NCG550423_Compliance Evaluation Inspection_20181008

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ROY COOPER NORTH CAROLINA
Governor - Environmental Quality
MICHAEL S.REGAN
Secretary
LINDA CULPEPPER RECEIVED/DI NRIDWR
Interim Director October 8, 2018
OCT 172018
Matthew S. & Theresa K. Bennett
2051 Woodstock Road Water Resources
Permitting lection
Clemmons, NC 27012
SUBJECT: Compliance Evaluation Inspection Follow Up •
NC General Wastewater Permit NCG550000
Certificate of Coverage: NCG550423
Facility: 2051 Woodstock Road, Clemmons, NC 27012
Owner: Matthew S. Bennett
County: Forsyth
Dear Mr. & Mrs. Bennett:
Thank you for contacting Mr. Boone on October 8th, 2018, by phone to follow up on the
inspection of your home's wastewater treatment system. Your cooperation is greatly
appreciated.
You informed Mr. Boone that you do have the septic tank pumped at least every five years
and keep the paperwork on file with the rest of the system documentation.
Mr. Boone reminded you that the permit requires you to have the effluent water tested
once per year. You reminded him that there are three pipes right next to each other at the
stream and you cannot tell which one is yours. You therefore cannot take a representative
sample of your effluent. Please note, we may ask that you have your system dyed at
some point in the future to determine which pipe is yours.
You also informed Mr. Boone that the chlorinator cannot be located, as has been the case
in previous year's inspections. Please also note that If you ever upgrade the system in
the future, you will likely be required to install a chlorinator, dechlorinator, and cascade
aeration at that point.
NORTH caaounud�/
oeoatnom at EnWmnno,,imWld
North Carolina Department of Environmental Quality I Division of Water Resources
Winston-Salem Regional Office I 450 Hanes Mill Road,Suite 300 I Winston-Salem,North Carolina 27103
336.776.9800

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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 -1IN I 2 IS LI 3 I NCG550423 111 12 I 18/10/08 117 18 I�.I 19 201 I
211111111111111111 ( 1111111111111111111111111P6
Inspection Work Days Facility Self-Monitoring Evaluation Rating B1 QA Reserved
671 I 70 I
I 71 Li 72 I N I 731 1 174 7511 1 1 1 1 1 1 180
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) 01 24PM 18/10/08 13/08/01
2051 Woodstock Road
Exit Time/Date Permit Expiration Date
2051 Woodstock Rd
01 30PM 18/10/08 18/07/31
Clemmons NC 27012
Name(s)of Onsite Representative(s)/Titles(s)/Phone and Fax Number(s) Other Facility Data
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Name,Address of Responsible Official/Title/Phone and Fax Number
Contacted
Matthew Bennett,2051 Woodstock Rd Clemmons NC 27012/1/
No
Section C Areas Evaluated During Inspection(Check only those areas evaluated)
II 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
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Ron Boone WSRO WQ//336-776-9690/
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/ - py,- // s.
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Signature of Management Q A Reviewer Agency/Office/Phone and Fax Numbers Date
EPA Form 3560-3(Rev 9-94)Previous editions are obsolete
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' Owner-Facility: 2051 Woodstock Road
Permit: NCG550423 tY
Inspection Date: 10/08/2018 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 0 0 • 0
application?
Is the facility as described in the permit'? • 0 0 0
#Are there any special conditions for the permit'? 0 • 0 0
Is access to the plant site restricted to the general public? • 0 0 0
Is the inspector granted access to all areas for inspection'? • 0 0 0
Comment None
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