NC0065358_Fact Sheet_20230419

DocuSign Envelope ID: D11509B2-E2A8-468B-856A-9AE2A56B6207
FACT SHEET FOR EXPEDITED PERMIT RENEWALS
This form must be completed by Permit Writers for all expedited permits which do not require
full Fact Sheets. Expedited permits are generally simple 100% domestics (e.g., schools, mobile
home parks, etc.) that can be administratively renewed with minor changes but can include
facilities with more complex issues (Special Conditions, 303(d) listed water, toxicity testing,
instream monitoring, compliance concerns).
Basic Information for Expedited Permit Renewals
Permit Writer/Date
Catherine Shadwell — 4/10/2023
Permit Number
NCO065358
Facility Name
Hidden Forest Estates WWTP
Basin Name/Sub-basin number
Cape Fear / 03-06-08
Receiving Stream
Randleman Lake
Stream Classification in Permit
WS-IV CA
Does permit need Daily Maximum NH3
limits?
No — already present
Does permit need TRC limits/language?
No — already present. Facility has replaced
chlorine disinfection with UV.
Does permit have toxicity testing?
No
Does permit have Special Conditions?
Standard nutrient reopener for Cape Fear
facilities
Does permit have instream monitoring?
No
Is the stream impaired on 303(d) list)?
No
Any obvious compliance concerns?
No enforcements since 2011. There have
been 12 notices of violation since 2017, 9 of
which are BOD violations.
Any permit mods since lastpermit?
No
New expiration date
3/31/2028
Comments received on Draft Permit?
Updated eDMR requirements
Updated outfall map
Changes to finalpermit?
No
Most Commonly Used Expedited Language:
• 303(d) language for Draft/Final Cover Letters: "Please note that Cane Creek is listed
as an impaired waterbody on the North Carolina 303(d) Impaired Waters List.
Addressing impaired waters is a high priority with the Division, and instream data will
continue to be evaluated. If there is noncompliance with this permit's effluent limits and
stream impairment can be attributed to your facility, then mitigative measures may be
required".
• TRC language for Compliance Level for Cover Letters/Effluent Sheet Footnote:
"The facility shall report all effluent TRC values reported by a NC certified laboratory
including field certified. However, effluent values below 50 µg/l will be treated as zero
for compliance purposes."

DocuSign Envelope ID: D11509B2-E2A8-468B-856A-9AE2A56B6207
Proof Of Publication in
COURIER -TRIBUNE
NCDENR/DWQ/NPDES
ATTN: WREN THEDFORD
1617 MAIL SERVICE CENTER
RALEIGH, NC 276991617
STATE OF NORTH CAROLINA, RANDOLPH COUNTY
To Whom It May Concern:
This is to certify the advertisement attached hereto has been
published in COURIER -TRIBUNE 1 time(s) in issues dated:
May 24, 2022
the last day of said publication being the
24th day of May, 2022
sworn to before me and subscribed in my presence by this the
24th day of May, 2022
FEE: $57.90 AMY KOKOTT
AD#: 0001455061 Notary Public
ACCT: 54946 State of Wisconsin
Public Notice
North Carolina Environmental
Management Commission/NPDES
Unit
1617 Mail Service Center
Raleigh, NC 27699-1617
Notice of Intent to Issue a NPDES
Wastewater Permit NCO065358
Hidden Forest Estates WWTP
The North Carolina Environmental
Management Commission propos-
es to issue a NPDES wastewater
discharge permit to the person(s)
listed below. Written comments
regarding the proposed permit
will be accepted until 30 days af-
ter the publish date of this notice.
The Director of the NC Division of
Water Resources (DWR) may hold
a public hearing should there be a
significant degree of public inter-
est Please mail comments and/or
information requests to DWR at
the above address. Interested per-
sons may visit the DWR at 512 N.
Salisbury Street. Raleigh, NC 27604
to review information on file. Ad-
ditional information on NPDES
permits and this notice may be
found on our website:
http://deq.nc.gov/about/divisions
/water-resources/water-
resources -permits/wastewater-
b r a n c h/ n p d e s-
wastewater/public-notices,or by
calling [phone]. SIP Hidden
Forest, LLC (P.O. Box 692571,
Quincy, MA 02269-2571) has re-
quested renewal of NPDES permit
NCO065358 for the Hidden Forest
Estates WWTP in Randolph Coun-
ty. This permitted facility dis-
charges treated wastewater to
the Deep River in the Cape Fear
River Basin. Currently, BOD, am-
monia nitrogen, dissolved oxygen,
total phosphorus, fecal coliform,
and total residual chlorine are wa-
ter quality limited. This discharge
may affect future allocations in
this portion of the watershed.
St: 5/24/2022
Page 1 of 1

