NC0043125_Permit (Issuance)_20140214

NPDES DOCUMENT SCANNINC COVER SHEET
NPDES Permit:
NC0043125
The Patterson
School WWTP
Document Type:
(rinitIsnce
Wasteload Allocation
Authorization to Construct (AtC)
Permit Modification
Complete File - Historical
Engineering Alternatives (EAA)
Correspondence
Instream Assessment
(67b)
Speculative Limits
Environmental Assessment (EA)
Permit
History
Document Date:
February 14, 2014
This document is printed on reuse paper - ignore aziy
content on the re -sr -ex -Ise side

ern
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Resources
Pat McCrory Thomas A. Reeder John E. Skvarla III
Governor Director Secretary
February 14, 2014
Mr. Walter J. Hogan
Patterson School Foundation, Inc.
P.O. Box 500
Patterson, N.C. 28661-0500
Subject: Issuance of NPDES Permit NC0043125
Patterson School Foundation
Class WW-1
Caldwell County
Dear Mr. Hogan:
Division personnel have reviewed and approved your application for renewal of the subject
permit. Accordingly, we are forwarding the attached NPDES discharge permit. This permit is
issued pursuant to the requirements of North Carolina General Statute 143-215.1 and the
Memorandum of Agreement between North Carolina and the U.S. Environmental Protection
Agency dated October 15, 2007 (or as subsequently amended).
This final permit includes the following major change from the draft permit sent
to you on November 6, 2013.
> The permittee name has been changed from The Patterson School to Patterson School
Foundation, per your request.
> Section A. (3) has been added to require electronic submission of effluent data.
Proposed Federal regulations require electronic submittal of all discharge monitoring
reports (DMRs). The proposed regulations specify that if a state does not establish a
system to receive such submittals permittees must submit DMRs electronically to the
Environmental Protection Agency (EPA). Accordingly, NC DENR has established an
electronic data -submission system. Permittees must begin using the system no later
than 270 days following the issuance of permit renewals. In your case, that deadline is
December 1, 2014.
If any parts, measurement frequencies or sampling requirements contained in this permit
are unacceptable to you, you have the right to an adjudicatory hearing upon written request
within thirty (30) days following receipt of this letter. This request must be in the form of a
written petition, conforming to Chapter 150B of the North Carolina General Statutes, and filed
with the Office of Administrative Hearings (6714 Mail Service Center, Raleigh, North Carolina
27699-6714). Unless such demand is made, this decision shall be final and binding.
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 512 North Salisbury Street, Raleigh, North Carolina 27604
Phone: [phone] / FAX [phone] l http:llportal.ncdenr.orglweb/wq
An Equal Opportunity/Affirmative Action Employer — 50% Recycled/10% Post Consumer Paper

Please note that this permit is not transferable except after notice to the Division. The
Division may require modification or revocation and reissuance of the permit. This permit does
not affect the legal requirements to obtain other permits which may be required by the Division of
Water Quality or permits required by the Division of Land Resources, the Coastal Area
Management Act or any other Federal or Local governmental permit that may be required.
If you have any questions concerning this permit, please contact Charles Weaver at
telephone number [phone].
Sincer
omas A. Reeder
cc: Central Files
Asheville Regional Office
NPDES Unit

Permit NC0043125
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 provision 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
Patterson School Foundation, Inc.
are hereby authorized to discharge wastewater from a facility located at
The Patterson School WWTP
4646 Patterson School Drive
Lenoir
Caldwell County
to receiving waters designated as the Yadkin River in the Yadkin -Pee Dee 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 March 1, 2014.
This permit and authorization to discharge shall expire at midnight on October 31, 2018.
Signed this day February 14 /2014
T as A. Reeder, Director
ision of Water Resources
By Authority of the Environmental Management Commission
1 of 5

