WQ0002284_More Information (Received)_20240129

Initial Review
Reviewer
nathaniel.thorn burg
Is this submittal an application? (Excluding additional information.) *
Yes No
If not an application what is the submittal type?* Annual Report
Residual Annual Report
Additional Information
Other
Permit Number (IR) * W00002284
Applicant/Permittee Outer Banks/Kinnakeet Associates, LLC
Email Notifications
Does this need review by the hydrogeologist? * O Yes OO No
Regional Office
CO Reviewer
Admin Reviewer

Submittal Form
Project Contact Information
Please provide information on the person to be contacted by NDB Staff regarding electronic submittal, confirmation of receipt, and other correspondence.
Name* MJ Chen
Email Address*
[e-mail]
Project Information
.........................
Application/Document Type*
New (Fee Required)
Modification - Major (Fee Required)
Renewal with Major Modification (Fee
Required)
Annual Report
Additional Information
Other
Phone Number*
8282528181
Modification - Minor
Renewal
GW-59, NDMR, NDMLR, NDAR-1,
N DAR-2
Residual Annual Report
Change of Ownership
We no longer accept these monitoring reports through this portal. Please click on the link below and it will take you to the correct form.
https://edoes.deq.nc.gov/Forms/NonDischarge_Monitoring_Report
Permit Type:*
Wastewater Irrigation
High -Rate Infiltration
Other Wastewater
Reclaimed Water
Closed -Loop Recycle
Residuals
Single -Family Residence Wastewater
Other
Irrigation
Permit Number:*
WQ0002284
Has Current Existing permit number
Applicant/Permittee Address*
PO Box 240908
Facility Name*
Kinnakeet Shores WWTP
Please provide comments/notes on your current submittal below.
At this time, paper copies are no longer required. If you have any questions about what is required, please contact Nathaniel Thornburg
at [e-mail].
Please attach all information required or requested for this submittal to be reviewed here.
(Application Form, Engineering Plans, Specifications, Calculations, Etc.)
RAI_response.pdf 101.94MB
Upload only 1 PDF document (less than 250 MB). Multiple documents must be combined into one PDF file unless file is larger
than upload limit.
* By checking this box, I acknowledge that I understand the application will not be accepted for pre -review until the fee (if required) has
been received by the Non -Discharge Branch. Application fees must be submitted by check or money order and made payable to the
North Carolina Department of Environmental Quality (NCDEQ). I also confirm that the uploaded document is a single PDF with all parts
of the application in correct order (as specified by the application).
Mail payment to:
NCDEQ — Division of Water Resources
Attn: Non -Discharge Branch
1617 Mail Service Center
Raleigh, NC 27699-1617
Signature
6W��
Submission Date 1/26/2024

v MCKIM&CREED
v
January 26, 2024
Zachary J. Mega
Engineer III
Division of Water Resources
512 North Salisbury Street
Raleigh, NC 27699
RE: Response to Additional Information Request #1
Application No. WQ0002284
Kinnakeet Shores WWTP
Mr. Mega,
E N G I N E E R S
S U R V E Y O R S
P L A N N E R S
M&C 09596-0001
Thank you for your thorough review of the permit application package
submitted on October 27, 2023. We have made edits to the application documents
based on your comments as outlined below. In order to expedite your review, we
have also summarized your questions/comments in Italic and our responses in
Bold here on a comment -for -comment basis.
A. Overall:
1. The submitted application package is unclear whether the Permittee for the issued
permit should be Outer Banks/Kinnakeet Associates, LLC or Carolina Water
Service, Inc. of North Carolina (CWS). Signature authority delegation
documentation was provided for CWS employees, and it is mentioned that CWS
has been designated as the Emergency Operator for the facility by the North
Carolina Utilities Commission (NCUC). Please clarify this and provide
documentation from the NCUC that shows which entity will be acting as the
Permittee going forward.
Please see the attached Oder in Docket No. W-1125 (Attachment A)
51 Thompson Street
issued by the North Carolina Utilities Commission (NCUC) appointing
Site o Carolina Water Service, Inc. of North Carolina as emergency operator of
the Outer Banks/Kinnakeet Associates, LLC owned Kinnakeet Shores
Asheville, NC 28803 WWTP.
B. Cover Letter (No Comment).
828.252.81 81
C. Application Fee (No Comment).
Fax [phone]
www.mckimcreed.com

D. Application (Form RWPI 06-16)
1. Item 1.3 — If the Permittee will be Outer Banks/Kinnakeet Associates, LLC, please
submit a properly executed Operational Agreement (Form: HOA 01-20) per 15A
NCAC 02T .0115(c). If the Permittee will be CWS, please submit a Certificate of
Public Convenience and Necessity from the NCUC or a letter from the NCUC's
Water and Sewer Division Public Staff stating an application for a franchise has
been received and that the service area is contiguous to an existing franchised
area or that franchise approval is expected.
Please see signed Operational Agreement for the final execution
(Attachment B).
2. Item 1.4 — Please complete all parts of this item.
Please see the revised Form RWPI 06-16 Item I.4 (Attachment Q.
E. Application (Form RWG 06-16):
1. Section IV— Please complete all items in this section.
Please see the revised Form RWG 06-16 Section IV (Attachment M
2. Item VILe — Please add information on the proposed chemical metering pumps to
this table.
Please see the revised Form RWG 06-16 Item VII.e (Attachment M
F. Setback Waivers:
1. Per Condition I.1.a of the Final Permit issued on August 17, 2018, and 15A
NCAC 02H .0219(j)(5), please submit fully executed setback waivers for any
habitable residence or place of assembly (including tennis courts) under separate
ownership that (1) are within 100 feet of the two foot freeboard elevation in the
3.07 million gallon (MG) lined five-day upset pond and (2) were constructed
before the five-day upset pond was originally permitted on August 7, 2002.
As per the Teams call on January 19, 2024, all parties agreed that the
priority is to implement proposed improvements upon the approval of
this permit application and bring the WWTP back to compliance. The
setback waivers will be provided later when the modification
application for the reclaimed water utilization system is submitted.
vWcICM&CREED

G. Engineering Plans:
1. Overall — Per Instruction D of Form: RWG 06-16, please revise the title sheet
and title block on all plan sheets to remove the phrase "PRELIMINARY
DESIGN — NOT FOR CONSTRUCTION" and replace it with "FINAL
DESIGN —NOT RELEASED FOR CONSTRUCTION".
Addressed and please see the revised drawings (Attachment E).
2. Sheet C01.2 —
a. Please remove all structures, pipes, valves, and appurtenances that are
proposed to be demolished on Sheet C01.1 for clarity.
Addressed and please see the revised Sheet C01.2 (Attachment E).
b. Please remove the traveling bridge filter and UV channel labels for clarity.
Addressed and please see the revised Sheet C01.2 (Attachment E).
H. Specifications:
1. Overall — Per Instruction E of Form: RWG 06-16, please revise the cover sheet to
remove the phrase "FINAL DESIGN — ISSUED FOR PERMIT — NOT FOR
CONSTRUCTION" and replace it with "FINAL DESIGN — NOT RELEASED
FOR CONSTRUCTION".
Addressed and please see the cover sheet for the specification
(Attachment F).
2. Section 46 33 42 (Liquid Chemical Metering Pump) —
a. Please include the three proposed chemical storage tanks for liquid chlorine in
the Specifications.
Water Guard Inc. will provide polyethylene bulk storage tanks
manufactured by Shutz Packaging Solutions to store sodium
hypochlorite 12.5% solution. Section 46 33 42 is provided to specify
these tanks (Attachment G).
b. Please include a Safety Data Sheet (SDS) for the selected liquid chlorine in
the Specifications.
Please see the attached SDS for sodium hypochlorite 12.5% solution
(Attachment H).
AeWcKIM&CREED

I. Engineering Calculations
1. Overall —
a. Per Instruction F of Form: RWG 06-16, please submit manufacturer
information for the proposed chemical metering pumps and chemical storage
tanks.
Please see attached manufacture information for proposed chemical
metering pumps and chemical storage tanks (Attachment I).
b. Per Instruction H of Form: RWG 06-16, please include an evaluation of the
residuals generated from the proposed tertiary filters that include
calculations for (1) the anticipated residuals production rate of the proposed
tertiary filters, (2) the maximum anticipated residuals production rate for the
modified facility, and (3) the residuals storage capacity of the modified
facility. Please demonstrate that the modified facility still meets the
minimum required 30 days of residual storage for dedicated reclaimed water
systems per 15A NCAC 02U.0402(j).
The only waste generated by proposed tertiary filters is backwash
waste, which will be pumped back to the headworks to be treated.
This project does not propose any modifications to the biosolids
treatment process. Residual coming out from secondary clarifiers
will continue to be sent to the sludge holding tank.
J. Site Map:
1. Per Instruction J of Form: RWG 06-16 and 15A NCAC 02U .0201(d), please
submit a Site Map that has been signed, sealed, and dated by a North Carolina
licensed Professional Engineer (PE) or Professional Land Surveyor (PLS) and
shows:
a. All facility -related structures and fences within 500 feet of all treatment and
storage units and all existing and proposed treatment and storage units
(please exclude the roof).
b. 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 treatment
and storage units.
vWcICM&CREED

c. Setbacks as required by 15A NCAC 02U .0701(a). Please note that the 5.1
MG storage/infiltration pond that was originally permitted on August 7,
2002, has the setbacks listed under 15A NCAC 02H .0219(k). If any listed
setback features do not exist within 500 feet of all treatment and storage
units, please disregard them.
d. d. All habitable residences or places of public assembly (including tennis
courts) within 500 feet of all treatment and storage units.
Because the dedicated reclaimed water utilization system is currently inoperable and
is planned to have a future modification, the Site Map only needs to show the
treatment and storage units associated with the Kinnakeet Shores WWTP.
Please see the signed and sealed site map attached herein (Attachment J).
K. Distribution System Monitoring Plan:
1. Per Instruction I of Form: RWG 06-16, please submit a distribution system
monitoring plan for verifying that reclaimed water standards outline under 15A
NCAC 02U.0301.
As stated previously, because the dedicated reclaimed water utilization
system is currently inoperable and is planned to have a future
modification, the distribution system monitoring plan will be provided
when the modification application for the reclaimed water utilization
system is submitted.
L. Additional Documentation:
1. Existing Permit:
a. Per Conditions 1.4, 1.7, and I.10 of the Final Permit issued on August 17,
2018, and 15A NCAC 02T .0108(b)(1)(B), please provide Form GW-1 for
each of the proposed monitoring wells (i.e., MW-10, MW-11, and MW-12).
Robert Tankard of the Washington Regional Office (WaRO) conducted a site
visit on September 31, 2023, and confirmed these monitoring wells have been
constructed, however, the Non -Discharge branch has not received
construction documentation.
Please see attached GW-1 forms for monitoring wells MW-10, MW-
11, and MW-12 (Attachment K).
2. Operational Agreement
a. See Comment D.1.
AeWcKIM&CREED

Please see the signed Operational Agreement - Form HOA 01-20
(Attachment B).
Please let me know if you have any questions or need additional information.
Sincerely,
MJ Chen, P.E., PhD.
McKim & Creed, Inc.
cc: Tony Konsul, CWS, Inc. of North Carolina
Jimmy Holland, McKim & Creed, Inc.
v, McKIM&CREED

ATTACHMENT
v MCMQM&CREED
ENGINEERS SURVEYORS PLANNERS

STATE OF NORTH CAROLINA
UTILITIES COMMISSION
RALEIGH
DOCKET NO. W-1125, SUB 9
DOCKET NO. W-1125, SUB 10
BEFORE THE NORTH CAROLINA UTILITIES COMMISSION
DOCKET NO. W-1125, Sub 9
In the Matter of
Greater Kinnakeet Shores Home Owners, Inc
c/o Pat Weston, P. O. Box 853, Avon, North
Carolina 27915,
Complainant
V.
Outer Banks/Kinnakeet Associates, LLC.,
Defendant
DOCKET NO. W-1125, Sub 10
In the Matter of
Kashf Ain, 17715 Dry Mill Road, Leesburg,
Virginia 20175,
Complainant
V.
Outer Banks/Kinnakeet Associates, LLC.,
Defendant
ORDER APPOINTING
CAROLINA WATER SERVICE,
INC. OF NORTH CAROLINA AS
EMERGENCY OPERATOR,
APPROVING RATES, AND
REQUIRING CUSTOMER
NOTICE AND SUBMISSION OF
CUSTOMER INFORMATION
BY THE COMMISSION: On June 28, 2022, the Commission issued an order in the
above -referenced dockets directing Outer Banks/Kinnakeet Associates, LLC (OBKA) to
appear before the Commission on Friday, July 22, 2022, at 10.00 a.m. in Commission
Hearing Room 2115, Dobbs Building, 430 North Salisbury Street, Raleigh, North Carolina,
and show cause why the Commission should not exercise its authority under N.C. Gen.
Stat. § 62-116(b) to appoint an emergency operator to furnish sewer utility service to the
Kinnakeet Shores subdivision'. Docket No. W-1125, Sub 9 involves the complaint of
In the order granting this franchise to OBKA and approving rates in Docket No. W-1125, Sub 0,
the franchise area included the Kinnakeet Shores Subdivision and nearby commercial development,
including Hatteras Plaza, Sun Coast Realty Office, U.S. Post Office — Avon, and Kinnakeet Shores
Clubhouse, in Dare County. Any reference to the Kinnakeet Shores subdivision and abbreviations for same

Greater Kinnakeet Shores Home Owners, Inc. (HOA) against OBKA, and Docket
No. W-1125, Sub 10 involves the complaint of Kashf Ain against OBKA. Both complaints
pertain to OBKA's ownership and operation of the Kinnakeet Shores Wastewater
Treatment Plant (WWTP).
The order also, among other things, consolidated Docket No. W-1125, Sub 9 and
Docket No. W-1125, Sub 10, scheduled an expert witness hearing on these consolidated
dockets to be held in conjunction with the show cause hearing, and directed the
participation of the Public Staff by providing expert witness testimony related to the
allegations of the complaints and the Commission's investigation into whether to appoint
an emergency operator.
On July 22, 2022, following the show cause and expert witness hearing, the
Commission issued an order finding that a real emergency exists at the WWTP, as the
WWTP is in very poor condition and in need of significant repair, is in non-compliance
with its permits, is not treating wastewater received, is not providing customers adequate
service, and as OBKA does not have the technical, managerial, and financial capacity to
become compliant with its obligations. (Emergency Order) In the Emergency Order, the
Commission instructed the Public Staff to (1) confirm whether Carolina Water Service,
Inc., of North Carolina (CWSNC) is willing to serve as emergency operator and, if so,
pursuant to what conditions; (2) confirm whether OBKA consents to the appointment of
an emergency operator; and (3) report to the Commission as soon as possible, but no
later than noon on Friday, July 29, 2022, on the foregoing matters.
On July 29, 2022, the Public Staff filed its report stating that Ray E. Hollowell, Jr.
(Mr. Hollowell), sole company official and managing member of OBKA, had yet to confirm
whether OBKA consents to the appointment of an emergency operator, but that CWSNC
is willing to serve as the emergency operator of the OBKA owned Kinnakeet Shores
WWTP and Kinnakeet Shores Collection System (WWTP), subject to certain conditions.
CWSNC CONTINGENCIES AS EMERGENCY OPERATOR
The Public Staff states in its report that CWSNC's agreement to serve as the
emergency operator of the WWTP is contingent upon the following conditions, quoted
verbatim below:
1. CWSNC intends to operate the Kinnakeet Shores system with contract
labor and provide management and oversight through use of its existing
CWSNC staff in North Carolina;
2. CWSNC anticipates being able to begin serving as emergency operator
for the Kinnakeet Shores system two weeks after being appointed;
3. CWSNC has requested that the Commission's Order appointing
CWSNC as the emergency operator clearly state:
in this Order includes those commercial properties and any additional commercial properties currently
serviced by the Kinnakeet Shores WWTP for any use throughout this order.
2

a. That CWSNC as emergency operator shall not be
responsible for, or liable for, any acts, omissions, system
operations and maintenance, or system installations,
occurring prior to the date of the appointment as
emergency operator.
b. That CWSNC shall have no responsibility for OBKA's
handling of customer deposits, if any, or any other
obligations or liabilities of OBKA arising from its operation
of the water and wastewater utility systems.
c. That CWSNC shall not be responsible for, or liable for, any
acts, omissions, obligations, or liabilities of OBKA; Ray E.
Hollowell, Jr. (Mr. Hollowell); the owners of any property
on which the utility assets are located, or any of them.
d. That CWSNC as emergency operator shall be made
financially whole by being reimbursed for all capital
investment for replacements and upgrades, earn the
Commission approved return on CWSNC's capital
investments, earn the Commission approved operating
margin on CWSNC's reasonable operating expenses,
recovering all of CWSNC's reasonable operating
expenses as emergency operator.
e. That there be a true up at the time CWSNC is relieved of
its duties.
f. That upon appointment of CWSNC as emergency
operator, the customers of this system shall be subject to
the applicable CWSNC uniform rates.
g. That CWSNC as emergency operator may petition the
Commission at any time to be discharged as the
emergency operator, which discharge the Commission
shall approve.
Public Staff Report at 2-3. The Public Staff states that it fully supports the conditions
required by CWSNC for its appointment as Emergency Operator.
CWSNC'S PLAN TO ALLEVIATE EMERGENCY
The Public Staff also provides information concerning CWSNC's plan to alleviate
the emergency that currently exists within the Kinnakeet Shores WWTP and Kinnakeet
Shores Collection System. The Public Staff states that based on North Carolina
Department of Environmental Quality (DEQ), Division of Water Resources (DWR), Water
Quality Regional Operations Section records, and its preliminary due diligence, CWSNC
anticipates spending no less than $1,000,000 for necessary replacements and upgrades
to the WWTP. In its preliminary due diligence, CWSNC identified the immediate needs
which must be addressed to alleviate the emergency, and materially improve the
operation and compliance status of the WWTP to require repairing or replacing: (a) the
existing irrigation system for effluent disposal; (b) critical pumps, motors, and blowers;
3

(c) electrical systems; (d) emergency generator; (e) UV disinfection system; (f) stairs and
walkways; (g) building roof; and (h) tank coatings.
The Public Staff states that CWSNC has agreed to immediately invest its own
funds to expedite the system improvements and bring the system closer to permit
compliance. While CWSNC's advancement of the plant improvement capital funds will
greatly accelerate the necessary renovations and replacements, CWSNC would be fully
reimbursed for the expeditious capital renovations through eventual distribution of the
bond funds and rates subject to true up. Per the Public Staff, CWSNC notes that this
process will be more expedient than postponing renovations until after the Commission
receives the forfeited bond proceeds. The Public Staff states that the costs for the
necessary immediate improvements are estimated to materially exceed OBKA's existing
$110,000 bond amount.
The Public Staff notes that obtaining qualified entities to serve as emergency
operators has become more difficult, and traditional ratemaking approaches have failed
to compensate emergency operators for the substantial financial and management
resources required to operate and maintain a water or wastewater utility system owned
by another entity. Therefore, the Public Staff recommends the following:
a. CWSNC be authorized to earn a return on investment in plant and
recover the annual depreciation expense related to the investment. The
Public Staff maintains that an appropriate return would be the overall
rate of return of 7.14% which is the same return approved for CWSNC
for its other North Carolina service areas by general rate case order
issued April 8, 2022, in Docket No. W-354, Sub 384, which is based on
a capital structure of 49.80% long-term debt with an embedded cost of
4.85%, and 50.20% common equity with an equity return of 9.40%.
b. That CWSNC may petition the Commission for approval to adjust the
rate of return to the most recent approved rate in its most recent rate
case order.
c. That CWSNC should be allowed to earn a margin on its reasonable and
prudent operating expense. As CWSNC would receive the annual
depreciation funds as its plant investment declines, the operating margin
would not apply to the depreciation expense as is normal rate making
practice under the operating ratio Montclair method previously approved
by the Commission. The Public Staff recommends that a 7.14%
operating margin will be fair compensation for CWSNC given the
magnitude and difficulty of its responsibilities as emergency operator of
the OBKA sewer utility system.
Id. at 5-6.
The Public Staff states that CWSNC should be allowed to charge Kinnakeet
Shores' customers its current uniform sewer rates. CWSNC's current rates have been in
effect since April 8, 2022, pursuant to the Commission's Order in Docket No. W-354,
12

Sub 384. Based on the ratemaking approach described in the preceding paragraphs, the
Public Staff recommends that the Commission appoint CWSNC as emergency operator
of the OBKA sewer utility system and grant a rate increase from OBKA's current rates to
CWSNC's uniform flat rate sewer charges on a provisional basis as exemplified in
Appendix A attached to the Public Staff's Report.
OBKA'S REFUSAL TO CONSENT TO APPOINTMENT OF CWSNC AS
EMERGENCY OPERATOR
OBKA has fully participated in this matter with the filing of responsive pleadings, a
motion to strike, a motion to dismiss, representation by three separate attorneys, and the
filing of memoranda stating the utility's vacillating positions on the direction the utility
would prefer the matter to proceed.
On the morning of July 22, 2022, the day of the hearing, Mr. Hollowell filed an
affidavit through the utility's attorney, Patrick Buffkin, stating that he, on behalf of OBKA,
executed an Asset Purchase Agreement between OBKA and Currituck Water and Sewer,
LLC. (Currituck), in contemplation of the sale of the Company's assets, subject to the
Commission's approval of the transfer of the OBKA's certificate of public convenience
and necessity.
Also on July 22, 2022, at the beginning of the show cause and expert witness
hearing which began at 10.00 a.m., Mr. Buffkin informed the Commission that his
representation had been terminated that morning prior to the commencement of the
hearing, and the contract between OBKA and Currituck was no longer being pursued.
Additionally on July 22, 2022, Mr. Hollowell filed in these dockets a letter titled
"RESPONSE TO HEARING TODAY, JULY 22, 2022 BEFORE THE NORTH CAROLINA
UTILITIES COMMISSION" (July 22 Letter) in which Mr. Hollowell states that despite
driving overnight to attend the hearing, he turned around near the Virginia state line to
return to Cleveland, Ohio for heart catheterization procedures scheduled for 2.00 p.m.
that afternoon. He states that he dismissed his attorney at 7.43 a.m. In the letter, Mr.
Hollowell informed the Commission that he was no longer proceeding with the sale of
OBKA to Currituck, that he was preparing to sell OBKA to CWSNC and that sales
documents regarding the sale to CWSNC would be executed that day. Finally, Mr.
Hollowell states in the letter that he was prepared to suggest OBKA's bond funds be given
to the new operator, and he would "certainly do the same thing with Carolina Water if that
is acceptable to ... the Commission."
On July 29, 2022, the Public Staff filed a report with the Commission indicating that
it had made multiple attempts to contact Mr. Hollowell by telephone and email to confirm
whether OBKA consents to the appointment of an emergency operator. The Public Staff
states that it received a call from Mr. Hollowell that morning wherein he indicated that he
2 Mr. Buffkin is the third attorney to move to withdraw as counsel of record for OBKA in this docket.

would either send an email to the Public Staff or make a filing in these dockets. However,
no email or filing was made prior to the noon deadline established in the Emergency Order
for a response.
Following the noon deadline on July 29, 2022, Mr. Hollowell emailed the Public
Staff correspondence (July 29 Email) stating that his consent to the appointment of an
Emergency Operator is contingent upon the designee and that OBKA objects to the
appointment of CWSNC as the emergency operator. In this correspondence, Mr.
Hollowell informs the Commission that OBKA has again entered into an agreement with
Currituck for the sale of the WWTP and will not enter into a purchase agreement with
CWSNC "now or at anytime in the future." The information provided in the July 29 Email
directly contradicts the information provided in the July 22 Letter, a contradiction Mr.
Hollowell freely admits in paragraph 11 of the July 29 Email.
CONCLUSION
While Mr. Hollowell's correspondence has repeatedly provided consent to the
appointment of an emergency operator, he is under the mistaken impression that he can
direct which company the Commission may choose to appoint as that emergency
operator. Mr. Hollowell states in his July 29 Email that he has had time to "further consider
the best and most expeditious course of action to meet the needs of the community."
However, that analysis is within the sole purview of the Commission and not up to the
discretion of any party or utility appearing before it. Mr. Hollowell has filed an affidavit and
other statements stating that he intends to transfer this OBKA facility first to Currituck,
then to CWSNC, and then a reversal back to Currituck; but a search of the docket shows
that no transfer application has been filed and no docket has been reserved to accept the
filing of a transfer application. The Commission is not persuaded by Mr. Hollowell's filings
and finds that Mr. Hollowell's communications lack candor. Mr. Hollowell's actions have
stalled and thwarted the provision of adequate sewer service to the residents and property
owners of Kinnakeet Shores subdivision.
OBKA and Mr. Hollowell, sole company official and managing member of OBKA, have
failed to act on the requirements of the North Carolina Utilities Commission, the North
Carolina Division of Environmental Quality (DEQ), and the Public Staff, as described in the
Commission's Order Declaring an Emergency and Directing Public Staff to Identify
Emergency Operator issued on July 22, 2022. Mr. Hollowell has refused to voluntarily
surrender control of the system and has failed to properly maintain and operate the WWTP
in accordance with State standards and provide adequate, and in some instances any, sewer
utility service to his customers. He has refused to make the needed repairs to have the
moratorium lifted, refused to alleviate the emergency conditions affecting the service territory,
and refused to take action to stop current and continual damage to the surrounding
environment, which constitutes an abandonment of this system.
9

