WQ0002005_Application_20230808

NOUSEOF
S99
August 8, 2023
Nathaniel D. Thornburg
Branch Chief
Non -Discharge Branch
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
SUBJECT: WQ0002005 - House of Raeford -Rose Hill Spray Irrigation Permit Renewal
Hello Mr. Thornburg,
Please find the enclosed required information for the permit renewal for our Rose Hill Plant. The site
maps were updated in 2016 and have not changed since so please use the maps that are in the enclosed
permits.
One request that we do have is to reduce the PH and Chlorine monitoring frequency back to twice a
month as it used to be in our permits prior to the most recent one. I have not seen any lab results for PH or
Chlorine that are of concern and we feel that checking them S days a week is a bit much and it is costing
the plant around 50,000 dollars a year.
Please let me know if you have any questions.
J. Nicole Reynolds
Plant Manager
House of Raeford Farms — Rose Hill
910-289-3191
3333 US Highway 117 South, Rose Hill, North Carolina 28458 — PO Box 40 — [phone]

DWR
State of North Carolina
Department of Environmental Quality
Division of Water Resources
Division of Water Resources
15A NCAC 02T .0500 — WASTEWATER IRRIGATION SYSTEM — RENEWAL
FORM: WWIS-R 02-21
Pursuant to 15A NCAC 02T .0107(b), if the application does not include all required information and the necessary supporting
documentation, the application shall be returned. The application and attachments shall be prepared in accordance with 15A
NCAC 02T .0100, 15A NCAC 02T .0500, and Division Policies. For more information, visit the Water Quality Permitting
Section's Non -Discharge Branch website. The Applicant shall submit an electronic copy of the application and attachments
uploaded as a single Portable Document Format (PDF) file to https://edocs.deci.nc.l!ov/Forms/NonDischart!e-Branch-Submittal-
Form-Ver2, or entailed to Non-Discharl!e.Reports(a,ncdenr.l!ov if less than 20 megabytes (MB).
SECTION I —
APPLICANT INFORMATION
se of Raeford Farms, Inc.
7Pennit
Q0002005
3.
Signature authority: Nicole Reynolds
Phone number: [phone] Cell
Title: Rose Hill Processing Plant Complex Manager
Email: nicole.reynoldsAhouseofraeford.com
4.
Mailing address: P.O. Box 699
City: Rose Hill
State: NC Zip: 28458-
5.
Contact person: Mason Drew
Primary phone number: [phone] Cell
Email [e-mail]
Secondary phone number: ( ) - Select
SECTION II — FACILITY INFORMATION
1. Physical address: 3333 US 117 North
City: Rose Hill
2. Treatment facility coordinates to the sixth decimal degree:
Latitude: 34.860346' Longitude:-78.028125'
County: Duplin Parcel No.: 12-1942
State: NC Zip: 28458-
Method: Digital or raw photo extraction
SECTION III —FLOW INFORMATION
1111111111
1.
Permitted flow: 800000 GPD (The maximum allowable flow based on what has been permitted)
2.
As -built flow: 800000 GPD (The maximum allowable flow based on what has been constructed)
3.
Average flow: 296203 GPD (The average of all reported flows on the previous calendar year's NDMRs)
4.
Hydraulic capacity: 37 % (Divide the average flow in Item 3 by the As -built flow in Item 2)
5.
Wastewater composition: Domestic: 0 % Industrial: 95 % Stormwater: 5 %
SECTION IV — BILLING INFORMATION
1. Billing address: P.O. Box 40
City: Rose Hill State: NC Zip: 28458-
2. Verify the Applicant does not have any overdue annual fees:
https:Hdeg.nc. gov/about/divisions/water-resources/water-resources-permits/wq-cpavments
Pursuant to 15A NCAC 02T .0120(c), permits for renewing facilities shall not be granted if the Applicant or any affiliation has
an unpaid annual fee.
FORM: WWIS-R 02-21 Page 1 of 7

SECTION V — OPERATOR IN RESPONSIBLE CHARGE (ORC) INFORMATION
1. ORC: Mason Drew
Grade: SI Certification No.: 1002071
Mailing address: P.O. Box 40
City: Rose Hill
State: NC Zip: 28458-
Phone number: [phone] Cell
Email [e-mail]
2. Back -Up ORC: Matt Sutton
Grade: SI Certification No.: 1006243
Mailing address: P.O. Box 40
City: Rose Hill
State: NC Zip: 28458-
Phone number: [phone] Cell
Email:
SECTION VI — OPEN -ATMOSPHERE STRUCTURES
1. List all open -atmosphere treatment and storage structures associated with the renewing permit. Attach additional sheets if
necessary.
Type
Parcel No.
Volume (gal)
Liner Type
Freeboard (ft)
Latitude
Longitude
Treatment
12-1942
7,755,000
Full, clay
2
34.8599560
-78.0276190
Treatment
12-1942
8,175,000
Full, clay
2
34.8605940
-78.0250230
Storage
12-909
35,000,000
Full, clay
2
34.8526090
-78.0599900
Select
Select
0-
°
SECTION VII — RELATED PERMITS
1. List all wastewater permits (i.e., sewer, collection system, NPDES, residuals) that have interactions with the renewing permit.
Attach additional sheets if necessary.
Permit Type
Permit No.
Relationship Type
Collection System
WQ0000040
Upstream sewer
Sewer
WQ0001481
Receiving WWTP
Select
Select
Select
Select
SECTION VIII — MONITORING WELLS
1. List all groundwater monitoring wells associated with the renewing permit. Attach additional sheets if necessary.
Well Name
Parcel No.
Status
Gradient
Location
Latitude
Longitude
MW-1
12-1888
Active
Downgradient
Inside Review Boundary
34.5113650
-78.032080
MW-2A
12-1934
Active
Downgradient
Inside Review Boundary
34.5134590
-78.032522
MW-3
12-909
Active
Downgradient
Inside Review Boundary
34.5057290
-78.034781
MW-4
12-909
Active
Downgradient
Inside Review Boundary
34.5102100
-78.033641
MW-5
12-1888
Active
Downgradient
Inside Review Boundary
34.5100710
-78.031947
MW-6
12-121
Active
Upgradient
On Compliance Boundary
34.8553920
-78.066149
MW-7
12-1939
Active
Cross gradient
Inside Review Boundary
34.5138790
-78.013554
MW-8
12-1942
Active
Downgradient
Inside Review Boundary
34.5137310
-78.012694
MW-9
12-1942
Active
Cross gradient
Inside Review Boundary
34.5131990
-78.020276
MW-10
12-1942
Active
Downgradient
Inside Review Boundary
34.5135630
-78.013198
MW-11
12-1939
Active
Downgradient
On Compliance Boundary
34.5140100
-78.013318
FORM: WWIS-R 02-21 Page 2 of 7

SECTION V
— OPERATOR IN RESPONSIBLE CHARGE (ORC) INFORMATION
1. ORC:
Grade:
Certification No.:
Mailing address:
City:
State:
Zip: -
Phone number: ( ) -
Select Email:
2. Back -Up ORC:
Grade:
Certification No.:
Mailing address:
City:
State:
Zip: -
Phone number: ( ) -
Select Email:
SECTION VI — OPEN -ATMOSPHERE STRUCTURES
1. List all open -atmosphere treatment and storage structures associated with the renewing permit. Attach additional sheets if
necessary.
Type
Parcel No.
Volume (gal)
Liner Type
Freeboard (ft)
Latitude
Longitude
Select
Select
0-
°
Select
Select
0-
°
Select
Select
0-
°
Select
Select
0-
°
SECTION VII — RELATED PERMITS
1. List all wastewater permits (i.e., sewer, collection system, NPDES, residuals) that have interactions with the renewing permit.
Attach additional sheets if necessary.
Permit Type
Permit No.
Relationship Type
Select
Select
Select
Select
Select
Select
Select
Select
SECTION VIII — MONITORING WELLS
1. List all groundwater monitoring wells associated with the renewing permit. Attach additional sheets if necessary.
Well Name
Parcel No.
Status
Gradient
Location
Latitude
Longitude
MW-12
12-861
Active
Downgradient
Inside Review Boundary
34.5134340
-78.013305
MW-13
12-1939
Active
Downgradient
Inside Review Boundary
34.5142510
-78.012574
MW-14
12-1939
Active
Cross gradient
Inside Review Boundary
34.5144430
-78.014032
MW-15
11-258
Active
Downgradient
Inside Review Boundary
34.5137590
-78.012541
MW-16
12-1887
Active
Downgradient
Inside Review Boundary
34.5126140
-78.024859
MW-17
12-909
Active
Downgradient
Inside Review Boundary
34.5056370
-78.034156
Select
Select
Select
°
- °
Select
Select
Select
°
- °
Select
Select
Select
°
- °
Select
Select
Select
°
- °
Select
Select
Select
°
- °
FORM: WWIS-R 02-21 Page 3 of 7

SECTION IX — IRRIGATION FIELDS
1. List all irrigation fields associated with the renewing permit. Attach additional sheets if necessary.
Field
County
Parcel No.
Deeded Owner
Area
Cover Crop
Latitude
Longitude
4
Duplin
12-909
Nash Johnson & Sons' Farms
23.00
Coastal Bermuda
34.5135570
-78.033422
5-A
Duplin
12-1888
Nash Johnson & Sons' Farms
6.90
Coastal Bermuda
34.5126360
-78.032640
5-AA
Duplin
12-909
Nash Johnson & Sons' Farms
5.50
Coastal Bermuda
34.5130160
-78.033186
5-B
Duplin
12-1888
Nash Johnson & Sons' Farms
6.90
Coastal Bermuda
34.5116570
-78.032408
6-A
Duplin
12-909
Nash Johnson & Sons' Farms
16.20
Coastal Bermuda
34.5105160
-78.032605
6-B
Duplin
12-1887
Nash Johnson & Sons' Farms
6.70
Coastal Bermuda
34.5110510
-78.031524
Ll
Duplin
12-909
Nash Johnson & Sons' Farms
12.04
Coastal Bermuda
34.5129240
-78.034488
L2
Duplin
12-909
Nash Johnson & Sons' Farms
12.04
Coastal Bermuda
34.5123110
-78.034858
L3
Duplin
12-909/12-121
Nash Johnson & Sons' Farms
12.04
Coastal Bermuda
34.5116360
-78.035254
L4
Duplin
12-909/12-121
Nash Johnson & Sons' Farms
12.04
Coastal Bermuda
34.5110280
-78.035612
L5
Duplin
12-121
Nash Johnson & Sons' Farms
10.52
Coastal Bermuda
34.5103990
-78.040001
L6
Duplin
12-909/12-121
Nash Johnson & Sons' Farms
8.60
Coastal Bermuda
34.5101030
-78.035059
L7
Duplin
12-909/12-121
Nash Johnson & Sons' Farms
12.04
Coastal Bermuda
34.5106720
-78.034765
L8
Duplin
12-909
Nash Johnson & Sons' Farms
12.04
Coastal Bermuda
34.5113150
-78.034397
L9
Duplin
12-909
Nash Johnson & Sons' Farms
12.04
Coastal Bermuda
34.5119650
-78.034029
L10
Duplin
12-909
Nash Johnson & Sons' Farms
12.04
Coastal Bermuda
34.5126190
-78.033637
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Total Acreage:
180.64
FORM: WWIS-R 02-21 Page 4 of 7

ATTACHMENT A — SITE MAP Was the facility originally permitted or had a major modification issued after September 1, 2006?
❑ Yes — Pursuant to 15A NCAC 02T .0105(d), submit a site map pursuant to the requirements in 15A NCAC 02T .0504(d). These
requirements are:
❑ A scaled map of the site with topographic contour intervals not exceeding 10 feet or 25 percent of total site relief and showing
all facility -related structures and fences within the wastewater treatment, storage, and irrigation areas.
❑ Soil mapping units shown on all irrigation sites.
❑ The location of all wells (including usage and construction details if available), streams (ephemeral, intermittent, and
perennial), springs, lakes, ponds, and other surface drainage features within 500 feet of all wastewater treatment, storage,
and irrigation sites.
❑ Delineation of the compliance and review boundaries per 15A NCAC 02L .0107 and .0108, and 15A NCAC 02T .0506(c)
if applicable.
❑ Setbacks as required by 15A NCAC 02T .0506.
❑ Site property boundaries within 500 feet of all wastewater treatment, storage, and irrigation sites.
❑ All habitable residences or places of public assembly within 500 feet of all treatment, storage, and irrigation sites.
® No — Skip Attachment A.
ATTACHMENT B — SIGNATURE AUTHORITY DELEGATION
Does the signature authority in Section I, Item 3 meet the requirements pursuant to 15A NCAC 02T .0106(b)?
❑ Yes — Skip Attachment B.
® No — Submit a delegation letter pursuant to 15A NCAC 02T .0106(c) authorizing the signature authority to sign.
ATTACHMENT C — FLOW REDUCTION
Does the existing permit include an approved flow reduction?
❑ Yes — Submit a copy of the flow reduction approval letter, as well as the measured monthly average amount of wastewater flow
contributed per unit for the 12 months prior to permit renewal. If any of these monthly averages are within 20% of the approved
flow reduction value, the Permittee shall provide a reevaluation of the reduced flow value pursuant to the requirements in 15A
NCAC 02T .0114(f).
® No — Skip Attachment C.
WMW ATTACHMENT D — CERTIFICATE OF PUBLIC CONVENIENCE AND NECESSITY M
Is the Applicant a Privately -Owned Public Utility?
❑ Yes — Pursuant to 15A NCAC 02T .0115(a)(1), submit the Certificate of Public Convenience and Necessity from the North
Carolina Utilities Commission demonstrating the Applicant is authorized to hold the utility franchise.
® No — Skip Attachment D.
ATTACHMENT E — OPERATIONAL AGREEMENT
Is the Applicant a Home/Property Owners' Association or Developer of Lots to be Sold?
❑ Yes (Home/Property Owners' Association) — Pursuant to 15A NCAC 02T .0I 15(a)(2), submit an executed Operational Agreement
(FORM: HOA). Pursuant to 15A NCAC 02T .0115(c), if the applicant is a legally formed Homeowners' or Property Owner's
Association, submit a copy of the Articles of Incorporation, Declarations, and By-laws.
❑ Yes (Developer of Lots to be Sold) — Pursuant to 15A NCAC 02T .0115(a)(2), submit an executed Operational Agreement
(FORM: DEW Pursuant to 15A NCAC 02T .0115(b), if the applicant is a developer of lots to be sold, submit a copy of the
Articles of Incorporation, Declarations, and By-laws.
® No — Skip Attachment E.
FORM: WWIS-R 02-21 Page 5 of 7

ATTACHMENT F — DEMONSTRATION OF FUTURE WASTEWATER TREATMENT CAPACITIES
Is the applicant a municipality, county, sanitary district, or public utility?
❑ Yes — Proceed to the next question.
® No — Skip Attachment F.
Does the hydraulic capacity in Section III, Item 4 exceed 70%?
❑ Yes (the hydraulic capacity is greater than 70%, but less than 80%) — Pursuant to 15A NCAC 02T .0118(1), prior to exceeding
80 percent of the system's permitted hydraulic capacity (based on the average flow during the last calendar year), the permittee
shall submit an engineering evaluation of their future wastewater treatment, utilization, and disposal needs. This evaluation shall
outline plans for meeting future wastewater treatment, utilization, or disposal needs by either expansion of the existing system,
elimination or reduction of extraneous flows, or water conservation and shall include the source of funding for the improvements.
If expansion is not proposed or is proposed for a later date, a justification shall be made that wastewater treatment needs will be
met based on past growth records and future growth projections, and as appropriate, shall include conservation plans or other
measures to achieve waste flow reductions.
❑ Yes (the hydraulic capacity greater than 80%) — Proceed to the next question.
❑ No — Skip Attachment F.
If answered Yes above, does the hydraulic capacity in Section III, Item 4 exceed 80%?
❑ Yes (the hydraulic capacity is greater than 80%) — Pursuant to 15A NCAC 02T .0118(2), prior to exceeding 90 percent of the
system's permitted hydraulic capacity (based on the average flow during the last calendar year), the permittee shall obtain all
permits needed for the expansion of the wastewater treatment, utilization, or disposal system and, if construction is needed,
submit final plans and specifications for expansion, including a construction schedule. If expansion is not proposed or is proposed
for a later date, a justification shall be made that wastewater treatment needs will be met based on past growth records and future
growth projections, and as appropriate, shall include conservation plans or other specific measures to achieve waste flow
reductions.
❑ No — Skip Attachment F.
ATTACHMENT G — EASEMENT, ENCROACHMENT, AND LEASE AGREEMENTS
Does the Permittee own all of the land associated with the wastewater collection, treatment, conveyance, and irrigation system?
❑ Yes — Skip Attachment G.
® No — Pursuant to 15A NCAC 02T .0116(c), provide a copy of all easements, lease agreements, and encroachment agreements
allowing the Permittee to operate and maintain the wastewater collection, treatment, conveyance, and irrigation system on
property not owned by the Permittee.
ATTACHMENT H — AFFILIATIONS
Are the Permittee's affiliations of record correct? Check affiliations.
® Yes — Skip Attachment H.
❑ No — Provide the corrected affiliations and their contact information.
ATTACHMENT I — COMPLIANCE SCHEDULES
Does the existing permit include any Compliance Schedules? (See Section I of the most recently issued permit)
❑ Yes — Submit documentation that the compliance schedules have been met.
® No — Skip Attachment I.
ATTACHMENT J — CIVIL PENALTIES AND OUTSTANDING VIOLATIONS
Does the Permittee have any existing civil penalties or outstanding violations?
❑ Yes (civil penalties) — Submit payment for the civil penalty, or proof of remission request.
❑ Yes (violations) — Submit a copy of your response to the Notice of Violation.
® No — Skip Attachment J.
FORM: WWIS-R 02-21 Page 6 of 7

ATTACHMENT K — INDUSTRIAL WASTEWATER
Does the wastewater composition in Section III, Item 5 include any industrial wastewater?
® Yes — Proceed to the next question.
❑ No — Skip Attachment K.
Has the nature of the industrial wastewater changed since the last permit issuance (i.e., changes in industrial process, introduction of
new materials or chemicals, etc.)?
❑ Yes — Provide a chemical analysis of the wastewater pursuant to the requirements in 15A NCAC 02T .0504(h). Provide an
overview of the manufacturing process; an inventory of all chemical and biological materials used in the manufacturing process;
and an overview of the cleaning and treatment methodology.
® No — Provide an overview of the manufacturing process; an inventory of all chemical and biological materials used in the
manufacturing process; and an overview of the cleaning and treatment methodology.
ATTACHMENT L — SETBACK WAIVERS
Does the existing permit include setback waivers?
® Yes — Pursuant to 15A NCAC 02T .0506(d), provide setbacks waivers that have been written, notarized, signed by all parties
involved, and recorded with the county Register of Deeds. Waivers involving the compliance boundary shall be in accordance
with 15A NCAC 02L .0107.
❑ No — Skip Attachment L.
APPLICANT'S CERTIFICATION
I, Nicole Reynolds attest that this application
(Signature authority's name as noted in Section I, Item 3)
has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that if all required parts of this
application package are not completed, and that if all required supporting information and attachments are not included, this
application package will be returned as incomplete. I further certify pursuant to 15A NCAC 02T .0120(b), that the applicant, or any
parent, subsidiary, or other affiliate of the applicant has: not been convicted of environmental crimes under; not previously abandoned
a wastewater treatment facility without properly closing the facility; not paid a civil penalty; not been compliant with any compliance
schedule in a permit, settlement agreement, or order; not paid an annual fee.
Note: The Applicant's Certification shall be signed pursuant to 15A NCAC 02T .0106(b). An alternate person may be delegated as
the signing official if a letter is provided pursuant to 15A NCAC 02T .0106(c). Pursuant to § 143-215.6A and § 143-215.6B, any
person who knowingly makes any false statement, representation, or certification in any application package shall be guilty of a Class
2 misdemeanor, which may include a fine not to exceed $10,000 as well as civil penalties up to $25,000 per violation.
Signature: �u—g� Date: 8/8/23
THE COMPLETED APPLICATION AND ATTACHMENTS SHALL BE SUBMITTED AS A SINGLE PDF FILE VIA:
Email:
Non-Discharge.Repo rts(&ncdenr.gov
Laserfiche Upload:
http s:Hedo cs.deci.nc.gov/Fo rm s/NonDis charge-Branch-
Submittal-Form-Ver2
FORM: WWIS-R 02-21 Page 7 of 7

Attachments
House of Raeford Farms, Inc. Permit Renewal — Permit no. WQ0002005
Attachments
Attachment B — Signature Authority Delegation
Attachment G — Easement, Encroachment, and Lease Agreements
Attachment K — Industrial Wastewater
Attachment L — Setback Waivers

Attachments
House of Raeford Farms, Inc. Permit Renewal — Permit no. WQ0002005
Attachment B
Signature Authority Delegation
Pages - 1
Attachment B

� FO OF
July 19, 2013
Mr. Ed Hardee
Division of Water Quality
Aquifer Protection Section
1636 Mail Service Center
Raleigh, NC 27699-1636
Dear Mr. Hardee:
This letter serves as verification that the Complex Manager (Nicole Reynolds) for our Rose Hill
Processing Plant has my permission to sign off on our Spray Irrigation reporting requirements for
Permit Number: WQ0002005.
Sincerely,
Robert C�son
CEO
House of Raeford Farms, Inc.
P. O. Box 699 • 3425 US Hwy 117 South • Rose Hill, NC 28458 • 910.289.3191

Attachments
House of Raeford Farms, Inc. Permit Renewal — Permit no. WQ0002005
Attachment G
Easement, Encroachment, and Lease Agreements
Documents — 6
1. DOT Agreement (Pages — 20)
2. Agreement No. CSX850194 (Pages —14)
3. Invoice for Agreement No. CSX850194 (Pages —1)
4. Agreement No. CSX850194 — Exhibit A (Pages — 2)
5. Certificate of Liability Insurance Sample (Pages —1)
6. Agreement Checklist (Pages —1)
Attachment G

STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
ROY COOPER
GoVERNOR
September 18, 2017
Division 3, District 2
Duplin/Sampson County
House of Raeford
3425 US HWY 117
Rose Hill, NC 28458
Dear Mr. Murray,
Subject: Encroachment Agreement on US 117 in Duplin County.
(Reference Number: E032-31-17-8839)
JAm ES H. TROGDON, III
SECRETARY
Description: Installation of a 12" PVC waste distribution line in 18" steel casing by dry
bore.
Authorization is hereby granted for you to proceed with construction of the attached
encroachment agreement.
Please notify Kevin Bradshaw at 910-592-6174 prior to beginning work on NCDOT right of way.
Please note the attached Special Provisions and Standard Drawings which have been included as
a part of this agreement.
Please refer to Encroachment Agreement E032-31-17-8839 in all future correspondence with this
office concerning this project.
Sincerely,
DocuSignetl by.
7"' 458ACC4
ei�8tason, 'V.E., District Engineer
For Karen Collette, P.E., Division Engineer
Attachments
Mailing Address:
NC DEPARTMENT OF TRANSPORTATION
DIVISION OF HIGHWAYS
5501 BARBADOS BOULEVARD
CASTLE HAYNE, NC 28429-5647
Telephone: [phone]
Fax. [phone]
Customer Service: 1-877-368-4968
Website: www.ncdotgov
Location:
5501 BARBADOS BOULEVARD
CASTLE HAYNE, NC 28429-5647

`f .c STATE OF NORTH CAROLINA
ROUTE j 8ry f 1 7 PROJECT 1 o L���r;L� t1'� �incCOUNTY OF -
DEPARTMENT OF TRANSPORTATION RIGHT OF WAY ENCROACHMENT AGREEMENT
. _ _-AND- A PRIMARY AND SECONDARY HIGHWAYS
THIS AGREEMENT, made and entered into this the day of 5 �c y 2� 20 �_ by and between the Department
of Transportation, party of the first part; and /1cGCSe a� �o Tint Prr4s �Nc
party of the second part,
WITNESSETH
THAT WHEREAS, +the party of the second part desires to encroach on the right ofway of the public road designated as
Route(s) U S r w,( l 1 7 located 8f d r ndr i S� o 1,
' Farm I�.ci.
Nith the construction and/or erection of: "
//tf
WHEREAS, it is to the material advantage of the party of the second part to effect this encroachment, and the party of
he first part in the exercise of authority conferred upon it by statute, Is willing to permit -the encroachment within the limits of the
ight of way as indicated, subjectio the conditions of this agreement;
NOW, THEREFORE, IT IS AGREED that the party of the first part hereby grants to the party of the second part the right
and privilege to make this encroachment as shown on attached plan sheet(s), specifications and special provisions which are
nade a part hereof upon the following conditions, to wit:
That the installadon, operation, and maintenance of the above described faciilty wllI be accomplished in accordance with the party of
the first part's latest POLICIES AND PROCEDURES FOR ACC.QMMOCATINr, UFi ITIES ON HIGHWAY R( HTS OF WAY and such
revisions and amendments thereto as may be in effect at the date of this agreement. Information as to these policies and procedures
may be obtained from the Division Engineer or State Utility Agent of the party of the first part
That the said party of the second part binds and obligates himself to Install and maintain the encroaching facility In such safe and
proper condition that it will not interfere with or endanger travel upon said highway, nor obstruct nor interfere with the proper maintenance
thereof, to reimburse the party of the first part for the cost incurred for any repairs or maintenance to its roadways and structures
necessary due to the installation and existence of the facilities of the party of the second part, and if at any time the party of the first part
shall require the removal of or changes In the location of the said facilities, that the said party of the second part binds himself, his
successors and assigns, to promptly remove or alter the said faclllties, in order to conform to the said requirement, without any cost to the
party of the first part
That the party of the second part agrees to provide during construction and any subsequent maintenance proper signs, signal lights,
flagmen and other warning devices for the protection of traffic In conformance with'the latest Manual on Uniform Traffic Control Devices
for Streets and Hlahways and Amendments or Supplements thereto. Information as to the above rules and regulations may be obtained
from the Division Engineer of the party of the first part.
That the party of the second part hereby agrees to indemnify and save harmless the party of the first part from all damages and
claims for damage that may arise by reason of the Installation and maintenance of this encroachment
That the party of the second part agrees to restore all areas disturbed during Installation and maintenance to the satisfaction of the
Division Engineer of the party of the first part The party of the second part agrees to exercise every reasonable precaution during
construction and maintenance to prevent eroding of soil; silting or pollution of rivers, streams, lakes, reservoirs, other water
Impoundments, ground surfaces or other property; or pollution of the air. There shall be compliance with applicable rules and regulations
of the North Carolina Division of Environmental Management, North Carolina Sedimentation Control Commission, and with ordinances
and regulations of various counties, municipalitle8 and other official agencies relating to pollution prevention and control. When any
Installation or maintenance operation disturbs the ground surface and existing ground cover, the party of the second part agrees to
remove and replace the sod or otherwlse reestabilsh the grass cover to meet the satisfaction of the Division Engineer of the party of the
first part
That the party of the second part agrees to assume the actual cost of any Inspection of the work considered to be necessary by the
Division Engineer of the party of the first part.
That the party of the second part agrees to have available at the construction site, at all times during construction, a copy of this
agreement showing evidence of approval by the party of the first part. The party of the first part reserves the right to stop all work unless
evidence of approval can be shown.
Provided the work contained In this agreement is being performed on a completed highway open to traffic-, the party of the second part
agrees to give written notice to the Division Engineer of the party of the first part when all work contained herein has been completed.
Unless specifically requested by the party of the first part, written notice of completion of work on highway projects under construction will
not be required.
That in the case of noncompliance with the terms of this agreement by the party of the second part, the party of the first part reserves
the right to stop all work until the facility has been brought Into compliance or removed from the right of way at no cost to the party of the
first part
That it Is agreed by both parties that this agreement shall become void if actual construction of the work contemplated herein is not
begun within one (1) year from the date of authorization by the party of the first part unless written waiver is secured by the party of the
second part from the party of the first part
During the performance of this contract, the second party, for Itself, Its assignees and successors in Interest (hereinafter referred to as
the "contractor"), agrees as follows:
a. Compliance with Regulations: The contractor shall comply with the Regulatlons relative to nondiscrimination in Federally -
assisted programs of the U. S. Department of Transportation, Title 42, Code of Federal Regulations, Part 21, as they may be
amended from time to time, (hereinafter referred to as the Regulations), which are herein Incorporated by reference and
ORM R/W 16.1 (Rev. July 1, 1977)

made a part of this contract.
b. Nondiscrimination: The contractor, with regard to the work performed by it during the contract, shall not discriminate on the,
grounds of race, color, or national origin in the selection and retention of subcontractors, including procurements of materials
and leases -of equipment- The contractor shall not participate either directly or Indirectly in the discrimination prohibited by
Section•21.5 of the Regulations, Including employment practices when the contract covers a program set forth in Appendix 8
of the Regulations.
C. Scilcitatlons for Subcontracts including Procurements of Materials and Enuloment In all solicitations either by competitive
bidding or negotiation made by the contractorfor work to be performed under a subcontract, including procurements of
materials or leases of equipment, each potential subcontractor or supplier shall• be notified by the contractor of the
contractors obligations under this contract and the Regulations relative to nondiscrimination on the grounds of race, color,
or national origin.
d_ Information and Reports: The contractor shall provide all information and reports required by the Regulations, or directives
Issued pursuant thereto, and shall permit access to its books, records, accounts, other sources of information, and its
fadiltle'Us may be determined by the Department of Transportation or the Federal Highway Administration to be pertinent
to ascartaln compliance with such Regulations or directives. Where any information required of a contractor is in the
exclusive possession of another who fails or refuses to furnish this Information, the contractor shall so certify to the
Department of Transportation, or the Federal Highway Administration as appropriate, and shall set forth what efforts it has
made to obtain the information.
e. Sancticim for Noncomollance: In the event of the contractor's noncompliance with the nondiscrimination provisions of this
contract, the Department of Transportation shall impose such contract sanctions as it or the Federal Highway Administration
- may determine to be appropriate, including, but not limited to,
(1) withholding of payments to the contractor under the contract until the contractor complies, and/or
(2) cancellation, termination or suspension of the contract, In whole or in part.
f. Incorporation of Provisions: The contractor shall Include the provisions of paragraphs "a" through "I" In every subcontract,
Including procurements of materials and leases of equipment, unless exempt by the Regulations, or directives issued
pursuant thereto. The contractor shall take such action with respect to any subcontract or procurement as the Department
of Transportation or the Federal Highway Administration may direct as a means of enforcing such provisions including
sanctions for noncompliance: Provided, however, that, In the event a contractor becomes Involved In, or is threatened with,
litigation with a subcontractor or supplier as a result of such direction, the contractor may request the Department of
Transportation to enter into such litigation to protect the Interests of the State, and, In addition, the contractor may request
the United States to enter into such litigation to protect the Interests of the -United States,
RM/ (161) : Party of the Second Part certi ies that this agreement is true and accurate copy of the farm
RM (161) incorporating all revisions to date,
IN WITNESS WHEREOF, each of the parties to this agreement has caused the same to be executed the day and
year first above written.
'EST OR WITNESS: f
®'
DEPARTt 1 �°55' fSPORTATiON
BY: T—
Kei �Boffe4�9--District Engineer
For Ka en Collette,, Di lion Engineer
�r�
Second. Parry
When the applicant is a corporation or a municipality, this agreement must -have the corporate seal and be attested by the corporation
secretary or by the empowered city official, unless a waiver of corporate seal and attestation by the secretary or by the empowered City
official Is on file In the Raleigh office of the Manager of Right of Way. in the space provided in this agreement for execution, the name of
the corporation or municipality shall be typed above the name, and title of all persons signing the agreement should be typed directly
below their signature.
When the applicant is not a corporation, then his signature must be witnessed by one person. The address should be included in this
agreement and the names of all persons signing the agreement should be typed directly below their signature.
This agreement must be accompanied, In the form of an attachment, by plans or drawings showing the following applicable information:
1. All roadways and ramps.
2 Right of way lines and where applicable, the control of access lines.
3. Location of the existing and/or proposed encroachment
4. Length, size and type of encroachment.
5. Method of lnstallatlon.
6. Dimensions showing the distance from the encroachment to edge of pavement, shoulders, etc.
7. Location by highway survey station number. If station number cannot be obtained, location should be shown by
distance from some identifiable point, such as a bridge, road, Intlersactlon, etc. (To assist in preparation of the
encroachment plan, the Department's roadway plans may be seen at -the various Highway Division Offices, or at the
Raleigh office.)
a. Drainage structures or bridges if affected by encroachment (show vertical and horizontal dimensions from
encroachment to nearest part of structure).
9. Method of attachment to drainage structures or bridges.
10. Manhole design.
11. On underground utilities, the depth of bury under all traveled lanes, shoulders, ditches, sidewalks, etc
12. Length, size and type of encasement where required.
13. On underground crossings, notation as to method of crossing - boring and Jacking, open cut, etc.
14. Location of vents.
Any attachment to a bridge or other drainage structure must be approved by the Head of Structure Design in Raleigh
prior to submission of encroachment agreement to the Division Engineer.
All crossings should be as near as possible normal to the centertfne of the highway.
Minimum vertical clearances of overhead wires and cables above all roadways must conform to clearances set out in -
the National Electric Safety* Code.
Encasements shall extend from ditch line to ditch line in cut sections and 5' beyond toe of stapes In ill sections,
All vents should be extended to the right of way line or as otherwise required by the Department.

