NC0074110_LM20170018_20170628

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ROY COOPER
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MICHAEL S. RECAN
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Certified Mail # 7016 1370 0001 6571 8416
Return Receipt Requested
June 28, 2017
Mizpah Healthcare Inc RECEIVEDINCDEWWR
260 Center Way Dr
Hendersonville, NC 28792 JUL 0 6 2017
Water Quality
SUBJECT Notice of Violation and Assessment of Civil Penalty
Permitting Section
for Violations of North Carolina General Statute (G S) 143-215 1(a)(6)
and NPDES WW Permit No NCO074110
Mizpah Healthcare Inc
Mountain View Assisted Living
Case No LM -2017-0018
Henderson County
Dear Permittee
This letter transmits a Notice of Violation and assessment of civil penalty in the amount of $566 62 ($450 00 civil penalty +
$116 62 enforcement costs) against Mizpah Healthcare Inc.
This assessment is based upon the following facts a review has been conducted of the Discharge Monitoring Report
(DMR) submitted by Mizpah Healthcare Inc for the month of April 2017 This review has shown the subject facility to be
in violation of the discharge limitations and/or monitoring requirements found in NPDES WW Permit No NCO074110 The
violations, which occurred in April 2017, are summarized in Attachment A to this letter
Based upon the above facts, I conclude as a matter of law that Mizpah Healthcare Inc violated the terms, conditions or
requirements of NPDES WW Permit No N00074110 and G S 143-215 l(a)(6) in the manner and extent shown in
Attachment A In accordance with the maximums established by G S. 143-215 6A(a)(2), a civil penalty may be assessed
against any person who violates the terms, conditions or requirements of a permit required by G S 143-215 1(a)
Based upon the above fmdmgs of fact and conclusions of law, and in accordance with authority provided by the Secretary
of the Department of Environmental Quality and the Director of the Division of Water Resources, I, G Landon Davidson,
P G, Regional Supervisor, Asheville Regional Office hereby make the following civil penalty assessment against Mizpah
Healthcare Inc
State of North Carolina I Environmental Quality 1 Water Resources
2090 U S 70 Highway, Swannanoa, NC 28778
828-296-4500

$200.00 2 of the 3 violations of 143-215.1(x)(6) and Permit No.NC0074110, by discharging wastewater into
the waters of the State in violation of the Permit Daily Maximum for BOD - Cone.
$250.00 1 of the 1 violations of 143-215:l(a)(6) and Permit No NCO074110, by discharging waste water into
the waters of the State in violation of the Permit Monthly Average for BOD - Cone
$0.00 for 0 of the 1 failures to properly monitor FLOW in violation of Permit No. NCO074110
$450.00 TOTAL CIVII, PENALTY
$116.62 Enforcement Costs
$566.62 TOTAL AMOUNT DUE
Pursuant to G. S. 143-215.6A(c), in determining the amount of the penalty I have taken into account the Findings of Fact, and
Conclusions of Law and the factors set forth at G.S. 143B -282.1(b), which are:
(1) The degree and extent of harm to the natural resources of the State, to the public health, or to private property
resulting from the violation;
(2) The duration and gravity of the violation;
(3) The effect on ground or surface water quantity or quality or on air quality,
(4) The cost of rectifying the damage,
(5) The amount of money saved by noncompliance;
(6) Whether the violation was committed willfully or intentionally;
(7) The prior record of the violator in complying or failing to comply with programs over which the Environmental
Management Commission has regulatory authority; and
(8) The cost to the State of the enforcement procedures.
Within thirty (30) days of receipt of this notice, you must do one of the following -
(1) Submit payment of the penalty, OR
(2) Submit a written request for remission, OR
(3) Submit a written request for an administrative hearing
Option 1: Submit payment of the penalty:
Payment should be made directly to the order of the Department of Environmental Quality (do not include waiver
form) Payment of the penalty will not foreclose further enforcement action for any continuing or new violation(s).
Please submit payment to the attention of -
Wastewater Branch
Division of Water Resources
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

