NC0039420_Renewal Application_20180807

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ROY COOPER NORTH CAROLINA
Gov rear Environmental Quality
MICHAEL S_REGAN
Secretary
LINDA CULPEPPER
Interim Director
August 21, 2018
Allen Campbell
Virginia DOT
1401 E Broad St
Richmond, VA 23219
Subject: Permit Renewal
Application No. NC0039420
Virginia DOT/I-77 Rest Area
Surry County
Dear Applicant:
The Water Quality Permitting Section acknowledges the August 13, 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://deq.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,jtVIVOAM
^
Wren Thedford
Administrative Assistant
Water Quality Permitting Section
cc: Central Files w/application
ec: WQPS Laserfiche File w/application
DEQ
North Carolina Department of Environmental Quality I Division of Water Resources
1617 Mail Service Center I Raleigh,North Carolina 27699-1617
919-807-6300

f
Bowman
C O N S LJ L A i N G
August 7, 2018
Mr.John Hennessy RECEIVED(DENRIDWR
NPDES Water Permit Writer AUG 13 2018
N.C. Department of Environment and Natural Resources
Waterrces
Division of Water Quality/ NPDES Unit erm t ingReSection
Section
1617 Mail Service Center,
Raleigh, NC 27699-1617
Re: VDOT I-77 Rest Area WWTP—Carroll County, Virginia (NPDES NC0039420)
NPDES Permit Renewal Application
BCG Project#008129-04-001
Dear Mr. Hennessy:
On behalf of VDOT, please see the attached NPDES permit renewal application for the above
referenced facility.
If you should have any questions comments, please send them directly to me. I can be reached
at 757-229-1776. You can also send me an email at [e-mail].
Sincerely,
BOWMAN CONSULTING GROUP, LTD.
Jessica M. Kwiatkowski, P.E.
Senior Project Manager
Cc: Mr. Allen Campbell, VDOT (Letter Only)
460 McLaws Circle,Suite 120,Williamsburg,VA 23185 0
p: 757.229.1776 I f: 757.229.4683
www.bowmanconsulting.com

NPDES APPLICATION FOR PERMIT RENEWAL - FORM A
For Publicly Owned Treatment Works (POTW) or other treatment systems treating
domestic wastes < 0.1 MGD with no pretreatment program.
Mail the complete application to:
N. C. Department of Environment and Natural Resources
Division of Water Quality / NPDES Unit
1617 Mail Service Center, Raleigh, NC 27699-1617
NPDES Permit NC0039420
If you are completing this form in computer use the TAB key or the up - down arrows to move from one
field to the next. To check the boxes, click your mouse on top of the box. Otherwise,please print or type.
1. Contact Information:
Owner Name Virginia Department of Transportation
Facility Name I-77 Rest Area WWTP
Mailing Address 1401 E. Broad Street,
City Richmond
State / Zip Code Virginia 23219-2000
Telephone Number [phone]
Fax Number ( )
e-mail Address [e-mail]
2. Location of facility producing discharge:
Check here if same address as above ❑
Street Address or State Road I-77 Rest Area, Mile 0 on I-77, Near the NC/VA State Line
City Lambsburg
State / Zip Code Virginia / 24351
County Carroll County, VA / Surry County, NC
3. Operator Information:
Name of the firm, public organization or other entity that operates the facility. (Note that this is not
referring to the Operator in Responsible Charge or ORC)
Name Pioneer Electric Contractors- Jeff Cash
Mailing Address 1952 Magnolia Avenue
City Buena Vista
State / Zip Code Virginia 24416
Telephone Number [phone]
Fax Number [phone]
4. Population served: 2,400
1 of 3 Form-A 1/06

