NC0020338_Renewal (Application)_20240702

e.Mw��v
ROY COOPER •i :; .-
Governor :o.
ELIZABETH S.BISER �� ,,..
Secretary ,. >
RICHARD E.ROGERS,JR. NORTH CAROLINA
Director Environmental Quality
July 02, 2024
Town of Yadkinville
Attn: Mike Koser
PO Box 816
Yadkinville, NC 27055-0816
Subject: Permit Renewal
Application No. NC0020338
Yadkinville WWTP
Yadkin County
Dear Applicant:
The Water Quality Permitting Section acknowledges the July 2, 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. 150E-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.
Mk
S3in�cerel __
Wren hedford
Administrative Assistant
Water Quality Permitting Section
cc: Grant F. Trivette, ORC
ec: WQPS Laserfiche File w/application
D E y North Carolina Department of Environmental Quality Division of Water Resources
Wfnston-Sakm Regional Office 450 West Hanes Mill Road,Suite 300 Winston-Salem North Carolina 27105
+� -ram /' 336.776.9800

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June 26, 2024
RECE/vED
Mr. Mike Montebello
JUL 0
NCDEQ- Municipal Permitting Unit NPDES 2 2024
NC
D
EQ/D
1617 Mail Service Center WR/NpDEs
Raleigh, NC 27699-1617
Re: NPDES Permit Renewal NC0020338
Mr. Montebello:
Please find enclosed our Form 2A NPDES and attachments for review. The attachments
included are:
1- Flow Narrative
2- Sample Reduction Request
3- Maps
4- Supporting Data
5- 2021-2023 Toxicity results and PPA Scans
All C. Dubia toxicity results had PASS results. We had one 2nd species (FH minnow) test
to show toxicity January 2023. Comments on results noted fungal growth noted in
effluent treatments but not in control. This is likely cause of slight toxic effect.
If you have any additional questions, please contact Grant Trivette at [phone] or
[phone]
Sincerely,
, .44 Aatit) I
Grant F.Trivette
WWTP ORC/Pretreatment Coordinator
213 Van Buren Street
Post Office Drawer 816 Telephone (336) 679-8732
Yadkinville, North Carolina 27055-0816 Fax (336) 679-6151

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
110000540898 NC0020338 Town of Yadkinville WWTP OMB No.2040-0004
Form U.S.Environmental Protection Agency
2A /EPA Application for NPDES Permit to Discharge Wastewater
NPDES NEW AND EXISTING PUBLICLY OWNED TREATMENT WORKS
SECTION 1.BASIC APPLICATION INFORMATION FOR ALL APPLICANTS(40 CFR 122.21(j)(1)and (9))
1.1 Facility name
Town of Yadkinville Wastewater Treatment Plant
Mailing address(street or P.O. box)
P.O.Box 816
City or town State ZIP code
o Yadkinville North Carolina 27055
EContact name(first and last) Title Phone number Email address
Grant Trivette WWTP ORC [phone] [e-mail]
Location address(street,route number,or other specific identifier) D Same as mailing adRECEIVED
0 1620 Fred Hinshaw Road
w
City or town State ZIP codj 0 2 2024
Yadkinville North Carolina 27055
1.2 Is this application for a facility that has yet to commence discharge? NCDEQ/DWR/NPDES
❑ Yes 4 See instructions on data submission 0 No
requirements for new dischargers.
1.3 Is applicant different from entity listed under Item 1.1 above?
❑ Yes [ No 4 SKIP to Item 1.4.
Applicant name
Applicant address(street or P.O. box)
0
City or town State ZIP code
Contact name(first and last) Title Phone number Email address
a.
1.4 Is the applicant the facility's owner,operator,or both?(Check only one response.)
❑ Owner ❑ Operator ❑✓ Both
1.5 To which entity should the NPDES permitting authority send correspondence?(Check only one response.)
❑ Facility El Applicant 0 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.)
d Existing Environmental Permits
E NPDES(discharges to surface 0 RCRA(hazardous waste) UIC(underground injection
water) control)
E NC0020338
o ❑ PSD(air emissions) ❑ Nonattainment program(CM) ❑ NESHAPs(CM)
rn
.N ❑ Ocean dumping(MPRSA) ❑ Dredge or fill(CWA Section ❑ Other(specify)
w 404)
WQ0001800 WQCS00130
EPA Form 3510-2A(Revised 3-19) Page 1

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
110000540898 NC0020338 Town of Yadkinville WWTP OMB No.2040-0004
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 0 Maintain
wTown of 3900 Yadkinville %combined storm and sanitary sewer ❑ Own ❑ Maintain
0 Unknown ❑ Own 0 Maintain
c %separate sanitary sewer ❑ Own 0 Maintain
w %combined storm and sanitary sewer ❑ Own ❑ Maintain
❑ Unknown ❑ Own 0 Maintain
a %separate sanitary sewer ❑ Own 0 Maintain
c %combined storm and sanitary sewer 0 Own 0 Maintain
0 0 Unknown ❑ Own ❑ Maintain
w %separate sanitary sewer ❑ Own ❑ Maintain
N %combined storm and sanitary sewer ❑ Own 0 Maintain
a 0 Unknown ❑ Own 0 Maintain
Total
0 Population
o Served
Separate Sanitary Sewer System Combined Storm and
Sanitary Sewer
Total percentage of each type of 100
/°sewer line(in miles) _
1.8 Is the treatment works located in Indian Country?
a
'o 0 Yes El No
C)
R 1.9 Does the facility discharge to a receiving water that flows through Indian Country?
c ❑ Yes El No
1.10 Provide design and actual flow rates in the designated spaces. Design Flow Rate
2.5 mgd
3 Annual Average Flow Rates(Actual)
aCD Two Years Ago Last Year This Year
Co 2021 0.778 mgd 2022 0.793 mgd 2023 0.837 mgd
u" Maximum Daily Flow Rates(Actual) '
o Two Years Ago Last Year This Year
2021 1.831 mgd 2022 1.807 mgd 2023 1.863 mgd
u, 1.11 Provide the total number of effluent discharge points to waters of the United States by type.
o Total Number of Effluent Discharge Points by Type
a a Constructed
CD
1- Treated Effluent Untreated Effluent Combined Sewer Bypasses Emergency
03 -0 Overflows Overflows
t.)
0 1
EPA Form 3510-2A(Revised 3-19) Page 2
I

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
110000540898 NC0020338 Town of Yadkinville WWTP OMB No.2040-0004
Outfalls Other Than to Waters of the United States
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 United States?
❑ Yes E 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)
❑ Continuous
gpd ❑ Intermittent
O Continuous
gpd ❑ Intermittent
❑ Continuous
gpd ❑ Intermittent
t 1.14 Is wastewater applied to land?
❑ Yes ❑✓ No 4 SKIP to Item 1.16.
0 1.15 Provide the land application site and discharge data requested below.
0 Land Application Site and Discharge Data
o Continuous or
Average Daily Volume
Location Size Applied Intermittent
(check one)
acres d ❑ Continuous
o gp 0 Intermittent
acres d 0 Continuous
o gp ❑ Intermittent
0 Continuous
acres gpd ❑ Intermittent
Tu 1.16 Is effluent transported to another facility for treatment prior to discharge?
o ❑ 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
EPA Form 3510-2A(Revised 3-19) Page 3

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
110000540898 NC0020338 Town of Yadkinville WWTP OMB No.2040-0004
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
-0 Facility name Mailing address(street or P.O.box)
d
City or town State ZIP code
0
Contact name(first and last) Title
0
Phone number Email address
o0 NPDES number of receiving facility(if any) 0 None
Average daily flow rate mgd
N
0 1.21 Is the wastewater disposed of in a manner other than those already mentioned in Items 1.14 through 1.21 that do not
have outlets to waters of the United States(e.g., underground percolation,underground injection)?
L ElYes ❑ No 4 SKIP to Item 1.23.
0 1.22 Provide information in the table below on these other disposal methods.
Information on Other Disposal Methods
o Disposal Location of Size of Annual Average Continuous or Intermittent
Method Disposal Site Disposal Site Daily Discharge (check one)
Description Volume
acresgpd 0 Continuous
0 Intermittent
o 0 Continuous
acres gpd 0 Intermittent
acres gpd 0 Continuous
0 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.
n Consult with your NPDES permitting authority to determine what information needs to be submitted and when.)
3 ❑ Discharges into marine waters(CWA ❑ Water quality related effluent limitation(CWA Section
Section 301(h)) 302(b)(2))
0 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 ❑ No+SKIP to Section 2.
1.25 Provide location and contact information for each contractor in addition to a description of the contractor's operational
and maintenance responsibilities.
Contractor Information
Contractor 1 Contractor 2 Contractor 3
0
Contractor name
(company name)
Mailing address
(street or P.O.box)
City,state,and ZIP
code
Contact name(first and
0
last)
Phone number - - -
Email address
Operational and
maintenance
responsibilities of
contractor
EPA Form 3510-2A(Revised 3-19) Page 4

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
110000540898 NC0020338 Town of Yadkinville WWTP OMB No.2040-0004
SECTION 2.ADDITIONAL INFORMATION(40 CFR 122.21(j)(1)and(2))
o Outfalls to Waters of the United States
2.1 Does the treatment works have a design flow greater than or equal to 0.1 mgd?
❑ Yes ❑ No 4 SKIP to Section 3.
0 2.2 Provide the treatment works'current average daily volume of inflow Average Daily Volume of Inflow and Infiltration
and infiltration. <20,000
gpd
Indicate the steps the facility is taking to minimize inflow and infiltration.
c Reline gravity sewers as needed;Ongoing sewer video and jetting program. Smoke testing for inflow points.
w
0
2.3 Have you attached a topographic map to this application that contains all the required information?(See instructions for
o specific requirements.)
0)
0
0 El Yes El No
E 2.4 Have you attached a process flow diagram or schematic to this application that contains all the required information?
c ;° (See instructions for specific requirements.)
rn
Li co
c ElYes El No
2.5 Are improvements to the facility scheduled?
❑ Yes ❑ No 4 SKIP to Section 3.
Briefly list and describe the scheduled improvements.
1.
E
Ea 2.
0 0
3.
d
cn
4.
2.6 Provide scheduled or actual dates of completion for improvements.
Scheduled or Actual Dates of Completion for Improvements
Affected Attainment of
Scheduled Begin End Begin
> Outfalls Operational
o Improvement Construction Construction Discharge
(from above) (list outtall (MM/DD/YYYY) (MM/DD/YYYY) (MM/DD/YYYY) Level
number) (MM/DD/YYYY)
1.
0 2.
cn
3.
4.
2.7 Have appropriate permits/clearances concerning other federal/state requirements been obtained?Briefly explain your
response.
❑ Yes ❑ No ❑ None required or applicable
Explanation:
EPA Form 3510-2A(Revised 3-19) Page 5

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
110000540898 NC0020338 Town of Yadkinville WWTP OMB No.2040-0004
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 Yadkin
City or town Yadkinville
0
0 Distance from shore N/A ft. ft. ft.
fl.
Depth below surface N/A ft. ft. ft.
Average daily flow rate 0.800 mgd mgd mgd
Latitude 36 0S 01" Na o
Longitude 80 3i 32" V❑
3.2 Do any of the outfalls described under Item 3.1 have seasonal or periodic discharges?
❑ Yes r❑ No 4 SKIP to Item 3.4.
A 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
Average duration of each
discharge(specify units)
o Average flow of each mgd mgd mgd
cn discharge
y Months in which discharge
occurs
3.4 Are any of the outfalls listed under Item 3.1 equipped with a diffuser?
❑ Yes D No 4 SKIP to Item 3.6.
C, 3.5 Briefly describe the diffuser type at each applicable outfall.
Outfall Number Outfall Number Outfall Number
N
Ei
vi 3 6 Does the treatment works discharge or plan to discharge wastewater to waters of the United States from one or more
discharge points?
❑ Yes ❑ No+SKIP to Section 6.
EPA Form 3510-2A(Revised 3-19) Page 6

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
110000540898 NC0020338 Town of Yadkinville WWTP OMB No.2040-0004
3.7 Provide the receiving water and related information(if known)for each outfall.
Outfall Number 001 Outfall Number Outfall Number
Receiving water name North Deep Creek
Name of watershed,river,
0 or stream system Yadkin Pee-Dee River
0- U.S.Soil Conservation
H Service 14-digit watershed
o code
°' Name of state
management/river basin Yadkin-Pee Dee River Basin
Ca
C U.S.Geological Survey
w 8-digit hydrologic 03040101
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
26.5
low flow CaCO3 CaCO3 CaCO3
3.8 Provide the following information describing the treatment provided for discharges from each outfall.
Outfall Number ow Outfall Number Outfall Number
Highest Level of ❑ Primary ❑ Primary 0 Primary
Treatment(check all that 0 Equivalent to 0 Equivalent to ❑ Equivalent to
apply per outfall) secondary secondary secondary
O Secondary 0 Secondary 0 Secondary
❑ Advanced 0 Advanced 0 Advanced
O Other(specify) 0 Other(specify) 0 Other(specify)
c
0
'QU Design Removal Rates by
.F.)-
Outfall
ul
CI
BOD5 or CBOD5 >85
d
0 TSS >85 % % 0/0
it
III Not applicable ❑ Not applicable 0 Not applicable
Phosphorus % % %
0 Not applicable 0 Not applicable 0 Not applicable
Nitrogen % % %
Other(specify) 0 Not applicable 0 Not applicable 0 Not applicable
% % %
EPA Form 3510-2A(Revised 3-19) Page 7

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
110000540898 NC0020338 Town of Yadkinville WWTP OMB No.2040-0004
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.
a
One ton chlorine gas cylinders are utilized at the WWTP and sulfur dioxide cylinders used for dechlorination.
a)
0
c Outfall Number 001 Outfall Number Outfall Number
.2- Disinfection type Chlorine Gas
tR
Seasons used
as Year Round
Dechlorination used? ❑ Not applicable ❑ Not applicable ❑ Not applicable
O Yes El Yes El Yes
❑ No ❑ No ❑ No
3.10 Have you completed monitoring for all Table A parameters and attached the results to the application package?
O 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 001 Outfall Number Outfall Number
Acute Chronic Acute Chronic Acute Chronic
Number of tests of discharge
water 21
Number of tests of receiving
water 1
3.13 Does the treatment works have a design flow greater than or equal to 0.1 mgd?
❑ Yes ❑ No 4 SKIP to Item 3.16.
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?
d 0 Yes 4 Complete Table B, including chlorine. ❑ No 4 Complete Table B,omitting chlorine.
t• 3.15 Have you completed monitoring for all applicable Table B pollutants and attached the results to this application
package?
❑✓ Yes ❑ No
3.16 Does one or more of the following conditions apply?
• The facility has a design flow greater than or equal to 1 mgd.
• The POTW has an approved pretreatment program or is required to develop such a program.
• The NPDES permitting authority has informed the POTW that it must sample for the parameters in Table C,must
sample other additional parameters(Table D),or submit the results of WET tests for acute or chronic toxicity for
each of its discharge outfalls(Table E).
Yes 4 Complete Tables C, D,and E as
❑ applicable. CINo—) SKIP to Section 4.
3.17 Have you completed monitoring for all applicable Table C pollutants and attached the results to this application
package?
O Yes ❑ No
3.18 Have you completed monitoring for all applicable Table D pollutants required by your NPDES permitting authority and
attached the results to this application package?
No additional sampling required by NPDES
0 Yes ❑ permitting authority.
EPA Form 3510-2A(Revised 3-19) Page 8

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
NC0020338
110000540898 Town of Yadkinville WWTP OMB No.2040-0004
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?
No 4 Complete tests and Table E and SKIP to
❑r Yes ❑ Item 3.26.
3.20 Have you previously submitted the results of the above tests to your NPDES permitting authority?
0 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
(MM/DD/YYYY)
All test C.dubia test passed. 3 FH minnow test passed 1 showed toxicity.
Attached are the quarterly results for the years 2021-2023.
v
m
c
C
ca 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 4 SKIP to Item 3.26.
III 3.23 Describe the cause(s)of the toxicity:
w
d
uJ
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?
El Yes a Not applicable because previously submitted
information to the NPDES •ermittin• authorit .
SECTION 4.INDUSTRIAL DISCHARGES AND HAZARDOUS WASTES(40 CFR 122.21(j)(6)and(7))
4.1 Does the POTW receive discharges from SIUs or NSCIUs?
❑ Yes ❑ No -4 SKIP to Item 4.7.
4.2 Indicate the number of SIUs and NSCIUs that discharge to the POTW.
Number of SIUs Number of NSCIUs
4
- 4.3 Does the POTW have an approved pretreatment program?
N ❑
Yes ❑ No
W, 4.4 Have you submitted either of the following to the NPDES permitting authority that contains information substantially
identical to that required in Table F:(1)a pretreatment program annual report submitted within one year of the
application or(2)a pretreatment program?
El Yes ❑ No 4 SKIP to Item 4.6.
a 4.5 Identify the title and date of the annual report or pretreatment program referenced in Item 4.4.SKIP to Item 4.7.
Town of Yadkiknville PAR 02/7/2024
-o
4.6 Have you completed and attached Table F to this application package?
El Yes ❑ No
EPA Form 3510-2A(Revised 3-19) Page 9

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
110000540898 NC0020338 Town of Yadkinville WWTP OMB No.2040-0004
4.7 Does the POTW receive,or has it been notified that it will receive, by truck, rail,or dedicated pipe,any wastes that are
regulated as RCRA hazardous wastes pursuant to 40 CFR 261?
❑ Yes 0 No 4 SKIP to Item 4.9.
4.8 If yes,provide the following information:
I Annual
Hazardous Waste Waste Transport Method Amount of Units
Number (check all that apply) Waste
Received
❑ Truck ❑ Rail
❑ Dedicated pipe ❑ Other(specify)
0
❑ Truck El Rail
❑ Dedicated pipe El Other(specify)
0
� I
N ❑ Truck ❑ Rail
_ ❑ Dedicated pipe ❑ Other(specify)
=
V)
as 4.9 Does the POTW receive,or has it been notified that it will receive,wastewaters that originate from remedial activities,
N including those undertaken pursuant to CERCLA and Sections 3004(7)or 3008(h)of RCRA?
❑ Yes ❑ No 4 SKIP to Section 5.
4.10 Does the POTW receive(or expect to receive)less than 15 kilograms per month of non-acute hazardous wastes as
= specified in 40 CFR 261.30(d)and 261.33(e)?
El Yes 4 SKIP to Section 5. ❑ No
4.11 Have you reported the following information in an attachment to this application:identification and description of the
site(s)or facility(ies)at which the wastewater originates;the identities of the wastewater's hazardous constituents;and
the extent of treatment,if any,the wastewater receives or will receive before entering the POTW?
❑ Yes ❑ No
SECTION 5.COMBINED SEWER OVERFLOWS(40 CFR 122.21(j)(8))
5.1 Does the treatment works have a combined sewer system?
El Yes ❑r No+SKIP to Section 6.
▪ 5.2 Have you attached a CSO system map to this application?(See instructions for map requirements.)
a ElYes ElNo
• 5.3 Have you attached a CSO system diagram to this application?(See instructions for diagram requirements.)
o ❑ Yes El No
EPA Form 3510-2A(Revised 3-19) Page 10

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
110000540898 NC0020338 Town of Yadkinville WWTP OMB No.2040-0004
5.4 For each CSO outfall,provide the following information. (Attach additional sheets as necessary.)
CSO Outfall Number CSO Outfall Number CSO Outfall Number
City or town
0
Q State and ZIP code
U
U,
o County
cv
° ° °
o Latitude
co Longitude °
o
Distance from shore ft. ft. ft.
Depth below surface ft. ft. ft.
5.5 Did the POTW monitor any of the following items in the past year for its CSO outfalls?
CSO Outfall Number CSO Outfall Number CSO Outfall Number
Rainfall 0 Yes 0 No 0 Yes ❑ No ❑ Yes ❑ No
an
c
o CSO flow volume ❑ Yes ❑ No 0 Yes ❑ No 0 Yes ❑ No
CSO pollutant ❑ Yes ❑ No ❑ Yes 0 No 0 Yes ❑ No
o concentrations
co
o Receiving water quality ❑ Yes ❑ No 0 Yes 0 No 0 Yes 0 No
CSO frequency 0 Yes ❑ No 0 Yes ❑ No 0 Yes 0 No
Number of storm events ❑ Yes ❑ No 0 Yes ❑ No 0 Yes ❑ No
5.6 Provide the following information for each of your CSO outfalls.
CSO Outfall Number CSO Outfall Number CSO Outfall Number
L
>- Number of CSO events in events events events
% the past year
3-
cAverage duration per hours hours hours
c event D Actual or 0 Estimated 0 Actual or 0 Estimated 0 Actual or 0 Estimated
w million gallons million gallons million gallons
o Average volume per event
co
o ❑Actual or❑ Estimated 0 Actual or 0 Estimated ❑Actual or 0 Estimated
Minimum rainfall causing inches of rainfall inches of rainfall inches of rainfall
a CSO event in last year 0 Actual or 0 Estimated 0 Actual or 0 Estimated 0 Actual or 0 Estimated
EPA Form 3510-2A(Revised 3-19) Page 11

