NC0024538_Renewal (Application)_20240221

ROY COOPER
Governor
ELIZABETH S. BISER
Secretary
RICHARD E. ROGERS, JR.
Director
Rick Howell, City Manager
City of Shelby
300 S Washington St
PO Box 207
Shelby, NC 28151-0207
Subject: Permit Renewal
Application No. NCO024538
First Broad River WWTP
Cleveland County
Dear Applicant:
NORTH CAROLINA
Environmental Quality
February 21, 2024
The Water Quality Permitting Section acknowledges the February 21, 2024 receipt of your permit renewal application and
supporting documentation. Your application will be assigned to a permit writer within the Section's NPDES WW permitting
branch. Per G.S. 150B-3 your current permit does not expire until permit decision on the application is made.
Continuation of the current permit is contingent on timely and sufficient application for renewal of the current permit. The
permit writer will contact you if additional information is required to complete your permit renewal. Please respond in a
timely manner to requests for additional information necessary to allow a complete review of the application and renewal
of the permit.
Information regarding the status of your renewal application can be found online using the Department of Environmental
Quality's Environmental Application Tracker at:
https•//deq nc gov/hermits-regulations/permit-guidance/environmental-application-tracker
If you have any additional questions about the permit, please contact the primary reviewer of the application using the
links available within the Application Tracker.
ec: WQPS Laserfiche File w/application
Sincerely,
0' r�
Cynthia Demery
Administrative Assistant
Water Quality Permitting Section
TM D_ Qom;
rarr
North Carolina Department of Environmental Quality I Division of Water Resources
Mooresville Regional Office 1 610 East Center Avenue, Suite 301 1 Mooresvilk, North Carolina 28115
704.663.1699

ROY COOPER
Governor
ELIZABETH S. BISER
Secretary
RICHARD E. ROGERS, JR.
Director
Rick Howell, CIrty Manager
City of Shelby
300 S Washington St
PO Box 207
Subject: Permit Renewal
Application No. NCO024538
First Broad River WWTP
Cleveland County
Dear Applicant:
NORTH CAROLINA
Environmental Quality
February 21, 2024
The Water Quality Permitting Section acknowledges the February 21, 2024 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•//dgg.nc gov/permits-regulations/permit-guidance/environmental-application-tracker
If you have any additional questions about the permit, please contact the primary reviewer of the application using the
links available within the Application Tracker.
ec: WQPS Laserfiche File w/application
Sincerely,
�
Cynthia Demery
Administrative Assistant
Water Quality Permitting Section
North Carolina Department of Environmental Quality I Division of Water Resources
Mooresville Regional Office 1 610 East Center Avenue, Suite 301 1 Mooresville, North Carolina 28115
704.663.1699

ffin,ft-ONIVIS
First Broad
NPIDES #NC1024538
Permit Renewal — 2024
�XM _i

February 12, 2024
Ms. Wren Thedford
NC DEQ — DWR — NPDES
1617 Mail Service Center
Raleigh, NC 27699-1617
Re: City of Shelby — First Broad WWTP
NPDES #NC0024538
Ms. Thedford,
Shelby
NORTH CAROLINA/
Post Office Box 207 Shelby NC 28151-0207 ��rr
RECEIVED
FEB 21 2024
NCDEQ/DWR/NPDES
On behalf of the City of Shelby, I am requesting the renewal of the National Pollutant Discharge
Elimination System Permit #NC0024538 for the First Broad River Wastewater Treatment Plant.
The permit application and associated information are being submitted along with this letter.
The First Broad River WWTP continues to operate a 6.0 MGD activated sludge plant for treating
municipal wastewater for the City of Shelby, Town of Fallston and Town of Kingstown.
All analyses have been conducted by NC Certified laboratories and contain data collected from
January 2021 through December 2023.
If you have any questions or need additional information regarding this permit renewal
application, please do not hesitate to contact me at brian.wilsongcilyofshelby.com
Respectfull submitted,
Brian Wilson
Director of Water Resources
RECEIVED
FEB 21 2024
NCDEQ/DWR/NPDES

EPA Identification Number
NPDES Permit Number
Facility Name
Form Approved 03/05/19
110018809921
NCO024538
First Broad River WWTP
OMB No. 2040-0004
orm
For
U.S. Environmental Protection Agency
:.EPA Application for NPDES Permit to Discharge Wastewater
NPDES
NEW AND EXISTING PUBLICLY OWNED TREATMENT WORKS
SECTION•N
INFORMATION FOR i
Facility name
1.1
First Broad River Wastewater Treatment Plant
Mailing address (street or P.O. box)
Post Office Box 201
City or town
State
ZIP code
o
Shelby
NC
281510207
€
Contact name (first and last) TTitle
Phone number
Email address
w
Brian Wilson
Director of Water Resources
[phone]
[e-mail]
c
Location address (street, route number, or other specific identifier) ❑ Same as mailing address
U-
1940 South Lafayette Street
City or town
State
ZIP code
Shelby
NC
28152
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?
0 Yes No -+ SKIP to Item 1.4.
Applicant name
Applicant address (street or P.O. box)
0
City or town
State
ZIP code
c
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 Both
1.5
To which entity should the NPDES permitting authority send correspondence? (Check only one response.)
❑ Facility E? Applicant ❑ Facility and applicant
(they are one and the same)
1.6
Indicate below any existing environmental permits. (Check all that apply and print or type the corresponding permit
number for each.
Existing Environmental Permits
a
NPDES (discharges to surface
( 9
❑ RCRA (hazardous waste)
UIC (underground injection
❑ ( g )
water)
control)
E
NCO024538
c
❑ PSD (air emissions)
❑ Nonattainment program (CAA)
❑ NESHAPs (CAA)
w
a>
❑ Ocean dumping (MPRSA)
❑ Drree) ge or fill (CWA Section
[� Other (specify)
w
Stormwater NCG110040
EPA Form 3510-2A (Revised 3-19) Page 1

EPA Identification Number
NPDES Permit Number
Facility Name
Form Approved 03105/19
110018809921
NCO024538
First Broad River WWTP
OMB No.2040-0004
1.7
Provide the collection system information
requested below for the treatment works.
Municipality
Population
Collection System Type
Ownership Status
Served
Served
(indicate percentage)
Shelby
100 % separate sanitary sewer
E f Own ❑ Maintain
m
21,826
% combined storm and sanitary sewer
❑ Own ❑ Maintain
z
d
❑ Unknown
❑ Own ❑ Maintain
Fallston
100 % separate sanitary sewer
El Own D Maintain
604
% combined storm and sanitary sewer
❑ Own ❑ Maintain
❑ Unknown
❑ Own ❑ Maintain
CL
0
100 % separate sanitary sewer
El Own 0 Maintain
V
Kingstown
g
581
% combined storm and sanitary sewer
❑ Own ❑ Maintain
❑ Unknown
❑ Own ❑ Maintain
d%
separate sanitary sewer ❑ Own ❑ Maintain
>%
% combined storm and sanitary sewer ❑ Own ❑ Maintain
`"
c
I ElUnknown ElOwn ❑ Maintain
w
Total
Population 23,011
v
Served
Combined Storm and
Separate Sanitary Sewer System
Sanitary Sewer
Total percentage of each type of
o �0 0 �0
sewer line (in miles)
100 0
iT
1.8
Is the treatment works located in Indian Country?
c
o
❑ Yes No
m1.9
Does the facility discharge to a receiving water that flows through Indian Country?
c
❑ Yes Q No
1.10
Provide design and actual flow rates in the designated spaces.
Design Flow Rate
6.0 mgd
Annual Average Flow Rates (Actual)
v,
Two Years Ago
Last Year
This Year
Cr
e=c 3
3.40 mgd
3.11 mgd
3.43 mgd
c o
rnLL
Maximum Daily Flow Rates (Actual)
CD
o
Two Years Ago
Last Year
This Year
9.45 mgd
7.22 mgd
11.29 mgd
Provide the total number of effluent discharge points to waters of the United States by type.
c
Total Number of Effluent Discharge Points by Type
a o-
Combined Sewer
Constructed
�
aF
R T
Treated Effluent
Untreated Effluent
Overflows
Bypasses
Emergency
c
Overflows
AA
-0
1
0
0
0
0
EPA Form 3510-2A (Revised 3-19) Page 2

