WQ0006785_SSO Reporting Form_20200804

Division of Water Resources
State of North Carolina
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
sanitary sewer overflow (SSO).
Permit Number: WQ0006785 (WQCS# if active, otherwise use WQCSD#)
Facility: Collection System Incident #: Isasis Owner: Town of Murfreesboro
Region: Washington City: Murfreesboro County: Hertford
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 - i.e. Pump '�•°
Station 6, Manhole at Westall & Bragg Street, etc.): Cotton St Lift Station�i`
Manhole #:
Latitude (degrees/minute/second)
�� �
Longitude (degrees/minute/second):
Incident Started Dt: 8-4-2020 Time: 6:30 Incident End Dt: 8-4-2020 Time: 9:30
(mm-dd-yyyy) (hh:mm) AM/PM (mm-dd-yyyy) (hh:mm) AM/PM
Estimated volume of the SSO: 2,700 gallons Estimated Duration (round to nearest hour): 3 hour(s)
Describe how the volume was determined: I in plume of wate from a 36 inch manhole cover
Weather conditions during the SSO event: Hurricane Isasis
Did the SSO reach surface waters? ❑ Yes ❑ No ® Unknown
Volume reaching surface waters: gallons 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:
®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): Chris Creighton
❑DWR ®Emergency Management Date (mm-dd-yyy): 08-04-2020Time: (hh:mm AM/PM): 6:00
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 11 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 I I 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 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 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: Hurricane Isasis. Terential rains and wind caused power outage
City wide. The Cotton St Lift Station has a stand by generator that failed.
How much advance warning did you have and what actions were taken in preparation for the event? We had 72 hours
warning. We placed generators and bypass pumps in arears of known problems. There was a generator on site at this Lift
station that failed. All generators were fueled and checked on Friday and or Monday. When alarm went off at this station
we tried to correct the problem, however was unsuccessful. We called a Septic Tank Service to pump station down.
Inflow and Infiltration with the rain amd the normal flow to this station overwhelmed the holding tank and the SSO
occurred. The estimation of gallon was determined from water lifting the 36 inch manhome lid about 1 inch and the total
spill time was about 3 hours. There were times that the overflow was not as great but the whole event lasted about 3 hours.
Comments:
Form CS-SSO Page 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? < 6 months
Do you have an enforceable grease ordinance that requires new or retrofit of
grease traps/interceptors? ❑ 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? ® Yes ❑ No ❑NA ❑ NE
Explain.
Have educational material about grease been distributed in the past? ❑ Yes ❑ No ®NA ❑ NE
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: daily
Were the floats clean? ® Yes ❑ No [:]NA ❑ NE
Comments:
Form CS-SSO Page 4

