NC0087491_Renewal (Application)_20240523

STATE
„irr, 4%\t
ROY COOPER
Governor
ELIZABETH S.BISER �` ^I1^""i= �
•
RIAM '
Secretary
RICHARD E.ROGERS,JR. NORTH CAROLINA
Director Environmental Quality
May 23, 2024
Beaufort County Water System
Attn: Erick Jennings, Water System Manager
121 W 3rd St
Washington, NC 27889-1988
Subject: Permit Renewal
Application No. NC0087491
Chocowinity/Richland Township WTP
Beaufort County
Dear Applicant:
The Water Quality Permitting Section acknowledges the May 23, 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://www.deq.nc.Rov/permits-rules/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.
Sin rely,
ii:qz:1
Wren Thedford
Administrative Assistant
Water Quality Permitting Section
cc: Brian M. Alligood, County Manager
ec: WQPS Laserfiche File w/application
D_E C North Carolina rt of Environmental Quality Division Re
//�� Washington RegionalDepa Office ment 943 W'ashington Square Mall WashingtoofWatern North
sources Carolina 27889
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Beaufort County, North Carolina
Department of Public Works
Water Division
»,z
111 West 2nd Street I Washington, North Carolina 127889
Phone [phone] I co.beaufort.nc.us
May 20, 2024 RECEIVED
MAY 2 3 2024
Division of Water Resources NCDEQ/DWR/NPDES
Water Quality Permitting Section - NPDES
1617 Mail Service Center
Raleigh, NC 27699-1617
SUBJECT: NPDES Permit Renewal
NPDES Permit NC0087491
Chocowinity/Richland Township WTP
Beaufort County
To Whom It May Concern:
Please find enclosed the following information for the subject permit:
1. One (1) original and two (2) copies of this cover letter.
2. One (1) original and two (2) copies of the completed application forms.
3. One (1) original and two (2) copies of a Sludge Management Plan.
4. Three (3) copies of a map showing the location of existing discharge of outfall to
include latitude and longitude.
5. Three (3) copies of a Schematic Diagram of flow through the water treatment
plant facility.
6. Three (3) copies of a Site Plan Map of the water treatment plant facility.
7. Three (3) copies of a Flow Process Map of the water treatment facility (extracted
from plans showing build out/installation of treatment assets within plant).
There have been no changes at the Chocowinity/Richland Township WTP since the last
NPDES Permit renewal. We hereby request renewal of NPDES Permit NC0087491.
Please advise as I may provide any additional information for your review.
Sincerely,
aid
Erick Jenning
Beaufort County Water Department
Water Systems Manager
Enclosures

•
EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
NC0087491 Chocowinity/RichlandTownship WTP OMB No.2040-0004
Form U.S.Environmental Protection Agency
1 if/EPA Application for NPDES Permit to Discharge Wastewater
NPDES GENERAL INFORMATION
SECTION 1.ACTIVITIES REQUIRING AN NPDES PERMIT(40 CFR 122.21(f)and(f)(1))
1.1 Applicants Not Required to Submit Form 1
Is the facility a new or existing publicly owned Is the facility a new or existing treatment works
1.1.1 12
treatment works? 1. . treating domestic sewage?
If yes,STOP.Do NOT complete ❑✓ No If yes,STOP.Do NOT 0✓ No
Form 1.Complete Form 2A. complete Form 1.Complete
Form 2S.
1.2 Applicants Required to Submit Form 1
1.2.1 Is the facility a concentrated animal feeding 1.2.2 Is the facility an existing manufacturing,
operation or a concentrated aquatic animal commercial,mining,or silvicultural facility that is
a. production facility? currently discharging process wastewater?
Yes 4 Complete Form 1 ❑� No El Yes 4 Complete Form ❑ No
a and Form 2B. 1 and Form 2C.
1.2.3 Is the facility a new manufacturing,commercial, 1.2.4 Is the facility a new or existing manufacturing,
as
mining,or silvicultural facility that has not yet commercial,mining,or silvicultural facility that
commenced to discharge? discharges only nonprocess wastewater?
❑ Yes 4 Complete Form 1 ❑✓ No ❑ Yes 4 Complete Form ❑✓ No
ce and Form 2D. 1 and Form 2E.
1.2.5 Is the facility a new or existing facility whose
discharge is composed entirely of stormwater
a associated with industrial activity or whose
discharge is composed of both stormwater and
non-stormwater?
❑ Yes 4 Complete Form 1 El No
and Form 2F
unless exempted by
40 CFR
122.26(b)(14)(x)or
b 15 .
SECTION 2.NAME,MAILING ADDRESS,AND LOCATION(40 CFR 122.21(f)(2))
2.1 Facility Name
Chocowinity/Richland Township WTP
2.2 EPA Identification Number
0
0
J
-O
co 2.3 Facility Contact
Name(first and last) Title Phone number
v Erick Jennings Water System Manager [phone]
c Email address
[e-mail]
2.4 Facility Mailing Address
ZStreet or P.O.box
ill West Second Street
City or town State ZIP code
Washington North Carolina 27889
EPA Form 3510-1(revised 3-19) Page 1

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
NC0087491 Chocowinity/RichlandTownship WTP OMB No.2040-0004
fn 2.5 Facility Location
a .- Street,route number,or other specific identifier
Q o 116 Windmill Road
U
c 0 County name County code(if known)
Beaufort
0
E City or town State ZIP code
z m Chocowinity North Carolina 27817
SECTION 3.SIC AND NAICS CODES(40 CFR 122.21(f)(3))
3.1 SIC Code(s) Description(optional)
4941 Water Treatment Plant
a)
a)
0
0
0
U
z 3.2 NAICS Code(s) Description(optional)
� I
Co
U
N
SECTION 4.OPERATOR INFORMATION(40 CFR 122.21(f)(4))
4.1 Name of Operator
Beaufort County Water Department
0 4.2 Is the name you listed in Item 4.1 also the owner?
❑✓ Yes ❑ No
4.3 Operator Status
❑ Public—federal ❑ Public—state ❑✓ Other public(specify)County
o ❑ Private ❑ Other(specify)
4.4 Phone Number of Operator
[phone]
4.5 Operator Address
o Street or P.O. Box
111 West Second Street
o S
• .5 City or town State ZIP code
o o Washington North Carolina 27889
c Email address of operator
[e-mail]
SECTION 5.INDIAN LAND(40 CFR 122.21(f)(5))
-0 5.1 Is the facility located on Indian Land?
•� ❑Yes ❑✓ No
EPA Form 3510-1(revised 3-19) Page 2

