NCG550736_Compliance Evaluation Inspection_20191107

ROY COOPER
Governor
MICHAEL S. REGAN
Serrefory
LINDA CULPEPPER
Uimcror
Sharon Gilbert
436 Church Lane
Sutherlin, VA 24594
Dear Ms. Gilbert:
NORTH CAROUNA
Environmental Quality
November 7"', 2019
Subject: Compliance Evaluation Inspection
Single Family Wastewater Treatment System
Permit No. NCG550736
Person County
On November 6`f', 2019, Josh Brigham from the Raleigh Regional Office visited your single-
family residence (SFR) wastewater treatment system to evaluate compliance with the above
permit to discharge wastewater. Your assistance during the inspection was Featly appreciated.
The checked boxes below show what conditions were noted at your facility:
® In compliance: You are reminded to regularly maintain the chlorine disinfection,
have the effluent sampled once a year, and have the septic tank pumped out every 3 to 5
years. Thank you for operating and maintaining your wastewater treatment system in
accordance with your permit.
® Other: During the inspection you stated that your system never discharges and a
laboratory was not able to gather samples. If you do find in the future that your system is
discharging, the permit requires having the effluent analyzed.
If you have questions or comments about this inspection or the requirements to take corrective
action, please contact Josh Brigham or me at 919-79I-4200. Licensed plumbers should be used
to make plumbing changes within your home. Contractors for installing disinfection or other
equipment may be found in the Yellow Pages under Environmental Consultants.
Sincerely,
K L�Z
S. y merman, P.G., Chief
Water Q ality Regional Operations Section
Raleigh Regional Office, Water Quality Regional
Operations Section, Division of Water Resources
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Attachments:
Single Family Wastewater System Checklist
Inspection Report
cc: RRO files

United States Environmental Pratecteon Agency
Forst 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 Cod�ee NPDES yrlmolday Inspection Type
Inspector Fac Type
I�
Fry i 2 15 3 NCG55073S 1 1 1 121 19/1,106 17 18 L-JI f I
19 I s I 201 I
211 1 1 1 1 1 1 I I I III I I I I I I I I I I I I I I I I II I I
1
I I I I I I 1 I r6
I
Inspection Work Days Facility Self -Monitoring Evaluation Rating B1 OA
Reserved
72 LuJ 73 I 74 751 1 1 1 1 I 80
67 70 Lj
71 itJ
Section 8: Facility Data
Name and Location of Facility Inspected (For Industrial Users discharging to POTW, also indude Entry Time/Date
Permit Effective Date
POTW name and NPDES permit Number)
0100PM 19'11:06 13008101
62 Sam Caulder Drive
62 Sam Cautder Dr Exit Time, Date
Permit Expiration Hate
Semora NC 27343 C 1 50PM 19+11.'06 18,07e31
Name(s) of Onsite Representative(s)/Titles(s)lPhone and Fax Numbers) Other Facil ty Data
p!
Name, Address of Responsible Offscialfride/Phone and Fax Number
Sharon O Gflbert,436 Church Ln 5utherlin VA 24594d434-822-6173; Contacted
No
Section C Areas Evaluated During Inspection (Check only those areas evaluated)
Permit E Operations & Maintenance
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
(See attachment summary)
Name(s) and Signature(s) of Inspectors) Agency, Ofce..Pr%ane and Fax Numbers
Dale
Joshua S Brigham DWRIRRC W0r919-791.420� f
7,, -7-2lL'
II
fl /%/l 1
Signature of Management A Reviewer Agen-y'Office,Phcre and Fax N..mbers
Date
EPA Fern 3540-3 (Rev 9-94) Previous editions are obsolete.
Page#

NPDES yrlmolday Inspect-Dn Type (Cont.)
31 NCG550736 I11 12 19n1: 6 117 18 I r I
Section D Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
On November 6th, 2019, Josh Brigham from the Raleigh Regional Office visited your single-family
residence (SFR) wastewater treatment system to evaluate compliance with the above permit to
discharge wastewater. Your assistance during the inspection was greatly appreciated. The checked
boxes below show what conditions were noted at your facility:
1 In compliance: You are reminded to regularly maintain the chlorine disinfection, have the effluent
sampled once a year, and have the septic tank pumped out every 3 to 5 years_ Thank you for operating
and maintaining your wastewater treatment system in accordance with your permit.
1 Other: During the inspection you stated that your system never discharges and a laboratory was not
able to gather samples. if you do find in the future that your system is discharging, the permit requires
having the effluent analyzed.
If you have questions or comments about this inspection or the requirements to take corrective action,
please contact Josh Brigham or me at 919-791-4200. Licensed plumbers should be used to make
plumbing changes within your home. Contractors for installing disinfection or other equipment may be
found in the Yellow Pages under Environmental Consultants,
Page*

Permit: NCG550736 Owner -Facility- 62 5am Caulder l)nve
Inspection Dale: 1110612019 Inspection Type: Ccrmphance 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
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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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0
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Is access to the plant site restricted to the general publi--?
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0
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Is the inspector granted access to all areas for inspecticn?
M
❑
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Comment:
Pagan 11

