NC0044954_Fact Sheet_20220831

DocuSign Envelope ID: 7AE9F06B-1209-4A45-9C3D-E7777A1A53F8
FACT SHEET FOR EXPEDITED PERMIT RENEWALS
This form must be completed by Permit Writers for all expedited permits which do not require
full Fact Sheets. Expedited permits are generally simple 100% domestics (e.g., schools, mobile
home parks, etc.) that can be administratively renewed with minor changes but can include
facilities with more complex issues (Special Conditions, 303(d) listed water, toxicity testing,
instream monitoring, compliance concerns).
Basic Information for Ex edited Permit Renewals
Permit Writer/Date
Charles Weaver — 8/30/2022
Permit Number
NC0044954
Facility Name
South Stokes High School
Basin Name/Sub-basin number
Roanoke / 03-02-01
Receiving Stream
Little Neatman Creek
Stream Classification in Permit
C
Does permit need Daily Maximum NH3
limits?
N/A
Does permit need TRC limits/language?
No — already present
Does permit have toxicity testing?
Yes. All tests passed since 2016.
Does permit have Special Conditions?
No
Does permit have instream monitoring?
No
Is the stream impaired (on 303(d) list)?
No
Any obvious compliance concerns?
No enforcements since 2012. No
NODs/NOVs during this permit cycle.
Any permit mods since last permit?
No
New expiration date
2/28/2027
Changes to Draft Permit?
Installed ammonia limits and removed tox test
as per 2016 NH3 guidance. Gave compliance
schedule until January 2027 to allow for
treatment upgrades.
Most Commonly Used Expedited Language:
• 303(d) language for Draft/Final Cover Letters: "Please note that Cane Creek is listed
as an impaired waterbody on the North Carolina 303(d) Impaired Waters List.
Addressing impaired waters is a high priority with the Division, and instream data will
continue to be evaluated. If there is noncompliance with this permit's effluent limits and
stream impairment can be attributed to your facility, then mitigative measures may be
required".

DocuSign Envelope ID: 7AE9F06B-1209-4A45-9C3D-E7777A1A53F8
South Stokes High School
N C0044954
Prepared By: Charles Weaver
Enter Design Flow (MGD):
Enter s7Q10(cfs):
Enter w7Q10 (cfs):
IWC Calculations
0.0173
0.27
0.68
Residual Chlorine
7Q10 (cfs)
DESIGN FLOW (MGD)
DESIGN FLOW (cfs)
STREAM STD (ug/L)
UPS BACKGROUND LEVEL (l
IWC (%)
Allowable Conc. (ug/I)
Fecal Limit
(If DF >331; Monitor)
(If DF <331; Limit)
Dilution Factor (DF)
NPDES Servor/Current Versions/IWC
0.27
0.0173
0.026815
17.0
0
9.03
188
200/100m1
11.07
Ammonia (NH3 as N)
(summer)
7Q10 (CFS)
DESIGN FLOW (MGD)
DESIGN FLOW (cfs)
STREAM STD (mg/L)
UPS BACKGROUND LEVEL (mg/L)
IWC (%)
Allowable Conc. (mg/I)
Ammonia (NH3 as N)
(winter)
7Q10 (CFS)
DESIGN FLOW (MGD)
DESIGN FLOW (cfs)
STREAM STD (mg/L)
UPS BACKGROUND LEVEL (mg/L)
IWC (%)
Allowable Conc. (mg/I)
0.27
0.0173
0.02682
1.0
0.22
9.03
8.9
0.68
0.0173
0.02682
1.8
0.22
3.79
41.9
8/31/2022

