NC0088609_Renewal Application_20181005

rr
�fSX[2+144 X41 Y
15-fr
5 17-
--'Litiyv
ROY COOPER NORTH CAROLINA
Gaser740r Environmental Quality
MICHAEL S_BEGAN
SecretWY
LINDA CULPEPPER
Interim Director
October 05, 2018
Thomas Roberts
Aqua North Carolina Inc
202 Mackenan Ct
Cary, NC 27511
Subject: Permit Renewal
Application No. NC0088609
Windgate Subdivision - #1
Surry County
Dear Applicant:
The Water Quality Permitting Section acknowledges the October 5, 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. 1506-3 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,
iCIght'gtAA
Wren Thedford
Administrative Assistant
Water Quality Permitting Section
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

A ID _
.. •l4.,-r�r SM
October 4, 2018
_- Mr.Wren Thedford.. . .
NDPES Unit
DWR, NCDEQ
1617 Mail Service Center
Raleigh,NC 27699-1617
RE: Application for Permit Renewal
Aqua North Carolina, Inc.
Windgate Subdivision,Well #1 -WTP
NPDES Permit NC0088609
Dear Mr. Thedford:
Enclosed are three (3) copies of the completed application Form C-WTP. This
submittal includes necessary attachments for your office to renew the subject
permit.
Aqua North Carolina, Inc-(AQUA) has reviewed the Division of Water Resource's
General Permit NCG5900000 for Greensand WTP Effluent Limitations and
Monitoring Requirements - Discharging to Freshwater, and AQUA hereby requests
that treated discharge from Windgate-Well #1 be considered for coverage under
this General Permit. AQUA understands that if coverage under a general permit is
granted,the Division will rescind individual NPDES Permit NC0088609.
Best Regards, ��CE91/�®�DENI DWS
L.� �/� �2
Amanda BergerPermitting 0 C T 201
Water Resources
ng Section
Manager, Environmental Compliance
cc: Laurie Ison _-
Joseph_Pearce
Shannon Becker
202 MacKenan Court,Cary,NC,27511 • 919.467.8712 • AquaAmerica.com

NPDES PERMIT APPLICATION - SHORT FORM C - WTP
For discharges associated with water treatment plants
Mail the complete application to:
N. C. Department of Environment and Natural Resources
Division of Water Quality / NPDES Unit
1617 Mail Service Center, Raleigh, NC 27699-1617
NPDES Permit Number NC0088609
.
If you are completing this form in computer use the TAB key or the up - down arrows to move from one
field to the next. To check the boxes, click your mouse on top of the box. Otherwise,please print or type.
1. Contact Information:
Owner Name Aqua North Carolina, Inc.
Facility Name Windgate Subdivision-Well #1 WTP
Mailing Address 202 Mackenan Ct
City Cary
State / Zip Code NC/27511
Telephone Number [phone]
Fax Number [e-mail]
e-mail Address [e-mail]
2. Location of facility producing discharge:
Check here if same as above ❑
Street Address or State Road Simmons Road
City Mt. Airy
State / Zip Code NC/ 27030
County Surry
3. Operator Information:
Name of the firm, consultant or other entity that operates the facility. (Note that this is not referring to the
Operator in Responsible Charge or ORC)
Name Aqua North Carolina, Inc.
Mailing Address 4163 Sinclair Street
City Denver
State / Zip Code NC / 28037
Telephone Number [phone]
Fax Number [e-mail]
Page 1 of 3 Version 5/2012

NPDES PERMIT APPLICATION - SHORT FORM C - WTP
For discharges associated with water treatment plants
4. Ownership Status: --- - - —_-- -
Federal D State ❑ Private N Public ❑
5. Type of treatment plant:
❑ Conventional (Includes coagulation, flocculation, and sedimentation, usually followed by
filtration and disinfection)
❑ Ion Exchange (Sodium Cycle Cationic ion exchange)
® Green Sand Filter (No sodium recharge)
❑ Membrane Technology (RO, nanofiltration)
Check here if the treatment process also uses a water softener ❑
6. Description of source water(s) (i.e. groundwater, surface water)
Groundwater Well
7. Describe the treatment process(es) for the raw water:
Raw water is treated by greensand filters in series with a 0.0016 MGD discharge of filter
backwash wastewater. Chemicals utilized during this process consist of: .
• Potassium Permanganate
• Chlorine
• Caustic soda
8. Describe the wastewater and the treatment process(es) for wastewater generated by the
facility:
Wastewater discharge from said treatment works at the location specified on the attached
map into an unnamed tributary to Fisher River, classified C waters in-the Yadkin-Pee Dee
River.
9. Number of separate discharge points: 1
Outfall Identification number(s) 001
10. Frequency of discharge: Continuous ❑ Intermittent El
If intermittent:
Days per week discharge occurs: 7 Duration: 100 minutes
11. Plant design potable flow rate 0.018 MGD
Backwash or reject flow 0.002 MGD
r J 12. Name of receiving stream(s) (Provide a map showing the exact location of each outfall, including
latitude and longitude):
Unnamed Tributary to Fisher River (Yadkin Pee Dee Basin)
13. Please list all water treatment additives, including cleaning chemicals or disinfection
treatments, that have the potential to be discharged. - __. ,._.�_ ..
Page 2 of 3 Version 5/2012

NPDES PERMIT APPLICATION,- SHORT FORM C - WTP
For discharges associated with water treatment plants
- Alum /-aluminum sulfate -•--. -. ____ .- Yes No X _- -- ----- _., n_-
Iron sulfate / ferrous sulfate Yes No X
Fluoride Yes No X
Ammonia nitrogen / Chloramines Yes No X
Zinc-orthophosphate or sweetwater CP1236 Yes No X
List any other additives below:
-_ - ,Chlorine . ,-. - , , ..._. . - -. , --
Potassium Permanganate - _,
14. Is this facility located on Indian country? (check one)
Yes ❑ No
15. Additional Information:
• Provide a schematic of flow through the facility, include flow volumes at all points in
the water treatment process. The plan should show the point[s] of addition for
chemicals and all discharges routed to an outfall [including stormwater].
• Solids Handling Plan
o N/A
16. NEW Applicants
Information needed in addition to items 1-15:
• New applicants must contact a permit coordinator with the NCDENR Customer
Service Center.
Was the Customer Service Center contacted? ❑ Yes ❑ No
• Analyses of source water collected
• Engineering Alternative Analysis
• Discharges from Ion Exchange and Reverse Osmosis plants shall be evaluated using a
water quality model.
17. Applicant Certification
I certify that I am familiar with the information contained in the application and that to the
best of my knowledge and belief such information is true, complete, and accurate.
Amanda Berger Manager Environmental Compliance, Aqua North Carolina, Inc.
Avvt_ed name of Person Signing Title
an .( / , , x14112-61E3- -- - - - -
North
--
North Carolina General Statute 143-215 6(b)(2)provides that:Any person who knowingly makes any false statement representation,or certification in any application,
record,report,plan,or other document files or required to be maintained under Article 21 or regulations of the Environmental Management Commission implementing that
Article,or who falsifies,tampers with,or knowingly renders inaccurate any recording or monitoring device or method required to be operated or maintained under Article 21
or regulations of the Environmental Management Commission implementing that Article,shall be guilty of a misdemeanor punishable by a fine not to exceed$25,000,or by
imprisonment not to exceed six months,or by both. (18 U.S.C.Section 1001 provides a punishment by a fine of not more than$25,000 or imprisonment not more than 5
years,or both,for a similar offense.)
Page 3 of 3 Version 5/2012

; .
. .
. s ,
v-r-
,
EXIST. WELL HOU
i
Z SCH 46 PVC
TOP COVER ....4-- ,
(SEA NOTE #12) r,_ __, EXISTING FILTER
--- 4i'' MiN.
, i l' 1 , BACKWASO
Lrrhi:: ' ' EXIST. ..........-..-7'- , • Sr.- ; ''' -'41.'''''..V.'
UMNI I i I
FrIA I '
i t_ , GRADE : I r 46' ' ' g . . ' 4' , 4 . ,4 • " -
...., -..4 —
r.,77.Jn_ I ....„ 1 1_,. . 4
1; --", - ' '11P-I -
---1 --t _ -------7.
4 ! I
1 1 1 I
SEE ,
, .
. ? I
! , ,
i 1 ,
NOTE
. I 1 i
24" MIN.[--------'
RGE I
, 1
1
; tt":-s) WI.,
I ii 1
i , ATFP-jzrirl. -6- grE;gric.*ITV7-6 -tsb N,
Nt 1 i 1 t
I PROPOSED DECHLORINATI
MIN. / (SEE NOTE it2)
i . 1 / .
/; ,t9
4" LEVEUNG STONE
--PROPOSED DEOHLORINE .
• .:
DETENTION f MIXING BASIN

