WQCS00179_DV-2021-0178_20211203

ROY COOPER
Governor
EL[ZABETH S. BISER
Secretary
S. DANIEL SMITH
Director
Certified Mail # 7020 3160 0000 4115 6594
Return Receipt Requested
Christopher Doherty, Director Public Utilities
Franklin County Public Utilities
1630USHwy 1
Youngsville, NC 27596-9661
NORTH CAROLINA
Environmental Quality
December 03, 2021
SUBJECT: Notice of Violation and Assessment of Civil Penalty
for Violations of North Carolina General Statute (G. S.) 143-215.1(a)(1)
and Collection System Permit No. WQCS00179
Franklin County Public Utilities
Franklin County Collection System
Case No. DV-2021-0178
Franklin County
Dear Mr. Doherty:
This letter transmits a Notice of Violation and assessment of civil penalty in the amount of $1,036.57 ($1,000.00 civil penalty
+ $36.57 enforcement costs) against Franklin County Public Utilities.
This assessment is based upon the following facts: a review has been conducted of the Sanitary Sewer Overflow (SSO)
5-Day Report submitted by Franklin County Public Utilities. This review has shown the subject facility to be in violation of
the requirements found in Collection System Permit No. WQCS00179 and G.S. I43-215.1(a)(1). The violation(s) that
occurred are summarized in Attachment A to this letter.
Based upon the above facts, [ conclude as a matter of law that Franklin County Public Utilities violated the terms, conditions
or requirements of Collection System Permit No. WQCS00179 and G.S. 143-215.1(a)(1) in the manner and extent shown in
Attachment A. In accordance with the maximums established by G.S. 143-215.6A(a)(2), a civil penalty may be assessed
against any person who violates the terms, conditions or requirements of a permit required by G.S. 143-215.1(a).
North Carolina Department of Environmental QwRty Division of Water Resources
Raleigh Regional office ! 3600 Barren Drive Raleigh. North Caro6na 27609
919.791.4200

Based upon the above findings of fact and conclusions of law, and in accordance with authority provided by the
Secretary of the Department of Environmental Quality and the Director of the Division of Water Resources, I, Scott
Vinson, Regional Supervisor, Raleigh Regional Office hereby make the following civil penalty assessment against
Franklin County Public Utilities:
$1,000.00 For 1 of the 1 violations of Collection System Permit No. WQCS00179 and G.S. 143-215.1(a)(1) for
Sanitary Sewer Overflow(s) resulting in a discharge without a valid permit.
$1,000.00 TOTAL CIVIL PENALTY
$36.57 Enforcement Costs
$1,036.57 TOTAL AMOUNT DUE
Pursuant to G.S. 143-215.6A(c), in determining the amount of the penalty I have taken into account the Findings of Fact and
Conclusions of Law and the factors set forth at G.S. 143B-282.1(b), which are:
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
The degree and extent of harm to the natural resources of the State, to the public health, or to private property
resulting from the violation;
The duration and gravity of the violation;
The effect on ground or surface water quantity or quality or on air quality;
The cost of rectifying the damage;
The amount of money saved by noncompliance;
Whether the violation was committed willfully or intentionally;
The prior record of the violator in complying or failing to comply with programs over which the Environmental
Management Commission has regulatory authority; and
The cost to the State of the enforcement procedures.
Within thirty (30) days of receipt of this notice, you must do one of the following:
(1) Submit payment of the penalty, OR
(2) Submit a written request for remission, OR
(3) Submit a written request for an administrative hearing
Option 1: Submit payment of the penalty:
Payment should be made directly to the order of the Department of Environmental Quality (do not include waiver
form). Payment of the penalty will not foreclose further enforcement action for any continuing or new violation(s).
Please submit payment to the attention of:
Attn: PERCS Branch
Division of Water Resources
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