The failure of OBKA to provide adequate sewer utility service to the franchise area
continues to constitute an emergency as defined in N.C.G.S. § 62-116(b)3 and, in
addition, OBKA's failure and continued refusal to alleviate the emergency has reached
such an egregious level as to constitute an abandonment of the system. Moreover, this
emergency situation will only worsen with the continued and constant inflow of untreated
sewage to the WWTP, and there is no alternative supplier of wastewater treatment
available to these customers.
OBKA has been given more than ample opportunity to correct the problems on its
own or surrender the system to allow a viable operator to alleviate the emergency, yet
has refused to do so. Accordingly, the Commission finds that it should appoint CWSNC
as the emergency operator of the WWTP pursuant to N.C.G.S. § 62-116(b), and hereby
does grant emergency and temporary operating authority to CWSNC, who now
successfully operates water and sewer systems in the coastal areas of North Carolina
and is willing and capable of assuming the duties of emergency operator for the Kinnakeet
Shores WWTP and Kinnakeet Shores Collection System.
Because of OBKA's lack of response to continued requests from the DEQ and the
Public Staff to improve its system, the system is in a dilapidated and malfunctioning state.
Therefore, the Commission should restrict the use of the lands, rights -of -way, ponds, and
all facilities of the WWTP for the provision of sewer utility service and require OBKA to
immediately turn over the customer names, addresses, and billing information concerning
the Kinnakeet Shores subdivision no later than Wednesday, August 10, 2022, at
5.00 p.m., by filing the detailed and complete list confidentially in the Commission's STAR
database.
Due to increasing difficulty in finding emergency operators and the failure of
traditional ratemaking approaches to compensate emergency operators for the
substantial financial and management resources required to alleviate emergency
conditions and operate and maintain a wastewater utility system owned by another entity,
implementing increased rates pursuant to the rate structure proposed by CWSNC and
recommended by the Public Staff is just and reasonable and should be approved.
Accordingly, CWSNC should be allowed to charge Kinnakeet Shores' customers its
current uniform flat rate sewer charge on a provisional basis. CWSNC's current rates
have been in effect since April 8, 2022, pursuant to the Commission's Order in Docket
No. W-354, Sub 384.
The Commission shall maintain jurisdiction over the emergency operator and these
proceedings should any further order be required in the future.
3 Section 62-116(b) defines an emergency as the imminent danger of losing adequate water or
sewer utility service or the actual loss thereof.
7

IT IS, THEREFORE, ORDERED, as follows:
1. That OBKA has abandoned the Kinnakeet Shores WWTP and Kinnakeet
Shores Collection System in Dare County and that a real emergency continues to exist in
this service area because there is a loss of adequate sewer utility service and an actual
loss thereof for certain customers;
2. That the appointment of CWSNC as an emergency operator pursuant to
N.C.G.S. § 62-116(b) is necessary to take control of and operate the public utility system
of Kinnakeet Shores subdivision in order to alleviate the existing emergency and assure
the continued operation of the sewer utility system;
3. That CWSNC is hereby appointed as the emergency operator of the
Kinnakeet Shores WWTP and Kinnakeet Shores Collection System in Dare County
subject to the conditions listed in the preceding paragraphs of this Order;
4. That OBKA be, and hereby is, in conjunction with the appointment of an
emergency operator, required to: (a) make the lands, facilities, and rights -of -way, ponds,
and other facilities used to render sewer utility service to all of the customers of Kinnakeet
Shores subdivision available for continued use in providing such service; (b) refrain from
putting the lands, rights -of -way, ponds, and other facilities heretofore used and being
used to provide sewer utility service to all of the customers of Kinnakeet Shores
subdivision to any other use; and (c) refrain from taking any action to frustrate, impede,
impair, or interfere with such continued use of the lands, rights -of -way, ponds, and all
facilities heretofore used and being used to provide sewer utility service to all of the
customers of Kinnakeet Shores subdivision;
5. That OBKA is compelled to turn over to CWSNC immediately all of OBKA's
customers' names, addresses, and billing information concerning the Kinnakeet Shores
sewer utility customers no later than Wednesday, August 10, 2022, at 5:00 p.m., by filing
a complete list, confidentially, in the Commission's online filing system;
6. That CWSNC is authorized to charge Kinnakeet Shores' customers its
current uniform flat rate sewer charge on a provisional basis, said rates having been in
effect since April 8, 2022, pursuant to the Commission's Order in Docket No. W-354,
Sub 384;
7. That a copy of the Notice to Customers, attached hereto as Appendix A
shall be mailed or hand delivered to all Kinnakeet Shores' customers within ten business
days of the date the confidential list of customers is filed in this docket, and that the
CWSNC shall submit to the Commission the attached Certificate of Service, properly
signed and notarized, not later than ten days after the date the confidential list of
customers is filed in this docket;
8. That the Schedule of Rates, attached hereto as Appendix B, is hereby
approved and deemed filed with the Commission pursuant to N.C.G.S. § 62-138;
A

9. That the Commission shall retain jurisdiction and supervision over the
emergency operator for the duration of the emergency and that CWSNC as emergency
operator may petition the Commission at any time to be discharged as the emergency
operator, which discharge the Commission shall approve with good cause shown; and
10. That the Commission shall provide such other and further relief as deemed
necessary and required in this matter.
ISSUED BY ORDER OF THE COMMISSION.
This the 3rd day of August, 2022.
NORTH CAROLINA UTILITIES COMMISSION
A� it G�� -
Erica N. Green, Deputy Clerk

STATE OF NORTH CAROLINA
UTILITIES COMMISSION
RALEIGH
DOCKET NO. W-1125, SUB 9
DOCKET NO. W-1125, SUB 10
BEFORE THE NORTH CAROLINA UTILITIES COMMISSION
DOCKET NO. W-1125, Sub 9
In the Matter of
Greater Kinnakeet Shores Home Owners, Inc
c/o Pat Weston, P. O. Box 853, Avon, North
Carolina 27915,
Complainant
V.
Outer Banks/Kinnakeet Associates, LLC.,
Defendant
DOCKET NO. W-1125, Sub 10
In the Matter of
Kashf Ain, 17715 Dry Mill Road, Leesburg,
Virginia 20175,
Complainant
V.
Outer Banks/Kinnakeet Associates, LLC.,
Defendant
APPENDIX A
PAGE 1 OF 2
NOTICE TO CUSTOMERS OF
KINNAKEET SHORES SEWER
UTILITY SYSTEM
NOTICE IS HEREBY GIVEN that the North Carolina Utilities Commission
(Commission) has appointed Carolina Water Service, Inc. of North Carolina (CWSNC) as
emergency operator for the Kinnakeet Shores sewer utility system in Dare County, North
Carolina.
CWSNC is currently serving as emergency operator for multiple water and
wastewater utility systems throughout North Carolina. CWSNC owns and operates ten
wastewater treatment plants and collection systems in the coastal region, the closest
being The Village at Nags Head, which is approximately 40 miles away from the
Kinnakeet Shores system. The Public Staff — North Carolina Utilities Commission
recommended that CWSNC be appointed emergency operator.

APPENDIX A
PAGE 2OF2
In its preliminary due diligence, CWSNC identified the need for immediate system
renovations and replacements in order to materially improve the operation and
compliance of the Kinnakeet Shores sewer utility system. These immediate
improvements will include repair or replacement of (a) the existing irrigation system for
effluent disposal, (b) critical pumps, motors, and blowers, (c) electrical systems, (d)
emergency generator, (e) disinfection system, (f) stairs and walkways, (g) building roof,
and (h) tank coatings. These improvements will take a period of time to complete.
That upon appointment of CWSNC as emergency operator, the customers of this
system shall be subject to CWSNC's uniform flat rate sewer charges on a provisional
basis, subject to true up at the time CWSNC is relieved of its duties. The Schedule of
Provisional Rates is attached hereto as Appendix B. The provisional rates will increase
the monthly residential bill for homes with three bedrooms or less from $37.44 to $85.12.
The increase will vary for residential and commercial customers greater than one REU.
CWSNC will begin as emergency operator on August 17, 2022. The telephone
number to call CWSNC for service issues and billing questions is 800-525-7990.
Customers may review the complete Commission Order dated August 3, 2022,
appointing CWSNC emergency operator on the Commission's website (www.ncuc.net)
by clicking on Docket Search under Dockets portal; then for Docket Number, entering
W-1148 Sub 9, and clicking on Documents to locate the Order dated August 3, 2022.
ISSUED BY ORDER OF THE COMMISSION
This the 3rd day of August, 2022.
NORTH CAROLINA UTILITES COMMISSION
5�� /t C-to�
Erica N. Green, Deputy Clerk

APPENDIX B
PAGE 1 OF 2
SCHEDULE OF PROVISIONAL RATES
for
OUTER BANKS/KINNAKEET ASSOCIATES, LLC
(Carolina Water Service, Inc. of North Carolina, Emergency Operator)
for providing sewer utility service in
KINNAKEET SHORES SUBDIVISION,
PHASES 6 THROUGH 12 AND 15 THROUGH 22,
HATTERAS PLAZA, SUN COAST REALTY OFFICE,
HATTERAS REALTY COMPLEX, US POST OFFICE — AVON
AND KINNAKEET SHORES CLUBHOUSE
Dare County, North Carolina
Monthly Flat Rate Service, per SFE or REU: $ 85.12
Multi -residential customers who are served by a master
meter shall be charged the flat rate per unit. $ 85.12
New Sewer Customer Charge: $ 27.00
Connection Fee:
Reconnection Charge. 2/
$2,500 per REU '/, with a minimum of $2,500
If sewer service is cut off by utility for good cause
MISCELLANEOUS UTILITY MATTERS
Charge for processing NSF Checks
Bills Due:
Bills Past Due:
Billing Frequency:
Finance Charge for Late Payment:
$ 25.00
On billing date
Actual Cost
21 days after billing date
Bills shall be rendered monthly
1 % per month will be applied to the
unpaid balance of all bills still past due
25 days after billing date.

APPENDIX B
PAGE 2OF2
Notes-
11 REU = Residential Equivalent Unit = 360 gallons/day design flow utilizing the 2T
Rules.
2/ The utility shall itemize the estimated cost of disconnecting and reconnecting service
and shall furnish this estimate to customer with cut-off notice. Customers who request to
be reconnected within nine months of disconnection at the same address shall be
charged the base facility charge for the service period they were disconnected.
Issued in Accordance with Authority Granted by the North Carolina Utilities Commission
in Docket No. W-1125, Subs 9 and 10, on this the 3rd day of August, 2022, effective
August 17, 2022.

CERTIFICATE OF SERVICE
I, , mailed with sufficient postage
or hand delivered to all affected customers the attached Notice to Customers issued by
the North Carolina Utilities Commission in Docket No. W-1125, Subs 9 and 10, and the
Notice was mailed, or hand delivered by the date specified in the Order.
This the
day of , 2022.
By:
The above named Applicant,
Signature
Name of Utility Company
, personally
appeared before me this day and, being first duly sworn, says that the required Notice to
Customers was mailed or hand delivered to all affected customers, as required by the
Commission Order dated in Docket No. W-1125, Subs 9
and 10.
Witness my hand and notarial seal, this the day of , 2022.
(SEAL) My Commission Expires:
Notary Public
Printed Name
Date

ATTACHMENT B:
v MCMQM&CREED
ENGINEERS SURVEYORS PLANNERS

STATE OF NORTH CAROLINA
COUNTY OF Dare Permit No. WQ0002284
OPERATIONAL AGREEMENT
This AGREEMENT made pursuant to G.S. 143-215.1 (dl) and entered into this 19 day of
January 2024 , by and between the North Carolina Environmental Management
Commission, an agency of the State of North Carolina, hereinafter known as the COMMISSION; and
Out Banks/Kinnakeet Associates, LLC. by Carolina Water Service, Inc. of North Carolina (Emergency Operator) , a non-profit corporation organized
and existing under and by virtue of the laws of the State of North Carolina, hereinafter known as the
ASSOCIATION.
WITNESSETH:
The ASSOCIATION was formed for the purpose, among others, of handling the property, affairs and
business of the development known as Out Banks/KimekM Associates, LLC. by Carolina water service, Inc. of Nor* Carolina (Emergency operator)
(hereinafter the Development); of operating, maintaining, re -constructing and repairing the common
elements of the lands and improvements subject to unit ownership, including the wastewater collection
system with pumps, wastewater treatment works, and/or disposal facilities (hereinafter Disposal System);
and of collecting dues and assessment to provide funds for such operation, maintenance, re -construction
and repair.
2. The ASSOCIATION desires, to construct and/or operate a Disposal System to provide sanitary sewage
disposal to serve the Development on said lands.
The ASSOCIATION has applied to the COMMISSION for the issuance of a permit pursuant to G.S. 143-
215.1 to construct, maintain, and/or operate the Disposal System.
4. The Development was created subject to unit ownership in the dwellings units, other improvements and
lands through filing of a Declaration of Unit Ownership (hereinafter Declaration), pursuant to Chapter
47C of the North Carolina General Statutes.
The COMMISSION desires to assure that the Disposal System of the Development is properly
constructed, maintained and operated in accordance with law and permit provisions in order to protect the
quality of the waters of the State and the public interest therein.
NOW, THEREFORE, in consideration of the promises and the benefits to be derived by each of the parties
hereto, the COMMISSION and ASSOCIATION do hereby mutually agree as follows:
1. The ASSOCIATION shall construct the Disposal System and/or make any additions or modifications to
the Disposal System in accordance with the permit and plans and specifications hereafter issued and
approved by the COMMISSION, and shall thereafter properly operate and maintain such systems and
facilities in accordance with applicable permit provisions and law.
2. The ASSOCIATION shall provide in the Declaration and Association Bylaws that the Disposal System
and appurtenances thereto are part of the common elements and shall thereafter be properly maintained
and operated in conformity with law and the provisions of the permit for construction, operation, repair,
and maintenance of the system and facilities. The Declaration and Bylaws shall identify the entire
wastewater treatment, collection and disposal system as a common element, which will receive the highest
priority for expenditures by the Association except for Federal, State, and local taxes and insurance.
FORM: HOA 01-20 Page 1 of 2

3. The ASSOCIATION shall provide in the Declaration and Association Bylaws that the Disposal System
will be maintained out of the common expenses. In order to assure that there shall be funds readily
available to repair, maintain, or construct the Disposal System beyond the routine operation and
maintenance expenses, the Declaration and Association Bylaws shall provide that a fund be created out of
the common expenses. Such fund shall be separate from the routine maintenance fund allocated for the
facility and shall be part of the yearly budget.
4. In the event the common expense allocation and separate fund(s) are not adequate for the construction,
repair, and maintenance of the Disposal System, the Declaration and Association Bylaws shall provide for
special assessments to cover such necessary costs. There shall be no limit on the amount of such
assessments, and the Declaration and Bylaws shall be provided such that special assessments can be made
as necessary at any time.
If a wastewater collection system and wastewater treatment and/or disposal facility provided by any city,
town, village, county, water and sewer authorities, or other unit of government shall hereinafter become
available to serve the Development, the ASSOCIATION shall take such action as is necessary to cause the
existing and future wastewater of the Development to be accepted and discharged into said governmental
system, and shall convey or transfer as much of the Disposal System and such necessary easements as the
governmental unit may require as condition of accepting the Development's wastewater.
Recognizing that it would be contrary to the public interest and to the public health, safety and welfare for
the ASSOCIATION to enter into voluntary dissolution without having made adequate provision for the
continued proper maintenance, repair and operation of its Disposal System, the ASSOCIATION shall
provide in the ASSOCIATION Bylaws that the ASSOCIATION shall not enter into voluntary dissolution
without first having transferred its said system and facilities to some person, corporation or other entity
acceptable to and approved by the COMMISSION by the issuance of a permit.
7. The ASSOCIATION shall not transfer, convey, assign or otherwise relinquish or release its responsibility
for the operation and maintenance of its Disposal System until a permit has been reissued to the
ASSOCIATION's successor.
8. The agreements set forth in numbered paragraphs 1, 2, 3, 4, S, 6, and 7 above shall be conditions of any
permit issued by the COMMISSION to the ASSOCIATION for the construction, maintenance, repair and
operation of the Disposal System.
9. A copy of this agreement shall be filed at the Register of Deeds in the County(ies) where the Declaration
is filed and in the offices of the Secretary of State of North Carolina with the Articles of Incorporation of
the Association.
IN WITNESS WHEREOF, this agreement was executed in duplicate originals by the duly authorized
representative of the parties hereto on the day and year written as indicated by each of the parties named below:
FOR THE ENVIRONMENTAL
MANAGEMENT COMMISSION
S. Daniel Smith, Director
Division of Water Resources
(Date)
Out BW*WjWA1e4 MwdatM u.c. by CaMU . way« Swim, Im Orxpm CMHM c Op"U )
Name of ASSOCIATION
!(Sigxnajture)
Tony Konsul, Director of Operations - CWSNC
Print Name and Title
k ��- AtL�
(Date)
FORM: HOA 01-20 Page 2 of 2

ATTACHMENT C:
v MCMQM&CREED
ENGINEERS SURVEYORS PLANNERS

State of North Carolina
DWR
Division of Water Resources
Department of Environmental Quality
Division of Water Resources
15A NCAC 02U — RECLAIMED WATER SYSTEMS — PROJECT INFORMATION
INSTRUCTIONS FOR FORM: RWPI 06-16 & SUPPORTING DOCUMENTATION
Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application.
For more information, visit the Water Quality Permitting Section Non -Discharge Permitting Unit website.
General —This form is required for all projects involving the generation, utilization, and or distribution of reclaimed water. At least one
of the following forms must also be included in the application package. However, multiple forms may be applicable. Unless
otherwise noted, the Applicant shall submit one original and two copies of the application and supporting
documentation. Please check the boxes below as appropriate to indicate which additional forms are included in the
application package:
® Reclaimed Water Generation (FORM: RWG) — for wastewater treatment facilities producing reclaimed water.
® Non -Conjunctive Utilization (FORM: RWNC) — for reclaimed water utilization activities, when the reclaimed water
utilization activity is required in order to meet the wastewater disposal needs of the facility.
❑ Conjunctive Utilization (FORM: RWCU) — for reclaimed water utilization activities, when the reclaimed water option is
not necessary to meet the wastewater disposal needs of the facility and other wastewater utilization/disposal methods are
available.
❑ Bulk Distribution (FORM: RWBD) — for distribution of reclaimed water in a bulk manner.
❑ Distribution Lines (FORM: RWDL) — for construction of reclaimed water distribution lines.
❑ Wetland Augmentation (FORM: RWWA) — for projects seeking to utilize reclaimed water for the purpose of wetland
augmentation.
❑ Local Program Approval (FORM: RWLPA) —for projects seeking permitting delegation for reclaimed water users.
A. Cover Letter (All Application Packages):
® List all items included in the application package, as well as a brief description of the requested permitting action.
B. Application Fee (All New and Major Modification Application Packages):
® Submit a check, money order or electronic funds transfer made payable to: North Carolina Department of Environmental
Quality (NCDEQ) according to the following fee schedules:
® STANDARD REVIEW —Submit the appropriate fee for all new and major modification applications as listed in the table
below.
Facility Classification
New Permit
Major Modification'
Major Generator/User (ADF > 10,000 gallons per day)
FS1,310
S395
Minor Generator/User (ADF < 10,000 gallons per day)
$810 S245
Reclaimed Water Distribution Lines
7S480 N/A
' A major modification shall be defined as any permit modification that: increases the generating facility's
average daily flow (ADF); increases the utilization area acreage; adds additional utilization areas not
previously approved; or includes the addition of new treatment units/processes not previously permitted.
There is no fee for minor permit modifications.
INSTRUCTIONS FOR FORM: RWPI 06-16 & SUPPORTING DOCUMENTATION Page 1 of 2

C. Reclaimed Water Project Information Form (FORM: RWPI 06-16) (All application packages):
® Submit the completed and appropriately executed Reclaimed Water Project Information (FORM: RWPI 06-16) form. Please
do not make any unauthorized content changes to this form.
® The applicant name in Item I.1. shall be consistent with the applicant name on the plans, specifications, agreements, etc.
® The Applicant's Certification on Page 3 of this form shall be signed in accordance with 15A NCAC 02T .0106(b). The
application must be signed by a principal executive officer of at least the level of vice-president or his authorized representative
for a corporation; by a general partner for a partnership or limited partnership; by the proprietor for a sole proprietorship;
and by either an executive officer, an elected official in the highest level of elected office, or other authorized employee for a
municipal, state, or other public entity. An alternate person may be designated as the signing official if a delegation letter is
provided from a person who meets the criteria in 15A NCAC 02T .0106(b).
❑ If this project is for a renewal without modification, use the Non -Discharge System Renewal (FORM: NDSR) application.
There is no fee for permit renewal without modification.
D. Existing Permit: (All Modification Packages):
® Submit the most recently issued existing permit.
❑ Provide a list of any items within the permit the Applicant would like the Division to address during the permit modification
(i.e., compliance schedules, permit description, monitoring, permit conditions, etc.).
ONE ORIGIANL AND TWO COPIES OF THE COMPLETED APPLICATION AND SUPPORTING DOCUMENTATION
SHALL BE SUBMITTED TO:
NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF WATER RESOURCES
WATER QUALITY PERMITTING SECTION
NON -DISCHARGE PERMITTING UNIT
By U.S. Postal Service:
1617 MAIL SERVICE CENTER
RALEIGH, NORTH CAROLINA 27699-1617
TELEPHONE NUMBER: [phone]
By Courier/Special Deliverv:
512 N. SALISBURY STREET
RALEIGH, NORTH CAROLINA 27604
FAX NUMBER: [phone]
INSTRUCTIONS FOR FORM: RWPI 06-16 & SUPPORTING DOCUMENTATION Page 2 of 2

State of North Carolina
DWR
Department of Environmental Quality
Division of Water Resources
Division of Water Resources 15A NCAC 02U — RECLAIMED WATER SYSTEMS — PROJECT INFORMATION
FORM: RWPI06-16
L GENERAL INFORMATION:
1. Applicant's name: Outer Banks Kinnakeet Associates, LLC by Carolina Water Service Inc, of NC (EmergencyOperators)
Mailing address: PO Box 240908
City: Charlotte State: NC Zip: 28224-908
Telephone number: 7( 04) 576-1685 Email Address: Tony. Konsulkearolinawaterservicene.com
2. Signature authority's name: Tony Konsul (per 15A NCAC 2U .0106) Title: Director of Operations- CWSNC
3. Applicant type (check all that apply):
❑ Government > ❑ Federal ❑ State ❑ Municipal ❑ County
❑ Individual
❑ Corporation
✓ For new permits, submit documentation that the company is registered for business with the NC Secretary of State.
❑ General Partnership
✓ For new permits, submit a copy of the certificate filed with the Register of Deeds in the county of business.
❑ Privately Owned Public Utility
✓ For new permits, submit a Certificate of Public Convenience and Necessity from the NC Utilities Commission, or a
letter from the NC Utilities Commission's Water and Sewer Division Public Staff stating an application for a
franchise has been received and that the service area is contiguous to an existing franchised area or that franchise
approval is expected.
® Home Owners Association
✓ For new permits, submit a properly executed Operational Agreement (FORM: HOA); and proposed or approved
Articles of Incorporation, Declarations and By-laws.
❑ Developer (where residential lots are to be sold)
✓ For new permits, submit a properly executed Operational Agreement (FORM: DEV)
4. Demonstration of historical consideration for permit approval:
Has the Applicant or any parent, subsidiary or other affiliate exhibited the following?
a. Has been convicted of environmental crimes under Federal law or G.S. 143-215.6131) ❑ Yes or ® No
b. Has previously abandoned a wastewater treatment facility without properly closing that facility? ❑ Yes or ® No
c. Has unpaid civil penalty where all appeals have been abandoned or exhausted? ❑ Yes or ® No
d. Is non -compliant with an existing non -discharge permit, settlement agreement or order? ® Yes or ❑ No
e. Has unpaid annual fees in accordance with 15A NCAC 02T .0105(e)(2)? ❑ Yes or ® No
FORM: RWPI 06-16 Page 1 of 3

