NC0055158_Renewal (Application)_20181114

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ROY COOPER NORTH CAROLINA
Governor Environmental Quality
MICHAEL S_REGAN
Secretary
LINDA CTJLPEPPER
IIntertrn Director
November 26, 2018
Lee Rollins, Manager Town
Town of Bermuda Run
120 Kinderton Blvd Ste #100
Advance, NC 27006
Subject: Permit Renewal
Application No. NC0055158
Bermuda Run WWTP
Davie County
Dear Applicant:
The Water Quality Permitting Section acknowledges the November 14, 2018 receipt of your permit renewal application
and supporting documentation. Your application will be assigned to a permit writer within the Section's NPDES WW
permitting branch. Per G.S. 150B-3 your current permit does not expire until permit decision on the application is made.
Continuation of the current permit is contingent on timely and sufficient application for renewal of the current permit. The
permit writer will contact you if additional information is required to complete your permit renewal. Please respond in a
timely manner to requests for additional information necessary to allow a complete review of the application and renewal
of the permit.
Information regarding the status of your renewal application can be found online using the Department of Environmental
Quality's Environmental Application Tracker at:
https://ded.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.
Since ely, 9..afaci
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

TOWN OF4‘.
0eP/Widek I 2 ren
NORTH CAROLINA
120 Kinderton Boulevard, Suite Ioo
11/8/18 Bermuda Run, NC 27006
336.998.0906
MS. Wren Thedford Fax [phone]
NCDEN R/DWR/N PDES townofbr.com
1617 Mail Service Center RECEI i
Raleigh, NC 27699-1617 VED,DENR/D WR
Re: Town of Bermuda Run NOV 14 2018
Application to renew NPDES Permit # NC0055158 Water Resour
Pefmittin ces
g Section
Dear Ms. Thedford,
Please renew the above referenced Town of Bermuda WWTP NPDES permit.
Enclosed herewith are a signed original and two copies of each of the following:
1. Cover letter requesting renewal.
2. Completed application form with location map and process diagram.
3. Signed sludge management plan.
Thank you,
Town of Bermuda Run
Lee Rollins, Town Manager
A Vibrant Community of Vision

Town ofBermuda
Run Wastewater Treatment Plant
Sludge Management Plan
The Forsyth Rooter Service, Inc. (2960 Griffith Rd., Winston-Salem, NC 27103,
Attn: Mr. Steve Newsome) is informally contracted to pump 8,000 to 16,000
gallons of waste sludge (normally 3% to 7% solids) as requested by the operator
(approximately monthly). Waste sludge is delivered to the Winston Salem, Muddy
Creek WWTP for processing.
Signed: /77/�,.-- Date: //0 0/r
H. Lee Rol ins, Town Manager

TOWN OF�r
gerrnki
NORTH CAROLINA
120 Kinderton Boulevard, Suite 100
11/8/18 Bermuda Run, NC 27006
336.998.0906
MS. Wren Thedford Fax [phone]
N C D E N R/DW R/N P D ES townofbr.com
1617 Mail Service Center
Raleigh, NC 27 -1617
g 699
Re: Town of Bermuda Run
Application to renew NPDES Permit# NC0055158
Dear Ms. Thedford,
Please renew the above referenced Town of Bermuda WWTP NPDES permit.
Enclosed herewith are a signed original and two copies of each of the following:
1. Cover letter requesting renewal.
2. Completed application form with location map and process diagram.
3. Signed sludge management plan.
Thank you,
Town of Bermuda Run
Lee Rollins, Town Manager
A Vibrant Community of Vision

Town of Bermuda Run Wastewater Treatment Plant
Sludge Management Plan
The Forsyth Rooter Service, Inc. (2960 Griffith Rd., Winston-Salem, NC 27103,
Attn: Mr. Steve Newsome) is informally contracted to pump 8,000 to 16,000
gallons of waste sludge (normally 3% to 7% solids) as requested by the operator
(approximately monthly). Waste sludge is delivered to the Winston Salem, Muddy
Creek WWTP for processing.
Signed: . Date: /V o?NT
H. Lee Rol ins, Town Manager

