NCG500149_complete file-historical_20130515

NIFTWA
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Chuck Wakild, P.E. Dee Freeman
Governor Director Secretary
May 15, 2013 RECEIVED
Mr. Carlton Cashwell
Duplin General Hospital, Inc.
401 North Main Street
Kenansville, NC 28349
Dear Mr. Cashwell,
MAY 21 Z013
CENTRAL FILES
DWQ/3QG
Subject: NPDES Compliance Inspection Report
Duplin General Hospital
NPDES Permit No. NCG500149
Duplin County
A compliance inspection of the Duplin General Hospital Facility was conducted on May 7, 2013. This
inspection was performed to verify that the facility is operating in compliance with the conditions and
limitations specified in NPDES Permit No. NCG500149 regarding the discharge of cooling tower and
boiler blowdown wastewater. The findings and comments noted during this inspection are provided in
the enclosed copy of the inspection report entitled "Water Compliance Inspection Report". There
were no significant issues or findings noted during this inspection, thus a response to this inspection
report is not required.
If you have any questions concerning this report, you may contact me at the letterhead contact
information or via email at [e-mail].
Sincerely,
-
Tom Tharrington
Wastewater Treatment Plant Consultant
Enclosure
Cc: Wilmington Regional Office — Yellow File
Central Files, Surface Water Protection Section
Wilmington Regional Office One
127 Cardinal Drive Extension Wilmington, NC 28405 NorthrCarofiina
Phone: [phone] / FAX: [phone] Naturally
Internet: www.ncwaterguality.org

United States Environmental Protection Agency
Form Approved.
Washington, D.C.20460
EPA
OMB No. 2040-0057
Approval expires 8-31-98
Section A: National Data System Coding (i.e., PCS)
Transaction Code NPDES yr/mo/day Inspection Type Inspector Fac Type
1 1 N l 2 1 s 1 31 NCG500149 111 121 13/05/07 117
LLJJ �U_�
181 C I 191 c I 201 1
!� U lJ
Remarks
211.I I I I I I I I I I I I I I I I I I I I I I I III I I I I
1 1 1 1 1 Jill III 1 1 1 16
Inspection Work Days Facility Self -Monitoring Evaluation Rating B1 QA
------------------------Reserved----------------_-.---
67 169 70 16I 71 U 72 U
73 `W ' 174 751 1 I ' I I I 180
Section B: Facility Data
Name and Location of Facility Inspected (For Industrial Users discharging to POTW, also include
Entry Time/Date
Permit Effective Date
POTW name and NPDES permit Number)
Duplin General Hospital - Kenansville
01:05 PM 13/05/07
12/08/01
Exit Time/Date
Permit Expiration Date
401 N Main St
Kenansville NC 28349
01:45 PM 13/05/07
15/07/31
Name(s) of Onsite Representative(s)/Titles(s)/Phone and Fax Number(s)
Other Facility Data
111
Name, Address of Responsible Officiallritle/Phone and Fax Number
Carlton Cashwell,401 N Main St Kenansville NC 28349/Director Contacted
No
Engineer/910-296-0941 /9102961174
Section Q Areas Evaluated During Inspection (Check only those areas evaluated)
Permit 0 Records/Reports 0 Facility Site Review
0 Effluent/Receiving Waters
Section D: Summary of Finding/Comments Attach additional sheets of narrative and checklists as necessa
(See attachment summary)
Name(s) and Signature(s) of Inspector(s) Agency/Office/Phone and Fax Numbers Date
Tom Tharrington WIRO WQ///
Islh 151i 3
Signature of Manag ent Q A Reviewer Agency/Office/Phone and Fax Numbers Date
` C>-;ke-
- �WI RO WQIII
James Gregson
I
EPA Form 3660-3 (Rev -94) Previous editions are obsolete.
Page # 1

