NCGNE0762_COMPLETE FILE - HISTORICAL_20110301

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
DOC TYPE M"'HISTORICALFILE
❑ MONITORING REPORTS
DOC DATE ❑ �UI
YYYYMMDD

.An
7j;r A
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
February 22, 2011
Joseph Sloop, Town Manager
Town of Yadkinville
PO Box 816
Yadkinville, NC 27055
Subject: No-Exposure Certification NCGNE0762
Town of Yadkinville WWTP
1620 Fred Hinshaw Road
Yadkin County
Dear Mr. Sloop:
The Division has reviewed your submittal of the No-Exposure Certification for Exclusion from NPDES Stormwater
Permitting form. Based on your submittal and signed certification of no exposure at the above referenced facility, the
Division is granting your conditional exclusion from permitting as provided for under 40 CFR 126.22(g), which is
incorporated by reference in North Carolina regulations.We are also hereby rescinding your current permit Certificate
of Coverage, NCG110137
Please note that by our acceptance of your no-exposure certification, you are obligated to maintain no-exposure
conditions at your facility. If conditions change such that your facility can no longer qualify for a no-exposure
exclusion, you are obligated to immediately obtain NPDES permit coverage for your stormwater discharge.
Otherwise, the discharge becomes subject to enforcement as an un-permitted discharge.
Your conditional exclusion from permitting does not affect your facility's legal requirements to obtain environmental
permits that may be required under other federal, state, or local regulations or ordinances.
If you have any questions or need further information, please contact Sue White at [phone], or at
[e-mail].
Sincerely, _
,_far- Coleen H. Sullins �� Z 201,
cc:Winston Salem Regional Office Stormwater Permitting File NCG11s ��AL
Stormwater Permitting Unit No- Exposure Files Fran McPherson-Budget Office ►�crt
Tom Gray, ORC Yadkinville WWTP
North Carolina Division of Water Quality, Winston-Salem Regional Office
Location:585 Waughtown St.Winston-Salem,North Carolina 27107 1�7One
Phone:[phone] FAX:[phone] Customer Service:1-877-623-6748 .l�_Of thCarolina
Internet:www.ncwaterquality.org ']Vatura
An Equal Opportunity 1 Affirmative Action Employer L "

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NC®ENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
February 22, 2011
Joseph Sloop, Town Manager
Town of Yadkinville
PO Box 816
Yadkinville, NC 27055
Subject: No-Exposure Certification NCGNE0762
Town of Yadkinville WWTP
1620 Fred Hinshaw Road
Yadkin County
Dear Mr. Sloop:
The Division has reviewed your submittal of the No-Exposure Certification for Exclusion from NPDES Stormwater
Permitting form. Based on youf submittal and signed certification of no exposure at the above referenced facility, the
Division is granting your conditional exclusion from permitting as provided for under 40 CFR 126.22(g), which is
incorporated by reference in North Carolina regulations. We are also hereby rescinding your current permit Certificate
of Coverage, NCG110137
Please note that by our acceptance of your no-exposure certification, you are obligated to maintain no-exposure
conditions at your facility. If conditions change such that your facility can no longer qualify for a no-exposure
exclusion, you are obligated to immediately obtain NPDES permit coverage for your stormwater discharge.
Otherwise, the discharge becomes subject to enforcement as an un-permitted discharge.
Your conditional exclusion from permitting does not affect your facility's legal requirements to obtain environmental
permits that may be required under other federal, state, or local regulations or ordinances.
If you have any questions or need further information, please contact Sue White at(336)771-5000, or at
sue.white@ncdenr,gov.
Sincerely,
jor— Coleen H. Sullins
cc:Winston Salem Regional Office Stormwater Permitting File NCG110137
Stormwater Permitting Unit No- Exposure Files Fran McPherson-Budget Office
Tom Gray, ORC Yadkinville WWTP
North Carolina Division of Water Quality, Winston-Salem Regional Office
Locators:585 waughtown St.Winston-Salem,North Carolina 27107 One
Phone:[phone]FAX:[phone] Customer Service:1-877-623-6748 Noci hCarofina
Internet:www.ncwaterqualit.org Nat
//�
An Equal Opportunity 1 Affirma''M Action Employer �/ y "

