NC0025984_Renewal Application_20190204

ROY COOPER :_
Governors '
MICHAEL S.REEGAN -
Secretary ! ` "'"
LINDA CULPEPPER NORTH CAROLINA
Director Environmental Quality
February 05, 2019
John Condrey, City Manager
Town of Forest City
1107 Red Hill Church Rd
Dunn, NC 28334
Subject: Permit Renewal
Application No. NC0025984
Forest City WWTP
Rutherford County
Dear Applicant:
The Water Quality Permitting Section acknowledges the February 4, 2019 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. 150E-3 your current permit does not expire until permit decision on the application is made.
Continuation of the current permit is contingent on timely and sufficient application for renewal of the current permit.The
permit writer will contact you if additional information is required to complete your permit renewal. Please respond in a
timely manner to requests for additional information necessary to allow a complete review of the application and renewal
of the permit.
Information regarding the status of your renewal application can be found online using the Department of Environmental
Quality's Environmental Application Tracker at:
https://deq.nc.gov/permits-regulations/permit-guidance/environmental-application-tracker
If you have any additional questions about the permit, please contact the primary reviewer of the application using the
links available within the Application Tracker.
Sincerely,
gd
Wren Thedford
Administrative Assistant
Water Quality Permitting Section
ec: WQPS Laserfiche File w/application
North Carofina Departrn nt of Environmental quality I Division of Water Resources
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January 29,2019
To. Ms.Wren Thedford
NC DENR/DWR/NPDES
1617 Mail Service Center
Raleigh, NC 27699-1617
From: Jeff Dotson,WRF Superintendant
Town of Forest City WWTP
Cc: John Condrey, City Manager
Subject: Town of Forest City Permit Renewal (NC0025984)
The Town of Forest City would like to request the renewal of the Town of Forest City Wastewater Treatment Plant, NPDES Permit
Number NC0025984.The Town of Forest City WWTP has been through some changes since it's last permit renewal. The plant no
longer has a sludge dryer which produced a class A biosolid and given away to residents&farmers.The sludge dryer reached the
end of its estimated 15-year life span and no longer made economic sense to operate. The town removed the sludge dryer in 2015
and reverted to land applying class B cake sludge on local farmlands in 2016. The biosolids are hauled away to local farmers by
Southern Soil Builders. (Permit No.WQ0037135)for land application.
The town has entered an upgrade phase to one of its existing digesters to increase the mixing and air capabilities of the tank to
better serve with solids handling and treatment. The town has applied and received monies from a community development block
grant that will also improve treatment at the plant in the following areas: Upgrade to the second existing digester, new sludge
thickener, & new loader for the loading of the class B biosolids along with improvements to its Bracket Creek lift station. These
improvements will ensure the town can meet all existing and future permitted requirements for the handling of its biosolids program.
Any questions or comments, please feel free to contact myself or Sonny Penson at 828-248-5217.
Jeff Dotson, Superintendent
,-own o'F. est City WWTP
ieffdotson atownofforestcity.com
Sonny Penson, (ORC, Chief Operator)
sonnpenson antownofforestcity.com
PO Box 728 Forest City,NC 28043 Telephone[phone] Fax [phone]
Email address: [e-mail]
Visit our website
www.townofforestcity.com

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
Town of Forest City WWTP, NC0025984 Renewal Broad
-111107-
FORM -11111-
2A PDES 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 Z 0.1 mgd. All treatment works that have design flows
greater than or equal to 0.1 million gallons per day must complete 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(SlUs)or receives RCRA or CERCLA wastes must complete Part F(Industrial User Discharges
and RCRA/CERCLA Wastes). SlUs 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:
Town of Forest City WWTP, NC0025984 Renewal Broad
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 Town of Forest City WWTP
Mailing Address Post Office Box 728
Forest City.North Carolina,28043
Contact Person Jeff Dotson
Title WRF Superintendant
Telephone Number [phone]
Facility Address Riverside Drive
(not P.O.Box) Forest City,North Carolina,28043
A.2. Applicant Information. If the applicant is different from the above,provide the following:
Applicant Name Town of Forest City WWTP
Mailing Address Post Office Box 728
Forest City,North Carolina,28043
Contact Person John Condrey
Title City Manager
Telephone Number [phone]
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.
❑ 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 NC0025984 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 Forest City Separate Municipal
Rutherford County :,i. Separate Municipal
Total population served 6 li0
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:
Town of Forest City WWTP, NC0025984 Renewal Broad
A.5. 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 12th month of"this year"occurring no more than three months prior to this application submittal.
a. Design flow rate 4.95 mgd
Two Years Ago Last Year This Year
b. Annual average daily flow rate 1.087 0.923 1.319
c. Maximum daily flow rate 5.440 3.071 8.099
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.
0 Separate sanitary sewer 100
E 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.? 0 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 n/a
iii. Combined sewer overflow points n/a
iv. Constructed emergency overflows(prior to the headworks) nia
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 ® No
If yes,provide the following for each surface impoundment:
Location:
Annual average daily volume discharge to surface impoundment(s) 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 0 intermittent?
d. Does the treatment works discharge or transport treated or untreated wastewater to another
treatment works? 0 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:
Town of Forest City WWTP, NCOO25984 Renewal Broad
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 ( L
For each treatment works that receives this discharge,provide the following:
Name
Mailing Address
Contact Person
Title
Telephone Number f___ _L__
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.B.through A.8.d above(e.g.,underground percolation,well injection): ❑ 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 ❑ continuous or ❑ 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:
Town of Forest City WWTP, NC0025984 Renewal Broad
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 Forest City 28043
(City or town,if applicable) (Zip Code)
Rutherford North Carolina
(County) (State)
35° 19'35"N 81°50'24"W
(Latitude) (Longitude)
c. Distance from shore(if applicable) n/a ft.
d. Depth below surface(if applicable) n/a ft.
e. Average daily flow rate 1.319 mgd
f. Does this outfall have either an intermittent or a periodic discharge? ❑ Yes ® No (go to A.9.g.)
If yes,provide the following information:
Number of times per year discharge occurs: n/a
Average duration of each discharge: n/a
Average flow per discharge: n/a mgd
Months in which discharge occurs: n/a
g. Is outfall equipped with a diffuser? ❑ Yes ® No
A.10. Description of Receiving Waters.
a. Name of receiving water Second Broad River
b. Name of watershed(if known) Broad
United States Soil Conservation Service 14-digit watershed code(if known): Unknown
c. Name of State Management/River Basin(if known):Broad
United States Geological Survey 8-digit hydrologic cataloging unit code(if known): Unknown
d. Critical low flow of receiving stream(if applicable)
acute n a cfs chronic n'a cfs
e. Total hardness of receiving stream at critical low flow(if applicable): n/a mg/I of CaCO3
EPA Form 3510-2A(Rev.1-99). Replaces EPA forms 7550-6&7550-22. Page 5 of 22
11
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FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
Town of Forest City WWTP, NC0025984 Renewal Broad
A.11. Description of Treatment
a. What level of treatment are provided? Check all that apply.
El Primary ® Secondary
❑ Advanced ❑ Other. Describe:
b. Indicate the following removal rates(as applicable):
Design BOD5 removal or Design CBOD5 removal 85
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:
Chlorine
If disinfection is by chlorination is dechlorination used for this outfall? El Yes 0 No
Does the treatment plant have post aeration? ® Yes ❑ 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: 1
MAXIMUM DAILY VALUE AVERAGE DAILY VALUE
PARAMETER
Value Units Value Units Number of Samples
pH(Minimum) 6.0 s.u.
pH(Maximum) 7.5 s.u.
Flow Rate 8.099 MGD 1.319 MGD 365
Temperature(Winter) 16.2 °C 9,6 °C 59
Temperature(Summer) 26.0 "C 24.4 °C 65
For pH please report a minimum and a maximum daily value
MAXIMUM DAILY AVERAGE DAILY DISCHARGE
DISCHARGE ANALYTICAL
POLLUTANT METHOD MUMDL
Conc. Units Conc. Units Number of
Samples
CONVENTIONAL AND NON CONVENTIONAL COMPOUNDS
BIOCHEMICAL OXYGEN BOD5 36 mg/I 1.06 mg/I 249 00310 2
DEMAND(Report one) CBOD5
FECAL COLIFORM 2960 #/100 ml 8.93 # 00 248 31616 2
ml
TOTAL SUSPENDED SOLIDS(TSS) 68 mg/I 9.12 mg/I 249 00530
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:
Town of Forest City WWTP, NC0025984 Renewal Broad
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 2 0.1 mgd must answer questions B.1 through B.6. All others go to Part C(Certification).
B.1. Inflow and Infiltration. Estimate the average number of gallons per day that flow into the treatment works from inflow and/or infiltration.
unknown gpd
Briefly explain any steps underway or planned to minimize inflow and infiltration.
A flow monitoring protect is currently underway to determine the location and extent of Ill.
B.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 ® 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:
Mailing Address:
Telephone Number: _1
Responsibilities of Contractor:
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 8.5
for each. (If none,go to question 8.6.)
a. List the outfall number(assigned in question A.9)for each outfall that is covered by this implementation schedule.
Improvements to the digester piping and aeration are currently under design. No impact to effluent quality or design
capacity is anticipated.
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:
Town of Forest City WWTP, NC0025984 Renewal Broad
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 / / / /
-Begin Discharge / / / /
-Attain Operational Level / / / /
e. Have appropriate permits/clearances concerning other Federal/State requirements been obtained? 0 Yes 0 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 is discharged. 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: 1
MAXIMUM DAILY AVERAGE DAILY DISCHARGE
DISCHARGE ANALYTICAL
POLLUTANT METHOD ML/MDL
Conc. Units Conc. Units Number of
Samples
CONVENTIONAL AND NON CONVENTIONAL COMPOUNDS
AMMONIA(as N) 1.8 mg/I 0.665 mg/I 4 EPA 350.1, 0.1
SM4500NH3D
CHLORINE(TOTAL ND mg/I ND mg/I 4 SM4500-CLG 0.02
RESIDUAL,TRC)
DISSOLVED OXYGEN 10.8 mg/I 8.95 mg/I 4 SM4500-0G 6.0
TOTAL KJELDAHL 2.2 mg/I 1.5 mg/I 4 EPA 351.2 0.5,0.2,0.5,1.0
NITROGEN(TKN)
NITRATE PLUS NITRITE 23.6 mg/I 18.9 mg/I 4 EPA 353.3, 0.2,1.0,2.0,2.0
NITROGEN SM4500-NO3H
OIL and GREASE ND mg/I ND mg/I 4 EPA 1664A, 5
EPA1664B
PHOSPHORUS(Total) 5.3 mg/I 4.2 mg/I 4 EPA 365.1,EPA 0.25,0.04,0.1,
200.7 0.04
TOTAL DISSOLVED SOLIDS 370 mg/I 313.8 mg/I 4 SM2540C 25,10,10,10
(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. Page 8 of 22

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
Town of Forest City WWTP, NC0025984 Renewal Broad
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:
El Part D(Expanded Effluent Testing Data)
® Part E(Toxicity Testing: Biomonitoring Data)
® Part F(Industrial User Discharges and RCRA/CERCLA Wastes)
O 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 John Ci
ty
y, Manager
Signature
Telephone number (828?245-4747
Date signed
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

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
Town of Forest City WWTP, NC0025984 Renewal Broad
SUPPLEMENTAL APPLICATION INFORMATION
PART D. EXPANDED EFFLUENT TESTING DATA
Refer to the directions on the cover page to determine whether this section applies to the treatment works.
Effluent Testing: 1.0 mgd and Pretreatment Works. If the treatment works has a design flow greater than or equal to 1.0 mgd or it has(or is required
to have)a pretreatment program,or is otherwise required by the permitting authority to provide the data,then provide effluent testing data for the following
pollutants. Provide the indicated effluent testing information and any other information 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 analyses conducted using 40 CFR Part 136 methods. In addition,these 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. Indicate in the blank rows provided below
any data you may have on pollutants not specifically listed in this form. At a minimum,effluent testing data must be based on at least three pollutant
scans and must be no more than four and one-half years old.
Outfall number: 1 (Complete once for each outfall discharging effluent to waters of the United States.)
P 9 9
MAXIMUM DAILY DISCHARGE AVERAGE DAILY DISCHARGE
POLLUTANT Number ANALYTICAL MUMDL
Conc. Units Mass Units Conc. Units Mass Units of METHOD
Samples
METALS(TOTAL RECOVERABLE),CYANIDE,PHENOLS,AND HARDNESS.
0.007 mg/I 0.05 lbs 0.006 mg/I 0.03 lbs 3 EPA 200.7, 0.005
ANTIMONY EPA 200.8,
ND mg/I 0.00 lbs ND mg/I 0.00 lbs 4 EPA 200.7, 0.01
ARSENIC EPA 200.8,
ND mg/I 0.00 lbs ND mg/I 0.00 lbs 3 EPA 200.7, 0.001
BERYLLIUM EPA 200.8,
ND mg/I 0.00 lbs ND mg/I 0.00 lbs 4 EPA 200.7, 0.001
CADMIUM EPA 200.8
ND mg/I 0.00 lbs ND mg/I 0.00 lbs 4 EPA 200.7, 0.005
CHROMIUM EPA 200.8
0.012 mg/I 0.02 lbs 0.009 mg/I 0.01 lbs 4 EPA 200.7, 0.005,
COPPER EPA 200.8, 0.001
ND mg/I 0.00 lbs ND mg/I 0.00 lbs 4 EPA 200.7, 0.005
LEAD EPA 200.8
11.2 ng/I 0.00 lbs 5.150 ng/I 0.00 lbs 4 EPA 1631, 0.5
MERCURY EPA 1664A,
EPA 1631 E
ND ug/I 0.00 lbs ND ug/I 0.00 lbs 4 EPA 200.7, 5,10,
NICKEL EPA 200.8 0.00001,
0.01
ND mg/I 0.00 lbs ND mg/I 0.00 lbs 4 EPA 200.7, 0.01
SELENIUM EPA 200.8
ND mg/I 0.00 lbs ND mg/I 0.00 lbs 4 EPA 200.7, 0.005
SILVER EPA 200.8
ND mg/I 0.00 lbs ND mg/I 0.00 lbs 3 EPA 200.7, 0.01,
THALLIUM EPA 200.8 0.0005
0.141 mg/I 0.10 lbs 0.080 mg/I 0.07 lbs 4 EPA 200.7, 0.01
ZINC EPA 200.8
0.015 mg/I 0.05 lbs 0.009 mg/I 0.04 lbs 4 SM4500CNE 0.008,
CYANIDE 0.005
TOTAL PHENOLIC 0.01 mg/I 0.05 lbs 0.007 mg/I 0.04 lbs 4 EPA 420.4, 0.01,
COMPOUNDS EPA 420.1 0.005
'67.5 mg/I 9.53 lbs 29.41 mg/I 4.94 lbs 4 SM2340B,EPA 0.662,1,
HARDNESS(as CaCO3) 200.7 0.001,1
Use this space(or a separate sheet)to provide information on other metals requested by the permit writer
EPA Form 3510-2A(Rev.1-99). Replaces EPA forms 7550-6&7550-22. Page 10 of 22

