NCG510002_NCG510002_Complete File_20130621_20130621

Cy P
LT
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Pat McCrory Thomas A. Reeder John E. Skvarla III
Governor Acting Director Secretary
June 21, 2013
Mr. Deryl Bruorton
Blue Ridge Regional Hospital, Inc.
125 Hospital Dr
Spruce Pine, NC 28777
Subject:Rescission of Certificate of Coverage
NCG510002
Spruce Pine Hospital
Mitchell County
Dear Mr. Bruorton:
Division staff has confirmed that the subject Certificate of Coverage (CoC)
is no longer required. Therefore, in accordance with your request, NPDES
CoC NCG51OOO2 is rescinded, effective immediately.
If in the future your facility wishes to discharge wastewater to the
State's surface waters, you must first apply for and receive a new
NPDES permit.
If you have any questions concerning this matter, please contact Charles H.
Weaver at [phone] or via e-mail [[e-mail]].
'Sincer)ly,
C
he y
asT•iomA. Reeder
cc: Asheville Regional Office / Surface Water Protection
NPDES Unit
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 512 North Salisbury Street, Raleigh, North Carolina 27604
Phone: [phone] / FAX [phone] / Internet: www.ncwaterquality.org
An Equal Opportunity/Affirmative Action Employer - 509/6 Recycled/101/6 Post Consumer Paper

11 .
Weaver, Charles
From: Deryl L Bruorton <[e-mail]>
Sent: Friday, June 21, 2013 12:33 PM
To: Weaver, Charles
Subject: RE: NCG510002 is no longer needed
Mr. Weaver
I am in agreement to rescind NCG510002 and understand this will eliminate our annual fee.
Thanks
Deryl Bruorton
VP of Outreach and Service Development
Blue Ridge Regional Hospital
828-766-1803
spcdlb .msj.org
From: Weaver, Charles[maiIto: [e-mail]]
Sent: Wednesday, June 19, 2013 10:53 AM
To: Deryl L Bruorton
Cc: aquarles(-asmeinc.com
Subject: NCG510002 is no longer needed
Importance: High
Mr. Bruorton:
The UST Supervisor in the NC DEN Asheville Regional Office has notified our Division that the subject Certificate of
Coverage (CoC) is no longer required.
NCG510002 covered a discharge of remediated groundwater from the Spruce Pine Hospital in Mitchell
County. According to the UST Supervisor, this CoC is no longer necessary and all discharge has ceased.
Do you wish to rescind NCG510002? This will eliminate the annual fee of $100.00.
I would appreciate any information you have on this site.
Charles H. Weaver
NPDES Unit
----------------------------------------- This message and its attachments may contain confidential and/or legally -
sensitive information that is intended for the sole use of the addressee(s). Any unauthorized review, use,
disclosure, or distribution of the information contained in this message and its attachments is prohibited. If you
have received this message or any of its attachments in error, please destroy all originals and copies of the same
and notify the sender immediately.

Weaver, Charles
From: Wiggs, Linda
Sent: Tuesday, June 18, 2013 11:01 AM
To: Weaver, Charles
Subject: RE: NPDES General Permit NCG510000 renewal notices - UST sites
Attachments: Copy of NCG510 March 2011.xls
Hi Charles,
I had Jan Andersen (Supervisor of UST in ARO) go through these and give me a response.
She said none of the ones listed here in yellow in the ARO need our NPDES permit anymore ,,,they no longer discharge.
Linda
Linda Wiggs - [e-mail]
North Carolina Dept. of Environment and Natural Resources
Asheville Regional Office
Division of Water Quality - Water Quality Section
2090 U.S. 70 Highway
Swannanoa, NC 28778
Tel: [phone]
Fax: [phone]
Link to Division of Water Quality Home Page
http://portal.ncdenr.org/web/wq
Notice: E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and
therefore may be disclosed to third parties.
From: Weaver, Charles
Sent: Monday, June 17, 2013 3:23 PM
To: Wiggs, Linda
Subject: FW: NPDES General Permit NCG510000 renewal notices - UST sites
Many of these were resolved. Any CoC that's expired in BIMS remains unresolved.
CHW
From: Weaver, Charles
Sent: Thursday, March 10, 2011 10:31 AM
To: Andersen, ]an; Bullock, Scott; Jackson, Gene; Rintoul, Cindy; Taraban, Ron; Harmon, Karen
Cc: Edwards, Roger; Krebs, Rob; Smith, Danny; Thorpe, Roger; Shiver, Rick; Basinger, Corey; Hennessy, John
Subject: NPDES General Permit NCG510000 renewal notices - UST sites
I'm currently sending out renewal notices to Certificate of Coverage (CoC) holders under the subject
General Permit. These CoCs were issued to UST cleanup sites which discharge remediated
groundwater. I've attached the database of current CoC holders showing the progress thus far in
contacting them. I've also attached the renewal form being sent to the CoC holders.
UST personnel:
1. The database is FYI in case your contacts at these sites ask why they are receiving the notice.

N
CoC Number
Status
Owner Organization Name
FACILITY NAME
County Name '
NCG510066
Active
Lewis Oil Company Inc
Cullowhee Exxon site
Jackson
NCG510086
Active
M D Ledbetter Oil Company Inc
former K&J Auto site
McDowell
NCG510138
Active
M D Ledbetter Oil Company Inc
Rainbow Pantry #5
Avery
NCG510144
Active
M D Ledbetter Oil Company Inc
Rainbow Pantry #4
Mitchell
NCG510154
Active
M D Ledbetter Oil Company Inc
Nebo Amoco
McDowell
NCG510268
Active
M D Ledbetter Oil Company Inc
Rainbow Pantry #2
McDowell
NCG510362
Active
NC DOT- Environmental Operations
Marble Maintenance Facility
Cherokee
NCG510412
Active
0 A Gregory Inc
D&D Grocery
Buncombe
NCG510002
Active
Spruce Pine Community Hospital
Spruce Pine Community Hospital
Mitchell
NCG510511
Active
Pope Air Force Base
Site SS007 Remediation System
Cumberland
NCG510526
Active
145th Airlift Wing NC Air National Guard
145th Airlift Wing, NC Air National Guard
Mecklenburg
NCG510463
Expired
Anne Cain
Roscoe's Grocery
Iredell
NCG510367
Active
Bellsouth Telecommunications
former Remount Road Service Operations Center
Gaston
NCG510006
Active
BP Products North America Inc
Paw Creek remediation
Mecklenburg
NCG510429
Active
Brawley Construction Company
Brawley Construction Company
Iredell
NCG510052
Active
Catawba Oil Company
Baucom's Grocery
Union
NCG510097
Active
Catawba Oil Company
Simpson's Grocery
Union
NCG510207
Active
Colonial Pipeline Company
Paw Creek Terminal
Mecklenburg
NCG510390
Active
Conocophillips Company
Circle K Store #8379
Gaston
NCG510235
Expired
Easy Serve
Easy Serve
Catawba
NCG510500
Active
General Store of Denver Inc
General Store of Denver
Catawba
NCG510340
Active
Holding Brothers Inc
Fisher Auto Holding Bros Inc
Rowan
NCG510462
Active
Holding Brothers Inc
Johnny's Sav-A-Sum
Cabarrus
NCG510464
Active
Petroleum World Inc
Bantam Mart
Union
NCG510384
Active
Quality Oil Company LLC
Springs Road Gas House
Catawba
NCG510513
Active
Schneider National Inc
Schneider National Operating Facility
Mecklenburg
NCG510514
Active
The Vue Charlotte LLC
The Vue Charlotte
Mecklenburg
NCG510408
Active
A G Lee Oil Co Inc
Dash-N #16
Johnston
NCG510441
Active
ABF Freight System Inc
former Carolina Freight facility
Nash
NCG510529
Active
ATC Associates of NC PC
Strayhorn Wrecker Service
Durham
NCG510117
Active
Bowers & Burrows Inc
Gillburg Grocery
Vance
NCG510484
Active
Boyette & Abrams Investment Group LLC
Robbins Grocery
Nash
NCG510003
Active
Cary Oil Company Inc
Blalocks Convenience Mart
Durham

