NC0025712_Fact Sheet_20230810

DocuSign Envelope ID: 3BFEAOE9-29FE-4A7F-B3DB-ECC73E93AF32
FACT SHEET FOR EXPEDITED PERMIT RENEWALS
This form must be completed by Permit Writers for all expedited permits which do
not require full Fact Sheets. Expedited permits are generally simple 100%
domestics (e.g., schools, mobile home parks, etc.) that can be administratively
renewed with minor changes but can include facilities with more complex issues
(Special Conditions, 303(d) listed water, toxicity testing, instream monitoring,
compliance concerns).
Basic Information for Expedited Permit Renewals
Permit Writer/Date
Charles H. Weaver 8/10/2023
Permit Number
NCO025712
Facility Name
Hookerton Wastewater Treatment Plant
Basin Name/Sub-basin number
Neuse / 03-04-07
Receiving Stream
Neuse River
Stream Classification in Permit
C-Swamp NSW
Does permit need Daily Max NH3 limits?
N/A due to massive dilution
Does permit need TRC limits/language?
No — already present
Does permit have toxicity testing?
No
Does permit have Special Conditions?
Neuse special conditions
Does permit have instream monitoring?
Dissolved Oxygen and Temperature
Is the stream impaired (on 303(d) list)?
For what parameter?
No
Any obvious compliance concerns?
Two enforcements, five NOVs and four
NODS during this permit cycle.
Any permit modifications since last
permit?
None.
New expiration date
5/31/2028
Changes in Draft Permit
➢ Updated eDMR text
➢ Added Neuse modeling reopener
Changes to Final Permit
➢ None

DocuSign Envelope ID: 3BFEAOE9-29FE-4A7F-B3DB-ECC73E93AF32
The Daily Reflector - The Daily Advance - The Rocky Mount Telegram
Bertie Ledger - Chowan Herald - Duplin Times - Farmville Enterprise - Perquimans Weekly
EAMA
.;..
Standard Laconic - Tarboro Weekly - Times Leader - Williamston Enterprise
PO Box 1967, Greenville NC 27835
[phone]
Media of Eastern North CaroNna
NCDEQ - DIVISION OF WATER RESOURCES
ATTN: WREN THEDFORD
1617 MAIL SERVICE CENTER
RALEIGH NC 27699
PAID VIA
❑Cas it Card
Date Paid
Copy Line: NCO025712 Hookerton
Lines: 42
Total Price: $84.00
Account: 133315 Ticket: 447448
PUBLISHER'S AFFIDAVIT
NORTH CAROLINA Public Notice
North Carolina Environmental Man -
Greene County agementCommission/NPDES Unit
1617 Mail Service Center
Raleigh, 99-1
t �J affirms that he/she is clerk of The
t o
Notice of Intent to Issue 1 NPDES
Issue a
Wastewater Permit NC002572 Hook -
Standard Snow Hill, a newspaper published weekly at Snow Hill, Greene County,
e!ton virn W TPThe al Manage North
Comm ss n-
North Carolina, and that the advertisement, a true copy of which is hereto at-
proposes to issue a NPDES wastewater
tached, entitled NCO025712 Hookerton was published in said The Standard
discharge permit to the person(s) listed
Snow Hill on the following dates:
below. Written comments regarding
the proposed permit will be accepted
until 30 days after the publish date of
Saturday, June 24, 2023
this notice. The Director of the NC Di-
vision of Water Resources (DWR) may
hold a public hearing should there be
a significant degree of public interest.
and that the said newspaper in which such notice, paper, document or legal
P P 9
Please mail comments and/or Bove ad -
lion requests to DWR at the above ad -
advertisement
advertisement was published, was at the time of each and every publication, a
dress. Interested persons may visit the
newspaper meeting all of the requirements and qualifications of Chapter 1, Sec-
9 q q P
DWR at vie N. Salisbury Street, Raleigh,
NC to review information on file. Ad-
tion 597 of the General Statutes of North Carolina and was a qualified newspaper
ditional information on NPDES per -
found
within the meaning of Chapter 1, Section 597 of the General Statutes of North
mits and this notice may be on
our website: http://deq.nc.gov/about/
CaroDn4.
divisions/water-resources/water-re-
sources-permits/wastewater-branch/
npdes-wastewater/publ ic-notices, or
by calling [phone].The Town of
Hookerton has requested renewal of
Affir ed and subscribed fo me this 14th day of July 2023
WTP
NPDES y 123 Hook 712 for its Greene
(NC Hwy 123, Hookerton) in GreeneCounty.This
permitted facility discharg-
1,�
��'
es treated wastewater to Contentnea
bliC SI
(Nola g rlatur
Creek in the Neuse River Basin. Current -
ly, total residual chlorine (TRC) and fe-
cal coliform are water -quality limited.
This discharge may affect future waste -
load allocations in this portion of the
(Notary Public Printed Namt)
receiving stream.
- Q Q ��
06/24/2023
My commission expires _CQ -�
KIMBERLY GOFF BANDY
Notary Public, North Carolina
Nash County
My Commission Expires
February 22, 2026