7r()-
%., a .. :.
---..
tL ,i ; ,
r r�f ( j'1OJ7 \
Li/7
\ 't ', .•,:b --. .1t— C...
`.. J .. j• i /7-1/ rr ( r
,,,,
; \/00 /$) \\•/9',:' i ,y. ••••>. \\ 1.--:- ,,ii,/ 0.. t
..„
_, _ ) ., ..,....A.I.,() _ ,i_...:.„:::,„,, , , , ,.. ....
I .✓ , 11 \ '\.L' 1 •S/ V
til 4 '-'1. i.,`,,; ( ��� ; `_ �,, ,�, °f►Q + ° �„
.7 ' 1 ' \s, '., if; ci". ,-... . /1'\ . * ) \ \ ,
. s . - //yr, ,, f 1 . 4 1, ; d ,,, . s, . s..... J.,
: ,,,,, ::-.--., ..,Q/ /f,--/j's' ,,'-...,,,' 11 t ''''i 's \/,. i \* \ (- i')ii, )
• 1�'ry~� .�kl ,.,.•• :r-'- '� / ( I , �.../.-:,e 4(i.C- -1 -4.-
1' Ili ^l a
c +�VaGJ 1 a11.r• :rr•_" ,r/ f� +��: ./.. ..� I it,• • �\i '~'`
i (
\\, Y t J '�•--,, ,/ ' WF// / ~~ r' J,,' •
f r Outfall 001
\ ' !`, f rpt ��� �;'�^'�': I'(rJ `f "1;5_ �t rr'` -1Z �` )/�/f;ff( '`.\yam \\,.
! !�
111
„,,......,,,,/, . . •, ,,.. ., '”4:.., ,, 4 ,,,,,, , , r\,::........Ss\ r,,,,_,. ,./v,,,
'..1 6 .,....-;-1 .--•,. A.,.. \ '' ,;...,•:N-.# ii .rf,,, .- •
..'; 'Ns 1-?0,,,; " ts;:. -'-',—.. .'-'S .s:\‘' -:.itti ' '
.. 140,,40/1:j ...t,';':- ::- ',."` ''' 4.„,..".4°-Ntsbj\ ' . rif./..,....7„-01,.... ? 1,
77 t ,\.,,.:, .. ..\ ,.. ) cil .iiiiii.f;i (
i , 1, 0 :
te„ , „,:,,,, -,.. c ----\,,,.\ \,, ,,. .. .,--.A ',,,' . C'',\I I, (1, ,,) ,../''''- ' l) 6 ..\ .
lsvi
t,., s-• —1'4\s. ) r i /r.
5":••••""\ ''''t .( .1.•'' .
C-—% \ t.,. ..\\.,,,s. ""'""n"."sill , (.\''..' :I it' I :
71 ,_ \, :. ,)ti \ • i
. 4f-1\ '
\ J r ill
•
�.�=' 0 , } sir :��,.s+ ,�.:- � ,,, CI::.�..,� , , .�;�,.
_ eta f ��, • ,r r I C' � 'r r
II
•
i.
. ____ _
i
Xi, Aili 44iii, e ',� '' ,,��,/� ; `` J"J' _ ',� • VI-
). ' '.
I.
.1'' ` 11 \ Adig . .' 0 , `
4
Aqua North Carolina, Inc. Facility .
Windgate Subdivision Well #1 WTP Location
at ittdet 36°24'29"N State Grid: Dobson not to scale
Loagitudc: 80°40'43"w Permitted Flow:0.00168 MGD
Beeeivine Strew:UT to Fisher River Stream Class: - Cn North i -� NPDES Permit No.NC0088609 --._
Drabaate Bain` Yadkin-Pee Dee River Basin Sub-Basin:_ 03-07-02 1 Y !6 Surry County

NPDES PERMIT NO.:NC0088609 PERMIT VERSION:3.0 PERMIT STATUS:Active
FACILITY NAME:Wtndgate Subdivision-#1 CLASS:PCNC COUNTY:Surry
OWNER NAME:Aqua North Carolina Inc ORC,Not Required ORC CERT NUMBER:995491
GRADE:PCNC ORC HAS CHANGED.No
eDMR PERIOD:07-2018(July 2018) VERSION:1 0 STATUS Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
50950 00407 50060 C11539 01045 01055 00070 01091
e "s `s = ?
°s
e. — c
'�- e w Monthly 2 X month 2 X month 2 X month Quarterly `Quarterly 2 X month Quarterly
Z 6 ` r 6
3 e 0 o` & Instantaneous Grab Grub Grab Grab I Grab Grab Grab
., .E —e a•
1: u
C 3 A O O 6 >:. FLOW pit cnLORuNC FSS•Cunc moo 61ANG5rOSb TO
Rltin7Y 1 ZINC
2409 clock me 2409 clock On WAIN mFd au uc/I mit IV npy I .nth 1 os/I
7
a
5
6
7
9
9
10 1053 L.57 Y 0.0014 6,62 14 1<23 419 343 04
17
12
13
14 I
15 - i
16
17
18
19 1 1
20 1 1
31
22
13
24 1439 035 Y 00014 665 5 <25 ] 4;
35
26 1 1
27
36
15 1 _
29
31
Menthh Arerepc Ll511 s 130
8I.8h1v Armpr 0 0914 9.5 5 41.9 343 CSS
Dully M.:110010 0.0014 6.62 14C 41.9 34 3 0 7
ll.Ily Minimum •"Y-
0.0014 6.55 5 0 _419 343 _04
`"`No Reporting Reason.ENFRUSE—No Flow-Reuse/Recycle, ENVWTIIR=No Visitation—Adverse Weather,NOFLOW=No Flow. HOLIDAY--No Visitation—Holiday

NPDES PERMIT NO.:NC0088609 PERMIT VERSION:3.0 PERMIT STATUS: Active
FACILITY NAME:Windgate Subdivision-#1 CLASS:PCNC COUNTY:Surry - _ _-.
OWNER NAME:Aqua North Carolina Inc ORC:Not Required ORC CERT NUMBER:995491
GRADE:PCNC ORC HAS CHANGED:No
eDMR PERIOD:07-2018(July 2018) VERSION:1 0 STATUS:Processed
COMPLIANCE STATUS:Compliant CONTACT PHONE it:3369929000 SUBMISSION DATE:08/22/2018
'✓"' y y.� .>. _..«., . ...: fv,,... 0BId.S/2018.,
ORC/Certifier ignature: William Young E-Mail:btyoung rr aquaamerica corn Phone #.[phone] Dale
By this signature,I certify that this report is accurate and complete to the best of my knowledge.
The permittee shall report to the Director or the appropriate Regional,Office any noncompliance that potentially threatens public health or the environment
Any information shall be provided orally within 24 hours from the time the perrn,ttee became aware of the circumstances.A written submission shall also be
provided within 5 days of the time the permittee becomes aware of the circumstances.
If the facility is noncompliant,please attach a list of corrective actions being taken and a time-table for improvements to be made as required by part LLE 6 of
the NPDES permit.
Esl•Z 08/22/2018
Permittee/Submitter Signature:*** Dave McDaniel E-Mail:[e-mail] Phone #•336-992-9000 Date
Permittee Address.266 Simpson Rd Dobson NC 27017 Permit Expiration Date:01/31/2019
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 managed the
system,or those persons directly responsible for gathenng 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.
CERTIFIED LABORATORIES
LAB NAME:Water Tech INC,Aqua NC
CERTIFIED LAB#:50 5035
PERSON(s)COLLECTING SAMPLES:William Young
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit(919)807-6300 or by visiting http://portal.ncdetir org/web/wq/swp/ps/npdes/forms
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data.
*No Flow/Discharge From Site:Check this box if no discharge occurs and,as a result,there are no data to be entered for all of the parameters on the DMR
for entire monitoring period.
**ORC on Site?:ORC-must visit facility and document visitation of facility as required per 15A NCAC 8G.0204.
*"*Signature of Permittee:If signed by other than the permittee,then delegation of the signatory authority must be on file with the state per 15A NCAC 2B
.0506(b)(2)(D).