K; WA
A_LT
NCDENR
North Carolina Department of Environment and
Division of Water Quality
Beverly Eaves Perdue, Governor Coleen H. Sullins, Director
October 18, 2011
Mr. Deryl L. Bruorton
Blue Ridge Regional Hospital, Inc.
125 Hospital Dr
Spruce Pine, NC 28777
Natural Resources
Dee Freeman, Secretary
Subject: NPDES General Permit NCG510000
Certificate of Coverage (CoC) NCG510002
Spruce Pine Hospital
Mitchell County
Dear Permittee:
The Division received your request for renewal of NCG510002 on April 4, 2011. The revised General
Permit was signed on September 20th, 2011 and took effect October 1, 2011. This renewed CoC is issued
pursuant to the requirements of North Carolina General Statute 143-215.1 and the Memorandum of
Agreement between North Carolina and the US Environmental Protection agency dated October 15, 2007 [or
as subsequently amended].
A copy of the NCG510000 is enclosed, as well as an updated Technical Bulletin. The Technical
Bulletin summarizes the changes from the previous version of NCG510000. If any parts, measurement
frequencies or sampling requirements contained in this permit are unacceptable to you, you have the right to
request an individual permit by submitting an individual permit application. Unless such demand is made,
this CoC shall be final and binding.
The CoC is not transferable except after notice to the Division. You must notify the Division if you sell
or otherwise transfer ownership of the permitted facility. The Division may require modification or reissuance
of the CoC.
If your facility ceases discharge of wastewater before the expiration date of this permit, contact the
Regional Office listed below. Once discharge from your facility has ceased, this CoC may be rescinded. This
permit does not affect the legal requirements to obtain other permits which may be required by the Division of
Water Quality, the Division of Land Resources, Coastal Area Management Act or any other Federal or Local
government. If you have any questions concerning this permit, please contact Charles H. Weaver at the
telephone number or e-mail address listed below.
Si tl-
Coleen H. Sullins
cc: Asheville Regional Office — Surface Water Protection
NPDES file
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 One
512 North Salisbury Street, Raleigh, North Carolina 27604 NorthCarolina
Internet: www.ncwaterquality.org
Phone: [phone] I FAX [phone] Naturally
[e-mail]
An Equal Opportunity/Affirmative Action Employer — 50% Recycled/10% Post Consumer Paper

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NCG510000
CERTIFICATE OF COVERAGE NCG510002
TO DISCHARGE PETROLEUM CONTAMINATED GROUNDWATER AND SIMILAR WASTEWATERS
UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards and
regulations promulgated and adopted by the North Carolina Environmental Management Commission, and
the Federal Water Pollution Control Act, as amended,
Blue Ridge Regional Hospital, Inc.
is hereby authorized to operate a groundwater remediation system for petroleum -contaminated groundwater
or similar waste streams that will discharge treated wastewater from the
Spruce Pine Hospital
125 Hospital Dr
Spruce Pine
Mitchell County
to receiving waters designated as an unnamed tributary to Beaver Creek, a class C-Trout stream in
subbasin 04-03-06 of the French Broad River Basin.
All discharges shall be in accordance with the effluent limitations, monitoring requirements, and
other conditions set forth in Parts I, II, III and IV of General Permit NCG510000 as attached.
This Certificate of Coverage shall take effect on October 18, 2011.
This Certificate of Coverage shall expire on September 30, 2016.
Signed this day, October 18, 2011
.iT Colgo H. Sullins, Director IE:/
D' sion of Water Quality
By Authority of the Environmental Management Commission

NC DENR / DWQ / Water Quality Section
��- National Pollutant Discharge Elimination System
NCDENR
N�R.� �Ro�N. oEP�R.MEN1 DF ENVIRONMENT AND NATURAL Re-cE4 N C G 510000
RENEWAL application for coverage under General Permit NCG510000
[remediation projects treating petroleum -contaminated groundwater]
(Please print or type) Certificate of Coverage number: NCG510002
1) Mailing address of site Owner:
Company Name: Blue Ridge Regional Hospital, Inc. (formerly, Spruce Pine Hospital)
Company Contact: Deryl L Bruorton
Street Address: 125 Hospital Drive
City: Spruce Pine State: NC ZIP Code: 28777
Telephone No.: 828-766-1803 Fax:
e-mail address: [e-mail]
2) Location of remediation site producing discharge:
Facility Name: Spruce Pine Hospital
Facility Contact: Deryl Bruorton
Street Address: 125 Hospital Drive
City: Spruce Pine State: NC ZIP Code: 28777
County: Mitchell
Telephone No.: 828-766-1803 Fax:
e-mail address: [e-mail]
3) System operator / Consultant ID [if different from Owner]:
Company Name: S&ME, Inc. (under contract with the NCDENR. DWM, UST Section, State Lead)
Company Contact: Al Quarles (operator: David Reames)
Street Address: 9751 Southern Pine Blvd.
City: Charlotte State: NC ZIP Code: 28273
Telephone No.: 704-523-4726 Fax: [phone]
e-mail address: [e-mail] ([e-mail])
4) Site ranking & ID:
GW incident #: 3659
Site Ranking [if available] J 125D
Date of most recent discharge: Current
___ __1116_19
APR 0 4 2011
Additional data required:
a) A site map clearly showing the path of the remediation system effluent from the site to its
discharge point.
b) If this application is being submitted by a consulting engineer (or engineering firm), include
documentation from the current permittee showing that the person[s] submitting the
application has been designated an Authorized Representative.
Page 1 of 2

NCG510000 renewal application
CERTIFICATION:
I certify that I am familiar with the information contained in this application and
that to the best of my knowledge and belief such information is true, complete, and
accurate.
Printed Name of Person Signing: Deryl L Bruorton
Title: Vice Preside -at
(Signature Applicant) (Date Signed)
North Carolina General Statute 143-215.6 B (i) provides that:
Any person who knowingly makes any false statement, representation, or certification in any
application, record, report, plan or other document filed or required to be maintained under
Article 21 or regulations of the Environmental Management Commission implementing that
Article, or who falsifies, tampers with or knowingly renders inaccurate any recording or
monitoring device or method required to be operated or maintained under Article 21 or
regulations of the Environmental Management Commission implementing that Article, shall be
guilty of a misdemeanor punishable by a fine not to exceed $10,000, or by imprisonment not to
exceed six months, or by both. (18 U.S.C. Section 1001 provides a punishment by a fine of not
more than $10,000 or imprisonment not more than 5 years, or both, for a similar offense.)
DWQDWQDWQDWQDWQDWQDWQDWQDWQDWQDWQDWQ
Mail THIS COMPLETED FORM to:
Mr. Charles H. Weaver
NC DENR / DWQ / NPDES
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
NPDESNPDESNPDESNPDESNPDESNPDESNPDESNPDESNPDES
For electronic copies of this form or the NCG510000 Fact Sheet, send a request to:
[e-mail]
Page 2 of 2

RDischarge
omfr
emediato� ft
ova -
k�� / ��
System �; �ifJo <
Remediation System
SrAftomn SYS?s:.)A \ j i /• ;ems •' %
1 �
r 1
Underground
Piping
Hospital
Figure from S&ME's October 1998 Site Map for Engineering Drawings
Scale: Shown
-
ENGINEERING . TESTING
ENVIRONMENTAL SERVICES
Site Aerial Map — Discharge Path
Blue Ridge Reg Hosp (Spruce Pine Hosp)
NCG510002, 125 Hospital Dr
Spruce Pine, North Carolina
Figure No.
1
Checked by:
Drawn by: WA
Date: 03-31-2011
JobNo.: 1354-09-212D

�AR'Tja
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins
Governor Director
May 18, 2009
Transmitted via FAX — 1 page total
MEMORANDUM
To: Keith Holtsclaw / Spruce Pine Community Hospital
From: Charles H. Weaver, Jr. / NFDES Unit
Subject: Contact for status of remediation project covered by NCG510002
Dee Freeman
Secretary
Mr. Holtsclaw: the person to contact regarding the current status of your groundwater
remediation project is Mr. Scott Ryals at 919 733-1318. Mr. Ryals is with the State Trust Fund
group within the Underground Storage Tank program; he can answer your questions regarding
payment of the annual fee.
If Mr. Ryals informs you that remediation is no longer necessary at your site, you may request
rescission of your Certificate of Coverage. Simply contact me with the information from Mr.
Ryals, should you wish to rescind.
If you have any additional questions regarding the permit rescission [or renewal] process, contact
me at the telephone number or address listed below.
�r�J �,; 678
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 919 807-6391 (fax) 919 807-66495
VISIT US ON THE INTERNET @ http:/hwiw.ncwaterquality.org charles.Weaver o@ ncdenr.gov
An Equal opportunity/Affirmative Action Employer — 50% Recycled110% Post Consumer Paper

