WQCS00258_Regional Office Historical File Pre 2018 (3)

I
I—
J
TOWN OF TROUTMAN
HIGH PRIORITY / PROBLEM SEWER LINE
2013
Location
Last Stoppage
Inspected
Jetted
Technician
New St. ROW
8 / 2012
4 / 2013
11 / 2013
TH
7 / 2013
9 / 2013
400 N. Eastway Dr
6 / 2011
1 / 2013
11 / 2013
TH
9 / 2013
Thomas St. ROW
3 / 2011
4 / 2013
11 / 2013
TH
7 / 2013
9 / 2013
Cedar Ln. ROW
2 / 2011
1 / 2013
11 / 2013
TH
7 / 2013
9 / 2013
Mill Village
9 / 2010
1 / 2013
12 / 2013
TH
9 / 2013
S00 Georgie St
7 / 2010
1 / 2013
12 / 2013
TH
9 / 2013
Food Lion / Bank
4 / 2010
1 / 2013
12 / 2013
TH
9 / 2013
Calvin / Wagner
11 / 2009
1 / 2013
12 / 2013
TH
9 / 2013
Patterson / New
6 / 2010
1 / 2013
12 /2013
TH
St.
9 / 2013

i�Qcsv�'25IQ 0C
sS 1I/�/I
704--5.7,q-X00 F1,.,;A - 3-1vo
f
to 3oF z 5
IiroJrnq'% /1�G As it6
3 Inspection Checklist
eANOr
P5 General Information
1.
2.
3.
4.
5.
Number of Pump stations ` 5'
SCADA system PS
Telemetry PS
Audible and Visual only
Generators Permanent
a. Frequency tested wo
Generators Portable .3
A. Quick -connect plugin.
PS
OL4
/
A" I tY
o:IJcv.-�aw�,h cT1� b 77
B. Frequency tested ol— �y % o �.Ls�f "r 1�5/-re,_� V_
yPump stations served by --by-satre-generators'
6.
ORC_ A A c.L i Pl" `°� B-ORC 8,'..4y CS-
?oi+-52 o© s0
C z '20 'IC2-'7t.-S(J
Sewer Use drdanance L.,-'
Enforcements Last Yea
FOG Program 7 v V1CLll✓ a ti �c-t� I �� (P `r � �i �. s
s! scc1. �a'R
Inspections
V-1
Public ED How
Annual Report Date -;,of 6,
Root Control Program p �fi �,��'� s e V1 I�'.� , <,:, f ; sf� r a of ,,.,, I c, f
CIP Budget $
IJ7ev000 for 201 S
Documentation of All _�,*M 14 <r 44,
1. Line Cleaning (10%) ; 16- �' D 6
9 -if788 �� �p7- 3�' �j,
2. High priority lines' (6 mos)I�e t 6 r�y��� ��.- + �%9 aye: A
o "9f,o�:L�,;P<;•�.'1ac`'�•isF`
.-Y•7 -a�.��,,,7iw��e4stem observation annual
3.vSyI sC.,04 2. J aY/y � l H No:v
Ils
4.46W mowing
/' -'� O r1 L✓�(.I J Y J �.�� �1��•�"/.7VAl��A4��`ir�G ��lvd'G

,AA fJ•I��' -' V�"/f� •�,r`"�r�-1l� NS� �`�LI En tcl A�C�[ ,
Review logs for PS O&M W,1-(<1 4 o-('s —10 tAmf
Reportable Spills
jvno
Repeat Location/Cause
�ts+
Non reportable spills I
yryr- o rc'S d I I J
Customer complaints f 7 j
Spare parts inventory �a y� ;,M. `f*s a I l r A ,,es� LJ"� �✓f
L,M--ap of system % complete

Pump Station Inspection Checklist
Name 5. � .,,,� VV0 p o/ No of Pumps 1 `�
2�
Address Operational l
2
Capacity of each (gpm)
1
2
Runtime hour meter reading average
1.
2
Housekeeping, -
Secure ..//
Accessible
Identification Signage
Inspection Schedule Daily Weekly
Wet Well — Floats
Free of debris
High water float _ �-; y,� m ✓� .1 v+�a� .✓a l �P sc� �:lcl ri -�a..
Telemetry s v --t
Audio -Visual
SCADA
Alarm system tested for communications
Emergency power Generator Portable Quick -connect Onsite
Fuel tank . F ,, J , Gallons per hour usage rate
Testing schedule Automatic
Bypass pumping configured
Overflow piping
Manhole upstream
Inspection Logs

Collection System Inspection Checklist
S' oles- Lines- Right Of Way- Aerials
1. Manhole location or address ���=' u10
Cover present -gent 66d cover above grade - vent screened
Visible signs of overflow "' F
Sinkholes and depressions
Good condition properly seated /
Bypass structures or pipes present �
Invert in good condition Size 1 inches Pipe capaci l/3/a diameter.
Line free flowing and unrestricted ✓ _ J
Excessive grease, roots, or sand J
2. Right of Way - location or name of outfall in
Accessible
Free of sinkholes or depressio I/
No evidence of leakage
Free of non -utility motorized traffic
3. Aerials - High Priority lines
Exposed line of ductile material
Water crossings and supports in good condition
Level of debris on or behind line
Free of damage
Right of Way mowing records
Visual inspection of off street lines
General observation of system (annual)

PA
Pump Station Inspection Checklist
Name ` j �/j ` ,,7 No of Pumps 1 '
2
Address
Housekeepin
Secure /
Accessible
Identification Signage L"
Inspection Schedule Daily
Weekly p/
Operational l t/
2
Capacity of each (gpm)
1
2
Runtime hour meter reading average
1
2
Wet Well — Floats
F f d b' -- --v 0 A�, ,�z. .�.._� z al s �, i-r -1110 9!�7
ree o ens
High water float
Telemetry / f
Audio -Visual. �/✓ v =-'� ��, ,�
SCADA
Alarm system tested for communications �J
Emergency power Generator
Fuel tank .
Testing schedule
Bypass pumping configured
Overflow piping
Manhole upstream
Inspection Logs
otaQuick-connect` Ons'rte
Ga bper hour usage rate
Automatic

Collection System Inspection Checklist
Manholes- Lines- Right Of Way- Aerials
1. Manhole location or address A ; -/A/(; 0
Cover present - vent and cover above grade - vent screened
Visible signs of overflow n/
Sinkholes and depressions
Good condition properly seated
Bypass structures or pipes present
Invert in good condition Size -inc s Pipe capaci 1% '/2 3/a diameter.
Line free flowing and unrestricted
Excessive grease, roots, or sand
2. Right of Way - location or name of outfall line
Accessible
Free of sinkholes or depressions
No evidence of leakage
Free of non -utility motorized traffic
3. Aerials - High Priority lines
Exposed line of ductile material
Water crossings and supports in good condition
Level of debris on or behind line
Free of damage
Right of Way mowing records
Visual inspection of off street lines
General observation of system (annual)

3
Name
Address
Pump Station Inspection Checklist
IM , 0 V; I �' No of Pumps 1 �" 2
Housekeeping
Secure Jam/
Accessible
Identification Signage
Inspection Schedule Daily
Weekly
Operational
2
Capacity of each (gpm)
1
2
Runtime hour meter reading average
1�
2
G �Piq'1 e-CCL�
A��.2s�
Wet Well — Floats
Free of debris
High water float
Telemetry t/ i
Audio -Visual y,, 6 1✓, �. �� ,— �t �i c% J , ��
SCADA
Alarm system tested for communications
. W CP .r.4 v`
Emergency power Generator Portable Quick -connect Onsite '
Fuel tank . t/ Gallons per hour usage rate
Testing schedule Automatic
Bypass pumping configured
Overflow piping
Manhole upstream
Inspection Logs

Collection System Inspection Checklist
Manholes- Lines- Right Of Way- Aerials
1. Manhole location or address
Cover present - vent and cover above grade - vent screened
Visible signs of overflow
Sinkholes and depressions
.�
Good condition properly seated
Bypass structures or pipes present
Invert in good condition Size inches Pipe capacity'' Y. % diameter.
Line free flowing and unrestricted
Excessive grease, roots, or sand
2. Right of Way - location or name of outfall line
Accessible
Free of sinkholes or depressions
No evidence of leakage ;�
Free of non -utility motorized traffic
3. Aerials - High Priority lines
Exposed line of ductile material r
Water crossings and supports in good condition
Level of debris on or behind line
Free of damage
Right of Way mowing records
Visual inspection of off street lines
General observation of system (annual)

0
Name
Address
Pump Station Inspection. Checklist
No of Pumps
1 2�
Housekeeping
Secure /
Accessible tc/ j
Identification Signage_l/
Inspection Schedule Daily .
Weekly
Wet Well — Floats
Free of debris -
High water float.
Telemetry
Audio -Visual
S CADA
Alarm system tested for communications
Operational 1
2V
Capacity of each (gpm)
1
2
Runtime hour meter reading average
l
2
Emergency pow r Generator Portable Quick-connect—=nsite
Fuel tank T� [ ( Gallons per hour usage rate
Testing schedule Automatic J
Bypass pumping configured C, Fi f ✓'
Overflow piping
Manhole upstream
Inspection Logs

Collection System Inspection Checklist
Manholes- Lines- Right Of Way- Aerials s
1. Manhole location or address
Cover present - vent and cover above grade - vent screened
Visible signs of overflow
Sinkholes and depressions
Good condition properly seated �~
Bypass structures or pipes present
Invert in good condition Size _inc es Pipe capacity 1/4 %2 3/4 diameter.
Line free flowing and unrestricted
Excessive grease, roots, or sand
2. Right of Way - location or name of outfall line 4—o
Accessible ✓
Free of sinkholes or depressions
No evidence of leakage
Free of non -utility motorized traffic
3. Aerials - High Priority lines �I -4 Cj
Exposed line of ductile material
Water crossings and supports in good condition t/J
Level of debris on or behind linevq
Free of damage
Right of Way mowing records
Visual inspection of off street lines
General observation of system (annual)

11S
��C' 1��� l_hc�✓I�s C� l.vr 11 tdf�d'anw kcsj.,; �
-, �/� G-r.y r.,�°� -- cvu.��i yn� rrcic►'1 ��oa"�' to '�'o-s�
--T_ � ✓',�- :1 tt C/� '—c41AJ`+�'lyc1'ic�H �l N�orK
. �j�%ys�c"'ov'a�lan d✓ ro S�Jv�
p � F
16 -4
Chetr��S
F,t+ `�dYS oYk�•.O dleelM(� tvcc'��
41-Z
all
v,r © c -.A
_.M ass S•f ✓ oI� �,��� ,�, �,�
(/ .J 1 �ot1�V' 1 v'w� �.�C( SrJ •�lS ..� �p r"�`t ✓I .ai
�i

`f'w,! 9 ;o 0 -- P100
" W QC 5,00 2 5�
.h hN t3 Tvw v, 14c,. c7J Zr
/5 dHp��x General Information
Inspection Checklist
1. Dumber of Pump stations
61A 0/ 3 2. SCADA system PS
3. 'Telemetry PS
4. Audible and Visual only
5. Generators Permanent I I
a. Frequency tested
Generators Portable s� n �; •, s r �'� ✓ '�
A. Quick -connect plugin �L PS
D. Frequency tested
1/
Pump stations served
_by same generator.
6. Csz
ORC A 4.— L-' Fo ""1�-®1�C �4 ., �1;, c- , f l ; 17 �r CS-2
5-2- — 6C'V Sim-�6o 0
Sewer Use Ordinance bl�"—
Enforcements Last Year
T
FOG Program -E-4-,- �nG-"y � r�p
/nti�hC/ "4 at4 �.e'lS� 7 ✓ �L � S �/ � ��PCt C ,/V y q �1 � � ei� /
Inspections j J )
Public ED How --
Annual Report Date�—
Foot Control Program
✓CIP l get Fears
Documentation of
`Z 1. Line Cleaning
(10%)
t
7� 2
; > 6 0
y}Iej
Hi hpriority lines (6 mos) 3�
�%a-4.m- r f 21' r I i �
4A0 -2� �7
System observation annual
4- h /.
n �- Yz�coY $ o �✓1 a�a-ZB
q,- 4. ROW mowing �-x at e1i
1 4o}5 I

Review logs for PS O&M h rs • (}
G: �C qN/LNeM 0✓y' �s! a'� � .�/ Q f i w'� G � 2_G�C � f�0)
wA j 1 CIS t7:c C!!7 Ya✓G �SY� ✓n�✓ti V G1_�� L �� �til�,t
L �Nt�l7 �� jNs�"r'�/�(jA.�Ci �.. y-N.D� p.0 �'• i+il.�HN�Arii4l�FV' j^I.0 oln in o».)/7�I fJ d1/�, �f�tl��/ BSI I
� ��YerITY aldr✓` J'v/�-.�jlleo i/<.:f.iyJ 1 �l%N�u'�%11�d .�90e0 d� � `��''IVY'�or'Tcil�•�
b2eportable Spills /
3r✓s-`l/7114 - :5(,?— Soo+ter S L- 1"'-( SOH. C-.7,r bt.l,l,iw, ,•,xlf,-y
4/9 2/1 L+ - g'ovo�5-o0O M ;It V 1 11 A) — 4 S
lZtV13e,44=-,,M Si riot✓� �i.b:.ss
&CV
21;
/ 3/J2.— gOo�3op J'4. S�� N S't,
v Repeat Location/Cause
VI1-
V Ikon reportable spills VI
VC/ustomer complaints
yfs� a
Spare parts inventory
'z map of system % complete r 2rl.�-
g.
r
mar+�of.v .S
ci -k ice"
N N N n c •' j �/
O t�i.G �ct✓�) `�` of 1 S co j7
V1G
.i � 1 rcre>✓S�c_/o .r'�rYac.Yjw d^S�e»��, liie�-f
rct c.r �.r�r��nc%p' 76dn�s
— S 17r Sc1 Yd 17s71 b,1/p/.eq'1 anp-,-Jv.-,,(j'
-(vr4 SS© rxSscSSd+',eh� d

ram=
Address
Lh, i 5
Tn al of
Pump Station Inspection Checklist
Jq ve.4 No of Pumps 1
2
MY--,- V,
Operational 1
2 v'
Capacity of each (gpm)
1
2
Runtime hour meter reading average
1
2
Housekeeping
Secure /
Accessible
Identification Signage -- i
Inspection Schedule Daily Weekly ✓�-�/�� ,.�� �/ �,�
/�/ohtT/�%Y N16tr,yo rit61/�`i•a� S
Wet Well — Float 7
Free of debris
High water float — n o
Telemetry era hof
Audio isual
SCADA
Alarm system tested for communications
,• w� mot i �1 u. � ;J [� „v�,'f�v-
�O Ga�cS� �t'ccwvK �Lµol��fy:s�
Emergency power nerator Portable Quick -connect
Fuel tank Gallons per hour usage rate
Testing schedule a is 3o N„�J,
Bypass pumping configured
Overflow piping
Manhole upstream
Inspection Logs !/

1
Collection System Inspection Cheeklist
M oles- Lines-f RightJOf Way- Aerials
1. Manhole location or address /l
1� "Oe
Cover present - vent and cover above grade - vent screened
Visible signs of overflow
Sinkholes and depressions tj
Good condition properly seated L.----
Bypass structures or pipes present 1/
Invert in good condition b_%Size 2,0 inches Pipe capacity 1/4 1/2 3/4 diameter.
Line free flowing and unrestricted L— yo
Excessive grease, roots, or sand �
2. Right of Way - location or name of outfall line
Accessible ; / ' '{� G 1 4-
Free of sinkholes or depression
No evidence of leakage
Free of non -utility motorized traffic
3. Aerials - High Priority lines
z
Exposed line of ductile material
Water crossings and supports in good condition ✓� n �,
Level of debris on or be 'nd line h s—
Free of damage
Right of Way mowing records ii
Visual inspection of off street lines
General observation of system (annual)

Pump Station Inspection Checklist
WIM
Address
Housekeeping ✓
Secure �-
Accessible ✓
Identification Signage
Inspection Schedule Daily
Wet Well — Floats ✓
Weekly ✓
No of Pumps 1
2
Operational 1 V/
2 X
Capacity of each (gpm)
1
2
Runtime hour meter reading average
1
2
Free of debris — -A d 4. t+—
High water float�,4 11{ N{
Telem so
Audio -Visual
SCADA /
Alarm system tested for communications I/
Emergency power enerator Portable Quick -connect Onsite
Fuel tank Gallons er hour usage rate
Testing schedule utomati _
Bypass pumping configured `�%�
Overflow piping
Manhole upstream
Inspection Logs

Collection System Inspection Checklist
Manholes- Lines- Right Of Way- Aerials
1. Manhole location or address
Cover present - vent and cover above grade - vent screened
Visible signs of overflow
Sinkholes and depressions
Good condition properly seated
Bypass structures or pipes present
Invert in good condition Size inches Pipe capacity 1/4 %2 3/a diameter.
Line free flowing and unrestricted
Excessive grease, roots, or sand
2. Right of Way - location or name of outfall line
Accessible
Free of sinkholes or depressions
No evidence of leakage
Free of non -utility motorized traffic
3. Aerials - High Priority lines
Exposed line of ductile material
Water crossings and supports in good condition
Level of debris on or behind line
Free of damage
Right of Way mowing records
Visual inspection of off street lines
General observation of system (annual)

Pump Station Inspection Checklist
Name r- AV No of Pumps 1
2
Address Operational 1
2
Capacity of each (gpm)
1
2 -
Runtime hour meter reading average
1.
2
Housekeeping
Secure
Accessible 1/
Identification Signage
Inspection Schedule Daily Weekly L/
Wet Well - Floats
Free of debris
High water float - p �, f i y�(
Telemetry - 5�-,
Audio -Visual •-- k ��
SCADA
Alarm system tested for communications
1 j �1 •- ,
:[ ✓.p 6 cv o` 1 t� J') � �i.� y)� c�' R v..., S W o ri
Emergency power Generator ortabl uick-connec `J ' nsite r
Fuel tank qans per hour usage rate
Testing schedule Automatic
Bypass pumping configured
Overflow piping
Manhole upstream
Inspection Logs

Collection System Inspection Checklist
Manholes- Lines- Right Of Way- Aerials
1. Manhole location or address
Cover present - vent and cover above grade - vent screened
Visible signs of overflow
Sinkholes and depressions
Good condition properly seated
Bypass structures or pipes present
Invert in good condition Size inches Pipe capacity'/4 %2 3/4 diameter.
Line free flowing and unrestricted
Excessive grease, roots, or sand
2. Right of Way - location or name of outfall line
Accessible
Free of sinkholes or depressions
No evidence of leakage
Free of non -utility motorized traffic
3. Aerials - High Priority lines
Exposed line of ductile material
Water crossings and supports in good condition
Level of debris on or behind line
Free of damage
Right of Way mowing records
Visual inspection of off street lines
General observation of system (annual)

Pump Station Inspection Checklist
Name — G
Address
Housekeeping
Secure
Accessible /
Identification Signage v
Inspection Schedule Daily
Wet Well - Floats
Weekly
Free of debris v
High water float _ �, w (.:/ K/1" - , - - A
TelemVL.�- 4- s f
Audio -Visual
SCADA
Alarm system tested for communications --
0Af►
Elms{ a�q � s wor k-e-
p
No of Pumps 1
2�
Operational 1
2 ✓
Capacity of each (gpm)
1
2 -
Runtime hour meter reading average
1
2
Emergency power ` G_ neraior--� Portable Quick -connect <� Onsite
Fuel tank Gallons per hour usage rate
Testing schedule Automatic — 30, , , , - t - Tu em s_ yS
Bypass pumping configured h g 4-�, f �,
Overflow piping
Manhole upstream 1
"/0
Inspection Logs` ( ��"i' ✓� z
�`o s sin •�
IZ
�an 5 r

CoUeetgon System Inspection Checklist
Manholes- Lines- Right Of Way- Aerials
1. Manhole location or address
Cover present - vent and cover above grade - vent screened
Visible signs of overflow m
Sinkholes and depressions
Good condition properly seated
Bypass structures or pipes present
Invert in good condition Size inches Pipe capaci 1/a 1/2 3/a diameter.
Line free flowing and unrestricted j/
Excessive grease, roots, or sand Ll�
2. Right of Way - location or name of outfall line
Accessible
Free of sinkholes or depressions
No evidence of leakage
Free of non -utility motorized traffic
3. Aerials - High Priority lines
Exposed line of ductile material
Water crossings and supports in good condition
Level of debris on or behind line
Free of damage
Right of Way mowing records
Visual inspection of off street lines
General observation of system (annual)

Inspection Checklist
General Information
1. -Number of r uuip stuLioun
2. SCADA system.PS o4
3. Telemetry PS
4. Audible and Visual only o-
5. Generators Permanent /O
a. Frequency tested w�, T O"Pl
Generators Portable 14
A. Quick -connect plugin
B. Frequency tested 0
Pump stations served
PS
by same generator.
6.
ORC A � l.: mA B-ORC � � G CS -
Sewer Use Ordinanca—
Enforcements Last Year.
FOG Program (w+A�s"S t is
Inspections
Public ED How
CIP Budget. Years
Documentation of
1. Line Cleaning (10%) i
2. High priority lines (6 mos)
3. System observation annual
4. ROW mowing 3�Lms�
Review logs for PS O&M
11-1
Review PS logs information
95
I\T reportable spills

�./� �'
�
�
3
�
�
�
�
�
r �
�
`1_
3

Pump Station Inspection Checklist
Name:
fh�s5 S Sf
Address:
# Pumps -
2
Working -
Run Time -
Weather:
YES
NO
Signage:
Housekeeping:
Secure:
Wet Well Floats:
Debris:
Working High Water Float:
Te
SCADA.-
AudioNisual:
r
Is alarm system tested, How often:
Inspection Logs:
Emergency Power:
Type: Portable O site Fuel - ScheduleNender -
Ouick Connect:
Testing Schedule:
Backflow:
Overflow Piping:
Bypass Pumping:
Inspection Schedule: .I. Q
Comments/ Observations:

Pump Station Inspection Checklist
Name:
Address:
# Pumps -
2
Working -
(�b
Run Time —
Weather-cle' —
YES
NO
Signage:
Housekeeping:
l
Secure:
Wet Well Floats:
^^ (c11
Debris:
Working High Water Float:
Telemetry:
SCADA:
Audio/Visual:
/
Is alarm system tested, How often:
Inspection Logs:
Emergency Power:
Type: Portable Orisi Fuel - Schedule/Vender -
Ouick Connect:
Testing Schedule: WeQS L��
Backflow:
OverflowPiping'
Bypass pin
Inspection Schedule:
Comments/ Observations:
Nt'p-ju c',
(`la7aCeSU���L r

Pump Station Inspection Checklist
Name:
Address:
# Pumps -
1
2
Working -
Run Time —
Weather:
YES
NO
Signage:
Housekeeping:
Secure:
Wet Well Floats:
Debris:
Working High Water Float:
Telemetry:
SCADA:
Audio/Visual:
Is alarm system tested, How often:
Q��
Inspection Logs.
Emergency Power:
Type: Portable
Onsite
Fuel - Schedule/Vender -
Ouick Connect:
Testing Schedule:
Backflow:
Overflow Piping:
Bypass Pumping:
Inspection Schedule:
Comments/ Observations:

Pump Station Inspection Checklist
Name:
Qja.&
Address:
# Pumps -
2
Working -
Run Time -
Weather:
YES
NO
Signage:
�f
Housekeeping:
Secure:
Wet Well Floats:
Debris:
Working High Water Float:
/
Telemetry:
SCADA:
Audio/Visual:
J
//
Is alarm system tested, How often: U`c
Inspection Logs:
l
Emergency Power:
Type: o e Onsite Fuel - Schedule/Vender -
Ouick Connect:
Testing Schedule: A `-t
j
Backflow:
Overflow Piping:
Bypass Pumping:
Inspection Schedule:
Comments/ Observations:
SA S. &Jn<< (WC�
S

Pump Station Inspection Checklist
Name:
'
Address:
# Pumps -
2
Working -
•�
Run Time —
Weather:
YES
NO
Signage:
Housekeeping:
Secure:
Wet Well Floats:
Debris:
Working High Water Float:
s
Telemetry:
SCADA:
Audio/Vis al: �?1Z--� wpr f'< <a U 5.>n. Jork/—
Is alarm system tested, How often:
Inspection Logs:
Emergency Power:
Type: rfa Onsite Fuel - Schedule/Vender -
Ouick Connect:
Testing Schedule: aN
Backflow:
Overflow Piping:
Bypass Pumping:
Inspection Schedule: 2 —3 C-, w-wJL
Comments/ Observations: {
Fro
A-cLi 0Ay k'Or--

Pump Station Inspection Checklist
Name:
Address:
# Pumps -
1
2
Working -
�]
Run.Time -
Weather:
YES
NO
Signage:
Housekeeping:
Secure:
Wet Well Floats:
Debris:
`
Working High Water Float:
Telemetry:
SCADA.
AAoNisual: W U
Is alarm system tested, How often:
Inspection Logs:
Emergency Power:
(�
Type: Portable Fuel -1 ScheduleNender -
Ouick Connect:
Testing Schedule:
Backflow:
Overflow Piping:
Bypass Pumping:
Inspection Schedule:
Comments/ Observations:

Collection System Inspection Checklist
Manholes- Lines- Right Of Way- Aerials
Olt 14
0,Lc�u
Manhole location or address
Gas 6ro�a� per- . .
Cover present -vent and cover above grade -vent screened
l
Visible signs of overflow .�
f
Sinkholes and depressions ✓�
Good condition properly seated /
Bypass structures or pipes present✓
lnvert in good condition Size inches Pipe capacity'/4 1/2'/4 diameter.
Line free flowing and uniestiicted
Excessive grease, roots, or sand
Right of Way - location or name of outfall line
Accessible
Free of sinkholes or depressions
No evidence of leakage
Free of non -utility motorized traffic
Aerials - HighFriority_line's
Exposed line of ductile material ood condition.
dater crossings_and supports in g
Level of debris on or behind line
Free of damage
Right of Way mowing records
Visual inspection of off street lines
General observation of system (annual)

Collection System Inspection Checklist
Manholes- Lines-
Right Of Way- Aerials
r
3� U r`
1
Manhole location or address 3:ku--,'
�b
Cover present - vent and cover above grade - vent screened
�
r
Visible signs of overflow -
Sinkholes and depressions
/
Good condition properly seated
Bypass structures or pipes present
Invert in good condition Size
inches Pipe capacity VA
'/2 3/4 diameter.
Line free flowing and unrestricted
Excessive grease, roots, or sand
Right of Way - location or name of outfall line
Accessible
Free of sinkholes or depressions
No evidence of leakage
Free ofnon-utility motorized traffic
Aerials - HighPriority.lines
Exposed line of ductile material
Water crossings acid supports in good condition.
Level of debris on or behind line
Free of damage
Right of Way mowing records
Visual inspection of off street lines
General observation of system (annual)