IL PROJECT INFORMATION
1. Application type: Major Modification (See Instruction B) Fee Submitted $395 (See Instruction B)
2. For modifications, provide the existing permit number: WQ0002284 and most recent issuance date: 8/17/2018
3. Provide a brief description of the activities proposed for permitting: Convert the existing sand filter to disc filters and convert
the UV disinfection to the chlorine disinfection.
4. What is the status of the following associated permits and/or certifications ? (if not applicable, please mark as N/A)
Permit/Certification
Date Submitted
Date Approved
Permit/Certification No.
Agency Reviewer
Collection System (Q >
200,000 GPM
N/A
Dam Safety
N/A
Erosion & Sedimentation
Control Plan
N/A
Nationwide 12 / Section 404
N/A
Pretreatment
N/A
Sewer System
N/A
Stormwater Management Plan
N/A
Other:
✓ For any of the permits and certifications listed above that will directly impact the construction of the proposed reclaimed
water project, please provide documentation of permit approval or final certification. Note: This application may be
considered incomplete, or the resulting permit may be issued conditionally if a pending issuance of any of the related
permits/certifications directly impacts the proposed facility.
5. Documentation of the presence or absence of threatened or endangered aquatic species at the project site utilizing information
provided by the Department's Natural Heritage Program is required for construction of all new WWTP projects and/or non -
conjunctive utilization sites, and for any project involving expansion of a WWTP and/or non -conjunctive utilization site in
accordance with 15A NCAC 02T .0105(c)(10). Provide the location in application package where this documentation is
located: ; or explain why this item is N/A. N/A, It is an exiting121ant with process changes only.
6. Does this project utilize public monies or lands? ❑ Yes or ® No
✓ If yes, was an Environmental Assessment required under 15A NCAC 01 C?
Yes ❑ No
Include one of the following final environmental documents with this submittal:
❑ Finding of No Significant Impact, or ❑ Record of Decision
Describe any mitigating factors from the Environmental Assessment that impact the design and/or construction of the
reclaimed water project:
7. Is any portion of the proposed project (reclaimed water treatment units, storage units, distribution lines, or utilization areas)
located within the 100 year flood plain? ❑ Yes or ® No
✓ If yes, specify which portion(s) of the project are affected?
✓ If yes, has the Applicant submitted written documentation of compliance with § 143 Article 21 Part 6? ❑ Yes or ❑ No
Documentation should consist of a letter from the local authority (i.e., county/municipality) stating that the project
complies with any local floodplain ordinance that may apply.
FORM: RWPI 06-16 Page 2 of 3

Applicant's Certification (signing authority must be in compliance with 15A NCAC 02U .0106):
Tony Konsul Director of Operations- CWSNC
(signing authority name - PLEASE PRINT) (title)
attest that this application for Outer Banks Kinnakeet Associates LLC by Carolina Water Service of NC, Inc (Emergency Operators)
(facility name)
has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that any discharge of wastewater
from this non -discharge system to surface waters or the land will result in an immediate enforcement action that may include civil
penalties, injunctive relief, and/or criminal prosecution. I will make no claim against the Division of Water Resources should a
condition of this permit be violated. I also 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 to me as incomplete.
I further certify that the applicant or any affiliate has not been convicted of an environmental crime, has not abandoned a wastewater
facility without proper closure, does not have an outstanding civil penalty where all appeals have been exhausted or abandoned, are
compliant with any active compliance schedule, and do not have any overdue annual fees under Rule 15A NCAC 02U .0105. Note:
In accordance with NC General Statutes 143 A and 143-215.6B, any person who knowingly makes any false statement,
representation, or certification in any applicat n pac ge shall be guilty of a Class 2 misdemeanor, which may include a fine not to
exceed $10,000 as w 11 as civil penaViel up to 5,000 r violation.
Signature- Date: Z�2
FORM: RWPI 06-16 Page 3 of 3

ATTACHMENT D:
v MCMQM&CREED
ENGINEERS SURVEYORS PLANNERS

State of North Carolina
Department of Environmental Quality
DWR Division of Water Resources
15A NCAC 02U — RECLAIMED WATER SYSTEMS — GENERATION
Division of Water Resources INSTRUCTIONS FOR FORM: RWG 06-16 & SUPPORTING DOCUMENTATION
Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application.
For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting Unit website.
General — This application shall be used for projects involving the generation of reclaimed water that is to be utilized in either a
conjunctive or non -conjunctive manner. Non -conjunctive use means that the reclaimed water utilization activity is required
to meet the wastewater disposal needs of the generating facility. Conjunctive use means that the proposed utilization option
is not required to meet the wastewater disposal needs of the generating facility, and that other permitted utilization/disposal
alternatives are also available. Unless otherwise noted, the Applicant shall submit one original and two copies of the
application and supporting documentation.
Do not submit this application without an associated Reclaimed Water Project Information form (FORM: RWPI
A. Reclaimed Water Generation Application (FORM: RWG 06-16) (All application packages):
® Submit the completed and appropriately executed Reclaimed Water Generation (FORM: RWG 06-16) application. Please do
not make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to
the application may be made, as long as the attachments are numbered to correspond to the section and item to which they
refer.
® The facility name in Item IL 1. shall be consistent with the facility name on the plans, specifications, agreements, etc.
® The Professional Engineer's Certification on Page 9 of this form shall be signed, sealed and dated by a North Carolina licensed
Professional Engineer.
® The Applicant's Certification on Page 9 of this form shall be signed in accordance with 15A NCAC 02T .0106(b). The
application must be signed by a principal executive officer of at least the level of vice-president or his authorized representative
for a corporation; by a general partner for a partnership or limited partnership; by the proprietor for a sole proprietorship;
and by either an executive officer, an elected official in the highest level of elected office, or other authorized employee for a
municipal, state, or other public entity. An alternate person may be designated as the signing official if a delegation letter is
provided from a person who meets the criteria in 15A NCAC 02T .0106(2).
❑ If this project is for a renewal without modification, use the Non-DischargeSystem Renewal (FORM: NDSR) application.
B. Property Ownership Documentation (All Application Packages involving new or expanding generation systems):
❑ Per 15A NCAC 02U .0201(e) or 15A NCAC 02U .0202(f), the Applicant shall provide written documentation of ownership
for all property containing the reclaimed water generation equipment, reclaimed water storage units, and 5-day upset units.
Documentation shall consist of one (or more) of the following:
❑ Legal documentation of ownership (i.e., GIS deed or article of incorporation), or
❑ Written notarized intent to purchase agreement signed by both parties with a plat or survey map, or
❑ An easement running with the land specifically indicating the intended use of the property and meeting the requirements
of 15A NCAC 02L .0107(f), or
❑ A written notarized lease agreement signed by both parties, indicating the intended use of the property, as well as a plat or
survey map.
C. Wastewater Chemical Analysis (For new or expanding generation systems treating Industrial Waste):
❑ Per 15A NCAC 02U .0201(g) or .0202 provide a complete Division certified laboratory chemical analysis of the effluent
to be irrigated for the following parameters (For new facilities, an analysis from a similar facility's effluent is acceptable):
❑ Ammonia Nitrogen (NH3-N) ❑ 5-day BOD (BOD5) ❑ Total Dissolved Solids
❑ Calcium ❑ Magnesium ❑ Total Kjeldahl Nitrogen (TKN)
❑ Chemical Oxygen Demand (COD) ❑ Nitrate Nitrogen (NOs-N) ❑ Total Organic Carbon
❑ Chloride ❑ pH ❑ Total Phosphorus
❑ Coliphage (Type 2 reclaimed water only) ❑ Phenol ❑ Total Trihalomethanes
❑ Clostridium perfringens (Type 2 reclaimed water) ❑ Sodium ❑ Total Volatile Organic Compounds
❑ Fecal Coliform or E. coli ❑ Sodium Adsorption Ratio (SAR) ❑ Toxicity Test Parameters
INSTRUCTIONS FOR FORM: RWG 06-16 & SUPPORTING DOCUMENTATION Page 1 of 4

D. Engineering Plans (All Application Packages):
® Per 15A NCAC 02U .0201(c) or .0202(c), submit standard size and 11 x 17-inch plan sets that have been signed, sealed and
dated by a North Carolina licensed Professional Engineer.
® The engineering plans shall include the following items:
® Table of contents with each sheet numbered.
® A general location map with at least two geographic references, a vicinity map, fencing around treatment and storage
facilities.
® A process flow diagram showing all flow, recycle/return, aeration, chemical, and wasting paths. (For conjunctive facilities,
include only those treatment units, in addition to existing units, that are needed to produce reclaimed water.)
® Plan and profile views of all treatment and storage units, including their piping, valves, and equipment (i.e., pumps,
blowers, mixers, diffusers, flow meters, etc.), as well as their dimensions and elevations. (For conjunctive facilities,
include only those treatment units, in addition to existing units, that are needed to produce reclaimed water.
❑ Auxiliary power supply. (Non -conjunctive systems only.)
® A hydraulic profile from the treatment plant headworks to the point where reclaimed water is released to the distribution
system. (Non -conjunctive systems only.)
® Plans shall represent a completed design and not be labeled with preliminary phrases (e.g., FOR REVIEW ONLY, NOT
FOR CONSTRUCTION, etc.) that indicate they are anything other than final specifications. However, the plans may be
labeled with the phrase: FINAL DESIGN - NOT RELEASED FOR CONSTRUCTION.
E. Specifications (All Application Packages):
® Per 15A NCAC 02U .0201(c) or .0202(c), submit specifications that have been signed, sealed and dated by a North Carolina
licensed Professional End.
® At a minimum, the specifications shall include the following items:
® Table of contents with each section/page numbered.
® Detailed specifications for each treatment and storage unit, as well as all piping, valves, equipment (i.e., pumps, blowers,
mixers, diffusers, flow meters, etc.), audible/visual high water alarms, liner material, etc. (For conjunctive facilities,
include only those treatment units, in addition to existing units, that are needed in order to produce reclaimed water.)
❑ Site Work (i.e., earthwork, clearing, grubbing, excavation, trenching, backfilling, compacting, fencing, seeding, etc.)
® Materials (i.e., concrete, masonry, steel, painting, method of construction, etc.)
❑ Electrical (i.e., control panels, transfer switches, automatically activated standby power source, etc.)
® Means for ensuring quality and integrity of the finished product, including leakage, pressure and liner testing.
® Specifications shall represent a completed design and not be labeled with preliminary phrases (e.g., FOR REVIEW ONLY,
NOT FOR CONSTRUCTION, etc.) that indicate they are anything other than final specifications. However, the specifications
may be labeled with the phrase: FINAL DESIGN - NOT RELEASED FOR CONSTRUCTION.
F. Engineering Calculations (All Application Packages):
® Per 15A NCAC 02U .0201(c) or .0202(c), submit engineering calculations that have been signed, sealed and dated by a North
Carolina licensed Professional Engineer.
® At a minimum, the engineering calculations shall include the following items:
® Hydraulic and pollutant loading calculations for each treatment unit demonstrating how the designed effluent
concentrations in Application Item V.1. were determined (NOTE: "black box" calculations are unacceptable). (For
conjunctive facilities, include only those treatment units, in addition to existing units, that are needed to produce reclaimed
water.)
® Sizing criteria for each treatment unit and associated equipment (i.e., blowers, mixers, flow meters, pumps, etc.). (For
conjunctive facilities, include only those treatment units, in addition to existing units, that are needed in order to produce
reclaimed water.)
❑ Total and effective storage calculations for each storage unit.
❑ Friction/total dynamic head calculations and system curve analysis for each pump used.
® Manufacturer's information for all treatment units, pumps, blowers, mixers, diffusers, flow meters, etc.
❑ Flotation calculations for all treatment and storage units constructed partially or entirely below grade.
INSTRUCTIONS FOR FORM: RWG 06-16 & SUPPORTING DOCUMENTATION Page 2 of 4

G. Water Balance (For Non -Conjunctive application packages that include new or modified reclaimed water storage units to be
located on the property of the reclaimed water generator):
❑ Per 15A NCAC 02U .0202(k), submit a water balance that has been signed, sealed and dated by a qualified professional and
includes at a minimum:
❑ The water balance should be run over at least a two year iteration, should consider precipitation into and evaporation from
all open atmosphere storage impoundments, and should use variable number of days per month and include:
❑ Precipitation based on the 80' percentile and a minimum of 30 years of observed data.
❑ Potential Evapotranspiration (PET) using the Thornthwaite method, or another approved methodology, using a minimum
of 30 years of observed temperature data.
❑ Soil drainage based on the geometric mean of the in -situ KsAT tests in the most restrictive horizon and a drainage coefficient
ranging from 4 to 10% (unless otherwise technically documented).
❑ Other factors that may restrict the hydraulic loading rate when determining a water balance include:
❑ Depth to the SHWT and lateral groundwater movement.
❑ Nutrient limitations and seasonal application times to ensure reclaimed water is applied at appropriate agronomic rates.
❑ Note: Guidance on completing a water balance for non -conjunctive systems is available in the Water Balance Calculation
Policy.
H. Residuals Management Plan (All Application Packages with new, expanding or replacement wastewater treatment systems):
❑ Per 15A NCAC 02U .0802, submit a Residuals Management Plan that shall include, at a minimum:
❑ A detailed explanation of how generated residuals (including trash, sediment and grit) will be collected, handled, processed,
stored, and disposed.
❑ An evaluation of the treatment facility's residuals storage requirements based upon the maximum anticipated residuals
production rate and ability to remove residuals. NOTE: Per 15A NCAC 02U .0402(n), a minimum of 30 days of residual
storage shall be provided for non -conjunctive reclaimed water systems.
❑ A permit for residuals utilization or a written commitment to the Applicant from a Permittee of a Department approved
residuals disposal/utilization program that has adequate permitted capacity to accept the residuals or has submitted a
residuals/utilization program application. NOTE: Per 15A NCAC 02U .0202(i), a written commitment is not required at
the time of this application; however, it shall be provided prior to operation of any permitted facilities herein.
❑ If oil/grease removal and collection are a designed unit process, submit an oil/grease disposal plan detailing how the
oil/grease will be collected, handled, processed, stored and disposed. NOTE: If an on -site restaurant or other business with
food preparation is contributing wastewater to this system, an oil/grease disposal plan shall be submitted.
I. Distribution System Monitoring Plan (All application packages):
❑ Include a distribution system monitoring plan for verifying that reclaimed water standards (15A NCAC 02U .0301) will be met
at the utilization site(s). At a minimum, the following items shall be included:
❑ Specify the sampling locations within the distribution system that will provide data representative of the reclaimed water
delivered to users.
❑ The number of sampling locations should be equivalent to approximately 25 percent of the service connections to the
reclaimed water distribution system; or 5 locations, whichever is fewer. In no case shall fewer than two locations be
sampled.
❑ Monitoring shall include samples of: fecal coliform, pH, and total residual chlorine.
INSTRUCTIONS FOR FORM: RWG 06-16 & SUPPORTING DOCUMENTATION Page 3 of 4

Site Map (All Application Packages):
® Non -Conjunctive Systems
® Per 15A NCAC 02U .0202(d), submit standard size and 11 x 17-inch site maps that have been signed, sealed and dated by
a North Carolina licensed Professional Engineer and/or Professional Land Survey.
® For clarity, multiple site maps of the facility with cut sheet annotations may be submitted.
® At a minimum, the site map shall include the following:
® 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 and storage areas.
® 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 treatment and storage
sites.
❑ Setbacks as required by 15A NCAC 02U .0701(a) and (b).
® Site property boundaries within 500 feet of all treatment and storage units.
® All habitable residences or places of public assembly within 500 feet of all treatment and storage units.
❑ Conjunctive Systems
❑ Per 15A NCAC 02U .0201(d), submit standard size and 11 x 17-inch site maps that have been signed, sealed and dated by
a North Carolina licensed Professional Engineer and/or Professional Land Survey.
❑ For clarity, multiple site maps of the facility with cut sheet annotations may be submitted.
❑ At a minimum, the site map shall include the following:
❑ A scaled map of the site showing all facility -related structures and fences within the wastewater treatment and
storage areas.
❑ Location of features in 15A NCAC 02U .0701(a) and (b), to the extent needed to determine compliance with
setbacks.
K. Education Program (All New Generators)
❑ Per 15A NCAC 02U .0501, provide documentation of a program of education and approval for all reclaimed water users. At a
minimum this material shall include:
❑ Definition of reclaimed water.
❑ Information on the proper use of reclaimed water.
❑ Examples of improper uses of reclaimed water.
❑ Clarification that reclaimed water is not for drinking.
❑ Clarification that reclaimed water cannot be discharged to surface waters and should not be allowed to runoff from the
utilization areas.
❑ Address any other environmental and/or public health protection measures.
❑ Methods to be used to provide employees educational material in a language they can understand.
ONE ORIGINAL AND TWO COPIES OF THE COMPLETED APPLICATION AND SUPPORTING DOCUMENTATION
SHALL BE SUBMITTED TO:
NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF WATER RESOURCES
WATER QUALITY PERMITTING SECTION
NON -DISCHARGE PERMITTING UNIT
By U.S. Postal Service:
1617 MAIL SERVICE CENTER
RALEIGH, NORTH CAROLINA 27699-1617
TELEPHONE NUMBER: [phone]
By Courier/Special Delivery:
512 N. SALISBURY STREET
RALEIGH, NORTH CAROLINA 27604
FAX NUMBER: [phone]
INSTRUCTIONS FOR FORM: RWG 06-16 & SUPPORTING DOCUMENTATION Page 4 of 4

State of North Carolina
DWR
Department of Environmental Quality
Division of Water Resources
15A NCAC 02U — RECLAIMED WATER SYSTEMS — GENERATION
Division of Water Resources FORM: RWG 06-16
L CONTACT INFORMATION:
1. Applicant's name: Outer Banks Kinnakeet Associates, LLC by Carolina Water Service Inc. of NC (Emergency perators)
2. Signature authority's name: Tony Konsul (per 15A NCAC 02T .0106) Title: Director of Operations- CWSNC
3. Applicant's mailing address: PO Box 240908
City: Charlotte State: NC Zip: 28224-908
Telephone number: 7( 04) 576-1685 Email Address: Tony.Konsulkearolinawaterservicenacom
4. Consulting Engineer's name: Manjiang Chen License Number: 039025 Firm: McKim & Creed
Mailing address: 51 Thompson Street, Suite D
City: Asheville State: NC Zip: 28803-
Telephone number: [phone] Email Address: mchenA_mckimcreed.com
IL FACILITY INFORMATION
1. Reclaimed water generating facility name: Kinnakeet Shores WWTP
Facility's physical address: 41105 Big Kinnakeet Drive
City: Avon State: NC Zip: 27915-1158 County: Dare
2. Facility Coordinates: Latitude: 35' 20' 39" Longitude: -75' 30' 24"
Datum: NAD83 Level of Accuracy Unknown Method of Measurement Address matching
3. USGS Map Name: 7.5-minute
4. Information for nearest waterbody a:
Stream Index No.: 30-22 Stream Classification: SA,HQW
a To determine the waterbody stream index number and its associated classification, download the current classifications list
at the following web address: https://nedenr.s3.amazonaws.com/s3fs-
public/Water%20Qualit Aquifer%2OProtection/LAU/Agreements/WSCA%2008-13.pdf.
5. Facility status: Existing
6. Reclaimed water utilization will be:
® Non -Conjunctive —reclaimed water utilization is required to meet the wastewater disposal needs of the facility.
Conjunctive — reclaimed water option is not necessary to meet the wastewater disposal needs of the facility and other
wastewater utilization or disposal methods are available at all times (15A NCAC 02U .0103(3)).
For Conjunctive, what is the alternate wastewater disposal method?
❑ NPDES Permit No.
❑ Other (specify): _
FORM: RWG 06-16 Page 1 of 9

III. INFORMATION ON RECLAIMED WATER GENERATION:
1. What is the origin of the influent (i.e., school, residential, hospital, municipality, industry, etc.)? Residential
2. Reclaimed water generating capacity for this project: 350,000 gallons per day (GPD)
3. What is the wastewater type? ® Domestic or Industrial (See 15A NCAC 02T .0103(20))
Is there a Pretreatment Program in effect? ❑ Yes or ❑ No
Has a wastewater chemical analysis been submitted in accordance with
Instruction C? ❑ Yes or ❑ No
4. How was the influent flow rate determined? ❑ 15A NCAC 02T .0114 or ® Representative Data
5. Hasa flow reduction been approved under 15A NCAC 02T .0114(f)? ❑ Yes or ® No
6. Provide the required information in the table below to document design flow pursuant to 15A NCAC 02T .0114:
Establishment Type
Daily Design Flow a
No. of Units
Flow
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
GPD
IV. TREATMENT AND STORAGE UNIT SETBACKS (15A NCAC 02U .0701)
1. Provide the actual minimum distance in feet from the treatment units, storage units, and utilization areas to each item listed
(distances greater than 500 feet may be marked N/A):
Setback Parameter
Treatment Units/
Final Effluent Storage
5-day Upset Storage
Units
Required
Actual
Required
Actual
Any habitable residence or place of assembly under separate
ownership or not to be maintained as part of the project site
100
42
In
I
Any private or public water supply source
100
N/A
100
N/A
Surface waters (streams — intermittent and perennial,
perennial waterbodies, and wetlands
50
111
50
245
Any well with exception of monitoring wells
100
N/A
100
N/A
Any property line
50
42
50
27
2. Do the treatment and storage units comply with all setbacks found in the river basin rules (15A NCAC 213 .0200)?
❑ Yes or ® No If no, list non -compliant setbacks: Any habitatable residence or places and aU grope , line
3. Are any setback waivers required in order to comply with 15A NCAC 02U .0701? ® Yes or ❑ No
✓ If yes, have these waivers been written, notarized signed by all parties involved and recorded with the County Register
of Deeds? ❑ Yes or ® No
✓ If yes, has the required Non -Discharge Wastewater System Waiver (FORM: NDWSW) been included with this
application package? ❑ Yes or ® No
FORM: RWG 06-16 Page 2 of 9

V. RECLAIMED WATER CHARACTERISTICS:
1. Complete the table below by filling in the estimated influent concentrations and design effluent characteristics (15A NCAC 2U .0301):
Design Effluent
Design Effluent Design Effluent
Estimated
Monthly Average
Geometric Mean Daily Maximum
Parameter
Influent
Concentration
Actual
Required
Actual
Required Actual
Required
BOD5
mg/1
10 mg/1
10 mg/1(Type 1)
15 mg/1
15 mg/1(Type 1)
5 m /I (Type 2)
10 m /I (Type 2)
TSS
mg/1
5 mg/1
5 mg/1(Type 1)
10 mg/1
10 mg/1(Type 1)
5 m /I (Type 2)
10 m /I (Type 2)
NH3-N
mg/1
4 mg/1
4 mg/1(Type 1)
6 mgn
6 mg/1(Type 1)
lm /1 (Type 2
2m /1 (Type 2
NO3-N
mg/1
10 mg/1
NO2-N
mg/1
mg/1
Total Nitrogen
mg/1
mg/1
4 mg/1(wetland
au mentation only)
Total Phosphorus
mg/1
mg/1
1 mg/1(wetland
au mentat ion only)
TKN
mg/1
Turbidity
10 NTU
10 NTU (Type 1)
5 NTU (Type 2
Fecal Coliforms
OR
/100 ml
14/100 ml
14/100 ml (Type 1) 25/100 ml
25/100 ml (Type 1)
E. Coli ❑
3/100 ml (Type 2)
25/100 ml (Type 2)
choose one
Coliphage - (Type 2 only)
/100 ml
/100 ml
51100 ml (Type 2) /100 ml
25/100 ml (Type 2)
Clostridium perfingen - (Type 2 only)
/100 ml
/100 ml
51100 ml (Type 2) /100 ml
25/100 ml (Type 2)
2. Have calculations or historical data been provided to justify the design effluent values shown in Item V.I. above? (See Application Instruction F)? ® Yes ❑ No
✓ If No, please explain:
FORM: RWG 06-16 Page 3 of 9

VI. RECLAIMED WATER SYSTEM DESIGN CRITERIA (15A NCAC 02U .0401 or .0402)
1. Plan sheet number where instrumentation for continuous monitoring/recording for turbidity/particle count is shown: N/A
2. Plan sheet number where instrumentation for continuous flow recording is shown: N/A
3. What is the method of preventing public access to the treatment facility and five day upset basin? Fence
✓ Plan sheet number where restricted access method is shown: N/A
4. Is there an automatically activated standby power supply onsite? ® Yes ❑ No
✓ If Yes, plan sheet number where standby power supply is shown: C01.0
✓ If No, what other means will be used to prevent improperly treated wastewater from entering the storage, distribution, or
utilization system?
5. Will a certified operator of a grade equal or greater than the facility classification be on call 24 hrs/day? ® Yes or ❑ No
6. What classification of reclaimed water does the generator intend to provide per (15A NCAC 02U .0301)?
® Type 1 — 15A NCAC 02U .0301(b); or
Type 2 - 15A NCAC 02U .0301(a) - (Note: Type 2 required for indirect contact irrigation of food chain crops where the
food product will not be peeled, skinned, cooked or thermally processed prior to human consumption.)
Are the following design criteria met for Type 2?
✓ Dual disinfection systems containing both UV disinfection and chlorination (or equivalent dual disinfection processes)
provided pursuant to 15A NCAC 02U .0401(h) or .0402(a)? ❑ Yes ❑ No
✓ Has documentation been provided to show that the combined treatment and disinfection processes are capable of the
following pathogen reductions pursuant to 15A NCAC 02U .0401(i) or .0402(r)?
➢ log 6 or greater reduction of E. coli ❑ Yes ❑ No
➢ log 5 or greater reduction of Coliphage ❑ Yes ❑ No
➢ log 4 or greater reduction of Clostridium perfringens ❑ Yes ❑ No
❑ Other — 15A NCAC 02U .0301(c) — reclaimed water will be produced by an industrial facility, will be used at the facility
in the industry's process, use area has no public access, and the use will not result in employee exposure.
Items VL7.—VI.15. are for NON CONJUNCTIVE SYSTEMS — If you checked "Conjunctive" in Item IL6., skip to Section VIL•
7. Is aerated flow equalization provided with a capacity of at least 25% of daily system design flow? ® Yes or ❑ No
✓ If no, how does the Applicant intend on complying with 15A NCAC 02U .0402(b)?
8. Are dual facilities provided for all essential treatment units? ® Yes or ❑ No
Note: This refers to any unit process whose loss would likely render the facility incapable of meeting require performance
criteria including aeration, clarification, filtration, disinfection, pumps, blowers, etc. (See 15A NCAC 02T .0103(16�)
✓ If no, how does the Applicant intend on complying with 15A NCAC 02U .0402(c)?
9. Is automatic flow diversion to a 5-day upset pond provided in the event of plant upset? ® Yes or ❑ No
10. Does the treatment facility include any bypass or overflow lines? ❑ Yes or ® No
If yes, describe what treatment units are bypassed, why this is necessary, and where the bypass discharges:
11. Are multiple pumps provided wherever pumps are used? ® Yes or ❑ No
✓ If no, how does the Applicant intend on complying with 15A NCAC 02U .0402(k)?
FORM: RWG 06-16 Page 4 of 9

