NC0032565_fact sheet_20230717

DocuSign Envelope ID: 87A340E9-61C0-4BFF-A179-714631FD6EF0
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 Weaver — 7/17/2023
Permit Number
NCO032565
Facility Name
North Lenoir High School WWTP
Basin Name/Sub-basin number
Neuse / 03-04-07
Receiving Stream
UT Wheat Swam
Stream Classification in Permit
C-Swamp NSW
Does permit need Daily Max NH3 limits?
NH3 limits are at BAT to protect against
instream toxicity
Does permit need TRC limits/language?
No — already resent
Does permit have toxicity testing?
No
Does permit have Special Conditions?
Neuse nutrient conditions
Does permit have instream monitoring?
Temperature & Dissolved Oxygen
Is the stream impaired (on 303(d) list)?
No
For whatparameter?
Any obvious compliance concerns?
Sixteen enforcements during this permit cycle,
along with twenty-three NOVs and one NOD.
An examination of flow violations has
determined the facility was reporting
incorrectly, which led to the appearance of
flow exceedances.
An inspection of the facility was
conducted on January 31, 2023. The
inspection revealed that the WWTP
requires significant
maintenance/repair/upgrade or
replacement if permit limits are to be met
on a consistent basis. However, even in its
current state, it appeared possible that the
existing system could perform in
compliance but for the state of the influent
it receives. The influent was unusually
clear and did not bring enough food source
to the system to promote good biological
activity in the activated sludge process.
Under these circumstances, it will be very
difficult for the facility to meet ammonia
nitrogen effluent limits. It appeared that
the operator of the WWTP coaxed its best
performance from the existing system, but

DocuSign Envelope ID: 87A34OE9-61 CO-4BFF-A179-714631 FD6EFO
it was obvious that the permittee must
invest more into system maintenance.
Positive developments occurred just prior
to and following the inspection. The
school system has significant funding
devoted to the future of wastewater
treatment. The school system has been in
continuing discussions with a reputable
engineering firm that has guided them in
an examination of possible solutions and
the recommendation of one in particular.
They are going to recommend
construction of a pump station and sewer
force main to connect the school to the
City of Kinston collection system. They
further recommend entry into the SOC to
cover the school during the time period of
construction.
Any permit modifications since the last
None.
permit?
New expiration date
5/31/2028
Changes in Draft Permit
Updated eDMR text.
Added Neuse modeling reo ener
Changes in final permit
None
Most Commonly Used Expedited Language:
• 303(d) language 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 language for Compliance Level for Cover Letters/Effluent Sheet Footnote:
"The facility shall report all effluent TRC values reported by an NC certified laboratory
including field certified. However, effluent values < 50 µg/1 will be treated as zero for
compliance purposes."

DocuSign Envelope ID: 87A340E9-61C0-4BFF-A179-714631FD6EF0
AFFP
Public Notice
Public Notice North Carolina
North Carolina Environmental
Management Commission]NP-
Affidavit of Publication
DES Unit
1617 Mail Service Center
Raleigh, NC 27699-1617
Notice of Intent to Issue a NPDES
STATE OF NC I Ss
Wastewater Permit NCO032565
COUNTY OF WAYNE
North Lenoir High School WWTP
The North Carolina Environment -
al Managernent Commission pro-
Christy Williamson, being duly sworn, says:
poses to issue a NPDES wastewa-
That she is Christy Williamson, Advertising Director of the
ter discharge permit to the
Goldsboro News-Argus, a daily newspaper of general
person(s) listed below. Written
circulation, printed and published in Goldsboro, Wayne
comments regarding the proposed
County, NC: that the publication, a copy of which is
permit will be accepted until 30
attached hereto, was published in the said newspaper on
days after the publish date of this
June 03, 2023
notice. The Director of the NC Di-
vision of Water Resources (DWR)
may hold a public hearing should
there be a significant degree of
public interest. Please mail com-
ments and/or information requests
That said newspaper was regularly issued and circulated
to DWR at the above address. In -
on those dates.
terested persons may visit the
SIGNED-
DWR at 512 N. Salisbury Street,
Raleigh, NC 27604 to review the
information on file. Additional in -
Christy Williamson, Advertising Director
formation on NPDES permits and
Subscribed to and sworn to me this 3rd day of June 2023.
this notice may be found on our
website: https:Hde!q.nc.gov/public-
notices-heariqg�s,or by calling
[phone]. The Lenoir
County Public Schools requested
✓
renewal of NPDES permit
Elizabeth 600dwin Howell, , Wayne County, NC
NC,0032565 for its North Lenoir
High School WWTP (24M Insfi-
My commission expires: July 13, 202a0"Ijj to
GOOD;P/
tote Rd, La Orange, NC). This fa-
cility discharges to an Unnamed
Qj :4 xAOTARy
Tributary to Wheat Swamp/Neuse
River
70095697 70687444
Basin. Currently, BOD5, arnmo-
13 20
Wren Thedford (138 News-Argus
nia-nitrogen, fecal coliform, dis-
solved oxygenand
DEQ-Division of Water Resources
,
1617 Mail Service Center
total residual chlorine are water
Raleigh, NC 27699-1617
quality limited. This discharge
may affect future
allocations in this portion of the re-
ceiving stream.
June 3

