NCG551017_Regional Office Historical File 2007 to 2017

ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
S. JAY ZIMMERMAN
Director
June 29, 2017
James Griffin
469 Triple Creek Drive
Hendersonville, NC 28739
SUBJECT: Compliance Evaluation Inspection
469 Triple Creek Drive
Permit No: NCG551017
Henderson County, NC
Dear Mr. Griffin:
On June 21, 2017, Mikal Willmer and I conducted a Compliance Evaluation Inspection (CEI) of
the Single Family Residence (SFR) wastewater treatment system located at 469 Triple Creek
Drive. The property and the system were well maintained and appeared to be in compliance with
NPDES Permit No. NCG551017.
Please refer to the enclosed inspection report for additional observations and recommendations. I
have also attached a Name/Ownership Change Form should _you wish to sell the property in the
future. If you have any questions, please feel free to contact me at 828-296-4500 or by email at
[e-mail].
Sincerely,
Tim Heim, P.E.
Environmental Engineer
Asheville Regional Office
Enclosure: Inspection Report
Name/Ownership Change Form
cc: MSC 1617-Central Files
40WWQ*7As , et+•i'11e Files
G:\WR\WQ\Henderson\Wastewater\General\NCG55 SFR\1017 Jim Griffen\CEI Letter 6-21-2017.docx
State of North Carolina I Environmental Quality I Water Resources
2090 U.S. 70 Highway, Swannanoa, NC 28778
828-296-4500

United States Environmental Protection Agency
e
Form Approved.
Washington, D.C. 20460
EPA
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 ydrno/day Inspection Type Inspector Fac Type
1 IN I 2 15 I 3 I N6G551017 I11 12 17/b6/21 17
18 LCJ 19 I Gj 201 I
211III I I I I I III 11 1 I I I I I I I I I I I I I I
I I I I I III I I I I I �6
Inspection
Work Days Facility Self -Monitoring Evaluation Rating B1 CIA
—Reserved--
67
701 I 71 72 LNJ
LJ Ll
73L75IJJI I I I I
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)
02:OOPM 17/06/21
13l08/01
Triple Creek Subdivision / Lot 28
Triple Creek Subdivision Lot 28
Exit Time/Date
Permit Expiration Date
Hendersonville NC 28739
i
02:45PM 17/06/21
18/07/31
Name(s) of Onsite Representative(s)/Tities(s)/Phone and Fax Number(s)
Other Facility Data
Name, Address of Responsible Official/Title/Phone and Fax Number
Contacted
James P Griffin,111 Grovers Mill Rd Plainsboro NJ08536N
No
Section C: Areas Evaluated During Inspection (Check only those areas evaluated)
Operations & Maintenance N 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
Timothy H Heim ARO WQ//828-296-4665/
Signature of Management Q A Reviewer Agency/Office/Phone and Fax Numbers
Date
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete.
Page#

NPDES
yr/mo/day
31 NCG551017 -' I11 12 ' 17/06/21 17
Inspection Type
18I„i .
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
Tim Heim and Mikal Willmer of the Asheville Regional Office performed a Compliance Evaluation
Inspection on June 21, 2017. The facility appeared well maintained and operated at the time of the
inspection. No negative impact to the receiving.'stream was observed.
Page#

I
Permit: NCG551017
Inspection Date: 06/21/2017
Operations & Maintenance
Owner - Facility: Triple Creek Subdivision / Lot 28
Inspection Type: Compliance Evaluation
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
N
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Page# 3

Inspection Date: * VX � / ) % Start Time: ! - D) IIA End -Time: '� q �— ®�!7
SINGLE FAMILY WASTEWATER SYSTEM CHECKLIST
11512015
Permittee: V
Permit:
Address: Q ��I (i, &P-AC D�-Nl'Q E-mail-. "
Phone:(` �0��-- `��11 Cell Phone:(_) -
County:
r
1�211G�'CY)
The Permittee is responsible for the operation and maintenance of the entire wastewater treatment and disposal system.
Doesn't Did Not
Yes
No
Apply Investigate
1. Is the current resident in the home the Permittee?
El
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2. If not does the resident rent from the permittee?
n0
1 \A
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3. Change of Ownership form needed? (mail the form with the inspection letter)
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4. Is there a inspection and maintenance agreement with a c ntractor?
5. If yes to #4 who is the contractor? 0 Ups— (tip 5 t
SEPTIC TANK The septic tank and filters should be checked annually and pumped/cleaned as needed.
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6. Is all wastewater from the home connected to the septic tank?
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7. Does the permittee/resident know where the septic tank is. located?
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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 If proof, describe
10. Does the septic tank have an EFFLCENT FILTE - or SANITARY T? . (circle one)
11. If Yes to filter when was the filter cleaned? By whom?
SAND FILTER / TREATMENT PODS YES SrNO
If no proceed to the next section.
Accessible sand filter surfaces shall be raked and leveled every six months and any vegetative growth shall be removed
man ey.
❑
El12.
Is system something other than a sand filter?
13. If yes, what kind? (examples - Peat, Textile, Other or brand name - Advantex, etc.)
14. Does the permittee know where the filter is located?
Ey
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EI
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1:1
15. Does the filter require maintenance?
If maintenace is required explain in the comment section.
DISINFECTION / UV YES NO
If 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 ensure proper disinfection.
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16. Is UV working?
17. Has the UV Unit been serviced and bulbs cleaned?
18. Who completes the weekly check for the UV?( Non -Di arge)
DISINFECTION / TABLETS YES NO
If no proceed to the next section.
The tablet chlorinator unit shall be checked weekly to ensure continuous and proper operation. -
19. Does the permittee have the correct chlorine tablets?(If none, mark No)
20. Does the Permittee know the location of the chlorinator?
❑
21. Were chlorine tablets observed in the chlorinator?
22. Are tablets contacting water? If possible poke them to 2termine.
0
DECHLOR (Discharge only) YES NO Lj
be
If no proceed to the next section.
The dechlorinator unit shall checked weekly to ensure continuous and proper operation.
V
0
23. Does the permittee know where the dechlor is?
ESI�
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0
24. Does the permittee have the correct dechlor tablets?
T
.
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25. Were dechlor tablets observed in the dechlorination chamber?
EN/
26. Are tablets contacting water? If possible poke them to determine.

