NCG550400_Matthew_Epperson_SFR_CEI_Report_20240530

United States Environmental Protection Agency
Form Approved.
EPA Washington, D.C. 20460
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 IN 2 u 3 I NCG550400 111 121 24/04/29 I17 18 I C I 19 I s I 20L]
21111I I I I I I I II I I I I I I I I I I I I I I I I I I I I I I I II I I I I I r6
Inspection
Work Days Facility Self -Monitoring Evaluation Rating B1 QA ---------------------- Reserved -------------------
67
I 72 I ni I 73 � I 74 79 I I I I I I I80
70 I I 71 I LL -1 I I
LJ
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 Dermit Number)
04:OOPM 24/04/29
21/08/05
1664 West Lexington Avenue
1664 W Lexington Ave
Exit Time/Date
Permit Expiration Date
High Point NC 27262
04:30PM 24/04/29
25/10/31
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
Matthew Epperson,1664 W Lexington Ave High Point NC 27262//336-408-0304/
No
Section C: Areas Evaluated During Inspection (Check only those areas evaluated)
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
Ron Boone Docusigned by: DWR/WSRO WQ/336-776-9690/
ona& Boo., 5/30/2024
B20F8DD5F2A3460...
Signature of Management Q A Reviewer ocusigned byAgency/Office/Phone and Fax Numbers Date
Lon T. Snider F�- T. 15,,dcr 5/30/2024
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete.
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NPDES yr/mo/day Inspection Type
NCG550400 I11 12I 24/04/29 117 18 i c i
(Cont.)
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
On April 29th, 2024, Ron Boone, of the Winston-Salem Regional Office of the NC Division of Water
Resources, conducted a compliance evaluation inspection of your single family wastewater treatment
system. The inspection was conducted via telephone because of work schedule conflicts. Thank you
for assisting Mr. Boone in completing the inspection. The inspection results are summarized below:
Your home and the home at 1660 West Lexington Avenue (neighbor to your east), which is owned by
Christine Minear C/O Farmer Trust, both have single family wastewater treatment systems. Both
homes have a separate septic tank and subsurface sand filter, but both share the same chlorinator
and discharge
pipe. As was the case during the previous inspection is 2019, you manage the application of chlorine
to the effluent from both systems before they're discharged to the receiving stream.
You are reminded that, in accordance with the permit, you must have the septic tank pumped at least
every five years. You informed Mr. Boone that four people live in the house. It is likely sufficient
then to have the tank pumped every three to four years. This will keep the tank in good condition and
prevent loss of solids to the subsurface sand filter, which would clog the filter and require it to be
repaired or replaced at a high cost.
The location of the discharge pipe for both homes is currently unknown and no effluent samples have
been taken to date. We have provided a list of certified laboratories as an attachment to this report.
You may take samples to any of the listed laboratories for the required analysis. We have also
included a copy of the general permit for reference to what parameters must be tested for. Your
requirements are on page 3. The permit requires the effluent to be tested at least once annually. You
are currently not required to submit test results to the Division but you must keep them on file with all
your other related records such as the certificate of coverage, permit fee invoices, tank pumping
invoices, etc. Please do share the results with Mr. Boone when you get them so we can get an idea of
how well your system is functioning.
The annual fee for the permit is $60 and all your fees have been paid in full to date. The general
permit number is NCG550000, and your specific permit #, otherwise known as your certificate of
coverage #, under the general permit, which is assigned specifically to your home, is NCG550400.
You are technically non -compliant with the permit at this time due to not having it tested annually.
If you have any questions or concerns about compliance, the inspection, or this report, please
contact
Mr. Boone by phone at 336-776-9690, or by email at [e-mail].
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Permit: NCG550400
Inspection Date: 04/29/2024
Owner -Facility: 1664 West Lexington Avenue
Inspection Type: Compliance Evaluation
Permit
(If the present permit expires in 6 months or less). Has the permittee submitted a new
application?
Is the facility as described in the permit?
# Are there any special conditions for the permit?
Is access to the plant site restricted to the general public?
Is the inspector granted access to all areas for inspection?
Comment: Please refer to the inspection summary section of this report.
Yes No NA NE
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