NC0075027_Regional Office Historical File Pre 2016

Borth Carolina Department of Environmental Quality
Pat McCrory
Governor
October 21, 2015
Eleanor Wood
Cains Way Homeowners Association
P.O. Box 846
Walkertown, NC 27051
Subject: NOTICE OF VIOLATION
NOV-2015-LV-0674
Permit No. NCO075027
Cains Way Mobile Home Park
Forsyth County
Dear Ms. Wood:
Donald R. van der Vaart
Secretary .
A review of Cains Way Mobile Home Park's monitoring report for,July 2015 showed the following violations:
Parameter
Date
Limit Value
Reported Value
Limit Type
Coliform, Fecal MF, M-FC
Broth,44.5C
7/30/2015
400.000
#/loom[
2,420:000
#/loom[
Daily Maximum
Exceeded
Kemedial actions, it not already implemented, should be taken to correct the above noncompliance
problem. Please be aware that violations of your NPDES permit could. result in enforcement action by the
Division of Water Resources for this and any additional violations of State law.
If you should have any questions, please do not hesitate to contact me or Ron Boone at (336)
776-9800.
Sincerely,
W. Corey Basinger, Regional Supervisor
Water Quality Regional Operations Section
Division of Water Resources, NC DEQ
cc: DW
W— Cwntral Files
Si
450 W. Hanes Mill Rd, Suite 300; Winston-Salem, NO 27105
Phone: [phone] Internet: www.ncdenr.gov
An Equal Opportunity 1 Affirmative Action Employer— Made in part by recycled paper

Facility: h
Parameter
DMR RevWw Record
Permit No.: 7 So 2 Pipe No.: 079-7 MonthNear: / s
Monthly Average Violations
Permit Limit DMR Value % Over Limit
Weekly/Daily Violations
Date Parameter Permit Limit Limit TrLpe DMR Value % Over Limit
A/A.V
Monitoring Frequency Violations
Date Parameter Permit Frequency Values Reported
# of Violations
Action
Action
Action
Other Violations/Staff Remarks:
1/36 %is —` AW3 94-,,kx �r� Ae — 2/2 ,-33 /(o. --5.Y0 — ,VdV; �3',/� iivH3
o G 1
g6v- 2-615 - L.f%_ 6 L 74
Supervisor Remarks:
R>j
Completed by: ���� a D te:
Assistant Regional
Supervisor Sign Off: Date:
Regional Supervisor Sign lj��!
Oft: Date:

b EFFLUENTM�W. ,_
( April 1 through October 31 )
NPDES PERMIT NO.: NCO075027 DISCHARGE NO.: 001 MONTH: July YEAR: 2015
FACILITY NAME: Cains Way MHP CLASS: II COUNTY: Forsyth
OPERATOP. IN RESPONSIBLE CHARGE: Bradley Flynt
GRADE: IV PHONE: [phone]
CERTIFIED LABORATORIES: (1 ) Statesville Analytical (2 )
Check box if orc has changed [ ] PERSON(S) COLLECTING SAMPLES: Bradley Flynt
Mail ORIGINAL and ONE COPY to: ` p
ATTN: CENTRAL FILES
DIVISION OF WATER QUALITY (SIGNATURE OF O[f� ) j DATE
DENR BY THIS SIGNATUFiE,'I ERTIFYTHATTHIS REPORT IS
1617 MAIL SERVICE CENTER ACCURATE AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
del Ctr_W Mr 97A99-1617
DEM Forth MR-1 (12103)

v'
Cains Way MHP Status: (Please check one of the following)
All monitoring data and sampling frequencies meet permit requirements [ ]
Compliant
All monitoring data and sampling frequencies do NOT meet permit requirements IX ]
Noncompliant
If the facility is noncompliant, please comment on corrective actions being taken in respect to equipment, operation,
maintenance, etc, and a time table for improvements to be made.
l-YCeP4C(! (YICy,4 lYcr'%c/ t c��� d1/9D�wm/ r,,i 7/.3'o115Oahe r¢&ne Li nw-)&�
"1 certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision
in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information sub-
mitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for
gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and com-
plete. I am aware that there are significant penalties for submitting false information, including the possibility of fines
and imprisonment for knowing violations."
Permittee Address:
00010 Temperature
00076 Turbidity
00080 Color (Pt -Co)
00082 Color (ADMI)
00300 Dissolved Oxygen
00310 B O D 5
00340 C O D
00400 pH
00530 T S S
00545 Settleable Solids
00556 Oil and Grease
00600 Total Nitrogen
z�&; n
Permittee (Please print or type)
Signatur f errAitteef U Date
Phone Number: Permit Exp. Date SIa(I j(5
PARAMETER CODES
00610 Ammonia Nitrogen
01032 Hexavalent
00625 Total Kjeldah
Chrc 32730 Total Phenolics
Nitrogen
01034 Chromium 34235 Benzene
00630 Nitrate/Nitrite
01037 Total Cobal34481 Toluene
00665 Total Phosporous
01042 Copper 38260 MBAS
00720 Cyanide
01045 Iron 39516 PCBs
00745 Total Sulfide
01051 Lead 50050 Flow
00927 Total Magnesium
01067 Nickel 50060 Total Residual
00929 Total Sodium
01077 Silver Chlorine
00940 Total Chloride
01092 Zinc 71880 Formal-
00951 Total Fluoride
01105 Alumimum dehyde
01002 Total Arsenic
01147 Total Selen 71900 Mercury
01027 Cadmium
31616 Fecal Colifc 81551 Xylene
Parameter Code assistance may be obtained by calling the Water Quality Compliance Group at [phone] ext 581 or 534
The monthly average for fecal coliform is to be reported as a GEOMETRIC mean. Use only units designed in the reporting
facility's permit for reporfing data.
ORC must visit the facility and document visitation of facility as required per 15A NCAC 8A .0202(b)(5)(B)
" If signed by other than the permittee, delegation of signatory authority must be on file with the state per
15A NCAC 28.0506 (b)(2)(D)

NPIDES PERMIT NO:NC0075027 DISCHARGE NO.: 001 MONTH: July YEAR: 2015
FACILITY NAME: Cains Way MHP COUNTY:Forsyth
STREAM: Ader Creek LOCATION: @ 100ft Above Discharge Point STREAM: Ader Creek LOCATION: @ NCSR 1979
UPSTREAM
DOWNSTREAM
00010
00300
31616
00010
00300
31616
D
Fecal
Fecal
A
Time
Dissolved
Coliform
—D
Time
Dissolved
Collform
T
Temp
Oxygen
—A
T
Temp
Oxygen
E 12400
1
Geometric
E
2400
Geometric
Clock
(DO)
Mean
Clock
(DO)
Mean
#
HIRS
C
mcl
#11 00ml
#
HRS
C
IL
#/loom[
...............
2
2
ti,
4
.4
6
18:30
26.0
7.2
6
18:37
26.0
6.9
OEM,
31,
ONO,
All
R
8
8
10
10
12
12
sae
70
�Z
_4,
5,
14
14
A.,
g
Xi
16
16
18
18
9
20
18:45
27.0
6.8
20
18:51
27.0
6.7
21:
22
22
23
RZI`,;�'.�S,
.........
24
24
255
—
4
5 -
26
26
T� 0
Sam
W-0
28
28
20
g
30
30
AWE
AVERAGE
1 26.5
1 7.1
1
1
11AVERAGE
26.51
6.91
MINIMUM
1 26.01
6.8
MINIMUM
26.01
6.7
CAP
"R* ,
lam
U
DEM Form MR-3 (12/93) DEM Form MR-3 (12/93)

EFFLUENT
( April 1 through October 31)
NPDES PERMIT NO.: NCO075027
DISCHARGE NO.: 001
MONTH: July
YEAR: 2015
FACILITY NAME: Cains Way MHP
CLASS: II
COUNTY: Forsyth
OPERATOR IN RESPONSIBLE CHARGE: Bradley Flynt
GRADE: IV
PHONE: [phone] tMMr
RECEIVED
N.C. Dept. of ENR
CERTIFIED LABORATORIE
(1) Statesville Analytical
(2)
Check box if orc has changed
PERSON(S) COLLECTING SAMPLES:
Bradley Flynt
SEP
Mail ORIGINAL and ONE ,COPY•to* q B
ATTN: CENTRAL FILES- �- �O J -1 X C, $/ �/ WINSTON-SALEN
DIVISION OF WATER QUALITY (SIGNATURE OF O DATE REGIONAL OFFICI
DENR BY THIS SIGNATU ERTIFY THAT THIS REPORT IS
1617 MAIL SERVICE CENTER ACCURATE AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
RALEIGH, NC 27699-1617

Cains Way MHP Status: (Please check one of the following)
All monitoring data and sampling frequencies meet permit requirements [ ]
Compliant
All monitoring data and sampling frequencies do NOT meet permit requirements IX ]
Noncompliant
If the facility is noncompliant, please comment on corrective actions being taken in respect to equipment, operation,
maintenance, etc, and a time table for improvements to be made.
1.Y(wa-ledma ��J&( �u°ca� 9YaD�m.n/ co 7/ro%S .B�Me n--ari,',ge -ecl bu ra,[a n e�,ne ►�f
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision
in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information sub-
mitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for
gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and com-
plete. I am aware that there are significant penalties for submitting false information, including the possibility of fines
and imprisonment for knowing violations."
Permittee Address:
00010 Temperature
00076 Turbidity
00080 Color (Pt -Co)
00082 Color (ADM])
00300 Dissolved Oxygen
00310 B O D 5
00340 C O D
00400 pH
00530 T S S
00545 Settleable Solids
00556 Oil and Grease
00600 Total Nitrogen
PARAMETER CODES
00610 Ammonia Nitrogen
00625 Total Kjeldah
Nitrogen
00630 Nitrate/Nitrite
00665 Total Phosporous
00720 Cyanide
00745 Total Sulfide
00927 Total Magnesium
00929 Total Sodium
00940 Total Chloride
00951 Total Fluoride
01002 Total Arsenic
01027 Cadmium
Ta rq I ice.; n
Permittee (Please print or type)
_Signatureff,erAtteef Date
Phone Nu ber: Permit Exp. Date SIdt,&E
01032 Hexavalent
Chrc 32730 Total Phenolics
01034 Chromium 34235 Benzene
01037 Total Cobal34481 Toluene
01042 Copper 38260 MBAS
01045 Iron 39516 PCBs
01051 Lead 50050 Flow
01067 Nickel 50060 Total Residual
01077 Silver Chlorine
01092 Zinc 71880 Formal-
01105 Alumimum dehyde
01147 Total Selen 71900 Mercury
31616 Fecal Colifc 81551 Xylene
Parameter Code assistance may be obtained by calling the Water Quality Compliance Group at [phone] ext 581 or 534
-----------------------------------------------------------------------------------------
The monthly average for fecal coliform is to be reported as a GEOMETRIC mean. Use only units designed in the reporting
facility's permit for reporting data.
ORC must visit the facility and document visitation of facility as required per 15A NCAC 8A .0202(b)(5)(B)
If signed by other than the permittee, delegation of signatory authority must be on file with the state per
15A NCAC 213.0506 (b)(2)(D)

NPDES PERMIT NO:NC0075027 DISCHARGE NO.: 001 MONTH: July YEAR: 2015
FACILITY NAME: Cains Way MHP COUNTY:Forsyth
STREAM: Ader Creek LOCATION: @ 100ft Above Discharge Point STREAM: Ader Creek LOCATION: @ NCSR 1979
UPSTREAM
DOWNSTREAM
00010
00300
31616
00010
00300
31616
D
Fecal
D
Fecal
A
Time
Dissolved
Coliform
A
Time
Dissolved
Coliform
T
Temp
Oxygen
T
Temp
Oxygen
E 12400
1
1
Geometrii I
I
E 12400
1
1
Geometric
Clock
DO
Mean
Clock
DO
Mean
#
HRS
C
mg/L
#/100ml
#
HRS
C
m /L
#/100ml
1
1
2
2
3
3
4
4
5
5
6
18:30
26.0
7.2
6
18:37
26.0
6.9
7
7
8
8
9
9
10
10
11
11
12
12
13
1 17:50
27.01
7.0
1
1
1
13
1 17:57
27.01
6.8
14
14
15
15
16
16
17
17
18
1
18
19
19
20
18:45
27.0
6.8
20
18:51
27.0
6.7
21
21
22
22
23
23
24
24
25
25
26
26
27
17:45
26.0
7.2
27
17:52
26.0
7.2
28
1
1
28
29
29
30
30
31
31
AVERAGE
26.5
7.1
1
1
AVERAGE
1 26.5
6.9
MAXIMUM
27.0
7.2
MAXIMUM
27.0
7.2
MINIMUM
26.0
6.8
MINIMUM
26.0
6.7
COMP/GRAB
GRAB
GRAB
COMP/GRAB
GRAB
GRAB
DEM Form MR-3 (12/93) DEM Form MR-3 (12/93)

NCDENR
Borth Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
September 11, 2015
Eleanor Wood
Cains Way Homeowners Association
PO Box 846
Walkertown, NC 27051
Subject: NOTICE OF VIOLATION
NOV-2015-LV-0588
Permit No. NCO075027
Cains Way Mobile Home Park
Forsyth County
Dear Ms Wood:
Donald R. van der Vaart
Secretary
A review of Cains Way Mobile Home Park's monitoring report for June 2015 showed the following
vinlatinns-
Parameter
Date
Limit Value
Reported Value
Limit Type
Nitrogen, Ammonia Total (as N) -
6/30/2015
2.000 mg/I
2.330 mg/I
Monthly
Concentration
Average
Exceeded
Remedial actions, if not already implemented, should be taken to correct the above noncompliance
problem. Please be aware that violations of your NPDES permit could result in enforcement action by the
Division of Water Resources for this and any additional violations of State law.
If you should have any questions, please do not hesitate to contact Ron Boone at [phone].
cc: DWR — Central Files
=_�
Sincerely,
W. Corey Basinger, Regional Supervisor
Water Quality Regional Operations Section
Division of Water Resources, NC DENR
450 W. Hanes Mill Rd, Suite 300; Winston-Salem, NC 27105
Phone: [phone] Internet: www.ncdenr.gov
An Equal Opportunity 1 Affirmative Action Employer— Made in part by recycled paper

Facility:
Permit No.: 7 6 ,ts 2. 7 Pipe No.:
Oi / Month/Year:
Monthly Average Violations
Parameter
Permit Limit DMR Value
% Over Limit
Action
Weekly/Daily Violations
Date Parameter
Permit Limit Limit Type DMR Value
% Over Limit
Action
Monitoring Frequency Violations
Date Parameter
Permit Frequency Values Reported
# of Violations
Action
Other Violations/Staff Remarks: l
Supervisor Remarks:
!lI CAI/' ^� ..
Completed by: �
Date: �
Assistant Regional
Supervisor Sign Off: Date:
Regional Supervisor Sign
Off: tve.'� �_
Date: 6
/� 1 �h

EFFLUENT
( April 1 through October 31 )
NPDES PERMIT NO.: NCO075027
DISCHARGE NO.: 001
MONTH:June
YEAR: 2015
FACILITY NAME: Cains Way MHP
CLASS: II
COUNTY: Forsyth
OPERATOR IN RESPONSIBLE CHARGE: Bradley
Flynt
GRADE: IV PHONE:
336-298-3489
CERTIFIED LABORATORIES:
( 1 )
Statesville Analytical
(2 )
Check box if orc has changed [ ]
PERSON(S) COLLECTING SAMPLES:
Bradley Flynt
Mail ORIGINAL and ONE COPY to:
AU 2 20t
ATTN: CENTRAL FILES
X e
��
DIVISION OF WATER QUALITY
(SIGNATURE OF O
DATE
DENR
BY THIS SIGNATU RTIFY
THAT THIS REPORT IS
1617 MAIL SERVICE CENTER
ACCURATE AND COMPLETE
TO THE BEST OF MY KNOWLEDGE.
RALEIGH, NC 27699-1617
50050
00010
00040
50060
00310
00610
00530
31616
00300
00625
00630
00600
00665
D
Opr.
Opr.
Fecal
D
A
Arrive
Time
Orc
Flow
Res
BOD5
T
Coliform
Dissolvd
Total
Nitrates
Total
Total
A
T
Time
on
on
Temp.
pH
@
NH3-N
S
Oxygen
Khejdahl
Nitrites
Nitrogen
Poo
T
E
2400
Site
Site
[ ] Inf
Cl2
20C
S
Geometric
(DO)
Nitrogen
E
clock
X Eff
Mean
# JHRS
JHRS
YIN I
MGD I
C
UNITS I
u /L
mg/L I
mg/L
mg/L I
#/100ml
mg/L
m /L
mg/L
m /L
mg/L
#
»»s>0s0090::::::
..............................
.....................................................................:.:....
2
17:35
0.25
y
0.0080
22.0
2
..:::...:::0:0080::::.t.:0...::::..::...
::.::..::::::.
�:.
..::.;:.;:.;:.;:.;:.;:.;:.;:.;:.;:.;:.;:.::.;::.:::.,::...:.:..:::.:::::::::::::::::::::::::.:::.:...:::.::::::::::.:.::::.::::..
:.........................................................................................................
.
.. , .:... �..
... .......
.... .
4
5:00
0.25
0.0080
21.0
3.8
1.57
5.3
< 1
4
a aa�s
w
Q,
s¢
a
s 4s•s
s
s as s
MMMFMssa
4
e
ammm
ONCE==
s ss:s
a
m
11
mm
•
!!
a
m4
a!•!
a
mmmm
26 112:001 0.251y 1 0.0100 1 28.0
fm
28 0.0130
30
117:301
0.251y
1
0,0100
27.0
$......................:....:.....................................::...:.:...............................
AVERAGE
0.0087
25.3
31.3
3.9
- 233 f y
- -
4.9
9
::<I:I:fIS31:34I:3:::?::6'lil:
i:: f
?:9ii:
:.4'345>Yii<i''`iiiiiiiii<�z'`2`2
i?;
i;'?'i:i
MINIMUM
0.0050
20.0
7.1
19.0
3.1
< 0.50
2.9
< 1
:::::::
........................:.Gq........CaR
.....!�..............�............�1,W?...........-4'................................
ts3F:::::<:#:`•GQl41P?3:?::E2Jis<
:::::::::::::':::::::::::
I::::::;':
....
DAILY LIMIT
NA
NA
NA
NA
16.5
45
400
:::::::......
CAE7kE7TE2L 7 l IMRI ::::<::<:::::::::>::::i::::..�1
:
`li::#:;::#:;::Nic::::::
....................:....!5:....:..
2::I3''::::`:
::::::NA
N a........................................
.....
..........
........ .......................
.
............
.............. .:.....
.......
MONTHLY LIMIT
0.0432
NA
>6,<9
NA
11.0
2
30
200
::610%liTi7R hl.. RE4U NG..........
G...............y........
£y......
::::: :..........y.
y................
y.................y.............................................:.:..
FREQUENCY MET
yes
YES
YES
YES
yes
YES
YES
YES
::GOM..LIi1i3 .:..................:....::::.yes
Total Monthly Flow
0.2620 MG
TN Monthly Loading (Ibs.)
DEM Form MR-1 (12/03)
Annual TN Mass Loading (lbs./yr)
24
30
3'f
#
N.C. Dept ofDENR
AUG 19 2015
R GIONAL OFFICE r'

Cains Way MHP Status: (Please check one of the following)
All monitoring data and sampling frequencies meet permit requirements [ ]
Compliant
All monitoring data and sampling frequencies do NOT meet permit requirements [ ✓]
Noncompliant
If the facility is noncompliant, please comment on corrective actions being taken in respect to equipment, operation,
maintenance, etc, and a time table for improvements to be made.
-� 1 A� ' �- !y �3 � r c r s � e9 a;,- to
a Q rv► c� �► �/ @ iv►� � s7 % ct L.i rn .
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision
in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information sub-
mitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for
gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and com-
plete. I am aware that there are significant penalties for submitting false information, including the possibility of fines
and imprisonment for knowing violations."
Permittee Address:
00010 Temperature
00076 Turbidity
00080 Color (Pt -Co)
00082 Color (ADMI)
00300 Dissolved Oxygen
00310 B O D 5
00340 C O D
00400 pH
00530 T S S
00545 Settleable Solids
00556 Oil and Grease
00600 Total Nitrogen
PARAMETER CODES
00610 Ammonia Nitrogen
00625 Total Kjeldah
Nitrogen
00630 Nitrate/Nitrite
00665 Total Phosporous
00720 Cyanide
00745 Total Sulfide
00927 Total Magnesium
00929 Total Sodium
00940 Total Chloride
00951 Total Fluoride
01002 Total Arsenic
01027 Cadmium
,bamd C&o)
Permittee-(Please print or type)
Signature otffeUttee4 Date
Phone Number: Permit Exp. Date
01032 Hexavalent
Chrc 32730 Total Phenolics
01034 Chromium 34235 Benzene
01037 Total Cobal34481 Toluene
01042 Copper 38260 MBAS
01045 Iron 39516 PCBs
01051 Lead 50050 Flow
01067 Nickel 50060 Total Residual
01077 Silver Chlorine
01092 Zinc 71880 Formal-
01105 Alumimum dehyde
01147 Total Selen 71900 Mercury
31616 Fecal Colifc 81551 Xylene
Parameter Code assistance may be obtained by calling the Water Quality Compliance Group at [phone] ext 581 or 534
-----------------------------------------------------------------------------------------
The monthly average for fecal coliform is to be reported as a GEOMETRIC mean. Use only units designed in the reporting
facility's permit for reporting data.
* ORC must visit the facility and document visitation of facility as required per 15A NCAC 8A .0202(b)(5)(B)
If signed by other than the permittee, delegation of signatory authority must be on file with the state per
15A NCAC 213.0506 (b)(2)(D)

NPDES PERMIT NO:NC0075027 DISCHARGE NO.: 001 MONTH: June YEAR: 2015
FACILITY NAME: Cains Way MHP COUNTY:Forsyth
STREAM: Ader Creek LOCATION: @ 100ft Above Discharge Point STREAM: Ader Creek LOCATION: @ NCSR 1979
I IPgTRFCM
DOWNSTREAM
00010
00300
31616
00010
00300
31616
D
Fecal
D
Fecal
A
Time
Dissolved
Coliform
A
Time
Dissolved
Coliform
T
Temp
Oxygen
T
Tem
Oxygen
E 12400
1
1
Geometrii I
I
E 12400
1
1
Geometric
Clock
(DO)
Mean
Clock
DO
Mean
#
HRS
C
m /L
#/100ml
#
HRS .
C
m /L
#/loom[
1
18:00
22.0
7.2
1
18:08
22.0
7.0
2
2
3
3
4
4
5
5
6
6
7
7
8
8
9
9
10
16:40
23.0
7.1
10
16:46
23.0
6.9
11
11
12
12
13
1
1
1
1
1
13
14
14
15
17:45
25.0
6.9
15
17:51
25.0
6.8
16
16
17
17
18
1
1
1
1
1
18
19
19
20
20
21
21
22
17:50
27.0
6.7
22
17:56
27.0
6.5
23
1
123
24
24
25
25
26
26
27
27
28
28
29
17:40
25.0
6.8
29
17:46
25.0
6.7
30
30
31
31
AVERAGE
24.4
6.9
AVERAGE
1 24.4
6.8
MAXIMUM
27.0
7.2
MAXIMUM
27.0
7.0
MINIMUM
22.0
6.7
MINIMUM
22.0
6.5
COMP/GRAB
GRAB
GRAB
COMP/GRAB
GRAB
GRAB
DEM Form MR-3 (12/93) DEM Farm MR-3 (12193)

NCDENK
Borth Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
July 16, 2015
Cains Way Homeowner's Association
Attn: Eleanor Wood, Owner
P.O. Box 846
Walkertown, NC 27051
Subject: NOTICE OF DEFICIENCY
NOD-2015-LV-0062
Permit No. NCO075027
Cain's Way Mobile Home Park
Forsyth County
Dear Ms. Wood:
Donald R. van der Vaart
Secretary
A review of Cain's Way's monitoring report for April, 2015, showed the following deficiencies:
Parameter
Date
Limit Value
Reported Value
Limit Type
Ammonia Nitrogen
04/30/2015
2.0
2.5
Monthly
Average
Remedial actions should be taken to correct the cause(s) of these deficiencies. Unresolved deficiencies may
lead to the issuance of a Notice of Violation and/or assessments of civil penalties by the Division of Water
Resources of up to $25,000.00 per day for each violation. Any efforts undertaken to bring the facility back
into compliance are not an admission of culpability. Your response, the degree and extent of harm to the
environment, and the duration and gravity of the deficiency(ies) will be considered in any future actions
undertaken.
If you should have any questions, please do not hesitate to contact Ron Boone at [phone]
cc: SAT — Central Files
Sincerely,
L
W. Corey Basinger, Regional Supervisor
Water Quality Regional Operations Section
Division of Water Resources, NC DENR
450 West Hanes Mill Road, Suite #300, Winston-Salem, NC 27105
Phone: [phone] Internet: www.ncdenr.gov
An Equal Opportunity 1 Affirmative Action Employer— Made in part by recycled paper

ON/ RevWw Record
Facility: 0, ivl !'l� -�. Permit No.: `756,;2 7 Pipe No.: Month/Year:
Monthly Average Violations
Parameter Permit Limit DMR Value % Over Limit Action
, ll-13 ,2 y 41
Weekly/Daily Violations
Date Parameter Permit Limit Limit Type DMR Value % Over Limit Action
Monitoring Frequency Violations
Date Parameter Permit Frequency Values Reported # of Violations Action
I Other Violations/Staff Remarks:
'upervisor Remarks:
Completed by:
cyi
Assistant Regional
Supervisor Sign Off:
Regional Supervisor Sign
Off:
�d6-2vis--L. -oD62
Date:
Date:
/o/ d
Date: �S

EFFLUENT
( April 1 through October 31 )
JUN 2A 2015
NPDES PERMIT NO.: NCO075027
DISCHARGE NO.: 001
MONTH: April YEAR: 2015
T S
FACILITY NAME: Cains Way MHP
CLASS: II
COUNTY: Forsyth
OPERATOR IN RESPONSIBLE CHARGE:
Bradley Flynt
GRADE: IV PHONE: [phone]
!a, 3 :)
CERTIFIED LABORATORIES:
( 1 ) Statesville Analytical
(2)
_ �!�- �� j
Check box if orc has changed[ ]
PERSON(S) COLLECTING SAMPLES:
Bradley Flynt
Mail ORIGINAL and ONE COPY to:
/
JI . - 0a5
ATTN: CENTRAL FILES
X_ 16 /L6 ,(
5 % S
DIVISION OF WATER QUALITY
(SIGNATURE OF
DATE
pJlt(i` a.,._
�' +1ON
DENR
BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS
I,l"
1^± r, ,. ,
1617 MAIL SERVICE CENTER
ACCURATE AND COMPLETE
TO THE BEST OF MY KNOWLEDGE.
RALEIGH, NC 27699-1617
50050
00010
00040
50060
00310
00610
00530
31616
00300
00625
00630
00600
00665
D
Opr.
Opr.
Fecal
D
A
Arrive
Time
Orc
Flow
Res
BOD5
T
Coliform
Dissolvd
Total
Nitrates
Total
Total
A
T
Time
on
on
Temp.
pH
@
NH3-N
S
Oxygen
Khejdahl
Nitrites
Nitrogen
Poo
T
E
2400
Site
Site
[ ] Inf
Cl2
20C
S
Geometric
(DO)
Nitrogen
E
clock
Eff
Mean
# JHRS
jHRS
YIN I
MGD I
C JUNITS
I
ug/L
m /L I
mg/L I
m /L I
#/100ml
mg/ L
mg/L
mg
mg/L I
mg/L
#
i `00
::;:::0 2a
::::..:::::::.:.:..................
:.>::::>:::::<::«:::o>D08>
i::::::>
t6s0::>.:<:::>::::
-,....:::::
«:::>::::::>:::8g:;«::>:::::>::::>::::>::>::::>::>
::.:::::.........................
.
:..............X..:....
.........
2
9-oo
0.25
v
0.0010 1
17.0 1
1
1
5.6 j<
0.50 1
4.3
< 1
2
4
1
1
0.0030
6
17:15
0.50
y
0.00201
18.0
6.3
20
....;:.......:.
7:> >
:<1 <3`20
::.::..:::.:
,X0 25
:.::.::,:.; :.;:.;:;:
`:::: ::::2::4
;:,;:.;:
3d �
....,...........
.................................................:.......
.
8
19:001
0.25
y
0.0020
18.0
0>0 t
7;2::
tG:':::t:
10
17:301
0.25
0.0110
18.0
42
ma
12
0.0140
:::.....................
........
....
14
18:10
0.25
y
0.0080
20.0
777.7.7
16
5:00
0.25
y
0.0080
19.0
4.8
4.30
6.3
<1
<::
<>:>::::>::.............................................................
g::
:>::::>::::>
..............
18
0.0080
..................
20
17:30
0.50
y
0.01101
18.0
6.2
<15
22
18:00
0.25
0.0080
17.0
::.......:::..........
XXX
24
19:50
0.25
ly
0.0080
18.0
31
.
...........
26
0.0080
27>:2::278D5:::>:
::::::::::;:tis��$�:.
«:t};D::....................
......................
.......................................
28
19:20
0.25
y
0.0090
17.0
I< 2.0
< 0.50
9.0
< 1
30
17:40
0.25
0.0080
18.0
AVERAGE
0.0079
16.0
28.1
3.7
WRfh
I!r 7.1
2
:isr,:r,::>:;:...:';::::::::::0016L#::....:<2�:0::::
.::::::..::::::::::::
.
::::d
:.........................................
:.:.0`E:E:zE2EE
....................
Etta?`3'E3
MINIMUM
0.0010
16.0
6.2
19.0
< 2.0
< 0.50
6.3
< 1
;:.s:.: •:::::::;::;:::::::;:::::::: : F ii:::::::::::::::::::::::::i::;::i:::
;:.....:::::::
RAg:::::
...................
Ni...........
DAILY LIMIT
NA
NA
NA
NA
16.5
45
400
..............;:.:::;::::.;:.:;.;;:.;:.;:.>:;::::::::::.;:.::::::::::::;:;;:;;:;::
:::[3UPiff'f�RGY:INltf:::::::::::::::::::NA:;.::
`NA:::.................................................�.....................................
::I?Ts:::::
i flt4::
::::::::iJA :i::::i:::::>
:::::''A::;:;::::<::'IiIA::::>:::::::<�:
14:>
MONTHLY LIMIT
0.0432
NA
>6,<9
NA
11.0
2
30
200
Y...............Y
Y:.....
`kl
........ Y
FREQUENCY MET
yes
YES
YES
YES
yes
YES
YES
YES
.. ................
:s�::�::<:::>:'�es:::::E::.:i::'Y:�S::<:
...
.....
... :.:::.::::::i::i::.::.>:.:X,
;:
Total Monthly Flow
0.2380 MG
DEM Form MR-1 (12/03)
6.5
6.8
TN Monthly Loading (lbs.)
Annual TN Mass Loading (Ibs./yr)
24
JUN 2 9 2015
REGIONAL OFFICE

Cains Way MHP Status: (Please check one of the following)
All monitoring data and sampling frequencies meet permit requirements [ ]
Compliant
All monitoring data and sampling frequencies do NOT meet permit requirements [ �/ J
Noncompliant
If the facility is noncompliant, please comment on corrective actions being taken in respect to equipment, operation,
maintenance, etc, and a time table for improvements to be made.
LX(en-A,a' filoAAba /Vl`�-,'n�,VL r,)re,:j n/1 i n � cr��af'on Ji.(:2. Ond 0(50
I•Gr%l H D,-op on Aelel-I C;mom -�o br.'�� d1l up. AA.Ovd 50 146 61,MP es)7 '//;&//5'
u1,r9 6Ja5-VeC�' -jC> b)5eS%r on /io/ /dc�� r'�l�y' PH onrp &r'11a,.,+ 5iul , /�'zE°�% et�1 �r -Nl �. �l r
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision
in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information sub-
mitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for
gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and com-
plete. I am aware that there are significant penalties for submitting false information, including the possibility of fines
and imprisonment for knowing violations."
Permittee Address:
00010 Temperature
00076 Turbidity
00080 Color (Pt -Co)
00082 Color (ADM[)
00300 Dissolved Oxygen
00310 B 0 D 5
00340 C O D
00400 pH
00530 T S S
00545 Settleable Solids
00556 Oil and Grease
00600 Total Nitrogen
PARAMETER CODES
00610 Ammonia Nitrogen
00625 Total Kjeldah
Nitrogen
00630 Nitrate/Nitrite
00665 Total Phosporous
00720 Cyanide
00745 Total Sulfide
00927 Total Magnesium
00929 Total Sodium
00940 Total Chloride
00951 Total Fluoride
01002 Total Arsenic
01027 Cadmium
'Da rq / ("a," )
Permittee (Please print or type)
gittz,&,Y_/,;aZ
Signatur of er itte Date
Phone Number: Permit Exp. Date
01032 Hexavalent
Chrc 32730 Total Phenolics
01034 Chromium 34235 Benzene
01037 Total Cobal 34481 Toluene
01042 Copper 38260 MBAS
01045 Iron 39516 PCBs
01051 Lead 50050 Flow
01067 Nickel 50060 Total Residual
01077 Silver Chlorine
01092 Zinc 71880 Formal-
01105 Alumimum dehyde
01147 Total Selen 71900 Mercury
31616 Fecal Colifc 81551 Xylene
Parameter Code assistance may be obtained by calling the Water Quality Compliance Group at [phone] ext 581 or 534
-----------------------------------------------------------------------------------------
The monthly average for fecal coliform is to be reported as a GEOMETRIC mean. Use only units designed in the reporting
facility's permit for reporting data.
* ORC must visit the facility and document visitation of facility as required per 15A NCAC 8A .0202(b)(5)(B)
* If signed by other than the permittee, delegation of signatory authority must be on file with the state per
15A NCAC 213.0506 (b)(2)(D)

NPDES PERMIT MO:NC0075027 DISCHARGE NO.: 001 MONTH: March YEAR: 2015
FACILITY NAME: Cains Way MHP COUNTY:Forsyth
STREAM: Ader Creek LOCATION: @ 100ft Above Discharge Point STREAM: Ader Creek LOCATION: @ NCSR 1979
CARM
DOWNSTREAM
00010
00300
31616
00010
00300
31616
D
Fecal
D
Fecal
A
Time
Dissolved
Coliform
A
Time
Dissolved
Coliform
T
Temp
Oxygen
T
Temp
Oxygen
E
2400
Geometric
JE
12400
Geometric
Clock
DO
Mean
Clock
DO
Mean
#
HRS
C
m /L
#/lo0ml
#
HRS
C
m /L
#/loom[
1
17:35
19.0
7.6
1
17:42
19.0
7.5
2
2
3
3
4
4
5
5
6
6
7
7
8
8
9
9
10
10
11
11
12
12
13
18:30
19.0
7.4
13
18:36
19.0
7.5
14
14
15
15
16
16
17
17
18
18
19
19
20
17:50
18.0
7.5
20
17:57
18.0
7.1
21
21
22
22
23
23
24
24
25
25
26
26
'
27
18:25
16.0
7.9
27
18:33
16.01
7.4
28
128
29
29
30
30
31
31
AVERAGE
1 18.0
7.6
AVERAGE
1 18.0
7.4
MAXIMUM
19.0
7.9
MAXIMUM
19.0
7.5
MINIMUM
16.0
7.4
MINIMUM 1
16.0
7.1
COMP/GRAB
GRAB
GRAB
EiE
I COMP/GRAB
GRAB
GRAB
DEM Form MR-3 (12/93) DEM Farm MR-3 (12/93)

To: W. Corey Basinger
From: Cainsway Mobile Home Park
Subject: Compliance Evaluation Inspection May 8, 2015
�•' RECEIVED
N.C. Dept of ENR
JUN 215 2015
REGIONAL OFFICE
The Cainsway Mobile Home Park had an inspection on May 8, 2015 and it was noted that the
composite sampler was not sampling in flow proportional mode but was doing fine in time paced mode.
At this time, Cainsway has gotten permission from DENR, Winston-Salem Regional Office, to continue
sampling in the time paced mode. It was also noted that the facility does not have an operating bar
screen due to a failure of a pump station wall. The entire section where,the screen was located had to
be removed and replaced with a new galvanized culvert. Replacing the bar screen is a difficult and
dangerous task, therefore it has taken longer than it should to come up with a plan on how to install a
new screen. As of this day, 6/15/2015 the material has been ordered and fabrication began on the new
screen. I have been assured by Daryl Cain, CWHOA President, that the installation will be complete
within the 90 day deadline. Thanks and if you have any questions please feel free to contact me.
Sincerely,
Bradley Flynt.
Cainsway MHP ORC

AMM4
'
MC®ENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
May 11, 2015
Cains Way Homeowners Association
Attn: Ms. Eleanor Wood, Owner
P.O. Box 846
Walkertown, NC 27051
Subject: Request for Waiver from Flow Proportional Sampling
Permittee: Cains Way Homeowners Association
Facility: Cains Way Mobile Home Park Wastewater Treatment Plant
NPDES Permit#: NCO075027
Forsyth County
Dear Ms. Wood:
Donald R. van der Vaart
Secretary
The Division of Water Resources has received your request for exemption from flow proportional composite
sampling.
In accordance with your request and Part II, Section A, of the permit, Cain's Way Homeowner's Association is
hereby authorized to collect all composite samples required by the permit using a constant-time/constant volume
sampling regimen. Please note that the aliquots must be collected over a full 24-hour period and must also be collected
at time intervals not to exceed 20 minutes in length.
Please ensure the operator of the plant, Bradley Flynt, gets a copy of this letter and maintains it on site at the
wastewater treatment plant at all times. A copy of this letter will be required during all compliance evaluation inspections.
If you have any questions regarding this issue, please call Mr. Boone or me at [phone]. Thank you for
your cooperation in this matter.
Sincerely,
� r
W. Corey Basinger
Regional Supervisor
Water Quality Regional Operations
Division of Water Resources
CC: SR{)
entral Files
NPDES Unit
Bradley Flynt, 8467 Southard Road, Stokesdale, NC, 27357
450 West Hanes Mill Road, Suite #300, Winston-Salem, North Carolina 27105
Phone: [phone] Internet: www.ncdenr.gov
An Equal Opportunity %Affirmative Action Employer— Made in part by recycled paper

NC®ENR
Borth Carolina Department of Environment and Natural Resources
Pat McCrory Donald R. van der Vaart
Governor Secretary
May 18, 2015
Cains Way Homeowners Association
Attn: Ms. Eleanor Wood, Owner
P.O. Box 846
Walkertown, NC 27051
Subject: Compliance Evaluation Inspection & Notice of Deficiency No. NOD-2015-PC-0117
Permittee: Cains Way Homeowners Association
Facility: Cains Way Mobile Home Park Wastewater Treatment Plant
NPDES Permit #: NCO075027
Forsyth County
Dear Ms. Wood:
Ron Boone, of the Winston-Salem RegionalOffice of the NC Division of Water Resources (DWR or the
Division) conducted a compliance evaluation inspection (CEI) of the Cain's Way Mobile Home Park Wastewater
Treatment Plant (WWTP) on May 8, 2014. The assistance and cooperation of Bradley Flynt, Operator in Responsible
Charge (ORC), was greatly appreciated. An inspection checklist is attached for your records and inspection findings are
summarized below.
General Information
The Cains Way Mobile Home Park WWTP is located on the far west side of Cains Way Mobile Home Park at
approximate coordinates 36.2065000N,-80.152222°W, off of Pine Hall Road, in Walkertown, Forsyth County, NC. The
permit authorizes you to operate this 0.0432 MGD WWTP, which consists of an aerated equalization basin, a bar screen,
a splitter box, dual extended aeration basins, a clarifier, tertiary filters, a tube type chlorinator, and a tube type
dechlorinator, and discharge the treated effluent to Ader Creek via outfall 001, which is currently classified as Class C
waters in the Roanoke River basin.
Site Review
Mr. Flynt has done a good job operating and maintaining the plant using the resources that are available to him.
However, there are some issues as noted below:
The effluent composite sampler is still not pulling flow proportional samples as required by the permit. Mr. Flynt
requested a waiver for this requirement. The waiver has been granted and has been sent to you in the mail.
Please ensure Mr. Flynt has a copy of the waiver and maintains it at the plant at all times.
2. The bar screen was removed when the influent pump station collapsed over a year ago. The bar screen still
hasn't been replaced. A new bar screen should be reinstalled as soon as possible to filter out large solids and
prevent further severe wear and tear to the equalization basin pumps. Also, a bar screen is included in the plant
description in the permit, so it should be there or be removed from the permit. A new bar screen should be
installed within 90 days of receipt of this letter.
The tertiary filters were not in operation at the time of the inspection.
450 West Hanes Mill Road, Suite #300, Winston-Salem, North Carolina 27105
Phone: [phone] Internet: www.ncdenr.gov
An Equal Opportunity 1 Affirmative Action Employer — Made in part by recycled paper

Documentation Review
All documentation was reviewed. Mr. Flynt has done a good job with the documentation required by the permit.
This includes operations and visitation logs, discharge monitoring reports and laboratory and field laboratory records,
chains of custody, etc. No issues were noted.
Please reply to this letter in writing within 20 business days of receiving it. Your written response should detail
what you plan to do to comply with the 90 day deadline to install a new bar screen as discussed above in paragraph (2).
You are reminded that, in accordance with NC General Statute 143-215.6A, the Director of the Division of Water
Resources may assess civil penalties not to exceed $25,000 per day, per violation, for violations of the NC0075027
NPDES permit. Your written response to this letter and the actions you take to get a bar screen back in place will weigh
heavily in our decision of whether or not to assess any civil penalty.
If you have any questions regarding the inspection or this letter, please call Mr. Boone or me at [phone].
Thank you for your cooperation in this matter.
Sincerely,
7. 4
t
I
W. Corey Basinger
Regional Supervisor
Water Quality Regional Operations
Division of Water Resources
Attachments:
1. BIMS Inspection Report
CC: 3' OR - SWO-
entral Files
NPDES Unit
Bradley Flynt
8467 Southard Road
Stokesdale, NC 27357

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 I5 . I 3 I NCO075027 111 12 15/05/08 17 18 1,1 191 G I 201
211I11 I I I I I I II 11I I I I I I I I I I I I I I,I I I I I I I II I l l i l I66
Inspection
Work Days Facility Self -Monitoring Evaluation Rating B1 QA ---- Reserved-----------
67
72 L,J 73I 174 751 I I I I I
70LJ 71 ty
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)
09:OOAM 15/05/08
12/05/01
Cains Way Mobile Home Park
Pinehall Rd
Exit Time/Date
Permit Expiration Date
Walkertown NC 27051
10:OOAM 15/05/08
17/02/28
Name(s) of Onsite Representative(s)/Titles(s)/Phone and Fax Number(s)
Other Facility Data
Bradley Todd Flynt/ORC/336-433-7262/
Name, Address of Responsible Official/Title/Phone and Fax Number
Contacted
Daryl Cain,PO Box 846 Walkertown NC 270510846///
No
Section C: Areas Evaluated During Inspection (Check only those areas evaluated)
Permit 0 Flow Measurement Operations & Maintenance Records/Reports
Self -Monitoring Program 0 Sludge Handling Disposal Facility Site Review Effluent/Receiving Waters
Laboratory
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
Ron Boone — WSRO WQ//336-776-96901
Signature of Management Q A Reviewer Agency/Office/Phone and Fax Numbers Date
r� '" ' ..r�*�,a� ✓'x T"c�-''.�'��"""` ,=:a - =�"�:+ ".� s tLYl fi?;= 'u� §+.fr-ate
�;%' ..t 2'
01 nyn
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete.
Page#

NPDES yr/mo/day Inspection Type
31 N00075027 �1 12 15/05/08 17 18ICI
_J
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
Please refer to the attached inspection summary letter.
1
Page# 2

Permit: NCO075027 Owner -Facility: Cains Way Mobile Home Park
Inspection Date: 05/08/2015 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
❑
❑
❑
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?
®
❑
❑
❑
Is the inspector granted access to all areas for inspection?
■
❑
❑
❑
Comment: The bar screen no longer exists due to cave in of the vault that it was located in. The vault
was restored but the bar screen has not been replaced yet. Bar screen solids settle in the
equalization basin and remain there until they're pumped out.
Record Keeping
Yes No NA NE
Are records kept and maintained as required by the permit?
®
❑
❑
❑
Is all required information readily available, complete and current?
®
❑
❑
❑
Are all records maintained for 3 years (lab. reg. required 5 years)?
■
❑
❑
❑
Are analytical results consistent with data reported on DMRs?
N
❑
❑
❑
Is the chain -of -custody complete?
®
❑
❑
❑
Dates, times and location of sampling
Name of individual performing the sampling
Results of analysis and calibration
Dates of analysis
Name of person performing analyses
Transported COCs
Are DMRs complete: do they include all permit parameters?
0
❑
❑
❑
Has the facility submitted its annual compliance report to users and DWQ?
❑
❑
®
❑
(If the facility is = or > 5 MGD permitted flow) Do they operate 24/7 with a certified operator
❑
❑
❑
on each shift?
Is the ORC visitation log available and current?
N
❑
❑
❑
Is the ORC certified at grade equal to or higher than the facility classification?
N
❑
❑
❑
Is the backup operator certified at one grade less or greater than the facility classification?
®
❑
❑
❑
Is a copy of the current NPDES permit available on site?
N
❑
❑
❑
Facility has copy of previous year's Annual Report on file for review?
❑
❑
®
❑
Comment: None
Laboratory Yes No NA NE
Page# 3

Permit: NCO075027 Owner - Facility: Cains Way Mobile Home Park
Inspection Date: 05/08/2015 Inspection Type: Compliance Evaluation
Laboratory
Yes No NA NE
Are field parameters performed by certified personnel or laboratory?
0
❑
❑
❑
Are all other parameters (excl ud in g field parameters) performed by a certified lab?
❑
❑
❑
# Is the facility using a contract lab?
❑
❑
❑
# Is proper temperature set for sample storage (kept at less than or equal to 6.0 degrees
❑
❑
❑
Celsius)?
Incubator (Fecal Coliform) set to 44.5 degrees Celsius+/- 0.2 degrees? ❑ ❑ ❑
Incubator (BOD) set to 20.0 degrees Celsius +/- 1.0 degrees? ❑ ❑ ❑
Comment: None
Effluent Sampling
Yes No NA NE
Is composite sampling flow proportional?.
❑
❑
❑
Is sample collected below all treatment units?
N
❑
❑
❑
Is proper volume collected?
0
❑
❑
❑
Is the tubing clean?
0
❑
❑
❑
# Is proper temperature set for sample storage (kept at less than or equal to 6.0 degrees
❑
❑
❑
Celsius)?
Is the facility sampling performed as required by the permit (frequency, sampling type
0
❑
❑
❑
representative)?
Comment: Facility not sampling at the time of the inspection. Permittee has been
granted waiver from
doing flow proportional sampling_
Upstream / Downstream Sampling Yes No NA NE
Is the facility sampling performed as required by the permit (frequency, sampling type, and ❑ ❑ ❑
sampling location)?
Comment: None
Pump Station -Influent
Yes No NA NE
Is the pump wet well free of bypass lines or structures?
0
❑
❑
❑
Is the wet well free of excessive grease?
0
❑
❑
❑
Are all pumps present?
0
❑
❑
❑
Are all pumps operable?
N
❑
❑
❑
Are float controls operable?
❑
❑
❑
Is SCADA telemetry available and operational?
❑
E
❑
❑
Is audible and visual alarm available and operational?
0
❑
❑
❑
Comment: None
Page# 4

Permit: NCO075027 Owner -Facility: Cains Way Mobile Home Park
inspection Date: 05/018/2015 Inspection Type: Compliance Evaluation
Bar Screens
Yes No NA NE
Type of bar screen
a.Manual
b.Mechanical
❑
Are the bars adequately screening debris?
❑
N
❑
❑
Is the screen free of excessive debris?
❑
❑
❑
Is disposal of screening in compliance?
❑
0
❑
❑
Is the unit in good condition?
❑
■
❑
❑
Comment: The bar screen was removed over a vear aqo when the influent vault, which sits atop the
equalization basin, collapsed. The bar screen has not vet been reinstalled. The Cain's Way
Homeowner's Association is given 90 days to get the bar screen reinstalled.
Aeration Basins Yes No NA NE
Mode of operation Ext. Air
Type of aeration system
Is the basin free of dead spots?
Are surface aerators and mixers operational?
Are the diffusers operational?
Is the foam the proper color for the treatment process?
Does the foam cover less than 25% of the basin's surface?
Is the DO level acceptable?
Is the DO level acceptable?(1.0 to 3.0 mg/1)
Comment: Foam covers about 50% of aeration basin surface area.
Secondary Clarifier
Is the clarifier free of black and odorous wastewater?
Is the site free of excessive buildup of solids in center well of circular clarifier?
Are weirs level?
Is the site free of weir blockage?
Is the site free of evidence of short-circuiting?
Is scum removal adequate?
Is the site free ofexcessive floating sludge?
Is the drive unit operational?
Is the return rate acceptable (low turbulence)?
Is the overflow clear of excessive solids/pin floc?
Diffused
■
❑
❑
❑
❑
❑
■
❑
❑
❑
❑
E
❑
❑
❑
❑
0
❑
❑
❑
❑
❑
❑
❑
❑
E
Yes No NA NE
❑
❑
❑
E
❑
❑
❑
•
❑
❑
❑
•
❑
❑
❑
■
❑
❑
❑
❑
❑
❑
■
❑
❑
❑
■
❑
❑
❑
❑
❑
❑
■
❑
❑
❑
Page# 5