EPA Identification Number
NPDES Permit Number
Facility Name
Form Approved 03/05/19
110018809921
NCO024538
First Broad River WWTP
OMB No.2040-0004
Outfalls Other Than to Waters of the United States
1.12
Does the POTW discharge wastewater to basins, ponds, or other surface impoundments that do not have outlets for
discharge to waters of the United States?
❑ Yes D No 4 SKIP to Item 1.14.
1.13
Provide the location of each surface impoundment and associated discharge information in the table below.
Surface Impoundment Location and Discharge Data
Average Daily Volume
Continuous or Intermittent
Location
Discharged to Surface
(check one)
Impoundment
❑ Continuous
gpd
❑ Intermittent
❑ Continuous
gpd
❑ Intermittent
❑ Continuous
gpd
❑ Intermittent
0
=
1.14
Is wastewater applied to land?
❑ Yes No 4 SKIP to Item 1.16.
U)
1.15
Provide the land application site and discharge data requested below.
C
Land Application Site and Discharge Data
o
Average Daily Volume
Continuous or
0
Location
Size
Applied
Intermittent
L
(check one)
`O
y
0
acres
gpd
❑ Continuous
❑ Intermittent
❑ Continuous
t
acres
gPd
❑ Intermittent
acres
gpd
❑ Continuous
❑ Intermittent
R
1.16
Is effluent transported to another facility for treatment prior to discharge?
o
❑ Yes No 4 SKIP to Item 1.21.
1.17
Describe the means by which the effluent is transported (e.g., tank truck, pipe).
1.18
Is the effluent transported by a party other than the applicant?
❑ Yes ❑ No 4 SKIP to Item 1.20.
1.19
Provide information on the transporter below.
Transporter Data
Entity name
Mailing address (street or P.O. box)
City or town
State
ZIP code
Contact name (first and last)
Title
Phone number
Email address
EPA Form 3510-2A (Revised 3-19) Page 3

EPA Identification Number
NPDES Permit Number
Facility Name
Form Approved 03105/19
110018809921
NCO024538
First Broad River WWTP
OMB No.2040-0004
1.20
In the table below, indicate the name, address, contact information, NPDES number, and average daily flow rate of the
receiving facility.
Facility name
Mailing address (street or P.O. box)
0
d
City or town
State
ZIP code
_
0
Contact name (first and last)
Title
0
0
Phone number
Email address
QNPDES
number of receiving facility (if any) ❑ None
Average daily flow rate mgd
N
0
1.21
Is the wastewater disposed of in a manner other than those already mentioned in Items 1.14 through 1.21 that do not
8
have outlets to waters of the United States (e.g., underground percolation, underground injection)?
CD
❑ Yes 0 No 4 SKIP to Item 1.23.
0
1.22
Provide information in the table below on these other disposal methods.
d
Information on Other Disposal
Methods
o
Disposal
Location of
Size of
Annual Average
Continuous or Intermittent
Method
Description
Disposal Site
Disposal Site
Daily Discharge
Volume
(check one)
El
acres
gpd
❑ Intermittent
0
❑ Continuous
acres
gPd
❑ Intermittent
acres
❑ Continuous
9Pd
❑ 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.)
❑ Discharges into marine waters (CWA ❑ Water quality related effluent limitation (CWA Section
Section 301(h)) 302(b)(2))
[� Not applicable
1.24
Are any operational or maintenance aspects (related to wastewater treatment and effluent quality) of the treatment works
the responsibility of a contractor?
D Yes ❑ No 4SKIP to Section 2.
1.25
Provide location and contact information for each contractor in addition to a description of the contractor's operational
and maintenance responsibilities. SEE ATTACHMENT A
Contractor Information
Contractor 1
Contractor 2
Contractor 3
=
0
Contractor name
(company name
E
Mailing address
(street or P.O. box
`o
City, state, and ZIP
code
L
c
Contact name (first and
c�
last
Phone number
Email address
Operational and
maintenance
responsibilities of
contractor
EPA Form 3510-2A (Revised 3-19) Page 4

EPA Identification Number NPDES Permit Number Facility Name Fo m Approved 03/05/19
110018809921 NCO024538 First Broad River WWTP OMB No.2040-0004
SECTIONDD• •• • r
e Outfalls to Waters of the United States
=
2.1
Does the treatment works have a design flow greater than or equal to 0.1 mgd?
o
[� Yes ❑ No 4 SKIP to Section 3.
c
2.2
Provide the treatment works' current average daily volume of inflow
Average Dal ty Volume of Inflow and Irfilbadon
100,000 9Pd
and infiltration.
Indicate the steps the facility is taking to minimize inflow and infiltration.
The city performs point repairs and continues to identify rehabilitation projects for annual capital improvement projects. The
cc
3
city installed smart covers in 2023 at several locations. The city continues to identify sources of inflow and infiltration via
manhole inspections, flow monitoring (smart covers), and videoing of sewer lines.
2
2.3
Have you attached a topographic map to this application that contains all the required information? (See instructions for
specific requirements.) SEE ATTACHMENT B
fl
rn ea
o
0'
[} Yes ❑ No
2.4
Have you attached a process flow diagram or schematic to this application that contains all the required information?
E
1c
o 6
(See instructions for specific requirements.) SEE ATTACHMENT C
o
[� Yes ❑ No
2.5
Are improvements to the facility scheduled?
❑ Yes 0 No 4 SKIP to Section 3.
Briefly list and describe the scheduled improvements.
c
0
1.
c
a�
E
d
a
2.
E
0
0
y
d
3.
CD
d
4.
2.6
Provide scheduled or actual dates of completion for improvements.
Scheduled or Actual Dates of Completion for Improvements
E
Scheduled
Affected
Outfalls
Begin
End
Begin
Attainment of
operational
'o
a
Improvement
p
(list outfall
Construction
Construction
Discharge
Level
E
(from above)
number)
(MM/DDIYYYY)
(MMIDDIYYYY)
(MM1DD/YYYY)
(MM/DD/YYYY)
d
0
d
s
in
2.
3.
4.
2.7
Have appropriate permits/clearances concerning other federal/state requirements been obtained? Briefly explain your
response.
❑ Yes ❑ No ❑ None required or applicable
Explanation:
EPA Form 3510-2A (Revised 3-19) Page 5

EPA Identification Number
NPDES Permit Number
Facility Name rorm Hpproveo us/uoi is
OMB No.2040-0004
110018809921
NC0024538
First Broad River WWTP
SECTION•R
• ON
for each outfall. (Attach additional sheets if you have more than three outfalls.)
3.1
Provide the following information
Outfall Number 001
Outfall Number
Outfall Number
State
North Carolina
County
Cleveland
!
3
o
City or town
Shelby
w
0
a
Distance from shore
N/A fl.
ft•
fl.
.Q
Depth below surface
fl.
N/ACD
ft•
ft•
0
Average daily flow rate
3.43 mgd
mgd
mgd
Latitude
35° 14' 34"
Longitude
81' 34' 28"
„
3.2
Do any of the outfalls described under Item 3.1 have seasonal or periodic discharges?
R
❑ Yes 0 No 4SKIP to Item 3.4.
o
3.3
If so, provide the following information for each applicable outfall.
N
Outfall Number
Outfall Number
Outfall Number
0
2
Number of times per year
a
0
discharge occurs
a
Average duration of each
o
discharge (specify units
a
Average flow of each
mgd
mgd
mgd
N
discharge
(,
Months in which discharge
occurs
3.4
Are any of the outfalls listed under Item 3.1 equipped with a diffuser.?
❑ Yes D No 4 SKIP to Item 3.6.
3.5
Briefly describe the diffuser type at each applicable outfall.
d
CL
Outfall Number
Outfall Number
Outfall Number
d
0
Does the treatment works discharge or plan to discharge wastewater to waters of the United States from one or more
vi
l! :j
3.6
discharge points?
3
[� Yes ElNo -SKIP to Section 6.
EPA Form 3510-2A (Revised 3-19) Page 6