Weaver, Charles
From: Haynes, Keith
Sent: Tuesday, May 12, 2009 2:50 PM
To: Weaver, Charles; Edwards, Roger
Subject: RE: NCG510002 - status?
Charles, a county or a facility name would have been nice! This is a State Trust Fund site, so they need to contact Scat,
Ryals at 919-733-1318. He should take of the billing issue by contacting the engineering firm. The site is still active.
Keith Haynes - [e-mail]
North Carolina Dept. of Environment and Natural Resources
Asheville Regional Office
Division of Water Quality - Surface Water Protection
2090 U.S. 70 Highway
Swannanoa, NC 28778
Tel: [phone]
Fax: [phone]
Notice: E-mail correspondence to and from this address may be subject to the NC Public Records Law and may be
disclosed to third parties.
From: Weaver, Charles
Sent: Tuesday, May 12, 2009 2:14 PM
To, Edwards, Roger
Cc: Haynes, Keith
Subject: NCG510002 - status?
Keith Holtsclaw from this facility called today, after his maintenance man called yesterday. They have the annual fee
invoice for the CoC and no longer have an engineering firm to whom they can send it.
The system is [apparently] shut down. No one at the hospital knows much about it.
PLEASE have someone from UST contact them [or me] and determine if this CoC is still necessary. Also, wher do they
send the bill?
Thanks,
CHW

ADVANTEX® O&M MANUAL
Treatment Process/Performance Expectations
(continued)
AdvanTex Textile Filter
The AdvanTex textile filter provides secondary
wastewater treatment. The filter is a sturdy,
watertight fiberglass basin filled with an engi-
neered textile material. This lightweight, highly
absorbent textile material treats a tremendous
amount of wastewater in a small space.
The AdvanTex filter operates in the recirculating
mode, just like a recirculating sand or gravel fil-
ter, but loading rates are typically 5-20 times
higher, for a number of reasons. For one thing,
the textile media has a very large surface area —
about 5 times greater than that of an equivalent
volume of sand. Textile also has a greater void
volume (for free flow of oxygen) and greater
water -holding capacity.
Wastewater percolates both through and between
the textile media. A visible biological film nor-
mally develops on the filter medium within a few
days. BOD5 and TSS reductions occur almost
immediately.
Within the filter, aerobic conditions exist that
are ideal for microbes that convert ammonia to
nitrate (nitrification). Other conditions exist, too,
that result in fiu-ther nitrogen reduction within
the media. Some AdvanTex filters are configured
(Mode 3) so that the filtrate recirculates back to
the high -carbon, low -oxygen environment at the
inlet end of the processing tank, which is ideal
for microbes that reduce nitrates to nitrogen gas
(denitrification). Harmless nitrogen gas is then
released freely back into the atmosphere. The
acclimation period for nitrification may range
from four to eight weeks, or longer in colder
climates.
AdvanTex filtrate effluent quality is dependent
upon proper management of the recirc/blend
effluent flowing into the filter (which, in turn,
is dependent on the conditions described on the
previous page). If proper conditions are met, and
with typical average daily flows of 40-60 gallons
per capita per day, you can expect the following
treatment performance:
Performance Expectations
BOD,
TSS
TKN
mg/L
mg/L
mg/L
Raw Influent'
450
500
70
Primary Chamber
Effluent
150
40
65
----- ----------------------------------------------------------------------
Processing Tank
Recirc/Blend Effluene
15-4o
10-20
-"
-------------------------------------------------------
AXN FIftMe3
5
--------------------
5
-°
/ Source.• Crier d Tchohanoglour m ll and
Decentralized WartewaterManwgement S nv ems
p. 180 189 IA98. McGraw-Hill. Bared on
50&,d
2 Will vary with recirc ratios and mode configuration.
The numbers here represent a retire ratio between 2.1
and 4:1 and are derived from Orenco and third -
party testing in Mode 1.
3 Actual performance results, based on a six-month
accumulative average from NSF (National
Sanitation Foundation) testing on theAX20Nat
500 gpd, using composite sampling. Seepage 17 for
additional information on treatment performance.
Performance and servicing frequencies will tend to
vary relative to the mass load being treated.
Procedures for treating excessively high loads will
require engineering review. For more information,
please review AdvanTex Design Criteria.
4 Dependent on treatment system configuration and
recirc ratios.

Michael F. Easley
Governor
William G. Ross, Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E., Director
Division of Water Quality
September 29, 2006
Keith Holtsclaw
Spruce Pine Community Hospital
P.O. Box 9
Spruce Pine, NC 28777
Subject: General Permit NCG510000
Certificate of Coverage NCG510002
Spruce Pine Community Hospital
Mitchell County
Dear Permittee:
The Division received your request for renewal of the subject Certificate of Coverage (CoC) on June
19, 2006. The revised General Permit was signed on September 201h, 2006 and takes effect October 1, 2006.
Accordingly, we are forwarding the attached CoC to discharge under NCG510000. This CoC is issued
pursuant to the requirements of North Carolina General Statute 143-215.1 and the Memorandum of
Agreement between North Carolina and the US Environmental Protection agency dated May 9, 1994.
A copy of the renewed General Permit is enclosed, as well as an updated Technical Bulletin. The
Technical Bulletin summarizes the changes from the previous version of NCG510000. If any parts,
measurement frequencies or sampling requirements contained in this permit are unacceptable to you, you
have the right to request an individual permit by submitting an individual permit application. Unless such
demand is made, this Certificate of Coverage shall be final and binding.
The CoC is not transferable except after notice to the Division. You must notify the Division if you
sell or otherwise transfer ownership of the permitted facility. The Division may require modification or
reissuance of the CoC.
If your facility ceases discharge of wastewater before the expiration date of this permit, contact the
Regional Office listed below. Once discharge from your facility has ceased, this permit may be rescinded.
This permit does not affect the legal requirements to obtain other permits which may be required by the
Division of Water Quality, the Division of Land Resources, Coastal Area Management Act or any other
Federal or Local government. If you have any questions concerning this permit, please contact Charles
Weaver at the telephone number or e-mail address listed below.
cc: Central Files
Asheville Regional Office — Surface Water Protection
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
An Equal Opportunity Affirmative Action Employer
Sincerely,
foT Alan W. Klimek
919 733-5083, extension 511 (fax) 919 733-0719
e-mail: [e-mail]

r f
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NCG510000
CERTIFICATE OF COVERAGE NCG510002
TO DISCHARGE PETROLEUM CONTAMINATED GROUNDWATER AND SIMILAR WASTEWATERS
UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful
standards and regulations promulgated and adopted by the North Carolina Environmental
Management Commission, and the Federal Water Pollution Control Act, as amended,
Spruce Pine Community Hospital
is hereby authorized to operate a groundwater remediation system for petroleum -contaminated groundwater
or similar waste streams that will discharge treated wastewater from the
Spruce Pine Community Hospital
Mitchell County
to receiving waters designated as an unnamed tributary to Beaver Creek, a class C-Trout stream
in subbasin 40306 of the French Broad River Basin.
All discharges shall be in accordance with the effluent limitations, monitoring requirements, and
other conditions set forth in Parts I, II, III and IV of General Permit NCG510000 as attached.
This certificate of coverage shall become effective October 1, 2006.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day, September 29, 2006.
ZOL, -A � �-"
foT Alan W. Klimek, P.E., Director
Division of Water Quality
By Authority of the Environmental Management Commission