Permit: NC0075027 Owner - Facility: Cains Way Mobile Home Park
Inspection Date: 05/0812015 Inspection Type: Compliance Evaluation
Secondary Clarifier Yes No NA NE
Is the sludge blanket level acceptable? (Approximately % of the sidewall depth) ❑ ❑ ❑
Comment: None
Pumps-RAS-WAS
Yes No NA NE
Are pumps in place?
0
❑
❑
❑
Are pumps operational?
❑
❑
❑
Are there adequate spare parts and supplies on site?
❑
❑
❑
Comment: None
Flow Measurement - Effluent
Yes No NA NE
# Is flow meter used for reporting?
E
❑
❑
❑
Is flow meter calibrated annually?
0
❑
❑
❑
Is the flow meter operational?
❑
N
❑
❑
(if units are separated) Does the chart recorder match the flow meter?
S
❑
❑
❑
Comment: Permittee has been -granted waiver from flow proportional sampling.
Disinfection -Tablet
Yes No NA NE
Are tablet chlorinators operational?
N
❑
❑
❑
Are the tablets the proper size and type?
0
❑
❑
❑
Number of tubes in use?
4
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: None
De -chlorination
Yes No NA NE
Type of system ?
Tablet
Is the feed ratio proportional to chlorine amount (1 to 1)?
❑
❑
❑
Is storage appropriate for cylinders?
❑
❑
❑
# Is de -chlorination substance stored away from chlorine containers?
0 ❑
❑
❑
Are the tablets the proper size and type?
0 ❑
❑
❑
Comment: None
Are tablet de -chlorinators operational? 0 ❑ ❑ ❑
Page# 6

I
Permit: NCO075027
Inspection Date: 05/08/2015
De -chlorination
Number of tubes in use?
Comment: None
Owner - Facility: Cains Way Mobile Home Park
Inspection Type: Compliance Evaluation
Effluent Pipe
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: None
Aerobic Digester
Is the capacity adequate?
Is the mixing adequate?
Is the site free of excessive foaming in the tank?
# Is the odor acceptable?
# Is tankage available for properly waste sludge?
Comment: None
Operations & Maintenance
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: None
Yes No NA NE
4
Yes No NA NE
❑ ❑ ❑
■ ❑ ❑ ❑
❑ N ❑ ❑
Yes No NA NE
• ❑ ❑ ❑
• ❑ ❑ ❑
■ ❑ ❑ ❑
■ ❑ ❑ ❑
■ ❑ ❑ ❑
Yes No NA NE
■
❑
❑
❑
■
❑
❑
❑
Page# 7

North Carolina- Department of Environment and Natural Resources
Pat McCrory
Governor
December 3, 2014
Eleanor Wood
Cains Way Homeowner's Association
P.O. Box 846
Walkertown, NC 27051
Subject:, NOTICE OF VIOLATION.
NOV-2014-LV-0513
Permit No. NCO075027
Cains Way MHP Wastewater Treatment' Plant
Forsyth County
Dear Ms: Wood:
John E. Skvarla, III
Secretary
A review of Cains Way MHP's monitoring report for 08/2014 showed the following violations:
Parameter
Date
Limit Value
Reported Value
Limit Type
BOD5
8/28/2014
16.5
21.9
Daily
Maximum
Remedial actions, if not already implemented, should be taken to correct the above noncompliance problem.
Please be aware that violations of your NPDES permit could result in enforcement. action by the Division of
Water Resources for this and any additional violations of State law.
If you should have any questions, please do not hesitate to contact Ron Boone at [phone].
cc: DWR — Central Files
Sincerely,
W. Corey Basinger
Regional Supervisor
Water Quality Regional Operations
Division of Water Resources
450 West Hanes Mill Road, Suite #300, Winston-Salem, NC 27105
Phone: [phone] Internet: www.ncdenr.gov
An Equal Opportunity 1 Affirmative Action Employer— Made in part by recycled paper

fflw�� F';LcMCI,l
Facility:
A,; �" '� 1'i P
Permit No.: 3 2-1 Pipe No.:
0-0 t MonthNear:
Monthly Averaae Violations
Parameter
Permit Limit DMR Value
% Over Limit Action
Weekly/Daily Violations
Date
Parameter
Permit Limit Limit Type DMR Value
% Over Limit Action
Dal 2i>
Monitoring Frequency Violations
Date
Parameter
Permit Frequency Values Reported
# of Violations Action
I
Other Violations/StaffRemarks: N d V —.,1-) I L. v — 0513
Supervisor Remarks:
Y�bl�
Completed by:yr�1
Assistant Regional
Supervisor Sign Off:
Regional Supervisor Sign
Off: O
Date: � �'�
Date:
Date: % % G 2-J

,;
EFFLUENT
( April 1 through October 31 )
NPDES PERMIT NO.: NC0075027 DISCHARGE NO.: 001 MONTH: August YEAR: 2014
FACILITY NAME: Cains Way MHP CLASS: II COUNTY: Forsyth
OPERATOR IN RESPONSIBLE CHARGE: Bradley Flynt GRADE: IV PHONE: [phone]
CERTIFIED LABORATORIES: ( 1 ) Statesville Analytical (2 )
Check box if orc has changed [ ] PERSON(S) COLLECTING SAMPLES: Bradley FlyntMail ORGINAL and ONE
_
ATTN: CIEN RAL FILES COPY to: X l It C�
DIVISION OF WATER QUALITY (SIG ATURE OF ) DATE
DENR BY THIS SIGNAT ERTI Y THAT THIS REPORT IS
1617 MAIL SERVICE CENTER ACCURATE AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
RALEIGH, NC 27699-1617
A

Cains Way MHP Status: (Please check one of the following)
All monitoring data and sampling frequencies meet permit requirements
Compliant
All monitoring data and sampling frequencies do NOT meet permit requirements [ ]
Noncompliant
If the facility is noncompliant, please comment on corrective actions being taken in respect to equipment, operation,
maintenance, etc, and a time table for improvements to be made.
t✓AN����'�� ,� � Cad L�n�,`t n> > Vmld x 1\16 ti,iire cA q if u)46 L akA I I 6+hes` llarCn{e-fei"S
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision
in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information sub-
mitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for
gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and com-
plete. I am aware that there are significant penalties for submitting false information, including the possibility of fines
and imprisonment for knowing violations."
Permittee Address:
PARAMETER CODES
rtchi /1
Permittee (Please print or type)
4
Signature AYerirrfittee-V Date
Phone Nu er: Permit Exp. Date
00010
Temperature
00610
Ammonia Nitrogen
01032
Hexavalent
00076
Turbidity
00625
Total Kjeldah
Chrc 32730
Total Phenolics
00080
Color (Pt -Co)
Nitrogen
01034
Chromium 34235
Benzene
00082
Color (ADMI)
00630
Nitrate/Nitrite
01037
Total Coba 34481
Toluene
00300
Dissolved Oxygen
00665
Total Phosporous
01042
Copper 38260
MBAS
00310
B O D 5
00720
Cyanide
01045
Iron 39516
PCBs
00340
COD
00745
Total Sulfide
01051
Lead 50050
Flow
00400
pH
00927
Total Magnesium
01067
Nickel 50060
Total Residual
00530
T S S
00929
Total Sodium
01077
Silver
Chlorine
00545
Settleable Solids
00940
Total Chloride
01092
Zinc 71880
Formal-
00556
Oil and Grease
00951
Total Fluoride
01105
Alumimum
dehyde
00600
Total Nitrogen
01002
Total Arsenic
01147
Total Seler 71900
Mercury
01027
Cadmium
31616
Fecal Colifi 81551
Xylene
Parameter Code assistance may be obtained by calling the Water Quality Compliance Group at [phone] ext 581 or 534
The monthly average for fecal coliform is to be reported as a GEOMETRIC mean. Use only units designed in the reporting
facility's permit for reporting data.
* ORC must visit the facility and document visitation of facility as required per 15A NCAC 8A .0202(b)(5)(B)
"* If signed by other than the permittee, delegation of signatory authority must be on file with the state per
15A NCAC 2B .0506 (b)(2)(D)

' is
NPDES PERMIT NO:N00075027 DISCHARGE NO.: 001 MONTH: August
FACILITY NAME: Cains Way MHP COUNTY:Forsyth
STREAM: Ader Creek LOCATION: @ 100ft Above Discharge Point
YEAR: 2014
STREAM: Ader Creek LOCATION: @ NCSR 1979
00010
100300
1 31616
00010
100300
1 31616
D
Fecal
D
Fecal
A
Time
Dissolved
Coliform
A
Time
Dissolved
Colifonn
T
Temp
Oxygen
T
Temp
Oxygen
E
2400
Geometric
E.
2400
Geometric
Clock
(DO)
Mean
Clock
(DO)
Mean
OEM Form MR-3 (12/93) DEM Form MR-3 (12193)

NC®ENR
North Carolina Department of Environment and Natural Resources
Pat McCrory John E. Skvarla, III
Governor Secretary
June 16, 2014
Cains Way Homeowners Association
Attn: Ms. Eleanor Wood, Owner
P.O. Box 846
Walkertown, NC 27051
Subject: Compliance Evaluation Inspection & Notice of Deficiency No. NOD-2014-PC-0127
Permittee: Cains Way Homeowners Association
Facility: Cains Way Mobile Home Park Wastewater Treatment Plant
NPDES Permit #: NCO075027
Forsyth County
Dear Ms. Wood:
Ron Boone, of the Winston-Salem Regional Office of the NC Division of Water Resources (DWR or the
Division) conducted a compliance evaluation inspection (CEI) of the Cains Way Mobile Home Park Wastewater
Treatment Plant (WWTP) on June 6, 2014. The assistance and cooperation of Bradley Flynt, Operator in Responsible
Charge (ORC), was greatly appreciated. An inspection checklist is attached for your records and inspection findings are
summarized below. -
General Information
The Cains Way Mobile Home Park WWTP is located on the far west side of Cains Way Mobile Home Park at
approximate coordinates 36.206500°N,-80.152222°W, off of Pine Hall Road, in Walkertown, Forsyth County, NC. The
permit authorizes you to operate this 0.0432 MGD WWTP, which consists of an aerated equalization basin, a bar screen,
a splitter box, dual extended aeration basins, a clarifier, tertiary filters, a tube type chlorinator, and a tube type
dechlodnator, and discharge the treated effluent to Ader Creek via outfall 001, which is currently classified as Class C
waters in the Roanoke River basin.
Site Review
Mr. Flynt has done a good job operating and maintaining the plant using the resources that are available to him.
However, there are some issues as noted below:
The visual alarm on the equalization tank was inoperable during the inspection.
2. The effluent composite sampler is still not pulling flow proportional samples as required by the permit. This was
a finding from the previous inspection. If the permittee wishes to use another sampling regime other than flow
proportional, they must request permission to do so from the Division and receive the approval in writing before
doing so.
3. The bar screen was removed when the influent pump station collapsed recently, and has never been replaced.
A new bar screen should be reinstalled to filter out large solids and prevent the influent pumps from pumping
them. This may place undue wear on the pumps. Also, the plant description says there is a bar screen so it
should be reinstalled.
585 Waughtown Street, Winston-Salem, North Carolina 27107
Phone: [phone] Internet: www.ncdenr.gov
An Equal Opportunity 1 Affirmative Action Employer— Made in part by recycled paper

4. The tertiary filters are still not in operation.
Documentation Review
All documentation was reviewed. Mr. Flynt has done a good job with the documentation required by the permit.
This includes operations and visitation logs, discharge monitoring reports and laboratory and field laboratory records,
chains of custody, etc. No issues were noted.
You are reminded that, in accordance with NC General Statute 143-215.6A, the Director of the Division of
Water Quality may assess civil penalties not to exceed $25,000 per day, per violation, for violations of the NC0075027
NPDES permit. Please reply to this letter in writing within 20 business days and tell us how you plan to address items 1 —
4 above. Your reply will be considered in determining whether any further action on our part is required.
If you have any questions regarding the inspection or this letter, please call Mr. Boone or me at [phone].
Thank you for your cooperation in this matter.
Attachments:
1. BIMS Inspection Report
Central Files
NPDES Unit
2
Sincerely,
W. Corey Basinger
Regional Supervisor
Water Quality Regional Operations
Division of Water Resources

_t
United States Environmental Protection Agency
Form Approved.
EPA Washington, D.C.20460
OMB No. 2040-0057
Water Compliance Inspection Report,
Approval expires8-31-98
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 NCO075027 111 12 14/06/06 17 18 l,.l
19 i G I 201 I
21111111 111111111II1111III I I I I I I I IIIIII�����
f6
I
Inspection Work Days Facility Self -Monitoring Evaluation Rating Ill QA —Reserved-
67 70 71 LJ I 72 i N i 73I I I74 75Ill jLj80
LJ I I I
Section
i
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)
07:OOAM 14/06/06
12/05/01
Cains Way Mobile Home Park
Exit Time/Date
Permit Expiration Date
P
Pinehall Rd
Walkertown NC 27051
09:OOAM 14/06/06
17/02/28
Name(s) of Onsite Representative(s)/rities(s)/Phone and Fax Number(s)
Other Facility Data
///
Bradley Todd Flynt/ORC/336-433-7262/
Name, Address of Responsible Official/Title/Phone and Fax Number
Daryl Cain, PO Box 846 Walkertown NC 270510846///
Contacted
No
Section C: Areas Evaluated During Inspection
(Check only those areas evaluated)
Permit Flow Measurement Operations & Maintenance Records/Reports
Self -Monitoring Program Sludge Handling Disposal Facility Site Review Effluent/Receiving Waters
Laboratory
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/Office/Phone and Fax Numbers
Date
"1
Ron Boone WSRO WQ//336-771-4967/
Signature of Management Q A Reviewer Agency/Office/Phone and Fax Numbers
Date
o
v
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete.
Page#

NPDES yr/mo/day Inspection Type
31 N00075027 I11 12 14/06/06 17 18I
CI
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
Please refer to the attached inspection summary letter.
Page#

Permit: NCO075027 Owner - Facility: Cains Way Mobile Home Park
Inspection Date: 06/06/2014 Inspection Type: Compliance Evaluation
Permit
Yes
No Na No
(If the present permit expires in 6 months or less). Has the permittee submitted a new
application?
El
0
El
El
Is the facility as described in the permit?
# Are there any special conditions for the permit?
E
11
0
Is access to the plant site restricted to the general public?
0
Is the inspector granted access to all areas for inspection?
Comment: Bar screen removed recently when influent pump station collapsed.
Record Keeping
Yes
No Na Ne
Are records kept and maintained as required by the permit?
Is all required information readily available, complete and current?
N
El
El
❑
Are all records maintained for 3 years (lab. reg. required 5 years)?
N
❑
El
0
Are analytical results consistent with data reported on DMRs?
Is the chain -of -custody complete?
Dates, times and location of sampling
Name of individual performing the sampling
Results of analysis and calibration
Dates of analysis
Name of person performing analyses
Transported COCs
Are DMRs complete: do they include all permit parameters?
El
El
E
El
Has the facility submitted its annual compliance report to users and DWQ?
(If the facility is = or > 5 MGD permitted flow) Do they operate 24/7 with a certified operator
on each shift?
0
El
El
❑
Is the ORC visitation log available and current?
N
Is the ORC certified at grade equal to or higher than the facility classification?
N
El
El
❑
Is the backup operator certified at one grade less or greater than the facility classification?
■
El
❑
❑
Is a copy of the current NPDES permit available on site?
El
❑.
0
El
Facility has copy of previous year's Annual Report on file for review?
Comment: None
Laboratory Yes No Na Ne
Page# 3

t
Permit: NCO075027 Owner - Facility:
Cains Way Mobile Home Park
Inspection Date: 06/06/2014 Inspection Type:
Compliance Evaluation
Laboratory
Yes
No Na Ne
Are field parameters performed by certified personnel or laboratory?
El
El
Are all other parameters(excluding field parameters) performed by a certified lab?
0
El
El
0
# Is the facility using a contract lab?
# Is proper temperature set for sam le stora k t t I th I
El
p ge ( ep a ess an or equa to 6.0 degrees
Celsius)?
Incubator (Fecal Coliform) set to 44.5 degrees Celsius+/- 0.2 degrees?
❑
N
Incubator (BOD) set to 20.0 degrees Celsius +/- 1.0 degrees?
❑
0
Comment: None
Effluent Sampling
Yes
No Na Ne
Is composite sampling flow proportional?
El
❑
Is sample collected below all treatment units?
❑
El
Is proper volume collected?
❑
'Is the tubing clean?
El
El
# Is proper temperature set for sample storage (kept at less than or equal to 6.0 degrees
N
Celsius)?
Is the facility sampling performed as required by the permit (frequency, sampling type
representative)?
Comment: Composite sampling is constant time/constant volume.
Upstream / Downstream Sampling
Yes
No Na Ne
Is the facility sampling performed as required by the permit (frequency, sampling type, and
S
El
El
El
sampling location)?
Comment: None
Pump Station - Influent
Yes
No Na Ne
Is the pump wet well free of bypass lines or structures?
0
❑
El
❑
Is the wet well free of excessive grease?
S
El
11
El
Are all pumps present?
Are all pumps operable?
Are float controls operable?
0
El
1-1
El
Is SCADA telemetry available and operational?
❑
E
❑
El
Is audible and visual alarm available and operational?
El
0
❑
El
Comment: Visual alarm was out at the time of the inspection.
Bar Screens
Yes
No Na Ne
Page# 4

:If
Permit: NCO076027 Owner -Facility;
Cains Way Mobile Home Park
t
Inspection Date: 06/06/2014 Inspection Type:
Compliance Evaluation
Bar Screens
Yes
No
Na
Ne
Type of bar screen
❑
a.Manual
❑
b.Mechanical
El
M
❑
Are the bars adequately screening debris?
El
®
D
❑
Is the screen free of excessive debris?
11
❑
El
Is disposal of screening in compliance?
Is the unit in good condition?
Comment: Bar screen was removed when the influent pump station collapsed in on itself
recently. Bar screen never replaced. A new bar screen must be installed.
Aeration Basins
Yes
No Na Ne
Mode of operation
Ext. Air
Type of aeration system
Diffused
a
Is the basin free of dead spots? .
0
El
Are surface aerators and mixers operational?
El
D
❑
Are the diffusers operational?
M
❑
El
Is the foam the proper color for the treatment process?
0
El
El
El
Does the foam cover less than 25% of the basin's surface?
M
Is the DO level acceptable?
M
Is the DO level acceptable?(1.0 to 3.0 mg/1)
Comment: None
Secondary Clarifier
Yes
No Na Ne
M
❑
11
Is the clarifier free of black and odorous wastewater?
❑
0
El
El
Is the site free of excessive buildup of solids in center well of circular clarifier?
Are weirs level?
M
El
El
11
M
El
❑
Is the site free of weir blockage?
®
❑
Is the site free of evidence of short-circuiting?
MEI
0
El
Is scum removal adequate?
■
❑
Is the site free of excessive floating sludge?
0
El
El
El y
Is the drive unit operational?
®
❑
El
Is the return rate acceptable (low turbulence)?
Page#
5

Permit: NC0075027 Owner - Facility: Cains Way Mobile Home Park
Inspection Date: 06/06/2014 Inspection Type: Compliance Evaluation
Secondary Clarifier Yes No Na Ne
Is the overflow clear of excessive solids/pin floc? 0 11 ❑
Is the sludge blanket level acceptable? (Approximately % of the sidewall depth) ❑ 11 El M
Comment: None
Pumps-RAS-WAS
Yes
No. Na Ne
Are pumps in place?
❑
❑
Are pumps operational?
El
❑
Are there adequate spare parts and supplies on site?
M
Comment: None
Disinfection -Tablet
Yes
No Na Ne
Are tablet chlorinators operational?
0
❑
❑
❑
Are the tablets the proper size and type?
M
❑
El
D
Number of tubes in use?
4
Is the level of chlorine residual acceptable?
11
❑
0
Is the contact chamber free of growth, or sludge buildup?
M
El
❑
❑
Is there chlorine residual prior to de -chlorination?
❑
❑
❑
0
Comment: None
De -chlorination
Yes
No Na Ne
Type of system ?
Tablet
Is the feed ratio proportional to chlorine amount (1 to 1)?
El
❑
Is storage appropriate for cylinders?
M
❑
❑
# Is de -chlorination substance stored away from chlorine containers?
❑
Are the tablets the proper size and type?
M
Comment: None
Are tablet de -chlorinators operational?
M
❑
El
Number of tubes in use?
4
Comment: None
Flow Measurement - Effluent Yes No Na Ne
# Is flow meter used for reporting? 0 El ED ❑
Is flow meter calibrated annually? 0 ❑. El El
Page# 6

Permit: NCO075027 Owner -Facility:
Inspection Date: 06/06/2014 Inspection Type:
Cains Way Mobile Home Park
Compliance Evaluation
Flow Measurement - Effluent
Yes
No Na Ne
Is the flow meter operational?
®
❑
❑
❑
(If units are separated) Does the chart recorder match the flow meter?
®
❑
❑
❑
Comment: None
Effluent Pipe
Yes
No Na Ne
Is right of way to the outfall properly maintained?
E
❑
❑
❑
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: None
Aerobic Digester
Yes
No Na Ne
Is the capacity adequate?
❑
❑
❑
Is the mixing adequate?
■
❑
❑
❑
Is the site free of excessive foaming in the tank?
❑
❑
❑
# Is the odor acceptable?
❑
❑
❑
# Is tankage available for properly waste sludge?
❑
❑
❑
Comment: None
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 ® ❑ ❑ ❑
Solids, pH, DO, Sludge Judge, and other that are applicable?
Comment: None
Page# 7

Aj L)
NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
September 15, 2014
Eleanor Wood
Cains Way Homeowners Association
P.O. Box 846
Walkertown, NC 27051
Subject: NOTICE OF VIOLATION
NOV-2014-LV-0415
Permit No. NCO075027
Cains Way Mobile Home Park
Forsyth County
Dear Ms. Wood:
John E. Skvarla, III
Secretary
A review of Cains Way Mobile Home Park's monitoring report for June, 2014, showed the following
violations:
Parameter
Date
Limit Value
Reported Value
Limit Type
BOD5
06/26/14
16.5mg/1
18.5 mg/l
Daily
Maximum.
Exceeded
Remedial actions, if not already implemented, should be taken to correct the above noncompliance problem.
Please be aware that violations of your NPDES permit could result in enforcement action by the Division of
Water Resources for this and any additional violations of State law.
If you. should have any questions, please do not hesitate to contact Ron Boone at [phone].
cc: DWR— Central Files
s
Sincerely,
W. Corey Basinger
Regional Supervisor
Water Quality Regional Operations
Division of Water Resources
585 Waughtown St., Winston-Salem, NC 27107
Phone: [phone] Internet: www.ncdenr.gov
An Equal Opportunity l Affirmative Action Employer — Made in part by recycled paper

Facility: Ca i h s
Parameter
Date Parameter
Date Parameter
her Violations/Staff Remarks:
0MR-G3eAsw Record
Permit No.: 75y Pipe No.: 6-01 MonthNear: 6 0
Monthly Average Violations
Permit Limit DMR Value % Over Limit Action
Weekly/Daily Violations
Permit Limit Limit Type DMR Value
Monitoring Frequency Violations
Permit Frequency Values Reported
% Over Limit Action
# of Violations Action
Supervisor Remarks:
jJo V LV - o Lfr -s-
Completed by: 943Vk, c Date: 9 9 /
Assistant Regional
Supervisor Sign Off: Date:
Regional Supervisor Sign
Off: Date: 7i

EFFLUENT,-..
( April 1 through October 31)
g 2O
NPDES PERMIT NO.; NC0075027
DISCHARGE NO.: 001
MONTH: J'fi YEAR: 2014
RECEIVED
;- N.C. Dept. of ENR
FACILITY NAME: Cains Way MHP
CLASS: II
COUNTY: Forsyth
_
OPERATOR IN RESPONSIBLE CHARGE: Bradley Flynt
GRADE: IV PHONE; 336-298-3489sit
AUG 19 Zo'
CERTIFIED LABORATORIES:
(1) Statesville Analytical
(2 )
Check box if orc has changed [ ]
PERSON(S) COLLECTING SAMPLES:
Bradley FIVnt
REG ST -SASE QM E
Mail ORIGINAL and ONE COPY to:
ATTN: CENTRAL FILES
X,
6�
AUG 14 2v%
DIVISION OF WATER QUALITY
(SIGNATURE OF O
DATE
DENR
BY THIS SIGNATU I RTIFY
THAT THIS REPORT IS
1617 MAIL SERVICE CENTER
ACCURATE AND COMPLETE
TO THE BEST OF MY KNOWLEDGE.
RALEIGH, NC 27699-1617

Cains Way MHP Status: (Please check one of the following)
All monitoring data and sampling frequencies meet permit requirements [ ]
Compliant
All monitoring data and sampling frequencies do NOT meet permit requirements [ V1
Noncompliant
If the facility is noncompliant, please comment on corrective actions being taken in respect to equipment, operation,
maintenance, etc, and a time table for improvements to be made.
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision
in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information sub-
mitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for
gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and com-
plete. I am aware that there are significant penalties for submitting false information, including the possibility of fines
and imprisonment for knowing violations." , ))a r I / I 6e //)
Permitted (Please print or type)
Permittee Address:
00010 Temperature
00076 Turbidity
00080 Color (Pt -Co)
00082 Color (ADM[)
00300 Dissolved Oxygen
00310 B O D 5
00340 C O D
00400 pH
00530 T S S
00545 Settleable Solids
00556 Oil and Grease
00600 Total Nitrogen
PARAMETER CODES
00610 Ammonia Nitrogen
00625 Total Kjeldah
Nitrogen
00630 Nitrate/Nitrite
00665 Total Phosporous
00720 Cyanide
00745 Total Sulfide
00927 Total Magnesium
00929 Total Sodium
00940 Total Chloride
00951- Total Fluoride
01002 Total Arsenic
01027 Cadmium
Signature r: mit ee— Dat
Phone Nu Permit Exp. Date �/7
01032 Hexavalent
Chrc 32730 Total Phenolics
01034 Chromium 34235 Benzene
01037 Total Coba 34481 Toluene
01042 Copper 38260 MBAS
01045 Iron 39516 PCBs
01051 Lead 50050 Flow
01067 Nickel 50060 Total Residual
01077 Silver Chlorine
01092 Zinc 71880 Formal-
01105 Alumimum dehyde
01147 Total Seler 71900 Mercury
31616 Fecal Colif, 81551 Xylene
Parameter Code assistance may be obtained by calling the Water Quality Compliance Group at [phone] ext 581 or 534
----------------- -------------------------------------------------------------•---------
The monthly average for fecal coliform is to be reported as a GEOMETRIC mean. Use only units designed in the reporting
facility's permit for reporting data.
ORC must visit the facility and document visitation of facility as required per 15A NCAC 8A .0202(b)(5)(B)
* If signed by other than the permittee, delegation of signatory authority must be on file with the state per
15A NCAC 213.0506 (b)(2)(D)

� NPDES PERMIT NO:NC0075027 DISCHARGE NO.: 001 MONTH: June YEAR: 2014
FACILITY NAME: Gains Way MHP COUNTY:Forsyth
STREAM: Ader Creek LOCATION: I 00ft Above Discharge Point STREAM: Ader Creek LOCATION: @ NCSR 1979
UPSTREAM
DOWNSTREAM
00010
00300
31616
00010
00300
31616
D
Fecal
ID
I
Fecal
A
Time
Dissolved
Goliform
A
Time
Dissolved
Coliform
T
Temp
Oxygen
T
Temp
Ongen
E
2400
Geometric
E
—
2400
Geometric
Clock
(DO)
Mean
Clock
DO)
Mean
#
jHRS
C
I m-q/L
#/100m1
I #
HRS
G
mg/L
#11 00ml
U""
fk' E"
7
7 -774� -77
—
yq',77777.77477'
'3,' ""k
2
20:20
18.0
8.7
2
20:27
18.0
8.5
21
2
4
4
4
77-7
7
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16 A"-
"k,
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14
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20
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24
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21.0
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N
01M ,1
Ia
�4
1AVERAGE
1 20.01
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20.01
8.31
1
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Q
MINIMUM
18.0
8.3
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GRAB:
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DEM Form MR-3 (12/93) DEM Form MR-3 (12J93)

NCO075027
Cains Way Mobile Home Park
Limit Violation
Coliform, Fecal MF, M-FC Broth,44.5C
Nitrogen, Ammonia Total (as N) - Concentration

NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
August 8, 2014
Eleanor Wood
Cains Way Homeowners Association
P.O. Box 846
Walkertown, NC 27051
Subj ect: NOTICE OF DEFICIENCY
NOD-2014-LV-0082
Permit No. NCO075027
Cains Way Mobile Home Park
Forsyth County
Dear Ms. Wood:
John E. Skvarla, III
Secretary .
A review of Cains Way Mobile Home Park's monitoring report for May 2014 showed the following
deficiencies:
Parameter
Date
Limit Value
Reported Value
Limit Type
Nitrogen, Ammonia Total (as N) -
05/31/14
2 mg/1
2.11 mg/1
Monthly
Concentration
Average
Exceeded
Remedial- actions should be taken to correct the cause(s) of these deficiencies. Unresolved deficiencies may
lead to the issuance of a Notice of Violation and/or assessments of civil penalties by the Division of Water
Resources of up to $25,000.00 per day for each violation. Any efforts undertaken to bring the facility back
into compliance are not an admission of culpability. Your response, the degree and extent of harm to the
environment, and the duration and gravity of the deficiency(ies) will be considered in any future actions
undertaken. -
If you should have any questions, please do not hesitate to contact Ron Boone at [phone].
cc: SW — Central Files
W,SRQ�F�ielesw,
Sincerely, n
f
W. Corey Basinger
Regional Supervisor
Water Quality Regional Operations
Division of Water Resources
585 Waughtown St., Winston-Salem, NC 27107
Phone: [phone] Internet: www.ncdenr.gov
An Equal Opportunity 1 Affirmative Action Employer — Made in part by recycled paper

OMR Review Record
Facility: UCH i m 5 �� Permit No.: '7s 7 Pipe No.: U I Month/Year: S 2©I
Monthly Average Violations
Parameter Permit Limit DMR Value % Over Limit
Weekly/Daily Violations
Date Parameter Permit Limit Limit Type DMR Value % Over Limit
Monitoring Frequency Violations
Date Parameter Permit Frequency Values Reported # of Violations
Other Violations/Staff Remarks:
/VO D - 264 - LV - 002
Supervisor Remarks:
10b
Completed by: I J66-1�i e-
Assistant Regional
Supervisor Sign Off:
Regional Supervisor Sign
Off:
Date: 1-?Ilq
Date:
Action
Action
Action
Date: 2�G�

A '7
47A1
NCDENR
Forth Carolina Department of Environment and natural Resources
Pat McCrory
Governor
July 14, 2014
Eleanor Wood
Cains Way Homeowners Association
P.O. Box 846
Walkertown, NC 27051
Subject: NOTICE OF VIOLATION
NOV-2014-LV-0312
Permit No. NCO075027
Cains Way Mobile Home Park
Forsyth County
Dear Ms. Wood:
John E. Skvarla, III
Secretary
A review of Cains Way Mobile Home Park's monitoring report for April 2014 showed the following
violations:
Parameter
Date
Limit Value
Reported Value
Limit Type
Nitrogen, Ammonia Total (as N) -
04/24/14
10 mg/l
11.2 mg/l
Daily
Concentration
Maximum
Exceeded
Nitrogen, Ammonia Total (as N) -
04/30/14
2 mg/1
2.46 mg/l
Monthly
Concentration
Average
Exceeded
Remedial, actions, if not already implemented, should be taken to correct the above noncompliance problem.
Please be aware that violations of your NPDES permit could result in enforcement action by the Division of
Water Resources for this and any additional violations of State law.
If you should have any questions, please do not hesitate to contact Ron Boone at [phone].
cc: DWR — Central Files
Sincerely,
ry'
' W. Corey Basinger, Regional Supervisor
Water Quality Regional Operations Section
Division of Water Resources, NC DENR
585 Waughtown St., Winston-Salem, NC 27107
Phone: [phone] Internet: www.ncdenr.gov
An Equal Opportunity 1 Affirmative Action Employer— Made in part by recycled paper

I�i,V, R Re �i�Gi� ,Recc �cJ
Facility:
Ga 4 h r lam ilN
Permit No.: ? S-o a%
Pipe No.:
001 Month/Year:
W/O
Monthly Average Violations
Parameter
Permit Limit
DMR Value
% Over Limit
Action
Weekly/Daily
Violations
Date
Parameter
Permit Limit Limit Type
DMR Value
% Over Limit
Action
4114
01
to
T
I I•2-
2
Monitoring Frequency Violations
Date
Parameter
Permit Frequency
Values Reported
# of Violations
Action
Other Violations/Staff Remarks:
l/aU- 261V- -L V- 0312
Supervisor Remarks: N O V
Completed by: ��' ` yat3-Vx c
Assistant Regional
Supervisor Sign Off:
Regional Supervisor Sign
Off:
Date: 7
T
Date:
Date:

NCO075027
Cains Way Mobile Home Park
Limit Violation
DOD, 5-Day (20 Deg. C) - Concentration
Chlorine, Total Residual
..NValue
Violation
'Calculated
Percent
Over
Daily
--
No Action,
Maximum
Micrograms per
2013 4 04-04-2013 BPJ
Exceeded
28 42
50 Liter
2 X week
Daily
No Action,
Maximum
Micrograms per
2013
4
04-11-2013
BPJ
Exceeded
28
34
21.42857
Liter
2 X week
Daily
No Action,
Maximum
Micrograms per
2013
5
05-03-2013
BPJ
Exceeded
28
35
25
Liter
2 X week
Daily
No Action,
Maximum
Micrograms per
2013
5
05-09-2013
BPJ
Exceeded
28
39
39.28571
Liter
2 X week
Daily
No Action,
Maximum
Micrograms per
20131
5
05-23-2013
BPJ
Exceeded
28
45
60.71429
Liter
2 X week

Daily
No Action,
Maximum
Micrograms per
2013
5
05-31-2013
BPJ
Exceeded
28
39
39.28571
Liter
2 X week
Daily
No Action,
Maximum
Micrograms per
2013
6
06-06-2013
BPJ
Exceeded
28
48
71.42857
Liter
2 X week
Daily
No Action,
Maximum
Micrograms per
2013
6
06-10-2013
BPJ
Exceeded
28
29
3.571428
Liter
2 X week
Daily
No Action,
Maximum
Micrograms per
2013
6
06-28-2013
BPJ
Exceeded
28
39
39.28571
Liter
2 X week
Daily
No Action,
Maximum
Micrograms per
2013
7
07-05-2013
BPJ
Exceeded
28
45
60.71429
Liter
2 X week
Daily
No Action,
Maximum
Micrograms per
2013
7
07-19-2013
BPJ
Exceeded
28
33
17.85714
Liter
2 X week
Daily
No Action,
Maximum
Micrograms per
2013
7
07-26-2013
BPJ
Exceeded
28
47
67.85714
Liter
2 X week
Daily
No Action,
Maximum
Micrograms per
2013
8
08-09-2013
BPJ
Exceeded
28
45
60.71429
Liter
2 X week
Daily
No Action,
Maximum
Micrograms per
2013
8
08-12-2013
BPJ
Exceeded
28
31
10.71429
Liter
2 X week
Daily
No Action,
Maximum
Micrograms per
2013
8
08-30-2013
BPJ
Exceeded
28
41
46.42857
Liter
2 X week
Daily
No Action,
Maximum
Micrograms per
2013
9
09-03-2013
BPJ
Exceeded
28
29
3.571428
Liter
2 X week
Daily
No Action,
Maximum
Micrograms per
2013
9
09-06-2013
BPJ
Exceeded
28
44
57.14286
Liter
2 X week
Daily
No Action,
Maximum
Micrograms per
2013
9
09-09-2013
BPJ
Exceeded
28
31
10.71429
Liter
2 X week
Daily
No Action,
Maximum
Micrograms per
20131
9
09-13-2013
BPJ
lExceeded
281
39
39.28571
Liter
2 X week

Daily
No Action,
Maximum
Micrograms per
2013
9
09-20-2013
BPJ
Exceeded
28
29
3.571428
Liter
2 X week
Daily
No Action,
Maximum
Micrograms per
2013
9
09-27-2013
IBPJ
Exceeded
28
48
71.42857
Liter
2 X week
Daily
No Action,
Maximum
Micrograms per
2013
10
10-11-2013
BPJ
Exceeded
28
33
17.85714
Liter
2 X week
Daily
No Action,
Maximum
Micrograms per
2013
10
10-18-2013
BPJ
Exceeded
28
41
46.428571
Liter
2 X week
Daily
No Action,
Maximum
Micrograms per
2013
10
10-25-2013
BPJ
Exceeded
28
48
71.42857
Liter
2 X week
Daily
No Action,
Maximum
Micrograms per
2013
10
10-28-2013
BPJ
Exceeded
28
30
7.142857
Liter
2 X week
Daily
No Action,
Maximum
Micrograms per
2013
11
11-01-2013
BPJ
Exceeded
28
45
60.71429
Liter
2 X week
Daily
No Action,
Maximum
Micrograms per
2013
11
11-15-2013
BPJ
Exceeded
28
39
39.28571
Liter
2 X week
Daily
No Action,
Maximum
Micrograms per
2013
11
11-22-2013
BPJ
Exceeded
28
40
42.85714
Liter
2 X week
Daily
No Action,
Maximum
Micrograms per
2013
11
11-27-2013
BPJ
Exceeded
28
38
35.71429
Liter
2 X week
Daily
No Action,
Maximum
Micrograms per
2013
12
12-05-2013
BPJ
Exceeded
28
37
32.14286
Liter
2 X week
Daily
No Action,
Maximum
Micrograms per
2013
12
12-09-2013
BPJ
Exceeded
28
31
10.71429
Liter
2 X week
Daily
No Action,
Maximum
Micrograms per
2013
12
12-20-2013
BPJ
Exceeded
28
44
57.14286
Liter
2 X week
Daily
No Action,
Maximum
Micrograms per
20131
12
12-27-2013
BPJ
Exceeded
28
29
3.571428
Liter
2 X week

Daily
No Action,
Maximum
Micrograms per
2014
1
01-03-2014
BPJ
Exceeded
28
29
3.571428
Liter
2 X week
Daily
No Action,
Maximum
Micrograms per
2014
1
01-10-2014
BPJ
Exceeded
28
45
60.71429
Liter
2 X week
Daily
No Action,
Maximum
Micrograms per
2014
1
01-13-2014
BPJ
Exceeded
28
36
28.57143
Liter
2 X week
Daily
No Action,
Maximum
Micrograms per
2014
1
01-24-2014
BPJ
Exceeded
28
39
39.28571
Liter
2 X week
Daily
No Action,
Maximum
Micrograms per
2014
1
01-27-2014
BPJ
Exceeded
28
.45
60.71429
Liter
2 X week
Daily
No Action,
Maximum
Micrograms per
2014
1
01-31-2014
BPJ
Exceeded
28
29
3.571428
Liter
2 X week
Daily
No Action,
Maximum
Micrograms per
2014
2
02-13-2014
BPJ
Exceeded
28
34
21.42857
Liter
2 X week
Daily
No Action,
Maximum
Micrograms per
2014
2
02-17-2014
BPJ
Exceeded
28
29
3.571428
Liter
2 X week
Daily
No Action,
Maximum
Micrograms per
2014
2
02-28-2014
BPJ
Exceeded
28
301
7.142857
Liter
2 X week
Daily
No Action,
Maximum
Micrograms per
2014
3
03-07-2014
BPJ
Exceeded
28
45
60.71429
Liter
2 X week
Daily
No Action,
Maximum
Micrograms per
2014
3
03-10-2014
BPJ
Exceeded
28
30
7.142857
Liter
2 X week
Daily
No Action,
Maximum
Micrograms per
2014
3
03-21-2014
BPJ
Exceeded
28
33
17.85714
Liter
2 X week
Daily
No Action,
Maximum
Micrograms per
2014
3
03-28-2014
BPJ
Exceeded
28
401
42.85714
Liter
2 X week
Coliform, Fecal MF, M-FC Broth,44.5C

NC®EN�
North Carolina Department of Environment and Natural Resources
Pat McCrory John E. Skvarla, III
Governor Secretary
June 16, 2014
Cains Way Homeowners Association
Attn: Ms. Eleanor Wood, Owner
P.O. Box 846
Walkertown, NC 27051
Subject: Compliance Evaluation Inspection & Notice of Deficiency No. NOD-2014-PC-0127
Permittee: Cains Way Homeowners Association
Facility: Cains Way Mobile Home Park Wastewater Treatment Plant
NPDES Permit #: NCO075027
Forsyth County
Dear Ms. Wood:
Ron Boone, of the Winston-Salem Regional Office of the NC Division of Water Resources (DWR or the
Division) conducted a compliance evaluation inspection (CEI) of the Cains Way Mobile Home Park Wastewater
Treatment Plant (WWTP) on June 6, 2014. The assistance and cooperation of Bradley Flynt, Operator in Responsible
Charge (ORC), was greatly appreciated. An inspection checklist is attached for your records and inspection findings are
summarized below.
General Information
The Cains Way Mobile Home Park WWTP is located on the far west side of Cains Way Mobile Home Park at
approximate coordinates 36.2065000N,-80.152222°W, off of Pine Hall Road, in Walkertown, Forsyth County, NC. The
permit authorizes you to operate this 0.0432 MGD WWTP, which consists of an aerated equalization basin, a bar screen,
a splitter box, dual extended aeration basins, a clarifier, tertiary filters, a tube type chlorinator, and a tube type
dechlorinator, and discharge the treated effluent to Ader Creek via outfall 001, which is currently classified as Class C
waters in the Roanoke River basin.':
Site Review
Mr. Flynt has done a good job operating and maintaining the plant using the resources that are available to him.
However, there are some issues as noted below:
1. The visual alarm on the equalization tank was inoperable during the inspection.
2. The effluent composite sampler is still not pulling flow proportional samples as required by the permit. This was
a finding from the previous inspection. If the permittee wishes to use another sampling regime other than flow
proportional, they must request permission to do so from the Division and receive the approval in writing before
doing so.
3. The bar screen was removed when the influent pump station collapsed recently, and has never been replaced.
A new bar screen should be reinstalled to filter out large solids and prevent the influent pumps from pumping
them. This may place undue wear on the pumps. Also, the plant description says there is a bar screen so it
should be reinstalled.
585 Waughtown Street, Winston-Salem, North Carolina 27107
Phone: [phone] Internet: www.ncdenr.gov
An Equal Opportunity 1 Affirmative Action Employer— Made in part by recycled paper

4. The tertiary filters are still not in operation.
Documentation Review
All documentation was reviewed. Mr. Flynt has done a good job with the documentation required by the permit.
This includes operations and visitation logs, discharge monitoringreports and laboratory and field laboratory records,
chains of custody, etc. No issues were noted.
You are reminded that, in accordance with NC General Statute 143-215.6A, the Director of the Division of
Water Quality may assess civil penalties not to exceed $25,000 per day, per violation, for violations of the NC0075027
NPDES permit. Please reply to this letter in writing within 20 business days and tell us how you plan to address items 1 —
4 above. Your reply will be considered in determining whether any further action on our part is required.
If you have any questions regarding the inspection or this letter, please call Mr. Boone or me at [phone].
Thank you for your cooperation in this matter.
Sincerely,
W. Corey Basinger
Regional Supervisor
Water Quality Regional Operations
Division of Water Resources
Attachments:
BIMS Inspection Report
CC: 5 � o - Vvl
Central Files
NPDES Unit

United States Environmental Protection Agency
Form Approved.
EPA Washington, D.C.20460
OMB No. 2040-0057
Water Compliance Inspection Report
Approval expires8-31-98
Section A: National Data System Coding (i.e., PCS)
Transaction Code NPDES yr/mo/day Inspection Type
Inspector Fac Type
1 IN 2 15 1 3 I NCO075027 111 12 14/06/06 17 -18 i C i
19 i G i 201
21111111 111111111 II I II 1-111 1111111 11111111111
f6
Inspection Work Days Facility Self -Monitoring Evaluation Rating B1 QA —
Reserved-
67 70 Lj u 71 72 LJ L �, � 73 Lj_]74 751 I I I I I I I80
L
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)
07:OOAM 14/06/06
12/06/01
Cains Way Mobile Home Park
Exit Time/Date
Permit Expiration Date
Pinehall Rd
Walkertown NC 27051
09:OOAM 14/06/06
17/02/28
Name(s) of Onsite Representative(s)[Titles(s)/Phone and Fax Number(s)
Other Facility Data
///
Bradley Todd FIynUORC/336-433-7262/
Name, Address of Responsible Official/Title/Phone and Fax Number
Contacted
Daryl Cain,PO Box 846 Walkertown NC 270510846///
- No
Section C: Areas Evaluated During Inspection (Check only those areas evaluated)
Permit N Flow Measurement Operations & Maintenance N Records/Reports
Self -Monitoring Program N Sludge Handling Disposal Facility Site Review 0 Effluent/Receiving Waters
Laboratory
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
Ron Boone WSRO WQ/l336-771-4967/
Signature of Manag�eemeennt Q A6�lRReeviewer Agency/Office/Phone and Fax Numbers
Date
�AwA�A f(Q
p
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete.
Page#

NPDES yr/mo/day Inspection Type 1
31 NCo075027 I11 12 14/06/06 17 18 1,1
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
Please refer to the attached inspection summary letter.
Page# 2

Permit: NCO075027 Owner -Facility; Cains Way Mobile Home Park
Inspection Date: 06/06/2014 Inspection Type: Compliance Evaluation
Permit
Yes
No Na Ne
El
El
H
D
(if the present permit expires in 6 months or less). Has the permittee submitted a new
application?
El
W
El
El
Is the facility as described in the permit?
El
®
El
❑
# Are there any special conditions for the permit?
S
El
El
11
Is access to the plant site restricted to the general public?
Is the inspector granted access to all areas for inspection?
Comment: Bar screen removed recently when influent pump station collapsed.
Record Keeping
Yes
No Na Ne
Are records kept and maintained as required by the permit?
El
Is all required information readily available, complete and current?
Are all records maintained for 3 years (lab. reg. required 5 years)?
0
El
El
❑
Are analytical results consistent with data reported on DMRs?
e
❑
Is the chain -of -custody complete?
Dates, times and location of sampling
Name of individual performing the sampling
Results of analysis and calibration
Dates of analysis
Name of person performing analyses
Transported COCs
Are DMRs complete: do they include all permit parameters?
010
Has the facility submitted its annual compliance report to users and DWQ?
El
❑
®
❑
(If the facility is = or > 5 MGD permitted flow) Do they operate 24/7 with a certified operator
S
El
on each shift?
Is the ORC visitation log available and current?
©
❑
El
11
Is the ORC certified at grade equal to or higher than the facility classification?
■
❑
Is the backup operator certified at one grade less or greater than the facility classification?
11
El
Is a copy of the current NPDES permit available on site?
Facility has copy of previous year's Annual Report on file for review?
®
❑
Comment: None
Laboratory Yes No Na Ne
Page# 3

Permit: NCO075027 Owner - Facility: Cains Way Mobile Home Park
Inspection Date: 06/06/2014 Inspection Type: Compliance Evaluation
Laboratory
Yes
No Na Ne
Are field parameters performed by certified personnel or laboratory?
E
❑
❑
❑
Are all other parameters(excluding field parameters) performed by a certified lab?
❑
❑
❑ .
# Is the facility using a contract lab?
❑
❑
❑
# Is proper temperature set for sample storage (kept at less than or equal to 6.0 degrees
❑
❑
❑
E
V Celsius)?
Incubator (Fecal Coliform) set to 44.5 degrees Celsius+/- 0.2 degrees?
❑
❑
❑
0
Incubator (BOD) set to 20.0 degrees Celsius +/-1.0 degrees?
❑
❑
❑
0
Comment: None
Effluent Sampling
Yes
No Na Ne
Is composite sampling flow proportional?
❑.
❑
❑
Is sample collected below all treatment units?
❑
❑
❑
Is proper volume collected?
❑
❑
❑
Is the tubing clean?
❑
❑
❑
# Is proper temperature set for sample storage (kept at less than or equal to 6.0 degrees
❑
❑
❑
■
Celsius)?
Is the facility sampling performed as required by the permit (frequency, sampling type
0
❑
❑
❑
representative)?
Comment: Composite sampling is constant time/constant volume.
Upstream / Downstream Sampling
Yes
No Na Ne
Is the facility sampling performed as required by the permit (frequency, sampling type, and
❑
❑
❑
sampling location)?
Comment: None
Pump Station; Influent
Yes
No Na Ne
Is the pump wet well free of bypass lines or structures?
❑
❑
❑
Is the wet well free of excessive grease?
❑
❑
❑
Are all pumps present?
N
❑
❑
❑
Are all pumps operable?
❑
❑
❑
Are float controls operable?
0
❑
❑
❑
Is SCADA telemetry available and operational?
❑
❑
❑
Is audible and visual alarm available and operational?
❑
❑
❑
Comment: Visual alarm was out at -the time of the inspection.
Bar Screens
Yes
No Na Ne
Page# 4

