WQ0010093_Staff Report_20240214

February 14, 2024
To: DWR Central Office — WQ, Non -Discharge Unit
Attn: Leah Parente
From: Caitlin Caudle
Winston-Salem Regional Office
State of North Carolina
Division of Water Resources
Water Quality Regional Operations Section
Staff Report
Application No.: W00010093
Facility name: 4688 Riverwood Trail SFR
Note: This form has been adapted from the non -discharge facility staff report to document the review of both non -discharge and NPDES permit applications and/or renewals. Please complete all sections m they are applicable.
I. GENERAL AND SITE VISIT INFORMATION
1. Was a site visit conducted? ❑ Yes or ® No
II. EXISTING FACILITIES: MODIFICATION AND RENEWAL APPLICATIONS
1. Are there appropriately certified Operators in Charge (ORCs) for the facility? ❑ Yes ❑ No ® N/A
2. Are the design, maintenance, and operation of the treatment facilities adequate for the type of waste and disposal
system? ® Yes or ❑ No
3. Are the site conditions (e.g., soils, topography, depth to water table, etc) maintained appropriately and adequately
assimilating the waste? ❑ Yes or ® No
If no, please explain: A garden may be located close to the spray, field.
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 ❑ No
If yes, please explain: Potentially. The parcel with the setback waiver has changed ownership.
5. Are the existing application rates (e.g., hydraulic, nutrient) still acceptable? ® Yes or ❑ No
6. Are there any setback conflicts for existing treatment, storage, and disposal sites? ❑ Yes or ® No
7. Is the description of the facilities as written in the existing permit correct? ® Yes or ❑ No
8. Has a review of compliance history been completed (CEI's)? ® Yes or ❑ No
9. Are there any permit changes needed in order to address ongoing BIMS violations? ❑ Yes or ® No
10. Check all that apply:
❑ No compliance issues ❑ Current enforcement action(s) ❑ Currently under JOC
® Notice(s) of Deficiency ❑ Currently under SOC ❑ Currently under moratorium
11. Are there any issues related to compliance/enforcement that should be resolved before issuing this permit?
❑ Yes ®No❑N/A
FORM: WQROSSR 04-14 Page 1 of 2

III. REGIONAL OFFICE RECOMMENDATIONS
1. Do you foresee any problems with issuance/renewal of this permit? ❑ Yes or ® No
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
Included in the staff report is a setback waiver signed in 2018. The parcel has
Setback waiver
changed ownership. Is a new setback waiver needed?
3. 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
❑ Issue
❑ Deny (Please state reasons: )
/,Docuftned by:
4. Signature of report preparer:
99D49D...
Signature of regional supervisor:
Date: 2/14/2024
IV. ADDITIONAL REGIONAL STAFF REVIEW ITEMS
See attached correspondence from most recent compliance inspection in Ma,, 2023.
FORM: WQROSSR 04-14 Page 2 of 2

ROY COOPER
Governor
ELIZABETH S. BISER
Secretary
RICHARD E. ROGERS, JR.
Director
NORTH CAROLINA
Environmental Quality
June 6, 2023
Delivered electronically via email: waynecrashhen ry(a_gmail.com
Wayne G. and Lori S. Henry
4688 Riverwood Trail
Burlington, NC 27217
SUBJECT: Notice of Deficiency (NOD-2023-PC-0150)
Compliance Evaluation Inspection
4688 Riverwood Trail SFR
Permit No. WQ0010093
Alamance County
Dear Mr. and Mrs. Henry:
On May 16, 2023, Division of Water Resources staff Jim Gonsiewski conducted a routine
compliance inspection. Wayne Henry, Owner, was present during the entire inspection.
A review of all treatment units was completed. This review mostly reflected compliance
with the subject permit. The following deficiencies were noted:
A. Permit Condition V.2 states an inspection log shall be maintained that includes,
at a minimum, the date and time of inspection, observations made, and any
maintenance, repairs, or corrective actions taken. Permit Condition 111.12 lists
inspection frequencies for specific treatment units. Begin maintaining an
inspection log containing the weekly and monthly inspections.
B. Mr. Henry stated that he inspects the chlorinator monthly. Permit Condition
111.12b. and the Operation and Maintenance Agreement state that the chlorinator
shall be inspected weekly. Begin inspecting the chlorinator weekly and
recording these events in the inspection log.
C. A small garden was observed west of the spray field. A small portion of the garden
extends under the fence into the spray field. Permit Condition 111.3 states that a
suitable year round vegetative cover shall be maintained at all times in the spray
field. The area extending into the spray field must be removed from use as a
garden and reseeded to establish a year round vegetative cover. Additionally,
the proximity of this garden to the spray area is a concern as the garden may be
impacted by wastewater drift during spray events. This office recommends the
entire garden be relocated to avoid potential health issues.
North Carolina Department of Environmental Quality I Division of Water Resources
Winston-Salem Regional Office 1 450 W. Hanes Mill Rd, Suite 300 I Winston-Salem, North Carolina 27105
NoanicaaouNn
oep.m.m or em�nmen� Qualm
336.776.9800

