WQCS00016_DV-2020-0009_20200205

ROY COOPER
420Agroor
S, REGAN
R. DANIEL %gm
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Certified Mail # 7017 2620 0000 6789 4919
Return Receipt Requested
February 05, 2020
Michael J Ferris, City Manager
City of Albemarle
PO Box 190
Albemarle, NC 28002-0190
SUBJECT: Notice of Violation and Assessment of Civil Penalty
for Violations of North Carolina General Statute (1G.S) 143-215.1(a)(0
and Collection System Permit No. WQCS00016
City of Albemarle
Albemarle Collection System
Case No. DV-2020-0009
Stanly County
Dear Mr. Ferris:
This letter transmits a Notice of Violation and assessment of civil penalty in the amount of $1,126.93 (51,000,00 civil penalty
S126„93 enforcement costs) against City of Albemarle.
This assessment is -based upon the foliowing, facts: a review has been conducted of the Sanitary Sewer Overflow (SSO)
5-Day Report submitted by City of .Albemarle. This review has shown the subject facility to be in violation of the
requirements found in Collection System Permit No WQCS00016 and G.S. 143-215.1(a)(1), The violation(s) that occurred
are summarized in Attachment A to this letter,
Based upon the above facts, 1 conclude as a matter of law that City of Pau-tade violated the terms, conditions or
requirements of Collection. System Permit No. WQCS00016 and G.S. 143-215,1(a)( 1) in the manner and extent shown in
Attachment A, In accordance with the maximums established by G.S. 143-215,.6A(a)(2)., a civil penalty may be assessed
against any person who violates the terms, conditions or requirements of a permit required by G.S. 1.43-215. (a).
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Based upon the above findings of fact and conclusions °flaw,. and in accordance with authority provided by the
Secretary of the Department of Environmental Quality and the Director of the Division. of Water Resources, 1, W. Corey
Basinger, Regional Supervisor, Mooresville Regional Office hereby make the following civil penalty assessment against
City of Albemarle:
SI 000.00 For 2 of the 2 violations of Collection System Permit No. WQCS00016 and CJ.S 143-215.1(a)(1) for
Sanitary Sewer Overtlow(s) resulting, in a discharge without a valid permit,
Sld)OOl) TOTAL CIVIL PENALTY
S126,93 Enforcement Costs
$1,1.26.93 TOTAL AMOUNT DUE
Pursuant to G,S. 1 43-215.6A(0, in determining the amount of the penalty1 have taken into account the Findings of fact and
Conclusions of Law and the factors set forth at G.S. 143B-282..1(h), which are:
(1) The degree and extent of harm to the natural resources .of the State, to the public health, or to private property
resulting front the violation;
(2) The duration and gravity of the V ol at ion:,
(3) The effect on ground or surface water quantity or quality' or on air quaIit.
(4) The cost of rectifying the damage;
(5) The amount of money saved by noncompliance:
(6) Whether the violation was committed willfully or intentionatly
(7) The prior record of the violator in complying or failing to comply with programs over which the Environmental
Nlanagemeni Commission has regulatory authority; and
(8) The cost to the State of the enforcement procedures.
Within thirty (30) days of receipt of this notice, you must do one of the .following
(I ) Submit payment of the penalty, OR
(2) Submit a wrnten request for remission. OR
(3) Submit a written request for an administrative hearing
Option Submit payment of the penalty:
Payment should be made directly to the order of the Department of Environmental Quality (do riot include waiver
Iormj Payment of the penalty will not foreclose further enforcement action for any continuing or new violation(s).
Please submit payment to the attention of:
Attn. PE:RCS Branch
Division of Water Resources
1617 Mail Service Center
Raleigh. North Carolina 27699-161. 7