Permit NC0043125
SUPPLEMENT TO PERMIT COVER SHEET
All previous NPDES Permits issued to this facility, whether for operation or discharge are hereby
revoked. As of this permit issuance, any previously issued permit bearing this number is no longer
effective. Therefore, the exclusive authority to operate and discharge from this facility arises under
the permit conditions, requirements, terms, and provisions included herein.
The Patterson School Foundation, Inc. is hereby authorized to:
1. Continue to operate an existing 0.025 MGD wastewater treatment
system [AeroFlo model S-250-55-5] that includes the following
components:
• Bar screen with mechanical comminutor
• Aeration tank
• Recirculation
• Secondary clarifier
The system is located at The Patterson School WWTP off Patterson
School Drive near Lenoir in Caldwell County.
2. Discharge via outfall 001 from said treatment works at the location
specified on the attached map into the Yadkin River, currently a class C-
Trout stream in subbasin 03-07-02 the Yadkin -Pee Dee River Basin.
2 of 5

Permit NC0043125
Part I
A. (1) EFFLUENT LIMITATIONS AND MONITORING REQUIREMENTS
During the period beginning on the effective date of the permit and lasting until
expiration, the Permittee is authorized to discharge from outfall 001. Such discharges
shall be limited and monitored' by the Permittee as specified below:
PARAMETER
[PCS Code]
LIMITS'
MONITORING' REQUIREMENTS
Monthly
Average
Daily
-Maximum
Measurements
" . Frequency
1 Sample Type
; SampleLocation
Flow
[50050]
0.025 MGD
Weekly
Instantaneous
Influent or Effluent
BOD, 5-day (20°C)
[00310]
30.0 mg/L
45.0 mg/L
2/Month
Grab
. Effluent
Total Suspended Solids
[00530]
30.0 mglL
45.0 mg/L
2/Month
Grab
Effluent
NH3 as N
[00610]
Monthly
Grab
Effluent
Temperature
[00010]
Weekly
Grab
Effluent
Total Residual Chlorine (TRC)2
[50060]
17 pg/L
Weekly
Grab
Effluent
pH
[00400]
> 6.0 and < 9.0 standard units
—
Weekly
Grab
Effluent
Notes
1. No later than December 1, 2014, the permittee shall begin submitting discharge monitoring reports
electronically using the Division's eDMR application system [see A. (3)].
2. Limit and associated TRC monitoring requirements apply only if chlorine is used for disinfection. The
Permittee shall report all effluent TRC values reported by a NC -certified laboratory [including field -
certified]. Effluent values < 50 µg/L will be treated as zero for compliance purposes.
There shall be no discharge of floating solids or visible foam in other than trace amounts.
A. (2) NUTRIENT REOPENER FOR HIGH ROCK LAKE
This permit may be reopened and modified to implement nutrient requirements in accordance
with any future TMDL and / or nutrient management strategy for High Rock Lake.
3 of 5

