NC0037001_Regional Office Historical File Pre 2016

Facility: M
Parameter
DMR Review Record
Permit Nofitoc>3�co ( Pipe No.:
Monthly Average Violations
Permit Limit DMR Value
Date Parameter Permit Limit
Al 01
Date Parameter
Violations/Staff Remarks:
supervisor Remarks: -8 PZ
MonthNear: I S
% Over Limit Action
Weekly/Daily Violations
Limit Type DMR Value % Over Limit Action
J-
Monitoring Frequency Violations
Permit Frequency Values Reported # of Violations Action
Completed by:�1✓dam
Assistant Regional
Supervisor Sign Off:
Regional Supervisor Sign
Off:
Date: 11
Date:
Date:

Rockingham
NCO037001
Limit Violation
Bethany Elementary School

RMA
NCDEE R
North Carolina Department of Environment and Natural Resources
Pat McCrory Donald R. van der Vaart
Governor Secretary
June 15, 2015
CERTIFIED MAIL
RETURN RECEIPT REQUESTED
7011 1570 0001 8546 2989
Rockingham County Board of Education
Rodney Shotwell
511 Harrington Hwy
Eden NC 27288
Subject: Notice of Violation and Recommendation for Enforcement
NOV-2015-LV-0386
Permit No. NCO037001
Bethany Elementary School
Rockingham County
Dear Mr. Shotwell:
A review of Bethany Elementary School's monitoring report for February 2015 showed the following
violations:
Parameter
Date
Limit Value
Reported Value
Limit Type
Coliform, Fecal MF, M-FC
Broth,44.5C
- ----- -
2/3/2015
400.000 2,420.000 #/100ml
#/100ml �
— - - - -- - -1_
Daily Maximum
Exceeded
A Notice of Violation/Notice of Recommendation for Enforcement (NOV/NRE) is being issued for
the noted violation(s) of North Carolina General Statute (G.S.) 143-215.1 and NPDES Permit No. .
Pursuant to G.S. 143-215.6A, a civil penalty of not more than twenty-five thousand dollars ($25,000.00)
may be assessed against any person who violates or fails to act in accordance with the terms, conditions,
or requirements of any permit issued pursuant to G,S. 143-215.1. If you wish to provide additional
information regarding the noted violation(s), request technical assistance, or discuss overall compliance,
please respond in writing within ten (10) days after receipt of this Notice. A review of your response
will be considered along with any information provided on the's, February 2015, Discharge Monitoring
Report. You will then be notified of any civil penalties that may be assessed regarding the violation(s). If no
North Carolina Division of Water Resources, Winston-Salem Regional Office
Location: 450 West Hanes Mill Road, Suite #300, Winston-Salem, North Carolina 27105
Phone: [phone] \ FAX: [phone] \ Customer Service; 1-877-623-6748
Internet: www.ncwaterquality.org
An Equal Opportunity 1 Affirmative Action Employer

response is received in this Office within the 10-day period, a civil penalty assessment may be
prepared.
Remedial actions, if not already implemented, should be taken to correct any problems. The
Division of Water Resources may pursue enforcement actions for this and any additional violation(s). If the
violation(s) are of a continuing nature, not related to operation and/or maintenance problems, or you
anticipate remedial construction activities, then you may wish to consider applying for a Special Order by
Consent.
If you have questions concerning this matter, please do not hesitate to contact Lon Snider or me at
[phone].
Sincerely,
W. Corey Basinger
Regional Supervisor
Water Quality Regional Operations
Division of Water Resources
cc: Point Source Branch
SWP — Central Files
WSRO Files

NC _.
Rockingham County Schools
Administrative Offices
511 Harrington Highway
Eden, North Carolina 27288
June 25, 2015
North Carolina Dept. of Environment and Natural Resources
Division of Water Quality, Winston-Salem Regional Office
450 West Hanes Mill Road, Suite #300
Winston-Salem, NC 27105
Attn: Mr. W. Corey Basinger
Ref: Notice of Violation and Recommendation For Enforcement
NOV-2015-LVO386
Permit No. NCO037001
Bethany Elementary School
Rockingham County
Dear Mr. Basinger,
JUN 2 9 2oz
it RWNS EGIONAL SALEM
OFFICE
Rodney Shotwell, Ed.D.
Superintendent of Schools
[phone] Fax [phone]
This letter is in response to your letter dated June 15, 2015, concerning a notice of violation at Bethany
Elementary School. Attached, please find correspondence from our Waste Water Operator, John Holcomb,
stating remedial actions taken to correct this problem.
Please advise my office if you have further recommendations.
Sincerely,
Dr. Rodney Shotwell, Superintendent
Enclosure:
Empowering All Students To Compete Globally

ROCKINGHAM
COUNTY SCHOOLS
June 25, 2015
Division of Water Quality
Attn: Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
TO WHOM IT MAY CONCERN:
RE: Notice of Violation dated 2/3/15
I received written notice on June 25, 2015 on the above dated violation. On January 26, 2015, I
found rotten puppies that had come through the emergency effluent pipe. I have since covered
this opening with wire. On February 3, 2015, the fecal count came back elevated. Once that came
to my attention, I promptly contacted Billingsley Septic Tank to have the plant pumped and the
tanks inspected this was completed on February 6, 2015. It was noted that the head tank from
the new school was a solid cake. I changed the pumping schedule on the head tank from yearly
to quarterly. During this time, there had been a lot of weather and power issues that I am sure
contributed to some of these issues.
On February 27, 2015, my fecal sample came back at a 0.0 which showed that my station was
back to normal. During March, my zones weren't changing properly so I ordered and installed
new selenoids and coils but this didn't seem to help. I then called Ed Macldowney, an engineer
from Guilford County Schools waste water plant, who visited our plant on March 16, 2015. He
then made contact with Perk -Rite and Jack Harmon which was the original installer. Jack
Harmon and I visited our Waste Water plant on March 17, 2015 and trouble shot the system. We
replaced three diaphragms, a high pressure tube and slowed down the flow for more detention
time in the UV tubes. As of June 25, 2015, the Bethany Waste Water Plant is operating normally.
If there are any recommendations or questions, please contact me at [phone].
Sincerely,
Imo- //,,,-
John Holcomb
RCS Maintenance Department, 391 County Home Road, Reidsville, NC 27320
E. C. Stophel, Director of Maintenance
[phone], Fax: [phone]

NCDENR
North Carolina Department of Environment and Natural Resources
Donald R. van der Vaart
Governor Secretary
June 15, 2015
CERTIFIED MAIL
RETURN RECEIPT REQUESTED
7011 1570 0001 8546 2989
Rockingham County Board of Education
Rodney Shotwell
511 Harrington Hwy
Eden NC 27288
Subject: Notice of Violation and Recommendation for Enforcement
NOV-2015-LV-0386
Permit No. NCO037001
Bethany Elementary School
Rockingham County
Dear Mr. Shotwell:
A review of Bethany Elementary School's monitoring report for February 2015 showed the following
violations:
Parameter
Date
Limit Value
Reported Value
Limit Type
Coliform, Fecal MF, M-FC
Broth,44.5C
2/3/2015
400.000
#/100ml
2,420.000 #/100ml
Daily Maximum
Exceeded
A Notice of Violation/Notice of Recommendation for Enforcement (NOV/NRE) is being issued for
the noted violation(s) of North Carolina General Statute (G.S.) 143-215.1 and NPDES Permit No. .
Pursuant to G.S. 143-215.6A, a civil penalty of not more than twenty-five thousand dollars ($25,000.00)
may be assessed against any person who violates or fails to act in accordance with the terms, conditions,
or requirements of any permit issued pursuant to G.S. 143-215.1. If you wish to provide additional
information regarding the noted violation(s), request technical assistance, or discuss overall compliance,
please respond in writing within ten (10) days after receipt of this Notice. A review of your response
will be considered along with any information provided on the's, February 2015, Discharge Monitoring
Report. You will then be notified of any civil penalties that may be assessed regarding the violation(s). If no
North Carolina Division of Water Resources, Winston-Salem Regional Office
Location: 450 West Hanes Mill Road, Suite #300. Winston-Salem, North Carolina 27105
Phone: [phone] FAX: [phone] Customer Service; 1-877-623-6748
Internet: www.ncwaterqualo.org
An Equal Opportunity 1 Affirmative Action Employer

response is received in this Office within the 10-day period, a civil penalty assessment may be
prepared.
Remedial actions, if not already implemented, should be taken to correct any problems. The
Division of Water Resources may pursue enforcement actions for this and any additional violation(s). If the
vio a ions are of a continuing tated-to-operation-and/or-maintenance probte or yoo-- ----
anticipate remedial construction activities, then you may wish to consider applying for a Special Order by
Consent.
If you have questions concerning this matter, please do not hesitate to contact Lon Snider or me at
[phone].
Sincerely,
W. Corey Basinger
Regional Supervisor
Water Quality Regional Operations
Division of Water Resources
cc: Point Source Branch
SWP - Central Files
WSRO Files

vmn Rcviuw MMUFU
Facility: �yQ;T t,�p�,� �i Z— Permit No.: f V CVZ � ( MonthNear: 'q� � (S _._.�� Pipe No,�
Monthly Average Violations
Parameter Permit Limit DMR Value % Over Limit Action
i
Weekly/Daily Violations
Date Parameter Permit Limit Limit Type DMR Value % Over Limit Action
tom;
Monitoring Frequency Violations
Date Parameter Permit Frequency Values Reported # of Violations Action
Other Violations/Staff Remarks: t 1
efc, }0 �,cJu✓e 0.3� w�n�-T S
+�Nc�r
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tupervisor Remarks: N u
Completed by: LoA L b2
Date:
Assistant Regional
Supervisor Sign Off: �• Date:
Regional Supervisor Sign
Off: Date:

RECEED
N.C.Dept. of ENR
PR
9?:$ Winston-Salem, ' ZQ1
UAR^a: Regior7al0�PELU.ENT �1�� c�
NPDES PERMIT NO. /V 00 DISCHARGE NO. MONTH /,ad p YEAR �S
FACILITY NAME s CLASS�COUNTY
CERTIFIED LABORATORY CERTIFICATION NO.,� S�
(list additional laboratories on the backside/page 2 of t is form) /
OPERATOR IN RESPONSIBLE CHARGE (ORC)h /`C �Ct7���J GRADE_,7 CERTIFICATION NO.
PERSON(S) COLLECTING SAMPLES Z 9iCc'i ORC PHONE, ?y4 - /,.�r5� 70
CHECK BOX IF ORC HAS CHANGED NO FLOW/ DISCHARGE FROM SITE*
Mail ORIGINAL and ONE COPY to:
ATTN: CENTRAL FILES
DIVISION OF WATER QUALITY
1617 MAIL SERVICE CENTER
RALEIGH, NC 27699-1647
G N`16161!1&4_z--
BY THIS SIGNATURE, 1 CERTIFY THAT THIS REPORT IS
ACCURATE AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
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Pat McCrory
Governor
.A
NCDENR
North Carolina Department of Environment and Natural Resources
August 5, 2015
Mr. E. C. Stophel, Director of Maintenance
Rockingham County Board of Education
511 Harrington Highway
Eden, NC 27288
Subject: Compliance Evaluation Inspection
NPDES Permit NCO037001
Bethany Elementary School Wastewater Treatment Plant
Rockingham County
Dear Mr. Stophel:
Donald van der Vaart
Secretary
Mr. Lon Snider of the Winston-Salem Regional Office of the North Carolina Division of Water Resources
(DWR) conducted a compliance evaluation inspection of the Bethany Elementary School wastewater
treatment plant (WWTP) on 17 July 2015. The assistance and cooperation of Mr. John Holcomb, operator in
responsible charge (ORC), were greatly appreciated. Inspection findings are summarized below and an
inspection report is attached for your records.
The facility is located on the north side of the old Bethany School building, at the intersection of Bethany
Road and NC Highway 65, in Rockingham County, North Carolina. The plant consists of a septic tank/pump
tank, a dual pump system with flow meters and zone control, a re -circulating sand filter, and ultraviolet
(UV) disinfection. Treated wastewater is discharged from the plant to Huffines Mill Creek, which is currently
classified as Class C waters in the Roanoke River Basin.
Site Review
The facility was clean and secured. The treatment system was inspected and found to be well maintained
and operational. The septic tank had just been pumped, roughly coinciding with the end of the school year.
Chlorination tubes are still in place as a backup disinfection system in case of failure of the UV system.
Backup power is also available if necessary. No discrepancies from the permit were noted.
Documentation Review
Visitation and operation and maintenance (O&M) logs were reviewed and found to be complete, current,
and very thorough. Records were available for all process control data, operations, maintenance, upkeep,
and rainfall data.
Laboratory data and discharge monitoring reports (DMRs) are kept at the Rockingham County Schools
office in Wentworth. Mr. Snider evaluated laboratory data and DMRs from November & December of 2014.
Comparison of available lab reports and field monitoring data with DMRs showed no concerns or errors.
450 West Hanes Mill Road, Suite 300, Winston-Salem, NC 27105
Phone: [phone] \ Internet: www.ncwaterguality.ore
An Equal Opportunity \ Affirmative Action Employer— Made in part by recycled paper

Chain of custody records were available and complete. All required non -field testing for the facility is
conducted by Pace Analytical Laboratories.
The facility has received multiple Notice of Violations (NOV) from this office over the last calendar year. The
NOV's were issued for exceeding the daily and monthly limits for fecal coliform. Mr. Snider and Mr.
Holcomb have discussed ways in trying to figure out what are causing these random spikes.
We appreciate your efforts to effectively operate and maintain this treatment system. No additional
response to this letter is required. If you have questions regarding the inspection or this letter, please do
not hesitate to contact Mr. Snider or me at [phone].
Sincerely,
Sherrie V. Knight, P.E.
Assistant Regional Supervisor
Water Quality Regional Operations
Division of Water Resources
Attachments:
1. BIMS Inspection Report
CC: Central Files w/attachments
WSRO/SWP w/attachments

United States Environmental Protection Agency
Form Approved.
EPA Washington, D.0 20460
OMB No. 2040-0057
Water Compliance Inspection Report
Approval expires 8-31-98
Section A: National Data System Coding (i.e., PCS)
Transaction Code NPDES yr/mo/day Inspection Type Inspector Fac Type
1 IN 1 2 15 1 3 I NCO037001 I11 12 15/07/14 17 18 I s d 19 L G 201 I
211 1-� 1 I I I I I I I 11 I I 1 I I I I I I I I I I I I I I I I I I i l I I I I I I I f 6
Inspection Work Days Facility Self -Monitoring Evaluation Rating B1 QA -- --- Reserved--------------
671 70I_j 71 I I 72 1 N 1 731 1 74 75 1jj80
LJ I I
Section B: Facility Data
Name and Location of Facility Inspected (For Industrial Users discharging to POTW, also include
Entry Time/Date
Permit Effective Date
POTW name and NPDES permit Number)
09:OOAM 15/07/14
12/06/01
Bethany Elementary School
Exit Time/Date
Permit Expiration Date
6371 NC Hwy 65
09:45AM 15/07/14
17/05/31
Reidsville NC 27320
Name(s) of Onsite Representative(s)/Titles(s)/Phone and Fax Number(s)
Other Facility Data
///
John P Holcomb/ORC/336-634-3270/
Name, Address of Responsible Official/Title/Phone and Fax Number
Contacted
John Holcomb,6371 NC 65 Reidsville NC 27320/Grade 1 Waste Water/336-634-3270/
No
Section C: Areas Evaluated During Inspection (Check only those areas evaluated)
Permit N Flow Measurement Operations & Maintenance Records/Reports
Self -Monitoring Program E Sludge Handling Disposal Facility Site Review Effluent/Receiving Waters
Laboratory
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
(See attachment summary)
Name(s) and Signature(s) of Inspector(s) Agency/Office/Phone and Fax Numbers Date
Lon Snider WSRO WQ//336-776-9701/
Signature of Management Q A Reviewer Agency/Office/Phone and Fax Numbers Date
—
! l ZZ
,�; �✓�� Boa. � - : � ?.r'..L , � t' � � r .s
4J
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete.
Page#

NPDES
yr/mo/day
31 NCO037001 I11 121 15/07/14 1
17
Inspection Type
18 ICI
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
Page#

P,(PPPPPPP-
Permit: NCO037001
Inspection Date: 07/14/2015
Owner - Facility: Bethany Elementary School
Inspection Type: Compliance Evaluation
Operations & Maintenance Yes No NA NE
Is the plant generally clean with acceptable housekeeping? 0 ❑ ❑ ❑
Does the facility analyze process control parameters, for ex: MLSS, MCRT, Settleable ❑ ❑ 0 ❑
Solids, pH, DO, Sludge Judge, and other that are applicable?
Comment:
Permit
Yes No NA NE
(If the present permit expires in 6 months or less). Has the permittee submitted a new
❑
❑
M
❑
application?
Is the facility as described in the permit?
M
❑
❑
❑
# Are there any special conditions for the permit?
❑
M
❑
❑
Is access to the plant site restricted to the general public?
0
❑
❑
❑
Is the inspector granted access to all areas for inspection?
0
❑
❑
❑
Comment:
Record Keeping
Yes No NA NE
Are records kept and maintained as required by the permit?
0
❑
❑
❑
Is all required information readily available, complete and current?
M
❑
❑
❑
Are all records maintained for 3 years (lab. reg. required 5 years)?
0
❑
❑
❑
Are analytical results consistent with data reported on DMRs?
0
❑
❑
❑
Is the chain -of -custody complete?
M
❑
❑
❑
Dates, times and location of sampling
Name of individual performing the sampling
Results of analysis and calibration
Dates of analysis
M
Name of person performing analyses
Transported COCs
Are DMRs complete: do they include all permit parameters?
M
❑
❑
❑
Has the facility submitted its annual compliance report to users and DWQ?
❑
❑
M
❑
(If the facility is = or > 5 MGD permitted flow) Do they operate 24/7 with a certified operator
❑
❑
M
❑
on each shift?
Is the ORC visitation log available and current?
M
❑
❑
❑
Is the ORC certified at grade equal to or higher than the facility classification?
0
❑
❑
❑
Is the backup operator certified at one grade less or greater than the facility classification?
M
❑
❑
❑
Is a copy of the current NPDES permit available on site?
0
❑
❑
❑
Page# 3

Permit: NCO037001
Inspection Date: 07/14/2015
Owner -Facility: Bethany Elementary School
Inspection Type: Compliance Evaluation
Record Keepinq Yes No NA NE
Facility has copy of previous year's Annual Report on file for review? ❑ ❑ M ❑
Comment:
Flow Measurement - Effluent
Yes No NA NE
# Is flow meter used for reporting?
M
❑
❑
❑
Is flow meter calibrated annually?
M
❑
❑
❑
Is the flow meter operational?
❑
❑
❑
❑
(If units are separated) Does the chart recorder match the flow meter?
❑
❑
M
❑
Comment: The meter was calibrated on 3/17/2015.
Laboratory
Yes No NA NE
Are field parameters performed by certified personnel or laboratory?
0
❑
❑
❑
Are all other parameters(excluding field parameters) performed by a certified lab?
M
❑
❑
❑
# Is the facility using a contract lab?
0
❑
❑
❑
# Is proper temperature set for sample storage (kept at less than or equal to 6.0 degrees
❑
❑
❑
Celsius)?
Incubator (Fecal Coliform) set to 44.5 degrees Celsius+/- 0.2 degrees?
❑
❑
❑
Incubator (BOD) set to 20.0 degrees Celsius +/- 1.0 degrees?
❑
❑
❑
Comment:
Solids Handling Equipment
Yes No NA NE
Is the equipment operational?
❑
❑
0
❑
Is the chemical feed equipment operational?
❑
❑
N
❑
Is storage adequate?
❑
❑
0
❑
Is the site free of high level of solids in filtrate from filter presses or vacuum filters?
❑
❑
0
❑
Is the site free of sludge buildup on belts and/or rollers of filter press?
❑
❑
0
❑
Is the site free of excessive moisture in belt filter press sludge cake?
❑
❑
0
❑
The facility has an approved sludge management plan?
❑
❑
N
❑
Comment:
Septic Tank Yes No NA NE
(If pumps are used) Is an audible and visual alarm operational? ❑ ❑ M ❑
Is septic tank pumped on a schedule? 0 ❑ ❑ ❑
Are pumps or syphons operating properly? ❑ ❑ 0 ❑
Page# 4

Permit: NCO037001
Inspection Date: 07/14/2015
Septic Tank
Are high and low water alarms operating properly?
Comment:
Owner - Facility: Bethany Elementary School
Inspection Type: Compliance Evaluation
Sand Filters (Low rate)
(If pumps are used) Is an audible and visible alarm Present and operational?
Is the distribution box level and watertight?
Is sand filter free of ponding?
Is the sand filter effluent re -circulated at a valid ratio?
# Is the sand filter surface free of algae or excessive vegetation?
# Is the sand filter effluent re -circulated at a valid ratio? (Approximately 3 to 1)
Comment:
Disinfection - UV
Are extra UV bulbs available on site?
Are UV bulbs clean?
Is UV intensity adequate?
Is transmittance at or above designed level?
Is there a backup system on site?
Is effluent clear and free of solids?
Yes No NA NE
❑ ❑ ■ ❑
Yes No NA NE
❑ ❑ ■ ❑
• ❑ ❑ ❑
• ❑ ❑ ❑
■ ❑ ❑ ❑
■ ❑ ❑ ❑
■ ❑ ❑ ❑
Yes No NA NE
❑ M ❑ ❑
❑ ❑ ❑
■ ❑ ❑ ❑
■ ❑ ❑ ❑
❑ ■ ❑ ❑
❑ ❑ ❑
Comment: There are not extra tubes onsite they are kept at the storage facility.
The permitte has been having some problems with high fecal counts and is continuing to try
to work through and find the issue casuing it.
Effluent Sampling
Is composite sampling flow proportional?
Is sample collected below all treatment units?
Is proper volume collected?
Is the tubing clean?
# Is proper temperature set for sample storage (kept at less than or equal to 6.0 degrees
Celsius)?
Is the facility sampling performed as required by the permit (frequency, sampling type
representative)?
Comment:
Yes No NA NE
❑ ❑ M ❑
■ ❑ ❑ ❑
■ ❑ ❑ ❑
❑ ❑ ■ ❑
❑ ❑ ❑
■ ❑ ❑ ❑
Page# 5

Permit: NC0037001
Inspection Date: 07/14/2015
Owner - Facility: Bethany Elementary School
Inspection Type: Compliance Evaluation
Effluent Pipe
Is right of way to the outfall properly maintained?
Are the receiving water free of foam other than trace amounts and other debris?
If effluent (diffuser pipes are required) are they operating properly?
Comment: No flow at the time of inspection.
Yes No NA NE
■ ❑ ❑ ❑
■❑❑❑
❑ ❑ ❑ ■
Page# 6

MA
A��.,rrrM.
Pr N�NEW
North Carolina Department of Environment and Natural Resources
Pat McCrory John E. Skvarla, III
Governor Secretary
September 12, 2014
Mr. R. William Holcomb,
Rockingham County Board of Education
511 Harrington Highway
Eden, NC 27288
Subject: Compliance Evaluation Inspection
NPDES Permit NCO037001
Bethany Elementary School Wastewater Treatment Plant
Rockingham County
Dear Mr. Holcomb:
Mr. Lon Snider of the Winston-Salem Regional Office of the North Carolina Division of Water Quality (DWQ)
conducted a compliance evaluation inspection of the Bethany Elementary School wastewater treatment
plant (WWTP) on 8 August 2014. The assistance and cooperation of Mr. John Holcomb, operator in
responsible charge (ORC), were greatly appreciated. Inspection findings are summarized below and an
inspection report is attached for your records.
The facility is located on the north side of the old Bethany School building, at the intersection of Bethany
Road and NC Highway 65, in Rockingham County, North Carolina. The plant consists of a septic tank/pump
tank, a dual pump system with flow meters and zone control, a re -circulating sand filter, and ultraviolet
(UV) disinfection. Treated wastewater is discharged from the plant to Huffines Mill Creek, which is currently
classified as Class C waters in the Roanoke River Basin.
Site Review
The facility was clean and secured. The treatment system was inspected and found to be well maintained
and operational. The septic tank had just been pumped, roughly coinciding with the end of the school year.
UV bulbs were replaced on 18 April 2013 and additional bulbs were available. Chlorination tubes are still in
place as a backup disinfection system in case of failure of the UV system. Backup power is also available if
necessary. No discrepancies from the permit were noted.
Documentation Review
Visitation and operation and maintenance (O&M) logs were reviewed and found to be complete, current,
and very thorough. Records were available for all process control data, operations, maintenance, upkeep,
and rainfall data.
Laboratory data and discharge monitoring reports (DMRs) are kept at the Rockingham County Schools
office in Wentworth. Mr. Snider evaluated laboratory data and DMRs. Comparison of available lab reports
585 Waughtown Street, Winston-Salem, North Carolina 27107
Phone: [phone] Internet: www.ncdenr.gov
An Equal Opportunity 1 Affirmative Action Employer— Made in part by recycled paper

and field monitoring data with DMRs showed no concerns or errors. Chain of custody records were
available and complete. All required non -field testing for the facility is conducted by Pace Analytical
Laboratories.
The facility has received multiple Notice of Violations (NOV) from this office over the last calendar year. The
NOV's were issued for exceeding the daily and monthly limits for fecal coliform. Mr. Snider has discussed
this with Mr. John Holcomb and recommended a technical assistance visit from Gary Hudson of our office.
Mr. Hudson conducted his visit and it is believed that finally getting the proper tubes in will resolve this
problem.
We appreciate your efforts to effectively operate and maintain this treatment system. No additional
response to this letter is required. If you have questions regarding the inspection or this letter, please do
not hesitate to contact Mr. Snider or me at [phone].
Sincerely,
Sherrie V. Knight, P.E.
Assistant Regional Supervisor
Water Quality Regional Operations
Division of Water Resources
Attachments:
1. BIMS Inspection Report
CC: Central Files w/attachments
WSRO/SW P w/attachments

