NC0040975_Renewal (Application)_20160216

Operations Division
iI R A N D o L P H Larry Chilton, Facilities and Maintenance Director
M. 223M. County School System
4-B Enterprise Street
Asheboro, NC 27205
Phone [phone]
Fax [phone]
randolph.k12.nc.us
RECEIVEDINCDECWR
February 9, 2016 "';.g l 6
To. NC DEW DWR/ NPDES Unit, Water Quality
Permitting Section
Please accept this letter as official notification of our desire to have the permit renewed for Coleridge
Elementary School, NPDES Permit NC0040975. The current permit expires at midnight on September
30, 2016.
We have had no changes or modifications to our treatment system and it is still functioning normally.
Thank you in advance for your assistance.
La ry T. Chilton
Director of Facilities and Maintenance
Randolph County School System
Mobile#[phone]

s
NPDES APPLICATION - FORM D
For privately-owned treatment systems treating 100%domestic wastewaters <1.0 MGD
Mail the complete application to:
N. C. DENR/ Division of Water Resources/NPDES Program
1617 Mail Service Center, Raleigh, NC 27699-1617
NPDES Permit NC00 41-0975-
If you are completing this form in computer use the TAB key or the up - down arrows to move from one field to
the next. To check the boxes, click your mouse on top of the box. Otherwise, please print or type.
1. Contact Information:
Owner Name R0.�/ol�0/11) Tye _5-L4)01,0/ Sys-der-,,
Facility Name r ilex i/ P E/e-meaU'fax y SGL oo r
Mailing Address r2t2 3'}- 3 EN-te.rpr;Se S( +
City 4SLe-boro AJC a7aoS
State/Zip Code Alor 4-1n Care l,a& , aZ 7 oZ 0
Telephone Number (3 ) oZ/S- 3 g 35"
Fax Number (336)2/3 - (0079 RECEIVEDINCDEClDWR
e-mail Address /cC� Doti rmi o/p), . k is . Nc. u s FEB 16 2010
Water Quality
2. Location of facility producing discharge: Permitting Section
Check here if same address as above❑
Street Address or State Road ./5-2 g A/c w c2,2
City Rck.m52u
State/Zip CodeA.J• C , 273/
County i2aNdo/pl,
3. Operator Information:
Name of the firm, public organization or other entity that operates the facility. (Note that this is not referring to the
Operator in Responsible Charge or ORC)
Name RaNh//A auN , -Sc.�oo sysi
Mailing Address o2a 3If nJ pr,se_ S-+
City 4S4elier-D
State/Zip Code N• c• .?"700,5-
Telephone
"7aosTelephone Number (33.6 )
Fax Number Number , ) —607.7
e-mail Address /Cbr Am/Q_r o//4 . k/a.A/c. V 5
1 of 4 Form-D 912013

F
NPDES APPLICATION - FORM D
For privately-owned treatment systems treating 100%domestic wastewaters <1.0 MGD
4. Description of wastewater:
Facility Generating Wastewater(check all that apply):
Industrial ❑ Number of Employees
Commercial ❑ Number of Employees
Residential �❑l Number of Homes
School Lb Number of Students/Staff cf2S
Other ❑ Explain:
Describe the source(s)of wastewater(example: subdivision, mobile home park, shopping centers, restaurants,
etc.): Efen�•e.v-> 7 se.11oo?
j5Number of persons served: ;15---
5.
. Typ of collection system
I Separate (sanitary sewer only) ❑ Combined (storm sewer and sanitary sewer)
6. Outfall Information:
Number of separate discharge points 1-
Outfall Identification number(s) 00�
Is the outfall equipped with a diffuser? ❑ Yes ElNo
7. Name of receiving stream(s) (NEW applicants: Provide a map showing the exact location of each outfall):
aP•e p otr
8. Frequency of Discharge: ❑ Continuous intermittent
If intermittent:
Days per week discharge occurs: S Duration: !.5-.20 .1A;n's
9. Describe the treatment system
List all installed components, including capacities, provide design removal for BOD, TSS, nitrogen and
phosphorus. If the space provided is not sufficient, attach the description of the treatment system in a separate
sheet of paper.
o, OOS6 ma iD W.li/. 1-r4. -F�cr'I,'l,t r.',' f lof/ow,,,v co�.�Pe vQ,Jts=
• woo cr., 9rew.S� -f r�►p
• S400 j..l syhc
• adsvdal des:AI ►.,,k
• /3532 42{z Sort-ace- P-a/•er
Grexse- -Prowl +tri jr►ea52 4retp tiA/ shd,a .-�'i,v», 41-42Sa.pi c- -rim)k is evifio,
by Rte►o7 eG,•cifo.k s��•t T k ,ib;"j, i- o are_ pinta
4,4- 142 51- 0.,t.,Nvc./ly but CO, ,"f.,cws �d,,rd wtirran�♦ MOIL amen,• r�5 rS
p+c�- s . fes_ oQtrly ePax�ton 40 le- •.+.
2 of 4 Form-D 9/2013