NPDES APPLICATION FOR PERMIT RENEWAL - FORM A
For Publicly Owned Treatment Works (POTW) or other treatment systems treating
domestic wastes < 0.1 MGD with no pretreatment program.
5. Do you receive industrial waste?
® No ❑ Yes (if you have an approved pre-treatment program, must complete Form 2A)
6. Type of collection system
® Separate (sanitary sewer only) 0 Combined (storm sewer and sanitary sewer)
7. Outfall Information:
Number of separate discharge points 1
Outfall Identification number(s) 001
Is the outfall equipped with a diffuser? ❑ Yes ® No
8. Name of receiving stream(s) (Provide a map showing the exact location of each outfall):
Naked Run Creek, Upper Yadkin-Pee Dee River Basin
9. Frequency of Discharge: ® Continuous El Intermittent
If intermittent:
Days per week discharge occurs: Duration:
10.Describe the treatment system
List all installed components, including capacities,provide design removal for BOD, TSS, nitrogen and
phosphorus. If the space provided is not sufficient, attach the description of the treatment system in a
separate sheet of paper.
The plant is a secondary treatment process utilizing the extended aeration/activated
sludge process. Effluent is subjected to ultra-violet disinfection, chlorine and then de-
chlorination and re-aeration prior to discharge. Treated effluent is discharged to Naked
Run Creek in the Yadkin-Pee Dee River basin. The wastewater treatment plant is
permitted for an average flow rate of 20,000 gpd.
11. Flow Information:
Treatment Plant Design flow 0.02 MGD
Annual Average daily flow 0.0072 MGD (for the previous 3 years)
' Maximum daily flow 0.01 MGD (for the previous 3 years)
12. Is this facility located on Indian country?
❑ Yes ® No
2 of 3 Form-A 1/06

NPDES APPLICATION FOR PERMIT RENEWAL - FORM A
For Publicly Owned Treatment Works (POTW) or other treatment systems treating
domestic wastes < 0.1 MGD with no pretreatment program.
13. Effluent Data
Provide data for the parameters listed.Fecal Coliform, Temperature and pH shall be grab samples,for all other
parameters 24-hour composite sampling shall be used. Effluent testing data must be based on at least three samples
and must be no more than four and one half years old.
Parameter Daily Monthly Units of Number of
Maximum Average Measurement Samples
Biochemical Oxygen Demand 18.3 7.14 mg/L 77
(BODS)
Fecal Coliform 2420 5.46 N/CmL 77
Total Suspended Solids 17.3 5.48 mg/L 77
Temperature (Summer) 25 20.2 Celcius 77
Temperature (Winter) 17 11.7 Celcius 77
pH 7.6-8.2 N/A S.U. N/A
14. List all permits, construction approvals and/or applications:
Type Permit Number Type Permit Number
Hazardous Waste (RCRA) NESHAPS (CAA)
UIC (SDWA) Ocean Dumping (MPRSA)
NPDES NC0039420 Dredge or fill (Section 404 or CWA)
PSD (CAA) Special Order of Consent (SOC)
Non-attainment program (CAA) Other
15. APPLICANT CERTIFICATION
I certify that I am familiar with the information contained in the application and that to the
best of my knowledge and belief such information is true, complete, and accurate.
Allen Campbell SRA Infrastructure PM
Printed name of Person Signing Title
C24477) ( , (01 7 --i8'
Signature of Applicant Date
North Carolina General Statute 143-215.6 (b)(2) states: Any person who knowingly makes any false statement
representation, or certification in any application, record, report, plan, or other document files or required to be
maintained under Article 21 or regulations of the Environmental Management Commission implementing that
Article, or who falsifies, tampers with, or knowly renders inaccurate any recording or monitoring device or method
required to be operated or maintained under Article 21 or regulations of the Environmental Management
Commission implementing that Article, shall be guilty of a misdemeanor punishable by a fine not to exceed
$25,000, or by imprisonment not to exceed six months, or by both. (18 U.S.C. Section 1001 provides a
punishment by a fine of not more than $25,000 or impnsonment not more than 5 years, or both, for a similar
offense.)
3 of 3 Form-A 1/06