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' m Division of Water ualit /Surface Water Protection Date K"cjYed
Q Y t_ Year Mom}, Day
RCDENR
National Pollutant Discharge Elimination System Ce,tifica,curCovcrage
NO EXPOSURE CERTIFICATION for Exclusion C G tv E D 7
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NCGNE0000
NO EXPOSURE CERTIFICATION
National Pollutant Discharge Elimination System application for exclusion-from a Stormwater Permit based
on NO EXPOSURE:
Submission of this No Exposure Certification constitutes notification that your facility does not require a
permit for stormwater discharges associated with industrial activity in the State of North Carolina because
it qualifies for a no exposure exclusion. A condition of no exposure at an industrial facility means all
industrial materials and activities are protected by a storm resistant shelter(with some exceptions) to
prevent exposure to rain, snow, snowmelt, and/or runoff.
For permitted facilities in North Carolina, DWQ must approve your application for No
Exposure Certification before this exclusion is effective. Until you are issued a No
Exposure Certification and your NPDES permit is rescinded, your facility must continue
to abide by the terms and conditions of the current permit.
Industrial materials or activities include, but are not limited to: material handling equipment or activities,
industrial machinery, raw materials, intermediate products, by-products, final products, or waste products.
Material handling activities include the storage, loading and unloading, transportation, or conveyance of
any raw material, intermediate product, final product or waste product. A storm resistant shelter is not
required for the following industrial materials and activities: drums, barrels, tanks, and similar containers
that are tightly sealed, provided those containers are not deteriorated and do not leak. "Sealed"means
banded or otherwise secured and with locked or non-operational taps or valves;adequately maintained
vehicles used in material handling;and final products, other than products that would be mobilized in
stormwater discharges(e.g., rock salt).
A No Exposure Certification must be provided for each facility qualifying for the no exposure exclusion. In
addition, the exclusion from NPDES permitting is available on a facility-wide basis only--not for individual
outfalls. If any industrial activities or materials are, or will be, exposed to precipitation, the facility is not
eligible for the no exposure exclusion. By signing and submitting this No Exposure Certification form, you
certify that a condition of no exposure exists at this facility or site and are obligated to comply with the
terms and conditions of 40 CFR 122.26(g).
You are re uired to self re-certify our No Exposure Exclusion annually.
For questions,please contact the DWQ Regional Office for your area. (See page 6)
(Please print or type)
1) Mailing address of owner/operator(address to which all certification correspondence will be mailed):
Name vLJ A) d F Y6 K;-v its'ff e_
Contact �5 P 1
Street Address r
City f} ' ;11 ' State �' • ZIP Code Jr
Telephone No. 3/o 7 - 7773 Fax: 3 3& 22- 6 l5
E mail
Page 1 of 7 FEB Y 0 2011
SWU NE-12Aug201f3 ff TS WETIAHIIA MMMMIMAKf

h.0 ,
NCGNE0000 No Exposure Certification FEB
2) Location of facility producing discharge: Wn
_ �/ }}j �, Regicrr
Facility Name _ _! ^� D != N_f K;�J; t 4_e, �s�,} �.�.� �f"
Facility Contact
Facility Street Address "Us KW c ,
City ki ACI k'LA)i,F`� State ZIP Code Z
Countyya4 ` N
Telephone No. (� - �k Fax: � �_ (0 7 9 � L, 15 !
Email GL' e
3) Physical location information:
Please provide a narrative description of how to get to the facility (use street names, state road numbers, and
distan and direction from roadway intersection). o r,F L lfvy Y: �d_ 1 CWz Wi "" "
�►ct i��,t'r,a� r I Tea f, RT" �x L I� �i z l T Ffz hAW 9( P/144fi �N
(A copy of a map with the facility clearly located on it should be included with the certification application.)
4) Is the facility located on Native American Lands? ❑ Yes KNo
5) Is this a Federal facility? ❑ Yes DdNo
6) Latitude 36, D7 I 50 Longitude 1)3 0 37 min., seconds)
7) This NPDES No Exposure Exclusion application applies to which of the following:
© New or Proposed Facility Date operation is to begin
t" Existing Date operation began
❑ Renewal of existing No Exposure Certification Certification No.: NCGNE
8) Was this facility or site ever covered under an NPDES Stormwater Permit?_9 Yes ❑ No
If yes, what is the NPDES Permit Number? I• �l 101 3�
9) Standard Industrial Classification:
Provide the 4 digit Standard Industrial Classification Code (SIC Code) that describes the primary industrial
activity at this facility
SIC Code:_q_ -5— _L _L
10) Provide a brief description of the types of industrial activities and products produced at this facility:
11) Does this facility have any Non-Discharge permits(ex: recycle permits)?
igNo
❑ Yes
If yes, list the permit numbers for all current Non-Discharge permits for this facility:
Page 2 of 7
SWU-NE-12Aug2010

