NC0062855_Performance Annual Report 2003_20040101

TOWN OF ROBBINS
WASTEWATER TREATMENT FACILITY
DENR FRO
OCT 1'3 2O04
W:
ANNUAL PERFORMANCE REPORT
For the Calendar Year 2003
Prepared: January 2004

2003 Annual Performance Report
for the
Town of Robbins
Wastewater Treatment Facility
I. General Information
Facility/System Name: Town of Robbins Wastewater Treatment Plant
Responsible Entity: Town of Robbins
Person in Charge/Contact: Mr. James Britt
Town of Robbins
101 N. Middleton Street
Robbins, NC 27325-0296
[phone]
Description of Collection System or Treatment Process:
The Town of Robbins Wastewater Treatment Plant is a 1.3 MGD design capacity
facility. The facility treats a combination of domestic, commercial, and industrial
wastewaters. The current treatment scheme includes a primary treatment unit
which includes a splitter box with mechanical screening and a manual bar screen.
Three 40 HP influent pumps are provided to transfer the influent wastewater to the
secondary wastewater treatment unit. Dual activated sludge treatment units are
provided with integral center -feed clarifiers. Activated sludge basin mixing and
aeration are provided by diffused aeration. Chemical addition is provided through
the use of Caustic and Alum. The treated effluent is disinfected by chlorination
followed by dechlorination through the use of Sulfur Dioxide. Excess sludge is
transferred to an aerobic digester for stabilization. Stabilized sludge is currently
land applied in liquid form on permitted sites. The effluent is discharged into the
Deep River in the Cape Fear River Basin.
II. Compliance Performance
The North Carolina Department of Environment and Natural Resources
(NCDENR) regulates the Town of Robbin's effluent discharge under the National
Pollutant Discharge Elimination System (NPDES). The NCDENR issued to the
Town a NPDES Permit that includes water quality limits and sampling and
monitoring requirements. The NPDES Permit requires the Town to test more
than 27 different constituents in the treated water. The monitoring frequency for
these constituents are set at various intervals such as continuous, daily, weekly,
three times per week, monthly, and quarterly. During the reporting period, the
Town conducted 3,337 tests of the treated water before it was discharged to the
creek. The WWTP achieved a Compliance Level of 100% with its NPDES Permit
requirements. Following is a summary of the testing for the parameters that are
assigned Water Quality Standards by the NPDES Permit. Please note the

summary does not include parameters that only incorporate a monitoring
requirement, nor does it include daily process control testing.
Constituent
Number of Test
Required
Number of Test
Conducted *
Flow
Continuous
Continuous
Biochemical Oxygen Demand (BOD)
156
157
Total Suspended Solids (TSS)
156
157
Ammonia
156
157
Fecal. Coliform
156
160
Chlorine
156
225
Total: Nitrogen
12
20
Total. Phosphorus
52
54
Oil & Grease
52
53
Zinc
12
12
Mercury
12
52
Cyanide
12
12
Conductivity
156
157
Copper
12
12
Toxicity
4
4
* Testing is not required during Holidays or Inclement Weather.
In addition to the required testing, the Town conducted over 2,808 in-house test
to ensure the proper operation of the wastewater treatment plant.
Following is a summary of the permit violations, which occurred during the year.
There were no permit violations during the reporting period.

Part Ill- Certification
I have personally examined and am familiar with the information submitted in this
document and attachments. Based upon my inquiry of those individuals
immediately responsible for obtaining the information reported herein, I believe
that the submitted information is true, accurate, and complete. I amaware that
there are significant penalties for submitting false information.
Signed this
day of } a 2004.
Town Manager

