WQ0007521_NOV-Past Due Fees_20230616

Re: [External] Fwd: 6917 Kemp Rd, Raleigh - sand filter system- Options
Bernard, Jane
Fri 6!1612023 7 11 AM
To:Joanne Empie <Joanne [e-mail]>;Lee, David <[e-mail]>
R 3 attachments r907 KB: -
Past due fees.pdf: 2022 Notice of Volat on,pdt. Application 3 bedrooms.pdf;
Joanne,
1. The permit is not current. I have attached the invoices that would need to be paid to bring the permit back into active status. Our system will
only let you pay one permit fee per day.
2- 1 have attached the NOV that was ssued in 2022. All items need to be addressed Immediately to confirm that the facility is meeting the permit
requirements and sample parameters.
3. The permit is for 3 bedrooms only. This can not be increased until all items are addressed and an engineer has applied for a permit
modification and upgrade of the sand filter. Application attached.
4. If a name change is needed I have attached that application as well.
Jane R. Bernard, Environmental Specialist 11
Water quality Regional Operations Section
Division of Water Resources
3800 Barrett Drive, Raleigh, NC 27609
Office: [phone] Cell- [phone]
Fax. [phone]
NEW [e-mail]
web page: http://www.ncwater,orgLfncwater.orgl
€rrral correspondence to and from this address is subject to the
North Carolina Publrc Records Law and may be disclosed to fhrrd parties.
From: Joanne Empie goanne.empie@gmai .com>
Sent: Thursday, June 15, 2023 3.51 PM
To: Bernard, lane <[e-mail]>
Subject: Re: [External) Fwd: 6917 Kemp Rd, Raleigh - sand filter system- Options
CAUTION: External email. Do not ckck ♦inks or open attaghmeets unless verified Report Su%piCcpus emaiils with the Report Message button located on your Outlook menu bar on
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Hello Jane,
Can the new owner who purchased the property in 4/23 still ask for a transfer? You must not have the transfer request on file. There are people
living in a mobile home on the property I believe who have been using the sand filter system Although nothing has changed with the mobile
home on the property, you are saying they do not have an approved sept`c system because the permit has expired.
Are you saying that sand filter systems are no longer approved?
Is it possible to get an idea w th the soils on the property what might be options for the septic system? It looks like most all the €et is one type of
soli
Sorry for all the questions
Joanne Empie, Broker/Realtor
Capital City Realty
919-819-1981
On Thu, Jun 15, 2023 at 3:29 PM Bernard, lane <jane.bernardCa deq 1r ggvv> wrote
Joanne,
The permit was not maintained and is considered expired. I would refer to my original email.

Jane R. Bernard, Environmental Specialist it
Water Quality Regional Operations Section
Division of Water Resources
3800 Barrett Drive, Raleigh, NC 27609
Office: [phone] Cell- [phone]
Fax- [phone]
NEW EMAIL- [e-mail]
web page; httr rgL[ncwalff g.Eg]
Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties.
From: Joanne Empie <joanne.empjgAgma-l.com>
Sent: Thursday, June 15, 2023 2:02 PM
To: Bernard, Jane <janalamilrd aCl-{a-ric gw>
Subject: Fwd- [External) Fwd: 6917 Kemp Rd, Raleigh - sand filter system- can another house be added?
CAUTION: External email- Do not click links or open attachments unless verified. Report suspicious emails with the Report Message button located on your Outlook menu bar
on the Home tab, _
Hello Jane, I have attached the documents that were with the original email Please let me know which questions in that email you can answer.
Thank you
Joanne Empie, Broker/Realtor
Capital City Realty
919-819-1981
Serving the Tnangle
---------- Forwarded message ---------
From: Lee, David <david-Iee(o)deq.nc,govv>
Date: Thu, Jun 15, 2023 at 1:21 PM
Subject: RE: [External] Fwd: 6917 Kemp Rd, Raleigh - sand filter system- can another house be added?
To: Reinhardt, Dylan <dylan.reinhardt@deq n-cgg_v>, Joanne Empie <joanne.empjgL@—gmail.com>
Cc: Bernard, Jane <jane.bernardCa deg nc govv>
Thank you Dylan and I hope you are continuing to get better.
Joanne,
Regarding your inquiry associated with the property located at 6917 Kemp Rd, Raleigh, NC, located in Durham County, your questions
surrounding a conventional septic system applicability for a new home on this property would need to be directed to Durham County.
As far as an existing, or what may be a newly required, sand filter system, those questions would best be directed to Jane Bernard, with our
Water Quality Regional Operations Section in the Raleigh Regional Office.
(Please note that Dylan did not forward on the original attachments that you stated were in your email to him. I am not sure if Jane needs these
or not, as the address may be sufficient for her to look up any existing information, but 1 just wanted to make you aware, etc...)
I have copied Jane in this reply, for your convenience, and she may also be reached at [phone].
Please let me know if I may assist you further.
Thank you,
David
David S. Lee
Environmental Assistance Coordinator
Raleigh Regional Office
North Carolina Department of Environmental Quality
[phone]