DocuSign Envelope ID: 3BFEAOE9-29FE-4A7F-B3DB-ECC73E93AF32
ROY COOPER
Governor
ELIZABETH S. BISER
Secretary
RICHARD E. ROGERS, JR.
Director
Town of Hookerton
Attn: Bobby Taylor, Mayor
PO Box 296
Hookerton, NC 28538
Subject: Permit Renewal
Application No. NCO025712
Hookerton WWTP
Greene County
NORTH CAROLINA
Environmental Quality
January 09, 2023
Dear Applicant:
The Water Quality Permitting Section acknowledges the December 28, 2022, receipt of your permit renewal application
and supporting documentation. Your application will be assigned to a permit writer within the Section's NPDES WW
permitting branch. Per G.S. 150B-3 your current permit does not expire until permit decision on the application is made.
Continuation of the current permit is contingent on timely and sufficient application for renewal of the current permit. The
permit writer will contact you if additional information is required to complete your permit renewal. Please respond in a
timely manner to requests for additional information necessary to allow a complete review of the application and renewal
of the permit.
Information regarding the status of your renewal application can be found online using the Department of Environmental
Quality's Environmental Application Tracker at:
https //deg nc gov/permits regulations/permit-quidance/environmental-application-tracker
If you have any additional questions about the permit, please contact the primary reviewer of the application using the
links available within the Application Tracker.
Sincerely
Wren The ford
Administrative Assistant
Water Quality Permitting Section
ec: WQPS Laserfiche File w/application
D_E Q�� North Carolina Department of Environmental Quality I Division of Water Resources
r Washington Regional Office 1 943 Washington Square Mall I Washington North Carolina 27889
252.946.6481

DocuSign Envelope ID: 3BFEAOE9-29FE-4A7F-B3DB-ECC73E93AF32
Mayor Town Clerk/Finance Officer/Notary
w .GJ� k1xdon Mayor Pro -Tern y
Utility Billing/Tax CollectorlNotary
!Y
oria
Utilities uperinte
�� .•.. "••
Commissioners ✓Qf,Uw Ol `IED
12/06/2022
DES 2
NCDEQ/DWR E�w�NppES
Attn; NPDES Unit NCO
1617 Mail Service Center
Raleigh, NC 27699-1617
Subject: Request for NPDES Renewal
NPDES Permit #NC000025712
Town of Hookerton
Hookerton WWTP
Greene County
Dear NPDES Unit:
The Town of Hookerton is submitting the renewal application package for NPDES #: NC0025712. The
permit expiration date is May 31, 2023. The renewal application package consists of:
• Cover letter
• Modified Application Form 2A with tables A, B, and D
• Topographic map
Please let me know if you have any additional questions.
Sincerely,
-;r
19� ",
Bobby Taylor; Mayor
Town of Hookerton
P.O. Box 296 • Hookerton, NC 28538
[phone] • FAX [phone] • [e-mail]
www.hookertonnc.com
�'a ����,e:� �d low.

DocuSign Envelope ID: 3BFEAOE9-29FE-4A7F-B3DB-ECC73E93AF32
North Carolina
Department of Environmental Quality Modified Application Form 2A
Division of Water Resources Revised March 2021
Modified Application
Form 2A
Minor Sewage Facilities < 0.1 MGD
and No Pretreatment Program
NPDES Permitting Program RECEIVED
DEC 2 0 2022
KDEQIDWRINMES
Note: Complete this form if your facility is a MINOR new or existing publicly owned treatment works.

