NCG550364_Compliance Evaluation Inspection_20200924

EPA
United States Environmental Protection Agency
Washington, D.C. 20460
Water Compliance Inspection Report
Form Approved.
OMB No. 2040-0057
Approval expires 8-31-98
Section A: National Data System Coding (i.e., PCS)
Transaction Code NPDES yr/mo/day Inspection Type Inspector Fac Type
1 N 52 NCG550364 20/09/23 C S31112171819 20
21 66
Inspection Work Days Facility Self-Monitoring Evaluation Rating B1 QA ----------------------Reserved-------------------
N67707172 73 74 75 80
Section B: Facility Data
Name and Location of Facility Inspected (For Industrial Users discharging to POTW, also include
POTW name and NPDES permit Number)
466 Coweeta Lake Circle
466 Coweeta Lake Cir
Otto NC 28763
Entry Time/Date Permit Effective Date
Exit Time/Date Permit Expiration Date
11:45AM 20/09/23 13/08/01
Name(s) of Onsite Representative(s)/Titles(s)/Phone and Fax Number(s)
///
Other Facility Data
12:15PM 20/09/23 18/07/31
Name, Address of Responsible Official/Title/Phone and Fax Number
Tommy A Broach,5023 Ashby Ave North Charleston SC 29405//843-709-8554/Contacted
No
Section C: Areas Evaluated During Inspection (Check only those areas evaluated)
Permit
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
Lauren E Armeni DWR/ARO WQ/828-296-4500/
Signature of Management Q A Reviewer Agency/Office/Phone and Fax Numbers Date
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete.
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DocuSign Envelope ID: 15378C6D-F380-4B14-AEFA-C3DD5B8F9108
9/29/2020
9/29/2020
NPDES yr/mo/day
20/09/23
Inspection Type
C3111218
1
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
On 09/23/2020, I (Lauren Armeni) conducted a compliance evaluation inspection of the single-family
residence system that services 466 Coweeta Lake Circle. At the time of the inspection, no system
components (including the discharge pipe) were able to be located. No impact to the receiving stream
or other signs of system failure were observed. The property appears to be used as a vacation home
and was not occupied at the time of the inspection.
NCG550364 17
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DocuSign Envelope ID: 15378C6D-F380-4B14-AEFA-C3DD5B8F9108
Permit:NCG550364
Inspection Date:09/23/2020
Owner - Facility:
Inspection Type:
466 Coweeta Lake Circle
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?
The property was purchased by a new owner in 2014 and a Change of Ownership form still
needs to be submitted.
Comment:
Page#3
DocuSign Envelope ID: 15378C6D-F380-4B14-AEFA-C3DD5B8F9108