NC0077615_Fact Sheet_20190221

FACT SHEET FOR EXPEDITED PERMIT RENEWALS
This form must be completed by Permit Writers for all expedited permits which do not require
full Fact Sheets. Expedited permits are generally simple 100% domestics (e.g., schools,
mobile home parks, etc) that can be administratively renewed with minor changes, but can
include facilities with more complex issues (Special Conditions, 303(d) listed water, toxicity
testing, instream monitoring, compliance concerns).
Basic Information for Expedited Permit Renewals
Permit Writer / Date
Sydney Carpenter 2/21/2019
Permit Number
NCO077615
Facility Name / Facility Class
Origin Food Group LLC / WW-2
Basin Name / Sub -basin number
Yadkin Pee Dee / 03-07-06
Receiving Stream / HUC
Third Creek / 03040102
Stream Classification in Permit
C / Index: 12-108-20-4
Does permit need Daily Max NH3 limits?
No
Does permit need TRC limits/language?
No — Already resent
Does permit have toxicity testing?
No
Does permit have Special Conditions?
High Rock Lake nutrient reo ener
Does permit have instream monitoring?
No
Is the stream impaired on 303 d list)?
No
Any obvious compliance concerns?
No. No enforcements since 2007. Four violations
in 2018.
Any permit mods since lastpermit?
No
New expiration date
03/31/2024
Comments on Draft Permit?
Added regulatory citations
Updated Section A. (3.)
Updated Map with aerial imagery.
Changes in Final Permit?
None

Statesville Record & Landmark
Advertising Affidavit
PO Box 968
Hickory, NC 28603
NC DENR/DWQ
ATTN: WREN THEDFORD
1617 MAIL SERVICE CENTER
RALEIGH, NC 27699-1617
Account Number
3142720
Date
January 11, 2019
Date Category Description Ad Number Ad Size
01/11/2019 Legal Notices Public Notice North Carolina Environmental Management Comm 0000532533 2 x 31 L
Publisher of
Statesville Record & Landmark
Iredell County
Before the undersigned, a Notary Public of Iredell County, North Carolina, duly
commissioned, qualified, and authorized by law to administer oaths, in said
County and State; that he/she is authorized to make this affidavit and swom
statement; that the notice or other legal advertisement, a copy of which is attached
hereto, was published in the Statesville Record & Landmark on the following
dates:
01/11/2019
and that the said newspaper in which such notice, or legal advertisement was
published, was a newspaper meeting all the requirements and qualifications of
Section 1-597 of the General Statutes of North Carolina.
4
Assislan! Bookkeeper
Newspaper reference: 0000532533
Swom to and subscribed before me, this,_\ day of 2019
tl r.,n_mOm XX LA wmm�O��i
Notary Public
r
Noier
Z r eae/r COU04,
My Commission expires: '% �,"Lt QL."mil O�
I70
THIS IS NOT A BILL. PLEASE PAY FROM INVOICE. TH N YOU

Management Com rdssiollLPDES Unit
Raleigh, NC 27699-1617
Notice of Intent to Issue a NPDES Wastewater Permit
The North Carolina Environmental Management Commission proposes to
issue a NPDES wastewater discharge permit to the person(s) listed below.
Written comments regarding the proposed permit will be accepted until
30 days after the publish date of this notice. The Director of the NC Divi-
sion of Water Resources (DWR) may hold a public hearing should there be
a significant degree of public interest. Please mail comments and/or infor-
mation requests to DWR at the above address. Interested persons may vis-
it the DWR at 512 N. Salisbury Street, Raleigh, NC to review information
on file. Additional information on NPDES permits and this notice may be
found on our website: http,.//deq.nc. ov ahout/dNisi0nS/water-resources
noticeS,or by calling [phone]. Lowe's Home Centers requested re-
newal of NPDES permit NC0085120/Iredell County Distribution Center
WWTP. Facility discharges to an unnamed tributary to Rocky
Creek/Yadkin-Pee Dee River Basin. Currently, ammonia nitrogen and fe-
cal coliform are water quality limited. Origin Food Group, LLC has request-
ed renewal of permit NC0077615/Origin Food Group, LLC WWTP; Iredell
County. Facility discharges to Third Creek/Yadkin-Pee Dee River Basin.
Currently, oil & grease, fecal coliform, and total residual chlorine are wa-
ter quality -limited. Iredell-Statesville Schools requested renewal of
NPDES permit NC0037371/North Iredell High School WWTP. Facility dis-
charges to Patterson Creek/Yadkin-Pee Dee River Basin. Currently fecal
coliform and total residual chlorine are water quality limited.
Publish: January 11, 2019.