DocuSign Envelope ID: 3BFEAOE9-29FE-4A7F-B3DB-ECC73E93AF32
NPDES Permit Number
Facility Name
Modified Application Form 2A
NCO025712
Hookerton WWTP
Modified March 2021
Form
NC Department of Environmental Quality - Application for NPDES Permit to Discharge Wastewater
MINOR SEWAGE FACILITIES (Before completing this form, please read the instructions. Failure to follow
NPDES
the instructions may result in denial of the application.)
SECTION•N
INFORMATION FOR i
Facility name
1.1
Town of Hookerton WWTP
Mailing address (street or P.O. box)
PO Box 296
City or town
State
ZIP code
0
Hookerton
NC
28538-0296
EContact
name (first and last)
Title
Phone number
Email address
0
c
Bobby Taylor
Mayor
[phone]
[e-mail]
Location address (street, route number, or other specific identifier) ❑ Same as mailing address
R
LL
NC Highway 123
City or town
State
ZIP code
Hookerton
NC
28538
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
oCity
or town
State
ZIP code
w
Contact name (first and last)
Title
Phone number
Email address
Q
a
a
1.4
Is the applicant the facility's owner, operator, or both? (Check only one response.)
❑ Owner ❑ Operator 0 Both
1.5
To which entity should the NPDES permitting authority send correspondence? (Check only one response.)
❑ Facility ❑ Applicant Facility and applicant
(they are one and the same)
1.6
Indicate below any existing environmental permits. (Check all that apply and print or type the corresponding permit
number for each.)
Existing Environmental Permits
❑ NPDES (discharges to surface
❑ RCRA (hazardous waste)
❑ UIC (underground injection
water)
control)
d
NCO025712
_
o
❑ PSD (air emissions)
❑ Nonattainment program (CAA)
❑ NESHAPs (CAA)
w
rn
N
❑ Ocean dumping (MPRSA)
❑ Dredge or fill (CWA Section
❑ Other (specify)
w
404)
Page 1

DocuSign Envelope ID: 3BFEAOE9-29FE-4A7F-B3DB-ECC73E93AF32
NPDES Permit Number
Facility Name
Modified Application Form 2A
NCO025712
Hookerton WWTP
Modified March 2021
1.7
Provide the collections stem information
requested below for the treatment works.
Municipality
Population
Collection System Type
Ownership Status
Served
Served
(indicate percentage)
100 % separate sanitary sewer
0 Own ❑ Maintain
Hookerton
409
% combined storm and sanitary sewer
❑ Own ❑ Maintain
❑ Unknown
❑ Own ❑ Maintain
% separate sanitary sewer
❑ Own ❑ Maintain
R
% combined storm and sanitary sewer
❑ Own ❑ Maintain
❑ Unknown
❑ Own ❑ Maintain
% separate sanitary sewer
❑ Own ❑ Maintain
o
% combined storm and sanitary sewer
❑ Own ❑ Maintain
❑ Unknown
❑ Own ❑ Maintain
% separate sanitary sewer ❑ Own ❑ Maintain
cn
% combined storm and sanitary sewer ❑ Own ElMaintain
i
❑ Unknown ❑ Own ❑ Maintain
Total
Population 409
U
Served
Separate Sanitary Sewer System Combined Storm and
Sanitary Sewer
Total percentage of each type of
sewer line in miles 100
Is the treatment works located in Indian Country?
1.8
o
U
❑ Yes ❑ 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
0.060 mgd
Annual Average Flow Rates Actual
a
Two Years Ago
Last Year
This Year
= 0
0.0461 mgd
0.0517 mgd
0.0083 mgd
.� "
Maximum Daily Flow Rates Actual
Two Years Ago
Last Year
This Year
1.54 mgd
0.048 mgd
0.052 mgd
1.11
Provide the total number of effluent discharge points to waters of the State of North Carolina by type.
o Total Number of
Effluent Discharge Points
by Type
—
Treated Effluent Untreated Effluent
Combined Sewer
Constructed
Bypasses Emergency
Overflows
Overflows
I
i5 i
I i
Page 2

