NC0020737_Renewal Application_20180302

Water Resources
ENVIRONMENTAL OUALITV
March 06, 2018
Ricky Duncan
City of Kings Mountain
PO Box 429
Kings Mountain, NC 28086-0429
Subject: Permit Renewal
Application No. NCO020737
Pilot Creek WWTP
Cleveland County
Dear Applicant:
ROY COOPER
Governor
nIICHAEL S. BEGAN
Secretan
LINDA CUL.PEPPER
Interim'Di►ector
The Water Quality Permitting Section acknowledges the March 2, 2018 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://deg. nc.gov/permits-regulations/permit-guidance/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.
Sincerely,
Wren The ord
Administrative Assistant
Water Quality Permitting Section
cc: Central Files w/application
ec: WQPS Laserfiche File w/application(MRO)
State of North Carolina I Environmental Quality I Water Resources
1617 Mail Service Center I Raleigh, North Carolina 27699-1617
919-807-6300

THE CITY OF KINGS MOUNTAIN
Water Resources Department.
Kings Mountain, North Carolina
P.O. Box 429- Kings Mountain, North Carolina, 28086 - Phone [phone] - Fax [phone]
RICKY DUNCAN, WATER RESOURCES DIRECTOR
E-MAIL: rickyd�cityofkm.com
February 26, 2018
Ms. Wren Thedford
NC DENR / DWR / NPDES
1617 Mail Service Center RECEIVED/DENR/DWR
Raleigh, NC 27699-1617 MAR 0 2 2018
Subject: NPDES Permit # NC 0020737 RENEWAL Water Resources
Permitting Section
Dear Ms. Thedford,
The City of Kings Mountain desires to renew the above referenced permit for operations of our
Pilot Creek WWTP.
This facility is a 6MGD Activated Sludge treatment unit. Solids handling information is enclosed.
Richelle Meek spoke with Cindy Moore with the Aquatic Toxicology Unit on Thursday, February
22, 2018. Cindy Moore and the City of Kings Mountain's WWTP have set a schedule to analyze
the required second source specie testing in the months of March, April, May and June of 2018.
The fathead minnow organisms will be analyzed each of the above mentioned months. In April
a ceriodaphnia dubia, fathead minnow, and PPA will be analyzed. Upon receipt of these
analyses, the results will be submitted immediately to the branch.
Since the last renewal of our NPDES permit, we have not had any changes to the operations of
the facility. However, the plant is currently operating under a SOC for an increase of the thallium
limit. This Special Order by Consent is to expire August 31, 2020.
The City would like to ask for an increase on the thallium limit set for this permit renewal. A
meeting with the NPDES permit writers is in works to discuss the limit which the City feels is
reasonable for meeting while protecting the environment at the same time.
Concerning the requirement for 24-hour manned operations of our wastewater treatment plant,
our plant is not now manned continuously by a certified operator. We do have what we believe,
and our experience has proven adequate, measures in place to protect both the plant and the
environment. SCADA systems are located at the influent and throughout the facility to monitor

any event which needs immediate assisting. Employee are to report to the SCADA call within
30 minutes of receiving the SCADA alarm.
We hereby apply for a waiver of this rule and submit information which we believe will
demonstrate the adequacy of our system to prevent our having to add a minimum of four
persons to our staff to act as watchmen.
Thank you for your consideration in the above matters. If you need additional information,
please call 704-734-4525.
Sincerely,
Ricky Duncan, Water Resources Director

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
PILOT CREEK WWPCF„ NCO020727 RENEWAL BROAD RIVER
FORM
2A DES ORM 2A APPLICATION O
NPDES y
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 z 0.1 mgd. All treatment works that have design flows
greater than or equal to 0.1 million gallons per day must complete questions B.1 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 1mgd,
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 RCRA/CERCLA 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)
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 1 of 22

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
PILOT CREEK WWPCF„ NC 0020737 RENEWAL BROAD RIVER
i
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 Pilot Creek Wastewater Treatment Facility
Mailing Address P.O. BOX 429
Kings Mountain, NC 28086
Contact Person Richelle Meek
Title Supervisor/ORC
Telephone Number ((704739-7131
Facility Address 200 Potts Creek Road
(not P.O. Bax) Kings Mountain, NC 28086
A.2. Applicant Information. If the applicant is different from the above, provide the following.
Applicant Name -City of Kings Mountain
Mailing Address P.O. BOX 429
Kings Mountain, NC 28086
Contact Person Ricky Duncan
Title Water Resources Director
Telephone Number ([phone]
Is the applicant the owner or operator (or both) of the treatment works?
[A owner R] 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 NC 0020737 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
City of Kings Mountain 13,500 Separate Municipal
Total population served
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 2 of 22

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
PILOT CREEK WWPCF, NCO020737 RENEWAL BROAD RIVER
A.S. Indian Country.
a. Is the treatment works located in Indian Country?
❑ Yes X 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 X No
A.6. 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`h month of "this year" occurring no more than three months prior to this application submittal.
a. Design flow rate 6.0 mgd
Two Years Ago Last Year This Year
b. Annual average daily flow rate 1.4687475 MGD 1.857844 MGD 1.8154 MGD
C. Maximum daily flow rate 3.669 MGD 4.297 MGD 2.391 MGD
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.
X 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 1
ii. Discharges of untreated or partially treated effluent 0
iii. Combined sewer overflow points 0
iv. Constructed emergency overflows (prior to the headworks) 0
V. Other 0
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: N/A
C.
d.
Annual average daily volume discharge to surface impoundment(s)
Is discharge ❑ continuous or ❑ intermittent?
Does the treatment works land -apply treated wastewater?
If yes, provide the following for each land application site.
Location: N/A
Number of acres: N/A
Annual average daily volume applied to site: N/A
Is land application ❑ continuous or ❑ intermittent?
Does the treatment works discharge or transport treated or untreated wastewater to another
treatment works?
N/A mgd
❑ Yes X No
mgd
❑ Yes X No
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 d 7550-22. Page 3 of 22

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
PILOT CREEK WWPCF„ NCO020737
RENEWAL
BROAD RIVER
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).
N/A
If transport is by a party other than the applicant, provide:
Transporter Name N/A
Mailing Address N/A
N/A
Contact Person N/A
Title N/A
Telephone Number 1 N/�
For each treatment works that receives this discharge, provide the following
Name N/A
Mailing Address N/A
N/A
Contact Person N/A
Title N/A
Telephone Number ( N/' )p `
If known, provide the NPDES permit number of the treatment works that receives this discharge N/A
Provide the average daily flow rate from the treatment works into the receiving facility. N/A 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 X No
If yes, provide the following for each disposal method:
Description of method (including location and size of site(s) if applicable).
N/A
Annual daily volume disposed by this method _N/A
Is disposal through this method ❑ continuous or ❑ intermittent?
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 4 of 22

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
PILOT CREEK WWPCF,, NCO020737 RENEWAL BROAD RIVER
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.8.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 001
Below Concluence of Clear Fork and Muddy Fork of Buffalo Creek, Just North of US
b. Location 74 West of Kings Mountain
(City or town, if applicable) (Zip Code)
_Cleveland County North Carolina
(County) (Slate)
30° 15,649'North 810 26,636' West
(Latitude)
c. Distance from shore (if applicable)
d. Depth below surface (if applicable)
e. Average daily flow rate
f. Does this outfall 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?
A.10. Description of Receiving Waters.
a. Name of receiving water Buffalo Creek
b. Name of watershed (if known) Buffalo Creek Sub -Division of Broad River
United States Soil Conservation Service 14 -digit watershed code (if known): N/A
C. Name of State Management/River Basin (if known) _ Buffalo River
United States Geological Survey 8 -digit hydrologic cataloging unit code (if known):
d. Critical low flow of receiving stream (if applicable)
acute N/A cfs chronic
e. Total hardness of receiving stream at critical low flow (if applicable) N/A
N/A
N/A
cfs
mg/I of CaCO3
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 5 of 22
(Longitude)
N/A
ft.
N/A
n.
N/A
mgd
❑ Yes
X No (go to A.9.9.)
N/A
N/A
N/A
mgd
N/A
❑ Yes
❑ No
A.10. Description of Receiving Waters.
a. Name of receiving water Buffalo Creek
b. Name of watershed (if known) Buffalo Creek Sub -Division of Broad River
United States Soil Conservation Service 14 -digit watershed code (if known): N/A
C. Name of State Management/River Basin (if known) _ Buffalo River
United States Geological Survey 8 -digit hydrologic cataloging unit code (if known):
d. Critical low flow of receiving stream (if applicable)
acute N/A cfs chronic
e. Total hardness of receiving stream at critical low flow (if applicable) N/A
N/A
N/A
cfs
mg/I of CaCO3
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 5 of 22

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
PILOT CREEK WWPCF, NCO020737
RENEWAL
BROAD RIVER
A.11. Description of Treatment
a. What level of treatment are provided? Check all that apply.
❑ Primary X Secondary
❑ Advanced ❑ Other. Describe-
b. Indicate the following removal rates (as applicable)
Design BOD5 removal or Design CBOD5 removal 85 %
Design SS removal 85
Design P removal N/A
Design N removal N/A Bio
Other -__-- N/A
C. What type of disinfection is used for the effluent from this outfall? If disinfection varies by season, please describe:
Chlorine
If disinfection is by chlorination is dechlorination used for this outfall? lel Yes ❑ No
Does the treatment plant have post aeration? ❑ Yes X 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: 01
MAXIMUM DAILY VALUE AVERAGE DAILY VALUE
PARAMETER
Value
Units Value
Units
Number of Samples
pH (Minimum)
6.54
S.u.
pH (Maximum)
7.08
S.U.
Flow Rate
6.552
MGD 1.606
MGD
1086
Temperature (Winter)
20.4
°C
300
Temperature (Summer)
31.1
°C 23.78
°C
446
For pH please report a minimum and a maximum daily value
MAXIMUM DAILY
DISCHARGE
AVERAGE DAILY DISCHARGE
POLLUTANT
ANALYTICAL
MUMDL
Conic.
Units
Conc.
Units
Number of
METHOD
Samples
CONVENTIONAL AND NON CONVENTIONAL COMPOUNDS
BIOCHEMICAL OXYGEN
BODS
14.9
MG/L
1.26
MG/L
746
SM 5210 B
2.0 MG/L
DEMAND (Report one)
CBOD5
—
FECAL COLIFORM
60000
#/100ML
9.56
#/1 OOML
746
SM 9222D
1.0/100ML
TOTAL SUSPENDED SOLIDS (TSS)
300
MG/L
7.13
MG/L
746
SM 2540 D
1.0 MG/L
END OF PART A.
REFER TO THE APPLICATION OVERVIEW (PAGE 1) TO DETERMINE WHICH OTHER PARTS
j OF FORM 2A YOU MUST COMPLETE
EPA Form 3510-2A (Rev. 1-99). Replaces EPA fors 7550-6 & 7550-22. Page 6 of 22

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
PILOT CREEK WWPCF, NCO020737
RENEWAL
BROAD RIVER
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 >- 0.1 mgd must answer questions B.1 through B.6. All others go to Part C (Certification).
B.1. Inflow and Infiltration. Estimate the average number of gallons per day that flow into the treatment works from inflow and/or infiltration.
3 year avg.= 148,715 gpd
Briefly explain any steps underway or planned to minimize inflow and infiltration.
Sewer mains are videoed and smoked to locate issues. If an issue is found it is repaired immediately. $60,000.00 was spent
on installing sealed manhole lids and vent pipes on one of the major outfalls. We have also purchased point source repair
—equipment to repaiLSnLrces of Ikl_ — _-- -- ---
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 '/. 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.
f. If the treatment works receives waste 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 Diagram or Schematic. Provide 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 dechlorination). 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.
B.4. 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 X No
If yes, list the name, address, telephone number, and status of each contractor and describe the contractor's responsibilities (attach additional
pages if necessary).
Name: N/A
Mailing Address: N/A
N/A
Telephone Number: ( N/A)
Responsibilities of Contractor N/A
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 outfall that is covered by this implementation schedule.
N/A
b. Indicate whether the planned improvements or implementation schedule are required by local, State, or Federal agencies.
❑ Yes X No
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 7 of 22

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
PILOT CREEK WWPCF, NCO020737
RENEWAL
BROAD RIVER
c- If the answer to B.5.b 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/YYYY MM/DD/YYYY
Begin Construction /
End Construction
Begin Discharge
Attain Operational Level
e. Have appropnate permits/clearances concerning other Federal/State requirements been obtained? ❑ Yes ❑ No
Describe briefly N/A
8.6. 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
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 pollutant scans and must be no more than four and on -half years old.
Outfall Number: 001
MAXIMUM DAILY
AVERAGE DAILY DISCHARGE
DISCHARGE
ANALYTICAL
POLLUTANT
METHOD
ML/MDL
Conc.
FUnits
Conc.
Units
Number of
Samples
CONVENTIONAL AND NON CONVENTIONAL COMPOUNDS
AMMONIA (as N)
6.15
MG/L
2.08
MG/L
3
SM4500NH3 D
0.1
CHLORINE (TOTAL
RESIDUAL, TRC)
19
UG/L
18.5
UG/L
3
SM4500C1-G
15
DISSOLVED OXYGEN
8.4
MG/L
7.55
MG/L
3
SM5210B
1
TOTAL KJELDAHL
NITROGEN (TKN)
<1
MG/L
<1
MG/L
3
SM450ONH3F
1
NITRATE PLUS NITRITE
NITROGEN
29
MG/L
23
MG/L
3
450ONO3H
0.05
OIL and GREASE
<6.2
MG/L
<6.2
MG/L
3
EPA413.1
6.2
PHOSPHORUS (Total)
5.6
MG/L
4.67
MG/L
3
SM450OPE
0.05
TOTAL DISSOLVED SOLIDS
(TDS)
1 1151
MG/L
386.07
MG/L
1
SM2540C
1
OTHER
END OF PART B.
REFER TO THE APPLICATION OVERVIEW (PAGE 1 ) TO DETERMINE WHICH OTHER PARTS
i
OF FORM 2A YOU MUST COMPLETE
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 8 of 22

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
PILOT CREEK WWPCF, NCO020737
RENEWAL
BROAD RIVER
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:
X Basic Application Information packet Supplemental Application Information packet.
X Part D (Expanded Effluent Testing Data)
X Part E (Toxicity Testing: Biomonitoring Data)
X 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 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 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 '. GV,V J/u-n L Qh �" "�' "�- 1 ,—* sot -�'� r f Y
--�-
Signature LO
Telephone number 704 )734-0333
Date signed a /X G %4 I
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
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 9 of 22