Please refer to the enclosed inspection report for additional comments and observations.
If you have any questions, please contact me or Jim Gonsiewski at the letterhead address
and phone number, or by email at lon.snider(aD-deg.nc.gov or jim.gonsiewski(a-_)deg.nc.gov.
Sincerely,
Doc uSiig<
gned by:
%w. l . cin,l tr
1-5'ME225CMEA...
Lon T. Snider, Regional Supervisor
Water Quality Regional Operations Section
Division of Water Resources, NCDEQ-WSRO
Enc: Inspection Report
Cc: Alamance County Environmental Health (electronic copy)
D North Carolina Department of Environmental Quality I Division of Water Resources
✓ Winston-Salem Regional Office 1 450 W. Hanes Mill Rd, Suite 300 1 Raleigh, North Carolina 27105
NORTH CAROLINA 336.776.9800
naparMeM of EmironmanW 9uallly

Compliance Inspection Report
Permit: WQ0010093 Effective: 08/21/18 Expiration: 07/31/23 Owner: Wayne G Henry
SOC: Effective: Expiration: Facility: 4688 Riverwood Trl. SFR
County: Alamance 4688 Riverwood Trl
Region: Winston-Salem
Burlington NC 27217
Contact Person: Wayne G Henry Title: Phone:
Directions to Facility:
System Classifications:
Primary ORC:
Secondary ORC(s):
On -Site Representative(s):
Related Permits:
Inspection Date: 05/16/2023 Entry Time 04:45PM
Primary Inspector: Jim J Gonsiewski
Secondary Inspector(s):
Certification:
Phone:
Exit Time: 05:50PM
Phone: [phone]
Reason for Inspection: Routine Inspection Type: Compliance Evaluation
Permit Inspection Type: Single -Family Residence Wastewater Irrigation
Facility Status: ❑ Compliant Not Compliant
Question Areas:
Miscellaneous Questions Permit Status Septic Tank
Sand Filter/Treatment Pods Disinfection Tablets Pump Tank
Drip or Irrigation General
(See attachment summary)
Page 1 of 4