Collection System Inspection Checklist
Manholes- Lines- Right of Way- Aerials
Manhole location or address &A4
Cover present -vent and cover above grade - vent screened
Visible signs of overflow Sinkholes and depressions
Good condition properly seated
Bypass structures or pipes present
iSize -3 inches Pipe capacity'/, 1/2 3/, diameter.
Invertn good condition
Line free flowing and unrestricted
Excessive grease, roots, or sand
Right of Way - location or name of outfall line SkC , 0 M
Accessible
Free of sinkholes or depressions
No evidence of leakage
Free of non -utility motorized traffic
Aerials- HighPrioritylines
Exposed line of ductile material good condition.
dater crossings.and supports in g
Level of debris on or behind line
Free of damage
Right of Way, mowing records
Visual inspection of off street lines
General observation of system (annual)

Inspection Checklist
General Information
1. 1rumDer orTum_ stationsf r l� 2. SCADA system PS cy
3. Telemetry PS
4. Audible and Visual only o
5. Generators Permanent
a. Frequency tested �J�e 4 oy
Generators Portable
A. Quick -connect plugin G"', PS
B. Frequency tested VX,-k1
Pump stations served
by same generator.
6.
� ORCjr Y B-ORC Q,tw�y C•� (� ��� CS-
Sewer Use Ordinance —
Enforcements Last Year r,
FOG Program
Inspections — ik ik�
Public ED How
CIP Budget. S Years
Documentation of
CZ t\ 1. Line Cleaning (10%)--
I 11
2. High priority lines (6 mos) S t,,—s y�
3. System observation annual
4. ROW mowing MW
Review logs for PS O&M M-4-'
Review PS logs information
Non reportable spills

Customer complaints
Spare parts inventory
T.T___ r__._a_._._ 100 04 nnmr�lnfn
Map Vl system iv

Collection System Inspection Checklist
Manholes- Lines- Right Of Way- Aerials
Manhole location or address �_I\-
Cover present - vent and cover above grade - vent screened
Visible signs of overflow---
Sinkholes and depressions
Good condition properly seated
Bypass structures or pipes present, -,--
Invert in good condition Size v inches Pipe capacity 1/4 / 3/4 diameter.
Line free flowing and unrestricted
Excessive grease, roots, or sand
Right of Way - location or name of outfall line %' '3 S r/ 5L
Accessible
Free of sinkholes or depressions
No evidence of leakage
Freeof non -utility motorized traffic :-
J."
Aerials - High Priority lines rt'` s5 cad S
Exposed line of ductile material = _ -" ._
Water crossings and supports in good condition.
Level of debris on or behind line _
Free of damage'
Right of Way mowing records
Visual inspection of off street lines -
General observation of system (annual)---

Collection System Inspection Checklist
Manholes- Lines- Right Of Way- Aerials
Manhole location or address <�, err Lrj
Cover present - vent and cover above grade - vent screened
Visible signs of overflow
Sinkholes and depressions
Good condition properly seated,i- `
Bypass structures or pipes present--''�
Invert in good condition Size inches Pipe capacity 1/2 3/4 diameter.
Line free flowing and unrestricted
Excessive grease, roots, or sand
Right of Way - location or name of outfall line,�,,�.-
Accessible �-
Free of sinkholes or depressions
No evidence of leakage G_ ---- —
Free of non -utility motorized traffic
Aerials - High Priority lines cp—s sr- (A,;,3 e--
Exposed line of ductile material
Water crossings and supports in good condition.
Level of debris on or behind line
Free of damage
Right of Way mowing records
Visual inspection of off street lines
General observation of system (annual)

0
Collection System Inspection Checklist rt,
Manholes- Lines- Right Of Way- Aerials
Manhole location or address
Cover present - vent and cover above grade - vent screened
Visible signs of overflow
Sinkholes and depressions
Good condition properly seatedd'—
Bypass structures or pipes presenty
Invert in good condition Size Y-� inches Pipe capacity'/4 1?, 3/4 diameter.
Line free flowing and unrestricted
Excessive. grease, roots, or sand
Right of Way - location or name of outfall line`_��'�--
Accessible
Free of sinkholes or depressions
No evidence of leakage �!
Free of non -utility motorized traffic
Aerials - High Priority lines C. _*n Lc"- ( "i Z
Exposed line of ductile material
Water crossings and supports in good condition. -
Level of debris on or behind line-----�
Free of
Right of way mowing records
Visual inspection of off street lines
General observation of system (annual)

Collection System Inspection Checklist
Manholes- Lines- Right Of Way- Aerials
Manhole location or address pi
Cover present - vent and cover above grade - vent screened
Visible signs of overflow
Sinkholes and depressions - -
Good condition properly seatecT--
Bypass structures or pipes -
inches Pipe ca acit tl� 1/z 3/4 diameter.
Invert in good condition Size �� P P � -
Line free flowing and unrestricted
Excessive. grease, roots, or sand
Right of Way - location or name of outfall line
Accessible
Free of sinkholes or depressions
No evidence of leakage
Free of non -utility motorized traffic
Aerials - High Priority lines
Exposed line of ductile material
Water crossings and supports in good condition.
Level of debris on: or behind line
Free of damage
Right of Way mowing records
Visual inspection of off street lines
General observation of system (annual)

• Pump Station Inspection
Checklist
Name:
SRun
Address:
# Pumps -
1
(25
Working -
1
Time -
Weather: .V
YES
NO
Si na e:
Housekeeping:
r..
Secure:
Wet Well Floats:
Debris:
Working High Water Float:
Telemetry:
SCADA:
Audio/Visual:
Is alarms stem tested, How often:
Inspection Logs:
Emergency Power:
Type: Portable 0nsii_e Fuel - ScheduleNendet - (2)�q1; L
Ouick Connect:
Testing Schedule:
Backflow:
Overflow Piping:
Bypass Pumping:
Inspection Schedule: '3y
Comments/ Observations:

. Pump
Station Inspection Checklist
Name:
Address:
# Pumps -
1
Working -
1
Run Time -
Weather:
YES
NO
Si na e:
Housekeeping:
Secure:
Wet Well Floats:
J
Debris:
�~
Working High Water Float:
Telemetry:
SCADA:
AudioNisual:
Is alarms stem tested, How often:
Inspection Logs:
Emergency Power:
Type: Portable Onsite) Fuel -
ScheduleNendef -
Quick�Connect:
Testing Schedule: tit.,,)
Backflow:
Overflow Piping:
Bypass Pumping:
Inspection Schedule: }x �,�,.ec, L, ,
Comments/ Observations:

Pump Station Inspection Checklist
Name:
rn�l1
I i
Address:
.
# Pumps -
1
2
Working -
Run Time -
Weather:
YES
NO
Si na e:
Housekeeping:
-Secure.-
Wet Well Floats:
_
Debris. -
Working High Water Float:
Telemet :
SCADA:
by
A'udio/Visual:
Is alarms stem tested, How often: l.J
Inspection Logs:
Emergency Power:
r
Type: Portable n'sitFuel - ScheduleNendef - c�
Ouick Connect:
Testing Schedule: �J
Backfl.ow:~--
Ovey-flo_w-P pin I
Bypass gimping l"
Inspection Schedule: 3x WL�
Comments/ Observations:

Pump Station Inspection Checklist
Name:
( I � �s1(
�-.,�
Address:
# Pumps -
1
"�2
Working -
1
��
Run Time -
Weather:
YES
NO
Si na e:~
Housekeeping:
Secure:
Wet Well Floats:
"~r
Debris:
Working High Water Float:
Telemetry:
SCADA:
Audio/Visual:
Is alarms stem tested, How often:
(..
Inspection Logs:
_
Emergency Power:
Type: Portable onsite-` Fuel,± ScheduleNendef-
Ouick Connect:
Testing Schedule.-,(,—)
Backflow:
Overflow Piping:
Bypass Pumping:
Inspection Schedule:
Comments/ Observations:

A I Pump Station Inspection Checklist
Name:
Address:
# Pumps -
1
Working -
1
Run Time -
Weather:
YES
NO
Si na e:
Housekeeping:
Secure. -
Wet Well Floats:
Debris:
Working High Water Float:
Telemetry:
S CA DA:
Audio/Visual.-
Is alarms stem tested, How often:
-
Inspection Logs:
Emergency Power:
Type: orta Onsite Fuel - Schedule/Vender -
Ouick Co ct:
--�'—
Testing Schedule:
Backflow:
Overflow Piping:
Bypass Pumping:
Inspection Schedule:
Comments/ Observations:

. 41
4J
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins ei me
Governor Directorl`Sec etary`
Mr. David Saleeby, Town Manager
Town of Troutman
Post Office Box 26
Troutman, North Carolina 28166
SUBJECT:
Dear Mr. Saleeby:
May 7, 2009
Town of Troutman
MAY 1 2 2009
s UL;�''y�
s ..
DWG -Surface eater Proiled,lon
Sewer Improvements .
Approval of the Funding Application for
American Recovery and Reinvestment Act of 2009
Project No. 2W370580-04
The subject project was submitted for funding under the American Recovery and
Reinvestment Act of 2009 (ARRA). Some ARRA conditions are different than base Clean
Water State Revolving Fund (CWSRF) projects — please carefully read this entire letter.
The review for completeness and adequacy of the funding application including the project
engineering report and construction documents submitted for consideration of funding under the
ARRA has been concluded by the Construction Grants & Loans Section (Section) of the North
Carolina Division of Water Quality. Therefore, said documents are hereby approved. A
Determination of Minor Construction Activities for the project is attached for your files. A loan
offer will be transmitted to you separately, contingent upon approval by the Local Government
Commission at their May 5, 2009 or May 14, 2009 meetings.
Eligibility for Revolving Loan funding is determined as follows:
Eligible
Modification of the Massey Street Pump Station, consisting of construction of a smaller wet -well
structure; sewer rehabilitation consisting of replacement of approximately 400 linear feet of 8-inch
gravity sewer, relining (cured -in -place piping) of approximately 771 linear feet of 8-inch gravity
pipe, replacement of approximately 10 manholes, rehabilitation of 2 manholes, and reconnection of
service laterals within and up to the existing right-of-way.
Non Eligible
Any installation of sewer service laterals outside the right-of-way.
1633 Mail Service Center, Raleigh, North Carolina 27699-1633 One
Location: 2728 Capital Blvd. Raleigh, North Carolina 27604 NorthCarolina
Phone: 919-73 1 FAX: [phone] Customer Service: 1 877 623-6748 Nahmally
Internet: vuww.ncwatecwaterquality.orgAn Equal Opportunity 1 Affirmative Action Employer

f
Mr. David Saleeby, Town Manager
May 7, 2009
Page Two
In the event that received bids exceed the amount established through the funding offer,
and local funds are not adequate to award contract(s), it will be necessary to consider all
alternatives including redesign, re -advertising, and rebidding. Please note that the specifications
must include the special provisions of the ARRA (i.e., buy American, Davis -Bacon wage
requirements, job reporting) in addition to the regularly required SRF Special Conditions. Job
reporting requirements have not been established by the US EPA at this time, but will likely
include jobs created oryetained, hours worked, type of jobs, etc.
Attached is one (1) copy of the Project Bid Information (Authority to Award) which is to
be completed after bids have been received, and submitted to Mr. Mark Hubbard, P.E.,
Upon review and approval of this information, the Section will authorize the Recipient to award
contracts. All elements required for a complete Bid Information package must be submitted to
ensure a timely review by the Section.
In accordance with a goal of the ARRA, contracts are expected to be executed by June
171h. If these dates cannot be met, you must contact the Section with a detailed explanation and
proposed alternative deadlines. Upon execution of contracts and issuance of Notice to Proceed, a
bound set of contract documents must be submitted to the Section for approval. Funds cannot be
dispersed until executed contracts are approved. While rejection of all bids is possible, such
action may be taken only with prior Section concurrence, and only for good cause.
In the event that progress on the approved ARRA CWSRF project is not made in
accordance with the loan agreement, construction contracts, or other pertinent
requirements reimbursements may be withheld or suspended indefinitely. Funds not
requested for reimbursement in a timely manner may also be reallocated to other ARRA
ready -to -go projects on the final State project list.
Once the project costs are established, final awards may be adjusted downward in the case
of low bids. Five percent contingency is included in the final amount to accommodate change
orders and amendments to the engineering contract. In no case will awards be increased.
Neither the State nor Federal Government, nor any of its departments, agencies or
employees is or will be a parry to the invitation to bids, addenda, any resulting contracts or
contract negotiations/changes.
Your project is subject to the one-year performance certification requirements. By this,
you are required on the date one year after the completion of construction and initial operation of
the subject treatment facilities, to certify, based on your consulting engineer's advisement,
whether or not such treatment works meet the design performance, specifications and the permit
conditions and effluent limitations.
In accordance with the Federal Regulations, the Recipient is required to assure compliance
with the OSHA safety regulations on the subject project. In complying with this regulatory
responsibility, the Recipient should, by letter, invite the Bureau Chief, Education Training and
Technical Assistance Unit, NC OSHA Division, 1101 Mail Service Center, Raleigh, NC 27699-

Mr. David Saleeby, Town Manager
May 7, 2009
Page Three
1101 at [phone], to participate in the Preconstruction Conference to assure that proper
emphasis is given on understanding and adhering to the OSHA regulations.
It is the responsibility of the Recipient and the Consulting Engineer to insure that the
project plan documents are in compliance with Amended N. C. G. S. 133-3 (ratified July 13,
1993). The administrative review and approval of these plans and specifications, and any
subsequent addenda or change order, do not imply approval of a restrictive specification for
bidding purposes; nor is it an authorization for noncompetitive procurement actions.
Any addenda to be issued for subject project plans and specifications must be submitted by
the Recipient for review/approval action by the Section.
It is mandatory for project facilities to be constructed in accordance with the North
Carolina Sedimentation Pollution Control Act, and, when applicable, the North Carolina Dam
Safety Act. In addition, the specifications must clearly state what the contractors' responsibilities
shall be in complying with these Acts.
A goal of 8% of the contract price is established for Minority Business Enterprise (MBE)
participation in this project, and a goal of 5% of the contract price is established for Women's
Business Enterprise (WBE) participation in this project. The Recipient and Bidders shall make a
good faith effort to assure that MBE's and WBE's are utilized, when possible, as sources of
goods and services. The good faith effort must include the following affirmative steps: (a)
including small, minority, and women's businesses on solicitation lists; (b) assuring that small,
minority, and women's businesses are solicited whenever they are potential sources; (c) dividing
total requirements, when economically feasible, into small tasks or quantities to permit
maximum participation by small, minority, and women's businesses; (d) establishing delivery
schedules, and (e) using the services of the Small Business Administration and the Minority
Business Development Agency of the U.S. Department of Commerce. Please note that the
solicitation efforts should include documentable follow-up phone calls.
The Recipient shall comply with the provisions of 40 CFR, Part 7, Subpart C -
Discrimination Prohibited on the Basis of Handicap.
Two (2) copies of any change order must be promptly submitted by the Recipient to the
Section. If additional information is requested by the Section, a response is required within two
(2) weeks, or the change order will be returned without further or final action.
One (1) set of plans and specifications identical to the approved set must be available at
the project site at all times. Upon completion of the project construction, the Recipient shall
submit a letter confirming that the project has been constructed in accordance with the plans and
specifications approved by the Section. "As -built" plans will need to be submitted with any
changes clearly documented on the plans if the above confirmation cannot be made.

C
Mr. David Saleeby, Town Manager
May 7, 2009
Page Four
If there are any questions concerning this matter, please do not hesitate to contact Kim H.
Colson, P.E. at [phone] or Mark Hubbard, P.E. at [phone].
Sincerely,
GAP ��• gsz'4��-e-Q
Daniel M. Blaisdell, P.E., Section Chief
Construction Grants & Loans Section
Attachments: Determination of Minimum Construction Activity
Bid Information Form
I OVNIUN
cc: Benjamin B. Thomas, P.E., West Consultants, PLLC, Morganton, NC
OSHA Bureau Chief, Wanda Lagoe
DWQ Mooresville Regional Office
Daniel Blaisdell, P.E.
Mark Hubbard, P.E.
Jennifer Haynie
CIG
SRF

I
Determination of Minor Construction Activity
North Carolina Division of Water Quality
Construction Grants and Loans Section
Project Applicant: Town of Troutman
Date: April 29, 2009
Project Number: 2W370580-04
Estimated Project Cost: $ 237,595
Estimated Funding Amount: $ 237,595
Project Description: The proposed project consists of sewer rehabilitation including the
replacement of approximately 400 linear feet of 8-inch gravity sewer, relining (CIPP)
approximately 771 linear feet of 8-inch gravity pipe, replacement of approximately 10
manholes, rehabilitating (raising) 2"manholes, and modification of the Massey Street
Pump Station, consisting of construction of a smaller wet -well structure.
The above named applicant intends to apply for assistance from the State Revolving Fund
program associated with the American Recovery and Reinvestment Act of 2009 to
construct the wastewater facilities described above. The North Carolina Division of
Water Quality (DWQ) has conducted a review of the project in accordance with the
procedures (NCAC 15A Subchapter 1 C) for conformance with the North Carolina
Environmental Policy Act. The DWQ has determined that this project is a minor
construction activity, and that the preparation of additional environmental documents is
not required.
This determination shall become effective upon its distribution by DWQ. This
determination can be revoked at any time adverse information is made available. The
documentation to support this decision will be on file with the North Carolina
Department of Environment and Natural Resources, Division of Water Quality,
Construction Grants and Loans Section, and is available for public review at
www.nccgl.net.
Comments concerning this decision may be addressed to Mr. Kim H. Colson; P.E.,
Assistant Chief, Construction Grants and Loans Section, Division of Water Quality, 1633
Mail Service Center, Raleigh, North Carolina 27699-1633, or he may be reached by
phone at [phone].
Sincerely,
�P. /3
Daniel M. Blaisdell, P.E., Chief
Construction Grants and Loans Section
Division of Water Quality

PROJECT BID INFORMATION
Previously referred to as the "Part B" in State programs.
Previously referred to as the "Project Review and Cost Summary" in Federal programs
JAWARD RECIPIENT INFORMATION(
Name Project Number
Address
Attach the following supplemental information and submit with this form:
(a) Tabulations of all bids received (sealed by engineer).
(b) Copies of the bid(s) and bid bond the applicant wishes to accept.
(c) Resolution of tentative award.
(d) Engineer's recommendation of award letter.
(e) Proof of advertisement
(f) MBE/WBE Requirements:
State Programs
■ Include affidavits A, B, C or D as required.
■ Submit certification of subcontract awards to minority business firms
with documentation to comply with G.S. 143-128.2. (Complete attached form)
Federal Programs (SRF and STAG)
■ Documentation of Contractor's "good faith" effort to procure MBE/WBE
subcontractors.
■ Certification regarding debarment, suspension and other responsibility matters
for each prime and subcontractor.
DDITIONAL INFORMATIO i
Addenda
All addenda must be submitted to CG&L for approval prior to opening bids. Changes to the
scope of the project may require a permit modification.
Site Certificates (2)
Submit if not previously submitted or if changes have occurred.
Additional Items
• Land Costs (State Loans & Grants Only) Submit form if seeking payment.
• A/E Contracts — Submit for approval if seeking payment.
• Sewer Use Ordinance, User Charge System and Sewer budget (SRF Only) Payments
stop at 90% of total project costs if not approved.
• 4700 Form (SRF Only)
• Submit proof of adequate resident inspection (resume of inspector).

- ii� -..t 4., Cn, tT—'...•` 7
-.t�.."Y
� F �t /�f{� SFi> ,Z A'Y' ti`-t' S
� twitL�t'f1�
�{✓G fi`..` ky#t S✓yPa+^+�y � � �,r^<�„��+ .pay rt� si�� ie�'}`�{�.+�x.�
Y.dFY4.:�., �r��'v
.:.4 .... ,.3 a_. ..'i `A' .k� r. S.k {„�_ �.'e`�.taa...�l+rl. � A�•Sjy, y'i .. '6'ac..:ti "ii.r� �.2�..,13�L .:§�i '.�. 5k;...'�`'�.'b�r�� 4"-st f a"t `c.
List contractor names below:
TOTAL
ELIGIBLE
1.
$
$
2.
3.
4.
5.
EQUIPMENT -AND MATERIALS
(*�
TECHNICAL SERVICES attach contract
LEGAL
ADMINISTRATIVE
CONTINGENCY 5% of construction
OTHER (specify)
REAL PROPERTY ACQUISTION COSTS
CLOSING COSTS
,✓ �, 2 r i e ti`
di �x_.q� 'FS k , *,�v �,�LS`,k 2Tra 7 <<t��'1¢r +,,, r-.sa5'�'%�� .".z�.'�. s�t,.5.��1 � �t :i <:,. "':y�r�lm '� �` �yh7). �"` �b "'"i �y �._'t" ti,� �J�ne Y. u`x•�,•',j :�f�+�'tfb» qr y_ .
List funds that are available for this project:
AMOUNT
CASH
$
GENERAL OBLIGATION BONDS
REVENUE BONDS
OTHER (specify)
FEDERAL LOAN/GRANT (specify agency) b
STATE LOAN
STATE GRANT
r TO'�AL
$
4i
The undersigned representative of the Recipient certifies that the information contained above and in
any attached statements and material in support thereof is true and correct to the best of his or her
knowledge.
Signature of Authorized Representative Name and Title (type or print)
Date

. . I
INSTRUCTIONS FOR SUBMITTING
PROJECT BID INFORMATION FORM
This information must be submitted as soon as possible after construction bids are opened.
For STAG and State projects send to:
Don Evans
Construction Grants and Loans Section
1633 Mail Service Center
Raleigh, NC 27699-1633
Page 1
For SRF Projects send to:
Mark Hubbard, PE
Construction Grants and Loans Section
1633 Mail Service Center
Raleigh, NC 27699-1633
Enter all requested information such as, Name, Address, and Project Number. Documentation
listed from (a) to (f) must be submitted. Addenda should be submitted before bids are opened
with enough time for CG&L to approve them (7 days). Site information should be attached if
not previously submitted.
Page 2
PROJECT COST SUMMARY
(1) Enter the contractor's company or corporate name. Enter the amount of the
bid or bids the applicant wishes to accept.
(2) If equipment or materials are to be or have been purchased outside the
construction contracts, enter the estimated or actual costs as applicable.
(3) If not previously submitted, attach copies of any engineering contracts or
agreements. Formal agreements are required for disbursement of funds.
(4) Contingency is limited to 5% of the total construction bid amount.
(5) Appraisals and a copy of the Deed are required for disbursement of real
property costs.
(6) Closing costs are not eligible for reimbursement under the SRF. They are 1.5% for
State Grants, 2% for SRF Loans and 2.5% for State Loans.
REVENUE SOURCES FOR PROJECT CONSTRUCTION
(1) Enter the amount of general obligation bonds and revenue bonds authorized
but not yet sold for this project.
(2) Enter the amount of the grant, if any, offered by Federal or State Agency(s)
and list name of agency(s).
(3) Enter the amount of the loan or grant offered.
(4) Total funds available must equal or exceed the Total Project Cost.
The form must be signed by the applicant's authorized representative.

