FOREWARD - NC



North Carolina

Emergency Response Plan

For

Public Water Systems

Prepared By

Public Water Supply Section

Division of Water Resources

In Accordance With

Section 1431 - Safe Drinking Water Act

G.S. 130A-323 – NC Drinking Water Act (Article 10)

N.C. Emergency Operation Plan for Multi-Hazards

October 1, 1992

Revised July 2006

Revised July 2007

Revised October 2010

Revised March 15, 2011

Revised April 12, 2012

Revised October 8, 2015

Revised October 3, 2016

Revised April 5, 2018

FOREWORD

The Secretary of the Department of Environmental Quality (formerly Department of Environment and Natural Resources) is charged with developing and implementing an adequate plan for the provision of drinking water under emergency circumstances (NCGS 130A-323). This plan responds to the need for a coordinated approach to ensure the availability of drinking water to citizens of North Carolina during a time of crisis. This plan in no way limits emergency powers vested in the Governor or the Secretary under the North Carolina General Statutes.

The Secretary shall implement this plan whenever the available supply of drinking water is inadequate and shall be done on a case-by-case basis. The decision to implement the plan and initiate state action shall be guided by the following goals:

• protection of public health, safety and welfare;

• conservation of essential drinking water resources; and

• the reasonable allocation of supply;

The types of circumstances in which it may be necessary to implement this plan include hazardous material releases, contamination, mechanical and power failures, acts of bioterrorism, natural disasters and other water shortages.

The purpose of this Emergency Response Plan for Public Water Systems is to provide a comprehensive procedure to effectively respond to emergencies affecting public water supply systems.

Water quality and available quantity demands the highest technical response following a disruption of the systems structural integrity by an unforeseen event. The lack of adequate water will require immediate reaction.

Providing timely and accurate response during emergency operations is the responsibility of government officials at the appropriate level. In localized, low level emergencies or advisories, the Regional Office of the Public Water Supply Section of the Division of Water Resources assumes a key role in providing technical assistance and information to the water plant officials and general public. As the emergency situation increases additional state and federal agencies become more involved. Dealing with emergencies involves the input and coordination from a multitude of staff and governmental agencies. Being able to identify the key personnel is essential in effectively responding to any emergency.

North Carolina has experienced numerous natural and man-made emergencies, from hurricanes to hazardous chemical spills, all of which have a potential impact on the quality of our drinking water. Common problems that public water systems encounter include, equipment failure, leaking or disrupted water lines, and variations in source water quality and coordination and communication necessary to address these problems.

It must be understood that an effective response to an emergency impacting a public water system requires a significant degree of preparedness by the local water supplier. Therefore, the development and implementation of a public water system specific plan is an important supplement to the North Carolina Emergency Response Plan for Public Water Systems. The Public Water Supply Section encourages each public water system to review its vulnerability to emergency situations and stand ready to implement their plan of preparedness.