Permit: WQ0010093 Owner - Facility: Wayne G Henry
Inspection Date: 05/16/2023 Inspection Type: Compliance Evaluation Reason for Visit: Routine
Inspection Summary:
On May 16, 2023, Division of Water Resources staff Jim Gonsiewski conducted a routine compliance inspection. Wayne
Henry, Owner, was present during the entire inspection. A review of all treatment units was completed. This review reflected
non-compliance with the subject permit.
The following items of concern were noted:
• Permit Condition V.2 states an inspection log shall be maintained that includes, at a minimum, the date and time of
inspection, observations made, and any maintenance, repairs, or corrective actions taken. Permit Condition 111.12 lists
inspection frequencies for specific treatment units. Begin maintaining an inspection log containing the weekly and monthly
inspections.
• Mr. Henry stated that he inspects the chlorinator monthly. Permit Condition 111.12b. and the Operation and Maintenance
Agreement state that the chlorinator shall be inspected weekly. Begin inspecting the chlorinator weekly and recording these
events in the inspection log.
• A small garden was observed west of the spray field. A small portion of the garden extends under the fence into the
spray field. Permit Condition 111.3 states that a suitable year round vegetative cover shall be maintained at all times in the
spray field. The area extending into the spray field must be removed from use as a garden and reseeded to establish a year
round vegetative cover. Additionally, the proximity of this garden to the spray area is a concern as the garden may be
impacted by wastewater drift during spray events. This office recommends the entire garden be relocated to avoid potential
health issues.
Other observations:
• Mr. Henry stated that he replaced the system pump three months ago and that he had not had any major problems with
the system. He also recently replaced the system spray heads.
• Mr. Henry used the correct type of chlorine tablets.
• There were no areas of ponding or runoff observed.
• There is no metering equipment in the system.
• Mr. Henry last pumped the septic tank on 5/30/2023. He also stated that he now plans to pump the tanks every 5
years.
• Currently two people are living in the home.
• The alarm for the system is located inside the residence in the laundry room. It was tested and both the audio and
visual alarms work.
• The system appears to be well maintained with no leaks or odors observed during the inspection.
Page 2 of 4

Permit: WQ0010093 Owner - Facility: Wayne G Henry
Inspection Date: 05/16/2023 Inspection Type: Compliance Evaluation Reason for Visit: Routine
Permit Status Yes No NA NE
# Is the current resident in the home the Permittee? ❑ ❑ ❑
# If not, does the resident rent from the Permittee? ❑ ❑ ❑
Change of Ownership form needed? (Mail the form with the inspection letter) ❑ ❑ ❑
# Is there an inspection and maintenance agreement with a contractor? ❑ ❑ ❑
If YES, who is the contractor (include contact info)?
Comment: See comments
Septic Tank Yes No NA NE
*** The septic tank and filters should be checked annually and pumped/cleaned as needed. **
Is all wastewater from the home connected to the septic tank? 0 ❑ ❑ ❑
# Does the permittee/resident know where the septic tank is located? ❑ ❑ ❑
Has the septic tank been pumped in the last 5 years? ❑ ❑ ❑
If YES, describe if known and proof (include date pumped):
Tank pumped on 05/30/2023.
# Does the septic tank have an EFFLUENT FILTER or SANITARY T? ❑ ❑ ❑
If FILTER, when was the filter cleaned and by who?
Comment: The permittee was not sure if the tank has a filter.
Sand Filter/Treatment Pods Yes No NA NE
*** Accessible sand filter surfaces shall be raked/leveled every 6 months and vegetative growth shall be
removed manually. ***
# Is system something other than a sand filter? ❑ 0 ❑ ❑
# If YES, what kind? (examples - Peat, Textile or brand name - Advantex, etc.)
# Does the permittee know where the sandfilter is located? ❑ ❑ ❑
Does the sandfilter require maintenance? ❑ ❑ ❑
If maintenace is required, explain:
Comment: See comments
Disinfection Tablets Yes No NA NE
*** Tablet chlorinator unit shall be checked weekly to ensure continuous and proper operation. ***
Does the permittee have the correct chlorine tablets? (If none, mark No) ❑ ❑ ❑
# Does the Permittee know the location of the chlorinator? ❑ ❑ ❑
Were chlorine tablets observed in the chlorinator? ❑ ❑ ❑
Are tablets contacting water? (If possible, poke them to determine.) 0 ❑ ❑ ❑
Comment:
Pump Tank
Yes No NA NE
*** All pump and alarm sytems shall be inspected monthly. (Non -Discharge) ***
Page 3 of 4

