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RECEIVED
cc: Technical Support Branch FEB 0 71991
Permits and Engineering
County Health Dept. TECIiI 1Ca '„ WPM SiOteti
Central Files
WSRO ..
Date February 1, 199Z
NPDES STAFF REPORT AND RECOMMENDATIONS
County Forsyth
NPDES Permit No. NC0031097
PART I - GENERAL INFORMATION
1 . Facility and Address :
Mr. Sam Bradley
120 Roswell Drive
Kernersville, N.C. 27284
2 . Date of Investigation: February 1, 1991
3 . Report Prepared by: Cynthia Myers,
Environmental Technician
4 . Persons Contacted and Telephone Number:
Mr. Sam Bradley 919-996-2753
5 . Directions to Site:
The subject dwelling is located in Cliffwood Estates
which has an entrance road on Piney Grove Road (NC SR
1969) north of Kernersville. Follow entrance road to
end to Roswell Drive. The house is at the junction.
6 . Discharge Point - Latitude: 36° 09 ' 05"
Longitude: 80° 04 ' 25"
Attach a USGS Map Extract and indicated treatment
plant site and discharge point on map.
USGS Quad No. C18NE or
USGS Quad Name Belews Creek
7 . Size ( land available for expansion and upgrading) :
.25 acre
8 . Topography (relationship to flood plain included) :
The home is in an upland position. The back yard falls
steeply to the west and has a high water table. Ground
cover is fescue grass .
9 . Location of nearest dwelling: There are private
dwellings on either side of this home at approximately
80-100 feet.

r
10 . Receiving stream or affected surface waters : U.T.
to Belews Creek.
a. Classification: C
b. River Basin and Subbasin No. : Roanoke (03 02 01)
c. Describe receiving stream features and pertinent
downstream uses : The stream flows through a wooded
area behind Cliffwood Estates Development.
PART II - DESCRIPTION OF DISCHARGE AND TREATMENT WORKS
1 . Type of wastewater: 100% Domestic
% Industrial
a. Volume of Wastewater: 450 GPD
b. Types and quantities of industrial wastewater:
N/A
c. Prevalent toxic constituents in wastewater: N/A
d. Pretreatment Program (POTWs only) :N/A
in development approved
should be required not needed
2 . Production rates ( industrial discharges only) in
pounds : N/A
a. highest month in the last 12 months
b. highest year in last 5 years
3 . Description of industrial process ( for industries only)
and applicable CFR Part and Subpart: N/A
4 . Type of treatment (specify whether proposed or
existing) :
Existing 900 gallon capacity septic tank, 391 square
feet standard subsurface sandfilter, sanuril
disinfection unit with 30 minute holding tank.
5 . Sludge handling and disposal scheme:
Sludge is pumped as necessary by a licensed hauler and
tanker to the nearest municipal WWTP.

6 . Treatment plant classification: N/A
7 . SIC Code(s) 4952
Wastewater Code(s) 04
PART III - OTHER PERTINENT INFORMATION
1 . Is this facility being constructed with Construction
Grants Funds (municipals only) ? N/A
2 . Special monitoring requests : N/A
3 . Additional effluent limits requests : N/A
4 . Other: N/A
PART IV - EVALUATION AND RECOMMENDATIONS
The system appears to be operating well . No solids are
in the creek. No odor is detectable. WSRO recommends the
permit be reissued.
Signature of report pre arer
Water Quality Supervisor

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