NCG550386_Compliance Evaluation Inspection_20191112

ROY COOPER
Gavcrnor
MICHAEL S. REGAN
Secroar'V
LINDA CULPEPPER
Vir cc for
Stanton Moss
318 Lake Ridge Dr.
KernersviIle, NC 27284
Dear Mr. Moss
N,')PrH C.ARCLUNA
EnvIronmenral Quality
November 12"', 2019
Subject: Compliance Evaluation Inspection
Single Family Wastewater Treatment System
Permit No. NCG550386
176 Whippoorwill Ln., Semora, NC 27343
Person County
On November 6`h, 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:
® Treatment tablets missing or are wrong kind: You are responsible for always
having chlorine tablets and dechlorination tablets (if a required part of your system) in
place. They must be the kind for wastewater treatment and not for swimming pools.
® Pumping the septic tank: The septic tank should be pumped out every 3 to 5 years.
A pumping company can check the status periodically and determine when pumping is
required.
Please respond to the checked f �]C via email or a written letter within 30 days of receiving this
letter. Please email your response to JosI1Lla.BriLhaln ccricdenr.+,ov or to Josh Brigham's
attention at the address at the bottom of the first page of this letter.
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. Thank you for your cooperation. If you have questions or comments
about this inspection or the requirements to take corrective action, please contact the inspector or
me at 919-791-4200.
�x ti��i'll'� Ir.r[r'I rrrn�rlufEn+.irunrrcntalCZud!irq [7i.l,inncifNr,rU.rficso+rr.ry
A,a. Uh EL ui .rta +) ' r 1,800 [S<sr i rrl I:h i:r PA,' ,' 01. Nm th C•wrol7rw L74>09
/�� 91 3 (M's IN)

Sincerely,
iimmennan,
S. ay P.G., Chief
Water Quality Regional Operations Section
Raleigh Regional Office, Division of Water Resources
Attachments
Single Family Wastewater System Checklist
Inspection Report
cc: RRO files
DWR Lasencche

United States Environmental Protection Agency
EPA Washington, D C. 20460
Form Approved
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 yrlmolday Inspectic-1 Type
Inspector Fac Type
1 u 2 15 1 3 I NCG550386 111 12 19111;06 17 18 I (
u
19 I S( 20I I
u u
21
6
Inspection Work Days Facility Self -Monitoring Evaluation Rating B 1 OA
Reserved
67 70 fJ 71 LJ 72 Lj ti ( 73 LLJ74
75 III I 11J80
Section B: Facility Data
Name and Location of Facility Inspected (For Industrial Users discharging to POTW, also include Entry TimelDale
Permit Effective Date
POTW name and NPDES oermit Number)
02 30PM 19/11/06 13,08101
Coon Ridge Trail 1 Lot #2
176 Whippoorwill Ln Exit TimelDale
Perm„1 Expiration Date
Semora NC 27343 02 45PNI 19/11/06 18f07J31
Names) of Onsile Representative(s)ITitles(s)1Phone and Fax Number(s) Other Fa-a,ty Data
111
Name, Address of Responsible Otficial/Tille/Phone and Fax Number
Stanton J Moss,318 Lakerfdge Dr Kernersville NC 27284 ?910-996-2085r Contacted
No
Section C; Areas Evaluated During Inspection (Check only those areas evaluated)
Permit 0 Operations & MatntenanCE N Effluent/Receiv ng Waters
Section D. Summary of Finding Comments (Attach additional streets of narrative and checklists as necessary)
(See attachment summary)
Name(s) and Signalure(s) of Inspector(s) Agency.,OfficelPhone and Fax Numbers
Date
Joshua S Brigham DWRIRRO WO+919-791-42G3:
Signature of Management O A Reviewer AgencylOf ice, Phcne and Fax Numbers
Date
EPA
Form 3i5a -3 ev 9-94) Previous ed tions are obso'ete.
Page#

NPOE5 yr'moiday Inspection Type
31 NCG550386 I11 12 19111,06 17 18 ICI
J
Section D_ Summary of FindinglCommenls (Attach additional sheets of narrative and checklists as necessary)
1 Treatment tablets missing or are wrong kind: You are responsible for always having chlorine tablets
and dechlorination tablets (if a required part of your system) in place. They must be the kind for
wastewater treatment and not for swimming pools.
1 Pumping the septic tank: The septic tank should be pumped out every 3 to 5 years. A pumping
company can check the status periodically and determine when pumping is required.
page#

