NC0075353_Renewal (Application)_20240924

•
ROY COOPER
Governor
ELIZABETH S.BISER • "^•�^"
Secretary _-
RICHARD E.ROGERS,JR. NORTH CAROLINA
Director Environmental Quality
September 24, 2024
McDowell Assisted Living, LLC
Attn: Linda Isaacs
PO Box 909
Marion, NC 28752-0909
Subject: Permit Renewal
Application No. NC0075353
McDowell Assisted Living WWTP
McDowell County
Dear Applicant:
The Water Quality Permitting Section acknowledges the September 24, 2024, receipt of your permit renewal application
and supporting documentation. Your application will be assigned to a permit writer within the Section's NPDES WW
permitting branch. Per G.S. 150B-3 your current permit does not expire until permit decision on the application is made.
Continuation of the current permit is contingent on timely and sufficient application for renewal of the current permit. The
permit writer will contact you if additional information is required to complete your permit renewal. Please respond in a
timely manner to requests for additional information necessary to allow a complete review of the application and renewal
of the permit.
Information regarding the status of your renewal application can be found online using the Department of Environmental
Quality's Environmental Application Tracker at:
https://www.deq.nc.gov/permits-rules/environmental-application-tracker
If you have any additional questions about the permit, please contact the primary reviewer of the application using the
links available within the Application Tracker.
Sinc rel
Wren Thedford
Administrative Assistant
Water Quality Permitting Section
cc: Juanita James, ORC
ec: WQPS Laserfiche File w/application
DE Q�� Northvi Carolille Regional ne DepartmentOffice2090 of EnvironmentalU.SHighway Q70ualitySwannanoa.Division of NorWaterthCarolina Resources_ om/ ) Ashe 28778
..�w -•+�.� / 828 296 4500

NPDES Permit Number Facility Name Modified Application Form 2A
j „ 515� 1 M C a ^,4;' , `N/ Modified March 2021
Form
NC Department of Environmental Quality-Application for NPDES Permi o Discharge Wastewater
NPDES MINOR SEWAGE FACILITIES(Before completing this forth,please read the instructions.Failure to follow
the instructions may result in denial of the application.)
SECTION 1.BASIC APPLICATION INFORMATION FOR ALL APPLICANTS(40 CFR 122.21(j)(1)and(9))
1.1 Facility name
Me a)vvell PS.S ;s-ted LWinoi Li(--
Mailing address(street or P.O.box)
o 13avr9t
City or town State ZIP code
o rion . KG 21 we- 28c/5 a
€E Contact name(first and last) Title P •ne number Email address
r :Z 6- (a�S2-3a33 rn�.l� , h 1 e nrr,/
c Li nag. \SOLAcs C \r w (4r?f3 &h3-)33rD
Location address(street,route number,or other specific identifier) 0 Same as mailing address
,� 3 /�t C --- --- — — -- —j
� City or town State ZIP code
lNkariert NC 0 /3—a
1.2 Is this application for a facility that has yet to commence discharge?
❑ Yes 4 See instructions on data submission [3 No RECEIVED
requirements for new dischargers.
1.3 Is applicant different from entity listed under Item 1.1 above?
�s SEP 2 4 2024
vi Yes ,(� No 4 SKIP to Item 1.4.
Applicant name /, NCDEQ/DWP/NPDES
il,t.an r /1/11 s
c Applicant address(street or P.O.box)
&y 3I g
o State ZIP code
v City or town
btcn i.r Ab rn,e 1J G 2 8 75&
Cont t name(first an last) Title Phone number mail address . .
ri tGnat4-, nteS N vp' ' g28-/pq7-D6193 j ja tes@Beta ,4.4
a 1.4 Is the applicant the facility's owner,operator,or both?(Check only one response.)
❑ Owner f Operator ❑ Both
1.5 To which entity should the NPDES permitting authority send correspondence?(Check only one response.)
rig Facility ❑ Applicant ❑ Facility and applicant
(they are one and the same)
1.6 Indicate below any existing environmental permits.(Check all that apply and print or type the corresponding permit
A number for each.)
Existing Environmental Permits
a NPDES(discharges to surface ❑ RCRA(hazardous waste) ElUIC(underground injection
owater) control)
2 ❑ PSD(air emissions) ❑ Nonattainment program(CM) NESHAPs(CM)
c
w
as
'n ❑ Ocean dumping(MPRSA) ❑ Dredge or fill(CWA Section 0 Other(specify)
404)
Page 1
I

