NC0063720_Renewal (Application)_20230615

Y 4\
ROY COOPER 's r , 2
Governor \�, 0,
ELIZABETH S.BISER • ''�� �'
Secretary
RICHARD E.ROGERS,JR. NORTH CAROLINA
Director Environmental Quality
June 15, 2023
Aqua North Carolina, Inc
Attn: Amanda Berger
202 Mackenan Dr
Cary, NC 27511-6447
Subject: Permit Renewal
Application No. NC0063720
Forest Ridge WWTP
Forsyth County
Dear Applicant:
The Water Quality Permitting Section acknowledges the June 15, 2023, 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.
Sincerely,
x2c°A
Wren Thedford
Administrative Assistant
Water Quality Permitting Section
ec: WQPS Laserfiche File w/application
D_E Q North Carolina Department of Environmental Quality I Dlvislon of Water Resources
Wmston-Salero Regional Office 1450 West Hanes Mfll Road,Suite 300 I Winston-Seleny North Carolina 27105
mrs: 336.776.9800

AQUA.
An 4Essential Utilities Company
June 16 2023
NC Department of Environment and Natural Resources
Division of Water Quality
NPDES Unit
1617 Mail Service Center
Raleigh, NC 27699-1617
Subject: Application for Permit Renewal
Aqua North Carolina, Inc.
Forest Ridge Subdivision
WWTP NPDES No. NC0063720
Forsyth County
To Whom It May Concern:
Attached are three (3) copies of the completed application Modification
Application Form 2A and a topographic map. This letter and attachments are
Aqua North Carolina's request to renew the subject permit.
If you need any additional information or assistance, please feel free to contact
me at [e-mail].
Sincerely,
,S ►,v4k' a 94-r3
Amanda Berger
Director, Environmental Compliance

North Carolina
Department of Environmental Quality Modified Application Form 2A
Division of Water Resources Revised March 2021
Modified Application
Form 2A
Minor Sewage Facilities < 0. 1 MGD
and No Pretreatment Program
NPDES Permitting Program
Note: Complete this form if your facility is a MINOR new or existing publicly owned treatment works.

NPDES Permit Number Facility Name Modified Application Form 2A
NC0063720 Forest Ridge Modified March 2021
Form NC Department of Environmental Quality-Application for NPDES Permit to Discharge Wastewater
NPDES MINOR SEWAGE FACILITIES(Before completing this form,please read the instructions.Failure to follow
the instructions may result in denial of the application.
SECTION 1. BASIC APPLICATION INFORMATION FOR ALL APPLICANTS(40 CFR 122.21(j)(1)and(9))
1.1 Facility name
Forest Ridge Subdivision WWTP
Mailing address(street or P.O.box)
202 Mackenan Court
City or town State ZIP code
0 Cary NC 27511
Contact name(first and last) Title Phone number Email address
Amanda Berger Director,Environmental ComK [phone] [e-mail]
Location address(street,route number,or other specific identifier) ❑ Same as mailing address
R 6931 August Drive
City or town State ZIP code
Clemmons NC 27012
1.2 Is this application for a facility that has yet to commence discharge?
❑ Yes 4 See instructions on data submission 0 No
requirements for new dischargers.
1.3 Is applicant different from entity listed under Item 1.1 above?
❑ Yes No 4 SKIP to Item 1.4.
Applicant name
= Applicant address(street or P.O.box)
0
0 City or town State ZIP code
L
Contact name(first and last) Title Phone number Email address
.0
1.4 Is the applicant the facility's owner,operator,or both?(Check only one response.)
❑ Owner ❑ Operator ElBoth
1.5 To which entity should the NPDES permitting authority send correspondence?(Check only one response.)
❑ Facility El Applicant ❑ Facility and applicant
(they are one and the same)
1.6 Indicate below any existing environmental permits.(Check all that apply and print or type the corresponding permit
number for each.)
Existing Environmental Permits
CD
a 0 NPDES(discharges to surface ❑ RCRA(hazardous waste) ❑ UIC(underground injection
water) control)
NC0083925
o ❑ PSD(air emissions) ❑ Nonattainment program(CM) ❑ NESHAPs(CM)
a)
y ❑ Ocean dumping(MPRSA) ❑ Dredge or fill(CWA Section ❑ Other(specify)
404)
Page 1