Permit NC0043125
A. (3) ELECTRONIC REPORTING OF DISCHARGE MONITORING REPORTS
Proposed federal regulations require electronic submittal of all. discharge monitoring reports
(DMRs) and specify that, if a state does not establish a system to receive such submittals, then
permittees must submit DMRs electronically to the Environmental Protection Agency (EPA). The
Division anticipates that these regulations will be adopted and is beginning implementation in
late 2013.
NOTE: This special condition supplements or supersedes the following sections within Part II of this
permit (Standard Conditions for NPDES Permits):
• Section B. (11.)
• Section D. (2.)
• Section D. (6.)
• Section E. (5.)
Signatory Requirements
Reporting
Records Retention
Monitoring Reports
1. Reporting ESupersedes Section D. (2.) and Section E. (5.) (a)1
Beginning no later than December 1, 2014, the permittee shall begin reporting discharge
monitoring data electronically using the NC DWR's Electronic Discharge Monitoring Report
(eDMR) internet application.
Monitoring results obtained during the previous month(s) shall be summarized for each month
and submitted electronically using eDMR. The eDMR system allows permitted facilities to
enter monitoring data and submit DMRs electronically using the internet. Until such time
that the state's eDMR application is compliant with EPA's Cross -Media Electronic Reporting
Regulation (CROMERR), permittees will be required to submit all discharge monitoring data
to the state electronically using eDMR and will be required to complete the eDMR submission
by printing, signing, and submitting one signed original and a copy of the computer -printed
eDMR to the following address:
NC DENR / Division of Water Resources / Information Processing Unit
ATTENTION: Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
If a permittee is unable to use the eDMR system due to a demonstrated hardship or due to the
facility being physically located in an area where less than 10 percent of the households have
broadband access, then a temporary waiver from the NPDES electronic reporting requirements
may be granted and discharge monitoring data may be submitted on paper DMR forms (MR 1,
1.1, 2, 3) or alternative forms approved by the Director. Duplicate signed copies shall be
submitted to the mailing address above.
Requests for temporary waivers from the NPDES electronic reporting requirements must be
submitted in writing to the Division for written approval at least sixty (60) days prior to the
date the facility would be required under this permit to begin using eDMR. Temporary
waivers shall be valid for twelve (12) months and shall thereupon expire. At such time, DMRs
shall be submitted electronically to the Division unless the permittee re -applies for and is
granted a new temporary waiver by the Division.
4 of 5

Permit NC0043125
Information on eDMR and application for a temporary waiver from the NPDES electronic
reporting requirements is found on the following web page:
http://portal.ncdenr.org/web/wq/admin/bog/ipu/edmr
Regardless of the submission method, the fast DMR is due on the last day of the month
following the issuance of the permit or in the case of a new facility, on the last day of the
month following the commencement of discharge.
2. Signatory Requirements 'Supplements Section B. (11.) (b) and supersedes Section B.
(11.) (d)1
All eDMRs submitted to the permit issuing authority shall be signed by a person described in
Part II, Section B. (11.)(a) or by a duly authorized representative of that person as described in
Part II, Section B. (11.)(b). A person, and not a position, must be delegated signatory authority
for eDMR reporting purposes.
For eDMR submissions, the person signing and submitting the DMR must obtain an eDMR
user account and login credentials to access the eDMR system. For more information on North
Carolina's eDMR system, registering for eDMR and obtaining an eDMR user account, please
visit the following web page:
http://portal.ncdenr.org/web/wciladmin/bog/ipu/edmr
Certification. Any person submitting an electronic DMR using the state's eDMR system shall
make the following certification [40 CFR 122.22]. NO OTHER STATEMENTS OF
CERTIFICATION WILL BE ACCEPTED:
"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 fines and imprisonment for knowing violations."
3. Records Retention [Supplements Section D. (S.)]
The permittee shall retain records of all Discharge Monitoring Reports, including eDMR
submissions. These records or copies shall be maintained for a period of at least 3 years from
the date of the report. This period may be extended by request of the Director at any time [40
CFR 122.41].
5 of 5

Quad: Vienna, N.C.
Subbasin: 30701
Latitude: 36°00'26"
Longitude: 81°31'06"
Receiving Stream: Yadkin River
Stream Class: C-Trout
NC00431 25
The Patterson School WWTP
Facility
Location
North
,5C LE1:i'BO

