WQCS00221_Regional Office Historical File Pre 2018 (2)

FILE
CERTIFIED ![NAIL #: 7017 2620 0000 6788 9731
RETURN RECEIPT REQUESTED
August 22, 2019
Jason A Brown, City -Manager
City of Claremont
PO Box 446
Claremont, NC 28610-0446
SUBJECT: NOTICE OF VIOLATION
Tracking Number: NOV-2019-DV-0330
Sanitary sewer Ovefflows - une 2019
- - - - - --Collection--System -Perm it -No-- WQC-SO0221
Claremont Collection System
Catawba County
Dear Mr. Brown:
The self -reported Sanitary Sewer Overflow (SSO) 5-Day Report submitted by City of Claremont indicates violations
of permit conditions stipulated in the subject permit and North Carolina G.S. 143-215.1. Violations include failing to
effectively manage, maintain, and operate the subject collection system so that there is no SSO to the land or
-- - -surface waters and -making -an outlet to waters of the State for purposes -of G.S.-143=2-15.1(a)(1)�-for which -a- --
permit is required.
Specific incident(s) cited in the subject report include the following:
Total Vol
Total
Surface
Incident Start Duration
Vol
Water
Plumber Date (Mina) Location Cause
(Gals)
(Gals) DWR Action
201901058 6/8/2019 180 3382 N Oxford St Debris in line, Pump
2,400
2,400 Notice of Violation
station equipment
Flood condition
failure, Severe Natural
Condition

Remedial actions, if not already implemented, should be taken to correct the above noncompliance. Please submit
a written response to this Notice -of Violation. Your response is to be received by the regional office within 15
business days following receipt of this violation. Please include any additional documentation about this incident(s)
in the response. The submittal will be considered in determining whether the Division will assess a civil penalty for
the cited violations.
If you should have any questions, please do not hesitate to contact Michael Meilinger or me in the Mooresville
Regional Office at 704-663-1699 or via email at michael.meilingerOncdenr.gov or corey.basinger(a)ncdenr.gov.
Sincerely,
DocuSigned by:
A14CC681 AF27425...
W. Corey Basinger, Regional Supervisor
Water Quality Regional Operations Section
Mooresville Regional Office
Division of Watel
Cc: Mooresville Regional Office - WQS File
Central Files, Water Quality Section
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$ CITY OF CLAREMONT
r— s p0 13OX 446
o s. CLAREMONT NC: 28610-0446
ATTN: JASON BROWN, CITY MGR.
c. Dwr/mm 8/22/19
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Water Resources
ENVIRONMENTAL QUALITY
May 25, 2017
Catherine Renbarger, City Manager
City of Claremont
PO Box 446
Claremont, NC 28610
SUBJECT: Sanitary Sewer Overflows - April 2017
Collection System Permit No. WQCS00221
Claremont Collection System
Catawba County _
Dear Ms. Renbarger:
ROY COOPEV
Governor
MICHAEL S. REGAN
Seemary
S. JAY ZIMMERMAN
Director
A review has been conducted of the self -reported Sanitary Sewer Overflow (SSO) 5-Day Report submitted by City
of Claremont. This review has shown the City of Claremont to be in violation of the requirements found in the
subject permit and/or North Carolina G.S. 143-215.1(a)(1). The violations that occurred are summarized below:
Incident Start
Number Date
201700646 4/24/2017
Duration
(Mins) Location
30 3000 Cloniger St
Cause
Debris in line, Grease
Total Vol
Total Surface
Vol Water
(Gals) (Gals) DWR Action
150 150 No Further Action
Remedial actions, if not already implemented, should be taken to correct the above noncompliance.
If you should have any questions, please do not hesitate to contact Lon Snider with the Water Quality Section in
the Mooresville Regional.Office at 704-663-1699 .or via email at [e-mail].
Sincerely,
i�
U,,,y -W. Corey Basinger, Regional Supervisor
Water Quality Regional Operations Section
Mooresville Regional Office
Division of Water Resources,. NCDEQ
Cc: Mooresville Regional Office - WQS File
Central Files, Water Quality Section
State of North Carolina I Environmental Quality I Water Resources
610 East Center Avenue, Suite 301, Mooresville, NC 28115
704-663-1699