E-mail correspondence to and from this address may be subject to the North Carolina public Records taw and may be disclosed to third parties
From: Reinhardt, Dylan <dylan.rein hardt@deg,lr_94y>
Sent: Thursday, June 15, 2023 12:37 PM
To: Joanne Empie <joanne.empi mgmail.com>
Cc: Lee, David <david.lee@deq. .gov>
Subject: RE: [External] Fwd: 6917 Kemp Rd, Raleigh - sand filter system- can another house be added?
Hello,
Sorry for the delay in my reply, I have been in and out of the office sick the past few weeks and trying to get caught up. Unfortunately I don't
think I can do much to help you with your request, but I'm copying David lee on my reply. He is our regional Environmental Assistance and
Outreach coordinator and should be able to guide you to the appropriate persons and/or resources.
Thanks and let me know If you have any further questions,
Dylan Reinhardt (he/him/his)
Assistant Regional Engineer
North Carolina Department of Environmental Quality
Division of Energy, Mineral, and Land Resources
Raleigh Regional Office
3800 Barrett Drive
Raleigh, NC 27609
Office: [phone] 1 Cell: [phone] 1 Slylan.reinhardt@deqftQgQu
DEQ is updating its email addresses to @¢gqxLgQv in phases from May 7st to June 9th.
Employee email addresses may took different, but email performance will not be impacted.
Q� .
py�,laenl �f f w.ww.meeLl (fu W�
Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties
From: Joanne Empie <Joanne.empL�P_gmad.com>
Sent: Tuesday,lune 13: 2023 9.42 AM
To. Reinhardt, Dylan <dylan.reinhard [e-mail]>
Subject. [Externall Fwd: 6917 Kemp Rd, Raleigh - sand falter system- can another house be added?
CAUTION: External email Do not click links or open attachments unless verified Report suspicious emails with the Report Message button located on your
Outlook menu bar on the Home tab.
Hi Dylan, I called today about this and expanded the map with soils below I don't know If this helps answer the question but soils on the lot
are WsC primarily, with small sections of WxE and ApC
------- -- Forwarded message ---------
From Joanne Empie <Joanne.emp a a7gma .co >
Date: Fri, Jun 9, 2023 at 10:43AM
Subject: 6917 Kemp Rd, Raleigh - sand filter system- can another house be added?
To: eylan.relnhardt@degs gov>

Hello Dylan
i am Inquiring about this 2 acre lot In Durham County that has a '929 home which is not habitable and a mobile home currently. The new
owner would like to put a new home on the lot and likely demolish the 1929 home. There is a sand filter Certificate for the mobile home.
There was a Sept c application to apply for a conventional septic system back in 2011 and it was denied and only a sand filter system was
approved.
I do not know if the soil in another part of the lot would support a conventional system. Should the ownerjust ask for a perk test or can you tell
if another sand f Iter system would be all that would be supported? Do you approve sand filter systems anymore?
I have attached these documents
sand filter septic system Certificate and full file on the sept c. documents
land survey
maps
Can you tell me if the new owners have Pah Kue and Ba Reh have asked for the sand filter certificate to be transferred to them?
So is and Topo
Power
It hank you for your assistance.
Joanne Empie, Broker/Realtor
Capital City Realty
919-819 1981
Serving the Triangle
Mobile home on the right and 1929 home on the left.
easement behind homes
Email correspondence to and from this address may be subject to the North Carolina PuNK Records I aw and may be disclosed to third parties by an authorized slate official

