NCG590003_Renewal Application_20181114

- Pat W.Swann Water Treatment Plant
inston-Salem•Forsyth County
City of Winston-Salem T 336.727 8000
1? /County Utilities 2800 River Ridge Road F 336.946.2574
Pfafftown,NC 27040 www.cityofws org
November 14,2018
Mr. Charles Weaver
North Carolina Department of Environmental Quality
Division of Water Resources-Water Quality Permitting Section
1617 Mail Service Center
Raleigh,NC 27699-1617
Dear Mr.Weaver,
The City of Winston-Salem has General Permit NCG590003 that expires July 31,2019 for the Swann
WTP located in Pfafftown,NC. The Swann WTP is a 25.0 MGD conventional water treatment plant
owned and operated by the City of Winston-Salem that discharges wastewater from our treatment process
into an unnamed tributary of Bashavia Creek. This facility has two 4.3 MG residuals lagoons that settle
alum residuals from our plants backwash and settling basins. Residual chlorine from our process is
treated with sodium bisulfite to dechlorinate our final effluent.
Attached is a completed General Permit Renewal Application for this facility for your review that I
obtained from Ron Boone in the Winston-Salem Regional Office. Should you have any questions
regarding this renewal application please feel free to call me at 336-945-1179.
Sincerely,
AtAP
William C.Brewer
Water Treatment Superintendent
CC: Courtney Driver—Director of Utilities
City Council Mayor Allen joules;Pic tan H.Burke,'Mayor Pro Tempore,Northeast Ward,Denise D.Adams,North Ward,Dan Besse,Southwest Ward,Robert C Clark,West
, Ward,John C.Larson,South Ward,Jeff Macintosh,Northwest Ward;Dern m L.Montgomery,East Ward;James Taylor,Jr-,Southeast Ward.City Manager.Lee D.Gamty
CityLink311
County Commissioners-Dai td R_Plyler,Chairman;Don Marro,Vice Chair,Fleming El Amin;Ted Kaplan;Richard V Lmvdle;Gloria D Whisenhua5 Everette Witherspoon,
County Manager Dudley Watts,Jr
Call 311 or 336-727-8000
citIlnk Clt 01WS.Or City/County Utilities Commission_Randall S.Tutde,Chsi�+naa,Wesley Curtis,Jr.Vice-Chair,Harold E.Day,Tom Gnffm,Ysonne H.Hines,Duane Long Hu alt W.Jernigan,
y y 9 Allan Younger,Chris Parker,Jim Ruffle;Donald R.Stewart

inston-Salem•Forsyth County Pat W.Swann Water Treatment Plant
1P \
}
. City of Winston-Salem T 336.727.8000
(City/County Utilities 2800 River Ridge Road F 336.946.2574
Pfafftown,NC 27040 www.cityofws org
November 14,2018
Mr. Charles Weaver
North Carolina Department of Environmental Quality
Division of Water Resources-Water Quality Permitting Section
• 1617 Mail Service Center
Raleigh,NC 27699-1617
Dear Mr.Weaver,
The City of Winston-Salem has General Permit NCG590003 that expires July 31,2019 for the Swann
WTP located in Pfafftown,NC. The Swarm WTP is a 25.0 MGD conventional water treatment plant
owned and operated by the City of Winston-Salem that discharges wastewater from our treatment process
into an unnamed tributary of Bashavia Creek. This facility has two 4.3 MG residuals lagoons that settle
alum residuals from our plants backwash and settling basins. Residual chlorine from our process is
treated with sodium bisulfite to dechlorinate our final effluent.
Attached is a completed General Permit Renewal Application for this facility for your review that I
obtained from Ron Boone in the Winston-Salem Regional Office. Should you have any questions
regarding this renewal application please feel free to call me at 336-945-1179.
Sincerely,
�� r,
William C.Brewer
Water Treatment Superintendent
CC: Courtney Driver—Director of Utilities
City Council Mayor Allen James,Vn ian H.Burke,Ma)orPro Tempore,NortheastWard;Denise D.Adams,North Ward;Dan Besse,Southwest Ward;Robert C.Clark,West
]yT,t. -"J". "'=' Ward,John C.Larson.South Ward,Jeff MacIntosh,Northwest Ward,Dern in L Montgomery,East Ward;James Taylor,Jr.,Southeast Ward,Cit)Manager.Lee D.Garrity
11.
-c!-Y('nk3„, County Commissioners'Das idRPlyler,Chairman;Don Marnn,Vice Chau;Fleming El-.Amm;Ted Kaplan;Richard V Linville;Gloria D Whisenhunt;Everette Witherspoon,
Call 311 or 336 727-8000
County Manaeer.Dudley Watts,Jr
[e-mail] CutyJCountJ UtilitiesCommission-RandallS.Tuttle,Chaiman,WesleyCirrus,Jr.Vice-Chau;Harold E.Day,Tom Griffiin,VsonneH.Hines,Duane LongHugh W Jernigan,
Allan Younger,Chris Parker,Jim Ruf£m,Donald R Stewart

