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Home My WebLink AboutNCG550408_ncg550408 CEI epa form 2024_20240705 DocuSign Envelope ID:762034CO-9023-419C-BOD9-05D297315425 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 NCG550408 111 121 24/06/19 I17 18 I C I 19 I G I 20U 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 70 J 71 Ity 72 L-J 73 1 74 79 I I I I 80 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 Dermit Number) 12:11 PM 24/06/19 21/08/09 179 Asbury Church Road 179 Asbury Church Rd Exit Time/Date Permit Expiration Date Sanford NC 27330 12:18PM 24/06/19 25/10/31 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 Leonard N Gunter,Rt 4 Box 810 Sanford NC 27330//919-774-6645/ No Section C:Areas Evaluated During Inspection (Check only those areas evaluated) Permit 0 Operations&Maintenar 0 Records/Reports 0 Facility Site Review 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 Stephen D Smith DWR/RRO WQ/919-791-4200/ DocuSigned by: 7/7/2024 9EC679823B1D478... Signature of Management Q A Reviewer Agency/Office/Phone and Fax Numbers Date DocuSigned by: 7/8/2024 Uatn c,ssa f. AQ' ut,(, B2916E6AB32144F... EPA Form 3560-3(Rev 9-94)Previous editions are obsolete. Page# DocuSign Envelope ID:762034CO-9023-419C-BOD9-05D297315425 NPDES yr/mo/day Inspection Type 1 31 NCG550408 I11 12I 24/06/19 11 7 18 i c i Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary) Page# 2 DocuSign Envelope ID:762034CO-9023-419C-BOD9-05D297315425 Permit: NCG550408 Owner-Facility: 179 Asbury Church Road Inspection Date: 06/19/2024 Inspection Type: Compliance Evaluation Operations & Maintenance Yes No NA NE Is the plant generally clean with acceptable housekeeping? 0 ❑ ❑ ❑ Does the facility analyze process control parameters, for ex: MLSS, MCRT, Settleable ❑ ❑ ❑ Solids, pH, DO, Sludge Judge, and other that are applicable? Comment: Single Family Residence - Single Pass Gravity Sandfilter Unable to contact home owner. Called, visited site, and left information packet. Will request a follow up call to RRO by letter to discuss sytem and to confirm contact info.. 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? ❑ ❑ 0 ❑ Is access to the plant site restricted to the general public? ❑ ❑ ❑ Is the inspector granted access to all areas for inspection? ❑ ❑ ❑ Comment: Page# 3