HomeMy WebLinkAboutWQCSD0123_Regional Office Physical File Scan Up To 11/6/2020W;ATFRQ
Michael F. Easley, Governor
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C) ° G
William G. Ross Jr., Secretary
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North Carolina Department of. Environment and Natural Resources
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Q 5 `
Alan W. Klimek, P.E. Director
Division of Water Quality
SURFACE WATER PROTECTION
January 18, 2007
CERTIFIED MAIL
RETURN RECEIPT REQUESTED - 7005 1820 0002 9207 4878
Blue Star Camps, Incorporated
Route 3 Crab Creek Road
Hendersonville, North Carolina 28793
SUBJECT: Deemed Permitted Wastewater Collection System
Permit No: WQCSDO123
Henderson County
Dear Wastewater Collection System Owner and/or Operator:
As a result of'reporting a sanitary sewer overflow (SSO) in the past you have been
issued a "Deemed Permit". The regulations that address this are15 A NCAC 02T —
Waste Not Discharged to Surface Waters, which were implemented by the North
Carolina Environmental Management Commission on September 1, 2006. These
regulations place significant operation, maintenance, and reporting requirements on
those entities that own and/or operate a wastewater collection system with average daily -
flows of less than 200,000 gallons per day. This letter is provided as guidance to assist
you in complying with the new reporting and operation and maintenance (O&M)
requirements, and to advise you that you are subject to system review, inspections, and
possible enforcement, if the system is not in compliance with the regulation.
Please be advised that the Asheville Regional Office will be performing NPDES
Wastewater Collection System inspections sometime in the near future. If this office has not
previously inspected your wastewater collection system and records of same, you should be
prepared to demonstrate compliance with all criteria listed above. In an effort to promote
compliance with the regulation and offer assistance please see enclosed a copy of the 02T
regulation regarding deemed wastewater collection system O&M.
Also, please note the Asheville Regional Office has a WWTP Consultant on staff to
offer assistance to you in complying with the requirements of the regulation. If you decline
assistance, are inspected, and don't meet the requirements of the regulation, you will receive
a "Notice of Violation" (NOV) and will be subject to possible enforcement action.
Nne
orthCarolina
Natitrally
North Carolina Division of Water Quality 2090 U.S. Highway 70 Swannanoa, NC 28778 Phone (828) 2964500 Customer Service
Internet: www.ncwaterquality.org FAX (828) 299-7043 1-877-623-6748
An Equal Opportunity/Affirmative Action Employer— 50% Recycled110% Post Consumer Paper
Blue Star Camps, Inc.
January 18, 2007
Page 2
Should you have questions or need additional information regarding this issue, please
contact.Don Price or Roy Davis in this office at (828) 296-4500.
Sincerely,
Roger C. Edwards, Supervisor
Surface Water Protection
cc: Don Price
Blue Star Camps, Inc. 3595 Sheridan St. Ste. 10, Hollywood, Fl. 33021
Asheville Regional Office File
Central .Office Files
m a ► Vi�
Jeff Poupart, PERCS
Q1NAr Michael F. Easley, Governor
Q� William G. Ross Jr., Secretary
u& `� North Carolina Department of Environment and Natural Resources
'a
i
Coleen H. Sullins, Director
Division of Water Quality
�aGi�Ligim}:t�.BP✓+Yam'fl�$Cd[Y'W6'a'a44�A'1Y.tl!anur�J1.P{5'kPkYQ1c. Y+t
SURFACE WATER PROTECTION SECTION
September 6, 2007
Mr. Rosenberg
Blue Star Camps/ Inc
3595 Sheridan St Ste 10
Hollywood, FL 33021-3608
SUBJECT: Wastewater Collection System
Owner & Operator Requirements
Blue Star Camps WWTP
WQCSDO123
Henderson County
Dear Mr. Rosenberg:
would like to take this opportunity to discuss the requirements for sewerage collection
systems that were first established in 15 NCAC .02H .0200 in March 2000 and are now found in
15 NCAC 2T .0403, Waste Not Discharged to Surface Waters, which became effective
September 1, 2006. These Regulations place significant operation, maintenance and reporting
requirements on those entities that own or operate a wastewater collection system with average
daily flows of less than 200,000 gallons per day.