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
Town of Forest City WWTP, NC0025984 Renewal Broad
Outfall number: 1 (Complete once for each outfall discharging effluent to waters of the United States.)
MAXIMUM DAILY DISCHARGE AVERAGE DAILY DISCHARGE
POLLUTANT Number ANALYTICAL MUMDL
Conc. Units Mass Units Conc. Units Mass Units of METHOD
Samples
VOLATILE ORGANIC COMPOUNDS
ND ug/I 0.00 lbs ND ug/I 0.00 lbs 4 EPA 624 5
ACROLEIN
ND ug/I 0.00 lbs ND ug/I 0.00 lbs 4 EPA 624 50,5,5,5
ACRYLONITRILE
ND ug/I 0.00 lbs ND ug/I 0.00 lbs 4 EPA 624 2
BENZENE
ND ug/I 0.00 lbs ND ug/I 0.00 lbs 4 EPA 624 2
BROMOFORM
CARBON ND ug/I 0.00 lbs ND ug/I 0.00 lbs 4 EPA 624 2
TETRACHLORIDE
ND ug/I 0.00 lbs ND ug/I 0.00 lbs 4 EPA 624 2
CHLOROBENZENE
CHLORODIBROMO- ND ug/I 0.00 lbs ND ug/I 0.00 lbs 4 EPA 624 2
METHANE
ND ug/I 0.00 lbs ND ug/I 0.00 lbs 4 EPA 624 2
CHLOROETHANE
2-CHLOROETHYLVINYL ND ug/I 0.00 lbs ND ug/I 0.00 lbs 4 EPA 624 5
ETHER
14.4 ug/I 0.02 lbs 8.450 ug/I 0.01 lbs 4 EPA 624 2
CHLOROFORM
DICHLOROBROMO- 2.7 ug/I 0.02 lbs 2.175 ug/I 0.01 lbs 4 EPA 624 2
METHANE
ND ug/I 0.00 lbs ND ug/I 0.00 lbs 4 EPA 624 2
1,1-D ICH LOROETHANE
ND ug/I 0.00 lbs ND ug/I 0.00 lbs 4 EPA 624 2
1,2-D ICH LOROETHANE
TRANS 1,2-DICHLORO- ND ug/I 0.00 lbs ND ug/I 0.00 lbs 4 EPA 624 2
ETHYLENE
1,1-DICHLORO- ND ug/I 0.00 lbs ND ug/I 0.00 lbs 4 EPA 624 2
ETHYLENE
ND ug/I 0.00 lbs ND ug/I 0.00 lbs 4 EPA 624 2
1,2-D ICH LOROPROPAN E
1,3-DICHLORO- ND ug/I 0.00 lbs ND ug/I 0.00 lbs 4 EPA 624 2,1,1,1
PROPYLENE
ND ug/I 0.00 lbs ND ug/I 0.00 lbs 4 EPA 624 2
ETHYLBENZENE
ND ug/I 0.00 lbs ND ug/I 0.00 lbs 4 EPA 624 2
METHYL BROMIDE
ND ug/I 0.00 lbs ND ug/I 0.00 lbs 4 EPA 624 2
METHYL CHLORIDE
ND ug/I 0.00 lbs ND ug/I 0.00 lbs 4 EPA 624 2
METHYLENE CHLORIDE
1,1,2,2-TETRA- ND ug/I 0.00 lbs ND ug/I 0.00 lbs 4 EPA 624 2
CHLOROETHANE
TETRACHLORO- ND ug/I 0.00 lbs ND ug/I 0.00 lbs 4 EPA 624 2
ETHYLENE
ND ug/I 0.00 lbs ND ug/I 0.00 lbs 4 EPA 624 2
TOLUENE
EPA Form 3510-2A(Rev.1-99). Replaces EPA forms 7550-6&7550-22. Page 11 of 22

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
Town of Forest City WWTP, NCOO25984 Renewal Broad
Outfall number: 1 (Complete once for each outfall discharging effluent to waters of the United States.)
MAXIMUM DAILY DISCHARGE AVERAGE DAILY DISCHARGE
POLLUTANT Number ANALYTICAL MUMDL
Conc. Units Mass Units Conc. Units Mass Units of METHOD
Samples
1 1 1 ND ug/I 0.00 lbs ND ug/I 0.00 lbs 4 EPA 624 2
TRICHLOROETHANE
1 1 2- ND ug/I 0.00 lbs ND ug/1 0.00 lbs 4 EPA 624 2
TRICHLOROETHANE
ND ug/I 0.00 lbs ND ug/I 0.00 lbs 4 EPA 624 2
TRICHLOROETHYLENE
ND ug/I 0.00 lbs ND ug/I 0.00 lbs 4 EPA 624 2
VINYL CHLORIDE
Use this space(or a separate sheet)to provide information on other volatile organic compounds requested by the permit writer
ACID-EXTRACTABLE COMPOUNDS
ND ug/I 0.00 lbs ND ug/I 0.00 lbs 4 EPA 625 5
P-CHLORO-M-CRESOL
ND ug/I 0.00 lbs ND ug/1 0.00 lbs 4 EPA 625 5
2-CHLOROPHENOL
ND ug/I 0.00 lbs ND ug/I 0.00 lbs 4 EPA 625 5
2,4-DICHLOROPHENOL
ND ug/1 0.00 lbs ND ug/I 0.00 lbs 4 EPA 625 10,5,5,5
2,4-DIMETHYLPHENOL
ND ug/I 0.00 lbs ND ug/I 0.00 lbs 4 EPA 625 20,5,5,5
4,6-DINITRO-0-CRESOL
ND ug/I 0.00 lbs ND ug/I 0.00 lbs 4 EPA 625 50,5,20,
2,4-DINITROPHENOL 10
ND ug/I 0.00 lbs ND ug/I 0.00 lbs 4 EPA 625 5
2-NITROPHENOL
ND ug/I 0.00 lbs ND ug/I 0.00 lbs 4 EPA 625 50,5,5,5
4-NITROPHENOL
ND ug/I 0.00 lbs ND ug/I 0.00 lbs 4 EPA 625 10,5,10,
PENTACHLOROPHENOL 5
ND ug/I 0.00 lbs ND ug/I 0.00 lbs 4 + EPA 625 5
PHENOL
2,4,6- ND ug/I 0.00 lbs ND ug/1 0.00 lbs 4 EPA 625 10,5,5,5
TRICHLOROPHENOL
Use this space(or a separate sheet)to provide information on other acid-extractable compounds requested by the permit writer
BASE-NEUTRAL COMPOUNDS
ND ug/I 0.00 lbs ND ug/I 0.00 lbs 4 EPA 625 5
ACENAPHTHENE
ND ug/I 0.00 lbs ND ug/I 0.00 lbs 4 EPA 625 5
ACENAPHTHYLENE
ND ug/I 0.00 lbs ND ug/I 0.00 lbs 4 EPA 625 5
ANTHRACENE
ND ug/I 0.00 lbs ND ug/l 0.00 lbs 4 EPA 625 50,80,80,
BENZIDINE 80
ND ug/I 0.00 lbs ND ug/I 0.00 lbs 4 EPA 625 5
BENZO(A)ANTHRACENE
ND ug/I 0.00 lbs ND ug/I 0.00 lbs 4 EPA 625 5
BENZO(A)PYRENE
EPA Form 3510-2A(Rev.1-99). Replaces EPA forms 7550-6&7550-22. Page 12 of 22

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
Town of Forest City WWTP, NC0025984 Renewal Broad
Outfall number: 1 (Complete once for each outfall discharging effluent to waters of the United States.)
MAXIMUM DAILY DISCHARGE AVERAGE DAILY DISCHARGE
POLLUTANT Number ANALYTICAL MUMDL
Conc. Units Mass Units Conc. Units Mass Units of METHOD
Samples
3,4 BENZO- ND ug/I 0.00 lbs ND ugh0.00 lbs 4 EPA 625 5
FLUORANTHENE
ND ug/I 0.00 lbs ND ugh 0.00 lbs 4 EPA 625 5
BENZO(GHI)PERYLENE
BENZO(K) ND ug/I 0.00 lbs ND ugh0.00 lbs 4 EPA 625 5
FLUORANTHENE
BIS(2-CHLOROETHOXY) ND ugh0.00 lbs ND ug/I 0.00 lbs 4 EPA 625 10,5,5,5
METHANE
BIS(2-CHLOROETHYL)- ND ugh0.00 lbs ND ug/I 0.00 lbs 4 EPA 625 5
ETHER
BIS(2-CHLOROISO- ND ugh0.00 lbs ND ugh0.00 lbs 4 EPA 625 5
PROPYL)ETHER
BIS(2-ETHYLHEXYL) 7.82 ugh0.05 lbs 5.705 ug/I 0.03 lbs 4 EPA 625 5
PHTHALATE
4-BROMOPHENYL ND ugh0.00 lbs -ND ugh0.00 lbs 4 EPA 625 5
PHENYL ETHER
BUTYL BENZYL ND ugh0.00 lbs ND ugh0.00 lbs 4 EPA 625 5
PHTHALATE
2-CHLORO- ND ug/I 0.00 lbs ND ugh0.00 lbs 4 EPA 625 5
NAPHTHALENE
4-CHLORPHENYL ND ugh0.00 lbs ND ugh0.00 lbs 3 EPA 625 5
PHENYL ETHER
ND ugh 0.00 lbs ND ugh 0.00 lbs 4 EPA 625 5
CHRYSENE
ND ug/I 0.00 lbs ND ugh 0.00 lbs 4 EPA 625 5
DI-N-BUTYL PHTHALATE
ND ugh 0.00 lbs ND ugh 0.00 lbs 4 EPA 625 5
DI-N-OCTYL PHTHALATE
DIBENZO(A,H) ND ugh0.00 lbs ND - ugh0.00 lbs 4 EPA 625 5
ANTHRACENE
ND ug/I 0.00 lbs ND ugh 0.00 lbs 4 EPA 625 2
1,2-DICH LOROBE NZENE
ND ugh 0.00 lbs ND ugh 0.00 lbs 4 EPA 625 2
1,3-DICHLOROBENZENE 1
ND ugh 0.00 lbs ND ugh 0.00 lbs 4 EPA 625 2
1,4-DICHLOROBENZENE
3,3-DICHLORO- ND ug/I 0.00 lbs ND ugh0.00 lbs ' 4 EPA 625 25,5,5,5
BENZIDINE
ND ugh 0.00 lbs ND ugh 0.00 lbs 4 EPA 625 5
DIETHYL PHTHALATE
ND ugh 0.00 lbs ND ugh 0.00 lbs 4 EPA 625 5
DIMETHYL PHTHALATE
ND ug/I 0.00 lbs ND ugh 0.00 lbs 4 EPA 625 5
2,4-DINITROTOLUENE
ND ugh 0.00 lbs ND ug/I 0.00 lbs 4 EPA 625 5
2,6-DINITROTOLUENE
1,2-DIPHENYL- ND ugh0.00 lbs ND ugh0.00 lbs -4 EPA 625 5
HYDRAZINE
EPA Form 3510-2A(Rev.1-99). Replaces EPA forms 7550-6&7550-22. Page 13 of 22
1

r
FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
Town of Forest City WWTP, NC0025984 Renewal Broad
Outfall number: 1 __ (Complete once for each outfall discharging effluent to waters of the United States.)
MAXIMUM DAILY DISCHARGE AVERAGE DAILY DISCHARGE
POLLUTANT Number ANALYTICAL ML/MDL
Conc. Units Mass Units Conc. Units Mass Units of METHOD
Samples
ND ug/I 0.00 lbs ND ug/I 0.00 lbs 4 EPA 625 5
FLUORANTHENE
ND ug/I 0.00 lbs ND ug/I 0.00 lbs 4 EPA 625 5
FLUORENE
ND ug/I 0.00 lbs ND ug/I 0.00 lbs 4 EPA 625 5
HEXACHLOROBENZENE
HEXACHLORO- ND ug/I 0.00 lbs ND ug/I 0.00 lbs 4 EPA 625 5
BUTADIENE
HEXACHLOROCYCLO- ND ug/I 0.00 lbs ND ug/I 0.00 lbs 4 EPA 625 10,10,5,
PENTADIENE 5
ND ug/I 0.00 lbs ND ug/I 0.00 lbs 4 EPA 625 5
HEXACHLOROETHANE
INDENO(1,2,3 CD) ND ug/I 0.00 lbs ND ug/I 0.00 lbs 4 EPA 625 5
PYRENE
ND ug/I 0.00 lbs ND ug/I 0.00 lbs 4 EPA 625 10,5,5,5
ISOPHORONE
ND ug/I 0.00 lbs ND ug/I 0.00 lbs 4 EPA 625 5
NAPHTHALENE
ND ug/I 0.00 lbs ND ug/I 0.00 lbs 4 EPA 625 5
NITROBENZENE
N-NITROSODI-N- ND ug/I 0.00 lbs ND ug/I 0.00 lbs 4 EPA 625 5
PROPYLAMINE
N-NITROSODI- ND ug/I 0.00 lbs ND ug/I 0.00 lbs 4 EPA 625 5
METHYLAMINE
N-NITROSODI- ND ug/I 0.00 lbs ND ug/I 0.00 lbs 4 EPA 625 10,5,5,5
PHENYLAMINE
ND ug/I 0.00 lbs ND ug/I 0.00 lbs 4 EPA 625 5
PHENANTHRENE
ND ug/I 0.00 lbs ND ug/I 0.00 lbs 4 EPA 625 5
PYRENE
1,2,4.. ND ug/I 0.00 lbs - ND ug/I 0.00 lbs 4 EPA 625 5,2,2,2
TRICHLOROBENZENE
Use this space(or a separate sheet)to provide information on other base-neutral compounds requested by the permit writer
Use this space(or a separate sheet)to provide information on other pollutants(e.g.,pesticides)requested by the permit writer
END OF PART D.
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 14 of 22

