NC0037176_Permit Issuance_20151207

Water Resources
ENVIRONMENTAL QUALITY
Mr. Nick Dmytryszyn, CFO
Bon Worth, Inc.
P.O. Box 2890
Hendersonville, NC 28739
Dear Mr. Dmytryszyn:
PAT MCCRORY
Gom,n or
DONALD R. VAN DER VAART
sccreorry
S. JAY ZIMMERMAN
December 7, 2015 Dl1 cloy
Subject: Issuance of NPDES Permit NCO037176
Bon Worth WWTP
40 Francis Road, Hendersonville 28739
Henderson County
The Division of Water Resources (the Division) hereby issues the attached NPDES permit for the subject
facility. 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 U.S. Environmental Protection
Agency dated October 15, 2007, or as subsequently amended.
The Division understands that you have made no significant changes to your facility the last permit
renewal. We have made the following updates to your previous permit:
updated the facility description (see supplement to cover sheet) and map
the coordinates for the Outfall 001 were adjusted to the following as indicated on the facility map
attached to the application:
Latitude: 350 20' 49" Longitude: 82126' 16"
added Electronic Reporting - Discharge Monitoring Reports page [Section A. (2.)].
Proposed federal regulations require electronic submittal of all discharge monitoring reports (DMRs) and
specify that, if a state does not establish a system to receive such submittals, then permittees must submit
DMRs electronically to the Environmental Protection Agency (EPA). The Division anticipates that these
regulations will be adopted and is beginning implementation.
The requirement to begin reporting discharge monitoring data electronically using the NC DWR's
Electronic Discharge Monitoring Report (eDMR) internet application has been added to your NPDES
permit. [See Special Condition A. (2.)] For information on eDMR, registering for eDMR and obtaining
an eDMR user account, please visit the following web page:
http://portal.ncdenr.org/web/wq/admin/boglipu/edmr.
For information on EPA's proposed NPDES Electronic Reporting Rule, please visit the following web
site:
http://www2.epa.gov/compliance/proposed-npdes-electronic-reporting-rule.
If any parts, measurement frequencies, or sampling requirements contained in this permit are
unacceptable, you have the right to an adjudicatory hearing, upon written request submitted within thirty
1617 Mail service Center, Raleigh, North Carolina 27699-1617
Phone: [phone] \ Intemet w .ncmterquality.org
An Equal Opportunity \ Affirmative Action Employer —Made in part by recycled paper

r
Mr. Dmytryszyn
December 7, 2015
Page 2 of 2
(30) days after receiving this letter. Your request must take the form of a written petition conforming to
Chapter 150B of North Carolina General Statutes, and you must file it with the Office of Administrative
Hearings, 6714 Mail Service Center, Raleigh, North Carolina 27699-6714. Unless such a demand is
made, this permit shall remain final and binding.
Please note that this permit is not transferable except after notice to the Division. The Division may
require modification or revocation and reissuance of the permit. This permit does not affect the legal
requirements to obtain other permits which may be required by the Division of Water Resources or any
other Federal, State, or Local governmental permits that may be required.
If you have questions, or if we can be of further service, please contact Derek Denard at
[[e-mail]] or call [phone].
X
,
merman, P.G. re for
Division of Water Resources, NCDEQ
Enclosure: NPDES Permit NC0037176 (Issuance Final)
hc: Central Files
NPDES Program Files
ARO Files/ Attu: Landon Davidson