Permit: WQ0010093 Owner - Facility: Wayne G Henry
Inspection Date: 05/16/2023 Inspection Type: Compliance Evaluation Reason for Visit: Routine
Is the pump working?
Is the audible and visual high water alarm operational?
# Does the permittee know how to check the pump & high water alarm?
# Last functional test:
Comment:
Drip or Irrigation
*** Irrigation sysetm shall be inspected monthly to ensure system is free of leaks and equipment is operating
as designed. ***
# Type of system (DRIP or IRRIGATION):
# If IRRIGATION, number of sprinkler heads:
Are buffers and setbacks adequate?
Is the site free of ponding and runoff?
Does the application equipment appear to be working properly?
Is there a minimum two wire fence surrounding the entire irrigation area?
Comment:
General
# Are the treatment units locked and/or secured?
# Has resident had any sewage problems?
If YES, explain:
Does the system match the permit description?
❑ ❑ ❑
❑ ❑ ❑
❑ ❑ ❑
Yes No NA NE
Irrigation
4
❑ ❑ ❑
❑ ❑ ❑
❑ ❑ ❑
■❑❑❑
Yes No NA NE
■❑❑❑
❑■❑❑
■❑❑❑
If NO, explain:
See comments
Is the system compliant? ❑ ❑ ❑
Is the system failing? (If yes, take pictures if possible) ❑ ❑ ❑
If system is failing, describe any exposures to people/animals or environmental risks.
Comment: The chlorinator is not inspected weekly and no inspection log is maintained. Also, a small
section of garden adaicent to the spray field extends into the field.
Page 4 of 4

Compliance Inspection Report
Permit: WQ0010093 Effective: 08/21/18 Expiration: 07/31/23 Owner: Wayne G Henry
SOC: Effective: Expiration: Facility: 4688 Riverwood Trl. SFR
County: Alamance 4688 Riverwood Trl
Region: Winston-Salem
Burlington NC 27217
Contact Person: Wayne G Henry Title: Phone:
Directions to Facility:
System Classifications:
Primary ORC:
Secondary ORC(s):
On -Site Representative(s):
Related Permits:
Inspection Date: 05/16/2023 Entry Time 04:45PM
Primary Inspector: Jim J Gonsiewski
Secondary Inspector(s):
Certification:
Phone:
Exit Time: 05:50PM
Phone: [phone]
Reason for Inspection: Routine Inspection Type: Compliance Evaluation
Permit Inspection Type: Single -Family Residence Wastewater Irrigation
Facility Status: ❑ Compliant Not Compliant
Question Areas:
Miscellaneous Questions Permit Status Septic Tank
Sand Filter/Treatment Pods Disinfection Tablets Pump Tank
Drip or Irrigation General
(See attachment summary)
Page 1 of 4

Permit: WQ0010093 Owner - Facility: Wayne G Henry
Inspection Date: 05/16/2023 Inspection Type: Compliance Evaluation Reason for Visit: Routine
Inspection Summary:
On May 16, 2023, Division of Water Resources staff Jim Gonsiewski conducted a routine compliance inspection. Wayne
Henry, Owner, was present during the entire inspection. A review of all treatment units was completed. This review reflected
non-compliance with the subject permit.
The following items of concern were noted:
• Permit Condition V.2 states an inspection log shall be maintained that includes, at a minimum, the date and time of
inspection, observations made, and any maintenance, repairs, or corrective actions taken. Permit Condition 111.12 lists
inspection frequencies for specific treatment units. Begin maintaining an inspection log containing the weekly and monthly
inspections.
• Mr. Henry stated that he inspects the chlorinator monthly. Permit Condition 111.12b. and the Operation and Maintenance
Agreement state that the chlorinator shall be inspected weekly. Begin inspecting the chlorinator weekly and recording these
events in the inspection log.
• A small garden was observed west of the spray field. A small portion of the garden extends under the fence into the
spray field. Permit Condition 111.3 states that a suitable year round vegetative cover shall be maintained at all times in the
spray field. The area extending into the spray field must be removed from use as a garden and reseeded to establish a year
round vegetative cover. Additionally, the proximity of this garden to the spray area is a concern as the garden may be
impacted by wastewater drift during spray events. This office recommends the entire garden be relocated to avoid potential
health issues.
Other observations:
• Mr. Henry stated that he replaced the system pump three months ago and that he had not had any major problems with
the system. He also recently replaced the system spray heads.
• Mr. Henry used the correct type of chlorine tablets.
• There were no areas of ponding or runoff observed.
• There is no metering equipment in the system.
• Mr. Henry last pumped the septic tank on 5/30/2023. He also stated that he now plans to pump the tanks every 5
years.
• Currently two people are living in the home.
• The alarm for the system is located inside the residence in the laundry room. It was tested and both the audio and
visual alarms work.
• The system appears to be well maintained with no leaks or odors observed during the inspection.
Page 2 of 4

