WQCSD0632_Regional Office Physical File Scan Up To 12/3/2020

G_
NCDENR
North Carolina Department.of Environment and Natural Resources"
Pat McCrory' Donald R. van der Vaart
Governor Secretary
June 10, 2015
CERTIFIRED MAIL
RETURN RECEIPT REQUESTED 7014 0510 0000 4466 0691
Aubrey L. Deaver
A&D Water Service, Inc.
PO Box 1407
Pisgah Forest, NC 28768-1407
.SUBJECT: NOTICE OF VIOLATION
NOV-2015-PC-0151
Compliance Evaluation Inspection
High Vista Falls Collection System
Permit No.: WQCSD0632
Henderson County
Dear Mr. Deaver:
Enclosed please find a copy of the Inspection Report From from the inspection conducted on 2015-05-07. The Collection System
Inspection was conducted by Beverly Price of the Asheville Regional Office. .The facility was found to be in violation of Permit
WQCSD0632 for the following:
Overation.and Maintenance Reciuirements: _.
Permit condition 15A NCAC 02T' .0403 Permitting by Regulation (a)(10)' states "Documentation shall be kept for Subparagraphs
(a)(1) through (a)(9) of this Rule for a minimum of three years with the exception of the map, which shall be maintained for the life of
the system".
I have attached a copy of the permit conditions (a)(1), through (a)(9). "On the day of the inspection there were no
operatioh/maintenance records available: Iri"addition, there was no confirmation that Grease Control Program materials were
distributed bi-annually as required.
Please refer to the enclosed inspection report for additional observations and comments.
To prevent further action, carefully review these violations and deficiencies and respond in writing to this office within thirty (30)
days 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 Bev Price at 828-296-4500.
Sincerely,
L�
P
G. Landon Davidson, P:G., Regional Supervisor
Water Quality Regional Operations
Asheville Regional Office
Enc.
cc: MSC 1617-Central Files -Basement
AR©�Fi1es .
CjAWR\WQ\Henderson\Collection Systems\High Vista Falls Collection System\CEI15 NOV-2015-PC-0151.doe
Water Quality Regional Operations —Asheville Regional Office
2090 U.S. Highway 70, Swannanoa, North Carolina 28778 ;,,,
Phone: [phone] FAX: [phone]
Internet: http:l/portal.ncdenr.orgAveb/wq/
p.� An Equal Opportunity \ Affirmative Action Employer L
v

Compliance Inspection -Resort
Permit: WQCSD0632 Effective: 06/09/15 Expiration: Owner: Aubrey Lewis Deaver
SOC: Effective: Expiration: Facility: High Vista Falls
County: Henderson
Region: Asheville
Contact Person:. .Aubrey Lewis Deaver Title: Phone: [phone]
Directions to Facility:
System Classifications:
Primary ORC:
Secondary ORC(s):
On -Site Representative(s):
24 hour contact name
On -site representative
Related Permits:
Inspection Date: 05/07/2016
Primary Inspector: Beverly Price
Secondary Inspector(s):
Certification:
Phone:
Aubrey Lewis Deaver 828-884-9772
Aubrey Lewis Deaver 828-884-9772
Entry Time: 11:30AM Exit Time: 12:30PM
Phone: [phone]
Reason for Inspection: Routine Inspection Type: Collection System Inspect Non Sampling
Permit Inspection Type: Deemed permitted collection system management and operation
Facility Status: ❑ Compliant Not Compliant
Question Areas:
Miscellaneous Questions Performance Standards Operation & Maint Reqmts
Records Inspections Manhole
(See attachment summary)
Page: 1

Permit: WQCSD0632 Owner -Facility: Aubrey Lewis Deaver
Inspection Date: 05/07/2015 Inspection Type: Collection System Inspect Non Sampling Reason for Visit: Routine
Inspection Summary:
Operation/Maintenance Issues:
There was no indication that FOG materials were distributed bi-annually as required.
There were no maintenance/inspection records available at the time of inspection. An annual observation of the entire
system is required annually.
Pipe size and material should be added to the map which is dated 6/3/02 - this is the "As -Built" map.
Log sheets for documenting compliance with the 2T Rules were provided to Mr. Deaver following the 2014 inspection.
The Mills River Health & Rehabilitation Center came on-line in July 2014.
Page: 2

Permit: WQCSD0632 Owner -Facility: Aubrey Lewis Deaver
Inspection Date: 05/07/2015 Inspection Type: Collection System Inspect Non Sampling Reason for Visit: Routine
Performance Standards
Is Public Education Program for grease established and documented?
What educational tools are used?
Mr. "Deaver indicated that flyers are mailed out to customers with their water bills.
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 1"master plan\" 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?
2-4-hour contact numbers
If no, list deficient pump stations
# Do ALL pump stations have an "auto polling" feature/SCADA?
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?
Yes No NA NE
❑ ❑ ❑
❑ ❑ M ❑
❑,❑ ■ ❑
❑❑■❑
❑ ❑ M ❑
❑❑■❑
❑ ❑ M ❑
❑❑M'❑
1111 ❑
❑ ❑ N ❑
❑❑■❑
Page: 3

Permit: WQCSD0632 Owner - Facility: Aubrey Lewis Deaver
Inspection Date: 05/07/2015 ' Inspection Type: Collection System Inspect Non Sampling Reason for Visit: Routine
# If yes, date implemented?
Describe:
Comment: Mr. Deaver was unsure whether FOG materials had been distributed bi-annually.
Inspections Yes No NA NE
Are maintenance records for sewer lines available? ❑ ❑ ❑
Are records available that document pump station inspections? ❑ ❑ 0 ❑
Are SCADA or telemetry equipped pump stations inspected at least once a week? ❑ ❑ ❑
Are non-SCADA/telemetry equipped pump stations inspected every day? ❑ ❑ M ❑
Are records available that document citizen complaints? ❑ ❑ ❑
# Do you have a system to conduct an annual observation of entire system? El ❑ El
# Has there been an observation of remote areas in the last year? DEIN ❑
Are records available that document inspections of high -priority lines? ❑ ❑ ❑
Has there been visual inspections of high -priority lines in last six months? ❑ ❑ 0 ❑
Comment: Maintenance records were not available at the time of inspection. Mr. Deaver was provided with
log sheets for documenting compliance,after the 2014 inspection.
Operation & Maintenance Requirements Yes No NA NE
Are.all log books available? ❑ ❑ ❑
Does supervisor review all log books on a regular basis? ❑ ❑ N ❑
Does the supervisor have plans to address documented short-term problem areas? ❑ 110 ❑
What is the schedule for reviewing inspection, maintenance, & operations logs and problem areas?
Are maintenance records for equipment available? ❑ ❑ ❑
Is a schedule maintained for testing emergency/standby equipment? ❑ 0 ❑ ❑
What is the schedule for testing emergency/standby equipment?
Do pump station logs include:
Inside and outside cleaning and debris removal?
❑ ❑ ❑
Inspecting and exercising all valves?
❑ ❑ N❑
Inspecting and lubricating pumps and other equipment?
❑ ❑ N ❑
Inspecting alarms, telemetry and auxiliary equipment?
❑ 1-10 ❑
Is there at least one spare pump for each pump station w/o pump reliability?
❑ ❑. N ❑
Are maintenance records for right-of-ways available?
❑ E ❑ ❑
Are right-of-ways currently accessible in the event of an emergency?
N ❑ ❑ ❑
Are system cleaning records available?
❑ 0 ❑ ❑
Has at,least 10% of system been cleaned annually?
❑ ❑ ❑
What areas are scheduled for cleaning in the next 12 months?
Is a Spill Response Action Plan available?
0 ❑ ❑ ❑
Does the plan include:
Page: 4

Permit: WQCSD0632 Owner -Facility: Aubrey Lewis Deaver
Inspection Date: 05/07/2015 Inspection Type : Collection System Inspect Non Sampling
Reason for Visit: Routine
24-hour contact numbers
0❑ ❑ ❑
Response time
❑ ❑ ❑
Equipment list and spare parts inventory
0❑ ❑ ❑
Access to cleaning equipment
M ❑ ❑ ❑
Access to construction crews, contractors, and/or engineers,
❑ ❑ ❑
Source of emergency funds
❑ ❑ ❑
Site sanitation and cleanup materials
❑ ❑ ❑
Post-overflow/spill assessment
0 ❑ ❑ ❑
Is a Spill Response Action Plan available for all personnel?
0 ❑ ❑ ❑
Is the spare parts inventory adequate?
❑ ❑ ❑
Comment: Spare parts inventory was not available.
Records Yes No NA NE
Are adequate records of all SSOs, spills and complaints available? ❑ ❑ ❑
Are records of SSOs that are under the reportable threshold available? ❑ ❑ 0 ❑
Do spill records indicate repeated overflows (2 or more in 12 months) at same location? ❑ ❑ 0 ❑
If yes, is there a corrective action plan? ❑ ❑0 ❑
Is a map of the system available? 0 ❑ ❑ ❑
Does the map include:
Pipe sizes
❑ 0 ❑ ❑
Pipe materials
❑ ❑ ❑
Pipe location
0 ❑ ,❑ ❑
Flow direction
❑ M ❑ ❑
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
# Does the permittee have a copy of their permit?
❑ ❑ M ❑
Comment: Pipe size and material should be added to the map.
MH#1 PHASE I - Field adjac
Manhole Yes No NA NE
Is manhole accessible? ❑ ❑ ❑
# Is manhole cover/vent above grade? 0 ❑ ❑ ❑
Is the manhole free of visible signs of overflow? 0 ❑ ❑ ❑
Is the manhole free of sinkholes and depressions? ❑ ❑ ❑
Is manhole cover present? 0❑ ❑ ❑
Page: 5

