WQ0004972_Final Permit_20160429

F —7--
TI&
Water Resources
ENWRONVENTAL QUALITY
PAT MCCRORY
Governor
DONALD R. VAN DER VAART
Secretary
S. JAY ZIMMERMAN
Director
April 29, 2016
DAVID KOZY — SENIOR VICE PRESIDENT
MHC TT, INC.
2 NORTH RIVERSIDE PLAZA, SUITE 800
CHICAGO, ILLINOIS 60606
Dear Mr. Kozy:
Subject: Permit No. WQ0004972
Forest Lake Preserve
Wastewater Irrigation System
Davie County
In accordance with your permit renewal request received May 4, 2015, we are forwarding herewith
Permit No. WQ0004972 dated April 29, 2016, to MHC TT, Inc. for the continued operation of the subject
wastewater collection, treatment and irrigation facilities.
This permit shall be effective from the date of issuance until March 31, 2021, shall void Permit No.
WQ0004972 issued September 11, 2009, and shall be subject to the conditions and limitations as specified
therein. Please pay particular attention to the monitoring requirements listed in Attachments A, B and C.
Failure to establish an adequate system for collecting and maintaining the required operational information
shall result in future compliance problems.
Please note the following permit conditions are new since the last permit issuance dated
September 11, 2009:
➢ Condition I1I.13. —This condition requires that the Permittee maintain a gauge to monitor waste
levels in the effluent storage lagoon.
➢ Condition IV.2. — This condition requires an annual representative soils analysis to be
conducted on each irrigation site listed in Attachment B.
➢ Attachment A — PPI 001 and PPI 002 have been combined under PPI 001. Monitoring for
Chloride, Total Chlorine, Total Nitrogen, Total Dissolved Solids and Total Suspended Solids
has been added to the effluent monitoring requirements; the monitoring frequency has been
increased from 3 times a year to monthly and monitoring for pH has increased from 3 times a
year to 5 x week to be consistent with our Non -Discharge Effluent Monitoring for Domestic
Wastewater guidelines based on the average effluent of less than 24,400 gallons per day.
If any parts, requirements or limitations contained in this permit are unacceptable, the Permittee
has the right to request an adjudicatory hearing upon written request within 30 days following receipt of
this permit. This request shall be in the form of a written petition, conforming to Chapter 150B of the North
Carolina General Statutes, and filed with the Office of Administrative Hearings at 6714 Mail Service
Center, Raleigh, NC 27699-6714. Unless such demands are made, this permit shall be final and binding.
State of North Carolina I Environmental Quality I Water Resources I Water Quality Permitting I Non -Discharge Permitting
1617 Mail Service Center I Raleigh, North Carolina 27699-1617
919 807 6464

Mr. David Kozy
April 29, 2016
Page 2 of 2
If you need additional information concerning this permit, please contact Alice M. Wessner at (919)
807-6425 or alice.wessner cx,ncdenr.ggy.
Sincerely,
S. Jay Zimmerman, P.G., Director
Division of Water Resources
cc: Davie County Health Department Suzanne Wright, MPH, suzanne.wright(c�r�,co.davie.nc.us
(Electronic Copy)
Winston Salem Regional Office, Water Quality Regional Operations Section (Electronic Copy)
Digital Permit Archive (Electronic Copy)
Central Files

NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENTAL QUALITY
RALEIGH
WASTEWATER IRRIGATION SYSTEM PERMIT
In accordance with the provisions of Article 21 of Chapter 143, General Statutes of North Carolina as
amended, and other applicable Laws, Rules and Regulations
PERMISSION IS HEREBY GRANTED TO
MHC TT, Inc.
Davie County
FOR THE
operation of a 24,400 gallon per day (GPD) wastewater collection, treatment and irrigation facility
consisting of the:
continued operation of a wastewater collection system. serving 283 camp sites and 18 cabins consisting of:
seven grinder pump stations with associated collection piping; 430 linear feet (LF) of 3-inch force main;
455 LF of 4-inch force main; 935 LF of 6-inch force main; and all associated piping, valves, controls and
appurtenances; and the
continued operation of a wastewater treatment and irrigation facility consisting of an extended aeration
wastewater treatment facility with a treatment capacity of 45,000 GPD which includes one 14,800 gallon
aerated surge tank with influent bar screen served by two 74 gallon per minute (GPM) submersible pumps
and a high water alarm; a 45,000 gallon aeration tank served by two 285 cubic feet per minute (CFM)
blowers; a 4,500 gallon sludge holding tank; a 7,500 gallon clarifier; a 940 gallon baffled chlorine contact
tank with a hypochlorinator; a 0.408 million gallon (MG) synthetically lined effluent storage lagoon; two
142 GPM effluent dosing pumps; a 9.0 acre spray irrigation area with 18 sprinklers; and all associated
piping, valves, controls and appurtenances
to serve Forest Lake Preserve, with no discharge of wastes to surface waters, pursuant to the application
received May 4, 2015, and in conformity with the project plans, specifications, and other supporting data
subsequently filed and approved by the Department of Environmental Quality and considered a part of this
permit.
This permit shall be effective from the date of permit issuance until March 31, 2021, shall void Permit No.
WQ0004972 issued September 11, 2009 and shall be subject to the following specified conditions and
limitations:
WQ0004972 Version 3.0 Shell Version 151201 Page 1 of 9

I. SCHEDULES
No later than six months prior to the expiration of this permit, the Permittee shall request renewal of
this permit on official Division forms. Upon receipt of the request, the Division will review the
adequacy of the facilities described therein, and if warranted, will renew the permit for such period of
time and under such conditions and limitations as it may deem appropriate. Please note Rule 15A
NCAC 02T .0105(d) requires an updated site map to be submitted with the permit renewal application.
[15A NCAC 02T .0105(d), 02T .0106, 02T .0109, 02T .0115(c)]
II. PERFORMANCE STANDARDS
The subject non -discharge facilities shall be effectively maintained and operated at all times so there is
no discharge to surface waters, nor any contravention of groundwater or surface water standards. In
the event the facilities fail to perform satisfactorily, including the creation of nuisance conditions due
to improper operation and maintenance, or failure of the irrigation areas to adequately assimilate the
effluent, the Permittee shall take immediate corrective actions including Division required actions, such
as the construction of additional or replacement wastewater treatment or irrigation facilities. [G.S. 143-
215.1, 143-213.3(a)]
2. This permit shall not relieve the Permittee of their responsibility for damages to groundwater or surface
water resulting from the operation of this facility. [15A NCAC 02B ,0200, 02L .0100]
3. All wells constructed for purposes of groundwater monitoring shall be constructed in accordance with
15A NCAC 02C .0108 (Standards of Construction for Wells Other than Water Supply), and any other
jurisdictional laws and regulations pertaining to well construction. [15A NCAC 02C .0108]
4. The wastewater collection facilities shall be properly maintained and operated at all times. The
Permittee shall maintain compliance with an individual system -wide collection system permit for the
operation and maintenance of these facilities in accordance with 15A NCAC 02T .0400. If an
individual permit is not required, the following performance criteria shall be met:
a. The sewer system shall be effectively maintained and operated at all times to prevent discharge to
land or surface waters, and any contravention of groundwater or surface water standards.
b. A map of the sewer system shall be developed and actively maintained.
c. An operation and maintenance plan shall be developed, implemented and maintained.
d. Pump stations not connected to a telemetry system shall be inspected every day (i.e., 365 days per
year). Pump stations connected to a telemetry system shall be inspected at least once per week.
e. High -priority sewers shall be inspected at least once every six months.
f. A general observation of the entire sewer system shall be conducted at least once per year.
g. Overflows and bypasses shall be reported to the Winston Salem Regional Office in accordance
with 15A NCAC 02B .0506(a), and public notice shall be provided as required per North Carolina
General Statute § 143-215.1 C.
h. A grease control program shall be developed, implemented and maintained.
i. Right-of-ways and easements shall be maintained.
j. Inspection and maintenance records for Conditions II.4.a. through IIA.i. shall be maintained for a
period of at least three years, except for Conditions 1I.4.b. and I1.4,c., which shall be maintained
for the life of the system.
[15A NCAC 02T .0403]
5. Effluent quality shall not exceed the limitations specified in Attachment A. [15A NCAC 02T
.0108(b)(1)]
WQ0004972 Version 3.0 Shell Version I51201 Page 2 of 9

