HomeMy WebLinkAboutWQCS00182_5DAY SSO Report_20190131 Form CS-SSO
Collection System Sanitary Sewer Overflow Reporting Form
State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
Manhole at Westall & Bragg Street, etc):
This form shall be submitted to the appropriate DWQ Regional Office within five days of the first knowledge of the sanitary sewer
overflow (SSO).
Permit Number:(WQCS# if active, otherwise use WQCSD#)
Facility:Incident #:
Owner:
Region:City:County:
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 #:
Latitude (Decimal Degrees):Longitude (Decimal Degrees):
Incident Started Dt:Time:Incident End Dt:Time:
(mm-dd-yyyy)(hh:mm AM/PM)(mm-dd-yyyy)(hh:mm AM/PM)
Estimated Volume of the SSO:gallons Estimated Duration (Round to nearest hour):
Describe how the volume was determined:
Weather conditions during the SSO event:
Did SSO reach surface waters?Yes No Unknown Volume reaching surface waters (gals):
Surface water name:
Did the SSO result in a fish kill?Yes No Unknown If Yes, what is the estimated number of fish killed?
01/29/2019
Clyde
Junaluska Sanitary District
Junaluska Collection System 201900255
AshevilleHaywood
Hospital Line behind Our Savior Lutheran Church Paragon Pkwy
5,500 4:10
Based on gpm normal flow on line times the duration of the overflow
Around 30 degrees and light snow
5000
WQCS00182
17
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þ ¨¨
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9:30 am 01/29/2019 01:40 pm
Jones Cove Branch
PART I:
SPECIFIC cause(s) of the SSO:
hours
35.529 -82.945
þ Debris in line
24 hour verbal notification (name of person contacted ):
DWR Emergency Mgmt Date (mm-dd-yyy):01/29/2019¨04:19:00 pmþTime (hh:mm AM/PM):
Mikal Willmer
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 alternative 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
Debris in line
What type of debris has been found in the line?
A mophead, rags, and sanitary/cleaning wipes
Suspected cause or source of debris.
Hospital complex, Medical Office, Assisted Living facility
Are manholes in the area secure and intact?NENANoYesþ¨¨¨
When was the area last checked/cleaned?
2014
Have cleaning and inspections ever been increased at this location due to previous
problems with debris?
NENANoYes¨þ ¨¨
Explain:
NO problems before in this area. It is due for inspection/cleaning this year.
Are appropriate educational materials being developed and distributed to prevent future
similar occurrences?
NENANoYesþ¨¨¨
Comments:
System Visitation
ORC Yesþ
Backup Yesþ
Name:
James P. Stinnett
Cert#
1000851
Date visited:
01/29/2019
Time visited:
01:05 PM
CS-SSO Form Page:2
How was the SSO remediated (i.e. Stopped and cleaned up)?
Crew used our Sewer Jetter to remove the blockage causing the overflow, and restored normal flow on the line, eliminating
the overflow at the upstream manhole. Any debris that came out of the manhole was picked up and the area's affected were
treated with Lime
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:Date:01/31/19 09:09 am
Signature:Title:
Telephone Number:
Any addition information desired to be submitted should be sent to the appropriate Division Regional Office within five 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).
James P Stinnett
CS-SSO Form Page:3