r'� NC DENR / DWQ / Water Quality Section
�� A
National Pollutant Discharge Elimination System
NCDENR NNCG510000
NORiN CXiOLIMDrP�RTMENr OF
ENVIRONMENT wei0 .Qtf{1/1 RESOURCE$
RENEWAL application for coverage under General Permit NCG510000
[remediation projects treating petroleum -contaminated groundwater]
(Please print or type) Certificate of Coverage number: NCG 51 OOOZ
1) Mailing address of site Owner:
Company Name: 5Pf2_UL6 PIN5 GomrhoN�v�� W- 3SptT1aL-
Company Contact: _ 6 TH 14C)L-T S LA W
Street Address: P. o. -60X 9
City: _ S'?PUC.6 piwb State: "« ZIP Code: 287-7-7
Telephone No.: 61 76r.- 21-10 l Fax: 'B26 '765- b)�329
e-mail address:
2) Location of remediation site producing discharge:
Facility Name: 5?9-VC,V rflr-4,6 Co~vr4Yr 1bSPISAU
Facility Contact: Roti 6)KwoS
Street Address: 125 HOSPl'G,L_ OV,
City: _ SYtzuC b F1State: Mc- ZIP Code: Zf5-n:j
County: M Schlgu
Telephone No.: 1628 7475 -2-Li of Fax: E5-2.6 _7C5 CDg2-4
e-mail address:
3) System operator / Consultant ID [if different from Owner]:
Company Name: W 1rNwS �_ V-xJ6961-i 1Ke-•
Company Contact: CIH ah 5 ANp
Street Address: i 11 Mp4z"(�4 ye-"
City: � _ State: _W L ZIP Code: Z-15l
County: W AK4
Telephone No.: q19 r7:355202 Fax: 91535 LlSy5
e-mail address: c,6N_cr* tywt�l�ersraveilel,[o�
4) Site ranking & ID:
GW incident#: 3(.59
Site Ranking (A - E): t0l >)�b aAfa
Date of most recent site ranking: i996
Date of most recent discharge: 2-00'-1
Additional data required:
a) A site map clearly showing the path of the remediation system effluent from the site to its
discharge point.
b) If this application is being submitted by a consulting engineer (or engineering firm), include
documentation from the current permittee showing that the persons] submitting the
application has been designated an Authorized Representative.
Page 1 of 2 /�

I - NCG510000 renewal application
CERTIFICATION:
I certify that I am familiar with the information contained in this application and
that to the best of my knowledge and belief such information is true, complete, and
accurate.
Printed Name of Person Signing: C . Be-q PAT P� (-,
Title: Cbh(S11Lwf& NOW' --A UST SGGZ'wJ sDares LG!-o C'OKWUC,' X"z—
(Signature of Applicant) (Date Signed)
North Carolina General Statute 143-215.6 B (i) provides that:
Any person who knowingly makes any false statement, representation, or certification in any
application, record, report, plan or other document filed or required to be maintained under
Article 21 or regulations of the Environmental Management Commission implementing that
Article, or who falsifies, tampers with or knowingly renders inaccurate any recording or
monitoring device or method required to be operated or maintained under Article 21 or
regulations of the Environmental Management Commission implementing that Article, shall be
guilty of a misdemeanor punishable by a fine not to exceed $10,000, or by imprisonment not to
exceed six months, or by both. (18 U.S.C. Section 1001 provides a punishment by a fine of not
more than $10,000 or imprisonment not more than 5 years, or both, for a similar offense.)
Mail THIS COMPLETED FORM to:
Mr. Charles H. Weaver, Jr.
NC DENR / DWQ / NPDES
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
!Y{:�►1�111_�\!111:�►1!YI_�►1!1113 �\!YI:�\�lY��11!Y1=�►1!11��
For electronic copies of this form or the NCG510000 Fact Sheet, send a request to:
[e-mail]
Page 2 of 2

;' 1, _. � ',a--`_%; t,,,;�,:..,t�k ;,t\ a �: ;� ,,, ;,:�-- � `73.�- _� ,!"
, Tvt
1 X
j(—
,h Sr4 I. T . t r,, el
Z;
od
l—
•
7• ck
—, Nw-
.. 1 l a t� g}�� �;J r •,••�. `%%� /''\�.+. ..�FirslF�'1,?��ti7 �'--
t2 171
;Iry
C7
k�
�S
"N
T
effy cha
"'A A,
r
V
N
ir
t
J, Y"
"606
Y.
N
v
A
7
p
A
7
V f
IF ..1
Iq t
V
WITHERS &— RAVENEL
GENERAL 'o" MAP
SPRUCT PM COMMUffff HOSPITA;
—
4�--20001
sKp
1
ENGINEERS I PLANNERS I SURVEYORS
125 HOSPEAL DRIVE
SPRUCE PM NORTH CAMMA
APPROVED BY.
DAM
JOB NO:
Ill Mad(erw Drive Cary, Mw5 CaTAw 27511 m.wbffwumwLam
USGS SPRUCE PM NC
tok 919-4W-9006 fmc 919-535-4545
7.5 min. Quadrangle
CCB
02123106
.099715.0

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Michael F. Easley, Governor William G. Ross, Jr., Secretary
Alan W. Klimek, P.E., Director
June 5, 2006
CERTIFIED MAIL
RETURN RECEIPT REQUESTED
Keith Holtsclaw
Spruce Pine Community Hospital
P.O. Box 9
Spruce Pine,NC 28777
Subject: Notice of Violation
Failure to Submit Permit Renewal Application
Certificate of Coverage NCG510002
Spruce Pine Community Hospital
Mitchell County
Dear Permittee:
NPDES General Permit NCG510000, under which the subject facility is covered, expires on
September 30, 2006. North Carolina Administrative Code (15A NCAC 2H.0105(e)) requires that an
application for permit renewal be filed at least 180 days prior to expiration of the current permit. To satisfy
this requirement, your renewal package should have been sent to the Division postmarked no later than
April 3, 2006.
The Division has not received a renewal request for the subject CoC. This is a violation of your
permit at Part H. B. 10, which states "Any permittee that has not requested renewal at least 180 days prior
to expiration... will subject the permittee to enforcement procedures as provided in NCGS 143-215.6 and 33
USC 1251 et. seq.".
To prevent an assessment of civil penalties you must submit a completed permit application (see
enclosed forms) no later than June 19, 2006. If the system is inactive due to lack of trust fund payments,
but the remediation equipment is still on site, the CoC should be renewed.
If all remediation discharge from this facility has ceased and you wish to rescind this CoC [or if you
have any other questions], contact Charles Weaver of my staff. Mr. Weaver's telephone number, fax number
and e-mail address are listed at the bottom of this page.
Sincerely,
N A. V1fILSON
Alan' Klimek, P.E.
cc: Central Files
Asheville Regional Office / Surface Water Protection
NPDES File
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 919 733-5083, extension 511 (fax) 919 733-0719
VISIT US ON THE INTERNET @ http://h2o.enr.state.nc.us/NPDES e-mail: [e-mail]

,I
■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
Keith Holtsclaw
Spruce Pine Community Hospital
PO Box 9
Spruce Pine, NC 28777
ent
❑ Addressee
i by (Pnn ameI C. Date ojDleli\veerry
LL�r.✓ y
D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
Service Type
❑ Certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) n v-
2. Article Number
(Transfer from service laW ! 6CO 1030 ODD Q61I G l 6lq6 b
PS Form 3811, August 2001 Domestic Return Receipt 102595-02-M-1540

