NC0040274_Regional Office Physical File Scan Up To 2/18/2021

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Sanitary Sewer, Pump Station and WWTP Spill or Bypass Report Form
Permittee: GREEN MOUNTAIN PARK RESORT Permit Number: NCO040274 County: CALDWELL
Incident Started: Date 100"M TimeG'7Op Incident Ended: Date 10/21-1g8 Time /2-� 30
Source of Spill/Bypass (Check One): O-Sanitary Sewer Pump Station O-Wastewater Treatment Plant
Level of Treatment (Check One): 'g-None O-Primary Treatment O-Wastewater Treatment Plant
Estimated Volume of Spill/Bypass: 3O40 (A volume must be given even if it is a rough estimate.)
Did the Spill/Bypass reach the Surface Waters? )(-Yes O-No If yes please list the following.
Volume Reaching Surface Waters; ZOO Surface Water Name:
Did the Spill/Bypass result in a Fish Kill? O-Yes ANo
Location of theSpiillBypass: L,jf't zfaf'iarr in Pcirk;n_I ar .beside sewer PJ°tn`
Cause of the Spill Bypass: jai ece o-r Wood i a ni rn ed o n i "p.a e-r e, i �f
motor-. (/App;-aX. 5`txc , 3'X 3/y'1X y')
Describe the Repairs made: Pull ecl pump, r'e_n70 ved wood; C.6—eked o p erailo" c 1'lOunsP
Mcf-oY'i replece�Q awry ih we//j PUA p o f3-erafe 5
Action Taken to Contain Spill, Clean Up Waste and Remediate the Site: l'ilade
backlog '�° e.on"}ai,, �P',1J . Added cM,-,jhe +6 e1a)jT.;,,@d sp, l urp." O-+", ��llecl
sepj%c Jaij, dek-Vile fro Pump oat W-A a)J ceaaj-,ej wcc eQr, CoUe,reel -0-ec- c Q
.spi li wl-+k Nydre-+r--1 J-o -ctrj out.
a 1 eon . c.11,ed W-a+&.-4ek. L,bs 4- 4-a ate via ie ✓ 1-2.y,P41, s
Action Taken or Proposed to be Taken to Prevent Future S ip 11s �t this Location:,y141,�;,,�
6aiid To+ Jvr -P-,- 4�P'f Lid uJaS rlernav,ej e4j dispase�0 o.0
Other Agencies Notified: ►a%iOra&s-�p�,i• %Qhkrvice I�a%ev�eK �.s QL,11�(c Ce:io j►h �r7`�ce
Person Reporting SpillBypass:'Ay ► jo E. CL/R n Y Phone Number: 8z�17,T8 —
Signature Date: 1®,Z/6/98
For DWQ Use Only:
Oral Report Taken by: Report Taken: Date ime
DWQ Requested an Additional Written Report: O-Yes O-No .�
If Yes, What Additional Information Needed:
GIp �CCjj��
spilUBypass Repo o�3R_

Sewer Spill of 10/26/98

Sewer Spill of 10/26/98

SPILL RESPONSE EVALUATION FACTORS
Criteria
Requirement
Evaluation
Total
Points
1
24 hour contact list which includes phone
Complete List = 10 points
numbers for:
• Personnel / staff to address the situation
No list = 0 points
r (7
• Contractors / staff for mechanical repair
2
Equipment list which includes:
Complete List = 10 points
• Required functional emergency equipment
• Location of functional equipment
No list = 0 points
3
On site assessment of spill as soon as possible
Initial assessment time ASAP and not
(ASAP), or at least within 120 minutest of
more than 120 min. = 10 points
notification of spill. Documentation and
explanation required on length of response
Initial assessment time not ASAP or
time.
more than 120 min. = 0 points
4
Mobilization of necessary response after initial
Adequate mobilization = 10 points
assessment.
Inadequate mobilization 0
d
= points
5
DWQ contacted immediately, or at least within
Contact within 24 hours = 10 points
24 hours of notification of spill.
l Q
Contact after 24 hours = 0 points
TOTAL SPILL RESPONSE SCORE
d
Notes
120 minute maximum initial assessment time valid until 7/1/99. After 7/1/99, maximum initial assessment time shall
be 60 minutes.
Paae 2