NPDES Permit Number Facility Name Modified Application Form 2A
NC0063720 Forest Ridge Modified March 2021
1.7 Provide the collection system information requested below for the treatment works.
Municipality Population Collection System Type Ownership Status
Served Served (indicate percentage)
i0o %separate sanitary sewer El Own 0 Maintain
58 %combined storm and sanitary sewer 0 Own ❑ Maintain
d 0 Unknown 0 Own 0 Maintain
co %separate sanitary sewer 0 Own 0 Maintain
c %combined storm and sanitary sewer 0 Own ❑ Maintain
co
❑ Unknown ❑ Own ❑ Maintain
a %separate sanitary sewer ❑ Own 0 Maintain
c %combined storm and sanitary sewer ❑ Own ❑ Maintain
R ❑ Unknown 0 Own ❑ Maintain
E
%separate sanitary sewer 0 Own 0 Maintain
>n %combined storm and sanitary sewer 0 Own ❑ Maintain
c 0 Unknown ❑ Own ❑ Maintain
Total 58
d Population
ci Served
Separate Sanitary Sewer System Combined Storm and
Sanitary Sewer
Total percentage of each type of o a/o
sewer line(in miles) 100 /o
z' 1.8 Is the treatment works located in Indian Country?
c
o' ❑ Yes 0 No
V
c 1.9 Does the facility discharge to a receiving water that flows through Indian Country?
c 0 Yes 0 No
1.10 Provide design and actual flow rates in the designated spaces. Design Flow Rate
0.0165 mgd
Ti a Annual Average Flow Rates(Actual)
aII Two Years Ago Last Year This Year
co 0.0045 mgd 0.004 mgd 0.0038 mgd
u" Maximum Daily Flow Rates(Actual)
o Two Years Ago Last Year This Year
0.009 mgd 0.008 mgd 0.008 mgd
y 1.11 Provide the total number of effluent discharge points to waters of the State of North Carolina by type.
c Total Number of Effluent Discharge Points by Type
a a Constructed
a, . Combined Sewer
E T Treated Effluent Untreated Effluent Overflows Bypasses Emergency
-0 Overflows
N
a 1
Page 2

NPDES Permit Number Facility Name Modified Application Form 2A
NC0063720 Forest Ridge Modified March 2021
Outfalls Other Than to Waters of the State of North Carolina
1.12 Does the POTW discharge wastewater to basins,ponds,or other surface impoundments that do not have outlets
for discharge to waters of the State of North Carolina?
❑ Yes ❑✓ No 4 SKIP to Item 1.14.
1.13 Provide the location of each surface impoundment and associated discharge information in the table below.
Surface Impoundment Location and Discharge Data
Average Daily Volume Continuous or Intermittent
Location Discharged to Surface (check one)
Impoundment
❑ Continuous
gpd ❑ Intermittent
❑ Continuous
gpd 0 Intermittent
❑ Continuous
gpd 0 Intermittent
r 1.14 Is wastewater applied to land?
❑ Yes ❑✓ No 4 SKIP to Item 1.16.
c 1.15 Provide the land application site and discharge data requested below.
y Land Application Site and Discharge Data
o Continuous or
Location Size Average Daily Volume Intermittent
Applied (check one)
acresgpd 0 Continuous
o 0 Intermittent
acresgpd 0 Continuous
o 0 Intermittent
-a 0 Continuous
acres gpd 0 Intermittent
R 1.16 Is effluent transported to another facility for treatment prior to discharge?
o ❑ Yes © No 4 SKIP to Item 1.21.
1.17 Describe the means by which the effluent is transported(e.g.,tank truck,pipe).
1.18 Is the effluent transported by a party other than the applicant?
❑ Yes ❑ No 4 SKIP to Item 1.20.
1.19 Provide information on the transporter below.
Transporter Data
Entity name Mailing address(street or P.O. box)
City or town State ZIP code
Contact name(first and last) Title
Phone number Email address
Page 3

