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CSOs flood waterways with contaminants including microbial pathogens, suspended solids, chemicals, trash, and nutrients that deplete dissolved oxygen. Microbial pathogens and toxics can be present in CSOs at levels that pose risks to human health.
The cons of combined sewer systems include: Polluted stormwater can flow into natural bodies of water and streets. A large intake of fluid to process at treatment plants. The large size of the pipeline can be an encumbrance.
Sanitary sewers are different than combined sewers, which are designed to collect large volumes of stormwater in addition to sewage and industrial wastewater. Occasionally, sanitary sewers will release raw sewage. These types of releases are called sanitary sewer overflows (SSOs).
Combined sewer overflows (CSOs) were developed as overflow valves to reduce the risk of sewage backing up during heavy rainfall. Overflows of diluted sewage during heavy rainfall are not a sign that the system is faulty.
Combined sewer systems (CSS) that carry stormwater, domestic sewage and industrial wastewater can be overwhelmed by rainwater and melting snow. These CSSs can send untreated waste into nearby waterbodies through combined sewer overflows.
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CSOs are a major water pollution and public health concern for approximately 700 communities in the United States. CSOs can contain bacteria, debris, and other hazardous substances that can be harmful to people, pets, and wildlife.

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