DocuSign Envelope ID: 3BFEAOE9-29FE-4A7F-B3DB-ECC73E93AF32

DocuSign Envelope ID: 3BFEAOE9-29FE-4A7F-B3DB-ECC73E93AF32
NPDES Permit Number
Facility Name
Modified Application Form 2A
NCO025712
Hookerton WWTP
Modified March 2021
1.20
In the table below, indicate the name, address, contact information, NPDES number, and average daily flow rate of the
receiving facility.
Receiving F cility Data
a
Facility name
Mailing address (street or P.O. box)
d
City or town
State
ZIP code
0
U
a
Contact name (first and last)
Title
0
Z
Phone number
Email address
o
NPDES number of receiving facility (if any) ❑ None
Average daily flow rate mgd
a
1.21
Is the wastewater disposed of in a manner other than those already mentioned in Items 1.14 through 1.21 that do
0
not have outlets to waters of the State of North Carolina (e.g., underground percolation, underground injection)?
t
❑ Yes 0 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
oDisposal
Location of
Size of
Annual Average
Continuous or Intermittent
Method
Disposal Site
Disposal Site
Daily Discharge
(check one)
Description
Volume
r°
acres
gp d
ElContinuous
-
❑ Intermittent
ElContinuous
acres
gpd
❑ Intermittent
El Continuous
acres
gp d
❑ Intermittent
1.23
Do you intend to request or renew one or more of the variances authorized at 40 CFR 122.21(n)? (Check all that apply.
Consult with your NPDES permitting authority to determine what information needs to be submitted and when.)
El El into marine waters (CWA ElWater quality related effluent limitation (CWA Section
Section 301(h)) 302(b)(2))
Not applicable
1.24
Are any operational or maintenance aspects (related to wastewater treatment and effluent quality) of the treatment works
the responsibility of a contractor?
❑ Yes ❑ No -*SKIP to Section 2.
1.25
Provide location and contact information for each contractor in addition to a description of the contractor's operational
and maintenance responsibilities.
Contractor Information
Contractor 1
Contractor 2
Contractor 3
0
Contractor name
(companyname
E
Mailing address
0
street or P.O. box)
o
City, state, and ZIP
R
code
Contact name (first and
c�
last
Phone number
Email address
Operational and
maintenance
responsibilities of
contractor
Page 4

DocuSign Envelope ID: 3BFEAOE9-29FE-4A7F-B3DB-ECC73E93AF32
NPDES Permit Number Facility Name Modified Application Form 2A
NCO025712 Hookerton WWTP Modified March 2021
SECTION11 • •' • i
o Outfalls to Waters of the State of North Carolina
2.1
Does the treatment works have a design flow greater than or equal to 0.1 mgd?
o
❑ Yes 0 No -+ SKIP to Section 3.
0
2.2
Provide the treatment works' current average daily volume of inflow
Average Daily Volume of Inflow and Infiltration
R
and infiltration.
gpd
Indicate the steps the facility is taking to minimize inflow and infiltration.
R
3
O
C
t
2.3
Have you attached a topographic map to this application that contains all the required information? (See instructions for
M
specific requirements.)
C
0
C
O
0
❑ Yes ElNo
E
2.4
Have you attached a process flow diagram or schematic to this application that contains all the required information?
3 2
o
(See instructions for specific requirements.)
a,
LL R
o
❑ Yes ❑ No
2.5
Are improvements to the facility scheduled?
❑ Yes ❑ No 4 SKIP to Section 3.
Briefly list and describe the scheduled improvements.
0
is
1.
d
E
2.
E
0
0
N
3.
L)
4.
R
2.6
Provide scheduled or actual dates of completion for improvements.
Scheduled or Actual Dates of Com letion for Im rovements
E
Scheduled
Affected
Begin
End
Begin
Attainment of
>
o
Improvement
Outfalls
Construction
Construction
Discharge
Operational
E
—
(from above)
(list o )
number)
(MM/DD/YYYY)
(MM/DD/YYYY)
YYY
(MMIDD/Y)
Level
MM/DD/YYYY
rn
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:
Page 5

DocuSign Envelope ID: 3BFEAOE9-29FE-4A7F-B3DB-ECC73E93AF32
NPDES Permit Number
Facility Name Modified Application Form 2A
NC0025712
Hookerton WWTP Modified March 2021
SECTION•-
• ON 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
North Carolina
w
County
Greene
5
0
City or town
Hooker -ton
0
0
.Q
Distance from shore
N/A ft.
N
Depth below surface
N/A ft.
a
0
Average daily flow rate
0.0083 mgd
mgd
mgd
Latitude
35° 25' 42" N
Longitude
77° 35 35"
3.2
Do any of the outfalls described under Item 3.1 have seasonal or periodic discharges?
o
❑ Yes 0 No 4 SKIP to Item 3.4.
d
R
3.3
If so, provide the following information for each applicable outfall.
N
Outfall Number
Outfall Number
Outfall Number
0
Number of times per year
discharge occurs
a
Average duration of each
`o
discharge(specify units
oAverage
flow of each
mgd
mgd
mgd
discharge
n
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 t pe at each applicable outfall.
a
>
Outfall Number
Outfall Number
Outfall Number
`m
Z
� vi
3 6
Does the treatment works discharge or plan to discharge wastewater to waters of the State of North Carolina from
one or more discharge points?
0 Yes ❑ No 4SKIP to Section 6.
Page 6

