NC0039331_Renewal (Application)_20211026

M.STAT[o-
ROY COOPER 5 t. 1
Governor i
ELIZABETH S.BISER
axe .ra,`
Secretary
S.DANIEL SMITH NORTH CAROLINA
Director Environmental Quality
October 26, 2021
Chatham County Schools
Attn: Chris Blice, Assistant Superintendent
PO Box 128
Pittsboro, NC 27713
Subject: Permit Renewal
Application No. NC0039331
Bonlee Elementary School
Chatham County
Dear Applicant:
The Water Quality Permitting Section acknowledges the October 25, 2021 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.
Sincerely
' y�
Wren Thedfo •
Administrative Assistant
Water Quality Permitting Section
ec: WQPS Laserfiche File w/application
D_E Q No th CarolinaDepartment ofEnvironmental QualityIDivisionofWaterResourcesRaleghRegionalOffice 3800BarrettDrive aleigh.North Carolina 27609 919.7914200

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
NC0039331 OMB No 2040-0004
Form U.S.Environmental Protection Agency SEC E I VE D
=\•EPA Application for NPDES Permit to Discharge Wastew t
NPDES GENERAL INFORMATION Jr,Jr,T 2 5 2021
SECTION 1.ACTIVITIES REQUIRING AN NPDES PERMIT(40 CFR 122.21(f)and(f)(1))
1.1 Applicants Not Required to Submit Form 1 NCDFQ/DWR/NPrES
Is the facility a new or existing publicly owned Is the facility a new or existing treatment works
1.1.1 12
treatment works? 1. . treating domestic sewage?
If yes, STOP.Do NOT complete 0 No If yes, STOP.Do NOT ❑ No
Form 1.Complete Form 2A. complete Form 1.Complete
Form 2S.
1.2 Applicants Required to Submit Form 1
1.2.1 Is the facility a concentrated animal feeding 1.2.2 Is the facility an existing manufacturing,
operation or a concentrated aquatic animal commercial,mining,or silvicultural facility that is
a production facility? currently discharging process wastewater?
oElYes 4 Complete Form 1 ❑ No El Yes 4 Complete Form ❑ No
a and Form 2B. 1 and Form 2C.
1.2.3 Is the facility a new manufacturing,commercial, 1.2.4 Is the facility a new or existing manufacturing,
mining,or silvicultural facility that has not yet commercial,mining,or silvicultural facility that
commenced to discharge? discharges only nonprocess wastewater?
Yes S Complete Form 1 ❑ No ❑ Yes 4 Complete Form 0 No
ce and Form 2D. 1 and Form 2E.
i ql
-V. 1.2.5 Is the facility a new or existing facility whose
discharge is composed entirely of stormwater
associated with industrial activity or whose
discharge is composed of both stormwater and
non-stormwater?
❑ Yes-S Complete Form 1 0 No
and Form 2F
unless exempted by
40 CFR
122.26(b)(14)(x)or
b 15 .
SECTION 2.NAME,MAILING ADDRESS,AND LOCATION(40 CFR 122.21(f)(2))
2.1 Facility Name
Bonlee Elementary School Wastewater Treatment Plant
0 2.2 EPA Identification Number
0
0
J
R 2.3 Facility Contact
Name(first and last) Title Phone number
-a Chris Bice Chief operations officer [phone]
Email address
[e-mail]
R
2.4 Facility Mailing Address
Street or P.O.box
PO BOX 128
City or town State ZIP code
Pittsboro NC 27713
EPA Form 3510-1(revised 3-19) Page 1

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
OMB No.2040-0004
u 7, 2.5 Facility Location
a .. Street,route number,or other specific identifier
Q o 61 Randolph Street
rn
c o County name County code(if known)
R Chatham
V i
—' City or town State ZIP code
z Bonlee NC 27213
SECTION 3.SIC AND NAICS CODES(40 CFR 122.21(f)(3))
3.1 SIC Code(s) Description(optional)
0
ocn
3.2 NAICS Code(s) Description(optional)
c
SECTION 4.OPERATOR INFORMATION(40 CFR 122.21(f)(4))
4.1 Name of Operator
John Poteat
0 4.2 Is the name you listed in Item 4.1 also the owner?
6
8
0 ❑ Yes ElNo
= 4.3 Operator Status
❑ Public—federal ❑ Public—state ❑ Other public(specify)
0 Private 0 Other(specify)Chatham Count!
4.4 Phone Number of Operator
919-412-7554
= 4.5 Operator Address
Street or P.O. Box
E`6 PO Box 16474
�
o S)
c City or town State ZIP code
o o Chapel Hill NC 27516
U
Email address of operator
O [e-mail]
SECTION 5.INDIAN LAND(40 CFR 122.21(f)(5))
L
0 5.1 Is the facility located on Indian Land?
6,3
❑Yes ❑ No
EPA Form 3510-1(revised 3-19) Page 2