EPA Identification Number
NPDES Permit Number
Facility Name
Form Approved 03/05/19
OMB No.2040-0004
110018809921
NCO024538
First Broad River WWTP
3.7
Provide the receiving water and related information (if known) for each outfall.
Outfall Number 001
Outfall Number
Outfall Number
Receiving water name
First Broad River
Name of watershed, river,
Broad River Basin
c
or stream system
a
U.S. Soil Conservation
y
Service 14-digit watershed
N/A
o
code
d
is
3
Name of state
management/river basin
Broad River Basin
rs
U.S. Geological Survey
8-digit hydrologic
03050105
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
N/A mg/L of
mg/L of
mg/L of
low flow
CaCO3
CaCO3
CaCO3
3.8
Provide the following information
describing the treatment provided for discharges from each outfall.
Outfall Number 001
Outfall Number
Outfall Number
Highest Level of
❑ Primary
❑ Primary
❑ Primary
Treatment (check all that
❑ Equivalent to
❑ Equivalent to
❑ Equivalent to
apply per outfall)
secondary
secondary
secondary
Ct Secondary
❑ Secondary
❑ Secondary
❑ Advanced
❑ Advanced
❑ Advanced
❑ Other (specify)
❑ Other (specify)
❑ Other (specify)
0
aDesign
Removal Rates by
Outfall
d
BOD5 or CBOD5
>85 %
%
%
c
d
E
L
TSS
>85 %
%
%
t—
Lj Not applicable
❑ Not applicable
❑ Not applicable
Phosphorus
%
%
%
Ej Not applicable
❑ Not applicable
❑ Not applicable
Nitrogen
%
Other (specify)
LI Not applicable
❑ Not applicable
❑ Not applicable
EPA Form 3510-2A (Revised 3-19) Page 7

EPA Identification Number
NPDES Permit Number
Facility Name
Form Approved 03/05/19
110018809921
NCO024538
First Broad River WWTP
OMB No.2040-0004
3.9
Describe the type of disinfection used for the effluent from each outfall in the table below. If disinfection varies by
season, describe below.
Chlorination
m
3
c
0
Outfall Number 001
Outfall Number
Outfall Number
0
fl
L
Disinfection type
Chlorination
0
d
Seasons used
N/A
E
d
Dechlorination used?
❑ Not applicable
❑ Not applicable
❑ Not applicable
~
E} Yes
❑ Yes
❑ Yes
❑ No
❑ No
❑ No
3.10
Have you completed monitoring for all Table A parameters and attached the results to the application package?
D 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?
Ei 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 001
Outfall Number
Outfall Number
Acute
Chronic
Acute
Chronic
Acute
Chronic
Number of tests of discharge
N/A
20
water
Number of tests of receiving
N/A
N/A
water
3.13
Does the treatment works have a design flow greater than or equal to 0.1 mgd?
E:' Yes ❑ No 4 SKIP to Item 3.16.
0
3.14
Does the POTW use chlorine for disinfection, use chlorine elsewhere in the treatment process, or otherwise have
reasonable potential to discharge chlorine in its effluent?
d
[� Yes + Complete Table B, including chlorine. ❑ No 4 Complete Table B, omitting chlorine.
3.15
Have you completed monitoring for all applicable Table B pollutants and attached the results to this application
package?
w
0' Yes ❑ No
3.16
Does one or more of the following conditions apply?
• The facility has a design flow greater than or equal to 1 mgd.
• The POTW has an approved pretreatment program or is required to develop such a program.
• The NPDES permitting authority has informed the POTW that it must sample for the parameters in Table C, must
sample other additional parameters (Table D), or submit the results of WET tests for acute or chronic toxicity for
each of its discharge outfalls (Table E).
Ej Yes + Complete Tables C, D, and E as ❑ No + SKIP to Section 4.
applicable.
3.17
Have you completed monitoring for all applicable Table C pollutants and attached the results to this application
package?
D Yes ❑ No
3.18
Have you completed monitoring for all applicable Table D pollutants required by your NPDES permitting authority and
attached the results to this application package?
[� Yes ❑ No additional sampling required by NPDES
permitting authority.
EPA Form 3510-2A (Revised 3-19) Page 8

EPA Identification Number
NPDES Permit Number
Facility Name
Form Approved 03/05/19
110018809921
NCO024538
First Broad River WWfP
OMB No.2040-0004
3.19
Has the POTW conducted either (1) minimum of four quarterly WET tests for one year preceding this permit application
or (2) at least four annual WET tests in the past 4.5 years?
Q 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 your NPDES permitting authority and provide a summary of the results.
Date(s) Submitted
Summary of Results
(MM/DD/YYYY)
m
c
0
R
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?
c
❑ Yes ❑ No 4 SKIP to Item 3.26.
3.23
Describe the cause(s) of the toxicity:
c
d
Uj
w
3.24
Has the treatment works conducted a toxicity reduction evaluation?
❑ Yes ❑ No 4 SKIP to Item 3.26.
3.25
Provide details of any toxicity reduction evaluations conducted.
3.26
Have you completed Table E for all applicable outfalls and attached the results to the application package?
Q Yes ❑ Not applicable because previously submitted
information to the NPDES permitting authority.
SECTION•D•
r
Does the POTW receive discharges from SIUs or NSCIUs?
4.1
Ei Yes ❑ No -+ SKIP to Item 4.7.
4.2
Indicate the number of SIUs and NSCIUs that discharge to the POTW.
Number of SIUs
Number of NSCIUs
H
6
0
0
-a
4.3
Does the POTW have an approved pretreatment program?
R
Yes ❑ No
r-
4.4
Have you submitted either of the following to the NPDES permitting authority that contains information substantially
4)
identical to that required in Table F: (1) a pretreatment program annual report submitted within one year of the
application or (2) a pretreatment program?
y
❑ Yes No + SKIP to Item 4.6.
c
4.5
Identify the title and date of the annual report or pretreatment program referenced in Item 4.4. SKIP to Item 4.7.
N
3
'G
4.6
Have you completed and attached Table F to this application package?
D Yes ❑ No
EPA Form 3510-2A (Revised 3-19) Page 9

EPA Identification Number
NPDES Permit Number
Facility Name
Form Approved 03/05/19
OMB No.2040-0004
110018809921
NCO024538
First Broad River WWTP
4.7
Does the POTW receive, or has it been notified that it will receive, by truck, rail, or dedicated pipe, any wastes that are
regulated as RCRA hazardous wastes pursuant to 40 CFR 261?
❑ Yes ❑ No + SKIP to Item 4.9.
4.8
If yes, provide the following information:
Annual
Hazardous Waste
Waste Transport Method
Amount of
Units
Number
(check all that apply)
Waste
Received
❑ Truck ❑ Rail
❑ Dedicated pipe ❑ Other (specify)
d
c
C
c)
❑ Truck ❑ Rail
❑ Dedicated pipe ❑ Other (specify)
N
10
t/1
0
_
❑ Truck ❑ Rail
R
❑ Dedicated pipe ❑ Other (specify)
x
4.9
Does the POTW receive, or has it been notified that it will receive, wastewaters that originate from remedial activities,
including those undertaken pursuant to CERCLA and Sections 3004(7) or 3008(h) of RCRA?
o
[� Yes ❑ No + SKIP to Section 5.
4.10
Does the POTW receive (or expect to receive) less than 15 kilograms per month of non -acute hazardous wastes as
3
specified in 40 CFR 261.30(d) and 261.33(e)?
❑ Yes 4 SKIP to Section 5. 0 No
4.11
Have you reported the following information in an attachment to this application: identification and description of the
site(s) or facility(ies) at which the wastewater originates; the identities of the wastewater's hazardous constituents; and
the extent of treatment, if any, the wastewater receives or will receive before entering the POTW?
SEE ATTACHMENT D
❑' Yes ❑ No
SECTION•
-• • i
Does the treatment works have a combined sewer system?
5.1
£
o
El Yes ❑ No -SKIP to Section 6.
4V
is
5.2
Have you attached a CSO system map to this application? (See instructions for map requirements.)
C
Q
❑ Yes ❑ No
cc
0
5.3
Have you attached a CSO system diagram to this application? (See instructions for diagram requirements.)
L)
❑ Yes ❑ No
EPA Form 3510-2A (Revised 3-19) Page 10

EPA Identification Number
NPDES Permit Number
Facility Name
Form Approved 03/05/19
110018809921
NCO024538
First Broad River WWTP
OMB No.2040-0004
5.4
For each CSO outfall, provide
the following information. (Attach
additional sheets as necessary.)
CSO Outfall Number
CSO Outfall Number
CSO Outfall Number
City or town
0
•L
State and ZIP code
U
Nl
0
County
Latitude
0
0
CO
Longitude
U
Distance from shore
ft.
ft•
ft.
Depth below surface
ft.
ft.
5.5
Did the POTW monitor any of the following items in the past year for its CSO outfalls?
CSO Outfall Number
CSO Outfall Number
CSO Outfall Number
Rainfall
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
rn
o
CSO flow volume
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
CSO pollutant
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
0
concentrations
Receiving water quality
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
CSO frequency
[--]Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Number of storm events
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
5.6
Provide the following information for each of your CSO outfalls.
CSO Outfall Number
CSO Outfall Number
CSO Outfall Number
Number of CSO events in
events
events
events
the past year
cAverage
duration per
hours
hours
hours
event
❑ Actual or ❑ Estimated
❑ Actual or ❑ Estimated
❑ Actual or ❑ Estimated
d
w'
million gallons
million gallons
million gallons
0
Average volume per event
❑ Actual or ❑ Estimated
❑ Actual or ❑ Estimated
❑ Actual or ❑ Estimated
Minimum rainfall causing
inches of rainfall
inches of rainfall
inches of rainfall
a CSO event in last year
❑ Actual or ❑ Estimated
❑ Actual or ❑ Estimated
❑ Actual or ❑ Estimated
EPA Form 3510-2A (Revised 3-19) Page 11

