NC0087980_Permit Issuance_20070614

NPDES DOCUMENT SCANNINO COVER SHEET
NPDES Permit:
NC0087980
Pine Hall Elementary School
Document Type:
Permit Issuance
Wasteload Allocation
Authorization to Construct (AtC)
Permit Modification
Complete File - Historical
Engineering Alternatives (EAA)
Correspondence
Owner Name Change
Staff Report
Instream Assessment (67b)
Speculative Limits
Environmental Assessment (EA)
Document Date:
June 14, 2007
This document is printed on reuse paper - ignore any
content on the reirerse side

of WAT '
QG Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Coleen H. Sullins, Director
Division of Water Quality
June 14, 2007
Mr. Ricky Goins
Maintenance Director
Stokes County Schools
PO Box 50
Danbury, North Carolina 27016
Subject: Issuance of NPDES Permit NC0087980
Pine Hall Elementary School WWTP
Stokes County
Dear Mr. Goins:
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 May 9,1994 (or as subsequently amended).
This final permit includes no major changes from the draft permit sent to you on March 28,
2007.
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.
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
Karen Rust at telephone number [phone], extension 361.
Sincerely,
Coleen H. Sullins
cc: Central Files
Winston-Salem Regional Office/Surface Water Protection Section
NPDES Files
o"�l
hCaro ina
Naturally
N. C. Division of Water Quality 1617 Mail Service Center Raleigh, North Carolina 27699-1617 Phone: [phone]I5 Customer Service
Internet: httpJm2o.enr.state.nc.us 512 N. Salisbury St. Raleigh, NC 27604 Fax: [phone]
An Equal Opportunity/Affirmative Action Employer

Permit No. NC0087980
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
PERMIT
TO DISCHARGE WASTEWATER UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provisions of North Carolina General Statute 143-215.1, other lawful standards
and regulations promulgated and adopted by the North Carolina Environmental Management
Commission, and the Federal Water Pollution Control Act, as amended,
Stokes County Board of Education
Pine Hall Elementary Wastewater Treatment Plant
is hereby authorized to discharge wastewater from a facility located at
Pine Hall Elementary WWTP
Pine Hall Road
Stokes County
to receiving waters designated as Eurins Creek in the Roanoke River Basin
in accordance with the discharge limitations, monitoring requirements, and other conditions set forth in
Parts I, II, III, and IV hereof.
This permit shall become effective July 1, 2007.
This permit and the authorization to discharge shall expire at midnight on February 29, 2012.
Signed this day June 14, 2007.
4rr ' Coleen H. Sullins, Director /
Division of Water Quality
By the Authority of the Environmental Management Commission

Permit No. NC0087980
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.
Stokes County Board of Education
Pine Hall Elementary Wastewater Treatment Plant
is hereby authorized to:
1. Continue to operate an existing 0.004 MGD wastewater treatment facility with the
following components:
• Septic tank
• Dosing chamber
• Recirculation system
• Surface sandfilter
• Ultraviolet disinfection
The facility is located at Pine Hall Elementary School, located off Highway 772 in Stokes
County.
2. Discharge wastewater from said treatment works at the location specified on the attached
map into Eurins Creek, which is classified WS IV waters in the Roanoke River Basin.
Pine Hall Elementary WWTP.
NPDES No. NC0087980

Latitude: 36°19'59" Stream Class: WS-IV
Longitude: 80°02'56" Subbasin: 03-02-01
Quad # B 18SE, Belews Lake
Receiving Stream: Eurins Creek
Permitted Flow: 0.004 MGD
Stokes County Board of Education
Pine Hall Elementary School WWTP — NC0087980

