NC0028711_CORRESPONDENCE_20151215

NPDES DOCUMENT SCANNING COVER SHEET
NPDES Permit:
NC0028711
Berryhill Elementary WWTP
Document Type:
Permit Issuance
Wasteload Allocation
Authorization to Construct (AtC)
Permit Modification
Complete File - Historical
Correspondence
Speculative Limits
Instream Assessment (67b)
Environmental Assessment (EA)
Permit
History
Document Date:
December 15, 2015
This documeat its priated on reuBe paper -ignore any
coatent on the reverse aide

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Resources
Pat McCrory John E. Skvarla, III
Governor WATER QUALITY PERMITTING SECTION Secretary
PERMIT NAME/OWNERSHIP CHANGE REQUEST
This form is for ownership changes or name changes of NPDES wastewater permits.
• "Pennittee" references the existing permit holder
• "Applicant" references the entity applying for the ownership/name change.
1. NPDES Permit No. (for which the change is requester):
or
Certificate of Coverage #:
11. Existing Permittee Information:
a. Permit issued to (company name):
b. Person legally responsible for permit:
RECEIVED/DENR/DWR
NC002871-1—
N C G 5
Mecklenburg Countv Schools
George M Jones
First MI Last
Director of Maintenance, Engineering & Energy
Management
Title
3301 Stafford Drive
DEC i 5 2olti Permit Holder Mailing Address
Charlotte NC 28208-
Water Quality
Permitting Section
c. Facility name:
d. Facility's physical address:
e. Facility contact person:
Ill. Applicant Information:
City State Zip
[phone] [phone]
Phone Fax
Berrvhill Elementary School WWTP
10501 Windy Grove Road
Address
Charlotte NC 28278-
City State Zip
Jeffery G. Mitchell [phone]
First / MI / Last Phone
a. Request for change is a result of: ❑ Change in ownership of the facility
® Name change of the facility or owner
;jother please explain: Name of road needs to be updated as well as name change of owner.
b. Permit issued to (company name): Charlotte -Mecklenburg Board of Education
c. Person legally responsible for permit George M Jones
First MI Last
Director of Maintenance, Engineering & Energy
Management
Title
3301 Stafford Drive
Permit Holder Mailing Address
Charlotte NC 28208-
City State Zip
Page I of 2 Revised 710112014

Phone
E-mail Address
d. Facility name:
e. Facility's physical address:
f. Facility contact person:
Berryhill Elementary School WWTP
10501 Windy Grove Road
Charlotte NC
28208
City State Zip
Jeffery G Mitchell
First MI Last
Environmental, Health & Stewardship Specialist
Title
[phone] [e-mail]
Phone E-mail Address
1V. Will the permitted facility continue to conduct the same commercial/industrial activities conducted prior to
this ownership or name change?
® Yes
❑ No (please explain)
If applicable, the applicant shall submit a major permit modification request to DWR. A major modification shall be
defined as one that increases the volume, increases the pollutant load, results in a significant relocation of the
discharge point, or results in a change in the characteristics of the waste generated.
V. Required Items: THIS APPLICATION WILL BE RETURNED UNPROCESSED IF ITEMS ARE
INCOMPLETE OR MISSING:
1. This completed application is required for both name change and/or ownership change requests.
2. Legal documentation of the transfer of ownership (such as relevant pages of a contract deed, or a bill of sale) is
required for an ownership change request. Articles of incorporation are not sufficient for an ownership change.
Applicable regulations: 40 CFR 122.41, 40 CFR 122.61 and 15A NCAC 02H .0114
...................................................................................................................
The certifications below must be completed and signed by both the permit holder prior to the change (Permittee), and the
new applicant in the case of an ownership change request. For a name change request, the signed Applicant's Certification
is sufficient.
PERMITTEE CERTIFICATION (Permit holder prior to ownership change):
I, Mark Jones, attest that this application for a name/ownership change has been reviewed and is accurate and complete to
the best of my knowledge. I understand that if all required parts of this application are not completed and that if all required
supporting information is not included, this application package will be returned as incomplete.
CI•Y< ZA/9 za z S
tgnature / Date
APPLICANT CERTIFICATION
I, Jeff Mitchell, attest that this application for a name/ownership change has been reviewed and is accurate and complete to
the best of my knowledge. I understand that if all required parts of this application are not completed and that if all required
supporting information is not included, this application package will be returned as incomplete.
Signature Date
PLEASE SEND THE COMPLETE APPLICATION PACKAGE TO:
Division of Water Resources
NPDES PERMIT NAME/OWNERSHIP CHANGE REQUEST
Page 2 of 2 Reri.sed 710112014

