Jackson City Council
April 27, 2026

City of Jackson
Spill Emergency Response Plan 8-17-23
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Page 4 of 47

1. PURPOSE
The purpose of the City of Jackson Spill Emergency Response Plan (SERP) is to support a prompt, orderly and effective response to spills (sanitary), reduce spill volumes, and collect information for prevention of future spills. A “spill” in this document is defined, by State Water Board Order No. WQ 2022-0103-DWQ as a discharge of sewage from any portion of a sanitary sewer system due to a sanitary sewer system overflow, operational failure, and/or infrastructure failure.

The SERP provides guidelines for City personnel to follow in responding to, cleaning up, reporting, and properly documenting spills that may occur within the City’s service area. This SERP satisfies the State Water Board Order No. WQ 2022-0103-DWQ, which require wastewater collection agencies to have a Spill Emergency Response Plan.

Additionally, the SERP outlines procedures for responding to sanitary sewer spill backups into structures as required by the City’s insurer. “Backup” is a term typically used by insurers to describe property damage resulting from exposure and contact to untreated or partially treated sewage.

2. POLICY
The City’s employees are required to report all spills from agency owned sewer mains and publicly owned laterals found and to take the appropriate action to secure the spill area, properly report to the appropriate regulatory agencies, relieve the cause of the spill, and ensure that the affected area is cleaned as soon as possible to minimize health hazards to the public and protect the environment. The City’s goal is to respond to sewer system spills as soon as possible following notification. The City will follow reporting procedures regarding sewer spills as set forth by the Central Valley Regional Water Quality Control Board and the State Water Board Order No. WQ 2022-0103-DWQ (SSSWDR).

3. DEFINITIONS AS USED IN THIS SERP
ANNUAL REPORT: An Annual Report (previously termed as Collection System Questionnaire in previous State Water Board Order No. 2006-0003-DWQ) is a mandatory report in which the City provides a calendar-year update of its efforts to prevent spills.

BASIN PLAN: A Basin Plan is a water quality control plan specific to a Regional Water Quality Control Board (Regional Water Board), that serves as regulations to: (1) define and designate beneficial uses of surface and groundwaters, (2) establish water quality objectives for protection of beneficial uses, and (3) provide implementation measures.

BENEFICIAL USES: The term “Beneficial Uses” is a Water Code term, defined as the uses of the waters of the State that may be protected against water quality degradation. Examples of beneficial uses include but are not limited to, municipal, domestic, agricultural, and industrial supply; power generation; recreation; aesthetic enjoyment; navigation; and preservation and enhancement of fish, wildlife, and other aquatic resources or preserves.

CALIFORNIA INTEGRATED WATER QUALITY SYSTEM (CIWQS): CIWQS is the statewide database that provides for mandatory electronic reporting as required in State and Regional Water Board-issued waste discharge requirements.

DATA SUBMITTER: A Data Submitter is an individual designated and authorized by the City’s Legally Responsible Official to enter spill data into the online CIWQS Sanitary Sewer System Database. A Data Submitter does not have the authority of a Legally Responsible Official to certify reporting entered into the online CIWQS Sanitary Sewer System Database.

City of Jackson
Spill Emergency Response Plan 8-17-23
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Page 5 of 47 DRAINAGECONVEYANCE SYSTEM: A drainage conveyance system is a publicly- or privately-owned separate storm sewer system, including but not limited to drainage canals, channels, pipelines, pump stations, detention basins, infiltration basins/facilities, or other facilities constructed to transport stormwater and non-stormwater flows.

ENVIRONMENTALLY SENSITIVE AREA: An environmentally sensitive area is a designated agricultural and/or wildlife area identified to need special natural landscape protection due to its wildlife or historical value.

EXFILTRATION: Exfiltration is the underground exiting of sewage from a sanitary sewer system through cracks, offset or separated joints, or failed infrastructure due to corrosion or other factors.

FOG – Fats, Oils, and Grease: Refers to fats, oils, and grease typically associated with food preparation and cooking activities that can cause blockages in the sanitary sewer system.

HYDROLOGICALLY CONNECTED: Two waterbodies are hydrologically connected when one waterbody flows, or hasthe potential to flow, into the other waterbody. For the purpose of the SWRCB Order, groundwater is hydrologically connected to a surface water when the groundwater feeds into the surface water. See image, right. The surface waterbody in this example is termed a gaining stream as it gains flow from surrounding groundwater.

LATERAL (INCLUDING LOWER AND UPPER LATERAL): A lateral is an underground segment of smaller diameter pipe that transports sewage from a customer’s building or property (residential, commercial, or industrial) to the City’s main sewer line in a street or easement. Upper and lower lateral boundary definitions are subject to local jurisdictional codes and ordinances, or private system ownership. A lower lateral is the portion of the lateral located between the sanitary sewer system main, and either the property line, sewer clean out, curb line, established utility easement boundary, or other jurisdictional locations. An upper lateral is the portion of the lateral from the property line, sewer clean out, curb line, established utility easement boundary, or other jurisdictional locations, to the building or property.

LEGALLY RESPONSIBLE OFFICIAL: A Legally Responsible Official is an official representative, designated by the City, with authority to sign and certify submitted information and documents required by State Water Board Order No. WQ 2022- 0103-DWQ (SSSWDR).

MAINLINE SEWER: Refers to City wastewater collection system piping downstream of the sewer laterals that is not a private sewer lateral connection to a building.

MAINTENANCE HOLE OR MANHOLE: Refers to an engineered structure that is intended to provide access to a sanitary sewer for maintenance and inspection
NOTIFICATION OF A SPILL: Refers to the time at which the City becomes aware of a spill event through observation or notification by the public or other source.

NUISANCE: For the purpose of the State Water Board Order No. WQ 2022-0103-DWQ (SSSWDR), a nuisance, as defined in Water Code section 13050(m), is anything that meets all of the following requirements:
• Is injurious to health, or is indecent or offensive to the senses, or an obstruction to the free use of property, so as to interfere with the comfortable enjoyment of life or property; • Affects at the same time an entire community or neighborhood, or any considerable number of persons, although the extent of the annoyance or damage inflicted upon individuals may be unequal; and

City of Jackson
Spill Emergency Response Plan 8-17-23
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Page 6 of 47 • Occurs during, or as a result of, the treatment or disposal of wastes.

PREVENTATIVE MAINTENANCE: Refers to maintenance activities intended to prevent failures of the wastewater collection system facilities (e.g. cleaning, CCTV, inspection).

PRIVATE LATERAL SEWAGE SPILL – Spills that are caused by blockages or other problems within a privately-owned lateral.

PRIVATE SANITARY SEWER SYSTEM: A private sanitary sewer system is a sanitary sewer system of any size that is owned and/or operated by a private individual, company, corporation, or organization. A private sanitary sewer system may or may not connect into a publicly owned sanitary sewer system.

PRIVATE SEWER LATERAL: A private sewer lateral is the privately-owned lateral that transports sewage from private property(ies) into a sanitary sewer system.

POTENTIAL TO DISCHARGE, POTENTIAL DISCHARGE: Potential to Discharge, or Potential Discharge, means any exiting of sewage from a sanitary sewer system which can reasonably be expected to discharge into a water of the State based on the size of the sewage spill, proximity to a drainage conveyance system, and the nature of the surrounding environment.

RECEIVING WATER: A receiving water is a water of the State that receives a discharge of waste.

SANITARY SEWER SYSTEM: A sanitary sewer system is a system that is designed to convey sewage, including but not limited to, pipes, manholes, pump stations, siphons, wet wells, diversion structures and/or other pertinentinfrastructure, upstream of a wastewater treatment plant headworks, including:
• Laterals owned and/or operated by the City;
• Satellite sewer systems; and/or
• Temporary conveyance and storage facilities, including but not limited to temporary piping, vaults, construction trenches, wet wells, impoundments, tanks, and diversion structures.

For purpose of the State Water Board Order No. WQ 2022-0103-DWQ (SSSWDR), sanitary sewer systems include only systems owned and/or operated by the City.

SATELLITE SEWER SYSTEM: A satellite sewer system is a portion of a sanitary sewer system owned or operated by a different owner than the owner of the downstream wastewater treatment facility ultimately treating the sewage.

SEWAGE: Sewage, and its associated wastewater, is untreated or partially treated domestic, municipal, commercial and/or industrial waste (including sewage sludge), and any mixture of these wastes with inflow or infiltration of stormwater or groundwater, conveyed in a sanitary sewer system.

SEWER BACKUP A sanitary sewer spill resulting from a sanitary sewer system overflow, operational failure, and/or infrastructure failure in a publicly owned sewer system, with an appearance point and subsequent discharge into a structure.

SPILL: A spill is a discharge of sewage from any portion of a sanitary sewer system due to a sanitary sewer system overflow, operational failure, and/or infrastructure failure. Exfiltration of sewage is not considered to be a spill under the State Water Board Order No. WQ 2022-0103-DWQ (SSSWDR) if the exfiltrated sewage remains in the subsurface and does not reach a surface water of the State.

City of Jackson
Spill Emergency Response Plan 8-17-23
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Page 7 of 47 • Category 1 Spill:

A Category 1 spill is a spill of any volume of sewage from or caused by a sanitary sewer system regulated under the State Water Board Order No. WQ 2022-0103-DWQ (SSSWDR) that results in a discharge to:
o A surface water, including a surface water body that contains no flow or volume of water; or o A drainage conveyance system that discharges to surface waters when the sewage is not fully captured and returned to the sanitary sewer system or disposed of properly.

Any spill volume not recovered from a drainage conveyance system is considered a discharge to surface water, unless the drainage conveyance system discharges to a dedicated stormwater infiltration basin or facility.

A spill from a City-owned and/or operated lateral that discharges to a surface water is a Category 1 spill; the City shall report all Category 1 spills per section 3.1 of Attachment E1 (Notification, Monitoring, Reporting and Recordkeeping Requirements) of State Water Board Order No. WQ 2022-0103-DWQ (SSSWDR).
• Category 2 Spill
A Category 2 spill is a spill of 1,000 gallons or greater, from or caused by a sanitary sewer system regulated under the State Water Board Order No. WQ 2022-0103-DWQ (SSSWDR) that does not discharge to a surface water.

A spill of 1,000 gallons or greater that spills out of a lateral and is caused by a failure or blockage in the sanitary sewer system, is a Category 2 spill.
• Category 3 Spill
A Category 3 spill is a spill of equal to or greater than 50 gallons and less than 1,000 gallons, from or caused by a sanitary sewer system regulated under the State Water Board Order No. WQ 2022-0103-DWQ (SSSWDR) that does not discharge to a surface water. A spill of equal to or greater than 50 gallons and less than 1,000 gallons, that spills out of a lateral and is caused by a failure or blockage in the sanitary sewer system is a Category 3 spill. • Category 4 Spill
A Category 4 spill is a spill of less than 50 gallons, from or caused by a sanitary sewer system regulated under the State Water Board Order No. WQ 2022-0103-DWQ (SSSWDR) that does not discharge to a surface water. A spill of less than 50 gallons that spills out of a lateral and is caused by a failure or blockage in the sanitary sewer system is a Category 4 spill.

TRAINING: Training is in-house or external education and guidance needed that provides the knowledge, skills, and abilities to comply with the State Water Board Order No. WQ 2022-0103-DWQ (SSSWDR).

WASH DOWN WATER: Wash down water is water used to clean a spill area.

WASTE: Waste, as defined in Water Code section 13050(d), includes sewage and any and all other waste substances, liquid, solid, gaseous, or radioactive, associated with human habitation, or of human or animal origin, or from any producing, manufacturing, or processing operation, including waste placed within containers of whatever nature prior to, and for purposes of, disposal.

WATERS OF THE STATE: Waters of the State are surface waters or groundwater within boundaries of the state as defined in Water Code section 13050(e), in which the State and Regional Water Boards have authority to protect beneficial uses. Waters of the State include, but are not limited to, groundwater aquifers, surface

City of Jackson
Spill Emergency Response Plan 8-17-23
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Page 8 of 47 waters, saline waters, natural washes and pools, wetlands, sloughs, and estuaries, regardless of flow or whether water exists during dry conditions. Waters of the State include waters of the United States.

WATERS OF THE UNITED STATES: Waters of the United States are surface waters or waterbodies that are subject to federal jurisdiction in accordance with the Clean Water Act.

WATER QUALITY OBJECTIVE: A water quality objective is the limit or maximum amount of pollutant, waste constituent or characteristic, or parameter level established in statewide water quality control plans and Regional Water Boards’ Basin Plans, for the reasonable protection of beneficial uses of surface waters and groundwater and the prevention of nuisance.

4. STATE REGULATORY REQUIREMENTS FOR ELEMENT 6, SPILL EMERGENCY RESPONSE PLAN The Sewer System Management Plan (SSMP) must include an up to date Spill Emergency Response Plan (SERP) to ensure prompt detection of and response to spills to reduce spill volumes and collect information for prevention of future spills.

The SERP must include procedures to:
• Notify primary responders, appropriate local officials, and appropriate regulatory agencies of a spill in a timely manner;
• Notify other potentially affected entities (for example, health agencies, water suppliers, etc.) of spills that potentially affect public health or reach waters of the State; • Comply with the notification, monitoring and reporting requirements of State Water Board Order No. WQ 2022-0103-DWQ (SSSWDR), State law and regulations, and applicable Regional Water Board Orders; • Ensure that appropriate staff and contractors implement the SERP and are appropriately trained; • Address emergency system operations, traffic control and other necessary response activities; • Contain a spill and prevent/minimize discharge to waters of the State or any drainage conveyance system; • Minimize and remediate public health impacts and adverse impacts on beneficial uses of waters of the State; • Remove sewage from the drainage conveyance system;
• Clean the spill area and drainage conveyance system in a manner that does not inadvertently impact beneficial uses in the receiving waters; • Implement technologies, practices, equipment, and interagency coordination to expedite spill containment and recovery;
• Implement pre-planned coordination and collaboration with storm drain agencies and other utility agencies/departments prior, during, and after a spill event; • Conduct post-spill assessments of spill response activities; • Document and report spill events as required in State Water Board Order No. WQ 2022-0103-DWQ (SSSWDR); and • Annually, review and assess effectiveness of the Spill Emergency Response Plan, and update it as needed.

The Sewer System Management Plan is available to the public at https://www.ci.jackson.ca.us/water_and_sewer_department/index.php.

City of Jackson
Spill Emergency Response Plan 8-17-23
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Page 9 of 47

5. SPILL EMERGENCY RESPONSE PLAN OBJECTIVES
The Spill Emergency Response Plan includes measures to protect public health and the environment. The City willrespond to spills from its system(s) in a timely manner that minimizes water quality impacts and nuisance by:
• Immediately stopping the spill and preventing/minimizing a discharge to waters of the State; • Intercepting sewage flows to prevent/minimize spill volume discharged into waters of the State; • Thoroughly recovering, cleaning up and disposing of sewage and wash down water; and • Cleaning publicly accessible areas while preventing discharges to waters of the State.

Additionally, City Staff will:
• Work safely;
• Properly document each spill event in a separate file including photos and/or video where applicable; • Collect information for prevention of future spills;
• Minimize public contact with the spilled wastewater;
• Mitigate the impact of the spill;
• Meet the regulatory reporting requirements;
• Evaluate the causes of failure related to spills;
• Perform post-spill response evaluation for adherence to procedures and effectiveness of response; and • Revise response procedures, modify maintenance practices or provide additional training based on the results from the debrief and failure analysis of spills, if needed.

6. SPILL DETECTION AND NOTIFICATION
ref. State Water Board Order No. WQ 2022-0103-DWQ (SSSWDR), ATTACHMENT D, Element 6, Page D-6 The processes that are employed to notify the City of the occurrence of a spill include: observation by the public, receipt of an alarm, or observation by City staff during the normal course of their work.

6.1 LIFT STATION ALARMS
The City operates 3 wastewater lift stations. In the event of a station failure the SCADA alarm system is activated and the City is contacted. To prevent spills, wastewater from the wet well can either be pumped into a vacuum truck for disposal to a nearby sanitary sewer manhole or bypassed around the station into the sanitary sewer system.

6.2 PUBLIC OBSERVATION
Public observation is the most common way that the City is notified of blockages and spills. Contact numbers and information for reporting sewer spills and backups are on the City’s website: https://www.ci.jackson.ca.us/public_works_wastewater_department/index.php. The City’s telephone number for reporting sewer problems is (209) 223-1646.

City of Jackson
Spill Emergency Response Plan 8-17-23
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Page 10 of 47 • Normal Work Hours: Customer Service at City Hall will receive call. Staff will log the caller’s information and nature of the Service Request and forward the request to the Public Works Superintendent and they will dispatch an available Public Works Maintenance Worker. They will perform an investigation and note findings and any actions taken in iWorQs (CMMS - work order system). For spills, the Spill Emergency Response Workbook will also be completed. • After Hours: The main number will auto-forward calls to the On Call Employee. The On Call Employee will log the caller’s information and nature of the service request and respond to the Service Request.

They will perform an investigation and note findings and any actions taken in iWorQs (CMMS - work order system). For spills, the Spill Emergency Response Workbook will also be completed.

When calls are received, either during normal work hours or after hours, the individual receiving the call will collect and include in the spill event file, at a minimum, the following information to record the complaint:
• Date, time, and method of notification,
• Date and time the complainant first noticed the spill, if available, • Narrative description of the complaint, including any information the caller provided regarding whether the spill has reached surface waters or a drainage conveyance system, if available, • Complainant’s contact information, if available, and
• Final resolution of the complaint.

If the spill or backup is not in the City’s service area the individual receiving the call provides the customer with the contact information for the responsible agency, and then notifies that agency.

6.3 CITY STAFF OBSERVATION
City staff conducts periodic inspections of its sewer system facilities as part of their routine activities. Any problems noted with the sewer system facilities are reported to appropriate City staff that, in turn, responds to emergency situations. Work orders are issued to correct non-emergency conditions.

6.4 CONTRACTOR OBSERVATION
Contractors working on the City sewer system will be informed of contractor spill response procedures. Contractors working on behalf of property owners will be provided spill response information by City Building Department at City Hall when they pull a permit. The following procedures are to be followed in the event that a contractor/plumber causes or witnesses a sanitary sewer spill. If the contractor/plumber causes or witnesses a spill they should:

1. Immediately notify the City at (209) 223-1646 and provide the following information if available:
a. Date, time contractor first noticed the spill
b. Description of the contractor’s observation, including any information regarding whether the spill has reached surface waters or a drainage conveyance system c. Contractor’s contact information

2. Protect storm drains.

3. Protect the public.

4. Direct ALL media and public relations requests to the City Manager.

City of Jackson
Spill Emergency Response Plan 8-17-23
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Page 11 of 47

6.5 NO OBSERVATION
If there are no witnesses or no call was received for a spill, the City staff will contact nearby residences or business owners in the vicinity of the spill, in an attempt to obtain information that brackets a given start time that the spill began. This information will be collected and documented on the Sanitary Sewer Spill Report in the Sanitary Sewer Spill/Backup Response Workbook.

7. SPILL RESPONSE PROCEDURES (Ref. State Water Board Order No. WQ 2022-0103-DWQ (SSSWDR), ATTACHMENT D Element 6 page D-6)

7.1 SEWER SPILL/BACKUP RESPONSE SUMMARY
The City will respond to spills as soon as feasible following notification of a spill/backup.

If it is not possible that the spill/backup is due to a failure in the City-owned/maintained sewer lines the Public Works Crew performs the following:
• Follows the instructions in the Sanitary Sewer Spill/Backup Response Workbook. • If the customer is not home the Public Works Crew completes the Door Hanger and leaves it on the customer’s door.
• If the customer is home the Public Works Crew:
o Explains that the blockage is in the customer’s lateral and the City does not have legal authority to maintain or perform work on privately owned laterals. o Recommends to the customer that they hire a licensed contractor to clear their line. o Gives the customer the Your Responsibilities as a Private Property Owner pages from the Sanitary Sewer Spill/Backup Response Workbook.

If it is possible that the spill/backup is due to a failure in the City-owned/maintained sewer lines the Public Works Crew:
• Follows the instructions in the Sanitary Sewer Spill/Backup Response Workbook. • Notifies Public Works Superintendent of the incident. • Relieves blockage and cleans impacted areas.
• Forwards the completed Sanitary Sewer Spill/Backup Response Workbook to the Public Works Superintendent.

The Public Works Superintendent, Asst. Public Works Superintendent, and/or Public Works Foreman performs required regulatory reporting in accordance with the Sanitary Sewer Spill/Backup Response Workbook’s Regulatory Reporting section.

If the overflow has impacted private property, the Public Works Crew:
• Follows the instructions in the Sanitary Sewer Spill/Backup Response Workbook. • Provides the customer with forms and information as indicated in the Sanitary Sewer Spill/Backup Response Workbook.

City of Jackson
Spill Emergency Response Plan 8-17-23
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Page 12 of 47 • Forwards the completed Sanitary Sewer Spill/Backup Response Workbook to the Public Works Superintendent.

The Public Works Superintendent notifies the City Manager of incident.

The City Manager or designee:
• Reviews incident reports, claim form and other incident information and forwards, as appropriate, to NCCSIF – Sedgwick.
• Communicates with claimant as appropriate.
• Communicates with NCCSIF - Sedgwick to adjust and administer the claim to closure. • Properly documents in writing all activities and communications before approving the final event file.

7.2 FIRST RESPONDER PRIORITIES
The first responder’s priorities are:
• Prompt response to spills.
• To follow safe work practices.
• To respond promptly with the appropriate and necessary equipment. • To reduce spill volume and contain the spill wherever feasible. • To restore the flow as soon as practicable.
• To minimize public access to and/or contact with the spilled sewage. • To promptly notify the Public Works Superintendent in event of a spill needing additional resources, and/or impacting environmentally sensitive areas.
• To return the spilled sewage to the sewer system.
• To restore the area to its original condition (or as close as possible). Collect information for the prevention of future spills. • Properly document the spill and response activities on the forms provided in the Sanitary Sewer Spill/Backup Response Workbook, including photos and/or video where practicable.

7.3 SAFETY
The first responder is responsible for following safety procedures at all times. Special safety precautions must be observed when performing sewer work. There may be times when City personnel responding to a sewer system event are not familiar with potential safety hazards peculiar to sewer work. In such cases it is appropriate to take the time to discuss safety issues, consider the order of work, and check safety equipment before beginning response activities.

If the first responders encounter access restrictions or unsafe conditions that prevent its compliance with spill response requirements or monitoring requirements in State Water Board Order No. WQ 2022-0103-DWQ (SSSWDR), the City provides written documentation of access restrictions and/or safety hazards in the corresponding required report.

City of Jackson
Spill Emergency Response Plan 8-17-23
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Page 13 of 47

7.4 INITIAL RESPONSE
The first responder must respond to the site of the spill/backup and visually check for potential sewer stoppages.

The first responder will:
• Note arrival time at the site of the spill/backup.
• Verify the existence of a public sewer system spill or backup. • Identify and assess the affected area and extent of spill. • Assess the spill location(s) and spread using photography, global positioning system (GPS), and other best available tools.
• Contact caller if time permits.
• Document the spill according to the requirements described in Section 10 of this SERP, including taking photos and/or videos of overflowing manhole(s)/cleanout(s). • Take steps to contain, recover, and return the spill to the sanitary sewer as feasible. For procedures refer to the Sanitary Sewer Spill/Backup Response Workbook.
• Protect surface waters to the extent practicable. For procedures refer to the Sanitary Sewer Spill/Backup Response Workbook.
• Implement pre-planned coordination and collaboration with storm drain agencies and other utility agencies/departments prior, during, and after a spill event.

7.5 INITIATE SPILL CONTAINMENT MEASURES
The first responder will attempt to contain as much of the spilled sewage as possible using the following steps:
• Determine the immediate destination of the overflowing sewage. • Plug storm drains using air plugs, sandbags, and/or plastic mats to contain the spill, whenever appropriate.

If spilled sewage has made contact with the storm drainage system, attempt to contain the spilled sewage by plugging downstream storm drainage facilities.
• Contain/direct the spilled sewage using dike/dam or sandbags. • Vacuum retrieve sewage whenever practicable.
• Pump around the blockage/pipe failure.

Containment efforts will be documented. For procedures refer to the Sanitary Sewer Spill/Backup Response Workbook.