NCGNE0000 No Exposure Certification
Exposure Checklists(12. - 14.)
12) Are any of the following materials or activities exposed to precipitation, now or in the foreseeable
future? (Please check either "Yes" or "No.") If you answer "Yes"to any of these items, you are not
eligible for the no exposure exclusion.
a. Using, storing, or cleaning industrial machinery or equipment;and areas where ❑ Yes X No
residuals from using, storing or cleaning industrial machinery or equipment remain
and are exposed to stormwater
b. Materials or residuals on the ground or in stormwater inlets from spills/leaks ❑ Yes P&No
c. Materials or products from past industrial activity ❑ Yes Ili No
d. Material handling equipment (except adequately maintained vehicles) © Yes 4 No
e. Materials or products during loading/unloading or transporting activities 0 Yes WNo
f. Materials or products stored outdoors (except final products intended for outside ❑ Yes KNo
use [e.g., new cars] where exposure to stormwater does not result in the discharge
of pollutants)
g. Materials contained in open, deteriorated or leaking storage drums, barrels, tanks, ❑ Yes PCNo
and similar containers
h. Materials or products handled/stored on roads or railways owned or maintained by ❑ Yes WNo
the discharger
i. Waste material (except waste in covered, non-leaking containers [e.g., dumpsters]) Cl Yes KNo
j. Application or disposal of process wastewater (unless otherwise permitted) ❑ Yes WNo
k. Particulate matter or visible deposits of residuals from roof stacks and/or vents not ❑ Yes .E�No
otherwise regulated (i.e., under an air quality control permit) and evident in the
stormwater outflow
I. Empty containers that previously contained materials that are not properly stored ❑ Yes K No
(i.e., not closed and stored upside down to prevent precipitation accumulation)
m. For any exterior ASTs, as well as drums, barrels, tanks, and similar containers ❑ Yes X No
stored outside, has the facility had any releases in the past three (3) years?
13) Above Ground Storage Tanks(ASTs): If you answer "No"to any of the following items, you are not
eligible for the no exposure exclusion.
a. Are exterior ASTs and piping free of rust, damaged or weathered coating, pits, or ❑ Yes m No I] NIA
deterioration, or evidence of leaks?
b. Is secondary containment provided for all exterior ASTs? If so, is it free of any ❑ Yes WNo ❑ NIA
cracks, holes, or evidence of leaks, and are drain valves maintained locked shut?
Page 3 of 7
SW U-NE-12Aug2o to

NCGNE0000 No Exposure Certification
14) Secondary Containment: If you answer "No" to any of the following items,you are not eligible for the
no exposure exclusion.
a. Is secondary containment provided for all single above ground storage ® Yes ❑ No ❑ NIA
containers (including drums, barrels, etc.) with a capacity of more than 660-
gallons?
b. Is secondary containment provided for above ground storage containers stored Yes ❑ No ❑ NIA
in close proximity to each other with a combined capacity of more than 1,320-
gallons?
c. Is secondary containment provided for Title III Section 313 Superfund ❑ Yes ❑ No 95N1A
Amendments and Reauthorization Act (SARA) water priority chemicals`?
d. Is secondary containment provided for hazardous substances"designated in 40 ❑ Yes ❑ No 20 NIA
CFR §116?
e. Are release valves on all secondary containment structures locked? ❑ Yes ❑ No 13NIA
15) Hazardous Waste:
a. Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility? ❑ Yes I<No
b. Is this facility a Small Quantity Generator(less than 1000 kg. of hazardous waste ❑ Yes K No
generated per month) of hazardous waste?
c. Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste ❑ Yes X No
generated per month) of hazardous waste?
If you answered yes to questions b. or c., please provide the following information:
Type(s) of waste:
How is material stored:
Where is material stored:
How many disposal shipments per year:
Name of transport 1 disposal vendor: _
Vendor address:
Footnotes to Questions 14) c. & d.
*Note that amounts below the 660-gallon (single) and 1,320-gallon (combined) bulk storage minimums require
secondary containment. However, some exceptions may be made for de minimis amounts of certain substances,
and/or other qualifiers, as described in the exemptions from reporting requirements of Title Ill SARA 313 in 40 CFR
§372.38.
**Note that amounts below the 660-gallon (single) and 1,320-gallon (combined) bulk storage minimums require
secondary containment. However, some exceptions may be made for amounts less than the Reportable Quantities
of the hazardous substances listed in 40 CFR §117.3.
Page 4 of 7
SWU-NE-12Aug2010