eDMR Owner Verification Report
Permit No.: NCO028711 Version: 4.00 Permt Status: Active
Owner/Permittee : Mecklenburg County Schools
Responsible Official: Mark Jones
Resp. Official Title:
Facility Name : Berryhill Elementary School WWTP
Facility Address: 10501 Walkers Ferry Rd
Charlotte, NC 28208
Registered for eDMR? : No
Facility Classification: WW-2
ORC Name
Smith, James J.
Mitchell, Jeff G.
Moorer. Jevon L.
Certification #
Cert Status
WW-4 / 1001846
Active
WW-1 /996082
Active
WW-1 /993989
Active
ORC Designation
ORC
Backup
Backup
Page # : 1
Date: 121912015

Permit NCO028711
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER RESOURCES
PERMIT
TO DISCHARGE WASTEWATER UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provisions of North Carolina General Statute 143-215.1, other lawful standards
and regulations promulgated and adopted by the North Carolina Environmental Management
Commission, and the Federal Water Pollution Control Act, as amended, the
Charlotte -Mecklenburg Board of Education
is hereby authorized to discharge wastewater from a facility located at the
Berryhill Elementary School WWTP
10501 Windy Grove Road
West of Dixie
Mecklenburg County
to receiving waters designated as the Catawba River (Lake Wylie) in the Catawba River Basin
in accordance with effluent limitations, monitoring requirements, and other conditions set forth in Parts
I, II, III and IV hereof.
This permit shall become effective August 1, 2015.
This permit and authorization to discharge shall expire at midnight on June 30, 2020.
Signed this day July 24, 2015
C44t 61V�'
S.,WZimmerman, L.G., Director,;,-'
ITivision of Water Resources
By Authority of the Environmental Management Commission
Page 1 of 6

,
4 �� r
NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
July 17, 2014
Mr. Mark Jones
Director of Maintenance
Charlotte -Mecklenburg Board of Education
3301 Stafford Drive
Charlotte, NC 28208
John E. Skvarla, III
Secretary
Subject: Confirmation Owner Name
Permit NCO028711
Berry hill Elementary School WWTP
Mecklenburg County
Dear Jones:
As requested by Mr. Rizzo, this letter is to confirm that the July 10, 2014 Permit Change Form
was received and all the appropriate Division records have been corrected. Please be aware in the
future that the owner, currently designated as Mr. Mark Jones in our records, needs to sign the permit
renewal application. When the owner name changes, you will need to submit the Permit Change
Form so we can update our records accordingly.
Sincerely,
PlIx, &rZ
Ron Berry, Engineer
Division of Water Resources, NCDENR
Cc: Mooresville Regional Office/Water Quality Programs
Mr. Richard J. Rizzo
Charlotte -Mecklenburg Board of Education
3301 Stafford Drive
Charlotte, NC 28208
Central Files
NPDES File
1617 Mail service Center, Raleigh, North Carolina 27699-1617
Phone: [phone] Internet www.ncwaterquality.org
An Equal OpportunityManative Action Employer

