WQCS00233_Regional Office Historical File Pre 2018

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ROY COOPER
Governor
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LINDA CULPEPPER
Dhzcror
NORTH ARQ &w&mwm�LQu
October 28, 2019
CERTIFIED MAIL #7015 1520 0002 8376 2876
RETURN RECEIPT REQUESTED
Mr. Tony Konsul, Regional Manager
Carolina Water Service Inc. of NC
PO Box 24098
Charlotte, North Carolina 28217
Subject: Notice of Violation
Compliance Evaluation Inspection
Case # NOV-2019-PC-0713
Permittee: Hemby Acres Wastewater Collection System
Permit No. WQCS00233
Union County; NC
Dear Mr. Konsul:
Mr. Tony Parker and of the Mooresville Regional Office of the NC Division of Water Resources
(DWR or the Division) conducted. a compliance evaluation inspection (CEI) of the subject
wastewater collection system (WWCS) on October 24, 2019. The assistance of Mr. Larry Henry
and Mr. Kylend Mullis during the inspection was greatly appreciated.
Violations were noted for failure to perform weekly visits to pump stations as required and failure
to have proper signage at some pump stations which do not list an address. A copy of the
inspection report is attached for your records and other inspection findings are summarized below.
Site/System Review
1. The following system components were inspected:
a. Four pump stations were inspected. Issues noted. Please see report for details.
b. Various manholes were inspected. No issues noted.
C. One right of way was inspected. Issues noted. See report.
...D North Carolina Department of Environmental Quality I Division of Water Resources
Mooresville Regional Office 1 610 East Center Avenue, Suite 3011 Mooresville, North Carolina 28US
704.6631699

2. As you are aware, owners of permitted collection systems must comply with their permit
and all rules listed under NC Administrative Code 15A NCAC 02T .0400, et seq. Your .
compliance status with each of these rules is summarized below:
a. 15A NCAC 02T .0403(a)(1): Requires that the system be effectively maintained
and operated at all times to prevent discharge to land or surface waters and any
contravention of ground or surface water standards. .
Observations: No reportable spills for the review period.
Compliance Status: Compliant
b. 15A NCAC 02T .0403(a)(2): Requires that a map of the wastewater collection
system be developed and actively maintained.
Observations: Maps were available for this inspection.
Compliance Status: Compliant
15A NCAC 02T .0403(a)(3): Requires that an operation and maintenance (O&M)
plan be developed and implemented, which includes pump station inspection
frequency, preventative maintenance schedule, spare parts inventory and overflow
response.
Observations: Protocol has been set up to address these needs. Pump station logs
were available documenting inspections of pump stations. However, instances
were noted at each pump station which indicated some weekly visitations were not
performed as required and therefore are in violation of reporting requirements.
Compliance Status: Not Compliant
d. 15A NCAC 02T .0403(a)(4): Requires that the permittee or its representative
inspect pump stations that are not connected to a telemetry system (i.e., remote
alarm system) every day (i.e., 365 days per year) and pump, stations that are
connected to a telemetry system at least once per week. .
Observations: The pump station inspection logs indicate that the pump stations
were not visited weekly as required.
Compliance Status: Not Compliant
e. 15A NCAC 02T .0403(a)(5): Requires that the permittee or its representative
inspect high -priority sewers (BPS = as defined in 15ANCAC 02T .0402(2)) at least
once every, six months and document the inspections.
Observations: Documentation provided.

Compliance Status: Compliant
£ 15A NCAC- 02T .0403(a)(6): Requires that the permittee or its representative
conduct a general observation of the entire wastewater collection system at least
once per year.
Observations: This requirement may have been met through line cleaning by
others and other observations. Line cleaning requirements were exceeded.
Compliance Status: Compliant.
g. 15A NCAC 02T .0403(a)(7): Requires that overflows and bypasses from the
system be reported to the Division's Mooresville Regional Office in accordance
with 15A NCAC 02B .0506(a), and that public notice must be provided as required
by G.S. 143-215.1C.
Observations: No SSO's have been reported for this review period. The NC
regulations and statutes, which cover the reporting requirements for .SSOs, are
found in NC Administrative Code 15A NCAC 02B .0506(a) and NC General
Statute 143-215.1 C, respectively. You may access the NC regulations online at the
NC Office of Administrative Hearings (OAH) website at:
http://www.oah.state.ne.us/rules/ and the NC General Statutes online at the NC
General Assembly's website at:
http•//www ncsza.state.nc.us/gascripts/Statutes/StatutesTOC.pl. You may wish to
review them to ensure you are fully familiar with all requirements.
When reporting SSOs to DWQ, you must call the Mooresville Regional Office
(MRO) at 704-663-1699 during normal business hours. If outside normal business
hours, you must report the spill to the NC Division of Emergency Management at
1-800-858-0368. Please note that all reportable SSOs must be reported within 24
hours of the occurrence, or first knowledge, of the SSO. Please also note that voice
mail or faxed messages are not considered as the initial verbal report. You must
talk to and report the spill to a live person.
Compliance Status: Compliant
h. 15A NCAC 02T .0403(a)(8): Requires that a grease control program be developed
and implemented as follows:
1. For privately owned collection systems, the Grease Control Program shall
include at least bi-annual distribution of grease education materials to users
and the legal means to require grease interceptors. The Program shall also
include legal means for inspections, enforcement, and legal means to
control grease entering the system from other public and private satellite
sewer systems.
2. Grease education materials shall be distributed more often than required
above if necessary to prevent grease -related sanitary sewer overflows.

Observations: The operator indicated educational information is mailed out 2/year.
Compliance Status: Compliant.
15A NCAC 02T..0403(a)(9): Requires that right-of-ways (ROW) and easements
be maintained in the full easement width for personnel and equipment accessibility.
Observations: Records were available documenting ROW maintenance.
Compliance Status: Compliant.
15A NCAC 02T .0403(a)(10): Requires that documentation be kept for all
activities you undertake to comply with the requirements of 15A NCAC 02T .0403,
subparagraphs (a)(1) through (a)(9), for a minimum of three years, with the
exception of the map, which shall be maintained for the life of the system.
Observations: Records were available for the activities listed above.
Compliance Status: Compliant
In accordance with NC General Statute 143-215.6A, these violations are subject to civil penalty
assessments not to exceed $25,000 per day, per violation. Your written response and the actions
that you take to address these violations listed herein and on the attached report will be considered
in deciding whether or not such penalties are necessary to compel compliance.
It is imperative that immediate actions be taken for all the above violations noted.
It is requested that a written response be submitted to this Office within fifteen (15) days of receipt
of this Notice regarding the above noted violations.
Also, please take note of the comments in the inspection report for all issues that need to be
addressed. The inspection report should be self-explanatory; however, if you have any questions
regarding the inspection report or this correspondence, please contact either Tony Parker at 704-
663-1699 (email at tony.parkerancdenr.gov) or me at 704-235-2194 (email. at
corey basingernncdenr.Qov).
Sincerely,
. DocuSigned by:
for
F161 F869A2D84A3...
W. Corey Basinger, Regional Supervisor
Mooresville Regional Office
Water Quality Regional Operations Section
Division of Water Resources, NCDEQ
Attachments: BIMS Inspection Report
CC: MRO, Central Files, PERCS Unit (LaserFiche)