0
Permit: NCO075027 Owner -Facility: Cains Way Mobile Home Park
Inspection Date: 06/06/2014 Inspection Type: Compliance Evaluation
Bar Screens
Yes
No Na Ne
Type of bar screen
a.Manual
b.Mechanical
®
❑
Are the bars adequately screening debris?
Is the screen free of excessive debris?
❑
®
11
❑
Is disposal of screening in compliance?
®
El
❑
Is the unit in good condition?
Comment: Bar screen was removed when the influent pump station collapsed in on itself
recently. Bar screen never replaced. A new bar screen must be installed.
Aeration Basins
Yes
No Na Ne
Mode of operation
Ext. Air
Type of aeration system
Diffused
M
El
0
El
Is the basin free of dead spots?
®
❑
Are surface aerators and mixers operational?
El
El
Are the diffusers operational?
Is the foam the proper color for the treatment process?
Does the foam cover less than 25% of the basin's surface?
N
El
❑
❑
Is the DO level acceptable?
■
❑
0
❑
Is the DO level acceptable?(1.0 to 3.0 mg/1)
Comment: None
Secondary Clarifier
Yes
No Na Ne
®
❑
Is the clarifier free of black and odorous wastewater?
®
❑
❑
Is the site free of excessive buildup of solids in center well of circular clarifier?
®
❑
11
Are weirs level?
®
❑
El
El
Is the site free of weir blockage?
Is the site free of evidence of short-circuiting?
®
El
❑
El
Is scum removal adequate?
9
El
El
D
Is the site free of excessive floating sludge?
®
❑
El
Is the drive unit operational?
®
❑
Is the return rate acceptable (low turbulence)?
Page# 5

4
Permit: NC0075027 Owner -Facility: Cains Way Mobile Home Park
Inspection Date: 06/06/2014 Inspection Type: Compliance Evaluation
Secondary Clarifier Yes No Na Ne
Is the overflow clear of excessive solids/pin floc? N ❑ ❑ ❑
Is the sludge blanket level acceptable? (Approximately Y4 of the sidewall depth) ❑ ❑ ❑ E
Comment: None
Pumps-RAS-WAS
Yes
No Na Ne
Are pumps in place?
E
❑
❑
❑
Are pumps operational?
0
❑
❑
❑
Are there adequate spare parts and supplies on site?
❑
❑
❑
Comment: None
Disinfection -Tablet
Yes
No Na Ne
Are tablet chlorinators operational?
0
❑
❑
❑
Are the tablets the proper size and type?
N
❑
❑
❑
Number of tubes in use?
4
Is the level of chlorine residual acceptable?
❑
❑
❑
M
Is the contact chamber free of growth, or sludge buildup?
M
❑
❑
❑
Is there chlorine residual prior to de -chlorination?
❑
❑
❑
M
Comment: None
De -chlorination
Yes
No Na Ne
Type of system ?
Tablet
Is the feed ratio proportional to chlorine amount (1 to 1)?
0
❑
❑
❑
Is storage appropriate for cylinders?
❑
❑
❑
# Is de -chlorination substance stored away from chlorine containers?
❑
❑
❑
Are the tablets the proper size and type?
❑
❑
❑
Comment: None
Are tablet de -chlorinators operational?
❑
❑
❑
Number of tubes in use?
4
Comment: None
Flow Measurement - Effluent Yes No Na Ne
# Is flow meter used for reporting? 0 ❑ ❑ ❑
Is flow meter calibrated annually? .0 ❑ ❑ ❑
Page# 6

.4
Permit: NCO075027
Inspection Date: 06/06/2014
Flog Measurement - Effluent
Is the flow meter operational?
Owner -Facility: Gains Way Mobile Home Park
Inspection Type: Compliance Evaluation
(If units are separated) Does the chart recorder match the flow meter?
Comment: None
Effluent Pipe
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: None
Aerobic Digester
Is the capacity adequate?
Is the mixing adequate?
Is the site free of excessive foaming in the tank?
# Is the odor acceptable?
# Is tankage available for properly waste sludge?
Comment: None
Operations & Maintenance
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: None
Yes No Na Ne
❑ ❑ ❑
® ❑ ❑ ❑
Yes No Na Ne
®❑ ❑ ❑
®❑ ❑ ❑
❑ ❑ ® ❑
Yes No Na Ne
IN ❑ ❑ ❑
0 ❑ ❑ ❑
❑ ❑ ❑
* ❑ ❑ ❑
®❑ ❑ ❑
Yes No Na Ne
E ❑ ❑ ❑
❑ ❑ ❑
Page# 7

i
MC®��
North Carolina Department of Environment and Natural Resources
Division of Water Resources
Water Quality Regional Operations Section
Pat McCrory Thomas A. Reeder
Governor Director
March 19, 2014
Eleanor Wood
Cains Way Homeowners Association
P.O. Box 846
Walkertown, NC 27051
Subject: NOTICE OF VIOLATION
NOV-2014-LV-0111
Permit No. NCO075027
Cains Way Mobile Home Park
Forsyth County
Dear Ms. Wood:
John E, Skvarla, III
Secretary
A review of Cains Way Mobile Home Park's monitoring report for December 2013, showed the following
violations:
Parameter
Date
Limit Value
Reported Value
Limit Type
Coliform, Fecal MF, M-FC
12/12/13
400 #/100m1
490 #/100ml
Daily
Broth,44.5C
Maximum
Exceeded
Remedial actions, if not already implemented, should be taken to correct the above noncompliance problem.
Please be aware that violations of your NPDES permit could result in enforcement action by the Division of
Water Resources for this and any additional violations of State law.
North Carolina Division of Water Resources, Winston-Salem Regional Office
Location: 585 Waughtown St. Winston-Salem, North Carolina 27107
Phone: [phone] FAX: 336-771A6301 Customer Service: 1-877-623-6748
Internet: www.ncwater.org
Natalrally
NofthCarolina
An Equal Opportunity 1 Affirmative Action Employer

If you should have any questions, please do not hesitate to contact Ron Boone at [phone]
Sincerely,
W. Corey Basinger
Regional Supervisor
Water Quality Regional Operations Section
Division of Water Resources
cc: SWP — Central Files
US+RQ Hiles :f�

Facility:
Parameter
©MR Review Record
Permit No.: 76 0 Z2 Pipe No.: lDy I MonthlYear:
Monthly Average Violations
Permit Limit DMR Value % Over Limit Action
Weeklv/Dally Violations
Date Parameter Permit Limit Limit TVPe DMR Value % Over Limit Action
Monitoring Frequency Violations
Date Parameter Permit Frequency Values Reported # of Violations Action
I Other ViolationsiStaff Remarks:
Yak- 201f -LV - all I
Supervisor Remarks: XX
Completed by: Count
Assistant Regional
Supervisor Sign Off:
Regional Supervisor Sign
Off:
t
Date:
Date:
Date: Zo, I Ir—

3' q
( November 1 through March 31 )
NPDES PERMIT NO.: NCO075027
DISCHARGE NO.:
001 MONTH: December YEAR: 2013
FACILITY NAME: Cains Way MHP
CLASS:
11 COUNTY: Forsyth
OPERATOR IN RESPONSIBLE CHARGE: Bradley Flynt
GRADE: IV PHONE: [phone]
CERTIFIED LABORATORIES:
(1 ) Statesville Analytical
(2 )
Check box if orc has changed( ]
PERSON(S) COLLECTING SAMPLES: Bradley Flynt
Mail ORIGINAL and ONE COPY to:
ATTN: CENTRAL FILES
DIVISION OF WATER QUALITY
(S NATURE OF,
C) DATE
DENR
BY THIS SIGNA
E CERTIFY THAT THIS REPORT IS
1617 MAIL SERVICE CENTER
ACCURATE AND E
PiTO THE BEST OF MY KNOWLEDGE.
RALEIGH, NC 27699-1617
FEBTMS
2 i,; 2014
50050
00010
00040
50060
00310
00610
00530
31616
00300
00625
00630
00600
00665
D
A
T
E
Opr.
Arrive
Time
2400
clock
Opr.
Time
on
Site
Orc
on
Site
Flow
[ ] Inf
X Eff
Temp.
pH
Res
Cl2
BOD5
@
20C
NH3-N
T
S
S
Fecal
Coliform
Geometric
Mean
Dissolvd
Oxygen
(DO)
Total
Khejdahl
Nitrogen
Nitrates
Nitrites
Total
Nitrogen
Total
Poo
D
A
T
E
#
IHRS
IHRS
Y/N
I MGD
I C
UNITS
I u /L
m /L
I m /L
m /L
#/100mi
mgfL
m /L
I m /L
m /L
m /L
#
1
0.0070
1
2
17:20
0.5
y
0.0070
13
7.1
<11
7.3
2
3
17:30
0.25
y
0.0080
13
3
4
17:20
0.5
y
0.0070
14
4
5
5:00
0.25
y
0.0080
15
37
2.5
< 0.10
1 3.4
275
1
5
6
10:15
0.25
0.0070
16
6
7
0.0090
--
� Tr
18 fl jj-
�
7
8
0.0080
`�
8�
��
d
Lj
8
9
18:00
0.5
0.0070
15E6.
31
7.5
9
10
17:45
0.25
0.0080
14
FEB v
4
10
11
17:25
0.25
0.0070
13
_
r-
11
12
5:06
0.25
0.0070
13
3.0
0.45
3.0
490
]
!
Itl 1 M/
t i" l�L.
12
13
8:30
0.25
y
1 0.00601
12
1 21
'� V 4
13
14
0.0100
14
15
0.0100
15
16
18:05
0.5
y
0.0070
13
7.3
<11
7.7
16
17
17:25
0.25
y
0.0080
13
17
18
*17:301
0.25
y
0.0010
13
18
19
5:00
0.25
0.0060
- 13
2.5
< 0.50
7.6
140
19
20
11:00
0.250.0070
14
44
20
21
0.0090
21
22
0.0140
22
23
18:10
0.5L0.0210
16
7.4
<11
3.4
0.53
3.7
21
7.9
23
24
10:561
0.25
y
0.0090
15
24
25
H
H
h
0.0080
H
H
H
H
H
H
H
H
H
H
H
H
25
26
16:30
0.25
y
0.0080
14
1
1
1
26
27
16:50
0.25
y
0.0090
13
29
27
28
0.0080
28
29
0.0130
29
30
1 'IT501
0.5
0.0090
13
7.1
24
7.7
30
31
114:001
0.251
0.0100
13
1
1
1
31
AVERAGE
0.0085
147RA
31.0
2.9
0.25
4.4
141
7.6
#
MAXIMUM
0.0210
16-
44.0
3.4
0.53
7.6
490
7.9
-
#
MINIMUM
0.0010
12
21.0
2.5
< 0.10
3.0
21
7.3
#
COMP/GRAB
CONT.
GRAB
GRAB
COMP.
COMP.
COMP.
GRAB
GRAB
#
DAILY LIMIT
NA
NA
NA
16.5
45
400
N/A
#
QUARTERLY LIMIT
NA
NA
NA
NA
NA
NA
NA
' NA
NA
#
MONTHLY LIMIT
0.0432
NA
>6,<9
NA
11.0
2
30
200
NA
#
MONITORING FREQUENCY
Cont.
Daily t__Wkly
21Wk
Wkly
Wkly
Wkly
Wkly
Wkly
#
FREQUENCY MET
yes
YES
YES
YES
YES
YES
YES
YES
YES
#
COMPLIANT
yes
YES
YES
YES
YES
YES
YES
yes
YES
4
Total Monthly Flow 0.2630 MG TN Monthly Loading (Ibs.)
DEM Form MR-1 (12/03) Annual TN Mass Loading (Ibs./yr)
DEM Form MRA (12103) Annual TN Mass Loading (Ibs./yr)
2
RECEIVED
N.C.Dept. of ENR
1�R 9 1201
Winston-Salem
Regional Office

Cains Way MHP Status: (Please check one of the following)
All monitoring data and sampling frequencies meet permit requirements [ ]
Compliant
All monitoring data and sampling frequencies do NOT meet permit requirements [
Noncompliant
If the facility is noncompliant, please comment on corrective actions being taken in respect to equipment, operation,
maintenance, etc, and a time table for improvements to be made.
'V �1 I (:...ti' Ter, / L-LoIrJa r-Tl 1 ro l /2 //02 /%�.Gi t/� �r7 Cr74� �f1 //�Y"r1 1'I'iPS'fDll!' t✓
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision
in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information sub-
mitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for
gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and com-
plete. I am aware that there are significant penalties for submitting false information, including the possibility of fines
and imprisonment for knowing violations."
Permittee Address:
00010 Temperature
00076 Turbidity
00080 Color (Pt -Co) .
00082 Color (ADMI)
00300 Dissolved Oxygen
00310 B O D 5
00340 C O D
00400 pH
00530 T S S
00545 Settleable Solids
00556 Oil and Grease
00600 Total Nitrogen
PARAMETER CODES
00610 Ammonia Nitrogen
00625 Total Kjeldah
Nitrogen
00630 Nitrate/Nitrite
00665 Total Phosporous
00720 Cyanide
00745 Total Sulfide
00927 Total Magnesium
00929 Total Sodium
00940 Total Chloride
00951 Total Fluoride
01002 Total Arsenic
01027 Cadmium
r I C /I
Permittee (Please print or type)
Signatur f ermitte * Date
Phone u ber: Permit Exp. Date
May 31, 2007
01032 Hexavalent
Chrc 32730 Total Phenolics
01034 Chromium 34235 Benzene
01037 Total Cobal34481 Toluene
01042 Copper 38260 MBAS
01045 Iron 39516 PCBs
01051 Lead 50050 Flow
01067 Nickel 50060 Total Residual
01077 Silver Chlorine
01092 Zinc 71880 Formal-
01105 Alumimum dehyde
01147 Total Selen 71900 Mercury
31616 Fecal Colifc 81551 Xylene
Parameter Code assistance may be obtained by calling the Water Quality Compliance Group at [phone] ext 581 or 534
The monthly average for fecal coliform is to be reported as a GEOMETRIC mean. Use only units designed in the reporting
facility's permit for reporting data.
* ORC must visit the facility and document visitation of facility as required per 15A NCAC 8A .0202(b)(5)(B)
** If signed by other than the permittee, delegation of signatory authority must be on file with the state per
15A NCAC 213.0506 (b)(2)(D)

NPDES PERMIT NO:NC0075027 DISCHARGE NO.: 001 MONTH: December YEAR: 2013
FACILITY NAME: Cains Way MHP COUNTY:Forsyth
STREAM: Ader Creek LOCATION: @ 100ft Above Discharge Point STREAM: Ader Creek LOCATION: @ NCSR 1979
UPSTREAM
DOWNSTREAM
00010
00300
31616
00010
00300
31616
D
Feral
D
Fecal
A
Time
Dissolved
Coliform
A
Time
Dissolved
Colifonn
T
Temp
Oxygen
T
Temp
Oxygen
E
12400
1
1 Geometrd
I
E
12400
1
1 Geometric
Clock
DO
Mean
Clock
DO
Mean
#
HRS
C
m /L
#/100ml
#
HRS
C
m /L
#1100ml
1
1
2
17:40
11.0
9.2
2
17:47
11.0
8.9
3
3
4
4
5
5
6
6
7
7
8
8
9
18:20
12.0
9.4
9
18:27
12.0
9.2
10
10
11
11
12
12
13
1
1
1
1
13
14
14
15
15
16
18:25
10.0
9.1
116
18:32
10.0
9.5
17
17
18
1
1
1
1
18
19
19
20
20
21
21
22
22
23
18:30
12.01
9.4
23
18:36
12.0
9.6
24
24
25
25
26
26
27
27
28
28
29
29
30
18:10
11.0
9.31
1
30
18:16
11.0
9.1
31
1
1
31
AVERAGE 1
11.2
9.3
1
1
1
1 1
AVERAGE
1 11.2
9.3
MAXIMUM
12.0
9.4
MAXIMUM
12.0
9.6
MINIMUM
10.0
9.1
MINIMUM
10.0
8.9
COMP/GRAB
GRAB
GRAB
COMP/GRAB
GRAB
GRAB
DEM Form MR-3 (12193) DEM Form MR-3 (12/93)

4
OUNEIAR
North Carolina Department of Environment and Natura
Division or Water Quality
Pat McCrory Charles Wakild, P.E.
Governor Director
February 28, 2014
Eleanor Wood
Cains Way Homeowners Association
P.O. Box 846
Walkertown, NC 27051
Subject: NOTICE OF VIOLATION: NOV-2014-LV-0082
Permit No. NCO075027
Cains Way Mobile Home Park
Forsyth County
Dear Ms. Wood:
Resources
John E. Skvarla, III
Secretary
A review of Cains Way Mobile Home Park's monitoring report for November 2013
showed the following violations:
Parameter
Date
Limit Value
Reported Value
Limit Type
Coliform, Fecal MF, M-FC
11/07/13
400 #/100ml
500 #/100ml
Daily
Broth,44.5 C
Maximum
Exceeded
Remedial actions, if not already implemented, should be taken to correct the above
noncompliance problem(s). Please be aware that violations of your NPDES permit could result
in enforcement action by the Division of Water -Quality for this and any additional violations of
State law.
If you should have any questions, please do not hesitate to.contact Ron Boone at (336)
771-5000.
cc: 'SWP — Central Files
- ile
North Carolina Division of Water Quality, Winston-Salem Regional Office
Location: 585 Waughtown St. Winston-Salem, North Carolina 27107
Phone: [phone] FAX: [phone] Customer Service:1-877-623-6748
Internet: www.ncwaterquality.org
An Equal Opportunity 1 Affirmative Action Employer
Sincerely,
6
W. Corey Basinger
Surface Water Regional Supervisor
Winston-Salem Regional Office
Division of Water Quality
One
NorthCarolina
aw1rally

Div R Re �icG^� F'Z�corc�J
Facility:
' /Vi J9
Permit No.: Z S d 27 Pipe No.:
CD/ Month/Year: 2 013
w(P
Monthly Average Violations
Parameter
Permit Limit DMR Value
% Over Limit Action
Weekly/Daily Violations
Date
Parameter
Permit Limit Limit Type DMR Value
% Over Limit Action
l 3
fe oe- 9 P ,n,.
6b Do r l Saas
Monitoring Frequency Violations
Date
Parameter
Permit Frequency Values Reported
# of Violations Action
Other Violations/Staff Remarks:
alW zo(z Fa #6d/lt v, ag�.s�� N�� NoV — 01� — L v
Supervisor R arks:
Completed by: Date:
Assistant Regional
Supervisor Sign Off: Date:
Regional Supervisor Sign
Off: Date:

(April 1 through October 31 )
NPDES PERMIT NO.: NC0075027 DISCHARGE NO.: 001 MONTH: November YEAR: 2013
FACILITY NAME: Cains Way MHP CLASS: II COUNTY: Forsyth
OPERATOR IN RESPONSIBLE CHARGE: Bradley Flint GRADE: IV PHONE: [phone]
CERTIFIED LABORATORIES: (1) SfuFdS J II@ Ar2 )
Check box if orc has changed [ ] PERSON(S) COLLECTING SAMPLES: "�C Bradley Flint
Mail ORIGINAL and ONE COPY to: /
ATTN: CENTRAL FILES X Cr14&Z4 &2
DIVISION OF WATER QUALITY (SIGNATURE OF DATE
DENR BY THIS SIGNATUR ERTIFY THAT THIS REPORT IS
1617 MAIL SERVICE CENTER ACCURATE AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
RALEIGH, NC 27699-1617

Cains Way MHP Status: (Please check one of the following)
All monitoring data and sampling frequencies meet permit requirements [ ]
Compliant
All monitoring data and sampling frequencies do NOT meet permit requirements [ ,X J
Noncompliant
If the facility is noncompliant, please comment on corrective actions being taken in respect to equipment, operation,
maintenance, etc, and a time table for improvements to be made.
i�a'�u +ee-CJ ii'nle,nn on t117//31 l nci( Ali AePn lirJ 1, Ae(orc r (q1q& fi,,4ke 9�1
Qng rna;nia +1 et ftilke, CI,, Jeael. Z. Rqr+
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision
in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information sub-
mitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for
gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and com-
plete. I am aware that there are significant penalties for submitting false information, including the possibility of fines
and imprisonment for knowing violations."
Permitt a (Please print or type)
Permittee Address:
00010 Temperature
00076 Turbidity.
00080 Color (Pt -Co)
00082 Color (ADMI)
00300 Dissolved Oxygen
00310 B 0 D 5
00340 C 0 D
00400 pH
00530 T S S
00545 Settleable Solids
00556 Oil and Grease
00600 Total Nitrogen
10,
/C1067 i�/a�/i3
Signat f P rmi cue** Date
Phone tuber: Permit Exp. Date
May 31, 2007
PARAMETER CODES
00610 Ammonia Nitrogen
01032 Hexavalent
00625 Total Kjeldah
Chrc 32730 Total Phenolics
Nitrogen
01034 Chromium 34235 Benzene
00630 Nitrate/Nitrite
01037 Total Cobal34481 Toluene
00665 Total Phosporous
W 042 Copper 38260 MBAS
00720 Cyanide
01045 Iron 39516 PCBs
00745 Total Sulfide
01051 Lead 50050 Flow
00927 Total Magnesium
01067 Nickel 50060 Total Residual
00929 Total Sodium
01077 Silver Chlorine
00940 Total Chloride
01092 Zinc 71680 Formal-
00951 Total Fluoride
01105 Alumimum dehyde
01002 Total Arsenic
01147 Total Selen 71900 Mercury
01027 Cadmium
31616 Fecal Colifc 81551 Xylene
Parameter Code assistance may be obtained by calling the Water Quality Compliance Group at [phone] ext 581 or 534
The monthly average for fecal coliform is to be reported as a GEOMETRIC mean. Use only units designed in the reporting
facility's permit for reporting data.
* ORC must visit the facility and document visitation of facility as required per 15A NCAC 8A .0202(b)(5)(B)
** If signed by other than the permittee, delegation of signatory authority must be on file with the state per
15A NCAC 2B .0506 (b)(2)(D)

M� -f
NC®EN
North Carolina Department of Environment and natural Resources
Division of Water Resources
Pat McCrory Thomas A. Reeder
Governor Acting Director
August 15, 2013
Eleanor Wood
Cains Way Homeowners Association
P.O. Box 846
Walkertown, NC 27051
Subject: NOTICE OF DEFICIENCY
NOD-2013-LV-0098
Eleanor Wood
Permit No. NCO075027
Cains Way Homeowners Association Wastewater Treatment Plant
Forsyth County
Dear Ms. Wood:
John E. Skvarla, III
Secretary
A review of the May, 2013 Discharge Monitoring Report (DMR) for Cains Way Homeowners Association
Wastewater Treatment Plant revealed a violation of the following parameter(s) at Outfall 001 :
Parameter
Date
Reported Value
Permit Limit
BOD
1 5/2/2013
18
1 16.5
Remedial actions *should be taken to correct the cause(s) of this violation. The violations described above
should be abated immediately and properly resolved.
Thank you for your attention to this matter. This office requires that the violations as described above be
properly resolved. Unresolved violations may lead to the issuance of a Notice of'Violation and/or
assessments of civil penalties.
If you have any questions or require any additional information, please contact Ron Boone at (336) 771-
5000 (ron.boone0_ncdenr.aov).
cc: WSR®_F_i e,C-_opy15
DWQ Central Files
Bradley Flynt
8467 Southerard Road
Stokesdale, NC 27357
N. C. Division of Water Quality
Winston-Salem Regional Office
585 Waughtown Street, Winston-Salem, NC 27.107
Phone:[phone] FAX:[phone]
Customer Service:1-877-623-6748
Internet: www.ncwaterqual!V.org
An Equal Opportunity 1 Affirmative Action Employer
Sincerely,
d
W. Corey Basinger
Surface Water Regional Supervisor
Winston-Salem Regional Office
Division of Water Resources
One
No thCarolina.
)UMM711y

DMR Review Record
Facility: Cains Way MHP WWTP Permit No.: 75027 Pipe No.: 001 MonthlYear: 05/2013
Monthly Average Violations
Parameter Permit Limit DMR Value % Over Limit Action
Date
5/2/13
Parameter
BOD
Date Parameter
Weekly/Daily Violations
Permit Limit Limit Type DMR Value
16.5 Daily Max 18
Monitoring Frequency Violations
Permit Frequency Values Reported
Other Violations/Staff Remarks: 1111112, FC, NOV; 513112, BOD, NOV; 5/31112, NH3, NOV;
pleted by:
Ron Boone
criteria
Failure to monitor parameter with limit: $50
Failure to monitor parameter without limits: $25
Any facility with just a single daily max violation to receive NOV only.
No civil assessment cases for less than $100, not including cost of investigation. NOV only.
Threshold for flow is 10%; threshold for all other parameters is 20%.
Stipulated demand letters for SOCs..... automatic.
Failure to obtain a permit ..... $4,000.
#DIV/0!
#DIV/0!
#DIV/0!
% Over Limit
9.09
#DIV/0!
#DIV/0!
#DIV/0!
# of Violations
Date:
8/14/13
Action
Action
Multipliers:
Number of assessments for previous 12 months:
0-2 Multiply base penalty by 1.0
3-5 Multiply base penalty by 1.25
6-8 Multiply base penalty by 1.5
9-12 Multiply base penalty by 2.0
Delgated Fast Track Penalties/Base Penalty Amounts:
DMR Monthly Flow Avg
Monthly Average
Weekly Average
Daily Max
50.05 MGD---------
$0-500
$0-200
$0-200
>0.05 but <0.1 MGD
$0-1,000
$0-500
$0-200
>0.1 but <0.5 MGD
$0-1,500
$0-500
$0-500
>_0.5 but <1.0 MGD
$0-2,000
$0-500
$0-500
>1.0 but <10.0 MGD
$0-3,000
$0-1,000
$0-500
>10.0 but <25.0 MGD
$0-4,000
$0-1,000
$0-500
>_25.0 MGD
$0-5,000
$0-1,000
$0-500
Supervisor Remarks:
t
Regional Water Quality
Supervisor Sign Off: Date: 72,��

d.
06
HCDENR
Forth Carolina Department of Environment and natural Resources
Division of Water Quality
Pat McCrory Charles Wakild, P. E.
Governor Director
May 13, 2013
Cains Way Homeowners Association
Attn: Ms. Eleanor Wood, Owner
P.O: Box 846
Walkertown, NC 27051
Subject: Compliance Evaluation Inspection
Permittee: Cains Way Homeowners Association
Facility: Cains Way Mobile Home Park Wastewater. Treatment Plant
NPDES Permit #: NCO075027
Forsyth County
Dear Ms. Wood:
John E. Skvarla, III
Secretary
Ron Boone of the Winston-Salem Regional Office of the NC Division of Water Quality (DWQ or the Division)
conducted a compliance evaluation inspection (CEI) of the Cains Way Mobile Home Park Wastewater Treatment
Plant (WWTP) on May 7, 2013. The assistance and cooperation of Bradley Flynt, Operator in Responsible Charge
(ORC), was greatly appreciated. An inspection checklist is attached for your records and inspection findings are
summarized below.
General Information
The Cains Way Mobile Home Park WWTP is located on the far west side of Cains Way Mobile Home Park
at approximate coordinates 36.2065000N,-80.152222°W, off of Pine Hall Road, in Walkertown, Forsyth County, NC.
The permit authorizes you to operate this 0.0432 MGD WWTP, which consists of an aerated equalization basin, a bar
screen, a splitter box, dual extended aeration basins, a clarifier, tertiary filters, a tube type chlorinator, and a tube
type dechlorinator, and discharge the treated effluent to Ader Creek via outfall 001, which is currently classified as
Class C waters in the Roanoke River basin.
Site Review
Mr. Flynt has done a good job operating and maintaining the plant using the resources that are available to
him. However, there are some issues as noted below:
The audible alarm on the equalization tank was inoperable during the inspection.
The effluent composite sampler is still not pulling flow proportional samples as required by the permit. -This
was a finding from the previous inspection. If the permittee wishes to use another sampling regime other
than flow proportional, they must request permission to do so from the Division and receive the approval in
writing before doing so.
North Carolina Division of Water Quality, Winston-Salem Regional Office
Location: 585 Waughtown St. Winston-Salem, North Carolina 27107
Phone: [phone] FAX: [phone] Customer Service; 1-877-623-6748
Internet: www.ncwaterquality.org One
An Equal Opportunity 1 Affirmative Action Employer NofthCarolina

Cains Way Homeowners Association, Attn: Ms. Eleanor Wood, Owner
Compliance Evaluation Inspection
Cains Way Mobile Home Park Wastewater Treatment Plant, NCO075027
May 13, 2013, Page 2 of 2
3. The plant is quite old and could use a considerable amount of cleaning, maintenance and attention to safety
issues. Although everything operates sufficiently, some components are in various states of disrepair. Also,
there are several open pits with no fall protection around them, presenting a considerable safety hazard.
4. The second aeration basin is still used as, an aerobic digester (eastern half) and a waste tank (western half).
The waste tank is also used as a receptacle for several items such as the supernatant off of the digester
and bar screenings.
5. The scraper in the clarifier has been repaired (last inspection) but the water in the clarifier was very cloudy.
However, there didn't appear to be any solids loss during the inspection. The effluent was clear and the
receiving stream was free of solids and foam, except for a small amount of foam where the discharge left
the pipe and fell into the stream.
6. The tertiary filters are not in operation.
Documentation Review
All documentation was reviewed. Mr. Flynt has done a good job with the documentation required by the
permit. This includes operations and visitation logs, discharge monitoring reports and laboratory and field laboratory
records, chains of custody, etc. No issues were noted.
You are reminded that, in accordance with NC General Statute 143-215.6A, the Director of the Division of
Water Quality may assess civil penalties not to exceed $25,000 per day, per violation, for violations of the
NCO075027 NPDES permit. If you have any questions regarding the inspection or this letter, please call Mr. Boone or
me at [phone]. Thank you for your cooperation in this matter.
Sincerely,
W. Corey Basinger
Surface Water Regional Supervisor
Winston-Salem Regional Office
Division of Water Quality
Attachments:
BIMS Inspection Report
CC: VV_NJ_R _SWF'-
Central Files
NPDES Unit

United States Environmental Protection Agency
Form Approved.
E P n Washington, D.C. 20460
A'�
OMB No. 2040-0057
Water Gompliannp
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� 2 15 I 3I NCO075027 111 121 13/05/07 117 18I C I 19S I 20I I
Remarks
21111111111111111111111111 1111 IIII IIII 11111-111 III6
Inspection Work Days Facility Self -Monitoring Evaluation Rating B1 QA --------------------------- Reserved ----------------------
67I 169 701 I 711 I 721 NJ 73 L jj 74 751 I I I I I I 180
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)
Cains Way Mobile Home Park /
01:00 PM 13/05/07
12/05/01
Exit Time/Date
Permit Expiration Date
Pinehall Rd
Walkertown NC 27051
03:00 PM 13/05/07
17/02/28
Name(s) of Onsite Representative(s)/Titles(s)/Phone and Fax Number(s)
Other Facility Data
///
Bradley Todd Flynt/ORC/336-433-7262/
Name, Address of Responsible Official/Title/Phone and Fax Number
Contacted
Eleanor Wood,PO Box 846 Walkertown NC 27051//336-595-4666/ Contato
No
Section C: Areas Evaluated During Inspection (Check only those areas evaluated)
Permit ® Flow Measurement Operations & Maintenance Records/Reports
Self -Monitoring Program Sludge Handling Disposal ® Facility Site Review Effluent/Receiving Waters
Laboratory
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
Ron Boone AS4 WSRO WQ//336-771-4967/
Signature of Management Q A Reviewer Agency/Office/Phone and Fax Numbers Date
le—D',s���y�j (/g
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete.
Page # 1

NPDES yr/mo/day Inspection Type 1
3 L NCO075027 111 12I 13/05/07 17 18I d
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
Please refer to the attached inspection summary letter.
Page # 2

Permit: NCO075027
Owner - Facility: Cains Way Mobile Home Park
Inspection Date: 05/07/2013
Inspection Type: Compliance Evaluation
Record Keeping
Yes,. No
NA
NE
Are records kept and maintained as required by the permit?
■
n
n
n
Is all required information readily available, complete and current?
■
n
n
n
Are all records maintained for 3 years (lab. reg. required 5 years)?
■
n
n
n
Are analytical results consistent with data reported on DMRs?
■
n
n
n
Is the chain -of -custody complete?
Dates, times and location of sampling
Name of individual performing the sampling
Results of analysis and calibration
Dates of analysis
Name of person performing analyses
Transported COCs
Are DMRs complete: do they include all permit parameters?
Has the facility submitted its annual compliance report to users and DWQ?
(If the facility is = or > 5 MGD permitted flow) Do they operate 24/7 with a certified operator on each shift?
Is the ORC visitation log available and current?
Is the ORC certified at grade equal to or higher than the facility classification?
Is the backup operator certified at one grade less or greater than the facility classification?
Is a copy of the current NPDES permit available on site?
Facility has copy of previous year's Annual Report on file for review?
Comment: Please refer to the attached inspection summary letter.
Permit
(if the present permit expires in 6 months or less). Has the permittee submitted a new 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?
Is the inspector granted access to all areas for inspection?
Comment: Please refer to the attached inspection summary letter.
Laboratory
Are field parameters performed by certified personnel or laboratory?
Yes No NA NE
Yes No NA NE
■nnn.
Page # 3

Permit: NCO075027 Owner - Facility: Cains Way Mobile Home Park
Inspection Date: 05/07/2013 Inspection Type: Compliance Evaluation
Laboratory Yes No NA NE
Are all other parameters(excluding field parameters) performed by a certified lab? ■ rl 0 0
# Is the facility using a contract lab? 011011
# Is proper temperature set for sample storage (kept at less than or equal to 6.0 degrees Celsius)?
■
n
n
n
Incubator (Fecal Coliform) set to 44.5 degrees Celsius+/- 0.2 degrees?
n
n
n
■
Incubator (BOD) set to 20.0 degrees Celsius +/-1.0 degrees?
n
n
n
■
Comment: Please refer to the attached inspection summary letter.
Effluent Sampling
Yes No
NA
NE
Is composite sampling flow proportional?
0
■
n
n
Is sample collected below all treatment units?
■
n
n
n
Is proper volume collected?
■
n
n
n
Is the tubing clean?
■
n
D
n
# Is proper temperature set for sample storage (kept at less than or equal to 6.0 degrees Celsius)?
■
n
n
n
Is the facility sampling performed as required by the permit (frequency, sampling type representative)?
■
n
n
n
Comment: Please refer to the attached inspection summary letter.
Equalization Basins
Yes . No
NA
NE
Is the basin aerated?
fl
■
n
Cl
Is the basin free of bypass lines or structures to the natural environment?
■
n
n
0
Is the basin free of excessive grease?
■
Cl
n
n
Are all pumps present?
■
n
n
n
Are all pumps operable?
■
n
n
n
Are float controls operable?
■
n
n
0
Are audible and visual alarms operable?
n
■
n
1)
# Is basin size/volume adequate? ■ fl 0 n
Comment: Please refer to the attached inspection summary letter.
Upstream / Downstream Sampling Yes No NA NE
Is the facility sampling performed as required by the permit (frequency, sampling type, and sampling location)? ■ 0 n fl
Comment: Please refer to the attached inspection summary letter.
Type of bar screen
a.Manual
Yes No NA NE
■
Page # 4

Permit: NCO075027
Inspection Date: 05/07/2013
Owner - Facility: Cains Way Mobile Home Park
Inspection Type: Compliance Evaluation
Bar Screens
Yes
No _
NA
NE
b.Mechanical
n
Are the bars adequately screening debris?
■
❑
n
n
Is the screen free of excessive debris?
■
n
n
n
Is disposal of screening in compliance?
■
n
Cl
n
Is the unit in good condition?
■
n
n
0
Comment: Please -refer to the attached inspection summary letter. Bar screen is a 5
gallon bucket with holes in it.
Aeration Basins
Mode of operation
Type of aeration system
Is the basin free of dead spots?
Are surface aerators and mixers operational?
Are the diffusers operational?
Is the foam the proper color for the treatment process?
Does the foam cover less than 25% of the basin's surface?
Is the DO level acceptable?
Is the DO level acceptable?(1.0 to 3.0 mg/1)
Comment: Please refer to the attached inspection summary letter.
Secondary Clarifier
Is the clarifier free of black and odorous wastewater?
Is the site free of excessive buildup of solids in center well of circular clarifier?
Are weirs level?
Is the site free of weir blockage?
Is the site free of evidence of short-circuiting?
Is scum removal adequate?
Is the site free of excessive floating sludge?
Is the drive unit operational?
Is the return rate acceptable (low turbulence)?
Is the overflow clear of excessive solids/pin floc?
Is the sludge blanket level acceptable? (Approximately'/4 of the sidewall depth)
Yes No NA NE
Ext. Air
Diffused
■nnn
nn■n
■nnn
■n,nn
n■nn
nnn■
n,nn■
Yes No NA NE
■nnn
■nnn
■nnn
■nnn
■nnn
■nnn
■
n
n
n
■nnn
■nnn
■nnn
n
n
n
■
Page # 5

Permit: NC0075027 Owner - Facility: Cains Way Mobile Home Park
Inspection Date: 05/07/2013 Inspection Type: Compliance Evaluation
Secondary Clarifier
Comment: Please refer to the attached inspection summary letter. Water in clarifier
was cloudy but effluent was clear with very little, if any, pin floc. May be a young sludge
or withdraw rate may cause too much turbulence, but difficult to tell.
Pumps-RAS-WAS
Are pumps in place?
Are pumps operational?
Are there adequate spare parts and supplies on site?
Comment: Please refer to the attached inspection summary letter.
Flow Measurement - Effluent
# Is flow meter used for reporting?
Is flow meter calibrated annually?
Is the flow meter operational?
(If units are separated) Does the chart recorder match the flow meter?
Comment: Please refer to the attached inspection summary letter.
Disinfection -Tablet
Are tablet chlorinators operational?
Are the tablets the proper size and type?
Number of tubes in use?
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: Please refer to the attached inspection summary letter.
De -chlorination
Type of system ?
Is the feed ratio proportional to chlorine amount (1 to 1)?
Is storage appropriate for cylinders?
# Is de -chlorination substance stored away from chlorine containers?
Are the tablets the proper size and type?
Comment: Please refer to the attached inspection summary letter.
Are tablet de -chlorinators operational?
Yes No NA NE
Yes No NA NE
■nnn
■nnn
■nnn
Yes No NA NE
Yes No NA NE
■nnn
■nnn
4
Yes No NA NE
Tablet
■nnn
nn■n
■nnn
■ n n n
Page # 6

r
Permit: NCO075027 Owner - Facility: Cains Way Mobile Home Park
Inspection Date: 05/07/2013 Inspection Type: Compliance Evaluation
De -chlorination Yes No NA NE
Number of tubes in use? 4
Comment: Please refer to the attached inspection summary letter.
Effluent Pipe Yes No NA NE
Is right of way to the outfall properly maintained? ■ n 0 0
Are the receiving water free of foam other than trace amounts and other debris? ■ n
If effluent (diffuser pipes are required) are they operating properly? ❑ ❑ ■ 0
Comment: Please refer to the attached inspection summary letter.
Aerobic Digester
Yes
No
NA
NE
Is the capacity adequate?
■
n
0
Q
Is the mixing adequate?
■
❑
0
0
Is the site free of excessive foaming in the tank?
■
❑
Q
Q
# Is the odor acceptable?
■
❑
fl
fl
# Is tankage available for properly waste sludge?
■
Q
Comment: Please refer to the attached inspection summary letter.,.
Operations & Maintenance
Yes
No
NA
NE
Is the plant generally clean with acceptable housekeeping?
■
❑
fl
171
Does the facility analyze process control parameters, for ex: MLSS, MCRT, Settleable Solids, pH, DO, Sludge ■ 0 ❑ 0
Judge, and other that are applicable?
Comment: Please refer to the attached inspection summary letter. Facility is well
maintained for the resources available, but the plant is quite old and is in fair condition.
Select upgrades could improve plant operation.
Page # 7

4
NCDEN
North Carolina Department of Environmdnt and Natural Resources
Division of Water Quality
Pat McCrory Charles Wakild, P.E. John E. Skvarla, 111
Governor Director Secretary
February 14, 2013
Eleanor Wood
Cains Way Homeowners Association
P.O. Box 846
Walkertown, NC 27051
Subject:. NOTICE OF VIOLATION
NOV-2013-LV-0114
Permit No. NCO075027
Cains Way Mobile Home Park
Forsyth County
Dear Ms. Wood:
A review of Cains Way Mobile Home Park's monitoring report for November 2012
showed the following violations:
Parameter
Date
Limit Value
Reported Value
Limit Type
Coliform, Fecal MF, M-FC
11/01/12
400 #/100ml
1,990 #/100ml
Daily
Broth,44.5C
Maximum
Exceeded
Remedial actions, if not already implemented, should be taken to correct the above
noncompliance problem(s). Please be aware that violations of your NPDES permit could result
in enforcement action by the Division of Water Quality for this and any additional violations of
State law.
If you should have any questions, please do not hesitate to contact Ron Boone at (336)
771-5000.
Sincerely,
cc: SWP — Central Files
W'S+IZ9�i�les ,_;
North Carolina Division of Water Quality, Winston-Salem Regional Office
Location: 585 Waughtown St. Winston-Salem, North Carolina 27107
Phone: [phone] FAX: [phone] Customer Service: 1-877-623-6748
Internet: www.ncwaterquality.org
W. Corey Basinger
Surface Water Regional Supervisor
Winston-Salem Regional Office
Division of Water Quality
Xatmlralltl
�T®n Carohna
An Equal Opportunity 1 Affirmative Action Employer

Cover Sheet from
Staff Member to
Regional Supervisor
DMR Review Record
Facility: Cains Way MHP Permit/Pipe No.: 75027/001 Month/Year Nov-12
Monthly Average Violations
Parameter Permit Limit DMR Value % Over Limit
,Fecal.. _ _ �`na 400,,;,. ° �a X990 . _ 391.5
P� #DIV/0!
#DIV/0!
#DIV/0!
Weekly/Daily Violations
Date Parameter Permit Limit/Type DMR Value % Over Limit
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
Monitoring Frequency Violations
Date Parameter Permit Frequency Values Reported # of Violations
Other Violations
See attached
Completed by: Ron Boone
Regional Water Quality 14
Supervisor Sign Off. ��r r ►'`� ��s"
jQ6J
Date: 2/14/2013
Date: J _—k s

MONITORING REPORT(MR) VIOLATIONS for:
Report Date: 02/14/13 Page: 1 of 4
PERMIT: NCO075027 FACILITY: Cains Way Homeowners Association - Cains Way COUNTY: Forsyth REGION: Winston-Salem
Mobile Home Park
Limit Violation
MONITORING
OUTFALL /
-REPORT
PPI
LOCATION
PARAMETER
05 -201,2
001
EEfeuent
BOD;•S=Day, (20,Deg�-=
t3oncenation
11 -2011
001
Effluent
Chlorine, Total Residual
11 -2011
001
Effluent
Chlorine, Total Residual
11 -2011
001
Effluent
Chlorine, Total Residual
12 -2011
001
Effluent
Chlorine, Total Residual
12 -2011
001
Effluent
Chlorine, Total Residual
12 -2011
001
Effluent
Chlorine, Total Residual
12 -2011
001
Effluent
Chlorine, Total Residual
01 -2012
001
Effluent
Chlorine, Total Residual
01 -2012
001
Effluent
Chlorine, Total Residual
01 -2012
001
Effluent
Chlorine, Total Residual
02 -2012
001
Effluent
Chlorine; Total Residual
02 -2012
001
Effluent
Chlorine, Total Residual
02 -2012
001
Effluent
Chlorine, Total Residual
03 -2012
001
Effluent
Chlorine, Total Residual
03 -2012
001
Effluent
Chlorine, Total Residual
03 -2012
001
Effluent
Chlorine, Total Residual
VIOLATION
UNIT OF
CALCULATED
DATE
FREQUENCY
MEASURE
LIMIT
VALUE
% OVER LIMIT
VIOLATION TYPE
VIOLATION ACTION
05l03%12i
Weekly
fig
16.5
(2Q
4.1,21
DailyMaxlmum Ezoeeded�
tFroceed t NOV
11/03/11
2 X week
ug/I
28
34
21.43
Daily Maximum Exceeded
No Action, BPJ
11/10/11
2 X week
ug/I
28
30
7.14
Daily Maximum Exceeded
No Action, BPJ
11/23/11
2 X week
ug/I
28
29
3.57
Daily Maximum Exceeded
No Action, BPJ
12/08/11
2 X week
ug/I
28
31
10.71
Daily Maximum Exceeded
No Action, BPJ
12/15/11
2 X week
ug/I
28
29
3.57
Daily Maximum Exceeded
No Action, BPJ
12/22/11
2 X week
ug/I -
28
38
35.71
Daily Maximum Exceeded
No Action, BPJ
12/30/11
2 X week
ug/I
28
39
39.29
Daily Maximum Exceeded
No Action, BPJ
01/12/12
2 X week
ug/I
28
29
3.57
Daily Maximum Exceeded
No Action, BPJ
01/19/12
2 X week
ug/I
28
35
25
Daily Maximum Exceeded
No Action, BPJ
01/26/12
2 X week
ug/I
28
29
3.57
Daily Maximum Exceeded
No Action, BPJ
02/02/12
2 X week
ug/I
28
33
17.86
Daily Maximum Exceeded
No Action, BPJ
02/09/12
2 X week
ug/I
28
39
39.29
Daily Maximum Exceeded
No Action, BPJ
02/23/12
2 X week
ug/I
28
29
3.57
Daily Maximum Exceeded
No Action, BPJ
03/01/12
2 X week
ug/I
28
39
39.29
Daily Maximum Exceeded
No Action, BPJ
03/08/12
2 X week
ug/I
28
31
10.71
Daily Maximum Exceeded
No Action, BPJ
03/16/12
2 X week
ug/I
28
31
10.71
Daily Maximum Exceeded
No Action, BPJ