EPA Identificabon Number NPDES Permit Number Facility Name Form Approved 03/05/19
NC0087491 Chocowinity/RichlandTownship wTP OMB No.2040-0004
SECTION 6.EXISTING ENVIRONMENTAL PERMITS(40 CFR 122.21(f)(6))
6.1 Existing Environmental Permits(check all that apply and print or type the corresponding permit number for each)
d m NPDES(discharges to surface ❑ RCRA(hazardous wastes) ❑ UIC(underground injection of
water) fluids)
o NC0084808
w a ElPSD(air emissions) ❑ Nonattainment program(CAA) ❑ NESHAPs(CAA)
w ❑ Ocean dumping(MPRSA) ❑ Dredge or fill(CWA Section 404) ❑ Other(specify)
SECTION 7.MAP(40 CFR 122.21(f)(7))
7.1 Have you attached a topographic map containing all required information to this application?(See instructions for
Q. specific requirements.)
❑✓ Yes ❑ No ❑ CAFO—Not Applicable(See requirements in Form 2B.)
SECTION 8.NATURE OF BUSINESS(40 CFR 122.21(f)(8))
8.1 Describe the nature of your business.
Groundwater from wells flow via transmission main to the Water Treatment Plant(WTP).Then it is treated as
follows:Aeration,potassium permangenate,pressure sand filtration,ion exchange softening,and then chloramines
for disinfection.
The filter and softener backwash water is sent to a waste handling tank where calcium thiosulfate is added.The
co water is then pumped to the discharge location into the Pamlico River via a diffuser.
0
o
is
z
SECTION 9.COOLING WATER INTAKE STRUCTURES(40 CFR 122.21(f)(9))
9.1 Does your facility use cooling water?
d ❑ Yes ❑� No 4 SKIP to Item 10.1.
9.2 Identify the source of cooling water.(Note that facilities that use a cooling water intake structure as described at
40 CFR 125,Subparts I and J may have additional application requirements at 40 CFR 122.21(r).Consult with your
o NPDES permitting authority to determine what specific information needs to be submitted and when.)
U �
SECTION 10.VARIANCE REQUESTS(40 CFR 122.21(f)(10))
10.1 Do you intend to request or renew one or more of the variances authorized at 40 CFR 122.21(m)?(Check all that
y apply.Consult with your NPDES permitting authority to determine what information needs to be submitted and
when.)
c ❑ Fundamentally different factors(CWA ❑ Water quality related effluent limitations(CWA Section
Section 301(n)) 302(b)(2))
❑ Non-conventional pollutants(CWA ❑ Thermal discharges(CWA Section 316(a))
Section 301(c)and(g))
❑� Not applicable
EPA Form 3510-1(revised 3-19) Page 3

r
EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
NC0087491 Chocowinity/RichlandTownship WTP OMB No.2040-0004
SECTION 11.CHECKLIST AND CERTIFICATION STATEMENT(40 CFR 122.22(a)and(d))
11.1 In Column 1 below,mark the sections of Form 1 that you have completed and are submitting with your application.
For 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:Activities Requiring an NPDES Permit 0 w/attachments
❑✓ Section 2:Name,Mailing Address,and Location 0 w/attachments
El Section 3:SIC Codes ❑ w/attachments
❑✓ Section 4:Operator Information ❑ w/attachments
❑✓ Section 5: Indian Land ❑ w/attachments
❑✓ Section 6: ExistingEnvironmental Permits ❑ w/attachments
w/topographic
❑✓ Section 7:Map ❑ map ❑ w/additional attachments
in
o 0Section 8:Nature of Business Elw/attachments
.173
❑✓ Section 9:Cooling Water Intake Structures ❑ w/attachments
0 Section 10:Variance Requests ❑ w/attachments
❑✓ Section 11:Checklist and Certification Statement ❑ w/attachments
d 11.2 Certification Statement
U
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 fine and imprisonment for knowing violations.
Name(print or type first and last name) Official title
Erick Jennings Water System Manager
Signature Date signed
aTAX6
OAVY
EPA Form 3510-1(revised 3-19) Page 4

- DocuSign Envelope ID:771 BOD71-BE30-41 BB-9662-7F120D402118
NPDES�Permit
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Beaufort County Water District VI 0 0.5 1 2 mi
Chocowinity/Richland Township WTPi.,! o + ; 2 4 km
116 Windmill Road, Chocowinity, NC 27817
Receiving Stream: Pamlico River Stream Index: 29-(5) North
Drainage Basin:Tar-Pamlico Sub-Basin:03-03-07
Copyright:©2013 National Geographic Society.i-cubed
Latitude:35.47194 Longitude:-76.98166
Stream Class: SB;NSW HUC: 030201040109
USGS Quad:Blounts Bay,NC County:Beaufort
ArcGIS Web AppBuilder
Copyright:©2013 National Geographic Society.i-cubed

WELLS
PROCESS SCHEMATIC
1.800 MGD BEAUFORT COUNTY WATER DISTRICT VI
WATER TREATMENT PLANT 61
1500 GPM GROUNDWATER TREATMENT PLANT
j AERATION IRON REMOVAL AND ION EXCHANGE SOFTENING
1.800 MGD (BASED ON 20 HOURS PER DAY OPERATION)
STORAGE
1.800 MGD DISCHARGE
TO RIVER
PUMPS PUMPS 0.288 MGD
SAMPLING
STATION
KMNO4 1.800 MGD 0.288 MGD
■- FILTERS BACKWASH & RINSE`0.178 MGD _WASTE HOLDING
1.782
MGD BACKWASH, REGENERATION, & RINSE
o 1.436 0.110 MGD
cn MGD
a BRINE-0.003 MGD
SOFTENERS ; BRINEMAKER
1.385 MGD
_J
tl
CHEMICALS 1.731 MGD a
F�
3 STORAGE ZcL
cn
ocn� o
m 1.731 MGD ° 3�
o
YQ Do
PUMPS 1,6
� a
Q �
m
1.731 MGD z
rn
m
STORAGE
1.672 MGD
TREATMENT PLANT
DISTRIBUTION GENERAL USES
0.010 MGD
1.662 MGD
CUSTOMERS
Drawing: W:\DBxx_gen\DB4x_eng\D845_oc\13-0008 Beaufort County Retainer\0100 WTP Process Schematics\BCWD VI — WTP 61 — Process Schemetic.dwg
Layout 20 Hours
Plotted: Soturdcy, December 15, 2012, 8:09:42am