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
110000540898 NC0020338 Town of Yadkinville WWTP OMB No.2040-0004
5.7 Provide the information in the table below for each of your CSO outfalls.
CSO Outfall Number CSO Outfall Number CSO Outfall Number
Receiving water name
Name of watershed/
v, stream system
U.S.Soil Conservation 0 Unknown 0 Unknown 0 Unknown
Service 14-digit
watershed code
'> (if known)
Name of state
management/river basin
cn U.S.Geological Survey 0 Unknown 0 Unknown 0 Unknown
8-Digit Hydrologic Unit
Code(if known)
Description of known
water quality impacts on
receiving stream by CSO
(see instructions for
exam•les
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
❑ Section 1: Basic Application ❑ w/variance request(s) ❑ wl additional attachments
Information for All Applicants
❑ Section 2:Additional w/topographic map 0 w/process flow diagram
Information w/additional attachments
0 w/Table A © w/Table D
❑ Section 3: Information on 0 w/Table B ❑ w/Table E
Effluent Discharges
E wl Table C ❑ w/additional attachments
Section 4: Industrial E w/SIU and NSCIU attachments 0 w/Table F
Discharges and Hazardous w/additional attachments
.173
Wastes
Section 5:Combined Sewer ❑ w/CSO map ❑ w/additional attachments
❑ Overflows ❑ w/CSO system diagram
❑ Section 6:Checklist and ❑ w/attachments
Certification Statement
N
6.2 Certification Statement
1 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
Df(
Signat re Date signed
?
EPA Form 3510-2A(Revised 3-19) Page 12

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
110000540898 NC0020338 Town of Yadkinville WWTP 001 0MB No.2040-0004
TABLE A.EFFLUENT PARAMETERS FOR ALL POTWS
Maximum Daily Discharge Average Daily Discharge Analytical ML or MDL
Pollutant
Value Units Value Units Samb lesf Method1 (include units)
•Biochemical oxygen demand
0 ML
CI BOD5 or D CBOD5 20 mg/I 3.8 mg/I 468 SM5210B 2.0 p MDL
resort one
0 ML
Fecal coliform 370 #/100 ml 14.51 #/100m1 468 SM9222D 1 O MDL
Design flow rate 2.5 MGD .812 MGD. 1095
pH(minimum) 6.1 Std.Unts
pH(maximum) 7.3 Std.Unts.
Temperature(winter) 10 deg.Celcius 14.5 deg.Celcius 453
1 Temperature(summer) 30 deg.Celcius 22.2 deg.Celcius 642
Total suspended solids(TSS) 29.0 mg/I 4.42 mg/I 468 SM2540D 2.5 O MDL
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 3510-2A(Revised 3-19) Page 13

This page intentionally left blank.

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
110000540898 NC0020338 Town of Yadkinville WWTP 001 OMB No.2040-0004
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
Value Units Value Units Number Samplesf Methods (include units)
ML
Ammonia(as N) 3.67 mg/I 0.122 mg/I 468 SM-4500-NH3F <0.10 p MDL
Chlorine 26 ug/I 8.4 ug/I 468 SM-4500-CIG <26 ❑ML
(total residual,TRC)2 o MDL
0 ML
Dissolved oxygen 14.5 mg/I 9.5 mg/I 780 SM-4500-0-G <6.0 2 MDL
0 ML
Nitrate/nitrite 22.8 mg/I 8.5 mg/I 156 SM-4500NH3(B&E) 1.0 2 MDL
0 ML
Kjeldahl nitrogen 4.6 mg/I 1.7 mg/I 156 SM4500-NO3 1.0 O MDL
0 ML
Oil and grease <5 mg/I <5 mg/I 36 SM5520B <5 O MDL
0 ML
Phosphorus 2.67 mg/I 1.88 mg/I 156 SM4500-P(B,5-E) 0.02 O MDL
0 ML
Total dissolved solids 298 mg/I 261 mg/I 3 SM2540C-2015 25 0 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 0.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 15

This page intentionally left blank.
1

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
110000540898
NC0020338 Town of Yadkinville WWTP 001 OMB No.2040-0004
TABLE C.EFFLUENT PARAMETERS FOR SELECTED POTWS
Maximum Daily Discharge Average Daily Discharge Analytical ML or MDL
Pollutant
Value Units Value Units Number of Method1 (include units)
Samples
Metals,Cyanide,and Total Phenols
ML
Hardness(as CaCO3) 32.2 mg/I 30.0 mg/I 3 EPA 200.7 Rev 4.4 .66 mg/I 0 MDL
0 ML
Antimony,total recoverable 111.0 ug/I 53.8 ug/I 3 EPA 200.8 Rev 5.4 1.0 ug/I LI MDL
0 ML
Arsenic,total recoverable 0.28 ug/I 0.23 ug/I 3 EPA200.8 Rev 5.4 1.0 ug/I El MDL
0 ML
Beryllium,total recoverable ND ug/I ND ug/I 3 EPA 200.8 Rev 5.4 1.0 ug/I I MDL
0 ML
Cadmium,total recoverable ND ug/I ND ug/I 3 EPA 200.8 Rev 5.4 0.20 ug/I MDL
0 ML
Chromium,total recoverable 0.66 ug/I 0.61 ug/I 3 EPA 200.8 Rev 5.4 1.0 ug/I MDL
0 ML
Copper,total recoverable 12.9 ug/I 11.1 ug/I 3 EPA 200.8 Rev 5.4 2.0 ug/I O MDL
0 ML
Lead,total recoverable 1.0 ug/I 0.37 ug/I 3 EPA 200.8 Rev 5.4 1.0 ug/I 0 MDL
0 ML
Mercury,total recoverable 2.14 ng/I 1.71 ng/I 3 EPA 1631E 0.50 ng/I O MDL
Nickel,total recoverable 3.80 ug/I 1.4 ug/I 3 EPA 200.8 Rev 5.4 0 ML
1.0 ug/I O MDL
Selenium,total recoverable 0.18 ug/I 0.13 ug/I 3 EPA 200.8 Rev 5.4 2.0 ug/I E MDL
0 ML
Silver,total recoverable ND ug/I ND ug/I 3 EPA 200.8 Rev5.4 0.4 ug/I 0 MDL
0 ML
Thallium,total recoverable ND ug/I ND ug/I 3 EPA 200.8 Rev 5.4 .47 ug/I 0 MDL
ML
Zinc,total recoverable 90.2 ug/I 73.9 ug/I 3 EPA 200.8 Rev 5.4 10.0 ug/I El MDL
0 ML
Cyanide ND mg/I ND mg/I 3 SM4500-CN-E 2011 10.0 ug/I O MDL
0 ML
Total phenolic compounds ND mg/I ND mg/I 3 EPA 420.4 0.02 mg/I O MDL
Volatile Organic Compounds
ML
Acrolein ND ug/I ND ug/I 3 EPA 624.1 5.0 ug/I o
MDL
0 ML
Acrylonitrile ND ug/I ND ug/I 3 EPA 624.1 5.0 ug/I O MDL
ML
Benzene ND ug/I ND ug/I 3 EPA 624.1 1.0 ug/I Li MDL
•
ML
Bromoform 46.4 ug/I 32.2 ug/I 3 EPA 624. 1 2.0 ug/I 0 MDL
EPA Form 3510-2A(Revised 3-19) Page 17

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
110000540898 NC0020338 Town of Yadkinville WWTP 001 OMB No.2040-0004
TABLE C.EFFLUENT PARAMETERS FOR SELECTED POTWS
Maximum Daily Discharge Average Daily Discharge Analytical ML or MDL
Pollutant
Value Units Value Units Number of Method1 (include units)
Samples _
0 ML
Carbon tetrachloride ND ug/1 ND ug/I 3 EPA 624.1 2.0 ug/I E MDL
0 ML
Chlorobenzene ND ug/I ND ug/I 3 EPA624.1 2.0 ug/I E MDL
0 ML
Chlorodibromomethane 14.8 ug/I 10.5 ug/I 3 EPA 624.1 2.0 ug/I t MDL
0 ML
Chloroethane ND ug/I ND ug/I 3 EPA 624.1 2.0 ug/1 O MDL
0 ML
2-chloroethylvinyl ether ND ug/1 ND ug/I 3 EPA 624.1 5.0 ug/I l MDL
0 ML
Chloroform 2.6 ug/I 2.5 ug/I 3 EPA 624.1 2.0 ug/I O MDL
0 ML
Dichlorobromomethane 3.5 ug/I 2.7 ug/I 3 EPA 624.1 2.0 ug/I O MDL
ML
1,1-dichloroethane ND ug/I ND ug/I 3 EPA 624.1 2.0 ug/1 0 MDL
0 ML
1,2-dichloroethane ND ug/I ND ug/I 3 EPA 624.1 2.0 ug/I O MDL
0 ML
trans-1,2-dichloroethylene ND ug/1 ND ug/I 3 EPA 624.1 2.0 ug/I O MDL
0 ML
1,1-dichloroethylene ND ug/I ND ug/I 3 EPA 624.1 2.0 ug/I O MDL
0 ML
1,2-dichloropropane ND ug/I ND ug/I 3 EPA 624.1 2.0 ug/1 O MDL
0 ML
1,3-dichloropropylene ND ug/1 ND ug/1 3 EPA 624.1 2.0 ug/I O MDL
ML
Ethylbenzene ND ug/1 ND ug/I 3 EPA 624.1 1.0 ug/I 0 MDL
Methyl bromide ND ug/I ND ug/I 3 EPA 624.1 2.0 ug/I O MDL
0 ML
Methyl chloride ND ug/I ND ug/I 3 EPA 624.1 2.0 ug/I O MDL
0 ML
Methylene chloride ND ug/I ND ug/I 3 EPA 624.1 2.0 ug/I O MDL
0 ML
1,1,2,2-tetrachloroethane ND ug/I ND ug/I 3 EPA 624.1 2.0 ug/I O MDL
0 ML
Tetrachloroethylene ND ug/1 ND ug/I 3 EPA 624.1 2.0 ug/I O MDL
0 ML
Toluene ND ug/I ND ug/I 3 EPA 624.1 1.0 ug/I O MDL
0 ML
1,1,1-trichloroethane ND ug/I ND ug/I 3 EPA 624.1 2.0 ug/I O MDL
ML
1,1,2-trichloroethane ND ug/I ND ug/I 3 EPA 624.1 2.0 ug/I p MDL
EPA Form 3510-2A(Revised 3-19) Page 18

EPA Identification Number NPDES Permit Number Facility Name Outfall Number 1 Form Approved 03/05/19
110000540898 NC0020338 Town of Yadkinville WWTP 001 0MB No.2040-0004
TABLE C.EFFLUENT PARAMETERS FOR SELECTED POTWS
Maximum Daily Discharge Average Daily Discharge
Pollutant Analytical ML or MDL
Value Units Value Units Number of Method1 (include units)
Samples
0 ML
Trichloroethylene ND ug/I ND ug/I EPA 624.1 EPA 624.1 2.0 ug/I 0 MDL
0 ML
Vinyl chloride ND ug/I ND ug/I EPA 624.1 EPA 624.1 2.0 ug/I O MDL
Acid-Extractable Compounds
0 ML
p-chloro-m-cresol ND ug/I ND ug/I 3 EPA 625.1 4.2 ug/I 0 MDL
0 ML
2-chlorophenol ND ug/I ND ug/I 3 EPA 625.1 4.2 ugh' 0 MDL
0 ML
2,4-dichlorophenol ND ug/I ND ug/I 3 EPA 625.1 4.2 ug/I 0 MDL
0 ML
2,4-dimethylphenol ND ug/I ND ug/I 3 EPA 625.1 8.3 ug/I 0 MDL
0 ML
4,6-dinitro-o-cresol ND ug/I ND ug/I 3 EPA 625.1 8.3 ug/I 0 MDL
0 ML
2,4-dinitrophenol ND ug/I ND ug/I 3 EPA 624.1 41.7 ug/I 0 MDL
0 ML
2-nitrophenol ND ug/I ND ug/I 3 EPA 625.1 4.2 ug/I 0 MDL
0 ML
4-nitrophenol ND ug/I ND ug/I 3 EPA 625.1 8.3 ugh' p MDL
0 ML
Pentachlorophenol ND ug/I ND ug/I 3 EPA 625.1 8.3 ug/I 0 MDL
ML
Phenol ND ug/I ND ug/I 3 EPA 625.1 4.2 ug/I 0 MDL
0 ML
2,4,6-trichlorophenol ND ug/I ND ug/I 3 EPA 625.1 8.3 ug/I 0 MDL
Base-Neutral Compounds
o ML
Acenaphthene ND ug/I ND ug/I 3 EPA 625.1' 4.2 ug/I O MDL
0 ML
Acenaphthylene ND ug/I ND ug/I 3 EPA 625.1 4.2 ug/I O MDL
0 ML
Anthracene ND ug/I ND ug/I 3 EPA 625.1 4.2 ug/I O MDL
0 ML
Benzidine ND ug/I ND ug/I 3 EPA 625.1 41.7 ug/I tEl MDL
0 ML
Benzo(a)anthracene ND ug/I ND ug/I 3 EPA 625.1 4.2 ug/I 8 MDL
0 ML
Benzo(a)pyrene ND ug/I ND ug/I 3 EPA 625.1 4.2 ug/I 0 MDL
0 ML
3,4-benzofluoranthene ND ug/I ND ug/I 3 EPA 625.1 4.2 ug/I O MDL
EPA Form 3510-2A(Revised 3-19) Page 19

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
110000540898 NC0020338 Town of Yadkinville WWTP 001 OMB No.2040-0004
TABLE C.EFFLUENT PARAMETERS FOR SELECTED POTWS
Maximum Daily Discharge Average Daily Discharge
Pollutant Analytical ML or MDL
Value Units Value Units Number of Method' (include units)
Samples
0 ML
Benzo(ghi)perylene ND ug/I ND ug/I 3 EPA 625.1 4.2 ug/I 0 MDL
0 ML
Benzo(k)fluoranthene ND ug/I ND ug/I 3 EPA 625.1 4.2 ug/I 0 MDL
0 ML
Bis(2-chloroethoxy)methane ND ug/I ND ug/I 3 EPA 625.1 8.3 ug/I 0 MDL
0 ML
Bis(2-chloroethyl)ether ND ug/I ND ug/I 3 EPA 625.1 4.2 ug/I 0 MDL
0 ML
Bis(2-chloroisopropyl)ether ND ug/I ND ug/I 3 EPA 625.1 4.2 ug/I 0 MDL
0 ML
Bis(2-ethylhexyl)phthalate ND ug/I ND ug/I 3 EPA 625.1 4.2 ug/I 0 MDL
0 ML
4-bromophenyl phenyl ether ND ug/I ND ug/I 3 EPA 625.1 4.2 ug/I 0 MDL
0 ML
Butyl benzyl phthalate ND ug/I ND ug/I 3 EPA 625.1 4.2 ug/I 0 MDL
0 ML
2-chloronaphthalene ND ug/I ND ug/I 3 EPA 625.1 4.2 ug/I 0 MDL
ML
4-chlorophenyl phenyl ether ND ug/I ND ug/I 3 EPA 625.1 4.2 ug/I 9 MDL
0 ML
Chrysene ND ug/I ND ug/I 3 EPA 625.1 4.2 ug/I 0 MDL
0 ML
di-n-butyl phthalate ND ug/I ND ug/I 3 EPA 625.1 4.2 ug/I 0 MDL
0 ML
di-n-octyl phthalate ND ug/I ND ug/I 3 EPA 625.1 4.2 ug/I 0 MDL
0 ML
Dibenzo(a,h)anthracene ND ug/I ND ug/I 3 EPA 625.1 4.2 ug/I 0 MDL
0 ML
1,2-dichlorobenzene ND ug/I ND ug/I 3 EPA 625.1 2.0 ug/I 0 MDL
0 ML
1,3-dichlorobenzene ND ug/I ND ug/I 3 EPA 625.1 2.0 ug/I 0 MDL
0 ML
1,4-dichlorobenzene ND ug/I ND ug/I 3 EPA 625.1 2.0 ug/I 0 MDL
ML
3,3-dichlorobenzidine ND ug/I ND ug/I 3 EPA 625.1 8.3 ug/I 0 MDL
0 ML
Diethyl phthalate ND ug/I ND ug/I 3 EPA 625.1 4.2 ug/I 0 MDL
0 ML
Dimethyl phthalate ND ug/I ND ug/I 3 EPA 625.1 4.2 ug/I 0 MDL
0 ML
2,4-dinitrotoluene ND ug/I ND ug/I 3 EPA 625.1 4.2 ug/I 0 MDL
1=1 ML
2,6-dinitrotoluene ND ug/I ND ug/I 3 EPA 625.1 4.2 ug/I 0 MDL
EPA Form 3510-2A(Revised 3-19) Page 20

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
110000540898 NC0020338 Town of Yadkinville WWTP 001 OMB No.2040-0004
TABLE C.EFFLUENT PARAMETERS FOR SELECTED POTWS
Maximum Daily Discharge Average Daily Discharge Analytical ML or MDL
Pollutant Number of Method' (include units)
Value Units Value Units Samples
0 ML
1,2-diphenylhydrazine ND ug/I ND ug/I 3 EPA 625.1 4.2 ug/I ID MDL
0 ML
Fluoranthene ND ug/I ND ug/I 3 EPA 625.1 4.2 ug/I 1 MDL _
ML
Fluorene ND ug/I ND ug/I 3 EPA 625.1 4.2 ug/I 0
MDL
0 ML
Hexachlorobenzene ND ug/I ND ug/I 3 EPA 625.1 4.2 ug/I O MDL
ML
Hexachlorobutadiene ND ug/I ND ug/I 3 EPA 625.1 4.2 ug/I p MDL
ML
Hexachlorocyclo-pentadiene ND ug/I ND ug/I 3 EPA 625.1 8.3 ug/I 0 MDL
0 ML
Hexachloroethane ND ug/I ND ug/I 3 EPA 625.1 4.2 ug/I El MDL
0 ML
Indeno(1,2,3-cd)pyrene ND ug/I ND ug/I 3 EPA 625.1 4.2 ug/I O MDL
0 ML
Isophorone ND ug/I ND ug/I 3 EPA 625.1 8.3 ug/I O MDL
0 ML
Naphthalene ND ug/I ND ug/I 3 EPA 625.1 4.2 ug/I O MDL
0 ML
Nitrobenzene ND ug/I ND ug/I 3 EPA 625.1 4.2 ug/I 0 MDL
0 ML
N-nitrosodi-n-propylamine ND ug/I ND ug/I 3 EPA 625.1 4.2 ug/I O MDL
N-nitrosodimethylamine ND ug/I ND ug/I 3 EPA 625.1 4.2 ug/I ID MDL
0 ML
N-nitrosodiphenylamine ND ug/I ND ug/I 3 EPA 625.1 8.3 ug/I O MDL
0 ML
Phenanthrene ND ug/I ND ug/I 3 EPA 625.1 4.2 ug/I O MDL
0 ML
Pyrene ND ug/I ND ug/I 3 EPA 625.1 4.2 ug/I O MDL
0 ML
1,2,4-trichlorobenzene ND ug/I ND ug/I 3 EPA 625.1 4.2 ug/I 0 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 0.See instructions and 40 CFR 122.21(e)(3).
EPA Form 3510-2A(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
110000540898 NC0020338 Town of Yadkinville WWTP 001 OMB No.2040-0004
TABLE D.ADDITIONAL POLLUTANTS AS REQUIRED BY NPDES PERMITTING AUTHORITY
Maximum Daily Discharge Average Daily Dischar e
Pollutant Analytical ML or MDL
(list Value Units Number of Methods (include units)
Value Units Samples
❑r No additional sampling is required by NPDES permitting authority.
❑ML
❑MDL
❑ML
0 MDL
❑ML
❑MDL
❑ML
❑MDL
❑ML
0 MDL
❑ML
0 MDL
0 ML
❑MDL
❑ML
❑MDL
❑ML
❑MDL
❑ML
0 MDL
0 ML
❑MDL
❑ML
0 MDL
0 ML
0 MDL
0 ML
❑MDL
❑ML
❑MDL
❑ML
❑MDL
❑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 0.See instructions and 40 CFR 122.21(e)(3).
EPA Form 3510-2A(Revised 3-19) Page 23

This page intentionally left blank.