ROY COOPER
#� i
ELIZABETHi S. BISER
RICHtARD E. ROGERS. A.
NORTH CAR{ LIMA
Dm-(+or
Environmental Quality
April 26, 2022
CERTIFIED MAIL # 7020 3160 0000 4115 4729
RETURN RECEIPT REQUESTED
Charles Cash
6917 Kemp Rd.
Raleigh, NC 27613
Subject. NOTICE OF VIOLATION
Tracking Number: NOV-2022-PC-0235
Compliance Evaluation Inspection
Single Family Wastewater Treatment System
NPDES General Permit NCG550000
Certificate of Coverage NCG551535
Facility Name: 6917 Kemp Rd
Durham County
Charles Cash,
On April 1, 2022, Chris Smith from the Raleigh Regional Office visited your single-family
residence (SFR) wastewater treatment system to evaluate compliance with the subject General
NPDES Pen -nit. Your assistance during the inspection was greatly appreciated. Our records
indicate the treatment system consists of a septic tank, sub -surface sand filter, tablet chlorinator
with chlorine contact chamber, tablet dechlorinator, discharge pipe and associated
appurtenances.
General NPDES Permit NCG550000 and Certificate of Coverage (COC) NCG551535 authorize
the discharge of domestic wastewater from your treatment system to receiving waters designated
as an unnamed tributary to Rocky Branch (segment 27-11-2-(1)] (classified WS-IV, NSW)
within subbasin 03-04-01 of the Neuse River Basin. Tile authorized discharge is in accordance
with the effluent limits and monitoring requirements established within the General Permit. The
items below show what conditions were noted at your facility:
Findings during the inspection were as follows:
1. Treatment system operation: The wastewater treatment system shall be maintained at
all times to prevent seepage of sewage to the surface of the ground. During the inspection
what appeared to be untreated wastewater was discharging to the surface of the ground.
2. Pumping the septic tank: You are required to inspect the septic tank at least yearly to
determine if solids must be removed or if other maintenance is necessary. Septic tanks

