WQCS00149_Regional Office Historical File Pre 2018 (3)

ROY COOPER
Governor
MICHAEL S. REGAN
Secrefnn•
S. DANIEL SMITH
Director
NORTH CAROLINA
Environmental Quality
CERTIFIED MAIL #: 7018 0360 0002 2099 6876
RETURN RECEIPT REQUESTED
June 25, 2020
Donald V Chamblee, Director Public Works of
Lincoln County
115 W Main St
Lincolnton, NC 28092
SUBJECT: NOTICE OF VIOLATION
Tracking Number: NOV-2020-DV-0292
Sanitary Sewer Overflows - May 2020
Collection System Permit No. WQCS00149
E Lincoln County Collection System
Lincoln County
Dear Mr. Chamblee:
The self -reported Sanitary Sewer Overflow (SSO) S-Day Report submitted by Lincoln County indicates violations of
permit conditions stipulated in the subject permit and North Carolina G.S. 143-215.1. Violations include failing to
effectively manage, maintain, and operate the subject collection system so that there is no SSO to the land or
surface waters and making an outlet to waters of the State for purposes of G.S. 143-215.1(a)(1), for which a
permit is required.
Specific incident(s) cited in the subject report include the following:
Total Vol
Total Surface
Incident Start Duration Vol Water
Number Date (Minn) Location Cause (Gals) (Gals) DWR Action
202001701 5/29/2020 94 4218 Ashehollow Lane Other 600 600 Notice of Violation
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Remedial actions, if not already implemented, should be taken to correct the above noncompliance. Please submit
a written response to this Notice of Violation. Your response is to be received by the regional office within 15
business days following receipt of this violation. Please include any additional documentation about this incident(s)
in the response. The submittal will be considered in determining whether the Division will assess a civil penalty for
the cited violations.
If you have any questions, please do not hesitate to contact Michael Meilinger or me with the Water Quality Section
in the Mooresville Regional Office at 704-6671-t6A9 or via email at michael.meilinQer(o--)ncdenr-.gov or
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Division of Water Resources
ffichState of North Carolina asee
Department of Environment and Natural Resources
Division of Water Resources
Collection System Sanitary Sewer Overflow Reporting Form
Form CS-SSO
PART I:
This form shall be submitted to the appropriate DWR Regional Office within five business days of the first knowledge of the
sanitary sewer overflow (SSO). RECcIVED/NCDENR/DWR
Permit Number: WQCS00149 (WQCS# if active, otherwise use WQCSD#) ��N t (-
Facility: Lincoln County Sewer System Incident #: Owner: Lincoln County
Region: Mooresville City: Denver County: Lincoln WQROS
MOORESVILLE REGIONAL OFFICE
Source of SSO (check applicable): ® Sanitary Sewer ® Pump Station / Lift Station
SPECIFIC location of the SSO (be consistent in description from past reports or documentation - 1,e. Pump
Station 6, Manhole at Westall & Bragg Street, etc.): 4218 Ash Hollow
Manhole #:
Latitude (degrees/minute/second): 35 31'42.47" N Longitude (degrees/minute/second): 80 58' 21.55"W
Incident Started Dt: 05-29-2020 Time: 4:01 pm Incident End Dt: 5-29-2020 Time: 6:35 pm
(mm-dd-yyyy) (hh:mm) AM/PM (mm-dd-yyyy) (hh:mm) AM/PM
Estimated volume of the SSO: 600 gallons Estimated Duration (round to nearest hour): 2 hour(s)
Describe how the volume was determined: Visual observation of the amount of flow mulitpied by the time
Weather conditions during the SSO event: clear
Did the SSO reach surface waters? ® Yes ❑ No ❑ Unknown
Volume reaching surface waters: 600 gallons Surface water name: unnamed tributary of Lake Norman
Did the SSO result in a fish kill? ❑ Yes ® No ❑ Unknown
If Yes, what is the estimated number of fish killed?
SPECIFIC cause(s) of the SSO:
❑Severe Natural Conditions ❑ Grease
❑Pump Station Equipment Failure ❑ Power Outage
®Other (Please explain in Part II)
❑Roots [-]Inflow & Infiltration
❑Vandalism ❑ Debris in line ❑Pipe Failure (Break)
24-hour verbal notification (name of person contacted): Jerry Belcher
❑DWR ®Emergency Management Date (mm-dd-yyy): 5-29-2020 Time: (hh:mm AM/PM): 7:23 pm
Per G.S. 143-215.1 C(b), the owner or operator of any wastewater collection system shall:
In the event of a discharge of 1,000 gallons or more of untreated wastewater to the surface waters of the State, issue
a press release to all print and electronic news media that provide general coverage in the county where the
discharge occurred setting out the details of the discharge. The press release shall be issued within 24 hours after
the owner or operator has determined that the discharge has reached surface waters of the State.
In the event of a discharge of 15,000 gallons or more of untreated wastewater to the surface waters of the State,
publish a notice of the discharge in a newspaper having general circulation in the county in which the discharge
occurs and in each county downstream from the point of discharge that is significantly affected by the discharge. The
Regional Office shall determine which counties are significantly affected by the discharge and shall approve the form
and content of the notice and the newspapers in which the notice is published.
WHETHER OF NOT PART II IS COMPLETED, A SIGNATURE IS REQUIRED SEE PAGE 13
Form CS-SSO Page I

In order to submit a claim for justification of an SSO, you must use Part II of form CS-SSO with additional documentation as
necessary. DWR staff will review the justification claim and determine if enforcement action is appropriate.
PART II:
ANSWER THE FOLLOWING QUESTIONS FOR EACH RELATED CAUSE CHECKED IN PART I OF THIS FORM AND
INCLUDE THE APPROPRIATE DOCUMENTATION AS REQUIRED OR DESIRED
COMPLETE ONLY THOSE SECTONS PERTAINING TO THE CAUSE OF THE SSO AS CHECKED IN PART
(In the check boxes below, NA = Not Applicable and NE = Not Evaluated)
A HARDCOPY OF THIS FORM SHOULD BE SUBMITTED TO THE APPROPRIATE DWR REGIONAL OFFICE UNLESS
IS HAS BEEN SUBMITTED ELECTRONICALLY THROUGH THE ONLINE REPORTING SYSTEM
Form CS-SSO Page 2

Severe Natural Conditions (hurricane, tornado etc.)
Describe the "severe natural condition" in detail:
Mow much advance warning did you have and what actions were taken in preparation for the event?
Comments:
Porin CS-SSO rage 3

Grease (Documentation such as cleaning inspection enforcement actions past overflow reports educational
material and distribution date etc. should be available upon request.)
When was the last time this specific line (or wet well) was cleaned?
Do you have an enforceable grease ordinance that requires new or retrofit of
grease trapsfinterceptors? ❑ Yes ❑ No ❑ NA ❑ NE
Have there been recent inspection and/or enforcement actions taken on near-
by restaurants or other nonresidential grease contributors? ❑ Yes ❑ No ❑NA ❑ NE
Explain:
Have there been other SSOs or blockages in this areas that were also caused
by grease ❑ Yes ❑ No ❑NA ❑ NE
When?
If yes, describe them:
Have cleaning and inspections ever been done at this location?
Explain.
Have educational material about grease been distributed in the past?
When:
and to whom:
❑ Yes ❑ No ❑NA ❑ NE
❑ Yes
Explain:
If the SSO occurred at a pump station, when was the wet well and pumps last checked
for grease accumulation:
Were the floats clean?
Comments:
❑ Yes
❑ No ❑NA ❑ NE
❑ No ❑NA ❑ NE
Form CS-SSO Page 4

Roots
Do you have an active root control program on the line / area in question? ❑ Yes ❑ No ❑NA ❑ NE
Describe:
Have cleaning and inspections ever been increased at this location because
of roots? ❑ Yes ❑ No ❑NA ❑ NE
Explain:
What corrective actions have been accomplished at the SSO location (and
surrounding system if associated with the SSO)?
What corrective actions are planned at the SSO location to reduce root intrusion?
Has the line been smoke tested or videoed within the past year? ❑ Yes ❑ No ❑NA ❑ NE
If Yes, when?
Comments;
Form CS-SSO Page 5

Inflow and Infiltration
Are you under an SOC (Special Order by Consent) or do you have a schedule
❑ Yes
❑ No ❑NA
❑ NE
in any permit that addresses Ill?
Explain if Yes:
What corrective actions have been taken to reduce or eliminate I & I related overflows this spill location
within the last year?
Has there been any flow studies to determine Ill problems in the
❑ Yes
❑ No DNA
❑ NE
collection system at the SSO location?
If Yes, when was the study completed and what actions did it recommend?
Has the line been smoke tested or videoed within the past year?
❑ Yes
❑ No DNA
❑ NE
If Yes, when and what actions are necessary and the status of such actions:
Are there Ill related projects in your Capital Improvement Plan?
❑ Yes
❑ No DNA
❑ NE
If Yes, explain:
Have there been any grant or loan applications for Ill reduction projects?
❑ Yes
❑ No ❑NA
❑ NE
If Yes, explain:
Do you suspect any major sources of inflow or cross connections
❑ Yes
❑ No DNA
❑ NE
with storm sewers?
If Yes, explain:
Have all lines contacting surface waters in the SSO location and upstream
❑ Yes
❑ No DNA
❑ NE
been inspected recently?
If Yes, explain:
What other corrective actions are planned to prevent future I/1 related SSOs at this location?
Comments:
Form CS-SSO Page 6

Pump Station Equipment Failure (Documentation of testing records etc should be provided upon request)
What kind of notification/alarm systems are present?
Auto-dialer/telemetry (one-way communication) ❑ Yes
Audible ❑ Yes
Visual ❑ Yes
SCADA (two-way communication) ❑ Yes
Emergency Contact Signage ❑ Yes
Other ❑ Yes
If Yes, explain:
Describe the equipment that failed:
What kind of situations trigger an alarm condition at this station (i.e. pump failure, power failure, high water, etc.)?
Were notification/alarm systems operable? ❑ Yes ❑ No DNA ❑ NE
In no, explain:
if a pump failed, when was the last maintenance and/or inspection performed?
What specifically was checked/maintained?
If a valve failed, when was it last exercised?
Were all pumps set to alternate?
❑ Yes ❑ No ❑NA ❑ NE
Did any pump show above normal run times prior to and during the SSO event? ❑ Yes ❑ No DNA ❑ NE
Were adequate spare parts on hand to fix the equipment
Was a spare or portable pump immediately available?
If a float problem, when were the floats last tested? How?
If an auto -dialer or SCADA, when was the system last tested? How?
Comments:
❑ Yes ❑ No ❑NA ❑ NE
❑ Yes ❑ No DNA ❑ NE
Form CS-SSO Page 7

Power outage (Documentation of testing, records, tec., should be provided of alternative power source upon
request.)
What is your alternate power or pumping source?
Did it function properly? ❑ Yes ❑ No ❑NA ❑ NE
Describe?
When was the alternate power or pumping source last tested under load?
If caused by a weather event, how much advance warning did you have and what actions were taken to prepare for the
event?
Comments:
Form CS-SSO Page 8

Vandalism
Provide police report number:
Was the site secured?
If Yes, how?
Have there been previous problems with vandalism at the SSO location?
If Yes, explain:
What security measures have been put in place to prevent similar
occurrences in the future?
Comments:
❑ Yes ❑ No
❑ Yes ❑No
❑NA
❑NA
❑ NE
❑ NE
Form CS-SSO Page 9

Debris in line (Rocks, sticks, rags and other items not allowed in the collection system etc.)
What type of debris has been found in the line?
Suspected cause or source of debris:
Are manholes in the area secure and intact?
When was the area last checked/cleaned?
Have cleaning and inspections ever been increased at this location
due to previous problems with debris?
Explain:
Are appropriate educational materials being developed and distributed
to prevent future similar occurrences?
Comments:
❑ Yes ❑ No ❑NA
❑ Yes ❑ No ❑NA
❑ Yes ❑ No ❑NA
❑ NE
❑ NE
❑ NE
Form CS-SSO Page 10

Other (Pictures and police report, as applicable, must be available upon request.)
Describe:
Were adequate equipment and resources available to fix the problem? ® Yes ❑ No ❑NA
If Yes, explain: The service truck was stocked with all necessary parts to make the repair.
If the problem could not be immediately repaired, what actions
were taken to lessen the impact of the SSO?
❑ Yes ❑ No ❑NA
❑ NE
❑ NE
Comments: On May 29, 2020 at 4:01 pm an electrical contractor hit a 2" low pressure sewer line while doing a bore.
Staff arrived at 4:55pm and identified the problem and dug a pit to contain the sewage, a pumper truck was on scene at
5:29pm and started pumping up the sewage. Flow was contained at 5:35pm. The section of damaged pipe was cut out and
replaced. The Lincoln County Health Director issued a no swim advisery at 7:30pm on Friday, May 29, 2020.
Form CS-SSO Page I I

Pipe Failure (Break)
Pipe size (inches)
What is the pipe material
What is the approximate age of the line/ pipe (years old)
Is this a gravity line?
Is this a force main line?
Is the line a "High Priority" line?
Last inspection date and findings
If a force main then,
Was the break on the force main vertical?
Was the break on the force main horizontal?
Was the leak at the joint due to gasket failure ?
Was the leak at the joint due to split bell?
❑ Yes ❑ No ❑NA ❑ NE
❑ Yes ❑ No ❑NA ❑ NE
❑ Yes ❑ No ❑NA ❑ NE
❑ Yes
❑ No
DNA
❑ NE
❑ Yes
❑ No
DNA
❑ NE
❑ Yes
❑ No
DNA
❑ NE
❑ Yes
❑ No
DNA
❑ NE
When was the last inspection or test of the nearest air -release valve to determine if operable?
When was the last maintenance of the air release performed?
If gravity sewer then,
Does the line receive flow from a force main immediately upstream ❑ Yes ❑ No DNA ❑ NE
of the failed section of pipe?
If yes, what measures are taken to control the hydrogen sulfide production?
When was the line last inspected or videoed?
If line collapsed, what is the condition of the line up and down stream of the failure?
What type of repair was made?
If temporary, when is the permanent repair planned?
Have there been other failures of this line in the past five years? ❑ Yes ❑ No DNA ❑ NE
If so, then describe
Form CS-SSO Page 12

System Visitation
ORC ® Yes
Backup ❑ Yes
Name: Michael Paul Simmons
Certification Number: 997855
Date visited: 5-29-2020
Time visited: 5:37 pm
Mow was the SSO remediated (Ue. Stopped and cleaned up)?
The broken piece of pipe was cut out and replaced. A pumper truck was used to clean up the area. Lime was
placed on grass surfaces.
As a representative for the responsible party, I certify that the information contained in this report is true and accurate to the
best of my knowledge.
Person submitting claim: Michael P. Simmons Date: 6-03-2020
Signature: �` Title: Ul: r; fJ Pf :unS sd f�/IfQen�
IJ
Telephone Number: 704-736-8497
Any additional information desired to be submitted should be sent to the appropriate Division Regional Office within five
business days of first knowledge of the SSO with reference to the incident number (the incident number is only generated
when electronic entry of this form is completed, if used).
Form CS-SSO Page 13

