NC0078271_Renewal (Application)_20170110

ANEW 1•1•16
Bets - :e � enn
- 4-H Educational Center
804 Cedar Lane•• Reidsville,N.C. 27320• [phone]• FAX [phone]
• Wren Thedford
NC DENR / DWR /NPDES Unit
1617 Mail Service Center
Raleigh,NC 27699-1617
RECEIVEDINCDEQIDWR
RE: Permit # NC0078271 JAN 1 0 2017
,Water Quality •
01-04-17 • Permitting section
To Whom It May Concern:
We are requesting renewal of the permit
There have been no changes since our last renewal. ,
Please find enclosed Application Form D..
Thank You'', .
effery Jo nson
Facilities Maintenance Supervisor _
Betsy-Jeff Penn 4-.H Educational.Center - .`
804 Cedar Lane Reidsville, NC 27320
Cooperative Extension Service,North Carolina State University,College of Agriculture and Life Sciences

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 1 NPDES Unit
1617 Mail Service Center,Raleigh, NC 27699-1617
NPDES Permit NCOO
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 North Carolina State University
Facility Name Betsy-Jeff Penn 4-H Center
Mailing Address 804 Cedar Lane
City Reidsville
State/Zip Code NC/27320
Telephone Number ( 336 349-9445
Fax Number ( 336 ) 634-0110
e-mail Address [e-mail]
2. Location of facility producing discharge:
Check here if same address as above Q
Street Address or State Road
City
State/Zip Code
County
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 Betsy-Jeff Penn 4-H Educational Center
Mailing Address 804 Cedar Lane
City Reidsville
State/Zip Code NC/27320
Telephone Number (336 ) 349-9445
Fax Number (336 ) 634-0110
e-mail Address [e-mail]
1 of3 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 El Number of Employees
Residential El Number of Homes
School ❑ Number of Students/Staff
Other ® Explain: Camp/Staff 19
Describe the source(s)of wastewater(example: subdivision, mobile home park, shopping centers, restaurants,
etc.): 8 Cabins that sleep 26 each,staff house that sleeps 9,Directors house that sleeps 4,the kitchen and main bath he
Number of persons served: 175 average
5. Type of collection system
LX 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 113N°
7. Name of receiving stream(s) (NEW applicants:Provide a map showing the exact location of each outfall):
Carroll Creek
8. Frequency of Discharge: ❑ Continuous 171 Intermittent
If intermittent:
Days per week discharge occurs: 7 Duration: Based on float controlled pump
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.
See Attached
2 of 3 Form-D 11/12

NPDES APPLICATION - FORM D
For privately-owned treatment systems treating 100%domestic wastewaters<1.0 MGD
10. Flow Information:
Treatment Plant Design flow 0.0131MGD
Annual Average daily flow .0024 MOD (for the previous 3 years)
Maximum daily flow .0078 MOD(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 otherparameters"N/A".
Parameter Daily Monthly Units of
Maximum Average Measurement
Biochemical Oxygen Demand (BODS) 7.7 1.8 Mg/L
Fecal Coliform 5.2 1 100mI
Total Suspended Solids 6.7 2.4 Mg/L
Temperature(Summer) 32 25 Celsius
Temperature(Winter) 20 13.1 Celsius
pH 8.1 6.5 Stsnderd 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 NC0078271 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.
Jeffery Johnson Facilities Maintenance Supervisior
Printed name of Person Si•ning Title
-
January 4 2017
Si I t. .f :. i Date
N� h Carolina Gene- tatute 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