Encroachee
ENCROACHMENT AGREEMENT
SPECIAL PROVISIONS
NCDOT WORK ZONE TRAFFIC CONTROL OUALIFICATIONS AND TRAINING PROGRAM
Effective July 1, 2010, all flagging operations within NCDOT Right of Way require qualified and trained Work
Zone Flaggers.
Effective July 1, 2011, qualified and trained Work Zone Traffic Control Supervisors will be required on
Significant Projects.
Training for this certification is provided by NCDOT approved training sources and by private entities that have
been pre -approved to train themselves. If you have questions, contact our web site at www.nedot.orz/—wztc, or
contact Stuart Bourne, P.E. with NCDOT Work Zone Traffic Control Unit at [phone] or
sbournena.ncdot.aov
SP 2
A Pre -Construction conference is required prior to performing any work under this agreement. Please contact (Kevin
Bradshaw) at 910-592-6174 to schedule the conference.
SP 3
An executed copy of this encroachment agreement shall be present at the construction site at all times during construction
NCDOT reserves the right to stop all work unless evidence of approval can be shown. If safety or traffic conditions
warrant such action, NCDOT reserves the rights to further limit, restrict, or suspend operations within the right of way.
SP 4
Materials and workmanship shall conform to the latest edition of the N. C. Department of Transportation's Standards and
Specifications_
SP 5
The encroaching Party is required to contact the appropriate Utility Companies involved and make satisfactory
arrangements to adjust the utilities in conflict with the proposed work prior to construction.
SP 5-A
Any alteration or deviation concerning the location of this utility as proposed by the attached approved plans, shall not be
allowed until written approval in the form of an approved revision, has been applied for, approved and is made a part of
this agreement package and on site_ Failure to comply with this special provision shall result in an immediate work
stoppage and removal of the installed utility or appurtenances.
SP 6
Proper temporary and permanent measures shall be used to control erosion and sedimentation in accordance with local,
State and Federal regulations. If any area in excess of one (1) acre will be disturbed, the Encroachee shall submit to the
District Engineer's Office a Sediment and Erosion Control Plan which has been approved by the appropriate regulatory
agency or authority prior to beginning any work on the Right of Way. Failure to provide this information shall be
grounds for suspension of operations.
SP 6-A
Work may not proceed on this project until all permits from The U.S. Army Corps of Engineers, Department of Water
Quality (DWQ) and North Carolina Department of Environment and Natural Resources (NCDENR) have been approved,
received and distributed by the NCDOT.
SP 8
Proper traffic control devices, signs, etc. shall be installed to insure public safety in accordance with the latest edition of
the Manual on Uniform Traffic Control Devices and any supplements.

The party of the second part shall provide traffic control devices, lane closures, road closures, positive protection and/or
any other warning positive protection devices necessary for the safety of motorists and workers during construction and
subsequent maintenance. This shall be performed in conformance with the latest NCDOT Roadway Standard Drawings
and Standard Specifications for Road and Structures and Amendments or Supplements thereto. When there is no
guidance provided in the Roadway Standard Drawings or Specifications, comply with the Manual on Uniform Traffic
Control Devices for Streets and Highways and Amendment or Supplement thereto. Information as to the above rules and
regulations may be obtained from the Division Engineer of the parry of the first part.
The needs and control of all road users (motorists, bicyclists, and pedestrians within the highway., including persons with
disabilities in accordance with the Americans with Disabilities Act of 1990 (ADA), Title II, Paragraph 35.130) through a
TTC zone shall be an essential part of highway construction, utility work, maintenance operations, and the management of
traffic incidents.
SP 11
A Performance and Indemnity Bond in the amount of ($5,000.00) for work within NCDOT Rights of Way ONLY shall be
executed and posted prior to beginning work_ Bonds may be in the form of a Corporate Surety Bond, Continuing
Indemnity Bond, Certified or Cashier's check, or Irrevocable Letter of Credit. The appropriate bond forms should be
submitted to: NC Department of Transportation - Division of Highways, District Engineer, 220 North Boulevard, Clinton
N.C. 28328
The applicant shall notify the Department of Transportation at 910-592-6174 upon completion of the work for a final
inspection to be performed by NCDOT personnel.
After the project has been completed for approximately one (1) year, and upon request, NCDOT personnel will conduct a
final investigation. If found to be satisfactory, the bond will be released.
SP 13
Approval excludes area(s) within Railroad Rights of Way.
SP 14
Approval of this Encroachment does not include any portion of the work outside The North Carolina Department of
Transportation's Rights of Way.
SP 15
Revisions shown in RED on attached plan(s).
SP 16
No lane closures shall be allowed between the hours of 6:00 am to 9:00 am and 4:00 pm to 7:00 pm. (Peak hours
restricted). Further conditions may apply due to traffic conditions.
SP 19
No lane closures or impediment to traffic shall be allowed on state holidays and local events.
SP 19-A
No lane closures or impediment to traffic shall be allowed on weekends without prior written approval from the District
Engineer.
SP 20
Any work requiring equipment or personnel within five (5) feet ten (10' on divided roadways) from the edge of any travel
lane shall require a lane closure with appropriate tapers.
SP 21 1 -
Open cut of pavement will not be allowed.

SP 28
The encroachee shall close only one lane at a time.
SP 29
All excavations inside the theoretical 1:1 slope from the existing edge of pavement to the bottom of the nearest trench
wall shall be made in accordance with the following conditions:
A. All trench excavation inside the limits of the theoretical 1:1 slope as defined by the policy shall be completely
backfilled and compacted at the end of each construction day. No portion of the trench shall be left open overnight.
B. The length of parallel excavation shall be limited to the length necessary to install and backfill one (1) joint of pipe at
a time.
C. Traffic shall be moved to a travel lane outside the limits of a theoretical 1:1 slope from the bottom of the nearest
trench wall to the pavement surface.
D. Installation of trench shoring shall be accomplished with minimal over -excavation. Trench boxes shall not be used
as shoring.
E. An NCDOT Inspector, the cost of which to be borne by the party of the second part, shall be assigned to this project if
deemed necessary by the Division Engineer.
F. The trench backfill material shall meet the Statewide Borrow Criteria. The trench shall be backfilled, in accordance
with Section 300-7 of the January 2012 Statewide Standard Specifications for Roads and Structures, which basically
requires the backfill material to be placed in layers not to exceed six (6) inches loose and compacted to at least 95% of
the density obtained by compacting a sample in accordance with AASHTO T99, as modified by DOT.
G. At the first sign of trench failure, a trench shall be immediately backfilled with materials consisting of A-1, A-3, A-2-
4 soils or A-4 soils having a maximum of 45% passing a No. 200 sieve and a maximum P.I. of 6. All work shall
cease, the Division Engineer shall be contacted. The Party of the Second Part shall be required to repair any damage
to the pavement caused by the excavation.
SP 29-A
Any excavation encroaching upon the theoretical 1:1 slope from the edge of pavement of any NCDOT maintained road
shall require temporary active shoring. No work shall be performed prior to a temporary active shoring submittal, which
includes design, calculations, and a geotechnical report, being reviewed and approved by NCDOT. It should be noted the
review time for this submittal will be a minimum of two months.
SP 31
The proposed steel casing pipe shall be installed in accordance with the Bore Detail Attachment.
SP 32
No part of any pit shall be within three (3) feet of edge of pavement or back of curb.
SP 33
All manholes and/or vaults shall be of a pre -approved design. If any proposed structure is not of a design pre -approved by
NCDOT, the Encroachee shall submit details and design calculations signed and sealed by a Professional Engineer for
approval prior to construction.
SP 34
The proposed manholes and/ or gate valves shall not be located in the existing ditch line or in a manner that would restrict
the maintenance or flow of the existing ditch line.
SP 36
All equipment and materials shall be removed from the right of way when not in use.

SP 37
This encroachment is approved with the understanding that the North Carolina Department of Transportation does not
guarantee the right of way on this road, nor will it be responsible for any claim for damages brought by any property
owner by reason of the installation.
SP 38
All plastic force main pipes shall be SDR 21 or better. ALL GATE VALVES, TEES, AND OTHER MATERIALS
SHALL BE TO AWWA STANDARDS. All ductile iron pipe shall be a Minimum Class 50 Strength.
SP 39
No lift stations shall be allowed inside the Rights of Way.
SP 40
Meter boxes, manholes and other appurtenances shall be located outside the Rights of Way or Control of Access right of
way line.
SP 41
All curb and gutter disturbed or damaged shall be removed to the next joint and replaced.
SP 42
Private driveways disturbed as a result of this encroachment shall be restored to the satisfaction of the District Engineer.
SP 43
Ingress and egress shall be maintained to all businesses and dwellings affected by the project. Special attention shall be
paid to police and fire stations, fire hydrants, and hospitals.
10
SP 44
The proposed utility shall be located a minimum of seven (7) feet from the nearest part of bridges and culverts, including
the toe of wingwalls and scour apron and a minimum of two (2) feet below streambed.
SP 46
If existing guardrail is disturbed, it shall be reset back to NCDOT Standards and as directed by the District Engineer.
SP 47
Any drainage structure disturbed or damaged shall be restored to its original condition as directed by the District
Engineer_
SP 48
No access, parking, or material storage shall be allowed along or from Control of Access Highways.
SP 49
In bore areas, pavement settlement and pavement buckling shall be repaired as directed by the District Engineer. This
may include removal of pavement, patching a fifty feet (50') mechanical overlay, pavement markings etc. as directed by
the District Engineer.
SP 50
Directional drilling methods have not been given statewide approval for use on NCDOT right of way. Under no condition
shall jetting alone or wet boring with water of utility pipelines be allowed. Directional boring using jetting with a
Bentonite (or equivalent material) slurry is approved at a minimum depth of ten (10') feet below the pavement surface
[fifteen (15') feet below the surface of partial and/or full control of access roads] and five (5') feet below any ditch line
and/or creek bed. Any parallel installation utilizing the directional boring method shall be made at a minimum depth of
four (4') feet (cover) below the ground surface and outside the theoretical 1:1 slope from the existing edge of pavement
except where the parallel installation crosses a paved roadway. All directional bores shall maintain ten (10') feet
minimum (clear) horizontal distance from the nearest part of any structure, including but not limited to bridges, footings,
pipe culverts or box culverts. All directional bores shall maintain ten (10') feet minimum (clear) vertical distance from

the nearest part of pipe culverts or box culverts. Directional bores are not allowed beneath bridge footings, culvert
wingwall footings or retaining walls. The tip of the drill string shall have a cutter head. Detection wire shall be installed
with non-ferrous material. Any changes shall be submitted to the District Engineer for approval prior to construction. For
multiple conduit installations (including perpendicular and parallel installations), install conduits with five (5') feet
minimum horizontal separation between each conduit or install multiple conduits within a single duct. All directional
bores shall maintain a minimum distance of five (5') feet from the nearest part of pipe culverts and box culverts and ten
(10') feet minimum horizontal clearance, including but not limited to bridges and footings.
All directional drilled piping for sewer force mains and waterlines shall be a minimum of SDR-9. All directional drilled
piping for gas mains operated at 60 lbs of pressure or less shall be a minimum of SDR-11.5. All directional drilled piping
for communication purposes shall be a minimum of SDR-13.5.
An overbore shall not be more than two (2") inches greater than the diameter of the pipe or encasement. An
overbore exceeding two (2") inches greater than the diameter of the pipe or encasement will be considered if the
encroachment agreement includes a statement signed and sealed by a North Carolina Registered Professional
Engineer indicating that an overbore in excess of two (2") inches of the diameter of the pipe or encasement will not
arch and no damage will be done to the pavement or sub -Grade. HDPE pipe installed by directional boring shall
not be connected to existing pipe or fittings for one (1) week from the time of installation to allow tensional stresses
to relax.
A copy of the bore log shall be provided to the District Engineer upon request.
SP 55
The encroaching parry shall comply with all applicable state and federal environmental regulations, and shall obtain all
necessary state and federal environmental permits, including but not limited to, those related to sediment control,
stormwater, wetland, streams, endangered species, and historical sites.
SP 56
Trenching, boring pits, and/or other excavations shall not be left open or unsafe overnight. The contractor shall apply
with all North Carolina Department of Transportation's and OSHA requirements and provide a competent person on site
to supervise excavations at all times.
Any part of excavations within the theoretical 1:1 slope of the roadway shall have active shoring in place and the
approved plans at the construction site.
SP 57
Any pavement damaged due to installation of this utility or damaged by equipment used to install this utility, shall be
resurfaced to the satisfaction of District Engineer.
SP 58
Right of way monuments disturbed during construction shall be referenced by a registered Land Surveyor and reset after
construction.
SP 59
All Roadway signs removed due to construction shall be reinstalled at the end of each day.
SP 60
Excavation material shall not be placed on the pavement. Drainage structures shall not be blocked with excavation
material. Any damage to the existing roadway including but not limited to the traffic markings and reflectors, shall be
replaced to the satisfaction of the District Engineer.
SP 61
The proposed construction shall in no way impede or alter the drainage of the existing roadway. Reshape the shoulders
and slopes to allow positive drainage.

SP 62
Strict compliance with the Policies and Procedures for Accommodating Utilities on Highway Rights of Way Manual shall
be required.
SP 65
No construction shall be permitted when shoulders are wet.
SP 66
Shoulders, ditch slopes, and ditches disturbed as a result of this encroachment, shall be seeded, mulched and restored to
the satisfaction of the District Engineer.
SP 67
The issuance of this encroachment does not preclude the encroacher from complying with any and all statutes, rules,
regulations, or ordinances which may be imposed by other government agencies (local, state, and federal) which have
jurisdiction.
SP 68
At no time will construction of kind be performed within the rights of way on a state holiday without prior approval_
SP 69
No access, parking, or material storage shall be allowed along or inside the rights of way line.
SP 75
During construction if there is a 2" drop-off or greater, then the drop-off has to be corrected the same workday. If it is in a
curb and gutter section, then there shall not be a drop-off behind the curb of 6" or more. If so then the correction has to be
made the same workday.
SP 76
All sections of pipe and/or manholes to be abandoned within NCDOT right of way shall be abandoned in accordance with
Section 1530 of the 2012 NCDOT Standard Specifications for Roads and Structures.

SP 78
All areas disturbed by this encroachment work shall be seeded ner the below noted seed detail.
SEED DETAIL
After the installation of the utility is complete, the area disturbed in a non-residential are shall be seeded as
follows:
50 lbs./acre
Tall Fescue
5 lbs./acre
Centipede
50 lbs./acre
Bermuda Grass
500lbs./acre
Fertilizer
4000lbs./acre
Limestone
All residential areas must be hand finished as directed by the Engineer to give a "lawn type appearance" and the
following seed mix should be applied:
50 lbs./acre Tall Fescue Type I
50 lbs./acre Tall Fescue Type II
5 lbs./acre Centipede
500lbs./acre Fertilizer
4000lbs./acre Limestone
Type I and Type H Tall Fescue shall be separate varieties chosen from the list below:
Adventure
Adventure H
Amigo
Anthem
Apache
Apache II
Arid
Brookstone
Bonanza
Chesapeake
Chieftain
Coronado
Crossfire H
Debutante
Duster
Falcon
Falcon II
Finelawn Petite
Finelawn
Finelawn I
Genesis
Grande
Guardian
Hounddog
Jaguar
Jaguar III
Kentucky 31
Kitty Hawk
Monarch
Montauk
Mustang
Olympic
Pacer
Pixie
Pyramid
Rebel
Rebel Jr.
Rebel II
Renegade
Safari
Shenandoah
Titan
Tomahawk
Trailblazer
Tribute
Wrangler
For all mixtures:
May 1- August 3 1 - add 10 lbs./acre Kobe or Korean Lespodeza
September 1- April 30- add 10 lbs./acre Rye Grain
Crimping Straw Mulch
Crimping shall be required with this agreement adjacent to any section of roadway where traffic is to be maintained or
allowed during construction. In areas within six (6') feet of the edge of pavement, straw is to be applied then crimped.
SP 79
Environmentally Sensitive Areas:

This project is located in an "Environmentally Sensitive Area". This designation requires special procedures to be used
for clearingand grubbing, temporary stream crossings, and grading operations within the area identified on the plans.
This also requires special procedures to be used for seeding and mulching and staged seeding within the project.
Clearina and arubbina:
In areas identified on the erosion control plans as "Environmentally Sensitive Areas", clearing operations can be
performed, but not grubbing operations until immediately prior to beginning grading operations as described in Section
200, Article 200-1, in the Standard Specifications. The "Environmentally Sensitive Area" shall be defined as a 50 foot
buffer zone on both sides of the stream (or depression) measured from top of streambank (or center of depression.) Only
clearing operations (not grubbing) shall be allowed in this buffer zone until immediately prior to beginning grading
operations. Erosion control devices shall be installed immediately following the clearing operation.
Grading:
Once grading operations begin in identified "Environmentally Sensitive Areas", work will progress in a continuous
manner until complete. All construction within these areas must progress in a continuous manner such that each phase is
complete and areas permanently stabilized prior to beginning of next phase. Failure to complete any phase of construction
in a continuous manner in "Environmentally Sensitive Areas" as specified will be just cause for the Engineer to direct the
suspension of work in accordance with Section 108-7 of the Standard Specifications.
Temporary Stream Crossinas:
Any crossing of streams within the limits of this project must be accomplished in accordance with Section 107-13(b) of
the Standard Specifications_
Seedina and mulching:
Seeding and mulching shall be performed in accordance with Section 1660 of the Standard Specifications and vegetative
cover sufficient to restrain erosion shall be installed immediately following grade establishment.
Seeding and mulching shall be performed on the areas disturbed by construction immediately following final grade
establishment. No appreciable time shall lapse into the contract time without stabilization of slopes, ditches and other
areas within the `Environmentally Sensitive Areas" as indicated on the E.C. Plans.
Stage Seeding:
The work covered by this section shall consist of the establishment of a vegetative cover on cut and fill slopes as grading
progresses. Seeding and mulching shall be done in stages on cut and fill slopes that are greater than 20 feet in height or
greater than 2 acres in area. Each stage shall not exceed the limits stated above.

(ICIDIE
IFEDGAH-77TYWAX 0B'--,TRUCTI0'N'--, L\-TERF=G
ATM TRAIFFFIK
19A--\-C-kC 2E-C404
Kwhow Wyouctions mclude dri: -.vxv OadmAds- Sucts- mrzd nervspa-p-er boxes
and oTerrondAW witha zraEc �r n2amc)tmance'
k! i It be miLxx-fffil to p1ace on- lughway Asumnou. uwhsdmga dn,-e,--wa-
htadlxaM fmce, mr-al
mallbiox, newspaper bo---, or other r-oad5i6t obs-mictimi -,,o as, To iwerfert miih the traffic or
MaUVMIZZIC-t Of dIC rOZdSalld 111ZLI. - y; of The sr.-azt high -wax_
i, i if ffit de-parr-meut des r ties. that an,�- Sksmy Asymmatum mcluding a dxive-.—ay heidivalL Saw.
Ti r-al rat-wipaptr d-fh-'-ezrho Lox.. 1"s o.- OTL,,,r roadsi&- obimucrion. constimTes ar,
-11reas'oILEt roadsidt. cods ILizard, tLe highwa- obstninicn thaE' 'be rcnio-.td b-, t,ht -pe'rson
pllaIlg the- flit- -w-IdIal Qfr'-Ctn'pT ofa molmov.
nouct jl7om dttparml=-' to rL� pt-rion :-or placing tilt olosm;ction widam TLt
'IN !-'x 4" -E%-'Dodcn or
t Only = -xts, or nttx�pkp� boxt-� "%-ith- non r�—pt SuzL, as -14
a dn=etcr al-t-'al typre, are permiard on road additions mat"- To th.—, ;rl-Lr hisl -'vay --;y�:Ino:
Nixy 1 1990 lle lcx-ation mAn At =0 of way of ar: a0mor to tht s�ysr-eni of any bri.& column-S,
mzulboxcs or box-'s Oil Li` la imilds Such a$ block-, itczlzof :any otht-r
dtr--m=avd r-o be a a-aSc liazzard is I-riroiiibit--d-
tAJ 111it failumt of it pefson rrtspoiisible in phang To ullow-flal obs�zruczwn witlim the nht of wav, to
rt-no-.-c- the +Dbszuczion villa 30 chys after -xrirz� nouct-- by the D-,panmeir, of Tr=sp%-rmL-otI s1aall
VLSIstirate a :n1,'5.d,-mearwr Failuxt tc rrino-,-c or make z-ifc =,y ziazalbox Or nt-,vspaper its
sr�pparts or any oditr obsar�ction- xid-iia TL-t specified 3-4) days of dds Nte AM be cause Wr the,
Dmjirtmeaf�; D-t-,-isooa Elmm"T to nke acnon to rown-ve the imacceptabit mailboxr �n- P.42-wipalper
deh-.-tly bom IT'i iupp�rrs Or oditr obs-m-iction wsmMKon slid also bin tL e rt5poiisablt parry for the
axperse ofrmaw-A if aplarc-I'TiaTt, ( Seepage- 15, -No, ISJ

(Check All Appropriate Boxes)
Permits from the N.C. Department of Environment and Natural Resources and the
U.S. Army Corp of Engineers are not required for this project. However, all
applicable federal and state regulations have been followed.
The required permits from the N.C. Department of Environment and Natural
Resources and the U.S. Army Corp of Engineers have been obtained for this project.
Copies of permits and Completion Certificates are attached.
7AII applicable NPDES Stormwater Permit requirements have been met for this project.
(The applicant should contact the N.C. Division of Water Quality in Raleigh to
determine if a'stormwater permit is required.)
The project is in compliance with all applicable sedimentation and erosion control
laws and regulations.
Project Name:
Township
Project Engineer:
Project Contact
Applicants Name: 140u®e. 6l I�"d
Date Submitted: I-']> (`I
County: I V.p
Phone No.: 4II0-2-93-21` 0
"•��n�
0
Sl-AL
® 122173
Ale��f,a
PE SEAL

HOUSE of RAEFORD
Rose Hill, NC
Proposed Pressure Processing Line Crossing
I r�:)
I
E
85- --- m
86—
PATH 31+00 r
� X$I
a
�v
PLAN VIE
SECTION VIE
90
E 1i
80
c
0 — —
7 _—
W 75 -- --
31+00 30+50
Station Numbers
880
3
X
\
j' rn Cn u`
I I+I
1
n
a I I —Prop. 18" Iron Casing,
{ I 100 LF by Jack/Bore
I ( I rop. 12" SDR21 PVC
�•I�II•
0.00
45-1nv 29+50 4' Wood Split
j• gd . , _` — ,� Rail Fence
-----a6
N e�
0
0
x 88.03 Exist. Elovati
Exist. ContOl.
rol �
n �
0 25 50
PLAN SCALE (ft)
30+00
Z" SDR21 PVC
8" Casing, 100 LF
6
4
2
0
PROFILE SCALE (ft)

Page 1
DETAILED SPECIFICATIONS
BORING UNDER HIGHWAYS AND RAILROADS
SCOPE: This section shall include furnishing all labor, tools, equipment and other incidentals
required to bore casing pipe under highways or railroads.
2. BORINGS: Procedures for boring shall be in accordance with the best -accepted methods of
the construction and as shown on the plans and specified and detailed in these specifications.
A. Boring Under Highways: Lines installed under highways shall be bored as shown on
the detail drawings contained in these specifications. Casings will be installed of the
type, size, and thickness as specified herein or on the detail drawings. The Contractor
shall be responsible for notifying the Department of Transportation at least five days
prior to any contemplated work and for securing any required permits for performing the
work. All work shall be accomplished under the supervision of the Engineer and the
District Engineer of the Department of Transportation or his authorized representative.
For casing pipe sizes of wall thickness see information in Section 00703 — 6.
1. Carrier Pipe: Carrier pipe used under highways shall be of an approved material and
installed to the satisfaction of the District Engineer of the Department of
Transportation. Carrier pipe shall be 12" SDR21, pressure pipe.
2. Casing Pipe: The inside diameter of the casing pipe shall not be less than 2" greater
than the largest outside diameter of the joints and couplings for carrier. It shall, in
all cases, be great enough to. easily remove carrier pipe without disturbing the casing
pipe.
Installation: The minimum depth from the roadway surface to the top of the casing
pipe at its closest point shall be 3'. The casing pipe ends shall be protected from the
entrance of foreign material. The casing pipe shall extend from ditch line to ditch
line or toe to toe of fill unless otherwise noted on the plans or specified herein.
Contractors shall be required to provide shoring of boring pits and trenches more
than 6' deep in accordance with the North Carolina Department of Transportation
and Federal Occupational Health and Safety Act.
B. Borings Under Railroads: All work on railroad rights of way shall be done under the
supervision of the Chief Engineer of the railroad, or his authorized representative, who
shall be notified at least 15 days before construction is begun. In addition, this work
shall only be done in the presence of the authorized representative of the Chief
Engineer, and no methods shall be used that, in the opinion of the representative, could
be hazardous to the railway.
Carrier Pipe: Carrier line pipe and joints shall be of the material shown on the
details of the railroad encroachment agreements or as approved by the Chief
Engineer or his authorized representative.
C:1Users\BcblDocuments\Word\Engr SpecslHOR-BoringSpecl7_doc

Page 3
2. Carrier Pipe Sizes 8" and Lamer: Steel pipe for casings over 8" shall be manufactured
from steel having a minimum yield strength of 35,000 psi with the minimum wall
thickness as shown below:
DIAMETER OF PIPE
INCHES
10"
12"
16"
18"
20"
24"
30"
3 611
MIN. WROUGHT STEEL
WALL THICKNESS
INCHES
0.188
0.188
0.250
0.250
0.250
0.250
0.312
0.375
B. Boring Under Railroads: The inside diameter of the casing pipe shall not be less than 2"
greater than the largest outside diameter of the joints and couplings for the carrier. It shall,
in all cases, be great enough to easily remove carrier pipe without disturbing the casing
pipe. Pipe manufactured from steel having minimum yield strength of 35,000 psi and
having a minimum permissible wall thickness as listed below shall be used as casing pipe.
DIAMETER MINIMUM WALL THICKNESS
INCHES INCHES
8"
0.322
10"
0.188
12"
0.251
16"
0.312
18"
0.313
20"
0.375
24"
0.407
30"
0.469
36"
0.532
C:1Users\Bob\DocumentslWord�Engr SpecslHOR-BoringSpecl Tdoc

SDR 211 PR 200 (WHITE) POTABLE WATER
SPECIFICATIONS
Pipe
Size
Outside
Diameter
(OD)
SDR 21
Minimum
Wall
**Bell
Length
(inches)
*Bell
Diameter
(inches)
**Reference
Mark
(inches)
Approx.
Weight
per foot
lbs.)
2"
2.375
0.113
4'/2"
3.063
3'/2"
0.539
2 '/2"
2.875
0.137
5"
3.775
4"
0.784
3"
3.500
0.167
5 'h"
4.567
4 '/2"
1.172
4"
4.500
0.214
5 '/2"
5.700
4 '/2"
1.913
6"
6.625
0.316
6 '/2"
8.069
5"
4.139
8"
8.625
0.410
7 '/2"
10.366
6"
6.937
10"
10.750
0.511
8 '/z"
12.875
7"
10.925
12"
12.750
0.606
9 '/2"
15.095
8"
15.584
hGM2 X
* Approximate Bell Diameter
** May vary up to #'/2"
200 PSI @ 23°C 173°F
Pipe made in 20-foot lay lengths.
18

w
w
E Q
�w Q l I z z
O yl I LA�- CD
w
N I I Z
w I I o of
NN W=
Z I I COL, QCD z a W O
I I =F- �J
�-- LLu W W J 0
Lf� I I ONO OW
y I I �LLJ_ wF-W �o
O I I w xu, oU
D I ICD
z J Z OZ
z O
CD = I I cn ¢z>-Z>-O
U) I I Q =-JwamZ.
N
U
T W
F-
I I F-wow~
I I wo���
_ _N z
o I I L/)F- 'N=o
Q '- I ------- Cl a yF'
O _ I I W UWWJzu
O ZZ>JWW
WJLL-U --N
I I v W
I I wz �
I I w O
LLJ
Ow o
O I ( N ry N
Q I— 0:—
= V) 1 I _5Q O O
U I Z
f—--------------- -------------------
o I I
I ( O
I T
Q a
O
O
W
z
N
N
N
JZ
�
Q �C
-
N
N
N
LC)
�U
O
O
O
O
O
O
O
O
T
H
ND
N
�
�
O
v
O
�
o�
wo
,
N
N
M
M
Q
w
�

0
Lane Closure on a Two -Lane Road
(Two-Flagger Operafion)
v"xweae
500,
ROAD A
500,
Y
500, ROADWORK
--�-00, 0. 500'
to
300, _A 100,
Speed Buffer
Limit (ft)
Buftr
40 170
,"451 220 r3 50'MIN
to Taper
50 280 A 100'MAX
55
500, 500'
too,w�u 500'
500,
AHEAD
1. A "Be Prepared To Stop" sign may be added to
the sign series, located between the Flagger symbol
and the 'One Lane Road Ahead' signs, If used, then
the spacing of all four signs in the series Aill be 500 feet.
1 For low -speed (35 MPH or less) conditions, a 200-foot
sign spacing may be used. For speeds of 40 to 50
MPH a 350-foot sign spacing may be used.
1 For operations of 60 minutes or less, the "Road Work
Ahead' sign may be omitted.
4. Generally, the use of "End Road Work' signs is optional
for short duration work sties. However, if the work site
itself is long, orthe beginning and end of the work
site are not visible to a driver passing through it, then
"End Road Work!" signs should be used,
ff
Shoulder Work
(Z-1 5,'From the Edgc of Pavement)
Speed Shoulder
LITrit Ta per (,ftj,
4c
0
Jr
..... .
.........
Shoulder
Taper
543 a
Notes:
Fad cr 60:nunu.-r lo-is, all siqni; antj
channelZzmq Levi s may be aDrninatea if v-abide
to an Br-M121eld rUtdIPTIg *r 3l:7,ubp light is used.
s. F,;,[ 1,35 klplm' or less) Ccil'alitiurs, a 2U0-
foot sign spa ing may be useu_ For speecs of 40
to 5D 10PH a 350-fcct sign srzangmzy be riseizL
3. 'Road 'Piri;:Ahead, orloVurke-,
symbot sigas may be useoinst:-zid of Lhc -Shoulcicf
'Nc,rk- sign,
4. Forwc rk peTformed cn a pa%--,d showder at least
8 feCL wide. an adtjitcnac �Varrtinl sligl-t
�e,g, -Road 'WoA--Ahead") should be used in
ad,mn c-p of the "Shoulder "Plork- sign.