Lincoln .County Health Department
200 Gamble Drive
Lincolnton, NC 28092
[phone]
FOR IMMEDIATE RELEASE
SWIMMING ADVISORY ISSUED
(LINCOLN COUNTY — 4218 Ash Hollow Ln, Denver, North Carolina)
Contact: Davin Madden
Health Director
[e-mail]
May 29, 2020
The Lincoln County Health Director issued a Swimming Advisory at 7:30 pm Friday, May 29, 2020 for a
sewage spill at 4218 Ash Hollow Ln, Denver, North Carolina. Approximately 600 gallons of untreated
sewage may have leaked into an unnamed creek which deposits into an unnamed cove on Lake
Norman. A wastewater spill occurred due to a line cut by a Duke Energy contractor. The flow has been
stopped and testing of the discharge site has commenced.
As a preventive measure, the Health Director is advising all residents and boaters that this area may be
contaminated with fecal coliform. Residents and lake users are advised not to swim or otherwise have
bodily contact in that area. No Swimming Advisory signs will be posted this evening, a public
notification message was sent to the properties affected and adjacent to the sewer spill site using a
mass notification system called Everbridge, and this release has been posted to the county's website
(www.lincoincounty.org .
The KCWWTP has starting taking water samples and results will be forwarded to the county Public
Works department who will notify the health department and public when it is clear to resume lake
activities in this area. Until at least two consecutive samples indicate fecal coliform counts <200/ml at
all sampling sites, the swimming advisory will remain in effect. This decision is based on state
guidelines per the Mooresville Regional Office of the NC Division of Environmental Management.
Davin Madden, MHSA, REHS
Lincoln County Health Director
For additional information please contact us at [phone] or visit us online at www.lincolncounty.orp.
® /LincolnCountyHealth

Parker, Tony R
From:
Basinger, Corey
Sent:
Monday, March 25, 2019 8:45 AM
To:
Parker, Tony R
Cc:
Love, Barry F
Subject:
FW: NCG140046 Possible Water Quality Violation
Tony,
Please review Lauren's email below.
Contact Lincolnton (or Lincoln County) collection system folks and find out what you can about this site.
I can't imagine them allowing this type of discharge into the collection system.
Let me know what you find out.
Tha n ks,
Corey
From: Garcia, Lauren V
Sent: Monday, March 25, 2019 8:30 AM
To: Basinger, Corey <[e-mail]>
Subject: NCG140046 Possible Water Quality Violation
Hi Corey,
This is a follow up of an email sent last week. I know you were out of the office and probably have a bunch of emails to
check up on.
Last week on 3/19/19, Alaina Morman (contact information provided below) -and I attended a joint EPA/DEQ Individual
Industrial Stormwater Permit Inspection at the following facility:
Concrete Supply Company (Permit No. NCG140046)
831 Madison Street
Lincolnton, NC 28092
Among other issues, we were particularly concerned that the facility seems to be pumping effluent directly into an
onsite manhole that is apparently linked to the city's wastewater treatment plant.
The discharged effluent is a mix of water and excess concrete, produced when the facilities' concrete trucks are rinsed
with water as part of routine maintenance (occurring multiple times daily). The concrete and water mixture is stored in a
system of three pools. Theoretically, the water moves through the pools and the excess concrete separates from the
water. When the third pool (expected to have the cleanest water) becomes full, the facility pumps the water into a
manhole.
The facility has no formal documentation of its "verbal" agreement with the city to discharge effluent into the
city system.
• The effluent is reported to have a high pH and receives no treatment other than time in the pools.
• The water in the third pool was observed to be an electric blue color. It is unknown what analytes are present in
the effluent discharged into the city system (fly ash is used in the concrete mixture and we have concerns about heavy
metal concentrations).
The quantity of effluent discharged into the city system is unknown.
Evidence of dried concrete was observed inside the manhole when opened.

Alaina and I were hoping you could direct us in how this should be handled. We do not believe the city is aware of the
effluent that is being discharged directly into their system. Is it ok for us to contact the city?
Thank you for your help,
Lauren Garcia
Contact Information:
Alaina Morman
Environmental Specialist
Stormwater Program
Division of Energy, Mineral, and Land Resources
North Carolina Department of Environmental Quality
919-707-9236 (0)
919-807-6494 (F)
[e-mail]
DEMLR Stormwater Program
512 N. Salisbury Street
1612 Mail Service Center
Raleigh, NC 27699-1612
Lauren Garcia
Environmental Specialist II
Stormwater Program
Division of Energy, Mineral, and Land Resources
North Carolina Department of Environmental Quality
919-707-3648 (0)
[e-mail]
DEMLR Stormwater Program
512 N. Salisbury Street
1612 Mail Service Center
Raleigh, NC 27699-1612
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Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties.
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Collection System SSO 24-Hour Notification
Collection System: Number and Name WQCS# ® ® 1 Y- 0(
Incident Number from BIMS 20150 1 z 0 k
Incident Reviewed (Date):
Incident Action Taken: BPJ
' NOV-2015-DV
DV-2015-
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Spill Date 50 15 Time 11'S O ml m 10. 0 1q r"j,
Reported Date � 3 / Time I t 6 a-0 m�/j m
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Cause of Spill A e, &A mt h o C— G( ®i Q �Ba v --e--
Total Estimated Gallons ! 0 fl ® Est. Gal to Stream 100 C?
Stream ci,Fish Kill: Yes o umber Species
Non Required Information and other comments relating to SSO incident:
Response time minutes Zone Map Quad
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Love, Barry F
From: Pitner, Andrew
Sent: Wednesday, September 30, 2015 3:44 PM
To: Sifford, Barbara; Love, Barry F
Subject: Charlotte Observer article on Lincoln Co SSO
Fyi...
http://www.charlotteobserver.com/news/local/a rticle37084314.html
No -swimming advisory issued for part of Lake
Norman
1,000 gallons of sewage spilled into cove
Mechanical failure at lift station blamed
Area is off Smith Harbour Drive in Denver, N.C.
By Joe Marusak
jmarusak ,charlotteobserver.com
A no -swimming advisory was issued Wednesday for a section of Lake Norman in Denver, N.C., after 1,000
gallons of sewage spilled into a cove off Smith Harbour Drive, off N.C. 16 north of Unity Church Road.
A mechanical failure at a lift station in the Smithstone subdivision caused the spill, Lincoln County Health
Director Margaret Dollar said. Dollar issued the no -swim advisory at 11:30 a.m.
The mechanical failure was reported at 9:50 a.m., and a crew from the Lincoln County Public Works
Department stopped the spill within 20 minutes, Dollar said.
"No Swimming" advisory signs were posted, and water testing began at 11 a.m.
As a preventive measure, Dollar advised residents and boaters that the spill area might be contaminated with
fecal coliform bacteria.
Lincoln County Public Works will continue water testing and will notify the health department and public when
it is clear to resume lake activities.
Andrew Pitner, P.G. [e-mail]
Division of Water Resources - Water Quality Regional Operations Section
Mooresville Regional Office (MRO)
North Carolina Department'of Environmental Quality
610 East Center Avenue, Suite 301, Mooresville, NC 28115

MRO Main Phone: [phone]
Direct Office Phone: [phone]
M RO Fax: [phone]
DWR website: http://www.ncwater.org
NOTICE: Email correspondence to and from this address is subject to the North Carolina Public Records Law and may be
disclosed to third parties unless the content is exempt by statute or other regulation.

10-07-'15 .09:31 FROM-LIN CO Public Works 704-736-8499
T-504 P0OO1f0O11 F-303
115 West Main Street
UnwIntan, N.C. 28002
phone, (704) - 730 - $497
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10-07-'15 09:31 FROM-LIN CO Public Works 704-736-8499 T-504 P0002/0011 F-303
State of North Uarohna
Department of Environment and Natural Resources
DWR.
Division of Water Resources
Collection System Sanitary Sewer Overflow Reporting Form
Division of Water Resources Form CS-SSO
PART I:
This form shall be submitted to the appropriate DWQ Regional Office within five days of the first knowledge of the sanitary sewer
overflow (SSO).
Permit Number: WQCS00149 (WQCS# if active, otherwise use WQCSD#)
Facility: E Lincoln County Collection System Incident #: 201501201
Owner: East Lincoln County Water & Sewer Dist
City: Denver County: Lincoln Legion: Mooresville
Source of S$O (check applicable): ❑ Sanitary Sewer [1 Frump Station I Lift Station
SPECIFIC location of the SSO (be consistent in description from past reports or documentation - Le. Pump Station B,
Manhole at Westall & Bragg Street, etc):
Manhole #:
Latitude (dogmas/minute/second):
Incident Started Dt: 09/30/2015
(mm-oo-yyyy)
Estimated Volume of the $SO: 1,000
Describe how the volume was determined:
• W66th& 66hditioA during thi 'SSO'event:
2392 Smith Harbor Drive, Lift Station 16
Longitude (degrees/minutelsecond):
Time: 9,50 am Incident End Dt: 09/30/2015 Time: 10:07 am
(hh:mm AM1PM) (mm-dd-yyyy) (hh:mm AM/PM)
gallons Estimated Duration (Round to nearest hour): 0:17 hours
Estimated Flow
Cloudy with intermittent rain '
Did SSO reach surface waters? [l Yes ❑ No ❑ Unknown Volume reaching surface waters (gals): 1 uuu _
Surface water name: CATAWBA RIVER (Lake Norman below elevation 760) {
Did the SSO result in a fish kill? ❑ Yes V No ❑ Unknown _ If Yes, what is the estimated number of fish killed? 0
SPECIFIC cause(s) of the SSO:
0 Pump Station Equipme
24 hour verbal notification (name of person contacted ): Barry F Love
[( DWR ❑ Emergency Mgmt Date (mm-dd-yyy): 2015/09Q0 Time (hh:mm AMIPM): 11:56:00 am
if an SSO is ongoing, please notify the appropriate Regional Office on a daily basis until SSO can be stopped.
Per G.S. 143-215.1C(b), the responsible party of a discharge of 1,000or more of untreated wastewater to surface waters
shall issue a press release within 48-hours of first knowledge to all print and electronic news media providing general
coverage in the county where the discharge occurred. When 15,000 gallons or more of untreated wastewater enters surface
waters, a public n Cice shall be published within 10 days and proof of publication shall be provided to the Division within 30
days_ Refer to the reference statute for further detail.
The Director, Division of Water Resources, may take enforcement action for $$Os that are required to be reported to
Division unless it is demonstrated that-
1) the discharge was cause by sever natural conditions and there were no feasible alternative to the discharge, or
2) the discharge was exceptional, unintentional, temporary and caused by factors beyond the reasonable control of the
Permittee and/or owner, and the discharge could not have been prevented by the exercise of reasonable control.
Part II must be completed to provide a justification claim for either of the above situations. This information will be the basis
WHETHER OR NOT PART III IS COMPLETED, A SIGNATURE IS REQUIRED AT THE END OF THIS FORM
CS-SSO Form Page: 1

10-07-'15 09:31 FROM-LIN CO Public Works 704-736-8499 T-504 . P0003/0011 F-303
PART II:
ANSWER THE FOLLOWING QUESTIONS FOR EACH RELATED CAUSE CHECKED IN PART I OF THIS FORM AND
INCLUDE THE APPROPRIATE DOCUMENTATION AS REQUIRED OR DESIRED
COMPLETE ONLY THOSE SECTONS PERTAINING TO THE CAUSE OF THE SSO AS CHECKED IN PART I
(In the check boxes below, NA = Not Applicable and NE - Not Evaluated)
A HARDCOPY OF THIS FORM SHOULD BE SUBMITTED TO THE APPROPRIATE DWR REGIONAL_ OFFICE UNLESS IS
pump Station Equipment Failure
What kind of notification/alarm systems are present?
Auto -dialer telemetry (one-way communication) 10 Yes
Audible r( Yes
Visual LA Yes
SCADA (two-way communication) ❑ Yes
Emergency Contact Signage M Yes
Other n Yes
Describe the equipment that failed?
Both Pump #1 and Pump #2 Th anal Overloads Tripped causing the pumas not to activate. Possible Power surge or
li htnin in the area_
What kind of situations trigger an alarm condition at this station (i.e. pump failure,
power failure, high water, etc.)?
High at well Loss of Power Pump Failure lump Thermal Overload Generat r Run.
Were notification/alarm systems operable?
M Yes M No F1 NA n NE
If no, explain:
AT&T Phone Line failed due to possible lightning. Dialer was operational but could not call out due to AT&T phone line
failure.
If a pump failed, when was the last maintenance and/or inspection performed?
Monday September 28, 2015.
What specifically was checked/maintained?
Float switches, pump operation. dialer functionality back-tjR generator functions, station overall functionality —
If a valve failed, when was it last exercised?
NfA
Were all pumps set to alternate? [A Yes n No r] NA ❑ NE
CS-SSO Form Page: 2

10-07-'15 09:31 FROM-LIN CO Public Works 704-736-8499
Did any pump show above normal run limes prior to and during the 530 event?
T-504 P0004/0011 F-303
D Yes o No DNA ONE
C
J ,
Were adequate spare parts on hand to fix the equipment (switch, fuse, valve, seal,
etc.)?
Was a spare or portable pump immediately available?
Yes r1 No D NA n NE
[0 Yes 0 No r] NA ❑ NE
If a float problem, when were the floats last tested? How?
Not a float problem but were tested on Monday Se t(�emb�r 28. 2015.
If an auto -dialer or SCADA, when was the system last tested? How?
Monday September 28, 20,15. Dialer program was checked, phone line was physically checked and called into, and the
high level float switch was raised to simulate an alarm status.
Comments:
Reason for thermal overload switch failure was not able to be determined, R set the thermal overloads on both pump and
reset normal and the pumps became operational. Celled into AT&T to repair the failed shone service and a temporary
service was installed same day.
System Visitation
ORC Yes
Backup Yes
Name:.: ...
Olen C. Henderson
Cart#
993572
Date visited:
09/30/2015
Time visited:
01:50 PM
How was the $SO remediated (i.e_ Stopped and cleaned up)?
Excess sewage was vacuumed utilizing Lake Norman Sewer & Septic pumper truck. No lime was applied due to proximity
to the lake and additional forecasted rain. No Swim dvisory was issued to the public with signs Emergency Notification
System, and Media Outlets.
CS-SSO Form Page: 3

10-07-'15 09:32 FROM-LIN CO Public Works 704-736.-8499 T-504 P0005/0011 F-303
' As a representative for the responsible party, I certify that the information contained in this report is true and accurate to the
best of my knowledge.
Person submitting claim: Olan C Henderson pate: 10107/15 09:05 am
Signature:
Telephone Number: IN -- 1.466 D
Title: Superintendent
Any addition information desired to be submitted should be sent to the appropriate Division Regional Office within five days of first
knowledge of the SSO with reference to the incident number (the incident number is only generated when electronic entry of this
form is completed, if used).
CS-SSO Form Page: 4