Doesn't
Did Not
Yes
No
Apply
Investigate
PUMP TANK YES NO ❑
If no proceed to the next section.
All pump and alarm sytems shall be inspected monthly. (non -discharge)
27. Is the pump working?
�%
u
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0
❑
28. Are the audible and visual high water alarms operational?
29. Does the. permittee know how to check the pump & high water alarm?
Lam'
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30. Last functional test?
DISCHARGE ONLY YES NO
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
31. Does the p&mittee know where the outfall is located? ❑
evidence of a malfunction.
❑ ❑
32. Were you able to locate the outfall?
❑
❑
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33. Is the end of the discharge pipe visible? If not, explain why.
El
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34. Is outlet discharging?
=
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35. Is right of way maintained around the discharge point?
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36. Any Lab Results available?
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37. Is there evidence of solids around the discharge point?
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DRIP or SPRAY YES Ej NO IV
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.
38. Is the system DRIP or IRRIGATION (circle one)? If irrigation number of sprinkler heads.
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?
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42. Is there a minimum two wire fence surrounding entire irrigation area?
❑
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GENERAL
43. Are the treatment units locked and or secured?
NK
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44. Has resident had any sewage problems? If yes explain in the comment section.
45. Does the system match the permit description? If no explain in the comment section.
46. Is the system compliant?
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47. Is the system failing? If yes, take pictures if possible.
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48. If system is failing, any sign of children or animals contacting sewage?
❑
❑
❑
NOD Sent M - - - NOV Sent M
-
- -
Comments: Photos Taken?
YES
NO
WA
INSPECTOR: SIGNATURE:

NCDENR
North Carolina Department of Environment and Natural Resources
Division. of Water Quality
Michael F. Easley, Governor
James P. Griffin
111 Grovers Mill Rd
Plainsboro, NJ 08536
Dear Permittee:
William G. Ross, Jr., Secretary
Coleen H. Sullins, Director
August 30, 2007
Subject: Renewal of coverage / General Permit NCG550000
Triple Creek Subdivision, Lot 28
Certificate of Coverage NCG551017
Henderson County
In accordance with your renewal application [received on January 16, 20071, the Division is renewing
Certificate of Coverage (CoC) NCG551017 to discharge under NCG550000. This CoC is issued pursuant to the
requirements of North Carolina General Statue 143-215.1 and the Memorandum of Agreement between North
Carolina and the US Environmental Protection agency dated May 9, 1994. [or as subsequently amended].
If any parts, measurement frequencies or sampling requirements contained in this General Permit are
unacceptable to you, you have the right to request an individual permit: by submitting an individual permit
application. Unless such demand is made, the certificate of coverage shall be final and binding.
Please take notice that this Certificate of Coverage is not transferable except after notice to the
Division. The Division may require modification or revocation and reissuance of the certificate of coverage.
Contact the Asheville Regional Office prior to any sale or transfer of the permitted facility.
Regional Office staff will assist you in documenting the transfer of this CoC.
This permit does not affect the legal requirements to obtain.other .permits which may be required by
the Division of Water Quality or permits required by the Division of Land Resources, Coastal Area
Management Act or any other Federal or Local governmental permit that may be required.
If you have any questions concerning the requirements. of the .General Permit, please contact Toya
Fields [919 733-5083, extension 551 or [e-mail] or Susan.Wilson [919 733-5083, extension 510
or [e-mail].
Sincerely,
for Coleen H.
cc: Central Files
W
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
512 North Salisbury Street, Raleigh, North Carolina 27604
Phone: [phone] / FAX [phone] / Internet: www.ncwaterquality.org
o ►.
SEP - 5 2007
ION I
e numm i G Pr-r InNAL OFFICE
An Equal Opportunity/Affirmative Action Employer— 50% Recycled/10% Post Consumer Paper

STATE OF NORTH CAROLINA
DEPARTMENT`OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NCG550000
CERTIFICATE OF COVERAGE NCG551017
DISCHARGE OF DOMESTIC WASTEWATER FROM SINGLE FAMILY RESIDENCES AND
OTHER 100% DOMESTIC DISCHARGES WITH SIMILAR CHARACTERISTICS UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards and
regulations promulgated and adopted by the North Carolina Environmental Management Commission, and
the Federal Water Pollution Control Act, as amended,
James P. Griffin
is hereby authorized to discharge domestic wastewater [360 GPD] from a facility located at
Triple Creek Subdivision, Lot 28
Hendersonville
Henderson County
to receiving waters designated as Mill Pond Creek in subbasin 04-03-02 of the French Broad River
Basin in accordance with the effluent limitations, monitoring requirements, and other conditions
set forth in Parts I, II, III and IV hereof.
This certificate of coverage shall become effective. August 30, 2007.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day August 30, 2007.
or C.oleen H. Sullins; Director
Division of Water Quality
By:.Authority of the Environmental Management Commission
j.

