WQ0006493_Staff Report_20221115

RE ,
November 15, 2022
State of North Carolina
Division of Water Resources
Water Quality Regional Operations Section
Staff Report
To: DWR Central Office — WQ, Non -Discharge Unit Application No.: W00006493
Attn: Alys Hannum Facility name: 5781 Union Ridge Road SFR
From: Caitlin Caudle
Winston-Salem Regional Office
Note: This form has been adapted from the non -discharge facility staff report to document the review of both non -discharge and NPDES permit applications and/or renewals. Please complete all sections as they are applicable.
L GENERAL AND SITE VISIT INFORMATION
1. Was a site visit conducted? ® Yes or ❑ No
a. Date of site visit: 11/8/2022
b. Site visit conducted by: J Gonsiewski
c. Inspection report attached? ® Yes or ❑ No
d. Person contacted: Keith Hall and their contact information: (336) 213 - 5920
II. EXISTING FACILITIES: MODIFICATION AND RENEWAL APPLICATIONS
1. Are there appropriately certified Operators in Charge (ORCs) for the facility? ❑ Yes ❑ No ® N/A
2. Are the design, maintenance and operation of the treatment facilities adequate for the type of waste and disposal
system? ® Yes or ❑ No
3. Are the site conditions (e.g., soils, topography, depth to water table, etc) maintained appropriately and adequately
assimilating the waste? ® Yes or ❑ No
4. Has the site changed in any way that may affect the permit (e.g., drainage added, new wells inside the compliance
boundary, new development, etc.)? ❑ Yes or ® No
5. Are the existing application rates (e.g., hydraulic, nutrient) still acceptable? ® Yes or ❑ No
6. Are there any setback conflicts for existing treatment, storage and disposal sites? ❑ Yes or ® No
7. Is the description of the facilities as written in the existing permit correct? ® Yes or ❑ No
8. Are there any permit changes needed in order to address ongoing BIMS violations? ❑ Yes or ® No
9. Check all that apply:
® No compliance issues ❑ Current enforcement action(s) ❑ Currently under JOC
❑ Notice(s) of violation ❑ Currently under SOC ❑ Currently under moratorium
Have all compliance dates/conditions in the existing permit been satisfied? ® Yes ❑ No ❑ N/A
10. Are there any issues related to compliance/enforcement that should be resolved before issuing this permit?
❑ Yes ®No❑N/A
FORM: WQROSSR 04-14 Page 1 of 2

III. REGIONAL OFFICE RECOMMENDATIONS
1. Do you foresee any problems with issuance/renewal of this permit? ❑ Yes or ® No
2. Recommendation: ❑ Hold, pending receipt and review of additional information by regional office
® Hold, pending review of draft permit by regional office
❑ Issue upon receipt of needed additional information
❑ Issue
❑ Deny (Please state reasons: )
�DocuSigned by:
3. Signature of report preparer:
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Signature of regional supervisor:
Date: 11/15/2022
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145B49E225C94EA...
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See attached staff report and site map.
FORM: WQROSSR 04-14 Page 2 of 2

Compliance Inspection Report
Permit: WQ0006493 Effective: 01/01/18 Expiration: 12/31/22 Owner: James Keith Hall
SOC: Effective: Expiration: Facility: 5781 Union Ridge Rd. SFR
County: Alamance 5781 Union Ridge Rd
Region: Winston-Salem
Burlington NC 27217
Contact Person: James Keith Hall Title: Phone:
Directions to Facility:
From Burlington take NC Hwy 62N. 1/2 mile after crossing Haw River, turn L onto Union Ridge Rd. Drive appx 6 miles to site on the
R side of road (before Willie Pace Rd.).
System Classifications:
Primary ORC: Certification: Phone:
Secondary ORC(s):
On -Site Representative(s):
Related Permits:
Inspection Date: 11/08/2022 Entry Time 10:10AM Exit Time: 11:20AM
Primary Inspector: Jim J Gonsiewski Phone: [phone]
Secondary Inspector(s):
Reason for Inspection: Routine Inspection Type: Compliance Evaluation
Permit Inspection Type: Single -Family Residence Wastewater Irrigation
Facility Status: Compliant ❑ Not Compliant
Question Areas:
Miscellaneous Questions Permit Status Septic Tank
Sand Filter/Treatment Pods Disinfection Tablets Pump Tank
Drip or Irrigation General
(See attachment summary)
Page 1 of 4

