NCG551657_ncg551657 EPA Form CEI 2024_20240911

Docusign Envelope ID: D55E2694-BA13-4BC7-AFEA-4FA02D377F11
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 NCG551657 111 121 24/08/13 I17 18[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) 12:40PM 24/08/13 15/03/31
6212 Old Kemp Road
6212 Old Kemp Rd Exit Time/Date Permit Expiration Date
Durham NC 27703 12:55PM 24/08/13 18/07/31
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
Carlos Hernandez,6212 Old Kemp Rd Durham NC 27703H919-697-7668/
No
Section C:Areas Evaluated During Inspection (Check only those areas evaluated)
Permit 0 Operations&Maintenar 0 Effluent/Receiving Wate
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 Docusigned by, DWR/RRO WQ/919-791-4200/
C 9/11/2024
9EC679823B1D478...
Signature of Management Q lwer Agency/Office/Phone and Fax Numbers Date
F��R' neydig
t,SSa f, lit atn 1,d 9/11/2024
EPA Form 3560-3(Rev 9-94)Previous editions are obsolete.
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Docusign Envelope ID: D55E2694-BA13-4BC7-AFEA-4FA02D377F11
NPDES yr/mo/day Inspection Type 1
31 NCG551657 I11 12I 24/08/13 11 7 18 i c i
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
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Docusign Envelope ID: D55E2694-BA13-4BC7-AFEA-4FA02D377F11
Permit: NCG551657 Owner-Facility: 6212 Old Kemp Road
Inspection Date: 08/13/2024 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 septic tank, EZ treeat system w/ UV disinfection and outlet pipe
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? 0 ❑ ❑ ❑
#Are there any special conditions for the permit? ❑ ❑ ■ ❑
Is access to the plant site restricted to the general public? 0 ❑ ❑ ❑
Is the inspector granted access to all areas for inspection? ❑ ❑ ❑
Comment: CEI provide in both English and Spanish. (Also, Tchnical bulletin and permit
provideded in Spanish with this CEI mailout.)
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