VI. RECLAIMED WATER SYSTEM DESIGN CRITERIA (Continued)
12. Are any treatment or storage units located within the 100-year flood plain? ❑ Yes or ® No
✓ If Yes, which units are affected? (Note that water tight seals or a minimum of two feet protection from the 100-year
floodplain is required.)
✓ If No, then provide the distance to the nearest flood zone: 1000 (feet); and provide the typical elevation at the edge of the
flood zone: 9 (feet)
13. How many days of residuals storage are provided? N/A (Note: 30 days required per 15A NCAC 02U .0402(n))
14. If an influent pump station is part of the proposed facility (i.e., within the wastewater treatment plant boundary), does the
influent pump station meet the design criteria in 15A NCAC 02T .0305(h)?
❑ Yes, ❑ No, ❑ N/A — To be permitted separately, or ❑ N/A — Gravity fed
VILDESIGN INFORMATION FOR NEW OR MODIFIED PORTIONS OF THE TREATMENT FACILITY
1. Type of treatment system (extended aeration, MBR, SBR, etc): Extended Aeration
2. Provide the requested treatment unit and mechanical equipment information (For conjunctive facilities, include only those
treatment units, in addition to existing units, that are needed to produce reclaimed water):
a. PRELIMINARY/PRIMARY TREATMENT: ❑ New Units, ❑ Modified Units ® N/A
Treatment Unit
Number
of Units
Manufacturer
or Material
Dimensions (ft)
/ Spacings in(gallons)
Volume
Plan Sheet
Number
Specification
Page Number
Select
Select
Select
Select
Select
Select
b. SECONDARY / TERTIARY TREATMENT ❑ New Units, ® Modified Units ❑ N/A
Treatment Unit
Number
of Units
Manufacturer
or Material(gallons)
Dimensions (ft)
Volume
Plan Sheet
Number
Specification
Page Number
Tertiary Filters
2
Hydrotech
MOLL
46 61 46
Select
Select
Select
Select
Select
Select
FORM: RWG 06-16 Page 5 of 9

VII. DESIGN INFORMATION FOR NEW OR MODIFIED PORTIONS OF THE TREATMENT FACILITY (Continued)
C. DISINFECTION ❑ New Units, ® Modified Units ❑ N/A
Number
Manufacturer
Volume
Plan Sheet
Specification
Treatment Unit
Dimensions (ft)
of Units
or Material(gallons)
Number
Page Number
21 x 8.5 x 4.52
Chlorination Tank
2
12,072 total
M02.1
N/A
each
Select
Select
Select
➢ If chlorination is the proposed method of disinfection, specify detention time provided: 49.7 minutes (NOTE: 30 minutes
minimum required), and indicate at what treatment unit chlorine contact occurs: Chlorine Contact Tanks
➢ If ultraviolet (UV) light is the proposed method of disinfection, specify the number of banks: number of lamps per
bank: and maximum disinfection capacity: GPM.
RESIDUALS TREATMENT ❑ New Units, ❑ Modified Units ® N/A
Treatment Unit
Number
of Units
Manufacturer
or Material(gallons)
Dimensions (ft)
Volume
Plan Sheet
Number
Specification
Page Number
Select
Select
Select
e. PUMPS ® New Units, ❑ Modified Units ❑ N/A
LocationTNumber
Pumps
purpose
Manufacturer /
Type
Ca acit
Plan Sheet
Number
Specification
Page Number
GPM
TDH
Near Chlorine
Contact Tanks
2
Disinfection
Pulsafeeder
0.03
100ft
C01.2
46 33 42
BLOWERS ❑ New Units, ❑ Modified Units ® N/A
LocationTBlowers
No. of
Units Served
TManufacturer /
Type
Capacity
CF
Plan Sheet
Number
Specification
Page Number
FORM: RWG 06-16 Page 6 of 9

VII. DESIGN INFORMATION FOR NEW OR MODIFIED PORTIONS OF THE TREATMENT FACILITY (Continued)
MIXERS ❑ New Units, ❑ Modified Units ® N/A
Location
No. of
Mixers
Units Served
Manufacturer /
Type
Power
h
Plan Sheet
Number
Specification
Pa a Number
FLOW METERS, OTHER RECORDING DEVICES & RELIABILITY ❑ New Units, ❑ Modified Units ® N/A
Device
Number
of Units
Maximum
Capacity
Manufacturer
Location
Plan Sheet
Number
Specification
Page Number
Select
Select
Select
Select
Select
Select
DISTRIBUION PUMP / DOSING TANK (IF APPLICABLE): ❑ New Units, ❑ Modified Units ® N/A
Plan Sheet
Reference
Specification
Reference
Internal dimensions (L x W x H or (p x H)
ft
ft
ft
Total volume
ft3 gallons
Dosing volume
ft3 gallons
Audible & visual alarms
Equipment to prevent irrigation during rain events
FORM: RWG 06-16 Page 7 of 9

VIIL DESIGN INFORMATION FOR EARTHEN STORAGE IMPOUNDMENTS: 15A NCAC 02U .0402
II0LYNMA=I:/Aa01aINILIall] l0]LIaaIaWID]V/I0]DIA0]0111MaFAI[Ili]01WD]=I:IMW-WeWNIVIaID[fJ I=1111419
1. Are there any earthen reclaimed water storage impoundments located at the generator site? ❑ Yes or ❑ No
✓ If no, then skip the remaining items in Section VIII.
2. What is the storage impoundment type? Select
3. Storage Impoundment Coordinates (degrees, minutes, seconds): Latitude: _° Longitude: -_°
Datum: Select Level of accuracy: Select Method of measurement: Select
4. Do any impoundments include a discharge point (pipe, spillway, etc)? ❑ Yes or ❑ No
✓ If Yes, has the required NPDES permit been obtained to authorize the discharge of reclaimed water? ❑ Yes or ❑ No
➢ Provide the NPDES permit number . or the date when NPDES application was submitted:
5. Are subsurface drains present beneath or around the impoundment to control groundwater elevation? ❑ Yes or ❑ No
6. Is the impoundment designed to receive surface runoff? ❑ Yes or ❑ No
✓ If yes, what is the drainage area? ft', and was this runoff incorporated into the water balance? ❑ Yes or ❑ No
7. Will the reclaimed water be placed directly into or in contact with GA classified groundwater? ❑ Yes or ❑ No
If yes, has the Applicant provided predictive calculations or modeling demonstrating that such placement will not result in a
contravention of GA groundwater standards? ❑ Yes or ❑ No
8. What is the depth to bedrock from the earthen impoundment bottom elevation? ft
✓ If the depth to bedrock is less than four feet, has the Applicant provided a liner with a hydraulic conductivity no greater
than 1 x 10-' cm/s? Yes, ❑ No or ❑ N/A
Has the Applicant provided predictive calculations or modeling demonstrating that surface water
or groundwater standards will not be contravened? ❑ Yes or ❑ No
✓ If the earthen impoundment is excavated into bedrock, has the Applicant provided predictive calculations or modeling
demonstrating that surface water or groundwater standards will not be contravened? ❑ Yes, ❑ No or ❑ N/A
9. If the earthen impoundment is lined and the mean seasonal high water table is higher than the impoundment bottom elevation,
how will the liner be protected (e.g., bubbling, groundwater infiltration, etc.)?
10. If applicable, provide the specification page references for the liner installation and testing requirements:
11. If the earthen impoundment is located within the 100-year flood plain, has a minimum of two feet of protection (i.e., top of
embankment elevation to 100-year flood plain elevation) been provided? ❑ Yes or ❑ No or ❑N/A
12. Provide the requested earthen impoundment design elements and dimensions:
Earthen Impoundment Design Elements11
Earthen Impoundment Dimensions
Liner type:
❑ Cla
❑ Synthetic
Top of embankment elevation:
ft
❑ Other
I ❑ Unlined
Liner hydraulic conductivity:
cm/s
Freeboard elevation:
ft
Hazard class:
Select
Toe of slope elevation:
ft
Designed freeboard:
ft
Impoundment bottom elevation:
ft
Total volume:
ft3
gallons
Mean seasonal high water table depth:
ft
Effective volume:
ft3
gallons
Embankment slope:
Effective storage time:
days
Top of dam water surface area:
ft2
Plan Sheet Reference:
Freeboard elevation water surface area:
ft2
Specification Section:
Bottom of impoundment surface area:
ft2
FORM: RWG 06-16 Page 8 of 9

Professional Engineer's Certification:
1, MJ Chen . attest that this application for Kinnakeet Shores W WTP
_ has been reviewed by me and is accurate, complete and consistent with the information supplied in the
engineering plans, calculations, and all other supporting documentation to the best of my knowledge. I further attest that to the best of my
knowledge the proposed design has been prepared in accordance with this application package and its instructions as well as all applicable
regulations and statutes. Although other professionals may have developed certain portions of this submittal package, inclusion of these
materials under my signature and seal signifies that I have reviewed this material and have judged it to be consistent with the proposed
design. Note: In accordance with NC General Statutes 143-215.6A and 143-215.613, 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.
North Carolina Professional Engineer's seal, signature, and date:
C A R p�
4
z. SEAL �•: J
•a 039025
i
1�114 kG I ty
Mit �1 AlN�?
Applicant's Certification (signing authority must be in compliance with 15A NCAC 02T .0106):
1, Tony Konsul Director of Operations-
CWSNC
(signing authority name — PLEASE PRINT) (title)
attest that this application for Kinnakeet Shores WWTP
(facility name)
has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that any discharge of wastewater from
this non -discharge system to surface waters or the land will result in an immediate enforcement action that may include civil penalties,
injunctive relief, and/or criminal prosecution. I will make no claim against the Division of Water Resources should a condition of this
permit be violated. I also 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 to me as incomplete. I further certify
that the applicant or any affiliate has not been convicted of an environmental crime, has not abandoned a wastewater facility without proper
closure, does not have an outstanding civil penalty where all appeals have been exhausted or abandoned, are compliant with any active
compliance schedule, and do not have any over a annual fees under Rule 15A NCAC 02T .010.5. Note: In accordance with NC General
Statutes 143-215.6A and 143-215.613, any p rson
o knowingly makes any false statement, representation, or certification in any
application package sh 1 be guilty of a Class _ misde anor, which may include a fine not to exceed $10,000 as well as civil penalties
up to $25,000 per viola � n. ' 1
Sianatu� lZ.�� Date: 2bL�17
FORM: RWG 06-16 Page 9 of

ATTACHMENT E:
v MCMQM&CREED
ENGINEERS SURVEYORS PLANNERS

CAROLINA WATER SERVICE - KINNAKEET SHORES WWTP
TERTIARY FILTER INSTALLATION AND DISINFECTION MODIFICATIONS
HARBOR RD
BIG KINNAKEET DR
\ I
NC HIGHWAY 12
VICINITY MAP
NOT TO SCALE
PROJECT NAME:
CAROLINA WATER SERVICE - KINNAKEET SHORES VWV-fP
TERTIARY FILTER INSTALLATION AND DISINFECTION MODIFICATIONS
OWNER/DEVELOPER:
4944 PARKWAY PLAZA BLVD
#375
CHARLOTTE, NC 28217
iW&,,.c9Vw Carolina Water Service
of North CarolinaT"
AIWAA`MCI<IM&CREED 1
8020 Tower Point Drive
Charlotte, North Carolina 28227
Phone: [phone], Fax: [phone]
NC License# F-1222
www.mckimcreed.com
PROJECT INFORMATION
PROJECT NO. 01554-0041
JANUARY 2024
FINAL DESIGN - NOT RELEASED FOR CONSTRUCTION
SHEET INDEX
SHEET NO.
SHEET TITLE
GENERAL
000.0
COVER SHEET
G01.0
GENERAL NOTES AND LEGENDS
G02.0
FLOW PROCESS DIAGRAM
G02.1
HYDRAULIC PROFILE
CIVIL: CIVIL SITE
C01.0
EXISTING SITE PLAN AND YARD PIPING
C01.1
PROPOSED DEMOLITION PLAN
C01.2
PROPOSED SITE PLAN AND YARD PIPING
MECHANICAL
M01.0
DISC FILTER PLAN AND SECTION
M02.0
FILTER DEMOLISH PLANS AND DETAILS
M02.1
CHLORINE CONTACT TANK PLAN AND SECTION
ELECTRICAL
E00.0
GENERAL NOTES AND ABBREVIATIONS
E00.1
TYPICAL POWER CONTROL SYMBOLS
E01.0
SINGLE LINE
E02.0
DISC FILTER PLAN 1 OF 2
E02.1
DISC FILTER PLAN 2 OF 2
E03.0
CHLORINE CONTACT TANK PLAN 1 OF 2
E03.1
CHLORINE CONTACT TANK PLAN 2 OF 2
DETAILS
D01.0
CIVIL AND MECHANICAL DETAILS
D01.1
CIVIL AND MECHANICAL DETAILS
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1 1 ABBREVIATIONS
1SFD
1 STORY FRAMED DWELLING
1SBKBUS
1 STORY BRICK BUSINESS
A
AIR
AC
ASBESTOS CEMENT
AL OR ALUM
ALUMINUM
ASPH
ASPHALT
ARV
AIR RELEASE VALVE
BC
BACK OF CURB
BFV
BUTTERFLY VALVE
BK
BRICK
BO
BOLLARD
BOV
BLOW OFF VALVE
BV
BALL VALVE
CATV
CABLE TELEVISION
CB
CATCH BASIN
C&G
CURB AND GUTTER
CHN
CHAIN
CI
CURB INLET
C/L, rL
CENTERLINE
CMP
CORRUGATED METAL PIPE
CMU
CONCRETE MASONRY UNIT
CO
CLEAN OUT
CON
CONCENTRIC
CONC
CONCRETE
CPLG
COUPLING
CPP
CORRUGATED PLASTIC PIPE
CS
COMPOST SOCK
CSF
COMBO SILT / TREE PROTECTION FENCE
CWTD
CLEAN WATER TEMPORARY DIVERSION
CV
CHECK VALVE
D
DRAIN
DI
DROP INLET / DUCTILE IRON
DIP
DUCTILE IRON PIPE
D/W
DRIVE WAY
DUCT
DUCT BANK
DWG
DRAWING
EL OR ELEV
ELEVATION
EOG
EDGE OF GRAVEL
EOI
END OF INFORMATION
EP, EOP
EDGE OF PAVEMENT
EX
EXISTING
EXP
EXPANSION
LP
LIGHT POLE
LT
LIGHT
FCA
FLANGE COUPLING ADAPTER
FD
FLOOR DRAIN
FDC
FIRE DEPARTMENT CONNECTOR
FH
FIRE HYDRANT
FHA
FIRE HYDRANT ASSEMBLY
FLG
FLANGE
FLR
FLOOR
FM
FORCE MAIN
FRP
FIBERGLASS REINFORCED PIPE
FO
FIBER OPTIC
GL
GUTTER LINE
GM
GAS METER
GRAV
GRAVEL
GTS
GAS TEST STATION
GV
GAS VALVE
GW
GUY WIRE
HB
HOTBOX
HDPE
HIGH -DENSITY POLYETHYLENE
HP
HIGH POINT
HWL
HIGH WATER LEVEL
INV
INVERT ELEVATION
IPF
IRON POST FOUND
JB
JUNCTION BOX
JT
JOINT
LF
LINEAR FEET
LOD
LIMITS OF DISTURBANCE
LP
LIGHT POLE
LSA
LANDSCAPE AREA
LWL
LOW WATER LEVEL
MB
MAIL BOX
MAX
MAXIMUM
MH
MANHOLE
MIN
MINIMUM
MTL
METAL
MJ
MECHANICAL JOINT
N.C.
NORMALLY CLOSED
N.O.
NORMALLY OPEN
NIC
NOT IN CONTRACT
NWL
NORMAL WATER LEVEL
OHE/OE
OVER HEAD ELECTRIC
O/F
OVERFLOW
OU
OVER HEAD UTILITIES
PE
PLAIN END
PIV
POST INDICATOR VALVE
POLY
POLYMER
PP
POWER POLE
PRV
PRESSURE REDUCING VALVE
PV
PLUG VALVE
PVC
POLY VINYL CHLORIDE
PW
POTABLE WATER
RCP
REINFORCED CONCRETE PIPE
REC
PER RECORD
RED
REDUCER
RFCA
RESTRAINED FLANGE COUPLING ADAPTER
RJ
RESTRAINED JOINT
RK
ROCK
R/W, ROW
RIGHT OF WAY
S
SIGN
SDMH
STORM DRAIN MANHOLE
SF
SILT FENCE
SS
SANITARY SEWER
S.S.
STAINLESS STEEL
SSF
SUPER / HIGH HAZARD SILT FENCE
SSMH
SANITARY SEWER MANHOLE
STA
STATION
SUE
SUBSURFACE UTILITY ENGINEERING
S/W
SIDE WALK
SVC
SERVICE
TBM
TEMPORARY BENCH MARK
TC
TERRA COTTA
TLP
TRAFFIC LIGHT POLE
TOB
TOP OF BANK
TOC
TOP OF CONCRETE
TH
TEST HOLE
TPF
TREE PROTECTION FENCE
TSBOX
TRAFFIC SIGNAL BOX
TYP
TYPICAL
LINO
UNLESS NOTED OTHERWISE
LINK
UNKNOWN
VAR
VARIABLE
VCP
VITRIFIED CLAY PIPE
WD
WOOD
WL
WATER LINE
WM
WATER METER
WV
WATER VALVE
WWF
WELDED WIRE FABRIC
XP
CROSS LIGHT POLE
YI
YARD INLET
REV.NO. DESCRIPTION DATE
B FINAL DESIGN - NOT RELEASED FOR CONSTRUCTION 2024.01
A i PRELIMINARY DESIGN - NOT FOR CONSTRUCTION 2023.10
REVISIONS
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8 I GENERAL NOTES
THE CONTRACTOR SHALL REVIEW AND VERIFY ALL LAYOUTS, DIMENSIONS AND ELEVATIONS ON THE PLANS WITH FINAL APPROVED EQUIPMENT DRAWINGS AS WELL AS ANY TECHNICAL SPECIFICATIONS SUPPLIED, IF ANY, PRIOR TO STARTING
CONSTRUCTION AND SHOULD DISCREPANCIES OCCUR, THE CONTRACTOR SHALL NOTIFY THE ENGINEER TO OBTAIN THE ENGINEER'S CLARIFICATION BEFORE COMMENCING WITH CONSTRUCTION.
2. THE CONTRACTOR SHALL COORDINATE ALL RELATED DISCIPLINE DRAWINGS TO ENSURE ACCURATE INSTALLATION OCCURS. CONTRACTOR SHALL NOTE, NOT ALL PIPING, VALVING, IN -LINE EQUIPMENT AND INSTRUMENTAION IS SHOWN ON THE
PLANS. CONTRACTOR SHALL REFER TO P&ID'S FOR ADDITIONAL INFORMATION ON THE ABOVE MENTIONED.
3. CONTRACTOR SHALL SLOPE GRAVITY LINES AS INDICATED ON THE DRAWINGS OR IF NOT INDICATED ON THE DRAWINGS SLOPE SHALL BE AT POSITIVE GRADE PER 15A OF NCAC 2T (MIN.) TO FACILITATE THE INTENDED DRAINAGE BETWEEN
STRUCTURES. CONTRACTOR SHALL CONFIRM ALL INVERTS PRIOR TO STARTING CONSTRUCTION.
4. ALL UNDERGROUND PRESSURE PIPE SHALL BE RESTRAINED AT ALL FITTINGS AND PIPE JOINTS.
5. CONTRACTOR SHALL VERIFY NO. OF YARD HYDRANTS & LOCATIONS WITH OWNER. CONTRACTOR SHALL PLACE HOSE RACKS AT ALL YARD HYDRANT LOCATIONS.
6. CONTRACTOR SHALL MAINTAIN A CLEAR PATH FOR ALL SURFACE WATER DRAINAGE STRUCTURES AND DITCHES DURING CONSTRUCTION.
7. ALL PIPE LINES SHALL HAVE A MINIMUM COVER OF 36" UNLESS OTHERWISE NOTED OR DIRECTED.
8. SEWER CLEAN -OUT SPACING SHALL BE 75' MAX. BETWEEN CLEAN -OUTS.
9. ADD PROTECTION BOLLARDS AT ALL HYDRANT LOCATIONS AS REQUIRED.
10. HEAT TRACE AND INSULATE ALL EXPOSED PIPING ABOVE GRADE, 6" OR SMALLER.
11. NOTE; ALL VAULTS, MANHOLES, INLET STRUCTURES, BASINS, WET WELLS ETC. SHALL BE CONSIDERED "CONFINED SPACE ENTRY" AND SHALL BE MARKED AS SUCH BY MEANS OF STAMPING MANHOLE COVERS AND PLACING PERMANENT SIGNAGE
ON THE VAULTS, BASINS OR STRUCTURES WARNING OF THE "CONFINED SPACE ENTRY" CONDITION.
12. NOTE: ALL NON-POTABLE/PLANT WATER USERS MUST BE CLEARLY LABELED AS "NON -POTABLE", NOT FOR HUMAN CONSUMPTION IN ACCORDANCE WITH 15A NCAC 02U.0403.
13. CONTRACTOR SHALL BE RESPONSIBLE FOR ALL PIPE SUPPORTS WHETHER SHOWN ON THE CONTRACT DOCUMENTS OR NOT. PIPE SUPPORTS SHALL BE INSTALLED PER MANUFACTURER'S RECOMMENDATIONS FOR SPACING AND SUPPORT.
ADDITIONALLY, PROVIDE SUPPORT WHERE ABOVE GRADE PIPING CHANGES DIRECTION, IS ADJACENT TO FLANGED VALVES OR OTHER APPURTENANCES OR AT EQUIPMENT CONNECTIONS AND HEAVY FITTINGS.
14. WELLS TO BE ABANDONED AS REQUIRED BY 15A NCAC 02C.0113 AND IN ACCORDANCE WITH THE 15A NCAC 18A SECTION 1900 RULES. WELL SUPPLY PIPING SHALL BE ABANDONED IN PLACE OR REMOVED AS REQUIRED BY OTHER WORK. WHERE
PIPING REMOVED, IT SHALL BE PLUGGED OR CAPPED.
15. CONTRACTOR TO FIELD VERIFY SIZE, DEPTH, LOCATION AND MATERIAL OF ALL UNDERGROUND UTILITIES PRIOR TO THE START OF CONSTRUCTION.
16. THE CONTRACTOR SHALL CAREFULLY SUPPORT AND PROTECT ALL UTILITIES, STRUCTURES, POWER POLES, PIPE LINES AND CONDUITS WHICH MAY BE ENCOUNTERED DURING COMPLETION OF THE WORK. ANY DAMAGE RESULTING FROM THE
CONTRACTOR'S OPERATIONS SHALL BE REPAIRED BY THE CONTRACTOR TO THE SATISFACTION OF THE ENGINEER AND UTILITY PROVIDER AT THE CONTRACTOR'S EXPENSE.
17. TRAFFIC FLOW SHALL BE MAINTAINED AT ALL TIMES DURING CONSTRUCTION.
18. CONTRACTOR SHALL COORDINATE WITH THE TOWN OF PITTSBORO AS APPLICABLE FOR ANY DISRUPTIONS OF THE NORMAL OPERATIONS OF WATER SERVICES.
19. CONTRACTOR SHALL BE RESPONSIBLE FOR PERMITTING ANY AND ALL ADDITIONAL AREAS OF DISTURBANCES NOT INCLUDED IN THE NCDENR APPROVED EROSION AND SEDIMENTATION CONTROL PLAN.
20. FOR ALL PLANT WATER EQUIPMENT END -USERS, PROVIDE A Y-TYPE STRAINER PRIOR TO EQUIPMENT HOOK UP.
21. CONTRACTOR SHALL WORK ALL MECHANICAL AND YARD PIPING PLANS WITH P&ID'S TO ENSURE ALL INSTRUMENTATION IS ACCOUNTED FOR.
22. CONTRACTOR SHALL BE RESPONSIBLE FOR LOW POINT DRAINS AND HIGH POINT VENTS.
v v MCMM&CREED
8020 Tower Point Drive
Charlotte, North Carolina 28227
l� Phone: [phone], Fax: [phone]
NC License# F-1222
www.mckimcreed.com
Carolina Water Service
1� of North CarolinaTM
CAROLINA WATER SERVICE - KINNAKEET SHORES WWTP
TERTIARY FILTER INSTALLATION
AND DISINFECTION MODIFICATIONS
GENERAL
GENERAL NOTES AND LEGENDS
PROJ. START DATE:
2023.07
MCE PROJ. #
01554-0041
DRAWN
MTN
DESIGNED
MC
CHECKED
MC
PROJ. MGR.
JH
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G O 1 . 0
HORIZONTAL:
NIA
DRAWING NUMBER
VERTICAL:
NIA
B
REVISION
STATUS: FINAL DESIGN
NOT RELEASED FOR CONSTRUCTION RELEASED FOR CONSTRUCTION
I:\01554\0041 \ENG\80—DRAWINGS\GENERAL\G01 .0-015540041 ( NOTES, LEG & PROC SCHEM ).DWG 01 /25/2024 09:31 :03 ANDREW BRANCH