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
PILOT CREEK WWPCF, NCO020737
RENEWAL
BROAD RIVER
SUPPLEMENTAL APPLICATION INFORMATION
PART D. EXPANDED EFFLUENT TESTING DATA T
Refer to the directions on the cover page to determine whether this section applies to the treatment works.
Effluent Testing: 1.0 mgd and Pretreatment Works. If the treatment works has a design flow greater than or equal to 1.0 mgd or it has (or is required
to have) a pretreatment program, or is otherwise required by the permitting authority to provide the data, then provide effluent testing data for the following
pollutants. Provide the indicated effluent testing information and any other information 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 analyses conducted using 40 CFR Part 136 methods. In addition, these 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. Indicate in the blank rows provided below
any data you may have on pollutants not specifically listed in this form. At a minimum, effluent testing data must be based on at least three pollutant
scans and must be no more than four and one-half years old.
Outfall number 001 (Complete once for each outfall discharging effluent to waters of the United States 1
MAXIMUM DAILY DISCHARGE
AVERAGE DAILY DISCHARGE
POLLUTANT
ANALYTICAL
ML/MDL
Number
Conic.
Units
Mass
Units
Conc.
Units
Mass
Units
of
METHOD
Samples
METALS (TOTAL RECOVERABLE), CYANIDE, PHENOLS, AND HARDNESS.
ANTIMONY
6
UG/L
4.5
UG/L
3
EPA 200.8
10
ARSENIC
155
UG/L
83.3
UG/L
3
EPA 200.8
10
BERYLLIUM
<5
UG/L
<5
UG/L
3
EPA 200.8
5
CADMIUM
<5
UG/L
<5
UG/L
3
EPA 200.8
5
CHROMIUM
<5
UG/L
<5
UG/L
3
EPA 200.8
5
COPPER
2
UG/L
3
EPA 200.8
10
6
UG/L
LEAD
<5
UG/L
<5
UG/L
3
EPA 200.8
5
MERCURY
<0.2
UG/L
<0.2
UG/L
3
EPA 1631 E
0.2
NICKEL
42
UG/L
36.7
UG/L
3
EPA 200.8
5
SELENIUM
24
U G/L
3
EPA 200.8
10
61
UG/L
<5
UG/L
3
EPA 200.8
5
SILVER
<5
UG/L
15.77
UG/L
3
EPA 200.8
2
THALLIUM
30.3
UG/L
9.
3
EPA 200.8
10
zlNc
46
UG/L
CYANIDE
<$
UG/L
TOTAL PHENOLIC
COMPOUNDS
0.02
MG/L
120
3
EPA 130.2
HARDNESS (as CaCO3)
140
MG/L
Use this space (or a separate sheet) to provide information on other metals requested by the permit writer
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 10 of 22

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
PILOT CREEK WWPCF, NCO020737
RENEWAL
BROAD RIVER
Outfall number: 001 (Complete once for each outfall discharging effluent to waters of the United States.)
MAXIMUM DAILY DISCHARGE AVERAGE DAILY DISCHARGE
POLLUTANT Number ANALYTICAL ML/MDL
Conc. UnitsMassLunits Conc. Units Mass Units Of METHOD
Samples
VOLATILE ORGANIC COMPOUNDS
<5
UG/L
3
EPA 624
5
ACROLEIN
<<j
UG/L
ACRYLONITRILE
<50
UG/L
<50
UG/L
3
EPA 624
50
BENZENE
<2
UG/L
<2
UG/L
3
EPA 624
2
BROMOFORM
2.6
UG/L
0.87
UG/L
3
EPA 624
2
CARBON
<2
UG/L
3
EPA 624
2
TETRACHLORIDE
<2
UG/L
CHLOROBENZENE
<2
UG/L
<2
UG/L
3
EPA 624
2
CHLORODIBROMO-
14.17
UG/L
3
EPA 624
2
METHANE
18.2
UG/L
CHLOROETHANE
<5
UG/L
<5
UG/L
3
EPA 624
2
2-CHLOROETHYLVINYL
<5
UG/L
3
EPA 624
5
ETHER
<5
UG/L
CHLOROFORM
15.23
U G/L
3
EPA 624
2
25.1
UG/L
DICHLOROBROMO-
METHANE
<2
UG/L
<2
UG/L
3
EPA 624
2
1,1-DICHLOROETHANE
<2
UG/L
3
EPA 624
2
1,2-DICHLOROETHANE
<2
UG/L
<2
UG/L
3
EPA 624
2
TRANS-I,2-DICHLORO-
ETHYLENE
<2
G/L
<2
UG/L
3
EPA 624
2
ETHYCHLORo-
ETHYLENE
<2
G/L
<2
UG/L
3
EPA 624
2
1,2-DICHLOROPROPANE
<2
G/L
<2
UG/L
3
EPA 624
2
1,3-DICHLORO-
PROPYLENE
<2
G/L
<2
UG/L
3
EPA 624
2
ETHYLBENZENE
<2
UG/L
<2
UG/L
3
EPA 624
2
METHYL BROMIDE
<2
G/L
<2
UG/L
3
FPA 694
2
METHYL CHLORIDE
<2
G/L
<
/
3
EPA 694
2
METHYLENE CHLORIDE
<2
G/L
3
EPA 624
1,1,2,2 -TETRA-
CHLOROETHANE
<2
UG/L
<
EPA 624
TETRACHLORO-
ETHYLENE
<2
UG/L
<
3
EPA 624
TOLUENE
<2
/L
EPA 624
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 11 of 22

FACILITY NAME AND PERMIT NUMBER:
PILOT CREEK WWPCF,'NC0020737
PERMIT ACTION REQUESTED:
RENEWAL
RIVER BASIN:
BROAD RIVER
Outfall number 01 (Complete once for each outfall discharging effluent to waters of the United States.)
POLLUTANT
MAXIMUM DAILY DISCHARGE
AVERAGE DAILY DISCHARGE
ANALYTICAL
METHOD
ML/MDL
Conc.
Units
Mass
Units
Conc.
Units
Mass
Units
Number
of
Samples
TRICHLOROETHANE
<2
UG/L
<2
UG/L
3
EPA 624
2
TRICHLOROETHANE
<2
UG/L
<2
UG/L
3
EPA 624
2
TRICHLOROETHYLENE
<2
UG/L
<2
UG/L
3
EPA 624
2
VINYL CHLORIDE
<
/
<2
I /
3
EPA 624
2
Use this space (or a separate sheet) to provide information on other volatile organic compounds requested by the permit writer
ACID -EXTRACTABLE COMPOUNDS
P -CHLORO -M -CRESOL
<5.1
UG/L
<5.1
UG/L
3
EPA 625
5.1
2 -CHLOROPHENOL
<5
UG/L
<5
UG/L
3
EPA 625
5
2,4-DICHLOROPHENOL
<5
G/L
<5
UG/L
3
EPA 625
5
2,4 -DIMETHYLPHENOL
<10
UG/L
<10
UG/L
3
EPA 625
10
4,6-DINITRO-0-CRESOL
<20
UG/L
<20
UG/L
3
EPA 625
20
2,4-DINITROPHENOL
<50 1
UG/L
<50
UG/L
3
EPA 625
50
2-NITROPHENOL
<5
UG/L
<5
UG/L
3
EPA 625
5
4-NITROPHENOL
<50
UG/L
<50 1
UG/L
3
EPA 625
50
PENTACHLOROPHENOL
<10
UG/L
3
EPA 625
in
PHENOL
<
/
3 1
EPA 625
5
2,4,6-
TRICHLOROPHENOL
<10
UG/L
<10
UG/L
3
EPAE25
10
Use this space (or a separate sheet) to provide information on other acid -extractable compounds requested by the permit writer
BASE -NEUTRAL COMPOUNDS
ACENAPHTHENE
<5
UG/L
<5
UG/L
3
EPA 625
5
ACENAPHTHYLENE
<5
UG/L
<5
UG/L
3
EPA 625
5
ANTHRACENE
<5
UG/L
<5
UG/L
3
EPA 625
5
BENZIDINE
<51
UG/L
<51
UG/L
3
EPA 625
51
BENZO(A)ANTHRACENE
<5
UG/L
<5
UG/L
3
EPA 625
5
BENZO(A)PYRENE
<5
UG/L
<5
UG/L
3
EPA 625
5
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 12 of 22

FACILITY NAME AND PERMIT NUMBER:
PILOT CREEK WWPCF,'NC0020737
PERMIT ACTION REQUESTED:
RENEWAL
RIVER BASIN:
BROAD RIVER
Outfall number 01 _ (Complete once for each outfall discharging effluent to waters of the United States.)
POLLUTANT
MAXIMUM DAILY DISCHARGE
AVERAGE DAILY DISCHARGE
ANALYTICAL
METHOD
MLIMDL
Conc.
Units
Mass
Units
Conc.
Units
Mass
Units
Number
of
Samples
3,4 BENZO-
FLUORANTHENE
<5
UG/L
<5
UG/L
3
EPA 625
5
BENZO(GHI)PERYLENE
<5
UG/L
<5
UG/L
3
EPA 625
5
BENZO(K)
FLUORANTHENE
<5
UG/L
<5
UG/L
3
EPA 625
5
BIS(2-CHLOROETHOXY)
METHANE
METHANE
<10
UG/L
<10
UG/L
3
EPA 625
10
BIS (2-CHLOROETHYL)-
ETHER
<5
UG/L
<5
UG/L
3
EPA 625
5
BIS (2 -CHL -
ETHER
PROPYL)ETHER
<5
UG/L
<5
UG/L
3
EPA 625
5
BISYLHEXYL)
PHTHALATE
<5
UG/L
<5
UG/L
3
EPA 625
5
4-BROMOPHENYL
PHENYLETHER
<5
UG/L
<5
UG/L
3
EPA 625
5
BUTYL BENZYL
PHTHALATE
<5
UG/L
<5
UG/L
3
EPA 625
5
2 -CHLORO-
NAPHTHALENE
<5
UG/L
<5
UG/L
3
EPA 625
5
4-CHLORPHENYL
PHENYLETHER
<5
UG/L
<5
UG/L
3
EPA 625
5
CHRYSENE
<5
UG/L
<5
UG/L
3
EPA 625
5
DI -N -BUTYL PHTHALATE
<5
UG/L
<5
UG/L
3
EPA 625
5
DI-N-OCTYL PHTHALATE
<5
UG/L
<5
UG/L
3
EPA 625
5
DIBENZANTHRACENE
ANTHRACENE
<5
UG/L
<5
UG/L
3
EPA 625
5
1,2 -DICHLOROBENZENE
<2
UG/L
<2
UG/L
3
EPA 624
2
1,3 -DICHLOROBENZENE
<2
LIG/L
<2
UG/L
3
EPA 624
2
1,4 -DICHLOROBENZENE
<2
UG/L
<2
UG/L
3
EPA 624
2
3,3-DICHLORO-
BENZIDINE
<25
UG/L
<25
UG/L
3
EPA 625
25
DIETHYL PHTHALATE
<5
UG/L
<5
UG/L
3
EPA 625
5
DIMETHYL PHTHALATE
<5
UG/L
<5
UG/L
3
EPA 625
5
2,4-DINITROTOLUENE
<5
UG/L
<5
UG/L
3
EPA 625
2,6-DINITROTOLUENE
<5
UG/L
EPA 625
1,2 -DIPHENYL -
HYDRAZINE
<5,1
UG/L
/
EPA 625
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 13 of 22

FACILITY NAME AND PERMIT NUMBER:
PILOT CREEK WWPCF, NCO020737
PERMIT ACTION REQUESTED:
RENEWAL
RIVER BASIN:
BROAD RIVER
Outfall number 01 (Complete once for each outfall discharging effluent to waters of the United States.)
POLLUTANT
MAXIMUM
DAILY
DISCHARGE
AVERAGE
DAILY DISCHARGE
ANALYTICAL
METHOD
ML/MDL
Conic.rul�i
Mass
Units
Conic.
Units
Mass Units
-- .---.
Number
of
Samples
3
-
FLUORANTHENE
<5
UG/L
<5
UG/L
EPA 625
5
FLUORENE
<5
UG/L
<5
UG/L
3
EPA 625
5
HEXACHLOROBENZENE
<5
UG/L
<5
UG/L
3
EPA 625
5
HEXACHLORO-
BUTADIENE
<5
UG/L
<5
UG/L
3
EPA 625
5
HEROCYCLO-
PENTADIENE
NTADIE
<10
UG/L
<10
UG/L
3
EPA 625
10
HEXACHLOROETHANE
<5
UG/L
<5
UG/L
3
EPA 625
5
INDENO(1,2,3 CD)
PYRENE
<5
UG/L
<5
UG/L
3
EPA 625
5
ISOPHORONE
<10
UG/L
<10
UG/L
3
EPA 625
10
NAPHTHALENE
<5
UG/L
<5
UG/L
3
EPA 625
5
NITROBENZENE
<5
UG/L
<5
UG/L
3
EPA 625
5
N-NITROSODI-N-
PROPYLAMINE
<5
UG/L
<5
UG/L
3
EPA 625
5
N-NITROSODI-
METHYLAMINE
<5
UG/L
<5
UG/L
3
EPA 625
5
N-NITROSODI-
PHENYLAMINE
<10
UG/L
<10
UG/L
3
EPA 625
10
PHENANTHRENE
<5
UG/L
<5
UG/L
3
EPA 625
5
PYRENE
<5
UGIL<5
UG/L
3
EPA 625
1,2,4-
TRICHLOROBENZENE
<5
UG/L
<5
UG/L
3
EPA 625
Use this space (or a separate sheet) to provide information on other base -neutral compounds requested by the permit writer
Use this space (or a separate sheet) to provide information on other pollutants (e.g., pesticides) requested by the permit writer
END OF PART D.
REFER TO THE APPLICATION OVERVIEW (PAGE 1) TO DETERMINE WHICH OTHER PARTS
OF FORM 2A YOU MUST COMPLETE
EPA Forth 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page s4 u+ 2-

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
PILOT CREEK WWPCF,'NC0020737
RENEWAL
BROAD RIVER
SUPPLEMENTAL APPLICATION INFORMATION
PART E. TOXICITY TESTING DATA
POTWs meeting one or more of the following criteria must provide the results of whole effluent toxicity tests for acute or chronic toxicity for each of the
facility's discharge points. 1) POTWs with a design flow rate greater than or equal to 1.0 mgd, 2) POTWs with a pretreatment program (or those that are
required to have one under 40 CFR Part 403), or 3) POTWs required by the permitting authority to submit data for these parameters.
• At a minimum, these results must include quarterly testing for a 12 -month penod within the past 1 year using multiple species (minimum of two
species), or the results from four tests performed at least annually in the four and one-half years prior to the application, provided the results
show no appreciable toxicity, and testing for acute and/or chronic toxicity, depending on the range of receiving water dilution. 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.
• In addition. submit the results of any other whole effluent toxicity tests from the past four and one-half years. If a whole effluent toxicity test
conducted during the past four and one-half years revealed toxicity, provide any information on the cause of the toxicity or any results of a
toxicity reduction evaluation, if one was conducted.
• If you have already submitted any of the information requested in Part E, you need not submit it again. Rather, provide the information
requested in question EA for previously submitted information. If EPA methods were not used, report the reasons for using alternate methods.
If test summaries are available that contain all of the information requested below, they may be submitted in place of Part E.
If no biomonitoring data is required. do not complete Part E. Refer to the Application Overview for directions on which other sections of the form to
complete.
E.1. Required Tests.
Indicate the number of whole effluent toxicity tests conducted in the past four and one-half years.
X chronic ❑ acute
E.2. Individual Test Data. Complete the following chart for each whole effluent toxicity test conducted in the last four and one-half years. Allow one
column per test (where each species constitutes a test). Copy this page if more than three tests are being reported
Test number 01 Test number 02 Test number 03
a. Test information.
Test Species & test method number
CERIODAPHNIA DUBIA/1002
CERIODAPHNIA DUBIA/1002
CERIODAPHNIA DUBIA/1002
Age at initiation of test
<24 HRS
<24 HRS
<24 HRS
Outfall number
001
001
001
Dates sample collected
01/12/2015 & 01/14/2015
04/13/2015 & 04/15/2015
07/13/2015 & 07/15/2015
Date test started
01/14/2015
04/15/2015
07/15/2015
Duration
7 DAY
7 DAY
7 DAY
b. Give toxicity test methods followed.
Manual title
EPA 821-R-02-013
EPA 821-R-02-013
EPA 821-R-02-013
Edition number and year of publication
4th ED 2002
4th ED 2002
4th ED 2002
Page number(s)
141-189
141-189
141-189
c. Give the sample collection method(s) used. For multiple grab samples, indicate the number of grab samples used.
24 -Hour composite
YES/ FLOW PRPORTIONAL
YES/FLOW PROPORTIONAL
YES/FLOW PROPORTIONAL
Grab
N/A
N/A
N/A
d. Indicate where the sample was taken in relation to disinfection. (Check all that apply for each.
Before disinfection
After disinfection
After dechlonnation
V
V
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 15 of 22

