NC0033553_Renewal (Application)_20230130

d.s.STATE
Max]D,ary
Q
ROY COOPER 'h` 43 p�
Governor , C
ELIZABETH S.BISER •
4or Q.,wM vN° `
Secretary ;, -
RICHARD E.ROGERS,JR. NORTH CAROLINA
Director Environmental Quality
January 31, 2023
Polk County BOE
Attn: Aaron Greene
PO Box 638
Columbus, NC 28722-0638
Subject: Permit Renewal
Application No. NC0033553
Polk Central School
Polk County
Dear Applicant:
The Water Quality Permitting Section acknowledges the January 30, 2023, 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-appl ication-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,
3cjWnr y
Wren Thed ord
Administrative Assistant
Water Quality Permitting Section
cc: Deborah Bradley-Clearwater Services
ec: WQPS Laserfiche File w/application
D_E Q North Carolina Department of Environmental Quality I Division of Water Resources
Asheville Regional Office 2090 U.S.Highway 70 Swannanoa.North Carolina 28778
n..wr.MWm*ur`� / 828 296 4500

Clearwater Services
2253 E. NC 108 Hwy
Columbus, N.C. 28722
Deborah Bradley
(828-817-9516)
January 27, 2023
Ms. Wren Thedford
NC DEQ-DWR-NPDES RECEIVED
1617 Mail Service Center
Raleigh, N.C. 27699-1617
JAN 3 0 2023
Subject: NPDES Permit NC0033553 Renewal
Polk Central Elementary School ®�/R�NPDES
Mill Spring, N.C. 28756 NCDECI
Polk County
Dear Ms.Thedford:
Please find enclosed one copy of NPDES Permit Renewal Application-Form 2A
for Polk Central Elementary School's Wastewater Treatment Facility. The permit expires on
July 31, 2018.
If you have questions, please call me at 828-817-9516 or my email [e-mail].
Sincerely,
532.1,04Q1, 6424J/el
Deborah Bradley
Contract Operator
Polk Central Elementary School
Enclosures

NPDES Permit Number Facility Name Modified Application Form 2A
Polk Central Elementary School Modified March 2021
NC0033553
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
Polk Central Elementary School
Mailing address(street or P.O.box)
P.O.Box 638
City or town State ZIP code
o Columbus NC 28722
74
E Contact name(first and last) Title Phone number Email address
Aaron Greene Superintendent 894-3051 [e-mail]
c p g g
P Location address(street,route number,or other specific identifier) ❑ Same as mailing address
LL 2141 South NC Hwy 9
City or town State ZIP code
Mill Spring NC 28756
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?
RECEIVED—
ElYes ❑ No 4 SKIP to Item 1.4.
Applicant name JAN 3 0 2OZ3
Deborah Bradley
Sc Applicant address(street or P.O.box) NCDEQ/D��/
2253 NC 108 Hwy E R/NPDE
g City or town State ZIP code
c Columbus NC 28722
8 Contact name(first and last) Title Phone number Email address
a Deborah Bradley Operator 817-9516 [e-mail]
a 1.4 Is the applicant the facility's owner,operator,or both?(Check only one response.)
❑ Owner 0 Operator ❑ Both
1.5 To which entity should the NPDES permitting authority send correspondence?(Check only one response.)
0 Facility El Applicant 0 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.)
▪E Existing Environmental Permits
a ❑ NPDES(discharges to surface ElRCRA(hazardous waste) ❑ UIC(underground injection
c water) control)
E NC0033553
o ❑ PSD(air emissions) ❑ Nonattainment program(CAA) ❑ NESHAPs(CM)
▪c
W
0)
y ❑ Ocean dumping(MPRSA) ❑ Dredge or fill(CWA Section El Other(specify)
w 404)
Page 1

