NC0035939_Renewal (Application)_20230707

ti STA7F o.{4'
ROY COOPER
Governor r
ELIZABETH S.BISER
Secretary vy Q r
RICHARD E.ROGERS,JR. NORTH CAROLINA
Director Environmental Quality
July 10, 2023
Bethel Colony of Mercy, Inc.
Attn: Paul Pruitt, Executive Director
1675 Bethel Colony Rd
Lenoir, NC 28645
Subject: Permit Renewal
Application No. NC0035939
Bethel Colony Women's Campus WWTP
Caldwell County
Dear Applicant:
The Water Quality Permitting Section acknowledges the July 7, 2023, 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. 150B-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:
https://deq.nc.gov/permits-regulations/permit-guidance/environmental-application-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,
A
Wren Thedford
Administrative Assistant
Water Quality Permitting Section
ec: WQPS Laserfiche File w/application
D_E Q?) North caroling Department of Environmrntal Quality Division of Water Resources
AsheviAc Regional Office 2090 US.Highway 70 I Swannanoa.North Carolina 28778
" 828 296 4500

North Carolina
Modified Application Form 2A
Department of Environmental Quality
Revised March 2021
Division of Water Resources
Modified Application
Form 2A
Minor Sewage Facilities < Oal MG *
and No Pretreatment Program
NPDES Permitting Program
RECEIVED
JUL o 7 2023
NCDECYDWRINPDES
Note: Complete this form if your facility is a MINOR new or existing publicly owned treatment works.

P
NPDES Permit Number Facility Name Modified Application Form 2A
NC0035939 Bethel Colony Women'sCampus Modified March 2021
Form NC Department of Environmental Quality-Application for NPDES Permit to Discharge Wastewater
NPDES MINOR SEWAGE FACILITIES(Before completing this form,please read the instructions.Failure to follow
the instructions may result in denial of the application.)
SECTION 1.BASIC APPLICATION INFORMATION FOR ALL APPLICANTS(40 CFR 122.210)(1)and(9))
1.1 Facility name
Bethel Colony's Women Camppus
Mailing address(street or P.O.box)
1181 Camp Carolwood Rd
City or town State ZIP code
0 Lenoir NC 28645
Contact name(first and last) Title Phone number Email address
c
Paul Pruitt Executive Director [phone] [e-mail]
Location address(street,route number,or other specific identifier) m Same as mailing address
City or town State ZIP code
1.2 Is this application for a facility that has yet to commence discharge?
❑ Yes 4 See instructions on data submission ❑ No
requirements for new dischargers.
1.3 Is applicant different from entity listed under Item 1.1 above?
ElYes ❑ No 4 SKIP to Item 1.4.
Applicant name
Bethel Colony of Mercy,Inc.
Applicant address(street or P.O.box)
1675 Bethel Colony Rd
City or town State ZIP code
Lenoir NC 28645
Contact name(first and last) Title Phone number Email address
n Paul Pruitt Executive Director [phone] [e-mail]
1.4 Is the applicant the facility's owner,operator,or both?(Check only one response.)
❑ Owner ❑ Operator ❑✓ Both
1.5 To which entity should the NPDES permitting authority send correspondence?(Check only one response.)
El 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
a NPDES(discharges to surface ❑ RCRA(hazardous waste) ❑ UIC(underground injection
w ter) control)
Coo3s,9343
2 ❑ PSD(air emissions) ❑ Nonattainment program(CM) ❑ NESHAPs(CM)
w
rn
.N ❑ Ocean dumping(MPRSA) ❑ Dredge or fill(CWA Section ❑ Other(specify)
404)
Page 1

NPDES Permit Number Facility Name Modified Application Form 2A
NC0035939 Bethel Colony Women'sCampus Modified March 2021
1.7 Provide the collection system information requested below for the treatment works.
Municipality Population Collection System Type
Served Served (indicate percentage) Ownership Status
%separate sanitary sewer 0 Own ❑ Maintain
%combined storm and sanitary sewer 0 Own ❑ Maintain
a) ❑ Unknown 0 Own ❑ Maintain
co
%separate sanitary sewer 0 Own ❑ Maintain
m %combined storm and sanitary sewer 0 Own ❑ Maintain
❑ Unknown ❑ Own 0 Maintain
a %
o separate sanitarysewer 0 Own ❑ Maintain
aP
3 �� %combined storm and sanitary sewer 0 Own ❑ Maintain
MI ❑ Unknown ❑ Own ❑ Maintain
E %separate sanitary sewer ❑ Own ❑ Maintain
to
%combined storm and sanitary sewer 0 Own ❑ Maintain
cn
c ❑ Unknown 0 Own ❑ Maintain
Total
°' Population
c) Served
Combined Storm and
Separate Sanitary Sewer System Sanitary Sewer j
Total percentage of each type of °/° °
sewer line(in miles) _ °
z' 1.8 Is the treatment works located in Indian Country?
Z
o ❑ Yes ❑✓ No
U
co 1.9 Does the facility discharge to a receiving water that flows through Indian Country?
Es ❑ Yes ❑✓ No
1.10 Provide design and actual flow rates in the designated spaces. Design Flow Rate
mgd
o
= y Annual Average Flow Rates(Actual)
aUa Two Years Ago Last Year This Year
re
03
c D, (1?)! mgd b , CO / mgd a, db ( mgd
7" Maximum Daily Flow Rates(Actual)
a Two Years Ago Last Year This Year
D. Q) I mgd 0 ca) f mgd D CO / mgd
y 1.11 Provide the total number of effluent discharge points to waters of the State of North Carolina by type.
c Total Number of Effluent Discharge Points by Type
a• - Constructed
Combined Sewer
as Treated Effluent Untreated Effluent Overflows Bypasses Emergency
.0 Overflows
0 /
Page 2

