NC0088897_Regional Office Historical File Pre 2016

Water Pollution Control System Operator Designation Form
WPCSOCC
NCAC 15A 8G .0201
Permittee Owner/Officer Name: C'IrY o F- glL x -S&Prr i3AF� 1Zo1�r G CVV lN��--P�'
Mailing Address: 4-Po Fo,::,x //.3a
City: %LIIV67 State: /VG Zip: c970,Pf - Phone #: 73& - 92
Email address: S
Signature: _ Date: - -
Facility Name: (, /T-Y OT 1,1iA,'G7 Permit
County: 57ak-&S / r170,e6Y"rH
SUBMIT A SEPARATE FORM FOR EACH TYPE SYSTEM!
Facility Type/Grade (CHECK ONLY ONE):
Biological Collection v Physical/Chemical Surface Irrigation Land Application
Operator in Responsible Charge (ORC)
Print Full Naine:�61IJ 7 9�,u wj $ • A-4 4-,_te Q Email:
Certificate Type / Grade / Number: QC / 199 0 30 Work Phone #: 336 -98s- - //957
Date: // 2.3 /S`
"I certify that I agree to m`yYignation as the Operator in Responsible Charge for the facility noted. I understand and will abide by the rules
and regulations pertaining to .the responsibilities of the ORC as set forth in 15A NCAC 08G .0204 and failing to do so can result in Disciplinary
Actions by the Water Pollution Control System Operators Certification Comnvssion. "
Back -Up Operator in Responsible Charge (BU ORC)
fyLO 1. Sf4Tfmail: r'rac�C� C-L, (e-' 0 6 . NJ C . U
Print Full Name: � 1 � ���� �.� '
Certificate Type /Grade Number; ' - i Work Phone #:
Signature: Date:
"I certify that I agree to my designation as a Back-up Operator in Responsible Cha't.`go' for the facility noted. I understand and will abide by the
rules and regulations pertaining to the responsibilities of the BU ORC as set forth in 15A NCAC 08G .0205 and failing to do so can result in
Disciplinary Actions by -the Water Pollution Control .System Operators Certification Commission."
Mail, fax or entail the W_PCSOCC, 1618 Mail Service Center, Raleigh, NC 27699-1618 Fax: [phone]
orisinal.to: Email: [e-mail]
Mail or fax a conV to the Asheville
appropriate Regional Office: 2090 US,Hwy 70
Swannanoa 28778
Fax: [phone]
Phone: [phone]
Washington
943 Washington Sq Mall
Washington 27889
Fax: [phone]
Phone: [phone]
Fayetteville
225 Green St
Suite 714
Fayetteville 28301-5043
Fax: [phone]
Phone: [phone]
Wilmington
127 Cardinal Dr
Wilmington 28405-2845
Fax: [phone]
Phone: [phone]
Mooresville
61.0 E Center Ave
Suite 301
Mooresville 28115
Fax:[phone]
Phone: [phone]
Winston-Salem
450 W. Hanes Mall Rd
Winston-Salem 27105
Fax: [phone]
Phone: [phone]
Raleigh
3800 Barrett Dr
Raleigh 27609
Fax: [phone]
Phone:[phone]
Revised 05-2015

1 North Carolina Department of Environmental- Quality
Pat McCrory Donald R. van der Vaart
Governor Secretary
November 16, 2015
City of King
Attn: John W. Cater, City Manager
P.O. Box 1132
King, NC 27021-1132
Subject: Compliance Evaluation Inspection
NPDES Permit NCO088897
City 'of King Water Treatment<Plant
Forsyth County
Dear Mr. Cater:
Ron Boone of the Winston-Salem Regional Office of the NC Division of Water Resources (DWR or the
Division) conducted a compliance evaluation inspection (CEI) at the King Water Treatment Plant on
November 4, 2015. The assistance and cooperation of Kenneth Gentry and Ben Marion, Operators in
Responsible Charge, was greatly appreciated. Inspection reports are attached for your records and the
inspection findings are summarized below.
General
2. The facility is located at 6949 Donnaha Road, in Tobaccoville, Forsyth County, North Carolina. The facility
is authorized to discharge wastewater from the water treatment works through outfall 001, which is
located at approximate coordinates 36.2225551 by 80.4274280, to Old Richmond Creek, which is
currently classified as Class WS-IV (water supply) waters in the Yadkin Pee -Dee River basin. The
wastewater treatment system consists of one upgraded wastewater pump station, dechlorination
equipment, a 300,000 gallon sludge decant thickening tank, and a filter belt press. The waste stream
consists of decant from the combination of backwash water from the water treatment system's filters and
sludge from the water treatment system's sedimentation basins.
Documentation & Monitoring Review
3. All required records were reviewed, including Discharge Monitoring Reports (DMR), chains of custody,
laboratory records, field laboratory records, operations and maintenance logs, and operator visitation
logs. All records were complete and current and no discrepancies were noted. Mr. Gentry has done an
excellent job of producing and keeping the required records.
Site Review
4. The site was very clean and well maintained. All equipment was in excellent condition and no
discrepancies were noted. Again, Mr. Gentry has done an excellent job managing operation and
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

