NC0041866_Renewal (Application)_20230828

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ROY COOPER 4 ; t _ ' 24
Governor d�' --
ELIZABETH S.BISER °
Secretory ��-m -r`"`�
RICHARD E.ROGERS,JR. NORTH CAROLINA
Director Environmental Quality
August 28, 2023
Surry County Schools
Attn: Robert K. Draughn, Director of Plant Operations
PO Box 364
Dobson, NC 27017-0364
Subject: Permit Renewal
Application No. NC0041866
Mountain Park Elementary
Surry County
Dear Applicant:
The Water Quality Permitting Section acknowledges the August 28, 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. 150E-3 your current permit does not expire until permit decision on the application is made.
Continuation of the current permit is contingent on timely and sufficient application for renewal of the current permit. The
permit writer will contact you if additional information is required to complete your permit renewal. Please respond in a
timely manner to requests for additional information necessary to allow a complete review of the application and renewal
of the permit.
Information regarding the status of your renewal application can be found online using the Department of Environmental
Quality's Environmental Application Tracker at:
https://deq.nc.gov/permits-regulations/permit-guidance/environmental-application-tracker
If you have any additional questions about the permit, please contact the primary reviewer of the application using the
links available within the Application Tracker.
Sinc ely,
Wren Thedford
Administrative Assistant
Water Quality Permitting Section
ec: WQPS Laserfiche File w/application
Q=v North Carolina Department of Environmental Quality Division of Water Resources
`►/�,�/ Winston Salem Regional Office 450 West Hanes Mill Road.Suite 300 Winston-Salem.North Carolina 27105
336.7769800

i
ef,,,..
41 SURRY COUNTY SCHOOLS
)111r Li i t- i 51-hwaliS to &lobal Cjvcx,.c,
August 23, 2023
NC Department of Environmental Quality RECEIVED
Division of Water Resources
512 North Salisbury Street AUG 25 2023
1617 Mail Service Center
Raleigh, North Carolina 27699-1617 NCDEQ/DWR/NPDES
SUBJECT: Application for NPDES Permit to Discharge Wastewater
Mountain Park Elementary
NPDES WW Permit No. NC0041866
Surry County
Please find the enclosed Modified Application (Form 2) along with additional supporting documents for
the renewal of the wastewater permit for Mountain Park Elementary School.
• Modified Form 2A
• Topographical map
• Current permit
• Compliance Inspection Report (2-24-2021)
Please contact my office if you need further documentation or have any questions related to the
application.
Resp ctfully,
Rob rt K. Draughn
Director of Plant Operations
Surry County Schools
336-386-8381
I

NPDES Permit Number Facility Name Modified Application Form 2A
NC0041866 Mountain Park Elementary Modified March 2021
,A/\A/TD
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
Mountain Park Elementary School WWTP
Mailing address(street or P.O.box)
209 N.Crutchfield Street PO Box 364
City or town State ZIP code
o Dobson NC 27017
47.
Contact name(first and last) Title Phone number Email address
Larry Riggans ORC [phone] [e-mail]
Location address(street,route number,or other specific identifier) ❑ Same as mailing address
R 505 Mountain Park Road
w
City or town State ZIP code
State Road NC 29676
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?
El Yes ❑ No 4 SKIP to Item 1.4.
Applicant name
Surry County Board of Education
= Applicant address(street or P.O. box)
209 N.Crutchfield Street PO Box 364
o City or town State ZIP code
Dobson NC 27017
Contact name(first and last) Title Phone number Email address
Dr.Travis L Reeves,Ed Superintendent [phone] [e-mail]
a
1.4 Is the applicant the facility's owner,operator,or both?(Check only one response.)
❑ Owner ❑ Operator 0 Both
1.5 To which entity should the NPDES permitting authority send correspondence?(Check only one response.)
El Facility ❑ 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.)
dExisting Environmental Permits
❑ NPDES(discharges to surface ❑ RCRA(hazardous waste) ❑ UIC(underground injection
water) control)
NC0041866
❑ PSD(air emissions) ❑ Nonattainment program(CM) ❑ NESHAPs(CM)
a)
❑ Ocean dumping(MPRSA) ❑ Dredge or fill(CWA Section ❑ Other(specify)
404)
Page 1