NPDES PERMIT NO.:NC0088609 PERMIT VERSION:3.0 PERMIT STATUS:Active
FACILITY NAME:Wlndgate Subdivision-41 CLASS:PCNC COUNTY:Sury • _. - - - -• _
OWNER NAME:Aqua North Carolina Inc ORC:Not Required ORC CERT NUMBER:995491
GRADE:PCNC ORC HAS CHANGED:No
eDIvIR PERIOD:06-2018(June 2018) VERSION.1.0 STATUS:Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
50060 i C0530 01040 010.$ C11070 01092
a E _ •
• 500.0 00402 �.
F E ,i m 'e
A
'- < to y u Monthly 2 X month 12 X month 2 X month Quarterly Quarterly 12 X month Quarterly
C E '^
S.�^ E 6 is Instantaneous IGrab Grab IGrab Grab Grab Grab Grab
f c'
t! 12 o D D L FLOW ,pI1 CIILORRiE TSS-0000 0000 Rih}GhCSE TUROtnTY ZINC
2420 cluck IIrt 2400 dock Ors YJtOIN mod so u411 mit WA ug/1 nlu 09411
1 I _
2
3
4
5
6
7 I ,
9 I 1 I
10
11 I I .,,. .. ..
12 1445 0 6 Y 0,0014 6.99 12 4.4 ,4.3
22 I t
14 1
16 I
16 _
17
18 1 I
19 I
20 I I I
21 1
22
13 I
2`' 1 - 1
25 I
16
27 921 0.62 Y 0 0514 2,03 5 8 o 75
28 I I
29
30 I I '
Monthly Avcrngo Limit 30
Monlhll A,N,00. 0.001a 83 62 2.675
- - Dolly Maumom, 0.00I4 7,03 12 6 -' --'n-I-- - 4.6 -
Dolly hllnlmom' 00014
6,99 5 14.4 0.75
*"•No Reporting Reason'ENFRUSE=No Flow-Reuo&Recycle, ENV WTHR-No V notation-Adverse'Weather, NOFLOW=No Flow: HOLIDAY=No Visitation-Hohday

NPDES PERMIT NO.:NC0088609 PERMIT VERSION:3.0 PERMIT STATUS:Active
FACILITY NAME:W'indgate Subdivision- 1 CLASS:PCNC - COUNTY:Surn .--
OWNER NAME:Aqua North Carolina Inc ORC:Not Required ORC CERT NUMBER:995491
GRADE:PCNC ORC HAS CHANGED:No
eDMR PERIOD:06-2018(lune 2018) VERSION: 1 0 STATUS:Processed
COMPLIANCE STATUS:Compliant CONTACT PHONE#:[phone] SUBMISSION DATE:07/23/2018
-_ . , 07/20/20.18— ...
ORC/Certifier ignatu - William Young 3-Mail:btyoung©aquaamerica.com Phone #•704-507-3303 Date
By this signature.I certify that this report is accurate and complete to the best of my knowledge.
The permittee shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment.
Any information shall be provided orally within 24 hours from the time the permittee became aware of the circumstances.A written submission shall also be
provided within 5 days of the tune the permittee becomes aware of the circumstances.
If the facility is noncompliant,please attach a list of corrective actions being taken and a time-table for improvements to be made as required by part I1.E.6 of
the NPDES permit. t,
r ` c 07/23/2018
Permittee/Submitter Signature•*** Dave McDaniel E-Mai1•dtmcdanieleaquaamerica.com Phone #:[phone] Date
Permittee Address:266 Simpson Rd Dobson NC 27017 Permit Expiration Date:01/31/2019
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 ofthe person or persons who managed the
system,or those persons directly responsible for gathering the_nfonnation,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.
CERTIFIED LABORATORIES
LAB NAME:Water Tech INC,Aqua NC
CERTIFIED LAB#:50 5035
PERSON(s)COLLECTING SAMPLES:William Young
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NODES Unit(919)807-6300 or by visiting http.//portal.ncdenr org/web/we/swp/ps/npdes/forms
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data.
*No Flow/Discharge From Site-Check this box if no discharge occurs and,as a result,there are no data to be entered for all of the parameters on the DMR
- - for entire monitoring period. - - - -
-- **ORC on-Site?:ORC must-visit facility and-document visitation of facility as required per 1SA NCAC 8G
***Signature of Permittee:If signed by other than the permittee,then delegation of the signatory authority must be on file with the state per 15A NCAC 2B
.0506(b)(2)(D)

NPDES PERMIT NO:NC0088609 PERMIT VERSION.3 0 PERMIT STATUS:Active
FACILITY NAME:VJindeate Subdrolslon-hl _ CLASS:PCNC COUNTY:.Sv r� - ----
OWNER NAME:Aqua No-tl1 Carolina Inc ORC:Nol Required ORC CERT NUMBER:995491
GRADE:PCNC ORC HAS CHANGED:No
eDMR PERIOD:05-2018(May 2018) VERSION: 1.0 STATUS:Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
50950 00460 '0000 C0530 01045 01055 06070 01092
r C n
e 8' Monthly 2 X month 2 X month 2 X month Quarterly
s <` F _ Quarterly 2 X month Quarterly
u - 3 0 8 instantaneous Grab Grab Grab Grab I Grab Grab Grab
E n ` e, 4
u t= c o e L FLOA PR C11LOrtivE 7B5•Cone 110016 MAINGNE:.E 1.1R131DTY ZINC
f
2400 clock lin 2400 clerk 11n W0/N mid 511 007 1004 U[ll alit niu u=;0
1 l434 053 B 00014 675 6 _6.8 75
5 I
6
7
R
9 I
10
ft I �
l2 I
13 1
14 I
15 1443 0.57 B 0,0014 6,94 13 5.3 I 4 5
16
17
16
29
211 I
21
12
23
l4
i
25
26 —
17
24
29 I
711 I .., ..
it Ir}
Monllhl,,AverageLlmlt I20
Monthly Aeerogq 00014 93 6.05 - 6.15 _ -
nany nfa;Lmum: 00014 6.94 13 5,8 7.k ..--- —'—'-- --- -- - - Dn11)mtnimam'
0l00I4 675 _6 5i 4.5
""No Reporting Reason.ENFRUSE-No Flow-Reuse/Recycle; ENV3 THR=No Visitation-Adverse Weather; NOFLOW=No now. HOLIDAY=No Vlvtation- Ho'idly

NPDES PERMIT NO.:NC0088609 PERMIT VERSION:3.0 PERMIT STATUS:Active
— FACILiTY NAME:W+ndgate Subdivision-#1 CLASS:-FCNC- -- - - COUNTY:Sunt' __ .-__ - _ ,
OWNER NAME:Aoua North Carolina Inc ORC:Not Required ORC CERT NUMBER:995491
GRADE:PCNC ORC HAS CHANGED:No
eDMR PERIOD:05-2018(May 2018) VERSION:1.0 STATUS:Processed
COMPLIANCE STATUS:Compliant CONTACT PHONE t:3369929000 SUBMISSION DATE:06/26/2018
.06/2.6/2018 •
ORC/Certifier sgnature1W Ilam Young E-Mail:btyoung©r. aquaamerica.com Phone # [phone] Date
By this signature,I certify that this report is accurate and complete to the best of my knowledge.
The permittee shall report to the D:rector or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment.
Any information shall be provided orally within 24 hours from the time the permittee became aware of the circumstances A written submission shall also he
provided within 5 days of the time the permittee becomes aware of the circumstances
If the facility is noncompliant,please attach a list of corrective actions being taken and a time-table for improvements to be made as required by part II.E.6 of
the NPDES permit.
(0, C�e 06/26/2018
Permittee/Submitter Signature:*** Dave McDaniel E-Mail.dtmcdaniei@aquaamerica corn Phone #.[phone] Date
Permittee Address:266 Simpson Rd Dobson NC 27017 Permit Expiration Date:01/31/2019
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 ofthe person or persons who managed the
system,or those persons directly responsible 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.
ZERTIFIED LABORATORIES
LAB NAME:Water Tech/Aqua North Carolina
CERTIFIED LAB rt:50/5035
PERSON(s)COLLECTING SAMPLES:William Young
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit(919)807-6300 or by visiting http.//portal ncdenr.org/web/wq/swp'ps/npdes/forms.
FOOTNOTES
Use only units of measurement designated in the reporting facil-ty's NPDES permit for reporting data.
*No Flow/Discharge From Site•Check this box if no discharge occurs and,as a result,there are no data to be entered for all of the parameters on the DMR
for entiremoiiiloringperiod.
- -= -*,*-ORC on Site?:"ORG_must.visit facility and document-visitation-of facility as required per 15A NCAG8G 0204.1«;., � „__X—__ : - � ta_
***Signature ofPermittee:If signed by other than the permittee,then delegation of the signatory authority must be on file with the state per I5A NCAC 2B
0506(b)(2)(D).

