NCG550853_Compliance Evaluation Inspection_20220707

DocuSign Envelope ID: C75A7E57-7F32-4B2D-B84F-B223CFC5BE8E
ROY COOPER
Governor
ELIZABETH S. BISER
Secretary
RICHARD E. ROGERS, JR.
Director
Jerome Thomas
908 Gum Springs Church Road
Moncure NC 27559
NORTH CAROLINA
Environmental Quality
July 7, 2022
Subject: Compliance Evaluation Inspection
Single Family Wastewater Treatment System
NPDES General Permit NCG550000
Certificate of Coverage NCG550853
Facility Name: 908 Gum Springs Church Road
Chatham County
Dear Mr. Thomas:
On March 30, 2022, Cheng Zhang from the Raleigh Regional Office visited your single-family
residence (SFR) wastewater treatment system to evaluate compliance with the subject General NPDES
Permit. Your assistance during the inspection was greatly appreciated.
Our records indicate the treatment system consists of a septic tank, one -pass sand filter, chlorinator, and
discharge pipe.
General NPDES Permit NCG550000 and Certificate of Coverage (COC) NCG550853 authorize the
discharge of domestic wastewater from your treatment system to receiving waters designated as
unnamed tributary to Robeson Creek (classified WS-IV, NSW, and CA waters) in the Cape Fear River
Basin. The authorized discharge is in accordance with the effluent limits and monitoring requirements
established within the General Permit. The items below show what conditions were noted at your
facility:
Findings during the inspection were as follows:
1. Treatment system operation: The wastewater treatment system shall be maintained at all times
to prevent seepage of sewage to the surface of the ground. The system was found maintained
properly and discharging at the time of inspection.
2. Pumping the septic tank: You are required to inspect the septic tank at least yearly to determine
if solids must be removed or if other maintenance is necessary. Septic tanks should be pumped
out every five years or when the solids level is found to be more than 1/3 of the liquid depth in
the septic tank compartment, whichever is greater. The septic tank was last pumped on October
7, 2019. The General NPDES Permit requires the permittee to retain records associated with
sewage disposal activities for a period of at least 5 years.
3. Chlorine tablets in the chlorinator: You are reminded that it is required that chlorine tablets be
maintained in the chlorinator to ensure proper disinfection of the discharged wastewater.
Chlorine tablets provide effective disinfection and prevent/limit harmful bacteria from
D_E QNORTH CAROLINA
DeperhneM of Environmental Oual�
North Carolina Department of Environmental Quality I Division of Water Resources
Raleigh Regional Office I 3800 Barrett Drive I Raleigh, North Carolina 27609
919.791.4200

DocuSign Envelope ID: C75A7E57-7F32-4B2D-B84F-B223CFC5BE8E
James Thomas, NCG551256
Page 2 of 3
discharging to the environment. The product label for these tablets must indicate the tablets
are approved for wastewater use and not for swimminji pools. Part 1, Section D (1) of General
NPDES Permit NCG550000 requires the permittee to inspect the tablet chlorinator weekly to
ensure there is an adequate supply of tablets for continuous and proper operation. Section D (4)
requires the permittee to maintain all system components, including...disinfection units...at all
times and in good operating order. The inspector observed chlorine tablets in the chlorinator
and noted that you had a supply of correct chlorine tablets stored on site. Please ensure the
correct type of tablets are used and maintained in the chlorinator as required by the General
NPDES Permit when the treatment system resumes operation.
4. Analyzing the effluent: Part 1. C., Effluent Limitations and Monitoring Requirements, within
General Permit NCG550000 requires a permittee to sample and analyze the effluent leaving
his/her treatment system prior to discharge annually. Parameters to be sampled and analyzed
include Flow, BOD (Biochemical Oxygen Demand), Total Suspended Solids, Fecal Coliform and
Total Residual Chlorine, additional parameters (Total Nitrogen, Total Phosphorous, and
Ammonia Nitrogen) were added to the current NPDES General Permit NCG550000, which
became effective November 1, 2020 for Freshwater Discharges to High Quality Waters (HQW)
and Nutrient Sensitive Waters (NSW) (including Water Supply Waters (WS-II, WS-III, WS-IV,
and WS-V). During the inspection, you provided effluent sampling report for 2020 and
2021, all parameters were found within the permit limit Please be reminded that
parameters (Total Nitrogen, Total Phosphorous, and Ammonia Nitrogen) were added to
the current NPDES General Permit NCG550000, which became effective November 1,
2020.
5. Discharge outlet location. The permittee is required to conduct a visual review of the outfall
location at least twice each year (one at the time of sampling) to ensure that no visible solids or
other obvious evidence of system malfunctioning is observed. Any visible signs of a
malfunctioning system shall be documented and steps taken to correct the problem. The
discharge pipe was visible and accessible the day of the inspection. Solids were observed
around the discharge point and in the contact chamber, please remove solids from the
contact chamber. Please continue to ensure the outlet is always visible/maintained and
cleared of vegetation, soil and leaves.
6. Part II Section B.14 of General Permit NCG550000 requires the permittee to "pay the annual
administering and compliance monitoring fee within thirty days after being billed by the
Division." Division records indicate the required annual fee ($60 per year) for the period ending
September 30, 2022 and due October 2, 2021, has been paid. There are no overdue fees for the
subject COC.
Please continue to periodically inspect the wastewater treatment system) to ensure the treatment
components are always maintained and in good operating order. You are also reminded to maintain all
monitoring data and associated maintenance records onsite for a minimum of three years and
available for inspection.
DE
NORTH CAROLINA
gaparhnanl of Environmental quality
North Carolina Department of Environmental Quality I Division of Water Resources
512 North Salisbury Street 11611 Mail Service Center I Raleigh, North Carolina 27699-1611
919.707.9000