These regulations are applicable to your facility. This letter is provided as guidance
to assist you in complying with the new reporting and operations and maintenance (O&M)
requirements and to advise you that you are subject to system review, inspections and possible
enforcement, if the system is not in compliance with the regulation.
For your convenience and easy reference, a highlight of these requirements and the
following guidance are offered (see enclosed). You may find the regulations using the following
web site: http://h2o.enr.state.nc.us/peres/Collection%20SVstems/CollectionSyste_msliorle.html
The Asheville Regional Office will be increasing the level of oversight, compliance
activities and enforcement relating to .collections systems, therefore, we wanted to be sure you
are aware of the requirements for these systems. We will be performing NPDES Wastewater
Collection System inspections sometime in the near future.
Noi thCarolina
North Carolina Division of water Quality 2090 US Hwy 70; Swannanoa, NC 28778 Phone (828) 296-4500
Internet: www..ncwaterquality.org Customer Service 1-877-623-6748 FAX (828) 299-7043
An Equal Opportunity/Affirmative Action Employer — 50% Recycled/10% Post Consumer Paper
September 6, 2007
Page 2 of 2
If this Office has not previously inspected your wastewater collection system and records
of same, you should be prepared to demonstrate compliance with all criteria listed above..
Enclosed is-an;.'inspection form that you can use to assemble your records prior to an inspection
by the staff of this Office.
This Office has a Wastewater Treatment Plant Consultant on staff to offer assistance to
you in complying with the requirements of these regulations. Should you have questions or
need additional information regarding this issue, please contact Don Price at (828) 296-4500.
Should you have any other questions concerning this correspondence or the
requirements relating to collection systems, please contact Roy Davis or Keith Haynes at 828-
296-4500.
Sincerely,
Roger C. Edwards, Supervisor
Surface Water Protection Section
cc: Deborah Gore - PERCS Unit - w/out enclosures
E . she rille-Regional--Office-facility-flle = w/out enclosures
DWQ - SWPS-- Cerft—ral-O-ffice-Files - w/out enclosures
a
Li
DDK Environmental, Inc./Blue Mountain Utilities, Inc.
Post Office Box 806
Brevard, NC 28712
704-884-5589
Fax: 704-884-8632
January 18, 2000
Mr. Roy Davis
NCDEHNR/DWQ/Asheville Regional Office
59 Woodfin Place
Asheville, NC 28801-2414
RE: Blue Star Camps
NPDES # NCO036251
Henderson County
Dear Roy,
Attached are:
1. Updated Spill Response Plan; and,
2. Collection System 0&M Plan.
These are for the above referenced utility system.
I If you have any questions, please feel free to call me a 828-884-5589.
Kindest regards,
Tom Kilpatrick
DDK Environmental Inc./Blue Mountain Utilities, Inc. Revised:
1 King Rd. 1/07/00
Pisgah Forest , NC 28769
Phone: (828) 884-5589 Fax: - (828) 884-8632
SPILL / BYPASS RESPONSE PLAN
Step 1: RECEIVE NOTIFICATION ABOUT SPILL/BYPASS
Step 2: CONTACT OPERATOR OF PLANT CORRESPONDING TO COLLECTION SYSTEM
Step 3: OPERATOR GOES TO SPILL SITE TO MAKE AN ASSESSMENT OF THE SPILL
Step 4: OPERATOR CONTACTS DWQ OFFICE TO ADVISE ABOUT SPILL
Step 5: PEOPLE AND EQUIPMENT ARE GATHERED TO STOP .SPILL
Step 6: SPILL/BYPASS 1S CONTAINED
Step 7- CLEANUP OF SITE
Step 8- CONTACT DIVISION OF WATER QUALITY AT CORRESPONDING REGIONAL OFFICE
WITHIN 24 HOURS OF FIRST NOTIFICATION OF THE SPILL
Step 9: FOLLOW-UP WITH WRITTEN REPORT WITHIN 5 DAYS - IF REQUIRED
24 HOUR CONTACT LIST
NAME
TITLE
AREA
PAGER
Mike Dodson
Pres.
