HomeMy WebLinkAboutNCG550079_Compliance Evaluation Inspection_20221230ROY COOPER
Governor
ELIZABETH S. BISER
Secretary
RICHARD E. ROGERS, JR.
Director
Diane Townsend
1239 Pine Knolls Road
Kernersville, NC 27284
NORTH CAROLINA
Environmental Quality
January 9, 2023
SUBJECT: Compliance Evaluation Inspection
Single Family Residence
1239 Pine Knolls Road
Permit #: NCG550079
Forsyth County
Dear Ms. Townsend:
On December 30, 2022, Gary Hudson of this office performed a Compliance Evaluation
Inspection on the wastewater treatment system referenced above. Observations indicated
that the subsurface sand filter was operating properly. There was no evidence of a
discharge during the inspection. Please note some of the activities that must be conducted
and documented, in addition to the laboratory analyses required if the system discharges:
• Please be aware that the Permit requires that the septic tank contents be pumped
out every five years to prevent solids from clogging the sandfilter system.
• The tablet chlorinator should be inspected weekly to ensure there is an adequate
supply of tablets for continuous operation. Be sure to order more tablets and
replace them often enough to ensure continuous disinfection.
If you have any questions concerning this letter, please contact Gary Hudson at (336)
776-9694.
GDE
NORTH CAROLINA '
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Sincerely,
Docu Signed by:
Low, ,,..);itx-
rlf5ShitferRegionaI Supervisor
Water Quality Regional Operations
Division of Water Resources
North Carolina Department of Environmental Quality I Division of Water Resources
Winston-Salem Regional Office 1450 W. Hanes Mill Rd, Suite 300 I Winston-Salem, North Carolina 27105
336.776.9800
United States Environmental Protection Agency
E PA Washington, D.C. 20460
Water Compliance Inspection Report
Form Approved.
OMB No. 2040-0057
Approval expires 8-31-98
Section A: National Data System Coding (i.e., PCS)
Transaction
1
21IIIIII
Inspection
671
IN
Code NPDES yr/mo/day Inspection
I 2 IL I 3 I NCG550079 111 121 22/12/30 117
Type
1810I
IIIIIIIIIII
Inspector Fac Type
19I S I 2011
IIIIIIIIIII IIIIIII I IIIIII
P6
Work Days Facility Self -Monitoring Evaluation Rating B1 QA Reserved
I 70I I 711 172 I N I 73I 1 74 71
I I
I I I I I I 180
Section B: Facility Data
Name and Location of Facility Inspected (For Industrial Users discharging to POTW, also include
POTW name and NPDES Dermit Number)
1239 Pine Knolls Road
1239 Pine Knolls Rd
Kernersville NC 27284
Entry Time/Date
09:OOAM 22/12/30
Permit Effective Date
20/11/20
Exit Time/Date
09:30AM 22/12/30
Permit Expiration Date
25/10/31
Name(s) of Onsite Representative(s)/Titles(s)/Phone and Fax Number(s)
///
Other Facility Data
Name, Address of Responsible Official/Title/Phone and Fax Number
Contacted
Diane Townsend,1239 Pine Knolls Rd Kernersville NC 27284///
No
Section C: Areas Evaluated During Inspection (Check only those areas evaluated)
Permit
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
(See attachment summary)
Name(s)
Gary
and Signature(s) of Inspector(s) Agency/Office/Phone and Fax Numbers Date
Hudson DWR/Division of Water Quality/336-776-9694/
1- DocuSigned by:
t oYt1 Raw, , 1/9/2023
SigralTADatftabtchent
Q A Reviewer Agency/Office/Phone and Fax Numbers Date
rDocuSigned by:
i.-0A. T, Sti,d� 1/9/2023
135545EZZ5CT4EA...
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete.
Page# 1
sI
NPDES yr/mo/day
NCG550079 111 121 22/12/30
117
Inspection Type
18 [j
1
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
*The single-family subsurface sand filter appeared to be very well maintained.
*The chlorinator was located during the inspection.
*The de -chlorinator was located during the inspection.
*The effluent pipe was not located during the inspection.
*Ms. Townend's Grandson comes by monthly to add chlorine and de-chlor tablets.
Page# 2
Permit: NCG550079
Inspection Date: 12/30/2022
Owner - Facility: 1239 Pine Knolls Road
Inspection Type: Compliance Evaluation
Permit Yes No NA NE
(If the present permit expires in 6 months or less). Has the permittee submitted a new El El ❑
application?
Is the facility as described in the permit? • El El El
# Are there any special conditions for the permit? El • El El
Is access to the plant site restricted to the general public? • ❑ ❑ ❑
Is the inspector granted access to all areas for inspection? • El El El
Comment:
Page# 3