NC0088617_Renewal Application_20181004

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GOL'87 norEnvironmental Quality
MICHAEL S_REGAN
Secret
LINDA CULPEPPER
Interim Director
October 05, 2018
Thomas Roberts
Aqua North Carolina Inc
202 Mackenan Ct
Cary, NC 27511
Subject: Permit Renewal
Application No. NC0088617
Snow Hill Subdivision
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://dea.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, 1
.,JCP/-7 10
Wren Thedford
Administrative Assistant
Water Quality Permitting Section
cc: Central Files w/application
ec: WQPS Laserfiche File w/application
DEQ
North Carolina Department of Environmental Quality I Division of Water Resources
1617 Mail Service Center I Raleigh,North Carolina 27699-1617
919-807-6300

A9UASM
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.
Snow Hill Subdivision,Well #2 -WTP
NPDES Permit NC0088617
Dear Mr.Thedford:
Enclosed are three (3) copies of the completed application Short 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 Snow Hill-Well#2 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 NC0088617.
Best Regards,
GAUCPRECEIVED/DENR/Dw
Amanda Berger R
)
Manager, Environmental C€ p4iance QCT 0 5 201$
Water Resources
Permitting Section
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 NC0088617
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 Snow Hill Subdivision-Well #2 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 0
Street Address or State Road Snow Hill Drive
City Dobson
State / Zip Code NC/ 27017
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 ❑ State ❑ Private ® 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 utilizing three (3) iron-removing, chemical-free oxidizing sand
filtration technology. Chlorine added for disinfection.
8. Describe the wastewater and the treatment process(es) for wastewater generated by the
facility:
Wastewater discharge is the backwash of the chemical.free sand filters. Discharge rate is
approximately 1,200 gallons per day_ Wastewater is discharged at the location specified
on the attached map into an unnamed tributary to Cody Creek.
9. Number of separate discharge points: 1
Outfall Identification number(s) 001
10. Frequency of discharge: Continuous El Intermittent
If intermittent:
Days per week discharge occurs: 7 Duration: Approx. 120 minutes
- -_ _____.-1-1:--Plant-design potable-flowrate-0:031— MGD ------------- ------------__.- -
Backwash or reject flow 0.00120 MGD
12. Name of receiving stream(s) (Provide a map showing the exact location of each outfall, including
latitude and longitude):
Unnamed Tributary to Cody Creek (Yadkin Pee Dee Basin)
Page 2 of 3 Version 5/2012

NPDES PERMIT APPLICATION - SHORT FORM C - WTP
For discharges associated with water treatment plants
13. Please list all water-treatment additives, including cleaning chemicals'or disinfection • -
treatments, that have the potential to be discharged.
Alum / aluminum sulfate Yes No X
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
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
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.
Printed name of Person Signing 'Title
3\114dA..da-- iete cI1Zo-Ie
:� PP
Si ature of Applicant Da
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 monitonng 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
impnsonment not to exceed six months,or by both (18 U S.0 Section 1001 provides a punishment by a fine of not more than$25,000 or impnsonment notmore than 5_.
years,or both,for a similar offense)
Page 3 of 3 Version 5/2012

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NPDES PERMIT NO.:NC0088617 PERMIT VERSION:3 0 PERMIT STATUS:Actrve
FACILITY NAME:Snow Hill Subdivision 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:06-2018(June 2018) VERSION.1.0 STATUS:Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
20555 00455 5000 (T5530 01045 01053 00575 01591
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NPDES PERMIT NO.:NC0088617 PERMIT VERSION:10 PERMIT STATUS:Active
FACILITY NAME:Snow Hill Subdivision CLASS:PCNC COUNTY.Sunt'
OWNER NAME:Aqua North Carolina Inc ORC:Not Required ORC CERT NUMBER:995491
GRADE:PCNC ORC HAS CHANGED:No
eDMR PERIOD:06-2018(lune2018) VERSION'LO STATUS:Processed
COMPLIANCE STATUS.Compliant CONTACT PHONE#:[phone] SUBMISSION DATE:07/23/2018
07/20/2018
ORC/Cerlifier natur ililliam Young [e-mail] Phone 4:704-507-3303 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.
ri ci0j 07/23/2018
Permittee/Submitter Signature:*** Dave McDaniel E-Mail dtmcdaniel@aquaamerica,com Phone #:[phone] Date
Permittee Address:Snow Hill Dr Dobson NC 27017 Permit Expiation Date:02/28/2019
I certify,under penalty of iaw,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 1 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:Witham Young
PARAMETER CODES
Parameter Code assis e be o tom ?by c ng the NPDES Unit(919)307-6300 or by visiting http://portal.ncdenr.org/web/wq/swp/ps/npdes/forms.
FOOTNOTES
Use only unit of mea. it riesieriated in the r -ortm-g facility's NPDES permit for reporting data
*No Flow/Discharge Frai<-Sile 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 LSA NCAC 8G.0204.
***Signature ofPermittee•If signed by other than the permittee,then delegation of the signatory authority must be on file with the slate per 15A NCAC 2B
.0506(b)(2XD). - _ - - - -_--