Permit: WQCS00233
SOC:
County: Union
Region: Mooresville
Contact Person: Dana Hill
Directions to Facility:
Compliance Inspection Report
Effective: 10/10/13 Expiration: 11/30/21 Owner: Carolina Water Service Inc of North Carolina
Effective: Expiration: Facility: Hemby Acres Collection System
PO Box 240908
System Classifications: CS2,
Primary ORC: Larry Darnell Henry
Secondary ORC(s):
On -Site Representative(s):
Title: Director of Operations
Certification: 1004209
Charlotte NC 282240908
Phone: [phone]
Phone: [phone]
Related Permits:
NC0035041 Carolina Water Service Inc of North Carolina - Hemby Acres WWTP-
Inspection Date: 1012412019 EntryTime: 10:OOAM Exit Time: 01:30PM
Primary Inspector: Tony Parker Phone: [phone]
Secondary Inspector(s):
Reason for Inspection: Routine Inspection Type: Collection System Inspect Non Sampling
Permit Inspection Type: Collection system management and operation
Facility Status: ❑ Compliant E Not Compliant
Question Areas:
Miscellaneous Questions General Sewer & FOG Ordinances
Capital Improvement Plan Map Reporting Requirements
Inspections Spill Response Plan Spills
Lines Manholes Pump Stations
(See attachment summary)
Page 1 of 7

Permit: WQCS00233 Owner - Facility: Carolina Water Service Inc of North Carolina
Inspection Date: 10/24/2019 Inspection Type : Collection System Inspect Non Sampling Reason for Visit: Routine
Inspection Summary:
Numerous issues observed that need to be corrected. Monitoring/visitation violations noted. Corrective actions need to
undertaken immediately to rectify and abate these issues and violations.
A response is requested within 15 days of receipt of this report.
Page 2 of 7

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Permit: WQCS00233 Owner - Facility: Carolina Water Service Inc of North Carolina
Inspection Date: 10/24/2019 Inspection Type: Collection System Inspect Non Sampling
Reason for Visit: Routine
Map
Yes No NA NE
Is there a overall sewer system map?
0 ❑ ❑ ❑
Does the map include:
Pipe Type (GS/FM)
M ❑ ❑ ❑
Pipe sizes
M ❑ ❑ ❑
Pipe materials (PVC, DIP, etc)
M ❑ ❑ ❑
Pipe location
0 ❑ ❑ ❑
Flow direction
0 ❑ ❑ ❑
Approximate pipe age
M ❑ ❑ ❑
Pump station ID, location and capacity
M ❑ ❑ ❑ -
# Force main air release valve location & type
❑ ❑ ❑ M
# Location of satellite connections
❑ ❑ ❑
Is the map being updated for changes/additions within 1 year of activation?
❑ ❑ M ❑
Comment:
Reporting Requirements Yes No NA NE
# Have there been any sewer spills in the past 3 years? 0 ❑ ❑ ❑
If Yes, were they reported to the Division if meeting the reportable criteria? 0 ❑ ❑ ❑
If applicable, is there documentation of press releases and public notices issued? ❑ ❑ 0 ❑
Is an Annual Wastewater Performance Report being filed with the Division, if required? . ❑ ❑ 0 ❑
Is the report being made available to all its sewer customers? ❑ ❑ ❑
# How is it being made available?
Comment: With flows less than 200,000 GPD the Permittee does not wish to file an Annual Report at this
time.
Inspections
Yes No NA NE
Are adequate maintenance records maintained? M ❑ ❑ ❑
Are pump stations being inspected at the required frequency? ❑ 0 ❑ ❑
# Is at least one complete functionality test conducted weekly per pump station? ❑ M ❑ ❑
Is there a system or plan in place to observe the entire system annually? ® ❑ ❑ ❑
Is the annual inspection documented? ❑ ❑ ❑
# Does the system have any high -priority lines/locations? M .❑ ❑ ❑
Are inspections of HPL documented at least every 6 months? 0 ❑ ❑ ❑
Are new lines being added to the HPL list when found or created? ❑ ❑ N ❑
Comment: Log books indicate the ORC is Not inspecting the pump stations as required. Some weekly
visits were not conducted at each of the 4 pump stations inspected. The ORC had no clear
explanation for these discrepancies.
Spill Response Action Plan Yes No NA NE
Page 4 of 7

Permit WQCS00233 Owner - Facility: Carolina Water Service Inc of North Carolina
Inspection Date: 10/2412019 Inspection Type : Collection System Inspect Non Sampling Reason for visit: Routine
Is a Spill Response Action Plan available?
Is a Spill Response Action Plan available for all personnel?
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
Does the Permittee appear to respond within 2 hours of first knowledge of a spill?
Comment: The system is not free of spills but are reporting as required.
Suills
Is system free of known points of bypass?
If No, describe type of bypass and location
Are all spills or sewer related issues/complaints documented?
# Are there repeated overflows/problems (2 or more in 12 months) at same location?
# If Yes, is there a corrective action plan?
Comment: All spills or complaints are documented via a work order.
Lines/Right-of-Ways/Aerial Lines
Please list the Lines/Right of Ways/Aerial Lines Inspected:
The Oak Grove US #3 RAN outfalls. This is a 2 line outfall/ R/W and both were overgrown and needs clearing.
Are right-of-ways/easements maintained for full width for access by staff/equipment?
If No, give details on temporary access:
See above comments.
Is maintenance documented?
Are gravity sewer cleaning records available?
Has at least 10% of lines older than 5 yrs been cleaned annually?
Were all areas/lines inspected free of issues?
Comment: Above ground vents were not screened. Missing vent screens need to be replaced.
Manholes
Please list the Manholes Inspected:
Various manholes were inspected and the only issues noted were above ground vent screens were missing.
Again these need to be replaced.
Are manholes accessible?
# Are manhole covers/vents above grade?
❑ ❑ ❑
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❑ ❑ ❑
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■❑❑❑
❑ ❑ ❑
❑ ❑ ❑
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❑ ❑ ❑
Yes No NA NE
❑ E ❑ ❑
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❑ ❑ ❑
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Yes No NA NE
❑ E ❑ ❑
❑ ❑ ❑
Page 5 of 7

Permit: WQCS00233 Owner - Facility: Carolina Water Service Inc of North Carolina
Inspection Date: 10124/2019 Inspection Type : Collection System Inspect Non Sampling
Reason for Visit: Routine
Are manholes free of visible signs of overflow?
EEI ❑. ❑
Are manholes free of sinkholes and depressions?
E ❑ ❑ ❑
Are manhole covers present?
E ❑ ❑ ❑
# Are manholes properly seated?
0 ❑ ❑ ❑
# Are manholes in good condition?
0 ❑ ❑ ❑
# Are inverts in good condition?
0 ❑ ❑ ❑
Is flow unrestricted in manholes?
■ ❑ ❑ ❑
Are manholes free of excessive amounts of grease?
0 ❑ ❑ ❑
Are manholes free of excessive roots?
E ❑ ❑ ❑
Are manholes free of excessive sand?
M ❑ ❑ ❑
Are manhole vents screened?
❑E ❑ ❑
Are vents free of submergence?
❑ ❑ ❑
Are manholes free of bypass structures or pipes?
❑ ❑ ❑
Comment: All vent pipes -visited need the screens replaced.
Pump Stations
Yes No NA NE
Please list the Pump Stations Inspected:
Main US at the WWTP, Oak Grove US #3, Hemby Acres #2 US and Hemby Acres#1 US. The signage at
each pump station visited lacked an address location identifier.
# Number of duplex or larger pump stations in system
4
# Number of vacuum stations in system
0
# Number of simplex pump stations in system
0
# Number of simplex pump stations in system serving more than one building
0
How many pump/vacuum stations have:
# A two-way "auto polling" communication system (SCADA) installed?
4
# A simple one-way telemetry/communication system (auto -dialer) installed?
0
For pump stations inspected:
Are they secure with restricted access?
❑ ❑ ❑
Were they free of by-pass structures/pipes?
0 ❑ ❑ ❑
Were wet wells free of excessive grease/debris?
❑ 0 ❑ ❑
# Do they all have telemetry installed?
E ❑ ❑ ❑
Is the communication system functional?
0 ❑ ❑ ❑
Is a 24-hour notification sign posted ?
■ ❑ ❑ ❑
Does the sign include:
Owner Name?
❑ ❑ ❑
Pump station identifier?
❑ ❑ ❑
# Address?
❑ E ❑ ❑
Instructions for notification?
0 ❑ ❑ ❑
Page 6 of 7