. s
NCGNE0000 No Exposure Certification
16) Other information: if you answer "Yes" to any of the following items,you might not be eligible for the
no exposure exclusion. A more in-depth evaluation of the site circumstances may be required.
a. Does your facility store used, recycled, or otherwise reclaimed pallets outside? ❑ Yes E4 No
b. Does your facility have coal piles on site? ❑ Yes X No
c. Does your facility store other fuel sources outside in piles, such as wood chips, ❑ Yes 54 No
sawdust, etc.?
d. Does your facility have air emissions associated with its industrial activity(e.g., ❑ Yes O No
degreasing operations, plating, painting and metal finishing)? If so, describe the
industrial activity:
e. If you answered yes to d., are those emissions permitted by an Air Quality Permit? ❑ Yes WNo ❑ NIA
Please specify:
f. Please list any other environmental program permits (federal, state, etc.) not
specified earlier in this application (such as Hazardous Waste Permits, etc.):
Permit: Program:
Permit: Program:
Permit: Program:
Permit: Program:
Permit: Program:
Permit: Program:
Permit: Program:
Page 5 of 7
SWU-NE-12Aug20 14

NCGNE0000 No Exposure Certification
17) Certification:
I certify under penalty of law that I have read and understand the eligibility requirements for claiming a condition of"no
exposure"and obtaining an exclusion from NPDES stormwater permitting.
I certify under penalty of law that there are no discharges of stormwater contaminated by exposure to industrial activities
or materials from the industrial facility or site identified in this document(except as allowed under 40 CFR 122.26(g)(2)).
I understand that I am obligated to annually self re-certify No Exposure and, if requested, submit the re-certification to
DWQ or the operator of the local municipal separate storm sewer system (MS4) into which the facility discharges (where
applicable). I understand that I must allow the North Carolina Division of Water Quality,or MS4 operator where the
discharge is into the local MS4,to perform inspections to confirm the condition of no exposure and to make such
inspection reports publicly available upon request.
In the event that the site no longer qualifies for a No Exposure Exclusion, I understand that I must obtain coverage under
an NPDES permit prior to any point source discharge of stormwater from the facility.Additionally, 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 gathered and evaluated 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.
certify that I am familiar with the information contained in this application and that to the best of my knowledge and belief
such information is true,complete,and accurate.
Printed Name of Person Signing: t;N\. .S �-
Title: 11.) ' _P 1
A� �2-
[J_
(Signature of Applicant) (Date Signed)
Please note: This application for the No Exposure Exclusion is subject to approval by the
NCDENR Regional Office prior to issuance. The Regional Office may inspect your facility for
compliance with no exposure conditions prior to that approval. The Regional Office may also
inspect your facility at any time in the future for compliance with the No Exposure Exclusion.
North Carolina General Statute 143-215.6 B(i) provides that:
Any person who knowingly makes any false statement,representation,or certification in any application, record, report,plan,or other
document filed or required to be maintained under this Article or a rule implementing this Article;or who knowingly makes a false
statement of a material fact in a rulemaking proceeding or contested case under this Article;or who falsifies,tampers with,or knowingly
renders inaccurate any recording or monitoring device or method required to be operated or maintained under this Article or rules of the
[Environmenial Management]Commission implementing this Article shall be guilty of a Class 2 misdemeanor which may inciude a fine
not to exceed ten thousand dollars($10,000).
There is currently no fee for a No Exposure Exclusion.
Page 6 of 7
SWU-NE-12Aug2010