RECIPIENT„
THE TOWN DOES HEREBY CERTIFY THAT IT HAS MET THE REQUIREMENTS OF G.S. 143-128.2 IN
REFERENCE TO MINORITY BUSINESS CONTRACTS FOR THIS CONSTRUCTION PROJECT. THE
CONTRACTOR HAS MET THE GOALS ESTABLISHED BY RESOLUTION OF THE TOWN AND THE
FOLLOWING CONTRACTS MEET THE REQUIREMENTS ADOPTED BY THE TOWN:
signature of authorized representative name of authorized representative
PLEASE LIST CONTRACTORS AND MINORITY SUBCONTRACTORS:
�r
CONTRACT: AMOUNT
MINORITY CONTRACT: AMOUNT
MINORITY CONTRACT: AMOUNT
CONTRACT: AMOUNT
MINORITY CONTRACT: AMOUNT
MINORITY CONTRACT: AMOUNT
CONTRACT: AMOUNT
MINORITY CONTRACT: AMOUNT
MINORITY CONTRACT: AMOUNT
CONTINUE IF MORE THAN THREE CONTRACTS
THE TOWN DOES HEREBY CERTIFY THAT IT HAS MET THE REQUIREMENTS OF G.S. 143-128.2 IN
REFERENCE TO MINORITY BUSINESS CONTRACTS FOR THIS CONSTRUCTION PROJECT. THE
CONTRACTOR HAS MET THE GOALS ESTABLISHED BY RESOLUTION OF THE TOWN AND THE
FOLLOWING CONTRACTS MEET THE REQUIREMENTS ADOPTED BY THE TOWN:
signature of authorized representative name of authorized representative
PLEASE LIST CONTRACTORS AND MINORITY SUBCONTRACTORS:
�r
CONTRACT: AMOUNT
MINORITY CONTRACT: AMOUNT
MINORITY CONTRACT: AMOUNT
CONTRACT: AMOUNT
MINORITY CONTRACT: AMOUNT
MINORITY CONTRACT: AMOUNT
CONTRACT: AMOUNT
MINORITY CONTRACT: AMOUNT
MINORITY CONTRACT: AMOUNT
CONTINUE IF MORE THAN THREE CONTRACTS

} 4
Ag= AA
NCDENR
North Carolina Department of Environment and Natur e�s,�}.tr
Division of Water Quality t.7� ; tty
Beverly Eaves Perdue Coleen H. Sullins D;ee e� ara ,
Governor Director Secretary`
May 7, 2009 MAY 1 2 2009
Ms. Deanna Rios, Assistant Finance Director
City of Hickory
Post Office Box 398 ®ir Q�luo f aco Water Fr oled4 �n
Hickory, North Carolina 28603
SUBJECT: City of Hickory
Cripple Creek Interceptor. Replacement
Approval of the Funding Application for
American Recovery and Reinvestment Act of 2009
Project No. 2W370389-19
Dear Ms. Rios:
The subject project was submitted for funding under the American Recovery and
Reinvestment Act of 2009 (ARRA). Some ARRA conditions are different than base Clean
Water State Revolving Fund (CWSRF) projects — please carefully read this entire letter.
The review for completeness and adequacy of the funding application including the project
engineering report and construction documents submitted for consideration of funding under the
ARRA has been concluded by the Construction Grants & Loans Section (Section) of the North
Carolina Division of Water Quality. Therefore, said documents are hereby approved. A
Determination of Minor Construction Activities for the project is attached for your files. A loan
offer will be transmitted to you separately, contingent upon approval by the Local Government
Commission at their May 5, 2009 or May 14, 2009 meetings.
Eligibility for Revolving Loan funding is determined as follows:
Eligible
Sewer replacement of existing 21-inch terra cotta outfall with approximately 14,112 linear feet of
24-inch gravity sewer along the existing alignment from 6"' Street NW south.traversing Cripple
Creek to the Moose Club Pump Station, and all necessary appurtenances within and up to the
existing right-of-way.
Non Eligible
Any installation of sewer service laterals outside the right-of-way.
1633 Mail Service Center, Raleigh, North Carolina 27699-1633 �T1�11t, 1
Location: 2728 Capital Blvd _Raleigh, North Carolina 27604 One
1 �i 0Cai 0111121
Phone: [phone] \ FAX: [phone] \ Customer Service: 1-877-623-6748
Internet: www.ncwaterquality.org
An Equal Opportunity \ Affirmative Action Employer �/

Ms. Deanna Rios, Assistant Finance Director
May 7, 2009
Page Two.
In the -event that received bids exceed the amount established through the funding offer,
and local funds are not adequate.to award contract(s), it will be necessary to consider all
alternatives.including redesign, re -advertising, and rebidding. Please note that the specifications
must include the special provisions of the ARRA (i.e., buy American, Davis -Bacon wage
requirements, job reporting) in addition to the regularly required SRF Special Conditions. Job
reporting requirements have not been established by the US EPA at this time,. but will. likely
include jobs created, or -•retained, hours worked, type of jobs, etc.
Attached is one (1) copy of the Project Bid Information (Authority to Award) which is to
be completed after bids have been received, and submitted to Mr. Mark Hubbard, P.E.,
Section Chief, Construction Grants and Loans �
Upon review and approval of this information, the Section will authorize the Recipient to.award
contracts. All elements required for a complete Bid Information package must be submitted to
ensure a timely review by the Section.
In accordance with a Goal of the ARRA, contracts are expected to be executed by June
17`h. If these dates cannot be met, you must contact the Section with a detailed explanation and
proposed alternative deadlines. Upon execution of contracts and issuance of Notice to Proceed, a
bound set of contract documents must be submitted to the Section for approval. Funds cannot be
dispersed until executed contracts are approved. While rejection of all bids is possible, such
action may be taken only with prior Section concurrence, and only for good cause.
In the event that progress on the approved ARRA CWSRF project is not made in
accordance with the loan agreement, construction contracts, or other pertinent
requirements reimbursements may be withheld or suspended indefinitely. Funds not
requested for reimbursement in a timely manner may also be reallocated.to other ARRA
ready -to -go projects on the final State project list.
Once the project costs are established, final awards may be adjusted downward in the case
of low bids. Five percent contingency is included in the final amount to accommodate change
orders and amendments to the engineering contract. In no case will awards be increased.
Neither the State nor Federal Government, nor any of its departments, agencies or
employees is or will be a party to the invitation to bids, addenda, any resulting contracts or
contract negotiations/changes.
Your project is subject to the one-year performance certification requirements. By this,
you are required on the date one year after the completion of construction and initial operation of
the subject treatment facilities; to certify, based on your consulting engineer's advisement,
whether or not such treatment works meet the design performance, specifications and the permit
conditions and effluent limitations.
In accordance with the Federal Regulations, the Recipient is required to assure compliance
with the OSHA safety regulations on the subject project. In complying with this regulatory.
responsibility, the Recipient should, by letter, invite the Bureau Chief, Education Training and
Technical Assistance Unit, NC OSHA Division, 1101 Mail Service Center, Raleigh, NC 27699-

-.1
Ms. Deanna Rios,'Assistant.Finance_Director
May 7, 2009
Page Three
1101 at, [phone], to participate in the Preconstruction Conference to assure that proper
emphasis is given on understanding and adhering to the OSHA regulations.
It is the responsibility of the Recipient and the Consulting Engineer to insure that the
project plan documents are in compliance with Amended N. C. G. S. 133-3 (ratified July 13,
1993). The administrative review and approval of these plans and specifications, and any
subsequent addenda or change order, do not imply approval of a restrictive specification for
bidding purposes; nor is it an authorization for noncompetitive procurement actions.
Any addenda to be issued for subject project plans and specifications must be submitted by
the Recipient for review/approval action by the Section.
It is mandatory for project facilities to be constructed in accordance with the North
Carolina Sedimentation Pollution Control Act, and, when applicable, the North Carolina Dam
Safety Act. In addition, the specifications must clearly state what the contractors' responsibilities
shall be in complying with these Acts.
A goal of 8% of the contract price is established for Minority Business Enterprise (MBE)
participation in this project, and a goal of 5% of the contract price is established for Women's
Business Enterprise (WBE) participation in this project. The Recipient and Bidders shall make a
good faith effort to assure that MBE's and WBE's are utilized, when possible, as sources of
goods and services. The good faith effort must include the following affirmative steps: (a)
including small, minority, and women's businesses on solicitation lists; (b) assuring that small,
minority, and women's businesses are solicited whenever they are potential sources; (c) dividing
total requirements, when economically feasible, into small tasks or quantities to permit
maximum participation by small, minority, and women's businesses; (d) establishing delivery
schedules, and (e) using the services of the Small Business Administration and the Minority
Business Development Agency of the U.S. Department of Commerce. Please note that the
solicitation efforts should include documentable follow-up phone calls.
The Recipient shall.comply with the provisions of 40 CFR, Part 7, Subpart C -
Discrimination Prohibited on the Basis of Handicap.
Two (2) copies of any change order must be promptly submitted by the Recipient to the
Section. If additional information is requested by the Section, a response is required within two
(2) weeks, or the change order will be returned without further or final action.
One (1) set of plans and specifications identical to the approved set must be available at
the project site at all times. Upon completion of the project construction, the Recipient shall
submit a letter confirming that the project has been constructed in accordance with the plans and
specifications approved by the Section. "As -built" plans will need to be submitted with any
changes clearly documented on the plans if the above confirmation cannot be made.

Ms. Deanna Rios, Assistant Finance Director
May 7, 2009
Page Four
If there are any questions concerning this matter, please do not hesitate to contact Kim H.
Colson, P.E. at [phone] or Mark Hubbard, P.E. at [phone].
Sincerely
--Daniel M. Blaisdell, P.E., Section Chief
Construction Grants & Loans Section
Attachments: Determination of Minimum Construction Activity
Bid Information Form
KHC:KOP
cc: G. Cecil Clark, P.E., Clark and Associates, Hickory, NC
OSHA Bureau Chief, Wanda Lagoe
DWQ Mooresville Regional Office
Daniel Blaisdell, P.E.
Mark Hubbard, P.E.
Jennifer Haynie
CIG
SRF

J
Determination of Minor Construction Activity
North Carolina Division of Water Quality
Construction Grants and Loans Section
Project Applicant: City of Hickory
Date: April 29, 2009
Project Number: 2W370389-19
Estimated Project Cost: $ 3,100,000
Estimated Funding Amount: $ 1;938,000.
Project Description: The proposed project consists of replacing an existing 21-inch terra
cotta outfall with a 24-inch PVC pipe and installing same adjacent to Cripple Creek and
Horseford Creek, an impaired stream, following the existing alignment.
The above named applicant intends to apply for assistance from the State Revolving Fund
program associated with the American Recovery and Reinvestment Act of 2009 to
construct the wastewater facilities described above. The North Carolina Division of
Water Quality (DWQ) has conducted a review of the project in accordance with the
procedures (NCAC 15A Subchapter 1 C) for conformance with the North Carolina
Environmental Policy Act. The DWQ has determined that this project is a minor
construction activity, and that the preparation of additional environmental documents is
not required.
This determination shall become effective upon its distribution by DWQ. This
determination can be revoked at any time adverse information is made available. The
documentation to support this decision will be on file with the North Carolina
Department of Environment and Natural Resources, Division of Water Quality,
Construction Grants and Loans Section, and is available for public review at
www.nccgl.net.
Comments concerning this decision may be addressed to Mr. Kim H. Colson, P.E.,
Assistant Chief, Construction Grants and Loans Section, Division of Water Quality, 1633
Mail Service Center, Raleigh, North Carolina 27699-1633, or he may be reached by
phone at [phone].
Sincerely,
13
Daniel M. Blaisdell, P.E., Chief
Construction Grants and Loans Section
Division of Water Quality

J-
PROJECT BID INFORMATION
Previously referred to as the "Part B" in State programs
Previously referred to as the "Project Review and Cost Summary" in Federal programs
AWARD RECIPIENT INFORMATIOaj
Name Project Number
Address
Attach the following supplemental information and submit with this form:
(a) Tabulations of all bids received (sealed by engineer).
(b) Copies of the bid(s) and bid bond the applicant wishes to accept.
(c) Resolution of tentative award.
(d) Engineer's recommendation of award letter.
(e) Proof of advertisement .
(f) MBE/WBE Requirements:
State Programs
Include affidavits A, B, C or D as required.
■ Submit certification of subcontract awards to minority business firms
with documentation to comply with G.S. 143-128.2. (Complete attached form)
Federal Programs (SRF and STAG)
■ Documentation of Contractor's "good faith" effort to procure MBE/WBE
subcontractors.
■ Certification regarding debarment, suspension and other responsibility matters
for each prime and subcontractor.
DDITIONAL INFORMATION
Addenda
All addenda must be submitted to CG&L for approval prior to opening bids. Changes to the
scope of the project may require a permit modification.
Site Certificates (2)
Submit if not previously submitted or if changes have occurred.
Additional Items
• Land Costs (State Loans & Grants Only) Submit form if seeking payment.
• A/E Contracts — Submit for approval if seeking payment.
• Sewer Use Ordinance, User Charge System and Sewer budget (SRF Only) Payments
stop at 90% of total project costs if not approved.
• 4700 Form (SRF Only)
• Submit proof of adequate resident inspection (resume of inspector).

List contractor names below:
TOTAL
ELIGIBLE
1.
$
$
2.
3.
4.
5.
EQUIPMENT AND MATERIALS
TECHNICAL SERVICES attach contract
LEGAL
ADMINISTRATIVE
CONTINGENCY 5% of construction
OTHER (specify)
REAL PROPERTY AC UISTION COSTS
CLOSING COSTS
p List funds that are available for this project: I AMOUNT
11
CASH $
GENERAL OBLIGATION BONDS
REVENUE BONDS
OTHER (specify)
FEDERAL LOAN/GRANT (specify agency)
b
STATE LOAN
STATE GRANT
TOTAL - $
The undersigned representative of the Recipient certifies that the information contained above and in
any attached statements and material in support thereof is true and correct to the best of his or her
knowledge.
Signature of Authorized Representative Name and Title (type or print) Date

J
INSTRUCTIONS FOR SUBMITTING
PROJECT BID INFORMATION FORM
This information must be submitted as soon as possible after construction bids are opened.
For STAG and State projects send to:
Don Evans
Construction Grants and Loans Section
1633 Mail Service Center
Raleigh, NC 27699-1633
Page 1
For SRF .Projects send to:
Steve Tsadwa
Construction Grants and Loans Section
1633 Mail Service Center
Raleigh, NC 27699-1633
Enter all requested information such as, Name, Address, and Project Number. Documentation
listed from (a) to (f) must be submitted. Addenda should be submitted before bids are opened
with enough time for CG&L to approve them (7 days). Site information should be attached if
not previously submitted.
Page 2
PROJECT COST SUMMARY
(1) Enter the contractor's company or corporate name. Enter the amount of the
bid or bids the applicant wishes to accept.
(2) If equipment or materials are to be or have been purchased outside the
construction contracts, enter the estimated or actual costs as applicable.
(3) If not previously submitted, attach copies of any engineering contracts or
agreements. Formal agreements are required for disbursement of funds.
(4) Contingency is limited to 5% of the total construction bid amount.
(5) Appraisals and a copy of the Deed are required for disbursement of real
property costs.
(6) Closing costs are not eligible for reimbursement under the SRF. They are 1.5% for
State Grants, 2% for SRF Loans and 2.5% for State Loans.
. REVENUE SOURCES FOR PROJECT CONSTRUCTION
(1) Enter the amount of general obligation bonds and revenue bonds authorized
but not yet sold for this project.
(2) Enter the amount of the grant, if any, offered by Federal or State Agency(s)
and list name of agency(s).
(3) Enter the amount of the. loan or grant offered.
(4) Total funds available must equal or exceed the Total Project Cost.
The form must be signed by the applicant's authorized representative.

PI80.�ECT.TITLE
THE TOWN DOES HEREBY CERTIFY THAT IT HAS MET THE REQUIREMENTS OF G.S. 143-128.2 IN
REFERENCE TO MINORITY BUSINESS CONTRACTS FOR THIS CONSTRUCTION PROJECT. THE
CONTRACTOR HAS MET THE GOALS ESTABLISHED BY RESOLUTION OF THE TOWN AND THE
FOLLOWING CONTRACTS MEET THE REQUIREMENTS ADOPTED BY THE TOWN:
signature of authorized representative name of authorized representative
PLEASE LIST CONTRACTORS AND MINORITY SUBCONTRACTORS:
J.
CONTRACT: AMOUNT .
MINORITY CONTRACT: AMOUNT
MINORITY CONTRACT: AMOUNT
CONTRACT: AMOUNT
MINORITY CONTRACT: AMOUNT
MINORITY CONTRACT: AMOUNT
CONTRACT: AMOUNT
$
MINORITY CONTRACT: AMOUNT
MINORITY CONTRACT: AMOUNT
CONTINUE IF MORE THAN THREE CONTRACTS

' A !JiA
NC®ENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
'e
Beverly Eaves Perdue Coleen H. Sullins M1 De '
Governor Director 1 Ewa ti` 5 fet y
May 7, 2009
MAY 1 2 2009
Mr. Jim Palenick, City Manager
City of Gastonia
P. O. Box 1748 _
Gastonia, North Carolina 28053 ®6���� ii,,aEn
SUBJECT: City of Gastonia
Sewer Pipe Lining at Catawba Creek Pump Station
Approval of the Funding Application for
American Recovery and Reinvestment Act of 2009
Project No. 2W370744-04
Dear Mr. Palenick:
The subject project was submitted for funding under the American Recovery and
Reinvestment Act of 2009 (ARRA). Some ARRA conditions are different than base Clean
Water State Revolving Fund (CWSRF) projects — please carefully read this entire letter.
The review for completeness and adequacy of the funding application including the project
engineering report and construction documents submitted for consideration of funding under the
ARRA has been concluded by the Construction Grants & Loans Section (Section) of the North
Carolina Division of Water Quality. Therefore, said documents are hereby approved. A
Determination of Minor Construction Activities for the project is attached for your files. A loan
offer will be transmitted to you separately, contingent upon approval by the Local Government
Commission at their May 5, 2009 or May 14, 2009 meetings.
Eligibility for Revolving Loan funding is detennined as follows:
Eligible
Rehabilitation of approximately 371 linear feet (19 of 24-inch with cured -in -place pipe (CIPP)
gravity sewer, rehabilitation of 17 vertical feet of existing vault, replacement of pipe bends,
installation of one (1) doghouse manhole, removal and replacement of pavement, roadways,
driveways and curbs, sedimentation and erosion control devices, and associated appurtenances
necessary for a complete system within and up to the existing right-of-way.
1633 Mail Service Center, Raleigh, North Carolina 27699-1633 1�TOne 1
Location: 2728 Capital Blvd. Raleigh, North Carolina 27604 NorthCarollna
Phone: [phone] FAX: [phone] Customer Service: 1-877-623-6748
Internet: www.ncwatergdality.org Naturallff
An Equal Opportunity 1 Affirmative Action Employer

r,
Mr. Jim Palenick, City Manager
May 7, 2009
Page Two
--Non Eligible �.
Any installation of sewer service laterals outside the right-of-way.
In the event that received bids exceed the amount established through the funding offer,
and local funds are not adequate to award contract(s), it will be necessary to consider all
alternatives including redesign, re -advertising, and rebidding. Please note that the specifications
must include the special provisions of the ARRA (i.e., buy American, Davis -Bacon wage
requirements, job reporting) in addition to the regularly required SRF Special Conditions. Job
reporting requirements have not been established by the US EPA at this time, but will likely
include jobs created or retained, hours worked, type of jobs, etc.
Attached is one (1) copy of the Project Bid Information (Authority to Award) which is to
be completed after bids have been received, and submitted to Mr. Mark Hubbard, P.E.,
Assistant Section Chief, Construction Grants and Loans Section by June loth for review.
Upon review and approval of this information, the Section will authorize the Recipient to award
contracts. All elements required for a complete Bid Information package must be submitted to
ensure a timely review by the Section.
In accordance with a goal of the ARRA, contracts are expected to be executed by June
17th. If these dates cannot be met, you must contact the Section with a detailed explanation and
proposed alternative deadlines. Upon execution of contracts and issuance of Notice to Proceed, a
bound set of contract documents must be submitted to the Section for approval. Funds cannot be
dispersed until executed contracts are approved. While rejection of all bids is possible, such
action may be taken only with prior Section concurrence, and only for good cause.
In the event that progress on the approved ARRA CWSRF project is not made in
accordance with the loan agreement, construction contracts, or other pertinent
requirements reimbursements may be withheld or suspended indefinitely. Funds not
requested for reimbursement in a timely manner may also be reallocated to other ARRA
ready -to -go projects on the final State project list.
Once the project costs are established, final awards may be adjusted downward in the case
of low bids. Five percent contingency is included in the final amount to accommodate change
orders and amendments to the engineering contract. In no case will awards be increased.
Neither the State nor Federal Government, nor any of its departments, agencies or
employees is or will be a party to the invitation to bids, addenda, any resulting contracts or
contract negotiations/changes.
Your project is subject to the one-year performance certification requirements. By this,
you are required on the date one year after the completion of construction and initial operation of
the subject treatment facilities, to certify, based on your consulting engineer's advisement,
whether or not such treatment works meet the design performance, specifications and the permit
conditions and effluent limitations.

Mr. Jim Palenick, City Manager
May 7, 2009
Page Three
In accordance with the Federal Regulations, the Recipient is required to assure compliance
with the OSHA safety regulations on the subject project. In complying with this regulatory
responsibility, the Recipient should, by letter, invite the Bureau Chief, Education Training and
Technical Assistance Unit, NC OSHA Division, 1101 Mail Service Center, Raleigh, NC 27699-
1101 at [phone], to participate in the Preconstruction Conference to assure that proper
emphasis is given on understanding and adhering to the OSHA regulations.
It is the responsibility of the Recipient and the Consulting Engineer to insure that the
project plan documents are in compliance with Amended N. C. G. S. 133-3 (ratified July 13,
1993). The administrative review and approval of these plans and specifications, and any
subsequent addenda or change order, do not imply approval of a restrictive specification for
bidding purposes; nor is it an authorization for noncompetitive procurement actions.
Any addenda to be issued for subject project plans and specifications must be submitted by
the Recipient for review/approval action by the Section.
It is mandatory for project facilities to be constructed in accordance with the North
Carolina Sedimentation Pollution Control Act, and, when applicable, the North Carolina Dam
Safety Act. In addition, the specifications must clearly state what the contractors' responsibilities
shall be in complying with these Acts.
A goal of 8% of the contract price is established for Minority Business Enterprise (MBE)
participation in this project, and a goal of 5% of the contract price is established for Women's
Business Enterprise (WBE) participation in this project. The Recipient and Bidders shall make.a
good faith effort to assure that MBE's and WBE's are utilized, when possible, as sources of
goods and services. The good faith effort must include the following affirmative steps: (a)
including small, minority, and women's businesses on solicitation lists; (b) assuring that small,
minority, and women's businesses are solicited whenever they are potential sources; (c) dividing
total requirements, when economically feasible, into small tasks or quantities to permit
maximum participation by small, minority, and women's businesses; (d) establishing delivery
schedules, and (e) using the services of the Small Business Administration and the Minority
Business Development Agency of the U.S. Department of Commerce. Please note that the
solicitation efforts should include documentable follow-up phone calls.
The Recipient shall comply with the provisions of 40 CFR, Part 7, Subpart C -
Discrimination' Prohibited on the Basis of Handicap.
Two (2) copies of any change order must be promptly submitted by the Recipient to the
Section. If additional information is requested by the Section, a response is required within two
(2) weeks, or the change order will be returned without further or final action.
One (1) set of plans and specifications identical to the approved set must be available at
the project site at all times. Upon completion of the project construction, the Recipient shall
submit a letter confirming that the project has been constructed in accordance with the plans and
specifications approved by the Section. "As -built" plans will need to be submitted with any
changes clearly documented on the plans if the above confirmation cannot be made.

Mr. Jim Palenick, City Manager
May 7, 2009
Page Four
If there are any questions concerning this matter, please do not hesitate to contact Kim H.
Colson, P.E. at [phone] or Mark Hubbard, P.E. at [phone]. .
Sincerely,
Daniel M. Blaisdell, P.E., Section Chief
Construction Grants & Loans Section
Attachments: Determination of Minimum Construction Activity
Bid Information Form
KHC:AR
cc: Rusty Bost, P.E., City of Gastonia, Gastonia, NC
OSHA Bureau Chief, Wanda Lagoe
DWQ Mooresville Regional Office
Daniel Blaisdell, P.E. .
Mark Hubbard, P.E.
Jennifer Haynie
CIG
SRF

Determination of Minor Construction Activity
North Carolina Division of Water Quality
Construction Grants and Loans Section
Project Applicant: City of Gastonia
Date: April 29, 2009
Project Number: 2W370744-04
Estimated Project Cost: $ 308,532
Estimated Funding Amount: $ 308,532
Project Description: The proposed project consists of installation of 371 linear feet of 24-
inch CIPP liner in a 24-inch corroded class A concrete pipe that has suffered extensive
corrosion from hydrogen sulfide, at the Catawba Creek Pumping Station. The project
includes rehabilitation of the main inflow vault, replacement and lining of 24-inch bends
in the pipe, temporary by-pass pumping or piping during the construction, and
replacement of incidental driveway and sidewalks necessary to complete the project.
The above named applicant intends to apply for assistance from the State Revolving Fund
program associated with the American Recovery and Reinvestment Act of 2009 to
construct the wastewater facilities described above. The North Carolina Division of
Water Quality (DWQ) has conducted a review of the project in accordance with the
procedures (NCAC 15A Subchapter 1 C) for conformance with the North Carolina
Environmental Policy Act. The DWQ has determined that this project is a minor
construction activity, and that the preparation of additional enviromnental documents is
not required.
This determination shall become effective upon its distribution by DWQ. This
determination can be revoked at any time adverse information is made available. The
documentation to support this decision will be on file with the North Carolina
Department of Environment and Natural Resources, Division of Water Quality,
Construction Grants and Loans Section, and is available for public review at
www.nccgl.net.
Comments concerning this decision may be addressed to Mr. Kim H. Colson, P.E.,
Assistant Chief, Construction Grants and Loans Section, Division of Water Quality, 1633
Mail Service Center, Raleigh, North Carolina 27699-1633, or he may be reached by
phone at [phone].
Sincerely,
Daniel M. Blaisdell, P.E., Chief
Construction Grants and Loans Section
Division of Water Quality

PROJECT BID INFORMATION
Previously referred to as the "Part B" in State programs
Previously referred to as the "Project Review and Cost Summary" in Federal programs
! WARD RECIPIENT INFORMATIO
Name Project Number
Address
BID INFORMATION
Attach the following supplemental information and submit with this form:
(a) Tabulations of all bids received (sealed by engineer).
(b) Copies of the bid(s) and bid bond the applicant wishes to accept.
(c) Resolution of tentative award.
(d) Engineer's recommendation of award letter.
(e) Proof of advertisement
(f) MBE/WBE Requirements:
State Programs
■ Include affidavits A, B, C or D as required.
■ Submit certification of subcontract awards to minority business firms
with documentation to comply with G.S. 143-128.2. (Complete attached form)
Federal Programs (SRF and STAG)
■ Documentation of Contractor's "good faith" effort to procure MBE/WBE
subcontractors.
■ Certification regarding debarment, suspension and other responsibility matters
for each prime and subcontractor.
ilADDITIONAL INFORMATIO
Addenda
All addenda must be submitted to CG&L for approval prior to opening bids. Changes to the
scope of the project may require a permit modification.
Site Certificates (2)
Submit if not previously submitted or if changes have occurred.
Additional Items
• Land Costs (State Loans & Grants Only) Submit form if seeking payment.
• A/E Contracts — Submit for approval if seeking payment.
• Sewer Use Ordinance, User Charge System and Sewer budget (SRF Only) Payments
stop at 90% of total project costs if not approved.
• 4700 Form (SRF Only)
• Submit proof of adequate resident inspection (resume of inspector).

�lyy ! 1 L
•\ 1y31.y F'�. t 1yy L Sa 2 F}' 3 T �.i } f t.`� i h:�' �(' N _ci4. �'} - r 4 P',.yN i?tT'S `t+}%f,5 .€
List contractor names below:
TOTAL
ELIGIBLE
1.
$
$
2.
3.
4.
5.
EQUIPMENT AND MATERIALS
SLTBTOTAI
TECHNICAL SERVICES (attach contract)
LEGAL
ADMINISTRATIVE
CONTINGENCY (5% of construction)
OTHER (specify)
REAL PROPERTY ACQUISTION COSTS
CLOSING COSTS
' �TOTAL
List funds that are available for this project: I AMOUNT 11
CASH $
GENERAL OBLIGATION BONDS
REVENUE BONDS
OTHER (specify)
FEDERAL LOAN/GRANT (specify agency) b
STATE LOAN
STATE GRANT
TOTAL $
The undersigned representative of the Recipient certifies that the information contained above and in
any attached statements and material in support thereof is true and correct to the best of his or her
knowledge.
Signature of Authorized Representative
Name and Title (type or print) Date

INSTRUCTIONS FOR SUBMITTING
PROJECT BID INFORMATION FORM
This information must be.submitted as soon as possible after construction bids are opened.
For STAG and State projects send to:
Don Evans
Construction Grants and Loans Section
1633 Mail Service Center
Raleigh, NC 27699-1633
Page 1
For SRF Projects send to:
Mark Hubbard, PE
Construction Grants and Loans Section
1633 Mail Service Center
Raleigh, NC 27699-1633
Enter all requested information such as, Name, Address, and Project Number. Documentation
listed from (a) to (f) must be submitted. Addenda should be submitted before bids are opened
with enough time for CG&L to approve them (7 days). Site information should be attached if
not previously submitted.
Page 2
PROJECT COST SUMMARY
(1) Enter the contractor's company or corporate name. Enter the amount of the
bid or bids the applicant wishes to accept.
(2) If equipment or materials are to be or have been purchased outside the
construction contracts, enter the estimated or actual costs as applicable.
(3) If not previously submitted, attach copies of any engineering contracts or
agreements. Formal agreements are required for disbursement of funds.
(4) Contingency is limited to 5% of the total construction bid amount.
(5) Appraisals and a copy of the Deed are required for disbursement of real
property costs.
(6) Closing costs are not eligible for reimbursement under the SRF. They are 1.5% for
State Grants, 2% for SRF Loans and 2.5% for State.Loans.
REVENUE SOURCES FOR PROJECT CONSTRUCTION
(1) Enter the amount of general obligation: bonds and revenue bonds authorized
but not yet sold for this project.
(2) Enter the amount of the grant, if any, offered by Federal or State Agency(s)
and list name of agency(s).:
(3) Enter the amount of the loan or grant offered.
(4) Total funds available must equal or exceed the Total Project Cost.
The form must be signed by the applicant's authorized representative.

