NCG550551_Inspection_20190912

DocuSign Envelope ID: 664453D1-CEC4-4831-AFAB-F9D271116872
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 I 2 15 I 3 I NCG550551 111 12 I 19/05/24 I17 18 I S J 19 L G] 201 I
211111 1 1 I I I I II I I I I I I I I I I I I 1 I I I I I I I I I I II I I I I I f6
Inspection
Work Days Facility Self -Monitoring Evaluation Rating 131 QA ---------------------- Reserved -------------------
671
70 I I 71 I I 72 I r I 73 � 74 75I I I I I I I I80
u ty I I
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 oermit Number)
03:10PM 19/05/24
13/08/01
3077 Stoney Creek Drive
3077 Stoney Creek Dr
Exit Time/Date
Permit Expiration Date
Morganton NC 28655
03:35PM 19/05/24
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
Thomas Gerald Clontz,3077 Stoney Creek Dr Valdese NC 28690///
Yes
Section C: Areas Evaluated During Inspection (Check only those areas evaluated)
Permit 0 Operations & Maintenance 0 Records/Reports Facility Site Review
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
Signature of Management Q A Reviewer Agency/Office/Phone and Fax Numbers D\ Date
G. Landon Davidson DWR/ARO WQ/828-296-4500/ 9/12/2019
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete.
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DocuSign Envelope ID: 664453D1-CEC4-4831-AFAB-F9D271116872
NPDES yr/mo/day Inspection Type (Cont.)
NCG550551 I11 121 19/05/24 117 18 ICI
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
On May 24, 2019, Ms. Janet Cantwell with the Division of Water Resources visited this facility.
She noted that the tablet chlorinator and de -chlorinator were present; she did not note if the proper
tablets were in use. She noted the septic tank was pumped —3 years ago. She noted the discharge
pipe was not discharging.
Please submit to this office documentation of the Permit requirements; refer to your Permit for these
requirements such as pumping the septic tank out at least every 5 years, annual sampling, proper
disinfection/de-chlorination tablets. You can send a copy of any documentation you may have such as
the septic hauler bill, the sample results, purchase slip for the chlorine tablets to the address at the
bottom of the letter or to email address: [e-mail].
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DocuSign Envelope ID: 664453D1-CEC4-4831-AFAB-F9D271116872
Permit: NCG550551 Owner - Facility: 3077 Stoney Creek Drive
Inspection Date: 05/24/2019 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
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0
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application?
Is the facility as described in the permit?
0
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# Are there any special conditions for the permit?
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0
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Is access to the plant site restricted to the general public?
0
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Is the inspector granted access to all areas for inspection?
0
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Comment: The permit expired 07/31/2018.
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:
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