maintenance of the decant, dechlorination, and filter belt press systems. The outfall was also inspected IJ
and no discrepancies were noted.
5. Please encourage Mr. Gentry and his crew to keep up the excellent work. No discrepancies were noted
during this inspection but you are politely reminded that violations of the NCO088897 permit are subject
to civil penalties not to exceed $25,000 per day, per violation.
6. If you have any questions regarding this letter or the inspection, please do not hesitate to contact Mr.
Boone or me at [phone]. Thank you!
Sincerely,
W. Corey Basinger
Regional Supervisor
Water Quality Regional Operations
Division of Water Resources
Attachments:
1. BIMS Inspection Report
cc:
Central Files
NPDES Unit, Attn: Charles Weaver
City of King
Attn: Kenneth Gentry, Operator in Responsible Charge
P.O. Box 1132
King; NC 27021-1132

1. 1
United States Environmental Protection Agency
Form Approved. .
EPA Washington, D.C. 20460
1
OMB No. 2040-0057.
Water Compliance Inspection Report
Approval expires8-31-98
Section A: National Data System Coding (i.e., PCS)
Transaction Code NPDES yr/mo/day Inspection Type Inspector Fac Type
1 H 2 15 I 3 I NCO088897 111 12 15/11/04 17 18 I C J 19 I i I 20 I
21111111 1111111 11 11 1 11 1111 1 1 11 111 I I I III I I I I I f6
Inspection Work Days Facility Self -Monitoring Evaluation Rating B1 QA -------------Reserved-----------
67 70 u 71 ,� 72 L � ] 731 I 174 75I I I I I I I I80
LJ I I I 1
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)
10:OOAM 15/11/04
14/06/01
King WTP
6949 Donnaha Rd
Exit Time/Date
Permit Expiration Date
Tobaccoville NC 27050
11:00AM 15/11/04
18/10/31
Name(s) of Onsite Representative(s)/Titles(s)/Phone and Fax Number(s)
Other Facility Data
Kenneth Ray Gentry/ORC/336-994-6877/
Name, Address of Responsible Official/Title/Phone and Fax Number
Contacted
John W Cater,PO Box 1132 King NC 270211132!/336-944-6888/
No
Section C: Areas Evaluated During Inspection (Check only those areas evaluated)
Permit E Flow Measurement Operations & Maintenance Records/Reports
Self -Monitoring Program 0 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
Ron Boone "4 t WSRO WQ!/336-776-9690/
Signature of Management A Reviewer Agency/Office/Phone and Fax Numbers Date
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete.
Page#

t
V
NPDES yr/mo/day Inspection Type
31 NCO088897 I11 12 15/11/04 17 18 ICI
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
Please refer to the attached inspection summary letter.
1

J
Permit: NCO088897 Owner - Facility: King WTP
Inspection Date: 11/04/2015 Inspection Type: Compliance Evaluation
Permit
Yes No NA NE
(If the present permit expires in 6 months or less). Has the permittee submitted a new
❑
❑
0
❑
application?
Is the facility as described in the permit?
M
❑
❑
❑
#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?
M
❑
❑
❑
Comment: None
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)?
0
❑
❑
❑
Are analytical results consistent with data reported on DM Rs?
M
❑
❑
❑
Is the chain -of -custody complete?
M
❑
❑
❑
Dates, times and location of sampling
M
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?
❑
❑
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?
0
❑
❑
❑
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?
0
❑
❑
❑
Is a copy of the current NPDES permit available on site?
0
❑
❑
❑
Facility has copy of previous year's Annual Report on file for review?
❑
❑
0
❑
Comment: None
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 ❑ ❑ ❑
Page# 3