�A:
NPDES Permit NCO037176
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF WATER RESOURCES
PERMIT
TO DISCHARGE WASTEWATER UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
DES)
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,
Bon Worth, Inc.
is hereby authorized to discharge wastewater from a facility located at the
Bon Worth WWTP
40 Francis Road, Hendersonville 28739
Henderson County
to receiving waters designated as Allen Branch in the French Broad River Basin, in accordance with
effluent limits, monitoring requirements, and other conditions set forth in Parts I, II, III and IV hereof.
This permit shall become effective January.. L 2016.
This permit and authorization to discharge shall expire at midnight on November 309 2020.
Signed this day December 7, 2015.
S.trwf'Limmerman, P.G., Direct ?` `'
Division of Water Resources
By Authority of the Environmental Management Commission
Page 1 of 5

e%.
NPDES Permit NCO037176
SUPPLEMENT TO PERMIT COVER SHEET
All previous NPDES permits issued to this facility, whether for operation or discharge are hereby
revoked. As of this permit issuance, any previously issued permit bearing this number is no longer
effective. Therefore, the exclusive authority to operate and discharge from this facility arises under the
permit conditions, requirements, terms, and provisions included herein.
Bon Worth, Inc.
is hereby authorized to:
1. continue to operate an existing 0.006 MGD (as -built flow) extended aeration package
wastewater treatment system and a permitted flow of 0.002 MGD with the following
.components;
• manual bar screen
• aeration basin with dual blowers providing diffused air
• hoppered clarifier with skimmer and sludge returns
• tablet chlorination
• chlorine contact basin
• tablet dechlorination
• effluent pump station
located at the Bon Worth WWTP, 40 Francis Road, Hendersonville, Henderson County,
2. discharge from said treatment works via Outfall 001, at the location specified on the attached
map into Allen Branch [6-55-11-14], a waterbody classified C located within Subbasin-
04-03-02 WC: 060101050302] of the French Broad River Basin.
Page 2 of 5

NPDES Permit NCO037176
PART I
A. (L) EFFLUENT LIMITATIONS AND MONITORING REQUIREMENTS
[15A NCAC 02B .0400 et seq., 02B .0500 et seq.]
During the period beginning on the effective date of this permit and lasting until expiration, the
Permittee is authorized to discharge from outfall 001. Such discharges shall be .limited, monitored and
reported' by the Permittee as specified below:
;EFFLUENT
CHARACTERISTICS
[Parawter. Codes] `
LI
MOTORING
EQU IE TS1
-Monthly
Average
Daily
Max�trium`"
Measurement
-
`Fre--ue�ic
�Sairiple
T e
YJP
Sapnple
Lo_ cation 2
Flow (MGD)
50050
0.002 MGD
Weekly
Instantaneous
I or E
Temperature (°C)
00010
Weekly
Grab
E
Total Residual Chlorine (TRC) 3 (µg/L)
50060
28 µg/L 3
2 / week
Grab
E
BOD, 5-day (20°C) (mg/L)
C0310
30.0 mg/L
45.0 mg/L
Weekly
Grab
E
Total Suspended Solids (TSS) (mg/L)
C0530
30.0 mg/L
45.0 mg/L
Weekly
Grab
E
Ammonia Nitrogen (NH3-N) (mg/L)
C0610
Weekly
Grab
E
Fecal Coliform 4 (#/loom')
31616
200/100 ml
400/100 ml
Weekly
Grab
E
pH (su)
00400
> 6.0 and < 9.0 standard units
Weekly
Grab
E
Footnotes:
L No later than 270 days from the effective date of this permit, begin submitting discharge monitoring
reports electronically using NC DWR's eDMR application system. See Special Condition A. (2.).
2. I = Influent; E = Effluent.
3. The Division shall consider all effluent TRC values .reported below 50 µg/L to be in compliance with the
permit. However, the Permittee shall continue to record and submit all values reported by North Carolina
certified test methods (including field certified), even if these values fall below 50 µg/L.
4. Fecal Coliform shall be calculated using the geometric mean, according to the procedure detailed in Part H.
Section A.
Conditions:
• There shall be no discharge of floating solids or foam visible in other than trace amounts.
Page 3 of 5

