NC0020567_Renewal (Application)_20230714

ROY COOPER
Governor
ELIZABETH S. BISER
Secretary
RICHARD E. ROGERS, JR.
Dire( for
Nicole Johnston, Director Executive
Yadkin Valley Sewer Authority
PO Box 828
Elkin, NC 28621
Subject: Permit Renewal
Application No. NCO020567
Yadkin Valley Sewer Authority WWTP
Surry County
Dear Permittee:
l�
qV �,tk
NORTH CAROLINA
Environmental Quality
July 14, 2023
The Water Quality Permitting Section acknowledges the July 14, 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. 150E-3 your current permit does not expire until permit decision on the application is made.
Continuation of the current permit is contingent on timely and sufficient application for renewal of the current permit. The
permit writer will contact you if additional information is required to complete your permit renewal. Please respond in a
timely manner to requests for additional information necessary to allow a complete review of the application and renewal
of the permit.
Information regarding the status of your renewal application can be found online using the Department of Environmental
Quality's Environmental Application Tracker at:
httl)s•//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.
Sincere) ,
6
Cynthia Demery
Administrative Assistant
Water Quality Permitting Section
ec: WQPS Laserfiche File w/application
North Carolina Derwtmem of Environmental Quaflty DrAslon of Water Resources
Winston Salem Regional Office 1 450 West Hanes MRl Road. Suite 300 ' Winston-Salem. North Carolina 27105
. V 336.776.9800

EXECUTIVE DIRECTOR
Nicole Johnston
SECRETARY
Rheajean Benge
TREASURER
Wayne V. Moore
July 11, 2023
NC DEQ / DWR /NPDES
1617 Mail Service
Center Raleigh, NC
27699-1617
/dk►n
�4
Re: Yadkin Valley Sewer Authority
WWTP NPDES Permit No.
NCO020567
Dear Sirs,
jlut'v�
CHAIR
Woody Faulk
VICE -CHAIR
Anita Darnell
BOARD OF DIRECTORS
Robert Ball
Rheajean Benge
Wayne V. Moore
RECEIVED
ja 1 4 "V,
NCDEQ/DWR/NPDES
Enclosed for your review is an NPDES Permit renewal package for the Yadkin Valley Sewer
Authority Wastewater treatment plant. The application was amended to include the results of
the Priority Pollutant Analysis. Our existing permit expires on January 31, 2024. We are
requesting the Division to renew our NPDES Permit. There are no changes at our facility since
the issuance of the last permit on August 1, 2020.
If you have any questions concerning the information provided, please feel free to give me a
call. Sincerely,
Yadkin Valley Sewer Authority
Nicole Johnston
Executive Director
Cc: Hal Transou
500 NC Hwy 268 W — Elkin, NC 28621
Phone: [phone] — www.yysa.org — Fax: [phone]

EPA Identification Number
NPDES Permit Number
Facility Name
Form Approved 03/05/19
110055992715
NCO020567
YVSA WWTP
OMB No. 2040-0004
Form
U.S. Environmental Protection Agency
2A
�'/EPA
Application for NPDES Permit to Discharge Wastewater
NPDES
NEW AND EXISTING PUBLICLY OWNED TREATMENT WORKS
SECTION•N
INFORMATION FOR i
1.1
Facility name
Yadkin Valley Sewer Authority
Mailing address (street or P.O. box)
500 NC Hwy 268 West
City or town
State
ZIP code
o
Elkin
NC
28621
€
Contact name (first and last)
Title
Phone number
Email address
.�
Nicole Johnston
Executive Director
[phone]
[e-mail]
c
Location address (street, route number, or other specific identifier) ❑ Same as mailing address
A
211 Marion Road
LL
City or town
State
ZIP code
Elkin
NC
28621
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?
❑ Yes ❑✓ No 4 SKIP to Item 1.4.
Applicant name
Applicant address (street or P.O. box)
0
�a
€
City or town
State
ZIP code
w
c
w
Contact name (first and last)
Title
Phone number
Email address
Q
n
a
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.)
❑ Facility and applicant
El Facility ❑✓ 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
w
number for each.
€
Existing Environmental Permits
a
❑ NPDES (discharges to surface
❑ RCRA (hazardous waste)
❑ UIC (underground injection
c
water)
control)
E
NCO020567
❑ PSD (air emissions)
❑ Nonattainment program (CAA)
❑ NESHAPs (CAA)
c
w
rn
Ocean dumping (MPRSA)
❑ Dredge or fill (CWA Section
❑ Other (specify)
w❑
EPA Form 3510-2A (Revised 3-19) Page 1

EPA Identification Number
NPDES Permit Number
Facility Name
Form Approved 03/05/19
110055992715
NCO020567
YVSA WW rP
OMB No. 2040-0004
1.7
Provide the collections stem information
requested below for the treatment works.
Municipality
Population
Collection System Type
Ownership Status
Served
Served
indicate percentage)
Elkin
4060
100 % separate sanitary sewer
El Own El Maintain
Z
%combined storm and sanitary sewer
❑ Own ❑ Maintain
❑ Unknown
❑ Own ❑ Maintain
Ronda
439
100 % separate sanitary sewer
0 Own ❑ Maintain
% combined storm and sanitary sewer
❑ Own ❑ Maintain
0
❑ Unknown
❑ Own ❑ Maintain
0
100 % separate sanitary sewer
0 Own ❑ Maintain
rZ
Jonesville
2314
% combined storm and sanitary sewer
❑ Own ❑ Maintain
❑ Unknown
❑ Own ❑ Maintain
d%
separate sanitary sewer
❑ Own ❑ Maintain
N%
combined storm and sanitary sewer
❑ Own ❑ Maintain
❑ Unknown
❑ Own ❑ Maintain
Total
6813
Population
v
Served
Combined Storm and
Separate Sanitary Sewer System
Sanitary Sewer
Total percentage of each type of
100 %
°
sewer line in miles)��
Z'
1.8
Is the treatment works located in Indian Country?
'
0
ElYes ✓❑ No
1.9
Does the facility discharge to a receiving water that flows through Indian Country?
❑ Yes No
1.10
Provide design and actual flow rates in the designated spaces.
Design Flow Rate
1.8 mgd
w
Annual Average Flow Rates Actual
Two Years Ago
Last Year
This Year
c o
0.873 mgd
0.903 mgd
0.867 Jan - May mgd
""
Maximum Daily Flow Rates Actual
a�
Two Years Ago
Last Year
This Year
1.170 mgd
1.032 mgd
0.956 mgd
1.11
Provide the total number of effluent discharge points to waters of the United States by type.
Total Number of Effluent Discharge Points b T e
dCLConstructed
Combined Sewer
Treated Effluent
Untreated Effluent
Overflows
Bypasses
Emergency
T
n
Overflows
N
0
1
0
0
0
0
EPA Form 3510-2A (Revised 3-19) Page 2

EPA Identification Number
NPDES Permit Number
Facility Name
Form Approved 03/05/19
110055992715
NCO020567
YVSA WWTP
OMB No. 2040-0004
Outfalls 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?
❑ 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 Im oundment Location and Dischar a Data
Average Daily Volume
Continuous or Intermittent
Location
Discharged to Surface
(check one)
Impoundment
❑ Continuous
gpd
❑ Intermittent
❑ Continuous
gpd
❑ Intermittent
❑ Continuous
gpd
❑ Intermittent
0
w
1.14
Is wastewater applied to land?
❑ Yes ❑✓ No 4 SKIP to Item 1.16.
y
1.15
Provide the land application site and discharge data requested below.
y
Land Application Site and Discharge Data
is
o
Average Daily Volume
Continuous or
Location
Size
Applied
Intermittent
check one
acres
gPd
❑ Continuous
0
❑ Intermittent
❑ Continuous
w
acres
gpd d
❑ Intermittent
acres
gpd
❑ Continuous
❑ Intermittent
1.16
Is effluent transported to another facility for treatment prior to discharge?
o
ElYes ❑ 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.
Trans otter 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
EPA Form 3510-2A (Revised 3-19) Page 3

EPA Identification Number
NPDES Permit Number
Facility Name
Form Approved 03/05/19
110055992715
NCO020567
YVSA WWTP
OMB No.2040-0004
1.20
In the table below, indicate the name, address, contact information, NPDES number, and average daily flow rate of the
facility.
-receiving
Rewc*llng F cility Data
Facility name
Mailing address (street or P.O. box)
o
d
3
City or town
State
ZIP code
0
U
Contact name (first and last)
Title
0
a
Phone number
Email address
c
NPDES number of receiving facility (if any) ❑ None
Average daily flow rate mgd
Q
N
0
1.21
Is the wastewater disposed of in a manner other than 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 injection)?
L
❑ Yes ❑✓ No 4 SKIP to Item 1.23.
0
1.22
Provide information in the table below on these other disposal methods.
Information on Other Disposal Methods
o
Disposal
Location of
Size of
Annual Average
Continuous or Intermittent
Method
Disposal Site
Disposal Site
Daily Discharge
(check one)
Description
Volume
❑ Continuous
acres
gpd
❑ Intermittent
❑ Continuous
acres
gpd
❑ Intermittent
❑ Continuous
acres
d
gpd
❑ 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.
N
Consult with your NPDES permitting authority to determine what information needs to be submitted and when.)
d
C y
ElDischarges 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?
1 Yes ❑ 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 1
Contractor 2
Contractor 3
o
Contractor name
Veolia
R
(company name
c
Mailing address
street or P.O. box
PO Box 1279
w
city, state, and ZIP
Clemmons, NC 27012
code
name (first and
c0iCon
last)tact
Jason Costa
Phone number
[phone]
Email address
[e-mail]
Operational and
Provide operation and
maintenance
maintenance of YVSA WWTP.
responsibilities of
contractor
EPA Forth 3510-2A (Revised 3-19) Page 4

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
110055992715 NCO020567 YVSA WWTP OMB No. 2040-0004
SECTIONDD• •' • r
c Outfalls to Waters of the United States
2.1
Does the treatment works have a design flow greater than or equal to 0.1 mgd?
v►
o
✓❑ 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.
0.112 gpd
Indicate the steps the facility is taking to minimize inflow and infiltration.
ca
one sewer improvement project is in progress, another sewer improvement project will start by the end of 2023,
3
0
another is in the design phase and is expected to start before the end of 2024, there are currently two Asset Inventory &
c
Assessment grant projects in progress to identify defective assets that contribute to 1/1
s
2.3
Have you attached a topographic map to this application that contains all the required information? (See instructions for
M Q
specific requirements.)
6 1°
o
0
Yes ❑ No
E
2.4
Have you attached a process flow diagram or schematic to this application that contains all the required information?
2
(See instructions for specific requirements.)
o �
" 0
0 Yes ❑ No
2.5
Are improvements to the facility scheduled?
❑ Yes ✓❑ No 4 SKIP to Section 3.
Briefly list and describe the scheduled improvements.
0
1.
a,
E
a
2.
E
0
0
d
3.
U
4.
N
I
2.6
Provide scheduled or actual dates of completion for improvements.
Scheduled or Actual Dates of Completion for Im rovements
E
E
Scheduled
Affected
Outfalls
Begin
End
Begin
Attainment of
Operational
o
Improvement
l
(list outfnumber)
Construction
Construction
Discharge
Level
E
(from above)
)
(MM/DD/YYYY)
(MM/DD/YYYY)
(MM/DD/YYYY)
MM/DDIYYYY
a
�
s
�
2.
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:
EPA Form 3510-2A (Revised 3-19) Page 5

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
110055992715 NC0020567 YVSA W WTP OMB No. 2040-0004
SECTION• • ON ti I
3.1 Provide the following information for each outfall. (Attach additional sheets if you have more than three outfalls.)
Outfall Number 001
Outfall Number
Outfall Number
State
NC
A
County
5urry
w
0
City or town
Elkin
s
Distance from shore
0 ft.
ft.
ft.
a
L
d
Depth below surface
2 ft.
ft.
ft.
0
Average daily flow rate
0.867 mgd
mgd
mgd
Latitude
34 14 5f'
°
Longitude
80 44 55"
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
a
0
L
discharge occurs
a
Average duration of each
`o
discharge (specify units
oAverage
flow of each
mgd
mgd
mgd
y
discharge
U,
Months in which discharge
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.
3.5
Briefly describe the diffuser type at each applicable outfall.
Outfall Number
Outfall Number
Outfall Number
d
N
7
Does the treatment works discharge or plan to discharge wastewater to waters of the United States from one or more
vi
3 6
discharge points?
w
✓❑ Yes ❑ No +SKIP to Section 6.
EPA Form 3510-2A (Revised 3-19) Page 6

EPA Identification Number
NPDES Permit Number
Facility Name
Form Approved 03/05/19
110055992715
NCO020567
YVSA W WTP
OMB No. 2040-0004
3.7
Provide the receiving water and related information if known for each outfall.
Outfall Number 001
Outfall Number
Outfall Number
Receiving water name
Yadkin River
Name of watershed, river,
c
or stream system
None
U.S. Soil Conservation
L
w
Service 14-digit watershed
None
o
code
L
°=
cc
Name of state
Yadkin Pee Dee
management/river basin
rn
U.S. Geological Survey
8-digit hydrologic
03040101
cataloging unit code
Critical low flow (acute)
204.78 cfs
cfs
cfs
Critical low flow (chronic)
cfs
cfs
cfs
Total hardness at critical
mg/L of
mg/L of
mg1L of
low flow
CaCO3
CaCO3
CaCO3
3.8
Provide the following information
describing the treatment provided for discharges from each outfall.
Outfall Number 001
Outfall Number
Outfall Number
Highest Level of
❑ Primary
❑ Primary
❑ Primary
Treatment (check all that
❑ Equivalent to
❑ Equivalent to
❑ Equivalent to
apply per outfall)
secondary
secondary
secondary
El Secondary
❑ Secondary
❑ Secondary
❑ Advanced
❑ Advanced
❑ Advanced
❑ Other (specify)
❑ Other (specify)
❑ Other (specify)
c
0
o
Design Removal Rates by
Outfall
H
C1
BOD5 or CBOD5
86 %
%
%
c
a,
E
m
TSS
86 %
%
%
IF—
• Not applicable
❑ Not applicable
❑ Not applicable
Phosphorus
o
°
o
• Not applicable
❑ Not applicable
❑ Not applicable
Nitrogen
%
Other (specify)
❑ Not applicable
❑ Not applicable
❑ Not applicable
EPA Form 3510-2A (Revised 3-19) Page 7

EPA Identification Number
NPDES Permit Number
Facility Name
Form Approved 03/05/19
110055992715
NCO020567
YVSA 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 varies by
season, describe below.
c
0
U
Outfall Number 001
OutfallNumber
OutfaUlNumber
0
a
`U
Disinfection type YP
Chlorine, gaseous
a)
m
0
Seasons used
All
d)
E
Dechlorination used?
❑ Not applicable
❑ Not applicable
❑ Not applicable
❑✓ Yes
❑ Yes
❑ Yes
❑ No
❑ No
❑ No
3.1 o
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 ❑ 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
by outfall number or of the receiving water near the discharge points.
-discharges
Outfall Number 001
Outfall Number
Outfall Number
Acute
Chronic
Acute
Chronic
Acute
Chronic
Number of tests of discharge
21
water
Number of tests of receiving
water
3.13
Does the treatment works have a design flow greater than or equal to 0.1 mgd?
Yes ❑ No + SKIP to Item 3.16.
0
3.14
Does the POTW use chlorine for disinfection, use chlorine elsewhere in the treatment process, or otherwise have
g'
reasonable potential to discharge chlorine in its effluent?
C
0 Yes 4 Complete Table B, 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?
w
Yes ❑ 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 NPDES 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).
❑ Yes 4 Complete Tables C, D, and E as ❑ 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?
✓❑ Yes ❑ No
3.18
Have you completed monitoring for all applicable Table D pollutants required by your NPDES permitting authority and
attached the results to this application package?
❑ Yes 0 No additional sampling required by NPDES
permitting authority.
EPA Form 3510-2A (Revised 3-19) Page 8

EPA Identification Number
NPDES Permit Number
Facility Name
Form Approved 03/05/19
110055992715
NCO020567
YVSA 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?
❑ Yes ❑ 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 our NPDES permitting authority and provide a summary of the results.
Date(s) Submitted
Summary of Results
MM/DD/YYYY
See Attachment IV
d
c
0
3.22
Regardless of how you provided your WET testing data to the NPDES permitting authority, did any of the tests result in
p
toxicity?
❑ Yes ❑✓ No 4 SKIP to Item 3.26.
3.23
Describe the cause(s) of the toxicity:
Uj
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 permittinq authority.
4. INDUSTRIAL
DISCHARGES AND
HAZARDOUSSECTION
Does the POTW receive discharges from SIUs or NSCIUs?
4.1
✓❑ Yes ❑ No 4 SKIP to Item 4.7.
y
!
4.2
Indicate the number of SIUs and NSCIUs that discharge to the POTW.
R
Number of SIUs
Number of NSCIUs
to
O
0
1
4.3
Does the POTW have an approved pretreatment program?
✓❑ Yes ❑ No
R
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
application or (2) a pretreatment program?
❑ Yes ❑ No + SKIP to Item 4.6.
0
R
4.5
Identify the title and date of the annual report or pretreatment program referenced in Item 4.4. SKIP to Item 4.7.
2022 Pretreatment Annual Report 2/27/23
4.6
Have you completed and attached Table F to this application package?
❑ Yes ❑ No
EPA Form 3510-2A (Revised 3-19) Page 9

EPA Identification Number
NPDES Permit Number
Facility Name
Form Approved 03/05/19
110055992715
NCO020567
YVSA 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 CFR 261?
❑ Yes ❑ No -* SKIP to Item 4.9.
4.8
If yes, provide the foliowin information:
Annual
Hazardous Waste
Waste Transport Method
Amount of
Units
Number
(check all that apply)
Waste
Received
❑ Truck ❑ Rail
❑ Dedicated pipe ❑ Other (specify)
_
_
0
U
❑ Truck ❑ Rail
❑ Dedicated pipe ❑ Other (specify)
H
7
0
a
N
❑ Truck ❑ Rail
_
❑ Dedicated pipe ❑ Other (specify)
A
U)
N
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?
U)
0
❑ Yes ❑ No 4 SKIP to Section 5.
Z4.10
Does the POTW receive (or expect to receive) less than 15 kilograms per month of non -acute hazardous wastes as
specified in 40 CFR 261.30(d) and 261.33(e)?
❑ Yes 4 SKIP to Section 5. ❑ No
4.11
Have you reported the following information in an attachment 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?
❑ Yes ❑ No
SECTION•
OVERFLOWS (40
Does the treatment works have a combined sewer system?
E
5.1
rn
❑ Yes ❑✓ No 4SKIP to Section 6.
A
5.2
Have you attached a CSO system map to this application? (See instructions for map requirements.)
_
c
❑ Yes ❑ No
A
5.3
Have you attached a CSO system diagram to this application? (See instructions for diagram requirements.)
0
U
❑ Yes ❑ No
EPA Form 3510-2A (Revised 3-19) Page 10

EPA Identification Number
NPDES Permit Number
Facility Name
Form Approved 03/05/19
110055992715
NCO020567
YVSA WWTP
OMB No. 2040-0004
5.4
For each CSO outfall, provide the following information. Attach additional sheets as necessar .
CSO Outfall Number
CSO Outfall Number
CSO Outfall Number
City or town
0
State and ZIP code
U)
W
0
County
A
Latitude
0
o
N
U
Longitude
Distance from shore
ft.
ft.
ft.
Depth below surface
ft.
ft.
ft.
5.5
Did the POTW monitor any of the following items in the past year for its CSO outfalls?
CSO Outfall Number
CSO Outfall Number
CSO Outfall Number
Rainfall
O Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
rn
c
o
.r
CSO flow volume
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
CSO pollutant
❑ Yes ❑ No
O Yes ❑ No
❑ Yes ❑ No
0
concentrations
U)
Receiving water quality
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
CSO frequency
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Number of storm events
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
5.6
Provide the following information for each of your CSO outfalls.
CSO Outfall Number
CSO Outfall Number
CSO Outfall Number
cc
d
r
Number of CSO events in
events
events
events
y
the past year
M
Average duration per
hours
hours
hours
event
❑ Actual or ❑ Estimated
❑ Actual or ❑ Estimated
❑ Actual or ❑ Estimated
d
w'
million gallons
million gallons
million gallons
o
Average volume per event
❑ Actual or ❑ Estimated
❑ Actual or ❑ Estimated
❑ Actual or ❑ Estimated
Minimum rainfall causing
inches of rainfall
inches of rainfall
inches of rainfall
a CSO event in last year
❑ Actual or ❑ Estimated
1 ❑ Actual or ❑ Estimated
1 ❑ Actual or ❑ Estimated
EPA Form 3510-2A (Revised 3-19) Page 11

EPA Identification Number
NPDES Permit Number
Facility Name
Form Approved 03/05/19
110055992715
NCO020567
YVSA W WTP
OMB No. 2040-0004
5.7
Provide the information in the table below for each of your CSO outfalls.
CSO Outfall Number_
CSO Outfall Number_
CSO Outfall Number_
Receiving water name
Name of watershed/
streams stem
U.S. Soil Conservation
❑ Unknown
❑ Unknown
❑ Unknown
Service 14-digit
watershed code
'>
if known
Name of state
management/river basin
U.S. Geological Survey
❑ Unknown
❑ Unknown
❑ Unknown
8-Digit Hydrologic Unit
Code if known
Description of known
water quality impacts on
receiving stream by CSO
(see instructions for
exam les
SECTION 6. CHECKLIST
AND CERTIFICATION STATEMENT (40 CFR 122.22(a) d (d
In Column 1 below, mark the sections of Form 2A that you have completed and are submitting with your application. For
6.1
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
❑ w/ variance request(s) ❑ w/ additional attachments
Information for All Applicants
Section 2: Additional
0 w/ topographic map ❑ w/ process flow diagram
Information
0 w/ additional attachments
0 w/ Table A ❑ w/ Table D
Q Section 3: Information on
❑ w/ Table B 0 w/ Table E
Effluent Discharges
E❑
w/ Table C Elw/ additional attachments
Section 4: Industrial
✓❑ w/ SIU and NSCIU attachments ❑ w/ Table F
❑✓ Discharges and Hazardous
❑
Wastes
w/ additional attachments
ElSection 5: Combined Sewer
Elw/ CSO map Elw/additional attachments
d
Overflows
❑ w/ CSO system diagram
U
o
Section 6: Checklist and
✓❑
❑ w/ attachments
Certification Statement
.r
Y
6.2
Certification Statement
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 (print or type first and last name)
Official title
Nicole Johnston
Executive Director
Signature
_tl _ <�
Date signed
? A
EPA Form 3510-2A (Revised 3-19) Page 12

EPA Identification Number
NPDES Permit Number
Facility Name
Outfall Number
110055992715
NCO020567
YVSA WWTP
001
Form Approved 03/05/19
OMB No. 2040-0004
1:11T2101:1141M
Maximum Daily Discharge
Average Daily Discharge
Analytical
Methods
ML or MDL
(Include units)
Pollutant
Value
Units
Value
Units
Number
Samples
Biochemical oxygen demand
❑o BOD5 or ❑ CBOD5
report one
1.7
mg/I
1.1
mg/I
103
521OB-16
<2.0 mg/I ❑o MDL
Fecal coliform
47.1
#/100 ml
13.7
#/100 ml
103
365
9222D-15
❑ ML
<1 #1101b
❑o MDL
Design flow rate
1.032
MGD
0.903
MGD
pH (minimum)
6.2
SU
pH (maximum)
6.5
5U
Temperature (winter)
17.9
C
14.8
C
120
Temperature (summer)
24.9
C
22
C
140
Total suspended solids (TSS)
6.5
mg/I
3.2
mg/I
103
2540d-15
<2.5 mg/I ❑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).
EPA Form 3510-2A (Revised 3-19) Page 13

This page intentionally left blank.

Number
110055992715
NPUL6 Permit Number
NCO020567
Facility Name
YVSA WWTP
ill Number
001
Form Approved 03/05/19
OMB No. 2040-0004
Average Daily Discharge
Analytical
Methods
ML or MDL
(Include units)
Pollutant
Maximum Daily
Discharge
Value
Units
Value
Units
Number
Samples
Ammonia (as N)
4.69
mg/I
0.66
mg/I
52
350. R2-93
<0.04 m ❑ ML
❑p MDL
Chlorine
total residual, TRC 2
14.8
ug/I
22.9
ug/I
156
2540E
❑ ML
50 ug/I p MDL
Dissolved oxygen
4.4
mg/I
3.4
mg/I
260
4500 OG
VIL
5 mg/I 0 MDL
Nitrate/nitrite
5.32
mg/I
2.34
mg/I
12
353.2 R2-93
1 mg/I 0 MDL
Kjeldahl nitrogen
4.51
mg/I
1.64
mg/I
12
353.2 R2-93
ML
1 mg/I � MDL
Oil and grease
<5
mg/I
<5
mg/I
1
1664B
<5 mg/I ❑O MDL
Phosphorus
0.39
mg/I
0.20
mg/I
12
365.4-74
0.01 mg/I 0 MIL
❑O MDL
Total dissolved solids
140
mg/I
140
mg/I
1
05907
15 mg/I ❑O MDL
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 15

This page intentionally left blank.

EPA Identification Number NPDES Permit Number Facility Name Outfall Number
Form Approved 03/05/19
110055992715 NCO020567 YVSA W WTP
OMB No. 2040-0004
•- •
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
Hardness (as CaCO3)
SEE Attachment III
❑ MDL
Antimony, total recoverable
❑ MDL
Arsenic, total recoverable
❑ ML
❑ MDL
Beryllium, total recoverable
❑ MDL
Cadmium, total recoverable
❑ MIL
❑ MDL
Chromium, total recoverable
❑ ML
❑ MDL
Copper, total recoverable
❑ MDL
Lead, total recoverable
❑ MIL
❑ MDL
Mercury, total recoverable
11 MIL
❑ MDL
Nickel, total recoverable
❑ MIL
❑ MDL
Selenium, total recoverable
❑ MIL
❑ MDL
Silver, total recoverable
❑ ML
❑ MDL
Thallium, total recoverable
❑ ML
❑ MDL
Zinc, total recoverable
❑ MIL
❑ MDL
Cyanide
0 MIL
❑ MDL
Total phenolic compounds
❑ MDL
Volatile Organic Compounds
Acrolein
❑ ML
❑ MDL
Acrylonitrile
❑ MIL
❑ MDL
Benzene
❑ MIL
❑ MDL
Bromoform
❑ MIL
❑ MDL
EPA Form 3510-2A (Revised 3-19) Page 17

EPA Identification Number NPDES Permit Number Facility Name Outfall Number
Form Approved 03/05/19
110055992715 NC0O2O567 YVSA WWTP
OMB No. 2040-0004
•' • • IM
Maximum Daily Discharge Average Daily Discharge
Analytical ML or MDL
Pollutant Number of
Method' (include units)
Value Units Value Units Samples
Carbon tetrachloride
❑ ML
❑ MDL
❑ ML
Chlorobenzene
❑ MDL
❑ ML
Chlorodibromomethane
❑ MDL
❑ MI
Chloroethane
❑ MDL
2-chloroethylvinyl ether
❑ MDL
Chloroform
❑ MMDI
❑ L
Dichlorobromomethane
❑ ML
❑ MDL
❑ ML
1,1-dichloroethane
❑ MDL
1,2-dichloroethane
❑ ML
❑ MDL
trans- 1,2-dichloroethylene
❑ MDL
1,1-dichloroethylene
❑ MDL
1,2-dichloropropane
❑ MDL
1,3-dichloropropylene
0 ML
❑ MDL
Ethylbenzene
❑ ML
❑ MDL
Methyl bromide
❑ MDL
Methyl chloride
❑ MDL
Methylene chloride
❑ MDL
1,1,2,2-tetrachloroethane
El MI
❑ MDL
Tetra chloroethylene
❑ MDL
Toluene
❑ ML
❑ MDL
❑ ML
1,1,1-trichloroethane
❑ MDL
❑ ML
1.1,2-trichloroethane
❑ MDL
EPA Form 3510-2A (Revised 3-19) Page 18

EPA Identification Number NPDES Permit Number Facility Name Outfall Number
Form Approved 03/05/19
110055992715 NC0020567 YVSA W WTP
OMB No. 2040-0004
•' ••
Maximum Daily Discharge Average Daily Discharge
Analytical ML or MDL
Pollutant Number of
Method' (include units)
Value Units Value Units
Samples
Trichloroethylene
El ML
❑ MDL
Vinyl chloride
❑ MDL
Acid -Extractable Compounds
p-chloro-m-cresol
❑ ML
❑ MDL
2-chlorophenol
❑ ML
❑ MDL
2,4-dichlorophenol
❑ MDL
2,4-dimethylphenol
❑ MDL
4,6-dinitro-o-cresol
❑ ML
❑ MDL
2,4-dinitrophenol
❑ ML
❑ MDL
2-nitrophenol
❑ ML
❑ MDL
4-nitrophenol
❑ ML
❑ MDL
Pentachlorophenol
❑ ML
❑ MDL
Phenol
❑ ML
❑ MDL
2,4,6-trichlorophenol
❑ MI
❑ MDL
Base -Neutral Compounds
Acenaphthene
❑ ML
❑ MDL
Acenaphthylene
❑ ML
❑ MDL
Anthracene
❑ ML
❑ MDL
Benzidine
❑ ML
❑ MDL
Benzo(a)anthracene
❑ MDL
Benzo(a)pyrene
❑ NIL
❑ MDL
3,4-benzofluoranthene
❑ ML
❑ MDL
EPA Form 3510-2A (Revised 3-19) Page 19

EPA Identification Number NPDES Permit Number Facility Name Outfall Number
Form Approved 03/05/19
110055992715 NC0O20567 YVSA WWTP
OMB No.2040-0004
Maximum Daily Discharge Average Daily Discharge
Analytical ML or MDL
Pollutant Number of
Method' (include units)
Value Units Value Units Samples
Benzo(ghi)perylene
0 ML
❑ MDL
Benzo(k)fluoranthene
❑ MDL
Bis (2-chloroethoxy) methane
❑ MDL
Bis (2-chloroethyl) ether
11 MIL
❑ MDL
Bis (2-chloroisopropyl) ether
11 MIL
❑ MDL
Bis (2-ethylhexyl) phthalate
❑ MDL
4-bromophenyl phenyl ether
11 MIL
❑ MDL
Butyl benzyl phthalate
0 MIL
❑ MDL
2-chloronaphthalene
❑ MDL
4-chlorophenyl phenyl ether
❑ MDL
Chrysene
0 MIL
❑ MDL
di-n-butyl phthalate
❑ MDL
di-n-octyl phthalate
OML
❑ MDL
Dibenzo(a,h)anthracene
0 MIL
❑ MDL
1,2-dichlorobenzene
❑ ML
❑ MDL
1,3-dichlorobenzene
❑ ML
❑ MDL
1,4-dichlorobenzene
❑ ML
❑ MDL
3,3-dichlorobenzidine
❑ ML
❑ MDL
Diethyl phthalate
❑ MDL
Dimethyl phthalate
❑ MDL
2,4-dinitrotoluene
❑ ML
❑ MDL
2,6-dinitrotoluene
❑ ML
❑ MDL
EPA Form 3510-2A (Revised 3-19) Page 20

EPA Identification Number NPDES Permit Number Facility Name Outfall Number
Form Approved 03/05/19
110OSS992715 NCO020567 YVSA WWTP
OMB No. 2040-0004
E• , NTM
Maximum Daily Discharge Average Daily Discharge
Analytical ML or MDL
Pollutant Number of
Method' (include units)
Value Units Value Units
Samples
1,2-diphenylhydrazine
❑ MDL
Fluoranthene
❑ MIL
❑ MDL
Fluorene
❑ ML
❑ MDL
Hexachlorobenzene
❑ ML
❑ MDL
Hexachlorobutadiene
❑ ML
❑ MDL
Hexachlorocyclo-pentadiene
❑ MDL
Hexachloroethane
❑ MIL
❑ MDL
Indeno(1,2,3-cd)pyrene
0 MIL
❑ MDL
Isophorone
❑ MIL
❑ MDL
Naphthalene
11 MIL
❑ MDL
Nitrobenzene
❑ MIL
❑ MDL
N-nitrosodi-n-propylamine
❑ MDL
N-nitrosodimethylamine
DMIL
❑ MDL
N-nitrosodiphenylamine
❑ ML
❑ MDL
Phenanthrene
❑ MIL
❑ MDL
Pyrene
0 MIL
❑ MDL
1,2,4-trichlorobenzene
❑ MIL
❑ MDL
.,amnlinn shall ha cnnducted accnrdino to suffiriently sensitive test procedures
(i.e.. methods) aooroved under 40 CFR 136 for the analvsis of oollutants
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 21

This page intentionally left blank.

