HomeMy WebLinkAboutWQCS00021_SSO 5-Day_20220606State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
DWR 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 overflow (SSO).
Permit Number: WQCS00021 (WQCS# if active, otherwise use WQCSD#)
Facility: Wilson Collection Systems Incident #: 202200828 Owner: City of Wilson
Region: Raleigh City: Wilson County: Wilson
Source of SSO (check applicable): ® 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.): 3100 Statonsburg Rd at Wastewatrer treatment plant close to rail road
tracts
Manhole #:
Latitude (degrees/minute/second): Longitude (degrees/minute/second):
Incident Started Dt: 06/01/2022 Time: 2:30PM Incident End Dt: 06/01/2022 Time: 7:OOPM
(mm-dd-yyyy) (hh:mm) AM/PM (mm-dd-yyyy) (hh:mm) AM/PM
Estimated volume of the SSO: 8,600 gallons Estimated Duration (round to nearest hour): 4.5 hour(s)
Describe how the volume was determined: Ditch was triangular and approximately 2,750 feet long from spill
location to berm. Water was approximatley 2 feet wide across the ditch and 5 inches deep. Estimated spill
volume = 2750' of ditch x (1/2) x 2' x (5"/12") = 1145 x 7.48 = 8570 gallons
Weather conditions during the SSO event: Clear, sunny
Did the SSO reach surface waters? ® Yes ❑ No ❑ Unknown
Volume reaching surface waters: 8600 gallons Surface water name: Ditch tributary to the Hominy Swamp
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 Conditions ❑ Grease []Roots ❑Inflow & Infiltration
❑Pump Station Equipment Failure ❑ Power Outage ❑Vandalism ❑ Debris in line ®Pipe Failure (Break)
®Other (Please explain in Part II)
24-hour verbal notification (name of person contacted): Cohn,Colleen
®DWR [-]Emergency Management Date (mm-dd-yyy): 06/02/2022Time: (hh:mm AM/PM): 9:57am
Per G.S. 143-215.1C(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.
Form CS-SSO Page 1
Pipe Failure (Break)
Pipe size (inches) 20 Inch
What is the pipe material Ductile Iron
What is the approximate age of the line/ pipe (years old) 48 Years Old
Is this a gravity line?
❑ Yes
® No
DNA
❑ NE
Is this a force main line?
® Yes
❑ No
❑NA
❑ NE
Is the line a "High Priority" line?
❑ Yes
® No
DNA
❑ NE
Last inspection date and findings
If a force main then,
Was the break on the force main vertical?
❑ Yes
® No
DNA
❑ NE
Was the break on the force main horizontal?
® Yes
❑ No
DNA
❑ NE
Was the leak at the joint due to gasket failure ?
❑ Yes
® No
DNA
❑ NE
Was the leak at the joint due to split bell?
❑ Yes
® No
DNA
❑ NE
When was the last inspection or test of the nearest air -release valve to determine if operable?
When was the last maintenance of the air release performed?
If gravity sewer then,
Does the line receive flow from a force main immediately upstream ❑ Yes ❑ No DNA ❑ NE
of the failed section of pipe?
If yes, what measures are taken to control the hydrogen sulfide production?
When was the line last inspected or videoed?
If line collapsed, what is the condition of the line up and down stream of the failure?
What type of repair was made? Old force main was taken off line and new 24" line was tied in and is online
permanently now.
If temporary, when is the permanent repair planned? new force main was tied in on 06/05/2022
Have there been other failures of this line in the past five years? ® Yes ❑ No DNA ❑ NE
If so, then describe Other leaks have occurred, leaks caused by pinholes at the bottom of the pipe, they have been repaired
with repair clamps, also 880 feet of 20" Pvc pipe was installed on January of 2018 to replace a section of the 20" ductile
iron pipe.
Form CS-SSO Page 13
System Visitation
ORC ❑ Yes
Backup ® Yes
Name: Fabian Padilla
Certification Number: 1005509
Date visited: 06/O1/2022
Time visited: 2:50PM
How was the SSO remediated (i./e. Stopped and cleaned up)?
New 24" force main is now on line permanently and old 20" ductile line is no longer in use, Sewer spill
contained with a berm the sewege in the dithch was vaccuemed out with vac truck and flushed with clean
drinking water from close by fire hydrant and also vac out of ditch
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: Fabian Padilla
Date: 06/06/2022
Signature: Title:C-7 dry �/JG/�i77��mfir�74.
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Telephone Number: 252-373-9593
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 14