• 4
NCGNE0000 No Exposure Certification
Final Checklist
This application should include the following items:
❑ This completed application and all supporting documentation.
❑ A map with the location of the facility clearly marked.
0 If the site currently has an NPDES Stormwater Permit, be sure to indicate the permit number in Question 8.
Mail the entire package to:
Stormwater Permitting Unit
Division of Water Quality
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Note
The submission of this document does not guarantee the issuance of a No Exposure Exclusion.
For questions,please contact the DWQ Regional Office for your area.
DWO Regional Office Contact Information:
S w
Asheville Office ...... [phone]
Fayetteville Office ... [phone] �
Mooresville Office ... [phone]
1 J
Raleigh Office ........ [phone]AV
- 'w% y4 a la�oor4sv Ic A, A' `'�
Washington Office ...[phone]
Wilmington Office ... [phone]
Winston-Salem ...... [phone] F n"b ilia• ::• :�ta '�
Central Office .........[phone] o
t W ngton
r
Page 7 of 7
5WU-NE-12Aug2010

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Latitude: 36"07 59
Longitude: go�37 57 ' NCG110137 Facility r
» *�
County: Yadkin Town of Yadkin�ille `' ''S +1N gas,
�: akin Location ,' -l.�,. _..
Stream Class: C WWTP' t �r i
Receiving Stream: Haw Branch
Sub-basin.: 03-07-02 (Yadkin River Basin) NOT HALED
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Cover Sheet from
Staff Member to
Regional Supervisor
DNIR Review Record
Facility: E-E>' • Permit/Pipe No.: t-LC-Cx-� (-lt Month/Year l o
Monthly Average Violations
Parameter Permit Limit DINIR Value % Over Lirnit
Wee aily iolations
Date Parameter Permit Lirnitli'vne DN1R Value % Limit
> <D
Monitoring Frequency Violations
Date Parameter Permit Frequency Values Reported rr of Violations
Ot r Violation
Completed b Date:
Regional Water Quality
Supervisor Signoff: Date:

EF WLNT
NPOES PERMIT NO. 29611 DISCHARGE NO. 1 MONTH January YEAR 2009
FACILITY NAME East Bend Elementary School CLASS 2 COUNTY yadkin
.OPERATOR IN RESPONSIBLE CHARGE (ORC) Mar atthews GRADE 2 PHONE [phone]
CERTIFIED LABORATORIES (1) TRITEST (2)
CHECK BOX IF ORC HAS CHANCED PERSON(S)COLLECTING SAMPLES Mark Matthews
Mail ORIGINAL and ONE CO Y to: RECf E}
N.C.pent.t. NR
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'
ATTN:CENTRAL FILES
DIV.OF WATER QUALITY APR 0 6 2009 I x z
DENR Winstan-saion (SIGNATURE OF OPERATOR IN RESPONSIBLE CHARGE) DATE
1617 MAIL SERVICE CENTER .- Regional cff ce - BY THIS SIGNATURE,I CERTIFY THAT THE REPORT IS �/ 7
RALEIGH,NC 27699-1617 ACCURATE AND COMPLETE TO THE BEST OF MY KNOWLEDGE 4�
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26 7:00 1 Y
28 7.00 1 Y
30 1 14:30 1 Y 0.005 8.1 5.95 7.59
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=- AVERAGE 0.005 8,075 21 10.8 3.5 1 7.9825
adAXIMUM:::. Q . : ;1T 4...
MINIMUM 0.005 7.9 5,95 21 4.6 3 1 7.59
:Gomp'(C)Grab(G)......::O:.
Monthly Avg.Limit 0.007 NA 6-9 NA 30 NA 30 200 >6`
:weeks °Avinit.`: i€:NA IAA.is N A NA 1�A ::::::NA:;:;! A.
A.. lA. ..N.......... ...... .
-Daily Maximum Limit NA NA NA 28 45 NA 45 400 NA
DE Form MR-1 (12/93) Forms by Caem3W(707186a-0545:p1n1115$vS 24;11112000;sln111 58 3 1 52

