NC0051608_Fact Sheet_20210621

DocuSign Envelope ID: 990CBA17-04A7-4FAF-8C55-3791E9E4727A
Fact Sheet
NPDES Permit No. NC0051608
Permit Writer/Email Contact Emily Phillips
Date: February 9, 2021
Division/Branch: NC Division of Water Resources/NPDES Complex Permitting
Fact Sheet Template: Version 09Jan2017
Permitting Action:
❑X Renewal
❑ Renewal with Expansion
❑ New Discharge
❑ Modification (Fact Sheet should be tailored to mod request)
Note: A complete application should include the following:
• For New Dischargers, EPA Form 2A or 2D requirements, Engineering Alternatives Analysis, Fee
• For Existing Dischargers (POTW), EPA Form 2A, 3 effluent pollutant scans, 4 2' species WET
tests.
• For Existing Dischargers (Non-POTW), EPA Form 2C with correct analytical requirements based
on industry category.
Complete applicable sections below. If not applicable, enter NA.
1. Basic Facility Information
Facility Information
Applicant/Facility Name:
Catawba County Schools/Bandys High School
Applicant Address:
540 East Bandys Road, Catawba NC 28609
Facility Address:
540 East Bandys Road, Catawba NC 28609
Permitted Flow:
0.0 MGD [-901 people]
Facility Type/Waste:
Minor Municipal; 100% domestic
Facility Class:
Class I
Treatment Units:
• grease trap (1000-gallon)
• duel (2) septic tanks (each 15,000-gallon in series)
• recirculation tank (10,000-gallon) w/ high-water alarm
• sand filter - gravel surfaced; elevated manifolds (PVC) w/
nozzle distribution
• chlorine contact chamber / tablet chlorinator
• tablet de -chlorinator
Pretreatment Program (Y/N)
N
County:
Catawba
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DocuSign Envelope ID: 990CBA17-04A7-4FAF-8C55-3791E9E4727A
Region
Mooresville
Briefly describe the proposed permitting action and facility background: Bandys High School has
applied for an NPDES permit renewal at 0.015 MGD. This facility serves a population of 901 people.
The facility has a single Outfall 001.
2. Receiving Waterbodv Information:
Outfalls/Receiving Stream(s):
Outfall 001 — UT to Battle
Run Creek
Stream Segment:
11-97-1
Stream Classification:
WS-IV
303(d) listed/parameter:
N/A
Basin/Sub-basin:
Catawba/03-08-32
3. Effluent Data Summary
Table. Effluent Data Summary Outfall 001
PARAMETER
[Parameter Codes]
LIMITS
MONITORING REQUIREMENTS
Monthly
Average
Daily
Maximum
Measurement
Frequency
Sample Type
Sample
Location
Flow
50050
0.015 MGD
Weekly
Instantaneous
Influent or
Effluent
Total Residual Chlorine
50060
28 µg/L 2
2/Week
Grab
Effluent
Temperature (°C)
00010
Weekly
Grab
Effluent
BOD, 5-day (20°C)
C0310
30.0 mg/L
45.0 mg/L
2/Month
Grab
Effluent
Total Suspended Solids
C0530
30.0 mg/L
45.0 mg/L
2/Month
Grab
Effluent
Ammonia (NH3 as N)
(Apr 1 — Oct 31)
C0610
7.7 mg/L
35.0 mg/L
2/Month
Grab
Effluent
Ammonia (NH3 as N)
(Nov 1 — Mar 31)
C0610
22.0 mg/L
35.0 mg/L
2/Month
Grab
Effluent
Fecal Coliform
(geometric mean)
31616
200 / 100 ml
400 / 100 ml
2/Month
Grab
Effluent
pH
00400
Not < 6.0 or > 9.0
standard units
2/Month
Grab
Effluent
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DocuSign Envelope ID: 990CBA17-04A7-4FAF-8C55-3791E9E4727A
4. Instream Data Summary
Instream monitoring may be required in certain situations, for example: 1) to verify model predictions
when model results for instream DO are within 1 mg/1 of instream standard at full permitted flow; 2) to
verify model predictions for outfall diffuser; 3) to provide data for future TMDL; 4) based on other
instream concerns. Instream monitoring may be conducted by the Permittee, and there are also
Monitoring Coalitions established in several basins that conduct instream sampling for the Permittee (in
which case instream monitoring is waived in the permit as long as coalition membership is maintained).
