NC0063355_Permit Issuance_20100224

e��
NCDENR
North Carolina Department of Environment and Natural Resources
Beverly Eaves Perdue
Governor
Mr. Michael A. Melton
Aqua North Carolina, Inc.
4163 Sinclair Street
Denver, NC 28037
Division of Water Quality
Coleen H. Sullins
Director
February 24, 2010
Subject: Issuance of NPDES Permit NCOO63355
Aqua North Carolina, Inc. — Killian Crossroads W WTP
Catawba County
Dear Mr. Melton:
Dee Freeman
Secretary
Division personnel have reviewed and approved your application for renewal of the subject permit. Accordingly,
we are forwarding the attached NPDES discharge 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
U.S. Environmental Protection Agency dated October 15, 2007 (or as subsequently amended).
This final permit includes no changes from the draft permit sent to you on January 6, 2010 (misdated as January
6, 2009).
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 receipt of this
letter. This request must be in the form of a written petition, conforming to Chapter 15OB of the North Carolina
General Statutes, and filed with the Office of Administrative Hearings (6714 Mail Service Center, Raleigh, North
Carolina 27699-6714). Unless such demand is made, this decision shall be 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 Quality or permits required by the Division
of Land Resources, the 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 Bob Sledge at telephone number (919) 807-
6398.
Sincerer
Coleen H. Sullins
cc: Central Files
Mooresville Regional Office/Surface Water Protection Section
NPDES Unit
1617 Mail Service Center, Raleigh, North Carolina 27699.1617 One
Location: $12 N. Salisbury St. Raleigh, North Carolina 27604 NO Carolina
Phone: [phone]\ FAX: [phone] \Customer Service: 1-877-623.6748 tCar �in
Internet: www.nmaterquality.org (((/// YYY Ll4
An Equal Opportunity\Aflirma ve Action Emgoyer

Permit NCO063355
- STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
PERMIT
TO DISCHARGE WASTEWATER 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,
Aqua North Carolina, Inc.
is hereby authorized to discharge wastewater from a facility located at
Killian Crossroads WWTP
4306 Mount Pleasant Road (NCSR 1849)
West of Terrell
Catawba County
to receiving waters designated as Lake Norman (Reed Creek) in the Catawba River Basin in
accordance with effluent limitations, monitoring requirements, and other conditions set forth in
Parts I, II, III and IV hereof.
This permit shall become effective April 1, 2010.
This permit and authorization to discharge shall expire at midnight on March 31, 2015.
Signed this day February 24, 2010.
Coleen H. Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission

Permit NC0063355
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.
Aqua North Carolina, Inc.
is hereby authorized to:
1. Continue operation of a 0.05 MGD wastewater treatment plant consisting of the
following treatment units:
• 0.025 MGD equalization basin
Flow splitter box w/ bar screen
Dual aeration basins with diffused air
Dual secondary clarifiers
Dual tertiary filters
• Diffused post aeration
Tablet chlorination with contact chamber
Tablet dechlorination
• Cascade post aeration
Aerated sludge holding tank
• Stand-by power generator
The facility is located at the Killian Crossroads WWTP, at 4306 Mt. Pleasant Road
(NCSR 1849), in Catawba County, and;
2. After receiving an Authorization to Construct from the Division of Water Quality,
construct additional treatment facilities to handle a maximum of 0.075 MGD of
wastewater, (See Special Condition A. (4.)), and;
3. Discharge treated wastewater from said treatment works at the location specified on the
attached map through outfall 001 into Lake Norman (Reed Creek), which is classified
WS-IV & B, CA waters, in the Catawba River Basin.