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FACILITY NAME AND PERMIT NUMBER: Form Approved 1/14/99
OMB Number 2040-0086
VDOT 1-77 Rest Area WWTP NC0039420
2A :NPDES;:F0 °¢ :#
RIVI{.2�1��APP�LICAI'I:O N�O\OE RVIE1IV.
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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 andC. Applicants with=a design flowgreater thanor: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. a
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>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 1 mgd,
2. Is required to have a pretreatment program(or has one in place), or
3. Is otherwise required by the permitting authority to provide the information
E. Toxicity Testing Data. A treatment works that meets one or more of the following criteria must complete Part E (Toxicity
Testing Data).
1. Has a design flow rate greater than or equal to 1 mgd,
2 Is required to have a pretreatment program(or has one in place), or
3. Is otherwise required by the permitting authority to submit results of toxicity testing
F. Industrial User Discharges and RCRA/CERCLA Wastes. A treatment works that accepts process wastewater from any
significant industrial users(Sills)or receives RCRA or CERCLA wastes must complete Part F(Industrial User Discharges and
RCRA/CERCLA Wastes) Sills 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 FC°(CERTIFICATION
EPA Form 3510-2A(Rev 1-99) Replaces EPA forms 7550-6&7550-22 Page 1 of 21

FACILITY NAME AND PERMIT NUMBER: Form Approved 1/14/99
VDOT 1-77 Rest Area WWTP NC0039420 OMB Number 2040-00e6
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.1. Facility Information.
Facility name VDOT 1-77 Rest Area WWTP
Mailing Address 1401 E Broad Street
Richmond,Virginia 23219-2000
Contact person Allen A Campbell
Title Safety Rest Area Infrastructure Program Manager,VDOT Maintenance Division
Telephone number [phone]
Facility Address 1-77 Rest Area WWTP. Mile Marker 0.near the NCNA State Line. Lambsburg.Virginia 24351
(not P 0 Box)
A.2. Applicant Information. If the applicant is different from the above,provide the following
Applicant name
Mailing Address
Contact person
Title
Telephone number
Is the applicant the owner or operator(or both)of the treatment works?
✓ owner operator
Indicate whether correspondence regarding this permit should be directed to the facility or the applicant
facility ✓ applicant
A.3. Existing Environmental Permits. Provide the permit number of any existing environmental permits that have been issued to the treatment
works(include state-issued permits)
NPDES NC0039420 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
Lambsburg 1-77 SRA 2,400 Separate State-VDOT
Total population served 2,400
EPA Form 3510-2A(Rev 1-99) Replaces EPA forms 7550-6&7550-22 Page 2 of 21

FACILITY NAME AND PERMIT NUMBER: Form Approved 1/14/99
OMB Number 2040-0086
VDOT 1-77 Rest Area WWTP NC0039420
A.5. Indian Country
a Is the treatment works located in Indian Country?
Yes ✓ No
b Does the treatment works discharge to a receiving water that is either in Indian Country or that is upstream from(and eventually flows
through)Indian Country?
Yes If 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 12th month of"this year"occurring no more than three months prior to this application submittal
a Design flow rate 0 02 mgd
Two Years Aqo Last Year This Year
b Annual average daily flow rate 0 007804 0 006278 0 007038 mgd
c Maximum daily flow rate 0.041 0.0227 0.022 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
ISeparate 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 9 ✓ 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
Annual average daily volume discharged to surface impoundment(s) mgd
Is discharge continuous or intermittent?
c Does the treatment works land-apply treated wastewater? Yes I No
If yes,provide the following for each land application site
Location
Number of acres
Annual average daily volume applied to site Mgd
Is land application continuous or intermittent?
d Does the treatment works discharge or transport treated or untreated wastewater to another
treatment works? Yes ✓ No
EPA Form 3510-2A(Rev 1-99) Replaces EPA forms 7550-6&7550-22 Page 3 of 21

FACILITY NAME AND PERMIT NUMBER: Form Approved 1/14/99
VDOT 1-77 Rest Area WWTP NC0039420 OMB Number 2040-0086
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)
If transport is by a party other than the applicant,provide
Transporter name
Mailing Address
Contact person
Title
Telephone number
For each treatment works that receives this discharge,provide the following
Name
Mailing Address
Contact person
Title
Telephone number
If known,provide the NPDES permit number of the treatment works that receives this discharge
Provide the average daily flow rate from the treatment works into the receiving facility mgd
e Does the treatment works discharge or dispose of its wastewater in a manner not included in
A 8 a through A 8 d above(e.g,underground percolation,well injection)' Yes ✓ No
If yes,provide the following for each disposal method
Description of method(including location and size of site(s)if applicable)
Annual daily volume disposed of by this method
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 21

