WQCS00033_Compliance Evaluation Inspection_20190326

r
J �M
ROY COOPER
Governor =`
11
MICHAEL S.REGAN ,
Secretary
LINDA CULPEPPER NORTH CAROLINA
Director Environmental Quality
March 26, 2019
Mrs. Barbara Jones, City Manager RED "/��DENRI®WR
City of Mount Airy
P.O. Box 70 APR 29 2019
Mount Airy, NC 27030
Water K;jources_
Subject: Compliance Evaluation Inspection Summary Letter Pormitii'ng Section
Permittee: City of Mount Airy
Facility: Mount Airy Wastewater Collection System
Permit#: 'WQCS00033
Surry County
Dear Mrs. Jones:
1. Gary Hudson of the Winston-Salem Regional Office of the NC Division of Water
Resources (DWR or the Division) conducted a compliance evaluation inspection (CEI)
of the Mount Airy wastewater collection system (WWCS) on February 28, 2019. The
assistance and cooperation of Ricky Dean, ORC, Jimmy Hodges and Daniel Jefferson
was greatly appreciated. An inspection checklist is attached for your records and
inspection findings are summarized below.
Site/System Review
2. As you are aware,,your permit contains numerous requirements with which the City must
comply. Your compliance status with each of these requirements is summarized below:
Part I, Performance Standards
a. Part I, Paragraph 2: The wastewater collection system shall be effectively managed,
maintained and operated at all times so that there is no SSO to land or surface waters,
nor any contamination of groundwater. In the the event that the wastewater collection
system fails to perform satisfactorily, including the creation of nuisance conditions, the
Permittee shall take immediate corrective actions, including actions that may be required
by the Division of Water Resources (Division), such as the construction of additional or
replacement sewer lines and/or equipment.
D QQ'
North Carolina Department of Environmental Quality I Division of Water Resources
Winston-Salem Regional Office 1 450 Hanes Mill Road.Suite 3001 Winston-Salem,North Carolina 27105
NOgTH CAHOIINA �
336.776.9800

Observations: In full consideration of all observations made during the inspection, as
reflected in paragraph 2 above, as well as in -the following -paragraphs, the Mount Airy
wastewater collection system is hereby deemed compliant with this permit condition.
Compliance Status: Compliant.
b. Part I. Paragraph 3: The Permittee shall establish by ordinance its legal authority to
require new sewers be properly constructed; to ensure proper, inspection and testing of .
sewer mains and service laterals; to address flows from satellite systems and to take
enforcement action as required by Condition 1(4).
Observations: The City of Mount Airy's sewer use ordinance (SUO) was reviewed in
detail and found to meet all minimum requirements.
Compliance Status: 'Compliant
c. Part I. Paragraph 4: The Permittee shall develop and implement an educational fats,
oils and grease program targeted at both residential and non-residential users. The
Permittee shall also develop and implement an enforceable fats, oils and grease
program for ,non-residential users under which the Permittee can take enforcement
against users who have not properly installed, operated and maintained grease traps or
grease interceptors as directed or otherwise violated the terms of the local ordinance
pertaining to fats, oils and grease.
Observations: The City's grease ordinance and Fats, Oils and Grease (FOG)
educational program was reviewed in detail and found to meet all minimum requirements.
Educational flyers are distributed twice per year as required. The City of Mount Airy has
developed and implemented an enforceable fats, oils and grease program for non-
residential users under which the Permittee can take enforcement actions against users
who have not properly installed, operated and maintained grease traps or grease
interceptors as directed or otherwise violated the terms of the local ordinance pertaining
to fats, oils and grease.
Compliance Status: Compliant
d. Part I. Paragraph 5: The Permittee shall adopt and implement a Capital Improvement
Plan (CIP) to designate funding for reinvestment into the wastewater collection system
infrastructure. The CIP should address the short-term needs and long-term "master
plan" concepts. The CIP should typically cover a three to five-year. period and include a
goal statement, description , of the project area, description of the existing facilities,
known deficiencies (over a reasonable period) and forecasted future needs. Cost
analysis is integral to the CIP.
Observations: The City of Mount Airy's CIP was reviewed in detail and found to meet
most of the minimum requirements.
Compliance Status: Compliant.