Charles Cash
NCG551535
April 26, 2022
Page 2 of 4
should be pumped out every five years or when the solids level is found to be more than
113 of the liquid depth in the septic tank compartment, whichever is greater. A pumping
company can check the status periodically and determine when pumping is required.
Within 30-days of receiving this letter, please send a copy of the most recent
receiptlirtvoice to this office showing the date the septic tank was last checked and/or
pumped out The General NPDES Permit requires the permittee to retain records
associated with sewage disposal activities for a period of at least 5 years.
3. Chlorine tablets in the chlorinator: You are reminded that it is required that chlorine
tablets be maintained in the chlorinator to ensure proper disinfection of the discharged
wastewater. Chlorine tablets provide effective disinfection and prevent.`limit harmful
bacteria from discharging to the environment. The product label for these tablets must
indicate the tablets are apj2roved fim wastewater use and not for swintininm pools. Part
1, Section D (1) of General NPDES Permit NCG550000 requires the permittee to inspect
the tablet chlorinator weekly to ensure there is an adequate supply of tablets for
continuous and proper operation. Section D (4) requires the permittee to maintain all
system components, including disinfection units, at all times and in good operating order.
The inspector was not able to locate the chlorinator and therefore did not observe any
chlorine tablets in the chlorinator. Please ensure the correct type of tablets are used and
maintained in the chlorinator as required by the General NPDES Permit
4. Dechlorination tablets: You are responsible for always having dechlorination tablets (if
a required part of your system) in place. They must be the kind for wastewater treatment
and not for swimming pools. The inspector was not able to locate the dechlorinator and
therefore did not observe any dechlorination tablets in the treatment unit. Please ensure
lire correct type of tablets are used and maintained in the dechlorinator as required by
the General NPDES Permit
5. Analyzing the effluent: Part 1. C., EfJlrrent Limitations and Monrtorurj> Requirements,
within General Permit NCG550000 requires a permittee to sample and analyr.e the
effluent leaving hisiher treatment system prior to discharge annually. Parameters to be
sampled and analyzed include Flow, BOD (Biochemical Oxygen Demand), Total
Suspended Solids, Fecal Coliform and Total Residual Chlorine. In the last inspection
letter dated March 29, 2017, you were requested to sample your effluent and to submit
the analytical results to this office. The Raleigh Regional Office has not received the
requested results. Within 30-dajfs of receiving this letter, please let this office know if
you have monitored your effluent discharge within the last 12 months and provide this
office with a copy of the lab results if you have. If you have not monitored your effluent,
then please collect a representative sample of the effluent, have it analyzed by a certified
commercial laboratory and submit the results to this office no later than July 25, 2022, If,
during this time, you are unable to collect a representative sample of the effluent
discharge due to insufficient flow from the discharge pipe, then update this office with
that information and continue to monitor the discharge and if conditions for sampling
become favorable, then arrange to collect a sample. Failure to monitor the effluent
discharge as required is a violation of NPDES General Permit NCG550000.
"� North Carolina Department of Enlrnnmenral Quality I Divisinn of Water Re,,ource.s
^E QR
uleiyh Regiunal ON ice 3800 Borrctt Chive f Rafcigh, forth C.rrolina 276QQ
ems'

Charles Cash
NCG551535
April 26, 2022
Page 3 of 4
6. Locations of treatment units are unknown: Within 30-days of receiving this letter,
provide this office with a sketch or map of the location of the treatment units (septic tank,
sub -surface sand filter, tablet chlorinator with chlorine contact chamber, tablet
dechlorinator, discharge pipe and associated appurtenances) in relation to the permitted
residence.
Discharge outlet location. The permittee is required to conduct a visual review of the
outfall location at least twice each year (one at the time of sampling) to ensure that no
visible solids or other obvious evidence of system malfunctioning is observed. Any
visible signs of malfunctioning system shall be documented and steps taken to correct
the problem. The end of discharge pipe was not visible nor accessible the day of the
inspection. To comply with the general permit monitoring requirements, you need to be
able to sample and analyze the effluent from your SFR system through the discharge
pipe. You need to keep the area around the discharge pipe cleared of vegetation, soil and
leaves. Please take the necessary steps to ensure the discharge outlet is visible and
accessible. Maintaining the area will allow you to monitor the discharge and to collect
effluent samples as required by the subject permit.
8. Part 11 Section B.14 of General Pen -nit NCG550000 requires the permittee to "pay the
annual administering and compliance monitoring fee within thirty days after being billed
by the Division." The an►tual fees ($60 pe►• year) for the period March 1, 2015 through
Februa►y 28, 2023 have not been paid and are overdue. Pay►neat in the amount gf'$60
per year (totaling $480) ►nuct be remitted to the Division as indicated on the attached
Annual Permit Fee Invoices.
The wastewater treatment system should be periodically inspected to ensure the treatment
components are always maintained and in good operating order. You are also reminded to
maintain all monitoring data and associated maintenance records onsite for a ►ninimunr of
threeyears and available for inspection.
This inspection report is being issued as a Notice of Violation because permit renewal fees have
not been paid for several years and because of failure to monitor the effluent as required by the
General Permit.
Within 30-days receipt of this letter, please submit a written response to this office indicating
the actions you will take or have taken to comply with or resolve the issues noted in items 1-9
above
-� D�� � North CarollnYf)rl'rar tmcnt at Em^.rnnn�cN51 t�taalcnni�•Ica�at 4Vatcr Rc .runic;
R.riciyh Rey oral Ofiicr t8o0 Li rrrrt[ [ir:vc R�triy9[, Vor1t i «rapna 17n0`�

N
Charles Cash
NCG551535
April 26, 2022
Page 4 of 4
If you have questions or comments about this inspection or the requirements to take corrective
action (if applicable), then please contact Chris Smith at 919-791-4257.
Sincerely,
DoCu$igned by:
E
/aun t,SSa f . ka�l�+ ut,i.
82919EBA632144F
Vanessa E. Manuel, Assistant Regional Supervisor
Water Quality Regional Operations Section
Raleigh Regional Office
Division of Water Resources, NCDEQ
Attachment(s): EPA Water Compliance Inspection Report
Annual Permit Fee Invoices (8)
NCDEQ Technical Bulletin General Permit NCG550000
Effluent Sampling Guidance Document
Cc: Laserfiche
North Carollna Department of [m lronn enial Quality I Division of Watrr Resources
Raleigli Regional Off ice 3800 Elora cit Drive I Raleigh, Nor th Carolina 27609
` N ems'

United States Environmental Protection Agency
Form Approved.
EPAWashington, DC 20460,
OMB No. 2040-0057
Water Compliance Inspection Report
Approval expires 8.31 98
Section A: National Data System Coding (i.e.. PCS)
Transaction Code NPDES yrlmo?day Inspection Type Inspector Fac Type
1 IN 1 2 15 1 3 I NCG551535 111 12 22/04/01 17 181r.1 191 2I 201 I
21111111 1 1 1 1 11 1 1 1 1 1 1 1 1 ILH I I I I I I I I I I I I I I I I 1 166
Inspection Work Days Facility Self-Monloring Evaluation Rating 61 QA ---------------------- Reserved -------------------
72 LeJ 73I 74 71 -1 _I__l__ 1 I80
67 70LJ 71 tyI
Section B: Facility Data
Name and Location of Facility Inspected (For Industrial Users discharging to POTW also include
Entry Time.'Date
Permit Effective Dale
POTW name and NPDES Dermit Numbed
02:10PM 22,'04?01
12l08101
6917 Kemp Road
6917 Kemp Rd
Exit Time?Date
Permit Expiration Date
Raleigh NC 27613
02 25PM 22:04:01
13l07+31
Name(s) of Onsite Representative(s)ffitles(s)lPhone and Fax Number(s)
Other Facility Data
111
Name, Address of Responsible Official/TitlelPhone and Fax Number
Contacted
Charles E Cash,307 5th St Butner NC 27509h/
No
Section C: Areas Evaluated During Inspection (Check only those areas evaluated)
Permit 0 Operations & Maintenat E Self -Monitoring Progran 0 Facility Site Review
Effluent/Receiving Wate
Section D: Summary of Finding. -Comments (Attach additional sheets of narrative and checklists as necessary)
(See attachment summary)
Name(s) and Signature{s) of Inspector(s) AgencylOffice/Phone and Fax Numbers Date
Chas Srnsth DWR/RRO WQ1919-791-42001
Signature of Management 0 A Reviewer Agency/Office/Phone and Fax Numbers Date
EPA Form 3560-3 (Rev 9.94) Previous editions are obsolete.
Page#

�J
CD
NPDES yrlmolday Inspection Type i
31 NCG551535 1" 1 22104101 17
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
None of the treatment components could be located at the time of the inspection. An upturned bucket
appeared to be covering the septic lid if the lid location corresponds to map in permit file. There
appeared to be untreated waste flowing from the area covered by the bucket. The bucket could not
be easily moved and was left in place.
Page#