EPA Identification Number
NPDES Permit Number
Facility Name
Form Approved 03/05/19
110018809921
NCO024538
First Broad River WWTP
OMB No.2040-0004
5.7
Provide the information in the table below for each of your CSO outfalls.
CSO Outfall Number
CSO Outfall Number_
CSO Outfall Number_
Receiving water name
Name of watershed/
streams stem
d
U.S. Soil Conservation
❑ Unknown
❑ Unknown
❑ Unknown
Service 14-digit
watershed code
(if known)
Name of state
management/river basin
U)
U.S. Geological Survey
❑ Unknown
❑ Unknown
❑ Unknown
8-Digit Hydrologic Unit
Code (if known)
Description of known
water quality impacts on
receiving stream by CSO
(see instructions for
exam les
SECTION
• 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
❑ w/ variance request(s) [} w/ additional attachments
Information for All A licants
Section 2: Additional
0 w/ topographic map Ej wl process flow diagram
Information
w/ additional attachments
[� w/ Table A Ej wl Table D
Q, Section 3: Information on
w/ Table B [} w/ Table E
Effluent Discharges
[� w/ Table C ❑ wl additional attachments
w
Section 4: Industrial
❑ wl SIU and NSCIU attachments w/ Table F
N
[� Discharges and Hazardous
© w/ additional attachments
Wastes
Section 5: Combined Sewer
❑ w/ CSO map 1 a t
RfOverflows
El wl CSO system diagram
d
Section 6: Checklist and
[�
❑ wl attachments 21 2024
FEB
Certification Statement
Y
6.2
Certification Statement
1 certify under penalty of law that this document and all attachments were prepared under my direction or supervisign -
accordance with a system designed to assure that qualified personnel properly galheraai fidt)ate the i f rfi 6dn
submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible
for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and
complete. I am aware that there are significant penalties for submitting false information, including the possibility of fine
and imprisonment for knowing violations.
Name (print or type first and last name)
Official title
Brian Wilson
Director of Water Resources
Signature
Date signed
EPA Form 3510-2A (Revised 3-19) Page 12
ES

EPA Identification Number NPDES Permit Number Facility Name Outfall Number
110018809921 1 NCO024538 I First Broad River WWTP 001
Form Approved 03/05/19
OMB No.2040-0004
Maximum Daily Discharge
Average Daily Discharge
Analytical ML or MDL
Method' (include units)
Pollutant
Value
Units
Value
Units
Number, of
Samples
Biochemical oxygen demand
aBOD5 or ❑ CBOD5
(report one)
128.2
mg/L
5.2
mg/L
747 SM
❑ ML
5210 B-2016 2.0 mg/L
❑MDL
Fecal coliform
>2,420
MPN
38
MPN
747 Idexx
Colilert 18 (MPN) 1 MPN ❑ ML
aMDL
Design flow rate
11.29
MGD
3.31
MGD
1,095
pH (minimum)
pH (maximum)
Temperature (winter)
6.02
7.55
22.7
S.U.
S.U.
°C
17.0
'C
304
Temperature (summer)
28.1
T
23.9
•c
443
Total suspended solids (TSS)
128.7
mg/L
4.5
mg/L
747
SM 2540 D-2015
2.5 mg/L
L3 MDL
I Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter I, subchapter N or 0. See instructions and 40 CFR 122.21(e)(3).
EPA Form 3510-2A (Revised 3-19) Page 13

This page intentionally left blank.

EPA Identification Number
NPDES Permit Number
Facility Name Outfall Number
Form Approved 03/05/19
110018809921
NCO024538
First Broad River WWTP 001
OMB No.20400004
Average Daily Discharge
Analytical
ML or MDL
Maximum Daily
Discharge
Value
Units
Value
Units
Number of
Pollutant
Methods
Include units
( )
Samples
❑ ML
Ammonia (as N)
18.1
mg/L
1.9
mg/L
747
SM 4500 NH3 D-2011
0.5 mg/L aMDL
Chlorine
46
ug/L
14
ug/L
747
SM 4500 Cl G-2011
10 ug/L ❑ ML
L3MDL
(total residual, TRC)z
Dissolved oxygen
20.40
mg/L
7.30
mg/L
747
SM 4500 O G-2016
LJ ML
0.1 mg/L C3kMDL
Nitrate/nitrite
10.0
mg/L
4.9
mg/L
12
353.2
0.1 mg/L ❑ ML
IJ MDL
Kjeldahl nitrogen
6.0
mg/L
3.8
mg/L
12
351.2
0.1 mg/L LI ML
DL
Oil and grease
31.0
mg/L
4.0
mg/L
12
1664 B
5.0 mg/L 0 ML
DL
Phosphorus
17.0
mg/L
3.7
mg/L
12
365.1
0.05 mg/L 0 L aMDL
❑ ML
Total dissolved solids
280
mg/L
270
mg/L
3
SM 2540 C-2015
25 mg/L L}MDL
1 cmmnrnrichau ho rnnrliictarl nrrnrrtinn to sirffiriently sensitive test nrnredures (i_e. methods) 20oroved under 40 CFR 136
for the analvsis of pollutants
or pollutant parameters or
required under 40 CFR chapter I, subchapter N or 0. See instructions and 40 CFR 122.21(e)(3).
2 Facilities that do not use chlorine for disinfection, do not use chlorine elsewhere in the treatment process, and have no reasonable potential to discharge chlorine in their effluent are not
required to report data for chlorine.
EPA Form 3510-2A (Revised 3-19) Page 15

This page intentionally left blank.

EPA Identification Number
110018809921
NPDES Permit Number Facility Name Outfall Number
NCO024538 First Broad River WWTP 001
•• ••
Maximum Daily Discharge Average Daily Discharge
Form Approved 03/05/19
OMB No.2040-0004
Analytical ML or MDL
Method' (include units)
Pollutant
Value
Units Value
Units
Number of
Samples
Metals, Cyanide, and Total Phenols
Hardness (as CaCO3)
84
mg/L
62
mg/L
12
SM 2340C- 2011
10 mg/L UML
MDL
Antimony, total recoverable
5
ug/L
5
ug/L
3
200.8
5 ug/L U ML
Arsenic, total recoverable
2
ug/L
2
ug/L
12
200.8
2 ug/L
U MDL
Beryllium, total recoverable
1
ug/L
1
ug/L
3
200.8
1 ug/L U MLDL
Cadmium, total recoverable
0.5
ug/L
0.5
ug/L
12
200.8
0.5 ug/L
6 MDL
Chromium, total recoverable
5
ug/L
5
ug/L
12
200.8
5 ug/L
a MDL
Copper, total recoverable
4
ug/L
2.3
ug/L
12
200.8
2 ug/L aMDL
Lead, total recoverable
2
ug/L
2
ug/L
12
200.8
2 ug/L
C3MDL
Mercury, total recoverable
4.3
ng/L
1.5
ng/L
12
1631E
0.5 ng/L L3ML
Nickel, total recoverable
3.1
ug/L
2
ug/L
12
200.8
2 ug/L
6 MDL
Selenium, total recoverable
5
ug/L
5
ug/L
12
200.8
5 ug/L aMDL
Silver, total recoverable
1
ug/L
1
ug/L
12
200.8
1 ug/L
U MDL
Thallium, total recoverable
2
ug/L
2
ug/L
3
200.8
2 ug/L
Ei MDL
Zinc, total recoverable
42
ug/L
27.7
ug/L
12
200.8
10 ug/L
C3MDL
Cyanide
0.018
mg/L
0.010
mg/L
36
SM 4500-CN E-2
0.010 mg/L
Cf MDL
Total phenolic compounds
0.005
mg/L
0.005
mg/L
12
420.4
0.005 mg/L C3 MDL
Volatile Organic Compounds
Acrolein
5
ug/L
5
ug/L
3
624.1
5 ug/L UMDL
Acrylonitrile
5
ug/L
5
ug/L
3
624.1
5 ug/L U ML
MDL
Benzene
1
ug/L
1
ug/L
3
624.1
1 ug/L
C}MDL
Bromoform
1
ug/L
1
ug/L
3
624.1
1 ug/L LIMC3ML
EPA Form 3510-2A (Revised 3-19) Page 17

