NC0065587_Compliance Evaluation Inspection_20151116

North Carolina Department of Environmental Quality
Pat McCrory Donald R. van der Vaart
Governor Secretary
November 16, 2015
Aqua North Carolina Inc.
Attn: Thomas J. Roberts, President and CEO
202 Mackenan Drive
Cary, NC 27511
Subject: Compliance Evaluation Inspection
Permittee: Aqua NC Inc.
Facilities: Wellesley Place Wastewater Treatment Plant, NCO084409
Forest Ridge Wastewater Treatment Plant, NCO063720
Frye Bridge Wastewater Treatment Plant, NCO065587
Forsyth County
Dear Mr. Roberts:
Ron Boone of the Winston-Salem Regional Office of the NC Division of Water Resources (DWR or the
Division) conducted compliance evaluation inspections (CEI) of the subject facilities on November 12, 2015.
The assistance and cooperation of Samuel Pegram, Operator in Responsible Charge, was greatly
appreciated. Inspection checklists are attached for your records and inspection findings are summarized
below.
Wellesley Place Wastewater Treatment Plant, NCO084409
General Information
The Wellesley Place Wastewater Treatment Plant is located in the Wellesley Place subdivision in
Lewisville, Forsyth County, NC at approximate coordinates 36.1181370N, 80.4175420W. The permit
authorizes Aqua to operate this 0.06 MGD WWTP, which consists of a bar screen, equalization basin, dual
pumps and blowers, flow splitter box, dual aeration basins with fine bubble diffusers and blowers, dual basin
clarifier, UV disinfection, backup dual tablet chlorinators and dechlorinators and a chlorine contact chamber,
aerobic sludge digester, and an effluent flow meter with a weir. The permit authorizes Aqua to discharge the
treated effluent from the WWTP via outfall 001 to Mill Creek, which is currently classified as WS -IV waters and
is located in the Yadkin Pee -Dee river basin.
Site Review
Plant operation and maintenance was reviewed with Mr. Pegram. He is doing an excellent job as the
plant was found to be well operated and maintained. No issues were noted.
Documentation Review
All documentation was reviewed and no discrepancies were found. Mr. Pegram has done an excellent
job documenting the operation and maintenance of the plant as required by the permit. This includes
operations and visitation logs, discharge monitoring reports, laboratory and field laboratory records, chains of
custody, etc.
450 West Hanes Mill Road, Suite #300, Winston-Salem, North Carolina 27105
Phone: [phone] Internet: www.ncdenr.gov
An Equal Opportunity 1 Affirmative Action Employer — Made in part by recycled paper

Forest Ridge Wastewater Treatment Plant, NC0063720
General Information
The Forest Ridge Wastewater Treatment Plant is located near 6931 August Drive in Clemmons,
Forsyth County, North Carolina, at approximate coordinates 36.060669° West, 80.397985° North. Aqua NC is
authorized to operate this 0.033 million -gallon -per -day (MGD) wastewater treatment plant, which consists of
aeration, secondary clarification, tablet chlorination, tablet dechlorination, post aeration, and sludge holding,
and discharge treated effluent from outfall 001 of said treatment works, which is located approximately 270
feet east of the treatment works at approximate coordinates 36.060804° West, 80.397024° North, to Blanket
Creek, which is currently classified as Class WS -IV (water supply) waters and is located in the Yadkin Pee -
Dee River Basin.
Site Review
Mr. Boone reviewed the entire plant with Mr. Pegram. No discrepancies or violations were noted.
The plant appears to be operated and maintained very well.
DOCUMENTATION REVIEW
Mr. Pegram had all required documentation for the inspection and everything was complete and
current. Mr. Boone found no discrepancies or violations. Mr. Pegram has done an excellent job of documenting
his operation and maintenance of the plant.
Frye Bridge Wastewater Treatment Plant, NC0065587
General Information
The Frye Bridge Wastewater Treatment Plant is located in Clemmons, Forsyth County, NC at
approximate coordinates 35.9889130N, 80.3534080W. The permit authorizes Aqua to operate this 0.027 MGD
WWTP, which consists of a bar screen, aeration basin, clarifier, aerated sludge holding tank, tablet chlorinator,
chlorine contact chamber, tablet dechlorinator, and post aeration. The permit authorizes Aqua to discharge the
treated effluent from the WWTP via outfall 001 to an unnamed tributary to Muddy Creek. Muddy Creek is
currently classified as Class C waters and is located in the Yadkin Pee -Dee river basin.
Site Review
Mr. Pegram has done an excellent job operating and maintaining the plant. The plant was clean and
well maintained. There is still significant corrosion in the plant that should be addressed as soon as possible.
This issue has been mentioned in the two inspection letters previous to this one (about two years). The plant is
operated quite well and sludge/solids are being effectively managed. Odors at the plant were minimal.
Documentation Review
All documentation was reviewed and no discrepancies were found. Mr. Pegram has done an excellent
job documenting the operation and maintenance of the plant as required by the permit. This includes
operations and visitation logs, discharge monitoring reports, laboratory and field laboratory records, chains of
custody, etc.