Town of Bermuda Run Wastewater Treatment Plant
Sludge Management Plan
The Forsyth Rooter Service, Inc. (2960 Griffith Rd., Winston-Salem, NC 27103,
Attn: Mr. Steve Newsome) is informally contracted to pump 8,000 to 16,000
gallons of waste sludge (normally 3% to 7% solids) as requested by the operator
(approximately monthly). Waste sludge is delivered to the Winston Salem, Muddy
Creek WWTP for processing.
Signed: �'/�,.- Date: ///,/,1011
H. Lee Rol ins, Town Manager
L

•
FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
N
Bermuda Run WWTP, NC0055158 Pe^e: Yadkin/Pee Dee
- - --------
FORM
2A NPDES FORM 2A APPLICATION OVERVIEW
NPDES
APPLICATION OVERVIEW
Form 2A has been developed in a modular format and consists of a "Basic Application Information" packet
and a "Supplemental Application Information" packet. The Basic Application Information packet is divided
into two parts. All applicants must complete Parts A and C. Applicants with a design flow greater than or
equal to 0.1 MGD must also complete Part B. Some applicants must also complete the Supplemental
Application Information packet. The following items explain which parts of Form 2A you must complete.
BASIC APPLICATION INFORMATION:
A. Basic Application Information for all Applicants. All applicants must complete questions A.1 through A.8. A treatment works
that discharges effluent to surface waters of the United States must also answer questions A.9 through A.12.
B. Additional Application Information for Applicants with a Design Flow a 0.1 MGD. All treatment works that have design flows
greater than or equal to 0.1 million gallons per day must compete questions B.1 through B.6.
C. Certification. All applicants must complete Part C(Certification).
SUPPLEMENTAL APPLICATION INFORMATION:
D. Expanded Effluent Testing Data. A treatment works that discharges effluent to surface waters of the United States and meets
one or more of the following criteria must complete Part D(Expanded Effluent Testing Data):
1. Has a design flow rate greater than or equal to 1 MGD,
2. Is required to have a pretreatment program (or has one in place), or
3. Is otherwise required by the permitting authority to provide the information.
E. Toxicity Testing Data. A treatment works that meets one or more of the following criteria must complete Part E(Toxicity Testing
Data):
1. Has a design flow rate greater than or equal to 1 MGD,
2. Is required to have a pretreatment program (or has one in place), or
3. Is otherwise required by the permitting authority to submit results of toxicity testing.
F. Industrial User Discharges and RCRA/CERCLA Wastes. A treatment works that accepts process wastewater from any
significant industrial users (Sills) or receives RCRA or CERCLA wastes must complete Part F(Industrial User Discharges
and RCRA/CERCLA Wastes). SIUs are defined as:
1. All industrial users subject to Categorical Pretreatment Standards under 40 Code of Federal Regulations(CFR)403.6 and
40 CFR Chapter I, Subchapter N (see instructions); and
2. Any other industrial user that:
a. Discharges an average of 25,000 gallons per day or more of process wastewater to the treatment works(with certain
exclusions); or
b. Contributes a process wastestream that makes up 5 percent or more of the average dry weather hydraulic or organic
capacity of the treatment plant; or
c. Is designated as an SIU by the control authority.
G. Combined Sewer Systems. A treatment works that has a combined sewer system must complete Part G(Combined Sewer
Systems).
ALL APPLICANTS MUST COMPLETE PART C (CERTIFICATION)
EPA Form 3510-2A(Rev. 1-99). Replaces EPA forms 7550-6&7550-22.
Page 1 of 22

