NCG550280_Permit (Issuance)_20110720

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NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
July 20, 2011
Ray McCoy & Cornelia Corey
6911 Mendelssohn Drive
Clemmons, North Carolina 27012
Subject: General Wastewater Permit NCG550280—Single Family Residence
6911 Mendelssohn Drive, Clemmons, North Carolina
Forsyth County
Dear Mr. McCoy& Ms. Corey:
Jenny Graznak of the Winston-Salem Regional Office performed a Compliance Evaluation
Inspection on the sandfilter wastewater treatment system at your property located at 6911
Mendelssohn Drive in Clemmons, Forsyth County, North Carolina on July 15, 2011. This type of
inspection consists of two basic parts: a review of self-monitoring data, and an on-site inspection of
the facility and its discharge. You were present during the inspection.
You hold a General Permit to discharge Domestic Wastewaters from Single Family
Residences under the National Pollutant Discharge Elimination System (NPDES). The system has a
chlorinator, consisting of two chlorine tablet feed tubes. You stated that you check the tubes on a
regular basis and add chlorine tablets as needed. The septic tank was last pumped out in 2007.
The effluent from the system discharges to an unnamed tributary to Johnson Creek in the Yadkin
River Basin via step aeration. No discharge was noted during the inspection. The receiving stream
appeared clear with no traceable solids, and no odor was noted on the day of the inspection. You
stated that the pipe does not discharge except during heavy rain events.
Should you ever detect a discharge from your system, permit text Part I Section A (attached
to this correspondence) specifies the limits and monitoring requirements for your permit. A
Laboratory with North Carolina Wastewater Certification (a list of nearby approved laboratories is
attached) must perform the monitoring. As a reminder, the permit also requires that you conduct
and document the following maintenance activities:
• Septic tanks shall be maintained at all times to prevent seepage of sewage
• Septic tanks will be checked at least yearly to determine if solids must be removed
• Septic tanks shall be pumped out within 3-5 years of issuance date of the Permit.
• Contents removed from septic tanks shall be disposed of at a location and in a manner
compliant with all local and state regulations
We appreciate your efforts to comply with your permit requirements. If you have any
questions regarding this letter, please contact Ms. Graznak or me at [phone].
North Carolina Division of Water Quality,Winston-Salem Regional Office
e9
Location:585 Waughtown St.Winston-Salem,North Carolina 27107 One
Phone:[phone] FAX:[phone] Customer Service:1-877-623-6748 NorthCarolina
Internet:www.ncwaterquality.org ;Vat/Ira/1M
An Equal Opportunity 1 Affirmative Action Employer

•
Sincerely,
W. Corey Basinger
Regional Supervisor
Surface Water Protection Section
cc: SWP s<1.rc -Its
SWP—WSRO

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 I NI 2 I SI 31 NCG550280 11 121 11/07/15 117 18I CI 19I SI 201
Remarks
211 ll11IIIIllllllIIII166
Inspection Work Days Facility Self-Monitoring Evaluation Rating B1 QA -------------Reserved-------
67 I 169 701 31 711 I 72 I NI 731 I 174 751 I I I I I I 180
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)
11:00 AM 11/07/15 07/08/01
6911 Mendelssohn Drive
6911 Mendelssohn Dr Exit Time/Date Permit Expiration Date
Clemmons NC 27012 11:30 AM 11/07/15 12/07/31
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
Ray McCoy,6911 Mendelssohn Dr Clemmons NC 27012//336-766-2012/ No
Section C: Areas Evaluated During Inspection(Check only those areas evaluated)
MI 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
Jennifer Graznak WSRO WQ//336-771-5000/ "1/ 0/1
4194
Signature of anagement Q A Reviewer Agency/Office/Phone and Fax Numbers Date
)tte&te't-tr -.1) ,SS1 s-114:) 74) 4.1...-47 7c) (
EPA Form 3560-3(Rev 9-94)Previous editions are obsolete.
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Permit: NCG550280 Owner-Facility: 6911 Mendelssohn Drive
Inspection Date: 07/15/2011 Inspection Type: Compliance Evaluation
Permit Yes No NA NE
(If the present permit expires in 6 months or less). Has the permittee submitted a new application? 0 0 •
Is the facility as described in the permit? ■ n n n
#Are there any special conditions for the permit? n ■ n n
Is access to the plant site restricted to the general public? n n U
Is the inspector granted access to all areas for inspection? ■ n n n
Comment: Mr. McCoy was very familair with the wastewater system, the permit, and
the requirements of the permit.
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