NPDES PERMIT NO.:NC0088617 PERMIT VERSION:3 0 PERMIT STATUS:Active
FACILITY NAME:Snow Hill Subdivision CLASS:PCNC COUNTY•Surry
OWNER NAME:Aqua Nortn 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
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*:NO
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Drib M{nteuna-0.0325 735 _5 3.5 0.4
•'••No Reporting Reason:ENFRUSE=No Flow-Reuse/Recycle, ENVWTIIR—No Visilatior—Adverse Weather NOFLOW=No Flow, IIOLIDAY=No V ISNali(ni—Holiday

NPDES PERMIT NO.:NC0088617 PERMIT VERSION:3.0 PERMIT STATUS:Active
FACILITY NAME:Snow Hill Subdivision CLASS:PCNC COUNTY:Suiry
OWNER NAME:Aqua North Carolina Inc ORC:Not Requited ORC CERT NUMBER:995491
GRADE:PCNC ORC HAS CHANGED:No
eDMR PERIOD:05-2018(May 20(8) VERSION:1 0 STATUS:Processed,
COMPLIANCE STATUS:Compliant CONTACT PHONE II:3369929000 SUBMISSION DATE:06/26,2018
C�Gt� = 06/26/2018- - - •
ORC/Certifier S' nature: William Young E-Mail•btyoung@aquaamerica coin 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 permitter 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 take[and a time-table for improvements to be made as required by part ILE 6 of
the NPDES permit. t/
4.0 (1, C(02 06/26/2018
Permittee/Submitter Signature:*** Dave McDaniel E-Mail:[e-mail] Phone # [phone] Date
Permittee Address.Snow Hill Dr Dobson NC 27017 Permit Expiration Date:02/28/2019
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.
CERTIFIED LABORATORIES
LAB NAME:Water Tech/Aqua North Carolina
CERTIFIED LAB#:50/5035
PERSON(s)COLLECTING SAMPLES:William Voting
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit(919)807-6300 or by visiting http://portal.nedenr.org/web/wq/swpips/npdeslforms.
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.
**DEC on Site?:ORC must visit facility and document visitation of facility as required per 15A NCAC 8G.0204.
***Signature ofPcririittcc: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:NC0088617 PERMIT VERSION:3.0 PERMIT STATUS:Active
FACILITY NAME•Snow H711 Subdivision 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(Apri12018) VERSION:3.0 STATUS:Processed
SAMPLING LOCATION:EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
j
SOMA 06422 .0050 C0022 21045 01255 001•C 21040
7. e F S
.44
9 2 : Y
L
E 2 X month 2 X month 2 X ln0mh 2 X month oU2vle71y Quenvty 2 X mo4ih Q71,22.11.2' `
J,
' Ii $ C o vt im mlancw Gnib Grab Gob Grab 0mb G1sb Grab
2 V r O clG i P1.014 01 CIILDa1222. DRS-Com 31100 2,1A0(04P.R: TU7211I0TY ZINC
742651=.M ns! 2000001 nn WI m34 40 0011 ma15 0q3 uvi nt11 uefl
1
3 1434 0.5 Y 0.0025 7.37 8 <2S 0.3
t
6
7
5
10
12 -
u
14
1S
76
17 1423 0 45 04 0.0025 7,67 2 4 4 542 260 25
IR
IS
m
11
22
01
24
25
15
I7
2P v
79 _ I
30
51.161y Ammo 1120111 37 ,
21amR1yA4er.lo 0,0025 5 2.2 542 260 1,4
Ddl}nGdmuml 0
A025 7.67 6 4,4 342 260 25
21.14 Mh4m+um 00055 757 2 0 542 200 03
•••'NoReporting Reason:ENFRUSE-Noflow-Reuse/Recycle, ENVWTHR-NoVisna;Ion—AdverseWeathrr, NOFLOW-No Flow:HOLIDAY=NoVtsitalion—Holiday <