EPA Identification Number NPDES Permit Number Facility Name Outfall Number
Form Approved 03/05/19
110055992715 NCOO20567 YVSA W WTP
OMB No. 2040-0004
Maximum Daily Discharge Average Dail Discharge
Pollutant
Analytical ML or MDL
y
Number of
(list) Value Units Value Units
Method' (include units)
Samples
❑✓ No additional sampling is required by NPDES permitting authority.
❑ ML
❑ 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
❑ 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).
EPA Form 3510-2A (Revised 3-19) Page 23

This page intentionally left blank.

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
110055992715 NC0020567 YVSA WWTP OMB No. 2040-0004
TABLE E. EFFLUENT MONITORING FOR WHOLE EFFLUENT TOXICITY
The table provides response space for one whole effluent toxicity sample. Copy the table to report additional test results.
Test Information
Test Number
Test Number
Test Number
Test species
See Attachment IV
Age at initiation of test
Outfall number
Date sample collected
Date test started
Duration
Toxicity Test Methods
Test method number
Manual title
Edition number and year of publication
Page number(s)
Sample Type
Check one:
❑ Grab
❑ 24-hour composite
❑ Grab
❑ 24-hour composite
❑ Grab
❑ 24-hour composite
Sample Location
Check one:
❑ Before Disinfection
❑ After Disinfection
❑ After Dechlorination
❑ Before Disinfection
❑ After Disinfection
❑ After Dechlorination
❑ Before disinfection
❑ After disinfection
❑ After dechlorination
Point in Treatment Process
Describe the point in the treatment process
at which the sample was collected for each
test.
Toxicity Type
Indicate for each test whether the test was
performed to asses acute or chronic toxicity,
Or both. (Check one response.)
❑ Acute
El Chronic
❑ Both
❑ Acute
❑Chronic
El Both
❑ Acute
El Chronic
El Both
EPA Form 3510-2A (Revised 3-19) Page 25

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
110055992715 NCO020567 YVSA WWTP OMB No. 2040-0004
TABLE E. EFFLUENT MONITORING FOR WHOLE EFFLUENT TOXICITY
e table provides response space for one whole effluent toxicity sample. Copy the table to report additional test results.
Test Number
i
Test Number
Test Number
Test Type
Indicate the type of test performed. (Check one
response.)
❑ Static
❑ Static -renewal
❑ Flow -through
❑ Static
❑ Static -renewal
❑ Flow -through
❑ Static
❑ Static -renewal
❑ Flow -through
Source of Dilution Water
Indicate the source of dilution water. (Check
one response.)
❑ Laboratory water
❑ Receiving water
❑ Laboratory water
❑ Receiving water
❑ Laboratory water
❑ Receiving water
If laboratory water, specify type.
If receiving water, specify source.
Type of Dilution Water
Indicate the type of dilution water. If salt
water, specify "natural' or type of artificial
sea salts or brine used.
❑ Freshwater
❑ Salt water (specify)
)
❑ Fresh water
Salt water (specify)
❑ Freshwater
❑ Salt water (specify)
Percentage Effluent Used
Specify the percentage effluent used for all
n the test series.
W
Parameters Tested
Check the parameters tested.
❑ pH
❑ Salinity
❑ Temperature
❑ Ammonia
❑ Dissolved oxygen
❑ pH
❑ Salinity
❑ Temperature
❑ Ammonia
❑ Dissolved oxygen
❑ pH
❑ Salinity
❑ Temperature
❑ Ammonia
❑ Dissolved oxygen
Acute Test Results
Percent survival in 100% effluent
%
LC50
95% confidence interval
%
%
%
Control percent survival
%
%
%
EPA Form 3510-2A (Revised 3-19) Page 26

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
110055992715 NCO020567 YVSA WWTP OMB No. 2040-0004
TABLE E. EFFLUENT MONITORING FOR WHOLE EFFLUENT TOXICITY
e table provides response space for one whole effluent toxicity sample. Copy the table to report additional test results.
Test Number
i
Test Number
Test Number
Acute Test Results Continued
Other (describe)
Chronic Test Results
NOEC
%
%
%
IC25
%
%
%
Control percent survival
%
%
%
Other (describe)
Quality Control/Quality Assurance
Is reference toxicant data available?
❑ Yes
❑ No
❑ Yes
ElNo
ElYes
ElNo
Was reference toxicant test within
acceptable bounds?
❑Yes
❑ No
❑Yes
El No
❑Yes
El
What date was reference toxicant test run
(MM/DD/YYYY)?
Other (describe)
EPA Form 3510-2A (Revised 3-19) Page 27

This page intentionally left blank.

EPA Identification Number
NPDES Permit Number Facility Name Form Approved 03/05/19
110055992715
NCO020567 YVSA WWTP OMB No. 2040-0004
TABLE F. INDUSTRIAL DISCHAKUL IWORMATION
Response space is provided for three SIUs. Copy the table to report information for additional SIUs.
SIU _
SIU _
SIU
Name of SIU
Mailing address (street or P.O. box)
City, state, and ZIP code
Description of all industrial processes that affect
or contribute to the discharge.
List the principal products and raw materials that
affect or contribute to the SIU's discharge.
Indicate the average daily volume of wastewater
discharged by the SIU.
gpd
gpd
gpd
How much of the average daily volume is
attributable to process flow?
gpd
gpd
gpd
How much of the average daily volume is
attributable to non -process flow?
gpd
gpd
gpd
Is the SIU subject to local limits?
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Is the SIU subject to categorical standards?
❑ Yes ❑ No
El Yes ❑ No
❑ Yes ❑ No
EPA Form 3510-2A (Revised 3-19) Page 29

EPA Identification Number
NPDES Permit Number Facility Name Form Approved 03/05/19
110055992715
NCO020567 YVSA W WTP OMB No. 2040-0004
TABLE F. INDUSTRIAL DISCHAKUt IWORMATION
Response space is provided for three SIUs. Copy the table to report information for additional SIUs.
Slu _
SIU _
SIU
Under what categories and subcategories is the
SIU subject?
Has the POTW experienced problems (e.g.,
upsets, pass -through interferences) in the past 4.5
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
ears that are attributable to the SIU?
If yes, describe.
EPA Form 3510-2A (Revised 3-19) Page 30

EPA Identification Number
NPDES Number
Facility Name
Outfall Number
1.10056E+11
NC0020567
YVSA WWTP
1
Pollutant (Required)
Method Number (if
CAS number I Applicable)
Reason Pollutant Believed Present in Discharge
Estimated Concentration {If
Known)
No pollutants were monitored that was not reported on the DMRs
Signed by:
Signature
Nicole Johnston
Printed Name
Date

ATTACHMENT I
Topographic Map

Latitude: 36214'51"
Longitude: 80449'S5"
Quad # C15NE
Receivirig Stream: Yadkin River
„ Class: C
jbasin: 30702
NCO020567
Yadkin Valley Sewer
Auth WWTP
Facility
Location
North SCALE 1.24000

Annual Monitoring and Pollutant Scan
Permit No. NCO020567 Month March
o,,tfall nn1 Year 2023
Parameter
Sample
Type
Analytical
Method
Quantitation
Level
Sample
Result
Units of
Measurement
Number of
samples
Volatile organic compounds (Cont.)
1, 1 -dichloroethylene
Grab
624
5
<5
ug/1
1
1,2-dichloropropane
Grab
624
5
<5
ug/1
1
1,3-dichloropropylene
Grab
624
5
<5
ug/1
1
Ethylbenzene
Grab
624
5
<5
ug/ 1
1
Methyl bromide
Grab
624
10
<10
ug/ 1
1
Methyl chloride
Grab
624
10
<10
ug/1
1
Methylene chloride
Grab
624
10
<10
ug/1
1
1,1,2,2-tetrachloroethane
Grab
624
5
<5
ug/1
1
Tetrachloroethylene
Grab
624
5
<5
ug/1
l
Toluene
Grab
624
5
<5
ug/1
I
1,1, l -trichloroethane
Grab
624
5
<5
ug/ 1
1
1,1,2-trichloroethane
('grab
624
5
<5
ug/1
1
Trichloroethylene
Grab
624
5
<5
ug/1
1
Vinyl chloride
Grab
624
10
<10
ug/1
1
Acid -extractable compounds
P-chloro-m-creso
Grab
625
5
<5
ug/1
1
2-chlorophenol
Grab
625
10
<10
ug/1
1
2,4-dichlorophenol
Grab
625
10
<10
ug/1
1
2,4-dimethylphenol
Grab
625
10
<10
ug/1
1
4,6-dinitro-o-cresol
Grab
625
10
<10
ug/1
1
2,4-dinitrophenol
Grab
625
50
<50
ug/1
1
2-nitrophenol
Grab
625
10
<10
ug/1
1
4-nitrophenol
Grab
625
50
<50
ug/1
1
Pentachlorophenol
Grab
625
50
<50
ug/1
1
Phenol
Grab
625
10
<10
ug/1
1
2,4,6-trichlorophenol
Grab
625
10
<10
ug/1
1
Base -neutral compounds
Acenaphthene
Grab
625
10
<10
ug/1
1
Acenaphthylene
Grab
625
10
<10
ug/1
1
Anthracene
Grab
625
10
<10
ug/1
1
Benzidine
Grab
625
100
<100
ug/1
1
Benzo(a)anthracene
Grab
625
10
<10
ug/1
1
Benzo(a)pyrenc
Grab
625
10
<10
ug/1
1
3,4 benzofluoranthene
Grab
625
10
<10
ug/1
1
Benzo(ghi)perylene
Grab
625
10
<10
ug/1
1
Benzo(k)fluoranthene
Grab
625
10
<10
ug/1
1
Bis (2-chloroethoxy) methane
Grab
625
10
<10
ug/1
1
Bis (2-chloroethyl) ether
Grab
625
10
<10
ug/1
1
Bis (2-chloroisopropyl) ether
Grab
625
10
<10
ug/1
1
Bis (2-ethylhexyl) phthalate
Grab
625
20
91.1
ug/1
1
4-bromophenyl phenyl ether
Grab
625
10
<10
ug/1
1
Butyl benzyl phthalate
Grab
625
10
<10
ug/i
1
2-chloronaphthalene
Grab
625
10
<10
ug/1
1
Form - DMR- PPA-1 Page 2

Annual Monitoring and Pollutant Scan
Permit No. NC0020567 Month March
Outfall 001 Year 2023
4-chlorophenyl phenyl ether
Grab
625
10
<10
ug/1
1
Parameter
Sample
Type
Analytical
Method
Quantitation
Level
Sample
Result
Units of
Measurement
Number of
samples
Base -neutral compounds (cont.)
Chrysene
Grab
625
10
<10
ug/1
1
Di-n-butyl phthalate
Grab
625
10
<10
ug/I
1
Di-n-octyl phthalate
Grab
625
10
<10
ug/l
1
Dibenzo(a,h)anthracene
Grab
625
10
<10
ug/l
1
1,2-dichlorobenzene
Grab
625
10
<10
ug/1
1
1,3-dichlorobenzene
Grab
625
10
<10
ug/l
1
1,4-dichlorobenzene
Grab
625
10
<10
ug/1
1
3,3-dichlorobenzidine
Grab
625
10
<10
ug/l
1
Diethyl phthalate
Grab
625
10
<10
ug/l
1
Dimethyl phthalate
Grab
625
10
<10
ug/1
1
2,4-dinitrotoluene
Grab
625
10
<10
ug/l
1
2,6-dinitrotoluene
Grab
625
10
<10
ug/l
1
1,2-diphenythydrazine
Grab
625
10
<10
ug/1
i
Fluoranthene
Grab
625
10
<10
ug/l
1
Fluorene
Grab
625
10
<10
ug/1
1
Hexachlorobenzene
Grab
625
10
<10
ug/1
1
Hexachlorobutadiene
Grab
625
10
<10
ug/l
1
Hexachlorocyclo-pentadiene
Grab
625
10
<10
ug/1
1
Hexachloroethane
Grab
625
10
<10
ug/1
1
Indeno(1,2,3-cd)pyrene
Grab
625
10
<10
ug/1
1
Isophorone
Grab
625
10
<10
ug/l
1
Naphthalene
Grab
625
10
<10
ug/1
1
Nitrobenzene
Grab
625
10
<10
ug/l
1
N-nitrosodi-n-propylamine
Grab
625
10
<10
ug/1
1
N-nitrosodimethylamine
Grab
625
10
<10
ug/l
1
N-nitrosodiphenylamine
Grab
625
10
<10
ug/1
1
Phenanthrene
Grab
625
10
<10
ug/1
1
Pyrene
Grab
625
10
<10
ug/l
1
1,2,4,-tichlorobenzene
Grab
625
10
<10
ug/I
1
Please note DO Result was on June 3, 2021
I certify under penalty of law that this document and all attachments were prepared under my direction
and supervision in accordance with a system to design to assure that qualified perdonnel properly
gather and evaluat the information submitted. Based on my inquiry of the person or persons that
manage the system, or those persons directly responsibel 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.
Lisa Morris
Authorized Representative name
Signature
Form - DMR- PPA-1 Page 3

WaypAoint0
NALYTICAL
SUEZ WATER (YVSA WWTP-PP)
NADINE BLACKWELL
P.O. BOX 1279
CLEMMONS, NC 27012
Effluent
PARAMETERS
Analysis Method
Date Analyst Code
Ammonia Nitrogen as N, mg/I
0.04
03/09/23
TRJ
350.1 R2-93
Total KJeldahl Nitrogen as N,mg/l
1.54
03/10/23
TRJ
351.2 R2-93
Nitrate+Nitrite as N, mg/I
1.26
03/08/23
AMC
353.2 R2-93
Total Phosphorus as P, mg/i
0.12
03/09/23
BMD
365.4-74
Oil & Grease (HEM), mg/1
<5.0
03/08/23
KJH
1664B
enol, ug/l
TESTED
iota] Cyanide, mg/l
< 0.005
03/20/23
HMM
450OCNE-16
Total Hardness, mg/l
28
03/13/23
JDJ
2340C-11
Total Dissolved Residue, mg/l
140
03/07/23
ADR
D5907-13
Antimony, ug/l
<3.0
03/31/23
HMM
EPA200.8
Arsenic, ug/1
<2.0
03/09/23
DRC
3113B-10
Beryllium, ug/l
< 1.0
03/07/23
MTM
EPA200.7
Cadmium, ug/l
<0.5
03/07/23
DRC
3113B-10
Total Chromium, ug/1
<5.0
03/07/23
MTM
EPA200.7
Copper, ug/l
4
03/07/23
MTM
EPA200.7
Lead, ug/i
<2.0
03/08/23
DRC
3113B-10
Nickel, ug/l
<5.0
03/07/23
MTM
EPA200.7
Selenium, ug/I
< 1.0
03/31/23
HMM
EPA200.8
Silver, ug/l
< 1.0
03/07/23
MTM
EPA200.7
Thallium, ug/l
< 1.0
03/31/23
HMM
EPA200.8
Zinc, ug/1
40
03/07/23
MTM
EPA200.7
Drinking Water ID: 37715
ID#: 972
DATE COLLECTED: 03/06/23
DATE REPORTED : 04/07/23
REVIEWED BY: --
NOTE: Any result listed above as "TESTED" was sub -contracted to another laboratory. The corresponding results are attached.

Waypoi nt
0
ANALYTICAL Drinking Water ID; 37715
114 OAKMONT DRIVt*
GREENVILLE, N.C. 27858
CLIENT: SUEZ WATER (YVSA WWTP-PP)
NADINE BLACKWELL
P.O. BOX 1279
CLEMONS, NC 27012
REVIEWED BY:
VOLATILE ORGANICS
EPA METHOD 624.1
FAX [phone]
CLIENT ID: 972
ANALYST: JAP
DATE COLLECTED: 03/06/23
DATE ANALYZED: 03/07/23
DATE REPORTED: 04/07/23
PARAMETERS, ug/l
Effluent
1.
Chloromethane
< 10.00
2.
Vinyl Chloride
< 10.00
3.
Bromomethane
< 10.00
4.
Chloroethane
< 10.00
5.
Trichlorofluoromethane
< 5.00
6.
l,l-Dichloroethane
< 5.00
7.
Methylene Chloride
< 10.00
8.
trans-1,2-Dichloroethene
<5.00
9.
1,1-Dichloroethene
< 5.00
10.
Chloroform
9.93
< 5.00
11.
1,1,1-Trichloroethane
< 5.00
12,
Carbon Tetrachloride
13.
Benzene
< 5.00
< 5.00
14.
1,2-Dichloroethane
< 5.00
15.
Trichloroethene
< 5.00
16.
1,2-Dichloropropane
<5.00
17.
Bromodichloromethane
18.
2-Chloroethylvinyl Ether
< 5.00
19.
cis-1,3-Dichloropropene
<5.00
< 5.00
20.
Toluene
<5.00
21.
trans-1,3-Dichloropropene
< 5.00
22.
1,1,2-Trichloroethane
< 5.00
23.
Tetrachloroethene
<5.00
24.
Dibromochloromethane
<5.00
25.
Chlorobenzene
< 5.00
26.
Ethylbenzene
<5.00
27.
28.
Bromoform
1,1,2,2-Tetrachloroethane
< 5.00
29.
1,3-Dichlorobenzene
< 5.00
< 5.00
30.
1,4-Dichlorobenzene
< 5.00
31.
1,2-Dichlorobenzene
< 50.00
32.
Acrolein
< 50.00
33.
Acrylonitrile

WaypAoin.NALYTICAL 0 Drinking Water IDS 37715
114 OAKMONT UHIVt
GREENVILLE, N.C. 27858
CLIENT: SUEZ WATER (YVSA WWTP-PP)
NADINE BLACKWELL
P.O. BOX 1279
CLEMMONS, NC 27012
REVIEWED BY:\
SEMIVOLATILE ORGANICS
EPA METHOD 625.1
CLIENT ID: 972
ANALYST: HIC
DATE COLLECTED: 03/06/23
DATE EXTRACTED: 03/13/23
DATE ANALYZED: 03/20/23
DATE REPORTED: 04/07/23
PARAMETERS, ug/1
Effluent
1.
N-Nitrosodimethylamine
< 10.00
2.
3.
Phenol
Bis(2-Chloroethyl) Ether
< 10.00
< 10.00
4.
2-Chlorophenol
< 10.00
< 10.00
5.
1,3-Dichlorobenzene
< 10.00
6.
1,4-Dichlorobenzene
<10.00
7.
8.
1,2-Dichlorobenzene
Bis(2-Chloro-l-methylethyl) Ether
< 10.00
9.
Hexachloroethane
10.00
< 10.00
10.
N-Nitroso-Di-N-Propylamine
11.
Nitrobenzene
< 10.00
< 10.00
12.
13.
lsophorone
2-Nitrophenol
<10.00
14.
2,4-Ditnethylphenol
< 10.00
15.
Bis(2-Chloroethoxy) Methane
< 10.00
16.
2,4-Dichlorophenol
< 10.00
17.
1,2,4-Trichlorobenzene
< 10.00
18.
Naphthalene
< 10.00
< 1010
19.
Hexachlorobutadiene
.00
< 00
20.00
20.
4-Chloro -3-Methylphenol
<
21.
Hexachlorocyclopentadiene
< 10.00
22.
2,4,6-Trichlorophenol
< 10.00
23.
2-Chloronaphthalene
< 10.00
24.
Acenaphthylene
< 10.00
25.
Dimethylphthalate
< 10.00
26.
2,6-Dinitrotoluene
< 0.00
10.00
27.
28.
Acenaphthene
2,4-Dinitrophenol
<
29.
4-Nitrophenol
0.00
< < 50.00
30.
2,4-Dinitrotoluene
< 10.00
31.
32.
Fluorene
Diethylphthalate
< 10.00
33.
4-Chlorophenyl Phenyl Ether
< 0.00
10.00
34.
4,6-Dinitro-2-Methylphenol
<
35.
N-Nitrosodiphenylamine
< 10.00
36.
4-Bromophenyl Phenyl Ether
< 10.00
37.
Hexachlorobenzene
0.00
< <10.00
38.
Pentachlorophenol
< 10.00
39.
Phenanthrene
< 10.00
40.
41.
Anthracene
Di-N-Butylphthalate
< 10.00
42.
Fluoranthene
0.00
< < 110.00
43.
Beuzidine
< 10.00
44.
45.
Pyrene
Butylbmzylpphthlate
< 10.00
46.
Benzo[a)anthracene
<10.00
47.
3,3'-Dichlorobenzidine
< 10.00
48.
Chrysene
Page: 1

WayPo�nt.ANALYTICAL Drinking Water ID_ 37715
114 OAKMONI UHIVt
GREENVILLE, N.C. 27858
CLIENT: SUEZ WATER (YVSA WWTP-PP)
NADINE BLACKWELL
P.O. BOX 1279
CLEMMONS, NC 27012
REVIEWED BY:
SEMIVOLATILE ORGANICS
EPA METHOD 625.1
WNE [phone]
FAX [phone]
CLIENT ID: 972
ANALYST: HIC
DATE COLLECTED: 03/06/23 Page: 2
DATE EXTRACTED: 03/13/23
DATE ANALYZED: 03/20/23
DATE REPORTED: 04/07/23
PARAMETERS, ug/I
Effluent
49.
Bis(2-Ethylhexyl)phthalate
91.10
50.
Di-N-Octylphthalate
< 10.00
51.
Benzo[blfluoranthene
< 10.00
52.
Benzo[k)nuoranthene
< 10.00
53.
Benzo[alpyrene
< 10.00
< 10.00
54.
Indeno(1,2,3-C,d)pyrene
55.
Dibenzo[a Manthracene
< 10.00
56.
Benzo[g,h,ilperylene
< 10.00
57.
1,2-Diphenylliydrazine
< 10.00

1:n.ir�uuncnt 1, Inc. CHAIN OF CUSTODY RECORD
I
1'(1 ,� ,(11"5 1 14()aknnul[ Page of
col\ IC.NC—
cia DISINFECTION {� 1 CHLORINE NEUTRALIZED AT COLLECTION
'S6 020l 'S'') 75o tv,�.;
972 Week:37 �CHI,ORINF
pH CHECK (LAB)
l"v
;UEZ WATER (YVSA WWTP-PP) P P P P G G P P P P P P G G CONTAINER TYPE,P/G
1ADINE BLACKWELL ❑ NONF
'.O. BOX 1279
;LEMMONS NC 27012 C C C C C C D C A A A A A CHEMICAL PRESERVATION
Z Cf) A - NONE D -NAOH
336 i-0270 v v cn ° a °: C B - HNO, E - HCL
z w w Z w z - o v v
z c a+
p O a :9 + a, y Qa v p s, C - H,SO, F ZINC ACETATE /NA(.
= U h- W o :; O o ..yam 7 7 w
COLLECTION C c Uj 0 E z .�L, a m 3 d 03 O ¢ G- NATHIOSULFATE
SAMPLE LOCATION DATE I IME ¢ o ELL
Ex» Z Fr a .�� d o
^fin^
t / 0 14 `v? '<" CLASSIFICATION:
�;
WASTEWATER (NPDES)
DR4NKING WATER
DWR/GW
SOLID WASTE SECTION
CHAIN OF CUSTODY (SEAL) IVIAINIAIN
DURING SHIPMENT/DELIVERY
N
SAMPLES COLLECTED BY:
(Please Print)P�_'T�111 S�
ISHEO BY IG.! (SAMPLER)DATErf1ME RECEIVED BY (SIG.)
NOU1SHEAY (SIG.) DATElnME RECE
INQUISHED BY (SIG.) DATEPIWE IVE B )
PLEASE READ Instructions for completing this `orm on the reverse side.
SAMPLES RECEIVFD IN LAB AT _`J. 0_
DATE/TIME COMMENTS / . t J 1
�t1?.3 1a3s— � 3
7 i jD TFJ7IME
DATUTIME
I
Sampler must place a "C" for composite sample or a "G" for
Grab sample in the blocks above for each parameter requested.

aceAnalytical
www.pecalabs.csm
I
Laboratory Report
Mark Oliveira
Waypoint Analytical
114 Oakmont Dr
Greenville, NC 27858
Project: YVSAVWVfP
Pace Project No.: 92655963
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersvilie, NC 28078
[phone]
Page 1 of 1
Report Date: 03/14/2023
Date Received: 03/09/2023
Sample: Effluent Lab to: 92656963001 Collected: 03/06/23 08:00 Matrix: Water
Method Parameters Results Units Report Limit Analyzed Qualifiers
EPA 420.4 Rev 1.0 1993 Phenolics, Total Recoverable ND mg/L 0.020 03/14/23 11:23
Reviewed by:
Stephanie Knott
704-977-0981
[e-mail]
Pace Analytical Services Asheville
2225 Riverside Drive, Asheville, NC 28804
Florida/NELAP Certification #: E87848
North Carolina Drinking Water Certification #: 37712
North Carolina Wastewater Certification #: 40
South Carolina Laboratory ID: 99030
South Carolina Certification #: 99030001
VirginlaNELAP Certification #: 460222
Page 1 of 5