DocuSign Envelope ID: 7AE9F06B-1209-4A45-9C3D-E7777A1A53F8
NORTH CAROLINA
STOKES COUNTY
AFFIDAVIT OF PUBLICATION
Before the undersigned, a Notary Public of said County and State, duly
commissioned, qualified and authorized by law to administer oaths,
personally appeared Sandra Hurley who being first duly
sworn, deposes and says: that he (she) is Regional Publisher
(Publisher or other officer or employee authorized to make affidavit) of
ADAMS PUBLISHING GROUP, LLC, engaged in the publication of a
newspaper known as THE STOKES NEWS, published, issued, and entered
as periodicals class mail in the city of King in said County and State; that
he (she) is authorized to make this affidavit and sworn statement; that the
notice or other legal advertisement, a true copy of which is attached hereto,
was published in THE STOKES NEWS on the following dates:
and that the said newspaper in which such notice, paper, document or
legal advertisement was published was, at the time of each and every such
publication, a newspaper meeting all of the requirements and
qualifications of Section 1-597 of the General Statutes of North Carolina
and was a qualified newspaper within the meaning of Section 1-597 of the
General Statutes of North Carolina.
This rr i4 d f
ay o y
LIADif
Signatu of person making idavit /
Sworn to and subscribed before me, this 2 7
, 2022
My Commission expires: / /i 8 / 2. 3
FERRIS W. SIMPSON
NOTARY PUBLIC
SURRY COUNTY, N.C.
, 2022
day of
Public Notice
North Carolina
Environmental Management
Commission/NPDES Unit
1617 Mail Service Center
Raleigh, NC 27699-1617
Notice of Intent to Issue a NP-
DES Wastewater Permit
NC0044954 South Stokes
High School WWTP, and
NC0087980 Pine Hall Ele-
mentary School WWTP
The North Carolina Environ-
mental Management Commis-
sion proposes to issue a NP-
DES Wastewater discharge •
permit to the person(s) listed
below. Written comments re-
garding the proposed permit
will be accepted until 30 days
after the publish date of this
notice. The Director of the NC
Division of Water Resources
(DWR) may hold a public hear-
ing should there be a signific-
ant degree of public interest.
Please mail comments and/or
information requests to DWR
at the above address. Inter-
ested persons may visit the
DWR at 512 N. Salisbury
Street, Raleigh, NC 27604 to
review information on file. Ad-
ditional information on NPDES
permits and this notice may be
found on our website:
http://deq. nc.gov/about/divi-
s ions/water-resources/wate r-
re sou rces-perm its/wastewater-
branch/n pdes-wastewate r/pu b-
lic-notices,or by calling (919)
707-3601. The Stokes County
Board of Education (PO Box
50. Danbury, NC 27016) has
requested renewal of NPDES
permit NC0044954 for the
South Stokes High School
WWTP. This permitted facility
discharges treated wastewater
to Little Neatman Creek in the
Roanoke River Basin. Cur-
rently, fecal coliform and total
residual chlorine are water
quality limited. This discharge
may affect future allocations in
this portion of the Roanoke
River Basin. The Stokes
County Board of Education
(P.O. Box 50, Danbury, NC
27016-0050) has requested re-
newal of NPDES permit
NC0087980 for the Pine Hall
Elementary School WWTP.
This permitted facility dis-
charges treated domestic
wastewater to Eurins Creek in
the Roanoke River Basin. Cur-
rently, fecal coliform is water
quality limited. This discharge
may affect future allocations in
this portion of the Roanoke
River Basin.
Publish: 6-23-22 70061991x2