Any
877-364-5166
Aubrey Deaver
Vice Pres.
Any
800-614-0112
Tom Kilpatrick
Vice Pres.
Any
877-364-5165
Mike Holder
Operator
Any
888-962-1005
Butch Howell
Operator
West Jefferson
336-957-5516
Richard Hughes
Operator
Gastonia area
888-962-1006
Rick Murrin
Operator
Highlands area
877-364-5168
Tom Good
Operator
Yancey County
877-364-5167
Tony Badurina
Operator
Raleigh area
888-962-0690
Kevin White
Operator
Henderson
888-962-0994
EQUIPMENT LIST
Service Trucks (2)
Vacuum Truck
3" trash pump
I" trash pump
Manhole blower
Tripods/harness/air packs
Lime & chlorine for cleanup
Hard hats/gloves/hand tools
Test Equipment
Location
HOME
828-884-6090
828-696-9391
828-891-8165
828-966-4771
336-877-1466
704-474-3014
828-586-1928
828-675-9185
919-775-2138
828-286-0583
Main Office at 1 King Road, Pisgah Forest, NC
Main Office
Main Office
Main Office
Main Office
Main Office
Main Office
Main Office
Main Office
FAX
828-884-8632
828-884-8632
828-884-8632
828-884-8632
336-394-4948
828-884-8632
828-884-8632
828-884-8632
828-884-8632
828-884-8632
Revised: 1/07/00
DDK Environmental Inc./Blue Mountain Utilities, Inc.
l King Rd.
Pisgah Forest , NC 28768
Phone: (828) 884-5589Fax: (828) 884-8632
WASTEWATER COLLECTION SYSTEM
OPERATION & MAINTENANCE PLAN
FOR
BLUE STAR CAMPS, INC.
DDK Environmental, Inc. provides the following service/assistance:
1. Maintains qualified staff and/or subcontractors for O&M activities;
2. Provides a 24 hour emergency contact and equipment list;
3. , Provides necessary equipment/repair parts or has access to same;
4. Maintains a line drawing system map;
5. Oversees and provides guidance to on -site staff concerning system O&M.
24 HOUR CONTACT LIST
NAME
TITLE
AREA
PAGER
HOME
FAX
Tom Kilpatrick
Vice Pres.
Any
877-364-5165
828-891-8165
828-884-8632
Mike Dodson
Pres.
Any
877-364-5166
828-884-6090
828-884-8632
Aubrey Deaver
Vice Pres.
Any
800-614-01 12
828-696-9391
828-884-8632
EQUIPMENTLIST
Service Trucks (2)
Vacuum Truck
3" trash pump
1 " trash pump
Manhole blower
Tripods/harness/air packs
Lime & chlorine for cleanup
Hard hats/gloves/hand tools
Test Equipment
Location
Main Office at I King Road, Pisgah Forest, NC
Main Office
Main Office
Main Office
Main Office
Main Office
Main Office
Main Office
Main Office
■ 910-d 699Z-ON OL 10:61 66/01/TT Sh
//OPERATION & MAINTENANCE EVALUATION
Permittee ,��t.� __15;72 Chin L Permit Number .��d03�.?Cl / County /" / .�".�_fd.✓
1. Is staff designated full-time for collection system operation and maintenance? Yes No ✓
r/C DO .e. i :vv/,z ��,J .v1 �! ,I,s e .