MONITORING REPORT(MR)VIOLATIONS for:
Report Date: mm^mu
Page: uof 4
2011 01
PERMIT: NCD075027
FACILITY: CainoWay Homeowners Association 'ConoWay
COUNTY:
Forsyth
REGION: Winston-Salem
Mobile Home Park
Limit Violation
moN|ron/we ourFALL/
v/ouAT|ow
UNIT OF
oALouuATso
nEponr
pp/
LooAnow
p«eAwsrEn
DATE
rnEousmcY meAauns
umn
»wLus
% OVER LIMIT VIOLATION TYPE
VIOLATION ACTION
03'2012
001
Effluent
Chlorine, Total Residual
03/22/12
2Xweek
ug/|
28
45
60.71
Daily Maximum Exceeded
NuAction, BPJ
03'2012
001
Effluent
Chlorine, Total Residual
03129/12
2Xweek
ug/|
28
30
7.14
Daily Maximum Exceeded
NoAction, BPJ
04'2012
081
Effluent
Chlorine, Total Residual
04/05/12
uXweek
ug0
28
no
7.14
Daily Maximum Exceeded
moAction, BPJ
04'2012
001
Effluent
Chlorine, Total Residual
04V16V12
2Xweek
ug/|
cO
33
17.e6
Daily Maximum Exceeded
NnAction, oPJ
04'2012
001
Effluent
Chlorine, Total Residual
04/17/12
2Xweek
ug/|
28
29
3.57
Daily Maximum Exceeded
NoAction, BPJ
05'2012
001
Effluent
Chlorine, Total Residual
05/1012
2Xweek
ug/|
28
39
3928
Daily Maximum Exceeded
NoAction, oPJ
05'2012
001
Effluent
Chlorine, Total Residual
05/17/12
2Xweek
ug/|
ua
45
60.71
Daily Maximum Exceeded
NoAction, aPJ
05'2012
001
Effluent
Chlorine, Total Residual
05/24/12
oXweek
ug0
28
33
17o6
Daily Maximum Exceeded
woAction, oPJ
06'2012
001
Effluent
Chlorine, Total Residual
0014/12
2Xweek
ug/|
uu
33
17.88
Daily Maximum Exceeded
NnAction, sPJ
00'2012
001
Effluent
Chlorine, Total Residual
0021/12
cXweek
ug/|
28
44
57.14
Daily Maximum Exceeded
NoAction, BPJ
06'2012
001
Effluent
Chlorine, Total Residual
06/25/12
zXweek
u00
28
30
28.57
Daily Maximum Exceeded
NoAction, oPJ
06'2012
001
Effluent
Chlorine, Total Residual
06/2012
2Xweek
ug/|
ua
nS
3.57
Daily Maximum Exceeded
NnAction, opJ
07-2012
001
Effluent
Chlorine, Total Residual
07Y12/12
2Xweek
ug/|
28
30
7.14
Daily Maximum Exceeded
NoAction, BPJ
07'2012
001
Effluent
Chlorine, Total Residual
07Y18/12
2Xweek
ug/|
28
33
17.00
Daily Maximum Exceeded
NuAction, oPJ
07-2012
001
Effluent
Chlorine, Total Residual
07/26V12
uXweek
uO/|
28
40
42.86
Daily Maximum Exceeded
NnAction, BPJ
08-2012
001
Effluent
Chlorine, Total Residual
0002/12
2Xweek
uO/|
28
33
17.86
Daily Maximum Exceeded
NnAction, 8PJ
08-2012
001
Effluent
Chlorine, Total Residual
0009/12
2Xweek
ug/|
28
35
nn
Daily Maximum Exceeded
NoAction, BPJ
08-2012
001
Effluent
Chlorine, Total Residual
08/16/12
2Xweek
ug/|
28
28
3.57
Daily Maximum Exceeded
NoAction, BPJ

k
MONITORING REPORT(MR) VIOLATIONS for: Report Date: 02/14/13 Page: 3 of 4
PERMIT: NCO075027 FACILITY: Cains Way Homeowners Association - Cains Way COUNTY: Forsyth REGION: Winston-Salem
Mobile Home Park
Limit Violation
MONITORING
OUTFALL /
VIOLATION
UNIT OF
CALCULATED
REPORT
PPI
LOCATION
PARAMETER
DATE
FREQUENCY
MEASURE
LIMIT
VALUE
% OVER LIMIT
VIOLATION TYPE
VIOLATION ACTION
08 -2012
001
Effluent
Chlorine, Total Residual
08/30/12
2 X week
ug/I
28
40
42.86
Daily Maximum Exceeded
No Action, BPJ
09 -2012
001
Effluent
Chlorine, Total Residual
09/07/12
2 X week
ug/I
28
41
46.43
Daily Maximum Exceeded
No Action, BPJ
09 -2012
001
Effluent
Chlorine, Total Residual
09/13/12
2 X week
ug/I
28
29
3.57
Daily Maximum Exceeded
No Action, BPJ
09 -2012
001
Effluent
Chlorine, Total Residual
09/20/12
2 X week
ug/I
28
35
25
Daily Maximum Exceeded
No Action, BPJ
09 -2012
001
Effluent
Chlorine, Total Residual
09/27/12
2 X week
ug/I
28
39
39.29
Daily Maximum Exceeded
No Action, BPJ
10 -2012
001
Effluent
Chlorine, Total Residual
10/04/12
2 X week
ug/I
28
39
39.29
Daily Maximum Exceeded
No Action, BPJ
10 -2012
001
Effluent
Chlorine, Total Residual
10/11/12
2 X week
ug/I
28
49
75
Daily Maximum Exceeded
No Action, BPJ
10 -2012
001
Effluent
Chlorine, Total Residual
10/22/12
2 X week
ug/I
28
31
10.71
Daily Maximum Exceeded
No Action, BPJ
10 -2012
001
Effluent
Chlorine, Total Residual
10/25/12
2 X week
ug/I
28
29
3.57
Daily Maximum Exceeded
No Action, BPJ
1 269 h
OU1
Efflue t
i d i#ortta Feel F tt C
4t3roth 44 5
11171� (y4feeR
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ueic
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Monitoring Violation
MONITORING
REPORT
OUTFALL/
PPI
LOCATION
PARAMETER
VIOLATION
DATE
FREQUENCY
UNIT OF CALCULATED
MEASURE LIMIT VALUE % OVER LIMIT
VIOLATION TYPE
VIOLATION ACTION
12 241j,
t111eCl iaAC Q� t 1liJV
9�0 p
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tltltltlQCl
j
4�,r iGjll rlCj! }/i?318fi1dR
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e
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MONITORING REPORT(MR) VIOLATIONS for: Report Date: 02114/13 Page: 4 of 4
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PERMIT: NCO075027 FACILITY: Cains Way Homeowners Association - Cains Way COUNTY: Forsyth REGION: Winston-Salem
Mobile Home Park
Monitoring Violation
MONITORING OUTFALL/ VIOLATION UNIT OF CALCULATED
REPORT PPI LOCATION PARAMETER DATE FREQUENCY MEASURE LIMIT VALUE % OVER LIMIT VIOLATION TYPE VIOLATION ACTION
001 Fgp[LijfL�1 FT16W in &n_8_uft_oLFt:h:6b
1�1'­_­_1111 &06�fid�E&Nl b6d)
LtrgL - gto)e �t plant)

Rcma
North Carolina Department of Environment and Natural
Beverly Eaves Perdue
Governor
Division of Water Quality
Chuck Wakild, P.E.
Director
August 27, 2012
Eleanor Wood
Cains Way Homeowners Association
P.O. Box 846
Walkertown, NC 27051
Subj ect: NOTICE OF VIOLATION
NOV-2012-LV-0443
Permit No. NCO075027
Cains Way Mobile Home Park
Forsyth County
Dear Ms. Wood:
Resources
Dee Freeman
Secretary
A review of Cains Way Mobile Home Park's monitoring report for May 2012 showed the following
violations:
Parameter
Date
Limit Value
Reported Value
Limit Type
BOD, 5-Day (20 Deg. C) -
05/03/12
16.5 mg/1
23.3 mg/1
Daily Maximum
Concentration
Exceeded
Nitrogen, Ammonia Total (as
05/31/12
2 mg/1
2.26 mg/l
Monthly
N) - Concentration
Average
Exceeded
Remedial actions, if not already implemented, should be taken to correct the above noncompliance
problem. Please be aware that violations of your NPDES permit could result in enforcement action by the
Division of Water Quality for this and any additional violations of State law.
If you should have any questions, please do not hesitate to contact Ron Boone at [phone].
cc: SWP — Central Files
WSR.O_F_ i_les�
North Carolina Division of Water Quality, Winston-Salem Regional Office
Location: 585 Waughtown St. Winston-Salem, North Carolina 27107
Phone: [phone] FAX: [phone] Customer Service: 1-877-623-6748
Internet: vvvvw.ncwaterquality.org
Sincerely,
W. Corey Basinger
Surface Water Regional Supervisor
Winston-Salem Regional Office
Division of Water Quality
One
NdithCarohna
An Equal Opportunity \, Affirmative Action Employer

I �i O
Dtl V
v D I Cover Sheet from
Staff Memb
er to
Regional Supervisor
DNIR Review Record
Facility: �u Pe='t/Pipe No.: 5627 1661 Month/Year
Parameter
Monthly Average Violations
Permit Limit DMR Value % Over Limit
Weekly/Daily Violations
Date Parameter Permit LimitfTvpe DMR Value % Over Limit
3-5)
Date
Parameter
Other Violations
ia//9 2-5 , Z4 , 2,�- -
IMOK"Alcon-
Completed by:
Regional Water Quality
Supervisor Signoff:
Monitoring Frequency Violations
Permit Frequency Values Reported # of Violations
jQe.., i,•,ai, r -�p-r o � vp � • //`/ems. 5
1w V
�j V
Date:
Date: 2 2 Ltd i 2
�bj

NCDENR
North Carolina Department of Environment and Natural Resources
Division of U1/ater Quality
Beverly Eaves Perdue Chuck Wakiid, P.E. Dee Freeman
Governor Director Secretary
March 9, 2012
Cains Way Homeowners Association
PO Box 846
Walkertown, NC 27051
Subject: NOTICE OF VIOLATION
NOV-2012-MV-0013
Permit No. NCO075027
Cains Way Mobile Home Park
Forsyth County
Dear:
A review of Cains Way Mobile Home Park's monitoring report for December 2011 showed the
following violations:
Parameter
Date
Limit Value
Reported Value
Limit Type
Coliform, Fecal MF, M-FC
11/17/11
400 #/100ml
6,000 #/100m1
Daily
Broth,44.5C
Maximum
Exceeded
Parameter
Date
Measuring
Violation
Frequency
Flow, in conduit or thru
12/25/11
Continuous
1
treatment plant
Flow,, in conduit or thru
12/19/11
Continuous
2
treatment plant
Flow, in conduit or thru
12/29/11
Continuous
3
treatment plant
Flow, in conduit or thru
12/26/11
Continuous
4
treatment plant
Remedial actions, if not already implemented, should be taken to correct the above
noncompliance problem. Please be aware that violations of your NPDES permit could result in
enforcement action by the Division of Water Quality for this and any additional violations of
State law.
North Carolina Division of Water Quality, Winston-Salem Rea ional Office
Location: 585 Waughtown St. Winston-Salem, North Carolina 27107
Phone: [phone] \ FAX: [phone] \ Customer Service: 1-877-623-6748
Internet: www,ncwaterquality.org
One -
NorthCarolina
NightrallY
An Equal OPPotunity \ Affirmative Action Employer

Cains Way Homeowner's Association
Cains Way Mobile Home Park Wastewater Treatment Plant, NCO075027
NOV-2012-MV-0013
March 9, 2012, Page 2 of 2
If you should have any questions, please do not hesitate to contact Ron Boone at [phone].
Sincerely,
W. Corey Basinger
Surface Water Regional Supervisor
Winston-Salem Regional Office
Division of Water Quality
cc: SWP — Central Files
AM RUTT esap

Cover Sheet from
Staff Member to
Regional Supervisor
DMR Review Record
Facility: �;gi n, ljz
M14P Permit/Pipe No.: -7502:7 0o!
Month/Year
k2/ o
Monthly Average Violations
Parameter
Permit Limit DMR Value
% Over Limit
Weekly/Daily Violations
'�
Date '
Da
1
Parameter
Permit LimitlTvpe DMR Value % Over Limit
UG Q" U
®� b"
!�
/
Monitoring Frequency Violations
Date
Parameter
-it Frequencv Values Reported
# of Violations
�o
l � �
� 1(�"1.J
/Perm
l�a Vl i/ldl/1.,� �
• ®1' l..(q[`
3 I
Other Violations r,1�31/+1 -"P,
�. 9lF37/
tAAK%
-AIM b - 7-
Completed by:
Regional Water Quality
Supervisor Signoff:
Date: 3 `7
Date: 11� � 1Z

ti
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Charles Wakild, P.E. Dee Freeman
Governor Director Secretary
February 1, 2012
Ms. Eleanor Wood
Cains Way Homeowners Association
P.O. Box 846
Walkertown, North Carolina 27051-0846
Subject: DRAFT NPDES PERMIT
Permit Number NCO075027
Cains Way MHP WWTP — Class WW-2
Forsyth County
Dear Ms. Wood:
Enclosed with this letter is a copy of the draft permit for your facility. Please review the
draft very carefully to ensure thorough understanding of the conditions and requirements it
contains. Your permit is among several in the Roanoke River Basin that the Division has
targeted for expedited renewal.
The following modifications have been made to the draft permit:
• Parameter codes have been added to Sections A.(l.).
• A Total Residual Chlorine footnote has been updated in Section A.(1.).
Please submit any comments to me no later than thirty (30) days following your receipt of
the draft. Comments should be sent to the address listed at the bottom of this page. If no adverse
comments are received from the public or from you, this permit will likely be issued in mid -
March 2012, with an effective date of May 1, 2012.
If you have any questions or comments concerning this draft permit, please contact me at
[phone] or Maureen. Scardinaancdenng_ov.
Sincerely,
Maureen Scardina
cc: NPDES Unit
ec: Winston-Salem Regional Office, Surface Water Protection Section
Steve Reid, Technical Assistance & Certification Unit
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Location: 512 N. Salisbury St Raleigh, North Carolina 27604
Phone: [phone] FAX: [phone]
Internet: http://portal.ncdenr.org/web/wgmome
An Equal Opportunity 1 Affirmative Action Employer
on
ofthCarolina
Awlinillif

Permit NCO075027
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
PERMIT
TO DISCHARGE WASTEWATER 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, the
Cains Way Homeowners Association
is hereby authorized to discharge wastewater from a facility located at the
Cains Way Mobile Home Park WWTP
Pinehall Road
North of Walkertown
Forsyth County
to receiving waters designated as Ader Creek in the Roanoke River Basin in accordance with effluent
limitations, monitoring requirements, and other conditions set forth in Parts I, H, III and IV hereof.
This permit shall become effective
, 2012.
This permit and authorization to discharge shall expire at midnight on February 28, 2017.
Signed this day
, 2012.
DRAFT
Charles Wakild, P.E., Director
Division of Water Quality
By Authority of the Environmental Management Commission

Permit NC0075027
SUPPLEMENT TO PERMIT COVER SHEET
All previous NPDES permits issued to this facility, whether for operation or discharge are hereby
revoked. As of this permit issuance, any previously issued permit bearing this number is no longer
effective. Therefore, the exclusive authority to operate and discharge from this facility arises under the
permit conditions, requirements, terms, and provisions included herein.
Cains Way Homeowners Association is hereby authorized to:
1. Continue to operate an existing 0.0432 MGD wastewater 'treatment system with the following
components:
♦ Aerated equalization basin
♦ Bar screen
♦ Splitter box
♦ Dual extended aeration basins
♦ Clarifier
♦ Tertiary filters
♦ Chlorinator
The facility is located North of Walkertown at Cains Way Mobile Home Park on Pinehall Road in
Forsyth County.
2. Discharge from said treatment works at the location specified on the attached map into Ader Creek,
currently classified C waters in sub -basin 03-02-01 of the Roanoke River Basin.

Permit NCO075027
A. (L) EFFLUENT LIMITATIONS AND MONITORING REQUIREMENTS - DRAFT
During the period beginning on the effective date of this permit and lasting until expiration, the
Permittee is authorized to discharge from outfall 001. Such discharges shall be limited and monitored
by the Permittee as specified below:
EFFLUENT
CHARACTERISTICS
LIMITS
MONITORING REQUIREMENTS
Monthly
Daily
Measurement
Sample
Sample
Parameter Code
Average
Maximum
Frequency
Tye
Locations
Flow
0.0432 MGD
Continuous
Recording
Influent or Effluent
50050
BOD, 5-day (20°C) —Summer*
11.0 mg/L
16.5 mg/L
Weekly
Composite
Effluent
C0310
BOD, 5-day (20°C) — Winter*
22.0 mg/L
33.0 mg/L
Weekly
Composite
Effluent
C0310
Total Suspended Solids
30.0 mg/L
45.0 mg/L
Weekly
Composite
Effluent
C0530
NH3 as N—Summer*
2.0 mg/L
10.0 mg/L
Weekly
Composite
Effluent
C0610
NH3 as N — Winter*
6.0 mg/L
30.0 mg/L
Weekly
Composite
Effluent
C0610
Dissolved Oxygen
Daily average > 5.0 mg/L
Weekly
Grab
Effluent
00300
—
Fecal Coliform (geometric mean)
200/100 ml
400/100 ml
Weekly
Grab
Effluent
31616
Total Residual Chlorine
28 µg/l,
2/Week
Grab
Effluent
50060
Temperature (°C)
Daily
Grab
Effluent
00010
pH
Not < 6.0 nor > 9.0
Weekly
Grab
Effluent
00400
Standard Units
Dissolved Oxygen
Weekly
Grab
Upstream &
00300
Downstream
Temperature (°C)
Weekly
Grab
Upstream &
00010
Downstream
*Summer: April 1 — October 31
*Winter: November 1— March 31
Footnotes:
1. Upstream = at least 100 feet above discharge point; Downstream = at NCSR 1979.
2. The Division shall consider all effluent TRC values reported below 50 µg/L to be in compliance
with the permit. However, the Permittee shall continue to record and submit all values reported by
a North Carolina certified laboratory (including field certified), even if these values fall below 50
µg/L.
THERE SHALL BE NO DISCHARGE OF FLOATING SOLIDS OR VISIBLE FOAM IN OTHER THAN TRACE AMOUNTS

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Cains Way Homeowner's Association
Facility ri�_ X__-'
Cains Way Mobile Home Park WWTP
Location -----
County: Forsyth Stream Class: C
Receiving Stream: Ader Creek Sub -Basin: 030201
(not to scale)
Latitude: 360 12' 20" Grid/Quad:
Longitude: 80° 09' 08"
Walkertown
NORTH
FNPDES Permit No. NCO075027

C®ENR
North Carolina Department of Environment and Natural resources
Beverly Caves Perdue
Governor
Cains Way Homeowners Association
P.O. Box 846
Walkertown, NC 27051
Division of Water Quality
Charles Wakild, P.E.
Director
January 3, 2012
Subject: NOTICE OF VIOLATION
NOV-2012-MV-0001
Permit No. NCO075027
Cains Way Mobile Home Park
Forsyth County
Dear Sir/Madam:
Dee Freeman
Secretary
A review of Cains Way Mobile Home Park's monitoring report for September 2011 showed the
following violations:
Parameter
Date
Measuring
Violation
Frequency
Flow, in conduit or thru
09/21/11
Continuous
1
treatment plant
Flow, in conduit or thru
09/20/11
Continuous
2
treatment plant
Remedial actions, if not already implemented, should be taken to correct the above
noncompliance problem. Specifically, our records show the meter was last calibrated in April,
2010. Please ensure that the meter has been properly calibrated and maintained since then, as
flow meters should be calibrated once per year. Furthermore, if the meter cannot be repaired so
as to avert any further such violations, serious consideration should be given to replacing the unit
with a new one.
Please be aware that violations of your NPDES permit could result in enforcement action by the
Division of Water Quality for this and any additional violations of State law.
North Carolina Division of Water Quality, Winston-Salem Regional Office
Location: 585 Waughtown St, Winston-Salem, North Carolina 27107
Phone: [phone] FAX: [phone] Customer Service: 1-877-623-6748
Internet: wwhro.ncwaterquality.org
Nne
ofthCarolina
An Equal Opportunity i Affirmative Action Employer

Cains Way Homeowners Association
Cains Way Mobile Home Park Wastewater Treatment Plant
NC0075027, NOV-2012-MV-0001
Page 2 of 2, January 3, 2012
If you should have any questions, please do not hesitate to contact Ron Boone at [phone].
Sincerely,
W. Corey Basinger
Surface Water Regional Supervisor
Winston-Salem Regional Office
Division of Water Quality
cc: SWP — Central Files
WSRO Files

Cover Sheet from
Staff Member to
Regional Supervisor
DNIR Review Record
Facility: 0/t/t,n Permit[Pipe No.: 75.07 DO/ Month/Year D9 /
Monthly Average Violations
Parameter Permit Limit DMR Value % Over Limit
Weekly/Daily Violations
Date Parameter Permit LimitrNpe DMR Value % Over Limit
Monitoring Frequency Violations
r
Date Parameter Permit Freq uencv Values Reported # of Violations
Other Violati/o is
G - i �" �rs� ®� ✓Lt9K '7!�! ire L•'t ,
Completed by: �n-Q- Date:
Regional Water Quality
Supervisor Signoff:
Date: �;r., � C Z

(� NP.,,,�, ��'L� p � (/ � �1�yO - C'�l���i.� � ! a,..� � e �Y S?s�•-� 6
ok
�% /A'n �: ( U - �s� 'J

MCDENR
North Carolina Department of Environment and Natural
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins .
Governor Director
September 30, 2011
BRADLEY T FLYNT
ORC
CAINS WAY HOMEOWNERS ASSOCIATION
PO BOX 846
WALKERTOWN NC 27051
Dear Mr. Flynt:
Resources
RECUR IVE0
N.C, deDt of ENR
OCT 0 5 20V
Winston-Salem
Regional Office
Subject: Receipt of permit renewal application
NPDES Permit NCO075027
Cains Way Mobile Home Park
Forsyth County
Dee Freeman
Secretary
The NPDES Unit acknowledges receipt of the permit renewal application for the above facility on
September 29, 2011; however, on initial review it was noted that the required Sludge Management Plan was not
included in the paperwork submitted. Please submit to this unit a narrative description of your Sludge Management
Plan. Describe how sludge (or other solids) generated during wastewater treatment are handled and disposed. If
your facility has no such plan (or the permitted facility does not generate any solids), explain this in writing.
For your convenience, we can accept a faxed copy at [phone] or you can mail it attention to me at
the mail service center address listed below. Upon receipt, a member of the NPDES Unit will further review your
application and will contact you if additional information is required.
If you have any additional questions concerning renewal of the subject permit, please contact Maureen
Scardina at [phone].
Sincerely,
Dina Sprinkle
Point Source Branch
cc: CENTRAL FILES
irsfo_n�--5 e s Rgi-na61Q,ffxee/Surface Water Protection
NPDES Unit
1617 hail Service Center, Raleigh, North Carolina 27699-1617
Location: 512 N. Salisbury St. Raleigh; North Carolina 27604 One
Phone: [phone] \ FAX: [phone] Customer Service: 1-877-623-6748 NorthCaji"oli na
Internet: wm.ncwaterquality.org � q /
An Equal Opportunity i Affirmative Action Employer j

NPDES APPLICATION - FORM D
For privately owned treatment systems treating 100% domestic wastewaters <1.0 MGD
Mail the complete application to:
N. C. DENR / Division of Water Quality / NPDES Unit
1617 Mail Service Center, Raleigh, NC 27699-1617
NPDES Permit INCOO 7,$'O
If you are completing this form in computer use the TAB key or the up down arrows to move from one
field to the next. To check the boxes, click your mouse on top of the box. Otherwise, please print or type.
1. Contact Information:
Owner Name
(' CQ i 5 w'r c t C►b�� 1 �' ncJi7 a.�5 5�x r�• �!-•; n>
Facility Name
LLCki !l �ic_��Cf�' / L.rJL.cJ l Y
Mailing Address
City (00 r /f0-L&2)1 c MC P JO5
State / Zip Code
Telephone Number
Fax Number
e-mail Address �j / A
2. Location of facility producing discharge:
Check here if same address as above ❑
Street Address or State Road
city Pub a l Rd 1 A 10 J �Cc�� o�JJ �
State / Zip Code (_ r70]
County �r'hg
3. Operator Information:
Name of the firm, public organization or other entity that operates the facility. (Note that this is not
referring to the Operator in Responsible Charge or ORC)
Name
Mailing Address
City
State / Zip Code
Telephone Number
Fax Number
3-It-" K__ SC:l'CC l
( 33-) -b-ci g - 3-1 9 c ) "I C e i / �V8 7 - D53 C)
133( 5') N .�
M yrN
i�pp F o
- i
1 of 3
Form-D 05/08

s
NPDES APPLICATION - FORM D
For privately owned treatment systems treating 100% domestic wastewaters <1.0 MGD
4. Description of wastewater:
Facility Generating Wastewater(check all that apply):
Industrial
F1
Number of Employees
Commercial
❑
Number of Employees
Residential
R'
Number of Homes
School
❑
Number of Students/Staff
Other
❑
Explain:
Describe the source(s) of wastewater (example: subdivision, mobile home park, shopping centers,
restaurants, etc.):
4nob,Ie dome- 'Pa.rK
Population served:
5. Type of collection system
Nes--eparate (sanitary sewer only) ❑ Combined (storm sewer and sanitarysewer)
6. Outfall Information:
Number of separate discharge points
Outfall Identification numbers)_
Is the outfall equipped with a diffuser? ❑ Yes [INo
7. Name of receiving stream(s) (Provide a map showing the exact location of each outfall):
8. Frequency of Discharge: [2�- Continuous ❑ Intermittent
If intermittent:
Days per week discharge occurs: Duration: _
9. Describe the treatment system
List all installed components, including cap
phosphorus.. If the space provided is not st
separate sheet of paper
er"C'�P� �GPLt�j y�t7 rU�7 �Q,JF�'r1
-Ear Screen
6pl;44eI Bol, n
l7c.o�l �a'�l encfPr/ tffFr-a�";G�i�JaS; ��s
GlCcr �,rrC'�
Ck tor; ,i c--I-o r
e, - C IJ o i'; nd%0 r
zcities, provide design removal for BOD, TSS, nitrogen and
fficient, attach the description of the treatment system in a
_, 65 747c
2 of 3 1 Form-D 05l08

NPDES APPLICATION - FORM D
For privately owned treatment systems treating 100% domestic wastewaters <1.0 MGD
10. Flow Information:
Treatment Plant Design flow MGD. -
Annual Average daily flow t�,�l MGD (for. the previous,3 years)
Maximum daily flow MGD (for the previous 3 years)
11. Is this facility located on Indian country?
. ❑ Yes E_ No
12. Effluent Data
Provide data for the parameters listed. Fecal Coliform, Temperature and pH shall be grab samples, for all other
parameters 24-hour composite sampling shall be used. If more than one analysis is reported, report daily maximum
and monthly average. If only one analysis is reported, report as daily maximum.
Parameter
Daily
Maximum
Monthly
Average
Units of
Measurement
Biochemical Oxygen Demand (BODs)
f►1 �L
Fecal Coliform
OUT
evr+le-h^8C !dean
Total Suspended Solids
�p O
i
Temperature (Summer)
I
Temperature (Winter)
)
+ i
pH
a �c�r7i
13. List all permits, construction approvals and/or applications:
Type Permit Number Type
Hazardous Waste (RCRA) NESHAPS (CAA)
UIC (SDWA) Ocean Dumping (MPRSA)
NPDES 7 Dredge or fill (Section 404 or CWA)
PSD (CAA) Other
Non -attainment program (CAA)
14. APPLICANT CERTIFICATION
Permit Number
I certify that I am familiar with the information contained -in the application and that to the
best of my knowledge and belief such information is true, complete, and accurate.
Printed name of Person
Signa
Title
Date
North Carolina General Statute 143-215.6 (b)(2) states: Any person who knowingly makes any false statement representation, or certification in any
application, record, report, plan, or other document files or required to be maintained under Article 21 or regulations of the Environmental Management
Commission implementing that Article, or who falsifies, tampers with, or knowingly renders inaccurate any. recording or monitoring device or method
required to be operated or maintained under Article 21 or regulations of the Environmental Management Commission implementing that Article, shall be
guilty of a misdemeanor punishable by a fine not to exceed $25,000, or by imprisonment not to exceed six months, or by both. (18 U.S.C. Section 1001
provides a punishment by a fine of not more than $25,000 or imprisonment not more than 5 years, or both, for a similar offense.)
3 of 3 Form-D 05108

�, s::P : f1

NC®ENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Pei -due Coleen H. Sullins Dee Freeman
Governor Director Secretary
October 14, 2011
Cains Way Homeowners Association
P.O. Box 846
Walkertown, NC 27051
Subject: NOTICE OF VIOLATION
NOV-2011-LV-0502
Permit No. NCO075027
Cains Way Mobile Home Park
Forsyth County
Dear Sir/Madam:
A review of Cains Way Mobile Home Park's monitoring report for July 2011 showed the
followinia violation:
Parameter
Date
Limit Value
Reported Value
Limit Type
Nitrogen, Ammonia Total
07/31/11
2 mg/l
2.52 mg/l
Monthly
(as N) - Concentration
Average
Exceeded
Remedial actions, it not aireaay lmpiemenLeu, httuuiu UU Larch LU Vull� �•�� ���.�
noncompliance problem. Please be aware that violations of your NPDES permit could result in
enforcement action by the Division of Water Quality ,for this and any additional violations of
State law.
If you should have any questions, please do not hesitate to contact Ron Boone at [phone].
Sincerely,
W. Corey Basinger
Surface Water Regional Supervisor
Winston-Salem Regional Office
Division of Water Quality
cc: SWP — Central Files
North Carolina Division of water Quality, Winston-Salem Regional Office One Location: 585 Waughtown St, Winston-Salem, North Carolina 27107 NofthCarollrla
Phone: [phone]FAX: [phone]%CustomerService: 1-8/7-623-6748 �p 9 f� A//�
Internet: wwtv,nuvaterquality.org f//0/a�i�fc ral
An Equal Opportunity 1 Affirmative Action Employer

Cover Sheet from
Staff Member to
Regional Supervisor
DNIR Review Record
Facility: ��+�� lIHi Permit/PipeNo.:75627 dc)i Month/Year
Monthly Average Violations
Parameter Permit Limit DMR Value % Over Limit
IV/3 a.6 -?.Sz �24. Zsl
Weekly/Daily Violations
Date Parameter Permit Limit/Type DMR Value % Over Limit
Monitoring Frequency. Violations
Date Parameter. Permit Frequency Values Reported # of Violations
Other Violations
5' 12 if /U. s dab —35
za
Completed by: �� Date: %D /✓
Regional Water Quality
Supervisor Signoff: Date:

461-1
A74
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins
Governor Director
Cains Way Homeowners Association
P.O. Box 846
Walkertown, NC 27051-0846
Dear Permittee:
August 2, 2011 RECEIVED
N.C. Deot of ENR
AUG`i 5 2011
Winston-Salem
Regicnal Qrtice
Subject: Renewal Notice
NPDES Permit NCO075027
Cains Way Mobile Home Park
Forsyth County
Dee Freeman
Secretary
Your NPDES permit expires on February 29, 2012. Federal (40 CFR 122.41) and North Carolina
(15A NCAC 2H.0105 (e)) regulations state that permit renewal applications must be filed at least 180 days
prior to expiration of the current permit. If you have already mailed your renewal application, you
may disregard this notice.
Your renewal package must be sent to the Division postmarked no later than September 2, 2011.
Failure to request renewal by this date may result in a civil penalty assessment. Larger penalties may be
assessed depending upon the delinquency of the request.
If any wastewater discharge will occur after February 29, 2012, the current permit must be renewed.
Discharge of wastewater without a valid permit would violate North Carolina General Statute 143-215.1;
unpermitted discharges of wastewater may be assessed civil penalties of up to $25,000 per day.
If all wastewater discharge has ceased at your facility and you wish to rescind this permit, contact
me at the telephone number or address listed below.
Use the enclosed checklist to complete your renewal package. The checklist identifies the items you
must submit with the permit renewal application. If you have any questions, please contact me at the
telephone number or e-mail address listed below.
Sincerely,
Charles H. Weaver, Jr.
NPDES Unit
cc: Central Files_ _
{�Wiriston=Salem RegioriahOffice;'Surface"Water=Proiectiori '
NPDES File
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 One 512 North Salisbury Street, Raleigh, North Carolina 27604 NOrthCarollrla
Phone: [phone] / FAX [phone] / [e-mail] Naturally
An Equal Opportunity/Affirmative Action Employer— 50% Recycled/10% Post Consumer Paper

NPDES HERMIT NC0075027
CAINS WAY MOBILE HOME PARK
FORSYTH COUNTY
The following items are REQUIRED for all renewal packages:
➢ A cover letter requesting renewal of the permit and documenting any changes at the facility since
issuance of the last permit. Submit one signed original and two copies.
➢ The completed application form (copy attached), signed by the permittee or an Authorized
Representative. Submit one signed original and two copies.
➢ If an Authorized Representative (such as a consulting engineer or environmental consultant) prepares
the renewal package, written documentation must be provided showing the authority delegated to any
such Authorized Representative (see Part II.B.I Lb of the existing NPDES permit).
➢ A narrative description of the sludge management plan for the facility. Describe how sludge (or other
solids) generated during wastewater treatment are handled and disposed. If your facility has no such
plan (or the permitted facility does not generate any solids), explain this in writing. Submit one signed
original and two copies.
The following items must be submitted byaU Municipal or Industrial facilities discharging
process wastewater:
1
Industrial facilities classified as Primary Industries (see Appendices A-D to Title 40 of the Code of Federal
Regulations, Part 122) and ALL Municipal facilities with a permitted flow >_ 1.0 MGD must submit a
Priority Pollutant Analysis (PPA) in accordance with 40 CFR Part 122.21.
The above requirement does NOT apply to privately owned facilities treating 100%
domestic wastewater, or facilities which discharge non process wastewater (cooling
water, filter backwasb, etc.)
Send the completed renewal package to:
Mrs. Dina Sprinkle
NC DENR / DWQ / Point Source Branch
1617 Mail Service Center
Raleigh, NC 27699-1617

RCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
September 15, 2011
Cains Way Homeowners Association
P.O. Box 846
Walkertown, NC 27051
Subject: NOTICE OF VIOLATION
NOV-2011-LV-0436
Permit No. NCO075027
Cains Way Mobile Home Park
Forsyth County
Dear Sirs/Madams:
A review of Cains Way Mobile Home Park's monitoring report for June 2011 showed the
following violations:
Parameter
Date
Limit Value
Reported Value
Limit Type
Coliform, Fecal MF, M-FC
06/30/11
400 #/100m1
900 #/100m1
Daily
Broth,44.5 C
Maximum
Exceeded
Remedial actions, it not atreacay impiementea, snOulu uc LU&U,11 LU l V1101 L LID, aUIJ.�
noncompliance problem. Please be aware that violations of your NPDES permit could result in
enforcement action by the Division of Water Quality for this and any additional violations of
State law.
If you should have any questions, please do not hesitate to contact Ron Boone at [phone].
Sincerely,
W. Corey Basinger
Surface Water Regional Supervisor
Winston-Salem Regional Office
Division of Water Quality
cc: SW — Central Files
SRRT* ��I,es
North Carolina Division of Water Quality, Winston-Salem Regional Office
Location: 585 Waughtown St Winston-Salem, North Carolina 27107
Phone: [phone] FAX: [phone] Customer Service: 1-877-623-6748
internet: wmtiv.ncvvaterquality.org
Nne
orthCarolina
Naturally
An Equal Oppo;t;mity 1 Affirmative Action Employer

Cover Sheet from
Staff Member to
Regional Supervisor
DMR Review Record
Facility: MP Permit/Pipe No.: 756;L7 vp1 Month/Year o6 r
w�✓' i �
Monthly Average Violations
Parameter Perniit Limit DIAR Value % Over Limit
Weekly/Daily Violations
Date Parameter Permit LimitlTv e DMR Value % Over Limit
v� 3v Fe o Awd a D
Monitoring Frequency Violations
Date Parameter. Permit Frequency Values Reported # of Violations
Other Violations
nl 3/ 12 / !�
Completed by: ,�. � � Date: 9 / 3 ,
Regional Water Quality
Supervisor Signoff: Date: D

&74
A
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
July 21, 2011
Cains Way Homeowners Association
P.O. Box 846
Walkertown, NC 27051
Subject: NOTICE OF VIOLATION
NOV-2011-LV-0265
Permit No. NCO075027
Cains Way Mobile Home Park
Forsyth County
Dear Sir/Madam:
A review of Cains Way Mobile Home Park's monitoring report for April 2011 showed the
following violations:
Parameter
Date
Limit Value
Reported Value
Limit Type
BOD, 5-Day (20 Deg. C) -
04/07/11
16.5 mg/1
35 mg/1
Daily
Concentration
Maximum
Exceeded
Remedial actions, if not already implemented, should be taken to correct the above
noncompliance problem. Please be aware that violations of your NPDES permit could result in
enforcement action by the Division of Water Quality for this and any additional violations of
State law.
If you should have any questions, please do not hesitate to contact Ron Boone at [phone].
Sincerely,
W. Corey Basinger
Surface Water Regional Supervisor
Winston-Salem Regional Office
Division of Water Quality
cc: SWP -Central Files
CWSRTFles
North Carolina Division of Water Quality, Winston-Salem Regional Office
Location: 585 Waughtown St. Winston-Salem, North Carolina 27107
Phone: [phone] FAX: [phone] \ Customer Service: 1-877-623-6748
Internet: www.ncwaterquality.org
Nne
orthCarohna
Naturally
An Equal Opportunity 1 Affirmative Action Employer

Cover Sheet from
Staff Member to
Regional Supervisor
DMR Review Record
Facility: grits A&u AfA00 Permit/Pipe No.: 75a27 dai Month/Year 44� /1
Monthly Average Violations
Parameter Permit Limit DMR Value % Over Limit
Weekly/Daily Violations
Date Parameter Permit LlmiuTypq DMR Value % Over Limit
Monitoring Frequency. Violations
Date Parameter. Permit Frequency . Values Reported # of Violations
Other Violations
-9, 6o D s /G. S. Fe- 0-& d/4sai®y ' 67he - A19 3v ,
1a � NOV; o��/n A101b lG S /�v and Ark /&5/29 �V��_
' Completed by: i6m, G
Regional Water Quality
Supervisor Signoff:
Date: 7 a/ //
Date: Vc
�oj

Ae
';�Ia
NCDENR
North Carolina Department of Environment and
RECEIVED
N.C. D"t. of ENR
MAY 12 2011
Winston -sale;,
Regional Office
Natural Resources
Division of Water Quality
Beverly Eaves Perdue, Govemor Coleen H. Sullins, Director Dee Freeman, Secretary
May 10, 2011
CERTIFIED MAIL ITEM 7009 1680 0002 2464 8627 - RETURN RECEIPT REQUESTED
Cains Way Homewoners Association
P.O. Box 846
Walkertown, N.C. 27051-0846
SUBJECT: Notice of Violation - Delinquent Annual Fee
NPDES Permit NCO075027
Cains Way Mobile Home Park
Forsyth County
Dear Permittee:
All NPDES permittees must pay an Annual Compliance Monitoring Fee. This requirement is documented in
your current permit at Part II. B. 14. The 2010 fee for your facility has not been paid. The total amount
owed is $860.00; a copy of the invoice previously sent to you is attached.
Failure to pay the annual fee is grounds for revocation of your permit, as documented in part II.
B. 13 and II. B. 14. This letter serves as final notice that the Division will pursue a lien against
your property for collection through the courts unless payment in the amount of $860.00 is
received by May 24, 2011. Further enforcement action [including the imposition of civil
penalties] may also occur if the fee remains unpaid.
Make checks payable to NC DENR; include the permit numbers and invoice numbers on the check. Send the
fee payment to:
Mrs. Fran McPherson
Annual Administering and Compliance Fee Coordinator
1617 Mail Service Center
Raleigh, NC 27699-1617
If you have questions regarding this matter, contact Charles H. Weaver of the NPDES program at 919 807-
6391 [or via e-mail: [e-mail]].
cc: Central Files
Winston-Salem=RegionaM0ffice Ll-Ro`n,Boone
NPDES file
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 One
512 North Salisbury Street, Raleigh, North Carolina 27604 NorthCarohna
Phone: [phone] /FAX [phone] I Internet: www.ncwaterquality.org An Equal Opportunity/Affirmative Action Employer —50% Recycled/10% Post Consumer Paper vvaturally

Cover Sheet from
Staff Member to
Regional Supervisor
DMR Review Record
Facility: OU-4L j✓ PerrnitJPipe No.: `15OA7 ©d� Month/Year G/
Monthly Average Violations
Parameter Permit Limit DMR Value % Over Limit
Date Parameter
Weekly/Daily Violations
Permit Limitfl'vi2e
DMR Value % Over Limit
Monitoring Frequency Violations
Date Parameter Permit Frequency_
In /J,�
Values Reported # of Violations
s�r
Other io a io s
Completed by:
Regional Water Quality
Supervisor Signoff:
Date: %
off /
Date:

0—14—'11 15:101 rHUM—W'I'H—'fLU—Al)MMFF T-110'( ?010101/I00d r-4M
A +4 tQcoC y I --7S;n�
er-
771-'16-30

03-14-'11 15:01 FROM-WTB-TZO-ADMMFP 373-7720 T-107 P0002/0O03 F-408
NCDENR
585 Waughtown St.
Winston-Salem, NC 27051
Subject: Compliance Evaluation Inspection Response
Cains Way Homeowners Association
Cains Way Mobile Home Park WWTP
N PDES Permit #: NC0075027
Forsyth County
Mr. Basinger,
will respond to the evaluation letter in the order that the deficiencies
were listed.
1. The clarifier drive unit is currently being evaluated by Tim Waddell
with Atlantic Utilities so he can give us a price on a replacement or
a rebuild of the gear box.
2. The effluent composite sampler was moved immediately when we
were notified that it was sampling from the wrong location. It was
relocated to the dechlorination contact chamber.
3. Cains Way H®A would like to request that we be allowed to
continue using the composite sampler without using the flow
proportional mode. It samples every 15 minutes and would

03-14-'11 15:01 FROM-WTR-TZO-ADMMFP 373-7720 T-107 P0003/0003 F-408
require an upgrade package or a completely new sampler. That
money would be better spent on plant maintenance.
4. The cleaning and repair maintenance around the plant has already
begun. Daryl Cain removed the float switches from the discharge
lines of the influent pumps and mounted them on a float tree. As
the weather permits we will clean and repair more of the,
equipment and look at maybe putting up some handrails around
the open tanks.
5. The use of the second aeration tank as a holding tank for
screenings and digester decant has always been standard
operations. We will send a permit update in as needed in part II,
Section E of the permit
If you have any question, please feel free to contact,
Daryl Cain CainsWay HOA President: Home 336-595-8250
Cell 336-391-0737
Bradley Flynt CainsWay WWTP ORC: Home 336-298-3489
Cell 336-587-0330
Sincerely,
Bradley Flynt
Plant ORC CainsWay WWTP

a
NCDENR
585 Waughtown St.
Winston-Salem, NC 27051
RECEIVED
N.C. Deot. of EN.4
MAR 1 7 2011
Subject: Compliance Evaluation Inspection Response
Cains Way Homeowners Association
Cains Way Mobile Home Park WWTP
NPDES Permit #: NC0075027
Forsyth County
Mr. Basinger,
. nsuc-Sz�en
I will respond to the evaluation letter in the order that the deficiencies
were listed.
1. The clarifier drive unit is currently being evaluated by Tim Waddell
with Atlantic Utilities so he can give us a price on a replacement or
a rebuild of the gear box.
2. The effluent composite sampler was moved immediately when we
were notified that it was sampling from the wrong location. It was
relocated to the dechlorination contact chamber.
3. Cains Way HOA would like to request that we be allowed to
continue using the composite sampler without using the flow
proportional mode. It samples every 15 minutes and would

require an upgrade package or a completely new sampler. That
money would be better spent on plant maintenance.
4. The cleaning and repair maintenance around the plant has already
begun. Daryl Cain removed the float switches from the discharge
lines of the influent pumps and mounted them on a float tree. As
the weather permits we will clean and repair more of the
equipment and look at maybe putting up some handrails around
the open tanks.
5. The use of the second aeration tank as a holding tank for
screenings and digester decant has always been standard
operations. We will send a permit update in as needed in part II,
Section E of the permit
If you have any question, please feel free to contact,
Daryl Cain CainsWay HOA President: Home 336-595-8250
Cell 336-391-0737
Bradley Flynt CainsWay WWTP ORC: Home 336-298-3489
Cell 336-587-0330
Sincerely,
Bradley Flynt
Plant ORC CainsWay WWTP

AAW14 i wg
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
February 4th, 2011
Cains Way Homeowners Association CERTIFIED MAIL
P.O. Box 846 RETURN RECEIPT REQUESTED
Walkertown, NC 27051 7008-3230-0003-2547-2354
Subject: Compliance Evaluation Inspection & Notice of Violation
NOV-2011-PC-0088
Permittee: Cains Way Homeowners Association
Facility: Cains Way Mobile Home Park Wastewater Treatment Plant
NPDES Permit #: NC0075027
Forsyth County
Dear Sir/Madam:
Mr. Ron Boone of the Winston-Salem Regional Office of the NC Division of Water
Quality (DWQ or the Division) conducted a compliance evaluation inspection (CEI) of the
Cains Way Mobile, Home Park Wastewater Treatment Plant (WWTP) on February 1 st, 2011.
The assistance and cooperation'of Mr. Bradley Flynt, Operator in Responsible Charge (ORC),
was greatly appreciated. An inspection checklist is attached for your records and inspection
findings are summarized below.
General Information
The Cains Way Mobile Home Park WWTP is located on the far west side of Cains Way
Mobile Home Park at approximate coordinates 36.2065000N,-80.152222°W, off of Pine Hall
Road, in Walkertown, Forsyth County, NC. The permit authorizes you to operate this 0.0432
MGD WWTP, which consists of an aerated equalization basin, a bar screen, a splitter box,
dual extended aeration basins, a clarifier, tertiary filters and a chlorinator, and discharge the
treated effluent to Ader Creek via outfall 001, which is currently classified as Class C waters in
the Roanoke River basin.
Site Review
Mr. Flynt has done a good job operating and maintaining the plant using the resources
that are available to him. However, there are some issues as noted below:
1. The drive unit on the clarifier is inoperable causing inefficient removal of settled sludge.
The inspector noted some large floating chunks of sludge, some of which did overflow
the weir into the clarifier effluent during the inspection. Mr. Flynt could not tell Mr.
Boone exactly how long the unit had been broken but indicated it had been broken for a
North Carolina Division of Water Quality, Winston-Salem Regional Office
Location: 585 Waughtown St. Winston-Salem, North Carolina 27107 One
Phone: [phone] l FAX: [phone] Customer Service:1-877-623-6748 NorthCarolina
Internet: www.ncwaterquality.org
An Equal Opportunity 1 Affirmative Action Employer Aaturallff

Cains Way Homeowners Association
Compliance Evaluation Inspection &
Notice of Violation NOV-201 1 -PC-0088
NC0075027, Cains Way MHP WWTP
Page 2 of 3, February 4`', 2011
fairly long time. He also indicated that the homeowners association made an attempt to
repair it themselves and that they were trying to raise the funds to have it repaired by a
contractor. This must be fixed immediately. It is considered improper operation and
maintenance of the plant which is a violation of Part 11, Section C of the permit.
2. The effluent composite sampler is pulling samples above the dechlorination unit, which
is a violation of Part 11, Section D of the permit. This should also be fixed immediately
by beginning to take the effluent samples downstream of all treatment units in the plant.
3. The effluent composite sampler is not pulling flow proportional samples as required by
the permit. If the permittee wishes to use another sampling regime other than flow
proportional, they must request permission to do so from the Division and receive the
approval in writing before doing so. This is a violation of Part 11, Section A of the permit.
4. The plant is quite old and could use a considerable amount of cleaning, maintenance
and attention to safety issues. Although everything operates sufficiently, some
components are in various states of disrepair. Also, there are several open pits with no
fall protection around them, presenting a considerable safety hazard.
5. The second aeration basin has been turned into an aerobic digester (eastern half) and a
waste tank (western half). The waste tank has been used as a receptacle for several
items such as the supernatant off of the digester and bar screenings. Mr. Flynt stated
he normally has the waste tank pumped when he has the digester pumped and the
materials are taken to Winston-Salem's Archie Elledge WWTP. At a minimum, the plant
description in the permit needs to be updated with such information -and this office
should have actually been notified of and approved such a change before A was
completed, as required in Part II, Section E of the permit.
Documentation Review
All documentation was reviewed. Mr. Flynt has done a good job with the documentation
required by the permit. This includes operations and 'visitation logs, discharge monitoring
reports and laboratory and field laboratory records, chains of custody, etc.
Please respond to this letter in writing within 20 days of receiving it. Your response
must include an action plan and implementation .schedule to correct all the
deficiencies/violations noted above in the enumerated paragraphs 1 through 5. Failure to
respond as required within this specified timeframe will likely result in further enforcement
actions.
- You are reminded that, in accordance with NC General Statute 143-215.6A, the Director
of the Division of Water Quality may assess civil penalties not.to exceed $25,000 per day, per
violation, for violations of the NCO075027 NPDES permit. If you have any questions

` Gains Way Homeowners Association
Compliance Evaluation Inspection &
Notice of Violation NOV-201 1 -PC-0088
NC0075027, Cains Way MHP WWTP
Page 3 of 3, February 4"', 2011
regarding the inspection or this letter, please call Mr. Boone or me at [phone]. Thank
you for your cooperation in this matter.
Sincerely,
W. Corey Basinger
Interim Regional Supervisor
Surface Water Protection Section
Attachments:
BIMS Inspection Report
CC: " P
Central Files
NPDES Unit

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 N00075027 111 121 11/02/01 117 18I CI 19I SI 20I II
Remarks
21111111111111111111111111 III I III I III I I I I 111111116
Inspection Work Days Facility Self -Monitoring Evaluation Rating 131 QA - --------Reserved-------
67 I 169 701 I .711 I 721 NJ 73 L Lj 74 751 I I I I I I 180
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)
Coins Way Mobile Home Park
1 2:00 PM 11/02/01
07/07/01
Exit Time/Date
Permit Expiration Date
Pinehall Rd
Walkertown NC 27051
01:30 PM 11/02/01
12/02/29
Name(s) of Onsite Representative(s)/Titles(s)/Phone and Fax Number(s)
Other Facility Data
Bradley Todd Flynt/ORC/336-433-7262/
Name, Address of Responsible Official/Title/Phone and Fax Number
Contacted
No
Section C: Areas Evaluated During Inspection (Check only those areas evaluated)
Permit Flow Measurement Operations & Maintenance Records/Reports
Self -Monitoring Program Sludge Handling Disposal Facility Site Review Effluent/Receiving Waters
Laboratory
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
Ron Boone WSRO WQ//704-663-1699.Ext.2202/
Signature Numbers Date
o►n/fManagement Q A Reviewer Agency/Office/Phone and Fax
q
1. k, � �,.�, 7v�
EPA Form 3560-3 (Rev 9-94) Previous edi#fons are obsolete.
Page # 1

NPDES yr/mo/day Inspection Type
3I NCO075027 I11 12I 11/02/01 1
17 18ICI
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
Please refer to the attached inspection summary letter.
Page # 2

Permit: NCO075027 Owner - Facility: Cains Way Mobile Home Park
Inspection Date: 02/01/2011 Inspection Type: Compliance Evaluation
V__ NV_ \IA AIC
(If the present permit expires in 6 months or less). Has the permittee submitted a new application?
❑
❑
■
❑
Is the facility as described in the permit?
■
n
n
n
# Are there any special conditions for the permit?
n
■
n
n
Is access to the plant site restricted to the general public?
■
❑
❑
❑
Is the inspector granted access to all areas for inspection?
®❑
❑
❑
Comment: Please refer to the attached inspection summary letter.
Record Keeping
Yes
No
NA
NE
Are records kept and maintained as required by the permit?
■
n
n
n
Is all required information readily available, complete and current?
■
n
n
n
Are all records maintained for 3 years (lab. reg. required 5 years)?
■
n
n
n
Are analytical results consistent with data reported on DMRs?
■
n
n
n
Is the chain -of -custody complete?
■
n
n
n
Dates, times and location of sampling
■
Name of individual performing the sampling
■
Results of analysis and calibration
■
Dates of analysis
■
Name of person performing analyses
■
Transported COCs
■
Are DMRs complete: do they include all permit parameters?
■
n
n
n
Has the facility submitted its annual compliance report to users and DWQ?
❑
❑
■
n
(If the facility is = or > 5 MGD permitted flow) Do they operate 24/7 with a certified operator on each shift?
n
■
n
n
Is the ORC visitation log available and current?
®❑
❑
❑
Is the ORC certified at grade equal to or higher than the facility classification?
■
Cl
n
n
Is the backup operator certified at one grade less or greater than the facility classification?
■
❑
❑
❑
Is a copy of the current NPDES permit available on site?
■
n
n
n
Facility has copy of previous year's Annual Report on file for review?
❑
❑
■
n
Comment: Please refer to the attached inspection summary letter.
Laboratory
Yes
No
NA
NE
Are field parameters performed by certified personnel or laboratory?
■
n
n
n
Page # 3