NPDES Permit Number Facility Name Modified Application Form 2A
NC0035939 Bethel Colony Women'sCampus Modified March 2021
Outfalls Other Than to Waters of the State of North Carolina
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 State of North Carolina?
❑ Yes ❑✓ 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 Impoundment Location and Discharge Data
Average Daily Volume Continuous or Intermittent
Location Discharged to Surface
(check one)
Impoundment
❑ Continuous
gpd ❑ Intermittent
❑ Continuous
gpd ❑ Intermittent
0 Continuous
gpd 0 Intermittent
a
s 1.14 Is wastewater applied to land?
❑ Yes ❑✓ No 4 SKIP to Item 1.16.
0 1.15 Provide the land application site and discharge data requested below.
N Land Application Site and Discharge Data
o Continuous or
o
Location Size Average Daily Volume Intermittent
Applied (check one)
acres d 0 Continuous
a gp 0 Intermittent
acres d 0 Continuous
5 gp ❑ Intermittent
acres d ❑ Continuous
gp ❑ Intermittent
1.16 Is effluent transported to another facility for treatment prior to discharge?
o ❑ Yes m 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?
❑ Yes ❑ 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 ZIP code
Contact name(first and last) Title
Phone number Email address
Page 3

NPDES Permit Number Facility Name Modified Application Form 2A
NC0035939 Bethel Colony Women'sCampus Modified March 2021
1.20 In the table below,indicate the name,address,contact information, NPDES number,and average daily flow rate of the
receiving facility.
Receiving Facility Data
-0 Facility name Mailing address(street or P.O.box)
0)
City or town State ZIP code
0
Contact name(first and last) ----1\ Title
0
Phone number Email address
QNPDES number of receiving facility(if any) 0 None Average daily flow rate mgd
N
1.21 Is the wastewater disposed of in a manner other than those already mentioned in Items 1.14 through 1.21 that do
N not have outlets to waters o a of orth Carolina(e.g.,underground percolation,underground injection).
o` �
�/
C,
❑ Yes V ❑ No 4 SKIP to Item 1.23.
V
0 1.22 Provide information in the table below on these other disposal methods.
CII Information on Other Disposal Methods
oDisposal Location of Size of Annual Average Continuous or Intermittent
Method Disposal Site Disposal Site Daily Discharge (check one)
Description Volume
To acres gpd 0 Continuous
3 `fin ❑ Intermittent
0 Continuous
acres gpd 0 Intermittent
acresgpd ❑ Continuous
❑ 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.
(u €n Consult with your NPDES permitting authority to determine what information needs to be submitted and when.)
c w ❑ Discharges into marine waters(CWA ❑ Water quality related effluent limitation(CWA Section
Section 301(h)) 302(b)(2))
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?
❑ Yes ❑ No+SKIP 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 1 Contractor 2 Contractor 3
0
Contractor name
(company name)
oMailing address
(street or P.O.box)
o City,state,and ZIP — (\1
code
0 Contact name(first and
c� last)
Phone number
Email address
Operational and
maintenance
responsibilities of
contractor
Page 4

NPDES Permit Number Facility Name Modified Application Form 2A
NC0035939 Bethel Colony Women'sCampus Modified March 2021
SECTION 2.ADDITIONAL INFORMATION(40 CFR 122.21(j)(1)and(2))
o Outfalls to Waters of the State of North Carolina
2.1 Does the treatment works have a design flow greater than or equal to 0.1 mgd?
❑ Yes )No 4 SKIP to Section 3.
0 2.2 Provide the treatment works'current average daily volume of inflow Average Daily Volume of Inflow and Infiltration
and infiltration.
gpd
Indicate the steps the facility is taking to minimize inflow and infiltration.
a
0
0
c
2.3 Have you attached a topographic map to this application that contains all the required information?(See instructions for
R Q specific requirements.)
rn '°
o
Q ❑ Yes ❑ No
E 2.4 Have you attached a process flow diagram or schematic to this application that contains all the required information?
aR (See instructions for specific requirements.)
a,
R
o ❑ Yes ❑ No
2.5 Are improvements to the facility scheduled?
❑ Yes No 4 SKIP to Section 3.
Briefly list and describe the scheduled improvements.'
1.
E
Q 2.
E
0
3.
a
4.
G7
2.6 Provide scheduled or actual dates of completion for improvements.
Scheduled or Actual Dates of Completion for Improvements
Affected Attainment of
Scheduled Begin End Begin
Outfalls Operational
2 Improvement Construction Construction Discharge
(from above) (list outfall (MM/DD/YYYY) (MM/DD/YYYY) (MM/DD/YYYY) Level
number) (MM/DD/YYYY)
1.
a
a
s
U 2.
N
3.
4.
2.7 Have appropriate permits/clearances concerning other federal/state requirements been obtained?Briefly explain your
response.
❑ Yes ❑ No ❑ None required or applicable
Explanation:
Page 5