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
OMB No.2040-0004
SECTION 6.EXISTING ENVIRONMENTAL PERMITS(40 CFR 122.21(f)(6))
6.1 Existing Environmental Permits(check all that apply and print or type the corresponding permit number for each)
❑✓ NPDES(discharges to surface ❑ RCRA(hazardous wastes) ❑ UIC(underground injection of
o .N water) fluids)
NC0039331
E
w W ❑ PSD(air emissions) ❑ Nonattainment program(CM) ❑ NESHAPs(CAA)
w ❑ Ocean dumping(MPRSA) ElDredge or fill(CWA Section 404) D Other(specify)
SECTION 7.MAP(40 CFR 122.21(f)(7))
7.1 Have you attached a topographic map containing all required information to this application?(See instructions for
specific requirements.)
0 Yes ❑ No ❑ CAFO—Not Applicable(See requirements in Form 2B.)
SECTION 8.NATURE OF BUSINESS(40 CFR 122.21(f)(8))
8.1 Describe the nature of your business.
PUBLIC SCHOOL SYSTEM
N
4)
N
m
N
t6
Z
SECTION 9.COOLING WATER INTAKE STRUCTURES(40 CFR 122.21(f)(9))
9.1 Does your facility use cooling water?
6- 1 ❑ Yes ❑ No 4 SKIP to Item 10.1.
- B 9.2 Identify the source of cooling water.(Note that facilities that use a cooling water intake structure as described at
w 40 CFR 125,Subparts I and J may have additional application requirements at 40 CFR 122.21(r).Consult with your
v' NPDES permitting authority to determine what specific information needs to be submitted and when.)
o °)
o
C
SECTION 10.VARIANCE REQUESTS(40 CFR 122.21(f)(10))
10.1 Do you intend to request or renew one or more of the variances authorized at 40 CFR 122.21(m)?(Check all that
apply.Consult with your NPDES permitting authority to determine what information needs to be submitted and
when.)
CD
c ❑ Fundamentally different factors(CWA ❑ Water quality related effluent limitations(CWA Section
Section 301(n)) 302(b)(2))
❑ Non-conventional pollutants(CWA ❑ Thermal discharges(CWA Section 316(a))
crs
Section 301(c)and(g))
❑ Not applicable
EPA Form 3510-1(revised 3-19) Page 3

•
EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
OMB No.2040-0004
SECTION 11.CHECKLIST AND CERTIFICATION STATEMENT(40 CFR 122.22(a)and(d))
11.1 In Column 1 below,mark the sections of Form 1 that you have completed and are submitting with your application.
For each section,specify in Column 2 any attachments that you are enclosing to alert the permitting authority. Note
that not all applicants are required to provide attachments.
Column 1 Column 2
❑ Section 1:Activities Requiring an NPDES Permit ❑r wl attachments
❑ Section 2:Name,Mailing Address,and Location 0 w/attachments
Section 3: SIC Codes ❑ w/attachments
❑ Section 4:Operator Information ❑r w/attachments
❑ Section 5:Indian Land ❑ w/attachments
❑ Section 6: Existing Environmental Permits ❑ w/attachments
1= w/topographic
wID Section 7:Map ❑� map ❑ wl additional attachments
o ❑ Section 8:Nature of Business ❑ w/attachments
El Section 9:Cooling Water Intake Structures ❑ wl attachments
❑ Section 10:Variance Requests ❑ w/attachments
❑ Section 11:Checklist and Certification Statement 0 wl attachments
11.2 Certification Statement
U
I certify under penalty of law that this document and all attachments were prepared under my direction or supervision
in accordance with a system designed to assure that qualified personnel properly gather and evaluate the
information submitted.Based on my inquiry of the person or persons who manage the system,or those persons
directly responsible for gathering the information,the information submitted is,to the best of my knowledge and
belief,true,accurate,and complete. I am aware that there are significant penalties for submitting false information,
including the possibility of fine and imprisonment for knowing violations.
Name(print or type first and last name) Official title
414-� D. iks6/4A-Sup0,4-i-cA4���
Sig re Date signed 16/17/ Jai
Do,c
EPA Form 3510-1(revised 3-19) Page 4

