NC0029602_Compliance Evaluation Inspection_20160322

PAT MCCRORY
".
Governor
DONALD R. VAN DER VAART
Secretary
Water Resources
ENVIRONMENTAL QUALITY S. JAY ZIMMERMAN
March 22, 2016 Director
Yadkin County Board of Education
Attn: Dr. Todd Martin, Superintendent RECEIVEDCDEOIDWR
121 Washington Street
Yadkinville, NC 27055 MAR 2 4 2016
Water,Quatity
SUBJECT: Compliance Evaluation Inspections Permitting Section
Yadkin County Board of Education Wastewater Treatment Plants "
Yadkin County
Dear Dr. Martin:
I
Ron Boone of the Winston Salem Regional Office (WSRO) of the North Carolina Division of Water
Resources (DWR or the Division) conducted compliance evaluation inspections at the following facilities on
March 15, 2016:
Facility Name NPDES Permit# u
Courtney Elementary School NC0029599 -
East Bend Elementary School NCO029611
Forbush Elementary School NCO029602 j!
Forbush High School NCO071773
Starmount High School NCO070459
The assistance and cooperation of Mitch Long, Operator in Responsible Charge '(ORC), was
greatly appreciated. Inspection reports are attached for your records and the inspection findings are
summarized below.
The following table shows important details about each plant:
Latitude& Relceiving Stream
Facility Name Plant Type Longitude Receiving Stream Classification
Courtney Sand Filter 36.067886, Harmon Creek WS-IV
Elementary School 80.602172 i
East Bend 36.213194,
Elementary School Sand Filter 80.509137 Logan Creek C
Forbush Activated Sludge 36.125681, Logan Creek WS-IV
Elementary School 80.498595
Forbush High Activated Sludge 36.142803, Forbush Creek WS-IV
School 80.559088
Starmount High Activated Sludge 36.182031, South Deep Creek WS-III
School 80.769535
State of North Carolina I Environmental Quality I Water Resources
450 West Hanes Nfill Road,Suite 300 1 Winston-Salem,North Carolina 27105
336 776 9800
- - u

SITE REVIEWS
Mr. Boone reviewed the plants with Mr. Long. For the most part, all plants were in good condition
and well maintained.The effluents were clear and there was no foam at the discharge points.The deficiencies
that Mr. Boone did note are detailed below,
1. Several alarms at the plants did not function when tested. The school board needs to test all alarms
and make sure they are operational.
DOCUMENTATION REVIEWS
There were no problems noted with Mr. Long's documentation for all five plants. Mr. Long had all
the required documentation and it meets requirements.
There were no other discrepancies noted. Please keep up the good work in ensuring the plants
are properly operated and maintained and meeting all the terms and conditions of the permits. Please
remember that in accordance with NC General Statute 143-215.6A, violations of the permit are subject to
enforcement actions not to exceed $25,000 per day, per violation.
If you have any questions regarding the inspection or this letter, please do not hesitate to contact
Mr. Boone or me at 336-776-9800. Thank you for your cooperation in this matter.
Sincerely,
Sherri V. Knight, P.E.
Regional Supervisor
Water Quality Regional Operations
Division of Water Resources
Attachments:
1. BIMS Inspection Reports (x5—one for each plant)
CC: Central Files
CNPDES`llnit
WSRCFISNAP-Files
Yadkin County Board of Education
Attn: Mitchell Long, Operator in Responsible Charge
121 Washington Street
Yadkinville, NC 27055

United States Environmental Protection Agency Form Approved
EPA Washington,.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
1 IN 1 2 15 I 3 I N00029599 I11 12 16/03/15 17 18 L j 19 L Gj 4 201
211111 1 1 1 1 1 1 II 1 1I I I I I I I I I I I I I I I I I I I I I II I I I I I f6
Inspection Work Days Facility Self-Monitoring Evaluation Rating B1 QA -------------------Reserved-------------
67 70 71 I I 72 I N I 731 I 174 75 80
Section B Facility Data LJ I I I
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) 09 OOAM 16/03/15 14/01/01
Courtney Elementary School WWTP
2529 Courtney-Huntsville Exit Time/Date Permit Expiration Date
Yadkinville NC 27055 10 OOAM 16/03/15 18/12/31
Name(s)of Onsite Representative(s)/Titles(s)/Phone and Fax Number(s) Other Facility Data
Mitchell Thomas Long/ORC/336-469-2711/
Name,Address of Responsible Official/Title/Phone and Fax Number
Contacted
Mark Matthews,121 Washington StY.adkinville NC 270557725//336-699-4481/
No
Section C:Areas Evaluated During Inspection(Check only those areas evaluated)
Permit ® Flow Measurement Operations&Maintenance ® Records/Reports
Self-Monitoring,Program ■ Facility Site Review Effluent/Receiving Waters 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
Ron Boone / WSRO WQ//336-776-9690/
Signature
o�f Management Q A Reviewer / Agency/Office/Phone and Fax Numbers Date
EPA Form 3560-3(Rev 9-94)Previous editions are obsolete
Page# 1

NPDES yr/mo/day Inspection Type 1
31 NCO029599 I11 12 16/03/15 17 18 JCJ
Section D:Summary of Finding/Comments(Attach additional sheets of narrative and checklists as necessary)
Please refer to the attached inspection summary letter.
Page# 2

B
Permit: NCO029599 Owner-Facility: Courtney Elementary School WVTP
Inspection Date: 03/15/2016 Inspection Type: Compliance Evaluation F
Operations& Maintenance Yes No NA NE
Is the plant generally clean with acceptable housekeeping? M ❑ ❑ ❑
Does the facility analyze process control parameters,for ex MLSS, MCRT, Settleable ® ❑ ❑ ❑
Solids, pH, DO, Sludge Judge, and other that are applicable?
Comment: None
Permit Yes No NA NE
(if the present permit expires in 6 months or less) Has the permittee submitted a new ❑ ❑ ® ❑
application?
Is the facility as described In the permit? ® ❑ ❑ ❑
#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? ® ❑ ❑ ❑
Comment: None '
Record Keeping Yes No NA NE
Are records kept and maintained as required by the permit? i ❑ ❑ ❑
Is all required Information readily available, complete and current? ■ ❑ ❑ ❑
Are all records maintained for 3 years(lab. reg required 5 years)? ® ❑ ❑ ❑
Are analytical results consistent with data reported on DMRs? ® ❑ ❑ ❑
Is the chain-of-custody complete? M ❑ ❑ ❑
Dates, times and location of sampling
Name of Individual performing the sampling r
Results of analysis and calibration
Dates of analysis
Name of person performing analyses S
Transported COCs ■
Are DMRs complete:do they Include all permit parameters? M ❑ ❑ ❑
Has the facility submitted Its annual compliance report to users and DWQ? ❑ ❑ 0 ❑
(If the facility is=or>5 MGD permitted flow) Do they operate 24/7 with a certified operator ❑ „M ❑ ❑
on each shift?
Is the ORC visitation log available and current? 0 ❑ ❑ ❑
Is the ORC certified at grade equal to or higher than the facility classification? 0 p❑ ❑ ❑
Is the backup operator certified at one grade less or greater than the facility classification? 0 ❑ ❑ ❑
Is a copy of the current NPDES permit available on site? ❑ ❑ ❑
Page# 3