WO# : 92655963
�"A'"��is�°�' A ''�` '1111111111111111111111
S.cto A s.Cam E s.etlmc
926963
R.,i+'.+ trr waw.rwc n.P&.a vrq.et arata..az irac. kra�.MwR
v
I r.
'
E 4i
PrAlln_�C•3J��■
n■■■■■■■■■■�■■■■
���■�
�■■���■��
_ -
■■■■■■■■■■a
n■■�■�■■■■■■n■■
■■■■■■■■E■O■
,::
MEMEMERNMEME
:_-
��■■■■■■■■■■■■
■■■■■■■i■■
■
r,
■��■■■■■■■■■■■■
■1■■M■■■■■n
��■��■■■■■�■■■■
M■■■E■■■■■t■
�■■■■■■■■®■n
■
■■n■■■■■■m
��
■■■■■■■■■■■
■■■■■■■E■■t■
.:
�■■■ME■■■■■EMENEWEEN
■■■�v■■■■■■
ME
Is
,: -_-- - —_ ^•i7 - s...;:.: 1- ;!
2 WA
-*
-_-
a:, »=arse_,=_r,:.�'
-Jl�.-ur_-.a-
4:Ja~T=4 ..
m_-_
Ir
N
O

w
0
Envirorinwnt 1, Inc.
P D. Sox 7085. 114 Onkmo:it Dr.
Greenville. NC 27858
environme lc.conl
Phase [phone] • Fax [phone]
972 Week.37
CLIENT:
SUEZ WATER OVSA WWII? -PP)
NAD M. BLACKWELL
P.O. BOX 1279
CLEM-MONS INC 27012
(336) 7664270
CHAIN OF CUSTODY RECORD
AA-V I
Page 1 of
333132
Bonanzas
ON
NOkE . NAGH
HND� E HCL
.
NADfOWATE
f
k
F
`G
t8
ACHAIN
Of CUSTOOY (SEAL) MANTAINED
I■■■■..■.■■.�..■■■�■
�.:MrAWAR
IM
PLEASE READ Instructions for complefing th a form on the reverse side.
FORM 05
sampfe> must place a "C" for composite sample or a'G" for
Grab sample in the Works above for each parameter requested

aC.B' f7C# Tltle: ENV-FRM•HUN1-0083 v01 Sample Condition Upon Receipt
.»resa.sa -
I ERacttve Date: 06112/2022
Laboratory receiving samples: 1
Asheville ❑ Eden❑ GreenwoodEl Huntersville ❑ Ra(eighl�J Mechanicsville[] Atlanta❑ Kemersvllle❑
Client Name:
Project k:
Courier. EJFed Cx UUPS L1 USPS lent
❑ Commercial ❑Pace ,� f/ ❑Other:
Custody Seat Present) ElYes �JfeO Seats Intact? ❑Yes►o
Date/Initials Person Dtamining Contents:
PackingMaterlak ❑DubbleWrap ❑Bubble Bags Vune ❑ Other Biological Tissue Fabian?
Thermometer: �TaOS
❑ IR Gun ID:
Type o! Ice: Wet O Blue
Correction Factor:
Coder Tern pc �' Add/Subtract ('CJ Q
Cooler Tamp Corrected ('
USDA Regulated Soll ( N/A, water samples
Did samples orllIna In a 10arantine tone within the United States: CA, NY, or SC
rrh.,k m ..e1D r7..
❑Yes ONO L/N/A
❑None
Tamp should be above freezing to eC
0samplesttu otertrpernerrxSamplacloue,tdoniVprocess
has begun
Oldamplas originate from a foreign source (intern navy,
1.
Chain of G to wont? sCIM :1 WA
Samples Arrlved'wlihln Hold Time?
a
No
bi A
2.
Short Hold Time Anatysla <72 hr.)?
OYes
A
OWA
3.
Rush Turn Around Time Requested?
Mel
A
4.
SuNklent Volume?
94
Do
0 WA
S.
Correct Containers Used?
-face ContainersUsed?
ffl
as
ONo
ON-
QWA
O WA
6.
Containerslntact) _
Yu
ONo
❑WA
7.
Dissolved ana sis:Samples Field Filtared7
OYe
13No
JfWA
9.
amp • Labeft atc
includes Date/Time/ID/Anslsis Matrix:
Yu
ONO
OWA
9.
Haads acelnVOAVials 3-5{mm?
OYas
OND
A
10.
Trip Blank Present?
Trip Blank Custody Seals Present?
OYes
Oyes
ONo
Ow
ADNIA
U16
11.
COMMENTS/SAMPLE
Fteld Data Required? U Yes Je7tto
Lot ID of spit t contalners:
CLIENT NOTIFICA RE30LU110N '
Person contacted:
ProJect ManagerSCURF Review:
Project Manager SRF Review:
rh..It v irl•rog14
Oate/Tlme:
Data:
Oats:
Page 4 of 5

J
Ln
0
a
D
a
i
x
0
0
e
4
s
=
D
Q
o
C
3
x
r
o
00
�
O
1
4
m
ri
Q
v
c .
�3�
q i
Vl
3
Ci
a
z
s
p
Uffm
MENEMEMENEW
Ing
ONEEMEMENEW
■■■-■■■■M■■'
, _ ..
� A
a
I
w
J

ATTACHMENT II
Plant Schematic

ATTACHMENT II
NPDES PERMIT RENEWAL
YADKIN VALLEY SEWER AUTHORITY WWTP
The Yadkin Valley Sewer WWTP is a 1.8 MGD design capacity activated sludge wastewater
treatment plant. The unit processes in the liquid train include preliminary treatment, optional
pH adjustment, oxidation ditches, secondary clarification, chlorination, and dechlorination.
Sludge stabilization is accomplished by an aerobic digester and sludge thickening/holding tank.
Liquid stabilized sludge may be land applied in liquid form to permitted agricultural sites. A
backup generator is on -site to provide power to the facility.
T
FINE SCREENING
T
AERATED GRIT
REMOVAL
OX DATION DIT:}I OXIDATION DITCH
#1 #2
10.900 N's) (0.900 MG)
I—
CLARIFIER#1 CLARIFIER#2 CLARIFIER#3
1 �_ - I — - -4
CL2 CONTACT
1
EFFLUENT
(to the River)
;,eneratorfor
alternate power
supply
DIGESTER
(0.200 MG)
SLUDGE SLUDGE
THICKENER/ �+ THICKENER/
HOLDING HOLDING
(0.300 MG) (0.200 MG)
_`* Land
Application

EXCEPTIONAL WATER QUALITY EVALUATION
Yadkin Valley Sewer Authority WWTP
DMR Data (1/1/2020 - 12/31/2022)
REDUCED MONITORING CRITERIA
1) Requirement: mean < 50% of monthly average
BOD Avg of 3.1 is < 15 (50% of BOD Monthly Avg
TSS Avg of 4.5 is < 15 (50% of TSS Monthly Avg)
Fecal Coliform Geomean Avg of 6.1 is < 100 (50% of Fecal Coliform Monthly Avg)
2) No more than 15 daily samples can be > 200% of the weekly average limit
BOD: 0 Samples > 200% of weekly avg limit
TSS: 0 Samples > 200% of weekly avg limit
Fecal Coliform. 0 Samples > 200% of weekly avg limit
3) Sampling results shall not show more than two non -monthly avg. limit violations in past year
0 non -monthly violations

EXCEPTIONAL WATER QUALITY EVALUATION
Yadkin Valley Sewer Authority WWTP
DMR Data (1/1/2020 - 12/31/2022)
Date
Effluent BOD
Effluent TSS
Effluent Fecal
mg/L
mg/L
#/100 ml
1/3/2020
2.3
3.6
4.0
1/6/2020
2.1
2.9
1.0
1/8/2020
<2.0
3.4
4.0
1/13/2020
3.4
3.2
5.0
1/15/2020
<2.0
3.0
3.0
1/21/2020
4.0
3.5
5.0
1/23/2020
5.1
11.0
2.0
1/27/2020
3.7
3.8
11.0
1/29/2020
<2.0
2.9
3.0
2/3/2020
3.2
6.0
8.0
2/5/2020
2.5
6.7
1.0
2/10/2020
2.3
4.9
9.0
2/12/2020
3.8
7.4
11.0
2/17/2020
3.4
4.1
4.0
2/19/2020
3.0
4.9
1.0
2/21/2020
2.8
6.4
2/24/2020
5.3
1.0
2/26/2020
3.8
5.6
<1.0
2/28/2020
3.6
3/2/2020
2.9
4.7
1.0
3/4/2020
2.9
6.0
3.0
3/9/2020
3.2
3.9
5.0
3/11/2020
2.2
3.7
3.0
3/16/2020
2.9
4.6
1.0
3/18/2020
2.8
4.3
1.0
3/23/2020
2.9
<2.5
3.0
3/25/2020
3.9
7.7
4.0
3/30/2020
3.3
<2.5
2.0
4/1/2020
<2.0
2.7
<1.0
4/6/2020
2.6
<2.5
2.0
4/8/2020
2.3
3.8
<1.0
4/13/2020
8.6
8.2
325.0
4/15/2020
2.4
3.6
1.0
4/20/2020
3.3
3.1
1.0
4/22/2020
2.7
4.1
1.0
4/27/2020
3.0
4.2
3.0
4/29/2020
2.6
3.7
1.0
5/4/2020
3.0
2.9
2.0
5/6/2020
3.3
2.7
1.0
5/11/20201
2.8
2.5
2.0

EXCEPTIONAL WATER QUALITY EVALUATION
Yadkin Valley Sewer Authority WWTP
DMR Data (1/1/2020 - 12/31/2022)
Date
Effluent BOD
Effluent TSS
Effluent Fecal
mg/L
mg/L
#/100 mi
5/13/2020
3.1
2.9
6.0
5/18/2020
6.5
3.4
3.0
5/20/2020
3.8
6.0
3.0
5/26/2020
2.1
3.7
2.0
5/28/2020
6.7
8.5
25.0
6/1/2020
2.8
<2.5
2.0
6/3/2020
2.3
<2.5
4.0
6/8/2020
7.4
<2.5
<1.0
6/10/2020
<2.0
3.1
1.0
6/15/2020
4.2
<2.5
3.0
6/17/2020
2.5
<2.5
6.0
6/22/2020
<2.0
<2.5
3.0
6/24/2020
<2.0
<2.5
6.0
6/29/2020
4.4
<2.5
12.0
7/1/2020
2.5
<2.5
3.0
7/6/2020
5.5
<2.5
3.0
7/8/2020
2.2
<2.5
11.0
7/13/2020
3.4
<2.5
4.0
7/15/2020
<2.0
<2.5
9.0
7/20/2020
3.7
<2.5
5.0
7/22/2020
2.2
<2.5
5.0
7/27/2020
2.1
<2.5
<1.0
7/29/2020
<2.0
<2.5
1.0
8/3/2020
2.2
<2.5
4.0
8/5/2020
<2.0
<2.5
4.0
8/10/2020
<2.0
<2.5
1.0
8/12/2020
<2.0
<2.5
<1.0
8/17/2020
<2.0
<2.5
6.0
8/19/2020
<2.0
<2.5
6.0
8/24/2020
<2.0
<2.5
2.0
8/26/2020
<2.0
<2.5
1.0
8/31/2020
3.2
<2.5
26.0
9/2/2020
2.0
<2.5
8.0
9/8/2020
3.6
<2.5
3.0
9/10/2020
<2.0
<2.5
4.0
9/14/2020
<2.0
<2.5
2.0
9/16/2020
<2.0
<2.5
3.0
9/21/2020
<2.0
<2.5
13.0
9/23/2020
<2.0
<2.51
S.0
9/28/2020
<2.0
<2.51
3.0

EXCEPTIONAL WATER QUALITY EVALUATION
Yadkin Valley Sewer Authority WWTP
DMR Data (1/1/2020 - 12/31/2022)
Date
Effluent BOD
Effluent TSS
Effluent Fecal
mg/L
mg/L
#/100 ml
9/30/2020
2.2
2.7
1.0
10/5/2020
2.2
<2.5
10.0
10/7/2020
<2.0
<2.5
9.0
10/12/2020
5.0
6.1
13.0
10/14/2020
<2.0
<2.5
9.0
10/19/2020
<2.0
<2.5
13.0
10/21/2020
<2.0
<2.5
3.0
10/26/2020
8.1
5.4
7.0
10/28/2020
<2.0
<2.5
6.0
11/2/2020
<2.0
<2.5
7.0
11/4/2020
<2.0
<2.5
12.0
11/9/2020
<2.0
<2.5
6.0
11/11/2020
<2.0
<2.5
15.0
11/16/2020
2.4
<2.5
17.0
11/18/2020
<2.0
<2.5
2.0
11/23/2020
<2.0
<2.5
<1.0
11/25/2020
2.2
<2.5
1.0
11/30/2020
3.4
3.3
2.0
12/2/2020
2.1
2.5
5.0
12/7/2020
2.2
3.9
2.0
12/9/2020
<2.0
3.3
2.0
12/14/2020
2.6
3.7
33.0
12/16/2020
<2.0
4.7
2.0
12/21/2020
<2.0
3.5
3.0
12/23/2020
<2.0
3.0
2.0
12/28/2020
3.2
9.0
4.0
12/30/2020
2.9
3.5
1.0
1/4/2021
2.9
<2.5
3.0
1/6/2021
2.7
<2.5
2.0
1/11/2021
3.1
2.7
6.0
1/13/2021
2.3
<2.5
3.0
1/19/2021
2.9
2.7
8.0
1/21/2021
2.1
3.0
18.0
1/25/2021
2.2
<2.5
4.0
1/27/2021
<2.0
<2.5
<1.0
2/1/2021
3.6
4.7
12.0
2/3/2021
2.6
4.5
2.0
2/8/2021
<2.0
<2.5
5.0
2/10/2021
<2.0
2.9
0
E33.
2/15/2021
3.7
4.7
0

EXCEPTIONAL WATER QUALITY EVALUATION
Yadkin Valley Sewer Authority WWTP
DMR Data (1/1/2020 - 12/31/2022)
Date
Effluent BOD
Effluent TSS
Effluent Fecal
mg/L
mg/L
#/100 ml
2/17/2021
3.3
7.5
21.0
2/22/2021
3.3
4.9
12.0
2/24/2021
3.5
6.2
4.0
3/1/2021
4.4
4.3
9.0
3/3/2021
3.0
2.9
8.0
3/8/2021
<2.0
<2.5
1.0
3/10/2021
2.7
<2.5
<1.0
3/15/2021
2.4
<2.5
3.0
3/17/2021
<2.0
<2.5
5.0
3/22/2021
3.0
3.3
3.0
3/24/2021
<2.0
<2.5
<1.0
3/29/2021
3.3
3.6
3.0
3/31/2021
<2.0
3.4
1.0
4/5/2021
3.1
3.1
4.0
4/7/2021
2.9
3.5
1.0
4/12/2021
4.5
3.2
3.0
4/14/2021
<2.0
<2.5
4.0
4/19/2021
2.9
5.6
18.0
4/21/2021
<2.0
4.6
4.0
4/26/2021
2.5
3.5
1.0
4/28/2021
<2.0
<2.5
12.0
5/3/2021
3.4
4.1
37.0
5/5/2021
<2.0
3.7
4.0
5/10/2021
2.8
2.5
41.0
5/12/2021
<2.0
3.4
24.0
5/17/2021
2.5
2.6
16.0
5/19/2021
<2.0
5.7
13.0
5/24/2021
4.4
6.0
14.0
5/26/2021
2.1
4.0
4.0
6/1/2021
<2.0
<2.5
17.0
6/3/2021
<2.0
<2.5
21.0
6/7/2021
2.2
<2.5
6.0
6/9/2021
<2.0
<2.5
32.0
6/14/2021
2.7
<2.5
10.0
6/16/2021
<2.0
<2.5
2.0
6/21/2021
2.8
<2.5
26.0
6/23/2021
<2.0
<2.5
13.0
6/28/2021
<2.0
<2.51
19.0
6/30/2021
<2.0
<2.5
7.0
7/6/20211
2.8
<2.51
15.0

EXCEPTIONAL WATER QUALITY EVALUATION
Yadkin Valley Sewer Authority WWTP
DMR Data (1/1/2020 - 12/31/2022)
Date
Effluent BOD
Effluent TSS
Effluent Fecal
mg/L
mg/L
#/100 ml
7/8/2021
<2.0
4.1
9.0
7/12/2021
<2.0
<2.5
13.0
7/14/2021
<2.0
<2.5
17.0
7/19/2021
2.1
<2.5
21.0
7/21/2021
<2.0
<2.5
21.0
7/26/2021
3.5
<2.5
3.0
7/28/2021
<2.0
<2.5
1.0
8/2/2021
3.0
<2.5
9.0
8/4/2021
<2.0
<2.5
4.0
8/9/2021
2.9
<2.5
7.0
8/11/2021
<2.0
3.3
7.0
8/16/2021
<2.0
<2.5
6.0
8/18/2021
<2.0
<2.5
6.0
8/23/2021
<2.0
<2.5
7.0
8/25/2021
<2.0
<2.5
11.0
8/30/2021
2.8
<2.5
12.0
9/1/2021
<2.0
<2.5
10.0
9/7/2021
<2.0
<2.5
18.0
9/9/2021
<2.0
<2.5
18.0
9/13/2021
2.5
<2.5
10.0
9/15/2021
<2.0
6.1
9.0
9/20/2021
3.1
<2.5
17.0
9/22/2021
<2.0
3.9
6.0
9/27/2021
2.4
3.0
11.0
9/29/2021
<2.0
2.8
6.0
10/4/2021
3.6
5.8
12.0
10/6/2021
<2.0
2.7
<1.0
10/11/2021
<2.0
<2.5
22.0
10/13/2021
<2.0
<2.5
9.0
10/18/2021
<2.0
<2.5
11.0
10/20/2021
<2.0
<2.5
17.0
10/25/2021
<2.0
<2.5
25.0
10/27/2021
<2.0
<2.5
8.0
11/1/2021
<2.0
3.3
18.0
11/3/2021
<2.0
2.5
15.0
11/8/2021
<2.0
<2.5
16.0
11/10/2021
<2.0
<2.5
17.0
11/15/2021
<2.0
<2.5
8.0
11/17/2021
<2.0
<2.5
3.0
11/22/2021
<2.0
<2.5
7.0

EXCEPTIONAL WATER QUALITY EVALUATION
Yadkin Valley Sewer Authority WWTP
DMR Data (1/1/2020 - 12/31/2022)
Date
Effluent BOD
Effluent TSS
Effluent Fecal
mg/L
mg/L
#/100 ml
11/24/2021
<2.0
4.4
<1.0
11/29/2021
<2.0
<2.5
16.0
12/1/2021
<2.0
<2.5
6.0
12/6/2021
<2.0
<2.5
5.0
12/8/2021
<2.0
<2.5
2.0
12/13/2021
<2.0
<2.5
7.0
12/15/2021
2.2
<2.5
5.0
12/20/2021
<2.0
<2.5
5.0
12/22/2021
<2.0
<2.5
2.0
12/28/2021
<2.0
<2.5
4.0
12/30/2021
<2.0
<2.5
4.0
1/3/2022
<2.0
<2.5
23.0
1/5/2022
<2.0
2.5
17.0
1/10/2022
3.2
12.0
8.0
1/12/2022
4.1
14.0
19.0
1/18/2022
4.5
16.0
4.0
1/20/2022
2.5
4.9
3.0
1/24/2022
<2.0
3.2
<1.0
1/26/2022
<2.0
2.7
4.0
1/31/2022
<2.0
3.2
7.0
2/2/2022
<2.0
3.0
6.0
2/7/2022
3.3
5.8
13.0
2/9/2022
2.9
3.7
9.0
2/14/2022
4.2
4.3
1.0
2/16/2022
2.8
2.7
3.0
2/21/2022
<2.0
<2.5
2.0
2/23/2022
<2.0
4.2
5.0
2/28/2022
<2.0
3.9
2.0
3/2/2022
2.4
5.2
2.0
3/7/2022
3.7
8.4
3.0
3/9/2022
2.7
5.6
3.0
3/14/2022
<2.0
<2.5
<1.0
3/16/2022
<2.0
<2.5
<1.0
3/21/2022
<2.0
<2.5
<1.0
3/23/2022
<2.0
<2.5
2.0
3/28/2022
2.0
<2.5
1.0
3/30/2022
<2.0
<2.S
1.0
4/4/2022
2.8
3.7
5.0
4/6/2022
<2.0
3.1
1.0
4/11/2022
<2.0
<2.S
2.0

EXCEPTIONAL WATER QUALITY EVALUATION
Yadkin Valley Sewer Authority WWTP
DMR Data (1/1/2020 - 12/31/2022)
Date
Effluent BOD
Effluent TSS
Effluent Fecal
mg/L
mg/L
#/100 ml
4/13/2022
<2.0
<2.5
2.0
4/18/2022
3.2
5.9
16.0
4/20/2022
<2.0
2.8
<1.0
4/25/2022
3.6
3.8
1.0
4/27/2022
2.5
<2.5
<1.0
5/2/2022
<2.0
3.5
7.0
5/4/2022
2.4
5.4
16.0
5/9/2022
3.2
7.4
300.0
5/11/2022
<2.0
3.8
10.0
5/16/2022
2.3
3.6
24.0
5/18/2022
<2.0
3.3
7.0
5/23/2022
3.2
4.1
7.0
5/25/2022
<2.0
3.2
6.0
6/2/2022
<2.0
<2.5
13.0
6/6/2022
2.4
3.0
6.0
6/8/2022
<2.0
3.3
<1.0
6/13/2022
2.1
3.6
10.0
6/15/2022
<2.0
3.1
2.0
6/20/2022
<2.0
<2.5
13.0
6/22/2022
<2.0
<2.5
14.0
6/27/2022
<2.0
<2.5
20.0
6/29/2022
<2.0
<2.5
15.0
7/5/2022
<2.0
<2.5
8.0
7/7/2022
<2.0
<2.5
2.0
7/11/2022
<2.0
3.7
4.0
7/13/2022
<2.0
<2.5
20.0
7/18/2022
<2.0
2.5
12.0
7/20/2022
<2.0
<2.5
9.0
7/25/2022
4.7
2.6
12.0
7/27/2022
2.0
<2.5
3.0
8/1/2022
3.3
<2.5
<1.0
8/3/2022
2.3
5.5
34.0
8/8/2022
2.7
<2.5
23.0
8/10/2022
<2.0
<2.5
3.0
8/15/2022
2.2
<2.5
3.0
8/17/2022
<2.0
2.9
4.0
8/22/2022
<2.0
<2.5
12.0
8/24/2022
<2.0
<2.5
5.0
8/29/2022
2.4
<2.51
12.0
8/31/2022
<2.0
< 2.51
18.0

EXCEPTIONAL WATER QUALITY EVALUATION
Yadkin Valley Sewer Authority WWTP
DMR Data (1/1/2020 - 12/31/2022)
Date
Effluent BOD
Effluent TSS
Effluent Fecal
mg/L
mg/L
#/100 ml
9/6/2022
<2.0
13.0
6.0
9/8/2022
<2.0
<2.5
20.0
9/12/2022
<2.0
3.1
5.0
9/14/2022
<2.0
2.9
26.0
9/19/2022
<2.0
3.4
30.0
9/21/2022
<2.0
4.5
25.0
9/27/2022
<2.0
2.8
18.0
9/29/2022
2.3
7.4
25.0
10/3/2022
2.2
7.2
14.0
10/5/2022
<2.0
5.9
26.0
10/10/2022
2.4
6.0
37.0
10/12/2022
<2.0
5.0
14.0
10/17/2022
2.7
4.6
9.0
10/19/2022
2.6
3.4
14.0
10/24/2022
2.6
3.3
35.0
10/26/2022
<2.0
3.2
22.0
10/31/2022
<2.0
3.3
34.0
11/2/2022
<2.0
<2.5
16.0
11/7/2022
2.7
<2.5
10.0
11/9/2022
<2.0
<2.5
9.0
11/14/2022
<2.0
3.5
11.0
11/16/2022
2.3
3.4
8.0
11/21/2022
2.2
7.5
11.0
11/23/2022
3.0
7.0
9.0
11/28/2022
<2.0
4.2
8.0
11/30/2022
<2.0
6.1
49.0
12/5/2022
<2.0
4.6
8.0
12/7/2022
2.4
3.4
17.0
12/12/2022
<2.0
3.9
8.0
12/14/2022
<2.0
3.0
13.0
12/19/2022
<2.0
<2.5
14.0
12/21/2022
<2.0
<2.5
13.0
12/27/2022
3.5
5.7
4.0
12/29/2022
<2.0
3.8
8.0
Average
3.1
4.5
6.1
NPDES Monthly
Avg Limit
30
30
200

EXCEPTIONAL WATER QUALITY EVALUATION
Yadkin Valley Sewer Authority WWTP
DMR Data (1/1/2020 - 12/31/2022)
Date
Effluent BOD
Effluent TSS
Effluent Fecal
mg/L
mg/L
#/100 ml
50% of Monthly
Average Limit
15
15
100
200% of Monthly
Avg
90
90
800
# samples >
200% of Monthly
Avg
0
0
0

ATTACHMENT III
Priority Pollutant Analyses

An tl Monitoring and Pollutant Scan
Permit No. NC0020567 Month June
Year 2021
Outfall 001
Facility Name Elkin WWTP
Date of sampling 06/08/21
ORC Hal Transou
Phone [phone]
Analytical Laboratory Environmental Testing Solutions
Parameter
Ammonia (as N)
Dissolved oxygen
Nitrate/Nitrite
Total Kjeldahl nitrogen
Total Phosphorus
Total dissolved solids
Sample
Type
Composite
Composite
Composite
Composite
Composite
Composite
Analytical
Method
4500NH3D
360.1
353.2
351.2
365.4
SM2540C
Quantitation
Level
0.01
0
0.1
1.5
0.05
10
Sample
Result
0.08
3
0.46
1.2
0.27
180
Units of
Measurement
rng/1
mg/l
mg/1
mg/1
mg/1
mg/1
Number of
samples
1
1
1
1
1
1
Hardness
Chlorine (total residual, TRC)
Oil and grease
Composite
Grab
Grab
2340 C
4500cIg
1664 A
1
0.012
5
28
<15
<5
mg/l
mg/1
mg/1
1
1
1
Metals (total recoverable), cyanide and total phenols
AntimonyComposite 200.8
Arsenic Composite SM3113B
0.003
0.005
<0.003
<0.002
mg/1
mg/l
1
1
Beryllium
Composite
200.7
0.001
<0.001
mg/l
1
Cadmium
Composite
SM3113B
0.001
<0.0005
mg/1
1
Chromium
Composite
200.7
0.005
<0.005
mg/1
1
Copper
Composite
200.7
0.01
0.004
mg/1
1
Lead
Mercury
Nickel
Selenium
Silver
Thallium
Zinc
Cyanide
Total phenolic compounds
Composite
Composite
Composite
Composite
Composite
Composite
Composite
Grab
Grab
SM3113B
1631
200.7
SM3113B
200.7
200.8
SM3113B
450OCNE
SM510A&13
0.005
0.01
0.01
0.005
0.001
0.01
0.005
0.005
<0.002
<1
0.003
<0.001
<0.001
<0.001
0.055
<0.005
<0.01
mg/1
ng/1
mg/l
mg/1
mg/1
mg/l
mg/1
mg/1
mg/1
1
1
1
1
1
1
1
1
1
Volatile organic compounds
Acrolein
Acrylonitrile
Grab
Grab
624
624
100
50
< 100
<50
ug/ 1
ug/1
1
1
Grab
624
5
<5
ug/ 1
1
Benzene
Grab
624
5
<5
ug/1
1
Bromoform
Grab
624
5
<5
ug/1
1
Carbon tetrachloride
Grab
624
5
<5
ug/1
1
Chlorobenzene
Grab
Grab
624
624
5
10
<5
< 10
ug/1
ug/ 1
1
1
Chlorodibromomethane
Chloroethane
Grab
624
5
<5
ug/1
1
2-chloroethylvinyl ether
Grab
624
5
5.82
ug/1
1
Chloroform
Grab
624
5
<5
ug/l
1
Dichlorobromomethane
1, 1 -dichloroethane
Grab
624
5
<5
ug/1
1
Grab
624
5
<5
ug/1
1
1,2-dichloroethane
Trans-1,2-dichloroethylene
Grab
624
5
<5
ug/1
1
Form - DMR- PPA-1
Page I.