permit: WQCSDO632 Owner -Facility: Aubrey Lewis Deaver
Inspection Date: 05/07/2015 Inspection Type: Collection System Inspect Non Sampling. Reason for Visit: Routine
# Is manhole properly seated? N ❑ ❑ ❑
# Is manhole in good condition? 0 ❑ ❑ ❑
# Is invert in good condition? ❑- ❑ ❑
Is line free -flowing and unrestricted in manhole? ❑ ❑ ❑
Is manhole free of excessive amounts of grease? 0 ❑ ❑ ❑
Is manhole free of excessive roots? N ❑ ❑ ❑
Is manhole free of excessive sand? N ❑ ❑ ❑
Is manhole's extended vent screened? ❑ 1:10 ❑
Are vents free of submergence? ❑ ❑. 0 ❑
Are manholes free of bypass structures or pipes? 0 ❑ ❑ ❑
Comment: This manhole was patched following the 2014 inspection.
Very slight amount of I&I on the day of inspection.
MH#30 PHASE IV - adjacen
Manhole
Is manhole accessible?
# Is manhole cover/vent above grade?
Is the manhole free of visible signs of overflow?
Is the manhole free of sinkholes and depressions?
Is manhole cover present?
# Is manhole properly seated?
# Is manhole in good condition?
# Is invert in good condition?
Is line free -flowing and unrestricted in manhole?
Is manhole free of excessive amounts of grease?
Is manhole free of excessive roots? .
Is manhole free of excessive sand?
Is manhole's extended vent screened?
Are vents free of submergence?
Are manholes free of bypass structures or pipes? -
Comment:
MH#7 PHASE V - in the stre
Manhole
Is manhole accessible?
# Is manhole cover/vent above grade?
Is the manhole free of visible signs of overflow?
Is the manhole free of sinkholes and depressions?
0
Yes No NA NE
❑ ❑ ❑
❑ ❑ ❑
❑ ❑ ❑
■❑❑❑
■❑❑❑
■❑❑❑
❑ ❑ ❑
❑ ❑ ❑
■❑❑❑
❑ ❑ ❑
❑ ❑ N ❑
❑ ❑ N ❑
■❑❑❑
Yes No NA NE
❑ ❑ ❑
❑ ❑ ❑
■❑❑❑
Page: 6

Permit; WQCSD0632 Owner- Facility: Aubrey Lewis Deaver
Inspection Date: 05/07/2015 Inspection type: Collection System Inspect Non Sampling
Reason for Visit: Routine
Is manhole cover present?
❑
# Is manhole properly seated?
M ❑ El 0
# Is manhole in good condition?
0 ❑ El El
# Is invert in good condition?
Q
Is line free -flowing and unrestricted in manhole?
Is manhole free of excessive amounts of grease?
M ❑
Is manhole free of excessiveroots?
E 0 El R
Is manhole free of excessive sand?
M ❑ 0
Is manhole's extended vent screened?
Are vents free of submergence?
M El
Are manholes free of bypass structures or pipes?
M El El El
Comment:
Page: 7

Page 20 of 69
(1) "Collection system" means a public or private sewer system, consisting of sewer lines, force mains, pump
stations or, any combination thereof that conveys wastewater to a designated wastewater treatment facility
or separately -owned sewer system. For purposes of permitting, the collection system is considered to be
any existing or newly installed system extension up to the wastewater treatment facility property or point of
connection with a separately -owned sewer system.
(2) "High -priority sewer" means any aerial sewer, sewer contacting surface waters, siphon, sewer positioned
parallel to streambanks that is subject to erosion that undermines or deteriorates the sewer, or sewer
designated as high priority .in a Division issued permit where the sewer does not meet minimum design
requirements.
History Note: Authority G.S. 143-215.1(a); 143-215.3(a); 143-215.9B,
Eff. September 1, 2006.
15A NCAC 02T .0403 PERMITTING BY REGULATION
(a) Collection systems having an actual, permitted or Division approved average daily flow less than 200,000 gallons per day
are deemed permitted pursuant to Rule .0113 of this Subchapter provided the system meets the criteria in Rule .0113 of this
Subchapter and all specific criteria required in this Rule:
(1) The sewer system is effectively maintained and operated at all times to prevent discharge to land or
surface waters, and to prevent any contravention'of groundwater standards or surface water standards.
(2) A map of the sewer system has been developed and is.actively maintained.
(3) An operation and maintenance plan including pump station inspection frequency, preventative
maintenance schedule, spare parts inventory and overflow response has been developed and implemented.
(4) Pump stations that are not connected to a telemetry system (i.e., remote alarm system) are inspected by the
permittee or its representative every day (i.e., 365 days per year). Pump stations .that are connected to a
telemetry system are inspected at least once per week.
(5) High -priority in
are inspected by the permittee or its representative at least once every six -months and
inspections are documented.
(6) A general observation by the permittee or its representative of the entire sewer system is conducted at least
once per year.
(7) Overflows and bypasses are reported to the appropriate Division regional office in accordance with 15A
NCAC 02B :0506(a), and public notice is provided as required by G.S. 143-215.1C.
(8) A Grease Control Program is in place as follows:
(A) For publicly owned collection systems, the Grease Control Program shall include at least bi-
annual distribution of educational materials for both commercial and residential users and the legal
means to require grease interceptors for new construction and retrofit, if necessary, of -grease
interceptors at existing establishments. The plan shall also include legal means for inspections of
the grease interceptors, enforcement for violators and the legal means to control grease entering
the system from other public and private satellite sewer systems.,
(B) For privately owned collection systems, the Grease Control Program shall include at least bi-
annual distribution of grease education materials to users of the collection system by the permittee
or its representative.
(C) Grease education materials, shall be.distributed more often than required in Parts (A) and (B) of
this Subparagraph if necessary to prevent grease -related sanitary sewer overflows.
(9) Right-of-ways and easements are maintained in the full easement width for personnel and equipment
accessibility.
(10) Documentation shall be kept for Subparagraphs (a)(1) through (a)(9) of this Rule for a minimum of three
years with exception of the map, which shall be maintained for the life of the system.
(b) Private collection systems on a, single property serving an industrial facility where the domestic wastewater contribution
is less than 200,000 gallons per day shall be deemed permitted.
(c) The Director may determine that a collection system should not be deemed to be permitted in accordance with this Rule
and Rule .0113 of this Subchapter. This determination shall be made in accordance with Rule .0113 (e) of this Subchapter.
History Note: Authority G.S. 143-215. I (a); 143-215.3(a); 143-215.9B;
Eff. September 1, 2006.
15A NCAC 02T .0404 MULTIPLE COLLECTION SYSTEMS UNDER COMMON OWNERSHIP
If a public entity owns multiple but separate collection systems (i.e., tributary to separate plants) and any one is subject to an
individual permit, all collection systems shall be covered under one permit. This shall not be applicable to public utilities
authorized to operate by the North Carolina Utilities Commission who own several individual systems within the state..
History Note: Authority G.S. 143-215. 1 (a); 143-215.3(a); 143-215.9B;
http://reports. oah.. state.nc.us/ncacltitle%2015 a%20%20environinent%2Oand%2Onatural%o2... 6/9/2015

A & D Water Service, Inc.
P.O. Box 1407 Pisgah Forest, NC 28768
June 30, 2014
Linda Wiggs
Environmental Senior Specialist
Dear Linda,
The collection system in High Vista consists of 30,400'of 8" gravity mains and 90
manholes. The 8" pipes are a combination of PVC and Ductile Iron.
The FOG materials were sent out once a year. The next mailing_ is due out at the end
of July to early August. We will set up a twice per year schedule.
I was unaware of the 10% per year inspection requirement or the need to document
inspections. I will be using. at the least a log, book to document these inspections in the.
future. We have inspected approximately 3,000' of lines & 12 manholes with a camera
in the past 2 years. The line paralleling the stream ( Split Creek Ct ) was inspected by
camera 2 years ago. No problems were found.
A & D purchased the. entire sewer system from NC 4'Cs in 2006.. The ownership name
change forms were sent in to Raleigh at that time and a new permit was issued.
The manhole we looked for below the Clubhouse does not exist. I was in error. The
nearest manhole is located at the intersection below the area we looked over. I have
looked in the manhole and have scheduled it to be cleaned.
The spill response plane is attached. All other records are available for inspection at
my office (46. Colwell Dr., Brevard ).
The manhole along 191 has been repaired.