Option 2: Submit a written request for remission or mitigation including a detailed justification for such
request:
Please be aware that a request for remission is limited to consideration of the five factors listed below as they may
relate to the reasonableness of the amount of the civil penalty assessed Requesting remission is not the proper
procedure for contesting whether the violation(s) occurred or the accuracy of any of the factual statements contained in
the civil penalty assessment document. Because a remission request forecloses the option of an administrative hearing,
such a request must be accompanied by a waiver of your right to an administrative hearing and a stipulation and
agreement that no factual or legal issues are in dispute Please prepare a detailed statement that establishes why you
believe the civil penalty should be remitted, and submit it to the Division of Water Resources at the address listed below.
In determining whether a remission request will be approved, the following factors shall be considered:
(1) whether one or more of the civil penalty assessment factors in NCGS 143B-282.I(b) was wrongfully
applied to the detriment of the petitioner;
(2) whether the violator promptly abated continuing environmental damage resulting from the violation,
(3) whether the violation was inadvertent or a result of an accident;
(4) whether the violator had been assessed civil penalties for any previous violations; or
(5) whether payment of the civil penalty will prevent payment for the remaining necessary remedial actions
Please note that all evidence presented in support of your request for remission must be submitted in writing. The
Director of the Division of Water Resources will review your evidence and inform you of his decision in the matter of
your remission request. The response will provide details regarding the case status, directions for payment, and
provision for further appeal of the penalty to the Environmental Management Commission's Committee on Civil Penalty
Remissions (Committee) Please be advised that the Committee cannot consider information that was not part of the
original remission request considered by the Director. Therefore, it is very important that you prepare a complete and
thorough statement in support of your request for remission
In order to request remission, you must complete and submit the enclosed "Request for Remission of Civil Penalties,
Waiver of Right to an Administrative Hearing, and Stipulation of Facts" form within tligty (30) days of receipt of this
notice. The Division of Water Resources also requests that you complete and submit the enclosed "Justification for
Remission Request."
Both forms should be submitted to the following address -
Wastewater Branch
Division of Water Resources
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

1 �
♦j
Option 3: File a petition for an administrative hearing with the Office of Administrative Hearings: It
If you wish to contest any statement in the attached assessment document you must file a petition for an administrative
hearing. You may obtain the petition form from the Office of Administrative Hearings. You must file the petition with
the Office of Administrative Hearings within thirty (30) days of receipt of this notice A petition is considered filed
when it is received in the Office of Administrative Hearings during normal office hours. The Office of Administrative
Hearings accepts filings Monday through Friday between the hours of 8 00 a in and 5:00 p.m., except for official state
holidays The petition may be filed by facsimile (fax) or electronic mail by an attached file (with restrictions) - provided
the signed original, one (1) copy and a filing fee (if a filing fee is required by NCGS §15OB-23 2) is received in the
Office of Administrative Hearings within seven (7) business days following the faxed or electronic transmission. You
should contact the Office of Administrative Hearings with all questions regarding the filing fee and/or the details of the
filing process.
The mailing address and telephone and fax numbers for the Office of Administrative Hearings are as follows.
Office of Administrative Hearings
6714 Mail Service Center
Raleigh, NC 27699-6714
Tel- [phone]
Fax [phone]
One (1) copy of the petition must also be served on DEQ as follows•
Mr William F. Lane, General Counsel
Department of Environmental Quality
1601 Mail Service Center
Raleigh, North Carolina 27699-1601
Please indicate the case number (as found on page one of this letter) on the petition.
Failure to exercise one of the options above within thirty (3 0) days of receipt of this letter, as evidenced by an internal
date/tune received stamp (not a postmark), will result in this matter being referred to the Attorney General's Office for
collection of the penalty through a civil action. Please be advised that additional penalties may be assessed for violations
that occur after the review period of this assessment
If you have any questions, please contact Janet Cantwell with the Division of Water Resources staff of the Asheville
Regional Office at [phone] or via email at janet cantwell@ncdenr gov.
Sincerely,
G. Landon Davidson, P G, Regional Supervisor
Water Quality Regional Operations Section
Asheville Regional Office
Division of Water Resources, NCDEQ
ATTACHMENTS
Cc: WQS Asheville Regional Office - Enforcament File
NPDES Compliance/Enforcement Unit - Enforcement File
6 \WRRVQ',Hendei5on\Wastewater\Nlmors4llonntam ViewAssisted Living 74110U.142017-0018 rtf

