NC0045152_Renewal (Application)_20160126

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 INC0045152 ,
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 Alamance-Burlington School System
Facility Name B.E. Jordan Elementary School WWTP
Mailing Address 1732 Vaughn Road
City Burlington
State / Zip Code NC / 27217 RECEIVED/WHO/NIP
Telephone Number [phone]
JAN 26 2,;H
Fax Number [phone]
Water Quality
e-mail Address jay_fuller©abss.k12.nc.us Permitting Section
2. Location of facility producing discharge:
Check here if same address as above 0
Street Address or State Road 5827 Church Road
City Graham
State / Zip Code NC / 27253
County Alamance
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 &Analytical Laboratories, Inc.
Mailing Address 106 Short Street
City Kernersville
State / Zip Code NC / 27284
Telephone Number [phone]
Fax Number [phone]
e-mail Address [e-mail]
1 of 3 Form-D 11/12

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 400 / 48
Other 0 Explain:
Describe the source(s) of wastewater (example: subdivision, mobile home park, shopping centers,
restaurants, etc.):
Elementary School
Number of persons served:
5. Type of collection system
® Separate (sanitary sewer only) 0 Combined (storm sewer and sanitary sewer)
6. Outfall Information:
Number of separate discharge points 1
Outfall Identification numbers) 001
Is the outfall equipped with a diffuser? 0 Yes ® No
7. Name of receiving stream(s) (NEW applicants:Provide a map showing the exact location of each
outfall):
Haw River
8. Frequency of Discharge: 0 Continuous ® Intermittent
If intermittent:
Days per week discharge occurs: 5 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.
*0.0075 MGD wastewater treatment system
*Comminutor
*Bar Screen
*Aeration basin with diffused aeration
*Secondary clarifier with sludge return
*UV Disinfection
2 of 3 Form-D 11/12

NPDES APPLICATION - FORM D
For privately-owned treatment systems treating 100% domestic wastewaters <1.0 MGD
10. Flow Information:
Treatment Plant Design flow 0.0075 MOD
Annual Average daily flow 0.0019 MGD (for the previous 3 years)
Maximum daily flow 0.0088 MOD (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".
Daily Monthly Units of
Parameter Maximum Average Measurement
Biochemical Oxygen Demand (BODS) 19.8 4.08 Mg/1
Fecal Coliform 500 4.3 Col/100 ml
Total Suspended Solids 13.1 2.48 Mg/1
Temperature (Summer) 26 23.1 °C
Temperature (Winter) 18 13.6 °C
pH 7.3 6.93 Std. Units
13. List all permits, construction approvals and/or applications:
Type Permit Number Type Permit Number
Hazardous Waste (RCRA) NESHAPS(CAA)
UIC(SDWA) Ocean Dumping(MPRSA)
NPDES NC0045152 Dredge or fill(Section 404 or CWA)
PSD (CAA) Other
Non-attainment program (CAA)
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.
Printed name of Person Signing Title
Signature of Applicant 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

a
PAT MCCRORY
DONALD R. VAN DER VAART
S. JAY ZIMMERMAN
Water Resources
ENVIRONMENTAL QUALITY
February 1, 2016
Joseph W. Fuller
Alamance-Burlington School System
1732 Vaughn Road
Burlington,NC 27217
Subject: Acknowledgement of Permit Renewal
Application No.NC0045152
B.E. Jordan Elementary School
Alamance County
Dear Permittee:
The Water Quality Permitting Section has received your permit renewal application on January 26,
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].
Sincerely,
W reAA, Tke-d-fa-rd/
Wren Thedford
Wastewater Branch
cc: Central Files
Winston-Salem Regional Office, Water Quality Regional Operations Section
NPDES Unit
State of North Carolina I Environmental Quality I Water Resources
1617 Mail Service Center I Raleigh,North Carolina 27699-1617
919-807-6300