NPDES Permit Number Facility Name Modified Application Form 2A
NC0035939 Bethel Colony Women'sCampus Modified March 2021
SECTION 3.INFORMATION ON EFFLUENT DISCHARGES(40 CFR 122.21(j)(3)to(5))
3.1 Provide the following information for each outfall.(Attach additional sheets if you have more than three outfalls.)
Outfall Number 013/ Outfall Number Outfall Number
State Id
6 County C41_- —et it
.Q
City or town 1_12i1A/4
0 Distance from shore V ft. ft. ft.
Q
o
Depth below surface D ft. ft. ft.
0
Average daily flow rate 0 - p a ( mgd / mgd mgd
Latitude 6.0`7-'5�218" °/i✓ ° „ o „
Longitude _10.531 3ft cl o GO a
3.2 Do any of the outfalls described under Item 3.1 have seasonal or periodic discharges?
o ❑ Yes No 4 SKIP to Item 3.4.
d
3.3 If so,provide the following information for each applicable outfall.
y Outfall Number Outfall Number Outfall Number
0
Number of times per year
s discharge occurs
a Average duration of each
`o discharge(specify units)
c Average flow of each
o mgdmgd9
mgd
m discharge
e
4)
Monthsin which discharge
�, g
occurs
3.4 Are any of the outfalls listed under Item 3.1 equipped with a diffuser?
❑ Yes No 4 SKIP to Item 3.6.
03.5 Briefly describe the diffuser type at each applicable outfall.
Outfall Number Outfall Number Outfall Number
v,
0
° us 3.6 Roe he treatment works discharge or plan to discharge wastewater to waters of the State of North Carolina from
a = one►,more discharge points?
3 E. it Yes 0 No+SKIP to Section 6.
Page 6

NPDES Permit Number Facility Name Modified Application Form 2A
NC0035939 Bethel Colony Women'sCampus Modified March 2021
3.7 Provide the receiving water and related information(if known)for each outfall.
Outfall Number tb / Outfall Number Outfall Number
Receiving water name /1 _ t
Name of watershed,river, � .'
0 or stream system ig — Pe- --. DE8=e
Q- U.S.Soil Conservation
Nr.
Service 14-digit watershed
o code
17.3
Name of state
management/river basin j/,,de-/A) - Pe& C-'"E----
rn
c U.S.Geological Survey
'c 8-digit hydrologic
ct cataloging unit code
Critical low flow(acute) cfs cfs cfs
Critical low flow(chronic) cfs cfs cfs
Total hardness at critical mg/L of mg/L of mg/L of
low flow CaCO3 CaCO3 CaCO3
3.8 Provide the following information describing the treatment provided for discharges from each outfall.
Outfall Number ON Outfall Number Outfall Number
Highest Level of ❑ Primary ❑ Primary ❑ Primary
Treatment(check all that ❑ Equivalent to 0 Equivalent to ❑ Equivalent to
apply per outfall) secondary secondary secondary
XSecondary ❑ Secondary 0 Secondary
❑ Advanced 0 Advanced ❑ Advanced
0 Other(specify) 0 Other(specify) ❑ Other(specify)
c
'Q Design Removal Rates by
.0 Outfall
M
N
o BODs or CBODs
E
m TSS A v
,
rot applicable ❑Not applicable ❑Not applicable
Phosphorus % o/o %
/o
rot applicable 0 Not applicable ❑Not applicable
Nitrogen % % %
Other(specify) ❑Not applicable ❑ Not applicable 0 Not applicable
Page 7

NPDES Permit Number Facility Name Modified Application Form 2A
NC0035939 Bethel Colony Women'sCampus Modified March 2021
3.9 Describe the type of disinfection used for the effluent from each outfall in the table below.If disinfection varies by
season,describe below.
m
c
C
o Outfall Number op I Outfall Number Outfall Number
fl Disinfection type
2e)C1;
Seasons used ()-Z2,
Dechlorination used? ❑ Not applicable ❑ Not applicable ❑ Not applicable
Yes ❑ Yes ❑ Yes
❑ No ❑ No ❑ No
3.10 Have you completed monitoring for all Table A parameters and attached the results to the application package?
Yes ❑ 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?
❑ Yes QSJ 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 outfall number or of the receiving water near the discharge points.
Outfall Number 80I Outfall Number Outfall Number
cti Acute Chronic Acute Chronic Acute Chronic
R
rn
Number of tests of discharge
_ water
Number of tests of receiving v 0
~ water
w
3.14 Does the POTW use chlorine for disinfection,use chlorine elsewhere in the treatment process,or otherwise have
reas able potential to discharge chlorine in its effluent?
Yes 4 Complete Table B,including chlorine. ❑ No 4 Complete Table B,omitting chlorine.
3.15 Have you completed monitoring r all applicable Table B pollutants and attached the results to this application
package?
❑ Yes (� ❑ No
Have you completed monitoring for all applicable Table D pollutants required by your NPDES permitting authority and
3.18 attached the results to this application package?
❑ Yes �/� / 11i ❑ No additional sampling required by NPDES
tf'J permitting authority.
Page 8