JUSTIFICATION FOR REMISSION REQUEST
Case Number: LM -2017-0018 County: Henderson
Assessed Party: Mizpah Healthcare Inc/ Mountain View Assisted Living
Permit No.: NC0074110 Amount ,Assessed: $566.62
Please use this form when requesting remission of this civil penalty You must also complete the "Request For Remission,
Waiver of Right to an Administrative Hearing, and Stipulation of Facts" form to request remission of this civil penalty.
You should attach any documents that you believe support your request and are necessary for the Director to consider in
evaluating your request for remission. Please be aware that a request for remission is limited to consideration of the five
factors listed below as they may relate to the reasonableness of the amount of the civil penalty assessed Requesting
remission is not the proper procedure for contesting whether the violation(s) occurred or the accuracy of any of the factual
statements contained in the civil penalty assessment document Pursuant to N.0 G.S § 143B-282 1(c), remission of a civil
penalty may be granted only when one or more of the following five factors apply. Please check each factor that you
believe applies to your case and provide a detailed explanation, including copies of supporting documents, as to why the
factor applies (attach additional pages as needed).
(a) one or more of the civil penalty assessment factors in N.C.G.S. 143B-282 1(b) were wrongfully applied to the
detriment of the petitioner (the assessment factors are listed in the civil penalty assessment document),
(b) the violator promptly abated continuing environmental damage resulting from the violation (i.e , explain the
steps that you took to correct the violation and prevent future occurrences),
(c) the violation was inadvertent or a result of an accident (i e, explain why the violation was unavoidable or
something you could not prevent or prepare for),
(d) the violator had not been assessed civil penalties for any previous violations,
(e) payment of the civil penalty will prevent payment for the remaining necessary remedial actions (i. e , explain
how payment of the civil penalty will prevent you from performing the activities necessary to achieve
compliance)
EXPLANATION:

I
STATE OF NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY
COUNTY OF HENDERSON
IN THE MATTER OF ASSESSMENT ) WAIVER OF RIGHT TO AN
OF CIVIL PENALTIES AGAINST ) ADMINISTRATIVE HEARING AND
STIPULATION OF FACTS
Mizpah Healthcare Inc )
Mountain View Assisted Living )
PERMIT NO. NCO074110 ) CASE NO. LM -2017-0018
Having been assessed civil penalties totaling $566.62 for violation(s) as set forth in the assessment document of the Division
of Water Resources dated June 28, 2017, the undersigned, desiring to seek remission of the civil penalty, does hereby waive
the right to an administrative hearing in the above -stated matter and does stipulate that the facts are as alleged in the
assessment document The undersigned further understands that all evidence presented in support of remission of this civil
penalty must be submitted to the Director of the Division of Water Resources within thirty (3 0) days of receipt of the notice
of assessment. No new evidence in support of a remission request will be allowed after (30) days from the receipt of the
notice of assessment.
This the day of , 20
SIGNATURE
ADDRESS
TELEPHONE

1 , -
ATTACHMENT A
Miapah Healthcare Inc
CASE NUMBER: LM -2017-0018
PERMIT: NCO074110
REGION:
Asheville
FACILITY: Mountain View Assisted Living
COUNTY:
Henderson
LIMIT VIOLATION(S)
SAMPLE LOCATION: Outfall 001 - Effluent
Violation Report
Unit of
Limit
Calculated
% Over
Violation
Penalty
Date Month/Yr Parameter
Frequency
Measure
Value
Value
Limit
Type
Amount
4/4/2017 4-2017 BOD, 5 -Day (20 Deg
Weekly
mg/1
750
1130
507
Daily
$10000
C) - Concentration
Maximum
Exceeded
4/11/2017 4-2017 BOD, 5 -Day (20 Deg
Weekly
mg/I
750
1390
853
Daily
$10000
C) - Concentration
Maximum
Exceeded
4/19/2017 4-2017 BOD, 5 -Day (20 Deg
Weekly
mg/I
750
810
8 3
Daily
$000
C) - Concentration
Maximum
Exceeded
4/30/2017 4-2017 BOD, 5 -Day (20 Deg
Weekly
mg/l
5
790
575
Monthly
$25000
C) - Concentration
Average
Exceeded
MONITORING VIOLATION(S)
SAMPLE LOCATION: Outfall 001 - Effluent
Violation Report
Unit of
Limit
Calculated
% Over
Violation
Penalty
Date Month/Yr Parameter
Frequency
Measure
Value
Value
Limit
Type
Amount
4/14/2017 4-2017 Flow, in conduit or thru
Continuous
mgd
Frequency
$000
treatment plant
Violation