Permit: NCG550386 Owner - Facility: Coon Ridge Trail ! Lot #2
Inspection Dale: 11/06/2019 Inspection Type: Compliance Evaluation
Permit
Yes No NA NE
(If the present permit expires in 6 months or less). Has the permittee submitted a new
❑
❑
M
❑
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?
0❑
❑
❑
Is the inspector granted access to all areas for inspection?
0
❑
❑
❑
Comment:
Operations & Maintenance Yes No NA NE
Is the plant generally clean with acceptable housekeeping? ❑ ❑ ❑
Does the facility analyze process control parameters, for ex: MLSS, MCRT, Settleable ❑ ❑ 0 ❑
Solids, pH, DO, Sludge Judge, and other that are applicable?
Comment:
Septic Tank
Yes No NA NE
(If pumps are used) Is an audible and visual alarm operational?
❑
❑
0
❑
Is septic tank pumped on a schedule?
❑
■
❑
❑
Are pumps or syphons operating properly?
❑
❑
■
❑
Are high and low water alarms operating properly?
❑
❑
so
Comment: Septic tank has never been Pumi3ed according to permittee.
Sand Filters Low rate
Yes No NA NE
(If pumps are used) Is an audible and visible alarm Present and operat.onal?
❑
❑
M
❑
Is the distribution box level and watertight?
❑
❑
❑
■
Is sand filter free of ponding?
■
❑
❑
❑
Is the sand filter effluent re -circulated at a valid ratio?
❑
❑
■
❑
# Is the sand filter surface free of algae or excessive vegetation?
M
❑
❑
❑
# Is the sand filter effluent re -circulated at a valid ratio? (Approximately 3 to l)
❑
❑
0
❑
Comment:
Disinfection -Tablet Yes No NA NE
Are tablet chlorinators operational? 0 ❑ ❑ ❑
Are the tablets the proper size and type? ❑ . ❑ ❑
Number of tubes in use? 2
Page# 3

Permit: NCG550386 Owner - Facility: Coon Ridge Trail 1 Lot #2
Inspection Date: 1110612019 Inspection Type: Compliance Evaluation
Disinfection -Tablet Yes No NA NE
is the level of chlorine residual acceptable?
Is the contact chamber free of growth, or sludge buildup?
Is there chlorine residual prior to de -chlorination?
Comment: No tablets observed in chlorinators.
Effluent Pi e
Is right of way to the outfall properly maintained?
Are the receiving water free of foam other than trace amounts and other debris?
If effluent (diffuser pipes are required) are they operating properly?
Comment:
❑ ❑ ■ ❑
❑ ❑ ❑
❑ ❑ M ❑
Yes No NA NE
M
❑
❑
❑
❑
❑
M
❑
❑
❑
M
❑
Page# 4

Inspection Date: l Start Timt3: yzp End Time: '>
5/15/20 f 5 51NGLE FAMILY WASTEWATER SYSTEM CHECKLIST
Permittee: .I o c-s Permit: N'E65 5 O
Address: Oo. Z !7G wk; r„�,z Lrr�1,�� 2. 3tiz
Phone: Cell Phone: �10
( _) ` i-7 13 County: Pe_ry c .,j
The Permittee Is responsible for the operation and maintenance of the entire wart-3water treatment and disposal system.
4 S Sit L� t�l�► J L Cs r
fps `� f=crncr5•,; 11 Z�NI. z-� 2 �; �� Doesn't Did Not
Yes No Apply Investigate
1. Is the current resident in the home the Permittee?
NJ-
❑
❑
2. If not does the resident rent from the permittee?
❑
❑
❑
3. Change of Ownership form needed? (mail the form with the inspection letter,
❑
�
❑
❑
4. Is there a inspection ar-d maintenance agreement,,vith a contractor?
❑
EK
❑
❑
5. If yes to #4 who is the contractor?
SEPTIC IC TANK The septic tank and filters shou!d ke checked annual y and purnpe.d,cl_aned as needed
3. Is all wastewater from the home connected to the septic tank?
N,
❑
❑
❑
7. Does the permittee/resident know where the septic tank is located?
L'ISI,
❑
❑
❑
3. Has the septic tank been pumped in the last 5 years?
❑
❑
El).
If yes to #8 date, if known If proof, describe
10. Does the septic tank have an EFFLUENT FILTER, or - AAIITAP,Y T? (circle one)
11. If Yes to filter when was the falter cleaned?
By whom?
SAND FILTER 1 TREATMENT PODS YES [j NO ❑ If
%ccessible sand filter surfaces shall be raked and leveled every six months and an ve ,., e
� _q_ta �- grovrth steal be
e r .proceed to the
removed manna y
next section.
2. Is system something other than a sandfilter?
❑
❑
❑
3. If yes, what kind? (examples - Peat, Textile, Other or brand name - Advantex etc )
4. Does the permittee know where the sandfilter is located?
�
❑
❑
❑
5. Does the sandfilter require maintenance?
❑
❑
❑
It maintenance is required explain in the rnmmcnr ­t,.,..
)ISINFECTION 1 UV YES ❑ r10
he ultraviolet unit shall be checked weekly The lamps and sleeves o,__ If no proceed to the next section.
P sh,uld L.C.to ce. d
- r re a--ed as
6. Is tiV �'lofking7
needed to ensure
❑
proFerd:'nfecto-
❑
❑
❑
7. Has the UV Unit been serviced and bulbs cleaned?
❑
❑
❑
❑
8. Who completes the weekly check for the UV?( Non -Discharge)
ISIINFECTION 1 TABLETS YES T10 ❑
ie tablet chlorinator unit shall be checked weekly to ensure continuous �r
1r no proceed t0 the next SeCtlon.
and r F-
p' -p- op- a' -
). Does the permittee have the correct chlorine tablets?(1f none, mark No)
LA
❑
❑
❑
?. Does the Permittee know the location of the chlorinator?
❑
❑
❑
1. Were chlorine tablets observed in the chlorinator?
1 1
'_. Are tablets contacting water? If possible poke them to determ'ne
❑
❑
Q
❑
=CHLOR (Discharge only) YES �—� l '-I
e dechlorinator unit shall be checked weekly to ensure continuo.) a d proper opera` o O
If n o proceed to the next section.
Does the permittee know where the dechlor is?
❑
❑
❑
❑
Does the permittee have the correct dechlor tablets?
❑
❑
❑
❑
Were dechlor tablets observed in the dechlorination chamber?
❑
❑
❑
Are tablets contacting 4vater? If possible poke them to determine
❑
❑
❑