NORTH CAROLINA,
CALDWELL COUNTY,
AFFIDAVIT OF PUBLICATION
Before the undersigned, a Notary Public of said County
and State, duly commissioned, qualified, and authorized by
law to administer oaths, personally appealed Terese
Public Notice
North Carolina Environmental Management Commission/NPDES Unit
1617 Mail Service Center
Raleigh, NC 27699-1617
Notice of Intent to Issue a NPDES Wastewater Permit
The North Carolina Environmental Management Commission proposes to issue a NPDES
wastewater discharge permit to the person(s) listed below. Written comments regarding
the proposed 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 comments and/or information requests
to DWR at the above address. Interested persons may visit the DWR at 512 N. Salisbury
Street, Raleigh, NC to review information on file.
Additional information on NPDES permits and this notice may be found on our website:
http:/lportal.ncdenr.org/web/wq/swp/ps/npdes/calendar, or by calling [phone].
The Patterson School, Inc. requested renewal of NPDES permit NC0043125 for its WWTP/
Caldwell County, Facility discharges to the Yadkin River/Yadkin-Pee Dee River Basin.
Currently total residual chlorine is water quality limited.
‘4,0 -9,p, : ita7 Public
My Conunissiooiexj}i:..:..5 `l1-0k0 L7
.o�gL IC
•e/(., N 0
sB"ill ACB6�

PATTERSON SCHOOL FOUNDATION, INC.
Post Office Box 500 . Patterson, North Carolina 28661-0500
828-754-5065 pattcrsonschoolfoundation4gmail.com
Visit us at: www.pattcrsonschoolfoundation.org
The Historic Patterson Boarding School Campus: Providing Opportunities
fir Education, Agriculture, ce Inspiration in an Idyllic Christian Environment
December 2, 2013
Mr. Charles H. Weaver, Jr.
NPDES Unit
NCDENR - Division of Water Resources
1617 Mail Service Center
Raleigh, NC 27699-1617
Dear Mr. Weaver:
Re: Draft NPDES Permit
NC0043125 letter
Nov. 6, 2013.
Thank you for considering my late application. The draft seems
alright as shown, except for the Permittee name on pages 1 and 2.
I believe it would be better to use Patterson School Foundation,
Inc. instead of The Patterson School, Inc.
The Patterson School, Inc. has become inactive since the school
closed in 2009. Most of its functions have been taken over by
Patterson School Foundation, Inc., including property management.
Ode lease part of our property to various educational groups
and are responsible for all utilities. The Foundation has been
the legal owner of all the real estate since 1994. It seems
to me the proper entity for working with NPDES on the WWTP and
Discharge Permit in the future.
There will be no change in the personnel involved. I will
remain ORC and will remain involved in both corporations.
I enclose copies of pages 1. and 2 from the Draft Permit with
my suggested changes outlined.
Respectfully,
41Z
Walter J. Ho , /Pres .
DENR-WATER QUALITY
POINT SOURCE BRANCH
W. J. "Jim" Hogan, Foundation Board President
Janet H. Spoon, Corresponding Secretary

Permit NC0043125
(en'
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 provision 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 Patterson School, Inc.
P4 ce re, 4-1 11 FcuJQ17on£nc
are hereby authorized to discharge wastewater m a fac ty ocated at
The Patterson School WWTP
4646 Patterson School Drive
Lenoir
Caldwell County
to receiving waters designated as the Yadkin River •in the Yadkin -Pee Dee 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
This permit and authorization to discharge shall expire at midnight on October 31, 2018.
Signed this day
Thomas A. Reeder, Director
Division of Water Quality
By Authority of the Environmental Management Commission
1 of 5

Permit NC0043125
All previous NPDES Permits issued to this facility, whether for operation or discharge are hereby
SUPPLEMENT TO PERMIT COVER SHEET
revoked. As of this permit issuance, any previously issued permit bearing this number is no longer
effective. Therefore, the exclusive authority to operate and discharge from this facility arises under
the permit conditions, requirements, terms, and provisions included herein.
C:61'''Lr- rN
The Patterson School, Inc. is hereby authorized to:
2:ttrs
P 5:- e' / ovK c! c ion nc
1. Continue to operate an existing 0.025 MGD wastewater treatment
system [AeroFlo model S-250-55-5] that includes the following
components:
• Bar screen with mechanical comminutor
• Aeration tank
• Recirculation
• Secondary clarifier
The system is located at The Patterson School WWTP off Patterson
School Drive near Lenoir in Caldwell County.
2. Discharge via outfall 001 from said treatment works at the location
specified on the attached map into the Yadkin River, currently a class C-
Trout stream in subbasin 03-07-02 the Yadkin -Pee Dee River Basin.
2 of 5

