NCG550045_Compliance Evaluation Inspection_20091109

Ara
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
9 November 2009
David E. Sexton
129 Forestdale Drive
Reidsville, NC 27320
SUBJECT: Compliance Evaluation Inspection
Single Family Residence Wastewater Treatment System Located at
129 Forestdale Drive, Reidsville, Rockingham County, NC, 27320
NPDES General Wastewater Permit NCG550000
Certificate of Coverage # NCG550045
Dear Mr. Sexton:
1. Ron Boone, of the NC Division of Water Quality's Winston-Salem Regional Office, conducted a
compliance evaluation inspection (CEI) of the Single Family Residence (SFR) Wastewater
Treatment System (WWTS) located at 129 Forestdale Drive, in Reidsville, Rockingham
County, NC, on 20 October 2009. According to our records, as well as those available county
records, you are the current owner of this SFR and are therefore'responsible for the WWTS, its
discharge, and its permit. An inspection report summarizing Mr. Boone's inspection is
attached for your records.
2. You were not present during the inspection. Mr. Boone did not detect any malfunctions with
the system and it was not discharging at the time of the inspection. You are reminded to have
the septic tank pumped out at least every three to five years, as required by the permit, as well
as to check the chlorinator on a monthly basis to ensure it still has enough chlorine. Also,
please ensure you're using chlorine tablets rated for wastewater; this should be indicated on
the container.
3. Your permit is currently up to date and all annual fees have been paid. Please continue to pay
the fees annually as well as to submit the permit renewal form every five years, at least 180
'days prior to the current permit expiring. The current permit expires 31 July 2012, so you
should submit a renewal form no later than 1 February 2012.
4. You are reminded that the Division may assess civil penalties (fines) against you, for up to
$25,000 per day, for each permit violation, pursuant to NC General Statute 143-215.6A. If you
have any questions or concerns about maintaining compliance with the general permit, please
don't hesitate to contact us. A copy of the general permit and technical bulletin is attached for
your information.
North Carolina Division of Water Quality,Winston-Salem Regional Office
Location:585 Waughtown St.Winston-Salem,North Carolina 27107 One
Phone:[phone] FAX:[phone] Customer Service:1-877-623-6748 NorthCarolina
Internet:www.ncwaterquality.org Naturally
An Equal Opportunity I Affirmative Action Employer 63`

Mr. David E.Sexton,Owner •
SFR 129 Forestdale Drive, Reidsville, NC,27320
NPDES Wastewater General Permit NCG550000
Certifcate of Coverage#: NCG550045
Page 2 of 2
5. Thank you for your cooperation in this matter. Should you have any questions please feel free
to contact Mr. Boone or me at [phone].
Sincerely,
41/0162;
Steve W. Tedder
Water Quality Regional Supervisor
Winston-Salem Region
Division of Water Quality
Attachments:
1. BIMS Inspection Checklist
2. NCG550000 General NPDES Wastewater Discharge Permit
3. NCG550000 Technical Bulletin
cc: SWP —WSRO
Central Files
aMESWeI ni't;TA-t CIi_arles Weaver

United States Environmental Protection Agency
E P A/1 Washington,D C 20460 Form Approved.
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 yr/mo/day Inspection Type Inspector Fac Type
1 I NI 2 151 31 NCG550045 111 121 09/10/20 117 181 CI 19I GI 201
Remarks J
211 III IIIIIIIIIIIIIIIIIIIIIIII lilt IIIIIIIIIIIIIII66
Inspection Work Days Facility Self-Monitoring Evaluation Rating B1 QA Reserved
671 169 70IJ 711 I 721 NI 731 I 174 75I 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 Entry Time/Date Permit Effective Date
POTW name and NPDES permit Number)
11:09 AM 09/10/20 07/08/01
129 Forestdale Drive
129 Forestdale Dr Exit Time/Date Permit Expiration Date
Reidsville NC 27320 11:30 AM 09/10/20 12/07/31
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
David E Sexton,129 Forestdale Dr Reidsville NC 27320//336-623-9906/ 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)and Signature(s)of Inspector(s) Agency/Office/Phone and Fax Numbers Date
Ron Boone WSRO WQ//704-663-1699 Ext.2202/
///,/,,ozy?
Signature of Mana ment Q/A Reviewer Agency/Office/Phone and Fax Numbers Date
4. l t Q/,y
EPA Form 3560-3(Rev 9-94)Previous editions are obsolete.
Page# 1

,1\
NPDES yr/mo/day Inspection Type 1
3, NCG550045 I11 12I 09/10/20 I17 181
CI
Section D: Summary of Finding/Comments(Attach additional sheets of narrative and checklists as necessary)
System is in good condition and appears to be operating properly. No discharge at time of inspection.
Permit is up to date, in correct owner's name, and all fees have been paid. Please refer to attached
inspection summary letter for additional information.
•
Page# 2

Permit: NCG550045 Owner-Facility: 129 Forestdale Drive
Inspection Date: 10/20/2009 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? n n a n
Is the facility as described in the permit? a n n n
#Are there any special conditions for the permit? n ■ n n
Is access to the plant site restricted to the general public? n ❑ • 0
Is the inspector granted access to all areas for inspection? ■ n n n
Comment: System is in good condition and appears to be operating properly. No
discharge at time of inspection. Permit is up to date, in correct owner's name, and all
fees have been paid. Please refer to attached inspection summary letter for additional
information.
Page# 3