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
Town of Forest City WWTP, NC0025984 Renewal Broad
SUPPLEMENTAL APPLICATION INFORMATION
PART E. TOXICITY TESTING DATA
POTWs meeting one or more of the following criteria must provide the results of whole effluent toxicity tests for acute or chronic toxicity for each of the
facility's discharge points: 1)PO7Ws with a design flow rate greater than or equal to 1.0 mgd;2)POTWs with a pretreatment program(or those that are
required to have one under 40 CFR Part 403);or 3)POTWs required by the permitting authority to submit data for these parameters.
• At a minimum,these results must include quarterly testing for a 12-month period within the past 1 year using multiple species(minimum of two
species),or the results from four tests performed at least annually in the four and one-half years prior to the application,provided the results
show no appreciable toxicity,and testing for acute and/or chronic toxicity,depending on the range of receiving water dilution. 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.
• In addition,submit the results of any other whole effluent toxicity tests from the past four and one-half years. If a whole effluent toxicity test
conducted during the past four and one-half years revealed toxicity,provide any information on the cause of the toxicity or any results of a
toxicity reduction evaluation,if one was conducted.
• If you have already submitted any of the information requested in Part E,you need not submit it again. Rather,provide the information
requested in question E.4 for previously submitted information. If EPA methods were not used,report the reasons for using alternate methods.
If test summaries are available that contain all of the information requested below,they may be submitted in place of Part E.
If no biomonitoring data is required,do not complete Part E. Refer to the Application Overview for directions on which other sections of the form to
complete.
E.1. Required Tests.
Indicate the number of whole effluent toxicity tests conducted in the past four and one-half years.
®chronic ❑acute
21 total tests:10/6/14,1/28/15,4/15/15,4/15/15*,7/8/15,10/21/15,1/25/16,4/19/16,7/11/16*,7/12/16,10/11/16,1/10/17,4/11/17,7/11/17,
10/2/17*,10/3/17, 1/8/18`,1/9/18,4/3/18,7/10/18,10/2/18(*denotes second species)
E.2. Individual Test Data. Complete the following chart for each whole effluent toxicity test conducted in the last four and one-half years. Allow one
column per test(where each species constitutes a test). Copy this page if more than three tests are being reported.
Test number: Test number: Test number:
a. Test information.
Test Species&test method number
Age at initiation of test
Outfall number
Dates sample collected
Date test started
Duration
b. Give toxicity test methods followed.
Manual title
Edition number and year of publication
Page number(s)
c. Give the sample collection method(s)used. For multiple grab samples,indicate the number of grab samples used.
24-Hour composite
Grab
d. Indicate where the sample was taken in relation to disinfection. (Check all that apply for each.
Before disinfection
After disinfection
After dechlorination
EPA Form 3510-2A(Rev.1-99). Replaces EPA forms 7550-6&7550-22. Page 15 of 22

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
Town of Forest City WWTP, NC0025984 Renewal Broad
Test number: 1 Test number: 2 Test number: 3
e. Describe the point in the treatment process at which the sample was collected.
Sample was collected:
f. For each test,include whether the test was intended to assess chronic toxicity,acute toxicity,or both
Chronic toxicity
Acute toxicity
g. Provide the type of test performed.
Static
Static-renewal
Flow-through
h. Source of dilution water. If laboratory water,specify type;if receiving water,specify source.
Laboratory water
Receiving water
i. Type of dilution water. If salt water,specify"natural"or type of artificial sea salts or brine used.
Fresh water
Salt water
j. Give the percentage effluent used for all concentrations in the test series.
k. Parameters measured during the test. (State whether parameter meets test method specifications)
pH
Salinity
Temperature
Ammonia
Dissolved oxygen
I. Test Results.
Acute:
Percent survival in 100%
effluent
LCso
95%C.I.
Control percent survival
Other(describe)
EPA Form 3510-2A(Rev.1-99). Replaces EPA forms 7550-6&7550-22. Page 16 of 22

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
Town of Forest City WWTP, NC0025984 Renewal Broad
Chronic:
NOEC
IC2.5
Control percent survival cyo
Other(describe)
m. Quality Control/Quality Assurance.
Is reference toxicant data available?
Was reference toxicant test within
acceptable bounds?
What date was reference toxicant test
run(MM/DD/YYYY)?
Other(describe)
E.3. Toxicity Reduction Evaluation. Is the treatment works involved in a Toxicity Reduction Evaluation?
❑ Yes ® No If yes,describe:
E.4. Summary of Submitted Biomonitoring Test Information. If you have submitted biomonitoring test information,or information regarding the
cause of toxicity,within the past four and one-half years,provide the dates the information was submitted to the permitting authority and a summary
of the results.
Date submitted: / / (MM/DD/YYYY)
Summary of results:(see instructions)
END OF PART E.
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 17 of 22

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
Town of Forest City WWTP, NC0025984 Renewal Broad
SUPPLEMENTAL APPLICATION INFORMATION
PART F.INDUSTRIAL USER DISCHARGES AND RCRA/CERCLA WASTES
All treatment works receiving discharges from significant industrial users or which receive RCRA,CERCLA,or other remedial wastes must
complete part F.
GENERAL INFORMATION:
F.1. Pretreatment program. Does the treatment works have,or is subject ot,an approved pretreatment program?
D] Yes ❑ No
F.2. Number of Significant Industrial Users(Sills)and Categorical Industrial Users(CIUs). Provide the number of each of the following types of
industrial users that discharge to the treatment works.
a. Number of non-categorical SIUs.
b. Number of CIUs.
SIGNIFICANT INDUSTRIAL USER INFORMATION:
Supply the following information for each SIU. If more than one SIU discharges to the treatment works,copy questions F.3 through F.8 and
provide the information requested for each SIU.
F.3. Significant Industrial User Information. Provide the name and address of each SIU discharging to the treatment works. Submit additional pages
as necessary.
Name: Everest Textiles
Mailing Address: 1331 West Main Street
Forest City,NC 28043
F.4. Industrial Processes. Describe all the industrial processes that affect or contribute to the SIU's discharge.
Weaving,knitting,finishing,non-manmade fibers&sewing
F.5. Principal Product(s)and Raw Material(s). Describe all of the principal processes and raw materials that affect or contribute to the SIU's
discharge.
Principal product(s): synthetic(non-cotton)fabrics&garments
Raw material(s): greige cloth,dyes,finishing chemicals.synthetic yarns
F.6. Flow Rate.
a. Process wastewater flow rate. Indicate the average daily volume of process wastewater discharge into the collection system in gallons per
day(gpd)and whether the discharge is continuous or intermittent.
880,000 gpd (X continuous or intermittent)
b. Non-process wastewater flow rate. Indicate the average daily volume of non-process wastewater flow discharged into the collection system
in gallons per day(gpd)and whether the discharge is continuous or intermittent.
55 000 gpd (a continuous or intermittent)
F.7. Pretreatment Standards. Indicate whether the SIU is subject to the following:
a. Local limits ® Yes ❑ No
b. Categorical pretreatment standards ❑ Yes ® No
If subject to categorical pretreatment standards,which category and subcategory?
na
EPA Form 3510-2A(Rev.1-99). Replaces EPA forms 7550-6&7550-22. Page 18 of 22

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
Town of Forest City WWTP, NC0025984 Renewal Broad
F.8. Problems at the Treatment Works Attributed to Waste Discharge by the SIU. Has the SIU caused or contributed to any problems(e.g.,
upsets,interference)at the treatment works in the past three years?
❑ Yes ® No If yes,describe each episode.
F.3. Significant Industrial User Information. Provide the name and address of each SIU discharging to the treatment works. Submit additional pages
as necessary.
Name: Valley Fine Foods
Mailing Address: 212 Nu Way Packing Road
Forest City,NC 28043
F.4. Industrial Processes. Describe all the industrial processes that affect or contribute to the SIU's discharge.
Processing of pasta,sauces,and prepared meals,cleanup
F.5. Principal Product(s)and Raw Material(s). Describe all of the principal processes and raw materials that affect or contribute to the SIU's
discharge.
Principal product(s): food processing company
Raw material(s): eggs,dairy,wheat,vegetables,herbs,spices
F.6. Flow Rate.
a.Process wastewater flow rate. Indicate the average daily volume of process wastewater discharge into the collection system in gallons per
day(gpd)and whether the discharge is continuous or intermittent.
5,000 gpd (X continuous or intermittent)
b. Non-process wastewater flow rate. Indicate the average daily volume of non-process wastewater flow discharged into the collection system
in gallons per day(gpd)and whether the discharge is continuous or intermittent.
15,300 gpd (X continuous or intermittent)
F.7. Pretreatment Standards. Indicate whether the SIU is subject to the following:
a. Local limits ® Yes ❑ No
b. Categorical pretreatment standards ❑ Yes ® No
If subject to categorical pretreatment standards,which category and subcategory'?
n/a
F.8. Problems at the Treatment Works Attributed to Waste Discharge by the SIU. Has the SIU caused or contributed to any problems(e.g.,
upsets,interference)at the treatment works in the past three years?
❑ Yes ® No If yes,describe each episode.
EPA Form 3510-2A(Rev.1-99). Replaces EPA forms 7550-6&7550-22. Page 19 of 22

1
F.3. Significant Industrial User Information. Provide the name and address of each SIU discharging to the treatment works. Submit additional pages
as necessary.
Name: Eaton Corporation
Mailing Address: 240 Daniel Road
Forest City,NC 28043
F.4. Industrial Processes. Describe all the industrial processes that affect or contribute to the SIU's discharge.
Rubber extrusion braiding and vulcanization
F.5. Principal Product(s)and Raw Material(s). Describe all of the principal processes and raw materials that affect or contribute to the SIU's
discharge.
Principal product(s): Rubber Hose
Raw material(s): Synthetic rubber,textile,wire processing aids,mold release,inks and dyes,lubricants
F.6. Flow Rate.
a.Process wastewater flow rate. Indicate the average daily volume of process wastewater discharge into the collection system in gallons per
day(gpd)and whether the discharge is continuous or intermittent.
4,000 gpd (X continuous or intermittent)
b. Non-process wastewater flow rate. Indicate the average daily volume of non-process wastewater flow discharged into the collection system
in gallons per day(gpd)and whether the discharge is continuous or intermittent.
8,950 gpd (X continuous or intermittent)
F.7. Pretreatment Standards. Indicate whether the SIU is subject to the following:
a. Local limits ® Yes ❑ No
b. Categorical pretreatment standards ❑ Yes ® No
If subject to categorical pretreatment standards,which category and subcategory'?
F.S. Problems at the Treatment Works Attributed to Waste Discharge by the SIU. Has the SIU caused or contributed to any problems(e.g.,
upsets,interference)at the treatment works in the past three years?
❑ Yes ® No If yes,describe each episode.
EPA Form 3510-2A(Rev.1-99). Replaces EPA forms 7550-6&7550-22. Page 20 of 22

F.3. Significant Industrial User Information. Provide the name and address of each SIU discharging to the treatment works. Submit additional pages
as necessary.
Name: Parker Hannifin
Mailing Address: PO Box 429 Pine Street
Forest City,NC 28043
F.4. Industrial Processes. Describe all the industrial processes that affect or contribute to the SIU's discharge.
Machining,assembly,pressure testing,metal finishing
F.5. Principal Product(s)and Raw Material(s). Describe all of the principal processes and raw materials that affect or contribute to the SIU's
discharge.
Principal product(s): hydraulic valves
Raw material(s): cast iron,ductile iron extrusions,steel,aluminum
F.6. Flow Rate.
a.Process wastewater flow rate. Indicate the average daily volume of process wastewater discharge into the collection system in gallons per
day(gpd)and whether the discharge is continuous or intermittent.
10,000 gpd (X continuous or intermittent)
b. Non-process wastewater flow rate. Indicate the average daily volume of non-process wastewater flow discharged into the collection system
in gallons per day(gpd)and whether the discharge is continuous or intermittent.
900 gpd (X continuous or intermittent)
F.7. Pretreatment Standards. Indicate whether the SIU is subject to the following:
a. Local limits ® Yes 0 No
b. Categorical pretreatment standards ® Yes 0 No
If subject to categorical pretreatment standards,which category and subcategory?
433.17
FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
Town of Forest City WWTP, NC0025984 Renewal Broad
F.8. Problems at the Treatment Works Attributed to Waste Discharge by the SIU. Has the SIU caused or contributed to any problems(e.g.,
upsets,interference)at the treatment works in the past three years?
0 Yes ® No If yes,describe each episode.
EPA Form 3510-2A(Rev.1-99). Replaces EPA forms 7550-6&7550-22. Page 21 of 22

F.3. Significant Industrial User Information. Provide the name and address of each SIU discharging to the treatment works. Submit additional pages
as necessary.
Name: West Rock
Mailing Address: 376 Pine Street
Forest City,NC 28043
F.4. Industrial Processes. Describe all the industrial processes that affect or contribute to the SIU's discharge.
Manufactures purchase displays from wood,metal,and plastic
F.5. Principal Product(s)and Raw Material(s). Describe all of the principal processes and raw materials that affect or contribute to the SIU's
discharge.
Principal product(s): purchase displays
Raw material(s): wood,laminates,metal,sheet plastic,paint(powder coat,water,and solvent-based),Iron phosphate,pretreatment
chemicals,and water-based contact adhesives
F.6. Flow Rate.
a.Process wastewater flow rate. Indicate the average daily volume of process wastewater discharge into the collection system in gallons per
day(gpd)and whether the discharge is continuous or intermittent.
10,000 gpd (X continuous or intermittent)
b. Non-process wastewater flow rate. Indicate the average daily volume of non-process wastewater flow discharged into the collection system
in gallons per day(gpd)and whether the discharge is continuous or intermittent.
2,670 gpd (X continuous or intermittent)
F.7. Pretreatment Standards. Indicate whether the SIU is subject to the following:
a. Local limits ® Yes ❑ No
b. Categorical pretreatment standards ® Yes ❑ No
If subject to categorical pretreatment standards,which category and subcategory?
433,463
FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
Town of Forest City WWTP, NC0025984 Renewal Broad
F.8. Problems at the Treatment Works Attributed to Waste Discharge by the SIU. Has the SIU caused or contributed to any problems(e.g.,
upsets,interference)at the treatment works in the past three years?
❑ Yes ® No If yes,describe each episode.
RCRA HAZARDOUS WASTE RECEIVED BY TRUCK, RAIL,OR DEDICATED PIPELINE:
F.9. RCRA Waste. Does the treatment works receive or has it in the past three years received RCRA hazardous waste by truck,rail or dedicated pipe?
❑ Yes ® No(go to F.12)
F.10. Waste transport. Method by which RCRA waste is received(check all that apply):
❑ Truck ❑ Rail ❑ Dedicated Pipe
F.11. Waste Description. Give EPA hazardous waste number and amount(volume or mass,specify units).
EPA Hazardous Waste Number Amount Units
EPA Form 3510-2A(Rev.1-99). Replaces EPA forms 7550-6&7550-22. Page 22 of 22