A79IrA
Division of Water Resources
IFNational Pollutant Discharge Elimination System (NPDES)
Application for Coverage Under General Permit FOR AGENCY USE ONLY
NCDENR NCG590000 Date Received
Year Month Day
Greensand&Conventional Water Treatment Plant
NOTICE OF INTENT Certificate of Coverage
N C G 5 9
[Required by 15A NCAC 02H .0127(d)]; [term definition see 15A NCAC 02H .0103(19)]
Check# Amount
(Press TAB to navigate form)
Assigned To.
1. Regional Office contact(Please note: This application will be returned if
you have not met with a representative from the appropriate regional office.):
Please list the NCDENR Regional Office representative(s)with whom you have met:
Name(s): Ron Boone Date: Renewal
2. Mailing address of owner/operator: (address to which all correspondence should be mailed)
Owner Name City of Winston-Salem
Street Address P.O.Box 2511
City Winston-Salem State NC Zip27102-
Telephone#(H) Telephone#(W) 336-727-8000
Cell/Mobile# Email billb@ cityofws.org
3. Location of facility producing discharge: (Iffacility is not yet constructed, give street address or lot#)
Street Address 2800 River Ridge Road
City Pfafftown State NC Zip 27040-
County Forsyth
Telephone# [phone] Cell/Mobile# [phone]
4. Physical location information:
Please provide a narrative description of how to get to the facility(use street names,state road numbers,and distance
and direction from a roadway intersection). From the intersection of Yadkinville/Vienna Dozier Road travel south
on Vienna Dozier Road. Stay straight onto River Ridge Road and for approximately V4 mile. Plant entrance
will be on your left lust before Beroth Road(2800 River Ridge Road).
5. This NPDES permit application applies to which of the following :
❑ New[term definition see 15A NCAC 021-1.0103(161]or Proposed(system not constructed)
® Existing[term definition see 15A NCAC 02H.0103(11)];If previously permitted by local or county health
department,please provide the permit number Renewal of General Permit NCG590003
and issue date 2/1/2015
❑ Modification; please describe the nature of the modification:
Page 1 of 4 Revised 8/4/14