6. Application rates, whether hydraulic, nutrient or other pollutant, shall not exceed those specified in
Attachment B. [15A NCAC 02T .0505(c), 02T .0505(n)]
7. This disposal system was individually permitted on or after December 30, 1983; therefore, the
compliance boundary is established at either 250 feet from the effluent disposal area, or 50 feet within
the property boundary, whichever is closest to the effluent disposal area. An exceedance of
groundwater standards at or beyond the compliance boundary is subj ect to remediation action according
to 15A NCAC 02L .0106(d)(2) as well as enforcement actions in accordance with North Carolina
General Statute 143-215.6A through 143-215.6C. [15A NCAC 02L .0106(d)(2), 02L .0107(b)]
8. In accordance with 15A NCAC 02L .0108, the review boundary is established midway between the
compliance boundary and the effluent disposal area. Any exceedance of groundwater standards at the
review boundary shall require action in accordance with 15A NCAC 02L .0106. [15A NCAC 02L
.0106, 02L .0108]
9. The Permittee shall apply for a permit modification to establish a new compliance boundary prior to
any sale or transfer of property affecting a compliance boundary. [15A NCAC 02L .0107(c)]
10. In accordance with 15A NCAC 02L .0107(d), no wells, excluding Division approved monitoring wells,
shall be constructed within the compliance boundary except as provided for in 15A NCAC 02L
.0107(g). [15A NCAC 02L .0107]
11. Except as provided for in 15A NCAC 02L .0107(g), the Permittee shall ensure any landowner who is
not the Permittee and owns land within the compliance boundary shall execute and file with the Davie
County Register of Deeds an easement running with the land containing the following items:
a. A notice of the permit and number or other description as allowed in 15A NCAC 02L .0107(f)(1);
b. Prohibits construction and operation of water supply wells within the compliance boundary; and
c. Reserves the right of the Permittee or the State to enter the property within the compliance boundary
for purposes related to the permit.
The Director may terminate the easement when its purpose has been fulfilled or is no longer needed.
[15A NCAC 02L .0107(f)]
12. The facilities permitted herein shall be constructed according to the following setbacks:
a. The setbacks for irrigation sites permitted under 15A NCAC 02H .0200 shall be as follows (all
distances in feet):
i. Any habitable residence or place of public assembly under separate ownership: 400
ii. Surface waters: 100
iii. Any well with exception of monitoring wells: 100
iv. Any property line: 150
v. Public right of way: 50
[ 15A NCAC 02H. 02190)]
b. The setbacks for storage and treatment units permitted under 15A NCAC 02H .0200 shall be as
follows (all distances in feet):
i. Any well with exception of monitoring wells:
ii. Any property line:
[15A NCAC 02H .02190)]
100
50
WQ0004972 Version 3.0 Shell Version 151201 Page 3 of 9