Permit: NC0029599 Owner-Facility: Courtney Elementary School WWTP
Inspection Date: 03/15/2016 Inspection Type: Compliance Evaluation
Record Keeping Yes No NA NE
Facility has copy of previous year's Annual Report on file for review? ❑ ❑ 0 ❑
Comment: None
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? ® ❑ ❑ ❑
If effluent (diffuser pipes are required) are they operating properly? ❑ ❑ M ❑
Comment: None
Flow Measurement- Effluent Yes No NA NE
#Is flow meter used for reporting? ■ ❑ ❑ ❑
Is flow meter calibrated annually? ❑ ❑ ❑
Is the flow meter operational? ® ❑ ❑ ❑
(If units are separated)Does the chart recorder match the flow meter? ❑ ❑ ® ❑
Comment: Facility uses water meter to measure flow.
Disinfection - UV Yes No NA NE
Are extra UV bulbs available on site? ® ❑ ❑ ❑
Are UV bulbs clean? _ ■ ❑ ❑ ❑
Is UV intensity adequate? i ❑ ❑ ❑
Is transmittance at or above designed level? ® ❑ ❑ ❑
Is there a backup system on site? 0 ❑ ❑ ❑
Is effluent clear and free of solids? ❑ ❑ ❑
Comment: None
Septic Tank Yes No NA NE
(If pumps are used)Is an audible and visual alarm operational? ❑ 0 ❑ ❑
Is septic tank pumped on a schedule? M ❑ ❑ ❑
Are pumps or syphons operating properly? ❑ ❑ 0 ❑
Are high and low water alarms operating properly? ❑ ❑ M ❑
Comment: Tank has no alarms.
Sand Filters (Low rate) Yes No NA NE
Page# 4

Permit: NCO029599 Owner-Facility: Courtney Elementary School WWTP
Inspection Date: 03/15/2016- Inspection Type: Compliance Evaluation
Sand Filters (Low rate) Yes No rNA NE
t
(If pumps are used)Is an audible and visible alarm Present and operational? ® ❑k ❑ ❑
Is the distribution box level and watertight? ❑ ❑ ❑ ■
Is sand filter free of ponding? M ❑ ❑ ❑
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) ® ❑ ❑ ❑
Comment- None
Laboratory Yes No NA NE
Are field parameters performed by certified personnel or laboratory? ® ❑ ❑ ❑
Are all other parameters(excluding field parameters)performed by a certified lab? N ❑ ❑ ❑
#Is the facility using a contract lab? ® ❑ ❑ ❑
#Is proper temperature set for sample storage(kept at less than or equal to 6.0 degrees ❑ ❑ ❑
Celsius)?
Incubator(Fecal Coliform)set to 44 5 degrees Celsius+/-0.2 degrees? ❑ 0 ❑ ■
Incubator(BOD)set to 20 0 degrees Celsius+/-1 0 degrees? ❑ ❑ ❑ ■
P
Comment- None
Effluent Sampling Yes No NA NE
Is composite sampling flow proportional? ❑ ❑ e Eld
Is sample collected below all treatment units? i El ❑ ❑
Is proper volume collected? S ❑ ❑ ❑
Is the tubing clean? ■ ❑ ❑ ❑
#Is proper temperature set for sample storage(kept at less than or equal to 6 0 degrees ❑ ❑ ❑
Celsius)?
Is the facility sampling performed as required by the permit(frequency, sampling type ® '❑ ❑ ❑
representative)?
Comment. None
Page# 5

I
United States Environmental Protection Agency II
Form Approved
EPA Washington,D C 20460 OMB No 2040"0057
Water Compliance Inspection Report Approval expires 8-31-98
i
Section A•National Data System Coding(i.e.,PCS) @
Transaction Code NPDES yr/mo/day Inspection Type Inspector a Fac Type
1 2 15 I 3 I NCO029611 111 12 16/03/15 17 18 19 1 G 20 LJ
211111 1 1 1 1 1 1 II 11 I I I I I I I I I I I I I I I I I I I I I II 11 I I 1166
Inspection Work Days Facility Self-Monitoring Evaluation Rating B1 QA --------------Reserved-------------
671 70 IJ 71 I I 72 L N J I I 731 I 174 75III 80
Section B Facility Data L_
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) 11 15AM 16/03/15 14/01/01
East Bend Elementary School WWTP
NC Hwy 67 E Exit Time/Date Permit Expiration Date
12 15P 16/03/15 18/12/31
East Bend NC 27018
Name(s)of Onsite Representative(s)/Titles(s)/Phone and Fax Number(s) Other Facility Data
///
Mitchell Thomas Long/ORC/336-469-2711/
Name,Address of Responsible Official/Title/Phone and Fax Number
Contacted
Mark Matthews,121 Washington StYadkinville NC 270557725//336-699-4481/
No
Section C Areas Evaluated During Inspection(Check only those areas evaluated)
Permit ® Flow Measurement Operations&Maintenance Records/Reports
Self-Monitoring Program ■ Facility Site Review Effluent/Receiving Waters 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
Ron Boon ll WSRO WQH336-776-9690/
Signature of Management Q A Reviewer Agency/Office/Phone and Fax Numbers Date
EPA Form 3560-3(Rev 9-94)Previous editions are obsolete
Page# 1