ROY COOPER NORTH CAROLINA
Governor Environmental Quality
INIICHAEL S_ REGAN
Secretm-'k,
LINDA CULPEPPER
Inierfrn Director
September 18, 2018
David Tupman, Plant Manager
Origin Food Group LLC
PO Box 7621
Statesville, NC 28687
Subject: Permit Renewal
Application No. NCO077615
Origin Food Group, LLC
Iredell County
Dear Applicant:
The Water Quality Permitting Section acknowledges the September 18, 2018 receipt of your permit renewal application
and supporting -documentation. Your application will be assigned to a permit writer within the Section's NPDES WW
permitting branch. Per G.S. 150B-3 your current permit does not expire until permit decision on the application is made.
Continuation of the current permit is contingent on timely and sufficient application for renewal of the current permit. The
permit writer will contact you if additional information is required to complete your permit renewal. Please respond in a
timely manner to requests for additional information necessary to allow a complete review of the application and renewal
of the permit.
Information regarding the status of your renewal application can be found online using the Department of Environmental
Quality's Environmental Application Tracker at:
https: 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.
ec: WQPS Laserfiche File w/application
Sincerely,
in�((
�Jl w Ruc�
Wren Thedford
Administrative Assistant
Water Quality Permitting Section
�IHT/ A9 9! D� Q /'
P.MaW OWA/�
North Carolina Department of Environmental Quality I Division of Water Resources
1617 Mail Service Center I Raleigh, North Carolina 27699-1617
919-807-6300

i
�f OPDES APPLICATION - FORM D
For privately-owlied treatr�ent systems treating 100% domestic wastewaters <1.0 MGD
Mail the complete application to:
N. C. DEl R / Division of Water Quality / NPDES Unit
1617 Mail Service Center, Raleigh, NC 27699-1617
NPDES Permit C0077615
If you are completing t is form ir� computer use the TAB key or the up —down arrows to move from one
field to the next. To ch ck the boxes, click your mouse on top of the box. Otherwise, please print or type.
1. Contact Informat
Owner Name
Facility Name
Mailing Address
City
State / Zip Code
Telephone Number
Fax Number
e-mail Address
2. Location of fac
Check here if same
Street Address or
City
State / Zip Code
County
3. Operator intormi
Name of the firm, pubt
to the Operator in Res
Name
Mailing Address
City
State / Zip Code
Telephone Number
Fax Number
e-mail Address
1 of 4
RECEIVED/DENR/DWR
';'. X
Origi% Food Group, LLC
PO Bpx 7621
Perrrritting Sections
NC 28687
y produc�ng discharge:
tress as a�ove ❑
Road 306 Stamey Farm Rd
Statesville
NC 28687
Iredell
i
Lion:
organization or other entity that operates the facility. (Note that this is not referring
,onsible Charge or ORC)
i
Envirolink Inc
470Q Homewood Ct Suite 108
Raleigh
NC P7609
(252'235-4900
[phone]
had4m aenvirolinkinc.com `
Form-D 11/12