-�.� i• • e .sv •v\� \ 1.►��L L/�vY♦\Y� '+I' .. .. •-♦ v• • ♦ v•••�
(Plq s Print or Type - Use Attachments if Needed )
erm�►-e:,, 'Tie- L.c� c �C �l s Permit Number: A) erY) b z 8 v Y County: PI o� r�
'ncidenc Started: Date 6 - z t - 3 Time :21 zv p cident Ended: Dace 6^ZL , Q 3 Time 2
source of Spill/Bypass (Check One): O Sanitary Sewer Pump Station O Wastewater Treatment Plant
level of Treatment (Check One): O None O Prim Treatment O Secondary Treatment 0 Chlorination OttrZ
F.stimaced Volume of Spill/Bypass: �(� o�� ' ( volume must be. given even if it is a rough estirt
p o
)id the Spill/Bypass reach the Surface Waters? 0 Yes No If yes, please list the following:
/olume Reaching Surface Waters: U —
Did the Spill/Bypass result in a Fish Kill?
vocation of the Spill/Bvpass: `
O Yes
Surface Water Name:
;cruse of the SgiIUHv�ass:
d
7. 13 AE ) s
(A� L brll
)
describe the Repairs Made: k
damd ,p a . (, h �.W,�-v€.8,
gyp, o> v �c.� �c0..Q , ti 5 n� ew
}
fiction Taken to Contain Spill. Clean Up Waste- and Remediate the Site:
'ction Taken or Proposed to be Taken to Prevent Fum,re Spills at this Location:
Other Agencies_ Notified.
'erson Reporting S ypass- A Si) -A-) )Yt ct) L ( _ Phone Number. 571, - 5t S ' ZQ 3
Signature �
_�- Date: 6'Z_(__ d 3
...
Eor DWQ Only:
Oral ReportTaken.by: ReporrTaken_ Date Time
'lWQ Requested an. Additional WrittenReport_
i'`U--f"A Lk j t N
pi
O Yes O No
_ Yes* WliatAdditional Information iSNeeded:
Spill/Bypass Reporting Form 8/9`r

• -...... .......:..• w..•y
'facicent Started: (oate!'Rme) -z t - 4)3 / Z
Incident !_nded:(Date/Time) b• 2 t- 0 3! 2 •
CY spill is ongoing, please notify Regiarrai Office on a dail until spill can be stopp ol .
Source of spilUbypass (check one): Sanitary Sewer . ump!Stadon WWTP Level Cl treatment (check one): /Ncn� •7f•1 reatment
Seconder/ Trio:fent_Cfibrihation•Cn!Y
Estimated volume of spilUypass(che k one): Sy o5 L • • 501.=1,000 gal. ,O01-2,coa gal
_,>2.000 gal. - estimate volume in newest 1' gallon It crements
Did spiiUbypass reach surface'watet5? Yes \/ NYo (lf.Yes, please list the following)
volume reaching surface waters?(check one): 42/0 t. _S4f-1,000 gal. 1,00t-2,000 gal
_2,000 gat. - estimate volume in nearest 1.007 Zion increments
Name of surface water
Die saill/bypass result in a fish killYes_IZ.No •
It Yes, wnat is the estimated number of fish kilted?_ •
Fsase crovtde fie teflowfrno i itarrnattorr
1. Location ofspill/bypass:_ 5,`' --e_f t. ' u'e-
2. Cause of spilUbypass: CAMC�d
€IhiS1U .0
3.:id you have personnel avaiianle to perform initial assessmenr24 hours/day (InGuding weekends zinc
holidays)?
Yes •/ No '
4. HcwJ ng did it take to make an initial assessment of the spliUoverflow after first knowledge?
5 Minutes
}how long die it take to get a repair crew arts?
Minutes ��
pease explain the time taken to rr�* in at ae ner ?
s e ✓�M.v� % o.rt1.r 6 L., -%_14.1,•
o,-,
tf:
p i r—
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5. Action taken to contain spill, clean up waist% an/or renieeilate:the;site: trwyk..)
5. Were 9te equipment andfor parts needed to make repairs readily available? •
Yes No. if no, please explain why:
•
7. It the spill/overflow•occurred at a pump station or was the r�stj tit4 pump station failure,
was the alarm system functional at the time of the spBi? ...• No. If the alarm
system did not function, please explain why:
•
8. Repairs made are: jPermanent Temporair.. • .
Please deSorfbe what repairt7were made. if the repairs areiembararY,Tlease indicate by
what date a permanent repair will be completed and notifyitte Regional Office within 7 days of the
permanent repair: ee /*- S— A 4e0-0e._ •
9. Comments: id 5:f 1 L.) a• A.. x de
Other agencies notited:
Person report g spill/bypas Mit 1 Phone Number q( 6 7 to, -t14..
Signature
• Date:
================================ -Tx==as • Enni_el re
For DWG Use Only:
Oral report taken by: Sewn taken: Date: • Time:
DWQ requested additional written report? yes
If yes, what additional information is needed?
Fayetteville Regional Office
—NCDENR - DWQ Section: Pbone: [phone] Fax: [phone]
After hours, Weekends, or Holidays, call 1-800-662-7956
=
tiSb1131A1
ZS6T-Lt6-13is LE :?:C 656T/57,7129