NPDES yr/mo/day Inspection Type 1
31 NCO029611 111 12 16/03/15 17 1.81 C I
Section D Summary of Finding/Comments(Attach additional sheets of narrative and checklists as necessary)
Please refer to the attached inspection summary letter.
Page# 2

Permit: NCO029611 Owner-Facility: East Bend Elementary School WVVrP
Inspection Date: 03/15/2016 Inspection Type: Compliance Evaluation
Operations & Maintenance Yes No NA NE
Is the plant generally clean with acceptable housekeeping? 0 ❑ 1 ❑ ❑
Does the facility analyze process control parameters, for ex: MLSS, MCRT, Settleable 0 ❑ ❑ ❑
Solids, pH, DO, Sludge Judge, and other that are applicable?
Comment: None
Permit Yes No NA NE
(If the present permit expires in 6 months or less). Has the permittee submitted a new ❑ ❑ 0 ❑
application?
Is the facility as described in the permit? 0 ❑ ❑ ❑
#Are there any special conditions for the permit? ❑ 0 ❑ ❑
Is access to the plant site restricted to the general public? 0 ❑ ❑ ❑
Is the inspector granted access to all areas for Inspection? 0 ❑ ❑ ❑
Comment: None
Record Keeping Yes No NA NE
Are records kept and maintained as required by the permit? 0 ❑ ❑ ❑
Is all required information readily available, complete and current? 0 ❑ ❑ ❑
Are all records maintained for 3 years(lab reg required 5 years)? ® ❑ ❑ ❑
Are analytical results consistent with data reported on DMRs? 0 ❑ ❑ ❑
Is the chain-of-custody completes 0 ❑ ❑ ❑
Dates, times and location of sampling
Name of Individual performing the sampling
Results of analysis and calibration
Dates of analysis
Name of person performing analyses
Transported COCs
Are MRS complete: do they Include all permit parameters? 0 ❑ ❑ ❑
Has the facility submitted its annual compliance report to users and DWQ? ❑ ❑ 0 ❑
(If the facility Is= or>5 MGD permitted flow)Do they operate 24/7 with a certified operator ❑ 0 ❑ ❑
on each shift?
Is the ORC visitation log available and current? 0 ❑ ❑ ❑
Is the ORC certified at grade equal to or higher than the facility classification? 0 ❑ ❑ ❑
Is the backup operator certified at one grade less or greater than the facility classification? 0 ❑ ❑ ❑
Is a copy of the current NPDES permit available on site? 0 ❑ ❑ ❑
Page# 3

Permit: NC0029611 Owner-Facility: East Bend Elementary School WVVTP
Inspection Date: 03/15/2016 Inspection Type: Compliance Evaluation
Record Keeping Yes No NA NE
Facility has copy of previous year's Annual Report on file for review? ❑ ❑ ■ ❑
Comment: None
Effluent Pipe Yes No NA NE
Is right of way to the outfall properly maintained? i ❑ ❑ ❑
Are the receiving water free of foam other than trace amounts and other debris? ® ❑ ❑ ❑
If effluent (diffuser pipes are required) are they operating properly? ❑ ❑ ® ❑
Comment. None
Flow Measurement- Effluent Yes No NA NE
#Is flow meter used for reporting? ® ❑ ❑ ❑
Is flow meter calibrated annually? ❑ ❑ ❑
Is the flow meter operational? ® ❑ ❑ ❑
(If units are separated) Does the chart recorder match the flow meter? ❑ ❑ ® ❑
Comment: Facility uses water meter for flow measurement.
Disinfection - UV Yes No NA NE
Are extra UV bulbs available on site? ® ❑ ❑ ❑
Are UV bulbs clean? ® ❑ ❑ ❑
Is UV Intensity adequate? ■ ❑ ❑ ❑
Is transmittance at or above designed level? M ❑ ❑ ❑
Is there a backup system on site? ® ❑ ❑ ❑
Is effluent clear and free of solids? ® ❑ ❑ ❑
Comment. None
Septic Tank Yes No NA NE
(If pumps are used) Is an audible and visual alarm operational? ❑ ❑ M ❑
Is septic tank pumped on a schedule? 0 ❑ ❑ ❑
Are pumps or syphons operating properly? ❑ ❑ i ❑
Are high and low water alarms operating properly? ❑ ❑ 0 ❑
Comment: Tanks use dosing siphons.
Sand Filters (Low rate) Yes No NA NE
Page# 4

Permit: NCO029611 Owner-Facility: East Bend Elementary School WWl"P
Inspection Date: 03/15/2016 Inspection.Type: Compliance Evaluation
Sand Filters (Low rate) Yes No NA NE
(If pumps are used) Is an audible and visible alarm Present and operatlonal'� ❑ ❑ ❑
Is the distribution box level and watertight? ❑ ❑ ❑ N
Is sand filter free of ponding? i ❑ ❑ ❑
Is the sand filter effluent re-circulated at a valid ratio? 0 ❑ ❑ ❑
#Is the sand filter surface free of algae or excessive vegetations 0 ❑ ❑ ❑
#Is the sand filter effluent re-circulated at a valid ratio?(Approximately 3 to 1) ■ ❑ ❑ ❑
Comment: None
Laboratory Yes No NA NE
Are field parameters performed by certified personnel or laboratory? M ❑ ❑ ❑
Are all other parameters(excluding field parameters)performed by a certified lab? 0 ❑ ❑ ❑
#Is the facility using a contract lab? ® ❑ ❑ ❑
#Is proper temperature set for sample storage(kept at less than or equal to 6.0 degrees ❑ ❑ ❑
Celsius)?
Incubator(Fecal Coliform)set to 44.5 degrees Celsius+/-0 2 degrees? ❑ ❑ ❑
Incubator(BOD)set to 20 0 degrees Celsius+/-1 0 degrees? ❑ ❑ ❑
Comment: None
Effluent Sampling Yes No NA NE
Is composite sampling flow proportional? ❑ ❑ 0 ❑
Is sample collected below all treatment units M ❑ ❑ ❑
Is proper volume collected? ® ❑ ❑ ❑
Is the tubing clean? ❑ ❑ 0 ❑
#Is proper temperature set for sample storage(kept at less than or equal to 6 0 degrees ❑ ❑ ❑ N
Celsius)?
Is the facility sampling performed as required by the permit(frequency, sampling type ❑ ❑ ❑ 0
representative)?
Comment: None
Page# 5