NPDES PERMIT NO.:NC0088617 PERMIT VERSION:3.0 PERMIT STATUS:Active -
FACILITY NAME:Snow Hill Subdivision CLASS:PCNC COUNTY:Suny
OWNER NAME:Aqua North Carolina Inc ORC:Not Required ORC CERT NUMBER:995491
GRADE:PCNC ORC HAS CHANGED:No
eDMR PERIOD:O4-3018(April 2.010 VERSION:3.0 STATUS:Processed
Outfall 001-Effluent Comments:
Reason for revision metals reporting wrong

NPDES PERMIT NO.:NC0088617 PERMIT VERSION:3 0 PERMIT STATUS:Active
•
FACILITY NAME:Snow Hill Subdivision CLASS:PCNC COUNTY:Surly
OWNER NAME:Aqua North Carolina Inc ORC:Not Requited ORC CERT NUMBER:995491
GRADE:PCNC ORC HAS CHANGED:No
eDMR PERIOD:04-2018(April2018) VERSION:3M STATUS:Processed
COMPLIANCE STATUS:Compliant CONTACT PHONE#:[phone] SUBMISSION DATE:06/10/2018
6 �1, 06/08/2018
ORC/Certifier Signature: William Young E-Mail.btyoungigaquaamerica.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.
iftAC( 06/10/20!8
Permittee/Submitter Signature *** Dave McDaniel E-Mail:[e-mail] Phone #:[phone] Date
Permittee Address:Snow Hill Dr Dobson NC 27017 Permit Expiration Date:02/28/2019
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 If: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 80.0204
*"*Signature of Permittee:if signed by other than the permitter,then delegation of the signatory authority must be on file with the state per ISA NCAC 2B
.0506(b)(2)(D).

1
NPDES PERMIT NO.:NCOOS8617 PERMIT VERSION:10 PERMIT STATUS:Active
FACILITY NAME:Snow H:11 Subdivision CLASS:PCNC COUNTY:Surry
OWNER NAME:Aqua North Carolina Inc ORC:Not Required ORC CERT NUMBER:995491 - -
GRADE:PCNC ORC HAS CHANGED:No
eD1YMR PERIOD:03-2018(March 2018) VERSION:1 0 STATUS:Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*:NO
^
50050 110429 55060 C0530 01095 *1059 2078 01002
r e F t3
0
Fr
E II g :4w 2 X month 2 X month 2 X tnonth 2 X month Quarterly Quarterly 2 X month Quarterly
3 s`= 5 Instantaneous Grua Grab Grab Grub Grab Gab Grab
0 2 `s `s a
S u r• 0 0' o z FLOW pH CHLORINE TSO-Cont MON MANCNLSE TUROWTY one
1979 clock lin 240d,ek {H, MN mq5 no 01,•71 'nt/i 0511 as2. nal 29/I
1 _
2
J
6 r
7
a
9
10
71
12
13 1417 24 1490 9.5 Y 0,0025 7,9 s 3.1 04
19
-
15 V^ _
16 I
17
18
19
20
21
22 ,
25
29 •
25 - - - v
26
27 1525 24 IMG 0,38 Y 00025 769 1 27 55 I
29 1 1
1
39 1
1
51 i
Monthly AraogcLInit. J7 1 11
Monthly A.er2p9 0 9025 3 29 3 1
may Mesimumo 00022 769 5 31 5.6
8911.Minimum:00025 75 1 Si 04
040*No Reporting Reason ENFRUSE=No Flow-RetudRSLyt,le,ENVWTHR=No V isilstion-Adverse Weather, NOFLOW=No Flow; HOLIDAY=No Visitation-Holiday- - - --- `

