NC0087084_Permit Issuance_20130829

NCD NR
North Carolina Department of Environment and Natural Resources
Division of Water Resources
Water Quality Programs
Pat McCrory Thomas A. Reeder
Governor Director
August 29, 2013
Mr. John Condrey, City Manager
Town of Forest City
P. O. Box 728
Forest City, NC 28043
Subject: Issuance of NPDES Permit NC0087084
Town of Forest City—Riverstone Industrial Park WWTP
Rutherford County
Dear Mr. Condrey:
John E. Skvarla, III
Secretary
Division personnel have reviewed and approved your application for renewal of the subject permit. Accordingly,
we are forwarding the attached NPDES discharge permit. This permit is issued pursuant to the requirements of
North Carolina General Statute 143-215.1 and the Memorandum of Agreement between North Carolina and the
U.S. Environmental Protection Agency dated October 15, 2007 (or as subsequently amended).
This final permit includes no significant changes to its terms from those found in the draft permit sent to you on
July 1, 2013.
If any parts, measurement frequencies or sampling requirements contained in this permit are unacceptable to you,
you have the right to an adjudicatory hearing upon written request within thirty (30) days following receipt of this
letter. This request must be in the form of a written petition, conforming to Chapter 150B of the North Carolina
General Statutes, and filed with the Office of Administrative Hearings (6714 Mail Service Center, Raleigh, North
Carolina 27699-6714). Unless such demand is made, this decision shall be final and binding.
Please note that this permit is not transferable except after notice to the Division. The Division may require
modification or revocation and reissuance of the permit. This permit does not affect the legal requirements to
obtain other permits which may be required by the Division of Water Resources or permits required by the
Division of Land Resources, the Coastal Area Management Act or any other Federal or Local governmental
permit that may be required.
If you have any questions concerning this permit, please contact Bob Sledge at telephone number (919) 807-
6398, or via e-mail at [e-mail].
Sincer y,
omas A. Zler��
cc: Central Files
Asheville Regional Office/Surface Water Protection Section
NPDES File
ec: Aquatic Toxicology Unit
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Location: 512 N. Salisbury St Ralegh, North Carolina 27604
Phone: 919$07-63001 FAX: 91M07-6492
Internet wlw+.ncwaterquality.org
An Equal Opportunity I Affirmative Action Employer

Permit NCO087084
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER RESOURCES
PERMIT
TO DISCHARGE WASTEWATER UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provisions of North Carolina General Statute 143-215.1, other lawful
standards and regulations promulgated and adopted by the North Carolina Environmental
Management Commission, and the Federal Water Pollution Control Act, as amended, the
Town of Forest City
is hereby authorized to discharge wastewater from a facility located at
Riverstone Industrial Park WWTP
Off US Highway 221
South of Forest City
Rutherford County
to receiving waters designated as the Broad River in the Broad River Basin in accordance with
effluent limitations, monitoring requirements, and other conditions set forth in Parts I, II, III, and IV
hereof.
The permit shall become effective October 1, 2013.
This permit and the authorization to discharge shall expire at midnight on July 31, 2018.
Signed this day August 29, 2013.
A. Reeder, Director
'sion of Water Resources
By Authority of the Environmental Management Commission
Page 1 of 7

Permit NC0087084
SUPPLEMENT TO PERMIT COVER SHEET
All previous NPDES Permits issued to this facility, whether for operation or discharge are hereby
revoked. As of this permit issuance, any previously issued permit bearing this number is no longer
effective. Therefore, the exclusive authority to operate and discharge from this facility arises under
the permit conditions, requirements, terms, and provisions included herein.
The Town of Forest City
is hereby authorized to:
1. Continue to operate an existing 0.05 MGD wastewater treatment plant consisting of:
• Bar Screen
• Flow equalization
• Sequencing Batch Reactor Unit
• Chlorine disinfection
• Dechlorination
• Digester
This facility is located at the Riverstone Industrial Park WWTP, located off US Highway 221, south
of Forest City, in Rutherford County, and,
2. After receiving an Authorization to Construct, expand the existing wastewater treatment facility to
a permitted design capacity of 0.10 MGD; and
3. Discharge from said treatment works through outfall 001 into Broad River, a Class C water in -the
Broad River Basin, at the location specified on the attached map.
Page 2 of 7