NPDES Permit Number Facility Name Modified Application Form 2A
•
NC0035939 Bethel Colony Women'sCampus Modified March 2021
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?
El Yes j No 4 Complete tests and Table E and SKIP to
''� Item 3.26.
3.20 Have you previously submitted the results of the above tests to your NPDES 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 NPDES permitting authority and provide a summary of the results.
Date(s)Submitted Summary of Results
(MM/DDNYYY)
v
a�
co
co 3.22 Regardless of how you provided your WET testing data to the NPDES permitting authority,did any of the tests result in
toxicity?
❑ Yes ❑ No 4 SKIP to Item 3.26.
CD 3.23 Describe the cause(s)of the toxicity:
(1)
w
3.24 Has the treatment works conducted a toxicity reduction evaluation?
❑ Yes ❑ 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 outfalls and attached the results to the application package?
❑ Yes ❑ Not applicable because previously submitted
information to the NPDES .ermittin• authori .
Page 9

NPDES Permit Number Facility Name Modified Application Form 2A
NC0035939 Bethel Colony Women'sCampus Modified March 2021
SECTION 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 attachments.
Column 1 Column 2
Section 1: Basic Application
Information for All Applicants 0
w/variance request(s) Elw/additional attachments
❑ Section 2:Additional ❑ w/topographic map ❑ w/process flow diagram
Information ❑ w/additional attachments
❑ w/Table A 0 wl Table D
❑ Section 3:Information on ❑ w/Table B 0 w/additional attachments
Effluent Discharges
g 0 w/Table C
d
ill
Section 4:Not Applicable
c
0
13,
g- Section 5:Not Applicable
iC
d
c Section 6:Checklist and
w/attachments
, 03
••, Certification Statement
Y 6.2 Certification Statement
u
CD
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 fine
and imprisonment for knowing violations.
Name(pri r type firs and last.name) Official title
ra4t
f4:e
.)te/-: 0,1/44'
Signature Date signe
/4..
ii -2 (i2d.),
Page 10

NPDES Permit Number Facility Name Outfall Number Modified Application Form 2A
NC0035939 Bethel Colony Women'sCampus a d / Modified March 2021
TABLE A.EFFLUENT PARAMETERS FOR ALL POTWS
Maximum Daily Discharge Average Daily Discharge Analytical ML or MDL
Pollutant Number of Methods include units
Value Units Sam•ies ( )
B'+chemical oxygen demand p Sivl. oleic,aML
[. BOD5 or❑CBOD5 1 S V- /!(�'/L 3, D 4 /Yl 8. /c. /a) sZ/O 14-20(` -1 - D ❑MDL
Dort one
Fecal coliform � -3 3 O <02 0Mgt" 7 -Amt.
S2 a_�,., • C� ❑MDL
Design flow rate 0 CD S Pi C-D 0- O 0/ /yl ( Z)' / D
pH(minimum) 42 , 1 S CA s 1, ..v
pH(maximum) Mg= It s
Temperature(winter) C ° I 2- C c ��
3. o y1(I�J
Temperature(summer) .2-y._. C ° EMI C b -
Total suspended solids(TSS) a yj g- L(p ,7 , .2 , a /y5/L / (f 7 s�0 A _�, 42.S I MDL
1 Sampling shall be conducted according to sufficiently sensitive test procedures(i.e.,methods)approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter I,subchapter N or 0.See instructions and 40 CFR 122.21(e)(3).
Page 11

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Modified Application Form 2A
Modified March 2021
NC0035939 Bethel Colony Women'sCampus
TABLE B.EFFLUENT PARAMETERS FOR ALL POTWS WITH A FLOW EQUAL TO OR GREATER,THAN 0.1 MGD
Maximum Daily Discharge erage Daily Disc • ge Analytical ML or MDL
Pollutant Number of Methods (include units)
Value Units Value • s Samples
Ammonia(as N) ❑ML
MDL
Chlorine ❑ML
(total residual,TRC)2 ❑MDL
❑Dissolved oxygen ML
❑MDL
❑ML
Nitrate/nitrite o MDL
❑ML
Kjeldahl nitrogen 0 MDL
❑ML
Oil and grease ❑MDL
❑ML
Phosphorus ❑MDL
❑ML
Total dissolved solids o MDL
1 Sampling shall be conducted according to sufficiently sensitive test procedures(i.e.,methods)approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter I,subchapter N or 0.See instructions and 40 CFR 122.21(e)(3).
2 Facilities that do not use chlorine for disinfection,do not use chlorine elsewhere in the treatment process,and have no reasonable potential to discharge chlorine in their effluent are not
required to report data for chlorine.
EPA Form 3510-2A(Revised 3-19) Page 12