III. OPERATION AND MAINTENANCE REOUIREMENTS
1. The facilities shall be properly maintained and operated at all times. The facilities shall be effectively
maintained and operated as a non -discharge system to prevent the discharge of any wastewater resulting
from the operation of this facility. The Permittee shall maintain an Operation and Maintenance Plan,
which at a minimum shall include operational functions, maintenance schedules, safety measures and
a spill response plan. [15A NCAC 02T .0507]
2. Upon the Water Pollution Control System Operators Certification Commission's (WPCSOCC)
classification of the subject non -discharge facilities, in accordance with 15A NCAC 08G .0200 the
Permittee shall designate and employ a certified operator in responsible charge (ORC) and one or more
certified operator(s) as back-up ORC(s). The ORC or their back-up shall visit the facilities in
accordance with 15A NCAC 08G .0200, and shall comply with all other conditions specified in the
previously cited rules. [15A NCAC 02T .0117]
3. A suitable year round vegetative cover shall be maintained at all times, such that crop health is
optimized, allows for even distribution of effluent and allows inspection of the irrigation system. [15A
NCAC 02T .0108(b)(1)]
4. Adequate measures shall be taken to prevent effluent ponding in or runoff from the irrigation sites listed
in Attachment B. [15A NCAC 02T .0108(b)(1)]
5. Irrigation shall not be performed during inclement weather or when the ground is in a condition that
will cause ponding or runoff. [15A NCAC 02T .0108(b)(1)1
6. All irrigation equipment shall be tested and calibrated at least once per permit cycle. Calibration records
shall be maintained at the facility for a period of no less than five years, and shall be made available to
the Division upon request. [15A NCAC 02T .0108(b)(1)]
T Only effluent from Forest Lake Preserve shall be irrigated on the sites listed in Attachment B. [G.S.
143-215.1]
8. No automobiles or machinery shall be allowed on the irrigation sites except during equipment
installation or while maintenance is being performed. [15A NCAC 02T .0108(b)(1)]
9. Public access to the irrigation sites and wastewater treatment facilities shall be prohibited. [ 15A NCAC
02T .0505(q)]
10. The residuals generated from the wastewater treatment facilities shall be disposed or utilized in
accordance with 15A NCAC 02T .l 100. The Permittee shall maintain a residual management plan
pursuant to 15A NCAC 02T .0508. [15A NCAC 02T .0508, 02T .1100]
11. Diversion or bypassing of untreated or partially treated wastewater from the treatment facilities is
prohibited. [15A NCAC 02T .05056)]
12. Freeboard in the 0.408 million gallon (MG) synthetically lined effluent storage lagoon shall not be less
than two feet at anytime. [15A NCAC 02T .0505(d)]
13. A gauge to monitor waste levels in the 0.408 million gallon (MG) synthetically lined effluent storage
lagoon shall be provided. This gauge shall have readily visible permanent markings, at inch or tenth
of a foot increments, indicating the following elevations. maximum liquid level at the top of the
temporary liquid storage volume; minimum liquid level at the bottom of the temporary liquid storage
volume; and the lowest point on top of the dam. [15A NCAC 02T .0108(b)(1)]
WQ0004972 Version 3.0 Shell Version 151201 Page 4 of 9

14. A protective vegetative cover shall be established and maintained on all earthen embankments (i.e.,
outside toe of embankment to maximum allowable temporary storage elevation on the inside of the
embankment), berms, pipe runs, erosion control areas, and surface water diversions. Trees, shrubs, and
other woody vegetation shall not be allowed to grow on the earthen dikes or embankments. Earthen
embankment areas shall be kept mowed or otherwise controlled and accessible. [15A NCAC 02T
.0108(b)(1)]
N. MONITORING AND REPORTING REQUIREMENTS
1. Any Division required monitoring (including groundwater, plant tissue, soil and surface water analyses)
necessary to ensure groundwater and surface water protection shall be established, and an acceptable
sampling reporting schedule shall be followed. [ 15A NCAC 02T .0108(c)]
A Division certified laboratory shall conduct all laboratory analyses for the required effluent,
groundwater or surface water parameters. [15A NCAC 02H .0800]
3. Flow through the treatment facility shall be continuously monitored, and daily flow values shall be
reported on Form NDMR.
The Permittee shall install and maintain an appropriate flow measurement device to ensure the accuracy
and reliability of flow measurement consistent with accepted engineering and scientific practices.
Selected flow measurement devices shall be capable of measuring flows with a maximum deviation of
less than ten percent from true flow; accurately calibrated at a minimum of once per year; and
maintained to ensure the accuracy of measurements is consistent with the selected device's accepted
capability. The Permittee shall maintain records of flow measurement device calibration on file for a
period of at least five years. At a minimum, documentation shalt include:
a. Date of flow measurement device calibration,
b. Name of person performing calibration, and
c. Percent from true flow.
[15A NCAC 02T .0105(k)]
4. The Permittee shall monitor the effluent from the subject facilities at the frequencies and locations for
the parameters specified in Attachment A. [15A NCAC 02T ,0108(c)]
5. The Permittee shall maintain adequate records tracking the amount of effluent irrigated. At a minimum,
these records shall include the following information for each irrigation site listed in Attachment B:
a. Date of infiltration/irrigation;
b. Volume of effluent infiltrated/irrigated;
c. Site infiltrated/irrigated;
d. Length of time site is irrigated;
e. Continuous weekly, monthly, and year-to-date hydraulic (inches/acre) loadings;
f. Continuous monthly and year-to-date loadings for any non -hydraulic parameter specifically
limited in Attachment B;
g. Weather conditions; and
h. Maintenance of cover crops.
[I 5A NCAC 02T .0108(c)]
6. Freeboard (i.e., waste level to the lowest embankment elevation) in the 0.408 million gallon (MG)
synthetically lined effluent storage lagoon shall be measured to the nearest inch or tenth of a foot, and
recorded weekly. Weekly freeboard records shall be maintained at the facility for a period of no less
than five years, and shall be made available to the Division upon request. [ 15A NCAC 02T .0108(c)]
WQ0004972 Version 3.0 Shell Version 151201 Page 5 of 9