NPDES PERMIT NO.:NC0088617 PERMIT VERSION:3 0 PERMIT STATUS:Active
FACILITY NAME:Snow Hill Subdivision CLASS:PCNC COUNTY:Sorry
- OWNER NAME:Aqua North Carolina Inc ORC:Not Required ORC CERT NUMBER:995491
GRADE:PCNC ORC HAS CHANGED:No
eDMR PERIOD:03-2018(March 2018) VERSION:1.0 STATUS.Processed
COMPLIANCE STATUS:Compliant CONTACT PHONE 4:3369929000 SUBMISSION DATE:04/25/2018
04119/2018
ORC/Certif. r Signature: William 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 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.
CC.4G ( 04/25/2018
Permittee/Submitter Signature:*** Dave McDaniel E-Mail:dtmcdaniel a@aquaamerica com Phone #:[phone] Date
Permittee Address:Snow Hill Dr Dobson NC 27017 Permit Expiration Date:02/28/2019
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 catling the NPDES Unit(919)807-6300 or by visiting kttp://portal ncdenr org/web/wglswp/pslnpdes/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 ISA NCAC 8G.0204.
- .4`.*__'!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.:NC0088617 PERMIT VERSION:3 0 PERMIT STATUS.Active
FACILITY NAME.Snow Hill Subdivision CLASS:PCNC __ Surly _.
COUNTY:Sor
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
~
e MOS rove SONSONC(1430 01045 01004 00020 move~ e o 0
at I. t e e 2 X mea h 2 X month 2 X month 2 X month Quarterly Quartrh 2 X month Quarterly
a Z F 6;
Ku 8 - e` 3 Instantaneous Grab Grab Grab Grab Grab Grab Grab
R C
o V c. O O C 2 Fl.nw pn CNI.GRINE TSE-Cone ,IRON MANGNES£ TURDtDTY EINC
2400 e1ork Kr. 2400 dock nIro YlalN mad he act mil I alit ate eel
t l-
2
2
4
5
6
7
6
9
ID
tt
17
13 1050 0.58 Y 0.0925 7.75 L ,2-4 0 5
la
IS
I6
17
18
It
20 ,
21
22
23
24
2.4
20
27 1540 0.07 V 00025 200 It 33 0.6
—
28
Monthly AvcreRe 1 lnll - 55
alenImy A.rrape 0,3025 7 335 _ 055
Deny Mralmam' 1101225 7,75 a 3.4 04.
Dail,ann e a 0.0025 7,30 G 5.3 05
*•4*No Reporting Reason,ENFRUSE=NoFlow-ReuseIRecycle, ENVWTHR=NoVisitation-Adverse Weather,,NOFLOW=No Flow; HOLIDAY=NoVisitation-Holiday

NPDES PERMIT NO.:NC0088617 PERMIT VERSION:3.0 PERMIT STATUS:Active
- -- •- '-FACILITY NAME:Snow Hill Subdivision CLASS:PCNC - COUNTY'Slimy " -
OWNER NAME:Aqua North Carolina(Sc 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#•3369929000 SUBMISSION DATE:03/27/20:8
- //d-ZR ---- -: - - . - —--—_ ..03/14/2018
ORC/CertifnatureHiram
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.
L....., 1,1 C�ti 4 03/27/2018
Permittee/Submitter Signature:*** Dave McDaniel E-Mail:[e-mail] Phone #.[phone] Date
Permittee Address:Snow Hill Dr Dobson NC 27017 Permit Expiration Date:02/28/2019
1 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.nedenr.org/web/wq/swp/ps/npdes/forms.
FOOTNOTES
L ase only-nnifr of measu,cu,ent 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 monitor mg peitod.
_ **ORC on Site?:ORC must visit facility and document visitation of facility as required per ISA 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).