Roots
Do you have an active root control program on the line / area in question?
Describe:
Have cleaning and inspections ever been increased at this location because
of roots?
Explain:
❑ Yes ® No ❑NA ❑ NE
❑ Yes ® No ❑NA ❑ NE
What corrective actions have been accomplished at the SSO location (and
surrounding system if associated with the SSO)? Holding tank was pumped out and another generator was brought to the
site to be used if needed. Power was returned about 12 noon.
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
If Yes, when?
Comments:
❑NA ❑ NE
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 1/1?
Explain if Yes:
What corrective actions have been taken to reduce or eliminate I & I related overflows this spill location
within the last year? None
Has there been any flow studies to determine 1/1 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: Collection System was mapped and smoked in
the last year.
Are there 1/1 related projects in your Capital Improvement Plan?
If Yes, explain: Slip lining areas of concern.
Have there been any grant or loan applications for 1/1 reduction projects?
If Yes, explain: We are just beginning on this project.
Do you suspect any major sources of inflow or cross connections
with storm sewers?
® Yes ❑ No [:]NA ❑ NE
® Yes ❑ No DNA ❑ NE
❑ Yes ® No DNA ❑ NE
If Yes, explain:
Have all lines contacting surface waters in the SSO location and upstream ❑ Yes ® No ❑NA ❑ NE
been inspected recently?
If Yes, explain:
What other corrective actions are planned to prevent future 1/1 related SSOs at this location? We are scheduled to rehab this
lift station this year to include a generator and improved pump capacities.
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: Aparrant stright line winds took all lines of communication, cell service and power out at one time.
If a pump failed, when was the last maintenance and/or inspection performed? daily
What specifically was checked/maintained? The operation of pump and alarms are checked daily. This station is
scheduled for rehab when funds are available.
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 ❑NA ❑ 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 ❑NA ❑ 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? generator
Did it function properly?
Describe? Generator failed.
❑ Yes ® No [:]NA ❑ NE
When was the alternate power or pumping source last tested under load? unknown
If caused by a weather event, how much advance warning did you have and what actions were taken to prepare for the
event? We had 72 hours waming. We placed generators and bypass pumps in arears of known problems. There was a
generator on site at this Lift station that failed. All generators were fueled and checked on Friday and or Monday. When
alarm went off at this station we tried to correct the problem, however was unsuccessful. We called a Septic Tank Service
to pump station down. Inflow and Infiltration with the rain amd the normal flow to this station overwhelmed the holding
tank and the SSO occurred. The estimation of gallon was determined from water lifting the 36 inch manhome lid about 1
inch and the total spill time was about 3 hours. There were times that the overflow was not as great but the whole event
lasted about 3 hours.
Comments:
Form CS-SSO Page 8

Form CS-SSO Page 9

Vandalism
Provide police report number: NA
Was the site secured? ❑ Yes ❑ No
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 ❑ Yes ❑ No
occurrences in the future?
Comments:
❑NA
❑ NA
❑ NE
❑ NE
Form CS-SSO Page 10

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? NA
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
❑ Yes ❑ No
❑ Yes ❑ No
❑NA ❑ NE
❑NA ❑ NE
❑NA ❑ NE
Form CS-SSO Page I I

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 ❑ NE
If Yes, explain: We contacted a Septic Tank Service to pump out the holding tank. They pumped with two trucks
alternating so to lesson the spill volume. When power returned and the pump was in operation the septic trucks
continnued until holding tank was empty. The flow form other stations, I and I, as well as the weather made it
difficult to keep up. Once the pump did catch up it was able to function normally with no additional problems.
If the problem could not be immediately repaired, what actions
were taken to lessen the impact of the SSO?
❑ Yes ❑ No ❑NA ❑ NE
Comments: We contacted a Septic Tank Service to pump out the holding tank. They pumped with two trucks alternating
so to lesson the spill volume. When power returned and the pump was in operation the septic trucks continnued until
holding tank was empty. The flow form other stations, I and I, as well as the weather made it difficult to keep up. Once
the pump did catch up it was able to function normally with no additional problems.
Form CS-SSO Page 12

Form CS-SSO Page 13

Pipe Failure (Break)
Pipe size (inches) NA
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
[:]NA
❑ NE
❑ Yes
❑ No
[:]NA
❑ NE
❑ Yes
❑ No
❑NA
❑ NE
❑ Yes
❑ No
❑NA
❑ 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 [:]NA ❑ 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 [:]NA ❑ NE
If so, then describe
Form CS-SSO Page 14

System Visitation
ORC ®Yes
Backup
Name: Becky Turner
Certification Number: 25660
Date visited: 8-4-2020
Time visited: 6:00 am
How was the SSO remediated (i./e. Stopped and cleaned up)?
❑ Yes
When alarm went off at this station we tried to correct the problem, however was unsuccessful. We called a Septic Tank
Service to pump station down. Inflow and Infiltration with the rain amd the normal flow to this station overwhelmed the
holding tank and the SSO occurred. The estimation of gallons was determined from water lifting the 36 inch manhome lid
about 1 inch and the total spill time was about 3 hours. There were times that the overflow was not as great but the whole
event lasted about 3 hours. The entire spill area was remediated with hydrated lime.
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: Becky Turner
Signature: Title:
Telephone Number: 252-578-5506+
Date: 8-5-2020
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 15