(Please Print or Type - Use Attachments if Needed )
`Perm� � icteee: (u ok -20,.c(7► tiA Permit Number: N C ob 62 es-5- County: PA mire,
Tncident Started: Date I - S - ° 3 Time i 2 ; 3 Sh, 1 w` i cident Ended: Date 1 "f' Time (2 ' q D P' wk
_,ounce of Spill/Bypass (Check One): O Sanitary Sewer dPump Station 0 WastewaterTreatment Plant
Level of Treatment (Check One):
Estimated Volume of Spill/Bypass: '7 5AQ-.
Did the Spill/Bypass reach the Surface Waters?
Volume Reaching Surface Waters:— —
O Yes
Cii' None 0 Primary Treatment 0 Secondary Treatment 0 Chlorination Only
( volume must be given even if it is a rough estimate.)
o If yes, please list the following:
Surface Water Name: /✓/144
Did the Spill/Bypass result in a Fish Kill? 0 Yes
1V 0
Location of the Spill/Bypass; cSw45��" dam. off.
Cause of the Spill/Bvoass:
l _ QP-IC' G
Describe the Repairs Made:
DL5(:), 7
Action Taken t . Clean Up Waste and Remediate the Site:'
Cc C-e- .) t— Se e.1
DE R—FRO
OCT 132001
DWQ
Action Taken orProposed to be Taken to Prevent Future Spills a thi Location:
:P. gd �. ),vs .c. (€A-i-i.`
��. �vv.��e� • N(e.51;
OtherAgencies Notified: Ai
Person Reporting Spill/Bypass: -
Signature
For DWQ Use Only:
Oral Report Taken. by:
1-1WQRequested as Additional Written Repore
Yes, What Additional Information is Needed:
jr Sow, / 4u,i(-€ t1
Phone Number_
Date: (- 5-03
Report Taken: Date Time
O Yes O No
Spill/Bypass Reporting Form 8/97

• me ••••i• • •••••••• •••••• •
incident Started: (OatelTime) tS -67' 3 12 3
.• 7
Incident Ended:pate/Time) .
.•••: •
( Y spa i.s angeing please notify Regidn-ad Office an a dellibasis unit splW can be sit:pm;
Source at spill/typass (check one): Sanitary Sewer PwiStadcn WWTP
Level of tree/merit (check one):. _1/None Prirnary•Thasehert
Secondary T Chk:OrtationCny.
Estimated volume at soilttypassictuack one): 0-500 gal: . • .5C1.i.1,000 gal. 1,001 -zaaa gat
,>2.00C gal. - estimate volumein nearest poll gallon Increments
Old spill/bypass reach surfacer waters?' - Yes \INCli.Yes. Please list the following)
. . .
volume reaching surface watersl(check one): 0 04197§31. •• 1 5111*-1,000 gal J,001-2400 gal
2,00C gal. - estimate volume in nearest 1,000' gallon .increments
Name of surface water
Die soillitlyaass result in a fish kill Yes No •
It Yes, wnat is the estimated hunter at fish killed?
Pyease orovide the tallawtrta interrhatiatu
I . Location of spill/bypass: *uNA-4 e•-••
.• I
2. Cause of spill/bypass: lAke-vs-x4..P4--")
3.:Id you have personnel availatole to p oriniUal assessnerit•24 hours/day (including weekends and
hallaayst
Yes Na
4. '-kreeg did it takelo make an initial assessment ofthe spill/overflow. alter lion knowledge?
minutes
14CM long did it take to get a repair crew omits?
Minutes
P!ea.sa explain tes20 :tint taken to make rtdlaL
enr
I .svv
edrt.AA..) JOLI t; Tretviis-
IP
A1
//- prioc_.e..d/LAst_s
my-ld 7517tna4
71S5t-Lv6-GT5 LE:Z;T 566T/5/voi