Option 2: Submit a written request for remission or mitigation including a detailed justification for such
request:
Please be aware that a request for remission is limited to consideration of the five factors listed below as they may
relate to the reasonableness of the amount of the civil penalty assessed. Requesting remission is not the proper
procedure for contesting whether the violation(s) occurred or the accuracy of any of the factual statements contained in
the civil penalty assessment document. Because a remission request forecloses the option of an administrative hearing,
such a request must be accompanied by a waiver of your right to an administrative hearing and a stipulation and
agreement that no factual or legal issues are in dispute. Please prepare a detailed statement that establishes why you
believe the civil penalty should be remitted, and submit it to the Division of Water Resources at the address listed below.
In determining whether a remission request will be approved, the following factors shall be considered:
(1) whether one or more of the civil penalty assessment factors in NCGS 143B-282.1(b) was wrongfully
applied to the detriment of the petitioner;
(2) whether the violator promptly abated continuing environmental damage resulting from the violation;
(3) whether the violation was inadvertent or a result of an accident;
(4) whether the violator had been assessed civil penalties for any previous violations; or
(5) whether payment of the civil penalty will prevent payment for the remaining necessary remedial actions.
Please note that all evidence presented in support of your request for remission must be submitted in writing. The
Director of the Division of Water Resources will review your evidence and inform you of his decision in the matter of
your remission request. The response will provide details regarding the case status, directions for payment, and
provision for further appeal of the penalty to the Environmental Management Commission's Committee on Civil Penalty
Remissions (Committee). Please be advised that the Committee cannot consider information that was not part of the
original remission request considered by the Director. Therefore, it is very important that you prepare a complete and
thorough statement in support of your request for remission.
In order to request remission, you must complete and submit the enclosed "Request for Remission of Civil Penalties,
Waiver of Right to an Administrative Hearing, and Stipulation of Facts" form within thirty (30) days of receipt of this
notice. The Division of Water Resources also requests that you coplete and submit the enclosed "Justification for
Remission Request."
Both forms should be submitted to the following address:
Attn: PERCS Branch
Division of Water Resources
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
AND
Scott Vinson, Regional Supervisor
Water Quality Regional Operations Section
Raleigh Regional Office
Division of Water Resources, NCDEQ
1628 Mail Service Center, Raleigh
Raleigh, NC 27699-1628

Option 3: File a petition for an administrative hearing with the Office of Administrative Hearings:
If you wish to contest any statement in the attached assessment document, you must file a petition for an administrative
hearing. You may obtain the petition form from the Office of Administrative Hearings. You must file the petition with
the Office of Administrative Hearings within thirty (30) days of receipt of this notice. A petition is considered filed
when it is received in the Office of Administrative Hearings during normal office hours. The Office of Administrative
Hearings accepts filings Monday through Friday between the hours of 8:00 a.m. and 5:00 p.m., except for official state
holidays. The petition may be filed by facsimile (fax) or electronic mail by an attached file (with restrictions) - provided
the signed original, one (1) copy and a filing fee (if a filing fee is required by NCGS § 150B-23.2) is received in the
Office of Administrative Hearings within seven (7) business days following the faxed or electronic transmission. You
should contact the Office of Administrative Hearings with all questions regarding the filing fee and/or the details of the
filing process.
The mailing address and telephone and fax numbers for the Office of Administrative Hearings are as follows:
6714 Mail Service Center
Raleigh, NC 27699 6714
Tel: [phone]
Fax: [phone]
One (1) copy of the petition must also be served on DEQ as follows:
Mr. William F. Lane, General Counsel
Department of Environmental Quality
1601 Mail Service Center
Raleigh, North Carolina 27699-1601
Please indicate the case number (as found on page one of this letter) on the petition.
Failure to exercise one of the options above within thirty (30) days of receipt of this letter, as evidenced by an internal
date/time received stamp (not a postmark), will result in this matter being referred to the Attorney General's Office for
collection of the penalty through a civil action. Please be advised that additional penalties may be assessed for violations
that occur after the review period of this assessment.
If you have any questions, please contact Mitchell Hayes with the Division of Water Resources staff of the Raleigh
Regional Office at [phone] or via email at [e-mail].
Sincerely,
Scott Vinson, Regional Supervisor
Water Quality Regional Operations Section
Raleigh Regional Office
Division of Water Resources, NCDEQ
ATTACHMENTS
Cc: WQS Raleigh Regional Office - Enforcement File
Laserfiche

