WQ0038971_SSOFile_20200922

State of North Carolina
Department of Environment • •
And Natural Resources �f
Asheville Regional Office
Michael F. Easley, Governor NCDENR
William G. Ross, Jr., Secretary NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
FAX MESSAGE_
DATE: /-
FROM: SFAX NUMBER:
TOTAL OF _:2 PAGES(Including Cover Page
MESSAGE: .SSoa�evi s
IIa0104, l4e_ or,;^4- t l� Si T -Foon
sonar ✓'a� .i en r�E-s, 1 a.Iso 4 c -ic( Some,&- 01CJC-✓'
.J 5os W SIC-•-t S .fC� l rlJe '� is 4. C(. e e.n i L,/a-
2090 US Highway 70 Phone:[phone]
Swannanoa,NC 28778 FAX: [phone]
An Equal Opportunity/Affirmative Action Employer—50%Recycled\10%Post Consumer Paper

Type Date Incident# Permit# GKL Liable Owner Facility Location Latitude Longitude Farm or Ms
SSO k-;7-Vt15:00.0 200802476 WQCSDO042 Goo Town of Rhodhiss Rhodhiss Collection S Manhole-Caldwell St. under bridge near new r
SSOp-oS-0230:00.0 200802117 WQCSDO042/4'00 Town of Rhodhiss Rhodhiss Collection S Manhole on Walnut Avenue
SSO/-ZA-O '30:00.0 200800281 WQCSDO042/00 Town of Rhodhiss Rhodhiss Collection S Lift Station
SSOS-23-0340:00.0 200702669 WQCSDO0421000 Town of Rhodhiss Rhodhiss Collection S Caldwell St
SSOj-O$•0700:00.0 200700435 WQCSDO042COO Town of Rhodhiss Rhodhiss Collection S Caldwell Street
SSO/-0/-0730:00.0 200700227 WQCSDO042 COO Town of Rhodhiss Rhodhiss Collection S Pump Station Number 1, Caldwell Streeet
SSO/ -0/-0330:00.0 200700228 WOCSDO042200 Town of Rhodhiss Rhodhiss Collection S Pump Station Number 2, Catawba Avenue
SSO19,-O$v600 00-0 200700431 WQCSDO042750 Town of Rhodhiss Rhodhiss Collection S Owens Pump Station
Bypass(/./3OS00:00.0 200502975 WQCS D00424000 Town of Rhodhiss Rhodhiss Collection S Sandfilter at WWTP.
SSO//-g-eSO0:00.0 200600348 WOCSDO042/000 Town of Rhodhiss Rhodhiss Collection S Catawba Avenue, Rhodhiss
SS06-30.O500:00.0 200501785 WQCSDO042;ZCWTown of Rhodhiss Rhodhiss Collection S Parking lot of Davis Wood Products
SS06-/9-415:00.0 200501615 WQCSDO042900 Town of Rhodhiss Rhodhiss Collection S Influent Pump Station
SSO(.,'(j.0$00:00.0 200500186 WQCSDO042 X50 Town of Rhodhiss Rhodhiss Collection S 235 Dogwood St, Rhodhiss
SSO/-/7-0$ 30:00.0 200500169 WQCSDO042.500 Town of Rhodhiss Rhodhiss Collection S 235 Dogwood St, Rhodhiss NC
(ate 64Tr./
SSO/Z-/0.Oy00:00.0 200500926 WQCSDO042300 Town of Rhodhiss Rhodhiss Collection S 310 Catawba Avenue
SSO/.X-00Y 00:00.0 200501004 WQCSDO0429p Town of Rhodhiss Rhodhiss Collection S 100 Burke Street, Rhodhiss
SSO/-07-6Y00:00.0 200400070 WQCSD0042;t.4�OpTown of Rhodhiss Rhodhiss Collection S Sycamore Drive /
✓-e pe4Tf Grv!✓y
SS06-AS03 20.00.0 19036 WQCSDO042(AOWPAlown of Rhodhiss Rhodhiss Collection S WLANUT AVENUE MANHOLE /
SSO14-10-Z30:00.0 19064 WQCSD00421jS00 Town of Rhodhiss Rhodhiss Collection S CATAWBA AVENUE PUMP STATION SITE.
SSO I-23-OZ00:00.0 14588 WQCSD0042yS00Town of Rhodhiss Rhodhiss Collection S CATAWBA AVENUE PUMP STATION SITE.

