NCG550864_Comments_20240621

I`10N DISCHARGE SINGLE FAMIi.Y W STEM/ATER 5Y57Efu1S
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f 'uS to ,;-1 '.rho is the cgnr,ra„lor?
SEPTIC T! l n.: ,•'I t t 11 a - , s' .. c cr :. . .
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%yE.,,- l no'., ." here the t%I11' is li)'
8 k i,h; ih•2 tiejfw tin? been l,I-I1,1;):,rf in tree last 5 y ars) /
'If y;:s to 9
,' ,10. Doos the Septic tan. heh:e ari EFFI UE-NI FILTER r r Sr1Nf TAR1' 1 .' 1 'rcl-. i1.:.!
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]�1: I6.,KQ ,,to filter';vlten uas the filter cleaned? By whom? . _
SAND�FILTER / TREATMENT YES NO If no proceed to the next section -
A es`sliile 4. S_i'1''. f.,rer 3I,rf3-efi 0111 t'? f3t:9;-' 3n.11a. 'en e!? r i . r •, l" 7 ? 9' d J:.l' i` 4 rt2 f: ' .e j ma:, "1 y
k, 1'2. Is; S/Sterhl Something Who, (horn a sarl,Qter'� { "�
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I,ind? (� ..=ull;)I - C)r,-ht T I;;tilo (?tll r c,• low t o 1'r' X41 t't )
1 � Do-25 the 11-crnl+iiee f nn,, rJhera lh ti:lrh;lfdtar I; I
ill^ 'sIn lillt::r re,,';:�;: 911:vnt::n:v,
DISINFECTION r UV YES NO 1f no proceed to the next section
17 l I hs the U'.' U n; lr.'rl , t ' t I'), t� 'r ! I _ "! C__l
' ��", air.:, rtl.t t. ,l
18 Who compi-�i-:s Ine v u-_, .lp c h ,.r for the UV?t N_m-€his. ih I-til')
DISINFECTION 1 TABLETS YES NO If no proceed to the rhext section
1 ci [7� li1E n 'r; its., , II 1 (ll r I)rrC ct c h! )rir�I: Gil S j [?nn I'
2'+ t )ca,'r- 1 Sji trio 0110.1`1 1")'
21 i" t'rr-. I Irlu•In<li'
22 Arm lat)lels cont:Ic,Jw %'.ater? if possitilo jlo3 e tilerl) t,) clat-:rnline l f i 4 j
bECHL.OR (Discharge only) YES NO I If no proceed to the next section.
1�r8 u3Chh3!Is'.:1S�f ��}: ;r�.l'i :.— .�'r `� ...x r h d•,3.°? CJ" n. .. ) r " , '
23
l.1Cln� Gle h�flil�li$8 lYl'o-:.'.`.il_':' tile' CI-:•:i11G• 1�? 1 I }
24. Do;,s the Eli;(,h'or
2.) 4': E'rd decill')r tablets ol;) er: -1J In (ha dechlorinaz Jn Cil tnit) ? ( { I .1 4 A
23 Are t it)lels Contacting Ater? If possi5la Doke them to EIelw-rmirle i � R � f f it 1I

'UMP TANK YES NO If no proceed to the next section
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Iti the p.lmp r,�Irkiny . 1 11 L -�
28 Ar!� the atld'ole a')d visual high avatar ala'ms operatiora.' 11. J ] ❑
29 Does the permiltee know how to check the pump & high water alarm?
30 Last fur PUMP _ _ AUDIBLE & VISUAL.
YES NO , If no proceed to the next section
oiSc"ARGE ONLY
M rfsual revreyy of tie o+,trari local, in shalt be extra+d�yl Cwiae each year (one at the 6"}'- %� 3xn5pLrvj to ensty • ' ' s � Ja pr�+ r e •,i n a d� t� ❑
31 Does the permittee know where the outfall is located? ❑ ❑ ❑
32, Wpte you able to locate the outfall? ❑ ❑ ❑
33 Is the end of the discharge pipe visible and accessible? ❑ ❑ ❑
34. Is outlet discharging? ❑ ❑ ❑ ❑
35. I.s right of Yway maintained around U d scharde point? ❑ ❑ ❑ ❑
$6, Any Lab Results available? ❑ ❑ ❑ ❑
$� Is.te eyidence of Olds around the disph Dint? NO if no proceed to the next section.
Li
W1 #[ S' AY n,ent is ope�atin as des. ed
The Irrlga an system shall be Inspocted n-onthly to ensure the systo r is tree of leaks and eq . 9 9
38. is the system DRIP or IRRIGATION (circle one)? If irrigation number of sprinkler heads. El ❑ ❑
39. Are the buffers adequate? ❑ ❑ ❑ ❑
40 is the Site free of pondirig and runoff? ❑ ❑ ❑
0. Does the application equipment appear to be wOrk199 properly? ❑ ❑
Q. Is there a minimum two v?ire fence surroundiris.l entire irrigation area? ❑ El
GENERAL L ❑ El❑
0. Are the treatment units locked and or secured? ❑ ❑ ❑ ❑
44, Has resident had any sewage problems? if yes a 43 n ill the se-:t,o,+ El45 Does the system match the permit description? it n.. a<pla+ri m h8 com-3 r,.; s„•to- El ❑ ❑
46. Is the system compliant? ❑ ❑ ❑
47 Is the system failing? if y=, take pictures if poss-bi_ ❑
D �� U
48 if system is failing any sign of children or animals contacting sewage? - - -
NOD Sent #: - - NOV Sent #:
Photos Taken? YES Lj NO
Comments
INSf�I=C7'OR SIGNAIUR�.