NC0029602_Compliance Evaluation Inspection_20170118

January 18, 2017
Yadkin County Board of Education
Attn: Dr. Todd Martin, Superintendent
121 Washington Street
Yadkinville, NC 27055
SUBJECT: Compliance Evaluation Inspections
Yadkin County Board of Education Wastewater Treatment Plants
Yadkin County
Dear Dr. Martin:
ROY COOPER
Governor
WILLIAM G. ROSS, JR.
Acting Secretary
..JAN 2 4 2017
Water Quality
Permitting Section
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 facilities and corresponding
dates specified in the table below:
Facility Name
NPDES Permit #
Date of Inspection
Courtne .Elementa School CES
NCO029599
December 14, 2016
Forbush Elementary School FES
NCO029602
December 14, 2016
Forbush High School FHS
NCO071773
December 14, 2016
Starmount High School SHSNCO070459
Logan Creek
December 14, 2016
East Bend Elementary School EBES
NCO029611
January 12, 2017
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:_
Facility Name
Plant Type
Latitude &
Longitude
Receiving Stream
Receiving'Stream
Classification
CES
Sand Filter
36.067886,
80.602172
Harmon Creek
WS -IV
EBES
Sand Filter
36.213194,
80.509137
Logan Creek
C
FES
Activated Sludge
36.125681,
80.49$559595
80.49
Logan Creek
WS -IV
FHS
Activated Sludge
03,
80.55 088
80.559088
Forbush Creek
WS -IV
SHS
Activated Sludge
36.182031,
80.769535
South Deep Creek
WS -III
- Nothing Coe pares'r-.,__,
State of North Carolina I Environmental Quality
450 West Hanes Mill Road, Suite 300, Winston-Salem, NC 27105
Phone: [phone] Internet: www.ncdenr.gov

9
SITE REVIEWS
Inspection of all five plants revealed no discrepancies, concerns, or violations. It appears that Mr. Long and
his backup operator(s) are doing a very good job operating all five plants. The plants are all in good condition and
appear to be operating at peak efficiency. Mr. Long and his backups should be congratulated for doing an outstanding
job.
DOCUMENTATION REVIEWS
Additionally, there were no problems noted with Mr. Long's documentation for all five plants. Mr. Long had
all the required documentation and it meets all requirements.
There were no discrepancies noted in any of the five inspections. Please encourage Mr. Long and Mr.
Hinshaw to keep up the good work in ensuring the plants are properly operated and maintained and consistently
meeting all terms and conditions of the permits. Please note that in accordance with NC General Statute 143-215.6A,
permit violations are subject to civil penalty assessments not to exceed $25,000 per day, per violation.
If you have any questions regarding the inspections 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,
'herri 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
NPDES Unit
WSRO/SWP 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.
Washington, D.C. 20460
EPA
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 U 2 15 I 3 I NCO029599 111 12 16/12/14 17 18 i C J 19 i s i 20 LJ
211111 1 1 1 1 1 1 II 1 1 I I I I I I I I I I I l i l i i l i i l III I I I D f
--- Reserved -----
Inspection Work Days Facility Self -Monitoring Evaluation Rating B1 QA -----Reserved ---
6772 L_ 73 174 75 1 1 1 1 1 80
71 lil
67 70L_j
Section B: Facility Data
Name and Location of Facility Inspected (For Industrial Users discharging to POTW, also include
Entry Time/Date
Permit Effective Date
POTW name and NPDES permit Number)
11:30AM 16/12/14
14/01/01
Courtney Elementary School WWTP
Exit Time/Date
permit Expiration Date
2529 Courtney -Huntsville
12:15PM 16/12/14
18/12/31
Yadkinville NC 27055
Name(s) of Onsite Representative(s)/Titles(s)/Phone and Fax Number(s)
Other Facility Data
Mitchell Thomas Long/ORC/336-518-4336/
Name, Address of Responsible Official/Title/Phone and Fax Number
Contacted
Mark Matthews,121 Washington St Yadkinville NC 270557725//336-699-44811
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 WSRO WQH336-776-9690/
62 7
Signature of Management Q A Reviewer Agency/Office/Phone and Fax Numbers . Date
/
c6t1� l l 1s, //T
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete.
Page#

