NC0043796_Renewal (Application)_20160531

NPDES APPLICATION FOR PERMIT RENEWAL - FORM A
For Publicly Owned Treatment Works (POTW) or other treatment systems treating
domestic wastes < 0.1 MGD with no pretreatment program.
Mail the complete application to:
N. C. Department of Environment and Natural Resources
Division of Water Quality / NPDES Unit
1617 Mail Service Center, Raleigh, NC 27699-1617
NPDES Permit NC0043796
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 Columbus County Board of Education
Facility Name Acem Delco Elementary School
Mailing Address PO Box 729
City Whiteville
State / Zip Code NC/28472
Telephone Number [phone] RECEIVED/NCDEQ/DWR
Fax Number [phone] MAY 26 2016
e-mail Address [e-mail] Water Quality
Permitting Section
2. Location of facility producing discharge:
Check here if same address as above ❑
Street Address or State Road 16337 Old Lake Road (NCSR 1740)
City Riegelwood
State / Zip Code NC/28456
County Columbus
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 Columbus County Board of Education
Mailing Address PO Box 729
City Whiteville
State / Zip Code NC/28472
Telephone Number [phone]
Fax Number [phone]
4. Population served: 396
1 of 3 Forth-A 1/06

NPDE3 APPLICATION FOR PERMIT RENEWAL - FORM A
For Publicly Owned Treatment Works (POTW) or other treatment systems treating
domestic wastes < 0.1 MGD with no pretreatment program.
5. Do you receive industrial waste?
® No ❑ Yes (if you have an approved pre-treatment program, must complete Form 2A)
6. Type of collection system
® Separate (sanitary sewer only) 0 Combined (storm sewer and sanitary sewer)
7. Outfall Information:
Number of separate discharge points 1
Outfall Identification number(s)
Is the outfall equipped with a diffuser? 0 Yes No
8. Name of receiving stream(s) (Provide a map showing the exact location of each outfall):
Unnamed Tributary to Pretty Creek in Cape Fear River Basin
9. Frequency of Discharge: 0 Continuous ® Intermittent
If intermittent:
Days per week discharge occurs: 5 Duration: 3hrs/dav
10.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.
9000 gallon septic tank with a recirculating sand filter bed with an ultraviolet
disinfection system.
11. Flow Information:
Treatment Plant Design flow .009 MGD
Annual Average daily flow .004 MGD (for the previous 3 years)
Maximum daily flow .006 MGD (for the previous 3 years)
12. Is this facility located on Indian country?
❑ yes ® No
2 of 3 Form-A 1106

NPDES APPLICATION FOR PERMIT RENEWAL - FORM A
For Publicly Owned Treatment Works (POTW) or other treatment systems treating
domestic wastes < 0.1 MGD with no pretreatment program.
13. Effluent Data
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.Effluent testing data must be based on at least three samples
and must be no more than four and one half years old.
Parameter Daily Monthly Units of Number of
Maximum Average Measurement Samples
Biochemical Oxygen Demand Summer-7.5 Summer-5.0 MG/L
(BOD5) Winter-15 Winter-10.0 /
Fecal Coliform 400 200 /100MIL
Total Suspended Solids 45 30 MG/L
Temperature (Summer) NA
Temperature (Winter) NA
pH 6-9
14. 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 NC0043796 Dredge or fill(Section 404 or CWA)
PSD (CAA) Special Order of Consent(SOC)
Non-attainment program (CAA) Other
15. 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.
Timothy Ward Plant Operations Director
Printed name of Person Signing Title
I l.Jc.d
Signature of plicant 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 knowly 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 3 Form-A 1/06

•
PAT MCCRORY
Governor
DONALD R. VAN DER VAART
Secretary
Water Resources S. JAY ZIMMERMAN
ENVIRONMENTAL QUALITY 1)trector
May 31,2016
Timothy Ward
Columbus County Board of Education
Po Box 729 .
Whiteville,NC 28.472
Subject: Acknowledgement of Permit Renewal
•
Application No.NC004311984319Lo
Acme Delco Middle School
Columbus County
Dear Permittee:
The Water Quality Permitting Section has received your permit renewal application on May 26,
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 w TH a fo-roL'
Wren Thedford
Wastewater Branch
cc: Central Files
NPDES
Wilmington Regional Office
State of Noah Carolina I Environmental Quality I Water Resources
1617 Mail Service Center I Raleigh,North Carolina 27699-1617
919-807-6300