Dhec Form 3685 is a form used to apply for or renew a South Carolina Child Care License. This form can be downloaded from the Dhec website, and must be filled out completely in order to process your application. There are specific instructions on how to fill out the form, so be sure to read through them carefully before submitting it. You will also need to provide various documents along with your application, such as proof of insurance and background checks. If you have any questions about the application process, don't hesitate to contact the Dhec office.
| 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)