DocuSign Envelope ID: 87A340E9-61C0-4BFF-A179-714631FD6EF0
Weaver, Charles
From: Bullock, Robert
Sent: Tuesday, May 23, 2023 1:32 PM
To: Weaver, Charles
Subject: RE: DRAFT permit renewal for NC0032565
I looked at the draft permit and I did not see any changes from the previous permit.
Therefore, I do not have any comments.
Thanks,
Robbie
Robbie Bullock
Environmental Program Consultant
Division of Water Resources
Water Quality Regional Operations
252-948-3843 Office
252-402-5832 Cell
Robert.e.bullock(a)deg.nc.gov Email
943 Washington Square Mall
Washington NC 27889
Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties.
From: Weaver, Charles <[e-mail]>
Sent: Tuesday, May 23, 2023 11:20 AM
To: Bullock, Robert <[e-mail]>; Kinney, Maureen <[e-mail]>
Subject: DRAFT permit renewal for NCO032565
This one will go to Notice next week. Send me any comments as time permits.
Charles H. Weaver
Environmental Specialist II
Division of Water Resources
919-707-3616
charles.weaverCccDdeg. nc. gov
(mailing address) 1617 Mail Service Center, Raleigh, NC 27699-1617
Email correspondence to and from this address is subyed to the North
Caro�ona Pvblrc Records Law and may be drsabsed to thrrd parties,

DocuSign Envelope ID: 87A340E9-61C0-4BFF-A179-714631FD6EF0
Weaver, Charles
From: Sledge, Bob
Sent: Wednesday, May 17, 2023 7:45 AM
To: Weaver, Charles
Subject: North Lenoir High School WWTP
Attachments: NC0032565 Inspection Rpt 01312023.pdf
Hi Charles,
Sorry for being tardy in sending this to you. Here is the text of information I sent to Region 4 as we briefed them on
facilities on the FY22Q4 Priority List:
NC0032565 North Lenoir High School WWTP
Violations have persisted through the submittal of the facility's last DMR (October 2022). An examination of flow
violations has determined the facility was reporting incorrectly, which led to the appearance of flow exceedances. The
facility has been assessed $7,500.00 for limit violations occurring during 2022; additional penalties are likely to be
assessed.
An inspection of the facility was conducted by the staff of the Washington Regional Office on January 31, 2023. The
inspection revealed that the WWTP is in need of significant maintenance/repair/upgrade or replacement if NPDEs
permit limits are to be met on a consistent basis. However, even in its current state, it appeared possible that the
existing system could perform in compliance but for the state of the influent it receives. The influent was unusually clear
and did not bring enough food source to the system to promote good biological activity in the activated sludge process.
Under these circumstances, it will be very difficult for the facility to meet ammonia nitrogen effluent limits. It appeared
that the operator of the WWTP coaxed its best performance from the existing system, but it was obvious that the school
system needed to invest more into system maintenance.
Positive developments occurred just prior to and following the inspection. The school system has significant funding
devoted to the future of wastewater treatment at this school. They have contracted with an engineering firm to
investigate the most practical and cost-effective options for wastewater treatment, including replacement of the
existing system and connection to municipal sewer. The school system is amenable to entering into a Special Order by
Consent that would guide the system through whatever construction phase and lead it to consistent compliance.
This was an update to the information noted above:
NC0032565 North Lenoir High School WWTP
The school system has been in continuing discussions with a reputable engineering firm that has guided them in an
examination of possible solutions and the recommendation of one in particular. They are going to recommend
construction of a pump station and sewer force main to connect the school to the City of Kinston collection system. They
further recommend entry into the SOC to cover the school during the time period of construction. They will bring the
recommendations to the county commissioners' meeting on April 3 for their concurrence.
I've attached a copy of the inspection report from BIMS for the January 31 inspection.
I hope this helps.
:..