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CHOCOWINITY/RICHLAND TOWNSHIP WTP
NC0087491
SLUDGE MANAGEMENT PLAN
Sludge Management
Sludge settling within the raw water reservoir will be drawn off several times daily and
pumped to the sludge holding tank. The sludge pumps will be controlled by a time clock
which will control both the time and duration of pumping.
Backwash from the iron filters will be piped to the wastewater holding tank where the
iron will settle. Periodically, this sludge will be removed and pumped to the sludge
holding tank. It is anticipated that removing sludge from the wastewater holding tank
will be required two to three times per year.
In the sludge holding tank, the sludge will be thickened by settling and drawing off
supernatant. Supernatant will be returned to the wastewater holding tank for treatment
and discharge.
As sludge builds up in the sludge holding tank, it will be periodically applied to the
sludge drying beds for dewatering. The drying bed filtrate will be collected and pumped
to the wastewater holding tank for treatment and discharge.
After sufficient sludge has been applied to a drying bed and allowed to dewater, the
dewatered sludge will be scraped from the bed and trucked to an approved disposal site.
__F1
Erick Jenn'
Beaufort County Water Department
Water Systems Manager

i
EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
NC0087491 Chocowinity/Richland Township WTP OMB No.2040-0004
Form U.S.Environmental Protection Agency
2C „EPA Application for NPDES Permit to Discharge Wastewater
NPDES EXISTING MANUFACTURING,COMMERCIAL,MINING,AND SILVICULTURE OPERATIONS
SECTI0111.OUTFALL LOCATION(40 CFR 122.21(g)(1))
1.1 Provide information on each of the facility's outfalls in the table below.
c Numbelr Receiving Water Name Latitude Longitude
V
001 Pamlico River 35° 28° 18.98" 76 58' 53.98'
0
SECTION 2.LINE DRAWING(40 CFR 122.21(g)(2))
a, 2.1 Have you attached a line drawing to this application that shows the water flow through your facility with a water
.3 balance?(See instructions for drawing requirements.See Exhibit 2C-1 at end of instructions for example.)
oci
J o ❑� Yes ❑ No
SECTION 3.AVERAGE FLOWS AND TREATMENT(40 CFR 122.21(g)(3))
3.1 For each outfall identified under Item 1.1,provide average flow and treatment information.Add additional sheets if
necessary.
"Outfall Number"001
Operations Contributing to Flow
Operation Average Flow
Water Treatment Plant mgd
c
mgd
R --
mgd
mgd
0 Treatment Units
a, Description Code from Final Disposal of Solid or
(include size,flow rate through each treatment unit, Table 2C•1 Liquid Wastes Other Than
retention time,etc.) by Discharge
Dechlorination 2-E
Sludge Treatment and Disposal 5-P Land Apllication
EPA Form 3510-2C(Revised 3-19) Page 1

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
NC0087491 Chocowinity/Richland Township WTP OMB No.2040-0004
3.1 **Outfall Number**
cont. Operations Contributing to Flow
Operation Average Flow
mgd
mgd
mgd
mgd
Treatment Units
Description Code from Final Disposal of Solid or
(include size,flow rate through each treatment unit, Table 2C 1 Liquid Wastes Other Than
retention time,etc.) by Discharge
-0
C
0
U
C
E
is
a�
F—
**Duffel!Number**
Operations Contributing to Flow
Operation Average Flow
u
a, mgd
a' mgd
mgd
mgd
Description Code from Final Disposal of Solid or
(include size,flow rate through each treatment unit, Table 2C 1 Liquid Wastes Other Than
retention time,etc.) by Discharge
•
3.2 Are you applying for an NPDES permit to operate a privately owned treatment works?
E ❑ Yes ❑� No 4 SKIP to Section 4.
3.3 Have you attached a list that identifies each user of the treatment works?
❑ Yes ❑ No
EPA Form 3510-2C(Revised 3-19) Page 2

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
NC0087491 Chocowinity/Richland Township WTP OMB No.2040-0004
SECTION 4.INT RMITTENT FLOWS(40 CFR 122.21(g)(4))
4.1 Except for storm runoff,leaks,or spills,are any discharges described in Sections 1 and 3 intermittent or seasonal?
❑✓ Yes 0 No 4 SKIP to Section 5.
4.2 Provide information on intermittent or seasonal flows for each applicable outfall.Attach additional pages,if necessary.
Outfall Operation Frequency I Flow Rate
Number (list) Average Average Long-Term Maximum Duration
DayslWeek Months/Year Average Daily
Intermittent 6/7 days/week 12 months/year .032 mgd .195 mgd .10 days
I
0 001 days/week months/year mgd mgd days
Li
days/week months/year mgd mgd days
CU
a, days/week months/year mgd mgd days
c 1
days/week months/year mgd mgd days
days/week months/year mgd mgd days
days/week months/year mgd mgd days
days/week months/year mgd mgd days
days/week months/year mgd mgd days
SECTION 5.PRODUCTION(40 CFR 122.21(g)(5))
5.1 Do any effluent limitation guidelines(ELGs)promulgated by EPA under Section 304 of the CWA apply to your facility?
❑ Yes ❑✓ No 4 SKIP to Section 6.
v, 5.2 Provide the following information on applicable ELGs.
w ELG Category ELG Subcategory Regulatory Citation
0
47,
a_
Q
Q 1
5.3 Are any of the applicable ELGs expressed in terms of production(or other measure of operation)?
❑ Yes 0 No 4 SKIP to Section 6.
0
;a 5.4 Provide an actual measure of daily production expressed in terms and units of applicable ELGs.
J Outfall Operation,Product,or Material Quantity per Day Unit of
'0 Number Measure
N
co
co
C
0
-
-.
0
7
O
0
EPA Form 3510-2C(Revised 3-19) Page 3