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
110000540898 NC0020338 Town of Yadkinville WWTP 001 OMB No.2040-0004
TABLE E.EFFLUENT MONITORING FOR WHOLE EFFLUENT TOXICITY
The table provides response space for one whole effluent toxicity sample.Copy the table to report additional test results.
Test Information
Test Number Test Number Test Number
Test species
Age at initiation of test
Outfall number
Date sample collected
Date test started
Duration
Toxicity Test Methods
Test method number
Manual title
Edition number and year of publication
Page number(s)
Sample Type
Check one: 0 Grab 0 Grab 0 Grab
0 24-hour composite ❑ 24-hour composite 0 24-hour composite
Sample Location
Check one: 0 Before Disinfection 0 Before Disinfection 0 Before disinfection
0 After Disinfection 0 After Disinfection 0 After disinfection
0 After Dechlorination 0 After Dechlorination ❑ After dechlorination
Point in Treatment Process
Describe the point in the treatment process
at which the sample was collected for each
test.
Toxicity Type
Indicate for each test whether the test was 0 Acute ElAcute ElAcute
performed to asses acute or chronic toxicity,
or both.(Check one response.) ❑ Chronic ❑ Chronic ❑ Chronic
0 Both El Both ❑ Both
EPA Form 3510-2A(Revised 3-19) Page 25

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03105/19
110000540898 NC0020338 Town of Yadkinville WWTP 001 OMB No.2040-0004
TABLE E. EFFLUENT MONITORING FOR WHOLE EFFLUENT TOXICITY
The table provides response space for one whole effluent toxicity sample.Copy the table to report additional test results.
Test Number Test Number Test Number
Test Type
Indicate the type of test performed.(Check one ❑ Static ❑ Static ❑ Static
response.)
❑ Static-renewal ❑ Static-renewal ❑ Static-renewal
© Flow-through © Flow-through ❑ Flow-through
Source of Dilution Water
Indicate the source of dilution water.(Check © Laboratory water © Laboratory water © Laboratory water
one response.)
❑ Receiving water ❑ Receiving water ❑ Receiving water
If laboratory water,specify type. MHSF
If receiving water,specify source.
Type of Dilution Water
Indicate the type of dilution water. If salt ❑ Fresh water ❑ Fresh water ❑ Fresh water
water,specify"natural"or type of artificial
sea salts or brine used. CISalt water(specify) CISalt water(specify) CISalt water(specify)
Percentage Effluent Used
Specify the percentage effluent used for all 5oi
concentrations in the test series. 50% 50% °
Parameters Tested
Check the parameters tested. ❑ pH ❑ Ammonia ❑ pH ❑ Ammonia ❑ pH CI Ammonia
❑ Salinity © Dissolved oxygen ❑ Salinity © Dissolved oxygen ❑ Salinity © Dissolved oxygen
❑ Temperature ❑ Temperature ❑ Temperature
Acute Test Results
Percent survival in 100%effluent %
LC50
95%confidence interval
Control percent survival % % %
EPA Form 3510-2A(Revised 3-19) Page 26

1
EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
110000540898 NC0020338 Town of Yadkinville WWTP 001 OMB No.2040-0004
TABLE E. EFFLUENT MONITORING FOR WHOLE EFFLUENT TOXICITY
The table provides response space for one whole effluent toxicity sample.Copy the table to report additional test results.
Test Number Test Number Test Number
Acute Test Results Continued
Other(describe)
Chronic Test Results
NOEC
IC25
Control percent survival % %
Other(describe)
Quality Control/Quality Assurance
Is reference toxicant data available? ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No
Was reference toxicant test within ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No
acceptable bounds?
What date was reference toxicant test run
(MM/DD/YYYY)?
Other(describe)
EPA Form 3510-2A(Revised 3-19) Page 27

This page intentionally left blank.

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
110000540898 NC0020338 Town of Yadkinville WWTP OMB No.2040-0004
TABLE F.INDUSTRIAL DISCHARGE INFORMATION
Response space is provided for three SIUs.Copy the table to report information for additional SIUs.
SIU 000E SIU "I SIU 000:
Name of SIU
Austin Electrical Enclosures B&G Foods Snacks Unifi Inc.
Mailing address(street or P.O.box) 2100 Hoots Road P.O.Box 23201 500 Nonni's Way 601 East Main St.
City,state,and ZIP code Yadkinville NC 27055 Yadkinville NC 27055 Yadkinville NC 27323-1437
Description of all industrial processes that affect
or contribute to the discharge. Manufactures eletrical enclosures Baked Goods and Chips Polyester Yard
List the principal products and raw materials that
affect or contribute to the SIU's discharge. Carbon Steel,Galvanized Steel, Wheat,Flour and Sugar Raw Polyester Yarn,Yarn Lubricants
Stainless Steel and Aluminum (Natural&Mineral)
Indicate the average daily volume of wastewater
discharged by the SIU. 3750 gpd 37500 gpd 13500 gpd
How much of the average daily volume is
attributable to process flow? 3000 gpd 12500 gpd 100o gpd
How much of the average daily volume is
attributable to non-process flow? 750 gpd 25000 gpd 12500 gpd
Is the SIU subject to local limits?
0 Yes ❑ No 0 Yes 0 No 0 Yes ❑ No
Is the SIU subject to categorical standards?
CI Yes ❑ No ❑ Yes El No ❑ Yes CI No
EPA Form 3510-2A(Revised 3-19) Page 29

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
110000540898 NC0020338 Town of Yadkinville WWTP OMB No.2040-0004
TABLE F.INDUSTRIAL DISCHARGE INFORMATION
Response space is provided for three SIUs. Copy the table to report information for additional SIUs.
SIU 000E SIU 000� SIU 000:
Under what categories and subcategories is the 40 CFR 433-Metal Finishing
SIU subject?
Has the POTW experienced problems(e.g.,
upsets,pass-through interferences)in the past 4.5 D Yes 0 No ❑ Yes 0 No ❑ Yes 0 No
years that are attributable to the SIU?
If yes,describe.
EPA Form 3510-2A(Revised 3-19) Page 30

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
110000540898 NC0020338 Town of Yadkinville WWTP OMB No.2040-0004
TABLE F.INDUSTRIAL DISCHARGE INFORMATION
Response space is provided for three SIUs.Copy the table to report information for additional SIUs.
SIU 200E SIU SIU
Name of SIU
Unifi Inc.
Mailing address(street or P.O. box) 1032 Unifi Industrial Road
City,state,and ZIP code
Yadkinville NC 27055
Description of all industrial processes that affect Polyester yarn texturing,air jet texturing of
or contribute to the discharge. polyester and nylon fiber,polyester fiber
spinning,PET flake and resin production.
List the principal products and raw materials that Polyester fiber,yarn lubricants(natural&
affect or contribute to the SIU's discharge. mineral oils),paper tubes,polyester chip
(white&color),PET bottle flake.
Indicate the average daily volume of wastewater
discharged by the SIU. 14000o gpd gpd gpd
How much of the average daily volume is
attributable to process flow? 10000o gpd gpd gpd
How much of the average daily volume is
attributable to non-process flow? a0000 gpd gpd gpd
Is the SIU subject to local limits?
✓❑ Yes El No ❑ Yes 0 No ❑ Yes El No
Is the SIU subject to categorical standards?
❑ Yes 0 No El Yes El No 0 Yes El No
EPA Form 3510-2A(Revised 3-19) Page 29

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
110000540898 NC0020338 Town of Yadkinville WWTP OMB No.2040-0004
TABLE F. INDUSTRIAL DISCHARGE INFORMATION
Response space is provided for three SIUs. Copy the table to report information for additional SIUs.
SIU SIU SIU
Under what categories and subcategories is the
SIU subject?
Has the POTW experienced problems(e.g.,
upsets,pass-through interferences)in the past 4.5 ❑ Yes 0 No ❑ Yes © No ❑ Yes CI No
years that are attributable to the SIU?
If yes,describe.
EPA Form 3510-2A(Revised 3-19) Page 30

Flow Narrative (Main Plant)
Influent enters the plant into a channel which has an automatic bar screen and screening press and a
manual bar screen. We utilize the automatic screen primarily unless maintenance is required for the
automatic,then we can switch over to the manual screen. After passing through the bar screen the flow
continues to the grit chamber/vortex then on into the influent pump station. Upon entering the influent
pump station,the influent is mixed with the return activated sludge (RAS)from the secondary clarifier
afterward it is pumped up to the 1st flow splitter box then into the oxidation ditch (1.5 MG). The flow
from then exits the oxidation ditch and continues to the 2'flow splitter box near the clarifier and from
there into the secondary clarifier. (The flow splitter boxes are in place for future expansion if needed for
an additional oxidation ditch and clarifier.)
Once in the clarifier the supernatant travels over the weirs to the chlorine chamber then to the
dechlorination chamber proceeding to the effluent pump station then pumped by force main to North
Deep Creek to the site designated as Outfall 001. The remaining settled sludge in the clarifier will settle
to the bottom of the clarifier to either be returned into the process via a 9" Parshall flume (RAS)or
diverted through a 3" Parshall flume (WAS)to the aerobic digestor.
Flow Narrative (Old Plant)
We have a second waste water plant that we keep maintained for usage during repairs or maintenance
on the main plant.The second plant receives its influent/RAS mixture from the 1st splitter box in the
main plant. The flow then travels through another flow splitter box at the head of 2 parallel aeration
basins. Once leaving the aeration basins the flow is divided between 2 secondary clarifiers. The
supernatant from the clarifiers travels through the same chlorine contact chamber and dechlorination
chamber as the main plant then on to the effluent pump station to Outfall 001.The RAS from both
secondary clarifiers flows into a lift station that pumps it back to the influent pump station to mix with
raw influent which is sent back to the 1st splitter box in the main plant.

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YAD
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' ct' TOWN OF YADKINVILLF
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• "A TOWN IN PROGRESS"
June 26, 2024
Division of Water Resources
WQ Permitting Section
ATTN: Mike Montebello
1617 Mail Service Center
Raleigh,NC 27699-1617
Subject: NPDES Permit Renewal
Sampling Reduction Request
Town of Yadkinville
WWTP
NPDES Permit#NC0020338
Yadkin County
We request that monitoring for BOD5, TSS, NH3-N and Fecal Coliform be reduced under the
"exceptionally performing facilities" criteria to two times per week. The attached data
(summarized in the following table) indicates that the WWTP effluent has greatly exceeded the
minimum criteria for reduced monitoring. The date used for this analysis was for the period of
January 2021 —December 2023.
Analysis of testing results for the past three years:
- Percent of Monthly Average Limit
Parameter Monthly Limit 3-Year Average % of Limit
BOD5 16.0 mg/1 3.8 mg/1 23.8 %
TSS 30.0 mg/L 4.4 mg/L 14.7
Fecal Coliform 200/100 ml 14.5 colonies/100 ml 7.25
NH3-N 2.0 mg/1 0.12 mg/1 6.0%
213 Van Buren Street
Post Office Drawer 816 Telephone (336) 679-8732
Yadkinville, North Carolina 27055-0816 Fax (336) 679-6151

YADK!
.,0 VVtr r L.� .... TOWN OF YADKINVILLE
18
"A TOWN IN PROGRESS"
T F
- Number of Samples Over 200% of MonthlyAverage Limit
P g
Parameter 200% of Monthly Limit Number of Samples Over
BOD5 32.0 mg/1 0
TSS 60 mg/1 0
NH3-N 4.0 mg/1 0
No Fecal Coliform sample exceeded 200%of the weekly average limit
In addition to the exceptional test results,the WWTP is in compliance with all other criteria listed
in Section B Approval Criteria of the October 22, 2012 guidance document regarding reduction
of monitoring frequencies. During the past 3-year review period, there have been no permit
violations or civil penalty assessments.
The Town appreciates the Division's effort to reduce the regulatory and monetary burden on
systems that strive consistently to provide exceptional wastewater treatment. We thank you for
your consideration in these matters
Grant Trivette
WWTP ORC/Pretreatment Coordinator
Town of Yadkinville WWTP
E-Mail:[e-mail]
Phone: [phone]
Fax: [phone]
Cell: [phone]
213 Van Buren Street
Post Office Drawer 816 Telephone (336) 679-8732
Yadkinville, North Carolina 27055-0816 Fax (336) 679-6151
I J

Three Year Data Summary-Yadkinville WWTP-NPDES NC0020338
January 2021-December 2023
FECAL FECAL
BOD BOD NH3 NH3 TSS TSS COLIFORM COLIFORM
Ave. Max Ave. Max Ave. Max (Geometric Geometric
Mean)Ave. Mean)Max
Month/Year mg/I mg/I vigil vigil mg/I mg/I #/100ML
Jan-21 3.3 4.0 0 0 3.6 8.0 3.4 7.0
Feb-21 3.3 5.0 0.46 2.57 6 21.0 1.7 5.0
Mar-21 3.6 5.0 0.54 2.73 4.8 12.0 _ 4.9 16.0
Apr-21 3.6 6.0 0 0 2.5 8.0 41.9 104.0
May-21 3.9 7.0 0.02 0.12 5.2 8.0 39.3 67.0
Jun-21 3.2 4.0 0 0 5.2 9.0 44.3 84.0
Jul-21 4.4 20.0 0 0 8.7 26.0 58.1 71.0
Aug-21 3.0 4.0 0.02 0.12 9.8 14.0 58.5 370.0
Sep-21 3.6 6.0 0.09 0.97 3.1 9.0 42.1 210.0
Oct-21 3.3 5.0 0 0 4.5 11.0 22.4 41.0
Nov-21 3.5 5.0 0.03 0.15 7.5 11.0 6.4 25.0
Dec-21 3.1 4.0 0.09 0.69 3 8.0 6.5 40.0
Jan-22 3.7 7.0 0.17 0.93 4.3 12.0 7.2 19.0
Feb-22 3.8 5.0 0.42 1 6.2 9.0 2.9 35.0
Mar-22 3.4 6.0 0.05 0.47 2.9 22.0 9.9 20.0
Apr-22 3.8 5.0 0 0 4.6 9.0 15.9 60.0
May-22 4.6 10.0 0.03 0.2 7.2 14.0 36.8 290.0
Jun-22 5.4 11.0 0.05 0.25 1.6 6.0 40.1 116.0
Jul-22 3.5 5.0 0.01 0.11 4.1 10.0 54.0 96.0
Aug-22 3.7 6.0 0.02 0.24 6 10.0 65.9 360.0
Sep-22 3.4 5.0 0 0 3.9 10.0 60.8 300.0
Oct-22 4.8 8.0 0.08 0.68 1.7 10.0 24.8 93.0
Nov-22 4.2 7.0 0.12 0.81 2.3 8.0 15.5 54.0
Dec-22 3.7 5.0 0.01 0.17 3.7 11.0 9.3 29.0 I
Jan-23 3.6 5.0 0.07 0.72 1.5 12.0 4.3 15.0
Feb-23 3.3 5.0 0.11 0.66 1.3 5.0 3.4 13.0
Mar-23 4.7 8.0 0.29 1.07 5.3 8.0 7.6 21.0
Apr-23 5.3 7.0 0.23 0.91 4.6 11.0 13.5 28.0
May-23 4.7 7.0 0.54 2.47 5.8 10.0 28.1 65.0
Jun-23 3.7 6.0 0.08 0.53 5.2 22.0 22.8 59.0
Jul-23 3.9 9.0 0.04 0.39 5.9 29.0 34.5 86.0
Aug-23 3.9 11.0 0.02 0.13 3.6 8.0 13.9 48.0
Sep-23 3.5 4.0 0 0 2.9 12.0 14.5 31.0
Oct-23 2.9 4.0 0.53 3.67 2.7 6.0 8.4 24.0
Nov-23 3.7 6.0 0.14 1.16 2.4 11.0 3.5 13.0
Dec-23 3.2 4.0 0.13 1.1 5.9 14.0 3.3 11.0
3-Year Ave. 3.8 0.12 4.4 14.5
Max.Daily result 20.0 3.67 29.0 370.0
Permit limit 16.0 2.0 30 200
C C C G
%of Limit 23.80% 6.00% 14.70% 7.25%

