WQCS00108_Report_20210311

Tuckaseigee Water and Sewer Authority
2020
Sanitary Sewer System
Overflow Reports

Division of Water Resources
State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
Collection System Sanitary Sewer Overflow Reporting Form
Form CS-SSO
PART I;
This form shall be submitted to the appropriate DWR Regional Office within five business days of the first knowledge of the
sanitary sewer o�W overflow (SSO). Q
Permit Number: OCS 00\ 02 (WQCS# if active, otherwise use WQCSD#)
Facility: Incident #: Owner: --c\-4-) 3 V1
Region, 1 t.`A) City: \ Nat. County: 50.-C-X36143
Source of SSO (check applicable): Naanitary Sewer E Pump Station 1 Lift 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.): 1 D �: t4 1 Or - r5� (? �7t Febirti J L i I 1
Manhole #:
Latitude (degrees/minute/second): Longitude (degreeslminutelsecond):
Incident Started Dt: pi 3' 3 Time: VID O Incident End Dt: r"?' Vo-1;10 Time: i ®, 3 t., flv‘
(hh:rum AN PM (mm-dd-yyyy) (hh:mm) PM
(mm-dd-yyyy)
Estimated volume of the 550: 5 140 gallons Estimated Duration (round to nearest hour): 1 howls)
Describe how the volume was determined: rvvp '('ts.040 Cyc e
Weather conditions during the SSO event: y C *leaf
Did the 550 reach surface waters? res ❑ No ❑ Unknown
Volume reaching surface waters: p3yyD gallons Surface water name: "1-04.. .Sep razVer
Did the 55O result in a fish kill? ❑ Yes EAU ❑ Unknown
If Yes, what is the estimated number of fish killed?
SPECIFIC cause(s) of the 550:
<vere Natural Conditions ❑ Grease ['Roots ['Inflow & Infiltration
['Pump Station Equipment Failure ❑ Power Outage ['Vandalism ❑ Debris in line ❑Pipe Failure (Break)
['Other (Please explain in Part 11)
24-hour verbal notification (name of person contacted): ' \((L\ \IQ ► k I vweic ❑
[WR ❑Emergency Management Date (mm-dd-yyy):�1'Time: (hh:mm AM/PM):. a.
Per G.S. 143-215.1 C(b), the owner or operator of any wastewater collection system shall:
In the event of a discharge of 1,000 gallons or more of untreated wastewater to the surface waters of the State, issue
a press release to all print and electronic news media that provide general coverage in the county where the
discharge occurred setting out the details of the discharge. The press release shall be issued within 24 hours after
the owner or operator has determined that the discharge has reached surface waters of the State.
In the event of a discharge of 15,000 gallons or more of untreated wastewater to the surface waters of the State,
publish a notice of the discharge in a newspaper having general circulation in the county in which the discharge
occurs and in each county downstream from the point of discharge that is significantly affected by the discharge. The
Regional Office shall determine which counties are significantly affected by the discharge and shall approve the form
and content of the notice and the newspapers in which the notice is published.
WHETHER OF NOT PART II IS COMPLETED, A SIGNATURE IS REQUIRED SEE PAGE 13
Form CS-SSO Page l

Severe Natural Conditions (hurricane. tornado, etc.)
Describe the "severe natural condition" in detail:
c3.-C c03064r
How much advance warning did you have and what actions were taken in preparation for the event?
Comments:
S b m`e.Cat'-e, ` ..? 'Dr-t S ct. y +k -1c-v1'
cow - .: rer (t-7- $,8\
Ct.ck4r -e- -ie " ,'.L.w4i;4,36 O -A c-re k &f ' 4-Nnre,
'* Dc < c)-vJc t"
Ou-s' 0.-‘) ckAL) \r\„1/4.a ibc1-15- soo.x.:}‹
3\W & .v copy
Form CS-SSO Page 3

System Visitation
ORC
Backup
Name: .17r6j flan m b JS
Certification Number: 99 5 t ! .D
Date visited: Df `3 1 °Wa
Time visited: 'fl 4 l t, T ■
Yes ❑ No
❑ Yes ❑ No
How was the SSO remediated (i./e. Stopped and cleaned up)?
1;vvN-e. c;.,Q6, C a\ A GL c ,c & 61/4..
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:' l Y Y\ a raj
Signature:
SAAtr.c.ot, OVYNNecvNi-Jazsrl.?
Telephone Number:
Tide:
Date: Or7 117) 1
Any additional information desired to be submitted should be sent to the appropriate Division Regional Office within five
business 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).
Form CS-SSO Page 13

The annual report of the Tuckaseigee Water and Sewer Authority Sanitary Sewer System
Overflow Reports for the calendar year 2020 is available to the public for review at the central
offices located at 1246 West Main St Sylva, NC 28779.
Notification of the availability of this report has been made to the customers or users of these
facilities through advertisements in the print media located in the geographic area the Authority
serves.
I certify under penalty of law that this report is complete and accurate to the best of my
knowledge. I further certify that this report has been made available to the user or customers of
the named system and that those users have been notified of its availability.
Troy Ammons
Collection System ORC
Tuckaseigee Water and Sewer Authority
Dated: 3/10/21