NPDES PERMIT NO:NC0088609 PERMIT VERSION:3.0 - - PERMIT STATUS:-Ac21ve-, - - -" ----
FACILITY NAME:Wlndgate Subdivision-in CLASS:PCNC COUNTY:Sony
OWNER NAME:Aqua North Carolina Inc ORC:Not Required ORC CERT NUMBER:995491
GRADE:PCNC ORC HAS CHANGED:No
eDMR PERIOD.04-2018(April 2018) VERSION:3 0 STATUS:Processed
• - • • SAMPLING LOCATION: EFFLUENT,-DISCHARGE NO.: 001 .NO DISCHARGE : NO.„ " • , .-- •-.
50070 150400 40067 C0,411 0104$ 010.5 001170 01052
E fi r I I{
1. c 6
e s E
1 a Monthly 1 2 X month 2 X month 2 X month Quarterly Quarterly 2 X month Quarterly
E 7. c
l 8 u0 C E _c . Instantaneous IGlab Grao Gala Grab Grab IGrab Ora ,
O E 9 t u a
ii C O 2. FLOW pH CHLORINE T3S.CCM IRON 31ANGNESE TURUOUT' WIC
1450 Noel. lin 2440 dock lin 77050 mod Ell a 50)1 I11:11 U;n URN non eg/l
1
I ' I
I !
j3 1346 055 B 0.0014 686 8 3.4 { y11
4 I {f
s
6
F 1 1 I
91 1
10
11
11
13 I I
14
IS 1
16
1' 1352 0 55 04 0.0214 6.93 0 2.7 252 281 4.2
In
19
20 I 1
11 . I -
17 1
21 (i
24 1 1
25
76 1 I
27
78
29
30
M.nml..lvrr.Re Loon 30
alonlbh Meow 0.0015
4 3.05 202 201 7 6
-
Welt,"Mmlmvm 00014 693 E 3.4 252 261 111
^_ - - _ "_ D.Is Minimum: 00014 6 96 - __- D-- - -2.7 252 281 - 14,2
' ••*•NoReporting Reason'ENFRUSE-NoHow-Reuse/Recycle,ENV WTHR=No Visitation-Adverse Weather,-NOFLOW=No Flow; HOLIDAY=No Vlsta:ion-Holiday_ _ _ ,

_._ __.NPDES PERMIT NO.:NCOD886O9 _.__ PERMIT VERSION:3.0 PERMIT STATUS_Active _ ,____ _ _ _ _
FACILITY NAME:Windgele Subdivision-fit CLASS:PCNC COUNTY:Surry
OWNER NAME:Aqua North Carolina Inc ORC:Not Required ORC CERT NUMBER:995491
GRADE:PCNC ORC HAS CHANGED:No
eDMR PERIOD:04-2018(April2018) VERSION:3.0 STATUS:Processed
Outfall 001-Effluent Comments:
Reason for revision metals reporting wrong

NPDES PERMIT NO..NC0088609 PERMIT VERSION.3.0 -PERMIT STATUS:Active
FACILITY NAME:Wmdgate Subdivision-1/1 CLASS:PCNC COUNTY:Surry
OWNER NAME:Aqua North Carolina Inc ORC:Not Required ORC CERT NUMBER:995491
GRADE:PCNC ORC HAS CHANGED:No -
eDMR PERIOD:04-2018(April 2018) VERSION:3.0 STATUS•Processed
COMPLIANCE STATUS:Compliant CONTACT PHONE#:[phone] SUBMISSION DATE:06/10/2018
06/08/2018
ORC/Certifier Sig attire: Yr1Iliani Young E-Mail:[e-mail] Phone #:[phone] Date
By this signature,I certify that this report is accurate and complete to the best of my knowledge.
The permittee shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment
Any information shall be provided orally within 24 hours from the time the permittee became aware of the circumstances.A wntten submission shall also be
provided within 5 days of the time the permittee becomes aware of the circumstances
If the facility is noncompliant,please attach a list of corrective actions being taken and a time-table for improvements to be made as required by part ILE.6 of
the NPDES permit
e
/61C
C 06/10/2018
Permittee/Submitter Signature:*** Dave McDaniel E-Mail-dtmedaniel@aquaalnerica corn Phone #.[phone] Date
Permittee Address:266 Simpson Rd Dobson NC 27017 Permit Expiration Date:01/31/2019
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 managed the
system,or those persons directly responsible 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.
CERTIFIED LABORATORIES
LAB NAME:Water Tech
CERTIFIED LAB#:50
PERSON(s)COLLECTING SAMPLES:William Young
• PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit(919)807-6300 or by visiting http://portal.ncdenr.org/web/wq/swp!ps/npdes/forrus•
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data.
*No Flow/Discharge From Site:Check this box if no discharge occurs and,as a result,there are no data to be entered for all of the parameters on the DMR
for entire monitoring period. - - -- - -
'*ORC on Site?:ORC must visit facility and document visitation of facility as required per 15A NCAC 8G.0204.
***Signature of Permitter:If signed by other than the permrttce,then delegation of the signatory authority must be on file with the state per-15A NCAC 2B u -
.0506(b)(2)(D)

NPDES PERMIT NO.:NC0088609 PERMIT VERSION:10 PERMIT STATUS:Active
FACILITY NAME:Windeate Subdivision-#1 CLASS:PCNC COUNTY:Su.-ry
` -"OWNER NAME:Aqua North Carolina Inc - ' •-ORC:Not Required _. , ORC.CERT NUMBR:995.491 _ __ ___ .______
GRADE:PCNC ORC HAS CHANGED:No
eDMR PERIOD:03-2018(YTar1r 2018) VERSION:1,0 STATUS:Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
. . _ 50051 00400 50060 C0930 01045 01055 00070 ,. 01092
.i e n
1° p o _
o°
I.
- — a S. m Monthly 2 X month 12 X month 2 X month Quarterly Quarterly 2 X month Quarterly
59 r.
I5i - - & F Instantaaxus Grab Grab Grab I Gab Grab Grab Grab
1 a =
C o 5 i FLOW pH CHLORINE 755-Croy TR6N MJ.NGItlESE 7'ORDm7Y ZINC
2400 dock Ore 241/6 clock Are YIMM I mgd I SU an/l mg/I n0.4 usli - ala uyal
1 I
2 I I
3
< 37
5 I i
6
8 I
9
10 1
11 _
12
13 1350 24 1330 0.48 B 0.0014 6 9 4 43 II
14 I
15
10
•
I7
LB I
19I I I
2C
21 I
22 _ 1
I
0
25 _
27 1458 24 1435 0.57 B 0.0014 6.93 4 7 1 11
28 I
29 I 1
30 1
31 I
— Monlhly Avernae Lima` 30
Monthly Aver,0r
0D014 4 5.65 11
Dnly Mnzimum_0,0014 6.93 14- 1 11
Dolly Minimum 0.0014 6.9 14 43 _1 I
_-t_---s.. _. _ -_--_— ... s.... . . ..:_
'k"No Reporting Reason ENFRUSE=Pdc Flow-Aeuse/Rccycle; F,;VR'THF=No�Gsitetion'—4dvcrsc Woxthe,I4OFL01%J=No Flow, HOLIDAY `.oto Visltahori=iioLdz}� "

