity:
LU
3.24
Has the treatment works conducted a toxicity reduction evaluation?
D Yes El No 4 SKIP to Item 3.26.
3.25
Provide details of any toxicity reduction evaluations conducted.
3.26
Have you completed Table E for all applicable ouffalls and attached the results to the application package?
Yes ED Not applicable because previously submitted
information to the NPDES nermit&r-aukofty, I
SECTION
4. INDUSTRIAL
DISCHARGES AND HAZARDOUS WASTES (40 CFR 122.210)(6) and (7))
oes the POTW receive discharges from SlUs or NSCIUs?
El Yes 21 No4SKIPtolteni
4.2
Indicate the number of SlUs and NSCIUs that discharge to the POTVV.
Number of SlUs
Number of NSCIUs
0
Does the POTW have an approved pretreatment program?
Yes No
4.4
Have you submitted either of the following to the NPDES permitting authority that contains information substantially
identical to that required in Table F: (1) a pretreatment program annual report submitted within one year of the
E,
application or (2) a pretreatment program?
Ja
Yes El No 4 SKIP to Item 4.6.
a
4.5
Identify the title and date of the annual report or pretreatment program referenced in Item 4A. SKIP to Item 4.7.
4.6
Have you completed and attached Table F to this application package?
[I Yes El No
EPA Fon 3510-2A (Revised 3-19) Page 9

EPA ldenfifi on Number
NPDES Permit Number
Facility Name
Form Approved 03/05119
1 NCO043176
I City of Dunn Black River WWTP
OMB No. 2040-0004
4.7
Does the POTW receive, or has it been notified that it will receive, by truck, rail, or dedicated pipe, any wastes that are
regulated as RCRA hazardous wastes pursuant to 40 CIFIR 261 ?
El Yes El No 4 SKIP to Item 4.9,
4.8
If yes, provide the foll ing information:
Annual
Hazardous Waste
Waste Transport Method
Amount of
Units
Number
(check all that apply)
Waste
Received
El Truck El Rail
Dedicated pipe Other (specify)
0
El Truck Rail
Dedicated pipe E] Other (specify)
El Truck 0 Rail
E] Dedicated pipe E] Other (specify)
4.9
Does the POTW receive, or has it been notified that it will receive, wastewaters that originate from remedial activities,
including those undertaken pursuant to CERCLA and Sections 3004(7) or 3008(h) of RCRA?
Yes No 4 SKIP to Section 5.
4.10
Does the POTW receive (or expect to receive) less than 15 kilograms per month of non -acute hazardous wastes as
specified in 40 CIFIR 261.30(d) and 261.33(e)?
Yes 4 SKIP to Section 5. El No
4.11
Have you reported the following information in an allachment to this application: identification and description of the
site(s) or facility(ies) at which the wastewater originates; the identities of the wastewater's hazardous constituents; and
the extent of treatment, if any, the wastewater receives or will receive before entering the POTW?
0 Yes El No
SECTION
5. COMBINED
SEWER OVERFLOWS (40 CFR 122.210)(8))
E
5.1
Does the treatment works have a combined sewer system?
El Yes IZI No +SKIP to Section 6.
5.2
Have you attached a CSO system map to this application? (See instructions for map requirements.)
El Yes El No
5.3
Have you attached a CSO system diagram to this application? (See instructions for diagram requirements.)
L)
0 Yes El No
EPA Form 3510-2A (Revised 3-19) Page 10

EPA Idenfificalion Number
NPIDES Permit Number
Facility Name
-1
;P
Form Approved 03/05/19
1 N(
I City of Dunn Black River W
OMB No� 2040-0004
5.4
For each CSO outfall, provii a the followinq information.. ( tach additional sheets as nece ary.)
CSOOuffall Number—
CS00utfall Number
CSOOuffall Number —
City or town
State and ZIP code
County
Latitude
0
0
Longitude
Distance from shore
ft.
ft.
Depth below surface
ft.
5.5
Did the POTW monitor any of the following items in the past year for its CSO outfalls?
CSOOuffall Number
CSOOuffall Number
CSOOutfall Number
Rainfall
11 Yes 11 No
El Yes El No
El Yes ONo
CSO flow volume
11 Yes 11 No
OYes ONo
El Yes ONo
0
z
CSO pollutant
11 Yes 11 No
[]Yes ONo
El Yes ONo
0
concentrations
U)
0
Receiving water quality
El Yes 11 No
OYes ONo
OYes 0 No
CSO frequency —=O
Yes El No
El Yes El No
OYes ONo
Number of storm events 1
0 Yes El No
El Yes El No
OYes ONo
5.6
Provide the following information for each of your CSO outfalls.
CSO Ouffall Number —
CSO Outfall Number
CSO Ouffall Number
>-
Number of CSO events in
events
events
events
V
the past year
if
.S
Average duration per
hours
hours
hours
2
C
0
event
11 Actual or 11 Estimated
0 Actual or El Estimated
C1 Actual or 0 Estimated
at
0
Average volume per event
million gallons
million gallons
million gallons
0 Actual or 0 Estimated
0 Actual or 0 Estimated
I El Actual or 13 Esfimatei
Minimum rainfall causing
inches of rainfall
inches of rainfall
inches of rainfall
a CSO event in last year
0 Actual or 0 Estimated
0 Actw
11 Actual or 0 Estimated
j
EPA Form 3510-2A (Revised 3-19) Page 11