JUSTIFICATION FOR REMISSION REQUEST
Case Number: DV-2021-0178
Assessed Party: Franklin County Public Utilities
Permit No.: WQCS00179
County: Franklin
Amount Assessed: $1,036.57
Please use this form when requesting remission of this civil penalty. You must also complete the `Request For Remission,
Waiver of Right to an Administrative Hearing, and Stipulation of Facts" form to request remission of this civil penalty.
You should attach any documents that you believe support your request and are necessary for the Director to consider in
evaluating your request for remission. Please be aware that a request for remission is limited to consideration of the five
factors listed below as they may relate to the reasonableness of the amount of the civil penalty assessed. Requesting
remission is not the proper procedure for contesting whether the violation(s) occurred or the accuracy of any of the factual
statements contained in the civil penalty assessment document. Pursuant to N.C.G.S. § 143B-282.1(c), remission of a civil
penalty may be granted only when one or more of the following five factors apply. Please check each factor that you
believe applies to your case and provide a detailed explanation, including copies of supporting documents, as to why the
factor applies (attach additional pages as needed).
(a) one or more of the civil penalty assessment factors in N.C.G.S. 143B-282.1(b) were wrongfully applied to the
detriment of the petitioner (the assessment factors are listed in the civil penalty assessment document);
(b) the violator promptly abated continuing environmental damage resulting from the violation (i.e., explain the
steps that you took to correct the violation and prevent future occurrences);
(c) the violation was inadvertent or a result of an accident (i.e., explain why the violation was unavoidable or
something you could not prevent or prepare for);
(d) the violator had not been assessed civil penalties for any previous violations;
(e) payment of the civil penalty will prevent payment for the remaining necessary remedial actions (i.e., explain
how payment of the civil penalty will prevent you from performing the activities necessary to achieve
compliance).
EXPLANATION:

STATE OF NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY
COUNTY OF FRANKLIN
IN THE MATTER OF ASSESSMENT
OF CIVIL PENALTIES AGAINST
Franklin County Public Utilities
Franklin County Collection System
PERMIT NO. WQCSOO 179
WAIVER OF RIGHT TO AN
ADMINISTRATIVE HEARING AND
STIPULATION OF FACTS
CASE NO. DV-2021-0178
Having been assessed civil penalties totaling $1,036.57 for violation(s) as set forth in the assessment document of the
Division of Water Resources dated December 03, 2021, the undersigned, desiring to seek remission of the civil penalty, does
hereby waive the right to an administrative hearing in the above -stated matter and does stipulate that the facts are as
alleged in the assessment document. The undersigned further understands that all evidence presented in support of
remission of this civil penalty must be submitted to the Director of the Division of Water Resources within thirty (30) days
of receipt of the notice of assessment. No new evidence in support of a remission request will be allowed after (30) days
from the receipt of the notice of assessment.
This the day of , 20
SIGNATURE
ADDRESS
TELEPHONE

ATTACHMENT A
Franklin County Public Utilities
CASE NUMBER: DV-2021-0178
PERMIT NO: WQCS00179
FACILITY: Franklin County Collection System
Other Violations
REGION: Raleigh
COUNTY: Franklin
INCIDENT VIOLATION TOTAL VOLUME PENALTY
NUMBER DATE VIOLATION TYPE VIOLATION DESCRIPTION (GALLONS) AMOUNT
202101543 7/8/2021 CSO/SSO(Sewer Overflow) Discharge without valid permit 65,000 $1,000.00

DIVISION OF WATER RESOURCES - CIVIL PENALTY ASSESSMENT
Violator: Franklin County Public Utilities
Facility Name: Franklin County Collection System
Permit Number: WQCS00179
County: Franklin
Case Number: DV-2021-0178
ASSESSMENT FACTORS
1) The degree and extent of harm to the natural resources of the State, to the public health, or to private
property resulting from the violation;
65,000 gallons overflowed from the YoungsviIle Regional Pump Station due to excessive rainfall. 62,000 gallons flowed
into Richland Creek a B, NSW+ waters in the Tar -Pamlico` River Basin.t Nutrients and pathogens to surface waters. CA
Cc, w 4 ft✓ wtiL� S-±-c -�/ v
2) The duration and gravity of the violation;
The pump station overflowed on July 08, 2021 at 2:00 pm and ended the same day at 7:47 pm.
3) The effect on ground or surface water quantity or quality or on air quality;
Nutrients and pathogens to surface waters4 n - _
4) The cost of rectifying the damage;
The cost of rectifying the damage is not given.
5) The amount of money saved by noncompliance;
It is believed that no money was saved by the noncompliance.
6) Whether the violation was committed willfully or intentionally;
It is believed the violation was not committed willfully or intentionally.
7) The prior record of the violator in complying or failing to comply with programs over which the
Environmental Management Commission has regulatory authority;
There have been no violations within the past 12 months.
8) The cost to the State of the enforcement procedures.
$36.57
J- 3-Ao2/
Date
Scott Vinson, Regional Supervisor
Water Quality Regional Operations Section
Raleigh Regional Office
Division of Water Resources, NCDEQ