NPDES Permit NCO037176
A. (2.) ELECTRONIC REPORTING OF DISCHARGE MONITORING REPORTS
[G. S . 143-215.1(b)]
Proposed federal regulations require electronic submittal of all discharge monitoring reports (DMRs)
and specify that, if a state does not establish a system to receive such submittals, then permittees must
submit DMRs electronically to the Environmental Protection Agency (EPA). The Division adopted
these regulations in 2013.
NOTE: This special condition supplements or supersedes the following sections within Part H of this
permit (Standard Conditions for NPDES Permits):
• Section B. (11.) Signatory Requirements
• Section D. (2.)
• Section D. (6.)
• Section E. (5.)
Reporting
Records Retention
Monitoring Reports
1. Reporting [Supersedes Section D. (2.) and Section E. (5.) (a)1 .
Beginning no later than 270 days from the effective date of this permit, the permittee shall report
discharge monitoring data electronically using the NC DWR's Electronic Discharge Monitoring
Report (eDMR) internet application.
Monitoring results obtained during the previous month(s) shall be summarized for each month and
submitted electronically using eDMR. The eDMR system allows permitted facilities to enter
monitoring data and submit DMRs electronically using the internet. Until such time that the state's
eDMR application is compliant with EPA's Cross -Media Electronic Reporting Regulation
(CROMERR), permittees will be required to submit all discharge monitoring data to the state
electronically using eDMR and will be required to complete the eDMR submission by printing,
signing, and submitting one signed original and a copy of the computer printed eDMR to the
following address:
NC DEQ / DWR / Information Processing Unit
ATTENTION: Central Files_ / eDMR
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
If a permittee is unable to use the eDMR system due to a demonstrated hardship or due to the
facility being physically located in an area where less than 10 percent of the households have
broadband access, then a temporary waiver from the NPDES electronic reporting requirements may
be granted and discharge monitoring data may be submitted on paper DMR forms (MR 1, 1.1, 2, 3)
or alternative forms approved by the Director. Duplicate signed copies shall be submitted to the
mailing address above.
Requests for temporary waivers from the NPDES electronic reporting requirements must be
submitted in writing to the Division for written approval at least sixty (60) days prior to the date the
facility would be required under this permit to begin using eDMR. Temporary waivers shall be
valid for twelve (12) months and shall thereupon expire. At such time, DMRs shall be submitted
Page 4 of 5

NPDES Permit NC0037176
electronically to the Division unless the permittee re -applies for and is granted a new temporary
waiver by the Division.
Information on eDMR and application for a temporary waiver from the NPDES electronic reporting
requirements is found on the following web page:
htti)://iDortal.ncdenr.org/web/Wa/admin/bogLipu/edmr
Regardless of the submission method, the first DMR is due on the last day of the month following
the issuance of the permit or in the case of a new facility, on the last day of the month following the
commencement of discharge.
2. Signatory Requirements [Supplements Section B. (11.) (b) and supersedes Section B. (11.) (d)]
All eDMRs submitted to the permit issuing authority shall be signed by a person described in Part
II, Section B. (11.)(a) or by a duly authorized representative of that person as described in Part II,
Section B. (I 1.)(b). A person, and not a position, must be delegated signatory authority for eDMR
reporting purposes.
For eDMR submissions, the person signing and submitting the DMR must obtain an eDMR user
account and login credentials to access the eDMR system. For more information on North
Carolina's eDMR system, registering for eDMR and obtaining an eDMR user account, please visit
the following web page:
http://i)ortal.ncdenr.or web/wq/admin/bog//ipu/edmr
Certification. Any person submitting an electronic DMR using the state's eDMR system shall
make the following certification [40 CFR 122.22]. NO OTHER STATEMENTS OF
CERTIFICATION WILL BE ACCEPTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my
direction or supervision in accordance with a system designed to assure that qualified personnel
properly gather and evaluate the information submitted. Based on my inquiry of the person or
persons who manage the system, or those persons directly responsible for gathering the
information, the information submitted is, to the best of my knowledge and belief, true, accurate,
and complete. I am aware that there are significant penalties for submitting false information,
including the possibility of fines and imprisonment for knowing violations. "
3. Records Retention [Supplements Section D. (6.)]
The permittee shall retain records of all Discharge Monitoring Reports, including eDMR submissions.
These records or copies shall be maintained for a period of at least 3 years from the date of the report. This
period may be extended by request of the Director at any time [40 CFR 122.41].
Page 5 of 5