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
Bermuda Run WWTP. NC0055158 Renewal Yadkin Pee Dee
BASIC APPLICATION INFORMATION
PART A. BASIC APPLICATION INFORMATION FOR ALL APPLICANTS:
All treatment works must complete questions A.1 through A.8 of this Basic Application Information Packet.
A.1. Facility Information.
Facility Name Bermuda Run wWrP
Mailing Address 120 Kinderton Boulevard,_Suite 100
Bermuda Run NC,27006
Contact Person Lee Rollins
Title Town Manager
Telephone Number [phone]
Facility Address Juniper Circle
(not P.O.Box) Bermuda Run,NC 27006
A.2. Applicant Information. If the applicant is different from the above,provide the following:
Applicant Name Town of Bermuda Run
Mailing Address 120 Kinderton Boulevard,Suite 100
Bermuda Run,NC 27006
Contact Person Lee RomUnp
Title Town Manager
Telephone Number ($38L998-0908
Is the applicant the owner or operator(or both)of the treatment works?
® owner ❑ operator
Indicate whether correspondence regarding this permit should be directed to the facility or the applicant.
0 facility ® applicant
A.3. Existing Environmental Permits. Provide the permit number of any existing environmental permits that have been issued to the treatment works
(include state-issued permits).
NPDES NC0055158 PSD
UIC
Other
RCRA --
Other
A.4. Collection System Information. Provide information on municipalities and areas served by the facility. Provide the name and population of each
entity and,if known,provide information on the type of collection System(combined vs.separate)and its ownership(municipal,private,etc.).
Name Population Served Type of Collection System Ownership
Town of Bermuda Run 147 . s Fparate Town of Bermuda Run
Total population served
EPA Form 3510-2A(Rev. 1-99). Replaces EPA forms 7550-6&7550-22.
Page 2 of 22

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
Bermuda Run WWTP, NC0055158 Renewal Yadkin Pee Dee
A.S. Indian Country.
a. Is the treatment works located in Indian Country?
Yes ® No
b. Does the treatment works discharge to a receiving water that is either in Indian Country or that is upstream from(and eventually flows
through)Indian Country?
❑ Yes ® No
A.6. Flow. Indicate the design flow rate of the treatment plant(i.e..the wastewater flow rate that the plant was built to handle). Also provide the
average daily flow rate and maximum daily flow rate for each of the last three years. Each year's data must be based on a 12-month time period
with the 12'"month of"this year"occurring no more than three months prior to this application submittal.
a. Design flow rate 0.193 MGD
Two Years Ago Last Year This Year
b. Annual average daily flow rate .125 .125 .137
c. Maximum daily flow rate .331 _ .351 .256
A.7. Collection System. Indicate the type(s)of collection system(s)used by the treatment plant. Check all that apply. Also estimate the percent
contribution(by miles)of each.
❑ Separate sanitary sewer
❑ Combined storm and sanitary sewer
%
A.8. Discharges and Other Disposal Methods.
a. Does the treatment works discharge effluent to waters of the U.S.? lE Yes ❑ No
If yes,list how many of each of the following types of discharge points the treatment works uses:
i. Discharges of treated effluent 1
ii. Discharges of untreated or partially treated effluent 0
iii. Combined sewer overflow points 0
iv. Constructed emergency overflows(prior to the headworks) 0
v. Other
b. Does the treatment works discharge effluent to basins,ponds,or other surface impoundments
that do not have outlets for discharge to waters of the U.S.? 0 Yes E No
If yes,provide the following for each surface impoundment:
Location:
Annual average daily volume discharge to surface impoundment(s) 0% MGD
Is discharge 0 continuous or 0 intermittent?
c. Does the treatment works land-apply treated wastewater? ❑ Yes
® No
If yes,provide the following for each land application site:
Location:
Number of acres:
Annual average daily volume applied to site: _ MGD
Is land application ❑ continuous or ❑ intermittent?
d. Does the treatment works discharge or transport treated or untreated wastewater to another
treatment works? ❑ Yes [ No
EPA Form 3510-2A(Rev. 1-99). Replaces EPA forms 7550-6&7550-22.
Page 3 of 22