DocuSign Envelope ID: 7AE9F06B-1209-4A45-9C3D-E7777A1A53F8
Water Resources
ENVIRONMENTAL QUALITY
NC Department of
Environmental Quality
Received
AUG 222016
Winston-Salem
Regional Office
Mr. Ricky Gains, Director of Maintenance
Stokes County Schools
PO Box 50
Danbury, NC 27016
Dear Mr. Goins:
August 16, 2016
PAT MCCRORY
DONALD R. VAN DER VAART
Secretary
S. JAY ZIMMERMAN
Director
Subject: Permit Renewal
Application No. NC0044954
South Stokes High School
Stokes County
The Water Quality Permitting Section acknowledges receipt of your permit application and
supporting documentation received on August 12, 2016. The primary reviewer for this renewal
application is Charles Weaver.
The primary reviewer will review your application, and he will contact you if additional
information is required to complete your permit renewal. Per G.S. 150B-3 your current permit
does not expire until permit decision on the application is made. Continuation of the current permit
is contingent on timely and sufficient application for renewal of the current permit.
If you have any additional questions concerning renewal of the subject permit, please
contact Charles Weaver at 919-807-6391 or [e-mail].
Sincerely,
Meet 76e rd
Wren Thedford
Wastewater Branch
cc: Central Files
NPDES
Winston-Salem Regional Office
State of North Carolina f Envirwnnental Quality] Water Resources
t617 Mail Service Center 1 Raleigh, North Carolina 27699-I617
919-807-6300

DocuSign Envelope ID: 7AE9F06B-1209-4A45-9C3D-E7777A1A53F8
Stokes County Schools
STOKES COUNTY BOARD OF EDUCATION
Sonya M. Cox, Chair
Patricia M. Messick, Vice Chair
Rebecca P. Boles
William F. Hart
Jamie B. Yontz
SUPERINTENDENT
Dr, Brad Rice
ASSISTANT SUPERINTENDENT
Tony George
www.stokes.k12.nc.us . 100 Courthouse Circle PO Box 50 Danbury, NC 27016 Phone: [phone] . Fax: [phone]i
August 5, 2016
NCDENR/DWRINPDES Unit
1617 Mail Service Center
Raleigh, NC 27699-1617
Attn: Mr. Wren Thedford
Re: South Stokes High School WWTP NPDES Renewal Application Cover Letter
NC NPDES Permit No. NC0044954
Stokes County, NC
AUG 2n.rn
Dear Mr. Thedford,
As required for all NPDES renewal application packaages, on behalf of the Stokes County Board of Education,
we request renewal of the South Stokes High School WWTP NPDES Premit No. NC0044954.
The following is a list of all changes made to the WWTP facility since the issuance of the last premit.
• Upgraded the existing WWTP from a single pass sand filter systm to a recirculating sand filter system.
• Installed WWTP effluent recirculating system, including recirculation tank, duplex dual alternating
recirculating pumps, duplex time dosing control panel and control floats, recirculation force mains, and
recirculation by-pass valve.
• Install new tablet chlorine disinfection unit, chlorine conatct tank, and tablet dechlorination unit.
The above referenced changes to the WWTP were completed in compliance with the Authorization to Construct
No. 049954A02.
Sincerely,
Stokes County Schools
Ricky Goins, Director of Maintenance
„ of

DocuSign Envelope ID: 7AE9F06B-1209-4A45-9C3D-E7777A1A53F8
Stokes County Schools
STOKES COUNTY BOARD OF EDUCATION
Sonya M. Cox, Chair
Patricia M. Messick, Vice Chair
Rebecca P. Boles
William F. Hart
Jamie B. Yontz
SUPERINTENDENT
Dr. Brad Rice.
ASSISTANT SUPERINTENDENT
Tony George
wwwstokes.kt2.nc.us . 100 Courthouse Circle . Po Box 50 . Danbury, NC 27016 . Phone: [phone] Pax: 336-593-2041
August 5, 2016
Sludge Management Plan
For
South Stokes High School WWTP
NPDES No. 0044962
The South Stokes High School WWTP utilizes both grease traps and septic tanks to capture solids generated by
the school. Stokes County Schools contracts with a licensed septage management firm to pump all tanks and
dispose of as required by North Carolina Division of Waste Management.
Slakes County Schools
Ricky Goins, Director of Maintenance

