NC0035157_Renewal (Application)_20240701

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I- n3
ROY COOPER i ,;, ii'''
Governor \4A
ELIZABETH S.BISER
Secretarycx«=
RICHARD E.ROGERS,JR. NORTH CAROLINA
Director Environmental Quality
July 01, 2024
McDowell County Adult Care One, LLC.
Attn: Frederic H. Leonard
PO Box 1257
Marion, NC 28752-1257
Subject: Permit Renewal
Application No. NC0035157
Cedarbrook Residential Center
McDowell County
Dear Applicant:
The Water Quality Permitting Section acknowledges the July 1, 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.gov/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.
Sincere)
_,L .2w
Wren Thedford
Administrative Assistant
Water Quality Permitting Section
cc: Rachael Kramer-KACE Environmental, Inc.
ec: WQPS Laserfiche File w/application
D_E Q) North Carolina Department of Environmental Quality I Division of Water Resources
Asheville Regional Office 2090 US.Highway 70 5wannanoa.North Carolina 28776
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+�+� 828.296.4500

•
KACE ENVIRONMENTAL, INC.
2905 Wood Rd Phone [phone]
Mooresboro,NC 28114 Fax [phone]
June 25, 2024
Ms. Wren Thedford NPDES Permit Ren Eii�c
NC DEQ—DWR-NPDES Cedarbrook Residentia C UU
e r
1617 Mail Service Center NPDES Permit No. Ny 035152024
Raleigh,NC 27699-1617 U L
NCDEQ/DWR/NPDES
Good afternoon,
The purpose of this letter is to request renewal for the NPDES Permit No. NC0035157 issued to
McDowell County Adult Care, LLC for Cedarbrook Residential Center.
There have been no major changes at the facility since the last permit renewal application in 2019.
Please advise should further information be required.
Thank you,
Rachael G. Kramer
Compliance Manager
KACE Environmental, Inc.
[phone]
[e-mail]

North Carolina
Department of Environmental Quality Modified Application Form 2A
Division of Water Resources Revised March 2021
Modified Application
Form 2A
Minor Sewage Facilities < 0.1 MGD
No Program
Pretreatment Pro ram
NPDES Permitting Program
Note: Complete this form if your facility is a MINOR new or existing publicly owned treatment works.

NPDES Permit Number Facility Name Modified Application Form 2A
NC0035157 Cedarbrook Residential Center Modified March 2021
Form NC Department of Environmental Quality-Application for NPDES Permit to Discharge Wastewater
NPDES MINOR SEWAGE FACILITIES(Before completing this form,please read the instructions.Failure to follow
the instructions ma result in denial of the application.)
)
SECTION 1.BASIC APPLICATION INFORMATION FOR ALL APPLICANTS(40 CFR 122.21(j)(1)and(9))
1.1 Facility name
Cedarbrook Residential Center
Mailing address(street or P.O.box)
PO Box 1257
City or town State ZIP code
o Marion NC 28752
Contact name(first and last) Title Phone number Email address
Mr.Frederic H.Leonard Owner [phone] [e-mail];meredith.bosw
Location address(street,route number,or other specific identifier) ❑ Same as mailing address
1267 Pinnacle Chruch Road
City or town State ZIP code
Nebo NC 28761
1.2 Is this application for a facility that has yet to commence discharge?
❑ Yes—I See instructions on data submission ❑ No
requirements for new dischargers.
1.3 Is applicant different from entity listed under Item 1.1 above?
El Yes ❑ No 4 SKIP to Item 1.4.
Applicant name
Rachael Kramer of KACE Environmental,Inc.
Applicant address(street or P.O.box)
2905 Wood Road
o City or town State ZIP code
Mooresboro NC 28114
Contact name(first and last) Title Phone number Email address
a Rachael G.Kramer Compliance Manager [phone] [e-mail]
a
1.4 Is the applicant the facility's owner,operator,or both?(Check only one response.)
❑ Owner ElOperator ❑ Both
1.5 To which entity should the NPDES permitting authority send correspondence?(Check only one response.)
El Facility 0 Applicant ❑ Facility and applicant
(they are one and the same)
1.6 Indicate below any existing environmental permits.(Check all that apply and print or type the corresponding permit
number for each.)
Existing Environmental Permits
NPDES(discharges to surface ❑ RCRA(hazardous waste) ❑ UIC(underground injection
water) control)
E NC0035157
o ❑ PSD(air emissions) ❑ Nonattainment program(CM) ❑ NESHAPs(CM)
w
rn _
❑ Ocean dumping(MPRSA) 0 Dredge or fill(CWA Section ❑ Other(specify)
404)
Page 1