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: • RIVER BASIN:
Bermuda Run VWVTP, NC0055158 Renewal Yadkin Pee Dee
If yes,describe the mean(s)by which the wastewater from the treatment works is discharged or transported to the other treatment works
(e.g.,tank truck,pipe).
If transport is by a party other than the applicant,provide:
Transporter Name
Mailing Address
Contact Person
Title
Telephone Number
For each treatment works that receives this discharge,provide the following:
Name
Mailing Address
Contact Person
Title
Telephone Number (_
If known,provide the NPDES permit number of the treatment works that receives this discharge
Provide the average daily flow rate from the treatment works into the receiving facility. MGD
e. Does the treatment works discharge or dispose of its wastewater in a manner not included
in A.8.through A.8.d above(e.g.,underground percolation,well injection): 0 Yes ® No
If yes,provide the following for each disposal method:
Description of method(including location and size of site(s)if applicable):
Annual daily volume disposed by this method:
Is disposal through this method 0 continuous or 0 intermittent?
EPA Form 3510-2A(Rev. 1-99). Replaces EPA forms 7550-6&7550-22.
Page 4 of 22

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
Bermuda Run WWTP, NC0055158 Renewal Yadkin Pee Dee
WASTEWATER DISCHARGES:
If you answered"Yes"to question A.8.a,complete questions A.9 through A.12 once for each outfall(including bypass points)through
which effluent is discharged. Do not include information on combined sewer overflows in this section. If you answered "No"to question
A.8.a,go to Part B,"Additional Application Information for Applicants with a Design Flow Greater than or Equal to 0.1 MGD."
A.9. Description of Outfall.
a. Outfall number 1
b. Location Town of Bermuda Run 2.7006
(City or town,if applicable)
(Zip Code)
Davie - NC
(County)
(State)
35 deg_59 min 47 sec 80 deg 25 min 12 sec
(Latitude)
(Longitude)
c. Distance from shore(if applicable) Na ft.
d. Depth below surface(if applicable) n/a ft
e. Average daily flow rate 0.137 MGD
f. Does this outfall have either an intermittent or a periodic discharge? ❑ Yes Z No (go to A.9.g.)
If yes,provide the following information:
Number f times per year discharge occurs:
Average duration of each discharge:
Average flow per discharge: MGD
Months in which discharge occurs:
g. Is outfall equipped with a diffuser? ❑ Yes Z No
A.10. Description of Receiving Waters.
a. Name of receiving water Yadkin River
b. Name of watershed(if known) Yadkin/Pee Dee
United States Soil Conservation Service 14-digit watershed code(if known):
c. Name of State Management/River Basin(if known):Yadkin/ Pee Dee
United States Geological Survey 8-digit hydrologic cataloging unit code(if known):
d. Critical low flow of receiving stream(if applicable) 7 Q 10 Approx. 1,265 cfs
acute cfs
- —-- — --- chronic cfs
e. Total hardness of receiving stream at critical low flow(if applicable): mg/I of CaCO3
EPA Form 3510-2A(Rev. 1-99). Replaces EPA forms 7550-6&7550-22. Page 5 of 22