10-07-'15 09:32 FROM-LIN CO Public works 704-736-8499
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10-07-'15 09:32 FROM-LIN CO Public Works 704-736-8499 T-504 P0008/0011 F-303
I #.
Lincoln County Health Department
°°ky
151 S19mon Road
Lincointon, NC 28092 0
Phone: [phone]
1
Fax: [phone]
$4 �®
`�?
Margaret B. Dollar, M.Ed.
N.ahCambia
CA
Health Director PublkROOM
rw,VMm Cwrv> r, ELF
PUBLIC $NOTICE & PRESS RELEASE
Release date: September 30, 2015
RE: SWIMMING ADVISORY ISSUED
(LINCOLIN COUNTY -2392 smith Harbor Drive, Denver, NC 28037)
The Lincoln County Health Director issued a Swimming Advisory at
11:30 am Wednesday, September 30, 2015. A sewage spill of
approximately 1,000 gallons occurred due to a mechanical failure at
lift station ##15 Smithstone Subdivision located at 2392 Smith Harbor
Drive in Denver. The spill leaked into the cove. The mechanical
failure was reported at 9:50 am on September 30, 2015. Lincoln
County Public Works Department was on the scene at 10:02 am and
the spill was stopped at 10:07 am. "'No Swimming" advisory signs
v�ere pst�i .end water testing began at 1:0Q am.
The Lincoln County Public Works Department is taking water
samples to determine the level of potential bacterial infection into
Lake Norman. As a preventive measure, the Health Director is
advising all residents and boaters that this area may be
contaminated with fecal coliform. Residents and lake users are
advised not to swim or otherwise have bodily contact in that area.
Residents in that immediate area will receive a pre-recorded alert
message if they are registered with the Lincoln County's emergency
notification system. This release is also being sent to all local media
and to the Lincoln County's website.
Lincoln County Public Works Department will continue water testing
and will notify the Lincoln County Health Department and public
when it is clear to resume lake activities in this area. Until at least
two consecutive samples indicate fecal coliform counts [200®ml at
all sampling sites, the swimming advisory will remain in effect. This
decision is based on state guidelines per the Mooresville Regional
Office of the NC Division of Environmental Management.
Margaret S. Dollar, M.Ed,
Lincoln County Health Director
09-30-15

10-07-'15 09:32 FROM-LIN CO Public Works 704-736-8499
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10-07-'15 09:32 FROM-LIN CO Public Works 704-736-8499 T-504 P0011/0011 F-303
Lincoln County Health Department
151 sigmon Road
Uncointon, NC 26092 °
Phone: 704-7'35-3001
Fox: 70�4-732-9034
a Margaret it. Dollar, M.Od.
r c�%o Health Director Nonbcaro P btreH�atrh
E ..ri,,,... 0.,YN . EMA*.
Press Release: CANCELLATION OF SWIM ADVISORY NOTICE
IN LINCOLN COUNTY
At 3:45 pm, on October 6, 2015, the Lincoln County Health Director cancelled the "No
Swimming" Advisory issued September 30, 2016 for the
Lake Norman cove which borders Smithstone Subdivision in Denver NC. Water quality
has now returned to a safe level so lake activities may resume in this area.
Lincoln County Public Works has collected water samples for testing daily from three
sites at the affected area. Two consecutive samples showed test results below the
required maximum levels at all three sites, and all sampling now meets the North
:..._., Carolina .Division of.Water (duality standards. Therefore the swim advisory has been
lifted.
The advisory was issued the morning of September 30th when approximately 1000
gallons of sewage spilled into the Smithstone cove on Lake Norman due to a
mechanical failure at lift station #16 located at 2392 Smith Harbor Drive in Denver. The
mechanical failure was repaired and the spill was stopped within an hour of it being
reported to Lincoln County Public Works. "No Swimming" advisory signs were
immediately posted; the public was informed through media releases and county
website postings; and residents in the immediate area received a pre-recorded phone
message alert if they were registered with the Lincoln County's emergency notification
system.
For further information, please contact Lincoln County Public Works at [phone].
Margaret B, Dollar, M.Ed.
Lincoln County Health Director .
October 6, 2015 3:40 pm

C®llection System SSO 24-Hour Notification
t
Collection System: Number and Name WQCS#
Incident Number from BIMS 20140
Incident Reviewed (Date):
Incident Action Taken: BPJ
NOV-2014-DV
DV-2014-
S�a� �5! ,,vY��Q
ONE MEN ■ G ■ E 0 ■ ■ a ■ MEN E E ■ ■ ■ ■ a ■ ■ NON ■ ■ ■ MEMO E ■ NEE E ■ ■ ■ ■ NORM OEM ■ ■ ■ ■ ■ ■'■ a E ■ ■ E ■ ■ ■ ■ ■ ■ I
ND-LL Cad "Iqfb P�111� 2
Spill Date Time � m/ pm
Reported Date Time (am/ m o
Regional Water Quality Staff reported to or EM Staff in Raleigh
SSO reported byl�,�r Vt�
Phone
Address of Spill =t�2:J�J
County City , V"
Cause of Spill
Total Estimated Gallons ` lC--)Cj0 Est. Gal to Stream
�Tl��Fish Kill: Ye umber SpeciesS ream
Non Required Information and other comments relating to SSO incident:
Response time minutes Zone Map Quad

Permit #
Owner and Facility Name
Permit #
Owner and Facility Name
WQCS00253
Bradfield Farms Water Company CS
WQCS00171
Greater Badin CS
WQCS00196
Carolina Water Service Cabarrus Woods CS
WQCSo0322
. Aqua Country Woods East CS
WQCS00233
Carolina Water Service Hemby Acres CS
WQCS00222
Town of Boiling Springs CS
WQCS00001
Charlotte -Mecklenburg CS
WQCS00341
Town of China Grove CS
WQCS00016
City of Albemarle CS
WQCS00231
Town of Cleveland CS
WQCS00046
City of Belmont CS
WQCS00058
Town of Cramerton CS
WQCS00107
City of Bessemer City CS
WQCS00165
Town of Dallas CS
WQCS00089
City of Cherryville CS
WQCS00342
Town of E. Spencer CS
WQCS00221
City of Claremont CS
WQCS00328
Town of Harrisburg CS
WQCS00326
City of Concord CS
WQCS00343
Town of Landis CS
WQCS00088
City of Conover CS
WQCS00310
Town of Longview CS
WQCS00017
City of Gastonia CS
WQCS00120
Town of Maiden CS
WQCS00020
City of Hickory CS
WQCS00344
Town of Marshville CS
WQCS00327
City of Kannapolis CS
WQCS00043
Town of Mooresville CS
WQCS00036
City of Kings Mountain CS
WQCS00125
Town of Mt Pleasant CS
WQCS00040
City of Lincolnton CS
WQCS00153
Town of Norwood CS
WQCS00164
City of Lowell CS
WQCS00190
Town of Oakboro CS
WQCS00026
City of Monroe CS
WQCS00325
Town of Stanfield CS
WQCS00059
City of Mount Holly CS
WQCS00180'
Town of Stanley CS
WQCS00044
City of Newton CS
WQCS00135
Town of Taylorsville CS
WQCS00019
City of Salisbury CS
WQCS00258
Town of Troutman CS
WQCS00037
City of Shelby CS
WQCS00345
Town of Wingate CS
WQCS00030
City of Statesville CS
WQCS00054
Union County CS
WQCS00149
East Lincoln CS
WQCS00009
WSA Cabarrus Co. CS
Deemed Permitted
Permit #
Owner and Facility Name
Permit #
Owner and Facility Name
WQCSDO130
Brooks Food Group -Brooks Food Group
WQCSD0064
Lincoln County CS
WQCSD0114
Charlotte Mecklenburg Schools - Misc Laterals
WQCSDO097
Martin Dev Gp-N Point & Portside CS
WQCSDO057
City of High Shoals CS
WQCSD0120
Martin Marietta Mallard Creek
WQCSDO117
Duke Energy Marshall Steam Station
WQCSDO019
Town of Richfield CS
WQCSD0257
Fallston
WQCSD0024
Town of Grover CS
WQCSD0116
Goose Creek Utilities Fairfield Plantation WWTP
WQCSD0038
Town of McAdenville CS
WQCSD0101
Harborside Dev LLC-Midtown T CS
WQCSDO002
Town of Ranlo CS
WQCSDO095
Kennerly Dev. Group LLC-Boardwalk Villas CS
WQCSD0049
Town of Spencer Mountain CS
WQCSDO098
Kennerly Dev. Group LLC-Kings Point CS
WQCSDO105
Kennerly Dev. Group LLC-Moon Bay Condos CS
WQCSD0252
All spills which do not have a pdrmit
WQCSD0107
Kennerly Dev. Group LLC-Schooner Bay CS
number assigned
WQCSDO099
Kennerly Dev. Group LLC-Spinnaker Point CS
--WQCSD0258--"sto
- — — -
---
— --
--
WQCSD0112
Lake Norman -South Point CS
WQCSDO104
Lake Norman -Villas S Harbour CS
WQCSD0102
Lake Norman -Vineyard Pt Resort CS

Collection System SSO 24-Hour Notification
Collection System: Number and Name WQCS# • b D I
Incident Number from BIMS 20130 D '6 9
Incident Reviewed (Date):
Incident Action Taken: v-' BPJ
NOV-2013-DV
DV-2013-
Spill Date (e Time & , 30 am/0
Reported Date 54 Time g Os- am(&
Reported To SWP Staff or EM Staff UA w�
Reported By zRalv`, Phone
Address of Spill (��c
County,( �� City
Cause of Spill wAOD Off• O.�
Total Estimated
gGallons BCD a Est. Gal to Stream
StreamAOj&_ Fish Kill: Yes No Number Species
Non Required Information and other comments relating to SSO incident:
Response time minutes Zone Map Quad

Form CS-SSO
i Collection System Sanitary Sewer Overflow Reporting Form
PART
This form shall be submitted to the appropriate DWQ Regional Office within five days of the first knowledge of
the sanitary sewer overflow (SSO).
Permit Number : OO + y (WQCS# if active, otherwise use treatment plant NC/WQ#)
60
Facility: Incident #
Owner: l uie-caL.N C_y"wty IOL461-ce. L Jd, t % Region:
city: County: L.11-+489.N
Source of SSO (check applicable) : Sanitary Sewer ❑ Pump Station
SPECIFIC location of the SSO (be consistent In description from past reports or documentation - i.e ump Station 6,
Manhole at Westall & Bragg Street, etc.)
Latitude (degrees/minutelsecond): Longitude(degrees/minute/seoond)-
Incident Started Dt Si- u `-aw Time Incident End Df-%4=20IS_. Time-_*1L06_.Rm_
(mm-dd-yyyy) hh:mm AMIPM (mm-dd-yyyy) hh:mm AM/PM
Estimated volume of the SSO: t Q�n - gallons Estimated Duration (Round to nearest hour). --
Describe how the volume was determined: !Z5`Tp nQ pi ,l:� NM 4 Lary 11I-ofic .Leak:n6,____�
Weather conditions during 580 event • a► ne .,.....,,.,..._.._..,�
Did SSO reach surface waters? Yes ❑No ® Unknown Volume reaching surface waters (gallons): a �p
Surface water name:
Did the SSO result In a fish kill? ❑ Yes ©No ❑ Unknown If Yes, what is the estimated number of fish killed?
SPECIFIC cause(s) of the SSO:
2—Severe Natural Condition ❑ Grease ❑ Roots
❑ Inflow and Infiltration ❑ Pump Station Equipment Failure ❑ Power outage
❑ Vandalism ❑ Debris in line 0 Other (Please explain in Part 11)
lm�mdiate 24-hour verbal notification reported to:
r�1141�
r v' DWQ 0 Emergency Mgmt. Date (mm-dd-yyyy): _j _ U- Z()t J Time (hh:mm AMIPM): Q rj : p$-
If an SSO is ongoing, please notify Regional Office on a daily basis until SSO can be stopped.
Per G.S. 143-215-1 C(b), the responsible party of a discharge of 1,000 gallons or more of untreated wastewater to surface
waters shall issue a press release within 48-hours of first knowledge to all print and electronic news media providing general
coverage in the County w er-Ti re tiie �scharge occurred, When 15,000 gallons or more of untreated wastewater enters surface
waters, a public notice shall be published within 10 days and proof of publication shall be provided to the Division within 30 days.
Refer to the referenced statute for further detail.
The Director, Division of Water Quality-, may take enforcement action for SSOs that are required to be reported to Division unless it
is demonstrated that:
1) the discharge was caused by severe natural conditions and there were no feasible alternatives to the discharge-, or
2) the discharge was exceptional, unintentional, temporary and caused by factors beyond the reasonable control of the Permittee
and/or owner, and the discharge could not have been prevented by the exercise of reasonable control.
Part II must be completed to provide a justification claim for either of the above situations. This information will be the basis
for the determination of any enforcement action. Therefore, it is Important to be as complete as possible.
WHETHER OR NOT PART Il IS COMPLETED, A SIGNATURE IS REQUIRED AT THE END OF THIS FORM.
CS-SSO Form October 9, 2003 Page 1

Form CS-SSO
_
F Collection System Sanitary Sewer Overflow Reporting Form
-
PART I
ANSWER THE FOLLOWING QUESTIONS FOR EACH RELATED CAUSE CHECKED IN PART I OF THIS FORM
AND INCLUDE THE APPROPRIATE DOCUMENTATION AS REQUIRED OR DESIRED
COMPLETE ONLY THOSE SECTIONS PERTAINING TO THE CAUSE OF THE SSO AS CHECKED IN PART I
in the check boxes below, NA = Not Applicable and NE = Not Evaluated
A HARDCOPY OF THIS FORM SHOULD BE SUBMITTED TO THE APPROPRIATE DWQ REGIONAL OFFICE
UNLESS IT HAS BEEN SUBMITTED ELECTRONICALLY THROUGH THE ONLINE REPORTING SYSTEM
Severe Natural Condition (hurricane, tomado, etc.)
Describe the "severe natural condition" in detail.
How much advance warning did you have and what actions were laken in preparation for the event?
Comments:\��e-OWner'S waS RVIWAk Colter+;- Orv& Cod CLIAMI&d br-`oust oQ- QA►>r-"% hr*d
Our Lao pre.SSv a SeAoor �,Nti UnG)vera4 ouv }tie. fkq,', ?w. ,ea 1-,. -je tw4u-
When was the last time this specific line (or wet well) was cleaned?
Do'you have an enforceable grease ordinance that requires new or retrofit of grease trapsfinterceptors?
Have there been recent inspections and/or enforcement actions taken on nearby restaurants or other
nonresidential grease contributors?
Explain.
1:1Y11E1 NANACINE
❑YeSE] N,VNA0NE
Have there been other SSOs or blockages in this area that were also caused by grease? ❑Ye NoONA ❑NE
When?
If yes, describe them:
Have cleaning and inspections ever been increased at this location? ❑Yes❑ No NA C]NE
Explain.
CS-SSO Form October 9, 2003 Page 2

Have educational materials about grease been distributed in the past? OYesO No uNA ONE
When?
and to whom?
Explain?
If the SSO occurred at a pump station, when was the wet well and pumps last checked for grease
accumulation? II11
Were the floats clean? ❑Ye O NoENA ONE
Comments:
Roots
Do you have an active root control program?
Describe
❑Ye,O NANAONE
Have cleaning and inspections ever been increased at this location because of roots? []YesON,IZNAONE
Explain:
What corrective actions have been accomplished at the SSO location (and surrounding system if
associated with the SSO)?
What corrective actions are planned at the SSO location to reduce root Intrusion?
Has the line been smoke tested or videoed within the past year? ❑Yes❑ No M NA NE
If Yes, when?
Comments
Inflow and Infiltration �-,,�
Are you under an SOC (Special Order by Consent) or do you have a schedule in any permit that ❑YesO No &KA ONE
addresses ill?
CS-SSO Form October 9, 2003 Page 3