An
4 Monitoring and Pollutant Scan
Month
June
Permit No. NCO020567
Year
2021
Outfall 001
Sample
Analytical
Quantitation
Sample
Units of
Number of
samples
Type
Method
Level
Result
Measurement
Parameter
Volatile organic compounds (Cont.)
ug/ 1
1
1,1-dichloroethylene
Grab
624
5
<5
<5
ug/ 1
1
1,2-dichloropropane
Grab
624
5
5
<5
ug/1
1
1,3-dichloropropylene
Grab
624
<5
ug/1
1
Ethylbenzene
Grab
624
5
10
<10
ug/1
1
Methyl bromide
Grab
624
10
<10
ug/1
1
Methyl chloride
Grab
624
10
<10
ug/1
1
Methylene chloride
Grab
624
5
<5
ug/ 1
1
1,1,2,2-tetrachloroethane
Grab
624
<5
ug/1
1
Tetrachloroethylene
Grab
624
5
<5
ug/I
1
Toluene
Grab
624
5
5
<5
ug/I
1
1, 1, 1 -trichloroethane
Grab
624
5
<5
ug/ 1
1
1,1,2-trichloroethane
Grab
624
5
<5
ug/I
1
Trichloroethylene
Grab
624
10
<10
ug/1
1
Vinyl chloride
Grab
624
Acid -extractable compounds
<5
ug/I
1
P-chloro-m-creso
Grab
625
5
10
<10
ug/1
1
2-chlorophenol
Grab
625
10
<10
ug/1
1
2,4-dichlorophenol
Grab
625
10
<10
ug/ I
1
2,4-dimethylphenol
Grab
625
10
<10
ug/1
1
4,6-dinitro-o-cresol
Grab
625
50
<50
ug/1
1
2,4-dinitrophenol
Grab
625
10
<10
ug/ 1
1
2-nitrophenol
Grab
625
50
<50
ug/1
1
4-nitrophenol
Grab
625
50
<50
ug/I
1
Pentachloropheno]
Grab
625
10
<10
ug/1
1
Phenol
Grab
625
625
10
<10
ug/ I
1
2 , 4, 6-trichlo rophenol
Grab
Base -neutral compounds
10
< 10
ug/ 1
1
Acenaphthene
Grab
625
10
<10
ug/1
1
Acenaphthylene
Grab
625
625
10
<10
ug/I
1
Anthracene
Grab
625
100
<100
ug/1
1
Benzidine
Grab
625
10
<10
ug/1
1
Benzo(a)anthracene
Grab
625
10
< 10
ug/ 1
1
Benzo(a)pyrene
b Gra
625
10
<10
ug/1
1
3,4 benzofluoranthene
Grab
10
<10
ug/1
1
Benzo(ghi)perylene
b
Grab
625
10
< 10
ug/ 1
1
Benzo(k)fluoranthene
Grab
625
10
< 10
ug/ 1
1
Bis (2-chloroethoxy) methane
Grab
625
<10
ug/1
1
Bis (2-chloroethyl) ether
Grab
625
10
<10
ug/1
1
Bis (2-chloroisopropyl) ether
Grab
625
10
ug/1
1
Bis (2-ethylhexyl) phthalate
Grab
625
20
<20
10
ug/ I
1
4-bromophenyl phenyl ether
Grab
625
10
�
<10
ug/1
1
Butyl benzyl phthalate
Grab
625
10
<10
ug/1
1
2-chloronaphthalene
Grab
625
10
Page 2
Form - DMR- PPA-1

An tl Monitoring and Pollutant Scan
Permit No. NCO020567
n„+f.ii nnl
4-chlorophenyl phenyl ether
Grab
Parameter
Sample
Type
Base -neutral compounds (cont.)
Chrysene
Grab
Di-n-butyl phthalate
Grab
Di-n-octyl phthalate
Grab
Dibenzo(a,h)anthracene
Grab
1,2-dichlorobenzene
Grab
1,3-dichlorobenzene
Grab
1,4-dichlorobenzene
Grab
3, 3-dichlorobenzidine
Grab
Diethyl phthalate
Grab
Dimethyl phthalate
Grab
2,4-dinitrotoluene
Grab
2,6 -dinitrotoluene
Grab
1,2-diphenylhydrazine
Grab
Fluoranthene
Grab
Fluorene
Grab
Hexachlorobenzene
Grab
Hexachlorobutadiene
Grab
Hexachlorocyclo-pentadiene
Grab
Hexachloroethane
Grab
Indeno(1,2,3-cd)pyrene
Grab
Isophorone
Grab
Naphthalene
Grab
Nitrobenzene
Grab
N-nitrosodi-n-propylamine
Grab
N-nitrosodimethylamine
Grab
N-nitrosodiphenylamine
Grab
Phenanthrene
Grab
Pyrene
Grab
1,2,4,-trichlorobenzene
Grab
Month June
Year 2021
625
10
<10
ug/1
1
Analytical
Method
Quantitation
Level
Sample
Result
Units of
Measurement
Number of
samples
625
10
<10
ug/l
1
625
10
<10
ug/1
1
625
10
<10
ug/1
1
625
10
<10
ug/l
1
625
10
<10
ug/ 1
1
625
10
<10
ug/1
1
625
10
<10
ug/l
1
625
10
<10
ug/l
1
625
10
<10
ug/l
1
625
10
<10
ug/1
1
625
10
<10
ug/1
1
625
10
<10
ug/1
1
625
10
<10
ug/l
1
625
10
<10
ug/l
1
625
10
<10
ug/ 1
1
625
10
<10
ug/ l
1
625
10
<10
ug/'
1
625
10
<10
ug/l
1
625
10
<10
ug/l
1
625
10
<10
ug/1
1
625
10
<10
ug/1
1
625
10
<10
ug/ 1
1
625
10
<10
ug/1
1
625
10
<10
ug/l
1
625
10
<10
ug/l
1
625
10
<10
ug/l
1
625
10
<10
ug/l
1
625
10
<10
ug/1
1
625
10
<10
ug/1
1
Please note DO Result was on j unc j, �..�
I certify under penalty of law that this document and all attachments were prepared under my direction
and supervision in accordance with a system to design to assure that qualified perdonnel properly
gather and evaluat the information submitted. Based on my inquiry of the person or persons that
manage the system, or those persons directly responsibel 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.
Gary Stainback
Authorized Representative name
Signature
Page 3
Form - DMR- PPA-1

E OREN 6 t�' &. ( "O�
nw, '� 1�10 hwTpo gli,
114 OAKMONT DRIVE
GREENVIL.L_E,. N C. 27813
SUEZ WATER (YVSA WWTP-PP)
NADINE BLACKWELL
P.O. BOX 1279
CLEMMONS, NC 27012
Effluent
Analysis
Method
PARAMETERS
Date Analyst
Code
Ammonia Nitrogen as N, mg/l
0.08
06/11/21
TLH
350.1 112-93
Total Kjeidahl Nitrogen as N,mg/I
1.21
06/15/21
TLH
351.2 R2-93
Nitrate+Nitrite as N, mg/1
0.46
06/11/21
KES
353.2 112-93
Total Phosphorus as P, mg/l
0.27
06/15/21
KES
365.4-74
Oil & Grease (HEM), mg/l
<5.0
06/10/21
KDS
1664B
Phenol, ug/t
TESTED
<0.005
06/21/21
KDS
450OCNE-11
Total Cyanide, mg/I
28
06/14/21
BLV
2340C-11
Total Hardness, mg/l
Total Dissolved Residue, mg/l
M 180
06/10/21
CAW
D5907-13
< 1.0
06/14/21
HMM
EPA200.8
Antimony, ug/l
<2.0
06/14/21
MTM
3113B-10
Arsenic, ug/l
< 1.0
06/14/21
MTM
EPA200.7
Beryllium, ug/l
<0.5
06/10/21
NAB
3113B-04
Cadmium, 119/1
< 5.0
06/ l4/21
MTM
EPA200.7
Total Chromium, 119/1
4
06/14/21
MTM
EPA200.7
Copper, ug/l
<2.0
06/11/21
NAB
3113B-10
Lead, ug/I
3
06/14/21
MTM
EPA200.7
Nickel, ug/I
< 1.0
06/14/21
HMM
EPA200.8
Selenium, ug/i
< 1.0
06/14/21
MTM
EPA200.7
Silver, ug/l
< 1.0
06/14/21
HMM
EPA200.8
Thallium, ug/l
55
06/14/21
MTM
EPA200.7
Zinc, ug/1
PHONE [phone]
FAX [phone]
ID#: 972
DATE COLLECTED: 06/08/21
DATE REPORTED : 07/01/21
��REVIEWED BY:
NOTE: Any result listed above as "TESTED" was sub -contracted to another laboratory. The corresponding results are attached.
All Qc requirements were not met, M Blank result exceeded method constant weight criteria.

CLIENT: SUEZ WATER (YVSA WWTP-PP) CLIENT ID:
NADINE BLACKWELL
P.O. BOX 1279 ANALYST:
CLEMMONS, NC 27012 DATE COLLECTED:
DATE ANALYZED:
� DATE REPORTED:
REVIEWED BY:
VOLATILE ORGANICS
EPA METHOD 624.1
PARAMETERS, ug/l
Effluent
1.
Chloromethane
< 10.00
2.
Vinyl Chloride
< 10.00
3.
Bromomethane
< 10.00
4.
Chloroethane
< 10.00
5.
Trichlorofluoromethane
<5.00
6.
1, I-Dichloroethane
<5.00
7.
Methylene Chloride
<10.00
8.
trans-1,2-Dichloroethene
< 5.00
9.
1,1-Dichloroethene
<5.00
10.
Chloroform
5.82
11.
1,1,1-Trichloroethane
<5.00
12.
Carbon Tetrachloride
< 5.00
13.
Benzene
< 5.00
14.
1,2-Dichloroethane
< 5.00
15.
Trichloroethene
< 5.00
16.
1,2-Dichloropropene
< 5.00
17.
Bromodichloromethane
<5.00
18.
2-Chloroethylvinyl Ether
<5.00
19.
cis-1,3-Dichloropropene
<5.00
20.
Toluene
<5.00
21.
trans- 1,3-Dichloropropene
< 5.00
22.
1,1,2-Trichloroethane
< 5.00
23.
Tetrachloroethene
< 5.00
24.
Dibromochloromethane
< 5.00
25.
Chlorobenzene
< 5.00
26.
Ethylbenzene
< 5.00
27.
Bromoform
<5.00
28.
1,1,2,2-Tetrachloroethane
< 5.00
29.
1,3-Dichlorobenzene
< 5.00
30.
1,4-Dichlorobenzene
< 5.00
31.
1,2-Dichlorobenzene
< 5.00
32.
Acrolein
< 100.00
33.
Acrylonitrile
<50.00
inking water M B7715
Wastewater ID: 10
PHONE (252) 7tie-6208
FAX (P52) 756 0633
972
JAP
06/08/21
06/11/21
07/01/21

�1
Drinking Water ID: 37715
CLIENT: SUEZ WATER (YVSA WWTP-PP)
NADINE BLACKWELL
P.O. BOX 1279
CLEMMONS, NC 27012
�-�
REVIEWED BY: _ _
SEMIVOLATILE ORGANICS
EPA METHOD 625.1
CLIENT ID: 972
ANALYST: HIC
DATE COLLECTED: 06/08/21
DATE EXTRACTED: 06/15/21
DATE ANALYZED: 06/21/21
DATE REPORTED: 07/01/21
PARAMETERS, ug/l
Effluent
1.
N-Nitrosodimethylamine
< 10.00
2.
Phenol
< 10.00
3.
Bis(2-Chloroethyl) Ether
< 10.00
4.
2-Chlorophenol
< 10.00
5.
1,3-Dichlorobenzene
< 10.00
6.
1,4-Dichlorobenzene
< 10.00
7.
1,2-Dichlorobenzene
< 10.00
8.
Bis(2-Chloro-l-methylethyl) Ether
< 10.00
9.
Hexachloroethane
< 10.00
10.
N-Nitroso-Di-N-Propylamine
< 10.00
11.
Nitrobenzene
< 10.00
12.
Isophorone
< 10.00
13.
2-Nitrophenol
< 10.00
14.
2,4-Dimethylphenol
< 10.00
15,
Bis(2-Chloroethoxy) Methane
< 10.00
16.
2,4-Dichlorophenol
<10.00
17.
1,2,4-Trichlorobenzene
< 10.00
18.
Naphthalene
< 10.00
19.
Hexachlorobutadiene
< 10.00
20.
4-Chloro-3-Methylphenol
< 20.00
21.
Hexachlorocyclopentadiene
< 10.00
22.
2,4,6-Trichlorophenol
< 10.00
23,
2-Chloronaphthalene
< 10.00
24.
Acenaphthylene
< 10.00
25.
Dimethylphthalate
< 10.00
26.
2,6-Dinitrotoluene
< 10.00
27.
Acenaphthene
<10.00
28.
2,4-Dinitrophenol
< S0.00
29.
4-Nitrophenol
< 50.00
30.
2,4-Dinitrotoluene
< 10.00
31.
Fluorene
< 10.00
32.
Diethylphthalate
< 10.00
33.
4-Chlorophenyl Phenyl Ether
< 10.00
34.
4,6-Dinitro-2-Methylphenol
< 50.00
35.
N-Nitrosodiphenylamine
< 10.00
36.
4-Bromophenyl Phenyl Ether
< 10.00
37.
Hexachlorobenzene
< 10.00
38.
Pentachlorophenol
< 50.00
39.
Phenanthrene
<10.00
40.
Antbracene
< 10.00
41.
Di-N-Butylphthalate
< 10.00
42.
Fluoranthene
< 10.00
43.
Benzidine
< 100.00
44.
Pyrene
< 10.00
45.
Butylbenzylphthlate
< 10.00
46.
Benzo[alanthracene
< 10.00
47.
3,31-Dichlorobenzidine
< 10.00
48.
Chrysene
< 10.00
Page: 1

ElMomm(w % hcoo Tpglfb�u
114 OAKMON I Ul ti v i
GREENVILLE, N.C. 27858
CLIENT: SUEZ WATER (YVSA WWTP-PP)
NADINE BLACKWELL
P.O. BOX 1279
CLEMMONS, NC 27012
REVIEWED BY: ✓ _ __
SEMIVOLATILE ORGANICS
EPA METHOD 625.1
CLIENT ID:
PHONE [phone]
FAX [phone]
972
ANALYST: HIC
DATE COLLECTED: 06/08/21 Page: 2
DATE EXTRACTED: 06/15/21
DATE ANALYZED: 06/21/21
DATE REPORTED: 07/01/21
PARAMETERS, ug/l
Effluent
49.
Bis(2-Ethylhexyl)phthalate
<20.00
50.
Di-N-Octylphthalate
< 10.00
51.
Benzo[b]fluoranthene
< 10.00
52.
Benzo[kIlluoranthene
< 10.00
53.
Benzo[alpyrene
< 10.00
54.
Indeno(1,2,3-C,d)pyrene
< 10.00
55.
Dibenzo[a,hjanthracene
< 10.00
56.
Benzo[g,h,i)perylene
< 10.00
57.
1,2-Diphenylhydrazine
< 10.00

Environment I. Inc.
-anon.
P.G. Box 7085, 114 vaK,uiw�� Dr.
Greenville. NC 27858
environmentl mc.com
Phone (,252) 756-6208 • Fax [phone]
972 Week:31
CLIENT:
SUEZ WATER (YVSA WWTP-PP)
NADINE BLACKWELL
P.O. BOX 1279
CLEMMONS NC 27012
[phone]
SAMPLE LOCATION
I
i
I
I
�EA BY (,W•) (SAMPLER)
JOUISHED BY (SI6
VOLLSHED BY (SIG.)
COLLECTION
DATE I TIME
$" 0 $00
DISINFECTION
a'CHLORINE
UV
NON
—z
z w Z 2
c:J To z
o� Q�� a
U ~a U w 0
Q a IL C�
0
{ I 14
CHAIN OF CUSTODY KE( URV
kPP
LGGP P G G P P P P P P G G G
Page 1 of 2
CHLORINE NEUTRALIZED AT COLLECTION
FpH CHECK (LAB)
it
CONTAINER TYPE,P/G
C C C
C
C
C
D
C
A A
A
A
A
A
A
CHEMICAL PRESERVATION
U) A -NONE D-NAOH
x o
V-4
°+1
N
C B- HNO, E- HCL
`n
o
a,
d
cc
LU C H2S0, F ZINC ACETATE%NAOi
c
o
y
LU
G- NATHIOSULFATE
z
H
o
a
H
a
�o
�o
a
CLASSIFICATION:
WASTEWATER (NPDES)
FADRINKING WATER
DWR/GW
SOLID WASTE SECTION
CHAIN OF CUSTODY (SEAL) MAIN rAIWI
DURINn MENT/DELIVERY
/ Y N
SAMPLES COLLECTED BY:
(Please Print)
SAMPLES RECEIVED IN LAB AT . 0-
DATErT1tJiE RECEIVED BY (SIG.) DATEMME _ COMMENTS'
ATE/TINE IRE BY (SIG.) DATEMME
DATIST&C TRECEIVED BY (SIG. DA71ME
Sampler must place a "C- for composite sample or a "G" for N9 395111
PLEASE READ Instructions for completing this form on the reverse side. Grab sample in the blocks above for each parameter requested.
Prvpm it"

ace Analytical
/ Will erpeetata cae
Laboratory Report
Mark Oliveira
Environment 1
114 Oakmont Dr
Greenville, NC 27858
Pace Andytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersvllle, NC 2W78
(704)875-W92
Page 1 of 1
Report Date: 06/22/2021
Date Received: 06/10/2021
Project: Environmental 1
Pace Project No.: 92543466
Sample: Suez Water YVSA WWTP-PP Eff Lab ID: 92543466001 Collected: 06/08/21 08:00 Matrix: Water
Results Units Report Limit Analyzed Qualifiers
Method Parameters
ND mg/L 0.020 06122/2114:33
EPA 420.4 Rev 1.0 1993 Phenolics, Total Recoverable
Reviewed by:
Stephanie Knott
704-977-0981
[e-mail]
Pace Analytical Services Asheville
2225 Riverside Drive, Asheville, NC 28804
Florida/NELAP Certification #: E87648
North Carolina Drinking Water Certification #: 37712
North Carolina Wastewater Certification #: 40
South Carolina Certification #: 99030001
Virginia/VELAP Certification #: 460222
Page 1 of 5

P.O .Box
085, 114 Oakmont Dr.
Greenvill
: NC 27859
eovironm
nrlinc_com
Phone (
) 756-6208 • Fax [phone]
972 weetr. 31
I�
�DISINFECTION
CHLORINE
CLIEN
❑ t;
SUEZ w
(YVSA wwFp-M
NIADINE I
LACKVVELL
❑
NONE
P.O. BOAC
1279
CLEMW
IqS NC 27012
(336) 7 70
a
� a
COLLECTION V Q
�������"'
SAMPI.Et6x;AlM DATE I TIME o
G
C
WOtt:92543466
III III IIII 11111111111111 ECTION
92543466
1 _k i Ir CONTAINERTYPEP/G
CHIEMALPRESERVATION
A -NONE D-NAOH
B-HNO, E-HCL
C - HZSO, F - ZINC ACEiATEMAOH
g
G - NATHI06ULFATE
CLASSIFICATION:
❑ WASTEWATERW)ES)
❑ DRHOW3WATER
mmw
❑ SOLD WASTE SECTION
CHAIN OF CUSTODY (SEAL) MAINTAINED
DURINCyGnIVENTIDELIVERY
Y N
SAMPLES COLLECTED By
Flemp"
SA ,RM REa3Vm N LAB AT . D 'C
gY ) (SAMPLER) DATEITW 6Y (SIG.) BATE71ME_ COMMENTS`.
BY(srx) ATEITME BY (3 }
DM) } D, �� DATTITME
%?
Sampler must place a "C for composite sample or a'G` for
rM o PLEASE READ Instrucdons for completing this form on the reverse side. Grab sample in the blocks above for each parameter requested.
4A A5
NIQ 395111

--L la
. I[
!y%n-1 I .! 6 a t,:! H., " i, i " �

Document Name: Document Revised: Ocnobar28, 2020
Sample Condition Up2n Rea Page 1 of 2
Issuing Authorft
« F.r1R-C%Z33-Rev-07 Pace Carolinas Qualky Office
Laboratory recehring samples:
Asheville ❑ Eden❑ Greenwood ❑ Huntersville ❑ Ralelgh� Mechanicsville❑ Atlanta[] KernersvAle❑
Client Name:
Project M:
D T-n�
Courier: []Fed Ex ❑UPS ❑USPS Client
❑ Commercial []Pace ❑other:
Custody Seal Present? []yes J�Nc Seals Intact? ❑Yes ]ZNo
Date/Inkfals Person Exan inhtg Contents: V rr 1 14;-/e i
Packing Material: ❑Bubble Wrap ❑fiubbie Bags •lone ❑ Other Biological Tissue Frozen?
[]Yes ❑N6 A&/A
Thermometer. ,®Wet ❑[]Noneslue one
❑ IR Gun 4D:_ Type of Ice:
Correction Factor:
Cooler Temp: L r Add/5ubtract ('C) d• 0 Temp should be above freezing to 6'C
L 9Sf ❑Sempks out of temp criteria. Samples an Ica, cooling process
Cooler Tamp Corrected rc): +t! has begun
USDA Regulated Soll (AN/A, water sample)
Did samples originate In a quarantine zone within the United States: CA, NY, or SC (check maps)? Did samples originate from a foreign source (internatlonal!y,
i..-. n..� u.—ft..A D—M Q1-17 MV►t nN.,
Yes UNo
CommenU/Discrepancy:
Chain of Custody Present?
EMes
nNo
N A
L
Samples Arrived within Hold Time?
MYs
r7No
N A
2.
Short Hold Time Analysis A72 hr.)?
Oyes
o
N/A
3.
Rush Turn Arowd Time Requested7
LILes
No
/A
4.
Sufficient Volume?
Vly.s
r7No
N/A
5.
Cared Containers Used?
-Pace Containers Used?
ZAEi 94yes
ONO
❑N/A N/A
O
6.
Containers Intact?
_ _Yes
No
N/A
7.
Dissolved analysis: Samples Field Filtered?[:]Yes
Sample Labeis Match COC? ;Rfes
-Includes Date/Time/ID/Analysis Matrix: w
Na
[-]No
/A
❑N/A
8.
9.
Heads ace in VOA Vials (>5-6mm ?
Yes
No
N/A
10.
Trip Blank Present?
Trip BlankCustod Seals Present?
Oyes
Yes
ON
No
WA
N A
11.
COMMENTS/SAMPLE DISCREPANCY
CLIENT NOTIFICATION/RESOLUTION
Person contacted:
Date/Time:
Lot ID of split containers:
PAhiData RegrUed? []Yes ❑No
"-""'p7t�j�it'iP3�'3�dT'SC'11Rf I -`-- �.•� -- ,
Page 4 of 5
Project Manager SRF Revfew: Date:

•_
:
it
�iii
iiii
ii
- ... .
■■■■■■■■■■■■
._:. . .

Enw,unfingiN % h(mp �'& N A.
.'-%
8 c.� ' . ` .e: c —sWJ. I =.f
114 OAKMONT DRIVE
GREENVILLE, N.C. 27858
SUEZ WATER (YVSA WWTP)
NADINE BLACKWELL
PO BOX 1279
CLEMMONS, NC 27012
Effluent
PARAMETERS
} a* a
PHONE [phone]
FAX [phone]
ID#: 952 C
DATE COLLECTED: 06/08/21
DATE REPORTED : 06/21/21
REVIEWED BY:
�✓ (\-
Field Analysis Method
Blank Date Analyst Code
Mercury (Method 1631E), ng/1 < 1 < 1 06/18/21 MTM EPA1631E

Environment 1, Inc.
P.O. Box 7085. 114 Oakmont Dr.
Greenville, NC 27858
CHAIN OF Cl!S1Y)UY Rt'(J)K0
environment I inc.com DISINFFCTION
Phone [phone] • Fax [phone]
952 C Week: 28 CHLORINE.
CLIENT:
SUEZ WATER (YVSA WWTP) G
NADINE BLACKWELL NONE
PO BOX 1279
CLEMMONS NC 27012 rA
[phone]
SAMPLE LOCATION
Influent
Field Blank
— z
0
Eo
0
w y
z�
y
�
Q -'
0�
z
Cr O
ED
z
d
_j
�'
w
U, o
6
o
COLLECTION
o
o
0
Q
o
.a
DATE
TIME
170
1E BY ( ) (SAMPLER) DATEMME I RECENED BY (SIG.)
Ji,IJA
zI
RELINQUISHED BY (SIG.) IIDATEMME RECCEIVIVED' BY (SIG.) DA
c--� �1 l 11 Y `l lLS-�•� to - "
RELINQUISHED BY (SIG.) I DATETME RECEIVED BY (SIG-) I DO
PLEASE READ Instructions for completing this form on the reverse side.
COMMENTS:
w !
Page 1 of 1
CHLORINE NEUTRALIZED AT COLLECTION
pH CHECK (LAB)
CONTAINER TYPE, P/G
CHEMICAL PRESERVATION
Cn A -NONE D-NAOH
Uj
B-HNO3 E-HCL
11,
C - H,SO, F -ZINC ACETATUNAOF
G - NATHIOSULFATE
a
CLASSIFICATION:
WASTEWATER (NPDES)
DRINKING WATER
DWR/GW
SOLID WASTE SECTION
CHAIN OF CUSTODY (SEAL) MAINIAINFC
DURI ENT/DELIVERY
Y N
SAMPLES COLLECTED BY:
(Please Print)
SAMPLES RECEIVED IN LAB AT
Sampler must place a "C" for composite sample or a "G" for
Grab sample in the blocks above for each parameter requested.
NQ395063
FORM #5

Agal Monitoring and Pollutant Scan
Permit No. NC0020567 Month September
Year 2022
Outfall 001
Facility Name YVSA WWTP ORC Hal Transou
Date of sampling 9/6/22 Phone [phone]
Analytical Laboratory Environmental Testing Solutions
Sample
Analytical
Quantitation
Sample
Units of
Number of
Type
Method
Level
Result
Measurement
samples
Parameter
Ammonia (as N)
Composite
P
4500NH3D
0.01
0.23
mg/l
1
Dissolved oxygen
Composite
P
360.1
0
2.8
mg/1
1
1
Nitrate /Nitrite
Composite
P
353.2
0.1
4.36
mg/I
Total Kjeldahl nitrogen
Composite
P
351.2
1.5
1.3
mg/1
1
1
Total Phosphorus
Composite
P
365.4
0.05
0.17
mg/I
Total dissolved solids
Composite
P
SM2540C
10
190
mg/I
1
Hardness
Composite
2340 C
1
37
mg/I
1
Chlorine (total residual, TRC)
Grab
4500cig
0.012
16
mg/1
1
Grab
1664 A
5
<5
mg/l
1
Oil and grease
Metals (total recoverable), cyanide and total phenols
1
Composite
200.8
0.003
<0.003
mg/1
Antimony
Composite
SM3113B
0.005
<0.003
mg/I
1
Arsenic
Composite
200.7
0.001
<0.002
mg/I
1
Beryllium
Composite
SM3113B
0.001
0.0009
mg/l
1
Cadmium
Composite
200.7
0.005
<0.005
mg/I
1
Chromium
Composite
200.7
0.01
0.004
mg/I
1
Copper
Composite
SM3113B
0.005
<0.002
mg/1
1
Lead
Composite
1631
6.1
ng/1
1
Mercury
Composite
200.7
0.01
0.003
mg/I
1
Nickel
Composite
SM3113B
0.01
<0.001
rng/I
1
Selenium
Composite
200.7
0.005
U.UO2
mg/l
1
Silver
Composite
200.8
0.001
<0.001
mg/1
1
Thallium
Composite
SM3113B
0.01
0.021
mg/I
1
Zinc
Grab
450OCNE
0.005
<0.005
mg/l
1
Cyanide
Total phenolic compounds
Grab
SM510A8vB
0.005
0.094
mg/1
1
Volatile organic compounds
1
Grab
624
100
<100
ug/1
Acrolein
Grab
624
50
<50
ug/l
1
Acrylonitrile
624
5
<5
ug/1
1
Benzene
Grab
624
5
<5
ug/1
1
Bromoform
Grab
5
<5
ug/1
1
Carbon tetrachloride
Grab
624
1
Grab
624
5
<5
ug/1
Chlorobenzene
624
5
<5
ug/1
1
Chlorodibromomethane
Grab
10
<10
ug/1
1
Chloroethane
Grab
624
5
<5
ug/ 1
1
2-chloroethylvinyl ether
Grab
624
7.77
ug/1
1
Chloroform
Grab
624
5
5
<5
ug/1
1
Dichlorobromomethane
Grab
624
<5
ug/l
1
1,1-dichloroethane
Grab
624
5
<5
ug/1
1
1,2-dichloroethane
Grab
624
5
<5
ug/1
1
Trans- l,2-dichloroethylene
Grab
624
1 5
Page 1

Aj al Monitoring and Pollutant Scan
Month September
Permit No. NCO020567
Year
2022
Outfall 001
Sample
Analytical
Quantitation
Sample
Result
Units of
Measurement
Number of
samples
Type
Method
Level
Parameter
Volatile organic compounds (Cont.)
<5
ug/1
1
1,1-dichloroethylene
Grab
624
5
5
<5
ug/1
1
1,2-dichloropropane
Grab
624
5
<5
ug/1
t
1,3-dichloropropylene
Grab
624
5
<5
ug/1
1
Ethylbenzene
Grab
624
10
<10
ug/1
1
Methyl bromide
Grab
624
10
<10
ug/1
1
Methyl chloride
Gr ab
624
10
<10
ug/1
1
Methylene chloride
Gab
r
624
5
<5
ug/1
1
1,1, 2 , 2-tetrachloroethane
Grab
624
5
<5
ug/ 1
1
Tetrachloroethylene
Grab
624
5
<5
ug/1
1
Toluene
Grab
624
5
<5
ug/1
t
1, 1, 1 -trichloroethane
Grab
624
5
<5
ug/ 1
1
1,1,2-trichloroethane
Grab
624
5
<5
ug/ 1
1
Trichloroethylene
Grab
624
10
<10
ug/1
1
Vinyl chloride
Grab
624
Acid -extractable compounds
<5
ug/1
1
P-chloro-m-creso
Grab
625
625
5
10
<10
ug/1
1
2-chlorophenol
Grab
625
10
<10
ug/1
1
loroprab
2,4-dichhenol
G
625
10
<10
ug/1
1
2,4-dimethylphenol
G rab
10
<10
ug/1
1
4,6-dinitro-o-cresol
Grab
625
50
<50
ug/1
1
2,4-dinitrophenol
Grab
625
10
<10
ug/1
t
2-nitrophenol
Grab
625
SO
<50
ug/1
1
4 -nitrophenol
Grab
625
50
<SO
ug/1
i
Pentachlorophenol
Grab
695
10
<10
ug/1
t
Phenol
Grab
6 25
625
10
<10
ug/1
1
2,4,6-trichlorophenol
Grab
Base -neutral compounds
< 10
ug/ 1
t
Acenaphthene
Grab
625
625
EEEE
<10
ug/1
1
Acenaphthylene
Grab
625
<10
ug/1
1
Anthracene
Grab
625
100
< 100
ug/ 1
t
Benzidine
625
10
<10
ug/ 1
1
Benzo(a)anthracene
ff
10
<10
ug/1
t
Benzo(a)pyrene
625
10
<10
ug/1
1
3,4 benzofluoranthene
10
<10
ug/1
1
Benzo(ghi)perylene
625
10
<10
ug/1
1
Benzo(k)fluoranthene
Grab
625
10
<10
ug/1
1
Bis (2-chloroethoxy) methane
Grab
625
10
<10
ug/1
1
Bis (2-chloroethyl) ether
Grab
625
10
<10
ug/1
1
Bis (2-chloroisopropyl) ether
Grab
625
<20
ug/ 1
1
Bis (2-ethylhexyl) phthalate
Grab
625
20
<10
ug/1
t
4-bromophenyl phenyl ether
Grab
625
10
10
<10
ug/1
1
Butyl benzyl phthalate
Grab
625
10
<10
ug/1
1
2-chloronaphthalene
Grab
625
Page 2