If applicable, summarize any instream data and what instream monitoring will be proposed for this
permit action: The current permit requires instream monitoring for Flow. Review of instream data for
the past three years indicates that the dissolved oxygen standard of 5 mg/1 was maintained.
Is this facility a member of a Monitoring Coalition with waived instream monitoring (Y/N): NO
Name of Monitoring Coalition: N/A
5. Compliance Summary
Summarize the compliance record with permit effluent limits (past 5 years): No limit violations, but
frequency violations for temperature and flow in 2016. One NOV in 2019 for monthly average exceeded
for Nitrogen.
No major activities or problems with this facility.
Summarize the compliance record with aquatic toxicity test limits and any second species test results
(past 5 years): N/A
Summarize the results from the most recent compliance inspection: Last inspection occurred December
2015, and appeared well -maintained and operated. Danger signs were recommended to be posted around
the facility fence.
6. Water Quality -Based Effluent Limitations (WQBELs)
Dilution and Mixing Zones
In accordance with 15A NCAC 2B.0206, the following stream flows are used for dilution considerations
for development of WQBELs: 1 Q 10 streamflow (acute Aquatic Life); 7Q10 streamflow (chronic Aquatic
Life; non -carcinogen HH); 30Q2 streamflow (aesthetics); annual average flow (carcinogen, HH).
If applicable, describe any other dilution factors considered (e.g., based on CORMIX model results): NA
If applicable, describe any mixing zones established in accordance with 15A NCAC 2B.0204(b): NA
Oxygen -Consuming Waste Limitations
Limitations for oxygen -consuming waste (e.g., BOD) are generally based on water quality modeling to
ensure protection of the instream dissolved oxygen (DO) water quality standard. Secondary TBEL limits
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DocuSign Envelope ID: 990CBA17-04A7-4FAF-8C55-3791E9E4727A
(e.g., BOD= 30 mg/1 for Municipals) may be appropriate if deemed more stringent based on dilution and
model results.
If permit limits are more stringent than TBELs, describe how limits were developed: NA
Ammonia and Total Residual Chlorine Limitations
Limitations for ammonia are based on protection of aquatic life utilizing an ammonia chronic criterion of
1.0 mg/1 (summer) and 1.8 mg/1 (winter). Acute ammonia limits are derived from chronic criteria,
utilizing a multiplication factor of 3 for Municipals and a multiplication factor of 5 for Non -Municipals.
Limitations for Total Residual Chlorine (TRC) are based on the NC water quality standard for protection
of aquatic life (17 ug/1) and capped at 28 ug/1(acute impacts). Due to analytical issues, all TRC values
reported below 50 ug/1 are considered compliant with their permit limit.
Describe any proposed changes to ammonia and/or TRC limits for this permit renewal: There are no
proposed changes.
Reasonable Potential Analysis (RPA) for Toxicants NA
If applicable, conduct RPA analysis and complete information below.
The need for toxicant limits is based upon a demonstration of reasonable potential to exceed water quality
standards, a statistical evaluation that is conducted during every permit renewal utilizing the most recent
effluent data for each outfall. The RPA is conducted in accordance with 40 CFR 122.44 (d) (i). The NC
RPA procedure utilizes the following: 1) 95% Confidence Level/95% Probability; 2) assumption of zero
background; 3) use of V2 detection limit for "less than" values; and 4) stream flows used for dilution
consideration based on 15A NCAC 2B.0206. Effective April 6, 2016, NC began implementation of
dissolved metals criteria in the RPA process in accordance with guidance titled NPDES Implementation of
Instream Dissolved Metals Standards, dated June 10, 2016.
A reasonable potential analysis was conducted on effluent toxicant data collected between NA. Pollutants
of concern included toxicants with positive detections and associated water quality standards/criteria.