United States Environmental Protection Agency
Form Approved.
EPA Washington, D.C. 20460
OMB No. 2040-0057
Water Compliance Inspection Report
Approval expires 8-31-98
Section A: National Data System Coding (i.e., PCS)
Transaction Code NPDES yr/mo/day Inspection Type Inspector Fac Type
1 2 15 I 3 I N00037001 111 12 14/08/28 17 181 " l 19 [ G I 201
211111 I I I I I III I I I I I I I I I I I I I I I I I I I I I I III I I I I I i66
Inspection
Work Days Facility Self -Monitoring Evaluation Rating B1 QA ---- -Reserved-------
67
70 I 71 J
I j 72 � �, � 731 I 174 75III
l_J L_J I I I
80
Section B: FacilityData
Name and Location of Facility Inspected (For Industrial Users discharging to POTW, also include
Entry Time/Date
Permit Effective Date
POTW name and NPDES permit Number)
09:20AM 14/08/28
12/06/01
Bethany Elementary School
6371 NC Hwy 65
Exit Time/Date
Permit Expiration Date
Reidsville NC 27320
09:50AM 14/08/28
17/05/31
Name(s) of Onsite Representative(s)/Titles(s)/Phone and Fax Number(s)
Other Facility Data
///
John P Holcomb/ORC/336-634-3270/
Name, Address of Responsible Official/Title/Phone and Fax Number
Contacted
John Holcomb,6371 NC 65 Reidsville NC 27320/Grade 1 Waste Water/336-634-3270/
No
Section C: Areas Evaluated During Inspection (Check only those areas evaluated)
Permit 0 Flow Measurement Operations & Maintenance Records/Reports
Self -Monitoring Program N Facility Site Review Effluent/Receiving Waters Laboratory
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
(See attachment summary)
Name(s) and Signature(s) of Inspector(s) Agency/Office/Phone and Fax Numbers Date
Lon Sjdr WSRO WQ//704-663-1699/
(14
Signature of Management Q A Reviewer Agency/Office/Phone and Fax Numbers Date
;d Y: 11 i
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete.
Page#

NPDES yr/mo/day Inspection Type
31 NCO037001 I11 12 14/08/28 17 18 ICI
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
Page#

pr
Permit: NCO037001 Owner - Facility: Bethany Elementary School
Inspection Date: 08/28/2014 Inspection Type: Compliance Evaluation
Operations & Maintenance Yes No NA NE
Is the plant generally clean with acceptable housekeeping? 0 ❑ ❑ ❑
Does the facility analyze process control parameters, for ex: MLSS, MCRT, Settleable ❑ ❑ ❑ 0
Solids, pH, DO, Sludge Judge, and other that are applicable?
Comment:
Permit
Yes No NA NE
(If the present permit expires in 6 months or less). Has the permittee submitted a new
❑
❑
M
❑
application?
Is the facility as described in the permit?
0
❑
❑
❑
# Are there any special conditions for the permit?
❑
❑
0
❑
Is access to the plant site restricted to the general public?
0
❑
❑
❑
Is the inspector granted access to all areas for inspection?
0
❑
❑
❑
Comment:
Record Keeping
Yes No NA NE
Are records kept and maintained as required by the permit?
❑
❑
❑
Is all required information readily available, complete and current?
0
❑
❑
❑
Are all records maintained for 3 years (lab. reg. required 5 years)?
0
❑
❑
Cl
Are analytical results consistent with data reported on DMRs?
M
❑
❑
❑
Is the chain -of -custody complete?
M
❑
❑
❑
Dates, times and location of sampling
Name of individual performing the sampling
Results of analysis and calibration
Dates of analysis
Name of person performing analyses
Transported COCs
Are DMRs complete: do they include all permit parameters?
M
❑
❑
❑
Has the facility submitted its annual compliance report to users and DWQ?
❑
❑
0
❑
(If the facility is = or > 5 MGD permitted flow) Do they operate 24/7 with a certified operator
❑
❑
0
❑
on each shift?
Is the ORC visitation log available and current?
0
❑
❑
❑
Is the ORC certified at grade equal to or higher than the facility classification?
❑
❑
❑
Is the backup operator certified at one grade less or greater than the facility classification?
❑
❑
M
❑
Is a copy of the current NPDES permit available on site?
0
❑
❑
❑
Page# 3

Permit: NC0037001
Inspection Date: 08/28/2014
Record Keeping
Facility has copy of previous year's Annual Report on file for review?
Owner - Facility: Bethany Elementary School
Inspection Type: Compliance Evaluation
Yes No NA NE
■❑❑❑
Comment: All process controll and data back ug records are beinq kept. Facilitv uses Pace Analvtical.
Field certification is #5126.
Effluent Pipe Yes No NA NE
Is right of way to the outfall property maintained? 0 ❑ ❑ ❑
Are the receiving water free of foam other than trace amounts and other debris? ❑ ❑ ❑ 0
If effluent (diffuser pipes are required) are they operating properly? ❑ ❑ ❑ M
Comment:
Flow Measurement - Effluent
Yes No NA NE
# Is flow meter used for reporting?
0
❑
❑
❑
Is flow meter calibrated annually?
❑
❑
❑
Is the flow meter operational?
0
❑
❑
❑
(If units are separated) Does the chart recorder match the flow meter?
❑
❑
0
❑
Comment: Flow meter is located on line as the flow is pumped to the discharge point.
Disinfection - UV
Yes No NA NE
Are extra UV bulbs available on site?
0
❑
❑
❑
Are UV bulbs clean?
❑
❑
❑
Is UV intensity adequate?
M
❑
❑
❑
Is transmittance at or above designed level?
N
❑
❑
❑
Is there a backup system on site?
❑
❑
❑
Is effluent clear and free of solids?
❑
❑
❑
Comment: Facility has had some problems with the UV system lately. as a result have had some hiah
fecal results on thier DMRs. They think with the new installed tubes that
problem will now be
fixed.
Septic Tank
Yes No NA NE
(If pumps are used) Is an audible and visual alarm operational?
0
❑
❑
❑
Is septic tank pumped on a schedule?
0
❑
❑
❑
Are pumps or syphons operating properly?
N
❑
❑
❑
Are high and low water alarms operating properly?
M
❑
❑
❑
Comment: Tank was pumped in the last few weeks.
Page# 4

IV
Permit: NCO037001 Owner - Facility: Bethany Elementary School
I -ti-n Date: 08/28/2014 1 cti T Compliance Evaluation
nspe nape on ype.
Sand Filters (Low rate)
Yes No NA NE
(If pumps are used) Is an audible and visible alarm Present and operational?
❑
❑
❑
Is the distribution box level and watertight?
0
❑
❑
❑
Is sand filter free of ponding?
M
❑
❑
❑
Is the sand filter effluent re -circulated at a valid ratio?
0
❑
❑
❑
# Is the sand filter surface free of algae or excessive vegetation?
M
❑
❑
❑
# Is the sand filter effluent re -circulated at a valid ratio? (Approximately 3 to 1) M ❑ ❑ ❑
Comment: Sand filter bed looks to be in great shape.
Laboratory
Yes No NA NE
Are field parameters performed by certified personnel or laboratory?
0
❑
❑
❑
Are all other parameters(excluding field parameters) performed by a certified lab?
0
❑
❑
❑
# Is the facility using a contract lab?
0
❑
❑
❑
# Is proper temperature set for sample storage (kept at less than or equal to 6.0 degrees
❑
❑
❑
Celsius)?
Incubator (Fecal Coliform) set to 44.5 degrees Celsius+/- 0.2 degrees?
❑
❑
❑
Incubator (BOD) set to 20.0 degrees Celsius +/-1.0 degrees?
❑
❑
❑
Comment:
Page# 5

AT3;
NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
April 27, 2015
Rodney Shotwell
Rockingham County Board of Education
511 Harrington Hwy
Eden, NC 27288
Subject: NOTICE OF VIOLATION (NOV-2015-LV-0277)
NPDES Permit No. NCO037001
Bethany Elementary School
Rockingham County
Dear Mr. Shotwell:
Donald van der Vaart
Secretary
A review of Bethany Elementary School's monitoring report for January 2015 showed the following
violations:
Parameter
Date
Limit Value
Reported Value
Limit Type
Coliform, Fecal MF, M-FC
Broth,44.5C
1/22/2015
400.000
#/100ml
437.000 #/100ml
Daily Maximum
Exceeded
Remedial actions, if not already implemented, should be taken to correct the above noncompliance
problem. Please be aware that violations of your NPDES permit could result in enforcement action
by the Division of Water Resources for this and any additional violations of State law.
If you should have any questions, please do not hesitate to contact Lon Snider at [phone].
Sincerely,
Sherry g V. Knight P.E'
Assistant Regional Supervisor
Water Quality Regional Operations
Division of Water Resources
cc: Central Files - SWP
WSRO
450 West Hanes Mill Road, Suite 300, Winston-Salem, NC 27105
Phone: [phone] \ Internet: www.ncwatercivality.org
An Equal Opportunity \ Affirmative Action Employer — Made in part by recycled paper

DMR Review Record
Facility: 4kl� ��cn�._ Permit No.; N l Pipe No.: MonthNear: !
Monthly Average Violations
Parameter Permit Limit DMR Value % Over Limit Action
Weekly/Daily Violations
Date Parameter Permit Limit Limit Tvpe DMR Value % Over Limit Action
L4cc� a 3� �as� NUJ
Monitoring Frequency Violations
Date Parameter Permit Frequency Values Reported # of Violations Action
I Other Violations/Staff Remarks:
supervisor Remarks:
fY D V
Completed by: `—'�'� ��� ��,� Date:
Assistant Regional
Supervisor Sign Off:
Regional Supervisor Sign
Off:
Date:
v
Date:avi/ /Ij

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CERTIFIED LABORATORY (I ace CERTIFICATION NO.S'
(list additional laboratories on the backside/page 2 of is form) -1
OPERATOR IN RESPONSIBLE CHARGE (ORC) 4l! O 1 '�Q�iyi1' GRADE CERTIFICATION NO.
PERSON(S) COLLECTING SAMPLES ORC PHONE -�3�„3c-)7C%
CHECK BOX IF ORC HAS CHANGED t I NO FLOW / DISCHARGE FROM SITE
Mail ORIGINAL and ONE COPY to:
ATTN: CENTRAL FILES
DIVISION OF WATER QUALITY
1617 MAIL SERVICE CENTER
RALEIGH, NC 27699-1617
6 THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS
ACCURATE AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
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A174
A
NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
March 12, 2015
Rodney Shotwell
Rockingham County Board of Education
511 Harrington Hwy
Eden, NC 27288
Subject: NOTICE OF VIOLATION (NOV-2015-LV-0118)
NPDES Permit No. NCO037001
Bethany Elementary School
Rockingham County
Dear Mr. Shotwell:
Donald van der Vaart
Secretary
A review of Bethany Elementary School's monitoring report for December 2014 showed the
following violations:
Parameter
Date
Limit Value
Reported Value
Limit Type
Coliform, Fecal MF, M-FC
12/4/2014
400.000
2,420.000
Daily Maximum
Broth,44.5C
#/100ml
#/100ml
Exceeded
Coliform, Fecal MF, M-FC
12/16/2014
400.000
2,420.000
Daily Maximum
Broth,44.5C
#/100ml
V100ml
Exceeded
Coliform, Fecal MF, M-FC
12/31/2014
200.000
2,420.000
Monthly
Broth,44.5C
#/100ml
#/100ml
Geometric Mean
Exceeded
Remedial actions, if not already implemented, should be taken to correct the above noncompliance
problem. Please be aware that violations of your NPDES permit could result in enforcement action
by the Division of Water Resources for this and any additional violations of State law.
If you should have any questions, please do not hesitate to contact Lon Snider at [phone].
Sincerely,
w"Y.
SherryKnight, V. E.
Assistant Regional Supervisor
Water Quality Regional Operations
Division of Water Resources
cc: Central Files - SWP
WSRO
450 West Hanes Mill Road, Suite 300, Winston-Salem, NC 27105
Phone: [phone] \ Internet: www.ncwatergualitV.org
An Equal Opportunity \ Affirmative Action Employer —Made in part by recycled paper

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January 27, 2015
Division of Water Quality
Attn: Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
TO WHOM IT MAY CONCERN:
RE: Fecal Count High for the Month of December 2014 Sampling
Fecal count being extremely high in December was a complete surprise. November
fecal count was average with a reading of 1.41/100 ml. I did not receive the results
from the 12/4/14 sample until after I had already taken samples on 12/16/14. Our
disinfection system is a UV system and corrective action has already been taken
for this. Over our school's Christmas break on 12/30/14, I installed new UV tubes
and sleeves. Our first fecal sample on 1/4/15 is a 0.0.
If there are any recommendations or questions, please contact me at (336) 634-
3270.
Sincerely,
�;4))
John Holcomb
RCS Maintenance Department, 391 County Home Road, Reidsville, NC 27320
E. C. Stophel, Director of Maintenance
[phone], Fax. [phone]

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FACILITY NAME CLASS _7— COUNTY D ck, 'sc
CERTIFIED LABORATORY (1 c n i' c CERTIFICATION NO.
(list additional laboratories on the backside/page 2 oft is form)
OPERATOR IN RESPONSIBLE CHARG..EAORC). 1 n A ko "6_ GRADE,Z CERTIFICATION NO.
PERSON(S) COLLECTING SAMPLES OR PH ON "�- ,?,'2%GW
CHECK BOX IF ORC HAS CHANGED NO FLOW / DISCHARGE FROM SITE
Mail ORIGINAL and ONE COPY to:
ATTN: CENTRAL FILES
DIVISION OF WATER QUALITY
1617 MAIL SERVICE CENTER
RALEIGH, NC 27699-1617
A&ttvva
BY THIS SIGNATURE, 1 CERTIFY THAT THIS REPORT IS
ACCURATE AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
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North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
June 24, 2014
R. William Holcomb
Rockingham County Board of Education
511 Harrington Hwy
Eden, NC 27288
Subject: NOTICE OF VIOLATION (NOV-2014-LV-0254)
NPDES Permit No. NCO037001
Bethany Elementary School
Rockingham County
Dear Mr. Holcomb:
John E. Skvarla, III
Secretary
A review of Bethany Elementary School's monitoring report for February 2014 showed the
following violations:
Parameter
Date
Limit Value
Reported Value
Limit Type
Coliform, Fecal MF, M-FC
02/27/14
400 #/100ml
2,420 #/100ml
Daily Maximum
Broth,44.5C
Exceeded
Coliform, Fecal MF, M-FC
02/05/14
400 #/100ml
2,420 #/100ml
Daily Maximum
Broth,44.5C
Exceeded
Coliform, Fecal MF, M-FC
02/28/14
200 #/100ml
542.08 #/100ml
Monthly
Broth,44.5C
Geometric Mean
Exceeded
Remedial actions, if not already implemented, should be taken to correct the above noncompliance
problem. Please be aware that violations of your NPDES permit could result in enforcement action
by the Division of Water Resources for this and any additional violations of State law.
If you should have any questions, please do not hesitate to contact Lon Snider at [phone].
Sincerely,
Sherri V. Knight, P.E.
Assistant Regional Supervisor
Water Quality Regional Operations
Division of Water Resources
cc: Central Files - SWP
WSRO
585 Waughtown Street, Winston-Salem, North Carolina 27107
Phone: [phone] Internet: www.ncdenr.gov
An Equal Opportunity 1 Affirmative Action Employer — Made in part by recycled paper

DMR Review Record
Facility: 31NA,-4 f1�, Permit No.: 1J�37O0 ( Pipe No.:
Monthly Average Violations
Parameter
Permit Limit
9,03
MonthNear: a
DMR Value % Over Limit Action
54�L 1`1t
Weekly/Daily Violations
Date Parameter
Permit Limit
Limit Type DMR Value
% Over Limit
Action
Monitoring Frequency Violations
Date Parameter Permit Frequency Values Reported # of Violations Action
Other Violations/Staff Remarks:
V V� 5�1 �v L i7IM°S" (atQVL jJ2,A.15 UO On icJ13S��nc� w
supervisor Remarks: U '
�v0 ,NUJ - �I� ��� -O�'4
Completed by: �—�� Date:
Assistant Regional 7// tl
Supervisor Sign Off: 1 Date: T
Regional Supervisor Sign
Off: Date:

APR d z0
EFFLUENT
NPDES PERMIT NO. /V Od 1 DISCHARGE N04�j MONTH Iui 711� YEAR,2P/4
FACILITY NAMEAffiC�e S': CLASS Z COUNTY�','.�
CERTIFIED LABORATORY O r" n 'i' CERTIFICATION NO �S�
(list additional laboratories on the backside/page 2 of is form)
OPERATOR IN RESPONSIBLE CHARGE (ORC) Z40k'm h GRADE CERTIFICATION NO. �76,'L
PERSON(S) COLLECTING SAMPLES /60.1".t/7 ORC PHONE ,:3— 6 — 42C -G3-7D
CHECK BOX IF ORC HAS CHANGER—IF-1 _ , NO FLOW / DISCHARGE FROM SITE
Mail ORIGINAL and ONE COPY to:N.C.Dept. F ENRiVIIHIS
ATTN: CENTRAL FILES '-'D(V1StON OF WATER QUALITY J ATURE OF OP •RATOR IN RESPONSIBLE CHARGE) DATE
P 2.,1617 MAIL SERVICE CENTER SIGNATURE, I CERTIFY THAT THIS REPORT IS
ACCURATE AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
RALEIGH, NC 27699-1617 " - .18 Tt
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March 25, 2014
Division of Water Quality
Attention: Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
TO WHOM IT MAY CONCERN:
I spoke with Lon Snider about possible problems with our high fecal count at our
Bethany waste water plant. On 2/19/14, a replacement ballast was ordered and new
UV tubes were also ordered. I did not have a full set of new UV tubes on hand.
Thank you and if you have any questions, please contact me at [phone].
S incerely,
John Holcomb
RCS Maintenance Department, 391 County Home Road, Reidsville, NC 27320
E. C. Stophel, Director of Maintenance
[phone], Fax. [phone]

A�
� ,A
NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
July 2, 2014
R. William Holcomb
Rockingham County Board of Education
511 Harrington Hwy
Eden, NC 27288
Subject: NOTICE OF VIOLATION (NOV-2014-LV-0300)
NPDES Permit No. NCO037001
Bethany Elementary School
Rockingham County
Dear Mr. Holcomb:
John E. Skvarla, III
Secretary
A review of Bethany Elementary School's monitoring report for March 2014 showed the following
violations:
Parameter
Date
Limit Value
Reported Value
Limit Type
Coliform, Fecal MF, M-FC
Broth,44.5C
03/13/14
400 #/100ml
2420 #/100ml
Daily Maximum
Exceeded
Remedial actions, if not already implemented, should be taken to correct the above noncompliance
problem. Please be aware that violations of your NPDES permit could result in enforcement action
by the Division of Water Resources for this and any additional violations of State law.
If you should have any questions, please do not hesitate to contact Lon Snider at [phone].
Sincerely,
W. Corey Basinger
Regional Supervisor
Water Quality Regional Operations
Division of Water Resources
cc: Central Files - SWP
WSRO
585 Waughtown Street, Winston-Salem, North Carolina 27107
Phone: [phone] Internet: www.ncdenr.gov
An Equal Opportunity 1 Affirmative Action Employer — Made in part by recycled paper

Facility: 3kt�A t-J �Cn^
DMR Review Record
Permit No.: N C)C) Pipe No.:
Monthly Average Violations
Permit Limit DMR Value
Date Parameter Permit Limit
Date Parameter
MonthNear:
% Over Limit
Weekly/Daily Violations
Limit Type DMR Value % Over Limit
Monitorinq Frequency Violations
Permit Frequency Values Reported # of Violations
Other Violations/Staff Remarks:
&4r3 t�— A -T4 4�,lfl)5
T pc�- .
Supervisor Remarks:
Completed by:
Assistant Regional
Supervisor Sign Off:
Regional Supervisor Sign
Off:
r\j cp') .- -rY., ,v - 030�
Date: L(
Date:
Action
Action
Action
Date: 2.7 & or—

RECEIVED
N.C.Dept. of ENR
MAY 0 6 2014
Winston-Salem APR 30 2 113
EFFLUENT-- E"ionalJffce
NPDES PERMIT NO. /V Od DISCHARGE NO. 0MONTH lll'G� YEAR a
FACILITY NAME CLASS -4 COUNTY
CERTIFIED LABORATORY (1) C= CERTIFICATION NO.
(list additional laboratories on the backside/page 2 of this form)
OPERATOR IN RESPONSIBLE CHARGE (ORC) -T/ )-I /' /?�!I C> w Z, GRADE CERTIFICATION NO.
PERSON(S) COLLECTING SAMPLES _T_Ar- 016v "7 6 ORC PHONE,73 - -3:;_'70
CHECK BOX IF ORC HAS CHANGED NO FLOW / DISCHARGE FROM SITE
Mail ORIGINAL and ONE COPY to:
ATTN: CENTRAL FILES
DIVISION OF WATER QUALITY
1617 MAIL SERVICE CENTER
RALEIGH, NC 27699-1647
BY THIS SIGNATURE, i CERTIFY THAT THIS REPORT IS
ACCURATE AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
11 I
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PPPPFP'
NCDENENR
North Carolina Department of Environment and Natural
Division of Water Quality
Thomas A. Reeder
Pat McCrory
Governor
Mr. R. William Holcomb,
Rockingham County Board of Education
511 Harrington Highway
Eden, NC 27288
Acting Director
10 June 2013
Subject: Compliance Evaluation Inspection
NPDES Permit NCO037001
Bethany Elementary School Wastewater Treatment Plant
Rockingham County
Dear Mr. Holcomb:
Resources
John E. Skvarla, III
Secretary
Ms. Aana Taylor -Smith of the Winston-Salem Regional Office of the North Carolina Division of Water Quality
(DWQ) conducted a compliance evaluation inspection of the Bethany Elementary School wastewater treatment
plant (WWTP) on 10 June 2013. The assistance and cooperation of Mr. John Holcomb, operator in responsible
charge (ORC), were greatly appreciated. Inspection findings are summarized below and an inspection report is
attached for your records.
The facility is located on the north side of the old Bethany School building, at the intersection of Bethany Road
and NC Highway 65, in Rockingham County, North Carolina. The plant consists of a septic tank/pump tank, a dual
pump system with flow meters and zone control, a re -circulating sand filter, and ultraviolet (UV) disinfection.
Treated wastewater is discharged from the plant to Huffines Mill Creek, which is currently classified as Class C
waters in the Roanoke River Basin.
Site Review
The facility was clean and secured. The treatment system was inspected and found to be well maintained and
operational. The septic tank had just been pumped, roughly coinciding with the end of the school year. UV bulbs
were replaced on 18 April 2013 and additional bulbs were available. Chlorination tubes are still in place as a
backup disinfection system in case of failure of the UV system. Backup power is also available if necessary. No
discrepancies from the permit were noted.
The outfall was also inspected, where only a trickle of effluent was observed. The effluent and receiving waters
appeared clear and free of solids and foam. Access to the discharge point was well maintained.
Documentation Review
Visitation and operation and maintenance (0&M) logs were reviewed and found to be complete, current, and
very thorough. Records were available for all process control data, operations, maintenance, upkeep, and
rainfall data.
North Carolina Division of Water Quality Winston-Salem Regional Office
Location: 585 Waughtown St Winston-Salem, North Carolina 27107 One
Phone: [phone] FAX: [phone] Customer Service: 1-877-623-6748 NorthCarolina
Internet: www.ncwaterquality.org Naturally
An Equal Opportunity 1 Affirmative Action Employer