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Page 11 of 11
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Town of Yadkinville
Wastewater Treatment Plant(WWTP)
Latitude: 36°08'01" Receiving Stream: North Deep Creek
Longitude: 80°08'32" Stream Class: C
Quad #: C16NW Sub Basin: 03-07-02
Permitted Row: 2.5 M G D
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Month/Year 50050 00010 00400 00400 50060 0031C 00610 30530 33'6'6 I
FLOW W E
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Feb-21 0.925 11.8 6.9 6.3 10.58 3.25 0.46 6 1.67
Mar-21 0.859 14.0 7.0 6.6 7.43 3.57 0.54 4.79 4.85
Apr-21 0.767 17.1 7.3 6.4 7.77 3.62 <.1 2.46 41.92
May-21 0.786 20.0 6.7 6.3 5.42 3.92 0.02 5.17 39.30
Jun-21 0.777 23.0 7.2 6.4 8.79 3.23 <.1 5.15 44.25
Jul-21 0.774 24.7 6.8 6.3 13.31 4.42 <.1 8.71 58.13
Aug-21 0.795 25.4 6.7 6.4 9.38 3 0.02 9.75 58.54
Sep-21 0.793 24.0 6.9 6.5 12.08 3.6 0.09 3.07 42.09
Oct-21 0.729 22.1 6.8 6.6 12.85 3.33 <.1 4.5 22.40
Nov-21 0.662 17.1 7.0 6.8 5.31 3.46 0.03 7.54 6.39
Dec-21 0.645 14.9 7.0 6.7 8.29 3.07 0.09 3 6.52
Jan-22 0.716 12.7 6.9 6.7 11.92 3.67 0.17 4.25 7.16
Feb-22 0.838 12.7 7.1 6.5 9.83 3.83 0.42 6.17 2.87
Mar-22 0.79 14.7 7.0 6.6 5.54 3.4 0.05 2.87 9.88
Apr-22 0.758 17.1 6.8 6.4 8.46 3.83 <.1 4.58 15.88
May-22 0.815 20.7 6.8 6.6 6.77 4.62 0.03 7.15 36.80
Jun-22 0.715 23.3 6.8 6.3 8.54 5.38 0.05 1.62 40.09
Jul-22 0.822 24.8 6.5 6.2 8.92 3.46 0.01 4.08 53.95
Aug-22 0.744 25.0 7.0 6.3 9.21 3.69 0.02 6 65.89
Sep-22 0.836 23.6 6.7 6.1 9.92 3.36 <.1 3.86 60.81
Oct-22 0.808 19.7 6.8 6.2 3.08 4.75 0.08 1.67 24.84
Nov-22 0.812 17.9 6.7 6.3 5.08 4.21 0.12 2.29 15.51
Dec-22 0.857 14.3 6.9 6.3 6.92 3.69 0.01 3.69 9.32
Jan-23 0.879 13.7 6.8 6.2 3.15 3.62 0.07 1.46 4.32
Feb-23 0.935 13.8 6.9 6.6 9.42 3.25 0.11 1.25 3.43
Mar-23 0.912 15.3 6.8 6.5 12.00 4.71 0.29 5.29 7.56
Apr-23 0.921 17.5 6.9 6.5 6.00 5.25 0.23 4.58 13.53
May-23 0.922 19.8 7.1 6.2 7.50 4.71 0.54 5.79 28.08
Jun-23 0.855 22.0 7.0 6.2 13.00 3.69 0.08 5.23 22.85
Jul-23 0.804 24.9 6.8 6.1 3.15 3.92 0.04 5.92 34.45
Aug-23 0.880 25.1 6.9 6.3 7.46 3.93 0.02 3.57 13.92
Sep-23 0.776 24.5 6.9 6.3 8.69 3.46 <0.1 2.92 14.49
Oct-23 0.740 21.1 6.9 6.4 7.69 2.92 0.53 2.69 8.44
Nov-23 0.724 17.5 6.8 6.3 10.08 3.71 0.14 2.43 3.45
Dec-23 0.701 14.3 7.0 6.5 12.92 3.18 0.13 5.91 3.35
Average 0.803 19.0 8.4 3.8 0.157 4.42 14.51
Max 0.935 25.39 7.3 6.8 13.307 5.38 0.540 9.75 65.89
Min. 0.645 11.75 6.5 6.1 3.076 2.92 0.01 1.25 1.67
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10.5 7.93 1.27 <4.8 <1 <0.2 0.15 2.99 8.7 83.2 <10
10.8 4.70 1.27 0.71 <0.2 0.16 1.02 8.7 117
9.9 5.26 1.18 <1 <0.2 <1 1.13 3.8 109
9.4 10.38 1.61 <4.8 0.56 <0.2 0.12 1.46 7.2 102 <10
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9.3 11.95 3.60 <5 0.71 <0.2 0.086 4.6 10.4 71.2 <10
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9.3 10.15 2.13 1.2 0.66 <0.2 0.11 1.61 12.9 90.2 <8
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10.2 7.96 0.78 10
10.5 7.88 1.12 <4.8 0.64 <0.2 0.14 1.37 7.5 79.2 <10
10.2 6.30 0.51 6.5
9.7 4.78 0.94 8.5
9.0 5.05 1.83 <4.8 0.74 <0.02 0.099 0.958 7.9 70.2 <8
8.5 11.53 2.60 8.9
8.4 11.00 1.91 10
8.1 14.25 2.78 <4.8 <1 <0.02 <1 1.1 13.4 71.1 <10
8.1 11.46 2.60 10
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9.2 16.22 2.24 9.9
9.7 9.98 1.60 10.3
9.5 10.3 1.8747083 1.35 0.64083 0.128214 1.7581 9.2 75.5
12.404 16.9 3.6 1.5 0.77 0.28 4.6 14.4 117
8.03333 3.45 0.26 1.2 0.52 0.086 0.958 3.8 49
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n w i� a, • A N V A. CD W N Cn Cn V P ." CO Cn O W C11 9 . O • A CO V O NO2+NO3
V W co Cn - V O Co A W V . O0 Co Co -I Co A CO N Co O W N Cn - W V O N O -• Co Cn W - O -
N W N Co W W C0 W N
N 1 N s ... N ..a N N -1 . . . . . .
Chi.) iv co . N .AANN co Co Co Co Co iD 4. 0. .JoarnA V Co 1Coia � v TKN
A O V W V C0 Cn o G1 A Cn Co A Co W Cb W 00 Co Co V Co CD o A o W CO CD Co O A 00 Cn w CT CD A Co
WW a WN N N N W W W W N N _ o
n � O -a V CO CO O w - 0 Ca — CO Co EFF. Hardness
in N -' Co Co A Co W Co N VA V Co -
o
0 0 o A A O O 0 O A 0 0 0 0 000 0 000 0 o
V -' IV U1 N 0 " " „ N -a• •• O O •-a -a -a• •-a -a -a .o Selenium
O CO N 00 W -'' con)
N A A A V N CD ai
N N N N N N N N N N N N) N N N o
o N w O CO oo A Co CO N Ja V 00 V Co 2 Creek Hardness S
Co N Cn is) 'CT W W A CO i.0 Co V 'CD - O 0

TKN NO2+NO3 1111 TKN NO2+NO3 TKN NO2+NO3
®i ®MEME 1/6/2022 2.1 0.42 1/5/2023 1.4 6.4
®i 6.8 1/12/2022 1.6 7.2 1/11/2023 1.1 6
®i ®111111/50.1 1/20/2022 1.3 10.8 1/19/2023 1.4 7.7
0.89 0 1/27/2022 1.5 6.8 1/26/2023 2.2 MINMEMIM=1/EM 6.68 Jan.Avq. 1.63 6.31 Jan.Avg. 1.53 6.35
0.84 INIEM. 2/2/2022 1.8 8.9 2/2/2023 1 5 6 5
IIMMECEIIIIImMEEM 2/10/2022 1.8 0 43 2/9/2023 1.3 9
MISECEMEMIMI© 2/17/2022 2.5 0.39 2/16/2023 1.9 0.28
MIESZEIMINEIBM® 2/24/2022 2.1 0.86 2/23/2023 1.3 3 4
'=lit=® Feb.Avg 2.05 2.65 Feb Avg 1 50 4 80
®IIIIMMIE 3/2/2022 1.2 1.2 3/2/2023 1.5 9.6
IMIESTENIM 0.84 W 3/10/2022 1.4 7.4 3/9/2023 2.3 0.34
MEME=.1.11:==EIM 3/17/2022 1.3 3.3 3/16/2023 1.5 3.6
MILEMEMEIMEMEI 3/24/2022 3.3 4.4 3/23/2023 1.9 0.8
.'111111161M11 4.83 3/31/2022 1.5 1.3 3/30/2023 2 0.37
March Avg 1.74 3.52 March Avg. 1.84 2.94 '
®� 4/14/2022 1.9 10.2 4/12/2023 '
ate: *-- a m+s r_:yea - - - .--. .
April Avg. MEMIIIIMIKEEMI April Avg 1 45 8.93 April Avg 1.60 3.47
MEERIMMIMEMIMINEEMII 5/5/2022 1.5 1.7 5/4/2023 1.2 8.6
5/13.'2021 1.7 ® 5/12/2022 2.2 12.3 5/11/2023 4.2 0.6
.1_ 1.3 ® 5/19/2022 2.3 22.8 5/18/2023 1.8 13.2
_ _ S 7 14 5/26/2022 2 3 11.3 5/25/2023 1.8 14.8
12.03 May Avg 2 25 9 30
II�, 6/2/2021� 2 4. 13.8 1
6/10/2021 1.8 14 2 6/9/2022 1 8 13 5 • 6/8/2023 1 6 12 3
._._ 6/16/2022 1.4 132 - 15/2023 1.3 16 -
6/23/2022 1.3 15.1 2/2023 1.3 5.5
.. -_,,1.2,_ .,...-A,#i&.....-•,...- 54.....
June Av.. 1.48 12.60 June Av.. 1.24 9.74
.. 7/14/2021 1 15 6' '7/13/2022, , 1/-5- ' t`9 ;$ 4,212.023 t 5 14 8
July Avg. 1.58 14.10 July Avg. 1.70 10 25 July Avg. 1.45 12.80
8/5/2021 21 16 4Et
874f2022 1.9 10.2 .1",.1", 8/3/2023 2
8/11/2021 1.2 127 8111J2022 5 1i.5 8/10/2023 1 1
8'19/C21 7 5 18t2Q22 _' 13 5 8/17/2023 0 94 •
8/26/2021 1.3 10.7 5/2022 2.3 8.4 8/24/2023 1.5
Aug.Avg. 1.40 11.83 Aug.Avg. 1.98 10.90 r+ - "• 1°" ''"
9/2/2021 1.6 10.1 9/1/2022 1.8 0.22 Aug.Avg. 1.45 10.02
9/8/2021 1.2 2.8 9/8/2022 2.1 8 9/7/2023 1.3 13.2
9/16/2021 1 9.4 9/15/2022 1.7 13.7 9/14/2023 1.3 11
9/23/2021 2.1 9 9/22/2022 2 12.6 9/21/2023 1.1 11.5
9/30/2021 1.4 3.8 9/29/2022 1.4 14.2 9/28/2023 1.3 7.2
Sept.Av 1.46 - 7.02 Set Av• 1 80 9.74 Seat.Av•. 1.25 10.73
10/21/2021 •ND 13.5 10/20/2022 A 1,9 10
Oct •
.Avg 1 60 11 60 Oct Av. 1.58 8.58 Oct.Avg. 2 18 14 10
11/10/2021 19 0.88 11/10/2022 1.9 75 1/9/2023 '2.6 171
11111111.111111111111111. 1.6 20.7 ,
1/2023 1.4 17.1 •
Nov.Av. 1.78 1.37 Nov.Avg. 1.83 5.51 • "�w ao
12/1/2022 ' Nov.Av.. 1.70 14.52
- 12/8/2022
12/16/2021 14 18 1215/2022 .1 4/2023 2
... ♦gets 1g
Dec.Avg. .1.48 1.58 Dec.Avg. 1.68 6.28 Dec.Avg. 1.83 8.18
52 samples 52 Samples 52 samples
12 Mo.Avg's 12 Mo.Avg's 12 Mo.Avg's
156 total samples

Removal Rate Calculations
FLOW BO B AMMONIA
Influent Used in Effluent Used in Influent Used in Effluent Used in Influent Used in Effluent Used in
Sample Date m Id < mg/L Calculation < mg/L Calculation < mg/L Calculation < mg/L Calculation < mg/L Calculation < mg/L Calculation
1/1/2021 Spreadsheet 0.832 151.25 151.25 3.33 3.33 144.33 144.33 3.58 3.58 14.46 14.46 ii 0.1 0.05
Instructions:
2/1/2021 1)Data 0.925 136.83 136.83' 3.25 3.25 146.17 146.17 6 6 12.23 12.23 0.46 0.46
entered only in
3/1/2021 Heavy 0.859 159.36 159.36 3.57 239.21 239.21 4.79 4.79 15.04 15.04 0.54
11
4/1/2021 Bordered
st r d cells 0.767 168.92 168.92 3.62 3.62 136.62 136.62 2.46 2.46 14.62 14.62 < 0.05
R5/1/2021 worksheet is 0 185.33 185.33 3.92 3.92 199.33 199.33 5.17 5.17 17.02 17.02 0.02 0.02
protected, �
6/1/2021 password is 0.777 169.69 169.69 3.23 3.23 191.23 191.23 t 5.15 5.15 16.02 16.02 < 0.1 0.05
7/1/2021 .,2.. 0.774 172.79 172.79 4.42 4.42 177.14 177.14 8.71 8.71 15.79 15.79 < 0.1 0.05
8/1/2021 2)For below 0.795 109.92 109.92 3.00 3.00 i 169.00 169.00 9.75 9.75 14.73 14.73 0.02 0.02
detection data,
9/1/2021 enter"<"in"<• 0.793 124.73 124.73 3.6 3.6 175.53 175.53 3.07 3.07 14.73 14.73 0.09 0.09
column,and
10/1/2021 enter detection 07)9
183.75 183.75 3.33 3.33 205.75 205.75 4.5 ' 4.5 17.11 17.11 < 0.1 0.05
1 1/1/2021 level in Influent 0.662 157.92 157.92 3.46 3.46 , 205.54 205.54 7.54 7.54 18.49 18.49 0.03 0.03
or Effluent
12/1/2021 mg/I columns. 0 189.57 , 189.57 3.07 3.07 208.29 208.29 3 3 17.84 17.84 1 0.09 0.09
Spreadsheet
I'I'2022 will auto- 0.716 175.83 175.83 3.67 3.67 185 185 4.25 4.25 14.68 14.68 0.17 0.17
2i1/2022 maticall calculate 0.838 159.5 159.5 3.83 3.83 177.33 177.33 6.17 ,, 6.17 14.21 14.21 0.42 0.42
3/1/2022 averages and 0.790 173.8 173.8 3.4 3.4 . 192.8 192.8 2.87 2.87 15.87 15.87 0.05 0.05
removal rates , ........... ��
4/1/2022 using 1/2 0.758 161.67 161.67 3.83 3.83 174 174 - 4.58 4.58 17.13 17.13 1 0.1 0.05
value entered.
5/1/2022 0.815 209.85 209.85 4.62 4.62 194.46 194.46 7.15 7.15 16.92 16.92 0.03 0.03
6/1/2022 3)Document 0.715 220.54 220.54 5.38 5.38 139.69 139.69 162 1.62 17 17 0.05 0.05
removal Rate wiassi ...1��
7/1/2022 choice 0.822 152.85 152.85 3.46 3.46 130.46 130.46 4.08 4.08 14.45 14.45 0.01 0.01
8'1'2022 4)Formulas in 0.744 180.62 180.62 3.69 3.69 117.23 117.23 6 6 18.27 18.27 0.02 0.02
9 12022 compre- 0� 163.14 .163.14 3.36 3.36 168.29 168.29 3.86 3.86 18.2 { 0.1 0.05
hensive Guide 1 _
10/1/2022 HWA Chapter, 0.808 210.17 210.17 4.75 4.75 138 138 1.67 1.67 20.17 20.17 0.08 0.08
Section E,
1 1/1/2022 page 1. 0.812 156.07 156.07 4.21 4.21 149.57 149.57 2.29 2.29 19.45 19.45 0.12 0.12
12/1/2022 0.857 187.69 187.69 3.69 3.69 148.62 148.62 3.69 3.69 21.06 21.06 0.01 0.01
IMIMMIr
1/1/2023 0.879 143.62 143.62 3.62 3.62 133.54 133.54 1.46 1.46 17.62 17.62 0.07 0.07
2/1/2023 0.935 166.58 166.58 3.25 3.25 153.33 153.33 1.25 1.25 17.87 17.87 0.11 0.11
3/1/2023 0.912 181.71 181.71 4.71 4.71 132.29 132.29 5.29 5.29 17.72 17.72 0.29 0.29
4/1/2023 0.921 202.67 202.67 5.25 5.25 140 140 4.58 4.58 18 18 0.23 0.23
5/1/2023 0.922 158.29 158.29 4.71 4.71 154.29 154.29 5.79 5.79 16.62 16.62 0.54 i 0.54
6/1/2023 0.855 151.31 151.31 3.69 3.69 150.31 150.31 5.23 5.23 14.84 14.84 0.08 0.08
7/1/2023 0.804 163.92 163.92 3.92 3.92 162.67 162.67 5.92 5.92 18.23 18.23 0.04 0.04
8/1/2023 0.88 147.93 147.93 3.93 3.93 140.29 140.29 3.57 3.57 17.82 17.82 0.02 0.02
9/1/20231 0.776 172.54 172.54 3.46 3.46 123.69 123.69 2.92 2.92 17.66 17.66 0.05
10/1/2023 0.74 173.08 173.08 2.92 2.92 167.69 167.69 2.69 2.69 19.9 19.9 0.53 0.53
1 1/1/2023 0.724 164.36 164.36 3.71 3.71 162 162 2.43 2.43 19.94 19.94 0.14 0.14
12/1/2023 0.701 166.36 166.36 3.18 3.18 152.73 152.73 5.91 5.91 16.55 16.55_ 0.13
Column Averages 0.802842 168.1711 3.778889 163.5117 4.416389 16.89611 0.132499
Unpaired Site Specific RR=>, 97.75% Unpaired Site Specific RR=> 97.30% Unpaired Site Specific RR=> 99.22%
Literature/Default RR=> 85.00% Literature/Default RR=> 85.00% Literature/Default RR=> 85.00%
(1 °„of data is BDL 0 °u of data is BDL 11 "°of data is BDL
RR for this HWA=>� RR for this HWA=>I RR for this HWA='�
Removal Rate Spreadsheet 2021-24
Removal Rates
Page 1 of 7 pages
3/4/2024, 11:40 AM
Revision:August 1999

Removal Rate Calculations
COPPER CYANIDE LEAD
Influent Used in Effluent Used in Influent Used in Effluent Used in Influent Used in Effluent Used in
Sample Date < mg/L Calculation < mg/L Calculation < mg/L Calculation < mg/L Calculation mg/L Calculation < mg/L Calculation
1/1/2021 0.0508 0.0508_ 0.0063 0.0063
2/1/2021 0.004 0.004 _
3/1/2021 0.0048 0.0048
4/1/2021 0.0398 0.0398 0.0063 0.0063
5/1/2021 0.0407 0.0407 0.0132 0.0132
6/1/2021 0.0395 0.0395 0.0102 0.0102
7/1/2021 0.0428 0.0428 0.0129 0.0129
8/1/2021 0.0423 0.0423 0.0122 0.0122
9/1/2021 0.0374 0.0374 0.0098 0.0098
10/1/2021 0.0407 0.0407 0.0119 0.0119
11/1/2021 0.0358 0.0358 0.0102 0.0102-
12/1/2021 0.0279 0.0279 0.009 0.009_ _
1/1/2022 0.0393 0.0393 0.0087 0.0087
2/1/2022 0.0369 0.0369 0.0087 0.0087
3/1/2022 0.0271 0.0271 0.0038 0.0038 ~
4/1/2022 0.0408 0.0408 0.0072
� 0.0072 _
5/1/2022 0.0078 0.0078 _
6/1/2022 _ 0.0096 0.0096
7/1/2022 0.0384 0.0384 0.0104 0.0104
1-18/1/2022 ...� 0.0144 0.0144
9/1/2022 0.0063 0.0063 1-1
101/2022 0.0368 0.0368 0.0129 0.0129
1 1/1/2022 0.0073 0.0073
12/1/2022 0.01 0.01
1/1/2023 0.0375 0.0375 0.0075 0.0075 1_,
2/1/2023 0.0065 0.0065
3/1/2023 0.0085 0.0085
4/1/2023 0.0404 0.0404 0.0079 0.0079
5/1/2023 0.0089 0.0089
6:1/2023 0.01 0.01
7/1/2023 0.033 0.033 0.0134 0.0134
8/1/2023 0.01 0.01
9/1/2023 0.012 0.012 _
I Oil/2023 0.01 0.01 _
I I/1/2023 0.0099 0.0099
12/1/2023 �� 0.0103 ��
Column Averages=>' 0.0383 0.0092
Unpaired Site Specific RR=> 75.87% Unpaired Site Specific RR=> Unpaired Site Specific RR=>
Literature/Default RR=> 86.00% Literature/Default RR=> 69.00% Literature/Default RR=> 61.00%
0 °°of data is BDL of data is BDL of data is BDL
RR for this HWA=>I RR for this HWA=>I RR for this HWA=>II
Removal Rate Spreadsheet 2021-24
Removal Rates
Page 3 of 7 pages
3/4/2024, 11:40 AM
Revision:August 1999
L

Effluent Toxicity Report Form-Chronic Pass/Fail and Acute LC50 Date 28-Jan-21
Facility: Yadkinville WWTP NPOES#NC0020338 Pipe# 001 County: Yadkin
Laboratory Performing Test: ETT Environmental,Inc. Comments
x .
(72 RN 7 Tilt if lic
S gnature of Operator in Responsible Charge
X
Signature of Laboratory Supervisor
MAIL ORIGINAL TO Environmental Sciences Branch
Div.of Water Quality
N.C.DENR
1621 Mail Service Center
Raleigh.North Carolina 27699-1621
North Carolina Ceriodaphnia Chronic Pass/Fail Reproduction Toxicity Test Chronic Test Results
Calculated t= -0.6051
Critical Value= 2.508
CONTROL ORGANISMS .. 1 4 5 6 7 8 ', 1, I. 12 %Reduction= -2.1%
a Young Produced 13 2: <. 20 20 16 . 21 "„Mortality Avg.Repro°.
Adult (UNe (D)ead L L L L I L L L _ L L L L L 0% 20.2
Control Control
Effluent% 50.0% 0% 20.6
Treatment 2 Treatment 2
Control CV
TREATMENT 2 ORGANISMS 2 3 4 5 6 7 r, 9 10 ii 1.2 9.2%
d Young Produced 2.; 22 19 1'- 24 .- _ 21 19 2G _n °',3rd Brood PASS FAIL
Adult (carve (Dead L L L L L L L L L L L L 100% I X I
Complete This for Either Test Test Start Date
S;.Vlleclion(Stara Date 13Jan-21
pH t i-Jan-21 Sama e 2 13-Jan-21
1st sample tat sample .na sanrplu Sample 1
Control 7.7 8.3 7.7 8.2 7.8 8.2 s.1ncje Typ jQurationl
Treatment 2 7.6 8.2 7.6 8.0 7.5 8.2 crab Comp Duration 1s' 2nd
Sample t X 24hrs. lax 1 ox
Sample 7 X 24hrs Dilution Saripi' S.,r=,,ir.
start enc start end start end
D.O. 'st sample 1sr sample 2nd sample Hardness img/L) 81.6
Control 7 7 8.0 7 8 7.7 7.9 7.9 Spec.Cond (limbos) S.'."I 446 478
Treatment 2 8.2 7.7 7.9 7.8 8.0 7.6 Chlorine(mg/L) <.05 <.05
Sample Temp.at receipt("C) 0.3 0.4
LC50IAcute Toxicity Test
(Mortality expressed as%,combining replicates)
Concentration
Mortality slan'en,' _tart;nn'1
LC50_ _ % Method of Determination
95%Confidence Limits 1'aowng Average Probit NI
°', n', Spearman Kerber Other pH D U.
Organism Tested Ceriodaphnia dubia I
DEM Form AT-1 Page 9 of 13
Page 2 of 6