DocuSign Envelope ID: 87A340E9-61C0-4BFF-A179-714631FD6EF0
Bob Sledge
Environmental Specialist II
Division of Water Resources — Water Quality Permitting Section
North Carolina Department of Environmental Quality
DEQ is updating its email addresses to @deq.nc.gov in phases from May 1s'to June grn
Employee email addresses may look different, but email performance will not be impacted.
919-707-3602
bob.sledge(a)-deg.nc.gov (note new email address)
512 N. Salisbury Street
1617 Mail Service Center
Raleigh, NC 27699-1617
Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties.
Email correspondence to and from this address may be subject to the North Carolina Public Records Law and may be disclosed to third parties by an authorized
state official.

DocuSign Envelope ID: 87A340E9-61C0-4BFF-A179-714631FD6EF0
North Carolina
Department of Environmental Quality
Division of Water Resources
Modified Application Form 2A
Revised March 2021
Modified Application
Form 2A
Minor Sewage Facilities < 0.1 MGD
and No Pretreatment Program
NPDES Permitting Program
Note: Complete this form if your facility is a MINOR new or existing publicly owned treatment works.

DocuSign Envelope ID: 87A340E9-61C0-4BFF-A179-714631FD6EF0
NPDES Permit Number
Facility Name
Modified Application Form 2A
North Lenoir High School
Modified March 2021
NCO032565
W WTP
Form
NC Department of Environmental Quality - Application for NPDES Permit to Discharge Wastewater
MINOR SEWAGE FACILITIES (Before completing this form, please read the instructions. Failure to follow
NPDES
the instructions may result in denial of the application.)
SECTION•N
INFORMATION FOR i
1.1
Facility name
North Lenoir High School WWTP
Mailing address (street or P.O. box)
500 Abbot St.
City or town
State
ZIP code
o
Kinston
INC
28504
r
EContact
name (first and last)
Title
Phone number
Email address
c
Cecil Outlaw
Maintenance Director
527-1407
[e-mail]
Location address (street, route number, or other specific identifier) ❑ Same as mailing address
R
LL-
2400 Insitute Rd
City or town
State
ZIP code
La Grange
INC
28551
1.2
Is this application for a facility that has yet to commence discharge?
❑ Yes -* 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 SKIP to Item 1.4.
Applicant name
Applicant address (street or P.O. box)
0
o
City or town
State
ZIP code
w
r
Contact name (first and last)
Title
Phone number
Email address
.Q
a
1.4
Is the applicant the facility's owner, operator, or both? (Check only one response.)
❑✓ Owner ❑ Operator ❑ Both
1.5
To which entity should the NPDES permitting authority send correspondence? (Check only one response.)
Facility and applicant
❑✓ Facility ❑ Applicant ElFacility
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
a
✓❑ NPDES (discharges to surface
❑ RCRA (hazardous waste)
❑ UIC (underground injection
R
water)
control)
E
c
NCO03565
❑ PSD (air emissions)
❑ Nonattainment program (CAA)
❑ NESHAPs (CAA)
w
a�
y
❑ Ocean dumping (MPRSA)
❑ Dredge or fill (CWA Section
❑ Other (specify)
w
404)
Page 1

DocuSign Envelope ID: 87A340E9-61C0-4BFF-A179-714631FD6EF0
NPDES Permit Number
Facility Name
Modified Application Form 2A
NCO032565
North Lenoir High School
Modified March 2021
1.7
Provide the collections stem information
requested below for the treatment works.
Municipality
Population
Collection System Type
Ownership Status
Served
Served
indicate percentage)
North Lenoir
1000
100 % separate sanitary sewer
0 Own ❑ Maintain
d
% combined storm and sanitary sewer
❑ Own ❑ Maintain
High school
❑ Unknown
❑ Own ❑ Maintain
c%
separate sanitary sewer
El Own ❑ Maintain
R
% combined storm and sanitary sewer
❑ Own ❑ Maintain
❑ Unknown
❑ Own ❑ Maintain
a
% separate sanitary sewer
ElOwn ElMaintain
% combined storm and sanitary sewer
❑ Own ❑ Maintain
❑ Unknown
❑ Own ❑ Maintain
2
% separate sanitary sewer ❑ Own ❑ Maintain
N%
combined storm and sanitary sewer ❑ Own ❑ Maintain
c
❑ Unknown ❑ Own ❑ Maintain
Total
loon
Population
�
Served
Separate Sanitary Sewer System Combined Storm and
Sanitary Sewer
Total percentage of each type of
sewer line in miles)100
o /o 0
/o
1.8
Is the treatment works located in Indian Country?
'
0
U
ElYes ElNo
1.9
Does the facility discharge to a receiving water that flows through Indian Country?
c
❑ Yes ❑ No
1.10
Provide design and actual flow rates in the designated spaces.
Design Flow Rate
0.018 mgd
= N
Annual Average Flow Rates Actual
Two Years Ago
Last Year
This Year
c 0
0.029 mgd
0.0194 mgd
0.034 mgd
Maximum Daily Flow Rates Actual
Two Years Ago
Last Year
This Year
0.24 mgd
0.051 mgd
0.12 mgd
1.11
Provide the total number of effluent discharge points to waters of the State of North Carolina by type.
oTotal
Number of Effluent Discharge Points b T pe
a Q-
a'
Combined Sewer
Constructed
Treated Effluent
Untreated Effluent
Overflows
Bypasses
Emergency
Overflows
M
1
Page 2