Explain if Yes:
What corrective actions have been taken to reduce or eliminate I & I related overflows at this spill location
within the last year?
Has there been any flow studies to determine Ill problems in the collection system at the SSO location?
❑YesO No NA ONE
If Yes, when was the study completed and what actions did it recommend?
Has the line been smoke tested or videoed within the past year?
❑YeD No EXA, ONE
If Yes, when and indicate what actions are necessary and the status of such actions:
Are there Ill related projects in your Capital Improvement Plan?
❑YesO No NA ❑NE
If Yes, explain:
Have there been any grant or loan applications for 1/1 reduction projects?
❑YesO No NA ONE
If Yes, explain:
Do you suspect any major sources of inflow or cross connections with storm sewers?
❑YesO No NA ONE
If Yes, explain:
Have all lines contacting surface waters in the SSO location and upstream been inspected recently?
11 YM No NA ONE
If Yes, explain:
What other corrective actions are planned to prevent future Ill related SSOs at this location?
Comments:
Pump Station Equipment Failure Documentation of tesfing, records etc.,
shoo! be provided upon request
What kind of notification/alarm systems are present?
Auto-dialer/telemetry (one-way communication)
❑Yes
CS-SSO Form October 9, 2003
Page 4

Audible ❑Yes
Visual ❑ Yes
SCADA (two-way communication) ❑Yes
Emergency Contact Signage ❑Yes
Other ❑ Yes
Describe the equipment that failed? .
What kind of situations trigger an alarm condition at this station (i.e. pump failure, power failure, high
water, etc.)?
Were notification/alarm systems operable? ❑Yes❑ No 10 NA ❑NE
If no, explain:
If a pump failed, when was the fast maintenance and/or inspection performed?
What specifically was checked/maintained?
If a valve failed, when was It fast exercised?
Were all pumps set to alternate? ❑Ye O No t _JNA ❑ NE
Did any pump show above normal run times prior to and during the SSO event? ❑Yes❑ No Ll NA ❑ NE
Were adequate spare parts on hand to fix the equipment (switch, fuse, valve, seal, etc.)? ❑Yes❑ No ONA ❑NE
Was a spare or portable pump immediately available? ❑Yes❑ No&KA❑NE
If a float problem, when were the floats last tested? How?
If an auto -dialer or SCADA, when was the system last tested? How?
Comments:
CS-SSO Form October 9, 2003 Page 5

Power outage (Documentation of testing, records, etc., should be
provided of aitemative power source upon request.)
What is your alternate power or pumping source?
Did it function properly? ❑Yes❑ Na❑NA❑NE
Describe?
When was the alternate power or pumping source last tested under load?
If caused by a weather event, how much advance warning did you have and what actions were taken to
prepare for the event?
Comments:
Vandalism
Provide police report number.
Was the site secured?
If Yes, how?
11Y,S0 NOLJNA❑NE
Have there been previous problems with vandalism at the $SO location? ❑Yes❑ No NA ❑NE
If Yes, explain:
11
What security measures have been put in place to prevent similar occurrences in the future? ❑YesO No NA ❑NE
Comments:
Debris in fine (Rocks, sticks, rags and other items not allowed in the
collection system, etc.)
What type of debiis has been found in the line?
Flow could it have gotten there?
Are manholes in the area secure and intact? ❑Yes❑ No ONA t_iNE
CS-SSO Form October 9, 2003 Page 6

When was the area last checked/cleaned?
Have cleaning and inspections ever been increased at this location due to previous problems with debris? 0YeJ NouNAONE
Explain:
i
Are appropriate educational materials being developed and distributed to prevent future similar ❑Ye O No NA ❑NE
occurrences?
Comments:
Other (Pictures and a police report should be available upon request.)
Describe:
Were adequate equipment and resources available to ix the problem? Yesu WONAONE
If Yes, explain:
If the problem could not be immediately repaired, what actions were taken to lessen the impact of the
SSO?
Comments:
For DWQ Use Only: . ❑rr--�� �
DWQ Requested an Additional Written Report. N,R NACINE
If Yes, What Additional Information is Needed:
Comments:
CS-SSO Form October 9, 2003 Page 7

As a_representative for the responsible party, I certify that the information contained in this report is true and accurate
to the best of my knowledge.
Person submitting claim:
ew
Signature:
Telephone Number:
Date: 5 - "11 - 1 3
Any additional information desired to be submitted should be sent to the appropriate Division Regional Office within five days of first
knowledge of the SSO with reference to the incident number (the incident number is only generated when electronic entry of this form
is completed, if used).
CS-SSO Form October 9, 2003 Page 8

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Collection System SSO 24-Hour Notification
Collection System: Number and Name WQCS#
Incident Number from BIMS 20130
Incident Reviewed (Date):
Incident Action Taken: t/ BPJ
NOV-2013-DV
DV-2013-
V�/ 2 .,�,W ��
S ill Date Time > 3d 5kP�p� f��
Reported Date 16 Time / / Oam/pm
Reported To SWP Staff or EM Staff 65
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���Reported By�� Phone
Address of Spill
3!
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Cause of Spill V � /2'� r �f
Total Estimated Gallons 0 Est. Gal to Stream
Stream /V,/Ii1�,.-) Fish Kill: Yes No Number Species
Non Required Information and other comments relating to SSO incident:
Response time
minutes Zone
Map Quad
�013
Iva --
7-64 ,/)"&
ham
A)D

04-16-'13 14:04 FROM-LIN CO Public works 704-736-8499 T-567 P0001/0009 F-156
Lincoln County Public Works
115 West Main street
uncolnion, N.C. 28092
Phone. (704) - 735 - 8497
Fax: [phone] - 8499
T®: BD►r%0.ro, is, ct F Qtlr:° �it } �n of154h
Pax: ZOy ` 6PG5"
? y 5 Date:
Phone 704 -,& (0-6 -11099 Pages; r
Reference: t) QCS 00 1 W -q CC:
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04-16-'13 14:04 FROM-LIN CO Public Works 704-736-8499 T-567 P0002/0009 F-156
-to CAao'� COUNTY OF LINCOLN, NORTH CAROLINA
11 S WEST MAIN STREET, 2ND FLOOR CITIZENS CENTER, LINCOLNTON, NORTH CAROLINA 29092
DEPARTMENT OF PUBLIC WORKS
PHONE [phone]
FAX [phone]
FOR IMMEDIATE RELEASE
NOTIFICATION OF WASTEWATER SPILL IN LINCOLN COUNTY
House Sill 1160, which the General Assembly enacted in July 1999, requires municipalities,
animal operations, industries and others who operate waste handling systems issue news releases
when a waste spill of 1,000 gallons on the ground or any amount reaches surface waters,
in accordance with this regulation, the following news release has been prepared and issued in
the affected county:
On Wednesday, April 10, 2013, in the 8300 block of Ranger island Marina Road, Denver,
North Carolina a wastewater spill occurred. The estimated amount of the spill that
reached Lake Norman was 20 gallons. The spill occurred due to a commercial vehicle
damaging a sewer connection, and the untreated sewage flowed into a cove that ruins into
Lake Norman in the Catawba River Basin. The flow has been stopped. The Lincoln
County Ifealth Department has been contacted, and they recommend that boaters,
fishermen and swimmers avoid contact with the lake water in this area until further
notification.
The Division of 'Water Quality was notified of the event on April 10, 2013, and is reviewing the
matter. For information contact Lincoln County Public Works at [phone].
April 10, 2013

04-16-'13 14:04 FROM-LIN CO Public Works 704-736-8499 T-567 P0003/0009 F-156
��Ga4rt CpL�
a�
COUNTY OF LINCOLN, NORTH CAROLINA
y�`I i►t�"�4 I IS WEST MAIN STREET, 3RD FLOOR CITIZENS CENTER, LINCOLNTON, NORTH CAROLINA 28092
DEPARTMENT OF PUBLIC WORKS
[phone]
FAX [phone]
CANCELLATION OF SWIM ADVISORrY NOTICE
IN LINCOLN COUNTY
As of April 15, 2013 at 8.15 a.m., the Lincoln County health Department has approved
Lincoln County Public Works cancelling a No Swimming Advisory for all residents in
the cove area bordering ' 8300 block of Ranger Island Marina Road, Denver, North
Carolina.
On Wednesday, April 10, 2013, a wastewater spill occurred. The estimated amount of
the spill that reached fake Norman was 20 gallons. The spill occurred due to a
commercial vehicle damaging a sewer connection, and the untreated sewage flowed into
a cove that rums into Lake Norman in the Catawba River Basin
Lincoln County Public Works has tested daily three sites for Fecal coliform levels at the
8300 block of Ranger Island Marina Road cove area. Two consecutive samples of
<200/ml per 100m1 were received at all three testing sites and all sampling meets the
Division of Water Quality standards
For further information, please contact Lincoln County Public Works at [phone].
ISSUE DATE, Monday, April 15, 2013

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04-16-'13 14:06 FROM-LIN CO Public Works 704-736-8499 T-567 P0007/0009 F-156
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04-16-'13 14:07 FROM-LIN CO Public works 704-736-8499
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Collection System SSO 24-Hour Notification
Collection System: Number and Name WQCS# Ir
� c� Cs o bOCP'C'
Incident Number from BIMS
Incident Reviewed (Date):
Incident Action Taken: BPJ
NOV-2007-DV
■•eeeeeeeeeseeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeteeeeeeeeeeeeeee�eee
Spill Date /l
p Time �- �(� am pm
Reported Date ' AA W Time - J 6 am m
Reported To SWP Staff or EM Staff.
Reported By ,��� Phone
Address of Spill A-C� 4,9�)
County i-f ,� �• City
Cause of Spill -?A—)
Total Estimated Gallons c5OO6 Est. Gal to Stream
StreamAln y o J Fish Kill: Yes No Number Species
Non Required Information and other comments relating to SSO incident:
Response time minutes Zone Map Quad
0

12-31-'12 13:34 FROM-LIN CO Public works 704-736-8499 T-433 PO0O1/0017 F-466
r
To.
Lincoln• Works
11$ West Wn Street
Uricolnton, N.C. 28092
Phone: U(14) .736 - 0497
Fax:1704) - 735 - 8499
From: C h �
Fax: j D N &n ,,5 _ &0 4 o Date:
Phone IUy' �o�a� "ilo R Peg!!:
Reference: � � n� � 4C«
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12-31-'12 13:34 FROM-LIN CO Public works 704-736-8499 T-433 P0002/0017 F-46b
ATE
Form CS-SSO
r Collection System Sanitary Sewer Overflow Reporting Form
V 1/2009 PART I
This form shall be submitted.to the appropriate DWQ Regional Office within five days of the first knowledge of
the sanitary sewer bverflow (SSO)_
Permit Number : WQ CA_ Od j i-2 (WQCS#f if active, otherwise use WQCSD#,
Facility: Lgne.olr. Caur+%l '�pweR
Owner: LiUC1131r• Co�1v�-lry
City: 0 e.r% ve R
Source of SSO (check applicable): ❑ S t S war
Incident #
Region:
County:
ani ary a Pump Station I Lift Station
SPECIFIC location of the SSO (be consist nt in description from pastreports or documentation - i.e. Pump Station 6,
Manhole at Westall & Bragg Street, etc.) : EMMA fta44Oh' ZIT — y 4 30 &%ri on L 4v%e_ t be-nVe-A N- -
Manhole# ly
Latitude (degrees/minute/second): '36 31 , y�'f � "--� Longitude(degrees/minute/second):.W" . qq' 1W 0
Incident Started 17t: tZ-fi~zo1? Tim ' ' 30 Incident End Dt: fZ-47"Zbl2 Time: ; +iff
(rnm-dd-y" hh:m M (mm-dd-yyyy) hh:mn(OPM
Estimated volume of the SSO; 1 O bC2 gallons Estimated Duration (Round to nearest hour):
Describe how the volume was determined: C:5Vj rn6;k i0[3LtseLA t)M *jI>r.0 ObSeryaopY\ !k * iDn'};mC
Weather conditions during SSO event; e. IeckR � �' `'� o u
Did SSO reach surface waters? 50 Yes D NoD Unknown Volume reaching surface waters (gallons): Qp(]
Surface water name: I ct ke 11q Rr'fM1cL r1
ElILr.I
Did the SSO result in a fish kill? Yes NoC] Unknown If Yes, what is the estimated number of fish killed?�
SPECIFIC cause(s) of the SSO:
❑ Severe Natural Condition
❑ Inflow and Infiltration
❑ Vandalism
El Pi a Failure (Rreak)
❑ Grease
Pump Station Equipment Failure
Debris in line
❑ Roots
Dower outage
Q Other (please explain in Part II) "
p
24-hour verbal notification (name of person contacted) OOrrlao m ' `rimer - Moorn Vr 1le W-01508
21 DWQ 0 Emergency Mgmt. Date (mm-dd-yyyy):12_Z7~6Q1"7 Time (hh:mm AM {� C
If an SSO is ongoing, please notify Regional Office on a daily basis until SSO can be stopped.
Per G.S. 143-215.1C(b), the responsible party of a discharge of 1,000 gallons or more of untreated wastewater to surface
waters shall issue a press release within 46-hours of first knowledge to all print and electronic news media providing general
coverage in the county w era a ischarge occurred. When 15,000 gallons or more of untreated wastewater enters surface
waters, a public notice shall be published within 10 days and proof of publication shall be provided to the Division within 30 days.
Refer to the re�n—ce-a statute for further detail,
The Director, Division of Water Quality, may take enforcement action for SSOs that are required to be reported to Division unless it
is demonstrated that:
1) the discharge was caused by severe natural conditions and there were no feasible alternatives to the discharge; or
2) the discharge was exceptional, unintentional, temporary and caused by factors beyond the reasonable control of the Permittee
and/or owner, and the discharge could not have been prevented by the exercise of reasonable control.
Part II must be completed to provide a justification claim for either of the above situations. This information will be the basis
for the determination of any enforcement action. Therefore, it is important to be as complete as possible.
WHETHER OR NOT PART 11 IS COMPLETED, A SIGNATURE IS REQUIRED AT THE END OF THIS FORM.
CS-SSO Form Page 1

12-31-'12 13:34 FROM-LIN CO Public Works 704-736-8499 T-433 P0003/0017 F-466
Form CS-SSO
Collection System Sanitary Sewer Overflow Reporting Form
PART I I
ANSWER THE FOLLOWING QUESTIONS FOR EACH RELATED CAUSE CHECKED IN PART I OF THIS FORM AND
INCLUDE THE APPROPRIATE DOCUMENTATION AS REQUIRED OR DESIRED
COMPLETE ONLY THOSE SECTIONS PERTAINING TO THE CAUSE OF THE SSO AS CHECKED IN PART I
(In the check boxes below, NA = Not Applicable and NE = Not Evaluated)
A HARDCOPY OF THIS FORM SHOULD BE SUBMITTED TO THE APPROPRIATE DWO REGIONAL OFFICE
UNLESS IT HAS BEEN SUBMITTED ELECTRONICALLY THROUGH THE ONLINE REPORTING SYSTEM
CS-SSO Form Page 2

