NCG510450_Inspection_20191021 (4)

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 2 15 I 3 I NCG510450 111 12 I 19/09/24 I17
18 I S J 19 L G] 201 I
211111 1 1 I I I I II I I I I I I I I I I I I 1 I I I I
I I I I I I II I I I I I f6
Inspection
Work Days Facility Self -Monitoring Evaluation Rating 131 QA
---------------------- Reserved -------------------
671
70 I2 71 I tyI 72 I r I
uI
73 I I 174 751 I I I I I I I80
I I i
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 oermit Number)
10:55AM 19/09/24
16/11/21
Woolen Store
2895 Iron Works Rd
Exit Time/Date
Permit Expiration Date
Reidsville NC 27323
11:10AM 19/09/24
20/09/30
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
Reid Teague,2507 Richardson Dr Reidsville NC 27320//336-349-8228/3366341744
No
Section C: Areas Evaluated During Inspection (Check only those areas evaluated)
Operations & Maintenance 0 Other
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
Jim J Gonsiewski DWR/Division of Water Quality/336-776-9704/
10/21/2019
by:
RDocuSigned
`sA`1�+.-
Signature of Management Q A Reviewer Agency/Office/Phone and Fax Numbers
Date
DocuSigned by:
FLl T Snider
10/21/2019
4bB49[=22b:94EA—
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete.
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NPDES yr/mo/day Inspection Type
NCG510450 I11 121 19/09/24 117 18 ICI
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
The remediation unit was not operational. On July 28, 2019 the unit was hit by a vehicle that moved the
entire unit at least a foot. According to the operator, the police stated that the vehicle operator fell
asleep and crossed Iron Works Road and hit the unit.
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Permit: NCG510450
Inspection Date: 09/24/2019
Other
Owner - Facility: woolen Store
Inspection Type: Compliance Evaluation
Comment:
Is the plant generally clean with acceptable housekeeping?
Does the facility analyze process control parameters, for ex: MLSS, MCRT, Settleable
Solids, pH, DO, Sludge Judge, and other that are applicable?
Comment:
Yes No NA NE
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