June 30, 2014
Please contact me or my office if you have any questions.
Aubrey Deaver, President

Revised: 01/01/14
A&D WATER SERVICE
P. O. Box 1407
PISGAH FOREST, NC 28768
SPILL / BYPASS RESPONSE PLAN
Step 1: RECEIVE NOTIFICATION ABOUT SPILL/BYPASS;
Step 2: CONTACT A&D and/or OPERATOR;
Step 3: A&D and/or OPERATOR GOES TO SPILL SITE TO MAKE AN ASSESSMENT OF
THE SPILL;
Step 4: A&D or OPERATOR CONTACTS DWQ OFFICE TO ADVISE ABOUT SPILL
WITHIN 2 HOURS;
Step 5: PEOPLE AND EQUIPMENT ARE GATHERED TO STOP SPILL;
Step 6: SPILL/BYPASS IS CONTAINED;
Step 7: CLEANUP OF SITE;
Step 8: CONTACT DWQ AT REGIONAL OFFICE WITHIN 24 HOURS OF FIRST
NOTIFICATION OF THE SPILL;
Step 9: FOLLOW-UP WITH WRITTEN REPORT WITHIN 5 DAYS - IF REQUIRED.
24 HOUR CONTACT LIST
EMERGENCY CONTACT LIST
NAME TITLE AREA
Aubrey Deaver A&D Any
Aubrey Deaver Jr. A&D Any
EQUIPMENT LIST
Service Trucks (2)
Manhole blower
Tripods/harness/air packs
Lime & chlorine for cleanup
Hard hats/gloves/hand tools
Test Equipment
CELL
828-507-9853
828-243-2562
HOME
828-696-9391
OFFICE
828-884-9772
828-884-9772
Location
A&D Office at 46 Colwell Dr., Brevard, NC
A&D Office
A&D Warehouse
A&D Warehouse
A&D Warehouse
A&D Warehouse
Other needed equipment is rented from the City of Hendersonville.

Revised: 1/01/14
A&D WATER SERVICE
P. O. Box 1407
PISGAH FOREST, NC 28768
WASTEWATER COLLECTION SYSTEM
OPERATION & MAINTENANCE PLAN
A&D Water Service provides the following services:
1. Maintains qualified staff and/or subcontractors for O&M activities;
1. Provides a 24 hour emergency contact list;
2. Provides necessary equipment and repair parts or have access to same;
4. Provides lift station O&M; Lift stations with telemetry are checked 1/wk.; Lift stations w/o telemetry
are checked daily (7/wk.);
5. Maintains a set of system maps;
6. Provides the annual observation inspection, the high priority semi-annual inspection and ospot.
inspections as needed;
7. Provides for right-of-way maintenance;
8. Provides I/I evaluation, manhole inspections and sewer line cleaning on an mas needed. basis;
9. Provides a Grease Control Program; Grease education materials are distributed biannually;
Non-residential users are inspected as needed;
10. Spills and overflows are reported as required; Public notice is provided if required;
11. Maintains logs and/or records as required to demonstrate compliance;
12. Provides other services as Owner desires.
EMERGENCY CONTACT LIST
NAME TITLE AREA
Aubrey Deaver A&D Any
Aubrey Deaver Jr. A&D Any
EQUIPMENT LIST
Service Trucks (2)
Vacuum Truck
Manhole blower
Tripods/harness/air packs
Lime & chlorine for cleanup
Hard hats/gloves/hand tools
Test Equipment
CELL HOME OFFICE
828-507-9853 828-696-9391 828-884-9772
828-243-2562 828-884-9772
Location
A&D Office, 46 Colwell Dr., Brevard, NC
Contractor
A&D Office
A&D Warehouse
A&D Warehouse
A&D Warehouse
A&D Warehouse
Other needed equipment is rented from the City of Hendersonville.

D ONIT
E
H G S
Tie GREASE GOBLIN Cause
The
GREASE 0613LIN
Your drain's worst enemy!
Put ila d grease in collection
g
z, ta, ne rs
Remove oil and grease from
-kitchen utensils, equipment
apd food preparation areas
- c r-apers/towels/brooms
-ep p
.grease out. of wash water
dod scraps
collection
A PTT "
Fps
, , I rng fl :C N.C.Divis
Toll'F ree
DO NOT !.
Pour oil and grease d1oWl"'I&
drains
(2) Wash fryers/gridd:le'-spots
-
pans, a n d plates withwatt
until oil and, grease-,,ar6-,.re1.,rr.
Use hot water.to i
grease off surface
Put-food:s&

MI.RAW/i
J V d.D ER
North Carolina Department of Environment arL*
Pat McCrory
Governor
June 13, 2014
Aubrey Lewis Deaver
A&D Water Service Inc.
PO Box 1407
Pisgah Forest, NC 28768-1407
SUBJECT: Collection System Inspection
High Vista Falls
Permit No: WQCSD0128
Henderson County
Dear Mr. Deaver:
Natural Resources
John E. Skvarla, III
Secretary
On May 20, 2014, I conducted a Collection System Inspection of the High Vista Falls system. The system was
noncompliant with 15A NCAC 02T.0403. It appears that some of the criteria of this rule are being performed;
however there is insufficient documentation to substantiate. Please respond in writing to this office by June
30, 2014, with how you plan to document the operation and maintenance of this system. This collection
system is listed as being owned by the development company NC Four C, LLC Robert Duffy. Please also
clarify the current ownership of this system.
Refer to the enclosed inspection report for observations and comments. If you or your staff have any questions,
please call me at 828-2964500.
Sincerely,
Linda Wiggs
Environmental Senior Specialist
Asheville Regional Office
Enc. Inspection Report
cc: MSC 1617-Central Files -Basement
Elshevll Fi"'les
G:\WR\WQ\Henderson\Collection Systems\High Vista Falls Collection System\CEI. 05.20.14.doc
Water Quality Regional Operations —Asheville Regional Office
2090 U.S. Highway 70, Swannanoa, North Carolina 28778
Phone: [phone] FAX: [phone]
Internet: http://portal.ncdenr.org/webtwq
An Equal Opportunity 1 Affirmative Action Employer

Permit: WQCSD0128
SOC:
County: Henderson
Region: Asheville
Compliance Inspection Report
Effective: 03/01/00 Expiration: Owner: NC Four C's, LLC
Effective: Expiration: Facility: High Vista Falls Phase V
Contact Person: Robert J Duffy
Directions to Facility:
System Classifications:
Primary ORC:
Secondary ORC(s):
On -Site Representative(s):
Related Permits:
Title:
Inspection Date: 05/20/2014 Entry Time: 11:00 AM
Primary Inspector: Linda S WiggsOhl-I
Secondary Inspector(s):
Phone: [phone]
Certification: Phone:
Exit Time: 01:00 PM
Phone: [phone]
Ext.4653
Reason for Inspection: Routine Inspection Type: Collection System Inspect Non Sampling
Permit Inspection Type: Deemed permitted collection system management and
operation
Facility Status: 0 Compliant ® Not Compliant
Question Areas:
® Miscellaneous Questions ® Performance Standards ® Operation & Maint Reqmts ® Records
® Monitoring & Rpting ® Inspections ® Manhole
Reqmts
(See attachment summary)
Page: 1

Permit: WQCSDO128 Owner - Facility: NC Four C's, LLC
Inspection Date: 05/20/2014 Inspection Type: Collection System Inspect Non Sampling Reason for Visit: Routine
Inspection Summary:
This collection system (CS) serves the High Vista development, a small industrial park and will soon serve the Mills River
Health and Rehabilitation center. A&D Maintenance Inc. operates and maintains the collection system and the
wastewater treatment plant. This is the first inspection of the collection system.. Aubrey Deaver with A&D Maintenance
was present for the inspection as was Bev Price with DWR.
Mr. Deaver stated this was his first collection system inspection and he did not have the required paperwork with him, nor
did he send it upon request (email 5/21/14). The Inspector informed him onsite, and in an email (5/21/14), of the required
paperwork to document compliance with the 2T rules. It is suggested that the log sheets sent to Mr. Deaver in the email
be used to gain compliance. This collection system is small and it is possible that several of the required CS program
components are being met, however without the proper documentation this inspection is considered non -compliant.
Mr. Deaver stated that mailings for grease (FOG) are sent to residents annually and that work order invoices are used to
track work performed on the CS. FOG materials should be sent 2/yr or more often if needed.
The owner of this system is listed as NC Four C's, LLC Robert J. Duffy. The LLC could not be found on the Secretary of
State website and Mr. Duffy cannot be reached at the phone number supplied. Please clarify the ownership of this system.
Written response is required to indicate how compliance will be achieved.
Page: 2

Permit: WQCSDO128 Owner - Facility: NC Four C's, LLC
Inspection Date: 05/20/2014 Inspection Type: Collection System Inspect Non Sampling
Performance Standards
Reason for Visit: Routine
Yes No NA NE
Is Public Education Program for grease established and documented? IN Cl n n
What educational tools are used?
Mr. Deaver indicated they are using the State suggested form in a yearly mailing.
Mailings need to be sent twice a year.
He also stated he believed the Clubhouse does have a grease trap and it is pumped 2/yr.
We were unable to find the manhole below the Clubhouse to evaluate for grease. He will determine where that
manhole is located and evaluate if cleaning is needed.
Is Sewer Use Ordinance/Legal Authority available? n ®n n
Does it appear that the Sewer Use Ordinance is enforced? n ❑ ® ❑
Is Grease Trap Ordinance available? ❑ ❑ ® n
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?
n
n
®
n
Does CIP address short term needs and long term \"master plant/ concepts?
n
n
®
n
Does CIP cover three to five year period?
n
❑
®
n
Does CIP include Goal Statement?
n
n
®
Cl
Does CIP include description of project area?
❑
❑
®
n
Does CIP include description of existing facilities?
n
n
®
n
Does CIP include known deficiencies?
n
n
®
n
Does CIP include forecasted future needs?
❑
n
®
n
Is CIP designated'only for wastewater collection and treatment? n n IN n
Approximate capital improvement budget for collection system?
Total annual revenue for wastewater collection and treatment?
CIP Comments
A formal CIP is not required for this system. However, reinvestment into this system through sufficient
operation and maintenance is required, therefore the development of some semblance of a CIP is suggested.
Is system free of known points of bypass? ■ n ❑
If no, describe type of bypass and location
Is a 24-hour notification sign posted at ALL pump stations? n 0 ■ n
# Does the sign include:
Instructions for notification? n ❑ M fl
Pump station identifier? n ❑ ® n
Page: 3