Three copies of all monitoring data (as specified in Conditions IV.3. and IVA.) on Form NDMR for
each PPI and three copies of all operation and disposal records (as specified in Conditions IV.5. and
IV.6.) on Form NDAR-1 ] for every site in Attachment B shall be submitted on or before the last day of
the following month. If no activities occurred during the monitoring month, monitoring reports are still
required documenting the absence of the activity. All information shall be submitted to the following
address:
Division of Water Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[15A NCAC 02T .0105(1)]
A record shall be maintained of all residuals removed from this facility. This record shall be maintained
at the facility for a period of no less than five years, and shall be made available to the Division upon
request. At a minimum, this record shall include:
a. Name of the residuals hauler;
b. Non -Discharge permit number authorizing the residuals disposal, or a letter from a municipality
agreeing to accept the residuals;
c. Date the residuals were hauled; and
d. Volume of residuals removed.
[15A NCAC 02T .0108(b)(1)]
9. A maintenance log shall be maintained at this facility. This log shall be maintained at the facility for a
period of no less than five years, and shall be made available to the Division upon request. At a
minimum, this log shall include:
a. Date of calibration of flow measurement device;
b. Visual observations of the plant and plant site; and
c. Record of preventative maintenance (e.g., changing of equipment, adjustments, testing, inspections
and cleanings, etc.).
[ 15A NCAC 02T .0108(b)(1)]
10. Monitoring wells shall be sampled at the frequencies and for the parameters specified in Attachment
C. All mapping, well construction forms, well abandonment forms and monitoring data shall refer to
the permit number and the well nomenclature as provided in Attachment C and Figure A. [ 15A NCAC
02T .0105(m)]
11. Two copies of the monitoring well sampling and analysis results shall be submitted on a Compliance
Monitoring Form (GW-59), along with attached copies of laboratory analyses, on or before the last
working day of the month following the sampling month. The Compliance Monitoring Form (GW-59)
shall include this permit number, the appropriate well identification number, and one GW-59a
certification form shall be submitted with each set of sampling results. All information shall be
submitted to the following address:
Division of Water Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[15A NCAC 02T .0105(m)]
WQ0004972 Version 3.0 Shell Version 151201 Page 6 of 9