FACILITY NAME AND PERMIT NUMBER: Form Approved 1/14/99
VDOT 1-77 Rest Area WWTP NC0039420 OMB Number 2040-0086
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
b Location 1-77, Mile Marker 0, near the NC/VA State Line 24351
(City or town,if applicable) (Zip Code)
Carroll County,Virginia VA
(County) (State)
36 33 0.65(36 564069) 8044 36 36(-80.743434)
(Latitude) (Longitude)
c Distance from shore(if applicable) NA ft
d Depth below surface(if applicable) NA ft
e Average daily flow rate 0 00 mgd
f Does this outfall have either an intermittent or a
periodic discharge?
Yes No (go to A 9.g.)
If yes,provide the following information
Number of times per year discharge occurs
Average duration of each discharge
Average flow per discharge mgd
Months in which discharge occurs
g Is outfall equipped with a diffuser? Yes ✓ No
A.10.Description of Receiving Waters.
a Name of receiving water Naked Run Creek
b Name of watershed(if known) Upper Yadkin River
United States Soil Conservation Service 14-digit watershed code(if known) Unknown
c Name of State Management/River Basin(if known) Yadkin-Pee Dee River Basin
United States Geological Survey 8-digit hydrologic cataloging unit code(if known) 02111000
d Critical low flow of receiving stream(if applicable)
acute 0.0 cfs chronic 0 0 cfs
e Total hardness of receiving stream at critical low flow(if applicable) NA mg/I of CaCO3
EPA Form 3510-2A(Rev.1-99) Replaces EPA forms 7550-6&7550-22. Page 5 of 21

FACILITY NAME AND PERMIT NUMBER: Form Approved 1/14/99
\/DOT 1-77 Rest Area WWTP NC0039420 OMB Number 2040-0086
A.11.Description of Treatment.
a What levels of treatment are provided?Check all that apply
Primary / Secondary
✓ Advanced Other Describe
b Indicate the following removal rates(as applicable)
Design BODS removal or Design CBOD5 removal 95
Design SS removal 95 %
Design P removal NA
Design N removal NA
Other
c What type of disinfection is used for the effluent from this outfall?If disinfection varies by season,please describe
Ultra-violet and Chlorination
If disinfection is by chlorination,is dechlorination used for this outfall? ✓ Yes No
d Does the treatment plant have post aeration? ✓ Yes No
A.12.Effluent Testing Information. All Applicants that discharge to waters of the US must provide effluent testing data for the following
parameters.Provide the indicated effluent testing required by the permitting authority for each outfall through which effluent is
discharged. Do not include information on combined sewer overflows in this section.All information reported must be based on data
collected through analysis conducted using 40 CFR Part 136 methods. In addition,this data must comply with QA/QC requirements
of 40 CFR Part 136 and other appropriate QA/QC requirements for standard methods for analytes not addressed by 40 CFR Part 136.
At a minimum,effluent testing data must be based on at least three samples and must be no more than four and one-half years apart.
Outfall number 001
PARAMETER MAXIMUM DAILY VALUE AVERAGE DAILY VALUE
Value Units Value Units Number of Samples
7 6
pH(Minimum) s u f. r•�_ -'T '
pH(Maximum) 8 2 s u yam; ,u. , ,=F. ''m« a £ °• ,aux u;ma = ,;
Flow Rate 0.0227 MGD 0.006532 MGD 546
Temperature(Winter) 17 Celcius 11.7 Celcuis 77
Temperature(Summer) 25 Celcius 20 2 Celcius 77
*For pH please report a minimum and a maximum daily value
POLLUTANT MAXIMUM DAILY AVERAGE DAILY DISCHARGE ANALYTICAL ML/MDL
DISCHARGE METHOD
Conc. Units Conc. Units Number of
Samples
CONVENTIONAL AND NONCONVENTIONAL COMPOUNDS.
BIOCHEMICAL OXYGEN BOD-5 18.3 mg/L 7.14 mg/L 77 SM 5210B 2 0
DEMAND(Report one) CBOD-5
FECAL COLIFORM 2420 N/CmL 5.46 N/CmL 77 SM 9223 1 0
TOTAL SUSPENDED SOLIDS(TSS) 17.3 mg/L 5 48 mg/L 77 SM 2540D 5.0
END OF PART A.
REFER TO THE APPLICATION OVERVIEW 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 6 of 21