DocuSign Envelope ID: 87A340E9-61C0-4BFF-A179-714631FD6EF0
NPDES Permit Number
Facility Name
Modified Application Form 2A
NCO032565
North Lenoir High School
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?
❑ 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 Im oundment Location and Discharge Data
Average Daily Volume
Continuous or Intermittent
Location
Discharged to Surface
(check one)
Impoundment
❑ Continuous
gpd
❑ Intermittent
ElContinuous
gpd
❑ Intermittent
gpd
ElContinuous
❑ Intermittent
Z
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.
C
Land Application Site and Discharge Data
o
0
Average Daily Volume
Continuous or
a,
Location
Size
Applied
Intermittent
check one
Hacres
d
gpd
❑ Continuous
o
❑ Intermittent
acres
d
gpd
El Continuous
o
ElIntermittent
acres
d
gpd
El Continuous
❑ Intermittent
R
1.16
Is effluent transported to another facility for treatment prior to discharge?
o
ElYes ElNo -* 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

DocuSign Envelope ID: 87A340E9-61C0-4BFF-A179-714631FD6EF0
NPDES Permit Number
Facility Name
Modified Application Form 2A
NCO032565
North Lenoir High School
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 F cility Data
-a
Facility name
Mailing address (street or P.O. box)
d
City or town
State
ZIP code
0
U
Contact name (first and last)
Title
0
d
Phone number
Email address
c
NPDES number of receiving facility (if any) ❑ None
Average daily flow rate mgd
0.
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
0
not have outlets to waters of the State of North Carolina (e.g., underground percolation, underground injection)?
Er
❑ 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
.�
acres
gpd
El
❑ Intermittent
acres
gpd
ElContinuous
❑ Intermittent
acres
gpd
❑ 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.
ti
Consult with your NPDES permitting authority to determine what information needs to be submitted and when.)
El El into marine waters (CWA ElWater quality related effluent limitation (CWA Section
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 ❑ No 4SKIP 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
(companyname
Joshua Move
Mailing address
street or P.O. box
4481 Norbert Hill Rd.
r
City, state, and ZIP
code
Lagrange NC, 28551
L
Contact name (first and
U
last)
Joshua Moye
Phone number
939-2197
Email address
[e-mail]
Operational and
maintenance
Operator is responsible for
responsibilities of
operation and testing of
contractor
facility
Page 4

DocuSign Envelope ID: 87A340E9-61C0-4BFF-A179-714631FD6EF0
NPDES Permit Number Facility Name Modified Application Form 2A
NCO032565 North Lenoir High School Modified March 2021
SECTION11 • •' • 1
o Outfalls to Waters of the State of North Carolina
a
2.1
Does the treatment works have a design flow greater than or equal to 0.1 mgd?
T
c
❑ Yes ❑ No 4 SKIP to Section 3.
c
2.2
Provide the treatment works' current average daily volume of inflow
Average Daily Volume of Inflow and Infiltration
;�
w
and infiltration.
gpd
=
Indicate the steps the facility is taking to minimize inflow and infiltration.
3
0
2.3
Have you attached a topographic map to this application that contains all the required information? (See instructions for
g
specific requirements.)
a�
C
0
0
El Yes ❑ No
H
E
2.4
Have you attached a process flow diagram or schematic to this application that contains all the required information?
c M
(See instructions for specific requirements.)
o
❑ Yes ❑ No
2.5
Are improvements to the facility scheduled?
❑ Yes ❑ No 4 SKIP to Section 3.
Briefly list and describe the scheduled improvements.
0
w
d
E
d
CL
2.
E
0
0
y
3.
d
4.
Cn
R
2.6
Provide scheduled or actual dates of completion for improvements.
Scheduled or Actual Dates of Completion for Improvements
E
a)
Scheduled
Affected
Begin
End
Begin
Attainment of
>
o
Improvement
Outfalls
Construction
Construction
Discharge
Operational
CL E
(from above)
(list o number)
(MM/DD/YYYY)
(MM/DD/YYYY)
(MM/DD/YYYY)
Level
MMIDDIYYYY
1.
a�
2.
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