CERCLA(SUPERFUND)WASTEWATER, RCRA REMEDIATION/CORRECTIVE ACTION
WASTEWATER,AND OTHER REMEDIAL ACTIVITY WASTEWATER:
F.12. Remediation Waste. Does the treatment works currently(or has it been notified that it will)receive waste from remedial activities?
❑ Yes(complete F.13 through F.15.) ® No
F.13. Waste Origin. Describe the site and type of facility at which the CERCLA/RCRA/or other remedial waste originates(or is excepted to originate in
the next five years).
F.14. Pollutants. List the hazardous constituents that are received(or are expected to be received). Include data on volume and concentration,if
known. (Attach additional sheets if necessary.)
F.15. Waste Treatment.
a. Is this waste treated(or will be treated)prior to entering the treatment works?
❑ Yes ❑ No
If yes,describe the treatment(provide information about the removal efficiency):
b. Is the discharge(or will the discharge be)continuous or intermittent?
❑ Continuous ❑ Intermittent If intermittent,describe discharge schedule.
END OF PART F.
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 23 of 22

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
Town of Forest City WWTP, NC0025984 Renewal Broad
SUPPLEMENTAL APPLICATION INFORMATION
PART G. COMBINED SEWER SYSTEMS
If the treatment works has a combined sewer system,complete Part G.
G.1. System Map. Provide a map indicating the following: (may be included with Basic Application Information)
a. All CSO discharge points.
b. Sensitive use areas potentially affected by CSOs(e.g.,beaches,drinking water supplies,shellfish beds,sensitive aquatic ecosystems,and
outstanding natural resource waters).
c. Waters that support threatened and endangered species potentially affected by CSOs.
G.2. System Diagram. Provide a diagram,either in the map provided in G.1 or on a separate drawing,of the combined sewer collection system that
includes the following information.
a. Location of major sewer trunk lines,both combined and separate sanitary.
b. Locations of points where separate sanitary sewers feed into the combined sewer system.
c. Locations of in-line and off-line storage structures.
d. Locations of flow-regulating devices.
e. Locations of pump stations.
CSO OUTFACES:
Complete questions G.3 through G.6 once for each CSO discharge point.
G.3. Description of Outfall.
a. Outfall number
b. Location
(City or town,if applicable) (Zip Code)
(County) (State)
(Latitude) (Longitude)
c. Distance from shore(if applicable) ft.
d. Depth below surface(if applicable) ft.
e. Which of the following were monitored during the last year for this CSO?
❑ Rainfall ❑ CSO pollutant concentrations ❑ CSO frequency
❑ CSO flow volume ❑ Receiving water quality
f. How many storm events were monitored during the last year?
G.4. CSO Events.
a. Give the number of CSO events in the last year.
events (0 actual or❑approx.)
b. Give the average duration per CSO event.
hours actual or 0 approx.)
EPA Form 3510-2A(Rev.1-99). Replaces EPA forms 7550-6&7550-22. Page 24 of 22

I �
FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
Town of Forest City WWTP, NC0025984 Renewal Broad
c. Give the average volume per CSO event.
million gallons(0 actual or 0 approx.)
d. Give the minimum rainfall that caused a CSO event in the last year
Inches of rainfall
G.5. Description of Receiving Waters.
a. Name of receiving water:
b. Name of watershed/river/stream system:
United State Soil Conservation Service 14-digit watershed code(if known):
c. Name of State Management/River Basin:
United States Geological Survey 8-digit hydrologic cataloging unit code(if known):
G.6. CSO Operations.
Describe any known water quality impacts on the receiving water caused by this CSO(e.g.,permanent or intermittent beach closings,permanent or
intermittent shell fish bed closings,fish kills,fish advisories,other recreational loss,or violation of any applicable State water quality standard).
END OF PART G.
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 25 of 22

Additional information,if provided,will appear on the following pages.
NPDES FORM 2A Additional Information

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Residuals Management Plan
Town of Forest City Wastewater Treatment Plant
The Town of Forest City Wastewater Treatment Plant (WWTP) wastes residual solids to a 45'
diameter, 18'depth(214,140 gallons total volume)aerobic digester(Digester 1)for pre-thickening
by means of decanting. Pre-thickened sludge is then pumped to a 1-meter belt thickener where it
is thickened from to an average of 3%solids and discharged to a 55' diameter, approximately 25'
depth (441,680 gallons total volume) aerobic digester(Digester 2) to reduce volatile solids by at
least 38% to meet USEPA vector attraction reduction requirements for Class B biosolids before
discharge to a 2-meter belt filter press and storage building. The biosolids are hauled away by
Southern Soil Builders (Permit No. WQ0037135) for land application.
Per 15A NCAC 02H a minimum of 30 days of solids storage is required. Solids will be produced
at a rate of 4,462 lbs/day based on a design flow of 4.95 MGD and historic average of 0.901 dry
pounds solids per 1,000 gallons of wastewater (4,950,000 day x 0.9011,0 o gat — 4,462 Z).
Assuming a typical reported 3% solids concentration from the belt thickener,approximately
[4,462 aay - (8.34 ibsgacter x 1.045(SG,3%sludge) x 3%)] x 30 days = 512,000 gallons
of sludge will be produced.
Digester 2 has sufficient capacity for only 26 days of sludge storage at 3% solids. However,
scheduled improvements to the solids handling train, including replacement of the thickener, are
anticipated to further reduce the sludge volume requiring storage and increase the total number of
days of sludge storage available. If sludge thickening can be improved to at least 3.1% solids, 30
days of combined storage will be available in the two digesters. Sludge thickening to at least 3.5%
solids will permit Digester 2 alone to store 30 days of thickened sludge.
If additional storage is needed as the WWTP approaches design capacity, the installation of an
additional pump or piping modifications to permit the transfer of thickened sludge to Digester 1
will be considered.
City anager
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Date
Page 1 of 1

Permit No. NC0025984 Annual Monitoring and Pollutant Scan Month April
Outfall 001 Year 2015
Facility Name Town of Forest City WWTP ORC Barnard Norris Penson,Jr.
Date of sampling April 15, 2015 Phone [phone]
Analytical Laboratory Pace Analytical Services, INC.
Sample Analytical Quantitation Sample Units of Number of
Parameter Type Method Level Result Measurement samples
Ammonia(as N) Composite EPA 350.1 0.10 0.48 mg/I 1
Dissolved oxygen Grab SM 4500-OG 6.0 7.9 mg/1 1
Nitrate/Nitrite Composite EPA 353.3 0.2 22.9 mg/1 1
Total Kjeldahl nitrogen Composite EPA 351.2 0.5 2.2 mg/1 1
Total Phosphorus Composite EPA 365.1 0.3 5.3 mg/1 1
Total dissolved solids Composite SM2540C 25.0 301 mg/1 1
Hardness Composite SM2340B 662.0 67500 ug/1 1
Chlorine (total residual, TRC) Grab SM4500-CLG 20.0 < 20.0 ug/1 1
Oil and grease Grab EPA 1664A 5.0 < 5.0 mg/1 1
Metals(total recoverable), cyanide and total phenols
Antimony Composite EPA 200.7 5.0 < 5.0 ug/1 1
Arsenic Composite EPA 200.7 10.0 < 10.0 ug/1 1
`
Beryllium Composite EPA 200.7 1.0 < 1.0 ug/1 1
Cadmium Composite EPA 200.7 1.0 < 1.0 ug/1 1
Chromium Composite EPA 200.7 5.0 < 5.0 ug/1 1
Copper Composite EPA 200.7 5.0 9.1 ug/1 1
Lead Composite EPA 200.7 5.0 < 5.0 ug/1 1
Mercury Composite EPA 1631 0.5 11.2 ng/1 1
-
Nickel Composite EPA 200.7 5.0 < 5.0 ug/1 1
Selenium Composite EPA 200.7 10.0 < 10.0 ug/1 1
Silver Composite EPA 200.7 5.0 < 5.0 ug/1 1
Thallium Composite EPA 200.7 10.0 < 10.0 ug/1 1
Zinc Composite EPA 200.7 10.0 141 ug/1 1
Cyanide Grab SM4500CNE 8.0 < 8.0 ug/1 1
Total phenolic compounds Grab EPA 420.4 0.010 < .010 mg/1 1
Volatile organic compounds
Acrolein Grab EPA 624 5.0 < 5.0 ug/1 1
Acrylonitrile Grab EPA 624 50.0 < 50.0 ug/1 1
Benzene Grab EPA 624 2.0 < 2.0 ug/1 1
Bromoform Grab EPA 624 2.0 < 2.0 ug/1 1
Carbon tetrachloride Grab EPA 624 2.0 < 2.0 ug/1 1
Chlorobenzene Grab EPA 624 2.0 < 2.0 ug/1 1
Chlorodibromomethane Grab EPA 624 2.0 < 2.0 ug/1 1
Chloroethane Grab EPA 624 2.0 < 2.0 ug/1 1
2-chloroethylvinyl ether Grab EPA 624 5.0 < 5.0 ug/1 1
Chloroform Grab EPA 624 2.0 3.9 ug/1 1
Dichlorobromomethane Grab EPA 624 2.0 < 2.0 ug/1 1
1,1-dichloroethane Grab EPA 624 2.0 < 2.0 ug/1 1
1,2-dichloroethane Grab EPA 624 2.0 < 2.0 ug/1 1
Trans-1,2-dichloroethylene Grab EPA 624 2.0 < 2.0 ug/1 1
Form - DMR- PPA-1 Page 1

1
Permit No. NC0025984 Annual Monitoring and Pollutant Scan Month April
C)utfall 001 Year 2015
Sample Analytical Quantitation Sample Units of Number of
Parameter Type Method Level Result Measurement samples
Volatile organic compounds (Cont.)
1,1-dichloroethylene Grab EPA 624 2.0 < 2.0 ug/1 l
1,2-dichloropropane Grab EPA 624 2.0 < 2.0 ug/1 1
1,3-dichloropropylene Grab EPA 624 2.0 < 2.0 ug/1 1
Ethylbenzene Grab EPA 624 2.0 ▪ < 2.0 ug/1 1
Methyl bromide Grab EPA 624 2.0 ▪ < 2.0 ug/1 1
Methyl chloride Grab EPA 624 2.0 ▪ < 2.0 ug/1 1
Methylene chloride Grab EPA 624 2.0 ▪ < 2.0 ug/1 1
1,1,2,2-tetrachloroethane Grab EPA 624 2.0 ▪ < 2.0 ug/1 1
Tetrachloroethylene Grab EPA 624 2.0 < 2.0 ug/1 1
Toluene Grab EPA 624 2.0 < 2.0 ug/1 1
1,1,1-trichloroethane Grab EPA 624 2.0 < 2.0 ug/1 1
1,1,2-trichloroethane Grab EPA 624 2.0 • < 2.0 ug/1 1
Trichloroethylene Grab EPA 624 2.0 < 2.0 ug/1 1
Vinyl chloride Grab EPA 624 2.0 ▪ < 2.0 ug/1 1
Acid-extractable compounds
P-chloro-m-creso Grab EPA 625 5.0 < 5.0 ug/1 1
2-chlorophenol Grab EPA 625 5.0 < 5.0 ug/1 1
2,4-dichlorophenol Grab EPA 625 5.0 - < 5.0 ug/1 1
2,4-dimethylphenol Grab EPA 625 10.0 < 10.0 ug/1 1
-4,6-dinitro-o-cresol Grab EPA 625 20.0 < 20.0 ug/1 1
2,4-dinitrophenol Grab EPA 625 50.0 < 50.0 ug/1 1
2-nitrophenol Grab EPA 625 5.0 - < 5.0 ug/1 1
4-nitrophenol Grab EPA 625 50.0 < 50.0 ug/1 1
Pentachlorophenol Grab EPA 625 10.0 < 10.0 ug/1 1
Phenol Grab EPA 625 5.0 < 5.0 ug/1 1
2,4,6-trichlorophenol Grab EPA 625 10.0 < 10.0 ug/1 1
Base-neutral compounds
Acenaphthene Grab EPA 625 5.0 < 5.0 ug/1 1
Acenaphthylene Grab EPA 625 5.0 < 5.0 ug/1 1
Anthracene Grab EPA 625 5.0 < 5.0 ug/1 1
Benzidine Grab EPA 625 50.0 < 50.0 ug/1 1
Benzo(a)anthracene Grab EPA 625 5.0 < 5.0 ug/1 1
Benzo(a)pyrene Grab EPA 625 5.0 < 5.0 ug/1 1
3,4 benzofluoranthene Grab EPA 625 5.0 < 5.0 ug/1 1
Benzo(ghi)perylene Grab EPA 625 5.0 < 5.0 ug/1 1
Benzo(k)fluoranthene Grab EPA 625 5.0 < 5.0 ug/1 1
Bis (2-chloroethoxy) methane Grab EPA 625 10.0 < 10.0 ug/1 1
Bis (2-chloroethyl) ether Grab EPA 625 5.0 < 5.0 ug/1 1
Bis (2-chloroisopropyl) ether Grab EPA 625 5.0 < 5.0 ug/1 1
Bis (2-ethylhexyl) phthalate Grab EPA 625 5.0 < 5.0 ug/1 1
4-bromophenyl phenyl ether Grab EPA 625 5.0 < 5.0 ug/1 1
Butyl benzyl phthalate Grab EPA 625 5.0 < 5.0 ug/1 1
2-chloronaphthalene Grab EPA 625 5.0 - < 5.0 ug/1 1
4-chlorophenyl phenyl ether Grab EPA 625 5.0 < 5.0 ug/1 1
Form - DMR- PPA-1 Page 2