1 P J
�Z 0% U" l ;
to P
o '0j
CL
zm
r
c f �T
n` � LL pjj k J
cli njj Z. , o cvlji r
C4
03 co
try- �' `� o � 1 r •-� +�`"``�, � 1
111111 S• p _ry'
co
��
00
$r'
+ < o `°
0 m e
a <
, Q7
m
`m Taylor —
o _
0
is

PS - FORM 1001
REVISED APRIL 29, 2008
AGREEMENT NO. CSX850194
FACILITY ENCROACHMENT AGREEMENT
THIS AGREEMENT, made and effective as of October 9, 2017, by and between CSX
TRANSPORTATION, INC., a Virginia corporation, whose mailing address is 500 Water Street,
Jacksonville, Florida 32202, hereinafter called "Licensor," and HOUSE OF RAEFORD FARMS,
INC., a limited liability company of the State of North Carolina, whose mailing address is 3425
US Highway 117, Rose Hill, North Carolina 28458, hereinafter called "Licensee,"
WITNES SETH:
WHEREAS, Licensee desires to construct (unless previously constructed and designated
as existing herein), use and maintain the below described facility(ies), hereinafter called
"Facilities," over, under or across property owned or controlled by Licensor, at the below
described location(s):
1. One (1) twelve inch (12") diameter sub -grade pipeline crossing, located at or near Rose
Hill, Duplin County, North Carolina, Florence Division, W And W Subdivision, Milepost AC-
199.38, Latitude N34:51:20.00, Longitude W78:02:25.00;
hereinafter, called the "Encroachment," as shown on print(s) labeled Exhibit "A," attached hereto
and made a part hereof,
NOW, THEREFORE, in consideration of the mutual covenants, conditions, terms and
agreements herein contained, the parties hereto agree and covenant as follows:
1. LICENSE:
1.1 Subject to Article 17, Licensor, insofar as it has the legal right, power and
authority to do so, and its present title permits, and subject to:
(A) Licensor's present and future right to occupy, possess and use its
property within the area of the Encroachment for any and all purposes;
(B) All encumbrances, conditions, covenants, easements, and limitations
applicable to Licensor's title to or rights in the subject property; and
(C) Compliance by Licensee with the terms and conditions herein
contained;
does hereby license and permit Licensee to construct, maintain, repair, renew, operate, use, alter
or change the Facilities at the Encroachment above for the term herein stated, and to remove
same upon termination.
1.2 The term Facilities, as used herein, shall include only those structures and
ancillary facilities devoted exclusively to the transmission usage above within the Encroachment,
and as shown on attached Exhibit A.
Page 1 of 14 o

PS - FORM 1001
REVISED APRIL 29, 2008
AGREEMENT NO. CSX850194
1.3 No additional structures or other facilities shall be placed, allowed, or
maintained by Licensee in, upon or on the Encroachment except upon prior separate written
consent of Licensor.
2. ENCROACHMENT FEE; TERM:
2.1 Licensee shall pay Licensor a one-time nonrefundable Encroachment Fee of
FIVE THOUSAND ONE HUNDRED AND 00/100 U.S. DOLLARS ($5,100.00) upon
execution of this Agreement. Licensee agrees that the Encroachment Fee applies only to the
original Licensee under this Agreement. In the event of a successor (by merger, consolidation,
reorganization and/or assignment) or if the original Licensee changes its name, then Licensee
shall be subject to payment of Licensor's current administrative and document preparation fees
for the cost incurred by Licensor in preparing and maintaining this Agreement on a current basis.
2.2 However, Licensee assumes sole responsibility for, and shall pay directly (or
reimburse Licensor), any additional annual taxes and/or periodic assessments levied against
Licensor or Licensor's property solely on account of said Facilities or Encroachment.
2.3 This Agreement shall terminate as herein provided, but shall also terminate
upon: (a) Licensee's cessation of use of the Facilities or Encroachment for the purpose(s) above;
(b) removal of the Facilities; (c) subsequent mutual consent; and/or (d) failure of Licensee to
complete installation within five (5) years from the effective date of this Agreement.
2.4 In further consideration for the license or right hereby granted, Licensee
hereby agrees that Licensor shall not be charged or assessed, directly or indirectly, with any part
of the cost of the installation of said Facilities and appurtenances, and/or maintenance thereof, or
for any public works project of which said Facilities is a part.
3. CONSTRUCTION, MAINTENANCE AND REPAIRS:
3.1 Licensee shall construct, maintain, relocate, repair, renew, alter, and/or remove
the Facilities, in a prudent, workmanlike manner, using quality materials and complying with any
applicable standard(s) or regulation(s) of Licensor (CSXT Specifications), or Licensee's
particular industry, National Electrical Safety Code, or any governmental or regulatory body
having jurisdiction over the Encroachment.
3.2 Location and construction of Facilities shall be made strictly in accordance
with design(s) and specifications furnished to and approved by Licensor and of material(s) and
size(s) appropriate for the purpose(s) above recited.
3.3 All of Licensee's work, and exercise of rights hereunder, shall be undertaken at
time(s) satisfactory to Licensor, and so as to eliminate or minimize any impact on or interference
with the safe use and operation of Licensor's property and appurtenances thereto.
3.4 In the installation, maintenance, repair and/or removal of said Facilities,
Licensee shall not use explosives of any type or perform or cause any blasting without the
Page 2 of 14 o

PS - FORM 1001
REVISED APRIL 29, 2008
AGREEMENT NO. CSX850194
separate express written consent of Licensor. As a condition to such consent, a representative
will be assigned by Licensor to monitor blasting, and Licensee shall reimburse Licensor for the
entire cost and/or expense of furnishing said monitor.
3.5 Any repairs or maintenance to the Facilities, whether resulting from acts of
Licensee, or natural or weather events, which are necessary to protect or facilitate Licensor's use
of its property, shall be made by Licensee promptly, but in no event later than thirty (30) days
after Licensee has notice as to the need for such repairs or maintenance.
3.6 Licensor, in order to protect or safeguard its property, rail operations,
equipment and/or employees from damage or injury, may request immediate repair or renewal of
the Facilities, and if the same is not performed, may make or contract to make such repairs or
renewals, at the sole risk, cost and expense of Licensee.
3.7 Neither the failure of Licensor to object to any work done, material used, or
method of construction or maintenance of said Encroachment, nor any approval given or
supervision exercised by Licensor, shall be construed as an admission of liability or
responsibility by Licensor, or as a waiver by Licensor of any of the obligations, liability and/or
responsibility of Licensee under this Agreement.
3.8 All work on the Encroachment shall be conducted in accordance with
Licensor's safety rules and regulations.
3.9 Licensee hereby agrees to reimburse Licensor any loss, cost or expense
(including losses resulting from train delays and/or inability to meet train schedules) arising from
any failure of Licensee to make repairs or conduct maintenance as required by Section 3.5 above
or from improper or incomplete repairs or maintenance to the Facilities or Encroachment.
3.10 In the event it becomes necessary for the Licensee to deviate from the
approved Exhibit, Licensee shall seek prior approval from CSXT, or when applicable, an official
field representative of CSXT permitted to approve changes, authorizing the necessary field
changes and Licensee shall provide CSXT with complete As -Built Drawings of the completed
work. As -Built Drawings shall be submitted to Licensor in either electronic or hard copy form
upon the substantial completion of the project and upon Licensor's request.
4. PERMITS, LICENSES:
4.1 Before any work hereunder is performed, or before use of the Encroachment
for the contracted purpose, Licensee, at its sole cost and expense, shall obtain all necessary
permit(s) (including but not limited to zoning, building, construction, health, safety or
environmental matters), letter(s) or certificate(s) of approval. Licensee expressly agrees and
warrants that it shall conform and limit its activities to the terms of such permit(s), approval(s)
and authorization(s), and shall comply with all applicable ordinances, rules, regulations,
requirements and laws of any governmental authority (State, Federal or Local) having
jurisdiction over Licensee's activities, including the location, contact, excavation and protection
Page 3 of 14 o

PS - FORM 1001
REVISED APRIL 29, 2008
AGREEMENT NO. CSX850194
regulations of the Occupational Safety and Health Act (OSHA) (29 CFR 1926.65 1 (b)), et al., and
State "One Call" - "Call Before You Dig" requirements.
4.2 Licensee assumes sole responsibility for failure to obtain such permit(s) or
approval(s), for any violations thereof, or for costs or expenses of compliance or remedy.
5. MARKING AND SUPPORT:
5.1 With respect to any subsurface installation or maintenance upon Licensor's
property, Licensee, at its sole cost and expense, shall:
(A) support track(s) and roadbed in a manner satisfactory to Licensor;
(B) backfill with satisfactory material and thoroughly tamp all trenches to
prevent settling of surface of land and roadbed of Licensor; and
(C) either remove any surplus earth or material from Licensor's property or
cause said surplus earth or material to be placed and distributed at location(s) and in such manner
Licensor may approve.
5.2 After construction or maintenance of the Facilities, Licensee shall:
(A) Restore any track(s), roadbed and other disturbed property; and
(B) Erect, maintain and periodically verify the accuracy of aboveground
markers, in a form approved by Licensor, indicating the location, depth and ownership of any
underground Facilities or related facilities.
5.3 Licensee shall be solely responsible for any subsidence or failure of lateral or
subjacent support in the Encroachment area for a period of three (3) years after completion of
installation.
6. TRACK CHANGES:
6.1 In the event that rail operations and/or track maintenance result in changes in
grade or alignment of, additions to, or relocation of track(s) or other facilities, or in the event
future use of Licensor's rail corridor or property necessitate any change of location, height or
depth in the Facilities or Encroachment, Licensee, at its sole cost and expense and within thirty
(30) days after notice in writing from Licensor, shall make changes in the Facilities or
Encroachment to accommodate such track(s) or operations.
6.2 If Licensee fails to do so, Licensor may make or contract to make such
changes at Licensee's cost.
Page 4 of 14 o

PS - FORM 1001
REVISED APRIL 29, 2008
AGREEMENT NO. CSX850194
7. FACILITY CHANGES:
7.1 Licensee shall periodically monitor and verify the depth or height of the
Facilities or Encroachment in relation to the existing tracks and facilities, and shall relocate the
Facilities or change the Encroachment, at Licensee's expense, should such relocation or change
be necessary to comply with the minimum clearance requirements of Licensor.
7.2 If Licensee undertakes to revise, renew, relocate or change in any manner
whatsoever all or any part of the Facilities (including any change in voltage or gauge of wire or
any change in circumference, diameter or radius of pipe or change in materials transmitted in and
through said pipe), or is required by any public agency or court order to do so, plans therefor
shall be submitted to Licensor for approval before such change. After approval, the terms and
conditions of this Agreement shall apply thereto.
8. INTERFERENCE WITH RAIL FACILITIES:
8.1 Although the Facilities/Encroachment herein permitted may not presently
interfere with Licensor's railroad or facilities, in the event that the operation, existence or
maintenance of said Facilities, in the sole judgment of Licensor, causes: (a) interference
(including, but not limited to, physical or interference from an electromagnetic induction, or
interference from stray or other currents) with Licensor's power lines, communication, signal or
other wires, train control system, or electrical or electronic apparatus; or (b) interference in any
manner, with the operation, maintenance or use of the rail corridor, track(s), structures, pole
line(s), devices, other property, or any appurtenances thereto; then and in either event, Licensee,
upon receipt of written notice from Licensor of any such interference, and at Licensee's sole risk,
cost and expense, shall promptly make such changes in its Facilities or installation, as may be
required in the reasonable judgment of the Licensor to eliminate all such interference. Upon
Licensee's failure to remedy or change, Licensor may do so or contract to do so at Licensee's sole
cost.
8.2 Without assuming any duty hereunder to inspect the Facilities, Licensor hereby
reserves the right to inspect same and to require Licensee to undertake repairs, maintenance or
adjustments to the Facilities, which Licensee hereby agrees to make promptly, at Licensee's sole
cost and expense.
9. RISK, LIABILITY, INDEMNITY:
With respect to the relative risk and liabilities of the parties, it is hereby agreed that:
9.1 Licensee hereby agrees to, defend, indemnify, and hold Licensor harmless
from and against any and all liability, loss, claim, suit, damage, charge or expense which
Licensor may suffer, sustain, incur or in any way be subjected to, on account of death of or
injury to any person whomsoever (including officers, agents, employees or invitees of Licensor),
and for damage to or loss of or destruction of any property whatsoever, arising out of, resulting
from, or in any way connected with the construction, repair, maintenance, replacement, presence,
existence, operations, use or removal of the Facilities or any structure in connection therewith, or
Page 5 of 14 o

PS - FORM 1001
REVISED APRIL 29, 2008
AGREEMENT NO. CSX850194
restoration of premises of Licensor to good order or condition after removal, EXCEPT when
proven to have been caused solely by the willful misconduct or gross negligence of Licensor.
HOWEVER, during any period of actual construction, repair, maintenance, replacement or
removal of the Facilities, wherein agents, equipment or personnel of Licensee are on the railroad
rail corridor, Licensee's liability hereunder shall be absolute, irrespective of any joint, sole or
contributory fault or negligence of Licensor.
9.2 Use of Licensor's rail corridor involves certain risks of loss or damage as a
result of the rail operations. Notwithstanding Section 9.1, Licensee expressly assumes all risk of
loss and damage to Licensee's Property or the Facilities in, on, over or under the Encroachment,
including loss of or any interference with use or service thereof, regardless of cause, including
electrical field creation, fire or derailment resulting from rail operations. For this Section, the
term "Licensee's Property" shall include property of third parties situated or placed upon
Licensor's rail corridor by Licensee or by such third parties at request of or for benefit of
Licensee.
9.3 Licensee assumes all responsibility for, and agrees to defend, indemnify and
hold Licensor harmless from: (a) all claims, costs and expenses, including reasonable attorneys'
fees, as a consequence of any sudden or nonsudden pollution of air, water, land and/or ground
water on or off the Encroachment area, arising from or in connection with the use of this
Encroachment or resulting from leaking, bursting, spilling, or any escape of the material
transmitted in or through the Facilities; (b) any claim or liability arising under federal or state
law dealing with either such sudden or nonsudden pollution of air, water, land and/or ground
water arising therefrom or the remedy thereof, and (c) any subsidence or failure of lateral or
subjacent support of the tracks arising from such Facilities leakage.
9.4 Notwithstanding Section 9.1, Licensee also expressly assumes all risk of loss
which in any way may result from Licensee's failure to maintain either required clearances for
any overhead Facilities or the required depth and encasement for any underground Facilities,
whether or not such loss(es) result(s) in whole or part from Licensor's contributory negligence or
joint fault.
9.5 Obligations of Licensee hereunder to release, indemnify and hold Licensor
harmless shall also extend to companies and other legal entities that control, are controlled by,
subsidiaries of, or are affiliated with Licensor, as well as any railroad that operates over the rail
corridor on which the Encroachment is located, and the officers, employees and agents of each.
9.6 If a claim is made or action is brought against Licensor, and/or its operating
lessee, for which Licensee may be responsible hereunder, in whole or in part, Licensee shall be
notified to assume the handling or defense of such claim or action; but Licensor may participate
in such handling or defense.
Page 6 of 14 o

PS - FORM 1001
REVISED APRIL 29, 2008
AGREEMENT NO. CSX850194
10. INSURANCE:
10.1 Prior to commencement of surveys, installation or occupation of premises
pursuant to this Agreement, Licensee shall procure and shall maintain during the continuance of
this Agreement, at its sole cost and expense, a policy of
(i) Statutory Worker's Compensation and Employers Liability Insurance with
available limits of not less than ONE MILLION AND 00/100 U.S. DOLLARS ($1,000,000.00),
which must contain a waiver of subrogation against CSXT and its Affiliates;
(ii) Commercial General Liability coverage (inclusive of contractual liability) with
available limits of not less than FIVE MILLION AND 00/100 U.S. DOLLARS ($5,000,000.00),
naming Licensor, and/or its designee, as additional insured and in combined single limits for
bodily injury and property damage and covering the contractual liabilities assumed under this
Agreement. The evidence of insurance coverage shall be endorsed to provide for thirty (30) days'
notice to Licensor, or its designee, prior to cancellation or modification of any policy. Mail CGL
certificate, along with agreement, to CSX Transportation, Inc., Speed Code J180, 500 Water
Street, Jacksonville, FL 32202. On each successive year, send certificate to
[e-mail].
(iii) Business automobile liability insurance with available limits of not less than ONE
MILLION AND 00/100 U.S. DOLLARS ($1,000,000.00) combined single limit for bodily
injury and/or property damage per occurrence;
(iv) Such other insurance as Licensor may reasonably require.
10.2 If Licensee's existing CGL policy(ies) do(es) not automatically cover
Licensee's contractual liability during periods of survey, installation, maintenance and continued
occupation, a specific endorsement adding such coverage shall be purchased by Licensee. If said
CGL policy is written on a "claims made" basis instead of a "per occurrence" basis, Licensee
shall arrange for adequate time for reporting losses. Failure to do so shall be at Licensee's sole
risk.
10.3 Licensor, or its designee, may at any time request evidence of insurance
purchased by Licensee to comply with this Agreement. Failure of Licensee to comply with
Licensor's request shall be considered a default by Licensee.
10.4 Securing such insurance shall not limit Licensee's liability under this
Agreement, but shall be security therefor.
10.5 (A) In the event Licensee finds it necessary to perform construction or
demolition operations within fifty feet (50') of any operated railroad track(s) or affecting any
railroad bridge, trestle, tunnel, track(s), roadbed, overpass or underpass, Licensee shall: (a) notify
Licensor; and (b) require its contractor(s) performing such operations to procure and maintain
during the period of construction or demolition operations, at no cost to Licensor, Railroad
Protective Liability (RPL) Insurance, naming Licensor, and/or its designee, as Named Insured,
Page 7 of 14 o

PS - FORM 1001
REVISED APRIL 29, 2008
AGREEMENT NO. CSX850194
written on the current ISO/RIMA Form (ISO Form No. CG 00 35 01 96) with limits of FIVE
MILLION AND 00/100 U.S. DOLLARS ($5,000,000.00) per occurrence for bodily injury and
property damage, with at least TEN MILLION AND 00/100 U.S. DOLLARS ($10,000,000.00)
aggregate limit per annual policy period, with Pollution Exclusion Amendment (ISO CG 28 31
11 85) if an older ISO Form CG 00 35 is used. The original of such RPL policy shall be sent to
and approved by Licensor prior to commencement of such construction or demolition. Licensor
reserves the right to demand higher limits.
(B) At Licensor's option, in lieu of purchasing RPL insurance from an insurance
company (but not CGL insurance), Licensee may pay Licensor, at Licensor's current rate at time
of request, the cost of adding this Encroachment, or additional construction and/or demolition
activities, to Licensor's Railroad Protective Liability (RPL) Policy for the period of actual
construction. This coverage is offered at Licensor's discretion and may not be available under all
circumstances.
11. GRADE CROSSINGS; FLAGGING:
11.1 Nothing herein contained shall be construed to permit Licensee or Licensee's
contractor to move any vehicles or equipment over the track(s), except at public road crossing(s),
without separate prior written approval of Licensor.
11.2 If Licensor deems it advisable, during any construction, maintenance, repair,
renewal, alteration, change or removal of said Facilities, to place watchmen, flagmen, inspectors
or supervisors for protection of operations of Licensor or others on Licensor's rail corridor at the
Encroachment, and to keep persons, equipment or materials away from the track(s), Licensor
shall have the right to do so at the expense of Licensee, but Licensor shall not be liable for failure
to do so.
12. LICENSOR'S COSTS:
12.1 Any additional or alternative costs or expenses incurred by Licensor to
accommodate Licensee's continued use of Licensor's property as a result of track changes or wire
changes shall also be paid by Licensee.
12.2 Licensor's expense for wages ("force account" charges) and materials for any
work performed at the expense of Licensee pursuant hereto shall be paid by Licensee within
thirty (30) days after receipt of Licensor's bill therefor. Licensor may, at its discretion, request
an advance deposit for estimated Licensor costs and expenses.
12.3 Such expense shall include, but not be limited to, cost of railroad labor and
supervision under "force account" rules, plus current applicable overhead percentages, the actual
cost of materials, and insurance, freight and handling charges on all material used. Equipment
rentals shall be in accordance with Licensor's applicable fixed rate. Licensor may, at its
discretion, require advance deposits for estimated costs of such expenses and costs.
Page 8 of 14 o

PS - FORM 1001
REVISED APRIL 29, 2008
AGREEMENT NO. CSX850194
13. DEFAULT, BREACH, WAIVER:
13.1 The proper and complete performance of each covenant of this Agreement
shall be deemed of the essence thereof, and in the event Licensee fails or refuses to fully and
completely perform any of said covenants or remedy any breach within thirty (30) days after
receiving written notice from Licensor to do so (or within forty-eight (48) hours in the event of
notice of a railroad emergency), Licensor shall have the option of immediately revoking this
Agreement and the privileges and powers hereby conferred, regardless of encroachment fee(s)
having been paid in advance for any annual or other period. Upon such revocation, Licensee
shall make removal in accordance with Article 14.
13.2 No waiver by Licensor of its rights as to any breach of covenant or condition
herein contained shall be construed as a permanent waiver of such covenant or condition, or any
subsequent breach thereof, unless such covenant or condition is permanently waived in writing
by Licensor.
13.3 Neither the failure of Licensor to object to any work done, material used, or
method of construction or maintenance of said Encroachment, nor any approval given or
supervision exercised by Licensor, shall be construed as an admission of liability or
responsibility by Licensor, or as a waiver by Licensor of any of the obligations, liability and/or
responsibility of Licensee under this Agreement.
14. TERMINATION, REMOVAL:
14.1 All rights which Licensee may have hereunder shall cease upon the date of
(a) termination, (b) revocation, or (c) subsequent agreement, or (d) Licensee's removal of the
Facility from the Encroachment. However, neither termination nor revocation of this Agreement
shall affect any claims and liabilities which have arisen or accrued hereunder, and which at the
time of termination or revocation have not been satisfied; neither party, however, waiving any
third party defenses or actions.
14.2 Within thirty (30) days after revocation or termination, Licensee, at its sole
risk and expense, shall (a) remove the Facilities from the rail corridor of Licensor, unless the
parties hereto agree otherwise, (b) restore the rail corridor of Licensor in a manner satisfactory to
Licensor, and (c) reimburse Licensor any loss, cost or expense of Licensor resulting from such
removal.
15. NOTICE:
15.1 Licensee shall give Licensor at least thirty (30) days written notice before
doing gny work on Licensor's rail corridor, except that in cases of emergency shorter notice may
be given. Licensee shall provide proper notification as follows:
a. For non -emergencies, Licensee shall submit online via the CSX Property
Portal from Licensor's web site, via web link:
https:Hpropertyportal.csx.com/pub_ps res/ps_resJ sf/public/index. faces
Page 9 of 14 o

PS - FORM 1001
REVISED APRIL 29, 2008
AGREEMENT NO. CSX850194
b. For emergencies, Licensee shall complete all of the steps outlined in
Section 15.1 a. above, and shall also include detailed information of the emergency. Licensee
shall also call and report details of the emergency to Licensor's Rail Operations Emergency
Telephone Number: 1-800-232-0144. In the event Licensor needs to contact Licensee
concerning an emergency involving Licensee's Facility(ies), the emergency phone number for
Licensee is: 252-230-6618.
15.2 All other notices and communications concerning this Agreement shall be
addressed to Licensee at the address above, and to Licensor at the address shown on Page 1, c/o
CSXT Contract Management, J180; or at such other address as either party may designate in
writing to the other.
15.3 Unless otherwise expressly stated herein, all such notices shall be in writing
and sent via Certified or Registered Mail, Return Receipt Requested, or by courier, and shall be
considered delivered upon: (a) actual receipt, or (b) date of refusal of such delivery.
16. ASSIGNMENT:
16.1 The rights herein conferred are the privileges of Licensee only, and Licensee
shall obtain Licensor's prior written consent to any assignment of Licensee's interest herein; said
consent shall not be unreasonably withheld.
16.2 Subject to Sections 2 and 16.1, this Agreement shall be binding upon and
inure to the benefit of the parties hereto and their respective successors or assigns.
16.3 Licensee shall give Licensor written notice of any legal succession (by
merger, consolidation, reorganization, etc.) or other change of legal existence or status of
Licensee, with a copy of all documents attesting to such change or legal succession, within thirty
(30) days thereof.
16.4 Licensor expressly reserves the right to assign this Agreement, in whole or in
part, to any grantee, lessee, or vendee of Licensor's underlying property interests in the
Encroachment, upon written notice thereof to Licensee.
16.5 In the event of any unauthorized sale, transfer, assignment, sublicense or
encumbrance of this Agreement, or any of the rights and privileges hereunder, Licensor, at its
option, may revoke this Agreement by giving Licensee or any such assignee written notice of
such revocation; and Licensee shall reimburse Licensor for any loss, cost or expense Licensor
may incur as a result of Licensee's failure to obtain said consent.
17. TITLE:
17.1 Licensee understands that Licensor occupies, uses and possesses lands,
rights -of -way and rail corridors under all forms and qualities of ownership rights or facts, from
full fee simple absolute to bare occupation. Accordingly, nothing in this Agreement shall act as
Page 10 of 14 o

PS - FORM 1001
REVISED APRIL 29, 2008
AGREEMENT NO. CSX850194
or be deemed to act as any warranty, guaranty or representation of the quality of Licensor's title
for any particular Encroachment or segment of Rail Corridor occupied, used or enjoyed in any
manner by Licensee under any rights created in this Agreement. It is expressly understood that
Licensor does not warrant title to any Rail Corridor and Licensee will accept the grants and
privileges contained herein, subject to all lawful outstanding existing liens, mortgages and
superior rights in and to the Rail Corridor, and all leases, licenses and easements or other
interests previously granted to others therein.
17.2 The term "license," as used herein, shall mean with regard to any portion of
the Rail Corridor which is owned by Licensor in fee simple absolute, or where the applicable law
of the State where the Encroachment is located otherwise permits Licensor to make such grants
to Licensee, a "permission to use" the Rail Corridor, with dominion and control over such
portion of the Rail Corridor remaining with Licensor, and no interest in or exclusive right to
possess being otherwise granted to Licensee. With regard to any other portion of Rail Corridor
occupied, used or controlled by Licensor under any other facts or rights, Licensor merely waives
its exclusive right to occupy the Rail Corridor and grants no other rights whatsoever under this
Agreement, such waiver continuing only so long as Licensor continues its own occupation, use
or control. Licensor does not warrant or guarantee that the license granted hereunder provides
Licensee with all of the rights necessary to occupy any portion of the Rail Corridor. Licensee
further acknowledges that it does not have the right to occupy any portion of the Rail Corridor
held by Licensor in less than fee simple absolute without also receiving the consent of the
owner(s) of the fee simple absolute estate. Further, Licensee shall not obtain, exercise or claim
any interest in the Rail Corridor that would impair Licensor's existing rights therein.
17.3 Licensee agrees it shall not have nor shall it make, and hereby completely and
absolutely waives its right to, any claim against Licensor for damages on account of any
deficiencies in title to the Rail Corridor in the event of failure or insufficiency of Licensor's title
to any portion thereof arising from Licensee's use or occupancy thereof.
17.4 Licensee agrees to fully and completely indemnify and defend all claims or
litigation for slander of title, overburden of easement, or similar claims arising out of or based
upon the Facilities placement, or the presence of the Facilities in, on or along any
Encroachment(s), including claims for punitive or special damages.
17.5 Licensee shall not at any time own or claim any right, title or interest in or to
Licensor's property occupied by the Encroachments, nor shall the exercise of this Agreement for
any length of time give rise to any right, title or interest in Licensee to said property other than
the license herein created.
17.6 Nothing in this Agreement shall be deemed to give, and Licensor hereby
expressly waives, any claim of ownership in and to any part of the Facilities.
17.7 Licensee shall not create or permit any mortgage, pledge, security, interest,
lien or encumbrances, including without limitation, tax liens and liens or encumbrances with
respect to work performed or equipment furnished in connection with the construction,
installation, repair, maintenance or operation of the Facilities in or on any portion of the
Page 11 of 14 o