BIMS Page 1 of 1
' f}sBasirwide Information
,; M 1
kl .:
Management System
Select Incidents
Incident Type : ---Select Value--- (.rr,atc
V" Edit View I Report
6 Items found, displaying all items.
1
i ,•,G�fL
Action Type Date Incident Permit# Region County City Liable Facility Location Latitude
# Owner
SSO 2000-08- 200011529 NCO025917 Asheville Burke Rhodhiss Town of Rhodhiss CALDWELL /goo
23 Rhodhiss WWTP STREET AT
08:00:00.0 BRIDGE
AT PUMP
STATION.
SSO 2000-08- 200011417 NCO025917 Asheville Burke Rhodhiss Town of Rhodhiss CAROLINA egoo
01 Rhodhiss WWTP AVENUE
10:00:00.0 BEHIND
OLD MILL.
' SSO 2000-04- 200010651 NCO025917. Asheville Burke Rhodhiss Town of Rhodhiss CATAWBA gQQ
30 Rhodhiss WWTP AVENUE
17:00:00.0 PUMP
STATION
#2.
.�I SSO 1999-07- 19997711 NCO025917 Asheville Burke Rhodhiss Town of Rhodhiss CATAWBAS3?S
07 Rhodhiss WWTP AVENUE
00:00:00.0 PUMP
STATION
#2.
SSO 1998-05- 19983395 NCO025917 Asheville Burke Rhodhiss Town of Rhodhiss LAKE (`O00
19 Rhodhiss WWTP HICKORY •..7
20:00:00.0 NEAR
RHODHISS
DAM.
t I SSO 1998-03- 19983394 NCO025917 Asheville Burke Rhodhiss Town of Rhodhiss CATAWBA
°fa 24 Rhodhiss WWTP AVENUE.
01:30:00.0
Export options: Excel I XML J CSV
http://bims.enr.state.nc.us:7001/login.do 11/20/2008

JUN 2 4 2005
VVA TER OUALITY SECTION
,�A iILLC Rf (-1.VAL OFFICE
TOWN OF RHODHISS
FACSIMILE TRANSMITTAL SHEET
'rG: f•RG N:
Jim Reed Rose Waldroup
COMPANY: nwrr_
DWQ 6/24/2005
FAX lylilM:9 7043 WrAL NO.OP PACIM MMUDING rOV RR:
i iii)]i:]2iLIM1lLft'i•. !:IL:ndiiYF-Il'_:::U(NCIu NUMIl1?.k:
" ••••r'.vma.a:vr""'a'es;rvew:e.0 eu.m—' u --uia},C, MM'Ii SIT �PLIIASA RripLY ©PLLASN&..-.... LCXCL!1._ .. _ . ..
NU'L'liti/CONMkNih -
Address as xequested as per rrmsraxatinn with Waym Wiisru
MGclnlxe XaleA .
J46�4 l.nllw+V n+�..a.
Tbanh you,
Rosc W dd=p
ETEF
i 1 11 I JUN 2 4 2005
WATT=11 OWM I-Y Si:5CTI0fJ
n devil Lr REC'ODIAI O VICE G
I'O KOX 411 RMODITISS, NORTH CAROLINA 28667
I 'd 5046-96E 828 dno ApleM asoy d1b:20 SO 42 unC

Ll i JUN 2 4 2005
WATER QUALITY CL'CTION
A51'.EVILLE REGIONAL.OFFICE
we`d^
�4T Forni'OS-SSO
Colleftim System Sanbty Sewer Overflew Reporting Form
PART I
....-7d'fs-b�mas2+slShe►subw+ixw.ito Wa@.pxu'a+ ?!a pW4 Ftegienal ONloe wAhin five dey of the first Imowladge of
ilw aaniiary avner'uWrfltyrY(SSO). /� y/,,
Permit Numbw! -J.--. -� (WWON ifvZwk 0MUMse usa treatrn@ntPlant NClWCIS)�Yd.®�
Facility: i'rurw\(+ ��.1Tn•..n �. Incident#
(]voter. Ira eer,1 t�� <4 L,n.'t�„r5 Regi@n: 11-U
City: -Ql,.r.,�(.:,r r !vi•4 County: _ Rt.r ke--
=-----.. n Lewer — re.np r"Mtlen -- -
.. .......a:..__rll. 4aD•hn.�naet+M...:..�7"N6lPbn@n.n poet 10.7 !.r ILT ,."r..ranfion.i.n.Cn.vrP-5; .atmr.
•. ::s-A'ah:aS 58.uuy Saua14IXa):--..--(�'n�n_e.11�w Ac)3
Lautuaa lu"vYli@niirin iL.`mo�'ii.��: ..8:.ylAld@(d@gWBSafllnat@73@Candt� ...__
h amat@d volume fn IM'Ssa [ ga for esumsted Durall@n(Round to Muf4st h@U(j
Desniba tleyx gl@vaume vres detalmirwd: r�icr±inr C.vfwx Awl
-_____ 'LiO iiP:V raeWl aarraao-werera% 'LjToal-jNOUf�tlnanown Vgamry ruaq.bg wNt.ca w:aura(gM:unq:
Slefocevealar name:-.A e,kr_ r'14 r 6f'r ,4cz
LLA'§@ve a Nalrml Condition- - - U Grease - � Roofs
r .-.
. _........ . - ......+++��d.:.:Y:::d ii..w`uAdpR :� '•--_racer w-�Rnern FdWra - ;©;---fI Poway vulwaa
❑ Vandalism LJ Dems(nGre tJ CAhar(Plwmle explain in Part II)
ImmFldl@[@LWfIWr YtlflhN r19e1Wllelryr:yr irrti iu: /• M �F'-�•L�-
-�tav±�x.:._=....�_ia..... _..n.,,;..f....,...a......><.� - :�-tir". -.s^4�e•^e..arfeoMl:- 5:er 7"k'1�1
if an 920 iv a a.Alpgs.a-nolityr.Rogiennl IXfieo on a daily basic until SSO eon be etepped.
l� on^aE..
' weoars slwn Issue a press rdlra9e wlmw wa-rlours m nrae i@la`riedpa io eii primaiic"a"iaa-a"cnio naves m�tllapiovfding gonoral
i r.. Ya`.::a le-r- -- -
04iw.i`y v.e t;:veter entersfaefae@
_.. ..
ye-
""-- - _-; t:w unv.:u. clew .road.uiw..--:i.ia inn a.....:.n.:dinu:.u.n n..arw u:ai a.ar ui:aiwvo: rMIWOIVWIen Ynlebed I _ --�
_e____Y-r-.._....�.�<.h.�""�'...:.�.�".s�_..�ri._.-...eFa......r..w_.•.HnnnH�n,JNr.:y.w.^M..r•It�AwNt��:Ly
1)m@ laaerunga wean anwptRami,-orlinlaalnrd,awnpurwy ww mused by tac ors C@yand ow rYAxorwll@ control ur Me Pennlit-
•..:+�... .....P-':d-ff.,fteharg@ eeuld n thave been prevented by the exeralte efraaeenabis central.
---=^=-..-:-I-:=::?:tClalti4a-fL w-i'3vTirs'M:xll1t .PdYSiK'Gri.Viazrn-rsr vici.Z_::3:.^.-.f�:`a•i".lTiatrtrk Twallb" RIFq•'r will @O pfelWaea .._ .
... . ... i..:_...r��..;.�,.:.„,::,,..,:..r..•.:,•,••••,•••�--�-:••�-iwr..f.;..,,:c:.:rnrnrromca ua nn t:.'rrv.ia:b:.36tLat6la.-____---_______-__.___. __ _-._.-___
Tf.'i-i"wr=fcr;W- kwzKi'UR2Y5 r%EQtHREUrAT THE'ENVOP THi5 FORM. ._.
1`^.n�r�..rn rYhnw•A '1IN15 ____ Vd.a. 1 ..-
2'd 90b6-96E 828 cinclipien asob di*tzo S❑ b2 un'r

