NCG550493_Compliance Evaluation Inspection_20190621

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NORTH CAROLINA
ROY COOPER Environmental Quality
Governor _
MICHAEL S. REGAN
Secretary
LINDA CULPEPPER
Director
June 21, 2019
Mr. Larry Rhymer
2030 Woodstock Rd
Clemmons, NC 27102
SUBJECT: Compliance Evaluation Inspection
Certificate of Coverage NCG550493
2030 Woodstock Rd JUL ®2 /019
Forsyth County Water Quality
"noting Section
Dear Mr. Rhymer,
On June 7, 2019 Kelli Park, of this office, performed a Compliance Evaluation Inspection of the
wastewater treatment system located at the above address. The State requires the Division of
Water Resources to inspect these types of systems at least once every five years.
We attempted to contact you via letters left at the house, and a letter sent in the mail. There was
no response to any attempt of getting in contact with you. Please note that in your permit
conditions(Part II, Section B.8 and Part II Section D.81 you are required to provide
information to the Division regarding your permitted system upon request and allow
inspection of the subject property. -
The violations found from the inspection outlined below:
1) The chlorine tubes were unable to be located, and it is unknown what type of chlorine is
put into the system. It is imperative that the tubes are checked routinely and that chlorine
tablets are added as needed to disinfect the wastewater. Via the permit wastewater
grade chlorine must be added to the system for disinfection.
2) The effluent pipe was not visible. It is a permit requirement to know the location<of the
pipe and to maintain the area around it at all times. Please locate and expose the
effluent pipe as soon as possible.
3) It is unknown if the effluent has been consistently tested by a laboratory. Water samples
from the effluent are required to be analyzed at least once a year by a certified laboratory.
These records are required to be maintained and should be shared with NCDEQ upon
request.
4) The permit requires that the septic tank contents be pumped out every 3-5 years to
prevent solids from clogging the sand filter system. It is unknown when the system was
last pumped. Please keep records of septic tank pumping on hand as a historical record
and proof that you had the tank pumped.

f
5) It has been noted that the house is for sale. Please be aware that a name change form for
the Certificate of Coverage associated with this house must be filed immediately upon
new ownership. Failure to do so will consider this site to be an illegal discharge into State
waters. Please contact me so that I can get you this form.
Failure to properly operate and maintain the system can result in expensive repair costs as well
as failure of the system to properly treat the wastewater. If you have any questions regarding
maintenance, operations, the permit, or this inspection do not hesitate to call us.
Please keep this letter with your records for the system along with copies of invoices from the
Division for the annual permit fee, the Certificate of Coverage, records of septic tank pumping,
maintenance and repair records, etc.
Please be aware that violations of your NPDES permit, or the NC statutes and regulations
under which it is promulgated, are subject to fines of up to $25,000 per day, per violation,
as set forth in'NC General Statute (NCGS) 143-215.6A, Enforcement Procedures, Civil
Penalties.
Please contact Miss Park at (336)-776-9689 or [e-mail] to report the unknown
information regarding your system and if you have any further questions.
Sincerely,
CDocuSlpned by:
Lo*, 'I sM1Cf
Lon,asn S
ieren..coa
Assistant Regional Supervisor
Water Quality Regional Operations
Division of Water Resources
Attachments: EPA Water Compliance Inspection Report
cc: WSRO ,
PDES_Unitil
Page 2 of 2

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 u 2 u 3 I NCG550493 I11 121 19/06/07 117
18 I I 19 I s 201 I
211111 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 11II l I I I I r6
Inspection Work Days Facility Self-Monitoring Evaluation Rating B1 - QA Reserved
67I I 70 I I 711 I 72 I N I 731
I 174
751 I I I I I I 1
80
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) 01 OOPM 19/06/07 09/08/04
2030 Woodstock Road
2030 Woodstock Rd Exit Time/Date Permit Expiration Date
01 20 P M 19/06/07 12/07/31
Clemmons NC 27012
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
Larry Rhymer,2030 Woodstock Rd Clemmons NC 27012///
No
Section C.Areas Evaluated During Inspection(Check only those areas evaluated)
1. Permit El Operations&Maintenance NI Facility Site Review Effluent/Receiving Waters
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
Kelli A Park WSRO WQ//336-776-9689/
//v;1410 6.la(' IC1
Signature of Management Q A Review oocusigned by Agency/Office/Phone and Fax Numbers
cL-
0A,
Date
T 'Miter 06/24/2019
1 d5RdQF775!`QdFA
EPA Form 3560-3(Rev 9-94)Previous editions are obsolete
Page# 1