Collection System SSO 24-Hour Notification
Collection System: Number and Name WQCS# 000/
Incident Number from BIMS 20140 0 ,7.zo
Incident Reviewed (Date):
Incident Action Taken: ?/ BPJ
NOV-2014-DV
DV-2014-
■ e n a o e a e n u e o u e o o i m u o f n e o w i e e e x G e■ ®� ■ O e e B■ ®� ■ G i l P
Spill DateTime l� 3� am pm
Reported Date �/ �/ % Time o� ` L7 aOpm
Reported To SWP Staff or EM Staff '80(.(t:1i?it
Reported By cz-� ACW) ��'i� `/ Phone
Address of Spill Eoo .
County 4�kCity
Cause of Spill � A
Total Estimated Gallons Est. Est. Gal to Stream fit}
Stream Fish Kill: Yes No Number Species
Non Required Information and other comments relating to SSO incident:
Response time minutes Zone Map Quad
1 �. 40-

e
Apr 17 14 11:,18a 828-322-1405 p.1
H.IC,KORY
Fax TransmittaC
City of Hickory
Pu6Cic UtiCities Department
PO Box 398 -
3-Cickory, NC 28603
[phone]
To:
Fro
Pages (including cover sheet): b�
Date:
Comments:

npr 17 14, 11:,18a
828-322-1405 p.2
i
Form CS-SSO
Collection System Sanitary Sewer Overflow Reporting Form
PART I
This form shall be submitted to the appropriate DWQ Regional Office within five days of the first knowledge of
the sanitary sewer overflow (SSO).
Permit Numab r . QG5a07, ` QCS# if active, otherwise use treatment plant NC/WQ#)
Facility: ~ `+ 6 Incident #
Owner: Region:
City:
iY! County.
Source of SSO (check applicable) : Ix Sanitary Sewer 11 Pump Station
SPECIFIC location of the SSO (be consistent in description=/t
ports documentation - i.e. Pump Station 6,
Manhole at Westall $ Bragg Street, etc.) :
Latitude (degreeslminutelsecond): Longitude(degrees/minute/second)
Incident Started Dt V 0 Id Time .. l' v Incident End Dt U •�o2ol Tim
(mm-dd-yyyy) hh:mm AMIPM (mm-dd-yyyy) hh:mm AMfPPA
Estimated volume of the SSO: gallons Estimated Duration (Round to nearest hour): i
e� t.Ldr!4 iif 8 y Pak -
Describe haw the volume was determizip g
ned: -
Weather conditions during SSO event: <& -&
Did SSO reach surface waters? ' KYesE1NoF-1 Unknown Volume reaching surface waters (gallons): 7i�a
Surface water name: /i 4y1fe
6re4 --
Did the SSO result in a fish kill? 0 Yes Zo 0 Unknown If Yes, what is the estimated number offish killed?
SPECIFIC cause(s) of the SSO:
Severe Natural Condition Grease El Roots
Inflow and Infiltration E3 Pump Station Equipment Failure 11 Power outage
Vandalism ❑ Debris in line R1 Other (Please explain)
Immediate 24-hour verbal notification reported to:
CRn DWQ 0 Emergency Mgmt. Date (mm-dd-yyyy): d / Time (hh:mm AWPM): ."
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 release within 24-hours of first knowledge to all print and electronic news media providing general
coverage in the county where the 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 Il IS COMPLETED, A SIGNATURE IS REQUIRED AT THE END OF THIS FORM.
CS-SSO Form October 7, 2003 Page 1

Apr 17 14 11:,18a
L.
828-322-1405
p.3
1
When was the area last checkedlcleaned?
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 ❑NE
occurrences?
Comments:
Other (Pictures and a police report should be available upon request.)
Describe:�{G .1219
i tAl
Were adequate equipment and resources avail ie to fix the problem? Yes❑ No ❑ NA ❑NE
if Yes, explain:
&&, k &-ds w-fdfc. �n
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:
CS-SSO Form October 7, 2003
❑Yes❑ No ❑NA ❑NE
Page 7

Apr 17 10 11:.19a 828-322-1405 p.4
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_
Z/
Person submitting claim: /4(
�` �G Date: %
Signature:
Telephone Number:
Title:
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 7, 2003
Page 8

