BETHANIA_COMPLETE FILE - HISTORICAL_20040225

�STORMWATER DIVISION CODING SHEET
Municipalities NOT MS4
PERMIT NO.
NCS0000
DOC TYPE
❑ COMPLETE FILE - HISTORICAL
MOST RECENT
DATE
❑
YYYY M M DD

.u.
State of North Carolina
Department of Environment & Natural Resources
Division of Water Quality
OFFIC USE ONLY
Date Reed
oz 25 zoo
BIMS
Cert. Number
P2CERr-X1 j
STORMVItATER NON -OWNERSHIP / NON-OPEBATO N CERTIFICATION FORM
This form is for use by Regulated Public Entities (RPE), pursuant to Title 15A North Carolina Administrative Code
2H .0126, to certify that they do not own or operate a small MS4.
I. APPLICANT STATUS INFORMATION
Name of Regulated Public Entity
-�-
IDVJN OF'
Status (federal, state, public, or
Pu ?3i-1 L
other)
Type of Public Entity (city, town,
coun rison school etc.)TO
!�
County(s)
RPE Jurisdictional Area in square
miles
II. OPTIONAL PERMITTING OPPORTUNITIES
Are you exercising your option to apply for a NPDES Stormwater Discharge
Permit? If yes, submit this form along with a complete application package
Yes ® No
(Form SWU-264 and a Comprehensive Stormwater Management Program
Report).
Are exercising your option to apply for Permit by Rule status? If yes, submit this
Yes ® No
form along with a completed form SWU-267
III. SIGNING OFFICIAL'S STATEMENT
I certify, under penalty of law, that the Regulated Public Body listed in 5e-cton I of this document does not
currently own or operate a small muniapal separate storm sewer system, as defined in 40 CFR 122. I further
certify 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 submitted is, to the best of my knowledge and
belief, true, acrurate, and complete lam aware that there are significant penalties for submitting false
information, indi ding passibility of fines and imprisonment for knowing violations.
Signature 6'
m k" L,,
Print Name
P68O&O 14 5-rbL-T4 oCn 12S
Title
MA0 2 1 TXOrlOF 1-251ETHAMiA
Street Address
S 15 FET-wAtj i A, P—o A I>
PO Box
—301><
City --17�Elllftl.Ji
A
State
NC
Zip
2 Df�
Telephone
(e - q Z Z . 4-7 ► �-+
Fax
3 3 L - 3 Z 2 41+

NPDES RPE Stormwater Permit Application
Page 2

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Copyright (0) 1998, Mantech, lnc.

Yadkin River Basin
W.-I.Tgawlim
Waters for which TMDLs are required.
Assessment
Year
Waterbody and Description Unit (AU)
Class
Subbasin
lmpairedUse
Listed Category and Reason for Listing
Potential Source(s)
Miles Acres
YADKIN RIVER (including lower 12-(124.5)a
WS-IV&B CA
30704
2004
5
10.8
portion of High Rock Lake)
From a point 0.6 mile upstream of dam of High Rock Lake to High Rock Dam
Aquatic Life
1, 2004
5
Standard violation: Turbidity
1. Source Unknown
YADKIN RIVER (including upper 12-(124.5)b
WS-IV&B CA
30704
2004
415
3.5
portion of Tucktertown Lake)
From High Rock Dam to mouth of Cabin Creek
Aquatic Life
1.2004
4b
Standard violation: Low
1. Hydromodification: Dam
Dissolved Oxygen
Release
Little Creek 12-110-3
30704
1998
6
6.5
From source to Grants Creek
Overall
1. 1998
6
Impaired biological integrity:
stressors not identified
Grants Creek 12-110b
C
30704
1998
5
1.2
From SR 1910 to Yadkin River
Aquatic Life
1. 1998
6
Impaired biological integrity:
1. Urban Runoff/Storm Sewers
stressors not identified
2. Source Unknown
2. 1998
5
Standard violation: Turbidity
3. Agriculture
3. 1998
4a
Standard violation: Fecal
Coliform
Town Creek 12-1 15-3
C
30704
1998
6
15.4
From source to Crane Creek
Aquatic Life
1. 1998
6
Impaired biological integrity:
1. Urban Runoff/Storm Sewers
stressors not identified
Muddy Creek 12-94-(0.5)b
C
30704
2004
6
15.2
From Mill Creek 03 to SR 2995
Aquatic Life
1. 2004
6
Impaired biological integrity:
1. Urban Runoff/Storm Sewers
stressors not identified
2. Minor Non -Municipal
Salem Creek (Middle Fork Muddy 12-94.12-(4)
C
30704
1998
5
12.0
Creek)
From Winston-Salem Water Supply Dam (Salem Lake) to Muddy Creek
Aquatic Life
1. 1998
6
Impaired biological integrity:
1. Urban Runoff/Storm Sewers
stressors not identified
2. 1998
5
Standard violation: Fecal
Coliform
Monday, April26, 2004
North Carolina 303(d) Impaired Waters List-2004
River Basin: Yadkin
Page 104 of 112
.. • r M