State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
Michael F. Easley, Governor
William G. Ross Jr., Secretary
Gregory J. Thorpe, Ph.D., Acting Director
September 26, 2001
J D BARKER
SPRUCE PINE COMM HOSPITAL
111 MACKENAN DR
CARY, NC 27511
1 � •
NCDENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
Subject: Reissue - NPDES Wastewater Discharge Permit
Spruce Pine Comm Hospital
COC Number NCG510002
Mitchell County
Dear Permittee:
In response to your renewal application for continued coverage under general permit NCG510000, the Division of
Water Quality (DWQ) is forwarding herewith the reissued wastewater general permit Certificate of Coverage
(COC). This COC is reissued pursuant to the requirements of North Carolina General Statute 143-215.1 and the
Memorandum of Agreement between the state of North Carolina and the U.S. Environmental Protection Agency,
dated May 9, 1994 (or as subsquently amended).
The following information is included with your permit package:
* A copy of the Certificate of Coverage for your treatment facility
* A copy of General Wastewater Discharge Permit NCG510000
* A copy of a Technical Bulletin for General Wastewater Discharge Permit NCG510000
Your coverage under this general permit is not transferable except after notice to DWQ. The Division may require
modification or revocation and reissuance of the Certificate of Coverage. This permit does not affect the legal
requirements to obtain other permits which may be required by DENR or relieve the permittee from responsibility
for compliance with any other applicable federal, state, or local law rule, standard, ordinance, order, judgment, or
decree.
If you have any questions regarding this permit package please contact Bill Mills of the Central Office Stormwater
and General Permits Unit at [phone], ext. 548
Sincerely,
�_6L_
for Gregory J. Thorpe, Ph.D.
cc: Central Files
Stormwater & General Permits Unit Files
Asheville Regional Office
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG510000
CERTIFICATE OF COVERAGE No. NCG510002
TO DISCHARGE PETROLEUM CONTAMINATED GROUNDWATER AND SI IILAR
WASTEWATERS UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards and
regulations promulgated and adopted by the North Carolina Environmental Management Commission, and the
Federal Water Pollution Control Act, as amended,
SPRUCE PINE COMM HOSPITAL
is hereby authorized to construct and operate or continue operation of a groundwater treatment system for
petroleum contaminated groundwater or similar waste streams with the discharge of treated wastewater from a
facility located at
SPRUCE PINE COMM HOSPITAL
NCSR 1121
SPRUCE PINE
MITCHELL COUNTY
to receiving waters designated as the North Toe River, a class WS IV Tr stream, in the French Broad River Basin
in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts I, II,
III, IV, V, and VI of General Permit No. NCG510000 as attached.
This certificate of coverage shall become effective October 1, 2001.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day September 28, 2001.
for Gregory J. Thorpe, Acting Director
Division of Water Quality
By Authority of the Environmental Management Commission

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG510000
CERTIFICATE OF COVERAGE No. NCG510002
TO DISCHARGE PETROLEUM CONTAMINATED GROUNDWATER AND SIMILAR
WASTEWATERS UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards and
regulations promulgated and adopted by the North Carolina Environmental Management Commission, and the
Federal Water Pollution Control Act, as amended,
SPRUCE PINE COMM HOSPITAL
is hereby authorized to construct and operate or continue operation of a groundwater treatment system for
petroleum contaminated groundwater or similar waste streams with the discharge of treated wastewater from a
facility located at
SPRUCE PINE COMM HOSPITAL
NCSR 1121
SPRUCE PINE
MITCHELL COUNTY
to receiving waters designated as the North Toe River, a class WS IV Tr stream, in the French Broad River Basin
in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts I, II,
III, IV, V, and VI of General Permit No. NCG510000 as attached.
This certificate of coverage shall become effective October 1, 2001.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day September 28, 2001.
for Gregory J. Thorpe, Acting Director
Division of Water Quality
By Authority of the Environmental Management Commission

State of North Carolina
Department of Environment,
Health and Natural Resources ffl�.'�VA
10
Division of Water Quality A14.1 •
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary F1
A. Preston Howard, Jr., P.E., Director
April 25, 1997
Keith Holtsclaw
Spruce Pine Community Hospital
P.O. Box 9
Spruce Pine, NC 28777
Subject: Renewal of NPDES Permit No. NCG510002
Mitchell County
Dear Permittee:
In accordance with your application for permit renewal, the Division is forwarding the subject NPDES general
permit for petroleum contaminated groundwater remediation systems. This General Permit is issued pursuant to the
requirements of North Carolina General Statute 143-215.1 and the Memorandum of Agreement between North
Carolina and the US Environmental Protection Agency dated December 6, 1983 and as subsequently amended.
The Certificate of Coverage previously issued to your facility is now valid under the revised General Permit for
discharges associated with groundwater remediation systems (NCG510000 - issued August 22, 1996). The new General
Permit is more comprehensive, in that it covers remediation of groundwater contaminated with heavier fuels (such as
diesel, fuel oil, and kerosene) as well as gasoline contamination. Please note that the permit has three effluent
limitations pages. The type of contamination at your site (gasoline only, heavy fuels only, or gasoline and heavy
fuels) will determine the effluent limitations for your discharge.
If any parts, measurement frequencies or sampling requirements contained in this permit are unacceptable to you, you
have the right to request an individual permit by submitting an individual permit application. Please take notice
that the previously issued Certificate of Coverage is not transferable except after notice to the Division of Water
Quality. The Division of Water Quality may require modification or revocation and reissuance of the Certificate of
Coverage.
This permit does not affect the legal requirements to obtain other permits which may be required by the Division of
Water Quality or permits required by the Division of Land Resources, the Division of Coastal Management, or any
other Federal or Local governmental permit that may be required.
If you have any questions or need additional information, please contact Charles Weaver at telephone number (919)
733-5083, extension 511.
Respectfully,
r
A. Preston Howard, Jr., P.E.
cc: Central Files
Asheville Regional Office
Permits & Engineering Unit
Facility Assessment Unit

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT, HEALTH, AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG510000
CERTIFICATE OF COVERAGE NO. NCG510002
TO DISCHARGE PETROLEUM -CONTAMINATED GROUNDWATER AND
SIMILAR WASTEWATERS UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards
and regulations promulgated and adopted by the North Carolina Environmental Management
Commission, and the Federal Water Pollution Control Act, as amended,
Spruce Pine Community Hospital
is hereby authorized to discharge treated wastewater from a groundwater remediation system
from a facility located at
Spruce Pine Community Hospital
NCSR 1121
Spruce Pine
Mitchell County
to receiving waters designated as subbasin 40306 in the French Broad River Basin
in accordance with the effluent limitations, monitoring requirements, and other conditions set forth
in Parts I, II, III and IV of General Permit No. NCG510000 as attached.
This certificate of coverage shall become effective April 25, 1997.
This certificate of coverage shall remain in effect for the duration of the General Permit.
Signed this day April 25, 1997.
�A. Preston Howard Jr., P.E., Director
Division of Water Quality
By Authority of the Environmental Management Commission

DIVISION OF WATER QUALITY
July 8, 1996
MEMORANDUM
To: Mike Parker
Asheville Regional Office
From: Greg Nizich050
NPDES Permits Unit
Subject: Permit Renewal
NPDES Permit #NC0082333 �C.G o0 o z
Spruce Pine Communtiy Hospital
Mitchell County
As we discussed previously, the individual permit was reinstated for this facility on July
29, 1994 since the groundwater remediation General Permit was not suitable for facilities
treating contamination from No. 2 fuel oil. Since that General Permit is currently in the
final stages of revision and will take effect in August or September, it will be appropriate
to cover this discharge under that revised General Permit and rescind the individual
permit at that time. A streamline package will not be submitted for this permit.
cc: Permit File
cs�

• Page 1
Note for Marcia Toler-McCullen
From: Susan Robson
Date: Mon, Jul 28, 1997 2:02 PM
Subject: RE: NC0082333
To: Marcia Toler-McCullen
Sorry for this delay ..... only NCG510002 is valid....
From: Marcia Toler-McCullen on WedJul 23, 1997 3:24 PM
Subject: NC0082333
To: Susan Robson
Spruce Pine Community Hospital has an NPDES permit under NC0082333. Then, I have a
permit map for the same facility under a General Permit number NCG510002.
Did this facility go from an NPDES permit to a General Permit? Or does it have two permits?
Thanks for you help ! ! !