'RECIPIENT ",
"PROJECT=TITLE _
PROJECT
THE TOWN DOES HEREBY CERTIFY THAT IT HAS MET THE REQUIREMENTS OF G.S. 143-128.2 IN
REFERENCE TO MINORITY BUSINESS CONTRACTS FOR THIS CONSTRUCTION PROJECT. THE
CONTRACTOR HAS MET. THE GOALS ESTABLISHED BY RESOLUTION OF •THE TOWN AND THE
FOLLOWING CONTRACTS MEET THE REQUIREMENTS ADOPTED BY THE TOWN:
signature of authorized representative name of authorized representative
PLEASE LIST CONTRACTORS AND MINORITY SUBCONTRACTORS:
�r
CONTRACT: AMOUNT
MINORITY CONTRACT: AMOUNT
MINORITY CONTRACT: AMOUNT
CONTRACT: AMOUNT
MINORITY CONTRACT: AMOUNT
MINORITY CONTRACT: AMOUNT
CONTRACT: AMOUNT
MINORITY CONTRACT: AMOUNT
MINORITY CONTRACT: AMOUNT
CONTINUE IF MORE THAN THREE CONTRACTS

A���
�LA
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullinsre
Governor Director S'
May 7, 2009
The Honorable Donald E. Duncan, Jr., Mayor
MAY 1 2 2009
City of Conover
101 1st Street East
Post Office Box 549 , ; ,
Conover, North Carolina 28613 DW-i�f�' ` ° S-°' e
SUBJECT: City of Conover
2009 ARRA NE Outfall and Associated Sewer System
Rehabilitation and Replacement Project
Approval of the Funding Application for
American Recovery and Reinvestment Act of 2009
Project No. 2W370436-05
Dear Mayor Duncan:
The subject project was submitted for funding under the American Recovery and
Reinvestment Act of 2009 (ARRA). Some ARRA conditions are different than base Clean
Water State Revolving Fund (CWSRF) projects — please carefully read this entire letter.
The review for completeness and adequacy of the funding application including the project
engineering report and construction documents submitted for consideration of funding under the
ARRA has been concluded by the Construction Grants & Loans Section (Section) of the North
Carolina Division of Water Quality. Therefore, said documents are hereby approved. A
Determination of Minor Construction Activities for the project is attached for your files. A loan
offer will be transmitted to you separately, contingent upon approval by the Local Government
Commission at their May 5, 2009 or May 14, 2009 meetings.
Eligibility for Revolving Loan funding is determined as follows:
Eligible
Cleaning and TV investigation of approximately 18,500 linear feet of sewer pipe and service
laterals; sewer rehabilitation to include point repairs of approximately 420 linear feet of 8-inch
gravity sewer, 36 linear feet of 10-inch gravity sewer, 36 linear feet of 12-inch gravity sewer, and
36 linear feet of 15-inch gravity sewer; point repairs to existing 4-inch and 6-inch service laterals;
replacement of 1, 235 linear feet of 8-inch gravity sewer; replacement of 635 linear feet of 12-inch
gravity sewer; rehabilitation to existing manholes; rehabilitation (using cured -in -place pipe lining)
of 700 linear feet of 8-inch gravity sewer, 50 linear feet of 10-inch gravity sewer, 150 linear feet of
1633 Mail Service Center, Raleigh, North Carolina 27699-1633
Location: 2728 Capital Blvd. Raleigh, North Carolina 27604
Phone: [phone] FAX: [phone] Customer Service: 1-877-623-6748
Internet: www.ncwaterquality.org
An Equal Opportunity 1 Affirmative Action Employer
NorthCarolina
Naturally

The Honorable Donald E. Duncan, Jr., Mayor
May 7, 2009
Page Two
12-inch gravity sewer, and 100 linear feet of 15-inch gravity sewer, and reconnection of service
laterals within and up to the existing right-of-way.
Non Eli ig ble
Any installation of sewer service laterals outside the right-of-way.
In the event that received bids exceed the amount established through the funding offer,
and local funds are not adequate to award contract(s), it will be necessary to consider all
alternatives including redesign, re -advertising, and rebidding. Please note that the specifications
must include the special provisions of the ARRA (i.e., buy American, Davis -Bacon wage
requirements, job reporting) in addition to the regularly required SRF Special Conditions. Job
reporting requirements have not been established by the US EPA at this time, but will likely
include jobs created or retained, hours worked, type of jobs, etc.
Attached is one (1) copy of the Project Bid Information (Authority to Award) which is to
be completed after bids have been received, and submitted to Mr. Mark Hubbard, P.E.,
Upon review and approval of this information, the Section will authorize the Recipient to award
contracts. All elements required for a complete Bid Information package must be submitted to
ensure a timely review by the Section.
In accordance with a goal of the ARRA, contracts are expected to be executed by June
17`h. If these dates cannot be met, you must contact the Section with a detailed explanation and
proposed alternative deadlines. Upon execution of contracts and issuance of Notice to Proceed, a
bound set of contract documents must be submitted to the Section for approval. Funds cannot be
dispersed until executed contracts are approved. While rejection of all bids is possible, such
action may be taken only with prior Section concurrence, and only for good cause.
In the event that progress on the approved ARRA CWSRF project is not made in
accordance with the loan agreement, construction contracts, or other pertinent
requirements reimbursements may be withheld or suspended indefinitely. Funds not
requested for reimbursement in a timely manner may also be reallocated to other ARRA
ready -to -go projects on the final State project list.
Once the project costs are established, final awards may be adjusted downward in the case
of low bids. Five percent contingency is included in the final amount to accommodate change
orders and amendments to the engineering contract. In no case will awards be increased.
Neither the State nor Federal Government, nor any of its departments, agencies or
employees is or will be a party to the invitation to bids, addenda, any resulting contracts or
contract negotiations/changes.
Your project is subject to the one-year performance certification requirements. By this,
you are required on the date one year after the completion of construction and initial operation of
the subject treatment facilities, to certify, based on your consulting engineer's advisement,

The Honorable Donald E. Duncan, Jr., Mayor
May 7, 2009
Page Three
whether or not such treatment works meet the design performance, specifications and the permit
conditions and effluent limitations.
In accordance with the Federal Regulations, the Recipient is required to assure compliance
with the OSHA safety regulations on the subject project. In complying with this regulatory
responsibility, the Recipient should, by letter, invite the Bureau Chief, Education Training and
Technical Assistance Unit, NC OSHA Division, 1101 Mail Service Center, Raleigh, NC 27699-
1101 at [phone], to participate in the Preconstruction Conference to assure that proper
emphasis is given on understanding and adhering to the OSHA regulations.
It is the responsibility of the Recipient and the Consulting Engineer to insure that the
project plan documents are in compliance with Amended N. C. G. S. 133-3 (ratified July 13,
1993). The administrative review and approval of these plans and specifications, and any
subsequent addenda or change order, do not imply approval of a restrictive specification for
bidding purposes; nor is it an authorization for noncompetitive procurement actions.
Any addenda to be issued for subject project plans and specifications must be submitted by
the Recipient for review/approval action by the Section.
It is mandatory for project facilities to be constructed in accordance with the North
Carolina Sedimentation Pollution Control Act, and, when applicable, the North Carolina Dam
Safety Act. In addition, the specifications must clearly state what the contractors' responsibilities
shall be in complying with these Acts.
A goal of 8% of the contract price is established for Minority Business Enterprise (MBE)
participation in this project, and a goal of 5% of the contract price is established for Women's
Business Enterprise (WBE) participation in this project. The Recipient and Bidders shall make a
good faith effort to assure that MBE's and WBE's are utilized, when possible, as sources of
goods and services. The good faith effort must include the following affirmative steps: (a)
including small, minority, and women's businesses on solicitation lists; (b) assuring that small,
minority, and women's businesses are solicited whenever they are potential sources; (c) dividing
total requirements, when economically feasible, into small tasks or quantities to permit
maximum participation by small, minority, and women's businesses; (d) establishing delivery
schedules, and (e) using the services of the Small Business Administration and the Minority
Business Development Agency of the U.S. Department of Commerce. Please note that the
solicitation efforts should include documentable follow-up phone calls.
The Recipient shall comply with the provisions of 40 CFR, Part 7, Subpart C -
Discrimination Prohibited on the Basis of Handicap.
Two (2) copies of any change order must be promptly submitted by the Recipient to the
Section. If additional information is requested by the Section, a response is required within two
(2) weeks, or the change order will be returned without further or final action.
One (1) set of plans and specifications identical to the approved set must be available at
the project site at all times. Upon completion of the project construction, the Recipient shall
submit a letter confirming that the project has been constructed in accordance with the plans and

r
The Honorable Donald E. Duncan, Jr., Mayor
May 7, 2009
Page Four
specifications approved by the Section. "As -built" plans will need to be submitted with any
changes clearly documented on the plans if the above confirmation cannot be made.
If there are any questions concerning this matter, please do not hesitate to contact Kim H.
Colson, P.E. at [phone] or Mark Hubbard, P.E. at [phone].
Sincerely,
Daniel M. Blaisdell, P.E., Section Chief
Construction Grants & Loans Section
Attachments: Determination of Minimum Construction Activity
Bid Information Form
KHC:KOP
cc: Ryan W. Hagar, P.E., WK Dickson & Co., Inc., Hickory, NC
OSHA Bureau Chief, Wanda Lagoe
DWQ Mooresville Regional Office
Daniel Blaisdell, P.E.
Mark Hubbard, P.E.
Jennifer Haynie
CIG
SRF

Determination of Minor Construction Activity
North Carolina Division of Water Quality
Construction Grants and Loans Section
Project Applicant: City of Conover
Date: April 29, 2009
Project Number: 2W370436-05
Estimated Project Cost: $ 1,727,025
Estimated Funding Amount: $ 1,727,025
Project Description: The proposed project consists of (1) cleaning and TV
investigation of approximately 18,500 linear feet of sewer pipe and service laterals; (2)
sewer rehabilitation to include point repairs of approximately 420 linear feet of 8-inch
gravity sewer, 36 linear feet of 10-inch gravity sewer, 36 linear feet of 12-inch gravity
sewer, and 36 linear feet of 15-inch gravity sewer; (3) point repairs to existing 4-inch and
6-inch service laterals; (4) replacement of 1, 235 linear feet of 8-inch gravity sewer; (5)
replacement of 635 linear feet of 12-inch gravity sewer; (6) rehabilitation to existing
manholes; and (7) rehabilitation (using cured -in -place pipe lining) of 700 linear feet of 8-
inch gravity sewer, 50 linear feet of 10-inch gravity sewer, 150 linear feet of 12-inch
gravity sewer, and 100 linear feet of 15-inch gravity sewer.
The above named applicant intends to apply for assistance from the State Revolving Fund
program associated with the American Recovery and Reinvestment Act of 2009 to
construct the wastewater facilities described above. The North Carolina Division of
Water Quality (DWQ) has conducted a review of the project in accordance with the
procedures (NCAC 15A Subchapter 1 C) for conformance with the North Carolina
Environmental Policy Act. The DWQ has determined that this project is a minor
construction activity, and that the preparation of additional environmental documents is
not required.
This determination shall become effective upon its distribution by DWQ. This
determination can be revoked at any time adverse information is made available. The
documentation to support this decision will be on file with the North Carolina
Department of Environment and Natural Resources, Division of Water Quality,
Construction Grants and Loans Section, and is available for public review at
www.nccgl.net.

Comments concerning this decision may be addressed to Mr. Kim H. Colson, P.E.,
Assistant Chief, Construction Grants and Loans Section, Division of Water Quality, 1633
Mail Service Center, Raleigh, North Carolina 27699-1633, or he may be reached by
phone at [phone].
Sincerely,
Daniel M. Blaisdell, P.E., Chief
Construction Grants and Loans Section
Division of Water Quality

PROJECT BID INFORMATION
Previously referred to as the "Part B" in State programs
Previously referred to as the "Project Review and Cost Summary" in Federal programs
1AWARD RECIPIENT INFORMATIONIi
Name
Address
Project Number
i ID INFORMATIO
Attach the following supplemental information and submit with this form:
(a) Tabulations of all bids received (sealed by engineer).
(b) Copies of the bid(s) and bid bond the applicant wishes to accept.
(c) Resolution of tentative award.
(d) Engineer's recommendation of award letter.
(e) Proof of advertisement
(f) MBE/WBE Requirements:
State Programs
■ Include affidavits A, B, C or D as required.
■ Submit certification of subcontract awards to minority business firms
with documentation to comply with G.S. 143-128.2. (Complete attached form)
Federal Programs (SRF and STAG)
■ Documentation of Contractor's "good faith" effort to procure MBE/WBE
subcontractors.
■ Certification regarding debarment, suspension and other responsibility matters
for each prime and subcontractor.
DDITIONAL INFORMATIO
Addenda
All addenda must be submitted to CG&L for approval prior to opening bids. Changes to the
scope of the project may require a permit modification.
Site Certificates (2)
Submit if not previously submitted or if changes have occurred.
Additional Items
• Land Costs (State Loans & Grants Only) Submit form if seeking payment.
• A/E Contracts — Submit for approval if seeking payment.
• Sewer Use Ordinance, User Charge System and Sewer budget (SRF Only) Payments
stop at 90% of total project costs if not approved.
• 4700 Form (SRF Only)
• Submit proof of adequate resident inspection (resume of inspector).

1� �-k 1's { :i. 4 � ii.+. � ^� �ir1a ,*st"" ��5 y-^t� iW ?7�� xlr � {�Y 1 is F �i" fi 5
✓ L� �i+f S4 ;SN q �
'`°' 2� �„� �i,.i
�"
.� �S�'� �
?x'r i "i,,Y i � t a' ,,� 7.7 � rV } ;., wt�' F'#•i�d 4 A r` 5,. �f "Y`&.y��."'§�ri'
tl.Ps . � .. , . �
,- a.�-n,.. ..;-.ei. no_. .. .� ....5._.T�. �, v^'�.`Ya..T'. Y....J �nYv` •I. Y»_:.r Ali er��.r.-.� ., .T'�.t:t�l cD.�..... �, s,�.,. ,-..�J. :V-1T.2�`�.
,,,�2 ',.P,� �w s' � �E€ w
>5-�,-�-. M�. .Y..'3_-�L `� i�.-. c"i
List contractor names below:
TOTAL
ELIGIBLE
1.
$
$
2.
3.
4.
5.
EQUIPMENT AND MATERIALS
TECHNICAL SERVICES attach contract)
LEGAL
ADMINISTRATIVE
CONTINGENCY 5% of construction
OTHER (specify)
REAL PROPERTY ACQUISTION COSTS
CLOSING COSTS
Q
$
Q
W
R'�OUI2C`�5)�02NPRO.I,T �Oil'TRNI;TIO�T
k? $�
> '��f
,,.6
._1i!.Y
List funds that are available for this project
AMOUNT
CASH
$
GENERAL OBLIGATION BONDS
REVENUE BONDS
OTHER (specify)
FEDERAL LOAN/GRANT (specify agency) b
STATE LOAN
STATE GRANT
t 'TOTAL
The undersigned representative of the Recipient certifies that the information contained above and in
any attached statements and material in support thereof is true and correct to the best of his or her
knowledge.
Signature of Authorized Representative Name and Title (type or print) Date

INSTRUCTIONS FOR SUBMITTING
PROJECT BID INFORMATION FORM
This information must be submitted as soon as possible after construction bids are opened.
For STAG and State projects send to:
Don Evans
Construction Grants and Loans Section
1633 Mail Service Center
Raleigh, NC 27699-1633
Page 1
For SRF Projects send to:
Mark Hubbard, PE
Construction Grants and Loans Section
1633 Mail Service Center
Raleigh, NC 27699-1633
Enter all requested information such as; Name, Address, and Project Number. Documentation
listed from (a) to (f) must be submitted. Addenda should be submitted before bids are opened
with enough time for CG&L to approve them (7 days). Site information should be attached if
not previously submitted.
Page 2
PROJECT COST SUMMARY
(1) Enter the contractor's company or corporate name. Enter the amount of the
bid or bids the applicant wishes to accept.
(2) If equipment or materials are to be or have been purchased outside the
construction contracts, enter the estimated or actual costs as applicable.
(3) If not previously submitted, attach copies of any engineering contracts or.
agreements. Formal agreements are required for disbursement of funds.
(4) Contingency is limited to 5% of the total construction bid amount.
(5) Appraisals and a copy of the Deed are required for disbursement of real
property costs.
(6) Closing costs are not eligible for reimbursement under the SRF. They are 1.5% for
State Grants, 2% for SRF Loans and 2.5% for State Loans.
REVENUE SOURCES FOR PROJECT CONSTRUCTION
(1) Enter the amount of general obligation bonds and revenue bonds authorized
but not yet sold for this project.
(2) Enter the amount of the grant, if any, offered by Federal or State Agency(s)
and list name of agency(s).
(3) Enter the amount of the loan or grant offered.
(4) Total funds available must equal or exceed the Total Project Cost.
The form must be signed by the applicant's authorized representative.

=PR0,JECT;le10.
THE TOWN DOES HEREBY CERTIFY THAT IT HAS MET THE REQUIREMENTS OF G.S. 143-128.2 IN
REFERENCE TO MINORITY BUSINESS CONTRACTS FOR THIS CONSTRUCTION PROJECT. THE
CONTRACTOR HAS MET THE GOALS ESTABLISHED BY RESOLUTION OF THE TOWN AND THE
FOLLOWING CONTRACTS MEET THE REQUIREMENTS ADOPTED BY THE TOWN:
signature of authorized representative name of authorized representative
PLEASE LIST CONTRACTORS AND MINORITY SUBCONTRACTORS:
CONTRACT: AMOUNT
MINORITY CONTRACT: AMOUNT
MINORITY CONTRACT: AMOUNT
CONTRACT: AMOUNT
MINORITY CONTRACT: AMOUNT
MINORITY CONTRACT: AMOUNT
CONTRACT: AMOUNT
MINORITY CONTRACT: AMOUNT
MINORITY CONTRACT: AMOUNT
CONTINUE IF MORE THAN THREE CONTRACTS

RA
WDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
August 17, 2009
Mr. David Saleeby, Town Manager AUG 1 9 7
Town of Troutman
Post Office Box 26
Troutman, North Carolina 28166
SUBJECT: Pre ConstrMu-w4iog,;
Town of Troutman, Iredell County
Sewer & Manhole Rehab.
Projects No. 2W 370 580-04
Dear Mr. Saleeby:
A Preconstruction conference was conducted on July 29, 2009 at 2:00 p.m. for subject
project at Town Hall, 400 North Eastway Drive. Attached is the agenda presented by the
undersigned representative from the Construction Grants & Loans Section. Please review the report
and then file for your records.
For the record, regularly scheduled progress meetings will be scheduled for 4`h Thursday
each month at 2:30 p.m. for the duration of the project. Contract Completion date for the project is
Nov. 27, 2009 with a substantial completion date of Oct. 30, 2009.
If you have any questions about this matter, please email me at gerald.horton@ncdenr.1zov or
call me at [phone].
Sincerely,
GerWrtn, PE, Project Engineer
Construction Inspection Group
G1V1l/gIvII
cc: Benjie Thomas, PE, West Consultants
F2ob I c$ebs Moots i11eyRRe nao F WQ +Off ce?
CG&L - Mark Hubbard, PE
H;1f7.. '� :" 1'i"i'P -
Construction Grants and Loans Section One
1633 Mail Service Center Raleigh NC 27699-1633 NorthCarolina
Phone: [phone] / FAX: [phone] / Internet: www.nccgl.net naturally
An Equal Opportunity/Affirmative Action Employer — 50% Recycled/10% Post Consumer Paper

Troutman, NC
Sewer & Manhole Rehab
Page 2 of 5
Pre construction meeting of
July 29, 2009
Pre -Construction Meeting List of Attendees:
Attendees :
David Saleeby
Steve Shealy
Benjie Thomas, PE
John Abernethy, Jr.
Ben Alter
Gerald W. Horton
Town of Troutman, Town Manager
Troutman, Finan. Dir.
West Consultants
West Consultants
Gilbert Engineering Co.
NC Construction Grants & Loans
704 528-7600
704 528-7600
704 433-5661
828 413-7383
704 902-5228
919 715-6219
Authorized Representatives:
Loan or Grant Recipient: David Saleeby, Town Manager
State: Mark Hubbard, PE, Gerald Horton, PE, NC-DENR, DWQ, CG&L
Consulting Engineer: West Consultants, Benjie Thomas
Inspector: John Abernethy, Jr.
Date and Time of next (first) Progress meeting: Thurs. Sept. 3 2:30 p.m. at Town Hall
Description of Eligible work
o Sewer rehabilitation consisting of replacement of approximately 400 linear feet of 8-inch
gravity sewer,
o relining (CIPP) of approximately 771 linear feet of 8-inch gravity pipe,
o replacement of approximately 10 manholes,
o rehabilitate (raise) 2 manholes, and
o modification of the Massey Street Pump Station, consisting of construction of a smaller
wet -well structure
Contract
Gilbert Engineering Co., PO Box 828, Statesville, NC 28687-0828, Lic # 999
Unlimited:Unclassified
Contract Amount: $211,495 (contract amount and eligible amount); Supt. — ?
Notice to Proceed issued July 29 effective July 30 for a completion date of Nov. 30, 2009 and a
construction period of 120 days; Liquidated damages $ 500 / day
Loan Budget, Eligible Amount
Gilbert Engineering Co. $ 211,495
Contingency $ 6,100
Technical Services $ 20,000
Total Eligible Costs $ 237,595
No reimbursement payments can be made until the contract documents have been approved,
the initial promissory note is executed, and the disbursement accounts are established.
Comments, observations and concerns discussed at the meeting:
1. Reader is also referred to Engineer prepared Pre -Construction minutes.
2. CG&L strongly recommended all parties make their own route and site video and/or
photography to document pre -construction conditions.
3. CG&L advised that contractor shall maintain records indicating compliance with the Davis
Bacon Act and "buy American".
4. CG&L reminded Owner and contractors that a project sign is required.