The Division greatly appreciates the efforts of Aqua and Mr. Pegram in running these plants effectively
and efficiently. Please consider an in-depth evaluation of the Frye Bridge WWTP to determine what can be
done to address the corrosion problem at that plant. Please remember that violations of these NPDES permits,
as well as the NC rules and regulations that implement them, are subject to civil penalties not to exceed
$25,000 per violation, per day.
If you have any questions regarding these inspections or this letter, please call Mr. Boone or me at
[phone]. Thank you for your cooperation in this matter.
Sincerely,
Sherri V. Knight
Asst. Regional Supervisor
Water Quality Regional Operations
Division of Water Resources
Attachments:
BIMS Inspection Report
CC: WSRO - SWP
Central Files
NPDES Unit
Aqua North Carolina Inc.
Attn: Dave McDaniel, Supervisor
152B Furlong Industrial Drive
Kernersville, NC 27284
Aqua North Carolina Inc.
Attn: Sam Pegram, Operator
152B Furlong Industrial Drive
Kernersville, NC 27284

United States Environmental Protection Agency
Form Approved
EPA Washington, D C 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 yr/mo/day Inspection Type Inspector Fac Type
1 IN 1 2 15 I 3 I NC0065587 I11 12 15/11/12 17 18 L,j 19 t ! j 201
211IIIII IIIII1I11II IIIIIII I I IIIII I111IIIIIII �6
Inspection Work Days Facility Self -Monitoring Evaluation Rating B1 QA -----------------Reserved-----------
67 70 I____I 71 I 72 LJI I I ti 73I I 174 751 I I I I I I I80
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)
01 OOPM 15/11/12
14/06/01
Frye Bridge WWTP
NCSR 2998
Exit Time/Date
Permit Expiration Date
Clemmons NC 27012
02 OOPM 15/11/12
19/05/31
Name(s) of Onsite Representative(s)/Titles(s)/Phone and Fax Number(s)
Other Facility Data
Samuel E Peg ram/O RC/704-489-9404/
Name, Address of Responsible Official Title/Phone and Fax Number
Contacted
Tim Waddell,202 Mackenan Cir Cary NC 27511//919-467-8712/
No
Section C: Areas Evaluated During Inspection (Check only those areas evaluated)
Permit ® Flow Measurement ® Operations & Maintenance Records/Reports
Self -Monitoring Program ® Facility Site Review ® Effluent/Receiving Waters ® Laboratory
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//336-776-9690/
Signature of Management Q A Reviewer Agency/Office/Phone and Fax Numbers Date
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete
Page#

NPDES yr/mo/day Inspection Type
31 NCO065587 I11 12 15/11/12 17 18 ICI
Section D Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
Please refer to the attached inspection summary letter
Page#

