NC0029602_Renewal Application_20180522

ROY COOPER
Governor
%.;
MICHAEL S.REGAN
Secretroy
Water Resources LENDA CULPEPPER
ENVIRONMENTAL QLDAUTY interim Director
June 04, 2018
Mitchell Long, ORC
Yadkin County Board of Education
121 Washington St
Yadkinville, NC 27055-7725
Subject: Permit Renewal
Application No. NC0029602
Forbush Elementary School IA/X(1/TP
Yadkin County
Dear Applicant:
The Water Quality Permitting Section acknowledges the May 22, 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:
haps://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,
Wren Thedford
Administrative Assistant
Water Quality Permitting Section
ec: WQPS Laserfiche File w/application(WSRO)
State of North Carolina I Environmental Quality I Water Resources
1617 Mail Service Center I Raleigh,North Carolina 27699-1617
919-807-6300

Yadkin County Board of Education
Renewal request for discharge wastewater
treatment facility:
RECEAVED/DENR/DWR
MAY 222018
Water Resources
Permitting Section
Forbush Elementary School WWTP
1400 Bloomtown Road,
East Bend, NC 27018
Permit # NC0029602

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 NCO()
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 Yadkin County Board of Education
Facility Name Forbush Elementary School
Mailing Address 121 Washington Street
City Yadkinville
State / Zip Code NC, 27055
Telephone Number 336-679-2051
Fax Number ( )
e-mail Address [e-mail]
2. Location of facility producing discharge:
Check here if same address as above ❑
Street Address or State Road 1400 Bloomtown Road
City East Bend
State / Zip Code NC, 27018
County Yadkin
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 Yadkin County Board of Education
Mailing Address 121 Washington Street
City Yadkinville
State / Zip Code NC, 27055
Telephone Number 336-679-2051
Fax Number ( )
e-mail Address [e-mail]
1 of 4 Form-D 612017

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 302
Other ❑ Explain:
Describe the source(s) of wastewater(example: subdivision, mobile home park, shopping centers,
restaurants, etc.): Elementary School
Number of persons served: 302
5. Type of collection system
x 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? 0 Yes x No
7. Name of receiving stream(s) (NEW applicants:Provide a map showing the exact location of each
•outfall):
Logan Creek
8. Frequency of Discharge: 0 Continuous x Intermittent
If intermittent:
Days per week discharge occurs_ 5 Duration: 16.6 hrs per day
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.
Equalization basin
Bar screen
Dual aeration basins
Dual clarifiers
Chlorination/dechlorination chambers for backup.
Ultraviolet disinfection system
Dual sludge holding tanks
Flow recording device
2 of 4 Form-D 612017

•
NPDES APPLICATION - FORM D
For privately-owned treatment systems treating 100%domestic wastewaters <1.0 MGD
10. Flow Information:
Treatment Plant Design flow 0.006 MGD
Annual Average daily flow 0.003 MGD (for the previous 3 years)
Maximum daily flow 0.003 MGD (for the previous 3 years)
11. Is this facility located on Indian country?
❑ Yes x 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) 26.03 17.05 mg/L
Fecal Coliform 2420 180.25 col/100m1
Total Suspended Solids 34.5 23.8 mg/L
Temperature (Summer) N/A N/A N/A
Temperature (Winter) 26.8 25.75 deg celsius
•
pH 8.0 ( 8.0 standard
13. List all permits, construction approvals and/or applications:
Permit Permit
Type TypNumber
e Number
Hazardous Waste (RCRA) NESHAPS (CAA)
UIC (SDWA) Ocean Dumping(MPRSA)
NPDES NC0029602 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.
Printed name of Person Signing: Mitchell Thomas Long Title: ORC
Signature of Applicant ive 7 i4€a3- Ao•ti3 Date $/i I/l 8'
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.)
4 of 4 Form-D 6/2017

Sludge Management Plan
All sludge generated during our wastewater
treatment facility operations is disposed of
through :
Lentz Septic Tank Service
418 Lentz Road, Statesville,
North Carolina 28625