Copyright 9 1992-2000 ChemSW®,Inc.,(707)864-0Ba5.All rights reserved.http:ttwww.chemsw.com
Facility Status: (Please check one of the following)
All monitoring data and sampling frequencies meet permit requirements xxx
Compliant
All monitoring data and sampling frequencies do NOT meet permit requirements 0
Noncompliant
., If the facility is noncompliant, please comment on corrective actions being taken in respect to equipment, operatioi
maintenance, etc:, and a time table for improvements to be made.
71 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 is, to the best of my knowledge and beli,
true, accurate, and complete. I am aware that there are significant penalties for submitting false information,
including the possibility of fines and imprisonment for knowing violations."
Yadkin County Board of Education
Permittee (Please print or type)
IsA
niture of Per tee" Date
:121 Washington St. Yadkinville N.C. 27055 336 679 2051 12/31/2013
-Permittee Address Phone Number Permit Exp. Date
Form �n ycnswl7o71es4-oe.s.Wn,,,sav5.a4:vlrt000:yn,llsaa152
PARAMETER CODES f
00010-Temperature- 00556 Oil & Grease 00951,Total Flouride 01067 Nickel.:. 50060
.00076 Turbidity ,, 00600 Total Nitrogen 01002 Total Arsenic 01077 Silver.
00080 Color Pt-co) 00610 Ammonia Nitrogen 01092 Zinc
00082 Color(ADNtII) 00625 Total Kjeldhal 01207 Cadmium 01105 Aluminum
Nitrogen
.00095 Conductivity 00630 Nitrates/Nitrites 01032 Hexavalent Chromium 01147 Total Selenium 71880
00300 Dissolved Oxygen 01034 Chromium 31616 Fecal Coliform 71900
03100 BOD5 00665 Total Phosphorous 32730 Total Phenolies 81551
00340 COD 00720 Cyanide 01307 Total Cobalt 34235 Benzene
00400 pH 00745 Total Sulfide 01042 Copper 34481 Toluene
00530 Total Suspended 00927 Total Magnesium 38260 MBAS
Residue . 00929 Total Sodium 01045 Iron 39516 PCBs
00545 Settleable Matter 00940 Total Chloride 01051 Lead 50050 Flaw
'Parameter Code assistance may be obtained by calling the Waer Quality Compliance Group at(919)733-5083,extension 581 or 534
The monthly average for fecal colifrrom is to be reprted as a GEOMETRIC mean. Use only units designated in the r
facility's permit for reprtin data. Q0 1 8V
ORC mmust visit facility and document visitation of faciclity as required per 15 A NCAC 8A.0202 (b) (5)(B)
If signed by other Phan the permittee, delegaation'of signatory authority must a on file with the state per 15A NCAC 2B .0506
(2) (D)
l ,

MONITORING REPORT(MR)VIOLATIONS for: Report Date: 05/04109 Page: 1 of 3
Permit: nc0029611 MRs Between: 1-2008 and 12-2008 Region:% Violation Category: % _ Program Category:
i
I Facility Name: % Param Name: % County:% Subbasin: % Violation Action:
Major Minor. %
PERMIT:NCO029611 FACILITY: Yadkin County Board of Education-East Bend COUNTY:Yadkin REGION: Winston-Salem
Elementary School WWTP
Monitoring Violation
MONITORING OUTFALL I VIOLATION UNIT OF CALCULATED
REPORT PPI LOCATION PARAMETER DATE FREQUENCY MEASURE LIMIT VALUE VIOLATION TYPE VIOLATION ACTION
06-2008 001 Effluent BOO,5-Day(20 Deg.C) 06/30/08 2 X month mg11 Frequency Violation None
08-2008 001 Effluent BOD,5-Day(20 Deg.C) 08/31/08 2 X month mg/1 Frequency Violation None
06-2008 001 Effluent Coliform,Fecal MIF,M-FC 06/30108 2 X month #1100m1 Frequency Violation None
Broth,44.5C
08-2008 001 Effluent Cofiform,Fecal MF,M-FC 08/31/08 2 X month #1100mi Frequency Violation None
Broth,44.5C
03-2008 001 Effluent DO,Oxygen,Dissolved 03/22/08 Weekly mgA Frequency Violation None
04-2008 001 Effluent DO,Oxygen,Dissolved 04/26/08 Weekly mgA Frequency Violation None
06-2008 001 Effluent DO,Oxygen,Dissolved 06/07/08 Weekly mg/l Frequency Violation None
06-2008 001 Effluent DO,Oxygen,Dissolved 06/14/08 Weekly mgA Frequency Violation None
06-2008 001 Effluent DO,Oxygen,Dissolved 06/21/08 Weekly Mgt[ Frequency Violation None
O6-2008 001 Effluent DO,Oxygen,Dissolved 06128/08 Weekly mgA Frequency Violation None
08-2008 001 Effluent DO,Oxygen,Dissolved 08/02/08 Weekly mg/I Frequency Violation None
08-2008 001 Effluent DO,Oxygen,Dissolved 08/09/08 Weekly mg/l Frequency Violation None
08-2008 001 Effluent DO,Oxygen,Dissolved 08/16/08 Weekly mg/I Frequency Violation None
08-2008 001 Effluent DO,Oxygen,Dissolved 08/23/08 Weekly mg/I Frequency Violation None
08-2008 001 Effluent DO,Oxygen,Dissolved 08/30/08 Weekly mg/l Frequency Violation None
12-2008 001 Effluent ❑O,Oxygen,Dissolved 12/27108 Weekly mgA Frequency Violation None
06-2008 001 Effluent Flow,in conduit or thru 06/14/08 Weekly mgd Frequency Violation None
treatment plant