DocuSign Envelope ID: 87A340E9-61C0-4BFF-A179-714631FD6EF0
NPDES Permit Number
Facility Name Modified Application Form 2A
NC0032565
North Lenoir High School Modified March 2021
SECTION•'
• ON DISCHARGES
3.1
Provide the following information for each outfall. (Attach additional sheets if you have more than three outfalls.)
Outfall Number 1
Outfall Number
Outfall Number
State
North Carolina
County
Lenoir
w
r
0
w
City or town
La Grange
0
c
rs
Distance from shore
NA ft.
ft.
ft.
n
'i
Depth below surface
NA ft.
c
Average daily flow rate
mgd
mgd
mgd
Latitude
35° 20' 55" N
Longitude
77' 40' 44" W
"
3.2
Do any of the outfalls described under Item 3.1 have seasonal or periodic discharges?
R
o
❑ Yes ❑ No 4 SKIP to Item 3.4.
a�
3.3
If so, provide the following information for each applicable outfall.
y
Outfall Number
Outfall Number
Outfall Number
0
Number of times per year
L
discharge occurs
a
Average duration of each
o
discharge (specify units
Average flow of each
mgd
mgd
mgd
0
discharge
R
in
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 t pe at each applicable outfall.
CL
Outfall Number
Outfall Number
Outfall Number
d
w
0
vi
3 6
Does the treatment works discharge or plan to discharge wastewater to waters of the State of North Carolina from
12
one or more discharge points?
3::
❑✓ Yes ❑ No 4SKIP to Section 6.
Page 6

DocuSign Envelope ID: 87A340E9-61C0-4BFF-A179-714631FD6EF0
NPDES Permit Number
Facility Name
Modified Application Form 2A
NCO032565
North Lenoir High School
Modified March 2021
3.7
Provide the receiving water and related information if known for each outfall.
Outfall Number
Outfall Number
Outfall Number
Receiving water name
UT to Wheat Swamp
Name of watershed, river,
0
or stream system
Contentnea
•L
U.S. Soil Conservation
N
Service 14-digit watershed
o
code
L
Name of state
a�
management/river basin
Neuse River
U.S. Geological Survey
8-digit hydrologic
cataloging unit code
03020203
Critical low flow (acute)
N/A cfs
cfs
cfs
Critical low flow (chronic)
N/A cfs
cfs
cfs
Total hardness at critical
mg/L of
mg/L of
mg/L of
low flow
N/A CaCO3
CaCO3
CaCO3
3.8
Provide the following information
describing the treatment pr vided for discharges from each outfall.
Outfall Number
Outfall Number
Outfall Number
Highest Level of
❑ Primary
❑ Primary
❑ Primary
Treatment (check all that
❑ Equivalent to
❑ Equivalent to
❑ Equivalent to
apply per outfall)
secondary
secondary
secondary
0 Secondary
❑ Secondary
❑ Secondary
❑ Advanced
❑ Advanced
❑ Advanced
❑ Other (specify)
❑ Other (specify)
❑ Other (specify)
0
Q
Design Removal Rates by
Outfall
d
c
BODS or CBODs
85 %
%
%
d
E
cc
TSS
85 %
%
%
0 Not applicable
❑ Not applicable
❑ Not applicable
Phosphorus
%
%
%
0 Not applicable
❑ Not applicable
❑ Not applicable
Nitrogen
%
%
%
Other (specify)
❑ Not applicable
❑ Not applicable
❑ Not applicable
Page 7

DocuSign Envelope ID: 87A340E9-61C0-4BFF-A179-714631FD6EF0
NPDES Permit Number
Facility Name
Modified Application Form 2A
NCO032565
North Lenoir High School
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.
>3
d
0
Outfall Number 1
Outfall Number
Outfall Number
0CL
r
Disinfection type
Chlorine Tablets
tp
N
G
Seasons used
N/A
E
r
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
Number of tests of discharge
a,
water
Number of tests of receiving
water
d
w
LU
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?
❑✓ Yes 4 Complete Table B, including chlorine. ❑ 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?
No additional sampling required by NPDES
❑✓ Yes El
permittingauthority.
Page 8

DocuSign Envelope ID: 87A340E9-61C0-4BFF-A179-714631FD6EF0
NPDES Permit Number
Facility Name
Modified Application Form 2A
NCO032565
North Lenoir High School
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 0 No + 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 our NPDES permitting authority and provide a summary of the results.
Date(s) Submitted
Summary of Results
MM/DD/YYYY
>3
m
c
0
W
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.
3.23
Describe the cause(s) of the toxicity:
d
w
L
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 0 Not applicable because previously submitted
information to the NPDES permitting authority.
Page 9

DocuSign Envelope ID: 87A340E9-61C0-4BFF-A179-714631FD6EF0
NPDES Permit Number
Facility Name Modified Application Form 2A
NCO032565
North Lenoir High School Modified March 2021
SECTION.
CHECKLIST
AND CERTIFICATION STATEMENT (40
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 requestEl wl additional attachments
ElInformation
for All A licants
Section 2: Additional
s❑ w/ topographic map ❑ wl process flow diagram
Information
❑ w/ additional attachments
❑✓ w/ Table A ❑✓ wl Table D
Section 3: Information on
✓❑ w/ Table B ❑ wl additional attachments
Effluent Discharges
E
❑ w/ Table C
d
ca
w.
`o
Section 4: Not Applicable
c
0
Section 5: Not Applicable
d
U
Section 6: Checklist and
❑
❑ wl attachments
w
Certification Statement
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
Brent Williams
Superintendent
Signature
Date signed
Page 10

DocuSign Envelope ID: 87A340E9-61C0-4BFF-A179-714631FD6EF0
NPDES Permit Number
Facility Name
Outfall Number
NCO032565
North Lenoir High School
001
Modified Application Form 2A
Modified March 2021
Maximum Daily Discharge
Average Daily Discharge
Pollutant
Analytical
ML or MDL
Number
Value Units
Value
Units
Methods
(include units)
Sampless
Biochemical oxygen demand
o BOD5 or ❑ CBOD5
13.0
mg/L
2.33
mg/L
52
5210E-11
El ML
2.0 mg/L 171 MDL
(report one
Fecal coliform
570
cfu/100ml
17.7
cfu/100ml
52
9222D-06
lcfu/100n 171 MDL
Design flow rate
0.018
MGD
0.034
MGD
52
pH (minimum)
6.0
su
pH (maximum)
7.6
su
Temperature (winter)
10.7
deg. C
14.8
deg. C
26
Temperature (summer)
26.2
deg. C
25
deg. C
26
Total suspended solids (TSS)
29
mg/L
2.3
mg/L
52
2540D-11 2.5 mg/L El ML
O 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

DocuSign Envelope ID: 87A340E9-61C0-4BFF-A179-714631FD6EF0
EPA Identification Number NPDES Permit Number Facility Name Outfall Number
NCO032565 North Lenoir High School 001
Modified Application Form 2A
Modified March 2021
•' • ' • • • •' I 1
Maximum Daily Discharge
Average Daily Discharge
Pollutant
Analytical
ML or MDL
Number of
Value
Units
Value
Units
Methods
Include units
( )
SamplesEl
Ammonia (as N)
22.2
mg/L
8.3
mg/L
52
350.1 R2-93
ML
0.1 mg/L 2 MDL
Chlorine 2
total residual, TRC
48
ug/L
11.9
ug/L
104
SM 4500 CI-G-11
10 ug/L ❑ ML
o MDL
Dissolved oxygen
6.9
mg/L
6.3
mg/L
52
4500-0 G-2016
0 ML
0.1 mg/L 2 MDL
Nitrate/nitrite
23.1
mg/L
10.3
mg/L
12
300.1 R1-97
0.1 mg/L El ML
2 MDL
Kjeldahl nitrogen
19.3
mg/L
10.4
mg/L
12
350.1 R2-93
El ML
0.1 mg/L I7 MDL
Oil and grease
N/A
N/A
N/A
N/A
N/A
❑ ML
❑ MDL
Phosphorus
3.95
mg/L
2.4
mg/L
12
365.4-74
0.3 mg/L El ML
0 MDL
Total dissolved solids
N/A
N/A
N/A
N/A
N/A
❑ 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).
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

