NCG550056_Compliance_20100415

North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
April 15, 2010
Michelle Moore
1040 Whirl-Win Drive
Winston-Salem, North Carolina 27101
Subject: General Wastewater Permit No. NCG550056—Single Family Residence
1040 Whirl-Win Drive,Winston-Salem, North Carolina
Forsyth County
Dear Ms. Moore:
Jenny Graznak of the Winston-Salem Regional Office performed a Compliance Evaluation
Inspection on the sandfilter wastewater treatment system at your property in Forsyth County, North
Carolina on April 14, 2010. This type of inspection consists of two basic parts: a review of self-monitoring
data, and an on-site inspection of the facility and its discharge. Your husband was present during the
inspection.
You hold a General Permit to discharge Domestic Wastewaters from Single Family Residences
under the National Pollutant Discharge Elimination System (NPDES). The discharge pipe is located at
the stream behind the house near the bridge. Ms. Graznak observed discharge from the pipe during her
inspection. The effluent and receiving stream appeared clear with no traceable solids on the day of the
inspection. The chlorinator is in the backyard. The septic tank was last pumped out in 2007.
Permit text Part I Section A (attached to this correspondence) specifies the limits and monitoring
requirements for your permit. A Laboratory with North Carolina Wastewater Certification (a list of nearby
approved laboratories is attached) must perform the monitoring. You must also conduct and document
the following maintenance activities:
• Septic tanks shall be maintained at all times to prevent seepage of sewage
• Septic tanks will be checked at least yearly to determine if solids must be removed
• Septic tanks shall be pumped out within 3-5 years of issuance date of the Permit.
Contents removed from septic tanks shall be disposed of at a location and in a manner compliant
with all local and state regulations
Since you were recently married and have since changed your name, you will need to complete
the enclosed Name/Ownership Change Form. Please send the completed form to the address specified
on the form. If you have any questions regarding this letter, please contact Ms. Graznak or me at (336)
771-5000.
Sincerely,
Steve W.Tedder
Regional Supervisor
Surface Water Protection Section
cc: SWP—Central Files/SWP—WSRO/ PDES-Unit--Charles Weaverw�
North Carolina Division of Water Quality,Winston-Salem Regional Office
Location:585 Waughtown St.Winston-Salem,North Carolina 27107 One
Phone:[phone] FAX:[phone] Customer Service:1-877-623-6748 NorthCarolina
Internet:www.ncwaterquality.org aty 6 nigh(
An Equal Opportunity 1 Affirmative Action Employer

11.
United States Environmental Protection Agency
EPA Washington,D.C.20460 Form Approved
OMB No 2040-0057
Water Compliance Inspection Report Approval expires 8-31-98
Section A: National Data System Coding(i.e, PCS)
Transaction Code NPDES yr/mo/day Inspection Type Inspector Fac Type
1 INI 2 I51 31 NCG550056 111 121 10/04/14 I17 181CI 191s1 20I 11
Remarks
211111111111111111111111111111111111111111111111166
Inspection Work Days Facility Self-Monitoring Evaluation Rating B1 QA ------ ---Reserved
671 169 791 31 711 I 721 NI 731 I 174 761 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 Entry Time/Date Permit Effective Date
POTW name and NPDES permit Number) '
11:00 AM 10/04/14 07/08/01
1040 Whirl-Win Drive
1040 Whirl-Win Dr Exit Time/Date Permit Expiration Date
Winston Salem NC 27101 11:30 AM 10/04/14 12/07/31
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
Michelle Moore,1040 Whirl-Win Dr Winston Salem NC 27101//336-748-0410/
Section C. Areas Evaluated During Inspection(Check only those areas evaluated)
ill Permit
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
Jennifer F Graznak WSRO WQ//336-771-5000/
Signature of Management Q A Reviewer Agency/Office/Phone and Fax Numbers Date
EPA Form 3560-3(Rev 9-94)Previous editions are obsolete.
Page# 1

•
Permit: NCG550056 Owner-Facility: 1040 Whirl-Win Drive
Inspection Date: 04/14/2010 Inspection Type: Compliance Evaluation
Permit Yes No NA NE
(If the present permit expires in 6 months or less). Has the permittee submitted a new application? 0 0 • 0
Is the facility as described in the permit? ■ n n n
#Are there any special conditions for the permit? n ■ n
Is access to the plant site restricted to the general public? n n U
Is the inspector granted access to all areas for inspection? ■ n n n
Comment:
•
•
Page# 3