EPA denfification Number
NPDES Permit Number
Facility Name
Form Approved 03105/19
1 NCO043176
I City of Dunn Black River WVVTP
OMB No. 2040-0004
5.7
Provide the information in the table below for each of your SO outfalls.
CSO Outfall Number
CSO Outfall Number
CSO Ouffall Number
Receiving water name
Name of watershed/
stream system
U.S. Soil Conservation
0 Unknown
El Unknown
0 Unknown
Service 14-digit
watershed code
Z
(if known)
Name of state
W
managernentliniver basin
0
cn
U.S. Geological Survey
0 Unknown
0 Unknown
El Unknown
0
8-Digit Hydrologic Unit
Code (if known)
Description of known
water quality impacts on
receiving stream by CSO
(see instructions for
examoles)
SECT18N
6. CHECKLIST
AND CERTIFICATION STATEMENT (40 CFR 122.22(a) and (d))
6.1
In Column 1 below, mark the sections of Form 2A that you have completed and are submitting with your application. For
each section, specify in Column 2 any attachments that you are enclosing to alert the permitting authority. Note that not
all applicants are required to provide a tachments.
Column I
Column 2
Section 1: Basic Application
w/ variance request(s) 13 wi additional attachments
Information for All Applicants
Section 2: Additional
wl topographic map El w/ process flow diagram
Information
0 w/ additional attachments
0 w/ Table A El w/ Table D
Section 3: Information on
r7l
mi w/ Table B 0 w/ Table E
Effluent Discharges
E=
El wt Table C w/ additional attachments
Section 4: Industrial
wi SIU and NSCIU attachments El w/ Table F
E] Discharges and Hazardous
.0
Wastes
El w/ additional attachments
Section 5: Combined Sewer
El
w/ CSO map El w/ additional attachments
Overflows
El wt CSO system diagram
Section 6: Checklist and
El w/ attachments
Certification Statement
6.2
Certification Statement
I certify underpenally of law that this document and all attachments were prepared under my direction orsupervision in
accordance with a system designed to assure that qualified personnel property 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 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 fine
and imprisonment for knowing violations.
Name (print or type first and last name)
Official title
Heather Adams
Public Utilities Director
ur
Signatur
Date signed
02/28/2023
EPA Form 3510-2A (Revised 3-19) Page 12

EPA Identification Number NPDES Permit Number Facility Name F—Ouffnall Numl�er
NCO043176 City of Dunn Black River WVJT 001
Form Approved 03/05119
OMB No. 2040-0004
Maximum Daily Discharge
Average Daily Discharge
P 0
Pollutant
'u t a n t
Analytical MIL or MDL
Value
Units
Value Units Number of Method' (include units)
---
Samples
S a m a
Biochemical oxygen de an
'o 'c ' 0 x y e n demand
D 0 r C
[a BOD5 or ii CBOD5
0 OB 0 D 5
10
mg/L
3.24
mg/L
34 5210 2.0 mg/l 11 ML
r e 0 rt 0 n
(report one)
e
Gj MDL
F e c Do f
Fecal coliform
I 0 r m
1300
#100 ml
#'oo m'
179
1.79
#100 ml
81 Colilert-18 Quant 1 #loot, 11 ML
121 MDL
,I
D e s n
Design flow rate
0 w r a te
6.137
MGD
MGD
2.22
222
MGD
123
pH (minimum)
6.1
slu
pH (maximum)
7.2
slu
Temperature (winter)
18
deg C
15.8
deg C
19
Temperature (summer)
28
deg C
26.6
deg C
19
OML
81 2540 D-2015 2.5 mg/11 Mn
I I IM� HL
Total suspended solids (TSS)
TSS)
I
9.3
mg/L
3.84
mg/L
Q�- H k Hk A 1-� -----
U — —vivil �j tu OUIIIUIUI IUY =IbILIM MW JJIU�UUIUS tj.e, MeInOOS) approved under 41) U-K 13b tor the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter 1, subchapter N or 0. See instructions and 40 CFR 122.21(e)(3).
EPA Form 3510-2A (Revised 3-19) Page 13

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