NC0034860_Correspondence_20221104

11/04/2022 08:25 FAX [phone]
SCHNEIDER MILLS
a 002
North Carolina Department of Environment and Natural Resources
Divlslon of Water Resources
WWTP Upset , Spill, or Bypass 5-Da Re ortin Form
(Please Print or Type Use Attachments If Needed).
Permittee: ScLPkeiC e( t14 ((S Permit Number: A/C O(3 1' 5
County: glexa/eter
Facility Name:
Incident Started: Date:
Incident Ended: Date:
Time: 3:00
Time: PAa
Level of Treatment:
None Primary Treatment ` Secondary Treatment
Chlorination/Disinfection Only,
Estimated Volume of Spill/Bypass: 3 3 00k [s (must be given even if it is a rough Es.n',
Did the Spill/Bypass reach the Surface Waters? _X Yes No
If yes, please list the following:
Volume Reaching Surface Waters: ,50O—PAC e4urface Water Name: rn14rl } fyk Cr�e
Did the Spilt/Bypass result in a Fish Kill? Yes X_No
Was WWTP compliant with permit requirements? X Yes No
Were samples taken during event? ,Yes No
Source of the U setlS ill/B ass Location orTreatment Unit):
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Cause or Reason for fhe UMsetlS.ilIIBYpass:
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Describe the Re airs Made or Actions Taken: 31,
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Soill/Uvpass Reporting Form (August 2014)

11/04/2022 08:25 FAX [phone]
SCHNEIDER MILLS
12003
•h:
WVNTP Upset , Spill, or Bypass 5-Day Reporting Form
,age 2
Attion Taken to Contain Spill, Clean Up and Remediate the Site (if applicable):
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rat -n oriDiro'osed to be Taken to Prevent Occurrences:
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omments About the E -nt: ff
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Ur- Report Made To:
Division of Water Resources Emergency Management
keg. ) r'i`/l e i Date: 1 t /(r Time: of See/4-�
.. v.,F
ter.Agencies Notified (Health Dept, etc): Aird
Webb ?,e;rson Reporting Event: b�tn'"ea�. ebb Phone Number: ? "��a
D.idt.WR Request an Additional Written Report? Yes XNo
If Yes, What Additional Information is Needed:
Spill/Bypass Reporting Form (August 2014)