Based on this analysis, the following permitting actions are proposed for this permit:
• Effluent Limit with Monitoring. The following parameters will receive a water quality -based
effluent limit (WQBEL) since they demonstrated a reasonable potential to exceed applicable
water quality standards/criteria: NA
• Monitoring Only. The following parameters will receive a monitor -only requirement since they
did not demonstrate reasonable potential to exceed applicable water quality standards/criteria,
but the maximum predicted concentration was >50% of the allowable concentration: NA
• No Limit or Monitoring: The following parameters will not receive a limit or monitoring, since
they did not demonstrate reasonable potential to exceed applicable water quality
standards/criteria and the maximum predicted concentration was <50% of the allowable
concentration: NA
• POTW Effluent Pollutant Scan Review: Three effluent pollutant scans were evaluated for
additional pollutants of concern.
o The following parameter(s) will receive a water quality -based effluent limit (WQBEL)
with monitoring, since as part of a limited data set, two samples exceeded the allowable
discharge concentration: NA
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DocuSign Envelope ID: 990CBA17-04A7-4FAF-8C55-3791E9E4727A
o The following parameter(s) will receive a monitor -only requirement, since as part of a
limited data set, one sample exceeded the allowable discharge concentration: NA
If applicable, attach a spreadsheet of the RPA results as well as a copy of the Dissolved Metals
Implementation Fact Sheet for freshwater/saltwater to this Fact Sheet. Include a printout of the RPA
Dissolved to Total Metal Calculator sheet if this is a Municipality with a Pretreatment Program.
Toxicity Testing Limitations
Permit limits and monitoring requirements for Whole Effluent Toxicity (WET) have been established in
accordance with Division guidance (per WET Memo, 8/2/1999). Per WET guidance, all NPDES permits
issued to Major facilities or any facility discharging "complex" wastewater (contains anything other than
domestic waste) will contain appropriate WET limits and monitoring requirements, with several
exceptions. The State has received prior EPA approval to use an Alternative WET Test Procedure in
NPDES permits, using single concentration screening tests, with multiple dilution follow-up upon a test
failure.
Describe proposed toxicity test requirement: NA
Mercury Statewide TMDL Evaluation
There is a statewide TMDL for mercury approved by EPA in 2012. The TMDL target was to comply
with EPA's mercury fish tissue criteria (0.3 mg/kg) for human health protection. The TMDL established a
wasteload allocation for point sources of 37 kg/year (81 lb/year), and is applicable to municipals and
industrial facilities with known mercury discharges. Given the small contribution of mercury from point
sources (.-2% of total load), the TMDL emphasizes mercury minimization plans (MMPs) for point source
control. Municipal facilities > 2 MGD and discharging quantifiable levels of mercury (>1 ng/l) will
receive an MMP requirement. Industrials are evaluated on a case -by -case basis, depending if mercury is a
pollutant of concern. Effluent limits may also be added if annual average effluent concentrations exceed
the WQBEL value (based on the NC WQS of 12 ng/l) and/or if any individual value exceeds a TBEL
value of 47 ng/1
NA Table. Mercury Effluent Data Summary
# of Samples
Annual Average Conc. ng/L
Maximum Conc., ng/L
TBEL, ng/L
WQBEL, ng/L
Describe proposed permit actions based on mercury evaluation: NA
Other TMDL/Nutrient Management Strategy Considerations
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DocuSign Envelope ID: 990CBA17-04A7-4FAF-8C55-3791E9E4727A
If applicable, describe any other TMDLs/Nutrient Management Strategies and their implementation
within this permit: NA
Other WQBEL Considerations
If applicable, describe any other parameters of concern evaluated for WQBELs: NA
If applicable, describe any special actions (HQW or ORW) this receiving stream and classification shall
comply with in order to protect the designated waterbody: NA
If applicable, describe any compliance schedules proposed for this permit renewal in accordance with
15A NCAC 2H. 0107(c)(2)(B), 40CFR 122.47, and EPA May 2007 Memo: NA
If applicable, describe any water quality standards variances proposed in accordance with NCGS 143-
215.3(e) and 15A NCAC 2B. 0226 for this permit renewal: NA
7. Technology -Based Effluent Limitations (TBELs)
Municipals (if not applicable, delete and skip to Industrials)
Are concentration limits in the permit at least as stringent as secondary treatment requirements (30 mg/l
BOD5/TSS for Monthly Average, and 45 mg/l for BOD5/TSS for Weekly Average). Yes, for TSS and
BOD.