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(s) serial number 001. Such discharges shall be
limited and monitored by the Permittee as specified below:
EFFLUENT
CHARACTERISTICS
LIMITS
MONITORING REQUIREMENTS
Monthly
Average
Weekly
Average
Daily
Maximum
Measurement
Frequency
Sample Type
Sample Location
Flow (MGD)
0.004 MGD
Continuous
Recording
Influent or Effluent
BOD, 5 day, 20°C
30.0 mg/I
45.0 mg/I
2/Month
Grab
Effluent
Total Suspended Solids
30.0 mg/I
45.0 mg/I
2/Month
Grab
Effluent
NH3 as N
Monthly
Grab
Effluent
pH1
2/Month
Grab
Effluent
Fecal Coliform
(geometric mean)
200/100 ml
400/100 ml
2/Month
Grab
Effluent
Total Residual Chlorine2
28 ugll
2/Week
Grab
Effluent
Temperature °C
Weekly
Grab
Effluent
Total Nitrogen
(NO2 + NO3 + TKN)
Quarterly
Grab
Effluent
Total Phosphorus
Quarterly
Grab
Effluent
Notes:
i The pH shall not be less than 6.0 standard units nor greater than 9.0 standard units.
z Residual chlorine shall be monitored/limited if chlorine is used as a disinfectant or elsewhere in the
treatment process.
There shall be no discharge of floating solids or visible foam in other than trace amounts.
Pine Hall Elementary WWTP
NPDES No. NC0087980

North Carolina Wildlife Resources Commission
Richard B. Hamilton, Executive Director
MEMORANDUM Cti t (_
TO: S an Wilson, NPDES Unit
ivision of Water Quality
FROM: Ron Linville, Regional Coordinator
Habitat Conservation Program
I p)
APR 2 0 2007
DEUR POINT
DATE: April 19, 2007
SUBJECT: Wastewater Treatment Plant (WWTP) Permits — Dan/Roanoke River Basin
Biologists with the North Carolina Wildlife Resources Commission (NCWRC) have reviewed
NC Division of Water Quality (DWQ) notices for the proposed issuance of WWTP permits for
potential impacts to fish and wildlife. Biologists with the NCWRC are familiar with habitat
values in the area. The NCWRC is authorized to comment and make recommendations which
relate to the impacts of this permit or project to fish and wildlife pursuant to Clean Water Act of
1977, North Carolina Environmental Policy Act, US National Environmental Policy Act,
Endangered Species Act (16 U. S. C. 1531-1543; 87 Stat 884), the Fish and Wildlife
Coordination Act (48 Stat. 401, as amended; 16 U.S.C. 661-667d) and/or Federal License of
Water Resource Project Act (Federal Power Act-16 U.S.C. 791a et seq.) as applicable.
DWQ is in the process of issuing and/or re -issuing National Pollutant Discharge Elimination
System (NPDES) permits for several WWTPs that discharge into the Dan/Roanoke River basin.
Biologists with the North Carolina Wildlife Resources Commission (NCWRC) have reviewed
the location of these sites and have determined that additional scrutiny is appropriate for
ammonia, chlorine, and copper. The specific NPDES permits we have reviewed are:
• Cains Way Homeowners Association (NC0075027)
• Horizons Residential Care Center (NC0056791)
• Kobe Wieland Copper Products, Inc. (NC0035173)
• Stokes County Board of Education (NC0044954, NC0044962, NC0087980)
• Town of Danbury (NC0043290)
• Twin Lakes Mobile Home Park (NC0057720)
Chlorine & Ammonia Concerns -
Chlorine is acutely toxic to aquatic organisms and forms secondary compounds that are also
detrimental to aquatic life, especially eggs and juveniles. We also have concerns regarding daily
ammonia concentrations. Freshwater mussels are among the most sensitive aquatic organisms
tested for impacts from ammonia, and ammonia may be a significant limiting factor for unionids
Mailing Address: Division of Inland Fisheries • 1721 Mail Service Center • Raleigh, NC 27699-1721
Telephone: [phone] • Fax: [phone]