Inspection Date: i 116�i Start Time: D 0 Q M End Time: : S D P M
5/152015 .--- _.---- ..,.1%%JI.-j6"wl
Permittee: a 0,1) G;I be f
Permi#;__IUCGSi5073b
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v d
Address: Z Scln�+ aer 12J Lol ' 5eAi,, /����E-mail'
ktron,
ctj of 1 5�
cll�b0.(6R
Phone:{ �j3 !) zS t _�7 ty Cell Phone:(_} -
County:
trSo-n
The Permittee Is responsible (or tho operation and maintenance at ti,e enure wastewater treatment and disposal system.
K36 C1,I-rCti C
Q�r)reS `�' 5�+6+sr I; n %)4 Z'tSaW
Yes
No
Doesn't
Apply
Did Not
Investigate
1. Is the current resident in the home the Permittee?
2. If not does the resident rent from the permittee?
❑
M
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3. Change of Ownership form needed? (mail the form with the inspection letter)
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El0
4. Is there a inspection and maintenance agreement with a contractor?
r
1Pl
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5. If yes to #4 who is the contractor? S , a/lM L-e wt O„ � ,I
SEPTIC TANK The septic tank and filters should be checked annually and Fumped; cleared as needed
6. Is all wastewater from the home connected to the sept:c tank?
�
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❑
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7. Does the permittee/resident know where the septic tank is located?
My
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8, Has the septic tank been pumped in the last 5 years?
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9. If yes to #8 date, if known 2e I fg If proof, describe
10. Does the septic tank have an EFFLUENT FILTER c• SANITARY T? (circle one)
11. If Yes to filter when was the filter cleaned? By whom?
SAND FILTER / TREATMENT PODS YES INA NO If no proceed to the next section.
Accessible sand filter surfaces shall be raked and leveled every six months
and any vegetative growth shalll
be removed
manua'ly
12, is system something other than a sandfilter?
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r
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13. If yes, what kind? (examples - Peat, Textile, Other or brand name - Advantex, etc.)
14. Does the permittee know where the sandfilter is located?
�I
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15. Does the sandfilter require maintenance?
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it maintenance is requuerl explain in tde comment section.
DISINFECTION / UV YES Ej NO It no proceed to the next section.
The ultraviolet unit shall be checked weekly. The lamps and sleeves should be cleaned or replaced as needed to proper disinfection
1 S. Is UV
working?
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17. Has the UV Unit been serviced and bulbs cleaned?
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18. Who completes the weekly check for the UV?( Non -Discharge)
DISINFECTION / TABLETS YES 0
The tablet chlorinator unit shall be checked weekly
NO 0
If no proceed to the next section.
to ensure continuous and proper operation.
19. Does the permittee have the correct chlorine tablets?(If none, mark No)
01
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20. Does the Permittee know the location of the chlorinator?
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21. Were chlorine tablets observed in the chlorinator?
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22. Are tablets contacting water? if possible poke them to determine.
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DECHLOR (Discharge only) YES NO
The dechlorinator unit shall be checked to
If no proceed to the next section.
week{y ensure continuous and proper operation
23. Does the permittee know where the dechlor is?
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24. Does the permittee have the correct dechlor tablets?
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25. Were dechlor tablets observed in the dechiorination chamber?
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26. Are tablets contacting water? if possible poke them to determine
❑
0
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0

Doesn't
Did Not
Yes
No
Apply
Investlgatr
SUMP TANK YES LJ NO
If no proceed to the next section.
kit pump and alarm sytems shall be inspected monthly. (non -discharge)
27. Is the pump working?
El
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28. Are the audible and visual high water alarms operational?
El
0
El
29. Does the permittee know how to check the pump & high water alarm?
30. Last functional test: PUMP AUDIBLE & VISUAL
DISCHARGE ONLY YES NO LJ
if no proceed
to
the next section.
A visual review of the outfall location shall be executed twice each year (one at the time of sampling to ensure no visible solids or
❑
evidence of a malfunction
❑ ❑
�
31. Does the permittee know where the outrali is located?
El
32. Were you able to locate the outfall?
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19
33. Is the end of the discharge pipe visible and accessible?
g PP
0
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❑
YN
34. Is outlet discharging?
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35. Is right of way maintained around the discharge point?
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q
36. Any Lab Results available?
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37. Is there evidence of solids around the discharge point's
RIP or SPRAY YES NO
if no proceed to the next
section.
The irrigation system shall be Inspected monthly to ensure the system is free of leaks and equipment is operating as
designed.
ID
38. Is the system DRIP or IRRIGATION (circle one)? If irrigation number of sprinkler
heads.
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39. Are the buffers adequate?
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40. Is the site free of ponding and runoff?
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41. Does the application equipment appear to be working properly?
42. is there a minimum two wire fence surrounding entire irrigation area?
0
El
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43. Are the treatment units locked and or secured?
i
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M
44. Has resident had any sewage problems? It yes explain In the comment section.
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45. Does the system match the permit description? tf no explain in the comment section.
El47.
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46. Is the system compliant?
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El
Is the system failing? Ir yes, take pictures if possible.
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48. if system Is failing, any sign of children or animals contacting sewage?
NOD Sent #: - NOV Sent #:
-
Comments: Photos Taken?
YES
NO
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INSPECTOR: -3n4 k SIGNATUR