Permit No. NC0025984 Annual Monitoring and Pollutant Scan Month April
Outfall 001 Year 2015
Sample Analytical Quantitation Sample Units of Number of
Parameter Type Method Level Result Measurement samples
Base-neutral compounds(cont.)
Chrysene Grab EPA 625 5.0 < 5.0 ug/1 1
Di-n-butyl phthalate Grab EPA 625 5.0 < 5.0 ug/1 1
Di-n-octyl phthalate Grab EPA 625 5.0 < 5.0 ug/1 1
Dibenzo(a,h)anthracene Grab EPA 625 5.0 < 5.0 ug/1 1
1,2-dichlorobenzene Grab EPA 625 2.0 < 2.0 ug/1 1
1,3-dichlorobenzene Grab EPA 625 2.0 < 2.0 ug/1 1
1,4-dichlorobenzene Grab EPA 625 2.0 < 2.0 ug/1 1
3,3-dichlorobenzidine Grab EPA 625 25.0 < 5.0 ug/1 1
Diethyl phthalate Grab EPA 625 5.0 < 5.0 ug/1 1
Dimethyl phthalate Grab EPA 625 5.0 < 5.0 ug/1 1
2,4-dinitrotoluene Grab EPA 625 5.0 < 5.0 ug/1 1
2,6-dinitrotoluene Grab EPA 625 5.0 < 5.0 ug/1 1
1,2-diphenylhydrazine Grab EPA 625 5.0 < 5.0 ug/1 1
Fluoranthene Grab EPA 625 5.0 < 5.0 ug/1 1
Fluorene Grab EPA 625 5.0 < 5.0 ug/1 1
Hexachlorobenzene Grab EPA 625 5.0 < 5.0 ug/1 1
Hexachlorobutadiene Grab EPA 625 5.0 < 5.0 ug/1 1
Hexachlorocyclo-pentadiene Grab EPA 625 10.0 < 10.0 ug/1 1
Hexachloroethane Grab EPA 625 5.0 < 5.0 ug/1 1
Indeno(1,2,3-cd)pyrene Grab EPA 625 5.0 < 5.0 ug/1 1
Isophorone Grab EPA 625 10.0 < 10.0 ug/1 1
Naphthalene Grab EPA 625 5.0 < 5.0 ug/1 1
Nitrobenzene Grab EPA 625 5.0 < 5.0 ug/1 1
N-nitrosodi-n-propylamine Grab EPA 625 5.0 < 5.0 ug/1 1
N-nitrosodimethylamine Grab EPA 625 5.0 < 5.0 ug/1 1
N-nitrosodiphenylamine Grab EPA 625 10.0 < 10.0 ug/1 1
Phenanthrene Grab EPA 625 5.0 < 5.0 ug/1 1
Pyrene Grab EPA 625 5.0 < 5.0 ug/1 1
1,2,4,-trichlorobenzene Grab EPA 625 5.0 < 5.0 ug/1 1
"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."
Authorized Representative name
Signature
Date
Form - DMR- PPA-1 Page 3

Permit No. NC0025984 Annual Monitoring and Pollutant Scan Month July
Outfall 001 Year 2016
Facility Name Town of Forest City WWTP ORC Barnard Norris Penson,Jr.
Date of sampling July 12, 2016 Phone [phone])
Analytical Laboratory Pace Analytical Services, INC.
Sample Analytical Quantitation Sample Units of Number of
Parameter Type Method Level Result Measurement samples
Ammonia (as N) Composite SM4500 NH3D 0.10 0.28 mg/1 1
Dissolved oxygen Grab SM 4500-OG 6.0 7.7 mg/1 1
Nitrate/Nitrite Composite SM4500-NO3H 1.0 21.4 mg/1 1
Total Kjeldahl nitrogen Composite EPA 351.2 0.2 0.70 mg/1 1
Total Phosphorus Composite EPA 200.7 0.040 5.0 mg/1 1
Total dissolved solids Composite SM2540C 10.0 350 mg/1 1
Hardness Composite EPA 200.7 1.0 50 mg/1 1
Chlorine (total residual,TRC) Grab SM4500-CLG 20.0 < 20.0 ug/1 1
Oil and grease Grab EPA 1664A 5.0 < 5.0 mg/1 1
Metals(total recoverable), cyanide and total phenols
Antimony Composite EPA 200.8 0.005 0.005 mg/1 1
Arsenic Composite EPA 200.8 0.010 < .010 mg/1 1
Beryllium Composite EPA 200.8 0.001 < .010 mg/1 1
Cadmium Composite EPA 200.8 0.001 < .001 mg/1 1
Chromium Composite EPA 200.8 0.005 < .005 mg/1 1
Copper Composite EPA 200.8 0.001 0.012 mg/1 1
Lead Composite EPA 200.8 0.005 < .005 mg/1 1
Mercury Composite EPA 1664A 0.500 5.05 ng/1 1
Nickel Composite EPA 200.8 0.010 < .010 mg/1 1
Selenium Composite EPA 200.8 0.010 < .010 mg/1 1
Silver Composite EPA 200.8 0.005 < .005 mg/1 1
Thallium Composite EPA 200.8 0.0005 < .0005 mg/1 1
Zinc Composite EPA 200.8 0.010 0.054 mg/1 1
Cyanide Grab SM4500CNE 0.005 0.006 mg/1 1
Total phenolic compounds Grab EPA 420.1 0.005 0.006 mg/1 1
Volatile organic compounds
Acrolein Grab EPA 624 5.0 < 5.0 ug/1 1
Acrylonitrile Grab EPA 624 5.0 < 5.0 ug/1 1
Benzene Grab EPA 624 2.0 < 2.0 ug/1 1
Bromoform Grab EPA 624 2.0 < 2.0 ug/1 1
Carbon tetrachloride Grab EPA 624 2.0 < 2.0 ug/1 1
-
Chlorobenzene Grab EPA 624 2.0 < 2.0 ug/1 1
Chlorodibromomethane Grab EPA 624 2.0 < 2.0 ug/1 1
Chloroethane Grab EPA 624 2.0 < 2.0 ug/1 1
2-chloroethylvinyl ether Grab EPA 624 5.0 < 5.0 ug/1 1
Chloroform Grab EPA 624 2.0 13.5 ug/1 1
Dichlorobromomethane Grab EPA 624 2.0 2.7 ug/1 1
1,1-dichloroethane Grab EPA 624 2.0 < 2.0 ug/1 1
1,2-dichloroethane Grab EPA 624 2.0 < 2.0 ug/1 1
Trans-1,2-dichloroethylene Grab EPA 624 2.0 < 2.0 ug/1 1
Form - DMR- PPA-1 Page 1

r
Permit No. NC0025984 Annual Monitoring and Pollutant Scan Month July
011tfall (lot Year 2016
Sample Analytical Quantitation Sample Units of Number of
Parameter Type Method Level Result Measurement samples
Volatile organic compounds(Cont.)
1 1-dichloroeth lene Grab EPA 624 2.0 < 2.0 ug/1 1
Y _ _
1,2-dichloropropane Grab EPA 624 2.0 < 2.0 ug/1 1
1,3-dichloropropylene Grab EPA 624 1.0 < 1.0 ug/1 1
Ethylbenzene Grab EPA 624 2.0 < 2.0 ug/1 1
Methyl bromide Grab EPA 624 2.0 < 2.0 ug/1 1
Methyl chloride Grab EPA 624 2.0 < 2.0 ug/1 1
Methylene chloride Grab EPA 624 2.0 < 2.0 ug/1 1
1,1,2,2-tetrachloroethane Grab EPA 624 2.0 < 2.0 ug/1 1
Tetrachloroethylene Grab EPA 624 2.0 < 2.0 ug/1 1
Toluene Grab EPA 624 2.0 < 2.0 ug/1 1
1,1,1-trichloroethane Grab EPA 624 2.0 < 2.0 - ug/1 1
1,1,2-trichloroethane Grab EPA 624 2.0 < 2.0 ug/1 1
Trichloroethylene Grab EPA 624 2.0 < 2.0 ug/1 1
Vinyl chloride Grab EPA 624 2.0 < 2.0 ug/1 1
Acid-extractable compounds
P-chloro-m-creso Grab EPA 625 5.00 < 5.00 ug/1 1
2-chlorophenol Grab EPA 625 5.00 < 5.00 ug/1 1
2,4-dichlorophenol Grab EPA 625 5.00 < 5.00 ug/1 1
2,4-dimethylphenol Grab EPA 625 5.00 < 5.00 ug/1 1
4,6-dinitro-o-cresol Grab EPA 625 5.00 < 5.00 ug/1 1
2,4-dinitrophenol Grab EPA 625 5.00 < 5.00 ug/1 1
2-nitrophenol Grab EPA 625 5.00 < 5.00 ug/1 1
4-nitrophenol Grab EPA 625 5.00 < 5.00 ug/1 1
Pentachlorophenol Grab EPA 625 5.00 < 10.0 ug/1 1
Phenol Grab EPA 625 5.00 < 5.00 ug/1 1
2,4,6-trichlorophenol Grab EPA 625 5.00 < 5.00 ug/1 1
Base-neutral compounds
Acenaphthene Grab EPA 625 5.00 < 5.00 ug/1 1
Acenaphthylene Grab EPA 625 5.00 < 5.00 ug/1 1
Anthracene Grab EPA 625 5.00 < 5.00 ug/1 1
Benzidine Grab EPA 625 80.0 _ < 80.0 ug/1 1
Benzo(a)anthracene Grab EPA 625 5.00 < 5.0 ug/1 1
Benzo(a)pyrene Grab EPA 625 5.00 < 5.00 ug/1 1
3,4 benzofluoranthene Grab EPA 625 5.00 < 5.00 ug/1 1
Benzo(ghi)perylene Grab EPA 625 5.00 < 5.00 ug/1 1
Benzo(k)fluoranthene Grab EPA 625 5.00 < 5.00 ug/1 1
Bis (2-chloroethoxy) methane Grab EPA 625 5.00 < 5.00 ug/1 1
Bis (2-chloroethyl) ether Grab EPA 625 5.00 < 5.00 ug/1 1
Bis (2-chloroisopropyl) ether Grab EPA 625 5.00 < 5.00 ug/1 1
Bis (2-ethylhexyl) phthalate Grab EPA 625 5.00 7.82 ug/1 1
4-bromophenyl phenyl ether Grab EPA 625 5.00 < 5.00 ug/1 1
Butyl benzyl phthalate Grab EPA 625 5.00 < 5.00 ug/1 1
2-chloronaphthalene Grab EPA 625 5.00 < 5.00 ug/1 1
4-chlorophenyl phenyl ether Grab EPA 625 5.00 < 5.00 ug/1 1
Form - DMR- PPA-1 Page 2

Permit No. NC0025984 Annual Monitoring and Pollutant Scan Month July
Dutfall 001 Year 2016
Sample Analytical Quantitation Sample Units of Number of
Parameter Type Method Level Result Measurement samples
Base-neutral compounds(cont.)
Chrysene Grab EPA 625 5.00 < 5.00 ug/1 1
Di-n-butyl phthalate Grab EPA 625 5.00 < 5.00 ug/1 1
Di-n-octyl phthalate Grab EPA 625 5.00 < 5.00 ug/1 1
Dibenzo(a,h)anthracene Grab EPA 625 5.00 < 5.00 ug/1 1
1,2-dichlorobenzene Grab EPA 625 2.0 < 2.0 ug/1 1
1,3-dichlorobenzene Grab EPA 625 2.0 < 2.0 ug/1 1
1,4-dichlorobenzene Grab EPA 625 2.0 < 2.0 ug/1 1
3,3-dichlorobenzidine Grab EPA 625 5.00 < 5.00 ug/1 1
Diethyl phthalate Grab EPA 625 5.00 < 5.00 ug/1 1
Dimethyl phthalate Grab EPA 625 5.00 < 5.00 ug/1 1
2,4-dinitrotoluene Grab EPA 625 5.00 < 5.00 ug/1 1
2,6-dinitrotoluene Grab EPA 625 5.00 < 5.00 ug/1 1
1,2-diphenylhydrazine Grab EPA 625 5.00 < 5.00 ug/1 1
Fluoranthene Grab EPA 625 5.00 < 5.00 ug/1 1
Fluorene Grab EPA 625 5.00 < 5.00 ug/1 1
Hexachlorobenzene Grab EPA 625 5.00 < 5.00 ug/1 1
Hexachlorobutadiene Grab EPA 625 5.00 < 5.00 ug/1 1
Hexachlorocyclo-pentadiene Grab EPA 625 10.0 < 5.00 ug/1 1
Hexachloroethane Grab EPA 625 5.00 < 5.0 ugh' 1
Indeno(1,2,3-cd)pyrene Grab EPA 625 5.00 < 5.00 ug/1 1
Isophorone Grab EPA 625 5.00 < 5.00 ug/1 1
Naphthalene Grab EPA 625 5.00 < 5.00 ug/1 1
Nitrobenzene Grab EPA 625 5.00 < 5.00 ug/1 1
N-nitrosodi-n-propylamine Grab EPA 625 5.00 < 5.00 ug/1 1
N-nitrosodimethylamine Grab EPA 625 5.00 < 5.00 ug/1 1
N-nitrosodiphenylamine Grab EPA 625 5.00 < 5.00 ug/1 1
Phenanthrene Grab EPA 625 5.00 < 5.00 ug/1 1
Pyrene Grab EPA 625 5.00 < 5.00 ug/1 1
1,2,4,-trichlorobenzene Grab EPA 625 2.0 < 2.0 ug/1 1
"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."
Authorized Representative name
Signature
Date
Form - DMR- PPA-1 Page 3

