WI0500414_Staff Report_20211028

WATER QUALITY OPERATIONS REGIONAL STAFF REPORT
Date: October 28, 2021
To: WQ Regional Operations CO
CO Reviewer: Shristi Shrestha
Regional Office Inspector: Eric Rice
I. GENERAL INFORMATION
1. This application is (check all that apply): ❑ New ® Renewal
❑ Minor Modification ❑ Major Modification
County: Orange
Permittee: Sarah Cohen
Project Name: Cohen & Diering SFR SFR
Permit # WI0500414
❑ Surface Irrigation ❑ Reuse 0 Recycle ❑ High Rate Infiltration 0 Evaporation/Infiltration Lagoon
❑ Land Application of Residuals
❑ Distribution of Residuals
❑ Attachment B included
❑ Surface Disposal
❑ 503 regulated 0 503 exempt
❑ Closed -loop Groundwater Remediation ® Geothermal Water Return
Was a site visit conducted in order to prepare this report? ® Yes or ❑ No.
a. Date of site visit: October I3, 2021
b. Person contacted and contact information: Sarah Cohen [phone]
c. Site visit conducted by: E. Rice
d. Inspection Report Attached: ® Yes or ❑ No.
2. Is the following information entered into the BIMS record for this application correct?
® Yes or ❑ No. If no, please complete the following or indicate that it is correct on the current application.
For Disposal and Infection Sites:
(If multiple sites either indicate which sites the information applies to, copy and paste a new section into the
document for each site, or attach additional pages for each site)
a. Location(s):
b. Driving Directions:
c. USGS Quadrangle Map name and number:
d. Latitude: Longitude:
IY'. INJECTION WELL PERMIT APPLICATIONS (Complete these two sections for all systems that use injection
wells, including closed -loop groundwater remediation effluent injection wells, in situ remediation injection wells, and heat
pump injection wells.)
Description Of Well(S) And Facilities — New., Renewal, And Modification
1. Type of injection system:
® Heating/cooling water return flow
❑ Closed -loop heat pump system
❑ In situ remediation (51)
FORM: W10500414 1

WATER QUALITY OPERATIONS REGIONAL STAFF REPORT
❑ Closed -loop groundwater remediation effluent injection (5L1"Non-Discharge")
❑ Other (Specify: )
2. Does system use same well for water source and injection? ❑ Yes ® No
3. Are there any potential pollution sources that may affect injection? ❑ Yes ® No
What is/are the pollution source(s)?
pollution source(s)?
4. Quality of drainage at site: ® Good
5. Flooding potential of site: ® Low
What is the distance of the injection well(s) from the
❑ Adequate 0 Poor
❑ Moderate ❑ High
V. EVALUATION AND RECOMMENDATIONS
1. Provide any additional narrative regarding your review of the application.: One well system. There is no
sampling port at the wellhead on the effluent side . A sample was collected on the influent side for chloride,
metals, and nutrients. 6" steel casing well, tag present, well was in good condition.
2. Do you foresee any problems with issuance/renewal of this permit? ® Yes ❑ No. If yes, please explain
briefly. No sample port present on effluent side.
3. List any items that you would like Central Office to obtain through an additional information request. Make
sure that you provide a reason for each item:
Item
Reason
Installation of an effluent sample port. A
sampling port on the effluent side is required
by rule.
Necessary
4. List specific Permit conditions that you recommend to be removed from the permit when issued. Make sure
that you provide a reason for each condition:
Condition
Reason
5. List specific special conditions or compliance schedules that you recommend to be included in the permit when
issued. Make sure that you provide a reason for each special condition:
FORM: WI0500414 2

10/28/2021
Compliance Inspection Report
Permit: WI0500414 Effective: 09/27/16 Expiration: 08/31/21 Owner : James Bartram
SOC: Effective: Expiration: Facility: James Bertram and Jane Bailey SFR
County: Orange 410 Whitehead Cir
Region: Raleigh
Contact Person: James Bertram
Directions to Facility:
Chapel Hill NC 27514
Title: Phone: [phone]
System Classifications:
Primary ORC: Certification: Phone:
Secondary ORC(s):
On -Site Representative(s):
Related Permits:
Inspection Date: 10/13/2021
Primary Inspector: Enc S Rice
Secondary Inspector(s):
Entry Time 11:OOAM Exit Time: 12:30PM
Phone: [phone]
Reason for Inspection: Routine Inspection Type: Compliance Evaluation
Permit Inspection Type: Injection Heating/Cooling Water Return Well
Facility Status: 0 Compliant ❑ Not Compliant
Question Areas:
Other
(See attachment summary)
Page 1 of 3

Permit: W10500414 Owner - Facility:James Bartram
Inspection Date: 10/13/2021 Inspection Type : Compliance Evaluation
Reason for Visit: Routine
Inspection Summary:
Weil system was in good condition. No sampling port was present on the effluent side. GW sample collected from the
influent side only.
Page 2 of 3

Permit: WI0500414 Owner - Facility:James Bertram
Inspection Date: 10/13/2021 Inspection Type : Compliance Evaluation
Reason for Visit: Routine
Other
Comment:
Yes No NA NE
Page 3 of 3