Dan River NPDES Permits
-Page 2 - April 19, 2007
(Augspurger et al., 2003). Recent research by Augspurger et al. (2003) found that ammonia
concentrations which may be protective of freshwater mussels range from 0.3 to 1.0 mg/L total
ammonia as N at pH 8.
Copper, Concerns -
Treated wastewater from Kobe Wieland Copper Products Inc. is discharged to an unnamed
tributary that flows into the lower portion of the Dan River, a Significant Aquatic Resource as
designated by the North Carolina Natural Heritage Program. The Dan River provides diverse
species habitats and harbors several State and Federally listed mussel and fish species, including
the James (River) Spiny Mussel, Pleurobema collina (State Endangered, Federal Endangered).
There are recent records (2001) for the Green floater, Lasmigona subviridis (State Endangered,
Federal Species of Concern) recorded in the NCWRC Aquatics Database. These records are
directly below the confluence of the aforementioned unnamed tributary to the Dan River.
Although the James (River) Spiny Mussel has not been reported in this lower section of the Dan
River, the possibility strongly exists since the Green Floater is a common species associate of the
James (River) Spiny Mussel in the Dan River. The discharge of copper to the unnamed tributary
is an immediate concern for both mussel species. In a 28-day chronic Copper toxicity
experiment, Wang et al. (in press) demonstrated that as little as 12-21 micrograms of copper per
liter of water (0.012-0.021 milligrams/liter) results in an LC-50 (concentration that kills 50% of
the animals in the sample; i.e., Lethal Concentration) for several species of native juvenile
freshwater mussels. This research suggests that mussels are more sensitive to copper pollutants
than other taxa (e.g., fish and microcrustaceans). Monitoring records indicate that on December
31 st, 2006 Kobe Wieland Copper Products Inc. discharged an average of 136 micrograms of
copper per liter of water (0.136 milligrams/liter) from pipe 001 and 380 micrograms of copper
per liter of water (0.380 milligrams/liter) from pipe 003 (data extracted from E.P.A. Envirofacts
Data Warehouse). Those discharge concentrations are well above detrimental levels for juvenile
freshwater mussels according to recent research (Wang et al. in press).
The following recommendations should be evaluated and incorporated into these and other
NPDES permits as appropriate to avoid and reduce potential impacts to fish and wildlife
resources, especially in areas known to support listed and highly sensitive species:
1. Only non -chemical disinfection like ultraviolet or ozone should be permitted and used.
Chlorine should be expressly prohibited from any use (including emergency operations)
at the WWTP. This should provide the additional benefit of removing hazardous
materials from the environment and the workplace.
2. Ammonia limits should be reduced to the maximum extent practicable. Ammonia and
pH monitoring should be required daily. Daily composite sampling may be appropriate.
3. If not already in place, we recommend provision of automatic stand-by power generation
to prevent plant emergencies and upsets caused by power outages.
4. If publicly owned collection systems and treatment works (POTW) become available,
these facilities should be required to connect to the POTW without delay.
5. Kobe Wieland Copper Products, Inc. and any other NPDES permits with copper issues
should have reduced copper limits to avoid potential impacts to aquatic species,
especially where federally listed aquatic species are known within the watershed.
Although other factors may also contribute to aquatic habitat degradation, we believe the above
evaluations and prevention measures are appropriate. Limits should protect aquatic habitats

Dan River NPDES Permits -Page 3 -
April 19, 2007
(water quality) and preclude acute or chronic issues from WWTP point source discharges. We
are especially concerned about maintaining aquatic habitat values in the Dan/Roanoke River
basin and similar healthy watersheds. These high value habitats are usually undeveloped
watersheds that need proactive management strategies to preclude impairment from development
as well as from point and non -point issues.
Thank you for the opportunity to provide input during the planning stages for this project. If we
can be of further assistance, please contact me at 336-769-9453. Mr. Robert Nichols, Aquatic
Wildlife Diversity Coordinator is very knowledgeable about the Dan/Roanoke basin's listed
aquatic species as well as the diversity of aquatic species present in the watershed. You may
contact Mr. Nichols at 919-786-1789. You may contact Tom Augspurger with the U.S. Fish and
Wildlife Service at 919-856-4520 for additional information concerning toxicity and federally
listed species.
Literature cited:
Augspurger, T., A.E. Keller, M.C. Black, W.G. Cope and F.J. Dwyer. 2003. Water quality
guidance for protection of freshwater mussels (Unionidae) from ammonia exposure.
Environmental Toxicology and Chemistry 22: 2569-2575. (See attached file: Augspurger
et al. Mussel Ammonia Article.ET&C.Nov.2003.pdf)
Wang, N., C.G. Ingersoll, E.I. Greer, D.K. Hardesty, C.D. Ivey, J.L. Kunz, F.J. Dwyer, A.D.
Roberts, T. Auspurger, C.M. Kane, R.J. Neves, and M.C. Barnhart. Assessing
contaminant sensitivity of early life stages of freshwater mussels (Unionidae): Chronic
toxicity testing of juvenile freshwater mussels with copper and ammonia. Environmental
Toxicology and Chemistry. In Press.
Wang, N. C.G. Ingersoll, D.k. Hardesty, C.D. Ivey, J.L. Kunz, T.W. May, F.J. Dwyer, A.D.
Roberts, T. Augspurger, C.M. Kane, R.J. Neves, and M.C. Barnhart. Assessing
contaminant sensitivity of early life stages of freshwater mussels (Unionidae): Acute
toxicity of copper, ammonia, and chlorine to glochidia and juvenile mussels.
Environmental Toxicology and Chemistry. In Press.