Permit NC0063355
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Latitude: 35OM35' NCO063355
Longitude: 81°01'55"
Facility
Location '.,,,•�•s, /
Receiving Stream: Lake Norman
Stream Class: WS-IV8 B, CA Aqua North Carolina, Inc.
Subbasin: 30832 Killian Crossroads
North
SCALE 1 :24000

Permit-NC0063355
A. (1.) EFFLUENT LIMITATIONS AND MONITORING REQUIREMENTS - FINAL
During the period beginning on the effective date of the permit and lasting until expiration or
expansion greater than 0.05 MGD, the Permittee is authorized to discharge treated wastewater
from outfall(s) 001. Such discharges shall be limited and monitored by the Permittee as
specified below:
Elf;
t: Characteristics
Monitoring Requirements . `
—
Monthly
Daily,.
Maximum.
Measurement
Frequency
Sample
Type, :
Sample
Location1;:
Flow
0.05 MGD
Continuous
Recording
I or E
BOD, 5-day, 200C
15.0 m L
22.5 m /L
Weekly
Composite
E
Total Suspended Residue
30.0 m /L
45.0 m /L
Wee kl
Composite
E
NHA
4.0 m /L
20.0 m /L
Weekly
Composite
E
Fecal Coliform
(geometric mean
200/ 100ml
400/ 100ml
Weekly
Grab
E
Dissolved Oxygen2
Weekly
Grab
E
H3
Weekly
Grab
E
Temperature
Daily
Grab
E
Total Residual Chlorine4
28 /L
2/Week
Grab
E
Oil and Grease
30.0 m /L
60.0 m /L
2/Month
Grab
E
MBAS
Monthly
Co m osite
E
Total Nitrogen
NO2 + NO3 + TKN
Quarterly
Composite
E
Total Phosphorus
Quarterly
Composite
E
Dissolved Oxygen
Weekly
Grab
U, D
Temperature
Weekly
Grab
U, D
Footnotes:
I. Sample Location: I- Influent, E — Effluent; U — Upstream at least 100 feet upstream of the
outfall; D - Downstream at the location designated on the attached map.
2. The daily average dissolved oxygen effluent concentration shall not be less than 6.0 mg/L.
3. The pH of the effluent shall not be less than 6.0 nor greater than 9.0 (on the standard units
scale).
4. 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 a North Carolina certified laboratory (including field certified), even if
these values fall below 50 lag/L.
There shall be no discharge of floating solids or visible foam in other than trace amounts.

Permit NCO063355
A. (2.) EFFLUENT LIMITATIONS AND MONITORING REQUIREMENTS - FINAL
During the period beginning upon expansion greater than 0.05 MGD and lasting until expiration,
the Permittee is authorized to discharge treated wastewater from outfall(s) 001. Such
discharges shall be limited and monitored by the Permittee as specified below:
Effluent
Characteristics
Monitoring Regu_rn= ,
Monthly
Average
Daily','
Maximum
Measurement
Frequency,
Sample
Type
Sample
Locationl
Flow
0.075 MGD
Continuous
Recording
I or E
BOD, 5-day, 200C
15.0 m /L
22.5 m fL
Weekly
Composite
E
Total Suspended Residue
30.0 m /L
45.0 m /L
Wee kl
Composite
E
NHA
4.0 m /L
20.0 m /L
Weekly
Composite
E
Fecal Coliform
(geometric mean
200/ 100m1
4001100m1
Weekly
Grab
E
Dissolved Oxygen2
Weekly
Grab ..
E
H3
Weekly
Grab
E
Temperature
Daily
Grab
E
Total Residual Chlorine4
28 /L
2/Week
Grab
E
Oil and Grease
30.0 m /L
60.0 m /L
2/Month
Grab
E
MBAS
Monthly
Composite
E
Total Nitrogen
NO2 + NO3 + TKN
Quarterly
Composite
E
Total Phosphorus
Quarterly
Com osh
E
Dissolved Oxygen
Weekly
Grab
U, D
Temperature
Weekly
Grab
U, D
Footnotes:
1. Sample Location: I- Influent, E — Effluent, U — Upstream at least 100 feet upstream of the
outfall; D- Downstream at the location designated on the attached map.
2. The daily average dissolved oxygen effluent concentration shall not be less than 6.0 mg/L.
3. The pH of the effluent shall not be less than 6.0 nor greater than 9.0 (on the standard units
scale).
4. 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 a North Carolina certified laboratory (including field certified), even if
these values fall below 50 µg/L.
There shall be no discharge of floating solids or visible foam in other than trace amounts.