NPDES Permit Number Facility Name Modified Application Form 2A
NC0041866 Mountain Park Elementary Modified March 2021
Q.-1.....I%Al\A/TD
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 0 Own 0Maintain
az3o %combined storm and sanitary sewer ❑ Own ❑ Maintain
N ❑ Unknown 0 Own ❑ Maintain
c %separate sanitary sewer 0 Own 0 Maintain
o %combined storm and sanitary sewer 0 Own ❑ Maintain
0 Unknown 0 Own 0 Maintain
0.
a %separate sanitary sewer 0 Own 0 Maintain
c %combined storm and sanitary sewer 0 Own 0 Maintain
10 0 Unknown ❑ Own ❑ Maintain
E %separate sanitary sewer 0 Own 0 Maintain
› %combined storm and sanitary sewer ❑ Own 0 Maintain
cn
c ❑ Unknown ❑ Own 0 Maintain
Total 230
°' Population
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?
o ❑ Yes 0 No
U
c 1.9 Does the facility discharge to a receiving water that flows through Indian Country?
cci
c ❑ Yes 0 No
1.10 Provide design and actual flow rates in the designated spaces. Design Flow Rate
0.0035 mgd
3 y Annual Average Flow Rates(Actual)
aTwo Years Ago Last Year This Year
0 0.0007 mgd 0.0008 mgd 0.0009 mgd
0 LT
Daily Flow Rates(Actual)
o Two Years Ago Last Year This Year
0.0002 mgd 0.0001 mgd 0.0003 mgd
to1.11 Provide the total number of effluent discharge points to waters of the State of North Carolina by type.
oTotal Number of Effluent Discharge Points by Type
a . Constructed
rn Combined Sewer
Treated Effluent Untreated Effluent Bypasses Emergency
_c Overflows Overflows
0
/n
6 1
Page 2

NPDES Permit Number Facility Name Modified Application Form 2A
NC0041866 Mountain Park Elementary 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 ❑r 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
❑ Continuous
gpd 0 Intermittent
❑ Continuous
gpd 0 Intermittent
O Continuous
gpd 0 Intermittent
s 1.14 Is wastewater applied to land?
© Yes ❑ No 4 SKIP to Item 1.16.
0 1.15 Provide the land application site and discharge data requested below.
y Land Application Site and Discharge Data
Continuous or
Location Size Average Daily Volume Intermittent
Applied (check one)
Discharges into a Dry Ditch acresgpd 0 Continuous
❑ Intermittent
acresgpd ❑ Continuous
❑ Intermittent
acresgpd 0 Continuous
0 Intermittent
R 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?
El 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
NC0041866 Mountain Park Elementary Modified March 2021
f.,M....I%ARA/TD
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
a Facility name Mailing address(street or P.O. box)
(1)
City or town State ZIP code
0
Contact name(first and last) Title
0
Phone number Email address
QNPDES number of receiving facility(if any) ❑ None Average daily flow rate mgd
6 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)?
ca ❑ Yes 0 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
cn
acres d ❑ Continuous
9P 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.
d w 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
j Section 301(h)) 302(b)(2))
ElNot applicable
1.24 Are any operational or maintenance aspects(related to wastewater treatment and effluent quality)of the treatment works
the responsibility of a contractor?
❑ Yes ❑ No 4SKIP to Section 2.
1.25 Provide location and contact information for each contractor in addition to a description of the contractors operational
and maintenance responsibilities.
Contractor Information
Contractor 1 Contractor 2 Contractor 3
o Contractor name
(company name)
8Mailing address
(street or P.O.box)
`o City,state,and ZIP
code
Contact name(first and
ci last)
Phone number
Email address
Operational and
maintenance
responsibilities of
contractor
Page 4