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Modified Application Form 2A
NC0035939 Bethel Colony Women'sCampus Modifed March 2021
TABLE C.EFFLUENT PARAMETERS FOR SELECTED POTWS
Maximum Daily Discharge Average Daily Discharge Analytical ML or MDL
Pollutant Number of Method' (include units)
Value Units Value Units Samples
Metals,Cyanide,and Total Phenols
❑ML
Hardness(as CaCO3) ❑MDL
0 ML
Antimony,total recoverable ❑MDL
Arsenic,total recoverable ❑ML
❑MDL
0 ML
Beryllium,total recoverable ❑MDL
Cadmium,total recoverable ❑ML
❑MDL
Chromium,total recoverable ❑ML
0 MDL
ML
Copper,total recoverable 0 MDL
Lead,total recoverable ❑ML
❑MDL
❑ML
Mercury,total recoverable 0 MDL
Nickel,total recoverable ID ML
❑MDL
Selenium,total recoverable ❑ML
❑MDL
Silver,total recoverable ❑ML
❑MDL
Thallium,total recoverable ❑ML
❑MDL
Zinc,total recoverable ❑ML
❑MDL
❑ML
Cyanide ❑MDL
Total phenolic compounds ❑ML
❑MDL
Volatile Organic Compounds
❑ML
Acrolein ❑MDL
ML
Acrylonitrile ❑MDL
Benzene 0 ML
❑MDL
Bromoform ❑ML
0 MDL
EPA Form 3510-2A(Revised 3-19) Page 13

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Modified Application Form 2A
NC0035939 Bethel Colony Women'sCampus Modified March 2021
TABLE C.EFFLUENT PARAMETERS FOR SELECTED POTWS
Maximum Daily Discharge Average Daily Discharge Analytical ML or MDL
Pollutant Number of Method1 (include units)
Value Units Value Units Samples
Carbon tetrachloride ❑ML
❑MDL
Chlorobenzene ❑ML
❑MDL
Chlorodibromomethane ❑ML
❑MDL
Chloroethane ❑ML
❑MDL
0 ML
2-chloroethylvinyl ether ❑MDL
Chloroform ❑ML
❑MDL
Dichlorobromomethane ❑ML
❑MDL
v.----)i 0 ML
1,1-dichloroethane 0 MDL
1,2-dichloroethane ❑ML
❑MDL
trans-1,2-dichloroethylene ❑MDL
7 ❑ML
1,1 dichloroethylene _ ❑MDL
,r/c
0 ML
1,2-dichloropropane o MDL
1,3-dichloropropylene ❑ML
❑MDL
Ethylbenzene ❑ML
❑MDL
Methyl bromide ❑ML
❑MDL
0 ML
Methyl chloride ❑MDL
0 ML
Methylene chloride 0 MDL
1,1,2,2-tetrachloroethane ❑ML
❑MDL
0 ML
Tetrachloroethylene ❑MDL
Toluene ❑ML
❑MDL
1,1,1-trichloroethane ❑ML
❑MDL
1,1,2-trichloroethane ❑ML
❑MDL
EPA Form 3510-2A(Revised 3-19) Page 14

EPA Identification Number I NPDES Permit Number Facility Name Outfall Number Modified Application Form 2A
NC0035939 Bethel Colony Women'sCampus Modified March 2021
TABLE C.EFFLUENT PARAMETERS FOR SELECTED POTWS
Maximum Daily Discharge Average Daily Discharge
Pollutant Analytical ML or MDL
Value Units Value Units Number of Method1 (include units)
Samples
0 ML
Trichloroethylene ❑MDL
0 ML
Vinyl chloride ❑MDL
Acid-Extractable Compounds
0 ML
p-chloro-m-cresol ❑MDL
0 ML
2-chlorophenol ❑MDL
0 ML
2,4-dichlorophenol ❑MDL
0 ML
2,4-dimethylphenol22 0 MDL
4,6-dinitro-o-cresol ❑ML
❑MDL
2,4-dinitrophenol 74 0 MDL
0 ML
2-nitrophenol 0 MDL
0 ML
4-nitrophenol ❑MDL
0 ML
Pentachlorophenol 0 MDL
Phenol ❑ML
❑MDL
0 ML
2,4,6-trichlorophenol 0 MDL
Base-Neutral Compounds
0 ML
Acenaphthene ❑MDL
0 ML
Acenaphthylene ❑MDL
Anthracene ❑ML
❑MDL
Benzidine ❑ML
❑MDL
0 ML
Benzo(a)anthracene ❑MDL
0 ML
Benzo(a)pyrene 0 MDL
3,4-benzofluoranthene 0 ML
❑MDL
EPA Form 3510-2A(Revised 3-19) Page 15