DocuSign Envelope ID: C75A7E57-7F32-4B2D-B84F-B223CFC5BE8E
James Thomas, NCG551256
Page 3 of 3
If you have questions or comments about this inspection or the requirements to take corrective action (if
applicable), then please contact Cheng Zhang at 919-791-4259.
Sincerely,
DocuSigned by:
bL1tss Ilia tAlta
B2916E6AB32144F...
Vanessa E. Manuel, Assistant Regional Supervisor
Water Quality Regional Operations Section
Raleigh Regional Office
Division of Water Resources, NCDEQ
Attachment(s): EPA Water Compliance Inspection Report
Cc: RRO/SWP Files
Laserfiche
D_E
NORTH CARCLINA
gaparhnanl of Environmental quality
North Carolina Department of Environmental Quality I Division of Water Resources
512 North Salisbury Street 11611 Mail Service Center I Raleigh, North Carolina 27699-1611
919.707.9000

DocuSign Envelope ID: C75A7E57-7F32-4B2D-B84F-B223CFC5BE8E
United States Environmental Protection Agency
EPA 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 NCG550853 111 121 22/03/30 I17 1810I 19I S I 2011
Type
21IIIIII
IIIIIIIIIII
IIIIIII
I
IIIIII
IIIIIIIIIII
P6
Inspection
671
Work Days
Facility Self -Monitoring
I 70I
Evaluation Rating
I 711
B1
1
72
QA
I N I
73I
1
I I
Reserved
74 71
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)
908 Gum Springs Church Road
908 Gum Springs Church Rd
Moncure NC 27559
Entry Time/Date
11:57AM 22/03/30
Permit Effective Date
21/12/17
Exit Time/Date
12:30PM 22/03/30
Permit Expiration Date
25/10/31
Name(s) of Onsite Representative(s)/Titles(s)/Phone and Fax Number(s)
///
Jerome L Thomas//919-545-2835 /
Other Facility Data
Name, Address of Responsible Official/Title/Phone and Fax Number
Contacted
Jerome L Thomas,908 Gum Springs Church Ro Moncure NC 27559//919-545-2835/
Yes
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)
Cheng Zhang
of Inspector(s) Agency/Office/Phone and Fax Numbers Date
,—Docusignedby: DWR/RRO WQ/919-791-4200/
ot"n',-2`"".)- 7/7/2022
"- D6171508E1 EC41 F...
Signature of Management Q A Reviewer Agency/Office/Phone and Fax Numbers Date
DocuSigned by:
I Valn.t,SSa f. lAit.A. utd,l, 7/8/2022
B2916E6AB32144F...
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete.
Page# 1

DocuSign Envelope ID: C75A7E57-7F32-4B2D-B84F-B223CFC5BE8E
31
NPDES yr/mo/day
N C G 550853 111 121 22/03/30
117
Inspection Type
18LI
1
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
The septic tank was last pumped on October 7, 2019. The permittee had a supply of correct chlorine
tables. Chlorine tablets were observed in the chlorinator. Effluent has been sampled and analyzed
annually. Effluent was found clear with no solids.
Page# 2