ROY COOPER
Governor
EUZABETH S. BISER
Secretary
S. DANIEL SMITH
Dtrectar
Certified Mali # 7020 3160 0000 2219 2788
Christopher Doherty, Director Public Utilities
Franklin County Public Utilities
1630 U S Hwy 1
Youngsville, NC 27596-9661
NORTH CAROLINA
EnvIreamettAgemay
August 10, 2021
SUBJECT: NOTICE OF VIOLATION & INTENT TO ISSUE CIVIL PENALTY
Tracking No.: NOV-2021-DV-0332
Sanitary Sewer Overflows - July 2021
Collection System Permit No. WQCS00179
Franklin County Collection System
Franklin County
Dear Mr. Doherty:
A review has been conducted of the self -reported Sanitary Sewer Overflows (SSO's) 5-Day Report/s submitted by
Franklin County Public Utilities. The Division's Raleigh Regional Office concludes that the Franklin County Public
Utilities violated Permit Condition I (2) of Permit No. WQCS00179 by failing to effectively manage, maintain, and
operate their collection system so that there is no SSO (Sanitary Sewer Overflow) to the land or surface waters
and the SSO constituted making an outlet to waters of the State for purposes of G.S. 143-215.1(a)(1), for which
a permit is required by G.S. 143-215.1.
The Raleigh Regional Office is providing the Franklin County Public Utilities an opportunity to provide evidence and
Justification as to why the Franklin County Public Utilities should not be assessed a civil penalty for the violation(s)
that are summarized below:
Incident Start Duration
Number Date (Mina) Location
Cause
Total Vol
Total Surface
Vol Water
(Gals) (Gals) DWR Action
202101543 7/8/2021 345 Yungsville Reg. lilt Severe Natural 65,000 62,000 Notice of Violation
Station Condition Notice of Intent
North CauirDrprtrrt Min.henu+MQuilly I DhdtknatMhatrAmmon
RAVI NegkxmlOfflot 1 MOO Sorrel gift ; Ilidsh.Narthamble MOO
119.741.4200

This Notice of Violation / Notice of Intent to Enforce (NOV/NOI) is being Issued for the noted violation. Pursuant
to G.S. 143-215.6A, a civil penalty of not more than twenty-five thousand dollars ($25,000.00) may be assessed
against any person who violates or fails to act in accordance with the terms, conditions, or requirements of any
permit issued pursuant to G.S. 143-215.1.
This office requests that you respond to this Nonce, in writing, within 10 business days of its
receipt. In your response, you should address the causes of non-compliance, remedial actions, and all other
actions taken to prevent the recurrence of similar situations. The response to this correspondence will be
considered in this process. Enforcement decisions will also be based on volume spilled, volume reaching surface
waters, duration and gravity, impacts to public health, fish kills or recreational area closures. Other factors
considered in determining the amount of the civil penalty are the violator's history of non-compliance, the cost of
rectifying the damage, whether the spill was intentional and whether money was saved by non-compliance.
If you have any questions, please do not hesitate to contact Mitchell Hayes with the Water Quality Section in
the Raleigh Regional Office at 919-791-4200 or via email at [e-mail].
Sincerely,
146t. Scott Vinson, Regional Supervisor
Water Quality Regional Operations Section
Raleigh Regional Office
Division of Water Resources, NCDEQ
cc: Raleigh Regional Office - WQS File
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ROY COOPER
Governor
EUZABETH S. BISER
Secretary
S. DANIEL SMITH
Director
Certified Mail # 7020 3160 0000 2219 2788
Return Receipt Regugsted
Christopher Doherty, Director Public Utilities
Franklin County Public Utilities
1630 U S Hwy 1
Youngsville, NC 27596-9661
NORTH CAROLINA
Earirtonmenta! Quality
August 10, 2021
SUBJECT: NOTICE OF VIOLATION & INTENT TO ISSUE CIVIL PENALTY
Tracking No.: NOV-2021-DV-0332
Sanitary Sewer Overflows - July 2021
Collection System Permit No. WQCS00179
Franklin County Collection System
Franklin County
Dear Mr. Doherty:
A review has been conducted of the self -reported Sanitary Sewer Overflows (SSO's) 5-Day Reports submitted by
Franklin County Public Utilities. The Division's Raleigh Regional Office concludes that the Franklin County Public
Utilities violated Permit Condition I (2) of Permit No. WQCS00179 by failing to effectively manage, maintain, and
operate their collection system so that there is no SSO (Sanitary Sewer Overflow) to the land or surface waters
and the SSO constituted making an outlet to waters of the State for purposes of G.S. 143-215.1(a)(1), for which
a permit is required by G.S. 143-215.1.
The Raleigh Regional Office is providing the Franklin County Public Utilities an opportunity to provide evidence and
justification as to why the Franklin County Public Utilities should not be assessed a civil penalty for the violation(s)
that are summarized below:
Total Vol
Total Surface
Inddent Start Duration Vol Water
Number Date (Mins) Location Cause (Gals) (Gals) DWR Action
202101543 7/8/2021 345 Yungsville Reg. Lift Severe Natural 65,000 62,000 Notice of Vlofation
Station Condition Notice of Intent
Ned%C..a1MM Osysrinent ofLI.1u.mmtM (May Whine; a Mater Re mums
RAW* Regional i Off , 13 OORanntb,We t WO" North G obna2ria9
W./91A OO