EPA Identification Number
110018809921
NPDES Permit Number Facility Name Outfall Number
NCOO24538 First Broad River WWTP 001
• ••
Maximum Daily Discharge Average Daily Discharge
Form Approved 03/05/19
OMB No.2040.0004
Analytical ML or MDL
Method' (include units)
Pollutant
Value
Units
Value
Units
Number of
Samples
Carbon tetrachloride
1
ug/L
1
ug/L
3
624.1
1 ug/L E3MDL
Chlorobenzene
1
ug/L
1
ug/L
3
624.1
1 ug/L f3MDL
Chlorodibromomethane
1
ug/L
1
ug/L
3
624.1
1 ug/L
C3MDL
Chloroethane
2
ug/L
2
ug/L
3
624.1
2 ug/L
E}MDL
2-chloroethylvinyl ether
5
ug/L
5
ug/L
3
624.1
5 ug/L U ML
Chloroform
2.1
ug/L
2.1
ug/L
3
624.1
UML
1 ug/L
E3MDL
Dichlorobromomethane
1
ug/L
1
ug/L
3
624.1
1 ug/L
EWDL
1,1-dichloroethane
1
ug/L
1
ug/L
3
624.1
UM
1 ug/L
E3MDL
1,2-dichloroethane
1
ug/L
1
ug/L
3
624.1
1 ug/L
alVIDL
trans-1,2-dichloroethylene
1
ug/L
1
ug/L
3
624.1
1 ug/L CiMDL
1,1-dichloroethylene
1
ug/L
1
ug/L
3
624.1
LJ NIL
1 ug/L 1:WDL
1,2-dichloropropane
1
ug/L
1
ug/L
3
624.1
1 ug/L U L aMDL
1,3-dichloropropylene
1
ug/L
1
ug/L
3
624.1
1 ug/L Li ML
© MDL
Ethylbenzene
1
ug/L
1
ug/L
3
624.1
IML
1 ug/L LJa MDL
Methyl bromide
2
ug/L
1.7
ug/L
3
624.1
2 & 1 ug/L U EWDL
Methyl chloride
2
ug/L
2
ug/L
3
624.1
2 ug/L EWDL
Methylene chloride
1
ug/L
1
ug/L
3
624.1
1 ug/L LJ C3ML
1,1,2,2-tetrachloroethane
1
ug/L
1
ug/L
3
624.1
1 ug/L
E3MDL
Tetrachloroethylene
1
ug/L
1
ug/L
3
624.1
1 ug/L L3 MDL
Toluene
1
ug/L
1
ug/L
3
624.1
1 ug/L
CC'MDL
1,1,1-tdchloroethane
1
ug/L
1
ug/L
3
624.1
1 ug/L U EWDL
1,1,2-tdchloroethane
1
ug/L
i
ug/L
3
624.1
1 ug/L U L E?MDL
EPA Form 3510-2A (Revised 3-19) Page 18

EPA Identification Number
110018809921
NPDES Permit Number Facility Name Outfall Number
NCOO24538 First Broad River WWTP 001
al •• 7 18
Maximum Daily Discharge Average Daily Discharge
Form Approved 03/05/19
OMB No.2040-M
Analytical ML or MDL
Method' (include units)
Pollutant
Value
Units
Value
Units
Number of
Samples
Trichloroethylene
1
ug/L
1
ug/L
3
624.1
1 ug/L L3MDL
Vinyl chloride
1
ug/L
1
ug/L
3
624.1
1 ug/L EWDL
Acid -Extractable Compounds
p-chloro-m-cresol
8
ug/L
8
ug/L
3
625.1
8 ug/L L3 MDL
2-chlorophenol
8
ug/L
8
ug/L
3
625.1
8 ug/LC?MDL
2,4-dichlorophenol
8
ug/L
8
ug/L
3
625.1
8 ug/L U UIVIDL
2,4-dimethylphenol
8
ug/L
8
ug/L
3
625.1
8 ug/L p MDL
4,6-dinitro-o-cresol
40
ug/L
40
ug/L
3
625.1
UML
40 ug/L
CiMDL
2,4-dinitrophenol
40
ug/L
40
ug/L
3
625.1
40 ug/L U ML
MDL
2-nitrophenol
16
ug/L
16
ug/L
3
625.1
1
16 ug/L 1ML
MDL
4-nitrophenol
40
ug/L
40
ug/L
3
625.1
40 ug/L U L EiMOL
Pentachlorophenol
40
ug/L
40
ug/L
3
625.1
U NIL
40 ug/L EML
Phenol
8
ug/L
8
ug/L
3
625.1
8 ug/L
Ed MDL
2,4,6-trichlomphenol
8
ug/L
8
ug/L
3
625.1
8 ug/L L MDL
Base -Neutral Compounds
Acenaphthene
8
ug/L
8
ug/L
3
625.1
8 ug/L p MDL
Acenaphthylene
8
ug/L
8
ug/L
3
625.1
8 ug/L p MDL
Anthracene
8
ug/L
8
ug/L
3
625.1
8 ug/L
L3MDL
Benzidine
40
ug/L
40
ug/L
3
625.1
40 ug/L
LkMDL
Benzo(a)anthracene
8
ug/L
8
ug/L
3
625.1
UML
8 ug/L UIVIDL
Benzo(a)pyrene
8
ug/L
8
ug/L
3
625.1
8 ug/L EWDL
3,4-benzofluoranthene
8
ug/L
8
ug/L
3
625.1
8 ug/L
DMDL
EPA Form 3510-2A (Revised 3-19) Page 19

EPA Identification Number
110018809921
NPDES Permit Number Facility Name Outfall Number
NCO024538 First Broad River WWTP 001
Maximum Daily Discharge Average Daily Discharge
Form Approved 03/05119
OMB No.2040-0004
Analytical ML or MDL
Method' (include units)
)
PollutantValue
Units
Value
Units
Numberof
Samples
Benzo(ghi)perylene
8
ug/L
8
ug/L
3
625.1
8 ug/L E3MDL
Benzo(k)fluoranthene
8
ug/L
8
ug/L
3
625.1
8 ug/L p.MDL
Bis (2-chloroethoxy) methane
8
ug/L
8
ug/L
3
625.1
8 ug/L
C:?MDL
Bis (2-chloroethyl) ether
8
ug/L
8
ug/L
3
625.1
8 ug/L E WDL
Bis (2-chloroisopropyl) ether
8
ug/L
8
ug/L
3
625.1
8 ug/L E3MDL
Bis (2-ethylhexyl) phthalate
40
ug/L
40
ug/L
3
625.1
40 ug/L Li E3ML
4-bromophenyl phenyl ether
8
ug/L
8
ug/L
3
625.1
Li ML
8 ug/L EWDL
Butyl benzyl phthalate
8
ug/L
8
ug/L
3
625.1
8 ug/L E3MDL
2-chloronaphthalene
8
ug/L
8
ug/L
3
625.1
8 ug/L U ML
4-chlorophenyl phenyl ether
8
ug/L
8
ug/L
3
625.1
8 ug/L E3'MDL
Chrysene
8
ug/L
8
ug/L
3
625.1
8 ug/L U ML
MDL
di-n-butyl phthalate
8
ug/L
8
ug/L
3
625.1
8 ug/L LJ ETML
di-n-octyl phthalate
8
ug/L
8
ug/L
3
625.1
ML
8 ug/L UEk MDL
Dibenzo(a,h)anthracene
8
ug/L
8
ug/L
3
625.1
8 ug/L LJ E3ML
1,2-dichlorobenzene
1
ug/L
1
ug/L
3
624.1
1 ug/L
E3MDL
1,3-dichlorobenzene
1
ug/L
1
ug/L
3
624.1
1 ug/L
UNIDL
1,4-dichlorobenzene
1
ug/L
1
ug/L
3
624.1
1 ug/L EkMDL
3,3-dichlorobenzidine
40
ug/L
40
ug/L
3
625.1
40 ug/L
a MDL
Diethyl phthalate
8
ug/L
8
ug/L
3
625.1
8 ug/L p MDL
Dimethyl phthalate
8
ug/L
8
ug/L
3
625.1
8 ug/L U ML
2,4-dinitrotoluene
16
ug/L
16
ug/L
3
625.1
I IL
16 ug/L
C3MDL
2,6-dinitrotoluene
16
ug/L
16
ug/L
3
625.1
16 ug/L C3 MDL
EPA Form 3510-2A (Revised 3-19) Page 20

