NCG550440_Inspection_20201019

DocuSign Envelope ID: 29BD50B6-EDB5-4B97-ACED-B7208AF99FFD
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 2 u 3 I NCG550440 111 121 20/09/28 I17 18 I C I 19 I s I 20L]
21111I I I I I I I II I I I I I I I I I I I I I I I I I I I I I I I II I I I I I r6
Inspection
Work Days Facility Self -Monitoring Evaluation Rating B1 QA ---------------------- Reserved -------------------
67
I 72 I n, I 73 � I 74 79 I I I I I I I80
70 I I 71 I LL -1 I I
LJ
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)
05:OOPM 20/09/28
19/11/04
4 Camelfield Drive
4 Camelfield Dr
Exit Time/Date
Permit Expiration Date
Weaverville NC 28787
05:20PM 20/09/28
20/10/31
Name(s) of Onsite Representative(s)/Titles(s)/Phone and Fax Number(s)
Other Facility Data
Name, Address of Responsible Official/Title/Phone and Fax Number
Contacted
Douglas N Clark,4 Camelfield Dr Weaverville NC 28787//828-658-8582/
No
Section C: Areas Evaluated During Inspection (Check only those areas evaluated)
Operations & Maintenar 0 Effluent/Receiving Wate
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
Daniel J Boss DWR/ARO WQ/828-296-4658/ 10/19/2020
E,2E397192DABFB4FF..
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: 29BD50B6-EDB5-4B97-ACED-B7208AF99FFD
NPDES yr/mo/day Inspection Type
NCG550440 I11 12I 20/09/28 117 18 i c i
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
On 9/28/2020, 1 (Daniel Boss) conducted a compliance evaluation inspection of the wastewater
treatment facility at 4 Camelfield Drive. The owner was not present.
I couldn't locate any system components during the inspection.
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DocuSign Envelope ID: 29BD50B6-EDB5-4B97-ACED-B7208AF99FFD
Permit: NCG550440 Owner -Facility: 4 Camelfield Drive
Inspection Date: 09/28/2020 Inspection Type: Compliance Evaluation
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:
Septic Tank
(If pumps are used) Is an audible and visual alarm operational?
Is septic tank pumped on a schedule?
Are pumps or syphons operating properly?
Are high and low water alarms operating properly?
Comment: Location of septic tank and date of last septic pumping are unknown.
Sand Filters (Low rate)
(If pumps are used) Is an audible and visible alarm Present and operational?
Is the distribution box level and watertight?
Is sand filter free of ponding?
Is the sand filter effluent re -circulated at a valid ratio?
# Is the sand filter surface free of algae or excessive vegetation?
# Is the sand filter effluent re -circulated at a valid ratio? (Approximately 3 to 1)
Comment: Location of sand filter is unknown.
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: The effluent pipe could not be located.
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