Weaver, Charles
From: Wiggs, Linda
Sent: Monday, November 04, 2013 1:20 PM
To: Weaver, Charles
Subject: RE: DRAFT permit renewal for NC0043125
Attachments: PermitReview.pattersonschool.Nov2013.docx
Hi Charles.
ARO recommends Raleigh proceed with this renewal.
Any issues, as noted in the attached document, regarding possible line issues can be dealt with in the region during an
inspection,,,,if or when the facility becomes active again.
:vela, r4
Linda.WiggsPncdenr.gov
Environmental Senior Specialist
North Carolina Dept. of Environment and Natural Resources
Asheville Regional Office
Division of Water Resources - Water Quality Regional Operations
2090 U.S. 70 Highway
Swannanoa, NC 28778
Tei• R7R-79F,-4Snn
Fax• R7R-799-71143
Link to Division of Water Resources Horne Paoc
htto://oortal.ncdenr.ore/web/wa
Notice: E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and
therefore may be disclosed to third parties.
From: Weaver, Charles
Sent: Monday, November 04, 2013 10:45 AM
To: Wiggs, Linda
Subject: FW: DRAFT permit renewal for NC0043125
Importance: High
na yes, ; m a set;le Diet tool iur leaving otr the attachments.
Sorry about that.
rw\A/
From: Weaver, Charles
Sent: Monday, November 04, 2013 10:44 AM
To: Wiggs, Linda
Subject: DRAFT permit renewal for NC0043125
Linda — this is a class WW-1 facility in Caldwell County.
Please send me any comments by December S`h.
Thanks,
i

NPDES Permit Renewal
Regional Office Comments
Permit number:
NC0043125
Region:
Asheville
Date:
Nov. 4, 2013
Facility name:
Patterson School
Staff:
Linda Wiggs
County:
Caldwell
Reviewer:
Charles Weaver
RO Supervisor:
Chuck Cranford
Requested
Action:
X Issue permit according to Draft
❑ Make changes as noted below
Comments:
ARO recommends issuance of permit.
Kathy Jimison-recent inspector stated there may be compromised lines
between source and WWTP. The facility has very little activity to generate
flows.
S:1SWP12 Templates&Forms\Permit Review\NPDESPeimitReview ROComments.Feb2412.docx

FACT SHEET FOR EXPEDITED PERMIT RENEWALS
This form must be completed by Permit Writers for all expedited permits which do not require
full Fact Sheets. Expedited permits are generally simple 100% domestics (e.g., schools, mobile
home parks, etc) that can be administratively renewed with minor changes, but can include
facilities with more complex issues (Special Conditions, 303(d) listed water, toxicity testing,
instream monitoring, compliance concerns).
Basic Information for Expedited Permit Renewals
Permit Writer/Date
Charles H. Weaver 11/4/2013
Permit Number
NC0043125
Facility Name
The Patterson School WWTP
Basin Name/Sub-basin number
03-07-01
Receiving Stream
Yadkin River
Stream Classification in Permit
C-Trout
Does permit need Daily Max NH3 limits?
N/A
Does permit need TRC limits/language?
No — already present
Does permit have toxicity testing?
No
Does permit have Special Conditions?
No
Does permit have instream monitoring?
No
Is the stream impaired (on 303(d) list)?
For what parameter?
No
Any obvious compliance concerns?
None. No enforcements since 2002. No flow
at facility since 2010. Repairs at school now
complete, discharge may return to normal
volume over the next permit cycle
Any permit modifications since last permit?
None.
New expiration date
10/31/2018
Comments on Draft Permit
Added parameter codes.
Added High Rock reopener condition.
Added eDMR requirements.
Most Commonly Used Expedited Language:
• 303(d) laneuaze for Draft/Final Cover Letters: "Please note that the receiving stream
is listed as an impaired waterbody on the North Carolina 303(d) Impaired Waters List.
Addressing impaired waters is a high priority with the Division, and instream data will
continue to be evaluated. If there is noncompliance with permitted effluent limits and
stream impairment can be attributed to your facility, then mitigative measures may be
required".
• TRC lan2uaee for Compliance Level for Cover Letters/Effluent Sheet Footnote:
"The facility shall report all effluent TRC values reported by a NC certified laboratory
including field certified. However, effluent values < 50 µg/1 will be treated as zero for
compliance purposes."
This page has been printed on scrap paper to save money and reduce our program's environmental
impact. Disregard any content on the back of this page.