Collection System SSO 24-Hour Notification
Collection System: Number and Name WQCS# D 0 oZ;�
Incident Number from BIMS 20130 11� 5-
Incident Reviewed (Date):
Incident Action Taken: / BPJ
NOV-2013-DV
DV-2013-
n n aNIB NilMEa as aIBMa as a MEN Ono 0 amMEN WEam a am a am an MR NOON a a a a a sunsman 0 am a a am t E m
Spill Date ! 3 Time . 3 m
Reported Date /5 Time v m pm �
Reported To SWP Staff or EM Staff
Reported By 4 bin -el Phone
Address of Spill ee,.x -f ,e� a%ell
����%% itw►t G�r�'
County . �GL �Gc/ City t C-40
Cause of Spill �2�,t,c
Total Estimated Gallons 5B6
Est. Gal to Stream 0�5a
Stream Fish Kill: Yes No Number Species.
Non Required Information and .other comments relating to SSO incident:
Response time minutes Zone Map Quad
vlv_� �,ok5
a

Q�aF wAr�,�Qp
Form CS-SSO
Collection System Sanitary Sewer Overflow Reporting Form
Q '<
PART I
This form shall be submitted to the appropriate DWO Regional Office within five days of the first knowledge of
the sanitarysewer overflow
�(SSOI).
Permit Number: -��y�. 1 (WQCSit if active, otherwise use treatment plant NCIWQ10 l J l d �-els
Facility: I incident# — U
`'IE (') Region:.
Owner, t l�
City: ��I County: � [� Es ,S10t, .
Source of SSO (check applicable) : VX Sanitary Sewer ❑ Pump Station
SPECIFIC location of the SSO (be consist rat in �c{ja�scnpfi n fr. m pas�(reports or documentation - i.e. Pr mp Station 1
Manhole at Westall &� Bragg Street, eic.) : C'j1'� II(J�� 11 ti��(� �
Latitude (degrees/minutt�e/second): ca
Incident Started Dt: � © � �Q �� Time' QV `10At rl
(mm-dd-yyyy) t'hh:mm AMiPM
Estimated volume of the 5S0: ';�Oo — gallons
Longitude(deg rees/mi nutelsecond)
incident EndDt: - Nro 2C(� Time � � Q Al
(rnm-dd-yyyy) hh:mm AMIPM
Estimated Duration (Round to nearest hour): 0 r
Describe how the volume was determined:. 000 Clr t Lien
Weather condltions during SSO event:
Did SSO reach surface waters? ' 0 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 Condition ❑ Grease ❑ Roots
❑ inflow and Infiltration �❑{ Pump Station Equipment Failure ❑ Power outage
❑ Vandalism
l Debris in line ❑ Other (Please explain)
i
Immediate 24-hour verbal notification reported to: t—c' I ����������
DWQ ❑ Emergency MgmL Date (rnm-dd-yyyy):�--`� Time (hh:mrnAt+NPM): r A -
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 release within 24-hours of first knowledge to all print and electronic news media providing general
coverage in the county where the 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 li 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 If IS COMPLETED, A SIGNATURE IS REQUIRED AT THE END OF THIS FORM.
CS-SSO Form October 7, 2003 Page 1

Power outage (Documentation of testing, records, etc., should be
provided of alternative power source upon request.)
What is your alternate power or pumping source?
Did it function property? ❑Yes❑ No❑NA❑NE
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? ❑Yes❑ No❑NA ONE
If Yes, how?
Have there been previous problems with vandalism at the SSO location? ❑Yes❑ No ❑NA ❑NE
If Yes, explain:
What security measures have been put in place to prevent similar occurrences in the future? ❑Yes] No ❑NA ❑NE
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?
a� - C.QU LL•lN W L tfY✓l �l-e0-Vh 1 VN' a
How could it aver 4en there?
Are manholes in the area secure and intact? Yes❑ No ❑NA ❑NE
CS-SSO Form October 7, 2003 Page 6

When was the area last checked/cleaned?
G�Jcc�� �� •'Z � 2©l3 �•�r�7uhto�3
Have cleaning and inspections ever been increased at this location due to previous problems with debris? Ely.0 No ❑NA ❑NE
Explain:
Are appropriate educational materials being developed and distributed to prevent future similar ❑Yes❑ No ❑ NA ❑NE
occurrences?
'Arm .
Other (Pictures and a police report snouia ue avaname upuir reques►. j -
Describe: I/
adequate equipment and resourcbs available to fix the problem? ❑Yes❑ No DNA
If Yes, explain:
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: ❑Yes❑ No ❑ NA ❑NE
If Yes, What Additional Information is Needed:
Comments:
CS-SSO Form October 7, 2003 Page 7

e
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: �' �n ��,� , 0ec
Signature: Xal
Telephone Number: �a� -323
Date: g/Q 61- W
Title:
�Gtf2ud `�
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 7, 2003 Page 8