FACILITY NAME AND PERMIT NUMBER: Form Approved 1/14/99
OMB Number 2040-0086
VDOT 1-77 Rest Area WWTP NC0039420
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). NOT APPLICABLE ,
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
gpd -
Briefly explain any steps underway or planned to minimize inflow and infiltration
B.2. Topographic Map. Attach to this application a topographic map of the area extending at least one mile beyond facility property boundaries
This map must show the outline of the facility and the following information (You may submit more than one map if one map does not show
the entire area)
a The area surrounding the treatment plant,including all unit processes
b The major pipes or other structures through which wastewater enters the treatment works and the pipes or other structures through which
treated wastewater is discharged from the treatment plant Include outfalls from bypass piping,if applicable
c Each well where wastewater from the treatment plant is injected underground
d Wells,springs,other surface water bodies,and drinking water wells that are 1)within 1/4 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 that 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 redundancy 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 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
Mailing Address
Telephone Number
Responsibilities of Contractor
B.5. Scheduled Improvements and Schedules of Implementation. Provide information on any uncompleted implementation schedule or
uncompleted plans for improvements that will affect the wastewater treatment,effluent quality,or design capacity of the treatment works If the
treatment works has several different implementation schedules or is planning several improvements,submit separate responses to question
B 5 for each (If none,go to question B 6)
a List the outfall number(assigned in question A 9)for each outfall that is covered by this implementation schedule
b Indicate whether the planned improvements or implementation schedule are required by local,State,or Federal agencies
Yes No
EPA Form 3510-2A(Rev. 1-99) Replaces EPA forms 7550-6&7550-22 Page 7 of 21

FACILITY NAME AND PERMIT NUMBER: Form Approved 1/14/99
OMB Number 2040-0086
VDOT 1-77 Rest Area WWTP NC0039420
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 / / _1 /
e Have appropriate permits/clearances concerning other Federal/State requirements been obtained? Yes No
Describe briefly
B.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 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
pollutant scans and must be no more than four and one-half years old
Outfall Number
POLLUTANT , MAXIMUM DAILY , AVERAGE DAILY DISCHARGE -
DISCHARGE
Conc. , Units' ;Conc Units= Number'of ANALYTICAL ML/MDL
Samples METHOD
CONVENTIONAL AND NONCONVENTIONAL COMPOUNDS.
AMMONIA(as N)
CHLORINE(TOTAL
RESIDUAL,TRC)
DISSOLVED OXYGEN
TOTAL KJELDAHL
NITROGEN(TKN)
NITRATE PLUS NITRITE
NITROGEN
OIL and GREASE
PHOSPHORUS(Total)
TOTAL DISSOLVED
SOLIDS(TDS)
OTHER
, END'OF PART B.
REFER TO THEAPPLICATION OVERVIEW°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 8 of 21

FACILITY NAME AND PERMIT NUMBER: Form Approved 1/14/99
OMB Number 2040-0086
VDOT 1-77 Rest Area 1NWTP NC0039420
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:
I Basic Application Information packet Supplemental Application Information packet
Part D(Expanded Effluent Testing Data)
Part E(Toxicity Testing Biomonitoring Data)
Part F(Industrial User Discharges and RCRA/CERCLA Wastes)
Part G(Combined Sewer Systems)
ALL APPLICANTS MUST COMPLETE THE FOLLOWING CERTIFICATION.
I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system
designed to assure that qualified personnel 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 Allen A Campbell,SRA Infrastructure Program Manager,VDOT Maintenance Div
`
Signature ( , a,,a4()
Telephone number [phone]
Date signed 0^ / / q
Upon request of the permitting authority,you must submit any other information necessary to assess wastewater treatment practices at the treatment
works or identify appropriate permitting requirements
SEND COMPLETED FORMS TO:
EPA Form 3510-2A(Rev 1-99) Replaces EPA forms 7550-6&7550-22. Page 9 of 21