NPDES Permit Number Facility Name Modified Application Form 2A
NC0063720 Forest Ridge Modified March 2021
1.20 In the table below,indicate the name,address,contact information,NPDES number,and average daily flow rate of the
receiving facility.
Receiving Facility Data
-a Facility name Mailing address(street or P.O.box)
City or town State ZIP code
0
y Contact name(first and last) Title
-0
0
Phone number Email address
QNPDES number of receiving facility(if any) ❑ None Average daily flow rate mgd
fA
O 1.21 Is the wastewater disposed of in a manner other than those already mentioned in Items 1.14 through 1.21 that do
not have outlets to waters of the State of North Carolina(e.g.,underground percolation,underground injection)?
❑ Yes El No 4 SKIP to Item 1.23.
c 1.22 Provide information in the table below on these other disposal methods.
Information on Other Disposal Methods
o Disposal Location of Size of Annual Average Continuous or Intermittent
Method Disposal Site Disposal Site Daily Discharge (check one)
Description Volume
V/
acres gpd 0 Continuous
0 Intermittent
o 0 Continuous
acres gpd 0 Intermittent
acresgpd ❑ Continuous
❑ Intermittent
1.23 Do you intend to request or renew one or more of the variances authorized at 40 CFR 122.21(n)?(Check all that apply.
U) Consult with your NPDES permitting authority to determine what information needs to be submitted and when.)
R 3
❑ Discharges into marine waters(CWA ❑ Water quality related effluent limitation(CWA Section
Section 301(h)) 302(b)(2))
❑✓ Not applicable
1.24 Are any operational or maintenance aspects(related to wastewater treatment and effluent quality)of the treatment works
the responsibility of a contractor?
❑ Yes ❑ No+SKIP to Section 2.
1.25 Provide location and contact information for each contractor in addition to a description of the contractor's operational
and maintenance responsibilities.
Contractor Information
Contractor 1 Contractor 2 Contractor 3
0
Contractor name
(company name)
Mailing address
(street or P.O.box)
City,state,and ZIP
R code
0 Contact name(first and
U last)
Phone number
Email address
Operational and
maintenance
responsibilities of
contractor
Page 4

NPDES Permit Number Facility Name Modified Application Form 2A
NC0063720 Forest Ridge Modified March 2021
SECTION 2.ADDITIONAL INFORMATION(40 CFR 122.21(j)(1)and(2))
o Outfalls to Waters of the State of North Carolina
1.7
2.1 Does the treatment works have a design flow greater than or equal to 0.1 mgd?
❑ Yes ❑✓ No 4 SKIP to Section 3.
= 2.2 Provide the treatment works'current average daily volume of inflow Average Daily Volume of Inflow and Infiltration
and infiltration. N/A gpd
Indicate the steps the facility is taking to minimize inflow and infiltration.
co
0
c
2.3 Have you attached a topographic map to this application that contains all the required information?(See instructions for
co 0. specific requirements.)
lam
0 z
❑✓ Yes ❑ No
E 2.4 Have you attached a process flow diagram or schematic to this application that contains all the required information?
c (See instructions for specific requirements.)
a,
" as ❑ Yes ElNo
2.5 Are improvements to the facility scheduled?
❑ Yes ❑ No 4 SKIP to Section 3.
Briefly list and describe the scheduled improvements.
0
C
1.
0
E
d
2.
E
0
3.
0)
d
4.
cn
g 2.6 Provide scheduled or actual dates of completion for improvements.
Scheduled or Actual Dates of Completion for Improvements
°' Affected Attainment of
d Scheduled Begin End Begin
> Outfalls Operational
2 Improvement Construction Construction Discharge
(from above) (list outfall Level
(MM/DD/YYYY) (MM/DD/YYYY) (MM/DD/YYYY)
number) (MM/DD/YYYY)
1.
2.
3.
4.
2.7 Have appropriate permits/clearances concerning other federal/state requirements been obtained?Briefly explain your
response.
❑ Yes ❑ No El None required or applicable
Explanation:
Page 5