Permit: NCO065587 Owner -Facility: Frye Bridge WVVrP
Inspection Date: 11/12/2015 Inspection Type: Compliance Evaluation
Yes No NA NE
Are records kept and maintained as required by the permit?
®
❑
Permit
Yes No NA NE
(If the present permit expires in 6 months or less) Has the permittee submitted a new
❑
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®
❑
application?
■
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❑
Is the facility as described in the permit?
®
❑
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# Are there any special conditions for the permit?
❑
0
❑
❑
Is access to the plant site restricted to the general public?
®
❑
❑
❑
Is the inspector granted access to all areas for inspection?
0
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Comment: None
Record Keeping
Yes No NA NE
Are records kept and maintained as required by the permit?
®
❑
❑
❑
Is all required information readily available, complete and current?
M
❑
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❑
Are all records maintained for 3 years (lab reg required 5 years)?
■
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❑
Are analytical results consistent with data reported on DMRs?
®
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Is the chain -of -custody complete?
e
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❑
❑
Dates, times and location of sampling
Name of Individual performing the sampling
Results of analysis and calibration
Dates of analysis
Name of person performing analyses
Transported COCs
■
Are DMRs complete. do they Include all permit parameters?
M
❑
❑
❑
Has the facility submitted its annual compliance report to users and DWQ?
❑
❑
e
❑
(If the facility is = or > 5 MGD permitted flow) Do they operate 24/7 with a certified operator
❑
0
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on each shift?
Is the ORC visitation log available and current?
0
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Is the ORC certified at grade equal to or higher than the facility classification?
0
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❑
Is the backup operator certified at one grade less or greater than the facility classification?
0
❑
❑
❑
Is a copy of the current NPDES permit available on site?
M
❑
❑
❑
Facility has copy of previous year's Annual Report on file for review?
❑
❑
M
❑
Comment: None
Laboratory Yes No NA NE
Are field parameters performed by certified personnel or laboratory? ! ❑ ❑ ❑
Are all other parameters(excluding field parameters) performed by a certified lab? 0 ❑ ❑ ❑
Page# 3

III
Permit: NCO065587 Owner -Facility: Frye Bridge WWTP
Inspection Date: 11/12/2015 Inspection Type: Compliance Evaluation
Laboratory Yes No NA NE
# Is the facility using a contract lab?
# Is proper temperature set for sample storage (kept at less than or equal to 6 0 degrees
Celsius)?
Incubator (Fecal Coliform) set to 44 5 degrees Celsius+/- 0 2 degrees?
Incubator (BOD) set to 20 0 degrees Celsius +/- 1 0 degrees?
Comment: None
Bar Screens
Type of bar screen
a Manual
b Mechanical
Are the bars adequately screening debris?
Is the screen free of excessive debris?
Is disposal of screening in compliance?
Is the unit in good condition?
Comment. None
Aeration Basins
Mode of operation
Type of aeration system
Is the basin free of dead spots?
Are surface aerators and mixers operational?
Are the diffusers operational?
Is the foam the proper color for the treatment process?
Does the foam cover less than 25% of the basin's surface?
Is the DO level acceptable?
Is the DO level acceptable?(1.0 to 3.0 mg/1)
Comment: None
Secondary Clarifier
Is the clarifier free of black and odorous wastewater?
Is the site free of excessive buildup of solids In center well of circular clarifier?
Are weirs level?
■ ❑ ❑ ❑
❑ ❑ ❑ N
❑ ❑ ❑ ■
❑ ❑ ❑
Yes No NA NE
® ❑ ❑ ❑
® ❑ ❑ ❑
® ❑ ❑ ❑
® ❑ ❑ ❑
Yes No NA NE
Ext Air
Diffused
® ❑ ❑ ❑
❑ ❑ ® ❑
® El ❑
® ❑ ❑ ❑
® ❑ ❑ ❑
❑ ❑ ❑ ■
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Yes No NA NE
. ❑ ❑ ❑
❑ ❑ ■ ❑
■ ❑ ❑ ❑
Page# 4

Permit: NC0065587
Inspection Date: 11/12/2015
Owner - Facility: Frye Bridge VWVTP
Inspection Type: Compliance Evaluation
Secondary Clarifier
Is the site free of weir blockage?
Is the site free of evidence of short-circuiting?
Is scum removal adequate?
Is the site free of excessive floating sludge?
Is the drive unit operational?
Is the return rate acceptable (low turbulence)?
Is the overflow clear of excessive solids/pin floc?
Is the sludge blanket level acceptable? (Approximately % of the sldewall depth)
Comment: None
Pumps -RAS -WAS
Are pumps in place?
Are pumps operational?
Are there adequate spare parts and supplies on site?
Comment: None
Disinfection -Tablet
Are tablet chlorinators operational?
Are the tablets the proper size and type?
Number of tubes In use?
Is the level of chlorine residual acceptable?
Is the contact chamber free of growth, or sludge buildup?
Is there chlorine residual prior to de -chlorination?
Comment: None
De -chlorination
Type of system ?
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: None
Are tablet de -chlorinators operational?
Yes No NA NE
❑ ❑ ❑
s❑❑❑
■ ❑ ❑ ❑
■ ❑ ❑ ❑
❑❑e❑
i ❑ ❑ ❑
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Yes No NA NE
® ❑ ❑ ❑
• ❑ ❑ ❑
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Yes No NA NE
®
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®
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3
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M
®
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M
Yes No NA NE
Tablet
■
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■
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■
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■
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M
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Page# 5