DIVISION OF WATER RESOURCES - CIVIL PENALTY ASSESSMENT (File)
Violator: Mizpah Healthcare Inc
Facility Name: Mountain View Assisted Living WWTP
Permit Number: NCO074110
County: Henderson
Case Number: LM -2017-0018
ASSESSMENT FACTORS
1) The degree and extent of harm to the natural resources of the State, to the public health, or to private property
resulting from the violation;
All effluent violations may be detrimental to the receiving stream but may not be immediately quantified.
2) The duration and gravity of the violation;
Three Daily Max SODS exceeded the permit limit by 50.66%, 85.33% & 8.26%.
One Monthly Average BOD exceeded the permit limit by 57.52%.
3) The effect on ground or surface water quantity or quality or on air quality;
All effluent violations may be detrimental to the receiving stream but may not be immediately quantified.
4) The cost of rectifying the damage;
The cost is unknown.
5) The amount of money saved by noncompliance;
The amount of money saved is unknown.
The amount of money saved would include the cost of excess solids removal and additional aeration. It
would also include more operating and maintenance time on site and the cost of additional chemical
treatment.
The amount of money saved would include the cost of collection of the additional samples and the cost of
analyzing them at a certified lab.
6) Whether the violation was committed willfully or intentionally;
It does not appear to be either.
7) The prior record of the violator in complying or failing to comply with programs over which the Environmental
Management Commission has regulatory authority; and
There have been four civil penalty enforcements in the twelve months prior to this violation.
8) The cost to the State of the enforcement procedures.
$116.62
Date
G. Landon Davidson, P.G., Regional Supervisor
Water Quality Regional Operations Section
Asheville Regional Office
Division of Water Resources, NCDEQ

NPDES PERMIT NO.: NCO074110
FACILITY NAME: Mountain View Assisted Living
OWNER NAME: Mlzpah Healthcare Inc
GRADE: WW -2
eDMR PERIOD. 04-2017 (April 2017)
PERMIT VERSION: 4 0
CLASS: WW -2
ORC: Shannon D James
ORC HAS CHANGED: No
VERSION: 10
PERMIT STATUS: Active�o*
COUNTY: Henderson
ORC CERT NUMBER: 1002526
STATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
****NoReporting Reason ENFRUSE=No Flow-Reuse/Recycle, ENVWTHR=NoVisitation — Adverse Weather, NOFLOW=No Flow, HOLIDAY =NoVisitation —Holiday
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00010
5Xweek
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TEMP -C
00400
Weekly
Grab
pH
50060
2Xweek
Grab
CHLORINE
C0310
Weekly
Composite
BOD -Co
C0610
Weekly
Composite
NH3-N-Cone
C0530
Weekly
Composite
TSS -Cone
31616
Weekly
Grab
FCOLI BH
00300
Weekly
Grab
DO
2400 elaek
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7400 clack
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UM
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153
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152
< 15
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164
8
00027
9
00027
10
0900
017
B
00027
146
11
1150
042
B
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152
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139
<01
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1074
12
1514
01
B
0002
164
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025
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0 002
178
14
HOLIDAY
15
0 0028
16
00028
17
0905
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00028
168
18
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178
606
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00027
171
22
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23
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24
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02
B
00027
163
< 15
25
11107
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B
00031
16
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<15
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0205
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83
26
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B
00031
178
27
1718
008
B
00031
171
28
1159
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00027
179
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30
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Monthly Avenge Limit 0005
5
2
30
200
Monthly Avenge
0002486
16163158
0
7 876
011275
0
1
932
DadyMsumum
0 0031
179
7
0
139
0 246
0
0
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Daily Mmimum
100015
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0
10
0
0
0
728
****NoReporting Reason ENFRUSE=No Flow-Reuse/Recycle, ENVWTHR=NoVisitation — Adverse Weather, NOFLOW=No Flow, HOLIDAY =NoVisitation —Holiday

NPDES PERMIT NO.: NCO074110
FACILITY NAME: Mountain View Assisted Living
OWNER NAME: Mizpah Healthcare Inc
GRADE: WW -2
eDMR PERIOD. 04-2017 (April 2017)
Report Comments.
PERMIT VERSION• 4 0
CLASS: WW -2
ORC. Shannon D James
ORC HAS CHANGED: No
VERSION 10
PERMIT STATUS: Active
COUNTY: Henderson
ORC CERT NUMBER: 1002526
STATUS. Processed
On the 4th and 25th, BOD data valid, Blank was >0 20mg/L On the 25th, BOD data valid, GGA was greater than 228 5mg/L On the 20th, BOD data valid, GGA was less than
167 5mg/L