If NO, provide a justification for alternative limitations (e.g., waste stabilization pond). NA
Are 85% removal requirements for BODS/TSS included in the permit? NA
If NO, provide a justification (e.g., waste stabilization pond). NA
Industrials (if not applicable, delete and skip to next Section) NA
Describe what this facility produces:
List the federal effluent limitations guideline (ELG) for this facility:
If the ELG is based on production or flow, document how the average production/flow value was
calculated:
For ELG limits, document the calculations used to develop TBEL limits:
Table. TBEL Development per NA
Pollutant
Daily Maximum
BPT/BAT
(lb/1000 lb)
Daily Maximum
Limit
(lb /d)
Monthly Average
BPT/BAT
(lb/1000lb)
Monthly Average
Limit
(lb/d)
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DocuSign Envelope ID: 990CBA17-04A7-4FAF-8C55-3791E9E4727A
If any limits are based on best professional judgement (BPJ), describe development: NA
Document any TBELs that are more stringent than WQBELs: NA
Document any TBELs that are less stringent than previous permit: NA
8. Antidegradation Review (New/Expanding Discharge):
The objective of an anti -degradation review is to ensure that a new or increased pollutant loading will not
degrade water quality. Permitting actions for new or expanding discharges require an anti -degradation
review in accordance with 15A NCAC 2B.0201. Each applicant for a new/expanding NPDES permit
must document an effort to consider non -discharge alternatives per 15A NCAC 2H.0105 (c)(2). In all
cases, existing instream water uses and the level of water quality necessary to protect the existing use is
maintained and protected.
If applicable, describe the results of the antidegradation review, including the Engineering Alternatives
Analysis (EAA) and any water quality modeling results: NA
9. Antibacksliding Review:
Sections 402(o)(2) and 303(d)(4) of the CWA and federal regulations at 40 CFR 122.44(1) prohibit
backsliding of effluent limitations in NPDES permits. These provisions require effluent limitations in a
reissued permit to be as stringent as those in the previous permit, with some exceptions where limitations
may be relaxed (e.g., based on new information, increases in production may warrant less stringent TBEL
limits, or WQBELs may be less stringent based on updated RPA or dilution).
Are any effluent limitations less stringent than previous permit (YES/NO): NO
If YES, confirm that antibacksliding provisions are not violated: NA
10. Monitoring Requirements
Monitoring frequencies for NPDES permitting are established in accordance with the following
regulations and guidance: 1) State Regulation for Surface Water Monitoring, 15A NCAC 2B.0500; 2)
NPDES Guidance, Monitoring Frequency for Toxic Substances (7/15/2010 Memo); 3) NPDES Guidance,
Reduced Monitoring Frequencies for Facilities with Superior Compliance (10/22/2012 Memo); 4) Best
Professional Judgement (BPJ). Per US EPA (Interim Guidance, 1996), monitoring requirements are not
considered effluent limitations under Section 402(o) of the Clean Water Act, and therefore anti -
backsliding prohibitions would not be triggered by reductions in monitoring frequencies.
For instream monitoring, refer to Section 4.
11. Electronic Reporting Requirements
The US EPA NPDES Electronic Reporting Rule was finalized on December 21, 2015. Effective
December 21, 2016, NPDES regulated facilities are required to submit Discharge Monitoring Reports
(DMRs) electronically. Effective December 21, 2020, NPDES regulated facilities will be required to
submit additional NPDES reports electronically. This permit contains the requirements for electronic
reporting, consistent with Federal requirements.
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DocuSign Envelope ID: 990CBA17-04A7-4FAF-8C55-3791E9E4727A
12.Summary of Proposed Permitting Actions:
A. Table. Current Permit Conditions and Proposed Changes NA
Parameter
Current Permit
Proposed Change
Basis for Condition/Change
NA
MGD — Million gallons per day, MA - Monthly Average, WA — Weekly Average, DM — Daily Max
13. Public Notice Schedule:
Permit to Public Notice: 03/09/21
Per 15A NCAC 2H .0109 & .0111, The Division will receive comments for a period of 30 days following
the publication date of the public notice. Any request for a public hearing shall be submitted to the
Director within the 30 days comment period indicating the interest of the party filing such request and the
reasons why a hearing is warranted.