MONITORING REPORT(MR)VIOLATIONS for: Report Date: 05/04109 Page: 2 of 3
Permit: nc0029611 MRs Between 1 2008 and 12 2008 Region:% Violation Category: % Program Category: %
Facility Name: % Param Name: % County:% Subbasin: 0% Violation Action: %
Major Minor: %
PERMIT:NCO029611 FACILITY: Yadkin County Board of Education -East Bend COUNTY:Yadkin REGION: Winston-Salem
Elementary School WWTP
Monitoring Violation
MONITORING OUTFALL! VIOLATION UNIT OF CALCULATED
REPORT PPI LOCATION PARAMETER DATE FREQUENCY MEASURE LIMIT VALUE VIOLATION TYPE VIOLATION ACTION
06-2008 001 Effluent Flow,in conduit or thru 06/21/08 Weekly mgd Frequency Violation None
treatment plant
06-2008 001 Effluent Flow,in conduit or thru 06/28/08 Weekly mgd Frequency Violation None
treatment plant
08-2008 001 Effluent Flow,in conduit or thru 08/02/08 Weekly mgd Frequency Violation None
treatment plant
08-20GB 001 Effluent Flow,in conduit or thru 08/09/08 Weekly mgd Frequency Violation None
treatment plant ,
08-2008 001 Effluent Flow,in conduit or thru 08/16/08 Weekly mgd Frequency Violation None
treatment plant
08-2008 001 Effluent Flow,in conduit or thru 08/23/08 Weekly mgd Frequency Violation None
treatment plant
12-2008 001 Effluent Flow,in conduit or thru 12/27/08 Weekly mgd Frequency Violation None
treatment plant
06-2008 001 Effluent Nitrogen,Ammonia Total(as 06/30/08 Monthly mg/3Frequency Violation None
08-2008 001 Effluent Nitrogen,Ammonia Total(as 08/31/08 Monthly mgA Frequency Violation None
06-20G8 001 Effluent Solids,Total Suspended 06/30/08 2 X month mgA Frequency Violation None
08-2008 001 Effluent Solids,Total Suspended 08131/08 2 X month mgll Frequency Violation None
03-2008 001 Effluent Temperature,Water Deg. 03/22/08 Weekly deg c Frequency Violation None
Centigrade
04-2008 001 Effluent Temperature,Water Deg. 04/26/08 Weekly deg c Frequency Violation None
Centigrade
06-2008 001 Effluent Temperature,Water Deg, 06/14/08 Weekly deg c Frequency Violation None
Centigrade
T

C
MONITORING REPORT(MR)VIOLATIONS for: Report Date: 05104109 Page: 3 of 3
Permit: rtc0029611 MRs between: 1-2008 and 12-2008 Region:% Violation Category:% Program Category:%�
I y ° ° County:°j° Subbasin:% Violation Action: %
Facility Name: /° Param Name: /°
j Major Minor: °/d
t PERMIT:NCO029611 FACILITY: Yadkin County Board of Education -East Send COUNTY:Yadkin REGION: Winston-Salem
Elementary School WWTP
Monitoring Violation
MONITORING OUTFALLI VIOLATION UNIT OF CALCULATED
REPORT PPI LOCATION PARAMETER DATE FREQUENCY MEASURE LIMIT VALUE VIOLATION TYPE VIOLATION ACTION
06-2008 001 Effluent Temperature,Water Deg" 06/21/08 Weekly deg c Frequency Violation None
Centigrade
06-2008 001 Effluent Temperature,Water Deg. 06/28/08 Weekly deg c Frequency Violation None
Centigrade
08-2008 001 Effluent Temperature,Water Deg. 08/02/08 Weekly deg c Frequency Violation None
Centigrade
08-2008 001 Effluent Temperature,Water Deg. 08/09/08 Weekly deg c Frequency Violation None
Centigrade
08-2008 001 Effluent Temperature,Water Deg, 08116/08 Weekly deg c Frequency Violation None
Centigrade
08-2008 001 Effluent Temperature,Water Deg. 08/23/08 Weekly deg c Frequency Violation !None
Centigrade
12-2008 001 Effluent Temperature,Water Deg. 12/27108 Weekly deg c Frequency Violation None
Centigrade
06-2008 001 Effluent pH 06/30108 2 X month su Frequency Violation None
08-2008 001 Effluent pH 08/31/08 2 X month su Frequency Violation None