aF wrr�•y
o�g FDrtn CS4S.9
� Collection System Sanitary Sewer tDtrerflow Reporting Form
PART I 1
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
I..the eheD4 batAS below,NA=Not Applicable and NE=Not Evaluated
A t tARDCOPY OF THIS FORM SHOULD BE SUBMITTED TO THE APPROPRIATE OWO REGIONAL OFFICE
UNLESS IT HAS BEEN SUBMITTED ELECTRONICALLY THROUGH THE ONLINE REPORTING SYSTEM
Severe Natural Condition(hurricane,wm*W,att-)
Describa the'swam ratulal condMW In dotal.
C..,
How lnuh advame Warrir9 did you have and whatactions were taken in proparation iw ere everte
Comments:
^^sa�(CD umentatian such as cWning inspec ions,enforcement
=cffuns,P-ast-:-a:!_-,w reports wefl nal mAtRMiAI Anil[rWKih eta
— Ow.anaula be available t!"renuest_)
;2e...."am last than,this spedac line(a wet wall)we*Omned?
w�You I'.n:....n r:w--Mc g:.^...�a"orftmce N.W tiyul w now Oe•rOtm1[I Mom a M mfiMnrQyr�}p.�( �Y ❑NA�1� _.__.-.
—a
nanraaidentlafpraewauntr�lH.Aon?���---'--•--':.�.::_.;;..;_...•....;...::�~:�-rT�.:���T
Explain
Nava two peen other$Son orblodcagae In this area that ware also caused by grease? Y No NA NE
When?
- rrvt><.:}q;rnTre them' .
u...,..,au.a p�...c m,.,,'nd.xons e.w t`aan lKree54d 13ttlis I0Lr9lJ^nZ Y60.a Na NA NC^
Explain. _ .. ..
-E—d 9046-96c S2a dno,ip Tt:M asob d1•bt20 SO 42 unr

Have educational rnalwtds about greaee lwendhsbtbutsd In die past? YJYNO No❑NAt..,1NE
WWhen?
and to wham?
Explain?
If the SSO cacumed ate Vmq of him.when was the wet well and pumps last chadwd forgroase
aceumulat"? r�/ICI
Were t e heels dean? UYwtJ No❑NA❑NE I,
ROct$
00 you have an mdw rcat control program? LJYaJJd Ne❑NAONE
Oaa stbe
Have cleaning and Inspedbns ever bean Bhgessed at this location because of roobl? Y N.UNA1JNE
Explain:
What corrective actions have been mcompttshoo at tw$SO location land surrounding systern t
associated with the SSO)?
Mal carrecbe actions are planned al the SSO location to reduce root Intrusion?
Nee artl thou 4awh whahke wsw:lw AJawJhnia:fih a:n yawlrmn? _ .. Uy Na NA NC
N Yay,whgn? .
Intlow and Infift atian
• :mn-una�4Yi�:JUt�S'P:R��r�. _����.���� �_ _ r—r
..:aA._.. :... .�..._..... f.�,..�—.R.:_.::—_•_-ya.m.y u.»a.as.e: n...w�aa.A.. ' 'nr .. .
n._.........-.... P� 9
tr'd goi B-Sae 828 dnojp Lem asoH dlir20 SO tit unr