!IlliFFII"-
Option 2: Submit a written request for remission or mitigation including a detailed justification for such
request:
Please be aware that a request for remission is limited to consideration of the five factors listed below as they may
relate to the reasonableness of the amount of the civil penalty assessed Requesting remission is not the proper
procedure tor contesting whether the vio(ation(s) occurred or the accuracy, of any of the factual statements contained in
the civil penalty: assessment document. Because a remission request forecloses the option of an administrative hearing,
such a request must be accompanied by a waiver of your right to an administrative hearing and a stipulation and
agreement that no factual or legal issues are in dispute, Please prepare a detailed statement that establishes why you
believe the civil penalty should be remitted, and submit it to the Division of Water Resources at the address listed below,
In determining whether a remission request will be approved, the following factors shall be considered:
(1) wheth.er one or more of the civil penalty assessment factors in NC(jS 143B-282.1(b) was wrongfully
applied to the detriment of the petitioner;
(2) whether the violator promptly abated continuing e.nvironmental damage resulting from the violation
(3) whether the violation was inadvertent or a result of an accident:
0) whether the violator had been assessed civil penalties for any previous violations: or
(5) .whether payment of the civil penalty will prevent payment for the remaining necessary remedial actions.
Please note that all evidence presented in support of your request for remission must be submitted in writing The
Director of the Division of Water Resources will review your evidence and inform you of his decision in the matter of
your remission request, The response NVffl provide details regarding the case status. directions for payment, and
provision for further appeal of the penalty to the Environmental Management Commission's Committee on Civil Penalty
Remissions (Committee). Please be advised that the Committee cannot consider 'information that was not part of the
original remission request considered by the Director. There fore, it is very important that you prepare a complete and
thorough statement in support of your request for remission.
In order to request remission, vou must complete and submit the enclosed :"Request for Remission of Civil Penalties,
Waiver of Right to an Administrative Hearn-1g, and Stipulation of Facts" form within thim, (30) days of receipt of this
notice. The Division of Water Resources also requests that you conalete and submit the enclosed "justification for
Remission Request,"
Both forms should he submitted to the following address
Attn: PERCS Branch
Division of Water Resources
1617 .MaiI Service Center
Raleigh, North Carolina 27699-1617
AND
W. Corey Basinger, Regional Supervisor
Water Quality Regional Operations Section
Mooresville Regional Office.
Division of Water Resources. \CDFQ
610 East Center Avenue, Suite 301
Suite 301,. Mooresville, NC 28

Option 3: File a petition for an administrative hearing with the Office of Administrative Hearings:
If you wish to contest any statement in the attached assessment document you must file a petition for an administrative
hearing. You may obtain the petition form from the Office of Administrative Hearings. You irmst file the petition with
the Office of Administrative Hearings within thirty (30) days of receipt of this notice. A petition is considered filed
when it is received in the Office of Administrative Hearings during normal office hours. The Office of .Administrative
Hearings accepts filings Monday through Friday between the hours of 800 a.m. and 5:00 p.m„ except for official state
holidays. The petition may be filed by facsimile (fax) or electronic mail by an attached file (with restrictions) - provided
the signed original. one (1) copy and a tiling fee (i a. tiling fee is required by NCGS §150B-23.2) is received in the
Office of Administrative Hearings within seven (7) business days following the, taxed or electronic transmission. YOU
Shou Id contact the Office of Administrative Hearings with all questions regarding the filing fee and the details of the
filing process.
The mailing address and telephone and fax numbers for the Office o 'Administrative Hearings are a toflos:
6714 Mail Service Center
Raleigh, NC 2'699 6714
Tel: [phone]
Fax: [phone]
One (1) copy of the petition .must also be served on DEQ as follows:
Mr. William E. Lane, General Counsel
Department of Environmental Quality
1601 Mail Service Center
Raleigh. North Carolina 27699-160 I
Please indicate the case number (as found on page one of this letter) on the petition.
Failure to exercise one of the options above within thirty (30) days of receipt of this letter, as evidenced by an internal
datettme received. stamp (not a postmark), will result in this matter being referred to the Attorney General's Office for
collection of the penalty" through a civil action. Please be advised that additional penalties may be assessed for violations
that occur after the review period of this assessment.
If you have any questions, please contact \lichael Meilinger with the Division of Water Resources staff of the Mooresville
Regional Office at [phone] or via email at rnichael.meilingerncdenr.gov,
Sincerely,
DocuSigned by:
A14CC681AF27425„.
W. Corey 'Basinger. Regional Supervisor
Water Quality Regional Operations Section
Mooresville Regional Office
Division of Water Resources, NCDEQ
ATTACHMENTS
Cc: WQS Mooresville Regional Office Enforcement File
PERCS Compliance/Enforcement Unit - Enforcement File