2. Do you have a list of 24-hour contacts? Yes ✓ No (if You, planes attach)
3. Do you have an emergency equipment list? Yes ^kl No (B Yes, please attach)
4. Staff distribution/time allocation:
Collection System (in . prart-time)
Pump Stations
1/1 Correction
Number Total staff
ems hours/week
._ / O ,e J e�
5. Are map(s) of the collection system available? Yes Na
6 Total number of pump stations: e) " (Plea*& Compht& a Pump Station form for each station_)
7 Is a preventive maintenance program In effect? ✓ yes
No
If yes, does It Include:
a. Maintaining logs/records
1/ Yes
(maintenance, inspection, etc)
b Trouble log (equipment/system malfunctions)
Yes
c. Establishing schedules
Yes
d. III evaluation
_!G Yes
e. Manhole inspection
✓ Yes
f. Sewer cleaning program
Yes
g. Hydrogen sulfide monitoring and Control
Yes
h. Lift station operation_-
i. Easernant/right-of-way maintenance
Yea
j. "Walking" or visual observation of lines
Yes
k. Spare parts inventory
Yes
(if Yes, please attach)
No
J/ No
No
No
No
No
✓ No
✓ No
No
No
V_ No
8. Please describe what type of ongoing Inspection program for the collection system exists
9. Please describe the schedule for line cleaning.
10. Is there a sewer use ordinance? , Yes jc=-No. Is there a grease ordinance? Yes �/No
If yes, please identify the responsible party for ensuring the ordinarx*s) Is followed.
/ (name/agency).
11. Please describe any sewer use ordinance enforcement priw iceis that exist.
N //d i{J E � %� d CLrG►`Ct [' ,�rC' F V ; w/ 611
Revision #1 6/1 1/99
9T 39VJ 17 9P:EZ• Sb6T;'LZ:"T +
oS�aF v4,trt�1 I
V E
y Form CS-SSO
C I ti Sys anitary Sewer Overflow Reporting Form
° JUL � T
PART I
This form shall be submitted to the ap opria*&MBAUftStMN with1h five days of the first knowledge of
the sanitary sewer overflow (SSO). ASHEVILLE REGIONAL OFFICE
Permit Number: Ne �D��.T �i (WQCS# if active, otherwise use treatment plant NC/WQ#)
Facility: iir �� 1 �� Incident # ���
Owner:
dc✓F�' /mod,<�.a Region: �,�
City: �ENC7cr�Sy.r/a1:1% /YC'. County:
Source of SSO (check applicable) : Sanitary Sewer Pump 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.)
Latitude (degrees/rninute/second): Long itude(degrees/min ute/second)
Incident Started Dt:e) 7j/ Time: -2'IX6 Incident End Dt-Ge-&-1 -,JZ Time- r-I
(mm-dd-yyyy) hh:mm WPM (mm-dd-yyyy) hh:mm AM/PM
Estimated volume of the SSO: �ao� gallons Estimated Duration (Round to nearest hour`- < -
Describe how the volume was determined:
Weather conditions during SSO event: A4�e/o C! 9Z-9 O P
Did SSO reach surface waters? �Yes ❑ No ❑ Unknown Volume reaching surface waters (gallons):
Surface water name: - 27/46-: 5^,41-1 Liz-'='
Did the SSO result in a fish kill? ❑ Yes �lo ❑ Unknown If Yes, what is the estimated number of fish killed?
SPECIFIC_ cause(s) of the SSO
❑ Severe Natural Condition ❑ Grease ❑ Roots
❑ Inflow and Infiltration ❑ Pump Station Equipment Failure ❑ Power outage
❑ Vandalism ❑ Debris in line Other (Please explain in Part ll)
Immediate 24-hour verbal notification reported to: dwy Awz,%s
[�DWQ ❑ Emergency Mgmt. Date (mm-dd-yyyy): ��_�„�_dy Time (hh:mm AM/PM):
If an SSO is ongoing, please notify Regional Office on a daily basis until SSO can be stopped.
Per G.S. 143-215.1 C(b), the responsible party of a discharge of 1,000 gallons or more of untreated wastewater to surface
waters shall issue a press reiease within 48-hours of first knowledge to all print and electronic news media providing general
coverage in the county where t e 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 referenced statute for further detail.