A ial Monitoring and Pollutant Scan Month September
Permit No. NC0020567 year 2022
Outfall 001 1
4-chlorophenyl phenyl ether
Grab 625 10 <10 ug/1
Sample Analytical Quantitation Sample Units of Number of
Parameter Type Method Level Result Measurement samples
Base -neutral compounds (coat.)
<10
ug/1
1
Chrysene
Grab
625
625
10
10
<10
ug/l
1
Di-n-butyl phthalate
Grab
10
<10
ug/I
1
Di-n-octyl phthalate
Grab
625
10
<10
ug/1
1
Dibenzo(a,h)anthracene
Grab
625
10
<10
ug/I
1
1,2-dichlorobenzene
Grab
625
10
<10
ug/I
1
1,3-dichlorobenzene
Grab
625
10
<10
ug/ I
1
1,4-dichlorobenzene
Grab
625
10
<10
ug/I
1
3,3 dichlorobenzidine
Grab
625
10
<10
ug/I
1
Diethyl phthalate
Grab
625
10
<10
ug/I
1
DimethyI phthalate
Grab
625
10
<10
ug/ 1
1
2,4-dinitrotoluene
Grab
625
10
<10
ug/1
1
2,6-dinitrotoluene
Grab
625
10
<10
ug/I
1
1,2-diphenylhydrazine
Grab
625
10
<10
u$/I
1
Fluoranthene
Grab
625
625
10
<10
ug/l
I
Fluorene
Grab
625
10
<10
ug/I
1
Hexachlorobenzene
Grab
625
10
<10
ug/ I
1
Hexachlorobutadiene
Grab
10
<10
ug/I
1
Hexachlorocyclo-pentadiene
Grab
625
<10
u$/ I
1
Hexachloroethane
Grab
625
10
10
< 10
ug/ I
1
Indeno(1,2,3-cd)pyrene
Grab
625
10
<10
ug/I
1
Isophorone
Grab
625
10
<10
ug/ I
1
Naphthalene
Grab
625
10
< 10
ug/ I
1
Nitrobenzene
Grab
625
10
<10
u$/1
1
N-nitrosodi-n-propylamine
Grab
10
<10
ug/ I
1
N-nitrosodimethylamine
Grab
625
10
<10
ug/I
1
N-nitrosodiphenylamine
Grab
625
10
< 10
ug/ I
1
Phenanthrene
Grab
625
625
10
<10
u$/I
1
Pyrene
Grab
Grab
625
10
<10
u$/I
1
1,2,4,-trichlorobenzene
Please note DO Result was on June
3, 2021
were
under my direction
I certify under penalty of law that
this document and all attachments
prepared
with a system to design to assure that qualified perdonnel properly
and supervision in accordance
the information submitted.
Based on my
inquiry of
the person or
persons that
gather and evaluat
or those persons directly responsibel for
gathering
the information, the
manage the system,
the best of my knowledge and belief, true,
accurate and
complete. I am
information submitted is , to
penalties for submitting
false information, including
the
aware that there are significant
of fines and imprisonment for knowing violations.
possibility
Page 3

SUEZ WATER (YVSA WWTP-PP)
NADINE BLACKWELL
P.O. BOX 1279
CLEMMONS, NC 27012
Effluent
Analysis
Method
PARAMETERS
Date Analyst
Code
Ammonia Nitrogen as N, mg/1
0.23
09/12/22
TRJ
350.1 R2-93
Total Kjeldahl Nitrogen as N,mg/I
1.40
09/15/22
TRJ
351.2 R2-93
Nitrate+Nitrite as N, mg/l
4.40
09/12/22
KES
353.2 112-93
Total Phosphorus as P, mg/l
0.12
09/15/22
BMD
365.4-74
Oil & Grease (HEW, mg/l
<5.0
09121/22
HMM
1664B
Phenol, ug/1
TESTED
<0.005
09/20/22
HMM
4500CNE-16
Total Cyanide, mg/l
37
09/10/22
DNS
2340C-11
Total Hardness, mg/l
190
09/08/22
BNC
D5907-13
Total Dissolved Residue, mg/1
<3.0
10/04/22
NAB
EPA200.8
Antimony, ug/l
<3.0
09/14/22
NAB
EPA200.8
Arsenic, ug/1
<2.0
09/09/22
MTM
EPA200.7
Beryllium, ug/l
0.9
09/14/22
NAB
EPA200.8
Cadmium, ug/I
<5.0
09/14/22
NAB
EPA200.8
Total Chromium, ug/l
4
09/14/22
NAB
EPA200.8
Copper, ug/1
<2.0
09/14/22
NAB
EPA200.8
Lead, ug/l
3
09/14/22
NAB
EPA200.8
Nickel, ug/l
< 1.0
10/03/22
NAB
EPA200.8
Selenium, ug/l
2
09/14122
NAB
EPA200.8
Silver, ug/1
< 1.0
09/14/22
NAB
EPA200.8
Thallium, ug/1
21
09/14/22
NAB
EPA200.8
Zinc, ugll
astu%la/ Ilan: to, 14715
wastewater ID. 10
P i.Ji ,F 125?_) t320E
FAX (252)
ID#: 972
DATE COLLECTED: 09/06/22
DATE REPORTED : 10/06/22
l
REVIEWED BY:
NOTE. Any result listed above as "TESTED" was sub -contracted to another laboratory. The corresponding results are attached.

i 14 OAK.,-,%,,Oi 1T DRI`i�
GREE'dVIL E..'C 2; 358
CLIENT: SUEZ WATER (YVSA WWTP-PP)
NADINE BLACKWELL
P.O. BOX 1279
CLEMMONS, NC 27012
REVIEWED BY: ✓ v
VOLATILE ORGANICS
EPA METHOD 624.1
PARAMETERS, u9/1
1.
Chloromethane
2.
Vinyl Chloride
3.
Bromomethane
4.
Chloroethane
5.
Trichlorotluoromethane
6.
1,1-Dichloroethane
7.
Methylene Chloride
8.
trans-1,2-Dichloroethene
9.
1,1-Dichloroethene
10.
11.
Chloroform
1,1,1-Trichloroethane
12.
Carbon Tetrachloride
13.
14.
Benzene
1,2-Dichloroethane
15.
Trichloroethene
16.
1,2-Dichloropropane
17.
Bromodichloromethane
18.
2-Chloroethylvinyl Ether
19.
cis-1,3-Dichloropropene
20.
21.
Toluene
trans-1,3-Dichloropropene
22.
1,1,2-Trichloroethane
23.
Tetrachloroethene
24.
Dibromochloromethane
25.
Chlorobenzene
26.
Ethylbenzene
27.
28.
Bromoform
1,1,2,2-Tetrachloroethane
29.
1,3-Dichlorobenzene
30.
1,4-Dichlorobenzene
31.
1,2-Dichlorobenzene
32.
Acrolein
33.
Acrylonitrile
CLIENT ID:
ANALYST:
DATE COLLECTED:
DATE ANALYZED:
DATE REPORTED:
Effluent
< 10.00
< 10.00
< 10.00
< 10.00
< 5.00
< 5.00
< 10.00
< 5.00
< 5.00
7.77
< 5.00
< 5.00
< 5.00
< 5.00
< 5.00
< 5.00
< 5.00
< 5.00
< 5.00
< 5.00
< 5.00
< 5.00
< 5.00
< 5.00
< 5.00
< 5.00
< 5.00
< 5.00
<5.00
< 5.00
<5.00
< 50.00
< 50.00
Drinking water ID: 37115
Waataratgr SDs 10
972
JAP
09/06/22
09/09/22
10/06/22

114 O/`-,KM0, i DRIVL
2
CLIENT: SUEZ WATER (YVSA WWTP-PP)
NADINE BLACKWELL
P.O. BOX 1279
CLEMONS, NC 27012
REVIEWED BY:
SEMIVOLATILE ORGANICS
EPA METHOD 625.1
PARAMETERS, U911
1. N-Nitrosodimethylamine
2. Phenol
3. Bis(2-Chloroethyl) Ether
4. 2-Chlorophenol
5. 1,3-Dichlorobenzene
6. 1,4-Dichlorobenzene
7. 1,2-D ichlorobenzen e
8. Bis(2-Chloral-methylethvi) Ether
9. Hexachloroethane
10. N-Nitroso-Di-N-Propylamine
11. Nitrobenzene
12. Isophorone
13. 2-Nitrophenol
14. 2,4-Dimeth Y iphenol
15. Bis(2-Chloroethoxy) Methane
16. 2,4-Dichlorophenol
17. 1, 2,4-Trichl orobenzene
18. Naphthalene
19. Hexachlorobutadiene
20. 4-Cldoro-3-Mcthylphenol
21. Hexachlorocyclopentadiene
22. 2,4,6-Trichlorophenol
23. 2-Chloronaphthalene
24. Acenaphthylene
25. Dimethylphthalate
26. 2,6-Dinitrotoluene
27. Acenaphthene
28. 2,4-D in itrophenol
29. 4-Nitrophenol
30, 2,4-Dtn Itrotoluene
31. Fluorene
32. Diethylphthalate
33. 4-Chl0rophenyl Phenyl Ether
34. 4,6-Dinitro-2-Me thylphenol
35. N-Nitrosodiphenylamine
36. 4-Bromophenyl Phenyl Ether
37. Hexachlorobenzene
38. Pentachlorophenol
39. Phenanthrene
40. Anthracene
41. I)i-N-Butylphthalate
42. F7uoranthene
43, Benzidine
44. Pyrene
45. Butylbenzylphthlate
46. Benzo[ajanthracene
47, 3,31-Dichlorobenzidine
48, Chrysene
CLIENT ID:
ANALYST:
DATE COLLECTED:
DATE EXTRACTED:
DATE ANALYZED:
DATE REPORTED:
Effluent
< 10.00
< 10.00
< 10.00
< 10.00
< 10.00
< 10.00
< 10.00
< 10.00
< 10.00
< 10.00
< 10.00
< 10.00
< 10.00
< 10.00
< 10.00
< 10.00
< 10.00
< 10.00
< 10.00
< 20.00
< 10.00
< 10.00
< 10.00
< 10.00
< 10.00
< 10.00
< 10.00
< 50.00
< 50.00
< 10.00
< 10.00
< 10.00
< 10.00
< 50.00
< 10.00
< 10.00
< 10.00
< 50.00
< 10.00
< 10.00
< 10.00
< 10.00
< 100.00
< 10.00
< 10.00
< 10.00
< 10.00
< 10.00
Drinking Water ID: 37715
wastewater IDS 10
972
HIC
09/06/22 Page: 1
09/13/22
09/13/22
10/06/22

CLIENT: SUEZ WATER (YVSA WWTP-PP)
NADINE BLACKWELL
P.O. BOX 1279
CLEMMONS, NC 27012
REVIEWED BY:
SEMIVOLATILE ORGANICS
EPA METHOD 625.1
PARAMETERS, ug/l
49.
Bis(2-Ethylhexyl)phthalate
50.
Di-N-Octylphthalate
51.
Benzo(b)fluoranthene
52,
Benzo(k)fluoranthene
53.
Benzo(a)pyrene
54.
l n deno(1,2, 3-C, d) py rene
55.
Dibenzo(a,h)a ct
56.
lene
Benzo(g,h,i]pe yene
57.
1,2-Diphenylhydrazine
Drinking water SD: 37715
R&St..mt.r zap to
CLIENT ID: 972
ANALYST: HIC
DATE COLLECTED: 09/06/22
DATE EXTRACTED: 09/13/22
DATE ANALYZED: 09/13/22
DATE REPORTED: 10/06/22
Effluent
< 20.00
< 10.00
< 10.00
< 10.00
< 10.00
< 10.00
< 10.00
< 10.00
< 10.00
Page: 2

•
aceAnavical
wW.pacelabs.caa
Laboratory Report
Mark Oliveira
Environment 1
114 Oakmont Dr
Greenville, NC 27858
Paco Analytical Services, LLC
9800 Kincey Ave. Suits 100
Huntersvllle, NC 28078
[phone]
Page 1 of t
Report Date: 09/15/2022
Date Received: 09/08/2022
Project: Environment 1 Suez Water 972
Pace Project No.: 92624325
Sample: Suez Water (YVSA WWTP-PP) Lab 10: 92624325001 Collected: 09106122 08:25 Matrix: Water
Method Parameters Results Units Report Limit Analyzed Qualifiers
EPA 420.4 Rev 1.0 1993 Phenolics, Total Recoverable
0.094 mg/L 0.020 09115/22 09:29
Reviewed by: `-"` a-""
Stephanie Knott
704-977-0981
5tephanie.knott@pace(abs.com
Pace Analytical Services Asheville South Carolina Laboratory ID: 9W30
2225 Riverside Drive, Asheville, NC 28804 South Carolina Cenificatlon #: 99030001
Florida/NELAP Certification #: E87648 vlr iniaNELAP Certification #: 460222
North Carolina Drinking Water Certification #: 37712 9
North Carolina Wastewater Certification #: 40
Page 1 of 5

lIkiltawatir 261 to
114 OAKMONT DRIVE
GREENVILLE• N.C. 27858
SUEZ WATER (YVSA WWTP-PP)
NADINE BLACKWELL
P.O. BOX 1279
CLEMONS, NC 27012
Effluent
PARAMETERS
PHONE [phone]
FAX [phone]
ID#: 972 A
DATE COLLECTED: 09/06/22
DATE REPORTED : 09/26/22
�.
REVIEWED BY:
Field Analysis Method
Blank Date Analyst Code
Mercury (Method 1631E), ng/I 6.1 < 1 09/23/22 MTM EPA1631E

FWN 708�. ' fie -
I"! Uak�linnt fir.
ecnvillc, !NC
�:;ivir<;nnuitt! ir.c. rim
DISINFi CfION
CHi_OKiNE
LICJ
s: 1 11 _ V .1- 972 A Week: 30
IF —
� ,
SUEZ WATER (YVSA WWTP-PP)
Nt?NI-
NADINE BLACKWELL
P.O. BOX 1279
CLEMMONS NC 27012
—z
U, q
1766-0270
ww_
JLU
U)
C J
oc
M O
z
_<
COLLECTION
L) Q
-
Qw
J
wct o
¢
O
SAMPI F I CrATInN
DATF
TI "E
Effluent
Ei
Field Blank
RELINQUISHED BY (SIG.) (SAMPLER)
D.AI Lq IME
RECEIVED BY (SG.)
I / un+ ri 1 NIL .�
1
Cid Cam.
—
_
lL z / v2s
pNIHpBY(SIG)
J ATE+T?ME�
REGEIVEDBYiSIG.i
DATtNIt
"
RELINQUISHED BY ISIG
'-'ME
RECEIVED BY (SIG.;
DATE!?Ily?E
COMMENTS:
Page 1 of 1
CHLORINE NEUTRALIZED AT COLLECTION
pH CHECK (LAB)
CONTAINER TYPE, RG
CHEMICAL PRESERVATION
A -NONE D-NAOH
B-HNO, E-HCL
cc
C H.SO, [
c G - NATHIOSULFATE
cc
d
CLASSIFICATION:
WASTEIAIATER (NPDES)
DRINKINGWATER
DWR;GW
SOLID WASTE SECTION
;^I,;1TOD; (SEAL) P;iGif l AINF[
DURIOnS IPN{ENTiDEI_IN/ERY
N
SAMPLES COLLECTED BY:
(Please Print)
0D
SAMPLES RECEIVED IN LAB AT 4 S
:..........3 By
PLEASE READ Instructions ffirm Dn the Ste.
Ste.Sampler must place a �`C" for composite sample or a °G" for
or completing this �Q 411784
Hann ks Grab sample in the blocks above for each parameter requested.

Annual Monitoring and Pollutant Scan
Permit No. NC0020567 Month March
Outfall 001 Year 2023
Facility Name Elkin WWTP ORC Hal Transou
Date of sampling 03/06/23 Phone [phone]
Analytical Laboratory Environmental Testing Solutions
Parameter
Sample
Type
Analytical
Method
Quantitation
Level
Sample
Result
Units of
Measurement
Number of
samples
Ammonia (as N)
Composite
4500NH3D
0.01
0.04
mg/l
1
Dissolved oxygen
Composite
360.1
0
3.4
mg/l
1
Nitrate/Nitrite
Composite
353.2
0.1
1.26
mg/l
1
Total Kjeldahl nitrogen
Composite
351.2
1.5
1.5
mg/l
1
Total Phosphorus
Composite
365.4
0.05
0.12
mg/l
1
Total dissolved solids
Composite
SM2540C
10
140
mg/1
1
Hardness
Composite
2340 C
1
28
mg/1
1
Chlorine (total residual, TRC)
Grab
4500c1g
0.012
<15
mg/1
1
Oil and grease
Grab
1664 A
5
<5
mg/1
1
Metals (total recoverable), cyanide
and total phenols
Antimony
Composite
200.8
0.003
<0.003
mg/l
1
Arsenic
Composite
SM3113B
0.005
<0.002
mg/1
1
Beryllium
Composite
200.7
0.001
<0.001
mg/I
1
Cadmium
Composite
SM3113B
0.001
<0.0005
mg/l
1
Chromium
Composite
200.7
0.005
<0.005
mg/l
1
Copper
Composite
200.7
0.01
0.004
mg/l
1
Lead
Composite
SM3113B
0.005
<0.002
mg/l
1
Mercury
Composite
1631
<1
ng/l
1
Nickel
Composite
200.7
0.01
<.005
mg/1
1
Selenium
Composite
SM3113B
0.01
<0.001
mg/1
1
Silver
Composite
200.7
0.005
<0.001
mg/1
1
Thallium
Composite
200.8
0,001
<0.001
mg/l
1
Zinc
Composite
SM3113B
0.01
0.040
mg/1
1
Cyanide
Grab
450OCNE
0.005
<0.005
mg/l
1
Total phenolic compounds
Grab
SM510A&B
0.005
<0.02
mg/l
1
Volatile organic compounds
Acrolein
Grab
624
100
<100
ug/1
1
Acrylonitrile
Grab
624
50
<50
ug/1
1
Benzene
Grab
624
5
<5
ug/l
1
Bromoform
Grab
624
5
<5
ug/1
1
Carbon tetrachloride
Grab
624
5
<5
ug/l
1
Chlorobenzene
Grab
624
5
<5
ug/1
1
Chlorodibromomethane
Grab
624
5
<5
ug/1
1
Chloroethane
Grab
624
10
<10
ug/1
1
2-chloroethylvinyl ether
Grab
624
5
<5
ug/1
1
Chloroform
Grab
624
5
9.93
ug/1
1
Dichlorobromomethane
Grab
624
5
<5
ug/1
1
1,1-dichloroethane
Grab
624
5
<5
ug/1
1
1,2-dichloroethane
Grab
624
5
<5
ug/l
1
Trans-1,2-dichloroethylene
Grab
624
5
<5
ug/1
1
Form - DMR- PPA-1 Page 1

ATTACHMENT IV
Toxicity Test Results

PO Box 7565
Asheville, NC 28802
Phone: [phone]
Fax: [phone]
en,nw«.•...u,rwmro sai,.va. n. Date: March 23, 2022
Effluent Toxicity Report Form -Chronic Fathead Minnow Multi -Concentration Test
NPDES q: NC 0020567 PIPe tf: 001 County'.
Surry
FacilitY SUEZ
Elkin WWTP e 1 037 Comments
taborst«Y Performing rest: Environmental Testin Solu ' ns nc
Signature of Operator in Responsible Charge (ORC
►rgect N: 1{770
ORC Phone / E-mail: Sample N tiosoeot.laottoos•:2oltl.os
Signature of t-aboratorY Supervisor: romelas
Test Organisms: Plmepholes p
a -Mail to: Al r •
ivision of water Resources
supplier
In-house Culture
ection / Aquatic ToxicologY Branch
Or Mail Original to:MMail
Begin hatch: 03-07-22 1455
e Center
End hatch: 03-00-22 0520
9-1621
Test Start Date: March 08, 2022
Replicate
number
1
2
3
4
10 Survival (-A)1
Control Surviving number of larvae
1D
1
10
10
1
10
1 Average vrt (rrigl 1. 1
13
Organisms ort{lnal number of lame
0•
0.
1
1 Average wt /
wd{ht/«I{Inal (mgJlame)
surviving Imgl
% EffluentSurviving number of larvae
10
10
10
iD
10
1 0
1 Survival (%1
Fair.] Original number of larvae
10
1-
1.
0. 54
1. Average wt Img) 1. 4
wait t/«n{mai Img/larvae)
% Effluent SurvWin{ number of larva
1
10
1
10
10
10
1 100.0
1 survive( (xl
lA4
0.43s% On{final number of larval
1•
1.0
1. 4
1. 2 Average wt (mg)
wayhV«Mlnal (m{/lame)
% Effluent surviving number of larvae
1
1
10
1
10 1 0.
1 survival (xl
0.{7% Oriprial number of larvae
1.1
1
0
1 Average wt (mgl LL064J
weight/odiginal in-4/11arvae)
% Effluent surviving number Of arvae
10
10
1
10
1
1
10
10 survival (x) 100.0
1. 7
L 74Ao Original number of lame
1. Average Wt (mg)
Wei{hVodginal (m{/larvael
% Effluent surviving number of larvae
10
10
10
10
10
10
1 Survival (xl 100.0
Original number Of larvae
1
0
1.1
1.1 2
1. Average wt (mg)
W eighVonginal I ma/larvaa )
Quality Data
N/dtar Q Y I n t1DY 1
WY 2
T my s
peY rs.., s
i i l Imnei I I l i nt final
Control
PH (50:
Do (mg/l):
Temp. ('Cl:
High Conce
PH (su):
DO (mg/t):
Temp. ('C)'
sample information
Collection start date:
Grab:
Composite duration:
AlkallnitY (m6A CaCOr):
Hardness (mg/L CaCOs):
ConductWlty (µmhos/cm):
Total nsiduat chlorine IMSAI:
sample Temp. at Receipt ('C):
Overall Analysis: ChV: >3.48%
Result: PASS LOEC: >3.48'Yo NOEL: 3.48%

trw�,annenur r.,uov sa�u�� wK.
Effluent Toxicity Report Form - Chronic Fathead Minnow Multi -Concentration Test
Facility: Veolia NPDES p: NC
Elkin WWTP
aboratory Performing Test: Environmental Testing So I nS, In ti i
ignature of Operator in Responsible Charge (ORC):
IRC Phone / E-mail:
ignature of Laboratory Supervisor: r
e-Mail to:
Or Mail Original to: North Carolina Division of Water Resources
Water Sciences Section / Aquatic Toxicology Branch
1621 Mail Service Center
Raleigh, NC 27699-1621
Test Start Date: July 12, 2022
Control
Organisms
% Effluent
0.218%
% Effluent
0.435%
% Effluent
0.87%
% Effluent
1.74%
% Effluent
3.48%
PO Box 7565
Asheville, NC 28802
Phone: [phone]
Fax: [phone]
Date: July 25. 2022
0020567 Pipe #: 001 County: Surry
M 037 Comments:
E
Project N: 17098
Sample 0: 220712 02, 210714.02, 220716 02
Test Organisms: Pimephales promelas
Supplier
In-house Culture
Begin hatch: 07-11-22 1511
End hatch: 07.12-22 0500
Replicate number
1 2 3 4
Surviving number of larvae
10
10
10
1
Original number of larvae
10
10
10
10
waight/original (mg/larvae)
I 0.813L
0.921
0.963
1 1.009
Surviving number of larvae
10
10
10
10
Original number of larvae
10
10
10
1
Weight/original (mg/larvae)
1 0.929 1
0.802
1 1.011
0.987
surviving number of larvae
10
10
10
10
Original number of larvae
10
10
10
1
Weight/original (mg/larvae)
0.975
0.808
0.919
f 0,491
surviving number of larvae
10
10
10
10
original number of larvae
10
10
10
10
Weight/original (mg/larvae)
0.950
0.935
0.943
0.993
Surviving number of larvae
1 10
10
1 10
10
Onginal number of larvae
10
10
1 10
1
walht/original (mg/larvae)
0.955 1
0.941
1 0.867
1 0.88T
Surviving number of larvae
1 10
1 10
1 10
1 1
Original number of larvae
1 10
1 10
I 10
1 10
welght/original (mg/larvae)
1 0.730
1 0.981
1 0.907
1 1.027
Survival (%)
100.0
Avenge wt (me)
0.927
Average wt/
0.9 TT
surviving (mg)
Survival (%) 1 .0
Average wt (mg) 93
Survival i%) 100.0
Avenge wt (mg) 0.916
Survival (%) 100.0
Avenge wt (mg) 0. $
Survival (X) 1 .0
Average wt (me) 0.912
Survival (%) 1
Avenge wt (mg)
Water Quality Data
Day 0 Day 1 Day 2 Day 3 Day 4 Day S Day 6
Initial I Final Initial Final Initial Final Instal Final Initial IFinal initial I Final I Initial I Final
Control
pH (SU):
DO (mg/L):
Temp. ('C):
High Concentration
pH (SU):
00 (mg/L)
Temp. ('C):
7.39
7.41
7.39
7.55
7.49
7.41
7.36
7.53
7.31
7.53
7.30
7.61
7.60
7.55
7.6
7.7
7.9
7.7
7.6
6.9
7.6
7.6
7.7
7.5
7.7
7.7
7.7
6.9
24.8
24.9
24.8
24.7
24.8
24.6
24.8
24.8
24.8
24.6
24.8
2.4.8
24.8
24,6
7.47
7.52
7.58
7.50
7.57
7.49
7.55
7.49
7.59
7.47
7.70
7.59
7.73
7.51
7.9
7.5
8.0
7.9
8.0
7.1
8.0
7.3
8.0
7-2
7.9
7.6
7.7
7.0
24.7
1 24.9
24.7
24.8
25.0
1 24.6
24.9
24.8
24.8
24.8
25.0
24.4
24.9
21.5
Sample information
Coliectlon start date:
Grob:
Composite duration:
Alkalinity (mg/L CaCOsl:
Hardness (mg/L CaCOs):
Conductivity (µmhos/cm):
Total residual chlorine (mg/L):
Sample Temp. at Receipt ('C):
Sample L
Sample 2
Sample 3
Control
07-10-22
07-12-22
07-14-22
24-h
24-h
24-h
28
42
47
61, 81, 61
31
41
26
86, 66, 86
210
251
1 280 1
293413
5.6
5.8
1 5.4
1
Anatyses
Normal:
Hom. Var.
NOEC:
LOEC:
ChV:
Method:
Overall Analysis:
Result: PASS LOEC: >3.48% NOEC: 3.48% ChV: >3.48%
MAID Du....A CI. AT-C
Survival
Growth
Yes
Yes
Yes
Yes
3.48%
3.48%
>3.48%
>3.48%
>3.48%
>3.48%
Visuallnsp.
Dunnett's
Survival
Growth
% Effluent
Critical
Calculated
Critical
Calculated
0.218%
2.410
-0.098
0.435%
2.410
0.184
0.871A
2.410
-0.492
1.74%
ZA10
0.257
3.48%
2.410
0.261

;t 18 22,09:39a
a
PO eor 7S65
Asheville, NC 28302
Phone; [phone]
Far: [phone]
EfRluent Toxicity Report Form - Chronic Fathead Minnow Multi -Concentration Test Qete: September 25, 2c22
Facllfty: Veolia NPOES M NC 0020567 Pipe 4: 001 County: Surry
Elkin WV1rTP
Laboratoev PBfOraiirig Test Environmental Tesb. Solutions, Inc., Certificate k 037 Q co rr.enn'
S,V%"orir ofc)psator in Responsible Oiarae (ORC):
ORCPhone iL-mall: Proton; 17249
Siariature of Laboeatixy Su Par vise'' - - / 54mDle a: 1A s:1 t4 i10is a, �DevN
f►Mhn to: Yost Organisms: Ansepholes prv/rrOM
Ur Mall Original to: North Carolina D,viSion otVVater Resources suppler
water 50e Kes Section / Aquatic folocolacy Branch 1r+hous4 Cuh.,r.
1621 Mad 5ervke Center 9ryln n,atxl: 09-12-2Z 1455
Raleigh, NC 27699-1621 End ketch. 09-1322 0500
Test Start Date: f I 1 2 _1
Control
organisms
% Effluent
o111fi
Replicate number
s 1 2 A
&rvlv4K ^u:tiber of larvae
10
10
1
Onalnal rwmbarc f e" -
1
wNFf /wli/nal (mi/I. vBe)0,736
1 0. 742
SurvnfiilinumberollinlM
I 1
0
I number of hrvee
1wif-ptl0fligInaTOwaT061
tur.hoi(%) 1
Aver7at wl (m8)
Averace r.t J
suv:vlrB (mt)
Surviwl (R)
A.vaaevt(mel 1 am
%Effluent lsurvMwnumbe•ofianne I IV 11 1 ryann
e.4331a MBI number d knot 1 10 1 Survival (x)
We�tNr a)ow I A',e7ae wt(ma) f 1�1.at1 �1
% Effluent
L"'•' r
% EfAuant
1L -
%[ffluent
a.4QG
5urwving number ul larvae
1jilf-, number of larvae
10 1
KAt/p+dnal("Wolae)
1
0.
0. Il
vrvfukr Aurrrbaratlrrvae
1
1
T 10 1 1
number of larvae
;
ID
hrlcadl )
0,8
1 0.693 1 0,%"
rvrAne numhar or larvae
1
Oridneinumberoria"m
W41e1+ alauu7 (me%larveei
A17
C2
SieVva' ("i)
Aceraea wt irrel 4
survnal (%sJ I MO
A.eraee Nt {r,4)
Suwlval (%)
Avera(e rc(mll �
Water Cbiality Data
Day 0 Day i Day 7 pap l Day a Dav S Oaf e
rilal Yiru: Lnn.Yl Few it tld final :mtltl I'.nel hlt'af Fkv11 inrth4 fHnai R4ual Rnal
CorrV01
PH ;SO):
00 (rnr,4.1:
Tt,. ('CI'
Hlah concenti
PH 191/):
D0(ri IL):
Temp i-C):
7.20
I.r
712
7.10
is
7.18
1 719
731
1 7.28
1 194
1.41
7A9
1.0
7,45
7.9
7.8
7.7
7,7
1.9
7.9
7.7
8.0
7.7
7.B
7.7
7 4
I B
T 3
24.a
24.9
24.7
24.6
2ks
243
14.8
24.0
11.7
145
24A
24.7
I41t
I 144
uioo
Z19
7.15
7,33
7.3C
M3
7.13
7.41
719
7,7i
7 25
7.59
1 7.43
7.52
1.40
7a
f10
a1
78
e.0
7.B
7.7
7E
30
7.7
8.0
74
8.0
7.5
ap 7
24.6
1 2"
1 24.7
25.0
245
25.0
243
24.5
24.5
1 75.0
1 24 7
24.6
243
Sample informatlon
collection stet: date:
Grab:
Canipoa1bt du-aLkm!
AlkaIINry lath CZCO,)
Hardnmw (taaiL CeCOJ:
CanduahlitY (larnhM/em):
Total retidual thleree (myl):
5aui4,k+ Temp. at Receipt ('Cl;
Analyses
Normal:
Horn. var.
NOP(;:
LOEC:
cW
me.hod:
overall Analysis:
Result: PASS LOEC: >3.48% NOEC: 3.48% ChV: >3AS%
AN pUnport Form AT-S
Survive,
Growth
Yes
yea
Yu
Yes
>3.48%
>3,48%
>3.46%
Zuw imp.
5unnetrs
5unilwal
Growth _-
%E'iltient
critical
Caicukili"
critical
Cakuhted
0.218%
2.410
-3.395
0.4i416
2.4tO
-L"s
O.K7'7G
1A.10
-A-ZOO
1.14%
2.410
-1.163
;,rgyg
24lo3.325
-- -- .- - -_.r _.. __ - ..._ -- -- --
__