NPDES yr/rno/day Inspection Type (Cont.) 1
31 NCc550493 I11 121 19/06/07 117 18 u
Section D Summary of Finding/Comments(Attach additional sheets of narrative and checklists as necessary)
Attempted to contact land owner multiple times. Never recieved a responce to my letters.
On June 7, 2019 Kelli Park, of this office, performed a Compliance Evaluation Inspection of the
wastewater treatment system located at the above address.The State requires the Division of Water
Resources to inspect these types of systems at least once every five years.
We attempted to contact you via letters left at the house, and a letter sent in the mail.There was no
response to any attempt of getting in contact with you. Please note that in your permit conditions (Part
II, Section B.8 and Part II Section D.8)you are required to provide information to the Division regarding
your permitted system upon request and allow inspection of the subject property. _
The violations found from the inspection outlined below.
1) The chlorine tubes were unable to be located, and it is unknown what type of chlorine is put into the
system. It is imperative that the tubes are checked routinely and that chlorine tablets are added as
needed to disinfect the wastewater.Via the permit wastewater grade chlorine must be added to the
system for disinfection.
2) The effluent pipe was not visible. It is a permit requirement to know the location of the pipe and to
maintain the area around it at all times. Please locate and expose the effluent pipe as soon as possible.
3) It is unknown if the effluent has been consistently tested by a laboratory. Water samples from the
effluent are required to be analyzed at least once a year by a certified laboratory.These records are
required to be maintained and should be shared-with NCDEQ upon request.
4) The permit requires that the septic tank contents be pumped out every 3-5 years to prevent solids
from clogging the sand filter system. It is unknown when the system was last pumped. Please keep
records of septic tank pumping on hand as a historical record and proof that you had the tank pumped.
5) It has been noted that the house is for sale. Please be aware that a name change form for the
Certificate of Coverage associated with this house must be filed immediately upon new ownership.
Failure to do so will consider this site to be an illegal discharge into State waters. Please contact me so
that I can get you this form.
Failure to properly operate and maintain the system can result in expensive repair costs as well as
failure of the system to properly treat the wastewater. If you have any questions regarding
maintenance, operations, the permit, or this inspection do not hesitate to call us.
Please keep this letter with your records for the system along with copies of invoices from the Division
for the annual permit fee, the Certificate of Coverage, records of septic tank pumping, maintenance
and repair records, etc.
Please be aware that violations of your NPDES permit, or the NC statutes and regulations under which
it is promulgated, are subject to fines of up to$25,000 per day, per violation, as set forth in NC General
Statute(NCGS) 143-215.6A, Enforcement Procedures, Civil Penalties.
Page# 2

Permit: NCG550493 Owner-Facility: 2030 Woodstock Road
Inspection Date: 06/07/2019 Inspection Type: Compliance Evaluation
Operations & Maintenance Yes No NA NE
Is the plant generally clean with acceptable housekeeping'? •' ❑ 0 ❑
Does the facility analyze process control parameters,for ex MLSS, MCRT,Settleable ❑ ❑ • ❑
Solids, pH, DO, Sludge Judge, and other that are applicable'?
Comment:
Permit Yes No NA NE
(If the present permit expires in 6 months or less). Has the permittee submitted a new 0 ❑ • ❑
application'?
Is the facility as described in the permit? 0 ❑ 0
#Are there any special conditions for the permit? ❑ M ❑ ❑
Is access to the plant site restricted to the general public'? • ❑ ❑ ❑
Is the inspector granted access to all areas for inspection'? • ❑ ❑ ❑
Comment: Could not locate effluent'pipesor chlorine tubes.
Effluent Pipe Yes No NA NE
Is right of way to the outfall properly maintained'? ❑ II ❑ ❑
Are the receiving water free of foam other than trace amounts and other debris'? • ❑ ❑ ❑
If effluent (diffuser pipes are required) are they operating properly'? 0 ❑ • ❑
Comment: Effluent pipe could not be located.
Disinfection-Tablet Yes No NA NE
Are tablet chlorinators operational'? ❑ ❑ ❑ •
Are the tablets the proper size and type'? - ❑ 0 ❑ •
Number of tubes in use'?
Is the level of chlorine residual acceptable'? ❑ 0 ❑ U
Is the contact chamber free of growth, or sludge buildup'? ❑ 0 ❑
Is there chlorine residual prior to de-chlorination' 0 ❑ ❑ II
Comment. Chlorine tubes were not located.
Page# 3