DocuSign Envelope ID: D11509B2-E2A8-468B-856A-9AE2A56B6207
ROY COOPER
Governor
ELIZABETH S. BISER
Secretary
RICHARD E. ROGERS, JR.
Director
NORTH CAROLINA
Emlronmental Quality
5/16/2022
SIP Hidden Forest, LLC
Attn: Mr. Sean Dyer, Manager
665 Hancock Street, Suite 3
Quincy, MA 02170-2868
Subject: Draft NPDES Permit NCO065358
Hidden Forest Estates WWTP
Randolph County
Grade II Biological WPCS
Dear Permittee:
The Division has reviewed your request to renew the subject permit. Please review this draft carefully to ensure
your thorough understanding of the information, conditions, and requirements it contains.
The draft permit includes the following significant changes from the existing permit:
• Section A. (3.) has been updated to require electronic submission of effluent data
reports (DMRs). Federal regulations require electronic submittal of all discharge
monitoring.
• An updated outfall map has been included.
With this notification, the Division will solicit public comment on this draft permit by publishing a notice in
newspapers having circulation in the general Randolph County area, per EPA requirements. Please provide your
comments, if any, to me no later than 30 days after receiving this draft permit.
Following the 30-day public comment period, the Division will review all pertinent comments and take
appropriate action prior to issuing a final permit. If you have any questions concerning this permit, please contact
Emily Phillips at emily.philliRsAncdenr.gov.
cc: NPDES files
ec: ARO
Sincerely,
DoeuSigned by:
lBE53 $1E460471—
Emily Phillips
Compliance and Expedited Permitting Unit
State of North Carolina I Environmental Quality I Water Resources
1617 Mail Service Center I Raleigh, NC 27699-1617
919-807-6300 919-807-6389 FAX
https://deq.nc.gov/aboutldivisions/water-resources/water-resources-permits/wastewater-branchlnpdes-wastewater-pennits

DocuSign Envelope ID: D11509B2-E2A8-468B-856A-9AE2A56B6207
Permit NCO065358
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF WATER RESOURCES
PERMIT
TO DISCHARGE WASTEWATER UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provisions of North Carolina General Statute 143-215.1, other lawful standards and
regulations promulgated and adopted by the North Carolina Environmental Management Commission, and the
Federal Water Pollution Control Act, as amended,
SIP Hidden Forest, LLC
is hereby authorized to discharge wastewater from a facility located at the
Hidden Forest Estates WWTP
6602 Holder Inman Road Extension
Randleman
Randolph County
to receiving waters designated as an unnamed tributary to Randleman Lake in subbasin 03-06-08 of the
Cape Fear River Basin in accordance with effluent limitations, monitoring requirements, and other
conditions set forth in Parts I, II, III and IV hereof.
This permit shall become effective
This permit and authorization to discharge shall expire at midnight on August 31, 2026.
Signed this day
Richard E. Rogers, Jr., Director
Division of Water Resources
By Authority of the Environmental Management Commission
Page 1 of 6

DocuSign Envelope ID: D11509B2-E2A8-468B-856A-9AE2A56B6207
Permit NCO065358
SUPPLEMENT TO PERMIT COVER SHEET
All previous NPDES Permits issued to this facility, whether for operation or discharge are hereby revoked, and as
of this issuance, any previously issued permit bearing this number is no longer effective. Therefore, the exclusive
authority to operate and discharge from this facility arises under the permit conditions, requirements, terms, and
provisions included herein.
SIP Hidden Forest, LLC is hereby authorized to:
Continue to operate an existing 0.027 MGD wastewater treatment facility with the following
components:
♦ Influent surge tank with bar screen
♦ Extended aeration basin
♦ Clarifiers (2)
♦ Sludge digester
♦ Tertiary sand filters (2)
♦ Ultraviolet disinfection unit
♦ Standby power generator
This facility is located near Randleman off the Holder Inman Road Extension at the Hidden Forest
Estates WWTP in Randolph County.
2. Discharge from said treatment works at the location specified on the attached map into an unnamed
tributary to Randleman Lake, currently classified WS-IV CA* waters in the Cape Fear River Basin.
Page 2 of 6

