WQ0004809_Staff Report_20240408

State of North Carolina
Division of Water Resources

Water Quality Regional Operations Section
Staff Report

FORM: WQROSSR 04-14 Page 1 of 2

April 8, 2024
To: DWR Central Office – WQ, Non-Discharge Unit Application No.: WQ0004809
Attn: Leah Parente Facility name: 116 Woody Rd, SFR

From: Kristen Potwora
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.
I. GENERAL AND SITE VISIT INFORMATION
1. Was a site visit conducted? Yes or No
a. Date of site visit: 03/04/2024
b. Site visit conducted by: Kristen Potwora
c. Inspection report attached? Yes or No
d. Person contacted: Joye B. Struchen and their contact information: (336) 694 - 4213
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. Has a review of compliance history been completed (CEI’s)? Yes or No
9. Are there any permit changes needed in order to address ongoing BIMS violations? Yes or No
10. 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
11. Are there any issues related to compliance/enforcement that should be resolved before issuing this permit?
Yes No N/A

III. REGIONAL OFFICE RECOMMENDATIONS
1. Do you foresee any problems with issuance/renewal of this permit? Yes or No
FORM: WQROSSR 04-14 Page 2 of 2
2. List any items that you would like the NPDES Unit or Non-Discharge Unit Central Office to obtain through an
additional information request:
Item Reason
Setback Waiver Waiver was executed for the wrong parcel. The parcel # should be 128/90, not
128/11. Does a new setback waiver need to be completed?
3. 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: )

4. Signature of report preparer:

Signature of regional supervisor:
Date:
IV. ADDITIONAL REGIONAL STAFF REVIEW ITEMS
See attached inspection report from most recent compliance inspection.
4/8/2024
4/8/2024
Compliance Inspection Report
Permit:WQ0004809 Effective:08/01/20 Expiration:11/30/24 Owner :Joye B Struchen
SOC:
Contact Person:
Region:
County:
Directions to Facility:
Caswell
Winston-Salem
Joye B Struchen
Effective:Expiration:Facility:116 Woody Rd. SFR
116 Woody Rd
Leasburg NC 27291
Title:Phone:
Take Hwy.-158 from Winston-Salem. Turn LT on Hwy.-119 North. Go about 0.9 miles and turn RT on Woody Road. Property is on
right (about 200 feet from Hwy.-119).
Secondary ORC(s):
Phone:Certification:Primary ORC:
System Classifications:
On-Site Representative(s):
Related Permits:
Secondary Inspector(s):
Primary Inspector:
Inspection Date:Exit Time:Entry Time:
Phone:
03/04/2024 10:00AM 10:40AM
Kristen Potwora 336-776-9800
Facility Status:
Permit Inspection Type:
Reason for Inspection:Inspection Type:
Not CompliantCompliant
Routine
Single-Family Residence Wastewater Irrigation
Compliance Evaluation
Question Areas:
Miscellaneous Questions Septic Tank Sand Filter/Treatment Pods
Disinfection Tablets Pump Tank Drip or Irrigation
General
(See attachment summary)
Page 1 of 4
Inspection Date:
Permit:
Inspection Type :
Owner - Facility:
Reason for Visit:
WQ0004809
03/04/2024 Compliance Evaluation
Joye B Struchen
Routine
Inspection Summary:
On March 4, 2024, Division of Water Resources staff Kristen Potwora conducted a scheduled routine compliance inspection
of the 116 Woody Rd. SFR in Caswell County. Joye B. Struchen was present during the entire inspection. A review of
available records, visual and audio alarms, and the spray irrigation field and equipment were completed. This review reflected
compliance with the subject permit.
The following item of concern was noted:
•The Septic Tank Riser has damage in the cement. Please continue to monitor the riser and make repairs if needed.

Other Observations:
•Property Boundary Waiver was signed and on site.
•The fence around the irrigation field had one intact strand of wire.
•Septic Tank was cleaned out June 23, 2022.
•Joye is the only resident currently living in the house.
Page 2 of 4
Inspection Date:
Permit:
Inspection Type :
Owner - Facility:
Reason for Visit:
WQ0004809
03/04/2024 Compliance Evaluation
Joye B Struchen
Routine
Septic Tank Yes No NA NE
*** 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):
6/23/2022
# Does the septic tank have an EFFLUENT FILTER or SANITARY T?
If FILTER, when was the filter cleaned and by who?6/22/2022
Comment:
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:
No maintenance needed.Comment:
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.)
Comment:
Pump Tank Yes No NA NE
*** All pump and alarm sytems shall be inspected monthly. (Non-Discharge) ***
Is the pump working?
Is the audible and visual high water alarm operational?
# Does the permittee know how to check the pump & high water alarm?
# Last functional test:
Comment:
Drip or Irrigation Yes No NA NE
Page 3 of 4
Inspection Date:
Permit:
Inspection Type :
Owner - Facility:
Reason for Visit:
WQ0004809
03/04/2024 Compliance Evaluation
Joye B Struchen
Routine
*** 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):Irrigation
# If IRRIGATION, number of sprinkler heads:4
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?
Comment:
General Yes No NA NE
# Are the treatment units locked and/or secured?
# 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.
See summary.Comment:
Page 4 of 4