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PART 4 : OVERFLOWS AND BYPASSES A. ( 1) List the number of times in the last year there was an overflow, bypass, or unpermitted discharge of untreated or incompletely treated wastewater due to heavy rain or snowmelt: 4 (Circle One) 0 = 0 points; 1 = 5 points; 2 = 10 points; 3 = 15 points; �� 30 points; 5 or more = 50 points; (2 ) List the number of bypasses, overflows, or unpermitted discharges shown in A ( 1 ) that were within the collection system and the number at the treatment plant. Collection System 4 Treatment Plant 0 B. ( 1) List the number of times in the last year there was a bypass or overflow of untreated or incompletely treated wastewater due to equipment failure, either at the treatment plant or due to pumping problems in the collection system: 2 (Circle One) 0 = 0 points; 1 = 5 points; 2 = 10 oints - 3 = 15 points; 4 = 30 points; 5 or more = 50 points • ( 2 ) List the number of bypasses or overflows shown in B ( 1 ) that were within the collection system and the number at the treatment plant. Collection System 2 Treatment Plant 0 C. Specify whether the bypasses came from the city or village sewer system or from contract or tributary communities/ sanitary districts, etc. City or village sewer systems D. Add the point values circled for A and B and place the total in the box below. TOTAI, POINT VALUE FOR PART 4 40 Enter this value on the point calculation table on the last page. E. List the person responsible for reporting overflows, bypasses or unpermitted discharges to State and Federal authorities : Eugene Townsley Superintendent POTW Plant (501) 698-2442 Name Title Telephone Number Describe the procedure for gathering, compiling, and reporting: Collection system personnel notify Eugene Townsley immediately with a written form and this information is then reported to ADPC&E 9