DocuSign Envelope ID: D11509B2-E2A8-468B-856A-9AE2A56B6207
Permit NCO065358
Part I.
A. (L) EFFLUENT LIMITATIONS AND MONITORING REQUIREMENTS
[15A NCAC 02B.0400 et seq., 15A NCAC 02B.0500 et seq.]
Grade Il Biological Water Pollution Control System [15A NCAC 08G .0302]
During the period beginning on the effective date of the permit and lasting until expiration, the Permittee is
authorized to discharge from outfall 001. Such discharges shall be limited and monitored' by the Permittee as
specified below:
PARAMETER
LIMITS
MONITORING REQUIREMENTS
Monthly
Daily
Measurement
Sample
Sample
PCS code
Average
Maximum I
Frequency
Type
Location
Flow
50050
0.027 MGD
Continuous
Recording
Influent or
Effluent
BOD, 5-day (20°C) (April 1 — October 31)
5.0 mg/L
7.5 mg/L
3/Week
Composite
Effluent
C0310
BOD, 5-day (20°C) (November 1— March
31)
10.0 mg/L
15.0 mg/L
3/Week
Composite
Effluent
C0310
Total Suspended Solids (TSS)
30.0 mg/L
45.0 mg/L
3/Week
Composite
Effluent
C0530
NH3 as N (April 1 — October 31)
2.0 mg/L
10.0 mg/L
3/Week
Composite
Effluent
C0610
NH3 as N (November 1 — March 31)
4.0 mg/L
20.0 mg/L
3/Week
Composite
Effluent
C0610
Dissolved Oxygen
Daily average > 6.0 mg/L
3/Week
Grab
Effluent
C0300
Fecal Coliform (geometric mean)
200 / 100 ml
400 / 100 ml
3/Week
Grab
Effluent
31616
Total Residual Chlorine (TRC)2
17 pg/L
3/Week
Grab
Effluent
50060
Temperature (°C)
3/Week
Grab
Effluent
00010
Total Nitrogen (NO2+NO3+TKN)
Monthly
Composite
Effluent
C0600
Total Phosphorus3
2.0 mg/L Quarterly average
Weekly
Composite
Effluent
C0665
pH
> 6.0 and < 9.0 standard
3/Week
Grab
Effluent
00400
units
Footnotes:
1. The Permittee shall begin submitting discharge monitoring reports electronically using the Division's eDMR system [see
A. (3)].
2. Limit and monitoring requirements apply only if chlorine is added to the treatment system. The Permittee shall report all
effluent TRC values reported by a NC -certified laboratory [including field -certified]. Effluent values below 50 µg/L will
be treated as zero for compliance purposes.
3. Compliance shall be based on a quarterly average of weekly samples.
THERE SHALL BE NO DISCHARGE OF FLOATING SOLIDS OR VISIBLE FOAM IN OTHER THAN TRACE AMOUNTS.
Page 3 of 6

DocuSign Envelope ID: D11509B2-E2A8-468B-856A-9AE2A56B6207
Permit NCO065358
A. (2.) PERMIT RE -OPENER: NUTRIENT MONITORING
[NCGS 143-215.1 ]
Pursuant to N.C. General Statutes Section 143-215.1 and the implementing rules found in the North Carolina
Administrative Code at 15A NCAC 2H.0112 (b) (1) and 2H.0114 (a) and Part 11 sections B-12 and B-13 of this
permit, the Director may reopen this permit to require supplemental nutrient monitoring of the discharge. The
purpose of the additional monitoring will be to support water quality modeling efforts within the Cape Fear River
Basin and shall be consistent with a monitoring plan developed jointly by the Division and affected stakeholders.
In addition, the results of water quality modeling may require that limits for Total Nitrogen and Total Phosphorus
be imposed in this permit upon renewal.
A. (3.) ELECTRONIC REPORTING - DISCHARGE MONITORING REPORTS
[G.S. 143-215.1 (b)]
Federal regulations require electronic submittal of all discharge monitoring reports (DMRs) and program reports.
The final NPDES Electronic Reporting Rule was adopted and became effective on December 21, 2015.
NOTE: This special condition supplements or supersedes the following sections within Part II of this permit
(Standard Conditions for NPDES Permits):
Section B. (11.)
Signatory Requirements
Section D. (2.)
Reporting
Section D. (6.)
Records Retention
Section E. (5.)
Monitoring Reports
Reporting Requirements [Supersedes Section D. (2.) and Section E. (5.) (a)l
The permittee shall report discharge monitoring data electronically using the NC DWR's Electronic Discharge
Monitoring Report (eDMR) internet application.
Monitoring results obtained during the previous month(s) shall be summarized for each month and submitted
electronically using eDMR. The eDMR system allows permitted facilities to enter monitoring data and submit
DMRs electronically using the internet. The eDMR system may be accessed at:
https:Hdeg.nc.gov/about/divisions/water-resources/edmr.
If a permittee is unable to use the eDMR system due to a demonstrated hardship or due to the facility being
physically located in an area where less than 10 percent of the households have broadband access, then a
temporary waiver from the NPDES electronic reporting requirements may be granted and discharge monitoring
data may be submitted on paper DMR forms (MR 1, 1. 1, 2, 3) or alternative forms approved by the Director.
Duplicate signed copies shall be submitted to the following address:
NC DEQ / Division of Water Resources / Water Quality Permitting Section
ATTENTION: Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
See "How to Request a Waiver from Electronic Reporting" section below.
Page 4 of 6