NPDES Permit Number Facility Name Modified Application Form 2A
NC0063720 Forest Ridge Modified March 2021
SECTION 3.INFORMATION ON EFFLUENT DISCHARGES(40 CFR 122.21(j)(3)to(5))
3.1 Provide the following information for each outfall.(Attach additional sheets if you have more than three outfalls.)
Outfall Number o01 Outfall Number Outfall Number
State NC
o County Forsyth
U
o City or town Clemmons
0
c
g Distance from shore ft. ft. ft.
Q
d Depth below surface ft. ft. ft.
0
Average daily flow rate 0.04 mgd mgd mgd
Latitude 36° 06' 81" ° ° '
Longitude -80° 39' 41" ' "
co
3.2 Do any of the outfalls described under Item 3.1 have seasonal or periodic discharges?
o ❑ Yes ElNo 4 SKIP to Item 3.4.
CO
R 3.3 If so,provide the following information for each applicable outfall.
1 y Outfall Number Outfall Number Outfall Number
0
10 Number of times per year
O discharge occurs
'i
a Average duration of each
`o discharge(specify units)
oAverage flow of each mgd mgd mgd
R discharge
o Months in which discharge
occurs
3.4 Are any of the outfalls listed under Item 3.1 equipped with a diffuser?
❑ Yes El No 4 SKIP to Item 3.6.
03.5 Briefly describe the diffuser type at each applicable outfall.
0_
1- Outfall Number Outfall Number Outfall Number
d
0
0
vi 3.6 Does the treatment works discharge or plan to discharge wastewater to waters of the State of North Carolina from
d = one or more discharge points?
3 w 0 Yes 0 No+SKIP to Section 6.
Page 6

NPDES Permit Number Facility Name Modified Application Form 2A
NC0063720 Forest Ridge Modified March 2021
3.7 Provide the receiving water and related information(if known)for each outfall.
Outfall Number 001 Outfall Number Outfall Number
Receiving water name Yadkin PD River Basin
Name of watershed,river,
c or stream system Blanket Creek
0- U.S.Soil Conservation
Service 14-digit watershed
code
Name of state
management/river basin
U.S.Geological Survey
8-digit hydrologic
cc cataloging unit code
Critical low flow(acute) cfs cfs cfs
Critical low flow(chronic) cfs cfs cfs
Total hardness at critical mg/L of mg/L of mg/L of
low flow CaCO3 CaCO3 CaCO3
3.8 Provide the following information describing the treatment provided for discharges from each outfall.
Outfall Number 001 Outfall Number Outfall Number
Highest Level of 0 Primary 0 Primary 0 Primary
Treatment(check all that 0 Equivalent to 0 Equivalent to 0 Equivalent to
apply per outfall) secondary secondary secondary
0 Secondary 0 Secondary 0 Secondary
❑ Advanced 0 Advanced 0 Advanced
0 Other(specify) 0 Other(specify) 0 Other(specify)
C
0
Design Removal Rates by
Outfall 001
M
BOD5 or CBOD5 85 %
m TSS 85
0 Not applicable 0 Not applicable 0 Not applicable
Phosphorus %
0 Not applicable 0 Not applicable 0 Not applicable
Nitrogen %
Other(specify) 0 Not applicable 0 Not applicable 0 Not applicable
Page 7

NPDES Permit Number Facility Name Modified Application Form 2A
NC0063720 Forest Ridge Modified March 2021
3.9 Describe the type of disinfection used for the effluent from each outfall in the table below. If disinfection varies by
season,describe below.
Tablet chlorination and dechlorination
-a
47.
c
0
Outfall Number 001 Outfall Number Outfall Number
0
Disinfection type Tablet chlorination
Seasons used All
E
Dechlorination used? ❑ Not applicable ❑ Not applicable ❑ Not applicable
El Yes ❑ Yes ❑ Yes
❑ No ❑ No ❑ No
3.10 Have you completed monitoring for all Table A parameters and attached the results to the application package?
El Yes ❑ No
3.11 Have you conducted any WET tests during the 4.5 years prior to the date of the application on any of the facility's
discharges or on any receiving water near the discharge points?
❑ Yes ❑✓ No 4 SKIP to Item 3.13.
3.12 Indicate the number of acute and chronic WET tests conducted since the last permit reissuance of the facility's
discharges by outfall number or of the receiving water near the discharge points.
Outfall Number 001 Outfall Number Outfall Number
Acute Chronic Acute Chronic Acute Chronic
Number of tests of discharge
= water
w
Number of tests of receiving
= water
3.14 Does the POTW use chlorine for disinfection,use chlorine elsewhere in the treatment process,or otherwise have
reasonable potential to discharge chlorine in its effluent?
✓❑ Yes 4 Complete Table B,including chlorine. ❑ No 4 Complete Table B,omitting chlorine.
3.15 Have you completed monitoring for all applicable Table B pollutants and attached the results to this application
package?
❑� Yes ❑ No
Have you completed monitoring for all applicable Table D pollutants required by your NPDES permitting authority and
3.18 attached the results to this application package?
El Yes ElNo additional sampling required by NPDES
permitting authority.
Page 8