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
NC0087491 Chocowinity/Richland Township WTP OMB No.2040-0004
SECTION 6.IMPROVEMENTS(40 CFR 122.21(g)(6))
6.1 Are you presently required by any federal,state,or local authority to meet an implementation schedule for constructing,
upgrading,or operating wastewater treatment equipment or practices or any other environmental programs that could
affect the discharges described in this application?
❑ Yes ❑✓ No 4 SKIP to Item 6.3.
6.2 Briefly identify each applicable project in the table below.
Affected Final Compliance Dates
Brief Identification and Description of Outfalls Source(s)of
o Project (list outfall Discharge Required Projected
number)
E
R
N
f6
6.3 Have you attached sheets describing any additional water pollution control programs(or other environmental projects
that may affect your discharges)that you now have underway or planned?(optional item)
❑ Yes ✓❑ No ❑ Not applicable
SECTION 7.EFFLUENT AND INTAKE CHARACTERISTICS(40 CFR 122.21(g)(7))
See the instructions to determine the pollutants and parameters you are required to monitor and,in turn,the tables you must
complete. Not all applicants need to complete each table.
Table A.Conventional and Non-Conventional Pollutants
7.1 Are you requesting a waiver from your NPDES permitting authority for one or more of the Table A pollutants for any of
your outfalls?
❑ Yes ❑✓ No 4 SKIP to Item 7.3.
7.2 If yes,indicate the applicable outfalls below.Attach waiver request and other required information to the application.
Outfall Number Outfall Number Outfall Number
O 7.3 Have you completed monitoring for all Table A pollutants at each of your outfalls for which a waiver has not been
requested and attached the results to this application package?
No;a waiver has been requested from my NPDES
❑✓ Yes ❑ permitting authority for all pollutants at all outfalls.
Table B.Toxic Metals,Cyanide,Total Phenols,and Organic Toxic Pollutants
41)
7.4 Do any of the facility's processes that contribute wastewater fall into one or more of the primary industry categories
listed in Exhibit 2C-3?(See end of instructions for exhibit.)
❑ Yes ❑ No 4 SKIP to Item 7.8.
• 7.5 Have you checked"Testing Required"for all toxic metals,cyanide,and total phenols in Section 1 of Table B?
❑ Yes ❑ No
7.6 List the applicable primary industry categories and check the boxes indicating the required GC/MS fraction(s)identified
in Exhibit 2C-3.
Primary Industry Category Required GCIMS Fraction(s)
(Check applicable boxes.)
❑Volatile ❑Acid ❑Base/Neutral ❑Pesticide
❑Volatile 0 Acid 0 Base/Neutral ❑Pesticide
❑Volatile 0 Acid ❑Base/Neutral 0 Pesticide
EPA Form 3510-2C(Revised 3-19) Page 4

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
NC0087491 Chocowinity/Richland Township WTP OMB No.2040-0004
7.7 Have you checked"Testing Required"for all required pollutants in Sections 2 through 5 of Table B for each of the
GC/MS fractions checked in Item 7.6?
❑ Yes ❑ No
7.8 Have you checked"Believed Present"or"Believed Absent"for all pollutants listed in Sections 1 through 5 of Table B
where testing is not required?
❑ Yes ❑ No
7.9 Have you provided(1)quantitative data for those Section 1,Table B,pollutants for which you have indicated testing is
required or(2)quantitative data or other required information for those Section 1,Table B,pollutants that you have
indicated are"Believed Present"in your discharge?
❑ Yes ❑ No
7.10 Does the applicant qualify for a small business exemption under the criteria specified in the instructions?
❑
Yes 4 Note that you qualify at the top of Table B,
N❑ o
-a then SKIP to Item 7.12.
7.11 Have you provided(1)quantitative data for those Sections 2 through 5,Table B,pollutants for which you have
c determined testing is required or(2)quantitative data or an explanation for those Sections 2 through 5,Table B,
c.) pollutants you have indicated are"Believed Present"in your discharge?
❑ Yes ❑ No
Table C.Certain Conventional and Non-Conventional Pollutants
El 7.12 Have you indicated whether pollutants are"Believed Present"or"Believed Absent"for all pollutants listed on Table C
for all outfalls?
❑ Yes ❑ No
7.13 Have you completed Table C by providing(1)quantitative data for those pollutants that are limited either directly or
c indirectly in an ELG and/or(2)quantitative data or an explanation for those pollutants for which you have indicated
"Believed Present"?
d ❑ Yes 0 No
w Table D.Certain Hazardous Substances and Asbestos
7.14 Have you indicated whether pollutants are"Believed Present"or"Believed Absent"for all pollutants listed in Table D for
all outfalls?
❑ Yes ❑ No
7.15 Have you completed Table D by(1)describing the reasons the applicable pollutants are expected to be discharged
and(2)by providing quantitative data,if available?
❑ Yes ❑ No
Table E.2,3,7,8-Tetrachlorodibenzo-p-Dioxin(2,3,7,8-TCDD)
7.16 Does the facility use or manufacture one or more of the 2,3,7,8-TCDD congeners listed in the instructions,or do you
know or have reason to believe that TCDD is or may be present in the effluent?
❑ Yes 4 Complete Table E. ❑ No 4 SKIP to Section 8.
7.17 Have you completed Table E by reporting qualitative data for TCDD?
❑ Yes ❑ No
SECTION 8.USED OR MANUFACTURED TOXICS(40 CFR 122.21(g)(9))
8.1 Is any pollutant listed in Table B a substance or a component of a substance used or manufactured at your facility as
an intermediate or final product or byproduct?
❑ Yes ❑✓ No 4 SKIP to Section 9.
8.2 List the pollutants below.
P2. 5. 8.
3. 6. 9.
EPA Form 3510-2C(Revised 3-19) Page 5

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
NC0087491 Chocowinity/Richland Township WTP OMB No.2040-0004
SECTION 9.BIOLOGICAL TOXICITY TESTS(40 CFR 122.21(g)(11))
9.1 Do you have any knowledge or reason to believe that any biological test for acute or chronic toxicity has been made
within the last three years on(1)any of your discharges or(2)on a receiving water in relation to your discharge?
�, ❑✓ Yes ❑ No- SKIP to Section 10.
9.2 Identify the tests and their Durposes below.
Submitted to NPDES
Test(s) Purpose of Test(s) Date Submitted
Permitting Authority?
0
WET Chronic test Permit Required(March,
June,Sept.,December) ✓❑ Yes ❑ No
0
❑ Yes ❑ No
❑ Yes ❑ No
SECTION 10.CONTRACT ANALYSES(40 CFR 122.21(g)(12))
10.1 Were any of the analyses reported in Section 7 performed by a contract laboratory or consulting firm?
❑✓ Yes ❑ No 4 SKIP to Section 11.
10.2 Provide information for each contract laboratory or consulting firm below.
Laboratory Number 1 Laboratory Number 2 Laboratory Number 3
Name of laboratory/firm Waypoint Analytical Environmental Testing
Solutions,Inc.
N
Laboratory address 114 Oakmont Drive P.O.Box 7565
Greenville,NC 27858 Asheville,NC 28802
U
Phone number
[phone] [phone]
Pollutant(s)analyzed All parametrs except for WET WET Testing
Testing.
SECTION 11.ADDITIONAL INFORMATION(40 CFR 122.21(g)(13))
11.1 Has the NPDES permitting authority requested additional information?
❑ Yes ❑� No. SKIP to Section 12.
0
11.2 List the information requested and attach it to this application.
`o
1. 4.
,71
'13 2. 5.
3. 6.
EPA Form 3510-2C(Revised 3-19) Page 6