Permit: WQCSDO128 Owner - Facility: NC Four C's, LLC
Inspection Date: 05/20/2014 Inspection Type: Collection System Inspect Non Sampling Reason for Visit: Routine
24-hour contact numbers
nn®n
If no, list deficient pump stations
# Do ALL pump stations have an "auto polling" feature/SCADA?
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?
# If yes, date implemented?
Describe:
Comment: See summary for detailed comments.
Inspections
Are maintenance records for sewer lines available?
Are records available that document pump station inspections?
Are SCADA or telemetry equipped pump stations inspected at least once a week?
Are non-SCADA/telemetry equipped pump stations inspected every day?
Are records available that document citizen complaints?
# Do you have a system to conduct an annual observation of entire system?
# Has there been an observation of remote areas in the last year?
Are records available that document inspections of high -priority lines?
Has there been visual inspections of high -priority lines in last six months?
Comment: See summary for detailed comments.
Operation & Maintenance Requirements
Are all log books available?
Does supervisor review all log books on a regular basis?
Does the supervisor have plans to address documented short-term problem areas?
What is the schedule for reviewing inspection, maintenance, & operations logs and problem areas?
See summary.
Are maintenance records for equipment available?
0000
11
Yes No NA NE
n®nn
n®nn
nn■n
nn®n
0 M 0 0
n®nn
n®nn
n®nn
n®nn
Yes No NA NE
n ® n n
Page: 4

Permit: WQCSDO128 Owner - Facility: NC Four C's, LLC
Inspection Date: 05/20/2014 Inspection Type: Collection System Inspect Non Sampling
Is a schedule maintained for testing emergency/standby equipment?
What is the schedule for testing emergency/standby equipment?
Do pump station logs include:
Inside and outside cleaning and debris removal?
Reason for Visit: Routine
Inspecting and exercising all valves?
Inspecting and lubricating pumps and other equipment?
Inspecting alarms, telemetry and auxiliary equipment?
Is there at least one spare pump for each pump station w/o pump reliability?
Are maintenance records for right-of-ways available?
Are right-of-ways currently accessible in the event of an emergency?
Are system cleaning records available?
Has at least 10% of system been cleaned annually?
What areas are scheduled for cleaning in the next 12 months?
Mr. Deaver stated they are doing camera work instead of cleaning. Camera work in concert with cleaning
should be performed.
See summary.
Is a Spill Response Action Plan available?
Does the plan include:
24-hour contact numbers
Response time
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: See summary.
Records
Are adequate records of all SSOs, spills and complaints available?
Are records of SSOs that are under the reportable threshold available?
nnffn
nn®n
nn®n
nn®n
nn®n
❑ ❑ 6 0
n®nn
0 N 0 0
n®nn
n®nn
0 U 0 0
Yes No NA NE
0 w 0 0
nMnn
Page: 5

Permit: WQCSD0128 Owner - Facility: NC Four C's, LLC
Inspection Date: 05/20/2014 Inspection Type: Collection System Inspect Non Sampling Reason for Visit: Routine
Do spill records indicate repeated overflows (2 or more in 12 months) at same location? n ® n Cl
If yes, is there a corrective action plan? n ON ❑ El
Is a map of the system available? W 0 n n
Does the map include:
Pipe sizes
❑
®n
Pipe materials
n
®
n
n
Pipe location
®
n
n
n
Flow direction
n
®
n
n
Approximate pipe age
n
®
n
n
Number of service taps
n
®
n
n .
Pump stations and capacity
n
n
®
ri
If no, what percent is complete?
List any modifications and extensions that need to be added to the map
Ths system is small and fairly young 1990's; the age and pipe material is similar. The map is the original
Engineer plan sheet, so the pertinent information is there.
# Does the permittee have a copy of their permit? ❑ ❑ a ❑
Comment: Deemed system.
2T Rule has been given to Mr. Deaver for assistance.
Monitoring and Reporting Requirements
Yes
No
NA
NE
Are copies of required press releases and distribution lists available?
Cl
n
®
n
Are public notices and proof of publication available?
n
n
®
n
# Is an annual report being prepared in accordance with G.S. 143-215.1C?
n
n
■
n
# Is permittee compliant with all compliance schedules in the permits?
n
n
n
If no, which one(s)?
Comment: Refer to summary.
MH -
Manhole
Yes
No
NA
NE
Is manhole accessible?
■
n
n
n
# Is manhole cover/vent above grade?
® n
n
n
Is the manhole free of visible signs of overflow?
® n
n
n
Is the manhole free of sinkholes and depressions?
■ n
n
n
Page: 6

Permit: WQCSD0128 Owner - Facility: NC Four C's, LLC
Inspection Date: 05/20/2014 Inspection Type: Collection System Inspect Non Sampling Reason for Visit: Routine
Is manhole cover present? ®❑ D fl
# Is manhole properly seated? ® D D D
# Is manhole in good condition?
®
D
D
D
# Is invert in good condition?
D
D
D
Is line free -flowing and unrestricted in manhole?
®
Cl
D
D
Is manhole free of excessive amounts of grease?
®
D
D
D
Is manhole free of excessive roots?
D
D
D
Is manhole free of excessive sand?
®
D
D
D
Is manhole's extended vent screened?
D
D
®
D
Are vents free of submergence?
D
Are manholes free of bypass structures or pipes?
®
D
D
D
Comment: There were several manholes inspected. As noted above, the one by the
clubhouse was not found during the inspection. Further conversation with Mr. Deaver
revealed he found the downstream manhole associated with the clubhouse. Upon
inspection he determined that line will need cleaning.
Two manholes (Split Crk Ct.) along the creek were inspected, they appeared ok. It was
suggested lines along the creek be considered for camera inspection to make sure I&I is
not ocurring.
The manhole by Hwy 191 did have some issues. This manhole will receive flows from
the Mills River Health Center. This manhole sits in a wetland and did have signs of I&I.
Since it was noted the WWTP receives elevated flows with rain events, remediating
sources of I&I should be a priority.
Page: 7

I L
North Carolina Department of Environment and Natural Resources
Pat McCrory John E. Skvarla, III
Governor Secretary
June 13, 2014
Aubrey Lewis Deaver
A&D Water Service Inc.
PO Box 1407
Pisgah Forest, NC 28768-1407
SUBJECT: Collection System Inspection
High Vista Falls
Permit No: WQCSDO128
Henderson County
Dear Mr. Deaver:
On May 20, 2014, I conducted a Collection System Inspection of the High Vista Falls system. The system was
noncompliant with 15A NCAC 02T.0403. It appears that some of the criteria of this rule are being performed;
however there is insufficient documentation to substantiate. Please respond in writing to this office by June
30, 2014, with how you plan to document the operation and maintenance of this system. This collection
system is listed as being owned by the development company NC Four C, LLC Robert Duffy. Please also
clarify the current ownership of this system.
Refer to the enclosed inspection report for observations and comments. If you or your staff have any questions,
please call me at 828-2964500.
Sincerely,
Linda Wiggs
Environmental Senior Specialist
Asheville Regional Office
Enc. Inspection Report
cc: MSC 1617-Central_ Files -Basement
Asheville Files =4
G:\WR\WQ\Henderson\Collection Systems\High Vista Falls Collection System\CEI. 05.20.14.doe
Water Quality Regional Operations — Asheville Regional Office
2090 U.S. Highway 70, Swannanoa, North Carolina 28778
Phone: [phone] FAX: [phone]
Internet: hUp.1/portal.nedenr.org/web/wq
An Equal Opportunity 1 Affirmative Acton Employer

Compliance Inspection Report
Permit:. WQCSDO128 Effective: 03/01/00
Expiration: Owner: NC. Four Cs, LLC
SOC: Effective:
Expiration: Facility: High Vista Falls Phase V
County: Henderson
Region: Asheville
Contact Person: Robert J Duffy
Title: Phone: 828-M-4000
Directions to Facility;
System Classifications:
Primary ORC:
Certification: Phone:
Secondary ORC(s):
On -Site Representative(s):
Related Permits:
Inspection Date: 05/20/2014 Entry Time:
11:00 AM Exit Time: 01:00 PM
Primary Inspector: Linda S Wiggs
Phone: [phone]
Ext.Secondary
Inspectors):
Reason for Inspection: Routine Inspection Type: Collection System Inspect Non Sampling
Permit Inspection Type: Deemed permitted collection system management and
operation
Facility Status: ❑ Compliant IN Not Compliant
Question Areas:
® Miscellaneous Questions Performance Standards Operation & Maint Reqmts ® Records
® Monitoring & Rpting ®Inspections Manhole
Reqmts
(See attachment summary)
Page: 1