l
NPDESPERMIT NO:NC008S617 PERMII VERSION:3.0 PERMIT STATUS:Active
FACILITY NAME:Snow Hill Subdivision CLASS:PCNCCOUNTY:Surry_ - --
' OWNER NAME:Aqua North Carolina Inc ORC:Not Required ORC CERT NUMBER:9954491
GRADE:PCNC ORC HAS CHANGED:No
. eDMRPERIOD:01-2018{January 2018) VERSION:1 0 STATUS:Process
i
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*:NO
w
1 j 51050 09406 mom C0930 01045 0109$ 04970 01091
F Q m 3
I fi C m
1 v g F 3 2 X month 2 X mood! 2 X month 2 X month Ouartaty Duarterty 2 X month Quartdy
e
d
Y $ -'d e $ S Inalantancum Grab Grab Grab Grab G-ab Grab Grab
X a C
o V F o a a A PLOW Pll CHLORINE TSS-Gene IRON MANCRESE TUR0'17N ZINC
( 2400 clock lira 2410 clock. 1 M,..WIVmad SU uail mon 0,^11 non ntu uw1
3
1
2 -
7
c 1
n I
L
B
9 l
w
10 937 0S5 Y 0 0025 7 61 10 3 7 406 2 W.f.
it
13
14
16
16
17
IB 1
19
20 `
21
22
0 1429 043 Y 0.0025 773 17 <2_5 106
31 I i
35
36 I
19 + .,29 4 +
30 1 I
31 1 I
6146110yAr.r"64 Llmlt 30 i 1 j
MaraMv Avn:9q 0.0025 135 1.85 406 12 10.6
nary ni.:imam• 0.0023 7.73 17 3.7 406 !2 06
119719 Mlnimuml 0002.9 751 IO 0 406 12 10.6
$"""No Repotting Reason ENFRUSE-Nu Flow-Reuse/Recycle; ENVWTHR-No Visitation—Adverse Weather, NOFLOW=No Flow;HOLIDAY=No Visitation—Holiday " -

NPDES PERMIT NO.:NC0088617 PERMIT VERSION.3.0 PERMIT STATUS:Active
FACILITY NAME:Snow Hill Subdivision CLASS:PCNC COUNTY:Sorry
OWNER NAME:Aqua North Carolina Inc ORC:Not Required ORC CERT NUMBER:995491
GRADE:PCNC ORC HAS CHANGED:No
eDMR PERIOD:01-2018(January2018) VERSION:1.0 STATUS:Processed
COMPLIANCE STATUS:Compliant CONTACT PHONE#:[phone] SUBMISSION DATE:02/27/2018
t -_ - - - --- - ------ - •-_ - . - _-- - - - -02/15/2018 -
ORC/Certifie Signature: William Young E-Mail:btyoungctaquaamerica corn Phone #:[phone] Date
By this signature,I certify that this report is accurate and complete to the best of my knowledge
The permittec 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 II.E.6 of
the NPDES permit.
r ---e C 4-0 --..j 02/27/2018
Permittee/Submitter Signature:*** Dave McDaniel E-Mail:[e-mail] aquaamerica.com Phone #:[phone] Date
Permittee Address:Snow Hill Dr Dobson NC 27017 Permit Expiration Date:02/28/2019
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. _
**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.:NC0088617 PERMIT VERSION:3,0 PERMIT STATUS:Active
FACILITY NAME:Snow Hill Subdivision 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
. _ -- _ _ --- _ - - 52950 --- 00400 52940 0 0230 01045 0:055 05970 01092 .
4
71 o 21 e Z 8 2 X month 2 X month 2. =min month 2 X nin Ut anerly- Onone4y 2 X month Quarterly •
c 3 ti. 11 h $ . Instantaneous Grab Grab Grab GrabGrab Gran Grab
o VI 3 = U
15 e o O T FLOW en CHLORINE T55-Cnne IRON MLNCNESE TUR0InT' ZINC
2400 deck l In 24110 r6ek Ile. YmM mad su owl mgrs o'1 tit ala owl
1 --
2
3
I
- 1
6
7
S
4 _
10
T
11
12
13 34 926 0.42 Y 6.525 7.66 7 '2 _ It
14
15
16 w I
17
I0
i
19 I ,
20 I
21
22 _
23
24
20
26 I
1
27 I I 3
I I
20 2.1 1130 0.93 Y 0 0025 7.49 5 61 17 3 i
29 1 1 I
30 I I I 1
' {
I 1 '
31
Monthly Ar.-.Sn Limit; , 35 I 1
Monthly Avenge: 9,0025 6 6.7 9.15
Gaily NU drum" oA0
25 766 7 72 11
Dolly dilnlnnum4 0
R025 7,49 _5 _6 2 7,7
No Reporting Rcson ENFRUSE=NoFlow-Reuse/Recycle, GNVWTiIR—No Visitation-Adverse Weather,NOFLOW=No Flow;HOLIDAY No Visitation-Holiday

