NC0030384_Renewal (Application)_20190412

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ROY COOPER '�yL7Tg i! '.
Governor r �'. i .,,,
MICHAEL S.REGAN `. ,;,,.
Secrrrary s 4xu vs
LINDA CULPEPPER NORTH CAROLINA
Director Environmental Quality
April 23, 2019
Brian Toomey, CEO
Piedmont Health Services Inc
229 Lloyd Street
Carrboro, NC 27510
Subject: Permit Renewal
Application No. NC0030384
Moncure Community Health Center
Chatham County
Dear Applicant:
The Water Quality Permitting Section acknowledges the April 12, 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. 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.
SincerelyQuc.a.Q,a
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Wren Thedford
Administrative Assistant
Water Quality Permitting Section
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NPDES APPLICATION - FORM D
For privately-owned treatment systems treating 100% domestic wastewaters <1.0 MGD
Mail the complete application to:
N. C. DENR / Division of Water Quality / NPDES Unit
1617 Mail Service Center, Raleigh, NC 27699-1617
NPDES Permit INC0030384
If you are completing this form in computer use the TAB key or the up - down arrows to move from one
field to the next. To check the boxes, click your mouse on top of the box. aygtI� intor type.
1. Contact Information: APR 1 2 2019
.
Owner Name
r-17111 100 NevWats► k,auurcea
Facility Name - ,. t c e Porf711�ifflg Section
Mailing Address ,2.,99 Loud S e.t-
City CCt1-f"beu-o
State / Zip Code C(itrtjtry 4 2 -J—io ._ kZ I
Telephone Number ) 1./2 - )910
Fax Number (y/C ) c/�/Z- /L/73 , t
e-mail Address 71001-7e7 Csi ,o e•drit ,/ t?ec�,t l •ot't
v
2. Location of facility producing discharge:
Check here if same address as above ❑
Street Address or State Road Z2 g P Al,S -- jL'7iyty
City P GoK 4 ) / ik/Lvlc:vre. , v)C—
State / Zip Code 2`(7-SrciII
County C htit 9l�fis "J ( �LYI�c�
3. Operator Information:
Name of the firm, public organization or other entity that operates the facility. (Note that this is not
referring to the Operator in Responsible Charge or OR C) I
Name R 11jj I cm-re ( sk 'c movi t 4-ac)
Mailing Address
PO (2�(-K sz�
City P` 4 6,1/f7
State / Zip Code I vC 27 I '1,-
Telephone Number (q1 q ) 2 L) - ). S (2)
Fax Number ) S45 -
e-mail Address b 4p W u (Ceo , (_.=C)i.1
1 of 3 Form-D 11/12

NPDES APPLICATION - FORM D
For privately-owned treatment systems treating 100% domestic wastewaters <1.0 MGD
10. Flow Information:
Treatment Plant Design flown,002,1'MGD
Annual Average daily flow(.000,02 MGD (for the previous 3 years)
Maximum daily flow() OJ T(� MGD (for the previous 3 years)
11. Is this facility located on Indian country?
0 Yes GEr No
12. Effluent Data
NEW APPLICANTS:Provde data for the parameters listed.Fecal Colfform, Temperature and pH shall be grab
samples,for all other parameters 24-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: Provide the highest single reading(Daily Maximum)and Monthly Average over
the past 36 months for parameters currently in your permit. Mark other parameters "N/A".
Parameter Daily Monthly Units of
Maximum Average Measurement
Biochemical Oxygen Demand (SODS) 2/0 Y/6//7- K (-76AL
Fecal Coliform 1,7-00 7)//g /j t7 //ODA
Total Suspended Solids ��2�i�' 1. 9 7 ;�5 /L
Temperature (Summer) j,,2, g/?///' .26 - � C (LI-us
Temperature (Winter) /5 G /.2 Jfl7 // - ,ci�1s
pH O , /c'/I G 7. L/J�
13. List all permits, construction approvals and/or applications:
Type Permit Number Type Permit Number
Hazardous Waste(RCRA) NESHAPS(CAA)
UIC (SDWA) Ocean Dumping(MPRSA)
NPDES Dredge or fill (Section 404 or CWA)
PSD (CAA) Other
Non-attainment program(CAA)
14. APPLICANT CERTIFICATION
I certify that I am familiar with the information contained in the application and that to the
best of my knowledge and belief such information is true, complete, and accurate.
• ract(\ Toone/ c e0
Printed name of Person Signing Title
(A.372/S 3/ "/i7
Signature of App_icant Date
North Carolina General Statute 143-215.6 (b)(2) states: Any person who knowingly makes any false statement representation, or certification in any
application, record, report, plan, or other document files or required to be maintained under Article 21 or regulations of the Environmental Management
Commission implementing that Article, or who falsifies, tampers with, or knowingly renders inaccurate any recording or monitoring device or method
required to be operated or maintained under Article 21 or regulations of the Environmental Management Commission implementing that Article,shall be
guilty of a misdemeanor punishable by a fine not to exceed$25,000,or by imprisonment not to exceed six months,or by both. (18 U.S C.Section 1001
provides a punishment by a fine of not more than$25,000 or imprisonment not more than 5 years,or both,for a similar offense.)
3 of 3 Form-D 11/12