Permit: WQCSDO128 Owner - Facility: NC Four C's, LLC
Inspection Date: 05/20/2014 Inspection Type: Collection System Inspect Non Sampling Reason for Visit: Routine
Inspection Summary:
This collection system (CS) serves the High Vista development, a small industrial park and will soon serve the Mills River
Health and Rehabilitation center. A&D Maintenance Inc. operates and maintains the collection system and the
wastewater treatment plant. This is the first inspection of the collection system.. Aubrey Deaver with A&D Maintenance
was present for the inspection as was Bev Price with DWR.
Mr. Deaver stated this was his first collection system inspection and he did not have the required paperwork with him, nor
did he send it upon request (email 5/21/14). The Inspector informed him onsite, and in an email �5/21/14); of the required
paperwork to document compliance with the 2T rules. It is suggested that the log sheets sent to Mr. Deaver in the email
be used to gain compliance. This collection system is small and it is possible that several of the required CS program
components are being met, however without the proper documentation this inspection is considered non -compliant.
Mr. Deaver stated that mailings for grease (FOG) are sent to residents annually and that work order invoices are used to
track work performed on the CS. FOG materials should be sent 2/yr or more often if needed.
The owner of this system is listed as NC Four C's, LLC Robert J. Duffy. The LLC could not be found on the Secretary of
State website and Mr. Duffy cannot be reached at the phone number supplied. Please clarify the ownership of this system.
Written response is required to indicate how compliance will be achieved.
Page: 2

Permit: WQCSDO128 Owner - Facility: NC Four C's, LLC
Inspection Date: 05/20/2014 Inspection Type: Collection System Inspect Non Sampling Reason for Visit: Routine
Performance Standards Yes No NA NE
Is Public Education Program for grease established and documented? ® n n n
What educational tools are used?
Mr. Deaver indicated they are using the State suggested form in a yearly mailing.
Mailings need to be sent twice a year.
He also stated he believed the Clubhouse does have a grease trap and it is_pumped 21yr.
We were unable to find the manhole below the Clubhouse to evaluate for grease. He will determine where that
manhole is located and evaluate if cleaning is needed.
Is Sewer Use Ordinance/Legal Authority available? n ® n n
Does it appear that the Sewer Use Ordinance is enforced? n n ( n
Is Grease Trap Ordinance available? n n ® n
Is Septic Tank Ordinance available (as applicable, i.e. annexation) n n ® n
List enforcement actions by permittee, if any, in the last 12 months
Has an acceptable Capital Improvement Plan (CIP) been implemented?
n
Cl ®
n
Does CIP address short term needs and long term \"master plant/ concepts?
n
n ®
n
Does CIP cover three to five year period?
nn®n.
Does CIP include Goal Statement?
n
n im
n
Does CIP include description of project area?
n
n IN
n
Does CIP include description of existing facilities?
n
n ®
n
Does CIP include known deficiencies?
n
n ®
n
Does CIP include forecasted future needs?
n
n IN
n
Is CIP designated' only for wastewater collection and treatment?
n
n ®
n
Approximate capital improvement budget for collection system?
Total annual revenue for wastewater collection and treatment?
CIP Comments
A formal CIP is not required for this system. However, reinvestment into this systemthrough sufficient
operation and maintenance is required, therefore the development of some semblance of a. CIP is suggested.
Is system free of known points of bypass?
®n
n
n
If no, describe type of bypass and location
Is a 24-hour notification sign posted at ALL pump stations? n n ® n
# Does the sign include:
Instructions for notification?
nn®n
Pump station identifier? n n ® n
Page: 3

Permit: WQCSDO128 Owner - Facility: NC Four C's, LLC
Inspection Date: 05/20/2014 Inspection Type: Collection System Inspect Non Sampling Reason for Visit: Routine
24-hour contact numbers n n n
If no, list deficient pump stations
# Do ALL pump stations have an "auto polling" feature/SCADA?
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?
# If yes, date implemented?
Describe:
Comment: See summary for detailed comments.
Inspections
Are maintenance records for sewer lines available?
Are records available that document pump station inspections?
Are SCADA or telemetry equipped pump stations inspected at least once a week?
Are non-SCADA/telemetry equipped pump stations inspected every day?
Are records available that document citizen complaints?
# Do you have a system to conduct an annual observation of entire system?
# Has there been an observation of remote areas in the last year?
Are records available that document inspections of high -priority lines?
Has there been visual inspections of high -priority lines in last six months?
Comment: See summary for detailed comments.
Operation & Maintenance Requirements
Are all log books available?
Does supervisor review all log books on a regular basis?
Does the supervisor have plans to address documented short-term problem areas?
What is the schedule for reviewing inspection, maintenance, & operations logs and problem areas?
See summary.
Are maintenance records for equipment available?
nnEgn
0
0INnn
onion
n®nn
nn®n
0 0 M 0
n®nn
0 a 0 0
0 M 0 0
OW00
nminn
Yes No NA NE
n Oil nn
nnIMn
nnEMn
n®nn
Page: 4

Permit: WQCSDO128 Owner - Facility: NC Four C's, LLC
Inspection Date: 05/20/2014 Inspection Type: Collection System•lnspect Non Sampling Reason for Visit: Routine
Is a schedule maintained for testing emergency/standby equipment? n n ®fl
What is the schedule for testing emergency/standby equipment?
Do pump station logs include:
Inside and outside cleaning and debris removal?
n
n
®
n
Inspecting and exercising all valves?
rl
n
®
n
Inspecting and lubricating pumps and other equipment?
n
Cl
w
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
Are right-of-ways currently accessible in the event of an emergency?
n
®n
n
Are system cleaning records available?
n
®
n
n
Has at least 10% of system been cleaned annually?
rll
®
n
n
What areas are scheduled for cleaning in the next 12 months?
Mr. Deaver stated they are doing camera work instead of cleaning. Camera work in concert with cleaning
should be performed.
See summary.
Is a Spill Response Action Plan available?
n
P1
0
n
Does the plan include:
24-hour contact numbers
n
®
n
n
Response time
❑
®
n
n
Equipment list and spare parts inventory
❑
■
Access to cleaning equipment
n
®
n
n
Access to construction crews, contractors, and/or engineers
In
®
n
n
Source of emergency funds
n
®
n
n
Site sanitation and cleanup materials
n
®
nl
n
Post-overflow/spill assessment
❑
N
0
n
Is a Spill Response Action Plan available for all personnel?
n
IN
n
n
Is the spare parts inventory adequate?
Cl
®❑
0
Comment: See summary.
Records Yes No NA NE
Are adequate records of all SSOs, spills and complaints available? n ❑ n
Are records of SSOs that are under the reportable threshold available? 0 ■ El fl
Page: 5

Permit: WQCSD0128 Owner - Facility: NC Four C's, LLC
Inspection Date: 05/20/2014 Inspection Type: Collection System Inspect Non Sampling Reason for Visit: Routine
Do spill records indicate repeated overflows (2 or more in 12 months) at same location? n ® n Cl
If yes, is there a corrective action plan? n 1W n n
Is a map of the system available? is Cl n n
Does the map include:
Pipe sizes
n
® n
n
Pipe materials
n
®n
n
Pipe location
Ng
n n
n
Flow direction
n
® o
o
Approximate pipe age
n
E n
n
Number of service taps
n
lm n
n
Pump stations and capacity
n
n ®
n
If no, what percent is complete?
.List any modifications and extensions that need to be added to the map
Ths system is small and fairly young 1990's; the age and pipe material is similar. The map is the original
Engineer plan sheet, so the pertinent information is there.
# Does the permittee have a copy of their permit?
n
Cl IN
❑
Comment: Deemed system.
2T Rule has been given to Mr. Deaver for assistance.
Monitoring and Reporting Requirements
Yes No NA
NE
Are copies of required press releases and distribution lists available?
n
n ®
n
Are public notices and proof of publication available?
n
n ®
n
# Is an annual report being prepared in accordance with G.S. 143-215.1 C?
n
n ®
n
# Is permittee compliant with all compliance schedules in the permits?
n
n ®
n
If no, which one(s)?
Comment: Refer to summary.
MIH o
Manhole
Yes
No
NA NE
Is manhole accessible?
®
n
n n
# Is manhole cover/vent above grade?
®
n
n n
Is the manhole free of visible signs of overflow?
n
n n
Is the manhole free of sinkholes and depressions?
n
n n
Page: 6

Permit: WQCSD0128 Owner - Facility: NC Four C's, LLC
Inspection Date: 05/20/2014 Inspection Type: Collection System Inspect Non Sampling Reason for Visit: Routine
Is manhole cover present?
o ❑ n
# Is manhole properly seated?
0 n n
# Is manhole in good condition?
pffi ❑ n Q
# Is invert in good condition?
® n ❑ n
Is line free -flowing and unrestricted in manhole?
9 ❑ 0 ❑
Is manhole free of excessive amounts of grease?
00 n
Is manhole free of excessive roots?
n n n
Is manhole free of excessive sand?
IN 00 n
Is manhole's extended vent screened?
n 00 n
Are vents free of submergence?
n n ® n
Are manholes free of bypass structures or pipes?
❑ 0
Comment: There were several manholes inspected. As noted above, the one by the
clubhouse was not found during the inspection. Further conversation with Mr. Deaver
revealed he found the downstream manhole associated with the clubhouse. Upon
'inspection he determined that line will need cleaning.
Two manholes (Split Crk Ct.) along the creek were inspected, they appeared ok. It was
suggested lines along the creek be considered for camera inspection to make sure I&I is
not ocurring.
The manhole by Hwy 191 did have some issues. This manhole will receive flows from
the Mills River Health Center. This manhole sits in a wetland and did have signs of I&I.
Since if was noted the WWTP receives elevated flows with rain events, remediating
sources of,l&I should be a priority.
Page: 7