Permit NCO087084
Part I
A. (I.) EFFLUENT LIMITATIONS AND MONITORING REQUIREMENTS - FINAL
Beginning on the effective date of this permit and lasting until expansion above 0.05 MGD, the
Permittee is authorized to discharge treated wastewater from Outfall 001. Such discharges shall be
limited and monitored by the Permittee as specified below:
-- - ;EFFLUENT'
�CH4 ,CTE�RIS S
.P�r r 4reter bode,
E FLUENT�L:IMIT 0
-
'
MONII'ORI,NG, EQUIREMENTS
_ ._.�..� ._ .�
Average
_
4..
i1IlGeekly
Averageaxiium
^--�
APT�•f. 1
s 'Dily
��'....-� .. �'T_-. ..... r'Ii 1
Measrementt
e
. ° "Fre un""cy
L .+
1� ....:...-/'iy,, _
Smple
T
ype
� ,•w`
Samle
L.o ation�
Flow 50050
0.05 MGD
Continuous
Recording
I or E
BOD, 5-day, 20°C2 C0310
30.0 mg/I
45.0 mg/l
Weekly
Composite
E, I
Total Suspended Solids2 C0530
30.0 mgfl
45.0 mg/I
Weekly
Composite
E,I
NH3 as N C0610
2/month
Composite
E
Total Residual ChlorinO 50060
28 Ng/I
Weekly
Grab
E
Fecal Coliform (geometric mean) 31616
200/100 ml
400/100 ml
Weekly
Grab
E
pH4 00400
Weekly
Grab
E
Temperature °C 00010
Weekly
Grab
E
Total Nitrogen (NO2+NO3+TKN) C0600
Semi-annually
Composite
E
Total Phosphorus C0665
Semi-annually
Composite
E
Acute Toxicity4 TGE6C
Quarterly
Composite
E
Notes:
1. Sample locations: E- Effluent, I- Influent.
2. The monthly average effluent BOD5 and TSS concentrations shall not exceed 15% of the
respective influent value (85% removal).
3. The Division shall consider all effluent TRC values reported below 50 µg/L to be in compliance
with the permit. However, the Permittee shall continue to record and submit all values reported
by a North Carolina certified laboratory (including field certified), even if these values fall below
50 µg/L.
4. The pH shall not be less than 6.0 standard units nor greater than 9.0 standard units.
5. Acute Toxicity Pass/Fail Limit (Fathead minnow); March, June, September, December; refer to
Special Condition A. (3.).
There shall be no discharge of floating solids or visible foam in other than trace amounts.
Page 3 of 7

Permit NCO087084
(2.) EFFLUENT LIMITATIONS AND MONITORING REQUIREMENTS - FINAL
Beginning on the date of expansion of the facility beyond 0.05 MGD and lasting until expiration,
the Permittee is authorized to discharge treated wastewater from Outfall 001. Such discharges shall
be limited and monitored by the Permittee as specified below:
EFFLUENT may.
CHARACTERISTICS
• . i : " "
'EFFLUENT LIMITATfOS
MON�ORING R Q~U� IR�MENTS
r'
_Monthly
_
Weekly --
Average
-_- Daiiy
MaximPmFqncy
Measurement
re- _
Sample �
TypAve-
Sample.
Location
Flow 50050
0.10 MGD
Continuous
Recording
I or E
BOD, 5-day, 20°C2 C0310
30.0 mg/l
45.0 mg/l
Weekly
Composite
E,I
Total Suspended Solids2 C0530
30.0 mg/l
45.0 mg/l
Weekly
Composite
E,I
NH3 as N C0610
2/month
Composite
E
Total Residual Chlorine3 50060
28 Ng/l
Weekly
Grab
E
Fecal Coliform (geometric mean) 31616
200/100 ml
400/100 ml
Weekly
Grab
E
pH4 00400
Weekly
Grab
E
Temperature °C 00010
Weekly
Grab
E
Total Nitrogen (NO2+NO3+TKN) C0600
Semi-annually
Composite
E
Total Phosphorus C0665
Semi-annually
Composite
E
Acute Toxicito TGE6C
Quarterly
Composite
E
Notes:
1. Sample locations: E- Effluent, I- Influent.
2. The monthly average effluent BODS and TSS concentrations shall not exceed 15% of the
respective influent value (85% removal).
3. The Division shall consider all effluent TRC values reported below 50 µg/L to be in compliance
with the permit. However, the Permittee shall continue to record and submit all values reported
by a North Carolina certified laboratory (including field certified), even if these values fall below
50 µg/L.
4. The pH shall not be less than 6.0 standard units nor greater than 9.0 standard units.
5. Acute Toxicity Pass/Fail Limit (Fathead minnow); March, June, September, December; refer to
Special Condition A. (3.).
There shall be no discharge of floating solids or visible foam in other than trace amounts.
Page 4 of 7