NPDES Permit Number Facility Name Modified Application Form 2A
NC0035157 Cedarbrook Residential Center Modified March 2021
1.7 Provide the collection system information requested below for the treatment works.
Municipality Population Collection System Type
Served Served (indicate percentage) Ownership Status
100 %separate sanitary sewer 0 Own El Maintain
Z N/A 80 %combined storm and sanitary sewer ❑ Own 0 Maintain
cc ❑ Unknown El ❑ Maintain
c %separate sanitary sewer El Own ❑ Maintain
w %combined storm and sanitary sewer 0 Own 0 Maintain
co
❑ Unknown ❑ Own ❑ Maintain
o %separate sanitary sewer ❑ Own 0 Maintain
a.
%combined storm and sanitary sewer El Own 0 Maintain
(o 0 Unknown 0 Own 0 Maintain
d %separate sanitary sewer 0 Own ❑ Maintain
N %combined storm and sanitary sewer CIOwn 0 Maintain
c ❑ Unknown ❑ Own 0 Maintain
u Total 80
d Population
o Served
Separate Sanitary Sewer System Combined Storm and
Sanitary Sewer
Total percentage of each type of 100 %
sewer line(in miles)
z 1.8 Is the treatment works located in Indian Country?
c
o 0 Yes El No
c1.9 Does the facility discharge to a receiving water that flows through Indian Country?
11 Yes ❑ No
1.10 Provide design and actual flow rates in the designated spaces. Design Flow Rate
0.003 mgd
= co) Annual Average Flow Rates(Actual)
a12 Two Years Ago Last Year This Year
c o 0.002689 mgd 0.002526 mgd 0.002438 mgd
`1 Maximum Daily Flow Rates(Actual)
c Two Years Ago Last Year This Year
0.003 mgd 0.003 mgd 0.003 mgd
1.11 Provide the total number of effluent discharge points to waters of the State of North Carolina by type.
s Total Number of Effluent Discharge Points by Type
m & Constructed
Treated Effluent Untreated Effluent Combined SewerOverflows Bypasses Emergency
Overflows
in 1
Page 2

NPDES Permit Number Facility Name Modified Application Form 2A
NC0035157 Cedarbrook Residential Center Modified March 2021
Outfalls Other Than to Waters of the State of North Carolina
1.12 Does the POTW discharge wastewater to basins,ponds,or other surface impoundments that do not have outlets
for discharge to waters of the State of North Carolina?
❑ Yes ❑ No 4 SKIP to Item 1.14.
1.13 Provide the location of each surface impoundment and associated discharge information in the table below.
Surface Impoundment Location and Discharge Data
Average Daily Volume Continuous or Intermittent
Location Discharged to Surface
Impoundment (check one)
O Continuous
gpd ❑ Intermittent
❑ Continuous
gpd ❑ Intermittent
❑ Continuous
gpd 0 Intermittent
2 1.14 Is wastewater applied to land?
2 ❑ Yes 0 No 4 SKIP to Item 1.16.
c 1.15 Provide the land application site and discharge data requested below.
h Land Application Site and Discharge Data
o Continuous or
o Location Size Average Daily Volume Intermittent
Applied (check one)
= acres d 0 Continuous
o gp ❑ Intermittent
acres d 0 Continuous
gp 0 Intermittent
0 Continuous
acres gpd ❑ Intermittent
O 1.16 Is effluent transported to another facility for treatment prior to discharge?
c ❑ Yes ❑✓ No 4 SKIP to Item 1.21.
1.17 Describe the means by which the effluent is transported(e.g.,tank truck,pipe).
1.18 Is the effluent transported by a party other than the applicant?
❑ Yes ❑ No 4 SKIP to Item 1.20.
1.19 Provide information on the transporter below.
Transporter Data
Entity name Mailing address(street or P.O.box)
City or town State ZIP code
Contact name(first and last) Title
Phone number Email address
Page 3