14. Fact Sheet Addendum (if applicable):
Were there any changes made since the Draft Permit was public noticed (Yes/No): NO
If Yes, list changes and their basis below: NA
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DocuSign Envelope ID: 990CBA17-04A7-4FAF-8C55-3791E9E4727A
Advertising Affidavit
Observer News Enterprise
309 N College Ave
Newton, NC 28658
Wren Thedford
NCDENR — Div. Of Water Resources
1617 Mail Service Center
Raleigh, NC 27699_ 1617
Date
03/13/21 Descri tion
Public Notice; Intent to
ance
reissue wastewater discharge e Ch~�
NC0051608 $130.00 Bat
NC0086304 permits
$130.00
, NCoo63355
North Carolina
Catawba County
Philip Rogers, BEING D
OBSERVER DULY SWORN SAYS: that he is the Composing
newspaperENTERPRISE
intent to reissue NEWSral ENTERPRISE, a newspaper Manager
elation in Catawba published at Newton, for the
thereof and ofis ba County and surrounding North Carolina. it is a
a true wastewater permits, was publishedg counties. The
beginning on March 13 copy of the Notice in said newspaperNotice of
NEWS ENTERPRISE , 2021, and as it was published in the regular and not a
RPRIh 1 was regularly
on March 13 supplement
gularly distributed to the subscribers and entire edition,
21, and that said OBSERVER
be re during said period.
me this da March 16, 2021.
Composing Manager:
NOTARY PUBLIC:
My Commission Expires:
2
1 BETH A Reeks-1101v
NOTARY PUBLIC
LINCOL
N couNrY, NORTH CAROLINA
•

DocuSign Envelope ID: 990CBA17-04A7-4FAF-8C55-3791E9E4727A
tr.V. LJVA IV IV,
The Catawba
County Schools
(P.O. Box 1010,
Newton, NC
28658) applied to
renew NPDES
permit
NC0086304 for
• Mill Creek Middle
School WWTP in
Catawba County.
This permitted fa-
cility discharges
treated, 200% do-
mestic wastewa-
ter to a UT to
Balls Creek in the
Catawba River
Basin. Currently
fecal coliform and
total residual
chlorine are wa-
ter -quality limited.
This discharge
may affect future
wasteload alloca-
tions in this por-1
tion of the Cata-
wba River Basin.
Aqua of North
Carolina, Inc. has
applied for re-
newal of permit
NC0063355 for
the Killian Cross-
roads WWTP in
Catawba County.
This permitted
discharge is treat-
ed domestic
wastewater to
Lake Norman
(Reed Creek) in
the Catawba Riv-
er Basin.
Publish: March
13, 2021
Newton, NC
28658) applied to
renew NPDES
permit
NC0051608 for
Bandys High
School WWTP,
Catawba County.
This permitted fa-
cility discharges
100% domestic
treated wastewa-
ter to Battle Run
Creek in the Cat-
awba River Ba-
sin. Currently Fe-
cal Coliform, Am-
monia Nitrogen 1
[NH3 as NJ and
Total Residual
Chlorine are wa- 1
ter -quality limited.
This discharge
may affect future
wasteload alloca-
tions in this por-
tion of the Cata-
wba River Basin.
Public Notic
North Carotin
Environments
Managemeni
Commissior/Nf
ES Unit
1617 Mail Servi.
i Center
Raleigh, NC
• 27699-1617
Notice of Intent
Issue a NPDE
Wastewater Pe
mit NC005160
Bandys Hig
School,
NC0086304 Mi
Creek Middle
School, and Kill
ian Crossroad;
WWTP
The North Caroli-
na Environmental
Management
Commission pro-
poses to issue e
NPDES wastewa•
ter discharge per-
mit to the
person(s) listed
below. Written
comments re-
garding the pro-
posed 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 hearing
should there be a
significant degree
of public interest.
Please mail com-
ments and/or in-
formation re-
quests to DWR at
the above ad-
dress. Interested
persons may visit
the DWR at 512
N. Salisbury
Street, Raleigh,
NC 27604 to re-
view information
on file. Additional
information on
NPDES permits
and this notice
may be found on
our website:
http://deq.nc.gov/
about/divisions/w
ater-
resources/wate r-
resources-per-
mits/wastewater-
branch/npdes-
wastewater/pub-
lic-notices,by call-
ing (919) 707-
3601. Catawba

DocuSign Envelope ID: 990CBA17-04A7-4FAF-8C55-3791E9E4727A
ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
S. DANIEL SMITH
Director
Catawba County Schools
Attn: Morgan C. Williams, Coordinator
PO Box 1010
Newton, NC 28658
Subject: Permit Renewal
Application No. NC0051608
Bandys High School
Catawba County
Dear Applicant:
NORTH CAROLINA:
Environmental Quality
April 30, 2020
The Water Quality Permitting Section acknowledges the April 30, 2020 receipt of your permit renewal application and
supporting documentation. Your application will be assigned to a permit writer within the Section's NPDES WW permitting
branch. 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. The
permit writer will contact you if additional information is required to complete your permit renewal. Please respond in a
timely manner to requests for additional information necessary to allow a complete review of the application and renewal
of the permit.