REV.NO. DESCRIPTION DATE
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8020 Tower Point Drive
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www.mckimcreed.com
Carolina Water Service
1� of North CarolinaTM
CAROLINA WATER SERVICE - KINNAKEET SHORES WWTP
TERTIARY FILTER INSTALLATION
AND DISINFECTION MODIFICATIONS
GENERAL
FLOW PROCESS DIAGRAM
PROJ. START DATE:
2023.07
MCE PROJ. #
01554-0041
DRAWN
MTN
DESIGNED
MC
CHECKED
MC
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JH
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G02.0
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NIA
DRAWING NUMBER
VERTICAL:
NIA
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NOT RELEASED FOR CONSTRUCTION RELEASED FOR CONSTRUCTION
I:\01554\0041 \ENG\80—DRAWINGS\GENERAL\G01 .0-015540041 ( NOTES, LEG & PROC SCHEM ).DWG 01 /25/2024 09:31 :04 ANDREW BRANCH

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8020 Tower Point Drive
Charlotte, North Carolina 28227
�[ Phone: [phone], Fax: [phone]
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www.mckimcreed.com
Carolina Water Service
1� of North CarolinaTM
CAROLINA WATER SERVICE - KINNAKEET SHORES WWTP
TERTIARY FILTER INSTALLATION
AND DISINFECTION MODIFICATIONS
GENERAL
HYDRAULIC PROFILE
EX T' RCP -
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PROJ. START DATE:
2023.07
MCE PROJ. #
01554-0041
DRAWN
MTN
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ill =2'-6"
B
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I:\01554\0041 \ENG\80-DRAWINGS\GENERAL\G01 .0-015540041 ( NOTES, LEG & PROC SCHEM ).DWG 01 /25/2024 09:31 :09 ANDREW BRANCH

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Il
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REV.NO. DESCRIPTION DATE
I A
B FINAL DESIGN - NOT RELEASED FOR CONSTRUCTION 2024.01
A PRELIMINARY DESIGN - NOT FOR CONSTRUCTION 2023.10
REVISIONS
O
AERATION it
(125, 000 gal)
�l C
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AERATION lil
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EQUALIZATION
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— — — — — — — — — — — — — — — —
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�S•.!VGINOti .•2 ?�%
NC License# F-1222
www.mckimcreed.com
Carolina Water Service
of North CarolinaTM
5' 0 5' 10, I I
II
SCALE: 1 "=5' (Horiz.)
CAROLINA WATER SERVICE - KINNAKEET SHORES WWTP
TERTIARY FILTER INSTALLATION
AND DISINFECTION MODIFICATIONS
CIVIL SITE
EXISTING SITE PLAN AND YARD PIPING
PROJ. START DATE:
2023.07
MCE PROJ. #
01554-0041
DRAWN
MTN
DESIGNED
MC
CHECKED
MC
PROJ. MGR.
.1H
8"AIR PIPING
SCALE
C01.0
HORIZONTAL:
1 1 /2" = V-0"
DRAWING NUMBER
VERTICAL:
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i
B
[
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I:\01554\0041 \ENG\80-DRAWINGS\CIVIL\C01 .0-0155400441 (EX SITE & YARD PIPING).DWG 01 /25/2024 09:31 :20 ANDREW BRANCH

E
RAS PUMP
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1D=23.5
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10'58" REDUCER
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EXISTING UV CHANNELS
DEMO: TRAVELING BRIDGE FILTERS
SEE DEMOLITION PLAN, SHEET M02.1
REMOVE ANY MECHANICAL
AND ELECTRICAL
EQUIPMENT ASSOCIATED
WITH THE UV SYSTEM
REV.NO. DESCRIPTION DATE
B FINAL DESIGN - NOT RELEASED FOR CONSTRUCTION 2024.01
A PRELIMINARY DESIGN - NOT FOR CONSTRUCTION 2023.10
REVISIONS
O
AERATION it
(125, 000 gal)
�l C
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INTERNAL RECYCLE PUMP (TYP. 3)
AERATION lil
(52,355 gal)
INTERNAL
CLARIFIER
ID=23.5
MIXER IMPELLER
(TYP. 2)
EQUALIZATION
(140, 000 gal)
EQ PUMPS /SPLITTER BOX
GENERATOR
— — — — — — — — — — — — — — — —
—
\\
\\\
IIII
/
IIII
IIII
\\
SLUDGE
/ j /
16
\\
HOLDING
/
\\
(61, 560 gal)
I I I I
\\
8"EFFLUENT
\\\
IIII
\
I I I I
\\
10'x8" REDUCER
II
\\ \
\
ANOXIC 1
\\
(26,340 gal)
\\
6"IR PIPE I I
AERATION I
l /
(172,645gaI)
10" DIP
CONTROL PANEL
71
EQUALIZERI
II
MUDWELL
i
I
1
i i
\—
/
— — — — — — — — — — — —
— — — — — — — — —
— —
II
BLOWER UNITS
6"BACKWASH WASTE
I I
I
II
II
8" DIP FIL TER
II
EFFL DENT
DEMO: INFLUENT PIPE,
I
OVERFLOW PIPE, AND
5' 0 5' 10'
BACKWASH WASTE PIPE
II
SCALE: 1 "=5' (Horiz.) I I
II
CARo��'%
EsSiO4,
••o y ,
SEALWQvs
—
�NG I N���• l
9 '•.., ,.•• •tip /
/�A N G`G�i�`
v v CREED
8020 Tower Point Drive
Charlotte, North Carolina 28227
�[ Phone: [phone], Fax: [phone]
NC License# F-1222
www.mckimcreed.com
Carolina Water Service
of North CarolinaTM
CAROLINA WATER SERVICE - KINNAKEET SHORES WWTP
TERTIARY FILTER INSTALLATION
AND DISINFECTION MODIFICATIONS
CIVIL SITE
PROPOSED DEMOLITION PLAN
PROJ. START DATE:
2023.07
MCE PROJ. #
01554-0041
DRAWN
MTN
DESIGNED
MC
CHECKED
MC
PROJ. MGR.
.1H
8"AIR PIPING
SCALE
C 0 1 .1
HORIZONTAL:
1 1 /2" = V-0"
DRAWING NUMBER
VERTICAL:
NIA
B
REVISION
STATUS: FINAL DESIGN
NOT RELEASED FOR CONSTRUCTION
I:\01554\0041 \ENG\80-DRAWINGS\CIVIL\C01 .0-0155400441 (EX SITE & YARD PIPING).DWG 01 /25/2024 09:31 :25 ANDREW BRANCH

=XISTING 12'S02" COMMERCIAL
OVERHEAD DOOR
SODIUMM HYPOCHLORITE STORAGE
(TYP. 3)
SECONDARY CONTAINMENT TANK
(TYP. 3)
CHEMICAL FEED PUMPS
PULSATRON SERIES A PLUS
AS MANUFACTURED BY PULSAFEEDER
(TYP. 2)
EMERGENCY
SHOWER/EYEWASH
STATION
2" SCH. 80 PVC
CHEMICAL CONT. PIPE
EXISTING UV CHANNEL
CONVERTED TO AN�
EFFLUENT BOX I I
EXISTING UV CHANNELS
EXISTING 12" RCP EFFLUENT PIPE
REV.NO. DESCRIPTION DATE
B FINAL DESIGN - NOT RELEASED FOR CONSTRUCTION 2024.01
A PRELIMINARY DESIGN - NOT FOR CONSTRUCTION 2023.10
REVISIONS
EXISTING 36" DOOR
10'5(8" REDUCER
- 8"EFFLUENT \ \ \ \ \ \ \\ \ \
10" PLUG VALVE \ \ \ \ \ \\ I \
(TYP. 2) \ \ \ \\ I I \ \
DI BACKWASH WASTE
10'5(8"REDUCER
ANOXIC 1 \ \ \ \ \
(26,340 gal) \ \ \ \ I I
/ II
6"IR PIPE \ I I
AERATION
i/ (172,645ga1)
\
CONTROL PANEL
MAIN PLANT
USE THE EXISTING \ \ \ / /� / EQUALIZERI
FLOOR PENETRATION \ \ / / / /IV
\ I
MUD WELL
- — — — — — — — — — — — — — �_ _ _ = � _ _ = � _ _ = � _ _ _ — _ _ /
BLOWER UNITS
6" BACKWASH WASTE FORCE MAIN BACK
TO THE HEAD OF THE PLANT
EXISTING MUDWELL AND VALVE VAULT
.CARo'- v MCMM&CREED
,`off E s yy o si
,
= SEAL — 8020 Tower Point Drive
0 Charlotte, North Carolina 28227
Ile
F �[ Phone: [phone], Fax: [phone]
•. NGIN�ti .•2 ?�%
' NC License# F-1222
www.mckimcreed.com
Carolina Water Service
of North CarolinaTM
II
II
5' 0 5' 10'
II
SCALE: 1"=5' (Horiz.)
II
CAROLINA WATER SERVICE - KINNAKEET SHORES WWTP
TERTIARY FILTER INSTALLATION
AND DISINFECTION MODIFICATIONS
CIVIL SITE
PROPOSED SITE PLAN AND YARD PIPING
PROJ. START DATE:
2023.07
MCE PROJ. #
01554-0041
DRAWN
MTN
DESIGNED
MC
CHECKED
MC
PROJ. MGR.
.1H
II
C01.2
SCALE
HORIZONTAL:
1 112" = V-0"
DRAWING NUMBER
VERTICAL:
NIA
i
B
[
REVISION
STATUS: FINAL DESIGN
NOT RELEASED FOR CONSTRUCTION
I:\01554\0041 \ENG\80—DRAWINGS\CIVIL\C01 .3-015540041 (PROP SITE & YARD PIPING).DWG 01 /25/2024 09:31 :42 ANDREW BRANCH

O CA
6" DI FL 9C
EL. 18.24'
HIGHPOINT OF FILTER
EL. 17.16'
6" BACKWASH WASTE
q EL. 16.56'
10" CLARIFIER EFFLUENT
WALKWAY
EL. 15.29'
10" FILTER INFLUENT
q EL. 13.42'
8" FILTER EFFLUENT
EL. 12.75'
PLATFORM
Tk EL. 10.92'
8" CCT INFLUENT
EL. 8.44'
6" PIPE
EL. 7.44'
EX. GRADE
REV.NO. DESCRIPTION DATE
B FINAL DESIGN - NOT RELEASED FOR CONSTRUCTION 2024.01
A PRELIMINARY DESIGN - NOT FOR CONSTRUCTION 2023.10
REVISIONS
PLAN VIEW
SCALE: 3/8" = 1'-0"
(2) 90° DI FL BEND
ROLLED 68'
VERTICALLY
10" DI FROM
CLARIFIERS
0
TERTIARY
DISC FILTER #1
II
Ifl
II
II
II
10" PLUG VALVE (TYP. 2) µ_
8"x8" DI FL HORIZ. TEES
6" DI TO EXISTING MUD WELL
6" DI FL 90' HORIZ. BEND
(TYP. 2)
0
TERTIARY
DISC FILTER #2
II
II
II
6"x6" DI FL VERT. TEE 6" DI FL 90° HORIZ. BEND
ii (TYP. 2)
le
T 10"x10" DI FL TEE
10" DI FL 90° HORIZ. BEND
(TYP. 3)
SECTION A -A
SCALE: 3/8" = 1'-0"
CAr 11'''�i
R p�
O� _ SEAL �:�
0
A N G
6" DI FL 90° VERT. BEND
v v MCMM&CMED
8020 Tower Point Drive
Charlotte, North Carolina 28227
l� Phone: [phone], Fax: [phone]
NC License# F-1222
www.mckimcreed.com
EL. 18.24'
HIGHPOINT OF FILTER
EL. 17.16'
6" BACKWASH WASTE
RM
EL. 16.56'
10" CLARIFIER EFFLUENT
(� EL. 15.29'
10" FILTER INFLUENT
(� EL. 13.42'
8" FILTER EFFLUENT
EL. 12.75'
PLATFORM
(� EL. 10.92'
8" CCT INFLUENT
EL. 8.44'
6" PIPE
EL. 7.44'
EX. GRADE
EL. 16.35'
WALKWAY
(� EL. 13.42'
8" FILTER EFFLUENT
EL. 12.75'
PLATFORM
EL. 7.44'
EX. GRADE
Carolina Water Service
of North CarolinaTM
II TERTIARY DISC FILTER II
6" DI TO
EXISTING
MUD WELL
6" DI FL 90° HORIZ. BEND
(TYP. 2)
(2) 6" DI FL 90° HORIZ. BEND
6.62'
SECTION B-B
SCALE: 3/8" = 1'-0"
6"x6" DI FL VERT. TEE
—(2) 90° DI FL BEND
ROLLED 68° VERTICALLY
i--10" DI FROM CLARIFIERS
`DTI---
10" DI FL 90' HORIZ. BEND
\—(2) 10" DI FL 90° HORIZ. BEND
1 11
6" DI TO EXISTING MUD WELL
6" DI FL 90° VERT. BEND
—6" DI FL 90°
HORIZ. BEND
SECTION C-C
SCALE: 3/8" = 1'-0"
CAROLINA WATER SERVICE - KINNAKEET SHORES WWTP
TERTIARY FILTER INSTALLATION
AND DISINFECTION MODIFICATIONS
MECHANICAL
DISC FILTER PLAN AND SECTION
PROJ. START DATE:
2023.07
MCE PROJ. #
01554-0041
DRAWN
MTN
DESIGNED
MC
CHECKED
MC
PROJ. MGR.
JH
SCALE
M01.0
HORIZONTAL:
AS NOTED
DRAWING NUMBER
VERTICAL.
NIA
B
REVISION
oo
STATUS: FINAL DESIGN
NOT RELEASED FOR CONSTRUCTION
I:\01554\0041\ENG\80—DRAWINGS\MECHANICAL\M01.0-015540041 (DISC FILTER PLAN & SECT).DWG 01/25/2024 09:31:59 ANDREW BRANCH

"E"
BACKWASH
EFFLUENT
INFLUENT o�
INFLUENT
BAFFLE
HIGH LEVEL
OVERFLOW
OVERFLOW WEIR
EFFLUENT
INFLUENT
DISTRIBUTION
TROUGH
..C"
� „E"
REMOVE MEDIA, UNDER DRAIN
MECHANICAL AND ELECTRICAL
EQUIPMENT ASSOCIATED WITH
THE TRAVELING BRIDGE FILTER
OVERFLOW WEIR
6"
BACKWASH �
EFFLUENT
INFLUENT WTi
EFFLUENT �
I
NOTE —
HIGH LEVEL DRAIN
OVERFLOW IS
NOT SHOWN IN
THIS VIEW
6 1--12A'
REV.NO. DESCRIPTION DATE
B FINAL DESIGN - NOT RELEASED FOR CONSTRUCTION 2024.01
A PRELIMINARY DESIGN - NOT FOR CONSTRUCTION 2023.10
REVISIONS
BACKWASH PUMP-'
IN FILTRATE CHANNEL
BACKWASH SHOE-/
SEAL ACTUATOR
PLAN VIEW
REMOVE THE
CONTROL PANEL
1/4 HP BRIDGE
DRIVE
FLOATING SKIMMER
(OPTIONAL)
,EMOVE BACKWASH
VASTE TROUGH
ELECTRICAL
FESTOONING CABLE
REMOVE MEDIA, UNDER DRAIN
MECHANICAL AND ELECTRICAL WASHWATER
EQUIPMENT ASSOCIATED WITH PUMP
THE TRAVELING BRIDGE FILTER
SAFETY CHAIN ACROSS OPENING
FOR ACCESS LADDER
ANODIZED ALUMINUM
HANDRAILS AND
TOEPLATE
WASHWATER RATE
CONTROL VALVE
BACKWASH WASTE
/ TROUGH
301 —I— — A"
ELEVATION VIEW — SECTION "C—C"
O BAR = 1" AT PLOT SCALE
HOOD CLEAN -
OUT PORT
3/16" FRP
CELL DIVIDERS
1.0-1.1 MM ANTHRACITE
.55-.65 MM FINE SAND
9
20"
12'-113"
TOTAL CELL ACTUAL CELL BACKWASH RATE BW WW
INF. FT' BASED ON AREA N0, BASED ON PUMP PUMP BIN UNIT UNIT OVER
FLOW GPD (GPM) .675 GPM/FT' IN FT' CELLS 25 GPM/FT' HP HP "A" "B" EFF INF EFf FLOW
350.000 1 243 360 360 30 300 GPM 5.6 3.6 40'— 0" 46'— 0 1/2" 8" 10" 10" 10"
REMOVE THE
CONTROL PANEL
SAC
EFF
IN
E
4
` WATER LEVEL
/ (VARIES)
V ICVV C-G
PLUG WALL PENETRATIONS
BACKWASH HEADER w/
HYDRAULICALLY SIZED
AND SPACED SUCTION
ORIFICES
r 3,.
5" f 184"
.8-1.2 MM COARSE SAND 8" I--j 4 UNDERDRAIN AND
TO TOP OF LATERAL 16" BACKWASH HEADER,
2 PER CELL
BACKWASH DETAIL
16" CELL
I
REV I DESCRIPTION
v
v MCRD,4&CMED
8020 Tower Point Drive
Charlotte, North Carolina 28227
�[ Phone: [phone], Fax: [phone]
NC License# F-1222
www.mckimcreed.com
I 10.3 i'm
BY
WASHWATER
PRESSURE
ID VALVE OPENS
2 SCOUR
21-
MIN
NEMA 4X
CONTROL PANEL
ALUMINUM
HANDRAILS
BACKWASH- ACCESS
PRESSURE LADDER
GAUGE
LIMIT SWITCH STOPS BRIDGE / LIMIT SWITCH
AT EACH BACKWASH ZONE STOPS BRIDGE
GUIDE WHEEL / HOOD AT ENDS
�yTG. BOXR ORiv� n In ll B
(4) / "' �CTROD - "G DRIVE WHEEL
PIVOTING PUMP (2)
SUPPORT / INFLUENT BROAD
ASPIRATING / WEIR
NOZZLE ASS'Y
BACKWASH RATE
CONTROL VALVE A W E
P
BACKWASH PUMP
EFFLUENT BROAD WEIR
01
? AIR VENT
/ PIPES I
4- '
4'-0" REMOVE MEDIA, UNDER DRAIN
32 / SHCEWASH MECHANICAL AND ELECTRICAL
EQUIPMENT ASSOCIATED WITH
uuuuuuuuuumnunllumnmmuuuuuuuumll umnnnnmummnnllllllullllllllllllllluunipuu THE TRAVELING BRIDGE FILTER
1 UNDERDRAIN AND 1"
4 BACKWASH HEADER 4
BACKWASH SHOE i 29j 8'•-112" 1 FILTERING MEDIA,
a SEE BACKWASH
SEAL ACTUATOR 4
11'-6" DETAIL
SECTION "D—D" A
COMPANY CONFIpENTVLL
ALL INFORMATION CONTAINED ON THIS DOCUMENT
DESIGNER
DATE
IS THE PROPERTY OF USFILTER ND/OR ITS
AFFILIATES (-USF-). THE DESIGN CONCEPTS AND
INFORMATION CONTAINED HEREIN ARE PROPRIETARY
TO USF AND ARE SUBMITTED IN CONFIDENCE. THEY
JWK
5-7-04
CHECKER
DATE
BE USED
OR THE PUARE NOT TURRPSOSEAFOR WHICHANDUST THE DOCUMENTNLY IS
RH
5-7-04
EXPRESSLY SUBREPRODUCEDM OE NEDHEY ORMUST U EDOINBANY OTHER
ENGINEER
DATE
MANNER WITHOUT THE EXPRESS WRITTEN CONSENT
OF USF. USF ASSUMES NO RESPONSIBILITY OR LIABILITY
FOR THE USE OF THIS DOCUMENT OR THE DESIGN
CONCEPTS AND INFORMATION CONTAINED HEREIN
MANAGER
DATE
FOR ANOTHER PROJECT, OR IN A MANNER THAT DOES
NOT RELATE TO THE FITNESS OR PURPOSE OF THIS
DOCUMENT. IN NO EVENT SMALL THIS DOCUMENT OR THE
DESIGN CONCEPTS AND INFORMATION CONTAINED HEREIN
FILE:
UPDATE:
BE USED IN ANY MANNER DETRIMENTAL TO THE INTEREST
DATE
OF USF. ALL PATENT RIGHTS ARE RESERVED. ACCEPTANCE
OF THE DELIVERY OF THIS DOCUMENT CONSTITUTES
A-FMFNT TO THEGF TFRMS ANO CONDITIONS.
SCALE: 1/2^
SIZE: D
Carolina Water Service
of North CarolinaTM
TITLE
350,000 GPD GRAVISAND0
SP IAS TRAVELING BRIDGE FILTER
CLIENT
KINNAKEET SHORES
DAVCO PRODUCTS
THOMASVILLE, GA
1-800-841-1550
PROJECT CODE DRAWING , SHEET
11031GA D11031GA—D1 j; OF
REV
000
CAROLINA WATER SERVICE - KINNAKEET SHORES WWTP 1
TERTIARY FILTER INSTALLATION
AND DISINFECTION MODIFICATION
MECHANICAL
FILTER DEMOLISH PLANS AND DETAILS
PROJ. START DATE:
2023.07
MCE PROJ. #
01554-0041
DRAWN
MTN
DESIGNED
MC
CHECKED
MC
PROJ. MGR.
JH
SCALE
M O 2 ■ C
HORIZONTAL:
NIA
DRAWING NUMBER
VERTICAL:
NIAi
[ A
REVISION
STATUS: FINAL DESIGN
NOT RELEASED FOR CONSTRUCTION
I:\01554\0041 \ENG\80—DRAWINGS\MECHANICAL\MO2.0-015540041 (CCC PLAN & SECT).DWG 01 /25/2024 09:32:13 ANDREW BRANCH

SANDBLAST AND PAINT EXISTING TANK
WALLS AS SPECIFIED IN TECHNICAL
SPECIFICATIONS SECTION 099000
6" DI FL 90'
VERT.BEND
EL. 16.35'
WALKWAY
EL. 13.46'
TOP OF STEEL TANK
EL. 13.42'
8" FILTER EFFLUENT
(� EL. 10.92'
8" CCT INFLUENT
EL. 8.44'
6" PIPE
EL. 7.44'
EX. GRADE
6" DI FL 90'
HORIZ. BEND
6" FILTER
BACKWASH
WASTE
6" DI FL 90'
VERT. BEND
REV.NO. DESCRIPTION DATE
B FINAL DESIGN - NOT RELEASED FOR CONSTRUCTION 2024.01
A PRELIMINARY DESIGN - NOT FOR CONSTRUCTION 2023.10
REVISIONS
0111111111,
CARO��'�.
%Q.—REssi0 4,
,o y ,
.97 SEAL r,:� —
Q
'/i� �/A N G1G\i��
8"x8" DI FL HORIZ. TEE
PLAN VIEW
SCALE: 3/8" = 1'-0"
WALKWAY
SECTION A -A
SCALE: 3/8" = 1'-0"
v v MCMM&CMED
8020 Tower Point Drive
Charlotte, North Carolina 28227
�[ Phone: [phone], Fax: [phone]
NC License# F-1222
www.mckimcreed.com
Carolina Water Service
l� of North CarolinaTM
EXISTING UV CHANNEL
CONVERTED TO EFFLUENT BOX
EL. 14.44' OL
WALKWAY
EL. 13.46'
TOP OF STEEL OUTER TANK
(� EL. 13.42'
8" FILTER EFFLUENT
EL. 11.52'
TOP OF STEEL INNER TANK
(� EL. 10.92' OL
8" CCT INFLUENT
(� EL. 8.94'
8" CCT EFFLUENT PIPE
EL. 7.44'
EX. GRADE
a
SECTION B-B
SCALE: 3/8" = 1'-0"
CAROLINA WATER SERVICE - KINNAKEET SHORES WWTP
TERTIARY FILTER INSTALLATION
AND DISINFECTION MODIFICATIONS
MECHANICAL
CHLORINE CONTACT TANK
PLAN AND SECTION
PROJ. START DATE:
2023.07
MCE PROJ. #
01554-0041
DRAWN
MTN
DESIGNED
MC
CHECKED
MC
PROJ. MGR.
JH
L
)0°
D
SCALE
M02.1
HORIZONTAL:
AS NOTED
DRAWING NUMBER
VERTICAL:
NIA
B
REVISION
STATUS: FINAL DESIGN
NOT RELEASED FOR CONSTRUCTION RELEASED FOR CONSTRUCTION
I:\01554\0041 \ENG\80—DRAWINGS\MECHANICAL\M02.0-015540041 (CCC PLAN & SECT).DWG 01 /25/2024 09:32:26 ANDREW BRANCH

