Upset Reporting Form

When an Upset is detected – no matter how small – it must be reported within 24 hours of its discovery to DEQ’s Water Quality Enforcement by using the online form below (the preferred method), by phone at (501) 682-0624, or by email at ssoadeq@adeq.state.ar.us. This initial 24-hour report should include the following information:

  • Permit Number
  • Location of overflow (manhole number or street address)
  • The receiving water (if applicable)
  • Cause of overflow (if known)
  • Estimated volume of overflow so far
  • Total duration of the overflow

If the “total duration of the overflow” is not known when the 24-hour Upset online report is submitted, then a follow-up report (5-day report) giving a detailed account of the overflow and the steps taken to resolve it must be submitted within 5 days of the overflow’s discovery. This report can be submitted by email at ssoadeq@adeq.state.ar.us or by mail (include Attn: Water Quality Enforcement).

Online Upset Reporting Form


*Asterisk indicates item is mandatory; all others are optional.

Facility/Permit Information
Date/Time Overflow Range
Location Information
  • Provide address and manhole number if numbered.
  • Include where the overflow went into a yard, ditch, stream, storm sewer, building, or other.
  • Be as specific as possible.
Description of Problem (check all items that apply)

Type of Overflow


Cause of Overflow

 
Environmental Damage (check all items that apply)
Action Taken (check all items that apply)

Short term and long-term action, including cleanup and any plans to remediate I & I.

 
Reported By

I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for knowing violations.



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