United States Environmental Protection Agency Form Approved
EPA Washington,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
1 IN 1 2 [5j 3 I NO0029602 111 12 16/03/15 17 18[, 19 G j 201 I
211111' 11111111111111111111111111111111111111 f6
Inspection Work Days Facility Self-Monitoring Evaluation Rating B1 QA --------------------Reserved------------
67 70 IJ 71 L.J 72 NJ 73L � 174 75 80
Section B:Facility Data LL1J
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) 12 30PM 16/03/15 14/01/01
Forbush Elementary School WWTP
Exit Time/Date Permit Expiration Date
1400 Bloomtown Rd
01 30P 16/03/15 18/12/31
East Bend NC 27018
Name(s)of Onsite Representative(s)/Titles(s)/Phone and Fax Number(s) Other Facility Data
Mitchell Thomas Long/ORC/336-469-2711/
Name,Address of Responsible Official/Title/Phone and Fax Number
Contacted
Mark Matthews,121 Washington StYadkinville NC 270557725//336-699-4481/
No
Section C-Areas Evaluated During Inspection(Check only those areas evaluated)
Permit ® Flow Measurement ® Operations&Maintenance Records/Reports
Self-Monitoring Program E Sludge Handling Disposal ® Facility Site Review ® Effluent/Receiving Waters
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
Ron Boone WSRO WQ//336-776-9690/
Signature of Management Q A Reviewer Agency/Office/Phone and Fax Numbers Date
EPA Form 3560-3(Rev 9-94)Previous editions are obsolete
Page#

NPDES yr/mo/day Inspection Type 1
31 NCO029602 I11 12 16/03/15 17 18 [,,j
l
Section D-Summary of Finding/Comments(Attach additional sheets of narrative and checklists as necessary)
Please refer to the attached inspection summary letter
Page# 2

t
Permit: NCO029602 Owner-Facility: Forbush Elementary School VW TP
Inspection Date: 03/15/2016 Inspection Type: Compliance Evaluation
Operations &Maintenance Yes No'NA NE
Is the plant generally clean with acceptable housekeeping? ® ❑ ❑ ❑
Does the facility analyze process control parameters, for ex MLSS, MCRT, Settleable M ❑ ❑ ❑
Solids, pH, DO, Sludge Judge, and other that are applicable?
Comment: None
Permit Yes No NA NE
(If the present permit expires In 6 months or less) Has the permittee submitted a new ❑ ❑ ® ❑
application?
Is the facility as described In the permit? ® ❑ ❑ ❑
#Are there any special conditions for the permit? ❑ ® ❑ ❑
Is access to the plant site restricted to the general public? e ❑ ❑ ❑
Is the inspector granted access to all areas for inspection? M ❑ ❑ ❑
Comment: None
Record Keeping Yes No NA NE
Are records kept and maintained as required by the permit? ® ❑ ❑ ❑
Is all required information readily available, complete and current? 0 ❑ ❑ ❑
Are all records maintained for 3 years(lab. reg required 5 years)? ® ❑ ❑ ❑
Are analytical results consistent with data reported on DMRs? ® ❑ ❑ ❑
Is the chain-of-custody complete? ® ❑ ❑ ❑
Dates,times and location of sampling
Name of Individual performing the sampling
Results of analysis and calibration
Dates of analysis
Name of person performing analyses
Transported COCs
Are DMRs complete do they Include all permit parameters? ■ ❑ ❑ ❑
Has the facility submitted its annual compliance report to users and DWQ? ❑ ❑ M ❑
(If the facility Is=or>5 MGD permitted flow) Do they operate 24/7 with a certified operator ❑ ❑ ❑
on each shift?
Is the ORC visitation log available and current? ■ ❑ ❑ ❑
Is the ORC certified at grade equal to or higher than the facility classification? 0 ❑ ❑ ❑
Is the backup operator certified at one grade less or greater than the facility classification? M ❑ ❑ ❑
Is a copy of the current NPDES permit available on site? ! ❑ ❑ ❑
Page# 3

Permit: NC0029602 Owner-Facility: Forbush Elementary School WVVTP
Inspection Date: 0311512016 Inspection Type: Compliance Evaluation
Record Keeping Yes No NA NE
Facility has copy of previous year's Annual Report on file for review? ❑ ❑ ® ❑
Comment: None
Effluent Pipe Yes No NA NE
Is right of way to the outfall properly maintained? 0 ❑ ❑ ❑
Are the receiving water free of foam other than trace amounts and other debris? ® ❑ ❑ ❑
If effluent (diffuser pipes are required) are they operating properly? ❑ ❑ ® ❑
Comment None
Flow Measurement- Effluent Yes No NA NE
#Is flow meter used for reporting? ® ❑ ❑ ❑
Is flow meter calibrated annually? ® ❑ ❑ ❑
Is the flow meter operational? ® ❑ ❑ ❑
(If units are separated)Does the chart recorder match the flow meter? ® ❑ ❑ ❑
Comment. None
Aerobic Digester Yes No NA NE
Is the capacity adequate? ® ❑ ❑ ❑
Is the mixing adequate? ® ❑ ❑ ❑
Is the site free of excessive foaming in the tank? ® ❑ ❑ ❑
#Is the odor acceptable? ® ❑ ❑ ❑
#Is tankage available for properly waste sludge? ® ❑ ❑ ❑
Comment. None
Bar Screens Yes No NA NE
Type of bar screen
a.Manual
b.Mechanical ❑
Are the bars adequately screening debris? ■ ❑ ❑ ❑
Is the screen free of excessive debris? i ❑ ❑ ❑
Is disposal of screening In compliance? M ❑ ❑ ❑
Is the unit in good condition? ■ ❑ ❑ ❑
Comment: None
Page# 4

