WQ0035784_Bypass Incident No. 202002670_20200924

DWRIncident Report
Division of Water Resources Report Number: 202002670
Incident Type :
Bypass
On -Site Contact
Category
Incident
First/Mid/Last Name : Robert P Barr
Incident Started ;
09/23/2020
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 : Danny D Holman
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
Ste 400
Page/Mobile Phone: /
City/State/Zip :
Wilmington DE 19808
Phone:
Material Category: Estimated City: UOM:
Chemical Name Reportable Qty.lbs. Reportable Qty.kgs.
< 500 gal.
DD:MM:SS Decimal
Position Method
Latitude :
Position Accuracy:
Longtitude :
Position Datum :
Location of Incident : EQ tank prior to screening device
Address :
City/State/Zip : Boone
Report Created 9/24/20 11:55 am Page 1

Cause/Observation : Directions :
Action Taken : Comments :
Reported cause due to rags clog in valve.
Incident Questions :
Did the Material reach the surface Water? No
Surface Water Name ?
Did the Spill result in a Fish Kill? Unknown
If the Spill was from a storage tank indicate type : EO tank
Containment? Unknown
Cleanup Complete? Unknown
Water Supply Wells within 1500ft : Unknown
Other (Please explain
in Part Ill
Event Type
Referred to Regional Office - Primary Contact
Report Entered
Report Received
SSO 24-hr Reported start
Event Date
Conveyance:
Estimated Number of fish?
(Above Ground or Under Ground)
Groundwater Impacted :Unknown
2020/09/24 11:53:04
2020/09/24 11:20:00
2020/09/23 4:00:00
Due Date Comment
Report Created 9/24/20 11:55 am Page 2

Standard Agencies Notified :
Agency Name Phone First Name M.I. Last Name
Contact Date
Other Agencies Notified :
Agency Name Phone First Name M.I. Last Name
DWQ Information :
Report Taken By:
Patrick Mitchell
Phone:
Date/Time: 2020/09/24 11:20:OOAM
Referred Via:
Did DWQ request an additional written report?
If yes, What additional information is needed?
Report Entered By:
Patrick Mitchell
2020/09/24 11:53:04AM
Contact Date
Regional Contact:
Patrick Mitchell
Report Created 9/24/20 11:55 am Page 3