DocuSign Envelope ID: D11509B2-E2A8-468B-856A-9AE2A56B6207
Permit NCO065358
Monitoring results obtained during the previous month(s) shall be summarized for each month and reported via
the eDMR system no later than the last calendar day of the month following the completed reporting period.
Regardless of the submission method, the first DMR is due on the last day of the month following the issuance of
the permit or in the case of a new facility, on the last day of the month following the commencement of discharge.
Starting on December 21, 2025, the permittee must electronically report the following compliance monitoring
data and reports, when applicable:
Sewer Overflow/Bypass Event Reports;
Pretreatment Program Annual Reports; and
Clean Water Act (CWA) Section 316(b) Annual Reports.
The permittee may seek an electronic reporting waiver from the Division (see "How to Request a Waiver from
Electronic Reporting" section below).
Electronic Submissions
In accordance with 40 CFR 122.41(1)(9), the permittee must identify the initial recipient at the time of each
electronic submission. The permittee should use the EPA's website resources to identify the initial recipient for
the electronic submission.
Initial recipient of electronic NPDES information from NPDES-regulated facilities means the entity (EPA or the
state authorized by EPA to implement the NPDES program) that is the designated entity for receiving electronic
NPDES data [see 40 CFR 127.2(b)].
EPA plans to establish a website that will also link to the appropriate electronic reporting tool for each type of
electronic submission and for each state. Instructions on how to access and use the appropriate electronic
reporting tool will be available as well. Information on EPA's NPDES Electronic Reporting Rule is found at:
https://www federalre zister Gov/documents/2015/10/22/2015-24954/national-pollutant-discharge-elimination-
s sty em-npdes-electronic-reporting-rule
Electronic submissions must start by the dates listed in the "Reporting Requirements" section above.
How to Request a Waiver from Electronic Reporting
The permittee may seek a temporary electronic reporting waiver from the Division. To obtain an electronic
reporting waiver, a permittee must first submit an electronic reporting waiver request to the Division. Requests
for temporary electronic reporting waivers must be submitted in writing to the Division for written approval at
least sixty (60) days prior to the date the facility would be required under this permit to begin submitting
monitoring data and reports. The duration of a temporary waiver shall not exceed 5 years and shall thereupon
expire. At such time, monitoring data and reports shall be submitted electronically to the Division unless the
permittee re -applies for and is granted a new temporary electronic reporting waiver by the Division. Approved
electronic reporting waivers are not transferrable. Only permittees with an approved reporting waiver request
may submit monitoring data and reports on paper to the Division for the period that the approved reporting waiver
request is effective.
Information on eDMR and the application for a temporary electronic reporting waiver are found on the following
web page:
http:Hdeg.nc.gov/about/divisions/water-resources/edmr
Signatory Requirements fSWlements Section B. (11.) (b) and Supersedes Section B. (11.) (d)l
All eDMRs submitted to the permit issuing authority shall be signed by a person described in Part II, Section B.
(11.)(a) or by a duly authorized representative of that person as described in Part U, Section B. (11.)(b). A person,
and not a position, must be delegated signatory authority for eDMR reporting purposes.
Page 5 of 6

DocuSign Envelope ID: D11509B2-E2A8-468B-856A-9AE2A56B6207
Permit NCO065358
For eDMR submissions, the person signing and submitting the DMR must obtain an eDMR user account and
login credentials to access the eDMR system. For more information on North Carolina's eDMR system,
registering for eDMR and obtaining an eDMR user account, please visit the following web page:
http://dgg.nc.gov/about/divisions/water-resources/edmr
Certification. Any person submitting an electronic DMR using the state's eDMR system shall make the following
certification [40 CFR 122.22]. NO OTHER STATEMENTS OF CERTIFICATION WILL BE ACCEPTED:
"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 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. "
1. Records Retention [Supplements Section D. (6.
The permittee shall retain records of all Discharge Monitoring Reports, including eDMR
submissions. These records or copies shall be maintained for a period of at least 3 years from the
date of the report. This period may be extended by request of the Director at any time [40 CFR
122.41].
Page 6 of 6

DocuSign Envelope ID: D1 1509B2-E2A8-468B-856A-9AE2A56B6207
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Latitude: 352 53' 53" NCO065358
Longitude: 792 49' 22" Hidden Forest Estates
Stream Class: WS-IV CA*
Facility
Location
Subbasin:03-06-08 WWTP
Receiving Stream: UT Randleman Lake
North
Randolph County