5-10602-
State of North Carolina
Department of Environment,
Health and Natural Resources
Division of Environmental Management
• James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
A. Preston Howard, Jr., P.E., Director
July 29, 1994
Mr. Keith Holtsclaw
Spruce Pine Community Hospital
PO Box 9
Spruce Pine, NC 28777
Dear Mr. Holtsclaw:
Affl1.W;VA
14
C>EHNR
Subject: Permit No. NCO082333
Authorization to Construct
Spruce Pine Community Hospital
Groundwater Treatment Facility
Mitchell County
A letter of request for an Authorization to Construct was received December 23, 1993 by the
Division and final plans and specifications for the subject project have been reviewed and found to be
satisfactory. Authorization is hereby granted for the construction of a groundwater remediation system
consisting of recovery wells, an oil/water separator with 1000 gallon oil holding tank, sump tank with
pump, low profile air diffuser, particulate filters and dual carbon cannisters in series with discharge of
• treated wastewater into an unnamed tributary to Beaver Creek.
This Authorization to Construct is issued in accordance with Part III, Paragraph A of NPDES
Permit No. NCO082333 issued July 29, 1994, and shall be subject to revocation unless the wastewater
treatment facilities are constructed in accordance with the conditions and limitations specified in Permit No.
NC0082333.
The sludge generated from these treatment facilities must be disposed of in accordance with G.S.
143-215.1 and in a manner approved by the North Carolina Division of Environmental Management.
In the event that the facilities fail to perform satisfactorily, including the creation of nuisance
conditions, the Permittee shall take immediate corrective action, including those as may be required by this
Division, such as the construction of additional or replacement wastewater treatment or disposal facilities.
The Asheville Regional Office, telephone number 704/251-6208, shall be notified at least forty-
eight (48) hours in advance of operation of the installed facilities so that an in -place inspection can be
made. Such notification to the regional supervisor shall be made during the normal office hours from 8:00
a.m. until 5:00 p.m. on Monday through Friday, excluding State Holidays.
Upon completion of construction and prior to operation of this permitted facility, a certification
must be received from a professional engineer certifying that the permitted facility has been installed in
accordance with the NPDES Permit, this Authorization to Construct and the approved plans and
specifications. Mail the Certification to the Permits and Engineering Unit, P.O. Box 29535, Raleigh, NC
27626-0535.
to P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper

•
r�
0
Dermit No. NC0082333
Authorization to Construct
Spruce Pine Community Hospital
July 29, 1994
Page 2
Upon classification of the facility by the Certification Commission, the Permittee shall employ a
certified wastewater treatment plant operator to be in responsible charge (ORC) of the wastewater treatment
facilities. The operator must hold a certificate of the type and grade at least equivalent to or greater than the
classification assigned to the wastewater treatment facilities by the Certification Commission. The
Permittee must also employ a certified back-up operator of the appropriate type and grade to comply with
the conditions of Title 15A, Chapter 8A, .0202. The ORC of the facility must visit each Class I facility at
least weekly and each Class II, III, and IV facility at least daily, excluding weekends and holidays, and
must properly manage and document daily operation and maintenance of the facility and must comply with
all other conditions of Title 15A, Chapter 8A, .0202.
A copy of the approved plans and specifications shall be maintained on file by the Permittee for the
life of the facility.
Failure to abide by the requirements contained in this Authorization to Construct may subject the
Permittee to an enforcement action by the Division of Environmental Management in accordance with
North Carolina General Statute 143-215.6A to 143-215.6C.
The issuance of this Authorization to Construct does not preclude the Permittee from complying
with any and all statutes, rules, regulations, or ordinances which may be imposed by other government
agencies (local, state, and federal) which have jurisdiction.
One (1) set of approved plans and specifications is being forwarded to you. If you have any
questions or need additional information, please contact Mr. Charles Alvarez, telephone number 919/733-
5083.
cc: Mitchell County Health Department
Asheville Regional Office, Water Quality
Training and Certification Unit
Sincerely,
4 Preston ard, Jr., P.E.
Division of Environmental Management

State -of North Carolina
Department of Environment,
Health and Natural Resources
Division of Environmental Management
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
A. Preston Howard, Jr., P.E., Director
ALIT X-; V, A
0
C)EHNR
July 29, 1994
Mr. Keith Holtsclaw
P.O. Box 9
Spruce Pine, NC 28777
Subject: Permit No. NCO082333
Spruce Pine Community Hospital
Mitchell County
Dear Mr. Holtsclaw:
In accordance with your application for discharge permit received on December 28, 1993
1993, we are forwarding herewith the subject state - NPDES permit. This permit is issued
pursuant to the requirements of North Carolina General Statute 143-215 .1 and the
Memorandum of Agreement between North Carolina and the US Environmental Protection
agency dated December 6, 1983.
If any parts, measurement frequencies or sampling requirements contained in this permit
are unacceptable to you, you have the right to an adjudicatory hearing upon written request
within thirty (30) days following receip� of this letter. This request must be in the form of a
written petition, conforming to Chapter 150B of the North Carolina General Statutes, and filed
with the Office of Administrative Hearings, Post Office Drawer 27447, Raleigh, North
Carolina 27611 -7447. Unless such demand is made, this decision shall be final and binding.
Please take notice this permit is not transferable. Part II, EA. addresses the requirements
to be followed in case of change in ownership or control of this discharge.
This permit does not affect the legal requirements to obtain other permits which may be
required by the Division of Environmental Management or permits required by the Division of
Land Resources, Coastal Area Management Act or any other Federal or Local governmental
permit that may be required.
If you have any questions concerning this permit, please contact Mr. Charlez Alvarez at
telephone number 9191733-5083.
Sincerely,
Original Signed By
David A. Goodrich
A. Preston Howard, Jr.
cc: Mr. Jim Patrick, EPA
Asheville Regional Office
P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper

Permit No. NCO082333
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT, HEALTH, AND NATURAL RESOURCES
DIVISION OF ENVIRONMENTAL MANAGEMENT
PERMIT
TO DISCHARGE WASTEWATER UNDER THE
In compliance with the provision of North Carolina General Statute 143-215.1,
other lawful standards and regulations promulgated and adopted by the North Carolina Environmental
Management Commission, and the Federal Water Pollution Control Act, as amended,
Spruce Pine Community Hospital
is hereby authorized to discharge wastewater from a facility located at
Spruce Pine Community Hospital
Hospital Drive
Spruce Pine
Mitchell County
to receiving waters designated as an unnamed tributary to Beaver Creek in the French Broad River
Basin
in accordance with effluent limitations, monitoring requirements, and other conditions set forth in
Parts I, II, and III hereof.
This permit shall become effective July 29, 1994
This permit and the authorization to discharge shall expire at midnight on December 31, 1996
Signed this day July 29, 1994
Original Signed By
David A. Goodrich
A. Preston Howard, Jr., P.E., Director
Division of Environmental Management
By Authority of the Environmental Management Commission

Permit No. NC0082333
SUPPLEMENT TO PERMIT COVER SHEET
Spruce Pine Community Hospital
is hereby authorized to:
1. Enter into a contract for construction of a wastewater treatment facility, and
2. Make an outlet into an unnamed tributary to Beaver Creek, and
3. After receiving an Authorization to Construct from the Division of Environmental
Management, construct and operate a 0.072 MGD wastewater treatment facility located at
Spruce Pine Community Hospital, Hospital Drive, Spruce Pine, Mitchell County (See
Part III of this Permit), and
4. Discharge from said treatment works at the location specified on the attached map into an
unnamed tributary to Beaver Creek which is classified class C-Trout waters in the French
Broad River Basin.

e \ R W
ve
•L . 4 • 1 n , rj •A •/i
Ll e`
,�,� �� • to •• :: �1 ,�/',' •'` � r %'
Sch rl 9 1 ..
Hospi I
if
NE
U J • 8 II (�' 1) • n
) i LLIXCJ� C •, errv,,Cha I ,:,i'..•.> P I
ON
I
t � � Z � � ,. \- oo � � ��n -- �'� -_r_ � �� �ti,_ _• • � ?bop 1 p
O j 'l I
�,I
�- V
11
Sitrl �� ��/^�IIIr�/�i�� (�=�SC�— ' \c lv `11 \_� `:� ^ •.='Cem ,•. -
04
Ioa rda Laki
000 FEET /� �1-- ;� �.%'11� 6ko
(L/TTLE•SW/rZERLAND 9no-o—

A. O. EFFLUENT LIMITATIONS AND MONITORING REQUIREMENTS FINAL Permit No. NCO082333
During the period beginning on the effective date of the permit and lasting until expiration, the Permittee is authorized to discharge from
outfall(s) serial number 001. Such discharges shall be limited and monitored by the permittee as specified below:
Effluent Characteristics Discharge Limitations
Lbs/dav Units(specify)
Mon. Avg. Daily Max Mon. Avg. Daily Max.
Flow 0.072 MGD
Oil and Grease 30.0 mg/I 60.0 mg/I
Toluene 6.0 µ g / I
Benzene
Xylene
Ethylbenzene
* Sample location: E - Effluent
Monitoring
Requirements
Measurement
Sam Ig_e
'Sample
Frequency
Type
Location
Continuous
Recording
E
2/Month
Grab
E
Quarterly
Grab
E
Quarterly
Grab
E
Quarterly
Grab
E
Quarterly
Grab
E
BTEX parameters should be monitored using an EPA approved method to a detection level of 1 ppb.
The pH shall not be less than 6.0 standard units nor greater than 9.0 standard units and shall be monitored 2/month at the effluent by grab
sample.
There shall be no discharge of floating solids or visible foam in other than trace amounts.