Compliance Inspection Report
PermEffective: 03/01/00 Expiration: Owner: NC Four C's, LLC
SOC: Effective: Expiration: Facility Hielh UisMIts Phas-
County: Henderson
Region: Asheville
Contact Person: Robert J Duffy
Directions to Facility:
System Classifications:
Primary ORC:
Secondary ORC(s):
On -Site Representative(s):
Related Permits:
Inspection Date: 05/16/2014
Primary Inspector: Linda S Wiggs
Secondary Inspector(s):
Title:
Certification:
Entry Time: 11:00 AM Exit Time: 01:00 PM
Phone: [phone]
Phone:
Phone: [phone]
Ext.4653
Reason for Inspection: Routine Inspection Type: Collection System Inspect Non Sampling
Permit Inspection Type: Deemed permitted collection system management and
operation
Facility Status: ❑ Compliant ❑ Not Compliant
Question Areas:
Miscellaneous Questions Performance Standards Operation & Maint Reqmts Records
■ Monitoring & Rpting ■ Inspections Pump Station Manhole
Reqmts
Lines
�f f,
(See attachment summary) �`7 �'�� � ' VVI/Ij
ems,
UH/cH-11YA,1
Page: 1

Permit: WQCSD0128 Owner -Facility: NC Four C's, LLC
Inspection Date: 05/16/2014 Inspection Type: Collection System Inspect Non Sampling Reason for Visit: Routine
Inspection Summary:
Page: 2

Permit: WQCSDO128 Owner - Facility: NC Four C's, LLC
Inspection Date: 05/16/2014 Inspection Type: Collection System Inspect Non Sampling Reason for Visit: Routine
Performance Standards f - 6 ,J�r—�
Is Public Education Program for grease established and documented? ` /q1
What educational tools are used? CIL
Is Sewer Use Ordinance/Legal Authority available?
Does it appear that the Sewer Use Ordinance is enforced?
Is Grease Trap Ordinance available? r
Is Septic Tank Ordinance available (as applicable, i.e. annexation) NA
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 \"master plan\" 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? y
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
Yes No NA NE
nnnn
n n n n
nnnn
n n n n
nnnn
nnnn
nnnn
n n n n
nnnn
n n n n
nnnn
n n n n
nnnn
n n n n
n n n n
nnnn
n n n n
n n n n
n n n n
Page: 3

Permit: WQCSDO128 Owner - Facility: NC Four C's, LLC
Inspection Date: 05/16/2014 Inspection Type: Collection System Inspect Non Sampling Reason for Visit: Routine
# Do ALL pump stations have an "auto polling" feature/SCADA?
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?
# If yes, date implemented?
Describe:
Comment:
Inspections C� 5 ►''^
Are maintenance records for sewer lines available?
Are records available that document pump station inspections?/V-A
Are SCADA or telemetry equipped pump stations inspected at least once a week?
Are non-SCADA/telemetry equipped pump stations inspected every day? IYA
Are records available that document citizen complaints? /t/OIV1°-1
# Do you have a system to conduct an annual observation of entire system?
# Has there been an observation of remote areas in the last year? y
Are records available that document inspections of high -priority lines? /✓A
Has there been visual inspections of high -priority lines in last six months?
Comment: C2
Operation & Maintenance Requirements
Are all log books available? i Cs2
Does supervisor review all log books on a regular basis? 0­7 IILI °
Does the supervisor have plans to address documented short-term problem areas?
What is the schedule for reviewing inspection, maintenance, & operations logs and problem areas?
Are maintenance records for equipment available? ` -
Is a schedule maintained for testing emergency/standby equipment? IVA
What is the schedule for testing emergency/standby equipment?
n n n n
nnnn
Yes No NA NE
n n n n
n n n n
n n n n
nnnn
n n n n
nnnn
Yes No NA NE
n n n n
nnnn
n n n n
n n n n
nnnn
Page: 4

Permit: WQCSDO128 Owner - Facility: NC Four C's, LLC
Inspection Date: 05/16/2014 Inspection Type: Collection System Inspect Non Sampling Reason for Visit: Routine
Do pump station logs include:
naidoutside cleaning a d debris removal?
�nsp:cting-and
❑
n
n
n
❑
n
n
ndeexercising
all valves.
'cating
n
n
n
n
Inspecting and lub pumps and other e ipment?
Inspecting alarms, teleme , and auxiliary equipment.
❑
Is there at least one spare pump fore pump station w/o pump reliability?
n
n
n
n
Are maintenance records for right-of-ways ava�table?
n
n
n
n
Are right-of-ways currently accessible in the event of an emergency?
n
n
n
n
Are system cleaning records available? /4/0
n
n
n
n
Has at least 10% of system been cleaned annually? /1/0
n
n
n
n
What areas are scheduled for cleaning in the next 12 months?
Is a Spill Response Action Plan available?
n
n
n
n
Does the plan include:
24-hour contact numbers
n
n
n
n
Response time
n
n
n
n
Equipment list and spare parts inventory
n
n
n
n
Access to cleaning equipment
n
n
n
n
Access to construction crews, contractors; and/or engineers
n
n
n
n
Source of emergency funds
n
n
n
In
Site sanitation and cleanup materials
❑
n
Post-overflow/spill assessment
n
n
n
n
Is a Spill Response Action Plan available for all personnel?
n
n
n
n
Is the spare parts inventory adequate?
n
n
n
n
Comment:
i�'tG ' " — LWJYes
Records
�'�� No
NA
NE
Are adequate records of all SSOs, spills and complaints available?
Are records of SSOs that are under the reportable threshold available? n n
n
n
Do spill records indicate repeated overflows (2 or more in 12 months) at same location? n n
n
In
If yes, is there a corrective action plan?
n n
n
n
Is a map of the system available?
n n
n
n
Page: 5

Permit: WQCSD0128 Owner - Facility: NC Four C's, LLC
Inspection Date: 05/16/2014 Inspection Type: Collection System Inspect Non Sampling 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
# Does the permittee have a copy of their permit? /P14
Comment:
Monitoring and Reporting Requirements
Are copies of required press releases and distribution lists available?
Are public notices and proof of publication available? /'1A
# 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:
1-
Pump Station
Pump station type VA
Are pump station logs available?
Is it accessible in all weather conditions?
# Is general housekeeping acceptable?
Are all pumps present?
Are all pumps operable?
Are wet wells free of excessive debris?
Are upstream manholes free of excessive debris/signs of overflow?
n n n n
n n n n
nnnn.
n n n n
nnnn
Yes No NA NE
Yes No NA NE
nnnn
nnnn
nnnn
nnnn
nnnn
nnnn
n n n n
Page: 6

Permit: WQCSD0128 Owner - Facility: NC Four C's, LLC
Inspection Date: 05/16/2014 Inspection Type: • Collection System Inspect Non Sampling
Reason for Visit:
Routine
Are floats/controls for pumps/alarms operable?
n
n
n
n
Is "auto polling" feature/SCADA present?
n
n
n
n
Is "auto pollin " feature/SCADA operational?
n
n
n
n
Is simple telemetry present?
n
n
Is simple telemetry'operational?
n
n
n
n
Are audio and visual alarms present?
n
n
n
n
Are audio and visual alai,Ts operable?
n
n
n
❑
Is the Pump station inspected as required?
n
n
n
n
Are backflow, devices in place,?
n
n
n
n
Are backflow devices operable?
n
n
n
n
z
Are it relief Ives in place?
n
n
o
o
Are air relief valve operable?
ti
n
n
n
n
# Is an emergency � enerator available?
n
n
n
n
Can the emergency ge erator run; the pumps?
1�
o
n
n
n
1
Is`the pump station equip ed for quick hook-up?
n
❑
n
n
Is the generator operable?
n
n
n
n
# Is fuel in tank and sufficient?
n
n
n
n
Is the ge�erator inspected according t, t eir schedule?
n
n
n
n
Is a 24-ho, r notification sign posted?
n
n
n
n
Does it i
cticlude:
Instruons for notification?
n
n
n
n
Pump station identifier?
n
n
n
n
Emergency phone number
n
n
n
n
Is public accessl_limited?
n
n
❑
n
Is pump station free of overflow piping?
n
n
n
n
Is the pump station free of signs of overflow?
n
n
n
n
Are run times comparable for multiple pumps?
Comment:
MAIN -
Lines/Right-of-Ways/Aeriel Lines Yes No NA NE
Page: 7