,J
Permit: NCO088897 Owner -Facility: IvngWTP
Inspection Date: 11/04/2015 Inspection Type: Compliance Evaluation
Laboratory
Yes No NA NE
# Is the facility using a contract lab?
M
❑
. ❑
❑
# Is proper temperature set for sample storage (kept at less than or equal to 6.0 degrees
❑
❑
0
❑
Celsius)?
Incubator (Fecal Coliform) set to 44.5 degrees Celsius+/- 0.2 degrees?
❑
❑
M
❑
Incubator (BOD) set to 20.0 degrees Celsius +/- 1.0 degrees?
❑
❑
0
❑
Comment: None
Chemical Feed
Yes No NA NE
Is containment adequate?
0
❑ ❑
❑
Is storage adequate?
0
❑ ❑
❑
Are backup pumps available?
M
❑ ' ❑
❑
Is the site free of excessive leaking?
0
❑ ❑
❑
Comment: None
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?
M
❑
❑
❑
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?
❑
❑
M
❑
Comment: None
Flow Measurement - Effluent
Yes No NA NE
# Is flow meter used for reporting?
M
❑
❑
❑
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: None
Effluent Pipe Yes No NA NE
Is right of way to the outfall' properly maintained? 0 ❑ ❑ ❑
Page# 4

1
Permit: NCO088897 Owner - Facility: Icing MP .
Inspection Date: 11/04/2015 Inspection Type: Compliance Evaluation
Effluent Pipe Yes No NA NE
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? ' ❑ ❑ 0 ❑
Comment: None
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: None
Page# 5

d
��
�MR
North Carolina Department of Environment and Natural Resources
Pat McCrory .
Governor
April 27, 2015
City of King
Attn: John W. Cater, City Manager
P.O. Box 1132
King, NC 27021-1132
Subject: Compliance Evaluation Inspection
NPD_ES Permit NCO088897
City of King Water Treatment Plant
Forsyth County
Dear Mr. Cater:
Donald R. van der Vaart
Secretary
1. Ron Boone of the Winston-Salem Regional Office of the NC Division of Water Resources (DWR or the
Division) conducted a compliance evaluation inspection (CEI) at the King Water Treatment Plant on
January 22, 2015. The assistance and cooperation of Kenneth Gentry and Ben Marion, Operators in
Responsible Charge, was greatly appreciated. Inspection reports are attached for your records and the
inspection findings are summarized below.
General
2. The facility is located at 6949 Donnaha Road, in Tobaccoville, Forsyth County,,Morth Carol la he
facility is authorized to discharge wastewater from the water treatment works through outfall 001, which
is located at approximate coordinates 36.2225551 by 80.4274280, to Old Richmond. Creek, which is
currently classified as Class WS-IV (water supply) waters in. the Yadkin Pee -Dee River basin. The
wastewater treatment system consists of one upgraded wastewater pump Station, dechlorination
equipment, a 300,000 gallon sludge decant thickening tank, and a filter belt press. The waste stream
consists of decant from the combination of backwash water from the water treatment system's filters
and sludge from the water treatment system's sedimentation basins.
Documentation & Monitoring Review
3. All required records were reviewed, including Discharge Monitoring Reports (DMR), chains of custody,
laboratory records, field laboratory records, operations and maintenance logs, and operator visitation
logs. All records were complete and current and no discrepancies were noted. Mr. Gentry has done an
excellent job of producing and keeping the required records.
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.ncwat6rquality.org
An Equal Opportunity \ Affirmative Action Employer

Site Review
v
4. The site was very clean and well maintained. All equipment was in excellent condition and no
discrepancies were noted. Again, Mr. Gentry has done an excellent job managing operation and
maintenance of the decant, dechlorination, and filter belt press systems.
5. Please encourage Mr. Gentry and his crew to keep up the excellent work. No discrepancies were noted
during this inspection but you are politely reminded that violations of the NC0088897 permit are subject
to civil penalties not to exceed $25,000 per day, per violation.
6. We apologize for the delay in getting this letter to the City and we are sorry if it has caused you any
trouble or inconvenience. If you would like to discuss the delay or if you have any questions regarding
this letter or the inspection, please do not hesitate to contact Mr. Boone or me at [phone].
Thank you!
Sincerely,
W. Corey Basinger
Regional Supervisor
Water Quality Regional Operations ,
Division of Water Resources
Attachments:
1. BIMS Inspection Report
cc: �' _
f files
NPDES Unit, Attn: Charles Weaver
City of King
Attn: Kenneth Gentry, Operator in Responsible Charge
P.O. Box 1132
King, NC 27021-1132

1,
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 IN 1 2 15 I 3 I NCO088897 I11 12 14/01/22 17 18 ICJ
19 1 G 1 201
211 1 1 1 1 1 I l l l l l l a l l l l l l l l l l l l l l l l l I I I
I I I I 1 1 I I f6
Inspection
Work Days Facility Self -Monitoring Evaluation Rating B1 QA ------ ---Reserved----=---
67
70 I I 71 I I 72 I N 73I I 174 751 I I I I I I I80
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 14/01/22
10/08/01
King WTP
Exit Time/Date
Permit Expiration Date
6949 Donnaha Rd
"
Tobaccoville NC 27050
10:OOAM 14/01/22
13/10/31
Name(s) of Onsite Representative(s)/Titles(s)/Phone and Fax Number(s)
Other Facility Data
Kenneth Ray Gentry/ORC/336-994-6877/
Name, Address of Responsible Official/Title/Phone and Fax Number
Contacted
John W Cater,PO Box 1132 King NC 270211132//336-944-6888/
No
Section C: Areas Evaluated During Inspection (Check only those areas evaluated)
Permit E Flow Measurement Operations & Maintenance Records/Reports
Self -Monitoring Program 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
Ron Boone WSRO WQ#336-776-9690/
/ 12-
Signaturepof Management Q A Reviewer Agency/Office/Phone and Fax Numbers
Date
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete.
Page#