NORTH CAROLINA
FORSYTH 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
appeared D.H. Stanfield, who being duly sworn, deposes and says: that he is
Controller of the Winston-Salem Journal, engaged in the publishing of a newspaper
known as Winston-Salem Journal, published, issued and entered as second class mail
in the City of Winston-Salem, in said County and State: that he is authorized to
make this affidavit and sworn statement: that the notice or other legal advertisement,
a true copy of which is attached hereto, was published in Winston-Salem Journal on
the following dates:
March 31, 2007
and that the said newspaper in which such notice, paper document, or legal
advertisement was published was, at the time of each and every such publication, a
newspaper meeting all the requirements and qualifications of Section 1-597 of the
General Statutes of North Carolina and was a qualified newspaper within the
meaning of Section 1-597 of the General Statutes of North Carolina.
This 2nd day of April, 2007
Abl
(signature o pers a g affidavit)
Sworn to and subscribed before me, this 2nd day of April, 2007
Nota blic
My Commission expires: September 28, 2010
KIMALEY JOHNSON
NOTARY PUBLIC
FORSYTH COUNTY
STATE OF NORTH CAR ! IN •
MY COMMISSION EXPIRES '
c �
01 zi mst ap o.
PtBNC NORM
SPATE OF NORTH CAROUNA r.«
ENVIRONMENTAL MANAGEMENT COMM1SS1OW
• NPDES UNIT
1617 MAIL SERVICE ENTER
• NOTIFICATION OF •To ICAMBE
A NPDE'S WASTE'WATERPER14T1; , ,�{,
pn the basis of thorough staff rev w and • Ukaticn
of NC General Statute 143 21, Pub[k aw 9 -500 and
other !awful arils a nd'.regulationsNorth
proposes
low
to Issue a Nat o at-Poliutant s arge
WrItten. comments w
re ing thintoposed permit
will be stccepted until 30 days after the publish date of
• this notice). Ali comments• ved prior to that date
nstd In the final determin ns arding
rot�pased it. The Di ¢ftte NC Division
Water Qual ay ec de�id * u#biia meting
e proposed perm sou a on remove a ;
s gN degree of public interest. • • 1
�I�s of draft Remelt and other supportl infer-
, oration on me °sea to determine oonwttons present
in the draft it•are available
aupon request and
payment mists ests forinformationinforrmpation tot the NC a of .
nts
Water pray at the above address or call Point
Source Branch at (919) 73, extension 363. Com-
ments can also be entWled to .• i. ,A{.:..c-.{it-:{,{;
tre�a� sseYinclude. e P 3- perm' .pnum ,
may it Me D v on eater Q• u • Ity at S12 N.
Sat�umry Street, Ra g NC 27604-1148 �
hoaeTss of600 a.m. ands. p m;to review t rmation •
• Stokos of a�plle on 00 ox 50 A nb '
(��Oo446� �e South Ste a wWTr in i
stokes permarK �y� discharges
0.0173i �ke River r to IM. Y rtat
Criuek , . Th aid al Isw q i �lsc use
may
Roanoko Basin. °Ili . i.. Per lon•a ••
Stokes ten
ViiWTP ha,afd VO i ASt
hrmtryryt0N044C27016)orthapNliertdhfSedSrN.HAPg p
in Stokes Couonty. This permittedfaciity doo
cnnarges 0.00111E MOD treated yewastewater to an un-
" named Curbrently.ttoothe
residual chin ne is water uaali-
quad-
-limited: This' disc a may a ct future ielloca-
tions in this pardon ofRoanoKe.River Basin. . .
•
• 2121)has appNem lied for renewal(PO �f Nic ' Wag, NC
PDES permIt
` lt; 0 for the Twin LakesMobile Home Park
n• Stokes County This permitted facility dis•
4 MGD es 0.0treated wastewater to an unnamed
to Timmons Creek to { Roanoke River fia-
Currently, 60D, ammonia-n i . • : n, and total re-
aiar hIorirg water gual united. This dis-
!ir atieen o D[�ntr tfecx al • .. • • ons in this portion of
Rao n