Permit: NCO029602 Owner-Facility: Forbush Elementary School WWfP
r
Inspection Date: 03/15/2016 Inspection Type: Compliance Evaluation
Equalization Basins Yes No .`NA NE
Is the basin aerated? 0 ❑ ❑ ❑
Is the basin free of bypass lines or structures to the natural environment? E ❑ ❑ ❑
Is the basin free of excessive grease? N ❑ ❑ ❑
Are all pumps present? E ❑ ❑ ❑
Are all pumps operable? ■ ❑ ❑ ❑
Are float controls operable? ® ❑ ❑ ❑
Are audible and visual alarms operable? S ❑ ❑ ❑
#Is basin size/volume adequate? N ❑ ❑ ❑
Comment. None
Secondary Clarifier Yes No NA NE
Is the clarifier free of black and odorous wastewater? ® ❑ ❑ ❑
Is the site free of excessive buildup of solids in center well of circular clarifier? ❑ ❑ ® ❑
Are weirs level? ® ❑ ❑ ❑
Is the site free of weir blockage? ® ❑ ❑ ❑
Is the site free of evidence of short-circuiting? ® ❑ ❑ ❑
Is scum removal adequate? ■ ❑ ❑ ❑
Is the site free of excessive floating sludge? ■ ❑ ❑ ❑
Is the drive unit operational? ❑ ❑ ® ❑
Is the return rate acceptable(low turbulence)? ® ❑ ❑ ❑
Is the overflow clear of excessive solids/pin floc? ® ❑ ❑ ❑
Is the sludge blanket level acceptable?(Approximately'/.of the sldewall depth) ❑ ❑ ❑ ■
Comment: None
Aeration Basins Yes No NA NE
Mode of operation Ext Air
Type of aeration system Diffused
Is the basin free of dead spots? e ❑ ❑ ❑
Are surface aerators and mixers operational? ❑ ❑ N ❑
Are the diffusers operational? 0 ❑ ❑ ❑
Is the foam the proper color for the treatment process? i ❑ ❑ ❑
Does the foam cover less than 25%of the basin's surface? ■ ❑ ❑ ❑
Is the DO level acceptable? ■ ❑ ❑ ❑
Page# 5

Permit: NCO029602 Owner-Facility: Forbush Elementary School WWTP
Inspection Date: 03/15/2016 Inspection Type: Compliance Evaluation
Aeration Basins Yes No NA NE
Is the DO level acceptable?(1.0 to 3 0 mg/1) 0 ❑ ❑ ❑
Comment: None
Disinfection - UV Yes No NA NE
Are extra UV bulbs available on site? 0 ❑ ❑ ❑
Are UV bulbs clean? 0 ❑ ❑ ❑
Is UV intensity adequate? 0 ❑ ❑ ❑
Is transmittance at or above designed level? 0 ❑ ❑ ❑
Is there a backup system on site? 0 ❑ ❑ ❑
Is effluent clear and free of solids? 0 ❑ ❑ ❑
Comment- None
Pumps-RAS-WAS Yes No NA NE
Are pumps in place? 0 ❑ ❑ ❑
Are pumps operational? 0 ❑ ❑ ❑
Are there adequate spare parts and supplies on site? 0 ❑ ❑ ❑
Comment: None
Laboratory Yes No NA NE
Are field parameters performed by certified personnel or laboratory? 0 ❑ ❑ ❑
Are all other parameters(excluding field parameters)performed by a certified lab? 0 ❑ ❑ ❑
#Is the facility using a contract lab? 0 ❑ ❑ ❑
#Is proper temperature set for sample storage(kept at less than or equal to 6.0 degrees ❑ ❑ ❑ 0
Celsius)?
Incubator(Fecal Coliform)set to 44.5 degrees Celsius+/-0.2 degrees? ❑ ❑ ❑ 0
Incubator(BOD)set to 20 0 degrees Celsius+/-1.0 degrees? ❑ ❑ ❑ 0
Comment: None
Effluent Sampling Yes No NA NE
Is composite sampling flow proportional? ❑ ❑ 0 ❑
Is sample collected below all treatment units? 0 ❑ ❑ ❑
Is proper volume collected? 0 ❑ ❑ ❑
Is the tubing clean? ❑ ❑ 0 ❑
Page# 6

Permit: NCO029602 Owner-Facility: Forbush Elementary School WWTP
Inspection Date: 03/15/2016 Inspection Type: Compliance Evaluation
Effluent Sampling Yes No NA NE
#Is proper temperature set for sample storage(kept at less than or equal to 6.0 degrees ❑ ❑ ❑ ■
Celsius)?
Is the facility sampling performed as required by the permit(frequency, sampling type ® ❑ ❑ ❑
representative)?
Comment. None
Page# 7

United States Environmental Protection Agency Form Approved
EPA - .-- Washington,D C 20460 OMB No 2040-0057
Water Compliance Inspection Report Approval expires 8-31-98
4
Section A National Data System Coding(i.e.,PCS)
Transaction Code NPDES yr/mo/day Inspection Type Inspector Fac Type
1 IN12 15 I 3 I NC0071773 I11 12 16/03/15 17 18 19 Li 201 I
211 1- 1 1 1 1 1 1 1 1 11 1 1 1 1 1 1 1 1 I I I I I I I I I I I I I I I I I I I I tLf6
Inspection Work Days Facility Self-Monitoring Evaluation Rating B1 QA ------------------Reserved------------
67 70 I I 71 I I 72 ,, ] 731 I 174 75 80
LJ Section B. Facility Data LJ I I I
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) 01 45PM 16/03/15 14/02/01
Forbush High School WWTP
Exit Time/Date permit Expiration Date
1525 Fallon Rd
02'45PM 16/03/15 18/12/31 ,
East Bend NC 27018
Name(s)of Onsite Representative(s)/Titles(s)/Phone and Fax Number(s) Other Facility Data
Mitchell Thomas Long/ORC/336-469-2711/
Name,Address of Responsible Official/Title/Phone and Fax Number
Contacted
Mark Matthews,121 Washington St Yadkinville NC 270557725//336-699-4481/
No
Section C:Areas Evaluated During Inspection(Check only those areas evaluated)
Permit 0 Flow Measurement - ® Operations&Maintenance ® Records/Reports
Self-Monitoring Program i Sludge Handling Disposal Facility Site Review Effluent/Receiving Waters
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
Ron Boone 1! WSRO WQH336-776-9690/
Signature of Management Q A Reviewer Agency/Office/Phone and Fax Numbers Date
EPA Form 3560-3(Rev 9-94)Previous editions are obsolete
Page#

NPDES yr/mo/day Inspection Type 1
31 NP0071773 I11 12 16/03/15 17 18
Section D Summary of Finding/Comments(Attach additional sheets of narrative and checklists as necessary)
Please refer to the attached inspection summary letter
0
Page# 2