The Director, Division of Water Quality, may take enforcement action for SSOs that are required to be reported to Division unless it
is demonstrated that:
1) the discharge was caused by severe natural conditions and there were no feasible alternatives 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
for the determination of any enforcement action. Therefore, it is important to be as complete as possible.
WHETHER OR NOT PART II IS COMPLETED, A SIGNATURE IS REQUIRED AT THE END OF THIS FORM.
CS-SSO Form October 9, 2003 Page 1
OF W r1 'rF�?
oN �� Form CS-SSO
r= Collection System Sanitary Sewer Overflow Reporting Form
p �
PART I I
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
In the check boxes below, NA = Not Applicable and NE = Not Evaluated
A HARDCOPY OF THIS FORM SHOULD BE SUBMITTED TO THE APPROPRIATE DWQ REGIONAL OFFICE
UNLESS IT HAS BEEN SUBMITTED ELECTRONICALLY THROUGH THE ONLINE REPORTING SYSTEM
Severe Natural Condition (hurricane, tornado, etc.
Describe the "severe natural condition" in detail.
How much advance warning did you have and what actions were taken in preparation for the event?
Comments:
Grease (Documentation such as cleaning, inspections, 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?
Do you have an enforceable grease ordinance that requires new or retrofit of grease traps/interceptors? ❑Yes❑ No ❑NA LINE
Have there been recent inspections and/or enforcement actions taken on nearby restaurants or other ❑Yes❑ No ❑NA LINE
nonresidential grease contributors?
Explain.
Have there been other SSOs or blockages in this area that were also caused by grease? ❑Yes❑ No ❑NA ❑NE
When?
If yes, describe them:
Have cleaning and inspections ever been increased at this location? Dyes[] No El NA ❑NE
Explain.
CS-SSO Form October 9, 2003 Page 2
Have educational materials 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?
Were the floats clean?
Comments:
Roots
Do you have an active root control program?
❑Yes❑ No ❑ NA ❑ NE
❑ Yes[—] No ❑ NA ❑ NE
Describe
Have cleaning and inspections ever been increased at this location because of roots? ❑Yes❑ No ❑NA ❑NE
Explain:
What corrective actions have been accomplished at the SSO location (and surrounding system if
associated with the SSO)?
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 ❑ NA ❑ NE
If Yes, when?
Comments:
Inflow and Infiltration
Are you under an SOC (Special Order by Consent) or do you have a schedule in any permit that
addresses 1/1?
❑YesE] No ❑NA ❑✓ NE
CS-SSO Form October 9, 2003 Page 3
ft
Explain if Yes:
What corrective actions have been taken to reduce or eliminate I & 1 related overflows at this spill location
within the last year?
Has there been any flow studies to determine 1/1 problems in the collection system at the SSO location? ❑YesC No ❑NA ❑NE
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 ❑NA ONE
If Yes, when and indicate what actions are necessary and the status of such actions:
Are there 1/1 related projects in your Capital Improvement Plan? Yes❑ No ❑ NA 11 NE
If Yes, explain:
Have there been any grant or loan applications for 1/1 reduction projects? ❑Yesl:l No ❑NA ONE
If Yes, explain:
Do you suspect any major sources of inflow or cross connections with storm sewers?
If Yes, explain:
Have all lines contacting surface waters in the SSO location and upstream been inspected recently?
If Yes, explain:
What other corrective actions are planned to prevent future 1/1 related SSOs at this location?
Comments:
Pump Station Equipment Failure (Documentation of testing, records etc.,
shoul be provided upon request.)
What kind of notification/alarm systems are present?
Auto-dialer/telemetry (one-way communication)
UYes❑ No ❑NA UNE
Yes❑ No ❑NA ❑NE
❑Yes
CS-SSO Form October 9, 2003 Page 4
Audible [Dyes
Visual ❑Yes
SCADA (two-way communication) []Yes
Emergency Contact Signage ❑Yes
Other ❑Yes
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 ❑NA❑NE
If no, explain:
If a pump failed, when was the last maintenance and/or inspection performed?