NPDES APPLICATION - FORM D
For privately-owned treatment systems treating 100% domestic wastewaters <1.0 MGD
4. Description of wastewater:
Facility Generating Wastewater(check all that apply):
Industrial ❑ Number of Employees
Commercial Q Number of Employees f> C)
Residential ❑ Number of Homes
School ❑ Number of Students/Staff
Other ❑ Explain:
Describe the source(s) of wastewater (example: subdivision, mobile home park, shopping centers,
restaurants, etc.):
Number of persons served: <3 OO -`R)J CA- CI C-` .
5. Type of collection system
Separate (sanitary sewer only) ❑ Combined (storm sewer and sanitary sewer)
6. Outfall Information:
Number of separate discharge points I
Outfall Identification number(s)
Is the outfall equipped with a diffuser? Z1 Yes ❑ No
7. Name of receiving stream(s) (NEW applicants:Provide a map showing the exact location of each
outfall):
Gt ) I duel`
8. Frequency of Discharge: ❑ Continuous f Intermittent
If intermittent:
Days per week discharge occurs: S Duration: 10
9. Describe the treatment system
List all installed components, including capacities,provide design removal for BOD, TSS, nitrogen and
phosphorus. If the space provided is not sufficient, attach the description of the treatment system in a
separate sheet of paper.
2 of 3 Form-D 11/12

Option 2:
re Submit a written request for remission or mitigation including a detailed justification for such
quest:
Please be aware that a request for remission is limited to consideration of the five factors listed below as they may
relate to the reasonableness of the amount of the civil penalty assessed. Requesting remission is not the proper
procedure for contesting whether the violation(s)occurred or the accuracy of any of the factual statements contained in
the civil penalty assessment document. Because a remission request forecloses the option of an administrative hearing,
such a request must be accompanied by a waiver of your right to an administrative hearing and a stipulation and
agreement that no factual or legal issues are in dispute. Please prepare a detailed statement that establishes why you
believe the civil penalty should be remitted,and submit it to the Division of Water Resources at the address listed below.
In determining whether a remission request will be approved,the following factors shall be considered:
(1) whether one or more of the civil penalty assessment factors in NCGS 143B-282.1(b)was wrongfully
applied to the detriment of the petitioner;
(2) whether the violator promptly abated continuing environmental damage resulting from the violation;
(3) whether the violation was inadvertent or a result of an accident;
(4) whether the violator had been assessed civil penalties for any previous violations; or
(5) whether payment of the civil penalty will prevent payment for the remaining necessary remedial actions.
Please note that all evidence presented in support of your request for remission must be submitted in writing. The
Director of the Division of Water Resources will review your evidence and inform you of his decision in the matter of
your remission request. The response will provide details regarding the case status, directions for payment, and
provision for further appeal of the penalty to the Environmental Management Commission's Committee on Civil Penalty
Remissions(Committee). Please be advised that the Committee cannot consider information that was not part of the
original remission request considered by the Director. Therefore, it is very important that you prepare a complete and
thorough statement in support of your request for remission.
In order to request remission,you must complete and submit the enclosed"Request for Remission of Civil Penalties,
Waiver of Right to an Administrative Hearing, and Stipulation of Facts"form within thirty(30) days of receipt of this
notice. The Division of Water Resources also requests that you complete and submit the enclosed"Justification for
Remission Request."
Both forms should be submitted to the following address:
Wastewater Branch
Division of Water Resources
1617 Mail Service Center
Raleigh,North Carolina 27699-1617

i
Option 3: File a petition for an administrative hearing with the Office of Administrative Hearings:
If you wish to contest any statement in the attached assessment document you must file a petition for an administrative
hearing. You may obtain the petition form from the Office of Administrative Hearings. You must file the petition with
the Office of Administrative Hearings within thirty(30)days of receipt of this notice. A petition is considered filed
when it is received in the Office of Administrative Hearings during normal office hours. The Office of Administrative
Hearings accepts filings Monday through Friday between the hours of 8:00 a.m. and 5:00 p.m., except for official state
holidays. The petition may be filed by facsimile(fax)or electronic mail by an attached file(with restrictions)-provided
the signed original, one(1)copy and a filing fee(if a filing fee is required by NCGS §150B-23.2)is received in the
Office of Administrative Hearings within seven(7)business days following the faxed or electronic transmission. You
should contact the Office of Administrative Hearings with all questions regarding the filing fee and/or the details of the
filing process.
The mailing address and telephone an'd fax numbers for the Office of Administrative Hearings are as follows:
6714 Mail Service Center
Raleigh,NC 27699 6714
Tel: [phone]
Fax: [phone]
One(1)copy of the petition must also be served on DEQ as follows:
Mr. William F. Lane, General Counsel
Department of Environmental Quality
1i601 Mail Service Center
Raleigh,North Carolina 27699-1601
Please indicate the case number(as found on page one of this letter)on the petition.
Failure to exercise one of the options aboye within thirty(30) days of receipt of this letter, as evidenced by an internal
date/time received stamp(not a postmark),will result in this matter being referred to the Attorney General's Office for
collection of the penalty through a civil action. Please be advised that additional penalties may be assessed for violations
that occur after the review period of this assessment.
If you have any questions,please contact ughie White or myself with the Division of Water Resources staff of the Fayetteville
Regional Office at(910)433-3300.
Sincerely,
2/74,4/4 p Aa4
Mark Brantley,Asst. Regional Supervisor
Water Quality Regional Operations Section
Fayetteville Regional Office
Division of Water Resources,NCDEQ
ATTACHMENTS
Cc: WQS Fayetteville Regional Office(HW)
NPDES Compliance/Enforcement Unit-Enforcement File
1