'State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
Michael F. Easley, Governor
William G. Ross, Jr., Secretary
Alan W. Klimek, P.E., Director '-----
OE.,R -
POINT
March 28, 2007
MEMORANDUM
To:
From:
Subject:
Lee Spencer
NC DENR / DEH / Regional Engineer
Winston-Salem Regional Office
Karen Rust
NPDES Eastern Unit
Review of Draft NPDES Permit NC0087980
Pine Hall Elementary School WWTP
Stokes County
ATA
CDENR
NORTH CAROLINA DEPARTMENT OF
__ gJVIRONMENT AND NATURAL RESOURCES
ITY
RECEIVED
N.C. Deot. of EN-'
MAR 2 9 2007
Regional O" ce
Please indicate below your agency's position or viewpoint on the draft permit and return this form by May 7, 2007.
If you have any questions on the draft permit, please contact me at the telephone number or e-mail address listed at
the bottom of this page.
RESPONSE: (Check one)
R.-----6
ncur with the issuance of this permit provided the facility is operated and maintained properly, the stated effluent limits
are met prior to discharge, and the discharge does not contravene the designated water quality standards.
Concurs with issuance of the above permit, provided the following conditions are met:
Signed
Opposes the issuance of the above permit, based on reasons stated below, or attached:
Date:
.6"// .7
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 919 733-5083, extension 361 (fax) 919 733-0719
VISIT US ON THE INTERNET @ http://h2o.enr.state.nc.us/NPDES Karen.Rust@ ncmail.net

1..
SEARCH & ANAIyTiCAL
bORATORiES, INC.
Analytical/Process Consultations
September 1, 2006
Mr. Charles H. Weaver, Jr.
NPDES Unit
Division of Water Quality
1617 Mail Service Center
Raleigh, NC 27699-1617
RE: Renewal of NPDES Permit No. NC00 g iWO
Pine Hall Elementary School WWTP
Stokes County
Dear Mr. Weaver,
OCT - 9 2006
DENR - WATER QUALITY
S JZcf ?RANCH
trit
Please renew NPDES Permit No.NC04 2338440for the wastewater treatment plant at Pine Hall
Elementary School. The signed application form in triplicate, a description of the method of
sludge disposal and a map of the location of the discharge are all attached.
Sincerely,
Research & Analytical Labs
/717
James M. Cheshire
Authorized Agent
JMC/s1
P.O. Box 473 • 106 Short Street • Kernersville. North Carolina 27284 • 336-996-2841 • Fax [phone]
www.researchandanalyticaLcom