TABLE OF CONTENTS

I. PURPOSE

A. General

B. Scope

1. Federal requirements

2. North Carolina Drinking Water Act (G.S. 130A-Article 10)

3. North Carolina Emergency Operation Plan (NCEOP)

II. AFFECTED PUBLIC WATER SUPPLY SYSTEMS

III ESTABLISHMENT OF ORGANIZATION STAFF AND RESPONSIBILITY

A. General

B. Organizations

1. Department Environmental Quality (DEQ)

2. Division of Water Resources (DWR)

3. Public Water Supply Section (PWS Section)

C. Coordination Plan with the Division of Emergency Management

1. Responsibility of Public Water Supply Section Chief

2. Responsibility of Public Water Supply Regional Office

IV STATE AND FEDERAL AGENCY COORDINATION AND ASSISTANCE

A. Department of Environmental Quality

1. Division of Water Resources, Public Water Supply Section

2. Division of Water Resources, Water Quality Regional Operations Section

3. Division of Waste Management

B. Department of Health and Human Services

1. Division of Public Health, Environmental Health Section

2. Division of Public Health, Epidemiology Section

3. State Laboratory of Public Health

C. Department of Public Safety

D. North Carolina National Guard

E. North Carolina Department of Transportation

F. Federal Emergency Management Agency (FEMA)

G. U.S Army Corps of Engineers

H. U.S. EPA, Office of Drinking Water

I. Tennessee Valley Authority

V. PUBLIC INFORMATION

A. Preparation

VI. EMERGENCY RESPONSE PLANS FOR PUBLIC WATER SYSTEMS

APPENDICES

A. Template Imminent Hazard Order

A. Map of Public Water Supply Section Regions

B. Post Event Assessment, Public Water System Status Report

C. Water Use Restriction Advisories and Notices

D. PWS Policy for Water Tankers Hauling Water

NORTH CAROLINA

PUBLIC WATER SUPPLY SECTION

DIVISION OF WATER RESOURCES

EMERGENCY RESPONSE PLAN FOR PUBLIC WATER SYSTEMS

I. PURPOSE

A. General

To present a comprehensive plan of action to effectively respond to emergencies, disasters, and hazards of any kind affecting public water systems thereby mitigating the imminent danger of losing safe, potable water supplies available in adequate quantities, or the actual loss thereof.

B. Scope

The Emergency Response Plan for Public Water Systems prepared and implemented by the Public Water Supply (PWS) Section is designed to cover all natural and man-made emergencies or disasters that could adversely affect drinking water provided to the residents and visitors of North Carolina served by public water systems. This document is intended for use as a supplement to the North Carolina Emergency Operation Plan maintained by the Department of Public Safety, Division of Emergency Management.

1. Federal Requirements

Section 1431 of the Safe Drinking Water Act provides for a state to have primary enforcement responsibility for public water systems if EPA determines that the state has satisfied five basic conditions. One of the conditions [Sec .1431 (a) (5)] requires that a state “has adopted and can implement an adequate plan for the provision of safe drinking water under emergency circumstances.” EPA Region IV reviewed the original version of this plan dated October 1, 1992. As documented in a letter from Ms. Rita Wayco, Chief, State Programs Unit, EPA Region IV to Mr. Wallace Venrich, Chief, Public Water Supply Section, EPA “determined that the plan adequately addresses the requirements of 40 CFR 142.11 (a) (5). A copy of the July 2006 revised version of the plan was sent to the Drinking Water and Groundwater Branch, EPA Region IV. Subsequent revisions of the plan have incorporated minor edits mostly to account for organizational changes within state government (e.g., the PWS Section move from the Division of Environmental Health to the Division of Water Resources).

2. North Carolina Drinking Water Act (Article 10)

General Statute 130A-323 requires that an adequate plan be developed and implemented for the provision of drinking water under emergency circumstances. By definition, emergency circumstances exist when the available supply of drinking water is inadequate.

In addition, according to General Statute 130A-322, the Secretary of the Department of Environmental Quality (DEQ) shall judge whether an imminent hazard exists concerning a present or potential condition in a public water system. The Secretary can issue an order requiring persons involved to take action necessary to protect public health. For example, the Secretary could order a public water system to provide bottled water to its customers. A template imminent hazard order is included in Appendix A.

3. North Carolina Emergency Operations Plan (NCEOP)

The Department of Public Safety has the primary state responsibility in preparing for and conducting emergency operations. The direction of this response is normally conducted through the State Emergency Response Team (SERT). Any state agency may be asked for emergency support and can be subject to direction and control once a disaster or emergency has been properly declared.

The NCEOP serves as the framework for the preparation of emergency plans by state agencies and local governments. Each state agency participating in the NCEOP is assigned general tasks. One of these tasks is to develop and maintain supporting plans, standard procedures and alerting lists subject to review and approval by the Department of Crime Control and Public Safety.

II. AFFECTED PUBLIC WATER SUPPLY SYSTEMS

All community and non-transient, non-community public water supply systems are covered under the Emergency Plan for Drinking Water.

A community water system is defined as a public water system that serves 15 or more service connections used by year-round residents or regularly serves at least 25 year-round residents.

A non-transient non-community water system means a public water system that is not a community water system and that regularly serves at least 25 of the same persons over 6 months per year. This classification includes schools, daycares, and industrial plants.

To the extent time and resources allow, the PWS Section will provide technical assistance to transient public water systems. This classification includes restaurants, convenience stores/gas stations and churches. In general, the continued operation of transient water systems is not essential to protect public health during an emergency.

III. ESTABLISHMENT OF ORGANIZATION STAFF AND RESPONSIBILITY

A. General

The Department of Environmental Quality (DEQ) is the state agency with primary responsibility in preparing for and conducting emergency operations pertaining to public water supply systems. The direction of this response is normally conducted through the Public Water Supply Section of the Division of Water Resources.