e. Part I, Paragraph 6: Existing overflow piping from manholes and pump stations,
excluding piping to approved equalization structures, known or discovered after permit
issuance shall 'be immediately removed or permanently capped. Plugged emergency
.pumping connections are allowable for portable pumping or rerouting without
intentionally bypassing the wastewater treatment facility.
Observations: No such overflows were identified during the inspection and the
operators stated that they believed none exist.
Compliance Status: Compliant
f. Part I, Paragraph 7: The Permittee shall maintain a contingency plan for pump failure
at each pump station. If one of the pumps in a pump station containing multiple pumps
fails, the process of repairing or replacing the pump shall be initiated immediately and
the new parts or pump shall be installed as soon as possible. If the pump in a simplex
pump station fails, it shall be replaced immediately.
Observations: Pump station contingency plans were reviewed in detail. The City of
Mount Airy was found to be fully compliant with this condition.
Compliance Status: Compliant.
g. Part I, Paragraph 8: Each pump station shall be clearly and conspicuously posted with
a pump station identifier and an emergency contact telephone number at which an
individual who can initiate or perform emergency service for the wastewater collection
system 24 hours per day, seven days per week can be contacted. This emergency
contact telephone number shall be coupled with instructions that the emergency contact
should be called if the visual alarm illuminates, if the -audible alarm sounds, or if an
emergency is apparent.
Observations: The pump station inspected had the required signage and Mr. Dean
stated that the other stations also have the same type of signage.
Compliance Status: Compliant
h. Part 1, Paragraph 9: Pump station sites, equipment and components shall have
restricted access, per 15A NCAC 2H .0219(h)(7).
Observations: The pump station inspected was sufficiently secured to provide
restricted access. Mr. Dean stated that the other station was also sufficiently secured.
Compliance -Status: Compliant.
Part I, Paragraph 10: Pump stations that do not employ an automatic polling feature
(i.e. routine contact with pump stations from a central location to check operational status
of the .communication system) shall have both audible and visual high-water alarms.
The alarms shall be weather-proof and placed in a clear and conspicuous location.
Permits issued for the construction of pump stations that included high water alarms in

the description must maintain the alarms even if simple telemetry (i.e. notification of an
alarm condition initiated by the pump station control feature) is installed.
Observations: The pump station inspected had operational and conspicuous audible
and visual alarms, as well as telemetry.. Mr. Dean stated that all four stations are
checked several days- per week.
Compliance Status: Compliant.
j. Part I. Paragraph 11: For all newly constructed, modified and rehabilitated pump
stations, all equipment and components located within the pump station shall be
corrosion -resistant and components in close proximity of the pump station shall be
sealed within a corrosion -resistant coating or encasement.
Observations: The City of Mount Airy is fully compliant with this permit requirement.
Compliance Status: Compliant.
k. Part I. Paragraph 12: All construction and rehabilitation of the wastewater collection
system (i.e., permitted or deemed permitted) shall be scheduled to minimize the
interruption of service by the existing utilities. Construction and rehabilitation shall not
result in the violation of Condition 1.2. of this permit.
Observations: No conditions that demonstrate noncompliance with this permit
condition were noted during the inspection. Mr. Dean stated that all such activities are
executed in such a manner as to avoid interruption of existing utility services or cause
sanitary sewer overflows (SSO).
Compliance Status: Compliant.
Part II. Operation and Maintenance Requirements
Part II, Paragraph 1: Upon classification of the collection system by the Water Pollution
Control System Operators Certification Commission (WPCSOCC), the Permittee shall
designate and employ a certified operator to be in responsible charge (ORC) and one
or more certified operator(s) to be back-up ORC(s) of the facilities' in accordance with
15A NCAC 8G .0201. The ORC shall visit the system within 24 hours of knowledge of
a bypass, spill, or overflow of wastewater from the system, unless visited by the Back -
Up ORC, and shall comply with all other conditions of 15A NCAC 8G .0204.
Observations: The ORC and backup ORCs have been properly designated as required
Compliance Status: Compliant.
m. Part II, Paragraph ,2: The Permittee shall develop and adhere to a schedule for
reviewing all inspection, maintenance, operational and complaint logs. If the review
process results in the identification of any recurring problem in the wastewater collection
system that cannot be resolved in a short time period, the Permittee shall establish a
plan for addressing the problem(s).

Observations: The ORC reviews all such logs on a weekly basis and have developed
written plans for identified recurring problems.
Compliance Status: Compliant.
n. Part II, Paragraph 3: The Permittee shall develop and adhere to a schedule for testing
emergency and standby equipment.
Observations: Generators, pumps, sewer cleaning equipment, etc, are inspected on a
monthly basis, if not used more often. Records of testing activities are also kept by
Water treatment plant personnel.
Compliance Status: Compliant
o. Part II, Paragraph 4: The Permittee shall develop and implement a routine pump station
inspection and, maintenance program, which shall include, but not be limited to, the
following maintenance activities:
1. Cleaning and removing debris from the pump station structure, outside perimeter,
and wet well;
2. Inspecting and exercising all valves;
3. - Inspecting and lubricating pumps and other mechanical equipment according to
the manufacturer's recommendations; and
4. Verifying the proper operation of the alarms, telemetry system and auxiliary
equipment.
Observations: The pump station inspection/maintenance program includes all the
above minimum items.
Compliance Status: Compliant.
p. Part II, Paragraph 5: For each pump station without pump reliability. (i.e. simplex pump
stations- serving more than a single building or pump stations not capable of pumping at
a rate of 2.5 times the average daily flow rate with the largest pump out of service), at
least one fully operational spare pump capable'of pumping peak flow shall be maintained
on hand.
Observations: The City of Mount Airy has no simplex pump stations.
Compliance Status: Compliant.
q. Part II, Paragraph 6: The Permittee shall maintain on hand at least two percent of the
number of pumps installed, but no less than two pumps, that discharge to a pressure
sewer and serve a single building, unless the Permittee has the ability to purchase and
install a replacement pump within 24 hours of first knowledge of the simplex pump failure
or within the storage capacity provided in any sewer line extension permit.
Observations: This permit condition was not evaluated due to time constraints.
Compliance Status: Not Evaluated.

Part II, Paragraph 7: Right-of-ways and/or easements shall be properly, maintained to
allow accessibility to the wastewater collectionsystem unless the Permittee can,
demonstrate the ability to gain temporary access in an emergency situation where
existing land -use conditions do not allow the establishment and maintenance of
permanent access. In this case, the Permittee shall continue to observe the lines
visually, utilize remote inspection methods (e.g. CCTV) and use the opportunity of drier
conditions to perform further inspections and necessary maintenance.
Observations: All right-of-ways (ROW) evaluated during the inspection were properly
maintained.
Compliance Status: Compliant.
Part II, Paragraph 8: The Permittee shall assess cleaning needs and develop and
implement a program for appropriately cleaning, whether by hydraulic or mechanical
methods, all sewer lines. At least 10 percent of the wastewater collection system,
selected at the discretion of the ORC, shall be cleaned each year. Preventative cleaning
is not required for sewer lines less than five years old. unless inspection otherwise
reveals the need for cleaning or cleaning is required by a sewer line extension permit.
Observations: The sewer line -cleaning program has been fully developed and
implemented. Line cleaning efforts over the last year have resulted in approximately 10
percent of the system being cleaned. All records are complete, current and were readily
available for inspection.
Compliance Status: Compliant.
t. Part Il, Paragraph 9: Adequate measures shall be taken to contain and properly
dispose of materials associated with SSOs. The Permittee shall maintain a Response
Action Plan that addresses the following minimum items:
1. Contact phone numbers for 24-hour response, including weekends and holidays;
2. Response time;
3. Equipment list and spare parts inventory;
4. Access to cleaning equipment;
5. Access to construction crews; contractors and/or engineers;
6. Source(s) of emergency funds;
7. Site sanitation and clean up materials; and
8. Post-SSO assessment.
Observations: The Sanitary Sewer Overflow (SSO) Response Action Plan (RAP)
includes all the above minimum items. All measures necessary to contain and properly
dispose of SSO materials are employed for all SSOs.
Compliance Status: Compliant.
u. Part II, Paragraph 10: The Permittee, or their authorized representative, shall conduct
an on -site evaluation for all SSOs as soon as possible, but no more than two hours after
first knowledge of the SSO.

Observations: The ORC or one of the BORCs normally responds to every SSO within
two hours. Records demonstrating this are kept through the city's database where
emergency response calls are normally reported. • The records in this database
specifically for SSOs are printed and kept in the SSO record binder in the ORC's office
along with the required 5-day reports, press releases and public notices, as necessary.
Compliance Status: Compliant.
v. Part II, Paragraph 11: In the event of a SSO ' or blockage within the wastewater
collection system, the Permittee shall restore the system operation, remove visible solids
and paper, sanitize any ground area and restore the surroundings.
Observations: No conditions were noted that demonstrate noncompliance with this
permit condition. The RAP details all steps taken to respond to an SSO, from the initial
report to the final 5-day report. The RAP containment, cleanup and system restoration
procedures are quite detailed and considered sufficient to address all SSOs.
Compliance Status: Compliant.
Part III, Records
W. Part III, Paragraph 1: Records shall be maintained to document compliance with
Conditions 1(4), II(2) - 11(4), 11(7) - 11(8), IV(3) and V(1) -V(4). Records shall be kept on
file for a minimum of three years.
Observations: All required records were readily available for inspection and were found
to be complete, accurate and current.
Compliance Status: Compliant.
x. Part Ill, Paragraph 2: The Permittee shall maintain adequate records pertaining to
S'SOs, and complaints for a minimum of three years. These records shall include, but
are not limited to, the following information:
1. Date of SSO or complaint;
2. Volume of wastewater released as a result of the SSO and/or nature of complaint;
3. Location of the SSO and/or complaint;
4. Estimated duration of the SSO;
5. Individual from the Division who. was informed about the SSO and/or complaint,
when applicable;
6. Final destination of the SSO;
7. Corrective actions;
8. Known environmental/human health impacts resulting from the SSO; and
9. How the SSO was discovered.
Observations: All required SSO/Complaint records were readily available for
inspection and were found to be complete, accurate and current.
Compliance Status: Compliant.

y. Part Ill, Paragraph 3: The Permittee shall maintain an up-to-date, accurate,
comprehensive map of its wastewater collection system that also notes the locations
where other wastewater collection systems become tributary. If a comprehensive map
of the collection system has not been established, a rough sketch shall be drawn. The
Permittee shall map approximately 10 percent of its existing collection system each year
for the next ten years, or until complete, whichever is sooner. The comprehensive map
shall include, but is not limited to: pipe size, pipe material, pipe location, flow direction,
approximate pipe age, number of active service taps, and each pump station
identification, location and capacity.
Observations: The, system map was reviewed in detailed and found to be accurate,
comprehensive and current. It contained all the required minimum information as
detailed above.
Compliance Status: Compliant.
z. Part III, Paragraph 4: The Permittee shall maintain records of all of the modifications
and extensions to the collection system permitted herein. The Permittee shall maintain
a copy of the construction record drawings and specifications for
modifications/extensions to the wastewater collection system for the life of the
modification/extension. Information concerning the extension shall be incorporated into
the map of the wastewater collection system within one year of the completion of
construction. The system description contained within this permit shall be updated to
include this modification/extension information upon permit renewal.
Observations: Mr. Dean has developed an excellent record keeping system. All such
records are maintained and incorporated into the system map as required.
Compliance Status: Compliant
Part IV, Monitoring and Reporting Requirements
aa. Part IV, Paraaraph 2: The Permittee shall verbally report to a Division of Water
Resources staff member at the Winston-Salem Regional Office, at telephone number
[phone] as soon as possible, but in no case more than 24.hours following the
occurrence or first knowledge of the occurrence of either of the following:
1. Any SSO and/or spill over 1,000 gallons; or ,
2. Any SSO and/or spill, regardless of volume, that reaches surface water.
Observations: The permittee reports all SSOs as required by the permit.
Compliance Status: Compliant.
bb. Part IV, Paragraph 3: The Permittee shall meet the annual reporting and notification
requirements provided in North Carolina General Statute §143-215.1C.
Observations: The permittee develops and distributes an annual compliance report to
all users of the system. ,
Compliance Status: Compliant.

Part V. Inspections
cc. Part V. Paragraph 1: The Permittee or the Permittee's designee shall inspect the
wastewater collection system regularly to reduce the risk of malfunctions and
deterioration,_ operator errors, and other issues that may cause or lead to the release of
wastes to the environment, threaten human health or create nuisance conditions. The
Permittee shall keep an inspection log or summary including, at a minimum, the date
and time of inspection, observations made, and any maintenance, repairs, or corrective
actions taken by the Permittee.
Observations: All collection system components have been completely inventoried and
inspection and maintenance schedules developed for every component. Completed
work order logs are kept as required in the ORC's office.
Compliance Status: Compliant
dd. Part V, Paragraph 2: Pump stations without Supervisory Control and Data Acquisition .
(SCADA) systems or telemetry shall be inspected everyday (i.e. 365 days per year).
Pump stations equipped with SCADA systems or telemetry shall be -inspected at least
once per week.
Observations: It is our understanding that all four pump stations have telemetry and
are checked several times per week.
Compliance Status: Compliant.
ee. Part V, Paragraph 3: A general observation of the entire collectionl"sys'tem`shalfte
performed throughout the course of every year.
Observations: A general observation of the entire collection system is performed each
year. Operators specifically concentrate on those obscure areas of the system that are
not normally be seen by either them or the general public during the course of the year.
The observations are recorded. Records of these inspections were complete, current
and readily available for inspection.
Compliance Status: Compliant.
ff. Part V. Paragraph 4: Inspections of all high priority lines (i.e. aerial line, sub -waterway
crossing, line contacting surface waters, siphon, line positioned parallel to stream banks
that are subject to eroding in such a manner that may threaten the sewer line, or line
designated as high -priority in a permit) shall be performed at least once per every six
month period of time. New high priority lines installed or identified after permit issuance
are incorporated by reference and subject to this permit condition until permit renewal -
where they shall be referenced in writing.
Observations: All high priority lines (HPL) have been identified and are inspected as
required. The inspections are recorded as required. The City is currently re-evaluating
the list of high priority lines and incorporating them into the new work order system data
base.
Compliance Status: Compliant

3. Mr. Dean -and his staff have done an excellent job of developing and implementing their
WWCS program. The Division thanks -the City of Mount Airy for their efforts in managing its
collection system and for their part in safeguarding the natural resources of North Carolina
for future generations. If you or Mr. Dean has any questions regarding the inspection or this
letter, please call Gary Hudson or me at (W6) 776-9800.
Sincerely,
11"EmcwEa..
Lon Snider .
Assistant Regional Supervisor
Water Quality Regional Operations
Division of Water Resources
cc: Jeff Boyles, Public.Services Director
WSRO — SWP
Central Files
RBRdS nits

Compliance Inspection Report
Permit: WQCS00033 Effective: 05/01/15 Expiration: 04/30/23 Owner: City of Mount Airy
SOC: Effective: Expiration: Facility: Mount Airy Collection System
County: Surry 300 S Main St
Region: Winston-Salem
Mount Airy NC 270300070
Contact Person: Travis James King Title: Utilities Maintenance Supervisor Phone: [phone]
Directions to Facility:
System Classifications: CS2,
Primary ORC: Ricky George Dean
Secondary ORC(s):
On -Site Representative(s):
Related Permits:
NCO021121 City of Mount Airy - Mount Airy WWTP
Inspection Date: 02/28/2019 Entry Time: 09:OOAM
Primary Inspector: Gary Hudson
Secondary Inspector(s):
Certification: - 987503 Phone: [phone]
Exit Time: 11:OOAM
Phone: [phone]
Reason for Inspection: Routine Inspection Type: Collection System Inspect Non Sampling
J
Permit Inspection Type: Collection system management and operation
Facility Status: Compliant ❑ Not Compliant
Question Areas:
Miscellaneous Questions Performance Standards Operation & Maint Reqmts
Records Monitoring & Rpting Reqmts Inspections
Pump Station
(See attachment summary)
Page 1 of 6

Permit: WQCS00033 Owner - Facility: City of Mount Airy
Inspection Date: 62/28/2019 Inspection Type : Collection System Inspect Non Sampling . ' Reason for Visit: Routine
Inspection Summary:
Page 2 of 6

Permit: WQCS00033 Owner - Facility: City of Mount Airy
Inspection Date: 02/28/2019 Inspection Type: Collection System Inspect Non Sampling Reason for Visit: Routine
Performance Standards
Is Public Education Program for grease established and documented?
What educational tools are used?
Is Sewer Use Ordinance/Legal Authority available?
Does it appear that the Sewer Use Ordinance is enforced?
Is Grease Trap Ordinance available?
Is Septic Tank Ordinance available (as applicable, i.e. annexation)
List enforcement actions by permittee, if any, in the last 12 months
Has an acceptable Capital Improvement Plan (CIP) been implemented?
Does CIP address short term needs and long term \"master plan\" concepts?
Does CIP cover three to five year period?
Does CIP include Goal Statement?
Does CIP include description of project area?
Does CIP include description of existing facilities?
Does CIP include known deficiencies?
Does CIP include forecasted future needs?
Is CIP designated only for wastewater collection and treatment?
Approximate capital improvement budget for collection system?
Total annual revenue for wastewater collection and treatment?
CIP Comments
Is system free of known points of bypass?
If no, describe type of bypass and location
Is a 24-hour notification sign posted at ALL pump stations?
# Does the sign include:
Instructions for notification?
Pump station identifier?
24-hour contact numbers
If no, list deficient pump stations
# Do ALL pump stations have an "auto polling" feature/SCADA?
Number of pump stations
Number of pump stations,that have SCADA
Number of pump stations that have simple telemetry
Yes No NA NE
❑ ❑ ❑
❑ ❑ ❑
❑ ❑ ❑
❑ ❑ ❑
■❑❑❑
■❑❑❑
0❑❑❑
■❑❑❑
❑❑❑■
❑ ❑ ❑
• ❑ ❑ ❑
• ❑ ❑ ❑
■❑❑❑
❑ ❑ ❑
■❑❑❑
❑ ❑ ❑
■❑❑❑
❑ ❑ ❑
M ❑ ❑ ❑
❑■❑❑
4
0
4
Page 3 of 6