Permit: WQCSD0128 Owner - Facility:
NC Four C's, LLC
/ Inspection Date: 05/16/2014 Inspection Type: Collection System Inspect Non Sampling Reason for Visit:
Routine
Is right-of-way accessible for emergency?
n
n
n
n
Is right-of-way free of sinkholes or depressions?
n
n
n
n `
Is line/right-of-way free of evidence of leakage?
n
n
n
n
# Are there areas of exposed line?
n
n
n
n
# Is any exposed line constructed of ductile iron or other approved material?
n
n
n
n
Are water crossing and supports in good condition?
n
n
n
n
# Is right-of-way free of non -utility motorized traffic?
n
n
n
n
Is line free of visible damage?
n
n
n
n
# Are there siphons in this system?
n
n
If yes, are they maintained and documented?
Comment:
���
MH -' !r✓� / /
Manhole
c-- 'I C_k es No
YL
NA
NE
Is manhole accessible? Y
�
n
n
n
n
# Is manhole cover/ventabove grade? 1
d"— 1
n
n
n
n
Is the manhole free of visible signs of overflow? j�
n
n
n
n
Is the manhole free of sinkholes and depressions?
/ y
o
o
n.
n
Is manhole cover present?Y
n
n
o
o
# Is manhole properly seated? 0 �" "� I
,./
�e tee/ M N )'/ SJ` F� l /J 1/�'
n
n
n
n
# Is manhole in good condition?�64-z-
CLL_
n
n
n
n
# Is invert in good condition?
"��l 4V�� MIAr�—�v '�
J
n
o
n
n
Is line free -flowing and unrestricted in manhole? Y
n
n
n
n
Is manhole free of excessive amounts of grease?y
d�J �v ��
n
n
n
n
Is manhole free of excessive roots?/v
n
n
n
n
Is manhole free of excessive sand? y
n
n
n
n
Is manhole's extended vent screened? /f i
n
n
n
n
Are vents free of submergence? /U�
n
n
n
n
Are manholes free of bypass structures or pipes? /v
Comment:
n
n
n
n
Page: 8

Wiggs, Linda
From: Wiggs, Linda
Sent: Wednesday, May 21, 2014 3:52 PM
To: [e-mail]
Subject: items needed High Vista .
Attachments: WWCS_Operational_Logs_Package 1206.xlsx
HI Aubrey,
I will wait to write up the inspection reports if you will get me the following items by Friday May 30th please. These items
are documentation needed to complete the inspection.
WWTP
*ORC designation form -this has not been received in Raleigh or Asheville, please resend the form with the ORC and
BORC. Send the form to the address in Raleigh, but also send me a copy.
*A copy of the Operator Log book entries for the last month; April 215Y thru May 21't. I contacted Vince to get this and
he is on vacation. This poses another question; who will be operating that WWTP in his absence?
*Flow meter calibration proof; work order.
*You stated two week ago Carolina Energy worked on the Generator; please send proof of this work ... you said you
should be receiving a bill that will show their visit.
CS
*Educational material for FOG.
*Spill Response Plan
*.Revenue collected for the wastewater and monies reinvested back into the system for 2013. For Example: Say if you
received $100,000 in -tap fees; that would be the revenue number. And if you had to make repairs to 25 feet of line
and/or had three days of laborers and equipment working on the system to clean, video, or smoke the lines; that would
be a reinvestment number. Do not include in the reinvestment workers' salaries for the year'or maintenance you did on
the WWTP, that is s separate line item and not what 1 am looking for here.
The above items can be sent to me electronically by May 30th. The items below will be incorporated into the inspection
report and will required a response as well. That response will be 15 days after the date on the inspection report letter
will go ahead and provide you a bullet list so you can plan for those items and response.
WWTP:
*litter on the ground from bar screen
*operational issues -I will talk with Vince once he is back to get some clarification on this but it will be mentioned in the
report so I will include it here.
** process controls, lack of blanket in clarifier, solids beyond clarifier, composite sampler (aliquot, location, method),
Chlorine dosing/tubing, flow recorder etc.
*EQ alarm
*Flow meter chart, solids in float chamber, calibration
*standby generator remedy
*paper trail
CS:
*documentation -O&M, inspections
*find Manhole (MH) by clubhouse
*fix I&I at MH by road
*may need to visit industries regarding their wasteflow/type to WWTP.

I have attached the collection system logs for your use. There are colored tabs along the bottom of the spreadsheet that
bring you to the different log sheets. There are many, you do not have to use all of these for your system. However,
there are several you should seriously consider using as they are laid out for proper documentation requirements and
are not difficult to use, i.e. FOG Log, ROW Log, Line, Cleaning, High Priority Insp/Maint. The Line Cleaning log can be
modified to document your video and smoke testing, the PS Gen Insp Log can be modified to use at the WWTP for that
generator.
Give me a call if you have any questions.
Thanks,
iQ"
[e-mail]
Environmental Senior Specialist
North Carolina Dept. of Environment and Natural Resources
Asheville Regional Office
Division of Water Resources - Water quality Regional Operations
2090 U.S. 70 Highway
Swannanoa, NC 28778
Tel: [phone]
Fax: [phone]
Link to Division of Water Resources Home Page
http://Porta I.ncde nr.or/web/wq
Notice: E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and
therefore may be disclosed to third parties.

Wiggs, Linda
To: [e-mail]
Subject: collection system info
Attachments: May2014 WQCSD0128.pdf; WWCS_Operational_Logs_Package 1206.xlsx;
WQ0020700.pdf
Hi Aubrey,
To assist you with the collection system (CS) inspections I have attached the following:
*A blank'inspection check list (May 2014 WQCSD0128). You will receive a completed copy of this with the inspection
letter.
*An excel spreadsheet of collection system logs (WWCS... ). There are colored tabs along the bottom that bring you to
many different log sheets; I believe there are 16 in total.
*The CS permit for High Vista (WQ0020700). This is actually referred to as a Fast Track Sewer'Extension Permit.
With regard to the permit, it is the only one I could find easily. I can put in a request to Raleigh if you would like to look
for others, but the older ones may be in Central Files. And they would basically be the same information which is what I
wanted you to see. I know Kathy said she gave you the 2T rules related to deemed systems. So that rule and this permit
language lets you see the legal citations regulating these systems.
With regard to the inspection report and the log sheets, these are designed to be all encompassing, so they cover
material for very large systems as well. Since your systems are smaller there may be areas you don't have to concern
yourself with.
It is not required that you use these log sheets, however, they were created by a DWQ staffer and do cover all the basis
with regard to what we look for and expect to be presented to us during an inspection. It is your call whether you don't
use them , use them or manipulate them to suit your preference. If nothing else definitely go through them thoroughly
so you get a feel for what ,we want to see for documentation requirements.
b }
Finally, the inspection check list is horribly laid out, it drives me crazy but I cannot change it. So bear with it being all over
the place. But go through it too. Once you look at it and the logs sheets you may decide it is easier to use those logs
instead of having to pull together work orders etc. I say this because I have found that some folks that use work orders
do not have enough detail listed on those work orders to properly document the job done; i.e. a work order might just
say cleared right of way (ROW) or cleaned lines. That would not be enough information because it would not tell the
inspector where the ROW was performed or which lines and how many feet of lines were cleaned.
Anyhow feel free to give me a call with questions,
!Q" owo-
[e-mail]
Environmental Senior Specialist
North Carolina Dept. of Environment and Natural Resources
Asheville Regional Office
Division of Water Resources - Water Quality Regional Operations
2090 U.S. 70'Highway
Swannanoa, NC 28778
Tel: [phone]
Fax: [phone]
Link to Division of Water. Resources Home Page
http://Porta1.ncdenr.org/web/wq

Betty Roberts
44 La Vista Drive
Mills River, NC 28759-2619
A V�TS�TA VJI'L ACrE CQI 1D(L31VI1NIiJ=IvLASSo'Ic
99 La Vista Drive, Mills River, NC 28759
26 September2010
Mr. Audrey Deaver
A & D Water Service, Inc.
P.O. Box 1407
Pisgah Forest, NC 28788
Dear Mr. Deaver,
Our association recently had our lift station professionally inspected. There were several
deficiencies and/or defects found. The most notable were:
(1) The telephone alarm system was inoperable. In addition to the
Telephone line having been cut, AT&T had disconnected service.
We are in the process of ascertaining when that occurred.
(2) One pump is operating below capacity, the second is not functioning
- and is being replaced.
(3) The generator has not been servicedtsin�3 2003 and the timer was notl
set.
W� CST��7e�8
In light of the situation you are advised that we have retained James & James Environmental
Management, Inc. To maintain and service our lift station. We have also transferred all the
applicable accounts into the name of La Vista Village Condominium Association.
CC: N.C. Utilities. Commission, Chief Clerk
Bruce -Vaughn, Engineer, Public Staff,
Roy Davis, NCDENR, Western Regional Office t!
Very truly yours,
La Vista Village Condominium
Association
Betty C. R�rts,x
President ,
E V
SE
P 2 8 2010 '
1 WATER QUALITY SECTION

