NC0031607_Renewal (Application)_20160126

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NPDES APPLICATION - FORM D
For privately-owned treatment systems treating 100% domestic wastewaters <1.0 MGD
Mail the complete application to:
N. C. DENR / Division of Water Quality / NPDES Unit
1617 Mail Service Center, Raleigh, NC 27699-1617
NPDES Permit INC0031607
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 Alamance-Burlington School System
Facility Name Western Alamance Middle School WWTP
Mailing Address 1732 Vaughn Road
City Burlington
State / Zip Code NC / 27217 RECEIVEDINCDEGUDWR
Telephone Number [phone] JAN 26 2016
Fax Number [phone] Water Quality
Pei Section
e-mail Address jay_fullerCuabss.k12.nc.us
2. Location of facility producing discharge:
Check here if same address as above ❑
Street Address or State Road 2100 Eldon Drive
City Elon
State / Zip Code NC / 27244
County Alamance
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 Research 8s Analytical Laboratories, Inc.
Mailing Address 106 Short Street
City Kernersville
State / Zip Code NC / 27284
Telephone Number [phone]
Fax Number [phone]
e-mail Address [e-mail]
1 of 3 Form-D 11/12

NPDES APPLICATION - FORM D
For privately-owned treatment systems treating 100% domestic wastewaters <1.0 MGD
4. Description of wastewater:
Facility Generating Wastewater(check all that apply):
Industrial ❑ Number of Employees
Commercial ❑ Number of Employees
Residential 0 Number of Homes
School ® Number of Students/Staff 882 / 80
Other ❑ Explain:
Describe the source(s) of wastewater (example: subdivision, mobile home park, shopping centers,
restaurants, etc.):
Middle School
Number of persons served:
5. Type of collection system
® Separate (sanitary sewer only) ❑ Combined (storm sewer and sanitary sewer)
6. Outfall Information:
Number of separate discharge points 1
Outfall Identification number(s) 001
Is the outfall equipped with a diffuser? ❑ Yes Z No
7. Name of receiving stream(s) (NEW applicants:Provide a map showing the exact location of each
outfall):
Haw River
8. Frequency of Discharge: 0 Continuous ® Intermittent
If intermittent:
Days per week discharge occurs: 5 Duration:
9. Describe the treatment system
List all installed components, including capacities,provide design removal for BOD, TSS, nitrogen and
phosphorus. If the space provided is not sufficient, attach the description of the treatment system in a
separate sheet of paper.
*0.015 MGD wastewater treatment system
*Two bar screens
*Flow equalization chamber
*Two activated sludge holding tanks
*Two aeration chambers
*Two clarifiers
*Dosing Tank
*W Disinfection
2 of 3 Form-011112

• NPDES APPLICATION - FORM D
For privately-owned treatment systems treating 100% domestic wastewaters <1.0 MGD
10. Flow Information:
Treatment Plant Design flow 0.015 MGD
Annual Average daily flow 0.0031 MGD (for the previous 3 years)
Maximum daily flow 0.0128 MGD (for the previous 3 years)
11. Is this facility located on Indian country?
❑ Yes ® No
12. Effluent Data
NEW APPLICANTS:Provide data for the parameters listed. Fecal Coliform, Temperature and pH shall be grab
samples,for all other parameters 24-hour composite sampling shall be used.If more than one analysis is reported,
report daily maximum and monthly average.If only one analysis is reported, report as daily maximum.
RENEWAL APPLICANTS: Provide the highest single reading(Daily Maximum)and Monthly Average over
the past 36 months for parameters currently in your permit. Mark other parameters 'N/A'.
Parameter Daily Monthly Units of
Maximum Average Measurement
Biochemical Oxygen Demand (BODS) 29.2 7.69 Mg/1
Fecal Coliform 180 16 Col/100 ml
Total Suspended Solids 18 4.52 Mg/1
Temperature (Summer) 26 22.8 °C
Temperature (Winter) 19 12.8 °C
pH 7.4 6.80 Std. Units
13. List all permits, construction approvals and/or applications:
Type Permit Number Type Permit Number
Hazardous Waste (RCRA) NESHAPS(CAA)
UIC(SDWA) Ocean Dumping(MPRSA)
NPDES NC0031607 Dredge or fill (Section 404 or CWA)
PSD (CAA) Other
Non-attainment program (CAA)
14. APPLICANT CERTIFICATION
I certify that I am familiar with the information contained in the application and that to the
best of my knowledge and belief such information is true, complete, and accurate.
r✓4 SC ?/-. 4 V ' T K��L1'� D 'n 2 c't7 A�'i Ji fi 1t f ofN' / /1iN •70t,4✓e
Printed fame of Person Signing Title
if • /244,...
Si ature of Applicant Date
North Carolina General Statute 143-215.6(b)(2) states: Any person who knowingly makes any false statement representation, or certification in any
application,record,report,plan,or other document files or required to be maintained under Article 21 or regulations of the Environmental Management
Commission implementing that Article, or who falsifies, tampers with, or knowingly renders inaccurate any recording or monitoring device or method
required to be operated or maintained under Article 21 or regulations of the Environmental Management Commission implementing that Article,shall be
guilty of a misdemeanor punishable by a fine not to exceed$25,000,or by imprisonment not to exceed six months,or by both. (18 U.S.C.Section 1001
provides a punishment by a fine of not more than$25,000 or imprisonment not more than 5 years,or both,for a similar offense.)
3 of 3 Form-D 11/12

PAT MCCRORY
•
f,1
Governor
iv
DONALD R. VAN DER VAART
Seclelm3
Water Resources S. JAY ZIMMERMAN
ENVIRONMENTAL QUALITY
February 1,2016
Joseph W. Fuller
Alamance-Burlington School System
1732 Vaughn Road
Burlington,NC 27217
Subject: Acknowledgement of Permit Renewal
Application No.NC0031607
Western Alamance Middle School
Alamance County
Dear Permittee:
The Water Quality Permitting Section has received your permit renewal application on January 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].
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Sincerely,
W reAvv Tin.20 ob
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Wren Thedford
Wastewater Branch
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cc: Central Files
Winston-Salem Regional Office, Water Quality Regional Operations Section
'=NPDES Unit
State of North Carolina I Environmental Quality I Water Resources
1617 Mail Service Center I Raleigh,North Carolina 27699-1617
919-807-6300
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