Permit: NCO071773 Owner-Facility: Forbush High School VW TP
Inspection Date: 03/15/2016 - Inspection Type: Compliance Evaluation
a
R
a
Operations& Maintenance Yes No 'NA NE
e
Is the plant generally clean with acceptable housekeeping? ❑` ❑ ❑
Does the facility analyze process control parameters, for ex- MLSS, MCRT, Settleable 0 ❑' ❑ ❑
Solids, pH, DO, Sludge Judge, and other that are applicable?
Comment: None
Permit Yes No NA NE
(If the present permit expires in 6 months or less) Has the permittee submitted anew ❑ ❑ 0 ❑
application?
Is the facility as described in the permit? 0 ❑ ❑ ❑
#Are there any special conditions for the permit? 0 ❑ ❑ ❑
Is access to the plant site restricted to the general public? 0 ❑ ❑ ❑
Is the inspector granted access to all areas for inspection? 0 ❑ ❑ ❑
Comment: None
Record Keeping Yes No NA NE
Are records kept and maintained as required by the permit? 0 ❑ ❑ ❑
Is all required information readily available, complete and current? 0 ❑ ❑ ❑
Are all records maintained for 3 years(lab reg. required 5 years)? 0 ❑ ❑ ❑
Are analytical results consistent with data reported on DMRs? 0 ❑ ❑ ❑
Is the chain-of-custody complete? 0 ❑ ❑ ❑
Dates, times and location of sampling 0
Name of individual performing the sampling 0
Results of analysis and calibration 0
Dates of analysis 0
Name of person performing analyses 0
Transported COCs 0
Are DMRs complete do they include all permit parameters? 0 ❑ ❑ ❑
Has the facility submitted its annual compliance report to users and DWQ? ❑ ❑ 0 ❑
(If the facility is=or>5 MGD permitted flow) Do they operate 24/7 with a certified operator ❑ 0 ❑ ❑
on each shift?
Is the ORC visitation log available and current? 0 ❑ ❑ ❑
Is the ORC certified at grade equal to or higher than the facility classification? 0 ❑ ❑ ❑
Is the backup operator certified at one grade less or greater than the facility classification? 0 ❑ ❑ ❑
Is a copy of the current NPDES permit available on site? 0 ❑ ❑ ❑
Page# 3

Permit: NC0071773 Owner-Facility: Forbush High School WNIrP
Inspection Date: 03/15/2016 Inspection Type: Compliance Evaluation
Record Keeping Yes No NA NE
Facility has copy of previous year's Annual Report on file for review? ❑ ❑ ® ❑
Comment: None
Effluent Pipe Yes No NA NE
Is right of way to the outfall properly maintained? 0 ❑ ❑ ❑
Are the receiving water free of foam other than trace amounts and other debris? ® ❑ ❑ ❑
If effluent (diffuser pipes are required) are they operating properly? ❑ ❑ 0 ❑
Comment: None
Flow Measurement- Effluent Yes No NA NE
#Is flow meter used for reporting? ® ❑ ❑ ❑
Is flow meter calibrated annually? ® ❑ ❑ ❑
Is the flow meter operational? ® ❑ ❑ ❑
(If units are separated) Does the chart recorder match the flow meter? ® ❑ ❑ ❑
Comment. None.
Aerobic Digester Yes No NA NE
Is the capacity adequate? ® ❑ ❑ ❑
Is the mixing adequate? ® ❑ ❑ ❑
Is the site free of excessive foaming In the tank? ® ❑ ❑ ❑
#Is the odor acceptable? ® ❑ ❑ ❑
#Is tankage available for properly waste sludge? ® ❑ ❑ ❑
Comment: None
Bar Screens Yes No NA NE
Type of bar screen
a Manual
b Mechanical ❑
Are the bars adequately screening debris? ® ❑ ❑ ❑
Is the screen free of excessive debris? N ❑ ❑ ❑
Is disposal of screening In compliance? 0 ❑ ❑ ❑
Is the unit in good condition? N ❑ ❑ ❑
Comment: None
Page# 4

Permit: NC0071773 Owner-Facility.
Forbush High School WNNTP
Inspection Date: 03/15/2016 Inspection Type: Compliance Evaluation
It
V
Equalization Basins Yes No iNA NE
Is the basin aerated? ® 01 ❑ ❑
Is the basin free of bypass lines or structures to the natural environment? ■ ❑ ❑ ❑
Is the basin free of excessive grease? N ❑ ❑ ❑
Are all pumps present? i ❑ ❑ ❑
Are all pumps operable? ® ❑ ❑ ❑
Are float controls operable? ■ ❑ ❑ ❑
Are audible and visual alarms operable? E ❑ ❑ ❑
#Is basin size/volume adequate? ® ❑ ❑ ❑
Comment: None
Secondary Clarifier Yes No NA NE
Is the clarifier free of black and odorous wastewater? ® ❑ ❑ ❑
Is the site free of excessive buildup of solids In center well of circular clarifier? ❑ ❑ ® ❑
Are weirs level? ® ❑ ❑ ❑
Is the site free of weir blockage? ® ❑ ❑ ❑
Is the site free of evidence of short-circuiting? A ❑ ❑ ❑
Is scum removal adequate? N ❑ ❑ ❑
Is the site free of excessive floating sludge? ® ❑ ❑ ❑
Is the drive unit operational? ❑ ❑ E ❑
Is the return rate acceptable(low turbulence)? ® ❑ ❑ ❑
Is the overflow clear of excessive solids/pin floc? ® ❑ ❑ ❑
Is the sludge blanket level acceptable?(Approximately'/.of the sldewall depth) ❑ ❑ ❑ i
Comment None
Aeration Basins Yes No NA NE
Mode of operation Ext.Air
Type of aeration system Diffused
Is the basin free of dead spots? E ❑ ❑ ❑
Are surface aerators and mixers operational? ❑ ❑ ■ ❑
Are the diffusers operational? ! ❑ ❑ ❑
Is the foam the proper color for the treatment process? E ,❑ ❑ ❑
Does the foam cover less than 25%of the basin's surface? 0 ❑ ❑ ❑
Is the DO level acceptable? E ❑ ❑ ❑
Page# 5