VARIES
VARIES 1/8" THICK NEOPRENE
EL. VARIES
BEARING PAD ALL AROUND
i
S.S. "U" BOLT
S.S. PIPE STRAP
' ` • '' ' '
PER HANGER MANUFACTURER
(2) S.S. BOLTS S.S. POST INSTALLED
PIPE SADDLES FABRICATED
ADHESIVE ANCHORS
r .. ...
''�. : °• ;
FROM 3/8 S.S. PLATE
PER MANUFACTURER
�� • ..
.....: '�, ...
2" MIN.
AL. "L" (TYP.)
•
S.S. HANGER ROD
f'' '
PIPE SIZE & PER MANUFACTURER
'' •:'. �:.
EL. VARIES
•.• ,
S.S. BRACKET B-LINE
S.S. CLEVIS HANGER
'
FIG. 63066 OR B3067
B-LINE FIG. B3102
•''�M
AS REQUIRED OR
OR APPROVED EQUAL
s
APPROVED EQUAL
Ell
S.S. POST INSTALLED
ADHESIVE ANCHORS
1 /8" THICK NEOPRENE
BEARING PAD ALL AROUND
PIPE SUPPORT TYPE 1
PIPE SUPPORT TYPE 2
NOT TO SCALE
NOT TO SCALE
PIPE 0 (VARIES) -
ADJUSTABLE PIPE SUPPT. w/ U-BOLT
(B-LINE FIG. 3092 OR EQUAL)
3"O SCH. 40 PIPE COL.
1 1/2" TYP
1" THK. (MIN.) NON -SHRINK
GROUT
a•, •q• I
1/8" THK. NEOPRENE BRG.
PAD (ALL AROUND)
ADJUSTABLE PIPE STAND SUPPORT
SIZED TO FIT PIPE SUPPORTED
3/16 (TYP.)
10" SQ. x 3/8" THK. BASE PLATE w/
(4) 3/4" 0 S.S. RED HEAD TRUBOLT
EXP. TYPE ANCHORS
(EMBED 3 1/2- (MIN.))
PIPE SUPPORT TYPE 5A (UP TO 1619 PIPE)
NOT TO SCALE
PIPE 0
(VARIES)
ADJUSTABLE PIPE SUPPT. w/ U-BOLT
(B-LINE FIG. 3092 OR EQUAL)
4"0 SCH. 40 PIPE COL.
1 1/2" TYP I I
1" THK. (MIN.) NON -SHRINK
GROUT
II
1 /8" THK. NEOPRENE BRG.
PAD (ALL AROUND)
ADJUSTABLE PIPE STAND SUPPORT
SIZED TO FIT PIPE SUPPORTED
1 /4 (�')
1'-2" SQ. x 1/2" THK. BASE PLATE w/
(4) 3/4" 0 S.S. RED HEAD TRUBOLT
EXP. TYPE ANCHORS
(EMBED 3 1/2- (MIN.))
p C
PIPE SUPPORT TYPE 5B (1811 TO 3611 PIPE)
NOT TO SCALE
HEAVY DUTY FRP CHANNEL
AT 5'-0" O.C. - AIKENSTRUT
20-2000 OR EQUIVALENT
EXTEND LENGTH AS REQ'D
FOR MULTIPLE PIPES
STEEL OR
AL. MEMBER
S.S. PIPE CLAMP-
B-LINE FIG. B3188
OR APPROVED EQUAL
� 1
1 1
S.S. BOLTS '
1 /8" THICK NEOPRENE
BEARING PAD ALL AROUND
(2) S.S. POST INSTALLED
ADHESIVE ANCHORS ° -
• 'v
CONCRETE a
... av
NOTE:
USE THIS DETAIL FOR SMALL DIA. PIPING OR CONDUIT ATTACHED TO
CONCRETE SLAB, WALL, CEILING, METAL FRAMING MEMBERS OR
EQUIPMENT MOUNTING BOARDS.
PIPE SUPPORT TYPE 3
NOT TO SCALE
PIPE 0 (VARIES)
PIPE FLG. BOLT CIRCLE
(SUPPT. HOLES TO MATCH FLG.
PATTERN)
ADJUSTABLE PIPE SUPPT. w/ FLANGE
TYPE SUPPORT
(B-LINE FIG. 3094 OR EQUAL)
3"O SCH. 40 PIPE
PIPE FLG. O.D.
ADJUSTABLE PIPE STAND SUPPORT
SIZED TO FIT PIPE SUPPORTED
3/16 (TYP.)
V111EXP.
10" SQ. x 1/2" THK. BASE PLATE w/
1 1/2" TYP I (4) 3/4" 0 S.S. RED HEAD TRUBOLT
1" THK. (MIN.) NON -SHRINK TYPE ANCHORS
1 GROUT 7(EMBED 3 1/2" (MIN.))
PIPE SUPPORT TYPE 6A (UP TO 1619 PIPE)
NOT TO SCALE
S.S. POST INSTALLED
ADHESIVE ANCHORS
S.S. THREADED ROD
-S.S. STRAP
B-LINE FIG. B3256
OR APPROVED EQUAL
PIPE OR TELESCOPING VALVE
\-1 /8" THICK NEOPRENE BEARING
PAD ALL AROUND
FACE OF CONC. WALL
PIPE STAND-OFF BRACKET TYPE 4
NOT TO SCALE
PIPE 0 (VARIES)
PIPE FLG. BOLT CIRCLE
(SUPPT. HOLES TO MATCH FLG.
PATTERN)
ADJUSTABLE PIPE SUPPT. w/ FLANGE
TYPE SUPPORT
PIPE FLG. O.D.
(B-LINE FIG. 3094 OR EQUAL) _ _ ADJUSTABLE PIPE STAND SUPPORT
SIZED TO FIT PIPE SUPPORTED
4"0 SCH. 40 PIPE COL. 3/16 (TYP.)
III
1 1 /2" TYP I I 1'-2" SQ. x 1/2" THK. BASE PLATE w/
1 (4) 3/4" 0 S.S. RED HEAD TRUBOLT
4" THK. (MIN.) NON -SHRINK EXP. TYPE ANCHORS
GROUT 1 1 (EMBED 3 1/2" (MIN.))
LJ
D: .D
p : p•.
NOTE: DO NOT DAMAGE REINF.
BARS INSTALLING ANCHOR
ASSEMBLIES
PIPE SUPPORT TYPE 6B (1811 TO 3611 PIPE)
NOT TO SCALE
L4x4x 1/2x4" LONG
(MIN.) ANGLE SECTION
316 316 S.S. BOLTS
(N.S. & F.S. OF PIPE)
3/4"0 S.S. BOLT THRU
(TYP.) 5/16
;
CLAMP
FLG.'s & L4
316 S.S. THREADED
ROD
316 316 S.S. THREADED ROD
e
PIPE CLAMP OR
,a:`—B-LINE
EQUAL
_
316 S.S. STRAP 3/8"x3"
316 S.S. STRAP 3/8"x3"
(3) 1/2"0 S.S. THREADED RODS
J1
B-LINE FIG. B3256
B-LINE FIG. B3256
ANCHORED TO CONC. w/ RED
: d :o:
1
L4 x 4
x 3/8 ANGLE SECTIONS
OR APPROVED EQUAL
OR APPROVED EQUAL
HEAD C6+ EPDXY ADHESIVE
I
(N.S. &
F.S. OF PIPE)
PIPE OR TELESCOPING VALVE
vp PIPE OR TELESCOPING VALVE
(EMBED 4 1/2" (MIN.))
_
[SPA. ® V-0"]
1 /8" THICK NEOPRENE BEARING
1 /8" THICK NEOPRENE BEARING
5 16
(TYP. EA. END)
PAD ALL AROUND
PAD ALL AROUND
5/16
316 SS 3/8" ANGLE
I/F OF CONC.
WALL
NOTE:
1. ALL PIPE SUPPORTS AND ASSOCIATED BOLTS
PIPE
SUPPORT TYPE
7
PIPE SUPPORT TYPE 8
& HARDWARE SHALL BE 316 SS. U.N.O.
2. DO NOT DAMAGE REINF. BARS INST
NOT TO SCALE
NOT TO SCALE
ANCHOR ASSEMBLIES
REV.NO. DESCRIPTION DATE
B FINAL DESIGN - NOT RELEASED FOR CONSTRUCTION 2024.01
A PRELIMINARY DESIGN - NOT FOR CONSTRUCTION 2023.10
REVISIONS
C.A Ro % v MCMM&CMED
— _ SEAL �' :9 '_ 8020 Tower Point Drive
0 r • Charlotte, North Carolina 28227
Phone: [phone], Fax: [phone]
NC License# F-1222
www.mckimcreed.com
Carolina Water Service
l� of North CarolinaTM
r CAROLINA WATER SERVICE - KINNAKEET SHORES WWTP 1
TERTIARY FILTER INSTALLATION
AND DISINFECTION MODIFICATION
DETAILS
CIVIL AND MECHANICAL DETAILS
PROJ. START DATE:
2023.07
MCE PROJ. #
01554-0041
DRAWN
MTN
DESIGNED
MC
CHECKED
MC
PROJ. MGR.
.1H
SCALE
D01.0
HORIZONTAL:
AS NOTED
DRAWING NUMBER
VERTICAL:
AS NOTED
B
REVISION
;TATUS: FINAL DESIGN
NOT RELEASED FOR CONSTRUCTION
I:\01554\0041 \ENG\80—DRAWINGS\DETAILS\D01 .0-015540041 (CIVIL & MECH DET).DWG 01 /25/2024 09:33:39 ANDREW BRANCH

SUPPLY 1-1/4"
NATIONAL PIPE
THREAD
BRACE
SIGN
SUPPLY 1-1/4"
NATIONAL PIPE
THREAD
WALL
BRACE
GRATING
e e d. .dV..a
e
PROVIDE ALARM SYSTEM CONSISTING OF
HORN, LIGHT, FLOW SWITCH AND CONTACTS
FOR REMOTE ALARM. HAWS MODEL 9001 OR
EQUAL.
STAINLESS STEEL
SHOWER HEAD
EMERGENCY PULL
HANDLE
STAINLESS STEEL
EYEWASH
n
PUSH PLATE
WASTE 1-1/4" NATIONAL
PIPE THREAD
FOOT PEDAL
EMERGENCY SHOWER/EYEWASH DETAIL
N.T.S.
NOTES:
1. EMERGENCY SHOWER AND EYEWASH ASSEMBLY SHALL BE HAWS 8330
STAINLESS STEEL COMBINATION EYEWASH STATION & DRENCH SHOWER,
OR APPROVED EQUAL
REV.NO. DESCRIPTION DATE
B FINAL DESIGN - NOT RELEASED FOR CONSTRUCTION 2024.01
A PRELIMINARY DESIGN - NOT FOR CONSTRUCTION 2023.10
REVISIONS
CUT FRP TO PROPER LENGTH
FOLLOWING MANUFACTURERS
RECOMMENDATIONS
STAINLESS STEEL U-BOLT W/SS I
NUTS & WASHERS--,dj 0
UNISTRUT F20PV-2200 OR EQUIVALENT
1X1/2 RED
®� BUSHING
1 SH-21
TUBING COIL
1/2SH-21(PVC HOSE)
1/2" TAPPED WELD-O-LET,
BOSS, OR TAPPING
SADDLE
1/4" PVC INJECTION SOLUTION
tube * SIZE &TYPE AS SPECIFIED,
LENGTH L=PIPE DIA/3
VITON SAF-T-SEAL @ TIP*
CASING PIPING
ANNULUS SEAL
— 1/2" CHEMICAL
CARRIER TUBING
1/2" RIGID PVC PIPE
1/2" BALL VALVE
0
0
*CHEMICAL INJECTION
____ —
ASSEMBLY AS MANUFACTURED
— — —
0
BY SAF-T-FLO, OR APPROVED
-- — — — _
L EQUAL
0
UNISTRUT F20PU-5853 OR EQUIVALENT
0
PUMP DISCHARGE MANIFOLD
TRANSITION FROM PVC TUBING
TO SCHEDULE 80 PVC RIGID
UNION PIPE USING BARB x SCK PVC
PVC BALL CHECK VALVE *
TRANSITION FITTING W/ SST
TUBING CLAMP
PVC QUICK COUPLING
1 /2V212 (TYP 2)
STAINLESS STEEL ANCHOR BOLTS
W/SS NUTS AND WASHERS, SIZED
TO MANUFACTURERS
RECOMMENDATIONS
NaOCL INJECTION DETAIL
N.T.S.
v v MCMM&CREED
8020 Tower Point Drive
Charlotte, North Carolina 28227
+� Phone: [phone], Fax: [phone]
NC License# F-1222
www.mckimcreed.com
Carolina Water Service
of North CarolinaTM
CHEMICAL INJECTION TRANSITION DETAIL
N.T.S.
P-32 SLUICE GATE
F
Non -Rising Stem
SQ. SOCKET
DIMENSIONS IN INCHES
"rA.. A
B
C*
D*
E
F
G
J
K
11
.94
75/8
43/4
33/8
97/8
51/2
143/8
43/4
13%
.94
75/8
4%
33/a
11
6%
175/8
51/2
16
.88
7%
43/4
3%
13%
8
203/4
67/a
19
1.12
8'/a
5
33/4
153/4
1 9'/z
1 24'/a
7%
21
1.12
8Ya
5
33/4
18
1 10%
1 26%
8"/b
Add grout pad thickness if applicable
E
A
�g
Rising Stem
8" SLIDE GATE DETAIL
N.T.S.
CAROLINA WATER SERVICE - KINNAKEET SHORES WWTP
TERTIARY FILTER INSTALLATION
AND DISINFECTION MODIFICATIONS
DETAILS
CIVIL AND MECHANICAL DETAILS
PARTS
No. Name
1 Frame - Cast Iron
2 Cover - Cast Iron
3 Guide Rails - Cast Iron
4 Rail Bolts - Stn. Stl.
5 Wedges- Bronze w/Stn.
Stl. Hdwr.
Non -Rising Stem Ass'y.
6a Thrust Nut - Bronze
7a Stem - Stn. Stl.
8 Lift Ass'y. - as req'd.
Rising Stem Ass'y.
6b Thrust Nut - Bronze
7b Stem - Stn. Stl.
9 Pin - Stn. Stl.
10 Stem Guide - Cast Iron
11 Bolt & Nut - Stn. Stl.
IF
PROJ. START DATE:
—IN
2023.07
MCE PROJ. #
01554-0041
DRAWN
MTN
DESIGNED
MC
CHECKED
MC
PROJ. MGR.
.1H
SCALE
D01.1
HORIZONTAL:
AS NOTED
DRAWING NUMBER
VERTICAL:
AS NOTED
B
REVISION
STATUS: FINAL DESIGN
NOT RELEASED FOR CONSTRUCTION
I:\01554\0041 \ENG\80—DRAWINGS\DETAILS\D01 .0-015540041 (CIVIL & MECH DET).DWG 01 /25/2024 09:33:45 ANDREW BRANCH

ATTACHMENT F:
v MCMQM&CREED
ENGINEERS SURVEYORS PLANNERS

TECHNICAL SPECIFICATIONS
Kinnakeet Shores WWTP Tertiary Filter Installation and
Disinfection Modifications
WQ0002284
FINAL DESIGN — NOT RELEASED FOR CONSTRUCTION
CARn f,
S�oy1�
SEAL
0394 5
f /f ;y A US
Prepared for:
CAROLINA WATER SERVICE INC.
4944 PARKWAY PLAZA BLVD, #375
CHARLOTTE, N.C. 28217
Prepared by:
4A Mq< M&CREED
-dcINI 41JRV[Y0kS PLANNERS
8020 TOWER POINT DR. #7726
CHARLOTTE, NC 28227
PHONE: [phone]
M&C Project # 01554-0041
License #F-1222
OCTOBER 2023
REVISION DATE: JANUARY 2024

ATTACHMENT G:
v MCMQM&CREED
ENGINEERS SURVEYORS PLANNERS

SECTION 43 4143 — CHEMICAL STORAGE FACILITIES
PART 1 - GENERAL
1.1 SUMMARY
A. Furnish and install the chemical storage tanks and accessories as shown on the drawings
and specified herein. The Contractor shall provide all labor, materials, equipment, and
incidentals to furnish and install the storage tanks complete and operational as shown and
specified.
1.2 RELATED WORK
A. Division 01
B. Division 09
C. Division 22
1.3 SUBMITTALS
A. Shop Drawings: Shop drawings shall be approved by the Engineer prior to the
manufacturing of the vertical tank(s). Submit the following as a single complete initial
submittal. Sufficient data shall be included to show that the product conforms to
Specification requirements. Provide the following additional information:
1. Vertical tank and fitting material
a. Resin Manufacturer Data Sheet.
b. Fitting Material.
c. Gasket style and material.
d. Bolt material.
2. Dimensioned tank drawings:
a. Location and orientation of openings, fittings, accessories, restraints and
supports.
b. Details of manways, flexible connections, and vents.
3. Calculations shall be stamped and signed by a Florida -registered professional
engineer:
a. Wall thickness. Hoop stress shall be calculated using 600 psi @ 100 degree
F.
b. Tank restraint system. The system shall meet 170 MPH (minimum) wind
load condition.
KINNAKEET SHORES WWTP TERTIARY FILTER INSTALLATION 43 41 43 - 1
AND DISINFECTION MODIFICATIONS
01554-0041 REVISION DATE: JANUARY 2024

B. Manufacturer's warranty.
C. Manufacturer's unloading procedure.
D. Manufacturer's installation instructions.
E. Supporting documentation of Manufacturer's certification to NSF/ANSI Standard 61 —
Drinking Water System Components for water treatment chemicals, when applicable.
F. Manufacturer to have a Quality Management System which equals or exceeds ISO 9001.
G. Manufacturer's Qualifications: Submit to engineer a list of five installations in the same
service as proof of manufacturer's qualifications.
H. Factory test report:
1. Material, specific gravity rating at 600 psi � 100 degrees F design hoop stress.
2. Uniform wall thickness verification exceeding current ASTM standards.
3. Fitting placement verification.
4. Visual inspection.
5. Impact test.
6. Gel test (minimum 70% gel).
7. Hydrostatic test.
1.4 REFERENCE STANDARDS
Reference standards and recommended practices referred to in this Specification Section shall be
the latest revision of any such document in effect at the bid time. The following documents are a
part of this Section. Where this Section differs from these documents, the requirements of this
Section shall apply.
A. American National Standards Institute (ANSI)
1. ANSI B16.5—Pipe Flanges and Flanged Fittings. B. American Society of Test-
ing Materials (ASTM)
2. ASTM D638—Standard Test Method for Tensile Properties of Plastics.
3. ASTM D746—Brittleness Temperature of Plastics and Elastomers by Impact.
4. ASTM D790—Standard Test Methods for Flexural Properties of Unreinforced
and Reinforced Plastics and Electrical Insulating Materials.
5. ASTM D883—Standard Definitions of Terms Relating to Plastics.
6. ASTM D 1505—Density of Plastics by the Density -Gradient Technique.
KINNAKEET SHORES WWTP TERTIARY FILTER INSTALLATION 43 41 43 - 2
AND DISINFECTION MODIFICATIONS
01554-0041 REVISION DATE: JANUARY 2024

7. ASTM D 1525—Vicat Softening Temperature of Plastics.
8. ASTM D 1693—ESCR Spec. Thickness 125" F50 — 10% Igepal.
9. ASTM D 1998—Standard Specification for Polyethylene Upright Storage Tank:
Section 11.3: Low Temperature Impact Test and Section I I A: Oxylene -Insoluble
Fraction (Gel Test).
B. American National Standards Institute
1. ANSI B 16.5—Pipe Flanges and Flanged Fittings. D. National Sanitation Founda-
tion
2. NSF/ANSI 61—Drinking Water System Components.
1.5 QUALITY ASSURANCE
A. NSF Standard: Comply with NSF 61, "Drinking Water System Components— Health
Effects," for materials that may come in contact with the liquid being stored.
B. ISO 9001: 2008 Quality Control Program or equal.
1.6 WARRANTIES
A. Warranties shall be in accordance with General Conditions, Supplementary Conditions,
and Division 01 General Requirements
B. The High -Density Cross -Linked Polyethylene (HDXLPE) storage tank shall be warranted
against defective design and materials for a period of 5 years. The warranty period shall
begin at substantial completion.
C. The associated tank accessories shall be warranted for 1 year from substantial
completion.
D. The warranty shall cover replacement/repair of equipment, materials, and parts for the
full warranty period.
1.7 DELIVERY, STORAGE, AND HANDLING
A. The Contractor shall adhere to the requirements specified in Division 01 General
Requirements for storing and protecting the items specified in this Section.
1.8 OPERATIONS AND MAINTENANCE (O&M) MANUALS
A. Operations and Maintenance Manuals shall be in accordance with General Conditions,
Supplementary Conditions, and Division 01 General Requirements.
1.9 SHOP QUALITY CONTROL AND TESTING
A. The tank manufacturer shall have ISO 9001: 2008 quality control procedures or equal,
adequate to ensure that all fabrications comply with these Specifications. Quality control
shall include in -process inspections as well as a final inspection by the manufacturer and
KINNAKEET SHORES WWTP TERTIARY FILTER INSTALLATION 43 41 43 - 3
AND DISINFECTION MODIFICATIONS
01554-0041 REVISION DATE: JANUARY 2024

written record of these inspections. The objective of manufacturer's quality control and
inspection procedure shall be to have each tank comply with the Contract Documents
Specifications and Drawings at the time of its first inspection.
B. Inspection records shall be made for each tank. Tank inspection records shall be available
to the Engineer upon request.
C. Final acceptance by the Owner may be contingent upon satisfactory inspection upon
delivery and installation at the job site.
D. The tank manufacturer shall perform the tests described below prior to shipping. Test
samples shall be taken from the cut out areas of where fittings are inserted in the tank.
The Engineer or representative shall have the option of witnessing these factory tests.
E. Impact Test: ASTM 1998-Section 11.3 shall be used for this test. Sample shall not shatter
at 120 ft. lbs. with sample at minus 20OF for a 1/2-inch wall thickness. For a wall
thickness less than 1/2-inch, the sample shall not shatter at 100 ft. lbs. and minus 20
degrees F.
F. Degree of Crosslinking Test: ASTM 1998-Section 11.4 shall be used in this test. A
minimum of 70 percent Gel must be obtained.
G. Hydrostatic Test: The tank shall be completely filled with water and checked to confirm
no leaks no less than 30 minutes after filling.
H. Wall Thickness: The tank shall have an actual wall thickness measurement taken at every
90 degrees, at each 1-foot elevation. Wall thickness reading shall demonstrate uniform
thickness throughout the entire vessel exceeding current ASTM standards.
PART2-PRODUCTS
2.1 GENERAL REQUIREMENTS
A. Tanks shall be rotationally -molded using high density cross -linked polyethylene
(HDXLPE) resin. Double walled tanks shall be flat bottom and consists of one
cylindrical closed top inner primary tank and one cylindrical open top outer containment
tank. Each tank shall be a rotationally molded one-piece seamless tank. The tanks shall be
designed for above -ground, vertical installation to store approved chemicals at
atmospheric pressures. The assembly shall be designed to prevent rainwater and debris
from entering the containment tank. Tanks shall be adequately vented as required by Poly
Processing Company's technical bulletin, "Venting -Design for ACFM (air cubic feet per
minute)". Where indicated, tanks shall be provided with ancillary mechanical fittings and
accessories. Tanks shall be marked to identify the manufacturer and date of manufacture.
Serial numbers must be permanently embossed into the tank.
B. The storage tanks shall be manufactured by Poly Processing Inc., Assmann Corporation
of America, or approved equal.
2.2 CHEMICAL STORAGE TANKS
A. Design Requirements
KINNAKEET SHORES WWTP TERTIARY FILTER INSTALLATION 43 41 43 - 4
AND DISINFECTION MODIFICATIONS
01554-0041 REVISION DATE: JANUARY 2024