-i
Troutman, NC
Sewer & Manhole Rehab
Page 4 of 5
Pre construction meeting of
July 29, 2009
o records of testing of materials, soils, concrete, equipment, and
o pending or executed change orders for completeness and accuracy.
4. The Division of Water Quality (DWQ) requests that all equipment and materials on job site be
properly stored, stockpiled, and protected. Improper storage of materials and equipment may
result in recommendation to reduce reimbursement amount. The job site(s) shall be maintained
in an acceptable manner.
5. Safe working conditions should be maintained at all times. CIG will discuss potential or
apparent safety violations, which may be life endangering or threatening of serious injury. If
warranted or deemed necessary, CIG will take prompt action including notifying State and
OSHA regional representatives of any noted conditions. It remains the Contractor's sole
responsibility to maintain safe working conditions and activities.
6. Results of the inspection will be discussed at the job site during or upon completion of the
inspection.
7. Formal copies of the inspection report will be sent to the STAG Grant Recipient, the Engineer
and to other parties, only if so requested.
8. CIG asks to be notified when the Engineer or Owner plan to schedule a pre final and/or the final
inspection(s). CG&L requests a copy of punch list(s). In order to close out the project CG&L
must conduct a final inspection.
CHANGE ORDERS
DWQ "approval" of change orders means the State determines the Grant or Loan eligibility thereof.
The Loan or Grant Recipient (Owner) should notify DWQ prior to commencement of any change
order work which change the scope of the project, except for emergency situations. Approval of
each change order is the responsibility of the Owner and Contractor. Records of change orders
should be available for review at any time and CG&L requires being one original of all executed
change orders and supporting information so CG&L may determine eligibility for the loan or grant.
However, approval of change orders by CG&L is not necessary on STAG projects. CG&L does
however request copies of all change orders on STAG projects. Owner is advised that occasionally
EPA requests the State review the change order(s) for efficacy and determine if justified.
RECIPIENT's (OWNER) AND ENGINEER's RESPONSIBILITY
1. The Owner and Engineer should become familiar with their responsibilities as deemed in the
Code of Federal Regulations Part 40 CFR.
2. Loan and/or grant conditions must be met and loan or grant objectives achieved.
3. For STAG (State and Tribal Assistance Grant) projects, the Owner shall submit Quarterly
Project Progress reports and separate Quarterly MBE/WBE reports. Progress Project Quarterly
report format and mailing information is attached. An electronic version is available on
CG&L's web site. Project Progress Quarterly reports are to be submitted to CG&L, however
the MBE/WBE quarterly reports are to be submitted directly to EPA as agreed to by Owner
upon acceptance of the STAG Grant offer. Owner should refer to that documentation.
OWNER PAYMENT REQUEST
1. Before first reimbursement request will be processed, the Owner must provide NC CG&L
executed engineering contract(s) and executed Construction contract(s).
2. Owner should provide the NC CG&L inspector with Schedule(s) of Values (SOV) and
Construction (Progress) Schedule for each construction contract. Schedule of Values should
correlate with Bid items or construction costs as applicable. Providing the SOV in electronic
format, excel or other spreadsheet would be appreciated.
3. Owner should submit all payment requests on form SF271 to the NC CG&L section with backup

Troutman, NC
Sewer & Manhole Rehab
Page 3 of 5
Pre construction meeting of
July 29, 2009
5. The approved set of contract drawings should be furnished to the Owner, inspector, and to
contractor's superintendent. A set of drawings shall be marked up as authorized changes
occur and as hidden site conditions are discovered. The marked up drawings are to be used
in preparing record (as -built) drawings. These marked -up drawings shall be maintained
and shall be made available for review by State inspectors at all tunes at the work site.
Should record drawings not be kept up to date or made available for review, CG&L may
consider withholding reimbursement until the matter is resolved.
6. CG&L Hereby requests acknowledges receipt of half size set of all project drawings be
provided to the CG&L inspector.
7. At meeting CG&L requested being notified when a pre -final and the final inspection will
occur. CG&L asks that it be provided punch list(s) generated.
8. Prior to commencement of work, contractor shall submit a "Construction Progress
Schedule" (i.e. Bar graph, CPM, etc.) showing a breakdown of the principal features of
construction correlating to the contract costs. Construction schedule(s) shall be prepared in
a format such that the percentage of work completed and the work scheduled for completion
at any given date may be determined or estimated.
9. Owner shall submit an itemized cost breakdown; that is, a "Schedule of Values" for each
contractor, which shall serve as the basis of reimbursement payments for contractor's
monthly estimates and progress payments. This office requests one copy only of each of
these two schedules. These may be emailed and the Schedule of Values is preferred in
electronic spreadsheet format or Excel.
10. The Owner confirmed at the meeting that all addenda have been submitted to CG&L for
approval and that approval was received on both contracts.
11. CG&L advised that OSHA, wage rates and other bulletins must be posted at job site.
12. CG&L presented highlights of remaining items in this Pre Constriction inspection report.
13. Engineer asked that contractor keep Owner and Engineer informed on scheduling especially
when starting on man hole rehab.
14. Owner asked contractor to coordinate the Massey St. P. Sta. work with Owner, refer to sheet 8.
ROLE OF THE CONSTRUCTION INSPECTION GROUP (CIG)
1. Conduct periodic inspections of the project.
2. Review change orders for necessity and reasonableness to determine eligibility for loan funding.
3. Purpose:
a. To ensure that the overall objectives of the loan or grant are realized.
b. To monitor administration of the loan and/or grant to ensure the project is executed in
accordance with State regulations and loan and/or grant conditions.
c. To ensure contract compliance and construction in accordance with NC DENR approved
contract documents.
d. To advise and offer assistance to the loan and/or grant Recipient.
CIG (Construction Inspection Group) INSPECTIONS
1. Prior notice will be given; however, unannounced inspections may also be conducted.
2. Inspections will be concerned with administrative matters and construction matters/activities.
3. During inspections, CIG may wish to review, observe and/or discuss:
o files and status of shop drawings, submittals,
o inspector's field reports,
o status of record (as -built) drawings,
o status of: Requests for Information (RFIs), Requests for Proposals (RFPs)
o revised construction schedules,

Troutman, NC
,r Sewer & Manhole Rehab
Page 5 of 5
Pre construction meeting of
July 29, 2009
documentation as needed to support the pay request. Forms may be obtained at CG&L web site
http://www.nccgl.net/
4. Owner should be aware of the following payment milestones:
a. Before first reimbursement can be made, Contract Documents must be approved.
b. Prior to 90% Disbursement - All tax must be reported.
c. Before final reimbursement - Engineer's Certification of Completion must be received.
5. Loan and or Grant Agreement/Amendments and all conditions placed on them, if applicable,
must be satisfied prior to reimbursements.
6. The Contractor's pay request should coincide with the items on the bid form or approved
schedule of values.
7. Do submit / report sales tax with each pay request. The sales tax report should indicate the time
period that is covered. The reimbursement amount will be reduced by the sales tax amount at
the 90% milestone. The sales tax is included in the Owner's loan or grant amount. Therefore,
the Owner should be prepared to cover this amount until they receive a disbursement or
reimbursement. If the contractor makes no purchases and has no sales tax to report for the
period, regardless, the sales tax report should be submitted and indicate "No sales tax to report
this period."
8. If requesting reimbursement / payment for materials stored on site, invoice(s) must be provided
to document material cost. Such materials shall be stored safely and securely on site or in a
bonded locafion(s). An affidavit from the Engineer may be requested by CG&L for items stored
at a bonded location.
ENVIRONMENTAL PROTECTION
The Owner is advised that the protection of the environment is a loan or grant requirement. It is for
Owner, Contractor(s), Engineer and other participating entities to comply with all environmental
pollution control programs established by the Local jurisdiction, the State, and the EPA. This
includes, but is not limited to:
1. Protection of existing trees, shrubs, and grass.
2. Dust control of haul roads, excavation areas, work areas, and borrow areas.
3. Submission of, adherence to, and compliance with the erosion and sedimentation control
plan approved by the applicable State or local agency.
4. Continued proper conveyance and treatment of Owner's wastewater during
construction.
5. Proper disposal of all solid and hazardous wastes encountered or generated as part of the
project.
6. Notifying the NC Division of Water Quality (DWQ) field office in Mooresville, NC,
telephone: ( 704 663-1699 ) to report an oil spill, sewer spill, or other environmental
emergency caused by any party. The responsible party shall take the initiative to report the
matter promptly and to initiate containment and cleanup activities.
7. Because this is an environmental project, it is expected that the Contractor(s) and sub
contractors collect and properly dispose of litter, trash and debris generated by workmen on
the project or on the site and along routes of the work.
< END Preconstruction Report >

�v
DIVISION OF WATER QUALITY
November 29, 2005
Memo To:
Z. Chen, Project Manager
Construction Grants and Loans
From.
Rex Gleason, P.E.
Prepared By:
Michael Parker )V51
Subject:
Town of Troutman
Sewer Interconnect with Town of Mooresville
Iredell County
Per your memo dated October 15, 2005, this Office has reviewed the subject preliminary
engineering report submitted by the Town of Troutman (the Town) regarding a proposed sewer
interconnect with the Town of Mooresville that will provide the Town with the necessary sewer
capacity to accomodate the anticipated growth expected to occur in the next 20 years.
Presently, the Town is sending all wastewater to the City of Statesville. The contractual
agreement between the Town and Statesville allows the Town to discharge up to .455 MGD of
wastewater into Statesville's collection system (current flows average 0.265 MGD). Based on
projected 20-year sewer capacity needs, the Town will be generating an estimated 0.846 MGD of
wastewater, which is almost double what Statesville and the Town have contracted for. Population
projections for the Troutman area indicate that the Town's population will more than triple in the
next 20 years, and additional development planned within the Town's sewer service area will further
increase demand on wastewater disposal. For this reason, the Town has begun the process of
examing all available options for future sewer capacity.
Ideally, the Town could increase the amount it sends to Statesville, which would be the
simplest way to solve the Town's future capacity concerns. Unfortunantly, Statesville is in a
position where expansion at the City's Fourth Creek WWTP is questionable due to impairment and
low 7Q 10 flow of the receiving stream. The Town has also considered constructing its own
WWTP, however, this option was explored extensively several years ago prior to the Town entering
into the sewer agreement with Statesville. At that time, it was discovered that there was not a
suitable receiving stream available to the Town in which to discharge. The Town then approached
the Town of Mooresville, who currently has available capacity in their WWTP that would take care
of the Town's current needs. Mooresville has also begun the process of expanding it's WWTP, and
could include the projected 20-year flow from Troutman in their expansion plans. This interconnect
would allow for Troutman to continue at their present growth rate, utilize existing treatment
capacity in non -impaired waters, and allow the Town to maintain the option of sending wastewater
to either Mooresville or Statesville depending on conditions at either facility. Troutman is
anticipating the addition of an ammonia nitrogen limit being imposed by Statesville in the near
future, but is not anticipating such from Mooresville. Such being the case, this Office has no
objection to the Town's constructing a sewer interconnect with the Town of Mooresville.

Page Two
If you have any questions regarding this matter, please advise.
/mlp
cc: Barbara Sifford
hAgenkogtmemo.doc

Permit
Issued
Effect Expired
Number
Owner Name - Facility Name
Owner Tvoe
Permit Tvoe
County
Date
Date Date
Primary Reviewer
Reqion
W00019199
Town of Mooresville - Upper Rocky River
Government -
Gravity Sewer Extension, Pump Stations, & Pressure
Iredell
08/02/02
08/02/02
kristin.miguez
Mooresville
Sewers/Dogwood Street Sewer
Municipal
Sewer Extensions
WQ0021108
Town of Mooresville - Wastewater Facilities, Mount
Government -
Gravity Sewer Extension, Pump Stations, & Pressure
Iredell
03/11/02
03/11/02
kristin.miguez
Mooresville
Mourne Force Main
Municipal
Sewer Extensions
WQ0021795
Town of Mooresville - Wastewater Facilities, West
Government -
Gravity Sewer Extension, Pump Stations, & Pressure
Iredell
11/08/02
11/08/02
kristin.miguez
Mooresville
Branch Reeds Creek
Municipal
Sewer Extensions
WQ0015286
Town of Mooresville - Williamson Road Sewerline
Government -
Gravity Sewer Extension, Pump Stations, & Pressure
Iredell
07/16/03
07/16/03
sylvia.barbour
Mooresville
Extension
Municipal
Sewer Extensions
W00020256
Town of Troutman -Autumn Creek Subdivision
Government -
Gravity Sewer Extension, Pump Stations, & Pressure
Iredell
09/17/01
09/17/01
kristin.miguez
Mooresville
Municipal
Sewer Extensions
r W00021877
t
Town of Troutman - Barium Seasons Village
Government -
Gravity Sewer Extension, Pump Stations, & Pressure
Iredell -
\L --- - -
11/22/02
-
11I22/02 s
-
kristin.miguez
Mooresville
Municipal
Sewer Extensions
W00024769
Town of Troutman - Charles Center
Government -
Gravity Sewer Extension, Pump Stations, & Pressure
Iredell
01/12/05
01/12/05
sonja.basinger
Mooresville
Municipal
Sewer Extensions
WQ0021876
Town of Troutman - Dogwood Estates, Phase I
Government -
Gravity Sewer Extension, Pump Stations, & Pressure
Iredell
11/22/02
11/22/02
kristin.miguez
Mooresville
Municipal
Sewer Extensions
WQ0020223
Town of Troutman - Eastern Heights Phase 2
Government -
Gravity Sewer Extension, Pump Stations, & Pressure
Iredell
08/27/01
08/27/01
kristin.miguez
Mooresville
Municipal
Sewer Extensions
W00020624
Town of Troutman - Jacob's Woods Subdivision
Government -
Gravity Sewer Extension, Pump Stations, & Pressure
Iredell
11/30/01
11/30/01
kristin.miguez
Mooresville
Municipal
Sewer Extensions
WQ0021978
Town of Troutman - Kenneth Bealer Homes, Lots 1-6
Government -
Gravity Sewer Extension, Pump Stations, & Pressure
Iredell
11/22/02
11/22102
kristin.miguez
Mooresville
Municipal
Sewer Extensions
W00020383
Town of Troutman - Pleasant Garden
Government -
Gravity Sewer Extension, Pump Stations, & Pressure
Iredell
09/28/01
09/28/01
kristin.miguez
Mooresville
Municipal
Sewer Extensions
WQ0022336
Town of Troutman - Quail Hollow Subdivision
Government -
Gravity Sewer Extension, Pump Stations, & Pressure
Iredell
02/24/03
02/24/03
marie.doklovic
Mooresville
Municipal
Sewer Extensions
WQ0029063
Town of Troutman - Troutman Industrial Park
Government -
Gravity Sewer Extension, Pump Stations, & Pressure
Iredell
07/08/05
07/08/05
dee.browder
Mooresville
Municipal
Sewer Extensions
WQ0017823
Town of Troutman - Troutman Town
Government -
Gravity Sewer Extension, Pump Stations, & Pressure
Iredell
03/22/00
03/22/00
kim.colson
Mooresville
Municipal
Sewer Extensions
W00018792
Town of Troutman - Troutman Town -Barium Lane
Government -
Gravity Sewer Extension, Pump Stations, & Pressure
Iredell
09/07/00
09/07/00
kristin.miguez
Mooresville
Municipal
Sewer Extensions
WQ0017155
Town of Troutman - Troutman Town -South Trace
Government -
Gravity Sewer Extension, Pump Stations, & Pressure
Iredell
08/06/99
08/06/99
kristin.miguez
Mooresville
Sub
Municipal
Sewer Extensions
WQ0015168
Town of Troutman - Troutman Town -US Hwy 21 Util
Government -
Gravity Sewer Extension, Pump Stations, & Pressure
Iredell
03/08/99
03/08/99
kim.colson
Mooresville
Municipal
Sewer Extensions
WQ0004108
Tricor - Tricor-Sewer
Non -Government
Gravity Sewer Extension, Pump Stations, & Pressure
Iredell
09/28/90
09/28/90
kim.colson
Mooresville
Sewer Extensions
W00021583
Tsumas Family Limited Partnership - Morrison
Non -Government
Gravity Sewer Extension, Pump Stations, & Pressure
Iredell
08/12/02
08/12/02
kristin.miguez
Mooresville
Executive Suites
Sewer Extensions
W00013800
Underhill Corp - Underhill Corp -Underhill Vill
Non -Government
Gravity Sewer Extension, Pump Stations, & Pressure
Iredell
05/02/97
05/02/97
kristin.miguez
Mooresville
Sewer Extensions
WQ0015791
Venture Properties III, LLC - Venture Properties I
Non -Government
Gravity Sewer Extension, Pump Stations, & Pressure
Iredell
09102/98
09/02/98
kristin.miguez
Mooresville
LLC-Stap
Sewer Extensions
WQ0019358
Village At Lake Norman Ph 1 - Village At Lake
Non -Government
Gravity Sewer Extension, Pump Stations, & Pressure
Iredell
02/19/01
02/19/01
kristin.miguez
Mooresville
Norman Ph 1
Sewer Extensions
W00003565
Vintage Dev Cc - Vintage Dev Co-Femcliff Est
Non -Government
Gravity Sewer Extension, Pump Stations, & Pressure
Iredell
07/11/90
07/11/90
kim.colson
Mooresville
Sewer Extensions
W00008658
W G S Inc - W G S Incorporated -Windsor Wds Subd
Non -Government
Gravity Sewer Extension, Pump Stations, & Pressure
Iredell
01/11/94
01/11/94
kim.colson
Mooresville
Sewer Extensions
WQ0019447
Wachovia Bank Na - Wachovia Bank Na-Brawley
Non -Government
Gravity Sewer Extension, Pump Stations, & Pressure
Iredell
02/19/01
02/19/01
kristin.miguez
Mooresville
Corn
Sewer Extensions
13

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins ee R e6r� y
r zs
Governor Director„nL secretary"`Y°°-'
May 15, 2009
MAY 19 2009
Mr. David Saleeby, Town Manager
Town of Troutman
Post Office Box 26
Troutman, North Carolina 28166
SUBJECT: Town of Troutman
Sewer Improvements
Approval of Addenda Nos. 1 and 2
American Recovery and Reinvestment Act of 2009
Project No. 2W370580-04
Dear Mr. Saleeby:
Reference is made to Addenda Nos. 1 and 2, received May 14, 2009, from the engineer
for revisions to the subject project.
The proposed addenda, as described in the attachments, have been reviewed by this
office, and are hereby approved, and eligible for funding in accordance with the loan offer and
conditions thereof.
The approval of these addenda does not constitute any change in the amount of your loan
for this project.
It is the responsibility of the recipient and the consulting engineer to insure that the
project plan documents are in compliance with Amended N.C.G.S. 133-3 (ratified July 13,
1993). The administrative review and approval of addenda do not imply approval of a restrictive
specification for bidding purposes; nor is it an authorization for noncompetitive procurement
actions.
Adequate time must be allowed for the potential bidders and this office to receive and act
on addenda prior to the receipt of bids for subject project.
A copy of the approved addenda is attached for your files, and one (1) copy retained for
our files.
1633 Mail Service Center, Raleigh, North Carolina 27699-1633 One
Location: 2728 Capital Blvd. Raleigh, North Carolina 27604 NorthCarolina
Phone: [phone] FAX: [phone] Customer Service: 1-877-623-6748 n n /
Internet: www.ncwaterquality.org
An Equal Opportunity 1 Affirmative A�yt�t+�llf �/
Action Employer �/

Mr. David Saleeby, Town Manager
Page 2
May.15, 2009
Should you have any questions regarding this matter, please do not hesitate to contact
Ken Pohlig, P.E. at [phone].
Sincerely,
&0 /� 5�
Seth Robertson, P.E., Supervisor
Design Management Unit
Construction Grants & Loans Section
kp/sr
Attachment
cc: Benjamin B. Thomas, P.E., West Consultants, PLLC, Morganton, NC
. DW_Q Mooresvilie_Regional_Office�
Mark Hubbard, P.E.
Ken Pohlig, P.E.
ARRA File

t
4
WEST -
CONSULTANTS me
405 South Sterling Street, Morganton NC 28655
828 433 5661 / Fax [phone] / [e-mail]
ADDENDUM NO. 1 r
, MAY 14 2009
t}. ►..'.
.:, , r.'
This ADDENDUM NO. 1 is being issued April 29, 2009, to all parties who hold a set of
CONTRACT DOCUMENTS on the project entitled:
TOWN OF TROUTMAN
SEWER IMPROVEMENTS
AMERICAN REINVESTMENT & RECOVERY ACT FUNDING
IREDELL COUNTY, NORTH CAROLINA
This ADDENDUM NO. 1 shall become part of the CONTRACT DOCUMENTS and its
receipt acknowledged on the BID DOCUMENTS at the time of bidding.
ARRA Special Conditions:
In accordance with the American Recovery and Reinvestment Act of 2009 (ARRA), the
following requirements apply to this project and the Contractor shall comply with each
one:
A. Prevailing Wages
Section 1606 of the ARRA contains the following language:
"Notwithstanding any other provision of law and in a manner consistent with
other provisions in this Act, all laborers and mechanics employed by contractors
and sub contractors on projects funded directly by or assisted in whole or in part
by and through the Federal Government pursuant to this Act shall be paid wages
at rates not less than those prevailing on projects of a character similar in the
locality as determined by the Secretary of Labor in accordance with subchapter
IV of chapter 31 of title 40, United States Code. With respect to the labor
standards specified in this section, the Secretary of Labor shall have the authority
and functions set forth in Reorganization Plan Numbered 14 of 1950 (64 Stat .
1267; S U. S. C.App.) and section 3145 of title 40, United States Code. "
Current wages for assumed types of laborers are included herein. Contractor
shall be required to pay prevailing wages at time of Contract and based on actual
labor category used.
B. American Iron, Steel, and Manufactured Goods
Section 1605 of the ARRA requires that none of the appropriated funds may be
used for the construction, alteration, maintenance, or repair of a public building
or public work unless all of the iron, steel, and manufactured goods used in the
project is produced in the United States unless (a) a waiver is provided to the
recipient by EPA or (b) compliance would be inconsistent with United States
Pagel of 2

TOWN OF TROUTMAN
SEWER IMPROVEMENTS
AMERICAN REINVESTMENT & RECOVERY ACT FUNDING Addendum No. 1
IREDELL COUNTY, NORTH CAROLINA April 29, 2009
obligations under international agreements. In order to receive a waiver, the
State must send a written request to the Administrator. A decision will be made
based on the following criteria:
1. The requirement is inconsistent with the public interest for purposes of the
project for which a waiver has been requested,
2. Iron, steel, and necessary manufactured goods are not produced in the
United States in sufficient and reasonably available quantities and of a
satisfactory quality or,
3. Inclusion of iron, steel, and manufactured goods produced in the United
States will increased the overall cost of the project by more than 25
percent.
If a waiver is granted by the Administrator, EPA will publish such waiver, with a
sufficient explanation, in the Federal Register. EPA will provide additional
guidance on this provision as it becomes available.
C. Reporting
States will be required to report no less than weekly on the uses offunds provided
by the ARRA. The CWRSF Benefit Reporting database (formally known as one -
pagers) and the Drinking Water Project Tracking System, will be used to gather
information regarding key project characteristics and milestones, as shown in
Attachment 4. Project data should be entered in to the reporting systems as soon
as agreements are signed with assistance recipients. The purpose of these
requirements is to ensure Agency and State compliance with the requirements to
track data in section 1512 of the ARRA. EPA will compile the data on a weekly
basis, as required by OMB, for publication at recovery.gov.
Therefore, the Contractor shall provide information to the Owner as may be
requested, on.a weekly basis. Such information may include, but not be limited
to, the current number of employees and hours worked.
ADDENDUM NO. 1
Issued this 29th day of April, 2009
AySf:B:.BCpp+
Per
C A Z"Y ty
,�
W "
Benjamin B. Thomas PE
20757, oRn
West Consultants, PLLC'a®
Morganton, North Carolina
o�
��8��9�OP6844g"� 4
/kj
Page 2 of 2

WWEST 405 South Sterling Street, Morganton NC 28655
CONSULTANTS P«< 828 433 5661 / fax [phone] / [e-mail],
a
Ny4Y 1 2009
ADDENDUM NO. 2
This ADDENDUM NO. 2 is being issued May 8, 2009, to all parties who hold a set of CONTRACT, u � r
DOCUMENTS on the project entitled:
TOWN OF TROUTMAN
SEWER IMPROVEMENTS
AMERICAN REINVESTMENT & RECOVERY ACT FUNDING
IREDELL COUNTY, NORTH CAROLINA
This ADDENDUM NO. I shall become part of the CONTRACT DOCUMENTS and its receipt
acknowledged on the BID DOCUMENTS at the time of bidding.
Water will be available for product application at no charge from fire hydrants on the Owner's
system. Contractor must provide and use backflow preventer.
2. Section 07310 Protective Coating and Lining for Manholes:
a.. Technical Specification Section 07310.7 shall allow microsilicate.
b. Technical Specification Section 07310.11 —Corrosion protection shall be epoxy and shall
be 100% solids. The epoxy shall have the following properties: compressive strength of
8800 psi, flexural strength of 12,400 psi, and tensile strength of 7700 psi. The epoxy
coating shall be Madewell Mainstay DS-5, Tnemec equal, Sherwin Williams equal,
Sprayroq equal, or other approved equal.
BID FORM: The BID FORM has been revised to add a separate item for the epoxy corrosion
protection. Bid Item No. 12 shall not include the corrosion protection. Bid Item No. 13 shall be
for epoxy corrosion protection of manholes that are relined. No manholes are to be coated with
epoxy that are not also relined. However, the Owner may elect to omit epoxy corrosion protection
from some relined manholes.
SRF Standard Conditions: The Office of Economic Recovery and Investment has requested that
additional provisions be included in projects funded by the American Reinvestment & Recovery
Act Funding of 2009 to clarify the process required to meet the requirements of the DBE Program.
These Conditions shall replace the existing SRF Special Conditions issued with the Contract
Documents.
ADDENDUM NO. 2
Issued this 80' day of May, 2009
Benjamin B. Thomas, PE
West Consultants, PLLC
Morganton, North Carolina
/kj
QeR,�p42A35S9?E�,CeAY
�` -„
757
i G0 9
t0® Pr u c t
•�fl � �Ii�b]9�a q`$ C
09' o6 fiv
d�eed�. ae es av se rsaFs
Page 1 of 1

t
BID FORM
BM Submitted by
TOWN OF TROUTMAN
SEWER IMPROVEMENTS
IREDELL COUNTY, NORTH CAROLINA
West Consultants, PLLC Project Aro. 09044
TABLE OF ARTICLES
Arlrlendain No.1, dater! rtlay 8, 2009
(Insert Company Name)
Page
Article1 —Bid Recipient......................................................................................................................................................................2
Article2 — Bidder's Acknowledgernents..............................................................................................................................................2
Article3 — Bidder's Representations....................................................................................................................................................2
Article4 — Further Representations...................................................................................................................................................... 3
Article5 — Basis of Bid.........................................................................................................................................................................4
Article6 — Time of Completion............................................................................................................................................................ 5
Article7 — Attachments To This Bid....................................................................................................................................................5
ArticleS — Defined Terms.................................................................................................................................................................... 5
Article 9 - Bid Submittal.........:...................I.................... 6
.................................................................................................................
FJCDC C410 Suggested Bid Form for Construction Contracts
Copyright t 2002 National Societe of Professional F,ngiaeers for EJCDC. All rights reserved.
00410 - 1

Arldenthim No. I, dated May 8, 2009
ARTICLE I — BID RECIPIENT
1.01 This Bid is submitted to:
Tower of Troutman
PO Box 26
400 Eastivay Drive
Troutman, NC 28166
1.02 The undersigned Bidder proposes and agrees, if this Bid is accepted, to enter into an Agreement with Owner in the form
included in the Bidding Documents to perform all Work as specified or indicated in the Bidding Documents for the
prices and within the times indicated in this Bid and in accordance with the other terms and conditions of the Bidding
Documents.
ARTICLE 2 _ BIDDER'S ACKNOWLEDGEMENTS
2.01 Bidder accepts all of the terms and conditions of the Instructions to Bidders, including Nvithout limitation those dealing
with the disposition of Bid security. This Bid will remain subject to acceptance for 60 days after the Bid opening, or for
such longer period of time that Bidder may agree to in writing upon request of Owner.
ARTICLE 3 — BIDDER'S REPRESENTATIONS
3.01 In submitting this Bid, Bidder represents that:
A. Bidder has examined and carefully studied the Bidding Documents, the other related data identified in the Bidding
Documents, and the following Addenda, receipt of which is hereby acknowledged.
Addendum No, Addendum Date
B. Bidder has visited the Site and become familiar with and is satisfied as to the general, local and Site conditions that
may affect cost, progress, and performance of the Work.
C. Bidder is familiar with and is satisfied as to all federal, state and local Laws and Regulations that may affect cost,
progress and performance of the Work.
D. Bidder has carefully studied all: (1) reports of explorations and tests of subsurface conditions at or contiguous to
the Site and all drawings of physical conditions in or relating to existing surface or subsurface structures at or
contiguous to the Site (except Underground Facilities) which have been identified in SC-4.02, if any, and (2) reports
and drawings of Hazardous Environmental Conditions that have been idenpfied in SC-4.06, if any.
E. Bidder has obtained and carefully studied (or accepts the consequences for not doing so) all additional or
supplementary examinations, investigations, explorations, tests, studies and data concerning conditions (surface,
subsurface and Underground Facilities) at or contiguous to the Site which may affect cost, progress, or performance
of the Work or which relate to any aspect of the means, methods, techniques, sequences, and procedures of
construction to be employed by Bidder, including applying the specific means, methods, techniques, sequences, and
procedures of construction expressly required by the Bidding Documents to be employed by Bidder, and safety
precautions and programs incident thereto.
F. Bidder does not consider that any further examinations, investigations, explorations, tests, studies, or data are
necessary for the determination of this Bid for performance of the Work at the price(s) bid and within the times and
in accordance with the other terms and conditions of the Bidding Documents.
EJCDC C410 Suggested Bid Form for Construction Contracts
Copyright O 2002 National Society of Professional Engineers for EJCDC. All rights reserved.
00410 - 2