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ROY COOPER
Governor
NCHAEL S. REGAN
Secretary
UNDA CULPEPPER
Director
NORTH CAROLINA
EnAronmadal Quality
October 28, 2019
CERTIFIED MAIL #7015 1520 0002 8376 2876
RETURN RECEIPT REQUESTED
Mr. Tony Konsul, Regional Manager
Carolina Water Service Inc. of NC
PO Box 24098
Charlotte, North Carolina 28217
Subject: Notice of Violation
Compliance Evaluation Inspection
Case # NOV-2019-PC-0713
Permittee: Hemby Acres Wastewater Collection System
Permit No. WQCS00233
Union County, NC
Dear Mr. Konsul:
Mr. Tony Parker and of the Mooresville Regional Office of the NC Division of Water Resources
(DWR or the Division) conducted a compliance evaluation inspection (CEI) of the subject
wastewater collection system (WWCS) on October 24, 2019. The assistance of Mr. Larry Henry
and Mr. Kylend Mullis during the inspection was greatly appreciated.
Violations were noted for failure to perform weekly visits to pump stations as required and failure
to have proper signage at some pump stations which do not list an address. A copy of the
inspection report is attached for your records and other inspection findings are summarized below.
Site/System Review
1. The following system components were inspected:
a. Four pump stations were inspected. Issues noted. Please see report for details.
b. Various manholes were inspected. No issues noted.
C. One right of way was inspected. Issues noted. See report.
DEQr��
North Carolina Department of Environmental Quality I Division of Water Resources
Mooresville Regional Office 1 610 East Center Avenue, Suite 301 1 Mooresville, North Carolina 28115
704.663.1699

2. As you are aware, owners of permitted collection systems must comply with their permit
and all rules listed under NC Administrative Code 15A NCAC 02T .0400, et seq. Your
compliance status with each of these rules is summarized below:
a. 15A NCAC 02T .0403(a)(1): Requires that the system be effectively maintained
and operated at all times to prevent discharge to land or surface waters and any
contravention of ground or surface water standards.
Observations: No reportable spills for the review period.
Compliance Status: Compliant
b. 15A NCAC 02T .0403(a)(2): Requires that a map of the wastewater collection
. system be developed and actively maintained.
Observations: Maps were available for this inspection.
Compliance Status: Compliant
15A NCAC 02T .0403(a)(3): Requires that an operation and maintenance (O&M)
plan be developed and implemented, which includes pump station inspection
frequency, preventative maintenance schedule, spare parts inventory and overflow
response.
Observations: Protocol has been set up to address these needs. Pump station logs
were available documenting inspections of pump stations. However, instances
were noted at each pump station which indicated some weekly visitations were not
performed as required and therefore are in violation of reporting requirements.
Compliance Status: Not Compliant
d. 15A NCAC 02T .0403(a)(4): Requires that the permittee or its representative
inspect pump stations that are not connected to a telemetry system (i.e., remote
alarm system) every day (i.e., 365 days per year) and pump stations that are
connected to a telemetry system at least once per week.
Observations: The pump station inspection logs indicate that the pump stations
were not visited weekly as required.
Compliance Status: Not Compliant
15A NCAC 02T .0403(a)(5): Requires that the permittee or its representative
inspect high -priority sewers (HPS - as defined in 15A NCAC 02T .0402(2)) at least
once every six months and document the inspections.
Observations: Documentation provided.

Compliance Status: Compliant
f. 45A NCAC 02T .0403(a)(6): Requires that the permittee or its representative
conduct a general observation of the entire wastewater collection system at least
once per year.
Observations: This requirement may have been met through line cleaning by
others and other observations. Line cleaning requirements were exceeded.
Compliance Status: Compliant.
g. 15A NCAC 02T .0403(a)(7): Requires that overflows and bypasses from the
system be reported to the Division's Mooresville Regional Office in accordance
with 15A NCAC 02B .0506(a), and that public notice must be provided as required
by G.S. 143-215.1C.
Observations: No SSO's have been reported for this review period. The NC
regulations and statutes, which cover the reporting requirements for SSOs, are
found in NC Administrative Code 15A NCAC 02B .0506(a) and NC General
Statute 143-215.1 C, respectively. You may access the NC regulations online at the
NC Office of Administrative Hearings (OAH) website at:
http://www.oah.state.nc. us/rules/ and the NC General Statutes online at the NC
General Assembly's website at:
http://www.ncga.state.nc.us/aascripts/Statutes/StatutesTOCal. You may wish to
review them to ensure you are fully familiar with all requirements.
When reporting SSOs to DWQ, you must call the Mooresville Regional Office
(MRO) at 704-663-1699 during normal business hours. If outside normal business
hours, you must report the spill to the NC Division of Emergency Management at
1-800-858-0368. Please note that all reportable SSOs must be reported within 24
hours of the occurrence, or first knowledge, of the SSO. Please also note that voice
mail or faxed messages are not considered as the initial verbal report. You must
talk to and report the spill to a live person.
Compliance Status: Compliant
h. 15A NCAC 02T .0403(a)(8): Requires that a grease control program be developed
and implemented as follows:
For privately owned collection systems, the Grease Control Program shall
include at least bi-annual distribution of grease education materials to users.
and the legal means to require grease interceptors. The Program shall also
include legal means for inspections, enforcement, and legal means to
control grease entering the system from other public and private satellite
sewer systems.
2. Grease education materials shall be distributed more often than required
above if necessary to prevent grease -related sanitary sewer overflows.

Observations: The operator indicated educational information is mailed out 2/year.
Compliance Status: Compliant.
15A NCAC 02T .0403(a)(9): Requires that right-of-ways (ROW) and easements
be maintained in the full easement width for personnel and equipment accessibility.
Observations: Records were available documenting ROW maintenance.
Compliance Status: Compliant.
15A NCAC 02T .0403(a)(10): Requires that documentation be kept for all
activities you undertake to comply with the requirements of 15A NCAC 02T .0403,
subparagraphs (a)(1) through (a)(9), for a minimum of three years, with the
exception of the map, which shall be maintained for the life of the system.
Observations: Records were available for the activities listed above.
Compliance Status: Compliant
In accordance with NC General Statute 143-215.6A, these violations are subject to civil penalty
assessments not to exceed $25,000 per day, per violation. Your written response and the actions
that you take to address these violations listed herein and on the attached report will be considered
in deciding whether or not such penalties are necessary to compel compliance.
It is imperative that immediate actions be taken for all the above violations noted.
It is requested that a written response be submitted to this Office within fifteen (15) days of receipt
of this Notice regarding the above, noted violations.
Also, please take note of the comments in the inspection report for all issues that need to be
addressed. The inspection report should be self-explanatory; however, if you have any questions
regarding the inspection report or this correspondence, please contact either Tony Parker at 704-
663-1699 (email at tony_parker riedenngov) or me at 704-235-2194 (email at
corey.basingernncdenr.aov).
Sincerely,
DocuSigned by:
HP
for
C
F161F869AZD84A3...
W. Corey Basinger, Regional Supervisor
Mooresville Regional Office
Water Quality Regional Operations Section
Division of Water Resources, NCDEQ
Attachments: BIMS. Inspection Report
CC: MRO, Central Files, PERCS Unit (LaserFiche)