`P,
r GEC
NPDES APPLICATION - FORM D Dar -A - `tJ':i Est QUALITY
POINT SOURCE BRANCH
For privately owned treatment systems treating 100% domestic wastewater "<10'MGB--
Mail the complete application to:
N. C. Department of Environment and Natural Resources
Division of Water Quality / NPDES Unit
1617 Mail Service Center, Raleigh, NC 27699-1617
NPDES Permit
pNcooSaa84
Ifyou are completing this form in computer use the TAB keygororthe up - down arrows to move from one
p 9
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 Stokes County Schools
Facility Name Pine Hall Elementary School
Mailing Address P. O. Box 50
City Danbury
State / Zip Code NC/27016
Telephone Number [phone]
Fax Number [phone]
e-mail Address [e-mail]
1. Location of facility producing discharge:
Check here if same address as above ❑
Street Address or State Road 1400 Pine Hall Rd
City
State / Zip Code
County
Pine Hall
NC/27042
Stokes
1. 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 Research And Analytical Laboratories, Inc.
Mailing Address P. O. Box 473
City Kernersville
State / Zip Code NC/27284
Telephone Number [phone]
Fax Number
[phone]
1 of 4 Form-D 1/06

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 173
Other 0 Explain:
Describe the source(s) of wastewater (example: subdivision, mobile home park, shopping centers,
restaurants, etc.):
Population served:
4. Type of collection system
® Separate (sanitary sewer only) 0 Combined (storm sewer and sanitary sewer)
4. Outfall Information:
Number of separate discharge points 1
Outfall Identification number(s) 001
Is the outfall equipped with a diffuser? 0 Yes
® No
7. Name of receiving stream(s) (Provide a map showing the exact location of each outfall):
Eurins Creek
7. Frequency of Discharge: ® Continuous ❑ Intermittent
If intermittent:
Days per week discharge occurs: 5 Duration:
7. Describe the treatment system
List all installed components, including capacity, provide design removal for BOD, TSS, nitrogen and
phosphorus. lithe space provided is not sufficient, attach the description of the treatment system in a
separate sheet of paper.
0.004 wastewater facility consisting of the following:
-septic tank
-dosing chamber
-recirculation system
-surface sandfilter
-ultraviolet disinfection
2 of 4 Form-D 1/06

NPDES APPLICATION - FORM D
For privately owned treatment systems treating 100% domestic wastewaters <1.0 MGD
7. Flow Information:
Treatment Plant Design flow 0.01730.004 MGD
Annual Average daily flow 0.001 MGD (for the previous 3 years)
Maximum daily flow 0.001 MGD (for the previous 3 years)
11. Is this facility located on Indian country?
❑ Yes ® No
12. Effluent Data
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. Effluent testing data must be based on at least three samples
and must be no more than four and one half years old.
Parameter
Daily
Maximum
Monthly
Average
Units of
Measurement
Number of
Samples
Biochemical Oxygen Demand
(BOD5)
3.32
2.88
mg/1
Fecal Coliform
<1.0
<1.0
col/ 100mis
Total Suspended Solids
<5.0
<5.0
mg/1
Temperature (Summer)
21.0
19.0
°C
Temperature (Winter)
NA
NA
NA
PH
6.45
5.76-6.45
SU
12. List all permits, construction approvals and/or applications:
Type
Hazardous Waste (RCRA) NESHAPS (CAA)
UIC (SDWA) Ocean Dumping (MPRSA)
NPDES NC008 S" Dredge or fill (Section 404 or CWA)
PSD (CAA) WNW Special Order of Consent (SOC)
Non -attainment program (CAA) Other
Permit Number
14. APPLICANT CERTIFICATION
Type
Permit Number
I certify that I am familiar w • the information contained in the application and that to the
best of my knowledge and b :C ch info ion is true, complete, and accurate.
James M. Cheshire
1.
Authorized Agent
Printed name of Person Signing / Title
3 of 4
Form-D 1/06

NPDES APPLICATION - FORM D
For privately ow d reatment�y�tems treating 100% domestic wastewaters <1.0 MGD
Signature of Applicant
Date
North Carolina General S'fatute 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 knowly 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 1/06

SLUDGE MANAGEMENT PLAN
PINE HALL SCHOOL WASTEWATER TREAMENT PLANT
NPDES PERMIT NO. NC0083384
giego
Sludge from the Pine Hall Elementary School wastewater treatment plant is disposed of in
the following way:
Solids are collected in the septic tank and digested
anaerobically. The excess solids are periodically pumped and
halved by a licensed septic pumper contractor and disposed
of at the City of Winston Salem wastewater treatment plant.