�PDES APPLICATION - FORM D
For privately-o ned treatment systems treating 100% domestic wastewaters <1.0 MGD
4. Description of
Facilitv Generati4a Wastev)ater(check all that apply):
Industrial
; Number of Employeesv-'
Commercial
Number of Employees
Residential
i Number of Homes
School
Number of Students/Staff
Other
i Explain:
Describe the source(s of waste�ater (example: subdivision, mobile home park, shopping centers,
restaurants, etc.): i
Domestic waste at 0 025 MGD;manufacturing facility.
i
Number of persons E erved:
5. Type of collection system
® Separate (sanitary sewer only) ❑ Combined (storm sewer and sanitary sewer)
6. OutfallInformation:
Number of separate discharge points 1
Outfall Identification nu4er(s) 001
i
Is the outfall eq ipped with a diffuser? ❑ Yes ® No
7. Name of receiving stream(ai) (NEW applicants: Provide a map showing the exact location of each
outfall):
Third Creek
S. Frequency of I
If intermittent:
Days per week i
There has not been
there is enough wa;
9. Describe the t
List all installed co
phosphorus. If the
separate sheet oft
2of4
❑ Continuous ® Intermittent
arge ocdurs: 0 Duration:
flow on the plant until recently. The ORC will store the wastewater in the EQ until
iter to t ,eat. Effluent flow is sampled during a discharge event.
ent sy Item
nts, incting capacities, prouide design removal for BOD, TSS, nitrogen and
provid4d is not sufficient, attach the description of the treatment system in a
Form-D 11112

v
For
0.025 MGD with
bar screen, weir
clarifier with slu
dechlorination f
3of4
is I PDES APPLICATION - FORM D
ed treat -Lent systems treating 100% domestic wastewaters <1.0 MGD
ise trap, duplex submersible pump station and force main, influent
t flow spitter box, equalization tank with pumps, aeration basin,
return 1,olding tank, chlorine contact basin with tablet chlorination,
with tablet dichlorination.
Form-Q 11112

I'INPDES APPLICATION - FORM D
For privately -owned trea{ment systems treating 100% domestic wastewaters <1.0 MGD
10. Flow
Treatment Plant Design
Annual Average daily fl4
Maximum daily flow 0. (
11. Is this facility
❑ Yes
0.025 MGD
0.000 MGD (for the previous 3 years)
(for the previous 3 years)
Indian country?
� No
12. Effluent Data {
NEW APPLICANTS: Pr vide data for the parameters listed. Fecal Coliform, Temperature and pH shall be grab
samples, for all other parameters 21-hour composite sampling shall be used. If more than one analysis is reported,
report daily maximum and monthly average. If only one analysis is reported, report as daily maximum.
RENEWAL APPLICANTS: Provfde the highest single reading (Daily Maximum) and Monthly Average
`(NIA"_
�Uer LRe UJc JU non
Parameter
r� yr ur rr«......, •.•.•.•
i
• •• . _ _ ..._
Daily
Maximum
Monthly
Average
Units of
Measurement
Biochemical Oxygen
Demand! (BODs)
18
18
mg/ L
Fecal Coliform
i
<1
1
#/ 100
Total Suspended Solids
j
44
44
mg/L
Temperature (Summer)
22.6
22.6
Deg C
Temperature (taint
r)
N/A
N/A
Deg C
pH
7.7
N/A
SU
13. List all permits, construction approvals and/or applications:
Type Pe;mit Number Type
Hazardous Waste (RC ) ; NESHAPS (CAA)
UIC (SDWA) Ocean Dumping (MPRSA)
NPDES NC 077615 Dredge or fill (Section 404 or CWA)
PSD (CAA) j Other
Non -attainment progra (CAA)
i
14. APPLICANT CE11TIFICATION
th b t
Permit Number
I certify that I am Mmiliar wit�i the information contained in the application and that to a es
of my knowledge an1d belief such information is true, complete, and accurate.
Printed name of
Signature of
North Carolina General Statut(
application, record, report, plar
Commission implementing that,
to be operated or maintained u
misdemeanor punishable by a
punishment by a fine of not moi
4of4
Title
Date
143-215.6 (b)(2) states: Any person who knowingly makes any false statement representation, or certification in any
or other document files or required to be maintained under Article 21 or regulations of the Environmental Management
uncle, or who falsifies, tampers with, or knowingly renders inaccurate any recording or monitoring device or method required
ider Article 21 �r regulations of the Environmental Management Commission implementing that Article, shall be guilty of a
ne not to exceed $25,000, or by imprisonment not to exceed six months, or by both. (18 U.S.C. Section 1001 provides a
than $25,000 pr imprisonment not more than 5 years, or both, for a similar offense.)
Form-D 11/12