NPDES yr/mo/day - Inspection Type
31 NCO029599 I11 12 16/12/14 17 18 1 C 1
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
Please refer to the attached inspection summary letter.
Page#
I

Permit: NCO029599 Owner - Facility: Courtney Elementary School WWTP
Inspection Date: 12/14/2016 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 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?
0
❑
❑
❑
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?
M
❑
❑
❑
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 DM Rs?
M
❑
❑
❑
Is the chain -of -custody complete?
M
❑
❑
❑
Dates, times and location of sampling
Name of individualperforming the sampling
Results of analysis and calibration
Dates of analysis
Name of person performing analyses
Transported COCl
Are MRS complete: do they include all permit parameters?
M
❑
❑
❑
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
❑
0
❑
❑
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?
❑
❑
.❑
Is the backup operator certified at one grade less or greater than the facility classification?
❑
❑
❑
Is a copy of the current NPDES permit available on site?
M
❑
❑
❑
Page# 3

Permit: NC0029599 Owner -Facility: Courtney Elementary School WWTP
Inspection Date: 12/14/2016 Inspection Type: Compliance Evaluation
Record Keeping Yes No NA NE
Facility has copy of previous year's Annual Report on file for review? ❑ ❑ M ❑
Comment: None
Effluent Pipe
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
# 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: Water meter used.
Disinfection - UV
Are extra UV bulbs available on site?
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
Septic Tank
(If pumps are used) Is an audible and visual alarm operational?
Is septic tank pumped on a schedule?
Are pumps or syphons operating properly?
Are high and low water alarms operating properly?
Comment: None
Sand Filters (Low rate)
Yes No NA NE
■ ❑ ❑ ❑
■ ❑ ❑ ❑
❑ ❑ ■ ❑
Yes No NA NE
■ ❑ 1:111
❑ ■ ❑ ❑
■ ❑ ❑ ❑
❑ ❑ ■ ❑
Yes No NA NE
• ❑ ❑ ❑
• ❑ ❑ ❑
■ ❑ ❑ ❑
M ❑ ❑ ❑
M ❑ ❑ ❑
■ ❑ ❑ ❑
Yes No NA NE
■ ❑ ❑ ❑
■ ❑ ❑ ❑
■ ❑ .❑ ❑
Yes No NA NE
Page# 4

Permit: NCO029599 Owner- Facility:
Courtney Elementary School WWfP
Are field parameters performed by certified personnel or laboratory?
N
Inspection Date: 12/14/2016 Inspection Type:
Compliance Evaluation
❑
Are all other parameters(excluding field parameters) performed by a certified lab?
M
Sand Filters (Low rate)
Yes No NA NE
(If pumps are used) Is an audible and visible alarm Present and operational?
❑
0
❑
❑
Is the distribution box level and watertight?
❑
❑
❑
0
Is sand filter free of ponding?
N
❑
❑
❑
Is the sand filter effluent re -circulated at a valid ratio?
N
❑
❑
❑
# Is the sand filter surface free of algae or excessive vegetation?
Incubator (BOD) set to 20.0 degrees Celsius +/-1.0 degrees?
❑
❑
❑
# Is the sand filter effluent re -circulated at a valid ratio? (Approximately 3 to 1)
0
❑
❑
❑
Comment: None
Laboratory
Yes No NA NE
Are field parameters performed by certified personnel or laboratory?
N
❑
❑
❑
Are all other parameters(excluding field parameters) performed by a certified lab?
M
❑
❑
❑
# Is the facility using a contract lab?
M
❑
❑
❑
# Is proper temperature set for sample storage (kept at less than or equal to 6.0 degrees
❑
❑
❑
0
Celsius)? -
❑
❑
❑
M
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?
❑
❑
❑
Is proper volume collected?
❑
❑
❑
Is the tubing clean?
❑
❑
N
❑
# Is proper temperature set for sample storage (kept at less than or equal to 6.0 degrees
❑
❑
❑
M
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 15 I 3 I N00029611 111 12 17/01/12 17 18 I S I 19 I c) . 20I j
211111 1 1 1 1 1 111 1 1 1 1 1 1 1 1 I I I I I I 1 I I I 1 1 H 1111 1 1 1 1 1 16
Inspection Work Days Facility Self -Monitoring Evaluation Rating 131 QA ---Reserved
— Reserved67
67701 I 71 I I 72 I N 731 I 174 751 I I I 1__H81
LJ I—I I I I L!_
Section B: Facility Data
Name and Location of Facility Inspected (For Industrial Users discharging to POTW, also include
Entry Time/Date
Permit Effective Date
POTW name and NPDES permit Number)
12:00PM 17/01/12
14/01/01
East Bend Elementary School WWTP
ExitTimelDate
Permit Expiration Date
NC Hwy 67 E
01:OOPM 17/01/12
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/336-518-4336/
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 N Flow Measurement Operations & Maintenance Records/Reports
Self -Monitoring Program N 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/
Min Xiao WSRO WQ//336769800/ ® �/7
Signature of Management Q A Reviewer Agency/Office/Phone and Fax Numbers Date
a6% ��� 1 �� 1 f�
7,
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete.
Page#