Permit: WQCS00233
SOC:
County: Union
Region: Mooresville
Contact Person: Dana Hill
Directions to Facility:
Compliance Inspection Report
Effective: 10/10/13 Expiration: 11/30/21 Owner : Carolina Water Service Inc of North Carolina
Effective: Expiration: Facility: Hemby Acres Collection System
PO Box 240908
System Classifications: CS2,
Primary ORC: Larry Darnell Henry
Secondary ORC(s):
On -Site Representative(s):
Title: Director of Operations
Certification: 1004209
Charlotte NC 282240908
Phone: [phone]
Phone: [phone]
Related Permits:
NC0035041 Carolina Water Service Inc of North Carolina - Hemby Acres WWTP
Inspection Date: 10/24/2019 EntryTime: 10:OOAM Exit Time: 01:30PM
Primary Inspector: Tony Parker Phone: [phone]
Secondary Inspector(s):
Reason for Inspection: Routine Inspection Type: Collection System Inspect Non Sampling
Permit Inspection Type: Collection system management and operation
Facility Status: ❑ Compliant N Not Compliant
Question Areas:
Miscellaneous Questions General Sewer & FOG Ordinances
Capital Improvement Plan Map Reporting Requirements
Inspections Spill Response Plan Spills
Lines Manholes Pump Stations
(See attachment summary)
Page 1 of 7

Permit: WQCS00233 Owner - Facility: Carolina Water Service Inc of North Carolina
Inspection Date: 10/24/2019 Inspection Type : Collection System Inspect Non Sampling Reason for Visit: Routine
Inspection Summary:
Numerous issues observed that need to be corrected. Monitoring/visitation violations noted. Corrective actions need to
undertaken immediately to rectify and abate these issues and violations.
A response is requested within 15 days of receipt of this report.
Page 2 of 7

Permit: WQCS00233 Owner - Facility: Carolina Water Service Inc of North Carolina
Inspection Date: 10/24/2019 Inspection Type : Collection System Inspect Non Sampling Reason for Visit: Routine
General
Is there a properly designated primary ORC and at least one back-up of proper grade?
Are logs being reviewed by the system management or owner on a regular basis?
# What is that frequency?
# Are there any issues being addressed currently or any in the planning stages?
Is there a specific pump failure plan available for all pump stations?
Does plan indicate if pump parts/new pumps are in spare parts/equipment inventory?
Are new/significantly upgraded pump stations equipped with anti -corrosion materials?
Does the permittee have a copy of their permit?
# Is permit expiring within the next 6 months?
If Yes, has the Permittee applied for renewal?
Comment: The existing collection system permit expires 11/30/2021.
Sewer and FOG Ordinances
Is Sewer Use Ordinance (SUO) or other Legal Authority available?
Does it appear that the Sewer Use Ordinance is enforced?
Is there a Grease Control Program that legally requires grease control devices?
What is the standard grease trap cleaning requirement in the FOG ordinance?
Is Grease Control Program enforced via periodic inspections/records review?
Is action taken against violators?
# Have satellite systems adopted an equivalent or more stringent ordinance?
Is grease/sewer education program documented with req'd customer distribution?
# Are other types of education tools used like websites, booths, special meetings, etc?
If Yes, what are they? (This can reduce mailing to annual.)
Flyers and website.
Comment:
Capital Improvement Plan
Has a Capital (CIP) or System Improvement Plan been developed and adopted?
Is it designated for wastewater only or does it have a dedicated section?
Does CIP cover three to five year period of earmarked improvements?
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?
Comment:
Yes No NA NE
■❑❑❑
■❑❑❑
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■❑❑❑
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Yes No NA NE
❑ ❑ ❑
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operator
❑ ❑ ❑
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Page 3 of 7

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10

Permit: WQCS00233 Owner - Facility: Carolina Water Service Inc of North Carolina
Inspection Date: 10/24/2019 Inspection Type : Collection System Inspect Non Sampling
Reason for Visit: Routine
Are manholes free of visible signs of overflow?
E ❑ ❑ ❑
Are manholes free of sinkholes and depressions?
N ❑ ❑ ❑
Are manhole covers present?
0 ❑ ❑ ❑
# Are manholes properly seated?
0 ❑ ❑ ❑
# Are manholes in good condition?
E ❑ ❑ ❑
# Are inverts in good condition?
N ❑ ❑ ❑
Is flow unrestricted in manholes?
E ❑ ❑ ❑
Are manholes free of excessive amounts of grease?
0 ❑ ❑ ❑
Are manholes free of excessive roots?
N ❑ ❑ ❑
Are manholes free of excessive sand?
E ❑ ❑ ❑
Are manhole vents screened?
❑ E ❑ ❑
Are vents free of submergence?
E ❑ ❑ ❑
Are manholes free of bypass structures or pipes?
N ❑ ❑ ❑
Comment: All vent pipes visited need the screens replaced.
Pump Stations
Yes No NA NE
Please list the Pump Stations Inspected:
Main US at the WWTP, Oak Grove US #3, Hemby Acres #2 US and Hemby Acres#1 US. The signage at
each pump station visited lacked an address location identifier.
# Number of duplex or larger pump stations in system
4
# Number of vacuum stations in system
0
# Number of simplex pump stations in system
0
# Number of simplex pump stations in system serving more than one building
0
How many pump/vacuum stations have:
# A two-way "auto polling" communication system (SCADA) installed?
4
# A simple one-way telemetry/communication system (auto -dialer) installed?
o
For pump stations inspected:
Are they secure with restricted access?
0 ❑ ❑ ❑
Were they free of by-pass structures/pipes?
0 ❑ ❑ ❑
Were wet wells free of excessive grease/debris?
❑ E ❑ ❑
# Do they all have telemetry installed?
❑ ❑ ❑
Is the communication system functional?
0 ❑ ❑ ❑
Is a 24-hour notification sign posted ?
0 ❑ ❑ ❑
Does the sign include:
Owner Name?
0 ❑ ❑ ❑
Pump station identifier?
N ❑ ❑ ❑
# Address?
❑ 0 ❑ ❑
Instructions for notification?
E ❑ ❑ ❑
Page 6 of 7

Permit: WQCS00233 Owner - Facility: Carolina Water Service Inc of North Carolina
Inspection Date: 10/24/2019 Inspection Type : Collection System Inspect Non Sampling Reason for Visit: Routine
24-hour emergency contact numbers? ❑ ❑ ❑
Are audio and visual alarms present? 0 ❑ ❑ ❑
Are audio and visual alarms operable? M ❑ ❑ ❑
# Is there a backup generator or bypass pump connected? 0 ❑ ❑ ❑
If tested during inspection, did it function properly? ❑ ❑ ❑
Is the back-up system tested at least bi-annually under normal operating conditions? M ❑ ❑ ❑
# Does it have a dedicated connection for a portable generator? M ❑ ❑ ❑
# Is the owner relying on portable units in the event of a power outage? 0 ❑ ❑ ❑
# If Yes, is there a distribution plan? 0 ❑ ❑ ❑
If Yes, what resources (Units/StaffNehicles/etc) are included in Plan?
The Permittee has a fleet of generators all across NC. Excessive grease noted at the Oak Grove US #3 and
needs to be cleaned out and the floats cleaned. Address markers need to be added at each P/S.
# Does Permittee have the approved percentage of replacement simplex pumps? ❑ ❑ M ❑
Is recordkeeping of pump station inspection and maintenance program adequate? M ❑ ❑ ❑
Do pump station logs include at a minimum:
Inside and outside cleaning and debris removal? 0 ❑ ❑ ❑
Inspecting and exercising all valves? 0 ❑ ❑ ❑
Inspecting and lubricating pumps and other equipment? 0 1100
Inspecting alarms, telemetry and auxiliary equipment? M ❑ ❑ ❑
Comment: All deficiencies previously mentioned.
Page 7 of 7

