WQ0020817_Staff Report_20221219

DocuSign Envelope ID: A7C2E2B7-FF39.4582-800E-92E642E2A62E
*� State of North Carolina
Division of Water Resources
" Water Quality Regional Operations Section
Environmental Staff Report
Quality
To: ❑ NPDES Unit X Non -Discharge Unit Application No.: #WQ0020817
Attn: Leah Parente Facility Name: 604 Perfect
Moment Drive
SFR
County: Durham
From: Jim Westcott
Raleigh Regional Office
Note: This form has been adapted from the non -discharge fgc acility staff report to document the review of both non -
discharge and NPDES permit applications and/or renewals. Please complete all sections as they applicable.
I. GENERAL AND SITE VISIT INFORMATION
1. Was a site visit conducted? X Yes or ❑ No
a. Date of site visit: 9/6/2022
b. Site visit conducted by: Jim Westcott
c. Inspection report attached. X Yes or No
d. Person contacted: Donna F. Haddock and their contact information: [phone] ext.
(Disconnected)
e. Driving directions:
2. Dise ar-ge PeiM(s)
Latitude:
3.
Longitude:
II. PROPOSED FACILITIES: NEW APPLICATIONS
FORM: WQROSSR 04-14 Page I of 5

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III. EXISTING FACILITIES: MODIFICATION AND RENEWAL APPLICATIONS
1. Are there appropriately certified Operators in Charge (ORCs) for the facility? X Yes ❑ No NIA
ORC: AQWA Inc.
2. Are the design, maintenance, and operation of the treatment facilities adequate for the type of waste and disposal
system? X Yes or ❑ No
If no, please explain:
Description of existing facilities: SFR/Irrigation
Wepesedflow--
Current permitted flow: 600 GPD
Explain anything observed during the site visit that needs to be addressed by the permit, or that may be important
for the permit writer to know (i.e., equipment condition, function, maintenance, a change in facility ownership,
etc.)
3. Are the site conditions (e.g., soils, topography, depth to water table, etc.) maintained appropriately and adequately
assimilating the waste? X Yes or ❑ No
If no, please explain:
4. Has the site changed in any way that may affect the permit (e.g., drainage added, new wells inside the compliance
boundary, new development, etc.)? ❑ Yes or X No
If yes, please explain:
S. Is the residuals management plan adequate?)? X Yes or No N'A
If no, please explain:
6: Are the existing application rates (e.g., hydraulic, nutrient) still acceptable? X Yes or ❑ No
If no, please explain-
Is the existing groundwater monitoring program adequate? Yes ❑ No ❑ X N/A
If no, explain and recommend any changes to the groundwater monitoring program:
8. Are there any setback conflicts for existing treatment, storage and disposal sites? ❑ Yes or X No
If yes, attach a map showing conflict areas.
9. Is the description of the facilities as written in the existing permit correct? X Yes or ❑ No
If no, please explain:
10. Were monitoring wells properly constructed and located? Yes ❑ No ❑ X NIA
If no, please explain:.. -
FORM: WQROSSR 04-14 Page 2 of 5

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Are the monitoring well coordinates correct in BIMS? ❑ Yes ❑ No ❑ N/A
If no, please complete the following (expand table if necessary):
Monitoring Well
Latitude
Longitude
o- r n
o- r n
11. Has a review of all self -monitoring data been conducted (e.g., DMR, NDMR, NDAR, GW)? X Yes or ❑ No
Please summarize any findings resulting from this review:
Provide input to help the permit writer evaluate any requests for reduced monitoring, if applicable.
-h'L Are there any permit changes needed in order to address ongoing BIMS violations? ❑ Yes or ❑ No
If yes, please explain:
13. Check all that apply:
X No compliance issues ❑ Current enforcement action(s) ❑ Currently under JOC
❑ Notice(s) of violation ❑ Currently under SOC ❑ Currently under moratorium
Please explain and attach any documents that may help clarify answer/comments (i.e., NOV, NOD, etc.)
If the facility has had compliance problems during the permit cycle, please explain the status. Has the RO been
working with the Permittee? Is a solution underway or in place?
Have all compliance dates/conditions in the existing permit been satisfied? X Yes No ❑ NIA
If no, please explain;
14. Are there any issues related to compliance/enforcement that should be resolved before issuing this permit?
❑ Yes X No ❑ N/A
If yes, please explain:
15. Possible toxic impacts to surface waters: N/A
16. Pretreatment Program (POTWs only):
I:M91I:6W"I sLi7yti[y�I:7rLili)Ut�trl`.i�7:411ti)�f.�
4-: Do you foresee any problems with issuance/renewal of this permit? ❑ Yes or X No
If yes, please explain:
2. List any items that you would like the NPDES Unit or Non -Discharge Unit Central Office to obtain through an
additional information request:
Item Reason
FORM: WQROSSR 04-14 Page 3 of 5

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3. List specific permit conditions recommended to be removed from the permit when issued:
Condition Reason
4. List specific special conditions or compliance schedules recommended to be included in the permit when issued:
Condition Reason
5. Recommendation: ❑ Hold, pending receipt and review of additional information by regional office
❑ Hold, pending review of draft permit by regional office
❑ Issue upon receipt of needed additional information
X Is
■5
6. Signature of report preparer:
Signature of regional supervis
Date: 12/19/2022
FORM: WQROSSR 04-14 Page 4 of 5