Inspection Date: 3 - 0 Zo yv
Start Time:
Mfiferfi End Time: % 2
SINGLE FAMILY WASTEWATER SYSTEM CHECKLIST
Rev. 5/10/2016
Permittee: Jerome Thomas Permit: NCG550853
Address: • 908 Gum Springs Church Road E-mail-
Phone:( 919 ) 545 -2835 Cell Phone:( ) - County: Chatham
The Permittee is responsible for the operation and maintenance of the entire wastewater treatment and disposal system.
Doesn't Did Not
Yes No Apply Investigate
1. Is the current resident in the home the Permittee? x ❑ ❑ ❑
2. If not does the resident rent from the permittee? ❑ ❑ x ❑
3. Change of Ownership form needed? (mail the form with the inspection letter) ❑ 13] ❑ ❑
4. Is there a inspection and maintenance agreement with a contractor? ❑ ❑ ❑ ❑
5. If yes to #4 who is the contractor?
SEPTIC TANK The septic tank and filters should be checked annually and pumped/cleaned as needed.
6. Is all wastewater from the home connected to the septic tank? 141❑ ❑ ❑
7. Does the permittee/resident know where the septic tank is located? [I ❑ ❑ ❑
8. Has the septic tank been pumped��11in the last 5 years? ❑ ❑ ❑ ❑
9. If yes to #8 date, if known 1 �/ — /7- Z /, If proof, describe / I- v v i c r2 .
10. Does the septic tank have an EFFLUENT FILTER or SANITARY T? (circle one)
11. If Yes to filter when was the filter cleaned? By whom?
SAND FILTER / TREATMENT PODS YES x NO ❑ If no proceed to the next section.
Accessible sand filter surfaces shall be raked and leveled every six months and any vegetative growth shall be removed manually
12. Is system something other than a sandfilter? ❑ x ❑ ❑
13. If yes, what kind? (examples - Peat, Textile, Other or brand name - Advantex, etc.)
14. Does the permittee know where the sandfilter is located? 14 ❑ ❑ ❑
15. Does the sandfilter require maintenance? ❑ x ❑ ❑
If maintenance is required explain in the comment section.
DISINFECTION / UV YES ❑ NO x If no proceed to the next section.
The ultraviolet unit shall be checked weekly The lamps and sleeves should be cleaned or replaced as needed to ensure proper disinfection.
16. Is UV working? ❑ ❑ ❑ ❑
17. Has the UV Unit been serviced and bulbs cleaned? ❑ ❑ ❑ ❑
18. Who completes the weekly check for the UV?( Non -Discharge)
DISINFECTION / TABLETS YES x NO ❑ If no proceed to the next section.
The tablet chlorinator unit shall be checked weekly to ensure continuous and proper operation
19. Does the permittee have the correct chlorine tablets?(If none, mark No) IN❑ ❑ ❑
20. Does the Permittee know the location of the chlorinator? ❑ ❑ ❑
21. Were chlorine tablets observed in the chlorinator? ❑ ❑ ❑
22. Are tablets contacting water? If possible poke them to determine. [2 ❑ ❑ ❑
DECHLOR (Discharge only) YES [�- NO If no proceed to the next section.
The dechlorinator unit shall be checked weekly to ensure continuous and proper operation
23. Does the permittee know where the dechlor is? ❑ ❑ ❑ ❑
24. Does the permittee have the correct dechlor tablets? ❑ ❑ ❑ ❑
25. Were dechlor tablets observed in the dechlorination chamber? ❑ ❑ ❑ ❑
26. Are tablets contacting water? If possible poke them to determine. ❑ ❑ ❑ ❑

Doesn't Did Not
Yes No Apply Investigate
PUMP TANK YES ❑ NO X If no proceed to the next section.
All pump and alarm sytems shall be inspected monthly. (non -discharge)
27. Is the pump working? ❑ ❑ ❑ ❑
28. Are the audible and visual high water alarms operational? ❑ ❑ ❑ ❑
29. Does the permittee know how to check the pump & high water alarm? ❑ ❑ ❑ ❑
30. Last functional test: PUMP AUDIBLE & VISUAL
DISCHARGE ONLY YES X NO ❑ If no proceed to the next section.
A visual review of the outfall location shall be executed 2x year (one at time of sampling to ensure no visible solids or evidence of a malfunction).
31. Does the permittee know where the outfall is located? X ❑ ❑ ❑
32. Were able to locate the outfall? X ❑ I ❑
you
33. Is the end of the discharge visible and accessible? X ❑ III ❑
pipe
Fi ❑ ❑ ❑
34. Is outlet discharging?
35. Is right of way maintained around the discharge point? X ❑ ❑ ❑
36. Any Lab Results available? X ❑ ❑ ❑
37. Is there evidence of solids around the discharge point? 0 ❑ ❑ ❑
DRIP or SPRAY YES ❑ NO X If no proceed to the next section.
The irrigation system shall be inspected monthly to ensure the system is free of leaks and equipment is operating as designed.
38. Is the system DRIP or IRRIGATION (circle one)? If irrigation number of sprinkler heads.
39. Are the buffers adequate? ❑ ❑ ❑ ❑
40. Is the site free of ponding and runoff? ❑ ❑ ❑ ❑
41. Does the application equipment appear to be working properly? ❑ ❑ ❑ ❑
42. Is there a minimum two wire fence surrounding entire irrigation area? ❑ ❑ ❑ ❑
GENERAL
43. Are the treatment units locked and or secured? x ❑ ❑ ❑
44. Has resident had any sewage problems? If yes explain in the comment section. X ❑ ❑ ❑
45. Does the system match the permit description? If no explain in the comment section. X ❑ ❑ ❑
46. Is the system compliant? X ❑ ❑ ❑
47. Is the system failing? If yes, take pictures if possible. ❑ X ❑ ❑
48. If system is failing, any sign of children or animals contacting sewage? ❑ ❑ x ❑
NOD Sent #: - - - NOV Sent #: - - -
Comments: Photos Taken? YES U NO ❑
INSPECTOR: Cheng Zhang SIGNATURE: CAA 7-91- (/