NCG551142_Compliance Evaluation Inspection_20211217

ROY COOPER
Governor
ELIZABETH S. BISER
Secretary
S. DANIEL SMITH
Director
Filomena Wampler
2632 Wessex Road
Winston-Salem, NC 27106
NORTH CAROLINA
Environmental Quality
December 17, 2021
SUBJECT: Compliance Evaluation Inspection
Wampler Single Family Residence
2632 Wessex Road
Permit #: NCG551142
Forsyth County
Dear Ms. Wampler:
On December 9, 2021, Gary Hudson of this office performed a Compliance Evaluation
Inspection on the wastewater treatment system referenced above. 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.
cc: Laserfiche
NORTH
D E
Department of Envimnmomni au.i`
Sincerely,
,-DocuSigned by:c
t . l . JnAc{Cr
'-145B49E225C94EA..
Lon Snider, Regional Supervisor
Water Quality Regional Operations
Division of Water Resources
North Carolina Department of Environmental Quality Division of Water Resources
Winston-Salem Regional Office 1450 West Hanes Mill Road, Suite 300 I Winston-Salem, North Carolina 27105
336.776.9800

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
21IIIIII
Code NPDES yr/mo/day Inspection
I 2 IL I 3 I NCG551142 111 121 21/12/09 117
Type
1810I
IIIIIIIIIII
Inspector Fac Type
19I S I 2011
IIIIIIIIIII IIIIIII I IIIIII
P6
Inspection Work Days Facility Self -Monitoring Evaluation Rating B1 QA Reserved
671 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 permit Number)
2632 Wessex Rd
2632 Wessex Rd
Winston Salem NC 27106
Entry Time/Date
10:OOAM 21/12/09
Permit Effective Date
20/08/14
Exit Time/Date
10:30AM 21/12/09
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
Filomena M Wampler,2632 Wessex Rd Winston Salem NC 27106///
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 Quality/336-776-9694/
Signature
of anagement Q A Reviewer Agency/Office/Phone and Fax Numbers Date
DoMcusigned by:
ri._0, 'r, 5,,,,k- 12/17/2021
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete.
Page# 1

sI
NPDES yr/mo/day
N CG551142 111 121 21/12/09
I17
Inspection Type
18 [j
1
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
*Met with Mr. Wampler (homeowner) on site.
*The SFR wastewater system appeared to be operating properly.
*The only components that were located was the aerial line crossing the creek and the septic tank lid.
Page# 2

Permit: NCG551142
Inspection Date: 12/09/2021
Owner - Facility: 2632 Wessex Rd
Inspection Type: Compliance Evaluation
Other
Comment: See Summary
Yes No NA NE
Page# 3