Bethany Elementary School Wastewater Treatment Plant
06/10/2013
Page 2 of 2
Laboratory data and discharge monitoring reports (DMRs) are kept at the Rockingham County Schools office in
Wentworth. Ms. Taylor -Smith evaluated laboratory data and DMRs. Comparison of available lab reports and
field monitoring data with DMRs showed no concerns or errors. Chain of custody records were available and
complete. All required non -field testing for the facility is conducted by Pace Analytical laboratories.
The facility received a Notice of Violation (NOV) from this office dated 6 June 2013. The NOV was issued for
exceeding the daily and monthly limits for fecal coliform in March 2013. Ms. Taylor -Smith discussed the NOV
with Mr. John Holcomb and, based on that conversation as well as the information included with the March
2013 DMR, noted that the UV bulb was changed in order to address the high fecal coliform levels.
We appreciate your efforts to effectively operate and maintain this treatment system. No additional response to
this letter is required. If you have questions regarding the inspection or this letter, please do not hesitate to
contact Ms. Taylor -Smith or me at [phone].
Sincerely,
Corey _Basinger
Surface Water Regional Supervisor
Winston-Salem Regional Office
Division of Water Quality
Attachments:
1. BIMS Inspection Report
CC: Central Files w/attachments
WSRO/SWP w/attachments

United States Environmental Protection Agency
Form Approved.
EPA Washington, D.C. 20460
EPA
OMB No. 2040-0057
Approval expires 8-31-98
Section A: National Data System Coding (i.e., PCS)
Transaction Code NPDES yr/mo/day Inspection Type Inspector Fac Type
1 I N 1 2 I� 31 NCO037001 111 12I 13/06/10 117 181 C I 19101 201 I
tt._!! !- IJ I-
Remarks
21111111111111111111111111111111IIIIIIIIIIIIIIIII6
Inspection Work Days Facility Self -Monitoring Evaluation Rating 131 QA --- —------------- Reserved--------------
67I 169 70 J 71 Lj 72 L N I 73 W 74 751 I I I I I Li 80
Section B: Facility Data
Name and Location of Facility Inspected (For Industrial Users discharging to POTW, also include
Entry Time/Date
Permit Effective Date
POTW name and NPDES permit Number)
Bethany Elementary School
09:00 AM 13/06/10
12/06/01
Exit Time/Date
Permit Expiration Date
6371 NC Hwy 65
Reidsville NC 27320
10:00 AM 13/06/10
17/05/31
Name(s) of Onsite Representative(s)/Titles(s)/Phone and Fax Number(s)
Other Facility Data
John P Holcomb/ORC/336-634-3270/
Name, Address of Responsible Official/Title/Phone and Fax Number
Contacted
R William Holcomb,511 Harrington Hwy Eden NC 27288//336-627-2611/3366272660 No
Section C: Areas Evaluated During Inspection Check only those areas evaluated)
Permit Flow Measurement Operations & Maintenance Records/Reports
Self -Monitoring Program Sludge Handling Disposal Facility Site Review Effluent/Receiving Waters
Laboratory
Section D: Summary of Finding/Comments Attach additional sheets of narrative and checklists as necessary)
(See attachment summary)
Name(s) and Signature(s) of Inspector(s) Agency/Office/Phone and Fax Numbers Date
Aana Taylor -Smith WSRO WQ//336-771-5000/
)A" � � J V JLtt^L-e 20 13
Signature of Management Q A Reviewer Agency/Office/Phone and Fax Numbers r Date
/c,v13
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete.
Page # 1

li!t]DT
yr/mo/day
31 NCO037001 I11 12, 13/06/10 I17
Inspection Type
18L _I
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
Please refer to attached inspection letter.
Page # 2

FFFr'
Permit: N00037001
Inspection Date: 06/10/2013
Record Keeping
Are records kept and maintained as required by the permit?
Is all required information readily available, complete and current?
Are all records maintained for 3 years (lab. reg. required 5 years)?
Are analytical results consistent with data reported on DMRs?
Is the chain -of -custody complete?
Dates, times and location of sampling
Name of individual performing the sampling
Results of analysis and calibration
Dates of analysis
Name of person performing analyses
Transported COCs
Are DMRs complete: do they include all permit parameters?
Owner - Facility: Bethany Elementary School
Inspection Type: Compliance Evaluation
Has the facility submitted its annual compliance report to users and DWQ?
(If the facility is = or > 5 MGD permitted flow) Do they operate 24/7 with a certified operator on each shift?
Is the ORC visitation log available and current?
Is the ORC certified at grade equal to or higher than the facility classification?
Is the backup operator certified at one grade less or greater than the facility classification?
Is a copy of the current NPDES permit available on site?
Facility has copy of previous year's Annual Report on file for review?
Comment: Very detailed records are kept, including all maintenance, operations,
conditions, process control data, and rain data. Back-up ORC is Donald Glenn Walker,
Grade I. Contract lab is Pace Analytical. Field parameter certification # - 5126.
Permit
(If the present permit expires in 6 months or less). Has the permittee submitted a new application?
Is the facility as described in the permit?
# Are there any special conditions for the permit?
Is access to the plant site restricted to the general public?
Is the inspector granted access to all areas for inspection?
Comment:
Operations & Maintenance
Yes No NA NE
■❑❑0
■❑❑❑
■ ❑ ❑ ❑
■ ❑ ❑ ❑
■ ❑ ❑ ❑
Yes No NA NE
Page # 3

Permit: NCO037001
Inspection Date: 06/10/2013
Owner - Facility: Bethany Elementary School
Inspection Type: Compliance Evaluation
Operations $ Maintenance Yes No NA NE
Is the plant generally clean with acceptable housekeeping? ■ ❑ ❑ ❑
Does the facility analyze process control parameters, for ex: MLSS, MCRT, Settleable Solids, pH, DO, Sludge ❑ ❑ ■ ❑
Judge, and other that are applicable?
Comment: Plant is very well maintained.
Septic Tank
Yes No
NA NE
(If pumps are used) Is an audible and visual alarm operational?
■ ❑
❑ ❑
Is septic tank pumped on a schedule?
■ ❑
❑ ❑
Are pumps or syphons operating properly?
■ ❑
❑ ❑
Are high and low water alarms operating properly?
■ ❑
❑ ❑
Comment: Septic tank pumped out last week. End of school year means sharply
decreased influent (if any).
Sand Filters (Low rate)
Yes No
NA NE
(If pumps are used) Is an audible and visible alarm Present and operational?
■ ❑
❑ ❑
Is the distribution box level and watertight?
❑ ❑
■ ❑
Is sand filter free of ponding?
■ ❑
❑ ❑
Is the sand filter effluent re -circulated at a valid ratio?
■ ❑
❑ ❑
# Is the sand filter surface free of algae or excessive vegetation?
■ ❑
❑ ❑
# Is the sand filter effluent re -circulated at a valid ratio? (Approximately 3 to 1)
■ ❑
❑ ❑
Comment: Sand filter is very well maintained. Area around filter should be mown
soon, but that has not been feasible due to frequent rain this month.
Disinfection - UV Yes No NA NE
Are extra UV bulbs available on site? ■ ❑ ❑ ❑
Are UV bulbs clean? ■ ❑ ❑ ❑
Is UV intensity adequate? ■ ❑ ❑ ❑
Is transmittance at or above designed level? ■ ❑ ❑ ❑
Is there a backup system on site? ■ ❑ ❑ ❑
Is effluent clear and free of solids? ■ ❑ ❑ ❑
Comment: System is made by International Water Guard Industries, Inc. and housed
indoors. Extra UV bulbs and sleeves are available. Old chlorination tubes are still
functional in case a backup system is needed. UV bulbs were just replaced 18 April
2013.
Effluent Sampling Yes No NA NE
Page # 4

PPP
Permit: NC0037001 Owner - Facility: Bethany Elementary School
Inspection Date: 06/10/2013 Inspection Type: Compliance Evaluation
Effluent Sampling Yes No NA NE
Is composite sampling flow proportional? ❑ ❑ M ❑
Is sample collected below all treatment units?
Is proper volume collected?
Is the tubing clean?
# Is proper temperature set for sample storage (kept at less than or equal to 6.0 degrees Celsius)?
Is the facility sampling performed as required by the permit (frequency, sampling type representative)?
Comment:
Effluent. Pipe
Is right of way to the outfall properly maintained?
Are the receiving water free of foam other than trace amounts and other debris?
If effluent (diffuser pipes are required) are they operating properly?
Comment: Effluent pipe is located near heavily vegetated area and end of pipe is
tapered to prevent vermin from entering the pipe. Very little discharge (trickle) at time of
inspection, likely due to end of school year 1-2 weeks prior.
Page # 5

COMPLIANCE EVALUATION INSPECTION
Facility: EZntjnkU A r,",,Dnt NPDES: t-,1C_n0P loot
Permit Effective Dates: to 11 112 to
Inspection Date: to 1101 13 Inspection Time: O°Im !WPM
PERMIT
Complete copy of current NPDES permit NP_W ns ca= c )tom 2o12
SELF -MONITORING PROGRAM
"ri1 %L, Nov. 201-
_ DMRs (Dates: to
Lab Data (per DMR dates)
LABORATORY
Laboratories used for analysis
Chain of Custody forms (per DMR dates)
Influent and/or effluent samplers �,. j�
Field Parameter certification # 5i2dc
FLOW MEASUREMENT
Flow meter calibration records N 1-Ar
Lge.(.0 vj w i i'% rovl rn jQs
Flow charts
SLUDGE HANDLING DISPOSAL
Sludge / Residuals hauling records �r,—t4VVV, e-1ArnT 1AStI_01,
OPERATION & MAINTENANCE
ORC current certification I
Back Up certification T)Owld (innn VVnlieox,arade 1

Process control data (includes field parameters tested and equipment calibrations)
VPXl QMA d, V,2 V1 MGiAA
✓ Generator Inspection / under load checks
RECORDS & REPORTS
Wastewater Annual Report (fiscal or calendar year — if applicable)
KI lA
Daily Operator's log / ORC visitation log
Maintenance log VQvu r ned " SDM As" e ve� la
FACILITY SITE REVIEW
inspection of
C_ZPlant visual HAA-
A 111111,11,1tim .0M
EFFLUENT/RECEIVING WATERS
V Stream accessible for inspection (at effluent discharge pipe)
EV1GI 6k 1 ilae ta pe rP-A =tz vrc# nl tfi vp rmi n
V.o �.,, ..�i+No �1�►rl�.�ovt� � Cr,In i Q N 1 -2 v�lu• Ac�o •

FROM: Renee Brown - 3366343272
FaX
TM Anna Smith
TO: 3367714630
prurm Renee Brown
Fauc [phone] Fa m [phone]
Company; pages: g
Dots: Jun 10, 2013 11:31 AM
Re:
Please call me & you have any questions.
ThanK You,
John Holcomb
Rockingham County Sohool
336-634-3270
PAGE: 1 of 9

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206 Eeet Meadow Hoed • BUft A
Won, NC 2720E
[phone]
Pace Analytcal 2ervlrm. Inc.
2228 Rhrenide Dr.
AchovNe. NC 200"
(828".7178
ANALYTICAL REISULT8
P.07i06
aoe Anoly\AW.
9100 Kl
Nu\
Project WW Testing 11/21/12
PW A PrQ*1 No.: 92139474
Sam01e: E"klwlt
Lib ID: 92129474001 Collected: 11/21/12 08:00
Received 11121112 12:40 Matrix: Vaster
Parmn"m
Results Units
Report Limit OF
Prepared Analyrod CAS No. Olwl
26400 lbtel Buependad Bolide
Andytlod Method: SM 9540D
Totel Bueponded Wids
NO mall
3.0 1
11/28/12 09:25
52108 DOM 5 day EON
Analytical Method: SM 52100
DOD, 5 day
NO Mp/L
2.0 1
11/2/112 16:26 11/26/12 12:32 84
00810"5 FeOe1 COU10111 WN
AnNyllOa!) McMod: Colllml•18
Fsoel ColMorna
148 MPN/100mL
1.0 1
1112W2 1a:110
260.1 ^mrnowia
Andlylioal Method: EPA 3S0.1
Nmupr% Aminuma 9A MOIL 0.10 1
1210411212:18 7664.41-7
Date:12JOW012 09:21 AM REPORT OF LABORATORY ANALYSIS Papa 4 of 10
Tana report umm not to Rpnmucca. e1 cApt irl MI,
w1lMlll ft Wll W ommm.t d PamAnslyWol SerAm. Ina.

M FROM: Renee Brown - 33GG343272 TO: 33G7714G30 PAGE: 9 of 9
PP'Fv
2013 11:23
ceAnal lm/
wtr{eoab6wwm
i
Pew Ane4rtleel aeMem lee.
205 East Meadow Road- Suits A
Edon, erC: 2 290
[phone]
Pe"AnelsWel aertrieee, Ina.
2225 Riviceside Or.
Ach"110. NC 28 W
1828)2U-7176
ANALYTICAL RI•SULTS
P.08i08
Pew Anaytlwl M
9801) Kinsey Ave.
Hunlow"ills, N
(7W07R-
Frolect VM T8Wn0 11 /W 2
Poor Projcd No.: 92137ege \A
Gample: 6ft1uanl Lab HP 1210109e001 Collaelao• 11/08/12 00'00 Ratyalyed11106112 00'%0 Lgmay tNA
. ter
Parameters
Rlaulte Unite
Report Limit
OF'
Propered Analyzed CAA No. duel
3b40D Total Suspended SoGde
AnelyiioN Method: SM 2640D
Total Suspended Solids
ND ntg/L
2.6
1
11/13112 00:14
62108 SOD, 6 day EDA
AnalAlcal Method: 5M 52100
BOD, 0 day
ND mg/L
2.0
1
11/08112 11:07 11113112 07!16 84
CoiilerV18 Fecal Coliform EON
Analytical Mo•+od: Caiila l.18
Fecal Coliformr
1.0 MPN/100mL
1.0
1
11/00/121Z37
350.1 Ammonia
AM441cal M9110d: EPA 350.1
Nitimmi, Ammonia
4.4 mg&
0.10
1
11P17112 14:12 7N4-41.7
Dote: 11=12012 02.00 PM
L5
REPORT OF LABORATORY ANALYSIS
This report rihell not De reproduced. except In full,
YekhMl thewrken eeneeni Of POWA1NIyll0el *"=. IrAL.
n
Page 4 of 10
TOTAL P.08

RECEIVED
N.C. Dept. of ENR
• ,iUL 0 5 7012 EFFLUENT
Winston-Salemj�I'�
Regional Office
OA
NPDES PERMIT NO. 04 DISCHARGE NO.106/ MONTH Y
FACILITY NAME CLASS_COU Y
CERTIFIED LABORATOR L CERTIFICATION NO.
(list additional laboratories on the backside/page2 of this fo )
OPERATOR IN RESPONSIBLE CHARGE (O C) GRADE CERTIFICATION N0. Z Sri
PERSON(S) COLLECTING SAMPLES tyd vh ORC PHONE 7
CHECK BOX IF ORC HAS CHa" J NO FLOW / DISCHARGE FROM SITE
Mail ORIGINAL and ONE COPY to: dg�--/ -Z
ATTN: CENTRAL FILES x
DIVISION OF WATER QUALITY (SIGNATURE OF OP OR IN RESPONSIBLE CHARGE) DATE
1617 MAIL SERVICE CENTER BY THIS SIGNATURE. I CVRTIFY THAT THIS REPORT IS
RALEIGH, NC 27699-1617 ACCURATE AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
I
lium
11 I
111 I
II•II
III
II I
II. I
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II II
hill
II��
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NAME 1 UNITS BELOW
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' 1
���►�//:�b�/�=1i"�1Li61/3i,
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tb"II/l_____�
D W Q Fowl MR 1 (L1M)

Facility Status: Phase check one of tine folbw ing)
A nlm oniDning data and son pinig hEquencies m eetpean itmquhan ants
(including w eekly avers, if applicable)
Can pliant
A 11m onibxhg data and sampling frequencies do NO T m eetpean it mequian ents F-1
N onoon pliant
The peon kBe dnan3EpoxttD tine D imcbrorthe appmpraheR egional0 The any nonam pliance do tpotentally
du atrans public health orthe a nvm m ant Any iib3m atom dmnbe pmvi:ied onally w ithh 24 hours from tine time the
pear tBe becan a aw aie of tine cirm stances. A written au fission d ianalso be pmviled w ith in 5 days of tine tine tte
peon ittee becan es awain of the dram sranoas.
If tine facility isnonccm pliant: phase attach a list of corrective actic nsbeing taken and a tin a -table fDr
in proven ents to be m ade as required by Part ICE .6 of the N PD E S perm it..
"I certify, underpenalty of l wr , that this doc= ent and all attarIn eats w etB p3q3am d under y diactibn orsuper sio n
in acmid ace w ith a systen desjned tD ass in, thatquabijBd pe3arrielp3ppe-dy gatherand evaluate the ribim atian
atm itt ed. B ased on m y inquiry of tine pennon orpetscns w ho m anaged the system , or those persons directly neqxmsible
fDrgadier ng the 3nfnrn ailan, the h5bun at ion aibm fitted 3s, to tine bestof m y know ]edge and belief; bm, aoouat e, and
Complete. Ian ava3e thatthere a3a signifi a ntpaialties fDrsihn tdrig bbB 3nforn atixi, inclxlkig the poambilityof
fines and im prlmnm a ntfork now 3ng viclatinns."
R. William Holcomb
Peon iU�L-) P lease
5/22/12
Si3 0WM of Penn $tom*** D ate
OZ equned unless aibm had ebcbmkaaW)
511 Harrington Highway, Eden, NC 27288 336-627-2600 _ �i-I Z
Pam iWee Add>Pss Phaie N tm ber ern anPenn $ExpIIaticn D ate
ADDITl0NAL CERTIFIED LABORATORIES
Maze .••G[•
PARAM ETER CODES
-Mar M•� \ •
Paxam eterC ode assistance m ap be obtained by calling the N PD E S U nitat (919) 733 -5083 orby visiting the Sufface
W at erPmt ectian Secti n's w eb site ath2o f nrstat7e ncxas�k crs and Bilking tD tine uni's ynfDnm atom pages.
U se only taints ofm easuam entdes#vated in the mpoiting facilitiy'sN PD ES pent itforrpoithg data.
* No Flow fib iadiarge From Site: Check this book if no dirhaige oauis aid, as a issu]k time ate no data to be
enuna3 forallof the paran eters cm the D M R forthe erit ae m onitnrng period.
** ORC OnSite?: ORCmustvmtfacilityand docLnentviSbbonoffacilityssi=1,Jn�per15ANCAC SG A204.
*** SJgnatireofPem tee: Ifsigtiedbyotherd-um lhepem ittee,dien the ofthe de7a3arsin siyiamxy authority m tistbe on
Me with the stateper15A NCAC 2B .0506b)(2)0).
Page 2

,?ECEIVFL
N.C. IDept. of EI�IN
EFFLUENT �� n ),I Winston-Salem
Regional Office `�'�
NPDES PERMIT NO. iV Od DISCHARGE NO. MONTH R>" YEAR D f Z
FACILITY NAME S CLASS COUNTY U < r N tq
CERTIFIED LABORATORY (1) i CERTIFICATION NO��' 44
(list additional laboratories on the backside/page 2 of th s form)
OPERATOR IN RESPONSIBLE CHARGE (O C) GRADE CERTIFICATION NO.
PERSON(S) COLL ORC PHONE 1p U--
CHECK BOX IF 01141R=ii NO FLOW I DISCHARGE FROM SITE
Mail ORIGINAL and ONNWPY Q: ) 0
ATTN: CENTRAL FILES x
DIVISION OF WATER QU y 1 (SIGMA URE O ERATOR I RES ONSIBL CHARGE) DATE
1617 MAIL SERVICE CENTERjjpP`_ ILES
BY THIS SIGNATU ,1 CERTIFY THAT THIS REPORT IS
RALEIGH. NC 276994617 0 Y v � 11 ACCURATE AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
II
III IoffIIII
III
II I
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II I
II II
hill
II..
_�__
NAME 1 UNITS BELOW
rc "I
m�rM%b%J�_�-____________
DW Q Fowl M R 1 (L1/04)

Facn7>ty Status: (Please check one of the fD1bw ing)
A 11m onitoilig data and awn pling frequencies m eetpean itzeclt mn ants
(including w eekly averages, if applicable)
C an pliant
A nm onimzang data and son pling frequencies do N 0 T m eetpem itmqu>ran ants
N oncom pliant
The pear 3tiee diall.meporttD the D le=ror the appncpriite R egbna10 Tine any noncom pEannee thatpotant>ally
thzatens public health orthe envio mt ent A ny hfDnn ation dhanbe pmvi`1ed omDy w thin 24 houzs firm the tin a the
pear Itee been e av are of the cmn un starnces. A w z� as isann dhallalso be provided within 5 days of the 1cm a the
peon itiee beoon es and am of the c=An stances.
If the faciT y is noncom pliant, plow attadn a list of corrective actions being taken and a tin e-table fDr
in proven ents to be m ade as required by Part IIE 6 of the N PD E S perm 3t
"I certify, underpenally of 1w , that this doamn eztand allattachm eats w ere prepared underm y diection orszpezvimn
in accordance w 3th a system destpad tD assuze thatqualified pemon nelpmperly gatherand evaluate the infDzm aton
sibm ktBd. B ased on m y inquny of the person o*pemon-s w ho m anaged the ;ystan , or those persms dhect ly n mpons3ble
forgathersng the 3nfomr ation, the mfDrm ati m a-±m hied is, to the bestof m y know ledge and belief, tnie, aaznate, and
complete. Ian a m are that theme arc - ' ..cazntpaua]tps foranbm ±deg bl e inf ire abon, xuAudizg the possbiffly of
fines and 3m prisornn entforknow szg v:bhtio s:'
R. WILLIAM HOLCOMB
Penn itifia raptor )
Z7-
1/3/13
Signat m of Pear 3tttee*** D ate
QZequited unless sztm iced ehcbnicaI1y)
511 Harrington Highway, Eden, NC 27288 336-627-2600
Pam Itee APlane N um ber e+n Pam itExpaadm Date
ADDITMNAL CERTIFIED LABORATORIES
- ntr-• Labo3story L) 1 CeitificadmNo.
C ettified Laboratory (4 )
Cedified Labozatmy e5)
PARAM ETER CODES
• - ..1■.: =71 M.
-our.0 •
Paw eterC ode assistane m ay be obtained by calling the N PD ES U nitat (919) 733 -5083 orby visiting the Sufface
W aterPmtectian Section's w eb site ath2o=.state nc igghi ors and li kYng Z the unites infon ation pages.
U se cnly units ofm 4 �*� entdesigrk� in the mportixg fa nl IsN PD ES peen jtfbrieportizg data.
* No Flow ib iainazge Fran Site: Check this box ifno di rha>ge oa= and, as a msilk there are no data to be
eit and foranof the pazan etem cn the D M R forthe entize m anitDrng period.
** ORC 0nSite?: ORCmustvisitfaml and doom eitvisitadmoff3catityasmplitedper15ANCAC BG A204.
*** S #iat ure of Perm ittee: if signed by otherthmi the perm ittee, that the de3egadon of the signatozy authority m ustbe on
file w 3th the state per 15A N CA C 2B D506 Q)) (2) 0 ) .
Page 2

AE
NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
May 12, 2014
R. William Holcomb
Rockingham County Board of Education
511 Harrington Hwy
Eden, NC 27288
Subject: NOTICE OF VIOLATION (NOV-2014-LV-0222)
NPDES Permit No. NCO037001
Bethany Elementary School
Rockingham County
Dear Mr. Holcomb:
John E. Skvarla, III
Secretary
A review of Bethany Elementary School's monitoring report for January 2014 showed the following
violations:
Parameter
Date
Limit Value
Reported Value
Limit Type
Coliform, Fecal MF, M-FC
1/19/14
400 #/100ml
2,420 #/100m1
Daily Maximum
Broth,44.5C
Exceeded
Coliform, Fecal MF, M-FC
1/23/14
400 #/100ml
2,420 #/100ml
Daily Maximum
Broth,44.5C
Exceeded
Coliform, Fecal MF, M-FC
1/31/14
200 #/100m1
369.3 #/100ml
Monthly
Broth,44.5C
Geometric Mean
Exceeded
Remedial actions, if not already implemented, should be taken to correct the above noncompliance
problem. Please be aware that violations of your NPDES permit could result in enforcement action
by the Division of Water Resources for this and any additional violations of State law.
585 Waughtown Street, Winston-Salem, North Carolina 27107
Phone: [phone] Internet: www.ncdenr.gov
An Equal Opportunity 1 Affirmative Acton Employer — Made in part by recycled paper

If you should have any questions, please do not hesitate to contact Lon Snider at [phone].
Sincerely,
P
W. Corey Basinger
Regional Supervisor
Water Quality Regional Operations
Division of Water Resources
cc: Central Files - S WP
WSRO

DMR Review Record
Facility:e��,e�n�
Permit No.: + C,' �I Co) Pipe No.:
Monthly Average Violations
MonthNear: 'a0 % q
Parameter Permit Limit DMR Value % Over Limit Action
P�-CA � ?W dal . � 9L4,6
Weekly/Daily Violations
Date Parameter Permit Limit Limit Type DMR Value
Monitoring Frequency Violations
Date Parameter Permit Frequency Values Reported
Other Violations/Staff Remarks:
% Over Limit Action
# of Violations Action
Supervisor Remarks:
l\l UV `% LZ�,-✓ cam/ C7��%�_ �, ��
(�,c.J�_ vJ � /��"`_Y - � .t_S'sv�la,�-- '•%��''ti r,f � � O �5�.
Completed by: a �� z �— Date: k I
Assistant Regional / I
Supervisor Sign Off: 2 y
Date:
Regional Supervisor Sign
Off: Date:

