NCG550808_Pamela_&_Lew_Johnson_SFR_CEI_Report_20240530

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 2 u 3 I NCG550808 111 121 24/05/02 I17 18 I C I 19 I s I 20L]
21111I I I I I I I II I I I I I I I I I I I I I I I I I I I I I I I II I I I I I r6
Inspection
Work Days Facility Self -Monitoring Evaluation Rating B1 QA ---------------------- Reserved -------------------
67
I 72 I n, I 73 � I 74 79 I I I I I I I80
70 I I 71 I LL -1 I I
LJ
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)
10:30AM 24/05/02
12/08/01
798 Jacob Street
798 Jacob St
Exit Time/Date
Permit Expiration Date
Thomasville NC 27360
11:00AM 24/05/02
13/07/31
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
Pamela P Hodgin,798 Jacob St Ext Thomasville NC 273607102///
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 Docusigned by: DWR/WSRO WQ/336-776-9690/
osiaecl Boone' 5/30/2024
B20F8DD5F2A3460...
Signature of Management Q A Reviewer Agency/Office/Phone and Fax Numbers Date
Lon T. Snider Docusigned by: 5/30/2024
FL- T. 5,,d r
�145B49 5C94EA.
EPA Form 3560-3 (Rev 9-94) Previous e�di ons are obsolete.
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NPDES yr/mo/day Inspection Type
NCG550808 I11 12I 24/05/02 117 18 i c i
(Cont.)
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
On May 2nd, 2024, Ron Boone, of the Winston-Salem Regional Office of the NC Division of Water
Resources, conducted a compliance evaluation inspection of your single family wastewater treatment
system. Thank you for assisting Mr. Boone in completing the inspection. The inspection results are
summarized below:
You told Mr. Boone that the septic tank has been pumped at least within the last five years. Please
note that the permit requires you to pump the tank every three to five years. This will keep the tank in
good condition and prevent loss of solids to the subsurface sand filter, which would clog the filter and
require it to be repaired or replaced at a high cost. There are only two people living in the home so
every four years would likely be ideal for your home.
You showed Mr. Boone your chlorine tablets. You are using the correct type. Be careful with these
tablets as they're toxic. Skin, eye, and respiratory protection should always be worn when handling
them. You should keep each chlorinator tube constantly stocked with 2 to 3 tablets. We have
attached some helpful information about chlorine.
The location of the discharge pipe is currently unknown. You stated that the property has
experienced many floods during heavy rains in the past and the pipe is difficult to find. You stated you
may hire a plumber to help find the discharge pipe so samples can be taken.
No samples of the effluent have been taken yet. We have provided a list of certified laboratories
where you may take samples for the required analysis. We have also included a copy of the general
permit for reference to what parameters must be tested for. Your requirements are on page 3. Please
be aware the permit requires on page 3 (Part I, Section C(1)) that you have the water tested annually
by a NC certified laboratory for the constituents listed in the permit. You are currently not required to
submit test results to the Division but you must keep them on file with all your other related records
such as the certificate of coverage, permit fee invoices, tank pumping invoices, etc. Please do share
the results with Mr. Boone when you get them so we can get an idea of how well your system is
functioning.
The permittee/owner names need to be changed. Mr. Boone has provided a Name/Ownership
Change form. Be sure follow the instructions on the form to fill it out, provide the proper attachments,
and send it in to our Raleigh Central Office.
Permit fees for this permit are $60 annually. It appears that only 2022 fees have not been paid.
The general permit number is NCG550000, and your specific permit #, otherwise known as your
certificate of coverage #, under the general permit, which is assigned specifically to your home, is
NCG550808.
You are technically non -compliant with the permit at this time due to not having it tested annually. If
you have any questions or concerns about compliance, the inspection, or this report, please contact
Mr. Boone by phone at 336-776-9690, or by email at [e-mail].
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Permit: NCG550808
Inspection Date: 05/02/2024
Owner -Facility: 798 Jacob Street
Inspection Type: Compliance Evaluation
Permit
(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?
Is the inspector granted access to all areas for inspection?
Comment: Please refer to the inspection summary section of this report.
Yes No NA NE
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