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
NC0087491 Chocowinity/Richland Township WTP OMB No.2040-0004
SECTION 12.CHECKLIST AND CERTIFICATION STATEMENT(40 CFR 122.22(a)and(d))
12.1 In Column 1 below,mark the sections of Form 2C that you have completed and are submitting with your application.
For 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 complete all sections or provide attachments.
Column 1 Column 2
❑✓ Section 1:Outfall Location ❑ wl attachments
❑✓ Section 2:Line Drawing ❑ wl line drawing ❑ wl additional attachments
Section 3:Average Flows and w/list of each user of
❑✓ Treatment El w/attachments 0 privately owned treatment
works
❑✓ Section 4: Intermittent Flows ❑ wl attachments
❑✓ Section 5: Production ❑ w/attachments
w/optional additional
❑✓ Section 6: Improvements ❑ wl attachments ❑ sheets describing any
additional pollution control
plans
❑
w/request for a waiver and ❑ w/explanation for identical
supporting information outfalls
w/small business exemption❑ request wl other attachments❑
❑ Section 7:Effluent and Intake ❑ w/Table A 0 w/Table B
Characteristics
0
� ❑ w/Table C ❑ w/Table D
ate, ❑ w/Table E ❑ w/analytical results as an
c� attachment
R ❑ Section 8:Used or Manufactured ❑ w/attachments
Toxics
❑ Section 9:Biological Toxicity ❑ w/attachments
Tests
U
❑✓ Section 10:Contract Analyses ❑ w/attachments
❑✓ Section 11:Additional Information ❑ wl attachments
ui Section 12:Checklist and ❑ w/attachments
Certification Statement
12.2 Certification Statement
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 fine and imprisonment for knowing violations.
Name(print or type first and last name) Official title
Erick Jennings Water System Manager
Signature Date signed
5/0ZG/cZy
EPA Form 3510-2C(Revised 3-19) Page 7

This page intentionally left blank.

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19 .
NC0087491 ' Chocowinity/Richland Township 001 OMB No.2040-0004
TABLE A.CONVENTIONAL AND NON CONVENTIONAL POLLUTANTS(40 CFR 122.21(g)(7)(iii))1
Effluent Intake
Waiver (Optional)
Pollutant Requested Units Maximum Maximum Long-Term
(if applicable
) (specify) Daily Monthly Average Daily Number of Long-Term Number of
Discharge Discharge Discharge Analyses Average Value Analyses
(required) (if available) (if available)
❑ Check here if you have applied to your NPDES permitting authority for a waiver for all of the pollutants listed on this table for the noted outfall.
Biochemical oxygen demand Concentration
1' El(BOD5) Mass
Chemical oxygen demand Concentration
2' El(COD) Mass
Concentration
3. Total organic carbon(TOC) 0
Mass
Concentration mg/I 34 34 7.34 95
4. Total suspended solids(TSS) ❑
Mass
Concentration mg/I 0.94 0.94 0.17 48
5. Ammonia(as N) ❑
Mass
6. Flow ❑ Rate mgd 0.195 0.195 0.032 1431
Temperature(winter) ❑ °C °C
7.
Temperature(summer) 0 °C °C
pH(minimum) 0 Standard units S.U. 8.4 8.4 7.9 96
8.
pH(maximum) 0 Standard units S.U. 8.4 8.4 7.9 96
1 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 3510-2C(Revised 3-19) Page 9

This page intentionally left blank.

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
NC0087491 Chocowinity/Richland Township 001 OMB No.2040-0004
TABLE B.TOXIC METALS,CYANIDE,TOTAL PHENOLS,AND ORGANIC TOXIC POLLUTANTS(40 CFR 122.21(g)(7)(v))1 -
Presence or Absence
(check one) Effluent Intake
(optional)
Pollutant/Parameter Testing Units Long-Term
(and CAS Number,if available) Required Believed Believed (specify) Maximum Maximum Average Number Long- Number
Present Absent Daily Monthly Daily of Term of
D(reghedge D(ifavalablle) Diischargescharge Analyses AValuee Analyses
(if available)
El Check here if you qualify as a small business per the instructions to Form 2C and,therefore,do not need to submit quantitative data for any of the organic toxic pollutants in Sections
2 through 5 of this table.Note,however,that you must still indicate in the appropriate column of this table if you believe any of the pollutants listed are present in your discharge.
Section 1.Toxic Metals,Cyanide,and Total Phenols
Antimony,total Concentration
1.1 (7440-36-0) Mass
Arsenic,total Concentration
1.2 (7440-38-2) Mass
Beryllium,total � Concentration
1.3 (7440-41-7) Mass
Cadmium,total � Concentration
1.4 (7440-43-9) Mass
Chromium,total Concentration
1.5 El 0 El
(7440-47-3) Mass _
Copper,total Concentration
1.6 (7440-50-8) Mass
Lead,total Concentration
1.7 El 1=1 El
(7439-92-1) Mass
Mercury,total Concentration
1.8 (7439-97-6) © Mass
Nickel,total Concentration
1.9 (7440-02-0) El
Mass
1.10 Selenium,total El 0 Concentration
(7782-49-2) Mass
Silver,total Concentration
1.11 0 0 0
(7440-22-4) Mass
EPA Form 3510-2C(Revised 3-19) Page 11

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
NC0087491 Chocowinity/Richland Township 001 OMB No.2040-0004
TABLE B.TOXIC METALS,CYANIDE,TOTAL PHENOLS,AND ORGANIC TOXIC POLLUTANTS(40 CFR 122.21(g)(7)(v))1
Presence or Absence
(check one) Effluent Intake
(optional)
Pollutant/Parameter Testing Units Long-Term
(and CAS Number,if available) Required Believed Believed (specify) Maximum Maximum Average Number Long- Number
Present Absent Daily Monthly Daily of Term of
Discharge Discharge
available) Discharge Analyses AValuee Analyses
(required) ( (if available)
Thallium,total Concentration
1.12 0 El
(7440-28-0) Mass
Zinc,total Concentration
1.13 (7440 66 6) ❑
Mass
1.14 Cyanide,total 0 Concentration
(57-12-5) Mass _
1.15 Phenols,total 0 Concentration
Mass
Section 2.Organic Toxic Pollutants(GC/MS Fraction—Volatile Compounds)
Acrolein Concentration
2.1 (107-02-8) Mass
2.2 Acrylonitrile ❑ 0 Concentration
(107-13-1) Mass
2.3 Benzene ci Concentration
0 El
(71-43-2) Mass
2 4 Bromoform El 0
0 Concentration
(75-25-2) Mass
2.5 Carbon tetrachloride ❑ 0 Concentration
(56-23-5) Mass
Chlorobenzene 1:1Concentration
2.6 0 0
(108-90-7) Mass
Chlorodibromomethane ✓ Concentration
2.7 0 El
(124-48-1) Mass
2.8 Chloroethane 1=1 Concentration
0 0
(75-00-3) Mass
EPA Form 3510-2C(Revised 3-19) Page 12