I
NPDES Permit Number Facility Name ( Modified Application Form 2A
NCoo 7S3 53 Aqg a J Ass s L1 V(VIL Modified March 2021
1.7 Provide the collection system information requested below for the treatment works. J
Municipality Population Collection System Type
Served Served (indicate percentage) Ownership Status
1(VIP%separate sanitary sewer l Own 0 Maintain
d '� %combined storm and sanitary sewer ❑ Own 0 Maintain
m T ❑ Unknown 0 Own ❑ Maintain
c %separate sanitary sewer ❑ Own ❑ Maintain
to
%combined storm and sanitary sewer 0 Own CI Maintain
"3 0 Unknown ❑ Own ❑ Maintain
c.
o %separate sanitary sewer ❑ Own 0 Maintain
c %combined storm and sanitary sewer ID Own 0 Maintain
10 0 Unknown ❑ Own El Maintain
E I %separate sanitary sewer El Own 0 Maintain
y %combined storm and sanitary sewer El Own ❑ Maintain
c El Unknown ❑ Own ❑ Maintain
o
Total
d ! Population ��y�
ci Served " ' `ift":. _,.« 4 .. {= 1
I Combined Storm and
Separate Sanitary Sewer System
Sanitary Sewer
Total percentage of each type of 0/0
sewer line(in miles) \OD %
Z. 1.8 Is the treatment works located in Indian Country?
c
0 0 Yes ® No
U
c 1.9 Does the facility discharge to a receiving water that flows through Indian Country?
co
0 Yes ] No
1.10 Provide design and actual flow rates in the designated spaces. Design Flow Rate
0. D I mgd
w N Annual Average Flow Rates(Actual)
< Two Years Ago Last Year This Year
c _ D.DD2
� � d.LU2 mgd mgd (�•bD 3 mgd
co" Maximum Daily Flow Rates(Actual)
41)
O Two Years Ago Last Year This Year
U. (o 22- mgd O. C7D22, mgd D. DD3 mgd
,,, 1.11 Provide the total number of effluent discharge points to waters of the State of North Carolina by type.
.o Total Number of Effluent Discharge Points by Type
a.
a Combined Sewer Constructed
L Treated Effluent Untreated Effluent Overflows Bypasses Emergency
Overflows
0
En - -- _
001 VCP 0 d
Page 2

NPDES Permit Number I Mc�i'� ci it ame Modified Application Form 2A
NC Db7 53 53 1 L` Modified March 2021
�siS -ed �v►hj.
Outfalls Other Than to Waters of the State of North Carolina
1.12 Does the POTW discharge wastewater to basins,ponds,or other surface impoundments that do not have outlets
for discharge to waters of the State of North Carolina?
❑ Yes 1g 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 ( one)
❑ Continuous
gpd ❑ Intermittent
❑ Continuous
gpd ❑ Intermittent
❑ Continuous
gpd ❑ Intermittent
.p° 1.14 Is wastewater applied to land?
El Yes 9 No 4 SKIP to Item 1.16.
3 1.15 Provide the land application site and discharge data requested below.
Land Application Site and Discharge Data
° Location Size Average Daily Volumeintermittent
Continuous or
v, Applied (check one)
• acres d 0 Continuous
c gp ❑ Intermittent
acres d ❑ Continuous
gp ❑ Intermittent
acres gpd ❑ Continuous
co ❑ Intermittent
11 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
Page 3