Permit: NCO065587 Owner - Facility: Frye Bridge VW TP
Inspection Date. 11/12/2015 Inspection Type: Compliance Evaluation
De -chlorination Yes No NA NE
Number of tubes In use? 3
Comment: None
Flow Measurement - Effluent
Yes No NA NE
# Is flow meter used for reporting?
M
❑
❑
❑
Is flow meter calibrated annually?
0
❑
❑
❑
Is the flow meter operational?
S
❑
❑
❑
(If units are separated) Does the chart recorder match the flow meter?
!
❑
❑
❑
Comment: None
Effluent Pipe Yes No NA NE
Is right of way to the outfall properly maintained? ® ❑ ❑ ❑
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: None
Operations & Maintenance Yes No NA NE
Is the plant generally clean with acceptable housekeeping? ® ❑ ❑ ❑
Does the facility analyze process control parameters, for ex: MIL SS, MCRT, Settleable ® ❑ ❑ ❑
Solids, pH, DO, Sludge Judge, and other that are applicable?
Comment: None
Page# 6

- United States Environmental Protection Agency
Form Approved
EPA Washington, D C 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 yr/mo/day Inspection Type Inspector Fac Type
1 IN 1 2 15 1 3 I N00063720 111 121 15/11/12 117
18 Ll 19 L G i 201
21111111111111111111111111111111111111111111
f6
Inspection Work Days Facility Self-Monitoring Evaluation Rating B1 QA
--------------------Reserved-------------
67 70 I_ 71 I I 72 I N I
t_J
73 I I II 74 751 1, I I I 1 1 180
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 30AM 15/11/12
14/02/01
Forest Ridge WWTP
Forest Ridge Subdivision
Exit Time/Date
Permit Expiration Date
Clemmons NC 27012
12 30PM 15/11/12
18/12/31
Name(s) of Onsite Representative(s)/Titles(s)/Phone and Fax Number(s)
Other Facility Data
Samuel E Peg ram/O RC/704-489-9404/
Name, Address of Responsible Official/Title/Phone and Fax Number
Contacted
Thomas J Roberts,202 Mackenan Ct Cary NC
No
27511 /P resident/919-653-6967/9194661583
Section C- Areas Evaluated During Inspection (Check only those areas evaluated)
® Permit ® Flow Measurement ® Operations & Maintenance .® Records/Reports
Self-Monitoring Program ® Sludge Handling Disposal 0 Facility Site Review ® Effluent/Receiving Waters
Laboratory
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//336-776-9690/
t lli L l s-
Signature of Management Q A Reviewer Agency/Office/Phone and Fax Numbers
Date
Ivl4 It S
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete
Page#

NPDES yr/mo/day Inspection Type
31 NCo063720 I11 12 15/11/12 17 18 l,, I
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
Please refer to the attached inspection summary letter.
Page#

Permit: NCO063720 Owner - Facility: Forest Ridge VWVT P
Inspection Date: 11/12/2015 Inspection Type: Compliance Evaluation
Yes No NA NE
Are records kept and maintained as required by the permit?,
®
❑
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?
❑
®
❑
❑
Is access to the plant site restricted to the general public?
M
❑
❑
❑
Is the Inspector granted access to all areas for inspection?
®
❑
❑
❑
Comment: None
Record Keeping
Yes No NA NE
Are records kept and maintained as required by the permit?,
®
❑
❑
❑
Is all required information readily available, complete and current?
■
❑
❑
❑
Are all records maintained for 3 years (lab reg required 5 years)?
®
❑
❑
❑
Are analytical results consistent with data reported on DMRs?
®
❑
❑
❑
Is the chain -of -custody complete?
i
❑
❑
❑
Dates, times and location of sampling
Name of individual performing the sampling
Results of analysis and calibration
Dates of analysis
Name of person performing analyses
Transported COCs
Are DMRs complete do they include all permit parameters?
S
❑
❑
❑
Has the facility submitted Its annual compliance report to users and DWQ?
❑
❑
M
❑
(If the facility Is = or > 5 MGD permitted flow) Do they operate 24/7 with a certified operator
❑
M
❑
❑
on each shift?
Is the ORC visitation log available and current?
M
❑
❑
❑
Is the ORC certified at grade equal to or higher than the facility classification?
0
❑
❑
❑
Is the backup operator certified at one grade less or greater than the facility classification?
0
❑
❑
❑
Is a copy of the current NPDES permit available on site?
M
❑
❑
❑
Facility has copy of previous year's Annual Report on file for review?
❑
❑
0
❑
Comment: None
Laboratory Yes No NA NE
Are field parameters performed by certified personnel or laboratory? M ❑ ❑ ❑
Are all other parameters(excluding field parameters) performed by a certified lab? M ❑ ❑ ❑
Page# 3