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
NC0087491 Chocowinity/Richland Township 001 OMB No.2040-0004
TABLE B.TOXIC METALS,CYANIDE,TOTAL PHENOLS,AND ORGANIC TOXIC POLLUTANTS(40 CFR 122.21(g)(7)(v))l
Presence or Absence Intake
(check one) Effluent (optional)
Pollutant/Parameter Testing Units Long-Term
(and CAS Number,if available) Required Believed Believed (specify) Maximum Maximum Average Number Long- Number
Present Absent Daily Monthly Dail of Term of
D(required)h ge Discharge
f available) Discharge Analyses AValuee Analyses
(if available)
2-chloroethylvinyl ether Concentration
2'9 IEI ID
(110-75-8) Mass
Concentration _
2.10 Chloroform(67-66-3) 0 Mass
2.11 Dichlorobromomethane El El 0 Concentration
(75-27-4) Mass
212 1,1-dichloroethane � Concentration
(75-34-3) Mass
2.13 1,2-dichloroethane 0 0 Concentration
(107-06-2) Mass
2.14 1,1-dichloroethylene IEI 0 Concentration
IEI
(75-35-4) Mass
1,2-dichloropropane � Concentration
2.15 (78-87-5) Mass
2.16 1,3-dichloropropylene IEI lEl 0 Concentration
(542-75-6) Mass
2.17 Ethylbenzene 0 Concentration
(100-41-4) Mass
2.18 Methyl bromide IEI 0 Concentration
(74-83-9) Mass
2.19 Methyl chloride 0 Concentration
0 El
(74-87-3) Mass
2.20 Methylene chloride lEl Q Concentration
El
(75-09-2) Mass
2.21 1 1,2 2-tetrachloroethane 0 0 0 Concentration
(79-34-5) Mass
EPA Form 3510-2C(Revised 3-19) Page 13

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
NC0087491 Chocowinity/Richland Township 001 OMB No.2040-0004
TABLE B.TOXIC METALS,CYANIDE,TOTAL PHENOLS,AND ORGANIC TOXIC POLLUTANTS(40 CFR 122.21(g)(7)(v))1
Presence or Absence Intake
(check one) Effluent (optional)
Pollutant/Parameter Testing Units Long-Term
(and CAS Number,if available) Required Believed Believed (specify) Maximum Maximum Average Number Long- Number
Present Absent Daily Monthly Term
Daily
D(reghred)arge D(ifavalablle) Diharge scharge Analyses AValuee Analyses
ui (if available)
Tetrachloroethylene ❑ ❑ Concentration
2.22 (127-18-4) Mass
Toluene Concentration
2.23 (108-88-3) 0 0 0 Mass
2.24 1,2-trans-dichloroethylene ❑ 0 0Concentration
(156-60-5) Mass
1,1,1-trichioroethane Concentration
2.25 (71-55-6) Mass
1,1,2-trichioroethane Concentration
2.26 (79-00-5) Mass
2.27 Trichloroethylene ❑ ❑ Concentration
(79-01-6) Mass
2.28 Vinyl chloride Concentration
(75-01-4) Mass
Section 3.Organic Toxic Pollutants(GCIMS Fraction—Acid Compounds)
2-chlorophenol Concentration
3.1 0 0 0
(95-57-8) Mass
2,4-dichlorophenol Concentration
3.2 0 0
(120-83-2) Mass
3.3 2,4-dimethylphenol ❑ Concentration
(105-67-9) Mass
3.4 4 6-dinitro-o-cresol Concentration
(534-52-1) Mass
3.5 2,4-dinitrophenol 0 Concentration
(51-28-5) Mass
EPA Form 3510-2C(Revised 3-19) Page 14

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
NC0087491 Chocowinity/Richland Township 001 OMB No.2040-0004
TABLE B.TOXIC METALS,CYANIDE,TOTAL PHENOLS,AND ORGANIC TOXIC POLLUTANTS(40 CFR 122.21(g)(7)(v))'
Presence or Absence
(check one) Effluent Intake
(optional)
Pollutant/Parameter Testing Units Long-Term
(and CAS Number,if available) Required Believed Believed (specify) Maximum Maximum Average Number Long- Number
Present Absent Daily Monthly Term
Daily
Discharge Discharge Discharge An lyses Average Analyses
(required) (if available) (if available)
Value
3.6 2-nitrophenol � Concentration
(88-75-5) Mass
4-nitrophenol Concentration
3.7 (100-02-7) � 1:1 El
Mass
3.8 p-chloro-m-cresol 1:1 Concentration
(59-50-7) Mass
3.9 Pentachlorophenol 0 0 Concentration
(87-86-5) Mass
Phenol Concentration
3.10 (108-95-2) Mass
3.11 2,4,6-trichlorophenol D Concentration
(88-05-2) Mass
Section 4.Organic Toxic Pollutants(GC/MS Fraction—Base/Neutral Compounds)
Acenaphthene � Concentration
4.1 1:1 El
(83-32-9) Mass
4.2 Acenaphthylene 0 Concentration
0 El
(208-96-8) Mass
4.3 Anthracene El
ID El(120-12-7) Mass
Benzidine Concentration
4.4 (92 87 5) Mass
4.5 Benzo(a)anthracene Concentration
(56-55-3) Mass
4.6 Benzo(a)pyrene ElConcentration
(50-32-8) Mass
EPA Form 3510-2C(Revised 3-19) Page 15

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
NC0087491 Chocowinity/Richland Township 001 OMB No.2040-0004
TABLE B.TOXIC METALS,CYANIDE,TOTAL PHENOLS,AND ORGANIC TOXIC POLLUTANTS(40 CFR 122.21(g)(7)(v))1
Presence or Absence
(check one) Effluent Intake
(optional)
Pollutant/Parameter Testing Units Long-Term
(and CAS Number,if available) Required Believed Believed (specify) Maximum Maximum Average Number Long- Number
Present Absent Daily Monthly Daily of Term of
Discharge Discharge Discharge Analyses Average Analyses
(required) (if available) Value
(if available)
4.7 3,4-benzofluoranthene ElConcentration
1:1 El
(205-99-2) Mass
Benzo(ghi)perylene Concentration
4.8 (191-24-2) © Mass
Benzo(k)fluoranthene ✓ Concentration
4.9 (207-08-9) Mass
4.10 Bis(2-chloroethoxy)methane © Concentration
0 El
(111-91-1) Mass
4.11 Bis(2-chloroethyl)ether El ❑ Concentration
(111-44-4) Mass
4.12 Bis(2-chloroisopropyl)ether 0Concentration
El El(102-80-1) Mass
4.13 Bis(2-ethyihexyl)phthalate ❑ Concentration
(117-81-7) Mass
4.14 4-bromophenyl phenyl ether ElConcentration
El
(101-55-3) Mass _
4.15 Butyl benzyl phthalate 0Concentration
(85-68-7) Mass
4.16 2-chloronaphthalene Concentration
(91-58-7) Mass
4-chlorophenyl phenyl ether Concentration
4.17 (7005 72 3) ❑ ❑
Mass
4.18 Chrysene Concentration
(218-01-9) Mass
4.1E Dibenzo(a,h)anthracene ❑ Concentration
(53-70-3) Mass
EPA Form 3510-2C(Revised 3-19) Page 16