NPDES PERMIT NO:NC0088509 PERMIT VERSION:3 0 PERMIT STATUS:Active
FACILITY NAME:Windgate Subdivision-#1 CLASS:PCNC COUNTY:Surry
O WNER NAME:Aqua North Carolina Inc — —-- ORC:Not Required ORC CERT-NUMBER095491 , - - - - - _-. --
GRADE:PCNC ORC HAS CHANGED:No
eDMR PERIOD:03-2018(March 2018) VERSION:1 0 STATUS:Processed
COMPLIANCE STATUS:Compliant CON FACT PHONE#:[phone] SUBMISSION DATE:04/25/2018
t' � 04/19/2018
ORCr//Certtiifiet -' •ig�niture: `Vd/tlltam Young -E-Mail:[e-mail] Phone 4:704-507-33-03, -Date _ _
By this signature,I certify that this report is accurate and complete to the best of my knowledge.
The permittee shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment.
Any information shall be provided orally within 24 hours from the time the permittee became aware of the circumstances.A written submission shall also be
provided within 5 days of the time the permittee becomes aware of the circumstances.
If the facility is noncompliant,please attach a list of corrective actions being taken and a time-table for improvements to be made as required by part II.E 6 of
the NPDES permit.
C'( 04/25/2018
Permittee/Submitter Signature:*** Dave McDaniel E-Maii:[e-mail] Phone #:[phone] Date
Permittee Address:266 Simpson Rd Dobson NC 27017 Permit Expiration Date:01/31/2019
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 managed the
system,or those persons directly responsible 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.
CERTIFIED LABORATORIES
LAB NAME:Water Tech INC
CERTIFIED LAB#:50
PERSON(s)COLLECTING SAMPLES:William Young
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit(919)807-6300 or by visiting http://portal.ncdenr.org/web/wq/swp/ps/npdes/forms.
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data
*No Flow/Discharge From Site:Check this box if no discharge occurs and,as a result,there are no data to be entered for all of the parameters on the DMR
for entire monitoring period.
-- **ORCon Site?-ORC must visit facility and document visitation of facility as required per-ISA NCAC 8G.0204. --- - -- - - -
- _ -***Sienatute bf Pertnttee If signed-by other thari'the permittee;then-delegation of-the signatory-authority must-be onsfrle:with the state_per 15A,NrCAC.2B
.0506(b)(2)(D).

NPDES PERMIT NO.:N00088609 PERMIT VERSION:10 PERMIT STATUS:Active
_ _ .FACILITY NAME:_Wmdgate Subdivision-#1 CLASS:_PCNC COUNTY:Sutry
OWNER NAME:Aqua North Carolina Inc ORC:Not Required ORC CERT NUMBER:995491
GRADE:PCNC ORC HAS CHANGED:No
eDMR PERIOD:02-2018(February 2018) VERSION:1.0 STATUS:Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
. 50050 00400 50060 C0530 01045 01055 001070 01092
8 . Monthly 2 X month 2 X month 2 X month Ouarterty 10uarterly 2X month Quartrly
$
o u` E c° E Instantaneous Grab Grab Grab Gab Cttah Grab Grab
a a
o U H C C O ,-Go FLOSS p0 CHLORINE 75S-Cont 0009 MANG\ESE TURamTS ZINC
2400aloek Hrs 2400 clock 11rc YAWN gond an uc/I mall upll Ur/ 1n aryl
I I ,
2
3 I I
4
5 ..
6 I I I —
a
I
4
10
u
12
13 953 0.77 B 9.0314 730 6 3.6 1 1.B
14 I
15i I
16 I 1+ I
I7
16
19 I I
20
21
22
J
33
24
25 I
26 1
27 1510 0 62 113 0,0314 6.61 5 7 19 I
26
Monthly A.eresc Limit. 30 1
Monthly Arrregc; 3,0014 53 5 3 10.4
TMIb A4eTlmuv' 0 0014 7 39 6 7 19
Drill Minimum: 0.0014 6 61 5 13 6 I 1.6
-**r*No Reporting Reason ENFRUSE=No Flow-Reuse/Recycle; ENVWrBR�-NoVisitation—Advers-eWeather, NOFLOW=NoFlow:HOLIDAY=No Visitation—Holiday y

NPDES PERMIT NO.:NC0088609 PERMIT VERSION:3.0 PERMIT STATUS:Active
FACILITY NAME:Windgate Subdivision-#1 -CLASS:PCNC COUNTY:Surry
OWNER NAME:Aqua North Carolina Inc ORC:Not Required ORC CERT NUMBER:995491
GRADE:PCNC ORC HAS CHANGED:No
eDMR PERIOD:02-2018(February 2018) VERSION:1 0 STATUS.Processed
COMPLIANCE STATUS:Compliant CONTACT PHONE#:[phone] SUBMISSION DATE:03/27/2018
- - [!�-'''��f-x""4.'• �''--,�--_ �-�l - - ,.. ,- 03/14/2018
ORC/Certifte Signature: 'William Young E-Mail:btyoung@aquaamerica corn Phone #:[phone] Date
By this signature,I certify that this report is accurate and complete to the best of my knowledge.
The permittee shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment.
Any information shall be provided orally within 24 hours from the time the permittee became aware of the circumstances A written submission shall also be
provided within 5 days of the time the perrnittee becomes aware of the circumstances
If the facility is noncompliant,please attach a list of corrective actions being taken and a time-table for improvements to be made as required by part II.E 6 of
the NPDES permit
C1--e (1 C.l 1i 03/27/2018
Permittee/Submitter Signature:*** Dave McDaniel E-Mail:[e-mail] Phone #.[phone] Date
Permittee Address.266 Simpson Rd Dobson NC 27017 Permit Expiration Date:01/31/2019
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 managed the
system,or those persons directly responsible 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.
CERTIFIED LABORATORIES
LAB NAME•Water Tech
CERTIFIED LAB#:50
PERSON(s)COLLECTING SAMPLES:William Young
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit(919)807-6300 or by visiting http://portal.ncdenr.org/web/wq/swp/ps/npdes/forms.
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data.
*No Flow/Discharge From Site:Check this box if no discharge occurs and,as a result,there are no data to be entered for all of the parameters on the DMR
for entire monitoring period. _ - . .
**-ORC on-Site?:-ORC must visit facility and document visitation`of facilityas required.per.15A N IAC 80.0204. _
***Signature of Permittee:If signed by other than the permittee,then delegation of the signatory authority must be on file with the state per l 5A NCAC 213
.0506(b)(2)(D).

NPDES PERMIT NO.:N00088609 PERMIT VERSION:3.0 PERMIT STATUS.Active
______ -- FACIIJTY NAME:Windgalc Subdivision-#1 CLASS PCNC COUNTY:Sony
OWNER NAME:Aqua North Carolina Inc ORC:Not Required ORC CERT NUMBER:995491
GRADE:PCNC ORC HAS CHANGED:No
eDMR PERIOD:01-2018(January 2018) VERSION:1.0 STATUS:Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
- - ' I " _6 E .. - - ---. 50050 00400 50060 'C0530 01045 01055 1011070 01092 „', " - ^-
E. h `.
F ^ cz
> s t.Sonthly 2 X month 2X month 2 X month Quertorly _Quarterly 2 X month Quartet
a o u,
8 8 = 8 1 Inatantaneoam Grab Grab Grab Grab Grab Grab Grab
a b 5 a
c :.J F O G 5 I. I FLOW pit CHLORINE 17FC-Cone IOWa if4xh Gh E.SE 'i'l1RnIn7Y ZINC
2400 el.d. 11ln 2401)Noel On YRLN I • 5
1. ugI rng4 og4 00/1nv 00A
----. 1. -----*--H
2 I I I f
3 I I
4 1
5
6
8
1553 032 B 0.0014 7.12 8 3.5 103 32 =1,3
10 ( 1
11
12
13
14
15
16
17
18 I
19
20
21 I
22
`
23 1359 043 B 0.0014 749 20 4 24
24 1 -
25
6I
22
28
29
30 -
31
Monthly Arer.gn1,bnItl 30
hinmMi Anm.ae`0.0014 14 3 75 103 32 - 195 -- -- — __ -
--- n.II Mnalnam 0.0014 749 20 4 103 32 26
*"'No Reporting Reason-ENFRUSE=No Flow-Reuse/Reeycle:ENVWTHR=No Visitation—Adverse Weather,, NOFLOW=No Flow: HOLIDAY=No Visitation—Holiday