In the event of an emergency, the organization for the North Carolina state government changes dramatically. The state has the option to activate the state Emergency Operations Center (EOC) on a limited or full-scale basis. For a full scale emergency the Division of Emergency Management can initiate a 24-hour operation made up of representatives of other state level departments in the EOC who form the State Emergency Response Team (SERT). Although the SERT meets in the state EOC, the state also has Area Coordinators empowered to respond immediately to an emergency by going to the site of the emergency to assess the situation and relay any recommendations or requests to the SERT-EOC.

Information on the Division of Emergency Management is available from the Department of Public Safety web page at . Click on the “Emergency Management” tab. Included at this site is a list of the Branch and Area office contacts with county assignments.

All state departments participating as a member of the State Emergency Response Team are assigned the following general tasks:

• Provide a departmental liaison to function as a member of the SERT, and to represent their agency in preparedness, response, and recovery activities.

• Provide equipment, facilities, and trained personnel as available and required by a specific emergency.

• Develop and maintain supporting plans, standard procedures and alerting lists for this plan, subject to review and approval by the Department of Public Safety.

• Plan and provide for the safety of employees and protection of state property in the damage area.

• Coordinate actions with the SERT and with agencies having related tasks.

• Participate in exercises to test emergency plans and procedures.

• Provide for record keeping and documentation of the effects of an emergency and actions taken.

• Keep counterpart agencies at local level informed of the situation.

• Prepare damage assessment reports.

• Prepare Disaster Assistance Project Applications as required.

• Provide other support commensurate with capabilities.

In order to adequately protect public drinking water during an emergency situation and implement an effective emergency response plan, a thorough knowledge of the state organization staffs and respective responsibilities is required.

B. Organizations

1. The Department of Environmental Quality (DEQ) as organized has two primary duties:

i. To promote and protect the public health of the citizens of the state, and;

ii. To provide for the environmental protection of the states’ natural resources; the air, water, land, and coastal resources.

The Department is organized into the Secretary’s Office and staff; administration, regional offices; programs and boards, councils and commissions.

In the event of an emergency that could adversely affect safe drinking water provided by public water systems DEQ is recognized as the lead agency and coordinates the states emergency response through its Division of Water Resources, Public Water Supply Section. DEQ information is available at .

2. The Division of Water Resources (DWR) includes the Public Water Supply (PWS) Section. During an emergency situation the PWS Section is responsible for assessing problems and damage at public water systems and communicating information to response agencies. The PWS Section provides technical assistance to public water system owners and operators. DWR information is available at .

3. The purpose of the PWS Section is to ensure that safe, potable water is available in adequate quantities to the residents and visitors of the state served by public water supplies. The Raleigh central office and the staff located in the seven statewide regional offices enable the PWS Section to quickly respond to emergency situations impacting drinking water supplies and to provide technical assistance as needed. PWS Section information is available at . Appendix B includes a map to depict the DEQ regions and corresponding PWS Section Regional Engineer with contact phone, fax and pager numbers.

C. Coordination Plan with the Division of Emergency Management

In 1995, the Division of Emergency Management began 24 hour, 7 days per week operation of the state Emergency Operations Center (EOC). The contact numbers are (919) 733-3300 and (800) 858-0368. Incidents such as the failure of a water system can be reported directly by the water system management, local emergency management, or local government (i.e. public health). Once reported, the on-call Area Coordinator would “close-the-loop” and inform/discuss the situation with the local emergency management coordinator and local government.

The state EOC Communication Center maintains the State Emergency Response Team (SERT) contact lists and the Incident Specific Response Guidelines (ISRGs). Based on the severity of the reported incident, the IRSGs include a call down list of contacts that must be notified. The greater the incident’s severity, the larger the number of people the emergency officers must contact to complete the notification. In accordance with the ISRGs, the Division of Emergency Management notifies only one point of contact per organization (i.e., Division of Water Resources). During the call down, the SERT will contact Division of Water Resources Emergency Response Coordinator who will in term contact appropriate regional office and/or central office PWS Section on-call staff as deemed necessary. The PWS Section on-call staff contact public water systems, the local health offices, and the Department, as appropriate.

For events that do not warrant the activation of the state EOC, but do require assistance to the water system, regional PWS Section staff serve as technical advisors to the local Incident Command System (ICS). The local Incident Commander (IC) may be the local public works director, water system manager, or fire chief. PWS Section staff members serve in that command structure as technical advisors to the IC on the General Staff, not as the Incident Commander.