Explain If Yes: .. -
_ withnthelastye LiP�feYibaxsnssnsRwlniaaee�:wKw+�T1!MeonF•-.�.I•�T,ir.�,.�,•I,x�..x,na-..sd14.:A1Y\,
.__.__..__.._sthnihelastyear4 n t
it n�''— • All i� r't 1liT.kR'•'>�
i c..nswraafarox�va�mnwwlsHnea�nk.a�ltl�.Aw..na.u.-��,•••���_•••rolr ea msmw lxaeana �r "• un eW - .___—.
tills the m`.a bean arnc*e tooted m videeed wRhin the past year? UyojPk.UNALINE
Ara teas Ill rotated prAecfa In your Capital Improvement flan? Ne NA NE
II Yes,explain:
c.•.....-----`--•`us{u lA.ad.101kI.0YOU IS'T 660 Nu UNAr WE
If Yes.enplatrr. _
Irli yea sunpecr any meter waist of tntew tr emswnn4mns with stain sewers? Y NA NE
t Yes,explain: - - •-
IfYes,explaet
_ . . S�'v,i-t'tc- �-t.i•' . 4•.I.S. i t]Y '� ��i�l 1 a• `^'r NlF i
wiw't.a:m....At...av::.aaw...a M.«rr�...w p=orc-d fu4ae IA nlebd SSOs at Mb ItmaonT
ry ht
Z!`- AAc 4l G,mmc Ain rg, f(LI ^ t6 P'`4°j4.1•c_1�aa Y'� S ow-r L oej
- - - '-ufiig StoWn E4hjiymont Pansre ofmstlnm nerd.
Shout be provided upon fenuest3
V4•a!�Y oinoa9aaton/eltpm syttanearo protonfl
_ s..o-.iN.a...n.:......i..,rang-aeey carmlea[Icafwnf Llvm _.
Page 4
-^'I _^?_ ___ DJ. 1..3 unt•

Audible C6.
Visual rhea
SCAOA pwweay corrrrnenicde0n) Qire's
Emergency Concoct Slgnage Elves
Omar Qraa
-Describe th WAAW eM that failed?
What kind of situations bigger an atamh oondltion at tlris elaeon(ka.pump fellure,pmawfaiture,tigh
water,era.)? 12 mac•.
Were notMealbMalarm ayeterns oprHhle? LAYMU No NA NE
If no,explain: -
If a pump failed,when was the hurt maintenance andler Inspection perbmwd?
1.;- 7. z-0:
What speoculy was dwilcadtrrrahtained?
-__---r(cAT, �AL�SI ,
Na valve failed,when vies It last exwd!e- r--r//�+1 r�7
Were all pumps get to alternate? Ud�rmrL1�I N/a 1,,,,1NA©NE
Old any pump show above normal run tines ptrortu and during the tiSf)evert? 0YYe/at�l NO©NA©NE
Ware adeWate opera parts OR hand to fix the e*pment(switch,fuse,valve,seal,eta)? B Y D M[:JNAONE
Was a spare or portable pump Immediately available? ©Yew]fly(]NAQNe
Rafloat problem,when were the RaelS last tested?H=7
if an sub-dialer m SCADAti when was the system lastfested?How?
Comments:
a�__��.Ctrh) err^' ti\ iiyC)e ��?� LeriP� - tLro.. a bAilvl f l (h4 Krc{.aC
CS-SSO form October 9.2M Page 5
S*d 5046-see SUB dno,iplen asoy d2y:20 SO 42 unC

Flower autat�e f Documentation of testing,records,etc.,should be
Tlrovhde oof alternative power stlurg7l:upon request.}
What is youralternate powerer punwi g source?
Did it tmxtion propedy7 Ns NA NE
Describe?
Man was the akemate paver or pumping vource last tested under load?
0 - o i
If caused by a weather evert,how much advance wan ft did you have and vdlatafflom were taken tD
prepare for the event?
Comments:
Vandalism
Provide police moon number.
' it Y.c :xAM9
Have there been previous problems wUh vandalism at the$SO location? �Yey..1 No NE
If Yes,esplalrx
1
M.nwn M.bdwpYRffryrjK OCMron,;ee in ale fi we l 11M NX NC
r�mtw
Debrts in ling(Rocks, sticks, raps and ottter itafm not allowed In the
collectIRD&MM,,g&.l
Borneo typo of dabria has baenfound In tha line?
How could it have gotten them? f
Are..;m.he.z In the.me..,p-,p,p,..d,Inted? JNOUFAUNE
peep e
L'd 9"B-Sse Sze dno.rpleM asoy d24r20 go 02 unC