4 -23' 900Nj 10:44 GREEN N103TAIN PARK TEL:[phone] P. 001
FAX COVER SHEET
GREEN MOUNTAIN PARK
2495 DE%UWETTE RDr
LENOIR, NC 28645
[phone]
FAX [phone]
HATE: z�`S
TO:
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FROM: C f6-4-A► VZ:'Z gc:crR&y
NUMBER OF PAGES INCLUDING COVER SHEET: 3
MESSAGE: ro/lo o)--4p

jN. -23' 9B(MON) 10:44 GREEN MOUNTAIN PARK TEL,704 758 7766 P. 002
Sanitary Sewer, Pump Station and WWTP Spill or Bypass Report Forlt>v
l"ermitfee: MMIMOI& UNFARIC F,9Z Permit Number- N 940274 Coumy:-CALDVE
Incident Started: Date 6 i7 98 Time'J� jf5 P�sl InrSdent Ended: Date 6 !s FB Time .2 AM
Source of Spill/Bypass (Check One): *-Sanitary Sewer 0-pump Station O-Wastewater Treatment plant
Level of Treatment (Check One): 6-None 0-primary Treatment 0.WaAewater Tmatment Plant
Estimated Volume of Spil}/Bypass ,gyp 44/ (A volume must be given even if it is a rough estimate.)
.Did the 5piWBypass reach the Surfttee Waters? *-Yes O-No If yes please fist the followin&
Volume Reael ing Surface Waters: Q64 �( Surface Water Name:
Did the 5pilMypass result is a Fish Kill? O-Yes *-No
Location ofthe SpMI13 _141anhole 40can-out behind Tennis Coarls,
Cause ofthr, C bill gMML—Sewer Line Stopped up.
Describe thr, ftairs Mad -Stoppage was cleared, and drainage Event back to normal,
Apfigg Taken to CoMifin bilL Clemjjp Waste Wd RNIediate the Overflow was reported at
7:45pm, 611719& Immediately started digging containment pira. Sewage sources w shut down (ice
Public Toilets, Bathhouse's and Laundry) Clorox was added to sewage in containment pits until
water How was stopped The stoppage was removed and water flow became normal. The spill area
was treated with lime and the pits were filled in.
Action Taken or Pmpodip be Taken to Prevent Egfin shills at this I.acation: A semnd pipe installed
above the original to pipe to act as a overflow in case of another stoppage.
Other Agencies Notified:
Person ]Reporting SpilVSypnas: DA iLb FL r-u R'V PhoneNumber: S W- 77G4
Signature Date:
For DWQ Use Only:
Oral Report Taken by: Report Taken: Date Time
DWQ Requested an Additional Written Report: 0-Yes O-No
IfYes, What Additional Information Needed:
IS 11 ISMMYxw ,g Farm &97
ni
JUN 2 2 1T8
; IV � WIS ER n' .-KTION
L ! S, Ai OFFICE

VN.-23'9B(MON) 10:45 GREEN MOUNTAIN PARK TEL:[phone] P.003
JUN-22 90 11:52 FROM;WATER TECH LABS-TNC. 170439G5761 TO:704 758 T766 PPGE:02
Water Tech Laboratories, Inc.
#5 Pinewood Plaza, Post Office $ox 1056
Granite Falls. North Carolina 28630-0040
( 704 ) 398-4444
Client :Green Mountain Park Collected 06/10/98 Time: 08:00
Address..:249 5 Dimmette ftd. -Sampler Douglas Lee Jr.
City ..... ;Lenoir Received... 06 f
� 8/90 Time: 0$;30
state....:NC Zips_.:26645
Faciiity__Green Mountain Park (Stream) Reported_.: 00/22/98
I a#! ........ NG00402 T4
DEPORTED BY: NC CERTIFIED LAS # 50
iq I; !
L. A. Gragg, SUPERVISOR

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