NPDES yr/mo/day_ Inspection Type
31 NCo088897 I11 12 14/01/22 17 18 Ll
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
Please refer to the attached inspection summary letter.
1
Page# 2

1
Permit: NCO088897 Owner - Facility: King WTP
Inspection Date: 01/22/2014 Inspection Type: Compliance Evaluation
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?
❑
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: None
Record Keeping
Yes No NA NE
Are records kept and maintained as required by the permit?
M
❑
❑
❑
Is all required iriformation 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?
0
❑
❑
❑
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?
0
❑
❑
❑
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
❑
❑
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?
M
❑
❑
❑
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
❑
❑
❑
Facility has copy of previous year's Annual Report on file for review?
❑
❑
0
❑
Comment: None
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 ❑ ❑ ❑
Page# 3

Permit: NCO088897 Owner - Facility: wng WTP
Inspection Date: 01/22/2014 Inspection Type: Compliance Evaluation ,
Laboratory
Yes No NA NE
# 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: None
Effluent Sampling
Yes No NA NE
Is composite sampling flow proportional?
❑
❑
0
❑
Is sample collected below all treatment units?
0
❑
❑
❑
Is proper volume collected?
0
❑
❑
❑
Is the tubing clean?
❑
❑
M
❑
# Is proper temperature set for sample storage (kept at less than or equal to 6.0 degrees
❑
❑
M
❑
Celsius)?
Is the facility sampling performed as required by the permit (frequency, sampling type
0
❑
❑
❑
representative)?
Comment: None
De -chlorination
Yes No NA NE
Type of system ?
Liquid
Is the feed ratio proportional to chlorine amount (1 to 1)?
❑
❑
❑
Is storage appropriate for cylinders?
❑
❑
M
❑
# Is de -chlorination substance stored away from chlorine containers?
M
❑
❑
❑
Are the tablets the proper size and type?
❑
❑
0
❑
Comment: None
Are tablet de -chlorinators operational? ❑ ❑ M ❑
Number of tubes in use?
Comment: None
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?
M
❑
❑
❑
(If units are separated) Does the chart recorder match the flow meter?
❑
❑
0
❑
Page# 4

0
Permit: NCO088897 Owner -Facility: King WTP
Inspection Date: 01/22/2014 Inspection Type: Compliance Evaluation
Flow Measurement- Effluent Yes No NA NE
Comment: None
Effluent Pipe Yes No NA NE
Is right of way to the outfall properly maintained? N ❑ ❑ ❑
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? ❑ ❑ N ❑
Comment: None
Operations & Maintenance Yes No NA NE
Is the plant generally clean with acceptable housekeeping? M ❑ ❑. ❑
Does the facility analyze process control parameters, for ex: MLSS, MCRT, Settleable ❑ ® ❑ ❑
Solids, pH, DO, Sludge Judge, and other that are applicable?
Comment: None
Page# 5

To: 13367714631
From: 13364227185
2-03-14 11:01am p, 1 of 5
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To: 13367714631 From: 13364227185 2-03-14 11:01am p, 2 of 5
EFFLUENT
NPDES PERMIT # NC0088897
DISCHARGE NO. 001 MONTH.
JANUARY YEAR 2013
PArll rT4' NAMI• CITY Or KiNO WATER
TREATMENT PLANT � CLAEM
1 COUNTY FORSYTH v
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d— riIONC =6 024 0363
-
CERTIFIED LABORATORIES (1) Research & Analytical Laboratories YnC. (2)
CHE'CK GOX IF ORC HAS CHANGED
PERSON(S) COLLECTING SAMPLES
Kenneth Gentry and Operators
Mail ORIGINAL and ONE COPY W:
+
ATINI. CMTRAL F1L8S
1XV1g101u OFw.lTLxQUA11TY
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SIG A URE C}I' FLaATOR IN RESPONSIBLE COARGH DATE
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.,t5 PERMIT # NCOGS8897 DISCHARGE NO, 001 MONTH
rAaUYTY NAME CITY OF: KING WATER TM-rMENT PLANT I CLASS
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