Permit: NC0075027 Owner - Facility: Cains Way Mobile Home Park
Inspection Date: 02/01/2011 Inspection Type: Compliance Evaluation
Laboratory Yes No NA NE
Are all other parameters(excluding field parameters) performed by a certified lab? ■ n 11 n
# Is the facility using a contract lab? ■ n ❑ ❑
# Is proper temperature set for sample storage (kept at less than or equal to 6.0 degrees Celsius)? ❑ n ❑ ■
Incubator (Fecal Coliform) set to 44.5 degrees Celsius+/- 0.2 degrees? ❑ n ❑ ■
Incubator (BOD) set to 20.0 degrees Celsius +/-1.0 degrees? n n n ■
Comment: Please refer to the attached inspection summary letter.
Effluent Sampling Yes No NA NE
Is composite sampling flow proportional? n ■ n n
Is sample collected below all treatment units? ❑ ■ ❑ ❑
Is proper volume collected? ■ ❑ n n
Is the tubing clean? ■ n n n
# Is proper temperature set for sample storage (kept at less than or equal to 6.0 degrees Celsius)? ❑ n n ■
Is the facility sampling performed as required by the permit (frequency, sampling type representative)? ■ n n ❑
Comment: Composite samples being pulled above dechlor. Composite samples are
not flow proportional and permittee has not acquired Division approval for this as
required by the permit. Please refer to the attached inspection summary letter.
Upstream / Downstream Sampling
Yes
No
NA
NE
Is the facility sampling performed as required by the permit (frequency, sampling type, and sampling location)? ■
n
n
n
Comment: Please refer to the attached inspection summary letter.
Bar Screens
Yes
No
NA
NE
Type of bar screen
a.Manual
■
b.Mechanical
n
Are the bars adequately screening debris?
n
n
n
■
Is the screen free of excessive debris?
■
n
Is disposal of screening in compliance?
■
C3
❑
Is the unit in good condition?
n
■
n
n
Page # 4

Permit: NCO075027 Owner - Facility: Cains Way Mobile Home Park
Inspection Date: 02/01/2011 Inspection Type: Compliance Evaluation
Bar Screens Yes No NA NE
Comment: Bar screen is actually approx 20' below grade and is very difficult to
assess. Operator has also installed a 5 gallon bucket with holes in bottom to help
remove screenings. Actual bar screen appears to be catwalk type grating. It appears
that some openings are clogged but this doesn't appear to inhibit flow. Operator
currently disposes of screenings by dumping them into a waste tank, which is the former
2nd aeration basin. Half of this former 2nd aeration basin is used as an aerated digester
and the other half as a waste tank. According to operator, he has waste tank pumped
when he has digester pumped, which is currently about once per year. Operator just
had sludge pumped week prior to inspection. The operator stated that Forsyth Rooter
usually does pumping and loads are taken to WS's Archie Elledge WWTP.
Equalization Basins
Yes
No
NA
NE
Is the basin aerated?
■
n
n
n
Is the basin free of bypass lines or structures to the natural environment?
®
n
n
n
Is the basin free of excessive grease?
n
n
n
■
Are all pumps present?
■
n
n
n
Are all pumps operable?
■
n
❑
n
Are float controls operable?
■
n
n
n
Are audible and visual alarms operable?
■
n
n
n
# Is basin size/volume adequate?
n
n
n
■
Comment: Please refer to the attached inspection summary letter.
Aeration Basins
Yes
No
NA
NE
Mode of operation
Ext. Air
Type of aeration system
Diffused
Is the basin free of dead spots?
■
n
n
n
Are surface aerators and mixers operational?
n
❑
■
❑
Are the diffusers operational?
■
n
n
n
Is the foam the proper color for the treatment process?
®
n
n
n
Does the foam cover less than 25% of the basin's surface?
■
n
n
n
Is the DO level acceptable?
■
n
n
n
Is the DO level acceptable?(1.0 to 3.0 mg/I)
■
n
n
n
Comment: Please refer to the attached inspection summary letter.
Secondary Clarifier
Yes
No
NA
NE
Is the clarifier free of black and odorous wastewater?
■
n
n
n
Page # 5

Permit: NCO075027 Owner - Facility: Cains Way Mobile Home Park
Inspection Date: 02/01/2011 Inspection Type: Compliance Evaluation
Secondary Clarifier
Yes
No NA NE
Is the site free of excessive buildup of solids in center well of circular clarifier?
n
■ n n
Are weirs level?
■
n ❑ n
Is the site free of weir blockage?
■
n n n
Is the site free of evidence of short-circuiting?
■
n ❑ n
Is scum removal adequate?
❑
■ n n
Is the site free of excessive floating sludge?
n
■ n n
Is the drive unit operational?
n
■ o o
Is the return rate acceptable (low turbulence)?
■
n n n
Is the overflow clear of excessive solids/pin floc?
■
n n n
Is the sludge blanket level acceptable? (Approximately'/4 of the sidewall depth)
n
n n ■
Comment: Clarifier's drive unit is inoperable, causing inefficient removal of settled
sludge. Inspector noted several large floating chunks of sludge, a couple of which
overflowed the weir during the inspection. Operator stated that the drive unit has been
down for quite some time now and the permittee does not have the funds to repair it.
Please refer to the attached inspection stjmmary letter.
Pumps-RAS-WAS
Yes
No
NA
NE
Are pumps in place?
■
n
n
n
Are pumps operational?
®❑
❑
❑
Are there adequate spare parts and supplies on site?
■
n
n
n
Comment: Air lift. Please refer to the attached inspection summary letter.
Flow Measurement - Effluent
Yes
No
NA
NE
# Is flow meter used for reporting?
■
n
n
n
Is flow meter calibrated annually?
■
n
n
n
Is the flow meter operational?
■
n
n
❑
(If units are separated) Does the chart recorder match the flow meter?
■
❑
n
n
Comment: Meter is an Isco 3230. It was last calibrated 04/10. Please refer to the
attached inspection summary letter.
Disinfection -Tablet
Yes
No
NA
NE
Are tablet chlorinators operational?
■
n
n
n
Are the tablets the proper size and type?
■
n
n
q
Number of tubes in use?
4
Is the level of chlorine residual acceptable?
n
n
Cl
■
Page # 6

Permit: NCO075027
Inspection Date: 02/01/2011
Disinfection -Tablet
Is the contact chamber free of growth, or sludge buildup?
Is there chlorine residual prior to de -chlorination?
Owner - Facility: Cains Way Mobile Home Park
Inspection Type: Compliance Evaluation
Comment: Please refer to the attached inspection summary letter.
Type of system ?
Is the feed ratio proportional to chlorine amount (1 to 1)?
Is storage appropriate for cylinders?
# Is de -chlorination substance stored away from chlorine containers?
Are the tablets the proper size -and type?
Comment: Please refer to the attached inspection summary letter.
Are tablet de -chlorinators operational?
Number of tubes in use?
Comment: Please refer to the attached inspection summary letter.
Effluent Pipe
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: Please refer to the attached inspection summary letter.
Aerobic Digester
Is the capacity adequate?
Is the mixing adequate?
Is the site free of excessive foaming in the tank?
# Is the odor acceptable?
# Is tankage available for properly waste sludge?
Comment: Please refer to the attached inspection summary letter.
Operations & Maintenance
Yes No NA NE
■ ❑ Cl ❑
nnn■
Yes No NA NE
Tablet
n n n ■
nn■n
■nnn
■ n n n
■nnn
4
Yes No NA NE
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?
Page # 7

Permit: NCO075027 Owner - Facility: Cains Way Mobile Home Park
Inspection Date: 02101/2011 Inspection Type: Compliance Evaluation
Operations & Maintenance Yes No NA NE
Comment: Plant is old and dilapidated and could use better housekeeping. There is a
small leak in the pipe from the equalization basin pump station to the aeration basin that
should be fixed. It does not appear that the proper resources are being dedicated to
properly operate, repair and maintain the plant. Please refer to the attached inspection
summary letter.
Page # 8

901)
Beverly Eaves Perdue
Governor
------- .
° MIN.
cc
North Carolina Department of Environment and Natural Resources Winston -Safer--
Division of Water Quality Regional Office
Coleen H. Sullins Dee Freeman
Director
January 6, 2011
CERTIFIED MAIL 7009-1680-0002-2464-7989
RETURN RECEIPT REQUESTED
Don R. Cain
Cains Way Home Owners Association
P.O. Box 846
Walkertown, North Carolina 27051
Subject: NOTICE OF VIOLATION
Cains Way Mobile Home Park
NPDES Permit NCO075027
Forsyth County
NOV-2011-LR-0001
Dear Mr. Cain:
Secretary
This is to inform you that the Division of Water Quality has not received your monthly monitoring report
for October 2010. This is in violation of Part II, condition D(2) of the NPDES permit, as well as 15A
NCAC 2B .506(a), which requires the submittal of Discharge Monitoring Reports no later than the last
calendar day following the reporting period. Failure to submit reports as required will subject the violator
to the assessment of a civil penalty of up to $25,000 per violation. You will be considered noncompliant
with the self -monitoring requirements of your NPDES permit until the report has been submitted.
To prevent further action, please submit said report within fifteen (15) days of receipt of this notice.
Additionally, this letter provides notice that this office will recommend the assessment of civil penalties if
future reports are not received within the required time frame during the next twelve (12) reporting
months. The Division must take these steps because timely submittal of discharge monitoring reports is
essential to the efficient operation of our water quality programs. We appreciate your assistance in this
matter. If you have any questions about this letter or discharge monitoring reports, please contact me at
919-807-6388.
Sincerely,
Maureen Scardina
cc: Maureen Scardina, NPDES Unit
d Qk n i� S� a Regional Office Supervisor, Surface Water Protection
Central Files
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Location: 512 N. Salisbury St. Raleigh, North Carolina 27604
Phone: [phone] FAX: [phone] Customer Service: 1-877-623-6748
Internet: http://portal.ncdenr.org/web/wq/home
Nne
orthCarohna
An Equal Opportunity ',Affirmative Action Employer

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue
Governor
Cains Way Homeowners Association
PO Box 846
Walkertown, NC 27051
Subject: NOTICE OF VIOLATION
NOV-2010-LV-0452
Permit No. NCO075027
Cains Way Mobile Home Park
Forsyth County
Dear Sir/Madam:
Coleen H. Sullins
Director
December 13, 2010
Dee Freeman
Secretary
A review of Cains Way Mobile Home Park's monitoring report for September 2010 showed the following
violations:
Parameter
Date
Limit Value
Reported Value
Limit Type
Coliform, Fecal MF, M-FC
09/23/10
400 #/100m1
900 #/100ml `
Daily Maximum
Broth,44.5C
Exceeded
BOD, 5-Day (20 Deg. C) -
09/16/10
16.5 mg/l
18 mg/1
Daily Maximum
Concentration
Exceeded
In addition, the monitoring report was not signed by the permittee on the reverse side. You must resubmit
an amended report that includes the permittee's signature on the reverse side.
Remedial actions, if not already implemented, should be taken to correct the above noncompliance
problem. Please be aware that violations of your NPDES permit could result in enforcement action by the
Division of Water Quality.
If you should have any questions, please do not hesitate to contact Ron Boone at [phone].
Sincerely,
(teve W. Tedder
Surface Water Regional Supervisor
Winston-Salem Regional Office
Division of Water Quality
cc: SWP — Central Files
TOM `: es
North Carolina Division of Water Quality, Winston-Salem Regional Office
Location: 585 Waughtown St. Winston-Salem, North Carolina 27107
Phone: [phone] FAX: [phone] Customer Service: 1-877-623-6748
Internet: www.ncwaterquality.org
One
NOrthCarohna
An Equal Opportunity %Affirmative Action Employer

Cover Sheet from
Staff Member to
Regional Supervisor
DMR Review Record
Facility: 10P Pernut/PipeNo.: 7sya7.&Y Month/Year i©
Monthly Average Violations
Parameter Permit Limit DMR Value % Over Limit
Date
Jzj I Z.
bq ")3
Date
'Weekly/Daily Violations
Parameter Permit Limit/Tvpe DMR Value % Over Limit
&yS /S 5- 5
FC' d i� 5'oti i a S
Monitoring Frequency Violations
Parameter Permit Frequency Values Reported # of Violations
Completed by: � -`��'`
Regional Water Quality
Supervisor SiQnoff:
Date: /a / 3 / 0
Date: �i� �� 3 —Ap
svr�
Y�

Permit NCO075027
A. (1.) EFFLUENT LIMITATIONS AND MONITORING REQUIREMENTS
During the period beginning on the effective elate of this permit and lasting until
expiration, the Permittee is authorized to discharge from outfa:ll 001. Such discharges
shall be limited and monitored by the Permittee as specified below:
;EFELU�NT£,' r-�,,� :
L j -s; _���-: L' M •��;.
MO ITORING .REQOIREMENTS:.
,
CHARACTERISTICS,:.:
2-
Montfil
VI(.eekl
Daly
Measurement
Sam" teT` a
;:=SampleALocation,;,"
r
4
Flow
0.0432 MGD
Continuous
Recording
Influent or Effluent
BOD, 5-day (20°C)
11.0 mg/L
16.5 mg/L
Weekly
Composite
Effluent
(April 1 —October 31
BOD, 5-day (202C)
22.0 mg/L
33.0 mg/L
Weekly
Composite
Effluent
November 1 — March 31
Total Suspended Residue
30.0 mg/L
45.0 mg/L
Weekly
Composite
Effluent
NH3 as N
2.0 mg/L
10.0 mg/L
Weekly
Composite
Effluent
1 —October 31
-(April
NH3 as N
6.0 mg/L
30.0 mg/L
Weekly
Composite
Effluent
November 1— March 31
Dissolved Oxygen2
Weekly
Grab
Effluent,
Upstream &
Downstream
Fecal Coliform (geometric mean)
200/100 ml
400/100 ml
Weekly
Grab
Effluent
Total Residual Chlorine3
28 µg/L
2/Week
Grab
Effluent
Temperature (2C)
Daily
Grab
Effluent
Temperature (2C)
Weekly
Grab
Upstream &
Downstream
pHa
Weekly
Grab
Effluent
Footnotes:
1. Upstream = at least 100 feet above discharge point; Downstream = at NCSR 1979.
2. The daily average dissolved oxygen concentration shall not be less than 5.0 mg/L.
3. The limit for total residual chlorine will take effect January 1, 2009, only if chlorine is "
used.
4. The pH shall not be less than 6.0 standard units nor greater than 9.0 standard units.
There shall be no discharge of floating solids or visible foam in other than trace amounts

MONITORING REPORT(NR)VIOLATIONS for:
n°portoate: 12n3n0
page. 1m3
PERM|T:0Co075V2T
FACILITY: CoinoWay Homeowners Association 'Cono
Way Mobile
COUNTY: Forsyth
REGION: Winston-Salem
Home Park
'
Limit Violation
Mmwromwo ourFALL/
wouTmw
UNIT OF
CALCULATED
nspoxr
pp/
Loom'mw
pAnAmcrsn
o«rs
pnsouswc,
me«nu«E
LIMIT
VALUE
mOVER LIMIT
VIOLATION TYPE
VIOLATION ACTION
04'2010
001
Effluent
000 »o <u»Deg. c>'
04/22/10
wmomy
Mgt[
16.5
zo
2121
Daily Maximum Exceeded
Proceed toNOV
unncon,movn
0*'2010
001
emuom
aoo (2»Deg. q'
0*/28110
mmomy
mox
16.5
un
75.76
Daily Maximum Exceeded
Proceed mNOV
~~..~......~n
uo'z000
001
Effluent
Chlorine, Total Residual
oomomo
oxweek
ugN
uu
ao
` 3e.2*
Daily Maximum Exceeded
woAction, Bpi
oe'unnn
001
Effluent
Chlorine, Total Residual
09/17/09
zxweek
ugx
uu
31
10.71
Daily Maximum Exceeded
NuAction, Bpu
10'2009
001
smuom
Chlorine, Total Residual
10m1m9
xXweek
ugN
zo
41
*6.43
Daily Maximum Exceeded
wnAction, Bpu
10'2009
001
Bnuom
Chlorine, Total Residual
10w8me
uXweek
ugN
xo
29
3.57
Daily Maximum Exceeded
woAction, apU
10'2009
001
emuom
Chlorine, Total Residual
10/2e0e
cxweek
uo8
uu
eo
3.57
Daily Maximum Exceeded
woAction, Bpi
11'2009
001
smuom
Chlorine, Total Residual
11/12m9
uXweek
un/|
zn
no
noz»
Daily Maximum Exceeded
wnAction, Bpi
11'2009
001
Effluent
Chlorine, Total Residual
11/1909
xxweek
uu/|
zo
z*
3.57
Daily Maximum Exceeded
wvAction, Bpi
11'2009
001
Effluent
Chlorine, Total Residual
11/25m9
zXweek
uyx
oo
48
71.43
Daily Maximum Exceeded
woAction, Bpi
12'200e
001
Effluent
Chlorine, Total Residual
12/0309
zXweek
ug8
co
ey
3.57
Daily Maximum Exceeded
wvAction, Bpi
12'2009
001
Effluent
Chlorine, Total Residual
12m3109
uXweek
uQ/|
ou
nn
17.86
Daily Maximum Exceeded
woAction, Bpi
12'2009
001
effluom
Chlorine, Total Residual
12/3109
zxweek
ug«
28
cn
3.57
Daily Maximum Exceeded
woAction, aFo
01-2010
001
effluom
Chlorine, Total Residual
01/07//0
oXweek
uu«
oo
uo
3a7
Daily Maximum Exceeded
woAction, Bpi
01'2010
001
Effluent
Chlorine, Total Residual
01C21/10
uXweek
ug0
eo
»u
35J1
Daily Maximum Exceeded
wvAction, Bpi
01'2010
001
Effluent
Chlorine, Total Residual
01/28/10
cXweek
uQ/|
ao
44
57.14
Daily Maximum Exceeded
wuAction, opJ
02'2010
001
Effluent
Chlorine, Total Residual
02111/10
2x*mek
«o/|
28
37
32.14
Daily Maximum Exceeded
wnAction, Bpi

MONITORING REPORT(MR) VIOLATIONS for:
Report Date: 12/13/10
Page: 2 of 3
Permit:
nc0075027
MRs Between: 9-2009 —and
8-2010 Region: %
Violation Category: Limit Violation Program Category: % i
Facility Name:
%
Param Name: %
County:
%
Subbasin:
Violation Action:
%
Major Minor:
PERMIT: NCO075027
FACILITY: Gains Way Homeowners Association - Gains Way Mobile
COUNTY: Forsyth
REGION: Winston-Salem
Home Park
Limit Violation
MONITORING OUTFALL/
VIOLATION
UNIT OF
CALCULATED
REPORT
PPI
LOCATION
PARAMETER
DATE
FREQUENCY
MEASURE
LIMIT
VALUE
%OVER LIMIT
VIOLATION TYPE
VIOLATION ACTION
03 -2010
001
Effluent
Chlorine, Total Residual
03/04/10
2 X week
ug/l
28
33
17.86
Daily Maximum Exceeded
No Action, BPJ
03 -2010
001
Effluent
Chlorine, Total Residual
03/18/10
2 X week
ug/I
28
41
46.43
Daily Maximum Exceeded
No Action, BPJ
03 -2010
001
Effluent
Chlorine, Total Residual
03/25/10
2 X week
ug/l
28
29
3.57
Daily Maximum Exceeded
No Action, BPJ
03 -2010
001
Effluent
Chlorine, Total Residual
03/31/10
2 X week
ug/I
28
41
46.43
Daily Maximum Exceeded
No Action, BPJ
04 -2010
001
Effluent
Chlorine, Total Residual
04/01/10
2 X week
ug/l
28
36
28.57
Daily Maximum Exceeded
No Action, BPJ
04 -2010
001
Effluent
Chlorine, Total Residual
04/15/10
2 X week
ug/I
28
29
3.57
Daily Maximum Exceeded
No Action, BPJ
04 -2010
001
Effluent
Chlorine, Total Residual
04/28/10
2 X week
ug/I
28
39
39.29
Daily Maximum Exceeded
No Action, BPJ
05 -2010
001
Effluent
Chlorine, Total Residual
05/06/10
2 X week
ug/I
28
29
3.57
Daily Maximum Exceeded
No Action, BPJ
05 -2010
001
Effluent
Chlorine, Total Residual
05/20/10
2 X week
ug/I
28
29
3.57
Daily Maximum Exceeded
No Action, BPJ
05 -2010
001
Effluent
Chlorine, Total Residual
05/28/10
2 X week
ug/I
28
41
46.43
Daily Maximum Exceeded
No Action, BPJ
06 -2010
001
Effluent
Chlorine, Total Residual
06/04/10
2 X week
ug/I
28
29
3.57
Daily Maximum Exceeded
No Action, BPJ
06 -2010
001
Effluent
Chlorine, Total Residual
06/11/10
2 X week
ug/I
28
39
39.29
Daily Maximum Exceeded
No Action, BPJ
06 -2010
001
Effluent
Chlorine, Total Residual
06/17/10
2 X week
ug/I
28
48
71.43
Daily Maximum Exceeded
No Action, BPJ
06 -2010
001
Effluent
Chlorine, Total Residual
06/24/10
2 X week
ug/l
28
44
57.14
Daily Maximum Exceeded
No Action, BPJ
07 -2010
001
Effluent
Chlorine, Total Residual
07/01/10
2 X week
ug/I
28
41
46.43
Daily Maximum Exceeded
No Action, BPJ
07 -2010
001
Effluent
Chlorine, Total Residual
07/08/10
2 X week
ug/I
28
39
39.29
Daily Maximum Exceeded
No Action, BPJ
07 -2010
001
Effluent
Chlorine, Total Residual
07/15/10
2 X week
ug/I
28
46
64.29
Daily Maximum Exceeded
No Action, BPJ
07 -2010
001
Effluent
Chlorine, Total Residual
07/22/10
2 X week
ug/I
28
39
39.29
Daily Maximum Exceeded
No Action, BPJ

MONITORING REPORT(MR) VIOLATIONS for:
Report Date: 12/13/10 Page: 3 of 3
PERMIT: NCO075027 FACILITY: Cains Way Homeowners Association - Cains Way Mobile COUNTY: Forsyth REGION: Winston-Salem
Home Park
Limit Violation
MONITORING
OUTFALL /
VIOLATION
UNIT OF
CALCULATED
REPORT
PPI
LOCATION
PARAMETER
DATE
FREQUENCY
MEASURE
LIMIT
VALUE
%OVER LIMIT
07 -2010
001
Effluent
Chlorine, Total Residual
07/29/10
2 X week
ug/I
28
44
57.14
08 -2010
001
Effluent
Chlorine, Total Residual
08/05/10
2 X week
u6/1
28
44
57.14
08 -2010
001
Effluent
Chlorine, Total Residual
08/12/10
2 X week
ug/I
28
45
60.71
08 -2010
001
Effluent
Chlorine, Total Residual
08/19/10
2 X week
ug/l
28
29
3.57
08 -2010
001
Effluent
Chlorine, Total Residual
08/26/10
2 X week
ug/1
28
31
10.71
09 -2009
001
Effluent
Coliform, Fecal MF, M-FC
09/17/09
Weekly
#/100ml
400
1,400
250
,
Broth,44.5C
07 -2010
001
Effluent
Nitrogen, Ammonia Total (as
07/31/10
Weekly
mg/I
2
2.24
12
N) - Concentration
VIOLATION TYPE
VIOLATION ACTION
Daily Maximum Exceeded
No Action, BPJ
Daily Maximum Exceeded
No Action, BPJ
Daily Maximum Exceeded
No Action, BPJ
Daily Maximum Exceeded
No Action, BPJ
Daily Maximum Exceeded
• No Action, BPJ
Daily Maximum Exceeded
Proceed to NOV
Monthly Average Exceeded Proceed to NOV

Permit Enforcement History Details by Owner
12/13/10
1
Owner: Cains Way Homeowners Association
Facility: Cains Way Mobile Home Park
Permit: NCO075027
Region: Winston-Salem
County: Forsyth
Penalty
Remission
Enf
EMC EMC OAH Collection
Has
Assessment Penalty
I
Enforcemen
Request Enf Conf
Remission
Hearing Remission Remission Memo Sent
Pmt
Case
Case Number MR Approved Amount
t Costs Damages Received Held
Amount
Held Amount Amount to AGO
Total Paid
Balance Due
Plan
Closed
LV-1998-0066 08/14/98 $1,000
$40.00
$.00
$1,040.00
$.00
No
09/17/98
LV-1998-0113 09/16/98 $1,250
$40.00
$.00 10/17/98 12/08/98
$.00
$1.290.00
$.00
No
02/03/99
LM-2001-0011 05/08/01 $450
$76.00
$.00 06/19/01 08/29/01
$200.00
$326.00
$.00
No
10/23/01
LV-2002-0568 11/19/02 $1,000
$105.50
$1,105.50
$.00
No
12/20/02
LV-2004-0416 5-2004 08/24/04 $250
$88.00
$338.00
$.00
No
09/17/04
LM-2007-0047 7-2007 10/08/07 $400
$102.00
$502.00
$.00
No
10/31/07
Total Cases: 6 Total Penalty Amount: $4,350
Total Enforcement Cost:
$451.50
Sum of Total Paid: $4,601.50 Total Balance Due:
$.00
Sum of Total Case Penalties:
$4,801.50
Total Penalties after remission(s):
$4,601.50

0
aA"v4 "'
MCDENR
Borth Carolina Department of Environment and Natural Resources
Beverly Eaves Perdue
Governor
Cain's Way Homeowners Association
P.O. Box 846
Walkertown, NC 27051
Division of 1Nater Quality
Coleen H. Sullins
Director
November 8, 2010
Subj ect: NOVICE OF VIOLATION
NOV-2010-LV-0397
Permit No. NCO075027
Cain's Way Mobile Home Park
Forsyth County
Dear Mr. Cain:
Dee Freeman
Secretary
A review of Cain's Way Mobile Home Park's monitoring report for July 2010 showed the
following violations:
Parameter
Date
Limit Value
Reported Value
Limit Type
Nitrogen, Ammonia Total
07/31/10
2 mg/1
2.24 mg/1
Monthly
(as N) - Concentration
Average
Exceeded
Remedial actions, if not already implemented, should be taken to correct the above
noncompliance problem. Please be aware that violations of your NPDES permit could result in
enforcement action by the Division of Water Quality.
If you have any questions, please do not hesitate to contact Ron Boone at [phone].
cc: SWP — Central Files
k, : s 5
North Carolina Division of Water Quafty, Winston-Salem Regional office
Location: 585 V%laughtown St. Winston-Salem, North Carolina 27107
Phone: [phone] FAX: [phone] Customer Service: 1-877-623-6748
Internet: mvmcwaterquality.org
Sincerely,
Steve W. Tedder
Surface Water Regional Supervisor
Winston-Salem Regional Office
Division of Water Quality
One
NorthCarolina
An Equal Opportunity t. Afiinnative .action Erapieyer

Cover Sheet from
Staff Member to
Regional Supervisor
DMR Review Record
Facility: Perrait/Pipe No.: 756X7&0t Month/Year
Monthly Average Violations
Parameter Permit Limit DMR Value % Over Limit
Weekly/Daily Violations
Date Parameter Permit Urnit/TVDe DMR Value % Over Limit
Monitoring Frequency Violations
Date Parameter Permit Frequency Values Reported # of Violations
Other Viol-aq,tti/ones
Completed by: "
Regional Water Quality
Supervisor SiQnoff:
Date: - 1145 o
Date:
s?/616

r
Permit NCOO75O27
A. (1.) EFFLUENT LIMITATIONS AND MONIT®RING REQUIREMENTS
During the period beginning on the effective date of this permit and lasting until
expiration, the Permittee is authorized to discharge from outfall 001. Such discharges
shall be limited and monitored by .the Permittee as specified below:
..
F E .r.:•.�'��M_0
-
;. -
N ITORING=�REQIIIREMENTS��
::.n
RATER S A C ST
,
- ?ai. � :><4a':•
. w
•t�,. - _
�:yi,. ,.'-i'lw-
.:,F' '•.71i: r,?, -,::...sF_`' ot{ a':.cs . ' b
�.:y'•�':�r ��-':+'`''%"_'i"y,w. n':%':=i:=-r�1 ,�-
-
;:CH
_
4.,.1.v
.: ice..,)
., ., ,:::
:�`.s:. ..i....,
• W'�
..,:-,a,'iL;Y' [stN
Measuremerit:
,T.,.::.e Y-
, �o
rSam" "Ie-L cat'ion,�
..1'.z-._-<,
fw, .•^Sri
Y 1f .'.:4.,-. ..,,-,,,t,.,....,i -...,, x.,,ts, :•,. ,.s,,, ,<. ,.,c..T,.
,. .3:c!'.r fi. ,x, v,...,a.:—.:,,,4..:t.,....,
4y
.._,.<_,....
i.
.. �+•
"eh-�'
r�,y ..r4-i:
P°'t Y:a:.
.�':. e• aerie. ,
Fr
- _ r.�;?
>..:p,.:`. ..,v;
�t
.�
Avera ,�;
ate,==> �Avera
aximiim
.q
_
Flow
0.0432 MGD
Continuous
Recording
Influent or Effluent
BOD, 5-day (202C)
11.0 mg/L
16.5 mg/L
Weekly
Composite
Effluent
(April 1 — October 31
BOD, 5-day (20°C)
22.0 mg/L
33.0 mg/L
Weekly
Composite
Effluent
November 1— March 31
Total Suspended Residue
30.0 mg/L
45.0 mg/L
Weekly
Composite
Effluent
NH3 as N
2.0 mg/L
10.0 mg/L
Weekly
Composite
Effluent
(April 1 —October 31
NH3 as N
6,0 mg/L
30.0 mg/L
Weekly
Composite
Effluent
November 1 — March 31)
Dissolved Oxygen2
Weekly
Grab
Effluent,
Upstream & '
Downstream
Fecal Coliform (geometric mean)
200/100 ml
400/100 ml
Weekly
Grab
Effluent
Total Residual Chlorine3
28 µg/L
2/Week
Grab
Effluent
Temperature (2C)
Daily
Grab
Effluent
Temperature (2C)
Weekly
Grab
Upstream &
Downstream
pt14
Weekly
Grab
Effluent
Footnotes:
1. Upstream = at least 100 feet above discharge point; Downstream = at NCSR 1979.
2. The daily average dissolved oxygen concentration shall not be less than 5.0 mg/L.
3. The limit for total residual chlorine will take effect January 1, 2009, only if chlorine is
used.
4. The pH shall not be less than 6.0 standard units nor greater than 9.0 standard units.
There shall be no discharge of floating solids or visible foam in other than trace amounts

Permit Enforcement History Details by Owner
11/05/10
1
Owner: Cains Way Homeowners Association
Facility: Cains Way Mobile Home Park
Permit:
Region: Winston-Salem County: Forsyth
Penalty Remission Enf EMC EMC OAH Collection Has
Assessment Penalty Enforcemen Request Enf Conf Remission Hearing Remission Remission Memo Sent Pmt Case
Case Number MR Approved Amount t Costs Damages Received Held Amount Held Amount Amount to AGO Total Paid Balance Due Plan Closed
LV-1998-0066 08/14/98 $1,000 $40.00 $.00 $1,040.00 $.00 No 09/17/98
LV-1998-0113 09/16/98 $1,250 $40.00 $.00 10/17/98 12/08/98 $.00 $1.290.00 $.00 No 02/03/99
LM-2001-0011 05/08/01 $450 $76.00 $.00 06/19/01 08/29/01 $200.00 $326.00 $.00 No 10/23/01
LV-2002-0568 11/19/02 $1,000 $105.50 $1,105.50 $.00 No 12/20/02
LV-2004-0416 5-2004 08/24/04 $250 $88.00 $338.00 $.00 No 09/17/04
LM-2007-0047 7-2007 10/08/07 $400 $102.00 $502.00 $.00 No 10/31/07
Total Cases: 6 Total Penalty Amount: $4,350 Total Enforcement Cost: $451.60 Sum of Total Paid: $4,601.50 Total Balance Due: $.00
Sum of Total Case Penalties: $4,801.60 Total Penalties after remission(s): $4,601.50

s
r
MONITORING REPORT(MR) VIOLATIONS for: Report Date: 11/05/10 Page: 1 of 3
m> —
;r�.t.,....�, e� `, a?� `MR's Between ` 7=2009.' SN"and 6=2010 Re'ion: 4Jo i''e Violation Cate o
mIE 9 g 9 rytYLimit Violation �fogramfCategory!�
d o R SubbasLna o
count
o /o . Violation Action:, !
Facilit``Name: Jo` P,aram'Name:. ou ty. ! :x
aet
Mafor Minor % _
PERMIT: N00075027 FACILITY: Cains Way Homeowners Association - Cains Way Mobile COUNTY: Forsyth REGION: Winston-Salem
Home Park
Limit Violation
MONITORING
OUTFALL /
VIOLATION
UNIT OF
CALCULATED
REPORT
PPI
LOCATION
PARAMETER
DATE
FREQUENCY
MEASURE
LIMIT
VALUE
%OVER LIMIT
VIOLATION TYPE
VIOLATION ACTION
08 -2009
001
Effluent
BOD, 5-Day (20 Deg. C) -
08/13/09
Weekly
mg/I
16.5
34
106.06
Daily Maximum Exceeded
Proceed to NOV
Concentration
04 -2010
001
Effluent
BOD, 5-Day (20 Deg. C) -
04/22/10
Weekly
mg/I
16.5
20
21.21
Daily Maximum Exceeded
Proceed to NOV
Concentration
04 -2010
001
Effluent
BOD, 5-Day (20 Deg. C) -
04/28/10
Weekly
mg/I
16.5
29
75.76
Daily Maximum Exceeded
Proceed to NOV
Concentration
07 -2009
001
Effluent
Chlorine, Total Residual
07/08/09
2 X week
ug/I
28
29
3.57
Daily Maximum Exceeded
No Action, BPJ
07 -2009
001
Effluent
Chlorine, Total Residual
07/23/09
2 X week
ug/I
28
29
3.57
Daily Maximum Exceeded
No Action, BPJ
08 -2009
001
Effluent
Chlorine, Total Residual
08/06/09
2 X week
ug/I
28
29
3.57
Daily Maximum Exceeded
No Action, BPJ
09 -2009
001
Effluent
Chlorine, Total Residual
09/03/09
2 X week
ug/I
28
39
39.29
Daily Maximum Exceeded
No Action, BPJ
09 -2009
001
Effluent
Chlorine, Total Residual
09/17/09
2 X week
ug/I
28
31
10.71
Daily Maximum Exceeded
No Action, BPJ
10 -2009
001
Effluent
Chlorine, Total Residual
10/01/09
2 X week
ug/I
28
41
46.43
Daily Maximum Exceeded
No Action, BPJ
10 -2009
001
Effluent
Chlorine, Total Residual
10/08/09
2 X week
ug/l
28
29
3.57
Daily Maximum Exceeded
No Action, BPJ
10 -2009
001
Effluent
Chlorine, Total Residual
10/22/09
2 X week
ug/I
28
29
3.57
Daily Maximum Exceeded
No Action, BPJ
11 -2009
001
Effluent
Chlorine, Total Residual
11/12/09
2 X week
ug/I
28
39
39.29
Daily Maximum Exceeded
No Action, BPJ
11 -2009
001
Effluent
Chlorine, Total Residual
11/19/09
2 X week
ug/I
28
29
3.57
Daily Maximum Exceeded
No Action, BPJ
11 -2009
001
Effluent
Chlorine, Total Residual
11/25/09
2 X week
ug/I
28
48
71.43
Daily Maximum Exceeded
No Action, BPJ
12 -2009
001
Effluent
Chlorine, Total Residual
12/03/09
2 X week
ug/I
28
29
3.57
Daily Maximum Exceeded
No Action, BPJ
12 -2009
001
Effluent
Chlorine, Total Residual
12/23/09
2 X week
ug/I
28
33
17.86
Daily Maximum Exceeded
No Action, BPJ
12 -2009
001
Effluent
Chlorine, Total Residual
12/31/09
2 X week
ug/I
28
29
3.57
Daily Maximum Exceeded
No Action, BPJ

MONITORING REPOmTVNR>VIOLATIONS for:
Report Date: 11m5n0
Page: emv
Violation Cate ory':' Ole
S4bbasin: RA
Violation Action:
W_
Major Minor:
%
PERM|T:NCDo760%7
FACILITY: ooinoWay Homeowners Association 'CuinoWay Mobile
COUNTY: Forsyth
REGION: Winston-Salem
Home Park
Limit Violation
MONITORING
ouTFau/
wouAT/ow
UNIT OF
CALCULATED
ncponT
pp/
LocAnow
pxnawsrsn
DATE
pRcuuswn,
mE»«uns
LIMIT
«nme
% OVER LIMIT
VIOLATION TYPE
VIOLATION ACTION
01'2010
001
Effluent
Chlorine, Total Residual
01m7/10
uxweek
uox
uu
uy
3.57
Daily Maximum Exceeded
mvAction, apu
01'2010
001
Effluent
Chlorine, Total Residual
01n1/10
uxweek
ug/l
ux
ou
35J1
Daily Maximum Exceeded
woAction, Bpu
01'2010
001
Effluent
Chlorine, Total Residual
01o010
uXweek
ug8
eo
44
57.14
Daily Maximum Exceeded
moAction, opu
02'2010
001
Effluent
Chlorine, Total Residual
02/11/10
oxweek
un0
za
or
32.14
Daily Maximum Exceeded
woAction, opo
03'2010
001
smuom
Chlorine, Total Residual
030*n0
cxweek
unx
zo
33
17.86
Daily Maximum Exceeded
moAction, BPJ
03'2010
001
Effluent
Chlorine, Total Residual
03/18/10
cxweek
v«/|
cn
41
46.43
Daily Maximum Exceeded
woAction, BpJ
03'2010
001
Effluent
Chlorine, Total Residual
omzono
uxweek
uc/I
zo
zo
3.57
Daily Maximum Exceeded
woAction, opo
03'2010
001
Effluent
Chlorine, Total Residual
03/31/10
cXweek
ug/|
ux
*1
46.43
Daily Maximum Exceeded
woAction, opJ
04'2010
001
Effluent
Chlorine, Total Residual
04/01/10
cXweek
ug/|
oo
on
28.57
Daily Maximum Exceeded
woAction, opJ
o* uo10
001
Effluent
Chlorine, Total Residual
0*/15/10
uXweek
un/|
uu
29
3.57
Daily Maximum Exceeded
moAction, apJ
04'2010
001
Effluent
Chlorine, Total Residual
0*o010
uKweek
ug/|
zn
no
39.29
Daily Maximum Exceeded
moAction, opJ
05'2010
001
Effluent
Chlorine, Total Residual
0e06/10
zxweek
uu/|
cn
co
3a7
Daily Maximum Exceeded
woAction, opJ
05'2010
001
Effluent
Chlorine, Total Residual
05o0/10
uxweek
uo/|
zo
zn
3.57
Daily Maximum Exceeded
woAction, opJ
05'2010
001
Effluent
Chlorine, Total Residual
05128/10
cxweek
ug0
cx
41
46.43
Daily Maximum Exceeded
wvAction, opJ
no zn10
001
Effluent
Chlorine, Total Residual
06/04/10
zxweek
uo/|
cx
co
3.57
Daily Maximum Exceeded
moAction, epJ
06'2010
001
Effluent
Chlorine, Total Residual
06111/10
zxweek
un/|
co
no
nozo
Daily Maximum Exceeded
woAction, BpJ
06'2010
001
Effluent
Chlorine, Total Residual
06/17/10
uxweek
uo/|
eo
48
71.43
Daily Maximum Exceeded
woAction, BrJ
oV zo10
001
Effluent
Chlorine, Total Residual
06/24/10
uxweek
ug/|
zu
44
57.14
Daily Maximum Exceeded
mvAction, ePJ
~

ft
MONITORING REPORT(MR) VIOLATIONS for:
ReportDate: 11/05/10 Page: 3 of 3
PERMIT: NCO075027 FACILITY: Cains Way Homeowners Association - Cains Way Mobile COUNTY: Forsyth REGION: Winston-Salem
Home Park
Limit Violation
MONITORING
OUTFALL /
VIOLATION
UNIT OF
REPORT
PPI LOCATION
PARAMETER
DATE
FREQUENCY
MEASURE
09 -2009
001 Effluent
Coliform, Fecal MF, M-FC
09/17/09
Weekly
#/100ml
Broth,44.5C
08 -2009
001 Effluent
Nitrogen, Ammonia Total (as
08/31/09
Weekly
mg/I
N) - Concentration
CALCULATED
LIMIT VALUE %OVER LIMIT
400 1,400 250
2 2.25 12.5
VIOLATION TYPE VIOLATION ACTION
Daily Maximum Exceeded Proceed to NOV
Monthly Average Exceeded Proceed to NOV

NCDENR
North Carolina Department of Environment and Natural Resources
Beverly Eaves Perdue
Governor
Cains Way Homeowners Association
P.O. Box 846
Walkertown, NC 27051
Division of Water Quality
Coleen H. Sullins
Director
July 12, 2010
Subject: NOTICE OF VIOLATION, NOV-2010-LV-0255
Permit No. NCO075027
Cains Way Mobile Home Park
Forsyth County
Dear Sir/Madam:
Dee Freeman
Secretary
A review of Cains Way Mobile Home Park's monitoring report for April 2010 showed the
following violations:
Parameter
Date
Limit Value
Reported Value
Limit Type
BOD, 5-Day (20 Deg. C) -
04/28/10
16.5 mg/l
29 mg/1
Daily
Concentration
Maximum
Exceeded
BOD, 5-Day (20 Deg. C) -
04/22/10
16.5 mg/l
20 mg/1
Daily
Concentration
Maximum
Exceeded
Remedial actions, if not already implemented, should be taken to correct the above
noncompliance problem. Please be aware that violations of your NPDES permit could result in
enforcement action for this by the Division of Water Quality for this and any additional
violations of State law.
If you have any questions, please do not hesitate to contact Ron Boone at [phone].
cc: SWP— Central Files
SRO Files , �'
North Carolina Division of Water Quality, Winston-Salem Regional Office
Location: 585 Waughtown St. Winston-Salem, North Carolina 27107
Phone: [phone] \ FAX: [phone] \ Customer Service: 1-877-623-6748
Internet: www.ncwaterquality.org
Sincerely,
Steve W. Tedder
Surface Water Regional Supervisor
Winston-Salem Regional Office
Division of Water Quality
One
Northcarolina
.naturally
An Equal Opportunity \ Affirmative Action Employer

Cover Sheet from
Staff Member to
Regional Supervisor
DMR Review Record
Facility: 11 /Permit/Pipe No.: -75,0271461 Month/Year
Monthly Average Violations
Parameter Permit Limit DMR Value % Over Limit
Date
�dW; .1.
I of
Date
Weekly/Daily Violations
Parameter Permit Limit/Type 'DMR Value % Over Limit
Bad J6. 6aZo a /. a/ 6/e
75. 7(,36
Monitorin-, Frequency Violations
Parameter Permit Frequency Values Reported # of Violations
Violations
"/Aw/�
Completed by:
Regional Water Quality
Supervisor Sianoff: AV
Date:
Date:
0-7 a7 /�
6 �r
V --,M i O ., LV -N 6�
J

t• '
( April 1 through October 31
I
NPDES PERMIT NO.: NCO075027
DISCHARGE NO.:
001 MONTH: Aoril
YEAR: 2010
FACILITY NAME: Cains Way MHP
CLASS:
II COUNTY: Forsyth
OPERATOR IN RESPONSIBLE CHARGE:
Bradley Flint
GRADE: IV PHONE:
336-445-9824
CERTIFIED LABORATORIES:
( 1 ) Water Tech Inc
(2 )
Check box if orc has changed [ ]
PERSON(S) COLLECTING SAMPLES: Bradley Flint
' y
Mail ORIGINAL and ONE COPY to:
/�p%
J�
IL�Ip /
ATTN: CENTRAL FILES
X -
i/ J��
c�UOsa
��y�
DIVISION OF WATER QUALITY
(SIGNATURE O
) DATE
4 1 �,•`O
DENR t
BY THIS SIG T
E, I CERTIFY THAT THIS REPORT IS
,
I: I„,
1617 MAIL SERVICE CENTER
ACCURATE AND COMPLETE
TO THE BEST OF MY KNOWLEDGE.
RALEIGH, NC 27699-1617
50050
00010
00040
50060
00310
00610
00530
31616
00300
006251
00630
00600
00665
D
Opr.
Opr.
Fecal
D
A
Arrive
Time
Orc
Flow
Res
BOD5
T
Coliform
Dissolvd
Total
Nitrates
Total
Total
A
T
Time
on
on
Temp.
pH
@
NH3-N
S
Oxygen
Khejdahl
Nitrites
Nitrogen
Poo
T
E
2400
Site
Site
[ ] Inf
C12
20C
S
Geometric
(DO)
Nitrogen
E
clock
[Xj Eff
Mean
*
uoc
uoc
vml
nnnn
R
IINITR
nn/I
mall-
ma/L
ma/L
#/t00mi
mg/L
mq/L
mg/L
mg/L
mg/L
#
4
1
0.0110
5::.;:.;
:; t 8.;0.5
D;i3 2Q.:
E.5
g,
•::.. 3.9
• ............
................
............. .
ti9 >`
tli:slislll::'I`i:.`<::':Ir:sl:3ll:l::::illltll<i?
I :.:...,..
6 1
5:15
0.25
0.0130
14
6
;;;:•;:::.:;:
3 06
:<": :
::. o
:";::»s<>:>:
.:::...:.....4
:fi337D::»::E:Si:<::::ii:i>:i:i>:I:I>:I:I;::»:I:I>:I:«ii:
..............................
...........
»<:>I<ii>II Iii:>i::>i>
I>z :
#> II>III>I I>
>">i>isi>:::;:'s»>:<:i>::>......I>::
«:<::>iii>::>:>::>:I>III>IIisi>I:::::<:>:>::>:>::>«::::>:::»>><''.
>i
.....
8
1 5:201
0.25
0.0180
15
19
< 4`
4.90
< 2.5
< 1
8
:;:: <.::•::•:...
ISD>
:. £` :i:i>:I:
I:I:I»»:II>::>
:I:I> :';:: ;:I
: I:I:I>:I:>:>: ::::::>
?'•>.?.<>III
Ii>:::y:::;<E:>::
::<:<:<:>III>I:::::
>:'I:::I::z:<:»::>::>`>II
<zl>I> i zl >III>I
III>::'»?>:>III> I<I'::':<':<>
9`
10
0.0110
10
:
'<; ::::::
:" • ':';"` ':::::`•::::i::i:i
:i` ::
i:i ::1::i::
::::::i :i:i::l: ' ::i
::......
:� : � i t?
i i i •`:
i i '::
{ i � ' <:
: ' I i i �:�«
i i � ' zz<
i i i i i?' � :..
12,
17:331
0.5
V
0.0110
15
7.0
<11
7.1
12
>:f3:>I15.5:2(3:::��5
"':I>:I:I:I:�><::(3Q:i:13D..
4..........
...........
...... ...
14
17:541
0.25
0.0100
14
14
>ii>>
>:>>II
IIII>i::>#
<IIIIil>III>IIi?i
>'s><I>Iisii><II >?>«IIi>iiiii>
<>III>>I »'15
16
5:15
0.25
V
0.0680
15
1 6
E7::.
:
::..:
:: 'i::
..............
:::: ?:;
....:........ ;::::a:::::::a:
•;;;:;:;;;:";::;;:>;;;:";:;:
;:: ;:.::.::;::: ;:;::
;:':'X>:•::.;:'.;::.;;:•>:;:;:;:
<;;:>:a:::::::::::n
:;:>.::o:::::
;:";:;:;::::::;";::::a::
s:";:;:::::::.::::::::::...:.::.::::::::::•::::
»1:.
18
0.0073
18
D6?':;
:::::::;;'E�,:;:;:
,,`:��I I :
:::.........
................
»><I<>II:I><<>>Iz
................................
5ilill>III:I.
3 ;9'.
20
18:251
0.25
V
0.0068
16
20
>::
x...
>D:flD75:I:i:i>:i:£
«:>:..............
?>:?<i:l:i>:i:i>:::::<:,>
<II>i>s:::::>:<::>:>::>;:»::::»:«<:I>III>::>:><:>III>III>II::
:>::':>:::::::::::::<:>:;:>::<>isisi>:::::><`:>':><:`:>::::::>::
:<::<:::>
II>i > i'•»>.........
:21:',
22
5:20
0.25
y
0.0086
15
19
0 9
0.10
9.0
1
22
::%'';:>::»;:;;:;;::
;`z:';:'>:':
;::::':< ::;;:;:;:::•:<;:;:;:
:::::%;•>?:::::::>:::a'::
`:<:. .:.:.:.:.::
:;:::::%i::i::::i::i::.:':
>:>::<::::%;:
`;::>:::::>:<%2::'<'?:::::>::i:#s:>`:<5::>:::2:'s:<::>::>:::>::>:»3::::::>:::'::':3::
".
24
0.0081
24
25
26
1 17:171
0.5
v 1
0.0051
16
7.4
<11
7.9
26
28
1 9:451
0.25
0.0028
16
399.0
2.00
8.0
60
28
>:>:::»:D:DDDO::<?:'•:E7i:l>:I:is>:i:l>:i:l>::>:
»»:I:>:I»:i:»<::>::»>::>:::<:<::«<::»>III>>III>::»>:«:>.>>::>::<::'>z!>>>II>I>i>>
«<:::>>>»
IIz:::::<:<_>>::»>III>:«:»::::......
29
30
7:001
0.25
V
0.0110
16
30
............
.............
............
............
............
............
a
AVERAGE
0.0114
15
28.4
9.8
1.60
4.0
2
7.4
#
;:;:;;MAXI?v1f;kR1.;:>:::;::::::::;:c::.;:::•za,058L#.,:.:..
::::::;:G:::::::
:::::::`;::;:;:::;:::::
•::•:::�;:�;.
t7:.::.::::�•d....::.:3�.0::::...:
�";:�;:
::>::;;i::i:::::;;S:::isi::::::::;:+y>%:i:::::::::•`:iSi::;:;::::::::::::::::
;•:; :�::�
:�;:�;:�: :.;::�::�
"1,9,D.:::::::::::4.00
:�;:�;:�: �� «::�::�.
...............
�:<�:<�it�:0:�i:<�::5::
...........................
�i:�>:�>6EF�:�i:�:�i:�:�i:�:�i�
.. :.............
.....................
3k
MINIMUM
0.0000
13
6.8
19.0
< 4.0
0.10
< 2.5
1
6.9
#
X.
GI�AB:::::::.Gi]MI?..........
.AR .............
....
...................
..CaF�........:..
�I............
C71v1............................:.......
DAILY LIMIT
NA
NA
NA
NA
16.5
45
400
N/A
NA
NA
NA
'
NA
#
:XX:�s!'��:�:4
•.:4UkfiTFR4Y.Llivlkr.>:>:;:: :: ;:;:�;:�;:::p1;4::::
:�:�:`>�'
a:o:N�:;::
�'�:�r���:22�:�
.::;!1A::
:;;:;::�::�:G:�.
:::.#A:::::::::NA...:::::::::
�:3:�:�:��:>:i:%�;�:�:
�:�:2`?$�?::i:�:�:
NA...
�:�i::;:::iiii:�:�:
:::::.........t�A...........................
�:.:.:...:.':�::ii:`•::i:2:�
:�:�::;::�::�: ;i:;
:t;:i:�::�::�::�:�i:;•
..................!`NA.............
�::`�::::>���::�::�::::�:
4i•':i1ifAi'iiii:
MONTHLY LIMIT
0.0432
NA......>6,<9......NA
:.::,NA::::::::::•::NANA:::.�:.�:::#:.
»::::.
..........:..............::::::::::::::30::.::::::::::::200::::::::::..�::NA::::::::::NA::::::::
>:;>:::
r:iii!Mld i::::>
�:::;:!eu4d ":;;:>::�;:::Mfld
:•;::•;::>::";;1+t9if
?::::•.:.....
.
1f...................................
9I%k. :::::
2N%t ......_..
FREQUENCY MET
0
YES
YES
YES
YES
YES
YES
YES
YES
YES
NO
NO
NO
#
WI.ltat;tT: »::;i4b::::>
Total Monthly Flow
0.3434 MG
RECEIVED
TN Monthly Loading (Ibs.)
3
DEM FormMR-1 (12/03)
N.C. Dept.
Of ENR
Annual TN Mass Loading
(Ibs./yr)
DEM Form MR-1 (12103)
Annual TN Mass Loading
(Ibs./yr)
JUN 2 S 2010
Winston-Salem
Regional Oice

