ncg551394_Compliance Evaluation Inspection_20220207

ROY COOPER
Governor
ELIZABETH S. BISER
Secretary
S. DANIEL SMITH
Director
Claudia Estrada
9228 Warren Road
Kernersville, NC 27284
NORTH CAROLINA
Environmental Quality
February 7, 2022
SUBJECT: Compliance Evaluation Inspection
Estrada Single Family Residence
9228 Warren Road
Permit #: NCG551394
Forsyth County
Dear Mr. & Mrs. Estrada:
On January 7, 2022, 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
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neoertmom of Envimnmomni au.i`
Sincerely,
DocuSigned by:
L-o, l Jn lAts
Lon" Sfi , egional 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

LD_E
NORTH CAROLINA
gapartmeM of Environmental quaky
North Carolina Department of Environmental Quality j 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 I
21I I I
Code NPDES yr/mo/day Inspection
2 IL I 3 I NCG551394 111 121 22/01/07 117
Type
181OI
I I I I I
Inspector Fac Type
19I S I 2011
I I I I I I I I I I I I I I I I I I I I I I I I I I
I I I
I I I 1 I P6
Inspection Work Days Facility Self -Monitoring Evaluation Rating B1 QA Reserved
671 I 70I I 711 172 I N I 73I I 74 71
I I
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)
9228 Warren Road
9238 Warren Rd
Kernersville NC 27284
Entry Time/Date
10:OOAM 22/01/07
Permit Effective Date
13/08/01
Exit Time/Date
10:30AM 22/01/07
Permit Expiration Date
18/07/31
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
Estrada Ugalde,57 Peach Grove Ct Kernersville NC 27284///
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
Management Q A Reviewer Agency/Office/Phone and Fax Numbers Date
FDocuSigned by:
L—o, T. SA,acr 2/7/2022
EPA Form 3560- ev uJJ44 FPrevious editions are obsolete.
Page# 1

31
NPDES yr/mo/day
NCG551394 111 121 22/01/07
I17
Inspection Type
18 [j
1
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
Ms. Estrada finally called me back and we were able to schedule a time to meet with her husband.
Met Mr. Estrada on January 7, 2022. The system is very well maintained. All components were
located except the discharge pipe. The system appeared to be operating properly without any
problems.
Page# 2

Permit: NCG551394
Inspection Date: 01/07/2022
Owner - Facility: 9228 Warren Road
Inspection Type: Compliance Evaluation
Other
Comment: See Summary
Yes No NA NE
Page# 3