Permit NC0087084
A. (3.) ACUTE TOXICITY PASS/FAIL PERMIT LIMIT (QUARTERLY)
The permittee shall conduct acute toxicity tests on a quarterly basis using protocols defined in the
North Carolina Procedure Document entitled "Pass/Fail Methodology For Determining Acute
Toxicity In A Single Effluent Concentration" (Revised December 2010 or subsequent versions). The
monitoring shall be performed as a Fathead Minnow (Pimephales promelas) 24 hour static test. The
effluent concentration at which there may be at no time significant acute mortality is 90% (defined
as treatment two in the procedure document). The tests will be performed during the months of
March, June, September and December. These months signify the first month of each three
month toxicity testing quarter assigned to the facility. Effluent sampling for this testing must be
obtained during representative effluent discharge and shall be performed at the NPDES permitted
final effluent discharge below all treatment processes.
Should any single quarterly monitoring indicate a failure to meet specified limits, then monthly
monitoring will begin immediately until such time that a single test is passed. Upon passing,
this monthly test requirement will revert to quarterly in the months specked above.
All toxicity testing results required as part of this permit condition will be entered on the Effluent
Discharge Monitoring Form (MR-1) for the month in which it was performed, using the parameter
code TGE6C. Additionally, DWR Form AT-2 (original) is to be sent to the following address:
Attention: North Carolina Division of Water Resources
Environmental Sciences Section
1621 Mail Service Center
Raleigh, North Carolina 27699-1621
Completed Aquatic Toxicity Test Forms shall be filed with the Environmental Sciences Section no
later than 30 days after the end of the reporting period for which the report is made.
Test data shall be complete and accurate and include all supporting chemical/physical measurements
performed in association with the toxicity tests, as well as all dose/response data. Total residual
chlorine of the effluent toxicity sample must be measured and reported if chlorine is employed for
disinfection of the waste stream.
Should there be no discharge of flow from the facility during a month in which toxicity monitoring is
required, the permittee will complete the information located at the top of the aquatic toxicity (AT)
test form indicating the facility name, permit number, pipe number, county, and the month/year of
the report with the notation of "No Flow" in the comment area of the form. The report shall be
submitted to the Environmental Sciences Section at the address cited above.
Should the permittee fail to monitor during a month in which toxicity monitoring is required, then
monthly monitoring will begin immediately until such time that a single test is passed. Upon passing,
this monthly test requirement will revert to quarterly in the months specified- above. Assessment of
toxicity compliance is based on the toxicity testing quarter, which is the three month time interval
that begins on the first day of the month in which toxicity testing is required by this permit and
continues until the final day of the third month.
Page 5 of 7

Permit NCO087084
A. (3.) ACUTE TOXICITY PASS/FAIL PERMIT LIMIT (QUARTERLY), continued
Should any test data from either these monitoring requirements or tests performed by the North
Carolina Division of Water Resources indicate potential impacts to the receiving stream, this permit
may be re -opened and modified to include alternate monitoring requirements or limits.
If the Permittee monitors any pollutant more frequently then required by this permit, the results of
such monitoring shall be included in the calculation & reporting of the data submitted on the DMR
& all AT Form submitted.
NOTE: Failure to achieve test conditions as specified in the cited document, such as minimum
control organism survival and appropriate environmental controls, shall constitute an invalid test
and will require immediate follow-up testing to be completed no later than the last day of the month
following the month of the initial monitoring.
Page 6 of 7

Pennit NCO087084
Page 7 of 7

PUBLIC NOTICE
North Carolina Environmental Management Commission/
NPDES Unit
1617 Mail Service Center
Raleigh, NC 27699-1617
Notice of Intent to Issue a NPDES Wastewater Permit
The North Carolina Environmental Management Commission
Proposes to issue a NPDES wastewater discharge permit to
the person(s) listed below. Written comments regarding the
proposed permit will be accepted until 30 days after the
publish date of this notice. The Director of the NC Division of
Water Quality (DWQ) may hold a public hearing should there
be a significant degree of public interest. Please mail
comments and/or information requests to DWQ at the above
address. Interested persons may visit the DWQat512 N.
Salisbury Street, Raleigh, NC to review information on file.
Additional information on NPDES permits and
this notice may be found .on our website:
http://portal.ncdenr.org/web/wq/swp/pslnpdes/calendar, or by
calling [phone]. The Town of Forest City
requested renewal of permit NC0074306 for the Town of
Forest City WTP; this permitted discharge is filter -backwash
wastewater to an unnamed tributary to the Second Broad
River in the Broad River Basin. The'Town of Forest City
requested renewal permit NC0087084 for the Riverstone
Industrial Park WWTP in Rutherford County; this permitted
discharge is treated industrial wastewater to the Broad River
in the Broad River Basin. The Town of Spindale requested
renewal of permit NC0020664 for Spindale WWTP in
Rutherford County; this facility discharge is treated municipal
wastewater to Catheys Creek, Broad River Basin.