Permit No. NC0025984 Annual Monitoring and Pollutant Scan Month OCTOBER
Outfall 001 Year 2017
Facility Name Town of Forest City WWTP ORC Barnard Norris Penson,Jr.
Date of sampling October 5, 2017 Phone [phone])
Analytical Laboratory Environmental Testing Solutions, Inc.
Sample Analytical Quantitation Sample Units of Number of
Parameter Type Method Level Result Measurement samples
Ammonia(as N) Composite SM4500NH3D 0.1 0.1 mg/1 1
Dissolved oxygen Grab SM 4500-OG 6.0 9.4 mg/1 1
Nitrate/Nitrite Composite SM 4500-NO3 H 2.0 23.6 mg/1 1
Total Kjeldahl nitrogen Composite EPA 351.2 0.5 1.25 mg/1 1
Total Phosphorus Composite EPA 200.7 0.1 3.6 mg/1 1
Total dissolved solids Composite SM2540C 10.0 370.0 mg/1 1
Hardness Composite EPA 200.7 1.0 98.0 ug/1 1
Chlorine (total residual, TRC) Grab SM4500-CLG 20.0 < 20.0 ug/1 1
Oil and grease Grab EPA 1664B 5.0 < 5.0 mg/1 1
Metals(total recoverable),cyanide and total phenols
Antimony Composite EPA 200.8 mg/1 1
Arsenic Composite EPA 200.8 0.010 < 0.010 mg/1 1
Beryllium Composite EPA 200.8 mg/1 1
Cadmium Composite EPA 200.8 0.001 < 0.001 mg/1 1
Chromium Composite EPA 200.8 0.005 < 0.005 mg/1 1
Copper Composite EPA 200.8 0.001 0.007 mg/1 1
Lead Composite EPA 200.8 0.005 < 0.005 mg/1 1
Mercury Composite EPA 1631 E 0.500 1.53 ng/1 1
Nickel Composite EPA 200.8 0.010 < 0.010 ng/1 1
Selenium Composite EPA 200.8 0.010 < 0.010 mg/1 1
Silver Composite EPA 200.8 0.005 < 0.005 mg/1 1
Thallium Composite EPA 200.8 mg/1 1
Zinc Composite EPA 200.8 0.010 0.036 mg/1 1
Cyanide Grab SM4500CNE 0.005 0.015 mg/1 1
Total phenolic compounds Grab EPA 420.1 0.005 < .005 mg/1 1
Volatile organic compounds
Acrolein Grab EPA 624 5.0 < 5.0 ug/1 1
Acrylonitrile Grab EPA 624 5.0 < 5.0 ug/1 1
Benzene Grab EPA 624 2.0 < 2.0 ug/1 1
Bromoform Grab EPA 624 2.0 < 2.0 ug/1 1
tetrachloride Grab EPA 624 2.0 < 2.0 u
Carbon to $/1 1
Chlorobenzene Grab EPA 624 2.0 < 2.0 ug/1 1
Chlorodibromomethane Grab EPA 624 2.0 < 2.0 ug/1 1
Chloroethane Grab EPA 624 2.0 < 2.0 ug/1 1
2-chloroethylvinyl ether Grab EPA 624 5.0 < 5.0 ug/1 1
Chloroform Grab EPA 624 2.0 14.4 ug/1 1
Dichlorobromomethane Grab EPA 624 2.0 < 2.0 ug/1 1
1,1-dichloroethane Grab EPA 624 2.0 < 2.0 ug/1 1
r
1,2-dichloroethane Grab EPA 624 2.0 < 2.0 ug/1 1
Trans-1,2-dichloroethylene Grab EPA 624 2.0 < 2.0 ug/1 1
Form - DMR- PPA-1 Page 1

Permit No. NC0025984 Annual Monitoring and Pollutant Scan Month OCTOBER
Outfall 001 Year 2017
Sample Analytical Quantitation Sample Units of Number of
Parameter Type Method Level Result Measurement samples
Volatile organic compounds(Cont.)
1,1-dichloroethylene Grab EPA 624 2.0 < 2.0 ug/1 1
1,2-dichloropropane Grab EPA 624 2.0 < 2.0 ug/1 1
1,3-dichloropropylene Grab EPA 624 1.0 < 1.0 ug/1 1
Ethylbenzene Grab EPA 624 2.0 < 2.0 ug/1 1
Methyl bromide Grab EPA 624 2.0 < 2.0 ug/1 1
Methyl chloride Grab EPA 624 2.0 < 2.0 ug/1 1
Methylene chloride Grab EPA 624 2.0 < 2.0 ug/1 1
1,1,2,2-tetrachloroethane Grab EPA 624 2.0 < 2.0 ug/1 1
Tetrachloroethylene Grab EPA 624 2.0 < 2.0 ug/1 1
Toluene Grab EPA 624 2.0 < 2.0 ug/1 1
1,1,1-trichloroethane Grab EPA 624 2.0 < 2.0 ug/1 1
1,1,2-trichloroethane Grab EPA 624 2.0 < 2.0 ug/1 1
Trichloroethylene Grab EPA 624 2.0 < 2.0 ug/1 1
Vinyl chloride Grab EPA 624 2.0 < 2.0 ug/1 1
Acid-extractable compounds
P-chloro-m-creso Grab EPA 625 5.00 < 5.00 ug/1 1
2-chlorophenol Grab EPA 625 5.00 < 5.00 ug/1 1
2,4-dichlorophenol Grab EPA 625 5.00 < 5.00 ug/1 1
2,4-dimethylphenol Grab EPA 625 5.00 < 5.00 ug/1 1
4,6-dinitro-o-cresol Grab EPA 625 5.00 < 5.00 ug/1 1
2,4-dinitrophenol Grab EPA 625 20.00 < 20.00 ug/1 1
2-nitrophenol Grab EPA 625 5.00 < 5.00 ug/1 1
4-nitrophenol Grab EPA 625 5.00 < 5.00 ug/1 1
Pentachlorophenol Grab EPA 625 10.0 < 10.00 ug/1 1
Phenol Grab EPA 625 5.00 < 5.00 ug/1 1
2,4,6-trichlorophenol Grab EPA 625 5.00 < 5.00 ug/1 1
Base-neutral compounds
Acenaphthene Grab EPA 625 5.00 < 5.00 ug/1 1
Acenaphthylene Grab EPA 625 5.00 < 5.00 ug/1 1
Anthracene Grab EPA 625 5.00 < 5.00 ug/1 1
Benzidine Grab EPA 625 80.00 < 80.00 ug/1 1
Benzo(a)anthracene Grab EPA 625 5.00 < 5.00 ug/1 1
Benzo(a)pyrene Grab EPA 625 5.00 < 5.00 ug/1 1
3,4 benzofluoranthene Grab EPA 625 5.00 < 5.00 ug/1 1
Benzo(ghi)perylene Grab EPA 625 5.00 < 5.00 ug/1 1
Benzo(k)fluoranthene Grab EPA 625 5.00 < 5.00 ug/1 1
Bis (2-chloroethoxy) methane Grab EPA 625 5.00 < 5.00 ug/1 1
Bis (2-chloroethyl) ether Grab EPA 625 5.00 < 5.00 ug/1 1
Bis (2-chloroisopropyl) ether Grab EPA 625 5.00 < 5.00 ug/1 1
Bis (2-ethylhexyl) phthalate Grab EPA 625 5.00 < 5.00 ug/1 1
4-bromophenyl phenyl ether Grab EPA 625 5.00 < 5.00 ug/1 1
Butyl benzyl phthalate Grab EPA 625 5.00 < 5.00 ug/1 1
2-chloronaphthalene Grab EPA 625 5.00 < 5.00 ug/1 1
Form - DMR- PPA-1 Page 2

Permit No. NC0025984 Annual Monitoring and Pollutant Scan Month OCTOBER
Outfall 001 Year 2017
4-chlorophenyl phenyl ether Grab EPA 625
Sample Analytical Quantitation Sample Units of Number of
Parameter Type Method Level Result Measurement samples
Base-neutral compounds (cont.)
Chrysene Grab EPA 625 5.00 < 5.00 ug/1 1
Di-n-butyl phthalate Grab EPA 625 5.00 < 5.00 ug/1 1
Di-n-octyl phthalate Grab EPA 625 5.00 < 5.00 ug/1 1
Dibenzo(a,h)anthracene Grab EPA 625 5.00 < 5.00 ug/1 1
1,2-dichlorobenzene Grab EPA 625 2.00 < 2.00 ug/1 1
1,3-dichlorobenzene Grab EPA 625 2.00 < 2.00 ug/1 1
1,4-dichlorobenzene Grab EPA 625 2.00 < 2.00 ug/1 1
3,3-dichlorobenzidine Grab EPA 625 5.00 < 5.00 ug/1 1
Diethyl phthalate Grab EPA 625 5.00 < 5.00 ug/1 1
Dimethyl phthalate Grab EPA 625 5.00 < 5.00 ug/1 1
2,4-dinitrotoluene Grab EPA 625 5.00 _ < 5.00 ug/1 1
2,6-dinitrotoluene Grab EPA 625 5.00 < 5.00 ug/1 1
1,2-diphenylhydrazine Grab EPA 625 5.00 < 5.00 ug/1 1
Fluoranthene Grab EPA 625 5.00 < 5.00 ug/1 1
Fluorene Grab EPA 625 5.00 < 5.00 ug/1 1
Hexachlorobenzene Grab EPA 625 5.00 < 5.00 ug/1 1
Hexachlorobutadiene Grab EPA 625 5.00 < 5.00 ug/1 1
Hexachlorocyclo-pentadiene Grab EPA 625 5.00 < 5.00 ug/1 1
Hexachloroethane Grab EPA 625 5.00 < 5.00 ug/1 1
Indeno(1,2,3-cd)pyrene Grab EPA 625 5.00 < 5.00 ug/1 1
Isophorone Grab EPA 625 5.00 < 5.00 ug/1 1
-
Naphthalene Grab EPA 625 5.00 < 5.00 ug/1 1
Nitrobenzene Grab EPA 625 5.00 < 5.00 ug/1 1
N-nitrosodi-n-propylamine Grab EPA 625 5.00 < 5.00 ug/1 1
N-nitrosodimethylamine Grab EPA 625 5.00 < 5.00 ug/1 1
N-nitrosodiphenylamine Grab EPA 625 5.00 < 5.00 ug/1 1
Phenanthrene Grab EPA 625 5.00 < 5.00 ug/1 1
Pyrene Grab EPA 625 5.00 < 5.00 ug/1 1
1,2,4,-trichlorobenzene Grab EPA 625 2.00 < 2.00 ug/1 1
"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."
Authorized Representative name
Signature
Date
Form - DMR- PPA-1 Page 3

Permit No. NC0025984 Annual Monitoring and Pollutant Scan Month January
Outfall 001 Year 2018
Facility Name Town of Forest City WWTP ORC Barnard Norris Penson,Jr.
Date of sampling January 9, 2018 Phone [phone])
Analytical Laboratory Environmental Testing Solutions, Inc.
Sample Analytical Quantitation Sample Units of Number of
Parameter Type Method Level Result Measurement samples
Ammonia(as N) Composite SM4500NH3D 0.1 1.8 mg/1 1
Dissolved oxygen Grab SM 4500-OG 6.0 10.8 mg/1 1
Nitrate/Nitrite Composite SM 4500-NO3 H 2.0 7.54 mg/1 1
Total Kjeldahl nitrogen Composite EPA 351.2 1.0 2.01 mg/1 1
Total Phosphorus Composite EPA 200.7 0.040 2.8 mg/1 1
Total dissolved solids Composite SM2540C 10.0 230.0 mg/1 1
Hardness Composite EPA 200.7 1.0 37.0 ug/1 1
Chlorine (total residual,TRC) Grab SM4500-CLG 20.0 < 20.0 ug/1 1
Oil and grease Grab EPA 1664B 5.0 < 5.0 mg/1 1
Metals(total recoverable),cyanide and total phenols
Antimony Composite EPA 200.8 0.005 0.007 mg/1 1
Arsenic Composite EPA 200.8 0.010 < 0.010 mg/1 1
Beryllium Composite EPA 200.8 0.001 < 0.001 mg/1 1
Cadmium Composite EPA 200.8 0.001 < 0.001 mg/1 1
Chromium Composite EPA 200.8 0.005 < 0.005 mg/1 1
Copper Composite EPA 200.8 0.001 0.008 mg/1 1
Lead Composite EPA 200.8 0.005 < 0.005 mg/1 1
Mercury Composite EPA 1631 E 0.500 2.82 ng/1 1
Nickel Composite EPA 200.8 0.010 < 0.010 ng/1 1
Selenium Composite EPA 200.8 0.010 < 0.010 mg/1 1
Silver Composite EPA 200.8 0.005 < 0.005 mg/1 1
Thallium Composite EPA 200.8 0.001 < 0.001 mg/1 1
Zinc Composite EPA 200.8 0.010 0.088 mg/1 1
Cyanide Grab SM4500CNE 0.005 < 0.005 mg/1 1
Total phenolic compounds Grab EPA 420.1 0.005 < 0.005 mg/1 1
Volatile organic compounds
Acrolein Grab EPA 624 5.0 < 5.0 ug/1 1
Acrylonitrile Grab EPA 624 5.0 < 5.0 ug/1 1
Benzene Grab EPA 624 2.0 < 2.0 ug/1 1
Bromoform Grab EPA 624 2.0 < 2.0 ug/1 1
Carbon tetrachloride Grab EPA 624 2.0 < 2.0 ug/1 1
Chlorobenzene Grab EPA 624 2.0 < 2.0 ug/1 1
Chlorodibromomethane Grab EPA 624 2.0 < 2.0 ug/1 1
Chloroethane Grab EPA 624 2.0 < 2.0 ug/1 1
2-chloroethylvinyl ether Grab EPA 624 5.0 < 5.0 ug/1 1
Chloroform Grab EPA 624 2.0 < 2.0 ug/1 1
Dichlorobromomethane Grab EPA 624 2.0 < 2.0 ug/1 1
1,1-dichloroethane Grab EPA 624 2.0 < 2.0 ug/1 1
1,2-dichloroethane Grab EPA 624 2.0 < 2.0 ug/1 1
Trans-1,2-dichloroethylene Grab EPA 624 2.0 < 2.0 ug/1 1
Form - DMR- PPA-1 Page 1