NPDES PERMIT NO.:NC0088617 PERMIT VERSION:3 0 PERMIT STATUS:Active
FACILITY NAME:Snow Hill Subdivision CT,ASS:PCNC COUNTY:Suriy--
OWNER NAME:Aqua North Carolina Inc ORC:Not Required ORC CERT NUMBER:995491
GRADE:PCNC ORC RAS CHANGED:No
eDMR PERIOD:12-2017(December 2017) VERSION:1-0 STATUS:Processed
COMPLIANCE STATUS:Compliant CONTACT PHONE#:[phone] SUBMISSION DATE:01/12/2018
lr, f v ._- 0.1/10/2018- --
ORC/Certifier Signature: William Young M1E-Mail:btyoung©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 shalt 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 penntttee 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 I1.E.6 of
the NP DES permit, /J,� n
Ow , " t CC 01/12/2018
Permittee/Submitter Signature.*** Dave McDaniel [e-mail] Phone #:[phone] Date
Permittee Address:Snow Hill Dr Dobson NC 27017 Permit Expiration Date:02/28/2019
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.nedenr.org/wthwq;swprps/npde rms.
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 Me 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 delegalionof the signatory authority must bean file with the state per 15A NCAC 2B
0506(b)(2)(D). V -`

NPDES PERMIT NO.•NC0088617 PERMIT VERSION:3.0 PERMIT STATUS:Active
FACILITY NAME.Snow Hill Subdivision 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(November2017) VERSION:1.0 STATUS:Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
• 50050 00400 50060 00520 01045 0106 00070 01092
y P .
c
'$ Fc 5 2 X month 2 X month 2 X monln 2 X murtn Quarterly Quarterly 2 X mean Dnsrterk,
' cs`
a
$ 9 — p' Instantaneous Grab Crab tGmh Grab Grab Grab Grab s
., a 4 I. a a
b , s o 0 o Z iLow pa t31LORINE 750.CM IRON MANGNEBE TIM/RIM ZINC
2400 clock 'II,. 2400 clock Ili. VRUN mrd ru urui mall unlf ufr':I ntu WI
2
3
4
6
1 1442 0.62 Y 0.0025 7.34 I2 4,8 42
B
9
10
li
I2
12
14-
li
16
17 (
18 t
l9
21 I 1254 0,65 Y 0.0425 7 86 6 4 2700 82 3 4
12
1-
24 I
25 1
126
ki a
29
1 _
ho t ,
i dlK ibly AwnHIJen% 3C
hluniler Armee,8.00259 4.4 2700 82 J.8
Ddiy M..Inum, 11.0093
7.86 12 4.8 2700 82 4,2
o°eyh7InK,um. 00023
7.34 6 4 2700 82 3,4
'••`NoReporting Reason:ENFRUSE=NoFlow-Reuse/Recycle; ENVWIHR-NoVisitation-Adverse Weather;NOFLOW=No Flow,HOLEDAY=NoVisitation-Holiday _ _

NPDES PERMIT NO.:Nang8617 PERMIT VERSION:3,0 PERMIT STATUS:Active
-- _- " FACILITY NAME:Snow-HO!Subdivision CLASS:PCNC COUNTY:Sorry'" ' - --
OWNER NAME:Aqua North Carolina Inc ORC:Not Required ORC CERT NUMBER:995491
GRADE:PCNC ORC HAS CHANGED:No
eDMRPERIOD:11--2017(November 2017) VERSION:1.0 STATUS:Processed
COMPLIANCE STATUS:Compliant CONTACT PHONE it:3369929000 SUBMISSION DATE:12/22/2017
-- • - - - - —12/2-l/2017
ORC/Certifier Sig ature: 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 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.
�—E (LI CC-0j- 12/22/2017
Permittee/Submitter Signature:*** Dave McDaniel E-Mail:[e-mail] Phone #:[phone] Date
Permittee Address:Snow Hill Dr Dobson NC 27017 Perritt Expiration Date:02/28/2019
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 tl:50
ifs)COLLECTING SAMPLES!Wilr'm?oung
PARAMETER CODES
PParameterCode assistance:.uey be obtained by calling the NPDES Unit(919)807-6300 or by visiting http://portal.nedenr.org/web/wq/swp/ps/npdes/forms.
FOOTNOTES
Use o=,.),tants of trteastx.n designated im the reporting facility's NPDES permit for reporting data.
*No Fiow/Discfiarge 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 80.0204.
***Signature of Permittee:If signed by other-than the pennittee,then delegation of the signatory authority must be on file with the state per 15A.NCAC 2B - -„ -
.0506(b)(2XD), -