NPDES Permit Number Facility Name Modified Application Form 2A
NC0035157 Cedarbrook Residential Center Modified March 2021
1.20 In the table below,indicate the name,address,contact information,NPDES number,and average daily flow rate of the
receiving facility.
Receiving Facility Data
CB
name Mailing address(street or P.O.box)
c
City or town State ZIP code
0
0 Contact name(first and last) Title
0
d Phone number Email address
0 NPDES number of receiving facility(if any) ❑None
O Average daily flow rate mgd
b 1.21 Is the wastewater disposed of in a manner other than those already mentioned in Items 1.14 through 1.21 that do
d not have outlets to waters of the State of North Carolina(e.g.,underground percolation,underground injection)?
0 ❑ Yes 0 No 4 SKIP to Item 1.23.
u
c 1.22 Provide information in the table below on these other disposal methods.
d Information on Other Disposal Methods
a Disposal Location of Size of Annual Average Continuous or Intermittent
c Method Disposal Site Disposal Site Daily Discharge (check one)
0, Description Volume
h 0 Continuous
al
45 acres gpd ❑ Intermittent
o 0 Continuous
acres gpd ❑ Intermittent
acres d ❑ Continuous
gp ❑ Intermittent
1.23 Do you intend to request or renew one or more of the variances authorized at 40 CFR 122.21(n)?(Check all that apply.
8 4 Consult with your NPDES permitting authority to determine what information needs to be submitted and when.)
S ❑ Discharges into marine waters(CWA ❑ Water quality related effluent limitation(CWA Section
CO 0 Section 301(h)) 302(b)(2))
O Not applicable
1.24 Are any operational or maintenance aspects(related to wastewater treatment and effluent quality)of the treatment works
the responsibility of a contractor?
✓❑ Yes 0 No+SKIP to Section 2.
1.25 Provide location and contact information for each contractor in addition to a description of the contractors operational
and maintenance responsibilities.
Contractor Information
Contractor 1 Contractor 2 Contractor 3
c Contractor name
A (company name) KALE Environmental,Inc.
oMailing address 2905 Wood Road
c (street or P.O.box)
$ City,state,and ZIP Mooresboro,NC 28114
code
0
ci last)
name(first and Robert Kramer
Phone number [phone]
Email address [e-mail]
Operational and Standard duties of an ORC.
maintenance Maintenance is the
responsibilities of resonsibility of the facility's
contractor .„,,;.,.
Page 4
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NPDES Permit Number Facility Name Modified Application Form 2A
NC0035157 Cedarbrook Residential Center Modified March 2021
SECTION 2.ADDITIONAL INFORMATION(40 CFR 122.21(j)(1)and(2))
o Outfalls to Waters of the State of North Carolina
2.1 Does the treatment works have a design flow greater than or equal to 0.1 mgd?
rn
o ❑ Yes ❑✓ No 4 SKIP to Section 3.
c 2.2 Provide the treatment works'current average daily volume of inflow Average Daily Volume of Inflow and Infiltration
and infiltration.
gpd
Indicate the steps the facility is taking to minimize inflow and infiltration.
0
c
2.3 Have you attached a topographic map to this application that contains all the required information?(See instructions for
0_ specific requirements.)
M
0
0 ❑ Yes CINo
E 2.4 Have you attached a process flow diagram or schematic to this application that contains all the required information?
o a,
(See instructions for specific requirements.)
II co
❑ Yes El No
2.5 Are improvements to the facility scheduled?
❑ Yes ❑ No 4 SKIP to Section 3.
= Briefly list and describe the scheduled improvements.
0
1.
a,
E
c 2.
E
0 0
3.
4.
2.6 Provide scheduled or actual dates of completion for improvements.
Scheduled or Actual Dates of Completion for Improvements
Affected Attainment of
d Scheduled Begin End Begin
Outfalls Operational
o Improvement Construction Construction Discharge
(from above) (list outfall Level
(MM/DD/YYYY) (MM/DD/YYYY) (MM/DD/YYYY)
number) (MM/DD/YYYY)
a
1.
2.
N
3.
4.
2.7 Have appropriate permits/clearances concerning other federal/state requirements been obtained?Briefly explain your
response.
❑ Yes ❑ No El None required or applicable
Explanation:
Page 5

NPDES Permit Number Facility Name Modified Application Form 2A
NC0035157 Cedarbrook Residential Center Modified March 2021
SECTION 3. INFORMATION ON EFFLUENT DISCHARGES(40 CFR 122.21(j)(3)to(5))
3.1 Provide the following information for each outfall.(Attach additional sheets if you have more than three outfalls.)
Outfall Number 001 Outfall Number Outfall Number
State North Carolina
County McDowell
� City or town
Nebo
w
0
Distance from shore 1 ft. ft. ft.
Depth below surface o ft. ft. ft.
Average daily flow rate 0.002 mgd mgd mgd
Latitude 35° 31 02" NII °
Longitude sl 52 35"
9 �❑
co
3.2 Do any of the outfalls described under Item 3.1 have seasonal or periodic discharges?
c ❑ Yes El No 4 SKIP to Item 3.4.
3.3 If so,provide the following information for each applicable outfall.
Outfall Number Outfall Number Outfall Number
Number of times per year
0 discharge occurs
a Average duration of each
discharge(specify units)
Average flow of each mgd mgd mgd
discharge
in Months in which discharge
occurs
3.4 Are any of the outfalls listed under Item 3.1 equipped with a diffuser?
❑ Yes 0 No 4 SKIP to Item 3.6.
3.5 Briefly describe the diffuser pe at each applicable outfall.
c.
Outfall Number Outfall Number Outfall Number
d
6.15
US 3 6 Does the treatment works discharge or plan to discharge wastewater to waters of the State of North Carolina from
•
one or more discharge points?
3 w ❑ Yes 0 No 4SKIP to Section 6.
Page 6