12-31-'12 13:35 FROM-LIN CO Public Works 704-736-8499 T-433 P0004/0017 F-46,6
Pump Station Equipment Failure Documentation of testing, records etc., shout be provided upon request.
What kind of notificationlalarm systems are present?
Auto-dialerltelometry (one -Way communication) 14Yes
Audible 12Yes
Visual I Yes
SCADA (two-way communication) ❑ Yes
Emergency Contact Signage 9 Yes
Other C3 Yes
Describe the equipment that failed?
AT S Irrcgler ra�v [arid [au�i-o �ei� a1 (2
What kind of situations trigger an alarm condition at this station (i.e. pump failure, power failure, high
water, eto.)?
CAM ;ciAura h , 1h le et atnd &e v _tr tpa �n
Were notification/alarm systems operable? Ye No NA� Nf
If no, explain;
i4tAo -gale s-trvck I i h r;mo a-e . tw�obhe live.
If a pump failed, when was the last maintenance and/or inspection performed?
What specifically was checked/maintained?
If a valve failed, when was it last exercised? NIA
Were all pumps set to alternate? Ye,0 No [j NAa NE
Did any pump show above normal run times prior to and during the SSO event? [� Yejy No o NA[] NE
Were adequate spare parts on hand to fix the equipment (switch, fuse, valve, seal, etc.)? Ye9[] No D NA❑ NE
Was a spare or portable pump immediately available? Ye,0 No [I NA❑ NE
CS-SSO Form Page 7

s 12-31-'12 13:35 FROM-LIN CO Public works 704-736-8499 T-433 P0005/0017 F-466
If a float problem, when were the floats last tested? How?
If an auto -dialer or SCADA, when was the System fast tested? How?
I z - I� - 20 ► � � C4,e�.k �cc+�a�h o n t.��r d � �I�R. c��d._ �he�.k_�ho�r� (i r►� .
Comments:
�u+n�p S�a�rtb r. k]aS 5�-t'uGlc %V _i i_�tY►'!'ni r+ �{r�i,�irr ca�se�1
h� A i 5 +a +ra eR +t;'l4em4m, 'C��I�b r'-1 ian , t1f1 a� rr Paw�'i�
�111d � �ne�ct'}oR poLc)eR 1, " auYn: &61 JDLA- 4e Cleo! -rani
�'Ja d Garr �-h�e A i S wo eo do,m ed . A+ +he 6e VC me l%6';I-+�111 %
gJrr L t k 4.kNa AT,,; ' +e-I epVno n$ 1 i ne det 5iY%� o, *c:,1 ure ; ne,
ONE_ Ru4-ay P'laleR . Perftf\nel arrt ved on -(scene -4o eonduc+
U.9eekl y c4a % aid do 6+~over �d 'the ,lure anc� re s� 1�F;na�
.55�.
ze8 5�&Ney 5ec +o remove
eu e.e.�s c�hd �.�plred lod I los a�
CommenoeA +es4-,n%c4 Calve Morman
Cove T-or a -Coh .
CS-SSO Form Page 0

12-31-'12 13:35 FROM-LIN CO Public Works 704-736-8499 T-433 P0006/0017 F-46,5
Power outage (Documentation of testing, records, etc., should be provided of alternative power source
upon reques .
What is your alternate power or pumping source?
_IaeUr4a0NAQNE
Did it function properly? �J
Describe?
5+rue.k' i MKfft
When was the alternate power or pumpA source IN tested under Io
1 Z.-al 2b 1'z j
/ Trar.s�e t?t�u�eR ih�h= �- t'un�1u>nnp .
If caused by a weather event, how much ad cc warning did you have and what 51ttions were taken to
prepare for the event?
o td?ali�si� n a car' a�h�tn na b h y 1'a�� n
,--� V��
Comments;
pleme- see
CS-SSO Form Page 9

12-31-'12 13:36 FROM-LIN CO Public Works 704-736-8499
T-433 P0007/0017 F-466
Systern Visitation �t i
ORC C)ICLrti C• I� de��arr
Backup (6 ri o r\ (,D'rikel D
Name' C) 1 cL" C • VA ena e-irSp r1
Cert#
Date visited:
Time visited:
iA Yes
I2^Z"1_Z4t7-
How was the SSO remodiated (i.e. Stopped and cleaned up)?
As s re resentative for the res ansible party, I certi that the information contained in this report is true and accurate to
e est my now a ge.
Iverson submitting claim: t) I ax., t^ • KCANA ex&w ,
gignature: VS vja�—==:A
Telephone Number, 104 -134- ` 4 9,
Date: t Z~_6j- Z o 1 Z
Title: rA i 13�1:i J 4t.�B�tl'ie1i��a'
Any additional information desired to be submitted should be sent to the appropriate Division Regional Office within five days of first
knowledge of the SSO with reference to the incident number (the incident number is only generated when electronic entry of this
form is completed, if used).
CS-SSO Form Page 15

12-31-'12 13:36 FROM-LIN CO Public Works 704-736-8499
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or land conveyance. The map is based on NC State Plane Coordinate System 1983 NAD. Lincoln County. NC Office of the Tax Administ(ator.
GIS Division
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12-31-'12 13:36 FROM-LIN CO Public Works 704-736-8499 T-433 P0009/0017 F-466
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12-31-`12 13:37 FROM-LIN CO Public Works 704-736-8499 T-433 P0010/0017 F-466
COG
C G V COUNTY OF LINCOLN, NORTH CAROLINA
115 WEST MAIN STREET, 2No FLOOR CITIZENS CENTER, LINCOLNTON, NORTH CAROLINA 2809Z
DEPARTMENT OF PUBLIC WORKS
PHONE [phone]
FAX [phone]
FOR IMMEDIATE RELEASE
NOTIFICATION OF WASTEWATER SPILL IN LINCOLN COUNTY
House Bill 1160, which the General Assembly enacted in July 1999, require municipalities,
animal operations, industries and others who operate waste handling systems issue news releases
when a waste spill of 1,000 gallons or more reaches surface waters.
In accordance with this regulation, the following news release has been prepared and issued in
the affected county:
On Thursday, December 27, 2012, in the 4400 block of Burton Lane, Denver, Forth
Carolina, adjacent to the Lakewood Subdivision, a wastewater spill occurred due to a
lightning strike at a sewage pump station resulting in a pump failure. The estimated
number of gallons spilled was 5,000 gallons. The untreated sewage flowed into an unnamed
cove in the 4400 block of Burton Lane, Denver, North Carolina, which runs into Lake
Norman in the Catawba River Basin. The flow has been stopped and testing of the
discharge site has commenced. The Lincoln County Health Department has been notified
and the Health Department recommends that all boaters, fishermen and swimmers avoid
contact with the lake water in this area until further notification.
The Division of Water Quality was notified of the event on December 27, 2012, and is reviewing
the matter. For information contact Lincoln County Public Works at [phone].
ncccmbor 27, 2012
2:00 pm

12-31-'12 13:37 FROM-LIN CO Public Works 704-736-8499 T-433 P0011/0017 F-466
Lincoln County Health Department
151 sigmon Road M
Lincolnton, NC 28092 Lr�.l
Phone: [phone]
m Fax: [phone]
b Margaret B. Dollar, M.Ed.
CA1�py� Health Director NwthC.WinnvoblkHmhh
PUBLIC NOTICE & DRESS RELEASE
EASE
Release date: December 27, 2012
R SWIMMING ADVISORY ISSUED
(LINCOLN COUNTY -4470 Burton Lane, Denvere NC 28037)
The Lincoln County Health Director issued a Swimming Advisory at
1:30 pm Thursday, December 27, 2012. A sewage spill of
approximately 5,000 gallons occurred due to a lightning strike
causing circuit damage on the lift station located at 4470 Burton
Lane in Denver. The spill leaked into an unnamed cove bordered by
Lakewood and Dorman Pointe Subdivisions. As of noon today the
power has been restored to the pump station and it is functioning
properly.
The county Public Forks Department is taking water samples to
determine the level of potential bacterial infection into Lake Norman.
As a preventive measure, the health director is advising all residents
and boaters that this area may be contaminated with fecal coliform.
Residents and lake users are advised not to swim or otherwise have
bodily contact in that area. No Swimming Advisory signs are being
posted this afternoon, and residents in that immediate area will
receive a pre-recorded alert message if they are registered with the
county's emergency notification '`Line Alert" system. This release is
also being sent to all local media and to the county's website.
County Public Works Department employees will continue water
testing and will notify the health department and public when it is
clear to resume lake activities in this area. Until at least two
consecutive samples indicate fecal coliform counts <200/ml at all
sampling sites, the swimming advisory will remain in effect. This
decision is based on state guidelines per the Mooresville Regional
Office of the NC Division of Environmental Management.
Margaret B. Dollar, M.N.
Lincoln County Health Director
12-27-12

12-31-'12 13:37 FROM-LIN CO Public Works 704-736-8499 T-433 P0012/0017 F-466'
MR
9t�~fir COUNTY OF LINCOLN, NORTH CAROLINA
CA
11 S WEST MAIN STREET, 2Nn FLOOR CITIZENS CENTER, LINCOLNTON, NORTH CAROLINA 28092
DEPARTMENT OF PUBLIC WORKS
PHONE [phone]
FAX [phone]
CANCELLATION OF SWIM ADVISORY NOTICE
IN LINCOLN COUNTY
As of December 31, 2012 at 10:00 AM, the Lincoln County health Department has
approved Lincoln County Public Works cancelling a "No Swimming Advisory" for
all residents in the area the 4400 block of Burton Lane, in Denver, North Carolina.
The advisory was issued because of a waste water spill of an estimated 5,000
gallons. The untreated wastewater spilled into Lake Norman in the Catawba River
Basin.
Lincoln County Public Works has collected water samples for testing daily from
three sites at the affected area. Two consecutive samples showed test results below
the required maximum levels at all three sites, and all sampling now meets the
North Carolina Division of Water Quality standards.
For further information, please contact Lincoln County Public Works at (704) 736-
8497.
Monday, Deocmber 31, 201.2
10:00 AM

rol
* Countsd With microscope
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V�
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins
Governor Director
March 19, 2010
Mr. Burns Whittaker, PE
Public Works Department
Lincoln County
115 West Main St.
Lincolnton, NC 28092
Subject: Compliance Evaluation Inspection
Permit No. WQCS00149
Lincoln County Collection System
Lincoln County
Dear Mr. Whittaker:
Dee Freeman
Secretary
Ms. Barbara Sifford, of the NC Division of Water Quality (DWQ), Mooresville Regional Office (MRO)
conducted a compliance evaluation inspection (CEI) of the Lincoln County wastewater collection system permit
number WQCS00149, on January 13, 2010. The assistance and cooperation of Mr. Chris Henderson, Mr. Barry
McKinnon and yourself was greatly appreciated. Please note that the sections completed on the report pertain
only to the areas that were inspected. An inspection report is attached for your records and inspection findings
are detailed in this report.
The collection system for Lincoln County consists of approximately 20 miles of gravity sewer
line, 50 miles of pressure sewer line, 13.7 miles of force main and thirty-six (36) duplex pump stations. The
system conveys wastewater to the Forney Creek WWTP (NPDES NCO074012 and Killian Creek WWTP
(NPDES NC0088722) not yet completed and the City of Lincolnton's WWTP (NPDES NC0025496) for
treatment. The collection system permit has not been issued, the permit application was received in August
2004 and needs to be updated to reflect all the changes in the system and to change the name of the facility.
Currently the system has not been classified.
Performance Standards
The County of Lincoln needs to develop and implement an educational fats, oils, and grease program for
both residential and non-residential users. The County may also need to develop and implement an enforceable
program for users of the collection system who violate the terms of the local ordinance pertaining to fats, oils
and grease. A schedule for implementation will be in the permit draft for you to review.
Mooresville Regional Office
Location: 610 East Center Ave., Suite 301 Mooresville, NC 28115
Phone: [phone] Fax: [phone] Customer Service: 1-877-623-6748
One
NorthCarolina

Lincoln County
WQCS00149
January 13, 2010 CEI
The Capital Improvement Plan addresses both short term and long term planning for the continued
expansion of the collection system and treatment capacity.
To clarify a question about simplex pump stations serving a single-family residence, such stations are
not required to. be checked daily (whether publicly or privately owned). However, they are required to have a
sticker notice inside the control panel with a 24-hour emergency contact number. Lincoln County has several
thousand privately owned single family pump stations that were issued to developers, LLC's, or now belong to
home owners associations, as well as some issued in the County's ownership. DWQ has concern about the
continued operation of these systems. A resolution to the regulatory requirements of these systems when a
failure occurs needs to be addressed. , In dealing with other County Environmental Health Departments several
North Carolina Administrative Codes can be used when a private system fails.
15A NCAC 18A.1961 (1) — A sewage collection, treatment, and disposal system that creates or has
created a public health hazard or nuisance by surfacing or effluent or discharging directly into groundwater or
surface waters, or that is partially or totally destroyed shall be repaired within 30 days of notification by the
state or local health department.
15A NCAC 18A.1937 Permits: (a) Any person owning or controlling a residence, place of business, or
place of assembly containing water —using fixtures connected to a water supply source shall discharge all
wastewater directly to an approved wastewater system permitted for that specific use.
A condition needs to be added in the permit that directs the cooperation of Lincoln County
Environmental Health Department with the Lincoln County Public Works Department to work together to
ensure that these systems remain functioning and take the proper corrective actions and enforcement when
needed for these private systems within your jurisdiction.
Inspections, Operation and Maintenance and Records
Right of ways are cleared by a contract services and found accessible. A list of high priority lines needs
to be developed for the system to include aerials and other line segments of potential concern that should be
checked more than once a year.
A customer compliant log is maintained, and used to determine areas for cleaning the following year.
The attached Compliance Evaluation Inspection report lists the information that should be available for review
along with the record keeping and reporting guidance.
The County is required to clean at a minimum 10 % of the collection system annually. Because the
collection system has low pressure lines and gravity sewer lines, both types are cleaned to obtain 70% of the
footage cleaned annually. The annual report was submitted 3/9/09 for the year 2008.