DocuSign Envelope ID: 3BFEAOE9-29FE-4A7F-B3DB-ECC73E93AF32
NPDES Permit Number
Facility Name
Modified Application Form 2A
NCO025712
Hookerton WWTP
Modified March 2021
3.7
Provide the receiving water and related information if known) for each outfall.
Outfall Number 001
Outfall Number
Outfall Number
Receiving water name
Contentnea Creek
Name of watershed, river,
0
or stream system
Neuse River
Q
U.S. Soil Conservation
N
Service 14-digit watershed
o
code
Name of state
management/river basin
Neuse
U.S. Geological Survey
8-digit hydrologic
cataloging unit code
Critical low flow (acute)
N/A cfs
cfs
cfs
Critical low flow (chronic)
N/A cfs
cfs
cfs
Total hardness at critical
mg/L of
mg/L of
mg/L of
low flow
N/A CaCO3
CaCO3
CaCO3
3.8
Provide the following information
describing the treatment provided for discharges from each outfall.
Outfall Number
Outfall Number
Outfall Number
Highest Level of
El Primary
❑ Primary
❑ Primary
Treatment (check all that
❑ Equivalent to
❑ Equivalent to
❑ Equivalent to
apply per outfall)
secondary
secondary
secondary
Secondary
❑ Secondary
❑ Secondary
❑ Advanced
❑ Advanced
❑ Advanced
❑ Other (specify)
❑ Other (specify)
❑ Other (specify)
0
'Q
Design Removal Rates by
L)
Outfall
d
BOD5 or CBOD5
90 %
%
%
d
E
aMi
TSS
80 %
%
%
H
0 Not applicable
❑ Not applicable
❑ Not applicable
Phosphorus
%
%
%
0 Not applicable
❑ Not applicable
❑ Not applicable
Nitrogen
%
%
%
Other (specify)
❑ Not applicable
❑ Not applicable
❑ Not applicable
Page 7

DocuSign Envelope ID: 3BFEAOE9-29FE-4A7F-B3DB-ECC73E93AF32
NPDES Permit Number
Facility Name
Modified Application Form 2A
NCO025712
Hookerton WWTP
Modified March 2021
3.9
Describe the type of disinfection used for the effluent from each outfall in the table below. If disinfection varies by
season, describe below.
Disinfection by Granular Chlorine
am
0
U
=
Outfall Number 001
Outfall Number
Outfall Number
0
Q
Disinfection type
Chlorine
m
0
Seasons used
m
N/A
;_
Dechlorination used?
❑ Not applicable
❑ Not applicable
❑ Not applicable
❑ Yes
❑ Yes
❑ Yes
[D No
❑ No
❑ No
3.10
Have you completed monitoring for all Table A parameters and attached the results to the application package?
0 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
discharges by outfall number or of the receiving water near the discharge points.
Outfall Number
Outfall Number
Outfall Number
Acute
Chronic
Acute
Chronic
Acute
Chronic
R
Number of tests of discharge
rn
water
Number of tests of receiving
water
w
w
3.14
Does the POTW use chlorine for disinfection, use chlorine elsewhere in the treatment process, or otherwise have
reasonable potential to discharge chlorine in its effluent?
❑✓ Yes 4 Complete Table 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?
0 Yes ❑ No
Have you completed monitoring for all applicable Table D pollutants required by your NPDES permitting authority and
3.18
attached the results to this application package?
No additional sampling required by NPDES
❑� Yes ❑permitting
authority.
Page 8

DocuSign Envelope ID: 3BFEAOE9-29FE-4A7F-B3DB-ECC73E93AF32
NPDES Permit Number
Facility Name
Modified Application Form 2A
NC0025712
Hookerton WWTP
Modified March 2021
3.19
Has the POTW conducted either (1) minimum of four quarterly WET tests for one year preceding this permit application
or (2) at least four annual WET tests in the past 4.5 years?
❑ 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/DDIYYYY)
_
m
0
3.22
Regardless of how you provided your WET testing data to the NPDES permitting authority, did any of the tests result in
o
toxicity?
❑ Yes ❑ No 4 SKIP to Item 3.26.
in
3.23
Describe the cause(s) of the toxicity:
w
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 F1 Not applicable because previously submitted
information to the NPDES permitting authority.
Page 9