rJnerrwaeihe area last chadcaNcleenedP
Yar::iserdna and Inspeoiene over been increased at this bcatlar due to prevlaes poMema vtlm debdr? IJY.u�tilnONA❑NP.
--cwmm: . ... ._. .
Are appn4xiate e&wadond motedais oWN developed and riismuuiau io p lv ni iuurm airriier 0rvoi�tro EINE
ocamencegY
Comments:
Other(Plower and a PoWe report should-be available upon request.)
Oescdbe:
Were Weamla equWment and resowoee avwlable to fix the problem? TTY44 UNA UNE
If Yas,explain:
If Im problem could not be lmmedlately npaM,who=Wns were taken to lesson the Impact or die
SSO?
c"Mente:
For OWO Use Q& f�^ �try't
OWO Requested an Additlonal Written Report ©Yet©No OKA OME
If Yes,What AddMonal Intoarw ivn is Needed:
ODMmenty
CSSSO Form OcObw 9,20e3 Pago 7
e'd Sob6-SSE 628 dno.ApleM asoy d2y:2o so 1,2 unr

Asa representative for the responsible poft,I certify that the information contained in this report is true and accurate
to the beat of my knowleda4.
Person Submitting daim: Date:
Signetura: rl i /� ' Title: ,�(r..��C 4/1 e ('c
Telephone Number.
krK WeQe of the SSOwIth afainiw wpm k8:idnnt,vwd4 (qm in:.ktu5t numbw in on(ygonotited whenalentnmlcenhyet'Wc:oz
l8 edrnl�ler69,g aCYd).
04 8b WA 2003 Page a ._.. .
_. ..... 0040 Soc 020 einoaplen asoM a24.20 s0 1.2 unr _....

search Page 1 of 1
6
Enter SSO
* Permit : WQCSDO042 Find Permit
Facility Name : 113hodhiss Collection System Com
Owner : ITown of Rhodhiss Regi
City
* Report Type : CJ�' 24 Hour 05 Day
* SSO Start Date/Time : (..Iddiyyry 06/19/2005 06:30 PM * Estimated Volume of S!
hh:mm nm) -._
County (if different from above) : Burke we
-m, City (if different from abo,
* Location of the SSO : Influent Pump Station
Did SSO Reach Surface Water : *Yes ONo OUnknown Vol. Reaching Surface Wa
Waterbody : CATAWBA RIVER (Lake Hickory below elevation 935)- 11-(51)
Other Waterbody : Conveyar
Did SSO result in Fish Kill : *Yes ONo *Unknown Estimated Fish b
* Report Received By : Reid, James R. * Date/Time : mMddiyyyyhh:n
Regional Contact : Reid,James R. Date/Time : (MMddiyyyyhhm
Reported By : ---Select Value---
First Name : Wayne Date/Time (5 day only)
hh:n
Middle Name : Pho
Last Name : Wilson
Specific Causes :
El Severe Natural Condition W1 Inflow and Infiltration ❑ Vandalism
U Grease El Pump Station Equipment Failure Eli Debris in line
El Roots J Power outage KI Other(Please explain in Part II)
Finish E:, Save and Cgntinue
http://bims.enr.state.nc.us:7001/selectOnePertnit.do?id=66AN2CF000 WE5 WE4AXUAR2... 6/20/2005