Bon Worth, Inc.
Bon Worth WWTP
40 Francis Road, Hendersonville 28739
Receiving Stream:
Allen Branch Stream Class:
C
Stream Segment:
6-55-11-14 Sub -Basin:
04.03-02
Drainage Basin:
French Broad HUC:
060101050302
Latitude:
35°20'49" Loneilude:
82°26'16"
State Grid/USGS
Ound: F9S W / Hendersonville, NC
v'• s� B'liJ4 '�,�:
IFacility
Scale 111 �t�4■f��is�
ram,
Henderson

/ 22
-7/ (S NPDES PERMIT NEW / RENEWAL
DRAFT / FINAL
CHECK LIST
FILE CONTENTS: Facility_
Permit No. N CG0 7 7/ 7 6
Left e:
BIMS Tracking Slip
NPDES Permit Writer: DEREK DENARD
Right Side:
❑ ,o&reamline Package Sheet
(to region, only if streamlined)
Draft Permit Cover Letter.
(add new policy text; summarize major changes to permit)
Draft Permit
(order: cover; Sup to Cover Sheet; effluent page (s), special conditions; map)
G7i acility Map
(E-Map: include facility Outfalls; U and D sample locations)
Pact Sheet
(documents permit writer's issues and/or re -issue logic)
IV ermit Writer's Notes
(if not in Facts Sheet -- chronology, strategy, DMR Review, RPA, etc.)
❑ Staff Report from Region
(as appropriate -- not needed if streamlined)
CV Old Permit
(Text, Effluent Sheets and Special Conditions)
Permit Application.
(New Permit or Renewal; any additional permittee correspondence)
53,' Acknowledgement Letter
(NPDES Unit written response to Renewal Application)
❑ Permittee Responses
(to acknowledgement letter, if any)
❑ Waste Load Allocation
(reference date; notes if recalculated for current action)
m/ Compliance History
(BIMS printout)
Note: Italics indicate special
conditions not always required or applicable.
& BIMS update "initiated DRAFT review" e a 0 Z /-5
/0/Z vtS
° 2c,
Peer Review Submitted to Date Admin cutoff / PN date �s
eer Review completed by Date
;tT-'UUpdat d Public Notice System [ te] �Q G / Updated BIMS/Events: Date
Submitted for Public N tice n 2 Newspaper Notice Received! d 2K . Actual Notice dates) % 2? /
egional Staff Revi w raft mailed / m � to Date
W Regional Office Draft Approved by t �r ,, ] r Date �—
Permittee Review [Dr a m d /emailed] to AlIl` D/h f w Date /v/2) Comments received Date
TOX (ATB) Review [Draft Permit emailed] to Date
�TOX (ATB) Review/Approval by Received Date
Gl .0 G
Water Supply (WS) Review: Yes N/A /y�}�1by Date
FINAL to oh / Tom for signature [date] �q{� 70 �'/},��y ' ` / Letter Dated 1 Z
t F' Is Transferred to Server (Permits Folder) `// BIMS Final Updates: Ev nis _Limits
ScanFinal Does / PDF (w/ signature) [Date] _ I ?/ % BIMS /Limits Double-check Email to Charles
❑ Email Finals to A/ / rF— Date
Version 04Jun2015

