NC0088927_Renewal (Application)_20160923

September 23, 2016
John Hennessy
Supervisor, Compliance and Expedited Permitting Unit
Division of Water Resources
Department of Environmental Quality
1617 Mail Service Center
Raleigh, NC 27699-1617
Re: Meadow Ridge Subdivision WTP
Permit Renewal Application
Permit # NCO088927
Guilford County
Mr. Hennessy:
Enclosed please find our application for renewal of our NPDES Permit and
required documentation.
Aqua North Carolina, Inc. requests the renewal of the current limitations for
this facility as recorded on the previous permit set to expire on February 28,
2017.
If you have questions feel free to contact me at [phone], Extension
57238 or by e-mail at MAMelton(aD-aguaamerica.com.
Sincerely,
"CA Cul 4- 04w—,
Michael A. Melton
Regional Manager of Compliance
Aqua North Carolina, Inc.
202 MacKenan Court, Cary, NC, 27511 • 919.467.8712 • AquaAmerica.com

NPDES PERMIT APPLICATION - SHORT FORM C - WTP
For discharges associated with water treatment plants
Mail the complete application to:
N. C. Department of Environment and Natural Resources
Division of Water Quality / NPDES Unit
1617 Mail Service Center, Raleigh, NC 27699-1617
NPDES Permit Number INCO088927
If you are completing this form in computer use the TAB key or the up - down arrows to move from one
field to the next. To check the boxes, click your mouse on top of the box. Otherwise, please print or type.
1. Contact Information:
Owner Name
AQUA NORTH CAROLINA, INC.
Facility Name
MEADOW RIDGE
Mailing Address
202 MACKENAN COURT
City
CARY
State / Zip Code
NORTH CAROLINA 27511
Telephone Number
[phone]
Fax Number
[phone]
e-mail Address
[e-mail]
2. Location of facility producing discharge:
Check here if same as above ❑
Street Address or State Road
City
State / Zip Code
County
7626 ANTHONY ROAD
STOKESDALE
NORTH CAROLINA 27284
GUILFORD
3. Operator Information:
Name of the firm, consultant or other entity that operates the facility. (Note that this is not referring to the
Operator in Responsible Charge or ORC)
Name AQUA NORTH CAROLINA, INC.
Mailing Address 202 MACKENAN COURT
City CARY
State / Zip Code NORTH CAROLINA 27511
Telephone Number [phone]
Fax Number [phone]
4. Ownership Status:
Federal ❑ State ❑
5. Type of treatment plant:
Private
Public ❑
Page 1 of 3 C-WTP 03/05

NPDES PERMIT APPLICATION - SHORT FORM C - WTP
For discharges associated with water treatment plants
❑ Conventional (Includes coagulation, flocculation, and sedimentation, usually followed by
filtration and disinfection)
❑ Ion Exchange (Sodium Cycle Cationic ion exchange)
® Green Sand Filter (No sodium recharge)
❑ Membrane Technology (RO, nanofiltration)
Check here if the treatment process also uses a water softener ❑
6. Description of source water(s) (i.e. groundwater, surface water)
Groundwater
7. Describe the treatment process(es) for the raw water:
Chlorination
Caustic for pH control
Four (4) greensand filter units
8. Describe the wastewater and the treatment process(es) for wastewater generated by the
facility:
Four (4) greensand filter units
Dechlorination
2" outfall pipe
9. Number of separate discharge points: 1
Outfall Identification number(s) 001
10. Frequency of discharge: Continuous ❑ Intermittent 0
If intermittent:
Days per week discharge occurs: As many as seven (7) days, and as few as three (3) days
depending on the flow. Duration: 80 minutes
11. Plant design potable flowrate 0.00010 MGD
Backwash or reject flow 0.00050 MGD
12. Name of receiving stream(s) (Provide a map showing the exact location of each outfall, including
latitude and longitudes
Unnamed tributary to Kings Creek.
Page 2 of 3 C-WTP 03/05

NPDES PERMIT APPLICATION - SHORT FORM C - WTP
For discharges associated with water treatment plants
13. Please list all water treatment additives, including cleaning chemicals or disinfection
treatments, that have the potential to be discharged.
Chlorine
Caustic Soda
14. Is this facility located on Indian country? (check one)
Yes ❑ No
15. Additional Information:
Provide a schematic of flow through the facility, include flow volumes at all points in
the treatment process, and point of addition of chemicals.
Solids Handling Plan
16. NEW Applicants
Information needed in addition to items 1-15:
New applicants must contact a permit coordinator with the NCDENR Customer
Service Center.
Was the Customer Service Center contacted? ❑ Yes ❑ No
➢ Analyses of source water collected
Engineering Alternative Analysis
Discharges from Ion Exchange and Reverse Osmosis plants shall be evaluated using a
water quality model.
17. Applicant Certification
I certify that I am familiar with the information contained in the application and that to the
best of my knowledge and belief such information is true, complete, and accurate.
Shannon V. Becker President
Printed name of Person Signing Title
�' V—
of Applicant
Date
North Carolina General Statute 143-215.6 (b)(2) provides that: Any person who knowingly makes any false
statement representation, or certification in any application, record, report, plan, or other document files or
required to be maintained under Article 21 or regulations of the Environmental Management Commission
implementing that Article, or who falsifies, tampers with, or knowingly renders inaccurate any recording or
monitoring device or method required to be operated or maintained under Article 21 or regulations of the
Environmental Management Commission implementing that Article, shall be guilty of a misdemeanor punishable
by a fine not to exceed $25,000, or by imprisonment not to exceed six months, or by both. (18 U.S.C. Section
1001 provides a punishment by a fine of not more than $25,000 or imprisonment not more than 5 years, or both,
for a similar offense.)
Page 3 of 3 C-WTP 03/05

Permit NCO088927
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Quad: C18NE (Belews Creek)
NCO088927
Facility J
Latitude: 36112'40"
Longitude: 80100'16°
Aqua North Carolina, Inc.
Location"" '`'
Stream Class: B
Meadow Ridge S/D WTP
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SCALE 1:24000
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Subbasin: 03-02-01
Receiving Stream: UT to Kings Creek