NPDES yr/mo/day Inspection Type
31 NCO029611 I11 12 17/01/12 17 1811 11-1„
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
Please refer to the attached inspection summary letter.
Page#

Permit: NCO029611 Owner -Facility: East Bend Elementary School WWrP
Inspection Date: 01/12/2017 Inspection Type: Compliance Evaluation
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
❑
❑
M
❑
application?
M.
❑
❑
❑
Is the facility as described in the permit?
0
❑
❑
❑
# Are there any special conditions for the permit?
❑
❑
❑
❑
Is access to the plant site restricted to the general public?
0
❑
❑
❑
Is the inspector granted access to all areas for inspection?
0
❑
❑
❑
Comment: None
Record Keepina
Yes No NA NE
Are records kept and maintained as required by the permit?
M
❑
❑
❑
Is all required information readily available, complete and current?
M.
❑
❑
❑
Are all records maintained for 3 years (lab. reg. required 5 years)?
0
❑
❑
❑
Are analytical results consistent with data reported on DMRs?
M
❑
❑
❑
Is'the chain -of -custody complete?
M
❑
❑
❑
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?
❑
❑
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?
❑
❑
❑
Is the ORC certified at grade equal to or higher than the facility classification?
M
❑
❑
❑
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?
0
❑
❑
❑
Page# 3

Permit: NC0029611 Owner- Facility: East Bend Elementary School WWTP
Inspection Date: 01/12/2017 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? 0 ❑ ❑ ❑
Are the receiving water free of foam other than trace amounts and other debris? 0 ❑ ❑ ❑
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?
N
❑
❑
❑
Is flow meter calibrated annually?
❑
N
❑
❑
Is the flow meter operational?
■
❑
❑
❑
(If units are separated) Does the chart recorder match the flow meter?
❑
❑
®
❑
Comment: School's potable water flow meter is used to determine flow to and out of UWVfP.
Pump Station - Effluent
Yes No NA NE
Is the pump wet well free of bypass lines or structures?
N
❑
❑
❑
Are all pumps present?
0
❑
❑
❑
Are all pumps operable?
M
❑
❑
❑
Are float controls operable?
0
❑
❑
❑
Is SCADA telemetry available and operational?
❑
0
❑
❑
Is audible and visual alarm available and operational?
0
❑
❑
❑
Comment: None
Disinfection - UV
Yes No NA NE
Are extra UV bulbs available on site?
N
❑
❑
❑
Are UV bulbs clean? _
M
❑
❑
❑
Is UV intensity adequate?
0
❑
❑
❑
Is transmittance at or above designed level?
❑
❑
❑
Is there a backup system on site?
0
❑
❑
❑
Is effluent clear and free of solids?
0
❑
❑
❑
Comment: None
Page# 4