JUSTIFICATION FOR RE ON REUES'
Case Number: IDS'-2020-0009
Assessed Party: City of Albemarle
Permit No.: WQCS00016
Please use this form when requesting remission of
11'aiv c r f Ri �ht to an „Administrative Near
County: Stanly
Amount Assessed: S1,1.26.9;3
penalty.- You mttst also compiete the "Request For Remi,ssio
titippulata`on trf`Facts" form to request remission ofthis civil penalty.
You should attach any documents that you believe support your request and are necessary for the Director to consider in.
evaluating your request for remission. Please be aware that a request for remission is limited to consideration of the live
factors listed below as they may relate to the reasonableness of the amount of the civil penalty assessed, Requesting
remission is not the proper procedure for contesting whether the violation(s) occurred or the accuracy of any ofthe factual
statements contained in the civil penalty" assessment document. Pursuant to NLC.G,S. § I43B-282,1(c), rem ssion ofa civil
penalty may be granted only when one or more of the following five factors apply, Please check each factor that you
believe applies to your case and provide a detailed explanation, including copies of supporting documents, as to why the
factor applies (attach additional pages as needed).
(a) one or more of the civil penalty assessment factors in N.C.G_S. 14313
detriment of the petitioner the assessment in the civil p
(b) the violator promptly' abated continuing
steps that t,orr took to correct the violation and preven
.ur°re"nces):
rongfully applied to the
the violation
the violation was inadvertent or a result of art accident i.e.,(explain why the d iolaif
sorrretl7irty tic r: could not prevent or prepay
(d) the violator had not been assessed cavil penalties for any previous violatic
(e) payment ofthe civil penalty will prevent payme
how payment of the civil penalty will prey
compliance).
EXPLANATION:
! idahle or
aiming nece.ssarwr remedial actions (i.e., explain
fe activitrer necessary to achieve

STATE T 1 NORM CARO1 [NA
COUNTY OF STA FY
1 CI'
...PENALTIES
11 S
1t: betnarle
lbrr►arle Collection
PERMIT NO. WQCSO0016
[) Pr' R°TM NI OF EN\°1ROI
L TA[ L. ,,LIT Y
W I `EROF RI HTT0
ADMINISTRATIVE HEARING ANI
STIPULATION TIO F FACTS
D r O2O 0009
Slaving been G .ssrssea civil penalties totaltnp ` 1 1 26.9 for vAiolationlst as sr;t forth in the as essrnent
Division of Water 1 esor€rasa elated 1 ebrtirEf mi3,4 ?tt t , the undersigned, desifipiE to seek rernisr
hereby waive e the right to an administrative hearin an tkze above -stated matter and ~foes stipulate th
alleged in the assessment document. The undersigned further understands that all evidence pr°est
gent of the
penalty, does
the facts are as
d in support of
remission of this civil penalty must be submitted to the Director of the E ivrision of Water Resources whirs thirty (" 0) days
of receipt c tithe notice of assessment. No new evidence in support of a
from the receipt of the notice of assessment.
[ has the
a
ion rearing s ill be allowed after s; tat days
I1wRt SS
TELEPHONE
1. R1

PERMIT : WQCS00016
FACILITY: Albemarle Collection System
Other Violet
ons
ATTACHMENT A
City of Albemarle
CASE NUMBER: DV= 0 0-000
INCIDENT VIOLATION
NUMBER DATE VIOLATION TYPE
VIOLATION DESCRIPTION
7 t1 0191 1 /1312 19 CSf SO(Sewer r Overflow) Discharge without vand perme'
2011 01912 1 /1 12019: O 550( er Overflow) Discharge apt gat valid p rrrrt
REGION: Mooresville
COUNTY: Stanly
TOTAL VOLUME
(GALLONS)
3;00
13,200
PENALTY
AMOUNT
$250 00
$750 03