Permit: NCO071773 Owner-Facility: Forbush High School WVVTP
Inspection Date: 03/15/2016 Inspection Type: Compliance Evaluation
Aeration Basins Yes No NA NE
Is the DO level acceptable?(1 0 to 3 0 mg/1) ® ❑ ❑ ❑
Comment: None
Disinfection - UV Yes No NA NE
Are extra UV bulbs available on site? M ❑ ❑ ❑
Are UV bulbs clean? ® ❑ ❑ ❑
Is UV Intensity adequate? ® ❑ ❑ ❑
Is transmittance at or above designed level? i ❑ ❑ ❑
Is there a backup system on site? M ❑ ❑ ❑
Is effluent clear and free of solids? ® ❑ ❑ ❑
Comment- None
Pumps-RASMAS Yes No NA NE
Are pumps in place? ® ❑ ❑ ❑
Are pumps operational? M ❑ ❑ ❑
Are there adequate spare parts and supplies on site? ® ❑ ❑ ❑
Comment: None
Laboratory Yes No NA NE
Are field parameters performed by certified personnel or laboratory? ■ ❑ ❑ ❑
Are all other parameters(excluding field parameters)performed by a Certified lab? ❑ ❑ ❑
#Is the facility using a contract lab? ® ❑ ❑ ❑
#Is proper temperature set for sample storage(kept at less than or equal to 6 0 degrees ❑ ❑ ❑
Celsius)?
Incubator(Fecal Coliform)set to 44 5 degrees Celsius+/-0 2 degrees? ❑ ❑ ❑
Incubator(BOD)set to 20.0 degrees Celsius+/-1.0 degrees? ❑ ❑ ❑ M
Comment: None
Effluent Sampling Yes No NA NE
Is composite sampling flow proportional? ❑ ❑ 0 ❑
Is sample collected below all treatment units? 0 ❑ ❑ ❑
Is proper volume collected? ■ ❑ ❑ ❑
Is the tubing clean? ❑ ❑ e ❑
Page# 6

Permit: NCO071773 Owner-Facility: Forbush High School WWTP
Inspection Date: 03/15/2016 Inspection-Type: Compliance Evaluation
Effluent Sampling Yes No NA NE
#Is proper temperature set for sample storage(kept at less than or equal to 6 0 degrees ❑ ❑ ❑ ■
Celsius)?
Is the facility sampling performed as required by the permit(frequency,sampling type ® ❑ ❑ ❑
representative)?
Comment: None
r
Page# 7

United States Environmental Protection Agency Form Approved
EPA Washington,D C 20460 OMB No 2040-0057
Water Compliance Inspection Report Approval expires8-31-98
Section A National Data System Coding(i e.,PCS)
Transaction Code NPDES yr/mo/day Inspection Type Inspector Fac Type
1 , 1 2 IS I 3 I NC0070459 I11 12 16/03n5 17 18 LC j 19 ICI 201 I
211111 1 1 1 1 1 1 II 1 LI I I I I I I I I I I I I I I I I I I I I II I I I I I J6
Inspection Work Days Facility Self-Monitonng Evaluation Rating B1 QA ---------------Reserved--------------
671 70 I I 71 L] 72 ti 73�74 75 80
LJ LJ Section 6-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) 03 OOPM 16/03/15 14/01/01
Starmount High School WWTP
Exit Time/Date Permit Expiration Date
2516 Longtown Rd
04.00PM 16/03/15 18(12131
Boonville NC 27011
Name(s)of Onsite Representative(s)/Titles(s)/Phone and Fax Number(s) Other Facility Data
Mitchell Thomas Long/ORC/336-469-2711/
Name,Address of Responsible Official/Title/Phone and Fax Number
Contacted
Mark Matthews,121 Washington St Yadkinville NC 270557725//336-699-4481/
No
Section C-Areas Evaluated During Inspection(Check only those areas evaluated)
® Permit ® Flow Measurement Operations&Maintenance ® Records/Reports
Self-Monitoring Program ® Sludge Handling Disposal ® Facility Site Review ■ Effluent/Receiving Waters
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
Ron Boone WSRO WQ//336-776-9690/
Signature of Management Q A Reviewer Agency/Office/Phone and Fax Numbers Date
EPA Form 3560-3(Rev 9-94)Previous editions are obsolete
Page# 1

NPDES yr/mo/day Inspection Type 1
31 NCO070459 I11 12 16/03/15 17 18 ICI
Section D Summary of Finding/Comments(Attach additional sheets of narrative and checklists as necessary)
Please refer to the attached inspection summary letter.
Page# 2

' 1 i
Permit: NCO070459 Owner-Facility: Starmount High School WWTP
Inspection Date: 03/15/2016 Inspection Type: Compliance Evaluation
Operations$ Maintenance Yes No INA NE
i
Is the plant generally clean with acceptable housekeeping? 0 ❑,' ❑ ❑
Does the facility analyze process control parameters, for ex MLSS, MCRT, Settleable 0 El El 1:1Solids, pH, DO, Sludge Judge, and other that are applicable?
Comment: None
Permit Yes No NA NE
(If the present permit expires In 6 months or less) Has the permittee submitted a new ❑ ❑ 0 ❑
application?
Is the facility as described in the permit? ❑ ❑ ❑ ❑
#Are there any special conditions for the permit? ❑ ® ❑ ❑
Is access to the plant site restricted to the general public? 0 ❑ ❑ ❑
Is the inspector granted access to all areas for inspection? 0 ❑ ❑ 0
Comment: None
Record Keeping Yes No NA NE
Are records kept and maintained as required by the permit? ® ❑ ❑ ❑
Is all required information readily available, complete and current? 0 0 ❑ ❑
Are all records maintained for 3 years(lab reg required 5 years)? 0 ❑ ❑ ❑
Are analytical results consistent with data reported on DMRs? 0 ❑ ❑
Is the chain-of-custody complete? 0 ❑ ❑ ❑
Dates, times and location of sampling
Name of individual performing the sampling
Results of analysis and calibration
Dates of analysis
Name of person performing analyses
Transported COCs
Are DMRs complete:do they Include all permit parameters? 0, ❑ ❑ ❑
Has the facility submitted its annual compliance report to users and DWQ? ❑'I ❑ 0 ❑
(If the facility is=or>5 MGD permitted flow) Do they operate 24/7 with a certified operator ❑ 0 ❑ ❑
on each shift?
r
Is the ORC visitation log available and current? 0"r ❑ ❑ El
Is the ORC certified at grade equal to or higher than the facility classification? 06 ❑ ❑ ❑
Is the backup operator certified at one grade less or greater than the facility classification? 0 ❑ ❑ ❑
Is a copy of the current NPDES permit available on site? 0 ❑ ❑ ❑
Page# 3