NPDES Permit Number Facility Name Modified Application Form 2A
NC0063720 Forest Ridge Modified March 2021
3.19 Has the POTW conducted either(1)minimum of four quarterly WET tests for one year preceding this permit application
or(2)at least four annual WET tests in the past 4.5 years?
❑ Yes 0 No+ Complete tests and Table E and SKIP to
Item 3.26.
3.20 Have you previously submitted the results of the above tests to your NPDES permitting authority?
El Yes ❑ No 4 Provide results in Table E and SKIP to
Item 3.26.
3.21 Indicate the dates the data were submitted to your NPDES permitting authority and provide a summary of the results.
Date(s)Submitted Summary of Results
(MWDDNYYY)
C,
m
c
c
w3.22 Regardless of how you provided your WET testing data to the NPDES permitting authority,did any of the tests result in
toxicity?
❑ Yes ❑ No 4 SKIP to Item 3.26.
3.23 Describe the cause(s)of the toxicity:
c
d
W
3.24 Has the treatment works conducted a toxicity reduction evaluation?
❑ Yes ❑✓ No 4 SKIP to Item 3.26.
3.25 Provide details of any toxicity reduction evaluations conducted.
3.26 Have you completed Table E for all applicable outfalls and attached the results to the application package?
❑ Yes g Not applicable because previously submitted
information to the NPDES sermittin. authorit .
Page 9

NPDES Permit Number Facility Name Modred Application Form 2A
NC0063720 Forest Ridge Modified March 2021
SECTION 6.CI-ECKLIST AND CERTIFICATION STATEMENT(40 CFR 122.22(a)and (d))
6.1 In Column 1 below,mark the sections of Form 2A that you have completed and are submitting with your application.For
each section,specify in Column 2 any attachments that you are enclosing to alert the permitting authority.Note that not
all applicants are required to provide attachments.
Column 1 Column 2
• Section 1: Basic Application
Information for All Applicants ❑ w/variance request(s) ❑ w/additional attachments
• Section 2:Additional ❑ wl topographic map ❑ w/process flow diagram
Information ❑ w/additional attachments
wl Table A ❑ wl Table D
O Section 3:Information on ✓❑ w/Table B ❑ w/additional attachments
Effluent Discharges
❑ w/Table C
Section 4:Not Applicable
0
Section 5:Not Applicable
d
❑ Section 6:Checklist and 0 w/attachments
Certification Statement
0 I
6.2 Certification Statement
1 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 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 fine
and imprisonment for knowing violations.
Name(print or type first and last name) Official title
Amanda Berger Environmental Compliance Director
Signature Date signed
,54ti1-1-4"zeo - ' f '�"� 06/15/2024
Page 10