AFFIDAVIT OF PUBLICATION
STATE OF NORTH CAROLINA
RUTHERFORD COUNTY
Before the undersigned, a Notary Public of said County and State, duly
commissioned, qualified, and authorized by law to administer oaths, personally
appeared
Bobbie Greene
who being first duly sworn, deposes and says: that they are
Customer Service Representative
(Owner, partner, publisher, or other officer or employee authorized to make this
affidavit) of THE DAILY COURIER, a newspaper published, issued and entered as
second class mail In the town of FOREST CITY, In said County and State; that they
are authorized to make this affidavit and sworn statement; that the notice or other
legal advertisement, a true copy of which is attached hereto, was published in THE
DAILY COURIER on the following dates:
July 3, 2013
and that said newspaper in which such notice, paper, document, or legal
advertisement was published was, at the time of each and every such publication, a
newspaper meeting all of the requirements and qualifications of Section 1-597 of the
General Statutes of North Carolina and was a qualified newspaper within the meaning
of Section 1-597 of the General Statutes of North Carolina.
This the 3rd day of July, 2013.
Bobbie Greene, Customer Service Representative
Sworn to and subscribed before me this the 3rd day of July, 2013
Cindy D. Branc (Notary Public)
My commission expires: February 18, 2017.

FACT SHEET FOR EXPEDITED PERMIT RENEWALS
This form must be completed by Permit Writers for all expedited permits which do not require
full Fact Sheets. Expedited permits are generally simple 100% domestics (e.g., schools, mobile
home parks, etc) that can be administratively renewed with minor changes, but can include
facilities with more complex issues (Special Conditions, 303(d) listed water, toxicity testing,
instream monitoring, compliance concerns).
Basic Information for Expedited Permit Renewals
Permit Writer/Date
Bob Sledge 6/20/2013
Permit Number
NC0087084
Facility Name
Forest City — Riverstone Ind. Park WWTP
Basin Name/Sub-basin number
Broad 03-08-02
Receiving Stream
Broad River
Stream Classification in Permit
C
Does permit need Daily Max NH3 limits?
No
Does permit need TRC limits/language?
Already included
Does permit have toxicity testing?
Yes no data; facility hasn't discharged)
Does permit have Special Conditions?
No
Does permit have instream monitoring?
No
Is the stream impaired on 303 d list)?
No
Any obvious compliance concerns?
No
Any permit mods since lastpermit?
No
Current expiration date
7/31/2013
New expiration date
7/3 1/28
Comments received on Draft Permit?
Yes PV If Yes, discuss response with
SuperMsor
To date, this facility has not discharged. Flow to the plant is pumped and hauled to the
Forest City WWTP for treatment.