I
NPDES Permit Number Facility Name Modified Application Form 2A
N^ �D�� 5 ��p Modified March 2021
l� ►5f 4 L'►vina
1 1.20 In the table below,indicate the name,address,contact information, NPDES number, nd average daily flow rate of the
receiving facility.
Receiving Facility Data
Facili y name
c Mailing address(street or P.O.box)
1, vvel► S�s} L��►n�yv�l� _
City o Awn State ZIP code
Ma
aOM WC ?grloa
a !' Cont ct name(first and last) Title
1 f-i r) a 1 Saae.5 Dwn-er
v Phone number Email address
$28 (05 2 3.)3 3Tei MeiA SD hatnai, ,Lz M
NPDES number of receiving facility(if any) l None Average daily flow rate 0.002 mgd
0.
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
C not have outlets to waters of the State of North Carolina(e.g.,underground percolation,underground injection)?
d
Q' ❑ Yes No 4 SKIP to Item 1.23.
en 1.22 Provide information in the table below on these other disposal methods.
d Information on Other Disposal Methods
o Disposal Location of Size of Annual Average Continuous or Intermittent
A Method Disposal Site Disposal Site Daily Discharge (check one)
VI Description Volume
1 Ti
❑ Continuous
acres gpd 0 Intermittent
0 ❑ Continuous
acres gpd ❑ Intermittent
❑ Continuous
acres gpd ❑ 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.
m y Consult with your NPDES permitting authority to determine what information needs to be submitted and when.)
o 4, ❑ Discharges into marine waters(CWA ❑ Water quality related effluent limitation(CWA Section
$ Section 301(h)) 302(b)(2))
NI Not applicable
1.24 Are any operational or maintenance aspects(related to wastewater treatment and effluent quality)of the treatment works
the responsibility of a contractor?
® Yes 0 No+SKIP to Section 2.
1.25 Provide location and contact information for each contractor in addition to a description of the contractor's operational
and maintenance responsibilities.
Contractor Information
Contractor 1 Contractor 2 Contractor 3
c Contractor name (lames t.
gtxes
:: (company name) (AvianN164-lmc,
€ Mailing address pp ill✓ 6t9
c (street or P.O.box) At . 1-tome, N C 2$Z 58
8 City,state,and ZIP
i code Ntin. V}61x4,N C 2$75&
c Contact name(first and 14vvie
(-) last) go (t�ne i S
Phone number 528-(og1_ otto3
Email address d,das e)jjene,2d
Operational and OtttrsGG 2 .
maintenance !►'tarn t4cwl
responsibilities ofPU,
contractor
Page 4

NPDES Permit Number eD acil y j rme Modified Application Form 2A
M C 0(77 53 53 . P• _ yn Modified March 2021
.( c� � js _
SECTION 2.ADDITIONAL INFORMATION(40 CFR 122.21(j)(1)and(2))
c Outfalls to Waters of the State of North Carolina
w
2.1 Does the treatment works have a design flow greater than or equal to 0.1 mgd?
c ❑ Yes 12 No 4 SKIP to Section 3.
c 2.2 Provide the treatment works'current average daily volume of inflow Average Daily Volume of Inflow and Infiltration
and infiltration.
gpd
0
Indicate the steps the facility is taking to minimize inflow and infiltration.
c
A
0
0
c
z 2.3 Have you attached a topographic map to this application that contains all the required information?(See instructions for
0 specific requirements.)
0
a
Yes❑
o ❑ No
E 2.4 Have you attached a process flow diagram or schematic to this application that contains all the required information?
E (See instructions for specific requirements.)
❑ Yes ❑ No
2.5 Are improvements to the facility scheduled?
❑ Yes ❑ No 4 SKIP to Section 3.
Briefly list and describe the scheduled improvements.
1.
5
2.
3.
= 4.
al 2.6 Provide scheduled or actual dates of completion for improvements.
•
Scheduled or Actual Dates of Completion for Improvements
4, Affected Attainment of
o Scheduled Begin End Begin
Outfalls Operational
(list outfall
Improvement Construction Construction Discharge Level
(from above) number) (MM/DD/YYYY) (MM/DD/YYYY) (MMlDD(YYYY) (MM/DD/YYYY)
1.
s
2.
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:
Page 5

