NCG550231_Compliance Evaluation Inspection_20201201

ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
S. DANIEL SMITH
Director
Mrs. Betty Davis
5852 Robbins Country Road
Trinity, NC 27370
NORTH CAROLINA
Environmental Quality
December 1, 2020
Subject: General Wastewater Permit Inspection
5852 Robbins Country Road
Certificate of Coverage # NCG550231
Randolph County
Dear Mrs. Davis:
On October 21, 2020, Gary Hudson of this office performed a Compliance Evaluation
Inspection on the wastewater treatment system at 5852 Robbins Country Road in Trinity,
NC. Observations indicated that the subsurface sand filter was operating properly. There
was no evidence of a discharge during the inspection. Please note some of the activities
that must be conducted and documented, in addition to the laboratory analyses required if
the system discharges:
Please be aware that the Permit requires that the septic tank contents be pumped
out every five years to prevent solids from clogging the sandfilter system.
The tablet chlorinator should be inspected weekly to ensure there is an adequate
supply of tablets for continuous operation. Be sure to order more tablets and
replace them often enough to ensure continuous disinfection.
If you have any questions concerning this letter, please contact Gary Hudson at (336)
776-9694.
Sincerely,
Docu&ggned by
��. l
06i'8?ira geE'Regional Supervisor
Water Quality Regional Operations
Division of Water Resources
cc: Laserfiche
D � North Carolina Department of Environmental Quality I Division of Water Resources
Winston-Salem Regional Office [ 450 West Hanes Mill Road, Suite 300 I Winston-Salem, North Carolina 27105
NOh r H CAROI.IN/+
^^ •^^ma^� u�•i` r 336.776.9800

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 2 u 3 I NCG550231 111 121 20/10/21 I17 18 I C I 19 I s I 20L]
21111I I I I I I I II I I I I I I I I I I I I I I I I I I I I I I I II I I I I I r6
Inspection
Work Days Facility Self -Monitoring Evaluation Rating B1 QA ---------------------- Reserved -------------------
67
I 72 I ni I 73 � I 74 79 I I I I I I I80
70 I I 71 I LL -1 I I
LJ
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 Dermit Number)
10:OOAM 20/10/21
19/06/25
5852 Robbins Country Road
5852 Robbins Country Rd
Exit Time/Date
Permit Expiration Date
Trinity NC 27370
10:30AM 20/10/21
20/10/31
Name(s) of Onsite Representative(s)/Titles(s)/Phone and Fax Number(s)
Other Facility Data
Name, Address of Responsible Official/Title/Phone and Fax Number
Contacted
Donald L Davis,5852 Robbins Country Rd Trinity NC 27370//336-431-5605/
No
Section C: Areas Evaluated During Inspection (Check only those areas evaluated)
Other
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
Gary Hudson DWR/Division of Water Qua Iity/336-776-9694/
Signature of Management Q A Reviewer Agency/Office/Phone and Fax Numbers Date
DocuSiiggned by: 12/1/2020
"- 145B49E225C94EA...
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete.
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NPDES yr/mo/day Inspection Type
NCG550231 I11 12I 20/10/21 117 18 i c i
(Cont.)
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
Mrs. Betty Davis
5852 Robbins Country Road
Trinity, NC 27370
Subject: General Wastewater Permit Inspection
5852 Robbins Country Road
Certificate of Coverage # NCG550231
Randolph County
Dear Mrs. Davis:
On October 21, 2020, Gary Hudson of this office performed a Compliance Evaluation Inspection on the
wastewater treatment system at 5852 Robbins Country Road in Trinity, NC. Observations indicated
that the subsurface sand filter was operating properly. There was no evidence of a discharge during
the inspection. Please note some of the activities that must be conducted and documented, in addition
to the laboratory analyses required if the system discharges:
• Please be aware that the Permit requires that the septic tank contents be pumped out every five
years to prevent solids from clogging the sandfilter system.
• The tablet chlorinator should be inspected weekly to ensure there is an adequate supply of tablets
for continuous operation. Be sure to order more tablets and replace them often enough to ensure
continuous disinfection.
Page#

Permit: NCG550231
Inspection Date: 10/21/2020
Other
Comment:
Owner -Facility: 5852 Robbins Country Road
Inspection Type: Compliance Evaluation
Yes No NA NE
Page#