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Modified Application Form 2A
Modified March 2021
NC0035939 Bethel Colony Women'sCampus
TABLE C.EFFLUENT PARAMETERS FOR SELECTED POTWS
Maximum Daily Discharge Average Daily Discharge Analytical ML or MDL
Pollutant Number of Methods (include units)
Value Units Value Units Samples
❑ML
Benzo(ghi)perylene ❑MDL
0 ML
Benzo(k)fluoranthene ❑MDL
0 ML
Bis(2-chloroethoxy)methane ❑MDL
0 ML
Bis(2-chloroethyl)ether ❑MDL
0 ML
Bis(2-chloroisopropyl)ether ❑MDL
D ML
Bis(2-ethylhexyl)phthalate ❑MDL
0 ML
4-bromophenyl phenyl ether ❑MDL
Butyl benzyl phthalate '')/ 0 ML
❑MDL
0 ML
2-chloronaphthalene ❑MDL
4-chlorophenyl phenyl ether ❑MDL
❑ML
❑MDL
0 ML
Chrysene
di-n-butyl phthalate ❑MDL
0 ML
di-n-octyl phthalate ❑MDL
0 ML
Dibenzo(a,h)anthracene ❑MDL
1,2-dichlorobenzene ❑ML
❑MDL
1,3-dichlorobenzene ❑ML
❑MDL
1,4-dichlorobenzene ❑ML
❑MDL
3,3-dichlorobenzidine ❑ML
❑MDL
0 ML
Diethyl phthalate ❑MDL
0 ML
Dimethyl phthalate ❑MDL
2,4-dinitrotoluene ❑ML
_ ❑MDL
2,6-dinitrotoluene ❑ML
❑MDL
EPA Form 3510-2A(Revised 3-19) Page 16

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Modified Application Form 2A
NC0035939 Bethel Colony Women'sCampus Modified March 2021
TABLE C.EFFLUENT PARAMETERS FOR SELECTED POTWS
Maximum Daily Discharge Average Daily Discharge Analytical ML or MDL
Pollutant Number of Methods (include units)
Value Units Value Units Samples
❑ML
1,2-diphenylhydrazine ❑MDL
Fluoranthene ❑ML
❑MDL
❑ML
Fluorene El MDL
Hexachlorobenzene ❑ML
----)74
D
Hexachlorobutadiene ❑❑MMLL
❑MDL
CI ML
Hexachlorocyclo-pentadiene El MDL
Hexachloroethane ❑ML
❑MDL
0 ML
Indeno(1,2,3-cd)pyrene ❑MDL
CI ML
Isophorone ❑MDL
CI ML
Naphthalene ❑MDL
Nitrobenzene ❑ML
❑MDL
O ML
N-nitrosodi-n-propylamine ❑MDL
O ML
N-nitrosodimethylamine ❑MDL
CI ML
N-nitrosodiphenylamine ❑MDL
Phenanthrene ❑ML
❑MDL
CI ML
Pyrene ❑MDL
1,2,4-trichlorobenzene ❑ML
❑MDL
1 sampling shall be conducted according to sufficiently sensitive test procedures(i.e., methods)approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR Chapter I,Subchapter N or 0. See instructions and 40 CFR 122.21(e)(3).
EPA Form 3510-2A(Revised 3-19) Page 17

NPDES Permit Number Facility Name Outfall Number Modified Application Form 2A
NC0035939 Bethel Colony Women'sCampus Modified March 2021
TABLE D.ADDITIONAL POLLUTANTS AS REQUIRED BY NPDES PERMITTING AUTHORITY
Pollutant Maximum Daily Discharge Average Daily Dischar a Analytical ML or MDL
(list) Value Units Value Units Number of Methods (include units)
Samples
❑ No additional sampling is required by NPDES permitting authority.
o ML
❑MDL
❑ML
❑MDL
❑ML
❑MDL
❑ML
❑MDL
❑ML
0 MDL
❑ML
❑MDL
❑ML
❑MDL
❑ML
❑MDL
❑ML
❑MDL
❑ML
❑MDL
❑ML
❑MDL
❑ML
❑MDL
❑ML
❑MDL
❑ML
❑MDL
❑ML
❑MDL
❑ML
❑MDL
❑ML
❑MDL
1 Sampling shall be conducted according to sufficiently sensitive test procedures(i.e.,methods)approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or required
under 40 CFR chapter I,subchapter N or 0.See instructions and 40 CFR 122.21(e)(3).
Page 18

Bethel
HATER TECH LABS Inc. EFFLUENT EFFLUENT INFLUENT STREAMS EXIT Colony-
EFFLUENT
!)ate 1►ido a, t esult Auaiy sis Result Analysis + ,,t..t .analysis Result i,.s.:_._, :- ,„_
5/21/2019 BOD <2.0 TSS 9.0 NH3 1.43 Fecal <1
Coliform
Fecal I
6/4/2019 BOD <2.0 TSS 8.6 NH3 1.98 <1
Coliform
6/18/2019 BOD <2.0 TSS 5.8 NH3 1.86 Fecal <1
Coliform
7/2/2019 BOD 25.4 TSS 11.3 NH3 1.48 Fecal <1
Coliform
7/16/2019 BOD 9.2 TSS 11.7 NH3 1.41 Fecal <1
Coliform
8/6/2019 BOD <2.0 TSS 8.0 NH3 4.68 Fecal <1
Coliform
8/20/2019 BOD <2.0 TSS <2.5 NH3 1.94 Fecal <1
Coliform
9/4/2019 BOD <2.0 TSS 5.8 NH3 <0.2 Fecal <1
Coliform
9/17/2019 BOD <2.0 TSS 3.5 NH3 1.91 Fecal <1
Coliform
10/8/2019 BOD 3.9 TSS 6.8 NH3 <0.2 Fecal <1
Coliform
10/22/2019 BOD <2.0 TSS 5.0 NH3 <0.2 Fecal <1
Coliform
11/5/2019 BOD 3.1 TSS 3.93 <0.2 Fecal <1
Coliform