NPDES Permit Number Facility Name Duffel!Number Modified Application Form 2A
NC0063720 Forest Ridge 001 Modified March 2021
TABLE A. EFFLUENT PARAMETERS FOR ALL POTWS
Maximum Daily Discharge Average Daily Discharge Analytical ML or MDL
Pollutant Number of Methods Include units)
Value Units Value Units Samples (
Biochemical oxygen demand 0 ML
0 BODE or 0 CBOD5 32.8 mg/L 3.72 mg/L 284 SM5201B 2 p MDL
(report one)
o ML
Fecal coliform 330 #/100m1 12.71 #/100m1 271 SM9222D;Coliert 18 1 p MDL
Design flow rate 0.0165 MGD 0.0049 MGD 1912
pH(minimum) 7.5
pH(maximum) 8.6
Temperature(winter) 25 Celsius 12.65 Celsius 413
Temperature(summer) 30 Celsius 22 Celsius 462
0 ML
Total suspended solids(TSS) 23'3 mg/L 2.94 mg/L 283 SM2540D 2 p MDL
1 Sampling shall be conducted according to sufficiently sensitive test procedures(i.e.,methods)approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter I,subchapter N or 0.See instructions and 40 CFR 122.21(e)(3).
Page 11

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Modified Application Form 2A
NC0063720 Forest Ridge 001 Modified March 2021
TABLE B. EFFLUENT PARAMETERS FOR ALL POTWS WITH A FLOW EQUAL TO OR GREATER THAN 0.1 MGD
Maximum Daily Discharge Average Daily Discharge Analytical ML or MDL
Pollutant Number of Method' Include units
Value Units Value Units Samples Method' (
)
0 ML
Ammonia(as N) 3.78 mg/L 0.25 mg/L 278 ASTMD142608A 0.2 O MDL
Chlorine ❑ML
48 ug/L 15.31 ug/L 563
(total residual,TRC)2 ❑MDL
0 ML
Dissolved oxygen 21.0 mg/L 10.07 mg/L 861 0 MDL
Nitrate/nitrite 50.2 mg/L 23.08 mg/L 22 SM4500NO3E ❑ML
E MDL
0 ML
Kjeldahl nitrogen 38.0 mg/L 3.79 mg/L 22 SM4500;EPA 351.2 0.14;0.26 2 MDL
0 ML
Oil and grease N/A ❑MDL
0 ML
Phosphorus 6.16 mg/L 5.14 mg/L 24 SM4500;EPA 351.2 0.16 O MDL
Total dissolved solids N/A ❑ML
❑MDL
' Sampling shall be conducted according to sufficiently sensitive test procedures(i.e.,methods)approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter I,subchapter N or 0.See instructions and 40 CFR 122.21(e)(3).
2 Facilities that do not use chlorine for disinfection,do not use chlorine elsewhere in the treatment process,and have no reasonable potential to discharge chlorine in their effluent are not
required to report data for chlorine.
EPA Form 3510-2A(Revised 3-19) Page 12

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Modified Application Form 2A
NC0063720 Forest Ridge 001 Modified March 2021
TABLE C.EFFLUENT PARAMETERS FOR SELECTED POTWS
Maximum Daily Discharge Average Daily Discharge
Pollutant Analytical ML or MDL
Value Units Value Units Number of Methods (include units)
Samples
Metals,Cyanide,and Total Phenols
ML
Hardness(as CaCO3) mg/L mg/L SM2340C 1 0 MDL
0 ML
Antimony,total recoverable ❑MDL
Arsenic,total recoverable ❑ML
❑MDL
0 ML
Beryllium,total recoverable ❑MDL
❑ML
Cadmium,total recoverable
❑MDL
Chromium,total recoverable ❑ML
❑MDL
0 ML
Copper,total recoverable mg/L mg/L EPA 200.7 0.002 E7 MDL
0 ML
Lead,total recoverable ug/L ug/L EPA 200.7 0.002 o MDL
0 ML
Mercury,total recoverable ❑MDL
Nickel,total recoverable ❑ML
❑MDL
Selenium,total recoverable ❑ML
❑MDL
Silver,total recoverable ❑ML
❑MDL
Thallium,total recoverable ❑ML
❑MDL
0 ML
Zinc,total recoverable mg/L mg/L EPA 200.7 0.002 0 MDL
0 ML
Cyanide ❑MDL
0 ML
Total phenolic compounds 0 MDL
Volatile Organic Compounds
Acrolein o ML
❑MDL
0 ML
Acrylonitrile ❑MDL
Benzene ❑ML
❑MDL
Bromoform 0 ML
❑MDL
EPA Form 3510-2A(Revised 3-19) Page 13