Doesn't
Did Not
Yes
NO
Apply
Investigate
YES �] NO Q
if no proceed to the next section.
PUMP YANK '
All pump and warm sytems s}a' be inspected monthly. (non d -._:,a 9__
❑
❑
❑
❑
27. Is the pump working?
❑
❑
❑
❑
28 Are the audible and visual high dater alarms operational?
❑
❑
❑
❑
29. Does the permittee know how to check the pump & high water a,arm?
3f] Last functional test PUAAP AUDIBLE & VISUAL
YES NO
L�
If no proceed to the next section.
DISCHARGE ONLY
A v :ua{ rei ev7fif th��[itfa'. l-cat-nn shall be executed twice ea- y�3 {^S�= a' t a t,r+'a at sampling is ens
s;a na ble sa❑l ds or ev de❑rlce ofs?
r?alfu❑nction
31. Does the permittee know where the outfall is lccated?
9L
❑
❑
32 Were you able to locate the outfall?
9��
❑
❑
33 Is the end of the discharge pipe visible and access Ala'
0
[A
❑
❑
34. is outlet d-scharging?
❑
❑
❑
35. Is right of viral mainta,ned around the discharg- P: --ri f
❑
❑
❑
36 Any Lab Resu',ts available?
❑
�
❑
❑
37. is there evidence of sol;ds around the discharge po nt?
YES
if no proceed to the next section.
DRIP or SPRAY
The irrgak:on system shall be inspected monthly to ensure the s js'am is f•=_: cf leaks and =;_ pr3e"t
r'] as
d-=`fined
e system DRIP or IRRIGATION (circle one)? 11 irrigation number of sprinkler
heads
❑
❑
the buffers adequate?
❑
❑
❑
❑
e site free of ponding and runoff?
❑
❑
❑
❑
s the application equipment appear to be working properly?
❑
❑
❑
❑
ere a minimum tvo wire fence surrounding entire ir:,igat'on area?
k1sthere
AL
t�l
❑
the treatment units locked and or secured?+s
resident had any se �vage problems? I y-2s e.<p'3'n in I ommar�t S-�t 3r;es
the system match the permit description? if r:) e,<p 3 n i� tl e cer?irrert se St! 0n
46. Is the system compliant?
47. Is the system failing? if yes take pictures if possible
48, if system is failing any sign of children or animals conta�;ting se'rraga?
NOD Sent #: - - - _.--- �JOV Sent #
�— Photos Taken?
Comments'.
rr ► (., -cru
r I i `Il ru 1'r1� r nw '-r,r, _Ir ULuS I
1�li�ta� lnon� Al 1
` 7 Q l+n p k
❑ ❑ ❑
YFS r NO
lkh
! t7 - c �. _nn eir r`IATI IRF