Information regarding the status of your renewal application can be found online using the Department of Environmental
Quality's Environmental Application Tracker at:
https://deq. nc.gov/permits-regulations/permit-guidance/environmental-application-tracker
If you have any additional questions about the permit, please contact the primary reviewer of the application using the
links available within the Application Tracker.
ec: WQPS Laserfiche File w/application
D_E
Sincerely,
Wren Thetford
Administrative Assistant
Water Quality Permitting Section
North Csrofine Department of Envvronmental Quality I Divs;on of Water Resources
Moo-resvT.e Reg ohal Office I 310 East center Avenue, Su to 301 I .Moore lie, North Carotins 28115
704463-1399 •

DocuSign Envelope ID: 990CBA17-04A7-4FAF-8C55-3791E9E4727A
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 Resources / NPDES Program
1617 Mail Service Center, Raleigh, NC 27699-1617
NPDES Permit
INC0051608
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 Catawba County Schools
Facility Name Bandys High School
Mailing Address . PO BOX 1010
City Newton
State / Zip Code NC/28658
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 5040 East Bandys Road
City
State / Zip Code
County
Catawba
NC/28609
Catawba
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
Catawba County Schools
PO BOX 1010
Newton
NC/28658
[phone]
[phone]
[e-mail]
1 of 4 Form-D 9/2013

DocuSign Envelope ID: 990CBA17-04A7-4FAF-8C55-3791E9E4727A
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 801 / 100
Other ❑ Explain:
Describe the source(s) of wastewater (example: subdivision, mobile home park, shopping centers,
restaurants, etc.):
High School
Number of persons served: 901
5. Type of collection system
® Separate (sanitary sewer only)
El Combined (storm sewer and sanitary sewer)
6. Outfall Information:
Number of separate discharge points 1
Outfall Identification number(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):
Battle Run Creek
8. Frequency of Discharge: ❑ Continuous ® Intermittent
If intermittent:
Days per week discharge occurs: 15 Duration: 10 minutes
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.
We have a sand filter system that uses a timer to dose the entire surface of the filter
intermittently with wastewater. This system draws oxygen from the atmosphere through
the sand medium area. Physical, chemical and biological processes are ways the effluent
is treated within the system. The treatment occurs through the bacteria that colonize in
the sand grains of the sand filter system. The microorganisms use the organic matter in
the effluent for growth and reproduction to help continually maintain the system
properly.
2 of 4 Form-D 9/2013

DocuSign Envelope ID: 990CBA17-04A7-4FAF-8C55-3791E9E4727A
NPDES APPLICATION - FORM D
For privately -owned treatment systems treating 100% domestic wastewaters <1.0 MGD
10. Flow Information:
Treatment Plant Design flow 0.015 (Monthly Avg.) MGD
Annual Average daily flow .000046 MGD (for the previous 3 years)
Maximum daily flow .00006 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".
Parameter
Daily
Maximum
Monthly
Average
Units of
Measurement
Biochemical Oxygen Demand (BOD5)
41.8
22.8
mg/L
Fecal Coliform
315
121.68
ml
Total Suspended Solids
26
22
mg/L
Temperature (Summer)
24.6
23.27
°C
Temperature (Winter)
19.8
17.46
°C
pH
6.6
N / A
s.u.
13. List all permits, construction approvals and/or applications:
Type Permit Number Type
Hazardous Waste (RCRA) NESHAPS (CAA)
UIC (SDWA) Ocean Dumping (MPRSA)
NPDES NC0051608 Dredge or fill (Section 404 or CWA)
PSD (CAA) Other
Non -attainment program (CAA)
14. APPLICANT CERTIFICATION
Permit Number
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.
Morgan C. Williams Health and Environmental Coordinator
Printed name of Person Signing Title
Morgan C. Williams 4-15-2020
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.)
4 of 4 Form-D 9/2013