FACILITY NAME AND PERMIT NUMBER:
PILOT CREEK WWPCF, NCO020737
PERMIT ACTION REQUESTED:
RENEWAL
RIVER BASIN:
BROAD RIVER
Test number: 01 Test number: 02 Test number: 03
e. Describe the point in the treatment process at which the sample was collected.
Sample was collected
EFFLUENT DISCHARGE AFTER
DECHLORINATION
EFFLUENT DISCHARGE AFTER
DECHLORINATI N
EFFLUENT DISCHARGE AFTER
DECHLORINATION
f. For each test, include whether the test was intended to assess chronic toxicity, acute toxicity or both
Chronic toxicity
✓
✓
✓
Acute toxicity
g. Provide the type of test performed.
Static
Static -renewal
✓
✓
✓
Flow-through
h. Source of dilution water. If laboratory water, specify type: if receiving water, specify source.
Laboratory water
SURFACE WATER
SURFACE WATER
SURFACE WATER
Receiving water
i. Type of dilution water. If salt water. specify "natural' or type of artificial sea salts or brine used.
Fresh water
✓
✓
✓
Salt water
j. Give the percentage effluent used for all concentrations in the test series.
33%
33%
33%
k. Parameters measured during the test. (State whether parameter meets test method specifications)
pH
✓
✓
✓
Salinity
Temperature
✓
✓
✓
Ammonia
Dissolved oxygen
✓
✓
I. Test Results.
Acute.
Percent survival in 100%
%
%
%effluent
LCso
95% C.I.
%
%
%
Control percent survival
%
%
%
Other (describe)
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 16 of 22

FACILITY NAME AND PERMIT NUMBER:
PILOT CREEK WWPCF„ NCO020737
PERMIT ACTION REQUESTED:
RENEWAL
RIVER BASIN:
BROAD RIVER
Chronic.
NOEC
%
%
%
C25
Control percent survival
92 %
92 %
100%
Other (describe)
PASS/FAIL @33%: PASS
PASS/FAIL@33%: PASS
PASS/FAIL@33%: PASS
m. Quality Control/Quality Assurance.
Is reference toxicant data available?
YES
YES
YES
Was reference toxicant test within
acceptable bounds?
YES
YES
YES
What date was reference toxicant test
run (MM/DD/YYYY)7
01 / 07 12015
04 / 02 12015
071 13 / 2015
Other (describe)
E.3. Toxicity Reduction Evaluation. Is the treatment works involved in a Toxicity Reduction Evaluation?
❑ Yes X No If yes, describe
E.4. Summary of Submitted Biomonitoring Test Information. If you have submitted biomonitoring test information, or information regarding the
cause of toxicity, wthin the past four and one-half years, provide the dates the information was submitted to the permitting authority and a summary
of the results.
Date submitted / / _ (MM/DD/YY-YY)
Summary of results: (see instructions)
END OF PART E.
DCCCD T!I TLIC ADDI IrIATInki !IVC01./IC1A/ /DAI"_C 41 Tr'% IICTCDAAIAIC IA1U1r1LI r%YLJCD DADTC
OF FORM 2A YOU MUST COMPLETE.
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 17 of 22

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
PILOT CREEK WWPCF,'NC0020737
RENEWAL
BROAD RIVER
SUPPLEMENTAL APPLICATION INFORMATION
PART E. TOXICITY TESTING DATA
POTWs meeting one or more of the following criteria must provide the results of whole effluent toxicity tests for acute or chronic toxicity for each of the
facility's discharge points. 1) POTWs with a design flow rate greater than or equal to 1.0 mgd, 2) POTWs with a pretreatment program (or those that are
required to have one under 40 CFR Part 403), or 3) POTWs required by the permitting authority to submit data for these parameters.
• At a minimum, these results must include quarterly testing for a 12 -month period within the past 1 year using multiple species (minimum of two
species), or the results from four tests performed at least annually in the four and one-half years prior to the application, provided the results
show no appreciable toxicity, and testing for acute and/or chronic toxicity, depending on the range of receiving water dilution. 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.
• In addition, submit the results of any other whole effluent toxicity tests from the past four and one-half years. If a whole effluent toxicity test
conducted during the past four and one-half years revealed toxicity, provide any information on the cause of the toxicity or any results of a
toxicity reduction evaluation, if one was conducted.
• If you have already submitted any of the information requested in Part E, you need not submit it again. Rather, provide the information
requested in question E.4 for previously submitted information. If EPA methods were not used, report the reasons for using alternate methods.
If test summaries are available that contain all of the information requested below, they may be submitted in place of Part E
If no biomonitoring data is required. do not complete Part E. Refer to the Application Overview for directions on which other sections of the form to
complete.
EA. Required Tests.
Indicate the number of whole effluent toxicity tests conducted in the past four and one-half years.
X chronic ❑ acute
E.2. Individual Test Data. Complete the follow ng chart for each whole effluent toxicity test conducted in the last four and one-half years. Allow one
column per test (where each species constitutes a test). Copy this page if more than three tests are being reported.
Test number 04 Test number 05 Test number 06
a. Test information.
Test Species & test method number
CERIODAPHNIA DUBIA/1002
CERIODAPHNIA DUBIA/1002
CERIODAPHNIA DUBIA/1002
Age at initiation of test
<24 HRS
<24 HRS
<24 HRS
Outfall number
001
001
001
Dates sample collected
11 /09/2015 & 11 /11/2015
01/11/2016 & 01/13/2015
04/13/2016 & 04/15/2016
Date test started
11/11/2015
11/13/2016
04/15/2016
Duration
7 DAY
7 DAY
7 DAY
b. Give toxicity test methods followed.
Manual title
EPA 821-R-02-013
EPA 821-R-02-013
EPA 821-R-02-013
Edition number and year of publication
4th ED 2002
4th ED 2002
4th ED 2002
Page number(s)
141-189
141-189
141-189
c. Give the sample collection method(s) used. For multiple grab samples, indicate the number of grab samples used.
24 -Hour composite
YES/ FLOW PRPORTIONAL
YES/FLOW PROPORTIONAL
YES/FLOW PROPORTIONAL
Grab
N/A
N/A
N/A
d. Indicate where the sample was taken in relation to disinfection. (Check all that apply for each.
Before disinfection
After disinfection
After dechlorination
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 15 of 22

FACILITY NAME AND PERMIT NUMBER:
PILOT CREEK WWPCF, NCO020737
PERMIT ACTION REQUESTED:
RENEWAL
RIVER BASIN:
BROAD RIVER
Test number: 04 Test number: 05 Test number: 06
e. Describe the point in the treatment process at which the sample was collected.
Sample was collected:
EFFLUENT DISCHARGE AFTER
DECHLORINATIONDECHLORINATION
TEFFLUENT DISCHARGE AFTER
EFFLUENT DISCHARGE AFTER
DECHLORINATION
f. For each test, include whether the test was intended to assess chronic toxicity, acute toxicity, or both
Chronic toxicity
V
V
V
Acute toxicity
g. Provide the type of test performed.
Static
Static -renewal
V
`✓
V
Flow-through
h. Source of dilution water. If laboratory water, specify type, if receiving water, specify source.
Laboratory water
SURFACE WATER
SURFACE WATER
SURFACE WATER
Receiving water
i. Type of dilution water If salt water. specify "natural" or type of artificial sea salts or brine used.
Fresh water
V
`✓
V
Salt water
j. Give the percentage effluent used for all concentrations in the test series.
33%
33%
33%
k. Parameters measured during the test. (State whether parameter meets test method specifications)
pH
V
V
V
Salinity
Temperature
V
V
V
Ammonia
Dissolved oxygen
V
V
V
I. Test Results.
Acute.
Percent survival in 100%
effluent
/o 0
0 /o
0
/o
LC5o
95% C.I.
%
%
%
Control percent survival
%
%
%
Other (describe)
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 16 of 22

FACILITY NAME AND PERMIT NUMBER:
PILOT CREEK WWPCF„ NCO020737
PERMIT ACTION REQUESTED:
RENEWAL
RIVER BASIN:
BROAD RIVER
Chronic:
NOEC
%
%
%
IC25
%
%
%
Control percent survival
100 %
100 %
92%
Other (describe)
PASS/FAIL @33%: PASS
PASS/FAIL@33%: PASS
PASS/FAIL@33%: PASS
m. Quality Control/Quality Assurance.
Is reference toxicant data available?
YES
YES
YES
Was reference toxicant test within
acceptable bounds?
YES
YES
YES
What date was reference toxicant test
run (MM/DD/YYYY)?
11/ 03 / 2015
01 / 04 / 2016
041 05 /2016
Other (describe)
E.3. Toxicity Reduction Evaluation. Is the treatment works involved in a Toxicity Reduction Evaluation?
❑ Yes X No If yes, describe.
EA. Summary of Submitted Biomonitoring Test Information. If you have submitted biomonitohng test information, or information regarding the
cause of toxicity, within the past four and one-half years, provide the dates the information was submitted to the permitting authority and a summary
of the results.
Date submitted / / (MM/DD/YYYY)
Summary of results (see instructions)
END OF PART E.
REFER TO THE APPLICATION OVERVIEW (PAGE 1) TO DETERMINE WHICH OTHER PARTS
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Paye ,' of 22

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
PILOT CREEK WWPCF, "NC0020737
RENEWAL
BROAD RIVER
SUPPLEMENTAL APPLICATION INFORMATION
PART E. TOXICITY TESTING DATA
POTWs meeting one or more of the following criteria must provide the results of whole effluent toxicity tests for acute or chronic toxicity for each of the
facility's discharge points 1) POTWs with a design flow rate greater than or equal to 1.0 mgd, 2) POTWs with a pretreatment program (or those that are
required to have one under 40 CFR Part 403), or 3) POTWs required by the permitting authority to submit data for these parameters.
• At a minimum, these results must include quarterly testing for a 12 -month period within the past 1 year using multiple species (minimum of two
species), or the results from four tests performed at least annually in the four and one-half years prior to the application, provided the results
show no appreciable toxicity, and testing for acute and/or chronic toxicity, depending on the range of receiving water dilution. Do not induce
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.
• In addition, submit the results of any other whole effluent toxicity tests from the past four and one-half years. If a whole effluent toxicity test
conducted during the past four and one-half years revealed toxicity, provide any information on the cause of the toxicity or any results of a
toxicity reduction evaluation, if one was conducted.
• If you have already submitted any of the information requested in Part E, you need not submit it again. Rather. provide the information
requested in question EA for previously submitted information. If EPA methods were not used, report the reasons for using alternate methods.
If test summaries are available that contain all of the information requested below, they may be submitted in place of Part E.
If no biomonitoring data is required, do not complete Part E. Refer to the Application Overview for directions on which other sections of the form to
complete.
E.1. Required Tests.
Indicate the number of whole effluent toxicity tests conducted in the past four and one-half years.
X chronic ❑ acute
E.2. Individual Test Data. Complete the following chart for each whole effluent toxicity test conducted in the last four and one-half years. Allow one
column per test (where each species constitutes a test). Copy this page if more than three tests are being reported.
Test number 07 Test number 08 Test number 09
a. Test information.
Test Species & test method number
CERIODAPHNIA DUBIA/1002
CERIODAPHNIA DUBIA/1002
CERIODAPHNIA DUBIA/1002
Age at initiation of test
<24 HRS
<24 HRS
<24 HRS
Outfall number
001
001
001
Dates sample collected
07/11/2016 & 07/13/2016
10/10/2016 & 10/12/2016
01/16/2017 & 01/18/2017
Date test started
07/12/2016
10/12/2016
01/18/2017
Duration
7 DAY
7 DAY
7 DAY
b. Give toxicity test methods followed.
Manual title
EPA 821-R-02-013
EPA 821-R-02-013
EPA 821-R-02-013
Edition number and year of publication
4th ED 2002
4th ED 2002
4th ED 2002
Page number(s)
141-189
141-189
141-189
c. Give the sample collection method(s) used. For multiple grab samples, indicate the number of grab samples used.
24 -Hour composite
YES/ FLOW PRPORTIONAL
YES/FLOW PROPORTIONAL
YES/FLOW PROPORTIONAL
Grab
N/A
N/A
N/A
d. Indicate where the sample was taken in relation to disinfection. (Check all that apply for each.
Before disinfection
After disinfection
After dechlorination
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 15 of 22

FACILITY NAME AND PERMIT NUMBER:
PILOT CREEK WWPCF, NC0020737
PERMIT ACTION REQUESTED:
RENEWAL
RIVER BASIN:
BROAD RIVER
Test number: 07 Test number: 08 Test number: 09
e. Describe the point in the treatment process at which the sample was collected.
Sample was collected
EFFLUENT DISCHARGE AFTER
DECHLORINATION
I EFFLUENT DISCHARGE AFTER
D H R NAT N
EFFLUENT DISCHARGE AFTER
DECHLORINATION
f. For each test, include whether the test was intended to assess chronic toxicity, acute toxicity, or both
Chronic toxicity
✓
✓
✓
Acute toxicity
g. Provide the type of test performed.
Static
Static -renewal
✓
✓
✓
Flow-through
h. Source of dilution water. If laboratory water, specify type, if receiving water, specify source.
Laboratory water
SURFACE WATER
SURFACE WATER
SURFACE WATER
Receiving water
i. Type of dilution water. If salt water. specify "natural" or type of artificial sea salts or brine used.
Fresh water
✓
✓
V
Salt water
j. Give the percentage effluent used for all concentrations in the test series.
33%
33%
33%
k. Parameters measured during the test. (State whether parameter meets test method specifications)
pH
✓
✓
✓
Salinity
Temperature
✓
V
✓
Ammonia
Dissolved oxygen
✓
✓
✓
I. Test Results.
Acute
Percent survival in 100%
effluent
LCso
95% C.I.
%
%
%
Control percent survival
%
%
%
Other (describe)
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 16 of 22