FACILITY NAME AND PERMIT NUMBER: Form Approved 1/14/99
VDOT 1-77 Rest Area WWTP NC0039420 OMB Number 2040-0086
SUPPLEMENTAL APPLICATION INFORMATION
PART D. EXPANDED EFFLUENT TESTING DATA NOT APPLICABLE
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 Treatment 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 (Complete once for each outfall discharging effluent to waters of the United States)
POLLUTANT MAXIMUM DAILY AVERAGE DAILY DISCHARGE
DISCHARGE
Conc Units Mass Units Conc. Units Mass Units Number ANALYTICAL ML/MDL
of . METHOD
Samples
METALS(TOTAL RECOVERABLE),CYANIDE,PHENOLS,AND HARDNESS.
ANTIMONY
ARSENIC
BERYLLIUM
CADMIUM
CHROMIUM
COPPER
LEAD
MERCURY
NICKEL
SELENIUM
SILVER
THALLIUM
ZINC
CYANIDE
TOTAL PHENOLIC COMPOUNDS
HARDNESS(AS CaCO3)
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 21

FACILITY NAME AND PERMIT NUMBER: Form Approved 1/14/99
VDOT 1-77 Rest Area WWTP NC0039420 OMB Number 2040-0086
Outfall number (Complete once for each outfall discharging effluent to waters of the United States)
POLLUTANT ' ',MAXIMUM DAILY - = AVERAGE:DAILY DISCHARGE=
DISCHARGE_ '_ .
Conc "Units Mass Units Conc., ,Units Mass Units .Number, ANALYTICAL MU MDL.
`of METHOD-
Samples •
VOLATILE ORGANIC COMPOUNDS.
ACROLEIN
ACRYLONITRILE
BENZENE
BROMOFORM
CARBON TETRACHLORIDE
CLOROBENZENE
CHLORODIBROMO-METHANE
CHLOROETHANE
2-CHLORO-ETHYLVINYL
ETHER
CHLOROFORM
DICHLOROBROMO-METHANE
1,1-DICHLOROETHANE
1,2-DICHLOROETHANE
TRANS-1,2-D I CH LO RO-ETHYLE N E
1,1-DICHLOROETHYLENE
1,2-DICHLOROPROPANE
1,3-DICHLORO-PROPYLENE
ETHYLBENZENE
METHYL BROMIDE
METHYL CHLORIDE
METHYLENE CHLORIDE
1,1,2,2-TETRACHLORO-ETHANE
TETRACHLORO-ETHYLENE
TOLUENE
EPA Form 3510-2A(Rev 1-99) Replaces EPA forms 7550-6&7550-22 Page 11 of 21

FACILITY NAME AND PERMIT NUMBER: Form Approved 1/14/99
VDOT 1-77 Rest Area WWTP NC0039420 OMB Number 2040-0086
Outfall number (Complete once for each outfall discharging effluent to waters of the United States)
POLLUTANT MAXIMUM DAILY AVERAGE,DAILY'DISCHARGE
. DISCHARGE _
t Conc.' Units Mass`" Units= :Cone. Units, 'Mass° Units. .Number ANALYTICAL ML/MDL
of ° METHOD
e Samples ..
1,1,1-TRICHLOROETHANE
1,1,2-TRICHLOROETHANE
TRICHLORETHYLENE
VINYL CHLORIDE
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
2-CHLOROPHENOL
2,4-DICHLOROPHENOL
2,4-DIMETHYLPHENOL
4,6-DINITRO-O-CRESOL
2,4-DINITROPHENOL
2-NITROPHENOL
4-NITROPHENOL
PENTACHLOROPHENOL
PHENOL
2,4,6-TRICHLOROPHENOL
Use this space(or a separate sheet)to provide information on other acid-extractable compounds requested by the permit writer
BASE-NEUTRAL COMPOUNDS.
ACENAPHTHENE
ACENAPHTHYLENE
ANTHRACENE
BENZIDINE
BENZO(A)ANTHRACENE
BENZO(A)PYRENE
EPA Form 3510-2A(Rev 1-99) Replaces EPA forms 7550-6&7550-22. Page 12 of 21