NPDES yr/mo/day Inspection Type (cont.) 1
3 NCG500149 I11 121
13/05/07 117 18' C
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
Site inspection to determine compliance with the general permit requirements, the facility was well
maintained and all sampling was performed as required. There were 2 additions that need to be added to
the existing records. The first is the vendor (Chem-Aqua)that provides the sampling data sheet should
include the temperature on the record, this information is being recorded with the pH sample but was not
printed with the other data. The second item is that the hospital staff or vendor should include a flow
estimate with the sampling event. The flow does not vary signifcantly and was estimated to be 3-4 gallons
per minute during the visit. The required sampling events are being performed semi-annually usually in the
December/January period and then again in the June/July period. Wastewater sources are 2 non -contact
cooling water tower blowdowns and the blowdown from 3 package boiler units.The outfall was observed at
the rear of the hospital, at this point it joins a drainage feature that runs behind the property and eventually
crosses under Seminary Street, no issues of concern were observed.
Page # 2

d
Permit: NCG500149
Inspection Date: 05/07/2013
Owner - Facility: Duplin General Hospital - Kenansville
Inspection Type: Compliance Evaluation
Permit
(If the present permit expires in 6 months or less). Has the permittee submitted a new application?
Is the facility as described in the permit?
# Are there any special conditions for the permit?
Is access to the plant site restricted to the general public?
Is the inspector granted access to all areas for inspection?
Comment: All required permit information and sampling records were made available
during the inspection. See summary
Yes No NA NE
Page # 3

men
w
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Michael F. Easley, Governor William G. Ross, Jr., Secretary
Coleen H. Sullins, Director
July 23, 2007
Carlton Cashwell
Duplin General Hospital, Inc.
401 North Main Street
Kenansville, NC 28349
Subject: Renewal of coverage / General Permit NCG500000
Duplin General Hospital
Certificate of Coverage NCG500149
Duplin County
Dear Permittee:
In accordance with your renewal application [received on December 28, 20061, the Division is renewing
Certificate of Coverage (CoC) NCG500149 to discharge under NCG500000. This CoC is issued pursuant to the
requirements of North Carolina General Statue 143-215.1 and the Memorandum of Agreement between North
Carolina and the US Environmental Protection agency dated May 9, 1994 [or as subsequently amended].
If any parts, measurement frequencies or sampling requirements contained in this General Permit are
unacceptable to you, you have the right to request an individual permit by submitting an individual permit
application. Unless such demand is made, the certificate of coverage shall be final and binding.
Please take notice that this Certificate of Coverage is not transferable except after notice to the
Division. The Division may require modification or revocation and reissuance of the certificate of coverage.
Contact the Wilmington Regional Office prior to any sale or transfer of the permitted facility.
Regional Office staff will assist you in documenting the transfer of this CoC.
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, Coastal Area
Management Act or any other Federal or Local governmental permit that may be required.
If you have any questions concerning the requirements of the General Permit, please contact Jim
McKay [919 733-5083, extension 595 or [e-mail].
Sincerely,
-A �t�
'
for Coleen H. Sullins
cc: Central Files
Wilmington Regional Office / Surface Water Protection
NPDES file
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 One
512 North Salisbury Street, Raleigh, North Carolina 27604 NorthCarolina
Phone: [phone] / FAX [phone] / Internet: www.newaterquality.org f�/�/ a a lima l y
An Equal Opportunity/AffinnativeAction Employer -50%Recycled/10%Post Consumer Paper L L "

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NCG500000
CERTIFICATE OF COVERAGE NCG500149
TO DISCHARGE NON -CONTACT COOLING WATER, COOLING TOWER AND BOILER
BLOWDOWN, CONDENSATE AND SIMILAR WASTEWATERS UNDER THE
NATIONAL POLLUTANT DISCHARGE ELINIINATION 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,
Duplin General Hospital, Inc.
is hereby authorized to discharge from a facility located at
Duplin General Hospital
401 N Main Street
Kenansville
Duplin County
to receiving waters designated as Grove Creek in subbasin 30622 of the Cape Fear River
Basin in accordance with the effluent limitations, monitoring requirements, and other
conditions set forth in Parts I, II, III and IV hereof.
This certificate of coverage shall become effective August 1, 2007.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day July 23, 2007.
/." -A GIB,-�
for Coleen H. Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission

CEC 2006 IL
NCDENR f
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Michael F. Easley, Governor William G. Ross, Jr., Secretary
Alan W. Klimek, P.E., Director
NOTICE OF RENEWAL INTENT
Application for renewal of existing coverage under General Permit NCG500000
Existing Certificate of Coverage (CoC): NCG500 149
(Please print or type)
1) Mailing address' of facility owner/operator:
Company Name Duplin General Hospital, Inc.
Owner Name Duplin County
Street Address 401 N. Main Street
City Kenansville State NC ZIP Code 28349
Telephone Number 910 296-0941 Fax: [phone]
Email address [e-mail]
Address to which all permit correspondence should be mailed
2) Location of facility producing discharge:
Facility Name
Facility Contact
Street Address
City
County
Telephone Number
Email address
Duplin General Hospital, General Hospital, Inc.
Carlton Cashwell
401 N. Main Street
Kenansville State NC ZIP Code 28981 9
910 296-0941
[e-mail]
3) Description of Discharge:
Fax: [phone]
a) Is the discharge directly to the receiving stream? KI Yes ❑ No
(If no, submit a site map with the pathway to the potential receiving waters clearly marked. This includes tracing the pathway of the
storm sewer to the discharge point, if the storm sewer is the only viable means of discharge.)
b) Number of discharge outfalls (ditches, pipes, channels, etc. that convey wastewater from the property):
1
c) What type of wastewater is discharged? Indicate which discharge points, if more than one.
l:l Non -contact cooling water Outfall(s) If: I
& Boiler Blowdown Outfall (s) #: I
Page 1 of 3

NCG500000 renewal application
M Cooling Tower Blowdown
M Condensate
❑ Other
Outfall (s) #: 1
Outfall (a) #: 1
Outfall (s) #:
(Please describe "Other")
d) Volume of discharge per each discharge point (in GPD):
#001: 50 GPD #002: #003: #004
4) Please check the type of chemical [s] added to the wastewater for treatment, per each separate discharge
point (if applicable, use separate sheet):
❑ Chlorine ❑ Biocides ❑ Corrosion inhibitors ❑ Algaecide ❑ Other
& None
5) If any box in item (4) above [other than None] was checked, a completed Biocide 101 Form and
manufacturers' information on the additive must be submitted to the following address for approval:
NC DENR / DWQ / Environmental Sciences Section
Aquatic Toxicology Unit
1621 Mail Service Center
Raleigh, NC 27699-1621
6) Is there any type of treatment being provided to the wastewater before discharge (i.e., retention ponds,
settling ponds, etc.)? ❑ Yes 99 No
(If yes, please include design specifics (i.e., design volume, retention time, surface area, etc.) with submittal package. Existing
treatment facilities should be described in detail. )
7) Discharge Frequency:
a) The discharge is: M Continuous ❑ Intermittent ❑ Seasonal*
i) If the discharge is intermittent, describe when the discharge will occur:
ii) *Check the month(s) the discharge occurs: XJ Jan E Feb IN Mar. M Apr EX May IX Jun ®CJul
%1 Aug. I& Sept. CK Oct. EKNov. IIM Dec.
b) How many days per week is there a discharge? 7
c) Please check the days discharge occurs: 11 Sat. ENSun. IX Mon. %7 Tue. f$ Wed. %] Thu. fF Fri.
8) Receiving stream[s]:
a) To what body or bodies of water (creek, stream, river, lake, etc.) does the facility discharge
wastewater? If the site discharges wastewater to a separate storm sewer system (4S), name the
operator of the 4S (e.g. City of Raleigh).
b) Stream Classification: Grove Creek (Cape Fear River Basin)
Page 2 of 3

