NC0051969_Permit (Issuance)_20170405

Water Resources
ENVIRONMENTAL QUALITY
April 7, 2017
Charles E. Trefzger, Jr. Owner
Castle Haynes Health Holdings LLC
P.O. Box 2568
Hickory, North Carolina 28603
ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
S. JAY ZIMMERMAN
Director
Subject: Issuance of Permit NCO051969
Castle Haynes Memory Care WWTP, Class II
4724 Castle Haynes Road, Hickory
New Hanover County
Dear Mr. Trefzger:
The Division of Water Quality (the Division) hereby issues the attached NPDES permit for the
subject facility. We issue this permit pursuant to the requirements of North Carolina General
Statute 143-215.1 and the Memorandum of Agreement between North Carolina and the U.S.
Environmental Protection Agency dated October 15, 2007, or as subsequently amended.
The Division understands that you have made no significant changes to your treatment processes since
last renewal. However, please note the following permit changes required for renewal:
Changes for Renewal
1. Updated facility description and site map.
2. Discontinued monitoring for Total Iron and Total Manganese (no longer required
for the ion -exchange WTP portion of this discharge).
3. Revised Dissolved Oxygen limits from 6.0 mg/L to 5.0 mg/L, appropriate for stream Class C; SW
4. Revised WET -Test "monitoring only" to WET -Test "Limited," based on poor compliance history
5. Added permit limits for Total Copper and Chloride [see A. (1.)] based on reasonable potential
analysis (RPA); monitoring increased from Quarterly to Weekly, as appropriate for limited
parameters. Please note that compliance to these permit limits will commence on May 1, 2019, two
(2) years from the permit Effective Date.
implementing Electronic Dischar a Monitoring Reports eDMRs .Please be advised that the Division
has implemented an electronic Discharge Monitoring Report (eDMR) program, in accord with
requirements promulgated by the US EPA. We include the details to implement the eDMR program in
this permit [see Section A. (3.)].
Federal regulations require electronic submittal of all DMRs and specify that, if North Carolina does not
establish a program to receive such submittals, Permittees must then submit eDMRs directly to EPA. For
more information on eDMRs, registering for eDMR submittal, and obtaining an eDMR user account,
please visit DWR's webpage:
htt:// ortal.ncdenr.or,,/web/w /admin/bo /i u/ed_
Nothing Compares,,
State of North Carolina I Environmental Quality I Water Resources
512 N. Salisbury Street 11611 Mail Service Center I Raleigh, NC 27699-1611
919.707.9000

For information on EPA's proposed NPDES Electronic Reporting Rule, please visit EPA's website:
htlp://www2.epa.gov/compliance/proposed-npdes-electronic-reporting-rule
If any parts, measurement frequencies, or sampling requirements contained in this permit are
unacceptable, you have the right to an adjudicatory hearing, upon written request submitted
within thirty (30) days after receiving this letter. Your request must take the form of a written
petition conforming to Chapter 150B of the North Carolina General Statutes, and you must file it
with the office of Administrative Hearings, 6714 Mail Service Center, Raleigh, North Carolina
27699-6714. Unless such a demand is made, this permit shall be final and binding.
This permit is not transferable except after notifying the Division of Water Quality. The Division
may require permit modification, or revocation and re -issuance. Please note that this permit does
not affect your legal obligation to obtain other permits required by the Division of Water Quality,
the Division of Land Resources, the Coastal Area Management Act, or other federal or local
governments.
If you have questions, or if we can further assist you, please contact Joe R. Corporon, L.G. at
fjoe.corporon(a),ncdenr.gov] or call [phone].
Res lly,
C
S. Jay Zimmerman, P.G., Director
Division of Water Resources
Enclosure: NPDES Permit NC0051969 (issuance final)
hc: Central files
NPDES Program Files
WiRO Jim Gregson, Supervisor
ec: WiRO/SWPS, Jim Gregson, Supervisor, Dean Hunkele
OCU, Maureen Kinney
ATU, Cindy Moore; Susan Meadows
Charles E. Trefzger [[e-mail]]
Nothing Compares,
State of North Carolina I Environmental Quality I Water Resources
512 N. Salisbury Street 11611 Mail Service Center I Raleigh, NC 27699-1611
919.707.9000