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
NC0087491 Chocowinity/Richland Township 001 OMB No.2040-0004
TABLE B.TOXIC METALS,CYANIDE,TOTAL PHENOLS,AND ORGANIC TOXIC POLLUTANTS(40 CFR 122.21(g)(7)(v))1
Presence or Absence Intake
(check one) Effluent (optional)
Pollutant/Parameter Testing Units Long-Term
(and CAS Number,if available) Required Believed Believed (specify) Maximum Maximum Average Number Long- Number
Present Absent Daily Monthly Dailischargey of Termof
Discharge (ifavalablle) Discharge Analyses Value Analyses
(required) ( (if available)
4.20 1,2-dichlorobenzene Concentration
(95-50-1) Mass
4.21 13-dichlorobenzene Concentration
(541-73-1) Mass
1,4-dichlorobenzene Concentration
4.22 (106-46-7) 0 El E✓
Mass
4.23 3,3-dichlorobenzidine Concentration
0 0 0
(91-94-1) Mass
4.24 Diethyl phthalate © Concentration
0 0(84-66-2) Mass
4.25 Dimethyl phthalate ❑ Concentration
(131-11-3) Mass
4.26 Di-n-butyl phthalate ❑ © Concentration
(84-74-2) Mass
4.27 2,4-dinitrotoluene Concentration
0 0 0
(121-14-2) Mass
2,6-dinitrotoluene Concentration
4.28 (606-20-2) El 0 0 Mass
Di-n-octyl phthalate Concentration
4.29 (117-84-0) Mass
1,2-Diphenylhydrazine Concentration
4.30 (as azobenzene)(122-66-7) Mass
4.31 Fluoranthene Concentration
(206-44-0) Mass
4.32 Fluorene Concentration
(86-73-7) Mass
EPA Form 3510-2C(Revised 3-19) Page 17

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
NC0087491 Chocowinity/Richland Township 001 OMB No.2040-0004
TABLE B.TOXIC METALS,CYANIDE,TOTAL PHENOLS,AND ORGANIC TOXIC POLLUTANTS(40 CFR 122.21(g)(7)(v))1
Presence or Absence
(check one) Effluent Intake
(optional)
Pollutant/Parameter Testing Units Long-Term
(and CAS Number,if available) Required Believed Believed (specify) Maximum Maximum Average Number Long- Number
Present Absent Daily Monthly Term
Daily
Discharge Discharge Discharge Analyses Average Analyses
(required) (if available) Value
(if available)
Hexachlorobenzene ❑ ❑ ❑ Concentration
4.33 (118-74-1) Mass
4.34 Hexachlorobutadiene ❑ ❑ 0Concentration
(87-68-3) Mass
4.35 Hexachlorocyclopentadiene 0Concentration
(77-47-4) Mass
Hexachloroethane � ❑ Concentration
4.36 (67-72-1) Mass
Indeno(1,2,3-cd)pyrene 0 Concentration
4.37 El El
(193-39-5) Mass
4.38 Isophorone Concentration
El 0 El
(78-59-1) Mass
Naphthalene ❑ Concentration
4.39 (91-20-3) Mass
Nitrobenzene Concentration
4.40 El IEI El
(98-95-3) Mass
N-nitrosodimethylamine ElConcentration
4.41 IEI El
(62 75 9) Mass
N-nitrosodi-n-propylamine ❑ ❑ Concentration
4.42 (621-64-7) Mass
4.43 N-nitrosodiphenylamine 0Concentration
(86-30-6) Mass
4.44 Phenanthrene El El0Concentration
(85-01-8) Mass
Pyrene Concentration
4.45 ❑ 0 ❑✓
(129 00 0)
Mass
EPA Form 3510-2C(Revised 3-19) Page 18

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
NC0087491 Chocowinity/Richland Township 001 OMB No.2040-0004
TABLE B.TOXIC METALS,CYANIDE,TOTAL PHENOLS,AND ORGANIC TOXIC POLLUTANTS(40 CFR 122.21(g)(7)(v))1
Presence or Absence Intake
(check one) Effluent (optional)
Pollutant/Parameter Testing Units Long-Term
(and CAS Number,if available) Required Believed Believed (specify) Maximum Maximum Average Number Long- Number
Present Absent Daily Monthly Daily of Term of
ech ed a (iflee Discharge Analyses AverageValue Analyses
(required)DischargeQ ) ( available) (if available)
4.46 1,2,4-trichlorobenzene ❑ ❑ ❑ Concentration
(120-82-1) Mass
Section 5.Organic Toxic Pollutants(GC/MS Fraction—Pesticides)
Aldrin Concentration
5.1 (309-00-2) 0 0 0 Mass
a-BHC Concentration
5.2 (319-84-6) ❑ Mass
Q-BHC Concentration
5.3 (319-85-7) ❑ ❑ 0
Mass
y-BHC Concentration
5.4 (58 89 9) 0 0 0 Mass
6-BHC Concentration
5.5 (319-86-8) ❑ ❑ ❑ Mass
5.6 Chlordane 0
0
0 Concentration
(57-74-9) Mass
5.7 '4,4'-DDT 0
0
0 Concentration
(50-29-3) Mass
5.8 4,4'-DDE ❑ ❑ ❑ Concentration
(72-55-9) Mass
5.9 4,4'-DDD ❑ ❑ ❑ Concentration
(72-54-8) Mass
Dieldrin ✓ Concentration
5.10 (60-57-1) 0 Mass
0
5.11 a-endosulfan a Concentration
(115-29-7) Mass
EPA Form 3510-2C(Revised 3-19) Page 19