I
NPDES PERMIT NO.:NC0088617 PERMIT VERSION:3.0 PERMIT STATUS:Active
FACILITY NAME:Snow Hill Subdivision CLASS;PCNC COUNTY:Sur y
OWNER NAME:Aqua North Carolina Inc ORC:Not Rcouircd ORC CERT NUMBER 995dQI
GRADE:PCNC ORC HAS CHANGED:No
a eDMR PERIOD;10-20[7(October 2017) VERSION. 1.0 STATUS:Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
- - S:MW 06V00 !LOW 0090 01045 01055 ' 0123T5 0262:_.. •,
1. g 9 F
2 C 1.4
e e
II F bu 9 2 X month .2 X month 2 X month 2 X month Quzneny Qnazter y 2 X ma:IR Qtr.-laxly
t= ei
8 u ke ! o i Inslanlaot,oca Grab Grab _ Crab Grab Grab Grob Grab
a
a u 15 O C a4p o SLOW p}i CHLORINE 155-Cant IRON 0LlNCNESE TOME/rY ZINC
2400 4ork fire 1400 dock Oro `YOCN mb`d su op./1 nlp/I uy/I u^Jl ntu WI
1 ,
1 1
3 1447 062 Y 00025 754 7 49 4
4
T
, 6
a
9
10
11
11
13 -
14
In
16 1
17
Is ,
19 1.
10
12
11
23
24 1
1r 1253 0.7 Y 00025 7.7, 6 <2S 4-
26 1 !1.1
27 1
25 1 1 !!;
29 1 ' ' I t
36 1
11 I ,
21 I 1 ,
Morally Averse Lrmlu 30 1 t
Mthly AntmRo 0.0525 65 1,95 4.2
Drilyh5o4rm9mr 00025 771 7 3.9 4.4
Drily 642nlma9• 00025 754 6 0 4 __
•+•+NoReporting Reason,19NFRUSE=NoFlow-Reuse/Recycle; ENVW't'RR-NoVisitation-Adverse Weather;NOFLOW-No Flow;HOLIDAY=No Visitation-Holiday - -
0

NPDES PERMIT NO.:NC0088617 PERMIT VERSION:3.0 PERMIT STATUS:Active
FACILITY NAME:Snow Hill Subdivision CLASS:PCNL--= COUNTY:Spiry - -
OWNER NAME:Agra North Carolina Inc ORC:Not Requited ORC CERT NUMBER:995491
GRADE:PCNC ORC HAS CHANGED:No
eDMR PERIOD: 0-2017(October 2017) VERSION:1.0 STATUS:Processed
COMPLIANCE STATUS:Compliant CONTACT PHONE#:[phone] SUBMISSION DATE:11/28/2017
- - - 11/20/2017
ORC/Certifie Signature: tlilliam 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 cireunt Lances.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.
ae. /AI ecf11/28/2017
Permittee/Submitter Signature:*** Dave McDaniel E-Mail:dtmcdanielaaquaamerica.com Phone #:[phone] Date
Permittee Address:Snow Hill Dr Dobson NC 27017 Permit Expiration Date.02/28/2019
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)COLLEC rINC SMYTH &williain Young
PARAMETER CODES
Parameter Code may be obtained by calling the NPDES Unit(919)807-6300 or by visiting http://portal ncdenr.org/web/wq/swp/ps/npdes/formms.
FOOTNOTES
onlyr .irs of mresur.i rn=nt riecignatrod in the reporting facility's NPDES permit for reporting data.
*No Flow./D;srharge 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.:NC0088617 PERMIT VERSION:3 0 PERMIT STATUS:Active
FACILITY NAME:Snow Hill Subdivision 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:09-2017(September 2017) VERSION:1.0 STATUS:Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
a.
- - - _ - 43050 Doing 50060 00530 01045 01060 - 00270 01592
1 k6 E;A F
n � $ 2 X month 2 X monlb 2 X month 2 X month Osorterly Q>.orterly 2 X month ,.Qonrlcdy
E
I13 e 0 g s InSlnetaneaao Gab grab crab (9rob Omb arab crab
r 6 c x et 0,
& a w a o o 3 FLOW PH CHLORINP, 25S.Core IRON MSNONFSE TURDIDTY ZINC
2400 clock M1 HU 2490 Bleck Ho. YIn 0 _ m_d as urjl DI0 1191 uh!91 Mu 4{II
2
2
3
4
5
6 I
7 I
II
9
10
II
12 1332 055 Y 90025 750 17 <2.5 2.45
13
14
15 ,
Ib
.
l
16
19
20
21
22
23 f
21 E
25 I Sttt
26 1642 0S5 Y 0.0025 7 70 2 4.3 5,2 1
27
28 •
29 I i
SD t t
r .4
0t9n1hl2 M01[0110110 512
1
Monllor Arsrege 00025 9.5 24 2225
DotI7M''""" 00025 779 17 4.8 sa
Dolly Minimums 00024 720 2 n 945
te"NoReporting Reesor.RNFRUSE=NaFlow-Reuse/Rccycle,ENVWTHR=NoVisitation—Adverse Weather, NOFLOW-NoFlow, HOLIDAY=NoVisitatton—Holiday ,