Permit: NCO063720 Owner - Facility: Forest Ridge WWTP
Yes No NA NE
Is composite sampling flow proportional?
M
❑
Inspection Date: 11/12/2015 Inspection Type: Compliance Evaluation
❑
Is sample collected below all treatment units?
®
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Laboratory
Yes No NA NE
# Is the facility using a contract lab?
0
❑
❑
❑
# Is proper temperature set for sample storage (kept at less than or equal to 6.0 degrees
❑
❑
❑
❑
Celsius)?
®
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❑
❑
Incubator (Fecal Coliform) set to 44 5 degrees Celsius+/- 0 2 degrees?
❑
❑
❑
0
Incubator (BOD) set to 20.0 degrees Celsius +/- 1.0 degrees?
❑
❑
❑
0
Comment: None
Effluent Sampling
Yes No NA NE
Is composite sampling flow proportional?
M
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❑
Is sample collected below all treatment units?
®
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Is proper volume collected?
®
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Is the tubing clean?
®
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# Is proper temperature set for sample storage (kept at less than or equal to 6 0 degrees
®
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❑
Celsius)?
❑
■
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Is the facility sampling performed as required by the permit (frequency, sampling type
®
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representative)?
Comment: None
Upstream / Downstream Sampling Yes No NA NE
Is the facility sampling performed as required by the permit (frequency, sampling type, and ® ❑ ❑ ❑
sampling location)?
Comment: None
Pump Station - Influent
Yes No NA NE
Is the pump wet well free of bypass lines or structures?
0
❑
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❑
Is the wet well free of excessive grease?
®
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Are all pumps present?
0
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Are all pumps operable?
0
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Are float controls operable?
®
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Is SCADA telemetry available and operational?
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Is audible and visual alarm available and operational?
M
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Comment: None
Bar Screens Yes No NA NE
Page# 4

Permit: NCO063720
Owner - Facility: Forest Ridge WWTP
Is the basin aerated?
®
❑
Inspection Date: 11/12/2015
Inspection Type: Compliance Evaluation
Is the basin free of bypass lines or structures to the natural environment?
®
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Bar Screens
Yes No NA NE
Type of bar screen
®
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a Manual
0
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b.Mechanical
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Are the bars adequately screening debris?
i
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Is the screen free of excessive debris?
®
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Is disposal of screening in compliance?
®
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❑
Is the unit in good condition?
®
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Comment: None
Equalization Basins
Yes No NA NE
Is the basin aerated?
®
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❑
❑
Is the basin free of bypass lines or structures to the natural environment?
®
❑
❑
❑
Is the basin free of excessive grease?
®
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❑
❑
Are all pumps present?
®
❑
❑
❑
Are all pumps operable?
®
❑
❑
❑
Are float controls operable?
N
❑
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❑
Are audible and visual alarms operable?
®
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❑
❑
# Is basin size/volume adequate?
®
❑
❑
❑
Comment: None
Aeration Basins
Yes No NA NE
Mode of operation
Ext. Air
Type of aeration system
Diffused
Is the basin free of dead spots?
E ❑
❑
❑
Are surface aerators and mixers operational?
❑ ❑
N
❑
Are the diffusers operational?
M ❑
❑
❑
Is the foam the proper color for the treatment process?
0 ❑
❑
❑
Does the foam cover less than 25% of the basin's surface?
® ❑
❑
❑
Is the DO level acceptable?
❑ ❑
❑
E
Is the DO level acceptable?(1.0 to 3.0 mg/1)
❑ ❑
❑
0
Comment: None
Secondary Clarifier Yes No NA NE
Page# 5