DocuSign Envelope ID: 87A340E9-61C0-4BFF-A179-714631FD6EF0
EPA Identification Number NPDES Permit Number Facility Name Outfall Number
Modified Application Form 2A
NC0032565 North Lenoir High School
Modified March 2021
Maximum Daily Discharge Average Daily Discharge
Analytical ML or MDL
Pollutant Number of
Method' (include units)
Value Units Value Units
Samples
Metals, Cyanide, and Total Phenols
Hardness (as CaCO3)
❑ ML
❑ MDL
Antimony, total recoverable
❑ ML
❑ MDL
Arsenic, total recoverable
❑ ML
❑ MDL
Beryllium, total recoverable
❑ ML
❑ MDL
Cadmium, total recoverable
❑ ML
❑ MDL
Chromium, total recoverable
❑ ML
❑ MDL
Copper, total recoverable
❑ ML
❑ MDL
Lead, total recoverable
❑ ML
❑ MDL
Mercury, total recoverable
❑ ML
❑ MDL
Nickel, total recoverable
❑ ML
❑ MDL
Selenium, total recoverable
❑ ML
❑ MDL
Silver, total recoverable
❑ ML
❑ MDL
Thallium, total recoverable
❑ ML
❑ MDL
Zinc, total recoverable
❑ ML
❑ MDL
Cyanide
❑ ML
❑ MDL
Total phenolic compounds
❑ ML
❑ MDL
Volatile Organic Compounds
Acrolein
❑ ML
❑ MDL
Acrylonitrile
❑ ML
❑ MDL
Benzene
❑ ML
❑ MDL
Bromoform
❑ ML
❑ MDL
EPA Form 3510-2A (Revised 3-19) Page 13

DocuSign Envelope ID: 87A340E9-61C0-4BFF-A179-714631FD6EF0
EPA Identification Number NPDES Permit Number Facility Name Outfall Number
Modified Application Form 2A
NC0032565 North Lenoir High School
Modified March 2021
Maximum Daily Discharge Average Daily Discharge
Analytical ML or MDL
Pollutant Number of
Method' (include units)
Value Units Value Units
Samples
Carbon tetrachloride
❑ ML
❑ MDL
Chlorobenzene
❑ ML
❑ MDL
Chlorodibromomethane
❑ ML
❑ MDL
Chloroethane
❑ ML
❑ MDL
2-chloroethylvinyl ether
❑ ML
❑ MDL
Chloroform
❑ ML
❑ MDL
Dichlorobromomethane
❑ ML
❑ MDL
1,1-dichloroethane
❑ ML
❑ MDL
1,2-dichloroethane
❑ ML
❑ MDL
trans- 1,2-dichloroethylene
❑ ML
❑ MDL
1,1-dichloroethylene
❑ ML
❑ MDL
1,2-dichloropropane
❑ ML
❑ MDL
1,3-dichloropropylene
❑ ML
❑ MDL
Ethylbenzene
❑ ML
❑ MDL
Methyl bromide
❑ ML
❑ MDL
Methyl chloride
❑ ML
❑ MDL
Methylene chloride
❑ ML
❑ MDL
1,1,2,2-tetrachloroethane
❑ ML
❑ MDL
Tetrachloroethylene
❑ ML
❑ MDL
Toluene
❑ ML
❑ MDL
1,1,1-trichloroethane
❑ ML
❑ MDL
1,1,2-trichloroethane
❑ ML
❑ MDL
EPA Form 3510-2A (Revised 3-19) Page 14

DocuSign Envelope ID: 87A340E9-61C0-4BFF-A179-714631FD6EF0
EPA Identification Number NPDES Permit Number Facility Name Outfall Number
Modified Application Form 2A
NC0032565 North Lenoir High School
Modified March 2021
Maximum Daily Discharge Average Daily Discharge
Analytical ML or MDL
Pollutant Number of
Method' (include units)
Value Units Value Units
Samples
Trichloroethylene
❑ ML
❑ MDL
Vinyl chloride
❑ ML
❑ MDL
Acid -Extractable Compounds
p-chloro-m-cresol
❑ ML
❑ MDL
2-chlorophenol
❑ ML
❑ MDL
2,4-dichlorophenol
❑ ML
❑ MDL
2,4-dimethyl phenol
❑ ML
❑ MDL
4,6-dinitro-o-cresol
❑ ML
❑ MDL
2,4-dinitrophenol
❑ ML
❑ MDL
2-nitrophenol
❑ ML
❑ MDL
4-nitrophenol
❑ ML
❑ MDL
Pentachlorophenol
❑ ML
❑ MDL
Phenol
❑ ML
❑ MDL
2,4,6-trichlorophenol
❑ ML
❑ MDL
Base -Neutral Compounds
Acenaphthene
❑ ML
❑ MDL
Acenaphthylene
❑ ML
❑ MDL
Anthracene
❑ ML
❑ MDL
Benzidine
❑ ML
❑ MDL
Benzo(a)anthracene
❑ ML
❑ MDL
Benzo(a)pyrene
❑ ML
❑ MDL
3,4-benzofluoranthene
El ML
❑ MDL
EPA Form 3510-2A (Revised 3-19) Page 15