FACILITY NAME AND PERMIT NUMBER:
PILOT CREEK WWPCF„ NCO020737
PERMIT ACTION REQUESTED:
RENEWAL
RIVER BASIN:
BROAD RIVER
Chronic
NOEC
%
%
%
IC25
%
%
%
Control percent survival
100%
100 %
100%
Other (describe)
PASS/FAIL @33%: PASS
PASS/FAIL@33%: PASS
PASS/FAIL@33%: PASS
m. Quality Control/Quality Assurance.
Is reference toxicant data available?
YES
YES
YES
Was reference toxicant test within
acceptable bounds?
YES
YES
YES
What date was reference toxicant test
run (MM/DD/YYYY)?
07/ 06 I 2016
10 I 04 / 2016
01/ 06 /2017
Other (describe)
E.3. Toxicity Reduction Evaluation. Is the treatment works involved in a Toxicity Reduction Evaluation?
❑ Yes X No If yes, describe ___
EA. Summary of Submitted Biomonitoring Test Information. If you have submitted biomonitoring test information, or information regarding the
cause of toxicity, within the past four and one-half years, provide the dates the information was submitted to the permitting authority and a summary
of the results.
Date submitted / / (MM/DD/YYYY)
Summary of results (see instructions)
END OF PART E.
REFER TO THE APPLICATION OVERVIEW (PAGE 1) TO DETERMINE WHICH OTHER PARTS !,
UI- t-UKM ZA YOU MUS I GUMPLt I t.
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 17 of 22

FACILITY NAME AND PERMIT NUMBER:
TPERMIT ACTION REQUESTED:
RIVER BASIN:
PILOT CREEK WWPCF, NCO020737
RENEWAL
BROAD RIVER
SUPPLEMENTAL APPLICATION INFORMATION
L_
PART E. TOXICITY TESTING DATA
POTWs meeting one or more of the following criteria must provide the results of whole effluent toxicity tests for acute or chronic toxicity for each of the
facility's discharge points- 1) POTWs with a design flow rate greater than or equal to 1.0 mgd, 2) POTWs with a pretreatment program (or those that are
required to have one under 40 CFR Part 403), or 3) POTWs required by the permitting authority to submit data for these parameters.
• At a minimum, these results must include quarterly testing for a 12 -month period within the past 1 year using multiple species (minimum of two
species), or the results from four tests performed at least annually in the four and one-half years prior to the application, provided the results
show no appreciable toxicity, and testing for acute and/or chronic toxicity, depending on the range of receiving water dilution. 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.
• In addition, submit the results of any other whole effluent toxicity tests from the past four and one-half years. If a whole effluent toxicity test
conducted during the past four and one-half years revealed toxicity, provide any information on the cause of the toxicity or any results of a
toxicity reduction evaluation, if one was conducted.
• If you have already submitted any of the information requested in Part E, you need not submit it again. Rather provide the information
requested in question EA for previously submitted information. If EPA methods were not used, report the reasons for using alternate methods.
If test summaries are available that contain all of the information requested below, they may be submitted in place of Part E.
If no biomonitoring data is required, do not complete Part E. Refer to the Application Overview for directions on which other sections of the form to
complete.
E.I. Required Tests.
Indicate the number of whole effluent toxicity tests conducted in the past four and one-half years.
X chronic ❑ acute
E.2. Individual Test Data. Complete the following chart for each whole effluent toxicity test conducted in the last four and one-half years. Allow one
column per test (where each species constitutes a test). Copy this page if more than three tests are being reported.
Test number. 10 Test number 11 Test number 12
a. Test information.
Test Species & test method number
CERIODAPHNIA DUBIA/1002
CERIODAPHNIA DUBIA/1002
CERIODAPHNIA DUBIA/1002
Age at initiation of test
<24 HRS
<24 HRS
<24 HRS
Outfall number
001
001
001
Dates sample collected
04/10/2017 & 04/12/2017
07/17/2017 & 07/19/2017
10/09/2017 & 10/11/2017
Date test started
04/12/2017
07/19/2017
10/11/2017
Duration
7 DAY
7 DAY
7 DAY
b. Give toxicity test methods followed.
Manual title
EPA 821-R-02-013
EPA 821-R-02-013
EPA 821-R-02-013
Edition number and year of publication
4th ED 2002
4th ED 2002
4th ED 2002
Page number(s)
141-189
141-189
141-189
c. Give the sample collection method(s) used. For multiple grab samples, indicate the number of grab samples used.
24 -Hour composite
YES/ FLOW PRPORTIONAL
YES/FLOW PROPORTIONAL
YES/FLOW PROPORTIONAL
Grab
N/A
N/A
N/A
d. Indicate where the sample was taken in relation to disinfection. (Check all that apply for each.
Before disinfection
After disinfection
After dechlorination
V
V
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 15 of 22

FACILITY NAME AND PERMIT NUMBER:
PILOT CREEK WWPCF, NCO020737
PERMIT ACTION REQUESTED:
RENEWAL
RIVER BASIN:
BROAD RIVER
Test number: 10 Test number: 11 Test number: 12
e Describe the point in the treatment process at which the sample was collected.
Sample was collected:
EFFLUENT DISCHARGE AFTER
DECHLORINATION
EFFLUENT DISCHARGE AFTER
DECHLORINATION
EFFLUENT DISCHARGE AFTER
DECHLORINATION
f. For each test, include whether the test was intended to assess chronic toxicity, acute toxicity, or both
Chronic toxicity
✓
✓
✓
Acute toxicity
g. Provide the type of test performed.
Static
Static -renewal
✓
✓
✓
Flow-through
h. Source of dilution water. If laboratory water, specify type, if receiving water, specify source.
Laboratory water
SURFACE WATER
SURFACE WATER
SURFACE WATER
Receiving water
i. Type of dilution water. If salt water, specify "natural" or type of artificial sea salts or brine used.
Fresh water
✓
✓
✓
Salt water
j. Give the percentage effluent used for ail concentrations in the test series.
33%
33%
33%
k. Parameters measured during the test. (State whether parameter meets test method specifications)
pH
✓
✓
✓
Salinity
Temperature
✓
✓
✓
Ammonia
Dissolved oxygen
✓
✓
✓
1. Test Results.
Acute
Percent survival in 100%
effluent
LC50
95% C.I.
%
%
%
Control percent survival
%
%
%
Other (describe)
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 16 of 22

FACILITY NAME AND PERMIT NUMBER:
PILOT CREEK WWPCF, NCO020737
PERMIT ACTION REQUESTED:
RENEWAL
RIVER BASIN:
BROAD RIVER
Chronic:
NOEC
%
%
%
I C25
%
%
%
Control percent survival
100 %
100 %
100%
Other (describe)
PASS/FAIL @33%: PASS
PASS/FAIL@33%: PASS
PASS/FAIL@33%: PASS
m. Quality Control/Quality Assurance
Is reference toxicant data available?
YES
YES
YES
Was reference toxicant test within
acceptable bounds?
YES
YES
YES
What date was reference toxicant test
run (MM/DD/(YYY)?
04/ 03 / 2017
07 / 03 / 2017
101 02 /2017
Other (describe)
E.3. Toxicity Reduction Evaluation. Is the treatment works involved in a Toxicity Reduction Evaluation?
❑ Yes X No If yes, describe.
E.4. Summary of Submitted Biomonitoring Test Information. If you have submitted biomonitonng test information, or information regarding the
cause of toxicity, within the past four and one-half years, provide the dates the information was submitted to the permitting authority and a summary
of the results.
Date submitted: ! / (MM/DD/YYYY)
Summary of results: (see instructions)
END OF PART E.
REFER TO THE APPLICATION OVERVIEW (PAGE 1) TO DETERMINE WHICH OTHER PARTS
OF FORM 2A YOU MUST COMPLETE.
EPA Foran 3510-2A (Rev. 1-99). Replaces EPA fors 7550-6 & 7550-22. Page 17 of 22

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
PILOT CREEK WWPCF, NC002b737
RENEWAL
BROAD RIVER
SUPPLEMENTAL APPLICATION INFORMATION
PART F. INDUSTRIAL USER DISCHARGES AND RCRA/CERCLA WASTES
All treatment works receiving discharges from significant industrial users or which receive RCRA,CERCLA, or other remedial wastes must
complete part F.
GENERAL INFORMATION:
F.1. Pretreatment program. Does the treatment works have, or is subject ot.. an approved pretreatment program?
X Yes ❑ No
F.2. Number of Significant Industrial Users (SIUs) and Categorical Industrial Users (CIUs). Provide the number of each of the following types of
industrial users that discharge to the treatment works.
a. Number of non -categorical SIUs. _0
b. Number of CIUs. 6
SIGNIFICANT INDUSTRIAL USER INFORMATION:
Supply the following information for each SIU. If more than one SIU discharges to the treatment works, copy questions F.3 through F.8 and
provide the information requested for each SIU.
F.3. Significant Industrial User Information. Provide the name and address of each SIU discharging to the treatment works. Submit additional pages
as necessary
Name. STEAG SCR -TECH
Mailing Address: 304 LINWOOD ROAD
KINGS MOUNTAIN, NC 28086
F.4. Industrial Processes. Describe all the industrial processes that affect or contribute to the SIU's discharge
CHEMICAL PRECIPITATION, CYCLONE, FILTRATION AND FLOCULATION
F.5. Principal Product(s) and Raw Material(s). Describe all of the principal processes and raw materials that affect or contribute to the SIU's
discharge.
Principal product(s) REGENERATED CATALYST MODULES FROM SELECTIVE CATALYST REDUCTION.
Raw matenal(s). SODIUM HYDROXIDE FORMIC ACID AMMONIUM HEPTAMOLYBATE AMMONIUM META TUNGSTATE.
F.6. Flow Rate.
a. Process wastewater flow rate. Indicate the average daily volume of process wastewater discharge into the Collection system in gallons per
day (gpd) and whether the discharge is continuous or intermittent.
50,000 gpd (_ X continuous or intermittent)
b. Non -process wastewater flow rate. Indicate the average daily volume of non -process wastewater flow discharged into the collection system
in gallons per day (gpd) and whether the discharge is continuous or intermittent.
5,500 gpd ( x continuous or intermittent)
F.7. Pretreatment Standards. Indicate whether the SIU is subject to the following
a. Local limits X Yes ❑ No
b. Categorical pretreatment standards X Yes ❑ No
If subject to categorical pretreatment standards, which category and subcategory?
415
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 8 7550-22. Page 18 of 22

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
PILOT CREEK WVVPCF, NC002b737
RENEWAL
BROAD RIVER
F.8. Problems at the Treatment Works Attributed to Waste Discharge by the SIU. Has the SIU caused or contributed to any problems (e.g.,
upsets, interference) at the treatment works in the past three years?
X Yes ❑ No If yes, describe each episode.
VWVfP PUT ON SOC DUE TO HIGH LEVELS OF THALLIUM RELEASED INTO
THE COLLECTION SYSTEM.
RCRA HAZARDOUS WASTE RECEIVED BY TRUCK, RAIL, OR DEDICATED PIPELINE:
F.9. RCRA Waste. Does the treatment works receive or has it in the past three years received RCRA hazardous waste by truck, rail or dedicated pipe?
❑ Yes X No (go to F. 12)
FA 0. Waste transport Method by which RCRA waste is received (check all that apply)
❑ Truck ❑ Rail ❑ Dedicated Pipe
FA 1. Waste Description. Give EPA hazardous waste number and amount (volume or mass, specify units).
EPA Hazardous Waste Number Amount Units
CERCLA (SUPERFUND) WASTEWATER, RCRA REM EDIATIONICORRECTIVE ACTION
WASTEWATER, AND OTHER REMEDIAL ACTIVITY WASTEWATER:
F.12. Remediation Waste. Does the treatment works currently (or has it been notified that it will) receive waste from remedial activities?
❑ Yes (complete F.13 through F.15.) X No
F.13. Waste Origin. Describe the site and type of facility at which the CERCLA/RCRA/or other remedial waste originates (or is excepted to origniate in
the next five years).
F.14. Pollutants. List the hazardous constituents that are received (or are expected to be received). Include data on volume and concentration, if
known. (Attach additional sheets if necessary.)
F.15. Waste Treatment.
a. Is this waste treated (or will be treated) prior to entering the treatment works?
❑ Yes ❑ No
If yes, describe the treatment (provide information about the removal efficiency)
b. Is the discharge (or will the discharge be) continuous or intermittent?
❑ Continuous ❑ Intermittent If intermittent, describe discharge schedule.
END OF PART F.
REFER TO THE APPLICATION OVERVIEW (PAGE 1) TO DETERMINE WHICH OTHER PARTS
OF FORM 2A YOU MUST COMPLETE
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 19 of 22

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
PILOT CREEK VWdPCF, NC0020737
RENEWAL
BROAD RIVER
SUPPLEMENTAL APPLICATION INFORMATION
PART F. INDUSTRIAL USER DISCHARGES AND RCRAICERCLA WASTES
All treatment works receiving discharges from significant industrial users or which receive RCRA,CERCLA, or other remedial wastes must
complete part F.
GENERAL INFORMATION:
F.1. Pretreatment program. Does the treatment works have, or is subject ot, an approved pretreatment program?
X Yes ❑ No
F.2. Number of Significant Industrial Users (SIUs) and Categorical Industrial Users (CIUs). Provide the number of each of the following types of
industrial users that discharge to the treatment works.
a. Number of non-categorical SIUs. 0_____
b. Number of CIUs. 6
SIGNIFICANT INDUSTRIAL USER INFORMATION:
Supply the following information for each SIU. If more than one SIU discharges to the treatment works, copy questions F.3 through F.8 and
provide the information requested for each SIU.
F.3. Significant Industrial User Information. Provide the name and address of each SIU discharging to the treatment works. Submit additional pages
as necessary.
Name COMMERCIAL VEHICLE GROUP (CVG)- MAYFLOWER
Mailing Address P.O. BOX 789
KINGS MOUNTAIN, NC 28086
F.4. Industrial Processes. Describe all the industrial processes that affect or contribute to the SIU's discharge.
FABRICATION, ASSEMBLY AND PAINTING OF TRUCK CABS AND SLEEPER BOXES
F.S. Principal Product(s) and Raw Material(s). Describe all of the principal processes and raw materials that affect or contribute to the SIU's
discharge.
Principal product(s): SPOT WELDING, PRIMER COATING, TOP COAT PAINTING
Raw matenal(s). STEEL BLANKS STEEL PANELS E-COAT PRIMER PAINT TOP COAT PAINTSEALER AND ADHESIVE
F.6. Flow Rate.
a. Process wastewater flow rate. Indicate the average daily volume of process wastewater discharge into the collection system in gallons per
day (gpd) and whether the discharge is continuous or intermittent.
22,000 gpd ( X continuous or _ intermittent)
b. Non-process wastewater flow rate. Indicate the average daily volume of non-process wastewater flow discharged into the collection system
in gallons per day (gpd) and whether the discharge is continuous or intermittent.
9,000 gpd ( continuous or X intermittent)
F.7. Pretreatment Standards. Indicate whether the SIU is subject to the following
a. Local limits X Yes ❑ No
b. Categorical pretreatment standards X Yes ❑ No
If subject to categorical pretreatment standards. which category and subcategory?
433-3713
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 18 of 22