7.6 RESTORE FLOW
Using the appropriate cleaning equipment, set up downstream of the blockage and hydro-clean upstream from a clear manhole. Attempt to remove the blockage from the system and observe the flows to ensure that the blockage does not reoccur downstream. If the blockage cannot be cleared within a reasonable time from arrival, or sewer requires construction repairs to restore flow, then initiate containment and/or bypass pumping. If other

City of Jackson
Spill Emergency Response Plan 8-17-23
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Page 14 of 47 assistance is required, immediately contact the Public Works Superintendent. For procedures refer to the Sanitary Sewer Spill/Backup Response Workbook.

7.7 EQUIPMENT
This section provides a list of specialized equipment that may be used to support this Spill Emergency Response Plan.
• Closed Circuit Television (CCTV) Inspection Unit – A CCTV Inspection Unit is required to determine the root cause for all spills from gravity sewers.
• Camera -- A digital or disposable camera (photo, video or phone) is required to record the conditions upon arrival, during clean up, and upon departure.
• Emergency Response Trucks -- A utility body pickup truck, or open bed is required to store and transport the equipment needed to effectively respond to sewer emergencies. The equipment and tools will include containment and clean up materials.
• Portable Generators, Portable Pumps, Piping, and Hoses – Equipment used to bypass pump, divert, or power equipment to mitigate a spill.
• Combination Sewer Cleaning Trucks -- Combination high velocity sewer cleaning trucks with vacuum tanks are required to clear blockages in gravity sewers, vacuum spilled sewage, and wash down the impacted area following the spill event.
• Air plugs, sandbags and plastic mats
• Spill Sampling Kits
• Portable Lights
Standard operating procedures for equipment that may be necessary in the event of a sanitary sewer overflow or backup can be found in the Corp Yard.

8. RECOVERY AND CLEANUP (Ref. State Water Board Order No. WQ 2022-0103-DWQ (SSSWDR), Element 6, ATTACHMENT D, Page D-6) The recovery and cleanup phase begins immediately after the flow has been restored and the spilled sewage has been contained to the extent possible. The spill recovery and cleanup procedures are described in the following sections.

8.1 ESTIMATE THE FLOW AND VOLUME OF SPILLED SEWAGE
A variety of approaches exist for estimating the volume of a sanitary sewer spill. The Public Works Crew members should use the method most appropriate to the sewer overflow in question and reference the Sanitary Sewer Spill/Backup Response Workbook which provides four (4) methods:
• Eyeball Estimation Method
• Duration and Flow Rate Calculation Method

City of Jackson
Spill Emergency Response Plan 8-17-23
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Page 15 of 47 • Area/Volume Method
• Upstream Connections Method
In addition, the following will be documented on the Sewer Spill Report form:

1. Description, photographs, and GPS coordinates of the system location where the spill originated. If a single spill event results in multiple appearance points, provide GPS coordinates for the appearance point closest to the failure point and describe each additional appearance point in the spill appearance point explanation field;

2. Estimated total spill volume exiting the system;

3. Description and photographs of the extent of the spill and spill boundaries;

4. Did the spill reach a drainage conveyance system? If yes:
• Description of the drainage conveyance system transporting the spill; • Photographs of the drainage conveyance system entry location(s); • Estimated spill volume that reached the drainage conveyance system; • Estimated spill volume fully recovered from the drainage conveyance system; • Estimated spill volume remaining within the drainage conveyance system • Estimated spill volume discharged to a groundwater infiltration basin or facility, if applicable; • Estimated spill travel time from the point of entry into the drainage conveyance system to the point of discharge into the receiving water.

5. Estimated total spill volume recovered.

8.2 RECOVERY OF SPILLED SEWAGE
Vacuum up and/or pump the spilled sewage and wash down water and discharge it back into the sanitary sewer system. Thoroughly recover and dispose of sewage and wash down water.

8.3 CLEAN-UP AND DISINFECTION
Clean up procedures will be implemented to reduce the potential for human health issues and adverse environmental impacts associated with a spill event. The procedures described are for dry weather conditions and will be modified as required for wet weather conditions. Where cleanup is beyond the capabilities of City staff, a cleanup contractor will be used.

Private Property
City crews are responsible for the cleanup when the property damage is minor in nature and is outside of private building dwellings, such as in front, side and backyards, easements, etc. In all other cases, affected property owners can call a water damage restoration contractor to complete the cleanup and restoration. If the overflow into property is the definite cause of City system failure, the property owner can call out a water damage restoration contractor to complete the cleanup and restoration. In both cases, property owners may submit a claim form.

City of Jackson
Spill Emergency Response Plan 8-17-23
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Page 16 of 47 Hard Surface Areas
Collect all signs of sewage solids and sewage-related material either by protected hand or with the use of rakes and brooms. Wash down the affected area with clean water and/or deozyme or similar nontoxic biodegradable surface disinfectant until the water runs clear. The flushing volume will be approximately three times the estimated volume of the spill. Take steps to contain and vacuum up the wastewater. Allow area to dry. Repeat the process if additional cleaning is required.

Landscaped and Unimproved Natural Vegetation
Collect all signs of sewage solids and sewage-related material either by protected hand or with the use of rakes and brooms. Wash down the affected area with clean water until the water runs clear. The flushing volume will be approximately three times the estimated volume of the spill. Either contain or vacuum up the wash water so that none is released. Allow the area to dry. Repeat the process if additional cleaning is required.

Natural Waterways
The Department of Fish and Wildlife will be notified by CalOES for spills greater than or equal to 1,000 gallons. For spills less than 1,000 gallons, contact Amador County Environmental Health for direction.

Wet Weather Modifications
Collect all signs of sewage solids and sewage-related material either by protected hand or with the use of rakes and brooms. Omit flushing and sampling during heavy storm events (i.e., sheet of rainwater across paved surfaces) with heavy runoff where flushing is not required and sampling would not provide meaningful results.

8.4 PUBLIC NOTIFICATION
Signs will be posted and barricades put in place to keep vehicles and pedestrians away from contact with spilled sewage. Amador County Environmental Health instructions and directions regarding placement and language of public warnings will be followed. Additionally, the Public Works Superintendent and/or Foreman positions will use their best judgment regarding supplemental sign placement in order to protect the public and local environment. Signs will not be removed until directed by Amador County Environmental Health or the Public Works Superintendent and/or Foreman.

Creeks, streams and beaches that have been contaminated as a result of a spill will be posted at visible access locations until the risk of contamination has subsided to acceptable background bacteria levels. Document the number and location of posted signs. The area and warning signs, once posted, will be checked every day to ensure that they are still in place. Photographs of sign placement will be taken.

In the event that an overflow occurs at night, the location will be inspected first thing the following day. The field crew will look for any signs of sewage solids and sewage-related material that may warrant additional cleanup activities.

When contact with the local media is deemed necessary, the City Manager or their designee will provide the media with all relevant information.

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9. WATER QUALITY (Ref. State Water Board Order No. WQ 2022-0103-DWQ (SSSWDR), Element 6, Attachment A - DEFINITIONs page A-5, Attachment E1 2.3 through 2.4 pages E1-5 through E1-8)

9.1 SURFACE WATERS OF CONCERN
The following waters of the State are in the City’s service area:
• Moore Ditch
• N Fork Jackson Creek
• S Fork Jackson Creek
• Middle Fork Jackson Creek
• Oneida Creek

9.2 WATER QUALITY SAMPLING AND TESTING
For sewage spills in which an estimated 50,000 gallons or greater are discharged into a surface water, the City will conduct the following water quality sampling as soon as possible but no later than 18 hours after the City’s knowledge of a potential discharge to a surface water. Collect one water sample, each day of the duration of the spill, at:
• The DCS-001 location as described in section 9.5 (Receiving Water Sampling Locations) below, if sewage discharges to a surface water via a drainage conveyance system; and/or • Each of the three receiving water sampling locations in section 9.5 (Receiving Water Sampling Locations) below;
If the receiving water has no flow during the duration of the spill, the City must report “No Sampling Due To No Flow” for its receiving water sampling locations.

The Public Works Crew will collect water quality samples in accordance with State Water Board Order No. WQ 2022-0103-DWQ (SSSWDR).

The Public Works Crew collecting the samples will complete the Chain of Custody prior to transferring ownership of the samples to Alpha Labs.

Alpha Labs shall analyze the collected receiving water samples for the following constituents:
• Ammonia, and
• E. coli:
o Amendment to the Basin Plan for Bacteria
Updates the water quality objectives for bacteria to use an E. coli pathogen indicator rather than fecal coliform. Status: Adopted by the Regional Board on 6 September 2002 in Resolution No. R5-2002-0150. This Amendment was not submitted for approvals due to a similar, concurrent state-wide effort. Updated state-wide bacteria water quality objectives are included in the State Water Resources Control Board's Part 3 of the Water Quality Control Plan for Inland Surface Waters, Enclosed Bays, and Estuaries of California, Bacteria Provisions and a Water Quality Standards Variance Policy (https://www.waterboards.ca.gov/bacterialobjectives/docs/bacteria.pdf), effective 4 February 2019

City of Jackson
Spill Emergency Response Plan 8-17-23
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Page 18 of 47 o Sacramento River and San Joaquin River: In waters designated for contact recreation (REC-1), the fecal coliform concentration based on a minimum of not less than five samples for any 30- day period shall not exceed a geometric mean of 200/100 ml, nor shall more than ten percent of the total number of samples taken during any 30-day period exceed 400/100 ml. o For Folsom Lake (50), the fecal coliform concentration based on a minimum of not less than five samples for any 30-day period, shall not exceed a geometric mean of 100/100 ml, nor shall more than ten percent of the total number of samples taken during any 30-day period exceed 200/100 ml.
o Tulare Lake: In waters designated REC-1, the fecal coliform concentration based on a minimum of not less than five samples for any 30-day period shall not exceed a geometric mean of 200/100 ml, nor shall more than ten percent of the total number of samples taken during any 30-day period exceed 400/100 ml.

Dependent on the receiving water(s), sampling of bacterial indicators shall be sufficient to determine post-spill (after the spill) compliance with the water quality objectives and bacterial standards of the California Ocean Plan or the California Inland Surface Water Enclosed Bays, and Estuaries Plan, including the frequency and/or number of post-spill receiving water samples as may be specified in the applicable plans.

The City shall collect and analyze additional samples as required by the applicable Regional Water Board Executive Officer or designee.

9.3 LAB SELECTION
Analytical Lab
Samples collected for spill response and background monitoring purposes will be analyzed at Alpha Labs, which is accredited through the California State Water Resources Control Board Environmental Laboratory Accreditation Program (ELAP). ELAP provides evaluation and accreditation of environmental testing laboratories to ensure the quality of analytical data used for regulatory purposes to meet the requirements of the State's drinking water, wastewater, shellfish, food, and hazardous waste programs. The State agencies that monitor the environment use the analytical data from these accredited labs. The ELAP-accredited laboratories have demonstrated capability to analyze environmental samples using approved methods.

Getting Samples to the Lab
At all times, sample hold times identified below will be observed in accordance with the following:

Analytical
Parameter
Maximum
Holding Time
Required
Container
Type
Required Preservative
Minimum
Amount
Ammonia (NH3 as N);
SM 4500NH3 B/C or B/G
28 days Plastic / Glass H2SO4 pH <2 +0-6°C 200 mL
Coliform, Total / E.Coli;
SM 9223 B (Present/Absent or Quantitray)
8 hours Plastic (sterile) Na2S2O3 + 0-10°C;
No regulatory temp.
req. for DW
100 mL
Once samples are collected, they will be transported by the Public Works Crew to the lab to be processed.

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9.4 WATER QUALITY ANALYSIS SPECIFICATIONS
Spill monitoring must be representative of the monitored activity (40 Code of Federal Regulations section 122.41(j)(1)).

Sufficiently Sensitive Methods
Sample analysis must be conducted according to sufficiently sensitive test methods approved under 40 Code of Federal Regulations Part 136 for the sample analysis of pollutants. For the purposes of State Water Board Order No. WQ 2022-0103-DWQ (SSSWDR), a method is sufficiently sensitive when the minimum level of the analytical method approved under 40 Code of Federal Regulations Part 136 is at or below the receiving water pollutant criteria.

Environmental Laboratory Accreditation Program-Accredited Laboratories The analysis of water quality samples required per State Water Board Order No. WQ 2022-0103-DWQ (SSSWDR) must be performed by a laboratory that has accreditation pursuant to Article 3(commencing with section 100825) of Chapter 4 of Part 1 of Division 101 of the Health and Safety Code. (Water Code section 13176(a).) The State Water Board accredits laboratories through its Environmental Laboratory Accreditation Program (ELAP).

9.5 RECEIVING WATER SAMPLING LOCATIONS
Receiving water samples shall be collected at the following locations.

Sampling of Flow in Drainage Conveyance System (DCS) Prior to Discharge Sampling Location Sampling Location Description
DCS-001 A point in a drainage conveyance system before the drainage conveyance system flow discharges into a receiving water.

Receiving Surface Water Sampling (RSW)1
Sampling Location Sampling Location Description
RSW-001:

Point of Discharge
A point in the receiving water where sewage initially enters the receiving water.

RSW-001U:

Upstreamof Point of
Discharge
A point in the receiving water, upstream of the point of sewage discharge, to capture ambient conditions absent of sewage discharge impacts.

RSW-001D:

Downstream of
Point ofDischarge
A point in the receiving water, downstream of the point of sewage discharge, where the spill material is fully mixed with the receiving water. 1 The City must use its best professional judgment to determine the upstream and downstream distances based on receiving water flow, accessibility to upstream/downstream waterbody banks, and size of visible sewage plume.

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9.6 STREAM VELOCITY MEASUREMENTS
If sampling is performed after the spill has stopped, the velocity of the impacted surface water must be determined to estimate spill travel time and select an accurate Downstream sample location. One way to measure the spill travel time is to use a velocity probe (such as a Global Water FP111-S Flow Probe) to determine the rate of flow in the water body. In cases where a water velocity probe is used, the manufacturer’s instructions will be followed.

9.7 SAMPLE TYPES
Grab Samples
Grab samples are appropriate for the characterization of surface waters at a particular time and place, to provide information about minimum and maximum concentrations, and to allow for the collection of variable sample volume.

Grab samples may be collected directly into the sample container, or a clean decontaminated intermediate container may be used if a wading sample is not possible or safe. If an intermediate container is used, when in the field, double rinse the sampling device (bucket, automatic sampler) with sample water prior to collecting the sample and be sure to discard rinse water downstream of where sample will be collected. If samples are collected in a bucket and distributed into a consolidation collection container, swirl the contents of the bucket as it is being poured into the consolidation collection container to avoid settling of solids (and pour in back-and-forth pattern – e.g., 1-2-3-3-2-1).
• Grab Sample: A grab sample is defined as an individual sample collected at a given time. Grab samples represent only the condition that exists at the time the sample is collected (US EPA 1977). • Surface Grab Sample: A sample collected at the water surface (i.e., skimming) directly into the sample container or into an intermediate container such as a clean bucket. A single or discrete sample collected at a single location.

Field Blanks
Field Blanks are used to evaluate the potential for contamination of a sample by site contaminants from a source not associated with the sample collected (e.g., airborne dust, etc.). Sterile, deionized water is taken into the field in a sealed container. This is the stock water. The stock water is then poured into the sample container. The containers and sample submission forms are labeled as “Field Blank.” The same template selected for the test samples should be used. Field blanks are subject to the same holding time limitations as samples. The appropriate FIELD QC box on the sample Chain of Custody form should be checked.

9.8 SAMPLE LABELING AND CHAIN OF CUSTODY PROCEDURES
At a minimum, the following grab samples will be collected:
• Field Blank: See Section 9.7 for discussion.
• Upstream: A point in the receiving water, upstream of the point of sewage discharge, to capture ambient conditions absent of sewage discharge impacts.

City of Jackson
Spill Emergency Response Plan 8-17-23
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Page 21 of 47 • Source: A point in the receiving water where sewage initially enters the receiving water. See Section 9.6 for information on determining velocity of the surface water in order to determine the Source sample location.
• “Downstream” of spill: A point in the receiving water, downstream of the point of sewage discharge, where the spill material is fully mixed with the receiving water. This location will vary with the velocity of the surface water to be sampled (see Section 9.6). • If possible, a point in a drainage conveyance system before the drainage conveyance system flow discharges into a receiving water.

Sample labels shall be completed for each sample, using waterproof ink.

Photos or video of each sample location will be taken, properly labeled with date, time, and view direction and a map of the photo locations completed. Photos and videos shall include relevant landmarks to identify sampling locations and their surroundings.

Due to the evidentiary nature of samples collected during enforcement investigations, possession must be traceable from the time the samples are collected until they are analyzed. To maintain and document sample possession, a Surface Water Sample Chain of Custody Record (see Sewer Spill/Backup Response Workbook) must be completed. A sample is under custody if:
• It is in your possession, or
• It is in your view, after being in your possession, or • It was in your possession and under your control to prevent tampering, or • It is in a designated secure area.

As few people as possible should handle samples. The person taking the samples is personally responsible for the care and custody of the samples collected until they are transferred or dispatched properly.

Samples are accompanied by a chain of custody record. When transferring the possession of samples, the individuals relinquishing and receiving will sign, date, and note the time on the record. This record documents sample custody transfer from the sampler, often through another person, to the analyst at the laboratory. The samples are typically transferred to the sample-receiving custodian at the laboratory.

9.9 SAMPLING EQUIPMENT
The following are examples of sampling equipment used by the City:
• Sampling pole with fixed container
• Sampling pole with removable container
• Sampling pail and rope
• Stream velocity meter
• Grab-n-Go Sample Kit

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9.10 GRAB-N-GO SAMPLING KIT
The City maintains a Grab-n-Go sampling kit located at the Corp Yard. The kit is inspected quarterly by the Forman of Water. Additionally, any City employee utilizing the kit is responsible for decontaminating sampling equipment and field monitoring devices and replenishing the kit.

Spill Sample Collection Kit Inventory:
• Cooler
• Surface Water Sampling SOP (in Sewer Spill/Backup Response Workbook) • Ice Pack
• 5 Ammonia sample bottles
• 5 Bacti sample bottles
• Minimum of 20 blank sample bottle labels
• Digital camera or smart phone camera
• Latex gloves
• Safety glasses/goggles
• Waterproof Pen
• Surface Water Sampling Worksheet (in Sewer Spill/Backup Response Workbook) • Chain of Custody form (in Sewer Spill/Backup Response Workbook)

9.11 DECONTAMINATION PROCEDURES
Removing or neutralizing contaminants from sampling equipment minimizes the likelihood of sample cross contamination, reduces or eliminates transfer of contaminants to clean areas, and prevents the mixing of incompatible substances.

Gross contamination can be removed by physical decontamination procedures. These abrasive and non-abrasive methods include the use of brushes, air and wet blasting, and high- and low- pressure water cleaning.

The decontamination procedures for the sample types and sampling equipment (other than sample bottles, which are provided to Public Works Crew in a “ready to be used” condition by the lab) used at the City may be summarized as follows:

1. Physical removal

2. Tap water rinse

3. Air dry

9.12 SAMPLING PROCEDURES

9.12.1 Sample Location and Identification Procedures
Samples will be collected by the Public Works Crew. It is impossible to establish hard and fast rules concerning sampling locations. However, the following general guidelines should be applied whenever surface waters are sampled:

City of Jackson
Spill Emergency Response Plan 8-17-23
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Page 23 of 47 • The sampling location should be far enough upstream or downstream of confluences or point sources so that the surface water and spill volume is well mixed. Natural turbulence can be used to provide a good mixture.
• Samples should be collected at a location where the velocity is sufficient to prevent deposition of solids, and to the extent practical, should be in straight reach having uniform flow. All flow in the reach should be represented, so divided flow areas should be avoided, and samples should be taken towards the middle of the reach where feasible.
• Sampler must always stand downstream of the collection vessel, and sample “into the current.” Care must be taken to avoid introducing re-suspended sediment into the sample.

9.12.2 Surface Water Sampling Standard Operating Procedure (SOP) The Surface Water Sampling SOP, Section F in the Sewer Spill/Backup Response Workbook, provides stepby-step procedures to collect samples and deliver them for analysis in accordance with State Water Board Order No. WQ 2022-0103-DWQ (SSSWDR), Element 6.

9.12.3 Follow Up Sampling
Sampling will be repeated every 24 hours, or as directed by the RWQCB or the Amador County Environmental Health, until such time as one of the following criteria have been met:
• The Amador County Environmental Health or the RWQCB indicates follow up sampling is no longer required, or
• Both the ammonia and bacteria levels downstream are approximately equal to or less than the upstream levels.

9.13 SAFETY AND ACCESS EXCEPTIONS
If the City encounters access restrictions or unsafe conditions that prevents its compliance with spill response requirements or monitoring requirements in State Water Board Order No. WQ 2022-0103-DWQ (SSSWDR), the City shall provide documentation of access restrictions and/or safety hazards in the corresponding required report.

Personal safety of staff engaged in any fieldwork activity (e.g. in transit, walking or hiking, and any field activities while at the sample site) is of primary importance. Staff should never place themselves in dangerous or risky situations. Any hazards that are known by field personnel should be communicated to other members of the field crew.

Fieldwork should be postponed if there is indication that engagement in the field activity could cause bodily harm.

Working during lightning storms, in heavy vegetation or poison oak, near aggressive wildlife or domestic animals, traversing steep or rugged terrain, unstable slopes or creek banks, near swiftly moving water or potential flash flood conditions, or during snowy weather is not considered "normal risk." If any member of the field crew is uncomfortable with a reasonable self-determined hazardous field condition, it is that person’s responsibility to bring this to the attention of the onsite field supervisor or their supervisor. A “reasonable self-determined hazardous field condition” is defined as other than normal risk. Supervisors shall not dismiss any person’s spoken concerns that field conditions are too hazardous to complete the work assignment.

City of Jackson
Spill Emergency Response Plan 8-17-23
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Page 24 of 47 The person taking the samples must have adequate protection, including protective clothing. They must wear gloves, as protection against chemical and/or bacteriological hazards, while they are sampling or handling samples that are known or suspected to be hazardous (e.g. visible solids or sheens, downstream from sewage spills, etc.), or if hands have open wounds. The type of gloves worn shall be determined by the sampling circumstance and type of pollutants expected – for instance longer gloves are needed when samples must be taken well below the surface.

When in a boat or wading in a stream and where the danger of drowning exists, a personal floatation device shall be worn at all times in addition to following the other requirements of Title 8 CCR 1602 Working Over or Near Water. Other protective measures shall be taken in accordance with City safety procedures.

Upon arrival at a sampling site, safety equipment such as signs, cones, lights, etc. shall be set out as appropriate.

Vehicles shall be parked in locations and directions to minimize traffic disruption and avoid sample contamination.

Photos should be ultimately taken of the placement of all safety equipment and signage.

The following guidelines apply to all fieldwork by City staff. • No sample or measurement is worth the risk of injury. • All staff shall use proper personnel protective gear as appropriate for the incident (e.g., life preservers, gloves, goggles, etc.)
• Field sampling crews should consist of at least two members unless otherwise approved by a supervisor. • Be conscious of the whereabouts of rattlesnakes, mountain lions, and other dangerous animals. • Open body wounds are entry sites for infection; take the necessary precautions for self-protection. • If there is storm activity in the work area, wait for safer conditions to develop or postpone the sampling. • Do not sample at night without approval from your supervisor. • Do not trespass on private property or posted restricted public lands without prior permission and written approval from property owner or administrator.
• If strange or suspicious looking people are in the work area, either wait for them to leave or postpone the work to a later time. Do not force confrontations with strangers and back away from any confrontations with the public. Be courteous and understanding of public concerns of the situation. • Take the necessary precautions against exposure to harmful weather conditions such as heat, wind, snow, cold, rain, etc.
• Carefully evaluate a given on-site situation to determine if the task can be performed safely. • Streams will not be entered unless the responding employees have the necessary protective footwear (e.g. rubber boots, waders) and the footwear does not pose an additional risk to worker safety (e.g. waders filling with water if the employee slips in the stream). • Streams will not be entered if deemed unsafe to so by the most senior employee on the responding crew and if entered, will only be done so in accordance with Title 8 CCR Section 1602 Work Over or Near Water.