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: ' RIVER BASIN:
Bermuda Run WWTP, NC0055158Renewal Yadkin Pee Dee
1
A.11. Description of Treatment
a. What level of treatment are provided? Check all that apply.
❑ Primary ® Secondary
i ❑ Advanced JOther Describe:
b. Indicate the following removal rates(as applicable):
Design BOD5 removal or Design CBOD5 removal 95 ,/o
Design SS removal 85-
Design P removal n/a
Design N removal n/a -
Other
c. What type of disinfection is used for the effluent from this outfall? If disinfection varies by season,please describe:
Chlorination
If disinfection is by chlorination is dechlorination used for this outfall? ® Yes 0 No
Does the treatment plant have post aeration? 0 Yes 0 No
A.12. Effluent Testing Information. All Applicants that discharge to waters of the US must provide effluent testing data for the following
parameters. Provide the indicated effluent testing required by the permitting authority for each outfall through which effluent is
discharged. Do not include information on combined sewer overflows in this section. All information reported must be based on data
collected through analysis conducted using 40 CFR Part 136 methods. In addition,this data must comply with QA/QC requirements of
40 CFR Part 136 and other appropriate QA/QC requirements for standard methods for analytes not addressed by 40 CFR Part 136. At a
minimum,effluent testing data must be based on at least three samples and must be no more than four and one-half years apart.
Outfall number.
PARAMETER MAXIMUM DAILY VALUE AVERAGE DAILY VALUE
Value Units Value Units Number of Samples
pH(Minimum) 6.8 s.u.
r
pH(Maximum) 7,2 s.u. ! /�. `/// /%
Flow Rate 0.260 MGD 0.14 MGD
273
Temperature(Winter) 21 C 14.67 C 12
Temperature(Summer) 23 C 18.86
*For pH please report a minimum and a maximum daily value C 24
MAXIMUM DAILY t i
DISCHARGE AVERAGE DAILY DISCHARGE
POLLUTANT ANALYTICAL ML/MDL
Conc. 1 Units i Conc. I Units I Number of j METHOD
i Samples
CONVENTIONAL AND NON CONVENTIONAL COMPOUNDS
1
BIOCHEMICAL OXYGEN BOD5 14 mg/I 3.51 mg/1 36 SM5210B
DEMAND(Report one)
CBOD5
FECAL COLIFORM 7.40 #/100m1 0.18 #/100ml 36 SM922D
TOTAL SUSPENDED SOLIDS(TSS) 21.33 mg/I 1.40 mg/I I 36 SM2540D
END OF PART A. ----- ---
REFER TO THE APPLICATION OVERVIEW (PAGE 1) TO DETERMINE WHICH OTHER PARTS
OF FORM 2A YOU MUST COMPLETE
EPA Form 3510-2A(Rev. 1-99). Replaces EPA forms 7550-6&7550-22.
Page 6 of 22

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
Bermuda Run WWTP. NC0055158 Renewal Yadkin/Pee Dee
BASIC APPLICATION INFORMATION
PART B. ADDITIONAL APPLICATION INFORMATION FOR APPLICANTS WITH A DESIGN FLOW GREATER THAN OR
EQUAL TO 0.1 MGD (100,000 gallons per day).
All applicants with a design flow rate 0.1 MGD must answer questions B.1 through B.6. All others go to Part C(Certification).
' 8.1. Inflow and Infiltration. Estimate the average number of gallons per day that flow into the treatment works from inflow and/or infiltration.
10,000 gpd
Briefly explain any steps underway or planned to minimize inflow and infiltration.
C ontin uing inspections-__
8.2. Topographic Map. Attach to this application a topographic map of the area extending at least one mile beyond facility property boundaries. This
map must show the outline of the facility and the following information. (You may submit more than one map if one map does not show the entire
area.)
a. The area surrounding the treatment plant,including all unit processes.
b. The major pipes or other structures through which wastewater enters the treatment works and the pipes or other structures through which
treated wastewater is discharged from the treatment plant. Include outfalls from bypass piping,if applicable.
c. Each well where wastewater from the treatment plant is injected underground.
d. Wells.springs,other surface water bodies,and drinking water wells that are: 1)within Y.mile of the property boundaries of the treatment
works,and 2)listed in public record or otherwise known to the applicant.
e. Any areas where the sewage sludge produced by the treatment works is stored,treated,or disposed.
f. If the treatment works receives waste that is classified as hazardous under the Resource Conservation and Recovery Act(RCRA)by truck,rail,
or special pipe.show on the map where the hazardous waste enters the treatment works and where it is treated,stored,and/or disposed.
B.3. Process Flow Diagram or Schematic. Provide a diagram showing the processes of the treatment plant,including all bypass piping and all
backup power sources or redundancy in the system. Also provide a water balance showing all treatment units,including disinfection(e.g.,
chlorination and dechlorination). The water balance must show daily average flow rates at influent and discharge points and approximate daily flow
rates between treatment units. Include a brief narrative description of the diagram.
B.4. Operation/Maintenance Performed by Contractor(s).
Are any operational or maintenance aspects(related to wastewater treatment and effluent quality)of the treatment works the responsibility of a
contractor? ❑ Yes r- No
If yes,list the name.address,telephone number.and status of each contractor and describe the contractor's responsibilities(attach additional
pages if necessary).
Name: Nick Slogic
Mailing Address: 172 Fox Run Drive
Mocksville NC 27028
Telephone Number: [phone]
Responsibilities of Contractor: Operations and Maintenance
B.5. Scheduled improvements and Schedules of Implementation. Provide information on any uncompleted implementation schedule or
uncompleted plans for improvements that will affect the wastewater treatment,effluent quality,or design capacity of the treatment works. If the
treatment works has several different implementation schedules or is planning several improvements,submit separate responses to question B.5
for each. (If none,go to question B.6.)
a. List the outfall number(assigned in question A.9)for each outfall that is covered by this implementation schedule.
b. Indicate whether the planned improvements or implementation schedule are required by local,State,or Federal agencies.
❑ Yes ❑ No
EPA Form 3510-2A(Rev. 1-99). Replaces EPA forms 7550-6&7550-22. Page 7 of 22