Part III Permit No. NCO082333
E. Toxicity Reopener Condition
This permit shall be modified, or revoked and reissued to incorporate toxicity limitations and
monitoring requirements in the event toxicity testing or other studies conducted on the effluent or
receiving stream indicate that detrimental effects may be expected in the receiving stream as a result
of this discharge.

p / W L 0 0 18Z333
% PERMIT NO.: -�
NPDES WASTE LOAD ALLOCATION
PERMITTEE NAME: Spruce Pine Community Hospital
FACILITY NAME: Spruce Pine Community Hospital
Facility Status: Proposed
Permit Status: New
Major Minor
Pipe No.: 001
Design Capacity: 0.072 MGD
Domestic (% of Flow):
Industrial (% of Flow): 100
Comments: Refer: Basinwide / Streamline WLA File
fuel oil contamination Completed By Permits & Engineering
At Front Of Subbasin
RECEIVING STREAM: an unnamed tributary to Beaver Creek
Class: C-Trout
Sub -Basin: 04-03-06
Reference USGS Quad
D 1 ONE
(please attach)
County: Mitchell
Regional Office: Asheville Regional Office
Previous Exp. Date: 00/00/00 Treatment Plant Class:
Classification changes within three miles:
Requested by: Charles Alvarez Date:.., 1/13/94
Prepared by: Date:
Reviewed by: Date:
AJA
Modeler Date Rec. #
SMa t t�
Drainage Area (mil) Avg. Streamflow (cfs):
7Q10 (cfs) 1, 7 Winter 7Q10 (cfs) . (P 30Q2 (cfs)
Toxicity Limits: IWC % Acute/Chronic
Instream Monitoring:
Parameters A)m c_
Upstream
Location
Downstream Location
Recommended Limits
Mon. Avg.
Flow (MGD) 0.072
Oil and Grease (mg/1): 30
pH (Si):
Benzene (}tg/1):
Toluene (µg/1):
Ethylbenzene (µg/1):
Xylene 4W):
S=iAL-Instructions or Conditions
Daily Max.
Frequency
continous
60
2/month
6.0-9.0
2/month
monitor
quarterly
6
quarterly
monitor
quarterly
monitor
quarterly
BTEX parameters should be monitored using an EPA -approved method to a detection
level of 1 ppb. Permit must contain flow monitoring requirement such that all
volumes of wastewater leaving the facility are monitored. Recommend continuous
flow monitoring.
A reopener clause should be placed in the permit to allow for additional limits on
these or other toxicants should whole -effluent toxicity monitoring by Aquatic Tox.
indicates toxic effects. If toxicity testing is implemented or requested by
administrative letter, then testing should coincide with monitoring of toxicant
parameters.
Comments: 41, ilr-(` LI, :S 1.c3e5

: t 6 t <�' '* _ �'.t�•�-fie �•>t, ���� ��R't (((���'dl'ai �l: 'j q
Y y a^ ,� �� ,F - •�\� _\\ Op
A `\ Fair ,i •y �/,{~/ 29 c -_ •i ii '� 3'}S.'Slll �'.3' ,7\
v.`, ;� t$ j'.,-5�" _�.rt.L .ts'.', '7y"k �'` ii' 1. / _ /i ��"�r:� �v{,i •FSIh// ��.� �: jSsF:
-'��, 't n�11 -' � d(, _� § ice' s:_a- _ / ��\ • i�'3 \� h c� •t r
.1�•,'PY„ /"' 1• \l \ � \\ 1 O � �. �t -'� •F' �I,:ftCa �ly:�� �r .�0�
� 1� 1, e' � bli'�S//j �ti/pf � ��� i �i�.'�' �� n:' :a ''s �i„ E __ /,�,'p >•
Creek \•
� �'�\ \ '\ ! i Pass � '' J• ;i';'. '\• • '' �ii
7-7
it
���, •_„>q, "• • •` '\'� � . i `- .•C- •h • •�\ `'� l•• ' -- - C' � • '+'}lam' • 1 = 1, � 7,'.� ' %
i• •� • i� 111 - �w.i� - I/•, } } 1..
/ ....- .,�.•. ".`_ -�- \ � I `•\\\ t.�•'S 77E. / r� :., � lam-' '' i.
�/ ••-�� �• 009Z�
13
qq
= . `mil -_'d`= _ _I _-_,; __).__ ! ice. �`� � .n 1 11 �_�' •f 'It/ .. N
' _ r it t r ll• i r/ 9 v
1 Y/S
ILL
+l ' b` „� tx a � � ., 5i � •• y , m i o

Facility Name:
NPDES No.:
Type of Waste:
Facility Status:
Permit Status:
Receiving Stream:
Stream Classification:
Subbasin:
County:
Regional Office:
Requestor:
Date of Request:
Topo Quad:
FACT SHEET FOR WASTELOAD ALLOCATION
Spruce Pine Community Hospital
NCO083897
Industrial - 100%
Proposed
New
Beaver Creek
C-Trout
04-03-06
Mitchell
Asheville
Charles Alverez
1/13/94
D 10NE
Wasteload Allocation Summary
(approach taken, correspondence with region, EPA, etc.)
Request # 7719
Stream Characteristic:
USGS #
Date:
Drainage Area (mi2):
Summer 7Q10 (cfs):
Winter 7Q10 (cfs):
Average Flow (cfs):
30Q2 (cfs):
IWC (%):
Regional Equations
Region HA 10
5.3
1.7
2.6
10.6
Remediation system for groundwater contaminated with No. 2 fuel oil. Limits set as per SOP for
groundwater remediation. Please see Special Instructions or Conditions.
Special Schedule Requirements and additional comments from Reviewers:
rv. s 14,", - h'o .
Recommended by:
Reviewed by
Instream Assessment:
Regio �'isor:
Permi & Engineerin
RETURN TO TECHNICAL -BY: ti ICW1 11, � 0
MW
Z/

TOXICS/CONVENTIONAL PARAMETERS
Type of Toxicity Test: NONE
Recommended Limit: Aquatic Tox. may monitor and assign test in future.
Monitoring Schedule:
Recommended Limits
Mon. Avg.
Daily Max. Frequency WQ/EL
Flow (MGD) 0.072
continous
Oil and Grease (mg/1): 30
60 2/month EL
pH (SU):
6.0-9.0 2/month EL
Benzene (µg/1):
monitor quarterly
Toluene (µg/l):
6 quarterly AL w q
Ethylbenzene (µg/l):
monitor quarterly
oe Xylene (µg/1):
monitor quarterly
'_'(
Dav
�1...,ny�yeant�
►}��'�� o l �� Peter" water quality limited. For some parameters, the available load capacity of
the immediate receiving water will be consumed. This may affect future water quality based
effluent limitations for additional dischargers within
this portion of the watershed.
OR
JW No parameters are water quality limited, but this discharge may affect future allocations.
MISCELLANEOUS INFORMATION & SPECIAL CONDITIONS
�. �• • • • •
BTEX parameters should be monitored using an EPA -approved method to a detection level of 1
ppb. Permit must contain flow monitoring requirement such that all volumes of wastewater
leaving the facility are monitored. Recommend continuous flow monitoring.
A reopener clause should be placed in the permit to allow for additional limits on these or other
toxicants should whole -effluent toxicitymonitoring by Aquatic Tox. indicate toxic effects. .
.� I - I � 7� 4 io C n-tpto n, �--b.a�v� j464e cc. jo 4 ,4 cC� LLYt �,
M&mh)v, � Skiid t&&c cv�� /DY
Explain exact rthway of discharge ( i.e. storm sewer to tributary, etc.)
From treatment system to storm drain to Beaver Creek (map attached)
Additional Information attached? (Y or N) If yes, explain with attachments.
pv),p a� 10 c ck-4- i 6-v--a� 0L.G--,

ry
V9
. zI
) , ) 0 7wzg

� a1
i
r
j s
! -
.. .� 40
ep
r�-,Aor_
- �-�--� - - � - �t�-- �"rya►. _-_ - - j�'L _ _ _ -(77
ri
=s
!i
i
`t
i�

ww•

4.
/Jc0013 7
-- -- 99%s�► 1e�a j- ' Q�b- - G---/rOLA ----
--L-7
r
17 0a
r
-5, 3 m l 2 - - = d . 672
777
C40,Ac e lr e-1,ve e- (ccS'G
je� rc,3
- _ . . �j t YYl J •� '"' _ - � j` �C� %t� � t .� � (�.,��.�.-� �`�-_'✓� `�-" _ 1� �n '.``v ��?T �Gt (`�(
? 1 (A) 00/e rsS .
OL
_. t

ww

-J \) '�� ��� (///' \_.�/ I � � �/.-� j" __ =fir - • - +� i,l—"' /_ ' ��^.'�� �,:�/ �a�l;� �/
� � _ _ '_'__ ��•-_,-���• �) �� •I �• r. _ �l/ <' ���������.._ .lam �/
� � .� • •. .) � ,_ � ;tip �
o i ��' � �1�• `.. /�''l�� ` v''�/^��/�1'� -�\f ��_ �=���'�r� -- '� �% SS. �-- `_\pry �= -�� -
1