&AA.Py
Permit: VRIM Owner - Faci
Inspection Date: 08/06/2019 Inspection Type • Collection System Inspect Non Sampling
Amino
Reason for visit: Routine
General
Yes No NA NE
Is there a properly designated primary ORC and at least one back-up of proper grade? C A. 7 14,_ r
❑/❑ ❑ ❑
Are logs being reviewed by the system management or owner on a regular basis?
IJ LJ ❑ ❑
# What is that frequency? kr: tA) 1" [ ']
# Are there any issues being addressed currently or any in the planing stta
,--�/
LJ7ges? ❑ ❑ ❑
Is there a specific pump failure plan available for all pump stations? C (rr•Q
0❑ ❑ ❑
Does plan indicate if pump parts/new pumps are in spare parts/equipment inventory? ? lam+
❑ ❑ ❑ ❑
Are new/significantly upgraded pump stations equipped with anti -corrosion materials?
❑ ❑
Does the permittee have a copy of their permit?
r��❑i
Isuy❑ ❑
# Is permit expiring within the next 6 months? AID V 3 U 2 0 2
El L1 ❑ ❑
E❑
If Yes, has the Permittee applied for renewal?
❑ ❑
Comment:
Sewer and FOG Ordinances
Yes No Na
❑
Is Sewer Use Ordinance (SUO) or other Legal Authority available?,
Does it appear that the Sewer Use Ordinance is enforced?
,�/
❑ �J
Is there a Grease Control Program that legally requires grease control devices? L'-
❑ a ❑
What is the standard grease trap cleaning requirement in the FOG ordinance? g vL1
�
El El �] '
Is Grease Control Program enforced via periodic inspections/records review?
,l-
❑ ❑�,
Is action taken against violators?
more
El ❑ ❑
# Have satellite systems adopted an equivalent or stringent ordinance?
I�
Is grease/sewer education program documented with req'd customer distribution?
❑ ❑
Are other types of education s, etc?
ion tools used like websites booths special meetings,
p 9
El El#
IDEl
If Yes, what are they? (This can reduce mailing to annual.)
Comment:
Capital Improvement Plan
Yes No NE
Has a Capital (CIP) or System Improvement Plan been developed and adopted?
[ ❑
PE01
Is it designated for wastewater only or does it have a dedicated section?
❑ ❑
Does CIP cover three to five year period of earmarked improvements?
2-"El ❑ ElDoes
D ❑ ❑ El
CIP include description of project area?
Does CIP include description of existing facilities?
❑ ❑ ❑ WJ/
Does CIP include known deficiencies?
❑ El
ElD
Does CIP include forecasted future needs?
LJ. ❑ ❑
Comment:
M Yes No NA NE
- - - Page 3 of 7

Permit! Owner - Facili>�
Inspection Date: O8/06/2019 Inspection Type : Collection System Inspect Non Sampling
Reason for Visit Routine
Is there a overall sewer system map?
DID ❑ ❑
Does the map include:
El 0 El ElPipe
Pipe Type (GS/FM)
DID ❑ ❑
sizes
Pipe materials (PVC, DIP, etc)
�❑ ❑ ❑
Pipe location
2[ ❑ ❑
Flow direction
u u ❑ ❑
Approximate pipe age
2T] ❑_ ❑
Pump station ID, location and capacity
1 u ❑ ❑
❑ ❑ ❑ El
# Force main air release valve location & type
# Location of satellite connections
❑ ❑
❑ ❑ E❑
Is the map being updated for changes/additions within 1 year of. activation?
Comment:
Reporting Requirements
Yes No NA"NE
# Have there been any sewer spills in the past 3 years?
00E—❑
If Yes were they reported to the Division if meeting the reportable criteria?
P
El
L� LJ LJ
If applicable, is there documentation of press releases and public notices issued?
❑ ❑ 210
�Q
Is an Annual Wastewater Performance Report being filed with the Division, if required? �'
❑ ❑ ❑ ❑
Is the report being made available to all its sewer customers?
❑ ❑ ❑ ❑
# How is it being made available?
Comment:
Inspections Yes
No NA NE
Are adequate maintenance records maintained? u ❑ ❑ ❑
Are pump stations being inspected at the required frequency? EffD ❑ ❑
# Is at least one complete functionality test conducted weekly. per pump station? �2-t ❑ El
Is there a system or plan in place to observe the entire system annually? [2 Ell ❑ ❑
Is the annual inspection documented? u u ❑ ❑
# Does the system have any high -priority lines/locations? ❑ ❑
Are inspections of HPL documented at least every 6 months? ❑/❑ ❑
Are new lines being added to the HPL list when found or created? El ❑ LJ ❑
Comment:
Spill Response Action Plan Yes No NA NE
NE
Is a Spill Response Action Plan available? = tiLJ t u ❑
Is a Spill Response Action Plan available for all personnel? 2 ❑ ❑
Does the plan include:
--- - ----Page-4 of T -

Permit: Owner -Facilil'�
Inspection Date: 08/06/2019 Inspection Type : Collection System Inspect Non Sampling
Reason for Visit: RoutineEl
0El
24-hour contact numbers
'=-'
LJ ❑
Response time
.❑
D/❑ ❑ ❑
Equipment list and spare parts inventory
�❑ ❑ ❑
Access to cleaning equipment
❑
Access to -construction crews, contractors, and/or engineers
❑ ❑ Q-Q-"
Source of emergency funds
u ❑ ❑ ❑
Site sanitation and cleanup materials
'El
Post-overflow/spill assessment
'-' ❑ ❑
B'❑ ❑ ❑
Does the Permittee appear to respond within 2 hours of first knowledge of a spill?
Comment:
SpIIIS Yes No NA NE
Is system free of known points of bypass? E310 ❑ ❑
If No, describe type of bypass and location
Are all spills or sewer related issues/complaints documented? Er ❑ ❑ ❑
# Are there repeated overflows/problems (2 or more in 12 months) at same location? ❑ Er❑
# If Yes, is there a corrective action plan?
Comment:
Lines/Right-of-Ways/Aerial Lines Yes No NA NE
Please list the Lines/Right of Ways/Aerial Lines Inspected:
Are right-of-ways/easements maintained for full width for access by staff/equipment? ❑ ❑ ❑ ❑
If No, give details on temporary access:
Is maintenance documented? El ❑
Are gravity sewer cleaning records available? D 6 ❑ ❑
Has at least 10% of lines older than 5 yrs been cleaned annually? L- u ❑ ❑
Were all areas/lines inspected free of issues? ❑ ❑ ❑ ❑
Comment:
Manholes
Yes No NA NE
Please list the Manholes Inspected:
Are manholes accessible?
❑ ❑ .❑ ❑
# Are manhole covers/vents above grade?
❑ ❑ ❑ ❑
Are manholes free of visible signs of overflow?
❑ 0 ❑ ❑
Are manholes free ofsinkholes and depressions?
❑ ❑ ❑
❑ ❑ ❑ El
Are manhole covers present?
❑ [.I ❑ ❑
# Are manholes properly seated?
El El 1-1
# Are manholes in good condition?
_...._.-. _ . ..-- . - -- -
- Page 5 of 7