NOV/NOI#
TONY:.
SSO EVALUATION ROUTING S.IP
NOv pV -6o013
PERMtTTEE:
BOO /G
MICHAEL
ANDREW
C©REY

P J 704,984.9605
F 1 704.984.9606
ALBEMARLE
NORTH CAROLINA
Waco." LitPd, gre'ta.riti
Januar 14, 2020
North Carolina Department of Environment Quality
Mooresville Regional Office
610 East Center Avenue, Suite 301
Mooresville NC 28115
ATN: W.Corey Basinger, Regional Supervisor
Water Quality Regional Operations Section
Mooresville Regional Office
Division of Water Resources, NCDEQ
RE: Notice of Violation with & 'Intent To Issue Civil Penalty
Tracking Number: NOV - 2020 -DV - 0008
Sanitary Sewer Overflows - December 2019
Collection System Permit No, WQCS00016
Albemarle Collection System
Stanly County
Dear Mr. Basinger,
www.albernarIenc,gov
PO Box 190
Albemarle, NC 28002
The purpose of this letter is to provide additional information for the consideration in the above
referenced matter in accordance with your letter dated January 08, 2020 and received by the City of
Albemarle Collections ORC on January 13, 2020, This matter relates to the sanitary sewer overflows that
the City of Albemarle experienced during the month of December 2019, These overflows are associated
with l&I / heavy rain event
12/1.3./20.1.9
Incident number 201901911 was associated with a low laying manhole 0411.48791 outside Vickers Store
Rd Lift station,
The City of .Albemarle has a Smart cover system installed on the manhole associated with this SSO.
During times of rain the Systems ORC and back up have real time alerts sent via email and text message
to try and lessen the impact of the SSO's. The systems back-up ORC was dispatched on site at the call of
the Smart cover system alarm. He then assessed the situation but due to the loss of one vactor truck to
repairs and being in the shop he had to divert his attention to another SSO outlined in the next paragraph
because of the high priority and the location of the event. However the backup did check the lift station
that leads from this manhole and saw that it was able to keep up with itself with all three pumps on. Back
up ORC visited site and found no debris due to flow of creek at this site walked creek bank and found no
debris associated with the SSO.
12/3/2019
Incident number 201.90191.2 is associated with a low laying manhole (MI-1kt 252) in the parking lot of
1.313 N.6th Street, Upon arrival the backup ORC dispatched crews to the site with with a Vactor truck to

P 1704.984.9605
F 1704.984.9606
ALBEMARLE
NORTH CAROLINA
laReee ire. /air€( 49,pv 6,44.
vvvdalbemar enc.gov
PO Box 190
Albemarle, NC 28002
try and lessen tle irnpact of the SSO. City crews were able to pull 10 loads approximately 26,000 gallons
from an upstream manhole to Lessen the impact and stop SSO. When SSO had stopped crews then
followed procedure and cleaned area / washed down parking lot and raked up debris.
In summary all of the above events were due to large amounts of rain (2. that the City of Al ertra.rle
experienced during this date. Funding is in place to perform an I'' [ study in this area and a study of the
lift station. We are also within the next month going to deploy flow 3 flow monitors in and around these
areas to try and track down, some of our I&.l. This work will be done by I.KC Engineering and the City of
Albemarle looks forward to seeing the outcome of this project for the betterment of our collection system.
The City of Albemarle appreciates the opportunity to provide this information for consideration in this
matter, It is hoped that we will be received favorably. If there are any more questions or information that
is needed, please feel free to contact this office.
rely,
, Collection System. °RC
704-96 1-6149
City of Albemarle

