NCG550490_Compliance Evaluation Inspection_20210930

United States Environmental Protection Agency
E PA Washington, D.C. 20460
Water Compliance Inspection Report
Form Approved.
OMB No. 2040-0057
Approval expires 8-31-98
Section A: National Data System Coding (i.e., PCS)
Transaction
1 IN
Code
I 2
IL
NPDES yr/mo/day Inspection Type Inspector Fac
I 3 I NCG550490 111 121 21/09/20 117 181OI 19I S I 2011
Type
21I
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I I
I
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I I I I I I
I I I
I
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I I
I I
I I I
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I I I I 1 I
P6
Inspection
671
Work Days
Facility Self -Monitoring
I 70I3
Evaluation Rating
I 711
B1
1
72
QA
I N I
73I
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Reserved
74 71
1
1 1
1
1
1
180
Section B: Facility Data
Name and Location of Facility Inspected (For Industrial Users discharging to POTW, also include
POTW name and NPDES oermit Number)
612 Frank Road
612 Frank Rd
Reidsville NC 27320
Entry Time/Date
02:25PM 21/09/20
Permit Effective Date
19/02/04
Exit Time/Date
03:OOPM 21/09/20
Permit Expiration Date
20/12/31
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
James L Brown,612 Frank Rd Reidsville NC 27320///
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
Alex Lowe DWR/WSRO WQ/336-776-9689/
Signature of Management Q A Reviewer Agency/Office/Phone and Fax Numbers Date
DocuSigned by:
10/19/2021
Lo, T. SA,�dcr
145B49E225C94EA...
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete.
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sI
NPDES yr/mo/day
N CG550490 111 121 21/09/20
117
Inspection Type
18 [j
(Cont.)
1
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
On Monday, September 20, 2021, Alex Lowe of the WSRO conducted an unnanounced routine
Compliance Evaluation Inspection at 612 Frank Road. Permittee Mr. James Brown was present for
the inspection. Mr. Brown was stated that he was able to provide a copy of his permit and proof of the
latest servicing of his wastewater system. However, since this was an unannounced visit with time
constraints, Lowe decided to prioritize seeeing system operation (pumping records were later
obtained from Billingsley Septic, and a copy of the most recent permit was sent with inspection letter
for Mr. Brown's records).
Chlorination tablets were observed to be of the proper variety, and were being replaced about every
two months into two contact chamber tubes. Several tablets were observed in the tubes at the time of
inspection.
Mr. Brown stated that he had sampled effluent in the past, but did not believe it had been completed
in the past year. Lowe encouraged Mr. Brown to complete testing soon to comply with permit
expectations, and offered to include a list of certified laboratories in his area (see attached).
Mr. Brown led Lowe to the outfall about a quarter mile from the home through a wooded area. No
effluent was observed exiting the pipe, though the soil at the edge of the outfall showed signed of
recent discharge. No solids buildup were observed.
This system appears to be in good order. To fulfill compliance expectations, Mr. Brown must only
complete an up-to-date annual sampling of effluent and retain a copy of the results.
Page# 2

Permit: NCG550490
Inspection Date: 09/20/2021
Owner - Facility: 612 Frank Road
Inspection Type: Compliance Evaluation
Other
Comment:
Yes No NA NE
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