Permit NCO063355
A. (3.) SPECIAL CONDITION — Operations
Pursuant to the terms of the Settlement Agreement established between Heater Utilities, Inc. and
the Division of Water Quality, signed on June 26, 2006, Aqua North Carolina, Inc. shall:
(a) ► Continue to operate a turbidimeter at the plant to measure turbidity in the plant effluent,
and set the turbidimeter to notify the plant operator automatically in the event that the
turbidimeter records a reading of 10 nephelometric turbidity units or greater;
(b) Inspect the performance of the plant's disinfection system every weekday and maintain a
log of such inspections; and
(c) Operate a Supervisory Control and Data Acquisition (SCADA) system at the plant.
A. (4.) SPECIAL CONDITION — Flow Expansion Request
Concurrent with any application for an Authorization to Construct that results in an expansion of flow, the
facility shall submit an updated flow justification and permit compliance review.
a) The flow justification shall include at least the following:
1. Provide Basic Identification of the Project
■ Facility name
■ County
■ Facility address
■ Facility telephone number
■ Preparer's name
■ Preparer's mailing address and telephone number
2. Provide a detailed description of the project requiring an expansion of wastewater disposal. The
wastewater flows should be calculated according to 15A NCAC 2H .0219. Demonstrate and
justify the need for flow volumes, to include any flow reductions realized through flow -
restricting devices. The use of flow -restricting or low -flow devices should be investigated.
Report findings should include flow reduction projections. Updated plat maps, a time schedule
for connection, and documentation of commitments shall be required.
3. If existing facilities will be used as part of an expansion, discuss those existing units including
present and past performance, unit capacities, and inadequacies of each. Include a schematic
with component sizes.
4. Indicate if the project will be constructed in phases. Provide the estimated wasteflow per phase.
Indicate current phase status for existing facilities and provide a schedule for constructing each
additional phase.
b) The compliance review report shall summarize the performance of the treatment works or collection
system and state the extent to which any terms of its permit, federal laws, or any State laws,
regulations or rules related to the protection of water quality have been violated.

Permit N0006335.5
A. (5.) SPECIAL CONDITION — Spill Notification
(a) Contacting Public Health Directors
The facility must notify the Iredell, Lincoln, Catawba, and Mecklenburg County Public Health
Directors within 12 hours of first knowled&e by the owner/operator of any*discharge of untreated
wastewater to waters of the State or a discharge from the wastewater treatment plant that has not
received adequate disinfection due to a malfunctioning treatment unit.
The County Public Health Directors can be contacted using the following information:
Catawba County Health Director
3070 1la' Ave. Dr. S.E.
Hickory, NC 28602
828-695-5800
Lincoln County Health Director
151 Sigmon Rd.
Lincolnton, NC 28092-8643
704-736-8634
(b) Public Notification
Iredell County Health Director
318 Turnersburg Highway
Statesville, NC 28625
704-878-5302
Mecklenburg County Health Director
249 Billingsley Rd.
Charlotte, NC 28211
704-336-4700
The facility must notify the public of untreated wastewater spills. Wastewater facility owners or
operators must issue a press release after a discharge to surface waters of 1,000 gallons within 48
hours of first knowledge of the spill by the owner/operator. The press release must be issued to
"all electronic and print news media outlets that provide general coverage in the county where
the discharge occurred." A copy of the press release must be maintained for one year by the
owner/operator. This press release is required in addition to the permit requirement of contacting
the North Carolina Division of Water Quality (DWQ).
If a discharge of 15,000 gallons or more reaches surface water, a public notice is required in
addition to the press release. The public notice must be placed in a newspaper having general
circulation in the County in which the discharge occurred and the county immediately
downstream. At a minimum the notice should be published in a newspaper of general circulation
in Iredell, Lincoln, Catawba, and Mecklenburg Counties. If a discharge of 1,000,000 gallons of
wastewater or more reaches surface waters, the DWQ regional office must be contacted to
determine in what additional counties, if any, a public notice must be published. A copy of these
public notices and proof of publication must be sent to the DWQ within 30 days of publication.
The copy should be sent to the following address:
PERCS Unit
Division of Water Quality
1617 Mail Service Center
Raleigh, NC 27699
The minimum content of the notice is the location of the discharge, estimated, volume, water
body affected and steps taken to prevent future discharges.