0
Permit:� Owner - Facilidsomm
Inspection Date: 08/0612019 Inspection Type : Collection System Inspect Non Sampling Reason for Visit Routine
# Are inverts in good condition? ❑ ❑ ❑l ElIs flow unrestricted in manholes? El El El El
Are manholes free of excessive amounts of grease? ❑ ❑ ❑ El
Are manholes free of excessive roots? ❑ ❑ ❑ ❑
Are manholes free of excessive sand? ❑ ❑ ❑ ❑
Are manhole vents screened? ❑ ❑ ❑ ❑
Are vents free of submergence? ❑ ❑ ❑ ❑
Are manholes free of bypass structures or pipes? ❑ ❑ ❑ ❑
Comment:
Pump Stations Yes No NA NE
Please list the Pump Stations Inspected:
# Number of duplex or larger pump stations in system
# Number of vacuum stations in system 0
# Number of simplex pump stations in system D
# Number of simplex pump stations in system serving more than one building (�
How many pump/vacuum stations have: ® / 5/L-
,tom/ , �� a
/ ` SS
# A two-way "auto polling" communication system (SCADA) installed? n
��//
# A simple one-way telemetry/communication system (auto -dialer) installed? X
For pump stations inspected:
Are they secure with restricted access?
❑ ❑ ❑ ❑
Were they free of by-pass structures/pipes?
❑ ❑ ❑ ❑
Were wet wells free of excessive grease/debris?
❑ ❑ ❑ ❑
# Do they all have telemetry installed? x
❑ ❑ ❑ ❑
Is the communication system functional?
� El 0, ❑
Is a 24-hour notification sign posted ?
❑ ❑ ❑ ❑
Does the sign include:
Owner Name?
❑ ❑ ❑ ❑
Pump station identifier?
❑ ❑ ❑ ❑
# Address?
❑ ❑ ❑ ❑
Instructions for notification?
❑ ❑ ❑ ❑
24-hour emergency contact numbers?
❑ ❑ ❑ ❑
Are audio and visual alarms present?
❑ ❑ ❑ ❑
Are audio and visual alarms operable? ����
❑ ❑ .❑ ❑
# Is there a backup generator or bypass pump connected? vas
❑ ❑ ❑ ❑
,f�-�F
If tested during inspection, did it function properly? �k/t r 55 � -L—J�,--�'� %j ��° yr �
El El❑ El
Is the back-up system tested at least bi-annually under normal operating conditions? ,_---
❑ ❑ ❑ ❑
---
- -Page6of7

PermiddlM, Owner - Facil"
Inspection Date: O8/06/2019 Inspection Type : Collection System Inspect Non Sampling Reason for Visit Routine
# Does it have a dedicated connection for a portable generator? y,El❑ ❑
# Is the owner relying on portable units in the event of a power outage? S�_f/., , ❑ ❑
# If Yes, is there a distribution plan? ex� �, a r„��,, y(��L'/ ❑ ❑ ❑ ❑
If Yes, what resources (Units/StaffNehicles/et) are included in Plan?
# Does Permittee have the approved percentage of replacement simplex pumps? ❑ ❑ D❑
Is recordkeeping of pump station inspection and maintenance program adequate? ❑ ❑ ❑ ❑
Do pump station logs include at a minimum:
Inside and outside cleaning and debris removal? ❑ ❑ ❑ ❑
Inspecting and exercising all valves? ❑ ❑ ❑ ❑
Inspecting and lubricating pumps and other equipment? ❑ ❑ ❑ ❑
Inspecting alarms, telemetry and auxiliary equipment? ❑ ❑ ❑ ❑
Comment:
.._ -.-------------------- - - - --Page 7-of 7--- --

F
PUMP Station Inspection Checklist
NAddress: #
'Name: purnps -
2
Workhq - 2
/VI
Run Time
YES NO
Leath6r
Secure-,
Wet Well Floats:
Debris: -
Working High Water Float
iTelemetry:
SCADA:
Audio/Visual:
Is alarms stem tested, i-low often:
Inspection Logs:
f 9 Y1 4
Emergency Pawer- 6"-4
Type: Portable Onsite Fuel I AA-AcheduleNend&
LJ
Duick'Connect.
resting Schedule:
bi A
oq
3ackflow-
)ve.rflaw Piping:
3-y.pass Pumping:
nsp ec. tion Schedule:
,omments/ Observati ns- J
CIM

PUMj2 Station Inspedflon Checklist
-Name: Address-
Punps
worbq 2
Address:
b
Run Time -
YES NO
Weather.
ISignage: Al"__4 C, /Z./,L.
.I Ho. usekeeping,
I -Secure.,
Wet Well Floats:
Debris:
VVorkino Hiah Water Float
ITe'lemetry-
SCADA:
Audio/Visual:
Is'alarms ysteo tested, How often:
Inspection Loqs:
Emerqency Power. i:J
Type: Portable Onsite Fuel - T? ScheduleNendet -
Duick Connect.
resting Schedule: w 1<1
3ackfiow:
Nerflow Piping:
3ypass.Pumping:
nspection Schedule.,
'ornments/ Observations:
1 S �
r l�
Y,
y)a4 ��,5&01,�
' 6io

Pump Station Inspection Checklist
Name: 2
lAddress: #P URPS-
�2
G.
Run Tine -
YES NO
Weather..
ISignage:
Housekeeping:
�Secure.
IWet Well Floats:
Debris. -
Working High Water Float
ITe*femetry-
SCADA:
Audio/Visual:
Is alarm sysWh tested, -How often:
Ins'pection, Logs: VC4( vII,( .5 JJ
Emerqency Power.
Type: qortabl�,) Onsite Fuel - Schedulp-Nendet -
Duick Connect.
resting Schedule:
3ackflow:
Nei -flow Piping:
A)
3ypass Pumping:
nspection Schedule:
'ornments/ Observations:

Pump Station Inspection Checklist
5
'Name- Address: Pumps
S
Workhq
1 "A Run T'kne -
01
-_ YES NO
Weather.. L
ISignage:
Housekeeping:
'Secure:
Wet Well Floats:
IlDebris.-
lWorkingHi h Wafer Float /
Telemet .
S CADA:
Audio/Visual:
Is alarms stem tested, tiow often'
Inspection Logs: ^� r
Emerqency Power.
Type: ab e Onsite Fuel - ScheduleNendet -
Cuick Conne ..
Festing Schedule: w'
3ackflow: N
overflow Piping:
3ypass Pumping:
nspection Schedule:
;omments/ Observations:
Y
S

f Inc (0outilities,
Mr. Robert B Krebs
Surface Water Protection Supervisor
Division of Water Quality
610 East Center Ave, Suite 301
Mooresville, NC 28115
Ref: Hemby Acres Collection System
WQCS00233
Hemby Wood Drive SSO of 2/8/09
Dear Mr. Krebs,
March 31 2009'"
API — 2 2009
M—Surf0ce Weer N 1�(;blbni
We are in receipt of your letter concerning the above referenced item. We believe due to our timely
response and the fact that the discharge was exceptional, unintentional, temporary and caused by
factors beyond our control a civil penalty would not be considered.
We received a telephone call from Union County Police Department about a manhole overflowing in
the street on Hemby Wood Drive at approximately 5:00pm on 2/08/09. Our on call staff was
immediately dispatched and was on site within one hour. The 8" sewer main was determined to have a
blockage due to rags and feminine hygiene products. The operator contacted a company to have the
line jet cleaned and vacuumed. The blockage was cleared and the overflow was stopped at
approximately 8:00pm on 2/08/09. The overflow did reach surface water but there was no impact to the
stream or fish kills of any kind.
The sewer main on Hemby Wood Drive has been cleaned in the past as part of the collections systems
10 % annual sewer maintenance cleaning. We have never had any prior problems with overflows or
blockages on this particular street. All areas were properly cleaned and lime applied to the affected
areas. There was no impact to public health and no public recreational areas were closed due to the
location of the spillage.
Should you have any further questions or if I can be of any further assistance please do not hesitate to
contact me at 704-525-7990 ext 218.
Sincerely
Anthony J Konsul
Regional Manager
Cc: Martin Lashua
Mary Armentrout
Mark Haver
Mitles, Inc. company Carolina Water Service, Inc. of North Carolina
P.O. Box 240908 0 Charlotte, NC 28224 / P: 704-525-7990 OF: 704-525-8174
5701 Westpark Dr., Suite 101 0 Charlotte, NC 282170 www.uiwater.com