NPDES Permit Number Facility Name Modified Application Form 2A
NC0041866 Mountain Park Elementary Modified March 2021
f.l.....1%A/\A/TD
SECTION 2.ADDITIONAL INFORMATION(40 CFR 122.21(j)(1)and(2))
o 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?
o ❑ Yes 0 No 4 SKIP to Section 3.
0 2.2 Provide the treatment works'current average daily volume of inflow Average Daily Volume of Inflow and Infiltration
o' and infiltration.
gpd
Indicate the steps the facility is taking to minimize inflow and infiltration.
0 2.3 Have you attached a topographic map to this application that contains all the required information?(See instructions for
0.
'Er) C specific requirements.)
❑ Yes ❑ No
E 2.4 Have you attached a process flow diagram or schematic to this application that contains all the required information?
o 2 (See instructions for specific requirements.)
a>
o ❑ Yes ❑ No
2.5 Are improvements to the facility scheduled?
❑ Yes E No 4 SKIP to Section 3.
= Briefly list and describe the scheduled improvements.
is 1.
E
d
2.
E
0
3.
CD
CS
co
4.
-a
R 2.6 Providescheduled or actual dates of completion for improvements.
Scheduled or Actual Dates of Completion for Improvements
d Scheduled Affected Begin End Begin I Attainment of
Outfalls Operational
o Improvement Construction Construction Discharge
(from above) (list outfall (MM/DD/YYYY) (MM/DD/YYYY) (MM/DD/YYYY) Level
CD
number) (MM/DD/YYYY)
CD
1.
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

NPDES Permit Number Facility Name Modified Application Form 2A
NC0041866 Mountain Park Elementary Modified March 2021
C 1.....1\AlIAITO
SECTION 3.INFORMATION ON EFFLUENT DISCHARGES(40 CFR 122.21(j)(3)to(5))
3.1 Provide the following information for each outfall.(Attach additional sheets if you have more than three outfalls.)
Outfall Number 1 Outfall Number Outfall Number
State NC
Surry
� County
o City or town
State Road
"6
o Distance from shore n/a ft. ft. ft.
Depth below surface n/a ft. ft. ft.
Average daily flow rate n/a mgd mgd mgd
Latitude 30 22' 24"
Longitude 80 51 15"
3.2 Do any of the outfalls described under Item 3.1 have seasonal or periodic discharges?
o ❑r Yes ❑ No+SKIP to Item 3.4.
3.3 If so,provide the following information for each applicable outfall.
Outfall Number 1 Outfall Number Outfall Number
� o
Number of times per year 2 times per week
discharge occurs
Average duration of each
o discharge(specify units) 2 hours
oAverage flow of each n/a mgd mgd mgd
R discharge
in Months in which discharge
OCCurS August-May
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
N
o vi 3.6 Does the treatment works discharge or plan to discharge wastewater to waters of the State of North Carolina from
a one or more discharge points?
w ❑ Yes ❑ No +SKIP to Section 6.
Page 6

NPDES Permit Number Facility Name Modified Application Form 2A
NC0041866 Mountain Park Elementary Modified March 2021
f..L,....I\A/\A/Tf]
3.7 Provide the receiving water and related information(if known)for each outfall.
Outfall Number 1 Outfall Number Outfall Number
Receiving water name Unnamed Tributary
Name of watershed,river,
0 or stream system Flat Branch
Q- U.S.Soil Conservation
*L
y Service 14-digit watershed
a code
Name of state Yadkin Pee Dee
management/river basin
a)
U.S.Geological Survey
8-digit hydrologic
CD
cataloging unit code
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 provided for discharges from each outfall.
Outfall Number 1 Outfall Number Outfall Number
Highest Level of ❑ 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 ❑ Advanced 0 Advanced
❑ Other(specify) ❑ Other(specify) 0 Other(specify)
UV disinfection
0
0_ Outfall
Removal Rates by
Outfall See data submitted via DMR
fn
BOD5 or CBOD5
TSS
❑ Not applicable ❑ Not applicable 0 Not applicable
Phosphorus %
❑ Not applicable ❑ Not applicable 0 Not applicable
Nitrogen
Other(specify) 0 Not applicable ❑ Not applicable 0 Not applicable
Page 7