Denard, Derek
19R 0 CA bft do* e 414,
From: Heim, Tim
Sent: Friday, November 06, 2015 10:21 AM
To: Denard, Derek; Davidson, Landon; Kinney, Maureen
Subject: RE: Draft renewal N0037176 Bon Worth, Inc.
Follow Up Flag: Follow up
Flag Status: Flagged
Derek,
No revisions to the permit as written.
-Tim
Tim Heim, P.E.
Environmental Engineer —Asheville Regional Office
Water Quality Regional Operations Section
NCDEQ — Division of Water Resources
828 296 4500 office
email: tim.heim(cDncdenr.gov
2090 U.S. Hwy. 70
Swannanoa, N.C. 28778
wo.
!/ Nothing Compares,
Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties.
From: Denard, Derek
Sent: Friday, October 23, 2015 5:49 PM
To: Davidson, Landon <[e-mail]>; Heim, Tim <[e-mail]>; Kinney, Maureen
<Maureen. Kinney@ ncdenr.gov>
Subject: Draft renewal NC0037176 Bon Worth, Inc.
Please find the attached draft renewal for NC0037176 Bon Worth, Inc. Please provide your comments, if any, to me via
email [[e-mail]] or write to my attention care of DEQ/ DWR / NPDES Program no later than
November 27, 2015.
Derek Denard
Environmental Specialist
N.C. Division of Water Resources
N.C. Department of Environmental Quality
919 807 6307 office

ASI-iEV=
CITIZEN TM ES
VOICE OF THE MOUNTAINS e CfIYZEMMIES.corn
AFFIDAVIT OF PUBLICATION
Public Notice BUNCOMBE COUNTY
North Carolina
Environmental
Management
SS.
Commisslon/Hpom
°Di`
1617 Mail servitt
NORTH CAROLINA
Center
Raleigh, NC 376 1617
Notice of Intent to Issue
a NPDES Wastewater
Permit
Before the undersigned, a Notary Public of said County and
ronhe North Carolina MEn-anage.
Manage.
ient Commission
lent Commission oDB
State, duly commissioned, qualified and authorized by law
ores to issue a NGOF3
erm [ toefthe person )
to administer oaths, personally appeared Emily Thomas,
sted below. Written
consents regardin
he
who, being first duly sworn, deposes and says: that she is
proposed nermil
gill be a ept a until
9 days atclet tf,e peb-
the Affidavit Clerk of The Asheville Citizen -Times
sh date of this notice.
he Direca of the NC
iIu es Ot Water Re-
f
engaged in publication of a newspaper known as The
p
of 1 (D11 may
cold a public hearing
teree a si-
C b
Asheville Citizen -Times, published, issued, and entered as
iCiI,
to Is c of pug-
c interest. and/or mail
omments in-
first class mail in the City of Asheville, in said County and
requests
pWR at the above ad-
State; that she is authorized to make this affidavit and
ress. Interested per-'.
one may the 8WR
N. to
inet, lei Salisbury
NC to
sworn statement; that the notice or other legal
eview Raleigh,
ee ew Additional Into,- nation
a
advertisement, a true copy of which is attached hereto, was
on NPDES per-
nits an thi notice
nag be found' on our
published in The Asheville Citizen -Times on the
resite: htto{/porta-
ai y calllling
following dates: October 22"d, 2015. And that the said
('1W
rt by calling (919) 8d7-
304
304. Healthcare,',
newspaper in which said notice paper, document or legal
, ,
tic. enderrson Coun
iepmit t foreneMouP pin
advertisement was published was, at the time of each and
reH
liew Assisted Living
V'N]P ENC0074110) di6-
every publication, a newspaper meeting all of the
itar Ing treated do-
eatherstonele'NatCreek
'reach
requirements and qualifications of Section 1-597 of the
Broad River Be.
';reystone Enter rises
no. , Henderson LPountvl
General Statues of North Carolina and was a qualified
ippiied to renew NPDES
1err ivisia r DreQttome
newspaper within the meaning of Section 1-597 of the
NC0068]99]a Ai�mea;9.
General Statutes of North Carolina.
Signed this 22"d day of October, 2015
(Signature ofperso making affidavit)
Sworn to and subscribed before me the 22"d day of
Octoh6r, 2015� , 1 /_11
My Comn{ission expires the 5`In day of October,
NOTARY
[phone] 1 [phone] FAX
140. HENRY AVE. I P.O. BOX 2090 1 ASHEVILLE, NC 28802 1 [phone] rUU
C) GAMWR

