In the dynamic landscape of environmental compliance, the DHEC 3685 form represents a crucial document for reporting sewer system overflows or pump station failures. This detailed form is a critical part of the procedure for notifying the SCDHEC Bureau of Water, Compliance Assurance Division, based in Columbia, SC, about incidents that could potentially impact public health and the environment. The requirement to mail or fax (to the specified 803.898.4215 number) this form, with a copy sent to the local EQC District Office, underscores the seriousness with which these events are taken. The form meticulously gathers information ranging from the permit number and the specifics of the overflow or failure (including the date, time, location, and estimated volume of wastewater released), to the immediate corrective actions taken and details about whether the wastewater entered a body of water. Furthermore, it asks for details about notification of downstream water intakes, pointing to a comprehensive approach towards mitigating environmental and public health risks. The DHEC 3685 form is a testament to the structured efforts made to manage and communicate about incidents that pose risks to water quality within South Carolina.
| Question | Answer |
|---|---|
| Form Name | Form Dhec 3685 |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | d 3685 pump station permits dhec south carolina form |
Sewer System Overflow or Pump Station Failure Report Form
Please submit this form to the SCDHEC Bureau of Water, Compliance Assurance Division 2600 Bull St. Columbia, SC 29201
Form must be MAILED and/or FAXED to 803.898.4215
A copy of the form should be sent to the local EQC District Office
P e r m i t te e : |
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Permit No: |
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County: |
( If yo u rs is a C o ll ec ti on S ys te m n o t o w n ed o r o p er at ed b y a P O T W , pl ea se in c lu d e t he n am e o f t he re c ei vi ng P O T W )
Da te SS O/F ailure: |
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Tim e: |
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(Military F orm at) |
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Da te DH EC notified: |
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Tim e: |
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Na me of person c ontacte d at D HE C: |
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Description of Source ( manhole, pump station, etc.): |
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Pu m p S tatio n N o.: |
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(Include any code or number used to identify pump stations)
Loc ation of S SO /Failure:
( S t re e t a d d r es s o r o t h e r a p p ro p r i a te d e s c r ip t i o n ; i n c l u d e m a p i f a v a i la b l e )
Ca use of S SO /Failure:
( I n c lu d e a n y r e l at e d w e a t h e r i n f o rm a t i o n )
Co ntrol action taken:
De scribe co rrective ac tion taken :
Estimated volume of wastewater released:
D i d w a st ew a te r e nt er a st re am o r b od y o f w a te r? Y es |
N o (Circle One) |
( I f d i s c h a rg e r e a c h e s an y w a t e r a l re a d y p r e s e n t i n a c o n v e y a n c e , d i t c h , e t c . i t is c o n s id e r e d t o h a v e r e a c h e d w a t e rs o f th e S t a t e)
If Yes, Where?
( S h o w l o c a t io n o n U S G S m a p o r c o p y t h e r e o f, in c l u d e n a m e o f w a t e r b o d y )
W e r e d ow n st re am w a te r i n- ta ke s n ot if ie d? |
Y es N o N /A (Circle one) If Yes, Who? |
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Da te correc tive action com pleted: |
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Tim e: |
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(Military Form at) |
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Da te clean up actio n taken : |
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Tim e: |
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Describe what was actually done in the clean up process?
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Phone #: |
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Date: |
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Nam e/Signature of Person Initiating Action |
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Date: |
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Signature/Sewer System O wner or other Responsible Individual |
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DHEC 3685 (02/2000)