Permit: WQ0010093 Owner - Facility: Wayne G Henry
Inspection Date: 05/16/2023 Inspection Type: Compliance Evaluation Reason for Visit: Routine
Permit Status Yes No NA NE
# Is the current resident in the home the Permittee? ❑ ❑ ❑
# If not, does the resident rent from the Permittee? ❑ ❑ ❑
Change of Ownership form needed? (Mail the form with the inspection letter) ❑ ❑ ❑
# Is there an inspection and maintenance agreement with a contractor? ❑ ❑ ❑
If YES, who is the contractor (include contact info)?
Comment: See comments
Septic Tank Yes No NA NE
*** The septic tank and filters should be checked annually and pumped/cleaned as needed. **
Is all wastewater from the home connected to the septic tank? 0 ❑ ❑ ❑
# Does the permittee/resident know where the septic tank is located? ❑ ❑ ❑
Has the septic tank been pumped in the last 5 years? ❑ ❑ ❑
If YES, describe if known and proof (include date pumped):
Tank pumped on 05/30/2023.
# Does the septic tank have an EFFLUENT FILTER or SANITARY T? ❑ ❑ ❑
If FILTER, when was the filter cleaned and by who?
Comment: The permittee was not sure if the tank has a filter.
Sand Filter/Treatment Pods Yes No NA NE
*** Accessible sand filter surfaces shall be raked/leveled every 6 months and vegetative growth shall be
removed manually. ***
# Is system something other than a sand filter? ❑ 0 ❑ ❑
# If YES, what kind? (examples - Peat, Textile or brand name - Advantex, etc.)
# Does the permittee know where the sandfilter is located? ❑ ❑ ❑
Does the sandfilter require maintenance? ❑ ❑ ❑
If maintenace is required, explain:
Comment: See comments
Disinfection Tablets Yes No NA NE
*** Tablet chlorinator unit shall be checked weekly to ensure continuous and proper operation. ***
Does the permittee have the correct chlorine tablets? (If none, mark No) ❑ ❑ ❑
# Does the Permittee know the location of the chlorinator? ❑ ❑ ❑
Were chlorine tablets observed in the chlorinator? ❑ ❑ ❑
Are tablets contacting water? (If possible, poke them to determine.) 0 ❑ ❑ ❑
Comment:
Pump Tank
Yes No NA NE
*** All pump and alarm sytems shall be inspected monthly. (Non -Discharge) ***
Page 3 of 4

Permit: WQ0010093 Owner - Facility: Wayne G Henry
Inspection Date: 05/16/2023 Inspection Type: Compliance Evaluation Reason for Visit: Routine
Is the pump working?
Is the audible and visual high water alarm operational?
# Does the permittee know how to check the pump & high water alarm?
# Last functional test:
Comment:
Drip or Irrigation
*** Irrigation sysetm shall be inspected monthly to ensure system is free of leaks and equipment is operating
as designed. ***
# Type of system (DRIP or IRRIGATION):
# If IRRIGATION, number of sprinkler heads:
Are buffers and setbacks adequate?
Is the site free of ponding and runoff?
Does the application equipment appear to be working properly?
Is there a minimum two wire fence surrounding the entire irrigation area?
Comment:
General
# Are the treatment units locked and/or secured?
# Has resident had any sewage problems?
If YES, explain:
Does the system match the permit description?
❑ ❑ ❑
❑ ❑ ❑
❑ ❑ ❑
Yes No NA NE
Irrigation
4
❑ ❑ ❑
❑ ❑ ❑
❑ ❑ ❑
■❑❑❑
Yes No NA NE
■❑❑❑
❑■❑❑
■❑❑❑
If NO, explain:
See comments
Is the system compliant? ❑ ❑ ❑
Is the system failing? (If yes, take pictures if possible) ❑ ❑ ❑
If system is failing, describe any exposures to people/animals or environmental risks.
Comment: The chlorinator is not inspected weekly and no inspection log is maintained. Also, a small
section of garden adaicent to the spray field extends into the field.
Page 4 of 4