System Description
Betsy Jeff Penn 4-H Educational Center
NPDES PERMIT No. NC 0078271
The influent enters the plant at a 13,000 gallon septic tank were most of the solids settle out.
From there it passes through a baffle wall into a filter chamber,there are two Polylok PL-525
effluent filters in the chamber. From there it flows into the first of two 8100 gallon
septic/recirculation tanks. Each tank has a pair of Polylok PL-525 effluent filters. After exiting
the second 8100 gallon Septic/recirculation tank it flows into a 8100 gallon filter dosing pump
tank. Up to this point every thing has been gravity feed.
The dossing pump tank has 3 sets of submersible duplex turbine pumps rated @ 52 gallons per
minute. Each set of pumps operates a zone of E-Z treat Pods, and each set is controlled by a
float level switches and a timer that controls the dossing time for each E-Z treat pod:The
pumps in each set alternate after each cycle of 4 minutes on 2 minutes off.There is a low limit
float that shuts off the pumps in case of low level conditions, and high level float that sets off
the alarm and flashing lights at the control panel.
The E-Z treat pods are 7feet 9inch square and 34 in deep,they contain a lightweight, non-
biodegradable synthetic sphere in three different diameters encapsulated in a mattress 7%feet
square by 2 feet thick. Each pod has a spray manifold system containing 12-.0625 diameter
brass nozzles that maintains a consistent misting spray.The effluent flows through the mattress
coming in contact with the media as it exits the mattress. It flows through 7 large 4 inch under
drains, and then flows to the recirculation tank to start the cycle over again.
There are three zones of pods. Zone one and two have eight, E-Z treat treatment pods, and
zone three has four E-Z treat treatment pods. 2/3 of the influent from each zone is returned to
the first septic/recirculation tank were it returns through the system again.The other 3rd is
sent back to the pump tank through a cross over ball float valve at which time it returns to the
pump tank for recirculation through the system.When the effluent level in the pump tank
reaches an elevation of 671.07'the ball valve closes and the effluent is sent to the discharge
tank.
The control panel contains three set of Ohio Electric electronic panels.This is a 120/240 volt
200 amp system with a heavy duty transfer switch for back up generation.There is a 15000
watt Guardian Ultra Source generator on site for emergency stand by.This is all protected by a
weather proof shelter.

The discharge tank is a1350 gallon tank with one 60 gallon per minute pump controlled by a
float switch and timer. This tank also has a high level float that if activated will set off a alarm
and flashing light at the control panel.The flow meter for the system is in this tank. It is a 2"
brass ABB T3000 cold water turbine meter numerical display.
Once the float is activated in the discharge tank the effluent goes through a SIM/TECH STF-
104/600 micron poly-knit filter sock,from here it enters the Trojan UV2000 ultraviolet
disinfection system.The discharge from the UV system goes into a 2'X2' catch basin and down a
4"schedule 40 PVC pipe to Carroll Creek.
The Betsy-Jeff Penn 4-H Educational Center has a NPDES permit that allows treated wastewater
from the camp to be discharged into Carroll Creek.The current permit, number NC0078271,
allows a maximum discharge of 13100 gallons per day and has the following limits on the
quality of the discharge.
Item Monthly Average Limits Daily Maximum Limits
BOD 30.0 mg/L 45.0 mg/L
TSS 30.0 NA
NH3 as N 12.0 mg/L 35.0 mg/L
Fecal Coliform 200/100 ml 400/100mI
PH not less than 6.0 nor greater than 9.0

Design Removal System influent Septic Tank Effluent E-Z Treat Treatment System Permitted
Concentration Percent Concentration Percent Concentration Monthly
Characteristic (mg/l-) Removal (mg/-) Removal (mg/L) Average(mg/L)
BOD5 250 40% 150 80% 30 30
TSS 250 40% 150 80% 30 30
Nitrogen 40 • 5% 38 65% 13.3 N/A
Phosphorous 11 10% 9.9 0% 9.9 N/A

Sludge Management Plan
The Betsy-Jeff Penn 4-H Education Center NPDES Permit # NC0078271 currently contracts with
Billingsley Septic Tank Company located in Reidsville NC,to have our tanks pump once a year to remove
solids and sludge. This is normally done during the winter months when our system sees the least
amount of influent.