�`TMS.
An EFFLUENT �pr� s) fD 7014
KV 4 101g, • kL1LGL-�l /''� t�
NPDES PERMIT NO. A) Od� DISCHARGE NO.Z_ MONTH ' YEAR /
FACILITY NAME p CLASS _Z_ COUNTY .k
CERTIFIED LABORATORY (1) ,Ge l- CERTIFICATION NO. S�
(list additional laboratories on the backside/page 2 of this form) /
OPERATOR IN RESPONSIBLE CHARGE (ORC) -�I �7 h��Gm�yt GRADE CERTIFICATION NO. 7�
PERSON(S) COLLECTING SAMPLES E I ORC PHONE J7lO ` oJ�S'���oZ70
CHECK BOX IF ORC HAS CHANGED NO FLOW / DISCHARGE FROM SITE
Mail ORIGINAL and ONE COPY to:
ATTN: CENTRAL FILES
DIVISION OF WATER QUALITY
1617 MAIL SERVICE CENTER
RALEIGH, NC 27699-1617
KY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS
ACCURATE AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
II I
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II�1
II I
II. I
11 1
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II II
II�11
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cwlwm�oM
®'
D W Q Foam MR 1 (11,04)
RCLCIYCU
N.C.Dept. of ENR
MAR 10 2014
Winston-Salem
Regional Office

��
WDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
April 15, 2014
R. William Holcomb
Rockingham County Board of Education
511 Harrington Hwy
Eden NC 27288
Subject: NOTICE OF VIOLATION (NOV-2014-LV-0166)
NPDES Permit No. NCO037001
Bethany Elementary School
Rockingham County
Dear Mr. Holcomb:
John E. Skvarla, III
Secretary
A review of Bethany Elementary School's monitoring report for December 2013 showed the
following violations:
Parameter
Date
Limit Value
Reported Value
Limit Type
Coliform, Fecal MF, M-FC
12/19/13
400 #/100m1
2,420 #/100ml
Daily Maximum
Broth,44.5 C
Exceeded
Coliform, Fecal MF, M-FC
12/31/13
200 #/100ml
755.72 #/100ml
Monthly
Broth,44.5C
Geometric Mean
Exceeded
Remedial actions, if not already implemented, should be taken to correct the above noncompliance
problem. Please be aware that violations of your NPDES permit could result in enforcement action
by the Division of Water Resources for this and any additional violations of State law.
If you should have any questions, please do not hesitate to contact Lon Snider at [phone].
Sincerely,
W. Corey Basinger
Regional Supervisor
Water Quality Regional Operations
Division of Water Resources
cc: Central Files - SWP
WSRO
585 Waughtown Street, Winston-Salem, North Carolina 27107
Phone: [phone] Internet: www.ncdenr.gov
An Equal Opportunity 1 Affirmative Action Employer— Made in part by recycled paper

�<"� DMR Review Record
Facility: ���le".6<L,aPermit No.: LD31Cx-�1 Pipe No.: Cep \ Month/Year: 0, -+rk3
Monthly Average Violations
Parameter Permit Limit DMR Value % Over Limit Action
P-C-1-1 ( � 5 S ,)4- 9�-1
Date Parameter
Date Parameter
Permit Limit
k oo
Weekly/Daily Violations
Limit Type DMR Value % Over Limit
EMI D S0s
Action
Monitoring Frequency Violations
Permit Frequency Values Reported # of Violations Action
Other Violations/Staff Remarks:
-i-'t-i; S �A--i.� b.►?�L , (-� � iS 1Y'�;n5 now iv ��5�� oSd- w�,�- � s 5o�,S cn to GAus e
�" s s%.)3at„ 5Q. Vc— jPCx-"0-
supervisor Remarks:
y�oV
Completed by: t -�I, d, Date: 4 y / y
Assistant Regional
Supervisor Sign Off: V, Date:
Regional Supervisor Sign
Off: Date:

201
f IJ r aL
EFFLUENT
NPDES PERMIT NO. IU Oe DISCHARGE NO. tZ;l MONTH, e°Gt ir//,�YEAR -2 C213
FACILITY NAME a y-c �e-li. , CLASS_ COUNTY
CERTIFIED LABO ATORY (1) ;,,e-L , CERTIFICATION NO. i
(list additional laboratories on the backside/page 2 of this form)
OPERATOR IN RESPONSIBLE CHARGE (ORC) h,"I #6/e-rO7 GRADE . r CERTIFICATION NO. >>�
PERSON(S) COLLECTING SAMPLES J-1e, An 7lckc y, 1 ORC PHONE
CHECK BOX IF ORC HAS CHANGED NO FLOW I DISCHARGE FROM SITE
Mail ORIGINAL and ONE COPY to:
ATTN: CENTRAL FILES
DIVISION OF WATER QUALITY
1617 MAIL SERVICE CENTER
RALEIGH, NC 27699-1617
6Y THIS SIGNATURE, i CERTIFY THAT THIS REPORT IS
ACCURATE AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
e—i i—
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i
NCDEE R
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
R. William Holcomb
Rockingham County Board of Education
511 Harrington Hwy
Eden NC 27288
Subject: NOTICE OF VIOLATION
NOV # NOV-2013-LV-0349
Permit No. NCO037001
Bethany Elementary School
Rockingham County
Dear Mr. Holcomb:
Division of Water Quality
Charles Wakild, P.E.
Director
6 June 2013
John E. Skvarla, III
Secretary
A review of Bethany Elementary School's monitoring report for March 2013 showed the following violations:
Parameter
Date
Limit Value
Reported Value
Limit Type
Fecal Coliform
03/06/13
400 #/100ml
2,420 #/100ml
Daily Maximum Exceeded
Fecal Coliform
03/31/13
200 #/100ml
633.81 #/100ml
Monthly Geometric Mean Exceeded
Remedial actions, if not already implemented, should be taken to correct the above noncompliance problem.
Please be aware that violations of your NPDES permit could result in enforcement action for this by the Division
of Water Quality for this and any additional violations of State law.
If you should have any questions, please do not hesitate to contact Aana Taylor -Smith or me at [phone].
cc: SWP — Central Files
WSRO Files
North Carolina Division of Water Quality, Winston-Salem Regional Office
Location: 585 Waughtown St. Winston-Salem, North Carolina 27107
Phone: [phone] FAX: [phone] Customer Service:1-877-623-6748
Internet: www.ncwaterquality.org
Sincerely,
W. Corey Basinger
Surface Water Regional Supervisor
Winston-Salem Regional Office
Division of Water Quality
Not thCarohna
Natumlly
An Equal Opportunity t Affirmative Action Employer

NOV_ 2aJ3-l-V-b34-9 Cover Sheet from
Staff Member to
Regional Supervisor
DMR Review Record
Facility: �l Permit/Pipe No.: ►�►1.nn2�1c)ea Month/Year �13
Monthly Average Violations
Parameter Permit Limit DMR Value % Over Limit
,VfP-A,I.<.nuVym Zoo J�a�.g l Zl"1�
Weekly aily Violations
Date Parameter Permit Limit/Tvpe DMR Value % Over Limit
3� l�11 IjN=0 Ono Z42p Sn5Rio
Monitoring Frequency Violations
Date Parameter Permit Frequency Values Reported # of Violations
Other Violations
a MMMATEFM 0
Completed by:-6jult2 Ti ,u 1 Dr— Q'IM,Wn
Regional Water Quality
Supervisor SiQnoff:
Date: UI (a 1 l 3
Date:
(o J.J•c -Z.0 c I

ppppppp,
a
EFFLUENT
N.C. Crept, of ENR
JUN
Winston-Salem
NPDES PERMIT NO. A) oa 1 DISCHARGE NO. e6V MONTH a'11'6df---
FACILITY NAME u. ,e^ CLASS Z COUNTY �.'KrYh
CERTIFIED LABORATORY { I fit; e J i G'L- CERTIFICATION NO.�5�
(list additional laboratories on the backside/page 2 of this form)
OPERATOR IN RESPONSIBLE CHARGE (ORC)171-Ii» �/�"C'lG�'n90 GRADE. CERTIFICATION NO.—�,7;l,�
PERSON(S) COLLECTING SAMPLES �j�_T__�e =' ORC PHONEr lj�%"
CHECK BOX IF ORC HAS CHANGED NO FLOW / DISCHARGE FROM SITE
Mail ORIGINAL and ONE COPY to:
ATTN: CENTRAL FILES ��}} c�
DIVISION OF WATER QUALItVR 2 3 201*3
1617 MAIL SERVICE CENTER
RALEIGH, NC 27699-1617
.BY THIS SIGNATURE, 1 CERTIFY THAT THIS REPORT IS
ACCURATE AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
/.2 "1--3
i®
•mm
11 �• :1
DW Q Fovn M R 1 (tl,W

Facility Status: (Please check one of the fr)lbw ing)
A 11m onrtoing data and can plaig frequencies m eetpenn itnequixen ents
(iicbdng w eekly averages, if applicable)
A Ilm onitcraig data and san plaig hEquezcies do N 0 T m eetpeim itrsquhlem ents
F-1
C om pliant
2�r
N onoom pliant
The peon >ttee span eportto the D he=rorthe appmpriate R egionalO ffke any noncom plimce thatpotendaDy
dusatEnspublic health orthe enrhxirn ent. Any infDxm at c n shanbe pmvided orally w ithn 24 hours from the fin a the
peen ittee becan a aw are of the c1n n stances. A w riWm au i� shaIlalm be provided within 5 days of the tin a the
perm ttee beoom es aw are of the cir-um stances.
If the facility is noncom pliant please attach a list of oorxecrae actions being taken and a tin a -table fDr
in proven ents to be m ade as required by Part IIE .6 of the N PD E S perm it.
"Iceitify, underpsnalty of lase , thatthis doamr entand ailat tid n Bits w ere pnqDated underm y dfiscdm ora4xm sicn
in a000rr9ance w ith a systan des fried tD asses thatqualified penumel.pmperiy gadierand evaliate tine infDun ate
submitted. Based on my inn , ny of the person orpersons w ho managed the system, or tbose perms directly renonstble
forgatheong the nfDzm at on, the hfbim adorn sabm rand is, to the bestof m y know ledge and belief, true, aoanatE, &rid
complete. Iam aware thatdieieare signi5c mitperaltienfDrs bm ittirg fare inform atior, inalkng the poambilityof
fates and in priE= eitfDrkrxra ing violations:'
R. William Holcomb
Perm ittee (Please printor tape)
1
Signature of Penn ittee*** D ate
Q2 eqused Inles; aJ3n itted ehctm kaIl()
511 Harrington Highway, Eden, NC 27288 336-627-2600 ,7//T
Perm ittee Addne s Phase N um ber ein Penn itExplation D ate
ADDTPIDNAL CERTIFIED LABORATORIES
— -• _ •• r. to C
- to ■' • . • • G 1•
PARAM ETER CODES
nI■r. �• •
[OMMI ••1 •
Pam eterC ode assjstanoe m ay be obtained by caMig the N PD ES Unitat [phone] orby visiting the Surface
W atPrPmtec Secd m's w eb site ath2o airstate nc vs�Ar cts and h*119 tD fire Inns nfDrm ation pages.
U se only naiiis ofm te3a t**a* entdesiyxatBJ in tine xQpoxting SCa1$3r'sN PD ES porn kfDrxepoxting data.
* N o F bw iD is:harge Fran Site: Check thisbcac.ifno disdjajge ooaus and, as a w---lt~ thee axe no data to be
ent ned brallof fire paxan eters on the D M R fDrthe ent m m cnitoi ng perod.
** ORC OnSite?: ORC mustvsitfxU1yand docL ne ntvsiadmoffamni asmcpita3per15A NCAC 8G A204.
*** S#iatnre of Perm bnee: If sgned by ottnerthan the perm ittee, than the dehgatsxn of the scgxah)ry authoncy m ustbe on
file w ith fire state per 15A N CA C 2B .0506 Q3) (2) OD) .
Page 2

pp�
s.
\..
7ni11pKINGHAM
COUNW SCHOOLS
April 15, 2013
Division of Water Quality
Attn: Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
TO WHOM IT MAY CONCERN:
RE: Fecal Count Extremely High on March 6, 2013 Sampling
After the March 6, 2013 sample returned a high fecal count, I questioned my
method first, then the UV process. I don't think my method was flawed, but I have
only recently become the ORC at Bethany School. I have ordered and received
new LTV tubes and will have them installed by 4/19/13. Also, I have contacted Pace
Analytical to ensure the release of the fecal results as soon as complete in an effort
to head off a potential problem.
If there are any recommendations or questions, please contact me at (336) 634-
3270.
Sincerely,
John Holcomb
RCS Maintenance Department, 391 County Home Road, Reidsville, NC 27320
E. C. Stophel, Director of Maintenance
[phone], Fax. [phone]

A
NCDENR
North Carolina Department of Environment and Natural
Division of Water Quality
Pat McCrory Charles Wakild, P.E.
Governor Director
February 11, 2013
R. William Holcomb
Rockingham County Board of Education
511 Harrington Hwy
Eden, NC 27288
Subject: NOTICE OF DEFICIENCY
NOD-2013-MV-0024
Permit No. NCO037001
Bethany Elementary School
Rockingham County
Dear Mr. Holcomb:
Resources
John E. Skvarla, III
Secretary
A review of Bethany Elementary School's monitoring report for November 2012 showed the following
deficiencies:
Parameter
Date
Measuring Frequency
Violation
DO, Oxygen, Dissolved
10/29/12 — 11/04/12
Weekly
1
Thank you for your attention to this matter. Remedial actions should be taken to correct the cause(s) of these
deficiencies. Unresolved deficiencies may lead to the issuance of a Notice of Violation and/or assessments of
civil penalties by the Division of Water Quality.
If you should have any questions, please do not hesitate to contact Aana Taylor -Smith or me at [phone].
cc: SWP — Central Files
WSRO Files
North Carolina Division of Water Quality, Winston-Salem Regional Office
Location: 585 Waughtown St. Winston-Salem, North Carolina 27107
Phone: [phone] FAX: [phone] Customer Service:1-877-623-6748
Internet: www.ncwaterquality.org
Sincerely,
j �
W. Corey Basinger
Surface Water Regional Supervisor
Winston-Salem Regional Office
Division of Water Quality
NorthCarolina
Naturally
An Equal Opportunity', Affirmative Action Employer

NOV Cover Sheet from
Staff Member to
Regional Supervisor
DMR Review Record
Facility: UtVvikii4 Ulnool Permit/Pipe No.: Month/Year Nov • Zo 12
Monthly Average Violations
Parameter Permit Limit
DMR Value % Over Limit
Weekly/Daily Violation
s
Other Violations
F)rt �4-F4nv 1UAAAA CA LQ_U+ck-r llrP
Completed by: Date: Z -1 1 �
Regional Water Quality
Supervisor Sianoff: Date: 1:94 20J r

04
W
EFFLUENT
F
EECEiVED.'aPt. of ENR
t12
inston-Saiemgional Office
NPDES PERMIT NO. 06 DISCHARGE NO.00 MONTH YEAR
FACILITY NAME L CLASS % COUNTY
CERTIFIED LABORATORY (1) LCERTIFICATION NO.
(list additional laboratories on the backside/page 2 of this form)
OPERATOR IN RESPONSIBLE CHARGE (0 ) '� WC9c7 4,4 GRADE CERTIFICATION NO. L oZ J
PERSON(S) COLLECTING SAMPLES % ORC PHONE � 3 U � Z
CHECK BOX IF ORC HAS CHANGED NO FLOW I DISCHARGE FROM SITE
Mail ORIGINAL and ONE CO I�Yjfq: s I 7ni
ATTN: CENTRAL FILES
DIVISION OF WATER QUALITY
1617 MAIL SERVICE CENTER
RALEIGH, NC 27699-1617
BY THIS SIGNATURE, kEVFY THAT THIS REPORT IS
ACCURATE AND COMP E TO THE BEST OF MY KNOWLEDGE.
D W Q Form M R 1 (11,b4 )

Facility Status: (P lease check One of the fDlbw hg)
A Ilm onkxbg data and san p1bg fiaquaicles m eetpenn itnaquian ants
(incbding w eekly wiaages, if app]icab]e)
C om pliant
A Ilm onbDi±ig data and san plug frequaicies do N 0 T m eetpehm itmquim ents F-1
N onoan pliant
The perm ifiee dia]LmpoxttD the D h9cbrortihe appmp3± h R egkna10 ffice any nonam plan a tiratpotl rntally
dmeatsispubhc health ortre a m>mm ent Any inf= atixn shanbe pmvrled oml%r w kiln 24 hmm film the tin a tine
peon ittee becan a aw ane of tihe chn n stances. A w i ten aft is= dh alsD be provided w thh 5 days of the t m a the
pe3rn itteebeocm es aware of tine ckman stances.
7f tine fad is noncom pliant, please attach a list of corrective actions being taken and a tin enable fDr
in proven ents to be m ade as requhted by Part IIE S of tine N PD E S peen it~
•Oitiurklerpaialtyof 1 1 docurn- .n• allanacbm erits JI- • 13•_ aunderm• 113•t•• or I * sb
in . ••• I•_I •- t MM•estj e• t• a,.qq I- thauffialiffid •Jtq• I - • I•'•J•1 •. t .mil .I • evaliaB 1 1• I ation
9-ftn 11B 'e• on • 1 • 1 •- I.• • •:.1.�• • �• 1 �� "tom • 1 ',•yam •- I. •' • 11� Iw•• Y•
1• � 1 .�I•• 1 - 1• I ••'. 1 .' [• I ••: • i11�• f• 1 ,' •w • � • �•� - � • •- •I �• r t- .I •
•• • � 1� I' 1 1 J,' - Y•I 1••�1 •� !•� 1• • i1• • r �- 1• I ••' • '• 1 - •• �:1• i• •
R. William Holcomb
Penn ' (P lease prin r qpe)
r 11/16/12
Siof P *** D ate
Qtequired miles, sutm fitted ebcb i alllcr)
511 Harrington Highway, Eden, NC 27288 336-627-2600 e
PenkneAM Phone NLim ber emAilPen ttExphadonDate
ADDITMNAL CERTIFIED LABORATORIES
C. gut•-• Labombiy I % _ Lt altno ■c •
c tir,, .••rt• t -Mica••i •
aul•-• ..•• c t•
JI•t•-• _••61• L - ■ur■•i •
PARAM ETER CODES
Paran eterc ode assis r m ay be obtained by calling the N PD ES Unitat [phone] orby visiting the Suibce
W atPrPmtectxr Section's w eb site ath2o anrstate nc u-Q Gr krs and linking to tine =Vs mfo n at ion pages.
U se Only un3M ofm easuen entdesignated in the mpoitng 1 'sN PD ES perm kfDrmpo2dV data.
* No Flow Ab is3harge Fran Site: Check this box ifno dk±oage oauzs and, as a re 12there are no data to be
entt3ad fDranof die pawn etem on the D M R forthe elntoe m OnIm hg perbd.
** ORC OnSite?: ORC mustvisi-exmlityand docunentvistationoffexiliasmg lia dperlSA NCAC 8G A204.
*** S tjnat um of Penn it18e: If si3rned by otherthan the peen Itee, oral the dehgat im of the signatnry authority m ustbe on
file w ifih the state per 15A N CA C 2B D5060))(2)0).
Page 2

Tv -
IF
s
QA
RECEIVED
' N.G. Dept. of ENR J A N
FEB 0 4 2014 i golf"
t EFFLUENT j��� ?��
Winston-Salem
Regional Office
NPDES PERMIT NO. iVC OD 3 Od DISCHARGE NO. �MONTH 7 G� YEAR r�D f Z
FACILITY NAME S CLASS COUNTY`
CERTIFIED LABORATORY (I) i CERTIFICATION NO,1X!;24 j
(list additional laboratories on the backside/page 2 of th s form)
OPERATOR IN RESPONSIBLE CH44t
os GRADE 7LCERTIFICATIONNO.
PERSON(S) COLL SAt4P�. �.✓I ORC PHONE /0 Cl— 3Z%d
CHECK BOX IF ORS H Af�tir NO FLOW /DISCHARGE FROM SITE
Mail ORIGINAL and ON PY 1�:2013
ATTN: CENTRAL FILES x
DIVISION OF WATER QU 7 (SIGNATURE O O ERATOR I RES ONS(BL CHARGE) DATE
1617 MAIL SERVICE CEN R,ip�L F�' BY THIS SIGNATU , 1 CERTIFY THAT THIS REPORT IS
RALEIGH, NC 27699-1617 0W , f ACCURATE AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
mmi�
��■
ism
i���������■�■i�
rNOrr�r�rr��®r�■������
D W Q Foan M R 1 (L1,b4 )

Facility Status: (Please check one of the fD]bw ang)
A 11 m on- Drag data and -an piing hequeZcies m eetpemn iniaquihm ents
(hcbding w eekly averages, if applicable)
C an pliant
A Ilm ornitDrng data and sam p1bg fteque ncies do N 0 T m eetpemn itnKpin n ents F-1
N oncom pliant
The peon i2tee ahaD.reporttD the D irectororthe appropriate R eghna10 thatpotantally
t ineattens public health orthe an :hcn m Ent A ny infDnn at hn donbe pmvi;led orally w thin 24 hours fiom the tin a the
Penn kBe becarn a aware of the cbr um stances. A w r>tian artm issbn dnallalm be provided w ithn 5 days of the tin a the
pern ittee beeom es aw am of the eit= stances.
If the facility isnoneom pliant:, please attach a hEtof corrective actionsbeing taken and a tin enable for
in proven ants to be made as required by Part IIE b of tine N PD E S permit.
"I amtify, underpenalty of Im , that this doaun entand allatiachn ents w ere prepared underm y diced± n ora4xmr cn
in acconJance w ith a system designed to ass 1 tinatquali5ad pemonnelpmperly gatherand evaluate the anfaun ation
subm fitted. B ased on m y equity of the person orpemns w ho m anaged the systsm , or those perms directly n?Eponsnle
forgatherre the inform atsun, the hfDrrn anon sri m hied is, to the bestof m y ]mow ledge and belief, true, acauate, and
complete. Ian aware thatthere are si3nifsantpenaldes toralxn Iti ng tOse in>nrm atio n, including the poembUty of
fines and in p=nm entfDr know aig viDlawns."
R. WILLIAM HOLCOMB
Perm t2fle rirntor typ )
1/3/13
SignatneofPeumliBe*** Date
Q2 equired unlesa ait m fitted ebcb kaD )
511 Harrington Highway, Eden, NC 27288 336-627-2600
Pem rose APhone N in ber en Penn kExpaadon D ate
ADDITIDNAL CERTIFIED LABORATORIES
CmthedLaboiatDiy(2)E,d-&JL-
Ceitified LaboiatoWed-15cation N •
extified LaboxatoiyL eitibcation N •
PARAM ETER CODES
Paean eterC ode assistance m ay be obtained by caMig the N PD ES Uneat [phone] orby vis±hg the Surface
W aterPmtection Section's web site ath2o anrstate nc u --* krs and linkng to the units inform anon pages.
Use only imi is ofm easuan entdes#iated in the reporting &oddity's N PD ES peon iformport hg data.
* No F bw fib i:rinarge Fran Site: Check this boc ifno disclmge ooaus and, as a result, dime are no data to be
aite� fDrallof the paten etars on the D M R fnrthe enter m cautmrng period.
* * O R C 0 n S it e? : O R C m ustvistfaml ty and doczun entvisi atim of facility as r>3qpuagi per 15A N CA C 8G .0204 .
*** Signature of Perm ith:e: If signed by otherthan the pear ]tine, than the delegatbn of the siyratory audxn: y m trstbe on
f0ewiththestateper15ANCAC 2B .05060D)(2)0).
Page 2

WIVINa MOVION MUG -MU
Facility: 10-V� 0 �' (e E111 Permit No.: M6-3 Pipe No.. Monthil'ear:T_��, �
SL�� ( Monthly Average Violations
Parameter
Permit Limit
DMR Value % Over Limit Action
Weekly_/_Daily Violations
Date Parameter r Permit Limit Limit Type DMR Value % Over Limit Action
Fe�c ` C OLr �` �ti1 00►� I �u�' �,,a �y b _ So-
Monitoring Frequency Violations
Date Parameter Permit Fregueng Values Reported # of Violations Action
Other Violations/Staff Remarks:
�- ►lnovi-A,�
TO
rL/201s �'e0 Cja-1 (LI Na � �;(�� `�
Supervisor Remarks:
No✓
Completed by: Date: y r _-
Assistant Regional
Supervisor Sign Off: -Ka, 21 Date:
t ,.
Regional Supervisor Sign
Off: Date:

DMR Review Record
Facility: 15E��N�, ��e^ Permit No.: N�-0D3:�JOD 1 Pipe No.: Month/Year:
Monthly Average Violations
Parameter
Permit Limit
DMR Value
% Over Limit
Action
— Pe
Weekly/Daily
Violations
Date Parameter
Permit Limit Limit Type
DMR Value
% Over Limit
Action
Monitoring Frequency Violations
Date Parameter
Permit Frequency
Values Reported
# of Violations
Action
Other Violations/Staff Remarks:
"e \0'acr,
Nod- q- L6 - otI65
� 1
Supervisor Remarks: N O O
Completed by:
Assistant Regional � y,
Supervisor Sign Off: Y�
Regional Supervisor Sign
Off:
Date:
Date: 16 I( 3) 14
Date:

EFFLUENT
NPDES PERMIT NO. A A DISCHARGE NO.� MONTH 1Q YEAR
FACILITY NAME CLASS_ COON 'n fcrD vri
CERTIFIED LABORATORY(]) ,` CERTIFICATION NO.eg—
(list additional laboratories on the backside/page 2 of this orm)
OPERATOR IN RESPONSIBLE CHARGE (ORC) % /,- GRADE S CERTIFICATION NO. 745
PERSON(S) COLLECTIN SAMPLES ✓" b ORC PHONE?j-j� — , 70
CHECK BOX IF ORC HAS C ANGERRECEIVED]NO FLOW I DISCHARGE FROM SITE
N.Q.Dept. MR
Mail ORIGINAL and ONE OPY 0 9 14
ATTN: CENTRAL FILES x
DIVISION OF WATER QUALI NATURE OF OPERATOR IN RESPONSIBLE CHARGE) DATE
1617 MAIL SERVICE CENTER Winston•Sa m THIS SIGNATURE. I CERTIFY THAT THIS REPORT IS t
D u c9r_u wr 77r110-1&17 onnu,.al n ro ALCURATE AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
1111l
I
III
I I I
I i l
I I I
I I i I I
I I
M21M
I
11b1
NAME AND UNITS BELOW
rim .r'
. immmmmm
D W Q Four H R 1 (L1iO4 )

WDENR
North Carolina Department of Environment and Natural Resources
Beverly Eaves Perdue
Governor
Mr. R. William Holcomb
Rockingham County Schools
511 Harrington HWY
Eden, NC 27288
Division of Water Quality
Charles Wakild, P.E.
Director
March 27, 2012
Subject: NOTICE OF DEFICIENCY
Mr. R. William Holcomb
Permit No.NC0037001
Bethany Elementary School
Rockingham County
Dear Mr. Holcomb:
Dee Freeman
Secretary
(2ot1)
A review of the December, 2012 Discharge Monitoring Report (DMR) revealed a violation of the
following parameter(s) at Outfall 001:
Parameter
Date
Measuring Frequency
Violation
Dissolved Oxygen
12/3 and 12/17
weekly2
Remedial actions should be taken to correct the cause(s) of this violation. The violations described above
should be abated immediately and properly resolved. Efforts undertaken to bring the facility back into
compliance are not an admission of guilt and are considered necessary to prevent any future
environmental damage.
If you have any questions or require any additional information, please contact Mike Thomas at (336)
771-5000 or at [e-mail].
Sincerely,
W. Corey Basinger
Surface Water Regional Supervisor
Winston-Salem Regional Office
Division of Water Quality
cc: SWPRO File Copy
DWQ Central Files
N. C. Division of Water Quality
Winston-Salem Regional Office
585 Waughtown St. Winston-Salem, NC 27107
Phone: [phone] \ FAX: [phone]
Customer Service:1-877-623-6748
Internet: www.ncwaterquality.org
An Equal Opportunity \ Affirmative Action Employer
Nne
orthCarolina
Naturq!!'y

Cover Sheet from
Staff Member to
Regional Supervisor
DMR Review Record
Facility: `'E6meA
wyrr Permit/Pipe No.: Md co VccC Month/Year !Z
Sc�c�
Monthly Average Violations
Parameter Permit Limit DMR Value % Over Limit
Weekly/Daily Violations
Date Parameter Permit Limit/Type DMR Value % Over Limit
Monitoring Frequency Violations
Date Parameter Permit Frequency Values Reported # of Violations
l2-3 'Lb W9�y
PL-t7 t� wt
IZ-3i �D W
Other Violations
:r- IA4W soft i Aw ogee x m00%
Completed by: Date: 3 S /Z
Regional Water Quality
Supervisor Signoff: Date:

E FFLUEN
N.C.Dept. of ENR
FEB 2 8 2012
Winston-Salem
L
JAN 2 6 2Q12
NPDES PERMIT NO. MC OD 31 0d 1 DISCHARGE NO. oa 1 MONTH &LQ bg YEAR 7�..0) I
FACILITY NAME daL CLASS COI
, OII
CERTIFIED LABORATORY (1) I "SIC L CERTIFICA—TIOTVhsjj
(list additional laboratories on the backside/page 2 of thisform)
OPERATOR IN RESPONSIBLE CH r}iir}ii/�MPL4 GRADE CERTIFICATION NO.
PERSON(S) COLLECTI a ORC PHONE 2. `? Q
/0 3 �l-3
CHECK BOX IF OR, HAS NO FLOW I DISCHARGE FROM SITE
Mail ORIGINAL and ONE COP
N: 14
ATTN: CENTRAL FILES x
DIVISION OF WATER QUALITY �aoo
(SIGNAT RE O E TOR IN RESPONSIBLE CHARGE) DATE
BY THIS SIGNATUR&,I&ERTIFY THAT THIS REPORT IS
RALEIGH, NC 2 699 611617 MAIL SERVICE 7TER p�ACCURATE AND COMPLETE O THE BEST OF MY KNOWLEDGE
I I I
III I
I I• I I
II . I
I I I
I I. I
I I I
®
1 1 I I
h i l l
I I��
_�__
NAME 1 UNITS BELOW
e79c
®",a
m-.I�__-1-___■-_
MIN
mm
1���
S�im�F`J�/T�1(
wififiuu�mI��JfI�___m_m
D w Q Form MR 1 (11,04 )

Facility Status: P lease dhedk one of the fDlbw jag)
A Rm onthtshg data and ran plug frequaxaes m eetpem itnxpim arts
(iiciudbg weekly averages, k applicable)
Canpbant
A nm onitoiitig data and --an piing hEquancies do N 0 T m eetpemt itnagahan tints a
N one om pliant
The peon itiee shaIl.mportto the D itectororthe appmprate Regixha10 ffice any rranobtt(plianoe fttpotPntauy
thtmtenspublic health orthe e m cm ant Any infDhm atixn shanbe pmviled orally w ithn 24 hoots ftom tine tin a the
peen ittee becan a aw ate of tine cno n stances. A w Y]liPSn ahlatt xsri sta abD be p=ijed w thin 5 days of the tmi a the
peim kee began es ad ate of the cha n stances.
If the facility is noncom plant, please attach a list of corrective acti ns being taken and.4 4�m e2able fnr
in provem ents bn be m ade as required by Part IIE 5 of the N PD E S perm i.
•a,•t i •,a •a • • - , _ • : ••• - _i • . 1 _ �r.• a ti ar- • ta•_ tc• i •.a • ua••r. • - i•� .yam,
_.••• 1•-1 •- � - -t3 •.w-1•t fZ76 1• _ - I ki N • _ It -it' - t• t ••I
• itta• -a• r, • 1 • •-.a• •ON•a.c• •a• . - - -ta • t .•-- •a,: •; • uc••• -+•
w c t . r • die x1frnin atr-n, the Jifbim. ■r a±m ntn• is, t• die • s • • • a•.• - athcl •- - u r acanate, _i •
Bnes andinprkm entforkthcw bg vbbdom
R. William Holcomb
Penn ktee (P lease p ' for e
1/18/12
Signatihm of Perm itiee** D ate
Q2 equ> tmless. ahbm hied elect)
.511 Harrington Highway, Eden, NC 27288 336-627-2600. ,S.— 3)- 1 Z
Pen inee APbcne N un ber em arladdtess Pam itExpiiatta D ate
ADDII'IDNAL CERTIFIED LABORATORIES
31NI■-• •• r i• O ■Lca mI •
PARAM ETER CODES
Patam eterC ode mice m ay be cbtained by caMig the N PD ES Untat (919) 733 -5083 orby visi> ng the Surface
W atierP3Dbx:C xr Section's w eb site ath2o enrstate nc1Lg/w QS and linking to the unks xibn ation pages.
U se only units ofm easm n ehtdee$hated n the tepothiV facflity'sN PD ES perm kfDrn porting data.
* No F bw ib is ikulge Fran Site: Check thisbcx ifno discharge ocmns and, as a nes ilt, thee are to data to be
entered fDranof the paten etas on the D M R fDrthe entire m cnmri7g period.
** 0 R C O n Ste?: 0 RC m ustvistf and docLn entvkbdjn of fy-11 as MMuimcl per15A N CAC 8G A204 .
*** Signature of Perm itiee: If signed by otherthan the pemt itiee, tires the dehgation of tine sidna xy authotcy m ustbe on
f0ewith the stateperl5ANCAC 2B A50603)(2)QD).
Page 2

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Charles Wakild, P.E.
Governor Director
January 24, 2012
R William Holcomb
Rockingham County Board of Education
511 Harrington Hwy
Eden NC 27288
Subject: NOTICE OF VIOLATION
Permit No. NCO037001
Bethany Elementary School
Rockingham County
Dear Mr Holcomb:
Dee Freeman
Secretary
A review of Bethany Elementary School's monitoring report for September 2011 showed the
following violations:
Parameter
Date
Limit Value
Reported Value
Limit Type
Nitrogen, Ammonia Total
09/30/11
14 mg/l
19 mg/1
Monthly
(as N) - Concentration
Average
Exceeded
Remedial actions, if not already implemented, should be taken to correct the above
noncompliance problem. Please be aware that violations of your NPDES permit could result in
enforcement action for this by the Division of Water Quality for this and any additional
violations of State law.
If you should have any questions, please do not hesitate to contact Mike Thomas at (336) 771-
5000.
cc: SWP — Central Files
WSRO Files
North Carolina Division of Water Quality, Winston-Salem Regional Office
Location: 585 Waughtown St. Winston-Salem. North Carolina 27107
Phone: [phone] FAX: [phone] Customer Service: 1-877-623-6748
Internet: www.ncwaterquality.org
Sincerely,
f
W. Corey Basinger
Surface Water Regional Supervisor
Winston-Salem Regional Office
Division of Water Quality
Nne
orthCarolina
;Vaturall#
An Equal Opportunity 1 Affirmative Action Employer

��� r �l2—t...v --nice(
Cover Sheet from
Staff Member to
Regional Supervisor
MIR. Review Record
Facility:
PermitlPipe No.: Kcco3�ppl MondVYear *1L
tle�,c,2 SrS+.v1
Monthly Average Violations
Permit Limit DMR Value % Over Lirrut
Parameter
Weekly/Daily Violations
Date Parameter Permit L'unitlTvpe D. Va]ue %Over Limit
Monitoring Frequency Violations
Date Parma r Permit Freauencv Values Re___ owned # of Violations
—
Other Violations
Completed by:
Resional Water Qua
Supervisor SiQnoff:
Date: Z z
` 24�,La, 2,ot z
u Date:

�V
_1�
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Charles Wakild, P.E.
Governor Director
January 19, 2012
R William Holcomb
Rockingham County Board of Education
511 Harrington Hwy
Eden NC 27288
Subject: NOTICE OF VIOLATION
Permit No. NCO037001
Bethany Elementary School
Rockingham County
Dear Mr Holcomb:
Dee Freeman
Secretary
A review of Bethany Elementary School's monitoring report for October 2011 showed the
following violations:
Parameter
Date
Limit Value
Reported Value
Limit Type
Nitrogen, Ammonia Total
10/31/11
14 mg/l
17.1 mg/1
Monthly
(as N) - Concentration
Average
Exceeded
Remedial actions, if not already implemented, should be taken to correct the above
noncompliance problem. Please be aware that violations of your NPDES permit could result in
enforcement action for this by the Division of Water Quality for this and any additional
violations of State law.
If you should have any questions, please do not hesitate to contact Mike Thomas at (336) 771-
5000.
cc: SWP — Central Files
WSRO Files
North Carolina Division of Water Quality, Winston-Salem Regional Office
Location: 585 Waughtown St. Winston-Salem, North Carolina 27107
Phone. [phone] FAX: [phone] Customer Service: 1-877-623-6748
Internet: www.ncwaterquality.org
Sincerely,
W. Corey Basinger
Surface Water Regional Supervisor
Winston-Salem Regional Office
Division of Water Quality
Ot]e
NorthCarolina
,Xaturally
An Equai Opportunity � Affirmative Action Employer

Cover Sheet from
Staff Member to
Regional Supervisor
MIR Review Record
� rn ��/ — Month/Year
Facility: �►+� ermitlPipe No.: [—
�w
Monthly Average Violations
Permit Limit DMR Value To over Limit
Parameter �L 35.E
Weekly/Daily Violations
Date Parameter
Permit L'uni� D= e % Over Limit
Monitoring Frequency Violations
ate Parameter Permit Frequency Values Reported # of Violations O�
D — N
!/
Other Violations
� A/zotP . AW4 ,too✓
5
�_ Date:
Completed by: (,
Regional Water Quality --�— 0 Date: t b IjAn �21—
Supervisor SiEnoff:

��
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins
Governor Director
September 6, 2011
R William Holcomb
Rockingham County Board of Education
511 Harrington Hwy
Eden NC 27288
Subject: NOTICE OF VIOLATION
Permit No. NCO037001
Bethany Elementary School
Rockingham County
Dear Mr Holcomb:
Dee Freeman
Secretary
A review of Bethany Elementary School's monitoring report for May 2011 showed the following
violations:
Parameter
Date
Limit Value
Reported Value
Limit Type
Nitrogen, Ammonia Total
05/31/11
14 mg/1
16.15 mg/1
Monthly
(as N) - Concentration
Average
Exceeded
Remedial actions, if not already implemented, should be taken to correct the above
noncompliance problem. Please be aware that violations of your NPDES permit could result in
enforcement action for this by the Division of Water Quality for this and any additional
violations of State law.
If you should have any questions, please do not hesitate to contact Mike Thomas at (336) 771-
5000.
cc: SWP — Central Files
WSRO Files
North Carolina Division of Water Quality, Winston-Salem Regional Office
Location: 585 Waughtown St. Winston-Salem, North Carolina 27107
Phone: [phone] FAX: [phone] Customer Service: 1-877-623-6748
Internet: www,ncwaterquality.org
Sincerely,
W. Corey Basinger
Surface Water Regional Supervisor
Winston-Salem Regional Office
Division of Water Quality
Nne
orthCarolina
;Vatumllty
An Equal Opportunity � Affirmative Action Employer

tI -l]- ogli'
Cover Sheet from
Staff Member to
Regional Supervisor
DMR Review Record
Facility: h4n E% Termit/Pipe No.: NWo3Z�nl MonUVYear
Monthly Avera;e Violations
Parameter Permit Limit DMR Value % Over Limit
S- 3 Solt,
Weekly/Daily Violations
Date Parameter Permit LumitlTvpe DMR Value %Over Limit
Date
Parameter
Monitoring Frequency Violations
Permit Frequency Values Reported # of Violations
Other Violations
Vice%�:
Completed by: Date:
Regional Water Quality Date:
Super visor Signoff:
ov

RC%✓C1 v CLJ
MAY 2 4 2011
CENTRAL FILES
DWQ/BOQ
o U
EFFLUENT
Winston-Salem
Regional Office
NPDES PERMIT NO. DISCHARGE NO.� MONTH YEAR/ /
FACILITY NAME SL d L CLASS I - COUNTY- A- h Aw1
CERTIFIED LABORATORY (1) L CERTIFICATION NO. .7
(list additional laboratories on the backsidelpage 2 of this fo
OPERATOR IN RESPONSIBLE CHARGE (ORCv GRADE t CERTIFICATION NO.
PERSON(S) COLLECTING SAMPLES _ ORC PHONE IdU— 3 3-,') 0
CHECK BOX IF ORC HAS CHANGED NO FLOW / DISCHARGE FROM SITE
Mail ORIGINAL and ONE COPY to:
ATTN: CENTRAL FILES x O — D
DIVISION OF WATER QUALITY (SIGNATURE OF O'RAT IN RESPONSIBLE CHARGE) DATE
1611 MAIL SERVICE CENTER BY THIS SIGNATURE.1 IFY THAT THIS REPORT IS
RALEIGH. NC 276"-1617 ACCURATE AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
_
11 1
BELOWSAME AND UNITS
MINIMUM
DW 0 Fonn M R-1 Q1A4)

-Faciliy Statics: Flues dieck one of the fnlbw ng)
A Ilm onimrkg data and san plig fmquariesm eetpeim itmquin n efts
aic]adig w e*V averages, if applicable)
Compliant
A Ilm onimrng data and san plig frequencies do N 0 T m eetpeim itmquiun ents F-1
N onaim pliant
The peen ittee shann portm the D imcmror the appmpxiate R egbnalO f re aiy noncom plianoe thatpowthBy
dhmatStspublic health orthe eTr= m ent A ny ]nfbim atin shanbe pmvxW ozaW w itiiin 24 houus fimm the tan a the
peim itteee becan a aN am of the cuwn stain's. A w rit2l=n atom is>rn di alm be provided w thin 5 days of tiie tine the
perm ittee becan es awam of the cin m stances.
if the facility is noncom pliant:, phase atiadz a Ikof aarzecive acd: nsbeing taken and a tan e-table for
in pzovem ents tD be m ade as zequired by Part IIE 5 of the N PD E S pezm it
"I aemfy, tuidwpsiaty of 13w , that this doom entad allam dm eats w ere pmpamd Lmderm y dimction ora>pervisrxr
n a000idaoe w ith a system designed m as3une thatqualtC35d pei=izielproperiy gadterad evaYate the inform atin
sibm itted. B aead on my ixpky of the person orpemcm w ho m aracg. ed the system , or those pens dimctly nmponsble
fbrgatherng the infomt aticn, the cif m ata7n aibm 12ed is, m the bestof m y know ]edge ad belief, tote, aoalratE, and
oom plete. Ian aware thatthere aie stjrdficantpenabes foram lbrg &be Jnfbzn aticn, itclAi g the possibility of
finesad inpric meftforknarkqvi:Dl3d3W"
R. WILLIAM HOLCOMB
Perot n' ge jV lease priator type
Signatum of Perot it2tae+++ Date
(t e*dad unless sibm tied ebc:=n aW)
511 Harrington Highway, Eden, NC 27288 336-627-2611 p�)— 3 / --/Z
Pam bee Addsffi Phone Nun be ein ailaddPam iExphadm D ate
ADDTTIDNAL CERTIFIED LABORATORIES
JOfle _ •• r w L eo1•r_ ••; N •
JI• •' • eir•• r 1• i. --I•Y ■• •
PARAM ETER CODES
Pam eterC ode assistirm m ay be obt fined by caDig the N PD ES U nit at [phone] orby visking the Suziaae
W aterProttxbm Section's w eb ste ath2o enr-qtge nciL-* cts and A*ng to the tm rs irifoan at bn pages.
U s!! anly unks ofm eaa 1xm eitdes4iemd in the iepoitiig B-11 y'sN PD ES peon iforiepozlig data.
* No F bw /b sdza:tW From Sibe: Check this box tno distaige ocans art, as a —1X rhea are no data to be
eiumd tbrallof the paian etels an the D M R brthe eft e m onlorng period.
** O R C 0 n S le?: O RC m ustvist baWty and doom eitvisbrbn of farallYy as nxlujmd per15A N CA C 8G D204 .
*** S ignatnre of Perm 3tee: If signed by otherdiai the peen tee, thief the debgat bn of the sijnatozy aithor$y m ustbe cn
file with the state per15A N CA C 2B D506 V (2) (D ) .
Page

pppppr,
AT4
NCDENR
North Carolina Department of Environment and
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins
Governor Director
25 February 2011
Mr. R. W. Holcomb
Rockingham County Schools
511 Harrington Way
Eden, NC 27288
Natural Resources
Subject: Compliance Evaluation Inspection
NPDES Permit NCO037001
Bethany Elementary School Wastewater Treatment Plant
Rockingham County
Dear Mr. Holcomb:
Dee Freeman
Secretary
Mr. Mike Thomas of the Winston-Salem Regional Office of the North Carolina Division of Water
Quality conducted a compliance evaluation inspection of the Bethany Elementary Wastewater
Treatment Plant (WWTP) on 22 February 2011. The assistance and cooperation of Mr. Anthony
Doom was greatly appreciated. Inspection findings are summarized below.
The WWTP is located on the North side of the old Bethany School building, at the intersection of
Bethany Road and NC Hwy 65, in Rockingham County, North Carolina. The plant consists pf septic
tank, a dosing tank, a dual pump system with flow meters and zone control, a re -circulating sand filter,
and ultraviolet disinfection. Treated wastewater is discharged from the plant to Huffines Mill Creek,
which is currently classified as Class C waters in the Roanoke River Basin.
Site Review
The facility was clean, secured, and well maintained. The treatment system was inspected and
found to be operational. No discrepancies from the permit were noted. The outfall was also inspected
and there was very little discharge at the time of inspection. The discharge point appeared free of
pollutant indicators and was in very good condition. Access to the discharge point was well
maintained. Mr. Doom's records indicated that the septic tank is pumped every year. He indicated
that he would be increasing the pumping schedule to keep pace with demands on the system.
Documentation Review
Mr. Thomas evaluated laboratory data during the inspection. Comparison of available lab reports
and field monitoring data with discharge monitoring reports (DMR) showed no concerns or errors.
North Carolina Division of Water Quality, Winston-Salem Regional Office
Location: 585 Waughtown St. Winston-Salem, North Carolina 27107 One
Phone: [phone] FAX: [phone] Customer Service: 1-877-623-6748 NorthCarolina
Internet www.ncwaterquality.org ;Vatura!!rf
An Equal Opportunity l Affirmative Action Employer

Rockingham County Schools
Compliance Evaluation Inspection NPDES Permit NCO037001
2/25/2011
Page 2
"�N
Chain of custody records were available and complete. The visitation and operation/maintenance logs
were reviewed and found to be complete and current.
The facility received a Notice of Violation (NOV) from this office on 14 February 2011. The NOV
was issued for not following the appropriate monitoring schedule outlined in the permit. I discussed
the NOV with Mr. Doom and understand his reasons for monitoring on the schedule that he did.
However, since receiving the NOV, Mr. Doom states that he adhere strictly to the schedule outlined in
the permit.
We appreciate your efforts to effectively operate and maintain this treatment system. No
additional response to this letter is required. If you have questions regarding the inspection or this
letter, please do not hesitate to contact Mr. Thomas or me at [phone].
Sincerely, A
W. Corey Basinger
Interim Regional Supervisor
Surface Water Protection
Winston-Salem Region
Attachments:
1. BIMS Inspection Report
Cc: WSRO — SWP w/ atch
Central Files w/ atch
NPDES West Unit

PPr- Pppr,
United States Environmental Protection Agency
Form Approved.
EPA Washington, D.C. 20460
OMB No. 2040-0057
Water Compliance Inspection Report
Approval expires 8-31-98
Section A: National Data System Coding (i.e., PCS)
Transaction Code NPDES yr/mo/day Inspection Type Inspector Fac Type
1 I NI 2 1 51 31 N00037001 Ill 121 11/02/23 117 18I CI 191 cl 20IU
Remarks
211111111111111111111111111111111111111111Jill 1116
Inspection Work Days Facility Self -Monitoring Evaluation Rating B1 QA -------Reserved---
67 1 169 70 I +— I 71 U 721 NJ 73 W 74 751 I I I I I I 180
Section B: Facility Data
Data
Name and Location of Facility Inspected (For Industrial Users discharging to POTW, also include
Entry Time/Date
Permit Effective Date
POTW name and NPDES permit Number)
09:00 AM 11/02/23
07/06/01
Bethany Elementary School
Exit Time/Date
Permit Expiration Date
6371 NC Hwy 65
Reidsville NC 27320
10:00 AM 11/02/23
12/05/31
Name(s) of Onsite Representative(s)/Titles(s)/Phone and Fax Number(s)
Other Facility Data
Anthony Wayne DOOm/ORC/336-634-3270/
Name, Address of Responsible Official/Title/Phone and Fax Number
R William Holcomb,511 Harringgton Hwy Eden NC Contacted
27288//336-627-2611/3366272660 No
Section C: Areas Evaluated During Inspection Check only those areas evaluated)
Permit 0 Flow Measurement Operations & Maintenance Records/Reports
Self -Monitoring Program 0 Facility Site Review Effluent/Receiving Waters Laboratory
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
(See attachment summary)
Name(s) and Signature(s) of Inspector(s) Agency/Office/Phone and Fax Numbers Date
Michael S Thomas WSRO WQ///
Signatu of Management Q A Reviewer Agency/Office/Phone and Fax Numbers Date
"716 r XCD>�-2 ;'NC r�� zS
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete.
Page # 1