What specifically was checked/maintained?
If a valve failed, when was it last exercised?
Were all pumps set to alternate?
Did any pump show above normal run times prior to and during the SSO event?
Were adequate spare parts on hand to fix the equipment (switch, fuse, valve, seal, etc.)?
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
❑Yes❑ No❑NA❑NE
❑Yes❑ No❑NA❑NE
CS-SSO Form October 9, 2003 Page 5
ft M
Power outage (Documentation of testing, records, etc., should be
provided of alternative power source upon request.)
What is your alternate power or pumping source?
•n-Site Generator WATS
Did it function properly? []Yes[:] No ❑NA ONE
Describe?
When was the alternate power or pumping source last tested under load?
If caused by a weather event, how much advance warning did you have and what actions were taken to
prepare for the event?
Comments:
Vandalism
Provide police report number:
Was the site secured?
11 Yes❑ No ❑ NA ❑ NE
If Vac hn\Al?
Padlocked Control Panel
Have there been previous problems with vandalism at the SSO location? 11 YesE] No EINA ❑NE
If Yes, explain:
What security measures have been put in place to prevent similar occurrences in the future? ❑Yes❑ No ❑ NA [IN E
Comments:
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?
How could it have gotten there?
Are manholes in the area secure and intact? LJYesLJ No ONA NE
CS-SSO Form October 9, 2003 Page 6
When was the area last checked/cleaned?
Have cleaning and inspections ever been increased at this location due to previous problems with debris? ❑Yes❑ No ❑NA ❑NE
Explain:
Are appropriate educational materials being developed and distributed to prevent future similar ❑Yes❑ No ❑NA FINE
occurrences?
Comments:
Other (Pictures and a police report should be available upon request.)
Describe:
.SrtJr�t. �iaye .sQnonn-�n✓ � /��C�'' r��x'b-���iA% �-.--
Were adequate equipment and resources available to fix the problem?
NoLJNAUNE
If Yes, explain: /�
C%&0&) lJ.t� .�i � - e2 Z - d � � OL 0 Z49 - , liin, "LA l'�rs�/J/J�l 4,/
If the problem could not be immediately repaired, what actions were taken to lessen the impact of the
SSO?
Comments:
For DWQ Use Only:
DWQ Requested an Additional Written Report:
If Yes, What Additional Information is Needed:
Comments:
❑Yes[] No DNA ❑NE
CS-SSO Form October 9, 2003 Page 7
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:
Signature:,
Date: //- .-f/ DS%
Title: Zti
Telephone Number:
Any additional 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 October 9, 2003 Page 8
Section 8:
SSO Enforcement Guidance
EXHIBIT B: SSO EVALUATION FACTORS
Incident #: 'AD1944 of"I
Permittee: 1`.� t- ��' Ty-,-V-5
Date.of Incident: Loy Z ;2,,o` —L
ARE ANY OF THESE FACTORS A BASIS FOR
PROCEEDING WITH FURTHER ACTION?
FACTOR
YES
NO
COMMENTS
Volume/Duration
Surface Water
• Sensitive/High Priority
SA / ORW / WS, etc.
Damage
• Fish Kill
• Property
t/
• Public Health Concerns
Weather Conditions and other Uncontrollable
Factors
• Severe Natural Condition (hurricane,
tornado, etc.)
• Vandalism/Third Party
• Other
Repetitiveness Same Location
(past 24 mo
Repetitiveness Same Cause
it
(past 24 mo
Preventability
• Proper O&M
• Storm Preparation
System -wide Compliance (past 24 mo)
• Similar causes multiple instances
• Previous actions like NOVs /
Enforcements
• Failure to react to Technical
Assistance from Division
Response to Spill
Adequate time & cleanup)4'f
Proactiveness
• Active programs for 1/I, grease, roots,
etc.
v
• CIP program
CONCLUSION: Does overall evaluation or
o Action
❑ Action
any one single factor result in the need to
taple this to report
NOV SOC Pending
proceed with action?