Cains Way MHP Status: (Please check one of the following)
All monitoring data and sampling frequencies meet permit requirements [
Compliant
All monitoring data and sampling frequencies do NOT meet permit requirements [K ]
Noncompliant
If the facility is noncompliant, please comment on corrective actions being taken in respect to equipment, operation,
maintenance, etc, and a time table for improvements to be made.
I1 /CGr� i YI l E'ly CIII 1//o7oZ/�� �LC7tcJ J i )YPlY ;G J�E7i JP�� (�i/M 7 Lr�s`/C� [3n11
T—Q -i 5 e C J, 0. Le l�-
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision
in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information sub-
mitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for
gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and com-
plete. I am aware that there are significant penalties for submitting false information, including the possibility of fines
and imprisonment for knowing violations."
Permittee Address:
00010 Temperature
00076 Turbidity
00080 Color (Pt -Co)
00082 Color (ADMI)
00300 Dissolved Oxygen
00310 B O D 5
00340 C O D
00400 pH
00530 T S S
00545 Settleable Solids
00556 Oil and Grease
00600 Total Nitrogen
PARAMETER CODES
00610 Ammonia Nitrogen
00625 Total Kjeldah
Nitrogen
00630 Nitrate/Nitrite
00665 Total Phosporous
00720 Cyanide
00745 Total Sulfide
00927 Total Magnesium
00929 Total Sodium
00940 Total Chloride
00951 Total Fluoride
01002 Total Arsenic
01027 Cadmium
Permittee (Please print or type)
It
Signature f rmittee'* I Date
Phone Number: Permit Exp. Date
May 31, 2007
01032 Hexavalent
Chrc 32730 Total Phenolics
01034 Chromium 34235 Benzene
01037 Total Coba 34481 Toluene
01042 Copper 38260 MBAS
01045 Iron 39516 PCBs
01051 Lead 50050 Flow
01067 Nickel 50060 Total Residual
01077 Silver Chlorine
01092 Zinc 71880 Formal-
01105 Alumimum dehyde
01147 Total Selen 71900 Mercury
31616 Fecal Colifc 81551 Xylene
Parameter Code assistance may be obtained by calling the Water Quality Compliance Group at [phone] ext 581 or 534
-----------------------------------------------------------------------------------------
The monthly average for fecal coliform is to be reported as a GEOMETRIC mean. Use only units designed in the reporting
facility's permit for reporting data.
ORC must visit the facility and document visitation of facility as required per 15A NCAC 8A .0202(b)(5)(B)
** If signed by other than the permittee, delegation of signatory authority must be on file with the state per
15A NCAC 2B .0506 (b)(2)(D)

NPDES PERMIT NO:NC0075027 DISCHARGE NO.: 001 MONTH: April YEAR: 2010
FACILITY NAME: Cains Way MHP COUNTY:Forsyth
STREAM: Ader Creek LOCATION: @ 100ft Above Discharge Point STREAM: Ader Creek LOCATION: @ NCSR 1979
DOWNSTREAM
uro. ­
,
00010
00300
31616
00010
00300
31616
D
Fecal
D
Fecal
A
Time
Dissolved
Coliform
A
Time
Dissolved
Coliform
T
i
TempOxygen
T
TempOxygen
E
2400
Clock
DO
Geometric
Mean
E
2400
Clock
DO
Geometric
Mean
#
HRS
C
m /L
#/100m1
#
HRS
C
m /L
#/100mI
1
y
2
2
3
3
4
4
5
18:30
• 13.0'
7.7
5'
18:36
13.0
7.5
6
8
9
V
10
17:50
14.0
7.7
12
17:56
14.0
7.7
13
14
14
15
15
16
16
17
17
18
18
19
18:20
14.0
" - ° 8.2
19
18:26
14.0
8.1
20
20
21
21-
22
23
t
, ..
22
23
24
124
25
25
26
5:40
14.0
8.2
26
5:56
14.0
7.9
27
27
28
28
29
29
30
30
31
31..
AVERAGE
13.
8.0
AVERAGE
13.8
7.8
MAXIMUM
14.0
.`_ :• 8.2
MAXIMUM
14 0
e
"= •8.1
MINIMUM
13.0
7.7
MINIMUM
13.0
7.5
COMP%GRAB
GRAB
GRAB..
COMP/GRAB
GRAB'
GRAB.`
'
DEM Form MR-3 (12/93) DEM Form MR-3 (12/93)

l
r
A. 1. EFFLUENT LIMITATIONS AND MONITORING REQUIREMENTS
During the period beginning on the effective date of this permit and lasting until
expiration, the Permittee is authorized to discharge from outfall 001. Such discharges
shall be limited and monitored by the Permittee as specified below:
rITORING
EFFLUENT
REMENT
REQUIS
f*..
Measurement' Sate I� T e Sample'LacatiBfi
�-;
Averaged `:: �Aveiage�>t,.���r MaXi►taam��:"�;��?guency���
� ., _�,� ..; .�...�
�#
Continuous Recording Influent or Effluent
Flow
0.0432 MGD
BOD, 5-day (20°C)
11.0 mg1L
16.5 mg/L
Weekly
Composite
Effluent
(April 1— October 31
BOD, 5-day (202C)
22.0 mg/L "
33.0 mg/L
Weekly
Composite
Effluent
November 1— March 31
Total Suspended Residue
30.0 mg/L
45.0 mg/L
Weekly
Composite
Effluent
NH3 as N
2.0 mg/L
10.0 mg/L
Weekly
Composite
Effluent
(April 1— October 31
NH3 as N
6.0 mg/L
30.0 mg/L
Weekly
Composite
Effluent
November 1— March 31)
Weekly
Grab
Effluent,
Dissolved Oxygen2
Upstream &
Downstream
Fecal Coliform (geometric mean)
200/100 ml
400/100 ml
Weekly
Grab
Effluent
Total Residual Chlorine3
28 µg/L
2/Week
Grab
Effluent
Daily
Grab
Effluent
Temperature CC)
Weekly
Grab
Upstream &
Temperature CC)
Downstream
Weekly
Grab
Effluent
pH4
Footnotes:
1. Upstream = at least 100 feet above discharge point; Downstream = at NCSR 1979.
2. The daily average dissolved oxygen concentration shall not be less than 5.0 mg/L.
3. The limit for total residual chlorine will take effect January 1, 2009, only if chlorine is
used.
4. The pH shall not be less than 6.0 standard units nor greater than 9.0 standard units.
There shall be no discharge of floating solids or visible foam in other than trace amounts

MONITORING REPORT(MR) VIOLATIONS for:
Report Date: 07/07/10 Page: 1 of 2
PERMIT: NCO076027 FACILITY: Cains Way Homeowners Association - Cains Way Mobile COUNTY: Forsyth REGION: Winston-Salem
Home Park
Limit Violation
MONITORING
OUTFALL /
REPORT
PPI
LOCATION
PARAMETER
D9>t
001
Effluent
q2W ' 200Le )Iyl
Concentration
com gift
001
Effluent
- MRQgi C) -
oncentration
2[iD9P
001
Effluent
-�= WMJ5 ')
Concentration
07 -2009
001
Effluent
Chlorine, Total Residual
07 -2009
001
Effluent
Chlorine, Total Residual
08 -2009
001
Effluent
Chlorine, Total Residual
09 -2009
001
Effluent
Chlorine, Total Residual
09 -2009
001
Effluent
Chlorine, Total Residual
10 -2009
001
Effluent
Chlorine, Total Residual
10 -2009
001
Effluent
Chlorine, Total Residual
10 -2009
001
Effluent
Chlorine, Total Residual
11 -2009
001
Effluent
Chlorine, Total Residual
11 -2009
001
Effluent
Chlorine, Total Residual
11 -2009
001
Effluent
Chlorine, Total Residual
12 -2009
001
Effluent
Chlorine, Total Residual
12 -2009
001
Effluent
Chlorine, Total Residual
12 -2009
001
Effluent
Chlorine. Total Residual
VIOLATION
UNIT OF
DATE
FREQUENCY
MEASURE
04/29/09
Weekly
mg/I
04/30/09
Weekly
mg/I
08/13/09 Weekly
CALCULATED
LIMIT VALUE %OVER LIMIT
16.5 39 136.36
11 12 9.09
VIOLATION TYPE VIOLATION ACTION
Daily Maximum Exceeded Proceed to NOV
Monthly Average Exceeded Proceed to NOV
mg/I 16.5 34 106.06 Daily Maximum Exceeded Proceed to NOV
07/08/09
2 X week
ug/I
28
29
3.57
Daily Maximum Exceeded
No Action, BPJ
07/23/09
2 X week
ug/I
28
29
3.57
Daily Maximum Exceeded
No Action, BPJ
08/06/09
2 X week
ug/I
28
29
3.57
Daily Maximum Exceeded
No Action, BPJ
09/03/09
2 X week
ug/I
28
39
39.29
Daily Maximum Exceeded
No Action, BPJ
09/17/09
2 X week
ug/I
28
31
10.71
Daily Maximum Exceeded
No Action, BPJ
10/01/09
2 X week
ug/I
28
41
46.43
Daily Maximum Exceeded
No Action, BPJ
10/08/09
2 X week
ug/I
28
29
3.57
Daily Maximum Exceeded
No Action, BPJ
10/22/09
2 X week
ug/I
28
29
3.57
Daily Maximum Exceeded
No Action, BPJ
11/12/09
2 X week
ug/I
28
39
39.29
Daily Maximum Exceeded
No Action, BPJ
11/19/09
2 X week
ug/I
28
29
3.57
Daily Maximum Exceeded
No Action, BPJ
11/25/09
2 X week
ug/I
28
48
71.43
Daily Maximum Exceeded
No Action, BPJ
12/03/09
2 X week
ug/I
28
29
3.57
Daily Maximum Exceeded
No Action, BPJ
12/23/09
2 X week
ug/1
28
33
17.86
Daily Maximum Exceeded
No Action, BPJ
12/31/09
2 X week
ug/I
28
29
3.57
Daily Maximum Exceeded
No Action, BPJ

MONITORING REPORT(K8R) VIOLATIONS for:
nep" oat° onmnv
Page: zmz
6cility, me:.
Na
PERM[T:NCVU75V2J
FACILITY: CainnWay Homeowners Association 'ConeWay Mobile
COUNTY:
Forsyth
REGION: Winston-Salem
Home Park
Limit Violation
mow/Tomwo ourFALL/
woLAT/ow
UNIT OF
CALCULATED
nsponr pp/ uooxnow
n^nAMsrsx
o^Ts
Fnsouswc, MEASURE
uM/r
VALUE
mOVER LIMIT
VIOLATION TYPE
VIOLATION ACTION
01 e010 001
Effluent
Chlorine, Total Residual
01/07/10
zxweek uo/|
28
zn
3.57
Daily Maximum Exceeded
moAction, oPJ
01'2010 001
Effluent
Chlorine, Total Residual
01/21/10
oxweek uo/|
co
na
35.71
Daily Maximum Exceeded
woAction, opJ
01'2010 001
Effluent
Chlorine, Total Residual
01/28/10
uXweek ug/|
xo
44
57.14
Daily Maximum Exceeded
mvAction, opJ
02'2010 001
Effluent
Chlorine, Total Residual
02/11/10.
zxweek uo/|
uo
n,
32.14
Daily Maximum Exceeded
mvAction, opx
03'2010 001
Effluent
Chlorine, Total Residual
03104/10
xxweek un/|
zn
nn
17.8e
Daily Maximum Exceeded
woAction, opJ
03'2010 001
Effluent
Chlorine, Total Residual
03/18/10
cxweek uo/|
ua
41
46.43
Daily Maximum Exceeded
wnAction, BpJ
03'2010 001
Effluent
Chlorine, Total Residual
03/25/10
cxweek ug/|
uu
uo
3.57
Daily Maximum Exceeded
wvAction, opx
03'2010 001
Effluent
Chlorine, Total Residual
03/31/10
cXweek ug/|
oa
41
46.43
Daily Maximum Exceeded
woAction, opx
Ur 0I�11118 001
Effluent
wu��C
owzymn
Weekly *Y100m|
400
4.800
1.100
Daily Maximum Exceeded
Proceed mNOV
�0��0�� on�
cmuon�
'umm�w°s*
nm17mn
Weekly #/�on |
e y m
�oo
1 �no
.
zso
o�| mmo Exnoemou
y mum
pmoeoumNOV
001
Effluent
08m1m9
woom' mg/|
z
2.25
12.5
Monthly Average Exceeded
Proceed mNOV

Permit Enforcement History by Owner
07/07/10
1
Owner: Cains Way Homeowners Association
Facility: Cains Way Mobile Home Park
Permit: NCO075027
Region: Winston-Salem County: Forsyth
Penalty
Remission
Enf EMC
EMC OAH Collection
Has
Assessment Penalty Enforcement
Request
Enf Conf Remission Hearing
Remission Remission Memo Sent
Pmt
Case
Case Number MR Approved Amount Costs Damages
Received
Held Amount Held
Amount Amount to AGO Total Paid
Balance Due
Plan
Closed
LV-1998-0066 08/14/98 $1,000 $40.00 $.00
$1,040.00
$.00
No
09/17/98
LV-1998-0113 09/16/98 $1,250 $40.00 $.00
10/17/98
12/08/98 $.00
$1,290.00
$.00
No
02/03/99
LM-2001-0011 05/08/01 $450 $76.00 $.00
06/19/01
08/29/01 $200.00
$326.00
$.00
No
10/23/01
LV-2002-0568 11/19/02 $1,000 $105.50
$1,105.50
$.00
No
12/20/02
LV-2004-0416 5-2004 08/24/04 $250 $88.00
$338.00
$.00
No
09/17/04
LM-2007-0047 7-2007 10/08/07 $400 $102.00
$502.00
$.00
No
10/31/07
Total Cases: 6 $461.50
$4,601.60
$.00
Total Penalties: $4,801.60
Total Penalties after remission(s):
$4,601.50

Cainway Homeowners Association
A To C No. 075027AOI
Issued December 18, 2008
RECEIVEC
n:-.nt of cyR V "
JUL 1.5 2010 �--�..F
Winston-Salem
Regional Office
Engineer's Certification d ,I
J1;rt�j
.
� r+�Lw�1� i
L,�:M: ii
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 modifications and improvements to the Cainway Homeowners
Association WWTP, located on Pinehall Road in Forsyth County for Cainway Homeowners
Association, hereby state that, to the best of my abilities, due care and diligence was used in the
observation of the following construction:
Installation of.a dechlorination system utilizing sodium sulfite pursuant to the fast
track application received on December 3, 2008, and in conformity with the
Minimum Design Criteria for Dechlorination Facilities.
I certify that the construction of the above referenced project was observed to be built
within substantial compliance and intent of the approved plans and specifications.
Sign
Date
Registration No.
Send to: Construction Grants & Loans
DENR/DWQ
1633 Mail Service Center
Raleigh, NC 27699-1633

40
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
December 14, 2009
Cains Way Homeowners Association
Post Office Box 846
Walkertown, North Carolina 27051
Subject: NOTICE OF VIOLATION — Effluent Limitations
NPDES Permit No. NC 0075027
Cains Way Mobile Home Park
Forsyth County
Dear Mr. Cain:
A review of the self -monitoring report for the month of September 2009 revealed the following
violation of permit limits:
Parameter
Date
Limit Value
Reported Value
Limit Type
Fecal coliform
9/2009
400 # / 100 ml
1,400 # /100 ml
Daily Maximum
Exceeded
Remedial actions, if not already implemented, should be taken to correct the above
noncompliance problem. Please be aware that violations of your NPDES permit could subject
you to enforcement action by this Division with the possible assessment of civil penalties of up
to $25,000 per day per violation. Should you have any questions, please contact Jenny
Graznak or me at [phone].
Sincerely,
Steve W. Tedder
Regional Supervisor
Surface Water Protection Section
cc: Central Files — SWP
North Carolina Division of Water Quality, Winston-Salem Regional Office
Location: 585 Waughtown St. Winston-Salem, North Carolina 27107
Phone: [phone] FAX: 336-77IA6301 Customer Service:1-877-623-6748
Internet: www.ncwaterquality.org
Nne
orthCarolina
Naturally
An Equal Opportunity 1 Affirmative Action Employer

Cover Sheet from
Staff Member to
Regional Supervisor
�D�pMR Review Record
Facility: S R lIV Permit/Pipe No.: N`�O�a� month/Year
Monthly Average Violations
Parameter Permit Limit DMR Value % Over Limit
ee yDaily Violations
Date Parameter Permit Limit/Tyve DMR Value % Over Limit
Ltoo
Monitoring Frequency Violations
Date Parameter Permit Frequency Values Reported # of Violations
Other Violations
Completed by: 6'1VV
Regional Water Quality
Supervisor SiQnoff:
Awl,
Date: I a' 11 Lo �
Date: /X- / X -el

^\
/
MONITORING REPOR�K8RU�O�T�NS�c
Report Date: �oomo Page: *mm
one
o
PERMIT: NCO051713
FACILITY: Lakeview 88HPLLC'Lakeview Mobile Home Park
COUNTY: Forsyth
REGION: Winston-Salem
Limit Violation
MONITORING ouTpAu/ VIOLATION
LOCATION pp/ �no�om pAnAwsren � "^'=
UNIT OF MEASURE
FREQUENCY
LIMIT VALUE
VIOLATION TYPE vmu�mw�cnow--
on'coon 001
smuom 000mnn.Fecal mr.M'pc oomomn
mmomv ' *v100m|
*oo roo
Daily Maximum Exceeded wvnu
Bmm.+*.5o
PERMIT:NCOVGi204
FACILITY: SnmrleftAcres Mobile Home Park 'SuedmftAcres K8MP
COUNTY: Forsyth
REGION: Winston-Salem
WWTP
Limit Vi|oU
MONITORING ourpAu/ vmuATmw
nEponr pp/ LooArow PARAMETER oArs
UNIT OF
pnsuuEwov Ms»a»nE
CALCULATED
uM/r VALUE
VIOLATION TYPE VIOLATION ACTION
oo-u000 001
emuom a»o «o (20Deg. q' 09m1m9
wmomv mnx
24 ua
Daily Maximum Exceeded None
cunoommnmn
PERMIT: NCO075027
ain
FACILITY: Cains Way Homeowners Association -,C-301%loblle
COUNTY:j �orsh
REGION: Winston-Salem
Limit Violation
MowITomwoo / VIOLATION
�^^
esponr ~'Puuo*Tmw p«nAMsrsn DATE
UNIT OF
pnsouswo, MEASURE
CALCULATED
um/T VALUE
VIOLATION TYPE VIOLATION ACTION
on-u000 001
Effluent cvnfonn.Fecal sp.M'pc 09/17m9
mmomv wv100m|
400 1.400
Daily Maximum Exceeded mvno
omm.**.5u
III

�7
RCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
November 4, 2009
Cains Way Homeowners Association
Post Office Box 846
Walkertown, North Carolina 27051
Subject: NOTICE OF VIOLATION — Effluent Limitations
NPDES Permit No. NC 0075027
Cains Way Mobile Home Park
Forsyth County
Dear Mr. Cain:
A review of the self -monitoring report for the month of August 2009 revealed the following
violation of permit limits:
Parameter
Date
Limit
Reported Value
Limit Type
Value
Nitrogen, Ammonia Total
8/2009
2 mg/I
2.25 mg/I
Monthly
(as N) - Concentration
Average
Biochemical Oxygen
8/13/2009
16.5 mg/I
34 rrg/I
Daily Limit
Demand (BOD)
Remedial actions, if not already implemented, should be taken to correct the above
noncompliance problem. Please be aware that violations of your NPDES permit could subject
you to enforcement action by this Division with the possible assessment of civil penalties of up
to $25,000 per day per violation. Should you have any questions, please contact Jenny
Graznak or me at [phone].
Sincerely,
Steve W. Tedder
Regional Supervisor
Surface Water Protection Section
cc: Central Files — SWP
Ik , = b @1NSUUIP.
North Carolina Division of Water Quality, Winston-Salem Regional Office
Location: 585 Waughtown St. Winston-Salem, North Carolina 27107
Phone: [phone] \ FAX: [phone] \ Customer Service:1-877-623-6748
Internet: www.ncwaterquality.org
An Equal Opportunity \ Affirmative Action Employer
Noi thCar®Iina
P.&MIly -

Cover Sheet from
Staff Member. to
Regional Supervisor
DMR Review Record
Facility: Permit/1?ipe No.: l�l����� Month/Year o�
Monthly Average Violations
Parameter Permit Limit DMR Value % Over Limit
N �N� .a
Weekly 6ly iolations
Date Parameter Permit Limit/Tvpe DMR Value % Over Limit
LL-
Monitoring Frequency Violations
Date Parameter Permit Frequency Values Reported # of Violations
Other Violations
Completed by:
Regional Water Quality
Supervisor Signoff:
a
Date: 11
Date:

-'„
EFFLUENT/ f .
( April 1 through October 31
NPDES PERMIT NO.: NCO075027
DISCHARGE NO.: 001 MONTH: August YEAR: 2009
FACILITY NAME: Cains Way MHP
CLASS: 11 COUNTY: Forsyth
OPERATOR IN RESPONSIBLE CHARGE: Bradley Flynt GRADE: IV PHONE: [phone]
CERTIFIED LABORATORIES:
(1) Water Tech Inc (2 )
Check box if orc has changed [ ]
PERSON(S) COLLECTING SAMPLES: Bradley Flynt
Mail ORIGINAL and ONE COPY to:
„
a
ATTN: CENTRAL FILES
X, d '!i
DIVISION OF WATER QUALITY
(SIGNATURE OF y DATE
DENR
BY THIS SIGNAT E, RTIFY THAT THIS REPORT IS
1617 MAIL SERVICE CENTER
ACCURATE AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
RALEIGH, NC 27699-1617
RAC,;»IVEr;
1of ENK
t UR
d:nsicn S rQ' E roc

MONITORING REPORT(MR) VIOLATIONS for: Report Date: 11/02/09 Page: 5 of 9
_ - _
q 'yNP-DES WW
Permit % , MRs Between 8-2009 and 8-2009 ;Region: Winston-Salem .ftiation Category Limit Violation- ~Prog�arri Category
krFacility Name:, % •Pafdm Name % � �
County: % Subbasin 9/Q __ Violation Action: None
r
Major Minor
PERMIT: NCO075027 FACILITY: Cains Way Homeowners Association -Gains Way obile COUNTY: Forsyth ""� REGION: Winston-Salem
Home Park
Limit Violation
MONITORING OUTFALL/
REPORT PPI LOCATION
PARAMETER
VIOLATION
DATE
FREQUENCY
UNIT OF
MEASURE
LIMIT
CALCULATED
VALUE
VIOLATION TYPE
VIOLATION ACTION
08 -2009 001 Effluent
BOD, 5-Day (20 Deg. C) -
08/13/09
Weekly
mg/1
16.5
34
Daily Maximum Exceeded
None
Concentration
08 -2009 001 Effluent
Nitrogen, Ammonia Total (as
08/31/09
Weekly
mg/l
2
2.25
Monthly Average Exceeded
None
N) - Concentration
PERMIT: NCO083933
FACILITY: Aqua North Carolina Inc - Salem Quarters WWTP
COUNTY: Forsyth
�y� REGION: Winston-Salem
Limit Violation
MONITORING OUTFALL/
REPORT PPI LOCATION
PARAMETER
VIOLATION
DATE
FREQUENCY
UNIT OF
MEASURE
LIMIT
CALCULATED
VALUE
VIOLATION TYPE
VIOLATION ACTION
08 -2009 001 Effluent
Nitrogen, Ammonia Total (as
08/31/09
Weekly
mg/I
2
2.32
Monthly Average Exceeded
None
N) - Concentration
PERMIT: NCO088501 FACILITY: Aqua North Carolina Inc - Stonington Subdivision - Well #1 COUNTY: Forsyth
ION: Winston-Salem
Limit Violation
MONITORING OUTFALL/ VIOLATION UNIT OF CALCULATED
REPORT PPI LOCATION PARAMETER DATE FREQUENCY MEASURE LIMIT VALUE VIOLATION TYPE VIOLATION ACTION
08 -2009 001 Effluent Chlorine, Total Residual 08/04/09 2 X month ug/I 17 562 Daily Maximum Exceeded None
Pi

A -i� 4 Z
MCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor . Director Secretary
July 27, 2009
Cains Way Homeowners Association
PO Box 846
Walkertown NC 27051
Subject: NOTICE OF VIOLATION
Permit No. NCO075027
Cains Way Mobile Home Park
Forsyth County
Dear Mr. Cain:
A review of Cains Way Mobile Home Park's monitoring report for April 2009 showed the following violations:
Parameter
Date
Limit Value
Reported Value
Limit Type
Coliform, Fecal MF, M-FC
04/29/09
400 #/100ml
4,800 9/100ml
Daily Maximum
Broth,44.5C
Exceeded
BOD, 5-Day (20 Deg. C) -
04/29/09
16.5 mg/l
39 mg/1
Daily Maximum
Concentration
Exceeded
BOD, 5-Day (20 Deg. C) -
04/30/09
11 mil
12 mg/1
Monthly Average
Concentration
Exceeded
Remedial actions should be taken to correct this problem. The Division of Water Quality may pursue enforcement
action for this and any additional violations of State law.
To prevent further action, carefully review these violations and deficiencies and respond in writing to this office
within 30 working day of receipt of this letter. You should address the causes of noncompliance and all actions
taken to prevent the recurrence of similar situations. If you should have any questions, please do not hesitate to
contact Rose Pruitt at 336-771-5000.
Sincerely,
Steve W Tedder
1�fct Water Quality Regional Supervisor
Winston-Salem Region
Division of Water Quality
Cc: Central Files —SWP
WW R®-A
North Carolina Division of Water Quality Winston-Salem Regional Office
Location: 585 Waughtown St. Winston-Salem, North Carolina 27107 . One
Phone: [phone] FAX: [phone] Customer Service:1-877-623-6748 NorthCarolina
Internet: www.ncwaterquality.org Naturallif
An Equal Opportunity \ Affirmative Action Employer

V
Cover Sheet from
Staff Member to
Regional Supervisor
DMR Review Record
Facility: C-4116 Ww Permit/Pipe No.: NG OO750Z9 Month/Year _
M 4- ? 2,001
Monthly Average Violations
Parameter Permit Limit DMR Value % Over Limit
Weekl Dly
iolations
Date Parameter Permit Limitgype DMR Value % Over Limit
o/
Monitoring Frequency Violations
Date Parameter Permit Frequency Values Reported # of Violations
Other Violations
Z(-VA-( � Completed by: Date:y
Regional Water Quality
Supervisor Signoff: Date:
NJ0V 2,0 0q

z
MONITORING REPORT(MR) VIOLATIONS for: Report Date: 07/20/09 Page: 1 of 2
Permit nc007bQ27 MRs Between: 4-2008--`and 3-2009 Region:% Violation Category:�ProgramCategory: % d
Facility"Name: ""IQ� Param Name: % County: % Subbasin: Violation Action: % 1
J:, Major Minor: °lfl -
PERMIT: NCO075027 FACILITY: Cains Way Homeowners Association - Cains Way Mobile COUNTY: Forsyth REGION: Winston-Salem
Home Park
Limit Violation
MONITORING OUTFALLI
REPORT
PPI
LOCATION
PARAMETER
04 -2008
001
Effluent
BOD, 5-Day (20 Deg. C)
05 -2008
001
Effluent
BOD, 5-Day (20 Deg. C)
09 -2008
001
Effluent
BOD, 5-Day (20 Deg. C)
09 -2008
001
Effluent
Coliform, Fecal MF, M-FC
Broth,44.5C
02 -2009
001
Effluent
Coliform, Fecal MF, M-FC
Broth,44.5C
Monitoring Violation
VIOLATION
UNIT OF
CALCULATED
DATE
FREQUENCY
MEASURE
LIMIT
VALUE
04/10/08
Weekly
mg/I
16.5
22
05/29/08
Weekly
mg/I
16.5
32
09/25/08
Weekly
mg/I
16.5
26
09/10/08
Weekly
#/100m1
400
600
02/12/09 Weekly #/100m1 400 510
VIOLATION TYPE
VIOLATION ACTION
Daily Maximum Exceeded
Proceed to NOV
Daily Maximum Exceeded
Proceed to NOV
Daily Maximum Exceeded
Proceed to NOV
Daily Maximum Exceeded
Proceed to NOV
Daily Maximum Exceeded Proceed to NOV
MONITORING OUTFALL/
VIOLATION
UNIT OF CALCULATED
REPORT
PPI
LOCATION
PARAMETER
DATE
FREQUENCY
MEASURE LIMIT VALUE
VIOLATION TYPE
VIOLATION ACTION
09 -2008
001
Effluent
Flow, in conduit or thru
09/27/08
Continuous
mgd
Frequency Violation
Proceed to NOV
treatment plant
09 -2008
001
Effluent
Flow, in conduit or thru
09/28/08
Continuous
mgd
Frequency Violation
Proceed to NOV
treatment plant
02 -2009
001
Effluent
Flow, in conduit or thru
02/01/09
Continuous
mgd
Frequency Violation
Proceed to NOV
treatment plant
02 -2009
001
Effluent
Flow, in conduit or thru
02/07/09
Continuous
mgd
Frequency Violation
Proceed to NOV
treatment plant
02 -2009
001
Effluent
Flow, in conduit or thru
02/08/09
Continuous
mgd
Frequency Violation
Proceed to NOV
treatment plant
02 -2009
001
Effluent
Flow, in conduit or thru
02/14/09
Continuous
mgd
Frequency Violation
Proceed to NOV
treatment plant
02 -2009
001
Effluent
Flow, in conduit or thru
02/15/09
Continuous
mgd
Frequency Violation
Proceed to NOV
treatment plant
02 -2009
001
Effluent
Flow, in conduit or thru
02/21/09
Continuous
mgd
Frequency Violation
Proceed to NOV
treatment plant

MONITORING REPORT(MR) VIOLATIONS for: Report Date: 07/20/09 Page: 2 of 2
Permit: nc0075027 MRs Between: 4-2008 and 3-2009 Region: % Violation Category: % Program Category: %
i Facility Name: % Param Name: % County: % Subbasin: % Violation Action: %
Major Minor: % .
PERMIT: NCO075027 FACILITY: Cains Way Homeowners Association - Cains Way Mobile COUNTY: Forsyth REGION: Winston-Salem
Home Park
Monitoring Violation
MONITORING OUTFALL/
VIOLATION
UNIT OF
CALCULATED
REPORT PPI LOCATION
PARAMETER
DATE
FREQUENCY
MEASURE
LIMIT VALUE
VIOLATION TYPE
VIOLATION ACTION
02 -2009 001 Effluent
Flow, in conduit or thru
02/22/09
Continuous
mgd
Frequency Violation
Proceed to NOV
treatment plant
02 -2009 001 Effluent
Flow, in conduit or thru
02/28/09
Continuous
mgd
Frequency Violation
Proceed to NOV
treatment plant
Reporting Violation
MONITORING OUTFALL/
VIOLATION
UNIT OF
CALCULATED
REPORT PPI LOCATION
PARAMETER
DATE
FREQUENCY
MEASURE
LIMIT VALUE
VIOLATION TYPE
VIOLATION ACTION
10-2008
12/01/08
Late/Missing DMR
No Action, BPJ
11 -2008
12/31/08
Late/Missing DMR
No Action, BPJ
I
t

EFFLUENT
( April 1 through October 31 )
NPDES PERMIT NO.: NCO075027 DISCHARGE NO.: 001 MONTH: April YEAR: 2009
FACILITY NAME: Cains Way MHP CLASS: II COUNTY: Forsyth
OPERATOR IN RESPONSIBLE CHARGE: Bradle/Ft GRADE: IV PHONE: [phone]
CERTIFIED LABORATORIES: (1 ) WatInc (2 )
Check box if orc has changed[ ] PERSON(S) COLLECTING SAMPLES: Bradley Flvnt
Mail ORIGINAL and ONE COPY to: / -y C�
ATTN: CENTRAL FILES X V ./off / d /
DIVISION OF WATER QUALITY (SIGNATURE OF O DATE
DENR BY THIS SIGNATU I RTIFY THAT THIS REPORT IS
1617 MAIL SERVICE CENTER ACCURATE AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
DAI CI(`_L1 RI!` 97R00_1R47
RECEIVED
N.C. Dept of ENR
JUN 2 9 2009
Winston-Salem
Regional Office
EL
JUN 15 2009
A
,.nnn

- 'L 4
Cains Way MHP Status: (Please check one of the following)
All monitoring data and sampling frequencies meet permit requirements [ ]
Compliant
All monitoring data and sampling frequencies do NOT meet permit requirements [ °� ]
Noncompliard-
If the facility is noncompliant, please comment on corrective actions being taken in respect to equipment, operation,
maintenance, etc, and a time tabl for improvements to be made. L ue -�o -leak" Aren fa ei�� lea,,i? e z z
monthly 3ab,.5XGe - 7 17te;(� rnc, ✓ (300 =rceP.�rr%.r //a5/09.
6,,C I°e4,PJ 5�1;��. T(sMped oU} CDh`�cFc>L G`�tisro✓%e�;
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision
in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information sub-
mitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for
gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and com-
plete. I am aware that there are significant penalties for submitting false information, including the possibility of fines
and imprisonment for knowing violations."
Permittee Address:
00010 Temperature
00076 Turbidity
00080 Color (Pt -Co)
00082 Color (ADMI)
00300 Dissolved Oxygen
00310 B O D 5
00340 C O D
00400 pH
00530 T S S
00545 Settleable Solids
00556 Oil and Grease
00600 Total Nitrogen
PARAMETER CODES
00610 Ammonia Nitrogen
00625 Total lgeldah
Nitrogen
00630 Nitrate/Nitrite
00665 Total Phosporous
00720 Cyanide
00745 Total Sulfide
00927 Total Magnesium
00929 Total Sodium
00940 Total Chloride
00951 Total Fluoride
01002 Total Arsenic
01027 Cadmium
6C. eo_ /'16!' (.,r;Wa�
Permittee (Please print or type)
(i K
Signature of Permittee**
Phone Number: Permit Exp. Date
May 31, 2007
01032 Hexavalent
Chrc 32730 Total Phenolics
01034 Chromium 34235 Benzene
01037 Total Cobal34481 Toluene
01042 Copper 38260 MBAS
01045 Iron 39516 PCBs
01051 Lead 50050 Flow
01067 Nickel 50060 Total Residual
01077 Silver Chlorine
01092 Zinc 71880 Formal-
01105 Alumimum dehyde
01147 Total Selen 71900 Mercury
31616 Fecal Colifc 81561 Xylene
Parameter Code assistance may be obtained by calling the Water Quality Compliance Group at [phone] ext 581 or 534
The monthly average for fecal coliform is to be reported as a GEOMETRIC mean. Use only units designed in the reporting
facility's permit for reporting data.
* ORC must visit the facility and document visitation of facility as required per 16A NCAC 8A .020�(b)(5)(B)
** If signed by other than the permittee, delegation of signatory authority must be on file with the state per
15A NCAC 213.0506 (b)(2)(D)

x
NPDES PERMIT NO:NC0075027 DISCHARGE NO.: 001 MONTH: April YEAR: 2009
FACILITY NAME: Calns Way MHP COUNTY. -Forsyth
STREAM: Ader Creek LOCATION: @ 100It Above Discharge Point STREAM: Ader Creek LOCATION: @ NCSR 1979
I IPCTRFOM
nnVdNSTRFAM
DEM Fort MR-3 (12/93) DEM Form MR-3 (12/93)

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary.
May 12, 2009
Cains Way Homeowners Association
PO Box 846
Walkertown NC 27051
Subject: NOTICE OF VIOLATION
Permit No. NC0075027
Cains Way Mobile Home Park
Forsyth County
Dear Ms Wood:
A review of Cains Way Mobile Home Park's monitoring report for February 2009 showed the
following violations: ,
Parameter
Date
Limit Value
Reported Value
Limit Type
Coliform, Fecal MF, M-FC
02/12/09
400 #/100m1
510 #/100m1
Daily-
Broth,44.5C
Maximum -
Exceeded
Parameter
Date
Measuring
Violation
Frequency
Flow, in conduit or thru_
02/08/09
Continuous
Frequency Violation
treatment plant
Flow, in conduit or thru
02/28/09
Continuous
Frequency Violation
treatment plant
Flow, in conduit or thru
02/01/09
Continuous
Frequency Violation
treatment plant
Flow, in conduit or thru
02/21/09
Continuous
Frequency Violation
treatment plant
Flow, in conduit or thru
02/14/09
Continuous
Frequency Violation
treatment plant
North Carolina Division of Water Quality, Winston-Salem Regional Office
Location: 585 Waughtown St. Winston-Salem, North Carolina 27107
>: One '.:,;:::>;;
Phone: [phone] FAX: [phone] Customer Service:1-877-623-6748 1V oftbCaro1llna
Internet: www.ncwaterquality.org
Rtur���
An Equal Opportunity 1 Affirmative Action Employer

Parameter
Date
Measuring
Violation
Frequency
Flow, in conduit or thru
02/22/09
Continuous
Frequency Violation
treatment plant
Flow, in conduit or thru
02/07/09
Continuous
Frequency Violation
treatment plant
Flow, in conduit or thru
02/15/09
Continuous
Frequency Violation
treatment plant
Remedial actions should be taken to correct this problem. The Division of Water Quality may
pursue enforcement action for this and any additional violations of State law.
To prevent further action, carefully review these violations and deficiencies and respond in
writing to this office within 30 working day of receipt of this letter. You should address the
causes of noncompliance and all actions taken to prevent the recurrence of similar situations. If
you should have any questions, please do not hesitate to contact Rose Pruitt at 336-771-5000.
Sincerely,
Steve W Tedder
Water Quality Regional Supervisor
Winston-Salem Region
Division of Water Quality
Cc: Central Files —SWP
WSRO

/Vo V • 2�� � Lrrl-o � 1 �
Cover Sheet from
Staff Member to
Regional Supervisor
n DMR Review Record
Facility:.Permit/Pipe No.: NCoa?60 2-7 Month/Year Feb
Zoo �
Monthly Average Violations
Parameter Permit Limit DMR Value % Over Limit
Weekly ally \iolations
Date
Parameter
Permit Limit/Type
DMR Value
% Over Limit
J
7,
Z• j5.0c9
I� C�Lt F
OD 00
Monitoring Frequency Violations
Date
Parameter
Permit Frequencv
Values Reported
# of Violations
2.
Z , F 0�z
?.•is•
LZ o
22,• 011
Z• 2,9 .py
ll
�•
Other Violations
Completed by: PL-Oc�
C
Regional Water Quality
Supervisor Signoff:
/v
Date: a `0
e,
Date: �

( November 1 through March 31 )
NPDES PERMIT NO.: NCO075027 DISCHARGE NO.: 001 MONTH: February YEAR: 2009
FACILITY NAME: Cains Way MHP CLASS: II COUNTY: Forsyth _ ,
OPERATOR IN RESPONSIBLE CHARGE: Bradley Flynt GRADE: IV PHONE: [phone]
CERTIFIED LABORATORIES: (1) Water Tech Inc (2 )
Check box if orc has changed[ ] PERSON(S) COLLECTING SAMPLES: Bradley Flynt
Mail ORIGINAL and ONE COPY to:
ATTN: CENTRAL FILES
DIVISION OF WATER QUALITY
DENR
1617 MAIL SERVICE CENTER
RALEIGH, NC 27699-1617
��'
��yy �o'
°" A
i w `cRR
ayins
RP9;oa,�iP'�
ACe
l � cc l ,c _ i
APR j. 7 I.ii09
x
(SIGNATURE OF OFF
DATE
BY THIS SIGNATUR ERTIFY THAT THIS REPORT IS
ACCURATE AND COMPLETE TO THE BEST OF MY KNOWLEDGE.