NPDES yr/mo/day Inspection Type 1
3I NC0037001 I11 12I 11/02/23 j17 18ICI
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
Page # 2

ppppr,
Permit: NCO037001
Inspection Date: 02/23/2011
Record Keeping
Are records kept and maintained as required by the permit?
Is all required information readily available, complete and current?
Are all records maintained for 3 years (lab. reg. required 5 years)?
Are analytical results consistent with data reported on DMRs?
Is the chain -of -custody complete?
Owner - Facility: Bethany Elementary School
Inspection Type: Compliance Evaluation
Yes No NA NE
■ ❑ ❑ ❑
■❑❑❑
■n❑n
■nnn
■ n n n
Dates, times and location of sampling
■
Name of individual performing the sampling
■
Results of analysis and calibration
■
Dates of analysis
■
Name of person performing analyses
■
Transported CM
■
Are DMRs complete: do they include all permit parameters?
■
❑
❑ ❑
Has the facility submitted its annual compliance report to users and DWQ?
❑
❑
■ ❑
(If the facility is = or > 5 MGD permitted flow) Do they operate 24/7 with a certified operator on each shift?
❑
❑
■ ❑
Is the ORC visitation log available and current?
■
❑
❑ ❑
Is the ORC certified at grade equal to or higher than the facility classification?
■
❑
❑ ❑
Is the backup operator certified at one grade less or greater than the facility classification?
■
n
❑ ❑
Is a copy of the current NPDES permit available on site?
■
n
n ❑
Facility has copy of previous year's Annual Report on file for review?
❑
❑
■ ❑
Comment:
Permit
Yes
No
NA
NE
(If the present permit expires in 6 months or less). Has the permittee submitted a new application?
❑
❑
■
❑
Is the facility as described in the permit?
■
n
n
❑
# Are there any special conditions for the permit?
❑
■
❑
❑
Is access to the plant site restricted to the general public?
■
n
❑
n
Is the inspector granted access to all areas for inspection?
■
❑
❑
❑
Comment:
Septic Tank
Yes
No
NA
NE
(If pumps are used) Is an audible and visual alarm operational?
■
ri
❑
n
Page # 3

Permit: NCO037001
Inspection Date: 02/23/2011
Owner - Facility: Bethany Elementary School
Inspection Type: Compliance Evaluation
Yes No
NA
NE
Septic Tank
Is septic tank pumped on a schedule?
Are pumps or syphons operating properly?
Are high and low water alarms operating properly?
■❑❑❑
Comment: Usually pumps the septic system every year but will be switching to every
90 days or so.
Yes No
NA
NE
Sand Filters (Low rate)
(if pumps are used) Is an audible and visible alarm Present and operational?
■❑❑❑
❑ ❑
■
❑
Is the distribution box level and watertight?
■❑❑❑
Is sand filter free of ponding?
Is the sand filter effluent re -circulated at a valid ratio?
# Is the sand filter surface free of algae or excessive vegetation?
■❑❑❑
# Is the sand filter effluent re -circulated at a valid ratio? (Approximately 3 to 1)
Comment:
Yes No NA NE
Disinfection - UV
■❑❑❑
Are extra UV bulbs available on site?
■ ❑ ❑ ❑
Are UV bulbs clean?
■❑❑❑
Is UV intensity adequate?
Is transmittance at or above designed level?
■❑❑❑
Is there a backup system on site?
■ ❑ ❑ ❑
Is effluent clear and free of solids?
Comment: Keeps extra bulbs and sleeves on hand. Old chlorination tubes are still
available and functioning in case a backup system is needed for the UV.
Yes No NA NE
Effluent Pipe
■❑❑❑
Is right of way to the outfall properly maintained?
Are the receiving water free of foam other than trace amounts and other debris? ■❑❑❑
0000
If effluent (diffuser pipes are required) are they operating properly?
Comment:
Yes No NA NE
Operations & Maintenance
■❑❑❑
Is the plant generally clean with acceptable housekeeping?
Does the facility analyze process control parameters, for ex: MLSS, MCRT, Settleable Solids, pH, DO, Sludge ❑ ❑ ■ ❑
Judge, and other that are applicable?
Page # 4

Ppp
Permit: NC0037001
Inspection Date: 02/23/2011
Operations & Maintenance
Comment:
Effluent Sampling
Is composite sampling flow proportional?
Is sample collected below all treatment units?
Is proper volume collected?
Is the tubing clean?
Owner - Facility: Bethany Elementary School
Inspection Type: Compliance Evaluation
# Is proper temperature set for sample storage (kept at less than or equal to 6.0 degrees Celsius)?
Is the facility sampling performed as required by the permit (frequency, sampling type representative)?
Comment:
Flow Measurement - Effluent
# Is flow meter used for reporting?
Is flow meter calibrated annually?
Is the flow meter operational?
(If units are separated) Does the chart recorder match the flow meter?
Comment:
Page # 5

NCDENR
North Carolina Department of Environment and Natural Resources
Beverly Eaves Perdue
Governor
R William Holcomb
Rockingham County Board of Education
511 Harrington Hwy
Eden NC 27288
Subject: NOTICE OF VIOLATION
Permit No. NCO037001
Bethany Elementary School
Rockingham County
Dear Mr Holcomb:
Division of Water Quality
Coleen H. Sullins
Director
February 14, 2011
Dee Freeman
Secretary
A review of Bethany Elementary School's monitoring report for November 2010 showed the following
violations:
Parameter
Date
Measuring
Violation
Frequency
DO, Oxygen, Dissolved
11/13/10
Weekly
Failure to monitor dissolved
oxygen.
Flow, in conduit or thru treatment
11 /27/10
Weekly
Failure to measure flow.
plant
DO, Oxygen, Dissolved
11/27/10
Weekly
Failure to monitor dissolved
oxygen.
Remedial actions, if not already implemented, should be taken to correct the above noncompliance
problem. Please be aware that violations of your NPDES permit could result in enforcement action for this
by the Division of Water Quality for this and any additional violations of State law.
If you should have any questions, please do not hesitate to contact Mike Thomas at [phone].
Sincerely,
_J�
W. Corey Basinger
Acting Surface Water Regional Supervisor
Winston-Salem Regional Office
Division of Water Quality
cc: SWP — Central Files
WSRO Files
North Carolina Division of Water Quality, Winston-Salem Regional Office
Location: 585 Waughtown St. Winston-Salem, North Carolina 27107
Phone: [phone] \ FAX: [phone] Customer Service: 1-877-623-6748
Internet: www.ncwaterquality.org
None
rthCarolina
vVaturally
An Equal Opportunity \ Affirmative Action Employer

Cover Sheet from
Staff Member to
Regional Supervisor
DMR Review Record
Facility: a ( erm ipe No.: /fie'-o231001 Month/Year !! /o
Monthly Avera;e Violations
Parameter Permit Limit DMR Value
Date Parameter
% Over Limit
Weekly/Daily Violations
Permit Limitrrype DMR Value % Over Limit
Monitorin.- Frequency Violations
Date Parameter Permit Frequency Values Reported # of Violations
'--Do e-VI
t- 2?-t D
t1-e-7-10 1 ioW
Other Violations
A ,anc,)
Completed by: !"\, ke . Date: Z -,
Regional Water Quality
Supervisor Signoff:
,1 D4 - 0111- Nt V - ccgq
Date: l -I `z- 7r-) t /
A w,

MONITORING REPORT(MR) VIOLATIONS for: Report Date: 02/08/11 Page: 21 of 33
Permit: ib MRs Between: 11-2010 and 11- 010 Region:'Nhnston-Salem Violation Category: Monitoring Violation Program Category: NPDES WW
Facility Name: % Param Name: % County: % Subbasin: % Violation Action: %
Major Minor: %
PERMIT: NCO037001 FACILITY: Rockingham County Board of Education - Bethany COUNTY: Rockingham REGION: Winston-Salem
Elementary School
Monitoring Violation
MONITORING OUTFALL /
VIOLATION
UNIT OF CALCULATED
REPORT PPI LOCATION
PARAMETER
DATE
FREQUENCY
MEASURE LIMIT VALUE % OVER LIMIT
VIOLATION TYPE
VIOLATION ACTION
11 -2010 001 Effluent
DO, Oxygen, Dissolved
11/13/10
Weekly
mg/I
Frequency Violation
None
11 -2010 001 Effluent
DO, Oxygen, Dissolved
11/27/10
Weekly
mg/I
Frequency Violation
None
11 -2010 001 Effluent
Flow, in conduit orthru
11/27/10
Weekly
mgd
Frequency Violation
None
treatment plant
PERMIT: NCO044750
FACILITY: Britthaven Of Madison - Britthaven of Madison WWTP COUNTY: Rockingham
REGION: Winston-Salem
Monitoring Violation
MONITORING
OUTFALL /
VIOLATION
UNIT OF CALCULATED
REPORT
PPI
LOCATION
PARAMETER
DATE
FREQUENCY
MEASURE LIMIT VALUE % OVER LIMIT
VIOLATION TYPE
VIOLATION ACTION
11 -2010
001
Effluent
Chlorine, Total Residual
11/06/10
2 X week
ug/1
Frequency Violation
None
11 -2010
001
Effluent
Chlorine, Total Residual
11/13/10
2 X week
ug/I
Frequency Violation
None
11 -2010
001
Effluent
Chlorine, Total Residual
11/20/10
2 X week
ug/I
Frequency Violation
None
11 -2010
001
Effluent
Chlorine, Total Residual
11/27/10
2 X week
ug/I
Frequency Violation
None
PERMIT: NCO035173 FACILITY: Wieland Copper Products LLC - Wieland Copper COUNTY: Stokes REGION: Winston-Salem
Products, LLC
Monitoring Violation
MONITORING OUTFALL / VIOLATION UNIT OF CALCULATED
REPORT PPI LOCATION PARAMETER DATE FREQUENCY MEASURE LIMIT VALUE / OVER LIMIT VIOLATION TYPE VIOLATION ACTION
11 -2010 001 Effluent Temperature, Water Deg. 11/06/10 5 X week deg c Frequency Violation None
Centigrade

JAN
EFFLUENT
NPDES PERMIT NO. 0.0 ti P (`( i DISCHARGE NO. )CD l MONTH A)() YEARC!�-O_
FACILITY NAME CLASS,-- COUNTY dP /JP i i, i
CERTIFIED LABORATORY (1) -10 b - CERTIFICATION NO.7�
(list additional laboratories on the backside/page 2 of this form)
OPERATOR IN RESPONSIBLE CHARGE (ORC `cc- a,,,:l &,, DE CERTIFICATION NO. 2 '�
PERSON(S) COLLECTING SAMPLES 4A ORC PHONE
I
CHECK BOX IF ORC HAS CHANGED �. ` tNO FLOW / DISCHARGE FROM SITE
''; l'`,
Mail ORIGINAL and ONE COPY to:
ATTN: CENTRAL FILES
DIVISION OF WATER QUALITY
1617 MAIL SERVICE CENTER
RALEIGH, NC 27699-1617
BY THIS SIGNATURE, I URTIFY THAT THIS REPORT IS
ACCURATE AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
NAME 1 UNITS BELOW
NINE
DEC 2,9 NIO
DWQ Frnm M R-1 Q1/09)
f.niormatwrl Pr6w99il15 Uliit
DVVar8 )G-

Facility Status: (P laase check one of the foDow frig)
A nm onitDring data and san plug ftequahciesm eetpeun itrequmm ants
(ncinding w eekly aveagess, if applicable) E��
Cam phEnnt
A llm onibi ing data and satn plug thequencies do N 0 T m eetpemn it mquinnan ants F-1
N onoom pliant
The peen tree stnaRmporttD the D ive=ror tine appropriate R egbr al0 Eice any rnoncom plane thatpotentally
threatens public health orthe a nv>lnran ent Any infoum atim dnanbe pn oviied ovally w ithn 24 hotus fm)m the tin a the
peon itee becarn a aw am of the cha n stances. A w mien subm i� shallal be piDviled within 5 days of the tin a the
perm Itee bemm es aw are of the cin n stances.
If the facility is nonoom pliant, phase attach a list of oorrec� actions being taken and a tin enable for
in proven ents to be m ade as required by Part II E .6 of the N PD E S perm it -
"I aertify, underpenalty of lase , thatdm doaan entand allatacm ents w e3e pneparad underm y dhacrt m orsupervicic n
in idance w inn a systan designed tD assue thatqualif ed penxm nelpmpedy gatherand evalaate the hb3r n atio n
subm ited. B aged on m y inquiry of the pens n orpemo ns w ho m arnaged the system , or those penror><s dinecdy >aqponsnble
fDrgathezing the infoum aton, n, the inform at on subm fitted is, to tine bestof m y know ]edge and belief, true, aoauate, and
complete. Ian aw are that thee am si3ni — itpeha]ties inrsnbm fining false x&irn atom, n Mxig the possibility of
firm and in puisorm entfDrkrnw bg v blatixns. "
R. William Holcomb
Penn ittee (P base printor tl pe)
SignahueofPe3m!ti a*** D at/Waa/Z/0
OZ equired unless subm ithed e3acbmically)
511 Harrington Highway, Eden, NC 27288 336-627-2600
Penn $Lae A Phaie Nun ber en ailaddPeon itExpbat io n Date
ADDIrMNAL CERTIFIED LABORATORIES
PARAM ETER CODES
Pam eterC ode annoy m ay be obtained by caDing the N PD E S U nitat (919) 73 3 -5083 orby visiting the Sunfam
W aterPmtectnn Section's web site ath2o anrstate nc uusti✓ ps and linking to the un>rs inform at ion pages.
U sa only units ofm easuan entdesignated in tine lepo2ting fxiligr's N PD ES peen itfor>epoitirhg data.
* N o F bw fib is3uarge Fran Site: Check this box ifm dissitaige ooaus and, as a nes llt, there am no data to be
entaai brallof the pam eteis on tine D M R forthe entie m onlomng period.
* * O R C O n S ite? : O R C m ustvvistit facility and doc an enty r of fatality as uaquited per15A N CA C 8G .0204.
* * * S ignatuure of Perm it tee: If signed by otherd-im the peen ittPe, then the delegation of the sigrn=ty authority m ustbe cn
file with thestateperl5A NCAC 2B .0506 b) (2) 0).
Page 2

prP--pppp"
United States Environmental Protection Agency
Form Approved.
EPA Washington, D.C. 20460
OMB No. 2040-0057
Water Compliance Inspection Report
Approval expires 8-31-98
Section A: National Data System Coding (i.e., PCS)
Transaction Code NPDES yr/mo/day Inspection Type Inspector Fac Type
1 �,NI 2 15I 31 N00037001 111 121 11/02/22 117 18I CI 19I SI 20III
Remarks
2111111111111111111111111111111111111111111111116
Inspection Work Days Facility Self -Monitoring Evaluation Rating 61 QA --------Reserved-------
67 I 169 701 I 71 U 721 NJ 73I I W 174 751 I I I I I I 180
Section B: Facility Data
Name and Location of Facility Inspected (For Industrial Users discharging to POTW, also include
Entry Time/Date
Permit Effective Date
POTW name and NPDES permit Number)
09:00 AM 11/02/22
07/06/01
Bethany Elementary School
Exit Time/Date
Permit Expiration Date
6371 NC Hwy 65
Reidsville NC 27320
10:00 AM 11/02/22
12/05/31
Name(s) of Onsite Representative (s)/Titles(s)/Ph one and Fax Number(s)
Other Facility Data
Anthony Wayne Doom/ORC/336-634-3270/
Name, Address of Responsible Official/Title/Phone and Fax Number
R William Holcomb ,511 Harrinton Hwy Eden NC Contacted
27288//336-627-2611/3366272690 No
Section C: Areas Evaluated During Inspection (Check only those areas evaluated)
Permit 0 Flow Measurement Operations & Maintenance Records/Reports
Self -Monitoring Program 0 Facility Site Review Effluent/Receiving Waters Laboratory
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
(See attachment summary)
Name(s) and Signature(s) of Inspector(s) Agency/Office/Phone and Fax Numbers Date
Michael S Thomas WSRO WQ///
Signature of Management Q A Reviewer Agency/Office/Phone and Fax Numbers Date
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete.
Page # 1

NPDES
yr/mo/day
31 NCO037001 I11 121 11/02/22 117
Inspection Type
18I C
"�q
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
Page # 2

Permit: NCO037001
Inspection Date: 02/22/2011
Owner - Facility: Bethany Elementary School
Inspection Type: Compliance Evaluation
Septic Tank
Yes{ No NA NE
Is septic tank pumped on a schedule?
J°t
Are pumps or syphons operating properly?
�(n n n
Are high and low water alarms operating properly?
' n n n
Comment:
Sand Filters (Low rate) J
Yes No NA NE
(If pumps are used) Is an audible and visible alarm Present and operational?
n n n n
Is the distribution box level and watertight?
❑ n n n
Is sand filter free of ponding?
X n ❑ n
Is the sand filter effluent re -circulated at a valid ratio?
tjen n
# Is the sand filter surface free of algae or excessive vegetation?
X n n ❑
# Is the sand filter effluent re -circulated at a valid ratio? (Approximately 3 to 1)
n n'W
Comment:
Disinfection - UV
Yes No NA
NE
Are extra UV bulbs available on site?
n n
Q
Are UV bulbs clean?,
n n
n
Is UV intensity adequate?
n n
n
Is transmittance at or above designed level?
n ❑
n
Is there a backup system on site?
'% n ❑
n
Is effluent clear and free of solids?
n n n
n
,,rr
Comment:
�I `
Q ✓a•` A '
Effluent Pipe
Yes No NA
NE
Is right of way to the outfall properly maintained?
, n ❑
n
Are the receiving water free of foam other than trace amounts and other debris?
n n
n
n
If effluent (diffuser pipes are required) are they operating properly? n n —
Comment:
Operations $ Maintenance Yes No NA NE
Is the plant generally clean with acceptable housekeeping? )K n n n
Does the facility analyze process control parameters, for ex: MLSS, MCRT, Settleable Solids, pH, DO, Sludge n ❑ 'OL10
Judge, and other that are applicable?
Comment:
Page # 4

Permit: NCO037001
Inspection Date: 02/22/2011
Owner - Facility: Bethany Elementary School
Inspection Type: Compliance Evaluation
"�q
Record Keeping Yes No NA NE
Are records kept and maintained as required by the permit? 0 ❑ ❑ ❑
Is all required information readily available, complete and current? ❑ ❑ ❑
Are all records maintained for 3 years (lab. reg. required 5 years)? ❑ ❑ ❑
Are analytical results consistent with data reported on DMRs? ' n n In
Is the chain -of -custody complete? n In n
Dates, times and location of sampling
Name of individual performing the sampling
Results of analysis and calibration
Dates of analysis
Name of person performing analyses
Transported COCs T�
Are DMRs complete: do they include all permit parameters? /` ❑ ❑ ❑
Has the facility submitted its annual compliance report to users and DWQ? ❑ ❑ ❑ ?
(If the facility is = or > 5 MGD permitted flow) Do they operate 2417 with a certified operator on each shift? ❑ ❑ ❑
Is the ORC visitation log available and current? k ❑ ❑ ❑
Is the ORC certified at grade equal to or higher than the facility classification? jX n n n
Is the backup operator certified at one grade less or greater than the facility classification? n n n
Is a copy of the current NPDES permit available on site? ❑ ❑ ❑
Facility has copy of previous year's Annual Report on file for review? ❑ ❑ ❑
Comment: Wkn I_IOICo"
Permit Yes No NA NE
(If the present permit expires in 6 months or less). Has the permittee submitted a new application? ❑ ❑ n n
Is the facility as described in the permit? X 171 ❑ ❑
# Are there any special conditions for the permit? ❑ ❑ ❑
Is access to the plant site restricted to the general public? %� n n ❑
Is the inspector granted access to all areas for inspection? Vz ❑ ❑
Comment:
Septic Tank Y s No NA NE
(If pumps are used) Is an audible and visual alarm operational? ❑ ❑ ❑
Page # 3

rp
Permit: NCO037001
Inspection Date: 02/22/2011
Owner - Facility: Bethany Elementary School
Inspection Type: Compliance Evaluation
Effluent Sampling Yes No NA NE
Is composite sampling flow proportional? O O 1A n
Is sample collected below all treatment units? n n n n
Is proper volume collected? n n n
Is the tubing clean? n n Vf n
# Is proper temperature set for sample storage (kept at less than or equal to 6.0 degrees Celsius)? n n n
Is the facility sampling performed as required by the permit (frequency, sampling type representative)? n n n
Comment:
Flow Measurement - Effluent Yes No NA NE
# Is flow meter used for reporting?
Is flow meter calibrated annually?
Is the flow meter operational?
(If units are separated) Does the chart recorder match the flow meter?
Comment:
;4nnn
*KX0 n
❑ n n
-%0d0
Page # 5

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins
Governor Director
21 July 2009
Rockingham County Board of Education
Attn: Mr. R. William Holcomb
511 Harrington Hwy
Eden, NC 27288
SUBJECT: Notice of Violation: NOV-2009-LV-0321
Bethany Elementary School Wastewater Treatment Plant
NPDES Permit NCO037001
Rockingham County
Dear Mr. Holcomb:
Dee Freeman
Secretary
1. A review of the April 2009 discharge monitoring report (DMR) for the Bethany Elementary
School Wastewater Treatment Plant revealed the following violation:
Parameter
Date
Limit
Reported
Limit Type
Remarks
Value
Value
_
Total
04/30/2009
14 mg/I
14.5 mg/I
Monthly
Average
3.6% over limit
Ammonia
2. Remedial actions, if not already implemented, should be taken to correct the above
noncompliance problems. Please be aware that violations of your NPDES permit could
result in enforcement action by the Division of Water Quality for this and any additional
violations of State law. If you should have any questions, please do not hesitate to
contact Ron Boone at [phone].
Sincerely,
Steve W. Tedder
Water Quality Regional Supervisor
Winston-Salem Region
Division of Water Quality
CC: Central Files
NPDES West Unit
W - /K(3 —S1,-f P Fi lCs
North Carolina Division of Water Quality, Winston-Salem Regional Office
Location: 585 Waughtown St. Winston-Salem, North Carolina 27107
Phone: [phone] FAX: [phone] Customer Service: 1-877-623-6748
Internet: www.ncwaterquality.org
North
Carolina
Naturally
An Equal Opportunity \ Affirmative Action Employer

Cover Sheet from
Staff Member to
Regional Supervisor
DMR Review Record
Facility: + E S Permit/Pipe No.: 3766/ a a 1 Month/Year
Monthly Average Violations
Parameter Permit Limit DMR Value % Over Limit
Weekly/Daily Violations
Date Parameter Permit Limit/Type DMR Value % Over Limit
Monitoring Frequency Violations
Date Parameter Permit Frequency Values Reported # of Violations
Other Violations
Completed by: ^t
Regional Water Quality
Supervisor Signoff:
Date: I
Date: % — 0 f
/��`� ��aq - LV,d3�l

RECEIVED E L C OA
N.C. Dept o4 ENR i
I /
JUN 2 2 2009 EF ENT EUiAY 2 ( 2 n 0 )ul'�
Winston-Salem
Regional Office YEAR��
NPDES PERMIT NO. -�--"'--81 CHARGE NO. �� MONTH bo
FACILITY NAME c L CLASS a coultryka uv 4 9.1-4
CERTIFIED LABORATORY (1) ; '!4 CERTIFICATION NO.'5`
(list additional laboratories on the backside/page 2 of this f )
OPERATOR IN RESPONSIBLE CHARGE (ORC) V/vc GRADE_U—CERTIFICATION NO. �J
PERSON(S) COLLECTING SAMPLES ORC PHONE — - ()
C11ECK BOX IF ORC HAS CHANGED NO FLOW / DISCHARGE FROM SITE
Mail ORIGINAL and ONE COPY to: �S •d�
ATTN: CENTRAL FILES x
Qvtl�
DIVISION OF WATER QUALITY (SIG ATURE OF ONRAT/)R IN RESPONSIBLE CHARGE) DATE
1617 MAIL SERVICE CENTER BY THIS SIGNATURE, I CF_FJ IFY THAT THIS REPORT IS
RALEIGH, NC 27699-1617 ACCURATE AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
11 I
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aummogran
D W Q Fovn M R -1 (11,b4 )