Michael F. Easley, Governor
William G. Ross Jr„ Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E., Director
Division of Water Quality
11/G/2002
THE TOWN OF BF THANIA
DEBORAH STOLTZ'I HOMPSON, MAYOR
P.O. BOX 259
BETHANIA, NC 27010-0259
Subject: NPDES Phase Il Stormwaler Program
2000 U.S. Census - Notification of Coverage
Deborah Stoltz Thompson:.
In 1990 the U.S. Environmental Protection Agency's (EPA) Phase I Stormwaler program was promulgated under the
Clean Water Act. Phase I relies on National Pollutant discharge Elimination System (NPDES) permit coverage to
address stormwater runoff from: (1) "medium" and "large" municipal separate storm sewer systems (MS4s) generally
serving populations of 100,000 or greater, (2) construction activity disturbing 5 acres of land or greater, and (3) ten
categories of industrial activity. The NPDES Stormwater Phase 11 Final Rule was promulgated in December 1999 and is
the next step in EPA's effort to preserve, protect, and improve the Nation's water resources from polluted stormwater
runoff. The Phase 11 program expands the Phase I program by requiring additional operators of MS4s in urbanized areas
and operators of small construction sites, through the use of NPDES permits, to implement programs and practices to
control stormwater runoff. Phase 11 is intended to further reduce adverse impacts to water quality and aquatic habitat by
instituting the use of controls on the unregulated sources of storm water discharges that have the greatest likelihood of
causing continued environmental degradation.
The NPDES Stormwater Phase 11 Final Rule requires nationwide coverage of all operators of small MS4s that are
located within the boundaries of a Bureau of the Census defined "urbanized area" based on the latest decennial Census.
The Bureau of Census has recently released data detailing the 2000 Census urbanized areas and using GIS data tiles
produced by the Bureau of Census, North Carolina Department of Environment and Natural Resources staff has
compiled a list of municipalities and counties that we believe fall in whole or in part within one or more of the seventeen
census -designated urbanized areas in North Carolina.
We are writing to you to notify you that the Town of Bethania has been identified as being located within a census
designated urbanized area. As a regulated community, you are required to develop a stormwater management program
and apply for stormwater permit coverage, if you own and operate a small MS4 or file a certification that the Town of
Bethania does not own or operate a small MS4. The deadline for submitting your application package or non -ownership
certification is 18 months from the date of this letter. Application and certification documents, as well as additional
information on the NPDES stormwater program, are available for download at our web site . Our web address is
httpa/h2o.enr.state.nc.us/su/stormwater.htmI- If you have any questions about this letter, please feel free to contact me
(919-733-5083, ext.525) or Darren England (919-733-5083, ext. 545)
Sincerely,
Bradley Bennett, Supervisor
Stormwater and General Permits Unit
cc: Central Files
Stormwater and General Permits Unit Files
Winston-Salem Regional Office
N. C. Division of Water Quality 1617 Mail Service Center Raleigh, NC 27699.1617 [phone]
eA
NCDENR
Customer Service
1-800-623-7748