Lincoln County
WQCS00149
January 13, 2010 CEI
Any comments should be submitted to the attention of Ms. Barbara Sifford, resubmit the application to
the PERCS unit in Raleigh as soon as possible with the correct and up to date information for the system. The
draft permit will then be issued and you will have 30 days to comment on the conditions in the permit.
If you have any questions concerning this inspection report or noted record keeping requirements, please
do not hesitate to contact Ms. Sifford.
Sincerely,
obert Krebs
Regional Supervisor
Surface Water Protection Section
Mooresville Regional Office
Cc: Chris Henderson- ORC
�iICS�incc n ;may
PERCS

N
Permit: WQCS00149
SOC:
County: Lincoln
Region: Mooresville
Compliance Inspection Report
Effective: Expiration: Owner: East Lincoln County Water & Sewer Dist
Effective: Expiration: Facility: E Lincoln County Collection System
115 W Main St
Contact Person: Stan B Kiser Title:
Directions to Facility:.
System Classifications: CSNC,
Primary ORC: Olan C. Henderson
Secondary ORC(s):
On -Site Representative(s):
Related Permits:
NC0088722 Lincoln County - Killian Creek WWTP
NCO074012 Lincoln County - Forney Creek WWTP
Inspection Date: 01/13/2010 Entry Time: 09:00 AM
Primary Inspector: - Barbara Sifford
Secondary Inspector(s):
Phone: [phone]
Certification:991657 Phone:[phone]
Exit Time: 04:00 PM
Phone: [phone]
Ext.2196
Reason for Inspection: Routine Inspection Type: Compliance Evaluation
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 ® Inspections Pump Station ® Manhole
Reqmts
® Lines
(See attachment summary)
Page. 1

Permit: WQC300149 Owner - Facility: East Lincoln County Water & Sewer Dist
Inspection Date: 01/13/2010 Inspection Type: Compliance Evaluation Reason for Visit: Routine
Inspection Summary:
Page: 2

Permit: WQCS00149 Owner - Facility: East Lincoln County Water & Sewer Dist
Inspection Date: 01/13/2010 Inspection Type: Compliance Evaluation Reason for Visit: Routine
oo.f.,—.,, c+-.,. —A. Yes No NA NE
Is Public Education Program for grease established and documented?
n
■
n
n
What educational tools are used?
Need to develop educational information for FOG program for both residential and commercial customers.
Is Sewer Use Ordinance/Legal Authority available?
El
n
n
n
Does it appear that the Sewer Use Ordinance is enforced?
®
n
n
n
Is Grease Trap Ordinance available?
n
n
n
■
Is Septic Tank Ordinance available (as applicable, i.e. annexation)
®
n
n
n
List enforcement actions by permittee, if any, in the last 12 months
Has an acceptable Capital Improvement Plan (CIP) been implemented?
■
n
n
n
Does CIP address short term needs and long term \"master plant/ concepts?
■
n
n
n
Does CIP cover three to five year period?
®n
n
n
Does CIP include Goal Statement?
®
n
n
n
Does CIP include description of project area?
®
n
n
n
Does CIP include description of existing facilities?
®
n
n
n
Does CIP include known deficiencies?
®n
n
n
Does CIP include forecasted future needs?
■
❑
❑
❑
Is CIP designated only for wastewater collection and treatment?
®
n
n
n
Approximate capital improvement budget for collection system?
Total annual revenue for wastewater collection and treatment?
CIP Comments
Capital Costs for 2009 - 2013 indicate a need of $23,577,461.00 this is for a new WWTP and new lines as
well as expansion of the collection system. The County also has a 20 year plan that was developed in 2004
that goes to 2023 for planning and funding purposes.
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?
®n
n n
# Does the sign include:
Instructions for notification?
®
n
n n
Pump station identifier?
®
n
n n
24-hour contact numbers
®
n
n n
Page: 3

Permit: WQCS00149 Owner - Facility: East Lincoln County Water & Sewer Dist
Inspection Date: 01/13/2010 Inspection Type: Compliance Evaluation Reason for Visit: Routine
If no, list deficient pump stations
# Do ALL pump stations have an "auto polling" feature/SCADA? n ■ n n
Number of pump stations 36
Number of pump stations that have SCADA 0
Number of pump stations that have simple telemetry 36
Number of pump stations that have only audible and visual alarms 0
Number of pump stations that do not meet permit requirements 0
# Does the permittee have a root control program? n n n ■
# If yes, date implemented?
Describe:
Not discussed
Comment: All pump stations have telemetry and audible and visual alarms. The
phone number is to 911 for the county should the telemetry fail.
Inspections
Yes
No
NA
NE
Are maintenance records for sewer lines available?
■
n
n
n
Are records available that document pump station inspections?
■
n
n
n
Are SCADA or telemetry equipped pump stations inspected at least once a week?
■
n
n
n
Are non-SCADA/telemetry equipped pump stations inspected every day?
❑
❑
■
n
Are records available that document citizen complaints?
■
❑
n
❑
# Do you have a system to conduct an annual observation of entire system?
■
❑
n
n
# Has there been an observation of remote areas in the last year?
■
n
❑
❑
Are records available that document inspections of high -priority lines?
n
®
n
n
Has there been visual inspections of high -priority lines in last six months?
n
■
n
n
Comment: High priority lines need to be inspected every six months.
Operation & Maintenance Requirements
Yes
No
NA
NE
Are all log books available?
■
❑
❑
Does supervisor review all log books on a regular basis?
■
❑
n
n
Does the supervisor have plans to address documented short-term problem areas?
■
n
n
n
What is the schedule for reviewing inspection, maintenance, & operations logs and problem areas?
Monthly at a minimum.
Are maintenance records for equipment available?
■
n
n
n
Is a schedule maintained for testing emergency/standby equipment?
®
n
n
n
Page: 4

Permit: WQCS00149 Owner - Facility: East Lincoln County Water & Sewer Dist
Inspection Date: 01/13/2010 Inspection Type: Compliance Evaluation
Reason for Visit: Routine
What is the schedule for testing emergency/standby equipment?
weekly
load test
Do pump station logs include:
Inside and outside cleaning and debris removal?
■
n
n
n
Inspecting and exercising all valves?
n
n
n
Inspecting and lubricating pumps and other equipment?
■
❑
❑
n
Inspecting alarms, telemetry and auxiliary equipment?
o
n
n
n
Is there at least one spare pump for each pump station w/o pump reliability?
®
n
n
n
Are maintenance records for right-of-ways available?
BODO
Are right-of-ways currently accessible in the event of an emergency?
■
n
n
n
Are system cleaning records available?
■
n
n
n
Has at least 10% of system been cleaned annually?
■
❑
n
❑
What areas are scheduled for cleaning in the next 12 months?
70 -80 % of the low pressure sewer lines are cleaned annually.
Is a Spill Response Action Plan available?
®n
❑
n
Does the plan include:
24-hour contact numbers
®n
n
n
Response time
®
❑
❑
❑
Equipment list and spare parts inventory
■
n
n
n
Access to cleaning equipment
®n
n
n
Access to construction crews, contractors, and/or engineers
■
n
n
n
Source of emergency funds
■
n
n
n
Site sanitation and cleanup materials
®
n
n
n
Post-overflow/spill assessment
®
n
n
7-
Is a Spill Response Action Plan available for all personnel?
®
n
❑
❑
Is the spare parts inventory adequate?
®
n
n
n
Comment: Need to update the names and phone numbers and submit to MRO for our
records for emergency calls.
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?
■
❑
n
Do spill records indicate repeated overflows (2 or more in 12 months) at same location?
n
El
n
n
Page: 5

Permit: WQCS00149 Owner - Facility: East Lincoln County Water & Sewer Dist
Inspection Date: 01/1312010 Inspection Type: Compliance Evaluation Reason for Visit: Routine
If yes, is there a corrective action plan? ❑ n n
Is a map of the system available? ■ n n n
Does the map include:
Pipe sizes
■
n
n
n
Pipe materials
■
n
Fl
n
Pipe location
■
n
❑
n
Flow direction
■
n
n
.n
Approximate pipe age
■
n
n
n
Number of service taps
■
n
n
n
Pump stations and capacity
■
n
n
n
If no, what percent is complete?
List any modifications and extensions that need to be added to the map
New Killian Creek line and pump station.
# Does the permittee have a copy of their permit?
n
■
n
n
Comment: In draft form and has not been issued yet.
Monitoring and Reporting Requirements
Yes
No
NA
NE
Are copies of required press releases and distribution lists available?
■
n
F1
F1
Are public notices and proof of publication available?
■
n
n
n
# Is an annual report being prepared in accordance with G.S. 143-215.1 C?
■
n
n
n
# Is permittee compliant with all compliance schedules in the permits?
n
n
■
n
If no, which one(s)?
Need to get FOG program implemented and inspections of commerial establishments. May need to add
more regulatory language tot he sewer use ordinance for grease but the system currently does not have a
grease problem.
Comment:
#10 - 8218 Hagers Ferry Road
Pump Station
Yes No
NA
NE
Pump station type
Duplex
Are pump station logs available?
■ n
n
n
Is it accessible in all weather conditions?
® n
n
❑
# Is general housekeeping acceptable?
® F1
R
n
Are all pumps present?
® ❑
n
❑
Page: 6

Permit: WQCS00149 Owner - Facility: East Lincoln County Water & Sewer Dist
Inspection Date: 01/13/2010 Inspection Type: Compliance Evaluation
Reason for Visit: Routine
Are all pumps operable?
■
❑
n
❑
Are wet wells free of excessive debris?
■
Are upstream manholes free of excessive debris/signs of overflow?
■
n
n
n
Are floats/controls for pumps/alarms operable?
®n
n
n
Is "auto polling"feature/SCADA present?
n
n
■
n
Is "auto polling" feature/SCADA operational?
❑
❑
■
Is simple telemetry present?
®
n
n
Is simple telemetry operational?
®
n
n
n
Are audio and visual alarms present?
®n
n
n
Are audio and visual alarms operable?
■
Is the Pump station inspected as required?
®
❑
❑
Are backflow devices in place?
®n
n
n
Are backflow devices operable?
■
❑
n
Are air relief valves in place?
®n
n
n
Are air relief valves operable?
®n
n
n
# Is an emergency generator available?
■
n
n
In
Can the emergency generator run the pumps?
®❑
❑
❑
Is the pump station equipped for quick hook-up?
n
®
n
Is the generator operable?
■
n
❑
n
# Is fuel in tank and sufficient?
®n
n
n
Is the generator inspected according to their schedule?
®
❑
❑
❑
Is a 24-hour notification sign posted?
Does it include:
Instructions for notification?
®
❑
n ❑
Pump station identifier?
®
❑
n ❑
Emergency phone number
n
n n
Is public access limited?
®
n
n n
Is pump station free of overflow piping?
Is the pump station free of signs of overflow?
®
n
n n
Are run times comparable for multiple pumps?
Page: 7

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Permit: WQCS00149 , Owner - Facility: East Lincoln County Water & Sewer Dist
Inspection Date: 01/13/2010 Inspection Type: Compliance Evaluation Reason for Visit: Routine
Is a 24-hour notification sign posted? ■ n n n
Does it include:
Instructions for notification?
■
n
n n
Pump station identifier.
■nnn
Emergency phone number
®
n
n n
Is public access limited?
■
n
n n
Is pump station free of overflow piping?
®
M
M M
Is the pump station free of signs of overflow?
■
n
n n
Are run times comparable for multiple pumps?
Comment: Generator on site, pump station logs indicate station runs 7-10 hours per
week. Duplex station with 180 GPM pumps. Pump station is 7 yrs old.
1587 HWY 16N -
Manhole
Yes
No
NA
NE
Is manhole accessible.
®nnn
# Is manhole cover/vent above grade?
®n
n
n
Is the manhole free of visible signs of overflow?
M
n
n
Is the manhole free of sinkholes and depressions?
■
n
n
n
Is manhole cover present?
■
n
n
n
# Is manhole properly seated?
®
n
n
n
# Is manhole in good condition?
n
n
n
# Is invert in good condition?
®
n
n
n
Is line free -flowing and unrestricted in manhole?
n
❑
❑
Is manhole free of excessive amounts of grease?
®
n
n
Is manhole free of excessive roots?
n
n
n
Is manhole free of excessive sand?
®
n
n
n
Is manhole's extended vent screened?
n
n
®
n
Are vents free of submergence? n n ® ❑
Are manholes free of bypass structures or pipes?
Comment: Manhole replaced with fiberglass, due to corrosion from sewer gases. This
manhole receives flow from two forcemains and one low pressure sewer line. This is
the beginning of the 18 " gravity trunk line to the VWVfP.
Page: 9

Permit: WQCS00149 Owner - Facility: East Lincoln County Water & Sewer Dist
Inspection Date: 01/13/2010 Inspection Type: Compliance Evaluation Reason for Visit: Routine
8218 HAGERS FERRY RD - across st from PS
Yes No
NA
NE
Manhole
n
n
n
Is manhole accessible?
■
n
n
n
# Is manhole coverlvent above grade?
Is the manhole free of visible signs of overflow?
■nnn
.
Is the manhole free of sinkholes and depressions?
■
®
rl
Is manhole cover present?
®
n
❑
# Is manhole properly seated?
■
n
n
n
# Is manhole in good condition?
®
❑
❑
# Is invert in good condition?
®
❑
❑
Is line free -flowing and unrestricted in manhole?
®
fl
❑
n
Is manhole free of excessive amounts of grease?
Is manhole free of excessive roots?
®
❑
Is manhole free of excessive sand?
■
n
n
n
❑
n
■
❑
Is manhole's extended vent screened?
fl
❑
®fl
Are vents free of submergence?
Are manholes free of bypass structures or pipes?
®
0
❑
❑
Comment: PS # 20 Club Drive flows in this 8 inch gravity line currently flowing about
25% capacity.
COWENS FORD OUTFALL -
Lines/Right-of-Ways/Aeriel Lines
Yes
No
NA
NE
Is right-of-way accessible for emergency?
®
❑
❑
Is right-of-way free of sinkholes or depressions?
®
0
0
0
®nnn
Is line/right-of-way free of evidence of leakage?
®nn
n
# Are there areas of exposed line?
# Is any exposed line constructed of ductile iron or other approved material?
■
n
n
n
Are water crossing and supports in good condition?
■
®
nnn
# Is right-of-way free of non -utility motorized traffic?
■nnn
Is line free of visible damage?
■
.n
n
n
# Are there siphons in this system?
Page: 10

Permit: WQCS00149 Owner - Facility: East Lincoln County Water & Sewer Dist
Inspection Date: 01/13/2010 Inspection Type: Compliance Evaluation Reason for Visit: Routine
If yes, are they maintained and documented?
Comment. -
FOOD LION OUTFALL -
Lines/Right-of-Ways/Aerie) Lines
Yes
No
NA
NE
Is right-of-way accessible for emergency?
i
❑
n
n
Is right-of-way free of sinkholes or depressions?
®
n
n
n
Is line/right-of-way free of evidence of leakage?
®n
❑
❑
# Are there areas of exposed line?
®❑
❑
fl
# Is any exposed line constructed of ductile iron or other approved material?
®n
n
n
Are water crossing and supports in good condition?
❑
❑
n
# Is right-of-way free of non -utility motorized traffic?
®
n
n
❑
Is line free of visible damage?
®
n
n
n
# Are there siphons in this system?
❑
❑
n
If yes, are they maintained and documented?
Comment:
FORNEY CREEK OUTFALL - At WWTP
Lin es/Rig ht-of-Ways/Aeriel Lines
Yes
No
NA
NE
Is right-of-way accessible for emergency?
®n
n
n
Is right-of-way free of sinkholes or depressions?
®
n
n
n
Is line/right-of-way free of evidence of leakage?
®
❑
n
❑
# Are there areas'of exposed line?
fl
n
# Is any exposed line constructed of ductile iron or other approved material?
®❑
Are water crossing and supports in good condition?
®
❑
❑
❑
# Is right-of-way free of non -utility motorized traffic?
❑
❑
❑
Is line free of visible damage?
n
n
n
# Are there siphons in this system?
n
n
n
If yes, are they maintained and documented?
Comment: Outfall line to WWTP a splitter box will be installed to send flow to Killian
Creek WWTP.
Page: 11

Permit: WQCS00149 Owner - Facility: East Lincoln County Water & Sewer Dist
Inspection Date: 01/13/2010 Inspection Type: Compliance Evaluation Reason for Visit: Routine
KILLIAN CREEK OUTFAL - Killian Creek WWTP
under construction
Lines/Right-of-Ways/Aerie) Lines
Yes
No
NA
NE
Is right-of-way accessible for emergency?
n
n
■
n
Is right-of-way free of sinkholes or depressions?
❑
❑
Is line/right-of-way free of evidence of leakage?
❑
# Are there areas of exposed line?
❑
f]
•
fl
# Is any exposed line constructed of ductile iron or other approved material?
n
n
■
fl
Are water crossing and supports in good condition?
❑
❑
■
❑
# Is right-of-way free of non -utility motorized traffic?
n
rl
®rl
Is line free of visible damage?
n
n
■
# Are there siphons in this system?
❑
[l
■
If yes, are they maintained and documented?
Comment: New line under construction to the new WV\fTP Killain Creek NCO088722
Page: 12

