WQCS00108_BIMS Report_20190422

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?
04/19/2019
Sylva
Tuckaseigee Water and Sewer Authority
Tuckaseigee Collection System 201900808
AshevilleJackson
1246 West Main St.
700 1:0
Estimate
Heavy rain, flooding conditions
0
700
WQCS00108
5001AA11
þ ¨
þ ¨¨
þ¨¨
2:00 pm 04/19/2019 03:00 pm
Scott Creek
PART I:
SPECIFIC cause(s) of the SSO:
hours
þ Severe Natural Condition
24 hour verbal notification (name of person contacted ):
DWR Emergency Mgmt Date (mm-dd-yyy):04/22/2019¨08:25:00 amþTime (hh:mm AM/PM):
Robert K Mitchell
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
Severe Natural Condition
Describe the "severe natural condition" in detail?
Heavy rain, flooding conditions, Sylva area receieved around 4-5" of rain on 4/19/2019
How much advance warning did you have and what actions were taken in preparation
for the event?
3-4 days
Comments:
Checked all pump stations in Sylva, Dillsboro and Cullowhee on 4/18/19.
System Visitation
ORC Yesþ
Backup Yes¨
Name:
Troy Ammons
Cert#
995178
Date visited:
04/22/2019
Time visited:
07:45 AM
How was the SSO remediated (i.e. Stopped and cleaned up)?
Heavy rain slowed and water started to recede. Scotts Creek had flooded around the manhole which is located about 10-15
feet from the creek.
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:Date:04/22/19 08:00 am
Signature:Title:ORC
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).
Troy Ammons
CS-SSO Form Page:3