S. Action taken to contains
r
`rp
an up waste, andlor rerr*Ilate: he:site:
1 ;)
c.�<", o 1-ti.�— -eo ice`
5. Were tl�'e equipment andlcr parts neededtomake repairs readily available?
Yes No. if no, please explain why: •
7. It the spill/overflow occurred at a pump station or was the r ota pump station failure,
was the alarm system functional at the time of the spill? Yes No. If the alarm
system did not function, please explain why:
8. Repairs made are: ' Permanent Temporary.:
Please describe what repairs were made. If the repairs are lemporary,::pleasa indicate by
what date a permanent repair will be completed an not the Regional Office within 7 days of the
permanent repair: See t* `5` A (0oV
9. Comments: ',e)
4.)e.> Less Le- k
Z
C. , c S•�Q
Other agencies notifed: iVow2 I
Person reportin spili/bypass� peso J 4- _ A- -►1) (Phone Number: CP1 b -2 410 -Z14'3 I
Signature `^~ ` 1-"6 Date:t -03
==== s=======_========_sa_em == _
For DWQ Use Only:
Oral report taken by: Report takers: Date:_ Time:
DWQ requested additional written report? Yes _ lo•
It yes, what additional information is needed?
Fayetteville Regional Office
NCDENR - DWQ Section: Phone: [phone] Fax: [phone]
After hours, Weekends, or Holidays, call 1-800-662-7956
EA Mtrd V5C(1014 7:5r t-Lt5-0T5 LE : ZT 5FEt/57,/bA

WV 1
i
Incident Started: (Date/Time) 8-Z l -03 / / , u1..
Incident Ended:(Date/Time) e-z1-o3! 1.•0
(If spill is ongoing, please notify Regional Woe an a dallY•basis t siil/:can be stn
Source of spill/bypass (check one): Sanitary Sewer _4Purip!Station _WWTP
Level kit treatment (check one): None ..._Primary.Tniatment
..SecondaryTi nt ( orr1ion•o
�"o
Estimated volume -of spilt ypass(check one): -50 gara.•501.4
501•=1,OODgaI. ;,041-2,000 'gat
'
_..>2.000 gal. - estimate volume in nearest1.000 gallon. increments
Old spill/bypass reach surface waters?' Yes V't1No (it.Yes.. please list the following)
Volume reaching surface waters?(check one): 0500 gal. _50r-I,000 gal. 1,001-2,000 gal
)2,000 gal. - estimate volume in nearest 1,000' gallon incr+ernents
Name of surface water A.)/A ' -
Dic spill/bypass result in a fish kill Yes '' No
If Yes, what is the estimated number of fish killed? -
?'ease Drcvids ine to,l0wing Information: .
1. Location of spilVbypass: 1-1.4-+tA6e.:1 .0e.. I_ -t•
2. Cause of spilt/bypass: CI,a.tkQ ! d
J s ►.w 4,
eroR
fart_ ISVA•A
Auer?) r c3 tic„
3. Old you have personnel available to perform initial assessment24 hours/day (including weekends and.
holidays)r�
Yes No
d. -low long did it t to a an initial assessment Who spilliomr first knowledge?
minutes 5 �i('¢ r�►ka..intcL',l . .
How long did intake to get a repair crew onsitee?
5 , Minutes
Please explain the tame taken to make initial assessment.
-r i ,
Tu-tki)
•
156t-LC6-076
LE: t 666t/6Z/ti9