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
Riverstone Industrial Park WWTP, NCO087084 Renewal Broad
FORM
2A NP A APPLICAT m
NPDES
APPLICATION OVERVIEW
Form 2A has been developed in a modular format and consists of a "Basic Application Information" packet
and a "Supplemental Application Information" packet. The Basic Application Information packet is divided
into two parts. All applicants must complete Parts A and C. Applicants with a design flow greater than or
equal to 0.1 mgd must also complete Part B. Some applicants must also complete the Supplemental
Application Information packet. The following items explain which parts of Form 2A you must complete.
BASIC APPLICATION INFORMATION:
A. Basic Application Information for all Applicants. All applicants must complete questions A.1 through A.8. A treatment works
that discharges effluent to surface waters of the United States must also answer questions A.9 through A.12.
B. Additional Application Information for Applicants with a Design Flow a 0.1 mgd. All treatment works that have design flows
greater than or equal to 0.1 million gallons per day must complete questions BA through B.6.
C. Certification. All applicants must complete Part C (Certification).
SUPPLEMENTAL APPLICATION INFORMATION:
D. Expanded Effluent Testing Data. A treatment works that discharges effluent to surface waters of the United States and meets
one or more of the following criteria must complete Part D (Expanded Effluent Testing Data):
1. Has a design flow rate greater than or equal to 1 mgd,
2. Is required to have a pretreatment program (or has one in place), or
3. Is otherwise required by the permitting authority to provide the information.
E. Toxicity Testing Data. A treatment works that meets one or more of the following criteria must complete Part E (Toxicity Testing
Data):
1. Has a design flow rate greater than or equal to 1 mgd,
2. Is required to have a pretreatment program (or has one in place), or
3. Is otherwise required by the permitting authority to submit results of toxicity testing.
F. Industrial User Discharges and RCRA/CERCLA Wastes. A treatment works that accepts process wastewater from any
significant industrial users (SIUs) or receives RCRA or CERCLA wastes must complete Part F (Industrial User Discharges
and RCRAICERCLA Wastes). SIUs are defined as:
1. All industrial users subject to Categorical Pretreatment Standards under 40 Code of Federal Regulations (CFR) 403.6 and
40 CFR Chapter I, Subchapter N (see instructions); and
2. Any other industrial user that:
a. Discharges an average of 25,000 gallons per day or more of process wastewater to the treatment works (with certain
exclusions); or
b. Contributes a process wastestream that makes up 5 percent or more of the average dry weather hydraulic or organic
capacity of the treatment plant; or
C. Is designated as an SIU by the control authority.
G. Combined Sewer Systems. A treatment works that has a combined sewer system must complete Part G (Combined Sewer
Systems).
ALL APPLICANTS MUST COMPLETE PART C (CERTIFICATION)
NPDES FORM 2A Additional Information

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
Riverstone Industrial Park WWTP, NCO087084
Renewal
Broad
BASIC APPLICATION INFORMATION
PART A. BASIC APPLICATION INFORMATION FOR ALL APPLICANTS:
All treatment works must complete questions A.1 through A.8 of this Basic Application Information Packet
A.I. Facility Information.
Facility Name Town of Forest City W WTP
Mailing Address Post Office Box 728
Forest City . North Carolina, 28043
Contact Person Jeff Dotson
Title WRF Superintendent
Telephone Number [phone]
Facility Address Riverside Drive
(not P.O. Box) Forest City, North Carolina, 28043
A.2. Applicant Information. If the applicant is different from the above, provide the following:
Applicant Name Town of Forest City WWTP
Mailing Address Post Office Box 728
Forest City . North Carolina. 28043
Contact Person John Condrev
Title City Manager
Telephone Number [phone]
Is the applicant the owner or operator (or both) of the treatment works?
® owner ® operator
Indicate whether correspondence regarding this permit should be directed to the facility or the applicant.
❑ facility ® applicant
A.3. Existing Environmental Permits. Provide the permit number of any existing environmental permits that have been issued to the treatment works
(include state -issued permits).
NPDES NCO087084 PSD
UIC Other
RCRA Other
A.4. Collection System Information. Provide information on municipalities and areas served by the facility. Provide the name and population of each
entity and, if known, provide information on the type of collection system (combined vs. separate) and its ownership (municipal, private, etc.).
Name Population Served Type of Collection System Ownership
Rutherford County commerciallunknown Separate Municipal
Total population served commerciallunknown
FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
NPDES FORM 2A Additional Information

r
Riverstone Industrial Park WWTP, NCO087084 I Renewal
Broad
A.S. Indian Country.
a. Is the treatment works located in Indian Country?
❑ Yes ® No
b. Does the treatment works discharge to a receiving water that is either in Indian Country or that is upstream from (and eventually flows
through) Indian Country?
❑ Yes ® No
A.B. Flow. Indicate the design flow rate of the treatment plant (i.e., the wastewater flow rate that the plant was built to handle). Also provide the
average daily flow rate and maximum daily flow rate for each of the last three years. Each year's data must be based on a 12-month time period
with the 12' month of "this year" occurring no mom than three months prior to this application submittal.
a. Design flow rate 0.050 mgd
Two Years Ago Last Year This Year
b. Annual average daily flow rate 0.0012 0.0012 0.0012
C. Maximum daily flow rate nla n/a nla
A.7. Collection System. Indicate the type(s) of collection system(s) used by the treatment plant. Check all that apply. Also estimate the percent
contribution (by miles) of each.
® Separate sanitary sewer 100
❑ Combined storm and sanitary sewer %
A.8. Discharges and Other Disposal Methods.
a. Does the treatment works discharge effluent to waters of the U.S.? ® Yes ❑ No
If yes, list how many of each of the following types of discharge points the treatment works uses:
I. Discharges of treated effluent
ii. Discharges of untreated or partially treated effluent
iii. Combined sewer overflow points
iv. Constructed emergency overflows (prior to the headworks)
V. Other
b. Does the treatment works discharge effluent to basins, ponds, or other surface impoundments
that do not have outlets for discharge to waters of the U.S.? ❑ Yes
® No
If yes, provide the following for each surface impoundment:
Location:
Annual average daily volume discharge to surface impoundment(s)
mgd
Is discharge ❑ continuous or ❑ intermittent?
G. Does the treatment works land -apply treated wastewater?
❑ Yes 0 No
If yes, provide the following for each land application site:
Location:
Number of acres:
Annual average daily volume applied to site:
mgd
Is land application ❑ continuous or ❑ intermittent?
d. Does the treatment works discharge or transport treated or untreated wastewater to another
treatment works?
I] Yes ❑ No
NPDES FORM 2A Additional Information