Permit: NCO029611 Owner- Facility: East Bend Elementary School WWfP
Inspection Date: 01/12/2017 Inspection Type: Compliance Evaluation
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?
❑
❑
❑
❑
Are pumps or syphons operating properly?
0
❑
❑
❑
Are high and low water alarms operating properly?
0
❑
❑
❑
Comment: None
Sand Filters (Low rate)
Yes No NA NE
(If pumps are used) Is an audible and visible alarm Present and operational?
❑
N
❑
❑
Is the distribution box level and watertight?
❑
❑
❑
0
Is sand filter free of ponding?
N
❑
❑
❑
Is the sand filter effluent re-dirculated at a valid ratio?
❑
❑
❑
❑
# Is the sand filter surface free of algae or excessive vegetation?
M
❑
❑
❑
# Is the sand filter effluent re -circulated at a valid ratio? (Approximately 3 to 1)
. 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?
M
❑
❑
❑
# 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)?
❑
❑
❑
M
Incubator (Fecal Coliform) set to 44.5 degrees Celsius+/- 0.2 degrees?
❑
❑
❑
0
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?
❑
❑
N
❑
Is sample collected below all treatment units?
0
❑
❑
❑
Is proper volume collected?
N
❑
❑
❑
Is the tubing clean?
0
❑
❑
# Is proper temperature set for sample storage (kept at less than or equal to 6.0 degrees
❑
❑
❑
M
Celsius)?
Is the facility sampling performed as required by the permit (frequency, sampling type
0
❑
❑
❑
representative)?
Page#

Permit: NC0029611
Inspection Date: 01/12/2017
Effluent Sampling
Comment: None
Owner - Facility: East Bend Elementary School 4WVT'P ��-
Inspection Type: Compliance Evaluation
Yes No NA NE
Page#

United States Environmental Protection Agency
Form Approved.
EPA Washington, D.C. 20460
OMB No. 2040-0057
Water Compliance Inspection Report
Approval expires 8-31-96
Section A: National Data System Coding (i.e., PCS)
Transaction Code NPDES yr/mo/day Inspection Type Inspector Fac Type
1 IN 2 15 1 3 I N00029602 I11 12 16/12/14 17 18 C I 19 I c I 20I
211IIIII IIIIIII�I II I II IIII I I II III IIIIIII (III r6
Inspection Work Days Facility Self -Monitoring Evaluation Rating B1 QA ---------Reserved
671 70 I I 71 Lj 72 � �, � 73I ILJI74 75LJ_LL 80
L� L � L
Section B: Facility Data
Name and Location of Facility Inspected (For Industrial Users discharging to POTW, also include
Entry Time/Date
Permit Effective Date
POTW name and NPDES permit Number)
11:30AM 16/12/14
14/01/01
Forbush Elementary School WWTP
Exit Time/Date
permit Expiration Date
1400 Bloomtown Rd
-
12:15PM 16/12/14
18/12/31
East Bend NC 27018
Name(s) of Onsite Representative(s)/Titles(s)/Phone and Fax Number(s)
Other Facility Data
111
Mitchell Thomas Long/ORC/336-518-4336/
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 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 R;ev�iew_Aer/Agency/Office/Phone and Fax Numbers Date
/Y/
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete.
Page#

NPDES
yr/mo/day
31 NCO029602 I11 12 16/12/14 17
Inspection Type
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#

Permit: NCO029602 Owner -Facility: Forbush Elementary School WWTP
Inspection Date: 12/14/2016 Inspection Type: Compliance Evaluation
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
❑
❑
M
❑
application?
M
❑
❑
❑
Is the facility as described in the permit?
0
❑
❑
❑
# Are there any special conditions for the permit?
❑
❑
❑
❑
Is access to the plant site restricted to the general public?
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?
M
❑
❑
❑
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?
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 2417 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?
M
❑
❑
❑
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?
0
❑
❑
❑
Page#
3