NPDES Permit Number Facility Name Modified Application Form 2A
NC0039331 Bonlee Elementary School Modified March 2021
Form NC Department of Environmental Quality-Application for NPDES Permit to Discharge Wastewater
NPDES MINOR SEWAGE FACILITIES(Before completing this form,please read the instructions.Failure to follow
the instructions may result in denial of the application.)
SECTION 1.BASIC APPLICATION INFORMATION FOR ALL APPLICANTS(40 CFR 122.21(j)(1)and(9))
1.1 Facility name
BONLEE ELEMENTARY SCHOOL WASTEWATER TREATMENT PLANT
Mailing address(street or P.O.box)
PO BOX 128
City or town State ZIP code
= PITTSBORO NC 27713
0
Contact name(first and last) Title Phone number Email address
CHRIS BLICE Chief operations officer [phone] [e-mail]
= i1t
Location address(street,route number,or other specific identifier) El Same as mailing address
153 Bonlee School Road
w
City or town State ZIP code
BONLEE NC 27213
1.2 Is this application for a facility that has yet to commence discharge?
❑ Yes 4 See instructions on data submission ❑ No
requirements for new dischargers.
1.3 Is applicant different from entity listed under Item 1.1 above?
❑ Yes ❑ No 4 SKIP to Item 1.4.
Applicant name
= Applicant address(street or P.O.box)
0
City or town State ZIP code
0
Contact name(first and last) Title Phone number Email address
a 1.4 Is the applicant the facility's owner,operator,or both?(Check only one response.)
ElOwner ❑ Operator ❑ Both
1.5 To which entity should the NPDES permitting authority send correspondence?(Check only one response.)
❑ Facility ❑ Applicant ❑ Facility and applicant
(they are one and the same)
1.6 Indicate below any existing environmental permits.(Check all that apply and print or type the corresponding permit
number for each.)
Existing Environmental Permits
❑ NPDES(discharges to surface ❑ RCRA(hazardous waste) ❑ UIC(underground injection
water) control)
E
2 ❑ PSD(air emissions) ❑ Nonattainment program(CM) ❑ NESHAPs(CM)
❑ Ocean dumping(MPRSA) ❑ Dredge or fill(CWA Section ❑ Other(specify)
w 404)
Page 1

NPDES Permit Number Facility Name Modified Application Form 2A
Modified March 2021
1.7 Provide the collection system information requested below for the treatment works.
Municipality Population Collection System Type Ownership Status
Served Served (indicate percentage)
438 100 %separate sanitary sewer 0 Own 0 Maintain
a %combined storm and sanitary sewer ❑ Own ❑ Maintain
o 0 Unknown 0 Own ❑ Maintain
co %separate sanitary sewer 0 Own ❑ Maintain
o
combined storm and sanitary sewer ❑ Own ❑ Maintain
❑ Unknown ❑ Own ❑ Maintain
a %separate sanitary sewer ElOwn ElMaintain
-a %combined storm and sanitary sewer ❑ Own ❑ Maintain
R ❑ Unknown ❑ Own ❑ Maintain
E %separate sanitary sewer ❑ Own ❑ Maintain
> %combined storm and sanitary sewer ❑ Own ❑ Maintain
cn
C ❑ Unknown ❑ Own ❑ Maintain
Total 438
°' Population
ci Served
Separate Sanitary Sewer System Combined Storm and
Sanitary Sewer
Total percentage of each type of 100 % %,
sewer line(in miles)
- ------1.8 Is the treatment works located in Indian Country?
o ❑ Yes 0 No
(.3
R 1.9 Does the facility discharge to a receiving water that flows through Indian Country?
15
❑ Yes ❑ No
1.10 Provide design and actual flow rates in the designated spaces. Design Flow Rate
.007 mgd
To
0) Annual Average Flow Rates(Actual)
a R Two Years Ago Last Year This Year
CO .0032 mgd .0033 mgd .0026 mgd
_�Er_
Daily Flow Rates(Actual)
in Two Years Ago Last Year This Year
.0049 mgd .0016 mgd .0048 mgd
1.11 Provide the total number of effluent discharge points to waters of the State of North Carolina by type.
o Total Number of Effluent Discharge Points by Type
a 0. Constructed
rn F Combined Sewer
Treated Effluent Untreated Effluent Bypasses Emergency
to- - ver Oflows Overflows
U i
N
0 one
Page 2

NPDES Permit Number Facility Name Modified Application Form 2A
Modified March 2021
Outfalls Other Than to Waters of the State of North Carolina
1.12 Does the POTW discharge wastewater to basins,ponds,or other surface impoundments that do not have outlets
for discharge to waters of the State of North Carolina?
El Yes ❑ No 4 SKIP to Item 1.14.
1.13 Provide the location of each surface impoundment and associated discharge information in the table below.
Surface Impoundment Location and Discharge Data
Average Daily Volume Continuous or Intermittent
Location Discharged to Surface
Impoundment (check one)
❑ Continuous
gpd ❑ Intermittent
❑ Continuous
gpd ❑ Intermittent
❑ Continuous
gpd ❑ Intermittent
s 1.14 Is wastewater applied to land?
❑ Yes ❑ No 4 SKIP to Item 1.16.
0 1.15 Provide the land application site and discharge data requested below.
0 Land Application Site and Discharge Data
Continuous or
Location Size Average Daily Volume Intermittent
Applied (check one)
6,3
0 acres d ❑ Continuous
o gp ❑ Intermittent
acres d 0 Continuous
o gp ❑ Intermittent
acres d ❑ Continuous
gp ❑ Intermittent
1.16 Is effluent transported to another facility for treatment prior to discharge?
o ❑ Yes ❑ No 4 SKIP to Item 1.21.
1.17 Describe the means by which the effluent is transported(e.g.,tank truck,pipe).
1.18 Is the effluent transported by a party other than the applicant?
❑ Yes ❑ No 4 SKIP to Item 1.20.
1.19 Provide information on the transporter below.
Transporter Data
Entity name Mailing address(street or P.O.box)
City or town State ZIP code
Contact name(first and last) Title
Phone number Email address
Page 3