Collection System SSO 24-Hour Notification
O o 'ZZ l
Collection System: Number and Name WQCS# CgIX j
Incident Number from BIMS z&(zCx:�9)-Ln
Incident Reviewed (Date):
Incident Action Taken: -PJ
NOV-2012-DV
i ■ ■ ■ ■ ■ m ■ ■ ■ ■ ■ o e ■ c ■ ■ o ® ■ ■ ■ ■ ■ ■ ■ o c ■ c ■ ■ ■ ■ ■ ■ ■ ■ a o ■ ■ ■ ■ ■ ■ ■ ■ ■ m ■ ■ ■ v e ■ ■ a a c ■ ■ o ■ u G ■ o ■ ■ e o
Spill Date 2 r2 Timepm
Reported Date 2 Time `�- S J am/ lid
Reported To SWP Staff or EM Staff LS
Reported By :l4"Ipj P. Phone
Address of Spill 3-c>0 Alpf-
County CityRrcr�^�
Cause of Spill �0 �S
Total Estimated Gallons 1�t(oo Est. Gal to Stream � (O O
Stream 07— t� (-4- Fish Kill: Yes No umber Species
Non Required Information and other comments relating to SSO incident:
Response time minutes Zone Map Quad

Mao 00 12 01:50uD 32P itnc n
0f!•Jr17���G
Form CS-SSO
a Collection System Sanitary Sewer Overflow Reporting Form
PART l
This form shall be submitted to the appropriate DWQ Regional Office within five days of the first knowledge of
the sanitary sewer overflow (SSO).
Permit Number: (WQCS# if active, otherwise use treatment plant NCJ1NQ#�7
Facility: 6 u e Incident# (�
Owner: Region:
City: IUeCf4Z�it County: �'Cvtrl.i S cC
--
Source of SSO (check applicable) : 0 Sanitary Sewer ❑ Pump Station
SPECIFIC location of the SSO (be consistent in descrjption from past reports or documentation - i.e. Pump Station 6,
Manhole at Westali & Bragg Street, etc.) : d b
Latitude (degrees/minute/second): Longitude(degrees/minute/second)-
Incident StartedDt: 123fzaI7- Time- D0;U0'40y1 Incident End Dt:l�'3a Time- V&Z.
(mm-dd-yyyy) hh:mm AM/PM (mm-dd-yyyy) hh:mm AM/PM
Estimated volume of the SSO: f - gallons Estimated Duration (Round to nearest hour): "s
Describe how the volume was determined: �- 0 '1 —60e
Weather conditions during SSO event:
Did SSO reach surface waters? Yes❑No❑ Unknown Volume reaching surface waters (gallons):
Surface water name: 1�&T CJ/P� �
Did the SSO result in a fish kill? ❑ Yes W No ❑ Unknown If Yes, what is the estimated number offish killed?
SPECIFIC cause(s) of the SSO:
❑ Severe Natural Condition ❑ Grease Roots
❑ Inflow and Infiltration ❑ Pump Station Equipment Failure ❑ Power oulage
❑ Vandalism ❑ Debris in line ❑ Other (Please explain)
Immediate 24-hour verbal notification reported to: ZAw
DWQ ❑ Emergency Mgmt. Date (mm-dd-yyyy): d Z mjZ 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 release within 24-hours of first knowledge to all print and electronic news media providing general
coverage in the county where the 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.publicalion 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 11 must be completed to provide a justification claim for either of the above situations- This information will b'e 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 7, 2003 Page 1

p
May 00 12- 01-50p
820 022
From:
Tax 1 �- a iSrri%i LIU..
Public UtiCities Department
J
PO BO_ use
Hickory, NC 286o3
[phone]
Pages (including cower sheet): `f
Date:�ss 7i
Comments-