Permit: WQ0006493 Owner - Facility: James Keith Hall
Inspection Date: 11/08/2022 Inspection Type: Compliance Evaluation Reason for Visit: Routine
Inspection Summary:
On November 8, 2022, staff of the North Carolina Division of Water Resources Winston-Salem Regional Office (DWR)
performed a compliance inspection of the subject wastewater irrigation system. This compliance inspection was conducted
by DWR staff person Jim Gonsiewski. It was noted that the permittee corrected the two concerns from the previous
inspection, fallen trees on the spray field fence and ponding around one of the spray heads.
Mr. Gonsiewski met with the permittee, Mr. Keith Hall. The system appeared to be in good operational order and, according
to Mr. Hall, has not had any problems. He is using the correct chlorine tablets. The alarm system for the pump was tested
and works. Mr. Hall stated that the system sprayed the night before, so no attempt was made to test the pump floats since
there would be insufficent water in the system to run the pump.
The inspection generally reflects compliance with the permit. However, the following issue was noted:
Mr. Hall stated that he checks the chlorinator tubes every Sunday night and checks the components of the system
quarterly. He has no records of these inspections. Permit Condition III.(12) lists specific inspection frequencies for the
system components and Permit Condition V.2 states that the Permittee shall maintain a log of these inspections for a
period of five years from the date of the inspection.
Page 2 of 4

Permit: WQ0006493 Owner - Facility: James Keith Hall
Inspection Date: 11/08/2022 Inspection Type: Compliance Evaluation Reason for Visit: Routine
Permit Status
# Is the current resident in the home the Permittee?
# If not, does the resident rent from the Permittee?
Change of Ownership form needed? (Mail the form with the inspection letter)
# Is there an inspection and maintenance agreement with a contractor?
If YES, who is the contractor (include contact info)?
Comment:
Septic Tank
*** The septic tank and filters should be checked annually and pumped/cleaned as needed. **
Is all wastewater from the home connected to the septic tank?
# Does the permittee/resident know where the septic tank is located?
Has the septic tank been pumped in the last 5 years?
If YES, describe if known and proof (include date pumped):
Last pumped in 9/2019. Permittee had receipt.
# Does the septic tank have an EFFLUENT FILTER or SANITARY T?
Yes No NA NE
❑ ❑ ❑
Yes No NA NE
■❑❑❑
❑ ❑ ❑
■❑❑❑
❑❑❑■
If FILTER, when was the filter cleaned and by who?
Comment: Outlet end of the septic tank was subsurface and inaccessible to evaluate if an effluent filter
was present.
Sand Filter/Treatment Pods
Yes No NA NE
*** Accessible sand filter surfaces shall be raked/leveled every 6 months and vegetative growth shall be
removed manually. ***
# Is system something other than a sand filter? ❑ ❑ ❑
# If YES, what kind? (examples - Peat, Textile or brand name - Advantex, etc.)
# Does the permittee know where the sandfilter is located? ❑ ❑ ❑
Does the sandfilter require maintenance? ❑ ❑ ❑
If maintenace is required, explain:
Comment: Sand filter is subsurface and appears to be functioning proerly.
Disinfection Tablets Yes No NA NE
*** Tablet chlorinator unit shall be checked weekly to ensure continuous and proper operation. ***
Does the permittee have the correct chlorine tablets? (If none, mark No) ❑ ❑ ❑
# Does the Permittee know the location of the chlorinator? ❑ ❑ ❑
Were chlorine tablets observed in the chlorinator? ❑ ❑ ❑
Are tablets contacting water? (If possible, poke them to determine.) 0 ❑ ❑ ❑
Comment:
Pump Tank Yes No NA NE
Page 3 of 4

Permit: WQ0006493 Owner - Facility: James Keith Hall
Inspection Date: 11/08/2022 Inspection Type: Compliance Evaluation Reason for Visit: Routine
*** All pump and alarm sytems shall be inspected monthly. (Non -Discharge) ***
Is the pump working? 0 ❑ ❑ ❑
Is the audible and visual high water alarm operational? 0 ❑ ❑ ❑
# Does the permittee know how to check the pump & high water alarm? 0 ❑ ❑ ❑
# Last functional test:
Comment: Pump ran the night before the inspection. Insuffient volume of water in the tank to test the
pump.
Drip or Irrigation Yes No NA NE
*** Irrigation sysetm shall be inspected monthly to ensure system is free of leaks and equipment is operating
as designed. ***
# Type of system (DRIP or IRRIGATION):
# If IRRIGATION, number of sprinkler heads: Irrigation
Are buffers and setbacks adequate? ❑ ❑ ❑
Is the site free of ponding and runoff? ❑ ❑ ❑
Does the application equipment appear to be working properly? ❑ ❑ ❑
Is there a minimum two wire fence surrounding the entire irrigation area? 0 ❑ ❑ ❑
Comment: A combination of two wire and wooden fencing used. According to the permittee, the system
sprayed the night before the inspection. No ponding observed on the spray field during the
inspection.
General Yes No NA NE
# Are the treatment units locked and/or secured? 0 ❑ ❑ ❑
# Has resident had any sewage problems? ❑ ❑ ❑
If YES, explain:
Does the system match the permit description? ❑ ❑ ❑
If NO, explain:
Is the system compliant? ❑ ❑ ❑
Is the system failing? (If yes, take pictures if possible) ❑ ❑ ❑
If system is failing, describe any exposures to people/animals or environmental risks.
Comment: The system appears to be very well maintained. According to the permittee, they have not had
problems with the operation of the systyem.
Page 4 of 4

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