The CharLotte Observer Publishing Co.
Charlotte, NC
North Carolina 3 ss Affidavit of Publication
Mecklenburg County}
THE CHARLOTTE OBSERVER
DINA SPRINKLE
NCDENR/DWQ/POINT SOURCE BRANCH
1617 MAIL SERVICE CENTER
RALEIGH NC 27699
REFERENCE: 30063432
6426206 aqua, no, inc
Before the undersigned, a Notary Public of said
County and State, duly authorized to administer
oaths affirmations, etc., personally appeared,
being duLy sworn or affirmed according to Law,
doth depose and say that he/she is a
representative of The Charlotte Observer
Pub Lishing Company, a corporation organized and
doing business under the Laws of the State of
De Laware, and publishing a newspaper known as The
Charlotte Observer in the city of CharLotte,
County of Mecklenburg, and State of North CaroLinal
and that as such he/she is familiar with the
books, records, fiLes, and business of said
Corporation and by reference to the files of said
pub Lication, the attached advertisement was
inserted. The foLLowing is correct Ly copied from
the books and files of the aforesaid Corporation
and Publication.
PUBLISHED ON: 01/10
AD SPACE: 100 LINE
FILED ON: 01/15/10
Pubf Notice
Na Carmine Ernao Mml Maragemern
- CommssaNNPDESUnn
1617 Meil Service CeMer
Raleigh NC 27M 1617
Notice of IMent to &s a NPDES Wastewater Permit
Tee Nonh Caroline Enh.m MM Meregement Commission
IaW sto"e_NPDEs wastewater dishwP Permit to lee
NAME: /! rM (/L `j(CPAn�t— TITLE: "*/�10
DATE:
In Testimony Whereof I have hereunto set my hand and affixed my seal, the
day and Hear a afores/aq�i/Aj- ,I ,`'r
Not�hy<,I(K//QN�-1/G� ! f' iU�^'y Commission Expires:
or
ommission Expires May 27, 2011

Sledge, Bob '
From:
Selzer, Britt
Sent:
Friday, January 08, 2010 11:12 AM
To:
Sledge, Bob
Cc:
James McRight
Subject:
RE: Draft NPDES Permits
-
I only found 5 NPDES permits attached, and there were no forms attached for my signature. I will try and handle these
with an e-mail so you don't have to send the forms to me.
The system I reviewed are listed below.
Castaways Shores/Bridgeport WWTP - NCO056154
Mallard Head Condominiums WWTP - NCO062481
Killians Crossroads WWTP - NCO063355
Diamond Head WWTP - NCO074772
Alexander Island WWTP - NCO075205
We concur with the issuance of these permits provided the facilities are operated and maintained properly, the stated
effluent limits are met prior to discharge, and the discharge does not contravene the designated water quality
standards.
Jim - Please add these to your tracking data base -Thanks
From: Sledge, Bob
Sent: Wednesday, January 06, 2010 2:22 PM
To: Setzer, Britt
Subject: Draft NPDES Permits
Hi Mr. Setzer,
Here are copies of 6 draft NPDES permits for facilities discharging in the Lake Norman area, along with associated cover
letters and the certifications for your review and signature. I apologize for the large number of files I've attached. We
had some problems with a server here in the Archdale building and I wasn't able to use a scanning function that would
allow me to consolidate some of the documents.
Please call or reply if you have any questions.
Bob Sledge
Environmental Specialist
NPDES Western Unit
NC Division of Water Quality
Bob. S led ee @ ncden r. eo v
[phone]