FACILITY NAME AND PERMIT NUMBER: Form Approved 1/14/99
VDOT 1-77 Rest Area WWTP NC0039420 OMB Number 2040-0086
Outfall number (Complete once for each outfall discharging effluent to waters of the United States)
POLLUTANT MAXIMUM DAILY AVERAGE DAILY DISCHARGE
DISCHARGE
Conc Units Mass Units Conc Units Mass Units Number ANALYTICAL ML/MDL
of METHOD
Samples
3,4 BENZO-FLUORANTHENE
BENZO(GHI)PERYLENE
BENZO(K)FLUORANTHENE
BIS(2-CHLOROETHOXY)
METHANE
BIS(2-CHLOROETHYL)-ETHER
BIS(2-CHLOROISO-PROPYL)
ETHER
BIS(2-ETHYLHEXYL)PHTHALATE
4-BROMOPHENYL PHENYL ETHER
BUTYL BENZYL PHTHALATE
2-CHLORONAPHTHALENE
4-CHLORPHENYL PHENYL ETHER
CHRYSENE
DI-N-BUTYL PHTHALATE
DI-N-OCTYL PHTHALATE
DIBENZO(A,H)ANTHRACENE
1,2-DICHLOROBENZENE
1,3-DICHLOROBENZENE
1,4-DICHLOROBENZENE
3,3-DICHLOROBENZIDINE
DIETHYL PHTHALATE
DIMETHYL PHTHALATE
2,4-DINITROTOLUENE
2,6-DINITROTOLUENE
1,2-DIPHENYLHYDRAZINE
EPA Form 3510-2A(Rev 1-99) Replaces EPA forms 7550-6&7550-22 Page 13 of 21

FACILITY NAME AND PERMIT NUMBER: Form Approved 1/14/99
OMB Number 2040-0086
VDOT 1-77 Rest Area WWTP NC0039420
Outfall number (Complete once for each outfall discharging effluent to waters of the United States)
POLLUTANT E .; ,. . . MAXIMUM DAILY - °`AVERAGE DAILY DISCHARGE - - ,
DISCHARGE _ _ ,
Conc Units Mass ,Units •Conc:' Units -Masse Units Number._ -'ANALYTICAL
of` METHOD 4
FLUORANTHENE
FLUORENE
HEXACHLOROBENZENE
HEXACHLOROBUTADIENE
HEXACHLOROCYCLO-
PENTADIENE
HEXACHLOROETHANE
INDENO(1,2,3-CD)PYRENE
ISOPHORONE
NAPHTHALENE
NITROBENZENE
N-N ITROSO DI-N-PROPYLAM I NE
N-NITROSODI-METHYLAMINE
NI-NITROSODI-PHENYLAMINE
PHENANTHRENE
PYRENE
1,2,4-TRI CHLOROB E NZEN E
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
D. .
-REFER TO THAPPLICATION OVERVIEW`TO
E= DETERMINE WHICH OTHER PARTS,,OF FORM:
a t ,2A YOU MUSTCOMPLETE '
EPA Form 3510-2A(Rev 1-99) Replaces EPA forms 7550-6&7550-22 Page 14 of 21