Permit: NC0070459 Owner-Facility: Starmount High School WVVrP
Inspection Date: 03/15/2016 Inspection Type: Compliance Evaluation
Record Keeping Yes No NA NE
Facility has copy of previous year's Annual Report on file for review? ❑ ❑ E ❑
Comment: None
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? ® ❑ ❑ ❑
If effluent (diffuser pipes are required) are they operating properly? ❑ ❑ ® ❑
Comment: None
Flow Measurement- Effluent Yes No NA NE
#Is flow meter used for reporting? ® '❑ ❑ ❑
Is flow meter calibrated annually? ® ❑ ❑ ❑
Is the flow meter operational? ® ❑ ❑ ❑
(If units are separated) Does the chart recorder match the flow meter? ® ❑ ,❑ ❑
Comment: None
Aerobic Digester Yes No NA NE
Is the capacity adequate? ® ❑ ❑ ❑
Is the mixing adequate? i ❑ ❑ ❑
Is the site free of excessive foaming In the tank? ® ❑ ❑ ❑
#Is the odor acceptable? ® ❑ ❑ ❑
#Is tankage available for properly waste sludge? ® ❑ ❑ ❑
Comment. None
Bar Screens Yes No NA NE
Type of bar screen
a Manual
b.Mechanical ❑
Are the bars adequately screening debris? ® ❑ ❑ ❑
Is the screen free of excessive debris? ■ ❑ ❑ ❑
Is disposal of screening in compliance? N ❑ ❑ ❑
Is the unit in good condition? N ❑ ❑ ❑
Comment: None.
Page# 4

h
Permit: NCO070459 Owner-Facility: Starmount High School WMlrP
Inspection Date: 03/15/2016 - Inspection Type: Compliance.Evaluation
Equalization Basins Yes No NA NE
Is the basin aerated? ❑
Is the basin free of bypass lines or structures to the natural environment? M ❑ ❑ ❑
Is the basin free of excessive grease? 0 ❑ ❑ ❑
Are all pumps present? ® ❑ ❑ ❑
Are all pumps operable? ■ ❑ ❑ ❑
Are float controls operable? E ❑ ❑ ❑
Are audible and visual alarms operable? .■ ❑ ❑ ❑
#Is basin size/volume adequate? ® ❑ ❑ ❑
Comment: None
Secondary Clarifier Yes No NA NE
Is the clarifier free of black and odorous wastewater? E ❑ ❑ ❑
Is the site free of excessive buildup of solids in center well of circular clarifier? ❑ ❑ ® ❑
Are weirs level? ® ❑ ❑ ❑
Is the site free of weir blockage? ❑ ❑ ❑ ❑
Is the site free of evidence of short-circuiting? -® ❑ ❑ ❑
Is scum removal adequate? ® •❑ ❑ ❑
Is the site free of excessive floating sludge? ! ❑ ❑ ❑
Is the drive unit operational? ❑ ❑ ® ❑
Is the return rate acceptable(low turbulence)? N ❑ ❑ ❑
Is the overflow clear of excessive solids/pin floc? N ❑ ❑ ❑
Is the sludge blanket level acceptable?(Approximately''/4 of the sidewall depth) ❑ ❑ ❑ 0
Comment: None -
Aeration Basins Yes No NA NE
Mode of operation Ext Air
Type of aeration system Diffused
Is the basin free of dead spots? 0 ❑ ❑ ❑
Are surface aerators and mixers operational? ❑ ❑ 0 ❑
Are the diffusers operational? N ❑ ❑ ❑
Is the foam the proper color for the treatment process? N ❑ ❑ ❑
Does the foam cover less than 25%of the basin's surface? ■ ❑ ❑ ❑
Is the DO level acceptable? 0 ❑ ❑ ❑
Page# 5

Permit: NCO070459 Owner-Facility: Starmount High School VVWTP
Inspection Date: 03/15/2016 Inspection Type: Compliance Evaluation
Aeration Basins Yes No NA NE
Is the DO level acceptable?(1 0 to 3.0 mg/1) M ❑ ❑ ❑
Comment: None
Disinfection - UV Yes No NA NE
Are extra UV bulbs available on site? M ❑ ❑ ❑
Are UV bulbs clean? ® ❑ ❑ ❑
Is UV intensity adequate? ® ❑ ❑ ❑
Is transmittance at or above designed level? ® ❑ ❑ ❑
Is there a backup system on site? ® ❑ ❑ ❑
Is effluent clear and free of solids? ® ❑ ❑ ❑
Comment: None
Pumps-RAS-WAS Yes No NA NE
Are pumps in place? ® ❑ ❑ ❑
Are pumps operational? ■ ❑ ❑ ❑
Are there adequate spare parts and supplies on site? ® ❑ ❑ ❑
Comment: None
Laboratory Yes No NA NE
Are field parameters performed by certified personnel or laboratory? ® ❑ ❑ ❑
Are all other parameters(excluding field parameters)performed by a certified lab? 0 ❑ ❑ ❑
#Is the facility using a contract lab? 0 ❑ ❑ ❑
#Is proper temperature set for sample storage(kept at less than or equal to 6 0 degrees ❑ ❑ ❑ ■
Celsius)? -
Incubator(Fecal Coliform)set to 44 5 degrees Celsius+/-0 2 degrees? ❑ ❑ ❑ M
Incubator(BOD)set to 20 0 degrees Celsius+/-1.0 degrees? ❑ ❑ ❑ 0
Comment: None
Effluent Sampling Yes No NA NE
Is composite sampling flow proportional? ❑ ❑ 0 ❑
Is sample collected below all treatment units? M ❑ ❑ ❑
Is proper volume collected? M ❑ ❑ ❑
Is the tubing clean? ❑ ❑ N ❑
Page# 6

Permit: NCO070459 Owner-Facility: Starmount High School WWTP
Inspection Date: 03/15/2016 Inspection Type: Compliance Evaluation
Effluent Sampling Yes No NA NE
!'
#Is proper temperature set for sample storage(kept at less than or equal to 6 0 degrees ❑ 0 ❑ 0
Celsius)?
Is the facility sampling performed as required by the permit(frequency, sampling type ® ❑ ❑ ❑
representative)?
Comment: None
Page# 7