Permit NCO051969
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF WATER RESOURCES
PERMIT
TO DISCHARGE WASTEWATER UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
(NEDES)
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards
and regulations promulgated and adopted by the North Carolina Environmental Management
Commission, and the Federal Water Pollution Control Act, as amended,
Castle Hayne AL Holdings, LLC
is hereby authorized to discharge wastewater from a facility located at the
Castle Creek Memory Care WWTP
4724 Castle Hayne Road, Castle Hayne
New Hanover County
to receiving waters designated as an unnamed tributary to Prince George Creek in the Cape Fear River
Basin in accordance with effluent limitations, monitoring requirements, and other conditions set forth in
Parts I, II, and III hereof.
This permit shall become effective May 1, 2017.
This permit and authorization to discharge shall expire at midnight on January 31, 2022.
Signed this day Apri17, 2017.
Zimmerman, P.G.
Director, Division of Water Resources
By Authority of the Environmental Management Commission
Page 1 of 7

Permit NCO051969
SUPPLEMENT TO PERMIT COVER SHEET
All previous NPDES permits issued to this facility, whether for operation or discharge are hereby
revoked. As of this permit issuance, any previously issued permit bearing this number is no longer
effective. Therefore, the exclusive authority to operate and discharge from this facility arises under the
permit conditions, requirements, terms, and provisions included herein.
Castle Hayne AL Holdings, LLC
is hereby authorized to:
1. continue to operate a potable -water treatment system (WTP) for filter backwash, and a wastewater
treatment system (WWTP) for 100%-domestic wastewater utilizing the following components:
'AWATAI
• influent lift station
■ dual (2) pumps
• 12,000 GPD aeration basin
• dual (2) hopper clarifiers
• micro -screen drum filter
• UV disinfection
WTP:
• two (2) each media filters (iron removal)
• an Ion Exchange unit
• storage tank (filter backwash)
• storage tank (potable water)
• appurtenant piping and discharge sample port
these facilities located at the Castle Creek Memory Care WWTP, 4724 Castle Hayne Road, Castle
Hayne, New Hanover County, and
2. discharge the combined effluent (0.012 MGD) from said treatment works via Outfall 001, at the
location specified on the attached map, into an unnamed tributary to Prince George Creek [stream
index 18-74-53], a waterbody currently classified C-Sw within subbasin 03-06-23 [HUC: 03030007]
of the Cape Fear River Basin.
Page 2 of 7