WATER POLLUTION CONTROL SYSTEM OPERATOR DESIGNATION FORM (WPCSOCC)
NCAC 15A 8G .0201
Press TAB to enter information
Permittee Owner/Officer Name: Tony J Konsul
Mailing Address: P.O. Box 240908
city: Charlotte
State: NC
Phone: [phone]
zip: 28224-0908
Email Address: [e-mail]
Signature: Date: 9l6/2017
Facility Name: Hemby Acres
County:
Union
Permit # WOCS-00233
YOU MUST SUBMIT A SEPARATE FORM FOR EACH TYPE AND CLASSIFICATION OF SYSTEMECEIVED/NCDENRIoyvR
Facility Type: CS SEP 12 2017
Facility Grade: II
11400Rr7o„... WQROS
OPERATOR IN RESPONSIBLE CHARGE (ORC)
Print Full Name: Larry D Henry
Certificate Type: CS .. Certificate Grade: III
Email Address:
[e-mail]
Work Phone: [phone]
Certificate #: 1004546
Signature: Z 1A Effective Date:
"1 certify that 1 agree to my designation as Operator in Responsible Charge for the facility noted. i understand and will abide by the
rules and regulations pertaining to the possibilities of the ORC asset forth in 15A NCAC 08G .0204 and failing to do so can result in
Disciplinary Actions by the Water Pollution Control System Operators Certification Commission."
BACKUP.ORC:
Print Full Name: Mark R Haver Work Phone:[phone]
Certificate Type: CS Certificate Grade: IV Certificate #: 992155
Email Address: [e-mail]
Signature: 41_111� r1f ; ��� Effective Date: -7
"I certify that I agree to my designation as. a Back-up Operator in Responsible Charge for the facility noted. i understand and will abide by
the rules and regulations pertaining to the responsibilities of the ORC as set forth in 15A NCAC 08G .0204 and failing to do so can result in
Disciplinary Actions by the Water Pollution Control System Operators Certification Commission."
Mail, fax or email WPCSOCC, 1618 Mail Service Center, Fax: [phone]
ORIGINAL to: Raleigh, NC 27699=1618
Mail. or Fax Asheville
a COPY'to: 2090 US Hwy 70
S.wahnanoa, NC 28778
Fax: [phone]
Phone:[phone]
Washington
943 Washington Sq. Mall
Washington, NC 27889
Fax: [phone]
Phone: [phone]
Fayetteville
225 Geeen St., Suite 714
Fayetteville, NC 28301-5043
Fax: [phone]
Phone: [phone]
Wilmington
127 Cardinal Dr.
Wilmington, NC 28405-2845
Fax: [phone]
Phone: [phone]
Mooresville
610 E. Center Ave., Suite 301
Mooresville, NC 28115
Fax:[phone]
Phone: [phone]
Winston-Salem
45 W. Hanes Mall Rd.
Winston-Salem, NC 27105
Fax: [phone]
Phone: [phone]
Raleigh
3800 Barrett Dr.
Raleigh, NC 27609
Fax: [phone]
Phone: [phone]
Revised 412016

16
WPCSOCC Operator Designation Form (continued) Page 2
Facility Name: Hemby Acres Permit M WQCS-00233
BACKUP ORC
Print Full Name: Tommy Capps Work Phone: [phone]
Certificate Type: CS Certificate Grade: I Certificate #: 997755
Email Address: tccapps@uiwatercom
Signature: Effective Date: g_ f 7
"7 certify that 1 agre2.t my designati n as a ack-up Operator in Responsible Charge for the facility noted. I understand and will abide by
the rules and regulations pertaining to the responsibilities of the ORC as. set forth in 15A NCAC 08G .0204 and foiling to.do so. can result in
Disciplinary Actions by the Water Pollution Control System Operators Certification Commission."
BACKUP ORC
Print Full Name: Work Phone:
Certificate Type: Select Certificate Grade: Select Certificate #:
Email Address:
Signature: Effective Date:
'Icertify that I agree to my designation as a -Back-up Operator in Responsible Charge for the -facility noted. 1 understand and will abide by
the rules. and regulations pertaining to the responsibilities of the ORC as set forth in 1S4.NCAC 08G .0204 and failing to do so can result in
Disciplinary Actions by the Water Pollution Control System Operators Certification Commission."
BACKUP ORC
Print Full Name: Work Phone:
Certificate Type: Select .
Email Address:
Signature:
Certificate Grade: Select
Certificate #:.
Effective Date:
"i certify that I,agree to my designation as a Back-up Operator in Responsible Charge for -the facility noted. _I understand and will abide by
the rules and regulations pertaining to the responsibilities of the ORC as set forth in 15A NCAC 08G .0204 and failing to do so can result in
Disciplinary Actions by the Water Pollution Control System Operators.Certification Commission."
BACKUP -ORC
Print Full Name: Work Phone:
Certificate Type: Select
Email Address:
Signature:
Certificate Grade: Select Certificate #:
Effective Date:
"9 certify that I agree to my:designotion as a Back-up Operator in Responsible Charge for the facility noted. 1 understand and will abide by
the rules and regulations pertaining. to the responsibilities of the ORC os set forth in 15A NCAC 08G .0204 and failing'to do so can result in
Disciplinary Actions by the Water Pollution ControlSystem Operators Certification Commission."
Revised 412016

r it Ut%l%t%E5, Inc'
Wastewater Treatment and Collection
Performance Annual Report
I. General Information MAR 2 4 2010
Facility/System Name: Hemby Acres County: Union
Service Area Includes: Hemby Acres / Beacon Hills, Oak Grove
Responsible Entity: Carolina Water Service, Inc. of NC
Contact Name/Phone #: Area Manager Mark Haver 704-525-7990
Applicable Permit(s): Permit Numbers NC003504L/,i�6TQC"50023'3—
Description of Collection System or Treatment Process:
NCO035041: Operate a 0.3 MGD wastewater treatment facility with the following components:
Influent pump station, manual bar screen, two aeration basins with mechanical aerators, two
secondary clarifiers, four aerobic sludge digesters, two tertiary filters, chlorination with contact
tank, post aeration, dechlorination and continuous flow measurement.
WQCS00233: The Operation and Maintenance of a wastewater collection system consisting of
approximately 7.6 miles of gravity sewer, approximately 1.26 miles
of force main, three duplex pump stations, and associated piping, valves, an
appurtenances.
Zulu
II. Performance �n+m -- ni ini rry
Overall Summary of System Performance for Calendar Year 2009:
NCO035041: The wastewater treatment plant consistently met permit limitations in 2009.
WQCS00233: The wastewater collection system had one occurrence that resulted in a sanitary
sewer overflow.
Hemby Acres Annual Sewer Performance Report 2009 Page 1

The following lists any violations of permit conditions or environmental
regulations that may have occurred during the year. If a violation is listed,
a description of any known environmental impact including the corrective
measures taken is included.
January
No violations/deficiencies noted.
February
No violations/deficiencies noted.
March
No violations/deficiencies noted.
April
No violations/deficiencies noted.
May
No violations/deficiencies noted.
June
A violation was issued after a sanitary sewer overflow occurred on 6/19/2009 at
the #1 Lift Station on Mill Grove Road. It consisted of an estimated 300 gallons
but with only 150 gallons reaching a storm water ditch and not contained. A pump
had clogged and tripped out which was reset and cleared. The area was thoroughly
cleaned and neutralized. Proper notification was made to the State Division of
Water Quality. No known environmental impact.
July
No violations/deficiencies noted.
August
No violations/deficiencies noted.
September
No violations/deficiencies noted.
October
No violations/deficiencies noted.
November
No violations/deficiencies noted.
December
No violations/deficiencies noted.
III. Notification
Customers will be notified of the availability of this report with a message on
their bills and copies will be provided upon request.
IV. Certification
I hereby certify that the information contained in this report is accurate and
complete to he be of m kn ledge.
February 26, 2010
Signature of Responsible Person Date
Martin Lashua
Printed Name
Regional Director
Title
Hemby Acres Annual Sewer PePformance Report 2009 Page 2