SOC PRIORITY PROJECT: No
To: Western NPDES Unit
Surface Water Protection Section
Attention: Bob Sledge
Date: November 2, 2009
NPDES STAFF REPORT AND RECOMMENDATIONS
County: Catawba
NPDES Permit No.: NC0063355 RECEIVED
PART I - GENERAL INFORMATION
1. Facility and address: Killian Crossroads WWTP NOV 1 0 2009
% Aqua North Carolina, Inc.
4163 Sinclair Street
Denver, N.C. 28037 DENR - WATER QUALITY
Den
'
2. Date of investigation: N/A POINT S(-".,1,ANCH
3. Report prepared by: Michael L. Parker, Environmental Engineer I1
4. Person contacted and telephone number: Michael Melton, [phone], ext. 57238
5. Directions to site: From the jet. of NC Hwy. 150 and SR 1849 (Mount Pleasant Road) in
southeastern Catawba County, travel northeast on SR 1849 = 0.5 mile. The WWTP site is
on the left (west) side of SR 1849.
6. Discharge point(s), list for all discharge points:
Latitude: 350 34' 35"
Longitude: 810 02' 55"
Attach a USGS Map Extract and indicate treatment plant site and discharge point on map.
USGS Quad No.: E 14 SE
7. Receiving stream or affected surface waters: Reed Creek (Lake Norman)
a. Classification: WS-IV, CA
b. River basin and subbasin no.: Catawba 030832
C. Describe receiving stream features and pertinent downstream uses: The receiving
stream is = 4-6 feet across and 6-12 inches deep. The stream has relatively slow
movement due to it emptying into Lake Norman at the point of discharge. Fish
were observed both upstream and downstream of the discharge point.

Page Two
PART H - DESCRIPTION OF DISCHARGE AND TREATMENT WORKS
1. a. Volume of wastewater: 0.050 MGD (Design Capacity)
b. What is the current permitted capacity: 0.050 MGD and 0.075 MGD
C. Actual treatment capacity of current facility (current design capacity): 0.050
MGD
d. Description of existing or substantially constructed WWT facilities: The existing
WWT facilities consist of an influent surge tank with a flow splitter box, a bar
screen, dual aeration basins (diffused), dual clarifiers, dual tertiary filters, tablet
chlorination with contact chamber, tablet dechlorination, diffused post aeration,
cascade post aeration, an aerated sludge holding tank, and a portable stand-by power
generator.
f. Description of proposed WWT facilities: There are no WWT facilities proposed at
this time.
PART III - OTHER PERTINENT INFORMATION
1. Special monitoring or limitations (including toxicity) requests: None at this time.
PART IV - EVALUATION AND RECOMMENDATIONS
The permittee, Heater Utilities (HU), has requested renewal of the subject permit. There have
been no changes to the NPDES permit since it was last renewed. HU has, however, recently
completed a replacement of many of the existing WWTP tanks and treatment processes (ATC
063355A01). These new treatment components replaced existing components that were in severe
stages of degradation and disrepair. It should be noted that this W WTP upgrade did not include an
increase in hydraulic flow even though the current permit contains effluent limitations up to 0.075
MGD.
The City of Hickory, which owns and operates the Town of Catawba!s WWTP, is actively
working towards expanding and developing the infrastructure to serve the area currently served by the
Killian's WWTP. Although the availability of sewer from the Town of Catawba is likely several years
away, the fact that there may be municipal sewer service available within the same service area as the
Killian's WWTP could have an effect on future of this facility. Current economic conditions will
likely delay Hickory's infrastructure expansion efforts, however, the overlapping of the service area of
these two W WTPs could become a local issue at some point during the term of the new permit.
Pending receipt, review, and approval of the draft permit, it is recommended that the Permit be
renewed as requested.
f
Si e of Report Preparer D to
Water Quality Regional Supervisor Date
h:ldsMsv09Uci11ien.doc