PS - FORM 1001
REVISED APRIL 29, 2008
AGREEMENT NO. CSX850194
Encroachment (collectively, "Liens or Encumbrances"), to be established or remain against the
Encroachment or any portion thereof or any other Licensor property.
17.8 In the event that any property of Licensor becomes subject to such Liens or
Encumbrances, Licensee agrees to pay, discharge or remove the same promptly upon Licensee's
receipt of notice that such Liens or Encumbrances have been filed or docketed against the
Encroachment or any other property of Licensor; however, Licensee reserves the right to
challenge, at its sole expense, the validity and/or enforceability of any such Liens or
Encumbrances.
18. GENERAL PROVISIONS:
18.1 This Agreement, and the attached specifications, contains the entire
understanding between the parties hereto.
18.2 Neither this Agreement, any provision hereof, nor any agreement or provision
included herein by reference, shall operate or be construed as being for the benefit of any third
person.
18.3 Except as otherwise provided herein, or in any Rider attached hereto, neither
the form of this Agreement, nor any language herein, shall be interpreted or construed in favor of
or against either party hereto as the sole drafter thereof.
18.4 This Agreement is executed under current interpretation of applicable
Federal, State, County, Municipal or other local statute, ordinance or law(s). However, each
separate division (paragraph, clause, item, term, condition, covenant or agreement) herein shall
have independent and severable status for the determination of legality, so that if any separate
division is determined to be void or unenforceable for any reason, such determination shall have
no effect upon the validity or enforceability of each other separate division, or any combination
thereof.
18.5 This Agreement shall be construed and governed by the laws of the state in
which the Facilities and Encroachment are located.
18.6 If any amount due pursuant to the terms of this Agreement is not paid by the
due date, it will be subject to Licensor's standard late charge and will also accrue interest at
eighteen percent (18%) per annum, unless limited by local law, and then at the highest rate so
permitted.
18.7 Licensee agrees to reimburse Licensor for all reasonable costs (including
attorney's fees) incurred by Licensor for collecting any amount due under the Agreement.
18.8 The provisions of this License are considered confidential and may not be
disclosed to a third party without the consent of the other party(s), except: (a) as required by
statute, regulation or court order, (b) to a parent, affiliate or subsidiary company, (c) to an
auditing firm or legal counsel that are agreeable to the confidentiality provisions, or (d) to
Page 12 of 14 o

PS - FORM 1001
REVISED APRIL 29, 2008
AGREEMENT NO. CSX850194
Lessees of Licensor's land and/or track who are affected by the terms and conditions of this
Agreement and will maintain the confidentiality of this Agreement.
18.9 Licensor shall refund to Licensee any overpayments collected, plus any taxes
paid in advance; PROVIDED, however, such refund shall not be made when the cumulative total
involved is less than One Hundred Dollars ($100.00).
[Signatures on the following page]
Page 13 of 14 o

PS - FORM 1001
REVISED APRIL 29, 2008
AGREEMENT NO. CSX850194
IN WITNESS WHEREOF, the parties hereto have executed this Agreement in duplicate
(each of which shall constitute an original) as of the effective date of this Agreement.
Witness for Licensor: CSX TRANSPORTATION, INC.
Print/Type Name:
Print/Type Title:
Witness for Licensee: HOUSE OF RAEFORD FARMS, INC
M.
Who, by the execution hereof, affirms that he/she has
the authority to do so and to bind the Licensee to the
terms and conditions of this Agreement.
Print/Type Name:
Print/Type Title:
Tax ID No.:
Page 14 of 14 o

[CSX
Now iomorraw moves
0• •01"
Invoice
HOUSE OF RAEFORD FARMS INC
3425 US HWY 117
ROSE HILL, NC 28458
Page 1 of 1
Account/Contract No. CSX850194
Customer Project No.
Date 10/9/2017
Please submit a copy of this statement with payment submission to the "Remit To"
address shown below.
Amount Due U.S. Dollars $ 4,200.00
Application Review Fee
$
1,950.00
Railroad Protective Liability
$
750.00
Passenger Services Surcharge
Expedited Review Fee
$
5,000.00
License Fee
$
1,500.00
Money on File
$
(5,000.00)
Total Current Fees in U.S. dollars
CSX Federal ID No.
CSX Canadian ID No.
CSX Quebec ID No.
Please remit payment to:
Legal Address:
500 Water Street, J180
Jacksonville, FL 32202
Questions? Contact:
$ 4,200.00
54-6000720
105203095 RC 0001
1022434469 IC 0001
CSX Transportation, Inc.
Mailing Address:
500 Water Street, J180
Jacksonville, FL 32202
Flavio [e-mail]
904.279.3860

CSX850194 EXHIBIT A
HOUSE of RAEFORD
Rose Hill, NC
Proposed Pressure Processing Line Crossing
Bore Pit to J`
be located oo I co 00 o Q0 00
outside
RR ROW I I \\\ CD
\\ 1 \
I I III I I
III
I I I III I I
� I III I
QI I III
III
DIRT PATH I of go S
\Mllolll I
��I=III I
CSX PROPERTY SERVICES REVIEW
[:]No Exceptions [@ Exceptions Noted
This review is for the general conformance with CSX utility
design specifications only. Sole responsibility for all
aspects of the overall design shall remain with the facility
owner. This review does not constitute approval to
proceed without meeting all of CSX's safety and
contractua U; ments.
BY: �—
PLAN VIEW
SECTION VIEW
85
c
0
co
m
w 80
52+00
Station Numbers
rop. 12" SDR21 PVC, Carrier Pipe
Bore Pit to
be located
outside
RR ROW
v,
Q
Prop. 18" Steel C sing,
I
130 LF by Jack/Bore
0.312" thick wall)
ILa Lo
Timber Location I
—
DITCH
�� — —88
—
Q —89
�I0
I T 899
[if X 898
X
I o
°
I
Exist. Elevation
I88.2
Exist. Contours
11
�8&
—=87
--87
-.
Vil C 0 ona "last long imber- PLAN SCALE (ft)
rade
N DT-: See CSX Pipeline crossing specifications enclosed.
MEF 6
LE 4
MEF
51+50 51+00 L�M2
0
50 25 G
PROFILE SCALE (ft)
asing, T30 LF

CSX850194
EXHIBIT A
NOTES:
1.THE BORING OPERATION SHALL BE PROGRESSED ON A 24 HOUR BASIS WITH STOPPAGE
UNTIL THE LEADING EDGE OF THE PIPE HAS REACHED THE REEIVING PIT.
2.UTILITY MARKER SIGNS SHALL BE PLACED IN ACCORDANCE WITH CSX SPECIFICAITONS.
33HE BORING OPERATION SHALL BE PROGRESSED ON A 24 HOUR BASIS WITH STOPPAGE
UNTIL THE LEADING EDGE OF THE PIPE HAS REACHED THE REEIVING PIT.
4. THE FRONT OF THE PIPE SHALL BE PROVIDED WITH MECHANICAL ARRANGEMENTS OR
DEVICES THAT WILL POSITIVELY PREVENT THE AUGER FROM LEADING THE PIPE SO THAT
NO UNSUPPORTED EXCAVATION IS AHEAD OF THE PIPE.
CSX PROPERTY SERVICES REVIEW
[:]No Exceptions [X Exceptions Noted
This review is for the general conformance with CSX utility
design specifications only. Sole responsibility for all
aspects of the overall design shall remain with the facility
owner. This review does not constitute approval to
proceed without meeting all of CSX's safety and
contractual uir ments.�
BY:
2 of 2 10/9/2017

CERTIFICATE 8F LIABILITY INSURANCE I GATE4111199DIDer"
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING FNSURERIS). AUTHORIZED
REPRESENTATIVE OR PRODUCER. AND THE CERTIFICATE HOLDER"
IMPORTANT: N the cerliRcate holder is an ADDITIONAL INSURED. the policyliesl must be endorsed" If SUBROGATION IS WAIVED, subject to
the terms and Conditions oI the policy, certain policies may require an endorsement, A statement on this certiTieate does not confer rlphts to the
PRODUCoA
WILAIEV The Licensee.rLesseellndustry identified in
r the agreement must be the named insured
4 CShT will not accept the contractors CGL
certificate
c
r..CIVFRAr:FC I FRTT F TC..ATF NI IAA%FF!• RFVI RION Mt1MRFR-
T-1 G IS TO CER'IFY THAT THE POLICIES C` Iti;-URANCE LISTED BELOW •DIVE BEES ILSUE0 'C THE INSIItED NA1V'_D ABOVE FOR TIE PC -.ICY ;:E DD
INDICATED. %WWOTHSTANIDING AhY RECLIAEVENT. TERAI OR CON01T*N OF ANY CCYTRAC7 OR O-HIIR DCCLIMI!%T'AITti ftE'SF EC- TO ►VH'CY -HIS
CM'IFrCATE NAY SE ISS[IED OR %AAY AERTAIN, THE INSLRANCE AFFORDED BY -HE POOCI_s DESCRIBED r•,RE!N 1C 21LE.ECT TO ALL THE TERMS
aycO .kr.IONS AND CONDITIONS O= %VCH oq, ]CIE$ 0%.IIT-� .STY01041464AY HAVE 6EEN RE7JCEn EY 7AO CLAISf-'
MIA
LtA
TTPP OF MEIIRAMCE
nIEA
=1D
P0LICI EFF BLIC i EAF
FCILI�Y NIIlnl Ell rMY•o6'T.rn rVIA-z"l'r r'•
L9YITL
A
o~AL LI'LRi3TT
e a an C CCuren Ct Q?t --
SM FEa vrcrrrI
s
[a+�AEt_ Kcsews _.suti
must be at least f"e ryillron dellar
AiU5•wn0E A❑ W'r-�A
(SS,000,000y, or the amcant in the box
CEO EXP ,Nry crr
=ERS[1YY;AII': 1.IJRY
I
A
Carttbined 1wrM the-Eacl OcCuren
coverage of any Excess L iibfity must be of
'�EVL.10::REBATE LIMIT APPJES
I- icy 79
F ER
UDC
sc 2'=-`S.=OL0. CPri
least five rnftn dollars �S5,000,00 }
S
ALIT0116081LEL"ILITY
ANY ,WrO
Combined single limit
of
ihJ ,ir•s-r C[n:.
:
ALLOILME'J S-�DVLfiCthane.:CiLT
UTC A_rycs
H-70S �C
.aREp V: OS ti TCS
h
not less {lt�5one�yrm�1
dollars lS I.UVQ 0V V 0
Dn
1
1
I
1
Fei a-Ecrrra+e
LM9RELLA LV$
'}f _'R
EA:N CC•_'_F FE•.:=
.Y.'aE:-.•-'_
CxCiif LIAR
CLSVA-#V E
I
C£D Rr,-vmo"
NGRy.ERi COMPVI,1Anp'1
ANDEMPWTEFII'L+AAWJTY Y,„
.qA' PMCUTR'E
-FnCEMINSMOV4EXC-:CEO`
I YMWalory In NH1
r rrs arsctr Lnxr
C E�GA[P"'-ry T 5
-_
Standard limits of liability.
Must contain a waiver
�u0b�a8 tla0 In ear o
I
of
curen
_,� - ••-�- _' -
E _ F+,C-
E_=:�1+°E•?•. F.•.:::•.e
.
L'"-
OM-RIFTIyN OF OPERATION4 / LOCArl i1 V01%U14 [AMWI1 ACOAO 1 Al, Aedto'w r+amrkc I6n6d la r m &Para Is nm*"
This Sox should contain the following. CSX Transportation. Inc..
is included as additional insured This certificate applies to all
contractslagreements between the named Insured and CS}{T.
CERTIFICATE HOLDER CANCELLATION
er the terms of the agreement this should state
CSX Transportation. Inc Should any of the above described policies be
500 Water Street, J180 tftodifierf"d-fncelled, or not renewed, the issuing
Jacksonville, FL 32202 insurer shall mail 30 days written notice to the
_certifi cate-I Dlder_rlamed-hefein

Agreement Checklist
Please perform the following when executing the attached instrument:
X Sign the signature page in order to execute the agreement. Once of the following should
apply.
Execution on behalf of a CORPORATION should be accomplished by the President,
Vice President, or an officer authorized by Board Resolution to execute legal documents
on behalf of the Corporation. (Cony of Board Authorization should be furnished for
anyone si2nin2, other than the President or Vice President.) If the Corporate name is
set out erroneously in the Agreement, the document should be executed and the name
corrected and initialed where it appears. (Municipal Corporation, furnish copy of such
Resolution.)
If the Agreement is with an INDIVIDUAL, that individual should sign the Agreement
exactly as the name is set out in the caption of the Agreement. If the name is set out
erroneously in the Agreement, the document should be executed and the name corrected
and initialed where it appears.
If the Agreement is with a PARTNERSHIP, all general members of the partnership
should
execute the document unless one member of the firm has been designated managing
partner or expressly by the partnership to execute the Agreement. (Furnish copy of such
authority.)
X NAME(S) and TITLE (S) of person (s) executing the agreement must be typed or printed
in ink directly beneath signature (s).
X Social Security Number is required if Agreement is with an INDIVIDUAL, if
Agreement is with other than an INDIVIDUAL, a Tax identification Number is
required.
X Furnish Certificate of Insurance which states "CSX Transportation, Inc. as additional
insured in the Description Box on the certificate, which is required under the
INSURANCE
Article, Certificate Holder address should be as follows:
CSX Transportation
Speed Code J180
500 Water Street,
Jacksonville FL 32202.
Questions regarding the insurance requirements should be directed to this office for
handling.

Attachments
House of Raeford Farms, Inc. Permit Renewal — Permit no. WQ0002005
Attachment K
Industrial Wastewater
Documents - 8
1. Brief Summary
2. Safety Data Sheet — 3131 (Pages — 5)
3. Safety Data Sheet — 4523 (Pages — 6)
4. Safety Data Sheet — 9635 (Pages — 6)
5. Safety Data Sheet — 30094 (Pages — 6)
6. Safety Data Sheet — 45642 (Pages — 7)
7. Safety Data Sheet — 85291 (Pages — 5)
8. Safety Data Sheet — Perasan A (Pages — 5)
Attachment K

The Rose Hill Processing Plant Complex owned by House of Raeford Farms, Inc., is located on
US Hwy 117 between the towns of Rose Hill and Magnolia in Duplin County, NC. It is a meat
processing plant for chicken. All human waste from employees is collected, transported, treated,
and disposed of separately from the industrial waste. All of the industrial waste (composed of
about 5% stormwater and the remainder direct industrial waste and washdown water) is disposed
of via non -discharge Permit No. WQ0002005 issued by NCDEQ.
The chemicals used for sanitation (washdown) include:
• Sodium hypochlorite
• Sodium hydroxide
• D-gluco-Heptonic acid, monosodium salt
• Phosphoric acid
• Nitric acid
• 1-Propanaminium, 3-amino-N-(carboxymethyl)-N,N-dimethyl-, N-coco acyl derivatives,
hydroxides, inner salts
• Tripropylene glycol monomethyl ether
• Sodium silicate
• 2-Butoxy-ethanol
• Sodium dodecylbenzenesulfonate
• Hydrogen peroxide
• Acetic acid
• Peroxyacetic acid.
Refer to attached safety data sheets for additional information.

Safety Data Sheet (SOS)
4t. CHEMSTATION 3131
SDS Revision Date: 0511912022
1. Identification of the substance/mixture and of the companylundertaking
1.1. Product identifier
Product Identity
Alternate Names
3131
3131
1,2. Relevant identified uses of the substance or mixture and uses advised against
Intended use
Contact ChemStation representative,
Application Method
Contact ChemStation representative.
1.3, Details of the supplier of the safety data sheet
Company Name
ChemStation of Eastern NC (Raleigh)
6275 NC-60
Benson. NC 27504
Emergency
CHEMTREC (USA) [phone]
Customer Service: ChemStation of Eastern NC 8884589625
(Raleigh)
2. Hazard identification of the product
2.1, Classification of the substance or mixture
Skin Corr. 1BIH314 Causes severe skin burns and eye damage.
Aqualic Acute 1;H400 Very toxic to aquatic life.
2.2. Label elements
4Q>< >
Danger
H314 Causes severe skin burns and eye damage.
H400 Very toxic to aquatic life.
jPrevention]:
P260 Do not breathe dust, fume, mist, vapors or spray.
P264 Wash thoroughly after handling.
P273 Avoid release to the environment.
P280 Wear protective gloves, eye protection, face prolection.
[Response]:
P301+330+331 IF SWALLOWED Rinse mouth. Do NOT induce vomiting.
P303+351+353 IF ON SKIN (or hair): Remove, take off immediately all contaminated clothing. Rinse skin with water,
shower.
P304+340 IF INHALED: Remove victim to fresh air and keep al rest in a position comfortable for breathing
P305+351+338 IF IN EYES: Rinse cautiously vrith water for several minutes. Remove contact lenses if present and
easy to do - continue rinsing.
P310 Immediately call a POISON CENTER, doctor or physician.
P363 Wash contaminated clothing before reuse.
P391 Collect spillage.
[Storage]:
P405 Store locked up.
[Disposal]:
P501 Dispose of contents 0r oonlain or In accordance wish local and national regulations.
3. Compositionlinformation on ingredients

This product contains the following substances that present a hazard within the meaning of the relevant State and
Federal Hazardous Substances regulations.
_ _ IngradinneClrrniical bosfgnalivna Wofghl � _ GH5 Clas_siflcatlnn I ND[es.
saaium hypvchlvritc 1�_
Skirl Con. 1B;H314 Ill]
CAS Nltmbar: 00075e1-52-9 Aquatic Aculy t;Ha00
I leye Dam. t;H378
1f] 150%1aace classlfed with n haallh a enviranmenlal hazard.
121 suostanc0 with 2 workPldce 9xM WO limit.
[31 PBT-subatahca or Vpys-aubstahce.
'The full Iexls of the phrases are shown in Secrlvn 16
Section 4, First -aid measures
4A. Description of first aid measures
General in all cases of doubt, or when symptoms persist, seek medical attention.
Never give anything by mouth to an unconscious person.
Inhalation
Remove to fresh air, keep patient warm and at rest. If breathing is Irregular or stopped, give
artificial respiration. if unconscious place In the recovery position and obtain immediate
medical attention. Give nothing by mouth,
Eyes
irrigate copiously with clean water for at least 15 minutes, holding the eyelids apart and
seek medical attention.
Skin
Remove contaminated clothing. Wash skin thoroughly with soap and water or use a
recognized skin cleanser.
Ingestion
If swallowed obtain immediate rnedieal allention. Keep at rest Do NOT induce vomiting.
4.2- Most important symptoms and effects, both acute and delayed
Overview
No specific symptom data available.
Check secfion 2 2 (GH5 Label Elements) for further details.
Section 5. Fire -fighting measures
5.1, Extinguishing media
Recommended extinguishing media; alcohol resistant foam, COz, powder. water spray
Unsullable extinguishing media: Do not use; water jet,
5.2, Speciat hazards arising from tho substance or mixture
Hazardous decomposition No hazardous decomposition data available
Do not breathe dust, fume, mist, vapors or spray.
5.3. Advice for fire-fighters
Cool dosed containers exposed to fire by spraying them with water. Do not allow run off water and contaminarils from
fire fighling to enter drains or water ways -
ERG Guide No. 154
Section 5. Accidental release measures
6.1. personal precautions, protective equipment and emergency procedures
Put oil appropriate personal protective equipment (see ser lion 8)-
6,2. Environmental precautions
Do not allow spills to enter drains ofwaterways-
Usegood personal hygiene practices. Wash hands before ealing, drinking, smoking or using toilet. Promptly remove
soiled clothing and wash thoroughly before reuse.
6.3. Methods and material for Containment and cleaning up
Ventilate the area and avoid breathing vapors- Take the personal protective measures listed in section 8.
Contain and absorb spillage with non-combustible materials e.g. sand, earth, vermiculite Place in closed containers
outside buildings and dispose of according to th9 Waste Regulations. [See section 131
Clean, preferably with a detergent. Do not use solvents.
Do not ailrnvsplits to enter drains or watercourses.
If drains, sewers, streams or lakes are contaminated, inform tha Ice -al water company Immedlately, In the case of
contamination of rivers, streams or lakes the Environmental Protection Agency should also be informed.
Section 7. Handling and storage
7-1. Precautions for safe handling
Handle containers rare fufly 10 prevent damage and spillage.

Check section 2.2 (GHS Label E[amenls) for further details. - [Prevention):
7.2. Conditions for safe storage, including any InoompatibIlIties
Incompatible materials: No data available.
Check section 2.2 (GHS Label Elements) far further details. - [Storage]:
7.3. Specific end usa(s)
No Bala available.
Section B. Exposure controls I personal protection
BA. Control parameters
Exposure
CAS No. Ingredient_ _ source
0007613f-52-9 sodium hypochlnrhe pSHA _ Na Estehllshed Llmrt
ACGIEI No Established t-tmll
N I45H Np Established Limit
'. Supplier I No Established Limit
Careinoteen Data
CAS No.
~ Inyredleni $vurce Value
- - - —
o0D7BBt-52-9
Sodium hynocnionle gStiA Ftegulaled Cardncgen: Na _ W
N7P _ xnawn: Na: 5usperted: Nd
IARC Group 1: No: Gmup 2a: Nq; Group 2b: No, Grave 3 No; Group 4- No;.
8.2. Exposure controls
Respiratory
Use NIOSHIM SHA approved respiralor, following manufacturer's recommendations whorl
concentrations exceed permissible exposure limits,
Eyes
Wear approved eye proteclion. The use of a face shield is also recommended For skin
protection in the area of the eyes. An eye wash station Is suggested as a flood workplace
practice.
Skin
Chemical resistant clothing such as cavern llslapron hoots should be worn. Chemical
impervious Gloves
Engineering Controls
Provide adequate ventilation. Where reasonably practicable this should be achieved by the
use of local exhaust ventilation and good general extraction. If these are not sufficient to
maintain concentrations of particulates and any vapor below occupational exposure limits
suitable respiratory protection most be worn
Other Work Practices Use good personal hyglene practices. Wash hands before eating, drinking, smoking or
using toilet. Promptly remove soiled clothing and wash thoroughly before reuse.
Check section 2.2 (GHS Label Elements) for further details. - [Prevenlionj:
Section 9. Physical and chemical propertles
Appearance
Odor
Odor threshold
pH
Melting point 1 freezing point
Initial boiling point and boiling range
Flash Point
Evaporation rate (Ether= 1)
Flammability (solid, gas)
IJpperNower flammability or explosive limits
Vapor pressure (Pa)
Vapor density
Relative density
Solubility in Water
Partition coot iclent n-octanollwater (Log Kow)
Auta•ignition temperature
Decomposition temperature
Viscosity (cst)
Foaming
9.2. Other information
No other retevant Information.
Clear, Pale Yellow Liquid
Mild, Chlorine
Not Measured
11 500 - 14,900
Not Measured
i 212 deg F
a 201 degrees F PMCC (combustible)
0.33
Not Applicable
Lower Explosive Limit: Not Measured
Upper Explosive Limit. Not Measured
Not Determined
Not ❑elarmirled
1.100 - 1.222
Not Measured
Not Measured
Not Measured
Not Measured
Not Measured
Low
Section 10. Stability and reactivity

10.1, Reactivity
Hazardous Polymerization will not occur,
10.2. Chemical stability
Stable under normal circumstances.
10.3, Possibillty of hazardous reactions
No data available.
10.4. Conditions to avoid
Avoid high temperatures, heating, eta.
U.S. Incompatible materials
No data available.
10.6. Hazardous decomposition products
No hazardous decomposition data available
I
Section 11. Toxicological information
Acute toxicity
Ingredient
_ — --
Oral L050,
mglkg —
J
Skin L050,
— mglkg
Inhalation
Vapor Lc50.
mWLJ4hr
Inhatatlort
DU5triY WLCSo,
mgltl4hr
hrl+nlatien
Gas LC56•
p,—
Sodium hyppcMi>nie - frSSl-5�91
1.100.00. Rai - . Rnh6ll -
Cplrgory. q Category P1A
10.60. Rol -
Category 4
Ptu date BVAdgol0l Nu tldt9
AValrilWe
classification _
Category
Hazard Description
Acute toxicity (oral) JO
Not Applicable _
Acute toxicity (dermal)
Hot Applicable
Acute toxicity ;inhalation _ w _ _O
Not Applicable
Skin corrosienlirri[augn
1t3
Causes severe skin burns and eye damage.
Serious eye damagehrritation
Nat Applicable
(aspirate sansitizalian
Nat Applicable
Skin sens}tixaHon
Not Applicable
Germ cell mutagenicity
Not Applicable
jGarcriogenicity
�I
Not Applicable
Reproducllve toxicity
fNot Applicable _
STOT-single exposure
-.Not
Applicable _
STOT-single exposure
FFCLPTOI at)
(CL,PTOIDesc)
STOT-repeated exposure v�
Not Applicable
As iration hazard
Not Applicable
Section 12. Ecological information
12A1 Toxicity
No additional information provided for this product. See Section 3 for chemical specific data.
Very toxic to aquatic life.
Aquatic Ecotoxicity
IM1gredlent
96 111 LC5o fish,
{6 hr EC50 grustacea,
Ereso algae,
Iran
rn911
Sodium hypochlorile - [Tfial •52-9]
0 04. Plrnephaleg
0.USz, Papllnla rlldyna
040 (72 hr), Dunaliatla
Farnafas
prlrriWeCla
12.2. Persistence and degradability
This product Is fully biodegradable
12.3. Biaaccumulative potential
Nos Measured
12A. Mobility In soil
No data available
1219 Results of PJBT and vPvB assessment
This product contains no PBTIvPvB chemicals.
12.6.Other adverse effects
No data available.
Section 13. Disposal considerations
13.1. Waste treatment methods
Observe all federal• state and local regulations when disposing of Ihis substance

Section 14. Transport information
14_1. UN number
14.2. UN proper shipping name
14.3. Transport hazard classes)
14A. Packing group
UN1791
Hypochlorite SoiuBon
8
ill
Section 15. Regulatory information
Regulatory overview The regulatory data in Section 15 is not intended to be all -Inclusive, only selected
regulalions are represented.
Toxic Substance All components of this material are either listed or exempt from listing an the TSCA
Control Act i TSCA) Inventory.
EPCIZA 3111312 Chemicals and R4s (Ibs)r
Sodium hypochlorite ( 100.00)
EPCRA 302 Extremely Hazardous :
(No Product Ingredients Listed}
EPCRA 313 Toxic Chemicals:
(No Product Ingredients Listed}
Proposition 65 - Carcinogans (>O.0%):
INo Product Ingredients Listen)
Proposition 66 • Developmental Toxins (a0.0%)_
(No Product Ingredients Listed)
Proposition 65 - Female Repro Toxins (>0.0%):
(No Product Ingredients Listed)
Proposition 65 - Male Repro Toxins (>M %):
(No Product Ingredients Listed)
N.J. RTK Substances (a1°%):
Serum hypochlorlte
Penn RTK Substances (1 1):
Sodium hypochlorlle
Section 16, Other information
Issue Hate 3131 )Lookup Field Unknown)
Revision History 3131(Lookup Field Unknown)
The information and recommendallons contained herein are based upon data believed to be correct. However, no
guarantee or warranty of any kind, expressed or Implied, is made with reaped to the information contalned herein We
accept no responsibiIily and disclaim all liability for any harmful effects which may be caused by exposure to our
products. Customerslusers of this producl must comply with all applicable health and safety laws, r%ulalIons, and
orders.
The full text of the phrases appearing in section 3 is;
H314 Causes severe skin bums and eye damage.
H318 Causes serious eye damage.
H400 Very toxic to aquatic We
End of document

Safety Data Sheet (SDS)
'F� `CHEMSTATION 4523
SDS Revision Date: 0412512022
1. Identification of the substancelmixture and of the companylundertaking
1.1. product identifier
Product Identity
4523
Alternate Names
4523
1.2. Relevant Tdentified uses of the substance or mixture and uses advised against
Intended use
Contact ChemStation representative.
Application Method
Contact ChemStation representative.
1.3. Details of the supplier of the safety data sheet
Company Name
ChemStation of Eastern NC (Raleigh)
6275 NC-50
Benson. NC 27504
Emergency
CHEMTREC (t1SA) [phone]
Customer Service: ChemStation of Eastern NC 8W589625
(Raleigh)
2. Hazard identification of the product
2.1. Classification of the substance or mixture
Mel. Corr. 1;H290 May he corrosive to metals.
Acute Tox. 4;H302 Harmful if swallowed.
Skin Corr. 1AIH314 Causes severe skin burns and eye damage
2.2. Label elements
i
Danger
H290 May be corrosive to metals.
H302 Harmful if swallowed.
H314 Causes severe skin burns and eye damage.
[Prevention]:
P234 Keep only in original container.
P260 Do not breathe dust, fume, mist, vapors or spray
P264 Wash thoroughly after handling.
P270 Do not eat, drink or smoke when using this product.
P280 Wear proleclive gloves, eye protection, faze protection.
[Response]:
P301+330+331 IF SWALLOWED: Rinse mouth Do NOT induce vomiting
P303+361+353 IF ON SKIN (or hair)- Remove, take off immediately all con laminated clothing. Rinse skin with water,
shower.
P304+312 IF INHALED: Call a poison center or doctor or physician if you feel unwell.
P305+351+338 IF IN EYES- Rinse cautiously with water for several minutes. Remove contact lenses if present and
easy to do - continue rinsing.
P310 Immediately call a POISON CENTER, doctor or physician.
P340 Remove victim to fresh air and keep at rest in a position comfortable for breathing.
P363 Wash contaminated clothing before reuse.
P390 Absorb spillage to prevent material damage.
[Storage]:

P405 Store locked up.
P406 Store in a corrosive resistant, container with B resistant inner liner.
[Disposal]:
P501 Dispose of contents or container in accordance with local and national rsguIall ans.
3. Composition/information on ingredients
This product contains the rollowing substances that present a hazard within the meaning of the relevant State and
Federal Hazardous Substances regulations.
I.-dlenuChomical PeaT�nallane
W fit% _,
_ _ _GHS Clasalnwllan f
_ Naten
shdIUm ox hydrida
25 - 50
4'
11i[2]
CAS Number. 0001�70.79.7
,
Meu Co r 1:H290
Ic aci003d1138.65adfum call, 12.a3.}
C9AS
1,0- ]a
—
N mbor.
i
;fat
Eyan[rnY� 2;H 14
[ll Sutntancs oae%if ea wilh a haalth or emitor mnhtal hazard.
[21 Suhslance wilh a workplam exposure I'mil,
[3l PB7 substance or rPvB-su bsianw.
'The full le.ls V the phnses are alxmn in Sedan Is
Section 4. First aid measures
4.1. Description of first aid measures
Generol In all cases of doubt, or when symptoms persist, seek medical attention
Never give anything by mouth to an unconscious person.
Inhaiation
Remove to fresh air, keep patient warm and at rest If breathing Is irregular or stopped. give
artificial respiration. If unconscious place in the recovery position and Obtain immediale
medical attention. Give nothing by mouth.
Eyes
Irrigale copiously with clean water for at laaat 15 minutes. holding the eyelids apart and
seek medical attention
Skin
Remove contaminated clothing. Wash skin thoroughly with soap and water or use a
recognized skin cleanser.
Ingestion
If swallowed obtain trtimedia to medical attention. Beep at rest. Do NOT induce vomiting.
4.2. Most Important symptoms and effects, both acute and delayed
Overview
No specific symptom data available.
Check section 2.2 (GHS Label Elam+anm) for Further details.
Section 5. Fire -fighting measures
5.1, Extinguishing media
Recommended extinguishing media. alcohol resistant foam. CO2, powder, water spray.
Unsuitable extinguishing media! Do not use; water jeI
5.2, Special hazards arising from tha substance or mixture
Hazardous decomposition: No hazardous decomposition data available.
Keep only in original container.
Do not breathe dust fume, mist, vapors or spray
5.3. Advice for fire-fighters
Cool closed containers exposed to fire by spraying them with water. Do not allow run off water and contaminants rrom
Fire fighting tc enW drains or water ways
ERG Guide No. 154
Section 6. Accidental release measures
6.1. Personal precautions, protective equipment and emergency procedures
Put on appropriate personal protective equipment (see section 8)
6.2. EnVironmental precautions
Do not allow spills to enter drains or waterways
Use good personal hygiene practices Wash hands before eating, drinking, smoking or using Toilet. Promptly remove
solled clothing and wash thoroughly before reuse.
6,3. Methods and material for containment and cleaning up
Ventilate the area and avoid breathing vapors. Take the personal protective measures listed in section 8.
Contain and absorb spillage with non-combustible malerials e.g sand, earth. vermiculite Place in closed containers

outside buildings and dispose of according to the Waste Regulations. (Sea section 13).
Clean, preferably with a detergent ❑o not use solvents.
Do not allow spills to enter drains or watercourses.
If drains, sewers, streams or fakes are contaminaled, Inform the local water company immediately. In the case of
cpntaminalion of rivers, streams or lakes the Environmental Protection Agency should also be informed -
Section 7. Handling and storage
7.1. Precautions for safe handling
Handle containers carefully to prevent damage and spillage.
Check seclion 2.2 (GHS Label Elements) for further details. - [Preventron]!
7.Z. Conditions for safe slorage, including any incompatibilities
Incornpatible materials -Any acidic material, ammonia, urea, oxidizable materials and metalssuch as nickel, copper,
tin, aluminum and iron.
Check section 2-2 (GHS Lahti Etemenls] far further derails. - [Storage]:
7.3. Specific end use(s)
No data available.
Section 8. Exposure controls I personal protection
8.1. Control parameters
Exposure.
CAS HC,
_ _ Ingredient
- --
Source• J�
Va{ua
00013 t9.73-P
Sodlunl trydrmido !
4sHA
TWA 2 mAnn3 _ J
Caliing:2 mglm3
C 2 rnggn3 _ _ J
ACGIH
NIOSH ., ._.�
Supplier
No Established Limit
W311?9�5.5
O�luRo-Hoplonic aeld,.mollosodtum saK.
GSHA
Na Establiziled Llmtl _
No Established Limit
No Established Limll _
No Estak1khed Lln l
ACGIH
NIflSH !
5u her
Carcinogen Data
CAS No.
ingrsdiank S.". I Value
GOc1710-i3-2
de ETP: R iL:o ad Carcinogen: Nn
r7—
IARG Group i s No; Group 2a: No: Group 2b. No: Group 3- Nu: Gf44p 4. Nv.
e55112&E5-S '
n-gluco-HepWnle KW. gsHA j 4lated CarCinO ert' No
+
Idanosnduun sak, t2',%I j- NTP ! Known: Na Suspecled: No �_ J
AARC Group I . Na; G 2a= Np; Group 2h; Nw Gree6 3- No; Group 4 No.
8.2. Exposure contrals
Respiratory
Use MOSHMSHA approved respirator, following manufaclurees recommendations when
concentrations exceed permissible exposure limits.
Eyes
Wear approved eye protection. The use of a face shield is also recommended for skin
protection In the area of the eyes. An eye wash station is suggested as a good workplace
practice
Skin
Chemical resistant clothing such as coverallslapron boots should be worn. Chemical
Impervious Gloves
Engineering Controls
Provide adequate ventilation. Where reasonably practicable this should be achieved by the
use of local exhaust ventllafton and good general extraction. If these are not sufficient to
maintain concentrations of particulates and any vapor below occupational exposure lirtllts
suitable respiratory protection must be worn
Other Work Practices Use good personal hygiene practices- Wash hands before eating, drinking, smoking or
using toilet. Promptly remove soiled clothing and wash thoroughly before reuse.
Check section 2.2 (GHS Label Elements) for further details. - {Prevention]:
Section S. Physical and chemical properties

Appearance
Odor
Odor threshold
PH
Melting pa]ni f freezing point
tnittal boiling point and (roiling range
Flash Point
Evaporation rate (Ether � 1)
Flammability (solid, gas)
Upperilower flammability or explosive limits
Vapor pressure (Pa)
Vapor Dons ity
Re$ative Density
Solubility in Water
partition coefficient n•octanollwater [Lag Kow)
Auto -ignition temperature
Decomposition temperature
Viscosity (cst)
Foaming
9.2. Other information
No other relevant informallon.
Brown Viscous ilquid
Mild
Nat Measured
14.000 - 14.000
Nor Measured
a 212 deg F
> 201 degrees F PMCC (combusuole)
0.33
No(Applicable.
Lower Explosive Limit: Not Measured
Upper Explosive Limit Not Measured
Not Determined
Not Determined
1.431 - 1,441
Not Measured
Not Measured
Not Measured
Not Measured
Nol Measured
Low
Section 10. Stability and reactivity
10.1. Reactivity
Hazardous Polymerization will not occur-
101. Chemical stability
Stable under normal rurcumstances.
10.3, Pass IbIIIty of hazardous reactiorls
No data available.
10.4. conditions to avoid
No dale available.
10.5. Incompatibte materials
Any acidic material, ammonia, urea, oxidizable materials and metals such as nickel, copper, lin. aluminum and iron
10.6. Hazardous decomposition products
No hazardous decomposition data available.
Section 11. Toxicological information
Acute toxicity
Ingredient
Aral LD sn,
FSkM 1-1360,
Inhalation
Inhalalfan
Inhalation
mgrkg
mgalg
LCSO,
Wpgr
Dusd9hS LGSG,
Sapl,G54,
m ILldhr
m L14hr
m
Spolilln It/drp%Wa - t131U•T3.2J
325.Ot1 Rallhll -[a.ZT.h;1
Nv data
F.,O.U.
Hv Hale aVailal,le
No Gala
Catego a
Y
aveiki4le
❑-glucomopiomC acid 111ufH15oGIum salt. S2.%I. j• -
_--.
I51138.65-5j
N4 aela
No dale
Ne data
Mo Aala availahte
CJ
No tlala
�Yailahle
availeble
ayelehla
available —
Note: When no route specific LDS❑ data Is available for an acute toxin, the converted acute toxicity point estimate
was used in the calculation of the product's ATE (Acute Texiclty Estimate) -
flnhlab} jGHST❑rInhaly jGjHSSt❑tSEj IGHSASPHAL) [RESPSENSJ:�} [Eyelabi lLi]{SEyeDam} ;Ski
15kin5ensl �CPHSSkinCorj 01IN14h) (GHSToxOralj {Craniclah[ 1FAOther2[
ClassiHoation
Category
Hazard Descripttort
Acute toxicity (oral)
4
Harmful if swallowed.
ute t_oxlcity [dermal]
INot Applicable
Acule toxici [inhalation)
f
Fot Applicable_ _
Skin carrosionlirritation
rA _
Causes severe skin bums and eye damage.
Seriauseye damoolrrltation
�
NOt Applicabl0--
Respiratory sensitization
—
Not Applicable _
Skin sens_itizalion
��
Not Applicable j
Germ cell mulagenicity
�!
Not Applicable
Carcinogenicity
�i
NaS Applicable
Mob: lGIiSToxDcntli

lReoroduclive toxicity
Not Applicable
Section 12. Ecological information
12.1. Toxicity
No additional information provided for this product. See Section 9 for chemical specific data.
Aquatic Ecotoxicity
Ingredirnl
U hr LCg50 rtsh,
43 hr ECSG crostacoa.
ErC 0 algae,
Sodlvm hytlroxida - (131 0-73.2�
M.W. Garrltaua attmia
40.40. Canodaphnln sp.
Not AVallahle
❑-gtuW-Haponlc acW, monosodium sat1.12,x�.N -
131138-85,5j Mo�AvallaWe
Nol Avallahte
Not Available
12.2, Persistence and degradability
This product Is fully biodegradable.
12.3. Bioaccumuiative potential
Not Measured
12A. Mobility in soil
No data available.
1Z5. Results of PST and vAvB assessment
This prod ucl contains no PBTIvPvB chemicals
12.8, other adverse effects
No data available.
Section U. Disposal considerations
13.1. Waste treatment methods
Observe all federal, state and local regulations when disposing of this substance.
Section 14. Transport information
14A1 UN number NA1760
14.2. UN proper shipping name Compound, Cleaning, Liquid, (Sodium Hydroxide)
14.3. Transport hazard class(es) a
14A, Packing group III
Section 15. Regulatory information
Regulatory overview The regulatory data In Section 15 is not intended to he ail -inclusive. only selected
regulations are represenled.
Toxic Substance Ali components of this material are aither listed or exempt from listing on the TSCA
Controi Act (TSCA) Inventory.
EPCRA 3111312 Chemicals and Ras (Ibs}:
Sodium hydroxide ( 1,000.0O)
EPCRA 302 Extremely Hazardous
(No Producl Ingredients Llsled)
EPCRA 313 Toxic Chemicals:
(No Product ingredients Listed)
Proposition 65 - Carcinogens (>G.0%):
(No Product Ingredients Listed)
Proposition 65 - 0eve lopmental Toxins (�0.0
iNa Product Ingredients Listed)
Proposition 65 - Female Repro Toxins (a0.0%):
(No Product Ingredients Listed)
Proposition 65 - Male Repro Toxins (}0.0%):
(No Product Ingredients Listed)

N.J. RTK Substances (a1 I ):
SWoorn hydroxide
Penn RTK Substances (ai I ):
Sodium hydroxide
Section 16. Other information
issue Date 4523 (Lookup Field Unknown)
Revision History 4523 (Lookup Plaid Unknown)
The information ano recommendations contained herein are based upon data bel loved to be correct, However, no
guarantee or warranty of any kind, expressed or implied. is made with respect to the inforinaiion contained herein. We
accept no responsibility and dIsclarm all liability for any harmful effects which may he caused by exposure to our
products. Customerslusers of Ihis product must comply with all nppllcabte health and safely laws, regulations, and
orders.
The full text of the phrases appearing in seolion 3 is:
H290 May be corrosive to metals.
H314 Causes severe skin bums and eye damage
H315 Causes skin irritation.
H318 Causes serious eye damage.
H319 Causes serious eye irritation.
End of document

Safety Data Sheet (SDS)
4tCHEMSTATION 8635
SIDS Revision date: 0412912022
1. Identification of the substancelmixture and of the companylundertaking
1.1. Product identifier
Product Identity 9635
Alternate Names 9635
1.2. Relevant identified uses of the substance or mixture and uses advised against
Intended use
Contact ChemStation representative.
Application Method
Contact ChemStation representative.
U. Details of the supplier of the safety data sheet
Company Name
ChemStation of Eastern NC (Raleigh)
6275 NC-50
Benson, NC 27504
Emergency
CHEMTREC (USA) [phone]
Customer Service: ChemStation of Eastern INC 8884589625
(Raleigh)
2. Hazard identification of the product
2.1. Classification of the substance or mixture
Skin Corr. 11B;H314 Causes severe skin burns and eye damage.
2.2. Label elements
Danger
H314 Causes severe skin bums and eye damage.
[Prevention):
P260 Do not breathe dust, fume, mist, vapors or spray.
P264 Wash thoroughly after handling.
P280 Wear protective gloves. eye protection, face protection.
[Response]:
P301+330+331 IF SWALLOWED: Rinse mouth. Do NOT induce vomiting.
P303+361+353 IF ON SKIN (or hair): Remove, take off immediately all contaminated clothing. Rinse skin with water,
shower.
P304+340 IF INHALED: Remove victim to fresh air and keep at rest in a position comfortable for breathing.
13305+351+338 IF IN EYES: Rinse cautiously with water for several minutes. Remove contact lenses if present and
easy to do - continue rinsing.
P310 1mmedlately call a POISON CENTER, doctor or physician.
P363 Wash contaminated clothing before reuse.
[Storage]:
P405 Store locked up.
[Disposal):
P501 Dispose of contents or container in accordance with local and natlonal regulations.
3. Composition/information on ingredients

This product conlains the fallowing substances that present a hazard within the meaning of the relevant State and
Federal Hazardous Subslances regulellons.
IngredtentfChemical Qesignallans �
Wefphl 5L _�
_ GHS Classlfl_ca_Ilon
_ __ Natas
Phormhorieacld
1.0-40
Itlf21 r
CAS Number: 0001664.38.2 - - --
-—SkinCPtr16;N374
_
NIS acid
].a - 50
272
3H
CAN umben 000768T-37.2
SkiU Cvr. A:H314
_
1-PraP snamlRl urn, 3-21111[no-N-Ira rboxymaihyll-N,N-
1.0 • t0
shin irrlt, 2:H315
[1]
d Irneth I-, Wcoco ac I derivalivea, h droxldes. inner
Y Y Y
E Irrit, 2;H319
Ya
salts
Aquatic Acute i;H400
CAS Num6or. 067789-40.0
TripropYleneglyaalmanntnefllyle7har
CAS Nurnber. 00254SI-49-t
1.0-10
Not Classified
4]
7] Suhalanc0 d"siF*d with a health or anvimnmsntal hazard.
71 substance mih a workplace exposure limit.
[31 PST substawe or vPVH-substance.
'The full texts or Iho ell rasa% are ariown yr S: Pildn Fa.
Section 4. First -aid measures
4.1. 0escription of first al measures
General In all cases of daubt, or when symptoms persist, seek inedicaI attention.
Never give anything by mouth to an unconscious person.
Inhalation
Remove to Fresh air, keep patient warm and at rest. If breathing is irregular or stopped, give
artificial respiralion. If unconscious place In the recovery position and obtain immediate
medical attention. Give nothing by mouth.
Eyes
Irrigate copiously with dean fresh water for at least 15 minutes, holding the eyelids apart
and seek medical attention.
Skin
Immediately flush the area with large amounts of water far at least 15 minutes, while
removing contaminated clothing. Launder clothing before re -use. Calla physician.
Ingestion
Do NOT induce vomiting. Rinse mouth and slowly drink several glasses of water. Call a
physician. Do NOT give anything by mouth to an unconscious or ccnvulsing person.
4.2. Most Imponant
symptoms and effects, both acute and delayed
Overview
EFFECTS OF OVEREXPOSURE:
SKIN: ❑irect contact may result in irritation. reddening, swelling, and, if untreated, severe
skin damage.
EYES: Contact may cause severs irfilaWn and corneal damage, if untreated.
INGESTION: May cause harmful to fatal chemical hums to the moulh, esophagus. and
stomach.
INHALATION: Aerosols and mists may severely damage contacted tissue and produce
scarring. Exposure to high comenirations may cause put monary edema and chemical
pneumonia.
Check section 2.2 (GHS Label Elements) For furtherdelails.
Section 5. Fire -fighting measures
5,1. ExttnguIshing media
Recommended extinguishing media; alcohol resistant foam. CC12, powder, Water spray.
Unsuitable extinguishing media: Do not use; water jet.
5.2. Special hazards arising from the substance or mixture
Hazardous decomposition Oxides of carbon and nitrogen.
Do not breathe dust, fume, mist, vapors or -spray.
5.3. Advice for fire-fighters
Coot closed containers exposed la fire by spraying them with water. Do not allow run off water and contaminants from
fire hghling to enter drains or water ways.
ERG Guide No. 154
Section 6. Accidental release measures
6Ar Personal precautions, protective equipment and omargency procedures
Put on appropriate personal prolactive equipment (see section a).
6.2. Environmental precautlons
❑o not allow spills to enter drains or waterways
Use good personal hygiene practices. Wash hands before eating, drinking, smoking or using toilet. Promptly remove
soiled clothing and wash thoroughly before reuse.
6.3. Methods and material for containment and cleaning up

Ventilate the area and avoid breathing vapors. Take the personal protective measures Ilsled in section 8.
Contain and absorb spiiIage with non-combustible materials e.g. sand, earth, vermiculite- Place in closed containers
outride bulldings and dispose of according to She Waste Regulations. [See section 13).
Clean, preferably with a detergent- ❑o not use solvents.
Do not allow spills to enter drains or watercourses.
If drains, sewers, streams or lakes are contaminated, inform the local water company immediately. In the case of
contamination of rivers, streams or lakes the Environmental Protection Agenoy should also be Informed.
Neutralize residual product in the spill area using sodium carbonate or sodium bicarbonate.
Section 7. Handling and storage
7.1. Precautions for safe handling
Handle containers carefully to prevent damage and spillage.
Check section 2-2 (GHS Label Elements) for further details. - [Prevention];
7.2. Conditions for safe storage, including any incompatibilities
Store in a coal dry place.
Incompatible materials This product will liberate flammable hydrogen gas when in eonlact with most metals. Avoid
contact with cyanides, sulfides, sulfites, chlorine or chlorine bleaches. which would release toxic gases. Avoid contact
With strong alkalis and mild steel
Check section 2.2 {GHS Label Elements] for further details. - IStorage]:
7,3. Speciffc end uselsj
No data available.
Section B. Exposure controls 1 personal protection
8.1. Control parameters
Exposure
cAs No, _I
ir-,wo lent _
Sourcn
_ _V_ aloe
0007004.78-2
Phosphoric acid
T
JOSKA
ITWA 1 M91M3
ACG4H
TINA; 1 mg+m3STEL: 3 mg+m3
NIOSH
TWA t rtgfm3 ST3 mg7m3 J
Ne Eslarkrtihed
OfM789737.2
___ _
Nllribacid
_
OSHA I
TWA 2 ppm (S mgfm3)
ACGIN
_
}'WA_' 2 Ppm Cailln9: y PPm _
— -
NIQSH
TWA 2 pis me r— j ST 4 ppm tp n 3)
Nq Esk17115hBd Limit ~
�pIN!r
0025498.49-1 J
rlpmpylena glycol nlwamelhyl alll r
INo Estabished Unilt
No Estehlisned Llmll _ _ _
~
ACGIH !
NIOSM
No Estdblished Urr l __
5uppller
llkLo Established Llinit
0061789AQ-0
�
1-Pmpanaminium, 3-amina-N•
I carbo><ymelhyll•N,N-dlmethyl-, N•wce
doy4 genral•ves, hydroz;des, +boar sdlt9
�
OSHA _
No Established Limb
CG{H f
No EsWbWsh ed Limit
NIOSH .
No Established LlRdl
No Established Ltmll_
Supplier I
Carcinogen Data
CAS Na. —it
_ - _ _. I redlRnt_—__
$wrce.
_ _ _ _ Value _
7717-2
177__
NTP .Irwwn:No;uspected;
u
IARC
Gmyp }- No; Group 21 No- Group 2b: No, Group 3- No; GrWP 4! NO:
77691'-117-1-
Wric acid
0—
Regulated Cardtnoga+r No _
NTP
Known. No, Sus ecled; No
— — -- —
wA
Group 1: Nd; Grodp 2a; Na: G_ra_ up 2tr: Nv; _Group 3: No; Grarp 4; No; _
���f
Z549a-49.1
r
Tripropylene glycol monomelhyl
allmr
_ _ _ _ _�
OSHA
Ragulalod Carcinogen: No
NTp
Rnown Nd, Suspe.Gad No
lARC
Group 1: No; Group 22; Na; Gfuup .n: Nv; _Group 3' Na; i3rou d: No;
aDE1759-40-0
I I-Prppanarneaurh, 3-0mu10-N- j
;cartrokyl d0v tlyos' iydm*d N•
corn acyl denvatluos, hydlo>ndes,
+nner salts
QSHA
Regulaled carorkogow No
NTp
Known: NO: Suspaclad' Na
IARC !
T
Grou 1: No; Group 2a: No; Group 2b: Na; Group 3 No: Group 4 No-
8.2. Exposure controls
Respiratory If workers are exposed to concentrations above the exposure limit Ihey must use the

appropriate, cerlifled respirators
Eyes
Wear a full lace shield if mixing or pouring this material.
Skin
Overalls which cover the body, arms and legs should be worn- Skin should not be exposed.
All parts of the body should be washed after conies!. Use neoprene or rubber gloves.
Engineering Controls
Provide adequate ventilation. Where masonabiy practicable this should he achieved by the
use of local exhaust ventilation and good general extraction If These are not suffcieni to
maintain concentrations of particulates and any vapor below occupational exposure limits
suitable respiratory protection must be worn -
Other Work Practices
An eyewash fountaln should be Ioraiad In areas where the product is used. Use good
personal hygiene practices. Wash hands before eating, drinking, smoking or using toilet.
Pfomppy remove soiled clothing and wash thoroughly before reuse.
Check secitan 2.2 (GHS
Label Elements) for further detalls- - [Prevenbonl-.
Section 9. Physical and chemical properties
Appearance
Odor
Odor threshold
PH
Melting point f freezing point
Initial boiling point and boiling range
Flash Paint
Evaporation rate (Ether = 1)
Flammability (solid, gas)
Upperllower flammability or explosive limits
Vapor pressure (Pa)
Vapor Density
Relative Density
Solubility in Water
Partition coefficient n-octanollwater (Log Kow)
Auto -ignition temperature
Deeompositlon temperature
Viscosity (Cst)
Foaming
9.2. Other information
No other relevant information.
Clear, Colorless Liquid
Mild
Not Measured
0-100 - 0,500
Not Measured
y 212 deg F
- 201 degrees F PMCC irombuslible)
0,33
Not Applicable
Lower Explosive Limit: Not Measured
upper Explosive Limit: Not Measured
Not Determined
✓`lot Determined
1.109 - 1,119
Net Measured
Not Measured
Not Measured
Not Measured
Not Measured
Moderate
Section 10. Stability and reactivity
10.1. Reactivity
Hazardous PolymerizMion will not occur.
10.2. Chemical stability
Stable under normal circumstances.
10.3. Possibility of hazardous reactions
No data available.
1DA. Conditions to avoid
High temperatures, Flames, and incompatibles.
Do not store near cyanide or oil lorine-containing compounds,
10.5. Incompatible materials
This product will liberate llamm able hydrogen pas when in contact with most metals. Avoid aentact with cyanides,
sulfides, sulfites. chlorine or chlorine bleaches, which would release toxIC gases. Avoid contact wlth strong alkalis and
mild steel.
10.6. Hazardous decomposition products
Oxides of carbon and nitrogen.
Section 11. Toxicological information
Acute toxicity
Ingredient
oral LD50.74o
1 0
Inhalation
-
iGas
10
Vapor LC50Inherallan,
Oq tfflist
LC50,
mg+l74hr
rng1L74hr
Phosphmr.. acid • fAEF4.38-21
l.70t].bU. Rat -
�����
�x.00R.00,
VJn data
Nb dafa available I�� dale

Cakgury 4 �Caiegbory
Ris
5
I available �I
L
�
avaiW6ly
Nitric acid - (7697.37.2y
L
No data
No data
No flfrla
Y,5U0-00. Ral -
Nv ttalll
availahW
avallahle
available
Categpry NA
available
mcaco
dime hy1-aN acyl dwrVallvas AydImmos] (Inner
Nod la
Nd data
Nd data
Nv dale aVailahla
dal.
sails-{6f7S9.400j
availably-
available
avallahk
avalFable
Tripnpylene glycol monvmwho ather-(25495-49.1)
--- J
—No
T
j No Ha'a
No data
Nv dale
No dale available
�
Nn Bala
j evadable
svallahle
I avallahle
available
Classification _ _E
Category
j Hazard Description
Acute loxicity (prat) _
Not Applicable j
Acute toxicity (dermal) — _ _ _ l
J
Not Applicable j
Acula Wx rily�L_ ationj —
�I
Nol Applicable
Skin corrosionfirrltation
1 S
j Causes severe skin bums and eye damag_ e.
Serious eye damage irritation_ _ I
—
Not Applicable
Respiratory sensitization _
� j
Not Applicable ____ _ _ I
Skin sensitization
Not Applicable
Germ ceH mutagenioity
f Not Applicable j
Carcinogenicity
Not Applicable_
Re reductive toxicity F--
]
Nat Applicable
STOT-single exposure
F
Not Applicable j
STOTsin&exposure
{CLPT01C81�1
UPTpIDesc J
STOT-repeated exposure
�-
J
Not Applicable j
Aspiration hazard ���--
Nat Applicable
i
Section 12. Ecotogicat information
12A. Toxicity
NA additional information provided for this product. See Section 3 for chemical specific Bala_
Aquatic Ecotoxlclty
Ingndlonl
— -
9fi hr LCSe fish,
II
411 hr EC5p crustacea.
mall
ErC5t1 algae.
mg11
PnrnWxx+e and - f75v4-:i8-21
- --
- - - —
75,10, Oryalas lalilms
101-00, Daphnia Magna
[GI 09 (72 hrl, ❑osmodesmirs
SUhyplcalvs
Nlulc acid - l7&97-37-2 )
l
fi,fi56. Liamhhala
490-0e, Daphne Mn"
Not Avaaegle
1-Prdpanaminlum, 3-amino-N{car6axymelnyl]-N,N-
dirna" -. N•coea acyl darfvativas. hydtoxldes, innpF
Nat Avadabla
Nal Available
Nok AmNable
sails-1817a9�a•el
- - w 1
- --
---------
THlxopylena glycol monomelhyl enter i25-099.49.1]
Nnt Avadabte
Nh1 Available
Not Available
12,2- Persistence and degradability
This product is fully biodegradable-
12-3- Bloaccumulative potential
Not Measured
12.4. MobIlity In Boll
No data available
112.5. Results of PST and vPvB assessmenl
This product contains no PSTIvPvl3 chemicals
12.6. Other adverse effects
No data available
Section 13. Disposal considerations
13.1. Waste treatment methods
Observe all federal, stale and local regulations when disposing of this substance
Section 14, Transport information

14.1. UN number NA1760
14.2. UN proper shipping name Compound, Clsaning, Llquid. (Phosphoric Acid)
14.3. Transport hazard class(es) 8
14A. Packing group ill
Section 15. Regulatory information
Regulatory Overview The regulatory data in Section 15 is not Intended to be all-inclusive. only seleated
regulations are represented.
Toxic Substance All coompanents of this material afe eithef Iisled or exempt from listing on the TSCA
Control Act ( TSCA) Inventory.
FPCRA 3111312 Chemicals and RRs (Ihs)
N96c.acid ( 1,000.00)
Phosphoric acid ( 5,000.00y
EPCRA 302 Extremely Hazardous:
Nitric acid
EPCRA 313 Toxic Chemicals;
Nitric acid
Proposition 65. Carcinogens (>0.0%):
(No Product ingredients Listed)
Proposition 65 - DeveIopmental Toxins
(No Product Ingredients Listed)
Proposition 65 - Female Repro Toxins (50.0 ):
(No Product Ingredients Listed)
Proposition 65 • Male Repro Toxins (>0.0%):
(No Product Ingredients Lislad3
N.J. RTK Substances (>1%):
Nitric acid
Phosphoric acid
Penn RTK Substances (>TY ):
Nitric acid
Phosphoric acid
I
Section 16. Other information
I
Issue Gate 9535 (Lookup Fleid Unknown)
Revision History S535 (Lookup Field Unknown)
The information and recoinmendalions contained herein are based upon data believed to be correct. However, no
guarantee or warranty of any king, expressed or implied, is made with respect to the information contained herein. We
accept no responsihility and disclaim all Iiability for any harmful effects which may he caused by exposure to our
products. Customersfusers of this product must comply with all applicable health and safety laws, regulations, and
orders.
The full text of the phrases appearing in section 3 is
H272 May Intensity fire; oxidizer.
H314 Causes severe skin burns and eye damage.
End of Document