NPDES Permit Number Facility Name Modified Applicafion Form 2A
Modified March 2021
1.20 In the table below,indicate the name,address,contact information, NPDES number,and average daily flow rate of the
receiving facility.
Receiving Facility Data
Facility name Mailing address(street or P.O.box)
.*6 City or town State ZIP code
0
Contact name(first and last) Title
0
Phone number Email address
QNPDES number of receiving facility(if any) 0 None Average daily flow rate mgd
tn
0 1.21 Is the wastewater disposed of in a manner other than those already mentioned in Items 1.14 through 1.21 that do
not have outlets to waters of the State of North Carolina(e.g.,underground percolation,underground injection)?
❑ Yes ❑ No 4 SKIP to Item 1.23.
0 1.22 Provide information in the table below on these other disposal methods.
Information on Other Disposal Methods
o Disposal Location of Size of Annual Average Continuous or Intermittent
Method Disposal Site Disposal Site Daily Discharge (check one)
Description Volume
NA acres d ❑ Continuous
gp 0 Intermittent
NA acres d ❑ Continuous
gp ❑ Intermittent
NA acres d 0 Continuous
gp ❑ Intermittent
1.23 Do you intend to request or renew one or more of the variances authorized at 40 CFR 122.21(n)?(Check all that apply.
Consult with your NPDES permitting authority to determine what information needs to be submitted and when.)
0,
0 CD El Discharges into marine waters(CWA ❑ Water quality related effluent limitation(CWA Section
p Section 301(h)) 302(b)(2))
ElNot applicable
1.24 Are any operational or maintenance aspects(related to wastewater treatment and effluent quality)of the treatment works
the responsibility of a contractor?
ElYes ❑ No+SKIP to Section 2.
1.25 Provide location and contact information for each contractor in addition to a description of the contractor's operational
and maintenance responsibilities.
Contractor Information
Contractor 1 Contractor 2 Contractor 3
o Contractor name JOHN POTEAT
(company name)
O Mailing address PO BOX 16474
(street or P.O.box)
o City,state,and ZIP CHAPEL HILL NC
code
O Contact name(first and JOHN POTEAT
c.) last)
Phone number 919 412 7554
Email address [e-mail]
Operational and System operation and
maintenance treatment
responsibilities of
contractor
Page 4

NPDES Permit Number Facility Name Modified Application Form 2A
Modified March 2021
SECTION 2.ADDITIONAL INFORMATION(40 CFR 122.21(j)(1)and(2))
o Outfalls to Waters of the State of North Carolina
rn
2.1 Does the treatment works have a design flow greater than or equal to 0.1 mgd?
o ❑ Yes ❑ No 4 SKIP to Section 3.
0 2.2 Provide the treatment works'current average daily volume of inflow Average Daily Volume of Inflow and Infiltration
;� and infiltration. 0.0 gpd
Indicate the steps the facility is taking to minimize inflow and infiltration.
The system has been smoke tested
0
0
1E 2.3 Have you attached a topographic map to this application that contains all the required information?(See instructions for
R R specific requirements.)
0
o ❑✓ Yes ❑ No
E 2.4 Have you attached a process flow diagram or schematic to this application that contains all the required information?
o R (See instructions for specific requirements.)
o ❑✓co
Yes ❑ No
2.5 Are improvements to the facility scheduled?
❑ Yes ❑ No 4 SKIP to Section 3.
Briefly list and describe the scheduled improvements.
R 1.
d
d
2.
E
0
3.
m
U)
4.
R 2.6 Provide scheduled or actual dates of completion for improvements.
• Scheduled or Actual Dates of Completion for Improvements
°' Affected Attainment of
Scheduled Begin End Begin
Outfalls Operational
2 Improvement Construction Construction Discharge
(from above) (list outfall (MM/DD/YYYY) (MM/DD/YYYY) (MM/DD/YYYY) Level
number) (MM/DD/YYYY)
1.
2.
cn
3.
4.
2.7 Have appropriate permits/clearances concerning other federal/state requirements been obtained?Briefly explain your
response.
❑ Yes ❑ No ❑ None required or applicable
Explanation:
Page 5