11/19/2019 BOD 12.4 TSS 5.7 NH3 3.70 Fecal 250
Coliform
12/3/2019 BOD <2.0 TSS <2.5 NH3 1.41 Fecal <1
Coliform
12/17/2019 BOD 4.4 TSS <2.5 NH3 3.13 Fecal <1
Coliform
1/7/2020 BOD <2.0 TSS <2.5 NH3 1.95 Fecal <1
Coliform
1/21/2020 BOD 12.1 TSS <2.5 NH3 4.70 Fecal <1
Coliform
2/4/2020 BOD 4.6 TSS <2.5 NH3 <0_2 Fecal <1
Coliform
2/18/2020 BOD 2.8 TSS <2.5 NH3 0.74 Fecal <1
Coliform
3/3/2020 BOD <2.0 TSS <2.5 NH3 <0.2 Fecal <1
Coliform
3/17/2020 BOD <2.0 TSS <2.5 NH3 <0.2 Fecal <1
Coliform
4/7/2020 BOD 5.5 TSS <2.5 NH3 4.08 Fecal <1
Coliform
4/21/2020 BOD 5.4 TSS <2.5 NH3 1.84 Fecal <1
Coliform
5/5/2020 BOD 15.3 TSS 26.7 NH3 1.62 Fecal 330
Coliform
5/19/2020 BOD 2.3 TSS <2.5 NH3 <0.2 Fecal <1
Coliform
6/9/2020 BOD 12.8 TSS <2.5 NH3 <0.2 Fecal <1
Coliform
6/23/2020 BOD 9.5 TSS <2.5 NH3 1.93 Fecal <1
Coliform

7/7/2020 BOD 8.2 TSS <2.5 NH3 <0.2 Fecal <1
Coliform
7/21/2020 BOD 5.1 TSS <2.5 NH3 <0.2 Fecal <1
Coliform
8/4/2020 BOD 4.2 TSS <2.5 NH3 <0.2 Fecal <1
Coliform
8/18/2020 BOD 5.4 TSS <2.5 NH3 0.32 Fecal <1 1
Coliform
8/26/2020 BOD <2.0 TSS <2.5 Fecal <1
Coliform
9/8/2020 BOD 2.7 TSS <2.5 NH3 <0.2 Fecal <1
Coliform
9/22/2020 BOD 10.2 TSS 5.4 NH3 0.95 Fecal <1
Coliform
10/5/2020 BOD 5.6 TSS <2.5 NH3 <0.2 Fecal <1
Coliform
10/20/2020 BOD 8.4 TSS <2.5 NH3 0.47 Fecal <1
Coliform
11/2/2020 BOD 2.5 TSS <2.5 NH3 <0.2 Fecal <1
Coliform
11/16/2020 BOD 4.1 TSS <2.5 NH3 0.57 Fecal <1
Coliform
12/10/2020 BOD 2.6 TSS <2.5 NH3 <0.2 Fecal <1
Coliform
12/29/2020 BOD 14.9 TSS 5.5 NH3 1.25 Fecal <1
Coliform
1/12/2021 BOD 11.3 TSS 12.3 NH3 3.77 Fecal 310
Coliform

1/27/2021 BOD 2.1 TSS <2.5 NH3 3.58 Fecal <1
Coliform
2/11/2021 BOD 18.7 TSS 5.8 NH3 4.87 Fecal <1
Coliform
2/25/2021 BOD <2.0 TSS 4.9 NH3 1.78 Fecal <1
Coliform
3/15/2021 BOD 4.6 TSS 11.7 NH3 <1.0 Fecal <1
Coliform 1
3/29/2021 BOD <2.0 TSS <2.5 NH3 3.89 Fecal <1
Coliform
4/12/2021 BOD <2.0 TSS 12.3 NH3 <1.0 Fecal <1
Coliform
4/26/2021 BOD 5.8 TSS <2.5 NH3 1.68 Fecal <1
Coliform
5/12/2021 BOD 5.3 TSS <2.5 NH3 3.22 Fecal <1
Coliform
5/27/2021 BOD <2.0 TSS <2.5 NH3 <1.0 Fecal <1
Coliform
6/14/2021 BOD <2.0 TSS <2.5 NH3 <1.0 Fecal <1
Coliform
6/28/2021 BOD 5.6 TSS 6.3 NH3 1.35 Fecal <1
Coliform
7/14/2021 BOD 2.1 TSS <2.5 NH3 1.14 Fecal <1
Coliform
7/28/2021 BOD <2.0 TSS <2.5 NH3 <1.0 Fecal <1
Coliform
8/12/2021 BOD 2.7 TSS 3.5 NH3 3.13 Fecal <1
Coliform
8/25/2021 BOD <2.0 TSS <2.5 NH3 2.69 Fecal <1
Coliform