, 23.12A0p
" T" f,alRor (ffl"
ar.;r�w.Mp lvl7 f.b.w YR
Effluent Toxicity Report Form -Chronic Fathead Minnow Multi -Concentration Test
Faclfity: Veolia
Elkin WWP
dtomtpry PerrormrnyTest: EnArortrnental TestIrM Sol tior
WAGire of Operator in Raiporulbk Crrr;e (ORCI
%C Dhow / 6ntal: Q(JL
Mto or Laboratory Super-Asor:
PO Box 7565
Asheville, NC 28802
Phone: (828► 3SO.9364
Fix. i828► 350.9368
02te December 30, 2022
NPDE5 9: NC 0020567 Pipe x: 001 County: Sorry
to4037
C© M
Ca.rne nry.
Project a: 174S7
34r.plea; 121 kdf,02, 22 Uo1aR 1212101p
-Mal Test Organisms: finrephaW promoim
or toted orlpnel to: Nwtt+Ca orlon D AmofYWte►Rerources svpprkr
Water Sderl ra Sectlan/ Aquatic Ta.icolotly Branch in -haw C1xMa
1623 Mail Serrke Center 9et7n h+rch: L7 OS i2 1eSS
Radeyh. NC 276519-1671 fiMhardi: 160612 OlOtl
Test Start Date: zoll
Repkato number
1 2 3 4
Control
wrnbarolYn.e 1 1
stnrl.,l(x)
Organisms
holMA in orkrwe
EJ
avers,ver6+ral
ro+Waj I U 144 1 U.NUI I U.In I D.840 I
Average Wt /
Sti EM vent
iwnew" nunftt of WV" ID in L
+wvlwr4 (m/1
a nwokref larvae I10 1SvnMl
nag
f 1O.ID5
Awn, Wz Imtl
Y. Effluent
a.n of larva 1
OA
nt,mberoiluvaeW ;W
(%)
Away M Ime1
% EMuent
aa.nNr of ►nee
®
r.nha otlarvw i1o�
sec vww lam
]
aw.r++rtCmtl
%Effluene
.' "flu"..
OryN.I nlinberor4nSS1 20 13 i 2urd
SurAvel l%1
I IIWI
0.71
7t Efligertt
ntunbar r1KV"
3A114
ra.rtberof brow 10 10 1 10 W
lViAmight/origi.no
kl4ifteal ULaveat++K(ma1
Water Cbellty Data
"6 waill 0"Y 2 fty 3 Day 4 Dq S on
ladw I flaw m1hel I alrrl Indal I final 6*w I Flnw Yildal I:nal k*W Flna( hit4tl ,,nil
Control
pKtw-b
lb trA&U
Tema. rCt
High Cowerib
PN (Sul:
Do lnN1:
Temy. rl:):
7,29 I 7.25
7.17
1 7.17
1 7A4 72e
7.26
73S
7.12
7.3%
1 7.15
1 721 7.2e
73a
7.1 7.9
1 7.7
1.e
7.1 7.1
711
7.7
7.e
7.6
7.7
7., ;A
7A
14.7 24.9
1 Me
U.7
243 24.9
247
24.6
24.2
24.1
14.6
24.7 24.7
242
751
1 74"
1 143 1 711
1 7-M 7AS
714
7.41 LU
71S 1 737
1 723 7.31
1.30
ze
9•0
79 1 7,7
7.7 zi
7.9
7.7 7.9 .
71 LO
73 70
7,9
?O,S
i41
I4.9 I4.7
NJ 241
2SA
24 3 24 f
24.a 24.7
24B 249
24.6
Sample Information
C0106M )n Hart MINTS.
Graff:
ramposni dUfAcn:
A"Waf (rn4%L CaCOtj;
Kwdnata (rlt3/( CK00:
Cdlaatleky ptmho.h+hi:
Tbral raw4at ima nna (.VL)
Umpla Temp. k eec.yft i'C):
Analyse
Morvret
Ftom. V4r.
teOFC
LOW
Chv.
Method:
Overall Analysis:
Result PASS LOEC: >3.48% NQEC: 3A3% ChV �m3.48%
ort tl1 A -5
wrvhvl
c �^
Y.s
Yoe
Yu
TO
1499
14.11%
>3:44%
aa.49%
a0.4111e6
.5.41%
Wawllnrp. I
Du"nen's
Swvhral
4mmh
N iRirnk
Crtilcal.
Ca uNto
CrRlal
CAkulatt4
0.21a%
IA10
-110
0.aleSf
2AS0
AMY
o•Ini
2.410.
CA%
1.741f
Z410
CIA
1.4e%
1411i
4 01

,s 23,08'42a
P'
Effluent Toxitity Report Form - Chronic Fathead Minnow Multi -Concentration Test
F2CI',tty, Vella NODES N: NC 0020567 Pipet 001
ElmWWTP
abo "M Perforrntn`Test, Erlrironmental Testis Sotupom. inc..ificee p 037
%nature of Operator In Responsttit CAar{e (;NCI:
MCPhoete/E-mail: �L -ati- L a�n oat
i& Mllre of Latrora tmi SW&vhw.
PO Box 7565
Asheville, INC 28W2
Phone: (828) 3SO-3364
Fax: [phone]
oate. Mardi 241013
County: Surry
CalrraeMc
vraiact t: 17'656
9.npie f. IaomAL 7aoseadl, U4JLIAt
e-Mall to Test or;artkms: Ptetepholrs promelds
Or Mail prl�1n71 tD: Notch Cardt.aa Division t>f water Resources S�>plkr
water stlerares Sec ion / Agtutic Toalctl M Branch fa d
1621 Mal Service Center 0ealn hatch: 03-0F23 IQ]
K"gh, NC 27699-1621 emd hakh: 03-07-23 05M
Test Start Date: Mech 01, 2023
ttapiicate number
1 2 3 4
Control
Orpnlsms
nanuabodlavm
10 1
10 1
W9iMvat
(7fl
rveraeewt(MI
n.l diarv.a
.1( ore
Avw4ae -t /
arils{ (rrt).
V. Effluent
021a%
F=maurmlsmt vw
(%1
ran►. orhrvae10
20SuMvai
_
elp.d (raaMrvaal
AvaratatAJ")
%Efftuent
O ci9!<
na.Darortrvaa
s avawl lxi
ecnober tN lxv.eI
sold fnr lhtr+eF
G.924
O,aUU
I U-Mg IMAvamo
e,t (mg)
XETfiruentWr_ytArj
nutnbKdYrw.
svl (N)
pumuer or urva4
i
L�
tIR oral rraN
c q i
AwnR r.r6)
%Effluent
SurYMra nvmbsrof aN1e
L74x
numosrdlarwe
s+irtawlYtt)
. 1UMS
Averaa. wt (ma)
% Effluent
j•4eX
Ae�avali><1
w nu~ N +m.1
10
10
1
or numberof
gveW M (.0
Wat*r Qua My Data
0 o.r 1 nay: ow a ow s oar I
Fin.l tatlal FtNt tNtYl i rnl Ia Rrta1 $,Itlti Itn.t 1 I RrmA I kodd I Final
Control
r*iwi
Do (n+a/11:
TaIN• rt�:
H%h ConceNtr
PH Istr).
DO lmjA)'
Tamplc):
a, la )A7
8.01
7)ti
0.04
1,76
7.92
7,)'7
&W
7.aa
a.07 -
7AS
76
7.5
7.6
75
7.8
73
7.9
79
79
Ms
24.7 24.6
24.7
MA
24J
24.3
24.7
24d
24.7
24.4
24.7 -
20
2"
aUVa
a.07
7A6
aA5
M7
7!
?At
GAS
790 a:!
70
79
T.9
7.8
7A
71
7.6
7.9
7.3 A
7! 7.1
�7.6
24.8
24.7
14.9
2418
M4
tat
24.4 2•L9
243
Sanapls Information
cahctbn start dole.
Grab:
Cornpoalle dreatlor:
Alkahnity.(m (L000,L):
words..}tn &A CaC%i;
cbrtd ueMry b+m►wf rnl: .
Tool resldial ddorrte (ma(L):
Sampi. Tgrnp, atpaceipt rclz
Analysts
Normal'
H m. Var.
NCEC
LCIEC:
chi:
Method:
Overa(i Analysts:
Result: PASS LOEQ >3.48% NOEC: 3.48% ChV: >3.48%
DWR Repoli Form AT-S
kwAkgt
Qr_*,
Yes
yes
Yes
Vol
3A8l:
5.46%
>3Aa%
AAM
vbwt imp
Dumed's
suiwal
&Omh
%9rluent
Clitkal
Cakulatod
0e101
t7Yteleted
03211%
2A10
L212
0.43M
LA10
.mzx
02r1%
2A20
0Aa7
1.71%
2.410
in
SAWS
2.410
2.a04

Environmental resting Solutions, Inc.
Effluent Toxicity Report Form - Chronic Pass/Fail and Acute LC50
Facility: SUEZ NPDES #: NC 0020567
Elkin WWTP
Laboratory Performing Test: Environmental Testir
Signature of Operator in Responsible Charge (ORC
ORC Phone / E-mail:
Signature of Laboratory Supervisor: r l"SA
PO Box 7565
Asheville, NC 28802
Phone: [phone]
Fax: [phone]
Date
Pipe #: 001 County
ficate # 037
e-Mail to: [e-mail]
Or Mail Original to: North Carolina Division of Water Resources
Water Sciences Section / Aquatic Toxicology Branch
1621 Mail Service Center
Raleigh, NC 27699-1621
North Carolina Ceriodaphnia Chronic Pass/Fail Reproduction Toxicity Test
Control Organisms 1 2 3 4 5 6 7 8 9 10 11 12
Number of Young Produced
34
32
28
28
31
29
30
31
34
29
34132
Adult Survival: (L)ive, (D)ead
L
L
L
L
L
L
L
L
I L
L
L
I L
Effluent Percentage
Treatment 2 Organisms 1 2 3 4 5 6 7 8 9 10 11 12
Number of Young Produced
32
37
29
36
35
36
37
30
33
30
36
37
Adult Survival: (L)ive, (D)ead
L
L
L
L
L
L
L
L
L
L
L
L
pH (S.U.)
1st Sample
2nd Sample
2nd Sample
Control
17.8717.901
17.7117.93
7.69 7.88
Treatment 2
1 7.8417.931
17.85 17.83
N W
N W
N W
D.O. (mg/L)
1st Sample
2nd Sample
2nd Sample
Control
7.8 7.9
7.7
8.0
7.8 7.9
Treatment 2
8.1 1 7.9
8.0
8.2
8.1 8.2
LC50/Acute Toxicity Test
(Mortality expressed as 3'c, combining replicates.)
Concentration (%)
Mortality (%)
LC50 = Method of Determination
95% Confidence Limits Trimmed Spearman Karber
to Probit
Other:
Organism Tested:
Duration:
Test Start Date
Collection (Start) Date:
Sample 1 03-09-20
March 23, 2020
Surry
Comments:
Project #: 14963
Sample #: 200311.06, 200313.06
Chronic Test Results
t-Stat / Rank Sum -2.742
1-Tailed Critical 2.508
Reduction: -9.7
Percent
Average
Mortality
Reproduction
Control
Control
0.0
31.0
Treatment 2
Treatment 2
0.0
34.0
Control CV
7.3
PASS FAIL
%control organisms producing
3rd brood
X
100.0
a
March 11, 2020
Sample Type/Duration
Grab Comp. Duration
Sample 1 X 24-n
Sample 2 X 2a-h
Alkalinity (mg CaCO3/L
Hardness (mg CaCO3/L
Conductivity (µmhos/cm
Total Residual Chlorine (mg/L,
Sample Temp. at Receipt (°C.
Sample 2 03-11-20
� r•1 N
p y N al
G G
0 3 M ,e,
to
t± a t: V
Control
High Conc.
pH (S.U.) DO (mg/L)
DWR Report Form AT-1

Env�ronm �nral rye tang $oluMons. Inc.
Effluent Toxicity Report Form - Chronic Pass/Fail and Acute LCso
Facility: SUEZ NPDES #: NC 0020567
Elkin WWTP
Laboratory Performing Test: Environmental Testing Sol
Signature of Operator in Responsible Charge (ORC):
ORC Phone/ E-mail:
Signature of Laboratory Supervisor:
PO Box7565
Asheville, NC 28802
Phone: [phone]
Fax: [phone]
Date: June 26, 2020
Pipe #: 001 County: Surry
# 037
e-Mail to: [e-mail]
Or Mail Original to: North Carolina Division of Water Resources
Water Sciences Section / Aquatic Toxicology Branch
1621 Mail Service Center
Raleigh, NC 27699-1621
North Carolina Ceriodaohnia Chronic Pass/Fail Reproduction Toxicity Test
rnntrni Oraanicmc 1 2 3 4 5 6 7 8 9 10 11 12
Number of Young Produced
131
28
28
28
28
29
131126
126
128
131128
Adult Survival: (L)ive, (D)ead
I L
L
L
L
L
L
I L
I L
I L I
L
I L
IL
Effluent Percentage 0.
Trawtms+nt 7 Oroanicmc 1 7 3 4 5 6 7 8 9 10 11 12
Number of Young Produced
127
30
30
128
125
128
132
129
128
26
28
131
Adult Survival: (L)ive, (D)ead
I L
L
L I
L
I L
I L
I L
I L
I L
L
L
I L
pH (S.U.)
1st Sample
Control
1 7.76
7.74
Treatment 2
1 7.71
7.96
to M C
N W
O.O. (mg/L)
1st Sample
Control
1 7.7 1
7.8
Treatment 2
1 7.9 1
7.9
2nd Sample
2nd Sample
7.66 17.991
17.6517.79
7.8618.051
17.9818.02
t a
t: a
2nd Sample
2nd Sample
7.8
F7.7
1 7.5
7.9
7.9
7.8
7.7
LC50/Acute Toxicity Test
(Mortality expressed as %, combining replicates.)
Concentration (%)
Mortality (%)
LC50 = Method of Determination
95% Confidence Limits Trimmed Spearman Karber
to Probit
Other:
Organism Tested:
Duration:
Test Start Date:
Collection (Start) Date:
Sample 1 06-08-20
Comments:
Project #: 15198A
Sample #: 200610.13, 200612.07
Chronic Test Results
t-Stat / Rank Sum 0.000
1-Tailed Crltical 2.508
% Reduction: 0.0
Percent
Average
Mortality
Reproduction
Control
Control
0.0
28.5
Treatment 2
Treatment 2
0.0
28.5
Control CV
6.1
PASS FAIL
%—Aw.j.d—"ducw
3rd brood
v
100.0
/�
June 10, 2020
ample Type/Duration
Grab Camp. Duration
Sample 1 X 24•h
Sample 2 X x4-n
Alkalinity (mg CaCO3/L;
Hardness (mg CaCC3/L;
Conductivity (µmhos/cm;
Total Residual Chlorine (mg/L;
Sample Temp. at Receipt (°C
Sample 2 06-10-20
c N N
o iu v v
b A a a
0 3 N 0
61
83
319, 323, 306
355
293
<0.10
<0.10
2.6
4.2
� w ,� w
Control
High Conc.
pH (S.U.) DO (mg/L)
DWR Report Form AT-1

Fmlrunmmrd rnuny W.U.o , I. -
PO Box 7565
Asheville, NC 28802
Phone: [phone]
Fax: [phone]
Effluent Toxicity Report Form - Chronic Pass/Fail and Acute LCsa Date: September 25, 2020
Facility: SUEZ NPDES q: NC 0020567 Pipe tt: 001 County: Surry
Elkin WWTP
.aboratory Performing Test: Environmental Testing So ion Inc. rt(flcate # 037 Comments
signature of Operator in Responsible Charge (ORC):
)RC Phone / E-mail: Project N: 15367
signature of Laboratory Supervisor: Sample N: 200909.05, 20091IDS
e-Mall to: ATForms.AT86Dncde6r.Rov
Or Mail Original to: North Carolina Division of Water Resources
Water Sciences Section / Aquatic Toxicology Branch
1621 Mall Service Center
Raleigh, NC 27699-1621
North Carolina Ceriodaphnia Chronic Pass/Fail Reproduction Toxicity Test
Control oreanisms 1 2 3 4 5 6 7 8 9 10 11 12
Number of Young Produced
26
28
29
28
126
128
128125
126
28
27
30
Adult Survival: Live, D)ead
L
L
L
L
L
L
L
L
L
L
I L
I L
Effluent Percentage 0.87%
Trwatmant 2 r)raanlcmc 1 2 3 4 S 6 7 R 9 10 11 12
Number of Young Produced
30
28
30
28
28
27
25
26
27
26
27
29
Adult Survival: Live, Dead
L
L
L
L
L
L
L
L
L
L
I L
I L
PH (S.U.) 1st Sample 2nd Sam le 2nd Sample Test Start Date:
Control 17.6417'92 7.62 7.73 7.48 7.85
Treatment 2 7.74 7.92 7.7817.901 17.8217.891Collection (Start) Date:
e t g t Sample 1 09-07-20
ry� A C
t%1 Lw N W V1 lIJ
Chronic Test Results
t-Stat / Rank Sum -0.271
7-Tailed Critical 2.508
% Reduction: -0.6
Percent
Average
Mortality
Reproduction
Control
Control
0.0
27.4
Treatment 2
Treatment 2
0.0
27.6
Control CV
5.3
PASS FAIL
«gww,-w"d kq
lyd ewoe
V
100.0
A
D.O. (mg/L) 1st Sam le 2nd Sam le 2nd Sam le Sample Type/Duration
Control 7.8 7.7 7.$ 7.8 7.9 7.9 Grab Comp. Duration
Treatment 2 8.0 7.8 8.1 7.9 8.1 8.1 sample s X
5 �
Sample 2 X za-n
S
09, 2020
Sample 2 09-09-20
LC50/Acute Toxicity Test
(Mortality expressed as %, combining replicates.)
Concentration (%)
Mortality (%)
LC50 = Method of Determination
95% Confidence Limits Trimmed Spearman Karber
to Probit
Other:
Organism Tested: Duration:
Alkalinity (mg CaCOIA
Hardness (mg CaCO,/L
Conductivity (µmhos/cm.
Total Residual Chlorine (mg/L,
Sample Temp. at Receipt ( a C:
58
A'
90-
314, 327, 299
313
351
<0.1a
<0.10
2.1
5.6
V�l C N OC
W W
Control
High Conc.
pH (S.U.) DO (mg/L)
DWR Report Form AT-1

Effluent Toxicity Report Form - Chronic Pass/Fail and Acute LC50
PO Box 7565
Asheville, NC 28802
Phone: [phone]
Fax: [phone]
Date: December 18, 2020
Facility: SUEZ NPDES #: NC 0020567 Pipe #: 001 County: Surry
Elkin WWTP
Laboratory Performing Test: Environmental Testing So
Signature of Operator in Responsible Charge (ORC):
ORC Phone / E-mail:
Signature of Laboratory Supervisor: r
# 037 Comments
Project #: 15605
Sample #: 201209.06, 201211.05
e-Mail to: [e-mail]
Or Mail Original to: North Carolina Division of Water Resources
Water 561brices Section /Aquatic Toxicology Branch
1621 Mail Service Center
Raleigh, NC 27699-1621
North Carolina Ceriodaphnia Chronic Pass/Fail Reproduction Toxicity Test
rnnfrni rtronnicmc 1 7 :t 4 5 6 7 R 9 10 11 12
Number of Young Produced
31
31
28
26
25
30
27
26
29
27
27
28
Adult Survival: (L))ve, (D)ead
L
L
L
L
L
L
L
L
L
L
I L
I L
Effluent Percentage 0.87%
Tr +r __q. I nrs­:­ 1 7 q A S A 7 R 9 10 11 17
Number of Young Produced
27
26
27
31
30
30
29
28
29
30
27
28
Adult Survival: (L)ive, D)ead
L
L
L
L
L
L
L
L
L
L
I I
I L
Chronic Test Results
t-Scat / Rank Sum -0.802
1-Tailed Critical 2.508
% Reduction: -2.1
Percent
Average
Mortality
Reproduction
Control
Control
0.0
27.9
Treatment 2
Treatment 2
0.0
28.5
Control CV
7.1
PASS FAIL
%eanva+errwJuor wedW&g
)rd broad
100.0
pH (S.U.) 1st Sample 2nd Sam le 2nd Sam le Test Start Date: December 09, 2020
Control 7.90 7.91 7.75 792 7.72 7.80
Treatment 2 7.90 7.86 7.84 7.$9 7.82 7.79 Collection (Start) Date:
t 10 t t Sample 1 12-07-20 Sample 2 12-09-20
n C N C C
N w N W N W
D.O. (mg/L) 1st Vamle 2nd 5am le 2nd Sam le Sample Type/Duration
Control 7.8 7.8 7.6 7.8 7.7 Grab Comp. Duration
Treatment 2 7.8 7.9 8.1 7.8 7.9 7.8 Sample 1
Sample 2
LC,,/Acute Toxicity Test Alkalinity (mg CaCO;/Q
(Mortality expressed as %, combining replicates.) Hardness (mg CaCO,/Lj
Conductivity (µmhos/cml
Concentration (%) Total Residual Chlorine (mg/Q
Mortality (%) Sample Temp. at Receipt ('Cl
LC50 = Method of Determination
N N
o v as u
v> n E
61, 61, 61
84, 91, 89
US, 329,309
298
360
<0.10
<0.10
!
2.6
2.0
95% Confidence Limits Trimmed Spearman Karber t a 0
to Probit W w
Other: Contr6
High Cora:.
Organism Tested: Duration: pH (S.U.) DO (mg/L)
DWR Report Form AT-1

PO Box 7565
Asheville, NC 29802
Phone: [phone]
Fax: [phone]
lnrrrorvxnl�l iuny Sdurlan� n.
Effluent Toxicity Report Form -
Chronic Pass/Fail and Acute LCSa
Date:
March 18, 2021
SUEZ
NPDES #: NC 0020567 Pipe #: 001
County:
Surry
Faculty.
Elkin WWTP
Laboratory Performing Test: Environmental Tes
Signature of Operator in Responsible Charge (ORC).
ORC Phone / E-mail:
Signature of Laboratory Supervisor: l
Certificate # 037 Comments
Pro ed q: 15841
Sample p: 210310.07, 210312.07
e-Mail to: ATForms ATB anncdenr.Qov
Or Mail Original to: North Carolina Division of Water Resources
Water Sciences Section / Aquatic Toxicology Branch
1621 Mail Service Center
Raleigh, NC 27699-1621
North Carolina Cerlodaphnia Chronic Pass/Fail Reproduction Toxicity Test
Control Or anlsms 1 2 3 4 5 6 7 8 9 10 11 12
Number of Youn Produced 34 34 33 32 30 32 33 31 31 29 28 29
Adult Survival: (L)ive, D ea d L L L L L L L L L L L L
Chronic Test Results
t-Stat / Rank Sum
-4.796
1-Talled Critical
2,508
% Reduction:
-12.2
Percent
Average
Mortality
Reproduction
Control
Control
0.0
31.3
Treatment 2
Treatment 2
0.0
35.2
Control CV
Effluent Percentage 0.87% 6.4 PASS FAIL
Treatment 2 Organisms 1 2 3 4 5 6 7 8 9 10 11 12 %
37 34 35 32 39N36 33 37 34 35 35 I,aerooa X
Number of Youn Produced 100.0
Adult Survival: L ive, D ead L L L L LL L LL L L
pH (S.U.) 1st Sam le 2nd Sam le 2nd Sam le Test Start ff
Control 7.48 7.48 7.32 7.64 7.62 7.56
Treatment 2 7.39 7.56 7.45 7.58 7.49 7.50 Collection (Start) Date:
Sample 1 03-08-21
W N w �, w
March 10, 2021
Sample 2 03-10-21
D.O. (mg/L) 1st Sam le 2nd Sam le 2nd Sam le Sample Type/Duration
7 7 7 9 Grab Comp. Duration
Control 7.7 7.7 7.7 8.0 N
7.8 7.9 Sample 1
8.0 7.8 7.8 8.1 o m
Treatment 2 E o
Sample 2 X za_n o 3
Alkalinity (mg CaCO3/L) 60
LC,/Acute Toxicity Test Hardness (mg CaCCl/L) g7
(Mortality expressed as %, combining replicates.) Conductivity (µmhos/cm) 313, 311, sts 37 3386
Total Residual Chlorine (mg/L)
<0.10 <0.10
Concentration (%) 3.4 3.9
Sample Temp. at Receipt (°q
Mortality (%I EEITIEE
LC50 = Method of Determination
Trimmed Spearman Karber 1095% Confidence Limits � W
to Probit EB
Control
Other:
High Conc.
Organism Tested:
Duration: pH (S.U.) DO (mg/L)

Enaronmenul fnunp Solutions, ln�.
Effluent Toxicity Report Form - Chronic Pass/Fail and Acute LCso
Facility: SUEZ NPDES tf: NC 0020567 Pipe #: 001
Elkin WWTP
Laboratory Performing Test: Environmental Testin 5 s, I 6 rtificate ti 037
Signature of Operator in Responsible Charge (ORC):
0RC Phone / E-mail:
Smnature of Laboratory Supervisor: t
e-Mail to: [e-mail]
Or Mail Original to: North Carolina Division of Water Resources
Water Sciences Section / Aquatic Toxicology Branch
1621 Mail Service Center
Raleigh, NC 27699-1621
North Carolina Ceriodaphnla Chronic Pass/Fall Reproduction Toxicity Test
I n n c r 7 R 9 1n 11 12
%,aims an v. 6 ........
Number of Youn Produced
27
--
27
28
-
28
25
27
29
27
26
31
25H27Adult
Survival: (L)ive, (D)ead
L
L
L
L
L
L
L
L
Effluent Percentage 0.87%
I n c A 7 R 9 10 11 12
Number of YoungProduced
27
26
26
26
27
26
27
28
30
28
27
28
Adult Survival: (L)ive, Dead
L
L T
L
I L
I L
L
L
I L
I
L
L
L
pH (S.U.) 1st Sam le 2nd Sam le 2nd Sam le
Control 8.18 8.04 8.17 8.19 8.23 8.06
Treatment Z 7.97 8.15 8.02 8.27 8.13 8.08
t: a t
M w
N N
D.O. (ril 1st 5am le 2nd Sam le 2nd Sam le
Control 7.8 7.6 7.6 8.0 7.9 8.0
Treatment 2 8.1 8.0 7.6 8.0 8.0 8.2
LC50/Acute Toxicity Test
(Mortality expressed as %, combining replicates.)
Concentration (%)
Mortality (%) Ei__H
LC50 = Method of Determination
Start Date
PO Box 7565
Asheville, NC 28802
Phone: [phone]
Fax: [phone]
Date: June 21, 2021
County. Surry
Comments
Project R: 16025
Sample N: 210609.06, 210611.06
ollection (Start) Date:
Sample 1 06-07-21
Chronic Test Results
t-Scat / Rank Sum 0.141
1-Tailed Critical 2.508
% Reduction: 0.3
Percent
Average
Mortality
Reproduction
Control
Control
0.0
27.3
Treatment 2
Treatment 2
0.0
27.2
Control CV
6.1
PASS FAIL
% wnN rrMlww. ErNo.`.E
100.0
X
June 09, 2021
Sample Type/Duration
Grab Comp. Duration
Sample 1 X :a n
Sample 2 X =,-h
Alkalinity (mg CaCOIA'
Hardness (mg CaCO3A
Conductivity (pmhos/cm',
Total Residual Chlorine (mg/L;
Sample Temp. at Receipt (°C'.
Sample 2 06-09-21
C rl N
v u
E E
61, 62, 59
86, 86, 84
313,305,323
329
326
<0.10
<0.10
5.8
2.6
95% Confidence Limits Trimmed Spearman Karber y c
N C W
to Probit
HOther: Control
High Conc.
Organism Tested: Duration: pH (S.U.) DO (mg/L)
DWR Report Form AT-1