-.:..WS:t,.,R-tL'*E�'arJ.;ea"P1.arvadi^H,.e,..-<,e,wnam.s,em+zTkm-t.<taYi6Pt'raec..',�r'" ;N
NCDENR
North .Carolina Department of Environment anq N
Division of Water Quality i.
Michael F. Easley, Governor l
�i
I
- - I --s•=---'4+�' •—� - .. aw.mww-�.:sw�av,.:awczruiuxttya;svar .a.-:x;
January 9; 2007
James Griffin
111 Grover's Mill Rd
Plainsboro, NJ 08536 .
Subject: Renewal Notice / General Permit NCG550000
Certificate of Coverage NCG551017
Henderson County
Dear"Permittee:
You are receiving this notice because you currently own a property covered under the subject
General Permit for the discharge of domestic wastewater. NCG550000 will expire on July 31, 2007.
Federal (40 CFR 122.41) and North Carolina (15A NCAC 2H.0105(e)) regulations require
that permit renewal applications be filed at least 180 days prior to expiration of the current permit.
To satisfy this requirement, the Division must receive a renewal request postmarked no later than
February 1, 2007. .
The Certificate of Coverage (CoC) specific to your property was last issued on May 3, 2002.
The Division needs information from you to. determine if coverage under NCG550000 is still
necessary.
➢ If your property still has a wastewater system like the ones described in the enclosed
Technical Bulletin, you must renew the subject CoC. Complete the.enclosed form and
submit it to the address on the form.
➢ If you are not sure what type.of system your property has, contact Keith Haynes in the
NC DENR Asheville Regional Office at. That person [or other staff members] can help
you determine if you should renew your CoC.
➢ If you know that your property no longer discharges wastewater, contact me at the
address or phone number listed below to request rescission of the CoC.
➢ This information request does not pertain to the Annual Fee of $50.06 billed
seuarately by the Division's Budeet Office. No money is required for this
procedure.. The Annual Fee is like the fee you annually pay the DMV for the sticker on
your vehicle's license plate. Renewal of your CoC is like the renewal of your Driver's.
License [ca. every five years].
➢ If you have already mailed a renewal request, you may disregard this notice.
1617 Mail Service Center, Raleigh, North Carolina,27699-1617 One
512 North Salisbury Street, Raleigh, North Carolina 27604 NOrthCarollna
Phone: [phone], extension 511 / FAX [phone]/[e-mail] y
An Equal Opportunity/Affirmative Action Employer— 50% Recycle.d/10% Post Consumer Paper ;Vatzaally

NCG551017 renewal notice
January 9, 2007
The attached application form shows the information the Division has on file for your
property. Please verify that the provided information is correct, or make corrections on the form.
Complete the additional questions, then sign and date the form.
The completed form should be submitted to the address listed below the signature block.
If you have any questions concerning this matter, please contact me at the telephone number
or e-mail address listed below. (If it is difficult to reach me, please be aware that your facility is one
of over 1100 that I am contacting regarding the renewal of NCG550000.)
Thanks for your attention to, this matter.
Sincerely,
Charles H. Weaver, Jr. .
NPDES Unit
cc: Central Files
NPDES file

4 :,
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins
Governor Director
James P. Griffin
111 Grovers Mill Road
Plainsborow, NJ 08536
Dear Mr. Griffin:
Kll(
Dee Freeman
Secretary
April 20, 2009
Subject: General Permit No. NCG550000
Authorization to Construct NCG551017
James P. Griffin Property
Henderson County
As you requested, I am writing this letter regarding the Authorization to Construct NCG551017 issued to you
on February 20, 2009. In that letter you were required to:sample the treated effluent for all parameters of your
NCG550000 General Permit and send the analysis to Roger Edwards, NCDENR, Asheville Regional Office,
Surface Water Protection, 2090 US Highway 70, Swannanoa, NC 28778 by June 30, 2009. Per our telephone
conversation last week, you are not intending to move into your house located in Henderson County until
sometime in July 2009. Therefore, the submission date for the sampling analysis is changed to October 31,
2009. The collected sample shall be representative of Lot No. 28's wastewaters and taken prior to mixing with
any other waters. All other conditions of the ATC remain the same.
If you have any questions concerning the requirements of this permit, please contact Julie Grzyb" at telephone
number 919/807-6389.
cc: Central Files
NPDES General Permit Files
ada
h-ew gil 1 l lffiee, Surface Water Protection
WATER QUALITY SECTION
ASHEVILLE REGIONAL OFF -ICE
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Location: 512 N. Salisbury St. Raleigh, North Carolina 27604 One
O/I/1Tla
Phone: [phone] \ FAX: [phone] \ Customer Service:1-877-623-6748 NOIIC Tn
Internet: www.ncwaterquality.org j aturLl6L�/
An Equal Opportunity 1 Affirmative Action Employer ��// �/

NCG551017
Engineer's Certification
I, TO-WA1 �¢�/, as a duly registered Professional Engineer in the State of North
'Carolina, having been authorized to observe (periodically, weekly, full time) the construction of the
following domestic wastewater treatment system project:
Project Name Location
For the permittee hereby state that, to the best of my abilities, due care and diligence was used in .
the observation of the construction such that the construction was observed to be built within
substantial 7/,iv,02
d inten of the approved plans and specifications.
Signature
Registration No. /1'/2-Y
Date a ' 2-00r7
�SSIO%y,9�.
DAN & ASSOCIATEa INC. MA-0
1f FORGE VALLEY DRIVE UNIT 1
AKW RIVER, NC 28759
J R•.
�rrnrrnnr»��

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 I NI 2 15I 31 NCG551017 111 121 06/08/28 117 181 CI 191 SI 20I II
Remarks
21111111111111111111111111111111111111111111111116
Inspection Work Days Facility Self -Monitoring Evaluation Rating 131 QA ---- --------------- ------ Reserved --- ------- ------- --
67 I 169 701 I 711 I 721 NJ 73I WI 174 751 I I I I I Li
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)
James P Griffin'- residence
0 5:20 PM 06/08/28
02/05/03
Exit Time/Date
Permit Expiration Date
Triple Creek Subdivision Lot 28
Hendersonville NC 28739
05:40 PM 06/08/28
07/07/31
Name(s) of Onsite Representative (s)/Titles(s)/Phone and Fax Number(s)
Other Facility Data
Name, Address of Responsible OfficiaUTitle/Phone and Fax Number
Contacted
James P Griffin,lll Grovers Mill Rd Plainsboro NJ 08536///
No
Section C: Areas Evaluated During Inspection (Check only those areas evaluated)
Facility Site Review
Section D: Summary of Find in/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
�®
Larry Frost � ARO WQ//828-296-4500 Ext.4658/�i
Signature of Management Q A Reviewer Agency/Office/Phone and Fax Numbers Date
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete.
Page # 1

I NCG5S1017 I
yr/mo/day Inspection Type
12I 06/08/28 I17 18ICI
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
This facility has NOT yet been built.
Page # 2

MIMI;I% & CON5VU010N 5�I;VIC�5
15 Forge Malley Drive, Unit.l.,,
Mills River, NC 28759
NC License # C-2372 G'
September 25, 2009
Mr. Roger Edwards
NCDENR, Asheville Regional Office
Surface Water Protection
2090 US Highway 70
Swannanoah, NC 28778
1
i
i
Myer 11 .. ....>...
Yrl^
Re: James P. Griffin, NPDES Permit No. NCG550000, Authorization to Construct NCG551017.
Dear Mr. Edwards:
Attached please find the results of tests performed by Pace Analytical Services, Inc. on the
effluent from the Griffin wastewater treatment system.
Please contact me if you have any questions or if I can provide any additional information.
Sincerely,
Dean & Associates, Inc.
AJohn Dean, PE
Cc: James Griffin
Phone [phone] Fax [phone]
Email —[e-mail]

U ) - LJ- VJJ 1VJ , `30 rK$VL J-r(:LUC H1JQ1y L-LUCL-L
aceAnalytical
OLOLJLldulo
Pace analytical services, Inc.
2225 Riverside Or.
Asheville, NC 28e04
1-1f-1 rVJYJ.LIVJVJO r-LJ+
Pace AnatytiCal Servloes, Inc.
8600 Kinceyke. Suite 100
Hunteraville, NC 28078
September 25, 2009
Private Drinking Wate Client
Private Drinking Water Client
Client Services Dept,
Asheville, NC 28804
RE: Project: DEAN CONST. 09/14
Pace Project No.: 9253028
[phone] [phone]
IIIpq/7' III\11/�%u, LWJ
j OCT - 2 2009 I 'i
I /
)' ";ATER QUALITY SECTION•
ASHEVILLE REGIONAL OFFICE
.s
Dear Private Wate Client:
Enclosed are the analytical results for sample(s) received by the laboratory on September 14, 2009.
The results relate only to the samples included in this report, Results reported herein conform to the
most current NELAC standards, where applicable, unless otherwise narrated in the body of the
report.
Inorganic Wet Chemistry and Metals analyses were performed at our Pace Asheville laboratory and
Organic testing was performed at our Pace Huntersville laboratory unless otherwise footnoted, All
Microbiological analyses were performed at the laboratory where the samples were received.
If you have any questions concerning this report, please feel free to contact me.
Sincerely,
Jane Meehan
[e-mail]
Project Manager
Enclosures
REPORT OF LABORATORY ANALYSIS
Page 1 of 7
This report shall not be reproduced, except in lull,
without the written Consent or Pace Analytical $ervloes, Inc-.
S/r1d�t�.y

eJJ-L:J- W,7 1U.'10 rnVL-J-rdUt: Mild1yL-LUdl. 6404 gold 1-114 1•1owellolots r-401
/I,..�I Pace Analytical Services, Inc. Pace Analytical Services, Inc.
I�Wce
Allcilyt�Cai ® 2225 Riverside Or. 9800 Kincey Ave. Suite 100
Asneville, NC 28804 HuntersVilles, NC 20076
wwa:PdJlse&mm
[phone] [phone]
CERTIFICATIONS
Project: DEAN CONST. 09/14
Paco Project No.: 9253028
Charlotte Certification IDS
West Virginia Certification #: 357
North Carolina Drinking Water Certification #: 3770E
Virginia Cortifloation M 00213
North Carolina Field Services Certification #: 5342
Connecticut Certification M PH-0104
North Carolina Wastewater Certification #:12
Florida/NELAP Certification #: E87627
Pennsylvania Certification #: 68-00784
Kentucky UST Certification M 84
South Carolina Certification #: 990060001
Louisiana/LEIAP Certification #: 04034
South Carolina Drinking Water Celt. #: 99006000/.
New Jersey Certification M NC012
Tennessee Certification #: 04010 �.
Asheville Certification IDS
West Virginia Certification M 356
North Carolina Wastewater Certification #: 4C
Floride/NELAP Certification M E87848
Pennsylvania Certification M 68-0357e
Louisiana/LELAP Certification #: 03095
South Carolina Bioassay Certification #: 990300029
Massachusetts Certification #: M-NCO30
South Carolina Certification #: 99030001
New Jersey Codification #: NC011
Tennessee Certification #: 2980
North Carolina Bioassay Certification M 4
Virginia Certification #: 00072
Connecticut Certification #: PH-0106
North Carolina Drinking Water Certification #: 37712
OCT - 2 2009
it WATER QUALITY SECTION
s;' L ASHEVILLE REGIONAL OFFICE
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduc0d, except in full,
Without the written consent of Pace Analytical Services, Inc..
n F �eCo�4
At
Page 2 of 7