Cains Way MHP Status: (Please check one of the following)
All monitoring data and sampling frequencies meet permit requirements [ ]
Compliant
All monitoring data and sampling frequencies do NOT meet permit requirements [ ]
No complian-
If the facility is noncompliant, please comment on corrective actions being taken in respect to equipment, operation,
maintenance, etc, and a time table for improvements to be made.
�A7"(%r �jP.1l1t� �.�,orKPr/ can.
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision
in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information sub-
mitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for
gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and com-
plete. I am aware that there are significant penalties for submitting false information, including the possibility of fines
and imprisonment for knowing violations."
Permittee Address:
00010 Temperature
00076 Turbidity
00080 Color (Pt -Co)
00082 Color (ADMI)
00300 Dissolved Oxygen
00310 B O D 5
00340 C O D
00400 pH
00530 T S S
00545 Settleable Solids
00556 Oil and Grease
00600 Total Nitrogen
PARAMETER CODES
00610 Ammonia Nitrogen
00625 Total Kjeldah
Nitrogen
00630 Nitrate/Nitrite
00665 Total Phosporous
00720 Cyanide
00745 Total Sulfide
00927 Total Magnesium
00929 Total Sodium
00940 Total Chloride
00951 Total Fluoride
01002 Total Arsenic
01027 Cadmium
Permittee (Please print or type)
Signature of Permittee"
Phone Number: Permit Exp. Date
May 31, 2007
01032 Hexavalent
Chrc 32730 Total Phenolics
01034 Chromium 34235 Benzene
01037 Total Cobal 34481 Toluene
01042 Copper 38260 MBAS
01045 Iron 39516 PCBs
01051 Lead 50050 Flow
01067 Nickel 50060 Total Residual
01077 Silver Chlorine
01092 Zinc 71880 Formal-
01105 Alumimum dehyde
01147 Total Selen 71900 Mercury
31616 Fecal Colifc 81551 Xylene
Parameter Code assistance may be obtained by calling the Water Quality Compliance Group at [phone] ext 581 or 534
The monthly average for fecal coliform is to be reported as a GEOMETRIC mean. Use only units designed in the reporting
facility's permit for reporting data.
* ORC must visit the facility and document visitation of facility as required per 15A NCAC 8A .0202(b)(5)(B)
** If signed by other than the permittee, delegation of signatory authority must be on file with the state per
15A NCAC 26.0506 (b)(2)(D)

NPDES PERMIT NO:NC0075027 DISCHARGE NO.: 001 MONTH: February YEAR: 2009
FACILITY NAME: Calns Way MHP COUNTY:Forsyth
STREAM: Ader Creek LOCATION: @ 100ft Above Discharge Point STREAM: Ader Creek LOCATION: @ NCSR 1979
UPSTREAM
DOWNSTREAM
DEM Form MR-3 (12193) DEM Form MR-3 (12/93)

MONITORING REPORT(MR) VIOLATIONS for: Report Date: 05/08/09 Page: 1 of 1
PERMIT: NCO075027 FACILITY: Cains Way Homeowners Association - Cains Way Mobile COUNTY: Forsyth REGION: Winston-Salem
Home Park
Limit Violation
MONITORING OUTFALL /
VIOLATION
UNIT OF
CALCULATED
REPORT PPI LOCATION
PARAMETER
DATE
FREQUENCY
MEASURE
LIMIT
VALUE
VIOLATION TYPE
VIOLATION ACTION
04 -2008 001 Effluent
BOD, 5-Day (20 Deg. C)
04/10/08
Weekly
mg/I
16.5
22
Daily Maximum Exceeded
Proceed to NOV
05 -2008 001 Effluent
BOD, 5-Day (20 Deg. C)
05/29/08
Weekly
mg/I
16.5
32
Daily Maximum Exceeded
Proceed to NOV
09 -2008 001 Effluent
BOD, 5-Day (20 Deg. C)
09/25/08
Weekly
mg/I
16.5
26
Daily Maximum Exceeded
Proceed to NOV
09 -2008 001 Effluent
Coliform, Fecal MF, M-FC
09/10/08
Weekly
#/100ml
400
600
Daily Maximum Exceeded
Proceed to NOV
Broth,44.5C
Monitoring Violation
MONITORING OUTFALL/
VIOLATION
UNIT OF
CALCULATED
REPORT PPI LOCATION
PARAMETER
DATE
FREQUENCY
MEASURE
LIMIT
VALUE
VIOLATION TYPE
VIOLATION ACTION
09 -2008 001 Effluent
Flow, in conduit or thru
09/27/08
Continuous
mgd
Frequency Violation
Proceed to NOV
treatment plant
09 -2008 001 Effluent
Flow, in conduit or thru
09/28/08
Continuous
mgd
Frequency Violation
Proceed to NOV
treatment plant
Reporting Violation
MONITORING OUTFALL /
REPORT PPI LOCATION PARAMETER
10 -2008
11 -2008
VIOLATION UNIT OF CALCULATED
DATE FREQUENCY MEASURE LIMIT VALUE VIOLATION TYPE
12/01/08 Late/Missing DMR
12/31/08 Late/Missing DMR
VIOLATION ACTION
No Action, BPJ
No Action, BPJ

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
April 30, 2009
Richard Donald Cain
Cains Way Homeowners Association
6075 Sullivantown Rd
Walkertown NC 27051
SUBJECT: Compliance Evaluation Inspection
Notice of Deficiency
Cains Way Mobile Home'Park
Permit No. NCO075027
Forsyth County
Dear Mr. Cain:
A Compliance Evaluation Inspection (CEI) was performed on the Cains Way Mobile Home Park wastewater treatment plant on April
23, 2009 by Rose Pruitt of the Winston-Salem Regional Office. Bradley Flynt, ORC was present for the inspection.
The inspection consisted of two parts: an on -site inspection of the treatment facility and a file review.
The treatment facility was found to be in compliance with permit NCO075027.
The following are the findings from the subject inspection.
I. Permit
The NPDES permit for the Cain's Way Mobile Home Park W WTP became effective July 1, 2007 and expires on February 29,
2012.The facility is located north of Walkertown on Pinehall Road in Forsyth County. The permitted components of the 0.0432 MGD
wastewater treatment plant include: aerated equalization basin, bar screen, splitter box, dual extended aeration basins, clarifier, tertiary
filters, and a chlorinator.
An authorization to construct has been granted to construct a dechlorination unit.
Discharge from said treatment works at the location specified is into Ader Creek, classified C waters in the Roanoke River Basin.
H. Records/Reports
A review of the laboratory reports, COC's and Discharge Monitoring Reports (DMRs) for the Cains Way MHP WWTP for the period
January 2008 through December 2008 were available. Operations records for this facility were available. Daily operator's and
maintenance logs, a spill response plan, and sludge hauling records were available. A complete copy of the permit was on site. The
annual report was available.
III. Facility Site Review
The facility site review indicated that the 0.0432 MGD treatment works is consistent with the permitted components. The actual
treatment system consists of an aerated equalization basin, bar screen, splitter box, dual extended aeration basins, clarifier, tertiary
filters, and a chlorinator. The recently approved dechlorination unit has not yet been installed. The facility is currently putting
chlorine tabs in the clarifier trough and putting declorination tabs in the chlorinator.
North Carolina Division of Water QualityWinston-Salem Regional Office
Location:585 Waughtown St. Winston-Salem, North Carolina 27107 One.
Phone: [phone] FAX: [phone] Customer Service:1-877-623-6748 NorthCarolina
Internet: www.ncwaterquality.org ;Vaturally
An Equal Opportunity lAffirmativeAction Employer L`

IV. Effluent / Receiving Stream
The WWTP discharges to Ader Creek, classified C waters in the Roanoke River Basin. The effluent was clear and free of visible
solids on the date of inspection. The receiving stream was free of solids, foam and debris.
V. Flow Measurement
Effluent flow is measured with an Isco 3230 bubble flow meter that was last calibrated on May 31, 2008 by Horizon Eng.
• The flow meter chart recorder has been broken since December 2008.
VI. Self -Monitoring Program
A review of the laboratory reports and Discharge Monitoring Reports (DMRs) for the Cains Way MHP WWTP for the period 7anuary
2008 through December 2008 revealed that the facility had four (4) limit violations and two monitoring violations for that period.
Notices of Violation were issued for these violations.
VII. Laboratory
Sample analyses are conducted by Tritest Labs, Inc, in Clemmons, NC. The laboratory was not reviewed at the time of the subject
inspection.
The certificate for the DWQ Laboratory Certification Program for Field Parameters issued to Bell Enterprises was current. Process
control data including field parameters tested and equipment calibrations were available.
VIH. Operation and Maintenance
Operation and maintenance at the time of the subject. inspection was deemed satisfactory.
IX. Sludge Utilization/Disposal
20,000 gal of solids were last removed on May 8, 2008 by Atlantic Utility.
X. Sewer Overflow
No Sewer Overflows reported.
Please refer to the enclosed Inspection Report for any additional observations and comments.
The Division of Water Quality greatly appreciates your continued oversight at this facility. The Division also encourages you to
continue to be proactive in your efforts to maintain compliance.
Please refer to the enclosed inspection report for additional observations and comments. If you or your staff have any questions,
please call Rose Pruitt at 336-771-5000.
Sincerely,
Steve W. Tedder
Water Quality Regional Supervisor
Winston-Salem Regional Office
Division of Water Quality
Attachments
cc: Bradley Flynt, ORC: 8467 Southerard Rd, Stokesdale NC 27357
Central Files
WSRO

i
i
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 I SI 31 14CO075027 111 12I 09/04/23 117 18I CI 1.9I SI 20!I—! I
Remarks
21111111111111111111111111111111111111111111111111
Inspection Work Days Facility Self -Monitoring Evaluation Rating 131 QA --- — - —Reserved--=--
67I i 69 701 I 711 I 72 I N I 73I I 174 751 I I I I I I 180
W
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)
11:30 AM 09/04/23
07/07/01
Cains Way Mobile Home Park
Exit Time/Date
Permit Expiration Date
Pinehall Rd
Walkertown NC 27051
12:30 PM 09/04/23
12/02/29
Name(s) of Onsite Representative(s)[Titles(s)/Phone and Fax Number(s)
Other Facility Data
Bradley Todd Flynt/ORC/336-433-7262/
Name, Address of Responsible Official/Title/Phone and Fax Number
Contacted
No
Section C: Areas Evaluated During Inspection (Check only those areas evaluated)
Permit Flow Measurement Operations & Maintenance Records/Reports
Self -Monitoring Program Sludge Handling Disposal 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
Rose Pruitt WSRO WQ//336-771-5000/ c j^ j0
(J C�
Signature of Managem 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 Inspection Type
3I N00075027 I11 12I 09/04/23 117 18ICI
Y.
(cont.) 1
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
The inspector was met at the facility by Bradley Flynt ORC and Randy bell backup ORC. At the time of the
inspection the facility appeared to be operating efficiently. The effluent was clear, the receiving stream was
clear and free of solids at the time of the inspection.
The dechlorination unit had not yet been constructed. Dechlor tabs are currently put into the chlorinator and
chlorine tabs are distributed in the clarifier trough.
The flow chart recorder has been broken since December 2008
Page # 2

Permit: NCO075027
Inspection Date: 04/23/2009
Owner - Facility: Cains Way Mobile Home Park
Inspection Type: Compliance Evaluation
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 Solids, pH, DO, Sludge ■
n
n
0-
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 application?
011
■
n
Is the facility as described in the permit?
■
n
n
n
# Are there any special conditions for the permit?
n
Cl
■
n
Is access to the plant site restricted to the general public?
■
n
n
n
Is the.inspector granted access to all areas for inspection?
■
n
n,
n ,
Comment:
Record Keeping
Yes
No
NA
NE
Are records kept and maintained as required by the permit?
■
n
n
n
Is all required information readily available, complete and current?
■
n
n
0,
"
Are all records maintained for 3 years (lab. reg. required 5 years)?
n
n
n
■
Are analytical results consistent with data reported on DMRs?
■
n
n
n
Is the chain -of -custody complete?
■
n
n
n
Dates, times and location of sampling
■
Name of individual performing the sampling
■
Results of analysis and calibration
■
Dates of analysis
■
Name of person performing analyses
■
Transported COCs
■
Are DMRs complete: do they include all permit parameters?
■
Has the facility submitted its annual compliance report to users and DWQ?
■
n
n
n
(If the facility is = or > 5 MGD permitted flow) Do they operate 24/7 with a certified operator on each shift?
n
n
■
n
Is the ORC visitation log available and current?
■
n
n
n
Is the ORC certified at grade equal to or higher than the facilityclassification?
■
n
n
n
Is the backup operator certified at one grade less or greater than the facility classification?
■
❑
n
n
Is a copy of the current NPDES permit available on site?
■
n
n
n
Page # 3

•
l
.j
1
Permit: NCO075027 Owner - Facility: Cains Way Mobile Home Park
Inspection Date: 04/23/2009 Inspection Type: Compliance Evaluation
Record Keeping
Yes
No
NA
NE
Facility has copy of previous year's Annual Report on file for review?
❑
❑
❑
■
Comment:
Effluent Pipe
Yes
No
NA
NE
Is right of way to the outfall properly maintained?
■
❑
❑
❑
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?
❑
❑
■
❑
Comment:
Flow Measurement - Effluent
Yes
No
NA
NE
# Is flow meter used for reporting?
■
❑
❑
❑
Is flow meter calibrated annublly?
■
❑
❑
❑
Is the flow meter operational?
■
❑
❑
❑
(If units are separated) Does the chart recorder match the flow meter?
a
■
❑
❑
Comment: Chart. recorder hasn't worked since Dec 2008
Type of bar screen
a.Manual
■
b.Mechanical
❑
Are the bars adequately screening debris?
■
n
n
n
Is the screen free of excessive debris?
■
❑
❑
❑
Is disposal of screening in compliance?
■
n
n
n
Is the unit in good condition?
■
❑
❑
❑
Comment:
Equalization Basins
Yes
No
NA
NE
Is the basin aerated?
■
❑
n
n
Is the basin free of bypass lines or structures to the natural environment?
■
n
n
n
Is the basin free of excessive grease?
■
n
n
n
Are all pumps present?
■
❑
❑
n
Are all pumps operable?
■
o
❑
❑
Are float controls operable?
❑
❑
❑
■
Are audible and visual alarms operable?
n
n
n
■
Page # 4

I
Permit: NC0075027 Owner - Facility: Cains Way Mobile Home Park
Inspection Date: 04/23/2009 Inspection Type: Compliance Evaluation
Equalization Basins
Yes
No
NA NE
# Is basin size/volume adequate?
■
0
00
Comment:
Secondary Clarifier
Yes
No
NA NE
Is the clarifier free of black and odorous wastewater?
■
n
n
n
Is the site free of excessive buildup of solids in center well of circular clarifier?
■
fl
n
n
Are weirs level?
■
❑
171
1-1
Is the site free of weir blockage?
■
n
Q
n
Is the site free of evidence of short-circuiting?
■
❑
n
Is scum removal adequate?
■
❑
❑
- (3,
Is the site free of excessive floating sludge?
■
n
n
Is the drive unit operational?
❑
❑
n
■
Is the return rate acceptable (low turbulence)?
n
n
fl
■
Is the overflow clear of excessive solids/pin floc?
■
❑
n
n
Is the sludge blanket level acceptable? (Approximately %. of the sidewall depth)
❑
n
❑
■
Comment:
Aeration Basins
Yes
No
NA
NE
Mode of operation
Ext.
Air
Type of aeration system
Diffused
Is the basin free of dead spots?
■
Q
❑
n
Are surface aerators and mixers operational?
■
Are the diffusers operational?
■
❑
❑
n
Is the foam the proper color for the treatment process?
■
Does the foam cover less than 25% of the basin's surface?
■
n
n
Is the DO level acceptable?
n
n
n
■
Is the DO level acceptable?(1.0 to 3.0 mg/1)
n
n
n
■
Comment:
r)a-rhlnrina+inn
Yes
No
NA
NE
Type of system ? Tablet
Is the feed ratio proportional to chlorine amount (1 to 1)? ❑ ❑ ■ n
Is storage appropriate for cylinders? ■ ❑ Q
Page # 5

0
Permit: NCO075027 Owner - Facility: Cains Way Mobile Home Paris
Inspection Date: 04/23/2009 Inspection Type: Compliance Evaluation
De -chlorination Yes No NA NE
# Is de -chlorination substance stored away from chlorine containers? ■ U U U
Are the tablets the proper size and type? ■ n n n
'Comment: dechlor in chlorinator, chlorine tabs in clarifier troughs
Are tablet de -chlorinators operational? n n ■ ❑
Number of tubes in use? 0
Comment: Dechlor unit not yet constructed
Disinfection -Tablet Yes No NA NE
Are tablet chlorinators operational?
❑
❑
■
❑
Are the tablets the proper size and type?
■
n
on
=
Number of tubes in use? _.
0:,
Is the level of chlorine residual acceptable?
❑
n
n
E.
Is the contact chamber free of growth, or sludge buildup?
■
❑
n
n
Is there chlorine residual prior to de -chlorination?
:n
n
n
■ '
Comment: chlorine tablets in clarifier troughs, dechlor in chlorinator
Effluent Sampling
Yes
No
NA
NE
Is composite sampling flow proportional?
n
n
In
■
Is sample collected below all treatment units?
■
n
n
n
Is proper volume collected?
❑
❑
n
■
Is the tubing clean?
■
❑
❑.
# Is proper temperature set for sample storage (kept at less than or equal to 6.0 degrees Celsius)?
n
n
n
■
Is the facility sampling performed as required by the permit (frequency, sampling type representative)?
■
n
n
n
Comment:
Uestream / Downstream SamDlina
Yes
No
NA
NE
Is the facility sampling performed as required by the permit (frequency, sampling type, and sampling location)? 0 n n n
Comment:
Page # 6

r
Faxed To: Bradley Flynt
Fax #: [phone] Phone [phone]
VWVTP Annual Inspection Checklist
This information should be available to the inspector at inspection time.
Facility: Cain's Way MHP NPDES: NC0075027
Permit Effective Dates: 7/01/2007 to 212912012
Inspection Date: April Z3, 2009 Inspection Time: am
./1) DMRs (Dates: January 2008 to December 2008 )
2) Lab Data (per DMR dates)
—3) Laboratories used for analysis & certification #'s
e--4) Chain of Custody forms (per DMR dates)
✓5) Complete copy of current NPDES permit
pplicable)
ORC and Back-up ORC current certification �%/r�y A
8) Wastewater Annual Report (fiscal or calendar year — if applicable)
�) Daily Operator's log / ORC visitation log
0) Maintenance log
e,l1.) Process control data (which includes field parameters tested and equipment
calibrations)
t-12) Field Parameter certification (if applicable) prs-- 2�'1
Flow meter calibration records (if applicable)
--t4) Influent and/or effluent samplers riy�
• tom-_
.15) Flow charts (If applicable) G2i
'PnPr'r3tf�f IncF..n+in.� / iriJor Ir.�rJ rhGCk$. ��G[S , Y!'®✓'� "
17) Spill Response Plan (with current emergency contact numbers) /� 2Q K
--'f8). Sludge / Residuals hauling records (if applicable) 5.�rJ�
Plant visual inspection of treatment units
20) Stream accessible for inspection (at effluent discharge pipe)
Please call with questions:
Rose Pruitt
NC Department of Environment & Natural Resources
Division of Water Quality
Winston-Salem Regional Office
[phone]
Fax: [phone]

MONITORING REPORT(MR) VIOLATIONS for: Report Date: 04/29/09 Page: 1 of 1
,r,'1'"'*r. .�,`??;:,'n«-°" rr';f "y�,..`",-,,. ^i«MM 3*n-- ar�ir��.�r,.r�m+�s+m-^ Rr.^4, ^^*rYrr^.,. ^.^ni t5+r,+-- :�-m�w.v,r�, -.
„Permit: nc0s?75027>.. MRs Between: 1-20d8_i.,,antl = �2 20d8 ;Region: °lo «'x Violation Category %,. '' Program Category. °!°
Facility.Name 1p ParamNbfn County'.% Subbasm °j°}-Violation'Aciion:'0!°' s
Major Minor
PERMIT: NCO075027
FACILITY: Cains Way Homeowners Association - Cains Way Mobile
COUNTY: Forsyth
REGION: Winston-Salem
Home Park
Limit Violation
MONITORING OUTFALL/
VIOLATION
UNIT OF
CALCULATED
REPORT PPI LOCATION
PARAMETER
DATE
FREQUENCY
MEASURE
LIMIT
VALUE
VIOLATION TYPE
VIOLATION ACTION
04 -2008 001 Effluent
BOD, 5-Day (20 Deg. C)
04/10/08
Weekly
mg/I
16.5
22
Daily Maximum Exceeded
Proceed to NOV
05 -2008 001 Effluent
BOD, 5-Day (20 Deg. C)
05/29/08
Weekly
mg/I
16.5
32
Daily Maximum Exceeded
Proceed to NOV
09 -2008 001 Effluent
BOD, 5-Day (20 Deg. C)
09/25/08
Weekly
mg/I
16.5
26
Daily Maximum Exceeded
Proceed to NOV
09 -2008 001 Effluent
Coliform, Fecal MF, M-FC
09/10/08
Weekly
#/100ml
400
600
Daily Maximum Exceeded
Proceed to NOV
Broth,44.5C
Monitoring Violation
MONITORING OUTFALL/
VIOLATION
UNIT OF
CALCULATED
REPORT PPI LOCATION
PARAMETER
DATE
FREQUENCY
MEASURE
LIMIT
VALUE
VIOLATION TYPE
VIOLATION ACTION
09 -2008 001 Effluent
Flow, in conduit or thru
09/27/08
Continuous
mgd
Frequency Violation
Proceed to NOV
treatment plant
09 -2008 001 Effluent
Flow, in conduit or thru
09/28/08
Continuous
mgd
Frequency Violation
Proceed to NOV
treatment plant
Reporting Violation
MONITORING OUTFALL/
VIOLATION
UNIT OF
CALCULATED
REPORT PPI LOCATION
PARAMETER
DATE
FREQUENCY
MEASURE
LIMIT
VALUE
VIOLATION TYPE
VIOLATION ACTION
10 -2008
12/01i08
Late/Missing DMR
No Action, BPJ
11 -2008
12/31/08
Late/Missing DMR
No Action, BPJ

o�oF wAT F9QG
C r
CERTIFIED MAIL 7008 0500 0002 0609 3437
Michael F. Easley, Governor
William G. Ross Jr., Secret°i . .
North Carolina Department of Environment and Natural )tesources
Coleen H. Sullins Director
Division of Water Quality
January 5, 2009
RETURN RECEIPT REQUESTED
Cains Way Homeowners Association
PO Box 846
Walkertown NC 27051
Subject: NOTICE OF, VIOLATION
Permit No. NCO075027
Cains Way Mobile Home Park
Forsyth County
Dear Mr. Cain:
A review of Cains Way Mobile Home Park's monitoring report for September 2008 showed the
following violations:
Parameter
Date
Limit Value
Reported Value
Limit Type
Coliform, Fecal MF, M-FC
09/10/08
400 #/100m1
600 #/100m1.
Daily Maximum,
Broth,44.5C
Exceeded
BOD, 5-Day (20 Deg. C)
09/25/08
16.5 mg/1
26 mg/1
Daily Maximum
Exceeded
Parameter
Date
Measuring
Frequency
Violation
Flow, in conduit or thru treatment plant
09/28/08
Continuous
Frequency Violation
Flow, in conduit or thru treatment plant
09/27/08
Continuous
Frequency Violation
Remedial actions should be taken to correct this problem. The Division of Water Quality may
pursue enforcement action for this and any additional violations of State law.
To prevent further action, carefully review these violations and deficiencies and respond in
writing to this office within 30 working day of receipt of this letter. You should address the
causes of noncompliance and all actions taken to prevent the recurrence of similar situations. If
you should have any questions, please do not hesitate to contact Rose Pruitt at 336-771-5000.
Sincerely,
teve W Tedder
Water Quality Regional Supervisor
Winston-Salem Region
Division of Water Quality
Cc: Central Files =SWP
585 Wauqhtown Street Winston-Salem, NC 27107 336-771-5000 (Telephone) 336-771-4630 (Fax)

S
Cover Sheet from
Staff Member to
Regional Supervisor
DMR Review Record
Facility:. C4 DNS Permit/Pipe No.: IUC, n0!1 60 2% Month/Year
ZOO g
Monthly Average Violations
Parameter Permit Limit DMR Value % Over Limit
Wee /Daily Violations
Date
Parameter
Permit Limit/Type
DMR Value % Over Limit
2� o
�5•v
Q�D�
..�
q' 4 "
�irCAL, 60 U O:
&.0
(D 0 0 K0 t��
Monitoring
Frequency Violations
Date
Parameter
Permit Frequency
Values Reported # of Violations
-27-08
C-t o iA/
CA -' 7
Other Violations
Completed by:
Regional Water Quality
Supervisor Signoff: Date:
A/h/
NoV 2,0

r '
EFFLUENT
( April 1 through October 31)
NPDES PERMIT NO.: NCO075027
DISCHARGE NO.: 001
ONTH: September
YEAR: 2008
FACILITY NAME: Cains Way MHP CLASS: 11
COUt�tTY::Farsytfi'`
DEC 2000
OPERATOR IN RESPONSIBLE CHARGE:
Bradley F nt
GRAD V PHONE:36
445-9824-
CERTIFIED LABORATORIES:
(1) Wa Tech Inc
(2)?'FYI
IL4 j
Check box if orc has changed [ ]
PERSON(S) COLLECTING SAMPLES:
Bradley Flynt
9@gt. of EIVR A A
Mail ORIGINAL and ONE COPY to: DEC 9 6 2008 �
ATTN: CENTRAL FILES X �/� � ' DEC 5 2008
DIVISION OF WATER QUALITY (SIGNATURE OF ) DATEWinston-Salem
DENR BY THIS SIGNA E, RTIFY THAT THIS REPORT IS ROgional Office
1617 MAIL SERVICE CENTER ACCURATE AND COMPLETE TO THE BEST OF MY KNOWLED
RALEIGH, NC 27699-1617

Cains Way MHP Status: (Please check one of the following)
All monitoring data and sampling frequencies meet permit requirements [ ]
Compliant
All monitoring data and sampling frequencies do NOT meet permit requirements [ ]
Noncomplian,
If the facility is noncompliant, please comment on corrective actions being taken in respect to equipment, operation,
maintenance, etc, and a time table for improvements to be made.
J)Lr;IL( B06 Ln�4 EXurco,oNab �\n� 9/�9 16 %%�foY 7c"�w,� 29j�0e�Iflrj,
40 Co1,'/1Q 10 7btle/ � ginkeo. CIC6,eld-ceU/.
37r6ken 5ee-Aerm
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision
in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information sub-
mitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for
gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and com-
plete. I am aware that there are significant penalties for submitting false information, including the possibility of fines
and imprisonment for knowing violations."
Permittee Address:
O1
PARAMETER CODES
00010 Temperature
00076 Turbidity
00080 Color (Pt -Co)
00082 Color (ADM[)
00300 Dissolved Oxygen
00310 B O D 5
00340 C O D
00400 pH
00530 T S S
00545 Settleable Solids
00556 Oil and Grease
00600 Total Nitrogen
00610 Ammonia Nitrogen
00625 Total Kjeldah
Nitrogen
00630 Nitrate/Nitrite
00665 Total Phosporous
00720 Cyanide
00745 Total Sulfide
00927 Total Magnesium
00929 Total Sodium
00940 Total Chloride
00951 Total Fluoride
01002 Total Arsenic
01027 Cadmium
Permittee (Please print or type)
Signature of Pemtittee—
Phone Number. Permit Exp. Date
May�2ee�-
01032 Hexavalent
Chrc 32730 Total Phenolics
01034 Chromium 34235 Benzene
01037 Total Cobal34481 Toluene
01042 Copper 38260 MBAS
01045 Iron 39516 PCBs
01051 Lead 50050 Flow
01067 Nickel 50060 Total Residual
01077 Silver Chlorine
01092 Zinc 71880 Formal-
01105 Alumimum dehyde
01147 Total Selen 71900 Mercury
31616 Fecal Colifc 81551 Xylene
Parameter Code assistance may be obtained by calling the Water Quality Compliance Group at [phone] ext 581 or 534
The monthly average for fecal coliform is to be reported as a GEOMETRIC mean. Use only units designed in the reporting
facility's permit for reporting data.
* ORC must visit the facility and document visitation of facility as required per 15A NCAC 8A .0202(b)(5)(B)
** If signed by other than the permittee, delegation of signatory authority must be on file with the state per
15A NCAC 213.0506 (b)(2)(D)

NV DES PERMIT NO:NC0075027 DISCHARGE NO.: 001 MONTH:September YEAR: 2008
FACILITY NAME: Cains Way MHP COUNTY:Forsyth
STREAM: Ader Creek LOCATION: @ 100ft Above Discharge Point STREAM: Ader Creek LOCATION: @ NCSR 1979
UPSTREAM
DOWNSTREAM
DEM Form MR-3 (12/93) DEM Form MR-3 (12193)

MONITORING REPORT(MR) VIOLATIONS for:
Ilan:°!o
IIn
z�
Report Date: 12/22/08 Page: 1 of 1
�tegory .Q K o Program Category °Io '
lbbasln Vtolatton Action °lo r,
4
PERMIT: NCO076027 FACILITY: Cains Way Homeowners Association - Cains Way Mobile
COUNTY: Forsyth
REGION: Winston-Salem
Home Park
Limit Violation
MONITORING OUTFALL /
VIOLATION
UNIT OF
CALCULATED
REPORT PPI
LOCATION
PARAMETER
DATE
FREQUENCY
MEASURE
LIMIT
VALUE
VIOLATION TYPE
VIOLATION ACTION
04 -2008 001
Effluent
BOD, 5-Day (20 Deg. C)
04/10/08
Weekly
mg/I
16.5
22
Daily Maximum Exceeded
Proceed to NOV
05 -2008 001
Effluent
BOD, 5-Day (20 Deg. C)
05/29/08
Weekly
mg/I
16.5
32
Daily Maximum Exceeded
Proceed to NOV
09 -2007 001
Effluent
Coliform, Fecal MF, M-FC
09/06/07
Weekly
#/100ml
400
6,000
Daily Maximum Exceeded
Proceed to NOV
Broth,44.5C
12 -2007 001
Effluent
Coliform, Fecal MF, M-FC
12/13/07
Weekly
#/100ml
400
580
Daily Maximum Exceeded
Proceed to NOV
Broth,44.5C
Monitoring Violation
MONITORING OUTFALL/
VIOLATION
UNIT OF
CALCULATED
REPORT PPI
LOCATION
PARAMETER
DATE
FREQUENCY
MEASURE
LIMIT
VALUE
VIOLATION TYPE
VIOLATION ACTION
11 -2007 001
Effluent
BOD, 5-Day (20 Deg. C)
11/03/07
Weekly
mg/I
Frequency Violation
None
11 -2007 001
Effluent
Coliform, Fecal MF, M-FC
11/03/07
Weekly
#/100ml
Frequency Violation
None
Broth,44.5C
11 -2007 001
Effluent
Nitrogen, Ammonia Total (as
11/03/07
Weekly
mg/I
Frequency Violation
None
11 -2007 001
Effluent
Solids, Total Suspended
11/03/07
Weekly
mg/I
Frequency Violation
None

O�0 W A T��QG
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Ms. Eleanor Wood
Cainway Homeowners Association
7005 Cain Forest Court
Walkertown, North Carolina 27051
Dear Ms. Wood:
Coleen H. Sullins,' or
1
Division of Wat�uality
ED
December 18, 2008 itECpof
h... Dept of E
EPlR
BE 2 2 2008
vdir,o,on-Salem
Reg;onaf Office
SUBJECT: Authorization to Construct
A to C No. 075027AOI
Cainway Homeowners Association
Cainway Homeowners Association WWTP
Dechlorination Facilities
Forsyth County
A fast track application for Authorization to Construct dechlorination facilities. was
received on December 3, 2008, by the Division. Authorization is hereby granted for the
construction of modifications to the existing Cainway Homeowners Association WWTP, with
discharge of wastewater effluent into Ader Creek in the Roanoke River Basin.
This authorization results in no increase in design or permitted capacity and is awarded
for the construction of the following specific modifications:
Installation of a dechlorination system utilizing sodium sulfite pursuant to the fast
track application received on December 3, 2008, and in conformity with the
Minimum Design Criteria for Dechlorination Facilities.
This Authorization to Construct is issued in accordance with Part III, Paragraph A of
NPDES Permit No. NC000075027 issued, and shall be subject to revocation unless the
wastewater treatment facilities are constructed in accordance with the conditions and limitations
specified in Permit No. NC0075027.
In the event that the facilities fail to perform satisfactorily, including the creation of
nuisance conditions, the Permittee shall take immediate corrective action, including those as may
be required by this Division, such 'as the construction of additional or replacement wastewater
treatment or disposal facilities.
NorthCarolina
Naturally
North Carolina Division of Water Quality 1617 Mail Service Center Raleigh, NC 27699-1617 Phone [phone] Customer Service
Internet: xm.ncwateMuality.orq 512 N. Salisbury St. Raleigh, NC 27604 FAX [phone]
An Equal Opportunity/Affirmative Action Employer— 50% Recycled110% Post Consumer Paper

Ms. Eleanor Wood
December 18, 2008
Page 2 ,
The Winston-Salem Regional Office, telephone number (336) 771- 5000 shall be notified
at least forty-eight (48) hours in advance of operation of the installed facilities so that an on site
inspection can be made. Such notification to the regional supervisor shall be made during the
normal office hours from 8:00 a.m. until 5:00 p.m. on Monday through Friday, excluding State
Holidays.
Upon completion of construction and prior to operation of these permitted facilities, the
attached Engineer's Certification form must be received from a professional engineer certifying
that the permitted facility has been installed in accordance with the NPDES Permit and this
Authorization to Construct. Mail the Certification to: Construction Grants & Loans,
DWQ/DENR, 1633 Mail Service Center, Raleigh, NC 27699-1633.
Upon classification of the facility by the Certification Commission, the Permittee shall
employ a certified wastewater treatment plant operator to be in responsible charge (ORC) of the
wastewater treatment facilities. The operator must hold a certificate of the type and grade at least
equivalent to or greater than the classification assigned to the wastewater treatment facilities by
the Certification Commission.
The Permittee must also employ a certified back-up operator of the appropriate type and
grade to comply with the conditions of T15A:8G.0202. The ORC of the facility must visit each
Class I facility at least weekly and each Class II, III and IV facility at least daily, excluding
weekends and holidays, must properly manage the facility, must document daily operation and
maintenance of the facility, and must comply with all other conditions of T15A:8G.0202.
A copy of the approved plans and specifications shall be maintained on file by the
Permittee for the life of the facility.
During the construction of the proposed additions/modifications, the permittee shall
continue to properly maintain and operate the existing wastewater treatment facilities at all times,
and in such a manner, as necessary to comply with the effluent limits specified in the NPDES
Permit.
You are reminded that it is mandatory for the project to be constructed in accordance
with the North Carolina Sedimentation Pollution Control Act, and, when applicable, the North
Carolina Dam Safety Act. In addition, the specifications must clearly state what the contractor's
responsibilities shall be in complying with these Acts.
Prior to entering into any contract(s) for construction, the recipient must have obtained all
applicable permits from the State.
Failure to abide by the requirements contained in this Authorization to Construct may
subject the Permittee to an enforcement action by the Division of Water Quality in accordance
with North Carolina General Statute 143-215.6A to 143-215.6C.
The issuance of this Authorization to Construct does not preclude the Permittee from
complying with any and all statutes, rules, regulations, or ordinances which may be imposed by
other government agencies (local, state, and federal) which have jurisdiction.

t Ms. Eleanor Wood
r
December 18, 2008
Page 3
If you have any questions or need additional information, please do not hesitate to contact
Seth Robertson, P.E. at telephone number [phone].
Sincerely,
d7c 1TOAL:)
a,&?
Coleen H. Sullins .
swc/sr
cc: J. Thurman Horne, P.E., Horizon Engineering & Consulting, Inc., 2510 Walker Rd.,
Mount Pleasant, NC 28124
Forsyth County Health Department
Technical Assistance and Certification
Point Source Branch, NPDES Program
Daniel Blaisdell, P.E.
Seth Robertson, P.E.
Steve Coffey, P.E.
ATC File No. 075027AO1

Cainway Homeowners Association
A To C No. 075027AOI
Issued December 18, 2008
Engineer's Certification
I, , 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 modifications and improvements to the Cainway Homeowners
Association WWTP, located on Pinehall Road in Forsyth County for Cainway Homeowners
Association, hereby state that, to the best of my abilities, due care and diligence was used in the
observation of the following construction:
Installation of a dechlorination system utilizing sodium sulfite pursuant to the fast
track application received on December 3; 2008, and in conformity with the
Minimum Design Criteria for Dechlorination Facilities.
I certify that the construction of the above referenced project was observed to be built
within substantial compliance and intent of the approved plans and specifications.
Signature
Date
Registration No.
Send to: Construction Grants & Loans
DENR/DWQ
1633 Mail Service Center
Raleigh, NC 27699-1633

0;?/04/2007 02:29 3365954666 DON AND TAMMIE CAIN PAGE 03/05
Pagel of 1
June 23, 2008
Dear Mr. Roberts:
I am writing to you with a formal complaint against Aqua North Carolina on behalf of the Calns Way Home
Owners Association in regards to our missing records ! These records where taken from our plant without
our knowledge while under contract with your company during 2007 by one of your employees that frequent
our plant. I am including a copy of the front page of a Violation of our permit NCO075027 , for Not having the
Required records and Lab Data for Jan. through Aug. of 2007, IN WHICH YOUR COMPANY WAS
RESPONSIBLE for keeping and maintaining copies to be left on our premises at all times. I am
also including a copy of the NOTICE that your company sent to'us stating their last day of services to us
would cease as of August 30th , 2007 . At which same time also corresponding with our Records as
to when they went missing as well . We are not sure if they where purposely or mistakenly removed
by Tim Waddell of Altantic Utility, INC,, or possibly by someone else from AQUA. None the less _
they where removed without our permission and or Notification of your intentions to do so . We have been
put out by your Companies Actions to say Me least.
We would appreciate it very much if you would Please Investigate this matter in a timely manner as to
where our records in question ,are and return them back to us as soon as possible . As it stands right now .
we are in Violation with the State because of your Companies Negligent Actions I
Please call me if you have any questions concerning this matter at the below number. Also please send
any correspondence to me as well to the address below.
In advance , THANK YOU ! , for your prompt Attention to this most serious matter!
Tammie Cain
0075 SUU_IVANTOWN , RD.
WALKERTOWN , NC., 27051
1 (336) 6954666
CC, ROSE PRUITT
Division Of Water Quialiry

03/04/2007 02:29 3365954666 DON AND TAMMIE CAIN
PAGE 04/05
Aqua North Carolina, Inc.
202 MacKenan Court
Cary, NC 27511
July 26, 2007
Cainsway Homeowners Association
Cainsway Mobile Home Park
P.O. Box 846
Walkertown, NC 27051
p,e: Contract Operations of Cainsway Mobile Home Park
Dear Mr. Cain:
1m
T 919.467.8712
F; 919,460.1788
www.aquanorthcarolina.com
Aqua North Carolina currently contract operates the wastewater system for Cainsway
Mobile Home Park_ Effective August 31, 2007, Aqua North Carolina will discontinue the
contract operations for this mobile home park and it will be necessary for you to locate another
company to operate the system.
You may also be aware that we have changed operators of your wastewater treatment
plant. Through the end of August, ,Aqua North Carolina has contracted the operation of your
wastewater system with Tim Waddell of Atlantic Utility, Inc.
We appreciate the opportuaaity of providing this service to you. If you have any
questions, you may contact our office at 919-467-8712.
RC/rt
Sincerely,
Reid Campbell
Regional Manager of Compliance
An Aqua America Company

03/04/2007 02:29
y
O _ �
3365954666
CIEgJIEXED_NAIL 7008 0150 0002 83421337
RETURN RECEIPT REQUESTED
Richard Donald Caazt
Cains Way Homeowners Association
6075 Sullivantown Rd
Walk.ertown NC 27051
CERIMED IVY QL 7008 0150 0002 83421344
RETURN RECEIPT REQUESTED
Thomas Roberts, President
,Aqua North -Carolina Inc
PO Box 4889 '
Cary NC 27519-4889 a
Dear Mr. Cain:
DON AND TAMMIE CAIN
PAGE 05/05
Ar1fduug F. Easley, Governor
Wflllam G. Ross Jr., Secretary
North Carolina Deparupetit of Environment and Natural Resources
Ccdeen N_ Sullins, Director
Division of Water Quality
June 11, 2008
SUBJECT: CompUance Evaluation Inspection
Notice of Violation : NOV-2008-PC-0397
Cains Way Mobile Home Park
Permit No. NCO075027
Forsyth County
A Compliance Evaluation lwpecbon (CEI) was perforated on the Cains Way Mobile Home Park
wastewater treatment plant on Juice 4, 2008 by Rose Pruitt of the Winston-Salem Regional Office.
Bradley Flynt, ORC was present for the inspection.
The inspection consisted of two parts: an on -site inspection of the treatment facility and a file
review. The treatment facility was, found to be in violation of permit NCO075027 for the
following:
Inspection Area
CompliaA.ce Issue
Records/Reports
Records not kept and maintained as required by permit
Record Keeping
Facility DMR records for Jan - Aug 2007 are missing. According to The ORC these
records were removed by Aqua NC in August 2007.
Record Keeping
Lab Data for Jan -Aug 2007 missing
Record Keeping
Chain of Custody's for Jan -Aug 2007 inissing
Record Keeping
ORC states he could not prepare Annual report without missing records.
The following are the -findings from the subject inspection.
585 Wnunhtown Street Winston-Salem_• NC 27107 Phone r3361771Z000 ' sway (3381771-4630

63/04/2007 02:29 3365954666 DON AND TAMMIE CAIN PAGE 01/05

60157
GcJaI Kertow &A, A/c.l ;Z%®. �
P
A0MCL Robe -f s , -PIr
Mq,L4ct AJ®vA C�w'a Tw C.
z.®a mots l4evtcm OaL4
ofgRX4 f nic .l -a� I i

03/03/2007 21:28' 3365954666
DON AND.TAMMIE CAIN
PAGE 01/01
Cainsway Homeowners Association
Cainsway Mobile Home Park
P-O. Box 846
Walkertown, NC 27051
Aqua North Carolina, Inc.
202 MacKenar, Court
Cary, NC 27511
July 26, 2007
Re: Contract Operations of Cainsway Mobile Home Park
Y_ 919.467.8712 iNN
F; 919,460,1788 i
www_aquanorthcarolina-com .
Dear Mr. Cain:
Aqua North. Carolina currently contract operates' the wastewater system for Cainsway
Mobile Horne Park. Effective August 31, 2007, Aqua North Carolina will discontinue the
contract operations for this mobile home park and it will be necessary for you to locate another
company to operate the system.
You may also be aware that we have changed operators. of your.wastewater treatment
plant. Through the, end of August, Aqua North Carolina has contracted the operation of your
wastewater system with Tim Waddell of Atlantic Utility, Inc.
We appreciate the opportunity of providing this service to you. If you have any
questions, you may contact our office at 919-467-8712.
RC/rt
Sincerely,
Reid Campbell
Regional Manager of Compliance
An Aqua America Company

&,� JA""w Z,
e-Y r, 7 it, ol 0-�
-I�a ree%,�

Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
June 11, 2008
CERTIFIED MAIL 7008 0150 0002 8342 1337
RETURN RECEIPT REQUESTED
Richard Donald Cain
Cains Way Homeowners Association
6075 Sullivantown Rd
Walkertown NC 27051
CERTIFIED MAIL 7008 0150 0002 8342 1344
RETURN RECEIPT REQUESTED .
Thomas Roberts, President
Aqua North Carolina Inc
PO Box 4889
Cary NC 27519-4889
SUBJECT: Compliance Evaluation Inspection
Notice of Violation: NOV-2008-PC-0397
Cains Way Mobile Home Park
Permit No. NCO075027
Forsyth County
Dear Mr. Cain:
Coleen H. Sullins, Director
Division of Water Quality
A Compliance Evaluation Inspection (CEI) was performed on the Cains Way Mobile Home Park
wastewater treatment plant on June 4, 2008 by Rose Pruitt of the Winston-Salem Regional Office.
Bradley Flynt, ORC was present for the inspection.
The inspection consisted of two parts: an on -site inspection of the treatment facility and a file
review. The treatment facility was found to be in violation of permit NCO075027 for the
following:
Inspection Area
Compliance Issue
Records/Reports
Records not kept and maintained as required by permit
Record Keeping
Facility DMR records for Jan - Aug 2007 are missing. According to the ORC these
records were removed by Aqua NC in August 2007.
Record Keeping
Lab Data for Jan -Aug 2007 missing
Record Keeping
Chain of Custody's for Jan -Aug 2007 missing
Record Keeping
ORC states he could not prepare Annual report without missing records.
The following are the findings from the subject inspection.
XXT
NOENN
585 Waughtown Street Winston-Salem, NC 27107 Phone [phone] Fax [phone]

Cains Way MHP
June 11, 2008
Page 2
I. Permit
The NPDES permit for the Cain's Way Mobile Home Park WWTP became effective July 1, 2007
and expires on February 29, 2012.The facility is located north of Walkertown on Pinehall Road in
Forsyth County. The permitted components of the 0.0432 MGD wastewater treatment plant
include;, aerated equalization basin, bar screen, splitter box, dual extended aeration basins, clarifier,
tertiary filters, and a chlorinator.
Discharge from said treatment works at the location specified is into Ader Creek, classified C
waters in the Roanoke River Basin.
II. Records/Reports
A review of the laboratory reports and Discharge Monitoring Reports (DMRs) for the Cains Way
MHP WWTP for the period January 2007 through December 2007 revealed that the facility had
three (3) limit violations. One was for exceeding monthly maximum limits for Nitrogen Ammonia
in July 2007, a penalty was assessed for this violation. One violation was for exceeding daily
maximum limits for Fecal Coliform in September 2007, a Notice of Violation was issued for this
violation. A violation for exceeding BOD in April 2007 was not of sufficient merit to receive any
further action. Nine Monitoring Violations were noted for this facility. Operations records for this
facility were incomplete. Daily operator's and maintenance logs, a spill response plan, and sludge
hauling records were available. A complete copy of the permit was on site.
Violations and deficiencies were noted in recordkeepin2:
DMR's were missing for January —August of 2007. The ORC stated that these
records had been removed by Aqua NC in August of 2007 and that he could not make
contact to obtain them.
• Sample analyses and lab data including COC's were missing for January —August of
2007. The ORC stated that these records had been removed by Aqua NC in August of
2007 and that he could not make contact to obtain them.
• A copy of the annual report for 2007 was not available. The ORC stated that he could
not prepare one because he could not obtain access to the Jan -Aug 2007 records from
Aqua NC.
III. Facility Site Review
The facility site review indicated that the 0.0432 MGD treatment works is consistent with the
permitted components. The actual treatment system consists of an aerated equalization basin, bar
screen, splitter box, dual extended aeration basins, clarifier, tertiary filters, and a chlorinator.
IV. , Effluent / Receiving Stream
The WWTP discharges to Ader Creek, classified C waters in the Roanoke River Basin.
The effluent was clear and free of visible solids on the date of inspection. The receiving stream
was free of solids, foam and debris.

Cains Way MHP
June 11, 2008
Page 3
V. Flow Measurement
Effluent flow is measured with an Isco 3230 bubble flow meter that was last calibrated on May 31,
2008 by Horizon Eng.
VI. Self -Monitoring Program
A review of the laboratory reports and Discharge Monitoring Reports (DMRs) for the Cains Way
MHP WWTP for the period January 2007 through December 2007 revealed that the facility had
three (3) limit violations. One was for exceeding monthly maximum limits for Nitrogen Ammonia
in July 2007, a penalty was assessed for this violation. One violation was for exceeding daily
maximum limits for Fecal Coliform in September 2007, a Notice of Violation was issued for this
violation. A violation for exceeding BOD in April 2007 was not of sufficient merit to receive any
further action. Nine Monitoring Violations were noted for this facility.
VII. Compliance Schedules
No compliance schedules to evaluate.
VIII. Laboratory
Sample analyses are reportedly conducted by Tritest Labs, Inc, in Clemmons, NC. The laboratory
was not reviewed at the time of the subject inspection.
The certificate for the DWQ Laboratory Certification Program for Field Parameters issued to Bell
Enterprises was current.
IX. Operation and Maintenance
Operation and maintenance at the time of the subject inspection was deemed satisfactory.
X. Sludge Utilization/Disposal
20,000 gal of solids were last removed on May 8, 2008 by Atlantic Utility.
XI. Pretreatment
Not evaluated during this inspection. No pretreatment program required.
XII. Stormwater
Not evaluated during this inspection.
XIV. Sewer Overflow
No Sewer Overflows reported.