FACILITY NAME AND PERMIT NUMBER: Form Approved 1/14/99
OMB Number 2040-0086
VDOT 1-77 Rest Area WWTP NC0039420
SUPPLEMENTAL APPLICATION INFORMATION
PART E. TOXICITY TESTING DATA NOT APPLICABLE
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.
E.1. Required Tests.
Indicate the number of whole effluent toxicity tests conducted in the past four and one-half years
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 Test number Test number
a Test information
Test species&test method number
Age at initiation of test
Outfall number
Dates sample collected
Date test started
Duration
b Give toxicity test methods followed
Manual title
Edition number and year of publication
Page number(s)
c Give the sample collection method(s)used. For multiple grab samples,indicate the number of grab samples used
24-Hour composite
Grab
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 21

FACILITY NAME AND PERMIT NUMBER: Form Approved 1/14/99
OMB Number 2040-0086
VDOT 1-77 Rest Area WWTP NC0039420
Test number Test number Test number
e Describe the point in the treatment process at which the sample was collected
Sample was collected
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
Receiving water
i Type of dilution water It salt water,specify"natural"or type of artificial sea salts or brine used
Fresh water
Salt water
t Give the percentage effluent used for all concentrations in the test series
•
.�,,, ,�. _ ,,. „U•�.-,� yob. =,�u
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 21

FACILITY NAME AND PERMIT NUMBER: Form Approved 1/14/99
OMB Number 2040-0086
VDOT 1-77 Rest Area WWTP NC0039420
Chronic
NOEC % % %
IC25 % % Ok
Control percent survival %
Other(describe)
m Quality Control/Quality Assurance
Is reference toxicant data available?
Was reference toxicant test within
acceptable bounds'?
What date was reference toxicant test
run(MM/DD/YYYY)?
Other(describe)
E.3. Toxicity Reduction Evaluation. Is the treatment works involved in a Toxicity Reduction Evaluation'?
Yes 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,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 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 17 of 21

FACILITY NAME AND PERMIT NUMBER: Form Approved 1/14/99
VDOT 1-77 Rest Area WWTP NC0039420 OMB Number 2040-0086
SUPPLEMENTAL APPLICATION INFORMATION ,
PART F. INDUSTRIAL USER DISCHARGES'AND RCRA/CERCLA WASTES NOT APPLICABLE
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 it subject to,an approved pretreatment program?
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. -
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
Mailing Address.
F.4. Industrial Processes. Describe all of the industrial processes that affect or contribute to the SIU's discharge
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).
Raw material(s).
F.6. Flow Rate.
a. Process wastewater flow rate Indicate the average daily volume of process wastewater discharged into the collection system in gallons
per day(gpd)and whether the discharge is continuous or intermittent
gpd ( 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
gpd ( continuous or_ intermittent)
F.7. Pretreatment Standards. Indicate whether the SIU is subject to the following
a Local limits Yes No
b. Categorical pretreatment standards Yes No
If subject to categorical pretreatment standards,which category and subcategory?
EPA Form 3510-2A(Rev.1-99) Replaces EPA forms 7550-6&7550-22. Page 18 of 21

FACILITY NAME AND PERMIT NUMBER: Form Approved 1/14/99
VDOT 1-77 Rest Area WWTP NC0039420 OMB Number 2040-0086
F.8. Problems at the Treatment Works Attributed to Waste Discharged 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
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) No
Provide a list of sites and the requested information(F 13-F.15)for each current and future site
F.13. Waste Origin. Describe the site and type of facility at which the CERCLA/RCRA/or other remedial waste originates(or is expected to originate
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 it 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 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 21

FACILITY NAME AND PERMIT NUMBER: Form Approved 1/14/99
VDOT 1-77 Rest Area WWTP NC0039420 OMB Number 2040-0086
SUPPLEMENTAL APPLICATION INFORMATION .
PART G. COMBINED SEWER SYSTEMS NOT APPLICABLE ,
If the treatnient`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 Locations 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:
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 CSO7
Rainfall _CSO pollutant concentrations CSO frequency
_CSO flow volume Receiving water quality
f. How many storm events were monitored during the last year?
G.4. 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 21

FACILITY NAME AND PERMIT NUMBER: Form Approved 1/14/99
OMB Number 2040-0086
VDOT 1-77 Rest Area WWTP NC0039420
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 States 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 closings,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 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 21 of 21