May 30 12 01:51lo
828-322-1405
p.3
Have educational materials about grease been distributed in the past?
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
❑Yes❑ No❑NA❑NE
❑YesO No❑NA❑NE
Do you have an active root control pro/gram? WiYes❑ No❑NA❑NE
C/'
,YLifrGS Opa C�117i�f /5 Sc!'lG4GCI� �U �G /f7 �%7G �( 66
Describe TUhr 41 eo 41IE614- VpAdVM.71--Y 5.3
00 lrC06 sou
Have cleaning and inspections ever been increased at this location because of roots? ❑Yesg NoONA ❑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 SSO locpt'on to re�uce ro t intrusion? f 1 Q� �`
Ss4rrcjA'( w/ y-ec��rl{z° ,y j'u7c
Has the line been smoke tested or videoed within the past year?
If Yes, when?
Comments:
Inflow and Infiltration
MYesO No❑NAONE
cbi- 2dtt
Are you under an SOC (Special Order by Consent) or do you have a schedule in any permit that ❑.Yes❑ No ❑ NA ❑NE
addresses 1117
CS-SSO Form October 7, 2003 Page 3

a 1 r-
May 30 12 01:51p 828-322-1405 p.4
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: M, �i'f�1Vt. %1/7iG Date:
Signature: �jt � �� "" Title: O2 C
Telephone Number: gag --3 Z 3 -71SP7
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 7, 2003 Page 8

Collection System. SSO 24-Hour Notification
ZZ�
Collection System: Number and Name WQCS# (3
Incident Number from BIMS UC)OZ,17L
Incident Reviewed (Date):
Incident Action Taken: 'BPJ 1 .
NOV-2010-DV
.....:;..
Spill Date C Time r,l pm
orted Date Time
Re S aml: r
P 8'
Reported To SWP Staff.or.EM.Staff L�
ed B J0 Phone .
Report Y
LS
Address of Spill'-�
::.. ' City
Count
Y
Cause -of Spill
Est.
Total Estimated Gallons
S o n .Gal to Stream
Stream �' Fish Kill: Yes Number Species.
Non Reou'red Information and other comments relating to SSO incident:
I.
Response time minutes Zone Map Quad.

Permit # ..
Owner and Facility Name
WQCS00253
Bradfield Farms Water Company CS
WQCS00196
Carolina Water Service Cabarrus Woods CS
Wo CS00233
Carolina Water -Service Hemby Acres CS
WQCS00001
Chadolte-Mecklenburg CS
WOCS00016
City of Albemarle CS
WQCS00046
City of Belmont CS
WQCS00107
City of Bessemer Cily CS
WOCS00089
City of Cherryville CS-
WQCS00221
City of Claremont CS
WOCS00326
City of Concord CS
VVQCS00088
City of Conover CS
WOCS00017
City of Gastonia CS
WQCS00020
City of Hickory CS
WQCS00327
City of Kannapolis CS
WQCS00036 '
City of K a Mountain CS
WQCS00040
City of. Lincolnion CS
. WQCS00164
City.of Lowell CS
WQCS00026 '
City of Monroe CS
WQCS00059
-City of Mount Holly CS
WQCS00044
':City of Newton CS
WQCS00019 .
.City of Salisbury CS
WQCS00037
City of Shelby CS
WQCS00030
. Cily of Slalesviile CS
WQCSOOi 49
' East Lincoln CS
Deemed Permitted.
Permit#
Owner and Facility Name
WQCS00130
Brooks Food Group -Brooks Food Group
WQCSDO114
Charlotte Mecklenburg Schools - Misc Laterals
WQCSDO057
City of High Shoals CS
WQCSD0117
Duke Energy Marshall Steam Station
WOCSDO257
Fallslon •
WOCSDO116
Gopse Creek Utilities Fair'iOd Plarilation VFW T P
bVQCSD0101
Hzrborside Dev LLC-Midtown T CS
WQCSDO095
Kennerly Dev..Group.LLGe•oardwalkvii!as CS
WQCSDO098
Kennerly Dev, Group LLC Kings Point CS
WQCSDO105
Kennerly Dev. Group LLC-Moon Bay Condos CS
WQCSDO107
Kennelly Dev. Group LLC-Schooner Bay CS '
WOCSDD099
Kennerly Dev. Group LLC-Spinnaker Point CS
WQCSD0258
Kingstown
WQCSDO112
Lake Norman -South Point CS -
WQCSD0104.
Lake Norman -'villas S Harbour CS
WQCSDO102
Lake Norman -Vineyard Pl Resort CS
Permit #
Owner and Facility Name
WQCS00171
Greater Badin CS
WQCS00322
Aqua Country Woods East CS
WQCS00222 :
Town•of Boiling Springs CS
WQCSOD341
Town of China Grove CS
WQCS0023i
!Town.of Cleveland CS
WQCS00058
Town of Cramerton CS .
WQCS00165
Town of Dallas CS
' WQCS00342
Town of E: Spencer CS
VVQCS00328
Town of Harrisburg CS
'WQCS00343
Town of Landis CS
WQCS00310
Town of Longview CS
WQCSob120
"'Town of'Maiden CS
WQCS00344.
Town of Marshville-CS
WQCS00043
Town of Mooresville CS
WQCS00125
Town of Mt Pleasant CS.
VJQCS00153
Town of Norwood CS
WQCS00190
Town of Oakbbro CS
VVQCSOD325
Town of Stanfield CS
-WQC800180
Town of Stanley CS
WQCS00135
Town of Taylorsville CS
WQCS00258
• Town of Troutman CS
WQCS00345
Town o(Wingate CS
.WQCS00054
Union County CS
WQCS00009
- WSA Cabarrus Co. CS
Permit#
Owner and Facilify Name
WOCSDO064 'Lincoln
County CS
WQCSDO097
Martin Dev Gp-N Point & Portside CS
WQCSD0120
Martin Marietta Mallard Creek '
WQCSD0019
Town of Richfield CS
WOCSDO024
Town of Grover CS
WOCSDO038
Town of fAcAdenville CS
WQCSDO002
Town of Ranlo CS
VVQCSDO049
Town of Spencer Mountain CS
WQCSD0252 All spills which do not have a permit
number assigned
T