Effluent Toxicity Report Form -Chronic Pass/Fail and Acute LC50 Date 21-Apr-21
Facility: Yadkinville WWTP NPDES#NC0020338 Pipe# 001 County. Yadkin
Laboratory Performing Test. comments
X A.CA„ J -L
ignature of Operator in Responsible Charge
x fe
Signature of Laboratory Supervisor
MAIL ORIGINAL TO Environmental Sciences Branch
Div.of Water Quality
N.C.DENR
1621 Mail Service Center
Raleigh,North Carolina 27699-1621
North Carolina Ceriodaphnia Chronic Pass/Fail Reproduction Toxicity Test Chronic Test Results
Rank sum= 180
Critical Value= 109
CONTROL ORGANI L[. 2 a 6 7 8 ., in 1' 12 %Reduction= -5.2%
a Young Produced 19 2C 20 2S 70 2' %Mortality Avg.Reproc.
Adult (Owe (o)ead L L L L L L L L L L L L 0% 20.9
Control Control
Effluent% 50.00 0% 22.0
Treatment 2 Treatment_
Control CV
TREATMENT 2 ORGANISMS 1 2 3 a rS e. 9 10 11 12 8.3%
tt Young Produced 23 21 77 2. _2 26 -2 2 20 21 2' 22 3rd Brood PASS FAIL
Adult (Liive (Plead L L L L L L L L L L L L 100% I X I
Complete This for Either Test Test Start Date
Collection(Start)Date 07-Apr-21
pH 1st sample 1st nompl° 2nd sample Sample 1 05-Apr•21 Sample_ °,r
Control 7.8 8.2 7.7 8.1 7.8 8.0 Sample Type iDvr-aiio.C1
Treatment 2 7.6 8.2 7.8 8.2 7.6 8.3 ;r,m Comp Duration is r
Sample 1 X 24hrs • -
Sample 2 X 24hrs :a.. ....,.
start ens start cod start end
D.O. 1st sans'le 1st sample 2nd sample Hardness Img/L) 35.1
Control 7.6 8.3 7.9 7.6 7.4 8.1 Spec.Cond.(pmhos; .'12 373 389
Treatment 2 8.2 8.3 8.2 7.7 8.2 8.0 Chlorine(mg/L) <.DS <.05
Sample Temp.at receipt(°C) 0.7 0.9
LC50/Acute Toxicity Test
Concentration
i
Mortality startrend start/end
LC50= % Method of Determination Control
..: :Confidence Limits Moving Average Probl( MI High Conc.
% °4 Spearman Kerber Other 1)H D.O.
Organism Tested Ceriodaphnia dubia
DEM Form AT-1 Page 9 of 13
Page 2 of 6

Effluent Toxicity Report Form-Chronic Pass/Fail and Acute LC50 Date 28-Jul-21
Facility:Yadkinville WWTP NPDES#NC0020338 Pipe* 003 County Yadkin
Laboratory Performing Test: ETT Environmental,Inc. Comments i
(signature of Operator in Responsible Charge
N'
X
Signature of Laboratory Supervisor
MAIL ORIGINAL TO Environmental Sciences Branch
Div.of Water Quality
N.C.DENR
1621 Mail Service Center
Raleigh,North Carolina 27699-1621
North Carolina Ceriodaphnia Chronic Pass/Fail Reproduction Toxicity Test Chronic Test Results
Calculated t= 0.3882
Critical Value= 2.508
CONTROL ORGANISMS 1 2 3 4 5 6 7 8 9 10 '1 12 % Reduction= 0.7%
8 Young Produced 25 23 22 • 21 23 23 21 21 22 22 22 23 %Mortality Avg Reprod
Adult (L)ive (D)ead L L L L L L L L L L L L 0% 22.3
Control Control
Effluent% 50.0% 0% 22.2
Treatment 2 Treatment 2
Control CV
TREATMENT 2 ORGANISMS 1 2 3 4 5 6 7 6 9 10 11 12 5.2%
6 Young ProduCsd 23 22 21 23 22 24 21 21 22 22 23 22 %3rd Brood PASS FAIL
Adult (L)ive (D)ead L L L L L L L L L L L L 100% I X I
Complete This for Either Test Test Start Date
Collection(Start)Date 14-Jui-21
pH 1st sample 1st sample 2nd sample Sample 1 12-Jul-21 Sample 2 14•Jul-21
Control 7.7 8.3 7.8 8.5 7.7 8.1 Samn:e Tyne(nitration)
Treatment 2 7.8 8.2 7.6 8.5 7.9 7.9 Grab Comp Duration 1st 2nd
Sample 1 X 24hrs. Tox Tax
Sample 2 X 24hrs Dilution Sample Sample
start end star; end stain snit
D.O. 1st sample1st sample 2nd sample Hardness(mg/L) 85.4
Control 8.0 8.2 8.0 8.1 8.2 7.9 Spec.Cond.(pmhos) 321 449 457
Treatment 2 8.9 8.7 9.1 8.2 8.6 8.0 Chlorine(mg/L) <.05 <.05
Sample Temp.at receipt(°C) 3.0 1.4
LC50/Acute Toxicity Test
(Mortality expressed as%.Combining'oni,caies)
Concentration
Mortality start/end staniend
LC50_ % Method of Determination Contro
95%Confidence Limits Moving Average Probit I HigrConc.
Spearman Kerber Other pH D.O.
Organism Tested Ceriodaphnia dubia I
DEM Form AT-1 Page 9 of 13
Page 2 of 6

I
Annual Monitoring and Pollutant Scan
'-Permit No. NC0020338 Month JULY
' Outfall-001 EFF PPA Year 2021
3. Facility Name Town of Yadkinville WWTP ORC Grant Trivette
+ Date of Sampling 07/14/2021 Phone [phone]
Analytical Laboratory: Pace Analytical Services
Parameter T Method Level Result Measurement
. . ,-, f4 _ - . yam. , .
Ammonia (as N) C0610 Composite SM 4500-NH3 0 10 ND mg/L
Chlorine (total residual. TRC) 50060 Grab SM 4500 CL G 26 13 ugh'
Dissolved oxygen 00300 Composite SM 4500 0 G 0.1 8.1 mg/L
Nitrite plus Nitrate Total(as N) 00630 Composite EPA 353.2 0.02 15.6 mg/L
Total Kjeldahl Nitrogen 00625 Composite EPA 351.2 0.5 1 mg/L
Oil and Grease 00556 Grab EPA 1664B 5 ND mg/L
Total Phosphorus C0665 Composite EPA 365.1 0.05 2.6 mg/L
Total Dissolved Solids 70295 Composite SM 2540C-2011 25.0 298 mg/L
Hardness1994
00900 Com osite EPA 200.7 Rev 4.4 662 32200 ug/L
4.., iW
01097 Com OSlte EPA 200.7 Rev 4.4 5 0 23.1 ug/L
Antimony p 1994
Arsenic 01002 Composite EPA 200.8 Rev 5.4 1 0.28 ug/I
EPA 200.7 Rev 4.4 1 0 ND ug/L
Beryllium 01012 Composite 1994
Cadmium 01027 Composite EPA 200.8 Rev 5.4 0.20 ND ug/L
Chromium 01034 Composite EPA 200.8 Rev 5.4 1.0 0.52 ug/L
Copper 01042 Composite EPA 200.8 Rev 5.4 2.0 12.9 ug/L
Lead 01051 Composite EPA 200.8 Rev 5.4 1.0 ND ug/L
Mercury (Method 1631E) COMER Composite EPA 1631E 0.50 2.14 ng/I
Nickel 01067 Composite EPA 200.8 Rev 5.4 1.0 3.8 ug/L
Selenium 01147 Composite EPA 200 8 Rev 5 4 2.0 0.10 ug/L
Silver 01077 Composite EPA 200.8 Rev 5.4 0.40 ND ug/L
EPA 200.7 Rev 4.4 10.0 ND ug/L
Thallium 01059 Composite 1994
Zinc 01092 Composite EPA 200.8 Rev 5.4 10.0 52.4 ug/I
Cyanide 00720 Grab EPA 335.4 0.01 ND ughl
Total phenolic compounds 32730 Grab EPA 420.4 0.020 ND mg/L I
Acrolein 34210 Grab EPA 624.1 5.0 ND ug/L
Acrylonitrile 34215 Grab EPA 624.1 5.0 ND ug/L
Benzene 34030 Grab EPA 624.1 1.0 ND ug/L
Bromoform 32104 Grab EPA 624.1 2.0 28.2 ug/L
Carbon tetrachloride 32102 Grab EPA 624.1 2.0 ND ug/L
Chlorobenzene 34301 Grab EPA 624.1 2.0 ND ug/L
Chlorodibromomethane 34306 Grab EPA 624.1 2.0 9.6 ug/L
Chloroethane 85811 Grab EPA 624.1 2.0 ND ug/L
2-chloroethyl vinyl ether 34576 Grab EPA 624.1 5.0 ND ug/L
Chloroform 32106 Grab EPA 624.1 2.0 2.3 ug/L
Dichlorobromomethane 32101 Grab EPA 624.1 2.0 2.3 ug/L
1,1-dichloroethane 34496 Grab EPA624.1 2.0 ND ug/L
1.2-dichloroethane 32103 Grab EPA 624.1 2.0 ND ug/L
Trans-1,2-dichloroethylene 34546 Grab EPA 624.1 2.0 ND ug/L
1,1-dichloroethylene 334501 Grab EPA624.1 2.0 ND ug/L
1,2-dichloropropane 34541 Grab EPA 624.1 2.0 ND ug/L
1,3-dichloropropylene 77163 Grab EPA 624.1 2.0 ND ug/L
Ethylbenzene 34371 Grab EPA 624.1 1.0 ND ug/L
Methyl Bromide 34413 Grab EPA 624.1 2.0 ND ug/L
Methyl Chloride 34418 Grab EPA 624.1 2.0 ND ug/L
I

Methylene Chloride 34423 Grab EPA 624.1 2.0 ND ug/L
, 1,1,2,2-tetrachloroethane 81549 Grab EPA 624.1 2.0 ND ug/L
Tetrachloroethylene 34475 Grab EPA 624.1 2.0 ND ug/L
Toluene 34010 Grab EPA 624.1 1.0 ND ug/L
1.1,1-trichloroethane 34506 Grab EPA 624.1 2.0 ND ug/L
1 1.2-trichloroethane 34511 Grab EPA 624.1 2.0 ND ug/L
Trichloroethylene 39180 Grab EPA 624.1 2.0 ND ug/L
Vinyl chloride 39175 Grab EPA 624.1 2.0 ND ug/L
• >i. ' i A.1�yw,sa.. r ��. S t AFT 1r �W-� ^r'x .,. ;:a .,'M +^wl4
.' . .. �>s ,> ._ . 4 ..,+., ?y,.^dX 4: n;�5 5" t=, s, 04;Nt .i"' t c4" 'i i6;K)r&*r +ary +r'i &. 't,"'�� ,`'�', ,*0'?
P-chloro-m-creso 34452 Grab EPA 625.1 5.0 ND ug/L
2-chlorophenol 34586 Grab EPA 625.1 5.0 ND ug/L
2.4-dichlorophenol 34601 Grab EPA 625.1 5.0 ND ug/L
2,4-dimethylphenol 34606 Grab EPA 625.1 10.0 ND ug/L
4,6-dinitro-o-cresol 34657 Grab EPA 625.1 10.0 ND ug/L
2,4-dinitrophenol 34616 Grab EPA 625.1 50.0 ND ug/L
2-nitrophenol 34591 Grab EPA 625.1 5.0 ND ug/L
4-nitrophenol 34646 Grab EPA 625.1 10.0 ND ug/L
Pentachlorophenol 39032 Grab EPA 625.1 10.0 ND ug/L
Phenol 34694 Grab EPA 625.1 5.0 ND ug/L
2.4.6-trichlorophenol 34621 Grab EPA 625.1 10.0 ND ug/L
Acenaphthene 34205 Grab EPA 625.1 5.0 ND ug/L
Acenaphthylene 34200 Grab EPA 625.1 5.0 ND ug/L
Anthracene CO220 Grab EPA 625.1 5.0 ND ug/L
Benzidine 39120 Grab EPA 625.1 50.0 ND ug/L
Benzo(a)anthracene 34526 Grab EPA 625.1 5.0 ND ug/L
Benzo(a)pyrene 34247 Grab EPA 625.1 5.0 ND ug/L
3.4 benzofluoranthene 34230 Grab EPA 625.1 5.0 ND ug/L
Benzo(ghi)perylene 34521 Grab EPA 625.1 5.0 ND ug/L
Benzo(k)fluoranthene 34242 Grab EPA 625.1 5.0 ND ug/L
Bis (2-chloroethoxy) methane 34278 Grab EPA 625.1 10.0 ND ug/L
Bis (2-chloroethyl) ether 34273 Grab EPA 625.1 5.0 ND ug/L
Bis (2-chloroisopropyl) ether 34283 Grab EPA 625.1 5.0 ND ug/L
Bis (2-ethylhexyl) phthalate 39100 Grab EPA 625.1 5.0 ND ug/L
4-bromophenyl phenyl ether 34636 Grab EPA 625.1 5.0 ND ug/L
Butyl benzyl phthalate 34292 Grab EPA 625.1 5.0 ND ug/L
2-chloronaphthalene 34581 Grab EPA 625.1 5.0 ND ug/L
4-chlorophenyl phenyl ether 34641 Grab EPA 625.1 5.0 ND ug/L
Chrysene 34320 Grab EPA 625.1 5.0 ND ug/L
Di-n-butyl phthalate 39110 Grab EPA 625.1 5.0 ND ug/L
Di-n-octyl phthalate 34596 Grab EPA 625.1 5.0 ND ug/L
Dibenzo(a,h)anthracene 34556 Grab EPA 625.1 5.0 ND ug/L
1,2-dichlorobenzene 34536 Grab EPA 624.1 2.0 ND ug/L
1,3-dichlorobenzene 34566 Grab EPA 624.1 2.0 ND ug/L
1.4-dichlorobenzene 34571 Grab EPA 624.1 2.0 ND ug/L
3,3-dichlorobenzidine 34631 Grab EPA 625.1 10.0 ND ug/L
Diethyl phthalate 34336 Grab EPA 625.1 5.0 ND ug/L
Dimethyl phthalate 34341 Grab EPA 625.1 5.0 ND ug/L
2,4-dinitrotoluene 34611 Grab EPA 625.1 5.0 ND ug/L
2,6-dinitrotoluene C0626 Grab EPA 625.1 5.0 ND ug/L
1,2-diphenylhydrazine 34346 Grab EPA 625.1 5.0 ND ug/L
Fluoranthene C0376 Grab EPA 625.1 5.0 ND ug/L
Fluorene 34381 Grab EPA 625.1 5.0 ND ug/L
Hexachlorobenzene C0700 Grab EPA 625.1 5.0 ND ug/L
Hexachlorobutadiene 39702 Grab EPA 624.1 5.0 ND ug/L
Hexachlorocyclo-pentadiene 34386 Grab EPA 625.1 10.0 ND ug/L

Hexachloroethane 34396 Grab EPA 625.1 5.0 ND ug/L
,. Indeno(1,213-cd)pyrene 34403 Grab EPA 625.1 5.0 ND ug/L
Isophorone 34408 Grab EPA 625.1 10.0 ND ug/L
Naphthalene 34696 Grab EPA 624.1 5.0 ND ug/L
Nitrobenzene 34447 Grab EPA 625.1 5.0 ND ug/L
N-nitrosodi-n-propylamine 34428 Grab EPA 625.1 5.0 ND ug/L
N-nitrosodimethylamine 34438 Grab EPA 625.1 5.0 ND ug/L
N-nitrosodiphenylamine 34433 Grab EPA 625.1 10.0 ND ug/L
Phenanthrene 34461 Grab EPA 625.1 5.0 ND ug/L
Pyrene 34469 Grab EPA 625.1 5.0 ND ug/L
1,2,4,-trichlorobenzene 34551 Grab EPA625.1 5.0 ND ug/L
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 managed 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 fines and imprisonment
for knowing violations.
G(Z-ProvT /4Vt if-
Au i e Representative Name
Signature
i1'/5" z
Date

Effluent Toxicity Report Form -Chronic Pass/Fail and Acute LC50 Date 29-Oct-21
Facility: Yadkinvllle WWTP NPDES#NC0020338 Pipe# 001 County Yadkin
Laboratory Performing Test. ETT Environmental, Inc. comments
X 4i, , 4,• �.14
Sign: ure of Operator in Responsible Charge /
X
Signature of Laboratory Supervisor
MAIL ORIGINAL TO Environmental Sciences Branch
Div.of Water Quality
N.C.DENR
1621 Mail Service Center
Raleigh,North Carolina 27699-1621
North Carolina Ceriodaphnia Chronic Pass/Fail Reproduction Toxicity Test Chronic Test Results
Calculated t= 3.0446
Critical Value= 2.508
CONTROL ORGANISMS 7 a 5 6 7 8 5 10 11 12 % Reduction= 5.6 nk
1 22 23 22 23 23 44,Mortality Avg,.Reprod.
Sr vouny Produced -•- 22 1 - .
Adult (Ltme (D(ead L L L L L L L L L L L L 0% 22.3
Control Control
Effluent% 50.0% 0% 21.0
Treatment 2 Treatment 2
CO11lr01 CV
TREATMENT 2 ORGANISMS 1 2 .. 4 5 6 7 8 9 10 ii 12 3.4%
#Young Produced 22 ' 21 21 20 21 23 21 22 I8 21 21 `,3rd Brood PASS FAIT
Adult (Liive (Dieted L L L L L L L L L L L L 100% I X l
Complete This for Either Test Test Start Date
Collecten_LStartl Date 13-Oct-21
pH 1st sample 15t sample 2nd sample Sample 1 11-Oct-21 Sample 2 13-Oct-21 _
Control 7.7 8.3 7.7 8.3 7.7 8.2 Sample Tvee IDuratienl
Treatment 2 7.8 8.3 7.7 8.3 7.7 8.1 Grab Comp Duration 1st 2nd
Gantpie 1 X 24hrs. Too Tox
Sample 2 X 24hrs Dilution SarrIrlo Sangw•
Stan end start end start end
D.O. 1st sample 1st sample 2nd sample Hardness(mg/L) 87.5
Control 8.2 8.8 8.3 8.5 8.0 8.3 Spec Cond (pmhos) 316 427 4,/1
Treatment 2 8.6 8.6 8.5 8.4 8.8 8.0 Chlonne(mg/L) <.05 <.0:
Sample Temp at receipt t•C, 1.0 `i t--
LC50/Acute Toxicity Test
(Mortality expressed as'',.combininu replicates)
Concentration
Mortality
LC i0 - % Method of Determination
95°6 Confidence Limits Moving Ave•age Probit IIIII
- "
°io Spearman Kerber Other pH D.O.
-
Organism Tested Ceriodaphnia dubia I
DEM Form AT-1 Page 9 of 13
Page 2 of 6