NPDES PERMIT NO.:NC0088609 PERMIT VERSION:3 0 PERMIT STATUS:Active
— FACILITY NAME:Windgate Subdivision-#+ CLASS-PCNC COUNT:Surry
OWNER NAME:Aqua North Carolina Inc CRC:Not Required ORC CERT NUMBER:995491
GRADE:PCNC ORC HAS CHANGED:No
eDMR PERIOD:01-2018(January 2018) VERSION:1 0 STATUS:Processed
COMPLIANCE STATUS:Compliant CONTACT PHONE#:[phone] SUBMISSION DATE:02/27/2018
/l< J - - - . - _ - 02/15/2018
ORC/Certifier Signature. William Young E-Mail:btyoungcraquaamerica.com Phone #:[phone] Date
By this signature,I certify that this report is accurate and complete to the best of my knowledge
The permittee shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment.
Any information shall be provided orally within 24 hours from the time the permittee became aware of the circumstances.A written submission shall also be
provided within 5 days of the time the permittee becomes aware of the circumstances.
If the facility is noncompliant,please attach a list of corrective actions being taken and a time-table for improvements to be made as required by part II.E.6 of
the NPDES permit.
r t OJ 02/27/2018
Permittee/Submitter Signature:*** Dave McDaniel E-Mail.dtmcdaniel®aquaamerica.com Phone #:[phone] Date
Permittee Address 266 Simpson Rd Dobson NC 27017 Permit Expiration Date:01/31/2019
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 managed the
system,or those persons directly responsible 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.
CERTIFIED LABORATORIES
LAB NAME:Water Tech INC
CERTIFIED LAB#:50
PERSON(s)COLLECTING SAMPLES:William Young
PARAMETER CODES
Parameter Codc assistance may be obtained by calling the NPDES Unit(919)807-6300 or by visiting httpi/portal.ncdenr org/web/wq/swp/ps/npdes/forms.
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data.
*No Flow/Discharge From Site-Check this box if no discharge occurs and,as a result,there are no data to be entered for all of the paiameters on the DMR
for entire monitoring period. -- - - - - ---- ---~ - -
**ORC on,Site9:ORC must visit facility and document visitation of facility,as-required per 15A NCAC 8G.0204. - _-,
***Signature of Permittee:If signed by other than the permittee,then delegation of the signatory authority must be on file with the state per 15A NCAC 2B
.0506(b)(2)(D).

NPDES PERMIT NO.:NC0088609 PERMIT VERSION:3.0 PERMIT STATUS:Active
FACILITY NAME:WindgaleSubdivision-#1 CLASS:PCNC - - - COUNTY:Surry _-__,. -_ .-- _ - - __`
OWNER NAME:Aqua North Carolina Inc ORC:Not Required ORC CERT NUMBER 995491
GRADE:PCNC ORC HAS CHANGED:No
eDMR PERIOD:12-2017(December 2017) VERSION:1 0 STATUS:Processed
SAMPLING LOCATION:EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
g/094 00400 90060 C0e30 01049 01850 Deem 01092
s e y •
C a I
- '- E Monthly 2 X month : month 12 Y,month 011anely Quarterly 2 X month Quarterly
e 2 F = G i
'g tnslanlanwas Grab Grab ±Grab Grab GmI1 Grab Grab
0 - [ a
c' ., E.
O Z FLOW pH CHLORINE 'MS•Cog IRON StAN°NESE TUR0IDTY ZINC
2400 a/nek Del 2400<tnck W. YIBIN mad Su IV MO aerI 111 Inm uart
1
2 I .
3
41
5 1
6 I
1
8
9 I
10 1
11 1 - ,
12 1
13 124 857 0.45 0 I 41.0014 7.56 4 3.6 035
14 1
IA I
16 1 ,
17 1 ,
In
19
20
21 1 1 i
22 1
23 1
24
25 .
26 I 1
Z7
28 24 1227 0 43 B 1 0 0014 7.28 4 3 4 0,0
29
30
•
it
Month11 Average LIm14 10
_ - ___ ___-L__ _ e innlhllArerene low 4- 4 3S ---_ ._- 0575
-- _ _ 5.11)Mexlmum 0A014 756 4 3 6 _04
_. _ - -- -- _ .'__" - 116118atlnto 9.0014 7 28 4 - 3,9 _ _ _, c 035- _--1- _ _
"'*No Reporting Reason:ENFRUSE=No Flow-Rcusc/Recycle,ENVWTHR=No Visitation-Adverse Weather; NOFLOW=No Flow;HOLIDAY-No Visitation-Holiday

NPDES PERMIT NO.:NC0088609 PERMIT VERSION:3 0 PERMIT STATUS:Active
-- - --FACILITY NAME:Wmdgate Subdivision-#1 CLASS:PCNC — - - COUNTY:-Surry °- --
OWNER NAME:Aqua North Carolina Inc ORC:Not Required ORC CERT NUMBER:995491
GRADE:PCNC ORC HAS CHANGED:TIo
eDMR PERIOD:12-2017(December 2017) VERSION:1.0 STATUS;Processed
COMPLIANCE STATUS:Compliant CONTACT PHONE#:[phone] SUBMISSION DATE.01/12/2018
_,. /17 01/10/2018 •-
s
ORC/Certifier . nature: William Young E-Mail:btyoung®aquaamerica.coni Phone #:[phone] Date
By this signature,I certify that this report is accurate and complete to the best of my knowledge.
The permittee shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment.
Any information shall be provided orally within 24 hours from the time the permittee became aware of the circumstances.A written submission shall also be
provided within 5 days of the time the permittee becomes aware of the circumstances.
If the facility is noncompliant,please attach a list of corrective actions being taken and a time-table for improvements to be made as required by part II.E 6 of
the NPDES permit. �y
6".„.....
, i .......„1" 0 1/1 2/201 8
Permittee/Submitter Signature:*** Dave McDaniel E-Mai1•[e-mail] Phone #:[phone] Date
Permittee Address.266 Simpson Rd Dobson NC 27017 Permit Expiration Date:01/31/2019
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 managed the
system,or those persons directly responsible 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.
CERTIFIED LABORATORIES
LAB NAME:Water Tech INC
CERTIFIED LAB#:50
PERSON(s)COLLECTING SAMPLES:William Young
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit(919)807-6300 or by visiting httpJ/portal ncdenr.org/web/wq/swp/ps/npdes/forms.
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data
*No Flow/Discharge From Site:Check this box if no discharge occurs and,as a result,there are no data to be entered for all of the parameters on the DMR
- for-entire-monitoring period.- -- •-__ - -"` - --- - --- -
- **.ORC on Site?:ORC must-visit facilityand-document visitation of facility as required per 15A NCAC 80.0204. _.,,_t___ ,•, ;.__--_—___=_,_._,_
***Signature of Permittee:If signed by other than the permittee,then delegation of the signatory authority must be on file with the state per 15A NCAC 2B
.0506(b)(2)(D).