F �
f' Utilities, Inc'
R"
$... 4yr-Uter
i
Treatment and Coltecxion
F E B 2 6 2008 Performance Annual
Dlp aQ-Sur ce Water P. hinformation
�r;w
Facility/System Name:
Service Area Includes:
Responsible Entity:
Repot �
Hemby Acres County: Union
Hemby Acres / Beacon Hills, Oak Grove
Carolina Water Service, Inc. of NC
Contact Name/Phone #: Area Manager Mark Haver 704-525-7990
Applicable Permit(s): Permit Numbers NCO035041 % �� 0:02!93—
Description of Collection System or Treatment Process:
NCO035041: Operate a 0.3 MGD wastewater treatment facility with the following components:
Influent pump station, manual bar screen, two areation basins with mechanical aerators, two
secondary clarifiers, four aerobic sludge digesters, two tertiary filters, chlorination with contact
tank, postaeration, continous flow measurement.
WQCS00233: The Operation and Maintenance of a wastewater collection system consisting of, at
the time of permit issuance, approximately 7.6 miles of gravity sewer, approximately 1.26 miles
of force main, four duplex or greater pump stations, and all associated piping, valves, and
appurtenances.
II. Performance
Overall Summary of System Performance for Calendar Year 2008:
NCO035041: The wastewater treatment plant had occurrences of exceeding the permit limits in
three months of 2008.
WQCS00233: The wastewater collection system consistently met permitted limitations in 2008.
Z
rD m
LU
L-.0 U
LV
0
z z
LLJ�
Hemby Acres Annual Sewer Performance Report 2008 Page 1

The following lists any violations of permit conditions or environmental
regulations that may have occurred during the year. If a violation is listed,
a description of any known environmental impact including the corrective
measures taken is included.
January
A violation was issued when a biological oxygen demand (BOD) result of 44 mg/L
exceeded the daily maximum limit of 22.5 mg/L and a single fecal coliform result
of 620/100 ml exceeded the daily maximum limit of 400/100 ml. The monthly
average was within limits. No known environmental impact.
February
No violations/deficiencies noted.
March
A violation was issued when a biological oxygen demand (BOD) result of 53 mg/L
exceeded the daily maximum limit of 22.5 mg/L. No known environmental impact.
April
A violation was issued when a single fecal coliform result of 480/100 ml exceeded
the daily maximum limit of 400/100 ml. The monthly average was within limits.
No known environmental impact.
May
No violations/deficiencies noted.
June
No violations/deficiencies noted.
July
No violations/deficiencies noted.
August
No violations/deficiencies noted.
September
No violations/deficiencies noted.
October
No violations/deficiencies noted.
November
No violations/deficiencies noted.
December
No violations/deficiencies noted.
III. Notification
Customers will be notified of the availability of this report with a message on
their bills and copies will be provided upon request.
IV. Certification
I hereby c�rtify that the information contained in this report is accurate and
complete t the st o my owledge.
February 6, 2009
Signature of Responsible Person Date
Martin Lashua
Printed Name
Regional Director
Title
Hemby Acres Annual Sewer Performance Report 2008 Page 2

Wastewater Treatment and Collection
Performance Annual Report
I. General Information
Facility/System Name:
p�H,,,embsy lc County: Union
Service Area Includes: Oak Grove
Responsible Entity: Carolina Water Service, Inc. of NC
Contact Name/Phone #: Area Manager Mark Haver 704-525-7990, ext 233
Applicable Permit(s): Permit Numbers NC0035041 �ti t
Description of Collection System or Treatment Process:
NCO035041: Operate a 0.3 MOD wastewater treatment facility with the following components:
Influent pump station, manual bar screen, two areation basins with mechanical aerators, two
secondary clarifiers, four aerobic sludge digesters, two tertiary filters, chlorination with contact
tank, postaeration, continous flow measurement.
WQCS00233: The Operation and Maintenance of a wastewater collection system consisting of, at
the time of permit issuance, approximately 7.6 miles of gravity sewer, approximately 1.26 miles
of force main, four duplex or greater pump stations, and all associated piping, valves, and
appurtenances. a
TT PPrfnrmnnrPf,-
Overall Summary of System Performance for Calendar Year 2007:
NCO035041: The wastewater treatment plant had one exceedance of the discharge Prthf trsiits.
WQCS00233: The wastewater collection system consistently met permitted limitations in
Ion
Hemby Acres Annual Sewer Performance Report 2007 Page 1

-The following lists any violations of permit conditions or environmental
regulations that may have occurred during the year. If a violation is listed,
a description of any known environmental impact including the corrective
measures taken is included.
January
No violations/deficiencies noted.
February
No violations/deficiencies noted.
March
A single fecal coliform result of 900/100 ml exceeded the daily maximum limit of
400/100 ml. The monthly average was within limits. No known environmental
impact. Isolated occurrence.
April
No violations/deficiencies noted.
May
No violations/deficiencies noted.
June
No violations/deficiencies noted.
July
No violations/deficiencies noted.
August
No violations/deficiencies noted.
September
No violations/deficiencies noted.
October
No violations/deficiencies noted.
November
No violations/deficiencies noted.
December
No violations/deficiencies noted.
III. Notification
Customers will be notified of the availability of this report with a message on
their bills and copies will be provided upon request.
IV. Certification
I hereby ertify that the information contained in this report is accurate and
comple e o the
est f nowledge.
�- January 31, 2008
Signature of Responsible Person Date
Martin Lashua
Printed Name
Regional Director
Title
Hemby Acres Annual Sewer Performance Report 2007 Page 2

�- �, ,'"Submit by Email �, Print Forme :�'
utilitiEs, Inc
�s
Wastewater Treatment and Collection
rEl- IVED
DIVISIONOFRATEER QUALITY
Performance Annual Report MAR 2M� r
I. General Information
� TL;
Facility/System Name Hemby Acres County Union
Service Area Includes:
Hemby Acres / Beacon Hills, Oak Grove
Responsible Party: Carolina Water Service, Inc. of NC
Contact Name and
Phone #:
Area Manager- Mark Haver 704-525-7990
Applicable Permit(s): NC0035041 / WQC500233
Description of
Collection System or
Treatment Process:
NC0035041: The operation of a 0.3 MGD wastewater treatment facility with the following components:
Influent pump station, manual bar screen, two aeration basins with mechanical aerators, two secondary
clarifiers, four aerobic sludge digesters, two tertiary filters, chlorination with contact tank, post aeration,
dechlorination and continuous flow measurement.
00233: The operation and maintenance of a wastewater collection system consisting of
dmately 7.6 miles of gravity sewer, approximately 1.26 miles of force main, three duplex pump
is, and associated piping, valves, and appurtenances.
II. Performance
Overall Summary of System Performance for Calendar Year: 2011 #
NC0035041: The wastewater treatment plant exceeded permit limitations twice during the year.
The wastewater collection system consistently met permit limitations during the year.
1
I

The following lists any violations of permit conditions or environmental regulations that may have occurred during the year. If a
violation is listed,.a description of any known environmental impact including the corrective measures taken is included.
January Ij . No violations/deficiencies noted.
February I No violations/deficiencies noted.
March I) No violations/deficiencies noted.
April I No violations/deficiencies noted.
May ! A violation was issued after a single fecal.coliform result of 880 mg/L exceeded the daily limit of 400 mg/L.
ISubsequent samples were within limits as well as the monthly average. No known environmental impact.
rof
iolation was issued after a single Biological Oxygen Demand (BOD) result of 25 mg/L exceeded the daily limit
June 13.5 mg/L. Subsequent samples were within limits as well as the monthly average. No known environmental
impact.
July 1 No violations/deficiencies noted.
August 1 No violations/deficiencies noted.
September 11 No violations/deficiencies noted.
October l No violations/deficiencies noted.
November 11 No violations/deficiencies noted.
December l No violations/deficiencies noted.
III. Notification
Customers will be notified of the availability of this report with a message on their bills and copies
will be provided upon request.
IV. Certification
I hereby certify that the informatimont 'ned i this r ort is accurate and complete to the
best of my knowledge. � M
Signature DateO
Printed Name Martin LasTitle: Regional Director