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
NC0087491 Chocowinity/Richland Township 001 OMB No.2040-0004
TABLE B.TOXIC METALS,CYANIDE,TOTAL PHENOLS,AND ORGANIC TOXIC POLLUTANTS(40 CFR 122.21(g)(7)(v)p
Presence or Absence
(check one) Effluent Intake
(optional)
Pollutant/Parameter Testing Units Long-Term
(and CAS Number,if available) Required Believed Believed (specify) Maximum Maximum Average Number Long- Number
Present Absent Daily Monthly Daily of Term of
Discharge
Discharge Average f availablle) Discharge Analyses Value Analyses
(if available)
5.12 13-endosulfan ❑ 0
0 Concentration
(115-29-7) Mass
Endosulfan sulfate Concentration
5.13 (1031-07-8) ❑ 0 0 Mass
Endrin Concentration
5.14 (72 20 8) El ❑ El
Endrin aldehyde Concentration
5.15 (7421-93-4) ID ❑ © Mass
5.16 Heptachlor ❑ 0
0 Concentration
(76-44-8) Mass
Heptachlor epoxide Concentration
5.17 (1024-57-3) 0 0 0 Mass
PCB-1242 Concentration
5.18 (53469-21-9) ❑ 0 0 Mass
PCB-1254 Concentration
5.19 (11097-69-1) ❑ ❑ 0 Mass
PCB-1221 Concentration
5.20 (11104-28-2) 0 ❑ El
Mass
PCB-1232 Concentration
5.21 (11141-16-5) ❑ ❑ 0 Mass
PCB-1248 Concentration
5.22 (12672-29-6) ❑ 0 0 Mass
PCB-1260 Concentration
5.23 (11096-82-5) ❑ ❑ E Mass
PCB-1016 Concentration
5.24 (12674-11-2) 0 0 0 Mass
EPA Form 3510-2C(Revised 3-19) Page 20

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
NC0087491 Chocowinity/Richland Township 001 OMB No.2040-0004
TABLE B.TOXIC METALS,CYANIDE,TOTAL PHENOLS,AND ORGANIC TOXIC POLLUTANTS(40 CFR 122.21(g)(7)(v))1
Presence or Absence
(check one) Effluent Intake
(optional)
Pollutant/Parameter Testing Units Long-Term
(and CAS Number,if available) Required Believed Believed (specify) Maximum Maximum Average Number Long- Number
Present Absent Daily Monthly Daily of Term of
D(req fireischargd a Df available)ischarge
Discharge Analyses AValuee Analyses
(if available)
Toxaphene Concentration
5.25 (8001-35-2) 0 0 0 Mass
1 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 3510-2C(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
OMB No.2040-0004
NC0087491 Chocowinity/Richland Township 001
TABLE C.CERTAIN CONVENTIONAL AND NON CONVENTIONAL POLLUTANTS(40 CFR 122.21(g)(7)(vi))1
Presence or Absence Intake
(check one) Effluent (Optional)
Pollutant Units Maximum Long-Term
Believed Believed (specify) Maximum Daily Long-Term
Present Absent Discharge Monthly Average Daily Number of Average Number of
Discharge Discharge Analyses Analyses
(required) Value
(if available) (if available)
❑ Check here if you believe all pollutants on Table C to be present in your discharge from the noted outfall.You need not complete the"Presence or Absence"column of Table C for
each pollutant.
❑ Check here if you believe all pollutants on Table C to be absent in your discharge from the noted outfall.You need not complete the`Presence or Absence"column of Table C for
each pollutant.
1 Bromide ❑ 0 Concentration
(24959-67-9) Mass
Chlorine,total Concentration ug/I 44 44 14.49 96
2. residual 0 0 Mass
3. Color 0 0 Concentration
Mass
4. Fecal coliform 0 0
Concentration
Mass
5 Fluoride ❑ ❑ Concentration
(16984-48-8)
Mass
Concentration mg/I .13 .13 .06 16
6 Nitrate-nitrite 0 0
Mass
Nitrogen,total Concentration mg/I 21.81 21.81 1.84 16
7' ❑
organic(as N) Mass
Concentration
8. Oil and grease 0 0 Mass
9 Phosphorus(as)
0 0 Concentration mg/I 0.67 0.67 0.20 16
P),total(7723-14-0) Mass
10. Sulfate(as SO4) ❑ 0 Concentration
(14808-79-8) Mass
Concentration
11. Sulfide(as S) 0 ✓❑
Mass
EPA Form 3510-2C(Revised 3-19) Page 23

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
NC0087491 Chocowinity/Richland Township 001 OMB No.2040-0004
TABLE C.CERTAIN CONVENTIONAL AND NON CONVENTIONAL POLLUTANTS(40 CFR 122.21(g)(7)(vi))1
Presence or Absence
(check one) Effluent Intake
(Optional)
Pollutant Units Maximum Long-Term
Believed Believed (specify) Maximum Daily Long-Term
Present Absent Discharge Monthly Average Daily Number of Average Number of
Discharge Discharge Analyses Analyses
(required) Value
(if available) (if available)
12. Sulfite(as S03) ❑ ❑ Concentration
(1426545-3) Mass
Concentration
13. Surfactants 0 0 Mass
14. Aluminum,total ❑ O Concentration
(7429-90-5) Mass '
15. Barium,total ❑ 0 Concentration
(7440-39-3) Mass
16. Boron,total ❑ ❑✓ Concentration
(7440-42-8) Mass
Cobalt,total Concentration
17. (7440-48-4) 0 0
Mass
18 Iron,total ❑ 0 Concentration
(7439-89-6) Mass
19 Magnesium,total 0 ❑ Concentration ,
(7439-95-0) Mass
Molybdenum, Concentration
20. total 0 ❑✓ Mass
(7439-98-7)
21. Manganese,total 0 O Concentration
•
(7439-96-5) Mass
22. Tin,total Concentration
0
(7440-31-5) ✓
Mass
Titanium,total Concentration
23. (7440 32 6) 0 0
Mass
EPA Form 3510-2C(Revised 3-19) Page 24

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
NC0087491 Chocowinity/Richland Township 001 OMB No.2040-0004
TABLE C.CERTAIN CONVENTIONAL AND NON CONVENTIONAL POLLUTANTS(40 CFR 122.21(g)(7)(vi))l
Presence or Absence Intake
(check one) Effluent (Optional)
Pollutant Units Maximum Long-Term
Believed Believed (specify) Maximum Daily Long-Term
Present Absent Discharge Monthly Average Daily Number of Average Number of
Discharge Discharge Analyses Analyses
(required) Value
(if available) (if available)
24. Radioactivity
Concentration
Alpha,total ❑ ❑✓
Mass
Concentration
Beta,total ❑ ❑✓
Mass
Concentration
Radium,total ❑ ❑✓
Mass
Concentration
Radium 226,total ❑ ❑✓ Mass
1 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 3510-2C(Revised 3-19) Page 25