r
Permit: NC0029602 Owner - Facility: Forbush Elementary School WWTP
Inspection Date: 12/14/2016 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? 0 ❑ ❑ ❑
Are the receiving water free of foam other than trace amounts and other debris? 0 ❑ ❑ ❑
If effluent (diffuser pipes are required) are they operating properly? ❑ ❑ 0 ❑
Comment: None
Flow Measurement - Influent
Yes No NA NE
# Is flow meter used for reporting?
N
❑
❑
❑
Is flow meter calibrated annually?
❑
0
❑
❑
Is the flow meter operational?
■
❑
❑
❑
(If units are separated) Does the chart recorder match the flow meter?
❑
❑
N
❑
Comment: Water meter used.
Aerobic Digester
Yes No NA NE
Is the capacity adequate?
0
❑
❑
❑
Is the mixing adequate?
N
❑
❑
❑
Is the site free of excessive foaming in the tank?
M
❑
❑
❑
# Is the odor acceptable?
0
❑
❑
❑
# Is tankage available for properly waste sludge?
M
❑
❑
❑
Comment: None
Bar Screens
Yes No NA NE
Type of bar screen
a.Manual
b. Mechanical
❑
Are the bars adequately screening debris?
M
❑
❑
❑
Is the screen free of excessive debris?
N
❑
❑
❑
Is disposal of screening in compliance?
M
❑
❑
❑
Is the unit in good condition?
❑
❑
❑
Comment: None
Page# 4

Permit: NCO029602 Owner - Facility: Forbush Elementary School VWVTP
Inspection Date: 12/14/2016 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?
0
❑
❑
❑
Is the basin free of excessive grease?
0
❑
❑
❑
Are all pumps present?
0
❑
❑
❑
Are all pumps operable?
M
❑
❑
❑
Are float controls operable?
M
❑
❑
❑
Are audible and visual alarms operable?
0
❑
❑
❑
# Is basin size/volume adequate?
❑
❑
❑
❑
Comment: None
Secondary Clarifier
Yes No NA NE
Is the clarifier free of black and odorous wastewater?
0
❑
❑
❑
Is the site free of excessive buildup of solids in center well of circular clarifier?
0
❑
❑
❑
Are weirs level?
0
❑
❑
❑
Is the site free of weir blockage?
0
❑
❑
❑
Is the site free of evidence of short-circuiting?
N
❑
❑
❑
Is scum removal adequate?
N
❑
❑
❑
Is the site free of excessive floating sludge?
0
❑
❑
❑
Is the drive unit operational?
❑
❑
0
❑
Is the return rate acceptable (low turbulence)?
0
❑
❑
❑
Is the overflow clear of excessive solids/pin floc?
M
❑
❑
❑
Is the sludge blanket level acceptable? (Approximately'/4 of the sidewall depth)
❑
❑
❑
N
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?
0 ❑ .
❑
❑
Is the foam the proper color for the.treatment process?
M ❑
❑
❑
Does the foam cover less than 25% of the basin's surface?
❑
❑
❑
Is the DO level acceptable?
❑ ❑
❑
0
Page# 5

Permit: NCO029602 Owner - Facility: Forbush Elementary School WWTP
Inspection Date: 12/14/2016 Inspection Type: Compliance Evaluation
Aeration Basins Yes No NA NE
Is the DO level acceptable?(1.0 to 3.0 mg/1) ❑ ❑ 110
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?
M
❑
❑
❑
Is transmittance at or above designed level?
M
❑
❑
❑
Is there a backup system on site?
M
❑
❑
❑
Is effluent clear and free of solids?
M
❑
❑
❑
Comment: None
Pumps-RASMAS
Yes No NA NE
Are pumps in place?
M
❑
❑
❑
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?
M
❑
❑
❑
# 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?
❑
❑
❑
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?
❑
❑
N
❑
Is sample collected below all treatment units?
❑
❑
❑
Is proper volume collected?
N
❑
❑
❑
Is the tubing clean?
❑
❑
M
❑
Page# 6

Permit: NCO029602 Owner - Facility: Forbush Elementary School WWTP
Inspection Date: 12/14/2016 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
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
Section A: National Data System Coding (i.e., PCS)
Transaction Code NPDES yr/mo/day Inspection Type Inspector Fac Type
1 E 2 15 1 3 I NCO071773 111 12 16/12/14 17 18 ICI 19 I G j 20 Lj
211111 1 1 111111 1 11 11 1 11 1111 1 1 1 1 1 1 11111111 11 1 1 t66
Inspection Work Days Facility Self -Monitoring Evaluation Rating B1 QA Reserved---- —
67 70 I I 71 I ' 72 I N I 73 74 75 80
L� I—! LJJ
Section B: FacilityData
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)
09:30AM 16/12/14
14/02/01
Forbush High School WWTP
1525 Fallon Rd
Exit Time/Date
Permit Expiration Date
East Bend NC 27018
12:0013M 16/12/14
18/12/31
Name(s) of Onsite Representative(s)/Titles(s)/Phone and Fax Number(s)
Other Facility Data
///
Mitchell Thomas Long/ORC/336-518-4336/
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 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//336-776-96901
/17
6'
Signature of ManagementQ 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
31 NCO071773 I11 12 16/12/14 17 18 I S 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#