Facility Stators: (Plc Check one of the folbw ing)
A Ilm oniving data and sin plaig frequencies m eetpehm it2equmr:m ents r
(ihcbding w eekly averages, if applicable)
Can pliant
I \ A-Ilm- onibdig dada, and sin plug fmquencies do N 0 T m eetpeun itmgii en ehts
t
0I,—O c ✓W 1 orti'' � S' VI � V _rL � s2�2 � V W�,IL 4 A<�, L,N=m�1;;'t��d � t a
T�the�pe ittee 11/ n�epoo, tD he D n> go"r de appmprate R egi�alO Mm any nomm� plEnoe t3�atpoten ally
";::m,E,spublic health orthe eivimnm ant Any inform ation dhallbe provided orally w ithin 24 hours fi m the tin a the
peon ittee becan a aw am of the cfiaan stances. A w ritEn sin ission shall also be pmvi3ed w ithii 5 days of the tin a the
peon bee bemn es aw are of the cite m stances.
If the facility is noncom pliant, please attach a listof corrective act:bnsbeing taken and a tin e-table for
in proven ents tD be made as required by Part IIE 6 of the N PD E S perm it.
"I certify, underpe- any of law , that this docL n eitand allattatiTn ants w ere pnEpanad underm y dhecthn oraTervision
in a000rdance w ith a system designed to ass ue thatqualif ed pemonnelpmpe dy gatherand eralrat e the inform ation
arbm hied. B asad on m y inquiry of the person orpemons w ho m anaged the system , or those perrons directly r?qoonsible
forgat exiig the inform ation, the ahform adon arbm ittB3 is, tD the bestof my know la ige and belief, tare, aco un e, and
com p3ete. Ian aware that there are sijniii :a ntparales for srbm 16M false inform ation, incbding the posmbility of
finesand inprisxm ehtforknow ing violations."
R. William Holcomb
Perm ' prihtor type)
5/19/09
Signature of Perm ittee*** D ate
(R equmed unless subm fitted ebcbrmirally)
511 Harrington Highway, Eden, NC 27288 336-627-2611 !�-3I - '')-
Per itme A ddrem Phone N un ber ern ailaddness Pam itExphabm Date
ADDITIDNAL CERTIFIED LABORATORIES
- nun• Labo3atcny t - nfic ■• •
C eltified L aboratDr_y (4 )
Certify-3 Laboratory (5 )
PARAM ETER CODES
■, �• •
Param eterCode a hmaybe obta- e by caIlng the N PD ES U nitat [phone] orby visitiig the Surface
W aterPmtect n Section's w eb site ath2o aw state nc wire qs and tanking to the tmks inform ation pages.
Use only units of e3s mn entdesighawd in the repoxdng facrlity'sN PD ES perm ktbrmpoidig data.
* N o F bw /t) isdharge From S ke: Check this box if no disdhaige oceans and, as a ie`srlt,"trem are no data to be
entemd forallof the paran elms can the D M R forthe ent�e m cnimring period.
* * O R C O n S it e? : 0 R C m ustvisi` fatality and docent entvisitatrm of faality as mquimi per 15A N CA C SG A204 .
* * * S ignatur:e of Perm ittne: If signed by otherthan the pen ittee, then the delegation of the signatory authority m ustbe on
file w ith the state per15A NCAC 2B .05060))(2)0).
Page 2

Permit Enforcement History by Owner
07/07/09
1
Owner: Rockingham County Board of Education
Facility: Bethany Elementary School
Permit: NCO037001
Region: Winston-Salem County: Rockingham
Penalty Remission Enf EMC EMC OAH Collection Has
Assessment Penalty Enforcemen Request Enf Conf Remission Hearing Remission Remission Memo Sent Pmt Case
Case Number MR Approved Amount t Costs Damages Received Held Amount Held Amount Amount to AGO Total Paid Balance Due Plan Closed
LR-1990-0033
01/24/90 $150.00 $.00 $.00
$150.00
$.00 No 02/19/90
LV-2007-0295 5-2007
07/25/07 $250.00 $104.00
$354.00
$.00 No 08/31/07
Total Cases: 2
$400.00 $104.00
$504.00
$.00
Total Penalties: $504.00 Total Penalties after remission(s): $504.00

MONITORING REPORT(MR) VIOLATIONS for:
Report Date: 07/07/09 Page: 1 of 2
PERMIT: NCO037001 FACILITY: Rockingham County Board of Education - Bethany COUNTY: Rockingham REGION: Winston-Salem
Elementary School
Monitoring Violation
MONITORING OUTFALL/
VIOLATION
UNIT OF CALCULATED
REPORT
PPI
LOCATION
PARAMETER
DATE
FREQUENCY
MEASURE LIMIT VALUE
VIOLATION TYPE
VIOLATION ACTION
10 -2008
001
Effluent
DO, Oxygen, Dissolved
10/11/08
Weekly
mg/I
Frequency Violation
None
11 -2008
001
Effluent
DO, Oxygen, Dissolved
11/01/08
Weekly
mg/I
Frequency Violation
None
11 -2008
001
Effluent
DO, Oxygen, Dissolved
11/15/08
Weekly
mg/I
Frequency Violation
None
11 -2008
001
Effluent
DO, Oxygen, Dissolved
11/29/08
Weekly
mg/I
Frequency Violation
None
12 -2008
001
Effluent
DO, Oxygen, Dissolved
12/13/08
Weekly
mg/I
Frequency Violation
None
12 -2008
001
Effluent
DO, Oxygen, Dissolved
12/27/08
Weekly
mg/1
Frequency Violation
None
01-2009
001
Effluent
DO, Oxygen, Dissolved
01/03/09
Weekly
mg/I
Frequency Violation
None
01 -2009
001
Effluent
DO, Oxygen, Dissolved
01/17/09
Weekly
mg/I
Frequency Violation
None
01-2009
001
Effluent
DO, Oxygen, Dissolved
01/31/09
Weekly
mg/I
Frequency Violation
None
02 -2009
001
Effluent
DO, Oxygen, Dissolved
02/14/09
Weekly
mg/1
Frequency Violation
None
02 -2009
001
Effluent
DO, Oxygen, Dissolved
02/28/09
Weekly
mg/I
Frequency Violation
None
03 -2009
001
Effluent
DO, Oxygen, Dissolved
03/14/09
Weekly
mg/I
Frequency Violation
None
03 -2009
001
Effluent
DO, Oxygen, Dissolved
03/28/09
Weekly
mg/I
Frequency Violation
None
12 -2008
001
Effluent
Flow, in conduit or thru
12/27/08
Weekly
mgd
Frequency Violation
None
treatment plant
01 -2009
001
Effluent
Flow, in conduit or thru
01/03/09
Weekly
mgd
Frequency Violation
None
treatment plant
11 -2008
001
Effluent
Temperature, Water Deg.
11/29/08
Weekly
deg c
Frequency Violation
None
Centigrade
12 -2008
001
Effluent
Temperature, Water Deg.
12/27/08
Weekly
deg c
Frequency Violation
None
Centigrade

MONITORING REPORT(MR) VIOLATIONS for: Report Date: 07/07/09 Page: 2 of 2

LWA
PV r A
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins
Governor Director
4 March 2009
Mr. R.W. Holcomb
Rockingham County Schools
511 Harrington Way
Eden, NC 27288
SUBJECT: Compliance Evaluation Inspection
NPDES Permit NCO037001
Bethany Elementary School Wastewater Treatment Plant
Rockingham County
Dear Mr. Holcomb:
Dee Freeman
Secretary
1. Mr. Ron Boone of the Winston-Salem Regional Office (WSRO) of the NC Division of
Water Quality (DWQ or Division) conducted a compliance evaluation inspection (CEI) of
the Bethany Elementary School wastewater treatment plant (WWTP) on 24 February
2009. The assistance and cooperation of Mr. Anthony Doom, Operator in Responsible
Charge (ORC), was greatly appreciated. Inspection findings are summarized below and
an inspection report is attached for your records.
2. The plant is located on the back side (north of) the old Bethany school building, and
southeast of the new school building, on the northeast corner of Bethany Road and NC
Hwy 65, in Reidsville, Rockingham County, North Carolina. The plant currently consists
of a septic tank, a pump or dosing tank, a dual pump system with flow meters and zone
control, a recirculating sand filter and ultraviolet disinfection. Treated wastewater is
discharged from the plant to Huffines Mill Creek, which is currently classified as Class C
waters in the Roanoke River basin.
SITE REVIEW
3. The entire system appears to be very well maintained. No operational or maintenance
issues were noted during the inspection. Mr. Doom stated that the septic tank is being
pumped as needed; the level of solids is monitored and the tank is pumped accordingly.
Records of sludge pumping are kept at Rockingham County Schools' main offices.
4. The plant was not discharging during the inspection. The outfall and receiving stream
were evaluated. There was no foam, floating solids or other signs of detrimental impact
of the discharge to the receiving stream. The right-of-way to the stream is well
maintained.
North Carolina Division of Water Quality, Winston-Salem Regional Office
Location: 585 Waughtown St. Winston-Salem, North Carolina 27107 One
Phone: [phone] FAX: [phone] Customer Service: 1-877-623-6748 NorthCarolina
Internet www.ncwaterquality.org �qtu"a���
An Equal Opportunity 1 Affirmative Action Employer

Mr. R.W. Holcomb
Rockingham County Schools
Bethany Elementary School Wastewater Treatment Plant
NPDES Permit NCO037001
Page2 of 2
DOCUMENTATION REVIEW
5. Mr. Doom's operator visitation records were reviewed and found to be complete and
current. Mr. Doom has various logs that he uses to record different items. It was
suggested that he combine these logs into one bound type book that he could use for his
operation/maintenance (O&M) logbook. He currently does not have a specific O&M
logbook as required. Please note that, although this is the ORC's responsibility,
Rockingham County Schools is ultimately responsible for all such records. Should the
operation of the facility change to another operator at any time in the future, Rockingham
County Schools must retain all O&M records.
6. Discharge monitoring reports (DMR) were reviewed and compared with laboratory
reports. No mistakes or transcription errors were noted. Pace Analytical Laboratories
performs non -field tests and Mr. Doom performs all other field lab tests, i.e. currently pH,
dissolved oxygen and temperature. All lab data, including chains of custody, was
complete and current.
7. No reply to this letter is necessary at this time. If you or Mr. Doom needs assistance or if
you have questions regarding the inspection or this letter, please contact Mr. Boone or
me at [phone].
Sincerely,
*lm��Icl_
Steve W. Tedder
Water Quality Regional Supervisor
Winston-Salem Region
Division of Water Quality
Attachments:
1. BIMS Inspection Checklist
CC: Central Files w/ atchs
NPDES West Unit w/ atchs
WSRO/SWP Files w/ atchs
Anthony Doom
412 Almond Road
Reidsville, NC 27320

United States Environmental Protection Agency
Form Approved.
EPA Washington, D.C. 20460
OMB No. 2040-0057
Water Compliance Inspection Report
Approval expires 8-31-98
Section A: National Data System Coding (i.e., PCS)
Transaction Code NPDES yr/mo/day Inspection Type Inspector Fac Type
1 INI 2 lSl 31 NCO037001 111 121 09/02/24 117 181r1 19u 201 I
IJ lJ l U L J LJ
Remarks
21111111111111111111111111111111111111111111111116
Inspection Work Days Facility Self -Monitoring Evaluation Rating 131 QA ------------ —--------- --- Reserved ------ ------ --------
67I 169 70I t— I 71 I tyf 72 (N I 73 � 74 751 I I I I I I 180
t —
Section B: Facility Data
Name and Location of Facility Inspected (For Industrial Users discharging to POTW, also include
Entry Time/Date
Permit Effective Date
POTW name and NPDES permit Number)
Bethany Elementary School '
01:00 PM 09/02/24
07/06/01
Exit Time/Date
Permit Expiration Date
6371 NC Hwy 65
Reidsville NC 27320
03:30 PM 09/02/24
12/05/31
Name(s) of Onsite Representative(s)/Titles(s)/Phone and Fax Number(s)
Other Facility Data
Anthony Wayne Doom//336=634-3270 /
Anthony Wayne Doom/ORC/336-634-3270/
Name, Address of Responsible Official/Title/Phone and Fax Number
R William Holcomb,511 Harrington Hwy Eden NC Contacted
27288//336-627-2611/3366272660 No
Section C: Areas Evaluated During Inspection (Check only those areas evaluated)
Permit Flow Measurement Operations & Maintenance Records/Reports
Self -Monitoring Program Sludge Handling Disposal Facility Site Review Effluent/Receiving Waters
Laboratory
Section D: Summary of Find in /Comments Attach additional sheets of narrative and checklists as necessary)
(See attachment summary)
Name(s) and Signature(s) of Inspector(s) Agency/Office/Phone and Fax Numbers Date
Ron Boone WSRO WQ//704-663-1699 Ext.2202/
1-4 v �a � xeo�
Signature of nageme�QAeviewer Agency/Office/Phone and Fax Numbers Date
WALL/'1.3- s-of
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete.
Page # 1

NPDES yr/mo/day Inspection Type
3I NCO037001 I11 121
09/02/24 1
17 18LI
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
Please refer to inspection summary letter.
Page # 2

Permit: NCO037001
Owner - Facility: Bethany Elementary School
Inspection Date: 02/24/2009
Inspection Type: Compliance Evaluation
Record Keeping
Yes
No
NA
NE
Are records kept and maintained as required by the permit?
❑
■
❑
❑
Is all required information readily available, complete and current?
■
❑
❑
❑
Are all records maintained for 3 years (lab. reg. required 5 years)?
■
❑
❑
❑
Are analytical results consistent with data reported on DMRs?
■
❑
❑
❑
Is the chain -of -custody complete?
■
❑
❑
❑
Dates, times and location of sampling
■
Name of individual performing the sampling
■
Results of analysis and calibration
■
Dates of analysis
■
Name of person performing analyses
■
Transported COCs
■
.
Are DMRs complete: do they include all permit parameters?
■
❑ ❑
❑
Has the facility submitted its annual compliance report to users and DWQ?
❑
1100
(If the facility is = or > 5 MGD permitted flow) Do they operate 24/7 with a certified operator on each shift?
❑
❑ ■
❑
Is the ORC visitation log available and current?
■
❑ ❑
❑
Is the ORC certified at grade equal to or higher than the facility classification?
■
❑ ❑
❑
Is the backup operator certified at one grade less or greater than the facility classification?
■
❑ ❑
❑
Is a copy of the current NPDES permit available on site?
■
❑ ❑
❑
Facility has copy of previous year's Annual Report on file for review?
❑
❑ ■
❑
Comment: Please refer to inspection summary letter.
Laboratory
Yes
No NA
NE
Are field parameters performed by certified personnel or laboratory?
■
❑ ❑
❑
Are all other parameters(excluding field parameters) performed by a certified lab?
■
❑ ❑
❑
# Is the facility using a contract lab?
■
❑ ❑
❑
# Is proper temperature set for sample storage (kept at less than or equal to 6.0 degrees Celsius)?
❑
❑ ❑
■
Incubator (Fecal Coliform) set to 44.5 degrees Celsius+/- 0.2 degrees?
❑
❑ ❑
■
Incubator (BOD) set to 20.0 degrees Celsius +/- 1.0 degrees?
❑
❑ ❑
■
Comment: Please refer to inspection summary letter.
Effluent Sampling
Yes No NA
NE
Page # 3

Permit: NC0037001 Owner - Facility: Bethany Elementary School
Inspection Date: 02/24/2009 Inspection Type: Compliance Evaluation
Effluent Sampling
Yes
No
NA
NE
Is composite sampling flow proportional?
❑
❑
■
❑
Is sample collected below all treatment units?
■
❑
❑
❑
Is proper volume collected?
■
❑
❑
❑
Is the tubing clean?
❑
❑
■
❑
# Is proper temperature set for sample storage (kept at less than or equal to 6.0 degrees Celsius)?
❑
❑
❑
■
Is the facility sampling performed as required by the permit (frequency, sampling type representative)?
❑
❑
❑
■
Comment: Please refer to inspection summary letter.
Permit
Yes
No NA NE
(If the present permit expires in 6 months or less). Has the permittee submitted a new application?
❑
❑ ■ ❑
Is the facility as described in the permit?
■
❑ ❑ ❑
# Are there any special conditions for the permit?
❑
■ ❑ ❑
Is access to the plant site restricted to the general public?
■
❑ ❑ ❑
Is the inspector granted access to all areas for inspection?
■
❑ ❑ ❑
Comment: Please refer to inspection summary letter.
Septic Tank
Yes
No NA NE
(If pumps are used) Is an audible and visual alarm operational?
■
❑ ❑ ❑
Is septic tank pumped on a schedule?
■
❑ ❑ ❑
Are pumps or syphons operating properly?
■
❑ ❑ ❑
Are high and low water alarms operating properly?
■
❑ ❑ ❑
Comment: Please refer to inspection summary letter.
Sand Filters (Low rate)
Yes
No
NA
NE
(If pumps are used) Is an audible and visible alarm Present and operational?
■
❑
❑
❑
Is the distribution box level and watertight?
❑
❑
■
❑
Is sand filter free of ponding?
■
❑
❑
❑
Is the sand filter effluent re -circulated at a valid ratio?
❑
❑
❑
■
# Is the sand filter surface free of algae or excessive vegetation?
■
❑
❑
❑
# Is the sand filter effluent re -circulated at a valid ratio? (Approximately 3 to 1)
❑
❑
❑
■
Comment: Please refer to inspection summary letter.
Flow Measurement - Effluent
Yes
No
NA
NE
# Is flow meter used for reporting?
■
❑
❑
❑
Page # 4

Permit: NCO037001 Owner - Facility: Bethany Elementary School
Inspection Date: 02/24/2009 Inspection Type: Compliance Evaluation
Flow Measurement - Effluent Yes No NA NE
Is flow meter calibrated annually? ❑ ■ ❑ ❑
Is the flow meter operational? ■ ❑ ❑ ❑
(If units are separated) Does the chart recorder match the flow meter? ❑ ❑ ■ ❑
Comment: Please refer to inspection summary letter.
Disinfection - UV
Yes
No
NA
NE
Are extra UV bulbs available on site?
■
❑
❑
❑
Are UV bulbs clean?
■
❑
❑
❑
Is UV intensity adequate?
■
❑
❑
❑
Is transmittance at or above designed level?
■
❑
❑
❑
Is there a backup system on site?
■
❑
❑
❑
Is effluent clear and free of solids?
■
❑
❑
❑
Comment: Please refer to inspection summary letter.
Pump Station - Effluent
Yes
No
NA
NE
Is the pump wet well free of bypass lines or structures?
■
❑
❑
.❑
Are all pumps present?
■
❑
❑
❑
Are all pumps operable?
■
❑
❑
❑
Are float controls operable?
■
❑
❑
❑
Is SCADA telemetry available and operational?
❑
■
❑
❑
Is audible and visual alarm available and operational?
■
❑
❑
❑
Comment: Please refer to inspection summary letter.
Effluent Pipe
Yes
No
NA
NE
Is right of way to the outfall properly maintained?
■
❑
❑
❑
Are the receiving water free of foam other than trace amounts and other debris?
■
❑
❑
❑
If effluent (diffuser pipes are required) are they operating properly? ❑ ❑ ■ ❑
Comment: Please refer to inspection summary letter.
Operations & Maintenance Yes No NA NE
Is the plant generally clean with acceptable housekeeping? ■ ❑ ❑ ❑
Does the facility analyze process control parameters, for ex: MLSS, MCRT, Settleable Solids, pH, DO, Sludge ■ ❑ ❑ ❑
Judge, and other that are applicable?
Comment: Please refer to inspection summary letter.
Page # 5

A7iA.
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
December 23, 2009
';,s1!n-Sa1
DeotofENR
5126DMr. Anthony W. Doom C U XM
Rockingham County Schools 511 Harrington Highway Ronal C"Ce
Eden, NC 27288-
SUBJECT: Wastewater/Groundwater Laboratory Certification Renewal
FIELD PARAMETERS ONLY
Dear Mr. Doom:
The Department of Environment and Natural Resources, in accordance with the provisions of NC GS 143-215-
.3 (a) (10), 15 NCAC 2H .0800, is pleased to renew certification for your laboratory to perform specified
environmental analyses required by EMC monitoring and reporting regulations 15 NCAC 2B .0500, 2H .0900 and
2L .0100, .0200, .0300, and 2N .0100 through .0800.
Enclosed for your use is a certificate describing the requirements and limits of your certification. Please review
this certificate to insure that your laboratory is certified for all parameters required to properly meet your
certification needs.
Please contact us at 919-733-3908 if you have questions or need additional information.
Sincerely,
n�
0AWV1
Pat Donnelly
Certification Branch Manager
Laboratory Section
Enclosure
cc: Ramon Cook
Dana Satterwhite
Winston - Salem Regional Office
DENR DWQ Laboratory Section NC Wastewater/Groundwater Laboratory Certification Branch
1623 Mail Service Center, Raleigh, North Carolina 27699-1623
Location: 4405 Reedy Creek Road. Raleigh, North Carolina 27607-6445
Phone: [phone] FAX: [phone]
Internet: www.dwqlab.org
An Equal opportunity 1 Affirmative Action Employer Customer Service: 1-877-623-6748 www.ncwaterquality.org
NorthCarofina
Naturally

STATE OF NORTH CAROLINA DEPARTMENT OF THE
ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
LABORATORY CERTIFICATION PROGRAM
In accordance with the provisions of N.C.G.S. 143-215.3 (a) (1), 143-215.3 (a)(10) and NCAC 2H.0800:
2010
ROCKINGHAM COUNTY SCHOOLS
Is hereby certified to perform environmental analysis as listed on Attachment I and report monitoring data to D WQ for
compliance with NPDES effluent, surface water, groundwater, and pretreatment regulations.
By reference 15A NCAC 2H .0800 is made a part of this certificate.
This certificate does not guarantee validity of data generated, but indicates the methodology, equipment, quality control procedures,
records, and proficiency of the laboratory have been examined and found to be acceptable.
This certificate shall be valid until Decemb�er'►3'11,, 2010
Certificate N 5126 (/
Pat Donnelly

1prr Attachment
North Carolina Wastewater/Groundwater Laboratory Certification
Certified Parameters Listing
Lab Name: Rockingham County Schools Certificate Number: 5126
Address: 511 Harrington Highway Effective Date: 01/01/2010
Eden, NC 27288- Expiration Date: 12/31/2010
Date of Last Amendment:
The above named laboratory, having duly met the requirements of 15A NCAC 21-1.0800, is hereby certified for the measurement of the parameters listed below.
CERTIFIED PARAMETERS
INORGANICS
DISSOLVED OXYGEN
Std Method 4500 O C
pH
Std Method 4500 H B
TEMPERATURE
Std Method 2550B
This certification requires maintance of an acceptable quality assurance program, use of approved methodology, and satisfactory performance on evaluation samples. Laboratories are
subject to civil penalties and/or decertification for infractions as set forth in 15A NCAC 21-1.0807.