' APR-19-1994 16:731 FROM Asheville RO UEWR
TO WATER DUALITY R P.01
Type of TwdcityTest:
ReendedLimit:
Monitoring Schedule:
2
TO) UCS1CONVE"o
r'Ost-it'brantif.*vr,--___ _
NONE
Aquatic Tox, may monitor and assign test in future_
Flow (MGD)
Mon. Avg. Daily Max. Frequency W'Q)EL
2
Oil atad Grease (mgA):
PH (SU):
contnnous
3U 60 Vmonth EL
Benzene (µg/1):
6.0-9.0 21n)onth EL
Toluene (µg/1):
moms' quarterly
Ethylbenzene (µgm:
Xylene (µ 1):
monitor qquarterly Ak Liq
Plunof{vg
monitor quarterly
m�,t;, or c ,t�. CW6 eJA66 077�'
P
the ianmediate
water quality limited For some parameters, the available load capacity of
receiving water will be consumed. This may affect future water quality based
effluent limitations for additional dischargers within this portion of the watershed.
K5
AW , No parameters are water quality limited, but this discharge may affect future allocations.
MISCELLANEOUS WORMATION & SPECIAL CONDMONS
BTEX parameters should be monitored using an EPA -approved medkod to a detection level of 1
ppb. Permit must contain flow monitoring requirement such that all volumes of wastewater
leaving the facility are monitored. Recommend continuous flow monitoring,
A reopener clause should be placed in the permit to allow for additional limits on these or other
toxicants should whole -effluent toxicity monitoring by Aquatic Tox. indicate toxic effects. .
Y. r 70y, 7.edj it E rOP0 r"4t xc/0Y N�i6'kd 0Lj AddnL Cc.f�, �
rrrB tvY�'w 5A�vtc� C�Ucide cvi'�kT'Iy,
Explain exact #athway of discharge ( i.e. storm sewer to tributary, etc.)
From treatment system to storm drain to Beaver Creels (map attached)
Additional Information attached? (Y or N) If yes, explain with attachments,
ryuw
TOTAL P.01

SOC PRIORITY PROJECT:Yes No X
IF YES, SOC NUMBER
TO: PERMITS AND ENGINEERING UNIT
WATER QUALITY SECTION
ATTENTION: Charles AlvarAz>a G
A k (
DATE: Janaury 26, 1994Q�
NPDES STAFF REPORT AND RECOMMENDATION
COUNTY Mitchell
PERMIT NUMBER NCO083897
PART I - GENERAL INFORMATION
1. Facility and Address: Spruce Pine Community Hospital
Post Office Box 9
Spruce Pine, North Carolina 28777
2. Date of Investigation: June 18, 1992
3. Report Prepared By: Michael R. Parker
4. Persons Contacted and Telephone Number:
5. Directions to Site: From the intersection of U.S. Highway 19E and
North Carolina Secondary Road 1121, travel east on NCSR 1121 0.01 mile
and turn left onto driveway to hospital. Go around back of Spruce Pine
Hospital behind the Physical Therapy Unit. The wastewater treatment
system will be located in the flat grassy area.
6. Discharge Point(s), List for all discharge points:
Latitude: 35054'43" Longitude: 82004'01"
Attach a USGS map extract and indicate treatment facility site and
discharge point on map.
U.S.G.S. Quad No. D10NE U.S.G.S. Quad Name Spruce Pine, N.C.
7. Site size and expansion area consistent with application?
X Yes No If No, explain:
8. Topography (relationship to flood plain included): The wastewater
treatment plant will be )ocated upland away from any stream and
will not be subject to flooding.
Page 1

�9,. Location of nearest dwelling: Greater than 500 feet to any
dwelling. It is approximately 375 feet to doctors offices.
10. Receiving stream or affected surface waters: Beaver Creek
a. Classification: C-trout
b. River Basin and Subbasin No.: FBR 06
C. Describe receiving stream features and pertinent downstream
uses: Industrial water supply, fishing, fish and wildlife
propagation, canoeing
PART II - DESCRIPTION OF DISCHARGE AND TREATMENT WORKS
1. a. Volume of wastewater to be permitted 0.072MGD (Ultimate
Design Capacity)
b. What is the current permitted capacity of the Wastewater
Treatment facility? NA
C. Actual treatment capacity of the current facility (current
design capacity NA
d. Date(s) and construction activities allowed by previous
Authorizations to Construct issued in the previous two years:
e. Please provide a description of existing or substantially
constructed wastewater treatment facilities:
f. Please provide a description of proposed wastewater treatment
facilities: It is proposed to construct a groundwater
remediation wastewater treatment facility consisting of 16
recovery wells, oil and water separator, air stripping unit
and granular activitated carbon. Also, interceptor trenches
will be installed to collect groundwater and free product
which will also be pumped to the treatment system.
Additionally, a mop oil skimmer will be installed in a
stormwater catch basin to remove oil which is collecting in
the basin. The oil will be diverted to a oil holding tank
and removed for recycling.
g. Possible toxic impacts to surface waters: None anticipated.
h. Pretreatment Program (POTWs only):
in development approved
should be required not needed
2. Residuals handling and utilization/disposal scheme: Product
recovered in the GW remeidation wastewater treatment plant will be
burned in the boiler at the hospital.
a. If residuals are being land applied, please specify DEM
Permit Number
Residuals Contractor
Telephone Number
b. Residuals stabilization: PSRP PFRP OTHER
Page 2

c. Landfill:
d. Other disposal/utilization scheme (Specify):
3. Treatment plant classification (attach completed rating sheet):
Class I.
4. SIC Codes(s): 5541
Wastewater Code(s) of actual wastewater, not particular facilities
i.e., non -contact cooling water discharge from a metal plating
company would be 14, not 56.
Primary 66 Secondary
Main Treatment Unit Code: 56000
PART III - OTHER PERTINENT INFORMATION
1. Is this facility being constructed with Construction Grant Funds
or are any public monies involved. (municipals only)?
2. Special monitoring or limitations (including toxicity) requests:
3. Important SOC, JOC, or Compliance Schedule dates: (Please
indicate)
Date
Submission of Plans and Specifications
Begin Construction
Complete Construction
4. Alternative Analysis Evaluation: Has the facility evaluated all
of the non -discharge options available. Please provide regional
perspective for each option evaluated.
Spray Irrigation:
Connection to Regional Sewer System: Town of Spruce Pine does not
have capacity to accept this wastewater.
Subsurface:
Other disposal options:
5. Other Special Items:
Page 3

PART IV - EVALUATION AND RECOMMENDATIONS
National Environmental Technologies is under contract to the
Department of Environment, Health and Natural Resources to design
groundwater remediation facilities for the trust fund clean up of
No. 2 fuel oil at the Spruce Pine Hospital. This oil was lost
years ago and there is a large amount of recoverable product in
the ground.
The proposed facilities should be capable of treating the
groundwater and complying with the NPDES Permit limits.
The company has not addressed the characteristics of the sludge
and final disposal of the sludge in the oil and water
separator. This information should be provided prior to permit
issuance.
When this question is answered satisfactorily, it is recommended
that the permit be issued.
Signature of Report Preparer
Water Qu5ality Regional Supervisor
Date
Page 4