NPDES Permit Number �D Facili
� ) lame
Modified Application Form 2A
C 7536 3 - Modified March 2021
SECTION 3.INFORMATION ON EFFLUENT DISCHARGES(40 CFR 122.21(j)(3)to(5))
3.1 Provide the following information for each outfall.(Attach additional sheets if you have more than three outfalls.)
Outfall Number CC I Outfall Number Outfan Number
State
County K~^DDwe.AI
City or town Ata {a
Distance from shore 3 ft. ft. ft.
a.
Depth below surface _ 2 ft. ft. ft.
Average daily flow rate .1)0 Z mgd mgd mgd
Latitude °S I cJ(.O y ° °
Longitude c ;�S
3.2 Do any of the outfalls described under Item 3.1 have seasonal or periodic discharges?
❑ Yes No 4 SKIP to Item 3.4.
w 3.3 If so,provide the following information for each applicable outfall.
Outfall Number Outfall Number Outfall Number
n Number of times per year
discharge occurs
a Average duration of each
`o discharge(specify units)
Average flow of each
$ discharge mgd mgd mgd
rn Months in which discharge
occurs
3.4 Are any of the outfalls listed under Item 3.1 equipped with a diffuser?
❑ Yes is No 4 SKIP to Item 3.6.
3.5 Briefly describe the diffuser type at each applicable outfall.
Outfall Number OutfaH Number Outfall Number
o Does the treatment works discharge or plan to discharge wastewater to waters of the State of North Carolina from
E j 3.6 one or more discharge points?
Yes ❑ No 4SKIP to Section 6.
Page 6

NPDES Permit Number M Facili Name Modified Application Form 2A
NCDb� 3�3 CbDW�iti Modified March2021
SAS i r1 1.1 v i ht
3.7 Provide the receiving water and related information(if known)for each outfall.
Outfall Number WI Outfall Number Outfall Number
Receiving water name tdDr 441
3 (lieGK
Name of watershed,river, 1" "�j
`c or stream system Ca�"QI DG. �11Vier n
o- U.S.Soil Conservation
.c
Service 14-digit watershed
o code
a Name of state
management/river basin Ca-4aw4�I iyezisin
cx,
U.S. Geological Survey
d
re 8-digit hydrologic
e cataloging unit code
Critical low flow(acute) cfs cfs cfs
Critical low flow(chronic) cfs cfs cfs
Total hardness at critical mg/L of mg/L of mg/L of
low flow CaCO3 CaCO3 CaCO3
3.8 Provide the following information describing the treatment provided for discharges from each outfall.
Outfall Numbar012 I Outfall Number Outfall Number
Highest Level of 14 Primary ❑ Primary ❑ Primary
Treatment(check all that 0 Equivalent to ❑ Equivalent to ❑ Equivalent to
apply per outfall) secondary secondary secondary
0 Secondary 0 Secondary ❑ Secondary
❑ Advanced ❑ Advanced ❑ Advanced
❑ Other(specify) ❑ Other(specify) 0 Other(specify)
c
IDesign Removal Rates by
•I Outfall
o BOD5 or CBOD5 �5 % % %
c
1 TSS S' % % %
Ill Not applicable 0 Not applicable 0 Not applicable
Phosphorus
a0.1 Not applicable ❑ Not applicable ❑Not applicable
Nitrogen
Other(specify) CX1 Not applicable ❑Not applicable El Not applicable
%
Page 7