Safety Data Sheet (SOS)
*ISCHEMSTATION 30094
Say Revision Date: 0711 W2 022
1. Identification of the substancelmixture and of the companyfundertaking
1.1. Product identifier
Product Identity
30094
Alternate Names
30094
1.2. Relevant identified uses of the substance or mixture and uses advised against
Intended use
Contact ChemStation representative.
Application Method
Contact ChemStation representative.
1.3. Details of the supplier of the safety data sheet
Company Name
ChemStation of EaMem NC (Raleigh)
6275 NC-50
Benson, INC 27504
Emergency
CHEMTREC (USA) [phone]
Customer Service: ChemStation of Eastern NC 8884589625
iRaleigh)
2. Hazard identification of the product
2.1. CiassiItcation of the substance or mixture
Met. Corr, 1:H290 May be corrosive to metals.
Acute Tox. 5,H303 May be harmful if swallowed_ (Notethis GHS classification was not adopted by US
OSHA).
Skin Corr. 1A:H314 Causes severe skin burns and eye damage,
2.2. Label elements
Danger
H290 May be corrosive to metals,
H303 May be harmful If swallowed.
H314 Causes severe skin burns and eye damage.
[Prevention]:
P234 Keep only in original container.
P260 Do not breathe dust, fume, mist, vapors or spray.
P264 Wash thoroughly after handling.
P260 Wear protective gloves, eye protection, face protection.
[Response]:
P301+330+331 IF SWALLOWED. Rinse mouth Do NOT induce vomiting.
P303+361+353 IF ON SKIN (or hair): Remove, take off immediately all contaminated clothing, Rinse skin Wlth Water,
shower.
P304+312 IF INHALED: Call a poison center or doctor or physician If you feel unwell.
P305+351+338 1F IN EYES: Rinse cautiously with water for several minutes. Remove contact tenses if present and
easy to do - continue rinsing.
P310 Immediately call a POISON CENTER, doctor or physician.
P340 Remove victim to fresh air and keep at rest in a position comfortable for breathing.
P363 Wash contaminated clothing before reuse.
P390 Absorb spillage to prevent material damage.
[Storage]:

P405 Store locked up.
P406 Slore in a corrosive resistant, container with a resistant Inner liner.
[Disposal]:
P501 Dispose of contents or container in accordance with local and national ragulalrons.
3. Compositionlinformatiion on ingredients
This product contains the following substances that present a hazard within the meaning of the relevant State and
Federal Hazardous Substances regulations.
ingrediantlChomical best na[g Ions _ ^
Wafyflt;G
GHS Ciasaffrcatl on
NnSes
sodium hydroxide
1,a -10
Skin Cnrr.1A;H314
][2y
CAS Numbar: 0001310.73.2
— -------1.0-70
MaS._Corr. 1;H240 _ _
stdium
5•kirneUCAoUBeF13H14
CASNurnhar:hlorlte 0007681.52.9
j
d00
- -
Eye oam, i:H3i8
ill SUbsierrce classified vrlth a health m ntmrornrnentel hazard.
2] 54so a Wllh a workplace a%po5Nre Irrml
131 PDT-Nubstanoe dr vPv8-w1Y91antA
'The roil toxic of the phrases are shown In Sod an ts.
Section 4. First -aid measures
4.1. Description of first aid measures
General
In all cases of doubt. or when symptoms persist, seek medical attention.
Never give anylhing by moulh to an unconscious person
Inhalation
Remove to fresh air, keep patient warm and at rest, If breathing is irregular or stopped, give
efficlat respire tion. If unconscious place in the recovery position and obtain immediate
medical attention. Give nothing by mouth.
Eyes
Irrigate copiously with dean water for at least 15 minutes. holding the eyelids apart and
seek medical attention.
Skin
Remove contaminated clothing. Wash skin thoroughly with soap and wafer or use a
recognized skin cleanser.
Ingestion
If swallowed Obtain Immediate medicai attention. Keep at rest. Do NOT induce vomill ng
4.2. Most important
symptoms and effects, both acute and delayed
Overview
No specific symplom data available.
Check section 2.2 (GHS Label Elements) for further del ails.
Section 5. Fire -fighting measures
5.1. Extinguishing media
Recommended extinguishing media; alcohol resistant foam, CoF, powder, water spray.
Unsuitable extinguishing medla Do not use; walerjet.
5.2. Special hazards arising from the substance or mixture
Hazardous decomposition: No hazardous decomposition data available.
Keep only in original container.
Do not breathe dust, fume, mist, vapors or spray.
5.3. Advice for fire-fighters
Cool closed containers exposed to fire by spraying them with water. Do not allow run off water and contaminants from
fire fighting to enter drains or water ways.
ERG Guide No. 154
Section 6. Accidental release measures
6,1. Personal precautions, protective equlpment and emergency procedures
Put on appropriate personal protective equlpment tsee. section 8].
6.2. Environmental precautions
Do not allow spills to enter drains or waterways -
Use good personal hygiene practices. Wash hands before eating, drinking, smoking cr using idle[ Promptly remove
soiled clothing and wash thoroughly halo re reuse.
6.3. Methods and tnaterial for containment and CIO aning up
Ventilate the area and avoid breathing vapors. Take the personal protective measures listed in section 8

Contain and absorb spillage with non -co mbuslIble malariais e.g. sand, earth, vermiculite. Place in closed containers
outside buildings and dispose of according to the Waste Regulations. (See sectlon 13).
Clean, preferably with a detergent, Do not use solvents.
Do not allow spills to an ter drains or watercourses.
If drains, sewers, streams or lakes are con laminaled, inform the local water company immed lately. In the case of
contamination or rivers, streams or IalkPs Ilie Environmental Protection Agency should also be Informed
Section 7. Handling and storage
7.1. Precautions far safe handling
Handle containers carefully to prevent damage and spillage.
Check sedan 2.2 (GHS Label Elements) for further details. - [Prev enlianJ:
7.2. Conditions for safe storage, including any Inccmpatihilitlas
Incompatible matarlals: Any acidic materlal, ammonia, urea, oxidizable materials and metals such as nickel, copper,
tin, aluminum and iron
CheCk section 2.2 (GH5 Label Elements) for lurther details. - [Sloragej:
7.3. Specific end use(s)
No data available.
Section 8. Exposure controls ! personal protection
L
8.1. Control parameters
Exposure
CAS tiaL
ingradienS
_
Source
Value
040131Q73-2 I
Sodium hydroxide
t
_ fj
OSHA
ACGiH
Su lur _ ]I
iWA 2 m m3
Cell :2 mglm3
No Eslabished Limll
4067851.52-9
Sodium FypnEblmdle
OSHA _
Nn Eslau9slled umR
ACGIH
No EeffiWiehed Limit
No E1%1Aizhed Llmlt
NIpSM
Su IW �
No Established Limit
Carcinogen Data
CAS Ha.
Iggredlenl __ Source`
_ Value
4G4137e73R
Scdlum hydrvXlda O5ru1 '
NTP 11Krw
RB ul Oisd Cercin �NB
No; Sueperr , 4o
Group 1 No; Group 2a: No: Group 2d: No; Group 3- Nd; Grcu d_ 14w
�
044708132.9
Sadlum hypochlorltu
OSHA
Regulated Carcinp�Jen: Ntr f
NTF
t l—: No; Suspected; No
IARC
rrraup 1 No; Group 2`a- Nd; Grdup 20: No: Group I No; Group 4: No:
8.2. Exposure controls
Respiratory
Use NIOSHIMSHA approved respirator, fallowing manufacturer's recommendations when
concentrations exceed parmissIble exposure limits.
Eyes
Wear approved eye protection. The use of a face shield is also recommended for skin
protection in the area of the eyes. An eye wash stalIon is suggested as a good workplace
practice.
Skin
Chemical resistant clothing such as cove rallslapron boots should be worn. Chemical
Impervious Gloves
Engineering Controls
Provide adequate ventilation. Where reasonably practicable this should be achieved by the
use of local exhaust venlilation and good general extraction. If these are not sufficient to
maintain concentrations of particulates and any vapor below occupational exposure limils
suitable respiratory protect3on roust be wom.
Other Work Practices Use good personal hygiene practices. Wash hands before eating, drinking, smoking or
using toilet. Promptly remove soiled clothing and wash thoroughly before reuse.
Check section 2.2 (GH5 Label Elements) for further details. - [Pravention]7
Section 9. Physical and chemical properties

Appearance
Odor
Odor threshold
PH
Melting point I freezing point
Initial boiling point and boiling range
Fiash Point
Evaporation rate (Ether =1)
Flammability (solid, gas)
Upperllowe r flammability or explosive limits
Vapor pressure (Pa)
Vapor Density
Relative Density
Solubility in Water
Partition coefficient n-octanollwater lLog Kow]
Auto4gnilion temperature
Decomposition temperature
Viscosity (CSt)
Foaming
9.2. Other Information
No other relevant information.
Yellow Thin liquid
Chlorine
Not Measured
11700- 14,000
Not Measured
} 212 deg F
- 201 degrees F PMCC (combustible)
0.33
Not Applicable
Lower Explosive Limit. Not Measured
Upper Explosive Limit: Not Measured
No[ Determined
Not Determined
1.123- 1,133
Not Measured
Not Measured
N61 Measured
Not Measured
Not Measured
Moderate
Section 10. Stability and reactivity
10.1. Reactivity
Hazardous Polymerization will not occur.
10.2. Chemical stabiltty
Stable under normal broumstances
10.3. Possibility of hazardous reactions
No data available.
10.4. Conditions to avoid
No data available.
10.5. Incompatible materials
Any acidic malerlal, ammonia, urea, oxidizable materials and melals such as nickel, copper, tin, aluminum and iron.
10.6. Hazardous decomposition products
No hazardous decomposition data available.
Section 11. Toxicological information
Acute toxicity
ingrsdiant
Ortl L050,
Skin L05d,
Inhalation
Inhalation
Inhalation
mgfk t
nl !k
9 e
Va LCSa.
POf
Oksllkrlst LC50,
Gas LC59,
��
_
mg7u41r
Mh U4 r
ppm�
Stld1smhydruxide-[7310.73.2}
325 00, Rabbit -
����
Nd tlata
No data
No dale avai4ibla
Np bola
CBlagory-
evailops
oradahle
:iVallaHte
Sodium hyptlChlonle - [7b8 Y-52.9]
},iOp.pn, Rol -
liabhll -
t0 50. Rat -
No data available
Ne data
Category: 4
t:ateghry' NA
cat -pry: d i�
avallede
!Classification J
Category
Fiaxard Description_ _
Acute toxicity (oral)
5
May be harmful if swallowed- [Note: this GHS
1 _
alassifcation was not adopted by US_OSHA).
__ _ _
]Acute toxicity [dermal}_
lNot Applicable
Acute toxicity [inhalation]
fJ
Not Applicable
Skin corrosionlirritation
1A
Causes severe skin burns and eye damage.
Serious eye demagelirritation
Not Applicable
Respiratory sensitization
^
Nol Applicable
Skin sensitization _ F
--
Nol Applicable _
Germ calf mutagenicity F—
Nal Applicable
Carcinagenicity
_ --- _
No[ Applicable
Reproductive toxicity
—
Nolicabfe
_
STOT single exposure_ -- -
7—
JI
Nol Applicable _
STOT-single exposure
{CLPTO1cat)
[ReLPTOicesc)

LSTOT-repeated exposure JENot Applicable
splratlon hazard Noi Applicable
Section 12. Ecological information
12.1, Toxicity
No addltionat information provided for this product. See Section 3 for chemical specific data.
Aquatic Ecotoxieity
Ingredlanl
95 hr LC50 nth,
roll
48 hr EC50 crustarea, IF
_ m911
ErC50 a19aN,
h n _- .-.
SorL��m hydroxide - (t 3 f c-73�21
125.00. Gnmbucia afOnia I
dodo, CetiodaphrHa sp.
Nol Avallaple
SCdlian nYI:MUhlorII@ - Iril5lr>2-s1
0.08, Plmeph8lns
F11m .032 bapnnin agna
pA0 (i2 hr}, Ptimallaila�
pranrelaz
primaleeta
17-2. Persistence and degradability
This product is Sully biodegradable
12.3. Bioaccumulative potential
Not Measured
12A. Mobility in soil
No data available,
12.5. Results of PST and vPVB assessment
This product contalns no PBTivPvB chemicals
12.6. Other adverse effects
No data available
Section 13. Disposal considerations
13.1. Waste treatment methods
Observe all federal. slate and local regulations when disposing of this substance.
Section 14, Transport information
14.1. UN number NA1760
M2. UN proper shipping name Compound, Claaning, Liquid. (Sodium Hydroxide)
14.3. Transport hazard class(es) 8
14.4. Packing group III
Section 15. Regulatory information
Regulatory Overview The regulatory data In Section 15 is not intended to he all-inclusive. only selected
regulations are represented.
Toxic Substance Ali components of this material are either listed or exempt from listing on the TSCA
Control Act (TSCA) Inventory.
EPCRA 3111312 Chemicals and R4s (lbs):
Sodium hydroxide (1,000.00)
Sodium hypachlorite ( i0g.00)
EPCRA 302 Extremely Hazardous :
(No Product Ingredients Listed)
EPCRA 313 Toxic Chemicals:
(No Product Ingredients Listed)
Proposition 65 - Carcinogens (aO.O%)!
(No Product Ingredients Listed)
Proposition 65 - Developmental Toxins (�O.0%)-
(No Product Ingredients Listed)
Pro posltton OS - Female (Repro Toxins (a0,0%):
(No Product Ingredients Listed)
Proposttion 65 - Male Repro Toxins [>0.0%)i
(No Product Ingredients Listed)
N.J. RTK Substances (>i Inj;

Sodium hydroxide
Sodium hypochlonte
Penn RTK Substances
Sodium hydrokide
Sodium hypoehlorite
Section 16. Other information
Issue Date 0410812015
0412912015
051210015
0712712015
0811712015
021014016
05iW2016
0813012016
M012017
0911512018
09114/2019
05103/2022
0WW2022
0710812022
07114=22
07115r2022
0711812022
Revision History 300940"&2015
0412912015
05121r2015
0712712015
0811712015
0210112016
05/0612016
Oa13612016
05120/2017
0911512018
0911412019
OW0312022
06/06/2022
0710812022
07/14/2022
07/15/2022
07118/2022
The information and moommendatlons contained herein are based upon data believed to be rArrect. However, no
guarantee or warranty of any kind, expressed or implied, Is made with respect to the information contained herein. We
accept no responsibi I ky and disclaim all ION IIty for any harmful effects which may he caused by exposure to our
producls. Cuslomerstusers of this product must comply with all applicable health and safety laws, regulations, and
orders.
The ful text of the phrases appearing in section 31s:
1-1290 May be corrnme to metals.
H314 Causes severe skin burns and eye damage.
H316 Causes serious eye damage.
H400 Very toxic to aquatic life
End of Document

Safety Data Sheet (SDS)
45542
SIDS Revision Date: 0311012021
1. Identification of the substancelmixture and of the company/undertaking
1.1. Product identifier
Product Identity 45642
Alternate Names 45642
1.2, Relevant identified uses of the substance or mixture and uses advised against
Intended use
Contact CherrmStatien representative.
Application Method
Contact ChemStation representative.
1.3. Details of the supplier of the safety data she et
Company Name
ChemStalion of NC (Greensboro)
1121 Willowbrook Or.
Greensboro, NC 27403
Emergency
CHEMTREC (USA) (800) 424-300
Customer Service: ChemStation of NC (Greensbora) (336) 2944050
2. Hazard identification of the product
2.1, Classification of the substance or mixture
Skin Irrit. 3:H316 Causes mild skin irritation. (Nate: this GHS classification was not adopted by US OSHA),
Eye Init. 2;H319 Causes serious eye irritation.
12. Label elements
■
Warning
H316 Causes mild skin irritation.
H319 Causes serious eye irritation,
[Prevention]:
P264 Wash thoroughly after handling.
P280 Wear protective gloves, eye protection, Face protection.
[Response]:
P305+351+338 IF IN EYES: Rinse cautiously with water for several minutes. Remove conlact tenses if present and easy
to do - continue rinsing.
P332+313 ff skin initation occurs: Gel medical advice or attention.
P337+313 If eye irritation persists. Get medical advice or attention.
[Storage]:
No GHS storage statements
[Disposal]:
Na GHS disposal statements
45642 page 1 of 7 Fbvision Date: 3/10/2021

I Compositionlinformation on ingredients
This product contains the following substances that present a hazard within the meaning of the relevant State and
Federal Hazardous Substances regulations.
Ingredie ntlChemical DLsignations
Nkight %
ISM Ciaos-dfcation
hates_
Sndlumsilicate
1.0-10
SkinIrrit.2*015[1]
CASWumber. W013"-O 9
- - —
rare Dam. 1;M1a
J
249utoxy-ethanol
1.0-10
Acute TaxA;Ki32
[11121
CASWmber. OM11-7rs2
AcutaTex 4:hR12
A ule Tax. 4;KWZ
Eye Irr it, 2'M19
i8kin irrit.2;H315
Tox.4;h[i02
Tax A 1 2
FE�,2A,.Wl
Isodiurndodetylbenzenesulfonate
CAS Number: 00251SFr30.0
1A-10
1am.
[1) Suhslaice dasaiw with a NOh nr uwe'anrrenlal hazard.
[2] Substance w�1h a worlplace exposure link[3) PBT-slbslance cr vF &substance.
7ha tu➢ lexls 0 the ovwes ors shown in Secllon 15.
Section 4. First -aid measures
4.1. Description of first aid measures
General In all cases of doubt, or when symptoms persist, seek medical atterion
Now give anything by n lth to an unconscious person,
inhalation
Remove to fresh air, keep patient warm and at rest. If breathing is irregular or stopped, glee
artificial respiration. If unconscious place In the recovery position and obtain Immadbate
medical attention. Gi e nothirg by ntouth.
Eyes
Irrigate copiously with clean water for at least 15 minutes, holding the eyelids apart and seek
medical attention.
Skin
Remove contaminated clothing. Wash skin thoroughly with slap and >nater or use a
recognized skin cleanser_
Ingestion
If swallowed obtain immadiIale medical attention. Keep at rest. Do NOT induce uxniting.
&2. Most important
symptoms and effects both acute and delayed
Overview
No specific symptom data a%eiIalle.
Check section 2.2 (GHS lzihel Elements) far further details.
Eyes
Causes senous eye imtation.
skin
Causes mild skin irritation. (Note: this GHS classification was not adopted by US OSHA),
Section 5. Fire -fighting measures
5.1. Extinguishing media
Pecommeneted extinguishing media; alcohol resistant foam. COZ, powder, water spray.
Unsuitable extinguishing meda: Do not use; water jet
5.2, Speclal hazards arising from the substance or mixture
Hazardous decomposition: No hazardous decomposition data a+ablable.
5.3. Advice for fire-fighters
Cool closed oonlainers exposed to fire by spraying them with vmW- Do not allow run off water and contaminants from
fire bighting to enter drains or waler ways.
ERG Guide No. 0
Section 6. Accidental release measures
6,1. Personal precautions, protective equipment and emergency procedures
Put on apprdpriale personal protector BgL¢prrent (see section S).
6.2. Environmental precautions
45642 {sage 2 of 7 Re'vision Cater 3IV2021

Do not allow souls to enter drains or waterways -
Ilse good personal hygiene practices- Wash hands before eating, drinkIN, smoking or using lodel. Promptly rermQw
soiled clothing and wash thoroughly before reuse.
6.3. Methods and material for containment and cleaning up
Ventilate the area and avoid breathing vapors. Take the personal protective measum listed in section B.
Contain and absorb spillage avith non-combLlstibla materials e,g, sand, earth, wrmiculile, Place in closest containers
outside buildings and dispose of according to the Waste Regulations. (See section 13).
Clean. preferably with a detergent. to not use sdwnls.
Do not allow spills to enter drains or watercourses.
If drains, sewers. streams or lakes are contaminated, inform the local water company immediately. In the case of
contamination of rivers, streams or takes the Enuronmental Protection Agency should also be Informed.
Section 7. Handling and storage
7.1. Pro rautionsfor safe handling
Check section 2,2 (OHS Label Elements) for further delaiIs. [Prenenfion]:
7.2. Conditions for safe storage, including any Incompatibilities
Handle contai rem carefully I preverll damage and spillage.
Incompatible materials: Any acidic material, ammonia, urea, oxidlzable materlals and metals such as nickel, copper,
tin, aluminum and iron.
Check section Z2 1GHS Label Elements] for further details. - [Storage]:
7.3. Specifto end use(s)
No data a�silable-
Section 8. Exposure controls I personal protection
8.1. Control parameters
Expia m
CAS No. Ingradlent
Vacua
0000111.7&2
2-DAaxy-etbM'd
NId45i1pprn(mwwera)Iswil
A03H
TV ' 20 PWRMed 20M. j
t� .� 77[i41f4
5 ppm [24.,J.BY [Sian] -
hhEtabMshrxlt�rR
C001344-g943
SndwrnsIYCBIe
y" j
w
-
Mo E.tabkshed--
Nb
— - - - - -
�-0-
I sH
I�h B—uw ed Lint—
- --- - —
15,r30d1
sodiumdoderylhenzenestdfonale
Fc&;�-1�6EslabWedLirri[
AM
t Established Lo.t -- —
I'M' T
Nb FsIa%hed L A
Carcinogen Data
CASKS.
Ingradlen!
Source Value
fl000111.76-2
2-fi Aa y-etharq
i FWMedC2P0ngg tI Akr
�"
WIC Grmv 1. No, Group 2a, Ntr Gmup 21�: Nr C3oup 3:es, YGroup 4: hb;
--
[M1344-0" ,
Sodiunsilkwe
_
�Xtn J Flev.9ked Carcinogery f b
— - - --
"KI W s DMIN34- hb - - --
-Py Group 1: hbc [soup 2a: W Croup 21:r. W. Girmo 3. Nb, Group 4' W
0025155-30-0
rkndod"Ibmver;;N�-
�FingulaiedLarcrnogarcl� - — - -- _—
IGnpwn Nx Suspected: rb
45642 page 3 of 7 %Msion Grate' 3110/2021

WF� Group1: hb; Group2a. t+bc GraPZD: hb; Cra-p3; Na. Group W: If
8.2. Exposure controls
Respiratory
Use NIOSWMSI-IA appro+ed respirator, following manufacturer's recommwdatiam when
concentrations exceed permissible exposure limits.
Eyes
Wear apprmed eye protection. The use of a Face shield is also re xmmemed for skin
protection in the area of the eyes. An eye wash station is suggested as a good va-kplam
practice.
Skin
Chemical resistant clothing such as coreralisdapron pools should be worn. Gtemical
Imperious Gloves
Engineering Controls
Provde adequate +entllalion. Where reasonably practicable this should be aohiered by the
use of local exhaust ,entilatlon and good general extraction. If these are not sufficient to
maintain concentratlons of particulates and any �,opor- Wow occupational exposure limits
suitable respiratory protection must towom.
Other Work Practices Use good personal hygiene practices_ Wash hands bertire eating, dunking, smoking or using
toilet. Promptly remove soiled clothing and Kash thoroughly before reuse:
Check section 2.2 (GEES Label Elements) brfurther details. - [Pra�enlion] -
Section 9. Physical and chemical properties
Appearance
Odor
Odor threshold
PH
McIHng polnt I freezing point
Initial boiling point and boiling range
Flash Point
Evaporation rate (Ether = 1)
Flammability (solid, gas)
Upper/lower flammability or explosive limits
Vapor pressure (Pa)
Vapor Density
Relative Density
Solubility In Water
Partition coefficient n-uctarnollwate+ (Log Kow)
Auto -ignition temperature
DooDmpo5ition temperature
Viscosity (cSt)
Foaming
9.2. Other information
Nb other Went infom>atiorm.
Clear, Pale Yellow thin liquid
Mild
Not Measured
12.5 -111
Not Measured
212 deg F
>200 degrees F Pfv1CC (non-flammahfe)
0.33
Not Applicable
Lower Explosive Limit: Not Measured
Upper Explosive LlrnIt Not Measured
Not Determined
Not Determined
1.019- U29
Not Measured
Not Measured
Not Measured
ltlot Measured
Not Measured
Moderate
Section 10. Stability and reactivity
10.1. Reactivity
Hazardous Polymerization will not occur.
10.2. Chemical stability
Stable under nomial circumstances.
10.1 Possibility of hazardous reactions
No data a�eilable.
10.4, Conditions to avoid
No data awilable.
10.5, Incompatible materials
Any acidic material, arnnonia. urea, oxidizable materials and metals such as nickel, copper, tin, aluminum and iron.
10.5, Hazardous decomposition products
No hazardous decomposition data a%eilab e.
45642 page 4 of 7 F4-�visivim Gate: N1412021

Section 11. Toxicological information
I
Acute toxicity
Ingredient
FOal LLLO,
Skin L—UO, tnhatation
Inhalation
Inhalation
mglkg
mglkg Vapor LC50, JjD-tWstLC5D,
Gas LC5D
— mglG4hr
mgltJ4hr
ppm
SxWsdicate-(134400-8)
S,15r� dale '
-----
�5,OrlO.OQ. I� � data
- — -
I�dala ardiehle
IW dale
avatable 1
-i�4agory N4 arataGle
"ladlo
�-@><vxy etharol - [711-7fr2]
1,414. W,
1,2Co.pp I F7 data
I h dale avala6ls
No data
L ffm Pig -
Qdnea F j - avala! 1e
avalable
Category; 4F
Category; d
s�ruf (2515S3t}t}]t�
QM�� 4s
adata
d*
Ii*]
Kb
-am.
a I
tooter When no We specific LD60 data is zi%vlable for an acute toxin, the concerted acute toxicity point estimate was
used in the calculation of the product's ATE (Acute -toxicity Estin-ole),
Classification _
Acute toxicity (oralj -
—
Categary
�
IFlazard Descriplio_n
Idol Applicable
Applicable i
---- — - --
e ioxiciiy (denTral)
- -J
Not Applicable __
e tokcity (inhalation)
j
Wot Applicable _ 1
Skin canvsianr rritation
_
�3
_ _ _ —I
Causes mild skin irrl[atiorr (Nate this GHS
classitcalion Kos not adopted by US OSHAy.
- -
Serious eye damage nitatlan
-�—�
Causes serous eye Irritation,
Respiratorysensitization
—
Wol Applicable
Sisin_sermitization
�
Wot Applicable
Germ cell mulagenicity
F
Nat Applicable
P'-- eWrit
—
t}ipt Applicalole.
Reproduct-w taxicity
STOT-single exposure
TOT-repeated exposure
Isp-IFBtion
L_ —
�
Not Applicable _
Nd Applicable
—
hazard ��
Not Applicable
Section 12. Ecological information
12.1. Toxicity
Wo additional information pmvJded for this product. See Section 3 for chemical specific data -
Aquatic Ecotoxicity
Ingredient
g6 hr LC5o fish,
mgfl
-
48 hr M50 crustacea.
mgll
Ereso algae,
mgli 1
-
�1tsCiCate- (1344-pA-8l
301.00, Lepar6
216.t7O- Mona migla
NA Avaiabe
-
2-Woxy-dtwd-1111-76-2j
1,474.OD. Cxortrynchus
1.550.00. Mrjoa
rrvw
rregre •
1,MOO (72 hr), P3eur oWc}xrwsb
st4lcatxtat�r - --
sod umdodecylber¢enasttror�rle - (25155.3a
Ol
10.i10 lano-rerio
2.5p, Cka 20a m3gna
I`
96 40 (72 hr), Pselxial6rdTW1dla
12.2. Persistence and degradability
This product is fully biodegradable
12.3. 8loaccumuladve potential
Not Measured
1Y.4. Mobility in sot!
45642 }gage 5 of 7 Revislvn Dale- 3/1012021

No data mailable.
12.5. Resultsof PBT and vPvs assessment
This product contains no PBTI�P\B chemicals.
12.6.Other adverse effects
No data mailable.
Section 13. Disposal considerations
13.1. Waste treatment methods
Ohsene all federal, state and local regulations Wrwn disposing of this substance.
Section 14. Transport information
14,1. UN number
IIAZ UN proper shipping name
14.3. Transport hazard clas{es)
14.4. Packing group
Not Applicahte
Compound. 0eaning,N.0.1-, Liquid
Not Applicabie.
Not Applicable
Section 15. Regulatory information
Regulatory Overview The nagulatory data in Section 15 is not intended to be all-inclusiYe. only selected regulations
are represented.
Toxic Substance All components of this material are either listed or exempt hom listing on the TSCA Inventory.
Control Act( TSCA)
WHMIS 1988 02B E
Classification
US EPA Tier II Hazards Fire:
Sudden Release of Pressure:
Reactive:
Immediate (Acute):
Delayed (Chronic):
EPCRA 3111312 Chemicals and RRs (Ibs):
sodium dodeeylWnzenesulfunale ( 1,DW-00)
EPCRA 302 Extremely Hazardous:
(% Product Ingredients Listed)
EPCRA 313 Taxfc Chemicals:
2-Butoxy-ethanol
Proposition 65 - Carcinogens (>0.U°k}:
(No Product Ingredients Listed)
Proposition 65 - Developmental Toxins (>G.014:
(No Product Ingredients Listed)
Proposition 65 - Female Repro Toxins (>0.0°Id:
(No Product Ingredients Listed)
Proposition 65 - Male Repro Toxins (>O.0*'4:
(No Product Ingredients Listed)
N.J. RTK Substances (>1114
P-Butaxy-athanol
sodi urn dodecyihenzsnesulionale
Penn RTK Substances (�)-1N:
2-Butoxy-elhand
sodium dodecylb omenesulfonate
Section 16. Other information
45642 page 6 of 7 Revislon ❑nte: 3/1012021

Issue date 04/09/2015
Revision History 04/09/2016
"2712015
M2112015
07/31/2015
M21/2015
11/1312015
11/17/2015
091i512Q18
M1412020
10)1&2020
10/2712020
11123/2020
12MY2020
0IIM021
03/10/2021
U102021
The information and recommendatiars contained herein are based upon data believed to be correct. However, no
guarantee or warranty of any kind, expressed or Implied, is made with respect to the information contained herein. We
acoept no responsibility and disclaim all Iialallty far arty hamdul effects wHch may be caused by exposure to cut
products. Customeralusers of this product must comply with all applicable health and safety laws, regulations, and
orders.
The full text of ft phrases appeaOrio in section 3 is:
R302 rtarn-Ag If swallowed.
H312 Harmful in ooniaot with skin,
H315 Causes skin irritation,
H318 Causes serous eye damage
H319 Causes servo$ eye i"alion
H332 Flanrdul if inhaled.
End of ❑QCUMenl
4%42 page 7 of 7 FbOsion Date; 311412021