12.5% Sodium Hypochlorite Solution:
Three 275 gallon tanks. 1.21 Specific Gravity.
B. The tanks shall be designed and constructed for storing the chemicals described herein.
C. All components/items shall be suitable for the service application.
D. The nominal properties of the polyethylene tank materials shall be as follows:
Property
Type I XLPE
ASTM Test
Environmental Stress Cracking Re-
sistance, F50, hours, 10% Igepal
>2,000
D1693
Tensile Strength, Ultimate psi, 2-inch
minimum
3,290
D638 Type IV Specimen
Elongation at Break, %,
640%
D638 Type IV Specimen
Flexural Modulus, psi
88,700
D790 Method B
E. The tanks shall be molded from compound black HDXLPE. Tanks shall be constructed of
Poly CLTM or equal High Density Cross- Link Polyethylene.
F. The plastic shall not contain any fillers. All plastic shall contain a minimum of 0.25
percent and maximum of 0.60 percent UV stabilizer. Pigments added shall not exceed 0.5
percent of the total weight of the tank if dry blended or 2 percent if melted compound.
Tank color shall be natural and have molded -in gallonage markers on the tank wall.
G. The tanks shall be permanently marked to identify the serial number. Tanks shall be
labeled as recommended by the Manufacturing Chemists Association.
H. The tank diameter shall be measured externally. Tolerance on the outside diameter
including out of roundness shall be plus or minus 3 percent. Measurement shall be taken
in a vertical position.
On closed top tanks the top head shall be integrally molded with the cylindrical wall. Its
minimum thickness shall be equal to the thickness of the top of the straight sidewall. In
most cases, flat areas shall be provided for attachment of large fittings on the dome of the
tank.
The bottom head shall be integrally molded with the cylindrical wall. Knuckle radius
shall be:
Tank Diameter, feet
Min. Knuckle Radius, inches
less than or equal to 6
1
greater than 6
1-1/2
K. The minimum wall thickness shall be calculated in accordance with ASTM D 1998. All
edges cut shall be trimmed smooth. Use flexible connections at all lower sidewall fittings.
KINNAKEET SHORES WWTP TERTIARY FILTER INSTALLATION 43 41 43 - 5
AND DISINFECTION MODIFICATIONS
01554-0041 REVISION DATE: JANUARY 2024

2.3 TANK FITTINGS
A. All tank fittings specified herein shall be furnished by the tank manufacturer. These tank
fittings are not necessarily shown in the Drawings. The Contractor shall coordinate the
location of the following accessories with the Drawings prior to submitting shop
drawings for the tank:
1. Nozzles:
a. Bolted Flange Fittings shall be constructed of one 150 lb. flange with ANSI
bolt pattern, one flange gasket and the correct number of stud bolts as speci-
fied by the flange manufacturer. Stud bolts shall have encapsulated chemical
resistant injection molded polyethylene heads and include VITON gaskets to
provide a sealing surface between the bolt head and the interior tank wall.
Stud bolt heads are to be color coded for visual ease of identifying the bolt
material by onsite operators (black- Titanium). All materials shall be com-
patible with chemical service.
2. U-Vents:
a. Provide one PVC U-vent per tank located at the peak of the tank dome.
b. Provide a non-metallic insect screen compatible with the chemical on each
tank vent.
c. Vents should be sized by the tank manufacturer.
d. Vents should comply with OSHA standards.
3. Manways:
a. Provide one 24-inch (minimum inside diameter) tank dome manway per
tank. The manway cover shall be manufactured out of HDPE.
b. Provide a Viton/EPDM gasket.
c. All bolts used to mount the manway cover shall be titanium or a non-metallic
material compatible with the chemical.
d. Manway assembly shall be hinged and weighted to provide additional
protection against over -pressurizing the tank during pneumatic filling
operations.
4. Fill Dip/Drop Pipes:
a. Provide one Schedule 80 PVC fill pipe per tank. Each fill line shall be
equipped with an internal anti -foam elbow diverting the liquid to cascade
down the internal tank wall. Each dip/drop pipe shall be furnished with a
non -obtrusive (no tank, wall penetrations) pipe support system. Each
dip/drop pipe shall be a 2-inch-diameter vent hole located at the overflow
crown elevation and oriented to face away from the tank's manway, vent,
overflow, and level element locations.
b. Pipes shall be supported at 6-foot maximum intervals.
5. Flexible Couplings/Connections:
KINNAKEET SHORES WWTP TERTIARY FILTER INSTALLATION
AND DISINFECTION MODIFICATIONS
01554-0041
43 41 43 - 6
REVISION DATE: JANUARY 2024

a. All fittings located on the lower third sidewall shall have 100% virgin PTFE
Flexi-Joint expansion joints manufactured by EthyleneTM. The expansion
joint shall have a minimum of three convolutions, stainless steel limit cables,
and ANSI 1501b FRP composite flanges. Galvanized parts will not be ac-
cepted. The expansion joint shall meet the following minimum performance
requirements:
1)
Axial Compression > 0.67"
2)
Axial Extension > 0.67"
3)
Lateral Deflection > 0.51"
4)
Angular Deflection > 140
5)
Torsional Rotation > 40
6. Level Transducer Connection
a. Provide a 1-1/2" molded NPT connection in the top of the tank. Connection
shall be a minimum of 8" away from the inner tank wall.
b. Reverse Float Level Indication: The level indicator shall be assembled on the
tank to act inversely to the tank contents and at no time shall allow tank con-
tents into the exterior sight tube. The indicator shall be neon orange for visu-
al ease. The level indication assembly shall include a PVC float, neon or-
ange indicator, polypropylene rope, 4-inch interior perforated pipe, PVC
roller guide elbows, 2-inch clear UV resistant PVC EnviroKing® sight tube
(C.F. Harvel) and all required pipe supports.
2.4 TANK ACCESSORIES
A. Tank Restraint System:
1. The manufacturer shall provide complete restraint system, including cables,
polyethylene restraint lugs, turnbuckles, thimbles, and clips, epoxy adhesive -type
anchor bolts, and all other necessary hardware to secure tank to concrete support
pad. All items shall be 300-series stainless -steel construction.
2. Restraint system shall be designed to meet 170 (minimum) wind load condition
and comply with the most recent edition of the International Building Code (IBC
2018) for seismic and wind.
PART 3 - EXECUTION
3.1 DELIVERY, STORAGE, AND HANDLING
A. The tanks shall be shipped in such a manner to protect them from damage and in
accordance with the tank manufacturer's requirements and recommendations. Loose
objects on trailers shall not be present.
B. All fittings and other components shall be factory installed and, if necessary,
subsequently removed for shipping and shipped separately as recommended by the tank
manufacturer.
KINNAKEET SHORES WWTP TERTIARY FILTER INSTALLATION 43 41 43 - 7
AND DISINFECTION MODIFICATIONS
01554-0041 REVISION DATE: JANUARY 2024

C. All flange faces shall be protected from damage. All openings shall be covered to prevent
the entrance of dirt, debris, and water.
D. Nozzles or other fittings not intended for tank lifting shall not be used for lifting.
Contractor shall not lift tank unless it is completely empty.
E. Upon arrival at the project site, the tanks and accessories shall be inspected for damage.
3.2 INSTALLATION
A. The tanks shall be installed in accordance with the Contract Documents and tank
manufacturer's written instructions and recommendations.
B. All items damaged during tank delivery and installation shall be replaced at no expense to
the Owner.
3.3 FIELD TESTING
A. After installation, the tank and connecting pipe fittings and valving shall be field tested
by being completely filled with potable water. The tank and fittings shall hold water
without loss, evidence of weeping or capillary action for a period of 24 hours prior to
acceptance. The Engineer may also inspect the tank for defects, damage, and
conformance with the Specifications.
B. Should any defects become evident during inspection and testing, the Contractor shall
repair or replace the defective tank or component in accordance with the tank
manufacturer's written instructions and recommendations.
C. The tank manufacturer/supplier shall inspect the completed tank installation and provide
written certification that the tank has been installed in accordance with the
manufacturer's recommendations and that the warranty is valid and in force.
3.4 CLEANING
A. After successful field testing, the tank shall be drained, thoroughly cleaned, and dried.
Each tank shall be disinfected in accordance with Division 22 Plumbing.
3.5 COORDINATION
A. The Contractor shall verify tank concrete support pad dimensions and its connecting
piping system, suit each tank and piping system being provided and comply with the tank
manufacturer's requirements prior to forming and pouring concrete pads. The
Contractor's failure to verify dimensions prior to construction of these pads shall require
new concrete pads be constructed at the Contractor's sole expense.
B. The contractor shall install all equipment per manufacturer recommendations and meet
the requirements of other piping, electrical, controls, and other specifications for the
project.
END OF SECTION 43 4143
KINNAKEET SHORES WWTP TERTIARY FILTER INSTALLATION 43 41 43 - 8
AND DISINFECTION MODIFICATIONS
01554-0041 REVISION DATE: JANUARY 2024

ATTACHMENT H:
v MCMQM&CREED
ENGINEERS SURVEYORS PLANNERS

Water Guard
INCORPORATED
Safety Data Sheet
Revision date: 04/24/2015
Section I CHEMICAL PRODUCT AND COMPANY IDENTIFICATION
Product Name(s): SODIUM HYPOCHLORITE SOLUTION
Chemical Name: Bleach 12.5 % by weight.
OTHER NAME/SYMBOL: Sodium Hypochlorite Solution, Bleach, Liquid Chlorine Solution, and
Liquid Bleach.
CAS NUMBER: 7681-52-9
CHEMICAL FAMILY: Alkali
FORMULA: NaOCI
DOT PROPER SHIPPING NAME: Hypochlorite Solution
DOT HAZARD CLASS: 8 (Corrosive) PG III; PG II (For solutions greater than 16% available chlorine)
DOT IDENTIFICATION NO: UN1791
RQ: 100 pounds
DOT EMERGENCY GUIDE NO: 154
Water Guard, Inc Emergency Response Number
P.O. Box 2226 1-800-633-8253 (24 hours)
Wilson, NC 27894
1-800-872-7665
SECTION II HAZARDS IDENTIFICATION
NFPA CLASSIFICATION (SCALE 0-4): Health=2 Fired Reactivity=l
EC CLASSIFICATION (ASSIGNED): C (Corrosive)
SIGNAL WORD: DANGER
HAZARD STATEMENTS.
Causes severe skin bums and eye damage.
Very toxic to aquatic life.
PRE CA UTIONARY STATEMENTS
Prevention:
Do not breathe mist, vapors, or spray.
Wash hands thoroughly after handling.
Avoid release to the environment.
Wear protective gloves/protective clothing/eye protection/face protection.
Response:
If Swallowed: Rinse mouth. DO NOT induce vomiting.
IF ON SKIN (or hair): Take off immediately all contaminated clothing. Rinse skin with water/shower.
Wash contaminated clothing before re -use.
IF INHALED: Remove person to fresh air and keep comfortable for breathing.
Immediately call a POISON CONTROL CENTER or doctor/physician.
Specific treatment (see First Aid Measures on Safety Data Sheet).
IF IN EYES: Rinse cautiously with water for several minutes. Remove contact lenses, if present and easy to
do. Continue rinsing

Water Guard
INCORPORATED
Collect spillage.
Storage:
Store locked up
Disposal: Dispose of contents/containers in accordance with locaFregional/national/intemational
regulations.
EMERGENCY OVERVIEW
COLOR: YellowPHYSICAL FORM: Liquid ODOR: Chlorine Odor
MAJOR HEALTH HAZARDS: Respiratory Tract Bums, Skin Burns, Mucous Membrane Bums, and Eye
Irritation
HAZARDOUS MIXTURES WITH OTHER LIQUIDS, SOLIDS, OR GASES: Reacts violently with acids
liberating chlorine gas. Also reacts with organic substance. When heated, gives off oxygen that may
increase fire hazard.
POTENTIAL HEALTH EFFECTS
INHALATION:
• SHORT TERM EXPOSURE: Irritation to respiratory tract. May have same as effects reported in
other routes of exposure, bums, blisters, nausea, difficulty breathing, and lung congestion.
• LONG TERM EXPOSURE: Same as effects reported in short term exposure.
SKIN CONTACT:
• SHORT TERM EXPOSURE: Irritant, reddening of the skin. May have bums, blisters, and itching
• LONG TERM EXPOSURE: Same as effects reported in short term exposure.
EYE CONTACT:
• SHORT TERM EXPOSURE: Irritation (possible severe), possible eye damage
• LONG TERM EXPOSURE: Same as effects reported in short term exposure.
INGESTION:
• SHORT TERM EXPOSURE: Bums, vomiting stomach pain, disorientation, bluish skin color,
convulsions, coma
• LONG TERM EXPOSURE: Same as effects reported in short term exposure.
CARCINOGEN STATUS: OSHA: N NTP: N IARC: N
Section III COMPOSITION, INFORMATION ON INGREDIENTS
INGREDIENT(S):
Water (HZO)
Sodium Hypochlorite (NaOCI)
Sodium Hydroxide (NaOH)
CAS#
wt. %
7732-18-5
82.0 — 87.3
7681-52-9
12.5 - 16.5
1310-73-2
0.20 — 1.5
SECTION IV FIRST AID MEASURES
INHALATION: Remove from exposure and get fresh air. Use bag valve mask or similar device to perform
artificial respiration (rescue breathing) if needed. Keep warm and at rest. Get medical attention
immediately if artificial respiration required.
SKIN CONTACT: Remove contaminated clothing, jewelry, and shoes immediately. Flush affected area
with large amounts of water, preferable a safety shower. Use soap or mild detergent and large amounts of
water until no evidence of chemical remains (at least 15-20 minutes). For bums, cover affected area
securely with sterile, dry, loose fitting dressing. If skin is burned, get medical attention immediately.
EYE CONTACT: Wash eyes immediately with large amounts of water, occasionally lifting upper and
lower lids, until no evidence of chemical remains (at least 15 minutes). Continue irrigating with a normal
2

Water Guard
INCORPORATED
saline solution until ready to transport to physician. Cover with sterile bandages. Get medical attention
immediately.
INGESTION: Rinse mouth with water. Drink large quantities of milk (water if no milk is available). Milk
of magnesia may be helpful. DO NOT USE ACIDIC ANTIDOTES SUCH AS SODIUM
BICARBONATE. When vomiting occurs, keep head lower than hips to help prevent aspiration. If person
is unconscious, do not induce vomiting and turn their head to the side. Never make an unconscious person
vomit or drink fluids. Get medical attention.
NOTE TO PHYSICIAN: For inhalation, consider oxygen. For ingestion, avoid gastric lavage, emesis,
sodium bicarbonate and acidic solutions. Consider the use of antacids.
SECTION V FIRE FIGHTING MEASURES
FLASH POINT: Non-flammable FLAMMABLE LIMITS: Non-flammable
FIRE AND EXPLOSION HAZARDS: Negligible fire hazard. Oxidizer, This material will react with some
metals and cause liberation of oxygen. May ignite or explode on contact with combustible materials. Toxic
fumes can be liberated by contact with acid or heat.
EXTINGUISHING MEDIA: Regular dry chemical, carbon dioxide, water, or foam suitable for surrounding
fire. For large fires, use regular foam or flood with fine water spray.
FIRE FIGHTING: Wear self-contained breathing apparatus and full protective clothing. Move container
from fire area if it can be done without risk. Cool containers with water spray until well after the fire is out.
Stay away from the ends of tanks. Use extinguishing agents appropriate for surrounding fire. Do not get
water directly on material. For large fires, flood with fine water spray. Reduce vapors with water spray.
Apply water from a protected location or from a same distance. Avoid body contact or inhalation of
material or combustion by —products. Stay upwind and keep out of low areas.
SECTION VI ACCIDENTAL RELESE MEASURES
OCCUPATIONAL RELEASE: Do not touch spilled material. Stop leak if possible without personal risk.
For small spills, collect spilled material in appropriate container for disposal and consider absorbing with
sand or other non-combustible material (e.g., do not use sawdust or other combustible material). Be
advised, however, that the use of absorbing material is creating hazardous waste and this absorbing material
must now be disposed of properly. Collect spilled material in appropriate container for disposal. For small
dry spills, move containers away from spill to a safe area. For large spills, dike for later disposal. If
possible, do not allow material to enter sewers, streams, ponds or storm conduits, as concentrated solutions
will seriously injure aquatic life. Keep unnecessary people away, isolate hazard area and deny entry.
Contain in as small an area as possible, such as a holding area for dilution and neutralization. Contain spill
in plastic drums when available. Dispose of in accordance with Federal, State, and local regulations.
Personnel engaged in cleanup operations must be equipped with NIOSH approved respirator protection,
rubber boots, gloves, and clothing to avoid body contact. Reportable Quantity (RQ): 100 pounds. Notify
Local Emergency Planning Committee and State Emergency Response Commission for release greater than
or equal to RQ (U.S. SARA Section 394). If release occurs in the U.S. and reportable under CERCLA
Section 103, notify the National Response Center at [phone] (USA) or [phone] (USA).
ADVANCE PLANNING: Plan in advance for an occupational release and have necessary equipment and
neutralization agents on -site. Contact Odyssey Manufacturing for assistance.
SECTION VII HANDLING AND STORAGE
Store in vented, closed containers that provide protection from direct sunlight. Keep separated from
incompatible substances and do not store near acids, heat, or oxidizable materials or organics. When
handling, do not mix with other cleaning agents that may liberate chlorine gas vapors (e.g., acidic agents)

Water Guard
INCORPORATED
Store and handle in accordance with all current regulations and standards including NFPA 430 Code for the
Storage of Liquid and Oxidizing materials.
SECTION VIII EXPOSURE CONTROLS AND PERSONNEL PROTECTION
EXPOSURE LIMITS: 2 mg/m3 AIHA recommended STEL 15 minutes for Sodium Hypochlorite
VENTILATION: Provide local exhaust ventilation system. Ensure compliance with applicable exposure
limits.
EYE PROTECTION: Splash goggles are preferred to a face shield. Another option is to wear splash
resistant safety goggles with a face shield. Provide an emergency eye wash fountain and quick drench
shower in the immediate work area.
CLOTHING: it is recommended to wear appropriate chemical resistant clothing to avoid body contact
such as a rubber apron or rain suit. Rubber boots are preferred footwear.
GLOVES: Wear appropriate chemical resistant gloves.
RESPIRATOR: Under conditions of frequent use or heavy exposure, respiratory protection may be
needed. Respiratory protection is ranked in order from minimum to maximum. Consider warning properties
before use.
• Any chemical cartridge respirator with organic vapor cartridge(s).
• Any chemical cartridge respirator with a full facepiece and organic vapor cartridge(s).
• Any air -purifying respirator with a full facepiece and an organic vapor canister.
• Any supplied -air respirator with a full facepiece and operated in a pressure -demand or other
positive pressure mode in combination with a separate escape supply (use for Unkonwn
Concentrations of those that may be Immediately Dangerous to Life or Health)
• Any self-contained breathing apparatus with a full facepiece (use for High Concentrations or those
which are Immediately Dangerous to life or Health)
SECTION IX PHYSICAL AND CHEMICAL PROPERTIES
PHYSICAL STATE and APPEARANCE: Liquid with pale yellow Color ODOR: Chlorine odor like
household bleach. MOLECULAR WEIGHT: 74.44
MOLECULAR FORMULA: Na-O-CI BOILING POINT: Degrades / Decomposes at 230 ° F
FREEZING POINT: — 100 F SPECIFIC GRAVITY: 1.19 -1.28 PH: Approximately 11.5-13.0
VAPOR PRESSURE (nun HG): Vapor Pressure of water + decomposition product vapor pressure
VAPOR DENSITY: Not Available SOLUBILITY IN WATER: Complete
VOLATILITY: Not Available EVAPORATION RATE: >1
COEFFICIENT OF WATER/OIL DISTRIBUTION: Not Available
SECTION X STABILITY AND REACTIVITY
REACTIVITY: Stable at normal temperature and pressure.
CONDITIONS TO AVOID: Avoid heat, flames, sparks and other sources of ignition. Dangerous gases
may accumulate in confined spaces. May ignite or explode on contact with combustible materials.
INCOMPATIBLES: Acids, metals, amines, combustible materials, reducing agents. Specific reactions
with sodium Hypochlorite include the following:
ACIDS: Violent reaction. ALUMINUM: Corrosive action. AMINES: Form explosive chloramines.
AMMONIA: Form explosive chloramines. AMMONIUM SALTS: May form explosive product.
BENZYL CYANIDE (ACIDIFIED): explosive reaction. ETHYLENEIMINE: Forms explosive 1-
chloroethyleneimine. FORMIC ACID: Explosive mixture.
METHANOL: May form explosive compound.
NITROGEN COMPOUNDS: Forms explosive N-chloro compounds.
ORGANIC AND COMBUSTIBLE MATERIALS: Fire and explosion hazard.
OXALIC ACID: Intense reaction. REDUCING AGENTS: Fire and explosion hazard
F1

Water Guard
INCORPORATED
ZINC: Corrosive HAZARDOUS DECOMPOSITION: Thermal decomposition products -Chlorine and
Hydrochloric Acid Vapors. Decomposition Products - Hypochlorous Acid Vapors
POLYMERIZATION: Will not polymerize.
SECTION XI TOXICOLOGICAL INFORMATION
IRRITATION DATA: 10 mg eyes -rabbit moderate
TOXICITY DATA: 1 gm/dg oral -woman: TDLo; 45 mg/kg intravenous -man TDLo; 5800 mg/kg oral -
mouse LD50; 140 mg/kq/9 week(s) continuous oral -rat TDLo
CARCINOGEN STATUS: According to the IARC, animal inadequate evidence, human no adequate data,
Group 3 (Hypochlorite salts)
LOCAL EFFECTS: Corrosive: inhalation, skin contact, eye, ingestion hazards
ACCUTE TOXICITY LIVEL: Slightly Toxic if ingested
MUTAGENIC DATA: Mutation in micro organisms -Salmonella typhimurium 1 mg/plate (-S9); DNA
repair-Escherichiacoli 20 µg/disc; DNA damage-Esoherichiacoli 420 µmol/L: phage inhibition capacity-
Esoherichiacoli 103 µg/well; micronucleus test-non=mammalian species multiple 200 ppb; cytogenetic
analysis -non -mammalian species multiple 120 µg/L; cytogenetic analysis -hamster lung 100 mg/1
HEALTH EFFECTS:
INHALATION
ACUTE EXPOSURE: May cause severe bronchial irritation, sore throat with possible blistering,
coughing, stomatitis, nausea labored breathing, shortness of breath and pulmonary epedema. 10-20 mg/m3
causes burning of the nose and throat; 40-60 mg/m3 may be fatal. If sufficient amounts are absorbed, may
cause effects as detailed in acute ingestion.
CHRONIC EXPOSURE: No data available.
SKIN CONTACT
ACUTE EXPOSURE: Extent of damage depends on concentration, pH, volume of solution & time of
contact. May cause redness, pain, blistering, itchy eczema & chemical bums. Sensitization reactions
possible in previously exposed persons.
CHRONIC EXPOSURE: Effects depend on concentrations and duration of exposure. Repeated or
prolonged contact with corrosive substances may result in dermatitis or effects similar to acute exposure.
Allergic dermatitis has also been reported.
EYE CONTACT
ACUTE EXPOSURE: May cause redness, pain, & blurred vision. Solutions of 5% splashed in human eyes
have caused a burning sensation and later only slight superficial disturbance of the corneal epithelium,
which cleared completely in the next day or two without special treatment. However, one animal study
reports a 5% solution causing only moderate irritation with clearing within 7 days. A higher concentration
of 15% tested on rabbit eyes caused immediate severe pain, hemorrhages, rapid onset of ground -glass
appearance of the corneal epithelium, moderate bluish edema of the whole cornea, chemosis and discharge
for several days. Such eyes have sometimes healed in 2-3 weeks with slight or no residual corneal damage
but they had neovascularization of the conjunctiva and distortion of the nictitating membrane by scarring.
CHRONIC EXPOSURE: Depending on concentration and time of exposure, symptoms may be as those of
acute exposure.
INGESTION
ACUTE EXPOSURE: May cause irritation and erosion of the mucous membranes, vomiting (possibly
bloody) and abdominal pain and spasms. A drop in blood pressure, shallow respiration, edema (possibly
severe) of pharynx, larynx, and glottis, confusion, convulsions, delirium and coma may occur. Cyanosis
and circulatory collapse are possible. Esophageal or gastric perforation and strictures are rare. Death may
occur, usually due to complications of severe local injury such as toxemia, shock, perforations,
hemorrhage, infection and obstruction. Massive ingestions may produce fatal hyperchloremic metabolic
acidosis or aspiration pneumonitis.
CHRONIC EXPOSURE: Sensitization reactions are reported in individuals who are exposed in small
amounts through their water supply. High doses have caused sperm abnormality in mice.