DocuSign Envelope ID: 87A340E9-61C0-4BFF-A179-714631FD6EF0
EPA Identification Number NPDES Permit Number Facility Name Outfall Number
Modified Application Form 2A
NC0032565 North Lenoir High School
Modified March 2021
Maximum Daily Discharge Average Daily Discharge
Analytical ML or MDL
Pollutant Number of
Method' (include units)
Value Units Value Units
Samples
Benzo(ghi)perylene
❑ ML
❑ MDL
Benzo(k)fluoranthene
❑ ML
❑ MDL
Bis (2-chloroethoxy) methane
❑ ML
❑ MDL
Bis (2-chloroethyl) ether
❑ ML
❑ MDL
Bis (2-chloroisopropyl) ether
❑ ML
❑ MDL
Bis (2-ethylhexyl) phthalate
❑ ML
❑ MDL
4-bromophenyl phenyl ether
❑ ML
❑ MDL
Butyl benzyl phthalate
❑ ML
❑ MDL
2-chloronaphthalene
❑ ML
❑ MDL
4-chlorophenyl phenyl ether
❑ ML
❑ MDL
Chrysene
❑ ML
❑ MDL
di-n-butyl phthalate
❑ ML
❑ MDL
di-n-octyl phthalate
❑ ML
❑ MDL
Dibenzo(a,h)anthracene
❑ ML
❑ MDL
1,2-dichlorobenzene
❑ ML
❑ MDL
1,3-dichlorobenzene
❑ ML
❑ MDL
1,4-dichlorobenzene
❑ ML
❑ MDL
3,3-dichlorobenzidine
❑ ML
❑ MDL
Diethyl phthalate
❑ ML
❑ MDL
Dimethyl phthalate
❑ ML
❑ MDL
2,4-dinitrotoluene
❑ ML
❑ MDL
2,6-dinitrotoluene
❑ ML
❑ MDL
EPA Form 3510-2A (Revised 3-19) Page 16

DocuSign Envelope ID: 87A340E9-61C0-4BFF-A179-714631FD6EF0
EPA Identification Number NPDES Permit Number Facility Name Outfall Number
Modified Application Form 2A
NC0032565 North Lenoir High School
Modified March 2021
Maximum Daily Discharge Average Daily Discharge
Analytical ML or MDL
Pollutant Number of
Method' (include units)
Value Units Value Units
Samples
1,2-diphenylhydrazine
❑ ML
❑ MDL
Fluoranthene
❑ ML
❑ MDL
Fluorene
❑ ML
❑ MDL
Hexachlorobenzene
❑ ML
❑ MDL
Hexachlorobutadiene
❑ ML
❑ MDL
Hexachlorocyclo-pentadiene
❑ ML
❑ MDL
Hexachloroethane
❑ ML
❑ MDL
Indeno(1,2,3-cd)pyrene
❑ ML
❑ MDL
Isophorone
❑ ML
❑ MDL
Naphthalene
❑ ML
❑ MDL
Nitrobenzene
❑ ML
❑ MDL
N-nitrosodi-n-propylamine
❑ ML
❑ MDL
N-nitrosodimethylamine
❑ ML
❑ MDL
N-nitrosodiphenylamine
❑ ML
❑ MDL
Phenanthrene
❑ ML
❑ MDL
Pyrene
❑ ML
❑ 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

DocuSign Envelope ID: 87A340E9-61C0-4BFF-A179-714631FD6EF0
NPDES Permit Number Facility Name Outfall Number
Modified Application Form 2A
NC0032565 North Lenoir High School
Modified March 2021
�� • •
• •
Maximum Dail Discharge Average Dail Discharge
Pollutant
Analytical ML or MDL
Number of
list
Value
Units Value
Units
Method (include units)
Samples
❑ No additional sampling is required by NPDES permitting authority.
Total Nitrogen
34.2
mg/L
20.7
mg/L
12
Calculated
N/A El ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
❑ ML
❑ MDL
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