Permit: NC0063720 Owner - Facility:
Forest Ridge WWiP
Are pumps in place?
®
❑
Inspection Date: 11/12/2015 Inspection Type:
Compliance Evaluation
Are pumps operational?
®
❑
Secondary Clarifier
Yes No NA NE
Is the clarifier free of black and odorous wastewater?
e
❑
❑
❑
Is the site free of excessive buildup of solids in center well of circular clarifier?
❑
❑
S
❑
Are weirs level?
■
❑
❑
❑
Is the site free of weir blockage?
■
❑
❑
❑
Is the site free of evidence of short-circuiting?
®
❑
❑
❑
Is scum removal adequate?
®
❑
❑
❑
Is the site free of excessive floating sludge?
®
❑
❑
❑
Is the drive unit operational?
❑
❑
®
❑
Is the return rate acceptable (low turbulence)?
®
❑
❑
❑
Is the overflow clear of excessive solids/pin floc?
®
❑
❑
❑
Is the sludge blanket level acceptable? (Approximately' % of the sidewall depth)
❑
❑
❑
Comment: None
Pumps -RAS -WAS
Yes No NA NE
Are pumps in place?
®
❑
❑
❑
Are pumps operational?
®
❑
❑
❑
Are there adequate spare parts and supplies on site?
®
❑
❑
❑
Comment: None
Disinfection -Tablet
Yes No NA NE
Are tablet chlorinators operational?
®
❑
❑
❑
Are the tablets the proper size and type?
®
❑
❑
❑
Number of tubes in use?
4
# Is de-chlonnation substance stored away from chlorine containers?
❑
❑
Is the level of chlonne residual acceptable?
❑
❑
❑
M
Is the contact chamber free of growth, or sludge buildup?
0
❑
❑
❑
Is there chlorine residual prior to de -chlorination?
❑
❑
❑
0
Comment. None
De -chlorination
Yes No NA NE
Type of system ?
Tablet
Is the feed ratio proportional to chlorine amount (1 to 1)?
■ ❑
❑
❑
Is storage appropriate for cylinders?
❑
❑
❑
# Is de-chlonnation substance stored away from chlorine containers?
❑
❑
❑
Page# 6

Permit: NCO063720 Owner - Facility: Forest Ridge VWVTP
Inspection Date: 11/12/2015 Inspection Type: Compliance Evaluation
De -chlorination Yes No NA NE
Are the tablets the proper size and type? ■ ❑ ❑ ❑
Comment: None
Are tablet de -chlorinators operational? ■ ❑ ❑ ❑
Number of tubes in use? 4
Comment: None
Flow Measurement - Effluent
Yes No NA NE
# Is flow meter used for reporting?
®
❑
❑
❑
Is flow meter calibrated annually?
®
❑
❑
❑
Is the flow meter operational?
■
❑
❑
❑
(If units are separated) Does the chart recorder match the flow meter?
®
❑
❑
❑
Comment: None
Effluent Pipe
Yes No NA NE
Is right of way to the outfall properly maintained?
M
❑
❑
❑
Are the receiving water free of foam other than trace amounts and other debris?
O
❑
❑
❑
If effluent (diffuser pipes are required) are they operating properly?
❑
❑
®
❑
Comment: None
■
❑
❑
❑
Aerobic Digester
Yes No NA NE
Is the capacity adequate?
®
❑
❑
❑
Is the mixing adequate?
❑
❑
❑
Is the site free of excessive foaming in the tank?
■
❑
❑
❑
# Is the odor acceptable?
■
❑
❑
❑
# Is tankage available for properly waste sludge?
❑
❑
❑
Comment: None
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 0 ❑ ❑ ❑
Solids, pH, DO, Sludge Judge, and other that are applicable?
Comment: None
Page# 7

United States Environmental Protection Agency
Form Approved
EPA Washington, D C 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 yr/mo/day Inspection Type Inspector Fac Type
1 IN 1 2 15 1 3 I NCO084409 I11 12 15/11/12 17
18 i c i 19 [ � j 201
211 I I I I I I I I I 11 1 1 I I I I I I I I I I I I I I I
I I I 1 1 1 11 1 1 1 1 1 �6
Inspection Work Days Facility Self -Monitoring Evaluation Rating 131 QA
-------------------Reserved-------------
I 71 I I 72 I N I
67 70 LI J il L_J
73 � 74 751 I I I I I I I80
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)
10 OOAM 15/11/12
14/02/01
Wellesley Place WWTP
Franklin Rd ncsr 1310
Exit Time/Date
Permit Expiration Date
Lewisville NC 27023
1100AM 15/11/12
18/12/31
Names) of Onsite Representative(s)/Titles(s)/Phone and Fax Number(s)
Other Facility Data
Samuel E Pegram/ORCf704-489-9404/
Name, Address of Responsible Official/Title/Phone and Fax Number
Contacted
David Abernathy, //919-467-7854/
No
Section C- Areas Evaluated During Inspection (Check only those areas evaluated)
Permit Flow Measurement ® Operations & Maintenance Records/Reports
Self -Monitoring Program Sludge Handling Disposal ® Facility Site Review e Effluent/Receiving Waters
Laboratory
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//336-776-9690/
Signature of Management Q A Reviewer Agency/Office/Phone and Fax Numbers
Date
�L- -),- . J
/ 15
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete
Page#