DocuSign Envelope ID: 7AE9F06B-1209-4A45-9C3D-E7777A1A53F8
NPDES APPLICATION - FORM D
For privately -owned treatment systems treating 100% domestic wastewaters <1.0 MGD
Mail the complete application to:
N. C. DENR / Division of Water Quality / NPDES Unit
1617 Mail Service Center, Raleigh, NC 27699-1617
NPDES Permit
NC0044954
If you are completing this form in computer use the TAB key or the up - down arrows to move from one
field to the next. To check the boxes, click your mouse on top of the box. Otherwise, please print or type.
1. Contact Information:
Owner Name Stokes County Board of Education
Facility Name South Stokes High School WWTP
Mailing Address P.O. Box 50
City Danbury
State / Zip Code NC 27016
Telephone Number [phone]
Fax Number [phone]
e-mail Address [e-mail]
2. Location of facility producing discharge:
Check here if same address as above ❑
Street Address or State Road 1100 South Stokes High Drive
City
State / Zip Code
County
Walnut Cove
NC 27052
Stokes
3. Operator Information:
Name of the firm, public organization or other entity that operates the facility. (Note that this is not
referring to the Operator in Responsible Charge or ORC)
Name Research and Analytical Laboratories, Inc.
Mailing Address P.O. Box 473 - 106 Short Street
City Kernersville
State / Zip Code NC 27285 - 27284
Telephone Number [phone]
Fax Number { }
e-mail Address [e-mail]
1 of 3
Form-D 11/12

DocuSign Envelope ID: 7AE9F06B-1209-4A45-9C3D-E7777A1A53F8
a
Type
Hazardous Waste (RCRA)
UIC (SDWA)
NPDES
PSD (CAA)
Non -attainment program (CAA)
NPDES APPLICATION - FORM D
For privately -owned treatment systems treating 100% domestic wastewaters <1.0 MGD
10. Flow Information:
Treatment Plant Design flow 0.0173 MGD
Annual Average daily flow 0.0037 MGD (for the previous 3 years)
Maximum daily flow 0.0172 MGD (for the previous 3 years)
11. Is this facility located on Indian country?
❑ Yes ® No
12. Effluent Data
NEW APPLICANTS: Provide data for the parameters listed. Fecal Coliform, Temperature and pH shall be grab
samples, for all other parameters 24-hour composite sampling shall be used. If more than one analysis is reported,
report daily maximum and monthly average. If only one analysis is reported, report as daily maximum.
RENEWAL APPLICANTS: Provide the highest single reading (Daily Maximum) and Monthly Average over
the past 36 months for parameters currently in your permit. Mark other parameters "N/A".
Units of
Measurement
Parameter
Biochemical Oxygen Demand (BOD5)
Fecal Coliform.
Total Suspended Solids
Temperature (Summer)
Temperature (Winter)
pH
Daily
Maximum
36.5
224
16
25
18
8.2
Monthly
Average
12.79
1.4
2.25
19.66
9.72
N/A
13. List all permits, construction approvals and/or applications:
Permit Number Type
NESHAPS (CAA)
Ocean Dumping (MPRSA)
NC0044954 Dredge or fill (Section 404 or CWA)
Other
MG/L
C01 / 100ML
MG/ L
oC
oC
SU
Permit Number
14. APPLICANT CERTIFICATION
I certify that I am familiar with the information contained in the application and that to the
best of my knowledge and belief such information is true, complete, and accurate.
Ricky Goins Director of Maintenance
Panted name of Person Signing Title
Fs-
Signaatur&of Applicant
North Carolina General Statute 143.215,6 (b)(2) states: Any person who knowingly makes any false statement representation, or certification in any
application, record, report, plan, or other document files or required to be maintained under Article 21 or regulations of the Environmental Management
Commission implementing that Article, or who falsifies, tampers with, or knowingly renders inaccurate any recording or monitoring device or method
required to be operated or maintained under Article 21 or regulations of the Environmental Management Commission implementing that Article, shall be
guilty of a misdemeanor punishable by a fine not to exceed $25,000, or by imprisonment not to exceed six months, or by both. (18 U.S.C. Section 1001
provides a punishment by a fine of not more than $25,000 or imprisonment not more than 5 years, or both, for a similar offense.)
Date
3 of 3
Form-D 11/12