If the event reached a level requiring regional coordination, communications between the PWS Section and the affected Division of Emergency Management Branch Office or Regional Coordination Center (RCC) must be on-going. The intelligence gathered from the regional phone calls to the water systems as well as the written reports [summaries of the “Post Event Assessment, Public Water System Status Report” see Appendix C] are forwarded to both the State EOC (if activated) and the Branch Office (on-call Area Coordinator or RCC Leader).

Under the North Carolina Emergency Operations Plan, the PWS Section has the following responsibilities:

( Respond to incidents involving water supply and contamination.

( Notify local water supply facilities to take measures to protect water intakes.

( Provide technical assistance and monitoring of local water supply operations.

( As necessary, request Secretary approval and execution of Imminent Hazard Order (see Appendix A).

1. Responsibilities of the Public Water Supply Section Chief:

a) Provide technical assistance and support before, during and after emergency situations.

b) Provide training in program implementation.

c) Develop assessment methodologies.

d) Prepare long range planning.

e) Assist in DWR training programs.

f) As necessary, make recommendations and develop Imminent Hazard Order.

1. Responsibilities of the Public Water Supply Section Regional Offices:

a) Provide emergency response coordinators and on-call personnel.

b) Coordinate with water utilities to ensure proper protective measures are taken before emergency situations.

c) Keep close contact with water utilities during emergencies and report to PWS Section central office in Raleigh.

d) Communicate with water systems to complete damage investigations and complete “Post Event Assessment, Public Water System Status Reports” (see Appendix C) and enter results in data tracking system.

e) Issue water use restriction advisories and notices, as necessary (see Appendix D)

f) Coordinate with local health departments to ensure they are alerted to health threatening emergencies at public water systems.

g) Provide technical assistance and/or advice to water utilities during and after emergencies.

h) Coordinate and consult with water utilities to verify water quality before returning impacted facilities to service.

i) Consult with PWS Section central office and Department of Health and Human Services, Division of Public Health, Epidemiology Section on possible health effects of contaminants found in drinking water supplies.

j) Maintain communication, as needed with the PWS Section management and local Emergency Management Coordinators.

k) Work with other entities to ensure that PWS Section policy for use of hauling potable water in tankers is adhered to (see Appendix E).

Following the tragedy of September 11, 2001, the National Response Plan (NRP) required that the National Incident Management Systems (NIMS) be utilized in all response functions. All first responders [fire, law enforcement, emergency communications, emergency management, emergency medical, public health, general health (hospitals), public works, HAZMAT, and general administration (elected/appointed officials)] are required to complete training in Independent Study #700 – Introduction in NIMS (IS-700) and complete the 100-level Incident Command System (ICS-100) by September 2006. The PWS Section staff are not first responders, rather they serve as technical advisors to the IC or work in the state EOC or RCC and are therefore not required to have the IS-700 and ICS-100 training. However, in an effort to enhance communication capability, most of the PWS Section regional office personnel completed the ICS-100 and ICS-200 level training.

IV. STATE AND FEDERAL AGENCY COORDINATION AND ASSISTANCE

A. Department of Environmental Quality (DEQ)

1. Division of Water Resources, Public Water Supply Section.

The PWS Section within the DWR has the primary responsibility of assessing emergency situations involving public drinking water systems.

2. Division of Water Resources, Water Quality Regional Operations Section.

The Water Quality Regional Operations Section (WQROS) within DWR has primary responsibility for assuring that containment and clean up is adequate at oil and hazardous substance spills into the states’ waters or on land if likely to reach waters. The WQROs responds to such spills and monitors all acute water pollution. The Water Sciences Section (WSS) of DWR has a laboratory program that supports surface water and groundwater programs by providing bacteriological, bio-chemical and a broad range of chemical analysis of source (raw) water supplies. The WQROS and the WSS will consult with the PWS Section, on restrictions placed on the use of drinking water and assist in the technical decision to prohibit use of water sources.

3. Division of Waste Management

The Division of Waste Management (DWM) provides public health standards and engineering assistance for the removal of solid and hazardous waste during an emergency.

B. Department of Health and Human Services, Division of Public Health

1. Division of Public Health, Environmental Health Section

The Division of Public Health, Environmental Health Section is responsible for administering programs in the following areas: food and lodging sanitation, institutional sanitation, on-site sewage and shellfish sanitation. During an emergency situation the PWS Section communicates public water system status and use restriction information to the Environmental Health Section.