1
S. Action taken to contain spill, Qlea up wast, andlor rmediatei;the:site:
0r-$sv— 5 t3,Jriln�� _ _ _ , A3cA �'�-, ro
IITTIOLATINEMILTWAILI9IFW
NM
• -
IPI-
6. Were qe equipment and/or parts needed to make repairs readily available?
Yes No. It no, please explain why:
. ;t the spiWfoverflow occurred at a pump station orwae the r
was the alarm system functional at the time of the spill?
system did riot function, please explain why: •
•
ot-a pt+mp station failure,
es No. If the alarm
8. Repairs made are: ,/Permanent Temporarr ease indicate by
?lease describe what repairs were made. it the repairs arelGmporary,;pl , d ys of IN
permanent what date a permanent repair will be conrieted and notify the Regional Ce within
a
permanent repair. S�xi.t- ee.a �� - �`" '�
rear, 5 si I •rl! w - 7, uve ee` e "-,
Aim...-,-,t4,,A,
cv
9. Comments: w•
Other agencies notifed: cP4I *t4) `1 10 -efab -1 S 461 8-za-03
Person reporting spiWbypases ----61-%tti Phone Number: 51o'14S -3'
Date: 8-2,2-,o 3
Signet
=asaaasasaaaa- aarsION.11 -� 112,== ===aaz01== �-^��a
aasaaaaaaasaaaas3ssa---�
For oWC use Only:
Oral report taken bY:. Report taken: Elate: Time:
DWCI requested additional written report? Yes _J'lo•
If yes, what additional information is needed?
Fayetteville Regional O1Tke
NCDENR - DWQ Section: Phone [phone] Fax: [phone]
After hours, Weekends, or Holidays, call 1-800-662-7956
74Cr_ire_nTe
I P- • r--•/rT/rel

iPlease Print or Type- - Use Attachments it Needed )
Penniitee���� �� - t.) /US. Permic Number. ICJ)-62.BS 5 County: /14d-73 r- e..
Incident Started: Date R-ZZ •e,3 Time 4. W A,wn • cident Ended: Date r .zZ-63 Tirne Qt Z ,
.ounce of Spill/Bypass (Check One): 0 Sanitary Sewer p Station ~ 0 Wastewater Treatment Plant
Level of Treatment (Check One): 0 None 0 Primary Treatment 0 Secondary Treatment 0 Chlorination Only
Estimated Volume of Spill/Bypass: 1 S 5 oQ� volume must be given even if it is a rough estimate.)
Did the Spill/Bypass reach the Surface Waters? (0 Yes e'No If yes, please list the following:
Volume Reaching Surface Waters: iV oM e. / Surface Water Name:
Did the Spill/Bypass result in a Fish Kill? 0 Yes 4o
Location of the Spill/Bypass:
Cause of the Spill/Bypass:
ee c NS Flo ,v�' fie.e •
Gam,
Describe the Repairs Made:
vv� rU 5 .y•^-,••
Cw�
Am8, /k at-) pistik.z.
N ( Act V e��, y��• l c
Action Taken to Contain Spill. Clean Up Waste and Remediate the Site:
r ew►�r - s� h 1%c,e.A s o ` L T cl
l�e - S ec,e j , te e,
Action Taken or Proposed to be Taken to Prevent Future Spills ar this Location:
Other Agencies Notified:
Person Reporting SpillByp
Sim
,Nox).e_
Phone -Nu �h. �.:.:crYp Qy zq3
Dates q - z z-o.3
For DWQ Use Only:
Oral.Report Takeo. by- Reporr aken: Date
nWQ Requested as AdditionaLWrittenrReporc
_ Yes. WhatAdditional Information isNeeded:
0 Yes. 0 No
SpiIl/Bypass Reporting Form 8/97