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Modified Application Form 2A
NC0063720 Forest Ridge 001 Modified March 2021
TABLE C.EFFLUENT PARAMETERS FOR SELECTED POTWS
Maximum Daily Discharge Average Daily Discharge
Pollutant Analytical ML or MDL
Value Units Value Units Number of Methods (include units)
Samples
Carbon tetrachloride 0 ML
❑MDL
Chlorobenzene ❑ML
❑MDL
Chlorodibromomethane ❑ML
❑MDL
Chloroethane ❑ML
❑MDL
0 ML
2-chloroethylvinyl ether 0 MDL
Chloroform ❑ML
❑MDL
Dichlorobromomethane ❑ML
❑MDL
1,1-dichloroethane 0 ML
❑MDL
1,2-dichloroethane ❑ML
❑MDL
0 ML
trans-1,2-dichloroethylene ❑MDL
0 ML
1,1-dichloroethylene ❑MDL
0 ML
1,2-dichloropropane 0 MDL
0 ML
1,3-dichloropropylene 0 MDL
0 ML
Ethylbenzene 0 MDL
0 ML
Methyl bromide 0 MDL
0 ML
Methyl chloride 0 MDL
0 ML
Methylene chloride ❑MDL
1,1,2,2-tetrachloroethane ❑ML
❑MDL
0 ML
Tetrachloroethylene ❑MDL
Toluene ❑ML
❑MDL
1,1,1-trichloroethane ❑ML
❑MDL
1,1,2-trichloroethane 0 ML
❑MDL
EPA Form 3510-2A(Revised 3-19) Page 14

EPA Identification Number NPDES Permit Number Facility Name Outfall Number I Modified Application Form 2A
NC0063720 Forest Ridge 001 Modified March 2021
TABLE C.EFFLUENT PARAMETERS FOR SELECTED POTWS
Maximum Daily Discharge Average Daily Discharge Analytical ML or MDL
Pollutant
Value Units Value Units Number of Methods (include units)
Samples0 ML
Trichloroethylene ❑MDL
0 ML
Vinyl chloride ❑MDL
Acid-Extractable Compounds
p-chloro-m-cresol 0 MDL I
❑ML
• •• •
❑MDL i
❑ML
• • •• •
❑MDL
❑ML
• • • ❑MDL
4,6-dinitro-o-cresol ❑ML
❑MDL
0 ML
2,4-dinitrophenol 0 MDL
2-nitrophenol ❑ML
❑MDL
❑ML
4-nitrophenol 0 MDL
0 ML
Pentachlorophenol 0 MDL
Phenol 0 ML
❑MDL
0 ML
2,4,6-trichlorophenol 0 MDL
Base-Neutral Compounds
Acenaphthene ❑MDL
0 ML
Acenaphthylene 0 MDL
Anthracene 0 ML
❑MDL
Benzidine ❑ML
❑MDL
0 ML
Benzo(a)anthracene 0 MDL
0 ML
Benzo(a)pyrene _ 0 MDL
3,4-benzofluoranthene 0 ML
❑MDL
EPA Form 3510-2A(Revised 3-19) Page 15

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Modified Application Form 2A
NC0063720
Forest Ridge 001 Modified March 2021
TABLE C.EFFLUENT PARAMETERS FOR SELECTED POTWS
Maximum Daily Discharge Average Daily Discharge
Pollutant Analytical ML or MDL
Value Units Value Units Number of Methods (include units)
Samples
Benzo(ghi)perylene ❑ML
❑MDL
0 ML
Benzo(k)fluoranthene ❑MDL
0 ML
Bis(2-chloroethoxy)methane I ❑MDL
0 ML
Bis(2-chloroethyl)ether ❑MDL
0 ML
Bis(2-chioroisopropyl)ether ❑MDL
0 ML
Bis(2-ethylhexyl)phthalate 0 MDL
0 ML
4-bromophenyl phenyl ether 0 MDL
0 ML
Butyl benzyl phthalate ❑MDL
0 ML
2-chloronaphthalene ❑MDL
4-chlorophenyl phenyl ether ❑ML
❑MDL
0 ML
Chrysene ❑MDL
0 ML
di-n-butyl phthalate ❑MDL
0 ML
di-n-octyl phthalate ❑MDL
0 ML
Dibenzo(a,h)anthracene 0 MDL
1,2-dichlorobenzene ❑ML
❑MDL
1,3-dichlorobenzene ❑ML
❑MDL
1,4-dichlorobenzene ❑ML
❑MDL
3,3-dichlorobenzidine ❑ML
❑MDL
0 ML
Diethyl phthalate ❑MDL
0 ML
Dimethyl phthalate ❑MDL
2,4-dinitrotoluene ❑ML
❑MDL
2,6-dinitrotoluene 0 ML
❑MDL
EPA Form 3510-2A(Revised 3-19) Page 16