File
Enforcement Moratorium
Close out incident in BIMS
No Action
Additional Comments:
Form completed by ��/��° Date
Page 9 of 9 10/03
s
,71Jn 1 R n4 1 ?: 47p "1 ... ... [..
05/4:54 4
PArF 15
PiHrnmi* Mummer
3. Jncident started: {d2te/tlnt9l
L = -2 —
/3�
4. incident Ended (date/t!m --
..-- -•. w■,t wwa wncl smu Can De YCO -
s_ source of spllllb ypass_ apeaa
sanitary Sewer Pump station VjVvTp
6. Level of treatment_ _,,,-None Primary T- rt_ Secondary Trt
- Chlorination Only other (l.e_ upset conditions):
7. Estimated volume of spill/pass: 0. BOO vallons 501- 1,000 gallons
1,0O1- 2.000 gallons � ✓ >2,O00 gallons
S. Estimate volume in nearest 1,00O Gallan Increments,..
9, Did spill/bypass reach surface waters? .,,,,,yes _-No
10. ifyes, list the volume reaching surftm w "W o- Sap oaltonS
5Q1- 1,O0O gallons—1.001- 4.wo oallnnc — ii
1'1. IF ves_ ,asti,r.aYo -scri��a=wsa�a¢,s�...�-- �-`�...-.va_r�oo.e■�3�: - rf r.•!1
..�--
- '* s ri■.-■ .e�-•KSYbYp^es r�-�:6 E- - -� _ _ _ _ _ d. � -_ - __ __ ��i'aw _— _ -- ...
14_ If rw�.. v■Rat icr�o raifmas��s■■w�rs. ram_ lR�� :_._:� .�
15. LocaLiali of spIIUOYPa --
16. Cause of spill/bypasS:
=-
17, Did you have personnel available to perform an Initial assessment 24 hours
2 day (including weekerM and hoKdaVo? i/' yes No
18. How long did it take to matte an In tlal aesegament of the spill/Overflow
after first knowledge? .3"� �,:,, � c _ minutes
19_ How long did It take to get a repair train) on$lte?
D EC:,EE E
J ?' N 1 6 9Lf),0]-
WATER QUALITY yF-^TIQN
Jun 16 04 12:47p m Kilpatrick 165 p.2
86/18/2881 14.54 d
PAGE 16
Sewage Spill Response Evaluation (page 2)
2 i, sactivrz to - *Piii, cierrn uA WRst®,_�nareir rs►�rfa.�ti[a�a_ttas. sates _--
22. Were the equipment and/or parts needed to make repairs readily available?
No.
23. if no, please explain why:
2 If the spililiiverflow occurred at a pump station or was the result of a pump
station failure, was the alarm system functional at the time of the spill?
yes No
25_ if the alarm systems did not function, please explain why:
26. 1'he repairs matte were/are: Permanent Temporary •
if the repairs are temporary, please Indicate by what slate a permanent
repair will be completed and notlfy the ReWanai Office within 7 days of the
permanent repair. (date:!
27. nescribe what repairs were made. ., f� �-a •fs o F '�
28. -�omrnents;
29. Other agencies notified:
30. Person reporting spill/bypass. , o phone // s1;X8- 6 is - �f e
slate- -_ ' - / - o :` -
oral report taken by:
Report taken an (date): time: M
nWp requested additional written report? yes no
IF yes, what additional information 1s needed?
P[pasp (end this report to_ Asheville 4e-g—ta tol-Q¢�16�-.1'CI�E'.�f��-SE'4'$
Phone: S28/251-6208 Fax: S28/231-6452
after hours. weekends. or holidays, call: 1-800-858-0368
Post -it' Fax dote 7671
oat
# of slo.
Page
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From
Co./Dept.
Co.
Phone #
Plnnne #
Fax q / 7j y�
Fax X
10
12
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