tnciaent Started: (Date/Time) - 22- 011 5; 2,0 d i.th.:, •
Incident Ended:(Date/Time) -2 2-1A3! '( Zb- 4AA- .
(,Y spill is ongoing. please notify Regional Chide an a dal basis 'Loa spill can be stopped!.
Source of spill/bypass (check one): Sanitary Sewer .�111np,Station ___WWTP
Level of treatment (cleric one): ✓ Ncne • . PMrr yTreatment
Secondary Treeauns <_Cttiorfriallort by
Estimated volume at spiittypass(ctteck one): • 501•=1,000 gal. ; ,001-2,000 gal
__. 2.000 gal. - estimate volume in nearest 1 gallon Increments
•
Old spill/bypass reach surface waters?' Yes- No (lf.Yes. please list the following)
volume reaching surface waters?(check one): O 04feeffat. • • 501-1,000 gal. 1,001-2,000 gal
2,000I gal. - estimate volume in nearest 1.000' gallon increments
Name of surface water /
Dia sail&bypass result in a fish kill Yes " No
If Yes, what is the. estimated number of fish killed?
Pease arovide ire IVIOWifter infomrattfan! c�
1. Location of spilt/bypass:_ .37^"-,S
2. Cause of spill/bypass: �� + 2 S bct i i e ) �26� � &) Ad }— S Z
3.:id you ha a personnel available to perform initial! assessmenr24.hours/day (induding weekends and
holidays)?
Yes 1 Na '
a. How long did it take to make an initial assessment of -the spill/overflow after firer knowledge?
S minutes
How long didit take to get a repair crew errsite?
S Minutes I
Please explain the time n to malca initial assesanent�a i ... 5.kk. v i 5S., Gd rt)D
Les -Th h ti c . a _ d 0,v,..? . ,,t-eA,_ _c (v,5 cit., v cl l . S
AV-ee� 0 ,Le.a
,.a �!rd
751710W :S6t-LV5-975 Lc 'Tt 565t/5Z/V9

r4'
S. Action taken to contain spill, clean Up waste, anElior remeila*theaite:
-rcflitt _ Pie46 Q.-ut4 ph ic),ci
Nos 0 (p, ej e.n.i.)Q..04 1, A;
.1 • ,
'‘\ r see.clfd
v•,v-P5-k StAAZt
SDi
,Q..) • I
tAt ted 11-r-FLCI
S. Were
equipment and/or parts needed to make repairs readllY available?
Yes No. If no, please explain why: •
7. If the spilt/overflow occurred at a pump station orwas the r4 tif.A pump station failure,
was the alarm system functional at the tirrie of the spill? es • No. tithe alarm
system did not function, please explain why:
B. Repairs made are: ..iperrnanent - Temporary
Please describe what repairs were made. if the repairs arelembOraryflplease indicate by
what data a permanent repair will be completed and notifylhe Regional Office within 7 days of the
permanent repair: ZSke. ;4 f 0-ce.
9. Comments: -5 ,0 --11•<_,ct t, /s Tr,) y
Other agencies notifed:
1-) kttAkett * Phone NUmber: qi ?q -"2-Y. / Person reporting spill/bypase:---3
"-5
Date:
For DWQ. Use Only:
Orel report taken by:
Report taken: Date: Time: -
DWQ requested additional written report? Yes •NO.
If yes, what additional information is needed?
Fayetteville Regional Office
NCDENR - DWQ Section: Phone: [phone] Fax: [phone]
After hours, Weekends, or Holidays, call 1-800-662-7956
PQ =Orf.-1 tlqWW1W 7AAT-itA-QTA ):7:7T TJ7/