NCG590003 Renewal Application
6. Description of Discharge: [Required by 15A NCAC 02H.0105(c)(1)]
a) Amount of wastewater to be discharged:Max amount=25 MGD
Number of bedrooms N/A x 120 gallons per bedroom= N/A
Up to 25,000,000. Average discharge is 500,000 gallons per day to be permitted
b) Type of facility producing waste(please check one):
❑ Primary residence ❑ Vacation/second home
/1 Other: Conventional water treatment plant
7. Please check the components that comprise the wastewater treatment system:
[Required by 15A NCAC 02H.0105(c)(3)]
❑ Septic tank ❑ Dosing tank
❑ Primary sand filter ❑ Secondary sand filter ❑ Recirculating sand filter(s)
❑ Chlorination ® Dechlorination ❑ Other form of disinfection:
❑Post Aeration(sped type)
8. For new or proposed systems only-Please address the feasibility of alternatives to discharging for the
following options in the cover letter for this application:
[Evaluation required by G.S. 143-215.1(b)(5)(a)and 15A NCAC 02H.0105(c)(2)]
a) Connection to a Regional or Municipal Sewer Collection System.
b) Letter from local or county health department describing the suitability or non-suitability of the site for all types of
wastewater ground adsorption and innovative non-discharge systems.Document the repair potential of the failed
system.
c) Land Application such as spray irrigation or drip irrigation.
9. Receiving waters: [Required by 15A NCAC 02H.0105(c)(1)]
a) What is the name of the body or bodies of water(creek,stream,river,lake,etc.)that the facility wastewater
discharges end up in? Unnamed tributary to Bashavia Creek
b) Stream Classification(if known): Class C
10. The application must include the following or it will be returned,as allowed by 15A NCAC 02H .0107(b):
a) For Certificates of Coverage:
® An original letter and two(1)copy requesting coverage under NCG550000.
® A signed and completed original and one copy of this Notice of Intent Application.
O A check or money order for the permit fee of$60.00[per G.S 143-215.3(a)(lb)1 made payable to NCDENR.
O Invoice showing that the septic tank has been pumped and serviced within the last 12 months(only when
existing service tank will be used).
Page 2 of 4 Revised 9/1/13

A77,es, Division of Water Resources
National Pollutant Discharge Elimination System (NPDES)
Application for Coverage Under General Permit FOR AGENCY USE ONLY
NCDENR NCG590000 Date Received
Year Month Day
Greensand&Conventional Water Treatment Plant
Certificate of Coverage
NOTICE OF INTENT
N C G 5 9
[Required by 15A NCAC 02H.0127(d)]; [term definition see 15A NCAC 02H.0103(19)]
Check# Amount
(Press TAB to navigate form)
Assigned To:
1. Regional Office contact(Please note: This application will be returned if
you have not met with a representative from the appropriate regional office.):
Please list the NCDENR Regional Office representative(s)with whom you have met:
Name(s): Ron Boone Date: Renewal
2. Mailing address of owner/operator: (address to which all correspondence should be mailed)
Owner Name City of Winston-Salem
Street Address P.O.Box 2511
City Winston-Salem State NC Zip27102-
Telephone#(H) Telephone#(W) 336-727-8000
Cell/Mobile# Email billb@ cityofws.org
3. Location of facility producing discharge: (If facility is not yet constructed, give street address or lot#)
Street Address 2800 River Ridge Road
City Pfafftown State NC Zip 27040-
County Forsyth
Telephone# [phone] Cell/Mobile# [phone]
4. Physical location information:
Please provide a narrative description of how to get to the facility(use street names,state road numbers,and distance
and direction from a roadway intersection). From the intersection of Yadkinville/Vienna Dozier Road travel south
on Vienna Dozier Road. Stay straight onto River Ridge Road and for approximately'A mile. Plant entrance
will be on your left just before Beroth Road(2800 River Ridge Road),
5. This NPDES permit application applies to which of the following :
❑ New[term definition see 15A NCAC 02H.0103(16)1 or Proposed(system not constructed)
® Existing[term defmition see 15A NCAC 02H.0103(11)];If previously permitted by local or county health
department,please provide the permit number Renewal of General Permit NCG590003
and issue date 2/1/2015
❑ Modification; please describe the nature of the modification:
Page 1 of 4 Revised 8/4/14