Safety Data Sheet (SDS)
CHEMSTATION 85291
SDS Revision Date: OSMW2022
1. identification of the substanceimixture and of the companylundertaking
1.1. Product identifier
Product Identity
85291
Alternate Names
85291
1.2. Relevant identified uses of the substance or mixture and uses advised against
Intended use
Contact ChemStation representative.
Application Method
Contact ChemStation representative.
1.3, Details of the supplier of the safety data sheet
Company Name
ChemStation of Eastern INC (Raleigh)
6275 NC-50
Benson, INC 27504
Emergency
CHEMTREC (USA) [phone]
Customer Service: ChemStation of Eastern NC 8884589625
(Raleigh)
2. Hazard identification of the product
2.1. Classification of the substance or mixture
No applicable GHS categories.
2.2. Label elements
No applicable GHS categories.
[Prevention]:
No GHS prevention statements
[Response]:
No GHS response statements
[Storage]:
No GHS storage statements
[Disposal]:
No GHS disposal statements
3. Composition/information on ingredients
This product contains the Following substances that present a hazard within the meaning of the relevant State and
Federal Hazardous Substanoes regulations.
InryredientlChemical Oesiyna[ions __ Wel$htj J
GHs Cl a WficaSion
Notes
sodium dedocytbenzenesulfonale 1.0-ifl
_ _
Aeule ToX.6;H302
[i'
CAS Number. 0025165.30.0
Acute To. ,;H312
l
Eya 2A; H 319
[7] Substance classified wish a health or a kanmeotal hazard.
[2] Substance with a workVaoe dxposure rlm.t.
[3] PST•subslance or vPYB-subslance.
'The full texts or the phrases are shown In Section 16.
Section 4. First -aid measures

4.1. Description of first aid measures
General In all cases of doubt, or when symptomspersist, seek medical attention.
Never give anything by mouth to ari Lincor%sr ous person.
Inhalation
Remove to trash air, keep patient warm and at rest. If breathing is irregular or slapped. give
artificlal respira lion. II unconscious place in the recovery position and obtain Immediate
medical attentl on, Give nothing by mouth.
Eyes
Irrigate, copiously with clean water for at least 15 minutes, holding the eyelids apart and
seek medical attention
Skin
Remove contaminated clothing. Wash skin thoroughly wlthso@p and water or use a
recognized skin ctaanser.
Ingestion
If swallowed obtain irnmedia le medical attention. Keep all rest. Dq NQ7 induce vomiting.
4.2. Most important symptoms and effects, both acute and delayed
Overview
No specific symptom data available.
Check section 2.2 (GHS Label Elements) for further details.
Section 5. Fire -fighting measures
5.1. Extinguishing media
Recommended extinguishing media, alcohol resistant foam, CO2, powder, water spray.
Unsuitable extinguishing media: Do not use; Wale rlet.
5.2. 5peciat hazards arising from the substance or mixture
Hazardous decompasitlon: No hazardous decornpositien data available.
5.3. Advice for Ifro-righters
Coal closed containers exposed to fire by spraying them with water. Do not allow run off water and contaminants iron}
fire fighting to enter drains or water ways
ERG Guide No. a
Section 6. Accidental release measures
6.1. Personal precautions, protective equipment and emergency procedures
Put on appropriate personal protectiVe equipment (see seciton 8),
6.2. Environmental precautions
Do pal allow spills to enter drains or waterways.
Use good personal hygiene practices. Wash hands belcre eating, drinking, smoking or using toilet. Promptly remove
soiled clothing and wash thoroughly before reuse,
6.3. Methods and material for containment and cleaning up
Ventilate the area and avoid breathing vapors 'fake the personal proleciive measures listed In section a.
Contain and absorb spillage with non-combusllble materials e.g. sand, earth, vermiculite. Place in closed containers
outside buildings and dispose of according to the Waste Regulalions, (See section 13).
Clean, preferably with a dt tergent. Do not use solvents.
Do not allow spills to enter drain s.or watercourses.
If drains, sewers, streams or lakes are contaminated, inform the local water company immediately. In the case of
contamination of rivers, streams or lakes the Environmental Protection Agency should also he informed.
Section 7. Handling and storage
7.1. Precautions for safe handling
Handle can Isine r6 carerully to prevent damage and spillage.
Check section 2.2 (GHS Label Elements) for further details. - [PreYention]:
7.2- Conditions for safe storage, InctudIng any incompatibilitles
Incompatible materials: No dales available.
Cheek section 2 2 )GHS Label Elements) for further details. - ISioragej:
7.3. Specific end use(s)
No data avallabte
Section 8, Exposure controls I personal protection

8.1. Control parameters
Exposure
CAS Ho, _ Inpredlenl _ _Source W41.
]P7.`1 �s-aa-IY ~ swl4m dddewylbdnnenn%dlfonal® OSHA No Eslahllahad Limil
ACGIH Nvfsl9hllshed Lind
NIOSH _ No Eslatk%had Limit
Sup tar No Established Limit
Carcinogen data
CAS No. _
Ing.diml Ilafue
0e251---30-0
�Source'
5nrtium dadeLyrberannd5ulydngle I�mo+ . ReguWed Cardflegen: No
rNW Known_No: 3dgnpcled; Nb
IARC ]GMILGMg 1: Nd: Group2a; Nh_ GFL. No_Grdup T Ne;
8.2. Exposure controls
Respiratory
If workers are exposed to concentrations above the exposure limit they must use the
appropriate, certified respirators.
Eyes
Protective safety glasses recommended.
Skin
Keep skin contact to a minimum.
Engineering Controls
Provide adequate ventilation. Vvhere reasonably practicable this should be achieved by the
use of local exhaust ventilation and good general extraction. it these are not sufficient to
mainWin concentrations of particulates and any vapor beloW occupational exposure limits
suitable respiratory protection must be w*rn.
Other Work Practices Use good personal hygiene practices. Wash hands before eating, drinking, smoking or
using toilet. Promptly remove soiled clothing and wash thoroughly before reuse.
Check section 2.2 (GHS Label Elements) for further details. - [Preventionl:
Section 9. Physical and chemical properties
Appearance
Odor
Odor threshold
PH
Melting point 1 freezing point
Initial boiling point and boiling range
Flash Point
Evaporation rate (Ether =1)
Flammability (solid, gas)
Uppe0lower flammability or explosive limits
Vapor pressure (Pa)
Vapor Density
Relative Density
Solubility in Water
Partition coefficient n-octanollwater (Log Kow)
Auto -ignition temperature
Decomposition temperature
Viscosity {cst)
Foaming
9,2. Other information
No other relevant informalion
Clear. yellow Liquid, viscous
Mild, soap
Not Measured
9.800. 10.400
Not Measured
*212deg F
* 201 degrees F PMCC (combustible)
0.33
Not Applicable
Lower Explosive Limit: Not Measured
Upper Explosive Limit: Not Measured
Nol Determined
Not ❑elermned
1.008 - 1.018
Not Measured
Not Measured
Not Measured
Not Measured
Not Measured
Moderate
Section 10. Stability and reactivity
10.1. Reactivity
Hazardous Polymerization will not occur,
10.2. Chemical stability
Stable under normal dreummances.
10.3. Possibility of hazardous reactions
No dala availaule.
10.4. Conditions to avoid
No data available

10.5, Incompatible materials
No data available.
10.6, Hazardous decomposition products
No hazardous decomposition data available.
Section 11. Toxicological information
Acute toxicity
Ingredient —�
s9tl4lm tladecyA6ansenesulfonala - t25155.30.4}
-�
amemoa,
1,080.00, Rai -
Ca!egury:4
—
Skin LQ9 g,
aalbl
InhalationiC
nraletl6l
nusmg+ Allon
QC50,
jLN_'�a—'tl�a`la'._�ava—ila—ble,II
G�PmSp,
�nvNao�ladblatoa
Classification
category
[Hazard Description
Acute toxicity {oraly
Not Applicable
Acute toxicity{dermaly
INot Applicable _
Acute toxicity (inhalation)
7 -
Not Applicable
Skln corrosionlirrilation
0
Nat Applicable
Serious eye damageArritabon
Nat Applicable
Respiratory sensitization
0
Not Applicable -
Skin sensittzation
Not Applicable
Germ cell mutagenichy Y
—
Nat Applicable
Carcinogenicity
—
Nol Applicable
Reproductive toxicity
0
Not Applicable
STOT single exposure_
Nat Applicable
STOT-single exposure _
CLPTOICat}
{CLPTQtpesc}
STOT-repeated exposure J
Not Applicable
^I
[Aspiration hazard
Not Applicable
Section 12. Ecological information
12.1. Toxicity
No additional informadon provided for this product. See Section 3 far chemical specific data.
Aquatic Ecotoxiclty
IngradlanL
9s hr LC5g Flab,
4111 EC50myll Crmlatea,
��
ErCM algae,
sdtliumtivtlacyl6enzanesulfonate-{25755.30•QI
$0.00. Demo rerlo
2,50. Daphnia magma
e5.40 (72 hr), Pmudnkimhmerialla'
swtltapiwe
12.2. Persistence and degradabillty
This product is fully biodegradable.
U.3. Bioaccumulative potential
Not Measured
12* Mobility In soil
No data available.
12.6. Results of PST and vPvB assessment
This product contains no PBTIvPvB chamicals
12.6Other adverse effects
No data avallable
Section 13. Disposal considerations
13.1. Waste treatment methods
Observe all federal, state and local regulations when disposing of this substance.
Section 14. Transport information

14.1. UN number Not Applicable
14.2. UN proper shipping name Compound, Cleaning,N.O.I, Liquid
14.3, Transport hazard class(es) Not Applicable
14.4. Packing group Not Applicable
Section 15. Regulatory information
Regulatory Overviews The regulatory data m Soclion 15 is n o I intended to be all-inclusive, only sale clad
regulations are represenled.
Toxic Substance All components of this material are ofther listed or exempt from listing on the TSCA
Control Act ( TSCA) Inventory.
EPCRA 3111312 Chemicals and RQs (Ibs):
sodium dodecylbenzenesullonale (1,000.00)
EPCRA 302 Extremely Hazardous
(No Product ingredients Listed)
EPCRA 313 Toxic Chemicals:
ProposiVia n 65 - Carr=inogens (>0,0'I ):
(No Product Ingredients Listed)
Proposition 65 - Developmental Toxins {a0,0Ic):
(No Product Ingredianls Listed)
Proposition 65 - Female Repro Toxins (4.0h):
(No Product Ingredients Listed)
Proposition 65 - Male Repro Toxins (>0.0%)-.
(No Product Ingredients Listed)
N.J. RTK Substances (a1%):
sodium dodecylbenrenesulfonate
Penn RTK Substances (>IIQ-
sodium dodecylbenzenesulfenatr:
f -
Section 16. Other information
Issue Date
Revision History
0511512015
0813012015
1213MO15
09I1 BI2018
0510812022
852910511512015
0613012015
1213012015
oS1181201 a
06/06/2022
051OW022
The information and recommendations contained herein are based upon data believed to be correct. However, no
guarantee or warranty of any kind, expressed or implied, is made with respect to the information contained herein. We
accept no responsibility and disotalm all liability for any harmful effects which may be caused by exposure to our
products. Custome Wusers of this produce muss comply with all applicable health and safety laws, regulations.. and
orders.
The full text of the phrases appearing In section 3 Is-
Not Applicable
End 0 Document

PERASAN A
Envrro Tech Chemical Services, Inc. 500 Wlnmoore Way Modesto, CA 95358
SAFETY DATA SHEET
SECTION 1 - IDENTIFICATION
Product Identifier: PERASAN A product Code: 35
Registration Number: 63838-1
Enviro Tech Chemical Services, Inc.
500 Winmoore Way Modesto, CA 95358
[phone] (7 AM to 5 PM, PST, Monday to Friday)
24 Hr. Emergency Tel.#: [phone]
SECTION 2 -HAZARDS IDENTIFICATION
This chemical is a pesticide product registered by the Environmental Protacl ion Agan cy and is subject to certain label Ing requirements under
the Federal Insecticide, Fungicide and Rodenticide Act (FIFRA). These requirements differ from the ctassi5catron criteria and hazard
information required for safety data sheets of non -pesticide chemicals. Please see Section 15 for FIFRA labeling information.
Classification of the Substance or Mixture:
Skin Conosion - Category 1
Serious Eye Damage - Category 1
Oxidizing Liquids - Category 2
Corrosive 10 Metals - Category 1
Organic Peroxides - Type G
Acute Toxicity - Oral Category 4
Acute Toxicity - Dermal Category 5
Hazardous to the Aquatic Environment, Acute Toxlclty Calegory 2
Signal Word: DANGER
Hazard Statements:
Causes severe skin burns and eye damage
May intensify hie; oxidizer
May be corrosive to metals
Harmful if swallowed
May be harmful in Contact with skin
Toxic to aquatic life
Precautionary Statements:
Prevention
Wear protective gloveslproteclive ctolhingleye prdtectlon1face protection.
Wash hands thoroughly after handling
Keep away from heallsparkslopen flameslhot surfaces - No smoking.
KeeplStore away from clothingfcuinbustibte materials.
Do not Sal, drink or smoke when using this product.
Keep only in original container.
Fake any precaulion to avoid mixing with combustibles
goo
Response
IF SWALLOWED: Rinse mouth. Do NOT induce vomiting.
IF SWALLOWED: Immediately call a POISON CENTER or doctorlphysician.
IF ON SKIN [or hair]: RemovelTake off immediately all contaminaled clothing. Rinse skin with waterlshower.
IF IN EYES: Rinse cautiously with water for several minutes. Remove contact lenses if present and easy to do. Continue rinsing.
IF INHALED: Remove victim to fresh air and keep at rest in a position comfortable for brealhing.
IF exposed or you feel unwell: Call a POISON CENTER or doctorlphysician
Wash contaminated clothing before reuse.
In case of fire: Use water for extinction.
Absorb spillage to prevent material damaga
Storage
Store locked up.
Page I of 5

PERASAN A
Enviro Tech Chemical Services, Inc. 500 WinmDore Way Modesto, CA95358
SAFETY DATA SHEET
Store in a corrosive resistant con lain a with a resistanl innar li oar.
Disposal
Dispose of cdntenWoorltainer In accordance with local regulations.
SECTION 3 - COMPOSITION / INFORMATION ON INGREDIENTS
Paga+ F of 5
Ingredient ICAS Number lConcentration
HYDROGEN PEROXIDE
7722-84-1
25-27.4%
ACETIC: ACID
6r;-19-7
3-8%
PEROXYACETICACID
79.21-0
5.0-5.9%
SECTION 4 - FIRST -AID MEASURES
Inhalation: Remove sourea of exposure or move person fo fresh alr and keep comfortable for breathing. immediately call a PCISON CENTERIdoctor lI
breathing Is difficult. trained personnel should administer emergency oxygen if advised to do so by the POISON CENTERIdoclar. Symptoms of pulmonary
edema can he delayed up to 4If hours after exposure. If direct contact during rescue breathing poses a threat to the First aid provider, "Avoid
mouth-to-mouth contact by using a barrier device."
Skin Contact- Take off Immediately contaminated clothing, shoes and leather goods (e.g watchbands, belts). Rinse skin with lukewarm. gently flowing
waterlshower with a hushing duration of 30 minutes. Immediately call POISON CENTERlduclor. Wash conlammated clothing before re -use,
Eye Contact: Remove sourca of axpnsura or move person to fresh air. Rinse eyes cautiously wish lukewarm, gently flowing water for several minutes, while
holding Ilia eyelids open. Remove contact lenses, if present and easy to do. Continua dnsing for W minutes. Take care not to rinse contaminated water into
the unaffeclad eye or into the face. Immediately call a PC [SON CENTERIdodor.
Ingestion: Rinse moulrt. Do NOT induce vomiting. Immediately call a POISON CENTERIdactor, II vomiting occurs netorably. iie an your aide. in the
recovery, position.
Masi ImporlanI Byrnploms and Effects, both Acute and Delayed: Causes severe skin burns and eye damage, burning of the rnoulh. throat. and
esophagus
Indication of any Immediate Medical Attention and Spacial Treatment Needed; Treat symptomalica liy
SECTION 5 - FIREFIGHTING MEASURES
Extinguishing Media: Use water spray, powder, foam, carbon dioxide.
Special hazards arising from the substance or mixture_ Nun corribuslible. May give off irritating or toxlcfumoz (or goses) in a pre.
Flammability classification {OSHA 29 CFR 1910.106) 1Hazcom 2012}i Non flammable
Hazardous Combustion Products: May cause fire and expbsions when In contact with Incompatible materials.
Special protective equipment and precautions torfirafighters: In the event of a fire, wear full prolective clothing and NIOSH•approvedself-contained
breathing apparalus.
SECTION 6 - ACCIDENTAL RELEASE MEASURES
Personal precautions, protective equipment and emergency procedures: Ventilate area of fee orsplIt- Wear appropriate personal protective
souipmant as specified in Section 8. Isolate nalard area. Keep unnecessary and unprolectsd personnel from entering.
Methods and materials For containment and clearling up; SMALL SPILLS (less than 1 gallon)! Neufrallxe with soda ash or cover with dry earth. sand or
olher non oonlbuslible material, place: into loosely covered plastic Containers for laler disposal. If neutralixod, material can be dilulad into drairs. LARGE
SPILL: Raslndt access to area until completion of cleanup. Prevent liquid from entering sewers or waterways. Stop or reduce leak if safe to de so. Dlke
with inert material Isand, earth, etc.J. Collect into plastic containers for disposal. Ensure adequata deconiami ria lion of tools and equipment followlrg clean
up
5poctal spilt response procedures_ Collect spIlls In plastic containers only. Prevent from anlering sewers, waterways, or low areas.
SECTION 7 - HANDLING AND STORAGE
Procautlons for Sefo Handling: Wear al least chemical reslslanl gloves and eye protection, face shield, and chemical resistant garments when Iiandling,
moving or using ihis product Do riot contaminate water, road, or feed by slurage or disposal -
Cc ndition 5 for safe Storaga: Store In a cool. dry. well ventllaled place away from direct sunlight. Keep container closed when riot in use
Incompatible Materials: Avoid strong reducing agents, soft metais, heal and bases (unless product has been diluted to less than 1000pprn, then bases
may be used to gradually adjust to a pH of less then 9)
SECTION 8 - EXPOSURE CONTROLS f PERSONAL PROTECTION

PERAGAN A
Enviro Tech Chemical Services, Inc 50r1 Wlnmoore Way kAodasto. CA 95356
SAFETY DATA SHEET
Page 3 of 5
EXPOSURE LIMITS:
OSHA PEL
ACGIH TLV
CHEMICAL NAME
GAS NO,
TVVA
STELICEILING
TWA
STEL
ACETIC ACID
64-19-7
10 ppm
15 ppml40 ppm (CalOSHA)
1q ppm
15 ppm
HYDROGEN PEROXIDE
7722-84-1
1 ppm
1 ppm/NIA {CalOSHA)
1 ppm
NIA
PERACETIC ACD
79-21-1
NIA
NIA
NIA
0.4 ppm
VenliIation and engineering measures: Forced air, local exhaust, or open afr is adequate.
Respiratory Protection: In rase of ctnfned spaces or Itligh levels an0ountorod in the an, wear self contained breathlrrg apparatus.
Skin Protection, Wear ohemical resistant glov4s and chemical resistant garmenis when handling. wash garments before re -use,
EyelFaco Protection: Wear chemical goggles; alsn wear face shleId It splashing hazard exists.
Other Protective Equipment: Eye wash facility and anrergencyshowershould be in close proximity.
General Hygiene Conditions: Do not aat, drink or smoke when using this product. Wash tharouglily after handling- Remove and wash can laminated
Oothing before ra-uso. Handle in accordance wilh good industry hygiene and safety practice -
SECTION 9 - PHYSICAL AND CHEMICAL PROPERTIES
Appearance: Clear colorless liquid
Odor: Vinegar odor
PH; -1 (1:14)
MeltinglFreexing point; No information available
In [flat bolling point and balling range; Na Information available
Flush Pont: �200° F 1 s93 ° C
Flammability (sofld, gas): Non flammable
Vapor Pressure (mm Hg); 22
Specific gravity: 1.12 glmi-
Solubillty in Water; Complete
Auto Ignlllon Temperature: >51 go FI >2700 C
DacompoeIll on temparature: No information available
Viscosity. 5-15 cSt at 20°C I WF
Volatlles I% by weight): �99
Volatile Organic Compounds (VOC's): No information available
SECTION 10 - STABILITY AND REACTIVITY
Reactivity: Raaclive with bases, melsts, reducing agents and combustible materiels
Chemical Stability: Stable for up to 1 year when stored under normal concillions.
Possibility of Hazardous Reactians' May react with incompatible materiafa
Conditions to Avoid: Incompatible materials and high temperatures
Tncompatible Materials- Reacilve with bases, metals, reducing agents and combustible materials
Hazardous Decomposition Products; Oxygen which supports combustion.
SECTION 11 -TOXICOLOGICAL INFORMATION
1nfonnation on likely routes of exoostere.
Routes of entry - Inhalation: YES
Routes of entry -skin & eye: YES
Routes of entry - ingestion; YES
Routes or entry - skin absorption: N❑
Potential Health Effects:
Signs and symptoms of short term (acme) exposure, -
Inhalation , Inhaln lion of the mist may produra severe irrialion of rrrspiralory tract, characlerized by coughing, choking, sliortnessof brasth headaches-
dizainess, nausea, weakness aridlor drowsiness.
Ingestion: Corrosive! Swallowing causes severe hurna of mouth, throal, and stomach- Severe scarring of tissue, corrdsinn, permanent tissue destructlon
and death may result Symptoms may include ;evv?a pale, nausea, vomiting, diarrhea. shock, hemorrhaging and±or fall in blood pressure Damage may
appear dgys after axposura.

PERASAN A
Enviro Tech Chemical Services. Inc. 500 Winmoere Way Mod enia. CA 95358
SAFETY DATA SHEET
Skin: Corrosivel Contact with skin causes Irritation or severe bums and scarring with greater exposures.
Eye; Cvrreslve! Causes Irritation of eyes. and with greater exposures it can cause hums that may result In permanent impairment of vision. even blindness.
Potentiit Chronic Health Eff 05
M utageni ci ty; No known mutagenic effects
Corel no pant city : Not a known carcinogen or lumorigen
Reproductive effects: No known reproductive affects
Sensitization to Frio terla1: No expected to cause sensitizatlon
5pecIII c target organ effects: No information available
Medical conditions aggravated by overnXposure; Na inlormation available
Toxicological data: The calculated ATE values for this mixture are:
ATE oral = 668 mglkg
ATE de rmal = 480a mglkg
ATE inhalation = a20 mg1L OF }20,oW ppm
SECTION 12 - ECOLOGICAL INFORMATION
Ecotoxlclty: May harmful to aquatic life.
Persistence and degradabil4: Not expected to persist. Expected to readily biode0rada
Bioaccumulation potential: Not expected to bio accumulate.
Mobility In sail: No information available
SECTION 13 - DISPOSAL CONSIDERATIONS
Handling for disposal: Do not contaminate water, food. or feed by storage andlor disposal. When handling refer to protective measures listed M sections
7 and 8. Empty residue from containers, rinse container well.
Method of disposal; Dispose of in accordance with all applicable federal. slate. provincial and local regulations. COrtlact your local, state. provincial er
federal environmenlat agency for specific rules.
RC RA: If product becomes a waste, it does meat the cnterla of a hazardous waste as defined by the US EPA. because OF; Corruylvlly TX02
SECTION 14 - TRANSPORTATION INFORMATION
Cerlain shipping modes or package sizes may have exceptions from the transport regulations. The classification provided may not reflect those
exceptions and may not apply to all shipping modes or package sizes.
Please note the GHS and POT Standards are NOT identical and therelore can have varying classificalions
US 49 CFRJD0T11ATA11MDG information:
UN Nc,. 3098
UN Proper Shipping Name: QxidWrip {iquid, corrosive, n.e.s. icantains hydrogen peroxide and peroxyacdtic acid mixture, stabitfxedj
Transportation hazard cfassiesl_ 5.1 t8}
Packing Group: II
Environmental hazards: No hazards Identified.
SECTION IS- REGULATORY INFORMATION
FIFRA Classlffcabonrfypieal Hazard Labeling, as outlined in EPA Label Review Manual
Hazard Data
Page 4 of 5
Signal Word
DANGER
Acute Toxicity. oral
Category III- Harmful if swallowed
Acute Toxicity. dermal
Category III: Harmful if absorbed through skin
Acute Toxicity. Inhalation
Category II; May be fatal If Inhaled
Skin initaflonlcorrosidn
Category I Corrastve. Causes skin bums
Serious eyed amage
Category l: Currosivo. Causes irreversible eye damage
sensluzatlon
Not Classified SNC)
Environmental (aqualic) toxicity
This pesticide is toxic to fish and other aquatic organisms.

PERASAIV A
Env Ira Tech Chemical Servlces, Inc. 500 Winmoore Way Modesto, CA M58
SAFETY DATA SHEET
US Federal Info nnation:
TSCA informal ion: All components are listed an the TSCA alvetilory.
U5 CERCLA Reportable quantity (Hazardous substance RQ;: Acelic acid has a RC of approximataly TMW Iba. a} as Is chemicat
US EPCRA Reportable quarkVly (Extremely hazardous substance RQI: Porous tic acid has a RO of approximately $900 lbs. of as is chemical.
Clean Al Act Sociion 112jr) Thwho Id Ounail ly (TR}: Peracelic Acid has a TO of approx+nintaly 178000lbs. of as is chemical
SARA Tllie III Hazard Categories: Reac0dily Hazard, Acute Health Hazard
International information: WHMIS: Class C: Oxidizing rrailenal. CI8SS E: CQUO-Aiv9 material
This product has boon classified in acurdanee wilh the hazard criteria of the Controlled Preducls Regulations.
SECTION 16 - OTHER INFORMATION
Page 5 of 5
NFPA
Health Hazards 3
Flammability 1
StablHty 1
Special Hazards OX, CO
HMIS
Health Hazards 3
Flammability i
Physical Hazard 1
Personal Protection C
NFPAIHMIS Ratings Legend Severe = 4; Serious = 3; Modefate = 2; Slight = 1: Mirrlmal no
Special hazards: OX = Oxidlzer; COR = Corroslva
Personal PIMtection = C (safety glasses, gloves, protective apron)
Leoond:
SARA: The Superfund Amendments acid Reautharizaiioln AM
RCRA: Resource ConservalIon and Rectwery Act
TSCA_ Tvxie Substances Conhal Act
CFR: Cade of Federal Regulations
QOT: Department of Transportation
ATE: Acuie Toxicity Estimate
Preparation dale; 3:1r2U16

Attachments
House of Raeford Farms, Inc. Permit Renewal — Permit no. WQ0002005
Attachment L
Setback Waivers
Total of Eleven (11) Waivers
Recorded in June 2017 in
Deed Book 1851, Pages 241— 266 of
Duplin County Registry
(26 pages total)
Attachment L

Doc No: 10012798
Recorded: 06/08/2017 11:44:33 AM
Fee Amt: $26.00 Page 1 of 2
Duplin County North Carolina
Davis H. Brinson, Register of Deeds
BK 1851 PG 241 - 242 (2)
I,
Address:
State of North Carolina
Department of Environmental Quality
Division of Water Resources
AGREEMENT TO WAIVE SETBACKS AS REQUIRED BY
15A NCAC 02T .0506(a), .0506(b), .0606(a), .0706(a) AND .1006(a)
certify that I am a deeded owner of the property located at:
Parcel No.: A�LI ,4�� 7
City: ®'5� �E— G State: WC Zip Code: ,2,9 County:
Furthermore, I certify that I am authorized to make decisions regarding this property, and that I do hereby
agree that the setback distances cited below be granted to the Applicant/Permittee listed on the following
page.
I understand the setback requirements set forth in 15A NCAC 02T. For the parcel identified
above, I consent to a reduced setback from feet to C) feet, thereby allowing the
application of wastewater effluent as near as e7 feet from my property line.
❑ I understand the setback requirements set forth in 15A NCAC 02T. For the parcel identified
above, I consent to a reduced setback from feet to feet, thereby allowing the
application of wastewater effluent as near as feet from my residence.
❑ I understand the setback requirements set forth in 15A NCAC 02T. For the parcel identified
above, I consent to a reduced setback from feet to feet, thereby allowing the
construction of wastewater treatment and storage units as near as _ feet from my property line.
❑ I understand the setback requirements set forth in 15A NCAC 02T. For the parcel identified
above, I consent to a reduced setback from feet to feet, thereby allowing the
constructi of stewater treatment and storage units as near as feet from my residence.
Signature: Date:
FORM: NDWSW 03-17 Page 1 of 2

Book 1851
Page 242
Applicant/Permittee:
Address: Parcel No.:
City: D5 J L State/zf�— Zip Code: (�--101��5 6'County: '"��
NORTH CAROLINA, NM n 0AX COUNTY
I, Ka W Ryy eS' a Notary Public for Noy Raymucounty, North Carolina,
do hereby certify that GN i S M w ( personally appeared before me this day
and acknowledged the due execution of the foregoing instrument.
Witness my hand and official seal, this the /� I day of M OXM , 12I T
SEAL ���EE�T Aa,P,
s Zirns
=
y �, e�
•hMnnnM`
DER C�J
aww A,
Signature of Notary Public
My commission expires
Once notarized, this form shall be recorded at the Register of Deeds in the county or
counties in which the described properties are located. A copy of the recorded
waiver shall be sent to the following address:
Division of Water Resources
Water Quality Permitting Section
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
FORM: NDWSW 03-17 Page 2 of 2