Permit: NCO071773 Owner - Facility: Forbush High School WWTP
Inspection Date: 12/14/2016 Inspection Type: Compliance Evaluation
Operations & Maintenance Yes No NA NE
Is the plant generally clean with acceptable housekeeping? • 0 ❑ ❑ ❑
Does the facility analyze process control parameters, for ex: MLSS, MCRT, Settleable ❑ ❑ ❑
Solids, pH, DO, Sludge Judge, and other that are applicable?
Comment: None
Permit
Yes No NA NE
(if the present permit expires in 6 months or less). Has the permittee submitted a new
❑
❑
M
❑
application?
M
❑
❑
❑
Is the facility as described in the permit?
M
❑
❑
❑
# Are there any special conditions for the permit?
❑
- 0
❑
❑
Is access to the plant site restricted to the general public?
M
❑
❑
❑
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?
M
❑
❑
❑
Is all required information readily available, complete and current?
M
❑
❑
❑
Are all records maintained for 3 years (lab. reg. required 5 years)?
M
❑
❑
❑
Are analytical results consistent with data reported on DMRs?
0
❑
❑
❑
Is the chain -of -custody complete?
M
❑
❑
❑
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?
M
❑
❑
❑
Has the facility submitted its annual compliance report to users and DWQ?
❑
❑
❑
(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?
M
❑
❑
❑
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?
M
❑
❑
❑
Page# 3

Permit: NC0071773 Owner - Facility: Forbush High School WWTP
Inspection Date: 12/14/2016 Inspection Type: Compliance Evaluation
Record Keeping Yes No NA NE
Facility has copy of previous year's Annual Report on file for review? ❑ ❑ M ❑
Comment: None
Effluent Pipe
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
# 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
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
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?
Is the unit in good condition?
Comment: None
Yes No NA NE
M
❑
❑
❑
■
❑
❑
❑
❑
❑
M
❑
Yes No NA NE
M ❑ ❑ ❑
M ❑ ❑ ❑
M ❑ ❑ ❑
Yes No NA NE
■ ❑ ❑ ❑
■ ❑ ❑ ❑
M ❑ ❑ ❑
M ❑ ❑ ❑
M ❑ ❑ ❑
Yes No NA NE
M ❑ ❑ ❑
■ ❑ ❑ ❑
Page# 4

Permit NCO071773 Owner - Facility:
Inspection Date: 12/14/2016 Inspection Type:
Forbush High School WWTP
Compliance Evaluation
Is the clarifier free of black and odorous wastewater?
0
❑
Equalization Basins
Yes No NA NE
Is the basin aerated?
0
❑
❑
❑
Is the basin free of bypass lines or structures to the natural environment?
0
❑
❑
❑
Is the basin free of excessive grease?
0
❑
❑
❑
Are all pumps present?
0
❑
❑
❑
Are all pumps operable?
0
❑
❑
❑
Are float controls operable?
0
❑
❑
❑
Are audible and visual alarms operable?
0
❑
❑
❑
# Is basin size/volume adequate?
0
❑
❑
❑
Comment: None
Secondary Clarifier
Yes No NA NE
Is the clarifier free of black and odorous wastewater?
0
❑
❑
❑
Is the site free of excessive buildup of solids in center well of circular clarifier?
0
❑
❑
❑
Are weirs level?
E
❑
❑
❑
Is the site free of weir blockage?
0
❑
❑
❑
Is the site free of evidence of short-circuiting?
0
❑
❑
❑
Is scum removal adequate?
0
❑
❑
❑
Is the site free of excessive floating sludge?
N
❑
❑
❑
Is the drive unit operational?
0
❑
❑
❑
Is the return rate acceptable (low turbulence)?
N
❑
❑
❑
Is the overflow clear of excessive solids/pin floc?
E
❑
❑
❑
Is the sludge blanket level acceptable? (Approximately'/ 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?
N ❑
❑
❑
Are surface aerators and mixers operational?
❑ ❑
0
❑
Are the diffusers operational?
❑
❑
❑
Is the foam the proper color for the treatment process?
0 ❑
❑
❑
Does the foam cover less than 25% of the basin's surface?
N ❑
❑
❑
Is the DO level acceptable?
0 ❑
❑
❑
Page# 5