Adden(luni No. I, dated May 8, 2009
G. Bidder is aware of the general nature of work to be perfonned by Owner and others at the Site that relates to the
Work as indicated in the Bidding Documents.
H. Bidder has correlated the information known to Bidder, information and observations obtained from visits to the
Site, reports and drawings identified in the Bidding Documents, and all additional examinations, investigations,
explorations, tests, studies, and data with the Bidding Documents.
1. Bidder has given Engineer written notice of all conflicts, errors, ambiguities, or discrepancies that Bidder has
discovered in the Bidding Documents, and the Nwitten resolution thereof by Engineer is acceptable to Bidder.
J. The Bidding Documents are generally sufficient to indicate and convey understanding of all'terms and conditions
for the performance of the Work for which this Bid is submitted.
K. Bidder Aill submit written evidence of its authority to do bushiness in the state where the Project is located not later
than the date of its execution of the Agreement.
ARTICLE 4 = FURTHER REPRESENTATIONS
4.01 Bidder further represents that:
A. this Bid is genuine and not made in the interest of or on behalf of any undisclosed individual or entity and is not
submitted in conformity with any agreement or rules of any group, association, organization or corporation;
B. Bidder has not directly or indirectly induced or solicited any other Bidder to submit a false or sham Bid;
C. Bidder has not solicited or induced any individual or entity to refrain from bidding; and
D. Bidder has not sought by collusion to obtain for itself any advantage over any other Bidder or over Owner.
EJCDC C410 Suggested Bid Form for Construction Contracts
Copyright 0 2002 National Society o£Professional Engineers for EJCDC. All rights reserved.
00410 - 3

e
Arldenrlunt No. 1, dated May 8, 2009
ARTICLE 5 — BASIS OF BID
5.01 Bidder will complete the Work in accordance with the Contract Documents for the following price(s):
Item
Quantity Unit
Unit Price
Total Bid
1
8" PVC Sanitary Sewer
380 LF
$
$
2
8" DIP Sanitary Sewer
20 LF
$
$
3
Cured In Place Pipe (CIPP)
771 LF
$
$
4
Replace 4" Sewer Service to
R/W (Pipe Only)
7 EA
$
$
5
4" Clean Out (To be Installed for
Each Tap Within the Proposed
Work Area)
38 EA
$
$
6
8" X 4" Sanitary Sewer Service
Saddles
15 EA
$
$
7
8" X 4" DIP Wye
3 EA
$
$
8
Replace Manhole
10 EA
$
$
9
Locate and Raise Manholes
2 EA
$
$
10
Massey Street Wet Well
Modifications (includes removal
and disposal of all debris and
solids in existing wetwell)
1 LS
$
$
11
Aerial Stream Crossing Piers
Replacement
1 LS
$
$
12
Manhole Relining
256 VF
$
$
13
Corrosion Protection - Epoxy
256 VF
$
$
14
Replace 4" Service Lateral (MH
#21, Sheet 7)
40 LF
$
$
Total Bid
S
'NOTE: Costs for all mobilization, fertilizing, seeding, and mulching, landscaping, ctilvu•t atadlence replacements,
and stone foundation conditioning, if any, shall be included in the various bid items. No separate payment will be inade
for these items.
Unit Prices have been computed in accordance with Para, aph 11.03.B of the General Conditions.
Bidder acknowledges that estimated quantities are not guaranteed, and are solely for the purpose of comparison of Bids,
and final payment for all Unit Price Bid items will be based on actual quantities, determined as provided in the Contract
Documents,
EJCDC C410 Suggested Bid Form for Construction Contracts
Copyright 02002 National Society or Professional Engineers for EJCDC. All rights reserved.
00410 - 4

Adrlefultun No. 1, dated rV1ajo 8, 2009
ARTICLE 6 — TIME OF COMPLETION
6.01 Bidder agrees that the Work will be substantially complete within 90 calendar days after the date when the Contract
Tunes commence to run as provided in Paragraph 2.03 of the General Conditions, and will be completed and ready for
final payment in accordance with Paragraph 14.07.13 of the General Conditions within 120 calendar days after the date
when the Contract Times commence to run.
6.02 Bidder accepts the provisions of the Agreement as to liquidated damages in the event of failure to complete the Work
within the Contract Times.
ARTICLE 7 — ATTACHMENTS TO THIS BID
7.01 The following documents are attached to and made a condition of this Bid:
A. Required Bid security.
B. "Affidavit A —Listing of Good Faith Efforts" or "Affidavit B — Intent to Perform Contract with Own Workforce"
C. Identification of Minority Business Participation, if applicable.
D. For building contracts:
A list of proposed Subcontractors for Heating, Ventilating, and Air Conditioning; Plumbing; and Electrical.
E. For any Subcontractors proposed to perform more than 25% of the total work, provide a list of such Subcontractors
with the following information as a minimum:
Name, address, telephone number, license type and number, five references, experience history, and a list of
current projects.
ARTICLE 8 — DEFINED TERMS
8.01 The terns used in this Bid with initial capital letters have the meanings stated in the Instructions to Bidders, the General
Conditions, and the Supplementary Conditions.
EJCDC C410 Suggested Bid Form for Construction Contracts
Copyright!) 2002 National Society of Professional Engineers for EJCDC. All rights reserved.
00410 - 5

I
ARTICLE 9 — BID SUBMITTAL
9.01 This Bid submitted by:
If Bidder is:
An Individual
Name (typed or printed):
By:
Doing business as:
A Partnershin
(Individual 's signature)
Addendum No.1, dated dray 8, 2009
(SEAL)
Partnership Name: (SEAL)
By:
(Signature of genera! partner — attach evidence of authority to sign)
Name (typed or ptinted):
A Corporation
Corporation Name:
State of Incorporation:
Type (General Business, Professional, Service, Limited Liability):
By:
(Signature — attach evidence of authority to sign)
Name (typed or printed):
Title:
Attest:
(Signatu•e of Corporate Secretar})
Date of Qualification to do business in
(CORPORATE SEAL)
[State Where Project is Located] is 1 1
EJCDC C410 Suggested Bid Form for Construction Contracts
Copyright V 2002 National Society of Professional Engineers for F,JCDC. All rights reserved.
00410 - G
(SEAL)

e
1
Addenduni No.], dated May 8, 2009
A Joint Venture
Name of Joint Venturer:
First Joint Venturer Name:
By:
(Signature of fir st joint venture partner — attach evidence of authority to sign)
Name (typed or printed):
Title:
Second Joint Venturer Name:
By:
(SEAL)
(SEAL)
(Signature of second joint venture partner — attach evidence of authority, to sign)
Name (typed or printed):
Title:
(Each joint venturer must sign. The manner of signing for each individual, partnership, and corporation that is a party to
the joint venture should be in the manner indicated above.)
Bidder's Business address:
Phone: Facsimile:
Submitted on 20
State Contractor License No. (If applicable)
EJCDC C-410 Suggested Bid Form for Construction Contracts
Copyright 2002 National Society of Professional Engineers for EJCDC. All rights reserved.
00410 - 7

NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
MOORESVILLE REGIONAL OFFICE
DIVISION OF WATER QUALITY
July 26, 1999
Mr. Tom Addley
Town of Troutman
PO Box 26
Troutman, North Carolina 28164-0026
Subject: Collection System Spill Response
And O&M Plan Review
Troutman
NPDES Permit No. NCO026832
Iredell County, NC
Dear Mr. Addley:
Mooresville Regional Office staff have completed a review of the Spill
Response and Operation and Maintenance Evaluation Plans. The information will be
used in determining the adequacy of operation of the subject collection system in the
event of bypasses. Beginning July 1, 1999 all sewage bypasses must be reported in
accordance with the following procedures:
Wastewater Collection System bypasses must be reported to the Water Quality
Section of the Mooresville Regional Office (see attached list) during regular
business hours (8:00 am through 5:00 pm, Monday through Friday, excluding
holidays) by telephone within 24 hours of first knowledge of the bypass. A
wastewater bypass in any amount which reaches surface waters or a bypass to
the land greater than 1,000 gallons must be reported.
2. Sampling of the impacted stream(s) consisting of dissolved oxygen, pH, and
conductivity must be conducted upstream, at the point of entry to the
stream, and downstream of the bypass when the spill reaches surface waters.
The data must be reported on the Sewage Spill Response Evaluation Form
within five (5) working days. The report should be sent to the Water Quality
Section of the Mooresville Regional Office (address at the bottom of this
letter).
3. The responsible parry must immediately notify the North Carolina Wildlife
Resources Commission at [phone] should the bypass cause a fish kill.
919 NORTH MAIN STREET, MOORESVILLE, NORTH CAROLINA 28115
PHDNE 704-663-1699 FAX [phone]
AN EQUAL OPPORTUNITY / AFFIRMATIVE ACTION EMPLOYER - 50% RECYCLED/1 O% POST -CONSUMER PAPER

Spill Response and O&M Plans
Page 2
4. A wastewater bypass that is the result of vandalism must be reported to this
Office within 24 hours of first knowledge (see Number 1 above). Pictures of
the.vandalism and/or a copy of the police report should be included with the
written report (see Number 2 above).
Be advised that a minimum civil penalty of four thousand dollars ($4,000)
may be assessed against the responsible party who does not report a sewage bypass in
a timely manner as described above.
Should you have any questions concerning our review or any of the above
requirements, please contact Mr. G.T. Chen or Mr. John Lesley of this Office.
Sincerely,
D. Rex Gleason, P.E.
Water Quality Regional Supervisor
Cc:
Jeff Poupart, Non -Discharge Compliance Group
Central Files
Iredell County Health Department
JL/GTC

Mooresville Regional Office
Division of Water Quality
Water Quality Section
[phone]
Name
Extension Number .
G.T. Chen
207
Mike Parker
223
Charley Swartz
226
Samar Bou-Ghazale
225
Barry Love
228
Wes Bell
229
Linda Love
231
Robert Scheller
263
John Lesley
230
Richard Brid eman
264
*Allen Johnson
232
Ellen Hufftnan
233
* Rex Gleason
204
* contact only if other staff are unavailable
t;

Facility Name: Troutman WWTP
Permit Number: NC0026832
Contact: G. T. Addley, [phone]
Criteria
Requirement
Evaluation Points
Evaluation Points
Total
for Gravity Sewer
for Pump Station
Points
I
Map of Collection System
Yes = 5; (No = 0)
Yes = 4; (No = 0)
9
Annual visual inspection of all lines
Conducted = 10
Conducted = 9
2
not visible from normal public access.
19
Regular visual inspection of high
Not conducted = 0
Not conducted = 0
prioirty areas
3
Right of way maintenance to allow
Adequate = 5
Adequate = 4
9
system accessibility
Inadequate = 0
Inadequate = 0
4
Schedules/conducts line cleanings
Yes = 5; (No = 0)
Yes = 4; (No = 0)
9
5
Spare parts inventory & list of
Yes = 5; (No = 0)
Yes = 4; (No = 0)
9
contrators
6
Up -to date maintenance, inspection
Yes = 5; (No = 0)
Yes = 4; (No = 0)
9
and equipment testing records
7
Maintains trouble location log
(Yes = 10); No = 0
(Yes = 9); No = 0
0
8
Adopt sewer use ordinance
Yes = 2; (No = 0)
Yes = 2; (No = 0)
4
9
Follow sewer use ordinance
Yes = 3; (No = 0)
Yes = 2; (No = 0)
5
10
(Pump station only) Monthly test
N/A
Yes = 4; (If reliability &
4
back-up equipment and/or reliability
back-up power req.'s do
systems
not apply) (No = 0)
I 1
(Pump station only) Pump stations
N/A
Yes = 4; (No = 0)
4
inspect 3-times/week for systems
without telemetry or once a week for
systems with telemetry
Total O/M Program Score
91
2. Starting 07/01/99, minimum semi-annual inspection of all high priority line (e.g. aerial lines,
aerial crossings, stream crossings, siphons and streambank lines, etc.) In addition to the annual
inspection of all lines not visible from the normal public access.
11. Beginning 07/01/00, pump stations shall be inspected daily if telemetry is not used. Beginning
07/01/01, pump stations shall be inspected once every 24 hrs if telemetry is not used.

'A1
TOWN OF TROUTMAN
SANITARY SEWER OVERFLOW (S.S.O.)
CLEANUP AND PUMPING
PROCEDURES
AS ADOPTED BY:
WASTEWATER COLLECTIONS
TOWN OF TROUTMAN, SYSTEM OPERATOR
G.THOMAS ADDLEY

Department of Public Works
Operations Division
MEMO TO: All Town of Troutman Operations Personnel
FROM: G.T. Addley, Collection System Operato�Y ,
Date: September 22, 1997
- -SUBJECT: Sanitary Sewer -Overflow S.S.O. Operations Division Response - - -
Procedures
1) Sanitary Sewer Overflows endanger our environment and potentially the
health of any citizens, or employees that come into contact with an S.S.O.
Unchecked S.S.O.'s can result in significant penalties from State and Federal
environmental regulatory agencies as well. The procedures below were
designed to protect our environment, citizens, and employees from an S.S.O.
event. These procedures apply to Town of Troutman, Operations personnel.
2) Upon discovery of an S.S.O. an initial response will be made by the "on call
person" on the Wastewater crew. Upon arrival, the "on call person" will
make an immediate assessment to determine if a S.S.O, event has taken
place. If an event has taken place, or is in progress, the on call person will
attempt to eliminate the source of the S.S.O. and contact the Town of
Troutman's collection system operator.
3) The Collection System Operator, or his alternate will respond to the location
without delay. Upon arrival, the Collection System Operator will make an
assessment of the S.S.O. and determine what is required to mitigate the event
and establish a course of action for clean-up and restoration of S.S.O. site.
4) If a blockage has occurred and overflow is in progress the Collection System
Operator will:
Contact a Public Works Personnel needed for assisting in corrective action
including: Jetting Lines, Excavation, Bypass Pumping, or any repair.
5) The Collection System Operator will record all events as per the Town of
Troutman's "S.S.O. Clean-up Procedures Instruction dated September 19,
1997 and will be the primary contact to -VAWx County and State of North
Carolina authorities. J-1c` OCILL
Collection System Operator
G.T. Addley

PURPOSE:
The purpose of this document is to protect the citizens of Troutman,
North Carolina and the Environment by establishing written procedures
for responding to Sanitary Sewer Overflows (S.S.0). This procedure
applies to all Public Works employees that in the course of their work may
deal with S.S.O's. These procedures will be reviewed at least semi-
annually, or whenever revised guidance from county, state or federal
authorities dictate a revision is necessary.

ON ASPHALT OR CONCRETE
1) Set up containment at or near the storm drainage system; do not let the spill
_ _enter the storm drainage system
2) Put up tape, black on red "Danger Do Not Enter," around the S.S.O. area.
3) Spread line on spillage and sand (or equivalent material) to a depth of 1 inch.
Let this stand for 1 hour and sweep up. If moisture or grease is still present,
repeat procedure.
4) After removing the contaminated material, wash down the area with high
water pressure and Clorox. Pump this back into the sewer system. Transport
wet sand to drying beds at the Old Public Works site and dispose of (after
drying) at the County Landfill.
5) If this spill goes into the storm drainage system, refer to creek procedure.
IN CREEK OR STREAM
1) Take conductivity readings of creek in order to determine the proper
placement of dam. The dam needs to be constructed near a manhole
or at a location which is accessible to the jet/vacuum truck. Placement of
the dam should be at a point where the lowest conductivity reading is
measured if possible. Build the dam using dirt that is capable of handling
creek and hydrant water without dam failure. Station two pumps at the
dam that are capable of handling creek flow. Use one pump for backup.
Have backhoe at site with extra material at all times so dam can be rebuilt
if a breach occurs. There will be two workers at the pump site at all times
during pumping operations. Pump effluent from the dam into the manhole.
2) Put up warning tape, black on red "Danger Do Not Enter," from the S.S.O.
site to the pump site on both sides of the creek in populated areas. In
unpopulated areas restrict access where there is any chance of humans
coming in contact with the S.S.O.

3) Take fecal coliform samples at the S.S.O. site, 100 feet above the S.S.O.
site, and at 400 foot downstream intervals until reaching the pump site.
Bring the samples to the Waste Water Treatment Plant. Pull samples
every 24 hours until readings of 500 colonies/ml, or less are obtained.
4) Flush stream with water from a sufficient number of hydrants to remove
waste product from the creek. Continue to pump and flush stream until all
fecal coliform tests come back 500 colonies/ml or less. Pull samples every
24 hours until this reading is obtained. Pull samples 100 feet above the
S.S.O. site, and at 400 feet intervals until reaching the pump site. Notify
water treatment plant when starting and stopping of stream- flushing. - -
5) If Rip Rap is in creek, wash down with high water pressure until there is no
waste residue remaining on, or within the Rip Rap structure.
6) If sludge is in creek, broom creek bottom and sides until there is no waste
residue remaining.
7) If creek flows into a body of water used for recreation, and or drinking,
notify the affected county and local officials as soon as the problem is
discovered. If this happens, refer to pond, lake procedure.
IN POND OR LAKE
1) Put up warning tape, black on red "Danger Do Not Enter," on the
shoreline at the contaminated area.
2) In a pond, collect fecal coliform samples and Dissolved Oxygen (D.O.)
readings around the entire circumference. Set up pumping operations
below the dam.
3) In a large lake, collect fecal samples 2 feet off the bottom. D.O. readings
are to be done 1 foot under the surface. Take equal sampling amounts
around the circumference of the structure.
4) When the first sampling results come in, contact the Public Works
Director for appropriate action if the fecal coliform counts are greater
than 8,000 colonies/ml.
5) Continue pumping until 500 colonies/ml or less are obtained in the
structure.
6) Keep monitoring fecal coliform counts until the North Carolina

Department of Water Quality or the Iredell County Public Health
Department says that monitoring is no longer required.
OUTFALL
1) Put up warning tape, "Danger Do Not Enter," around the S.S.O. site.
2) In -open area, lime (powder) heavily -and till.- -Repeat procedure.- Seed- _ -
and then put down straw.
3) In an area where there is undergrowth or small trees, wash area with
large amounts of water. Push into creek towards the pump site. Do this
until no waste remains. Wait for 12 or 24 hours then lime the area
heavily. Do not get lime in the creek. Do not lime when the weather
forecast is predicting rainfall.
IN CITIZEN'S YARD
1) Till the area whenever possible. Apply lime, seed, and straw.
2) If not able to till, apply lime and two inches of topsoil and mix
thoroughly. Lime again lightly, then seed, and cover with straw.
S.S.O. REPORTING PROCEDURES
1) Upon discovery of a possible S.S.O. site during normal duty hours,
notify the Collection System Operator at the telephone numbers below:
G.T. Addley [phone], Home
[phone], Cell
or
A.J. Barghothi [phone],Home
[phone],Cell
2) After normal duty hours contact G.T. Addley on pager number

838-9221. In the event that he cannot be reached, contact A.J. on his
cell phone at 312-0462. In the event that these individuals cannot be
reached, call the Communications Center at 878-3100.
3) S.S.O. Contact Monitors will be the primary interface between the
Town of Troutman and the State of North Carolina Department of
Water Quality and the Iredell County Health Department on all S.S.O.
matters.
4) S.S.O. Contact Monitors will report overflows from any sewer line or
_pump station, -or the bypass of any wastewater treatment system or
any component thereof. This requirement applies in the following
cases according to the Collection System Enforcement Guidance.
COLLECTION SYSTEM ENFORCEMENT GUIDANCE
( Numbers Correspond to Flow Chart)
1) The reporting threshold shall be 1,000 gallons for spills on the ground
which do not reach surface waters. The report must occur within 24
hours of knowledge of the spill.
The following spills must be reported immediately (or within 24
hours of first knowledge):
a) spills that reach surface waters (i.e. any spill that reaches any
water already present in a conveyance, stream, ditch, etc...)
b) spills greater than 1,000 gallons on the ground regardless of
whether they are contained.
• The 1,000 gallon threshold applies only to spills on the ground
that are captured, fully contained and removed quickly, ensuring
that no wastewater reaches surface waters. Municipalities must
keep records of all spills for a period of three years and those
records must be available for review by DWQ staff upon request.
• Volume estimations shall be expressed as a range, rather than a
specific amount (e.g. 0-1,000 gallons and 1,001-2,500 gallons, as
opposed to exactly 25 gallons).
2) Any spill that reaches surface waters must be reported. A spill that
reaches any water that was already present in a conveyance, stream,
ditch, etc. is considered to have reached surface waters. In addition,
spills which reach a conveyance or ditch and can not be captured and
contained are considered to have reached surface waters.

S.S.O. TELEPHONE CONTACT NUMBERS
State of North Carolina
Division of Water Quality
- - - State of North Carolina - - - - - - -
Division of Emergency Management
(For after hour spills that reach a waterway)
Iredell County Emergency
Health Division
Town Administrator
A.J. Barghothi
Director of Public Works
Tom Addley
[phone]
1-800-858-0638
[phone]
[phone]
[phone]
[phone]

Sec. 1. Purpose.
AN ORDINANCE TO REGULATE, RESTRICT AND LIMIT, IN THE
INTEREST OF .THE PUBLIC HEALTH AND SAFETY, THE DEPOSIT OR
DISCHARGE OF CERTAIN SUBSTANCES INTO ANY SANITARY SEWER
NOW MAINTAINED AND/OR OWNED BY OR WHICH MAY BECOME THE
PROPERTY OF OR WHICH MAY BE LEASED TO THE TOWN OF
TROUTMAN, COUNTY OF IREDELL, STATE OF NORTH CAROLINA.
WHEREAS, the Federal Water Pollution Control Act Amendments of .1972,
PL 92-500 (hereinafter referred to as the "Act") have resulted in an
unprecedented program of cleaning up our Nation's waters;
WHEREAS, the Town -of Troutman has already made and will continue to
make a substantial financial investment in its wastewater treatment system
to achieve the goals of the Act; and
WHEREAS, the Town of Troutman seeks to provide for the use of its
wastewater treatment system by industries served by it without damage to
the physical facilities, without impairment of their normal function of
collecting, treating and discharging domestic wastewater, and without the
discharge by this Town's wastewater treatment system of pollutants which
would violate the discharge allowed under its National Pollutant Discharge
Elimination System (NPDES) permit and the applicable rules of all
governmental authorities with jurisdiction over such discharges.
NOW, THEREFORE, be
Alderman of the Town
Carolina as follows:
Sec. 2. Definitions.
it ordained and enacted by the Town Board of
of Troutman, County of Iredell, State of North
(a) "Approving Authority" shall be the Mayor of the Town of
Troutman.
(b) "Biochemical Oxygen Demand" (BOD) means the quantity of
oxygen utilized in the biochemical oxidation of organic matter under
standard laboratory procedure in five (5) days at 20°C, expressed in
terms of weight and concentration (milligrams per liter) .
(c) "COD" (Chemical Oxygen Demand) means the quantity of
equivalent oxygen utilized in the chemical oxidation of organic matter as
measured by standard laboratory methods, as set out herein, expressed
in milligrams per liter.
(d) "Cooling Water" means the water discharged from any use
such as air conditioning, cooling or refrigeration, during which the only
pollutant added to the water is heat.
(e) "Compatible pollutant" means BOD, suspended solids, pH and
fecal coliform bacteria, and such additional pollutants as are now or may
be in the future specified and controlled in this Town's NPDES permit for
its wastewater treatment works where said works have been designed and
used to reduce or remove such pollutants.