NPDES Permit Number Facility Name Modified Application Form 2A
NC0035157 Cedarbrook Residential Center Modified March 2021
3.7 Provide the receiving water and related information(if known)for each outfall.
Outfall Number Outfall Number Outfall Number
Receiving water name
Name of watershed,river,
c or stream system
e U.S.Soil Conservation
h Service 14-digit watershed
c code
411)
Name of state
�o
3 management/river basin
U.S.Geological Survey
E 8-digit hydrologic
cc cataloging unit code
Critical low flow(acute) cfs cfs cfs
Critical low flow(chronic) cfs cfs cfs
Total hardness at critical mg/L of mg/L of mg/L of
low flow CaCO3 CaCO3 CaCO3
3.8 Provide the following information describing the treatment provided for discharges from each outfall.
Outfall Number Outfall Number Outfall Number
Highest Level of ❑ Primary ❑ Primary ❑ Primary
Treatment(check all that 0 Equivalent to ❑ Equivalent to 0 Equivalent to
apply per outfall) secondary secondary secondary
❑ Secondary 0 Secondary 0 Secondary
❑ Advanced 0 Advanced 0 Advanced
❑ Other(specify) 0 Other(specify) ❑ Other(specify)
c
0
o. Design Removal Rates by
Outfall
d
o BOD5 or CBOD5 % % %
c
m
i
e TSS % % %
1—
❑ Not applicable ❑Not applicable 0 Not applicable
Phosphorus % % °
/o
0 Not applicable ❑Not applicable 0 Not applicable
Nitrogen
Other(specify) ❑Not applicable 0 Not applicable 0 Not applicable
%
Page 7

NPDES Permit Number Facility Name Modified Application Form 2A
NC0035157 Cedarbrook Residential Center Modified March 2021
3.9 Describe the type of disinfection used for the effluent from each outfall in the table below.If disinfection varies by
season,describe below.
=
_
c
0
Outfall Number Outfall Number Outfall Number
0
.a Disinfection type
Seasons used
Dechlorination used? ❑ Not applicable ❑ Not applicable ❑ Not applicable
❑ Yes ❑ Yes ❑ Yes
❑ No ❑ No ❑ No
3.10 Have you completed monitoring for all Table A parameters and attached the results to the application package?
El Yes ❑ No
3.11 Have you conducted any WET tests during the 4.5 years prior to the date of the application on any of the facility's
discharges or on any receiving water near the discharge points?
❑ Yes ❑ No 4 SKIP to Item 3.13.
3.12 Indicate the number of acute and chronic WET tests conducted since the last permit reissuance of the facility's
discharges by outfall number or of the receiving water near the discharge points.
Outfall Number Outfall Number Outfall Number
Acute Chronic Acute Chronic Acute Chronic
0) Number of tests of discharge
= water
Number of tests of receiving
water
d
3.14 Does the POTW use chlorine for disinfection,use chlorine elsewhere in the treatment process,or otherwise have
reasonable potential to discharge chlorine in its effluent?
❑ Yes 4 Complete Table B,including chlorine. ❑ No 4 Complete Table B,omitting chlorine.
3.15 Have you completed monitoring for all applicable Table B pollutants and attached the results to this application
package?
❑ Yes ❑ No
Have you completed monitoring for all applicable Table D pollutants required by your NPDES permitting authority and
3.18 attached the results to this application package?
El Yes ❑ No additional sampling required by NPDES
permitting authority.
Page 8