NPDES Permit Number Md J C`�DwFacGLLjlity Name Modified Application Form 2A
A I C Dar/63 63
Piss�s��cd vi�j
Modified March 2021
�U i Li
3.9 Describe the type of disinfection used for the effluent from each outfall in the table-ielow.If disinfection varies by
season,describe below.
-0
c
0
c Outfall Number©C I Outfall Number Outfall Number
w
P- Disinfection type
-�ublell- Ch1cxt,ne
Seasons used
F �Cr Y owl ci
Dechlorination used? ❑ Not applicable ❑ Not applicable ❑ Not applicable
Cin Yes ❑ Yes 0 Yes
O No ❑ No ❑ No
3.10 Have you completed monitoring for all Table A parameters and attached the results to the application package?
❑ Yes 10, 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 gi No 4 SKIP to Item 3.13.
3.12 Indicate the number of acute and chronic WET tests conducted since the last permit reissuance of the facility's
discharges by outfall number or of the receiving water near the discharge points.
Outfall Number Outfall Number Outfall Number
Acute Chronic Acute Chronic Acute Chronic
Number of tests of discharge
water
Number of tests of receiving
water
3:13 <' .t m5ld 3.I , (0.0
3.14 Does the POTW use chlorine for disinfection,use chlorine elsewhere in the treatment process,or otherwise have
reasonable potential to discharge chlorine in its effluent?
❑ Yes 4 Complete Table B,including chlorine. 0 No-► Complete Table B,omitting chlorine.
3.15 Have you completed monitoring for all applicable Table B pollutants and attached the results to this application
package?
❑ Yes ❑ No
Have you completed monitoring for all applicable Table D pollutants required by your NPDES permitting authority and
3.18 attached the results to this application package?
0 Yes ❑ No additional sampling required by NPDES
permitting authority.
Page 8

NPDES Permit Number ^n G\D F cili ame Modified Application Form 2A
MC Ub 15 3 Gmi 3 s./I l� i6� L`vi Modified March 2021
3.19 Has the POTW conducted either(1)minimum of four quarterly WET tests for one rear preceding this permit application
or(2)at least four annual WET tests in the past 4.5 years?
El Yes ❑ No 4 Complete tests and Table E and SKIP to
Item 3.26.
3.20 Have you previously submitted the results of the above tests to your NPDES permitting authority?
El Yes ❑ No 4 Provide results in Table E and SKIP to
Item 3.26.
3.21 Indicate the dates the data were submitted to your NPDES permitting authority and provide a summary of the results.
Date(s)Submitted Summary of Results
(MM/DD/YYYY)
a+
C
3.22 Regardless of howyouprovidedyour WET testingdata to the NPDES permittingauthority,did anyof the tests result in
9
a toxicity?
Q ❑ Yes ❑ No 4 SKIP to Item 3.26.
I3.23 Describe the cause(s)of the toxicity:
'lc
W
3.24 Has the treatment works conducted a toxicity reduction evaluation?
❑ Yes ❑ No 4 SKIP to Item 3.26.
3.25 Provide details of any toxicity reduction evaluations conducted.
3.26 Have you completed Table E for all applicable outfalls and attached the results to the application package?
El Yes ❑ Not applicable because previously submitted
information to the NPDES •ermittin. authori .
Page 9

NPDES Permit Number i Y/►Ga)DZacility Name Modified Application Form 2A
1 C Q S3 3 ►sY�+1 Li Modified March 2021
,
SECTION 6.CHECKLIST AND CERTIFICATION STATEMENT(40 CFR 122.22(a)and(d))
6.1 In Column 1 below,mark the sections of Form 2A that you have completed and are submitting with your application.For
each section,specify in Column 2 any attachments that you are enclosing to alert the permitting authority.Note that not
all applicants are required to provide attachments.
Column 1 Column 2
511 Section 1: Basic Application w/variance request(s)
Information for All Applicants ❑ quest( ) ❑ w/additional attachments
Section 2:Additional ❑ wl topographic map ❑ wl process flow diagram
Information ❑ w/additional attachments
❑ w/Table A ❑ wl Table D
Section 3: Information on El w/Table B ❑ wl additional attachments
Effluent Discharges
❑ w/Table C
2
co Section 4:Not Applicable
0
Section 5:Not Applicable
d
0
c 91 Section 6: Checklist and
�jPl Certification Statement ❑ w/attachments
Y 6.2 Certification Statement
/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
Signature Date signed
a.a. � 2u
Page 10