Emnronm.,�ul rnUnp So�u4uru, Inc.
Effluent Toxicity Report Form - Chronic Pass/Fail and Acute LCso
Facility: SUEZ NPDES #: NC 0020567 Pipe #: 001
Elkin WWTP
.aboratory Performing Test: Environmental Testin So ' ns, I e tificate # 037
lignature of Operator in Responsible Charge (ORC):
)RC Phone / E-mail.
;ianature of Laboratory Supervisor: r
e-Mail to: [e-mail]
Or Mail Original to: North Carolina Division of Water Resources
Water Sciences Section / Aquatic Toxicology Branch
1621 Mail Service Center
Raleigh, NC 27699-1621
North Carolina Ceriodaphnia Chronic Pass/Fail Reproduction Toxicity Test
n c r 7 A Q In 11 12
wnuui v3 a3nanra
Number of Youniz Produced
37
-
3HaRML
-
32
31133
29
30
Adult Survival: Wive, (D)ead
L
L
L
L
L
L
Effluent Percentage 0.87%
!3 n c 9 7 R q 1n 11 12
i redimelEl c w, o,nanra
Number of Young Produced
34
34
-
36Nq�3±OT35Tfiff,21
-
35
31
30
34Adult
Survival: (L)ive, (Dead
L
L
LL
L
L
L
PO Box 7565
Asheville, NC 28802
Phone: [phone]
Fax: [phone]
Date. September 22, 2021
County: Surry
Comments
Project #: 16247
Sample #: 21o9o8.04, 210910.04
Chronic Test Results
t-Scat / Rank Sum -2.011
1-Tailed Critical 2.508
% Reduction: -6.3
Percent
Average
Mortality
Reproduction
Control
Control
0.0
31.8
Treatment 2
Treatment 2
0.0
33.8
Control CV
7.0
PASS FAIL
V-4
3,derwd
y
100.0
/�
.
pH (S.U.) M 2nd Sam le 2nd Sam le Test Start Date: September 08, 2021
Control 7.81 8.04 7.96 7.86Treatment 2 7.95 8.00 8.00 7.89 Collection (Start) Date:
t o e 10 t 2 Sample 1 09-06-21 Sample 2 09-08-21
N
D.O. (rl 15t Sam le 2nd Sam le 2nd Sam le
Sample Type/Duration
Control 7.7 7.8 7.7 8.0 7.7 7.8
Grab Comp Duration
Treatment 2 7.8 8.2 7.8 8.1 8.2 8.2
Sample 1 X �+ n
Sample 2 X �n.n
LC,,/Acute Toxicity Test Alkalinity (mg CaC0fA
(Mortality expressed as %, combining replicates.) Hardness (mg CaCO3/L
Conductivity (µmhos/cm'
Concentration (%) Total Residual Chlorine (mg/L',
Mortality (%) Sample Temp. at Receipt (°C
LC50 = Method of Determination
0 E E
57
86
315,301,314
332
381
<0.10
<0.10
5.7
5.8
95% Confidence Limits Trimmed Spearman Karber e, A
N W N W
to Probit
HOther: Control
High Conc.
Organism Tested: Duration: pH (S.U.) DO (rl
DWR Report Form AT-1

Envi,.nm-W r.0-9 5o1-0. .1M
Effluent Toxicity Report Form - Chronic Pass/Fail and Acute LCso
Facility: SUEZ NPDES #: NC 0020567 Pipe #: 001
Elkin VVWTP
.aboratory Performing Test. Environmental Testin Sol s, In rtificate # 037
signature of Operator in Responsible Charge (ORC):
)RC Phone / E-mail:
signature of Laboratory Supervisor:
e-Mall to: ATForms.ATB6Dncdenr.Rov
Or Mail Original to: North Carolina Division of Water Resources
Water Sciences Section / Aquatic Toxicology Branch
1621 Mail Service Center
Raleigh, NC 27699-1621
North Carolina Ceriodaphnia Chronic Pass/Fail Reproduction Toxicity Test
o n c r 7 A Q 1n 11 12
\.VIIl1 VI V
Number of Young Produced
32
313
291311
Adult Survival: (L)ive, (D)ead
H28
L
I L
I L
L
L
L
L
1 L
Effluent Percentage 0.874Yo
n S A 7 A Q 10 11 12
1 1 w.11-11
Number of Young Produced
3S
32
-
36
34
30
132
139
131
34
39
33
38
Adult Survival: (L)ive, Dead
L
L
I L
I L-1
L
I L
I L
I L
I L
I L
I L
L
PH (S.U.) 1st Sam le M
2nd Sam le
Control 7.65 7.80 7.72 7.66Treatment 2 7.65 7.31 7.72 7.73
Test Start Date:
PO Box 7565
Asheville, NC 28802
Phone: [phone]
Fax. [phone]
Date: January 01, 2022
County: Surry
Comments
Project #: 16542
Sample #: 21121S.04, 211217.04
Collection (Start) Date:
321
Chronic Test Results
t-5tat / Rank Sum -4.540
1-Talled Critical 2.508
% Reduction: -14.7
Percent
Average
Mortality
Reproduction
Control
Control
0.0
30.0
Treatment 2
Treatment 2
0.0
34.4
Control CV
4.7
PASS FAIL
7dk.M
X
100.0
December 15, 2021
t t a Sample 1 12-1
!A w V1 w w
D.O. (mg/L) 1st Sample 2nd Sample 2nd Sam le Sample Type/Duration
Control 7.9 7.9 7.8 7.8 7.7 7.9 Grab Comp. Duration
Treatment 2 8.1 7.8 7.9 8.0 8.0 8.2 sample 1 X 2<-h
Sample 2 X I 24•h
LC,,/Acute Toxicity Test
Alkalinity (mg CaCO./L
(Mortality expressed as %, combining replicates.)
Hardness (mg CaCO2/L
Conductivity (µmhos/cm
Concentration (%)
Total Residual Chlorine (mg/L
Mortality (%)
Sample Temp. at Receipt M
LC50 = Method of Determination
Sample 2 12-15-21
C - N
O0.
? W
3 EEq E
61
92
319, 295, 325
353
371
<0.10
<0.30
1.0
0.9
95% Confidence Limits Trimmed Spearman Karber r, 0 a
w w
to Probit
HOther: control
High Conc.
Organism Tested: Duration: pH (S.U.) DO (mg/L)
DWR Report Form AT-1

EnrlronnumdTeJlinq Sd uNana. Inc.
PO Box 7565
Asheville, NC 28802
Phone: [phone]
Fax: [phone]
Effluent Toxicity Report Form - Chronic Pass/Fail and Acute LC50 Date: March 22, 2022
Facility: SUEZ NPDES W NC 0020567 Pipe #: 001 County: Surry
Elkin WWTP
Laboratory Performing Test: Environmental Testing So io , Inc.,C1?jfjLate a 037 Comments:
Signature of Operator in Responsible Charge (ORC)
ORC Phone / E-mail: Project a: 16907
Signature of Laboratory Supervisor: Sample g: 220309.19, 220311.10
e-Mall to: [e-mail]
Or Mail Orlginal to: North Carolina Division of Water Resources
Water Sciences Section / Aquatic Toxicology Branch
1621 Mail Service Center
Raleigh, NC 27699-1621
North Carolina Cerlodaphnia Chronic Pass/Fail Reproduction Toxicity Test
1 1 1 2 4 S 6 7 8 9 10 11 12
Number of Young Produced
35
32
30
31
33
28
30
34
32
29
28
30
Adult Survival: (L)ive, (D)ead
L
L
L
L
L
L
L
L
L
L
L
L
Effluent Percentage o.87%
Tj ir% ­1­ 1 ? R 4 S 6 7 8 9 10 11 12
Number of Young Produced
33
34
37
33
32
30
34
30
31
31
34
30
Adult Survival: (L)ive, (D)ead
L
L
L
L
L
L
L
L
L
L
I I
I L
pH (S.U.) 1st Sample
2nd Sample
2nd Sample
Test Start Date:
Control
7.77
8.02
7.70 7.89
7.64 7.74
Treatment 2
7.85
7.99
7.80 7.90
7.89 7,75
Collection (Start) Date:
r
M
�
Sample 1 03-07-22
w
L C
w
Chronic Test Results
t-Stat / Rank Sum -1.574
1-Talled Critical 2.508
% Reduction: -4.6
Percent
Average
Mortality
Reproduction
Control
Control
0.0
31.0
Treatment 2
Treatment 2
0.0
32.4
Control CV
7.3
PASS FAIL
11 <MYd NE/MYnM.d��
J,A broad
V
100.0
^
March 09, 2022
D.O. (mg/L) 1st Sample
2nd Sample
2nd Sample
Sample Type/Duration
Control
7.7 7.8
7.7 8.0
Grab Comp. Duration
Treatment 20
K-dj5
7.8 7.8
7.7 7.9
Sample 1
Sample 2
LCso/Acute Toxicity Test
(Mortality expressed as %, combining replicates.)
Concentration (%) F±d
Mortality (%)
LC50 = Method of Determination
95% Confidence Limits Trimmed Spearman Karber
to Probit
Other:
. X za-h
�( 14-h
Alkalinity (mg CaCOs/LJ
Hardness (mg CaCO3/L;
Conductivity (µmhos/cml
Total Residual Chlorine (mg/Li
Sample Temp. at Receipt ('Cl
Sample 2 03-09-22
Z n a
'0 3
60, 61, 60
80, 80, 84
299, 311, 303
390
318
<0.10
<0.10
1.6
1 1.7
N C N C
f-T-1 Control m
High Conc

Enrironmmtal T�sNnq SaluUons, m<
Effluent Toxicity Report Form - Chronic Pass/Fail and Acute LC50
Facility: Veolia NPDES #i NC 0020567 Pipe t#: 001
Elkin WWTP
Laboratory Performing Test: Environmental Testing 4drIfins, I ertificate ## 037
Signature of Operator in Responsible Charge (ORC):
ORC Phone / E-mail.
Signature of Laboratory Supervisor:
e-Mail to: ATFgrms.ATB@ncdt!nr.Rov
Or Mail Original to: North Carolina Division of Water Resources
Water Sciences Section / Aquatic Toxicology Branch
1621 Mail Service Center
Raleigh, NC 27699-1621
North Carolina Ceriodaphnia Chronic Pass/Fail Reproduction Toxicity Test
, I I A S A 7 R 9 10 11 12
Number of Young Produced
34
131
30
33
30
28
33
29
31
32
29
28
Adult Survival: {L)ive, (D)ead
L
L
L
L
L
L
L
L
L
L
L
L
Effluent Percentage 0.879'q
..'2 f% --- :­ 1 1 A 4 5 6 7 8 9 10 11 12
Number of Young Produced
35
130
137
137
139
131
1 35
136
132
134
137
1 32
Adult Survival: (L)ive, (D)ead
ILI
LILI
L
L
L
L
L
L
l
1_1
L
PO Box 7565
Asheville, NC 28802
Phone: [phone]
Fax: [phone]
Date: June 23, 2022
County: Slurry
Comments.
Project #: 17062
Sample M: 220615.03, 220617.03
Chronic Test Results
t-Stat / Rank Sum -3.923
1-Tailed Critical 2.508
% Reduction: -12.8
Percent
Average
Mortality
Reproduction
Control
Control
0.0
30.7
Treatment 2
Treatment 2
0.0
34-6
Control CV
6.6
PASS FAIL
x <onvw an.ntim. rsudu<Mr
3,4 broad
X
100.0
pH (S.U.)
1st Sample
2nd Sample
2nd Sample
Test Start Date:
Control
17.6117.75
7.4017.781
7.58 7.75
Treatment 2
17.6117.68
1 7.631 7.83
7.78 7.82
Collection (Start) Date:
c
N W
N W
W
Sample 1 06-13-22
D.O. (mg/L)
1st Sample
2nd Sample
2nd Sample
Sample Type/Duration
Control
7.6
1 7.9
7.7 7.9
7.8 7.7
Grab Comp. Duratior
Treatment 2
8.0
8.0
8.0 18.0
7.9 8.0
Sample
LC50/Acute Toxicity Test
(Mortality expressed as %, combining replicates.)
Concentration (Yo)
Mortality (%)
LC50 = Method of Determination
95% Confidence Limits Trimmed Spearman Karber
to Probit
Other:
Organism Tested: Duration:
X 24-h
- X 24-h
June 15, 2022
Alkalinity (mg CaCO3/1_J
Hardness (mg CaCO3/L)
Conductivity (µmhos/cml
Total Residual Chlorine (mg/L)
Sample Temp. at Receipt (°C)
Sample 2 06-15-22
C rl N
O `u d a,
7 N
0 3 E E
60
85
310, 298, 298
319
378
<0.10
<0.10
5.8
5.0
t_ a t_ a
N W k W
Control
High Conc.
pH (S.U.) DO (mg/L)

22,02 14p
p1
` F��Manwa„�ITOMnF SaYtlks.K
Effluent Toxicity Report Form - Chronic Pass/Fail and Acute LCsa
PO Box 7S65
Asheville, NC 28802
Phone: [phone]
Fax: [phone]
Date: September 22, 2022
Facility: Veolia NPDES #: NC 0020567 Pipe k 001 County: Surry
Elkin WWTP
aboratory Performing Test: Environmental Testing Soluti , Inc., rtificate # 037
ignature of operator in Responsible Charge (ORC):
IRC Phone ! E-mail:
igWure of Laboratory Supervisor.
e-MW to:
Or Mail Original to: North Carolina 0lvlsion of Water Resources
Water 5ciences Section / Aquatic Toxicology Branch
1621 Mail Service Center
Raleigh, NC 27699-1621
North Carolina. Cerjodaphelst Qmnk Prix/gall Reproductbn TomilchyTest
n 1 > A r, 6 7 8 9 10 11 12
Number of YoungProduced
33132
36
32
28
30
3D
28 30
28
Z8
29
Adult Survival: (L)ive, (D)ead
L
I L
I L
I i
L
L
L
L L
L
l
L
Effluent Percentage 10'3*
-x I A S il;1 7 R 9 10 11 12
Number of Young Produced
129134
30
129
132
135
132
30
29
31
29
35
Adulcsuevival: (L)Ive, (D)ead
I L
L
L
L
L
L
L
L
L
L
LI
L
Comments:
Pf ect P; 17263
SampleI: 2 M 14.02. 2 20916.Oa
Chronic Test Results
t•Stat / Rank Sum -0.715
i-Tallrrt Cri:kai 2.W8
% Reduction: -2.2
Percent
Average
Mortality
Reproduction
Centro(
conbrol
0.0
30.3
Treatment 2
Treatment 2
0.0
31.0
Control CV
8.2
PASS FAIL
100.0
PH (S.U.) 1st Sam le 2nd Sample 2nd Sam a Test Start Date: Sepl
Control 7.Z2. 7.46 LH
7.35 7.37
Treatment 2 7.32 7.47 17.6717.48] Collection (start) Date:
r -a t! Sample 1 09-12-22
w
D_O. (mg/4) 1st Sample 2nd Sample 2nd Sample Sample Type/Duration
Control 7.7 7.8 7.7 8,0 7.8 7.7 Grab Comp Duration
Treatment 2 8.0 7.8 8.1 8.1 Sample I
LC50/Ac ute Taxi cl ty Test
(Mortality expressed as %, combining replicates.)
Sample 2 i(
AW..ahniry Img C4COiX
Hardness (mg CKOF/W
CmductivRy 4:rnhos/cm1
Concentration M Total Residual Chtorine (mg/U
Mortality (%)RISarmle Temp. at Receipt ra
2022
Sample 2 09-14-22
S N
W
D ro 0. a
3 EEry E
y Ul
61, 61, 63
97, 95, e7
323.302,313
328
311
<0-10
<0.10
1.S
1,1
LC50 = Metnod of Determination
95%Confidence Limits rimmed Spearman Karber N T t g
to Problt _
Other- Control
EE High Conc.
Organism Tested, Duration: PH (S.U.) DO (rttg/L)
DWR Report Form AT-1

jen 03 23,12.40p
t.ti.�wrn.v.dl.a.t,.ysduw.w.nc-
PC Box 7565
Asheville, NC 28902
Phone: [phone]
Fax: [phone]
Effluent Toxicity Report Form - Chronic Pass/Fail and Acute LCso Date: December 19, 2022
Facility: Veo(la NPDIES 4: NC 0020567 Pipe #: 001 County. Surry
Elkin WWTP
Laboramry Performing Test: Environmental Testing Solutions, Inc Certificate # 037 Comments:
Signature of Operator In Respoelslble Charge (QR.0
7RC Phone / E-mail. �
"JAtL T9i�A N - c Li VAO L. "4' Prged N: 17480
ilgnature of Laboratory Supervisor: Simpler: 221207.03, 22n1W Q3
e-Mail to:
or Mail Original to: North Carolina Division of Water Resources
Water Sciences Section /Aquatic Toxicology Branch
1621 Mall Service Center
Raleigh, NC 27699-1621
Chronic Pan/Fail Repts{!0lion Toxicky Test
Controllkmnisms 1 2 3 4 S 6 7 8 9 10 11 12
Number of Young Produced
30
28
31
33 34
32
30
3C
29
33
30
32
Adult Survival: (L)ive, (D)ead
L
L
L
L L
L
L
L
L
L
L
L
Effluent Percentage 0.8
Treatment 2 Ororibms 1 2 3 4 5 6 7 8 9 10 it 12
Number of You% Produced 33
27131131133129
132
134132
1,32
37
32
Adult Survival: (L)Ive, (D)ead L
L
I L I L
I L
I L I
L
L I L
L
L
Chronic Test Results
r-stat / Rank sum •1.038
1-Teiled Crkkal 2.508
% Reduction; -3.0
Percent
Average
Mortality
Reproduction
Control
Control
M
31.0
Treetroeet 2
Trvatment 2
0.0
319
Control CV
5.8
PASS FAIL
Ird"..
�/
X
100.0
'
pH (S.11.) 2st Sam le
Ind Sample
2nd Sample
Test Start Date: December 07, 2022
Control
7.27
7.36
17.2617.60
7.26 7.62
Treatment 2
7.54
7.57
7.30 7.61
7.62 7.67
Collection (Start) Date,
t 10G
V
D
N
Sample 1 12-05-22 Sample 2 12-07-22
D-O. (mg/L)
Controf
1st Sample
7.7 7.4
2nd Sample
7.8 8.0
2nd Sam le
7.8 8.0
Treatment2
7.6
7.9
7.7 7.9
7.7.9
Wso/Acute Taxtcity Test
(Mortality expressed as % combining replicates)
Concentration (94
Mortality Im
LC50 :; Method of Determination
b
ample Type/Duration
Grab Comp. Duration
Sample 1 JC 24,
sample 2 X is
Al kailrtlty (mg CaCD
Hardness (mg CaCor/L)
ConductNity (µ'nhos/em)
Total Residual Chlorine (rn"
Simple Temp. at Receipt ('q
C� ✓ V 'V
•� TL p.
dW 62.63, 61
84, 88, 86
31). sa, Sus 293 320
r A • 2.0 1.1
5596 Confidence Limlts Irtrnmem Spearman Kor er C = g
to Probit
Control
hth Cont.
Organism Tested. _ Duration: pH Kul DO (mgh)
DWR Report Form AT-1
5596 Confidence Limlts Irtrnmem Spearman Kor er C = g
to Probit
Control
hth Cont.
Organism Tested. _ Duration: pH Kul DO (mgh)
DWR Report Form AT-1

23,10:59a P.
i.,lrwnrwr r..w.a sa•rao sc
Effluent Toxicity Report Form - Chronic Pass/fail and Acute LCso
Facility: Veolla NPDES #: NC 0020567 Pipe'#: 001
E n WWTP
.aboratory Performtng Test: Environmental Testing Solutions, Inc Certificate p 037
iignature of Operator In Responsible Charge (O
)RC Phone I E-mail: 36
itrnature of Laboratory Supervisor: r rlaa I,• -_�
e-Mall to:
Or Mai) Original to: North Carolina Division of water Resources
Water Sciences Section / Aquatk Toxkology Branch
1921 W4iil Servite Ctnber
Raleigh, NC 27699-1621
�h C>anolitt� ��rlodt�a�tt�fiu ,5�g�i,� Fhitts/Fall Reoradnct n Toxlcit�r Ttlst
2 A r. A 7 S q 10 11 12
Number ofYoun^Produced
30
30
32
27
32 30
31
29
29
27
32
28
Adult Survival: (Ohre, Mead
L
I L
I L
I L
I L L
L I
L I
L I
L.1
L
L
Effluent Percentage Q V-%-
�_�__ , ')2 A S F 7 R 9 10 11 12
Number of You Produced 130130
1 32 F311 301
33 3i
31
28
35
331291
Adult Survival: (Clive, Mead I L.1
Lj L I L I L
I L I
L
L
L
L
I L
PH (S.U.), istSat»ple
2nd le
2nd Sample
Control
7.92
8.23
8.04 8.04
Treatment 2 M
7.98
8.21
18.1518-07
2
8 F
a g
D.O. [mg/L) 1st le 2nd Sam le 2nd Saimole
Control 7.9 8.0 7.6' 7.9 7.9 8.0
Treatment 2 7.9 7.7 T.8 8.1 8.0 8.0
Start Date:
PO Box 7565
Asheville, NC 28802
Phone: [phone]
Fax: [phone]
Date: March 18, 2023
County:_ Story I
Comments
Prciect 0: 17736
sampler: 23030tt.17, 230310M
Chronic Test Results
t•stat / Rank Sure .1.744
1-Talled CrMial 2,509.
% Reduction: -4.5
Percent
AVVVV
manaYtq
Rapmductkm
Control
Control
0.0
29.8
Treatment 2
Trammem 2
0.0
31.1
Control Cv
.6.1
IL
PASS FMX
01
100.0
Mardi 08, 2023
Collection (Start) Date:
Sample 1 03-06-23 Sample 2 034)8-23
T-
Sample Type/Duration
Grab Comp. Duration
Sample 1 X �r
Sample:2 X
a
LCsdAcute TOM City Test Alkalinity (me CaCCIA
(Mortality expressed as %, combining replicates.) Hardness (mg cacq/t,'
conductivity lwnhod*
Concentration K Total Residual Chlorine ImA
Artortaf*. (%) Sample Temp: at Receipt N
LC50 = Method of Determination
95%Confidence Limits rimmed Spearman Kerber W S W
to qP;bit
In
er
l antrd
high cone
Organism Tested: Duration: PH (S.U.) 00 (mg/L)
59, 59, 52
92, 92.91
m%j.ox 1tl1
271
312
<0.10
<0.10
O.S
1.5

EXECUTIVE DIRECTOR
Nicole Johnston
SECRETARY
Anita Darnell
TREASURER
Wayne V. Moore
November 30, 2022
Mr. Carlos Del Castillo, Plant Manager
Pittsburgh Glass Works, LLC
300 PGW Drive
Elkin, NC 28621
R
RE: Transmittal Letter for Modification of IUP No. IWP001
Dear Mr. Del Castillo:
CHAIR
Woody Faulk
VICE -CHAIR
Anita Darnell
BOARD OF DIRECTORS
Robert Ball
Rheajean Benge
Wayne V. Moore
Enclosed is a modified PGW IUP (IWP001). The following modifications were made:
• The December 31, 2022 IUP expiration date has been extended three years to December 31,
2025.
• Glass -cutting coolants was added to the effluent limits (Part 1 Section F) with the following
parameter description:
Discharge to Authority's collection system shall be exposed to only de minimis drag -out of
non -concentrated glass -cutting fluids (such as Acecool 6553 and 6563).
Please contact me at [phone] with any questions.
Sincerely,
Nicole Johnston
Executive Director
Enclosure: Modified IUP #IWP001
cc: Benjamin B. Thomas, PE
Tony Klass, Corporate EHS
Ken Herzer, EHS Manager
John McConnell, Maintenance Manager
Michael Montebello, Municipal Permitting Unit Supervisor
Keyes McGee, Municipal Permitting Unit Pretreatment Coordinator
500 NC Hwy 268 W -- Elkin, NC 28621
Phone: [phone] - www.yvsa.org - Fax: [phone]

Yadkin Valley Sewer Authority
Control Authority
PERMIT
Industrial User Pretreatment Permit (IUP)
To Discharge Wastewater Under the
Industrial Pretreatment Program
IWP001
IUP Number
N/A
40 CFR Catogory(ff Applicable)
In compliance with the provisions of North Carolina General Statute 143-215.1, any
applicable federal categorical pretreatment regulations, all other lawful standards and
regulations promulgated and adopted by the North Carolina Environmental Management
Commission, and the Yadkin Valley Sewer Authority Sewer User Ordinance (YVSA SUO).
The following Industry, hereafter referred to by name or as the permittee:
Industry name, pennittee:
Pittsburgh Glass Works PGW , LLC
Facility Located at Street Address
300 PGW Drive
city
Elkin
Slate, Zip
NC, 28621
is hereby authorized to discharge wastewater from the facility located at the above listed
address into the sanitary sewer collection system and the wastewater treatment facility of
the Control Authority listed below:
IUP Control Authority - WWTP name:
Yadkin Valley Sewer Authority (Authority) Elkin WWTP
NPDES Number:
NCO020567
W WTP Address -
Marion Rd
City, Stale, Zip
Elkin, NC 28621
in accordance with effluent limitations, monitoring requirements, and all other conditions
set forth in Parts I, II, and III of this Industrial User Pretreatment Pen -nit (IUP).
Effective date, this permit and the authorization to discharge shall become
effective at midnight on this date:
December 31, 2022
Expiration data, this peril and the authorization to discharge shall expire at
midnight on this date:
December 31, 2025
November 30, 2022 111d44e %4t6A—P-
Dale signed Exceutive CCtor

Industrial User Pretreatment Permit (IUP)
PART
Specific Conditions
IUP, PART I, OUTLINE:
A.) IUP Basic Information
B.) IUP Modification History
C.) Authorization Statement
D.) Description of Discharges
E.) Schematic and Monitoring Locations
F.) Effluent Limits & Monitoring Requirements
G.) Definitions and Limit Page(s) notes
A. IUP Basic Information:
Receiving Control Authority & WWTP Name:
POTW NPDES #:
Yadkin Valley Sewer Authority — Elkin W WTP
NCO020567
lUP Name:
IUP Number:
Pittsburgh Glass Works (PGW), LLC
IWP001
IUP Effective Date:
Pipe Numbers, list all regulated pipes:
December 31, 2022
001
IUP Expiration Date:
1 UP 40 CFR # (if applicable), or N/A.
December 31, 2025
N/A
I:jonowl9J
ete Permit History is
Effective Date Renewal or Modification Description of Changes Over Previous IUP
03/07/13 None This represents the first issuance of IWP001.
04/14/13 Modification PGW address correction and change TSS Required
Laboratory Detection Level to 2.5 mg/L (from 2.0 mg/L).
03/07/15 Renewal & Modification Monitoring requirement parameters have been limited to flow, pH,
grit, and oil/grease. The grit and oil/grease frequencies have changed
to once every 6 months.
06/14/16 Modification
pH limit requirement changed from 6.0-9.0 SU to 6.0-10.0 SU.
03/07/18 Renewal & Modification
Grit monitoring frequency changed from once/6 months to monthly.
01/20/19 Renewal & Modification
Annual average flow increased from 0.135 mgd to 0.150 mgd;
expiration date changed from 3/6/20 to 3/6/21.
08/21/19 Modification
Annual average flow increased from 0.150 mgd to 0.210 mgd.
03/07/21 Renewal & Modification
IUP expiration date extended; changed the grit content testing method.
07/28/21 Modification Approval of a backlight production line which will increase water
usage a maximum of 18,000 gpd. An increase in the average monthly
flow was not requested.
10/01/21 Renewal & Modification IUP expiration date modified to coincide with the Consent Order that
will take effect from 10/1/21 to 12/31/22. Part 1, Specific Conditions,
D.) Exceptions was expanded to include biocides (page 3).
12/31/22 Renewal 3 years was added to the 12/31/22 permit expiration.
Glass -cutting coolant was added to effluent limits.
2

Industrial User Pretreatment Permit (IUP)
PART I
Specific Conditions
C.) Authorization Statement:
1.) The Permittee is hereby authorized to discharge wastewater in accordance with the
effluent limitations, monitoring requirements, and all other conditions set forth in this
Industrial User Pretreatment Permit (IUP) into the sewer collection system and
wastewater treatment facility of the Authority.
2.) The Permittee is hereby authorized to continue operation of, and to discharge
wastewater from, the following treatment or pretreatment facilities. These facilities
must correspond to the treatment units listed on both the application and inspection
forms.
IU Treatment Units
Flow equalization facilities that limit the peak instantaneous flow rate of the total IU discharge
to 300 gallons per minute, as averaged over My consecutive 10-minute period.
3.) The Permittee is hereby authorized to, if required by the Authority and after receiving
Authorization to Construct (A to C) from the Authority, construct and operate
additional pretreatment units as needed to meet final effluent limitations.
D.) Description of IUP Discharge(s):
Describe the discharge(s) from all regulated pipes.