Permit: NCO071773 Owner - Facility: Forbush High School WWTP
Inspection Date: 12/14/2016 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?
M
❑
❑
❑
Is transmittance at or above designed level?
M
❑
❑
❑
Is there a backup system on site?
0
❑
❑
❑
Is effluent clear and free of solids?
M
❑
❑
❑
Comment: None
Pumps -RAS -WAS
Yes No NA NE
Are pumps in place?
N
❑
❑
❑
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?
M
❑
❑
❑
Are all other parameters(excluding field parameters) performed by a certified lab?
M
❑
❑
❑
# Is the facility using a contract lab?
M
❑
❑
❑
# 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?
❑
❑
❑
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?
N
❑
❑
❑
Is proper volume collected?
M
❑
❑
❑
Is the tubing clean?
❑
❑
0
❑
Page# 6

Permit: NCO071773 Owner - Facility: Forbush High School WWTP
Inspection Date: 12/14/2016 Inspection Type: Compliance Evaluation
Effluent Samplina 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
Upstream / Downstream Sampling
Is the facility sampling performed as required by the permit (frequency, sampling type, and
sampling location)?
Comment: None
❑ ❑ ❑ N
N ❑ ❑ ❑
Yes No NA NE
N ❑ ❑ ❑
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
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 NCO070459 I11 12 16/12/14 17 18 ICI 19 I G I 20I I
211 11 1 11-I I I I I I I l i l l i l l l l l l i l l l l i l i l l I I I I I I I I r6
Inspection Work Days Facility Self-Monitoring.Evaluation Rating B1 QA ---------Reserved---------
67 70I I 71I —J I 72 N 73I I 174 75 80
LJ LJ 1 I I
Section B: Facility Data
Name and Location of Facility Inspected (For Industrial Users discharging to POTW, also include
Entry Time/Date
Permit.Effective Date
POTW name and NPDES permit Number)
10:30AM 16/12/14
14/01/01
Starmount High School WWT'P
Exit Time/Date
permit Expiration Date
2516 Longtown Rd
11:15AM 16/12/14
18/12/31
Boonville NC 27011
Name(s) of Onsite Representative(s)/Titles(s)/Phone and Fax Number(s)
Other Facility Data
///
Mitchell Thomas Long/ORC/336-518-4336/
Name, Address of Responsible Official/Title/Phone and Fax Number
Contacted
Mark Matthews, 121 Washington StYadkinvilla NC 270557725//336-6994481/
No
Section, C: Areas Evaluated During Inspection (Check only those areas evaluated)
Permit N 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 Signatu of Inspector(s) Agency/Office/Phone and Fax Numbers Date
dd
Ron Boone WSR0 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
31 Nco070459 I11 12 16/12/14 17
Inspection Type
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#

Permit: NCO070459 Owner - Facility: Starmount High School WWTP
Inspection Date: 12/14/2016 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 ❑ ❑ ❑
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?
M
❑
❑
❑
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 I
Yes No NA NE
Are records kept and maintained as required by the permit?
M
❑
❑
❑
Is all required information readily available, complete and current?
M
❑
❑
❑
Are all records maintained for 3 years (lab. reg. required 5 years)?
0
❑
❑
❑
Are analytical results consistent with data reported on DMRs?
M
❑
❑
❑
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 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?
❑
❑
❑
Is the backup operator certified at one grade less or greater than the facility classification?
❑
❑
❑
Is a copy of the current NPDES permit available on site?
M
❑
❑
❑
Page# 3