NCG500000 renewal application
Additional Application Requirements:
The following information must be included in triplicate [original + 2 copies] with this application or it will
be returned as incomplete.
➢ Site map. If the discharge is not directly to a stream, the pathway to the receiving stream must
be clearly indicated. This includes tracing the pathway of a storm sewer to its discharge point.
➢ Authorization for representatives. If this application will be submitted by a consulting
engineer (or engineering firm), include documentation from the Permittee showing that the
consultant submitting the application has been designated an Authorized Representative of the
applicant.
Certification
I certify that I am familiar with the information contained in this application and that to the best of my
knowledge and belief such information is true, complete, and accurate.
Printed Name of Person Signing:
Title:
Carlton Cashwell
Director of Plant Engineering
12/18/2006
(Signature of Applicant) (Date Signed)
North Carolina General Statute 143-215.6 b (i) provides that:
Any person who knowingly makes any false statement, representation, or certification in any application, record, report, plan or other document
filed or required to be maintained under Article 21 or regulations of the Environmental Management Commission implementing that Article, or who
falsifies, tampers with or knowingly renders inaccurate any recording or monitoring device or method required to be operated or maintained under
Article 21 or regulations of the Environmental Management Commission implementing that Article, shall be guilty of a misdemeanor punishable by
a fine not to exceed $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.)
This Notice of Renewal Intent does NOT require a separate fee.
The permitted facility already pays an annual fee for coverage under NCG500000.
Mail the original and two copies of the entire package to:
Mr. Charles H. Weaver
NC DENR / DWQ / NPDES
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Page 3 of 3

State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
Michael F. Easley, Governor
William G. Ross Jr., Secretary
Alan W. Klimek, P.E. Director
July 26, 2002
CARLTON CASHWELL
DUPLIN GENERAL HOSPITAL
PO BOX 278
KENANSVILLE, NC 28349
1 ••
NC ENR
NORTH CARouNA DEPARTMENT OF
ENVIRONMENT AND NAruRAL RESOURCES
Subject: Reissue - NPDES Wastewater Discharge Permit
Duplin General Hospital
COC Number NCG500149
Duplin County
Dear Permittee:
In response to your renewal application for continued coverage under general permit NCG500000, the Division of
Water Quality (DWQ) is forwarding herewith the reissued wastewater general permit Certificate of Coverage
(COC). This COC is reissued pursuant to the requirements of North Carolina General Statute 143-215.1 and the
Memorandum of Agreement between the state of North Carolina and the U.S. Environmental Protection Agency,
dated May 9, 1994 (or as subsquently amended).
The following information is included with your permit package:
* A copy of the Certificate of Coverage for your treatment facility
* A copy of General Wastewater Discharge Permit NCG500000
* A copy of a Technical Bulletin for General Wastewater Discharge Permit NCG500000
Your coverage under this general permit is not transferable except after notice to DWQ. The Division may require
modification or revocation and reissuance of the Certificate of Coverage. This permit does not affect the legal
requirements to obtain other permits which may be required by DENR or relieve the permittee from responsibility
for compliance with any other applicable federal, state, or local law rule, standard, ordinance, order, judgment, or
decree.
If you have any questions regarding this permit package please contact Aisha Lau of the Central Office Stormwater
and General Permits Unit at [phone], ext. 578
Sincerely,
for Alan W. Klimek, P.E.
cc: Central Files
Stormwater & General Permits Unit Files
Wilmington Regional Office
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 Telephone [phone] FAX [phone]
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STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG500000
CERTIFICATE OF COVERAGE No. NCG500149
TO DISCHARGE NON -CONTACT COOLING WATER, COOLING TOWER AND BOILER
BLOWDOWN, CONDENSATE AND SIMILAR WASTEWATERS UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards and
regulations promulgated and adopted by the North Carolina Environmental Management Commission, and the
Federal Water Pollution Control Act, as amended,
DUPLIN GENERAL HOSPITAL
is hereby authorized to discharge
NON -CONTACT COOLING WATER / CONDENSATE
water or similar wastewater from a facility located at
DUPLIN GENERAL HOSPITAL
401 NORTH MAIN STREET
KENANSVILLE
DUPLIN COUNTY
to receiving waters designated as Grove Creek, a class C water, in the Cape Fear River Basin in accordance with
the effluent limitations, monitoring requirements, and other conditions set forth in Parts I, II, III, and IV of
General Permit No. NCG500000 as attached.
This certificate of coverage shall become effective August 1, 2002.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day July 26, 2002.
for Alan W. Klimek, P.E., Director
Division of Water Quality
By Authority of the Environmental Management Commission