. ;NI Notice of,Violation / Notice of Intent to Enforce (NOV/NOI) is being issued for the noted violation. Pursuant
to. SA3{2,15.6A a civil penalty of not more than twenty-five thousand dollars ($25,000.00) may be assessed
against any erson who violates or fails to act in accordance with the terms, conditions, or requirements of any
e rrif pursuant to G.S. 143-215.1.
This office requests that you respond to this Notice, in writing, within 10 business days of its
receipt. In your response, you should address the causes of non-compliance, remedial actions, and all other
actions taken to prevent the recurrence of similar situations. The response to this correspondence will be
considered in this process. Enforcement decisions will also be based on volume spilled, volume reaching surface
waters, duration and gravity, impacts to public health, fish kills or recreational area closures. Other factors
considered in determining the amount of the civil penalty are the violator's history of non-compliance, the cost of
rectifying the damage, whether the spill was intentional and whether money was saved by non-compliance.
If you have any questions, please do not hesitate to contact Mitchell Hayes with the Water Quality Section in
the Raleigh Regional Office at 919-791-4200 or via email at [e-mail].
Sincerely,
/fit Scott Vinson, Regional Supervisor
Water Quality Regional Operations Section
Raleigh Regional Office
Division of Water Resources, NCDEQ
cc: Raleigh Regional Office - WQS File
Laserfiche
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CHRISTOPHER DOHERTY, DIRECTOR PUBIC UTILITIES
FRANKLIN COUNTY PUBLIC UTIUTIES/1630 US HWY
1/YOUNGSVILLE, NC 27596-9661
NOV & INT TO ISSUE CP/NOV-2021-DV.O332/SSOs 7-
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WATER QUALITY REGIONAL OPERATIONS
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August 19, 2021
Scott Vinson, Regional Supervisor
Water Quality Regional Section
Raleigh Regional Office
Division of Water Resources, NCDEQ
3800 Barette Drive
Raleigh, NC 27609
SUBJECT: RESPONSE TO NOTICE OF VIOLATION & INTENT TO ASSESS CIVIL PENALTY
Tracking Number: NOV-2021-DV-0332
Permit Number: WQCS00179
Franklin County Collection System
Franklin County
Public Utilities
1630 US 81 Hwy
Youngsville, NC 27596
Phone: [phone]
www.franklincountvnc.us
Dear Mr. Vinson,
Franklin County is in receipt of NOV-2021-DV-0332 dated August 10,2021. Events that led to the SSO for
which this NOV references was due to Hurricane Elsa, a severe natural event. Rain from the event was recorded
at four plus inches within a six -hour timeframe.
Franklin County staff have worked diligently in the weeks since this event to determine sources of I&I into the
system and are currently creating a plan to address areas of the system deemed to be suspect. Franklin County's
Board of Commissioners have approved In the 2021-2022 fiscal year budget funds dedicated to sewer line and
manhole rehabilitation. Once the evaluation of the system is complete these funds will be used to mitigate and
correct issues within the system. Please note, a project to increase the Youngsville Lift Station force main is also
currently in discussions and will assist in allowing the station to be more efficient.
We are confident that with the above mentioned plan of action Franklin County can greatly lessen the chance
of future SSO's occurring within the system.
If you have any further questions, please contact our office at 919-556-6177.
Sincere
Christopher Doherty, D r of Public Utilities
Franklin County
1630 US Hwy 1
Youngsville, NC 27596
CC: File
'Equal Opportunity Employer"