•• 1 �` i / REC l
xkl� 0 lr� N.C.Deat,t.of of E4R
-=-�� APR 0 12009
NCDEN Winston-Satan
North Carolina Department of Environment and Natural Resources Regional Mice
- Division.of.Water-Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
March 27, 2009
Mr. Ken Larking
Town of Yadkinville
P.O. Box 816
Yadkinville, North Carolina 27055
Subject: General Permit No. NCGI 10000
Town of Yadkinville
COC No. NCG110137
Yadkin County
Dear Mr. Larking:
In accordance with your application for a discharge permit received on January 5, 2009, we are
forwarding herewith the subject certificate of coverage (COC) to discharge under the subject state—NPDES
general pen-nit. This pen-nit is issued pursuant to the requirements of North Carolina General Statute 143-215.1
and the Memorandum of Agreement between North Carolina and the US Environmental Protection Agency
dated October 15, 2007 (or as subsequently amended).
If any parts, measurement frequencies, or sampling requirements contained in this permit are
unacceptable to you, you have the right to request an individual permit by submitting an individual permit
application. Unless such demand is made, this certificate of coverage shall be final and binding.
Please take notice that this certificate of coverage is not transferable except after notice to the Division
of Water Quality. The Division of Water Quality may require modification or revocation and reissuance of the
certificate of coverage. This permit does not affect the legal requirements to obtain other permits which may be
required by the Division of Water Quality or permits required by the Division of Land Resources, Coastal Area
Management Act or any other federal or local governmental permit that may be required.
If you have any questions concerning this permit, please contact Bill Diuguiid at telephone number
[phone].
Sincerely,
ORIGINAL SIGNED BY
PICKLE.
Coleen H. u lens
cc: Winston-Salem Regional Office
Central Files
Stormwater Permitting Unit Files
Attachments
1617 Mail Service Center,Raleigh,North Carolina 27699-1617
Location:512 N-Salisbury St.Raleigh,North Carolina 27604 ope
Phone:[phone] FAX:[phone] Customer Service:1-877-623-6748 North C ai-o Li n a
tntemet:wvrnr.ncwaterqualiiy.org ��]� _,
An Equal opportunity 1 Affirmative Action Employer ;V/ `1��ra"J

STATE OF NORTH.CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG110000
CERTIFICATE OF COVERAGE No. NCG110137
STORMWATER DISCHARGES
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards and
regulations promulgated and adopted by the North Carolina Environmental Management Commission, and the .
Federal Water Pollution Control Act,as amended,
Town of Yadkinville
is hereby authorized to discharge stormwater from a facility located at
Town of Yadkinville WWTP
1620 Fred Hinshaw Road
Yadkinville
Yadkin County
to receiving waters designated as Haw Branch, a Class C creek,Yadkin River Basin; in accordance with the effluent
limitations, monitoring requirements, and other conditions set forth in Parts I, 1I, III,IV, V and VI of General Permit
No. NCG 110000,as attached.
This Certificate of Coverage shall become effective March 27, 2009.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day March 27.2009. ORIGINAL SIGNED BY
KEN PICKLE
Coleen H. Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission

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Latitude:136N7 59 NCG110137 Facility '
Longitude: 80°37'57"
'6�unty: Yadkin Town of Yadkinville Location M 41-x '
Stream Class: C
WWTP ,11 - .
Receiving Stream: Haw Branch
Sub-basin: 03-07-02 (Yadkin River Basin)
NOT![AUED