Pei`tiittee
ti
Incident Started: Date / a -/ 7- 03 Time
source of Spill/Bypass (Check One):
Level of Treatment (Check One):
(Pfci c Print or Type = Use Attachments if Needed j
2� b 1, A) s Permit Number. A)C- d a 6 c,� 5S County: M°a
ja- ( <- a 3 Time 8 : aS 4' W.
8:6a r4,t,tn.
cident Ended: Date
0 Sanitary Sewer Pump Station O Wastewater Treatment Plant
(//None 0 Primary Treatment 0 Secondary Treatment 0 Chlorination Only
Estimated Volume of Spill/Bypass: ZS, c Le,�'s ff
Did the Spill/Bypass reach the Surface Waters? 0 Yes O'No
Volume Reaching Surface Waters: — 0 -
Did the Spill/Bypass result in a Fish Kill?
O Yes Q/No
Cause of the SpiIlBvpass: (�
kr..c.,E,L ..
Describe the Repairs Made: •
(A volume must begiven even if it is a rough estimate.)
If yes, please list the following:
Surface Water Name: /)/A
Action Taken to Contain Spill. Clean Up Wate and Remediate the Site:
MCZ . v,0) VA L. hl r _ a,..,-' ' 5)-6-6 vim—
i A, c_av„, .Ili • (..tM7� / 5 `e— ci, /t, .�.
J
)4-LIGA i-1i
Action Taken or Proposed to be Takep to Prevent Future Spills at s Location:
A.)0 iPss . ('
OtherAgencies. Notified: /'U (A)
Person Repo g SpillB
Signature
For DWQ Us Only:
lakf
Phone Number. "TCo Z4
Date: 10-12-03
Oral Report Taken. byr ReportTaken_ Date: Time
riWQ Requested an Additional Written; Report
Yes, WhatAdditional Information is:Needed:
O Yes. O No
SpiII/Bypass Reporting Form 8/97

• ....ors. • v..* •••••••••• VIM/MI It y
- 47...
incident Started: (Oaterime) it-12-03 8.;
' Incident Ended:(0ate/Time) i D / -2 -e is =144 iii.x- *„ • . , .,.
Iff spill is ongoing, please notify Regional Office an a Celli basis La7t t spill can be stoppeol
. . • /
Source of spill/bypass (check one): Sanitary Sewer Station WWTP
Level at treatment peck one): 1/None • PrImaiy•Treatment
Secondary rearm* ChlorinationCruy
Estimated volume of spiittypass(check one): 0-500 gal: • • 501.0 ,000 gal. 1,001-2,000 gal
gal. - estimate volume in neatestq00 gallon Increments
Did spill/bypass reach surface waters? , Yes No (If.Yest please list the following)
. . .
Volume reaching surface waters?(check one): 04tieigal. • - 50T-1,000 gal. i ,001-2,000 gal
›2,000 gal. - estimate volume in nearest 1,000 gallon increments
Name of surface water
A
Die spilt/bypass result in a fish kill Yes
II Yes, wnat is the estimated number of fish killed? •""
Fisase crdvide re followinc information;
D. LocTr... of spill/bypass: it•Ad1/4)-4.
- \
2. Cause of spill/bypass: -Cm-AK)
3. :id you have personnel available to perform initial assessnerit-24 hours/day (including weekends and
holidary-
Yes No '
Howlong did it take io make an initial assessment oft* spill/overfldw after first knowledge?
_1 Minutes
How long did it take to get a repair crew =site?
Minutes
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5. Actibq taken to co rain spill, clean up wase, andlor a iate..the:ske:
z1a
6. Were tip equipment andlor parts needed to make repairs readily available?
Yes No. If no, please explain why: •
7. It the spill/overflow occurred at a pump station or was the r of *a pump station failure,
was the alarm system functional at the time of the spill? Yes No. If the alarm
system did not function, please explain why:
8. Repairs made are: ✓Permanent Temporary
Please describe what repairs were made. it the repairs arelemporary,::please indicate by
what date a permanent repair will be completed and n tify:the . egional Office within 7 dayl of the
permanent repair: da.w. �,�p� C s!Ir3--4� :v. N�
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9. Comments: 714A.giA, r,J:L-3z Ala /erss
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Other agencies notifed: Ax3-11-)
Person reporting spill/bypa --gttf- Phone Number c:?(i 148` 4.3 f'
Signatur
Date: /6-/?'o3
For DWQ. Use Only:
Oral report taken by: Report taken: Pate:. Time:
DWQ requested additional written report? Yes No-.
If yes, what additional information is needed?
Fayetteville Regional Office
NCDENR - DWQ Section: Phone: [phone] Fax: [phone]
After hours, Weekends, or Holidays, call 1-800-662-7956
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Tncidcn Srirted:Date !b -Za ` v?) Time (; 3e) . ' -
source of Spill/Bypass (Check One):/
Level of Treatment (Check One): 81 None 0 Primary Treatment 0 Secondary Treatment 0 Chlorination Only
Estimated Volume of Spill/Bypass: e_ (6z VQ_. ( volume must be: given even if it is a rough estimate.)
Did the Spill/Bypass reach the Surface Waters? 0 Yes (9'No If please lease Iist the following:
yes,
Volume Reaching Surface Waters: C) — / Surface Water Name: ,v/7•i(
(Lieasc errc or type use Attachments it Needed )
Permint r: (07-0.6 %/OS Permit Number. A)COO42-g5S County: M236 fZ.
cident Ended: Date /0 o -43 Time /,' 3 S � w.
Q Sanitary Sewer Z5 Pump Station .O Wastewater Treatment Plant
Did the Spill/Bypass result in a Fish Kill? (O Yes i o
Location of the Spil1/Bvp s:
T.1r�vz. - Act s Go.
Cause of the SgillBvpas :
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Describe the Repairs Made:
,Action Taken to Contain Spill. Clean Up Waste and Remediate the Site:
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Action Tgken or Prop o ed to be Taken to Prevent Future SDiIIs at this Location:
� a � �s (
s,0 .�a.
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OtherAgenciesNotified: ti/71 •
?ersoa Re _ Spill/Bypass. � Phone Number. 1127 � � S " Z.. �v .� - - ,
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For DWQ Use Only:
OraL Report Taken by: ReporrTaken: Date Time
r1WQ Requested an Additional Writterr Repo=
0 Yes O No
_ Yes, WhatAdditional Information isNeeded:
Spill/Bypass Reporting Foray 8/9T

