NCG550650_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
21IIIIII
Inspection
671
Code NPDES yr/mo/day Inspection
IN I 2 IL I 3 I NCG550650 111 121 21/09/30 117
Type
1810I
IIIIIIIIIII
Inspector Fac Type
19I S I 2011
IIIIIIIIIII IIIIIII I IIIIII
P6
Work Days Facility Self -Monitoring Evaluation Rating B1 QA Reserved
I 70I I 711 172 I N I 73I 1 74 71
I I
I I I I I I 180
Section B: Facility Data
Name and Location of Facility Inspected (For Industrial Users discharging to POTW, also include
POTW name and NPDES Dermit Number)
133 Glen Meadow Drive
133 Glen Meadow Dr
Reidsville NC 27320
Entry Time/Date
12:45AM 21/09/30
Permit Effective Date
20/04/07
Exit Time/Date
01:05PM 21/09/30
Permit Expiration Date
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
Jeffrey Lynn Edwards,133 Glen Meadow Dr 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: 1Loti 10/19/2021
T. SA,ae...
145B49E225C94EA...
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete.
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3I
NPDES yr/mo/day
N CG550650 111 121 21/09/30
117
Inspection Type
18 [j
(Cont.)
1
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
On Thursday, September 30, 2021, Alex Lowe of the WSRO conducted an unscheduled compliance
evaluation of the permitted septic system at 133 Glen Meadow Drive in Reidsville. Mrs. Edwards
stated that the system was pumped and the tank lid was replaced in late spring or early summer of
2020, but did not have the proof of service readily available. Service was later confirmed through
Billingsley Septic Services (see attached invoice).
Mrs. Edwards stated that testing was conducted yearly with Dan River Water, Inc. of Welcome, NC,
which her husband coordinates.
Chlorine tablets were confirmed to be of wastewater grade, and contact tubes were filled at the time
of inspection.
Mrs. Edwards expressed concern about the home two doors down (157 Glen Meadow), stating that
they have in the past smelled sewage there, and believe the system may be leaking or overflowing.
Lowe followed up on the same day, but was unable to get a response at the door. A follow-up to this
visit will be conducted.
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Permit: NCG550650
Inspection Date: 09/30/2021
Owner - Facility: 133 Glen Meadow Drive
Inspection Type: Compliance Evaluation
Other
Comment:
Yes No NA NE
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