7E
Jan 26 05 03i52p Jl1LIEJRRVIS 828 ass 5
if P 2
_ JAM 26 v0
of wnr�
° Farm C -sw
lei*aystemiS nary parer Overlow Reposing Form
O C
PART 1
This faun shall be suttmltted to the appropriate OM Rogbnal Of ko within fivo daysof the first knot' ledge of
the switowy se w awflow(SW). 6 por.dt Number: _ __. Nypffaarw.ortretwlae wa sw3hnane Baru NCmrxl) 2,W' yp(� rp
Faonftv.-- Adk& incldant#
O wr. rc%.i r3F ,li fc+xr�'fci fit' Rmlon: -
ay_ .P'�_altirct county; /jcii(r6
sohrco of SW(she&aWcMo): Sadtwy Rawer ❑ Pump Slatdn
SPECIFIC Io.wilon of the SSO(be camtslent in daeor(ptorh from pug repwm urdoahme -1.0.pump SLAM a.
Mantwe at ww"a Draw Street eto.): .��� "� P►.r,.�t�.�c
IatUde(dswmm r:ww"owhdg laxt wgm de( Y (7
IncidsttStertad0b ''��7US- Tirea'� irnidwa End nt_L2.G.1/ems' Tans_?*!• _ dl't. it
(am dd.yyyy) hhrwmAUM 4mm.dd yyyy) ML�A�ldylPlt�
Esgriated volmhe dffio SSM 12 ED-- _ gagwn F3tlmaied orates(Raul re hour zA&r Is neatest __
Describe tow the vd unm vim detowdred: ' WA TPr ./lL�� •n�
woatmr motions dttdng SSO amid• 62`A. a­6 dz& - ---
Did SSO.eadh.0m awetsre4 ©Yesgomo tmitnown valame mac hing surface wants(gallons): _---
sufacexawww a:� 15 1. - - -
[NdOmMOreddtinafishNCt ❑Yea pipin❑unknown ffYm.whatiathe eamhat mmibwofsub pjmw7_
SPWARC casse(s)arffia SSO:
❑ Soma Nsmralt7magm ❑ (Areas* Q Rests
❑ tr.gawmellnmlaallon ❑)J.,P�u�mp SVOW E�rOMet Failure ❑ Powerouls"
❑ VandaEem l'�Cl`^'°"'b'Ifne ❑Other(plasm explain in Pod 11)
Irrvnedlsis24Atwr vwbalnoGgceWr.rapatad to:
'fr7we2 0 Em*r9arwY lfprm. Wtt*(nan-dd�NIYY)- Time(hharan AWPM):
if an SSO le argming.plaaea notify Regional OMm on a daily basis until SSO can ba stopped.
PerG.S.143-279.7C(b).brat parry MadwhwWO I.egfi�pWbm art ot.ofirdtsotedamatdwehr+mwuka
vmtwsahell i*au*a 1��rarerele�s vdaln d&twu's dlflntlsnala0getm altplm rdelearddc nwrs malls ptwMing general
waterma� blo shall be published vsgL. Oi ays and proof apmsicaUm ollbwvwMWttheDsnnraaafece
days and proofdpvl>flattwh slips ba powdd raffia Oidsion NItNa 99 days.
fAefer ffi gie�sfaiugfarfuMardamg.
The Otvwwm Olw*m dweher Quality,now tabs ank memam action forSSOs 20 ere mak*W to be MLgW In MWBIm unless it
Isdonwaskowthat
t)g.ealdmrgewesr�usedbYaavarenahadeandltloraandthsaw�rmnekaag>teeltah.hetresbffiedsdhwgs:a'r
2)the dedmW vm mweptlanK ulnmaiormL leavotery aid ammad byfaoora hayontl te9 reaeahehblp oatrot of ma Pehmirtaa
andthm ovmer,and tisdsrhaW could nmlMve beanpmveantl by the etmrdhe.dreasmadme Control.
Part II mudbm oemplelad to provMe ajrxtgtation dahnferafrinrdtheabove Mumbons.Tuts IrhRrmadon vltl be its baste
for ins downdnavatof any eMamonem acftm Th-dbm,Itls impedertto be as mmplen as pvodble. y
WHETHER OR NOT PART II IS COMPLETED,A S)QNATURE IS REQU)REO AT THE END OF THIS FORM.
GSSSO Farm Ocubw e,2W3 page t

Jan 26 05 03252P J1ILIEJRRVIS 928 396-5365 P. 3
� °c Fotrrb C$-SSO
Colteci'ron System Shaniary Sewer Overflow ReporlNg Form
O K
PART I I
ANSWER THE FOLLOWING QUES71ONS FOR EACH RELATED CAUSE CHECKED IN PART 1 OF THIS FORM
AND INCLUDE THE APPROPRIATE DOCUMENTATION AS REQUIRED OR QESIREO
COMPLETE ONLY THOSE SECTIONS PERTAINING TO THE CAUSE OF THE SSO AS CHECKED IN PART I.
In tha heck boxes below,NA=NotApplicuhle and NE=Not Evultuded
A HAROCOPY OF THIS FORM SHOULD BE SUBMITTED TO THE APPROPRIATE DVVQ REGIONAL OFFICE
UNLESS IT HAS BEEN SUBMITTED ELECTRONICALLY THROUGH THE ONLINE REPORTM SYSTEM
Ssvera Natural CormMw urdcane iRtmado etbj
vescdbeh•he•sevem rmbaat cmWidme In dhhaai.
Now much advsnoe vmmmg did you have sndwho madam wars hAma Te prgherafim far the wime
Cbnmamx ,
rareaee ommentatlen such as Cle®r� 1 S en
dons I mateTM SM h�stdbuhvn date
etc.Shouts be ayailabb UPW Tahwest.)
When wag the mst dhrheThla sgadne llne(er wetwe0)vwz clewwd? A.)
Ib you lows an wh(amamTe gmaaeartehhmhce dhat reghtres haw«nammor�eretrgteAhhtxceplar8? r.dYaa�No�NnONIE
Have Ulwe bon meant impacdane andlorerlarcanwdadbns him as aeahby raataurarft or other' Elywa"oOV1aE
nonresldeminl arose conkibubW
Explain.
Have 8breben olh•r ssoe or bletlheW 6h adearea tiWWK9 aleo caused byarsasa? uyefgupLlmLJw
vhyiahh7 -
Ryes,dhwnlae then¢
Have cte®r&a mW havacdom everbem kchemad al We beanan? Y No NA NE
EXPI&L 9
05-88O Farm Oct rbW 9, 000 F Papa 2