CERTIFIED MAIL: 7016 1370 0000 2592 0324
RETURN RECEIPT REQUESTED
January 08, 2020
Michael Ferris, City Manager
City of Albemarle
PO Box 190
Albemarle, NC 28002-0190
SUBJECT: NOTICE OF VIOLATION & INTENT TO ISSUE CIVIL PENALTY
Tracking No.: NOV-2020-DV-0008
Sanitary Sewer Overflows - December 2019
Collection System Permit No. WQCS00016
Albemarle Collection System
Stanly County
Dear Mr, Ferris:
A review has been conducted of the self -reported Sanitary Sewer Overflows (SSO's) 5-Day Reports submitted by
City of Albemarle. The Division's Mooresville Regional Office concludes that the City of Albemarle violated Permit
Condition I (2) of Permit No. WQCS00016 by failing to effectively manage, maintain, and operate their collection
system so that there is no SSO (Sanitary Sewer Overflow) to the land or surface waters and the SSO constituted
making an outlet to waters of the State for purposes of G.S. 143-215.1(a)(1), for which a permit is required by
G.S. 143-215,1.
The Mooresville Regional Office is providing the City of Albemarle an opportunity to provide evidence and
justification as to why the City of Albemarle should not be assessed a civil penalty for the violation(s) that are
summarized below:
Incident Start Duration
Number Date (Mins) Location
Cause
Total Vol
Total Surface
Vol Water
(Gals) (Gals) DWR Action
201901911 12/13/2019 300 31601 NCHwy74O Severe Natural 3,600 3,600
Condition
-----^^^^-^-^^
Notice of Violation
Intent to Enforce
201901912 12/13/2019 840 1313 North bth Street Severe Natural 13,200 13,200 Notice of Violation
Condition Intent to Enforce
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This Notice of Violation / Notice of Intent to Enforce (NOV/NOI) is being issued for the noted violation. Pursuant
to G.S. 143-215.6A, a civil penalty of not more than twenty-five thousand dollars ($25,000.00) may be assessed
against any person who violates or fails to act in accordance with the terms, conditions, or requirements of any
permit issued pursuant to G.S. 143-215.1.
This office requests that you respond to this Notice, in writing, within 10 business days of its
receipt. In your response, you should address the causes of non-compliance, remedial actions, and all other
actions taken to prevent the recurrence of similar situations. The response to this correspondence will be
considered in this process. Enforcement decisions will also be based on volume spilled, volume reaching surface
waters, duration and gravity, impacts to public health, fish kills or recreational area closures. Other factors
considered in determining the amount of the civil penalty are the violator's history of non-compliance, the cost of
rectifying the damage, whether the spill was intentional and whether money was saved by non-compliance.
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 704-663-1699 or via email at michael.meinlingerC ncdenr.gov or
core rebasin er©ncdenr.nay.
Sincerely,
DocuSigned by:
A14CC581 AF274'25...
W. Corey Basinger, Regional Supervisor
Water Quality Regional Operations Section
Mooresville Regional Office
Division of Water Resources, NCDEQ
Cc: Mooresville Regional Office - WQS File
Central Files, Water Quality Section

State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
Collection System Sanitary Sewer Overflow Reporting Form
Form CS-SSO
This form shall be submitted to the appropriate DWQ Regional Office within five business days of the first knowledge of the
sanitary sewer overflow (SSO).
Permit Number: WQCS00016 (WQCS# if active, otherwise use WQCSD#)
Facility: Albemarle Collection System
owner: City of Albemarle
City: Albemarle
County: Staniy
Region:
Incident #:
Mooresville
201901911
Source of SSO (check applicable): El Sanitary Sewer Pump Station / Lift Station
SPECIFIC location of the SSO (be consistent in description from past reports or documentation - i.e. Pump Station 6,
Manhole at Westall & Bragg Street, etc): 31601 NC Hwy 740
Manhole #: 879
Latitude (Decimal Degrees): Longitude (Decimal Degrees):
Incident Started Dt: 12113/2019 Time: 7:00 pm Incident End Dt: 12/14/2019 Time: 12:00 am
(rnrn-dd-yyyy) (hh:mm AM/PM) (mm-dd-yyyy) (hh:mm AM/PM)
Estimated Volume of the SSO: 3,600
gallons Estimated Duration (Round to nearest hour):
Describe how the volume was determined: Estimated
Weather conditions during the SSO event:
5:0 hours
Heavy rain event 2"
Did SSO reach surface waters? El Yes D No El Unknown Volume reaching surface waters (gals): 3600
Surface water name: Mountain Creek
Did the SSO result in a fish kill? I:1 Yes El No WI Unknown If Yes, what is the estimated number of fish killed?
SPECIFIC cause(s) of the SSO:
El Severe Natural Conditi
24 hour verbal notification (name of person contacted ): George Bernard
DWR Emergency Mgmt Date (mm-dd-yyy): 12/14/2019 Time (hh:mm AM/PM): 11:44:00 am
If an SSO is ongoing, please notify the appropriate Regional Office on a daily basis until SSO can be stopped.
Per G.S. 143-2151C(b), the responsible party of a discharge of 1,000 or more of untreated wastewater to surface waters
shall issue a press release within 24-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 notice 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 enforc
Division unless it is demonstrated that:
n
action for SSOs that are required to be reported to
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 11 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 COMPLETED, A SIGNATURE IS REQUIREDREQ1JtREDATTHEEND OF THIS FORM
CS-SSO Form
Page:

PART
ANSWER THE FOLLOWING QUESTIONS FOR EACH RELATED CAUSE CHECKED IN PART I OF THIS FOR
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
Severs: Natural Condition
Describe the "severe natural condition" in detail?
A stron Fine of storms from the south that lasted ra ust of the day on 12/13/19 producincl 2"+ ©f rain.
How much advance warning did you have and what actions were taken in preparation
for the event?
24 hrs prior via the local weather station.
On call staff were made aware of the storms and had the vactor truck ready and on stand up.
Comments:
Our vactor truck was working on the sso on the other side of town while our 2nd vactor is in Monroe having repairs,
System Visitation
ORC
Backup
Nacre,
Christopher Palmer
Cert#
996205
Date visited:
12113/19
Time visited:
07:OOprn
El Yes
WI Yes
How was the SSO rernediated (Le, Stopped and cleaned up)?
The SSO stopped on its own while the vactor truck was working gri an SSO on the north side of town.
crews cleaned and sanitized area around manhole plus walked creek banks checking for debris but none was found,
CS-SSO Form
Page: 2

Signature:
'thing claim:
e reportsibe party, 1 certify that the information contained in this report is true and accurate to the
Christopher L Palmer
Telephone Number:
Date.
Title:
12/17119 09 00 am
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 tildident number (the incident number is only generated when electronic entry of this
form is completed, if used),
CS-SSO Form

Startly
Street Address:
P1601 740
43440.1110:01391111111.M.313.11K.opotting iytlps9.3www„.ncspana,no1.9L3oc11.,,3b(.)31rd,s.,3b.oarddat.a„:a.sJi.N31?,o.3r139Tulr9.„.
43 Rer3ortirtg
EM Level: NCEM Edited:
4 Yes
Taken by: Date/Time Reported:
George (3 Bernard 12,11412()1) 11:43:58
Reported by Agency:
Chris IaI 1 Albert -mile
County: City;
Albenlarle
EVENT TYPE
Type: Wastewater
Animal Disease Event Type: E3ornb Threat Event Type:
Include in Report
Yes
Date/Time Occurred:
12,HlyiY2019
Phone:
704,-961-61 58
Area:
Zip Code:
Complaint Event Type Fire Event Type
FNE Event Type ENE: Class
HazMat Event Type, HatiVtat Class HazMat Mode
Homeland Securely EventNon-FNF Event Non-FNE Event Type
Other Event Type; SAR Type:
Transportation Event Type:
Weather Event Type
State Resource Request
Wastewater Event Type:
:wateriSCHCLICV
Weather Event Name:
7 ita, 'fiej
Si/VI
WMD Event Type
1113 1(3 13(3 1 9, 89 33/` 333911,,v1

Point of Cant
tutu
(.fit) c)()O(X)()
RRT Request:
drinking
I of urie,
RRTApproved-
Point
Carr
Longitude,
RRT Tea
ct Phan ,
Number;
RRT iViistsion
Number,

State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
CollectionSystem Sanitary Sewer Overflow Reporting Form
Form CS-SSO
This form shall be submitted to the appropriate DWQ Regional Office within five business days of the first knowledge of the
sanitary sewer overflow (SSO).
Permit Number: WQCS00016 (WQCS# if active, otherwise use WQCSD#)
Facility: Albemarle Collection System
Owner: City of Albemarle
Incident it 20 01912
City: Albemarle
County- Stanly Region: Mooresville
Source of SSO (check applicable): El Sanitary Sewer
1.3 Pump Station I Lift Station
SPECIFIC location of the SSO (be consistent in description from past reports or documentation - i.e: Pump Station 6,
Manhole at Westall & Bragg Street, etc); 1313 North 6th Street
Manhole #: 1252
Latitude (Decimal Degrees): Longitude (Decimal Degrees):
Incident Started Dt: 121132019 Time: 7:00 pm Incident End Dt: 12/14/2019 Time: 09:00 am
(mm-dd-yyyy) (hh:mm AM/PM) (mm-dd-yyyy)
14:0.1 m "i hoursPM
Estimated Volume of the SSO: 13,200 gallons Estimated Duration (Round to nearest hour):
Describe how the volume was determined: estimated
Weather conditions during the SSO event: Heavy rain event 2" plus
Did SSO reach surface waters? Yes fl NoEj Unknown Volume reaching surface waters (gals): 13200
Surface water name: Melchor Branch
Did the SSO result in a fish kill? El Yes No 11 Unknown If Yes, what is the estimated number of fish killed?
SPECIFIC cause(s) of the SSO:
El Severe Natural Conditi
24 hour verbal notification (name of person contacted ); George Bernard
DWR El Emergency Mgmt Date (mm-dd-yyy): 12/14/2019
Time (hh:mm AM/PM): 11:44:00 am
0
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 1,000 or more of untreated wastewater to surface waters
shall issue a press release within 24-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 notice 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 enforcernent action for SSOs that are required to be reporteci to
Division unless it is demonsfrated 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:

PART II:
ANSWER THE FOLLOWING QUESTIONS FOR EACH RELATED CAUSE CHECKED IN PART I OF THIS FORM A
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
Severe Natural Condition
Describe the 'severe natural condition" in detail?
A strong line of storms from the south that produced 2"+ of in that lasted most of the day
How much advance warning did you have and what actions were taken in preparation
for the event?
The local weather station had forecast rain a 24 hrs prior to the event.
On raft staff were made aware of the rain coming and had vector truck on stand by.
Comments:
help with this issue.,
System Visitation
ORC
ackup
Name:
Christopher L Palmer
Cert#
996205
Date visited:
12l1312019
Time visited:
7:00r m
rocess of replacing crux ainsewer trunk line down stream o
his sso in hopes that wi
n Yes
Yes
How was the SSO remediated (i.e. Stopped and cleaned up)?
we were able to evacuate 26,000 gallons with our vector truck to help with re ediatinq the sso. after the sso had stopped
crews cleaned up all debris in area + washed and sanitized affected area.
CS-SSO Form
Page: 2

the responsible party, I certify that the information contained in this report is true and accurate to the
ge,
miffing claim: Christopher L Palmer Date: 12/17/19 08:19 am
Signature°
Telephone Number:
Title:
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

Taken by
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Street Addres
1313 North fat'
NE Edwted:
Yea
Dtet`t ime Repacked
Type:
Anirnal °lacese Event Type:
Complaint Event Type.
FNF Event Type:
HazMat Event hype;
Horneland Security Event
Other Event Type:
Tran portatic n Event Type:
"weather Event Type
Mate Respure Request
EVENT TYPE
L eer b Three t Event Type:
Fire Event Type:
FNF Class
FdazMat Mass:
Non-FNF Event
AR Type,
ncl.ude in Report:Yea
Time Deco tit
Phone:
Area:
.p Cod
Hazl at Mode
.t1a§.
Non-FNF Event Type
Weather Event Nam e: t Event Type:

anagernent EA1,13 i11p \ V IN 11s rt a.noPpoc 7.4). oards.boarddata.ashx7ckpr
ent Description:
The 'I own tit' A lberliarle rep,c)rteci tile release (kl'approxiniatc 1.;k2(X) gall(kns (II' sekkal.,id: froin a
nvdrihole due to it y rain. No drinking kkater sources \Acre alicrted and cleanup (k/kerations \Acre
conducted,.
Deaths: injuries: Evacuation, Radius:
(..i iri tii ()
Responsible Party: Responsible Party Phone:
Point of Contact
Latitude:
0Ei,000000
RRT Request:
Point of Contact Phone:
RRT Approved:
Longitude:
-00,000000
RRT Team Number:
RRT Mission
Number:

NCDEQ - Division of Water Resources
Water Quality Regional Office Operations Section - Mooresville
Sanitary Sewer Overflow Penalty Matrix
✓ Assessor:
Violator:
Case #:
Incident #:
ASSESSMENT FACTORS G.S. 14
1. Harm:
2. Duration and Gravity of the Violation
3. Effect on Water Quantity or Quality:
4. Cost of Rectifying Damage:
5. Amount saved by Noncompliance:
6. Violation was committed willf.ily or
intentionally:
7. Prior record of failing to comply with
Sanitary Sewer Overflows:
8. Enforcement Costs:
PENALTY AMOUNT:
Comments:
{=-�cDc.)5 Date:
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