NPDES Permit Number Facility Name Modified Application Form 2A
Modified March 2021
SECTION 3.INFORMATION ON EFFLUENT DISCHARGES(40 CFR 122.21(j)(3)to(5))
3.1 Provide the following information for each outfall.(Attach additional sheets if you have more than three outfalls.)
Outfall Number 001 Outfall Number Outfall Number
State
County
City or town
o Distance from shore 10 ft. ft. ft.
a
co Depth below surface 2.0 ft. ft. ft.
Average daily flow rate mgd mgd mgd
Latitude 35 38 36'
Longitude 79 23 25'
3.2 Do any of the outfalls described under Item 3.1 have seasonal or periodic discharges?
❑ Yes ❑ No 4 SKIP to Item 3.4.
R 3.3 If so,provide the following information for each applicable outfall.
N Outfall Number Outfall Number Outfall Number
Number of times per year
o discharge occurs
a Average duration of each
`o discharge(specify units)
Average flow of each mgd mgd mgd
Gn discharge
tO Months in which discharge
occurs
3.4 Are any of the outfalls listed under Item 3.1 equipped with a diffuser?
❑ Yes ❑ No 4 SKIP to Item 3.6.
3.5 Briefly describe the diffuser type at each applicable outfall.
Outfall Number Outfall Number Outfall Number
ui 3.6 Does the treatment works discharge or plan to discharge wastewater to waters of the State of North Carolina from
one or more discharge points?
❑r Yes ❑ No 4SKIP to Section 6.
Page 6

NPDES Permit Number Facility Name Modified Application Form 2A
Modified March 2021
3.7 Provide the receiving water and related information(if known)for each outfall.
Outfall Number 001 Outfall Number Outfall Number
BEAR CREEK
Receiving water name
Name of watershed,river, CAPE FEAR
0 or stream system
1 Q- U.S.Soil Conservation
Service 14-digit watershed
o code
R Name of state CAPE FEAR
management/river basin
a)
.5 U.S.Geological Survey
.0 8-digit hydrologic
rx cataloging unit code
Critical low flow(acute) cfs cfs cfs
Critical low flow(chronic) cfs cfs cfs
Total hardness at critical mg/L of mg/L of mg/L of
low flow CaCO3 CaCO3 CaCO3
3.8 Provide the following information describing the treatment provided for discharges from each outfall.
Outfall Number Outfall Number Outfall Number
Highest Level of ❑ Primary ❑ Primary 0 Primary
Treatment(check all that 0 Equivalent to 0 Equivalent to 0 Equivalent to
apply per outfall) secondary secondary secondary
❑ Secondary 0 Secondary 0 Secondary
❑ Advanced ❑ Advanced 0 Advanced
❑ Other(specify) 0 Other(specify) 0 Other(specify)
( P Y) ( P fY) ( P fY)
0
'Q Design Removal Rates by
.y Outfall
BODs or CBOD5 95 % % %
d
E
d TSS 98 % %
1-
0 Not applicable 0 Not applicable 0 Not applicable
Phosphorus %
0 Not applicable 0 Not applicable 0 Not applicable
Nitrogen %
Other(specify) 0 Not applicable 0 Not applicable 0 Not applicable
% % ok
Page 7

NPDES Permit Number Facility Name Modified Application Form 2A
Modified March 2021
3.9 Describe the type of disinfection used for the effluent from each outfall in the table below. If disinfection varies by
season,describe below.
a)
Outfall Number 001 Outfall Number Outfall Number
0
Disinfection type UV DISINFECTION
0
N
d
c
Seasons used ALL SEASONS
Dechlorination used? ❑ Not applicable El Not applicable ❑ Not applicable
❑ Yes El Yes El Yes
El No ❑ No El No
3.10 Have you completed monitoring for all Table A parameters and attached the results to the application package?
El Yes El No
3.11 Have you conducted any WET tests during the 4.5 years prior to the date of the application on any of the facility's
discharges or on any receiving water near the discharge points?
❑ Yes El No 4 SKIP to Item 3.13.
3.12 Indicate the number of acute and chronic WET tests conducted since the last permit reissuance of the facility's
discharges by outfall number or of the receiving water near the discharge points.
Outfall Number Outfall Number Outfall Number
Acute Chronic Acute Chronic Acute Chronic
Number of tests of discharge NA NA
water
F Number of tests of receiving NA NA
water
w
3.14 Does the POTW use chlorine for disinfection,use chlorine elsewhere in the treatment process,or otherwise have
reasonable potential to discharge chlorine in its effluent?
El Yes 3 Complete Table B,including chlorine. El No 3 Complete Table B,omitting chlorine.
3.15 Have you completed monitoring for all applicable Table B pollutants and attached the results to this application
package?
El Yes El No
Have you completed monitoring for all applicable Table D pollutants required by your NPDES permitting authority and
3.18 attached the results to this application package?
❑ Yes ❑ No additional sampling required by NPDES
permitting authority.
Page 8