North Carolina
October 1, 2009
Mrs. Dina Sprinkle
NC DENR/DWQ/POINT Source Branch
1617 Mail Service Center
Raleigh, NC 27699-167
Re: Killian Crossroads WWTP
Permit Renewal Application
Permit #: NCO063355
Catawba County
Dear Mrs. Sprinkle,
Aqua North Carolina, Inc. T: 704.489.9401
4163 Sinclair Street F: 704AS9.9409
Denver, NC 28037 vvww.aquanorthcarolina.com
Enclosed you'll find our application for renewal of our NPDES Permit and
required documentation.
Aqua North Carolina, Inc. requests the renewal of the current limitations
for this facility as recorded on the previous permit set to expire on March 31,
2010. If you have any questions feel free to contact me at [phone],
extension 57238.
Sincerely,
Michael A. Melton
Regional Manager of Compliance
Aqua North Carolina, Inc.
j rm / MAM
Enclosures
cc: Tom Roberts, President and COO, Aqua NC
H) - 5 2000
DENR - WATER OUALITY
POINT SOURCE BRANCH
An Aqua America Company

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 000063355
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
Aqua North Carolina, Inc
Facility Name
Mllian's Crossroads WWTP
Mailing Address
202 MacKenan Court
City
Cary
State / Zip Code
N.C., 27511
Telephone Number
[phone]
Fax Number
[phone]
e-mail Address
[e-mail]
2. Location of facility producing discharge:
Check here if same address as above ❑
Street Address or State Road 4306 Mount Pleasant Road-NCSR 1849
City
Sherrill's Ford
State / Zip Code
N.C., 28673
County
Catawba
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 Aqua North Carolina, Inc.
Mailing Address 4163 Sinclair Street
City Denver
State / Zip Code N.C., 28037
Telephone Number [phone] UC I - 5 2009
Fax Number [phone]
UALlTY
POINT SOURCE BRANCH
1 of 3 Form-D 05108

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 applyr
Industrial
❑
Commercial
Residential
School
❑
Other
❑
Number of Employees
Number of Employees
Number of Homes
Number of Students/ Staff
Explain:
128 - Estimate
66
Describe the source(s) of wastewater (example: subdivision, mobile home park, shopping centers,
restaurants, etc.):
Residential with shopping center and restaurants.
Population served: 490
5. Type of collection system
® 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 ® No
7. Name of receiving stream(s) (Provide a map shouring the exact location of each outfallj-
Lake Norman (see attachment)
S. Frequency of Discharge: ® Continuous ❑ Intermittent
If intermittent:
Days per week discharge occurs: 7 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.
The Killian's Crossroads plant has been upgraded to operate with the capacity of a
0.100 MGD wastewater treatment facility, consisting of a .025 MGD equalization tank
with grinder pumps, splitter box with bar screen, two 0.05 MGD aeration chambers, two
(2) clarifiers, two (2) tertiary sand filters with blower, tablet chlorination, de -chlorination
with post air, and 0.025 MGD digester, continuous flow recording, with refrigerated
composite sampler, cascade post aeration and standby power generator.
2 of 3 Form-D 05108

NPDES APPLICATION - FORM D
For privately owned treatment systems treating 100% domestic wastewaters <1.0 MGD
10. Flow Information:
Treatment Plant Design flow 0.100 MGD
Annual Average daily flow 0.028 MGD (for the previous 3 years)
Maximum daily flow 0.068 MGD (for the previous 3 years)
11. Is this facility located on Indian country?
❑ Yes ® No
12. Effluent Data
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, report daily maximum
and monthly average. If only one analysis is reported, report as daily maximum.
Parameter
Daily
Maximum
Monthly
Average
Units of
Measurement
Biochemical Oxygen Demand (BOD5)
4.6
2.2
MG/L
Fecal Coliform
3.3
1.0
# / 100ML
Total Suspended Solids
2.8
0.2
MG/L
Temperature (Summer)
27.30
26.00
*Celsius
Temperature (Winter)
13.00
9.30
'Celsius
pH
7.8
7.5
Units
13. List all permits, construction approvals and/or applications:
Type Permit Number Type
Hazardous Waste (RCRA) NESHAPS (CAA)
UIC (SDWA) Ocean Dumping (MPRSA)
NPDES NCO063355 Dredge or fill (Section 404 or CWA)
PSD (CAA) Other
Non -attainment program (CAA)
14. APPLICANT CERTIFICATION
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.
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 05108

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