UJ LJ-- PJJ aw.110
aceAnalytical
nnwrpnWafte"
rnUn—raUc HUGE-LY IUCLI OL64 L4016
Project: DEAN CONST, 09/14
Pace Project No.: 9253028
Pace Analytical Services, Inc.
3225 Riverside Dr.
Asheville, NC 26804
[phone]
ANALYTICAL RESULTS
1-114 1/01015/ 10.106 r—L51
Pace Analytical Services, Inc.
9000 Kinney Ave. Suite 100
Huntersville, NC 20078
[phone]
Sample: GRIFFIN RES Lab ID: 9253028001 Collected: 09/14/0913,45 Received: 09/1410915:00 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
Field Data
Analytical Method:
Collected By
MPS
1
09/25/09 09:34
Collected Date
09/14109
1
09/25/09 09:34
Collected Time
13:45
1
09125/09 09:34
Field pH
6.32 Std. Units
1
09/25/09 09:34
Field Temperature
19.7 deg C
1
09/26/09 09:34
Field Residual Chlorine
13 ug1L mg/L
1
09126/09 09:34
MBIO 92220 Fecal Coliform AVL
Analytical Method: SM 9222D
Fecal Coliforms
12.0 CFU/100 mL
1.0 1
0911410915:20
2540D Total Suspended Solids
Analytical Method: SM 2540D
Total Suspended Solids
7,0 mg/L
5.0 1
09117/0915:38
52108 80D, 5 day
Analytical Method: SM 52106
000, 5 day
13.3 mg/L
2.0 1
09/16/0918:30 0912010915:30
ul
�1 , . .... .-...+....ems•.-..,-...-.._r••
0 2 2009 I, -.11
CT
VeATF_R QUAL QFF= CE
Date: 09/25/2009 09:33 AM REPORT OF LABORATORY ANALYSIS Page 3 of 7
This report shall not oe reproduced, except in full,
without the written Consent of Pace Analytical SBMCes, Inc..
..OEC.

YJJ—LJ— W-2 au.130
aceAnalytical
wrw.p"wobomm
rrsvu—ratio MiJa1yL1Ua1 OLOLD41301b
Project: DEAN CONST. 09/14
Pace Project No.: 9263028
Pace Analytical Services, Inc.
7225 Riverside Dr.
Asheville, NC 20804
(8261254-7176
QUALITY CONTROL DATA
QC Batch: WET19761 Analysis Method; SM 5210E
QC Balch Method: SM 6210B Analysis Description: 52100 DOD, 5 day
Associated Lab Samples: 9253028001
METHOD BLANK: 336478 Matrix: Water
Associated Lab Samples: 9253028001
. Blank Repotting
Parameter . Units Result Limit Analyzed Qualifiers
BOD, 5 day mg/L ND 2.0 09/20/0916:30
LABORATORY CONTROL SAMPLE: 336479
Spike
Parameter Units Cone.
SOD, 5 day mg/L 198
SAMPLE DUPLICATE: 336480
rlovi/ vivia r—czii
Pace Analytical Services, Inc.
9800 Klncey Ave. Suite 100
Nuntersvlfle, NC 28078
[phone]
LCS LCS % Rec
Result % Rae Limits Qualifiers
211 107 84.115
9253003001 Dup
Parameter Units Result Result RPD Quallfisrs
BOD, 5 day mg/L ND ND
Date: 09/25/2009 09:33 AM
REPORT OF LABORATORY ANALYSIS
OCT - 2 2009
WATER QUALITY SECTION
P.SHEViLLE REGIONAL OFF11 E }
Page 4 of 7
This report shall nol be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc..
e '00

i
PJJ LJ W.) AV,`10 1"13VLJ-rG16,L: H1JCL1y1-.LUC21 04OLZIL11010
Pate Analytical Services, Inc.
ceAnalytical • 2225 Riverside Dr.
Asheville, NC 20504
wwrsepJJoplpby opn
[phone]
QUALITY CONTROL DATA
Project: DEAN CONST. 09/14
Pace Project No.: 9263028
QC Batch: IMBIO/3477 Analysis Method: SM 9222D
QC Batch Method: SM 9222D Analysis Description: 9222D MBIO Fecal Coliform - AVL
Associated Lab Samples: 9253028001
METHOD BLANK: 336232 Matrix: Water
Associated Lab Samples: 9253028001
Blank Reporting
Parameter Units Result Limit Analyzed Qualifiers
Fecal Coliforms CFU/100 mL NO 1.0 09/1410915:20
SAMPLE DUPLICATE: 337975
rvlviz)/ v vio r-czlr
Pace Analytical Services, Inc.
9800 IGnoey Ave. Suite 100
Huntersville, NC 2907e
[phone]
92529980011 Dup
Parameter Units Result Result RPD Qualifiers
Fecal Coliforms CFU/100 mL 0.0 6.0 0 ul
P
OCT - 2 2009
WATER QUALITY SECTION
ASHEVILLE REGIONAL OFFICE
Date: 09/25/2009 09:33 AM
REPORT OF LABORATORY ANALYSIS
This repon shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc..
r.tirNw�w oi.� e
Page 5 of 7