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
PILOT CREEK WWPCF, NC00210737
RENEWAL
BROAD RIVER
F.8. Problems at the Treatment Works Attributed to Waste Discharge by the SIU. Has the SIU caused or contributed to any problems (e.g.,
upsets, interference) at the treatment works in the past three years?
X Yes ❑ No If yes, describe each episode.
CIVIL PENALTIES ASSESSESD AND PLACED ON COMPLIANCE SCHEDULE. HIGH LEVELS OF
ZINC, LACK OF PREVENTATIVE MAINTENANCE ON TREATMENT SYSTEM.
RCRA HAZARDOUS WASTE RECEIVED BY TRUCK, RAIL, OR DEDICATED PIPELINE:
F.9. RCRA Waste. Does the treatment works receive or has it in the past three years received RCRA hazardous waste by truck, rail or dedicated pipe?
❑ Yes X No (go to F.12)
F.10. Waste transport Method by which RCRA waste is received (check all that apply)
❑ Truck ❑ Rail ❑ Dedicated Pipe
F.11. Waste Description. Give EPA hazardous waste number and amount (volume or mass, specify units).
EPA Hazardous Waste Number Amount Units
CERCLA (SUPERFUND) WASTEWATER, RCRA REMEDIATION/CORRECTIVE ACTION
WASTEWATER, AND OTHER REMEDIAL ACTIVITY WASTEWATER:
F.12. Remediation Waste. Does the treatment works currently (or has it been notified that it will) receive waste from remedial activities?
❑ Yes (complete F.13 through F.15.) X No
F.13. Waste Origin. Describe the site and type of facility at which the CERCLA/RCRA/or other remedial waste originates (or is excepted to origniate in
the next five years).
F.14. Pollutants. List the hazardous constituents that are received (or are expected to be received). Include data on volume and concentration, if
known. (Attach additional sheets if necessary.)
F.15. Waste Treatment
a. Is this waste treated (or will be treated) prior to entering the treatment works?
❑ Yes ❑ No
If yes, describe the treatment (provide information about the removal efficiency)
b. Is the discharge (or will the discharge be) continuous or intermittent?
❑ Continuous ❑ Intermittent If intermittent. describe discharge schedule.
END OF PART F.
REFER TO THE APPLICATION OVERVIEW (PAGE 1) TO DETERMINE WHICH OTHER PARTS
OF FORM 2A YOU MUST COMPLETE
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 19 of 22

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
PILOT CREEK WWPCF, NCO020737
RENEWAL
BROAD RIVER
SUPPLEMENTAL APPLICATION INFORMATION
PART F. INDUSTRIAL USER DISCHARGES AND RCRA/CERCLA WASTES
All treatment works receiving discharges from significant industrial users or which receive RCRA,CERCLA, or other remedial wastes must
complete part F.
GENERAL INFORMATION:
F.I. Pretreatment program. Does the treatment works have, or is subject ot, an approved pretreatment program?
X Yes ❑ No
F.2. Number of Significant Industrial Users (SIUs) and Categorical Industrial Users (CIUs). Provide the number of each of the following types of
industrial users that discharge to the treatment works.
a. Number of non -categorical SIUs.
b. Number of CIUs. 6
SIGNIFICANT INDUSTRIAL USER INFORMATION:
Supply the following information for each SIU. If more than one SIU discharges to the treatment works, copy questions F.3 through F.8 and
provide the information requested for each SIU.
F.3. Significant Industrial User Information. Provide the name and address of each SIU discharging to the treatment works. Submit additional pages
as necessary.
Name. KINGS MOUNTAIN INTERNATIONAL, INC.
Mailing Address: 1755 SOUTH BATTLEGROUND AVE.
KINGS MOUNTAIN, NC 28086
F.4. Industrial Processes. Describe all the industrial processes that affect or contribute to the SIU's discharge.
STEEL PLATE FINISHING AND PLATING OPERATIONS
F.5. Principal Product(s) and Raw Material(s). Describe all of the principal processes and raw materials that affect or contribute to the Sl U's
discharge.
Principal product(s): STAINLESS STEEL PLATES
Raw material(s) SULFURIC A .IDS BENTONILE, FERRIC H ORID PHOSPHRIC ACID, OXALIC ACID. SAND STEEL SHOT,
POLYETHELEYNE, CHROMIC ACID, ALKALINE CHROMESTRIP, PINK INK.
F.6. Flow Rate.
a Process wastewater flow rate. Indicate the average daily volume of process wastewater discharge into the collection system in gallons per
day (gpd) and whether the discharge is continuous or intermittent.
1,600 gpd ( continuous or X intermittent)
b. Non -process wastewater flow rate. Indicate the average daily volume of non -process wastewater flow discharged into the collection system
in gallons per day (gpd) and whether the discharge is continuous or intermittent.
800 gpd ( continuous or _ X intermittent)
F.7. Pretreatment Standards. Indicate whether the SIU is subject to the following:
a. Local limits X Yes ❑ No
b. Categorical pretreatment standards X Yes ❑ No
If subject to categorical pretreatment standards, which category and subcategory?
433
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 6 7550-22. Page 18 of 22

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
PILOT CREEK WWPCF, NC0020737
RENEWAL
BROAD RIVER
F.8. Problems at the Treatment Works Attributed to Waste Discharge by the SIU. Has the SIU caused or contributed to any problems (e.g.,
upsets, interference) at the treatment works in the past three years?
❑ Yes X No If yes, describe each episode.
RCRA HAZARDOUS WASTE RECEIVED BY TRUCK, RAIL, OR DEDICATED PIPELINE:
F.9. RCRA Waste. Does the treatment works receive or has it in the past three years received RCRA hazardous waste by truck, rail or dedicated pipe?
❑ Yes X No (go to F.12)
F.10. Waste transport Method by which RCRA waste is received (check all that apply).
❑ Truck ❑ Rail ❑ Dedicated Pipe
FA 1. Waste Description. Give EPA hazardous waste number and amount (volume or mass, specify units).
EPA Hazardous Waste Number Amount Units
CERCLA (SUPERFUND) WASTEWATER, RCRA REMEDIATION/CORRECTIVE ACTION
WASTEWATER, AND OTHER REMEDIAL ACTIVITY WASTEWATER:
F.12. Remediation Waste. Does the treatment works currently (or has it been notified that it will) receive waste from remedial activities?
❑ Yes (complete F.13 through F.15.) X No
F.13. Waste Origin. Describe the site and type of facility at which the CERCLA/RCRA/or other remedial waste originates (or is excepted to origniate in
the next five years).
F.14. Pollutants. List the hazardous constituents that are received (or are expected to be received). Include data on volume and concentration, if
known. (Attach additional sheets if necessary.)
F.15. Waste Treatment.
a. Is this waste treated (or will be treated) prior to entering the treatment works?
❑ Yes ❑ No
If yes, describe the treatment (provide information about the removal efficiency).
b. Is the discharge (or will the discharge be) continuous or intermittent?
❑ Continuous ❑ Intermittent If intermittent, describe discharge schedule.
END OF PART F.
REFER TO THE APPLICATION OVERVIEW (PAGE 1) TO DETERMINE WHICH OTHER PARTS
OF FORM 2A YOU MUST COMPLETE
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 19 of 22

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
PILOT CREEK VWVPCF, NC00210737
RENEWAL
BROAD RIVER
SUPPLEMENTAL APPLICATION INFORMATION
PART F. INDUSTRIAL USER DISCHARGES AND RCRAICERCLA WASTES
All treatment works receiving discharges from significant industrial users or which receive RCRA,CERCLA, or other remedial wastes must
complete part F.
GENERAL INFORMATION:
F.1. Pretreatment program. Does the treatment works have, or is subject ot, an approved pretreatment program?
X Yes [I No
F.2. Number of Significant Industrial Users (SIUs) and Categorical Industrial Users (CIUs). Provide the number of each of the following types of
industrial users that discharge to the treatment works.
a. Number of non -categorical SIUs. 0__
b. Number of CIUs. 6
SIGNIFICANT INDUSTRIAL USER INFORMATION:
Supply the following information for each SIU. If more than one SIU discharges to the treatment works, copy questions F.3 through F.8 and
provide the information requested for each SIU.
F.3. Significant Industrial User Information. Provide the name and address of each SIU discharging to the treatment works. Submit additional pages
as necessary.
Name CAROLINA FINISHING AND COATING
Mailing Address: 441 COUNTRYSIDE DRIVE
KINGS MOUNTAIN, NC 28086
F.4. Industrial Processes. Describe all the industrial processes that affect or contribute to the SIU's discharge.
ANODIZING OF ALUMINUM PLATES AND TUBING
F.5. Principal Product(s) and Raw Material(s). Describe all of the principal processes and raw materials that affect or contribute to the SIU's
discharge.
Principal product(s): ANODIZING OF ALUMINUM
Raw matenal(s): SULFURIC ACIDS, CAUSTIC SODA, NICKEL FLUORIDE
F.6. Flow Rate.
a. Process wastewater flow rate. Indicate the average daily volume of process wastewater discharge into the collection system in gallons per
day (gpd) and whether the discharge is continuous or intermittent.
3,500 gpd (_ X continuous or T __ intermittent)
b. Non -process wastewater flow rate. Indicate the average daily volume of non -process wastewater flow discharged into the collection system
in gallons per day (gpd) and whether the discharge is continuous or intermittent.
_1,500 gpd ( X continuous or _`_ intermittent)
F.7. Pretreatment Standards. Indicate whether the SIU is subject to the following
a. Local limits X Yes ❑ No
b. Categoncal pretreatment standards X Yes ❑ No
If subject to categorical pretreatment standards, which category and subcategory?
433 -3471 -
EPA Form 3510-2A (Rev. 1-99). Replaces EPA fors 7550-6 8 7550-22. Page 18 of 22

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
PILOT CREEK WWPCF, NCO02ID737
RENEWAL
BROAD RIVER
F.S. Problems at the Treatment Works Attributed to Waste Discharge by the SIU. Has the SIU caused or contributed to any problems (e.g.,
upsets, interference) at the treatment works in the past three years?
❑ Yes No If yes, describe each episode.
RCRA HAZARDOUS WASTE RECEIVED BY TRUCK, RAIL, OR DEDICATED PIPELINE:
F.9. RCRA Waste. Does the treatment works receive or has it in the past three years received RCRA hazardous waste by truck, rail or dedicated pipe?
❑ Yes ❑ No (go to F.12)
F.10. Waste transport. Method by which RCRA waste is received (check all that apply):
❑ Truck ❑ Rail ❑ Dedicated Pipe
FA 1. Waste Description. Give EPA hazardous waste number and amount (volume or mass, specify units).
EPA Hazardous Waste Number Amount Units
CERCLA (SUPERFUND) WASTEWATER, RCRA REMEDIATION/CORRECTIVE ACTION
WASTEWATER, AND OTHER REMEDIAL ACTIVITY WASTEWATER: ni
F.12. Remediation Waste. Does the treatment works currently (or has it been notified that it will) receive waste from remedial activities?
[] Yes (complete F.13 through F.15.) X No
F.13. Waste Origin. Describe the site and type of facility at which the CERCLA/RCRA/or other remedial waste onginates (or is excepted to origniate in
the next five years).
F.14. Pollutants. List the hazardous constituents that are received (or are expected to be received). Include data on volume and concentration, if
known. (Attach additional sheets if necessary.)
F.15. Waste Treatment.
a. Is this waste treated (or will be treated) prior to entering the treatment works?
❑ Yes ❑ No
If yes, describe the treatment (provide information about the removal efficiency).
b. Is the discharge (or will the discharge be) continuous or intermittent?
❑ Continuous ❑ Intermittent If intermittent, describe discharge schedule.
END OF PART F.
REFER TO THE APPLICATION OVERVIEW (PAGE 1) TO DETERMINE WHICH OTHER PARTS
OF FORM 2A YOU MUST COMPLETE
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 19 of 22

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
PILOT CREEK WWPCF, NC00210737
RENEWAL
BROAD RIVER
SUPPLEMENTAL APPLICATION INFORMATION
PART F. INDUSTRIAL USER DISCHARGES AND RCRA/CERCLA WASTES
All treatment works receiving discharges from significant industrial users or which receive RCRA,CERCLA, or other remedial wastes must
complete part F.
GENERAL INFORMATION:
F.I. Pretreatment program. Does the treatment works have, or is subject ot, an approved pretreatment program?
X Yes 0 No
F.2. Number of Significant Industrial Users (SIUs) and Categorical Industrial Users (CIUs). Provide the number of each of the following types of
industrial users that discharge to the treatment works.
a. Number of non -categorical SIUs. 0
b. Number of CIUs. 6
SIGNIFICANT INDUSTRIAL USER INFORMATION:
Supply the following information for each SIU. If more than one SIU discharges to the treatment works, copy questions F.3 through F.8 and
provide the information requested for each SIU.
F.3. Significant Industrial User Information. Provide the name and address of each SIU discharging to the treatment works. Submit additional pages
as necessary.
NameBUCKEYE ANODIZING COMPANY
Mailing Address. 110 KINGS ROAD
KINGS MOUNTAIN, NC 28086
F.4. Industrial Processes. Describe all the industrial processes that affect or contribute to the SILI's discharge.
ANODIZING OF ALUMINUM, MANUFACTURE EXTINGUISHERS, PHOSPHATE STEEL PLATES AND STEEL CYLINDERS
F.5. Principal Product(s) and Raw Material(s). Describe all of the principal processes and raw materials that affect or contribute to the SIU's
discharge.
Principal product(s)- FIRE EXTINGUISHERS, ANODIZING OF ALUMINUM
Raw material(s). PHOSPHORIC, SULFURIC, CHROMIC, AND NITRIC ACIDS, NALCLEAR 8173, CAUSTIC SODA, NAMLET 8154
F.6. Flow Rate.
a. Process wastewater flow rate. Indicate the average daily volume of process wastewater discharge into the collection system in gallons per
day (gpd) and whether the discharge is continuous or intermittent.
7,500 gpd f X continuous or intermittent)
b. Non -process wastewater flow rate. Indicate the average daily volume of non -process wastewater flow discharged into the collection system
in gallons per day (gpd) and whether the discharge is continuous or intermittent.
30,000 gpd ( X continuous or ____ intermittent)
F.7. Pretreatment Standards. Indicate whether the SIU is subject to the following:
a. Local limits X Yes ❑ No
b. Categorical pretreatment standards X Yes ❑ No
If subject to categorical pretreatment standards, which category and subcategory?
433-3471-3499
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 8 7550-22. Page 18 of 22