NPDES PERMIT NO.:NC0088609 PERMIT VERSION:3.0 PERMIT STATUS:Active
- --- --FACILITY NAME.Windgato Subdivision-#1 CLASS:PNC COUNTY Suny
OWNER NAME:Aqua North Carolina Inc ORC:Not Required ORC CERT NUMBER:995491
GRADE:PCNC ORC HAS CHANGED:No
eDMR PERIOD.11-2017(November 2017) VEERSION:1.0 STATUS:Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
e
50050 00400 50060 C0530 01045 !00059 00070 01042
I •
Fav 611
e
F Monthly 2 X month 2 X mnntF 12 X month Quarterly 0uz-lerly 2 X monthOuarted-v
S !°,, G In.StantanOn5 Grab IGab Grab Grab IGrab Grab Grab
T. 11f a
q V h O G o 2 MOW PH CHLORINE ISS-Cone IRON MANONESE I771RDID7Y ZINC
3400 clock ur, 2400 clock Io-, Y111ra1 mad ea oy l marl I ay7 alt ntu uo/I
1
I
3
4 I I I ,..
S
6 1 I 1(
7 1413 0.52 E 00014 71'1 ID 3.5 045
R
9 I
10 I l a� I
11
12 _
13
14 1
IS f
16
17
1S 1-
19 i 1
s0 -
21 1231 0 53 9 00014 7.38 5 5.8 32 28 1
22
23 1
24
25
26
27 -
26
29
30 ,
-
Monthly Average LW! 30
Monthly Avrregr. c 0014 7.5 4.60 32 20 0.025
D--Maolmum;0.0014 738 10 _ _. _ 5,8 __ - 32 28___ ____ 1.2 I ___ - -_
-_-- -_-- - -1---_ - -- Dolly Minimum' 00014 7.17 5 3.5 _ 32 28 045 1
f 0t No Reporting Reason.ENFRUSE=No Flow-Reuse/Recycle,ENVWFH R=No Visitation-Adverse Weather, NOFLOW:No Flow; HOLIDAY=No Visitation=Holiday- -- -

NPDES PERMIT NO.:NC0088609 PERMIT VERSION:3 0 PERMIT STATUS:Active
_ FACILITY NAME:Wmdeate Subdivision-#1 , CLASS:PCNC _ •, -_ COUNTY:Surry
OWNER NAME:Aqua North Carolina Inc ORC:Not Required ORC CERT NUMBER:995491
GRADE:PCNC ORC HAS CHANGED:No
eDMR PERIOD:11-2017(November 201 7) VERSION:1.0 STATUS:Processed
COMPLIANCE STATUS:Compliant CONTACT PHONE#•3369929000 SUBMISSION DATE:12/22/2017
12/21/2017;.
ORC/Certifier Signature: illram Young E-Mail:[e-mail] Phone #:[phone] Date
By this signature,I certify that this report is accurate and complete to the best of my knowledge.
The permittee shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment.
Any information shall be provided orally within 24 hours from the time the permittee became aware of the circumstances.A written submission shall also be
provided within 5 days of the time the permittee becomes aware of the circumstances. •
If the facility is noncompliant,please attach a list of corrective actions being taken and a time-table for improvements to be made as required by part II E.6 of
the NPDES permit.
�JC'
g---- / , 12/22/2017
Permittee/Submitter Signature•*** Dave McDaniel E-Mail:[e-mail] Phone #:[phone] Date
Permittee Address:266 Simpson Rd Dobson NC 27017 Permit Expiration Date:01/3I/2019
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 managed the
system,or those persons directly responsible 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
k nowingviolations.
CERTIFIED LABORATORIES
LAB NAME:Water Tech INC
CERTIFIED LAB#:50
PERSON(s)COLLECTING SAMPLES:William Young
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit(919)807-6300 or by visiting http://portal ncdenr.org/web/wq/swp/ps/npdes/forms.
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data.
*No Flow/Discharge From Site:Check this box if no discharge occurs and,as a result,there are no data to be entered for all of the parameters on the DMR
- — —for_entire monitoring period..
**ORC on Site?:ORC must visit facility and document visitation of facility as required per 15A NCAC 8G 0204.
***Signature of Permittee.If signed by other than the permittee,then delegation of the signatory authority must be on file with the state per I5A NCAC 2B
.0506(b)(2)(D).

NPDES PERMIT NO.:NC0038609 PERMIT VERSION 13.0 PERMIT STATUS:Active
• _ _FACILITY NAME:Wlndgate Subdlyision-RI CLASS:PCNC COUNTY:Surly
OWNER NAME:Aqua North Carolina Inc ORC:Not Required ORC CERT NUMBER'9954-91
GRADE:PCNC ORC HAS CHANGED:No
eDMR PERIOD:10-2017(October 2017) VERSION:1.0 STATUS:Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
50090 011410 50060 C0510 01045 01055 4#0.70 01092
1 E ,S /f,
C -.
-1, C K
E. t Fg Mnntnly 2 X month 2 h month 12 X month Quarterly 9ua.-terly "2 X month Quarterly
SE)
< v, ot
G o` E- Ustantanmis Grab Grab Grab Grab Grab Grab Grab
5 a u C
w z FLOW 411 CHLORINE 1300-Cone IRON �MANGNESE TURDin rY DNC
a J r ,i O O Z
A
24110,loci, (Ors 2400 clock Hr. 0/a/N mgd 80 ug/1 marl alit lug/1 non WI
.1 _ 1
2I
3 1404 0.68 0 0 0014 6.92 8 I<2.5 05
4
5
1
e I
9
10 -
11 I I
12 1
13 1 I
14 I
1
15
116 I
17
18 1
19 1
211 I
11
22
23
,
24
ss 1226 047 B 100014 702 5 <2.5 05
20 1
27 1
211 1
29 1
30
31
a 1
Momhh Average Llmh, S0
h'"'thl Avero6o. 0.001465 0 0.5
. ..__ ___ _ _ __ _ Denr M.nlmnm OWt4 7.02 •
_ 8 0 OS - _____ ____ —
Dolly Allnlmum: P0014 6-52 -9 0 05 -- �.
•r''No Reporting Reason.ENFRUSF.=No Flow-Reuse/Recycle, ENVWVTHR=No Visitation-Adverse Weather, NOFLOW=No Flow, HOLIDAY=No Visitation-Holiday

NPDES PERMIT NO.:NC0088609 PERMIT VERSION:3 0 PERMIT STATUS:Active
-_ FACILITY NAME:Wmdgate Subdivision-frl CLASS:PCNL COUNTY:Surry w,- ___
OWNER NAME:Aqua North Carolina Inc ORC:Not Required ORC CERT NUMBER:995491
GRADE:PCNC ORC HAS CHANGED:No
eDMR PERIOD:10-2017(October 2017) VERSION:1.0 STATUS:Processed
COMPLIANCE STATUS:Compliant CONTACT PHONE#:[phone] SUBMISSION DATE:11/28/2017
/-6(1
d_ -- 11/20/2017
ORC/Certifi 1Signature: Allam Young E-Mail:[e-mail] Phone 0:704-507-3303 Date
By this signature,I certify that this report is accurate and complete to the best of my knowledge.-
The permittee shall report to the Director or the appropriate Regional Office any noncompliance that-potentially threatens public health or the environment.
Any information shall be provided orally within 24 hours from the time the permittee became aware of the circumstances.A written submission shall also be
provided within 5 days of the time the permittee becomes aware of the circumstances.
If the facility is noncompliant,please attach a list of corrective actions being taken and a time-table for improvements to be made as required by part II.E.6 of
the NPDES permit.
711
C(Cij
11/28/2017
Permittee/Submitter Signature:*** Dave McDaniel E-ivlail:[e-mail] Phone #:[phone] Date
Permittee Address:266 Simpson Rd Dobson NC 2701'T Permit Expiration Date:01/31/2019
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 managed the
system,or those persons directly responsible 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 impnsonment for
knowing violations.
CERTIFIED LABORATORIES
LAB NAME:Water Tech INC
CERTIFIED LAB#:50
PERSON(s)COLLECTING SAMPLES:William Young
PARAMETER CODES
Parameter Code assistance maybe obtained by calling the NPDES Unit(919)807-6300 or by visiting http://portal.ncdenr org/web/wq/swp/ps/npdes/forms.
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data.
*No Flow/Discharge From Site:Check this box if no discharge occurs and,as a result,there are no data to be entered for all of the parameters on the DMR
- -- —--.for entire monitoring-period.- - - _--
- **ORC on Site?:ORC must visit facility and document visitation of facility as required per 15A NCAC 8G_0204._ -
***Signature of Permittee:If signed by other than the permittee,then delegation of the signatory authonty must be on file with the state per 15A NCAC 2B
.0506(b)(2)(D).

