WQ0035784_Bypass Incident No. 202101913_20210928

DWRIncident Report
Report Number: 202101913
Divlslon of Water Resources
Incident Type :
Bypass
Category
Incident
Incident Started ;
09/13/2021
Country :
Watauga
City:
Boone
Farm # :
Responsible Party:
Owner:
Wallace Loft LLC
Permit:
WQ0035784
Facility:
The Cottages of Boone WWTP
First Name :
Sean
Middle Name:
Last Name :
Devine
Address :
2711 Centerville Rd
Ste 400
City/State/Zip :
Wilmington DE 19808
Phone
Material Category:
Estimated Qty: UOM:
DD:MM:SS Decimal
Latitude
Longtitude
Location of Incident:
EQ basin
Address
City/State/Zip :
Boone
On -Site Contact :
First/Mid/Last Name
Company Name:
Phone :
Pager/Mobile Phone
Reported By :
First/Mid/Last Name : Don Feller
Company Name:
Address
City/State/Zip
Phone : [phone]
Page/Mobile Phone: /
Chemical Name Reportable Qty.lbs. Reportable Qty.kgs.
Position Method :
Position Accuracy:
Position Datum :
Report Created 9/28/21 2:28 pm Page 1

Cause/Observation : Directions :
Action Taken : Comments :
Operator stated that the membrane filters tripped and caused an air
lock in the pumps, preventing any flow into the plant. The EQ basin
overflowed into the storm drain next to the tank.
Incident Questions :
Did the Material reach the surface Water? Yes
Surface Water Name ? Laurel Fork
Did the Spill result in a Fish Kill? No
If the Spill was from a storage tank indicate type
Containment? Unknown
Cleanup Complete? Unknown
Water Supply Wells within 1500ft : Unknown
Did the Material reach the surface Water? Yes
Surface Water Name ? Laurel Fork
Did the Spill result in a Fish Kill? Unknown
If the Spill was from a storage tank indicate type
Containment? Unknown
Cleanup Complete? Unknown
Water Supply Wells within 1500ft : Unknown
Other (Please explain Maintenance
in Part II)
Conveyance:
Estimated Number of fish?
(Above Ground or Under Ground)
Groundwater Impacted :Unknown
Conveyance:
Estimated Number of fish?
(Above Ground or Under Ground)
Groundwater Impacted :Unknown
Report Created 9/28/21 2:28 pm Page 2

Event Type
Public Notice Received
Requested Additional Information
Requested Additional Information
5-Day Report Signed
Referred to Regional Office - Primary Contact
5-Day Report Entered
5-Day Report Received
Report Entered
Report Received
Verbally Reported 24 on 5 Day
Incident End
Incident Start
SSO 24-hr Reported start
Standard Agencies Notified
Agency Name Phone
Other Agencies Notified :
Agency Name Phone
DWQ Information:
Report Taken By:
Patrick Mitchell
Phone:
Date/Time: 2021/09/14 04:57:OOPM
Referred Via:
Did DWQ request an additional written report?
If yes, What additional information is needed?
Event Date
2021 /09/20 8:36:54
2021 /09/20 8:10:00
2021/09/14 5:28:01
2021/09/14 4:57:00
2021/09/14 4:45:00
2021 /09/13 8:00:00
2021 /09/13 7:00:00
2021/09/13 7:00:00
First Name
First Name
Due Date
M.I. Last Name
M.I. Last Name
Report Entered By:
Caitlin Caudle
2021/09/14 05:28:01 PM
Comment
Contact Date
Contact Date
Regional Contact:
Report Created 9/28/21 2:28 pm Page 3

Incident Type :
Bypass
On -Site Contact
Category
Bypass 5 Day.
First/Mid/Last Name
Incident Started :
09/13/2021
Company Name
Country :
Watauga
Phone
City:
Boone
Pager/Mobile Phone: /
Farm # :
Responsible Party:
Owner:
Wallace Loft LLC
Reported By
Permit:
WQ0035784
First/Mid/Last Name : Don Feller
Facility :
The Cottages of Boone WWTP
Company Name
First Name :
Sean
Address
Middle Name:
Last Name :
Devine
City/State/Zip
Address :
2711 Centerville Rd
Phone : [phone]
Ste 400
Page/Mobile Phone: /
City/State/Zip :
Wilmington DE 19808
Phone
Material Category: Estimated Qty: UOM:
Chemical Name Reportable Qty.lbs. Reportable Qty.kgs.
DD:MM:SS Decimal
Position Method
Latitude :
Position Accuracy:
Longtitude :
Position Datum :
Location of Incident: EQ basin
Address
City/State/Zip : Boone
Report Created 9/28/21 2:28 pm Page 4

Cause/Observation : Directions :
Action Taken : Comments :
Operator stated that the membrane filters tripped and caused an air
lock in the pumps, preventing any flow into the plant. The EQ basin
overflowed into the storm drain next to the tank.
Incident Questions :
Did the Material reach the surface Water? Yes
Surface Water Name ? Laurel Fork
Did the Spill result in a Fish Kill? No
If the Spill was from a storage tank indicate type
Containment? Unknown
Cleanup Complete? Unknown
Water Supply Wells within 1500ft : Unknown
Did the Material reach the surface Water? Yes
Surface Water Name ? Laurel Fork
Did the Spill result in a Fish Kill? Unknown
If the Spill was from a storage tank indicate type
Containment? Unknown
Cleanup Complete? Unknown
Water Supply Wells within 1500ft : Unknown
Other (Please explain Maintenance
in Part II)
Conveyance:
Estimated Number of fish?
(Above Ground or Under Ground)
Groundwater Impacted :Unknown
Conveyance:
Estimated Number of fish?
(Above Ground or Under Ground)
Groundwater Impacted :Unknown
Report Created 9/28/21 2:28 pm Page 5

Event Type
Public Notice Received
Requested Additional Information
Requested Additional Information
5-Day Report Signed
Referred to Regional Office - Primary Contact
5-Day Report Entered
5-Day Report Received
Report Entered
Report Received
Verbally Reported 24 on 5 Day
Incident End
Incident Start
SSO 24-hr Reported start
Standard Agencies Notified
Agency Name Phone
Other Agencies Notified :
Agency Name Phone
DWQ Information:
Report Taken By:
Patrick Mitchell
Phone:
Date/Time: 2021/09/14 04:57:OOPM
Referred Via:
Did DWQ request an additional written report?
If yes, What additional information is needed?
Event Date
2021 /09/20 8:36:54
2021 /09/20 8:10:00
2021/09/14 5:28:01
2021/09/14 4:57:00
2021/09/14 4:45:00
2021 /09/13 8:00:00
2021 /09/13 7:00:00
2021/09/13 7:00:00
First Name
First Name
Due Date
M.I. Last Name
M.I. Last Name
Report Entered By:
Caitlin Caudle
2021/09/14 05:28:01 PM
Comment
Contact Date
Contact Date
Regional Contact:
Report Created 9/28/21 2:28 pm Page 6