NPDES Permit Number Facility Name Modified Application Form 2A
NC0041866 Mountain Park Elementary Modified March 2021
3.9 Describe the type of disinfection used for the effluent from each outfall in the table below. If disinfection varies by
season,describe below.
a' Ultraviolet (chlorination as a backup)
;_. System is operated during normal school calendar year(August-May)June/July-system is shutdown for routine
= Outfall Number 1 Outfall Number Outfall Number
0
Disinfection type Duel UV
(clorination as backup)
m
= Seasons used During school operation
Aug-May
EL' Dechlorination used? Notapplicable Notapplicable
❑ Not applicable ❑ app ca e ❑
❑ 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
c
Number of tests of discharge
= water
CO 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. ❑ 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
NC0041866 Mountain Park Elementary Modified March 2021
c.-L.-.... %AnA,Tn
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 0 No 4 Complete tests and Table E and SKIP to
Item 3.26.
3.20 Have you previously submitted the results of the above tests to your NPDES permitting authority?
El Yes ❑ No—I 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)
m
0
03 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.
3.23 Describe the cause(s)of the toxicity:
c
d
4-
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 2Not applicable because previously submitted
information to the NPDES •ermittin• authori .
Page 9

NPDES Permit Number Facility Name Modified Application Form 2A
NC0041866 Mountain Park Elementary Modified March 2021
c..w....i eneirn
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 0 wl topographic map ❑ wl process flow diagram
Information ❑ w/additional attachments
0 w/Table A ❑ w/Table D
❑ Section 3: Information on ❑ wl Table B ❑ wl additional attachments
Effluent Discharges
❑ w/Table C
d
ci' Section 4: Not Applicable
0
w Section 5: Not Applicable
d
❑ Section 6:Checklist and ❑ w/attachments
Certification Statement
Y 6.2 Certification Statement
0
oc 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
Dr.Travis L.Reeves Superintendent
Signature Date signed
<4:44137i
08/22/2023
/ I
L
Page 10

NPDES Permit Number Facility Name Outfall Number Modified Application Form 2A
NC0041866 Mountain Park Elementary School Modified March 2021
\A/\A ITo
TABLE A.EFFLUENT PARAMETERS FOR ALL POTWS
Maximum Daily Discharge Average Daily Discharge Analytical ML or MDL
Pollutant Number of Methods include units
Value Units Value Units Samples Methods (
)
Biochemical oxygen demand ❑ML
o BODs or❑CBODs 6.7 mg/I ❑MDL
(report one)
❑ML
Fecal coliform 1600 Geometic Means 0 MDL
Design flow rate 0.0035
pH(minimum) 7.7
pH (maximum)
Temperature(winter) 16.0 C
Temperature(summer) 26.0 C
0 ML
Total suspended solids(TSS) 5.8 mg/I 0 MDL
1 Sampling shall be conducted according to sufficiently sensitive test procedures(i.e.,methods)approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter I, subchapter N or 0.See instructions and 40 CFR 122.21(e)(3).
Page 11

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NC0041866 - Mountain Park Elementary School Facility .. -
Location
USGS Quad: Elkin North, N.C. Latitude:
Receiving Stream:UT to Flat Branch 36°22'24" -*-
Stream Class: C Longitude: r Surry County
Subbasin: 03-07-02 80°51'15" Map not to scale

Permit NC0041866
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF WATER RESOURCES
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,the
Surry County Board of Education
is hereby authorized to discharge wastewater from a facility located at the
Mountain Park Elementary School WWTP
505 Mountain Park Road
Surry County
to receiving waters designated as an unnamed tributary to Flat Branch in Subbasin 03-07-02 of 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.
The permit shall become effective January 1, 2019.
This permit and the authorization to discharge shall expire at midnight on December 31, 2023.
Signed this day November 9, 2018.
7/(d
a Culpepper, Interim Direc
ivision of Water Resources
By Authority of the Environmental Management Commission
1 of 6

Permit NC0041866
Part I.
A. (1.) EFFLUENT LIMITATIONS AND MONITORING REQUIREMENTS
[15A NCAC 02B.0400 et seq., 15A NCAC 02B.0500 et seq.]
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 LIMITS MONITORING REQUIREMENTS
Monthly Measurem Sample Sample
[PCS Code] Average Daily Maximum ent Type Location2
Frequency
Flow Instantaneo Influent or
0.0035 MGD Weekly
[50050] us Effluent
BOD, 5-day, 20°C 20.0 mg/L 30.0 mg/L 2/Month Grab Effluent
[00310]
Total Suspended Solids 30.0 mg/L 45.0 mg/L 2/Month Grab Effluent
[00530]
NH3 as N 13.0 mg/L 35.0 mg/L 2/Month Grab Effluent
[00610]
Dissolved Oxygen Daily average >6.0 mg/L Weekly Grab Effluent
[00300]
Dissolved Oxygen Weekly Grab Downstream
[00300]
Fecal Coliform [31616] 200/100 ml 400/100 ml 2/Month Grab Effluent
(geometric mean)
Total Residual Chlorine
(TRC)3 28 pg/L 2/Week Grab Effluent
[50060]
Temperature (°C) Weekly Grab Effluent
[00010]
Total Nitrogen [00600] Quarterly Grab Effluent
(NO2+NO3+TKN)
Total Phosphorus Quarterly Grab Effluent
[00665]
pH >6.0 and <9.0 standard units 2/Month Grab Effluent
[00400] — —
Footnotes:
1. The permittee shall begin submitting discharge monitoring reports electronically using the Division's eDMR
application system[see A. (4)].
2. Downstream=at least 300 feet downstream from the outfall.
3. See A. (2.)for instructions should the facility's UV system fail and an alternate means of disinfection is
required. The TRC limit and monitoring requirements apply only if chlorine compounds are used for
disinfection.
All samples collected should be from a representative discharge event.
There shall be no discharge of floating solids or visible foam in other than trace amounts.
3of6

{
Permit NC0041866
1. Reporting (Supersedes Section D. (2.) and Section E. (5.) (a)1
Beginning no later than November 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/eDMR
1617 Mail Service Center
Raleigh,NC 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.
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 first 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.
5 of 6

f
ROY COOPER 4.•
Governor d � :. ' +
MICHAEL S.REGAN ., ,...r
Secretary
S.DANIEL SMITH NORTH CAROLINA
Director Environmental Quality
March 04, 2021
Robert K Draughn
Surry County Schools
PO Box 364
Dobson, NC 27017-0364
SUBJECT: Compliance Inspection Report
Mountain Park Elementary
NPDES WW Permit No. NC0041866
Surry County
Dear Permittee:
The North Carolina Division of Water Resources conducted an inspection of the Mountain Park
Elementary on 2/24/2021. This inspection was conducted to verify that the facility is operating in
compliance with the conditions and limitations specified in NPDES WW Permit No. NC0041866. The
findings and comments noted during this inspection are provided in the enclosed copy of the inspection
report entitled "Compliance Inspection Report".
There were no significant issues or findings noted during the inspection and therefore, a response to this
ORC LarryRiggans demonstrated good maintenance and operations
inspection report is not required. gg p
practices, all within the purview of the permit requirements.
Q- vN:rttaro,coDeportmortof:nvrorrcortoQuat_ I Dovso*ofWattrR4sorrats
�b W eiton4a em Reg ca Off a 450 V:rt panes td .Rosi,Su to 3OO I W eotoc.Se*vc Nora Cam
Caro ra 27105
325-778-95O0

Ifyoushould have anyquestions, pleasenothesitate to contact Alex Lowe with the Water Quality aquet , do Q ty
Regional Operations Section in the Winston-Salem Regional Office at 336-776-9800 or via email at
[e-mail].
Sincerely,
EDoewSigned by:
.-0A. T. SAJcA-
145B49E225094EA.
Lon T. Snider, Regional Supervisor
Water Quality Regional Operations Section
Winston-Salem Regional Office
Division of Water Resources, NCDEQ
ATTACHMENTS
Cc: WQS Winston-Salem Regional Office - Enforcement File
NPDES Compliance/Enforcement Unit - Enforcement File
Laserfiche— Digital Enforcement File
•
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R'nston59-em Fie;ane Qffce 14'SQ West�anrr�k 1 Fosv: te3s�11•:r;t;r�;em•Norsk Csro-na 27105
• '�"�"'�^ 338?76.9Sn