Water Guard
INCORPORATED
SECTION XII ECOLOGICAL INFORMATION
ECOTOXICITY DATA:
FISH TOXICITY: 94.0 µg/L 96 hour(s) LC50 (Mortality) Cutthroat trout (Oncorhynchus clarki)
INVERTEBRATE TOXICITY: 31.6 µg/L 7 hour(s) LC50 (Species Diversity) protozoan phylum
(Protozoa)
DAPHANIA MAGNA: Acute Toxicity LC50: 0.37 — 2.3 ppm (48 hour)
ALGAL TOXICITY: 90 µg/L 96 hour(s) LC50 (Mortality) Algae, phytoplankton, algai mat (Algae)
PHYTOTOXICITY: 230 µg/L 35 hour(s) (Biomass) Curled pondweed (Potamogeton crispus)
OTHER TOXICITY: 2.1 µg/L 28 day(s) (Chlorophyll) Aquatic community (Aquatic community)
SECTION XIII DISPOSAL CONSIDERATIONS
Subject to disposal regulations: U.S. EPA 40 CFR 262. Hazardous Waste Number(s): D001. Dispose in
accordance with all applicable regulations.
SECTION XIV TRANSPORT INFORMATION
U.S. DOT 49 CFR 172.101 SHIPPING NAME -UN NUMBER: Sodium Hypochlorite — UN1791
U.S. DOT 49 CFR 172.101 HAZARD CLASS OR DIVISION: 8
U.S. DOT 49 CFR 172.101 PACKING GROUP: III (less than 16% available chlorine)/II (16%or more
available chlorine)
U.S. DOT 49 CFR 172.101 AND SUBPART E LABELING REQUIREMENTS: Corrosive
U.S. DOT 49 CFR 172.101 PACKAGING AUTHORIZATIONS:
EXCEPTIONS: 49 CFR 173.154
NON -BULK PACKAGING; 49 CFR 173.203 (less that 16% available chlorine)/ 49 CFR 173.202
(16% or more available chlorine)
BULK PACKAGING: 49 CFR 173.241 (less that 16% available chlorine)/ 49 CFR 173.242 (16%
or more available chlorine)
U.S. DOT 49 CFR 172.101 QUANTITY LIMITATIONS:
PASSANGER AIRCRAFT OR RAILCAR: 5 LITERS (less that 16% available chlorine) / 1 LITERS (16%
or more available chlorine)
Cargo aircraft only: 60 liters (less that 16% available chlorine) / 30 liters (16% or more available chlorine)
*< •
SECTION XV REGULATORY INFORMATION
U.S. REGULATIONS
TSCA INVENTORY STATUS; Y TSCA 12(b) EXPORT NOTIFICATION: Not listed.
CERCLA SECTION 103 (40CFR302.4): Y SODIUM HYPOCHLORITE: 100 LBS RQ
SARA SECTION 302 (40CFR355.30): N SARA SECTION 304 (40CFR355.40): N
SARA SECTION 313 (40CFR372.65): N
SARA HAZARD CATEGORIES, SARA SECTIONS 311/312 (40CFR370.21):
ACUTE: Y CHRONIC: N FIRE: N REACTIVE: N SUDDEN RELEASE: N
OSHA PROCESS SAFETY (29CFR1SIO.19): N
STATE REGULATIONS: California Proposition 65: N
EUROPEAN REGULATIONS: EC NUMBER (BINECS): 231-668-3
EC RISK AND SAFETY PHRASES:
R 31 Contact with acids liberates toxic gas.
R 34 Causes burns
31

Water Guard
INCORPORATED
S '/2 Keep locked -up and out of reach of children.
S 28b After contact with skin, wash immediately with plenty of soap and water.
S 45 In case of accident or if you feel unwell, seek medical advice immediately (show the label where
possible)
S 50 Do not mix with incompatible materials.
CONCENTRATION LIMITS:
C>10% C R 31-34
5%<=C<=10% Xi R 31-36/38
GERMAN REGULATIONS: WATER HAZARD CLASS (WGK): 2 (Official German Classification)
FIFRA Information
This chemical is a pesticide product registered by the Environmental Protection Agency and is subject to
certain labeling requirements under federal pesticide law. These requirements differ from the classification
criteria and hazard information required for safety data sheets, and for workplace labels of non -pesticide
chemicals. Following is the hazard information as required on the pesticide label:
WARNING
May be fatal if swallowed or if absorbed through skin.
Harmful if inhaled.
Causes skin irritation.
Causes substantial but temporary eye injury.
This pesticide is extremely toxic to fish
SECTION XVI OTHER INFORMATION
For additional information, contact our Quality Assurance / Technical Service Department.
Information contained in this MSDS refers only to the specific material designated and does not relate to
any process or use involving other materials. This information is based on data believed to be reliable, and
the Product is intended to be used in a manner that is customary and reasonably foreseeable. Since actual
use and handling are beyond our control, no warranty, expressed or implied, is made and no liability is
assumed Water Guard, Inc. in connection with the use of this information.
11

ATTACHMENT I:
v MCMQM&CREED
ENGINEERS SURVEYORS PLANNERS

PULSAtron Series A Plus
The Pulsatron Series A Plus offers manual function controls over stroke length and stroke rate as standard with the option
to select external pace for automatic control.
Ten distinct models are available, having pressure capabilities to 250 PSIG (17 BAR) @ 12 GPD (1.9 Iph), and flow
capacities to 58 GPD (9.1 Iph) @ 100 PSIG (7.0 BAR), with a standard turndown ratio of 100:1, and optional ratio of
2000:1. Metering performance is reproducible to within ± 3% of maximum capacity.
FEATURES
• Manual Control by on-line adjustable stroke
rate and stroke length.
• Highly Reliable timing circuit.
• Circuit Protection against voltage and current upsets.
• Solenoid Protection by thermal overload with
auto -reset.
• Water Resistant, for outdoor and indoor applications.
• Internally Dampened To Reduce Noise.
• Guided Ball Check Valve Systems, to reduce
back flow and enhance outstanding priming
characteristics.
• Few Moving Parts and Wall Mountable.
• Safe & Easy Priming with durable leak -free bleed
valve assembly (standard).
• Optional Control: External pace with
auto.manual selection.
BENEFITS
• Reliable metering performance.
• Rated "hot' for continuous duty.
• High viscosity capability.
• Leak -free, sealless, liquid end.
CONTROLS
Manual Stroke Rate
Tested and Certified by WQA
• Turn -Down Ratio 10:1 against NSHANSVCAN 819 372.
Manual Stroke Length
• Turn -Down Ratio 10:1 F d
Cou5
External Pacing Option w
CE
External Stop Option
Intertek Intertek PVOF 8 PVC Ega Dess�Head Pumps.
External Pacie With Stop Option (125 PM only) 9700150 9700150 See www.wga.orgfor
certification parameters.

SPECIFICATIONS
MOD
----1
LB04
LB64
L�--
Capacity nominal (max) 11
rGP
�1
MM:�
�-
LPIM
1 '
• •
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GFPP, PVDF, 316SS or
PVC (W code) w/TFE
Pressure' Seats) PSIG
(max.) PVC (V code) Viton or (Ba
CSPE Seats / Degas
Liquid EndA
IN
MINNIE
•
I
IN,
M11
Tub-
, 1 � ; 11
1 . •1
1 . : •1
ections:
Pipi.
FStrokes/Minute ��
N.
•
Note 3: Pumps with rated pressure above 150 PSI will be de -rated to 150 PSI Max. when selecting certain valve options, see Price Book for details.
ENGINEERING DATA
1 .. ..
•
GFPPL, PVC, PVDF, 316 SS
PTFE-faced CSPE-backed
PTFE, CSPE, Viton
Ceramic, PTFE, 316 SS, Alloy C
GFPPL, PVC, PVDF
•
Same as fitting and check valve selected,
except 316SS
..
Same as fitting and check valve selected
Clear PVC, White PE
Important: Material Code - GFPPL=Glass-filled Polypropylene, PVC=Polyvinyl Chloride,
PE=Polyethylene, PVDF=Polyvinylidene Fluoride, CSPE=Generic formulation of Hypalon, a
registered trademark of E.I. DuPont Company. Viton is a registered trademark of E.I. DuPont
Company. PVC wetted end recommended for sodium hypochlorite.
DIMENSIONS
Reproducibility +3% at maximum capacity
Viscosity Max CPS 1000 CPS
For viscosity up to 3000 CPS, select connection size 3, 4, B or C with 316SS ball material.
Flow rate will determine connection/ball size. Greater than 3000 CPS require spring loaded
ball checks. See Selection Guide for proper connection.
125
1 .
101
1 .
101
115 VAC / 50-60 HZ / 1 ph
•
230 VAC / 50-60 HZ / 1 ph
0.6 Amps
•
0.3 Amps
mr.T.Maiggm
130 Watts
• .
50 Watts
ApprovalsConforms
to ANSI/NSF STD. 50
jA Series A
Model No. �1 B 11
LB02 / S2 �� ' .
PLUS Dimensions (inches) , I
C D E Shippin Wei ht 1
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. LBC2 .�
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���
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NOTE: Inches X 2.54 = cm
w rvALaHArccAWcAIr
27101 Airport Road
Punta Gorda, FL 33982
Tel: [phone]
Fax: [phone]
www.pulsatron.com
R.90
■.❑■
514
An ISO Certified Company
BLEED VALVE
B
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NC-10
IA=f
EMP025 A22

ECOBULK MX
Perfect for transport
and storage.
1 Approved for filling products of a maximum
density of 1.9
1 Perfectly suited for high bay warehousing
1 Can be stacked up to 4-high
1 Reinforced, warp resistant tubular steel grid jacket
1 Additional corner guards to protect the inner
container
1 Available in a variety of equipment packages
SCHUTZ
PACKAGING SYSTEMS
Inner bottle
1 Extrusion blow -moulded HDPE
1 SMP protective barrier
(optional)
1 Additional UV and light
protection of the filling
product (optional)
Outer container
1 Welded tubular steel grid,
galvanized
Bottom plate
1 To provide stability and to
facilitate minimum residual
contents from the inner
container
UN 31 HAIIN (optional)
1 Maximum density 1.9
SCHUTZ FOODCERT (optional)
1 System certification for food
(FDA included)
1 DN 150 with screw cap
1 DN 225 with screw cap
1 DN 400 with clamp -ring lid
(only for MX 1000)
MX 640
11,200 x 800 x 1,000 (L x W x H)
MX 820
11,200 x 1,000 x 1,000 (L x W x H)
MX 1000
11,200 x 1,000 x 1,160 (L x W x H)
MX 1250
11,200 x 1,000 x 1,350 (L x W x H)
MX 640
146 kg (steel), 50 kg (plastic)
MX 820
153 kg (steel), 56 kg (plastic)
MX 1000
158 kg (steel), 61 kg (plastic),
63 kg (full -plastic)
MX 1250
166 kg (steel), 68 kg (plastic)
steel frame ILL J -
steel skid �� . G✓
plastic skid 16-
full -plastic -skid 111111W
MX 640
1 640 litres (170 gal)
MX 820
1 820 litres (220 gal)
MX 1000
11,000 litres (275 gal)
MX 1250
11,250 litres (330 gal)
1 Integrated butterfly valve
DN 50, DN 80
1 Screwable butterfly valve
DN 50, DN 80, DN 150
1 Screwable ball valve DN 50
Filled ECOBULK according to
the specific weight of the filling
goods
up to 1.5 more than 1.5
2-high I 1-high
OO
Max.
4-high
�I
NIMBI
11= ■II
Rifl�ifl
I = oil
11- oil
11— ■I
NOM
W- -e
05/2014

ATTACHMENT
v MCMQM&CREED
ENGINEERS SURVEYORS PLANNERS

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0

ATTACHMENT K:
v MCMQM&CREED
ENGINEERS SURVEYORS PLANNERS

WELL CONSTRUCTION RECORD (GW-1)
HOO &RQWUDFWRU ,QIRUPDWLRQ,
Print Form
For Internal Use
Donald Cummings
Well Contractor Name
2412-A
1& :HOO &RQWUDFWRU &HUWLILFDWLRQ 1XPEHU
Applied Resource Management
Company Name
2. Well Construction Permit #: WQ0002284
List all applicable well construction permits (i.e. UIC, County, State, Variance, etc.)
3. Well Use (check well use):
Water Supply Well:
(Heating/Cooling Supply)
Non -Water Supply Well:
Recharge
Storage and Recovery
Test
rental Technology
mat (Closed Loop)
[3Municipal/Public
[3IResidential Water Supply (single)
[3IResidential Water Supply (shared)
Groundwater Remediation
0ISalinity Barrier
01 Stormwater Drainage
[71ISubsidence Control
01Tracer
under #21
D W H : H O O V MR9/9NIAd Wll ID# MW-10
-D :HOO /RFDWLRQ,
Outer Banks / Kinnakeet Assoc. LLC
Facility/Owner Name Facility ID# (if applicable)
41105 Big Kinnakeet Dr, Avon
3K\VLFDO $GGUHVV &LW\ DQG =LS
Dare 054905183600
County
Parcel Identification No. (PIN)
5b. Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(ifwell field, one lat/long is sufficient)
35 20' 39.71 " N 75 30' 23.26"
6.Is(are)the well(s):®IPermanent or rIJITemporary
7. Is this a repair to an existing well: []IYes or ®No
Ifthis is a repair, fill out known well construction information and explain the nature of the
repair under 421 remarks section or on the back of this form.
8. For Geoprobe/DPT or Closed -Loop Geothermal Wells having the same
construction, only 1 GW-1 is needed. Indicate TOTALNUMBER ofwells
drilled:
9. Total well depth below land surface: 15 (ft.)
For multiple wells list all depths if different (example- 3Cq)200' and 2@100')
10. Static water level below to of casing: 5.40 (ft )
If water level is above casing use
11. Borehole diameter: 8 1 /4
12. Well construction method: Auger
(i.e. auger, rotary, cable, direct push, etc.)
14. WATER ZONES
FROM
TO
DESCRIPTION
ft.
ft.
ft.
ft.
15. OUTER CASING (for multi -cased wells) OR LINER (if applicable)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
+ 2 ft.
3 ft.
2 in.
Sch 40
PVC
16. INNER CASING OR TUBING (geothermal closed -loop)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
ft.
ft.
in.
ft.
ft.
in.
17. SCREEN
FROM
TO
DIAMETER
SLOT SIZE
THICKNESS
MATERIAL
3 ft.
15 fL
2 in.
.010
Sch 40
PVC
ft.
ft.
in.
18. GROUT
FROM
TO
MATERIAL
EMPLACEMENT METHOD & AMOUNT
0.5 ft.
2 ft.
Bentonite
Poured
0 ft.
0.5 ft.
Neat Cement
Poured
ft.
ft.
19. SAND/GRAVEL PACK if applicable)
FROM
TO
MATERIAL
EMPLACEMENT METHOD
2 ft'
15 ft.
# 2 gravel
Poured
ft.
ft.
20. DRILLING LOG attach additional sheets if necessary)
FROM
TO
DESCRIPTION color, hardness, soil/rock type, grain size, etc.
2 ft.
4 ft.
Tan brown med to coarse sand with shell fragments
5 ft
7 ft
Tan brown coarse to gravely sand
10 ft
12 ft
7DQ EURZQ FRDUVH WR JUDYI
13 ft.
15 ft'
Med grey fine to med sands with minor shell fragments
ft.
ft.
ft.
ft.
ft.
ft.
2L REMARKS
22. Certification:
Signature of Certified Well Contractor
11 /8/2022
Date
By signing this form, I hereby certify that the well(s) was (were) constructed in accordance
with 15A NCAC 02C .0100 or 15A NCAC 02C . 0200 Well Construction Standards and that a
copy ofthis record has been provided to the well owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTRUCTIONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
Division of Water Resources, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Iniection Wells: In addition to sending the form to the address in 24a
above, also submit one copy of this form within 30 days of completion of well
construction to the following:
Division of Water Resources, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpm) Method of test: 24c. For Water Supply & Iniection Wells: In addition to sending the form to
the address(es) above, also submit one copy of this form within 30 days of
13b. Disinfection type: Amount: completion of well construction to the county health department of the county
where constructed.
Form GW-1 North Carolina Department of Environmental Quality - Division of Water Resources Revised 2-22-2016

Print Form
WELL CONSTRUCTION RECORD (GW-1)
1. Well Contractor Information:
Donald Cummings
Well Contractor Name
2412-A
NC Well Contractor Certification Number
Applied Resource Management
Company Name
2. Well Construction Permit #: WQ0002284
List all applicable well construction permits (i.e. UIC, County, State, Variance, etc.)
3. Well Use (check well use):
Water Supply Well:
PI Agricultural
[3Municipal/Pub lic
Geothermal (Heating/Cooling Supply)
[3IResidential Water Supply (single)
PIIndustrial/Commercial
[3IResidential Water Supply (shared)
Irrigation
Non -Water Supply Well:
® Monitoring
D Recovery
Injection Well:
13 Aquifer Recharge
Groundwater Remediation
®IAquifer Storage and Recovery
0ISalinity Barrier
Aquifer Test
01 Stormwater Drainage
Experimental Technology
[:]I Subsidence Control
bGeothermal (Closed Loop)
[:IITracer
4. Date Well(s) Completed: 10/20/2022 Well ID#
5a. Well Location:
Outer Banks / Kinnakeet Assoc. LLC
under #21
MW-11
Facility/Owner Name Facility ID# (if applicable)
41105 Big Kinnakeet Dr, Avon
Physical Address, City, and Zip
Dare 054905183600
County
Parcel Identification No. (PIN)
5b. Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(ifwell field, one lat/long is sufficient)
35 20' 40.50" N 75 30' 31.22" W
6.Is(are)the well(s):®IPermanent or rIJITemporary
7. Is this a repair to an existing well: []IYes or ®No
Ifthis is a repair, fill out known well construction information and explain the nature of the
repair under 421 remarks section or on the back of this form.
8. For Geoprobe/DPT or Closed -Loop Geothermal Wells having the same
construction, only 1 GW-1 is needed. Indicate TOTALNUMBER ofwells
drilled:
9. Total well depth below land surface: 15 (ft.)
For multiple wells list all depths if different (example- 3CJ)200' and 2@100')
10. Static water level below top of casing: 5.00 ft
If water level is above casing use ' - "
11. Borehole diameter: 8 1 /4
12. Well construction method: Auger
(i.e. auger, rotary, cable, direct push, etc.)
( •)
For
Use
14. WATER ZONES
FROM
TO
DESCRIPTION
ft.
ft.
ft.
ft.
15. OUTER CASING (for multi -cased wells) OR LINER (if applicable)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
+ 2 ft.
3 ft.
2 in.
Sch 40
PVC
16. INNER CASING OR TUBING (geothermal closed -loop)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
ft.
ft.
in.
ft.
ft.
in.
17. SCREEN
FROM
TO
DIAMETER
SLOT SIZE
THICKNESS
MATERIAL
3 ft.
15 fL
2 in.
.010
Sch 40
PVC
ft.
ft.
in.
18. GROUT
FROM
TO
MATERIAL
EMPLACEMENT METHOD & AMOUNT
0.5 ft.
2 ft.
Bentonite
Poured
0 ft.
0.5 ft•
Neat Cement
Poured
ft.
ft.
19. SAND/GRAVEL PACK if applicable)
FROM
TO
MATERIAL
EMPLACEMENT METHOD
2 ft'
15 ft
# 2 gravel
Poured
ft.
ft.
20. DRILLING LOG attach additional sheets if necessary)
FROM
TO
DESCRIPTION color, hardness, soil/rock type, grain size, etc.
2 ft.
4 ft.
Med brown fine to coarse sand mixtures with minor shell fragments
5 ft.
7 ft.
Med grey coarse to gravely sands with shell hash
10 ft
12 ft
Med grey coarse to gravely sands with shell hash
13 ft
15 ft'
Light med grey fine to med sands with minor shell fragments
ft.
ft.
ft.
ft.
ft.
ft.
2L REMARKS
22. Certification:
11 /8/2022
Signature of Certified Well Contractor Date
By signing this form, I hereby certify that the well(s) was (were) constructed in accordance
with 15A NCAC 02C .0100 or 15A NCAC 02C . 0200 Well Construction Standards and that a
copy ofthis record has been provided to the well owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTRUCTIONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
Division of Water Resources, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Iniection Wells: hi addition to sending the form to the address in 24a
above, also submit one copy of this form within 30 days of completion of well
construction to the following:
Division of Water Resources, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpm) Method of test: 24c. For Water Supply & Iniection Wells: In addition to sending the form to
the address(es) above, also submit one copy of this form within 30 days of
13b. Disinfection type: Amount: completion of well construction to the county health department of the county
where constructed.
Form GW-1 North Carolina Department of Environmental Quality - Division of Water Resources Revised 2-22-2016

WELL CONSTRUCTION RECORD (GW-1)
HOO &RQWUDFWRU ,QIRUPDWLRQ,
Print Form
For Internal Use
Donald Cummings
Well Contractor Name
2412-A
1& :HOO &RQWUDFWRU &HUWLILFDWLRQ 1XPEHU
Applied Resource Management
Company Name
2. Well Construction Permit #: WQ0002284
List all applicable well construction permits (i.e. UIC, County, State, Variance, etc.)
3. Well Use (check well use):
Water Supply Well:
(Heating/Cooling Supply)
Non -Water Supply Well:
Recharge
Storage and Recovery
Test
rental Technology
mat (Closed Loop)
[3Municipal/Public
[3IResidential Water Supply (single)
[3IResidential Water Supply (shared)
Groundwater Remediation
0ISalinity Barrier
01 Stormwater Drainage
[71ISubsidence Control
01Tracer
under #21
D W H :HOO V P/�964A W01 ID# M W-12
-D :HOO /RFDWLRQ,
Outer Banks / Kinnakeet Assoc. LLC
Facility/Owner Name Facility ID# (if applicable)
41105 Big Kinnakeet Dr, Avon
3K\VLFDO $GGUHVV &LW\ DQG =LS
DARE 054905183600
County
Parcel Identification No. (PIN)
5b. Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(ifwell field, one lat/long is sufficient)
35 20' 43.92" N 75 30' 29.48"
6.Is(are)the well(s):®IPermanent or rIJITemporary
14. WATER ZONES
FROM
TO
DESCRIPTION
ft.
ft.
ft.
ft.
15. OUTER CASING (for multi -cased wells) OR LINER (if applicable)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
+2 ft.
3 ft.
2 in.
Sch 40
PVC
16. INNER CASING OR TUBING (geothermal closed -loop)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
ft.
ft.
in.
ft.
ft.
in.
17. SCREEN
FROM
TO
DIAMETER
SLOT SIZE
THICKNESS
MATERIAL
3 ft.
15 ft
2 in.
.010
Sch 40
PVC
ft.
ft.
in.
18. GROUT
FROM
TO
MATERIAL
EMPLACEMENT METHOD & AMOUNT
0.5 ft.
2 ft.
Bentonite
Poured
0 ft.
0.5 ft.
Neat Cement
Poured
ft.
ft.
19. SAND/GRAVEL PACK if applicable)
FROM
TO
MATERIAL
EMPLACEMENT METHOD
2 ft.
15 ft.
#2 gravel
Poured
ft.
ft.
20. DRILLING LOG attach additional sheets if necessary)
FROM
TO
DESCRIPTION color, hardness, soil/rock type, grain size, etc.
2 ft.
4 ft.
Med to dark brown med to coarse sands wth minor shell fragments
5 ft.
7 ft.
Light brown coarse sands with some shell hash
10 ft.
1 2 ft.
Med grey fine to med sands, some coarse, minor shell fragments
13 ft.
15 ft.
OHG JUH\ ILQH WR PHG VDQGV VRPH F
ft.
ft.
ft.
ft.
ft.
ft.
2L REMARKS
22. Certification:
W z:)e4'a'"
Signature of Certified Well Contractor
7. Is this a repair to an existing well: []IYes or ®No
Ifthis is a repair, fill out known well construction information and explain the nature of the
repair under 421 remarks section or on the back of this form.
8. For Geoprobe/DPT or Closed -Loop Geothermal Wells having the same
construction, only 1 GW-1 is needed. Indicate TOTALNUMBER ofwells
drilled:
9. Total well depth below land surface: 15 (ft.)
For multiple wells list all depths if different (example- 3Cq)200' and 2@100')
10. Static water level below top of casing:
If water level is above casing use ' — "
11. Borehole diameter: 8 1 /4
12. Well construction method: Auger
(i.e. auger, rotary, cable, direct push, etc.)
M
11 /8/2022
Date
By signing this form, I hereby certify that the well(s) was (were) constructed in accordance
with 15A NCAC 02C .0100 or 15A NCAC 02C.0200 Well Construction Standards and that a
copy ofthis record has been provided to the well owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTRUCTIONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
(fL) Division of Water Resources, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Iniection Wells: In addition to sending the form to the address in 24a
above, also submit one copy of this form within 30 days of completion of well
construction to the following:
Division of Water Resources, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpm) Method of test: 24c. For Water Supply & Iniection Wells: In addition to sending the form to
the address(es) above, also submit one copy of this form within 30 days of
13b. Disinfection type: Amount: completion of well construction to the county health department of the county
where constructed.
Form GW-1 North Carolina Department of Environmental Quality - Division of Water Resources Revised 2-22-2016