DEQ / DWR / NPDES
EXPEDITED FACT SHEET - NPDES PERMIT DEVELOPMENT
NPDES Permit NCO037176
Derek Denard, Compliance & Expedited Permitting Unit / 919-807-6307 160ct201
-: Facility Inform ation..
ApplicantlFacility Narrie Bon Worth, Inc. -
Bon Worth WWTP
Applicanfi Address P.O. Box 2890, Hendersonville, NC 28739.
Facility Address 40 Francis Road, Hendersonville 28739
Permitted FJow,-(MGD) 0.002 MGD
Type .of Waste 100% Domestic Wastewater Discharge
Facility Class: T WW-2 Couinty Henderson
Pein�t Status -
Renewal
Regional;
Office
ARO
Stream Characteristics ;
Receiving Stream
Allen Branch
Stream Classlficatlon
C
Stream Segment
[6-55-11-14]
Drainage basin
French Broad
Summer 7Q10 (efs)
0.24
Subbasiri
04-03-02
Winter, 7Q10 (cfs) _
0.24
Use Support
No Data
3QQ2 (cfs) _ _ _
0.34
303(d) Listed..
No
Average Flo y (cfs)
1
State Grid
F9SW
1.28%
USGS Topo, Quad
Hendersonville, NC
Facility Summary
This facility is a minor facility (flow <1 MGD) that receives 100% domestic waste from a commercial
facility with 40 employees. The design capacity of the treatment system is 0.006 MGD and flow is
permitted for 0.002 MGD. No significant changes have been made to this facility since the last permit
renewal.
The facility consists of the following wastewater treatment units:
• manual bar screen
• aeration basin with dual blowers providing diffused air
• hoppered clarifier with skimmer and sludge returns
• tablet chlorination
• chlorine contact basin
• tablet dechlorination
• effluent pump station
Monthly average FLOW (MGD) — Last 36 months Aug2012-Ju12015:
[Ave 0.0011 MGD; Maximum, Monthly average flow = 0.0018 MGD]
Toxici — Not required
Renewal Summary — This permit reflects discharge at Outfall 001. DWR updated the following:
Fact Sheet
Renewal 2015 -- NPDES Permit NCO037176
Page 1

• updated the facility description (see supplement to cover sheet) and map
• the coordinates for the 4utfall 001 were adjusted to the following as indicated on the facility map
attached to the application:
Latitude: 35' 20' 49" Longitude: 82' 26' 16"
• added Electronic Reporting - Discharge Monitoring Reports page [Section A. (2.)].
Stream — Discharge from Bon Worth WWTP for outfall 001 is into Allen Branch [Stream Segment 6-55-
11-14]. The segment is not listed as impaired in the 2014 North Carolina Integrated report. The stream is
listed with no data.
RPA — A Reasonable Potential Analysis (RPA) was not applicable for any parameters for this permit
renewal.
Implementation of 2012 Statewide Mercury TMDL — Bon Worth WWTP was not required to sample for
mercury in the previous permit. Monitoring for Mercury is not required for this permit because it does not
serve a municipality. The renewal application indicated "commercial" for the facility generating wastewater
and "separate (sanitary sewer only)" for type of collection system. The WWTP serves Bon Worth, Inc.
which is a commercial facility with 40 employees. The facility does not serve any industries or dental
offices.
Fact Sheet
Renewal 2015 -- NPDES NCO037176
Page 2