FILED
ALAMANCE COUNTY, NC
HUGH WEBSTER
REGISTER OF DEEDS
FILED Aug 09, 2018
AT 10:34:21 am
BOOK 03799
START PAGE 0610
END PAGE 0611
INSTRUMENT 4 13391
EXCISE TAX (None)
RF
State of North Carolina
Department of Environmental Quality
Division of Water Resources
NON-DISCILNRGE WASTEWATER SYSTEM WAIVER
(THIS FORLI M t Y BE PHOTOCOPIED FOR USE .4S AN ORIGINAL)
The Division of Water Resources will.not consider this form complete unless all instructions are followed. Failure
to follow instructions or to submit all required items will lead to additional processing and review time.
For more information or for an electronic version of this form, visit our web site at:
hlly: Uortat ncdenr org.web wq'gulau•=lications.
INSTRUCTIONS TO THE APPLICANT
✓ Do not submit this form for review without a corresponding Non -Discharge Permitting Unit application form.
✓ Any changes to this form will result in the application package being returned.
✓ Any other setbacks required by 15A NCAC Subchapter 02T other than those referenced below, cannot be waived
through execution of this form.
✓ A copy of the completed and appropriately executed form must be provided to the property owner.
_AGREEMENT TO WAIVE SETBACKS AS REQUIRED BY
15A NCAC 02T .0506(a), .0506(b), .0606(a), .0706(a) and .1006(a)
The undersigned property,owper(s) hereby perm}ts:, , 1
Applicant's name:
Complete mailing address of applicYnt: M E t \Fe.Y C6 D U oU __Tr 1 \ r
city: State: KfC', zip: t'
Telephone number: 0 " g D 9 Facsimile number:
Hereinafter referred to as the Permittee, to (check all that apply):
❑ Non -Discharge disposal of wastewater effluent within feet of the property line,
i
Non -Discharge disposal of wastewater effluent within feet of the identified residence,
❑ Construct treatment and storage units within feet of the property line,
❑ Construct treatment and storage units within feet of the identified residence.
FOR I: NDWSW 10-16 Page 1 of 2

The waived setbacks apply as shown on the attached map and located at the following:
Location address of property: 92 - i V(, W c o a
City: � s_Z State: l Zip: Z. J 2-1
EF-rcertify that I am a deeded property owner of above -referenced property and am authorized to make decisions
regarding this property on behalf of other deeded property owners. Furthermore, I certify that I have read and
understand this Agreement and do hereby grant permission to the Permittee to dispose of wastewater effluent or
construct wastewater treatment units as specified herein. I further agree that I will record this waiver form with the
appropriate Register of Deeds and provide the Permittee and Division of Water Resources with documentation of
such.
Property owner(s)
Signature: �G
Signature:
NORTH CAROLINA, COUNTY
I, -"y 77_/O a Notary Public for A/aM4 YI C— e- County, North Carolina,
do hereby certify that i_I , A, g �� Ake,p, .� }C `� i �, ( persona 4 a pared before me this day and
acknowledged the due execution of the foregoing instrument.
Witness my hand and official seal this the day of
l�J`i2eL, 6%C1/ -�
SEAL
Signature ofNot ry Public 1
Tammy Richardson Aly commission expires
Notary Public
FAlamance County, NO
My Commission Expires
FORM: M)WSW 10-16 Page 2 of 2