NCG550283_Compliance Evaluation Inspection_20190409

ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
LINDA CULPEPPER
Director
Jeffrey and Martha Brown
122 Rockford Road
Kernersville, NC 27284
NORTH CAROLINA
Environmental Quality
April 9, 2019
RECc1Vr_-UDENRI J 0 WR
APR 29 2019
Wattr Resources
P®n,nitjng section
SUBJECT: Compliance Evaluation Inspection Report —Additional Information Needed
Certificate of Coverage NCG650283 under NPDES General Permit NCG660000
Facility Located at 122 Rockford Road, Forsyth County
Dear Mr. and Mrs. Brown:
On March 29, 2019 Paul DiMatteo of this office conducted a Compliance Evaluation Inspection on the
subject wastewater treatment facility, which included an overview of related wastewater treatment components.
Relevant findings are summarized in the enclosed inspection report. A copy of the"most recent permit was left
at the door following the inspection.
Please be reminded of the following requirements in the Permit:
1. You are required to have the discharged water sampled and analyzed by a certified laboratory annually.
A list of nearby certified laboratories is attached. Records of monitoring should be maintained for at least
3 years. At any time, the Division may request to review documentation required to be kept by the Permit
to determine compliance with its conditions.
2. Chlorine tablets used for disinfection must be labeled for use in wastewater or contain appropriate
ingredients for wastewater disinfection.
3. The outfall must be visually inspected twice per year, once at the time of sampling. If any signs of
malfunction are observed, the conditions should be documented, and steps should be taken to correct
the problem.
Please contact the inspector at [phone] within 30 days of receipt of this letter to discuss the above
activities.
Finally, please note that the General Permit was renewed effective October 23, 2018. A copy of the most
recent Technical Bulletin is enclosed. A copy of the General Permit was left at the property during the inspection;
additional copies are available by searching on our website(https://deg.nc.gov/abouttdivisions/water-resources)
or by contacting the inspector. You will be contacted by the Division through separate correspondence regarding
the status of renewal for your Certificate of Coverage. Please review these documents carefully.
D E Q North Carolina Department of Environmental Quality I Division of Water Resources
Winston-Salem Regional Office 1 450 Hanes Mil( Road, Suite 3001 Winston-Salem, North Carolina 27105
NORTH G1R01 INA
a��� 336.776.9800

If you should have any other questions or would like to further discuss your permit's requirements, please
do not hesitate to contact Paul DiMatteo at 336-776-9691 or [e-mail], or our office at 336-
776-9800.
Sincerely,
CLo-DmuP2Signed by.
-T ct—>m1w
145B49EMEA...
Lon T. Snider
Regional Supervisor
Water Quality Regional Operations
Division of Water Resources
Attachments: EPA Water Compliance Inspection Report, NCG5500000 Technical Bulletin,
List of Certified Labs, Pamphlet on Disinfection Tablets
cc: WSRO
E��U -

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 I I2, I5 I 3 NCG550263 1.1 12 19/03/29 17
I
18 C 19 I sI I_20I
I�_I
21 W' I. I I I I I I I I I I I I• I I I I
I I I I I I I I I I r6
Inspection Work Days' Facility Self -Monitoring Evaluation Rating 81 QA
Reserved
67 701 I 71 I I 72
LJ LJ
JData
731 I 174 75I III I I I I80
I I
Section B: Facility
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)
10:OOAM 19/03/29
13/08/01
122 Rockford Road '
122 Rockford'Rd.
Exit Time/Date
Permit Expiration Date
Kemersville NC 27264
10:15AM 19/03/29
18/07/31
Name(s) of Onsite Representative(s)/Tides(s)/Phone and Fax Number(s)
Other Facility Data
Name,,Address,of Responsible Official/Title/Phone and Fax Number
Contacted
Jeffrey Brown;122 Rockford Rd Kemersville NC 27284///
No
" Section C: Areas Evaluated During Inspection (Check only those areas evaluated)
Permit - - Operations & Maintenance Facility Site Review
Section D.Summary of Finding/Comments (Attach additignal sheets of narrative and checklists as necessary)
(See,attachrrient stammary)
Name(s) and Signature(s) of Inspector(s) Agency/Office/Phone and Fax Numbers
Date
DocuSigned by:
Paul .DiMatteo '- WSRO WQ//336-776-9691/
f. wG..�,J-1�,e .
4/11/2019
F10C7C2E5BB34D4...
Signature of Management Q'A Reviewer DocSigned by: Agency/Office/Phone and Fax Numbers
Date
Luti T `SM�cr
4/11/2019
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NPDES yr/mo/day Inspection Type (Cont.) 1
31 NC0550283 121 19/03/29 17 18 J C
I Section D: Summary of Finding/Comments (Attach additional lssheets of narrative and checklists as necessary)
On March 29, 2019 Paul DiMatteo visited this discharging wastewater system. Chlorinator tubes,
holding tank lid and discharge pipe were readily visible, but did have some growth surrounding it. There
appeared to' be chlorine in the chlorinators. Discharge was active and appeared clear. Outfall location
is just beyond holding tank. Inspector' left a card and a copy of the permit.
Permittee is reminded of -the following:
` 1': Annual sampling of the discharged water is required to be conducted by a certified laboratory. Such
data should be kept available upon request. At any time the Division may- request any such records
necessary -'(for example, results of required sampling) to determine compliance with the Permit.
2. Chlorine tabletsused for disinfection must be labeled for use in wastewater (do not use pool tablets).
3. The outfall must be, visually inspected twice per year (once at the time of sampling). If any signs of
malfunction are observed; the conditions should be documented and steps should be taken to correct
the problem.

'Permit: NCG550283 Owner - Facility: 122 Rockford Road
Inspection Date: 03129/2019 Inspection Type: Compliance Evaluation
Permit. ` .
Yes No NA NE
If he' present permit expires in 6 rrionths orles's): Has the permittee submitted a new
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application?
" Is the,facility as described in the permit?
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# Are there any special,conditions for.the permit?
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Is access=to the'plarit.site restricted to the general public?
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'Is the inspector granted access to all areas for inspection?
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Comment:._. '
Op@ratlo,nS.& Maintenance
Yes No NA NE
Is the plant generally clean with acceptable housekeeping?
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Does, the•faciIity analy2e process control parameters, for ex: MLSS, MCRT, Settleable
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'Solids, pH, DO, Sludge Judge, and other that are applicable?
Comment:.
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