DocuSign Envelope ID: 7AE9F06B-1209-4A45-9C3D-E7777A1A53F8
Stokes County Schools
STOKES COUNTY BOARD OF EDUCATION
Sonya M. Cox, Chair
Patricia M. Messick, Vice Chair
Rebecca P. Boles
William F. Hart
Jamie B. Yontz
SUPERINTENDENT
Dr. Brad Rice
ASSISTANT SUPERINTENDENT
Tony George
www.stokes.k12.nc.us . 100 Courthouse Circle . PO Box 50 Danbury, NC 27016 . Phone: [phone] . Fax: [phone]
August 5, 2016
Description of Waste Water Treatment System Components
South Stokes High School WWTP
1100 South Stokes High Drive
Walnut Cove, NC 27052
NPDES Permit No. NC0044954
The existing South Stokes High School WWTP includes the following components:
• Septic Tank (±15,000 gallons)
• Recirculation tank (±10,000 gallons)
• Dual alternating recirculation pumps
• Duplex recirculation time dosing control panel
• Effluent bypass ball valve
• Two surface sand filters (±1,380 sq. ft. each)
• Tablet chlorine disinfection unit
• Chlorine contact tank (±1,000 gallons)
• Tablet dechlorination unit

DocuSign Envelope ID: 7AE9F06B-1209-4A45-9C3D-E7777A1A53F8
Water Resources
ENVIRONMENTAL. QUALITY
NC Department of
Environmental Received oaiity
AUG 2 2 2016
Winston-Salem
Regional Office
Mr. Ricky Gains, Director of Maintenance
Stokes County Schools
PO Box 50
Danbury, NC 27016
Dear Mr. Goins:
August 16, 2016
PAT MCCRORY
Governor
DONALD R. VAN DER VAART
secretnly
S. JAY ZIMMERMAN
Director
Subject: Permit Renewal
Application No. NC0044962
North Stokes High School
Stokes County
The Water Quality Permitting Section acknowledges receipt of your permit application and
supporting documentation received on August 12, 2016. The primary reviewer for this renewal
application is Charles Weaver.
The primary reviewer will review your application, and he will contact you if additional
information is required to complete your permit renewal. Per G.S. 150B-3 your current permit
does not expire until permit decision on the application is made. Continuation of the current permit
is contingent on timely and sufficient application for renewal of the current permit.
If you have any additional questions concerning renewal of the subject peunit, please
contact Charles Weaver at 919-807-6391 or [e-mail].
Sincerely,�
Vtea 7G�.e40 �""
Wren Thedford
Wastewater Branch
cc: Central Files
NPDES
Winston-Salem Regional Office
State of North Carolina j Environmental Quality 1 Water Resources
1617 Mail Service Center 1 Raleigh, North Carolina 27699-1617
919-807-6300

DocuSign Envelope ID: 7AE9F06B-1209-4A45-9C3D-E7777A1A53F8
Stokes County Schools
STOKES COUNTY BOARD OF EDUCATION
Sonya M. Cox, Chair
Patricia M. Messick, Vice Chair
Rebecca P. Boles
William F. Hart
Jamie B. Yontz
SUPERINTENDENT
Dr. Brad Rice
ASSISTANT SUPERINTENDENT
Tony George
www.stokes.k12.nc.us . 100 Courthouse Circle . PO Box 50 . Danbury, NC 27016 . Phone: [phone] . Fax: [phone]
August 5, 2016
NCDENR/DWR/NPDES Unit
1617 Mail Service Center
Raleigh, NC 27699-1617
Attn: Mr. Wren Thedford
Re: North Stokes High School WWTP NPDES Renewal Application Cover Lettet°• `.w.
NC NPDES Permit No. NC0044962 AUG 1.2 2 10 j 0
Stokes County, NC
Dear Mr. Thedford,
As required for all NPDES renewal application packages, on behalf of the Stokes County Board of Education,
we request renewal of the North Stokes High School WWTP NPDES Premit No. NC0044962.
The following is a list of all changes made to the WWTP facility since the issuance of the last premit.
• Upgraded the existing WWTP from a single pass sand filter systm to a recirculating sand filter system.
• Installed WWTP effluent recirculating system, including recirculation tank, duplex dual alternating
recirculating pumps, duplex time dosing control panel and control floats, recirculation force mains, and
recirculation by-pass valve.
• Install new tablet chlorine disinfection unit, chlorine conatct tank, and tablet dechlorination unit.
The above referenced changes to the WWTP were completed in compliance with the Authorization to Construct
No. 044962A01.
Sincerely,
Stokes County Schools
Ricky Goins, Director of Maintenance
„�Q9Q-zops-4-43:

DocuSign Envelope ID: 7AE9F06B-1209-4A45-9C3D-E7777A1A53F8
Stokes County Schools
STOKES COUNTY BOARD OF EDUCATION.
Sonya M. Cox, Chair
Patricia M. Messick, Vice Chair
Rebecca P. Boles
William F. Hart
Jamie B. Yontz
SUPERINTENDENT
Dr. Brad Rice
ASSISTANT SUPERINTENDENT
Tony George
wmv.stokes.k12.nc.us . 100 Courthouse Circle , PO Box 50 . Danbury, NC 27016 Phone: [phone] . Fax: [phone]
August 5, 2016
Sludge Management Plan
For
North Stokes High School WWTP
NPDES No. 0044962
The North Stokes High School WWTP utilizes both grease traps and septic tanks to capture solids generated by
the school. Stokes County Schools contracts with a licensed septage management firm to pump all tanks and
dispose of as required by North Carolina Division of Waste Management.
Stpkes County Schools
Ricky Goins, Director of Maintenance

DocuSign Envelope ID: 7AE9F06B-1209-4A45-9C3D-E7777A1A53F8
NPDES APPLICATION - FORM D
For privately -owned treatment systems treating 100% domestic wastewaters <1.0 MGD
Mail the complete application to:
N. C. DENR / Division of Water Quality / NPDES Unit
1617 Mail Service Center, Raleigh, NC 27699-1617
NPDES Permit
NC0044962
If you are completing this form in computer use the TAB key or the up - down arrows to move from one
field to the next. To check the boxes, click your mouse on top of the box. Otherwise, please print or type.
1. Contact Information:
Owner Name Stokes County Board of Education
Facility Name North Stokes High School WWTP
Mailing Address P.O. Box 50
City
State / Zip Code
Telephone Number
Fax Number
e-mail Address
Danbury
NC 27016
[phone]
[phone]
[e-mail]
2. Location of facility producing discharge:
Check here if same address as above ❑
Street Address or State Road 1350 North Stokes School Road
City Danbury
State / Zip Code NC 27016
County Stokes
3. Operator Information:
Name of the firm, public organization or other entity that operates the facility. (Note that this is not
referring to the Operator in Responsible Charge or ORC)
Name
Mailing Address
City
State / Zip Code
Telephone Number
Fax Number
e-mail Address
Research and Analytical Laboratories, Inc.
P.O. Box 473 - 106 Short Street
Kernersville
NC 27285 - 27284
[phone]
( )
[e-mail]
1 of 3 Form-D 11l12