12. An annual representative soils analysis (i.e., Standard Soil Fertility Analysis) shall be conducted on
each irrigation site listed in Attachment B. These results shall be maintained at the facility for a period
of no less than five years, and shall be made available to the Division upon request. At a minimum, the
Standard Soil Fertility Analysis shall include the following parameters:
Acidity
Exchangeable Sodium Percentage
Phosphorus
Base Saturation (by calculation)
Magnesium
Potassium
Calcium
Manganese
Sodium
Cation Exchange Capacity
Percent Humic Matter
Zinc
Copper
pH
[ 15A NCAC 02T .0108(c)]
13. Noncompliance Notification:
The Permittee shall report by telephone to the Winston-Salem Regional Office, telephone number (336)
776-9800, as soon as possible, but in no case more than 24 hours, or on the next working day following
the occurrence or first knowledge of the occurrence of any of the following:
a. Treatment of wastes abnormal in quantity or characteristic, including the known passage of a
hazardous substance.
b. Any process unit failure (e.g., mechanical, electrical, etc.), due to known or unknown reasons,
rendering the facility incapable of adequate wastewater treatment.
c. Any facility failure resulting in a by-pass directly to receiving surface waters.
d. Any time self -monitoring indicates the facility has gone out of compliance with its permit
limitations.
e. Ponding in or runoff from the irrigation sites.
Any emergency requiring immediate reporting (e.g., discharges to surface waters, imminent failure of
a storage structure, etc.) outside normal business hours shall be reported to the Division's Emergency
Response personnel at telephone number [phone], [phone], or [phone]. Persons
reporting such occurrences by telephone shall also file a written report in letter form within five days
following first knowledge of the occurrence. This report shall outline the actions taken or proposed to
betaken to ensure the problem does not recur. [15A NCAC 02T .0105(l), 02T .0108(b)(1)]
WQ0004972 Version 3.0 Shell Version 15I201 Page 7 of 9

V. INSPECTIONS
1. The Permittee shall provide adequate inspection and maintenance to ensure proper operation of the
wastewater treatment and irrigation facilities. [15A NCAC 02T .0108(b)]
2. The Permittee or their designee shall inspect the wastewater treatment and irrigation facilities to prevent
malfunctions, facility deterioration and operator errors resulting in discharges, which may cause the
release of wastes to the environment, a threat to human health or a public nuisance. The Permittee shall
maintain an inspection log that includes, at a minimum, the date and time of inspection, observations
made, and any maintenance, repairs, or corrective actions taken. The Permittee shall maintain this
inspection log for a period of five years from the date of the inspection, and this log shall be made
available to the Division upon request. [15A NCAC 02T .0108(b)]
3. Any duly authorized Division representative may, upon presentation of credentials, enter and inspect
any property, premises or place on or related to the wastewater treatment. and irrigation facilities
permitted herein at any reasonable time for the purpose of determining compliance with this permit;
may inspect or copy any records required to be maintained under the terms and conditions of this permit,
and may collect groundwater, surface water or leachate samples. [G.S. 143-21.5.3(a)(2)]
VI. GENERAL CONDITIONS
1. Failure to comply with the conditions and limitations contained herein may subject the Permittee to an
enforcement action by the Division in accordance with North Carolina General Statutes 143-215.6A to
143-215.6C. [G.S. 143-215.6A to 143-215.6C]
2. This permit shall become voidable if the permitted facilities are not constructed in accordance with the
conditions of this permit, the Division approved plans and specifications, and other supporting
documentation. [ 15A NCAC 02T .0110]
3. This permit is effective only with respect to the nature and volume of wastes described in the permit
application, Division approved plans and specifications, and other supporting documentation. No
variances to applicable rules governing the construction or operation of the permitted facilities are
granted, unless specifically requested and approved in this permit pursuant to 15A NCAC 02T .0105(n).
[G.S. 143-21.5.11
4. The issuance of this permit does not exempt the Permittee from complying with any and all statutes,
rules, regulations, or ordinances, which may be imposed by other jurisdictional government agencies
(e.g., local, state, and federal). Of particular concern to the Division are applicable river buffer rules in
15A NCAC 02B .0200; erosion and sedimentation control requirements in 15A NCAC Chapter 4 and
under General Permit NCG010000; any requirements pertaining to wetlands under 15A NCAC 02B
.0200 and 02H .0500; and documentation of compliance with Article 21 Part 6 of Chapter 143 of the
General Statutes. [I5A NCAC 02T .0105(c)(6)]
In the event the permitted facilities change ownership or the Permittee changes their name, a formal
permit modification request shall be submitted to the Division. This request shall be made on official
Division forms, and shall include appropriate property ownership documentation and other supporting
documentation as necessary. The Permittee of record shall remain fully responsible for maintaining
and operating the facilities permitted herein until a permit is issued to the new owner. [15A NCAC
02T .0104]
6. The Permittee shall retain a set of Division approved plans and specifications for the life of the facilities
permitted herein.. [15A NCAC 02T .0108(b)(1)]
7. The Permittec shall maintain this permit until all permitted facilities herein are properly closed or
permitted under another permit issued by the appropriate permitting authority. [15A NCAC 02T
.01050)]
WQ0004972 Version 3.0 Shell Version 151201 Page 8 of 9