\�U�e NC®ENR
.no ro ' , a Department of Environment and Natural Resources
® Division of Water Resources
• iPat John E. Skvarla, III
Governor WATER QUALITY PERMITTING SECTION Secretary
•
I.
if.
PERMIT NAME/OWNERSHIP CHANGE FORM — FOR INDIVIDUAL PERMITS
This form is for ownership changes or name changes of an individual NPDES wastewater permit.
• " Pennittee" reverences the eXistino permit holder
• "Applicant" relerences the cmity applying for the oanershi /name change.
NPDES Permit No. ((or which the change is requester!): N C 0 0
Existing Permittee Information: tQA / q�( �7,- • /
a. Permit issued to (company name): lA1 AR l ahe - /"ip4(eAi6Fi4 tJL<l/Lct f/�l¢(1Yi/QA.'
_ .. ... .. _ _AA -
First'
MI
Last
Meg d emj4C, A8i
rc cirri
RECEIVED/DENR/DWR
/
Title
t�wive
3�/ Sifl' n6tl
JUL 1 7 2014
Permit Holder Mailing Address
eWe, /Y( A8J?
Water Quality
City
State
Zip
permitting Section
Rio) 3,/3- 6050
( )
c. Facility name:
Phone /
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f V L od
Fax �-
lj 4/,,TP 1 L
d. Facility's physical address:
/D5U'N[lY0A61Ujf,
W
Address
State
Zip
e. Facility contact person:
^ sS-flCity
09C J,01,s 11 '9(n i-zu
!I
("�flog/-7�1
First / MI / Last
Phone
III. Applicant Information:
a. Request for change is a result of: ❑ Change in ownership of the facility
❑ Name change of the facility or owner
If other please explain: fRj 2R50 � Ir
b. Permit issued to (company name . Ctiao�m p - 1�iPG�.1N u,ALn �htZ
Kj
c. Person legally responsible for permit: /i•��yo hr*�L
to v-rp Of P&&-Q ppe e,,
MI Last
.N&(t LeNOt'1Pe D4el716,-
Title
.33el S4a-R6PJ ,bp,
Permit Holder Mailing Address
l Aa its-Ae Vc 274 r
City State Zip
ftp) 31/; - 416SO
Phone E-mail Address

d. Facility name: �Po f Yet /� ���Ai en74 A1Li JdWo� tog,-IQ�
e. Facility's physical address:
rr Address
eivl
City State Zi
f. Facility contact person: 2, �M IT Azy,O
First MI Last
TitleTj7i2Gl�C'/}� F�t'i IP�/•KJ
Phone E-mail Address 4292 ta� ditge.
IV. Will the permitted facility continue to conduct the same commercial/industrial activities conducted prior to
t is wnership or name change?
Yes
❑ No (please explain)
if applicable, the applicant shall submit a major permit modification request major
defined as one that increases the volume, increases the pollutant load, results in a significant relocation of the
discharge point, or results in a change in the characteristics of the waste generated.
V. Required Items: THIS APPLICATION WILL BE RETURNED UNPROCESSED IF ITEMS ARE
INCOMPLETE OR MISSING:
1. This completed application is required for both name change and/or ownership change requests.
2. Legal documentation of the transfer of ownership (such as relevant pages of a contract deed, or a bill of sale) is
required for an ownership change request. Articles of incorporation are not sufficient for an ownership change.
Applicable regulations: 40 CFR 122.41, 40 CFR 122.61 and 15A NCAC 02H .0114
.....................................................................................................................
• The certifications below must be completed and signed by both the permit holder prior to the change (Permittee), and the
new applicant in the case of an ownership change request. For a name change request, the signed Applicant's Certification
is sufficient.
PERMITTEE CERTIFICATION (Permit holder prior to ownership change):
/Yia�s
attest that this application for a name/ownership change has been reviewed and is accurate and complete to the
best of my knowledge. I understand that if all required parts of this application are not completed and that if all required
supporting information is not "ed, this application package will be returned as incomplete.
el
Sign re 7—� Date
APPLICANT CERTIFICATION
I, _, attest that this application for a name/ownership change has been reviewed and is accurate and complete to the
best of my knowledge. I understand that if all required parts of this application are not completed and that if all required
supporting information is not included, this application package will be returned as incomplete.
Signature
Date
PLEASE SEND THE COMPLETE APPLICATION PACKAGE TO:
Division of Water Resources
Water Quality Permitting Section
• 1617 Mail Service Center
Raleigh, NC 27699-1617
INDIVIDUAL NPDES PERMIT NAME/OWNERSHIP CHANGE FORM

To Whom It May Concern could you PLEASE send a new cover sheet for our permit NC 0028711. That
will reflect the changes when they are made to the permit.
•
Thank You
Richard Rizzo 704-361-5251
ORC Berryhill Elementary School WWTP
0