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9.14 SPILL TECHNICAL REPORT: Spill Technical Report for Individual Category 1 Spill in which 50,000 Gallons or Greater Discharged into a Surface Water
For any spill in which 50,000 gallons or greater discharged into a surface water, within 45 calendar days of the spill end date, the Public Works Superintendentshall submit a Spill Technical Report to the online CIWQS Sanitary Sewer System Database. The Spill Technical Report, at minimum, must include the following information:

1. Spill causes and circumstances, including at minimum:
• Complete and detailed explanation of how and when the spill was discovered; • Photographs illustrating the spill origin, the extent and reach of the spill, drainage conveyance system entrance and exit, receiving water, and post-cleanup site conditions; • Diagram showing the spill failure point, appearance point(s), the spill flow path, and ultimate destinations;
• Detailed description of the methodology employed, and available data used to calculate the discharge volume and, if applicable, the recovered spill volume; • Detailed description of the spill cause(s);
• Description of the pipe material, and estimated age of the pipe material, at the failure location; • Description of the impact of the spill;
• Copy of original field crew records used to document the spill; and • Historical maintenance records for the failure location.

2. City’s response to the spill:
• Chronological narrative description of all actions taken by the City to terminate the spill; • Explanation of how the Sewer System Management Plan Spill Emergency Response Plan was implemented to respond to and mitigate the spill; and
• Final corrective action(s) completed and a schedule for planned corrective actions, including:
o Local regulatory enforcement action taken against an illicit discharge in response to this spill, as applicable,
o Identifiable system modifications, and operation and maintenance program modifications needed to prevent repeated spill occurrences, and o Necessary modifications to the Emergency Spill Response Plan to incorporate lessons learned in responding to and mitigating the spill.

3. Water Quality Monitoring, including at minimum:
• Description of all water quality sampling activities conducted; • List of pollutant and parameters monitored, sampled and analyzed; as required in Section 9.2. • Laboratory results, including laboratory reports;
• Detailed location map illustrating all water quality sampling points; and • Other regulatory agencies receiving sample results (if applicable).

5. Evaluation of spill impact(s), including a description of short-term and long-term impact(s) to beneficial uses of the surface water.

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9.15 TRAINING
Training will be provided in accordance with the table below:

Surface Water Sampling Training Program
Who Is Trained to Collect Surface Water Samples?Public Works Crew Training Curriculum At a minimum, training shall include:
• The City of Jackson Water Quality Monitoring Plan
• Sampling technique, including hands on practice
• Sampling equipment calibration, use and decontamination procedures, including hands on practice • Sampling safety
• Completion of the Sampling Equipment Calibration/Maintenance Log, Surface Water Sampling Report and Chain of Custody Training Documentation Attendees shall be required to sign-in to all training on the appropriate forms used by the City.

Refresher Training Frequency Annual
Who is Responsible for Ensuring Training Occurs?Public Works Superintendent/Assistant Public Works Superintendent Required Training Records Employee training sign in log Who is Responsible for Maintaining Records?Public Works Superintendent/ Assistant Public Works Superintendent

10. NOTIFICATION, REPORTING, MONITORING AND RECORDKEEPING REQUIREMENTS ref. ORDER WQ 2022-0103-DWQ Attachment E-1 and E-2

10.1 REPORTING REQUIREMENTS
All reporting required in State Water Board Order No. WQ 2022-0103-DWQ (SSSWDR) must be submitted electronically to the online CIWQS Sanitary Sewer System Database (https://ciwqs.waterboards.ca.gov), unless specified otherwise in State Water Board Order No. WQ 2022-0103-DWQ (SSSWDR). Electronic reporting may solely be conducted by a Legally Responsible Official or Data Submitter(s) previously designated by the Legally Responsible Official, as required in section 5.8 (Designation of Data Submitters) of the State Water Board Order No. WQ 2022-0103-DWQ (SSSWDR).

The City shall report any information that is protected by the Homeland Security Act, by email to [email protected], with a brief explanation of the protection provided by the Homeland Security Act for the subject report to be protected from unauthorized disclosure and/or public access, and for official Water Board regulatory purposes only.

Refer to APPENDIX A for detailed reporting requirements by spill category.

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10.2 REGULATOR REQUIRED NOTIFICATIONS

10.2.1 Spill Category 1: Spills to Surface Waters
Spill Requirement Due Method
Notification Within two (2) hours of the City’s
knowledge of a Category 1 spill of 1,000 gallons or greater, discharging or threatening to discharge to surface waters notify the
California Office of Emergency Services and
obtain a notification control number.

CaliforniaOffice of Emergency
Services at: (800) 852-7550
(Section 1 of Attachment E1
of the State Water Board Order No. WQ 2022-0103-DWQ
(SSSWDR))
Monitoring • Conduct spill-specific monitoring;
• Conduct water quality sampling of the
receiving water within 18 hours of initial
knowledge of spill of 50,000 gallons or
greater to surface waters.
(Section 2 of Attachment E1
of the State Water Board Order No. WQ 2022-0103-DWQ
(SSSWDR))
Reporting • Submit Draft Spill Report within three
(3) business days ofthe City’s knowledge
of the spill;
• Submit Certified Spill Report within 15
calendar days of the spill end date;
• Submit Technical Report within 45 calendar days after the spill end date for a Category 1 spill in which 50,000 gallons
or greater discharged to surface waters;
and
• Submit Amended Spill Report within 90
calendar days after the spill end date.
(Section 3.1 of Attachment E1
of the State Water Board Order No. WQ 2022-0103-DWQ
(SSSWDR))

10.2.2 Spill Category 2: Spills of 1,000 Gallons or Greater That Do Not Discharge to Surface Waters Spill Requirements Due Method
Notification Within two (2) hours of the City’s
knowledge of a Category 2 spill of 1,000 gallons or greater threatening to discharge to waters of the State: Notify California Office
of Emergency Services and obtain a notification control number.

CaliforniaOffice of Emergency Services at: (800) 852-
7550
(Section 1 of Attachment E1
of the State Water Board Order No. WQ 2022-0103-

DWQ (SSSWDR))
Monitoring Conductspill-specific monitoring. (Section 2 of Attachment E1 of the State Water Board Order No. WQ 2022-0103-

DWQ (SSSWDR))

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© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Page 28 of 47 Reporting • Submit Draft Spill Report within three
(3) business days of the City’s
knowledge of the spill;
• Submit Certified Spill Report within 15
calendar days of the spill end date; and
• Submit Amended Spill Report within 90
calendar days after the spill end date.
(Section 3.2 of Attachment
E1 of the State Water Board
Order No. WQ 2022-0103-

DWQ (SSSWDR))

10.2.3 Spill Category 3: Spills of Equal or Greater than 50 Gallons and Less than 1,000 Gallons That Does Not Discharge to Surface Waters
Spill Requirements Due Method
Notification Not Applicable Not Applicable
Monitoring Conduct spill-specific monitoring. (Section 2 of Attachment E1 of the State Water Board Order No. WQ 2022-0103-DWQ
(SSSWDR))
Reporting • Submit monthly Certified Spill Report
to the online CIWQS Sanitary Sewer
System Database within 30 calendars
days after the end of the month in
which the spills occur; and
• Submit Amended Spill Reports within 90
calendar days after the Certified Spill
Report due date.
(Section 3.3 and 3.5 of Attachment E1 of the State Water Board Order No. WQ 2022-0103-DWQ (SSSWDR))

10.2.4 Spill Category 4: Spills Less Than 50 Gallons That Do Not Discharge to Surface Waters Spill Requirements Due Method
Notification Not Applicable Not Applicable
Monitoring Conductspill-specific monitoring. (Section 2 of Attachment E1 of the State Water Board Order No. WQ 2022-0103-DWQ
(SSSWDR))
Reporting • If, during any calendar month, Category 4 spills occur, certify monthly, the estimated total spill volume exiting the
sanitary sewer system, and the total
number of all Category 4 spills into the
online CIWQS Sanitary Sewer System
Database, within 30 days after the end
of the calendar month in which the
spills occurred.
• Upload and certify a report, in an acceptable digital format, of all Category 4 spills to the online CIWQS Sanitary
(Section 3.4, 3.6, 3.7 and 4.4
of Attachment E1 of the State
Water Board Order No. WQ
2022-0103-DWQ (SSSWDR))

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© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Page 29 of 47 Sewer System Database, by February
1st after the end of the calendar year
in which the spills occur.

10.2.5 City Owned and/or Operated Lateral Spills That Do Not Discharge to Surface Waters Spill Requirements Due Method
Notification Within two (2) hours of the City’s
knowledge of a spill of 1,000 gallons or
greater, from an City- owned and/or operated lateral, discharging or threatening to discharge to waters of the State:

Notify California Office of Emergency Services and obtain a notification control number.

Not applicable to a spill of less than 1,000
gallons.

California Office of Emergency Services at: (800) 852- 7550
(Section 1 of Attachment E1
of the State Water Board Order No. WQ 2022-0103-

DWQ (SSSWDR))
Monitoring Conduct visual monitoring. (Section 2 of Attachment E1 of the State Water Board ORDER WQ 2022-0103-DWQ)
Reporting • Upload and certify a report, in an acceptable digital format, of all lateral spills (that do not discharge to a surface water) to the online CIWQS Sanitary Sewer System Database, by February 1st after the end of the calendar year in which the spills occur.
• Report a lateral spill of any volume
that discharges to a surface water as a
Category 1 spill.
(Sections 3.6, 3.7 and 4.4 of
Attachment E1 of the State
Water Board Order No. WQ
2022-0103-DWQ (SSSWDR))

10.3 COMPLAINT RECORDS
The City maintains records of all complaints received whether or not they result in sanitary sewer overflows.

These complaint records include, but are not limited to, records documenting how the City responded to notifications of spills. Each complaint record must, at a minimum, include the following information:
• Date, time, and method of notification,
• Date and time the complainant first noticed the spill, if available,

City of Jackson
Spill Emergency Response Plan 8-17-23
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Page 30 of 47 • Narrative description of the complaint, including any information the caller provided regarding whether the spill has reached surface waters or a drainage conveyance system, if available, • Complainant’s contact information, if available, and
• Final resolution of the complaint;
All complaint records will be maintained for a minimum of five years whether or not they result in a spill. Spill files (field notes, spill/Backup Response Workbook) are kept in iWorQs.

11. POST-SPILL ASSESSMENTS OF SPILL RESPONSE ACTIVITIES (ref. State Water Board Order No. WQ 2022-0103-DWQ (SSSWDR), Element 6, ATTACHMENT D, Page D-6) Every spill event is an opportunity to evaluate the City adherence to response and reporting procedures and effectiveness of the response. Each spill event is unique, with its own elements and challenges including volume, cause, location, terrain, climate, and other parameters.

As soon as possible after spill events all the participants, from the person who received the call to the last person to leave the site, will meet to review the procedures used and to discuss what worked and where improvements could be made in responding to and mitigating future spill events. The results of the debriefing will be documented and tracked to ensure the action items are completed as scheduled.

11.1 FAILURE ANALYSIS INVESTIGATION
The objective of the failure analysis investigation is to determine the “root cause” of the spill and to identify corrective action(s) needed that will reduce or eliminate future potential for the spill to recur or for other spills to occur.

The investigation will include reviewing all relevant data to determine appropriate corrective action(s) for the line segment. The investigation may include:
• Reviewing and completing the Sanitary Sewer Spill Report and any other documents related to the incident • Reviewing the incident timeline and other documentation regarding the incident • Reviewing communications with the reporting party and witness • Reviewing volume estimate, volume recovered estimate, volume estimation assumptions and associated drawings
• Reviewing available photographs
• Interviewing staff that responded to the spill
• Reviewing past maintenance records
• Reviewing past CCTV records,
• Conducting a CCTV inspection to determine the condition of all line segments immediately following the spill and reviewing the video and logs,
• Reviewing any Fats, Oils, Roots and Grease (FROG) related information or results

City of Jackson
Spill Emergency Response Plan 8-17-23
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Page 31 of 47 • Post spill debrief records
• Interviews with the public at the spill location
The product of the failure analysis investigation will be the determination of the root cause and the identification and scheduling of the corrective actions. The Collection System Failure Analysis Form (in Sanitary Sewer Spill/Backup Response Workbook) will be used to document the investigation.

12. SPILL RESPONSE TRAINING
(ref. State Water Board Order No. WQ 2022-0103-DWQ (SSSWDR), Element 6, Attachment D 4.3 page D-5 and Element 6 page D-6
This section provides information on the training that is required to support this Spill Emergency Response Plan.

12.1 INITIAL AND ANNUAL REFRESHER TRAINING
All City personnel who may have a role in responding to, reporting, and/or mitigating a sewer system spill will receive training on the contents of this SERP. All new employees will receive training before they are placed in a position where they may have to respond. Current employees will receive annual refresher training on this SERP and the procedures to be followed. The City will document all training.

Affected employees will receive annual training on the following topics by knowledgeable trainers:
• The requirements of State Water Board Order No. WQ 2022-0103-DWQ (SSSWDR), Element 6 • The City’s Spill Emergency Response Plan procedures and practice drills • Containment and cleanup methods
• Researching and documenting Sanitary Sewer Spill Start Times • Skilled estimation of spill volume for field operators • Impacted Surface Waters: Sample location selection, sampling, and documentation procedures • Electronic CIWQS reporting procedures for staff submitting data • State Water Resources Control Board Employee Knowledge Expectations Through SWRCB Employee Knowledge Expectations training, the employee will be able to answer the following:

1. Please briefly describe your name and job title.

2. Please describe for us approximately when you started in this field and how long you have worked for your agency.

3. Please expand on your current position duties and role in responding in the field to any spill complaints.

4. Please describe your SOPs used to respond/mitigate spills when they occur.

5. Describe any training your agency provides or sends you to for conducting spill volume estimates.

City of Jackson
Spill Emergency Response Plan 8-17-23
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Page 32 of 47

6. We are interested in learning more about how your historical spill response activities have worked in the field. We understand from discussions with management earlier that you use the SERP from the SSMP. Please elaborate on how you implement and utilize the procedures in the plan.

7. Historically, before any recent changes, can you please walk us through how you would typically receive and respond to any spill complaints in the field?

8. Can you tell us who is responsible for estimating spill volumes discharged? If it is you, please describe how you go about estimating the spill volume that you record on the work order/service request forms?

9. What other information do you collect or record other than what is written on the work order form?

10. Describe if and when you ever talk with people that call in spills (either onsite or via telephone) to further check out when the spill might have occurred based on what they or others know? If you do this, can you tell us where this information is recorded?

11. We understand you may be instructed to take pictures of some sewer spills/backups into structures. Other than these spills, when else would you typically take any pictures of a spill?

12. Please walk us through anything else you’d like to add to help us better understand how your field crews respond and mitigate spill complaints.

12.2 SPILL RESPONSE DRILLS
Periodic training drills or field exercises will be held to ensure that employees are up to date on these procedures, equipment is in working order, and the required materials are readily available. The training drills will cover scenarios typically observed during sewer related emergencies (e.g. mainline blockage, mainline failure, and lateral blockage). The results and the observations during the drills will be recorded and action items will be tracked to ensure completion.

12.3 SPILL TRAINING RECORD KEEPING
Records will be kept of all training that is provided in support of this SERP for 5 years. The records for all scheduled training courses and for each overflow emergency response training event will include date, time, place, content, name of trainer(s), names and titles of attendees, brief narrative description of the training, including training method(s) and training materials and/or equipment used.

12.4 CONTRACTORS WORKING ON CITY SEWER FACILITIES
All contractors working on City sewer facilities will be required to follow the spill response instructions on the Sanitary Sewer Spill Response Instructions for Contractors (Appendix C). Additional training may be required depending on the nature of the work on any or all of the following:
• The requirements of State Water Board Order No. WQ 2022-0103-DWQ (SSSWDR), Element 6 • Communication procedures to City in the event a spill is caused or witnessed • The City’s Spill Emergency Response Plan procedures and practice drills

City of Jackson
Spill Emergency Response Plan 8-17-23
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Page 33 of 47 • Skilled estimation of spill volume for field operators • Electronic CIWQS reporting procedures for staff submitting data

13. SEWER BACKUP INTO/ONTO PRIVATE PROPERTY CLAIMS HANDLING POLICY It is the policy of the City that a claims form shall be offered to anyone wishing to file a claim. The following procedures will be observed for all sewer overflows/backups into/onto private property:
• City staff will offer a City claim form irrespective of fault whenever it is possible that the sanitary sewer backup may have resulted from an apparent blockage in the City-owned sewer lines or whenever a City customer requests a claim form. The claim may later be rejected if subsequent investigations into the cause of the loss indicate the City was not at fault. • It is the responsibility of the Public Works Crew to gather information regarding the incident and notify the Public Works Superintendent or their designee.
• It is the responsibility of the City Manager or their designee to review all claims and to oversee the adjustment and administration of the claim to closure.

14. AUTHORITY
This SERP is written in accordance with the State Water Board Order No. WQ 2022-0103-DWQ (SSSWDR).

15. APPENDICES
A. Reporting Requirements by Spill Category
B. Door Hanger
C. Sanitary Sewer Spill Response Instructions for Contractors D. Sanitary Sewer Spill/Backup Response Workbook

City of Jackson
Spill Emergency Response Plan 8-17-23
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Page 34 of 47 APPENDIX A:

Reporting Requirements by Spill Category

City of Jackson
Spill Emergency Response Plan 8-17-23
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Page 35 of 47 REPORTING REQUIREMENTS FOR INDIVIDUAL CATEGORY 1 SPILL REPORTING Draft Spill Report
Within three (3) business days of the City’s knowledge of a Category 1 spill, the City shall submit a Draft Spill Report to the online CIWQS Sanitary Sewer System Database.

The Draft Spill Report must, at minimum, include the following items:

1. Contact information: Name and telephone number of City contact person to respond to spill-specific questions;

2. Spill location name;

3. Date and time the City was notified of, or self-discovered, the spill;

4. Operator arrival time;

5. Estimated spill start date and time;

6. Date and time the City notified the CaliforniaOffice of Emergency Services, and the assigned control number;

7. Description, photographs, and GPS coordinates of the system location where the spill originated; If a single spill event results in multiple appearance points, provide GPS coordinates for the appearance point closest to the failure point and describe each additional appearance point in the spill appearance point explanation field;

8. Estimated total spill volume exiting the system;

9. Description and photographs of the extent of the spill and spill boundaries;

10. Did the spill reach a drainage conveyance system? If Yes:
a. Description of the drainage conveyance system transporting the spill; b. Photographs of the drainage conveyance system entry location(s); c. Estimated spill volume fully recovered from the drainage conveyance system; d. Estimated spill volume remaining within the drainage conveyance system; e. Description and photographs of all discharge point(s) into the surface water; f. Estimated spill volume that discharged to surface waters; and g. Estimated total spill volume recovered.

Certified Spill Report
Within 15 calendar days of the spill end date, the City shall submit a Certified Spill Report for Category 1 spills, to the online CIWQS Sanitary Sewer System Database.

Upon completion of the Certified Spill Report, the online CIWQS Sanitary Sewer System Database will issue a final spill event identification number.

City of Jackson
Spill Emergency Response Plan 8-17-23
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Page 36 of 47 (Category 1 continued)
The Certified Spill Report must, at minimum, include the following mandatory information in addition to all information in the Draft Spill Report:

1. Description of the spill event destination(s), including GPS coordinates if available, that represent the full spread and reach of the spill;

2. Spill end date and time;

3. Description of how the spill volume estimations were calculated, including at a minimum:
a. The methodology, assumptions and type of data relied upon, such as supervisory control and data acquisition (SCADA) records, flow monitoring or other telemetry information used to estimate the volume of the spill discharged, and the volume of the spill recovered (if any volume of the spill was recovered), and
b. The methodology(ies), assumptions and type of data relied upon for estimations of the spill start time and the spill end time;

4. Spill cause(s) (for example, root intrusion, grease deposition, etc.);

5. System failure location (for example, main, lateral, pump station, etc.);

6. Description of the pipe material, and estimated age of the pipe material, at the failure location;

7. Description of the impact of the spill;

8. Whether or not the spill was associated with a storm event;

9. Description ofspillresponse activitiesincluding description of immediate spill containment and cleanup efforts;

10. Description of spill corrective action, including steps planned or taken to reduce, eliminate, and prevent reoccurrence of the spill, and a schedule of major milestones for those steps;

11. Spill response completion date;

12. Detailed narrative of investigation and investigation findings of cause of spill;

13. Reasons for an ongoing investigation (as applicable) and the expected date of completion;

14. Name and type of receiving water body(s);

15. Description of the water body(s), including but not limited to:
a. Observed impacts on aquatic life,
b. Public closure, restricted public access, temporary restricted use, and/or posted health warnings due to spill,
c. Responsible entity for closing/restricting use of water body, and d. Number of days closed/restricted as a result of the spill.

16. Whether or not the spill was located within 1,000 feet of a municipal surface water intake; and

17. If water quality samples were collected, identify sample locations and the parametersthe water quality samples were analyzed for. If no samples were taken, Not Applicable shall be selected.

City of Jackson
Spill Emergency Response Plan 8-17-23
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Page 37 of 47 (Category 1 continued)
Amended Certified Spill Reports
The City shall update or add additional information to a Certified Spill Report within 90 calendar days of the spill end date by amending the report or by adding an attachment to the Spill Report in the online CIWQS Sanitary Sewer System Database. The City shall certify the amended report.

After 90 calendar days, the City shall contact the State Water Board at [email protected] to request to amend a Spill Report. The Legally Responsible Official shall submit justification for why the additional information was not reported within the Amended Spill Report due date.

City of Jackson
Spill Emergency Response Plan 8-17-23
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Page 38 of 47 REPORTING REQUIREMENTS FOR INDIVIDUAL CATEGORY 2 SPILL REPORTING Draft Spill Report
Within three (3) business days of the City’s knowledge of a Category 2 spill, the City shall submit a Draft Spill Report to the online CIWQS Sanitary Sewer System Database.

The Draft Spill Report must, at minimum, include the following items:

1. Contact information: Name and telephone number of City contact person to respond to spill-specific questions;

2. Spill location name;

3. Date and time the City was notified of, or self-discovered, the spill;

4. Operator arrival time;

5. Estimated spill start date and time;

6. Date and time the City notified the California Office of Emergency Services, and the assigned control number;

7. Description, photographs, and GPS coordinates of the system location where the spill originated; If a single spill event resultsin multiple appearance points, provide GPS coordinates for the appearance point closest to the failure point and describe each additional appearance point in the spill appearance point explanation field;

8. Estimated total spill volume exiting the system;

9. Description and photographs of the extent of the spill and spill boundaries;

10. Did the spill reach a drainage conveyance system? If Yes:
• Description of the drainage conveyance system transporting the spill; • Photographs of the drainage conveyance system entry location(s); • Estimated spill volume fully recovered from the drainage conveyance system; • Estimated spill volume remaining within the drainage conveyance system;

11. Estimated spill volume discharged to a groundwater infiltration basin or facility, if applicable; and

12. Estimated total spill volume recovered.

Certified Spill Report
Within 15 calendar days of the spill end date, the City shall submit a Certified Spill Report for the Category 2 spill, to the online CIWQS Sanitary Sewer System Database (https://ciwqs.waterboards.ca.gov). Upon completion of the Certified Spill Report, the online CIWQS Sanitary Sewer System Database will issue a final spill event identification number.

The Certified Spill Report must, at minimum, include the following mandatory information in addition to all information in the Draft Spill Report:

1. Description of the spill event destination(s), including GPS coordinates if available, that represent the full spread and reach of the spill;

City of Jackson
Spill Emergency Response Plan 8-17-23
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Page 39 of 47 (Category 2 continued)

2. Spill end date and time;

3. Description of how the spill volume estimations were calculated, including at a minimum:
• The methodology, assumptions and type of data relied upon, such as supervisory control and data acquisition (SCADA) records, flow monitoring or other telemetry information used to estimate the volume of the spill discharged, and the volume of the spill recovered (if any volume of the spill was recovered), and
• The methodology(ies), assumptions and type of data relied upon for estimations of the spill start time and the spill end time;

4. Spill cause(s) (for example, root intrusion, grease deposition, etc.);

5. System failure location (for example, main, pump station, etc.);

6. Description of the pipe/infrastructure material, and estimated age of the pipe material, at the failure location;

7. Description of the impact of the spill;

8. Whether or not the spill was associated with a storm event;

9. Description ofspill response activitiesincluding description of immediate spill containment and cleanup efforts;

10. Description of spill corrective action, including steps planned or taken to reduce, eliminate, and prevent reoccurrence of the spill, and a schedule of major milestones for those steps;

11. Spill response completion date;

12. Detailed narrative of investigation and investigation findings of cause of spill;

13. Reasons for an ongoing investigation (as applicable) and the expected date of completion; and

14. Whether or not the spill was located within 1,000 feet of a municipal surface water intake.

Amended Certified Spill Reports
The City shall update or add additional information to a Certified Spill Report within 90 calendar days of the spill end date by amending the report or by adding an attachment to the Spill Report in the online CIWQS Sanitary Sewer System Database. The City shall certify the amended report.

