WQ0011761_Compliance Evaluation Inspection_20220504

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Date
Arrival Time
Exit Time 1 f Q M
NON_ DISCHARGE SINGLE FAMILY WASTEWATER SYSTMS
6115/2021 ,
Permittee: b A J f . eft K.b it- Permit: w 12 ton 11741
Address: LoT ZS' 1,4)nobc b L.,tee h.ot vG , 4f x ,ti L. E-mail-
Phone:( i ) I/G 9 -10ef Cell Phone:( ) - County: `,4AYEA
The Permittee is responsible for the operation and maintenance of the entire wastewater treatment and disposal system.
Doesn't Did Not
Yes No Apply Investigate
III IIII
1. Is the current resident in the home the Permittee? ❑ ❑
2. If not does the resident rent from the ❑ ❑ ❑ MI
permittee?
3. Change of Ownership form needed? (mail the form with the inspection letter) ❑ ❑ ❑ Cl
4. Is there a inspection and maintenance agreement with a contractor? ❑ ❑ ❑ Li
5. If yes to #4 who is the contractor?
i SEPTIC Ti The septic tank and filters should be checked annually and pumped/cleaned as needed.
6. Is all wastewater from the home to the tank? ❑ ❑
connected septic
7. Does the know where the septic tank is located? ❑ ❑ ❑
permittee/resident
1111
8. Has the septic tank been in the last 5 El ❑
pumped years?
19. If yes to #8 date, if known If proof, describe
10. Does the septic tank have an EFFLUENT FILTER or SANITARY T? (circle one)
11. If Yes to filter when was the filter cleaned? By whom?
SAND FILTER / TREATMENT YES ❑ NO n If no proceed to the next section.
Accessible sand filter surfaces shall be raked and leveled every six months and any vegetative growth shall be removed manually.
12. Is system something other than a sandfilter?1❑ ❑ O
13. If yes, what kind? (examples - Peat, Textile, Other or brand name - Advantex, etc.)
14, Does the permittee know where the sandfilter is located? ❑ ❑ II
15. Does the sandfilter require maintenance? ❑ ❑ El ❑
If maintenance is required explain in the comment section.
DISINFECTION 1 UV YES ❑ NO If no proceed to the next section.
The ultraviolet unit shall be checked weekly. The lamps and sleeves should be cleaned or replaced as needed to ensure proper disinfection,
16. Is UV working? ❑
17. Has the UV Unit been serviced and bulbs cleaned? ❑ ❑ ❑
18. Who completes the weekly check for the UV?( Non -Discharge)
1I
DISINFECTION / TABLETS YES I NO i If no proceed to the next section.
The tablet chlorinator unit shall be checked weekly to ensure continuous and proper operation
19. Does the permittee have the correct chlorine tablets?(If none, mark No) ❑ ❑ ❑ ❑
20. Does the Permittee know the location of the chlorinator? ❑ ❑ ❑ ❑
21. Were chlorine tablets observed in the chlorinator? 0 ❑ ❑ ❑
22. Are tablets contacting water? If them to determine. ❑ ❑ ❑ III
possible poke
DECHLOR (Discharge only) YES n NO n If no proceed to the next section.
The dechlorinator unit shall be checked weekly to ensure continuous and proper operation.
23. Does the permittee know where the dechlor is? ❑ ❑
24. Does the permittee have the correct dechlor tablets? ❑ ❑
25. Were dechlor tablets observed in the dechlorination chamber? ❑ ❑ El ❑
26. Are tablets contacting water? If possible poke them to determine. ❑ ❑ ❑ 0

PUMP TANK YES [1 NO
All pump and alarm sytems shall be inspected monthly. (non -discharge)
27. Is the pump working?
28. Are the audible and visual high water alarms operational?
29. Does the permittee know how to check the pump & high water alarm?
30. Last fur PUMP AUDIBLE & VISUAL
1f no proceed to the next section.
❑ ❑ ❑ ❑
❑ ❑ ❑ ❑
❑ ❑ ❑ ❑
DISCHARGE ONLY YES 1 1 NO 1 1 If no proceed to the next section.
A visual review of the ourfall location shall be executed twice each year (one at the time of sampling to ensure no visible solids or evidence of a malfunction.
31. Does the permittee know where the outfall is located? ❑ ❑ ❑ ❑
32. Were you able to locate the outfall? ❑ ❑ 0 ❑
33. Is the end of the discharge pipe visible and accessible? ❑ ❑ 11 ❑
34. Is outlet discharging? o ❑ ❑ ❑
35. Is right of way maintained around the discharge point? ❑ ❑ ❑ ❑
36. Any Lab Results available? ❑ ❑ ❑ ❑
37. Is there evidence of solids around the discharge point? DODO
DRIP or SPRAY YES U NO Cl If no proceed to the next section.
The irrigation system shall be inspected monthly to ensure the system is free of leaks and equipment is operating as designed.
38. Is the system DRIP or IRRIGATION (circle one)? If irrigation number of sprinkler heads.
39. Are the buffers adequate? ❑ ❑ ❑ ❑
40. is the site free of ponding and runoff? ELIO ❑
41. Does the application equipment appear to be working properly? DODO
42. Is there a minimum two wire fence surrounding entire irrigation area? ❑ ❑ ❑ ❑
GENERAL
43. Are the treatment units locked and or secured?
44. Has resident had any sewage problems? If yes explain in the comment section.
45. Does the system match the permit description? If no explain in the comment section.
46. Is the system compliant?
47. Is the system failing? If yes, take pictures if possible.
48. 1f system is failing, any sign of children or animals contacting sewage?
NOD Sent #: - NOV Sent #:
DODO
❑ ❑ ❑ El
❑ ❑ DO
❑ ❑ ❑ ❑
O DE ❑
DODD
Comments: Photos Taken? YES 1 NO
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INSPECTOR: SIGNATURE: