NCG550586_Compliance Evaluation Inspection_20190520

ROY COOPER
Governor
MICHAEL S.REGAN
Secretary
LINDA CULPEPPER NORTH
CAROLINA RECEIVED/NODEQ/DWR
Director Environmental a
MAY 2 0 2019
May 10, 2019 Water Quasection
Permitting
Mrs. Jean Blackwood
1550 Double Creek Dr.
Lewisville, NC 27023
SUBJECT: Compliance Evaluation Inspection
Certificate of Coverage NCG550586
1550 Double Creek Dr.
Forsyth County
Dear Mrs. Blackwood,
On May 9, 2019 Kelli Park, of this office, met with you and performed a Compliance
Evaluation Inspection of the wastewater treatment system located at the above address.
The State requires the Division of Water Resources to inspect these types of systems at
least once every five years. The violations found from the inspection outlined below:
1) The permit is not currently in your name. A name change form was provided to you
at the time of inspection. Please update this immediately.
2) The chlorine you are using is pool grade. Via the permit wastewater grade chlorine
must be added to the system for proper disinfection. Information was shared with
you during the inspection about the appropriate tablets to use. Please begin using
the correct chlorine as soon as possible.
3) The effluent pipe was not visible. It is a permit requirement to know the location of
the pipe and to maintain the area around it at all times. Please locate the effluent
pipe as soon as possible.
4) The effluent water has not been consistently tested by a laboratory. Water samples
from the effluent are required to be analyzed at least once a year by a certified
laboratory. These records are required to be maintained and should be shared with
NCDEQ upon request. A copy of the permit monitoring requirements and the
certified laboratories to do the analysis were given to you at the time of inspection
for reference of what should be monitored when you notice any discharge coming
out of the pipe during the year.
DEQ- North Carolina Department of Environmental Quality I Division of Water Resources
BB!J}///1/1Winston-Salem Regional Office 1450 West Hanes Mill Road,Suite 300 I Winston-Salem.North Carolina 27105
'
\ _ 336.776.9800

5) The permit requires that the septic tank contents be pumped out every 3-5 years
to prevent solids from clogging the sand filter system. It is unknown when the
system was last pumped. Please keep records of septic tank pumping on hand as
a historical record and proof that you had the tank pumped. Please qet it pumped
as soon as possible.
Failure to properly operate and maintain the system can result in expensive repair costs
as well as failure of the system to properly treat the wastewater. If you have any questions
regarding maintenance, operations, the permit, or this inspection do not hesitate to call
us.
Please keep this letter with your records for the system along with copies of invoices from
the Division for the annual permit fee, the Certificate of Coverage, records of septic tank
pumping, maintenance and repair records, etc.
Please be aware that violations of your NPDES permit, or the NC statutes and regulations
under which it is promulgated, are subject to fines of up to $25,000 per day, per violation,
as set forth in NC General Statute (NCGS) 143-215.6A, Enforcement Procedures, Civil
Penalties.
Please contact Miss Park at (336)-776-9689 or [e-mail] if you have any
further questions.
Sincerely,
DocuSigned by:
I -r sMxv
145649E225C94EA...
Lon Snider
Assistant Regional Supervisor
Water Quality Regional Operations
Division of Water Resources
Attachments: EPA Water Compliance Inspection Report
cc: WSRO
NPDES Unit
Page 2 of 2

United States Environmental Protection Agency Form Approved.
E PA 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 LI 2 IS I 3 NCG550586 111 121 19/05/09 117 18 L,. 19 I S I 2011
21I I I I I I I I I I lI l L [ 1 1 1 1 1 I I I I I I 1 1 1 1 1 I I I 111 I I I 1 1 166
Inspection Work Days Facility Self-Monitoring Evaluation Rating B1 QA — Reserved I
671
I 70II I 71 Li
I 72 I i I 73I 1 I74 75I1 l I I I I I 1 I80
Section B: Facility Data
LJ
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:OOAM 19/05/09 13/08/01
1550 Double Creek Drive
Exit Time/Date Permit Expiration Date
1550 Double Creek Dr
12:00PM 19/05/09 18/07/31
Lewisville NC 27023
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
W Art Blackwood,PO Box 606 Lewisville NC 27023//336-945-3969/
No
Section C:Areas Evaluated During Inspection(Check only those areas evaluated)
II Operations&Maintenance IN Effluent/Receiving Waters
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
Kelli A Park WSRO WQ//336-776-9689/
Si to/ iCk
Signature of Management Q A Reviewere—oocusigned by: Agency/Office/Phone and Fax Numbers Date
1-01' T 5MJC 5/10/2019
\---145649E225C94EA...
EPA Form 3560-3(Rev 9-94)Previous editions are obsolete.
Page# 1

NPDES yr/mo/day Inspection Type (Cont.) 1
31 NCG550586 I11 121 19/05/09 117 18 L
Section D:Summary of Finding/Comments(Attach additional sheets of narrative and checklists as necessary)
On May 9, 2019 Kelli Park, of this office, met with you and performed a Compliance Evaluation
Inspection of the wastewater treatment system located at the above address. The State requires the
Division of Water Resources to inspect these types of systems at least once every five years. The
violations found from the inspection outlined below:
1) The permit is not currently in your name.A name change form was provided to you at the time of
inspection. Please update this immediately.
2) The chlorine you are using is pool grade.Via the permit wastewater grade chlorine must be added
to the system for proper disinfection. Information was shared with you during the inspection about the
appropriate tablets to use. Please begin using the correct chlorine as soon as possible.
3) The effluent pipe was not visible. It is a permit requirement to know the location of the pipe and to
maintain the area around it at all times. Please locate the effluent pipe as soon as possible.
4) The effluent water has not been consistently tested by a laboratory. Water samples from the
effluent are required to be analyzed at least once a year by a certified laboratory.These records are
required to be maintained and should be shared with NCDEQ upon request.A copy of the permit
monitoring requirements and the certified laboratories to do the analysis were given to you at the time
of inspection for reference of what should be monitored when you notice any discharge coming out of
the pipe during the year.
5) The permit requires that the septic tank contents be pumped out every 3-5 years to prevent solids
from clogging the sand filter system. It is unknown when the system was last pumped. Please keep
records of septic tank pumping on hand as a historical record and proof that you had the tank pumped.
Please get it pumped as soon as possible.
Failure to properly operate and maintain the system can result in expensive repair costs as well as
failure of the system to properly treat the wastewater. If you have any questions regarding
maintenance, operations, the permit, or this inspection do not hesitate to call us.
Please keep this letter with your records for the system along with copies of invoices from the Division
for the annual permit fee, the Certificate of Coverage, records of septic tank pumping, maintenance
and repair records, etc.
Please be aware that violations of your NPDES permit, or the NC statutes and regulations under which
it is promulgated, are subject to fines of up to $25,000 per day, per violation, as set forth in NC General
Statute(NCGS) 143-215.6A, Enforcement Procedures, Civil Penalties.
Please contact Miss Park at(336)-776-9689 or [e-mail] if you have any further
questions.
Page# 2

• Permit: NCG550586 Owner-Facility: 1550 Double Creek Drive
Inspection Date: 05/09/2019 Inspection Type: Compliance Evaluation
Effluent Pipe Yes No NA NE
Is right of way to the outfall properly maintained? C11100
Are the receiving water free of foam other than trace amounts and other debris? • 0 0 0
If effluent (diffuser pipes are required) are they operating properly? 0 0 • 0
Comment: The effluent pipe was not located
Disinfection-Tablet Yes No NA NE
Are tablet chlorinators operational? • 0 0 ❑
Are the tablets the proper size and type? 0 III ❑ ❑
Number of tubes in use? 1
Is the level of chlorine residual acceptable? 0 0 0 •
Is the contact chamber free of growth, or sludge buildup? ❑ 0 ❑ U
Is there chlorine residual prior to de-chlorination? ❑ 0 ❑
Comment: The chlorine tube was found and chlorine was recently added.The tube is checked monthly.
Pool grade chlorine tablets were being used. Information was provided about what type of
tablets to use.
Operations & Maintenance Yes No NA NE
Is the plant generally clean with acceptable housekeeping? III 0 0 0
Does the facility analyze process control parameters, for ex: MLSS, MCRT, Settleable ❑ 0 • ❑
Solids, pH, DO, Sludge Judge, and other that are applicable?
Comment:
Page# 3