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
Bermuda Run, NC0055158 Renewal Yadkin/Pee Dee
c. If the answer to B.5.b is"Yes,"briefly describe,including new maximum daily inflow rate(if applicable).
`+
d. Provide dates imposed by any compliance schedule or any actual dates of completion for the implementation steps listed below,as
applicable. For improvements planned independently of local,State,or Federal agencies.indicate planned or actual completion dates,as
applicable. Indicate dates as accurately as possible.
Schedule Actual Completion
Implementation Stage MM/DD/YYYY MM/DD/YYYY
-Begin Construction / _/ / /
-End Construction /._.. / I /.
-Begin Discharge / / / /
-Attain Operational Level / / / /
e. Have appropriate permits/clearances concerning other Federal/State requirements been obtained? ❑ Yes ❑ No
Describe briefly:
B.6. EFFLUENT TESTING DATA(GREATER THAN 0.1 MGD ONLY).
Applicants that discharge to waters of the US must provide effluent testing data for the following parameters. Provide the indicated
effluent testing required by the permitting authority for each outfall through which effluent isdischarged. Do not include information
on combine sewer overflows in this section. All information reported must be based on data collected through analysis conducted
using 40 CFR Part 136 methods. In addition,this data must comply with QA/QC requirements of 40 CFR Part 136 and other appropriate
QA/QC requirements for standard methods for analytes not addressed by 40 CFR Part 136. At a minimum effluent testing data must be
based on at least three pollutant scans and must be no more than four and on-half years old.
Outfall Number:
MAXIMUM DAILY I AVERAGE DAILY DISCHARGE
POLLUTANT DISCHARGE ANALYTICAL I ML/MDL
Conc. Units Conc. Units Number of METHOD •
-, .s. ; Samples
CONVENTIONAL AND NON CONVENTIONAL COMPOUNDS _
AMMONIA(as N) 7.39 mg/I 1.71 mg/I 18 SM4500nh3f
CHLORINE(TOTAL 28 u I 20.92 u
RESIDUAL,TRC I 72 SM4500CLG
9/
DISSOLVED OXYGEN
TOTAL KJELDAHL
NITROGEN(TKN) 18.4 mg/I 11.48 mg/I SM45000RGB
NITRATE PLUS NITRITE
NITROGEN
OIL and GREASE J
PHOSPHORUS(Total) 12 mg/I 5.70 mg/I 9 SM4500PE
TOTAL DISSOLVED SOLIDS
(TDS)
OTHER
END OF PART B.
REFER TO THE APPLICATION OVERVIEW (PAGE 1) TO DETERMINE WHICH OTHER PARTS
OF FORM 2A YOU MUST COMPLETE
EPA Form 3510-2A(Rev.1-99). Replaces EPA forms 7550-6&7550-22