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Total Balance Due : $0.00
Sum Of Total Paid:$4.217.34
Total Enforcement Cost $147.34
Total Penalty Amount: $5,400
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Total Cases:
Total Penalties After Remissions : $4,217.34
Sum of Total Case Penalties: $5,547.34

DWR
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 DWQ Regional Office within five business days of the first knowledge of the
sanitary sewer overflow (SSO).
Permit Number: WQCS00179 (WQCS# if active, otherwise use WQCSD#)
Facility: Franklin County Collection System Incident #: 202101543
Owner: Franklin County Public Utilities
City: Youngsville
County: Franklin Region: Raleigh
Source of SSO (check applicable): El Sanitary Sewer ❑ Pump Station / 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): Yungsville Reg. Lift Station
Manhole #:
Latitude (Decimal Degrees): Longitude (Decimal Degrees):
Incident Started Dt: 07/08/2021 Time: 2:02 pm Incident End Dt: 07/08/2021 Time: 07:47 pm
(mm-dd-yyyy) (hh:mm AM/PM) (mm-dd-yyyy (hh:mm AM/PM)
Estimated Volume of the SSO: 65,000 gallons Estimated Duration (Round to nearest hour): 5:45 hours
Describe how the volume was determined: visual estimation
Weather conditions during the SSO event: Heavy rain from TS Elsa
Did SSO reach surface waters? g Yes ❑ No ❑ Unknown
Surface water name: Richland Creek
Volume reaching surface waters (gals): 62000
Did the SSO result in a fish kill? ❑ Yes El No ❑ Unknown If Yes, what is the estimated number of fish killed? 0
SPECIFIC cause(s) of the SSO:
El Severe Natural Con(
24 hour verbal notification (name of person contacted ): Stephanie Goss
DWR ❑ Emergency Mgmt Date (mm-dd-yyy): 07/09/2021 Time (hh:mm AM/PM): 11:20:00 am
If an SSO is ongoing, please notify the appropriate Regional Office on a daily basis until SSO can be stopped.
Per G.S. 143-215.1C(b), the responsible party of a discharge of 1,000 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 reference statute for further detail.
The Director, Division of Water Resources, may take enforcement action for SSOs that are required to be reported to
Division unless it is demonstrated that:
1) the discharge was cause by sever natural conditions and there were no feasible altemative 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
WHETHER OR NOT PART III IS COMPLETED. A SIGNATURE IS REQUIRED AT THE END OF THIS FORM
CS-SSO Form
Page: 1

PART II:
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 SECTONS 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 DWR REGIONAL OFFICE UNLESS IS
Severe Natural Condition
Describe the "severe natural condition" in detail?
TS Elsa rain was over 4 inches from 11AM to approximately 5PM
How much advance warning did you have and what actions were taken in preparatio
for the event?
weather advisories throughout the week. Staff made sure aen set was fueled and level indicators worked at all pump
stations
Comments:
System Visitation
ORC
p Yes
Backup [ Yes
Name:
Luther Payton Proctor
Cert#
999734
Date visited:
07/08/2021
Time visited:
3:30 PM
How was the SSO remediated (i.e. Stopped and cleaned up)?
Once overflow and rain stopped, staff went out and cleaned debris and spread lime.
CS-SSO Form Page: 2

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: Christopher Doherty Date: 07/12/21 12:55 pm
Signature: Title: Director Public Utilites
Telephone Number:
Any addition information desired to be submitted should be sent to the appropriate Division Regional Office within five days of 1
knowledge of the SSO with reference to the incident number (the incident number is only generated when electronic entry of th
form is completed, if used).
CS-SSO Form Page: 3