jfl,L Dr
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4
VVAT�C Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Coleen H. Sullins, Director
Division'of Water Quality
SURFACE WATER PROTECTION SECTION
September 6, 2007
Mr. Duffy
NC Four C's, LLC
81 Avondale Cir
Arden, NC 28704
SUBJECT: Wastewater Collection System
Owner & Operator Requirements
High Vista Falls Phase V
Wi jCtS,
.R,)-@
I 2i
Henderson County
Dear Mr. Duffy:
I would like to take this opportunity to discuss the requirements for sewerage collection
systems that were first established in 15 NCAC .02H .0200 in March 2000 and are now found in
15 NCAC 2T .0403, Waste Not Discharged to Surface Waters, which became effective
September 1, 2006. These Regulations place significant operation, maintenance and reporting
requirements on those entities that own or operate a wastewater collection system with average
daily flows of less than 200,000 gallons per day.
These regulations are applicable to your facility. This letter is provided as guidance
to assist you in complying with the new reporting and operations and maintenance (O&M)
requirements and to advise you that you are subject to system review, inspections and possible
enforcement, if the system is not in compliance with the regulation.
For your convenience and easy reference, a highlight of these requirements and the
following guidance are offered (see enclosed). You may find the regulations using the following
web site: http://h2o.enr.state.nc.us/peres/Collection%2OSystems/CollectionSystemsHome.html
The Asheville Regional Office will be increasing the level of oversight, compliance
activities and enforcement relating to collections systems, therefore, we wanted to be sure you
are aware of the requirements for these systems. We will be performing NPDES Wastewater
Collection System inspections sometime in the near future.
NorthCarolina
Naturally
North Carolina Division of Water Quality 2090 US Hwy 70; Swannanoa, NC 28778 Phone [phone]
Internet: www..ncwaterquality.org Customer Service 1-877-623-6748 FAX [phone]
An Equal Opportunity/Affirmative Action Employer — 50% Recycled/10% Post Consumer Paper

September 6, 2007
Page 2 of 2
If this Office has not previously inspected your wastewater collection system and records
of same, you should be prepared to demonstrate compliance with all criteria listed above.
Enclosed, is an inspection form that you can use to assemble your records prior to an inspection
by the staff of this Office.
This Office has a Wastewater Treatment Plant Consultant on staff to offer assistance to
you in complying with the requirements of these regulations. Should you have questions or
need additional information regarding this issue, please contact Don Price at [phone].
Should you have any other questions concerning this correspondence or the
requirements relating to collection systems, please contact Roy Davis or Keith Haynes at 828-
296-4500.
Sincerely,
Roger C. Edwards, Supervisor
Surface Water Protection Section
cc: Deborah Gore - PERCS Unit_- w/out enclosures_ _
��bwifle-Regional=Office-fac�l'ity-fiPe= w%out enclosures}
DWQ - SWPS - Central Office Files - w/out enclosures

Jul 12 04 03:23p MR*MRS HARRY JAMES 8286969738
James & James Environmental Management, Inc.
PO Box 1354, Mountain Hume, NC 28758
Office: [phone] Fax: [phone]
Recipient.--E�ef
Company:
Fax Number: ;2C7q - -705�3
Voice Number: c�l 0
Date: q 1 tZ *1 (54
Tltne: 17 2D p m
Total No. Pages
(includes cover).
Subject: q vj�ja
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JuI 12 04 03:23p MR*MRS HARRY JAMES 8286969738 p.3
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avided +mF ettti+ra i ssce upon+ regret.)
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Section 8:
SSO Enforcement Guidance
EXHIBIT B: SSO EVALUATION FACTORS
Incident #: a Q Q 1f0 ! �
Permittee:"v-
Date of Incident: (
ARE ANY OF THESE FACTORS A BASIS FOR
PROCEEDING WITH FURTHER ACTION?
FACTOR
YES
NO
COMMENTS
Volume/Duration
Surface Water
• Sensitive/High Priority
SA / ORW / WS, etc.
Damage ,
• Fish Kill
• Property
• Public Health Concerns
Weather Conditions and other Uncontrollable
Factors
• Severe Natural Condition (hurricane,
tornado, etc.)
• Vandalism/Third Party
• Other
Repetitiveness Same Location
(past 24 mo
Repetitiveness Same Cause
(past 24 mo
C.�
Preventability
• Proper O&M
• Storm Preparation
System -wide Compliance (past 24 mo)
• Similar causes multiple instances
• Previous actions like NOVs /
Enforcements
• Failure to react to Technical
Assistance from Division
Response to Spill
Adequate time & cleanup)t�
Proactiveness
• Active programs for III, grease, roots,
etc.
• CIP program
CONCLUSION: Does overall evaluation or
o Action
❑ Action
any one single factor result in the need to
Sta this to report
NOV SOC Pending
proceed with action?
File
Enforcement Moratorium
Close out incident in BIMS
No Action
Additional Comments:
Form completed by Date 7 h (0
Page 9 of 9 10/03

Section 8:
SSO Enforcement Guidance
EXHIBIT B: SSO EVALUATION FACTORS
Incident#: i�t� i7�-j-C� 1+3
Permittee: 1 3 Fcp,�
Date of Incident:
ARE ANY OF THESE FACTORS A BASIS FOR
PROCEEDING WITH FURTHER ACTION?
FACTOR
YES
NO
COMMENTS
Volume/Duration
Surface Water
• Sensitive/High Priority
SA / ORW / WS, etc.
t/
Damage
• Fish Kill
Cl
• Property
• Public Health Concerns
Weather Conditions and other Uncontrollable
Factors
/
• Severe Natural Condition (hurricane,
(O
tornado, etc.)
• Vandalism/Third Party
• Other
Repetitiveness Same Location
tl
(past 24 mo
Repetitiveness Same Cause
(past 24 mo
Preventability
• Proper O&M
• Storm Preparation
System -wide Compliance (past 24 mo)
• Similar causes multiple instances
• Previous actions like NOVs /
Enforcements
• Failure to react to Technical
Assistance from Division
Response to Spill
Adequate time & cleanup)C/
Proactiveness
• Active programs for 1/I, grease, roots,
etc.
• CIP program
CONCLUSION: Does overall evbluation or
lNo Action
❑ Action
any one single factor result in the need to
Staple this to report
NOV SOC Pending
proceed with action?
File
Enforcement Moratorium
Close out incident in BIMS
No Action
Additional Comments:
,.
Form completed by �) Date
Page 9 of 9 10/03

■ Co lete items 1, 2, and 3. Also complete A. Sig t e
it if Restricted Delivery is desired. X JW
■ P our name and address on the reverse
so that we can return the card to you. B. eceived by (rinte ame):
■ Attach this card to the back of the mailpiece,
_ or on the front if space permits.
North Carolina Department �i�f�ot;,te
elry
Environment and Natural Resou d S ss
,�fF18
Division of Water Reso s
Water Quality Regional Operations, gga�s io
2090 U.S. Highway,70, Swannanoa, NC 287 81
NCD "' NR
Aubrey. Lewis Deaver finegist
is Type
A & D Water Service, Inc. ertrtted Mail® Priorityy
Post office Box 1407i�'Led \�'.8etum Ri�+c,
Pisgah Forest, NC 28768-1407 ❑ Insured ai �❑ olJec Sn l
III didileee1eee1Hen1nr111en1IRestrictedDelivery? tra:V )
❑ Agent
❑ Addressee
Date of Deliver)
1? ❑ Yes
❑ No
❑ Yes
7014 05100000, 4466 0691, MTV-a2t115_ P� o�,��
PS` Fora 3811. Julv20y3 1 1 11 1 Domestic Return Receipt

UNITED STATES POSTALSER=E"
,.,.,fI�,,•,,,,,,, •',,,,„,,,. -first-ClassNtail
1.I I I P P stage & Fees
4 G�5 Permit o. G-14
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MS. BEVERLY P ICE �:•
NCDENR-DWR-WQROS aJ ,
2090 U.S. HIGHWAY 70
SWANNANOA NC 28778

■ Complete items 1, 2, and 3. Also complete A. Signature
item 4 if Restricted Delivery is desired. X
■ Print your name and address on the reverse
so that we can return the card to you. B. Received by
■ Attach this card to the back of the mailpiece,
or_on the f[ont_itspace permits.
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70' ;11187b Ibob13 10$17N123�'� 1 11 11 111 [ 11 1 1 Sw
PS Form 381.1. February 2004 Domestic Return RecelDt' 102595-02-M-154

UNITED STATES POSTAL SERVFiCst-6lass.Mai�l
<v �' Posxage _&Fees Paid
=gp
Pe r—m it rva�rte�
• Sender: Please print, `}c u !ref%, add ress,-q-irTfit -ir+
LINDA WIGGS - -- _
NCDENR-DWq-SWP
2090 U.S. HIGHWAY 70
1 SWANNANOA NC 28778
ill. Th-lill,lilli)-+hil

■ Complete items 1, 2, and 3. Also complete A 6
item 4 if Restricted Delivery Is desired.Z ❑ Agent
■ Print your name and address on the reverse X ❑ Addresse(
so that we can return the card to you. B, Re road by ( •nted Name) C. Deliver)
■ Attach this card to the back of the mailpiece,
or on the front if space permits. _-
- -- - - - iffen nt from item 17• ❑ es
addreelow: c
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Oil Abr vo
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,v CerM del•-'13 E rM m
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.• Restrict (EXtrd'Fee) A ❑Yes
71310 1100100R$11'267 121322
S�
Ps Form 3811, February 2004 Domestic Retum Receipt 102e95-02-Mll5a

UNITED STATES POSTALSE L� qi�
a PM
28 JAN
• Sender: Please prime, add
LINDA WIGGS
R-
NCDENDWq-SWP
2090 U.S. HIGHWAY 70
SWANNANOA NC 28778
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