wo—Li— wV aw , `tJ
aceAnalytical.
MwPOCeMtt MM
rnVn—raLc MUCUyLlUal 0L0LUL11U.L0 .
Project: DEAN CONST. 09/14
Pace Project No.: 9253028
Pace Analytical Services, Inc.
2226 Riverside Dr.
Asheville, NC 28804
[phone]
QUALITY CONTROL DATA
i-1r4 rvvia/vJloa r—Lz)r
Pace Analytical ServICe9, Inc.
9800 Kincey Ave, Suite 100
Huntersvills, NC 20071i
[phone]
QC Batch: WET/9766 Analysis Method: SM 2540D
QC Batch Method: SM 2540D Analysis Description: 2540D Total Suspended Solids
Associated Lab Samples: 9263028001
METHOD BLANK: 337964
Associated Lab Samples: 9263028001
Matrix: Water
Blank Reporting
Parameter Units Result Limit Analyzed Qualifiers
Total Suspended Solids mg/L ND 2,5 09/11/0916:28
LABORATORY CONTROL SAMPLE: 337965
Spike LCS LCS % Roe
Parameter Units Conc. Result % Rec Limits Qualifiers
Total Suspended Solids mg/L 250 262 105 80.120
SAMPLE DUPLICATE: 337966
Parameter Units
Total Suspended Solids mg/L
Date: 09/25/2009 09:33 AM ,
9252889006 Dup
Result Result
27.0 27.8
RPD Qualifiers
3
OCT - 2 2009
u, WATER QUALITY SECTION
ASHEVILLE REGIONAL OFFICE
REPORT OF LABORATORYANALY$,j4-;,. ., �............. Page6
This report shall not ce reproduced, except in full, .
without the written consent of Pace Analytical Services, Inc..
`,p,y lCCp�ip�

ru:J""LJ- ruJ aU,'10 rDVL'J-.rCXUL: MUCL1YL-LUCL1 040LOL1016 1-11'f r VJVJ r / IJVJC5 r—LJ 1
Pace Analytical Services, Inc. Pace Analytical Services, Inc.
• 2225 Riverside Dr. 8800 ftesy Ave. Sulte 100
weftlytical Aeheville. NC 28804 Huntersville, NC 20078
bamrPaeafeD&oast
[phone] [phone]
OUALIFIM
Project: DEAN CONST, 09/14
Pace Project No.: 9253028
DEFINITIONS
DF - Dilution Factor, if reported, represents the factor applied to the reported data due to changes in sample preparation, dilution of
the sample aliquot, or moisture content,
NO - Not Detected at or above adjusted reporting limit.
J - Estimated concentration above the adjusted method detection limit and below the adjusted reporting limit
MDL - Adjusted Method Detection Limit.
S - Surrogate
1,2-Diphenylhydrazine (8270 listed analyte) decomposes to Azobenzene.
Consistent with EPA guidelines, unfounded data are displayed and have been used to calculate % recovery and RPD values.
LCS(D) - Laboratory Control Sample (Duplicate)
MS(D) - Matrix Spike (Duplicate)
DUP - Sample Duplicate
RPD • Relative Percent Difference
NC - Not Calculable,
Pace Analytical is NELAP accredited. Contact your Pace PM for the current list of accredited analytes,
U - Indicates the compound was analyzed for, but not detected.
ANALYTE.QUALIFIERS
u1 Results based upon colony counts outside acceptable range.
D
t ' OCT - 2 2009 i �
WATER QUALITY SECTION
y ASHEVILLE REGIONAL OFFICE
Date: 09/25/2009 09:33 AM REPORT OF LABORATORY ANALYSIS Page 7 of 7
This report shall not be reproduced, except in full,
without the wrilten consent of Pace Analytical Services, Ina.
. r'/ I • !. •yi

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A'
_ NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
November 18, 2013
James P Griffin
469 Triple Creek Drive
Hendersonville, NC 28791
Division of Water Resources
Water Quality Programs.
Thomas A. Reeder
Director
SUBJECT: Compliance Evaluation Inspection
Triple Creek Subdivision / Lot 28
Permit No: NCG551017
Henderson. County
Dear Mr. Griffin:
s
John E. Skvarla, III
Secretary
Enclosed please find a copy of the inspection report conducted on November 7, 2013. The Compliance
Evaluat on Inspection was conducted by Jeff Menzel and Bev Price of the Asheville Regional Office:
The inspectors could not find the outfall pipe. It is recommended that the outfall pipe be located and the area
around the outfall be kept clear of brush and debris. The -disinfection tablets should be checked regularly and
replaced when necessary. The facility appears to be well maintained.
No violations of permit requirements or applicable regulations were observed during this inspection.
Please refer to the enclosed inspection report for additional observations and comments. A copy of the general
permit will also be included with this inspection report.
If you have any questions, please call me at 828-296-4500.
Sincerely,
Jeff Menzel
Environmental Specialist
cc: Central Files
' It Files
Water Quality Regional Operations — Asheville Regional Office
2090 U.S. Highway 70, Swannanoa, North Carolina 28778
Phone: [phone] FAX: [phone]
Internet: http://portal.ncdenr.org/web/wq/ws
An Equal Opportunity 1 Affirmative Action Employer
G:IWQiSWPIHenderson\WastewaterlGenerai\NCG55 SFR11017 Jim Griffen.doc