EPA Idenfification Number
110018809921
NPDES Permit Number Facility Name Outfall Number
NCO024538 First Broad River WWTP 001
•• 1 •s
Maximum Daily Discharge Average Daily Discharge
corm Approvea usiuon a
OMB No.2040-M
Analytical ML or MDL
Method' (include units)
Pollutant
Value
Units
Value
Units
Numberof
Samples
1,2-diphenylhydrazine
8
ug/L
s
ug/L
3
625.1
8 ug/L
C3MDL
Fluoranthene
8
ug/L
8
ug/L
3
625.1
8 ug/L
EkMDL
Fluorene
8
ug/L
8
ug/L
3
625.1
8 ug/L t3.MDL
Hexachlorobenzene
8
ug/L
8
ug/L
3
625.1
LJ NIL
8 ug/L CiMDL
Hexachlorobutadiene
8
ug/L
s
ug/L
3
625.1
LJ NIL
8 ug/L aMDL
Hexachlorocyclo-pentadiene
40
ug/L
40
ug/L
3
625.1
40 ug/L ❑,MDL
Hexachloroethane
8
ug/L
8
ug/L
3
625.1
8 ug/L
C3'MDL
Indeno(1,2,3-cd)pyrene
8
ug/L
8
ug/L
3
625.1
8 ug/L
C3MDL
Isophorone
8
ug/L
8
ug/L
3
625.1
UML
8 ug/L
aMDL
Naphthalene
8
ug/L
8
ug/L
3
625.1
8 ug/L ❑ MDL
Nitrobenzene
8
ug/L
8
ug/L
3
625.1
8 ug/L C1,MDL
N-nitrosodi-n-propylamine
s
ug/L
s
ug/L
3
625.1
UML
s ug/L
L3,MDL
N-nitrosodimethylamine
8
ug/L
8
ug/L
3
625.1
8 ug/L p MDL
N-nitrosodiphenylamine
8
ug/L
8
ug/L
3
625.1
8 ug/L
❑ MDL
Phenanthrene
8
ug/L
8
ug/L
3
625.1
8 ug/L p.MDL
Pyrene
8
ug/L
8
ug/L
3
625.1
8 ug/L
alVIDL
1,2,4-trichlorobenzene
1
ug/L
1
ug/L
3
624.1
1 ug/L
aMDL
1 Cnrn Hnn eh
mathndcl annrnved under 40 CFR 136 for the analvsis of pollutants
or pollutant parameters or
required under 40 CFR Chapter I, Subchapter N or 0. See instructions and 40 CFR 122.21(e)(3).
EPA Form 3510-2A (Revised 3-19) Page 21

This page intentionally left blank.

EPA Identification Number NPDES Permit Number
Facility Name Outfall Number
Form Approved 03/05/19
110018809921 NCO024538
First Broad River WWTP
OMB No.2040-M
Average Daily Discharge
Analytical ML or MDL
Maximum Daily Discharge
Number of
Pollutant
(list)
Value
Units
Value
Units
Method' (include units)
Samples
❑ No additional sampling is required by NPDES permitting authority.
--
❑ ML
1,4-Dioxane
3
ug/L
3
ug/L
3
624.1(SIM)
3 ug/L ❑.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 Comnlinn choll he rnnrinrforl orrnrrlinn fn entfirionfly cancitivp tact nmCPdllrAc (I P. methndsl Annrnved under 40 CFR 136
for the analvsis of Dollutants
or pollutant parameters or required
under 40 CFR chapter I, subchapter N or 0. See instructions and 40 CFR 122.21(e)(3).
EPA Form 3510-2A (Revised 3-19) Page 23

This page intentionally left blank.

EPA Identification Number NPDES Permit Number Facility Name Outfall Number t-orm Approved usiu5n9
110018809921 NCO024538 First Broad River WWTP 001 OMB No.2040-0004
TABLE E. EFFLUENT MONITORING FOR WHOLE EFFLUENT TOXICITY
The table provides response space for one whole effluent toxicity sample. Copy the table to report additional test results.
Test Information
Test Number 1
Test Number 1
Test Number
Test species
Pimephales promelas
Ceriodaphnia dubia
Age at initiation of test
<48 hours
<24 hours
Outfall number
001
001
Date sample collected
/8/2022, 2/ 102022, 2/11/2022
/8/2022, 2/10/2022
/3/2022, 5/5/2022, 5/6/2022
/3/2022,5/5/2022
/2/2022,8/4/2022, 8/5/2022
/2/2022,8/4/2022
11/15/2022, 11/17/2022, 11/18/2022
11/15/2022, 11/17/2022
Date test started
/8/2022
/9/2022
/3/2022
/412022
/2/2022
/3/2022
11/15/2022
11/16/2022
Duration
7 days
7 days
Toxicity Test Methods
Test method number
1000.0
1002.0
Manual title
Short-term Methods for Estimating the Chronic
Short-term Methods for Estimating the Chronic
Toxicity of Effluents and Receiving Waters to
Toxicity of Effluents and Receiving Waters to
Freshwater Organisms
Freshwater Organisms
Edition number and year of publication
4th edition- 2002
4th edition- 2002
Page number(s)
53-106
141-189
Sample Type
Check one:
❑ Grab
❑ Grab
❑ Grab
D 24-hour composite
Q 24-hour composite
❑ 24-hour composite
Sample Location
Check one:
❑ Before Disinfection
❑ Before Disinfection
❑ Before disinfection
❑ After Disinfection
❑ After Disinfection
❑ After disinfection
❑' After Dechlorination
❑' After Dechlorination
❑ After dechlorination
Point in Treatment Process
Describe the point in the treatment process at which
Effluent
Effluent
the sample was collected for each test.
Toxicity Type
Indicate for each test whether the test was
ElAcute
ElAcute
❑Acute
performed to asses acute or chronic toxicity,
❑'Chronic
❑'Chronic
❑ Chronic
or both. (Check one response.)
❑ Both
❑Both
El Both
EPA Form 3510-2A (Revised 3-19) Page 25

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03105N 9
110018809921 NCO024538 First Broad River WWTP 001 OMB No.2040-0004
TABLE E. EFFLUENT • •- FOR WHOLE EFFLUENT TOXICITY
The table provides response space for one whole effluent toxicity sample. Copy the table to report additional test results.
Test Number
Test Number
Test Number
Test Type
Indicate the type of test performed. (Check one
response.)
❑ Static
O'Static-renewal
❑ Flow -through
❑ Static IFStatic
O'Static-renewal
❑ Flow -through
Static -renewal
Flow -through
Source of Dilution Water
Indicate the source of dilution water. (check
one response.)
[i Laboratory water
❑ Receiving water
❑ Laboratory water
0' Receiving water
❑ Laboratory water
Receiving water
If laboratory water, specify type.
Reconstituted synthetic fresh water
If receiving water, specify source.
Lake Brandt
Type of Dilution Water
Indicate the type of dilution water. If salt
water, specify "natural" or type of artificial
sea salts or brine used.
D Fresh water
❑ Saltwater (specify)
❑ Fresh water
El Salt water (specify)
❑ Freshwater
El (specify) Salt water (speci
Percentage Effluent Used
the percentage effluent used for all 4.25%, 8.5%, 17%, 34 %, 68 %
trations in the test series.
17%
i
Parameters Tested
Check the parameters tested.
Q'pH
❑ Salinity
Q' Temperature
❑ Ammonia
❑ Dissolved oxygen
❑'pH
❑ Salinity
❑ Temperature
El Ammonia
0 Dissolved oxygen
El pH
❑ Salinity
❑ Temperature
Ammonia
❑ Dissolved oxygen
Acute Test Results
iiiiii
Percent survival in 100% effluent
N/A %
N/A %
%
LCso
N/A
N/A
95% confidence interval
N/A %
N/A %
%
Control percent survival
N/A %
N/A %
%
EPA Form 3510-2A (Revised 3-19) Page 26