08/11/2010 13:13 8284590596
CITY OF CLAREMONT
PAGE 01
� f W Aq G
Form CS-SSO
? Collection System Sanitary Sewer Overflow Reporting Form
t? C
PART 1
This form shall be submitted to the appropriate DWQ Regional Office within five days of the first knowledge of
the sanitary sewer overflow (SSO).
Permit Number: S per'L-0-- 1 (W(QCS# if active, otherwise use treatment plant NC/WQ#)
Facility: t lncident# -.
Owner: 1 J!, (r1e103aMo�l� Region: M150L-tSd;11&
City: 4mn��i County: (24N.APA
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 & 8ragg Street, etc.) : Lust p ap8�a�ninti irk m,
Latitude (dagraes/minute/second): Lon
Incident Started Dt; Mi09 Time- OB1 , Awl incident Iwnd Dt; �(0 Time:
(mm-ac-yyyy) hh:mm AM/PM (MM-dd-yyyy) hh:mrq AMIPM
Estimated volume of the SSO: 16000 gallons Eetimated Duration (Round to nearest hour):
Describe how the volume was datemilned:
Weather conditions during SSO event:
Did SSO reach surface waters? LK Yes ❑ No ❑ Unknown Volume reaching surface waters (gallons): p(� d
Surface water name;
Did the SSO result in a fish ki117 ❑ Yes (A No ❑ Unknown. If Yes, what is the estimated number of fish killed?
SPECIFIC cause(s) of the SSO-
❑ Severe Natural Condition ❑ Grease © Roots
❑ Inflow end Inftltraficn Pump Station Equipment Failure ❑ Power outage
❑ Vandatiarn ❑ Debris in line El Other (Please explain)
Immediate 24-hour verbal notification reported to' "w
UD DWQ ❑ 5rnaMancy Mgmt. Date (mm-dd-yyyy): o 2O4(O Time (tth.mm AM/PM): o;L'.--1"pt-#�
If an SSO is ongoing, please notify Regional Office on a daily basis until SSO can be stopped,
Per G.S. 1 3-215.1C(b), the responsible party of a discharge of 1,000 gallons or more of untreated wastewater to surface
waters shall issues PFe53T5leZ1&e within 244hours of first knowledge to all print and electronic news media providing general
coverage in the county w are the ischarge 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 pubiication shall be provided to the Division within 30 days_
Refer to the referencad statute for further detail_
The Director, Division of Water Quality, may take enforcement action for SSDs 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 Perrnittee
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 Justtficalion claim for either of the above situations. This information wilt 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 COMPL,ETI-D, A SIGNATURE IS RF-QUIRED AT THE ENO OF THIS FORM.
CS-SSO Form October 7, 2003 Page 1