United States Environmental Protection Agency Form Approved.
E PA VVashington,D.C.20460 OMB No.2040-0057
Water Compliance Inspection Report Approval expires 8-31-98
Section A: National Data System Coding(i.e., PCS)
Transaction Code NPDES yr/mo/day Inspection Type Inspector Fac Type
1L'J 2 u 3 I NC0041866 111 121 21/02/24 117 18 1 ] 19 Ls]] 201
211 III 1 I I I I1 11 1. 1 I I I I I I I I I I I I I I I I I 1 II 1 I I I I 166
Inspection Work Days Facility Self-Monitoring Evaluation Rating B1 QA 671 70 I 71I I 72 I N I 73 I 17471 I I I I I I 180
Section B: Facility Data
Name and Location of Facility Inspected(For Industrial Users discharging to POTW,also include Entry Time/Date Permit Effective Date
POTW name and NPDES permit Number) 08:50AM 21/02/24 19/01/01
Mountain Park Elementary
197 Mtn Park Rd Exit Time/Date Permit Expiration Date
State Road NC 28676 09:50AM 21/02/24 23/12/31
Name(s)of Onsite Representative(s)/tles(s)/Phone and Fax Number(s) Other Facility Data
///
Larry Odell Riggans/ORC/336-386-8381/
Name,Address of Responsible OfficialiTtle/Phone and Fax Number
Contacted
Robert K Draughn,PO Box 364 Dobson NC
270170364/Director/336-386-8381/3363864279 No
Section C:Areas Evaluated During Inspection(Check only those areas evaluated)
11 Permit Flow Measurement • Operations&Maintenar Records/Reports
III Self-Monitoring Progrart Facility Site Review In Effluent/Receiving Wate II Laboratory
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
(See attachment summary)
Name(s)and Signature(s)of Inspector(s) Agency/Office/Phone and Fax Numbers Date
Alex Lowe DWRNVSRO WQ/336-776-9689/
Signature of Management Q A Reviewer Agency/Office/Phone and Fax Numbers Date
p—DocuSigned by:
Low 1 Smk., 3/4/21
`-145B49E225C94EA...
EPA Form 3560-3(Rev 9-94)Previous editions are obsolete.
Page# 1

NPDES yr/mo/day Inspection Type (Cont.) 1
3I NC0041866 111 11 21/02/24 117 18
Section D: Summary of Finding/Comments(Attach additional sheets of narrative and checklists as necessary)
On FebruaryEnvironmental Specialist Alex Lowe of the North Carolina Division of Water
aljX Resources conducted an inspection of Mountain Park Elementary School wastewater treatment
03/04/24 system. This inspection was conducted to verify that the facility is operating in compliance with the
conditions and limitations specified in NPDES WW Permit No. NC0041866. ORC Larry Riggans was
present.
ORC was unable to provide copy of permit or past reporting data at the site, as it was filed in the
administrative building. Due to ongoing COVID-19 precautions, Lowe opted not to travel to the office,
but instead requested that photocopies be sent for review. These copies were provided promptly the
same morning. All records appear well organized and maintained.
No signs of permit violation were observed in the treatment process. The site was well maintained, and
backup parts were present for all necessary systems (e.g. the UV bulbs and plastic sprinkler heads.
Page# 2

Permit: NC0041866 Owner-Facility: Mountain Park Elementary
Inspection Date: 02/24/2021 Inspection Type: Compliance Evaluation
Operations & Maintenance Yes No NA NE
Is the plant generally clean with acceptable housekeeping? • 0 ❑ ❑
Does the facility analyze process control parameters, for ex: MLSS, MCRT, Settleable ❑ ❑ ❑ •
Solids, pH, DO, Sludge Judge, and other that are applicable?
Comment: Plant areas are well maintained and organized. ORC indicated upcoming replacement of
septic holding tank (current tank is original to 1950s era school buildings) and replacing sans
on filter bed.
Permit Yes No NA NE
(If the present permit expires in 6 months or less). Has the permittee submitted a new ❑ ❑ II ❑
application?
Is the facility as described in the permit? ❑ 0 ❑
#Are there any special conditions for the permit? ❑ • ❑ ❑
Is access to the plant site restricted to the general public? • ❑ ❑ ❑
Is the inspector granted access to all areas for inspection? • ❑ 0 0
Comment: Permit is kept off-site at administrative building, which I decided to avoid due to ongoing
COVID-19 precautions. Follow-up email from office provided a photocopy of the permit as
requested.
Effluent Sampling Yes No NA NE
Is composite sampling flow proportional? ❑ ❑ • ❑
Is sample collected below all treatment units? • ❑ ❑ ❑
Is proper volume collected? • 0 ❑ ❑
Is the tubing clean? ❑ ❑ • ❑
# Is proper temperature set for sample storage(kept at less than or equal to 6.0 degrees ❑ ❑ II ❑
Celsius)?
Is the facility sampling performed as required by the permit(frequency, sampling type • ❑ ❑ ❑
representative)?
Comment: Effluent sampling collected weekly by ORC with manual grab.
Disinfection-Tablet Yes No NA NE
Are tablet chlorinators operational? II 0 ❑ ❑
Are the tablets the proper size and type? • ❑ ❑ ❑
Number of tubes in use? 0
Is the level of chlorine residual acceptable? ❑ ❑ II ❑
Is the contact chamber free of growth, or sludge buildup? • ❑ ❑ ❑
Is there chlorine residual prior to de-chlorination? ❑ ❑ III Cl
Page# 3