Doc No: 10012799
Recorded: 06/08/2017 11:44:34 AM
Fee Amt: $26.00 Page 1 of 2
Duplin County North Carolina
Davis H. Brinson, Register of Deeds
BK 1851 PG 243 - 244 (2)
State of North Carolina
Department of Environmental Quality
Division of Water Resources
NON -DISCHARGE WASTWATER SYSTEM WAIVER
AGREEMENT TO WAIVE SETBACKS AS REQUIRED BY
15A NCAC 02T .0506(a), .0506(b), .0606(a), .0706(a) AND .1006(a)
I, certify that I am a deeded owner of the property located at:
Address: Parcel No.: / — ®
City:
State: 141C Zip Code: 2 �, --> ounty:
Furthermore, I certify that I am authorized to make decisions regarding this property, and that I do hereby
agree that the setback distances cited below be granted to the Applicant/Permittee listed on the following
page.
IV I understand the setback requirements set forth in 15A NCAC 02T. For the parcel identified
above, I consent to a reduced setback from/ . feet to feet, thereby allowing the
application of wastewater effluent as near as Z:) feet from my property line.
❑ I understand the setback requirements set forth in 15A NCAC 02T. For the parcel identified
above, I consent to a reduced setback from feet to feet, thereby allowing the
application of wastewater effluent as near as feet from my residence.
❑ I understand the setback requirements set forth in 15A NCAC 02T. For the parcel identified
above, I consent to a reduced setback from feet to feet, thereby allowing the
construction of wastewater treatment and storage units as near as _ feet from my property line.
❑ I understand the setback requirements set forth in 15A NCAC 02T. For the parcel identified
above, I consent to a reduced setback from feet to feet, thereby allowing the
constructs wa ewater treatment and storage units as near as feet from my residence.
Signature: Date: � -7
FORM: NDWSW 03-17 Page 1 of 2

Book 1851
Page 244
Applicant/Permittee:
Address: Z1,12) Parcel No.:
City: State: �ip Code: County:
NORTH CAROLINA, *q ft V V
COUNTY
I, K A A • FAY ACC ', a Notary Public for I N4 gRYAo County, North Carolina,
do hereby certify that _ C r 1'C' 1 ' 1 V personally appeared before me this day
and acknowledged the due execution of the foregoing instrument.
Witness my hand and official seal, this the day of MRYyY l , S T
BEN A, ,c0 .
SEAL
""',,TVER COv
Signature of Notary Public
My commission expires D 2 2�> f Z v z I
Once notarized, this form shall be recorded at the Register of Deeds in the county or
counties in which the described properties are located. A copy of the recorded
waiver shall be sent to the following address:
Division of Water Resources
Water Quality Permitting Section
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
FORM: NDWSW 03-17 Page 2 of 2

Doc No: 10012800
Recorded: 06/08/2017 11:44:35 AM
Fee Amt: $26.00 Page 1 of 4
Duplin County North Carolina
Davis H. Brinson, Register of Deeds
BK 1861 PG 245 - 248 M
State of North Carolina
Department of Environmental Quality
Division of Water Resources
NON -DISCHARGE WASTWATER SYSTEM WAIVER
AGREEMENT TO WAIVE SETBACKS AS REQUIRED BY
15A NCAC 02T .0506(a), .0506(b), .0606(a), .0706(a) AND .1006(a)
I �� /(c ��� , �� , certify that I am a deeded owner of the property located at:
Address:
Parcel No.: 11 — AR 74(!:� * /I - `% `! 1
City: � j�11L State: SL Zip Code: County:
Furthermore, I certify that I am authorized to make decisions regarding this property, and that I do hereby
agree that the setback distances cited below be granted to the Applicant/Permittee listed on the following
page.
D understand the setback requirements set forth in 15A NCAC 02T. For the parcel identified
above, I consent to a reduced setback from: 1-5-D feet to 5-2:, feet, thereby allowing the
application of wastewater effluent as near as _ feet from my property line.
❑ I understand the setback requirements set forth in 15A NCAC 02T. For the parcel identified
above, I consent to a reduced setback from feet to feet, thereby allowing the
application of wastewater effluent as near as feet from my residence.
❑ I understand the setback requirements set forth in 15A NCAC 02T. For the parcel identified
above, I consent to a reduced setback from feet to feet, thereby allowing the
construction of wastewater treatment and storage units as near as _ feet from my property line.
❑ I understand the setback requirements set forth in 15A NCAC 02T. For the parcel identified
above, I consent to a reduced setback from feet to feet, thereby allowing the
construction of wastewater treatnnt and storage units as near its feet from my residence.
Signature: / �Z �� . ' / / Date: -7
FORM: NDWSW 03-17 Pagel of2

Book 1851
Page 246
Applieant/Permittee:�E?'
Address: ' Z� Parcel No.: /Z 142
City: _ �/� L State✓ Zip Code uniy:
COUNTY
-�a�rrr�rr�cvrfNA, �"�
I, 1� t (, Notary Public forte
do hereby certify that IFIRrd �,�j'� personally appeared before me this day
and acknowledged the due execution of the foregoing instrument.
Witness my hand and official seal, this the '-t '1 day of `t 1
tsIIIIIII
; REGISTRATION 9.
184491
MY COMM. EXP. Signature of Notary Public
03.31-2020
! ti�F V1RG�N:�, My commission expires L r
,IZARY Ott\�,
Once notarized, this form shall be recorded at the Register of Deeds in the county or
counties in which the described properties are located. A copy of the recorded
waiver shall be sent to the following address:
Division of Water Resources
Water Quality Permitting Section
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
FORM: NDWSW 03-17 Page 2 of 2

00
i.l
LO
N
0
Fw
N
•(
N
>N�/
LL
W
W
=
C-�-� U
z
�4,�
Z_
Z
0c)
CC)
��
M
RiX
'axeL
°m
M
C
O
ti
N N ..
d
AC�P°
Book 1851
Page 247
z
z

A
Book 1851
Page 248
v
a
� � v
d0
N£Zm�f
v a Z c
K p N a
T Tr l0 N
N � C
�m�Eapi�
aapp�
o c v ark �
p E >
Eo
a
.ISO
cd co
i+ N
0� re
M - H
UU =co
FU LU
co a:�...� O U Z F=
vZ Z 4 W
6�LL cl
J
eqq� 00O z cn
U • Z CO is
~ LLI
M N G� O O U
rE-4 .� W Z i( O a 7 N 0 0< cA
(�pp
m o � � > d N O • V H
A ' ® N O m LL O y., Ef} p 0 �_ o d Q O 00 _
Z
";r � y y ) (0 d OO — LPL _Z N
iC N CD
coo rn i N V d U y m G Q
oo•°L�N�d�>ca•� dM c`a�O� V U
o
cn c r Nn1 a)aC c.MQQ.�Q 0cw >
aaaa.m00a.0-1 <-i-1-1 Lux:9 LLW WOZ9
ry

Dac Na: 017 11:44:36 AM
10012801
Recorded O6/08/2
Fee Amt: $26.00
Page 1 of 2
Duplin County North Carolina
Davis H. Brinson, Register of Deeds
BK 1861 PG 249 - 250 (2)
State of North. Carolina
Department of Environmental Quality
Division of Water Resources
NON -DISCHARGE WASTWATER SYSTEM WAIVER
AGREEMENT TO WAIVE SETBACKS AS REQUIRED BY
15A NCAC 02T .0506(a), .0506(b), .0606(a), .0706(a) AND .1006(a)
I, �s , certify that I am a deeded owner of the property located at:
Address: Z,�' Parcel No.:
City: State: � Zip Code: _ County:
Furthermore, I certify that I am authorized to make decisions regarding this property, and that I do hereby
agree that the setback distances cited below be granted to the Applicant/Permittee listed on the following
page.
❑ I understand the setback requirements set forth in 15A NCAC 02T. For the parcel identified
above, I consent to a reduced setback from feet to feet, thereby allowing the
application of wastewater effluent as near as feet from my property line.
❑ I understand the setback requirements set forth in 15A NCAC 02T. For the parcel identified
above, I consent to a reduced setback from feet to feet, thereby allowing the
application of wastewater effluent as near as feet from my residence.
I understand the setback requirements set forth 15A NCAC 02T. For the parcel identified
above, I consent to a reduced setback from feet to � feet, thereby allowing the
construction of wastewater treatment and storage units as near as,�� feet from my property line.
❑ I understand the setback requirements set forth in 15A NCAC 02T. For the parcel identified
above, I consent to a reduced setback from feet to feet, thereby allowing the
construction of !y*tewater treatment and storage units as near as feet from my residence.
v
Signature:
Date: _
FORM: NDWSW 03-17 1 "/ Page 1 of

Book 1851
Page 250
Applicant/Permittee:
177
Address: ® Parcel No.: 1Z
City: II State: Zip Code: ✓ County: fi
NORTH CAROLINA, RL N aY\bN-t`( COUNTY
I, Ko w 1-con R . �' DY O e S , a Notary Public for NtV RW'Uq County, North Carolina, lJll 1
do hereby certify that Y 1 S Avg ro� personally appeared before me this day
and acknowledged the due execution of the foregoing instrument.
Witness my hand and official seal, this the 3 l` /
day of I' l OXOn , � It
SEAL �OT A.
0'
;
NNNNM� ,\
� DER CD
(� WWX'V) 'q' - ��
-ul \IJ
Signature of Notary Public
My commission expires 20 1 -Z'0 Z' l
Once notarized, this form shall be recorded at the Register of Deeds in the county or
counties in which the described properties are located. A copy of the recorded
waiver shall be sent to the following address:
Division of Water Resources
Water Quality Permitting Section
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
FORM: NDWSW 03-17 Page 2 of 2

Doc No: 10012802
Recorded: 06/08/2017 11:44:37 AM
Fee Amt: S26.00 Page 1 of 2
Duplin County North Carolina
Davis H. Brinson, Register of Deeds
BK 1851 PG 251 - 252 (2)
State of North Carolina u -
Department of Environmental Quality
Division of Water Resources
NON -DISCHARGE WASTWATER SYSTEM WAIVER
AGREEMENT TO WAIVE SETBACKS AS REQUIRED BY
15A NCAC�T 02.0306(a), .0506(b), .0606(a), .0706(a) AND .1006(a)
✓recertify that I am a deeded owner of the property located at:
Address: W ��1, 5 Parcel No.:4' —
City:ram, "V'!
: �F- State. Zip Code: County: P � u
Furthermore, I certify that I am authorized to make decisions regarding this property, and that I do hereby
agree that the setback distances cited below be granted to the Applicant/Permittee listed on the following
page -
ET I understand the setback requirements set forth in 15A NCAC 02T. For the parcel identified
above, I consent to a reduced setback from feet to feet, thereby allowing the
application of wastewater effluent as near as feet from my property line.
❑ I understand the setback requirements set forth in 15A NCAC 02T. For the parcel. identified
above, I consent to a reduced setback from feet to feet, thereby allowing the
application of wastewater effluent as near as feet from my residence.
I understand the setback requirements set forth in 15A NCAC 02T. For the parcel identified
above, I consent to a reduced setback from -5 S " feet to z�D feet, thereby allowing the
construction of wastewater treatment and storage units as near as _�O feet from my property line.
❑ I understand the setback requirements set forth in 15A NCAC 02T. For the parcel identified
above, I consent to a reduced setback from feet to feet, thereby allowing the
construction of wastewater treatment an
d-stexage units as near as feet from/may residence.
Signature: //✓ „'i Date:
/ y
FORM: NDWSW 03-17 Pagel of2

Book 1851
Page 252
Applicant/Permittee: V-Sr
Address:
Parcel No.:
City: State: AIL Zip Code: 'fye Y` Co, 'ea-PAI.,V,
NORTH CAROLINA, COUNTY
",//r-//1 i LJ w Notary Public for Count
y, North Carolina,
do hereby certify that personally appeared before me this day
yf
and acknowledged the due execution of the foregoing instrument.
Witness my hand and official seal, this the, � ��-day of
VEAL tl L
P
Signature of Notary Public
My commission expires 3LZ4 7
Once notarized, this form shall be recorded at the Register of Deeds in the county or
counties in which the described properties are located. A copy of the recorded
waiver shall be sent to the following address:
Division of Water Resources
Water Quality Permitting Section
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
FORM: NDWSW 03-17 Page 2 of 2

Doc No: 10012803
Recorded: 06/08/2017 11:44:38 AM
Fee qmt: $2600 Page 1 of 2
Duplin County North Carolina
Davis K Brinson, Register of Deeds
SK 1851 PG 253 - 254 (2)
State of forth Carolina
Department of Environmental Quality
Division of Water Resources
AGREEMENT TO WAIVE SETBACKS AS REQUIRED BY
15A NCAC 02T .0506(a), .0506(b), .0606(a), .0706(a) AND .1006(a)
2'Q�ti�o
O.%j4m�'� , certify that I am a deeded owner of the property located at:
Address: �� Parcel No.:
City: Stater Zip Code: :;Zz County:
Furthermore, I certify that I am authorized to make decisions regarding this property, and that I do hereby
agree that the setback distances cited below be granted to the Applicant/Permittee listed on the following
page.
I understand the setback requirements set forth in 15A NCAC 02T. For the parcel identified
above, I consent to a reduced setback from % 5`� feet to ® feet, thereby allowing the
application of wastewater effluent as near as 0 feet from my property line.
❑ I understand the setback requirements set forth in 15A NCAC 02T. For the parcel identified
above, I consent to a reduced setback from feet to feet, thereby allowing the
application of wastewater effluent as near as feet from my residence.
❑ I understand the setback requirements set forth in 15A NCAC 02T. For the parcel identified
above, I consent to a reduced setback from feet to feet, thereby allowing the
construction of wastewater treatment and storage units as near as _ feet from my property line.
❑ I understand the setback requirements set forth in 15A NCAC 02T. For the parcel identified
above, I consent to a reduced setback from feet to feet, thereby allowing the
construction w �tewater treatment and storage units as near as feet from my residence.
7
Signature: Date:
FORM: NDWSW 03-17 Page 1 of

Book 1851
Page 254
Applicant/Permittee:/= U�
Address: �� �� Parcel No.: --1W-7
City: XV - State: � Zip Code: ��� ounty:
NORTH CAROLINA, I V w ftwa COUNTY
I, _ VAft R , RY ilb a Notary Public for M*County, North Carolina,
do hereby certify that Nos mmpersonally appeared before me this day
and acknowledged the due execution of the foregoing instrument.
Witness my hand and official seal, this the �
eEEN A. F�ys
SEAL ,'?V2, ».«T •....�.p .4
S 9
7
�mE iV
day of M a'y-m , U 1-7'
ALMIUAn - ,
Signature of Notary Public
My commission expires 'D I Z� ! I't) -Z' I
Once notarized, this form shall be recorded at the Register of Deeds in the county or
counties in which the described properties are located. A copy of the recorded
waiver shall be sent to the following address:
Division of Water Resources
Water Quality Permitting Section
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
FORM: NDWSW 03-17 Page 2 of 2

III IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII III
Doc No: 10012804
Recorded: 06/08/2017 11:44:39 AM
Fee Amt: $26.00 Page 1 of 2
Duplin County North Carolina
Davis H. Brinson, Register of Deeds
BK 1851 PG 255 - 256 (2)
State of North Carolina
Department of Environmental Quality
Division of Water Resources
NON-DISCHARGE WASTWATER SYSTEM WAIVER
AGREEMENT TO WAIVE SETBACKS AS REQUIRED BY
15A NCAC 02T .0506(a), .0506(b), .0606(a), .0706(a) AND .1006(a)
I, A% certify that I am a deeded owner of the property located at:
Address: e 'r ® Parcel No.:
City: Aic �� �. Stater Zip Code: County:
Furthermore, I certify that I am authorized to make decisions regarding this property, and that I do hereby
agree that the setback distances cited below be granted to the Applicant/Permittee listed on the following
page.
]� I understand the setback requirements set forth in 15A NCAC 02T. For the parcel identified
above, I consent to a reduced setback from �.� feet to fD feet, thereby allowing the
application of wastewater effluent as near as E) feet from my property line.
❑ I understand the setback requirements set forth in 15A NCAC 02T. For the parcel identified
above, I consent to a reduced setback from feet to feet, thereby allowing the
application of wastewater effluent as near as feet from my residence.
❑ I understand the setback requirements set forth in 15A NCAC 02T. For the parcel identified
above, I consent to a reduced setback from feet to feet, thereby allowing the
construction of wastewater treatment and storage units as near as _ feet from my property line.
❑ I understand the setback requirements set forth in 15A NCAC 02T. For the parcel identified
above, I consent to a reduced setback from feet to feet, thereby allowing the
constructio7astewater treatment and storage units as near as feet from my residence.
s
Signature: Date:
FORM: NDWSW 03-17 \/ Page 1 of 2

Book 1851
Page 256
Applicant/Permittee: ®L, e_ �� 5
Address: Parcel No.: J
City: " ® Z:nn State: e Zip Code: e��9-4 County:
NORTH CAROLINA, IVQ,Vd ROMD' X COUNTY
I, Y-,a-M"U,'n �- 1'' fACS, a Notary Public for NCW nut"(County, North Carolina,
V Y l
do hereby certify that y I Syy' (( 1� personally appeared before me this day
and acknowledged the due execution of the foregoing instrument.
Witness my hand and official seal, this the
A EN • F0"��.
ryT,Q.�SEAL
�Q %�L s�
fr 1
z
VER
day of Mam , !/v a
Signature of Notary Public p�
My commission expires ®2 Z D
Once notarized, this form shall be recorded at the Register of Deeds in the county or
counties in which the described properties are located. A copy of the recorded
waiver shall be sent to the following address:
Division of Water Resources
Water Quality Permitting Section
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
FORM: NDWSW 03-17 Page 2 of

Doc No: 10012805
Recorded: 06/08/2017 11:44:40 AM
Fee Amt: $26.00 Page 1 of 2
Duplin County North Carolina
Davis H. Brinson, Register of Deeds
BK 1851 PG 257 - 258 (2)
State of North Carolina
Department of Environmental Quality
Division of Water Resources
bNI
04
NON -DISCHARGE WASTWATER SYSTEM WAIVER
AGREEMENT TO WAIVE SETBACKS AS REQUIRED BY
15A NCAC 02T .0506(a), .0506(b), .0606(a), .0706(a) AND .1006(a)
certify that I am a deeded owner of the property located at:
Address: / ��_� Parcel No.:
City: State: Zip Code: "?_O�_�_County:
Furthermore, I certify that I am authorized to make decisions regarding this property, and that I do hereby
agree that the setback distances cited below be granted to the Applicant/Permittee listed on the following
page.
IRrI understand the setback requirements set forth in 15A NCAC 02T. For the parcel identified
above, I consent to a reduced setback from 1 2) feet to e?:) feet, thereby allowing the
application of wastewater effluent as near as feet from my property line.
❑ I understand the setback requirements set forth in 15A NCAC 02T. For the parcel identified
above, I consent to a reduced setback from feet to feet, thereby allowing the
application of wastewater effluent as near as feet from my residence.
❑ I understand the setback requirements set forth in 15A NCAC 02T. For the parcel identified
above, I consent to a reduced setback from feet to feet, thereby allowing the
construction of wastewater treatment and storage units as near as feet from my property line.
❑ I understand the setback requirements set forth in 15A NCAC 02T
above, I consent to a reduced setback from feet to
construction_of ewater treatment and storage units as near as
Signature:
. For the parcel identified
feet, thereby allowing the
feet from my residence.
Date:
FORM: NDWSW 03-17 \ / Page 1 of 2

Book 1851
Page 258
Applicant/Permittee:
Address: �� Parcel No.: Z�S'®
City: State-6 Zip Code: �� County:
NORTH CAROLINA, RM MY\U4tff COUNTY
1, Kgfttln N by In C S , a Notary Public for NM RMNU(County, North Carolina,
do hereby certify that C Y 1Y I S ' `� `y Y �l personally appeared before me this day
and acknowledged the due execution of the foregoing instrument.
Witness my hand and official seal, this the I day of
l�EN A OR '
SEAL J*,`4j - A R y %
% �
q'OVER GOv
A wuuw A -
"ure of Notary Public L� .
My commission expires ®2 2 v
Once notarized, this form shall be recorded at the Register of Deeds in the county or
counties in which the described properties are located. A copy of the recorded
waiver shall be sent to the following address:
Division of Water Resources
Water Quality Permitting Section
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
8
FORM: NDWSW 03-17 Page 2 of 2

III IIIIIIIIIIIIIIIIIIIIIIIIIIII III
Doc No: 10012806
Recorded: 06/08/2017 11:44:41 AM
Fee Amt: $26.00 Page 1 of 2
Duplin County North Carolina
Davis H. Brinson, Register of Deeds
BK 1851 PG 259 - 260 (2)
State of North Carolina
Department of Environmental Quality
Division of Water Resources
AGREEMENT TO WAIVE SETBACKS AS REQUIRED BY
15A NCAC 02T .0506(a), .0506(b), .0606(a), .0706(a) AND .1006(a)
I, � "� , certify that I am a deeded owner of the property located at:
Address: �® 90/t/ 7 6 Parcel No.:
City: 7 / e--Z State - At Zip Code: County:
Furthermore, I certify that I am authorized to make decisions regarding this property, and that 1 do hereby
agree that the setback distances cited below be granted to the Applicant/Permittee listed on the following
page.
4
J] I understand the setback requirements set forth in 5A NCAC 02T. For the parcel identified
above, I consent to a reduced setback from ® feet to C�' feet, thereby allowing the
application of wastewater effluent as near as ® feet from my property line.
❑ I understand the setback requirements set forth in 15A NCAC 02T. For the parcel identified
above, I consent to a reduced setback from feet to feet, thereby allowing the
application of wastewater effluent as near as feet from my residence.
❑ I understand the setback requirements set forth in 15A NCAC 02T. For the parcel identified
above, I consent to a reduced setback from feet to feet, thereby allowing the
construction of wastewater treatment and storage units as near as _ feet from my property line.
❑ I understand the setback requirements set forth in 15A NCAC 02T. For the parcel identified
above, I consent -to a reduced setback from feet to feet, thereby allowing the
constructioa -Of'—w aktewater treatment a d storage units as near as feet from my resid ce.
Signature: Date:
FORM: NDWSW 03-17 I/ Page 1 of 2

Book 1851
Page 260
Applicant/Permittee:��%� C �'
Address: Q 7 Parcel No.:
City: & ® 2�_ ��% L� State: II(JL— Zip Code: County: Z%
NORTH CAROLINA, %Vg H Q M?Y COUNTY
I, K A MftS , a Notary Public for County, North Carolina,
do hereby certify that C Y `, 6 S 1 ' Vy personally appeared before me this day
and acknowledged the due execution of the foregoing inst�rupment.
Witness my hand and official seal, this the J day of I �/ `Q V 06
SEAL"N A. F0
ge t YNd'
�oV, R CO
Sig -nature of Notary Public
My commission expires b Z l Z 1 I
Once notarized, this form shall be recorded at the Register of Deeds in the county or
counties in which the described properties are located. A copy of the recorded
waiver shall be sent to the following address:
Division of Water Resources
Water Quality Permitting Section
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
FORM: NDWSW 03-17 Page 2 of 2

III IIIIIIIIIIIIIIIIIIIIIIIIII I I III
Doc No: 10012807
Recorded: 06/08/2017 11:44:42 AM
Fee Amt: $26.00 Page 1 of 2
Duplin County North Carolina
Davis H. Brinson, Register of Deeds
BK 1851 PG 261 - 262 (2)
Division of Water Resourt
UP
AGREEMENT TO WArVE SETBACKS AS REQUERED BY
15A NCAC 02T .0506(a), .0506(b), .0606(a), .0706(a) AND .1006(a)
certify that I am a deeded owner of the property located at:
Address: q �� 17 S
City: State: Zip Coder County:
Furthermore, I certify that I am authorized to make decisions regarding this property, and that I do hereby
agree that the setback distances cited below be granted to the Applicant/Permittee listed on the following
page.
❑ I understand the setback requirements set forth in 15A NCAC 02T. For the parcel identified
above, I consent to a reduced setback from feet to feet, thereby allowing the
application of wastewater effluent as near as feet from my property line.
❑ I understand the setback requirements set forth in 15A NCAC 02T. For the parcel identified
above, I consent to a reduced setback from feet to feet, thereby allowing the
application of wastewater effluent as near as feet from my residence.
I understand the setback requirements set forth in 15A NCAC 02T. For the parcel identified
above, I consent to a reduced setback from .g2L feet to feet, thereby allowing the
construction of wastewater treatment and storage units as near as�eet from my property line.
❑ I understand the setback requirements set forth in 15A NCAC 02T. For the parcel identified
above, I consent to a reduced setback from feet to feet, thereby allowing the
construction of wastewater treatment and storage units as near as feet from my residence.
Signature: aar-, Date: e 1 7
FORM: NDWSW 03-17 Page 1 of

Book 1851
Page 262
Applicant/Permittee:
Address: Parcel No.: �� r
City: State: Zip Code: County:
NORTH
.:
COUNTY
�10vi L.-i Notary Public for Va County, North Carolina,
toherebycertify that,j?dA '/ personaUy before me thisday
and acknowledged the due execution of the foregoing instrument.
Witness ashy hand and official seal, this the day of MR r C
SEAL
.'
s
6-2
PUBLIC
—.cot J,
1
Signature o. f Notary Public
My commission expires 0 9' ®` 2—o Z D
Once notarized, this form shall be recorded at the Register of Deeds in the county or
counties in which the described properties are located. A copy of the recorded
waiver shall be sent to the following address:
Division of Water Resources
Water Quality Permitting Section
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
FORM: NDWSW 03-17 Page 2 of2

III uiiiiiiuiimiiiniiiii h
Doc No: 10012808
Recorded: 06/08/2017 11:44:43 AM
Fee Amt: $26.00 Page 1 of 4
Duplin County North Carolina
Davis H. Brinson, Register of Deeds
BK 1851 PG 263 - 266 (4)
State of North Carolina
Department of Environmental Quality
Division of Water Resources
0 N I
.1-2110,
NON -DISCHARGE WASTWATER SYSTEM WAIVER
AGREEMENT TO WAIVE SETBACKS AS REQUIRED BY
15A NCAC 02T .0506(a), .0506(b), .0606(a), .0706(a) AND .1006(a)
I, ��' ���*�• i`� .n - , certify that I am a deeded owner of the property located at:
Address:
Parcel No.: * // - 9 y
City: Az.�E �'j�/!1 State: _ VG Zip Coder County:
Furthermore, I certify that I am authorized to make decisions regarding this property, and that I do hereby
agree that the setback distances cited below be granted to the Applicant/Permittee listed on the following
page.
M4-understand the setback requirements set forth in 15A NCAC 02T. For the parcel identified
above, I consent to a reduced setback from 15-,D feet to 52> feet, thereby allowing the
application of wastewater effluent as near as j feet from my property line.
❑ I understand the setback requirements set forth in 15A NCAC 02T. For the parcel identified
above, I consent to a reduced setback from feet to feet, thereby allowing the
application of wastewater effluent as near as feet from my residence.
❑ I understand the setback requirements set forth in 15A NCAC 02T. For the parcel identified
above, I consent to a reduced setback from feet to feet, thereby allowing the
construction of wastewater treatment and storage units as near as _ feet from my property line.
❑ I understand the setback requirements set forth in 15A NCAC 02T. For the parcel identified
above, I consent to a reduced setback from feet to feet, thereby allowing the
construction of wastewater trea"nt and storage units as near as feet from my residence.
Signature: / �"� /� �/C!:;���e� Date: Y/y/1-7
FORM: NDWSW 03-17 Page 1 of

Book 1851
Page 264
Applicant/Permittee:
Address: ���2 i Parcel No.:
City: _ �/Z L- State; Zip Code���ounty:
DIORI4RET)�Il�TA COUNTY
- c
�I Notary Public for � , �•tg-C-a.�m,,
do hereby certify that _ (\ a=r. r .1"- personally appeared before me this day
and acknowledged the due execution of the foregoing instrument.
Witness my hand and official seal, this the LO)day of k
s
® N M. A/y l�
%/`�.�;Ir'NONWEgOF�Q.
S��ff . Go 'y •O-z :
0.
REGISTRATION #.
184491 -
MY COMM. EXP. =
Signature of Notary Public
03-31-2020 •
•
i� •� OP VIRG\r:\PC, ®�
My commission expires
ss OTARY P * N� %
sillies®®®
Once notarized, this form shall be recorded at the Register of Deeds in the county or
counties in which the described properties are located. A copy of the recorded
waiver shall be sent to the following address:
Division of Water Resources
Water Quality Permitting Section
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
FORM: NDWSW 03-17 Page 2 of

10
O
c�
iw
d'
M
00
N
41
Z
00 N
A U' n°, °:
Book 1851
Page 265
Co
00
LO
N
ICT
co
N
N
W
V ~_
L J
� Q
Z Z Z
o
z Z
M�1 M o U
LLI
d o O Q
O Q v LO o m> coLU
COCN �I � co I- - 0 O .L �-
O r- O ti 00 CO O O d O O
o �n C fi� E o
U) N N d � (If d o .� r- Z �I o
N
coAl CO i y v O N c O d v N m 0 a O O co
o 'a d L d O p o Gs d 0 v)
W ��* °;,a��,a�CL���"=��no°-N EE`C
a N '-' an d E N ca �a N' '� > t �° O�° I ca
>- > L •a
of Q•�•a���� m��� am }? c cU c`cZ ��
a U Z o •- 4)d) c v) w w M
'`+ aaaa�❑❑a❑� c° co
-j-iO cc °y 0y m v� 0
c «.
°Q-i-a>-w=��- iWWc)zH-

Book 1851
page 266
1=
T' O
co
}� N
O >
V UJ
�M � U J
•� U Z LU C0= 0 Q
�—+ z 1-4z Z z
Cri LL o
O 0 00 A LU
r O r z 00
1�1 M N O U
z o o Q ? C"L C) ca
x ,°D F-II m uj
o �� > C,4 O .L O
N p 00 LL In O Ff3 r N 0 ;.+ O
V V1 O CD 00 CL CD Or N O� N 0 00 .� r LL Z� N
•� _z
(D N 0 T O r r E� L Vj m 0 J �` c0
C)
L L V r (� (/� r 649. 0 U N L. L a, 0 r
00 O L(D N= i 'L d O V U d}
Aua`. w N>a �.� Nam,= >� 0 o
a L �> N LMM_�V N'0+ as LZ >
%Di 0 � Q - I.L. L) Q L V _ = V Z E N
w-1-1-1J}°UIL LEODa0mQ a=FI.-0zF°
r