NCG590003 Renewal Application
6. Description of Discharge: [Required by 15A NCAC 02H .0105(c)(1)]
a) Amount of wastewater to be discharged:Max amount=25 MGD
Number of bedrooms N/A x 120 gallons per bedroom= N/A
Up to 25,000,000. Average discharge is—500,000 gallons per day to be permitted
b) Type of facility producing waste(please check one):
❑ Primary residence ❑ Vacation/second home
® Other: Conventional water treatment plant
7. Please check the components that comprise the wastewater treatment system:
[Required by 15A NCAC 02H.0105(c)(3)]
❑ Septic tank ❑ Dosing tank
❑ Primary sand filter ❑ Secondary sand filter ❑ Recirculating sand filter(s)
❑ Chlorination ® Dechlorination ❑ Other form of disinfection:
❑ Post Aeration(sped type)
8. For new or proposed systems only-Please address the feasibility of alternatives to discharging for the
following options in the cover letter for this application:
[Evaluation required by G S. $ 143-215.1(b)(5)(a)and 15A NCAC 02H.0105(c)(2)]
a) Connection to a Regional or Municipal Sewer Collection System.
b) Letter from local or county health department describing the suitability or non-suitability of the site for all types of
wastewater ground adsorption and innovative non-discharge systems.Document the repair potential of the failed
system.
c) Land Application such as spray irrigation or drip irrigation.
9. Receiving waters: [Required by 15A NCAC 02H .0105(c)(1)]
a) What is the name of the body or bodies of water(creek,stream,river,lake,etc.)that the facility wastewater
discharges end up in? Unnamed tributary to Bashavia Creek
b) Stream Classification(if known): Class C
10. The application must include the following or it will be returned,as allowed by 15A NCAC 02H .0107(b):
a) For Certificates of Coverage:
® An original letter and two(1)copy requesting coverage under NCG550000.
® A signed and completed original and one copy of this Notice of Intent Application.
❑ A check or money order for the permit fee of$60.00[per G.S & 143-215.3(a)flb)]made payable to NCDENR.
❑ Invoice showing that the septic tank has been pumped and serviced within the last 12 months(only when
existing service tank will be used).
Page 2 of 4 Revised 9/1/13

NCG590003 Renewal Application
New or proposed facilities must also include:
❑ Letter from the county health department evaluating the proposed site for all types of ground absorption and
innovative non-discharge systems.Document the repair potential of the failed system.
El Evaluation of connection to a regional sewer system(approximate distance&cost to connect).
❑ Provide a 7Q10 flow estimate at the proposed wastewater discharge point from the US Geological Survey(919-
571-4000)
b) For an Authorization to Construct(ATC)only: (Note: There is no fee for an ATC)
❑ A letter requesting an ATC
El Three sets of plans and specifications (required by 15A NCAC 02H .0138) of proposed treatment system (see
Permit Application Checklist and Design Criteria for Single Family Discharge)
❑ Invoice showing that the septic tank has been pumped and serviced within the last 12 months(only when existing
septic tank will be used).
Additional Application Requirements:
a) If this application is being submitted by a consulting engineer(or engineering firm), include
documentation from the applicant showing that the engineer(or firm) submitting the application has
been designated an authorized Representative of the applicant,per 15A NCAC 02H.0138(b)(1).
b) If this application is being submitted by a consulting engineer(or engineering firm),final plans for the
treatment system must be signed and sealed by a North Carolina registered Professional Engineer and
stamped- "Final Design-Not released for construction;"per 15A NCAC 02H.0139.
c) If this application is being submitted by a consulting engineer(or engineering firm),final specifications
for all major treatment components must be signed and sealed by a North Carolina registered
Professional Engineer and shall include a narrative description of the treatment system to be
constructed; per 15A NCAC 02H.0139.
Page 3 of 4 Revised 9/1/13

NCG590003 Renewal Application
CERTIFICATION
I certify that I am familiar with the information contained in this application and that to the best of my
knowledge and belief such information is true, complete, and accurate.
Printed Name of Person Signing: William C.Brewer
Title: Water Treatment Superintendent
(Please review 15A NCAC 02H.0106(e)for authorized signing officials)
'l/,__e ___________ November 13,2018
(Signature of Applicant) (Date Signed)
North Carolina General Statute$143-215.6B provides that:
Any person who knowingly makes any false statement representation,or certification in any application,record, report,plan,or other
document filed or required to be maintained under this Article or a rule implementing this Article; or who knowingly makes a false
statement of a material fact in a rulemaking proceeding or contested case under this Article;or who falsifies,tampers with,or knowingly
renders inaccurate any recording or monitoring device or method required to be operated or maintained under this Article or rules of
the Commission implementing this Article, shall be guilty of a Class 2 misdemeanor which may include a fine not to exceed ten
thousand dollars($10,000). 18 U.S C Section 1001 provides a punishment by a fine or imprisonment not more than 5 years,or both,
for a similar offense.
Application must be accompanied by a check or money order for$60.00 [per G.S. 4 143-215.3(a)(lb)1
made payable to:
NCDENR
• • • • •
Mail this application and one copy of the entire package (with check) to:
NC DENR/DWR/Water Quality Permitting Section
1617 Mail Service Center
Raleigh,North Carolina 27699-1617
Attn: Charles Weaver
Note: The submission of this document does not guarantee the issuance of an NPDES permit
Page 4 of 4 Revised 9/1/13