Sept. 5, 2013
Mr. Charles H. Weaver
NCDENR/DWR!NPDES Unit
1617 Mail Service Center
Raleigh, NC 27699-1617
Dear Mr. Weaver:
Patterson School, Inc.
P. 0. Box 500
Patterson, NC 28661
SLUDGE MANAGEMENT
Our sludge management plan is to have sludge pumped from
the aeration basin and clarifier when needed, by a commercial
sewage pumping contractor. This has been needed only at
5 to 10 year intervals. The last time it was pumped was
in 2007. Floating objects such as plastic items are skimmed
off the.surface by the ORC and accumulated in 5 gallon buckets
and eventually sent to the landfill.
Respectfully,
W. ogan, Pres.

Patterson School, Inc.
P. 0. Box 500
Patterson, NC 28661
Sept. 5, 2013
Mr. Charles H. Weaver
NCDENR/DWR/NPDES Unit
3617 Mail Service Center
Raleigh, NC 27699-1617
Dear Mr. Weaver:
I request renewal of permit # NC0043125 for Patterson School.
No changes have been made in the facility since the current
permit was issued October 2008.
There is a change in the operation of the school which affects
the data I am presenting. The school closed in May 2009 due to
financial problems. I continued to operate the plant and take
samples on to the end of 2009, when the flow had dropped to
almost none. I was told at that time that I should stop testing
BOD, TSS, pH, and temperature and just keep checking the plant
weekly and record my visits and record 'no flow'. I started this
procedure in Jan. 2010 and have continued until now, continuing
to run the aeration the entire time. I still record'no flow'
every week when I check the plant.
I am using test data for the period Jan. 2007 thru Dec. 2009
as the most recent 36 months for which I have complete data.
This period covers our residential school in operation for most
of the time, although at well under our capacity for students.
In the period Jan. 2010 to now there has been little to no
residential use. We have two families on campus not connected
to the -wastewater system, and we have daytime only visitors at
the school. This use will increase starting in September and
I feel will increase the flow and I will resume normal testing.
I have taken samples Aug. 28 and find results of less than 2.0
for BOD and 6.2 TSS. This is under the same conditions that
have prevailed since Jan. 2010.
I request that our rated capacity for wastewater treatment be
kept at 25000 gallons per day, as this is the rated capacity
of our plant. We are slowly getting dormitories back in shape
to be occupied and are hoping for greatly increased campus use
in the future.
Our sludge removal plan, as always, is to have it pumped when
needed by a commercial sewage pumping contractor. This was last
done in 2007. It has only been needed every 5 to 10 years.

Continued
I am sorry I did not call for this renewal of our permit in
April. I knew that October was the renewal time but I had
forgot that I was supposed to start the process 6 months
ahead of the renewal date.
My home phone is 828 754-5065 for evening calls only (I am
widowed since Aug. 2032.and generally no one is here during
the day). My daytime cell number is 828 446-9353. Please
call if there is anything I can to expedite this renewal.
Respectfully,
W. J. Hogan, lyres.