S. This permit is subject to revocation or unilateral modification upon 60 days notice from the Division
Director, in whole or part for the requirements listed in 15A NCAC 02T .0110. [ 15A NCAC 02T A 110]
9. Unless the Division Director grants a variance, expansion of the permitted facilities contained herein
shall not be granted if the Permittee exemplifies any of the criteria in 15A NCAC 02T .0120(b). [15A
NCAC 02T .0120]
10. The Pennittee shall pay the annual fee within 30 days after being billed by the Division. Failure to pay
the annual fee accordingly shall be cause for the Division to revoke this permit. [15A NCAC 02T
.0105(e)(3)]
Permit issued this the 29tb day of April 2016
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
Jay Zimmerman, P.G., Director
Division of Water Resources
By Authority of the Environmental Management Commission
Permit Number WQ0004972
WQ0004972 Version 3.0 Shell Version 151201 Page 9 of 9

THIS PAGE BLANK

ATTACHMENT A — LIMITATIONS AND MONITORING REQUIREMENTS
PPI 001— WWTP Effluent
Permit Number: WQ0004972 Version: 3.0
EFFLUENT CHARACTERISTICS
EFFLUENT LIMITS
MONITORING REQUIREMENTS
PCS
Code
Parameter Description
Units of
Measure
Monthly
Average
Monthly
Geometric Mean
Daily Minimum
Daily Maximum
Measurement
Frequency
Sample
Type
00310
BOD, 5-Day (20 °C)
mg/L
Monthly
Grab
00940
Chloride (as CI)
mg/L
3 x Year i
Grab
50060
Chlorine, Total Residual
mg/L
5 x Week
Grab
31616
Coliform, Fecal MF, M-FC Broth, 44.5 °C
W100.mL
Monthly
Grab
50050
Flow, in Conduit or thru Treatment Plant
GPD
24,400
Continuous
Recorder
00610
Nitrogen, Ammonia Total (as N)
mg/L,
Monthly
Grab
00625
Nitrogen., Kjeldahl, Total (as N)
mg/L
Monthly
Grab
00620
Nitrogen, Nitrate Total (as N)
mg/L
Monthly
Grab
00600
Nitrogen, Total (as N)
mg/L
Monthly
Grab
00400
pH
su
5 x Week
Grab
00665
Phosphorus, Total (as P)
mg/L
Monthly
Grab
70300
Solids, Total Dissolved — 180 °C
mg/L
3 x Year 1
Grab
00530
Solids, Total Suspended
mglL
Monthly
Grab
1. 3 x Year monitoring shall be conducted in March, July and November.
WQ004972 Version 3.0 Attachment .Page 1 of 1

THIS PAGE BLANK

ATTACHMENT B - APPROVED LAND APPLICATION SITES AND LIMITATIONS
MHC TT, Inc. — Forest Lake Preserve
Permit Number: WQ0004972 Version: 3.0
IRRIGATION AREA INFORMATION
APPLICATION LIMITATIONS
Field
Owner
County
Latitude
Longitude
Net
Acreage
Dominant
Soil Series
Parameter
Hourly
Rate
Yearly
Max
Units
1
MHC TT, Inc.
Davie
35.8660650
-80.3953020
9.0
01284 — Non Discharge Application late
0.11
46.8
inches
WQ0004972 Version 3.0 Attachment B Page 1 of 1