Permit: WQCS00033 Owner - Facility: City of Mount Airy
Inspection Date: 02/28/2019 Inspection Type : Collection System Inspect Non Sampling
Number of pump stations that have only audible and visual alarms
Number of pump stations that do not meet permit requirements
# Does the permittee have a root control program?
# If yes, date implemented?
Describe:
Comment:
Inspections
Are maintenance records for sewer lines available?
Are records available that document pump station inspections?
Are SCADA or telemetry equipped pump stations inspected at least once a week?
Are non-SCADA/telemetry equipped pump stations inspected every day?
Are records available that document citizen complaints?
# Do you have a system to conduct an annual observation of entire system?
# Has there been an observation of remote areas in the last year?
Are records available that document inspections of high -priority lines?
Has there been visual inspections of high -priority lines in last six months?
Comment:
Operation & Maintenance Requirements
Are all log books available?
Does supervisor review all log books•on a regular basis?
Does the supervisor have plans to address documented short-term problem areas?
What is the schedule for reviewing inspection, maintenance, & operations logs and problem areas?
Weekly
Are maintenance records for equipment available?
Is a schedule maintained for testing emergency/standby equipment?
What is the schedule for testing emergency/standby equipment?
Do pump station logs include:
Inside and outside cleaning and debris removal?
Inspecting and exercising all valves?
Inspecting and lubricating pumps and other equipment?
Inspecting alarms, telemetry and auxiliary equipment?
Is there at least one spare pump for each pump station w/o pump reliability?
Are maintenance records for right-of-ways available?
Are right-of-ways currently accessible in the event of an emergency?
Are system cleaning records available?
Has at least 10% of system been cleaned annually?
Reason for Visit: Routine
0
0
❑❑❑■
Yes No NA NE
■❑❑❑
■❑❑❑
❑ ❑ ❑
❑ ❑ N ❑
■❑❑❑
❑ ❑ ❑
■❑❑❑
❑ ❑ ❑
❑ ❑ ❑
Yes No NA NE
• ❑ ❑ ❑
■ ❑ ❑ ❑ J
• ❑ ❑ ❑
• ❑ ❑ ❑
■❑❑❑
Page 4 of 6

Permit: WQCS00033 Owner - Facility: City of Mount Airy -
Inspection Dater 02/28/2019 Inspection Type : Collection System Inspect Non Sampling
Reason for Visit: . Routine
What areas are scheduled for cleaning in the next 12 months?
Is a Spill Response Action Plan available?
0, ❑ ❑ ❑
Does the plan include:
24-hourcontact numbers
0 ❑ ❑ ❑
Response time
0 ❑ ❑ El
Equipment list and spare parts inventory
❑ ❑ ❑
Access to cleaning equipment
0 ❑ ❑ ❑
Access to construction crews, contractors, and/or engineers
0 ❑ ❑ ❑
Source of emergency funds
❑ ❑ ❑ N
Site sanitation and cleanup materials
N ❑ ❑ ❑
Post-overflow/spill assessment
E ❑ ❑ ❑
Is a Spill Response Action Plan available for all personnel?
E ❑ ❑ ❑ '
Is the spare parts inventory adequate?
❑ ❑ ❑ E
Comment: _
Records
Yes No NA NE
Are adequate records of all SSOs, spills and complaints available?
❑ ❑ ❑
Are records of SSOs that are under the reportable threshold available?
E ❑ ❑ ❑
Do spill records indicate repeated overflows-(2 or more in 12 months) at same location?
❑ 0 ❑ ❑
If yes, is there a corrective action plan?
❑ ElEl
Is a map of the system available?
0 ❑ ❑ ❑
Does the map include:
Pipe sizes
E ❑ ❑ ❑
Pipe materials
M ❑ ❑ ❑
Pipe location
E ❑ ❑ ❑
Flow direction
0 ❑- ❑ ❑
Approximate pipe age
0 ❑ ❑ ❑
Number of service taps
E ❑ ❑ ❑
Pump stations and capacity
N ❑ ❑ ❑
If no, what percent is complete?
95%
List any modifications and extensions that need to be added to the map
# Does the permittee have a copy of their permit?
❑ 1111
Comment: _
Monitoring and Reporting Requirements Yes No NA NE
Are copies of required press releases and distribution lists available? 0 ❑ ❑ ❑
Are public notices and proof of publication available? 0 ❑ ❑ ❑
Page 5 of 6

Permit: WQCS00033 Owner - Facility: City of Mount Airy
Inspection Date: 02/28/2019' Inspection Type : Collection System Inspect Non Sampling Reason for Visit: Routine
# Is an annual report being prepared in accordance with G.S. 143-215.1 C? ❑
# Is permittee compliant with all compliance schedules in the permits? ❑ ❑
If no, which one(s)?
Comment: -
Page 6 of 6