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
Riverstone Industrial Park WWTP, NCO087084
Renewal
Broad
If yes, describe the mean(s) by which the wastewater from the treatment works is discharged or transported to the other treatment works
(e.g., tank truck, pipe).
Tank Truck
If transport is by a parry other than the applicant, provide:
Transporter Name Town of Forest City -Applicant
Mailing Address
Contact Person
Title
Telephone Number
For each treatment works that receives this discharge, provide the following:
Name Forest City WWTP
Mailing Address Post Office Box 728
Forest City, North Carolina 28043
Contact Person Jeff Dotson
Title WRF Superintendent
Telephone Number [phone]
If known, provide the NPDES permit number of the treatment works that receives this discharge NCO025984
Provide the average daily Flow rate from the treatment works into the receiving facility. 0.001233 mgd
e. Does the treatment works discharge or dispose of its wastewater in a manner not included
in A.8. through A.8.d above (e.g., underground percolation, well injection): ❑ Yes ® No
If yes, provide the following for each disposal method:
Description of method (including location and size of site(s) if applicable):
Annual daily volume disposed by this method:
Is disposal through this method ❑ continuous or ❑ intermittent?
WOES FORM 2A Additional Information

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
Riverstone Industrial Park WWTP, NCO087084 Renewal Broad
WASTEWATER DISCHARGES:
If you answered "Yes" to question A.8.a, complete questions A.9 through A.12 once for each outfall (Including bypass points) through
which effluent Is discharged. Do not Include Information on combined sewer overflows In this section. If you answered "No" to question
A.B.a, go to Part B, "Additional Application Information for Applicants with a Design Flow Greater than or Equal to 0.1 mgd."
A.9. Description of Outfall.
a. Outfall number 1
b. Location Town of Forest City 28043
(City or town, if applicable) (Zip Code)
(County)
(Latitude)
C. Distance from shore (if applicable)
d. Depth below surface (ff applicable)
e. Average daily flow rate
f. Does this ouffall have either an intermittent or a periodic discharge?
If yes, provide the following information:
Number f times per year discharge occurs:
Average duration of each discharge:
Average Flow per discharge:
Months in which discharge occurs:
g. Is outfall equipped with a diffuser?
(State)
(Longitude)
ft.
ff.
mgd
❑ Yes ® No (go to A.9.g.)
❑ Yes ® No
A.10. Description of Receiving Waters.
a. Name of receiving water Broad River
b. Name of watershed (if known) Broad
United States Soil Conservation Service 14-digit watershed code (if known):
C. Name of State Management/River Basin (if known):
United States Geological Survey 8-digit hydrologic cataloging unit code (if known):
d. Critical low flow of receiving stream (if applicable)
acute cis chronic _
e. Total hardness of receiving stream at critical low flow (if applicable):
mgd
Unknown
Unknown
cis
mgll of CaCO3
NPDES FORM 2A Additional Information