NPDES Permit Number Facility Name Modified Application Form 2A
Polk Central Elementary School Modified March 2021
NC0033553
1.7 Provide the collection system information requested below for the treatment works.
Municipality Population Collection System Type Ownership Status
Served Served (indicate percentage)
100 %separate sanitary sewer ID Own ID Maintain
424 %combined storm and sanitary sewer 0 Own 0 Maintain
d 0 Unknown 0 Own 0 Maintain
co %separate sanitary sewer 0 Own 0 Maintain
%combined storm and sanitary sewer 0 Own 0 Maintain
0 Unknown 0 Own 0 Maintain
a %separate sanitary sewer 0 Own 0 Maintain
c %combined storm and sanitary sewer 0 Own 0 Maintain
R 0 Unknown 0 Own 0 Maintain
E %separate sanitary sewer 0 Own 0 Maintain
%combined storm and sanitary sewer 0 Own 0 Maintain
co
c 0 Unknown 0 Own 0 Maintain
c Total
d Population 424
o Served
Separate Sanitary Sewer System Combined Storm and
Sanitary Sewer
Total percentage of each type of
sewer line(in miles)
1.8 Is the treatment works located in Indian Country?
c
o 0 Yes ❑ No
U
R 1.9 Does the facility discharge to a receiving water that flows through Indian Country?
c ❑ Yes El No
1.10 Provide design and actual flow rates in the designated spaces. Design Flow Rate
0.01 mgd
7-0
Annual Average Flow Rates(Actual)
15 to
a 0 Two Years Ago Last Year This Year
Co 0.0574 mgd 0.0675 mgd 0.0742 mgd
`j' Maximum Daily Flow Rates(Actual)
cu
o Two Years Ago Last Year This Year
0.01 mgd 0.01 mgd 0.01 mgd
co 1.11 Provide the total number of effluent discharge points to waters of the State of North Carolina by type.
c Total Number of Effluent Discharge Points by Type
a- a Constructed
an 1- Treated Effluent Untreated Effluent Combined Sewer Bypasses Emergency
r - Overflows Overflows
C.)
U)
a 1
Page 2

NPDES Permit Number Facility Name Modified Application Form 2A
Polk Central Elementary School Modified March 2021
NC0033553
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?
❑ 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 (check one)
Impoundment
O Continuous
gpd 0 Intermittent
O Continuous
gpd 0 Intermittent
O Continuous
Vl gpd 0 Intermittent
r 1.14 Is wastewater applied to land?
❑ Yes ❑✓ No 4 SKIP to Item 1.16.
c 1.15 Provide the land application site and discharge data requested below.
e Land Application Site and Discharge Data
Continuous or
Location Size Average Daily Volume Intermittent
Applied (check one)
acres gpd ID
o 0 Intermittent
°' acresgpd 0 Continuous
❑ Intermittent
-0 0 Continuous
acres gpd 0 Intermittent
7, 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 Application Form 2A
Polk Central Elementary School Modified March 2021
NC0033553
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
-0 Facility name Mailing address(street or P.O.box)
d
City or town State ZIP code
0
Contact name(first and last) Title
0
d Phone number Email address
NPDES number of receiving facility(if any) 0 None Average daily flow rate mgd
COO.
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)?
a'
❑ Yes 0 No 4 SKIP to Item 1.23.
0 1.22 Provide information in the table below on these other disposal methods.
d Information on Other Disposal Methods
o Disposal Location of Size of Annual Average Continuous or Intermittent
-a Method Daily Discharge
Description Disposal Site Disposal Site Volume (check one)
To'
acres gpd ❑ Continuous
0 Intermittent
0 Continuous
acres gpd ❑ Intermittent
acresgpd ❑ Continuous
❑ 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.)
Discharges into marine waters(CWA Water quality related effluent limitation(CWA Section
CO
CO ❑ Section 301(h)) ❑ 302(b)(2))
✓❑ Not 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?
❑ Yes El 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
0
Contractor name
(company name)
Mailing address
(street or P.O.box)
City,state,and ZIP
code
cContact name(first and
last)
Phone number
Email address
Operational and
maintenance
responsibilities of
contractor
Page 4

NPDES Permit Number Facility Name Modified Application Form 2A
Polk Central Elementary School Modified March 2021
NC0033553
SECTION 2.ADDITIONAL INFORMATION(40 CFR 122.21(j)(1)and(2))
c Outfalls to Waters of the State of North Carolina
2.1 Does the treatment works have a design flow greater than or equal to 0.1 mgd?
El Yes 0 No -+ SKIP to Section 3.
c 2.2 Provide the treatment works'current average daily volume of inflow Average Daily Volume of Inflow and Infiltration
and infiltration.
gpd
Indicate the steps the facility is taking to minimize inflow and infiltration.
c
0
Q2.3 Have you attached a topographic map to this application that contains all the required information?(See instructions for
mespecific requirements.)
0
0 ElYes ❑ No
E 2.4 Have you attached a process flow diagram or schematic to this application that contains all the required information?
0 im Ca (See instructions for specific requirements.)
o ❑ Yes El No
2.5 Are improvements to the facility scheduled?
El Yes ❑ No + SKIP to Section 3.
Briefly list and describe the scheduled improvements.
0
is 1.
c
E
EEL 2.
0 0
ti 3.
C,
d
4.
cn
2.6 Provide scheduled or actual dates of completion for improvements.
Scheduled or Actual Dates of Completion for Improvements
Affected Attainment of
d Scheduled Begin End Begin
Outfalls Operational
o Improvement Construction Construction Discharge
(from above) (list outtall (MM/DD/YYYY) (MM/DD/YYYY) (MM/DD/YYYY) Level
number) (MM/DD/YYYY)
1.
2.
c0
3.
4.
2.7 Have appropriate permits/clearances concerning other federal/state requirements been obtained?Briefly explain your
response.
El Yes ❑ No ❑ None required or applicable
Explanation:
Page 5