(f) "Domestic wastes" means liquid wastes (i) from the non-
commercial preparation, cooking, and handling of food, or (ii) containing
human excrement and similar matter from the sanitary conveniences of
dwellings, commercial buildings, industrial facilities, and institutions.
(g) "Excessive Radiation Dose" shall be a dose of radiation in
excess of the maximum dose.
(h) "Garbage" means solid wastes from the domestic and
commercial preparation, cooking, and dispensing of food, and from the
handling, storage, and sale of food.
(i) "Hearing Authority" means the mayor, - town -attorney, and
superintendent of wastewater treatment plants or their duly appointed
deputies' agents or representatives.
U) "IOD" (Immediate Oxygen Demand) means the quantity of
oxygen utilized by an industrial waste in excess of that normally
attributable to sewage as measured by using standard laboratory methods,
asset out herein, expressed in milligrams per liter.
(k) "Incompatible pollutant" means any pollutant which is not a
"compatible pollutant" as defined in this section.
(1) "ICR" is the Industrial Cost Recovery system developed by
the Town in accordance with applicable Federal regulations.
(m) "Industrial wastewater" .means the liquid wastes from
industrial, manufacturing, trade, or business establishments, as distinct
from domestic wastes.
(n) "Infiltration" is the water entering a sewer system, including
sewer service connections, from the ground, through such means as, but
not limited to, defective pipes, pipe joints, connections or manhole walls.
Infiltration does not include, and is distinguished from, inflow.
(o) "Inflow" is the water discharged into a sewer system,
including service connections from such sources as, but not limited to,
roof leaders, cellar, yard and area drains, foundation drains, cooling
water discharges, drains from springs and swampy areas, manhole
covers, cross connections from storm sewers and combined sewers, catch
basins, storm waters, surface run-off, street washwaters, or drainage.
Inflow does not include, and is distinguished from, infiltration.
(p) "Major Contributing Industry" means any industry whose flow
exceeds 25,000 gallons per day or who is subject to pretreatment
requirements for the removal of incompatible pollutants as defined in
section k.
(q) "Maximum Permissible Dose" shall be a dose of radiation to
any part of the body, internal or external, or both, that in the light of
present knowledge, is not expected to cause appreciable bodily injury to a
person at any time during his lifetime.
2

(r) "National Pollutant Discharge Elimination System" (NPDES)
means the program for issuing, conditioning and denying permits for the
discharge of pollutants from point sources into the navigable waters, the
contiguous zone, and the oceans pursuant to section 402 of the Act.
(s) "NH " (Nitrogen as Ammonia) shall mean the initial product in
the decompositiol of nitrogenous organic matter as measured by using
standard laboratory methods, as set out herein, expressed in mg/1.
(t) "PPM" means pats per million and is a mass to mass ratio
expressed as milligram per 10 milligram.
(u) "Person" means any individual, firm, company, partnership,
corporation,. association, group, or society, and includes the State of
North Carolina, and agencies, districts, commissions, and political
subdivisions created by, or pursuant to, state law.
(v) "pH" means the logarithm of the reciprocal of the
concentration of hydrogen ions in grams per liter of solution.
(w) "Pretreatment" means application of physical, chemical, and
biological processes to reduce the amount of pollutants -in or to alter the
nature of the pollutant properties of wastewater prior to discharging such
wastewater into the publicly owned wastewater treatment system.
(x) "Pretreatment standards" means all applicable federal rules
and regulations implementing section 307 of the Act, as well as any
nonconflicting state or local standards. In cases of conflicting standards
or regulations, the more stringent thereof shall be applied.
(y) "Properly shredded garbage" means the wastes from the
preparation, cooking, and dispensing of food that have been shredded to
such degree that all particles will be carried freely under the flow
conditions normally prevailing in public sewers, with no particle greater
than one-half (1/2) inch in any dimension.
(z) "Receiving stream" means a body of water, stream, or
watercourse receiving or formed by the discharge of waters from the
wastewater treatment plant.
(aa) "Sanitary sewer" means a sewer intended to receive domestic
sewage and industrial waste, except that of the type expressly prohibited
by this article, without the admixture of surface and storm water.
(bb) "Shall" means mandatory; "May" means permissive.
(cc) "Significant industrial user" means any industrial user of the
Town's wastewater treatment system whose flow exceeds the lesser of
(i) 25,000 gallons per day, or (ii) one (1) percent of the design capacity
of the treatment plant receiving the wastewater.
(dd) "Storm sewer or storm drain" means a sewer which carries
only storm or surface waters and drainage.
3

(ee) "Storm Water" means any water flow occurring during or
immediately following any form of natural precipitation and resulting
therefrom.
(ff) "Suspended solids" means the total suspended matter that
floats on the surface of, or is suspended in, water, wastewater, or other
liquids, and which is removable by laboratory filtering.
(gg) "Unpolluted water" means water not containing any pollutants
limited or prohibited by the effluent standards in effect, or water whose
discharge will not cause any violation of receiving water quality
standards.
(hh) "User" means any person who discharges, or causes or
permits the discharge of, wastewater into the Town's wastewater
treatment system.
(ii) "User classification" means a classification of users based on
the Standard Industrial Classification (SIC) Manual prepared by the
Office of Management and Budget.
(jj) "Wastewater" means the liquid and water -carried industrial or
domestic wastes from dwellings, commercial buildings, industrial facilities,
and institutions, whether treated or untreated, together with any
groundwater, surface water, and storm water that may be present, which
is discharged into, or permitted to enter, the Town's wastewater
treatment system.
(kk) "Wastewater treatment system" (system) means any devices,
facilities, structures, equipment, or works owned or used by the Town
for the purpose of the transmission, storage, treatment, recycling, and
reclamation of industrial and domestic wastes, or necessary to recycle or
reuse water at the most economical cost over the estimated life of the
system, including' intercepting sewers; outfall sewers; sewage collection
systems; pumping, power, and other equipment, and their
appurtenances; extensions, improvements, remodeling, additions, and
alterations thereof; elements essential to provide a reliable recycled
supply such as standby treatment units and clear well facilities; and the
wastewater treatment plant site or -land which is used for ultimate disposal
of residues resulting from such treatment.
(11) Town is the Town of Troutman, County of Iredell, State of
North Carolina.
Terms not otherwise defined herein shall be as adopted in the latest
edition of Standard Methods for the Examination of Water & Wastewater,
published by the American Public Health Association, the American Water
Works Association and the Water Pollution Control Federation.
Sec. 3. Prohibited Use of Public Sewers.
(a) Prohibitions on Wastewater
discharge or deposit or cause or allow to
the wastewater treatment system any
following:
Discharges. No person shall
be, discharged or deposited into
wastewater which contains the
0

C (1) Oils and Grease. Total fat, wax, grease or oil
concentration of more than 100 mg/l, whether emulsified or not, or
containing substances which may solidify or become viscous at
temperatures between 320 and 150OF (00 and 65°C) at the point of
discharge into the system.
(2) Explosive Mixtures. Liquids, solids or gases which by
reason of their nature of quantity are, or may be, sufficient either alone
or by interaction with other substances to cause fire or explosion or be
injurious in any other way to the sewerage facilities or to the operation of
the system. At no time shall two successive readings on an explosion
hazard meter, at -the point of discharge into the sewer system, be more
than five percent (5 o) nor any single reading over ten percent (10 0) of
the Lower Explosive Limit (LEL) of the meter. Prohibited materials
include, but are not limited to, gasoline, kerosene, naphta, benzene,
toluene, zylene , ethers, alchols , ketones, aldehydes, peroxides,.
chlorates, perchalorates, bromates, carbides, hydrides and sulfides.
(3) Noxious Material. Noxious or malodorous solids, liquids
or gases, which, either singly or by interaction with other wastes, are
capable of creating a public nuisance or hazard to life, or are or may be
sufficient to prevent entry into a sewer for its maintenance and repair.
(4) Improperly Shredded Garbage. Garbage that has not
been ground or comminuted to such a degree that all particles will be
carried freely in suspension tinder flow conditions normally prevailing in
the public sewers, with no particle greater than one-half (1/2) inch in any
dimension.
(5) Radioactive Wastes. Radioactive wastes or isotopes of
such half-life or concentration that they do not comply with regulations or
orders issued by the appropriate authority having control over their use
and which will or may cause damage or hazards to the sewerage facilities
or personnel operating the system.
(6) Solid or Viscous Wastes. Solid or viscous wastes which
will or may cause obstruction to the flow in a sewer, or otherwise
interfere with the proper operation of the wastewater treatment system.
Prohibited materials include, but are not limited to, grease, unconuninuted
garbage, animal guts or tissues, paunch manure, bones, hair, hides or
fleshings, entrails, whole blood, feathers, ashes, cinders., sand, spent
lime, stone or marble dust, metal, glass, straw, shavings, grass
clippings, rags, spent grains, spent hops, waste paper, wood, plastic,
tar, asphalt residues, residues from refining or processing of fuel or
lubricating oil, and similar substances.
(7) Excessive Discharge Rate. Wastewaters at a flow rate
or containing such concentrations or quantities of pollutants that exceeds
for any time period longer than fifteen (15) minutes more than five (5)
times the average twenty-four (24) hour concentration, quantities or flow
during normal operation and that would cause a treatment process upset
and subsequent loss of treatment efficiency.
5

(8) Toxic Substarices. Any toxic substances in amounts
Cexceeding standards promulgated by the Administrator of the United
States Environmental Protection Agency pursuant to Section 307(a) of the
Act, and chemical elements or compounds, phenols or other taste- or
odor -producing substances, or any other substances which are not
susceptible to treatment or which may interfere with the biological
processes or efficiency of the treatment system, or that will pass through
the system.
(9) Unpolluted Waters. Any unpolluted water including,
but not limited to, water from cooling systems or of stormwater origin,
which will increase the hydraulic load on the treatment system.
(10) Corrosive Wastes. Any waste which will cause
corrosion or deterioration of the treatment system. All wastes discharged
to the public sewer system must have a pH value in the range of (6) to
(9) standard units. Prohibited materials, include, but are not limited to,
acids, sulfides, concentrated chloride and fluoride compounds and
substances which will react with water to form acidic products.
(11) Any clothing, rags, textile remnants or waste, cloth,
scraps, except fibers of scrap that will pass through a one-fourth (1/4)
inch mesh screen or its equivalent in screening ability.
(12) Any waters or wastes in which the suspended solids
exceed three hundred (300) parts per million by weight.
(13) Any waters or wastes in which the BOD exceeds three
hundred (300) parts per million by weight.
(14) Any waters or wastes in which the COD exceeds six
hundred (600) parts per million by weight.
(15) Any waters or wastes in which the IOD exceeds 5.0
parts per million by weight.
(16) Any materials which form excessive amounts of scum or
foam that may interfere with the operation of the waste treatment works or
cause undue additional labor in connection with its operation.
(17) Any liquid or vapor having a temperature higher than
150°F.
(18) Any waters or wastes in which the total fixed solids
exceed 1,500 mg/l.
(19) Any waters or wastes in which the ammonia exceeds 15
mg/1.
(20) Any waters or wastes containing amounts of chromium,
zinc, nickel, copper, or other heavy metals which are in an ionic or
chemically active state.
6

C
C
(21) Any waters or wastes containing cyanide or other such
poisonous substances.
(22) Any waters or wastes containing suspended solids of
such character and quality that unusual attention or expense is required
to handle such materials at the waste treatment plant.
(23) Any
given constituent of
duration longer than
average .twenty-four
operation._ _
waters or wastes which, in concentration. of any
in quantity of flow, exceeds for any period of
fifteen (15) minutes more than five (5) times the
(24) hour concentrations or flows during normal
(24) Any water or wastes having an objectionable color
which is not sufficiently removable in the existing sewage treatment plant
processes to pass receiving stream standards.
(b) Limitations on Wastewater Discharges.. No person shall
discharge or convey, or permit or allow to be discharged or conveyed, to
a public sewer any wastewater containing pollutants of such character or
quantity that will:
(1) Not be susceptible to treatment or interfere with the
process or efficiency of the treatment system.
(2) Constitute a hazard to human or animal life, or to the
stream or water course receiving the treatment plant effluent.
(3) Violate pretreatment standards, as promulgated by the
United States Environmental Protection Agency or the State of North
Carolina.
(4) Cause the treatment plant to violate its NPDES permit
or applicable receiving water standards.
(c) Special Agreements. Nothing in this section shall be
construed as preventing any special agreement or arrangement between
the Town and any user of the wastewater treatment system -whereby
wastewater of unusual strength or character is accepted into the system
and specially treated subject to any payments or user charges as may be
applicable.
(d) No person shall discharge or cause to be discharged any
storm water, surface water, ground water, roof runoff, or subsurface
drainage into any sanitary sewer. No person shall connect, or cause to
be connected, to the sanitary sewer system any pipe or conduit which will
allow the discharge of the aforelisted inflow source into the sanitary sewer
system.
Sec. 4. Permissive Use of Public Sewers for Industrial Waste.
t (a) Any person who shall hereafter discharge any industrial
wastes into the Town's sanitary sewers or who desires to discharge any
industrial wastes into such sewers shall make application to the Approving
7

Authority. Approval .will be granted such applicants for a two-year
period when evidence is submitted by the applicant that the discharge of
wastes will comply with this Ordinance and applicable State and Federal
lawful requirements.
(b) Storage Facilities. In order to promote equalization of flows
over a 24 hour period, each person discharging a waste into the Town's
sanitary sewers having the following average daily volumes over a period
of his normal processing period in any one week shall construct and
maintain at his own expense a suitable storage facility of- the
corresponding minimum volumes:
MINIMUM VOLUME OF STORAGE
TANK. IN PERCENTAGE OF
VOLUME OF WASTE DISCHARGED DAILY VOLUME OF WASTE
AVERAGE GALLONS PER DAY DISCHARGED
0 - 20,000 0%
20,001 - 30,000 50%
30,001 - 40,000 60%
40,001 - 50,000 70%
50,001 - 60,000 80%
60,001 - 70,000- 90%
70,001 - and above 100%
Such storage facility shall have its outlet to the sewer
controlled by an approved device, the setting of flow rates being as
directed by the Approving Authority. When the processing period is less
than seven days in any week, the person discharging the waste shall
arrange the discharge rate so that his storage facility shall be
substantially full at the end of his processing period. The storage
facility shall be discharged during the period of shut -down unless
otherwise directed by the Approving Authority.
Storage facility requirements may be waived by the
Approving Authority in cases where.a constant rate of flow is discharged,
provided:
(1) That the normal operating day extends over a 24 hour
period and the rate of waste flow and load discharged is such that in the
opinion of the Approving Authority the installation of a storage tank
would not improve sewer and treatment plant loading conditions.
(2) That all other requirements of this Ordinance are
fulfilled.
(c) Control manhole. Any person discharging industrial wastes
into the Town sanitary sewer shall construct and maintain a suitable
control manhole to facilitate observation, measurements and sampling of all
wastes including domestic sewage from the industry.
The control manhole shall be constructed downstream from
any treatment, storage or other approved works at a suitable and
satisfactory location and built in a manner approved by the Approving
Authority.

(d) Measuring device. Where a storage tank is not required, the
control manhole shall be equipped with a permanent type volume
measuring device such as a nozzle, or other device approved by the
Approving Authority. The manhole shall be installed by the person
discharging the wastes at his own expense and shall be maintained by him
so as to be safe, accessible and in proper operating condition at all times.
(e) Plans. Plans for the construction of said storage tank,
control manhole and controlling devices shall be approved by the
Approving Authority prior to the beginning of construction.
(f) Any waters or wastes discharged by any person, which have
- - - - the following -characteristics, may be admitted into the sanitary sewers
after the adoption of this Ordinance, when such discharge is approved in
writing by the Approving Authority:
(1) A BOD greater than 300 mg/l ;
(2) or containing COD of more than 600 mg/1;
(3) or containing suspended solids of more than 300 mg/l;
(4) or containing ammonia of more than 15 mg/l;
(5) or having other characteristics prohibited in Section 3.
(g) All sewer users shall participate in the User
Charge/Industrial Cost Recovery Provision as applicable. When the
concentration of BOD, COD, suspended solids or .ammonia, in the
industrial waste discharge to the Town's sanitary severs exceed the limits
hereinbefore prescribed, a monthly surcharge shall be imposed upon the
offending industrial user's sewage flow when the excess is calculated
using the industrial plant water flow as hereinafter specified and the
difference between the actual BOD, COD, suspended solids or ammonia
concentration and the permissible limits of 300 mg/l, 600 mg/l, 300 mg/l,
and 15 mg/l respectively. The sewer surcharge shall be established by
the Town at a regular Board meeting of November for the following
calendar year. This surcharge shall be invoked as herein provided in
addition to the existing regular sewer service charge. The sewer
surcharge shall be applied beginning with the December utility billing and
during subsequent months during the calendar year. The surcharge shall
reflect the total cost of treating the excess pounds of industrial waste
including necessary cost of administration of the sewage plant and this
Ordinance. In addition, each industrial user affected by the surcharge
shall submit to the Approving Authority a current list of raw chemicals
and other materials used in their manufacturing process. The method
used to determine the surcharge amount shall consist of dividing the total
audited budget cost for operating each component of the Town's sewage
treatment plant which is affected by BOD, COD, SS, or NH , including
the applicable administrative and plant debt service, for the preceeding
fiscal year, by the total treatment plant design poundage of BOD, COD,
suspended solids or ammonia. The Approving Authority shall make a
report to the Board each quarter of all activities conducted under Section
4.
w7

C (1) The surcharge shall be billed and payable monthly on a
separate bill rendered to the proper users by the Town Water
Department.
Said bills will be sent through the United States mail
notifying all users of the amount and date due. Failure to receive notice
is not an excuse for nonpayment of bills.
Users not having paid their bills within 15 days of date
of billing will be delinquent. Notice shall be sent them through the
United States mails and if after 10 days' notice, given as above, the bills
_remain unpaid, _the water connection serving the premises will be severed
and will not be turned on again until said bill is paid.
In case a user discharging wastes into the Town
sanitary sewer system does not procure his water supply from the Town
of Troutman and becomes delinquent in his payment of the aforesaid
surcharge, his connection with the Town sewer system will be severed
and will only be reconnected at his expense.
(h) All applications for the discharge of industrial wastes into the
public sewers shall be made to the Approving Authority. Approval will be
granted such applications when evidence is submitted by the applicant
that the discharge of wastes into the public sewer will comply with this
Chapter.
(i) Grease, oil and sand interceptors shall be provided when, in
the opinion of the Approving Authority, they are necessary for the
proper handling of liquid wastes containing grease in excessive amounts,
or any flammable wastes, sand or other harmful ingredients; except that
such interceptors shall not be required for private living quarters or
dwelling units. All interceptors shall be maintained by the Owner at his
expense in continuously efficient operation at all times.
(j) Notice shall be given the Approving Authority when normal
industry will be interrupted for seventy-two (72) hours or longer and
wastes will not be available for discharge, or when a change of process is
contemplated or malfunction of the treatment facility occurs or is
anticipated, which will alter demands on the municipal treatment facilities.
"Normal operations" shall include allowance for legal holidays and other
announced plant shutdowns.
(k) Where preliminary treatment or holding facilities are provided
for any purpose, they shall be maintained continuously in satisfactory and
effective operation by the Owner at his expense, and there shall be no
discharge of wastes requiring pretreatment either directly or indirectly to
the Town's sewer system, without first notifying and obtaining approval
from the Approving Authority.
Sec. 5. User Charge:
(a) User charge shall be the charge levied on all users including,
but not limited to, persons, firms, corporations or governmental entities
that discharge, cause or permit the discharge of sewage into the public
sewerage facilities.
10

(b) The user charge shall reflect at least the costs of operation
Cand maintenance (including replacement) of the public sewerage facilities.
(c) Each user shall pay its proportionate cost(user charge) based
on volume of flow.
(d) The Approving Authority of the sewerage facilities shall
review not less often than every two years the sewage contributions of
users, the total costs of operation and maintenance (including
replacement) of the sewerage facilities, and the user charge system. The
Approving Authority shall revise the user charge, if necessary, to
accomplish the following:
(1) Maintain the proportionate distribution of operation and
maintenance costs among all users as provided herein.
(2) Generate sufficient revenue to pay at least the total
operation and maintenance costs necessary to the proper operation and
maintenance (including replacement) of the sewerage facilities.
(e) All flow to the sewerage facilities not directly attributable to
the users (i.e. infiltration/inflow) shall be distributed among all users of
the sewerage facilities based upon the volume of flow of the users.
(f) Each user shall be notified, at least annually, in conjunction
with a regular bill, of the rate and that portion of the user charge which
is attributable to operation and maintenance of the sewerage facilities.
i -
i Sec. 6. Powers and Authority for Inspection.
(a) Tile Approving Authority and duly authorized employees of
the Town shall be permitted to enter upon all properties for the purpose
of inspection, observation, measurement, sampling and testing in
accordance with the provisions of this Chapter.
(b) All tests and analyses of the characteristics of waters and
wastes to which reference is made in this Chapter shall be made in
accordance with the procedure given in the latest edition of STANDARD
METHODS FOR THE EXAMINATION OF WATER, SEWAGE AND
INDUSTRIAL WASTES published by the American Public Health
Association. Such tests and analyses shall be determined at the control
manhole provided for in Section 4, or at the point of discharge of any
waters or wastes at the site of their origin on the premises of any person
discharging such wastes into the sanitary sewers.
Sec. 7. Measurement and Flow.
(a) The volume of flow used in determining the total discharge of
industrial wastes shall be based upon:
(1) Metered water consumption as shown in the records of
meter readings maintained by the Town Water Department. In the event
that a person discharging wastes into the public sewers produces
evidence to the Approving Authority that more than 25 0 of the total

annual volume of water used for all purposes does not reach the public
C sewers, then an estimated percentage of total water consumption to be
used in determining industrial waste discharge may be agreed upon
between the Approving Authority and the person discharging such
industrial wastes into the public sewer;
(2) or, at the individual discharger's option, other flow
measuring devices, which measure the actual volume of wastewater
discharged to the sewer. Such devices shall be accessibly and safely
located, and the measuring system as specified by the Town shall be
installed in accordance with plans approved by the Approving Authority.
-The -metering system- shall be installed and maintained at the Owner's
expense according to arrangements that may be made with the Town.
(b) Where any person discharging wastes to the sanitary sewers
procures all or any part of his water supply from sources other than the
Town of Troutman Water Department, the person discharging said waste
shall install and maintain at his expense water meters of a type approved
by the approving authority for the purposes of determining the proper
volume of waste discharged to such sewers.
Sec. 8. Determination of Character and Concentration of wastes.
(a) Inspection. The industrial waste of each person discharging
such wastes into the public sewers shall be subject to periodic inspection
and a determination of character and concentration of such wastes shall be
made monthly for all "major" contributors and annually or more often as
may be deemed necessary by the Approving Authority or his authorized
assistant for the "minor" contributors. Such inspection and tests shall
also be made immediately after any process change which may affect the
quantity of quality of the wastes discharged. The determination of
"major" and "minor" contributor classifications shall be by the Approving
Authority.
(b) Samples. Samples shall be collected in such manner as to be
representative of the actual quality of the waste. Laboratory methods
used in the examination of such waste shall be those set forth in
STANDARD METHODS as hereinbefore described, a copy of which is on
file with the Town's Clerk for inspection by any interested parties.
(c) Authority. The determination of the character and
concentration of the industrial wastes by the Approving Authority or his
duly appointed representatives shall be binding as a basis for charges.
(d) Cost. Total costs incident to the supervision, inspection,
sampling and analyzing of wastes shall be included in the surcharge made
to persons discharging wastes into the Town sanitary sewers.
Sec. 9. Protection From Damage.
No person shall maliciously, willfully or negligently break, damage,
destroy, uncover, deface or tamper with any structure, appurtenance or
equipment which is a part of the sewage works.
12

Sec. 10. Control of Prohibited Wastes.
(a) Regulatory Actions. If wastewaters containing any substance
described in Section 3 of this Ordinance are discharged or proposed to be
discharged into the sewer system of the Town or to any sewer system
tributary thereto, the Approving Authority may. take any action necessary
to:
(1) Prohibit the discharge of such wastewater.
(2) Require a discharger to demonstrate that in -plant
modifications will reduce or eliminate the discharge of such substances in
conformity with this Ordinance .
(3) Require pretreatment, including storage facilities, or
flow equalization necessary to reduce or eliminate the objectionable
characteristics or substances so that the discharge will not violate these
rules and regulations.
(4) Require the person making, causing or allowing the
discharge to pay any additional cost or expense incurred by the Town for
handling and treating excess loads imposed on the treatment system.
(5) Take such other remedial action as may be deemed to be
desirable or necessary to achieve the purpose of this Ordinance.
(b) Submission of Plans. Where pretreatment or equalization of
wastewater flows prior to discharge .into any part of the wastewater
treatment system is required, plans, specifications and other pertinent
data or information relating to such pretreatment or flow -control facilities
shall first be submitted to the Approving Authority for review and
approval. Such approval shall not exempt the discharge of such facilities
from compliance with any applicable code, ordinance, rule, regulation or
order of any governmental . authority. Any subsequent alterations or
additions to such pretreatment or flow -control facilities shall not be made
without due notice to and prior approval of the Approving Authority.
(c) Pretreatment Facilities Operations. If pretreatment or control
of waste flows is required, such facilities shall be maintained in good
working order and operated as efficiently as possible by the owner or
operator at his own cost and expense, subject to the requirements of
these rules and regulations and all other applicable codes, ordinances,
and laws.
(d) Admission to Property. Whenever it shall be necessary for
the purposes of these rules and regulations, the Approvity Authority
upon the presentation of credentials, may enter upon any property or
premises at reasonable times for the purpose of (1) copying any records
required to be kept under the provisions of this Ordinance,
(2) inspecting any monitoring equipment or method, and (3) sampling any
discharge of wastewater to the treatment works. The Approving
Authority may enter upon the property at any hour under emergency
circumstances.
13

(e) Protection from Accidental Discharge. Each industrial user
shall provide protection from accidental discharge of prohibited materials
or other wastes regulated by this Ordinance. Facilities to prevent
accidental discharge of prohibited materials shall be provided . and
maintained at the owner or operator's own cost and expense. Detailed
plans showing facilities and operating procedures to provide this
protection shall be submitted to the Approving Authority for review, and
shall be approved by him before construction of the facility. Review and
approval of such plans and operating procedures shall not relieve the
industrial user from the responsibility to modify his facility as necessary
to meet the requirements of this Ordinance.
(f) Reporting of Accidental Discharge. 'If, for any reason, a
facility does not comply with or will be unable to comply with any
prohibition or limitations in this Ordinance, the facility responsible for
such discharge shall immediately notify the Approving Authority so that
corrective action may be taken to protect the treatment system. In
addition, a written report addressed to the Approving Authority detailing
the date, time and cause of the accidental discharge, the quantity and
characteristics of the discharge and corrective action taken to prevent
future discharges, shall be filed by the responsible industrial facility
within five (5) days of the occurrence of the noncomplying discharge.
Sec. 11. Industrial Wastewater Monitoring and Reporting.
(a) Discharge Reports.
(1) Every significant industrial user shall file a periodic
Discharge Report at such intervals as are designated by the Approving
Authority. The Approving Authority may require any other industrial
users discharging or proposing to discharge into the treatment system to
file such periodic reports.
(2) The discharge report shall include, but, in the
discretion of the Approving Authority, shall not be limited to, nature of
process, volume, rates of flow, mass emission rate, production quantities,
hours of operation, concentrations of controlled pollutants or other
information which relates to the generation of waste. In addition to
discharge reports, the Approving Authority may require information in
the form of Industrial Discharge Permit Application and self -monitoring
reports
(b) Records and monitoring
(1) All industrial users who discharge or propose to
discharge wastewaters to the wastewater treatment system shall maintain
such records of production and related factors, effluent flows, and
pollutant amounts or concentrations as are necessary to demonstrate
compliance with the requirements of this Ordinance and any applicable
State or Federal pretreatment standards or requirements..
(2) Such records shall be made available upon request by
the Approving Authority. All such records relating to compliance with
pretreatment standards shall be made available to officials of the U.S.
14

Environmental Protection Agency upon demand. A summary of such data
indicating the industrial user's compliance with this Ordinance shall be
prepared quarterly and submitted to the Approving Authority.
(3) The owner or operator of any premises or facility
discharging industrial wastes into the system shall install at his own cost
and expense suitable monitoring equipment to facilitate the accurate
observation, sampling, and measurement of wastes. Such equipment shall
be maintained in proper working order and kept safe and accessible at all
times.
(4)- The- - monitoring equipment shall -be -located- and -
maintained on the industrial user's premises outside of the building.
When such a location would be impractical or cause undue hardship on the
user, the Approving Authority may allow such facility to be constructed
in the public street or sidewalk area, with the approval of the public
agency having jurisdiction over such street or sidewalk, and located so
that it will not be obstructed by public utilities, landscaping or parked
vehicles.
(5) When more than one user can discharge into a common
sever; the Approving Authority may require installation of separate
monitoring equipment for each user. When there is a significant
difference in wastewater constituents and characteristics produced by
different operations of a single user, the Approving Authority may
require that separate monitoring facilities be installed for each separate
discharge.
(6) Whether constructed on public or private property, the
monitoring facilities shall be constructed in accordance with the
Approving Authority's requirements and all applicable construction
standards and specifications.
(c) Inspection, Sampling and Analysis.
(1) Compliance Determination. Compliance determinations
with respect to Section 3 prohibitions and limitations may be made on the
basis of either instantaneous grab samples or composite samples of
wastewater. Composite samples may be taken over a twenty-four (24)
hour period, or over a longer or shorter time span, as determined
necessary by the Approving Authority to meet the needs of specific
circumstances.
(2) Analysis of Industrial Wastewaters. Laboratory
analysis of industrial wastewater samples shall be performed in accordance
with the current edition of "Standard Methods," "Methods for Chemical
Analysis of Water and Waste" published by the U.S. Environmental
Protection Agency or the "Annual Book of Standards, Part 23, Water,
Atmospheric, Analysis" published by the American Society for Testing and
Materials. Analysis of those pollutants not covered by these publications
shall be performed in accordance with procedures established by the
North Carolina Department of Natural Resources and Community
Development.
15