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
Riverstone Industrial Park WWTP, NCO087084
Renewal
Broad
A.11. Description of Treatment
a. What level of treatment are provided? Check all that apply.
® Primary ® Secondary
❑ Advanced ❑ Other. Describe:
b. Indicate the following removal rates (as applicable):
Design BOOS removal or Design CBOD5 removal 85 %
Design SS removal 85 ^/
Design P removal N/A %
Design N removal WA %
Other /,
C. What type of disinfection Is used for the effluent from this outtall? If disinfection varies by season, please describe:
Chlorine
If disinfection is by chlorination is dechlorination used for this outfall? ® Yes ❑ No
Does the treatment plant have post aeration? ❑ Yes ® No
A.12. Effluent Testing Information. All Applicants that discharge to waters of the US must provide effluent testing data for the following
parameters. Provide the indicated effluent testing required by the permitting authority for each outfall through which effluent Is
discharged. Do not Include information on combined sewer overflows in this section. All Information reported must be based on data
collected through analysis conducted using 40 CFR Part 136 methods. In addition, this data must comply with QA/QC requirements of
40 CFR Part 136 and other appropriate QA/QC requirements for standard methods for analytes not addressed by 40 CFR Part 136. At a
minimum, effluent testing data must be based on at least three samples and must be no more than four and one-half years apart.
Outfall number: 1
MAXIMUM DAILY VALUE
AVERAGE DAILY VALUE
PARAMETER
Value
Units
Value
Units Number of Samples
pH (Minimum)
s.u.
pH (Maximum)
s.u.
Flow Rate
No wastewater was dispose of b dischar a uring this permit cycle.
Temperature (Winter)
Temperature (Summer)
' For pH please report a minimum and a maximum daily value
MAXIMUM DAILY
AVERAGE DAILY DISCHARGE
POLLUTANT
DISCHARGE
ANALYTICAL
MLIMDL
Conc.
Units
Conc. I
Units
Number of
METHOD
Samples
CONVENTIONAL AND NON CONVENTIONAL COMPOUNDS
BIOCHEMICAL OXYGEN
SODS
DEMAND (Report one)
CB005
FECAL COLIFORM
TOTAL SUSPENDED SOLIDS (TSS)
END OF PART A.
REFER TO THE APPLICATION OVERVIEW (PAGE 1) TO DETERMINE WHICH OTHER PARTS
OF FORM 2A YOU MUST COMPLETE
NPDES FORM 2A Additional Information

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
Riverstone Industrial Park WWTP, NCO087084
Renewal
Broad
BASIC APPLICATION INFORMATION
PART B. ADDITIONAL APPLICATION INFORMATION FOR APPLICANTS WITH A DESIGN FLOW GREATER THAN OR
EQUAL TO 0.1 MGD (100,000 gallons per day).
All applicants with a design flow rate t 0.1 mgd must answer questions B.1 through B.6. All others go to Part C (Certification).
BA. Inflow and Infiltration. Estimate the average number of gallons per day that flow into the treatment works from inflow and/or infiltration.
WA Plant is not currently discharging gpd
Briefly explain any steps underway or planned to minimize inflow and infiltration.
B.2. Topographic Map. Attach to this application a topographic map of the area extending at least one mile beyond facility property boundaries. This
map must show the outline of the facility and the following information. (You may submit more than one map If one map does not show the entire
area.)
a. The area surrounding the treatment plant, including all unit processes.
b. The major pipes or other structures through which wastewater enters the treatment works and the pipes or other structures through which
treated wastewater is discharged from the treatment plant. Include outfalls from bypass piping, if applicable.
c. Each well where wastewater from the treatment plant is injected underground.
d. Wells, springs, other surface water bodies, and drinking water wells that are: 1) within Y4 mile of the property boundaries of the treatment
works, and 2) listed in public record or otherwise known to the applicant.
e. Any areas where the sewage sludge produced by the treatment works is stored, treated, or disposed.
I. If the treatment works receives Basta that is classified as hazardous under the Resource Conservation and Recovery Act (RCRA) by truck, rail,
or special pipe, show on the map where the hazardous waste enters the treatment works and where it is treated, stored, and/or disposed.
B.3. Process Flow Dle.3rar., cr Schematic. F:ovide a diagram showing the processes of the treatment plant, including all bypass piping and all
backup power sources or redunancy in the system. Also provide a water balance showing all treatment units, including disinfection (e.g.,
chlorination and dedtiorinalion). The water balance must show daily average flow rates at influent and discharge points and approximate daily flow
rates between treatment units. Include a brief narrative description of the diagram.
BA. Operation/Maintenance Performed by Contractor(s).
Are any operational or maintenance aspects (related to wastewater treatment and effluent quality) of the treatment works the responsibility of a
contractor? ❑ Yes ® No
If yes, list the name, address, telephone number, and status of each contractor and describe the contractors responsibilities (attach additional
pages if necessary).
Name:
Mailing Address:
Telephone Number; ( 1
Responsibilities of Contractor:
B.5. Scheduled improvements and Schedules of Implementation. Provide information on any uncompleted implementation schedule or
uncompleted plans for improvements that will affect the wastewater treatment, effluent quality, or design capacity of the treatment works. If the
treatment works has several different implementation schedules or is planning several improvements, submit separate responses to question B.5
for each. (If none, go to question B.6.)
a. List the outfall number (assigned in question A.9) for each oudall that is covered by this implementation schedule.
1
b. Indicate whether the planned improvements or implementation schedule are required by local, State, or Federal agencies.
❑ Yes ® No
NPDES FORM 2A Additional Information