7-1-1 f ir n"Z/z //e I / 3e b
19111111
JNDIVIDUAL NPDES?WASTEWATER DISCHARGE PERMIT PRE -INSPECTION CHECKLIST
....................
... ............... ............... ........ ..... .............. .......... ...
............... ....
.... ........ ... ........ ... ................... .......
All information/documentation listed below must be available to the DWQ inspector at the scheduled inspection.
.
..........................................
..........................
....................... .... .....
.. ........ .... ............
........
........
............
..................
............
.....
... ............
.......... I ........
.... I ......
................ ........
.... I ...........
............ ...........
1
Discharge Monitoring Reports
Dates:
Through:
2
Lab Data, field and non -field
Dates:
Through:
3
Chain of Custody Forms
Dates:
Through:
4
Copies of current field lab certifications and lab certification 'le:F
5
If outside lab is used to conduct non -field parameters, lab's name and certification number.
6
Complete copy of the NPDES permit Yo,,r
7
Status of SOC or moratorium issuance and ongoing related issues if applicable)
8
ORC and BORC current certifications () K
9
Wastewater annual report if applicable
10
Daily Operator's Log/ORC Visitation Log.
11
Plant operations/maintenance loo 1,1
12.
Process control data, which includes field parameters tested and equipment calibrations 6-1
131
Flow meter calibration records
14
Flow Charts N r1t
15
Influent and effluent samplers PJ tl-
16
Generator inspection and test run records (may ask to runzrierator under load)fF
17
Spill response plan with current emergency contacts tJ
18,Sludge/residuals
hauling records
19
Visual inspection of plant and treatment units 0
20
Stream must be accessible for insRection at dischame Roint
........................
........ .. .. .. .....
............ ... ............ ............
.......... .................................... .......... ......... ........ ... .....
.......... ..... .. ............
Call
with Questions:
Ron Boone
NC Department of Environment and Natural Resources
Division of Water Quality
Winston-Salem Regional Office
[phone]
Fax: [phone]
"&, r5y �Yq-

MONITORING REPORT(MR) VIOLATIONS for:
Report Date: 02/24/09
Page 1 of 1
Permit:
nc0037001
MRs Between: -
and
-
Region: Winston-Saler,,
Violation Category:
Program Category:
Facility Name:
%
Param Name:
County: %
Subbasin:
Violation Action:
Major Minor:
PERMIT: NCO037001
FACILITY: Rockingham County Board of Education - Bethany
COUNTY: Rockingham
REGION: Winston-Salem
Elementary School
Monitoring Violation
MONITORING OUTFALL
/
VIOLATION
UNIT OF
CALCULATED
REPORT
PPI LOCATION
PARAMETER
DATE
FREQUENCY
MEASURE
LIMIT VALUE
VIOLATION TYPE
VIOLATION ACTION
01 -2008
001
Effluent
DO, Oxygen, Dissolved
01/05/08
Weekly
mg/I
Frequency Violation
None
01 -2008
001
Effluent
DO, Oxygen, Dissolved
01/19/08
Weekly
mg/I
Frequency Violation
None
02 -2008
001
Effluent
DO, Oxygen, Dissolved
02/02/08
Weekly
mg/I
Frequency Violation
None
02 -2008
001
Effluent
DO, Oxygen, Dissolved
02/16/08
Weekly
mg/I
Frequency Violation
None
03 -2008
001
Effluent
DO, Oxygen, Dissolved
03/15/08
Weekly
mg/I
Frequency Violation
None
10 -2008
001
Effluent
DO, Oxygen, Dissolved
10/11/08
Weekly
mg/I
Frequency Violation
None
11 -2008
001
Effluent
DO, Oxygen, Dissolved
11/01/08
Weekly
mg/I
Frequency Violation
None
11 -2008
001
Effluent
DO, Oxygen, Dissolved
11/15/08
Weekly
mg/I
Frequency Violation
None
11-2008
001
Effluent
DO, Oxygen, Dissolved
11/29/08
Weekly
mg/I
Frequency Violation
None
12 -2008
001
Effluent
DO, Oxygen, Dissolved
12/13/08
Weekly
mg/I
Frequency Violation
None
12 -2008
001
Effluent
DO, Oxygen, Dissolved
12/27/08
Weekly
mg/I
Frequency Violation
None
12 -2008
001
Effluent
Flow, in conduit or thru
12/27/08
Weekly
mgd
Frequency Violation
None
treatment plant
11-2008
001
Effluent
Temperature, Water Deg.
11/29/08
Weekly
deg c
Frequency Violation
None
Centigrade
12 -2008
001
Effluent
Temperature, Water Deg.
12/27/08
Weekly
deg c
Frequency Violation
None
Centigrade

Permit Enforcement History by Owner
02/24/09
1
Owner: Rockingham County Board of Education
Facility: Bethany Elementary School
Permit: NCO037001
Region: Winston-Salem County: Rockingham
Penalty Remission Enf EMC EMC OAH Collection Has
Assessment Penalty Enforcemen Request Enf Conf Remission Hearing Remission Remission Memo Sent Pmt Case
Case Number MR Approved Amount t Costs Damages Received Held Amount Held Amount Amount to AGO Total Paid Balance Due Plan Closed
LR-1990-0033 01/24/90 $150.00 $.00 $.00 $150.00 $.00 No 02/19/90
LV-2007-0295 5-2007 07/25/07 $250.00 $104.00
Total Cases: 2 $400.00 $104.00
$354.00 $.00 No 08/31/07
$504.00 $•00
Total Penalties: $504.00 Total Penalties after remission(s): $504.00

009 08:43 RCS MAINTENANCE
336 634 3272 P.01/0?
391!
ounty Home Road
Reid
Wille, NC 27320
Fax.`
336.634-3272
PhOna:
336-634-3270
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-2009 08:43
RCS MAINTENANCE
336 634 3272 P.02i07
•
370 West Meadow Road
7 A ^^f ^A'
rierll7KUyh& ;
Eden, NC 27288
W-10�com
I
RECEIVED
SEP
0 8
2008 [phone]
ANALYTICAL RESULTS
Project: 08/27/08
Pace Project No.: 9226475 i
Sample: Effluent i
Lab ID: 9226475001 Collected:
08/27108 08:00
Received: 08/27M 09:45 Matrix Water
Parameters
Results Units Report Limit
DF
Prepared Analyzed CAS No. Qual
25400 Total Suspended Solids;
Analytical Method: SM 2540D
i Total Suspended Solids
11.0 mg/L
2.5
1
08/28/00 08.43
M810 9222D Fecal Collform EDN
Analytical Method: SM 9222D
Fecal Coliforms
2.0 CFU/100 mL
1.0
1
08/27/0812:50 ul
52108 800, Low Level
Analytical Method: SM 5210B
BOD, 5 day
5.0 mg/L
2.0
1
08/28/0818,0o 09102/0815:50 B2
350.1 Ammonia
Analytical Method: EPA 350.1
Nitrogen, Ammonia
I
8.1 mg/L
0.10
1
09/02/08 19:18 776"1.7
i
I
Date: 09/03/2008 08:21 AM
i
REPORT OF LABORATORY ANALYSIS
This report shell not be reproduced, except in full,
without the written consent of Nee Anely ical Services, Inc,
Page 3 of 8

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-2009 08:43
RCS MAINTENANCE
336 634 32?2 P.04i0?
A
370 West Meadow Road
ce lil fQ lyticar
Eden, NC 27288
Y
[phone]
ANALYTICAL RESULTS
Project: WW Testing
16/08
Pace Project No.: 9217419
Sample: Effluent
Lab ID: 9217419001 Collected: 04/16/08 08:00
Recelved: 04/16/08 09:40 Matrix. Water
Parameters
Results Units
Report Limit DF
Prepared Analyzed CAS No. Qual
MB10 92220 Fecal Coliform ED.N
Analytical Method: SM 9222D
Fecal Collforms
7.0 CFU/100 mL -
1,0 1
04/16/08 13:58 u1
2540D Total Suspended Solids;•
Analytical Method: SM 2540D
Total Suspended Solids
4.5 mg/L
1.7 1
04/21/08 16:47
52108 BOD, Low Level
Analytical Method: SM 52106
80D, 5 day I
2.0 mg/L
2,0 1
0418/08 07:50 04/23/08 07:30 86
350.1 Ammonia
Analytical Method: EPA 350.1
Nitrogen, Ammonia
i
12.5 mg/L
1.0 10
04/27/08 23:49 7764-41-7
REPORT OF LABORATORY ANALYSIS
Thle report shell not be reproduced, except In full,
without the written consent of Pace Analytical Services, Inc..
Page 3 of 8

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7-2009 08:44
5ceAnalytical
arw.p9g1aD6,COm
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Project: WW Testing. t
Pace Project No.: 9216501
Sample: Effluent
Parameters
MBIO 9222D Fecal Coliform EDN
Fecal Coliforms
25400 Total Suspended Solids
Total Suspended Solids
62108 BOO, Low Level
BOO, 5 day
350.1 Ammonia
Nitrogen, Ammonia
i
i
RCS MAINTENANCE
ANALYTICAL RESULTS
336 634 3272 P.06i07
370 west Meadow Road
Eden, NC 27288
[phone]
Lab ID: 9216501001 Collected: 04/02/08 08:00
Received: 04/02/08 09:20 Matrix: Water
Results Units
Report Limit
OF
Prepared Analyzed CAS No. Qual
Analytical Method., SM 9222D
NO CFU/100 mL
1.0
1
04i02108 13:34
Analytical Method: SM 25400
4.5 mg/L
1.7
1
04/07/0819:34
Analytical Method: SM 52106
4.6 mg/L
2.0
1
04/04/06 07:00 04/09/08 09:00 B4. B5
Analytical Method: EPA 350.1
3.7 mg/L
0.10
1
04/15/081123 7764 41-7
i
Date: 04/15/2008 05:21 PM REPORT OF LABORATORY ANALYSIS Page 3 of 8
This report shall not be reproduced. except in full,
without the written consent of Pecs Analytical Services, Inc,•

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December 19, 2008
5126
Mr. Anthony W. Doom
Rockingham County Schools
511 Harrington Highway
Eden, NC 27288-
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
SUBJECT: Wastewater/Groundwater Laboratory Certification Renewal
FIELD PARAMETERS ONLY
Dear: Mr. Doom
Coleen H. Sullins, Director
Division of Water Quality
RECEIVED
14 1 Deot. of ENR
JAN 0 6 2009
,soon -Salem
Regional Office
The Department of Environment and Natural Resources, in accordance with the provisions of NC GS 143-215-.3
(a) (10), 15 NCAC 2H .0800, is pleased to renew certification for your laboratory to perform specified
environmental analyses required by EMC monitoring and reporting regulations 15 NCAC 26 .0500, 2H .0900 and
2L .0100, .0200, .0300, and 2N .0100 through .0800.
Enclosed for your use is a certificate describing the requirements and limits of your certification. Please review
this certificate to insure that your laboratory is certified for all parameters required to properly meet your
certification needs.
Please contact us at 919-733-3908 if you have questions or need additional information.
Sincerely,
Pat Donnelly
Certification Branch Manager
Laboratory Section
Enclosure
cc: Ramon L. Cook
Dana Satterwhite
Winston-Salem Regional Office
Noce Carolina
Xatura!!y
Laboratory Section 1623 Mail Service Center; Raleigh, NC 27699-1623 Phone [phone]
Location: 4405 Reedy Creek Road; Raleigh, NC 27607 FAX [phone]
Internet: www.dwglab.org/Customer Service 1-877-623-6748
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STATE OF NORTH CAROLINA DEPARTMENT OF THE
ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
LABORATORY CERTIFICATION PROGRAM
In accordance with the provisions of N.C.G.S. 143-215.3 (a) (1), 143-215.3 (a)(10) and NCAC 2H.0800:
Field Parameter Only
ROCKINGHAM COUNTY SCHOOLS
Is hereby certified to perform environmental analysis as listed on Attachment 1 and report monitoring data to DWQ for
compliance with NPDES effluent, surface water, groundwater, and pretreatment regulations.
By reference 15A NCAC 2H .0800 is made a part of this certificate.
This certificate does not guarantee validity of data generated, but indicates the methodology, equipment, quality control procedures,
records, and proficiency of the laboratory have been examined and found to be acceptable.
This certificate shall be valid until December 31, 2009
Certificate No. 5126

Attachment
North Carolina Wastewater/Groundwater Laboratory Certification
Certified Parameters Listing
FIELD PARAMETERS ONLY
i County Schools
ton Highway
Eden, NC 27288-
Certificate Number: 5126
Effective Date: 01/01/2009
Expiration Date: 12/31/2009
Date of Last Amendment:
The above named laboratory, having duly met the requirements of 15A NCAC 21-1.0800, is hereby certified for the measurement of the parameters listed below.
CERTIFIED PARAMETERS
INORGANICS
DISSOLVED OXYGEN
Std Method 4500 O C
pH
Std Method 4500 H B
TEMPERATURE
Std Method 2550B
This certification requires maintance of an acceptable quality assurance program, use of approved methodology, and satisfactory performance on evaluation samples. Laboratories are
subject to civil penalties and/or decertification for infractions as set forth in 15A NCAC 21-1.0807.

August 11, 2008
5126
Mr. Anthony W. Doom
Rockingham County Schools
511 Harrington Highway
Eden, NC 27288-
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Coleen H. Sullins, Director
Division of Water Quality
RECEIVED
N.C, Deot of ENR
AUG 2 2 2g6
f, .,.. -.
SUBJECT: North Carolina Wastewater/Groundwater Laboratory Certification (NC WW/GW LC)
Laboratory Certification Maintenance Inspection
Dear Mr. Doom
Enclosed is a report for the inspection performed on July 8, 2008 by Mr. Ramon Cook.
Where finding(s) are cited in this report, a response is required. Within thirty days of receipt,
please supply this office with a written item for item description of how these finding(s) were
corrected. If the finding(s) cited in the enclosed report are not corrected, enforcement actions
may be recommended. For certification maintenance, your laboratory must continue to carry
out the requirements set forth in 15A NCAC 2H .0800.
Copies of the checklists completed during the inspection may be requested from this
office. Thank you for your cooperation during the inspection. If you wish to obtain an electronic
copy of this report by email or if you have questions or need additional information, please
contact us at 919-733-3908.
Sincerely,
Dana Satterwhite
Certification Unit Supervisor
Laboratory Section
Enclosure
cc: Ramon Cook
Winston-Salem Regional Office
Noce hCarolina
�txu11,V
North Carolina Division of Water Quality 1623 Mail Service Center Raleigh, NC 27699-1623 Phone [phone] Customer Service
Internet: www.dwqlab.org Location: 4405 Reedy Creek Rd Raleigh, NC 27607 Fax [phone]
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LABORATORY NAME:
NPDES PERMIT #:
ADDRESS:
CERTIFICATE #:
DATE OF INSPECTION:
TYPE OF INSPECTION:
AUDITOR(S):
On -Site Inspection Report
Rockingham County Schools
NCO037001
511 Harrington Highway
Eden, NC 27788
5126
July 8, 2008
Field Maintenance
Ramon Cook
LOCAL PERSON(S) CONTACTED: Anthony Doom
INTRODUCTION:
This laboratory was inspected to verify its compliance with the requirements of 15A NCAC 2H .0800 for the
analysis of environmental samples.
II. GENERAL COMMENTS:
The laboratory is spacious and well equipped. All facilities and instrumentation are well maintained.
Some further quality control procedures need to be implemented. A technical assistance document is
attached for ATC verification and temperature sensor check of the pH meter.
III. FINDINGS, REQUIREMENTS, COMMENTS AND RECOMMENDATIONS:
Temperature — Standard Methods, 18"' Edition, 2550 B
pH — Standard Methods, 18"' Edition, 4500 H B
A. Finding: The temperature sensing device on the pH meter, and thermometers used to obtain
temperature readings has not been calibrated against an NIST certified or traceable
thermometer annually (i.e., every 12 months) and the temperature corrections were not posted.
Requirement: All temperature sensing devices on meters must be calibrated against a NIST
certified or NIST traceable thermometer annually (every 12 months) and proper corrections
made and documented. Ref: TECHNICAL ASSISTANCE FOR FIELD ANALYSIS OF pH and
Temperature dated 9/07. (See Attachment for Procedure) Please send a copy to our office
with your reply.
pH — Standard Methods, 18t' Edition, 4600 H+ B
B. Finding: The Automatic Temperature Compensator (ATC) has not been verified.
Requirement: The ATC must be verified annually (i.e., every twelve months) by analyzing a
buffer at 25 °C (the temperature that pH values are compensated to) and a temperature(s) that
bracket the temperature ranges of the samples to be analyzed. This may require the analysis of
a third temperature reading that is > 25°C. Ref: North Carolina Wastewater/Groundwater

IFPe 2
PON26 Rockingham County Schools
Laboratory Certification (NC WW/GW LC) Policy Statement September 2007. (See Attachment
for Procedure) Please send a copy to our office with your reply
IV. PAPER TRAIL INVESTIGATION:
The paper trail consisted of comparing laboratory bench sheets and contract lab reports to Discharge
Monitoring Reports (DMRs) submitted to the North Carolina Division of Water Quality. Data were
reviewed for the following months: February 2008, March 2008, April 2008, and May 2008. The
following errors were noted:
Date
Parameter
Location
Value on Benchsheet
Value on DMR
2/13/2008
Temp
Effluent
9.0 °C
10.0 °C
2/13/2008
pH
Effluent
7.1 s.u.
7.3 s.u.
3/5/2008
DO
Effluent
13.0 mg/1
10.0 mg/1
4/2/2008
DO
Effluent
13.0 mgn
9.0 mg/1
4/9/2008
Data taken -No
documentation
Effluent
Data taken -No documentation
Data taken -No
documentation
4/16/2008
DO
Effluent
10.0 mg/1
9.0 mg/1
4/23/2008
DO
Effluent
10.0 mg/1
9.0 mg/1
4/30/2008
DO
Effluent
10.0 mgn
9.0 mg/1
5/7/2008
pH
Effluent
7.6 s.u.
6.9 s.u.
5/11/2008
DO
Effluent
8.0 mg/1
11.0 mg/1
5/18/2008
Temperature
Effluent
18 °C
19 °C
5/28/2008
DO
Effluent
8.0 mg/1
11.0 mgn
In order to avoid a possible monitoring frequency violation or questions of legality, it is recommended
that you contact the appropriate Regional Office for guidance as to whether amended Discharge
Monitoring Reports will be required. A copy of this report will be forwarded to the Winston-Salem
Regional Office.
V. CONCLUSIONS:
Correcting the above -cited findings and implementing the recommendations will help this lab to produce
quality data and meet certification requirements. The inspector would like to thank the staff for its
assistance during the inspection and data review process. Please respond to all findings.
Report prepared by: Ramon L. Cook Date: July 14, 2008
Report reviewed by: Tonja Springer Date: August 1, 2008

Technical Assistance Procedure
Automatic Temperature Compensator (ATC) Check Procedure for pH meter:
The following must be performed on an annual (i.e., 12 month) basis:
1. Pour an adequate amount of buffer into a beaker or other container and analyze at 250 C.
Document the temperature and pH value.
2. Lower the temperature of the buffer by placing the container in cool water or a refrigerator
to less than the lowest anticipated sample temperature and analyze. Document the
temperature and pH value.
3. If samples greater than 25" C are to be analyzed, perform the following additional step:
Place the container in warm water, or a water bath and raise the temperature above 250 C
to greater than the highest anticipated sample temperature and analyze. Document the
temperature and pH value.
As the temperature increases or decreases, the value of the buffer must be within ± 0.1 S.U. of
the true value of the buffer.
Comment: Anticipated temperatures can be obtained from a review of the Discharge Monitoring
Reports (DMRs) from the peak summer and winter months. Historical data should provide a
reasonably accurate estimation of ranges that will bracket the expected sample temperatures.
Temperature Sensor Check Procedure:
To check a thermometer or the temperature sensor of a meter, read the temperature of the
thermometer/meter against a NIST thermometer and record the two temperatures. The
thermometer/meter readings must be less than or equal to 1°C from the NIST thermometer
reading. (NC WW/GW LC Policy). In the documentation include the serial number and
manufacturer of the NIST thermometer or NIST traceable thermometer that was used in the
comparison. Also document any correction that applies (even if zero) on both the
thermometer/meter and on a separate sheet to be filed.
Recommendation: Use a NIST calibrated thermometer that approximates the temperature range
on each thermometer used with an incubator, refrigerator, or freezer. You may borrow such a
thermometer, but keep a copy of the traceable to NIST certificate on file to show the inspector.
Requirement: All thermometers and temperature measuring devices must be checked every
12 months against a NIST certified or NIST traceable thermometer and the process
documented. NIST certified or NIST traceable thermometers used for temperature
measurement must be recalibrated in accordance with the manufacturer's recalibration date. If
no recalibration date is given, the NIST certified or NIST traceable thermometer must be
recalibrated on a periodic basis to not exceed five years. Ref: Technical Assistance for Field
Analysis for Temperature dated 9/07.

=i
Coleen H. Sullins, Director
Division of Water Quality
January 11, 2008
Mr. R. W. Holcomb
Rockingham County Schools
511 Harrington Highway
Eden, NC 27288
Subject: Notice of Violation - Effluent Limitations
Bethany Elementary School
NPDES No. NCO037001
NOV-2008-LV-0021
Rockingham County
Dear Mr. Holcomb:
A review of the self -monitoring report for the month of October 2007, revealed the following
effluent limit violation(s):
MONTHLY AVERAGE
Parameter Permit Limit Reported Value Units
NH3 14.0 16.1 mg/l
. Remedial actions, if not already implemented should be taken to correct the above
noncompliance problem(s). Please be aware that violations of your NPDES permit could subject you
to enforcement action by this Division with the possible assessment of civil penalties of up to
$25,000 per day per violation. Should you have any questions, please do not hesitate to contact
David Russell at [phone].
Sincerely,
Steve W. Tedder
Water Quality Supervisor
cc: Compliance Group
Central Files
WSRO
rNone Cary ina
at
North Carolina Division of Water Quality 585 Waughtown Street
Winston-Salem Regional Office Winston-Salem, NC 27107
Internet: www.ncwatgAuality.org
Phone [phone] Customer Service
Fax [phone]
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Cover Sheet from
Staff Member to
Regional Supervisor
DMR Review Record
Facility: Permit/Pipe No.: AJ" D °-37 Month/Year v 7
Monthly Average Violations
Parameter Permit Limit DMR Value % Over Limit
Weekly/Daily Violations
Date Parameter Permit Limit/1•vj2e DMR Value % Over Limit
Monitoring Frequency Violations
Date Parameter Permit Frequency Values Reported # of Violations
Other Viol ions Ale
/v o h-QI- /- ,�-- D 7
Completed by- Date:
Regional Water Quality
Supervisor Signoff: Date:

NPDES PERMIT NO.� IU
FACILITY NAME
CERTIFIED LABORATORY (1)
(list additional laboratories on the backside/page 2 of this
OPERATOR IN RESPONSIBLE CHARGE ORC
PERSON(S) COLLECTING SAMPLES
CHECK BOX IFORC HAS CHANGED
Mail ORIGINAL and ONE COPY to:
ATTN: CENTRAL FILES
DIVISION OF WATER QUALITY
1617 MAIL SERVICE CENTER
RALEIGH, NC 276"-1617
EFFLUENT
CAA
DEC (P 4 no/
KNW
DISCHARGE NO. da I MONTH • YEAR
CLASS COUNTY 1 '
CERTIFICATION NO.
GRADE 7 CERTIFICATION NO.,
ORCPHONE iC'1
NO FLOW / DISCHARGE FROM SITE
x
BY THIS SIGNATURE, 1 Cb(TIFY THAT THIS REPORT IS
ACCURATE AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
II I
III I
II�II
III
II I
I1� I
II I
®"
II II
tl�ll
11��
____
1 UNITS BELOW
�'NAME
©r"
IDS►��bz.����-____�___�__MOM
MWLE��
D W Q Foan M R -1 (11,04)

Facility Status: (Please check one of the fb1bw ng)
A Ilm ornitori ng data and san p]itg frequencies m eetpexn itrequ= ezts
(inc]uding w eekly averages, if applicable) El
C an pliant
A Ilm onitDring data and sam pliig frequencies do N 0 T m eetpemt it r xNham ents [��?
N oncom pliant
The peon ittee shall iEportto the D bectiororthe appropriate R egb nalO ff:b-- any noncom plianoe ftitpotendaDy
threatens public health orthe env irorim ent Any hfomn ation shanbe pmvided orally w nth in 24 houm fm)m the tin e the
peon Itee becam a aw are of the cira n stances. A w rhan subm ission shallalso be provi]ed w ]thin 5 days of the tin e the
peon ittee beacxn es aw am of the circum stances.
If tare facility isncncom phant,pbass attach a ]istof corrective actonsbeing taken and a tin e-table for
in proven eats to be made as requlred by Part IIE .6 of the N PD E S permit.
"I aettify, underpenalty of law, that this doc..an entand alladadin eats w ere prepared underm y dnecti:)n or a pexvision
fn acaoaiance- w ith a system designed to asa ire tbatqua]ibad perronnelpmpedy gatherand evalrate the infDrm ation
subs fitted. B aced on m y inquiry of the person orpenDris w ho m anaged the system , or those penons directly reEponsible
forgatheirg the inform ation, the xifortn ation s ibm hied is, to the bestof m y know ]edge and belief, Wie, aca uate, and
complete. lam aw aie thatthere am significantpenaldes fDrsubm kd ng t 0se- atfDmt amn, ncbding the posdbil ty of
fines and inprEormentfDrknowingviolations ,
i"y/l- d o-p- L-, AJ
bcAj-- )rk/ ad /,,
R. WILLIAM HOLCOMB
Peunittee CP lease prntortype)
�.J2 Signat m of Peon kt6e*** D ate
OR equimd unless srtm ittBd �)
f
511 HARRINGTON HIGH DEN NC 27288 336-627-2600
Pam imee A Phcm N um bet ern ai7addnam Penn it Expnabm D ate
ADDITIDNAL CERTIFIED LABORATORIES
-u•a• LaboiatDry i ertiGzation N •
CerdfipdLaboratory (4)
Certified LaboiatDry (5)
PARAM ETER CODES
Tel • Mrs • •
- � fir_. �•�� •
Paran eterC ode a. nce m ay be obtained by caIlixd the N PD E S U nitat [phone] orby visiting the Sulftoe
W aterPmtecticn Section's web site ath2o air -state nc use as and linking to the units hfbim ation pages.
RE x7r%
Use only units ofm easuian eitdesignated in the leportirg f—litj,'sN PD ES peen itformportarg data.
* No Flow A) isdrarge From Site: Check this box if no dis:haige ooaus and, as a u-n i h these am no data tD be NOV 2 8 20,07
a ft-m-A brallof the pa3-.m scnthe DM R fnrtheentimmcmitixaigpemd. Information Processing Unit
* * O R C On Site?: O R C m ustvisit facility and docun entvisiation of fac:rl$y as mcp Hind per15A N CA C 8G .0204. D W Q1B 0G
* * * S ijnature of P erm it We: If signed by other than the perm Vie, then the delegation of the siiato y aurho»y m ustbe on
file with the state per 15A N CA C 2B A506 0t) (2) 0)) .
Page 2

UNITED STATES OS7AL'$ERVICE First -Class Mail
Postage & Fees Paid
USPS
Permit No. G-10
• Sender�_Please print your name, address, and ZIP+4 in this box •
DIVISION OF WATER RESOURCES
Water Quality Regional Operations
450 West Hanes Mill Road, Suite 300
Winston-Salem, NC 27105
JIMP

■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece
or on the front if space permits.
1, Article Addressed to:
Mr, Roiney Shotwell
Rockingham Co, Board of ljc:ation
511 Harrington Highway
Eden, NC 27288
-k-V - D
A. nature
X eq-(
❑ Agent
ved b ( rinted Name)\J C. Date of E
ec E
D. Is delivery address differe from_ item 1? ❑ Yes
If YES, enter delivery address below: P( No
'4/N 19
3. Ser0te Type
Certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
7011 1570 0001 8546 2989
IS Form 3811, February 2004 Domestic Return Receipt ( . J ;:� �; r, _Sgk 102595-02-M-154