Permit: NC0041866 Owner-Facility: Mountain Park Elementary
Inspection Date: 02/24/2021 Inspection Type: Compliance Evaluation
Disinfection-Tablet Yes No NA NE
Comment: Chlorination contact chambers are not used regularly, but are in place as a backup in case
of UV system failure.
Disinfection - UV Yes No NA NE
Are extra UV bulbs available on site? • 0 ❑ ❑
Are UV bulbs clean? • ❑ ❑ ❑
Is UV intensity adequate? • 0 ❑ 0
Is transmittance at or above designed level? • ❑ ❑ ❑
Is there a backup system on site? • ❑ ❑ ❑
Is effluent clear and free of solids? • ❑ ❑ ❑
Comment: ORC stated that he always orders four bulbs whenever he replaces existing two bulbs, so
he always has at least two extras on site. They are cleaned weekly, and replaced annually,
or more frequently if fecal becomes an issue.
Septic Tank Yes No NA NE
(If pumps are used) Is an audible and visual alarm operational? 0 0 � ❑
Is septic tank pumped on a schedule? • ❑ ❑ ❑
Are pumps or syphons operating properly? ❑ ❑ • ❑
Are high and low water alarms operating properly? ❑ ❑ • ❑
Comment: Septic tank is entirely gravity fed. Sludge is pumped at the end of the school year every five
years, or as needed.
Sand Filters (Low rate) Yes No NA NE
(If pumps are used) Is an audible and visible alarm Present and operational? • ❑ ❑ ❑
Is the distribution box level and watertight? ❑ ❑ El III
Is sand filter free of ponding? • ❑ ❑ ❑
Is the sand filter effluent re-circulated at a valid ratio? • ❑ ❑ ❑
# Is the sand filter surface free of algae or excessive vegetation? • ❑ ❑ ❑
#Is the sand filter effluent re-circulated at a valid ratio? (Approximately 3 to 1) • 0 ❑ ❑
Comment: Recirculation pump is operable and alarm is present and functioning.
Effluent Pipe Yes No NA NE
Is right of way to the outfall properly maintained? • ❑ ❑ ❑
Are the receiving water free of foam other than trace amounts and other debris? ❑ ❑ IN El
If effluent (diffuser pipes are required) are they operating properly? ❑ ❑ • ❑
Page# 4

Permit: NC0041866 Owner-Facility: Mountain Park Elementary
Inspection Date: 02/24/2021 Inspection Type: Compliance Evaluation
Effluent Pipe Yes No NA NE
Comment: Drains to dry/rainwater drainage ditch which runs through several hundred feet of meadow
before contact with surface waters.
Flow Measurement - Influent Yes No NA NE
#Is flow meter used for reporting? • ❑ ❑ ❑
Is flow meter calibrated annually? • 0 ❑ ❑
Is the flow meter operational? 11 ❑ ❑ 0
(If units are separated) Does the chart recorder match the flow meter? ❑ ❑ • ❑
Comment: Flow into treatment plant is measured with meter on school building.
Pump Station - Effluent Yes No NA NE
Is the pump wet well free of bypass lines or structures? 11 ❑ ❑ 0
Are all pumps present? U ❑ ❑ ❑
Are all pumps operable? • ❑ 0 0
Are float controls operable? • 0 ❑ ❑
Is SCADA telemetry available and operational? ❑ ❑ 0 •
Is audible and visual alarm available and operational? • ❑ 0 0
Comment: ORC demonstrated effectiveness of both effluent and recirculation pump wells.
Page# 5