2. Division of Public Health, Epidemiology Section

The Division of Public Health, Epidemiology Section provides health risk evaluations of contaminants, which may be found in drinking water. The results of these evaluations provide an assessment as to whether the water is safe for human consumption and what steps can be taken to lessen the health effect of the contaminant to humans.

3. State Laboratory of Public Health

The State Laboratory of Public Health provides sample analyses to determine the drinking water quality.

C. Department of Public Safety

The Department of Public Safety is tasked by the Governor with oversight and control of the Emergency Management function in North Carolina. This oversight is sub-delegated to the Division of Emergency Management and its area coordinators. The Division of Emergency Management will assist local government in all state emergency responses to which it is called for assistance.

D. North Carolina National Guard

The PWS Section may request, through the Division of Emergency Management, the National Guard to provide trucks and drivers for hauling drinking water.

E. North Carolina Department of Transportation (DOT)

The North Carolina Department of Transportation will provide assistance in clearing wreckage from public property and waterways as requested after a disaster.

F. Federal Emergency Management Agency (FEMA)

After the occurrence of a significant disaster, the Governor may request a Presidential major disaster declaration under the provisions of the Stafford Act (Public Law 93-288, May 22, 1974). The President will declare a major disaster for the affected area and the Federal Emergency Management Agency Director, in consultation with the associate Director for State and Local Programs and Support, and the Regional Director will determine whether or not to activate the Federal Natural Disaster Response Plan. The Federal Natural Disaster Response Plan establishes the basis for fulfilling the Federal governments’ role in providing response and recovery assistance to a state and its affected local governments impacted by a significant disaster. FEMA is responsible for notifying other Federal agencies of the occurrence or the potential occurrence of a significant natural disaster.

G. U.S. Army Corps of Engineers (USACE)

USACE responsibilities include arranging for public works and engineering support for debris clearance, demolition, temporary repair to essential public services, and water supply.

H. U.S. Environmental Protection Agency (EPA), Office of Drinking Water

EPA provides personnel to assist in damage assessment of water system infrastructure and determines necessary emergency repairs during declared disasters.

I. Tennessee Valley Authority

The Tennessee Valley Authority will provide available resources in supporting the US Army Corps of Engineers’ mission to supply emergency water.

V. PUBLIC INFORMATION

A. Preparation

All PWS Section personnel who are involved in a drinking water emergency response will keep a copy of the Emergency Response Plan for Public Water Systems and current emergency contact information at their office and at home (Note: In consideration of employee privacy, home phone and cell numbers are not include in this document). A list of PWS Section staff is available at . This list includes all PWS Section technical staff and provides current work phone numbers and a 24/7 pager number for each of the seven regional offices.

The Division of Emergency Management’s North Carolina has county contact information on their web site. Click on the “Counties” tab on the NC Department of Public Safety web site .

The Division of Water Resources has a Public Information Officer (PIO). This PIO supports the PWS Section and is a media contact and spokesperson. The PIO will keep an updated list of media outlets across the state at home and the office. The PIO will disseminate information to area media through public service announcements, news releases, media response or other appropriate methods.

VI. EMERGENCY MANAGEMENT PLANS FOR PUBLIC WATER SYSTEMS

The Public Water Supply Section encourages each local water system to prepare its own emergency response plan. Community and Non-Transient-Non-Community public water systems that were created or significantly expanded or altered after October 1, 1999 were required to certify that they completed an Emergency Management Plan and that the plan is available to personnel responsible for emergency management at all times. The required information in the plan includes emergency contact information, identification of foreseeable emergency events and a description of an emergency response plan for each identified event. Key elements of a comprehensive local emergency management plan include:

A. Communication – Each public water system should appoint a disaster coordinator and designate a limited number of key operational personnel for calls during an emergency situation. Authorities to authorize expenditures during emergencies should be clearly set forth.

B. Alternate Sources – There should be an assessment of the alternate water supplies available to the public water system. Factors to be considered include items such as the interconnections to other public water systems and the accessibility of bottled water. Formal or informal mutual aid arrangements should be planned and implemented with nearby utilities, particularly those selected as alternate systems.