Collection System SSO 24-Hour Notification
Collection System: Number and Name WQCS# OX�-kLk
Incident Number from BIMS
Incident Reviewed (Date):
Incident Action Taken: BPJ
NOV-2009-DV
1 i ■ ■ 0 xS ■ 6 ■ ■ ■ ■ ■ Russ ■ Y ■ ■ ■ ■ ■ ■ ■ 6 ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ L ■ ■ ISKING
Spill Date 6 Time •c) ( (r I pm
Reported Date
4 Time l((, k 3 dDpm
Reported To SW Staff or EM Staff G�
Reported By 6� � Phone
Address of Spill 3 G hA-u Po, Dr
County ��'�� city
Cause of Spill �(,-
Total Estimated Gallons.3�
.N
Est. Gal to Stream 3c) ` -
Stream �-A (r�� IU (r�.ca.ov Fish Kill: Yes No Number Species
Non Required Information and other comments relating to SSO incident:
Response time minutes Zone Map Quad

Permit #
Owner and Facility Name
Permit #
Owner and Facility Name
WQCS00253
Bradfield Farms Water Company CS
WQCS00171
Greater Badin CS
WQCS00196
Carolina Water Service Cabarrus Woods CS
WQCS00322
Aqua Country Woods East CS
WQCS00233
Carolina Water Service Hemby Acres CS
WQCS00222
Town of Boiling Springs CS
WQCS06001
Charlotte -Mecklenburg CS
WQCS00341
Town of China Grove CS
WQCS00016
City of Albemarle CS
WQCS00231
Town of Cleveland CS
WQCS00046
City of Belmont CS
WQCS00058
Town of Cramerton CS
WQCS00107'
City of Bessemer City CS
WQCS00165
Town of Dallas CS
WQCS00089
City of Cherryville CS
WOCS00342
Town of E. Spencer CS
WQCS00221
City of Claremont CS
WQCS00328
Town of Harrisburg CS
WQCS00326
City of Concord CS
WQCS00343
Town of Landis CS
WQCS00088
City of Conover CS
WQCS00310
Town of Longview CS
WQCS00017
City of Gastonia CS .
WQCS00120
Town of Maiden CS
WQCS00020
City of Hickory CS
WOCS00344
Town of Marshville CS
WQCS00327
City of Kannapolis CS
WOCS00043
Town of Mooresville CS
WQCS00036'
City of Kings Mountain CS
WQCS00125
Town of Mt Pleasant CS
WQCS00040
City of Lincolnton CS
WQCS00153
Town of Norwood CS
WQCS00164
City of Lowell CS
WQCS00190
Town of Oakboro CS
WQCS00026
City of Monroe CS
WQCS00325
-Town of Stanfield CS
WQCS00059
City of Mount Holly CS
WQCS00180
Town of Stanley CS
WQCS00044
City of Newton CS
WQCS00135
Town of Taylorsville CS
WQCS00019
City of Salisbury CS-
WQCS00258
Town of Troutman CS
WQCS00037
City of Shelby CS
WQCS00345
Town of Wingate CS
WC,CS00030
City of Statesville CS
WQCS00054
Union County CS
`WQCS00149
East Lincoln CS
WQCS00009
WSA Cabarrus Co. CS
Deemed Permitted
Permit #
_Owner and Facility Name
Perm
Owner and Facility Name
WQCSDO130
Brooks Food Group -Brooks Food Group
WQQSDO064
Lincoln County CS
WQCSDO114
Charlotte Mecklenburg Schools - Misc Laterals
WQCSDO097
Martin Dev Gp-N Point & Portside CS
WOCSDO057
City of High Shoals CS
WQCSDO120
Martin Marietta Mallard Creek
WQCSDO117
Duke Energy Marshall Steam Station
WQCSDO019
Town of Richfield CS
WQCSD0257
Fallston
WQCSDO024
Town of Grover CS
WQCSDO116
Goose Creek Utilities Fairfield Plantation WWTP
WOCSDO038
Town of McAdenville CS
WOCSDO101
Harborside Dev LLC-Midtown T CS
WQCSD0002
Town of Ranlo CS
WQCSDO095
Kennerly Dev, Group LLC-Boardwalk Villas CS
WQCSDO049
Town of Spencer Mountain CS
WQCSDO098
Kennerly Dev. Group LLC-Kings Point CS
WQCSDO105
Kennerly Dev. Group LLC-Moon Bay Condos CS
WQCSD0252
All spills which do not have a permit
WQCSDD107
Kennerly Dev. Group LLC-Schooner Bay CS
number assigned
WQCSDO099
Kennerly Dev. Group LLC-Spinnaker Point CS
WOCSDO258
Kingstown
WQCSDO112
Lake Norman -South Point CS
1JJQCSD0104
Lake Norman -Villas S Harbour CS
WQCSD0102
Lake Norman -Vineyard Pt Resort CS

115 Weet Main Street
Uncolnton, N,C. 2W92
Phone: (704) - 730 - 8497
Fax RM - 736 - 84a9
TL
m
Mr-t � "&! W-A'O-,k AL
To: c5i�r+Drr� FtOwUl: 01� C`i S ! t_G'SPI
Fax; -
Phone Pages: �l
Reference; Oe 5p*11 CC:
❑ Urgent [�or Review ❑ Please Conumnt ❑ Please Reply ❑ Please Recycle
Comments:
11/10 06ed L61#
66MELbOL SHOM OII9Ad 01 WPZS:60 60OZ/60/b0

p Form CS-SSO
Collection System Sanitary Sewer Overflow Reporting Form
N "r V 1/2009 PART I
This form shall be submitted.to the appropriate DWQ Regional Office within five days of the first knowledge of
the sanitary sewer overflow (SSO). - - -
Permit Number: QQ I L(q (WQCSt1 if active, otherwise use WQCSD#)
Facility_ FnmeuC
Incident #
Owner: L i nGOi n Cnuni3 81A b I i 0 .nr�S
Region:
city: -D-e Il e.R „ ,.
county. Utan
Source of $SO (check applicable) : Sanitary Sewer
❑
Pump Station / Lift Station
SPECIFIC location of the SSO (be consistent in description from
past reports or documentation - l.e. Pump Elation 6,
Manhole at Westall & Bragg Street, etc,):
( ,
Manhole#
I k
Latitude (degreas/minutelsecond): - °3D �� 3,
Longitude(degross/minute/second): SST I w4.59
Incident Started Dt ay 0� OQ Time: 9:D0 �m
Incident End Dr Tme: b: 'Qf►'1
(myth-atl-yyyy} nhhh:mm AMfPM
(mm-ddry)W) hh:mm AK 11PM�
Estimated volume of the SSO: .�� ..... galllonts
Estimated Duration (Round to nearest hour): —sue +�O .�
Describe how the volume was determined: - �}r rtilo d
h 1i ! edka►me Flo t.--�
Weather conditions during SSO avant
m
r
Did SSO reach surface waters? 60 Yes❑ No❑ Unknown
Volume reaching surface waters (gallons): 390
Surface water name: Lo- k e N QXtY MY-\
Did the SSO result in a fish kill? ❑ Yes N No❑ Unknown
1f Yes, what 8 the estimated number of fish killed9
SPECIFIC causes) of the SSO:
❑ Severe Natural Condition
❑ Inflow and Infiltration
❑ Vandalism
IN Pipe Failure (Break)
24-hour verbal notification (name of person
0 DWQ ❑ Emergency Mgmt
❑ Grease ❑ Roots
I1 ❑- Pump Station Equipment Failure ❑ Power outage
t_.,r Debris In lino Other (Please explain in Par( li)
60" 5nyCek- moo z,Ile _.fitC b E N R _
Date (mm-cad-yyyy) Tlme (hh:rnm AM/PM) -4 25 a
If an SSO is ongoing, please notify Regional Office on a daily basis until SSO can be stopped.
Per G.S. 143-215AC(b), the responsible party of a discharge of 1,000 gallons or more of untreated wastewater to surface
waters shall Issue a pre$s release within 48-hours of first knowledge to all print and electronic news media providing general
coverage in the oounty-WtfAPi VT9-dscharge occurred. When 15,000 gallons or more of untreated wastewater enters surface
waters, a public notice shall be published within 10 days and proof of publication shall be provided to the Division within 30 days.
Refer to the to yenta statute for further detail.
The Director, Division of Water Quality, may take enforcement action for SSbs that are required to be reported to Division unless it
rs emons that
1) the discharge was caused by severe natural conditions and there were no feasible akematives to the discharge; or
2) the discharge was exceptional, unintentional, temporary and caused Iay factors beyond the reasonable control of the Permittee
and/or owner, and the discharge could not have been prevented by the exercise of reasonable control.
Part 11 must be completed to provide a justification claim for either of the above situations- This information will be the basis
for the determination of any enforcement action. Therefore, it $ important to be as complete as possible.
WHETHER OR NOT PART 11 1S COMPLETED, A SIGNATURE IS REQUIRED AT THE END OF THIS FORM,
CS-SSO Form Page 1
ti/ZO a6Ed 16I# 66MEL1OL SHOM OIlAfld Ol WE£S:60 60OZ/60/tO

04/09/2009 09;53am LC PUBLIC WORKS 7047368499 #197 Page 03/11
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11
uvICS3Ad�C�� ar, ,t,-, a�I \ W9 XIr�r }6 C�,a� „2h'Z � a% :u101dxe'sa�}i
3N []VN C) ON sti 4welgojd Gtn xg 01 elgellene saalnom pue juewdlnbe alenbepe auW
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System Visitation
ORC
Backup
Name: � �0.11 l 1eA V t7Y\
cert# 19 ZF-7 T
Date visited: " 11 &/ aOQq
Time visited: q W, r8 6 Ci -*-) "
How was the SSO ramediated (i.e. Stopped and c4eaned up)?
WYes
M:4
q
As a representative for the responsible part, ] certify that the information contained in this report is true and accurate to
mae best or my kriowiee. ---
Person submitting claim: D) a.Y1 • i`ei����,
Telephone Number.
Date: 4 19 lzczg
Title: r0. • 11'S 6iA �t11 detN- -
Any additional information desired to be submitted should be sent to the appropriate Division Regional Office within five days of first
knowledge of the SSO with reference to the incident number (the incident number is only generated when electronic entry of this
form is completed, If used).
CS-SSO Form Page 15
It/to 06ed L6I# 66MCLtOL SHOM oi1flnd 01 WE£5:60 600Z/60/60

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Map with Legend
Page I of 1
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County of Lincoln, NC - Official Website - Notification Of Sewage Spill Page 1 of 1
V-1 I•tu::,e eit print x:j>
Notification Of Sewage
spill
NOTIFY ME it.
SERVICE AGQ�UEST ►
L-SERVICES ACCESS
CONTACTUS 11�
iQ EMERGENCY ALERTS
Lincoln County Government
115 W, main St.
I,irwolntun,'NC 2.8097.
ph.(704, 736.8432
fax [phone]
�.:..:..,....�.�..,:..:4,U• ii�ti?�"�t:.: •!n: Q� .!.I r:�rl'•, •;'.. '•:�I'iP'iil I'ur{:a.°
..M ]��/f.ICES.,:. p PJ�RTMENTS;;
........�.i"!la. .. .. T—. ,. .... .. ,_-...
Yee Pro hero: l,lomc Rpddsnis+ Cmorquncy IntDMMhcn + timurgencyAtari Nell itabn Of Sewage SPAT
Lincoln County Emergency Alerts
Notificbtivn Of Sewage Spill In Lincoln County
For Irnmediot'e Release- Aprll 6, 2009
A wastewater spill of approximately 300 gallons was discovered In LinC'dlri County on April 6, 2009, The
untreated wastewal:c' pilk2d intu Lake Norman, In the Catawba River Bash. The Spill was due to a broken
sewer line, caused by a private contractor, at 8236 bay Pointe Drive. The split entered Lake Norman at 8191
t3ay Pointe Drive, The broken line has been repaired and the spill has stopped,
A swimming advisory notice has been posted in the area until the amount of contamination of the lake water
has been determined. The lake water is being tested, and when the wziter has been deemed to be safe, the
notirps wilt be removed, Residents cbn receive updates through the county's website, www.hncoincounty.orn
click on "Alerts" - or via press releases sent to the media.
The Lincoln County Department of Environmental Health is investigating the spill Incident and notlfyino
residents In the Immediate area through delivery of written notices as well as phone notlfi�otlon using the
county'u "RCVACSe 911" system. For further infprmatlon contact Environmental Health at 704-736-6426 or
LlnCotn County Public Works at 704-736-84137.
Residents are advised not to have bodily contact with die water in this area until the ban I$ Ilftetl due to the
possibillty of a -toll being present in the lake water. E-coli from raw untreated sewage Is a bacteria which occurs
naturally In small quantltle5 but wl,lch can be harmful to humans and wildlife at elevated levels. The State
Division of water Quality requires two successive clean water samples c200 parts per billion berpre the
swimming ban can be lifted.
Hoom I Irtr9nCt I Site Mop I Contact U: I Calgndpr I Ar'ehN@L I Pdnl Filendly I Enroll Pepe I RSS I Tran:Aauon i 4rr,,-.ihillty I I.ppyrlght Notices I Powered by C,rkPrua
http://www.lincolncoulity.org/index.asp?NID=638 4/9/2009
11/10 abed L6I# 66b89EML MOM OI19nd 01 WeSS:60 600Z/60/tO

r D
Date:
Uncolt. ;eunty
Forney Creek WWTP
Fecal Cofiform
p . L L fz n
rj f 0 0,� PM I WI-1r)
Sample Date; Sample
Date and Time in of Date and Time out Ml
Filter Countsl
Results
4 -
and Time Location
Blank
Incubation i of Incubation Sample
100
Factor
i 1'
100 ml
RepomdAnalyst(s)i
C12 mg&
50
2
25
4
t
11
10
10.
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2.0
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s
157
.38
i Upstream
10
10
Ji.
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5
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DDWOStrearn
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i
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Blank #2
100
1
- --- ---- ---
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Count = 3-, 6-19
Count = 10- 20+ Count
= 15
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!!MjLv 4?4? Ran is determined by the lowest count
value
refecolAls
FC Effluent DMIR <2.0 colonies
UP/Down DMR <5-0 colonies
Upstream - FCVVWTP
nnwncziranm . Ptonsr pnarj
1

If
m
0
R
1 Fomey Creek >riWWTP 0_�+
Date: Y1 f 0 Fecal Coliform
Sample Date Sample
pate and Time in Date and Time out
ml of
I
Fitter
4 Counts!
Re3ults
and Time
Location
_ . ....
Incubation
! of !n ubatio
C n
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amp-
acto
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4 ml
d i nal s
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1"-EdNW
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lefecol.xJ s
FC Effluent DMR <2.0 colonies
UpMown DMR <5.0 colonies
Upstream - FCWVIlTP

I
E
0
0
LIncolo, Jaunty �� r; `� r3 � 6,
/ Forney Creek WVVTP
C-) r Fecal Caliform
�Saimple Date': Sample
and Tirne Location
// Blank
7/7 1613 F.C. Effluent
F.C. Effluent
F.C_ Effluent
F.C. Elf. Dup.
upstream
Upstream
Upstream
Downstream
Downstream
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Culture + sempie
Blank #2
Date and done in Dana and Time out mi of � Filter Counts( Results
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1.00 1 F
i _ 1
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upstream - FCVVWTP
Downstreamn - PIPnk Road
1