.r
08/11/2010 13:13 8284590596 CITY OF CLAREMONT PAGE 02
Explain it Yes:
What corrective actions have been Taken to reduce or eliminate 1 & I related overflows at this spill location
within the last year?
Has there been any flow studies to determine III problems in the collection system at the SSO location? ElyaE No QNA ❑NE
If Yes, when was the study completed.and what actions did It eacornmend?
Has the line been Smoke tested or videced within the past year? 11YeSO No ❑NA ❑NE
If Yes, when and indicate what actions are necossary and the status of such actions:
Are there III related projects In your Capital IrnprovEArA$nf Plan? 1-1Y980 No ❑NA ©NE
If Yes, explain: t�� yI ��11 [I
Rave there been any grant or loan applications for III reduction projects? t_.uYeO No IJNA ©N6
If Yes, explain,
Do you suspect any major sources of inflow or Cross connectlona with storm sewers? 11Y110 No [DNA ONE
Have all lines contacting suffice waters in the SSO location and upstream been inspected recently? El YeSD NOD NA 13NE
If Yes, explain:
If YeLs, explain:
What other corrective actions are planned to prevent future 1/1 related SSOs at this location?
Commanis:
Pump Station Equipment Faifure (Documentation of testing, records etc.
shoul be provided upon re uest.)
What kind of notMGabon/alarm systems are present? N(Ad • I S�rsu a�
Auto-dieladtelematry (on6-way communication) LLYYOS
CS-SSO Form October 7, 2003 ' Page 4

08/11/2010 13:13 8284590596
CITY OF CLAREMONT
PAGE 03
IYQs
Audible
Visual
l� Ye9
SCADA (two-way communication)
/Yes
1= 1Yes
Pmergenq Contact Signage
Other
❑Yea
Describe the equipment that failed?
M 41 D � r�lo r� t�jlXiClr ��St�� r— inu � hCyhut �►7 ryie�
What kind of situations trigger' an alarm condition at this station O.e, pump failure, power failure, high
water, etc.) / �j f
(
>P � «-g— 1p " r 6-C
FFI
Were notificationlalarrn systems operable?
rp{ ��-
IL�IY90 No ❑NA ONE
If no, expiatn:
If a pump failed, when was the last maintenance and/or Inspection performed?
u
Cfi
cc�t//
at eci calls was hc cedlrha ntaelnad?
�i�ndrir /S 3 /L WLJr /(ysLOT 65Gt c-Af{a!ti !�G .0 I-1k
e tWl , Ala 9,1 2V8A—
If a valve failed, when was it last exercised? Artd�'� 4�c#� d�+
NA
Were all pumps set to alternate?
9)YsaD No I !NA QNI;
Did any pump show abase normal run times prior to and during the SSO event?
ElYea No I INA DNE
Were adequate spare parts on hand to fix the equipment (switch, fuse, valve, seal, etc,)?
0Yeaf-1 No ONA ONE
Was a spare or portable pump immediately available?
LpjYeso No IJNA ❑NE
If a float problem, when were the floats last tested? How?
MIA
If an auto -dialer or SCADA, when was the system last tested? Howl
17raftc 15 6hcacj v[,V&1q. a LVPlzz_, Lut.. a w
'.5A us efa►`4.
Comments:
GS-SSO Form October 7, 2003
Page 6

08/11/2010 13:13 8284590596 CITY OF CLAREMONT PAGE 04
As a representative for the rospnnsibie party, (certify That iha information contained in this report is true and accurate
to the best of my knowledge.
Person submitting claim:
Signature: c )'.4 ,,' "
in
Date: { t A G c 10
'Title: i �J7e'Q I I"^ C'' v M if 01A6t*
Telephone Number. 8z8 - c45 f --/W I
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 7. 2003 Pegg 8

610 East Center Avenue, Suite 301
Mooresville, North Carolina 28115
Telephone: [phone]
Fax: [phone]
FDER
resville
Regional
Office
To: �5 LA f From:
Fax- —r �� Pages:
Phone: Date:
Re: l & J2 LIX e7Ef CC:
❑ Urgent ❑ For Review ❑ Please Comment ❑ Please Reply ❑ Please Recycle