Permit: NCG551535 Owner -Facility: 6917 Kemp Road
Inspection Date: 04/01/2022 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
❑
❑
■
❑
application?
Is the facility as described in the permit?
❑
■
❑
❑
# Are there any special conditions for the permit?
❑
❑
M
❑
Is access to the plant site restricted to the general public?
❑
M
❑
❑
Is the inspector granted access to all areas for inspection?
■
❑
❑
❑
Comment: Permit exrlred_ _in 2013. No annual renewal fees have been paid since 2014.
Operations $ Maintenance Yes No NA NE
Is the plant generally clean with acceptable housekeeping? ❑ ❑ ■ ❑
Does the facility analyze process control parameters, for ex: MLSS, MCRT, Settleable ❑ ❑ ■ ❑
Solids, pH, DO, Sludge Judge, and other that are applicable?
Comment:
Effluent Pipe
Yes
No
NA NE
Is right of way to the outfall properly maintained?
0
❑
❑ ❑
Are the receiving water free of foam other than trace amounts and other debris?
❑
❑
❑ ■
If effluent (diffuser pipes are required) are they operating properly?
❑
❑
■ ❑
Comment: Pipe could not be located.
De -chlorination
Yes
No
NA NE
Type of system ?
Unknown
Is the feed ratio proportional to chlorine amount (1 to 1)?
❑
❑
❑
■
Is storage appropriate for cylinders?
❑
❑
❑
■
# Is de -chlorination substance stored away from chlorine containers?
❑
❑
❑
Are the tablets the proper size and type?
❑
❑
❑
Comment: The dechlorinator could not be located during the inspection.
Are tablet de -chlorinators operational?
❑
❑
❑
Number of tubes in use?
0
Comment:
Septic Tank Yes No NA NE
(If pumps are used) Is an audible and visual alarm operational? ❑ ❑ 0 ❑
Page# •i

Permit: NCG551535
Owner - Facility: 6917 Kemp Road
Inspection Date: 04/01/2022
Inspection Type: Compliance Evaluation
Septic Tank
Yes
No
NA NE
Is septic tank pumped on a schedule?
❑
❑
❑
Are pumps or syphons operating properly?
❑
❑
M
❑
Are high and low water alarms operating properly?
❑
❑
M
❑
Comment: Septic tank appeared to be discharging untreated waste to the surface.
Sand Filters (Low rate)
Yes
No
NA NE
(If pumps are used) Is an audible and visible alarm Present and operational?
❑
❑
■
❑
Is the distribution box level and watertight?
❑
❑
■
❑
Is sand filter free of ponding?
❑
❑
❑
0
Is the sand filter effluent re -circulated at a valid ratio?
❑
❑
0
❑
# Is the sand filter surface free of algae or excessive vegetation?
❑
❑
❑
# Is the sand filter effluent re -circulated at a valid ratio? (Approximately 3 to 1)
❑
❑
M
❑
Comment: Sand filter location is unknown.
Disinfection -Tablet
Yes
No
NA NE
Are tablet chlorinators operational?
❑
❑
❑
■
Are the tablets the proper size and type?
❑
❑
❑
M
Number of tubes in use?
Is the level of chlorine residual acceptable?
❑
❑
M
❑
Is the contact chamber free of growth, or sludge buildup?
❑
❑
M
❑
Is there chlorine residual prior to de -chlorination?
❑
❑
■
❑
Comment: The chlorinator could not be located during the inspection.
Effluent Sample
Yes
No
NA NE
Is composite sampling flow proportional?
❑
❑
■
❑
Is sample collected below all treatment units?
❑
❑
❑
Is proper volume collected?
❑
❑
❑
Is the tubing clean?
❑
❑
❑
# Is proper temperature set for sample storage (kept at less than or equal to 6.0
❑
❑
❑
■
degrees Celsius)?
Is the facility sampling performed as required by the permit (frequency, sampling type
❑
❑
❑
representative)?
Comment:
Page# 4