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
PILOT CREEK WWPCF, NC0020737
RENEWAL
BROAD RIVER
F.8. Problems at the Treatment Works Attributed to Waste Discharge by the SIU. Has the SIU caused or contributed to any problems (e.g.,
upsets, interference) at the treatment works in the past three years?
❑ Yes X No If yes, describe each episode.
RCRA HAZARDOUS WASTE RECEIVED BY TRUCK, RAIL, OR DEDICATED PIPELINE:
F.9. RCRA Waste. Does the treatment works receive or has it in the past three years received RCRA hazardous waste by truck, rail or dedicated pipe?
❑ Yes [] No (go to F.12)
F.10. Waste transport Method by which RCRA waste is received (check all that apply)
❑ Truck ❑ Rail ❑ Dedicated Pipe
FA 1. Waste Description. Give EPA hazardous waste number and amount (volume or mass, specify units).
EPA Hazardous Waste Number Amount Units
CERCLA (SUPERFUND) WASTEWATER, RCRA REMEDIATION/CORRECTIVE ACTION
WASTEWATER, AND OTHER REMEDIAL ACTIVITY WASTEWATER:
F.12. Remediation Waste. Does the treatment works currently (or has it been notified that it will) receive waste from remedial activities?
❑ Yes (complete F.13 through F.15.) X No
F.13. Waste Origin. Describe the site and type of facility at which the CERCLA/RCRA/or other remedial waste originates (or is excepted to origniate in
the next five years).
F.14. Pollutants. List the hazardous constituents that are received (or are expected to be received). Include data on volume and concentration, if
known. (Attach additional sheets if necessary.)
F.15. Waste Treatment.
a. Is this waste treated (or will be treated) prior to entering the treatment works?
❑ Yes ❑ No
If yes, describe the treatment (provide information about the removal efficiency).
b. Is the discharge (or will the discharge be) continuous or intermittent?
❑ Continuous ❑ Intermittent If intermittent, describe discharge schedule.
END OF PART F.
REFER TO THE APPLICATION OVERVIEW (PAGE 1) TO DETERMINE WHICH OTHER PARTS
OF FORM 2A YOU MUST COMPLETE
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 8 7550-22. -lac', I, of 2

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
PILOT CREEK WWPCF, NCO02b737
RENEWAL
BROAD RIVER
SUPPLEMENTAL APPLICATION INFORMATION
PART F. INDUSTRIAL USER DISCHARGES AND RCRA/CERCLA WASTES
All treatment works receiving discharges from significant industrial users or which receive RCRA,CERCLA, or other remedial wastes must
complete part F.
GENERAL INFORMATION:
F.1. Pretreatment program. Does the treatment works have, or is subject ot, an approved pretreatment program?
X Yes ❑ No
F.2. Number of Significant Industrial Users (SIUs) and Categorical Industrial Users (CIUs). Provide the number of each of the following types of
industrial users that discharge to the treatment works.
a. Number of non -categorical SIUs. _0_____
b. Number of CIUs.
SIGNIFICANT INDUSTRIAL USER INFORMATION:
Supply the following information for each SIU. If more than one SIU discharges to the treatment works, copy questions F.3 through F.8 and
provide the information requested for each SIU.
F.3. Significant Industrial User Information. Provide the name and address of each SIU discharging to the treatment works. Submit additional pages
as necessary.
Name: PREMIER COATING EAST, LLC.
Mailing Address. P.O. BOX 335
KINGS MOUNTAIN, NC 28086
F.4. Industrial Processes. Describe all the industrialprocesses that affect or contribute to the SIU's discharge.
IRON PHOSPHATE CLEANING OF CARBON STEEL AND ALUMINUM COMPONENTS PRIOR TO POWDER PAINTING. DISCHARGE IS
FROM PART RINSE AND CARRYOVER FROM PRIMARY WASH STAGE INTO THE RINSE STAGE. FLUSH AND RECHARGE OF THE
IRON PHOSPHATF .HFMIC AI S WII I Or`r'I IR WHFN (HFMICAI S nEPLFTFr)
F.5. Principal Product(s) and Raw Material(s). Describe all of the principal processes and raw materials that affect or contribute to the SIU's
discharge.
Principal product(s): IRON PHOSPHATE CLEANING OF CARBON STEED AND ALUMINUM COMPONENTS
Raw material(s): GF PHO 252DS AND UNIVAR CAUSTIC SODA 25%
F.6. Flow Rate.
a. Process wastewater flow rate. Indicate the average daily volume of process wastewater discharge into the collection system in gallons per
day (gpd) and whether the discharge is continuous or intermittent.
1500 gpd ( x continuous or intermittent)
b. Non -process wastewater flow rate. Indicate the average daily volume of non -process wastewater flow discharged into the collection system
in gallons per day (gpd) and whether the discharge is continuous or intermittent.
800 gpd ( X continuous or intermittent)
F.7. Pretreatment Standards. Indicate whether the SIU is subject to the following
a. Local limits X Yes ❑ No
b. Categorical pretreatment standards X Yes ❑ No
If subject to categorical pretreatment standards, which category and subcategory?
433
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 18 of 22

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
PILOT CREEK WVVPCF, NC002b737
RENEWAL
BROAD RIVER
F.8. Problems at the Treatment Works Attributed to Waste Discharge by the SIU. Has the SIU caused or contributed to any problems (e.g.,
upsets, interference) at the treatment works in the past three years?
❑ Yes X No If yes, describe each episode.
RCRA HAZARDOUS WASTE RECEIVED BY TRUCK, RAIL, OR DEDICATED PIPELINE:
F.9. RCRA Waste. Does the treatment works receive or has it in the past three years received RCRA hazardous waste by truck, rail or dedicated pipe?
❑ Yes X No (go to F. 12)
F.10. Waste transport Method by which RCRA waste is received (check all that apply)
❑ Truck ❑ Rail ❑ Dedicated Pipe
F.11. Waste Description. Give EPA hazardous waste number and amount (volume or mass, specify units).
EPA Hazardous Waste Number Amount Units
CERCLA (SUPERFUND) WASTEWATER, RCRA REMEDIATION/CORRECTIVE ACTION
WASTEWATER, AND OTHER REMEDIAL ACTIVITY WASTEWATER:
F.12. Remediation Waste. Does the treatment works currently (or has it been notified that it will) receive waste from remedial activities?
❑ Yes (complete F.13 through F.15.) X No
F.13. Waste Origin. Describe the site and type of facility at which the CERCLA/RCRA/or other remedial waste originates (or is excepted to ongniate in
the next five years).
F.14. Pollutants. List the hazardous constituents that are received (or are expected to be received). Include data on volume and concentration, if
known. (Attach additional sheets if necessary.)
F.15. Waste Treatment.
a. Is this waste treated (or will be treated) prior to entering the treatment works?
❑ Yes ❑ No
If yes, describe the treatment (provide information about the removal effiaency):
b. Is the discharge (or will the discharge be) continuous or intermittent?
❑ Continuous ❑ Intermittent If intermittent, describe discharge schedule.
END OF PART F.
REFER TO THE APPLICATION OVERVIEW (PAGE 1) TO DETERMINE WHICH OTHER PARTS
OF FORM 2A YOU MUST COMPLETE
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22.

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
PILOT CREEK WWPCF„ NCO020737
RENEWAL
BROAD RIVER
SUPPLEMENTAL APPLICATION INFORMATION
PART G. COMBINED SEWER SYSTEMS
If the treatment works has a combined sewer system, complete Part G.
G.1. System Map. Provide a map indicating the following. (may be included with Basic Application Information)
a. All CSO discharge points.
b. Sensitive use areas potentially affected by CSOs (e.g., beaches, drinking water supplies, shellfish beds, sensitive aquatic ecosystems, and
outstanding natural resource waters).
C. Waters that support threatened and endangered species potentially affected by CSOs.
G.2. System Diagram. Provide a diagram, either in the map provided in G.1 or on a separate drawing, of the combined sewer collection system that
includes the following information.
a. Location of major sewer trunk lines, both combined and separate sanitary.
b. Locations of points where separate sanitary sewers feed into the combined sewer system.
C. Locations of in-line and off-line storage structures.
d. Locations of flow -regulating devices.
e. Locations of pump stations.
CSO OUTFALLS: I i
Complete questions G.3 through G.6 once for each CSO discharge point
G.3. Description of Outfall.
a. Outfall number
b. Location
(City or town, if applicable) (Zip Code)
(County) (State)
(Latitude) (Longitude)
C. Distance from shore (if applicable) ft.
d. Depth below surface (if applicable) ft.
e. Which of the following were monitored during the last year for this CSO?
❑ Rainfall ❑ CSO pollutant concentrations ❑ CSO frequency
❑ CSO flow volume ❑ Receiving water quality
f. How many storm events were monitored during the last year?
GA. CSO Events.
a. Give the number of CSO events in the last year.
events (❑ actual or ❑ approx.)
b. Give the average duration per CSO event.
hours (❑ actual or ❑ approx.)
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 20 of 22

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
C. Give the average volume per CSO event.
million gallons (❑ actual or ❑ approx.)
d. Give the minimum rainfall that caused a CSO event in the last year
Inches of rainfall
G.5. Description of Receiving Waters.
a. Name of receiving water
b. Name of watershed/river/stream system.
United State Soil Conservation Service 14 -digit watershed code (if known):
C. Name of State Management/River Basin: _
United States Geological Survey 8 -digit hydrologic cataloging unit code (if known)
G.6. CSO Operations.
Describe any known water quality impacts on the receiving water caused by this CSO (e.g., permanent or intermittent beach closings, permanent or
intermittent shell fish bed dosings, fish kills, fish advisories, other recreational loss, or violation of any applicable State water quality standard).
END OF PART G.
REFER TO THE APPLICATION OVERVIEW (PAGE 1) TO DETERMINE WHICH OTHER PARTS
OF FORM 2A YOU MUST COMPLETE.
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22.

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SLUDGE DISPOSAL MANAGEMENT PLAN
PILOT CREEK WASTEWATER TREATMENT FACILITY
Wastewater Treatment Facility
7'he `Wastewater Treatment Facility (Pilot Creek '"7P), operated by the City
of Xings Nountain, is an extended aeration activatedsCudge facility. 71he
treatment facility is located at 200 Potts Creek Road, Xings .Mountain, NC and
services the city anddsurrounding areas.
7'he waste activatedsCudge ispumpedfrom secondary clarifiers to one of two
aerobic holding tanks. The waste concentration ranges from 2 to 3% 7"otaC
Suspended Solids. The sludge is then aerated andyH adjusted as needed. 7'he
solids are pumped to a 2.2 meter BeCt Filter Press for further dewatering to a
cake of 15 to 18% 7otaCSolufs. The facility produces approximately Boo dry tons
per year which is transported to the Cleveland County Landfid for final
disposaC
Disposal Facility Information
Cleveland County Landfill (Se f McNeilly .CandfiC0
250 Fielding Road
Cherryville, NC 28021
Contact Person: Mr. Sam -'Al. Lockridge
Phone Number: 704.484.5100

A Paint Filter Liquids Test is performed on each load transported to the
disposalsite. No Free Liquids can be detected as a result of the analysis. A
7CLP analysis is requiredby the disposalsite upon request. The following
parameters are analyzed on the activated sludge process monthly:
Cadmium, Chromium, Copper, Nickel, Lead, Zinc, Thallium and -Arsenic.
Temperature andyHare monitored daily.
Name: Richelle .'leek
title: Superintendent/Pretreatment Coordinator
Address: zoo Potts Creek Road, Xings -Mountain, NC 28o86
Phone: [phone]
Fax: [phone]
E-Nad richelle.meek@citVo km.cam

PILOT CREEK WWPCF EXPANDED EFFLUENT TESTING DATA PART D. 2015-2017 DATA
POLLUTANT
MAX DAILY DISCHARGE
CONC. UNITS
JAVERAGE DAILY DISCHARGE
CONC. UNITS
1#01F SAMPLES
ML/MDL
AMMONIA (as N)
6.15 MG/L
2.08 MG/L
3
0.1
CHLORINE (TRC)
19 UG/L
18.5 UG/L
3
15
DISSOLVED OXYGEN
8.4 MG/L
7.55 MG/L
3
1
TKN
<1 MG/L
<1 MG/L
3
1
NITRATE + NITRITE
29 MG/L
23 MG/L
3
0.05
0&G
<6.2 MG/L
<6.2 MG/L
3
6.2
PHOSPHROUS (Total)
5.6 MG/L
4.67 MG/L
3
0.05
TDS
1151 MG/L
386.07 MG/L
1
1

PILOT CREEK WWPCF EXPANDED EFFLUENT TESTING DATA PART D. 2015-2017 DATA
POLLUTANT
MIE-I ALS (I OTAL RECOVERABLE),
ANITOMY
MAX DAILY DISCHARGE
CONC. UNITS
CYANIDE, PHENOLS,
6 µg/L
JAVERAGE DAILY DISCHARGE
CONC. UNITS
AND HARDNESS
4.5 µg/L
ESAMPLES
3
ML/MDL
10
ARSENIC
155
µg/L
83.3
µg/L
3
10
BERYLLIUM
<5
µg/L
<5
µg/L
3
5
CADMIUN
<5
µg/L
<5
µg/l-
3
5
CHROMIUM
<5
µg/L
<5
µg/L
3
5
COPPER
6
µg/L
2
µg/L
3
10
LEAD
<5
µg/L
<5
4g/L
3
5
MERCURY
<0.2
µg/L
<0.2
µg/L
3
0.2
NICKEL
42
µg/L
36.7
µg/L
3
5
SELENIUM
61
µg/L
24
µg/L
3
10
SILVER
<5
µg/L
<5
µg/L
3
5
THALLIUM
30.3
µg/L
15.77
4g/L
3
2
ZINC
46
µg/L
29.67
µg/L
3
10
CYANIDE
<8
µg/L
<8
µg/L
3
8
TOTAL PHENOLIC
COMPOUNDS
0.02
MG/L
0.01
MG/L
3
0.005
HARDNESS
VOLATILEORGANIC COMPOUNDS
i 140
MG/L
120
MG/L
3
1
ACROLEIN
<5
µg/L
<5
µg/L
3
5
ACRYLONITRILE
<50
µg/L
<50
µg/L
3
50
BENZENE
<2
µg/L
<2
µg/L
3
2
BROMOFORM
2.6
µg/L
0.87
µg/L
3
2
CARBON TETRACHLORIDE
<2
4g/L
<2
µg/L
3
2
CHLOROBENSENE
<2
4g/L
<2
µg/L
3
2
CHLORODIBROMO-
METHANE
18.2
µg/L
14.17
µg/L
3
2
CHLOROETHANE
<5
µg/L
<2
µg/L
3
2
2-CHLOROETHYLVINYL
ETHER
<5
µg/L
<5
µg/l-
3
5
CHLOROFORM
25.1
µg/L
15.23
µg/L
3
2
DICHLOROBROMO-
METHANE
<2
µg/L
<2
µg/L
3
2
1,1-DICHLOROETHANE
<2
µg/L
<2
µg/L
3
2
1,2-DICHLOROTHANE
<2
µg/L
<2
µg/L
3
2
TRANS-1,2-
DICHLOROETHLYENE
<2
I.tg/L
<2
µg/L
3
2
1,1-DICHLOROETHYLENE
<2
µg/L
<2
µg/L
3
2
1,2-DICHLOROPROPANE
<2
pg/ L
<2
µg/L
3
2
1,3-DICHLOROPROPYLENE
<2
4g/L
<2
µg/L
3
2
ETHYBENZENE
<2
µg/L
<2
µg/L
3
2
METHYL BROMIDE
<2
µg/L
<2
µg/L
3
2
METHLY CHLORIDE
<2
µg/L
<2
4g/L
3
2
METHALYLENE CHLORIDE
<2
µg/L
<2
µg/L
3
2
1,1,2,2-TETRE-
CHLOROETHANE
<2
4g/L
<2
µg/L
3
2
TETRACHLOROETHYLENE
<2
µg/L
<2
µg/L
3
2
TOLUENE 1
<21
µg/L
<2
µg/L
31
2