Compliance Inspection Report
Pond WOOM17 Effectiw: 04/13/16 Expiration: 03/31/21
80C: Effective: Expiration:
County: Chatham
Region: Ralath
Contact Person: Donna F Haddock Titre:
Owner: Donna F Haddock
Facility: 604 Parfect Moment Dr. SFR
004 Parted Moment Dr
Durham NC 27713
Phone:
Directions to Facility:
1-40, Exit 278. NC 55 8, 4A mil. Rt on al(elly Chapel Rd., 2 miles. Rt on Royal Sunset Dr. (locked gate), 0.2 mi, first left on Pertsct
Moment Dr., 0.2 rn). House on lot
System ClsssNlcations:
Primary ORC: Certification: Phone:
Secondary ORC(s):
On4ft Representath*Q:
Inepacflon Date: 08/0812022 Entry Time 09:30AM Exit Time: 10:30AM
Primary Mapeotor: James WestoW Phone: [phone]
secondary Inspector(s):
Reason for Inspection: Routine Inspeation Type: Compliance Evaluation
Penrdt Inspection Type: Single-Farniiy Residence Wastawatar Irrigation
Fac)llly Status: N Compliant ❑ Not Compliant
Quastion Areas:
IMemllanowe Questions Permit Status Septic Tank
Pump Tank Drip or irrigation General
(See attachment summary)
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Parma: V'QN '7 owns-FacftDomla F Maddock
Impaction Dabr: Oa10e17M 4wpeq*m typo : Compknm Evapmbm Rwon for VIML i wAm
Inspection Summery:
Advantex AX 20 system was serviced at the time of inspection and all oompadments. medla,spmy patterns and uv
dlswdbctiDn unit were Inspected for proper opomtbn. The drip held was fenced and dearly dolniated.Ddp system lines
repaired in zone(m) #1 (4), #2 (37),03 (10). Previous maintenance reports were avallabte at dw time of inspection and the
current Inspection report was sent to Me oflloe and uploaded to Ila
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Parboil: W001=17 Owim - Facltgr:0onna F Haddock
Inspection Date: 0®r0e1 M Inspection Type: COMpllanoe Evaluation
Reason for VIM Roudna
Permit Status
# is the current resident In the hone the Perrnittes?
Yea No NA HE
0131313
# If not, doss the resident rent from the Perrrd tee?
❑ ❑ 0 ❑
Change of Ownership form needed? (Malt the form with the inspection letter)
❑ ❑ ■ ❑
# 1s therean inspacticrh and maintenance agreement with a cont adar?
M 131313
If YES, who is the contractor (Mdude contact info)?
AOWA, Inc.
2604 Me Court
Minn, NC 27896
252 243-7693
Comment:
Beoft bilk
' The "a tank and filters should be chocked annually and pumpoWdeaned as needed.
Is all weel3ewater from the home connected to the septic tank?
0131313
# Does the parmittas/resident know where the septic tank In located?
01313 ❑
Has the septic tank been pumped In the NO S years?
013 ❑ ❑
If YE$, describe if known and proof Qnduds date pumped):
Contract staff provided documentation at time of Inspec&M.
# Does the septic tank have an EFFLUENT FILTER or SAMTARY T?
M 131313
If FILTER, when was the filter donned and by who?
At the time of
Inspsdloo try the
AQWA*b&.
Comment:
Pump
I All pump and alarm sytems shall be Inspected monthly. (Non-Dlacharge)
ru 02 be
Is the pump working?
0131313
Is the audible and visual high water alarm operational?
0131313
# Does the permittee know how to check the pump & high water alarm?
M ❑ ❑ ❑
# Last functlonal test:
i AIM22
Comment:
Ddo or M aadon
Yea No MA NE
' Irrigation sysetm shall be Inspected monthly to ensure system Is free of leeks and equipment is operating
as deaNned.
Nf
Al Type of system (DRIP or IRRIGATK)N): Drip
# If IRRIGATION. number of sprinkler heads:
Are buffers and satbadke adequate? M ❑ ❑ ❑
Is the site free of por ding and runall? M ❑ ❑ ❑
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pwmlr WOMM17 Owner-FaeftDormFHMO&
rupaMeg aDdw 0910802mm hmpocftnlypa:CompesnosEvakmmi Rmm MrVkrit: PmAkw
Doss the application equipment appear to be worldng pro"fly? ■ ❑ ❑ ❑
Is there a minlmum two wke !once sunmmding the mitre Irrigation area? ■ ❑ ❑ ❑
Comment:
mmnd
d Are, lw treatment units locked andfor secured?
d Has resident had any sawage problems?
IMS. emlwn:
No concerns noted.
Does the system match the permit deser"on?
M NO. explain:
Is the system oom~
Is the system falling? (If yes. take picturos if poaabla)
H system is falling, dasalbe any exposuros to peophdanknals or envlra wwnW ricks.
No concerns noted.
Comment:
Mm me MA m
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❑ 13M❑
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❑❑M13
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