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03105119
110018809921 NCO024538 First Broad River WWTP 001 OMB No.2040-0004
TABLE E. EFFLUENT MONITORING FOR WHOLE EFFLUENT TOXICITY
table provides response space for one whole effluent toxicity sample. Copy the table to report additional test results.
Test Number 1 Test Number 1 Test Number
i
Acute Test Results Continued
Other (describe)
N/A
N/A
Chronic Test Results
NOEC
2/8/2022 68%
>17% %
53/2022 68%
&2 022 68%
11/1512022 68%
IC25
%
%
Control percent survival
2I8/2022 92.5%
219/2022 100%
%
5/3/M 970/6
5/4/2022 100%
8/2/2022 1000/0
813/2022 100%
11/1512022 92.5%
11/16rm 100%
Other (describe)
2/8/2022 >68%
2/9/2022 Pass
5/3/2022 >68%
5/4/2022 Pass
Chronic Value
8/2/2022 >68%
813/2022 Pass
11115/2022 >68%
11/16/2022 Pass
Quality ControVQuality Assurance
Is reference toxicant data available?
D' Yes
❑ No
❑' Yes
❑ No
❑ Yes
❑ No
Was reference toxicant test within
C k Yes
❑ No
Q' Yes
❑ No
❑ Yes
❑ No
acceptable bounds?
What date was reference toxicant test run
02/08/2022
Within two weeks of each test.
(MM/DD/YYYY)?
05/03/2022
08/02/2022
11/15/2022
Other (describe)
EPA Form 3510-2A (Revised 3-19) Page 27

EPA Identification Number
NPDES Permit Number Facility Name Form Approved 03/05119
110018809921
NC0024538 First Broad River WWTP OMB No.2040-0004
INDUSTRIAL_L
TABLE F. DIS7ARGE INFORMATION
Response space is provided for three SIUs. Copy the table to report information for additional SIUs.
SIU 1004
SIU 1007
SlU 1006
Name of SIU
Clearwater Paper Shelby, LLC
Clearwater Paper Shelby, LLC II
Greenheck Fan Corporation
Mailing address (street or P.O. box)
671 Washburn Switch Road
250 Leadership Drive
2000 Partnership Drive
City, state, and ZIP code
Shelby, NC 28150
Shelby, NC 28150
Shelby, NC 28150
Description of all industrial processes that affect
Process wastewater from papermaking
Process wastewater from papermaking
Paint system rinse water and reverse
or contribute to the discharge.
process, converting operations, maintenance
process and related maintenance activities,
osmosis backwash discharge
activities, wash -down water and
wash -down water, and converting dust
boiler/cooling tower blow -down
scrubbers
List the principal products and raw materials that
Consumer household paper towels, bath
Consumer household paper towels and
Ventilation products with fans being the
affect or contribute to the SIU's discharge.
tissue, and napkins.
bath tissue.
main component.
Raw materials is pulp.
Raw materials is pulp.
Raw materials include Aluminum and
Galvanized Steel.
Indicate the average daily volume of wastewater
discharged by the SIU.
419,000 gpd
380,000 gpd
11,000 gpd
How much of the average daily volume is
attributable to process flow?
419,000 gpd
380,000 gpd
11,000 gpd
How much of the average daily volume is
attributable to non -process flow?
o gpd
o gpd
0 gpd
Is the SIU subject to local limits?
0' Yes ❑ No
©Yes ❑ No
0' Yes ❑ No
Is the SIU subject to categorical standards?
❑ Yes No
El Yes ❑' No
❑'Yes ❑ No
EPA Form 3510-2A (Revised 3-19) Page 29

Attachment A
Contractor Information
Contractor 4
Contractor 5
Contractor 6
Contractor name (company name)
Charles Underwood
Clearwater, Inc.
Superior Scales, Inc.
Mailing address (street or P.O.
box)
2000 Boone Trail Road
P.O. Box 1469
2118 Carolina Place
City, state, and ZIP code
Sanford, NC, 27330
Hickory, NC, 28603
Fort Mill, SC, 29708
Contact name (first and last)
Travis Beal
Michael Outlaw
Heather Krerder
Phone number
19-775-2463
28-855-3182
03-548-3320
Email address
[e-mail]
[e-mail]
[e-mail]
Operational and maintenance
responsibilities of contractor
Pump repair shop.
Instrumentation calibration.
Preventative maintenance to chlorine and sulfa
lioxide scales.

Attachment A
Contractor Information
Contractor 7
Contractor 8
Contractor 9
Contractor name (company name)
ICR Electric
Electric Motor Repair
ACE Industries, Inc.
Mailing address (street or P.O.
box)
934 Thore Road
1 143 Airport Road
1851 Scott Futrell Drive
City, state, and ZIP code
Shelby, NC, 28150
Shelby, NC, 28150
Charlotte, NC, 28208
Contact name (first and last)
Bobby Davis
Scott Hamrick
Alex Duncan
Phone number
04-482-0329
04-482-9979
04-504-9230
Email address
[e-mail]
[e-mail]
[e-mail]
Operational and maintenance
responsibilities of contractor
Motor Repair.
Motor repair.
Hoist repair.

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
110018809921 NC0024538 First Broad River WWTP OMB No.2040-0004
TABLE F. INDUSTRIAL DISCHARGE INFORMATION
Response space is provided for three SIUs. Copy the table to report information for additional SIUs.
$IU 1004
SIU 1007
SIU 1006
Under what categories and subcategories is the
40 CFR Part 430 Pulp, Paper, & Paperboard
40 CFR Part 430 Pulp, Paper, & Paperboard
40 CFR Part 433- Metal Finisher
SIU subject?
Has the POTW experienced problems (e.g.,
upsets, pass -through interferences) in the past 4.5
❑ Yes ❑" No
❑ Yes D No
❑ Yes ❑ No
ears that are attributable to the SIU?
If yes, describe.
EPA Form 3510-2A (Revised 3-19) Page 31

EPA Identification Number
NPDES Permit Number Facility Name roan Approvea uaiuoria
OMB No.2040-M
110018809921
NCO024538 First Broad River WWTP
INDUSTRIALTABLE F. DISCHARGE INFORMATION
Response space is provided for three SIUs. Copy the table to report information for additional SIUs.
Stu 1008
SIU 1003
SIU 1005
Name of SIU
Greenheck Fan Corporation
IMC Metals America, LLC
KSM Castings USA Inc.
Mailing address (street or P.O. box)
1400 Commerce Center Drive
135 Old Boiling Springs Road
120 Blue Brook Drive
City, state, and ZIP code
Shelby, NC 28150
Shelby, NC 28150
Shelby, NC 28150
Description of all industrial processes that affect
Paint system rinse water and reverse osmosis
Wastewater from the process of producing
Melting, die casting, and machining of
or contribute to the discharge.
backwash discharge.
copper and tin anodes & rods by casting
Aluminum.
and forming.
List the principal products and raw materials that
Commercial louvers, used in ventilation
Copper and Tin anodes and rods.
Aluminum castings production for
affect or contribute to the SIU's discharge.
systems.
automotive parts.
Raw materials include Aluminum and
Raw materials include Copper, Silver
Raw materials include Aluminum.
galvanized steel.
copper, & Tin.
Indicate the average daily volume of wastewater
9,00o gpd
2,000 gpd
2,400 gpd
discharged by the SIU.
How much of the average daily volume is
9,00o gpd
2,000 gpd
2,400 gpd
attributable to process flow?
How much of the average daily volume is
o gpd
o gpd
o gpd
attributable to non -process flow?
Is the SIU subject to local limits?
0' Yes ❑ No
0' Yes ❑ No
0' Yes ❑ No
Is the SIU subject to categorical standards?
Q' Yes ❑ No
0' Yes ❑ No
U Yes ❑ No
EPA Form 3510-2A (Revised 3-19) Page 31

EPA Identification Number
NPDES Permit Number Facility Name rorrn Approvea uxuon a
OMB No.2040-0004
110018809921
NCO024538 First Broad River WWTP
INFORMATIONTABLE F. INDUSTRIAL DISCHARGE
Response space is provided for three SIUs. Copy the table to report information for additional SIUs.
SIU 1008
SIU 1003
SIU 1005
Under what categories and subcategories is the
40 CFR Part 433- Metal Finisher
40 CFR Part 468 Copper Forming
40 CFR Part 464 Metal Molding and
SIU subject?
Casting
Has the POTW experienced problems (e.g.,
upsets, pass -through interferences) in the past 4.5
❑ Yes No
❑ Yes ❑ No
❑ Yes O' No
ears that are attributable to the SIU?
If yes, describe.
EPA Form 3510-2A (Revised 3-19)
Click to go back to the beginning of Form
Page 32

Attachment A
Contractor Information
Contractor 1
Contractor 2
Contractor 3
Contractor name (company name)
Power Generation and Control, Inc.
ortech, Inc.
Piedniont Chlorinator Service
Mailing address (street or P.O.
box)
136 Charcoal Road
2124 Wilkinson Blvd.
7424 Orr Road
City, state, and ZIP code
Cherryville, NC, 28021
Charlotte, NC, 28208
Charlotte, NC, 28213
Contact name (first and last)
Derek Digh
Jon Forrest
Eric Howie
Phone number
04-769-8010
704-333-0621
704-597-7505
Email address
[e-mail]
[e-mail]
[e-mail]
Operational and maintenance
responsibilities of contractor
reventative and corrective maintenance on
emergency generators.
SCADA system repairs and programming.
Preventative and corrective maintenance to
chlorine and sulfur dioxide system equipment.

.. }� 4 ,fir 4'.' � �, .., • .. �' � ;�.
�� 1 � '� {ems' t ` �" �.:. 1� i^• ��, � ,�
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• � i
�;: •.fy - -•fir )(f �•._
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17
- �. t _ 1 +,• � 1 LL.,�r il��j�Y_�j}`:I�f��l �i f' `�� . `1'�..,f ..� ' f,�'� ..
,+^r,+ � -r. ,r'. { i�k .. il'• 4' 3 (�+'•F��F' d � •�`�v.v�.' � � .� � .i�~ 'ti.,. R�`�
i .4l
LA
Y :'BSI - ``���%n, I^•1:.y ••�:.Srr '1 _ ^Y .: �I ILG�C .fir �`•�..,.-A'L O''•e., .. _ .�'�` •'+ '{' �.•• +`' -0•.
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, •�--f3ia5fiiko'r66e Facility,
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it
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rawlw : �t
-441 :Son
Pr
lagrAlr f 'w ry-all d
t'c-. itarv.
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- Shdb
liar
' �} '� '�'` �.• �,� ► dIe 3ch opt y 1
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al: 59 Miles
�� � L 1 H 1� •I 1 •
'�- y ,.x+l - ia.... �: �i ,,, +r-�• * ~ • r `� � - I t j �oG . is
ti >rt
'k �, _ � Ili �. �� • 1 4 � +� ++,1� r•�fir
i. Wit. � +;, `.�� TM; ,; '-.I� evy l�'- ?. • �' � AI
FF
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yap
11 .�,��• r icy Yt� ,'� � s9rr, r ,
. •� ChmeFnt - 4� �. y .4�• :.i:�. -•

vA . 111.1 vT

Attachment B
n:! �� - •ram �;� •.r �-� «�� •, � •.� lip.•.. -",'"•^" '�:v'V
UV
.,
© _�_,. ��= J - ' • -�� Upstream _
First Broad Sa/
- �.� •.� � e'Cli � r`-'•1 � , — ;�z � �• ;'
i�- River WWTP ,
p rim
Beaverdam Creek
!J _'T ✓fit/ �.% .f t r r �•
Downstream z ''�' �'V .
1' a
F
��\J � "`� y "'�' � 'J •' � - J � j Jam; a ,�. � . .1J:. jrt.. _.-.�. tit _
City of Shelby WWTP - NCo024538 Facility
USGS Quad Name: Blacksburg North Lat.: 35°14'32" Location
Receiving Stream: First Broad River Long.: 81°34'31"
Stream class: c Subbasin: Broad - 030804 North Not to SCALE

The National Map Advanced Viewer
1 /2/2024, 1150:30 PM
Lines
Override 1
Override 2
Attachment B
1:18,056
0 0.13 0.25 05mi
0 02 0.4 0.8 km
Copyright:© 2013 National Geographic Society, i-cubed
USGS
2021 USGS

Attachment B
8/14/2023, 8:46:58 AM
The National Map Advanced Viewer
�t
RD
P 3 I Mr
� r
.E+v( SRO
f) r �&
b .V rim _ ..
. .. Pattascn
.... Spnng
G C .9,
n
CC)� 'o ai s l� Poesoht ON
1:36,112
0 0.33 0.65 1.3 mi
1 r t' r —rl
0 05 1 2km
USES Th Nat -al Map Nshonal Boundanes Damsel. 3DEp
Elevation program, Goograptw Names Ink matron System,
National Hydrography Datasel, Natiaul Land Cover Dalahase,
National Structures Oat", and National Transportalw Dalaset:
USGS
2G 21 USGS

Belt Presses
Attachment C
City of Shelby First Broad WWTP - Schematic
Holding Tank
Anaerobic Digesters
Digester
Control
Building
Sludge Pump Filtrate Pump Station
SP-5
Dewatered Cake
Storage
Thickened WAS
Filtrate
Equalization
Influent
mary Cl
I SP-2
77
Vecon ry larifie \ /
Chlorine Contact
Basins
H
a
3
WAS Sludge
from Boiling
Springs
Plant Effluent
First Broad River
Revised:04/06/2021

Attachment D
The City of Shelby issued a general user permit for Hart & Hickman to discharge pumped groundwater from
four recovery wells at the FAS Controls, Inc. (former Honeywell) site. The site had a storage tank of
chlorinated VOCs that released into the soil and groundwater. Soil remediation has been completed and
groundwater remediation has been conducted since 1996. Hart & Hickman is the environmental
consultant firm hired by Honeywell International to perform the remediation.
The following two tables include data from 2021-2023 provided by Hart & Hickman.
Averaee Monthly
Daily Flow (Gallons
ner davl
Month
2021
2022
2023
January
1,469
1,122
1,344
February
1,589
1,324
1,725
March
1,988
1,828
2,024
April
1,995
1,919
2,116
May
2,007
1,965
2,303
June
1,977
1,995
2,452
July
2,014
1,386
2,332
August
1,960
1,884
2,260
September
1,737
1,895
2,295
October
1,664
1,864
2,182
November
1,685
1,666
1,531
December
1,219
1,110
1,063

Attachment D
Summary of Effluent Analytical Results FAS Controls, Inc. (Former Honeywell) Site 1100 Airport Road
Shelby, Cleveland County, North Carolina General User Permit No. 2002
Data Provided by Hart and Hickman
Year
2021
2022
2023
Units
mg/L
mg/L
mg/L
VOCS
1,1,1-Tdchloroethane
0.0017
0.00197
0.000695J
1,1,2-Tdchloroethane
0.00112
0.00195
0.000683
1,1-Dichloroethane
0.0846
0.0801
0.0673
1,1,-Dichloroethene
0.172
0.245
0.103
1,2-Dichloroethane
0.00116
0.00221
0.0011
1,4-Dioxane
0.030175
0.018425
0.024933
Vans-1,2-Dichloroethene
<0.00050
<0.0020
0.000248J
Methylene Chloride
<0.00100
<0.00200
0.000374J
Tetrachloroethene
0.00201
0.00229
0.00165
Tdchloroethene
0.00209
0.00219
0.00111
Thchlorofluoromethane
<0.00050
<0.00100
<0.00018
Vinyl Chloride
0.000709
<0.00100
0.000607J
Cyanide
<0.0100
<0.0100
0.0049
Oil & Grease
<5.8 <5.3
<3.9
Chloride
19.4
18.3
17.1
BOO
<2.0
<2.0
<2.0
pH
6.4
6.38
6.9
Total Suspended Solids
<2.5
<2.5
<0.7
Ammonia as N
0.16
-
Metals
Arsenic
0.00387
0.0026
0.0024
Cadmium
<0.0010
<0.0001
<0.00005
Chromium
<0.0020
<0.001
0,001
Copper
<0.010
0.0099
0.0051
Lead
<0.0010
<0.0005
<0.00005
Mercury
<0.00020
<0.0002
<0.00013
Molybdenum
0.0050
0.0040
0.0030
Nickel
0.00326
0.0036
0.0044
Selenium
<0.0050
<0.001
0.0007J
Silver
<0.0010
<0.0001
<0.00002
Zinc
<0.020
<0.020
0.012
Notes:
mg/L - Milligrams per liter or parts per million EPA = Environmental Protection Agency
= Less than the Method Detection knit
J = Estimated value less than the Reporting Limit SM = Standard Method
pH is reported in Standard Units (SU)

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