NC0020401_Report_20201113

North Carolina Department of Environmental Quality
Division of Water Resources
Print or Tvpe Use
Permittee: o� C�rclzc,�y
Facility Name: _ N0(ITt+Er45T W U/T P
Permit Number:
N )(D2o uC�
County: CATT-A0►0A
Incident Started: Date: I I`IZ"� D Time: y'3�,4M
Incident Ended: Date: V I'12'2� Time: of � 3D ti-/Vf
Level of Treatment: '
_/None _Primary Treatment _Secondary Treatment _Chlorination/Disinfection Only
Estimated Volume of Spill/Bypass: � v 1 g 33 °j'� 5 (must be given even if it is a rough estimate)
Did the Spill/Bypass reach the Surface Waters? _Yes _No
If yes, please list the following
Volume Reaching Surface Waters: � �3 � Surface W/�ater Name: __ }'fi�L�,NG G��K
Did the Spill/Bypass result in a Fish Kill? _Yes �VNo
Was WWTP compliant with permit requirements? �' Yes _No
Were samples taken during event? V Yes No
Source of the Upset/Spill/Bypass (Location or Treatment Unit1:
Cause or Reason for the Upset/Spill/Bypass:
FLc�oosl�� t�N=��E OVE►� Co �►u+Es D-r= ��!
2c-co2o�a
Describe the Repairs Made or Actions Taken:
%-R�/� C.L.E�,N�n clP•9�� Tk+E DU���J SraPP�
Spill/Bypass Reporting Form (August 1997)

WWTP Upset , Spill, or Bypass 5-Day Reporting Form
Page 2
Action Taken to Contain Spill Clean Up and Remediate the Site (if applicable):
are-cL , /yIDS V tyler'In') Ck,6 rainwwk
Action Taken or Proposed to be Taken to Prevent Occurrences:
rth s k)os a. r4-w-a ( cxc a r^ ae
b e- An e � o ��e✓�,-� I i-
Additional Comments About the Event:
24-Hour Report Made To: Division of Water Resources '� Emergency Management
Contact Name: W 5 el Date: I✓I� �U Time:
Other Agencies Notified (Health Dept, etc):
Person Reporting Event: �`� 2h yn' c Phone Number:
Did DWR Request an Additional Written Report? _Yes _No
If Yes, What Additional Information is Needed:
Spill/Bypass Reporting Form (August 1997)