Permit NCO051969
Part I
A. (1.) EFFLUENT LIMITATIONS AND MONITORING REQUIREMENTS
[15 NCAC 02B .0400 et seq., 02B .0500 et seq.]
Beginning on the effective date of this permit and lasting until expiration, the permittee is authorized to
discharge a combined treated ion -exchange filter backwash, and treated 100% domestic wastewater
from Outfall 001. Such discharges shall be limited, monitored and reported 1 by the permittee as
specified below:
EFFLUENT
LIMITS
MONITORING REQUIREMENTS
CHARATERISTICS
Monthly
Daily
Measurement
Sample
Sample
(PARAMETER CODE)
Average
Maximum
Frequency
Type
Location 2
Flow
50050
0.012 MGD
Weekly
Instant
E
TRC 3
50060
17.0 µg/L
2/Week
Grab
E
pH
00400
Not < 6.0 or > 9.0 s.u.
Weekly
Grab
E
BOD, 5-day (20°C)
(01Apr-31 Oct)
CO310
5.0 mg/L
7.5 mg/L
Weekly
Grab
E
BOD, 5-day (20°C)
(O 1Nov-31Mar)
CO310
10.0 mg/L
15.0 mg/L
Weekly
Grab
E
Total Suspended Solids
00530
30.0 mg/L
45.0 mg/L
Weekly
Grab
E
NH3 as N
(OlApr — 31 Oct)
CO610
2.0 mg/L
10.0 mg/L
Weekly
Grab
E
NH3 as N
(O 1 Nov — 31 Mar)
CO610
4.0 mg/L
20.0 mg/L
Weekly
Grab
E
Total Copper 4
01040
7.88 µg/L
10.47 µg/L
Weekly
Grab
E
Chloride 4
00940
230 mg/L
Weekly
Grab
E
Fecal Coliform
(geometric mean)
31616
200/100 ml
400/100 ml
Weekly
Grab
E
Fecal Coliform
(geometric mean)
31616
Monitor & Report
Weekly
Grab
U, D
Temperature (°C)
00010
Monitor & Report
Weekly
Grab
E, U, D
Dissolved Oxygen
00300
Effluent: not < 5.0 mg/L
Weekly
Grab
E, U, D
Conductivity
00094
Monitor & Report
Monthly
Grab
E, U, D
Salinity
00480
Monitor & Report
Monthly
Grab
E, U, D
Total Hardness
[as CaCO3 or Ca + Mg]
00900
Monitor & Report
Monthly
Grab
E, U
Salinity
00480
Monitor & Report
Monthly
Grab
E
Turbidity
00076
Monitor & Report
Monthly
Grab
E
Total Dissolved Solids
CO530
Monitor & Report
Quarterly
Grab
E
Total Zinc
01090
Monitor & Report
Quarterly
Grab
E
Total Fluoride
00950
Monitor & Report
Quarterly
Grab
E
Chronic Whole Effluent
Toxicity (WET) g
THP3B
Quarterly
Grab
E
See Footnotes next page.
Page 3 of 7

Permit NCO051969
Table A. (1.) Footnotes:
1. Electronic reporting (eDMR) is required using DWR's eDMR reporting system [see A. (3)].
2. E = Effluent; U = Upstream — 50 feet above outfall; D = Downstream — 0.5 miles downstream of outfall.
3. Total Residual Chlorine (TRC) limit and monitoring apply only if the Permittee uses chlorine or a
chlorine derivative to disinfect. The Division shall consider compliant all TRC values reported below
50 µg/L. However, the Permittee shall continue to record and submit all values reported by a North
Carolina -certified test method, even if these values fall below 50 µg/L.
4. Compliance to permit limits begin on March 1, 2019, two (2) years from the permit Effective Date.
5. Chronic WET -Testing [THP3B] Pass/Fail using Ceriodaphnia dubia; effluent concentration at 90%, during
the months of January, April, July and October [see A. (2)].
Condition:
The Permittee shalldischarge no floating solids or foam visible in other than trace amounts.
A. (2.) CHRONIC TOXICITY - Limited (QUARTERLY)
[15A NCAC 02B .0500 et seq.]
The effluent discharge shall at no time exhibit observable inhibition of reproduction or significant mortality to
Ceriodaphnia dubia at an effluent concentration of 90 %.
The permit holder shall perform at a minimum, quarterly monitoring using test procedures outlined in the "North
Carolina Ceriodaphnia Chronic Effluent Bioassay Procedure," Revised December 2010, or subsequent versions
or "North Carolina Phase H Chronic Whole Effluent Toxicity Test Procedure" (Revised- December 2010) or
subsequent versions. The tests will be performed during the months of January, April, July and October.
These months signify the first month of each three-month toxicity testing quarter assigned to the facility. Effluent
sampling for this testing must be obtained during representative effluent discharge and shall be performed at the
NPDES permitted final effluent discharge below all treatment processes.
If the test procedure performed as the first test of any single quarter results in a failure or ChV below the
permit limit, then multiple -concentration testing shall be performed at a minimum, in each of the two
following months as described in "North Carolina Phase H Chronic Whole Effluent Toxicity Test
Procedure" (Revised -December 2010) or subsequent versions.
All toxicity testing results required as part of this permit condition will be entered on the Effluent Discharge
Monitoring Form (MR-1) for the months in which tests were performed, using the parameter code TGP3B for the
pass/fail results and TIW313 for the Chronic Value. Additionally, DWR Form AT-3 (original) is to be sent to the
following address:
Attention: North Carolina Division of Water Resources
Water Sciences Section/Aquatic Toxicology Branch
1621 Mail Service Center
Raleigh, NC 27699-1621
Completed Aquatic Toxicity Test Forms shall be filed with the Water Sciences Section no later than 30 days after
the end of the reporting period for which the report is made.
Page 4 of 7