PILOT CREEK WWPCF EXPANDED EFFLUENT TESTING DATA PART D. 2015-2017 DATA
POLLUTANT
MAX DAILY DISCHARGE
CONC. UNITS
AVERAGE DAILY DISCHARGE
CONC. UNITS
#OF SAMPLES
ML/MDL
1,1,1 -
TRICHLOROETHANE
<2 4g/L
<2
µg/L
3
2
1,1,2 -TRICHLOROETHANE
<2 µg/L
<2
µg/L
3
2
TRICHLOROETHYLENE
<2 µg/L
<2
µg/L
3
2
VINYL CHLORIDE
ACID -EXTRACTABLE• ••
<2 µg/L
<2
µg/L
3
2
P -CHLORO -M -CRESOL
<5.1 µg/L
<5.1
µg/L
3
5.1
2 -CHLOROPHENOL
<5 µg/L
<5
µg/L
3
5
2,4-DICHLOROPHENOL
<5 µg/L
<5
µg/L
3
5
2,4 -DIMETHYLPHENOL
<10 µg/L
<10
µg/L
3
10
4,6-DINITRO-0-CRESOL
<20 µg/L
<20
µg/L
3
20
2,4-DINITROPHENOL
<50 µg/L
<50
µg/L
3
50
2-NITROPHENOL
<5 4g/L
<5
µg/L
3
5
4-NITROPHENOL
<50 µg/L
<50
µg/L
3
50
PENTACHLOROPHENOL
<10 µg/L
<10
Iig/L
3
10
PHENOL
<5 µg/L
<5
µg/L
31
5
2,4,6 -TRICHLOROPHENOL
BASE-NEUTRALCOMPUNDS
<10 µg/L
<10
µg/L
3
10
ACENAPHTHENE
<5
µg/L
<5
µg/L
3
5
ACENAPHTHYLENE
<5
µg/L
<5
µg/L
3
5
ANTHRACENE
<5
µg/L
<5
µg/L
3
5
BENZIDINE
<51
µg/L
<51
µg/L
3
51
BENZO(A)ANTHRACENE
<S
µg/L
<5
µg/l_
3
5
BENZO(A)PYRENE
<5
µg/L
<5
µg/L
3
5
3,4 BENZOFLUORANTHENE
<5
µg/L
<5
µg/L
3
5
BENZO(GHI)PERYLENE
<5
µg/L
<5
µg/L
3
5
BENZO(K) FLUORANTHENE
<5
µg/L
<5
µg/L
3
5
BIS (2-CHLOROETHOXY)
METHANE
<10
µg/L
<10
µg/L
3
10
BIS (2-CHLOROETHYL)-ETHER
<5
µg/L
<5
µg/L
3
5
BIS (2-CHLOROISOPROPYL)
ETHER
<S
µg/L
<5
µg/L
3
5
BIS (2-ETHYLHEXYL)
PHTHALATE
<5
4g/L
<5
4g/L
3
5
4-BROMOPHENYL PHENYL
ETHER
<5
4g/L
<5
µg/L
3
5
BUTYL BENZYL PHTHALATE
<5
4g/L
<5
µg/L
3
5
2-CHLORONAPHTHALENE
<5
4g/L
<5
µg/L
3
5
4-CHLORPHENYL PHENYL
ETHER
<5
4g/L
<5
µg/L
3
5
CHRYSENE
<5
4g/L
<5
4g/L
3
5
DI -N -BUTYL PHTHALATE
<5
µg/L
<5
4g/L
3
5
DI-N-OCTYL PHTHALATE
<5
4g/L I
<5
µg/L
3=
1

PILOT CREEK WWPCF EXPANDED EFFLUENT TESTING DATA PART D. 2015-2017 DATA
POLLUTANT
MAX DAILY DISCHARGE
CONC. UNITS
AVERAGE DAILY DISCHARGE
CONC. UNITS
#OF SAMPLES
DIBENZO(A,H)ANTHRACENE
<5
µg/l-
<5
µg/L
3
5
1,2 -DICHLOROBENZENE
<2
µg/L
<2
µg/L
3
2
1,3 -DICHLOROBENZENE
<2
µg/L
<2
µg/L
3
2
1,4 -DICHLOROBENZENE
<2
µg/L
<2
µg/L
3
2
3,3-DICHLOROBENZIDINE
<25
µg/L
<25
µg/L
3
25
DIETHYL PHTHALATE
<5
µg/L
<5
µg/L
3
5
DIMETHYL PHTHALATE
<5
4g/L
<5
µg/L
3
5
2,4-DINITROTOLUENE
<5
µg/L
<S
µg/L
3
5
2,6-DINITROTOLUENE
<5
µg/L
<5
µg/L
3
5
1,2-DIPHENYLHYDRAZINE
<5.1
µg/l-
<5.1
µg/L
3
5.1
FLUORANTHENE
<5
µg/L
<5
µg/L
3
5
FLUORENE
<S
µg/L
<5
4g/L
3
S
HEXACHLOROBENZENE
<5
µg/L
<5
µg/L
3
5
HEXACHLOROBUTADIENE
<S
µg/L
<5
µg/L
3
5
HEXACHLOROCYCLOPENTADI
ENE
<10
µg/L
<10
µg/L
3
10
HEXACHLOROETHANE
<5
µg/L
<5
µg/L
3
S
INDENO(1,2,3-CD)PYRENE
<5
µg/L
<5
µg/L
3
5
ISOPHORONE
<10
ug/L
<10
µg/L
3
10
NAPHTHALENE
<5
µg/L
<S
µg/L
3
5
NITROBENZENE
<5
µg/L
<5
µg/L
3
5
N-NITROSODI-
NPROPYLAMINE
<5
µg/L
<S
µg/L
3
5
N-NITROSODIMETHYLAMINE
<S
µg/L
<5
µg/L
3
5
N-NITROSODIPHENYLAMINE
<10
4g/L
<10
µg/L
3
10
PHENANTHRENE
<5
µg/L
<S
µg/L
3
5
PYRENE
<S
µg/l-
<5
µg/l-
3
5
1,2,4-TRICHLOROBENZENE
<5
µg/l-
<5
µg/L
3
5

Annual Monitoring and Pollutant Scan
Permit No. 14C 0pZQa_2a Month nC+.
Outfall O 1 Year 2�)
Facility Name : Pilot Creek WWTP
Date of sampling: October 15, 2015
ORC : Kim Moss
Phone : [phone]
Analytical Laboratory : K & W Labs and Pilot Creek WWTP Laboratory
Ammonia (as N)
Composite
4500NH3C
0.10
0.10
MG/L
1
Dissolved oxygen
Grab
SM5210B
1.0
7.75
MG/L
2
Nitrate/Nitrite
Composite
450ONO3F
0.05
25.00
MG/L
1
Total Kjeldahl nitrogen
Composite
4500NH3D
1.0
<1
MG/L
1
Total Phosphorus
Composite
SM450OP-F
0.05
5.60
MG/L
1
Total dissolved solids
Composite
SM2540C
1.0
0.00
MG/L
1
Hardness
Composite
SM2340C
1.0
100.00
MG/L
1
Chlorine (total residual, TRC)
Grab
SM4500CIG
15.0
<15
UG/L
1
Oil and grease Grab EPA1664A
Petals (total recoverable), cyanide and total pheno '
5.6
<5.6
MG/L
1
Antimony
Composite
EPA 200.7
10.0
6.00
UG/L
1
Arsenic
Composite
EPA 200.7
10.0
44.00
UG/L
1
Beryllium
Composite
EPA 200.7
5.0
N/D
UG/L
1
Cadmium
Composite
EPA 200.7
5.0
<5
UG/L
1
Chromium
Composite
EPA 200.7
5.0
<5
UG/L
1
Copper
Composite
EPA 200.7
10.0
6.00
UG/L
1
Lead
Composite
EPA 200.7
5.0
<5
UG/L
1
Mercury
Composite
EPA 245.1
0.20
<.2
UG/L
1
Nickel
Composite
EPA 200.7
5.0
42.00
UG/L
1
Selenium
Composite
EPA 200.7
10.0
<10
UG/L
1
Silver
Composite
EPA 200.7
5.0
<5
UG/L
1
Thallium
Composite
EPA 200.7
10.0
17.00
UG/L
1
Zinc
Composite
EPA 200.7
10.0
46.00
UG/L
1
Cyanide
Grab
EPA 200.7
5.0
<8
UG/L
1
Total phenolic compounds
Grab
EPA 420.4
0.005
<0.01
MG/L
1
Acrolein
Grab
624
5.0
N/D
UG/L
1
Acrylonitrile
Grab
624
50.0
N/D
UG/L
1
Benzene
Grab
624
2.0
N/D
UG/L
1
Bromoform
Grab
624
2.0
N / D
UG/ L
1
Carbon tetrachloride
Grab
624
2.0
N/D
UG/L
1
Chlorobenzene
Grab
624
2.0
N/D
UG/L
1
Chlorodibromomethane
Grab
624
2.0
16.20
UG/L
1
Chloroethane
Grab
624
2.0
N/D
UG/L
1
2-chloroethylvinyl ether
Grab
624
5.0
N/D
UG/L
1
Chloroform
Grab
624
2.0
25.10
UG/L
1
Dichlorobromomethane
Grab
624
2.0
7.30
UG/L
1
1, 1 -dichloroethane
Grab
624
2.0
N/D
UG/L
1
1,2-dichloroethane
Grab
624
2.0
N/D
UG/ =
1
Trans-l,2-dichloroethylene
Grab
624
2.0
N/D
UG/L
1 1
Form - DMR- PPA -1 Page 1

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Annual Monitoring and Pollutant Scan
Permit No. Month
Outfall Year
04ichlorophenyl phenyl ether
rame er:....... , _..
Grab
Samp
Type
625
M od
5.1
,,.....,s
N/D
esn
UG/L
easuremen
Ek
1
samp es:. ,
Chrysene
Grab
625
5.1
N/D
UG/L
1
Di -n -butyl phthalate
Grab
625
5.1
N/D
UG/L
1
Di-n-octyl phthalate
Grab
625
5.1
N/D
UG/L
1
Dibenzo(a,h)anthracene
Grab
625
5.1
N/D
UG/L
1
1,2 -dichlorobenzene
Grab
624
2.0
N/D
UG/L
1
1,3 -dichlorobenzene
Grab
624
2.0
N/D
UG/L
1
1,4 -dichlorobenzene
Grab
624
2.0
N/D
UG/L
1
3,3-dichlorobenzidine
Grab
625
25.5
N/D
UG/L
1
Diethyl phthalate
Grab
625
5.1
N/D
UG/L
1
Dimethyl phthalate
Grab
625
5.1
N/D
UG/L
1
2,4-dinitrotoluene
Grab
625
5.1
N/D
UG/L
1
2,6-dinitrotoluene
Grab
625
5.1
N/D
UG/L
1
1,2-diphenylhydrazine
Grab
625
5.1
N/D
UG/L
1
Fluoranthene
Grab
625
5.1
N/D
UG/L
1
Fluorene
Grab
625
5.1
N/D
UG/L
1
Hexachlorobenzene
Grab
625
5.1
N/D
UG/L
1
Hexachlorobutadiene
Grab
625
5.1
N/D
UG/L
1
Hexachlorocyclo-pentadiene
Grab
625
10.2
N/D
UG/L
1
Hexachloroethane
Grab
625
5.1
N/D
UG/L
1
Indeno(1,2,3-cd)pyrene
Grab
625
5.1
N/D
UG/L
1
Isophorone
Grab
625
10.2
N/D
UG/L
1
Naphthalene
Grab
625
5.1
N/D
UG/L
1
Nitrobenzene
Grab
625
5.1
N/D
UG/L
1
N-nitrosodi-n-propylamine
Grab
625
5.1
N/D
UG/L
1
N-nitrosodimethylamine
Grab
625
5.1
N/D
UG/L
1
N-nitrosodiphenylamine
Grab
625
10.2
N/D
UG/L
1
Phenanthrene
Grab
625
5.1
N/D
UG/L
1
ene
r12,,44,,-tri
Grab
625
5.1
N/D
UG/L
1
chlorobenzene
Grab
624
5.1
N/D
UG/L
1
I certify under penalty of law that this document and all attachments were prepared under my direction
and supervision in accordance with a system to design to assure that qualified perdonnel properly
gather and evaluat the information submitted. Based on my inquiry of the person or persons that
manage the system, or those persons directly responsibel 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.
Authorized Representative name
Signature
Form - DMR- PPA -1 Page 3

Permit No. KICgp20:13a
Outfall OI
Facility Name : Pilot Creek WWTP
Date of sampling : October 13, 2016
Annual Monitoring and Pollutant Scan
ORC : Richelle Meek
Phone :[phone]
Analytical Laboratory : K & W Labs and Pilot Creek WWTP Laboratory
Month DC_
Year 2Cllu
Ammonia (as N)
;7,.
TIL- e
Composite
Method
4500NH3C
Level _ _i
0.10
Result_ ,_
6.15
ffi . ureme t..=Omni _.:.,..
MG/L
l
1
Dissolved oxygen
Grab
SM5210B
1.0
8.40
MG/L
2
Nitrate/Nitrite
Composite
450ONO3F
0.05
15.00
MG/L
1
Total Kjeldahl nitrogen
Composite
4500NH3D
1.0
N/D
MG/L
1
Total Phosphorus
Composite
SM450OP-F
0.05
4.90
MG/L
1
Total dissolved solids
Composite
SM2540C
10.0
7.20
MG/L
1
Hardness
Composite
SM2340C
1.0
120.00
MG/L
1
Chlorine (total residual, TRC)
Grab
SM4500CIG
15.0
19.00
UG/L
1
Oil and grease
Grab
EPA1664A
6.2
N/D
MG/L
1
Antimony
Composite
EPA 200.7
2.0
N/D
UG/L
1
Arsenic
Composite
EPA 200.7
5.0
51.00
UG/L
1
Beryllium
Composite
EPA 200.7
1.0
N/D
UG/L
1
Cadmium
Composite
EPA 200.7
5.0
N/D
UG/L
1
Chromium
Composite
EPA 200.7
5.0
N/D
UG/L
1
Copper
Composite
EPA 200.7
10.0
N/D
UG/L
1
Lead
Composite
EPA 200.7
5.0
N/D
UG/L
1
Mercury
Composite
EPA 245.1
0.20
N/D
UG/L
1
Nickel
Composite
EPA 200.7
5.0
42.00
UG/L
1
Selenium
Composite
EPA 200.7
10.0
61.00
UG/L
1
Silver
Composite
EPA 200.7
5.0
N/D
UG/L
1
Thallium
Composite
EPA 200.7
2.0
N/D
UG/L
1
Zinc
Composite
EPA 200.7
5.0
0.31
UG/L
1
Cyanide
I Grab
I EPA 200.71
8.0
N/D
UG/L
1
Total phenolic compounds
Acrolein
Grab
Grab
EPA 420.41
624
0.01
5.0
1 0.02
N/D
MG/L
UG/L
1
1
Acrylonitrile
Grab
624
50.0
N/D
UG/L
1
Benzene
Grab
624
2.0
N/D
UG/L
1
Bromoform
Grab
624
2.0
2.60
UG/L
1
Carbon tetrachloride
Grab
624
2.0
N/D
UG/L
1
Chlorobenzene
Grab
624
2.0
N/D
UG/L
1
Chlorodibromomethane
Grab
624
2.0
8.10
UG/L
1
Chloroethane
Grab
624
2.0
N/D
UG/L
1
2-chloroethylvinyl ether
Grab
624
5.0
N/D
UG/L
1
Chloroform
Grab
624
2.0
3.90
UG/L
1
Dichlorobromomethane
Grab
624
2.0
7.70
UG/L
1
1,1-dichloroethane
Grab
624
2.0
N/D
UG/L
1
1,2-dichloroethane
Grab
1 624
2.0
1 N/D
UG/L
1
Trans-l,2-dichloroethylene
Grab
1 624
2.0
1 N/D
UG/L
1
Form - DMR- PPA -1 Page 1

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4.