IWC Calculations
Facility: Bon Worth WWTP
NCO037176
Prepared By: Derek Denard
Enter Design Flow (MGD): 0.002
Enter s7Q10 (cfs): 0.24
Enter w7Q10 (cfs): 0.24
Total Residual Chlorine (TRC)
Daily Maximum Limit (ug/1)
Ammonia (Summer)
Monthly Average Limit (mg NH3-N/1)
s7Q10 (CFS)
0.24
s7Q10 (CFS)
0.24
DESIGN FLOW (MGD)
0.002
DESIGN FLOW (MGD)
0.002
DESIGN FLOW (CFS)
0.0031
DESIGN FLOW (CFS)
0.0031
STREAM STD (UG/L)
17.0
STREAM STD (MG/L)
1.0
Upstream Bkgd (ug/1)
0
Upstream Bkgd (mg/1)
0.22
IWC (%)
1.28
IWC (%)
1.28
Allowable Conc. (ug/1)
1333
Allowable Conc. (mg/1)
61.4
Ammonia (Winter)
Monthly Average Limit (mg NH3-N/1)
Fecal Coliform
w7Q10 (CFS)
0.24
Monthly Average Limit:
200/100mi DESIGN FLOW (MGD)
0.002
(If DF >331; Monitor)
DESIGN FLOW (CFS)
0.0031
(If DF<331; Limit)
STREAM STD (MG/L)
1.8
Dilution Factor (DF)
78.42 Upstream Bkgd (mg/1)
0.22
IWC (%)
1.28
Allowable Conc. (mgll)
124.1
Total Residual Chlorine
1. Cap Daily Max limit at 28 ug/I to protect for acute toxicity
Ammonia (as NH3-N)
1. If Allowable Conc > 35 mg/l, Monitor Only
2. Monthly Avg limit x 3 = Weekly Avg limit (Municipals); capped at 35 mg/I
3. Monthly Avg limit x 5 = Daily Max limit (Non-Munis); capped at 35 mg/I
4. BAT for Minor Domestics: 2 mg/I (summer) and 4 mg/I (winter)
5. BAT for Major Municipals: 1 mg/I (year-round)
Fecal Coliform
1. Monthly Avg limit x 2 = 400/100 ml = Weekly Avg limit (Municipals) = Daily Max limit (Non -Muni)
NPDES Server/Current Versions/WLA; TB 1/16/2009

Permit Reviewer Notes - Derek Denard
Permit Number:
C o 3-71�2p
Applicant/Facility Name: rf
04.1 or
Permit Status:
Regional Office:
Latitude: �� s n
Longitude: 920 G b
Facility Class:
County:
Outfall: �O
Flow:
Applicant Address:
Ao, /�. 2.8�0�w�.�v:--/-L NL 2973
Facility Address:
Lip —r.�✓�G i Wool ��vrQ�✓;{lt N� 29�3y
Type of Waste:
Stream Notes
Receiving Stream:
Stream Segment: (( /
Stream Classification:
Drainage Basin:
Summer 7Q10 (cfs): /p
Subbasin: ^ C? _ Q
Winter 7Q10 (cfs):
HUC Code:
oZ
30Q2 (cfs): 0, 3
State Grid:
'
Average Flow (cfs):
USGS Topo Quad:
IWC (%):
303 (d): Ao
Use: n ^
Notes

NPDES APPLICATION - FORM D
For privately -owned treatment systems treating 100% domestic wastewaters <1.0 MGD
Mail the complete application to:
N. C. DENR / Division of Water Quality / NPDES Unit
1617 Mail Service Center, Raleigh, NC 27699-1617
NPDES Permit XC0037176
If you are completing this form in computer use the TAB key or the up - down arrows to move from one
field to the next. To check the boxes, click your mouse on top of the box. Otherwise, please print or type.
1. Contact Information:
Owner Name Bon Worth, Inc.
Facility Name Bon Worth
Mailing Address P.-O.- Box 2890
-RECEIVE PJDWR
City Hendersonville
Q Pi?
State / Zip Code NC 28739
Telephone Number 828-697-2216
a
Permittinq Sectior
Fax Number 828-697-2170
e-mail Address
2. Location of facility producing discharge:
Check here if same address as above ❑
Street Address or State Road 40 Francis Road
City Hendersonville
State / Zip Code NC 28739
County Henderson
3. Operator Information:
Name of the firm, public organization or other entity that operates the facility. (Note that this is not
referring to the Operator in Responsible Charge or ORC)
Name Bon Worth, Inc.
Mailing Address
P. 0. Box 2890
City
Hendersonville
State / Zip Code
NC 287439
Telephone Number
828-697-2216
Fax Number
828-697-2170
e-mail Address
1 of 3 Form-D 11 /12