NPDES Permit Number Facility Name Modified Application Form 2A
Modified March 2021
3.19 Has the POTW conducted either(1)minimum of four quarterly WET tests for one year preceding this permit application
or(2)at least four annual WET tests in the past 4.5 years?
❑ Yes ❑ No 4 Complete tests and Table E and SKIP to
Item 3.26.
3.20 Have you previously submitted the results of the above tests to your NPDES permitting authority?
El Yes ❑ No 4 Provide results in Table E and SKIP to
Item 3.26.
3.21 Indicate the dates the data were submitted to your NPDES permitting authority and provide a summary of the results.
Date(s)Submitted Summary of Results
(MM/DDNYYY)
C)
d
3.22 Regardless of how you provided your WET testing data to the NPDES permitting authority,did any of the tests result in
o toxicity?
❑ Yes ❑ No 4 SKIP to Item 3.26.
F 3.23 Describe the cause(s)of the toxicity:
C)
w
3.24 Has the treatment works conducted a toxicity reduction evaluation?
❑ Yes ❑ No 4 SKIP to Item 3.26.
3.25 Provide details of any toxicity reduction evaluations conducted.
3.26 Have you completed Table E for all applicable outfalls and attached the results to the application package?
❑ Yes ❑ Not applicable because previously submitted
information to the NPDES .ermittin. authorit .
Page 9

NPDES Permit Number Facility Name Modified Application Form 2A
Modified March 2021
SECTION 6.CEECKLIST AND CERTIFICATION STATEMENT(40 CFR 122.22(a)and(d))
6.1 In Column 1 below,mark the sections of Form 2A that you have completed and are submitting with your application.For
each section,specify in Column 2 any attachments that you are enclosing to alert the permitting authority.Note that not
all applicants are required to provide attachments.
Column 1 Column 2
❑ Section 1: Basic Application ❑ w/variance request(s) ❑ w/additional attachments
Information for All Applicants
❑ Section 2:Additional ❑ wl topographic map ❑ w/process flow diagram
Information ❑ wl additional attachments
❑ w/Table A ❑ w/Table D
❑ Section 3: Information on ❑ w/Table B ❑ w/additional attachments
Effluent Discharges
❑ w/Table C
a)
Section 4:Not Applicable
o I
a)
Section 5:Not Applicable
v
R ❑ Section 6:Checklist and ❑ w/attachments
Certification Statement
6.2 Certification Statement
U
I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that qualified personnel properly gather and evaluate the information
submitted.Based on my inquiry of the person or persons who manage the system,or those persons directly responsible
for gathering the information, the information submitted is,to the best of my knowledge and belief,true,accurate,and
complete. I am aware that there are significant penalties for submitting false information,including the possibility of fine
and imprisonment for knowing violations.
Na a(print or Ae f t nd last name) Official title
dia6 40614.111-30frietkireit
Sign a 0 Date signed
//)if)Q/
Page 10

NPDES Permit Number Facility Name Outfall Number Modified Application Form 2A
Modified March 2021
TABLE A.EFFLUENT PARAMETERS FOR ALL POTWS
Maximum Daily Discharge Average Daily Discharge Analytical ML or MDL
Pollutant Number of Methods (include
Value Units Value Units Sam•les units)
Biochemical oxygen demand sf7.5. w/15.0 mg/I s/5.0.w/10.0 mg/I 2/month Standard methods
❑ML
o BOD5 or❑CBOD5 0 MDL
re.ort one
Fecal coliform 400/100 mpn 200/100 mpn 2/month Standard Methods ❑MDL
Design flow rate .007 mgd .0045 mgd NA
pH(minimum) 6 Standard
pH(maximum) 9 Standard
Temperature(winter)
Temperature(summer)
Total suspended solids(TSS) 45 mg/I CO mg/I 2/month Standard Methods 0 ML
0 MDL
1 Sampling shall be conducted according to sufficiently sensitive test procedures(i.e.,methods)approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter I,subchapter N or 0.See instructions and 40 CFR 122.21(e)(3).
Page 11

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Modified Application Form 2A
001 Modified March 2021
TABLE B.EFFLUENT PARAMETERS FOR ALL POTWS WITH A FLOW EQUAL TO OR GREATER THAN 0.1 MGD
Maximum Daily Discharge Average Daily Discharge Analytical ML or MDL
Pollutant Number of Methods (include
Value Units Value Units Samples units)
Ammonia(as N) 10 mg/I 2 mg/I 2/month 0 ML
0 MDL
Chlorine NA ❑ML
(total residual,TRC)2 ❑MDL
Dissolved oxygen >6 mg/I 2 mg/I 4/month ❑ML
❑MDL
❑ML
Nitrate/nitrite NA ❑MDL
❑ML
Kjeldahl nitrogen NA ❑MDL
❑ML
Oil and grease NA ❑MDL
❑ML
Phosphorus NA 0 MDL
❑ML
Total dissolved solids NA ❑MDL
1 Sampling shall be conducted according to sufficiently sensitive test procedures(i.e.,methods)approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter I,subchapter N or 0. See instructions and 40 CFR 122.21(e)(3).
2 Facilities that do not use chlorine for disinfection,do not use chlorine elsewhere in the treatment process,and have no reasonable potential to discharge chlorine in their effluent are not
required to report data for chlorine.
EPA Form 3510-2A(Revised 3-19) Page 12