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lncicent Started: (DatelTtme) /d Z0 `" S 1 / :3 ws .
!Incident Ended:(Date/Time) / o -Zo -4'31 3 ,
spill is angcing, please notify Regional Office on a dafip basis unit spill can be stw,pear
Source of spill/bypass (check one): Sanitary Sewer . utnp,Staticn WWTP
Levet of treatment (enact one): 11None •Rimy.
•Treatment
Secorta7yT Ctiorication y
Estimated volume of spiitrypass(cttec k one): =0-500 gal • 501.-1,000 gal. 1,D01-2,000 gal
__}2.000 gal. - estimate volume in neap 1;Q80 gallon Increments
014 spii ibyRass reach surface waters?' Yes J' fMo (lt.Yes. please list the following)
Volume` reaching surface waters?(check one): 10 eh at. _50E-i ,000 gal. 1,001-2,000 gat
›2,000 gal. - estimate volume it1 nearest 1,0OC gallon increments
Name of surface water N/A
Die soill/l ypass result in a fish kill Yes v No
•
It Yes, wnat is the estimated number of fish killed?'" (7^ •
?'ease arovide me fa}Iowin irrtcrrmat1on'
1. Location of spit pass: s•
{v�_
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2. Cause of spii by ass: a ---NI
rrsw`, t,--..cls_A_. a_. 1.0 dap -.
3. 21d you have personnel available to perforrn initial assessrnerit24 hours/day (including weekends and
holidaysr
Yes No
4, How long did it take to make an initial assessment of the s:A/overflew alter fltat knowledge?
Minutes
i-lcw hang did it take to get a repair crew ensile?
3 Minutes
Please expl2ltrteI o n A
N e,S C�!► �'�
A •
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