DocuSign Envelope ID: 7AE9F06B-1209-4A45-9C3D-E7777A1A53F8
NPDES APPLICATION - FORM D
For privately -owned treatment systems treating 100% domestic wastewaters <1.0 MGD
4. Description of wastewater:
Facility Generating Wastewater(check all that apply
Industrial ❑ Number of Employees
Commercial ❑ Number of Employees
Residential ❑ Number of Homes
School ® Number of Students/Staff 390/71
Other ❑ Explain:
Describe the source(s) of wastewater (example: subdivision, mobile home park, shopping centers,
restaurants, etc.):
High School
Number of persons served: 461
S. Type of collection system
® Separate (sanitary sewer only) ❑ Combined (storm sewer and sanitary sewer)
6. Outfall Information:
Number of separate discharge points 1
Outfall Identification numbed s) 001
Is the outfall equipped with a diffuser? ❑ Yes
® No
7. Name of receiving stream(s) (NEW applicants: Provide a map showing the exact location of each
outfall):
Little Neatman Creek
S. Frequency of Discharge: ® Continuous ❑ Intermittent
If intermittent:
Days per week discharge occurs: Duration:
9. Describe the treatment system
List all installed components, including capacities, provide design removal for BOD, TSS, nitrogen and
phosphorus. If the space provided is not sufficient, attach the description of the treatment system in a
separate sheet of paper.
See description of waste water treatment system components on separate sheet of paper
attached.
2 of 3 Form-? 11/12

DocuSign Envelope ID: 7AE9F06B-1209-4A45-9C3D-E7777A1A53F8
NPDES APPLICATION - FORM D
For privately -owned treatment systems treating 100% domestic wastewaters <1.0 MGD
10. Flow Information:
Treatment Plant Design flow 0.0115 MGD
Annual Average daily flow 0.0036 MGD (for the previous 3 years)
Maximum daily flow 0.0132 MGD (for the previous 3 years)
11. Is this facility located on Indian country?
❑ Yes ® No
12. Effluent Data
NEW APPLICANTS: Provide data for the parameters listed. Fecal Coliform, Temperature and pH shall be grab
samples, for all other parameters 24-hour composite sampling shall be used. If more than one analysis is reported,
report daily maximum and monthly average. If only one analysis is reported, report as daily maximum.
RENEWAL APPLICANTS: Provide the highest single reading (Daily Maximum) and Monthly Average aver
the past 36 months for parameters currently in your permit. Mark other parameters "N/A".
Parameter
Daily
Maximum
Monthly
Average
Units of
Measurement
Biochemical Oxygen Demand (BOD5)
41
9.14
MG/L
Fecal Coliform
>2420
1.25
C01 / 100ML
Total Suspended Solids
14.2
<5
MG/ L
Temperature (Summer)
25
19.64
°C
Temperature (Winter)
18
10.16
°C
pH
8.6
N/A
' SU
13. List all permits, construction approvals and/or applications:
Type
Hazardous Waste (RCRA)
UIC (SDWA)
NPDES
PSD (CAA)
Non -attainment program (CAA)
Permit Number
NC0044962
14. APPLICANT CERTIFICATION
I certify that I am familiar with the
best of my knowledge and belief such
Ricky Goins
P 'nted name of Person Signing
Signatu*e of Applicant
Type
NESHAPS (CAA)
Ocean Dumping (MPRSA)
Dredge or fill (Section 404 or CWA)
Other
Permit Number
information contained in the application and that to the
information is true, complete, and accurate.
Director of Maintenance
Title
8-9-No
Date
North Carolina General Statute 143-215.6 (b)(2) states: Any person who knowingly makes any false statement representation, or certification in any
application, record, report, plan, or other document files or required to be maintained under Article 21 or regulations of the Environmental Management
Commission implementing that Article, or who falsifies, tampers with, or knowingly renders inaccurate any recording or monitoring device or method
required to be operated or maintained under Article 21 or regulations of the Environmental Management Commission implementing that Article, shall be
guilty of a misdemeanor punishable by a fine not to exceed $25,000, or by imprisonment not to exceed six months, or by both. (18 U.S.C, Section 1001
provides a punishment by a fine of not more than $25,000 or imprisonment not more than 5 years, or both, for a similar offense.)
3 of 3 Form-D 11/12