Jan 26 05 03t52p JULIEJRRVI6 620 386-5365 p.4
Cleve gamy end matorM s abu tWesse been datdbrued In Ihs peat? 114 NOHOW
When?
andtovrhom?
E*Wn?
RCre Wo*WVmdatapest*ai 0, vd=-ftthbwetwallmdpUmpa lastdwdwdfer gteaae
o �a r�yy �»
wwo the floats deem? ❑ymo Ho mONE
rtwr Cemdx �Q
Raots
poyw have en acave nfotcmkW p ogram9 ❑Yew
Oeset4+a
Nava cgadag arW l a werbaerr lncresaed o Me bosden bsamas of toots? OlqNo NE
thud uarrsclho aclbns Mve been accatttpllalted attlteSSO WcaHwt{and aurnwmbtg ayefem tf
associadW vdit 8ta SSQ)?
iMret carec%o aoEono are planned Attlee SSO Iow§m to reduce mot Inftnion?
Heo the ins been emwm tented orwooeduffiln die peat year? Y tto NR NE
!f Yes,wWn4 -—
Inilaw Brat tn£Atration ����QQQQ t^�t
Are ywtndoran SOC(Spadd Orderby Cmroent)ordo you hawasChedote inarrypemdtthet ❑Vwj�Nnt,,,,68ME
addrasom Ip? i
C*490 Fbrm oateber a Tags P%o 3

Jan 26 05 03:52p JULIEJRRVIS 926 396-5365 p.5
Expdn If Yes:
11YItd eoneebvm aotlom have been liken W tedltcm a eltrrahste I&I rdats m ft m at this spa facom
wM*i the tedYGW —k bf
ea wry
Nastaem boil myeowstud4ato dwwrdnwWprobhmmbh dwoogedbn sydm atom 3WkWOSM? vWMho NE
ims,vAm was the a*cm~and whetodomdid Itramrmlmvr
IN
Hasum one boon Smoke tested arvueoedwiPhin rtro pesty9er4 Y bto NE
If Yes.when and iadcale andacuumumneceemxy erd Use stews of much oi;i S:
Arothem bt raleted Pra)eds In your CWW IMPWJ netdpbm9 moUmLINE
If Yes,008n:
r .J Pwtr Z�c
taw mere bemwWVnwworl
wn mWicaAomforMndudfm Pfoio*? wl 6UNE
N Yes,axplmin:
f]oyau suspaot ergrmtlrn" awmaml�worp06m6annmCdonewnh mtgAn mmNRima Nu NE
NY6%oxpwk
Have al Ares oonlacWV ewfaeawatds In tlhe 8304orMm aid Wabasm bomn inVmod maeMlitl No NE
R Yes,axpWn:
YAhatotlrmcmrealNra aalW:uare ptennsdb praverdriaum)A rdaUd 550a et 11tlBlar.86
Gansnethb:
Pump Station Eauiamor4 Faium(Ducumentftn of testtno,mcoide eW.,
shoal h0 t>mvidtld uuorl fBS14laSi.)
1Nhd ld:rdof�nneydmmm are presonl? -
Aulodiderl MWIY(mawaY amrmzkmdae) DYsm .,
w.
C"50 Fam pcmbw a,2M Pop 4

Jan 26 05 03t52p JULIEJRRVIS 820 396-5365 p.6
AUOW am
vhmw 13Yes
WJWAQWo-wey CWMW leaden) L_lYae
Emergermy COMM 3~ ❑Yee
pr1r QtMs
Oesral w tw GwOmwd#WAfai4d4
Wlta<MadofelhlatonsbipgaranmerrnamdNtonaRtlds&aYon(IapumpfMAu%pawarUWMhigh .
water,eta)?
Wen nodkod adium syemmc upwmbW? Y Na NA
Nrtq amwn:
R a pmV fWW.whon was rtta lsetnrdnrmmce andW IrwpaeUwr PKbmwd?
WhetapedOwlywae chOm*sd"WrthtnuV
N a vale feted,whm wm Il last wwdsed?
Were M pumps salvo altsnda? QY.O No MNA13NE
l("
Old arty pump stow abWO named Nm tlmespdor tonM dudny the M evari? ❑ ab y.P
ar Q_` DHE
Wms ade*wts$pen pnls an hand tofk lire sWlpm"rd CmmWv,ism%wb%owt etc.)? EIYaO No(PM[]WE
Was a Were orpohable pump brwns MAy NWbWe? Oyal❑Na((j(INn❑luE
Ka twat problem,when wan MefA M last leered?FoM? t(!
Iran auwMeror SCADA whm wmthe sydem last[Mead?how?
Comrneetx 1
CSSSO Form Octebsr 9,2m Pope 6