United States Environmental Protection Agency
Form Approved..
EPA Washington, D.C. 20460
OMB
No. 2040-0057
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 INI 2 15 I 31 NCG551017 111 121 13/11/07 117 181 C I
19I S I 201 I
Remarks
211III IIIIIIIIIIII IIIIIIII I'III"IIIIIIIIIIIIIIII1II6
Inspection Work Days Facility Self -Monitoring Evaluation Rating B1 QA -- ----- - -----Reserved--------------
67 I 169 70 I_I 711 I 721 N I 73 LU 74
751 I I I I I Li
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)
02:00 PM 13/11/07
13/08/01
Triple Creek Subdivision /Lot 28
Exit Time/Date
Permit Expiration Date
Triple Creek Subdivision Lot 28
Hendersonville NC 28739
02:30 PM 13/11/07
18/07/31
Name(s) of Onsite Representative(s)/Ttles(s)/Phone and Fax Number(s)
Other Facility Data
Name, Address of Responsible Official/Title/Phone and Fax Number
Contacted
James P Griffin,111 Grovers Mill Rd Plainsboro NJ 08536/// No
Section C: Areas Evaluated During Inspection (Check only those areas evaluated)
Operations & Maintenance 0 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
Jeff Menzel ARO WQ//828-296-4500/
Signature of Management Q A Reviewer Agency/Office/Phone and Fax Numbers
Date
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete.
Page #. 1

NPDES
yr/mo/day
3 NCG551017 1
11 121
13/11/07 117
Inspection Type
18I d
(cont.)
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
The inspectors could not find the outfall pipe. It is recommended that the outfall pipe be located and the
area around the outfall be kept clear of brush and debris. The disinfection tablets should be checked
regularly and replaced when necessary. No violations of permit requirements or applicable regulations were
observed during this inspection. The facility appears to be well maintained. A copy of the general permit will
be included with this inspection report. Please read over the permit and let me know if you have any
questions or concerns.
Page # 2•

Permit: NCG551017 Owner - Facility: Triple Creek Subdivision / Lot 28
Inspection Date: 11/07/2013 inspection Type: Compliance Evaluation
Operations & Maintenance
Yes
No
NA
NE
Is the plant generally clean with acceptable housekeeping?
■
❑
n
n
Does the facility analyze process control parameters, for ex: MLSS, MCRT, Settleable Solids,
pH, DO, Sludge n
n
■
n
Judge, and other that are applicable? ;
Comment:
Disinfection -Tablet
Yes
No
NA
NE
Are tablet chlorinators operational?
■
n
o
n
Are the tablets the proper size and type?
■
❑
n
Number of tubes in use?
2
Is the level of chlorine residual acceptable?
❑
n
n
■
Is the contact chamber free of growth, or sludge buildup?
■
Is there chlorine residual prior to de -chlorination?
■
n
n
n
Comment: Replace the chlorine tablets on an as needed basis.
De -chlorination
Yes No
NA
NE
Type of system ?
Tablet
Is the feed ratio proportional to chlorine amount (1 to 1)?
■
❑
00
Is storage appropriate for cylinders?
■
n
n
n
# Is de -chlorination substance stored away from chlorine containers?
■
n
n
n
Comment:
Are the tablets the proper size and type?
■
n
❑
Are tablet de -chlorinators operational?
■.
n
n
n
Number of tubes in use?
2
Comment:
Effluent Pipe
Yes No
NA
NE
Is right of way to the outfall properly maintained?
❑
■
n
n
Are the receiving water free of foam other than trace amounts and other debris?
■
n
n
n
If effluent (diffuser pipes are required) are they operating properly?
n
n
■
Comment: The inspectors could not find the outfall pipe. It is recommended that the
outfall pipe be located and the area around the outfall be kept clear of brush and debris.
Page # 3

i
General Permit NCG560000
STATE zOF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NCG550000
DISCHARGE OF DOMESTIC WASTEWATER FROM SINGLE FAMILY
RESIDENCES AND OTHER 100% DOMESTIC DISCHARGES WITH
SIMILAR CHARACTERISTICS UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other
lawful standards and regulations promulgated and adopted by the North Carolina
Environmental Management Commission, and the Federal Water Pollution Control
Act, as amended, this permit is hereby issued to all owners or. operators, hereafter
permittees, , which are covered by this permit as evidenced by receipt of a Certificate
of Coverage by the Environmental Management Commission to allow the discharge of
treated domestic wastewater in accordance with the effluent limitations, monitoring
requirements, and other conditions set forth in Parts I, II, III and IV hereof
This permit shall become effective August 1, 2013.
This permit shall expire at midnight on July 31, 2018.
Thomas A: Reeder, P.E., Acting Director
Division of Water Quality
By Authority of the Environmental Management Commission
Page 1 of 16 Pages