NPDES yr/mo/day, Inspection Type
31 NCO084409 I11 12 15/11/12 17 18 ICI
Section D Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
Please refer to the attached Inspection summary letter.
Page#

Permit: NCO084409 Owner - Facility: Wellesley Place WWTP
Inspection Date: 11/12/2015 Inspection Type: Compliance Evaluation
Yes No NA NE
Are records kept and maintained as required by the permit?
®
❑
Permit
Yes No NA NE
(If the present permit expires In 6 months or less) Has the permittee submitted anew
❑
❑
M
❑
application?
®
❑
❑
❑
Is the facility as described In the permit?
®
❑
❑
❑
# Are there any'special conditions for the permit?
❑
■
❑
❑
Is access to the plant site restricted to the general publics
0
❑
❑
❑
Is the Inspector granted access to all areas for inspection?
®
❑
❑
❑
Comment: None
Record Keeping
Yes No NA NE
Are records kept and maintained as required by the permit?
®
❑
❑
❑
Is all required Information readily available, complete and current?
®
❑
❑
❑
Are all records maintained for 3 years (lab. reg required 5 years)?
®
❑
❑
❑
Are analytical results consistent with data reported on DMRs?
®
❑
❑
❑
Is the chain -of -custody complete?
®
❑
❑
❑
Dates, times and location of sampling
Name of Individual performing the sampling
Results of analysis and calibration
Dates of analysis
Name of person performing analyses
Transported CDCs
Are DMRs complete do they Include all permit parameters?
®
❑
❑
❑
Has the facility submitted its annual compliance report to users and DWQ9
❑
❑
0
❑
(If the facility Is = or > 5 MGD permitted flow) Do they operate 24/7 with a certified operator
❑
0
❑
❑
on each shift?
Is the ORC visitation log available and current?
M
❑
❑
❑
Is the ORC certified at grade equal to or higher than the facility classification?
M
❑
❑
❑
Is the backup operator certified at one grade less or greater than the facility classification?
0
❑
❑
❑
Is a copy of the current NPDES permit available on sltO
0
❑
❑
❑
Facility has copy of previous year's Annual Report on file for review?
❑
❑
M
❑
Comment: None
Laboratory Yes No NA NE
Are field parameters performed by certified personnel or laboratory? 0 ❑ ❑ ❑
Are all other parameters(excluding field parameters) performed by a certified lab? ■ ❑ ❑ ❑
Page# 3

Permit: NCO084409 Owner - Facility: Wellesley Place WWTP
Inspection Date: 11/12/2015 Inspection Type: Compliance Evaluation
Laboratory
Yes No NA NE
# Is the facility using a contract lab?
N
❑
❑
❑
# Is proper temperature set for sample storage (kept at less than or equal to 6.0 degrees
S
❑
❑
❑
Celsius)?
Incubator (Fecal Coliform) set to 44 5 degrees Celsius+/- 0 2 degrees?
❑
❑
❑
i
Incubator (BOD) set to 20 0 degrees Celsius +/- 1 0 degrees?
❑
❑
❑
Comment: None
Effluent Sampling
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: None
Equalization Basins
Is the basin aerated? _
Is the basin free of bypass lines or structures to the natural environment?
Is the basin free of excessive grease?
Are all pumps present?
Are all pumps operable?
Are float controls operable?
Are audible and visual alarms operable?
# Is basin size/volume adequate?
Comment: None
Bar Screens
Type of bar screen
a.Manual
b Mechanical
Are the bars adequately screening debris?
Yes No NA NE
■ ❑ ❑ ❑
® ❑ ❑ ❑
® ❑ ❑ ❑
® ❑ ❑ ❑
® ❑ ❑ ❑
Yes No NA NE
® ❑ ❑ ❑
® ❑ ❑ ❑
® ❑ ❑ ❑
E ❑ ❑ ❑
® ❑ ❑ ❑
E ❑ ❑ ❑
■ ❑ ❑ ❑
® ❑ ❑ ❑
Yes No NA NE
❑ ❑ ❑
Page# 4