Effluent Toxicity Report Form-Chronic Pass/Fail and Acute LC50 Date 25-Jan-22
Facilit : Yadkinville WWTP NPDES#NC0020338 Pipe# 001 County Yadkin
Laboratory erforming Test Comments
X' �)i.4L✓f L.4 tte?
• Signature of Operator in Responsible Charge
x
Signature of Laboratory Supervisor
MAIL ORIGINAL TO Environmental Sciences Branch
Div.of Water Quality
N.C.DENR
1621 Mail Service Center
Raleigh.North Carolina 27699-1621
North Carolina Ceriodaphnia Chronic Pass/Fail Reproduction Toxicity Test Chronic Test Results
Calculated t= 1.3868
Critical Value= 2.508
' CONTROL ORGANISMS 2 4 6 7 b 9 10 11 1,, % Reduction= 3.8"s
of Young Produced 22 7'. _ , _ 2.1 21 20 3 %Modality Avg.Reprod
Adult (Live (D)ead L L L L L L L L L L L L 0% 22.0
' Control Control
Effluent% 50.0% 0% 21.2
Treatment 2 Treatment 2
Control CV
TREATMENT 2 ORGANISMS 1 2 3 4 5 E 7 8 9 10 11 12 6.7°yo
S Young Produced 19 21 20 24 22 ''-i 22 22 20 21 22 22 %3rd Brood PAS 1- FA'..
Adult (Wive (D1ead L L L L L L L L L L L L 100% I X 1
Complete This for Either Test Test Scut Doll
collection f Slat_DM 12-Jan-22
pH ist sample 1st:ampio 2nd sample Sample 1 10-Jan-22 Sample 2 12-Jan-22
Control 7.7 8.0 7.8 8.1 7.7 8.3 sample Tvoe IDurationt
Treatment 2 7.5 8.2 7.5 8.2 7.4 8.4 Grab Comp Duration tsl 2nd
Sample' X 24hrs. Tox Tox
Sample 2 X 24hrc ndutinn Sample Sampl.-
t`
start end clad end startend -
D.Q. 1s1 sample 1st sample 2nd sample Hardness(ng/L) 83.3
•
Control 8.1 7.5 7.5 7.7 7.9 7.6 Spec Cond (pmhos) 31
1 358 387
Treatment 2 8.5 8.1 7.5 8.2 8.7 7.9 Chlorine(mgtL) <05 <05
Sample Temp.at receipt("C i 0.4 1.3
LC50/Acute Toxicity Test
(Mortality expressed as Y.combining replicates)
Concentration
Mortality stareend startend
LC50= % Method of Determination Control
95%Confidence Limits Moving Average Problt II.
High Cone
% Spearman Karber Other pH D.O.
Organism Tested Ceriodaphnia dubia I
Page 9of13
DEM Form AT-1
Page 2 of 6

I
Effluent Toxicity Report Form -Chronic Pass/Fail and Acute LC50 Date 28-Apr-22
Facility: Yadkinville WWTP NPDES#NC0020338 Pipe a 001 County. Yadkin
Laboratory Performing Test: ETT Environmental, Inc. c,.,mments
' jL.r irt.
fX /ZC[. - 1
Sig ature of Operator in Responsible Charge
V '
x
Signature of Laboratory Supervisor
MAIL ORIGINAL TO Environmental Sciences Branch
Div.of Water Quality
N.C.DENR
1621 Mail Service Center
Raleigh.North Carolina 27699-1621
North Carolina Ceriodaphnia Chronic Pass/Fail Reproduction Toxicity Test Chronic Test Results
Calculated t= 1.1508
Critical Value= 2.508
CONTROL ORGANISMS 1 2 5 6 7 8 .. 10 11 12 % Reduction= 2.7%
a Young Produced 23 22 22 2 i 23 20 21 23 24 20 19 23 %Mortality Avg.Reprod
Adult (Lime (D)ead L L L L L L L L L L L _L 0% 21.8
Control Control
Effluent% 50.0% 0°A, 21.2
T,c:.uiment 2 Treatment 2
Control CV
TREATMENT 2 ORGANISMS 1 2 ' - 5 8 .. 10 11 12 7.1%
tt Young Produced 21 22 t 21 22 24 21 22 19 21 21 21 Y,o 3rd Brood PASS IFA4
More ore (D)ead L L L L L L L L L L L L 100% I
X
Complete This for Either Test Test Start Date
Collection tarlarti Out. 13-Apr-22
pH tsi sample sI saropie 2nd sample Sample 1 11-Apr-22 Sample 2 t3-Apr-22
Control 7,8 8.0 7.8 8.2 7.7 8.2 Samptejvoe tpuratlon_l
Treatment 2 7.4 8.0 7.6 8.1 7.6 8.2 crab Gump Duration 1st 2r.r1
Sample 1 X 24hrs Tax Too
Sample 2 X 24hrs Dilution Sample Sample
start end star! end start end ._.. .._.
D.O. t5t sample tsI sample sample Hardness(mgiLi 81.6
Control 7.5 7.9 8.0 7.9 7.9 7.8 Spec.Cone ,pmnos7 302 406 420
Treatment 2 8.7 7.7 7.9 7.7 8.2 7.6 Chlorine 1mg/Li <.05 <.05
Sample Temp at receipt(`CI 1.4 1.4
LC50/Acute Toxicity Test
tMortWtty expressed as 5,combining replicate.
I
start/end
LC50 = 90 Method of Determination
'rri r.Confidence Limns Moving Average Probit
' % Spearman Karber Other pH D-0
Organism Tested Ceriodaphnia dubia
DEM Form AT-1 Page 8 of 12
Page 2 of 6

Effluent Toxicity Report Form-Chronic Pass/Fail and Acute LC50 Date 26-Jul-22
Facility: Yadkinville WWTP NPDES#NC0020338 Pipe# 001 County: Yadkin
Laboratory Performing
}rmmiing Test: com"ent,
,
S nature of Operator in Responsible Charge �
X '("7",4J 4✓4
Signature of Laboratory Supervisor
MAIL ORIGINAL TO Environmental Sciences Branch
Div.of Water Quality
N.C.DENR
1621 Mail Service Center
Raleigh,North Carolina 27699-1621
North Carolina Ceriodaphnia Chronic Pass/Fail Reproduction Toxicity Test Chronic Test Results
Calculated t= 1
Critical Value= 2.508
CONTROL ORGANISMS 7 9 9 10 11 12 % Reduction= 2.3%
S Young Produced .. L0 22 ._2. 4I 20 22 22 21 22 Mortality Avg.Reprod.
Adult (L)ive (D)ead L L L L L L L L L L L L 0% 21.5
Control Control
Effluent% 50,0°'d 0% 21.0
Treatment 2 Treatment 2
Control CV
TREATMENT 2 ORGANISMS 2 3 4 5 6 7 9 10 11 12 4.2°7o i
a Young Produced 2i; 20 21 22 23 23 20 23 21 19 19 21 3rd Brood PASS FAIL
Adult (L)rve iDlead L L L L L L L L L L L L 100% I X I
Complete This for Either Test Test Start Date
c.glladtiOn(Siam Dalt 13-Jul-22
pH 1st sample 1st sample 2nd sample Sample 1 11-Jul-22 Sample 2 13-Jul-22
Control 7.8 8.0 7.7 8.2 7.7 8.0 Sample Tyoe iDuratrorll
Treatment 2 7.6 8.1 7.5 8.2 7.8 8.2 Grab Comp Durahrn. 1st 2nd
Sample 1 X 24hrs. Ton Toe
Sample 2 X 24hrs Dilution Svnrr, S-rmpio
;tart end start end start end
�.0. 1st sampia 1st sample 2nd sample Hardness(mg/L) 81.6
Control 8.5 8.7 8.2 8.0 8.1 8.8 Spec.Coed 1pmhosl 303 300 339
Treatment 2 8.4 8.9 8.4 8.4 8.4 8.8 Chlonne(mgl. <05 <05
Sample Temp.at receipt('C) 2.5_ 1.9
LC50/Acute Toxicity Test
!Mortality expressed as ,combining replicate
Concentration
Mortality startlend
LC50= % Method of Determination Control I
95%Confidence Limits Moving Aaeraga Prohlt High Conc.
' % 55 Spearman Karher Other pH D.O.
Organism Tested Ceriodaphnia dubia
DEM Form AT-1 Page 3 of 7
Page 2ofi

Effluent Toxicity Report Form-Chronic Pass/Fail and Acute LC50 Date 18-Oct-22
Facility: Yadkinville WWTP NPDES#NC0020338 Pipe# 001 County Yadkin
Laborator Performing Test: Comments
X r -t -:�.1.4tt. :;2
Signatur of Operator in Responsible Charge %
x
Signature of Laboratory Supervisor
MAIL ORIGINAL TO Environmental Sciences Branch
Div.of Water Quality
N.C.DENR
1621 Mail Service Center
Raleigh,North Carolina 27699-1621
North Carolina Ceriodaphnia Chronic Pass/Fail Reproduction Toxicity Test Chronic Test Results
Calculated t= 0
Critical Value= 2.508
CONTROL ORGANISMS I P, 9 10 11 12 %Reduction= 0.0%
n Voung Produced 2U 2u Ali 19 IF. .., 10 =0 18 22 +18 %Mortality Avg.Reprod.
Adult ILtive (Mead L L L L L L L L L L L L 0% 19.6
Control Control
Effluent% 50.0% 0% 19.6
Treatment 2 Treatment 2
Control CV
TREATMENT 2 ORGANISMS 1 2 3 4 a 6 7 8 9 10 11 1_ 6.3°0
#Young Produced 19 20 19 21 19 18 18 21 20 21 19 I %3rd Brood PASS FAIL
Adult (L)rve (Mead L L L L L L L L L L L L 100% I X I
Complete This for Either Test Test Start Date
Collection(Stanl Dow 05-Oct-22
pH 1st sample 1st,arnpie• 2nd sample Sample 1 03Oct-22 Sample 2 05-Oct-22
Control 7.8 8.0 7.8 8.2 7.7 7.8 Sample Type IDuratlonl
Treatment 2 8.0 8.0 7.6 8.2 7.6 7.9 Grab Comp Duration 1st 2nd
Sample 1 X 24hrs. Tox Tox
Sample 2 X 24hrs. Dilution Sample Sample
start end clan end slap end
D.O. 1st sample tot san�le. 2nd sample Hardness(mg/L) 82.0
Control 7.8 7.9 7.5 8.0 7.8 8.6 Spec.Cond.(pmhos) 319 405 418
Treatment 2 8.1 8.2 8.3 8.1 8.4 8.3 Chlorine(mg/L) <0.05 <0.05
Sample Temp.at receipt('C) 0.2 0.9
LC50/Acute Toxicity Test
(Mortality expressed as%,combining replicates)
Concentration
Mortality start/end starvend
LC50= % Method of Determination Control
951h Confidence Limits Moving Average Probit High Conc
Spearman Karber Other pH D.O.
Ceriodaphnia dubia
Organism Tested /� I
DEM Form AT-1 Page 9 of 13
Page 2 of 6

Annual Monitoring and Pollutant Scan
• Permit No. NC0020338 Month October
' Outfall-001 EFF PPA Year 2022
Facility Name Town of Yadkinville WWTP ORC Grant Trivette
Date of Sampling 10/05/2022 Phone [phone]
Analytical Laboratory: Pace Analytical Services
Parameter Parameter I Sample Analytical Quantitation Sample Units of
I Code Type Method Level Result Measurement
Ammonia (as N) CO610 Composite SM 4500-NH3 0.10 ND mg/L
Chlorine (total residual. TRC) 50060 Grab SM 4500 CL G 26 ND ug/L
Dissolved oxygen 00300 Composite SM 4500 0 G 0.1 9.3 mg/L
Nitrite plus Nitrate Total (as N) 00630 Composite EPA 353.2 0.2 11.6 mg/L
Total Kjeldahl Nitrogen 00625 Composite EPA 351.2 0.5 1.2 mg/L
Oil and Grease 00556 Grab EPA 1664B 4.8 1.2 mg/L
Total Phosphorus CO665 Composite EPA 365.1 0.05 1.9 mg/L
Total Dissolved Solids 70295 Composite SM 2540C-2015 25.0 257 mg/L
Hardness 00900 Composite EPA 200.7 Rev 4.4 0.66 29.3 mg/L
Antimony 01097 Composite EPA 200.8 Rev 5.4 1.0 27.3 ug/L
Arsenic 01002 Composite EPA 200.8 Rev 5.4 1.0 0.22 ug/L
Beryllium 01012 Composite EPA 200.8 Rev 5.4 0.10 ND ug/L
Cadmium 01027 Composite EPA 200.8 Rev 5 4 0.20 ND ug/L
Chromium 01034 Composite EPA 200.8 Rev 5.4 1.0 0.66 ug/L
Copper 01042 Composite EPA 200.8 Rev 5.4 2.0 12.9 ug/L
Lead 01051 Composite EPA 200.8 Rev 5.4 1.0 0.11 ug/L
Mercury (Method 1631E) COMER Composite EPA 1631E 0.50 1.61 ng/L
Nickel 01067 Composite EPA 200.8 Rev 5.4 1.0 2.1 ug/L
Selenium 01147 Composite EPA 200.8 Rev 5.4 2.0 0.10 ug/L
Silver 01077 Composite EPA 200.8 Rev 5.4 0.40 ND ug/L
Thallium 01059 Composite EPA 200.8 Rev 5.4 0.47 ND ug/L 1
Zinc 01092 Composite EPA 200.8 Rev 5.4 10.0 90.2 ug/L
Cyanide 00720 Grab 'M 4�m�� t 0.008 ND mg/L
Total phenolic compounds 32730 Grab EPA 420.4 0.02 ND mg/L
Acrolein 34210 Grab EPA 624.1 5.0 ND ug/L
Acrylonitrile 34215 Grab EPA 624.1 5.0 ND ug/L
Benzene 34030 Grab EPA 624.1 1.0 ND ug/L
Bromoform 32104 Grab EPA 624.1 2.0 46.4 ug/L
Carbon tetrachloride 32102 Grab EPA 624.1 2.0 ND ug/L
Chlorobenzene 34301 Grab EPA 624.1 2.0 ND ug/L
Chlorodibromomethane 34306 Grab EPA 624.1 2.0 14.8 ug/L
Chloroethane 85811 Grab EPA 624.1 2.0 ND ug/L
2-chloroethyl vinyl ether 34576 Grab EPA 624.1 5.0 ND ug/L
Chloroform 32106 Grab EPA 624.1 2.0 2.6 ug/L
Dichlorobromomethane 32101 Grab EPA 624.1 2.0 3.5 ug/L
1,1-dichloroethane 34496 Grab EPA 624.1 2.0 ND ug/L
1,2-dichloroethane 32103 Grab EPA 624.1 2.0 ND ug/L
Trans-1,2-dichloroethylene 34546 Grab EPA 624.1 2.0 ND ug/L
1.1-dichloroethylene 334501 Grab EPA 624.1 2.0 ND ug/L
1,2-dichloropropane 34541 Grab EPA 624.1 2.0 ND ug/L
1,3-dichloropropylene 77163 Grab EPA 624.1 2.0 ND ug/L
Ethylbenzene 34371 Grab EPA 624.1 1.0 ND ug/L
Methyl Bromide 34413 Grab EPA 624.1 2.0 ND ug/L
Methyl Chloride 34418 Grab EPA 624.1 2.0 ND ug/L
Methylene Chloride 34423 Grab EPA 624.1 2.0 ND ug/L

1,1,2,2-tetrachloroethane 81549 Grab EPA 624.1 2.0 ND ug/L
• Tetracnloroethylene 34475 Grab EPA 624.1 2.0 ND ug/L
Toluene 34010 Grab EPA 624.1 1.0 ND ug/L
1,1,1-trichloroethane 34506 Grab EPA 624.1 2.0 ND ug/L
1,1,2-trichloroethane 34511 Grab EPA624.1 2.0 ND ug/L
Triichloroethylene 39180 Grab EPA 624.1 2.0 ND ug/L
Vinyl hloride 39175 Grab EPA 624.1 2.0 ND ug/L
Acid-extractable compounds
P-chloro-m-creso 34452 Grab EPA 625.1 4.2 ND ug/L
2-chlorophenol 34586 Grab EPA 625.1 4.2 ND ug/L
2,4-dichlorophenol 34601 Grab EPA 625.1 4.2 ND ug/L
2,4-dimethylphenol 34606 Grab EPA 625.1 8.3 ND ug/L
4,6-dinitro-o-cresol 34657 Grab EPA 625.1 8.3 ND ug/L
2,4-dinitrophenol 34616 Grab EPA 625.1 41.7 ND ug/L
2-nitrophenol 34591 Grab EPA 625.1 4.2 ND ug/L
4-nitrophenol 34646 Grab EPA 625.1 8.3 ND ug/L
Pentachlorophenol 39032 Grab EPA 625.1 8.3 ND ug/L
Phenol 34694 Grab EPA 625.1 4.2 ND ug/L
2.4,6-trichlorophenol 34621 Grab EPA 625.1 8.3 ND ug/L
:„aa M Ys 3 y y�0�j�
/Acenaphthene 1 34205 Grab EPA 625.1 4.2 ND ug/L
Acenaphthylene 34200 Grab EPA 625.1 4.2 ND ug/L
Anthracene CO220 Grab EPA 625.1 4.2 ND ug/L
Benzidine 39120 Grab EPA 625.1 41.7 ND ug/L
Benzo(a)anthracene 34526 Grab EPA 625.1 4.2 ND ug/L
Benzo(a)pyrene 34247 Grab EPA 625.1 4.2 ND ug/L
3,4 benzofluoranthene 34230 Grab EPA 625.1 4.2 ND ug/L
Benzo(ghi)perylene 34521 Grab EPA 625.1 4.2 ND ug/L
Benzo(k)fluoranthene 34242 Grab EPA 625.1 4.2 ND ug/L
Bis (2-chloroethoxy) methane 34278 Grab EPA 625.1 8.3 ND ug/L
Bis (2-chloroethyl) ether 34273 Grab EPA 625.1 4.2 ND ug/L
,Bis(2-chloroisopropyl) ether 34283 Grab EPA 625.1 4.2 ND ug/L
Bis (2-ethylhexyl) phthalate 39100 Grab EPA 625.1 4.2 ND ug/L
4-bromophenyl phenyl ether 34636 Grab EPA 625.1 4.2 ND ug/L
Butyl benzyl phthalate 34292 Grab EPA 625.1 4.2 ND ug/L
2-chloronaphthalene 34581 Grab EPA 625.1 4.2 ND ug/L
4-chlorophenyl phenyl ether 34641 Grab EPA 625.1 4.2 ND ug/L
Chrysene 34320 Grab EPA 625.1 4.2 ND ug/L
Di-n-butyl phthalate 39110 Grab EPA 625.1 4.2 ND ug/L
Di-n-octyl phthalate 34596 Grab EPA 625.1 4.2 ND ug/L
Dibenzo(a,h)anthracene 34556 Grab EPA 625.1 4.2 ND ug/L
1,2-dichlorobenzene 34536 Grab EPA 624.1 2.0 ND ug/L
1,3-dichlorobenzene 34566 Grab EPA 624.1 2.0 ND ug/L
1,4-dichlorobenzene 34571 Grab EPA 624.1 2.0 ND ug/L
3,3-dichlorobenzidine 34631 Grab EPA 625.1 8.3 ND ug/L
Diethyl phthalate 34336 Grab EPA 625.1 4.2 ND ug/L
Dimethyl phthalate 34341 Grab EPA 625.1 4.2 ND ug/L
2,4-dinitrotoluene 34611 Grab EPA 625.1 4.2 ND ug/L
2,6-dinitrotoluene CO626 Grab EPA 625.1 4.2 ND ug/L
1,2-diphenylhydrazine 34346 Grab EPA 625.1 4.2 ND ug/L
Fluoranthene CO376 Grab EPA 625.1 4.2 ND ug/L
Fluorene 34381 Grab EPA 625.1 4.2 ND ug/L
Hexachlorobenzene CO700 Grab EPA 625.1 4.2 ND ug/L
Hexachlorobutadiene 39702 Grab EPA 624.1 4.2 ND ug/L
Hexachlorocyclo-pentadiene 34386 Grab EPA 625.1 8.3 ND ug/L
Hexachloroethane 34396 Grab EPA 625.1 4.2 ND ug/L