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Modified Application Form 2A .
Modified March 2021
TABLE C.EFFLUENT PARAMETERS FOR SELECTED POTWS .
Maximum Daily Discharge Average Daily Discharge Analytical ML or MDL
Pollutant Number of Method1 (include units)
Value Units Value Units Samples
Metals,Cyanide,and Total Phenols
❑ML
Hardness(as CaCO3) ❑MDL
,total recoverable ❑ML
Antimony, ❑MDL
Arsenic,total recoverable ❑ML
❑MDL
Beryllium,total recoverable o ML
0 MDL
Cadmium,total recoverable ❑ML
❑MDL
Chromium,total recoverable El ML
❑MDL
0 ML
Copper,total recoverable 0 MDL
Lead,total recoverable ❑ML
❑MDL
0 ML
Mercury,total recoverable 0 MDL
Nickel,total recoverable ❑ML
❑MDL
Selenium,total recoverable ❑ML
❑MDL
Silver,total recoverable ❑ML
❑MDL
Thallium,total recoverable El ML
❑MDL
Zinc,total recoverable ❑ML
❑MDL
0 ML
Cyanide ❑MDL
0 ML
Total phenolic compounds ❑MDL
Volatile Organic Compounds
Acrolein ❑ML
❑MDL
0 ML
Acrylonitrile ❑MDL
Benzene ❑ML
❑MDL
Bromoform 0 ML
❑MDL
EPA Form 3510-2A(Revised 3-19) Page 13

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Modified Application Form 2A
Modified March 2021
TABLE C.EFFLUENT PARAMETERS FOR SELECTED POTWS
Maximum Daily Discharge Average Daily Discharge Analytical ML or MDL
Pollutant Number of Method' (include units)
Value Units Value Units Samples
Carbon tetrachloride ❑ML
0 MDL
ML
Chlorobenzene 0 MDL
Chlorodibromomethane ❑ML
0 MDL
❑ML
Chloroethane 0 MDL
❑ML
2-chloroethylvinyl ether ❑MDL
Chloroform ❑ML
❑MDL
Dichlorobromomethane ❑ML
❑MDL
1,1-dichloroethane ❑ML
0 MDL
1,2-dichloroethane ❑ML
0 MDL
trans-1,2-dichloroethylene ❑ML
0 MDL
❑ML
1,1-dichloroethylene 0 MDL
1,2-dichloropropane ❑ML
0 MDL
1,3-dichloropropylene ❑ML
0 MDL
Ethylbenzene ❑ML
0 MDL
Methyl bromide ❑ML
0 MDL
Methyl chloride ❑ML
❑MDL
Methylene chloride ❑ML
0 MDL
❑ML
1,1,2,2-tetrachloroethane ❑MDL
Tetrachloroethylene ❑ML
❑MDL
Toluene ❑ML
❑MDL
1,1,1-trichloroethane ❑ML
0 MDL
1,1,2-trichloroethane 0 ML
❑MDL
EPA Form 3510-2A(Revised 3-19) Page 14

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Modified Application Form 2A
Modified March 2021
TABLE C.EFFLUENT PARAMETERS FOR SELECTED POTWS
Maximum Daily Discharge Average Daily Discharge Analytical ML or MDL
Pollutant Number of Method1 (include units)
Value Units Value Units Samples
Trichloroethylene ❑ML
❑MDL
Vinyl chloride ❑ML
❑MDL
Acid-Extractable Compounds
p-chloro-m-cresol ❑ML
❑MDL
0 ML
2-chlorophenol 0 MDL
2,4-dichlorophenol ❑ML
❑MDL
D ML
2,4-dimethylphenol ❑MDL
4,6-dinitro-o-cresol ❑ML
❑MDL
2,4-dinitrophenol ❑ML
❑MDL
❑ML
2-nitrophenol ❑MDL
4-nitrophenol ❑ML
0 MDL
0 ML
Pentachlorophenol 0 MDL
Phenol ❑ML
0 MDL
2,4,6-trichlorophenol ❑ML
❑MDL
Base-Neutral Compounds
Acenaphthene o ML
❑MDL
Acenaphthylene ❑ML
❑MDL
Anthracene ❑ML
❑MDL
Benzidine ❑ML
❑MDL
Benzo(a)anthracene ❑ML
❑MDL
Benzo(a)pyrene ❑ML
❑MDL
3,4-benzofluoranthene 0 ML
❑MDL
EPA Form 3510-2A(Revised 3-19) Page 15