THIS PAGE BLANK

ATTACHMENT C — GROUNDWATER MONITORING AND LIMITATIONS
Monitoring wells: MW-I, MW-2, MW-3, and MW-4
Permit Number: WQ0004972 Version: 3.0
GROUNDWATER CHARACTERISTICS
GROUNDWATER STANDARDS
MONITORING REQUIREMENTS
PCS Code
Parameter Description
Daily Maximum
Frequency Measurement
Sample Type
Footnotes
00680
00940
Carbon, Tot Organic (TOC)
Chloride (as Cl)
250
mg/L
mg/L
3 x Year
3 x Year
Grab
Grab
1,6
1
31616
Coliform, Fecal MF, M-FC Broth, 44,5 °C
#/100 mL
3 x Year
Grab
I
00620
Nitrogen, Nitrate Total (as N)
10
mg/L
3 x Year
Grab
1
00400
pH
6.5-8.5
su
3 x Year
Grab
1,2
GWVOC
Volatile Compounds (GC/MS)
Present: Yes/No
Annually
Grab
1, 4, 5
82546
Water Level, Distance from measuring point
feet
3 x Year
Calculated
1, 2, 3
1. 3 x Year monitoring shall be conducted in March, July & November; Annual monitoring shall be conducted every November.
2. The measurement of water levels shall be made prior to purging the wells. The depth to water in each well shall be measured from the surveyed point on the top of the casing. The measurement of
pH shall be made after purging and prior to sampling for the remaining parameters.
3. The measuring points (top of well casing) of all monitoring wells shall be surveyed to provide the relative elevation of the measuring point for each monitoring well_ The measuring points (top of
casing) of all monitoring wells shall be surveyed relative to a common datum.
4. Volatile Organic Compounds (VOC) - In November only, analyze by one of the following methods:
a. Standard Method 6230D, PQL at 0.5 µg/L or less
b. Standard Method 621 OD, PQL at 0.5 µg/L or less
C. EPA Method 8021, Low Concentration, PQL at 0.5 µg/L or less
d. EPA Method 8260, Low Concentration, PQL at 0.5 µg/L or less
e. Another method with prior approval by the Water Quality Permitting Section Chief
Any method used must meet the following qualifications:
a. A laboratory must be DWR certified to run any method used.
b. The method used must, at a minimum, include all the constituents listed in Table VIII of Standard Method 6230D.
c. The method used must provide a PQL of 0.5 µg/L or less that must be supported by laboratory proficiency studies as required by DWR. Any constituents detected above the MDL but below
the PQL of 0.5 µg/L must be qualified (estimated) and reported.
5. If any volatile organic compounds (VOC) are detected as a result of monitoring as provided in Attachment C, then the Winston Salem Regional Office supervisor, telephone number (336) 776-
9800, must be contacted immediately for further instructions regarding any additional follow-up analyses required_
6. If TOC concentrations greater than 10 mg/L are detected in any downgradient monitoring well, additional sampling and analysis must be conducted to identify the individual constituents comprising
this TOC concentration. If the TOC concentration as measured in the background monitor well exceeds 10 mg/L, this concentration will be taken to represent the naturally occurring TOC
concentration. Any exceedances of this naturally occurring TOC concentration in the downgradient wells shall be subject to the additional sampling and analysis as described above.
7. Monitoring wells shall be reported consistent with the nomenclature and location information provided in Figure A and this attachment.
WQ0004972 Version 3.0 Attachment C Page 1 of I

Path
P
to I / Well drlllad by I aw Engineering
deep;saR Water lovatllft .+
IX,
18tPRAYNEAD51N SPftAYF1ELD I
� t
r
I �1
]rC�
UJ.7�
1 r ... uj
AID—
LLA
ui
, f
W2
.. !'. YijEATM NTPI AN
MNCTT INC.
('r' I•' ��j {/� 7 ,I� - TNOIISANDT11A1L5 FOR EST LAKE PRESERVE 1
PERMRBW00001972
—`ufijp(aE. PSI^ \ \ WASTEWATER IRRIGATION SYSTEM
j, ��.�^" j ' ♦ns,wl C2 DAVIE COUNTY
UPDA1ED/-30.2015
-V e ifirR �A` ..b j'iCYI$t i
1 J i h 1.1 i. =^ .f ✓.
i'r J n p w'1' 1.
-R'oAOM1 MaP
. i
�

Google Maps
Page 1 of 1
Go gle Maps
WQ0004972 Forest Lake Preserve
Imagery 02016 DigitalGlobe, U.S. Geological Survey, USDA Farm Service Agency, Map data 02016 Google 200 ft
https://www.google.com/maps/@35.8623153,-80.3961242,585m... 2/15/2016