9/15/2021 BOD <2.0 TSS <2.5 NH3 <1.0 Fecal <1
Coliform
9/29/2021 BOD <2.0 TSS <2.5 NH3 <1.0 Fecal <1
Coliform
10/14/2021 BOD 4.8 TSS 5.4 NH3 2.61 Fecal <1
Coliform
10/27/2021 BOD <2.0 TSS <2.5 NH3 <1.0 Fecal <1
Coliform
11/15/2021 BOD <2.0 TSS <2.5 NH3 <1.0 Fecal <1
Coliform
11/29/2021 BOD <2.0 TSS 4.4 NH3 1.88 Fecal <1
Coliform
12/15/2021 BOD <2.0 TSS 5.4 NH3 2.64 Fecal <1
Coliform
12/29/2021 BOD 4.6 TSS <2.5 NH3 <1.0 Fecal <1
Coliform
1/11/2022 BOD <2.0 TSS <2.5 NH3 <1.0 Fecal <1
Coliform
1/26/2022 BOD <2.0 TSS 4.9 NH3 2.37 Fecal <1
Coliform
2/9/2022 BOD 8.7 TSS 4.3 NH3 2.41 Fecal <1
Coliform
2/23/2022 BOD 15.1 TSS 4.4 NH3 3.36 Fecal <1
Coliform
3/15/2022 BOD 3.1 TSS 4.3 NH3 3.24 Fecal <1
Coliform
3/30/2022 BOD <2.0 TSS 4.6 NH3 2.68 Fecal <1
Coliform

4/13/2022 BOD 4.0 TSS 4.4 NH3 2.63 Fecal <1
Coliform
4/27/2022 BOD <2.0 TSS 4.3 NH3 1.87 Fecal <1
Coliform
5/11/2022 BOD <2.0 TSS <2.5 NH3 <1.0 Fecal <1
Coliform
5/25/2022 BOD <2.0 TSS <2.5 NH3 <1.0 Fecal <1
Coliform
6/15/2022 BOD <2.0 TSS <2.5 NH3 <1.0 Fecal <1
Coliform
6/29/2022 BOD <2.0 TSS <2.5 NH3 1.68 Fecal <1
Coliform
7/14/2022 BOD <2.0 TSS <2.5 NH3 1.82 Fecal <1
Coliform
7/28/2022 BOD <2.0 TSS <2.5 NH3 <1.0 Fecal <1
Coliform
8/17/2022 BOD 3.6 TSS <2.5 NH3 1.33 Fecal <1
Coliform
8/30/2022 BOD <2.0 TSS <2.5 NH3 <1.0 Fecal <1
Coliform
9/8/2022 BOD <2.0 TSS <2.5 NH3 <1.0 Fecal 20
Coliform
9/21/2022 BOD <2.0 TSS <2.5 NH3 <1.0 Fecal <1
Coliform
10/6/2022 BOD <2.0 TSS <2.5 NH3 <1.0 Fecal <1
Coliform
10/20/2022 BOD <2.0 TSS <2.5 NH3 <1.0 Fecal <1
Coliform
11/3/2022 BOD 4.8 TSS <2.5 NH3 2.67 Fecal <1
Coliform

11/17/2022 BOD <2.0 TSS <2.5 NH3 <1.0 Fecal <1
Coliform
12/1/2022 BOD <2.0 TSS <2.5 NH3 2.34 Fecal 205
Coliform
12/15/2022 BOD 8.3 TSS 5.0 Fecal 300
Coliform
12/22/2022 Fecal <1
Coliform
1/5/2023 BOD <2.0 TSS <2.5 NH3 2.54 Fecal <1
Coliform
1/19/2023 BOD 14.1 TSS 3.8 Fecal <1
Coliform
2/2/2023 BOD 9.8 TSS 4.0 NH3 4.09 Fecal 250
Coliform
2/16/2023 BOD <2.0 TSS <2.5 Fecal <1
Coliform
3/2/2023 BOD 9.8 TSS 4.8 NH3 3.45 Fecal 260
Coliform
Fecal
3/16/2023 BOD 8.3 TSS 5.4 <1
Coliform
4/6/2023 BOD <2.0 TSS 10.8 NH3 3.58 Fecal <1
Coliform
4/20/2023 BOD <2.0 TSS <2.5 Fecal <1
Coliform
5/4/2023 BOD 10.7 TSS 6.3 NH3 3.34 Fecal <1
Coliform
5/18/2023 BOD <2.0 TSS <2.5 Fecal 130
Coliform

6/8/2023 BOD <2.0 TSS <2.5 NH3 1.74 Fecal <1
Coliform
6/22/2023 BOD 4.9 TSS 9.5 Fecal 21
Coliform