Collection System SSO 24-Hour Notification
Collection System: Number and Name WQCS# o t
Incident Number from BIMS.OI��P
Incident Reviewed (Date):
Incident Action Taken
BPJ
f NOV-2010-DV
S,J_
i a � � � � � ■ � � � � � t � � � � � � � r � � � s c ®� � o � � � � e o e a c � � � � � � � � e � � s � � � o � � � � � � e � s n � � � e � ® ■
Spill Date�,�
Reported Date` 4« O
Time ��� am/ rri
Time am r pm
Reported To SWP Staff or EM Staff
Reported By c�lY1 Phone
Address of Spill ��` VbUt-n '
County
Cause of Spill
Total Estimated Gallons
Stream
City.
15C)C) Est. Gal to Stream 50O
Fish Kill: Ye QO umber Species
Non Required Information and other comments relating to SSO incident:
Response time minutes Zone Map Quad

Permit #
Owner and Facility Name
WQCS00253
Bradfield Farms Water Company CS
WQCS00196
Carolina Water Service Cabarrus Woods CS
WQCS00233
Carolina Water Service Hemby Acres CS
WQCS00001
Charlotte -Mecklenburg CS
WOCS00016
City of Albemarle CS
WQCS00046
City of Belmont CS
WQCS00107
City of Bessemer City CS
WQCS00089
City of Cherryville CS-
WQCS00221
City of Claremont CS
WQCS00326
City of Concord CS
WQCS00088
Ciiy of Conover CS
WQCS00017
City of Gastonia CS
WQCS00020
City of Hickory CS
WQCS00327
City of Kannapolis CS
WQCS00036
City of Kings Mountain CS
WQCS00040
City of Lincolnton CS
WQCS00164
City of Lowell CS
WQCS00026 ,
City of Monroe CS
WQCS00059
City of Mount Holly CS
WQCS00044
City of Newton CS
WQCS00019
City of Salisbury CS
WQCS00037
City of Shelby CS
WQCS00030
- City of Statesville CS
WQCS00149
East Lincoln CS
Deemed Permitted
Permit #
Owner and Facility Name
WQCSDO130
Brooks Food Group -Brooks Food Group
WQCSDO114
Charlotte Mecklenburg Schools - Misc Laterals
WQCSDO057
City of High Shoals CS
WQCSDO117
Duke Energy Marshall Steam Station
WQCSD0257
Fallston
WQCSD0116
Gopse Creek Utilities Fairfield Plantation WWTP
WQCSDO101
Harborside Dev LLC-Midtown T CS
WQCSDO095
Kennerly Dev. Group LLC-Boardwalk Villas CS
WQCSDO098
Kennerly Dev. Group LLC-Kings Point CS
WQCSDO105
Kennerly Dev. Group LLC-Moon Bay Condos CS
WQCSDO107
Kennerly Dev. Group LLC-Schooner Bay CS
WOCSDO099
Kennerly Dev. Group LLC-Spinnaker Point CS
WQCSD0258
Kingstown
WQCSD0112
Lake Norman -South Point CS
WQCSDO104
Lake Norman -Villas S Harbour CS
WQCSDO102
Lake Norman -Vineyard Pt Resort CS
Permit #
Owner and Facility Name
WQCS00171
Greater Badin CS
WQCS00322
Aqua Country Woods East CS
WQCS00222
Town of Boiling Springs CS
WQCS00341
Town of China Grove CS
WQCS00231
Town.of Cleveland CS
WQCS00058
Town of Cramerton CS
WQCS00165
Town of Dallas CS
WQCS00342
Town of E. Spencer CS
WQCS00328
Town of Harrisburg CS
WQCS00343
Town of Landis CS
WQCS00310
Town of Longview CS
WQCS00120
Town of Maiden CS
WQCS00344
Town of Marshville CS
WQCS00043
Town of Mooresville CS
WOCS00125
Town of Mt Pleasant CS
WQCS00153
Town of Norwood CS
WQCS00190
Town of Oakboro CS
WOCS00325
Town of Stanfield CS
WQCS00180
Town of Stanley CS
WQCS00135
Town of Taylorsville CS
WQCS00258
Town of Troutman CS
WQCS00345
Town of Wingate CS
WQCS00054
Union County CS
WQCS00009
WSA Cabarrus Co. CS
Permit #
Owner and Facility Name
WQCSDO064
Lincoln County CS
WQCSDO097
Martin Dev Gp-N Point & Portside CS
WQCSDO120
Martin Marietta Mallard Creek
WOCSDO019
Town of Richfield CS
WQCSDO024
Town of Grover CS
WQCSDO038
Town of McAdenville CS
WQCSD0002
Town of Ranlo CS
WQCSDO049
Town of Spencer Mountain CS
WQCSD0252 All spills which do not have a permit
number assigned