Permit No. NC0025984 Annual Monitoring and Pollutant Scan Month January
Outfall 001 Year 2018
Sample Analytical Quantitation Sample Units of Number of
Parameter Type Method Level Result Measurement samples
Volatile organic compounds (Cont.)
1,1-dichloroethylene Grab EPA 624 2.0 < 2.0 ugh 1 1
1,2-dichloropropane Grab EPA 624 2.0 < 2.0 ug/1 1
1,3-dichloropropylene Grab EPA 624 1.0 < 1.0 ug/1 1
Ethylbenzene Grab EPA 624 2.0 < 2.0 ug/1 1
Methyl bromide Grab EPA 624 2.0 < 2.0 ug/1 1
Methyl chloride Grab EPA 624 2.0 < 2.0 ug/1 1
Methylene chloride Grab EPA 624 2.0 < 2.0 ug/1 1
1,1,2,2-tetrachloroethane Grab EPA 624 2.0 < 2.0 ug/1 1
Tetrachloroethylene Grab EPA 624 2.0 < 2.0 ug/l 1
Toluene Grab EPA 624 2.0 < 2.0 ug/1 1
1,1,1-trichloroethane Grab EPA 624 2.0 < 2.0 ug/1 1
1,1,2-trichloroethane Grab EPA 624 2.0 < 2.0 ug/1 1
Trichloroethylene Grab EPA 624 2.0 < 2.0 ug/1 1
Vinyl chloride Grab EPA 624 2.0 < 2.0 ug/1 1
Acid-extractable compounds
P-chloro-m-creso Grab EPA 625 5.00 < 5.00 ug/1 1
2-chlorophenol Grab EPA 625 5.00 < 5.00 ug/1 1
2,4-dichlorophenol Grab EPA 625 5.00 < 5.00 ug/1 1
2,4-dimethylphenol Grab EPA 625 5.00 < 5.00 ug/1 1
4,6-dinitro-o-cresol Grab EPA 625 5.00 < 5.00 ug/1 1
2,4-dinitrophenol Grab EPA 625 10.00 < 10.00 ug/1 1
2-nitrophenol Grab EPA 625 5.00 < 5.00 ug/1 1
4-nitrophenol Grab EPA 625 5.00 < 5.00 ug/1 1
Pentachlorophenol Grab EPA 625 5.0 < 5.00 ug/1 1
Phenol Grab EPA 625 5.00 < 5.00 ug/1 1
2,4,6-trichlorophenol Grab EPA 625 5.00 < 5.00 ug/1 1
Base-neutral compounds
Acenaphthene Grab EPA 625 5.00 < 5.00 ug/1 1
Acenaphthylene Grab EPA 625 5.00 < 5.00 ug/1 1
Anthracene Grab EPA 625 5.00 < 5.00 ug/1 1
Benzidine Grab EPA 625 80.00 < 80.00 ug/1 1
Benzo(a)anthracene Grab EPA 625 5.00 < 5.00 ug/1 1
Benzo(a)pyrene Grab EPA 625 5.00 < 5.00 ug/1 1
3,4 benzofluoranthene Grab EPA 625 5.00 < 5.00 ug/1 1
Benzo(ghi)perylene Grab EPA 625 5.00 < 5.00 ug/1 1
Benzo(k)fluoranthene Grab EPA 625 5.00 < 5.00 ug/1 1
Bis (2-chloroethoxy) methane Grab EPA 625 5.00 < 5.00 ug/1 1
Bis (2-chloroethyl) ether Grab EPA 625 5.00 < 5.00 ug/1 1
Bis (2-chloroisopropyl) ether Grab EPA 625 5.00 < 5.00 ug/1 1
Bis (2-ethylhexyl) phthalate Grab EPA 625 5.00 < 5.00 ug/1 1
4-bromophenyl phenyl ether Grab EPA 625 5.00 < 5.00 ug/1 1
Butyl benzyl phthalate Grab EPA 625 5.00 < 5.00 ug/1 1
2-chloronaphthalene Grab EPA 625 5.00 < 5.00 ug/1 1
Form - DMR- PPA-1 Page 2

1
Permit No. NC0025984 Annual Monitoring and Pollutant Scan Month January
Outfall 001 Year 2018
4-chlorophenyl phenyl ether Grab EPA 625
Sample Analytical Quantitation Sample Units of Number of
Parameter Type Method Level Result Measurement samples
Base-neutral compounds (cont.)
Chrysene Grab EPA 625 5.00 < 5.00 ug/1 1
Di-n-butyl phthalate Grab EPA 625 5.00 < 5.00 ug/1 1
Di-n-octyl phthalate Grab EPA 625 5.00 < 5.00 ug/1 1
Dibenzo(a,h)anthracene Grab EPA 625 5.00 < 5.00 ug/1 1
1,2-dichlorobenzene Grab EPA 625 2.00 < 2.00 ug/1 1
1,3-dichlorobenzene Grab EPA 625 2.00 < 2.00 ug/1 1
1,4-dichlorobenzene Grab EPA 625 2.00 < 2.00 ug/1 1
3,3-dichlorobenzidine Grab EPA 625 5.00 < 5.00 ug/1 1
Diethyl phthalate Grab EPA 625 5.00 < 5.00 ug/1 1
Dimethyl phthalate Grab EPA 625 5.00 < 5.00 ug/1 1
2,4-dinitrotoluene Grab EPA 625 5.00 < 5.00 ug/1 1
2,6-dinitrotoluene Grab EPA 625 5.00 < 5.00 ug/1 1
1,2-diphenylhydrazine Grab EPA 625 5.00 < 5.00 ug/1 1
Fluoranthene Grab EPA 625 5.00 < 5.00 ug/1 1
Fluorene Grab EPA 625 5.00 < 5.00 ug/1 1
Hexachlorobenzene Grab EPA 625 5.00 < 5.00 ug/1 1
Hexachlorobutadiene Grab EPA 625 5.00 < 5.00 ug/1 1
Hexachlorocyclo-pentadiene Grab EPA 625 5.00 < 5.00 ug/1 1
Hexachloroethane Grab EPA 625 5.00 < 5.00 ug/1 1
Indeno(1,2,3-cd)pyrene Grab EPA 625 5.00 < 5.00 ug/1 1
Isophorone Grab EPA 625 5.00 < 5.00 ug/1 1
Naphthalene Grab EPA 625 5.00 < 5.00 ug/1 1
Nitrobenzene Grab EPA 625 5.00 < 5.00 ug/1 1
N-nitrosodi-n-propylamine Grab EPA 625 5.00 < 5.00 ug/1 1
N-nitrosodimethylamine Grab EPA 625 5.00 < 5.00 ug/1 1
N-nitrosodiphenylamine Grab EPA 625 5.00 < 5.00 ug/1 1
Phenanthrene Grab EPA 625 5.00 < 5.00 ug/1 1
Pyrene Grab EPA 625 5.00 < 5.00 ug/1 1
1,2,4,-trichlorobenzene Grab EPA 625 2.00 < 2.00 ug/1 1
"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."
Authorized Representative name
Signature
Date
Form - DMR- PPA-1 Page 3

Pace Analytical Services,Inc.
aeAnaIIe 9800 Kincey Ave. Suite 100
Huntem7le,NC 28078
isvd cam^ [phone]
Page 1 of 1
Laboratory Report ( ` _1.€5
Report Date: 04/17/2015
Mr. Jeff Dotson
Forest City VWVTP Date Received: 04/15/2015
P.O. Box 728
397 Riverside Drive
Forest City, NC 28043
Project: BIOASSAY 04/14/2015
Pace Project No.:92245853
Sample: PIPE 001 Lab ID: 92245853001 Collected: 04/14/15 08:56 Matrix: Water
Parameters Results Units Report Limit Analyzed Qualifiers
P.promelas Full-range Chronic Pass 96 04/15/15 00:00
Reviewed by: U Stacy Tarie
stacy.tarte©pacelabs.com
Raleigh Certification IDs
6701 Conference Drive,Raleigh,NC 27607 North Carolina Bioassay Certification#:16
North Carolina Wastewater Certification#:67 North Carolina Drinking Water Certification#:37731
Page 1 of 2

Idf)
Effluent Aquatic Toxicity Report Form -Acute Pass/Fail Date i(C i')
\ -
Facility r r NPDES#NC � Pipe# ��(t P County 1r;; i1TtQ
Xa/ Pe ormi'ng Test
/ es Comments \l' #�'► ' ' -
Signature 4t Oge,raafor in Res nsible„Ch rge
Signature of Laboratory pervisor
Accumammusam
....-
L ORIGINAL TO., Dnv it f 4maenetall Sciie Ces Branch
N.C.DENR
1621 Mail Service Center
North_carolina Acute Pass/Fail Toxici Test Raleigh, North Carolina 27699-1621
Collection Date: 4-1-- 5 Organism Tested
Collection Time: s lI5lCCI
Test Start Date: -i� I� V2,11C �s
SampleType/Duration
Control �
Grab Com�, Duration pH
o Treatment. ,i
-
n' tc
o' t e
a n
Hardness(mg/I r d
t
Spec.Cond.(pmhos-MI . Control il Ai((
Chlorine(mg/l -
D.O.
Treatment��
Sample temp. at receip
Mortality Replicate Mean Mortality
Treatment 1 (Control) A B C D
1_0_1
1 L C.
l %ip j
[
Treatment 2 (Exposure) A B C D
Concentration
TestedfiEl i
I%( c I I [
:
1
1214;
(NOTE: If mean control mortality exceedsl0%,the test is considered invalid)
Calculate using
Arc-Sine Calculated Student's t PASS, ,i/r
Square Root
transformed Tabular Student's t FAIL 11111
data (ONE TAILED) _._
If the absolute value of the calculated t is less than or equal
to the absolute value of the tabular t, check PASS.
If the absolute value of the calculated t is greater than the
absolute value of the tabular t,check FAIL.
If all vessels within each treatment have the same response
but the treatment two response is greater than the control,check FAIL.
---- — -�
DWQ torn,AT-2(8/91)

g
Effluent Aquatic Toxicity Report Form -Acute Pass/Fail Date i tr-I5
Facility_3—D RSt L.t"�i_ NPDES#NC n RK� Pipe#CC County ' .-A4Mit'ii fci
Laboratory Performing Test 1 X 10 Q CIDO V 1 --
x Con imeiits NV) 61 6 3
Signature. o!- ator in ResppnsibICharge
Signature.Laboratory S pervisor
MAIL ORIGINAL TO DiviofWaneta caityesBranch
N.C.DENR
1621 Mall Service Center
North Carolina Acute Pass/Fail Toxicity Test Raleigh, North Carolina 27699-1621
Collection Date: Organism Tested
Collection Time: 5kCA
Test Start bate: 16-I9 \ 29 r.. s 3-0 tit S
SampleType/Duration Control EIE
Grab Com-7Duration pH
Treatment gee
E 2a n
r d
Hardness(mg/I, A l0 t
Spec.Cond.(pmhos I78-49 t Control E. qg
D.O. I
Chlorine(mg/I. Lc):j Treatment gliii
Sample temp. at receip 3.0
mortality Replicate Mean Mortality
Treatment 1 (Control) A B C D
Treatment 2(Exposure) A B C D
- -
o� % o 0 0
oA
Concentration ; 0 ('�� 2
Tested `-,`C 0 O/o 10
Oo 0 0 ,
(NOTE: If mean control mortality exceedsl0%, the test is considered invalid)
Calculate using - W^
Arc-sine Calculated Student's t =PASS \,,
Square Root
transformed Tabular Student's tL------- I FAIL -
data (ONE TAILED)
If the absolute value of the calculated t is less than or equal
to the absolute value of the tabular t,check PASS.
If the absolute value of the calculated t is greater than the
absolute value of the tabular t,check FAIL.
If all vessels within each treatment have the same response
but the treatment two response is greater than the control,check FAIL.
DWQ form AT-2(8/91)

Pace Analytical
Data Sheet for Acute Pass/Fail Test— Fathead minnow Pimephales promelas
Client: 1' .)1( 1).--\- (1.\ NPDES #: NC QQa 1 - Reviewed by: Si
Test Organism:pi 1 S L7MI-VOS Organism Born(Date/Time):4(p'6/l T Age of Organism: la pak.iS Time Fed: a( 0°-t?__
#Replicates per Treatment: 4 Total Organisms per Vessel: 10 Test Vessel Size:, "5Z MIL Volume/Vessel: E€Xr:L
Dilution Water Batch: I Temperature: 2-5.0 Randomized: v Incubator: 6\3
Start Date: '4-15.-16- Time: 3`•0 Analyst: K
End Date: ' -tlQ- 5 Time: 3. Analyst: Si-
,
# Organisms #Alive after 24hrs D.O. Temp. pH Conductivity
exposed (mg/L) _ (°C) (µS/cm)
Chlorine Total ;
Concentration A B C D A B C D T°. e 0 24 0 24 0 24 0 24 (mg/L) Hardness -
Alv
Control + (mom)
lU io 1a 10 I tQ 10 10 40 7.(340 .4 s.04. - 7 i 5.D ar -f� 4L2
`T 0 IQ Id t C) t v IC (0 01 lc 3G 6.49 (4.35240 2 5 g i ge °k39,,q r5 7 '-0, I
Comments:
100% Sample:
pH- , (p 0
conductivity(µS/cm) -

Larval Fish Growth and Survival Test-24 Hr Survival
Start Date: 4/15/2015 Test ID: forest Sample ID:
End Date: 4/16/2015 Lab ID: PACE-Raleigh#016 Sample Type:
Sample Date: Protocol: EPAF 91-EPA Freshwater Test Species: PP-Pimephales promelas
Comments:
Conc-% 1 2 3 4
control 1.0000 1.0000 1.0000 1.0000
90 1.0000 1.0000 0.9000 1.0000
Transform:Arcsin Square Root Rank 1-Tailed
Conc-% Mean N-Mean Mean Min Max CV% N Sum Critical
control 1.0000 1.0000 1.4120 1.4120 1.4120 0.000 4
90 0.9750 0.9750 1.3713 1.2490 1.4120 5.942 4 16.00 9.00
Auxiliary Tests Statistic Critical Skew Kurt
Shapiro-Wilk's Test indicates non-normal distribution(p<=0.05) 0.7064 0.818 -2.0367 4.9
Equality of variance cannot be confirmed
Hypothesis Test(1-tail,0.01)
Wilcoxon Two-Sample Test indicates no significant differences
Dose-Response Plot
1 •
0.9
0.8
0.7
R
0.6
Z
w 0.5
f 0.4
0.3
0.2
0.1
0
Q a
8
• e
Page 1 ToxCal:v5.0.23 Reviewed by: 71

Document Name: Date Revised:June 22,2012
. a .- .Bioassay Chain of Custody Page 1 of 1
Document Number. Issuing Authority:
1 • ",g.!i:.: ,.f4 AL-CS-007-rev.01 _ Pace Carolinas Quality Office
Bioassay Chain of Custody Form
Facility Name: --107.4 r G-E c, eSf C ; Afrof
Address: 397 R ., /Sic/P a P.O. Box: 72(
Ai tf' '4 , AJc• Phone#:_(�, 07 kf- S�/J
02 I7 / 1 Contact: R-Pl Aofro,
County: 70c/i i-4id .NPDES permit#: DOZS-ciri' pipe: C 'I
Effluent Dilution(WC): I1>..."-- Test Method: , i--iaa) /'7,a,ra...
Plant Flow.
Sample Collector: Print / 015 0—
Signature. .7 4...,/z(__-:-.-- _
Sample Type:
Composite _ ..---�-" of/-11.�::.:;: .T._�
Date Started y'1'T'l.:s .; t �:.:: :/°.?Q AM r PM
Date Ended �t i�..,?-f.. lime: O*SG or PM
Samples per Hr. . #.Hrs: . .
Grab
Date: Time: AM or PM
Sample Volume: L.,-3e. . Chilled during Collection? Sor No
Method of Transportation to the Lab:. P,'cE. "-- r ._ --_—
,
" Chain of Custody Release
Relinquished By Date- • •• Time Received By Date Time
�— y-,yam , /1 � yS
� � )i35
: . ,I -IS , � 1 ti L-1.-)Li 1451-
19 Pc t,G 4.lq 1 ,'} 1 h LI-I 1453-
r. V.,,,0:2-tiV-� �.\c 1 ,�J. 1- .� a .p V — e'
if 3- ii,
Oisa
Comments: r•
.;_
For Pace Analytical,Inc. Use Only
Pace Work Order Number: /?7.31e -:1 �
Receiving Temperature: 3. - Received By: WC-
Pace Analytical Services,Inc.Address:6701 Conference Dr.,Raleigh.NC 27607 Phone:[phone]