Permit NCO051969
Test data shall be complete, accurate, include all supporting chemical/physical measurements. and all
concentration/response data, and be certified by laboratory supervisor and ORC or approved designate signature.
Total residual chlorine of the effluent toxicity sample must be measured and reported if chlorine is employed for
disinfection of the waste stream.
Should there be no discharge of flow from the facility during a month in which toxicity monitoring is required,
the permittee will complete the information located at the top of the aquatic toxicity (AT) test form indicating the
facility name, permit number, pipe number, county, and the month/year of the report with the notation of "No
Flow" in the comment area of the form. The report shall be submitted to the Water Sciences Section at the
address cited above.
Should the permittee fail to monitor during a month in which toxicity monitoring is required, monitoring will be
required during the following month. Assessment of toxicity compliance is based on the toxicity testing quarter,
which is the three-month time interval that begins on the first day of the month in which toxicity testing is
required by this permit and continues until the final day of the third month.
Should any test data from this monitoring requirement or tests performed by the North Carolina Division of Water
Resources indicate potential impacts to the receiving stream, this permit may be re -opened and modified to
include alternate monitoring requirements or limits.
NOTE: Failure to achieve test conditions as specified in the cited document, such as minimum control organism
survival, minimum control organism reproduction, and appropriate environmental controls, shall constitute an
invalid test and will require immediate follow-up testing to be completed no later than the last day of the month
following the month of the initial monitoring.
A. (3.) ELECTRONIC REPORTING OF DISCHARGE MONITORING REPORTS
[NCGS 143-215.1 (b)]
Federal regulations require electronic submittal of all discharge monitoring reports (DMRs) and program reports
and specify that, if a state does not establish a system to receive such submittals, then permittees must submit
monitoring data and reports electronically to the Environmental Protection Agency (EPA). The final NPDES
Electronic Reporting Rule was adopted and became effective on December 21, 2015.
NOTE: This special condition supplements or supersedes the following sections within Part H of this permit
(Standard Conditions for NPDES Permits):
• Section B. (11.)
• Section D. (2.)
• Section D. (6.)
• Section E. (5.)
Signatory Requirements
Reporting
Records Retention
Monitoring Reports
1. Reporting Requirements [Supersedes Section D. (2.) and Section E. (5.) (a)]
Effective December 21, 2016, the permittee shall report discharge monitoring data electronically using the
NC DWR's Electronic Discharge Monitoring Report (eDMR) internet application.
Monitoring results obtained during the previous month(s) shall be summarized for each month and submitted
electronically using eDMR. The eDMR system allows permitted facilities to enter monitoring data and
submit DMRs electronically using the internet. Until such time that the state's eDMR application is
Page 5 of 7