Indeno(1,2,3-cd)pyrene 34403 Grab EPA 625.1 4.2 ND ug/L
Isophorone 34408 Grab EPA 625.1 8.3 ND ug/L
- Naphthalene 34696 Grab EPA 624.1 4.2 ND ug/L
Nitrobenzene 34447 Grab EPA 625.1 4.2 ND ug/L
N-nitrosodi-n-propylamine 34428 Grab EPA 625.1 4.2 ND ug/L
N-nitrosodimethylamine 34438 Grab EPA 625.1 4.2 ND ug/L
N-nitrosodiphenylamine 34433 Grab EPA 625.1 8.3 ND ug/L
Phenanthrene 34461 Grab EPA 625.1 4.2 ND ug/L
Pyrene 34469 Grab EPA 625.1 4.2 ND ug/L
1,2,4,-trichlorobenzene 34551 Grab EPA 625.1 4.2 ND ug/L
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 managed 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 fines and imprisonment
for knowing violations. /)2 //2 i V C c_
thorized Representative Name
Aignature

Annual monitoring anu roiiutdnl aL.ait
-Permit-Nc. NC0020338 Month January
Outfaii- 0b1 EFF PPA Year 2023
'Facility Name Town of Yadkinville WWTP ORC Grant Trivette
!Date of Sampling 01/11/2023 Phone [phone]
%Analytical Laboratory: Pace Analytical Services
Parameter Sample Analytical Quantitation Sample Units of
Parameter
. Code Type Method Level Result Measurement
Ammonia (as N) C0610 Composite SM 4500-NH3 0.1 ND mg/L
Chlorine (total residual, TRC) 50060 Grab SM 4500 CL G 26 7 ug/L
Dissolved oxygen 00300 Composite SM 4500 0 G 0.1 10.6 mg/L
Nitrite plus Nitrate Total(as N) 00630 Composite EPA 353.2 0.08 6.0 mg/L
Total Kjeldahl Nitrogen 00625 Composite EPA. 351.3 ' 0.5 1.1 mg/L
Oil and Grease 00556 Grab EPA 1664E 4.8 ND mg/L
1 Total Phosphorus C0665 Composite EPA 365.1 0.05 1.2 mgiL
Total Dissolved Solids 70295 Composite SM 2540C-2015 25.0 227 mg/L
Hardness 00900 Composite SM 2340B 0.66 28.5 mg/L
fbitajOkeital.recoverable),cyanicIfitAncliolal phenols
Antimony 01097 Composite EPA 200.8 Rev 5.4 1.0 111 I ug/L
f
Arsenic 01002 Composite EPA 200.8 Rev 5.4 1.0 0.19 ug/L
Beryllium 01012 Composite EPA 200.8 Rev 5.4 0.10 ND ug/L
Cadmium 01027 Composite EPA 200.8 Rev 5.4 0.20 ND ug/L
Chromium 01034 Composite EPA 200.8 Rev 5.4 1.0 0.64 ug/L
Copper 01042` • Composite EPA 200.8 Rev 5.4 2 7.5 ug/L
Lead 01051 Composite EPA 200.8 Rev 5.4 0.14 1.0 ug/L
Mercury(Method 1631E) COMER Composite EPA 1631E 0.5 1.37 ng/l
Nickel 01067 Composite EPA 200.8 Rev 5.4 1.0 2.1 ug/L
Selenium 01147 Composite EPA 200.8 Rev 5.4 2.0 0.18 ug/L
Silver 01077 Composite EPA 200.8 Rev 5.4 0.40 ND ug/L
Thallium 01059 Composite EPA 200.8 Rev 5.4 0.47 ND ug/L
Zinc 01092 Composite EPA 200.8 Rev 5.4 10.0 79.2 ug/L
Cyanide 00720 Grab JIVE 44JVU IJIWC 0.01 ND mg/L
oni-1
Total phenolic compounds 32730 Grab EPA 420.4 0.02 ND mg/L
• Acrolein 34210 Grab EPA 624.1 5.0 ND ug/L
1 , Acrylonitrile 34215 Grab EPA 624.1 5.0 ND ug/L
' Benzene 34030 Grab EPA 624.1 1.0 ND ug/L
• Bromoform 32104 Grab EPA 624.1 2.0 22.1 ug/L
• Carbon tetrachloride 32102 Grab EPA 624.1 2.0 ND ug/L
d Chlorobenzene 34301 Grab EPA 624.1 2.0 ND ug/L
, Chlorodibromomethane 34306 Grab EPA 624.1 2.0 7.2 ug/L
4 Chloroethane 85811 Grab EPA 624.1 2.0 ND ug/L
• 2-chloroethyl vinyl ether 34576 Grab EPA 624.1 5.0 ND ug/L
' Chloroform 32106 Grab EPA 624.1 2.0 2.6 ug/L
. Dichlorobromomethane 32101 Grab EPA 624.1 2.0 2.3. ug/L
, 1,1-dichloroethane 34496 Grab EPA624.1 2.0 ND ug/L 1
• 1,2-dichloroethane 32103 Grab EPA 624.1 2.0 ND ug/L
t Trans-1,2-dichloroethylene 34546 Grab EPA 624.1 2.0 ND ug/L
• 1,1-dichloroethylene 334501 Grab EPA 624.1 2.0 ND ug/L
• 1,2-dichloropropane 34541 Grab EPA 624.1 2.0 ND ug/L
' 1,3-dichloropropylene 77163 Grab EPA 624.1 2.0 ND ug/L
' Ethylbenzene _ 34371 Grab EPA 624.1 1.0 ND ug/L
• Methyl Bromide 34413 Grab EPA 624.1 2.0 ND ug/L
. Methyl Chloride 34418 Grab EPA 624.1 2.0 ND ug/L
, Methylene Chloride l 34423 Grab EPA 624.1 2.0 ND ug/L

1,1,2,2-tetrachloroethane 81549 Grab t1-7-k bZ4. I • L.0 i`+v uy,,_
-TetracFiloroethylene 34475 Grab EPA 624.1 2.0 ND ug/L
Toluene ' 34010 Grab EPA 624.1 1.0 ND ug/L
'1,1,1-trichloroethane 34506 Grab EPA 624.1 2.0 ND ug/L
/1,1,2-trichloroethane 34511 Grab EPA 624.1 2.0 ND ug/L
Trichloroethylene 39180 Grab EPA 624.1 2.0 ND ug/L
Vinyl chloride 39175 Grab EPA 624.1 2.0 ND ug/L
Acid-extractable compounds
P-chloro-m-creso 34452 Grab EPA 625.1 4.2 ND ug/L
2-chlorophenol 34586 Grab EPA 625.1 4.2 ND uglL
2,4-dichlorophenol 34601 Grab EPA 625.1 4.2 ND ug/L
2,4-dimethyiphenol 34606 Grab EPA 625.1 8.3 ND ug/L
4,6-dinitro-o-cresol 34657 Grab EPA 625.1 8.3 ND ug/L
2,4-dinitrophenol 34616 Grab EPA 625.1 41.7 ND ug/L
2-nitrophenol 34591 Grab EPA 625.1 4.2 ND ug/L
4-nitrophenol 34646 Grab EPA 625.1 8.3 ND ug/L
Pentachiorophenol 39032 Grab EPA 625.1 8.3 ND uglL
Phenol 34694 Grab EPA 625.1 4.2 ND ug/L
2,4,6-trichlorophenol 34621 Grab EPA 625.1 1 8.3 ND uglL
_
Sao Fe>e.a _ e.o,
Acenaphthene 34205 Grab EPA 625.1 4.2 ND ug/L
Acenaphthylene 34200 Grab EPA 625.1 4.2 ND . ug/L
Anthracene 00220 Grab EPA 625.1 4.2 ND ug/L
Benzidine 39120 Grab EPA 625.1 41.7 ND ug/L
Benzo(a)anthracene 34526 Grab EPA 625.1 4.2 ND ug/L
Benzo(a)pyrene 34247 Grab EPA 625.1 4.2 ND ug/L
• 3,4 benzofluoranthene 34230 Grab EPA 625.1 4.2 ND ug/L
Benzo(ghi)perylene 34521 Grab EPA 625.1 4.2 ND ug/L
Benzo(k)fluoranthene 34242 Grab EPA 625.1 4.2 ND ug/L
Bis(2-chioroethoxy) methane 34278 Grab EPA 625.1 8.3 ND ug/L
• Bis(2-chioroethyl) ether 34273 Grab EPA 625.1 4.2 ND ug/L
Bis(2-chioroisopropyl)ether 34283 Grab EPA 625.1 4.2 ND ug/L
Bis(2-ethyihexyi) phthalate 39100 Grab EPA 625.1 4.2 ND ug/L
4-bromophenyl phenyl ether 34636 Grab EPA 625.1 4.2 ND ug/L
4. Butyl benzyl phthalate 34292 Grab EPA 625.1 4.2 ND ug/L
2-chloronaphthalene 34581 Grab EPA 625.1 4.2 ND uglL
4-chiorophenyi phenyl ether 34641 Grab EPA 625.1 4.2 ND ug/L
Chrysene 34320 Grab EPA 625.1 4.2 ND ug/L
Di-n-butyl phthalate 39110 Grab EPA 625.1 4.2 ND ug/L
Di-n-octyl phthalate 34596 Grab EPA 625.1 4.2 ND ug/L
0 Dibenzo(a,h)anthracene 34556 Grab EPA 625.1 4.2 ND ug/L
1,2-dichlorobenzene 34536 Grab EPA 624.1 2.0 ND ug/L
1,3-dichlorobenzene 34566 Grab EPA 624.1 2.0 ND ug/L
1,4-dichlorobenzene 34571 Grab EPA 624.1 2.0 ND uglL
3,3-dichlorobenzidine 34631 Grab EPA 625.1 8.3 ND ug/L
Diethyl phthalate 34336 Grab EPA 625.1 4.2 ND ug/L
Dimethyl phthalate 34341 Grab EPA 625.1 4.2 ND ug/L
2,4-dinitrotoluene 34611 Grab EPA 625.1 4.2 ND ug/L
. 2,6-dinitrotoluene C0626 Grab EPA 625.1 4.2 ND ug/L
1,2-diphenylhydrazine 34346 Grab EPA 625.1 4.2 ND ug/L
Fluoranthene C0376 Grab EPA 625.1 4.2 ND ug/L
Fluorene 34381 Grab EPA 625.1 4.2 ND ug/L
Hexachlorobenzene C0700 Grab EPA 625.1 4.2 ND ug/L
Hexachlorobutadiene 39702 Grab EPA 624.1 4.2 ND ug/L
Hexachlorocyclo-pentadiene 34386 Grab EPA 625.1 8.3 ND ug/L
Hexachloroethane 34396 Grab EPA 625.1 4.2 ND ug/L

Indeno(1,2,3-cd)pyrene 34403 Grab EHA bLb."i 4.L IVU `" "
IIr s_Ophorone 34408 Grab EPA 625.1 8.3 ND ug/L
JNaphthaibne 34696 Grab EPA 624.1 4.2 ND ug/L
Nitrobenzen
e 34447 Grab EPA 625.1 4.2 ND ug/L
iN-nitrosodi-n-propylamme 34428 Grab EPA 625.1 ND ug/L
4.2
I N-nitrosodimethylamine 34438 Grab EPA 625.1 4.2 ND ug/L
N-nitrosodiphenylamine 34433 Grab EPA 625.1 8.3 ND ug/L
Phenanthrene 34461 Grab EPA 625.1 4.2 ND ug/L
Pyrene 34469 Grab EPA 625.1 4.2 ND ug/L
1,2,4,-trichlorobenzene 34551 Grab EPA 625.1 4.2 ND ug/L
I certify.under penalty of law.that this document and all attachments were prepared under my direction or super ision 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 managed the system.or those persons directly responsible for gathering
the information.the information submitted is.to the best of my know ledge and belief.true.accurate.and complete. I am aware
that there are significant penalties for submitting false information.including the possibility of lines and imprisonment
for knowing violations.
C Ift-Arr 12 i vE
Au ized Representative Name
Fef/vim( 01Sdi
Signature
/0 ., _3
Date

Effluent Toxicity Report Form -Chronic Pass/Fail and Acute LC50 Date 26-Jan-23
Facility:Yadkinville WWTP NPDES4 NC0020338 Pun 41 001 County Yadkin
Laboratory P-rforming Test: ETT Environmental, Inc.
X / C/ )
Signature of Operato in Responsible Charge
44iV o.
X
Signature of Laboratory Supervisor
MAIL ORIGINAL TO Environmental Sciences Branch
Div.of Water Quality
N.C.DENR
1621 Mail Service Center
Raleigh,North Carolina 27699-1621
North Carolina Ceriodaphnia Chronic Pass/Fail Reproduction Toxicity Test Chronic Test Results
Calculated t= 1.3704
Critical Value= 2.508
CONTROL ORGANISMS 1 2 3 9 �'i Reduction= 2.7
e Young Produced 22 21 22 21 :e:' !,,,•,.! is,,,i Rrpr Id
Adult (Urve (D)ead L L L L L L L L L L L L 0'1, 21.8
CmpIrol
Effluent% 50.0% 0 21.2
'i• .uncr._ Treatment 2
TREATMENT 2 ORGANISMS 1 2 3 4 5 6 7 Et 0 10 ti 2.9:.
#Young Produced 21 23 22 21 22 2 22 21 21 2 PASS FAIL
Adult {Live (D)ead L L L L L L L L L L L L 100% I X I
Complete This for Either Test Test Start Date
C:,i,.. . 1 t-Jan-23
pH 1st sample let sample 2nd sample .. , - I I-Jan-23
Control 7.8 8.2 7.8 8.2 7.7 8.0
Treatment 2 7.5 8.1 7.6 8.2 7.7 8.0
X ..:i,
. , X
D.O. start end start end start nd
1st sample1st sample 2nd sample I 80.0
Control 8.2 8.2 8.3 8.2 8.0 8.2 312 366 390
Treatment 2 9.0 8.2 8.9 8.0 8.8 7.8 L <0.05 <0.05
0.8 0.4
LC50/Acute Toxicity Test
(Mortality expressed as%.combining replicates)
Cenci,r,rai,on
startnend
LC50= % Method of Determination Conuei
95%Confidence Limits Moving Average Prohit I ti,gh Conic.
Spearman Karber Other pH D.O.
Organism Tested Ceriodaphnia dubia I
DEM Form AT-1 Page 9 of 13
Pace 2 of 6

Efllaent Toxicity Report Form-Chronic Fathead Minnow Multi-Concentration Test
Facility: YADKINVILLE NPDES it NC0020338 Pipe#. 001 County. Yadk.'
•
Laboratory ETT Environmental.Inc Comments I
x Fungal growth noteu in elflueni treatments Cut not In
'ounuur.Tnrs Is Itne!tycause tit sn9Tn coxtO erfem.
Signature of Operator In Responsible Charge
x
Signature of Laboratory Supervisor
\IA11.(IRIl1I\:ti I ii. Fue a enmvnt:9 Sciences Branch
the scion of St alai Quality
NC DENR
1621 Moil Sees ice Center
Raleigh.\C 276Y4-1621
Test Initiation 0ateiTime 01111/23 101.U0 PM Avg WtiSury Control 0.5951 Test Organisms
Elf. Repl. 1 2 4 4 Cultured In-House
Control Surviving a 8 9 10 8 %Survival 87.5% X Outside Supplier
Original# 10 10 10 10
WVoriginal(mg) 0.4910 0 5320 0.5430 0 5060 Avg Wt(mgi 0.5180 Hatch Date• 01/09
1
12.5 Surviving# 7 8 8 0 %Survival 86.5% Hatch Time: 1500.1830
Original a 8 10 9 li
Wttoriginat(mgl 0 4487 0.4060 0,5211 0 3510 Avg Wt(mg) 04392
25.0 Surviving 8 6 9 8 7 %Survival 76 95,
Original# 9 10 10 10
Wt/original(mg' 0.2733 0.5060 0,21410 0.2260 Avg Wt(mg) 0,3616
50.0 Surviving# 8 1 8 %Survival 84.6%
Original4 1U iu 9 10
Wtioriginal(mg) 0.4350 0,3770 0.2911 0.1870 Avg Wt(mg) 0.3225
75 0 Surviving It 10 8 8 %Survival 8(.5 0
Original# I) 10 10 10
WI/original(mg) 0 3710 0.4440 0.2750 0.3530 Avg WI 1mg) 0.3608
100.0 Surviving a 6 10 9 8 %Survival 87.5%
Original# 10 10 10 10
WI/original(mg) 0.3300 04880 0.3430 0.3050 Avg Wt(mg) 0.3615
Water Quality Data Day
Control u 2 3 4 5 6 7
pH(SU)snit/Fin 7,7 / -- 7.7 I 7.9 7.8 1 7.7 7 7 7.8 7.7 I 8.1 7.7 / 7.8 7.7 / 8.1 ----1 7 9
DO(mg/L) Init/Fin 7.8 i -• 8.2 / 6.8 8,4 I 6 7 8.2 7 1 7.9 I 6.7 8.1 I 7.2 8.2 / 6.8 •---1 6.4
Temp(C)Init/Fin 24.7 -- 24 5 ' 25.1 24,6 r 24 0 24 24.1 24 4 ' 24.6 24.3 r 24.6 24.6
High Concentration 0 1 2 3 4 5 6 7
pH(SU)Init/Fin 7.7 / -- 8.2 / 8.1 7.3 7.7 7.6 7.7 7.9 / 8.4 7.9 / 8.0 8.4 / 8.1 ----/ 8.0
DO(mg/L) Init/Fin 8.8 I -- 7.9 / 7.1 9.1 6.8 9.5 i 7.0 8.0 / 7.7 , 8.1 / 7.4 7.9 / 6,8 -1 6.7
Temp(C)Init/Fin 26.0 i -- 24,7 ' 25.1 25.2 24.6 24 7 • 24.7 24.4 / 24.6 24.3 ' 24 5 24.6 : 24.8 --- i 25.4
Sample 1 2 Survival Growth Overall Result
Collection Start Date 111/09/23 01/11,23 1)1.12 2:3 Normal 086 rI'.% CIA/ 17.7%
Grab Horn.Var. 2.96 6 u..,
Composite(Duration) 24 hr 24 hr 24 hr NOEC 100,0% 12.5'.
Hardness(mg/L) 28.6 31.4 29 4 LOEC > 100.0% 25.0
Alkalinity(mg/L) 68 8 58.8 58'/ ChV > 100.0% 17.7N
Conductivity(umhoslcm) 366 390 387 Method I Test I Test
Chlorine(mg/L) <0.05 <0.05 387
Temp at Receipt(C) ^.8 0.4 0.6 Stats Survival Growth
Cone. Critical Calculated Critical Calculated
Dilution H2O 13% 2,40 0.23 2.40 1.30
Hardness(mg/L) 83.0 25% 2 40 1.65 2.40 2.59
Alkalinity(mg/L) 120.0 50 r 2.40 0.52 2.40 3.23
Conductivity(umhos/cm] 56 75% 2.40 0.00 2,40 2.60
100% 2.40 U.00 2.40 2.59
DWQ Form AT•6(t/04)
-- 'age of 17
Pane 2 of 7

Effluent Toxicity Report Form-Chronic Pass/Fail and Acute LC50 Date 25-Apr-23
Facility: Yadkinville NPDES#s NC0020338 Pipe# 001 County: Yadkin
Laboratory Performing Test. ETT Environmental, Inc. comments
ir
.v,
Sig ature of per�in Responsible Charge
X i(. .t r', .:/:,.
Signature of Laboratory Supervisor
MAIL ORIGINAL TO Environmental Sciences Branch
Div.of Water Quality
N.C.DENR
1621 Mail Service Center
Raleigh,North Carolina 27699-1621
North Carolina Ceriodaohnia Chronic Pass/Fail Reproduction Toxicity Test Chronic Test Results
Calculated 1: 0.7316
Critical Value= 2.508
CONTROL ORGANISMS 1 2 3 4 .. 7 % Reduction= 2.851,
#Young Produced 18 16 24 23 Ti � :o I ;I 31 ,-...:q Repr;,C.
Adult iLlive ID)ead L L L L L L L L L L L L 0% 21.1
Contra Control
Effluent°Jo 50.0% 0% 20.5
Treat-1,'',I t Treatment 2
Cont....
TREATMENT 2 ORGANISMS 1 2 4 5 0 7 i? i i 1: 1 °`.'•,,
#Young Produced 20 18 20 21 18 23 22 __ 21 21
Adult (L)ive (D)ead L L L L L L L L L L L L 31 V I
Complete This for Either Test
cot leeti.n,tSIvIIJ_p to
pH 1st sample 1st sample 2nd sample Sample 1 10-Apr-23
Control 7.8 8.2 7.7 7.7 7.8 8.2 SAIn�l _Tytleinctrat10i
Treatment 2 7.6 8.2 7.7 7.8 7.3 8.2 Groh Comp Duration .t 2nd
X 23hrs Tex Ton
X 24his ;ample Sample
r
start end start end start t=nd
D.O. 1st sample lot sample 2nd srrnpie -...��.... :ny.Li 87.2
Control 7.9 8.5, 8.1 7.6 7.6 8.4 osr 307 .:!iu 390
Treatment 2 8.3 8.8 8.5 7.7 8.0 8.3 :l <0.05 <0.05
1.7 0.7
LC50/Acute Toxicity Test
i.t,-rtality expressed as To.combining replicates)
Concentration
Mortality starLend
LC50 = Method of Determination
95 I.ConfidenceL.n'_ Moving Average Probit Mil
% °'c Spearman Karber Other . H D.O.
Organism Tested Ceriodaphnia dubia I
DEM Form AT-1 Page 6 of 17
Panes7rfA