Industrial User Pretreatment Permit (IUP)
PART
awrl%; 11G %_U11U1L1V11J
Pipe # 001 , Description of Discharge:
All process flow (regulated wastestream) from the various glass fabrication activities: a) cutting, b) edge
grinding, c) hole drilling, d) washing, e) enamel and/or conductive paste screening, f) enamel and/or
conductive paste drying, g) heating, bending and tempering, h) lamination, i) mirror button or bracket
application, and j) air compressor condensate from compressors using oil -less motors. Boiler and cooling
tower blowdowns (diluted wastestream).
Exceptions: Concentrated volumes of oils, hydraulic fluids, coolants, and paint wastes which must be hauled
off (i.e., not part of production line normal use in process) - no discharge to Elkin WWTP allowed. No
domestic flow will discharge through pipe #001. No glass fragments (solids) shall be discharged to pipe
#001 per Part II Section 8 of this IUP.
Additionally, no biocides or other chemical additives are allowed in the discharge without first obtaining
permission from the Authority. The biocides ChemTreat CL206, ChemTreat CL427, and ChemTreat
C2198T are specifically prohibited. These biocides and any others not previously approved shall be deemed
toxic until Permittee proves otherwise (Biocides ChemTreat CL49, ChemTreat CL2250, and ChemTreat
CL6859 have previously been approved). If the Permittee requests the approval of a biocide or other
chemical deemed toxic, Permittee is to submit information showing the expected concentration of the
biocidal components in the discharge at average and maximum conditions. Also submit information
showing that the expected concentrations of the biocidal components will not inhibit the biological
treatment process of the POTW and will not be toxic to aquatic life in the receiving stream. Such information
will need to be based on pilot -scale or full-scale studies using the activated -sludge treatment process
(without primary clarification). If past studies meeting this requirement are not available, a new study shall
be conducted by the Permittee. The study shall be performed by a qualified engineer or scientist with
experience in municipal wastewater treatment inhibition studies.
E.) Schematic and Monitoring Locations:
The facility schematic and description of monitoring location(s) given below must show
enough detail such that someone unfamiliar with the facility could readily find and identify
the monitoring location(s) and connection to the sewer. Include and identify all regulated
pipes.
4

Industrial User Pretreatment Permit (IUP)
PART I
Specific Conditions
E.) Schematic and Monitoring Locations:
The facility schematic and description of monitoring location(s) given below must show
enough detail such that someone unfamiliar with the facility could readily find and identify
the monitoring location(s) and connection to the sewer. Include and identify all regulated
pipes.
W
Employee & Visitor Parking
14 --
——————— — — — — ——---------7
I
I
1
I
Domestic Offices
I
Domestic
I
I
I
I
I o4
c
�
I y
n
I
K
E E
I
co
V
I 0w
06
o
c
-CLC_
oa
E
O
°" 0
EL
I L
v�i
aJ
oq Y
0
V)
N
L
OD C C
a1 `�
N
U
E
9
C C V
- a1 -O
a, O
a c
c
E
I
cc LL
p—
u 2
O
7 O
1
a+
l7
o z
c c
I
ar a,
1
E E
I
o
a` E
— O
I
0
N v
m oc
I
a o
aJ
I
I
E
0
1 g
0
3
a
a
'n
+
O
�
z
�
1
I
— —
u
�
E
0
a
a, o
1'j L
C
p�
> fccO
t
a G
>
; v
v
N N
06
C C
00
W
C V1
d
C
a
aJ -O
a, C
N u
C ,
Q
L
V) 2
LE aJ
VI
0
0
U
Cooling
9

Or
FLOW DIAGRAM 1- TEMPERED SIDE AND/OR BACK WINDOW MANUFACTURING
Raw Glass Warehouse
Delivery
Glass Loaded Onto
Cold End
Notes:
1. Waste water consists of city or reverse osmosis generated water. Basic H may be added to the water
as outlined in a separate letter submitted to the YVSA (letter dated September 27, 2012). Water is
used to clean dirt, dust, and trace amounts of a glass separation media from the glass surface (see
example Glass Separation Media SDS-Endura PB-6293-30).
1 2
Glass Pre Wash &Dry Wastewater
1� 2 3
Glass Cutting, Edge Solids Separation Via
Grinding &Drilling Centrifuge >[7Wastewater
4 5
Glass Water Jet Cutting Solids Separation Via
& Grinding Centrifuge >F F
Wastewater Pretreatment > Pipe 001
6 Daily Maximum: 319,040 gal/day
Glass Wash &Dry Wastewater Monthly Average: 245, 280 gal/day
Annual Average: 210,000 gal/day
To Work In Progress
(WIP) Racks
From Work WIP Racks
Glass Wash & Dry
Glass Screening &
Drying
Furnace - Glass
Bending & Tempering
Glass Cooling &
Packing
TEMPERED SIDE OR
BACK WINDOW
Wastewater
Hand washing sink
FROM LAMINATED SIDE OR BACK WINDOW & WINDSHIELD MANUFACTURING (FLOW DIAGRAM 2)
T
FROM UTILITIES SUMMARY (FLOW DIAGRAM 3)
A glycol ether based glass cutting fluid is dripped onto the glass to facilitate cutting the glass to
shape (see example Glass Cutting Fluid Score 4150 SDS). A closed loop glass edge grinding coolant is
used to cool the glass and the grinding wheel. The coolant is 96%-97% water and 3%-4% glass
grinding coolant concentrate. The grinding coolant passes through a centrifuge to separate glass
solids. The liquid coolant is reused. The solids are recycled or disposed of as solid waste. One
closed loop glass grinding coolant centrifuge system serves the tempered side and/or back window
cold end area. Dirty tank volume is approx. 2500 gallons and clean tank volume is approx. 2000
gallons (See example Glass Grinding Coolant concentrate SDS - EC-S4).
3. Trace amounts of the glass cutting fluid and coolant noted in Item 2 above may be carried over to
wastewater. The glass grinding coolant will also periodically need to be replaced. Spent non -usable
glass grinding coolant is shipped off -site for disposal.
4. Glass water jet cutting will use water and a garnet cutting media. A small amount of glass grinding
coolant will also be used (see example Ace(ool 6563 SDS). The water jet cutting water passes
through a centrifuge system to separate the garnet & glass solids. The water is not reused. Solids are
disposed of as solid waste. The centrifuge tank volume is 525 gallons.
5. Trace amounts of the coolant noted in Item 2 above will be carried over to wastewater. In addition,
excess water will continuously drain from the centrifuge tank noted in Item 4 above (approximately
45 gallons per minute).
6. Waste water consists of city or reverse osmosis generated water. Basic H may be added to the water
as outlined in a separate letter submitted to the YVSA (letter dated September 27, 2012). Water is
used to clean glass cutting, edge grinding, drilling, and/or water jet cutting residue from the glass
surface. Trace amounts of the glass cutting fluid and coolant noted in Item 2 above will be carried
over to wastewater.
Waste water consists of city or reverse osmosis generated water. Water is used to clean ambient
dust/dirt from the glass.

FLOW DIAGRAM 2 - LAMINATED SIDE OR BACK WINDOW & WINDSHIELD MANUFACTURING
Raw Glass Warehouse
Glass Loaded Onto Cold
End
D.
Glass Pre -Wash & Dry 1 > Wastewater
9 10
Glass Cutting & Edge Solids Separation Via
Grinding Centrifuge
Glass Wash & Dry I 4 Wastewater
Glass Screening & I Hand washing sink
Drying
Furnace - Glass Bending
12
Glass Wash & Dry Wastewater
Vinyl Cut, Assembly &
Glass Matching
Pre -Press
(Air Elimination)
Mirror Button
Attachment
Autoclave
Vinyl Trimming
13
Glass Wash & Dry )-,I Wastewater
HI
Inspection &Packing LAMINATED SIDELITE
OR WINDSHIELD
Wastewater
Notes:
8. Waste water consists of city or reverse osmosis generated water. Basic H may be added to the water as outlined in a
separate letter submitted to the YVSA (letter dated September 27, 2012). Water is used to clean dirt, dust, and trace
amounts of a glass separation media from the glasssurface (see example Glass Separation Media MSDS -Endura PB-
6293-30).
9_ A glycol ether based glass cutting fluid is dripped onto the glass to facilitate cutting the glass to shape (see example
Glass Cutting Fluid Score 4150 SDS). A closed loop glass edge grinding coolant is used to cool the glass and the grinding
wheel. The coolant is 96%-97% water and 3%-4% glass grinding coolant concentrate. The grinding coolant passes
through a centrifuge to separate glass solids. The liquid coolant is reused. The solids are recycled or disposed of as
solid waste. One closed loop glass grinding coolant centrifuge system serves the laminated back window or windshield
cold end area (shared with the tempered side and back cold end area). Dirty tank volume is approx. 2500 gallons and
clean tank volume is approx. 2000 gallons (See example Glass Grinding Coolant concentrate SDS - EC-S4).
10. Trace amounts of the glass cutting fluid and coolant noted in Item 2 above may be carried over to wastewater. The
glass grinding coolant will also periodically need to be replaced. Spent non -usable glass grinding coolant is shipped off -
site for disposal.
11. Waste water consists of city or reverse osmosis generated water. Basic H may be added to the water as outlined in a
separate letter submitted to the YVSA (letter dated September 27, 2012). Water is used to clean glass cutting, edge
grinding, drilling, and/or water jet cutting residue from the glass surface. Trace amounts of the glass cutting fluid and
coolant noted in Item 9 above will be carried over to wastewater.
Pretreatment r--j) Pipe 001
Daily Maximum: 319,040 gal/day 12. Waste water consists of city or reverse osmosis generated water. Water is used to clean ambient dust/dirt from the
Monthly Average: 245, 280 gal/day glass.
Annual Average: 210,000 gal/day
13. Waste water consists of city or reverse osmosis generated water. Basic H may be added to the water as outlined in a
separate letter submitted to the YVSA (letter dated September 27, 2012). Water is used to clean vinyl trimming residue
and ambient dust/dirt from the glass surface.

FLOW DIAGRAM 3 - UTILITIES SUMMARY
Hot Water Boilers
Air Compressors
Reverse Osmosis Water Generation
Cooling Tower
(Existing)
Pump Room
14
Wastewater
15
Wastewater
16
Wastewater
17
Wastewater
18
—> I Wastewater
Notes:
14. The boilers are closed loop hot water boilers. There is no routine or periodic blowdown released to Pipe
001. Floor scrubber water is released to the floor sump in the boiler room. The floor scrubber water is
filtered prior to being pumped to Pipe 001.
15. Waste water consists of air compressor condensate. Air compressor condensate passes through oil/water
separators before release to waste water.
16. Waste water consists of reverse osmosis generation waste water.
17. Cooling tower (existing). Waste water consists of cooling tower blow down. It is not known at
this time if a cooling tower will be needed or what treatment chemicals would be needed.
� Pretreatment Pipe 001
18. Waste water consists of potential hot water and/or reverse osmosis water pump leaks to floor drains.
Daily Maximum: 319,040 gal/day
Monthly Average: 245, 280 gal/day
Annual Average: 210,000 gal/day

IUP, Part I Section F:
Effluent Limits and Monitoring Requirements
The Permittee may discharge from this specific
Pipe number according to these specific dates,
effluent limits, and monitoring requirements
Receiving POTW name =>
Receiving POTW NPDES # =>
Effective date for these Limits =>
Expiration date for these Limits =>
YVSA WWTP
IU name =>
NCO020567
IUP # =>
12/31/22
Pipe # =>
12/31/25
40 CFR # =>
THE LIMITS ON THIS PAGE ARE, (Check one below):
LIMITS for ENTIRE permit period => X
INTERIM Limits for period # 1 =>
INTERIM Limits for period # 2 =>
FINAL Limits Page =>
PGW
IWP001
001
N/A
if not applicable put N/A
Concentration
Limits Mass
Limits
Monitoring Free uenc
Daily
Max
Monthly
Aver a e
Annual
Avera e
Units
Daily
Max
Monthly
Average
Units
By Industry
B POTW
Sample
Collection
Method
C or G
Required
Laboratory
Detection
Level
I
Flow !'
0.319
0.245
0.210
MGD
Continuous/DailyZ'
Once/year 1'
Meter a
2
pH
6.0-10.0
SU
Every sample
Once/ ear
G
0.1 SU
3
Grit 3i
12
m L
Monthly
Once/year
G
2.5 m
4
Glass -cutting Coolants'-'
5
OTHER PARAMETERS; Permit is temporary. Additional parameters will be established based on the monitoring and sampling to be com leted
6
Oil and Grease
<100
m /L
Once/6 Months
Once/year
G
5.0 m L
7
8
10
11
12
13
14
15
1/ Peak instantaneous flow as averaged over any consecutive 10-minute period shall not exceed 300 gpm (see Part 1, C.2)
2/ See Part I, G, 3 and 4, and III, 3
3/ Developed by Waypoint Analytical. (Report #19-302-0153, 10/29/2019)— after removing organics, grit is filtered using a pre -weighed 47 mm diameter 70 mesh
(200 µm) standard screen mounted in a vacuum filtration apparatus. See full test method description attached to this permit.
4/ Discharge to Authority's collection system shall be exposed to only de minimis drag -out of non -concentrated glass -cutting fluids (such as Acecool 6553 and
6563).

Industrial User Pretreatment Permit (IUP)
PART I
Specific Conditions
G.) Definitions and Limit Page(s) notes:
In addition to the definitions in the YVSA SUO the following definitions and
requirements apply:
1. Composite Sample:
Unless defined differently below, a composite sample for the monitoring
requirements of this IUP, is defined as the automatic or manual collection
of one grab sample of constant volume, not less than 100 ml, collected every
hour during the entire discharge period on the sampling day. Sampling day
shall be a typical production, and discharge day.
2. Daily Monitoring Frequency
Daily monitoring frequency as specified in this IUP shall mean each day of
discharge.
3. Continuous/Daily Monitoring Frequency
For flow, "continuous" refers to the requirement to use a continuous
recording discharge flow meter. See Part III, 3 for more details. For flow,
"daily" shall mean the permittee shall read the flow meter totalizer every
day, including weekends and holidays, convert this to a daily flow, and
report these daily flows to the Authority with the report due under Part II,
2.
4. "Every Sample" Monitoring Frequency
A monitoring frequency of "every sample" as specified in this IUP shall
mean each time a composite or grab sample is collected.
5. Grab Sample
Grab sample for the monitoring requirements of this IUP, is defined as a
single "dip and take" sample collected at a representative point in the
discharge stream.
6. Instantaneous measurement
An instantaneous measurement for the monitoring requirements of this IUP
is defined as a single reading, observation, or measurement.
Z

Industrial User Pretreatment Permit (IUP)
PART I
Specific Conditions
7. Flow
Daily maximum is defined as the highest "daily discharge" during the
calendar month.
Monthly average is defined as arithmetic mean of all "daily discharges" of a
pollutant or flow measured during the calendar month.
Annual average is defined as arithmetic mean of all "daily discharges" of a
pollutant or flow measured during the calendar year.
10

Industrial User Pretreatment Permit (IUP
PART II
General Conditions
Outline of PART II,
1.
Representative Sampling
16.
Federal and/or State Laws
2.
Reporting
17.
Penalties
3.
Test Procedures
18.
Need to Halt or Reduce
4.
Additional Monitoring by
19.
Transferability
Permittee
5.
Duty to comply
20.
Property Rights
6.
Duty to Mitigate
21.
Severability
7.
Facilities Operation, Bypass
22.
Modification, Revocation,
Termination
8.
Removed substances
23.
Reapplication
9.
Upset Conditions
24.
Dilution Prohibition
10.
Right of Entry
25.
Reports of Changed Conditions
11.
Availability of Records
26.
Construction of pretreatment
facilities
12.
Duty to provide information
27.
Reopener
13.
Signatory Requirements
28.
Categorical Reopener
14.
Toxic Pollutants
29.
General Prohibitive Standards
15.
Civil and Criminal Liability
30.
Reports of Potential Problems
1. Representative Sampling
Samples and measurements taken as required herein shall be representative of the
volume and nature of the monitored discharge. All samples shall be taken at the
monitoring points specified in this permit and, unless otherwise specified, before
the effluent joins or is diluted by any other wastestream, body of water, or
substance. Monitoring points shall not be changed without notification to, and
approval by, the Authority.
2. Reporting
a.) Monitoring results obtained by the permittee shall be reported on forms
specified by the Yadkin Valley Sewer Authority, postmarked no later than the
twentieth day of the month following the month in which the samples were
taken. If no discharge occurs during a reporting period (herein defined as each
calendar month) in which a sampling event was to have occurred, a form with
the phrase "no discharge" shall be submitted. Copies of these and all other
reports required herein shall be submitted to the Authority and shall be sent to
the following address:
Nicole Johnston, Executive Director
Yadkin Valley Sewer Authority
PO Box 828
Elkin, NC 28621
11

Industrial User Pretreatment Permit (IUP)
PART II
General Conditions
b.) If the sampling performed by the permittee indicates a violation, the permittee
shall notify the Authority within 24 hours of becoming aware of the violation.
The permittee shall also repeat the sampling and analysis and submit the results
of the repeat analysis to the Authority within 30 days after becoming aware of
the violation.
3. Test Procedures
Test procedures for the analysis of pollutants shall be performed in accordance with
the techniques prescribed in 40 CFR part 136 and amendments thereto unless
specified otherwise in the monitoring conditions of this permit.
4. Additional Monitoring by Permittee
If the permittee monitors any pollutant at the location(s) designated herein more
frequently than required by this permit, using approved analytical methods as
specified above, the results of such monitoring shall be submitted to the Authority.
The Authority may require more frequent monitoring or the monitoring of other
pollutants not required in this permit by written notification.
5. Duty to Comply
The permittee must comply with all conditions of this permit. Any permit
noncompliance constitutes a violation of the YVSA SUO and is grounds for
possible enforcement action.
6. Duty to Mitigate - Prevention of Adverse Impact
The permittee shall take all reasonable steps to minimize or prevent any discharge
in violation of this permit, which has a reasonable likelihood of adversely affecting
human health, the POTW, the waters receiving the POTW's discharge, or the
environment.
7. Facilities Operation, Bypass
The permittee shall at all times maintain in good working order and operate as
efficiently as possible, all control facilities or systems installed or used by the
permittee to achieve compliance with the terms and conditions of this permit.
Bypass of treatment facilities is prohibited except when approved in advance by the
Authority. Bypass approval shall be given only when such bypass is in compliance
with 40 CFR 403.17.
8. Removed Substances
Solids, sludges, filter backwash, or other pollutants removed in the course of
treatment or control of wastewaters shall be disposed of in a manner such as to
prevent any pollutants from such materials from entering the sewer system. The
permittee is responsible for assuring its compliance with any requirements
regarding the generation, treatment, storage, and/or disposal of "Hazardous waste"
as defined under the Federal Resource Conservation and Recovery Act.
12

Industrial User Pretreatment Permit (IUP)
PART II
General Conditions
9. Upset Conditions
An "upset" means an exceptional incident in which there is an unintentional and
temporary noncompliance with the effluent limitations of this permit because of
factors beyond the reasonable control of the permittee. An upset does not include
noncompliance to the extent caused by operational error, improperly designed or
inadequate treatment facilities, lack of preventative maintenance, or careless or
improper operations.
An upset may constitute an affirmative defense for action brought for the
noncompliance. The permittee has the burden of proof to provide evidence and
demonstrate that none of the factors specifically listed above were responsible for
the noncompliance.
10. Right of Entry
The permittee shall allow the staff of the State of North Carolina Department of
Environment and Natural Resources, Division of Water Quality, the Regional
Administrator of the Environmental Protection Agency, the Authority, and/or their
authorized representatives, upon the presentation of credentials:
To enter upon the permittee's premises where a real or potential discharge
is located or in which records are required to be kept under the terms and
conditions of this permit; and
2. At reasonable times to have access to and copy records required to be kept
under the terms and conditions of this permit; to inspect any monitoring
equipment or monitoring method required in this permit; and to sample
any discharge of pollutants.
11. Availability of Records and Reports
The permittee shall retain records of all monitoring information, including all
calibration and maintenance records as well as copies of reports and information
used to complete the application for this permit for at least three years. All records
that pertain to matters that are subject to any type of enforcement action shall be
retained and preserved by the permittee until all enforcement activities have
concluded and all periods of limitation with respect to any and all appeals have
expired.
Except for data determined to be confidential under the Sewer Use Ordinance, all
reports prepared in accordance with terms of this permit shall be available for public
inspection at the Authority. As required by the Sewer Use Ordinance, effluent data
shall not be considered confidential.
13

Industrial User Pretreatment Permit (IUP)
PART II
General Conditions
12. Duty to Provide Information
The permittee shall furnish to the Authority's Director, within a reasonable time,
any information which the Director, his/her designee, or the Division of Water
Quality may request to determine whether cause exists for modifying, revoking and
reissuing, or terminating this permit or to determine compliance with this permit.
The permittee shall also furnish, upon request, copies of records required to be kept
by this permit.
13. Signatory Requirements
All reports or information submitted pursuant to the requirements of this permit
must be signed and certified by the IU Authorized Representative as defined under
the Sewer Use Ordinance. If the designation of an IU Authorized Representative
is no longer accurate because a different individual or position has responsibility
for the overall operation of the facility, or overall responsibility for environmental
matters for the company, a new authorization satisfying the requirements of this
section must be submitted to the Authority's Director prior to or together with any
reports to be signed by an IU Authorized Representative.
14. Toxic Pollutants
If a toxic effluent standard or prohibition (including any schedule of compliance
specified in such effluent standard or prohibition) is established under Section
307(a) of the Federal Clean Water Act for a toxic pollutant which is present in the
discharge and such standard or prohibition is more stringent than any limitation for
such pollutant in this permit, this permit may be revised or modified in accordance
with the toxic effluent standard or prohibition and the permittee so notified.
15. Civil and Criminal Liability
Nothing in this permit shall be construed to relieve the permittee from civil or
criminal penalties for noncompliance.
16. Federal and/or State Laws
Nothing in this permit shall be construed to preclude the institution of any legal
action or relieve the permittee from any responsibilities, liabilities, or penalties
established pursuant to any applicable Federal and/or State law or regulation.
17. Penalties
The YVSA SUO provides that any person who violates a permit condition is subject
to a civil penalty not to exceed $25,000 dollars per day of such violation.
Under state law, (NCGS 143-215.613), under certain circumstances it is a crime to
violate terms, conditions, or requirements of pretreatment permits. It is a crime to
knowingly make any false statement, representation, or certification in any record
or other document submitted or required to be maintained under this permit,
14

Industrial User Pretreatment Permit (IUP)
PART II
General Conditions
including monitoring reports or reports of compliance or noncompliance. These
crimes are enforced at the prosecutorial discretion of the local District Attorney.
18. Need to Halt or Reduce not a Defense
It shall not be a defense for a permittee in an enforcement action that it would have
been necessary to halt or reduce the permitted activity to maintain compliance with
the conditions of the permit.
19. Transferability
This permit shall not be reassigned or transferred or sold to a new owner, new user,
different premises, or a new or changed operation without approval of the
Authority.
20. Property Rights
This permit does not convey any property rights in either real or personal property,
or any exclusive privileges, nor does it authorize any injury to private property or
any invasion of personal rights, nor any infringement of Federal, State or local laws
or regulations.
21. Severability
The provisions of this permit are severable and, if any provision of this permit or
the application of any provision of this permit to any circumstance is held invalid,
the application of such provision to other circumstances and the remainder of this
permit shall not be affected thereby.
22. Permit Modification, Revocation, Termination
This permit may be modified, revoked and reissued or terminated with cause in
accordance to the requirements of the YVSA SUO and North Carolina General
Statute or implementing regulations.
23. Re -Application for Permit Renewal
The permittee is responsible for filing an application for reissuance of this permit
at least 180 days prior to its expiration date.
24. Dilution Prohibition
The permittee shall not increase the use of potable or process water or in any other
way attempt to dilute the discharge as a partial or complete substitute for adequate
treatment to achieve compliance with the limitations contained in this permit.
25. Reports of Changed Conditions
The permittee shall give notice to the Authority of any planned significant changes
to the permittee's operations or system which might alter the nature, quality, or
15

Industrial User Pretreatment Permit (IUP)
PART II
General Conditions
volume of its wastewater at least 180 days before the change. The permittee shall
not begin the changes until receiving written approval from the Authority. Also
see Part II, 30 below for additional reporting requirements for spill/slug issues.
Significant changes may include but are not limited to:
(a) increases or decreases to production;
(b) increases in discharge of previously reported pollutants;
(c) discharge of pollutants not previously reported to the Authority;
(d) new or changed product lines;
(e) new or changed manufacturing processes and/or chemicals.
The Authority will respond within 10 days of such notice stating if it deems the
proposed "changed conditions" to be significant or not.
26. Construction
No construction of pretreatment facilities or additions thereto shall be begun until
Final Plans and Specifications have been submitted to the Authority and written
approval and an Authorization to Construct (A to C) have been issued.
27. Reopener
The permit shall be modified or, alternatively, revoked and reissued to comply with
any applicable effluent standard or limitation for the control of any pollutant shown
to contribute to toxicity of the WWTP effluent or any pollutant that is otherwise
limited by the POTW discharge permit. The permit as modified or reissued under
this paragraph may also contain any other requirements of State or Federal
pretreatment regulations then applicable.
28. Categorical Reopener
This permit shall be modified, or alternatively, revoked and reissued, to comply
with any applicable effluent standard or limitation issued or approved under
Sections 302(b)(2)(C) and (D), 304(b)(2), and 307(a)(2) of the Clean Water Act, if
the effluent standard or limitation so issued or approved:
1.) contains different conditions or is otherwise more stringent than any
effluent limitation in this permit; or
2.) controls any pollutant not limited in this permit.
The permit as modified or reissued under this paragraph shall also contain any other
requirements of the Act then applicable.
29. General Prohibitive Standards
The permittee shall comply with the general prohibitive discharge standards in 40
CFR 403.5 (a) and (b) of the Federal pretreatment regulations.
16

Industrial User Pretreatment Permit (IUP)
PART II
General Conditions
30. Potential Problems
The permittee shall provide protection from accidental and slug discharges of
prohibited materials and other substances regulated by this permit. The permittee
shall notify the Authority immediately of any changes at its facility affecting the
potential for spills and other accidental discharge, discharge of a non -routine,
episodic nature, a non -customary batch discharge, or a slug load as defined in the
Sewer Use Ordinance.
Additionally, the permittee shall notify the Authority immediately of all discharges
that could cause problems to the POTW including any slug loadings as defined in
the Sewer Use Ordinance. If the permittee experiences such a discharge, they shall
inform the Authority immediately upon the first awareness of the commencement
of the discharge. Notification shall include location of the discharge, type of waste,
concentration and volume if known and corrective actions taken by the permittee.
A written follow-up report thereof shall be filed by the permittee within five (5)
days, unless waived by the Authority.
17

Industrial User Pretreatment Permit (IUP)
PART III
Special Conditions
1. Slug/Spill Control Plan
In addition to the requirements in Part II, the permittee shall implement, operate,
and/or maintain the specific protection measures, activities, plans, etc. as outlined
within the approved permittee slug/spill control plan and enclosed herein.
of Measure, Activity, Plan, Etc. I Implementation Date
Revised Slug/Spill Plan Submitted on 2/2/18 I Approved 3/6/18
Implement Slug/Spill Plan Continuous for duration of permit
Permittee shall submit new slug/spill plan if changes occur that were not previously
outlined in the approved plan.
If a measure fails, the permittee shall notify the Authority within 24 hours.
2. Sludge Management Plan
Ninety days prior to the initial disposal of sludge generated by any pretreatment
facility, the permittee shall submit a sludge management plan to the Authority.
3. Flow Measurement Requirements
(For SIUs with discharge flow meters)
The permittee shall maintain appropriate discharge flow measurement devices and
methods consistent with approved scientific practices to ensure the accuracy and
reliability of measurements of the volume of monitored discharges. Devices
installed shall be a continuous recording flow meter capable of measuring flows
with a maximum deviation of t0.5% from true discharge rates throughout the range
of expected discharge volumes. At the time of issuance of the permit, this method
consists of ultrasound discharge flow meter at sample point for Pipe 001. The
totalizer shall be non-resettleable. The devices shall be installed, calibrated, and
maintained to ensure accuracy. The meter shall be calibrated every year and
documentation submitted to the Authority within 15 days. Modifications to the
flow metering equipment shall be approved by the Authority prior to installation.
If a required flow measurement device fails, the Authority shall be notified within
24 hours.
4. Certified Laboratory Analysis
Pollutant analysis shall be performed by a North Carolina Division of Water
Quality Certified Laboratory that is certified in the analysis of the pollutant in
wastewater.
18

IUP Synopsis
A. IUP Basic Information
Receiving Control Authority & WWTP Name:
POT NPDES #:
Yadkin Valley Sewer Authority — Elkin W WTI'
NCO020567
lUP Name:
IUP Number:
Pittsburgh Glass Works (PG , LLC
IWP001
IUP Effective Date:
Pipe Numbers, list all regulated pipes:
December 31, 2022
1 001
[UP Expiration Date:
I UP 40 CFR # (if applicable), or N/A:
1
December 31, 2025
N/A
B. IUP Survey & Application Form (see Appendix B.6.l.b): Appendix B.6.l.b also
includes a listing of the expected process wastes and material safety data sheets.
a
C. IU Inspection Form (N/A)
D. Rationale For Limitations: (As listed on PART I, Section F of the IUP)
RATIONALE #1 (General Explanation):
Discharge restrictions are set based on expected flow from plant production
phases, WWTP pH and grit limitation, YVSA SUO, and evaluation of the
STMP.

IUP Synopsis
RATIONALE #2 (Rationale Specifics for Limitations):
The following rationale was used for developing IUP Limits.
Parameter
Rationale
Flow
Per IU request (peak instantaneous flow is based on limit of
receiving Candle cke Pump Station capacity).
p11
Per WWTP NPDES Permit. IU's flow is significant and
would require additional buffering at WWTP if below 6
SU's. Upper limit of 10 SU's is permitted (rather than 9)
because other wastewater in POTW is acidic.
Grit
Based on WWTP grit removal system capacity, IU monthly
average discharge of 0.12 mgd, particle size > 0.2 mm, and
specific gravity (S.G.) of glass -� 2.65. Limitation also
needed to protect downstream equipment, and is therefore
limited to normal domestic sewage characteristic.
Oil and7G—re­a-se71FPer
YVSA SUO Section 2.3 Local Limits
RATIONALE #3 (Categorical Industrial Limits, with no Over Allocation Situation):
Check if Combined Wastestream Formula (CWF) or other categorical limits
calculations were used.
Were used (attach calculations)
Were not used X