NC0068543_MV-2016-0003_20160126

PAT MCCRORY
DONALD R. VAN DER VAART
•
S. JAY ZIMMERMAN
Water Resources
ENVIRONMENTAL QUALITY
January 26, 2016
CERTIFIED MAIL #7013 1710 0002 1922 2989
RETURN RECEIPT REQUESTED
RECEIVED!NCDE
Reema Owens, CEO GIIDWR
Raintree Healthcare of Wilkesboro LLC FEB 0 2 2.016
2015 Ayrsley Town Blvd
Charlotte, NC 28273 Water Quality
Permitting Section
SUBJECT: Notice of Violation and Assessment of Civil Penalty
for Violations of North Carolina General Statute(G.S.) 143-215.1(a)(6)
and NPDES Permit NC0068543
Raintree Healthcare of Wilkesboro LLC
Wilkes County Adult Care WWTP
Case No. MV-2016-0003
Wilkes County
Dear Ms. Owens:
This letter transmits a Notice of Violation and assessment of civil penalty in the amount of$643.32 ($475.00 civil
penalty+ $ 168.32 enforcement costs)against the Raintree Healthcare of Wilkesboro LLC.
This assessment is based upon the following facts: a review has been conducted of the discharge monitoring report
(DMR)submitted by the Raintree Healthcare of Wilkesboro LLC for the month of September 2015. This review has shown
the subject facility to be in violation of the discharge limitations and/or monitoring requirements found in NPDES Permit
NC0068543. The violations, which occurred in September 2015, are summarized in Attachment A to this letter.
Based upon the above facts, I conclude as a matter of law that the Raintree Healthcare of Wilkesboro LLC violated
the terms, conditions or requirements of NPDES Permit NC0068543 and G.S. 143-215.1(a)(6) in the manner and extent
shown in Attachment A. In accordance with the maximums established by G.S. 143-215.6A(a)(2), a civil penalty may be
assessed against any person who violates the terms, conditions or requirements of a permit required by G.S. 143-215.1(a).
Based upon the above findings of fact and conclusions of law, and in accordance with authority provided by the
Secretary of the Department of Environment and Natural Resources and the Director of the Division of Water Resources, I,
Sherri V Knight, PE, Division of Water Resources Regional Supervisor for the Winston-Salem Region, hereby make the
following civil penalty assessment against the Raintree Healthcare of Wilkesboro I,1-,C:
State of North Carolina Environmental Quality Water Resources
450 West Hanes Mill Road.Suite 300,Winston-Salem,NC 27105
Phone:[phone] Internet:www ncdenrgov

$ 100.00 For 2 of the 2 failures to properly monitor BOD- Cone in violation of
NPDES Permit No.NC0068543.
$ 100.00 For 2 of the 2 failures to properly monitor Fecal Coliform- in violation of
NPDES Permit No. NC0068543.
$ 100.00 For 2 of the 2 failures to properly monitor TSS- Cone in violation of
NPDES Permit No.NC0068543.
$ 100.00 For 2 of the 2 failures to properly monitor CHLORINE in violation of
NPDES Permit No.NC0068543.
$ 50.00 For 1 of the 1 failures to properly monitor jH in violation of NPDES
Permit No.NC0068543.
$25.00 For 1 of the 1 failures to properly monitor Temperature in violation of
NPDES Permit No.NC0068543.
$475.00 TOTAL CIVIL PENALTY
$ 168.32 Enforcement Costs
$ 643.32 TOTAL AMOUNT DUE
Pursuant to G.S. 143-215.6A(c), in determining the amount of the penalty I have taken into account the Findings
of Fact and Conclusions of Law and the factors set forth at G.S. 143B-282.1(b),which are:
(1) The degree and extent of harm to the natural resources of the State, to the public health, or to private property
resulting from the violation;
(2) The duration and gravity of the violation;
(3) The effect on ground or surface water quantity or quality or on air quality;
(4) The cost of rectifying the damage;
(5) The amount of money saved by noncompliance;
(6) Whether the violation was committed willfully or intentionally;
(7) The prior record of the violator in complying or failing to comply with programs over which the Environmental
Management Commission has regulatory authority; and
(8) The cost to the State of the enforcement procedures.
Within thirty days of receipt of this notice,you must do one of the following:
1. Submit payment of the penalty:
Payment should be made directly to the order of the Department of Environmental Quality (do not include waiver form).
Payment of the penalty will not foreclose further enforcement action for any continuing or new violation(s). Please submit
payment to the attention of:
NC DEQ/DWR/NPDES
1617 Mail Service Center
Raleigh,North Carolina 27699-1617
OR
2. Submit a written request for remission including a detailed justification for such request:

Please be aware that a request for remission is limited to consideration of the five factors listed below as they may relate to
the reasonableness of the amount of the civil penalty assessed. Requesting remission is not the proper procedure for
contesting whether the violation(s) occurred or the accuracy of any of the factual statements contained in the civil penalty
assessment document. Because a remission request forecloses the option of an administrative hearing, such a request must
be accompanied by a waiver of your right to an administrative hearing and a stipulation and agreement that no factual or
legal issues are in dispute. Please prepare a detailed statement that establishes why you believe the civil penalty should be
remitted, and submit it to the Division of Water Resources at the address listed below. In determining whether a remission
request will be approved,the following factors shall be considered:
(1) whether one or more of the civil penalty assessment factors in NCGS 143B-282.1(b) were wrongfully applied to
the detriment of the violator;
(2) whether the violator promptly abated continuing environmental damage resulting from the violation;
(3) whether the violation was inadvertent or a result of an accident;
(4) whether the violator has been assessed civil penalties for any previous violations; or
(5) whether payment of the civil penalty will prevent payment for the remaining necessary remedial actions.
Please note that all evidence presented in support of your request for remission must be submitted in writing. The Director
of the Division of Water Resources will review your evidence and inform you of his decision in the matter of your remission
request. The response will provide details regarding the case status,directions for payment,and provision for further appeal
of the penalty to the Environmental Management Commission's Committee on Civil Penalty Remissions (Committee).
Please be advised that the Committee cannot consider information that was not part of the original remission request
considered by the Director. Therefore, it is very important that you prepare a complete and thorough statement in support
of your request for remission.
In order to request remission, you must complete and submit the enclosed "Request for Remission, Waiver of Right to an
Administrative Hearing, and Stipulation of Facts" form within thirty (30) days of receipt of this notice. The Division of
Water Resources also requests that you complete and submit the enclosed "Justification for Remission Request." Both
forms should be submitted to the following address:
NC DEQ/DWR/NPDES
1617 Mail Service Center
Raleigh,NC 27699-1617
OR
3. File a petition for an administrative hearing with the Office of Administrative Hearings:
If you wish to contest any statement in the attached assessment document you must file a petition for an administrative
hearing. You may obtain the petition form from the Office of Administrative Hearings. You must file the petition with the
Office of Administrative Hearings within thirty(30)days of receipt of this notice. A petition is considered filed when it is
received in the Office of Administrative Hearings during normal office hours. The Office of Administrative Hearings
accepts filings Monday through Friday between the hours of 8:00 a.m. and 5:00 p.m., except for official state holidays. The
original and one (1) copy of the petition must be filed with the Office of Administrative Hearings. The petition may be
faxed-provided the original and one copy of the document is received in the Office of Administrative Hearings within five
(5)business days following the faxed transmission. The mailing address for the Office of Administrative Hearings is:
Office of Administrative Hearings
6714 Mail Service Center
Raleigh,NC 27699-6714
Telephone[phone] Facsimile: [phone]
A copy of the petition must also be served on DEQ as follows:

John Evans, General Counsel
Department of Environmental Quality
1601 Mail Service Center
Raleigh,NC 27699-1601
Please indicate the case number(as found on page one of this letter)on the petition.
Failure to exercise one of the options above within thirty (30) days of receipt of this letter, as evidenced by an internal
date/time received stamp (not a postmark), will result in this matter being referred to the Attorney General's Office for
collection of the penalty through a civil action. Please be advised that additional penalties may be assessed for violations
that occur after the review period of this assessment.
If you have any questions,please contact George Smith of the Regional Office at 336-776-9700.
Sincerely,
Ati7
Sherri V Knight,PE
Regional Supervisor
Water Quality Regional Operations Section
Division of Water Resources
attachments
cc: WSRO Files w/attachments
Central Files w/attachments
NPDES Unit—Charles Weaver

ATTACHMENT A
Raintree Healthcare of Wilkesboro LLC
CASE NUMBER: MV-2016-0003
PERMIT: NC0068543 FACILITY: Wilkes County Adult Care WWTP COUNTY: Wilkes REGION: Winston-Salem
Monitoring Violations
MONITORING OUTFALL I VIOLATION UNIT OF CALCULATED %OVER
PENALTY REPORT PPI LOCATION PARAMETER DATE FREQUENCY MEASURE LIMIT VALUE LIMIT VIOLATION TYPE
$50.00 9-2015 001 Effluent BOD-Conc 9/5/15 Weekly mg/I Frequency Violation
$50.00 9-2015 001 Effluent BOD-Conc 9/12/15 Weekly mg/I Frequency Violation
$50.00 9-2015 001 Effluent CHLORINE 9/5/15 2 X week ug/I Frequency Violation
$50.00 9-2015 001 Effluent CHLORINE 9/12/15 2 X week ugh Frequency Violation
$50.00 9-2015 001 Effluent FEC COLI 9/5/15 Weekly #/100m1 Frequency Violation
$50.00 9-2015 001 Effluent FEC COLI 9/12/15 Weekly #/100m1 Frequency Violation
$50.00 9-2015 001 Effluent PH 9/5/15 Weekly su Frequency Violation
$25.00 9-2015 001 Effluent TEMP-C 9/5/15 Weekly deg c Frequency Violation
$50.00 9-2015 001 Effluent TSS-Conc 9/5/15 Weekly mg/I Frequency Violation
$50.00 9-2015 001 Effluent TSS-Conc 9/12/15 Weekly mg/I Frequency Violation

STATE OF NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL
QUALITY
COUNTY OF WILKES
REQUEST FOR REMISSION
IN THE MATTER OF ASSESSMENT ) WAIVER OF RIGHT TO AN
OF CIVIL PENALTIES AGAINST ) ADMINSTRATIVE HEARING AND
) STIPULATION OF FACTS
RAINTREE HEALTHCARE of WILKESBORO LLC )
)
PERMIT NO. NC0068543 ) FILE NO. MV-2016-0003
Having been assessed civil penalties totaling$643.32 for violation(s)as set forth in the assessment document of the Division
of Water Resources dated 1/26/2016,the undersigned, desiring to seek remission of the civil penalty,does hereby waive the right to an
administrative hearing in the above-stated matter and does stipulate that the facts are as alleged in the assessment document. The
undersigned further understands that all evidence presented in support of remission of this civil penalty must be submitted to the director
of the Division of Water Resources within thirty (30) days of receipt of the notice of assessment. No new evidence in support of a
remission request will be allowed after(30)days from the receipt of the notice of assessment.
This the day of ,20
SIGNATURE
ADDRESS
TELEPHONE

p
JUSTIFICATION FOR REMISSION REQUEST
DWR Case Number: MV-2016-0003 County: Wilkes
Assessed Party: Raintree Healthcare of Wilkesboro LLC
Permit No.(if applicable): NC0068543 Amount Assessed: $ 643.32
Please use this form when requesting remission of this civil penalty. You must also complete the "Request For Remission, Waiver of
Right to an Administrative Hearing, and Stipulation of Facts" form to request remission of this civil penalty. You should attach any
documents that you believe support your request and are necessary for the Director to consider in evaluating your request for remission.
Please be aware that a request for remission is limited to consideration of the five factors listed below as they may relate to the
reasonableness of the amount of the civil penalty assessed. Requesting remission is not the proper procedure for contesting whether the
violation(s)occurred or the accuracy of any of the factual statements contained in the civil penalty assessment document. Pursuant to
N.C.G.S. § 143B-282.1(c), remission of a civil penalty may be granted only when one or more of the following five factors applies.
Please check each factor that you believe applies to your case and provide a detailed explanation, including copies of supporting
documents, as to why the factor applies(attach additional pages as needed).
(a) one or more of the civil penalty assessment factors in N.C.G.S. 143B-282.1(b)were
wrongfully applied to the detriment of the petitioner(the assessment factors are listed
in the civil penalty assessment document);
(b) the violator promptly abated continuing environmental damage resulting from the
violation (i.e., explain the steps that you took to correct the violation and prevent future
occurrences);
(c) the violation was inadvertent or a result of an accident(i.e., explain why the violation
was unavoidable or something you could not prevent or prepare for);
(d) the violator had not been assessed civil penalties for any previous violations;
(e) payment of the civil penalty will prevent payment for the remaining necessary remedial
actions (i.e., explain how payment of the civil penalty will prevent you from performing
the activities necessary to achieve compliance).
EXPLANATION:

STATE OF NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
COUNTY OF WILKES DWR Case Number MV-2016-0003
IN THE MATTER OF ASSESSMENT )
OF CIVIL PENALTIES AGAINST: ) REQUEST FOR ORAL PRESENTATION
)
RAINTREE HEALTHCARE of )
WILKESBORO LLC )
I hereby request to make an oral presentation before the Environmental Management Commission's Committee On Civil Penalty
Remissions in the matter of the case noted above. In making this request, I assert that I understand all of the following statements:
• This request will be reviewed by the Chairman of the Environmental Management Commission and may be either granted or
denied.
• Making a presentation will require the presence of myself andior my representative during a Committee meeting held in Raleigh,
North Carolina.
• My presentation will be limited to discussion of issues and information submitted in my original remission request, and because
no factual issues are in dispute,my presentation will be limited to five(5)minutes in length.
The North Carolina State Bar's Authorized Practice of Law Committee has ruled that the appearance in a representative capacity at
quasi-judicial hearings or proceedings is limited to lawyers who are active members of the bar. Proceedings before the Committee on
Remissions are quasi-judicial. You should consider how you intend to present your case to the Committee in light of the State Bar's
gpinion and whether anyone will be speaking in representative capacity for you or a business or governmental entity. If you or your
representative would like to speak before the Committee,you must conipe°and return this form within thirty(30)days of receipt of
t .is=letter.
Depending on your status as an individual, corporation,partnership or municipality,the State Bar's Opinion affects how you may
proceed with your oral presentation. See www.ncbar.com/ethics,Authorized Practice Advisory Opinion 2006-1 and 2007 Formal
Epics Opinion 3.
• :,If you are an individual or business owner and are granted an opportunity to make an oral presentation before the Committee,
then you do not need legal representation before the Committee;however, if you intend on having another individual speak
on your behalf regarding the factual situations, such as an expert,engineer or consultant, then you must also be present at the
meetipg in order to avoid violating the State Bar's Opinion on the unauthorized practice of law.
• If you are a corporation,partnership or municipality and are granted an opportunity to make an oral presentation before the
Committee,then your representative must consider the recent State Bar's Opinion and could be considered practicing law
without a license-ifhBor she is not a licensed attorney. Presentation of facts by non-lawyers is permissible.
If you choose to request an oral presentation,please make sure that signatures on the previously submitted Remission Request form
end this Oral Presentation Request form are: 1)for individuals and business owners,your own signature and 2)for corporations,
partnerships and municipalities;signed by individuals who would not violate the State Bar's Opinion on the unauthorized practice of
law.
Para3 0:1=V,-;, P$. .� < ...�#�a L_ �i..t ....�°� ,..t ..... -' ' TTia ,.._....y.. r
_,.... ...
�y
r�34 9 4 �f Y gyF. (11a ....�°e
This the day of _ ,20
SIGNATURE
TITLE(President,Owner, etc.)
ADDRESS
TELEPHONE( )