COUNTY OF LINCOLN, NORTH CAROLINA
115 WEST MAIN STREET, 3RD FLOOR CITIZENS CENTER, LINCOLNTON, NORTH CAROLINA 28092
DEPARTMENT OF PUBLIC WORKS
[phone]
FAX (Ida) 735-0273
CANCELLATION OF SWIM ADVISORY NOTICE
IN LINCOLN COUNTY
At 10:30am on April 9, 2009 the Lincoln County Health Director cancelled
the No Swimming Advisory issued April 6 2009 for the wastewater spill
entering into Lake Norman at 8191 Bay Pointe Drive off Burton Lane in
Denver NC. This decision is based on daily water sample testing conducted
by the county's Public Works Department from three sites near the affected
area.
On April 7 and 8, two consecutive daily water samples taken from all three
sites indicated fecal coliform. counts below the maximum allowable
contaminant level (must be <00 parts per billion). This meets North
Carolina Division of Water Quality standards and therefore the swim
advisory has been lifted.
The advisory was originally issued 4-6-09 when approximately 300 gallons
of sewage spilled into Lake Norman. This was due to a broken sewer line at
8236 Bay Pointe Drive caused by a private contractor driving over the line.
Nearby residents are being notified today of the swimming advisory
cancellation through Reverse 911 phone messages. The general public is
being notified through this press release faxed to local media and posted on
the county's website, www.1incolncounty.org — click on "Emergency
Alerts". For further information, please contact Lincoln County Public
Works at [phone].
F,MJMI�
Apri19, 2009
10:30 am
11/11 a6Ed L61# 66b8 EEL sNdm oiiund 01 WEH:60 600Z/60/b0

Collection System SSO 24-Hour Notification
Collection System: Number and Name WQCS# �1 /(d
Incident Number from BIMS CroIK (0
Incident Reviewed (Date):
Incident Action Taken: BPJ
NOV-2008-DV
■ ...... 2 ... ■ ........................... ■ ............................... ■
Spill Date �[ Time aml pm
Reported Date g/ `tIOW Time pm
Reported To SWP Staff. or EM Staff
Reported By S Phone
Address of S ill
County C' liy �� c City
Cause -of Spill —
Total Estimated Gallons 50
Stream
ILV) &,
S �r
Est. Gal to Stream nC-, J
Fish Kill: Yes No Number Species
Non Required Information and other comments relating to SSO incident:
Response time minutes Zone Map Quad _ /� ea',�
5 >-ejv .
92
r�t �2; c��Xjoa," � v r�e

osx0F INN ATF�QG
� Y
Form CS-SSO
Collection System Sanitary Sower Overflow Reporting Form
This form shall be submitted to the appropriate DWO Regional Office within five days of the first knowledge of
the sanitary sewer overflow (SSO).
Permit Number, km n q q (WQCS# If active, otherwise use WQCSD#)
Facility: •- h C0 i� 1 4�hi 0 Q111BOi IDgfS
Owner: -L-:An6a111 Cnt.tn►Aj
City: L i vx m iyi "V'
Source of SSO (check applicable) Sancta Sewer ❑
Incident #
Region:
County:' >rtiC h
PART I
n'
Pump Station ! Lift Station
SPECIFIC location of the SSO (be consistent in description frOrp
past reports or documentation - i.e. Pump Station 6,
Manhole atWestall & Bragg Street, etc,): l- 4
RI i i l��x►rSeIR :
Manhole#
Latitude (deg reeslminLite/second): �Q • y r
Longitude(degrees/minute/second):_ sS Y, Zar
Incident Started Dt: & &4i Time: --.0? : 05dFn Incident End Dt: (2 ,4 zoo Time: Qz
(mm-dd-yyyy) hh:mm AMIPM
(mm-dd-yyyy) hh:Mm AM�IPM�
Estimated volume of the SSO:gallons
` n
Estimated Duration (Round to nearest hour):
Describe how the volume was determined:
Weather conditions during SSO event; _
t�Jr�
Did SSO reach surface waters? X] Yes NoLUnknown
Volume reaching surface waters (gallons):
Surface water name: take 14InrM&rX
Did the $SO result In a fish kill? ❑ Yes N No❑ Unknown
If Yes, what is the estimated number of fish killed?
SPECIFIC cause(s)ofthe SSO:
LJ Severe Natural Condition ❑ Grease
❑ Roots
❑ Inflow and Infiltration ❑ Pump Station Equipment Failure ❑ Power outage
❑ Vandalism debris in line
❑ Other (Please explain in Part II)
Pipe Failure (Break)
24-hour verbal notification (Hama of person contacted)D•
.r C_ l
X DWQ ❑ Emergency Mgmt. Date (mm-dd-yyyy): Time (hh:mm AWPM), Lo— h%
If an SSO is ongoing, please notify Regional Office an a daily basis until SSO can be stopped.
Per G.S. 143-215.10(b), the responsible party of a discharge of 1,000 gallons or more of untreated wastewater to surface
waters shall issue a press release within 48-hours of first knowledge to all print and electronic news media providing general
coverage in the wunty�w TeR` i"th�MNcharge occurred- When 15,000 gallons or more of untreated wastewater enters surface
waters, a public notice shall be published within 10 days and proof of publication shall be provided to the Division within 30 days.
Refer to the re rence statute for further detail.
The Director, Division of Water Quality, may take enforcement action for SSOs that are required to be reported to Division unless 4
rs aerrion.5trated that -
1) the discharge was caused by severe natural conditions and there were no feasible alternatives to the discharge; or
2) the discharge was exceptional, unintentional, temporary and Caused by factors beyond the reasonable control of the Pen-nittee
andlor owner, and the discharge could not have been prevented by the exercise of reasonable control,
Part II must be completed to provide a Justflcation claim for either of the above situations. This Information will be the basis
for the determination of any enforcement action. Therefore, it is important to be as complete as possible.
WHETHER OR NOT PART II IS COMPLETED, A SIGNATURE IS REQUIRED AT THE END OF THIS FORM,
CS-SSO Form Page 1
II/ZD 06ed 6Lt# 66MELtOL SMA oIlund 01 WE85:80 80H/80/80

Pipe Failure (Break)
Pipe size (inches)
What is the pipe material?
What is the approximate age of line/pipe? (years old)
Is this a gravity line?
Is this a force main line? L ow:� Pre66"te SeWM Serum L i nE'
Is the line a "High Priority" line?
a h it
5E.A �
❑ Yeg No O NACINE
WYeQ W ❑ NACI NE
❑ Ye4:1 Na M NAn NE
Last inspection date .and findings
- P T�
if a force main then,
Was the break on the force main veritical? Q YeM No © NA ❑ NE
Was the break on the force main horizantal?
Was the leak at the joint due to gasket failure?
Was the leak at the joint due to split bell?
When was the last Inspection or test of the nearest air -release valve to determine of operable?
When was the last malntenace of the air release performed?
If gravity sewer then,
Does the line receive flow from a force main immediately upstream of the failed section of pipe?
If yes, what measures are taker} to control the hydrogen sulfide production?
When was the line last inspected or videoed?
❑ Y4A No n NAn NE
Ye49 No n NA❑ NE
❑ YwO Non NAn NE
N /A
- - 'Y /A
❑ YeC No OD NA❑ NE
C&SSO Form Page 13
11/£0 e6ed tLt# 15MHLti0L SHOA OIlHd 01 wptS:80 800Z/80/80

if line collapsed, what Is the condition of the line up and down stream of the failure?
What type of repair was made? u
Is the repair temporary or permanent?
If temporary, when Is the permanent repair planned?
Have there been other failures of this fine in the past five years?
If so, then describe NIiA
Ye9 N. ❑ NA❑ NE
CS-S$O Form _ page 14
Too a6Ed tLt# 66b8 EEL SHOM OIlUd 01 W4:80 800Z/80/80

System Visitation
ORG
Backup ' Oeck1f\
Name: o 1c Y1 0, HexP— or\
Cert#
Date visited:
Time visited:
0,4 ::
12 Yqs
bIcLn-.,. ,. Heri�erz56n
016 flq fed
How was the M remedlated (1,e. Stopped and cleaned up)? 56,1
s� � ? �a7 P„ �"� h ►C9 � � b� ti v� � � rn �- b ra q 1
As a representative for the responsible party, I certify that the information contained in this report is true and accurate to
e best of my knoWledge.
Person submitting claim: O iio-Y-% 0 , IA e4--ae.'s-aY\
Signature: ...&I C - - �)� I
Telephone Number:
Date: 0 S I t)y wo?,
'title:
buPer`► ri'*
Any additional information desired to be submitted should be sent to the appropriate division Regional Office within five days of first
knowledge of the SSO with reference to the incident number (the incident number Is only generated when electronic entry of this
form is completed, if used)_
CS-SSO Form Page 15
11/H aSEd trLt# 13Sti89UL OL SMA OIIUAd 01 WEbS:80 800Z/80/80

115 West Main Street
Uncolnton, N.C. 28092
Phone; (704) - 736 - 8497
Fax: 1704) - 736, 8499
I JLWi iT i
To: Aar-6a Cj SJ r-,Vntj From:
Fax: & - p D Q Date: Z)$ wo,?
Phone: [phone] Pages:
Re: h,6, a� 'T� ". 1 ri A". 1 CC:
❑ Urgent 19 For Review ❑ Please Comment . ❑ Please Reply Q Please Recycle
COMMENTS
'1 5 i 5 +4%ie c o m D l toctj:�-kc to e
11/10 a6Ed tLb# 66ti8 EEL SHOM OIlUnd 01 WE£5:80 800Z/80/80

Map with Legend Page 1 of I
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.incoln County and its mapping contraCtOrs assume no legal responsibility for the information contained on this map. Tlds map is not to he used
or land conveyance. The map is based on NC State Plane Coordinate System 1883 NAD. Lincoln County, NC Office of the Tax Administrator,
318 Division
1Z'"9l1 51+e
ht#p://207.4,172,2061smIetleom.esri.esriraap.Esrimap?ServiceName=LCov&Form=True&... 8/4/2008
II/90 a6ed tLh# 66MELM SHOM OI]Hd 01 WeH:80 800Z/80/80

AUG-04-2006 12:52 From:LINCOLN CO HEALTH 704 732 9034 To:7047368499
P.1/1
Lincoln County Health Department
151 Siamon Read
Lincolnton, NC 28092
Phone! 704-73"634
'�+,,,Y FAX: [phone]
C. Margaret B. Dollar, M.Ed.
Health Director
SMIER SERVICE LEAK
MING AD It ISSUED
of
AUGUST 4, 2008
Approximately 50 gallons of sewage spilled Into a Burton Creek cove on L ko
Norman early this morning due to a county sewer system lock in the low pressure
line. The leek occurred at 8274 Blades Trail Road in Denver NC (near Badger
Run). The spill was reported to the Public, Works Department at 8:05 and
contained by 8:30 ant.
The media is NOT being notified since reporting to the general public is not
required for this amall of a spill; however, as a preventive health advisory to
nearby residents and boaters, the Lincoln County Health Director is posting "No
Swimming" sign& along the cove. Residenft; on the cove nearest the spill are
hereby notified of the potential fbr fe"I coliform contamination and are advised
to avoid bodily contact with the 10e water in this cove until further notice.
Children and petDa afro should refrain from playing in or drinking the lake water In
this area..
The county Public Works Department is taking water samples to make sure fecal
collform counts do not exceed the allowable standard of 2001ml at all ,sampling
Sites. At that time, the Lincoln County Wealth DiMetor will lift the Advisory. This
decision, is based on Public Health recommendations in consuhation with the
Mooresville Regional Office of the NC Olviaion of Environitnenial Management
M2rgar0t B. Dollar, RFd.
1-lncoln County Health Director
Ii/LO a6Ed tLt# 66ti898LtOL Sodom OIlBfld 01 weSS:80 8OR/80/80

FOMOY Ovek VftWP
(� l�
> Fe�a# cfl#ifcrtm�
Date: i1 v t f ' � i�1=5 j f
L@ t7�yo 7r
8ampk Dace
Sample
flnMte and Tults
ime in
Dabs and Time out_
nU of -_ r- _
k �_ T. - R --- -
�'
and 71rt1e
Location
Incubation I
oT I ubatiat
cu -
Umple Factor Coins
. _ — _
1 W of ' Reported
.- - . -
CO
to
I
- ._
BlankJT-1161.
/ --
100 1
_
L7 fy;crcvw
7l
F.C. EfY.— .
- --- - - — -
! --- - -- --- - .
10 t? .- 10
1 _
d-
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LO
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r~
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o V
3�= iw
1U-1 V
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upstream
3 20
Downstream � 20 s 75-
Dowream 10 i0 � =
��
.�
Downstream s -
Cultuie sample 10ug caMxating loop and 100 M of fecal buffer water _
Blank #2 3 100 1
1 . 1
11
. � 1
1
i - - - - T
JRPD Range tc000nies dMerence: "Cuum = 3: 6-19 Count = 10; 24+ Count = 15
F 1a1B�1 Rwme is determined by the lq� cauvu vuhw
rrCfe WAS
FC Eflfueni OUR -�2.0 colonies
• r w- .- /tea �R �t A ..]..I..
s 02 ROL
Upalream - FCVONM

�o N
)ate_ � 5 z� fS
Lind), .;Ounft
Forney Cassia WWTP
Fe"I Colifenn
5ampm Daft Sample Dace and Time in t hale and Time cut mi of Fi4�w } eount+5f Res"11!s
gjand Time Location Incubaiwn 1 of Incul>affian SaUWe Faealar Counts � 100 mi • Reported Analirsias) C12 mql/ -
Bl k l ` +� �f3i� 100 1 r T� L-
s- 135 D�arrt se-2 ! �
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j V i.�� : Utrearn 20 5 (? i
U�ream 10 t0
S U�tream i 5 20 �
!35-5 ream ` 20 5 f 100
S� Oowralream { 10 10 � }
S Downstream 5 . 20
Cullure + sample 10ug calibrating loop wAl 100 rFO of fecal Duffer water
iBlank Art ! 1DD
I
' RPD Range tealan[es d}iterewz: 0-5 Count = 3; 6-19 Gaunt = 1& 20+ Count =1-5 I
60oal1w jgp Ilion IUM Rartge is determined by 1he Vemst coursl value
Weed -xis
FC Effluent DMR c2.0 colonies
UpMown QMR {5.0 calanies
l"rearn - FC1 VWP
rvvAft kI rAil rn - PtA n [ a334Ad

08/0$/2008 09;02am LC PUBLIC WORKS 7047368499 #474 Page 10/11
AUG-7-2008 02:12P FROM:FORNEY CREEK 7048229668 TO:7047369499 PA/4
7
R 3 a
4
4
e

COUNTY OF LINCOLN, NORTH CAROLINA
115 WEST MAIN STREET, 3RD FLOOR CITIZENS CENTER, LINCOLNTON, NORTH CAROLINA 28092
DEPARTMENT OF PUBLIC WORKS
[phone]
FAX [phone]
CANCELLATION OF SWIM ADVISORY NOTICE
IN LINCOLN COUNTY
At 5:15 pm, August 7, 2008, the Lincoln County Health Director cancelled
the No Swimming Advisory issued August 4' for the Burton Creels cove
bordering 8274 Blades Trail in Denver, N,C. This decision is based on daily
water sample testing from three sites near the affected area, conducted by the
county's Public Works Department.
Two consecutive water samples from all three sites with fecal coliform
counts below the maximum contaminant level were reported at 5 pm today
which meets North Carolina Division of Water Quality standards. 1here£ore
the swim advisory has been lifted,
The advisory was issued August 4t' when approximately 50 gallons of
sewage spilled into this Burton Creek cove on Lake Norman due to a county
sewer system leak in the low presses lime.
For further information, please contact Lincoln County Public Works at
[phone].
August 7, 2008
5:25 pm
Tim a6Ed tLt#
66b89EML SHOM 0I18f1d 01 WEZ0:60 800Z/80/80