NCG590003 Renewal Application
New or proposed facilities must also include:
❑ Letter from the county health department evaluating the proposed site for all types of ground absorption and
innovative non-discharge systems.Document the repair potential of the failed system.
LI Evaluation of connection to a regional sewer system(approximate distance&cost to connect).
❑ Provide a 7Q10 flow estimate at the proposed wastewater discharge point from the US Geological Survey(919-
571-4000)
b) For an Authorization to Construct(ATC)only: (Note: There is no fee for an ATC)
❑ A letter requesting an ATC
❑ Three sets of plans and specifications (required by 15A NCAC 02H .0138) of proposed treatment system (see
Permit Application Checklist and Design Criteria for Single Family Discharge)
❑ Invoice showing that the septic tank has been pumped and serviced within the last 12 months(only when existing
septic tank will be used).
Additional Application Requirements:
a) If this application is being submitted by a consulting engineer(or engineering firm), include
documentation from the applicant showing that the engineer(or fuui) submitting the application has
been designated an authorized Representative of the applicant,per 15A NCAC 02H .0138(b)(1).
b) If this application is being submitted by a consulting engineer(or engineering firm),fmal plans for the
treatment system must be signed and sealed by a North Carolina registered Professional Engineer and
stamped- "Final Design-Not released for construction;"per 15A NCAC 02H .0139.
c) If this application is being submitted by a consulting engineer(or engineering firm),fmal specifications
for all major treatment components must be signed and sealed by a North Carolina registered
Professional Engineer and shall include a narrative description of the treatment system to be
constructed;per 15A NCAC 02H.0139.
Page 3 of 4 Revised 9/1/13

NCG590003 Renewal Application
CERTIFICATION
I certify that I am familiar with the information contained in this application and that to the best of my
knowledge and belief such information is true, complete, and accurate.
-
Printed Name of Person Signing: William C.Brewer
Title: Water Treatment Superintendent
(Please review 15A NCAC 02H.0106(e)for authorized signing officials)
/ ce( ________ November 13,2018
(Signature of Applicant) (Date Signed)
North Carolina General Statute 4 143-215.6B provides that:
Any person who knowingly makes any false statement representation,or certification in any application,record, report,plan,or other
document filed or required to be maintained under this Article or a rule implementing this Article; or who knowingly makes a false
statement of a material fact in a rulemaking proceeding or contested case under this Article;or who falsifies,tampers with,or knowingly
renders inaccurate any recording or monitoring device or method required to be operated or maintained under this Article or rules of
the Commission implementing this Article, shall be guilty of a Class 2 misdemeanor which may include a fine not to exceed ten
thousand dollars($10,000). 18 U S C Section 1001 provides a punishment by a fine or imprisonment not more than 5 years,or both,
for a similar offense.
Application must be accompanied by a check or money order for$60.00 [per G.S. $ 143-215.3(a)(lb)]
made payable to:
NCDENR
• • • • •
Mail this application and one copy of the entire package (with check) to:
NC DENR/DWR/Water Quality Permitting Section
1617 Mail Service Center
Raleigh,North Carolina 27699-1617
Attn: Charles Weaver
Note: The submission of this document does not guarantee the issuance of an NPDES permit
Page 4 of 4 Revised 9/1/13