DocuSign Envelope ID: 3BFEAOE9-29FE-4A7F-B3DB-ECC73E93AF32
NPDES Permit Number
Facility Name Modified Application Form 2A
NCO025712
Hookerton WWTP Modified March 2021
SECTION•
I
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 ❑
El wl variance request(s) El w/ additional attachments
Information for All Applicants
❑ Section 2: Additional
0 w/ topographic map ❑ w/ process flow diagram
Information
❑ w/ additional attachments
El w/ Table A wl Table D
❑ Section 3: Information on
✓❑ w/ Table B ❑ w/ additional attachments
Effluent Discharges
E
❑ w/ Table C
Section 4: Not Applicable
0
Section 5: Not Applicable
U
Section 6: Checklist and
❑
❑ wl attachments
Certification Statement
Y
6.2
Certification Statement
U
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 forknowin violations.
Name (print or type first and last name)
Official title
Signature
Date signed
Page 10

DocuSign Envelope ID: 3BFEAOE9-29FE-4A7F-B3DB-ECC73E93AF32
NPDES Permit Number
-T
Facility Name
Outfall Number
NCO025712
Hookerton WWTP
001
Modified Application Form 2A
Modified March 2021
Maximum Daily Discharge
Average Daily Discharge
Analytical
ML or MDL
Value
Units
Number of
Pollutant
Value Units
Methods
include units )
Samples
Biochemical oxygen demand
z BODS or ElCBOD�I
40.0
mg/L
14.3
mg/L
24
5210E-11
El IMIL
2.0 mg/L 2 MDL
(report one
Fecal coliform
2420
Cfu/100m1
11.3
Cfu/10om1
24
9222D-06
1Cfu/loon El NIL
El MDL
Design flow rate
0.052
MGD
0.0083
MGD
continuos
N/A
N/A
pH (minimum)
6.1
su
pH (maximum)
8.4
su
N/A N/A
Temperature (winter)
N/A
N/A
Temperature (summer)
N/A
N/A
N/A
N/A
Total suspended solids (TSS)
70.0
mg/L
38.4
mg/L
24
2540D-11
2.5 mg/L El ML
0 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).
Page 11

DocuSign Envelope ID: 3BFEA0E9-29FE-4A7F-B3DB-ECC73E93AF32
EPA Identification Number NPDES Permit Number Facility Name
NCO025712 Hookerton WWTP
Outfall Number
001
Modified Application Form 2A
Modified March 2021
Maximum Daily Discharge
Average Daily Discharge
Analytical
ML or MDL
Value
Units
Value
Units
Number
Pollutant
Methods
(Include units)
Samples
Ammonia (as N)
0.30
mg/L
0.07
mg/L
24
350.1 R2-93
0.1 mg/L 21 MDL
Chlorine
24.0
ug/L
11.5
ug/L
24
SM 4500 CI G 11
❑ ML
10 ug/L O MDL
total residual, TRC 2
Dissolved oxygen
N/A
N/A
N/A
N/A
N/A
N/A
❑ MDL
Nitrate/nitrite
N/A
N/A
N/A
N/A
N/A
N/A
❑ ML
❑ MDL
Kjeldahl nitrogen
N/A
N/A
N/A
N/A
N/A
N/A
OML
❑ MDL
Oil and grease
N/A
N/A
N/A
N/A
N/A
N/A
❑ MDL
Phosphorus
3.14
mg/L
1.93
mg/L
24
365.4-74
0.3 mg/L OML
O MDL
Total dissolved solids
N/A
N/A
N/A
N/A
N/A
N/A
❑ ML
❑ 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 12

DocuSign Envelope ID: 3BFEAOE9-29FE-4A7F-B3DB-ECC73E93AF32
NPDES Permit Number Facility Name
NCO025712 I Hookerton WWTP
Modified Application Form 2A
Modified March 2021
Maximum Daily Discharge Average Daily Dischar a
Analytical ML or MDL
Pollutant Number of
(list) Value Units Value Units
Method' (include units)
Samples
❑ No additional sampling is required by NPDES permitting authority.
Total Nitrogen
7.2
mg/L
5.1
mg/L
24
Calculated
❑ ML
N/A 0 MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
1 Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or required
under 40 CFR chapter I, subchapter N or 0. See instructions and 40 CFR 122.21(e)(3).
Page 18