Jan 26 05 03:52p Jl1LIEJRRVIS 028 386-5365 p. 7
P&Aw outaga(Documentation of 12M. atm should be
DnNijed OF aNOMMIwe power.scurtsB yPM f6hZU89.)
NRwtlsyaval6wiWo orparphmsm"?
Did It ANNOon piapaly?
Desadbr?
WaptM7M the alrefaat9tldwararpurnpinp 8aan'6 Seat IaaLed undvrtaad?
ncmrsed try a v�eatharavem,haw much advance wwrft didyou have and what aremrs were taken to
pr.pmtot ms avant?
ConmreMc
Vandalism
FmMa pdim report:vmibar. 11��tt r�
Waaths akesecured9 ❑raer...i N.r+� 11nE
pv�.s tw.O II -
Padlodced Control Pastel
Have there been p'realamPmbtenlb wim vandabra at ma SSD boadol? ljy* .ONO NE
(rYva,e*Wn- rt
14
What smwaymeasres havabean pola Phm kl paventaiMlar=wmnc"IntheMwo7 LJr Na ❑HE
Gamrna tx
Debris in litre(Racks.sus,raM S M o(her kerns not e8ownd in the
cowtion system.etc) —
WhatgpaardNulshas bWA foead N tha Ilse?
ltrnr mum n larva mar.?
N
Am manhates In the area secure andItAmW N
AJNAEIW
Form MbbwR2WS Pro. e

Jan 26 05 03:53P JULIEJRRVIS 920 396 5365 P.B
Vow vrpbth®6ra91wtdWA*ffdmnsd7 en)2+�
►�vsr na�rwuuperawnsawraaw��r a.dace,r��ddo�duemPrewwpo�emtiwMaebrh? 11Y#INOMIINE
exphim
Are apq WHate oft"ma uwWrb a bane dWdwped waamia W b prnrentft"SfMRW P�MN*EINAINE
0owwwwoee7
Conenente:
_ P To
Other(Pkxulae and a Eft naM s Kxfid 6e ayWdsbls uaon neaueat)
aewalhe:
vvereadequaEaequi�meMmdnmauroseeveYaWetetYCfhepro6tem? e�No tw NE
rtr.e.03PNM
tt hre WWm aedd netbs fmmedWAV rWakW whldadfwtisw udwn a leaven the h"ctotthe
SSW
Cwrments
Far�WQ Use 04F.. e-t
OMRegeea snAddtiwWWhl%n Report ©ywUNoud--�
NAONE
RYee.VftWAdd cnw hvbre'o,dm Is Needed:
ti0r eft:
y
CS-SSO Fans Oclobsr%2M Page 7

Jan 26 05 03:53p Jt1LIEJRRVIS 029 396-5365 p.9
Ass reaantmive fnrthe 1e9 a 1 lh9t the lydb i11 r&*W In this re is hue and amunate
to(In bmt of kn
Peraun submitting chdm: Date: �t(s_ Os-�
3'ignahm �G.C.r .._.. Tmw r �//L�7.�isin vp ft�lG�^ �f'�.+t,w
Telophmw Number.
Aryadd mWln�dashedtDbewWamddwtddbosxdtodwMWOWVMDMdonRN[onWW"WINntivedaysoftiwt
W%WWdp ufUw SSDwin fefemw Oo the bwAwd nkonbor(ffw lnddantnumbw Is**generated whom daCbpde wMartmafban
Is earmpletatl.If used).
G4-=Fan OcEeber 9,2W3 page 8

Jan 26 05 03: 51p JULIEJRRVIS 820 386-5365 p. 1
TOWN OF RHODHISS
FACSIMILE TRANSMITTAL SHEET
TO: tin Reic ' 'M` �LiKr��►�e �C�Iilsc»,
COMPANY: DATA•
PAY NOWS)ER: 79TAG po.PA YAGILS INf:LLIDiNG COVSH:.
zs 47— `Ioy3 j
PNONR NVMBHIL S8RnwsRHRBRSNCe NVMSPA
v Z &' 2 /� y i-7ro
RR: TOtl1CRRM knNCe NUMBER•
p VRGI?NT O FOR FLUVIS.W ❑PLRAsK COMMENT CI PLEASE REPLY ❑FLEAsR 11LCYCLB
Noaro�e:nauce�ara:
4
PO SOX 48 RHODHISS, NORTH CAROI,YNA 28667
_ ff
I
I !:;TLH QUALITY SECTION
I_F PIGIOAJAL OFFICE

Jan 25 02 04: 36p Town Of Rhodhiss 396-5365 p. 1
16WIU dF �6eV iSI
N
Town Of Rhodhiss� R"
POB 40
200 Burke Street
9 6 Rhodhiss, North Carolina 28667
Phone -828-396-8400
�N►SS Fax-828-396-5365
e-mail address:[e-mail]
Notification Of Waste Spill In Burke County
House Bill 1160, which the General Assembly enacted in July 1999, requires
that 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 that regulation, the fallowing news release has been
prepared and issued to media in the affected county.
The Town Of Rhodhiss had a wastewater spill January 23, 2002 of an estimated
4,600 gallons at Pump Station #2 on Catawba Avenue in Rhodhiss. The untreated
wastewater spilled into the Catawba River in the Catawba River Basin.
The spill occurred during a lengthy rainfall event and excess ground water
infiltrated the sewer system. A small collection tank reservoir block wall collapsed from
the water's weight causing the water to run into the Lake Hickory, some 300 feet away.
The Division of Water Quality was notified of the event on January 23, 2002 and
is reviewing the matter. For information, contact the Town of Rhodhiss at 828-396-8400
during office hours, Tuesdays, Wednesdays or Saturdays.
Mv28 �r,�,