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
Bermuda Run WWTP, N00055158 Renewal Yadkin/Pee Dee
BASIC APPLICATION INFORMATION
PART C. CERTIFICATION
All applicants must complete the Certification Section. Refer to instructions to determine who is an officer for the purposes of this
certification. All applicants must complete all applicable sections of Form 2A,as explained in the Application Overview. Indicate below which
parts of Form 2A you have completed and are submitting. By signing this certification statement,applicants confirm that they have reviewed
Form 2A and have completed all sections that apply to the facility for which this application is submitted.
Indicate which parts of Form 2A you have completed and are submitting:
® Basic Application Information packet Supplemental Application Information packet:
❑ Part D(Expanded Effluent Testing Data)
❑ Part E(Toxicity Testing: Biomonitoring Data)
❑ Part F(Industrial User Discharges and RCRA/CERCLA Wastes)
❑ Part G(Combined Sewer Systems)
ALL APPLICANTS MUST COMPLETE THE FOLLOWING CERTIFICATION.
I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system
designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who
manage the system or those persons directly responsible for gathering the information,the information is,to the best of my knowledge and belief,true,
accurate,and complete. I am aware that there are significant penalties for submitting false information,including the possibility of fine and imprisonment
for knowing violations.
Name and official title H. Lee Rollins, Town Manager
Signature —
Telephone number [phone]
Date signed f//g/�0/V
Upon request of the permitting authority,you must submit any other information necessary to assure wastewater treatment practices at the treatment
works or identify appropriate permitting requirements.
SEND COMPLETED FORMS TO:
NCDENR/ DWQ
Attn: NPDES Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
EPA Form 3510-2A(Rev. 1-99). Replaces EPA forms 7550-6&7550-22.
Page 9 of 22

PUMP STA. o
l o~
a
u_
ffl <
SLUDGE TO CITY OF SLUDGE TO CITY OF
WINSTON-SALEM WINSTON-SALEM
V Af
AEROBIC AEROBIC
DIGESTER DIGESTER
I- w
F m
J CC<
Cn�U
THE BERMUDA RUN TREATMENT
FACILITY IS A 0.193 MGD
EXTENDED AERATION, ACTIVATED
SLUDGE PACKAGE PLANT WITH
DUAL AERATION, CLARIFICATION,
Z z AND AEROBIC DIGESTION TREAMENT
O z O z TRAINS. THE PROCESS INCLUDES
Q CHLORINATION AND
Q < < DECHLORINATION. IT DISCHARGES
Qw m Q n INTO THE YADKIN RIVER. SLUDGE
IS DISPOSED OF BY HAULING TO A
CITY OF WINSTON-SALEM
TREATMENT FACILITY.
CLARIFIER CL2 CLARIFIER
SO2
TO YADKIN
/ RIVER
GREY ENGINEERING, INC_ TOWN OF BERMUDA RUN
Civil Design and Surveying
P.O. Box 9 Mocksville, N.C. 27028
greyengineering.com [phone] WWTP SCHEMATIC — EXISTING SHEET
DRAWN BY: G. BULLARD I PROJ. NO.: 402.019.GE
DESIGN BY: G. BULLARD DATE: 8/25/08 OF

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Bermuda Run WWTP - NC0055158
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USGS Quad Name: Advance Location
Lat.: 35°5947"
Receiving Stream: Yadkin River Long.: 80°25'12"
Stream Class: WS-IV CA
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Subbasin: Yadkin-Pee Dee-030702 North Not to SCALE