Inspection Date: (/�i ` 2a Z Start Time: l ' 4� tourv-'- End Time: s -0
SINGLE FAMILY WASTEWATER SYSTEM CHECKLIST
d0""5
P
G r 5
Permittee:
Permit:
Address: E-mail-
Phone:(Cell Phone:( -
County:
7X► r � ti
The Parmittse is responsible for the opamdon and maintenance of the entlre wastewater treatment and d
I s
Doesn't
Did Not
Yes No
�Xply
Investigate
1. Is the current resident In the home the Permittee?
ILI ifl_
Li
Li
2. If not does the resident rent from the permittee?
❑ -'0!
0
3. Change of Ownership form needed? (mail the form with the inspection letter)
❑ ❑
4. Is there a inspection and maintenance agreement,with a contractor?
❑
0
5. If yes to #4 who is the contractor?
SEPTIC TANK The septic tank and filters should be checked annually and pumped/cleaned as needed.
6. Is all wastewater from the home connected to the septic tank?
Fzr EJ
ID
El
7. Does the permitteetresident know where the septic tank is located?
P
8. Has the septic tank been pumped in the last 5 years?
0 J2
❑
9. 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 who?
SAND FILTER 1 TREATMENT PODS YES NO
If no proceed to the next section.
Awe=IA sand filter surfaces shall be raked and leveled every sbf rnokh5 and any vegetative growth shall be removed manual
12. Is system something other than a sand filter?
O
13. If yes. what kind? (examples - Peat, Textile or brand name - Advantex, etc.)
14. Does the permitter know where the filter is?
J2-- ❑
0
0
15. If above ground does the filter require maintenance?
❑
10'
n maintenew is required expain In the comment sedlon.
DISINFECTION I UV YES Lj NO
If no proceed to the next section.
Irm ultraviolet unit shall be checked weekly. The lamps and sleeves should be deaned or replacW as needed to ensure doper di
16. Is UV working?
0 ❑
❑
17. Has the UV Unit been serviced and bulbs cleaned?
ID C1
0
❑
18. Who completes the weekly check for the UV? Non -Discharge)
DISINFECTION I TABLETS YES NO
If no proceed to the next section.
tablet chlorlmtor unit shall be checked wreelkly to ensure kx illnuous 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?
❑
❑
El
21. Were chlorine tablets observed in the chlorinator? .L I ee �'��
L,>
to ` � ��El
E3
22. Are tablets contactingwater? If ssible poke th de . ,tjO
DECHLOR (Discharge only) YES YJ o0CS . NO
If no proceed to the next section.
Ro dechdorinator unit shall be checked weekly to ensure eonlln proper on.
23. Does the permittee know where the dechlor is?
O'� ❑
❑
❑
24. Does the permittee have the correct dechlor tablets?
a
25. Were dechlor tablets observed in the dechlorination chamber?
12- ❑
❑
26. Are tablets contacts water? If possible Wke them to determine.
hn' El
El

C
Doesn't Did Not
Yes No Apply Investioate
PUMP TANK YES LJ NO
If no proceed to the next section.
I pump and alarm sytems shall be inspected monthly. (non -discharge)
El
27. Is the pump working?
28. Is the audible and visual high water alarm operational?
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29. Did the permittee know how to check the pump S high water alarm?
30. Last functional test?
DISCHARGE ONLY YES NO LJ
K no proceed to the next section.
visual review of the outfatl location shall be executed twice each year {one at the time of sampling to ensure no visible solids or evienoe of a malfunction.
2r
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31. Does the permitter know where the oulfall Is?
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2r
0
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32. Were you able to beats the outfall?
t
discharge If tj' r +t a'
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0
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33. Is the end of the pipe visible? not, explain why.
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E�—
34. Is outlet discharging?
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35. Is right of way maintained around the discharge point?
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36, Any Lab Results available?
37. Is there evidence of solids around the discharge int?
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'Er
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DRIP or SPRAY YES Lj NO
If no proceed to the next section.
The irrigation sysebn shad 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.
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39. Are the buffers adequate?
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40. Is the site free of ponding and runoff?
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Cl
41 Does the application equipment appear to be working properly?
42- Is there a two wire fence?
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GENERAL
3. Are the treatment units locked and or secured?
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44, Has resident had any sewage problems? If yes explain In the comment section.
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45. Does the system match the permit description? a no explain in the comment section.
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46. Is the system compliant?
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47 Is the system failing? if yes, take pictures if possible.
48. 9 system is failing, any sign of children or animals contacting sewage?
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ED
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NOD Sent #: NOV Sent #:
Comments: Photos Taken?
YES
NO
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INSPECTOR: SIGNATURE:rw
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