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NPDES Permit Number Facility Name Modified Application Form 2A
NC0035157 Cedarbrook Residential Center Modified March 2021
3.19 Has the POTW conducted either(1)minimum of four quarterly WET tests for one year preceding this permit application
or(2)at least four annual WET tests in the past 4.5 years?
❑ Yes ❑ No 4 Complete tests and Table E and SKIP to
Item 3.26.
3.20 Have you previously submitted the results of the above tests to your NPDES permitting authority?
El Yes ❑ No 4 Provide results in Table E and SKIP to
Item 3.26.
3.21 Indicate the dates the data were submitted to your NPDES permitting authority and provide a summary of the results.
Date(s)Submitted Summary of Results
(MMIDDNYYY)
c
0
0 3.22 Regardless of how you provided your WET testing data to the NPDES permitting authority,did any of the tests result in
toxicity?
❑ Yes ❑ No 3 SKIP to Item 3.26.
3.23 Describe the cause(s)of the toxicity:
c
d
LU
w
3.24 Has the treatment works conducted a toxicity reduction evaluation?
❑ Yes ❑ No 4 SKIP to Item 3.26.
3.25 Provide details of any toxicity reduction evaluations conducted.
3.26 Have you completed Table E for all applicable outfalls and attached the results to the application package?
❑ Yes Not applicable because previously submitted
information to the NPDES ermittin authori .
Page 9

NPDES Permit Number Facility Name Modified Application Form 2A
NC0035157 Cedarbrook Residential Center Modified March 2021
SECTION 6.CHECKLIST AND CERTIFICATION STATEMENT(40 CFR 122.22(a)and(d))
6.1 In Column 1 below,mark the sections of Form 2A 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
EI Section 1: Basic Application
Information for All Applicants ❑ w/variance request(s) Elw/additional attachments
❑ Section 2:Additional El w/topographic map El w/process flow diagram
Information El w/additional attachments
0 wl Table A ❑ w/Table D
❑ Section 3:Information on ✓❑ w/Table B ❑ w/additional attachments
E' Effluent Discharges
❑ w/Table C
CO
Section 4:Not Applicable
0
Section 5:Not Applicable
❑ Section 6:Checklist and El w/attachments
Certification Statement
Y 6.2 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
Rachael G.Kramer Compliance Manager KACE Environme
Signatur Date signed
06/20/2024
Page 10

NPDES Permit Number Facility Name Outfall Number Modified Application Form 2A
NC0035157 Cedarbrook Residential Center 001 Modified March 2021
TABLE A.EFFLUENT PARAMETERS FOR ALL POTWS
Maximum Daily Discharge Average Daily Discharge Analytical ML or MDL
Pollutant Value Units Value Units Number of Method.' (include units)
Sam.les
Biochemical oxygen demand
0 ML
o BODE or❑CBOD5 43.3 mg/L 13.7083 mg/L 72 SM 5210 B 45 l MDL
resort one
0 ML
Fecal coliform 75 #/100m1 2.0361888 #/100m1 72 SM 9222 D 100/100m1 O MDL
Design flow rate 0.003 MGD 0.002438 MGD 780
pH(minimum) 6.6 Standard Units
pH(maximum) 7.1 Standard Units
Temperature(winter) 23.3 Degrees Celsius 17.4541 Degrees Celsius 780
F 5 k 51
Temperature(summer) N/A N/A N/A N/A N/A
0 ML
Total suspended solids(TSS) 22 mg/L 6.07556 mg/L 72 SM 2540 D 45 l7 MDL
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 O.See instructions and 40 CFR 122.21(e)(3).
Page 11

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Modified Application Form 2A .
NC0035157 Cedarbrook Residential Center 001 Modified March 2021
TABLE B. EFFLUENT PARAMETERS FOR ALL POTWS WITH A FLOW EQUAL TO OR GREATER THAN 0.1 MGD
Maximum Daily Discharge Average Daily Discharge Analytical ML or MDL
Pollutant Number of Methods Include units
Value Units Value Units Samples Methods (
)
0 ML
Ammonia(as N) 3.71 mg/L 2.5783 mg/L 12 SM 4500 NH3 D 35.0 l MDL
Chlorine 0 ML
(total residual,TRC)2 46 ug/L 30.8287 ug/L 24 SM 4500 Cl G-2011 28 p MDL
0 ML
Dissolved oxygen 0 MDL
Nitrate/nitrite 0 ML
❑MDL
0 ML
Kjeldahl nitrogen 0 MDL
0 ML
Oil and grease ❑MDL
0 ML
Phosphorus 0 MDL
Total dissolved solids ❑ML
❑MDL
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 O.See instructions and 40 CFR 122.21(e)(3).
2 Facilities that do not use chlorine for disinfection,do not use chlorine elsewhere in the treatment process,and have no reasonable potential to discharge chlorine in their effluent are not
required to report data for chlorine.
EPA Form 3510-2A(Revised 3-19) Page 12