Permit NCO051969
compliant with EPA's Cross -Media Electronic Reporting Regulation (CROMERR), permittees will be
required to submit all discharge monitoring data to the state electronically using eDMR and will be required
to complete the eDMR submission by printing, signing, and submitting one signed original and a copy of the
computer printed eDMR to the following address:
NC DENR / Division of Water Resources / Water Quality Permitting Section
ATTENTION: Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
If a permittee is unable to use the eDMR system due to a demonstrated hardship or due to the facility being
physically located in an area where less than 10 percent of the households have broadband access, then a
temporary waiver from the NPDES electronic reporting requirements may be granted and discharge monitoring
data may be submitted on paper DMR forms (MR 1, 1.1, 2, 3) or alternative forms approved by the Director.
Duplicate signed copies shall be submitted to the mailing address above. See "How to Request a Waiver from
Electronic Reporting" section below.
Regardless of the submission method, the first DMR is due on the last day of the month following the
issuance of the permit or in the case of a new facility, on the last day of the month following the
commencement of discharge.
Starting on December 21, 2020, the permittee must electronically report the following compliance monitoring
data and reports, when applicable:
Sewer Overflow/Bypass Event Reports;
Pretreatment Program Annual Reports; and
Clean Water Act (CWA) Section 316(b) Annual Reports.
The permittee may seek an electronic reporting waiver from the Division (see "How to Request a Waiver
from Electronic Reporting" section below).
2. Electronic Submissions
In accordance with 40 CFR 122.41(1)(9), the permittee must identify the initial recipient at the time of each
electronic submission. The permittee should use the EPA's website resources to identify the initial recipient
for the electronic submission.
Initial recipient of electronic NPDES information from NPDES-regulated facilities means the entity (EPA or
the state authorized by EPA to implement the NPDES program) that is the designated entity for receiving
electronic NPDES data [see 40 CFR 127.2(b)].
EPA plans to establish a website that will also link to the appropriate electronic reporting tool for each type of
electronic submission and for each state. Instructions on how to access and use the appropriate electronic
reporting tool will be available as well. Information on EPA's NPDES Electronic Reporting Rule is found at:
http://www2.epa.gov/compliance/final-national-pollutant-discharge-elimination-system-npdes-electronic-
reporting-rule.
Electronic submissions must start by the dates listed in the "Reporting Requirements" section above.
Page 6 of 7

Permit NCO051969
3. How to Request a Waiver from Electronic Reporting
The permittee may seek a temporary electronic reporting waiver from the Division. To obtain an electronic
reporting waiver, a permittee must first submit an electronic reporting waiver request to the Division.
Requests for temporary electronic reporting waivers must be submitted in writing to the Division for written
approval at least sixty (60) days prior to the date the facility would be required under this permit to begin
submitting monitoring data and reports. The duration of a temporary waiver shall not exceed 5 years and
shall thereupon expire. At such time, monitoring data and reports shall be submitted electronically to the
Division unless the permittee re -applies for and is granted a new temporary electronic reporting waiver by the
Division. Approved electronic reporting waivers are not transferrable. Only permittees with an approved
reporting waiver request may submit monitoring data and reports on paper to the Division for the period that
the approved reporting waiver request is effective.
Information on eDMR and the application for a temporary electronic reporting waiver are found on the
following web page:
http://deq.nc.gov/about/divisions/water-resources/edmr
4. Signatory Requirements [Supplements Section B. (11.) (b) and Supersedes Section B. (11.) (d)].
All eDMRs submitted to the permit issuing authority shall be signed by a person described in Part H, Section
B. (11.) (a) or by a duly authorized representative of that person as described in Part H, Section B. (11.) (b).
A person, and not a position, must be delegated signatory authority for eDMR reporting purposes.
For eDMR submissions, the person signing and submitting the DMR must obtain an eDMR user account and
login credentials to access the eDMR system. For more information on North Carolina's eDMR system,
registering for eDMR and obtaining an eDMR user account, please visit the following web page:
http://deq.nc.gov/about/divisions/water-resources/edmr
Certification. Any person submitting an electronic DMR using the state's eDMR system shall make the
following certification [40 CFR 122.22].
NO OTHER STATEMENTS OF CERTIFICATION WILL BE ACCEPTED:
"I certify, underpenalty of law, that this document and all attachments wereprepared 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 theperson or persons who manage 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
submittingfalse information, including the possibility offines and imprisonmentfor knowing violations."
5. Records Retention [Supplements Section D. (6.)]
The permittee shall retain records of all Discharge Monitoring Reports, including eDMR submissions. These
records or copies shall be maintained for a period of at least 3 years from the date of the report. This period
may be extended by request of the Director at any time [40 CFR 122.41 ].
Page 7 of 7

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