NC0033553_Renewal Application_20180131

Dater Resources
ENVIROMMENTAL QUALITY
January 31, 2018
Aaron Greene, Superintendent
Polk County Board of Education
PO Box 638
Columbus, NC 28722
Subject: Permit Renewal
Application No. NCO033553
Polk Central School
Polk County
Dear Applicant:
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The Water Quality Permitting Section acknowledges the January 31, 2018 receipt of your permit renewal application and
supporting documentation. Your application will be assigned to a permit writer within the Section's NPDES WW
permitting branch. 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.
The permit writer will contact you if additional information is required to complete your permit renewal. Please respond
in a timely manner to requests for additional information necessary to allow a complete review of the application and
renewal of the permit.
Information regarding the status of your renewal application can be found online using the Department of Environmental
Quality's Environmental Application Tracker at:
https•//deq nc gov/permits-regulations/permit-guidance/environmental-application-tracker
If you have any additional questions about the permit, please contact the primary reviewer of the application using the
links available within the Application Tracker.
Sincerely,
'5�" �'AA
Wren Thedford
Administrative Assistant
Water Quality Permitting Section
cc: Central Files w/application(ARO)
ec: WQPS Laserfiche File w/application
State of North Carolina I Environmental Quality I Water Resources
1617 Mail Service Center I Raleigh, North Carolina 27699-1617
919-807-6300

NPDES APPLICATION - FORM D
For privately -owned treatment systems treating 100% domestic wastewaters <1.0 MGD
Mail the complete application to:
N. C. DEQ / DWR / NPDES
1617 Mail Service Center, Raleigh, NC 27699-1617
NPDES Permit #CO033553
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
Polk County Schools
Facility Name
Polk Central Elementary School
Mailing Address
P.O. Box 638
City
Columbus
State / Zip Code
NC 28722
Telephone Number
[phone]
Fax Number
[phone]
e-mail Address
[e-mail]
2. Location of facility producing discharge:
Check here if same address as above ❑
Street Address or State Road 2141 South NC 108 Hwy
City Mill Spring
State / Zip Code NC 28756
County Polk
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 Clearwater Services
Mailing Address 2253 East NC 108 Hwy
City Columbus
State / Zip Code NC 28722
Telephone Number [phone]
Fax Number [phone]
e-mail Address [e-mail]
1 of 3 Form -D 6/2017

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
❑
Number of Homes
School
X
Number of Students/ Staff 371/57
Other
❑
Explain:
Describe the source(s) of wastewater (example: subdivision, mobile home park, shopping centers,
restaurants, etc.):
Number of persons served:
5. Type of collection system
® Separate (sanitary sewer only)
6. Outfall Information:
❑ Combined (storm sewer and sanitary sewer)
Number of separate discharge points 1
Outfall Identification number(s) 001
Is the outfall equipped with a diffuser? ❑ Yes ❑ No
7. Name of receiving stream(s) (NEW applicants: Provide a map showing the exact location of each
outfall):
South Branch Little White Oak Creek
S. Frequency of Discharge: ❑ Continuous ® Intermittent
If intermittent:
Days per week discharge occurs: 5 Duration: 6 to 8 hours daily
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.
0.01 MGD wastewater treatment facility
3000 -gallon grease interceptor adjacent to the cafeteria with a 3000 GPD effluent filter
11, 000 -gallon septic tank
3000 -gallon dosing tank with duplex alternating siphon (3000 gallons per dose)
1500 -gallon tank with a 5000 GPD effluent filter
3200 ft2 surface sand filter with low pressure distribution
Tablet chlorinator
5000 -gallon chlorine contact chamber
Tablet dechlorinator
2 of 3 Form -D 6/2017

NPDES APPLICATION - FORM D
For privately -owned treatment systems treating 100% domestic wastewaters <1.0 MGD
10. Flow Information:
Treatment Plant Design flow 0.010 MGD
Annual Average daily flow 0.00521 MGD (for the previous 3 years)
Maximum daily flow 0.00766 MGD (for the previous 3 years)
11. Is this facility located on Indian country?
❑ Yes B 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: Proinde 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
Maximum
Monthly
Average
Units of
Measurement
Biochemical Oxygen Demand (BODS)
16
6.8
mg/L
Fecal Coliform
54
4
mL
Total Suspended Solids
9.9
5.8
mg/L
Temperature (Summer)
24
23
°C
Temperature (Winter)
22
16
°C
pH
7.2
6.4
S.U.
13. List all permits, construction approvals and/or applications:
Type Permit Number Type
Hazardous Waste (RCRA)
UIC (SDWA)
NPDES
PSD (CAA)
Non -attainment program (CAA)
NCO033553
14. APPLICANT CERTIFICATION
NESHAPS (CAA)
Ocean Dumping (MPRSA)
Dredge or fill (Secton 404 or CWA)
Other
Permit Number
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.
Deborah Bradley ORC
Printed name of Person Signing Title
Applicant ✓J 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 6/2017