JUSTIFICATION FOR REMISSION REQLES1
Case Number: EV-2019-005I County: Hoke
Assessed Party: Hoke County
Permit No,: N(::0(189176 Amount Assessed: $528.28
Please use this form when requesting remission of this civil penalty. You must also complete die "Request For Remission,
Waiver of Right to all Administrative Hearing. and Stipulation of Facts"lotm to request remission of this civil penalty.
You should attach any documents that you believe support your request and are necessary for the Director to consider to
evaluating,your request for remission Please be aware that a request for remission IN limited to consideration of the five
factors listed below as they may relate to the reasonableness of the amount of the civil penalty assessed Requesting
remission is not the proper procedure for contesting whether the violation(5)occurred or the accuracy of any,of the factual
statements contained in the civil penalty assessment document Pursuant to N.C.G S § 1 4 3 13-282.1(c),remission ola civil
penalty may he granted only when one or more of the following five factors apply. Please check each factor that you
believe applies to your case and provide a detailed explanation, including copies of supporting documents, as to why the
factor applies(attach additional pages as needed).
t,a) one or more of the civil penalty assessment factors in N.C.(1 S. 14313-282.1(h)were wrongfully applied to the
detriment of the petitioner(the assessment factor§are listed in the civil penalty assesssment document).
X (b) the v rolatot promptly abated continuing environmental damage resulting from the violation(t c- ,explain the
steps that you took to correct the violation and prevent future occurrences).
X (c) the violation was inadvertent or a result of an accident(t.e.. explain wh).. the violation was unavoidable or
comethtng LOH could not prevent of prepare for)
X (di the violator had not been assessed civil penalties for any previous violations:
te) payment of the civil penalty will prevent pay ment for the remaining necessary remedial actions (i.e, explain
how payment of the civil penalty will prevent you from performing the uctivtties necessary to achieve
conmplutncet
EXPLANATION:
The rise in the Total Ammonia Nitrogen was due to unavoidable extreme inclement weather for the week January 1st, 2018
(see attached weather records for www.weatherunderground.com -Fayetteville,NC Regional Airport) Basin and effluent
temperatures for that week were at or below 10 degrees Celsius which inhibits the nitrification process(see attached
Operator's log sheets). To conserve the nitrifier population,wasting of activated sludge was halted,the pH level of the basin
was maintained at 7.00 s u for optimal alkalinity and nitrification,basin dissolved oxygen levels were kept between 1 0 and
2 0 mg/L, and all side streams were reduced and/or eliminated to avoid further water temperature reduction The additional
step of ordering bioaugmentation nitrifiers(BioRemove 585,nitrifying bacteria) from Maryland Biochemical was taken,
however,by the time the product arrived the nitrification process had begun to recover(see attached invoice,Jan 2018).
This incident is the first time this has occurred at the facility The staff continues to monitor weather and facility conditions
to minimize impact during winter months and the County has taken the additional step of keeping bioaugmentation nitrifiers
(BioRemove 585)on hand in case the product is needed(see attached invoice,Feb. 2019) The County's total cost fOr
bioaugmentation nitrifiers for 2018 -2019 is$2,619 36(see attached invoices)which exceeds the levied fine. The County
kindly asks that these matters be considered when reviewing and determining whether a penalty is assessed.

STATE OF NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY
COUNTY OF HOKE
IN THE MATTER OF ASSESSMENT ) WAIVER OF RIGHT TO AN
OF CIVIL PENALTIES AGAINST - ) ADMINISTRATIVE HEARING AND
) STIPULATION OF FACTS
Hoke County )
Hoke County WWTP )
)
PERMIT NO.NC0089176 ) CASE NO. LV-2019-0051
Having been assessed civil penalties totaling$528.28 for violation(s)as set forth in the assessment document of the Division
of Water Resources dated March 15,2019,the undersigned, desiring to seek remission of the civil penalty, does hereby
waive the right to an administrative hearing in the above-stated matter and does stipulate that the facts are as alleged in the
assessment document. The undersigned further understands that all evidence presented in support of remission of this civil
penalty must be submitted to the Director of the Division of Water Resources within thirty(30) days of receipt of the notice
of assessment. No new evidence in support of a remission request will be allowed after(30) days from the receipt of the
notice of assessment.
441
This the day of Ape Y ,20 f 9
GL-t;te
IGNATURE
ADDRESS
2 X 17 k- /111a/n 5
TELEPHONE