Permit: NCO084409
Owner - Facility: Wellesley Place WWlrP
Mode of operation
Ext Air
❑
Inspection Date: 11/12/2015
Inspection Type: Compliance Evaluation
Diffused
El
1:1
Bar Screens
Yes No NA NE
Is the screen free of excessive debris?
N
❑
❑
❑
Is disposal of screening in compliance?
N
❑
❑
❑
Is the unit In good condition?
®
❑
❑
❑
Comment: None
Aeration Basins
Yes No NA NE
Mode of operation
Ext Air
❑
❑
Type of aeration system
Diffused
El
1:1
Is the basin free of dead spots?
® ❑
❑
❑
Are surface aerators and mixers operational?
❑ ❑
®
❑
Are the diffusers operational?
® ❑
❑
❑
Is the foam the proper color for the treatment process?
® ❑
❑
❑
Does the foam cover less than 25% of the basin's surface?
® ❑
❑
❑
Is the DO level acceptable?
❑ ❑
❑
®
Is the DO level acceptable?(1 0 to 3.0 mg/1)
❑, ❑
❑
Is the drive unit operational?
Comment None
Secondary Clarifier
Yes No NA NE
Is the clarifier free of black and odorous wastewater?
®
❑
❑
❑
Is the site free of excessive buildup of solids in center well of circular clarifier?
El
1:1
®
E]
Are weirs level?
®
❑
❑
❑
Is the site free of weir blockage?
®
❑
❑
❑
Is the site free of evidence of short-circuiting?
®
❑
❑
❑
Is scum removal adequate?
®
❑
❑
❑
Is the site free of excessive floating sludge?
®
❑
❑
❑
Is the drive unit operational?
❑
❑
■
❑
Is the return rate acceptable (low turbulence)?
®
❑
❑
❑
Is the overflow clear of excessive solids/pin floc?
®
❑
❑
❑
Is the sludge blanket level acceptable? (Approximately ''Y4 of the sldewall depth)
❑
❑
❑
■
Comment: None
Pumps-RASMAS Yes No NA NE
Are pumps In place? ® ❑ ❑ ❑
Page# 5

Permit: NC0084409
Inspection Date: 11/12/2015
Pumps -RAS -WAS
Are pumps operational?
Are there adequate spare parts and supplies on site?
Comment: None
Disinfection - UV
Are extra UV bulbs available on site?
Are UV bulbs clean?
Is UV intensity adequate?
Is transmittance at or above designed level?
Is there a backup system on site?
Is effluent clear and free of solids?
Comment. None
Owner -Facility: Wellesley Place VWVTP
Inspection Type: Compliance Evaluation
Flow Measurement - Effluent
# Is flow meter used for reporting?
Is flow meter calibrated annually?
Is the flow meter operational?
(If units are separated) Does the chart recorder match the flow meter?
Comment: None
Effluent Pipe
Is right of way to the outfall properly maintained?
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: None
Aerobic Digester
Is the capacity adequate?
Is the mixing adequate?
Is the site free of excessive foaming In the tank?
# Is the odor acceptable?
# Is tankage available for properly waste sludge?
Comment: None
Yes No NA NE
® ❑ ❑ ❑
® ❑ ❑ ❑
Yes No NA NE
® ❑ ❑ ❑
® ❑ ❑ ❑
® ❑ ❑ ❑
® ❑ ❑ ❑
® ❑ ❑ ❑
® ❑ ❑ ❑
Yes No NA NE
® ❑ ❑ ❑
® ❑ ❑ ❑
® ❑ ❑ ❑
® ❑ ❑ ❑
Yes No NA NE
®❑ ❑ ❑
® ❑ ❑ ❑
❑ ❑ ® ❑
Yes No NA NE
® ❑ ❑ ❑
® ❑ ❑ ❑
N ❑ ❑ ❑
■ ❑ ❑ ❑
® ❑ ❑ ❑
Page# 6

Permit: NCO084409
Inspection Date: 11/12/2015
Owner -Facility: Wellesley Place WWTP
Inspection Type: Compliance Evaluation
Operations & Maintenance
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 None
Yes No NA NE
■ ❑ ❑ ❑
■ ❑ ❑ ❑
Page# 7