NPDES APPLICATION - FORM D
For privately -owned treatment systems treating 100% domestic wastewaters <1.0 MGD
Mail the complete application to:
N. C. DENR / Division of Water Quality / NPDES Unit
1617 Mail Service Center, Raleigh, NC 27699-1617
NPDES Permit
'NCO() 125
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
Facility Name
Mailing Address
City
State / Zip Code
Telephone Number
Fax Number
e-mail Address
Patterson School Foundation, Inc.
Patterson School, Inc.
P. 0. Box 500
Patterson
NC / 28661
( 828) 754-5065, 828 728-3189, 828 729-0163
[phone] (call first)
[e-mail]
2. Location of facility producing discharge:
Check here if same address as above ❑
Street Address or State Road 4646Patterson School Drive
City
State / Zip Code
County
Lenoir
NC / 28645
Caldwell
3. Operator Information:
Name of the fug 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
Patterson School Foundation, Inc.
P. 0. Box 500
Patterson
NC / 28661
[phone], 828 728-3189, 828 729-0163
[phone] (call first)
[e-mail]
1 of
Form-D 11/12

NPDES APPLICATION - FORM D
For privately -owned treatment systems treating 100% domestic wastewaters <1.0 MGD
4. Description of wastewater:
Facility Generating Wastewater(check all that apply
Industrial 0 Number of Employees
Commercial 0 Number of Employees
Residential el Number of Homes 3
School ® Number of Students/ Staff 50 t 3
Other 0 Explain:
Describe the source(s) of wastewater (example: subdivision, mobile home park, shopping centers,
restaurants, etc.):
Number of persons served: 55
5. Type of collection system
® Separate (sanitary sewer only) ❑ 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 6 No
7. Name of receiving stream(s) (NEW applicants: Provide a map showing the exact location of each
outfall)
Yadkin River
8. Frequency of Discharge: It Continuous ❑ Intermittent
If intermittent:
Days per week discharge occurs: Duration:
9. Describe the treatment system
List all installed components, including capacities, provide design removal for BOD, TSS, nitrogen and
phosphorus. If the space provided is not sufficient, attach the description of the treatment system in a
separate sheet of paper.
Existing AeroFlo Model S-250-55-5 with:
Bar Screen with Mechanical Comminutor
Aeration Tank
Recirculation
Secondary Clarifier
2 of 4
Form-D 11/12

NPDES APPLICATION - FORM D
For privately -owned treatment systems treating 100% domestic wastewaters <1.0 MGD
10. Flow Information:
Treatment Plant Design flow . 0 2 5 MGD
Annual Average daily flow • 0049 MGD (for the previous 3 years) (Jan. 2007 - Dec. 2009)
.010 (Jan. 2007 - Dec. 2009)
Maximum daily flow 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
tl our ermit. Mark other parameters "N/A".
-
the past 36 months for parameters curl rt. y in y P
Parameter
Daily
Mum
Monthly
Average
Units of
Measurement
Biochemical Oxygen Demand (BOD5)
33.0
9.9
mg/L
Fecal Coliform
N/A
N/A
Total Suspended Solids
19.0
5.8
mg/L
Temperature (Summer)
25.5
22.1
C.
Temperature (Winter)
10.0
12.7
C.
pH
70
7.0
pH
13. List all permits, construction approvals and/or applications:
Type Permit Number Type
Hazardous Waste (RCRA) NESHAPS (CAA)
Permit Number
UIC (SDWA) Ocean Dumping (MPRSA)
NPDES NC0043125 Dredge or fill (Section 404 or CWA)
PSD (CAA) Other
Non -attainment program (CAA)
14. APPLICANT CERTIFICATION
I certify that I am familiar with the information contained in the application and that to the
best of my knowledge and belief such information is true, complete, and accurate.
W. J. Hogan Pres.
Printed name of Person Signing Title
Signatur&ojplicant
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.)
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