NPDES PERMIT NO.:NC0088609 PERMIT VERSION:3.0 PERMIT STATUS:Active
FACILITY NAME:Wjndgate Subdlvlsioz-4'1 CLASS:?CNC COUNTY:Surry
OWNER NAME:Aqua North Carolina Inc ORC:Not Reoulred ORC CERT NUMBER:995491
GRADE:PCNC ORC HAS CHANGED:No
eDMR PERIOD:09-2017(September 2017) VERSION:1.0 STATUS:Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
-_.sass__ -.n_. .. . ,., _ _--" .-..... - - — —
Srpor. 00400 89069 (C0036 01019 01055 00100 10)090
F 6 fi w e
l
u It O
y e FIn
_ ,Monthly 2 X month 2 X month 2 X month Quarterly Ouertcrly 12 X month Quarterly
e'
g. vC
T. C o -e
Insla.tainous Grab Grab Grab Grab Grab Cab Grab
o 6 %fO O CC
2 FLOW p11 1CHLORINE TSS•Conc iMON MANGNESE 211RDIDTY ZINC
2400 clock Iles 7400 dock lin YAM mod su WI mill ulr. ug/1 mu oWl
I.
7 !1 1
3 I
4 1 1
5 I
6 1 -
7
9 I
10 1
11
12 1257 9.62 B 0.0014 7.36 4 <23 035
13
14
15 1
•
16 1
17 1
16
09
20"
21 I
u 1
73 I ,
24
29
76 1217 105 B D 0014 7 D8 6 3,1 10 65
27 J
20 1
29 1
30
Monthly Average Limb. 30
Monthly Areroke. 5,0014 5 135 0.65 _
15.11y M.r1
mum 00014 736 6 3J 065
- ___ _ :. _ _ _.._ - ____ - __-
Dully Mlnlmum 0.0014 758 4 :I 0-65 -- - - --
*000No Reporting Reason CNFRUSE=NoFlow-Reuse/Recycle;•ENVWTIIR=No Vlsitahon_Advers Weather NOFLOW=No Flow, HOLIDAY_=_NoNOstlation=Holiday _-__ „_-,:-:.__,_,__:_„:-

NPDES PERMIT NO.:NC0088609 PERMIT VERSION:3 0 PERMIT STATUS:Active
FACILITY NAME:Wmdgate Subdivision- CLASS:PCNC COUNTY:Surry
OWNER NAME:Aqua North Carolina Inc ORC:Not Required ORC CERT NUMBER:99549I
GRADE:PCNC ORC HAS CHANGED:No
eDMR PERIOD:09-2017(September 2017) VERSION:1 0 STATUS:Processed
COMPLIANCE STATUS:Compliant CONTACT PHONE#:[phone] SUBMISSION DATE:10/29/2017
_ I0/23/2017,
ORC/Certifier Sigr.a ure: Wham Young E-Mail:btyoung@aquaamerica corn Phone #•704-507-3303 Date
By this signature,I certify that this report is accurate and complete to the best of my knowledge
The permittee shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment.
Any information shall be provided orally within 24 hours from the time the permittee became aware of the circumstances A written submission shall also be
provided within 5 days of the time the permittee becomes aware of the circumstances.
If the facility is noncompliant,please attach a list of corrective actions being taken and a time-table for improvements to be made as required by part II.E.6 of
the NPDES permit
Le itjVC00-110/29/2017
Permittee/Submitter Signature:*** Dave McDaniel E-Mail:[e-mail] Phone #:[phone] Date
Permittee Address:266 Simpson Rd Dobson NC 27017 Permit Expiration Date:01/31/2019
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 Bather and evaluate the information submitted Based on my inquiry of the person or persons who managed the
system,or those persons directly responsible for gathering the information,the information submitted is,to the best of my knowledge and belief,true,
accurate,and complete.1 am aware that there arc significant penalties for submitting false information,including the possibility of fines and imprisonment for
knowing violations.
CERTIFIED LABORATORIES
LAB NAME:Water Tech INC
CERTIFIED LAB#:50
PERSON(s)COLLECTING SAMPLES:William Young
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit(919)807-6300 or by visiting httpi/portal.ncdenr org/web/wq/swp/ps/npdes/forms
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data.
*No Flow/Discharge From Site•Check this box if no discharge occurs and,as a result,there are no data to be entered for all of the parameters on the DMR
for entire monitoring period
**ORC on Site?:ORC must visit facility and document visitation of facility as required per•l5A NCAC 80.0204.
***Signature of Permittee:If signed by other than the permittee,then delegation of the signatory authority must be on file with the state per 15A NCAC 2B
.0506(b)(2)(D).

NPDES PERMIT NO.:NC0088609 PERMIT VERSION:3 0 PERMIT STATUS:Active
FACILITY NAME:Windgate Subdivision-#1 CLASS:PCNC COUNTY:Sorry
OWNER NAME:Aqua North Caroitna Inc ORC:No:Required ORC CERT NUMBER:995491
GRADE:PCNC ORC HAS CHANGED:No
eDMR PERIOD:08-2017(August 2017) VERSION:1 0 STATUS:Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
_ t
/ 50050 - - 110600 s 50060 : 00530 01845 01055 100070 01092
EF E C
m y
E - +
y '[ ,g _ g 'Armagh' 12 X month 2 X montn 2 X month Quarterly Qnertcrly I2 X month Quarterly r
At E < L
u E c" 8 lnstartar.mus Grab Crab Grab Grab Grab Grab Grab
Y. E u C
A 0 4 o &- o z FLOW pit CHLORINE 756-Cone IIRoh MANCNCSE _ITURBTDTY ZINC
2400 clock 'lira 17400 e1ock Ilra Y/BIN mgd 511 nal mg/1 ug/1 ug/1 otu ur/I
t I 0 00014
2 I
3 I
4 f
5 I I I 1
6 I
7
.E 1453 0.53 Y I0.00014 VA 6 <25 04
9
10
ii I
12 I 1
03 1
fd I
15 0 00314 .
tc _ 1
17 I
15 I I I
19 I 4
10 I I
21
22 1306 0.48 Y 0.0014 6.95 8 3.9 87 49 035
23
24 I
25
26
2? 1 I
25
29 0 00014
30
11 I
1 4
Monthly Avcrap.Llmll. 30
Monthly Average. 0,000392 i 1.95 87 29 0375
-
- Dat0 974410004. 0 00I4 I i 08 +8 3.9 87 49 OA _
__ ._ ___ __ _ _ s.....7;"•—•:..Ag-11 Minimam• 0.0-0314- 6 93---- - 6 - 0 S7 " 49
No Reporting Reason.ENFRUSE No Flow-Rcnse/Recycle; ENVWTHR=NoVtsaation—AdverseWeather,NOFLOW=No Flow, HOLIDAY=No Visitation—Holiday

NPDES PERMIT NO.:NC0088609 PERMIT VERSION:3.0 PERMIT STATUS:Active
FACILITY NAME:Windgate Subdivision-Pi CLASS:PCNC COUNTY:Surry
OWNER NAME:Aqua North Carolina Inc ORC:Not Required ORC CERT NUMBER:995491
GRADE:PCNC ORC HAS CHANGED:No
eDMR PERIOD:08-2017(August 2017) VERSION:1 0 STATUS:Processed
COMPLIANCE STATUS;Compliant CONTACT PHONE#:[phone] SUBMISSION DATE:09/25/2017
. / 09/19/2017
ORC/Certifier Signature: iliiam Young E-Mail:btyoung@aquaamerica corn Phone #:[phone] Date
By this signature.I certify that this report is accurate and complete to the best of my knowledge
The permittee shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment
Any information shall be provided orally within 24 hours from the time the permittee became aware of the circumstances.A written submission shall also be
provided within 5 days of the time the permittee becomes aware of the circumstances.
if the facility is noncompliant,please attach a list of corrective actions being taken and a time-table for improvements to be made as required by part ILE.6 of
the NPDES permit
CCal 09/25/2017
a P
Permittee/Submitter Signature:*** Dave McDaniel E-Mail:[e-mail] Phone [phone] Date
Permittee Address:266 Simpson Rd Dobson NC 27017 Permit Expiration Date=01/31/2019
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 managed the
system,or those persons directly responsible 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,
CERTIFIED LABORATORIES
LAB NAME:Water Tech INC
CERTIFIED LAB#:50
PERSON(s)COLLECTING SAMPLES:William Young
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit(919)807-6300 or by visiting http://portal.ncdenr.org/webiwq/swp/ps/npdes/forms.
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data.
*No Flow/Discharge From Site.Check this box if no discharge occurs and,as a result,there are no data to be entered for all of the parameters on the DMR
for entire monitoring period. - ------- --- _ . - -
**ORC on Site?:ORC must visit facility and document visitation of facility as required per 1SA NCAC 8G.0204. _
***Signature of Permittee:If signed by other than the permittee,then delegation of the signatory authority must be on file with the state per 15A NCAC 2B
0506(b)(2)(D).