NPDES APPLICATION - FORM D
For privately -owned treatment systems treating 100% domestic wastewaters <1.0 MGD
4. Description of wastewater:
Facility Generating Wastewater(check all that apply}:
Industrial ❑
Number of Employees
Commercial X
Number of Employees 140
Residential
Number of Homes
School
Number of Students/ Staff
Other
Explain: Nursing Home
Describe the source(s) of wastewater (example: subdivision, mobile home park, shopping centers,
restaurants, etc.):
Bathroom waste only
Number of persons served:
5. Type of collection system
X Separate (sanitary sewer only) ❑ Combined (storm sewer and sanitary sewer)
6. Outfall Information:
Number of separate discharge points 1
Outfall Identification number(s) 001
Is the outfall equipped with a diffuser? ❑ Yes X No
7. Name of receiving stream(s) (NEW geplicants: Provide a map showing the exact location of each
outfallp.
Allen Branch of the French Broad River Basin
S. Frequency of Discharge: X Continuous ❑ Intermittent
If intermittent:
Days per week discharge occurs: Duration: _
9. Describe the treatment system
List all installed components, including capacities, provide design removal for BOD, TSS, nitrogen and
phosphorus. If the space provided is not sufficient, attach the description of the treatment system in a
separate sheet of paper.
A 0.006 MGD facility with manual bar screen, aeration basin with dual blowers providing
diffused air, hoppered clarifier with skimmer and sludge returns, tablet chlorination,
chlorine contact basin, tablet dechlorination, effluent pump station.
2 of 3 Form-D 11/12

NPDES APPLICATION - FORM D
For privately -owned treatment systems treating 100% domestic wastewaters <1.0 MGD
10. Flow Information:
Treatment Plant Design flow 0.006 MGD
Annual Average daily flow .001 MGD (for the previous 3 years)
Maximum daily flow 0.002 MGD (for the previous 3 years)
11. Is this facility located on Indian country?
❑ Yes X No
12. Effluent Data
1VEW APPLICANTS: Provide data for the parameters listed. Fecal Coliform, Temperature and pH shall be grab
samples, for all other parameters 24-hour composite sampling shall be used. If more than one analysis is reported,
-re
port -daily maximum and monthly -average. If only one analysis is reported, report as daily maximum.
RENEWAL APPLICANTS: Provide the highest single reading (Dairy Maximum) and Monthly Average over
the past 36 months for parameters currently in your permit. Mark other parameters "N/A".
Parameter
Daily
Maximum
Monthly
Average
Units of
Measurement
Biochemical Oxygen Demand (BODs)
20.2
12.1
MG/L
Fecal Coliform
600
83.3
CFU/ 100ML
Total Suspended Solids
28.2
17.6
MG/L
Temperature (Summer)
22.1
20.1
C
Temperature (Winter)
11.3
7.5
C
pH
7.5
7.1
units
13. List all permits, construction approvals and/or applications:
Type Permit Number Type
Hazardous Waste (RCRA)
UIC (SDWA)
NPDES NCO037176
PSD (CAA)
Non -attainment program (CAA)
14. APPLICANT CERTIFICATION
NESHAPS (CAA)
Ocean Dumping (MPRSA)
Dredge or fill (Section 404 or CWA)
Other
Permit Number
I certify that I am familiar with the information contained in the application and that to the
best of my knowledge and belief such information is true, complete, and accurate.
/1l cf1 2),W0Y9Z-YA) CFO
Printed name gf-R#rson Signing Title
Signature of A
7
Date
North Carolina General Statute 143-215.6 (b)(2) states; Any person who knowingly makes any false statement representation, or certification in any
application, record, report, plan, or other document files 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 $25,000, 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 $25,000 or imprisonment not more than 5 years, or both, for a similar offense.)
3 of 3 Form-D 11/12