NPDES APPLICATION - FORM D
For privately-owned treatment systems treating 100% domestic wastewaters <1.0 MGD
10. Flow Information:
Treatment Plant Design flow D.OtW6 MGD
Annual Average daily flown,to2ffb MGD (for the previous 3 years)
Maximum daily flow D.0034°IH MGD (for the previous 3 years)
11. Is this facility located on India country?
El Yes LuJNo
12. Effluent Data
NEW APPLICANTS:Provide data for the parameters listed. Fecal Coliform, Temperature and pH shall be grab samples, for
all other parameters 24-hour composite sampling shall be used. If more than one analysis is reported, report daily maximum
and monthly average. If only one analysis is reported, report as daily maximum.
RENEWAL APPLICANTS: Provide the highest single reading (Daily Maximum) and Monthly Average over the
oast 36 months for parameters currently in your permit. Mark otherparameters "N/A".
Parameter Daily Monthly Units of
Maximum Average Measurement
Biochemical Oxygen Demand (BODS) 31,7 q. q tri_e/j
n'/ AA/
Fecal Coliform
Total Suspended Solids 59.1 3. 6 .Z m5/1
Temperature (Summer) a 6.s 1. °C
Temperature (Winter) ,?3.3 13. a oC
pH 7. 8 6. 61 5.y.
13. List all permits, construction approvals and/or applications:
Type Permit Number Type Permit Number
Hazardous Waste(RCRA) NESHAPS(CAA)
UIC (SDWA) Ocean Dumping (MPRSA)
NPDES 1tJ 00µD475— Dredge or fill (Section 404 or CWA)
PSD(CM) Other
Non-attainment program(CM)
14. APPLICANT CERTIFICATION
I certify that I am familiar with the information contained in the application and that to the best of my
knowledge and belief such information is true, complete, and accurate.
L c&.-ry 7. ell I4on/ 0:ee.G4Or' +►T ! �Gi 1►4,e5 d-,fl 1 A)-ho4IV C�
Printed name of Person Signing Title
s _ .2- —/,
ignat !'of Applicant Date
North Carolina General Statute 143-215.6 (b)(2) states: Any person who knowingly makes any false statement representation, or certification in any
application, record, report, plan,or other document files or required to be maintained under Article 21 or regulations of the Environmental Management
Commission implementing that Article, or who falsifies, tampers with, or knowingly renders inaccurate any recording or monitoring device or method
required to be operated or maintained under Article 21 or regulations of the Environmental Management Commission implementing that Article, shall be
guilty of a misdemeanor punishable by a fine not to exceed$25,000,or by imprisonment not to exceed six months,or by both. (18 U.S.C.Section 1001
provides a punishment by a fine of not more than$25,000 or imprisonment not more than 5 years,or both,for a similar offense.)
3 of 4 Form-D 9/2013

PAT MCCRORY
DONALD R. VAN DER VAART
S. JAY ZIMMERMAN
Water Resources
ENVIRONMENTAL QUALITY
February 23, 2016
Mr. Larry T. Chilton
Randolph County School System
2234 B Enterprise St
Asheboro,NC 27205
Subject: Acknowledgement of Permit Renewal
Application No. NC0040975
Coleridge Elementary School
Randolph County
Dear Permittee:
The Water Quality Permitting Section has received your permit renewal application on February 16,
2016. A member of the NPDES Unit will review your application. They will contact you if additional
information is required to complete your permit renewal. Per G.S. 150B-3 your current permit does not
expire until permit decision on the application is made. Continuation of the current permit is contingent on
timely and sufficient application for renewal of the current permit. Please respond in a timely manner to
requests for additional information necessary to complete the permit application.
If you have any additional questions concerning renewal of the subject permit, please contact Charles
Weaver at 919-807-6391 or [e-mail].
Sincerely,
W re vt/ Ykeo(2o-rot
Wren Thedford
Wastewater Branch
cc: Central Files
NPDES
Winston-Salem Regional Office
State of North Carolina I Environmental Quality Water Resources
1617 Mail Service Center I Raleigh,North Carolina 27699-1617
919-307-6300