After 90 calendar days, the City shall contact the State Water Board at [email protected] to request to amend a Spill Report. The Legally Responsible Official shall submit justification for why the additional information was not reported within the Amended Spill Report due date.

City of Jackson
Spill Emergency Response Plan 8-17-23
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Page 40 of 47 REPORTING REQUIREMENTS FOR INDIVIDUAL CATEGORY 3 SPILL REPORTING Monthly Certified Spill Reporting
The City shall report and certify all Category 3 spills to the online CIWQS Sanitary Sewer System Database within 30 calendar days after the end of the month in which the spills occurred. (For example, all Category 3 spills occurring in the month of February shall be reported and certified by March 30th). After the Legally Responsible Official certifies the spills, the online CIWQS Sanitary Sewer System Database will issue a spill event identification number for each spill.

The monthly reporting of all Category 3 spills must include the following items for each spill:

1. Contact information: Name and telephone number of City contact person to respond to spill-specific questions;

2. Spill location name;

3. Date and time the City was notified of, or self-discovered, the spill;

4. Operator arrival time;

5. Estimated spill start date and time;

6. Description, photographs, and GPS coordinates where the spill originated. If a single spill event results in multiple appearance points, provide GPS coordinatesforthe appearance point closest to the failure point and describe each additional appearance point in the spill appearance point explanation field;

7. Estimated total spill volume exiting the system;

8. Description and photographs of the extent of the spill and spill boundaries;

9. Did the spill reach a drainage conveyance system? If Yes:
a. Description of the drainage conveyance system transporting the spill; b. Photographs of the drainage conveyance system entry locations(s); c. Estimated spill volume fully recovered from the drainage conveyance system; and d. Estimated spill volume discharged to a groundwater infiltration basin or facility, if applicable.

10. Estimated total spill volume recovered;

11. Description of the spill event destination(s), including GPS coordinates, if available, that represent the full spread and reaches of the spill;

12. Spill end date and time;

13. Description of how the spill volume estimations were calculated, including, at minimum:
a. The methodology and type of data relied upon, including supervisory control and data acquisition (SCADA) records, flow monitoring or other telemetry information used to estimate the volume of the spill discharged, and the volume of the spill recovered (if any volume of the spill was recovered), and b. The methodology and type of data relied upon to estimate the spill start time, on-going spill rate at time of arrival (if applicable), and the spill end time;

14. Spill cause(s) (for example, root intrusion, grease deposition, etc.);

City of Jackson
Spill Emergency Response Plan 8-17-23
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Page 41 of 47 (Category 3 Continued)

15. System failure location (for example, main, pump station, etc.);

16. Description of the pipe/infrastructure material, and estimated age of the pipe/infrastructure material, at the failure location;

17. Description of the impact of the spill;

18. Whether or not the spill was associated with a storm event;

19. Description of spill response activities including description of immediate spill containment and cleanup efforts;

20. Description of spill corrective actions, including steps planned or taken to reduce, eliminate, and prevent reoccurrence of the spill, and a schedule of the major milestones for those steps; including, at minimum:
a. Local regulatory enforcement action taken against an illicit discharge in response to this spill, as applicable, and
b. Identifiable system modifications, and operation and maintenance program modifications needed to prevent repeated spill occurrences at the same spill event location, including:
§ Adjusted schedule/method of preventive maintenance,
§ Planned rehabilitation or replacement of sanitary sewer asset, § Inspected, repaired asset(s), or replaced defective asset(s), § Capital improvements,
§ Documentation verifying immediately implemented system modifications and operating/maintenance modifications, § Description of spill response activities,
§ Spill response completion date, and
§ Ongoing investigation efforts, and expected completion date of investigation to determine the full cause of spill;

21. Detailed narrative of investigation and investigation findings of cause of spill.

Amended Certified Spill Reports
Within 90 calendar days of the certified Spill Report due date, the City may update or add additional information to a certified Spill Report by amending the report or by adding an attachment to the Spill Report in the online CIWQS Sanitary Sewer System Database. The City shall certify the amended report.

After 90 calendar days, the Legally Responsible Official shall contact the State Water Board at [email protected] to request to amend a certified Spill Report. The Legally Responsible Official shall submit justification for why the additional information was not reported within the 90-day timeframe for amending the certified Spill Report, as provided above.

City of Jackson
Spill Emergency Response Plan 8-17-23
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Page 42 of 47 REPORTING REQUIREMENTS FOR INDIVIDUAL CATEGORY 4 SPILL REPORTING Monthly Certified Spill Reporting
The City shall report and certify the estimated total spill volume exiting the sanitary sewer system, and the total number of all Category 4 spills to the online CIWQS Sanitary Sewer System Database, within 30 calendar days after the end of the month in which the spills occurred.

Annual Certified Spill Reporting of Category 4 and/or Lateral Spills For all Category 4 spills and spills from its owned and/or operated laterals that are caused by a failure or blockage in the lateral and that do not discharge to a surface water, the City shall:
• Maintain records persection 4.4. of Attachment E1 (Notification, Monitoring, Reporting and Recordkeeping Requirements) of State Water Board Order No. WQ 2022-0103-DWQ (SSSWDR). The City shall provide records upon request by State Water Board or Regional Water Board staff. • Annually upload and certify a report, in an appropriate digital format, of all recordkeeping of spills to the online CIWQS Sanitary Sewer System Database, by February 1st after the end of the calendar year in which the spills occurred.

A spill from an City-owned and/or operated lateral that discharges to a surface water is a Category 1 spill; the City shall report all Category 1 spills per section 3.1 of Attachment E1 (Notification, Monitoring, Reporting and Recordkeeping Requirements) of State Water Board Order No. WQ 2022-0103-DWQ (SSSWDR).

Monthly Certification of “No-Spills” Or “Category 4 Spills” and/or “Non-Category 1 Lateral Spills” If either (1) no spills occur during a calendar month or (2) only Category 4, and/or City-owned and/or operated lateral spills (that do not discharge to a surface water) occur during a calendar month, the City shall certify, within 30 calendar days after the end of each calendar month, either a “No-Spill” certification statement, or a “Category 4 Spills” and/or “Non-Category 1 Lateral Spills” certification statement, in the online CIWQS Sanitary Sewer System Database, certifying that there were either no spills, or Category 4 and/or Non-Category 1 Lateral Spills that will be reported annually (per section 3.6 of Attachment E1 (Notification, Monitoring, Reporting and Recordkeeping Requirements) of State Water Board Order No. WQ 2022-0103-DWQ (SSSWDR)) for the designated month.

If a spill starts in one calendar month and ends in a subsequent calendar month, and the City has no further spills of any category, in the subsequent calendar month, the City shall certify “no-spills” for the subsequent calendar month.

If the City has no spills from its systems during a calendar month, but the City voluntarily reported a spill from a private lateral or a private system, the City shall certify “no-spills” for that calendar month.

If the City has spills from its owned and/or operated laterals during a calendar month, the City shall not certify “no spills” for that calendar month.

City of Jackson
Spill Emergency Response Plan 8-17-23
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Page 43 of 47 APPENDIX B:

Door Hanger

On (date)
at (location)
we responded to a reported blockage of the
sanitary sewer service to your property.

We discovered a blockage in:
o The sanitary sewer main and cleared
the line
o Your sanitary sewer lateral, which is
your responsibility to maintain.

If you require assistance to clear your portion
of the lateral you can search the internet for
“Sewer Contractors” or “Plumbing Drains &
Sewer Cleaning.” If you plan to hire a contractor, we recommend getting estimates from more than one company.

City representative notes:

City representative name:

For questions or comments, please call
City of Jackson
(209) 223-1646
City of Jackson
On (date)
at (location)
we responded to a reported blockage of the
sanitary sewer service to your property.

We discovered a blockage in:
o The sanitary sewer main and cleared the
line
o Your sanitary sewer lateral, which is your
responsibility to maintain.

If you require assistance to clear your portion
of the lateral you can search the internet for
“Sewer Contractors” or “Plumbing Drains &
Sewer Cleaning.” If you plan to hire a contractor, we recommend getting estimates from more than one company.

City representative notes:

City representative name:

For questions or comments, please call
City of Jackson
(209) 223-1646
City of Jackson

City of Jackson
Spill Emergency Response Plan 8-17-23
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Page 45 of 47 APPENDIX C:

Sewer Spill Response Instructions for Contractors

© 2004-2023 DKF Solutions Group, LLC. All rights reserved.

City of Jackson
Spill Emergency Response Plan
Sewer Spill Response Instructions for Contractors
For contractors working on the sanitary sewer system the City expects them to have, at all worksites, spill response materials necessary to block drainage conveyance system entry points near the work area and surface waters.

Additionally, contractor must be trained on spill response materials and equipment.

The following procedures are to be followed in the event that a contractor/plumber causes or witnesses a sanitary sewer spill. If the contractor/plumber causes or witnesses a spill they should:
1 Immediately notify the City at (209) 223-1646 and provide the following information if available:
• Date, time contractor first noticed the spill
• Description of the contractor’s observation, including any information regarding whether the spill has reached surface waters or a drainage conveyance system
• Contractor’s contact information
â
2 Protect storm drains.
â
3 Protect the public.
â
4 Direct ALL media and public relations requests to the City Manager at (209) 223-1646.

City of Jackson
Spill Emergency Response Plan 8-17-23
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Page 47 of 47 APPENDIX D:

Sewer Spill/Backup Response Workbook

© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson
Sewer Spill Emergency Response Plan
Sewer Spill/Backup Response
Workbook
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only.

© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 INSERT TAB:

Tab A: Start Here

© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson Spill Emergency Response Plan A-1
Sanitary Sewer Spill/Backup Response Workbook
See the following page for contact information as needed. o Make immediate notifications:
o If this spill is discharging or threatening to discharge greater than or equal to 1,000 gallons to waters of the State, immediately contact the Public Works Superintendent at (209) 273-8807, Assistant Public Works Superintendent at (209) 273-8780, and/or Public Works Foreman at (209) 273-8783, who will notify CalOES at (800) 852-7550 within 2 hours and obtain a control number. Record this number on the following pages: A-4, B-2, and D-1 Page 1.
o If there is a backup into a residence/business that may be due to a problem in the City’s sewer, notify the Public Works Superintendent at (209) 273-8807.
o For media inquiries/requests contact the City Manager at (209) 223-1646. o Refer to the Regulatory Reporting Guide in this Workbook for additional reporting requirements.

PUBLIC WORKS CREW: CHAIN OF CUSTODY
o Refer to the Spill Event Checklist (A-4), follow the instructions on the Spill/Backup Response Flowchart (C-1), and complete forms in this Workbook as indicated.
o Complete the chain of custody record (to the right) and deliver this workbook to the Public Works Superintendent.

Print Name:

Initial:

Date:

PUBLIC WORKS SUPERINTENDENT:
o Review the Spill Event Checklist (A-4) and the forms in this Workbook. Contact the Public Works Crew for additional information if necessary. o Confirm that all required regulatory notifications have been made (B-1). o If this was a Sewer Backup, follow instructions on the Backup Forms Checklist (F-1). o Complete the Post Spill Assessment (H-1) and Collection System Failure Analysis Form (H-2).
o Complete the Chain of Custody record (right) and forward Workbook to Data Submitter

CHAIN OF

CUSTODY
Print Name:

Initial:

Date:

DATA SUBMITTER: CHAIN OF CUSTODY
o Refer to Spill Event Checklist (A-4) Data Submitter Responsibilities o Complete the chain of custody record (to the right) and deliver this workbook to a Legally Responsible Official (see A-2 for LROs).

Print Name:

Initial:

Date:

LEGALLY RESPONSIBLE OFFICIAL: CHAIN OF CUSTODY
o Refer to Spill Event Checklist (A-4) Data Submitter Responsibilities o Complete the chain of custody record (to the right) and file this Workbook with the spill file.

Print Name:

Initial:

Date:

© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson Spill Emergency Response Plan
Contact Information A-2
Contact Description Telephone/Email/Address
Alpha Labs Water quality sample analysis (916) 686-5190 9090 Union Park Way #113
Elk Grove, CA 95624
Amador County Environmental
Health
o Notifications
o Sign placement guidance
(209) 223-6439
CAL/OES California Office of Emergency
Services
(800) 852-7550
Central Valley Regional Water
Quality Control Board
(916) 464-3291
City Manager Media inquiries/requests (209) 223-1646
NCCSIF – Sedgwick
Alyssa Reese
Assistance with sewer backup
customers
(916) 746-8802
(800) 576-8492
Public Works Superintendent
Asst. Public Works Superintendent
Public Works Foreman
CalOES 2-hour notification and
other regulatory notifications
(209) 273-8807
(209) 273-8780
(209) 273-8783
Public Works Superintendent
Assistant Public Works
Superintendent
Outside Assistance / Mutual Aid (209) 273-8807
(209) 273-8780
Restoration/Remediation Cleaning Services ServPro (209) 912-5720 State Water Resources Control
Board
Walter Mobley (916) 323-0878
[email protected]
Authorized Personnel:

The following are authorized to perform regulatory reporting of spills:

Job Title Telephone Check if LRO
Public Works Superintendent (209) 273-8807 ✔
Assistant Public Works Superintendent (209) 273-8780 ✔
Public Works Foreman (209) 273-8783 ✔
The City’s Legally Responsible Officials (LROs) are authorized to electronically sign and certify spill reports in CIWQS.

© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson Spill Emergency Response Plan
Key Definitions & Category Determination A-3: Page 1
NOTE: All references to “SSWDR” refer to State Water Board Order No. WQ 2022-0103-DWQ.

DRAINAGE CONVEYANCE SYSTEM: A drainage conveyance system is a publicly- or privately-owned separate storm sewer system, including but not limited to drainage canals, channels, pipelines, pump stations, detention basins, infiltration basins/facilities, or other facilities constructed to transport stormwater and non-stormwater flows.

SPILL: A spill is a discharge of sewage from any portion of a sanitary sewer system due to a sanitary sewer system overflow, operational failure, and/or infrastructure failure. Exfiltration of sewage is not considered to be a spill under SSWDR if the exfiltrated sewage remains in the subsurface and does not reach a surface water of the State. • Category 1 Spill:

A Category 1 spill is a spill of any volume of sewage from or caused by a sanitary sewer system regulated under SSWDR that results in a discharge to:
o A surface water, including a surface water body that contains no flow or volume of water; or o A drainage conveyance system that discharges to surface waters when the sewage is not fully captured and returned to the sanitary sewer system or disposed of properly.

Any spill volume not recovered from a drainage conveyance system is considered a discharge to surface water, unless the drainage conveyance system discharges to a dedicated stormwater infiltration basin or facility.

A spill from an City-owned and/or operated lateral that discharges to a surface water is a Category 1 spill; the City shall report all Category 1 spills per section 3.1 of Attachment E1 (Notification, Monitoring, Reporting and Recordkeeping Requirements) of SSWDR.
• Category 2 Spill
A Category 2 spill is a spill of 1,000 gallons or greater, from or caused by a sanitary sewer system regulated under SSWDR that does not discharge to a surface water. A spill of 1,000 gallons or greater that spills out of a lateral and is caused by a failure or blockage in the sanitary sewer system, is a Category 2 spill. • Category 3 Spill
A Category 3 spill is a spill of equal to or greater than 50 gallons and less than 1,000 gallons, from or caused by a sanitary sewer system regulated under SSWDR that does not discharge to a surface water. A spill of equal to or greater than 50 gallons and less than 1,000 gallons, that spills out of a lateral and is caused by a failure or blockage in the sanitary sewer system is a Category 3 spill. • Category 4 Spill
A Category 4 spill is a spill of less than 50 gallons, from or caused by a sanitary sewer system regulated under SSWDR that does not discharge to a surface water. A spill of less than 50 gallons that spills out of a lateral and is caused by a failure or blockage in the sanitary sewer system is a Category 4 spill.

WATERS OF THE STATE: Waters of the State are surface waters or groundwater within boundaries of the state as defined in Water Code section 13050(e), in which the State and Regional Water Boards have authority to protect beneficial uses.

Waters of the State include, but are not limited to, groundwater aquifers, surface waters, saline waters, natural washes and pools, wetlands, sloughs, and estuaries, regardless of flow or whether water exists during dry conditions. Waters of the State include waters of the United States.

© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 Did the spill result in a discharge to surface water, including a surface water body that contains no flow or volume of water? YES
NO
Did the spill result in a discharge to a drainage
conveyance system that discharges to surface water?
Does the drainage conveyance system discharge to a
dedicated stormwater infiltration basin or facility?
Category
1 Spill
YES
YES
NO
NO
Less than 50
gallons
Category
4 Spill
Between 50 gallons
and 999 gallons
Category
3 Spill
1,000 gallons or
greater
Category
2 Spill
Was the sewage spill from or caused by the City’s
sanitary sewer system, which is regulated under the
Sanitary Sewer Systems General Order?
The City is not required to report
spills that are not from or caused
by its regulated sewer system.

NO
YES
Was the sewage in the drainage conveyance system
fully captured and returned to the sanitary sewer
system or disposed of properly?
What is the estimated spill volume?
YES
NO
City of Jackson Spill Emergency Response Plan
Key Definitions & Category Determination A-3: Page 2
INSTRUCTIONS: Answer each question in order and stop at the red box once you have determined the category.

© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson Spill Emergency Response Plan
Spill Event Checklist A-4
Date of Spill: Spill Location/Name:

CIWQS Event ID #: Category? £ 1 £ 2 £3 £4 OES#:

Property Damage? £ Yes £ No Service Request #:

PUBLIC WORKS CREW RESPONSIBILITIES
o Effort made to contain and return a portion/all to the sanitary sewer
o Pictures/video taken of spill
o Pictures taken of affected/unaffected area
o If property damage, start that process
o Pictures taken of containment efforts
o If spill is Cat 1 > 1000 gallons or Cat 2 > 1000 gal
threatening to discharge to waters of the State:

OES Control #
o Were surface waters impacted waters?
o Impacted waters identified?
o Assess and document spill location and spread
including photos
o Spill Report Form Complete (includes fields for all
required fields in CIWQS, and a sketch of spill)
o Volume Estimation Worksheet(s) done
o Start Time Determination Form done
o Follow Water Quality Monitoring and Sampling
procedures

PUBLIC WORKS SUPERINTENDENT RESPONSIBILITIES
o Map of where samples were taken, if applicable
o For Cat 1 Spills 50,000 gallons or larger, obtain sampling results
o Ensure Technical Report is written
o Initial review of forms is complete (ensure
consistency of dates, times, volumes, and other data)
o Review of photos and videos (label/date)
o Conduct Post Spill Assessment & complete form (H-1)
o Failure Analysis
o TV to determine cause
o Review Asset History
o Determine next steps to prevent recurrence
o Document findings and next steps on Spill Report
o Start folder for all documentation for this spill event. Put everything in it (Spill Report, Field Reports, Worksheets/Forms, follow-up work orders, notes, photos, drawings, CIWQS print outs, emails, etc.)

DATA SUBMITTER RESPONSIBILITIES
o Submit Draft in CIWQS w/in 3 business days (for
Categories 1 and 2 only)
o Print CIWQS Draft hard copy and email
o Review CIWQS, spill Report, Worksheets, CMMS, and
any other documentation to ensure data is consistent
(e.g. dates, times, volumes, cause, follow-up action, etc. o Attach photos, forms etc. to CIWQS
o Attach Technical Report to CIWQS, if applicable
o Submit Ready to Certify in CIWQS (with sufficient time for LRO review)
o Print CIWQS Ready to Certify and email
o Hand Workbook to LRO and complete Chain of Custody
form

LRO RESPONSIBILITIES
o LRO review Workbook and CIWQS verify accurate and
consistent data
o Certify in CIWQS (within 15 calendar days for
Categories 1 & 2, 30 days after the month for Category
3 & 4)
o Print Certified CIWQS and email
o Any changes? Change in CIWQS and hard copies and
explain changes, print our current version
o Move completed Workbook and spill folder to spill files o If any changes are made to SSMP
o Update SSMP and link on CIWQS to SSMP
o Add change to SSMP Change Log
o Consider need to re-certify SSMP

© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 INSERT TAB:

Tab B: Regulatory Reporting

© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson Spill Emergency Response Plan
Regulatory Reporting Guide B-1: Page 1
The City’s Legally Responsible Officials (LROs) are authorized to electronically sign and certify spill reports in CIWQS. See contact information for LROs on page A-2.

Deadline Category 1 Spill* Category 2 Spill++ Category 3 Spill++ Category 4 Spill++ 2 hours after
awareness of spill
Within two (2) hours of the
City’s knowledge of a
Category 1 spill of 1,000
gallons or greater,
discharging or threatening
to discharge to Waters of
the State, notify CalOES
and obtain a notification
control number.

Within two (2) hours of
the City’s knowledge of a
Category 2 spill of 1,000
gallons or greater
threatening to discharge
to Waters of the State,
notify CalOES and obtain a
notification control
number.
-
-
Within 18 hours of
awareness of spill Conduct water quality
sampling of the receiving
water within 18 hours of
initial knowledge of spill of
50,000 gallons or greater to
surface waters.
- - -
3 Business Days after
awareness of spill Submit Draft Spill Report in
the CIWQS database.

Submit Draft Spill Report in
the CIWQS database. - -
15 Days after the spill
end date
Submit Certified Spill
Report within 15 calendar
days of the spill end date.
(Submit Amended Spill
Report, as needed, within
90 calendar days after the
spill end date.)
Submit Certified Spill
Report within 15 calendar
days of the spill end date.
(Submit Amended Spill
Report, as needed, within
90 calendar days after the
spill end date.)
- -
Within 30 calendars
days after the end of
the calendar month in
which the spill occurs - -
Submit monthly Certified Spill
Report to the online CIWQS
Sanitary Sewer System
Database
(Submit Amended Spill Report,
as needed, within 90 calendar
days after the Certified Spill
Report due date.)
Certify monthly, the
estimated total spill
volume exiting the
sanitary sewer system,
and the total number of
all Category 4 spills into
the online CIWQS
Sanitary Sewer System
Database.
45 days after spill end
date
Submit Technical Report
within 45 calendar days
after the spill end date for
a Category 1 spill in which
50,000 gallons or greater
discharged to surface
waters; and
- - -
By February 1st after
the end of the
calendar year in which
the spills occur. - See ++ note below. -
Upload and certify a
report, in an acceptable
digital format, of all
Category 4 spills to the
online CIWQS Sanitary
Sewer System
Database.
* A spill from an Enrollee-owned and/or operated lateral that discharges to a surface water is a Category 1 spill. ++ See following page for notes.

© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson Spill Emergency Response Plan
Regulatory Reporting Guide B-1: Page 2
++ Agency owned lateral spills (Cat 2-4) to be reported by Feb 1 of the following year. • Monthly Spill Reporting of Non-Category 1 Lateral Spills: If either (1) no spills occur during a calendar month or (2) only Category 4, and/or Enrollee-owned and/or operated lateral spills (that do not discharge to a surface water) occur during a calendar month, the Enrollee shall certify, within 30 calendar days after the end of each calendar month, either a “No-Spill” certification statement, or a “Category 4 Spills” and/or “Non-Category 1 Lateral Spills” certification statement, in the online CIWQS Sanitary Sewer System Database, certifying that there were either no spills, or Category 4 and/or Non-Category 1 Lateral Spills that will be reported annually for the designated month. • Annual Certified Spill Reporting of Category 4 and/or Lateral Spills: For all Category 4 spills and spills from its owned and/or operated laterals that are caused by a failure or blockage in the lateral and that do not discharge to a surface water, the Enrollee shall annually upload and certify a report, in an appropriate digital format, of all recordkeeping of spills to the online CIWQS Sanitary Sewer System Database, by February 1st after the end of the calendar year in which the spills occurred.

© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson Spill Emergency Response Plan
Regulatory Reporting/Notifications Log B-2
Agency/Firm Contacted Individual Spoken to: Date Time Notes CalOES Control Number:

© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 INSERT TAB:

Tab C: Flowchart

© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson Spill Emergency Response Plan
Spill/Backup Response Flowchart C-1: Page 1
YES
NO
Does the
spill/backup appear
to be due to a problem
in the Cityowned/maintained
sewer line?
This is a Private Spill

1. Photograph the extent of the discharge and the discharge boundaries if possible.

2. Notify the property owner that the blockage is in their lateral and that the City does not have legal authority to maintain or perform work on privately-owned laterals.

3. Give customer the “Your Responsibilities as a Private Property Owner” pages from this Workbook (F-6).

4. Recommend to customer they hire a contractor to clear their line.

5. If customer is not home:
• Complete Door Hanger and leave on customer’s door.
• Leave a message on the customer’s voicemail.

6. If the property owner is unable or unwilling to address the cause of the Spill, immediately contact your supervisor and discuss whether Code Enforcement, the County Department of Environmental Health or Regional Water Quality Control Board should be notified.

7. If you are directed to, break the stoppage and clean up the private spill. Be sure to document City staff time and equipment used for potential billing purposes and take pictures.

1. Document the service call according to City procedures.

2. STOP. Do not continue to PAGE 2
Go to PAGE 2

1. Document arrival time.

2. Consider the need to call out additional staff, contractor or mutual aid assistance.

3. If it is possible that this is a Category 1 spill greater than or equal to 1,000 gallons or a Category 2 spill that is threatening to discharge to waters of the State, immediately contact the Public Works Superintendent, Foreman of Water, and/or Public Works Foreman who will notify make the 2-hour notification to Cal-OES and obtain a control number. Record this number on the following pages: A-4, B-2, and D-1 Page 1.

1. Record manhole number or cleanout location of the spill appearance point closest to the failure point, and describe each additional appearance point on the Spill Report (D-1).

2. Take photographs of all spill appearance points, the extent of the spill, and spill boundaries.

START HERE

© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson Spill Emergency Response Plan
Spill/Backup Response Flowchart C-1: Page 2

BEGIN DIVERSION AND CONTAINMENT, AS NECESSARY

1. DIVERT AWAY FROM SENSITIVE AREAS:
a. Cover unplugged storm drains w/mats, or use dirt/other material to divert sewage away from sensitive areas (e.g., schools, playgrounds, intersections, etc.)
b. ENSURE PUBLIC CONTACT DOES NOT OCCUR. Use cones/barricades to isolate area.

2. CONTAIN SPILL & RETURN TO SYSTEM, IF POSSIBLE:
a. As practical, plug or block drainage conveyance system entry locations or use rubber mats to cover basin inlet and divert flow to a downstream sanitary sewer manhole (barricade manhole if left open and monitor after barricade) or area suitable to capture the spill for later collection.

If any amount has already reached the drainage conveyance system, trace it downstream to a dry manhole and block it from entering surface waters. i.e., plugs, sandbags, or vacuum truck. b. If you are confident that you can capture the spill in the drainage conveyance system, trace it downstream to a dry manhole and then divert the spill to the drainage conveyance system for later recovery and return to the sanitary sewer.
c. Use bypass pumps to pump around blockage until it can be removed. d. Divert to low area of ground where it can be collected later.

3. PHOTOGRAPH each drainage conveyance system entry location.

ADDRESS CAUSE OF SPILL/BACKUP ASAP

1. For spill/backups not related to a pump station, relieve the stoppage. Note the distance of the obstruction from the manhole and catch/remove debris that could cause another stoppage. After flow has returned to normal, clean the pipe thoroughly. Consider televising (CCTV) the affected line.

2. For pump station related spill/backups refer to that station’s Emergency Response Plan.

3. Photograph staff activities while clearing the blockage.

Go to
PAGE 3
Continue from PAGE 1

© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23

1. Sample surface waters the spill has reached if safe and if the property owner allows (if the surface water access point is on private property):
• If preliminary volume estimates of the spill are 50,000 gallons or greater, begin collecting as soon as possible but no later than 18 hours after becoming aware of the spill.
• If people are fishing or swimming in the waters, collect samples regardless of the volume of the spill.

2. Refer to and follow the sampling standard operating procedure (Tab G in this Workbook).

Contain/recover/clean up as much of the spill in the waters and shoreline as possible. Contact Public Works Superintendent to request outside assistance, as appropriate.

NO
YES
Is it feasible/practical
to contain/recover any of the spill from
the surface waters?
Has the spill
reached surface
waters?
YES
NO

DRAINAGE CONVEYANCE SYSTEM CLEANING SOP

1. Seal or berm the drainage conveyance system immediately downstream of point the spill reached.

2. Photograph impacted drainage conveyance system before cleaning.

3. Vacuum any visible sewage – Record the volume of sewage recovered. Record volume on the spill report.

4. Flush impacted sections of the drainage conveyance system with 3X amount of spill, if possible, and contain. Record volume of flush water used and volume of flush water returned to the sanitary sewer on Spill Report.

5. Ensure all visible signs of sewage have been removed.

6. Photograph drainage conveyance system after cleaning is completed.

YES
NO
Was drainage
conveyance
system impacted?

IMPACTED AREA CLEANUP, AS NECESSARY

1. Assign staff to begin cleanup. If you might use the area measured volume method to estimate the volume, draw a sketch of the spill footprint and capture dimensions before washing it down.

2. Remove all signs of gross pollution with a shovel, broom, rake, and bucket. (toilet paper, solids, grease, etc.)

3. Flush impacted area with 3X amount of spill, if possible, and contain. Record volume of flush water used and volume of flush water returned to the sanitary sewer on the Spill Report (D-1).

4. Setup berm/other means to contain all water so it can be returned to sewer

5. Don’t use disinfectants if they may enter storm drain system and not be fully recovered or if they may enter surface waters.

6. Address saturated soil with removal and/or in-place treatment, depending on the extent of the contamination, the location, and land use. Take measures to prevent accidental contact by the public.

NOTE: addressing saturated soil may involve returning to the site one or more days after the spill event.

7. Photograph the area when cleanup operations are complete Go to
PAGE 4
Continue from PAGE 2
City of Jackson Spill Emergency Response Plan
Spill/Backup Response Flowchart C-1: Page 3

© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 Complete the First Responder Form (F-2).

Ask for permission to photograph the
affected area or ask the customer to take
photos. If they decline, note that on the form.

1. If the Livability Assessment on the First Responder Form (F-2) indicates a need for temporary relocation, complete the Lodging Authorization form (F-4).

2. Take a photo of the form to document what was given to the customer.

3. Give the Lodging Authorization form (F-4) to the customer.

4. Give the customer the Information for the Customer Letter (F-5), along with the claim form and the Your Responsibilities as a Private Property Owner guide pages (F-6).

5. Have the customer sign the Backup Forms Checklist (F-1).

Photograph the
backwater
prevention device or
cleanout if you can
locate one on the
affected building

1. Follow the routing instructions indicated on the front of this workbook.

2. Include any photos and/or notes related to this event.

3. Document the service call according to City procedures Did this
spill cause a
sewer backup
impacting private
property?

REGULATORY REPORTING
Make notifications indicated in the Regulatory Reporting Guide (B-1).

YES
NO
Does the
customer want
cleaning service?

1. Complete the Declination of Cleaning Services form
(F-3).

2. Take a photo of the form to document what was given
to the customer.

3. Give the form to the Customer.

1. Call for a restoration/remediation team. See Contact information on page A-2.

2. Wait for restoration team to arrive, if possible.

3. Clean/disinfect any spill outside of the building. Note:

DO NOT allow any disinfectants to escape to storm
drains.

YES
NO
Continue from PAGE 3

DOCUMENTATION AND VOLUME ESTIMATION

1. Complete the Spill Report (D-1).

2. In the Start Time Determination section for the Spill Report (D1) remember that the spill was probably occurring for a period of time before it was reported.

3. Estimate and document spill volume using two or more of the worksheets provided in the Spill/Backup Response Workbook (E-1 through E-6).

Call the City
Manager and relay
the information from
the First Responder
Form (F-2)
City of Jackson Spill Emergency Response Plan
Spill/Backup Response Flowchart C-1: Page 4

© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 INSERT TAB:

Tab D: Spill Report

© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson Spill Emergency Response Plan
Sanitary Sewer Spill Field Report D-1: Page 1
Check spill category (see A-3 for definitions): oCATEGORY 1 oCATEGORY 2 oCATEGORY 3 oCATEGORY 4

Names of the Persons Completing this Report Contact Information

PHYSICAL LOCATION DETAILS
Spill location name:

Location description:

Address of spill:

City: Jackson Cross Street:

Regional Water Quality Control Board: Central Valley County: Amador

DATE/TIME
Date and time the City was notified of, or self-discovered, the spill:

Operator arrival time:

PHOTOGRAPHS
Photos must be taken during the spill event. At a minimum, the following photos must be taken:
¡ Appearance point closest to the failure point ¡ All discharge points into surface waters ¡ Extent of the spill and spill boundaries ¡ Location(s) of clean up ¡ Entry location of each drainage conveyance
system the sewage entered
Where are photographs stored?
* Within two (2) hours of the City’s knowledge of a Category 1 or Category 2 spill of 1,000 gallons or greater, discharging or threatening to discharge to waters of the State, notify CalOES and obtain a notification control number.

CalOES NOTIFICATION*
Date: Time: Assigned Control Number:

© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson Spill Emergency Response Plan
Sanitary Sewer Spill Field Report D-1: Page 2

SPILL ORIGINATION
Description and GPS coordinates of the system location where the spill originated*:

Include manhole number or cleanout location of the spill appearance point closest to the failure point as applicable.

Latitude: Longitude:

Number of additional appearance points:

Spill appearance points: (Check all that apply)
o Backflow Prevention Device
o Combined Sewer Drain Inlet (Combined Collection System Only) o Force Main
o Gravity Mainline
o Inside Building/Structure
o Lateral Clean Out (Private)
o Lateral Clean Out (Public)
o Lower Lateral (Private)
o Lower Lateral (Public)
o Manhole
o Other Sewer System Structure
o Pump Station
o Upper Lateral (Private)
o Upper Lateral (Public)
o Other, describe:

Describe each spill appearance point:

Check to confirm photos were taken of all appearance points: o * Note: If a single spill event results in multiple appearance points, provide GPS coordinates for the appearance point closest to the failure point and describe each additional appearance point in the “Describe each spill appearance point” description section above. Take photos of spill appearance point(s).

© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson Spill Emergency Response Plan
Sanitary Sewer Spill Field Report D-1: Page 3
SPILL DESTINATION (Check all that apply)
Final spill destination(s):
o Drainage Conveyance System That Discharges to Surface Water o Surface Water
o Building or Structure
o Drainage Conveyance System
o Groundwater Infiltration Basic or Facility
o Paved Surface
o Street/Curb and Gutter
o Unpaved Surface
o Other, describe:

Description of the spill event destination(s) including GPS coordinates if available that represent the full spread and reach of the spill.

Latitude: Longitude:

Latitude (if needed): Longitude (if needed):

Latitude (if needed): Longitude (if needed):

Latitude (if needed): Longitude (if needed):

Check to confirm photos were taken of spill destination/boundaries: o

© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson Spill Emergency Response Plan
Sanitary Sewer Spill Field Report D-1: Page 4

SPILL VOLUME
Estimated total spill volume exiting the system: gallons Did the spill reach a drainage conveyance system? o YES o NO If yes:
• Estimated time the spill reached the drainage conveyance system:
• Distance from drainage conveyance system to entry point to surface waters: feet • Method to determine travel time from point of entry to drainage conveyance system to receiving waters:

• Describe the drainage conveyance system transporting the spill:

Estimated spill volume fully recovered from the drainage conveyance system: gallons Estimated spill volume remaining within the drainage conveyance system: gallons Check to confirm photos taken of entry location of drainage conveyance system the sewage entered: o Did the spill reach surface water? o YES o NO
If yes:
• Estimated time the spill entered the surface water:
• Distance from spill appearance point to entry point to surface water: feet • Method to determine travel time to receiving waters:
• Describe all discharge points:

Estimated spill volume that discharged to surface waters: gallons Estimated total spill volume recovered: gallons
Check to confirm photos were taken of the following, as applicable: all discharge points into surface waters, waterbody bank erosion, floating matter, water surface sheen, discoloration of receiving water, any notable impacts to the receiving water: o
Did the spill discharge to a groundwater infiltration basin or facility? o YES o NO If yes,
• Estimated time the spill entered the groundwater infiltration basin or facility:
• Estimated spill volume discharged to the
groundwater infiltration basin or facility: gallons
Estimated spill volume that did NOT reach
drainage conveyance system, surface water,
or groundwater infiltration basin or facility: gallons
Estimated Total Spill Volume Recovered: gallons

© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson Spill Emergency Response Plan
Sanitary Sewer Spill Field Report D-1: Page 5
SPILL VOLUME (continued)
Method and explanation of volume estimation methods used: (Check all that apply) o Eyeball Estimate (worksheet included in Spill/Backup Response Workbook) o Counting Upstream Connections (worksheet included in Spill/Backup Response Workbook) o Duration and Flow Rate (worksheet included in Spill/Backup Response Workbook) o Measured Volume (worksheet included in Spill/Backup Response Workbook) o Other (provide worksheet/calculations)
Description of how the spill volume estimations were calculated, including at a minimum, the methodology, assumptions and types of data relied upon, such as supervisory control and data acquisition (SCADA) records, flow monitoring or other telemetry information, used to estimate the volume of the spill discharged, and the volume of the spill recovered (if any volume of the spill was recovered):

© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson Spill Emergency Response Plan
Sanitary Sewer Spill Field Report D-1: Page 6
SPILL START TIME and END TIME DETERMINATION
Were there witnesses to the spill? o YES o NO If yes, provide Spill Witness Statements below:

Witness 1 Name: Witness 1 Contact Information:

Where did they see sewage spill from? c Manhole c Inside Building c Vent/Clean Out c Catch Basin c Wet Well/Lift Station c Other (describe):

When did the witness notice the sewage spilling? ____________ AM / PM Date _____ /______ /_______ Witness description of spill and affected area:

Is it currently spilling? o YES o NO
When did the witness last observe NO Spill occurring? ____________ AM / PM Date _____ /______ /_______ Did the witness notice if the spill had reached the storm drain or surface waters? Comments:

Witness 2 Name: Witness 2 Contact Information:

Where did they see sewage spill from? c Manhole c Inside Building c Vent/Clean Out c Catch Basin c Wet Well/Lift Station c Other (describe):

When did the witness notice the sewage spilling? ____________ AM / PM Date _____ /______ /_______ Witness description of spill and affected area:

Is it currently spilling? o YES o NO
When did the witness last observe NO Spill occurring? ____________ AM / PM Date _____ /______ /_______ Did the witness notice if the spill had reached the storm drain or surface waters? Comments:

Witness 3 Name: Witness 3 Contact Information:

Where did they see sewage spill from? c Manhole c Inside Building c Vent/Clean Out c Catch Basin c Wet Well/Lift Station c Other (describe):

When did the witness notice the sewage spilling? ____________ AM / PM Date _____ /______ /_______ Witness description of spill and affected area:

Is it currently spilling? o YES o NO
When did the witness last observe NO Spill occurring? ____________ AM / PM Date _____ /______ /_______ Did the witness notice if the spill had reached the storm drain or surface waters? Comments:

© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson Spill Emergency Response Plan
Sanitary Sewer Spill Field Report D-1: Page 7
SPILL START TIME and END TIME DETERMINATION (continued) Are the volume of the spill and rate of flow known? o YES o NO If yes, divide volume by rate of flow to get duration of spill event:

Gallons ÷ GPM = Minutes
Spill Volume Flow Rate Spill Duration
Subtract the duration from the spill end date/time to establish the spill start date/time:
— =
Spill End Date/Time Duration Spill Start Time
Method to determine flow rate:

Solids Present? o None or small amount (indicates recent start) o Significant amount of buildup
Staining? o None (indicates recent start)
o Minor
o Significant
Distance sewage has traveled from spill point:

Spill Start Time:

Spill End Date and Time:

How was end time determined?
o Broke stoppage
o Turned pump station back on
o Other, explain:

Description of the methodology(ies), assumptions and type of data relied upon for estimations of the spill start time and the spill end time.

© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson Spill Emergency Response Plan
Sanitary Sewer Spill Field Report D-1: Page 8
SPILL CAUSE (check all that apply)
o Air Relief Valve (ARV)/Blow Off Valve (BOV)/Backwater Valve Failure o Construction Diversion Failure
o Collection System Maintenance Failure (Specify Below) o Damage by Others Not Related to CS Construction/Maintenance (Specify Below) o Debris from Construction
o Debris from Lateral
o Debris-General
o Debris-Rags
o Debris-wipes/Non-disposables
o Flow Exceeded Capacity (Separate CS Only)
o Fats, Oils and Grease (FOG)
o Inappropriate Discharge to CS
o Natural Disaster (Specify Below)
o Operator Error (Specify Below)
o Pipe Structural Problem/Failure – Installation
o Pipe Structural Problem/Failure – Controls
o Pump Station Failure – Power
o Pump Station Failure – Mechanical
o Pump Station Failure – Controls
o Rainfall Exceeded Design, I and I (Separate CS Only)
o Root Intrusion
o Siphon Failure
o Surcharged Pipe (Combines CS Only)
o Vandalism (Specify Below)
o Other, specify:

© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson Spill Emergency Response Plan
Sanitary Sewer Spill Field Report D-1: Page 9

SYSTEM FAILURE LOCATION
System failure location:
o Air Relief Valve (ARV)/Blow Off Valve (BOV) Failure
o Force Main
o Gravity Mainline
o Lower Lateral
o Manhole
o Pump Station Failure – Controls
o Pump Station Failure – Mechanical
o Pump Station Failure – Power
o Siphon
o Upper Lateral (Specify Below)
o Other, specify:

Description of the pipe material at the failure location:
o Copper
o Galvanized Steel
o Polyvinyl Chloride (PVC)
o Acrylonitrile Butadiene Styrene (ABS)
o Cross-Linked Polyethylene (PEX)
o Cast Iron
o Vitrified Clay
o Concrete
o Ductile Iron
o Fiberglass
o Other, specify:

Estimated age of sewer asset at the point of blockage or failure (if applicable):
years
Diameter of sewer pipe at the point of blockage or failure: inches

© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson Spill Emergency Response Plan
Sanitary Sewer Spill Field Report D-1: Page 10

SPILL IMPACT
Description of the impact of the spill:

STORM EVENT
Was spill associated with a storm event? o YES o NO
SPILL RESPONSE ACTIVITIES (check all that apply)
o Cleaned Up (Specify Below)
o Mitigated Effects of Spill (Specify Below)
o Contained All or Portion of Spill
o Restored Flow
o Returned All Spill to Sanitary Sewer System
o Returned Portion of Spill to Sanitary Sewer System
o Property Owner Notified
o Other Enforcement Agency Notified
o Other, specify:

Description of spill response activities including description of immediate spill containment and cleanup efforts:

© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson Spill Emergency Response Plan
Sanitary Sewer Spill Field Report D-1: Page 11
SPILL CORRECTIVE ACTION (check all that apply)
o Added Sewer to Preventive Maintenance Program
o Adjusted Schedule/Method of Preventive Maintenance
o Enforcement Action Against FOG Source
o Inspected Sewer Using CCTV to Determine Cause
o Plan Rehabilitation or Replacement of Sewer
o Repaired Facilities or Replaced Defect
o Other, specify:

Refer to Collection System Failure Analysis Report for details about:
• Spill corrective action, including steps planned or taken to reduce, eliminate, and prevent reoccurrence of the spill, and a schedule of major milestones for those steps. • Schedule of major milestones
Check to confirm completion of each report:
o Post-Spill Assessment
o Collection System Failure Analysis
Spill response completion date:

INVESTIGATION
Detailed narrative of investigation and investigation findings of cause of spill:

Is the City conducting an ongoing investigation? o YES o NO If yes, reasons for an ongoing investigation:

If yes, expected date of completion of investigation:

© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson Spill Emergency Response Plan
Sanitary Sewer Spill Field Report D-1: Page 12
SURFACE WATERS (Complete for Category 1 Spills Only)
Name of receiving
water body
Type of receiving
water body: Stream,
Ocean, Wetland, Slough,
Estuary, River, Lake,
Reservoir, Vernal Pool,
Wash, or Other (specify)
Description of the water body(s), including but not limited to:
o Observed impacts on aquatic life,
o Public access impact(s): public closure, restricted public access, temporary restricted use, and/or other (specify below)
o Responsible entity for closing/restricting use of water body, and o Number of days closed/restricted as a result of the spill.

MUNICIPAL INTAKE (Complete for Category 1 and 2 Spills Only) Was the spill located within 1,000 feet of a municipal surface water intake? o YES o NO Describe:

© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson Spill Emergency Response Plan
Sanitary Sewer Spill Field Report D-1: Page 13

WATER SAMPLING
Were water quality samples collected? o YES o NO o N/A
If yes, identify sample locations:

Identify parameters the water quality samples were analyzed for: (Check all that apply) o Total Coliform Bacteria
o Fecal coliform bacteria
o E-coli
o Ammonia
o Other, specify:

© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 INSERT TAB:

Tab E: Volume Estimation

© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson Spill Emergency Response Plan
Volume Estimation Computations & Examples E-1: Page 1
Miscellaneous Computations & Examples
To convert inches to feet
(NOTE: for the purposes of
this worksheet, the unit of
measurement will be in
feet for formula examples)
Divide the inches by 12 or use the chart on the right.

Example 1: 27" ÷ 12 = 2.25'
Example 2: 1¾" = ?'
1" (0.08') + ¾" (0.06') = 0.14'
Volume of one cubic foot 7.48 gallons of liquid
Area:

Two-dimensional
measurement represented
in square feet (SQ/FT or
ft2)
Square/rectangle: Area = Length x Width
Circle: Area = π x r2
(where π ≈ 3.14 and r = radius = ½ diameter)
Triangle: Area = ½ (Base x Height)
Volume:

Three-dimensional
measurement represented
in cubic feet (CU/FT or ft3)
Rectangle/square footprint: Volume = Length x Width x Depth Circle footprint (cylinder): Volume = π x r2 x Depth
(where π ≈ 3.14 and r = radius = ½ diameter)
Triangle footprint: Volume = ½ (Base x Height) x Depth
Depth:

Wet Stain on Concrete or
asphalt surface
If the depth is not measurable because it is only a wet stain, use the following estimated depths:
o Depth of a wet stain on concrete surface: 0.0026' (1/32") o Depth of a wet stain on asphalt surface: 0.0013' (1/64") These were determined to be a reasonable depth to use on the respective surfaces through a process of trial and error. One gallon of water was poured onto both asphalt and concrete surfaces. Once the area was determined as accurately as possible, different depths were used to determine the volume of the wetted footprint until the formula produced a result that (closely) matched the one gallon spilled. This process was repeated several times.

Depth:

Contained or “Ponded”
sewage
Measure actual depth of standing sewage whenever
possible. When depth varies, measure several representative sample points and determine the average. Use that number in your formula to determine volume.

© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson Spill Emergency Response Plan
Volume Estimation Computations & Examples E-1: Page 2
Miscellaneous Computations & Examples (continued)
Area/Volume of a Rectangle or Square
Formula: Length x Width x Depth = Volume in cubic feet
25' X 12' X 0.14' = 42 Cubic Feet
Length Width Depth Volume
Multiply the volume by 7.48 gallons to determine the volume in gallons:
42 ft3. X 7.48 = 314.16 gallons
Volume gal/ft3 Volume
Area/Volume of a Right Triangle
Formula: Base x Height x Depth = Volume in cubic feet

0.5 X 45' X 10' X 0.05' x 7.48 = 84.15 gallons
Base Height Depth gal/ft3 Volume
Area/Volume of a Circle
Formula: π x r2 x Depth = Volume in cubic feet
The radius is ½ the diameter, which is a straight line passing from side to side through the center of a circle.

13.5' X 13.5' X 3.14 X 0.06' x 7.48 = 256.8 gallons
Radius Radius π Depth gal/ft3 Volume
12'
25'
Depth = 1 ¾"
10'
45'
Depth = 5/8"
For isosceles triangles
(two sides are equal lengths),
break it down into two right triangles
and compute area as you would for
the right triangle.
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson Spill Emergency Response Plan
Volume Estimation: Eyeball Estimation Method (for ≤100 gallons) E-2 Spill Date: Location:

This method is invalid if surface conditions are wet (due to rainfall, irrigation, etc.) DO NOT use this method under these circumstances.

STEP 1: Position yourself so that you have a vantage point where you can see the entire spill.

STEP 2: Imagine one or more buckets or barrels of water tipped over. Depending on the size of the spill, select a bucket or barrel size as a frame of reference. It may be necessary to use more than one bucket/barrel size.

STEP 3: Estimate how many of each size bucket or barrel it would take to make an equivalent spill. Enter those numbers in Column A of the row in the table below that corresponds to the bucket/barrel sizes you are using as a frame of reference.

STEP 4: Multiply the number in Column A by the multiplier in Column B. Enter the result in Column C.

A B C
Size of bucket(s)/barrel(s) How many of this size? Multiplier Estimated Spill Volume x 1 gallon
x 5 gallons
x 32 gallons
x 55 gallons
x gallons
Estimated Total Spill Volume:

STEP 5: List assumptions made to arrive at the total estimated spill volume:

STEP 6: Take photographs. Where are photographs stored? The following photos must be taken: appearance point closest to the failure point, extent of the spill and spill boundaries, the entry location of each drainage conveyance system the sewage entered, all discharge points into surface waters (Category 1 spill only), and location(s) of clean up. © 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson Spill Emergency Response Plan
Volume Estimation: Duration and Flow Rate Comparison Method E-3: Page 1 Spill Date: Location:

Compare the spill to reference images below to estimate flow rate of the current spill. NOTE: If the manhole cover in your picture has vent holes or more than one pry hole, do not use these pictures for comparison.

Describe which reference photo(s) were used and any additional factors that influenced applying the reference photo data to the actual spill:

Flow Rate Based on Photo Comparison: gallons per minute (gpm) (Continued on next page)
Near View
Far View
Near View
Far View
5 gpm 25 gpm 50 gpm 100 gpm
150 gpm 200 gpm 300 gpm 400 gpm
SSCSC Manhole Spill Gauge: CWEA Southern Section Collections Systems Committee. Spill Simulation courtesy of Eastern Municipal Water District. © 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson Spill Emergency Response Plan
Volume Estimation: Duration and Flow Rate Comparison Method E-3: Page 2 Start Date and Time 1.

End Date and Time 2.

Spill Event Total Time Elapsed
(subtract Line 1 from Line 2. Show in minutes.)

3. Average Flow Rate GPM
(Account for diurnal flow pattern)

4. Total Volume Estimated Using Duration and
Flow Method (Line 3 x Line 4)

5. List assumptions made to arrive at the total estimated spill volume:

Take photographs. Where are photographs stored?
The following photos must be taken: appearance point closest to the failure point, extent of the spill and spill boundaries, the entry location of each drainage conveyance system the sewage entered, all discharge points into surface waters (Category 1 spill only), and location(s) of clean up. © 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson Spill Emergency Response Plan
Volume Estimation: Area/Volume Method E-4: Page 1
Spill Date: Location:

STEP 1: Describe spill area surface: c Asphalt c Concrete c Dirt c Landscape c Inside Building c Other:

STEP 2: Draw/sketch the outline (footprint) of the spill. Then break the footprint down into recognizable shapes.

Label/identify each sketch outline area (Area 1, Area 2, etc.) See example below. © 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson Spill Emergency Response Plan
Volume Estimation: Area/Volume Method E-4: Page 2
STEP 3: Calculate the area of the footprint by completing the table below for each area in Step 2. Measure actual depth of standing sewage whenever possible. When depth varies, measure several representative sample points and determine the average. If the depth is not measurable because it is only a wet stain, use the following estimated depths: Depth of a wet stain on concrete surface: 0.0026' (1/32") Depth of a wet stain on asphalt surface: 0.0013' (1/64") Rectangles:

Area #
(from
labeled
drawing)
Length X Width X % Wet = Area X Depth = Volume
à ft X ft X % = ft2 X ft = ft3
à ft X ft X % = ft2 X ft = ft3
à ft X ft X % = ft2 X ft = ft3
Circles:

Area #
(from
labeled
drawing)
π X Radius X Radius X % Wet = Area X Depth = Volume
à 3.14 X ft X ft X % = ft2 X ft = ft3
à 3.14 X ft X ft X % = ft2 X ft = ft3
à 3.14 X ft X ft X % = ft2 X ft = ft3
STEP 4: If part of the spill is in a gutter, use the formula below to calculate the volume:

X X X 0.5 = ft3
Length Depth Width Volume
STEP 5: Calculate Total Spill Volume (sum of all of the volume calculations above): ft3 STEP 6: Convert from cubic feet to gallons by multiplying by 7.48. ft3 x 7.48 gallons = gallons
spill volume in cubic feet Total estimated volume
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson Spill Emergency Response Plan
Volume Estimation: Area/Volume Method E-4: Page 3
STEP 7: List assumptions made to arrive at the total estimated spill volume. Adjust estimation up for moderate to severe cracking and/or roughness of surface (General Rule 20% to 40%):

STEP 8: Take photographs. Where are photographs stored? The following photos must be taken: appearance point closest to the failure point, extent of the spill and spill boundaries, the entry location of each drainage conveyance system the sewage entered, all discharge points into surface waters (Category 1 spill only), and location(s) of clean up. © 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson Spill Emergency Response Plan
Volume Estimation: Upstream Connections Method E-5
Spill Date: Location:

Attach and/or reference system map and identify location of spill and buildings contributing to spill.

STEP 1: Determine the number of Equivalent Dwelling Units (EDUs) for this spill: EDUs NOTE: A single-family residential home = 1 EDU. For commercial buildings, refer to agency documentation.

STEP 2: This volume estimation method utilizes the City’s daily usage data. Column A shows SAMPLE DATA on how an average daily usage of “X” amount of gallons per day is distributed during each 6-hour period. Adjust the table as necessary to accurately represent the actual data. Discharge per Average Daily Use is based on where in the City the spill occurred. The City has quantified this information and it is available in GIS.

Complete Column E by entering the number of minutes the spill was active during each 6-hour time period.

Multiply column D times Column E to calculate the gallons spilled during each time period. Add the numbers in Column F together for the Total Estimated spill Volume per EDU.

Time Period
Flow Rate Per EDU Spill

A B C D E F
Gallons
per
Period
Hours
per
period
A÷B =
Gallons
per Hour
C÷60 =
Gallons per
Minute
Minutes spill
was active
during period
D × E = Gallons
spilled per period
6am-noon 72 6 12 0.20
noon-6pm 36 6 6 0.10
6pm-midnight 54 6 9 0.15
midnight-6am 18 6 3 0.05
Total Estimated Spill Volume per EDU:

STEP 3: Multiply the Estimated spill Volume per EDU from Step 2 by the number of EDUs from Step 1. gallons X = gallons
Volume per EDU # of EDUs Estimated spill Volume
STEP 4: Adjust spill volume as necessary considering other factors, such as activity that would cause a fluctuating flow rate (doing laundry, taking showers, etc.). Explain rationale below and indicate adjusted spill estimate (attach a separate page if necessary).

Total Estimated spill Volume: gallons
STEP 7: List assumptions made to arrive at the total estimated spill volume:

STEP 8: Take photographs. Where are photographs stored? The following photos must be taken: appearance point closest to the failure point, extent of the spill and spill boundaries, the entry location of each drainage conveyance system the sewage entered, all discharge points into surface waters (Category 1 spill only), and location(s) of clean up.

SAMPLE DATA
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson Spill Emergency Response Plan
Drawing Worksheet E-6
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 INSERT TAB:

Tab F: Backup Forms
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson Spill Emergency Response Plan
Backup Forms Checklist (Backup Only) F-1
Complete this form only if there is a backup into a residence or business.

Instructions to Public Works Crew:

1. Take photo of each form before giving it to the customer for documentation.

2. Tear forms listed below out of this workbook and hand to customer. Leave this page (F-1) and the First Responder Form (F-2) in this workbook, do not give to Customer.

3. Check each item that was provided to the customer.

4. Have customer sign below.

Forms/Documents:
o Form F-3: Declination of Cleaning Services
o Form F-4: Lodging Authorization
o Form F-5: Customer Information Letter
o Form F-6: Your Responsibilities as a Private
Property Owner
o Form F-7: Claim Form
Forms Provided to:

Customer Name
Customer Signature
Date
Check here if customer declines to sign: o
Formularios / Documentos:
o F-3: Declinación de los Servicios de Limpieza
o F-4: Autorización de Alojamiento
o F-5: Carta de Información del Cliente
o F-6: Sus Responsabilidades Como Propietario
de Una Propiedad Privad
o F-7: Formulario de Reclamación
Formularios Proporcionados a:

Nombre del cliente
Firma del cliente
Fecha
Marque aquí si el cliente se niega a firmar: o
Forms Provided by:

Employee Name Initial Date
Instructions to Public Works Superintendent:

Send photos, including the photos of the documents given to the customer, and a copy of the First Responder form to the City Manager. © 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson Spill Emergency Response Plan
First Responder Form (Backup Only) F-2: Page 1
Complete this form only if there is a backup into a residence or business.

Fill out this form as completely as possible.

Ask customer if you may enter the home. If so, take photos of all damaged and undamaged areas.

PERSON COMPLETING THIS FORM:

Name:

Title:

PHONE:

DATE:

TIME:

TIME STAFF ARRIVED ON-SITE:

DOES THE CUSTOMER WANT THE CITY TO CALL FOR CLEANING SERVICE? o Yes o No If no, give the customer the Cleaning Declination Form and have them sign here: __________________________ If customer called a cleaning contractor, provide name and contact number:

RESIDENT NAME:
o Owner
o Renter

IF RENT,
PROPERTY MANAGER(S):

OWNER:

ADDRESS:

PHONE:

ADDRESS:

PHONE:
# OF PEOPLE LIVING AT RESIDENCE:

Approximate Age of Home: # of Bathrooms: # of Rooms Affected:

Numbers of Photographs or Videos Taken:
o Photographs ________ o Video ________
o Customer did not provide or allow photographs
Where are photos/video stored?
Is nearest upstream manhole visibly higher than the drain/fixture that spilled? o Yes o No Does property have a Property Line Cleanout or BPD? o Cleanout o BPD o Neither o Unknown If yes, was the Property Line Cleanout/BPD operational at the time of the spill? o Yes o No o Unknown Have there ever been any previous spills at this location? o Yes o No o Unknown Has the resident had any plumbing work done recently?
If YES, please describe:
o Yes o No o Unknown
GO TO PAGE 2
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson Spill Emergency Response Plan
First Responder Form (Backup Only) F-2: Page 2

LIVABILITY ASESSMENT
• Is there insufficient non-contaminated living space for residents to stay during cleaning including a functioning and non-contaminated bathroom? o Yes o No
• Are there any residents that are pregnant, are children, have severe allergies/asthma, have respiratory problems, and/or have a compromised immune system? o Yes o No
• Is the area a childcare or extended care facility? o Yes o No • Is the food preparation area contaminated? o Yes o No • Is it currently after 8pm, or if it is currently before 8pm will the cleaning and disinfection be completed after 10pm? o Yes o No
If the answer to any of the questions above is YES, complete the Lodging Authorization form.

If temporary lodging was offered by the City check one: o Accepted o Rejected

SANITARY SEWER LINE BLOCKAGE LOCATION

PLEASE CHECK THE BOXES THAT
DESCRIBE YOUR OBSERVATIONS:

On the diagram below, place an X where in the mainline or lateral you believe the problem occurred.

Building Cleanout Was:
o Non-Existent
o Full
o Empty
Property Line Cleanout was:
o Non-Existent
o Full
o Empty
Did sewage go under buildings? ☐ Yes ☐ No ☐ Unsure
Recommended Follow-Up Action(s):
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson Spill Emergency Response Plan
Declination of Cleaning Services (Backup Only) F-3
Customer Information
NAME: ADDRESS: TELEPHONE:

ON
(date)
AT
(time)
Approximately
(quantity)
GALLONS OF:
o Sewage o Grey Water o Toilet Bowl Water o Odor
o Other (describe):

Spilled from (or odor emanating from)
o Toilet o Shower/Tub o Washer o Other (describe):

The spill affected the following areas (check one):
o Bathroom o Bedroom o Hallway o Garage
o Kitchen o Crawlspace o Other (specify):

The spill affected the following flooring:
o Tile o Wood Flooring
o Linoleum o Carpet
o Other (specify):
and/or additional materials:
o Area Rugs o Towels
o Clothing o Other (specify):

This Form Completed By: Name: Date:
(Write legibly) Title: Time:

CUSTOMER, please read the following and sign below. I/We acknowledge that City of Jackson (City) has offered to provide professional cleaning and decontamination services to remediate the sewage backup and/or spill described above and that we declined the offer. We further understand and acknowledge that because we have declined, any necessary remediation activities will be conducted without City assistance, and that the City will not accept responsibility for work performed by persons other than those engaged by the City. The City will also not accept responsibility for any charges related to this incident that are not usual and customary. Refer to “Your Responsibilities as a Private Property Owner” (Page F-6) for recommendations regarding spill cleanup.

CLIENTE, por favor lea lo siguiente y firme a continuación. Yo/Nosotros reconocemos que City of Jackson (ciudad) se ha ofrecido a proporcionar servicios profesionales de limpieza y descontaminación para remediar la reserva de aguas residuales y/o derrame descrita anteriormente y que rechazamos la oferta. Además, entendemos y reconocemos que debido a que hemos rechazado, cualquier actividad de remediación necesaria se llevará a cabo sin la asistencia de ciudad, y que ciudad no aceptará responsabilidad por el trabajo realizado por personas que no sean las contratadas por ciudad. La ciudad tampoco aceptará responsabilidad por ningún cargo relacionado con este incidente que no sea habitual y habitual. Consulte "Sus Responsabilidades Como Propietario De Una Propiedad Privada" (Página F-6) para obtener recomendaciones sobre la limpieza de derrames.

Customer Signature / Firma del cliente *: Date:

The information above was
explained to the customer by
the following employee:

Name: Title:

Signature: Date:
*Note to responders: if customer declines to sign this form, then have a co-worker sign here as a witness:

Name: Signature: Date:
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson Spill Emergency Response Plan
Lodging Authorization (Backup Only) F-4
INSTRUCTIONS TO EMPLOYEE:

1. Complete this form if the Livability Assessment on the First Responder Form indicates a need for temporary relocation and the customer accepts the offer.

2. Notify the Public Works Superintendent who will make arrangements via telephone and pay for the hotel with a credit card.

3. Complete the voucher as instructed by the Public Works Superintendent.

4. Take a photo of the form for records and then give it to the customer.

5. Indicate if they accept or reject the offer of temporary relocation on the First Responder Form (F-2).

INSTRUCTIONS TO RESIDENT:

City of Jackson recommends that you temporarily relocate to one of the hotels listed below for your safety and convenience while your residence is being cleaned. Please note that this emergency authorization is granted under the following conditions:

1. This authorization provides for one (1) night’s lodging at one of the hotels listed below.

2. The authorization is good for room and tax ONLY. Phone, food, mini-bar and other incidental charges will be your responsibility.

3. Additional nights and/or other allowances/incidentals may be discussed by contacting the City Manager at (209) 223- 1646.

INSTRUCCIONES PARA EL RESIDENTE:

City of Jackson recomienda que se traslade temporalmente a uno de los hoteles enumerados a continuación por su seguridad y comodidad mientras se limpia su residencia. Tenga en cuenta que esta autorización de emergencia se concede bajo las siguientes condiciones:

1. Esta autorización prevé una (1) noche de alojamiento en uno de los hoteles que se enumeran a continuación.

2. La autorización es válida para habitación e impuestos SOLAMENTE. Teléfono, comida, minibar y otros cargos incidentales serán su responsabilidad.

3. Las noches adicionales y / u otras asignaciones / imprevistos pueden discutirse comunicándose con el City Manager al (209) 223-1646.

VOUCHER
Good for one (1) night’s stay on (date): Number of Affected Residents:

Customer’s Name:

Field Supervisor’s Name: Phone Number:

Best Western
200 S. State Highway 49
Jackson, CA 95642
(800) 780-7234
Jackson Lodge
850 N. State Highway 49
Jackson, CA 95642
(209) 257-4077
Holiday Inn Express
101 Clinton Road
Jackson, CA 95642
(209) 257-1500
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson Spill Emergency Response Plan
Customer Information Letter (Backup Only) F-5 (English) Dear Property Owner:

We recognize that sewer backup incidents can be stressful and require immediate response while all facts concerning how an incident occurred are still unknown. Rest assured that we do all we can to prevent this type of event from occurring in the first place. Nevertheless, occasionally tree roots or other debris in the sewer lines causes a backup into homes immediately upstream of the blockage. At this time the City is investigating the cause of this incident. We recommend that you immediately contact your homeowners or renters’ insurance and inform them of the incident.

If the City is found to be responsible for the incident, we are committed to cleaning and restoring your property, and to protecting the health of those affected during the remediation process.

The cleaning contractor provided by the City has been selected because of their adherence to established protocols that are designed to assure to all parties thorough, cost-effective and expeditious cleaning services. You also have the right to select your own cleaning contractor, but the City does not guarantee payment of fees/expenses incurred and reserves the right to dispute fees/expenses deemed not usual and customary.

Depending on the extent of the backup our Public Works Crew may advise you to consider relocating temporarily while the living area is cleaned. In that case, the City will arrange for lodging for you for one night. Please see the Lodging Authorization form for details.

To discuss this matter, contact the Public Works Superintendent at (209) 273-8807. To submit a claim for damages contact the City Manager at (209) 223-1646.

Sincerely,
The City of Jackson
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson Spill Emergency Response Plan
Customer Information Letter (Backup Only) F-5 (Spanish) Estimado Propietario:

Reconocemos que los incidentes de la red de alcantarillado pueden ser estresantes y requieren una respuesta inmediata, mientras que todos los hechos relacionados con la forma en que ocurrió el incidente aún son desconocidos.

Tenga la seguridad de que haremos todo lo posible para evitar que este tipo de evento ocurra en primer lugar. Sin embargo, ocasionalmente las raíces de los árboles u otros residuos en las líneas de alcantarillado causan una copia de seguridad en los hogares inmediatamente antes del bloqueo. En este momento el ciudad está investigando la causa de este incidente. Te recomendamos que contactes inmediatamente con tu seguro de propietarios o inquilinos y les comuniques la incidencia.

Si se determina que el ciudad es responsable del incidente, nos comprometemos a limpiar y restaurar su propiedad, ya proteger la salud de las personas afectadas durante el proceso de remediación.

El contratista de limpieza proporcionado por el Distrito ha sido seleccionado debido a su adhesión a los protocolos establecidos que están diseñados para garantizar a todas las partes servicios de limpieza exhaustivos, rentables y rápidos. También tiene derecho a seleccionar su propio contratista de limpieza, pero el ciudad no garantiza el pago de los honorarios / gastos incurridos y se reserva el derecho de disputar los honorarios / gastos que se consideren no habituales y habituales.

Dependiendo de la extensión de la copia de seguridad, nuestro Public Works Crew puede aconsejarle que considere reubicarse temporalmente mientras se limpia la sala de estar. En ese caso, el City organizará el alojamiento para usted por una noche. Consulte el formulario de autorización de alojamiento para obtener más detalles.

Para discutir este asunto, comuníquese con el Public Works Superintendent al (209) 273-8807. Para presentar un reclamo por daños comuníquese con la City Manager al (209) 223-1646.

Sinceramente,
The City of Jackson
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson Spill Emergency Response Plan
Your Responsibilities as a Private Property Owner (Backup Only) F-6: Page 1 How a Sewer System Works
A property owner's sewer pipes are called service laterals and are connected to larger local main and regional trunk lines. Service laterals run from the connection at the home to the connection with the public sewer. The lateral is the responsibility of the property owner and must be maintained by the property owner.

How do sewage spills happen?
Sewage spills occur when the wastewater in
underground pipes spills through a manhole, cleanout,
or broken pipe. Most spills are relatively small and can be stopped and cleaned up quickly, but left unattended
they can cause health hazards, damage to homes and
businesses, and threaten the environment, local
waterways, and beaches. Common causes of sewage
spills include grease build-up, tree roots,
broken/cracked pipes, missing or broken cleanout
caps, undersized sewers, and groundwater/rainwater
entering the sewer system through pipe defects and
illegal connections.

Prevent most sewage backups with a Backflow Prevention Device This type of device can help prevent sewage backups into homes and businesses. If you don’t already have a Backflow Prevention Device, contact a professional plumber or contractor to install one as soon as possible.

Is my home required to have a backflow prevention device? Section 710.1 of the Uniform Plumbing Code (U.P.C.) states: “Drainage piping serving fixtures which have flood level rims located below the elevation of the next upstream manhole cover or private sewer serving such drainage piping shall be protected from backflow of sewage by installing an approved type of backwater valve.” The intent of Section 710.1 is to protect the building interior from mainline sewer spills or surcharges.

Additionally, U.P.C. 710.6 states:
“Backwater valves shall be located where
they will be accessible for inspection and
repair at all times and, unless
continuously exposed, shall be enclosed
in a masonry pit fitted with an
adequately sized removable cover.”
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson Spill Emergency Response Plan
Your Responsibilities as a Private Property Owner (Backup Only) F-6: Page 2 Spill cleanup inside the home:

For large clean ups, a professional cleaning firm should be contacted to clean up impacted areas, If you hire a contractor, it is recommended to get estimates from more than one company. Sometimes, homeowner’s insurance will pay for the necessary cleaning due to sewer backups. Not all policies have this coverage, so check with your agent.

If you decide to clean up a small spill inside your home, protect yourself from contamination by observing the following safety measures. Those persons whose resistance to infection is compromised should not attempt this type of clean up.

Other Tips:
• Keep children and pets out of the affected area.
• Turn off heating/air conditioning systems
• Wear rubber boots, rubber gloves, and goggles during cleanup. • Discard items that cannot be washed and disinfected (such as: mattresses, rugs, cosmetics, toys, etc.)
• Remove and discard drywall and insulation that has been contaminated with sewage or flood waters. • Thoroughly clean all hard surfaces (such as flooring, concrete, molding, wood and metal furniture, countertops, appliances, sinks and other plumbing fixtures) with hot water and laundry or dish detergent. • Help the drying process with fans, air conditioning units, and dehumidifiers. • After completing cleanup, wash your hands with soap and water. Use water that has been boiled for 1 minute (allow the water to cool before washing your hands) OR use water that has been disinfected (solution of 1/8 teaspoon of household bleach per 1 gallon of water). Let it stand for 30 min. If water is cloudy, use ¼ teaspoon of household bleach per 1 gallon of water.
• Wash clothes worn during cleanup in hot water & detergent (wash apart from uncontaminated clothes). • Wash clothes contaminated with sewage in hot water and detergent. Consider using a Laundromat until your onsite wastewater system has been professionally inspected and serviced.

Spill cleanup outside the home:
• Keep children and pets out of the affected area until cleanup has been completed. • Wear rubber boots, rubber gloves, and goggles during cleanup of affected area. • Clean up sewage solids (fecal material) and place in properly functioning toilet or double bag and place in garbage container.
• On hard surfaces areas such as asphalt or concrete, it is safe to use a 2% bleach solution, or ½ cup of bleach to 5 gallons of water, but don’t allow it to reach a storm drain as the bleach can harm the environment. • After cleanup, wash hands with soap and water. Use water that has been boiled for 1 minute (allow to cool before washing your hands) OR use water that has been disinfected (solution of 1/8 teaspoon of household bleach per 1 gallon of water). Let it stand for 30 min. If water is cloudy, use ¼ teaspoon of household bleach per 1 gallon of water.
• Wash clothes worn during cleanup in hot water and detergent (wash apart from uncontaminated clothes). • Wash clothes contaminated with sewage in hot water and detergent. Consider using a laundromat until your onsite wastewater system has been professionally inspected and serviced.