General Permit NCG550000
PART
MONITORING, CONTROLS, AND LIMITATIONS FOR PERMITTED DISCHARGES
A. EFFLUENT LIMITATIONS AND MONITORING REQUIREMENTS
Applicability of Coverage
This permit authorizes discharges (pursuant to the conditions described in this permit) to all waters
of the state unless otherwise excluded in this section. Discharges to the following waters are
excluded from permit coverage and will require an individual permit to discharge:
Waters classified as WSI (Water Supply I)
Waters classified as HQW (High Quality Waters, excluding WS II)
Waters classified as SA
Waters classified as ORW (Outstanding Resource Waters)
Waters located in the Randleman Lake Watershed
Applicable to Treatment Systems:
1) Single Pass Filter Systems discharging less than 1000 gallons per day (applicable to existing
facilities only) .
2) Multi -Phase Filter Systems (Primary & Secondary Single Pass, Recirculating Sand Filters as well
as other alternative technologies that provide treatment equivalent to, or greater than,
recirculating sand filters) discharging less than 1000 gallons per day
Treatment system requirements for existing systems (built prior to August 1, 2007) systems:
• Septic Tank
• Sand or media filter component (Single Pass Filter Systems, Multi -Phase Filter Systems)
• Disinfection. (All facilities adding chlorination after the August 1, 2007-will also be required to
add dechlorination. If a system had chlorination before August 1, 2007, then the addition of
dechlorination is not required)
Treatment system requirements for new and existing systems (built after August 1, 2007):
• Septic tank (with riser)
• Filter media
•. Recirculating pump tank(s) per approved design (Multi -Phase Filter Systems only)
• Primary & Secondary Single Pass Filter Systems (Multi -Phase Filter Systems only)
• Filter media component per approved design
• Disinfection unit (Chlorination/dechlorinaiion, or equivalent means of disinfection),
• Effluent pipe/outfall with aeration/erosion control (rip rap)
For purposes of this permit, failed or failing systems that require replacement will be subject to
requirements for new systems built after August 1, 2007.
For purposes of this permit, systems that were constructed prior to August 1, 2007 that did not have
a valid permit shall be required to get a valid permit. They will not be required to replace or
upgrade systems installed prior to August 1, 2007 unless they are failing and require,replacement.
Page 2 of 16 Pages

General Permit NCG560000
During the period beginning on August 1, 2013 and lasting until expiration; the Permittee is
authorized to discharge domestic wastewater from outfall 001. Such discharges shall be limited and
monitored by the Permittee as specified below:
PARAMETER
LIMITS
MONITORING REQUIREMENTS
Monthly
Daily
Measurement
Sample
Sample
Average
Maximum
Frequency
Type
Loeationi
Flow 2 [50050]
Annually
Estimate
Effluent
BOD, 5-Day, 20°C3[00310]
30.0 mg/1
45.0 mg/1
Annually
Grab
Effluent
Total Suspended Solids
30.0 mg/1
45.0 mg/1
Annually
Grab
Effluent
[00530]
Fecal Coliform
200/100 ml
400/100 ml
Annually
Grab
Effluent
Geometric mean 31616
Total Residual Chlorine 3,4
[50060]
Annually
Grab
Effluent
Enterococci3°5
Annually
Grab
Effluent
1. Effluent is defined as wastewater leaving the treatment system, prior to discharge into a creek or
other water body.
2. The wastewater discharge flow from this facility may not in any case exceed 1000 gallons per
day.
3. A North Carolina certified laboratory must perform the wastewater analysis.
4. Receiving stream chlorine levels are not to exceed 17 µg/L. The sample shall be taken from the
effluent pipe, prior to discharge into a creek or other waterbody.
5. Applicable for discharges to SB and SC waters only. In SB and SC waters, the requirement for a
fecal coliform sample is not required.
There shall be no discharge of floating solids or foam visible in other than trace amounts.
Page 3 of 16 Pages

General Permit NCG560000
Permit Conditions: -
(Operation & Maintenance)
1) The tablet chlorinator and dechlorinator [if applicable] shall be inspected weekly to ensure
there is an adequate supply of tablets for continuous & proper operation. The dechlorinator
unit shall be labeled "dechlorination only".
2) Treatment systems shall be maintained at all times to prevent seepage of sewage to the surface
of the ground.
3) Septic tanks and secondary tank (recirculating/pump tanks) shall be inspected at least yearly to
determine if solids must be removed or if other maintenance is necessary. Septic tanks shall be
pumped out every five years or when the solids level is found to be more than 1/3 of the liquid
depth in any compartment, whichever is greater. All tanks should be emptied of their contents
whenever any of the tanks meet this requirement. Effluent filters shall be inspected at least
once a year, cleaned and reinstalled or replaced. Contents removed from septic tanks shall be
disposed at a location and in a manner compliant with all local and state regulations.
4) All system components, including but not necessarily limited to, septic tanks, surface sand
filters, other filter components, pump/recirculation tanks, controls and alarms, disinfection
units, dechlorination apparatus, and the outfalls shall be maintained at all times and in good
operating order.
5) All monitoring data shall be retained onsite for a minimum of five years and available for
inspection. The permittee shall notify the Division upon receipt of a sampling or monitoring
report indicating noncompliance with the permit.
6) A visual review of the outfall location shall be executed twice each year (one at the time of
sampling) to ensure that no visible solids or other obvious evidence of system malfunctioning
is observed. Any visible signs of a malfunctioning system shall be documented and steps taken
to correct the problem.
Transfer Coverage from Other Permits
7) Upon issuance of this general permit, all existing and acting certificates of coverage issued in
conjunction with the NCG5700000 permits will be eligible for coverage under this permit.
8) Upon issuance of this general permit, all existing and active individual permits issued since
June of 2010 for discharge of domestic wastewater from single family residences and other
100% domestic discharges with similar characteristics will be eligible for coverage under this
permit.
This permit does not affect the legal requirements to obtain other permits that may be required by the
North Carolina Department of Natural Resources, or any other federal or local governmental permit.
Page 4 of 16 Pages