Cains Way MHP
June 11, 2008
Page 4
XV. Pollution Prevention
Not evaluated during this inspection.
XVI. Multimedia
Not evaluated during this inspection.
The Division of Water Quality will greatly appreciate your prompt attention to the non-compliance
issues noted in this inspection. Your permit is very specific about the types of reports and records
that must be retained, the length of time they must be retained and your responsibility to furnish
them on request.
to Provide Information:
The permittee shall furnish to the Permit Issuing Authority, within a reasonable time, any
information which the Permit Issuing Authority may request to determine whether cause exists for
modifying, revoking and reissuing, or terminating this permit. The permittee shall also ficrnish to
the Permit Issuing Authority upon request, copies of records required to be kept by this permit.
Please provide this office with the followinLy records within 30 days from receipt of this
notice.
a) All Permittee's copies of DMR's for period between January 2007 and August
2007.
b) Chain of custody forms (per DMR dates) for lab data for the same period.
c) Lab Data per DMR dates (from a certified lab) for the same period.
d) Annual Report for 2007.
The report and all supporting documentation must be received in this Office no later than 30 days
from receipt of this letter.
Please refer to the enclosed inspection report for additional observations and comments. If you or
your staff has any questions, please call Rose Pruitt at 336-771-5000.
Sincerely,
Steve W. Tedder
Water Quality Regional Supervisor
Winston-Salem Regional Office
Division of Water Quality
Attachments
cc: Bradley Flynt, ORC: 8467 Southerard Rd, Stokesdale NC 27357
Central Files
smffiO*

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 2 151 31 NCO075027 111 121 08/06/04 117 181 CI 191 sl 201 1
Remarks
21111111111111111111111111111111111111111111111116
Inspection Work Days Facility Self -Monitoring Evaluation Rating B1 QA --------------------------- Reserved ----------------------
671 169 701 1 711 1 721 N I 73 I I 174 751 1 1 1 1 1 1 1 80
LEI
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)
08:50 AM 08/06/04
07/07/01
Gains Way Mobile Home Park
Exit Time/Date
Permit Expiration Date
Pinehall Rd
Walkertown NC 27051
10:10 AM 08/06/04
12/02/29
Name(s) of Onsite Representative(s)/Titles(s)/Phone and Fax Number(s)
Other Facility Data
Bradley Todd Flynt/ORC/336-433-7262/
Name, Address of Responsible Official/Title/Phone and Fax Number
Richard Donald Cain,6075 Sullivantown Rd Walkertown NC Contacted
27051//336-595-4666/ No
Section C: Areas Evaluated During Inspection (Check only those areas evaluated)
Permit Flow Measurement Operations & Maintenance Records/Reports
Self -Monitoring Program Sludge Handling Disposal Facility Site Review ® Effluent/Receiving Waters
Laboratory
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
Rose Pruitt WSRO WQ//336-771-5000/
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 Inspection Type
3I NCO075027 I11 12I 08/06/04 117 18ICI
(cont.)
Section D: Summary of_Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
The inspector was met at the facility by Bradley Flynt ORC. At the time of the inspection the facility
appeared well maintained. The effluent was clear with only a trace of foam. The stream was free of debris
and solids at the time of the inspection.
The ORC stated that paperwork related to the facility DMRs and associated lab reports for the months of
January - august 2007 had been removed from the facility in August 2007 by Aqua NC, additionally the
ORC stated he could not prepare the Annual report for this facility without the aformentioned reports.
Page # 2

Permit: NCO075027
Inspection Date: 06/04/2008
Owner - Facility: Cains Way Mobile Home Park
Inspection Type: Compliance Evaluation
Operations & Maintenance Yes No NA NE
Is the plant generally clean with acceptable housekeeping? ■ n 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:
(If the present permit expires in 6 months or less). Has the permittee submitted a new application?
n
n
■
n
Is the facility as described in the permit?
■
n
n
171
# Are there any special conditions for the permit?
❑
n
■
❑
Is access to the plant site restricted to the general public?
■
n
n
n
Is the inspector granted access to all areas for inspection?
■
n
n
n
Comment:
Record Keeping
Yes
No
NA
NE
Are records kept and maintained as required by the permit?
n
■
n
n
Is all required information readily available, complete and current?
n
■
n
n
Are all records maintained for 3 years (lab. reg. required 5 years)?
n
■
n
n
Are analytical results consistent with data reported on DMRs?
n
n
n
■
Is the chain -of -custody complete?
❑
❑
n
■
Dates, times and location of sampling
n
Name of individual performing the sampling
n
Results of analysis and calibration
n
Dates of analysis
Name of person performing analyses
Transported COCs
Are DMRs complete: do they include all permit parameters?
■
n
n
n
Has the facility submitted its annual compliance report to users and DWQ?
❑
®❑
n
(If the facility is = or > 5 MGD permitted flow) Do they operate 24/7 with a certified operator on each shift?
n
n
■
n'
Is the ORC visitation log available and current?
®
n
n
n
Is the ORC certified at grade equal to or higher than the facility classification?
■
n
n
n
Is the backup operator certified at one grade less or greater than the facility classification?
■
n
n
n
Is a copy of the current NPDES permit available on site?
■
n
n
n
Page # 3

4
Permit: NCO075027 Owner - Facility: Cains Way Mobile Home Park
Inspection Date: 06/04/2008 Inspection Type: Compliance Evaluation
Record Keeping Yes No NA NE
Facility has copy of previous year's Annual Report on file for review? n n n ■
Comment: Facility records for Jan - Aug 2007 are missing. according to ORC these
records were removed by Aqua NC in August 2007. ORC states he could not prepare
Annual report without missing records. ORC states he has been unable to reach Aqua
NC by phone.
Effluent Pipe
Yes
No
NA
Nt
Is right of way to the outfall properly maintained?
■
n
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
■
n
Comment:
Flow Measurement - Effluent
Yes
No
NA
NE
# Is flow meter used for reporting?
■
n
n
n
Is flow meter calibrated annually?
■
n
n
n
Is the flow meter operational?
■
n
❑
n
(If units are separated) Does the chart recorder match the flow meter?
n
n
■
n
Comment: ISCO 3230 calibrated 05/31/2008 by Horizon Eng
,. V.. M tie tiF
Type of bar screen
a.Manual
■
b.Mechanical
n
Are the bars adequately screening debris?
■
n
n
n
Is the screen free of excessive debris?
■
❑
❑
n
Is disposal of screening in compliance?
■
n
n
n
Is the unit in good condition?
■
n
n
n
Comment:
Equalization Basins
Yes
No
NA
NE
Is the basin aerated?
■
n
In
n
Is the basin free of bypass lines or structures to the natural environment?
■
n
n
n
Is the basin free of excessive grease?
■
n
n
n
Are all pumps present?
■
n
n
n
Are all pumps operable?
■
n
n
n
Page # 4

v
Permit: NCO075027 Owner - Facility: Cains Way Mobile Home Park
Inspection Date: 06/04/2008 Inspection Type: Compliance Evaluation
Equalization Basins
Yes
No
NA NE
Are float controls operable?
®
n
n
n
Are audible and visual alarms operable?
■
❑
❑
n
# Is basin size/volume adequate?
n
n
n
■
Comment:
Secondary Clarifier
Yes
No
NA NE
Is the clarifier free of black and odorous -wastewater?
■
❑
❑
n
Is the site free of excessive buildup of solids in center well of circular clarifier?
■
Are weirs level?
■
In
n
n
Is the site free of weir blockage?
■
n
n
n
Is the site free of evidence of short-circuiting?
■
n
Is scum removal adequate?
■
n
n
n
Is the site free of excessive floating sludge?
■
n
n
n
Is the drive unit operational?
n
❑
■
Is the return rate acceptable (low turbulence)?
■
❑
n
"n
Is the overflow clear of excessive solids/pin floc?
■
n
n
rl
Is the sludge blanket level acceptable? (Approximately''/4 of the sidewall depth)
❑
n
❑
■
Comment:
Aeration Basins
Yes
No
NA
NE
Mode of operation
Type of aeration system
Is the basin free of dead spots?
n
n
■
n
Are surface aerators and mixers operational?
❑
n
In
❑
Are the diffusers operational?
❑
❑
■
❑
Is the foam the proper color for the treatment process?
n
n
■
n
Does the foam cover less than 25% of the basin's surface?
n
n
■
❑
Is the DO level acceptable?
❑
❑
■
n
Is the DO level acceptable?(1.0 to 3.0 mg/1)
❑
❑
■
n
Comment:
De -chlorination
Yes
No
NA
NE
Type of system ?
Page
# 5

4
Permit: NCO075027
Inspection Date: 06/04/2008
Owner - Facility: Cains Way Mobile Home Park
Inspection Type: Compliance Evaluation
De -chlorination
Yes
No
NA
NE
Is the feed ratio proportional to chlorine amount (1 to 1)?
n
n
■
n
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
n
■
n
Are tablet de -chlorinators operational?
n
n
■
Number of tubes in use?
Comment:
Laboratory
Yes
No
NA
NE
Are field parameters performed by certified personnel or laboratory?
■
n
n
❑
Are all other parameters (excluding field parameters) performed by a certified lab?
■
n
n
n
# Is the facility using a contract lab?
■
n
n
n
# Is proper temperature set.for sample storage (kept at less than or equal to 6.0 degrees Celsius)?
n
n
■
n
Incubator (Fecal Coliform) set to 44.5 degrees Celsius+/- 0.2 degrees?
❑
❑
■
n
Incubator (BOD) set to 20.0 degrees Celsius +/- 1.0 degrees?
n
n
■
n
Comment: Tritest #103,•Bell Enterprises
Disinfection -Tablet
Yes
No
NA
NE
Are tablet chlorinators operational?
■
n
n
n
Are the tablets the proper size and type?
■
n
n
n
Number of tubes in use?
4
Is the level of chlorine residual acceptable?
n
n
n
Is the contact chamber free of growth, or sludge buildup?
■
n
n
n
Is there chlorine residual prior to de -chlorination?
n
n
n
■
Comment:
Effluent Sampling
Yes
No
NA
NE
Is composite sampling flow proportional?
n
n
n
■
Is sample collected below all treatment units?
®.F1
n
n
Is proper volume collected?
n
n
n
■
Is the tubing clean?
■
'n
n
n
# Is proper temperature set for sample storage (kept at less than or equal to 6.0 degrees Celsius)?
n
n
n
■
Page # 6

b
Permit: NCO075027
Inspection Date: 06/04/2008
Owner - Facility: Cains Way Mobile Home Park
Inspection Type: Compliance Evaluation
Effluent Sampling Yes No NA NE
Is the facility sampling performed as required by the permit (frequency, sampling type representative)? ■ Q ❑ f]
Comment: Isco 2710 sampler with ice
Upstream / Downstream Sampling Yes No NA NE
Is the facility sampling performed as required by the permit (frequency, sampling type, and sampling location)? ■ 0 ❑ Q
Comment:
Page # 7

t
Compliance Inspection Report
Permit: WQCSD0199 Effective: 03/01/00 Expiration: Owner: Cains Way Homeowners Association
SOC: Effective: Expiration: Facility: Cains Way MHP Collection System
County: Forsyth
Region: Winston-Salem
Contact Person: Richard Donald Cain Title: Phone: [phone]
Directions to Facility:
System Classifications:
Primary ORC: Certification: Phone:
Secondary ORC(s):
On -Site Representative(s):
Related Permits:
Inspection Date: 06/04/2008 Entry Time: 08:50 AM Exit Time: 10:10 AM
Primary Inspector: Rose Pruitt Phone: [phone]
Secondary Inspector(s):
Reason for Inspection: Routine Inspection Type: Compliance Evaluation
Permit Inspection Type: Deemed permitted collection system management and
operation
Facility Status: ❑ Compliant [1 Not Compliant
Question Areas:
Miscellaneous Questions ■ Performance Standards N.Operafion & Maint Reqmts Records
® Monitoring & Rpting N Inspections
Reqmts
(See attachment summary)
Page: 1

Permit: WQCSD0199 Owner - Facility: Cains Way Homeowners Association
Inspection Date: 06/04/2008 Inspection Type: Compliance Evaluation Reason for Visit: Routine
Inspection Summary:
Page: 2

u
a
Permit: WQCSDO199 Owner - Facility: Cains Way Homeowners Association
Inspection Date: 06/04/2008 Inspection Type: Compliance Evaluation
Performance Standards
Is Public Education Program for grease established and documented?
What educational tools are used?
Flyer
Is Sewer Use Ordinance/Legal Authority available?
Does it appear that the Sewer Use Ordinance is enforced?
Is Grease Trap Ordinance available?
Is Septic Tank Ordinance available (as applicable, i.e. annexation)
List enforcement actions by permittee, if any, in the last 12 months
Has an acceptable Capital Improvement Plan (CIP) been implemented?
Does CIP address short term needs and long term Vmaster plant/ concepts?
Does CIP cover three to five year period?
Does CIP include Goal Statement?
Does CIP include description of project area?
Does CIP include description of existing facilities?
Does CIP include known deficiencies?
Does CIP include forecasted future needs?
Is CIP designated only for wastewater collection and treatment?
Approximate capital improvement budget for collection system?
Total annual revenue for wastewater collection and treatment?
CIP Comments
Is system free of known points of bypass?
If no, describe type of bypass and location
Is a 24-hour notification sign posted at ALL pump stations?
# Does the sign include:
Instructions for notification?
Pump station identifier?
24-hour contact numbers
If no, list deficient pump stations
Reason for Visit: Routine
■nnn
nn■n
1 Page: 3

S
Permit: WQCSDO199 Owner - Facility: Cains Way Homeowners Association
Inspection Date: 06/04/2008 Inspection Type: Compliance Evaluation Reason for Visit: Routine
# Do ALL pump stations have an "auto polling" feature/SCADA? 0 ❑ ■ ❑
Number of pump stations
Number of pump stations that have SCADA
Number of pump stations that have simple telemetry
Number of pump stations that have only audible and visual alarms
Number of pump stations that do not meet permit requirements
# Does the permittee have a root control program? ❑ fl ■
# If yes, date implemented?
Describe:
Comment:
Inspections
Yes
No
NA
NE
Are maintenance records for sewer lines available?
0000
Are records available that document pump station inspections?
n
n
■
n
Are SCADA or telemetry equipped pump stations inspected at least once a week?
n
n
■
n
Are non-SCADA/telemetry equipped pump stations inspected every day?
n
n
■
n
Are records available that document citizen complaints?
❑
❑
■
# Do you have a system to conduct an annual observation of entire system?
■
❑
❑
0
# Has there been an observation of remote areas in the last year?
n
n
■
n
Are records available that document inspections of high -priority lines?
n
n
■
Has there been visual inspections of high -priority lines in last six months?
n
n
■
n
Comment:
Operation & Maintenance Requirements
Yes
No
NA
NE
Are all log books available?
■
n
00
Does supervisor review all log books on a regular basis?
■
n
n
n
Does the supervisor have plans to address documented short-term problem areas?
n
n
■
What is the schedule for reviewing inspection, maintenance, & operations logs and problem areas?
monthly
Are maintenance records for equipment available?
®
n
n
n
Is a schedule maintained for testing emergency/standby equipment?
DOED
What is the schedule for testing emergency/standby equipment?
Page: 4

Permit: WQCSDO199 Owner - Facility: Cains Way Homeowners Association
Inspection Date: 06/04/2008 Inspection Type: Compliance Evaluation
Reason for Visit: Routine
Do pump station logs include:
Inside and outside cleaning and debris removal?
n
n
■
Inspecting and exercising all valves?
fl
❑
■
n
Inspecting and lubricating pumps and other equipment?
n
n
■
❑
Inspecting alarms, telemetry and auxiliary equipment?
n
n
■
n
Is there at least one spare pump for each pump station w/o pump reliability?
❑
❑
■
n
Are maintenance records for right-of-ways available?
■
n
n
n
Are right-of-ways currently accessible in the event of an emergency?
■
n
n
n
Are system cleaning records available?
■
❑
❑
n
Has at least 10% of system been cleaned annually?
■
n
n
n
What areas are scheduled for cleaning in the next 12 months?
is a Spill Response Action Plan available?
■
Does the plan include:
24-hour contact numbers
❑
❑
❑
■
Response time
❑
❑
❑
■
Equipment list and spare parts inventory
■
n
n
n
Access to cleaning equipment
❑
n
■
n
Access to construction crews, contractors, and/or engineers
n
n
■
n
Source of emergency funds
❑
❑
■
n
Site sanitation and cleanup materials
■
n
n
n
Post-overflow/spill assessment
■
n
n
n
Is a Spill Response Action Plan available for all personnel?
n
n
n
■
Is the spare parts inventory adequate?
n
n
n
■
Comment: needs update
Yac
Mn
NA
NIP
Are adequate records of all SSOs, spills and complaints available?
n
n
■
n
Are records of SSOs that are under the reportable threshold available?
n
n
®fl
Do spill records indicate repeated overflows (2 or more in 12 months) at same location?
n
n
■
n
If yes, is there a corrective action plan?
nn■n
Is a map of the system available?
■
n
n
n
Page: 5

Permit: WQCSD0199 Owner - Facility: Cains Way Homeowners Association
Inspection Date: 06/04/2008 Inspection Type: Compliance Evaluation Reason for Visit: Routine
Does the map include:
Pipe sizes
Pipe materials
Pipe location
Flow direction
Approximate pipe age
Number of service taps
Pump stations and capacity
If no, what percent is complete?
List any modifications and extensions that need to be added to the map
# service taps
# Does the permittee have a copy of their permit?
Comment:
Monitoring and Reporting Requirements
Are copies of required press releases and distribution lists available?
Are public notices and proof of publication available?
# Is an annual report being prepared in accordance with G.S. 143-215.1 C?
# Is permittee compliant with all compliance schedules in the permits?
If no, which one(s)?
MOTI IT, IT -Tog
nn■n
Page: 6

&0V- 2- t-208- r�G-- 03f7
Faxed To: Bradley Flynt
Fax #: [phone] Phone [phone]
WWTP Annual Inspection Checklist
This information should be available to the inspector at inspection time.
Facility: Cain's Way MHP NPDES: NC0075027
Permit Effective Dates: 7/1/2007 to 212912012
Inspection Date: WED June 4, 2008 Inspection Time: 8:30 am (�
C � .
1) DMRs (Dates: January 2007 to December 2007 )
f2) Lab Data (per DMR dates)
3) Laboratories used for analysis & certification #'s -)ITV- ITVT ?4 (05 '1
Chain of Custody forms (per DMR dates)
4.-5) Complete copy of current NPDES permit
6) Status of SOC or Moratorium issuance (if applicable) V�
✓7) ORC and Back-up ORC current certification
�(_ ___-8) ' Wastewater Annual Report (fiscal or calendar year — if applicable) v�.zC
9) Daily Operator's log / ORC visitation log
,/10) Maintenance log
V11) Process control data (which includes field parameters tested and equipment
calibrations)
12) Field Parameter certification (if applicable) 'S
✓13) Flow meter calibration records (if applicable)
--'f4) Influent and/or effluent samplers '
,/1"5) Flow charts (if applicable) ma`s 3 0
�6)/M­Generator Inspection / under load checks
,,,,,17) Spill Response Plan (with current emergency contact numbers)
,,A8) Sludge / Residuals hauling records (if applicable) 5):(Af -ZD
✓19) Plant visual inspection of treatment units
�20) Stream accessible for inspection (at effluent discharge pipe)
Please call with questions: [1
Rose Pruitt I
NC Department of Environment & Natural Resources
Division of Water Quality
Winston-Salem Regional Office
[phone]
Fax: [phone] aV
Out
i

MONITORING REPORT(MR) VIOLATIONS for:
Report Date: 03/06/08 Page: 1 of 2
PERMIT: NCO075027
FACILITY: Cains Way Homeowners Association - Cains Way Mobile
COUNTY: Forsyth
REGION: Winston-Salem
Home Park
Limit Violation
MONITORING OUTFALL / LOCATION
PARAMETER
VIOLATION FREQUENCY
UNIT OF
LIMIT CALCULATED
VIOLATION TYPE VIOLATION ACTION
REPORT PPI
DATE
MEASURE
VALUE
04 -2007 001 Effluent
BOD, 5-Day (20 Deg. C)
04/25/07 Weekly
mg/I
16.5 17
Daily Maximum Exceeded No Action, BPJ
09 -2007 - 001 Effluent
Coliform, Fecal MF, M-FC
09/06/07 Weekly
#/100ml
400 6,000
Daily Maximum Exceeded Proceed to NOV
Broth,44.5C
12 -2007' 001 Effluent Coliform, Fecal MF, M-FC 12/13/07 Weekly
Broth,44.5C
07 -2007 001 Effluent Nitrogen, Ammonia Total (as 07/31/07 Weekly
N)
#1100ml 400
mg/I 2
580 Daily Maximum Exceeded None
3.16 Monthly Average Exceeded Proceed to
Enforcement Case
Monitoring Violation -
MONITORING OUTFALL /
LOCATION
PARAMETER
VIOLATION
FREQUENCY
UNIT OF LIMIT CALCULATED
VIOLATION TYPE
VIOLATION ACTION
REPORT PPI
DATE
MEASURE VALUE
1/
11-2007 001
Effluent
BOD, 5-Day (20 Deg. C)
11/03/07
Weekly
mg/I
Frequency Violation
None
03 -2007 001
Effluent
Chlorine, Total Residual
03/24/07
2 X week
mg/1
Frequency Violation
None
11 -2007 001
Effluent
Coliform, Fecal MF, M-FC
11/03/07
Weekly
#1100ml
Frequency Violation
None
Broth,44.5C
-»
07 -2007 001
Effluent
Flow, in conduit or thru
07/04/07
Continuous
mgd
Frequency Violation
Proceed to
treatment plant
08 -2007
001
Effluent
Flow, in conduit or thru
08/31/07
Continuous
treatment plant
f
11 -2007
001
Effluent
Nitrogen, Ammonia Total (as
11/03/07
Weekly
N)
ve
11 -2007
001
Effluent
Solids, Total Suspended
11/03/07
Weekly
06 -2007
001
Effluent
Temperature, Water Deg.
06/02/07
5 X week
Centigrade
1�
'i
07 -2007
001
Effluent
Temperature, Water Deg.
07/07/07
5 X week
Centigrade
Enforcement Case
mgd
Frequency Violation None
mg/I
Frequency Violation None
mg/I
Frequency Violation , None
deg c
Frequency Violation None
deg c Frequency Violation
Proceed to
Enforcement 0/

llbk
MONITORING REPORT(MR) VIOLATIONS
for:
Report Date: 03/06108 Page: 2 of 2
Permit: nc0075027
MRs Between:. -2007
and' 1,2-2007 Region: %
VFiolation Category: %
gram Category: o
!Facility Name: -%
Param Name: %
County: %
Subbasin: %
Violation Action: %
Major,Minor: 0/b
PERMIT: N00075027
FACILITY: Cains Way Homeowners Association - Cains Way Mobile
COUNTY: Forsyth
REGION: Winston-Salem
Home Park
Monitoring Violation
MONITORING OUTFALL/ LOCATION
PARAMETER
VIOLATION FREQUENCY UNITOF
LIMIT CALCULATED
VIOLATION TYPE VIOLATION ACTION
REPORT PPI
DATE MEASURE
VALUE
07-2007 001 Effluent
pH
07/28/07 Weekly su
Frequency Violation Proceed to
Enforcement Case

NORTH CAROLINA
DEPARTMENT OF
ENVIRONMENT AND
NATURAL RESOURCES
FAX TRANSMITTAL
Water Quality Section
Winston-Salem Regional Office
585 Waughtown Street
Winston-Salem, N.C. 27107
Phone: [phone]
TO
FAX NUMBER:
FROM:
r772-c--)
DATE:
Number of pages (including cover page): _
COMMENTS:
i
/6) �5
Pax: [phone]
lU11�j
1�

COLLECTION SYSTEM INSPECTION CHECKLIST
To:Qi'�ll `�'`7 Facility: _�NS wl Nl'Fax #:
Inspection Date: � ZQ®S Inspection Time:
Please have the following information available for the inspector.
1. Sanitary Sewer Overflows (SSOs)
- Number of SSOs in the past 12 months and copies of reports
- Copies of public notice for all spills over 15,000 gallons
- Copies of press release for all SSOs reaching surface water & over 1,000 gallons
2. Current Collection System Map with the following information:
- Approximate age of sewer lines - Line size
- Pipe material - Flow direction
- Pump stations - Major tap locations of satellite systems
- Annual updates - Construction drawings if available
3. Grease Control Program
- Copies of the educational materials that have been distributed
4. High Priority Sewer Lines (i.e. suspended, in channel, or under body of water)
- Inspection log that includes: date, inspection method and corrective actions
5. Operation & Maintenance Plan with the following information:
- Pump station inspection frequency - Preventative maintenance sched.
- Spare parts inventory - Overflow response plan
- Schedule to test emergency equip.
6. Pump Station Inspections & Maintenance — show evidence of the following tasks:
- Removal of interior and exterior debris as needed
- Exercising of all valves
- Lubrication of pumps & mechanical equipment
- Operation of alarms, telemetry, and generator
- Pump failure contingency plan posted at pump station
Have this information available for inspector:
Total # Pump Stations:
# Pump Stations with telemetry:
# Pump Stations w/out telemetry:
# Pump Stations with emergency contact information posted:
7. Right-of-ways and easements maintenance
Provide any maintenance logs or maps to show progress
8. Sewer line cleaning (should be performed at a rate of 10% of lines per year)
Provide any maintenance logs or maps to show progress
9. General observation of entire system (should be performed on an annual basis)
Provide any maintenance logs or maps to show progress
10. All records should be maintained for 3 years

PV"
wor-'(S "D. 0 /ff
Permit: WQCSDO190 Owner - Facility: Tim Horner
Inspection Date: 10/1712007 Inspection Type: Compliance Evaluation Reason for Visit: Routine
Inspections Yes No NA NE
Are maintenance records for sewer lines available? F,?,n n n
Are records available that document pump station inspections?
Z1f n nnj n
Are SCADA or telemetry equipped pump stations inspected at least once a week?
n
n /--
day?
❑
❑ n
Are non-SCADA/telemetry equipped pump stations inspected every
Are records available that document citizen complaints?
n
n t' n
// Do you have a system to conducl an annual observation of entire systen-0
�
n [1 n
# Has there been an observation of remote areas in the last year?
n
❑ n
Are records available that document inspections of high -priority lines?
n
n n
P
Has there been visual inspections of high -priority lines in last six months?
n
❑ n
Comment:
Operation & Maintenance Requirements
Yes
No NA NE
Are all log books available?
❑ ❑ n
Does supervisor review all log books on a regular basis?
f7
n n n
Does the supervisor have plans to address documented short-term problem areas?
n
n n
What is the schedule for reviewing inspection, maintenance, & operations logs and problem areas?
Are maintenance records for equipment available? n n n
Is a schedule maintained for testing emergency/standby equipment? n n n
What is the schedule for testing emergency/standby equipment?
Do pump station logs include
Inside and.outside cleaning and debris removal? n ❑ '.�I
Inspecting and exercising all valves? ❑ n ZZ
Inspecting and lubricating pumps and other equipment? ❑ n r/1 n
Inspecting alarms, telemetry and auxiliary equipment? n n n
Is there at least one spare pump for each pump station w/o pump reliability? n n n
Are maintenance records for right-of-ways available? n n n
Are right-of-ways currently accessible in the event of an emergency? ❑ n n
Are system cleaning records available? (l n n n
Has at least 10% of system been cleaned annually? ) n n
1^�
�LV tiv
Page: 3

Permit: WQCSDO190 Owner - Facility: Tim Horner
Inspection Date: 10/17/2007 Inspection Type: Compliance Evaluation Reason for Visit: Routine
What areas are scheduled for cleanin4in henex 12 months?
Is a Spill Response Action Plan available? ( n n n
Does the plan include:
24-hour contact numbers 7
Response time V
Equipment list and spare parts inventory
Access to cleaning equipment
Access to construction crews, contractors, and/or engineers
Source of emergency funds
Site sanitation and cleanup materials
Post-overflow/spill assessment
Is a Spill Response Action Plan available for all personnel?
Is the spare parts inventory adequate?
Comment:
Records
Are adequate records of all SSOs, spills and complaints available?
Are records of SSOs that are under the reportable threshold available?
Do spill records indicate repeated overflows (2 or more in 12 months) at same location?
If yes, is there a corrective action plan?
Is a map of the system available?
Does the map include:
St
Pipe sizes
Pipe materials 1 y
Pipe location
Flow direction
Approximate pipe age 0 l�
Number of service taps Z ,
Pump stations and capacity
If no, what percent is complete?
l
II
1
nnnn
n n n n
nnnn
nnnn
nn�in
nnnn
�l.nr�n
n n n
F7 n
nnnn
nnn
nnnn
nnnn
nnnn
nnnn
�innn
�innn
tlnnn
nnnn
fAnnn
nnnn
nnnn
Page: 4

V
Permit: WQCSD0190 Owner - Facility: Tim Horner
Inspection Date: 1011712007 Inspection Type: Compliance Evaluation
List any modifications and extensions that need to be added to the map
#41
Comment:
Monitoring and Reporting Requirements
Are copies of required press releases and distribution lists available?
Are public notices and proof of publication available?
# Is an annual report being prepared in accordance with G.S. 143-215.1 C?
# Is permittee compliant with all compliance schedules in the permits?
If no, which one(s)?
Comment
Pump Station
Pump station type
.Are pump station logs vailable?
Is it accessible in all eather conditions?
# Is general housek eping acceptable?
Are all pumps pre ent?
Are all pumps o erable?
Are wet wells ee of excessive debris?
Are upstrea manholes free of excessive debris/signs of overflow?
Are floats/ ontrols for pumps/alarms operable?
Is "auto olling" feature/SCADA present?
Is "aut polling" feature/SCADA operational?
Is si ple telemetry present?
Is si ple telemetry operational?
Ar audio and visual alarms present?
A audio and visual alarms operable?
Is the Pump station inspected as required?
Are backflow devices in place?
Reason for Visit: Routine
n n n n
Yes No NA NE
nn�in
nn�in
n Fj
Yes No NA NE
nnnn
n n n n
nnnn
nnnn
n n n n
nnnn
n n n n
nnnn
nnnn
nnnn
n n n n
nnnn
nnnn
nnnn
nnnn
nnnn
Page: 5

y
Permit: WQCSDO190 Owner - Facility: Tim Horner
Inspection Date: 10/17/2007 Inspection Type: Compliance Evaluation
Are backflow devices perable?
Are air relief valves in place?
Are air relief valves ol'perable?
# Is an emergency generator available?
Can the emerg �rncy generator run the pumps?
Is the pump s tion equipped for quick hook-up?
Is the generator perablo?
# Is fuel in tank nd sufficient?
Is the generato inspected according to their schedule?
Is a 24-hour n tification sign posted?
Does it incl de:
Instructio s for notification?
Pump st ion identifier?
Emerge cy phone number
Is public ac ess limited?
Is pump st lion free of overflow piping?
Is the pu p station free of signs of overflow?
Are run times comparable for multiple pumps?
Comment:
Is Education Program for grease established and documented? GaA;7
What educational tools are used? (Reg. says distribute info.twice/year)
Is system free of known points of bypass?
If no, describe type of bypass and location.
Reason for Visit: Routine
nnnn
n n n n
nnnn
nnnn
nnnn
nnnn
nrinri
nnnn
n n n n
nnnn
nnnn
n n n n
nnnn
nnnn
nnnn
nnnn

W AT F9QG
7
� r
CERTIFIED MAIL 7008 0150 0002 8342 1450
RETURN RECEIPT REQUESTED
Richard Donald Cain
Cains Way Homeowners Association
6075 Sullivantown Rd
Walkertown NC 27051
Subject: NOTICE OF VIOLATION
Permit No. NCO075027
Cains Way Mobile Home Park
Forsyth County
Dear Mr Cain:
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
July 7, 2008
Coleen H. Sullins Director
Division of Water Quality
A review of Cains Way Mobile Home Park's monitoring report for April 2008 showed the
following violations:
Parameter
Date
Limit Value
Reported Value
Limit Type
BOD, 5-Day (20 Deg. C)
04/10/08
16.5 mg/1
22 mg/l
Daily
Maximum
Exceeded
Remedial actions should be taken to correct this problem. The Division of Water Quality may
pursue enforcement action for this and any additional violations of State law.
To prevent further action, carefully review these violations and deficiencies and respond in
writing to this office within 30 working day of receipt of this letter. You should address the
causes of noncompliance and all actions taken to prevent the recurrence of similar situations. If
you should have any questions, please do not hesitate to contact Rose Pruitt at [phone].
Sincerely,
Steve W. Tedder
Water Quality Regional Supervisor
Winston-Salem Region
Division of Water Quality
Cc: WQ Central Files
585 Waughtown Street Winston-Salem, NC 27107 336-771-5000 (Telephone) 336-771-4630 (Fax)

Cover Sheet from
Staff Member to
Regional Supervisor
DMR Review Record
Facility: \W--W94 Permit/Pipe No.: W- 0 6 75o z7 Month/Year Ppe I L-
.Monthly Average Violations
Parameter Permit Limit DMR Value % Over Lin -lit
Wee /Daily Violations
Date Parameter Permit Limit/Tvpe DMR Value % Over Limit
'Now 22ot 114.5 ZZ
Monitoring Frequency Violations
Date Parameter Permit Frequency Values Reported # of Violations
Other Violations
Completed by: (� Date:
Regional Water Quality
Supery isor Signoff: Date:

EFFLUENT
( April 1 through October 31 }
NPDES PERMIT NO.: NCO075027
DISCHARGE NO.: 001
MONTH: April YEAR: 2008
FACILITY NAME: Cains Way MHP
CLASS: II
COUNT'—groRyi# r; I
OPERATOR IN RESPONSIBLE CHARGE: Bradley Flynt
GRADE: IV PHONE: [phone]
CERTIFIED LABORATORIES:
(1) Water Tech Inc
(2 )
Check box if orc has changed [ ]
PERSON(S) COLLECTING SAMPLES:
Bradley Flynt
Mail ORIGINAL and ONE COPY to:
'
V
ATTN: CENTRAL FILES
X
O�
DIVISION OF WATER QUALITY
(SIGNATURE OF O )
DATE
DENR
BY THIS SIGNAT E, I
ERTIFY THAT THIS REPORT IS
1617 MAIL SERVICE CENTER
ACCURATE AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
RALEIGH, NC 27699-1617
A
JU
R
N.C.7ofJUNWinReg
juN I o, 2008

Cains Way MHP Status: (Please check one of the following)
All monitoring data and sampling frequencies meet permit requirements [ ]
Compliant
All monitoring data and sampling frequencies do NOT meet permit requirements [ ]
Noncompliant
If the facility is noncompliant, please comment on corrective actions being taken in respect to equipment, operation,
maintenance, etc, and a time table for improvements to be made.
"1 certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision
in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information sub-
mitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for
gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and com-
plete. I am aware that there are significant penalties for submitting false information, including the possibility of fines
and imprisonment for knowing violations."
Permittee (Please print or type)
Signature of Permittee— Date
Permittee Address: �� / %/ �- Phone Number. Permit Exp. Date
C-0t� � Y • ®. ,�OJ( W��/� �f /OCt%/1 r��n / May 31, 2007
00010 Temperature
00076 Turbidity
00080 Color (Pt -Co)
00082 Color (ADMI)
00300 Dissolved Oxygen
00310 B O D 5
00340 C O D
00400 pH
00530 T S S
00545 Settleable Solids
00556 Oil and Grease
00600 Total Nitrogen
PARAMETER CODES
00610 Ammonia Nitrogen
00625 Total Kjeldah
Nitrogen
00630 Nitrate/Nitrite
00665 Total Phosporous
00720 Cyanide
00745 Total Sulfide
00927 Total Magnesium
00929 Total Sodium
00940 Total Chloride
00951 Total Fluoride
01002 Total Arsenic
01027 Cadmium
01032 Hexavalent
Chrc 32730 Total Phenolics
01034 Chromium 34235 Benzene
01037 Total Cobal34481 Toluene
01042 Copper 38260 MBAS
01045 Iron 39516 PCBs
01051 Lead 50050 Flow
01067 Nickel 50060 Total Residual
01077 Silver Chlorine
01092 Zinc 71880 Formal-
01105 Alumimum dehyde
01147 Total Selen 71900 Mercury
$1616 Fecal Colifc 81551 Xylene
Parameter Code assistance may be obtained by calling the Water Quality Compliance Group at [phone] ext 581 or 534
The monthly average for fecal coliform is to be reported as a GEOMETRIC mean. Use only units designed in the reporting
facility's permit for reporting data.
* ORC must visit the facility and document visitation of facility as required per 15A NCAC 8A .0202(b)(5)(B)
** If signed by other than the permittee, delegation of signatory authority must be on file with the state per
15A NCAC 26.0506 (b)(2)(D)

S
JUN - 3 2008
Information Processing Unit
DWQ/BOG

/ 1
NPDES PERMIT NQ:NC0075027 DISCHARGE NO.: 001 MONTH: April
YEAR: 2008
FACILITY NAME: Catne Way MHP COUNTY -.Forsyth
STREAM: Ader Creek LOCATION: @ 100ft Above Discharge Point
I Iowmahm
STREAM: Ader Creek LOCATION: @ NCSR 1979
nnunlerovnu
OEM Form MR-3 (12/93) DEM Form MR-3 (IV93)

t
RECEIVED
JUN e 3 2008
snl°rmation P
DWQ/Sp--Sing Uno

MONITORING REPORT(MR) VIOLATIONS for: Report Date: 07/07/08 Page: 1 of 2
Permit nc0075027 # MRs' Between: A 2t)07 arid' C 3 2Ct08 Regiori; °1a Violation Category Ito Program Category°la t
r:4 0 :4=
Facility Name=.0X, :•.f'aram fume` 1a County„% ,Subbasin. to Violation Acton to
C fi'�`� i
Malor6Minor * °lo 1
.:%,. r'..."S�'•.•.,...u._.,..�...m.. ��-»»< .. u..,w...,...._,a...�o„..._,..,.b.:a�__a�,._��.�.e.�......�.. u,.i,... �,!.a,dsn> w...a.,os_S[...�..�..a,......mn., .__... �.�..�..,_._. �u.,..:.,�. R'.`d.,•..._..._...�,.-...,..»,..:,.t;......— y._....»�..,.,.�..,..� .:.._ -.,�,...»�..�..,.�.�.'
PERMIT: NCO075027 FACILITY: Cains Way Homeowners Association - Cains Way Mobile COUNTY: Forsyth REGION: Winston-Salem
Home Park
Limit Violation
MONITORING OUTFALL /
VIOLATION
UNIT OF
CALCULATED
REPORT
PPI
LOCATION
PARAMETER
DATE
FREQUENCY
MEASURE
LIMIT
VALUE
VIOLATION TYPE
VIOLATION ACTION
04 -2007
001
Effluent
BOD, 5-Day (20 Deg. C)
04/25/07
Weekly
mg/I
16.5
17
Daily Maximum Exceeded
No Action, BPJ
09 -2007
001
Effluent
Coliform, Fecal MF, M-FC
09/06/07
Weekly
#/100ml
400
6,000
Daily Maximum Exceeded
Proceed to NOV
Broth,44.5C
12 -2007
001
Effluent
Coliform, Fecal MF, M-FC
12/13/07
Weekly
#/100ml
400
580
Daily Maximum Exceeded
Proceed to NOV
Broth,44.5C
07 -2007
001
Effluent
Nitrogen, Ammonia Total (as
07/31/07
Weekly
mg/I
2
3.16
Monthly Average Exceeded
Proceed to
N)
Enforcement Case
Monitoring Violation
MONITORING OUTFALL /
VIOLATION
UNIT OF
CALCULATED
REPORT
PPI
LOCATION
PARAMETER
DATE
FREQUENCY
MEASURE
LIMIT
VALUE
VIOLATION TYPE
VIOLATION ACTION
11 -2007
001
Effluent
BOD; 5-Day (20 Deg. C)
11/03/07
Weekly
mg/1
Frequency Violation
None
11 -2007
001
Effluent
Coliform, Fecal MF, M-FC
11/03/07
Weekly
#/100ml
Frequency Violation
None
Broth,44.5C
07 -2007
001
Effluent
Flow, in conduit or thru
07/04/07
Continuous
mgd
Frequency Violation
Proceed to
treatment plant
Enforcement Case
08 -2007
001
Effluent
Flow, in conduit or thru
08/31/07
Continuous
mgd
Frequency Violation
None
treatment plant
11 -2007
001
Effluent
Nitrogen, Ammonia Total (as
11/03/07
Weekly
mg/I
Frequency Violation
None
11 -2007
001
Effluent
Solids, Total Suspended
11/03/07
Weekly
mg/I
Frequency Violation
None
06 -2007
001
Effluent
Temperature, Water Deg.
06/02/07
5 X week
deg c
Frequency Violation
None
Centigrade
07 -2007
001
Effluent
Temperature, Water Deg.
07/07/07
5 X week
deg c
Frequency Violation
Proceed to
Centigrade
Enforcement Case
07 -2007
001
Effluent
pH
07/28/07
Weekly
su
Frequency Violation
Proceed to
Enforcement Case

MONITORING REPORT(MR) VIOLATIONS for:
Report Date: 07/07/08
Page: uofu
/

W A rF Michael F. Easley, Governor
`O�0 9QG William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
rColeen H. Sullins Director
i Division of Water Quality
August 27, 2008
CERTIFIED MAIL 7008 0150 0002 8342 1580
RETURN RECEIPT REQUESTED
Richard Donald Cain
Cains Way Homeowners Association
6075 Sullivantown Rd
Walkertown NC 27051
Subject: NOTICE OF VIOLATION
Permit No. NCO075027
Cains Way Mobile Home Park
Forsyth County
Dear Mr Cain:
A review of Cains Way Mobile Home Park's monitoring report for May 2008 showed the
following violations:
Parameter
Date
Limit Value
Reported Value
Limit Type
BOD, 5-Day (20 Deg. C)
05/29/08
16.5 mg/l
32 mg/l
Daily
Maximum
Exceeded
Remedial actions should be taken to correct this problem. The Division of Water Quality may
pursue enforcement action for this and any additional violations of State law.
To prevent further action, carefully review these violations and deficiencies and respond in
writing to this office within 30 working day of receipt of this letter. You should address the
causes of noncompliance and all actions taken to prevent the recurrence of similar situations. If
you should have any questions, please do not hesitate to contact Rose Pruitt at [phone]..
Sincerely,
teve W Tedder
Water Quality Regional Supervisor
Winston-Salem Region
Division of Water Quality
Cc: WQ Central Files
W81I0, .
585 Waughtown Street Winston-Salem, NC 27107 336-771-5000 (Telephone) 336-771-4630 (Fax)

Cover Sheet from
Staff Member to
Regional Supervisor
DMR Review Record
Facility: OA 14LS kVW Permit/Pipe No.: NG 00750 Month/Year 11144f
Parameter
Monthly Average Violations .
Permit Limit DMR Value % Over Limit
Weekly/Daily Violations
Date Parameter Permit Limitfl'vpe DMR Value % Over Limit
Monitoring Frequency Violations
Date Parameter Permit Frequency Values Reported- # of Violations
Other Violations
Completed by: �1� Date:
Regional Water Quality
Supervisor SiQnoff: Date:

i
EFFLUENT
( April 1 through October 31QA
NPDES PERMIT NO.: NCO075027
DISCHARGE NO,: 001
MONTH: May
YEAR: 2008 Jul_
2 3 2008
FACILITY NAME: Cains Way MHP
CLASS: ]I
COU TY: Forsyth �
OPERATOR IN RESPONSIBLE CHARGE: Bradley nt
GRADE: IV PHONE: [phone]
CERTIFIED LABORATORIES:
,FI
(1 ) WateNT In
(2 )
Check box iforc has changed { ]
PERSON(S) COLLECTING SAMPLES:
Bradley Flynt
RECEIVED
Mail ORIGINAL and ONE COPY to:
/
a
N-C, Dept. of ENR
ATTN: CENTRAL FILES
f `TURE
(�DIVISION o 4 2008
OF WATER QUALITY
DENR
( OF 0 ) DA E
BY THISSIGNAT E, C TIFYTHATTHISREPORTI
`0G
Winston-Salem
1617 MAIL SERVICE CENTER
ACCURATE AND COM TE
TO THE BEST OF MY KNOI LEDGE
-Regional Off ce
RALEIGH, NC 276W1617

Cains Way MHP Status: (Please check one of the following)
All monitoring data and sampling frequencies meet permit requirements [
Compliant
All monitoring data and sampling frequencies do NOT meet permit requirements [ x'
Noncompliant
If the facility is noncompliant, please comment on corrective actions being taken in respect to equipment, operation,
maintenance, etc, and a time table for improvements to be made.
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision
in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information sub-
mitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for
gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and com-
plete. I am aware that there are significant penalties for submitting false information, including the possibility of fines
and imprisonment for knowing violations."
6_lra&2r-. P4 . !mv
Permittee (Please print or type)
Signature of Permittee** Date
Permittee Add es70-
Phone Number: Permit Exp. Date
COS 10� 50X A6a ,�e�orJ+�, NC a%l�5/ May 31, 2007
PARAMETER CODES
00010 Temperature
00610 Ammonia Nitrogen
01032 Hexavalent
00076 Turbidity
00625 Total Keldah
Chrc 32730 Total Phenolics
00080 Color (Pt -Co)
Nitrogen
01034 Chromium 34235 Benzene
00082 Color (ADMI)
00630 Nitrate/Nitrite
01037 Total Cobal 34481 Toluene
00300 Dissolved Oxygen
00665 Total Phosporous
01042 Copper 38260 MBAS
00310 B O D 5
00720 Cyanide
01045 Iron 39516 PCBs
00340 COD
00745 Total Sulfide
01051 Lead 50050 Flow
00400 pH
00927 Total Magnesium
01067 Nickel 60060 Total Residual
00530 T S S
00929 Total Sodium
01077 Silver Chlorine
00545 Settleable Solids
00940 Total Chloride
01092 Zinc 71880 Formal-
00556 Oil and Grease
00951 Total Fluoride
01105 Alumimum , dehyde
00600 Total Nitrogen
01002 Total Arsenic
01147 Total Selen 71900 Mercury
01027 Cadmium
31616 Fecal Colffc 81551 Xylene
Parameter Code assistance may be obtained by calling the Water Quality Compliance Group at [phone] ext 581 or 534
The monthly average for fecal coliform is to be reported as a GEOMETRIC mean. Use only units designed in the reporting
facility's permit for reporting data.
* ORC must visit the facility and document visitation of facility as required per 15A NCAC 8A
.0202(b)(5)(B)
** If signed by other than the permittee, delegation of signatory authority must be on file with
the state per
15A NCAC 213.0506 (b)(2)(D)

NPDES PERMIT NO:N00075027 DISCHARGE NO.: 001 MONTH: May YEAR: 2008
FACILITY NAME: Calns Way MHP COUNTY:Forsyth
STREAM: Ader Creek LOCATION: @ 10011 Above Discharge Point STREAM: Ader Creek LOCATION: @ NCSR 1979
I IOCTOCAM
rinvumCT17FAhfi
DEM Fonn MR-3 (12/93) - DEM Form MR-3 (12193)

MONITORING REPORT(MR) VIOLATIONS for:
Report Date: 08/12/08 Page: 1 of 2
e
PERMIT: NCO075027 FACILITY: Cains Way Homeowners Association - Cains Way Mobile COUNTY: Forsyth REGION: Winston-Salem
Home Park
Limit Violation
MONITORING OUTFALL /
VIOLATION
UNIT OF
CALCULATED
REPORT PPI
LOCATION
PARAMETER
DATE
FREQUENCY
MEASURE
LIMIT
VALUE
VIOLATION TYPE
VIOLATION ACTION
04 -2008 001
Effluent
BOD, 5-Day (20 Deg. C)
04/10/08
Weekly
mg/I
16.5
22
Daily Maximum Exceeded
Proceed to NOV
09 -2007 001
Effluent
Coliform, Fecal MF, M-FC
09/06/07
Weekly
#/100ml
400
6,000
Daily Maximum Exceeded
Proceed to NOV
Broth,44.5C
12 -2007 001
Effluent
Coliform, Fecal MF, M-FC
12/13/07
Weekly
#/100ml
400
580
Daily Maximum Exceeded
Proceed to NOV
Broth,44.5C
07 -2007 001
Effluent
Nitrogen, Ammonia Total (as
07/31/07
Weekly
mg/I
2
3.16
Monthly Average Exceeded
Proceed to
N)
Enforcement Case
Monitoring Violation
MONITORING OUTFALL /
VIOLATION
UNIT OF CALCULATED
REPORT
PPI
LOCATION
PARAMETER
DATE
FREQUENCY
MEASURE LIMIT VALUE
11 -2007
001
Effluent
BOD, 5-Day (20 Deg. C)
11/03/07
Weekly
mg/I
11 -2007
001
Effluent
Coliform, Fecal MF, M-FC
11/03/07
Weekly
#/100ml
Broth,44.5C
07 -2007
001
Effluent
Flow, in conduit or thru
07/04/07
Continuous
mgd
treatment plant
08 -2007
001
Effluent
Flow, in conduit or thru
08/31/07
Continuous
mgd
treatment plant
11 -2007
001
Effluent
Nitrogen, Ammonia Total (as
11/03/07
Weekly
mg/I
11 -2007
001
Effluent
Solids, Total Suspended
11/03/07
Weekly
mg/l
06 -2007
001
Effluent
Temperature, Water Deg.
06/02/07
5 X week
deg c
Centigrade
07 -2007
001
Effluent
Temperature, Water Deg.
07/07/07
5 X week
deg c
Centigrade
07 -2007
001
Effluent
pH
07/28/07
Weekly
su
VIOLATION TYPE
VIOLATION ACTION
Frequency Violation
None
Frequency Violation
None
Frequency Violation
Proceed to
Enforcement Case
Frequency Violation
None
Frequency Violation
None
Frequency Violation
None
Frequency Violation
None
Frequency Violation
Proceed to
Enforcement Case
Frequency Violation
Proceed to
Enforcement Case

MONITORING REPORT(MR) VIOLATIONS for: Report Date: 08/12/08 Page: 2 of 2

ACLU A.
North
July 22, 2008
Carolina
GIs. Rose �'ston-Salem
NC DENR Regional Office
Div' of Water Quality
585 Waughtown Street
Winston-Salem,, NC 27107
RECEIVED
( INX, Not, of EHR
s
JUL'2.4 2000.
�:��,aa�h�Eelom
Regional2!to -
RE: CAINS WAY - DMR's and Documentation
Dear Ms.. Pruitt,
Enclosed please find copies of documentation we received today from our ORC,
Tim Waddell, Atlantic Utilities, Inc., in reference to your request for supporting
data for the Cain's Way MHP.
Sincerely,
Tony R. Parker
Area Manager
TRP/pp
Enclosures
C: Gary Moseley, State Operations Manager, Aqua NC
4163 Sinclair Drive • Denver, NC 28037. • [phone]

ATLANTIC UTILITY, INC
203 E. BODENIIAMER STREET
KERNERSVILLE, NC 27284
JULY 28, 2008
Rose Pr!: t-
--,,T-CDENR
585 Waughtown Street
Winston-Salem, NC 27107
Dear Rose,
:;. Gea. of @4R
2 9 2000
rv�
Winston-Salem
Regional Office
Please find enclosed the Cainsway Mobile Home Park documentation that we were
able to locate for you. In addition, please find an envelope enclosed that contains an
ORC resignation form for your records.
Thank you, as always, for your assistance.
Sincerely,
Timothy J. Waddell
Atlantic Utility, Inc.

■ Complete'Mems 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
Richard D. Cain - -
Cains Way HOA
6075 Sullivantown Road
Walkertown, NC 27051
A�Sjgnatur6
❑ jgent
ETAddresse(
B. Receivqa by I Pfinted Name) C. Date of Deliv
D. Is delivery address different from item 1? ❑ Ye
If YES, enter delivery address below: ❑ o
3. S rvice Type
Certified Mail ❑ Express Mail
egistered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
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70178`' 1'150 l70172' 8f342 15817 !%'l i ! i t ! . � I l / AN
PS Form 3811. February 2004 Domestic Return Receipt .g A 2 o,*— 102595-02-M-154

UNITED STATES POSTAL SERVICE First-Cla s Mail
Postage Paid
LISPS
Permit No. G-10
• Sender: Please print your name, address, and ZIP+4 in this box •
NCDENR-Division of Water-Quaflty,,o —�
N.C. Dept. of ENR
. per.
CEP 0 3 2003
585 Waughtown Street I Winston-Salem
Regional
Winston-Salem, NC 27107 —Office
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* -Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
Richard D. Cain
Cains Way Homeowners Assoc.
6075 Sullivantown Road
Walkertown, NC 27051 —
0180 gOO2 8342
A. Signature � �
�✓ /' IVAgent
X CGly✓.vi Lp ( ❑ Address(
B. Received by (Printed Name) C. Date of Delivei
6 / -
D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: B'IqO_
3. Service Type
Certified Mail F�cp ess Mail
Registered Retum Receipt for Merchandis
❑ Insured Mail C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
PS Form 3811. February 2004 Domestic Return Receipt / ) % /r O 47- , 1025 5-02-M-15

UNITED STATES POSTAL SERVICE
First -Class Mail
Postage & Fees Paid'
USPS
Permit No, G-10
• Sender: Please print your name, address, and ZIP+4 in this box •
NCDENR- Water Quality Section
1)0_Lc
you
585 Waughtown Street
Winston-Salem, NC 27107
ifd1111111111t111 i l i I l i i 1f fit I I fit Ii 1111111 ifif f if f 1111if 111

■ Complete items 1, 2, and-3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
Article Addressed to:
Cains Way Homeowners Assn.
P.O. Box 846
Walkertown, NC 27051
❑ Agent
❑ Addresses
b. Re ived' by (Printed Name) C17-1
Date gfpeliVer
�G: &'Ofi)Uk & 00� Y d e
D. Is delivery.address different from ftem 1? ❑ Yes
If YES, enter delivery address below: ❑ No
3, SeS ice Type
Q Certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail. ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑'yes
1 7p `$ 0,50.01100102 1060.11134137.1 i lY� o✓ 1 1'; i f
oe-c....., QQ1 1 cti..,.,-- onne n _ ., o ... '; --- .-. / -- -1 "'2 /» .....—; ..., .. —

IGNITED STATES POSTAL SERVICE First -Class Mail
Postage & Fees Paid
USPS
Permit No. G-10
• Sender.: -Please print your name, address, and ZIP+4 in this box'
Surface Water Protection Section
N.C. Dept. of Environment and Natural Resources
585 Waughtown Street
Winston-Salem, NC 27107

■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
A Attach this card to the back of the mailpiece,
or on the front if space permits.
1.Article Addressed to: — — —_—
Cains Way Homeowners Assoc.
PO Box 846
Walkertown, NC 27651
A. i r3a re
X ❑ Agent
A Addressee
B. R eived by (Pr1g16 j Name) C: IjJEti Delivery
D. Is delivery ad ress different from item 1? ❑ Yes
If YES, ente r
elivery address below, 1 No
FEB 14 2011
3 Service Type �7�Q�
Certified Mail ❑ ENp.��a 1
eglstered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Numberi
(rran'sferfro. serviq 1 i i IUQQ 32-30 0003 i2547 2354 : , �: a�1�
PC Pnrm RRi 1 Form vnn/ gnna nnmwctin Rafivn Rarainf _ L I,A-� !�� 1n25gs-w-M-154

UNITED STATES First -Class Mail
Postage & Fees Paid
USPS
0 Sender: Please print your name, address, and ZIP+4 in this box 0
NC DEN R -Water Quality Section
585 Waughtown Street
Winston-Salem, NC 27107
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