Seek immediate
attention if you
become injured or ill
during or after the
cleanup process.
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson Spill Emergency Response Plan
Sus Responsabilidades Como Propietario de Una Propiedad Privada F-6 Página 1: en español Cómo funciona un sistema de alcantarillado
Las tuberías de alcantarillado de un propietario se denominan servicios laterales y están conectadas a líneas troncales principales y regionales locales más grandes. Los servicios laterales se ejecutan desde la conexión en el hogar hasta la conexión con el sistema de alcantarillado del Distrito. El lateral es responsabilidad del dueño de la propiedad y debe ser mantenido por el dueño de la propiedad.
¿Cómo ocurren los derrames de aguas residuales?
Los derrames de aguas residuales ocurren cuando las aguas residuales en las tuberías subterráneas se desbordan a través de un pozo de acceso, limpieza o tubería rota. La mayoría de los derrames son relativamente pequeños y se pueden
detener y limpiar rápidamente, pero si se los deja
desatendidos, pueden causar riesgos para la salud, dañar viviendas y negocios y amenazar el medio ambiente, las vías fluviales locales y las playas. Las causas comunes de
derrames de aguas residuales incluyen acumulación de
grasa, raíces de árboles, tuberías rotas / agrietadas, tapas de limpieza faltantes o rotas, alcantarillas de tamaño
insuficiente y aguas subterráneas / pluviales que ingresan al sistema de alcantarillado a través de defectos en las tuberías y conexiones ilegales.

Prevenga la mayoría de las copias de seguridad de aguas residuales con un dispositivo de prevención de reflujo Este tipo de dispositivo puede ayudar a prevenir las copias de seguridad de aguas residuales en hogares y empresas.

Si aún no tiene un dispositivo de prevención de reflujo, comuníquese con un plomero o contratista profesional para instalar uno lo antes posible.
¿Se requiere que mi hogar tenga un dispositivo de prevención de reflujo? La Sección 710.1 del Código Uniforme de Plomería (UPC) establece: “Los accesorios de tuberías de drenaje que tienen llantas de nivel de inundación ubicadas debajo de la elevación de la siguiente boca de alcantarilla corriente arriba o la alcantarilla privada que atiende dicha tubería de drenaje deben protegerse contra el reflujo de aguas residuales al instalar un tipo de válvula de evacuación ”. La intención de la Sección 710.1 es proteger el interior del edificio de los desagües o sobrecargas de alcantarillado de la línea principal.

Adicionalmente, U.P.C. 710.6 dice: Las válvulas de aguas residuales deben ubicarse donde puedan ser inspeccionadas y reparadas en todo momento y, a menos que estén continuamente expuestas, deben estar encerradas en un pozo de mampostería equipado con una cubierta removible del tamaño adecuado. © 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson Spill Emergency Response Plan
Sus Responsabilidades Como Propietario de Una Propiedad Privada F-6 Página 2: en español Limpieza de derrames dentro de la casa:

Para grandes limpiezas, se debe contactar a una empresa de limpieza profesional para limpiar las áreas afectadas. Si contrata a un contratista, se recomienda obtener estimaciones de más de una compañía. A veces, el seguro del propietario de vivienda pagará la limpieza necesaria debido a las reservas de alcantarillado. No todas las pólizas tienen esta cobertura, así que consulte con su agente.

Si decide limpiar un pequeño derrame dentro de su casa, protéjase de la contaminación observando las siguientes medidas de seguridad. Aquellas personas cuya resistencia a la infección esté comprometida no deben intentar este tipo de limpieza.

Otros consejos:
o Mantenga a los niños y mascotas fuera del área afectada. o Apague los sistemas de calefacción / aire acondicionado o Use botas de goma, guantes de goma y gafas durante la limpieza. o Deseche los artículos que no se puedan lavar y desinfectar (como: colchones, alfombras, cosméticos, juguetes, etc.)
o Retire y deseche los paneles de yeso y el aislamiento contaminado con aguas residuales o aguas de inundación.
o Limpie a fondo todas las superficies duras (como pisos, concreto, molduras, muebles de madera y metal, mostradores, electrodomésticos, fregaderos y otros accesorios de plomería) con agua caliente y ropa o detergente para platos.
o Ayude al proceso de secado con ventiladores, unidades de aire acondicionado y deshumidificadores. o Después de completar la limpieza, lávese las manos con agua y jabón. Use agua que haya sido hervida por 1 minuto (deje que el agua se enfríe antes de lavarse las manos) O use agua que haya sido desinfectada (solución de 1/8 cucharadita de lejía doméstica por 1 galón de agua). Dejar reposar durante 30 min. Si el agua está turbia, use ¼ cucharadita de lejía de uso doméstico por 1 galón de agua. o Lave la ropa usada durante la limpieza con agua caliente y detergente (lave aparte de la ropa no contaminada).
o Lavar la ropa contaminada con aguas residuales en agua caliente y detergente. Considere usar una lavandería hasta que su sistema de aguas residuales en el sitio haya sido inspeccionado y reparado profesionalmente.

Limpieza de derrames fuera de la casa:
o Mantenga a los niños y las mascotas fuera del área afectada hasta que se haya completado la limpieza. o Use botas de goma, guantes de goma y gafas protectoras durante la limpieza del área afectada. o Limpie los sólidos de alcantarillado (material fecal) y colóquelos en un inodoro o bolsa doble que funcione correctamente y colóquelos en un contenedor de basura.
o En áreas de superficies duras como el asfalto o el concreto, es seguro usar una solución de lejía al 2%, o ½ taza de lejía a 5 galones de agua, pero no permita que llegue a un drenaje de tormenta ya que la lejía puede dañar la ambiente.
o Después de la limpieza, lávese las manos con agua y jabón. Use agua que haya sido hervida por 1 minuto (deje enfriar antes de lavarse las manos) O use agua que haya sido desinfectada (solución de 1/8 cucharadita de cloro por 1 galón de agua). Dejar reposar durante 30 min. Si el agua está turbia, use ¼ cucharadita de lejía de uso doméstico por 1 galón de agua. o Lave la ropa usada durante la limpieza con agua caliente y detergente (lave aparte de la ropa no contaminada).
o Lavar la ropa contaminada con aguas residuales en agua caliente y detergente. Considere usar una lavandería hasta que su sistema de aguas residuales en el sitio haya sido inspeccionado y reparado profesionalmente.

Busque atención
inmediata si se lesiona
o se enferma durante
o después del proceso
de limpieza.

GOVERNMENT CLAIM FORM
City of Jackson
200 Cemetary Lane, Jackson, CA 95642
209-223-1646
This form is provided pursuant to Government Code Sections 910 et seq. and shall be used by any person presenting a claim to City of Jackson under Government Code Section 810 et seq. If additional space is needed please attach additional sheets.
***Please return this claim form and all attachments to the District at the address stated above.*** A. THE NAME AND POST OFFICE ADDRESS OF THE CLAIMANT: B: THE POST OFFICE ADDRESS TO WHICH THE

PERSON PRESENTING THE CLAIM DESIRES
NOTICES TO BE SENT:

DAYTIME TELEPHONE:

EVENING TELEPHONE: TELEPHONE:

C. THE DATE, PLACE, AND OTHER CIRCUMSTANCES OF THE OCCURRENCE OR TRANSACTION WHICH GAVE RISE TO THE CLAIM ASSERTED:

DATE OF OCCURRENCE: TIME OF OCCURRENCE:

PLACE OF OCCURRENCE:

ClRCUMSTANCES:

D. A GENERAL DESCRIPTION OF THE INDEBTEDNESS, OBLIGATION, INJURY, DAMAGE OR LOSS INCURRED SO FAR AS IT MAY BE KNOWN AT THE TIME OF PRESENTATION OF THE CLAIM:

E. THE NAME OR NAMES OF THE PUBLIC EMPLOYEE OR EMPLOYEES CAUSING THE INJURY, DAMAGE, OR LOSS,

IF KNOWN
F. AMOUNT OF CLAIM: $
(if less than $10,000.00)
JURISDICTION OF CLAIM: __ MUNICIPAL COURT (CLAIMS TO $25,000) __ SUPERIOR COURT (CLAIMS OVER $25,000)
BASIS OF COMPUTATION:

SIGNATURE OF CLAIMANT OR REPRESENTATIVE: ____________________________________ DATE: _____________ For your protection California law requires the following to appear on this form: Section 72 of the Penal Code provides that “every person who, with intent to defraud, presents for allowance or for payment to any State Board or Officer, or to any county, town, city, district, ward, or village, board or officer authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher, or writing, is guilty of a felony”.

F-7
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 INSERT TAB:

Tab G: SAMPLING SOP
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson Spill Emergency Response Plan
Surface Water Sampling SOP: Table of Contents G-1
Table of Contents (this page)...........................................G-1 Specifications & Requirements ......................................... -2 Introduction & Overview .................................................. -3 Equipment & Safety .......................................................... -4 Before Sampling ................................................................ -5 Surface Water Sampling ................................................... -6 After Sampling .................................................................. -7 Attachment E1 Summary .................................................. -8 Quick-Reference Guide ..................................................... -9 Surface Water Sampling Worksheet................................ -10 Surface Water Sample Chain of Custody Record............. -11 © 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson Spill Emergency Response Plan
Surface Water Sampling SOP: Specifications & Requirements G-2 Process: Surface Water Sampling
Personnel Required: • 1
Personal Protective
Equipment: • Safety Glasses
• Rubber Gloves
License Required: • None required
Common Hazards: • Drowning or submersion
• Slip, trip, and fall
• Exposure
• Insect/Wildlife
• Weather
• Boat/Watercraft
• Physical Strain or Injury
Safe Operation Guidelines: • Wear proper PPE
• Be aware of currents, depth, and unstable banks
• Do not eat, drink or smoke while sampling
• Avoid cross-contamination
• Label all samples clearly
Lab Contact Information Alpha Labs
(916) 686-5190
9090 Union Park Way #113
Elk Grove, CA 95624
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson Spill Emergency Response Plan
Surface Water Sampling SOP: Introduction & Overview G-3: Page 1 Surface water sampling helps to ensure water quality by identifying areas of concern and potential failure mechanisms that may impact surface waters or stormwater infrastructure in the service area.

Minimize Impacts
Surface water sampling allows for the proper evaluation of potential contamination following a sanitary sewer
spill.

Having a thorough understanding of the service area and its various challenges can help responders be better prepared to minimize the impacts of a spill on local surface waters and stormwater infrastructure.
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson Spill Emergency Response Plan
Surface Water Sampling SOP: Introduction & Overview G-3: Page 2 Before beginning the sampling process there are several important steps that must be taken to ensure that the samples collected are representative of the water quality in the area being monitored.

These steps include:

1. Gathering the necessary equipment:
• The surface water sampling worksheet, chain of custody, sampling pole, sample containers, and PPE are essential tools that must be prepared and organized before sampling can begin.

2. Donning appropriate personal protective equipment:
• To protect against exposure to potentially harmful contaminants and the sulfuric acid preservative in the Ammonia sample bottles, workers must wear gloves, eye protection, and other personal protective equipment, as needed.

3. Determining the point of spill entry into the waterway:
• It's important to locate the point at which any spill entered the waterway in order to collect the required samples: point of entry into the surface water, downstream, and upstream.

The approximate stream velocity and time since the spill flow to the surface water stopped should be determined to calculate the appropriate distance to move downstream to collect:

1. The downstream sample,

2. Move upstream to collect the spill entry point sample,

3. And move further upstream to collect the upstream or reference sample.
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson Spill Emergency Response Plan
Surface Water Sampling SOP: Equipment & Safety G-4
Personal Protective Equipment
Personal Protective Equipment (PPE) should be used when conducting surface water sampling. The PPE that is required includes:
• Gloves
• Eye Protection
Sampling Equipment
In addition to PPE, other sampling equipment is necessary:
• Sample Bottles & Containers
• Cooler with Ice, or Ice packs
• Sampling Pole, or
• Rope & Bucket
The use of PPE and proper sampling equipment is important for the safety of the sampler and for ensuring accurate and reliable sampling results. © 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson Spill Emergency Response Plan
Surface Water Sampling SOP: Before Sampling G-5: Page 1 Test Type
Sample Locations
Spill Area Downstream
of Spill
Upstream of
Spill
Drainage
Conveyance System
(as applicable)
Ammonia/
Nitrogen
1 pint with
H2SO4
1 pint with
H2SO4
1 pint with
H2SO4
1 pint with H2SO4
e. Coli 1 bacti bottle 1 bacti bottle 1 bacti bottle 1 bacti bottle Water samples must be collected in different bottles for various tests and then transported in a cooler with ice packs.

For each of the three sampling sites (plus drainage conveyance system as applicable), one bottle is needed for ammonia/nitrogen testing, and one bacti bottle is required for each type of bacteria being tested.

Additionally, one field blank sample is required for each constituent. Field blank sample bottles are filled with sterilized water during sampling to serve as quality control on the sampler's sampling methods.

Since the sample bottles contain sterilized water, bacteria and ammonia should not be present in the water. If the lab analysis shows the presence of bacteria or ammonia, it indicates that the sampler's method may not have been correct, and the other bacti samples may have been contaminated.

Surface Water Sampling – Preparation
Step 1 of 4
Prepare the cooler for sample storage by adding an instant ice pack, ice pack, or ice to keep the samples cold during transport to the lab.
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson Spill Emergency Response Plan
Surface Water Sampling SOP: Before Sampling G-5: Page 2 Step 2 of 4
Identify the point of the spill where the wastewater entered the waterway and take a photograph of this location with a reference point in the picture.

Step 3 of 4
Begin completing the Surface Water Sampling Worksheet
to record the relevant information about the sampling
location and collected samples.

Step 4 of 4
To determine which direction is upstream and
downstream for sample collection, you should observe the direction of water movement from the point of discharge. © 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson Spill Emergency Response Plan
Surface Water Sampling SOP: Surface Water Sampling G-6: Page 1 The purpose of this procedure is to provide a standard for collecting surface water samples to assess water quality, avoid contamination, and ensure that samples can be accurately labeled and transported to the lab for processing.

Notes:

Start by collecting downstream samples first.

In order to determine where the downstream sample is located in a stream, creek, or river, you will need to determine the velocity of the surface water. This can be accomplished through the use of a stream velocity meter or by measuring off a distance along the bank and timing how long it takes for a floating object to travel that distance.

Use the formula on the Surface Water Sampling Worksheet to calculate the stream velocity. Once known, determine the time that the spill has not been entering the surface water.

This, along with the stream velocity, will inform you how far downstream you need to travel to collect the downstream sample.
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson Spill Emergency Response Plan
Surface Water Sampling SOP: Surface Water Sampling G-6: Page 2 Step 1 of 9
Don the appropriate PPE from your sampling kit. This
should include latex or rubber gloves and safety glasses.

Step 2 of 9
Label all samples with their location (refer to table on G-8), your name, and the date and time they are collected.

Record this information on the surface water sampling
worksheet.

Step 3 of 9
Take photos of each sample location and ensure a reference point is visible in each photo. In the photo (left), the dock and sign serve as excellent reference points.
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson Spill Emergency Response Plan
Surface Water Sampling SOP: Surface Water Sampling G-6: Page 3 Step 4 of 9
Remove the seal from the Ammonia sample container just
prior to collecting your sample, as applicable.

To reduce the likelihood of contamination, remove the cap immediately before collecting each sample.

Step 5 of 9
To prevent sample contamination, do not allow the inside of the cap to touch anything while you are obtaining the sample.

Step 6 of 9
When filling the ammonia nitrogen sample bottle, don't
overfill it because it contains sulfuric acid. Sweep the bottle or dipper upstream and out of the water without disturbing the bottom sediment. Remember to leave the sulfuric acid in the bottle and avoid skin contact.
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson Spill Emergency Response Plan
Surface Water Sampling SOP: Surface Water Sampling G-6: Page 4 Step 7 of 9
Fill the Ammonia sample bottle to the fill line, and
immediately replace the cap. If there is no clear fill line, fill it to the “neck” of the bottle.

Step 8 of 9
Open the Bacteria sample container and allow water to
gently flow into the bottle just to the fill line.

Repeat the sampling process for all sample points, and provide a “field blank” sample using sterile water, which verifies the quality of the samples.

Step 9 of 9
Place all samples in the cooler on the ice pack. To ensure accurate analysis, the Bacti samples must be transported to the lab within 6 hours of the time of collection.
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson Spill Emergency Response Plan
Surface Water Sampling SOP: After Sampling G-7
Step 1 of 4: Documentation
All samples must be labeled with their location, your name, and the date and time they were collected. Refer to the state requirements found on the last page of this document.

Record this information on the chain of custody form and the surface water sampling worksheet.

Chain of Custody Record Surface Water Sampling Worksheet Step 2 of 4: Contact the Lab
Inform the lab that the following samples require processing: ammonia-nitrogen, and/or e. Coli. Provide any additional information the lab may require.

Step 3 of 4: Transport Samples
Place the samples in the cooler on the ice pack and transport them to the lab within 6 hours of collection time. Complete the chain of custody form and ensure all samples are properly secured during transport.

Step 4 of 4: Post Warning Signs
If directed by your supervisor or the county environmental health division, post warning signs in the affected area. Keep track of sign locations and remove warning signs and lift restrictions only when authorized to do so.
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson Spill Emergency Response Plan
Surface Water Sampling SOP: WDR Attachment E1 Summary G-8 The Enrollee shall collect receiving water samples
at the following locations:

Sampling of Flow in Drainage Conveyance System (DCS) Prior to Discharge Sampling Location Sampling Location Description
DCS-001 A point in a drainage conveyance system before the drainage conveyance system flow discharges into a receiving water.

Receiving Surface Water Sampling (RSW¹)
Sampling Location Sampling Location Description
RSW-001
Point of Discharge
A point in the receiving water where sewage initially enters the receiving water.

RSW-001U
Upstream of
Point of Discharge
A point in the receiving water, upstream of the point of sewage discharge, to capture ambient conditions absent of sewage discharge impacts.

RSW-001D
Downstream of
Point of Discharge
A point in the receiving water, downstream of the point of sewage discharge, where the spill material is fully mixed with the receiving water. ¹The Enrollee must use its best professional judgment to determine the upstream and downstream distances based on receiving water flow, accessibility to upstream/downstream waterbody banks, and size of visible sewage plume.
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson Spill Emergency Response Plan
Surface Water Sampling SOP: Quick Reference Guide G-9
Before Sampling:
-Sample Kit
-PPE
Sample Procedure:

After Sampling:

PREPARE PHOTOGRAPH
Take pictures of the
spill point.

PAPERWORK
Begin filling out the
Sample Worksheet
PPE
Put on the required
PPE
LABELS
Begin Labeling the
sample bottles
CAP
Keep the sample bottle
cap clean
SAMPLE
Take samples at each
location

FIELD BLANK
Use sterile water for a
field blank sample.

STORE SAMPLE
Place samples into
the cooler

PAPERWORK PAPERWORK
Complete the Chain
of Custody form
Complete the Sample
Worksheet
NOTIFY
Inform the Lab of the
incoming samples

DELIVER
Deliver the sampled
to the lab

POST SIGNS
Post warning signs
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson Spill Emergency Response Plan
Surface Water Sampling Worksheet G-10
Sample Date: Sample Time: ☐AM ☐PM Sample Location:

Sampler(s)’ Name(s):

Sampler(s)’ Signature(s):

What is being sampled?
☐Stream ☐Pond ☐Lake ☐River ☐Other:

If the spill was not actively entering the surface water during sampling:

A. Stream Velocity: CFS
B. How Long Has the spill NOT Been Entering the Surface Water? minutes X 60sec/min = seconds
C. How Far Downstream Did You Travel To Collect The SOURCE Sample? (A X C = Feet): feet
D. Explain why you travelled a different distance, if you did, to collect the source sample:

Weather at time of sampling:
☐Sunny ☐Overcast ☐Sprinkling ☐Raining
Was the spill actively entering the surface water during Sampling? ☐YES ☐NO If no, complete A-D in the gray box to the right.

Sample Location Sample
Label
# of
Samples*
Photo ID# of Sample
Location Visual Observations and/or Interferences
Drainage
Conveyance
DCS-001 2
Source RSW-001 2
Upstream RSW-001U 2
Downstream RSW-001D 2
Field Blank Field Blank 2

FINISH CHECKLIST NOTES / OBSERVATIONS
o All Samples Labeled with:
o Date: a six-digit number indicating the year, month, day of collection o Time: a four-digit number indicating military time of collection. e.g. 0954 o Sample Location: Drainage Conveyance, Source, Upstream, or Downstream o Samplers: each sampler is identified
o Parameter/preservative: analysis to be conducted for sample/sample preservation o Chain of Custody Completed
o Samples on Ice in Cooler
o Pictures Taken of Each Sample Location and the Photo ID/# Noted Above o All Sampling Equipment Collected
Corporate Laboratory ELAP 1551 707-468-0401 North Bay Lab (NB) ELAP 2303 707-769-3128 208 Mason Street, Ukiah CA 95482 737 Southpoint Blvd, Unit D, Petaluma CA 94954 Los Angeles Lab (LA) ELAP 3091 424-267-5032 Bay Area Lab (BAL) ELAP 2728 925-828-6226 1230 E 223rd St #205, Carson CA 90745 262 Rickenbacker Circle, Livermore CA 94551 San Diego Lab (SD) ELAP 3055 760-930-2555 Central Valley Lab (CV) ELAP 2922 916-686-5190 2722 Loker Ave West, Ste A, Carlsbad CA 92010 9090 Union Park Way #113, Elk Grove CA 95624 Lab No. Pg of Company: Contact: Project Name:

Attn: Email Address: Project Number:

Phone: Phone: PO Number:

Physical Address: Frequency:

Email address:

Field Sampler - Printed Name and Signature:

State System No:

GeoTracker
EDF Report
Facility Global ID No:

Sampling Company Log Code:

CA DDW CLIP
Data Upload
Date Additional Requirements
____ days
Bottle size
250mL500mL1LHalf Gbacti
DDW CLIP Code
[email protected]
Container Preservation Matrix
Other
Report to Invoice to (if different) Project Info Analysis Request TAT Temp °C Glass bottle None HCl HNO3 Na2S2O3 Other Drinking Water ↓
Poly bottle
↓
Glass jarSoilOther
Ukiah
Livermore (BAL)
Elk Grove (CV)
Petaluma (NB)
Carlsbad (SD)
Carson (LA)
Standard
10-day
RUSH:
5-day 25%
2-day 75%
Relinquished by Received by Time Wastewater
Sample Identification Sampled on
Time Date
40mL vialOther
Chain of Custody Record
Reports and Invoices delivered by email as PDF files
Total Number of Containers per Sample ID
G-11
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 INSERT TAB:

Tab H: POST-SPILL
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson Spill Emergency Response Plan
Post-Spill Assessment H-1: Page 1

SPILL LOCATION
Spill location name:

Address of spill:

NOTIFICATION AND COMMUNICATION PROCEDURES
Were notification procedures adhered to? ☐ Yes ☐ No
Were notification procedures effective? ☐ Yes ☐ No

RESPONSE PROCEDURES
Were response time goals met? ☐ Yes ☐ No
Were safety procedures adhered to? ☐ Yes ☐ No
Were safety procedures effective? ☐ Yes ☐ No
Were initial response procedures adhered to? ☐ Yes ☐ No Were initial response procedures effective? ☐ Yes ☐ No
Were containment procedures adhered to? ☐ Yes ☐ No
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson Spill Emergency Response Plan
Post-Spill Assessment H-1: Page 2
RESPONSE PROCEDURES (continued)
Were containment procedures effective? ☐ Yes ☐ No
Were clean up and recovery procedures adhered to? ☐ Yes ☐ No Were clean up and recovery procedures effective? ☐ Yes ☐ No Were sewer back up procedures adhered to? ☐ Yes ☐ No
Were sewer back up procedures effective? ☐ Yes ☐ No
Were chain of custody procedures adhered to? ☐ Yes ☐ No Was failure analysis investigation performed and documented? ☐ Yes ☐ No

REPORTING AND NOTIFICATION PROCEDURES
Were reporting and notification timeline requirements met? ☐ Yes ☐ No © 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson Spill Emergency Response Plan
Post-Spill Assessment H-1: Page 3

DOCUMENTATION
Was spill file created? ☐ Yes ☐ No
Was QA/QC performed to ensure field data matched CIWQS data? ☐ Yes ☐ No

RECOMMENDED CHANGES
☐ N/A

ATTENDEES

FACILITATED BY
Date:
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson Spill Emergency Response Plan
Collection System Failure Analysis H-2: Page 1

OFFICE USE ONLY
Incident Report # Prepared By
Spill/Backup Information
Cause
Summary of Historical Spills/Backups/Service Calls/Other Problems Date Cause Date Last Cleaned Crew
Records Reviewed By: Record Review Date:

Summary of CCTV Information
CCTV Inspection Date File Name/Number
CCTV File Reviewed By CCTV Review Date
Observations
Go to Page 2
© 2004-2023 DKF Solutions Group, LLC. All rights reserved. Licensed to City of Jackson for City use only. 8-17-23 City of Jackson Spill Emergency Response Plan
Collection System Failure Analysis H-2: Page 2
Recommendations
✓ Type Specific Actions Who is
Responsible?
Completion
Deadline
Who Will Verify
Completion?
No Changes or
Repairs Required n/a n/a n/a n/a
Added sewer to
preventive
maintenance
program
Adjusted
schedule/method
of preventive
maintenance
Enforcement
action against FOG
source
Plan rehabilitation
or replacement of
sewer
Repaired facilities
or replaced defect
Change(s) to Spill
Response
Procedures
Training
Misc.