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Modified Application Form 2A
Modified March 2021
TABLE C.EFFLUENT PARAMETERS FOR SELECTED POTWS
Maximum Daily Discharge Average Daily Discharge Analytical ML or MDL
Pollutant Number of Method"' (include units)
Value Units Value Units Samples
0 ML
Benzo(ghi)perylene ❑MDL
0 ML
Benzo(k)fluoranthene ❑MDL
0 ML
Bis(2-chloroethoxy)methane ❑MDL
0 ML
Bis(2-chloroethyl)ether ❑MDL
0 ML
Bis(2-chloroisopropyl)ether 0 MDL
0 ML
Bis(2-ethylhexyl)phthalate 0 MDL
0 ML
4-bromophenyl phenyl ether 0 MDL
0 ML
Butyl benzyl phthalate ❑MDL
0 ML
2-chloronaphthalene ❑MDL
0 ML
4-chlorophenyl phenyl ether ❑MDL
0 ML
Chrysene 0 MDL
0 ML
di-n-butyl phthalate 0 MDL
0 ML
di-n-octyl phthalate ❑MDL
0 ML
Dibenzo(a,h)anthracene ❑MDL
1,2-dichlorobenzene ❑ML
❑MDL
1,3-dichlorobenzene ❑ML
❑MDL
1,4-dichlorobenzene ❑ML
❑MDL
3,3-dichlorobenzidine ❑ML
❑MDL
0 ML
Diethyl phthalate 0 MDL
0 ML
Dimethyl phthalate ❑MDL
2,4-dinitrotoluene 0 ML
❑MDL
2,6-dinitrotoluene ❑ML
❑MDL
EPA Form 3510-2A(Revised 3-19) Page 16

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Modified Application Form 2A •
Modified March 2021
TABLE C.EFFLUENT PARAMETERS FOR SELECTED POTWS -
Maximum Daily Discharge Average Daily Discharge Analytical ML or MDL
Pollutant Number of Method"' (include units)
Value Units Value Units Samples
0 ML
1,2-diphenylhydrazine 0 MDL
Fluoranthene 0 ML
❑MDL
Fluorene ❑ML
❑MDL
Hexachlorobenzene ❑MDL
Hexachlorobutadiene ❑ML
❑MDL
0 ML
Hexachlorocyclo-pentadiene 0 MDL
Hexachloroethane 0 ML
❑MDL
0 ML
Indeno(1,2,3-cd)pyrene 0 MDL
0 ML
Isophorone 0 MDL
0 ML
Naphthalene 0 MDL
Nitrobenzene ❑ML
❑MDL
0 ML
N-nitrosodi-n-propylamine 0 MDL
0 ML
N-nitrosodimethylamine 0 MDL
0 ML
N-nitrosodiphenylamine ❑MDL
Phenanthrene ❑ML
❑MDL
❑ML
Pyrene 0 MDL
1,2,4-trichlorobenzene ❑ML
❑MDL
1 Sampling shall be conducted according to sufficiently sensitive test procedures(i.e.,methods)approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR Chapter I, Subchapter N or 0.See instructions and 40 CFR 122.21(e)(3).
EPA Form 3510-2A(Revised 3-19) Page 17

NPDES Permit Number FacilityName Outfall Number Modified Application Form 2A
pP •
Modified March 2021
TABLE D.ADDITIONAL POLLUTANTS AS REQUIRED BY NPDES PERMITTING AUTHORITY
Maximum Daily Discharge Average Daily Dischar a Analytical ML or MDL
Pollutant Number of y
(list) Value Units Value Units Method1 (include units)
Samples
❑ No additional sampling is required by NPDES permitting authority.
❑ML
❑MDL
❑ML
❑MDL
❑ML
❑MDL
❑ML
❑MDL
❑ML
❑MDL
❑ML
❑MDL
❑ML
❑MDL
❑ML
❑MDL
❑ML
❑MDL
❑ML
❑MDL
❑ML
❑MDL
❑ML
❑MDL
0 ML
0 MDL
❑ML
❑MDL
❑ML
❑MDL
❑ML
❑MDL
❑ML
❑MDL
I Sampling shall be conducted according to sufficiently sensitive test procedures(i.e.,methods)approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or required
under 40 CFR chapter I,subchapter N or 0.See instructions and 40 CFR 122.21(e)(3).
Page 18

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USGS Quad:Siler City,N.C. NC0039331 i Facility
Latitude:35°38'36"
Longitude:79°25'25' Chatham County Schools Location
Stream Class:C Bonlee Elementary School
Subbasin:30612
Receiving Stream:UT Bear Creek Neuttfi Map not to scale