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
Riverstone Industrial Park WWTP, NCO087084
Renewal
Broad
C. If the answer to B.5.1b is "Yes,' briefly describe, including new maximum daily inflow rate (if applicable).
d. Provide dates imposed by any compliance schedule or any actual dates of completion for the implementation steps listed below, as
applicable. For improvements planned independently of local, State, or Federal agencies, indicate planned or actual completion dates, as
applicable. Indicate dates as accurately as possible.
Schedule Actual Completion
Implementation Stage MM/DD/YYl'Y MM/DD/YYYY
- Begin Construction / / / I
- End Construction I l l I
- Begin Discharge
- Attain Operational Level / / I I
e. Have appropriate permits/clearances cwnceming other FederallState requirements been obtained? ❑ Yes ❑ No
Describe briefly:
B.S. EFFLUENT TESTING DATA (GREATER THAN 0.1 MGD ONLY).
Applicants that discharge to waters of the US must provide effluent testing data for the following parameters. Provide the Indicated
effluent testing required by the permitting authority for each outfall through which effluent is discharged. Do not include information
on combine sewer overflows in this section. All Information reported must be based on data collected through analysis conducted
using 40 CFR Part 136 methods. In addition, this data must comply with QA/QC requirements of 40 CFR Part 136 and other appropriate
QAIQC requirements for standard methods for anatytes not addressed by 40 CFR Part 136. At a minimum effluent testing data must be
based on at least three pollutant scans and must be no more than four and on -half years old.
Outfall Number. 1
MAXIMUM DAILY
DISCHARGE
AVERAGE DAILY DISCHARGE
POLLUTANT
ANALYTICAL
MLIMDL
Conc.
Units
Cone.
Units
Number of
METHOD
Samples
CONVENTIONAL AND NON CONVENTIONAL COMPOUNDS
AMMONIA(as N)
No wastewater was disposed of by discharge during this permit cycle.
CHLORINE (TOTAL
RESIDUAL, TRC)
DISSOLVED OXYGEN
TOTAL KJELDAHL
NITROGEN (TKN)
NITRATE PLUS NITRITE
NITROGEN
OIL and GREASE
PHOSPHORUS (Total)
TOTAL DISSOLVED SOLIDS
(TDS)
OTHER
END OF PART B.
REFER TO THE APPLICATION OVERVIEW (PAGE 1) TO DETERMINE WHICH OTHER PARTS
OF FORM 2A YOU MUST COMPLETE
NPDES FORM 2A Additional Information

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
Riverstone Industrial Park WWTP, NCO087084
Renewal
Broad
BASIC APPLICATION INFORMATION
PART C. CERTIFICATION
All applicants must complete the Certification Section. Refer to instructions to determine who is an officer for the purposes of this
certification. All applicants must complete all applicable sections of Form 2A, as explained in the Application Overview. Indicate below which
parts of Form 2A you have completed and are submitting. By signing this certification statement, applicants confirm that they have reviewed
Form 2A and have completed all sections that apply to the facility for which this application is submitted.
Indicate which parts of Form 2A you have completed and are submitting:
® Basic Application Information packet Supplemental Application Information packet:
❑ Part D (Expanded Effluent Testing Data)
❑ Part E (Toxicity Testing: Biomonitoring Data)
❑ Part F (Industrial User Discharges and RCRA/CERCLA Wastes)
❑ Part G (Combined Sewer Systems)
ALL APPLICANTS MUST COMPLETE THE FOLLOWING CERTIFICATION.
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 property 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 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 and official title John ondrem. Ci Manager`�,//
Signature a!'t-Cng�'.�
Telephone number (8281245-4747
Date signed / — 3 ^F! ^ Gp 3
Upon request of the permitting authority, you must submit any other information necessary to assure wastewater treatment practices at the treatment
works or identify appropriate permitting requirements.
SEND COMPLETED FORMS TO:
NCDENR/ DWQ
Attn: NPDES Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
NPDES FORM 2A Additional Information

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