NPDES PERMIT NO.:NC0088617 PERMIT VERSION:3.0 PERMIT STATUS:Active
--- - FACILITY NAME:Snow Hill Subdivision 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:09-2017(September 2017) VERSION:1.0 STATUS:Processed
COMPLLANCE STATUS:Compliant CONTACT PHONE t:3369929000 SUBMISSION DATE:10/29/2017
611°--11":"e"' - — � - - 10/23/2017 =
ORC/Certifier Sign tures Wil<7—n Young E-Mail:btyoungaaquaamerica.com Phone #:[phone] Date
By this signature,I certify that this reportis 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.
Ifthe 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.
f it-tC J 10/29/2017
Permittee/Submitter Signature:*** Dave McDaniel E-Mail:dtmcdaniel@aquaamerica,eom Phone #:[phone] Date
Permittee Address:Snow Hill Dr Dobson NC 27017 Permit Expiration Date.02/28/2019
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.
**ORC on Site?:ORC must visit facility and document visitation of facility as required per ISA 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.:NC0088517 PERMIT VERSION:3.0 PERMIT STATUS:Active
FACILITY NAME:Snow Hill Subdivision CLASS:PCNC COUNTY:Surry
OWNER NAME:Aqua North Carolina Inc ORC:No: Required ORC CERTNUMBER 995491-
GRADE:PCNC ORC HAS CHANGED:No
eDMR PERIOD:08-2017(August 2017) VERSION:1 0 STATUS:ProLesscd
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*:NO
.. - -,_,.--. - 800W- _- D 40.3__,- ,,_50060-._ , cum „ ,,,, 01840 -, 01 C¢3, , r....,Outrel 01092 ,
e F
21 7 r
5 < ` ,T 2 X nwiih 2 X month 2 X melt 2 X memh Quarterly Quarterly 2 X month Quarterly
a Iesteniancom Crab Grab Grub Gras Grab Orb Crab
U e'+ O 6 O z` FLOW Per CI0IARI1E TSO-Core IRON MANCNESE TOMrYTY ZINC
1450 clack Ors 1100 sires Ors Y2a/9 mgrl Tn uo17 mill sortl nul nv utfl
1 0 0025
4
s
6
7
R 1521 D4$ Y 0.0025 7.9 16 <25 1,2
9
10
II
12
13
14
15 0 0025
16
17 -
IR
Is
20
21
22 1354 0.38 Y 0,0025 7,4 10 451 439 12 055
23
24
20
26
n
22
29 0,002$
32
•u
3.11,6114y 4vrnge Lome 30
Sirelhly Average 0.0025
13 2.45 435 12 0$75
Drnyalnslmum 00025
7.9 I6 4,9 _435 12 1,2
nally0fimmum. 00025 7.4 10 0 435 12 (LSS
••••No Reporting Reason'ENFRUSE=No Flow-Reuse/Recycle; ENVWTHR=No Visitation—Adverse Weather;NOFLOW=No Flow; HOLIDAY-No Visitation—Holiday