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Modified Application Form 2A
NC0063720
Forest Ridge 001 Modified March 2021
TABLE C. EFFLUENT PARAMETERS FOR SELECTED POTWS
Maximum Daily Discharge Average Daily Discharge Analytical ML or MDL
Pollutant Number of Method1 (include units)
Value Units Value Units Samples
0 ML
1,2-diphenylhydrazine ❑MDL
Fluoranthene 0 ML
❑MDL
Fluorene ❑ML
❑MDL
Hexachlorobenzene ❑ML
❑MDL
Hexachlorobutadiene 0 ML
❑MDL
0 ML
Hexachlorocyclo-pentadiene ❑MDL
Hexachloroethane ❑ML
❑MDL
0 ML
Indeno(1,2,3-cd)pyrene ❑MDL
0 ML
Isophorone ❑MDL
Naphthalene ❑MDL
Nitrobenzene ❑ML
❑MDL
0 ML
N-nitrosodi-n-propylamine ❑MDL
0 ML
N-nitrosodimethylamine ❑MDL
0 ML
N-nitrosodiphenylamine 0 MDL
Phenanthrene 0 ML
❑MDL
0 ML
Pyrene 0 MDL
1,2,4-trichlorobenzene 0 ML
❑MDL
1 Sampling shall be conducted according to sufficiently sensitive test procedures(i.e.,methods)approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR Chapter I,Subchapter N or 0.See instructions and 40 CFR 122.21(e)(3).
EPA Form 3510-2A(Revised 3-19) Page 17

NPDES Permit Number Facility Name Outfall Number Modified Application Form 2A
NC0063720 Forest Ridge Modified March 2021
TABLE D.ADDITIONAL POLLUTANTS AS REQUIRED BY NPDES PERMITTING AUTHORITY
Pollutant Maximum Daily Discharge Average Daily Dischar a Analytical ML or MDL
(list) Value Units Value Units Number of Method1 (include units)
Samples
0 No additional sampling is required by NPDES permitting authority.
0 ML
piC/L piC/L Calculated 0.01 MDL
0 ML
mg/L mg/L DM4500CL-C 1 2 MDL
0 ML
piC/L piC/L Calculated 0.01 2 MDL
❑ML
piC/L piC/L Calculated 0.01 2ML
MDL
piC/L piC/L EPA 904 0.01 o MDL
El ML
piC/L piC/L EPA 904 0.01 2 MDL
0 ML
piC/L piC/L EAP 905;ASTM D58] 0.01 ❑MDL
ML
EPA 906 1 2 MDL
ML
EPA 200.8 0.01 2 MDL
❑ML
❑MDL
❑ML
❑MDL
❑ML
❑MDL
❑ML
❑MDL
❑ML
❑MDL
❑ML
❑MDL
❑ML
❑MDL
❑ML
❑MDL
1 Sampling shall be conducted according to sufficiently sensitive test procedures(i.e.,methods)approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or required
under 40 CFR chapter I,subchapter N or 0.See instructions and 40 CFR 122.21(e)(3).
Page 18

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Aqua North Carolina, Inc. ii Facility
Forest Ridge Subdivision WWTP X
Location
Coun : Forsyth Stream Class: WS-IV (not to scale)
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Receiving Stream: Blanket Creek Sub-Basln: 03-07-02 -B-
Latitude: 36°03'39" Grid/Quad: Clemmons LNPDES Permit: NC0063720
Longitude: 80°23'47" HUC#: 03040101 North