•
PO Box 7565
Asheville,NC 28802
Phone: [phone]
Fax: [phone]
Environmental Testing Solutions,Inc.
August 05, 2016
Mr. Jeff Dotson
Forest City
PO Box 728
Forest City,NC 28043
RE: ETS PROJECT NUMBER: 11559
Dear Mr. Dotson:
Enclosed are toxicity test results for samples from the Forest City WWTP received by
Environmental Testing Solutions, Inc. July 11 through July 15, 2016.
Parameter Test Procedure EPA Method Final Result
Code Number
THP6C Fathead Minnow(Pimephales promelas) Larval EPA-82 1-R-02-013 ChV>721)/0
Survival and Growth,Test Method 1000.0
Note: ChV=Chronic Value. A numeric value representing the geometric mean of the highest concentration having no
detectable impairment of survival or growth and the lowest concentration that does have a detectable impairment of survival or
growth.
If this test was performed as an NPDES requirement or by Administrative Letter, please enter the
ChV value>72% on the Effluent Discharge Monitoring Form (MR-1) for the collection date
July 11, 2016 using the parameter code THP6C.
Additionally, please sign and submit the original DWQ Aquatic Toxicity Form (AT-5) by
August 31, 2016.
If you have any questions concerning these results, please feel free to contact me.
Sincerely,
J144414
Jim umner
Laboratory Director
This report should not be reproduced,except in its entirety.without the written consent of Environmental Testing Solutions.Inc.
The results in this report relate only to the samples submitted for analysis.
North Carolina Certificate Numbers: Biological Analyses: 37, Drinking Water: 37786,Wastewater: 600
South Carolina Certificate Number: Clean Water Act: 99053-001

PO Box 7565
Asheville,NC 28802
Phone: [phone]
Fax: [phone]
E-mail: [e-mail]
Environmental Testing Solutions,Inc. Date: August 05.2016
Effluent Aquatic Toxicity Report Form-Chronic Fathead Minnow Multi-Concentration Test
Facility: Forest City WWTP NPDES#: NC-0025984 Pipe#: 001 County: Rutherford
Laboratory Performing Test: Environmental Testing Solutions,Inc. Comments:
Signature of Operator in Responsible Charge:
Signature of Laboratory Supervisor: Project: 11559
Samples: 160711.01,160713.30,160715.18
Mail Original To: North Carolina Department of Environment and Natural Resources
DWQ/Environmental Sciences Branch
1621 Mail Service Center Start date: End date: Start time: End time:
Raleigh,NC 27699-1621 07-12-16 07-19-16 0825 0730
Replicate number
1 2 3 4 Test Organisms
Control Surviving number of larvae 10 10 10 10 Survival(%) 100.0 Outside supplier:
Organisms Original number of larvae 10 10 10 10 Average wt(mg) 0.787 I In-house Culture
Weight/original(mg/larvae) 0.812 0.815 0.723 0.797 Average wt/ 0.787
surviving(ing) Begin hatch: 07-I1-16 1600
Effluent Surviving number of larvae 10 10 10 10 End hatch: 07-12-16 0610
4.5% Original number of larvae 10 10 10 10 Survival(e) 100.0
Weight/original(mg/larvae) 0.736 0.773 0.827 0.781 Average vet(mg) 0.779
%Effluent Surviving number of larvae 10 10 10 10
9.0% Original number of larvae 10 10 10 10 Survival(%) 100.0
Weight/original Ong/larvae) 0.705 0.655 0.767 0.793 Average wt(mg) 0.730
%Effluent Surviving number oflarvae 10 10 10 10
18% Original number of larvae 10 10 10 - 10 Survival(%) 100.0
Weight/original(mg/larvae) 0.743 0.773 0.732 0.733 Average wt(mg) 0.745
Effluent Survivingnumberoflarvae 10 10 10 10
36%1 Original number of larvae 10 10 10 10 Survival(%) 100.0
Weight/original(mg/larvae) 0.639 0.747 0.703 0.711 Average wt(mg) 0.700
%Effluent Surviving number of larvae 10 10 10 10
72% Original number of larvae 10 10 10 10 Survival(%) 100.0
Weight/original(rngllarvac) 0.653 0.789 0.730 0.843 Average wt(mg) 0.754
Water Quality Data
Day 0 Day I Day 2 Day 3 Day 4 Day 5 Day 6
Initial I Final Initial I Final Initial I Final Initial I Final Initial I Final Initial I Final Initial I Final
Control
pH(SU): 7.69 7.49 7.61 7.30 7.63 7.47 7.73 7.45 7.67 7.29 7.74 7.59 7.58 7.51
DO(ing/L): 7.9 7.9 7.9 7.6 7.9 7.6 7.9 7.8 7.9 6.8 7.8 7.7 7.9 6.7
Temp.("C): 24.7 24.4 24.6 24.2 24.7 24.2 24.7 24.5 24.8 24.6 24.6 24.4 24.6 24.6
High Concentration
psi(SU): 7.39 7.31 7.38 7.19 7.28 7.29 739 7.14 7.44 7.21 7.47 7.40 7.44 7.40
DO(mg/L): 7.9 7.8 8.0 7.7 8.0 7.7 8.0 7.7 8.0 7.0 7.7 7.8 7.8 7.7
Temp.(°C): 24.8 24.3 24.7 24.4 24.7 243 24.8 24.6 25.0 24.4 • 24.7 24.2 24.6 24.7
Sample Information Sample I Sample 2 Sample 3 Control Analyses Survival Growth
Collection start date: 07-10-16 07-12-16 07-14-16 ,24 " Nonnal: Yes Ycs
Grab: . . 'A ?: Flom.Var. Yes Yes 1
Composite duration: 22•1 24-11 24.25 It NOEC: 72% 72%
Alkalinity(mg/L CaCOi): 21 18 24 35,34 LOEC: >72% >72%
Hardness(mg/L CaCO,)' 56 50 64 44,46 ChV: >72% >72%
Conductivity(limbos/cm): 532 527 582 150-158 Method: Visual lnsp. Dunnett's
Total residual chlorine(mg/L): <0.10 <0.10 <0.10 .. x ',
Sample Temp.at Receipt("C): 0.7 4.8 5.5 Survival Growth
%Effluent Critical Calculated Critical Calculated
4.5% . . 2.410 0.204
9.0% . 2.410 0.155
18% . . 2.410 1.131
36% . 2.410 2.364
Overall Analysis: 72% . . 2.410 0.899
Result: PASS LOEC: >72% NOEC: 72% ChV: >72%
D IVQ form AT-5(8/03)

° (; '....___I L .! Page 1 of 5
. i'
._` Environmental Testing Solutions,Inc.
Chronic Whole Effluent Toxicity Test (EPA-821-R-02-013 Method 1000.0)
' Species: Pimephales promelas
Client: Forest City WWTP County: Rutherford
NPDES #: NC 0025984 Outfall#: 001
Project#: 1\SS'\ Chronic Limit: 18%
I
Dilution preparation information: Comments:
Dilution prep(%) 4.5 9.0 18 36 72
Effluent volume(mL) 45 90 180 360 720
Diluent volume(mL) 955 910 820 640 280
Total volume(mL) 1000 1000 1000 1000 1000
Test organism information: Test information:
Organism source: In-house culture Randomizing template: `rel .o J
Age: <24-hours old Incubator number and shelf 1(-
location:
Spawn date: al-cry-IL, Artemia CHM number: CHM882
Hatch dates and times: c t-tl-►to 0.00 -T0 Drying information for weight
CT1•vl-t l 06 t(7 determination:
Transfer vessel information: pH= ,.SO S.U. Date/Time in oven: e-t-N-tb t1So
•
Temperature= Lt. °C Initial oven temperature: 100'<
Average transfer volume: 0.1749 mL Date/Time out of oven: C11-1,3-1 to t► O
Final oven temperature: \,p'L,
Total drying time: -L1-}1p‘y,,A.S
Daily feeding and renewal information:
Day Date Morning feeding Afternoon feeding Test initiation,renewal, Sample SSW
or termination number used batch used
Time Analyst Time Analyst Time Analyst
0 07-12-16 0:06 1(( l5 00 & 0825 8` tta(r1t\.01 cri-oy-Ire
1 07-13-16 mbeo y t'L00 g 6kt"L , k _16011.01 al-fl`-1-ib
07-14-16 6100 �( 13)5 e Oat. 1b6,,,,.. �0 n-fn-i to
3 07-15-16 (nbp `1 t31D 041I\ , lbtTtt3.3Q o-1-(51-1b
07-16-16 C.5-ltS 1fk�` t3NS l,{ 0eVYS il 1t.crltS. 1' m- cr•tb
5 07-17-16 (3-1.1S Al t3\5 el O°t L 6y lbcstt.S•lg- 0-1-(-t•1(o
6
07-18-16 OS 1-0 �t t`�Zo 0-r-to 1( Ibct' 1 Q- c 1-61-I to
7 07-19-16 O-13. g
Control information: Acceptance criteria Sunuttary of test endpoints:
% Mortality: L 07, s 20% 7-day LCS0 .>-n 7.
Average weight per initial larvae: p,l$1 NOEC 1-2.7,
Average weight per surviving larvae: 0.1 g 1 >—0.25mg/larvae LOEC )127.
ChV 77L7•
IC25 >121
SOP AT20—Exhibit AT20.3,revision 11-01-14
1

F777 ( /` Page 2 of 5
' Environmental Testing Solutions,Inc.
1
P
Species: Pime hales romelas Date: 07-12-16
P P
Client: Forest City WWTP
Survival and Growth Data
Day CONTROL 4.5% 9.0%
A BCDE FGH I J K L
0 10 10 10 10 10 10 10 10 10 10 10 10
• 1 ( 10l 11 I
Ip 0 b � 10 l0 10 O 0 0 (0
2 10 10 /0 /0 ►p 10 to 10 1 p l0 10 10
3 (0 10 to 10 ID 10 (0 to tc l0 (0 (p
a to 10 to to 10 ib /0 lb /0 I0 /0 10
5 /0 10 1D i0 10 ( p 10 (p fo 10 10 l0
6
Jo 10 10 to l0 ( D 1D 10 /D ID 10 to
I D to ur 10 10 10 10 10 10 10 10 I p 10
A=Pan weight(mg)
Tray color code:: Pt os.11. i5RA, 1G.gb 6.53 t5.gq 15.41, IC.41 Il0.3 15.gl 15.2q 15 415.3}
Analyst: 5(40
Date: f?b2� 11a
B=Pan+Larvae weight(mg)
Analyst: _,t//(...‘.5 23-982q.11VeIG
2.-%22.$2 23.'0 211.6523.3222.8821.gy 2�..to1 ?1t.3
Date: -•23 16 7.2lb
C=Larvae weight(mg)=B--A
Hand calculated. { �,\ - $,1-j 1.23 Al� 1.3b ' $.13 Z"ij 1,81 '1.05 b.55 1.b� 1.q3
Analyst: XX\
U _
Weight per initial number of larvae(mg)
=C/Initial number of larvae
`V
Hand calculated. � �1) ^J n� `C' n� p� 4) , Co
Analyst: cb c• /� /\ /� 0, ^ o ��
p- d ° o (�' _ p' t Cf 0
Average weight per initial Percent
number of larvae(mg) reduction
from control 0.1.a1 0.114\ \.lJ7. 3-130
(%)
Comment codes: c=clear,d=dead, fg=fungus, k=killed,m=missing,sk=sick,sm=unusually small,
lg=unusually large, d&r=decanted and returned,w=wounded.
Continents:
SOP AT20—Exhibit AT20.3,revision 1 1-0I-14

•
o Page 3 of 5
Environmental Testing Solutions,Inc.
•
Species: Pinrephales prorelas
Client: Forest City WWTP Date: 07-12-16
Survival and Growth Data
Day 18% 36% 72%
M N 0 P Q R S T U V W X
0 10 10 10 10 10 10 10 10 10 10 10 10
' 10 (0 ICI Io to to t0 to 10 to Io 10
• 2
ID 10 10 to to 10 (0 l0 10 10 10 10
3 10 10 10 10 10 10 10 /0 10 ID I0 10
4 ID HD IO 10 10 10 t0 tO /0 10 to 10
5 10 it) lb 10 (6 11) 10 ID 10 1p 10 '0
6
ID I0 ID 10 10 ID lb 10 10 ID 10 10
7 tUr
ID /p to 10 1D ID to (Q /0 10 10 I0
A=Pan weight(nig)
Tray color code:: PeAAO 1,Sg9 1513 i�wI
Analyst: � lto�-b 15319 I530 15,253 15.i0215•42, I10:30 t4,1Gi
Date: 0 b-29-110
B=Pan+Larv, weight(mg) v'1t�
Analyst: Gf 23-4 22.31i 23.05 24.6i 22•16 22.2ifolli 9y 2Z-�23,3423.( '22,62
Date: p�-•23
C=Larvae weight(mg)=B-A
Hand calculated. ),� `) 1'J 1. � - l• ' lo.'fj -1•`k -Los 1.11 6.53 1.5S i.30 g.-` 3
Analyst:
Weight per initial number of larvae(mg)
=C/Initial number of larvae
n t
Hand calculated. ^J� 0"(� ^^�N n� �
Analyst: 0. 0. O. 0' 0- O' 0• O' t-
Average weight per initial Percent
number of larvae(mg) reduction MS
S "S1. G--MC) 14. 01. 0.15v 1 y•Z�•
from control •1
(%)
Comment codes: c=clear,d=dead, fg=fungus,k=killed,m=missing,sk=sick,sm=unusually small,
Ig=unusually large, d&r=decanted and returned,w=wounded.
Comments:
SOP AT20—Exhibit AT20.3,revision 11-01-14