State of North Carolina
Department of Environment,
Health and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Wayne McDevitt, Secretary
A. Preston Howard, Jr., P.E., Director
Carlton Cashwell
Duplin General Hospital
P.O. Box 278
Kenansville, NC 28349
Dear Permittee:
dowedgkonow
E)EHNR
July 24,1997
Subject: Certificate of Coverage No. NCG500149
Renewal of General Permit
Duplin General Hospital
Duplin County
In accordance with your application for renewal of the subject Certificate of Coverage, the Division is forwarding
the enclosed General Permit. This renewal is valid until July 31, 2002. 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 December 6,1983. If any parts, measurement
frequencies or sampling requirements contained in this permit are unacceptable to you, you have the right to request
an individual permit by submitting an individual permit application. Unless such demand is made, this certificate
of coverage shall be final and binding.
The Certificate of Coverage for your facility is not transferable except after notice to the Division. Use the enclosed
Permit Name/Ownership Change form to notify the Division if you sell or otherwise transfer ownership of the
subject facility. The Division may require modification or revocation and reissuance of the Certificate of Coverage.
If your facility ceases discharge of wastewater before the expiration date of this permit, contact the Regional
Office listed below at [phone]. Once discharge from your facility has ceased, this permit may be rescinded.
This permit does not affect the legal requirements to obtain other permits which may be required by the Division of
Water Quality, the Division of Land Resources, Coastal Area Management Act or any other Federal or Local
governmental permit that may be required.
If you have any questions concerning this permit, please contact the NPDES Group at the address below.
Sincerely,
A. Preston Howard, Jr., P.E.
cc: Central Files
Wilmington Regional Office
NPDES File
Facility Assessment Unit
P.O. Box 29535, Raleigh, North Carolina 27626.0535 [phone] FAX [phone] p&[e-mail]
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STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT, HEALTH, AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG500000
CERTIFICATE OF COVERAGE NO. NCG500149
TO DISCHARGE NON -CONTACT COOLING WATER, COOLING TOWER AND BOILER
BLOWDOWN, CONDENSATE, EXEMPT STORMWATER, COOLING WATERS ASSOCIATED WITH
HYDROELECTRIC OPERATIONS, AND SMULIAR WASTEWATERS UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards
and regulations promulgated and adopted by the North Carolina Environmental Management
Commission, and the Federal Water Pollution Control Act, as amended,
Duplin General Hospital
is hereby authorized to discharge
non -contact cooling water, condensate and other similar wastewaters
from a facility located at
Duplin General Hospital
401 North Main Street
Kenansville
Duplin County
to receiving waters designated as subbasin 30622 in the Cape Fear River Basin
in accordance with the effluent limitations, monitoring requirements, and other conditions set forth
in Parts I, II, III and IV of General Permit No. NCG500000 as attached.
This certificate of coverage shall become effective August 1,1997.
This certificate of coverage shall remain in effect for the duration of the General Permit.
Signed this day July 24,1997.
A. Preston Howard, Jr., P.E., Director
Division of Water Quality
By Authority of the Environmental
Management Commission

April 15, 1997
Letter to CARLTON CASHWELL
NCG500149
INVOICE FOR RENEWAL OF
NPDES PERMIT
❑ Check here if you do NOT wish to renew this permit.
Please return this page along with a letter documenting your reasons
for not requesting renewal to:
Mr. Charles H. Weaver, Jr.
Division of Water Quality/WQ Section
NPDES Group
Post Office Box 29535
Raleigh, North Carolina 27626-0535
Check here if you wish to renew this permit.
Please verify that the following information is documented accurately:
MM1M.T.T.1 R-
_t V56 (3
_� WOO
CARLTON CASHWELL eQ No revision required.
DLIPLIN GENERAL HOSPITAL
P.O. BOX 278 ❑ Revision required. (Please specify below.)
KENANSVILLE, NC 28349
Phone number: [phone]
Fax number: Cll D — an- /l 244
e-mail address:
Facility Location
CARLTON CASHWELL
DUPLIN G NERAL HOSPITAL
401 N ST.
KENANS LLE, NC 28349
0-<o--revision required.
Revision required. (Please specify below.)
1
Please return this page with your letter requesting renewal, and $400 fee (payable to NCDEHNR) to:
Mr. Charles H. Weaver, Jr.
Division of Water Quality/WQ Section
NPDES Group
Post Office Box 29535
Raleigh, North Carolina 27626-0535
Signature of applicant or authorized representative : il,4M 4
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