Effluent Toxicity Report Form-Chronic Fathead Minnow Multi•Concentratlon Test
Facility Yadkinville NPDES a NC0020338 Pipe e: 001 County. Yadkin
Labo to • FT invironmental,Inc. Comments I - __
x .4.
gnature of Operator in Responsible Charge
Signature of Laboratory Supervisor
MAIL ORI(il\31. I U: Fni irunmental Sciences Branch
ilk isin,,of% ater Qualitr
\t 1)1 5K
162I tail Scrslcc Center
It:dcigh,♦( 17eee.leOi
Test initiation Dato.Time 04,12123 t 01:40 PM Avg'vVt/Sure.Control 1.0219 1 Test Organisms
%Eft. Rept. 1 2 4 4 Cultured In-House
Control Surviving# 9 10 8 1., 11e Survival 100.0% X Outside Supplier
Originals 9 10 8 10
Wttoriginal(mg) 1 0022 1 0010 lilit. 1 0880 Avg Wt(mg) J219 Hatch Date 04/10
12 5 Surviving# 10 10 f, 10 We Survival 100.0e4, Hatch Time: 1500-1630
Original a 10 10 1 10
WI/original(mg) 0 8260 0 7730 0 899i' I 715', Avg WI(mg) 0 8.388
'1
, Surviving# 10 10 9 10 %Survival 100.1',
Original# 10 10 9 10
WVorigmal(mg) 0.7580 0.8470 1.0056 0.9010 Avg Wt(mg) 0.8779
50.0 Surviving# 10 10 10 10 %Survival 100.0%
Original# 10 10 10 10
Wt/original(mg) 0.8280 0 8460 08110 0.8460 Avg WI(mg) 0.8328
75.0 Surviving if 10 A 9 10 %Survival 10i)i 47,
Original if 10 5 9 10
Wt/original(mg) 0.9020 1 0538 0 9644 0.9460 Avg Wt(mg) 0.9665
100.0 Surviving# 10 10 10 %Survival 100.0 %
Originals 10 10 t 0 10
Wt/original(mg) 1 0070 0.9680 0.9510 0.8820 Avg WI(mg) 0.9520
Water Quality Data Day
Control 0 1 3 4 5 6 7
pH(SU)Init/Fin 77 I ---- 77 - 78 77 7.8 8.5 77 1 7.9 7.7 I 74 78 • 78 -- 77
DO(mg/L) Intt/Fin 8.5 t -- 8.2 ' 7 1 8 5 i 7 0 8.0 6.6 8 2 / 7.3 7 7 , 5.9 7 8 . 6.1 -- , 7.4
Temp(C)Init/Fin 24.4 -- 24 5 . 25 1 24 5 24.8 24.7 • 25.2 24 5 :. .4 4 25.3 24 5 t 25 I --- i 25 2
High Concentration 0 I 2 3 5 6
pH(SU)Init/Fin 7 3 r - 7 3 '3 7.3 1 7 7 7-2 I 7.5 7.8 , 7.8 7.7 i 7.5 7.7 . 7.8 - , 7.8
OO(mg/L) Init7Fin 9.3 -- 9.1 6.8 9.2 t 7.2 9.1 i 6.7 7.9 / 6.9 7.9 i 8 7 8.0 / 6-9 ---- 7 1
Temp(C)Init/Fin 25 0 -- 24 8 25 1 24 7 r 24.8 25 2 26 2 24 8 25 2 26.1 i 25 3 24,8 r 25.' -•-' 25 2
Sample 1 2 Survival Growth Overall Result
Collection Start Date 04/10.23 04 12,23 04;13/23 Normal 1 0 0.97 OhV > 100%
Grab Horn.Var. 0.0 7.25
Composite(Duration) 24 hr 24 hr NOEC 100.0% 100.0%
Hardness(mg/LI 32 7 3;1 e 32 7 LOEC > 100.0% tt 100.0%
Alkalinity(mg/L) 41 8 60.9 64 4 CPV - 100.0% > 100.0%
Conductivity(umhos/cm) "351; 390 354 Method t Test t Test
Chlorine(eng/L) <0.05 <005 "34
Temp at Receipt(Cl .,3 i;9 State Survival Growth
Conc. Critical Calculated Critical Calculated
Dilution H2O 13% 10 10 2 40 4.22
Hardness(mg/L) 872 25% 10 11 2.40 3.32
Alkalinity(mgiL) 58 9 50% 10 10 2.40 4.36
Conductivity(umhos/cm) 307 75e.%o 10 11 2.40 1.28
100% 11 2.40 1.61
DWO Form AT-5(i/04) Page 1 L of 17
Donn ')r.f 7

Effluent Toxicity Report Form-Chronic Pass/Fail and Acute LC50 Date 03-Aug-23
Facility:Yadkinville NPDES`NC0020338 Pipe tt 001 County. Yadkin
Laboratory Performing Test: ETT Environmental,Inc. Comments
�
X Lott:44- i )1-45?5611:5---
Signa re o Operator in Responsible Charge
Signature of Laboratory Supervisor
MAIL ORIGINAL TO Environmental Sciences Branch
Div.of Water Quality
N.C.DENR
1621 Mail Service Center
Raleigh,North Carolina 27699-1621
North Carolina Ceriodaphnia Chronic Pass/Fail Reproduction Toxicity Test Chronic Test Results
Calculated t= 0.2774
Critical Value= 2.508
CONTROL ORGANISMS 1 2 3 4 5 F r F u lb 11 12 %Reduction= 0.8°%ir
#Young Produced 21 19 19 21 1"0 19 22 in 2 .. _-. >,,Mortality Avg Reprod
Adult (L)ive (D)ead L L L L L L L L L !_ L L 0% 20.0
Control Control
Effluent% 50.0% 0% 19.8
Treatment 2 Treatment 2
TREATMENT 2 ORGANISMS 1 2 3 4 5 9 7 8 s 10 12 9.0%
#Young Produced 19 18 20 20 21 19 21 21 20 2' 19 1r• PASS FAIL
Adult (Llive (D)ead L L L L L L L L L L L L 1 uu I X I
Complete This for Either Test Test Start Date
Collection(Start)Date 12-Jul-23
pH 1st sample 1st sample 2nd sample Sample 1 10-Jul-23 Sample 2 12-Jul-23
Control 7.8 8.1 7.7 7.8 7.7 8.2 ple Type':.Gl!'„Minn
Treatment 2 7.4 8.0 7.4 7.8 7.3 8.2 Gran Gump Duration 1St
Sample 1 X 24hrs Tox Tox
Sample 2 X 24hrs. D4utaro Sample Sample
Slant end start end start end
D.O. 1st sample 1st sample 2nd sample Hardness Qny/L) 82.0
Control 7.6 7.9 7.8 7.4 7.4 7.5 Spec.Cond.(pmhos) 314 -:2 429
Treatment 2 7.6 7.8 8.1 7.8 8.0 7.9 Chlorine lmgiu <0.05 <0.05
,l 3.0
LC50/Acute Toxicity Test
(Mortality expressed as%,combining replicates)
1 r
slartienr-
LC50= . Method of Determination Control
Moving Average f rObit I High Conc.
cyo __% Spearman Karher Other ':H D.O.
Organism Tested Ceriodaphnia dubia
DEM Form AT-1 Page 6 of 17
Paae 2 of 6

Went Toxicity Report Form•Chronic Fathead Minnow Mulu•Concentiation Toot
Facility. Yadkinville NPDES# NC0020338 Pipe#: 001 County. Yo,i,
Labors ry: Comments I
x
Si nature of Operator in Responsible Charge •
"'"x 444
Signature of Laboratory Supervisor
\TAIL ORIGI\AL TO: Ent irunniental Sciences Branch
Uistslon of 59 tier Quality
\( I)E\It
1e21 .\tall Strs lee(enter
Raleigh,\( 2T699.10.I
Test initiation Dale/Time 07/12)23 / 01:00 PM Avg Wt/Surv.Control 0.9703 Test Organisms
%Eff. Repl. 1 2 4 4 Cultureu In-House:
Control Surviving# 10 10 10 '.•b Survival 100.0% X Outside Supplier
Original# 10 1 u 10 10
W tlortginal(mg) 0.9440 0 9830 1 0270 0 9270 Avg Wt(mg) 0.9703 Hatch Date. 07/10
12.5 Surviving# 10 9 10 •'.Survival 97.5°' Hatch Time: 1500-1630
Original# 10 10 10
Wtioriginal(mg) 0.8520 1 o/.7i' 0.8960 0.90c. -_ , Avg Wt(mg) 0.935:
25.0 Surviving# 10 10 10 '%<,Survival 100. '.
Original# 10 10 10 c,
Wt/original(mg) 0.9180 0.9690 1.0450 � 9678 Avg W t(mg) 0.9749
50 0 Surviving# 10 tO 10 57o Survival 100.0%
Original# _ 10 10 !� 10 _
W tioriginal Ong) 1 0540 1 0500 1.0580 Avg W t(mg) 1.0696
75.0 Surviving# 10 16 10 10 to Survival 100.0%
Original# 10 10 111 I!
W tloriginal(mg) 0 9760 ., %r380 it 9()Si1 1 s i.' Avg W t(mg) 0.9510
100.0 Surviving# 10 I s Survival 100.0%
Original# 10 i 1i1
Wt/original(mg) 1.0190 1 0333 Inh)55 Avg At (mg) 1.0398
tier Quality Data Day
Control 0 1 2 3 4 5 6 7
pH(SU)InitlFin 7.7 / -- 7.8 , 7.6 7 7 r 7 7 7 7 / 7 6 7.7 i 7.6 7.8 7.6 7.6 1 7.7 ----/ 7 8
DO(mg/L) Init/Fin 7.9 , -- 8.0 / 6.6 8 1 6.8 8.0 / 6 8 7.9 / 6.5 7 Ii 6 0 7.6 / 5.8 ----I 6.4
Temp(C)Init/Fin 24.6 -- 24 6 25 4 24 5 25 5 1'4 6 24 7 24°,
gh Concentration 0 1 2 3 7. 5 6 7
pH(SU)Init/Fin 6.9 / -- 7.3 - 7.1 7.3 / 7.2 7.4 i 7.2 7.5 i 7.6 7.7 / 7.6 8.0 1 7.7 ---i 7.8
DO(mg/L) Init/Fin 7.9 ! -- 8.0 5.3 8.5 / 5.6 8.6 / 6.1 8.0 / 6.5 7.8 / 6.2 7.5 1 6.1 ----! 6.2
Temp(C)Init/Fin 25 0 i -- 24 7 25 4 24.8 25.5 24 7 24 7 24 e . 25.4 24.9 25.3 24 8 / 25.2 ----/ 25.5
Sample 1 2 Survival Growth Overall Result
Collection Start Date 07/10(23 . 12r23 (17/13/23 Normal 0.47 0 92 ChV > ',ill;
Grab Horn.Var. int 9.95
Composite(Duration) 24 hr 24 hr 24 hr NOEC 100.0% 100.0"r%
Hardness(mg/L) 34.7 34.0 30.0 LOEC > 100.0% > 100.0k
Alkalinity(mg/L) 30.5 40.1 52.6 ChV > 100.0% > 100 0%
Conductivity(umhos/cnl) 442 429 430 Method Rank Sum i Test
Chiorine(mg/L) <0,05 <0.05 430
Temp at Receipt(C) 14 3 0 0.0 Stats Survival Growth
Conc. Critical Calculated Critical Calculated
Dilution H2O 13',. 10.00 16.00 2 40 0.62
Hardness(mg/L) 82.0 25% 10.00 18.00 2.40 -0.08
Alkalinity(mg/L) 58.5 50% 10.00 18.00 2.40 •1.75
Conductivity IurrlhosIcmi 314 75°�r 10.00 1800 2.40 0.34
10.00 1800 2.40 -1 22
page 12 of 17
NO Farm A T-5(1/04)
Paoe 2 of 7

Effluent Toxicity Report Form-Chronic Pass/Fail and Acute LC50 Date 24-Oct-23
Facility:Yadkinville WWTP NPDESPNCoo20338 Pipe# 001 County: Yadkin
Laboratory Performing Test: ETT Environmental,Inc. Comments
dir
X / •
ei...-7/ J G z
Signature of Operator in Responsible Charge
x R C/6CPf 7<'e((cJ
Signature of Laboratory Supervisor
MAIL ORIGINAL TO Environmental Sciences Branch
Div.of Water Quality
N.C.DENR
1621 Mail Service Center
Raleigh,North Carolina 27699-1621
North Carolina Ceriodaphnia Chronic Pass/Fail Reproduction Toxicity Test Chronic Test Results
Calculated t= 0.6519
Critical Value= 2.508
CONTROL ORGANISMS 1 2 3 4 5 6 7 8 9 10 11 12 `-/Reduction= 2.0%
#Young Produced 19 20 21 19 21 21 19 .24 21 20 19 22 %Mortality Aso.Reprod.
Adult (L)ive (D)ead L L L L L L L L L L L L 0% 20.5
Control Control
Effluent% 50.0% 0% 20.1
Treatment 2 Treatment 2
Control CV
TREATMENT 2 ORGANISMS 1 2 3 4 5 6 7 8 9 10 11 12 7.4%
#Young Produced 22 21 18 23 20 20 17 19 21 20 20 20 °n 3rd Brood PASS FAIL
Adult (L)ive (D)ead L L L L L L L L L L L L 100% I X I
Complete This for Either Test Test Start Date
Collection(Star,)Dale 04-0ct-23
pH 1st sample 1st sample 2nd sample Sample 1 02-Oct-23 Sample 2 04-Oct-23
Control 7.7 7.9 7.7 8.1 7.8 8.2 sample ieee(Durations
Treatment 2 7.6 7.8 7.4 8.0 7.5 8.2 Grab Comp Duration 1st 2nd
Sample 1 X :Mho, Tox lox
Sample 2 X 24hrs. Dilution Sample Sample
D.O. start end start end start end
1st sample 1st sample 2nd sample Hardness(mg/L) 82.0
Control 8.1 8.3 8.1 8.6 8.2 9.5 Spec.Cond.(pmhos) 320 457 458
Treatment 2 8.6 9.1 8.8 8.6 8.7 9.3 Chlonne(mgtL) <0.05 0.07
.ample Temp.at receipt CC) 1.3 0.1
LC50/Acute Toxicity Test
(Mortality expressed as"a,combuung replicates)
Concentration
Mortality. ...,art;ear{ s:arier.d
LC50= % Method of Determination •",,,tr.,l
95%Confidence Limits Moving Average Probit I High Conc.
% °e Spearman Karber Other __ pH D.O.
Organism Tested Ceriodaphnia dubia I
DEM Form AT-1 Page 6 of 17
Paae 2 of 6

affluent Toxicity Report Form-Chronic Fathead Minnow Multi-Concentration Test
Facility: YADKINVILLE NPDES# NC0020338 Pipe#: 001 County: Yadkin
Laboratory: ETTSnvinonnten;al.Inc. Comments I
x
Signature of Operator in Responsible Charge
x Robert a/elieel
Signature of Laboratory Supervisor
MAIL ORIGINAL TO: Environmental Sciences Branch
Division ut Water Quality
NC DENR
1621 \tail Sara ice Uenter
Raleigh.NC. 27699-1621
Test Initiation Date/Time 10/04/23 / 12:10 PM Avg W I/Surv.Control 0.6986 Test Organisms
%Eff. Rept. 1 2 4 4 Cultured In-House
Control Surviving# 10 8 10 9 %Survival 100.0% X Outside Supplier
Original# 10 8 10 9
Wt/original(mg) 0.6940 0.7500 0.6550 0.6956 Avg Wt(mg) 0.6986 Hatch Date: 10/02
12.5 Surviving# 9 10 10 9 55 Survival 95.0% Hatch Time: 1500-1630
Original# 10 10 10 10
Wt/original(mg) 0.6903 0.6880 0.7010 0.6500 Avg Wt(mg) 0.6823
25.0 Surviving# 9 9 10 10 °o Survival 100.0%
Original# 9 9 10 10
Wt/original(mg) 0.6033 0.6267 0.6250 0.6610 Avg Wt(mg) 0.6290
50.0 Surviving# 10 9 10 10 %Survival 100.0%
Original# 10 9 10 10
Wt/original(mg) 0.6460 0.6789 0.5500 0.7390 Avg Wt(mg) 0.6535
75.0 Surviving# 10 10 10 10 %Survival 100.0%
Original# 10 10 10 10
Wt/original(mg) 0.7050 0.5760 0.5910 0.7100 Avg Wt(mg) 0.6455
100.0 Surviving# 10 10 10 10 °o Survival 100.0%
Original# 10 10 10 10
Wt/original(mg) 0.7020 0.7580 0.7320 0.7500 Avg Wt(mg) 0.7355
Vater Quality Data Day
Control 0 1 2 3 4 5 6 7
pH(SU)Init/Fin 7.7 I -- 7.8 / 7.7 7.7 i 7.9 7.7 i 7.7 7.7 I 7.7 7.7 / 7.9 7.8 / 7.8 ----/ 7.8
DO(mg/L) 'nit/Fin 8.1 / -- 8.0 / 7.0 8.1 7.6 8.2 / 7.8 8.1 / 7.9 8.4 / 8.2 8.4 / 8.1 ----/ 8.3
Temp(C)Init/Fin 24.7 i -- 25.6 i 0.0 24.5 i 25.1 24.5 I 24.7 24.5 I 25.1 24.6 ' 25.0 24.4 / 25.0 ----/ 25.0
i ugh Concentration 0 1 2 3 4 5 6 7
pH(SU)!nit/Fin 7.5 / -- 7.5 / 7.7 7.1 / 7.5 7.5 / 7.5 7.4 I 7.6 7.5 / 7.5 7.3 / 7.8 ----/ 7.8
DO(mg/L) Init/Fin 9.3 I -- 7.1 / 8.2 9.6 / 7.9 9.3 / 7.4 9.3 / 7.8 9.1 / 8.1 9.2 / 8.7 ----/ 7.8
Temp(C)Init/Fin 25.0 / -- 24.5 / 0.0 24.8 / 25.1 24.7 / 24.7 24.8 1 25.1 25.2 , 25.0 24.7 / 25.0 ----/ 25.0
Sample 1 2 Survival Growth Overall Result
Collection Start Date 10/02/23 10/04/23 10/05/23 Normal 0.58 0.98 ChV > 100%
Grab Hom.Var. inf 8.48
Composite(Duration) 24 hr 24 hr 24 hr NOEC 100,0% 100.0%
Hardness(mg/L) 36.7 36.7 34.7 LOEC > 100.0% > 100.0%
Alkalinity(mg/L) 46.3 46.1 47.3 ChV > 100.0% > 100.0%
Conductivity(umhos/cm) 457 458 463 Method Rank Sum I Test
Chlorine(mg/L) <0.05 0.07 463
Temp at Receipt(C) 1.3 0.1 0.1 Stats Survival Growth
Conc. Critical Calculated Critical Calculated
Dilution H2O 13% 10.00 14.00 2.40 0.47
Hardness(mg/L) 86.0 25% 10.00 18.00 2.40 2.00
Alkalinity(mg/L) 60.1 50% 10.00 18.00 2.40 1.29
Conductivity(umhos/cm) 320 75% 10.00 18.00 2.40 1.52
100% 10.00 18.00 2.40 -1.06
)WQ Form AT-5(1/04) Page 12 of 17
Paae 2 of 7