DocuSign Envelope ID: 7AE9F06B-1209-4A45-9C3D-E7777A1A53F8
s
a
Stokes County Schools
STOKES COUNTY BOARD OF EDUCATION
Sonya M. Cox, Chair
Patricia M. Messick, Vice Chair
Rebecca P. Boles
William F. Hart
Jamie B. Yontz
SUPERINTENDENT
Dr. Brad Rice
ASSISTANT SUPERINTENDENT
Tony George
www.stokes.k12.nc.us . 100 Courthouse Circle PD Box 50 . Danbury, NC 27016 , Phone: [phone] . Fax: [phone]
August 5, 2016
Description of Waste Water Treatment System Components
North Stokes High School WWTP
1350 North Stokes School Road
Danbury, NC 27016
NPDES Permit No. NC0044962
The existing North Stokes High School WWTP includes the following components:
• Septic Tank (±15,000 gallons)
• Recirculation tank (±10,000 gallons)
• Dual alternating recirculation pumps
• Duplex recirculation time dosing control panel
• Effluent bypass ball valve
• Two surface sand filters (±2,165 sq. ft. each)
• Tablet chlorine disinfection unit
• Chlorine contact tank (±1,000 gallons)
• Tablet dechiorination unit

DocuSign Envelope ID: 7AE9F06B-1209-4A45-9C3D-E7777A1A53F8
• v
Stokes County Schools
STOKES COUNTY BOARD OF EDUCATION
Sonya M. Cox, Chair
Patricia M. Messick, Vice Chair
Rebecca P. Boles
William F. Hart
Jamie B. Yantz
SUPERINTENDENT
Dr. Brad Rice
ASSISTANT SUPERINTENDENT
Tony George
www,stokes.k12.nc.us . 100 Courthouse Circle PO Box 56 . Danbury, NC 27016 . Phone: [phone] . Fax: [phone]
August 5, 2016
Description of Waste Water Treatment System Components
North Stokes High School WWTP
1350 North Stokes School Road
Danbury, NC 27016
NPDES Permit No. NC0044962
The existing North Stokes High School WWTP includes the following components:
• Septic Tank (±15,000 gallons)
• Recirculation tank (±10,000 gallons)
• Dual alternating recirculation pumps
• Duplex recirculation time dosing control panel
• Effluent bypass ball valve
• Two surface sand filters (±2,165 sq. ft. each)
• Tablet chlorine disinfection unit
• Chlorine contact tank (11,000 gallons)
• Tablet dechlorination unit
051-1-al ��:

DocuSign Envelope ID: 7AE9F06B-1209-4A45-9C3D-E7777A1A53F8
Water Resources
ENVSRONNIENTAL QUALITY
N C Department of
Environmental Quality
Received
JUN 3 0 2016
Winston-Salem
Regional Office
Mr. Christopher H. Johnson
R.H. Johnson Constructive Company
207 Sleepy Gap Road
Arden, NC 28704
Dear Permittee:
June 24, 2016
PATNMCCRORY
DONALD R. VAN DER VAART
Salvia!),
S. JAY ZIMMERMAN
Director
Subject: Permit Renewal Application
No. NC0079049
R.H. Johnson Construction WWTP
Forsyth County
The Water Quality Permitting Section has received your permit renewal application on June 16,
2016. A member of the NPDES Unit will review your application. They will contact you if additional
information is required to complete your permit renewal. Per G.S. 150B-3 your current permit does not
expire until permit decision on the application is made. Continuation of the current permit is contingent on
timely and sufficient application for renewal of the current permit. Please respond in a timely manner to
requests for additional information necessary to complete the permit application.
If you have any additional questions concerning renewal of the subject permit, please contact Charles
Weaver at 919-807-6391 or [e-mail].
cc: Central Files
NPDES Unit
Sincerely,
WreAA, T D(Jo-rol
Wren Thedford
Wastewater Branch
Regional Office, Water Quality Regional Operations Section
State of North Carolina Environmental Quality 1 Water Resources
1617 Mail Service Center 1 Raleigh, North Carolina 27699-1617
919-807-6300