C. Inventory – Each public water system should maintain a complete inventory on such items as chemical supplies, spare parts, water sampling and analysis equipment, portable pumps and generators, and personnel protective equipment. If a private or public water system does not have the resources to keep certain emergency equipment or services in-house, a list should be developed where the equipment or services can be obtained in the event of an emergency.

Should a water system require assistance, their plan should outline where they will look for help first. If the system is part of local government, they can ask for mutual aid between cities. They can also ask for help from the county government. All counties in North Carolina are signatories to the “Statewide Emergency Management Mutual Aid and Assistance Agreement.” If the response is beyond their means, cities through their county or counties themselves can request state assistance.

If the system is a publicly regulated utility, mutual aid could come from other utilities or local governments. If the system cannot help itself and no local resources are available, then the county the utility is located in would ask for state assistance. All of this assistance depends on local governments declaring a state of emergency when an incident of this level of significance occurs.

The North Carolina Water/Wastewater Agency Response Network (NCWaterWARN) is also a valuable resource for members. NCWaterWARN is a network of water utilities helping each other respond to and recover from emergencies. This organization of water systems works independently of state government to assist members during an emergency. The mission of WARN is to provide expedited access to specialized resources needed to respond to and recover from natural and human caused events that disrupt public and private drinking water and wastewater utilities.

The N.C. American Water Works Association – Water Environment Association took a leadership role with support from the Public Water Supply Section, N.C. Rural Water Association, N.C. Water Treatment Operators Association and N.C. League of Municipalities to develop and implement NCWaterWARN.

More information about the NCWaterWARN is available at

APPENDICES

Appendix A

Template Imminent Hazard Order

North Carolina Department of Environmental Quality

IMMINENT HAZARD ORDER

TO: [SUPPLIER]

RE: [SYSTEM]

[ID #], [COUNTY]

The Secretary of the Department of Environmental Quality is authorized by N.C. Gen. Stat. §130A-322 to determine whether an imminent hazard, as defined by N.C. Gen. Stat. §130A-2(3), exists concerning a present or potential condition in a public water system. The Secretary may, without notice or hearing, order any person involved to immediately take action necessary to protect the public health. [if authority is delegated, add....The Secretary has delegated authority to take these actions to the …].

Determination

1. [Supplier] owns, operates or controls a public water system serving [Water System], located in [County] which is regulated under the N.C. Drinking Water Act.

2. [Describe the situation creating an imminent hazard].

3. This situation is likely to cause [ Insert one or more: an immediate threat to human life, an immediate threat of serious physical injury, an immediate threat of serious adverse health effects or a serious risk of irreparable damage to the environment] if no immediate action is taken.

4. Based upon the foregoing it is determined that an Imminent Hazard exists at the public water system.

Order

[Supplier] IS HEREBY ORDERED to abate the Imminent Hazard as follows:

1. [Supplier] shall [List actions necessary to abate the hazard. More than one paragraph or subparagraphs may be used].

2.

Effective Date

This Order is effective immediately and shall remain in effect until modified or rescinded by the Secretary or by a court of competent jurisdiction.

This the____________ day of ________________________, 20__.

By: ______________________________

Appendix B

Map of Public Water Supply Section Regions

[pic]

Appendix C

Post Event Assessment

Public Water System Status Report

Post Event Assessment

Public Water System Status Report

Send completed reports: Via e-mail to: PWSS@ or Via fax to: (919) 715-4374

PWS System Name: ______________________________________ PWS ID:______________________________________

System Population: _______________________________________ Date & Time: __________________________________

System Contact Name: ____________________________________ Title: _________________________________________

System Phone No(s): ___________________________________Report Completed By: ______________________________

Section 1: Event Impact

Check to indicate answers by System Contact:

No Yes Unk.

1. Was the PWS system impacted by the event? If “No” or “Unknown” skip to Section 5.

2. Did the impact include the loss of primary power? If yes, complete Section 2.

3. Did the impact include flooding? If yes, complete Section 3.

4. Did the impact include damage to any other system infrastructure? If yes, complete Section 4.

Section 2: Primary Power Loss

If impact included the loss of primary power, check (√) applicable conditions below:

Scenario A

____ System lost primary electrical power, but did not lose system pressure (i.e., pressure did not fall below 20 psi).

_____ No power, but pressure holding.

_____ System operating on backup power.

_____ System operating by interconnection to another system not on advisory or notice.

_____ Primary power has been restored.

Scenario B

_____ System lost primary electrical power and lost system pressure ( ................
................

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