Comments/Notes:

Reviewed By: Review Date:

City of Jackson
Sewer System Management Plan, May 2026 pg. 73
Appendix E: Technical Report
Technical Report
Outline
(updated 3/2026)

1. Introduction
• Agency/system description

2. Spill Technical Report - Contents and Responses
a. Causes and Circumstances of the Spill
• i. Detailed explanation of how and when the spill was discovered • ii. Diagram indicating spill "Cause point", appearance point, and final destination (use attachments, maps, and diagrams as needed)
• iii. Detailed description of methodology employed and available data used to calculate the spill volume and any volume recovered
• iv. Detailed description of the cause(s) of the spill • v. Copies of the original field crew records used to document the spill (attachment) • vi. Historical maintenance records for the lines involved in the cause of the spill (attachment) b. Agency's Response to the Spill
• i. Chronological narrative description of actions taken by the agency to terminate the spill • ii. Description of how the SERP was implemented to respond to and mitigate any impacts of the spill • iii. Final corrective action(s) completed and/or planned, including a schedule for actions not yet completed c. Water Quality Monitoring
• i. Description of all water quality sampling activities conducted, including analytical results and evaluation of the results
• ii. Detailed location map illustrating all water quality sampling points

3. Conclusion
City of Jackson
Sewer System Management Plan, May 2026 pg. 74
Appendix F: Annual Performance Reports
The following is a list of the available Annual Performance Reports prepared by the City. • FY 2017-18 Annual Performance Review
• FY 2018-19 Annual Performance Review
• FY 2019-20 Annual Performance Review
• FY 2020-21 Annual Performance Review
• FY 2021-22 Annual Performance Review
• FY 2022-23 Annual Performance Review
• FY 2023-24 Annual Performance Review
• FY 2024-25 Annual Performance Review
City of Jackson
Sewer System Management Plan, May 2026 pg. 75
Appendix G: FOG Control Program Documents
G-1: Instructions and Examples for a Fats, Oils and Grease Best Management Plan G-2: Grease Trap and Grease Interceptor Inspection Form G-3: Grease Trap/Interceptor Cleaning Log
City of Jackson, CA Sanitary Sewer Management Plan
Instructions and Examples for a Fats, Oils and Grease Best Management Plan (Please note examples are illustrative and are not necessarily applicable for your facility) DEFINITIONS:

FOG - Fats, Oils and Grease
BMP - Best Management Plan
Food Service Establishments – all food service operations or retail food establishments that produce, or may produce FOG containing wastewater that is discharged, directly or indirectly, to the City of Jackson sewer system.

Grease Interceptor – a device located underground and outside of a food service facility designed to collect, contain or remove food wastes and grease from the wastewater while allowing the balance of the liquid waste to discharge to the wastewater collection system by gravity. Interceptors shall have at least one inspection hatch on the top surface to facilitate inspection, cleaning and maintenance.

Grease Trap – a device located in a food service facility or under a sink designed to collect, contain or remove food wastes and grease form the wastewater while allowing the balance of the liquid waste to discharge to the wastewater collection system by gravity. Traps shall have a removable lid on the top surface to facilitate inspection, cleaning and maintenance.

EXAMPLES:

Item 1 – List FOG sources and handling/cleaning practices to minimize discharge Food wastes form salad dressings, Employees instructed to scrape food wastes
butter, fats and grease from meat. into trash prior to cleaning dishes.

Food preparation Employees instructed to scrape all
food wastes into trash.

Grease from cooking (grill troughs, Employees instructed to dump waste grease deep fryer, hood filters, etc.) into barrel for off-site disposal.

Item 2 – List any additional practices to minimize FOG discharges or buildup in sewer lines.

Employees have been instructed to use paper towels to wipe grease from items such as grill utensils and cooking pans prior to washing.

Recently posted “NO GREASE” signs above the three-compartment sink and mop sinks.

A separate sign explains the garbage disposal is not routed to the grease trap or interceptor.

All new employees will review our BMP.

Evaluated and implemented menu changes (such as changing to baked fries) to limit FOG generation.

Employees have been instructed to conserve water; this will allow the grease trap or grease interceptor to work more efficiently.

Employees have been trained to use the proper concentrations of cleaners and soaps to improve grease trap or grease interceptor effectiveness.

Using dishwashing detergents specifically designed to allow optimal separation of grease in the grease trap or grease interceptor.

Item 3 – List routine inspection and maintenance procedures of the grease trap or interceptor:

The condition of the grease trap or grease interceptor will be checked each time it is cleaned. If the condition is not satisfactory, notify the kitchen manager.

Certification Statement
Authorized Facility Representative shall sign their name, title and date. The completed FOG BMP and associated documents must be kept on-site and must be available for review by the City Inspector or a copy submitted to the City upon request.

All BMP’s shall be kept with the Grease Trap/Interceptor Cleaning Logs for a minimum of 3 years. The on-site copy of the cleaning log and BMP are subject to review by Amador County Environmental Health Department or by the City of Jackson Sewer Department upon request.

For more information please call the City of Jackson at (209) 223-1646.

City of Jackson, CA Sanitary Sewer Management Plan
Grease Trap and Grease Interceptor Inspection Form
Inspector: Establishment:

Signature: Address:

Date: Contact Name:

Time Inspection Started: Phone:

Time Inspection Completed:

Field data Compliance

1. The establishment has implemented a training program to ensure that the BMP’s are followed.2. The establishment recycles waste cooking oil and can provide records of this.

3. Water temperatures at all sinks, especially the pre-rinse sink before the mechanical dishwasher or the sinks in the three-sink system, are less than 140F. Measure and record the temperature.

4. The establishment “dry wipes” pots, pans, and dishware prior to rinsing and washing.

5. Food waste is properly disposed of and is not discharged to the grease traps or interceptors.

6. The grease trap or interceptor is cleaned and maintained regularly. Note and record the frequency of cleaning and maintenance.

7. The cleaning frequency of the grease trap or interceptor is documented on a maintenance or cleaning log. Obtain a copy of the document.

8. The grease trap or interceptor does not contain greater than 1/3 the depth in grease accumulation. Estimate and record amount of grease in the unit.

9. The grease trap or interceptor does not contain greater than 1/4 the depth in sediment accumulation. Estimate and record amount of sediment if possible.

10. Outdoor grease and oil storage containers are covered and do not show signs of overflowing.

11. Grease and oil storage containers are protected from discharge to storm drains.

12. The exhaust system filters are cleaned regularly, which is documented by cleaning records. Note and record frequency of cleaning.

Additional Notes and Comments:

Date Cleaned: Gallons of Grease
Removed*:

Grease Trap/Interceptor
Condition**:
* Record the gallons of grease removed, NOT the total volume of liquid removed. ** Mark the Trap/Interceptor Condition as “Satisfactory or Unsatisfactory”. If the condition is unsatisfactory, indicate the action taken to correct the problem.

I CERTIFY UNDER PENALTY OF LAW THAT I HAVE PERSONALLY EXAMINED

AND AM FAMILIAR WITH THE INFORMATION ON THIS FORM AND BELIEVE THE INFORMATION IS TRUE, ACCURATE AND COMPLETE.

Authorized Representative Signature Title Date
______________________________ ________________________

CITY OF JACKSON
Council Meeting Memorandum
Monday April 27, 2026 – 6:30 PM Regular Meeting
To: Honorable Mayor and Members of the City Council
From: Carl Simpson, City Manager
Date: April 23, 2026
Agenda Item #3j: Approve submission of Encampment Resolution Funding Program grant application.

RECOMMENDATION:

That the City Council receive, review and approve resolution No.2026-15 authorizing the submission of an application of the Encampment Resolution Funding (ERF) Program grant.

DISCUSSION:

Over the years the City of Jackson has seen an increase in its unhoused population. This shift has created a range of challenges affecting not only unsheltered individuals, but also local businesses, residents, and City staff tasked with managing related impacts.

The California Department of Housing and Community Development (HCD) has released a Notice of Funding Availability (NOFA), making $93 million available to California cities, counties, and Continuums of Care (CoCs) for Fiscal Year 2025-2026 through rolling application process. Applications will be accepted until June 30, 2026, or until funds are exhausted, whichever occurs first.

ERF Round 5 will fund actionable, person-centered local proposals that meet the NOFA’s threshold requirements. The program is designed to support the transition of individuals from encampments into stable housing while addressing immediate health and safety needs.

Attachments:

Resolution #2026-15
Resolution No. 2026-15

A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF JACKSON AUTHORIZING AN

APPLICATION FOR THE ENCAMPMENT RESOLUTION FUNDING PROGRAM (ERF) ROUND

5. ERF ROUND 5 WILL FUND ACTIONABLE, PERSON-CENTERED, LOCAL PROPOSALS

THAT MEET THIS NOFAS THRESHOLD REQUIREMENTS TO PROVIDE STABLE HOUSING

AND ADDRESS THE IMMEDIATE HEALTH AND SAFETY NEEDS OF THE INDIVIDUALS RESIDING IN SPECFIC ENCAMPMENTS.

WHEREAS, the Department of Housing and Community Development ("HCD") has issued a Notice of Funding Availability ("NOFA") for the Encampment Resolution Funding Program (ERP) Round 5 dated March 27, 2026, for the purpose of funding actionable, person centered, local proposals and address the immediate health and safety needs of the individuals residing in specific encampments; and WHEREAS, the City of Jackson ("City" or "Applicant"), desires to apply for the encampment funds to acquire and convert the property to a low barrier shelter.; and WHEREAS, the City of Jackson is the sole applicant and has agreed that it will be fully responsible and comply with obligations from the Encampment Resolution Funding program, and that the City shall bear financial, operational, and programmatic responsibility for the ongoing implementation of the project; and
NOW, THEREFORE, BE IT RESOLVED by the City Council of the City of Jackson that:

The City Manager is hereby authorized and directed to submit an application to HCD and participate in the Encampment Resolution Funding Program, for a total amount not to exceed $3,000,000.

The City Manager is authorized to take the requisite steps to submit an application for the Project for an award from the Encampment Resolution Funding Program Round 5.

The City Manager shall negotiate any and all documents required or deemed necessary to receive or secure the Encampment Resolution Funding and to complete participation in the program.

The City of Jackson will commit to acting as the fiscal agent, and service provider, directly or through a third-party professional services agreement, will assume full and exclusive responsibility for all administrative, financial and operational obligations of the Encampment Resolution Funding Program.

This includes and is not limited to:

1. Preparation and submission of the ERP application including all exhibits, attestations, and attachments:

2. Execution and management of the Standard Agreement with the California Department of Housing and community Development (HCD);

3. Financial Management, including budget oversight, fiscal reporting, disbursement requests, and fund accounting in compliance with state guidelines;

4. Program compliance, including tenant restrictions, tenant eligibility verification, affordability term enforcement and service documentation;

5. All legal and regulatory requirements filings, including CEQA determinations, prevailing wage compliance, procurement records, and insurance coverage;

6. Delivery of all supportive services, including case management, behavioral health coordination, and HUD-VASH integration;

7. Monitoring, auditing, and reporting, including regular performance reports to HCD and maintenance of audit-ready records throughout the affordability period.

PASSED AND ADOPTED this 27th day of April 2026, by the following vote:

AYES:

NOES:

ABSENT:

ABSTAIN:

CITY OF JACKSON
______________________
Chad Simmons, Mayor
ATTEST:
_________________________________
John Georgette, City Clerk
3 Amador Child
Care Council
Local Child Care Planning Council
2 Council Members
Confidential
Erica Miller–Chairperson
Aimee Breazeal –Vice Chairperson
Karen Frazier–Secretary
Kindy Kelly
Mia Huss
Michelle Loffswold
Deborah Moore
The mission of the Amador Child Care
Co u n c il (ACCC) is to s u p p o rt th e
d e ve lo p m e n t o f affordable , accessible ,
quality child care th a t p ro m o te s th e
s u c c e s s o f a ll c h ild re n , th e ir fa m ilie s , a n d th e e c o n o m y o f o u r c o m m u n itie s . We
e n vis io n a n in c lu s ive , a ffo rd a b le c h ild c a re s ys te m th a t p ro m o te s h e a lth y, s u c c e s s fu l c h ild re n a n d yo u th .

Amador Child Care Council
Confidential
The Roots of Our Mission: History & Authority
1990: Federal Foundation
Congress enacted the Child Care and Development Block Grant and the Title IV-A At-Risk Child Care Program. ● Purpose: To increase the availability, affordability, and quality of child care nationwide. 1991: State Activation
The California Department of Education (CDE) offered funding to every county to establish Local Child Care Planning Councils. ● Mandate: To develop county-wide priorities for child care and development services specifically for low-income families. ● Early Childhood Development Act of 2020 restructured early childhood services. The state aimed to build an integrated system that serves the “whole child” by aligning child care with other social services already housed with the California Department of Social Services (went into effect July 1, 2021).

Our Local Role
The Amador County Office of Education (ACOE) is the entity tasked by the CDE and CDSS to lead this work within our community.

Highlights from our Local Child Care Planning Council Needs Assessment:
● W e have about 300 babies born in Amador County each year. ● Number of children 0-5 year in families who receive public assistance (including CalFresh, housing support, and Medical benefits): 938
● In 2024-2025 The Resource Connection R&R received a total of 239 requests for child care. ● In 2024-2025
● Infants and Toddlers receiving special education services: 49 ● Number of Children under Protective Services:
○ 0-36 months: 12
○ 3 and 4 year olds: 6
Enrollment Waitlist
Head Start/Early Head Start 60 18
California State Preschool 87 39
122 TK (ACUSD) 57 (The Resource Connection R&R)
Amador Child Care Council: Strategic Vision (2025-2030) Who We Are
A collaborative partnership of community members, consumers, providers, and public agencies dedicated to coordinating high-quality early care and education.

Our Core Mission
To partner with the community to identify needs and promote affordable, accessible, and quality learning options across Amador County.

The 2025–2030 Comprehensive Child Care Plan
The Council’s sixth formal strategic plan, serving as a roadmap for the next five years:
● Data-Driven: Based on the gaps identified in the 2025-2030 Needs Assessment. ● Action-Oriented: Outlines specific steps and accountability measures to enhance child care access. ● Unified Direction: Provides a framework for the entire community to improve early childhood outcomes.

ACCC Comprehensive Plan LPC: GOAL #1: Increase Child Care Access, Affordability, and Facility Development ● Partner with City Councils to support zoning and licensing reforms that enable new child care facility development. ● Support partner organizations in recruiting new family child care providers. ● Collaborate with local businesses to explore child care facility expansion. ● Advocate for policy changes to improve affordability, including changes to the subsidized payment system. ● Support providers in accessing resources to provide infant and toddler care in addition to overnight/weekend care.

ACCC Comprehensive Plan LPC: GOAL #2: Strengthen Employer Support for Working Families ● Develop an Employer Toolkit with strategies for supporting working parents. ● Distribute the toolkit to at least 10 local businesses. ● Facilitate employer roundtable discussions on family-friendly policies. ● Encourage implementation of employer-sponsored soltuions. ● Presentation to the Chamber of Commerce a minimum of twice a year. ● Utilize inserts to share information with community members regarding child care and family resources within the county.

ACCC Comprehensive Plan LPC: GOAL #3: Support the Early Learning Field ● Participate in at least four state and federal advocacy efforts annually, such as writing letters, attending meetings, and collaborating with child care organizations.
● Launch a social media campaign on the importance of child care. ● Increase provider access to professional development by collaborating with state, regional, and local efforts, such as Quality for Kids.
● Share survey data with local organizations to tailor professional development opportunities. 10 Questions?
11 Thank you!
Contact our team
209-257-5338
Confidential
City of Jackson
Council Meeting Memorandum
Monday, April 27, 2026 – 6:30 PM Regular Meeting
Honorable Mayor and Members of the City Council
Erin Ventura, Contract City Planner
Carl Simpson, City Manager
April 22, 2026
Façade Improvement Program Application – 20 Main Street To:

From:

Via:

Date:

Agenda Item #6c:

Recommendation:

Staff recommends that the City Council approve a request from Jay Michel for $2433.81 in Façade Improvement Program funds to assist with the replacement of the existing awning at 20 Main Street.

Background and Discussion:

In 2010, the City Council established the Façade Improvement Program to assist business owners with enhancing the appearance of commercial building façades, signage, and awnings throughout the City. Under the program, eligible applicants may receive up to $2,500 in City funds to support qualifying façade improvement projects.

Jay Michel has requested Façade Improvement Program funds of $2433.81 to cover the total cost to install a new awning to replace the existing damaged awning.

Staff is recommending that the City Council award $2433.81 in Façade Grant Improvement Program funds to Jay Michel, the owner of the building.

City of Jackson
33 Broadway
Jackson, California 95642
Telephone: (209) 223-1646
Facsimile: (209) 223-3141
E-mail: [email protected]
Application for Commission/Committee
Appointed by the Jackson City Council
Name of Commission/Committee: P l 0. an,' n fl C. om m , · s s J 'o a NOTE: To serve on the City Council, applicants must reside within city limits and are registered to vote.

Applicant's Name: M; k e.2) 2 i'vod'l c, v, ·c.

Residence Address:. __
Mailing Address (if different): _____________________ _ Phone: Home _______ Business _________ Cell
Email:

Occupation: Bus; ne.ss O'-0Qe.r
How long have you lived in Jackson? S � e.a. r .S And/or Amador County ___ _ Previous volunteer organization or commission/committee experience and your role:

Pl�.se. Se.e. o.t...,C\ched
Reasons for wishing to serve on this body: ________________ _ Pleo..se See. o.t+cu,hecl
Qualifications for serving on this body: P le.4Se. .See. a. �ohe.d A_dditional sheets may be attached if more space is required Signature Date
~~ Please return to City Clerk, City of Jackson, 33 Broadway, Jackson, CA 95642 ~~ Previous Volunteer Organizations
I represented the City of Jackson on the official sister-city delegation to Herceg Novi and Trebinje, helping strengthen cultural and economic ties abroad. I have volunteered at St.

Sava Mission, supporting community programs such as summer camp and other youth activities. I am also active in the Jackson Lions Club and regularly contribute to local initiatives, including Argonaut High School.

Reasons for Wishing to Serve on This Body
As a Main Street business owner,.I have a strong personal investment in Jackson's longterm vitality and economic health. I believe thoughtful planning and responsible development are essential to strengthening our local economy while preserving the historic character that defines our community.

I want to play an active role in shaping Jackson's future by supporting balanced growth, encouraging local business opportunity, and ensuring that development decisions reflect the values and identity of our town.

Qualifications for Serving on This Bodv
• Main Street business owner with practical experience navigating local regulations, zoning considerations, and economic conditions
• Active civic volunteer with ongoing involvement in community initiatives • Representative of the City of Jackson through participation in the sister-city delegation • Strong appreciation for historic preservation, infrastructure planning, and responsible commercial growth
• Long-term commitment to Jackson's prosperity as both a resident and business owner City of Jackson
33 Broadway
Jackson, California 95642
Telephone: (209) 223-1646
Facsimile: (209) 223-3141
E-mail: [email protected]
Application for Commission/Committee
Appointed by the Jackson City Council
Name of Commission/Committee: P{t01f\ih.j Col,,,t""11S5�0V\ Applicant's Name: __ (_a...>L\f __ _,.G=i ..... \>:_,_i""..,a..(q_11.___,,"-. ------------­ Residence Address: - .. -�
Mailing Address (if different):_
Phone (horn\. (busines _cell) $"'1M-<- CI.-S :Pus-� ...f:4.-) Occupation: Ore,
c0.:lion& !v\o,.'h�.f(" "f-- 1.e<eS<'\1
::, Plttl(. �r £Glwi;ly bi-l.SJl-t.l�5'
How long have you lived in Jackson Z>O t yeA<S and/or Amador County 5C!M{, ( b<9fvt �.f C: a"4\ Previous volunteer organization or commission/committee experience and your role:
(e1v._otetl J
� ( � OI.M-f" -Q. e-i . �lOr "'-r k,.._ vti"O( �f
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R�
asons for wishing to serve on �is body: l bOI.� k,et'.' t�cou✓� to JPif\ t\'�� ,�\).e by """Y 4,q�;ly qr.,d 5aiw,.. loo�( l-eodA(5 l?eetttA� sf Q! !'Ott .!:e,,r �rtt ·{ o Mi' � f- Pl� an/A · :/ity to t:l5,k:: 1(..(lc:;i, �W Cl f'el) i9v\S � �CV'I C (Q\.t�c,\ �if � � ,i{. 01.-\ {r ovi· (�cto,r °'"'� reGLd-- rt.Ce.re�, 1 �o''6 co\l� kv:t( c1v,1 ���l-\Uri'� U)U.(Se_:7 (;1£,)d h&<� LC¼O ll{tt"AadwV\ k:t11ow�dd ,. l4.dditional sheets of paper may be submitted if more space is required - Lff � !2-0 2- {p
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~~ Please return to City Clerk, City of Jackson, 33 Broadway, Jackson, CA 95642 - m�:�.�:�w
BY: O.:.�t.

City of Jackson
33 Broadway
Jackson, CA 95642
Telephone: (209) 223-1646
Facsimile: (209) 223-3141
E-mail: [email protected]�ca.us
Application for Commission/ Committee
Appointed by the Jackson City Council
i
Name of Commission Committee: -Planning ----=--Commissio -----n ----------------- Applicants Name:--'-Ka.:....nd__i_T_ho_m_p__._
s_on ____________________________ _
Residence Address:

Mailing Address (if different)--"'-s=ame��a=s�a=b--=-o-'-ve;::;.._ _____________________ _ Phone: Home__,_N.:..=o:..:..;n=e __________ Business Cell_ Email address:

Occupation: Real Estate Broker/Owner
How long have you lived in Jackson? my whole life And/ or Amador County_s_a_m_e ______ _ Previous volunteer organization or commission/committee experience and your role:

I held a seat on the Amador County Unified School Board of Trustees for 6 years. For four years I was Board Clerk And the last two years, I held the position of Board President. I am a Director for Lodi Association of Realtors Board.

I also hold the position of Amador Youth Basketball Board President and have for the last 6 years.

Qualifications for serving on this body: ________________________ _ I am the Broker/Owner of Berkshire Hathaway HomeServices Divine Properties and Divine Properties Property Managment and bave been actively involved io real estate and pcapecty management since 2011 I ave�see a large portfolio of residential and commercial properties, including multifamily units, retail spaces, storage facilities, and homeowner associations. Through this work, I have developed a strong understanding of land use, zoning, tenant and owner relations, and the practical impacts of local regulations. I am also a Certified Commercial Agent and a member o the CCIM Institute, which has further strengthened my knowledge of commercial development and investment. I believe my experience in the real estate industry in commercial, residential, land and mixed-use would add value to the City of Jackson Plaftf'ttt � Ve,t,O<lov,oOF .. ,,.

Signature · • · Date 312612026
~---- Please return to City Clerk, City of Jackson, 33 Broadway, Jackson, CA 95642