NPDES Permit Number Facility Name Modified Application Form 2A
Polk Central Elementary School Modified March 2021
NC0033553
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.)
1
Number Number Outfall Outfall Number
State North Carolina
rn Polk
County
City or town Mill Spring
s Distance from shore 300 ft. ft. ft.
Q
'C
Depth below surface 2 ft. ft. ft.
Average daily flow rate o.01 mgd mgd mgd
PI
Latitude 35° 285' 449" N 0
0
Longitude -82° 128' 722" W "
3.2 Do any of the outfalls described under Item 3.1 have seasonal or periodic discharges?
o ❑ Yes ❑ No-4 SKIP to Item 3.4.
3.3 If so,provide the following information for each applicable outfall.
Outfall Number Outfall Number Outfall Number
a Number of times per year
o discharge occurs
a Average duration of each
discharge(specify units)
o Average flow of each mgd mgd mgd
discharge
Months in which discharge
occurs
3.4 Are any of the outfalls listed under Item 3.1 equipped with a diffuser?
❑ Yes 0 No-4 SKIP to Item 3.6.
C, 3.5 Briefly describe the diffuser type at each applicable outfall.
0-
Outfall Number Outfall Number Outfall Number
d
N
c 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?
cu
r ❑ Yes 0 No 4SKIP to Section 6.
Page 6

NPDES Permit Number Facility Name Modified Application Form 2A
Polk Central Elementary School Modified March 2021
NC0033553
3.7 Provide the receiving water and related information(if known)for each outfall.
Outfall Number Outfall Number Outfall Number
Receiving water name
Name of watershed,river,
c or stream system
U.S.Soil Conservation
H Service 14-digit watershed
o code
R Name of state
management/river basin
U.S.Geological Survey
w 8-digit hydrologic
W 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 0 Primary 0 Primary 0 Primary
Treatment(check all that 0 Equivalent to 0 Equivalent to 0 Equivalent to
apply per outfall) secondary secondary secondary
O Secondary 0 Secondary 0 Secondary
❑ Advanced 0 Advanced 0 Advanced
❑ Other(specify) 0 Other(specify) 0 Other(specify)
c
0
a Design Removal Rates by
'5 Outfall
N
0
0 BOD5 or CBOD5 % %
c
d
E
EL) TSS % % %
1--
0 Not applicable 0 Not applicable 0 Not applicable
Phosphorus % % %
0 Not applicable 0 Not applicable 0 Not applicable
Nitrogen % % ok
Other(specify) 0 Not applicable 0 Not applicable 0 Not applicable
% % ok
Page 7

NPDES Permit Number Facility Name Modified Application Form 2A
Polk Central Elementary School Modified March 2021
NC0033553
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)
O
V
c Outfall Number Outfall Number Outfall Number
.2- Disinfection type
U
Seasons used
Dechlorination used? ❑ Not applicable ❑ Not applicable ❑ Not applicable
❑ Yes ❑ Yes ❑ Yes
❑ No ❑ No ❑ No
3.10 Have you completed monitoring for all Table A parameters and attached the results to the application package?
❑ Yes ❑ 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 ❑ 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
R
0)
Number of tests of discharge
water
Number of tests of receiving
water
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?
❑ Yes 4 Complete Table B,including chlorine. El No 4 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?
❑ Yes ❑ 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
Polk Central Elementary School Modified March 2021
NC0033553
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?
El 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?
❑ 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/DD/YYYY)
v
m
0
3.22 Regardless of how you provided your WET testing data to the NPDES permitting authority,did any of the tests result in
toxicity?
❑ Yes ❑ No 4 SKIP to Item 3.26.
Fa 3.23 Describe the cause(s)of the toxicity:
c
m
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
Polk Central Elementary School Modified March 2021
NC0033553
SECTION 6. CHECKLIST 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 ❑ w/topographic map ❑ wl process flow diagram
Information ❑ wl additional attachments
❑ wl Table A ❑ w/Table D
Section 3: Information on ❑ w/Table B ❑ wl additional attachments
❑ Effluent Discharges
❑ w/Table C
Section 4:Not Applicable
0
Section 5:Not Applicable
❑ Section 6:Checklist and ❑ w/attachments
Certification Statement
17,
Y 6.2 Certification Statement
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
Deborah Bradley Contract Operator
Signature Date signed
&A-d 01/26/2023
Page 10