Annual Monitoring and Pollutant Scan
Permit No.
Outfall
Month
Year
"""`'
Sample
Type
Analytical
Method
Quantitation
Level
Sample
Result
Units o
Measureme
Number of
samples
4Pa
Grab
625
5.0
N/D
UG/L
0111L—
1
Di -n -butyl phthalate
Grab
625
5.0
N/D
UG/L
1
Di-n-octyl phthalate
Grab
625
5.0
N/D
UG/L
1
Dibenzo(a,h)anthracene
Grab
625
5.0
N/D
UG/L
1
1,2 -dichlorobenzene
Grab
624
2.0
N/D
UG/L
1
1,3 -dichlorobenzene
Grab
624
2.0
N/D
UG/L
1
1,4 -dichlorobenzene
Grab
624
2.0
N/D
UG/L
1
3,3-dichlorobenzidine
Grab
625
25.0
N/D
UG/L
1
Diethyl phthalate
Grab
625
5.0
N/D
UG/L
1
Dimethyl phthalate
Grab
625
5.0
N/D
UG/L
1
2,4-dinitrotoluene
Grab
625
5.0
N/D
UG/L
1
2,6-dinitrotoluene
Grab
625
5.0
N/D
UG/L
1
1,2-diphenylhydrazine
Grab
625
5.1
N/D
UG/L
1
Fluoranthene
Grab
625
5.0
N/D
UG/L
1
Fluorene
Grab
625
5.0
N/D
UG/L
1
Hexachlorobenzene
Grab
625
5.0
N/D
UG/L
1
Hexachlorobutadiene
Grab
625
5.0
N/D
UG/L
1
Hexachlorocyclo-pentadiene
Grab
625
10.0
N/D
UG/L
1
Hexachloroethane
Grab
625
5.0
N/D
UG/L
1
Indeno(1,2,3-cd)pyrene
Grab
625
5.0
N/D
UG/L
1
Isophorone
Grab
625
10.0
N/D
UG/L
1
Naphthalene
Grab
625
5.0
N/D
UG/L
1
Nitrobenzene
Grab
625
5.0
N/D
UG/L
1
N-nitrosodi-n-propylamine
Grab
625
5.0
N/D
UG/L
1
N-nitrosodimethylamine
Grab
625
5.0
N/D
UG/L
1
N-nitrosodiphenylamine
Grab
625
10.0
N/D
UG/L
1
Phenanthrene
Grab
625
5.0
N/D
UG/L
1
Pyrene
Grab
625
5.0
N/D
UG/L
1
1,2,4,-trichlorobenzene
Grab
624
5.0
N/D
UG/L
1
I certify under penalty of law that this document and all attachments were prepared under my direction
and supervision in accordance with a system to design to assure that qualified perdonnel properly
gather and evaluat the information submitted. Based on my inquiry of the person or persons that
manage the system, or those persons directly responsibel 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.
Authorized Representative name
Signature
Date
Form - DMR- PPA -1 Page 3

Annual Monitoring and Pollutant Scan
Permit No. &It 0020a3a- Month T w
Outfall 0 1 Year 7014
Facility Name: Pilot Creek WWTP
Date of sampling: July 20, 2017
ORC : Richelle Meek
Phone : [phone]
Analytical Laboratory : K & W Labs and Pilot Creek WWTP Laboratory
Ammonia (as N)
Composite
moth"
4500NH3C
,JAWV1
0.10
Result
<0.1
1!%s>s=01�4t1�tt
MG/L
sam s3s
1
Dissolved oxygen
Grab
SM5210B
1.0
6.50
MG/L
2
Nitrate/Nitrite
Composite
450ONO3F
0.05
29.00
MG/L
1
Total Kjeldahl nitrogen
Composite
4500NH31)
1.0
<1
MG/L
1
Total Phosphorus
Composite
SM450OP-F
0.05
3.50
MG/L
1
Total dissolved solids
Composite
SM2540C
10.0
1151.00
MG/L
1
Hardness
Composite
SM2340C
1 1.0
140.00
MG/L
1
Chlorine (total residual, TRC)
Grab
SM4500CIG
15.0
18.00
UG/L
1
Oil and grease
Antimony
Grab
Composite
EPA1664A
EPA 200.7
6.2
2.0
<6.2
3.00
MG/L
UG/L
1
1
Arsenic
Composite
EPA 200.7
5.0
155.00
UG/L
1
Beryllium
Composite
EPA 200.7
1.0
N/D
UG/L
1
Cadmium
Composite
EPA 200.7
5.0
<5
UG/L
1
Chromium
Composite
EPA 200.7
5.0
<5
UG/L
1
Copper
Composite
EPA 200.7
10.0
<5
UG/L
1
Lead
Composite
EPA 200.7
5.0
<5
UG/L
1
Mercury
Composite
EPA 245.1
0.20
N/D
UG/L
1
Nickel
Composite
EPA 200.7
5.0
26.00
UG/L
1
Selenium
Composite
EPA 200.7
10.0
11.00
UG/ L
1
Silver
Composite
EPA 200.7
5.0
<5
UG/L
1
Thallium
Composite
EPA 200.7
2.0
30.30
UG/L
1
Zinc
Composite
EPA 200.7
5.0
12.00
UG/L
1
Cyanide
Grab
EPA 200.7
8.0
<8
UG/L
1
Total phenolic compounds
Grab
EPA 420.4
0.01
0.01
MG/L
1
,Volatile organic compounds
Acrolein
Grab
624
5.0
N/D
UG/L
1
Acrylonitrile
Grab
624
50.0
N/D
UG/L
1
Benzene
Grab
624
2.0
N/D
UG/L
1
Bromoform
Grab
624
2.0
N/D
UG/L
1
Carbon tetrachloride
Grab
624
2.0
N/D
UG/L
1
Chlorobenzene
Grab
624
2.0
N/D
UG/L
1
Chlorodibromomethane
Grab
624
2.0
18.20
UG/L
1
Chloroethane
Grab
624
2.0
N/D
UG/L
1
2-chloroethylvinyl ether
Grab
624
5.0
N/D
UG/L
1
Chloroform
Grab
624
2.0
16.70
UG/L
1
Dichlorobromomethane
Grab
624
2.0
9.60
UG/L
1
1,1-dichloroethane
Grab
624
2.0
N/D
UG/L
1
1,2-dichloroethane
Grab
624
2.0
N/D
UG/L
1
Trans-1,2-dichloroethylene
Grab
624
2.0
N/D
UG/L
1
Form - DMR- PPA -1 Page 1

Annual Monitoring and Pollutant Scan
Permit No. Month
Outfall Year
rameter
Sample
Type
Analytical
Method
Quantitation
Level
Sample
Result
Units of
Measurement
Number o
samples -sJ
1,1-dichloroethylene Grab
624 2.0 N/D UG/L
1
1,2-dichloropropane
Grab
624
2.0
N/D
UG/L
1
1,3-dichloropropylene
Grab
624
2.0
N/D
UG/L
1
Ethylbenzene
Grab
624
2.0
N/D
UG/L
1
Methyl bromide
Grab
624
2.0
N/D
UG/L
1
Methyl chloride
Grab
624
2.0
N/D
UG/L
1
Methylene chloride
Grab
624
2.0
N/D
UG/L
1
1,1,2,2 -tetrachloroethane
Grab
624
2.0
N/D
UG/L
1
Tetrachloroethylene
Grab
624
2.0
N/D
UG/L
1
Toluene
Grab
624
2.0
N/D
UG/L
1
1,1,1 -trichloroethane
Grab
624
2.0
N/D
UG/L
1
1,1,2 -trichloroethane
Grab
624
2.0
N/D
UG/L
1
Trichloroethylene
Grab 1
624 1
2.0 1
N/D
UG/L I1
Vinyl chlorid I
P-chloro-m-creso
Grab
Grab
624
625
2.0
5.1
N/D
N/D
UG/L
UG/L
1
1
2 -chlorophenol
Grab
625
5.0
N/D
UG/L
1
2,4-dichlorophenol
Grab
625
5.0
N/D
UG/L
1
2,4 -dimethylphenol
Grab
625
10.0
N/D
UG/L
1
4,6-dinitro-o-cresol
Grab
625
20.0
N/D
UG/L
1
2,4-dinitrophenol
Grab
625
50.0
N/D
UG/L
1
2-nitrophenol
Grab
625
5.0
N/D
UG/L
1
4-nitrophenol
Grab
625
50.0
N/D
UG/L
1
Pentachlorophenol I
Grab
625
10.0
N/D
UG/L 1
1
Phenol I
Grab
625
5.0
N/D
UG/L 1
1
2,4,6 -trichlorophenol I
Grab
625
10.0
N/D
UG/L
1
Acenaphthene
Grab
625
5.0
N/D
UG/L
1
Acenaphthylene
Grab
625
5.0
N/D
UG/L
1
Anthracene
Grab
625
5.0
N/D
UG/L
1
Benzidine
Grab
625
50.0
N/D
UG/L
1
Benzo(a)anthracene
Grab
625
5.0
N/D
UG/L
1
Benzo(a)pyrene
Grab
625
5.0
N/D
UG/L
1
3,4 benzofluoranthene
Grab
625
5.0
N/D
UG/L
1
Benzo(ghi)perylene
Grab
625
5.0
N/D
UG/L
1
Benzo(k)fluoranthene
Grab
625
5.0
N/D
UG/L
1
Bis (2-chloroethoxy) methane
Grab
625
10.0
N/D
UG/L
1
Bis (2-chloroethyl) ether
Grab
625
5.0
N/D
UG/L
1
Bis (2-chloroisopropyl) ether
Grab
625
5.0
N/D
UG/L
1
Bis (2-ethylhexyl) phthalate
Grab
625
5.0
N/D
UG/L
1
4-bromophenyl phenyl ether
Grab
625
5.0
N/D
UG/L
1
Butyl benzyl phthalate
Grab
625
5.0
N/D
UG/L
1
2-chloronaphthalene
Grab
625
5.0
N/D
UG/L
1
4-chlorophenyl phenyl ether
Grab
625
5.0
N/D
UG/L7
1
Form - DMR- PPA -1 Page 2

Annual Monitoring and Pollutant Scan
Permit No.
Outfall
Month
Year
I certify under penalty of law that this document and all attachments were prepared under my direction
and supervision in accordance with a system to design to assure that qualified perdonnel properly
gather and evaluat the information submitted. Based on my inquiry of the person or persons that
manage the system, or those persons directly responsibel 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.
Authorized Representative name
Signature
Date
Form - DMR- PPA -1 Page 3
;'Analyti
Method
,Quantitation
Level
Sample
Result
is o _
Me ' uremea
of
_._. es
Chrysene
Grab
625
5.0
N/D
UG/L
1
Di -n -butyl phthalate
Grab
625
5.0
N/D
UG/L
1
Di-n-octyl phthalate
Grab
625
5.0
N/D
UG/L
1
Dibenzo(a,h)anthracene
Grab
625
5.0
N/D
UG/L
1
1,2 -dichlorobenzene
Grab
624
2.0
N/D
UG/L
1
1,3 -dichlorobenzene
Grab
624
2.0
N/D
UG/L
1
1,4 -dichlorobenzene
Grab
624
2.0
N/D
UG/L
1
3,3-dichlorobenzidine
Grab
625
25.0
N/D
UG/L
1
Diethyl phthalate
Grab
625
5.0
N/D
UG/L
1
Dimethyl phthalate
Grab
625
5.0
N/D
UG/L
1
2,4-dinitrotoluene
Grab
625
5.0
N/D
UG/L
1
2,6-dinitrotoluene
Grab
625
5.0
N/D
UG/L
1
1,2-diphenylhydrazine
Grab
625
5.1
N/D
UG/L
1
Fluoranthene
Grab
625
5.0
N/D
UG/L
1
Fluorene
Grab
625
5.0
N/D
UG/L
1
Hexachlorobenzene
Grab
625
5.0
N/D
UG/L
1
Hexachlorobutadiene
Grab
625
5.0
N/D
UG/L
1
Hexachlorocyclo-pentadiene
Grab
625
10.0
N/D
UG/L
1
Hexachloroethane
Grab
625
5.0
N/D
UG/L
1
Indeno(1,2,3-cd)pyrene
Grab
625
5.0
N/D
UG/L
1
Isophorone
Grab
625
10.0
N/D
UG/L
1
Naphthalene
Grab
625
5.0
N/D
UG/L
1
Nitrobenzene
Grab
625
5.0
N/D
UG/L
1
N-nitrosodi-n-propylamine
Grab
625
5.0
N/D
UG/L
1
N-nitrosodimethylamine
Grab
625
5.0
N/D
UG/L
1
N-nitrosodiphenylamine
Grab
625
10.0
N/D
UG/L
1
Phenanthrene
Grab
625
5.0
N/D
UG/L
1
Pyrene
Grab
625
5.0
N/D
UG/L
1
1,2,4,-trichlorobenzene
Grab
624
5.0
N/D
UG/L
1
I certify under penalty of law that this document and all attachments were prepared under my direction
and supervision in accordance with a system to design to assure that qualified perdonnel properly
gather and evaluat the information submitted. Based on my inquiry of the person or persons that
manage the system, or those persons directly responsibel 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.
Authorized Representative name
Signature
Date
Form - DMR- PPA -1 Page 3