Permit: NC0070459 Owner - Facility: Starmount High School WWTP '\
Inspection Date: 12/14/2016 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? N ❑ ❑ ❑
Are the receiving water free of foam other than trace amounts and other debris? M ❑ ❑ ❑
If effluent (diffuser pipes are required) are they operating properly? ❑ ❑ 0 ❑
Comment: None
Flow Measurement - Influent
Yes No NA NE
# Is flow meter used for reporting?
N
❑
❑
❑
Is flow meter calibrated annually?
❑
0
❑
❑
Is the flow meter operational?
®
❑
❑
❑
(if units are separated) Does the chart recorder match the flow meter?
❑
❑
0
❑
Comment: Water meter used.
Aerobic Digester
Yes No NA NE
Is the capacity adequate?
®
❑
❑
❑
Is the mixing adequate?
N
❑
❑
❑
Is the site free of excessive foaming in the tank?
N
❑
❑
❑
# Is the odor acceptable?
0
❑
❑
❑
# Is tankage available for properly waste sludge?
M
❑
❑
❑
Comment: None
Bar Screens
Yes No NA NE
Type of bar screen
a.Manual
b.Mechanical
❑
Are the bars adequately screening debris?
N
❑
❑
❑
Is the screen free of excessive debris?
0
❑
❑
❑
Is disposal of screening in compliance?
0
❑
❑
❑
Is the unit in good condition?
0
❑
❑
❑
Comment: None
Page# 4

Permit: N00070459 Owner -Facility:
Inspection Date: 12/14/2016 Inspection Type:
StarmountHigh School WWTP
Compliance Evaluation
Is the clarifier free of black and odorous wastewater?
S
❑
Equalization Basins
Yes No NA NE
Is the basin aerated?
N
❑
❑
❑
Is the basin free of bypass lines or structures to the natural environment?
0
❑
❑
❑
Is the basin free of excessive grease?
0
❑
❑
❑
Are all pumps present?
®
❑
❑
❑
Are all pumps operable?
0
❑
❑
❑
Are float controls operable?
N
❑
❑
❑
Are audible and visual alarms operable?
E
❑
❑
❑
# Is basin size/volume adequate?
N
❑
❑
❑
Comment: None
Secondary Clarifier
Yes No NA NE
Is the clarifier free of black and odorous wastewater?
S
❑
❑
❑
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?
N
❑
❑
❑
Is the site free of evidence of short-circuiting?
0 ❑
❑
❑
❑
Is scum removal adequate?
N
❑
❑
❑
Is the site free of excessive floating sludge?
0
❑
❑
❑
Is the drive unit operational?
❑
❑
E
❑
Is the return rate acceptable (low turbulence)?
®
❑
❑
❑
Is the overflow clear of excessive solids/pin floc?
N
❑
❑
❑
Is the sludge blanket level acceptable? (Approximately %4 of the sidewall depth)
❑
❑
❑
E
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?
. ❑
❑
❑
Is the foam the proper color for the treatment process?
0 ❑
❑
❑
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 WWTP
Inspection Date: 12/14/2016 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?
N
❑
❑
❑
Are UV bulbs clean?
E
❑
❑
❑
Is UV intensity adequate?
0
❑
❑
❑
Is transmittance at or above designed level?
N
❑
❑
❑
Is there a backup system on site?
0
❑
❑
❑
Is effluent clear and free of solids?
N
❑
❑
❑
Comment: None
Pumps -RAS -WAS
Yes No NA NE
Are pumps in place?
M
❑
❑
❑
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?
M
❑
❑
❑
Are all other parameters(excluding field parameters) performed by a certified lab?
N
❑
❑
❑
# Is the facility using a contract lab?
N
❑
❑
❑
# Is proper temperature set for sample storage (kept at less than or equal to 6.0 degrees
❑
❑
❑
E
Celsius)?
Incubator (Fecal Coliform) set to 44.5 degrees Celsius+/- 0.2 degrees?
❑
❑
❑
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?
❑
❑
E
❑
Is sample collected below all treatment units?
❑
❑
❑
Is proper volume collected?
❑
❑
❑
Is the tubing clean?
❑
❑
0
❑
Page# 6

Permit: NCO070459 Owner -Facility: Starmount High School WWTP
Inspection Date: 12/14/2016 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
Celsius)?
Is the facility sampling performed as required by the permit (frequency, sampling type ❑ ❑ ❑
representative)?
Comment: None
Page# 7