(3) Sampling Frequency. Sampling of industrial wastewater
for the purpose of compliance determination with respect to Section 3
prohibitions and limitations will be done at such intervals as the
Approving Authority may designate. However, it is the intention of the
Approving Authority to conduct compliance sampling or to cause such
sampling to be conducted for all major contributing industries at least
once in every three months.
Sec. 12. Industrial Discharge Permit System
(a) Wastewater Discharge Permits Required. All significant
industrial-- users proposing to connect or to discharge into -any -part of the
wastewater treatment system must first obtain a discharge permit
therefor. All existing significant industrial users connected to or
discharging to any part of the Town system must obtain a wastewater
discharge permit within one hundred twenty (120) days from and after the
effective date of this Ordinance.
(b) Permit Application. Users seeking a wastewater discharge
permit (Attachment A) shall complete and file with the Approving
Authority an application on the form prescribed by the Approving
Authority, and accompanied by the applicable fee. In support of this
application, the user shall submit the following information:
(1) Name, address, and SIC number of applicant.
(2) Volume of wastewater to be discharged.
(3) Wastewater constituents and characteristics including,
but not limited to, those set forth in Section 3 of this Ordinance as
determined by a reliable analytical laboratory.
(4) Time and duration of discharge.
(5) Average and 60-minute peak wastewater flow rates,
including daily, monthly and seasonal variations, if any.
(6) Site plans, floor plans, mechanical and plumbing plans
and details to show all sewers and appurtenances by size, location and
elevation.
(7) Description of activities, facilities and plant processes
on the premises including all materials and types of materials which are,
or could be, discharged.
(8) Number of employees, and hours of work.
(9) Any other information as may be deemed by the
Approving Authority to be necessary to evaluate the permit application.
The Approving Authority will evaluate the data furnished by
the user and may require additional information. After evaluation and
acceptance of the data furnished, the Approving Authority may issue a
wastewater discharge permit subject to terms and conditions provided
herein.
a

(c) Permit Conditions. Wastewater discharge permits (Attachment
B) shall be expressly subject to all provisions of this Ordinance and all
other regulations, user charges and fees established by the Town. The
conditions of wastewater discharge permits shall be uniformly enforced in
accordance with this Ordinance, and applicable State and Federal
regulations. Permit conditions will include the following:
(1) The unit charge or schedule of user charges and fees
for the wastewater to be discharged to the system.
(2) The average and maximum wastewater constituents and
characteristics. - - -
(3) Limits on rate and time of discharge or requirements
for flow regulations and equalization.
(4) Requirements for installation of inspection and sampling
facilities, and specifications for monitoring programs. -
(5) Requirements for maintaining and submitting technical
reports and plant records relating to wastewater discharges.
(6) Daily average and daily maximum discharge rates, or
other appropriate conditions when pollutants subject to limitations and
prohibitions are proposed or present in the user's wastewater discharge.
(7) Compliance schedules.
(8) Other conditions to ensure compliance with this
Ordinance.
(d) Outside Connections. Any user owning or controlling
premises located beyond the corporate limits of the Town of Troutman and
desiring to install a plumbing system for the purpose of discharging
domestic' sewage and/or industrial waste into the sanitary sewers of the
Town may do so by complying with the requirements of this Ordinance and
by paying an additional permit fee and a yearly sewer rental charge to be
fixed by the Town Board.
(e) Duration of Permits. Permits shall be issued for a specified
time period, not to exceed one year. A permit may be issued for a period
of less than (one) year, or may be stated to expire on a specific date.
The terms and conditions of the permit may be subject to modification and
change by the Approving Authority during the life of the permit, as
limitations or requirements as identified in Section 3 are modified and
changed. The user shall be informed of any proposed changes in his
permit at least (30) days prior to the effective date of change. Any
changes or new conditions in the permit shall include a reasonable time
schedule for compliance.
(f) Transfer of a Permit. Wastewater discharge permits are
issued to a specific user for a specific operation. A wastewater discharge
a_ permit shall not be reassigned or transferred or sold to a new owner, new
user, different premises, or a new or changed operation.
17

(g) Revocation of Permit. Any user who violates the following
conditions of his permit or of this Ordinance, or of applicable State and
Federal regulations, is subject to having his permit revoked. Violations
subjecting a user to possible revocation of his permit include, but are not
limited to, the following:
(1) Failure of a user to accurately report the wastewater
constituents and characteristics of his discharge;
(2) Failure of the user to report significant changes in
operations, or wastewater constituents and characteristics;
(3) Refusal of -reasonable access to the user's premises for
the purpose of inspection or monitoring; or,
(4) Violation of conditions of the permit.
Sec. 13. New Sewer Construction.
New sewers and new connections shall be properly designed and
constructed in accordance with such guidelines as published by the
Environmental Protection Agency (Reference 40 CFR Section 35.927-4) .
Sec. 14.1. Enforcement Procedures.
(a) Notification of Violation. Whenever the Approving Authority
finds that any person has violated or is violating this Ordinance, or any
prohibition, limitation or requirement contained herein, he may serve
upon such 'person a written notice stating the nature of the violation and
providing a reasonable time, not to exceed thirty (30) days, for the
satisfactory correction thereof.
(b) Show Cause Hearing.
(1) If the violation is not corrected by timely compliance,
the Approving Authority may order any person who causes or allows an
unauthorized discharge to show cause before the hearing authority why
service should not be terminated. A notice shall be served on the
offending party, specifying the time and place of a hearing to be held by
the hearing authority regarding the violation, and directing the offending
party to show cause before said authority why an order should not be
made directing the termination of service. The notice of the hearing shall
be served personally or by registered or certified mail (return receipt
requested) at least ten days before the hearing. Service may be made on
any agent or.officer of a corporation.
(2) The Hearing Authority may itself conduct the hearing
and take the evidence, or may designate any of its members or any officer
or employee of the legal department to:
(i) Issue in the naive of the Hearing authority
notices of hearings requesting the attendance and testimony of witnesses
and the production of evidence relevant to any matter involved in any
such hearings.

(.- (ii) Take the evidence.
(iii) Transmit a report of the evidence and hearing,
including transcripts and other evidence, together with recommendations
to the Hearing Authority for action thereon.
(3) At any public hearing, testimony taken before the
Hearing Authority or any person designated by it, must be under oath
and recorded stenographically. The transcript. so recorded, will be made
available to any member of the public or any party to the .hearing upon
payment of the usual charges therefor.
(4) After the Hearing Authority has reviewed the evidence,
it may issue an order to the party responsible for the discharge directing
that, following a specified time period, the sewer service be discontinued
unless adequate treatment facilities, devices or other related
appurtenances shall have been installed or existing treatment facilities,
devices or other related appurtenances are properly operated, and such
further orders and directives as are necessary and appropriate.
(c) Legal Action. Any discharge in violation of the substantive
provisions of this Ordinance or an Order of the Hearing Authority shall
be considered a public nuisance. If any person discharges sewage,
industrial wastes or other wastes into the Town treatment system contrary
to the substantive provisions of this Ordinance of any Order of the
Hearing Authority, the Town Attorney shall commence an action for
appropriate legal and/or equitable relief in the Superior Court of this
County.
Sec. 14.2. Penalty; Costs.
Any person who is found to have violated an Order of the Hearing
Authority or who willfully or negligently failed to comply with any
provision of this Ordinance, and the orders, rules and regulations issued
hereunder, shall be fined not more than fifty (50) dollars for each
offense. Each day on which a violation shall occur or continue shall be
deemed a separate and distinct offense.
Sec. 14.3. Saving Clause.
If any provision, paragraph, work, section or article of this Ordinance is
invalidated by any court of competent jurisdiction, the remaining
provisions, paragraphs, words, sections, and articles shall not be
affected and shall continue in full force and effect.
Sec. 14.4. Conflict.
All ordinances and parts of ordinances inconsistent or conflicting with any
part of this Ordinance are hereby repealed to the extent of such
inconsistency or conflict.
HK

Sec. 14. 5 . Maximum Restrictions.
The effluent standards and limitations contained in this Ordinance shall be
no more restrictive than the most nearly applicable federal effluent
standards and limitations. In the event the effluent standards and
limitations adopted in this Ordinance are more restrictive than the most
nearly applicable federal effluent standards and limitations, then the said
federal standards shall apply.
Sec. 14.6. Effective Date.
This Ordinance shall be in full force and effect on the day of
U�GEmBr- rz 19 ?'o
INTRODUCED THE ?7,2, day of 19 F'o
FIRST READING: /2, P 19 p-Q
SECOND READING: , 19.
PASSED this Fr1, day of D c E,,, Q E2 19 7-6
AYES: 3
NAYS: 0
ABSENT: 1
NOT VOTING: t3 c TT y i
20

TOWN OF TROUTMAN
P.O. BOX 26
TROUTMAN N.C. 28166
yck:
ta+i
1
TOM ADDLEY
'`
1
DIRECTOR OF
PUBLIC WORKS
TO DWQ,
ENCLOSED YOU WILL FIND AN ARRANGEMENT OF OUR
OPERATION AND MAINTENANCE PLAN/DOCUMENTS. HOPEFULLY THIS IS
IN AN ACCEPTABLE FORMAT, IF NOT PLEASE LET US KNOW IMMEDIATELY
OF ANY REQUIRED REVISIONS.
ENCLOSED IS BASICALLY THE TOOLS WE WILL USE TO
PROPERLY MONITOR OUR SYSTEM TO MAINTAIN A STATE OF READINESS.
PLEASE NOTE THAT OUR SEWER USE ORDINANCE WILL BE
UPDATED BY W.K. DICKSON ENGINEERS SOMETIME THIS FALL AS WELL
AS A NEW MAP OF OUR COLLECTION SYSTEM IDENTIFYINGMANHOLE
LOCATIONS AND I.D. NUMBERS.WE ARE CURRENTLY INVOLVED IN AN I/I
STUDY AS WELL.
THANK YOU FOR ALL YOUR SUPPORT OF SEMINARS AS WELL
AS YOUR INVOLVEMENT OF TOWNS AND CITIES STATEWIDE.
SINCERELY,
TOM ADDLEY (DPW)

OPERATION & MAINTENANCE EVALUATION
1. Is staff designated full-time for collection system operation and maintenance? Yes No
2. Do you have a list of 24 hour contacts?_ Yes No (If Yes, please attach)
3. Do you have an emergency equipment list? Yes No (if Yes, please attach)
4.. Staff distribution/time allocation: JU
IS-199
Number Total staff
employed hours/week ;J: r-
Collection System (incl. part-time)
Pump Stations ! /o
1/1 Correction _ _ Aal) X -)/C/<
.1 :4 ca.-t-
5. Are map(s) of the collection system available? _'� Yes No Eve
6. Total number of pump stations: (.P (Please complete a Pump Station form for each station.)
7. Is a preventive maintenance program in effect? Yes
If yes, does it include:
a.'Maintaining logs/records
b. Determining equipment/system malfunction rates
c. Establishing schedules
d. 1/1 evaluation
e. Manhole inspection
f. Sewer cleaning program
g. Hydrogen sulfide monitoring and control
h. Lift station operation
i. Easement/right-of-way maintenance
j. "Walking or visual observation of lines
k. Spare parts inventory
No (If Yes, please attach)
_X Yes
No
Yes
X No
_ 4
Yes
No
X
Yes
No
K
Yes
No
Yes
No
Yes
x No
Yes
No
Yes
No
Yes.
No
Yes
No
B. Please describe what type of ongoing inspection program for the collection system exists:
9. Please describe the schedule for line cleaning: /Do do
10. Is there a sewer use ordinance? Yes _ No. , Is there a grease ordinance? - Yes _ No y /U 5,
If yes, please identify the responsible party for ensuring the ordinance(s) is enforced.
22:k ,Ao�� (name of responsible person/agency).
11. Please describe any sewer use ordinance enforcement practices that exist:
9

SPILL RESPONSE PLAN EVALUATION
1. Do you have a current 24 hour contact list which includes phone numbers of key personnel and/or
contractors?'Yes No (If Yes, please attach)
2. Do you have an qupment list which includes what functional equipment is available and where it is
located? Yes No (If Yes, please attach)
3. Do you have the staff resources to make an on -site assessment of a spill with in two hours of notification
of the spill? Yes No (If No, please explain below)
4. Please list your standard spill response procedures:Off'
5. Is your spill response plan readily available to all essential personnel? Yes No
If No, please explain why:
6. Are all esserttl personnel familiar with the spill response plan and clearly understand its contents?
y� Yes No
If No, please explain why:

Collection System Evaluation:
1. Please es`ti�ate how many miles of sewer line are in your collection system
X <100mi. 100-500mi. 501-1,000mi.
2. How many pump stations are in your collection system? C9
3. Please list any problem areas within your collection system. Include exact location of problems.
(e.g. Chronically surcharging manholes, pump stations which frequently fail, lines with severe
Infiltration and Inflow, etc..)
4. Please rank the problems listed in No. 3 in order of importance. If possible, include an estimated date
by which the problem will be appropriately addressed.
5. Please describe any ongoing efforts or plans to rehabilitate and/or renovate the collection system.
Include exact location of ongoing or planned work.
(e.g. Infiltration and Inflow studies, pump station upgrades, pipe replacement, etc..)
412
NOTE: Please attach any additional sheets and/or information if needed.

MONTHLY PREVENTATIVE
MAINTENANCE CHECKLIST
GORMAN-RUPP T - SERIES ABOVE GROUND LIFT
STATION PUMPS
INITIALS
• CHECK AIR FLOW INDICATOR,
IF EQUIPPED TO ENSURE PROPER AIR FLOW --------------------
• CHECK OIL LEVEL IN BEARING AND SEAL CAVITIES ---=---------------
• CHECK BELTS,TENSION
• CHECK AIR PUMP
• CHECK AIR RELEASE VALVES
• LUBE A.R.V.'S
• EXERCISE ALL ISOLATION VALVES
• CHECK BACKFLOW VALVES

TOWN OF TROUTMAN 24 HR. CONTACT LIST
NAME PAGER HOME CELL.
WAYNE MILLS[CHIEF] 9280380
ERIC HENDERSON[TPD] 9280382
ANDY JONES[TPD] 9280383
JOE GENTLE[TPD] 9280384
BRANTLEY OSTWALT[TPD] 9380381
KEVIN DAVIS[TPD] 5826073
BUTCH BROWN[TPW]
BRENT LILLY[TPW] 3509292
NATE WILLIAMS[TPW] 9280401
TOM ADDLEY [DPW,CSO] 8784195
A.J. BARGHOTHI[ADMIN]
LOREN POWELL[MAYOR]
BELL CONSTRUCTION[CONTRACTOR]
CITY OF STATESVILLE[WATER/SEWER] 7-3
CITY OF STATESVILLE[WATER/SEWER].3-7
TOWN OF MOORESVILLE[WATER/SEWER]DAY
TOWN OF MOORESVILLE[WATER/SEWER]EVE
NCDENR MOORESVILLE
PAUL JUDGE PWS
EAGLE RENTALS
STATESVILLE RENTALS
SIGMON ENVIRONMENTAL
TOWN ALARM SYSTEM
TOWN SEWER PLANT
TOWN HALL
TEC UTILITIES[STEVE ROGERS]
CITIES SUPPLY[BILLIE VESTAL]
PIPELINE SUPPLY[DAYTON RUGG]
RODDERS SUPPLY[MIKE BUTNER]
HUGHES SUPPLY[BILL ROBERTSON]
WK DICKSON ENGINEERING
EMORY WILSON[BARRY HARMS]
IREDELL CO.HEALTH DEPT
IREDELL CO.ENV. HEALTH
8727839 2015502
873 8902 2015941
5286345 2015984
8712380 2015985
5289584 2016919
6630636 2016046
5280818 201 6054
6644701 2016082
8739946 2016084
5281027 2016103
9247408 3120462
528 4627 POLK 828 625 9266
8736378
8783417
8783406
6643705
6643311
663 1699
663 1699
8723621
873 1951
873 8954 CELL 902 3741
5287619
5287606
5287600
800 968 7088
H546 5890
800 672 7553
H336 463 5291
800 273 3688
803 547 7378
336 6813840
5964080
H8643758.
3345348
800 948 0823
8785300
8785305

MONTHLY PREVENTATIVE MAINTENACE CHECKLIST
CANTEX/FAIRBANKS MORSE
PUMP STATION
DATE OF P.M.
PERSON PERFORMING P.M.
• IS VENTILATION FAN PROPERLY OPERATING
• IS SUMP PUMP OPERATING PROPERLY
• IS WET WELL CLEAR OF LARGE
FLOATING SOLIDS AND GREASE BALLS
• EXERCISE ALL ISOLATION VALVES AND ENSURE
PROPER OPERATION OF CHECK VALVES
• REPLACE SEAL CAVITY LUBRICANT FILTER
• CHECK OPERATION OF PUMP STATION THROUGH
ONE CYCLE, PER PUMP TO ENSURE PROPER OPERATION

WASTEWATER COLLECTION SYSTEM
QUARTERLY INSPECTION REPORT
THE PURPOSE OF THIS FORMIS TO ENSURE THE CONDITION OF GRAVITY SEWERS
AND FORCE MAINS NOT READILY VISIBLE BY PUBLIC AND ROUTINE DAILY ACTIVITIES.
1999 00A-t-TC- -Ly

EMERGENCY EQUIPMENT LIST
LOCATION
GENERATION/STAND BY POWER
110 V. HONDA PORTABLE GENERATOR MASSEY ST SHOP
110 V. PORTABLE MILITARY GENERATOR MASSEY ST SHOP
240 V. 3 PH. ONAN TOWABLE GASOLINE MASSEY ST SHOP SHELTER
240 V. 3 PH. ONAN MILITARY PORTABLE DEISEL MASSEY ST SHOP
LIGHTING
PORTABLE LIGHT SET 110V. MASSEY ST SHOP
PORTABLE LIGHT SET 110V. MASSEY ST SHOP
PUMPS, HOSES
3" "MUD" DIAPHRAM PUMP GASOLINE MASSEY ST SHOP
3" CENTRIFUGAL TRASH PUMP GASOLINE MASSEY ST SHOP
2" CENTRIFUGAL SUMP PUMP 220V.
1 1/2" SUMP PUMP 110V. & 25' DISHARGE HOSE MASSEY ST SHOP
600 FT LAY FLAT DISCHARGE HOSE MASSEY ST SHOP
REMEDIAL SUPPLIES
STRAW BALES, 15 ON HAND MASSEY ST SHOP SHELTER
LIME 50# BAGS, 4 ON HAND MASSEY ST SHOP
BARRICADES,CONES ETC. MASSEY ST SHOP

TOWN OF TROUTMAN
SEWER TROUBLE LOG
WORK NAME LOCATION DESCRIPTION DATE/TIME TIME CALL CALL RESPONSE COMMENTS
ORDER ADDRESS OF OF OF OF OF RC'D ASSG'D TIME ACTION
NUMBER CALLER PROBLEM PROBLEM PROBLEM CALL BY TO IN HRS. TAKEN

GORMAN/RUPP T SERIES 3 " PUMP PARTS SPARE PARTS LIST
PART #
QTY.
DESCRIPTION
FS- 1748
6
O- RING
25113-033
4
DISCH. GASKET
13130
4
WEAR PLATE SHIM SET
37-J
3
IMPELLER SHIMS
11406
2
IMPELLER
11407-A
2
WEAR PLATE
12364-A
4
SEAL ASSY.
11876-A
2
SHAFT SLEEVE
S-1748
4
SHAFT SLEEVE O RING
S-250
1
BEARING
S-1749
1
BEARING
51352
2
OIL SEAL
S- 244
1
RETAINER
11557-A
2
FLAP VALVE PIN
10278
2
IMPELLER WASHER
DM-1005
2
IMPELLER BOLT
10959-G
1
SEAL PLATE GASKET
11408-G
1
BEARING CAP GASKET
46411
4
FLAP VALVE
38571-717
1
80# COMP. SPRING
11412-G
3
A.R.V. GASKET
38676-404
3
A.R.V. DIAPHRAM

PEABODY BARNES SPARE PUMP PARTS
PART#
DESCRIPTION
QTY.
25331
O RING
7
16067
O RING
5
17713
O RING
10
25332
O RING
6
53936
O RING
7
52906
BRG LOCKWASHER
2
52905
LOCKNUT
2
29915
SLINGER
2
29317
O RING
2
52807
O RING
6
52806
O RING
3
52907
SHAFT SLEEVE
2
26051
O RING
9
18008
CK VLV GASKET
3
67500
CK VLV WEIGHT
2
52782
SHIM SET
1
52783
SHIM SET
1
24998
SHAFT SEAL
2
52935
BRG SINGLE
3
29860
BRG DOUBLE
3
24997
OIL SEAL
8

DAILY SEWER GLEANING REPORT
DATE
OPERATOR
ASSISTANT
STREET NAME IMANHOLE # FROM (MANHOLE # TO (FOOTAGE I# OF PASSES

Sewer Manhole Inspection Form
Manholes are significant contributors of I/I into wastewater collection systems. Therefore, it is
important to perform detailed Sewer Manhole (SMH) Inspections and properly document defects
so that an accurate rehabilitation program can be designed. The attached form is a tool to be used
in accomplishing this goal.
■ Fill out the SMH specific information on the top of the front page of this form.
■ Accurately illustrate the direction of flow in the SMH in the figures provided.
■ List the cover size, SMH size, drop connection, area around SMH, depth of SMH from rim
-and depth of wet ring from rim.
■ For each pipe entering or exiting the SMH, provide the information listed in the lower
center of this form. Assign a letter to each line starting with "A' being the effluent line
and proceeding clockwise.
■ Explain any defects observed and list the Photo Number, if any. Types of defects would
include:
• Number of defects in any one manhole section
• Rating manhole as illustrated on the Manhole Overflow Rating System Form
■ On the top of the back page, list the MH ID. and the initials of the person reviewing the
form.
■ In the left-hand column of the back page of this form, answer items 1.0 through 7.0
accordingly, Item 8.0 should be filled out by Operation Managers using the
Recommendation Codes provided at the bottom of the form.
■ In the right-hand column of the back page, answer Items 1.0 through 9.0 accordingly with
the Condition, Infiltration, and Inflow Codes provided on the bottom of the form.
raj
C
0
r,,.

Manhole Depth from Rim:
Pipe Size Material
A.
B.
C.
D.
E.
Explanation of Defects:
Manhole Inspection Report
Manhole _
Vlini-System
Date
Time
Location
District —
Inspector
Weather.
Cover Size 24" 30" Other Area Around Manhole
Manhole Size 4' 5' Other Paved: Satisfactory
Drop Y/N Cracked
Missing Pavement
Vegetation Growth
Unpaved: Satisfactory
Eroded
Depth to Wet Ring: from Rim:
From/To MH# Invert Depth Debris Depth Condition
(fr. Rim) (fr. invert)
Photo Number:

1.0 Location
A Roadway C Alley
B Roadside D Easement
Above inches BY Back yard
Grade FY Front yard
Below inches E Other
u nnannoie material
BRK
Brick
CON
Poured Concrete
FIB
Fiberglass
MSK
Manhole Block
POL
Polyethylene
PRC
Precast Concrete
Other
3.0 Surcharge
A No Evidence
B Evidence of Surcharge
Height above Invert It.
4.0 Clarity of Flow
A Normal Sewage Appearance
B Clear Water Appearance
C No Flow
5.0 Flow
A Steady E Stagnant
B Pulsing F Sluggish
C Turbulent G No Flow
D Surcharging
.0 Ability to Quantify Ill
A Very Difficult C Good
B Poor D Excellent
E
7.0 Ponding
Ponding YIN _ inches
ti.0 Hecommenclatlons
Recommendation Codes
nvv.c--- uy.
-1.0 Cover
# of Pickholes
# of Vent Holes _
Condition Codes
Inflow Code
2.0 Frame
Condition Codes
Inflow Code -
3.0 Chimney
Condition Codes
Inflow Code
Material
4.0 Cone
Condition Codes
Inflow Code
Material
5.0 Wall
Condition Codes
Inflow Code
Material
6.0 Bench
Condition Codes
Inflow Code
Material
7.0 ChannellInvert
Condition Codes
Inflow Code
Material
8.0 Base
Condition Codes
Inflow Code_
Material
9.0 Steps
S Safe
U Unsafe
M Missing
Condition Codes
A Satisfactory
E Cracks
1 Broken
M Needs Raising
a
Sulfide Corrosion U Bad Invert
B Misaligned
F Medium Deterioration
J Missing
N Obstructed
R
Mineral Deposits
C Poor Filling
G Material Missing
K Light Deterioration
O Bad Pipe Connection
S
Roots
D Loose or Worn
H Severe Separation
L Heavy Deterioration
P Silted/Debris Buildup
T
Snags
Recommendation Codes
Infiltration Codes
A No Action Required
F Improve Drainage
A
No Evidence of Infiltration
F Observed Infiltration (2-3 gpm)
B Rebuild or Line Manhole
G Repair Pavement
B
Evidence of Prior Infiltration
G Observed Infiltration (3-4 gpm)
C Reset Frame and Cover
H GearvRemove Debris from Invert
C
Observed Infiltradon (0-.5 gpm)
H Observed Infiltration (4-5 gpm)
D Point Repalr of VI Source
I Repay Channel
D
Observed Infiltration (.5-1 gpm)
I Observed Infatratlnn (>S ppm)
E Seal or Install Leak Resistant Cover
J Replace Extension Ring
E
Observed Infiltration (1-2 gpm)
Inflow Codes
M No Evidence of Inflow O
Medium Inflow Source
N Small Inflow Source P
Large Inflow Source

• GENERATOR LOAD TESTING CHECKLIST
DATE:
GENERATOR:
TESTED BY:
DATE GENERATOR
LAST TESTED:
DATE GENERATOR
LAST SERVICED:
WHERE IS
GENERATOR
BEING TESTED:
® WHAT IS GENERATOR
BEING TESTED ON:
WHAT PHASE:
WHAT VOLTAGE:
WHAT AMPERAGE:
MINUTES TESTED:
IS TEST ACCEPTABLE:

EQUIPMENT MAINTENANCE WORKSHEET
DATE:
EQUIP. BEING
SERVICED:
TYPE OF SERVICE:*
PERSON PERFORMING
SERVICE:
PARTS USED:
SUPPLIES USED:
IS SERVICE
COMPLETED:
IS FOLLOW
UP NEEDED:
IF SO
WHAT?:
DATE/HRS.NEXT
SERVICE NEEDED:
NOTES:
" TYPES OF SERVICE; REPAIR
ROUTINE
PREVENTATIVE
LUBRICATION