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HomeMy WebLinkAboutWQ0005247_Final Permit_20091105W �ICDENR North Carolina Department of Environment and Natural Resources Division or Water duality Beverly Eaves Perdue Coleen H. Sullins Govemor Director November 5, 2009 Mr. Scott M. Kershner, Park Superintendent Palls Lake State Recreation Area 13304 Creedmoor Road Wake Forest, North Carolina 27587 Dear Mr. Kershner: Dee Freeman Secretary SCANNED DATE: 1 /6(15' Subject: Permit No. WQ0005247 Rollingview State Recreation Area Wastewater Collection, Treatment and Irrigation System Durham County In accordance with your permit minor modification request received September 30, 2009, we are forwarding herewith Permit No. WQ0005247, dated November 5, 2009, to NCDENR — Division of Parks and Recreation for the continued operation of the subject wastewater collection, treatment, and irrigation facilities. The following modifications to the subject permit are as follows: Effluent monitoring has been changed from March, July and November to March, July and September to allow effluent monitoring to be performed during times of operation of the treatment facility. Effluent monitoring for Nitrite plus Nitrate Nitrogen will be replaced with monitoring for Residual Chlorine so that all facilities will be monitored for the same parameters. Effluent monitoring for pH will be changed from weekly (year-round) to, along with Residual Chlorine, weekly monitoring from March through September, and "per spray event" during the remainder of the vear. 4 On August 5, 2009, Session Law 2009-406, entitled "An Act to Extend Certain Government Approvals Affecting the Development of Real Property Within the State." was enacted by the General Assembly and signed into law. The Act, known as the Permit Extension Act of 2009, extends the expiration date of certain government approvals and permits. The subject permit falls within the scope of this Act and is therefore being extended until October 31, 2014. This permit shall be effective from the date of issuance until October 31, 2014, shall void Permit No. WQ0005247 issued December 21, 2007. and shall be subject to the conditions and limitations as specified therein. Please pay particular attention to the monitoring requirements listed in Attachments A AQUIFER PROTECTION SECTION 1636 Mail Service Center. Raieign. North Carolma 27699-16H Location: 2728 Capital Boulevard. Paieioh, North Carolina 27604 Phone: 919.733.R21 1 FAX 1: 919-715-)588: FAY, 2: 919.715-60481 Customer Service, 1-977-623-6748 Irltemer. www.ncwateroualitv.ora M Equal Gpponarnty . Aflnmalive AClior. =m m olic NorthCarolina Mr. Scott M. Kershner November 5, 2009 Page 2 of 2 and B for they may differ from the previous permit issuance. Failure to establish an adequate system for collecting and maintaining the required operational information shall result in future compliance problems. Please note the following permit conditions are new since the last permit issuance: Condition II.11. — additional setbacks have been added ➢ Condition E11.9. - forbids public access to the irrigation sites and treatment facilities ➢ Condition IV.8. — requires maintaining a record of all residuals removed from the facility ➢ Condition IV.9. — requires maintaining of a maintenance log for the facility ➢ Condition IV. 1I.e. — requires the timely notification of ponding in or runoff from the irrigation sites ➢ Condition VI.S. — allows the permit to be revoked or unilaterally modified under certain conditions ➢ Condition VI.9. - prohibits the permitted facilities from being expanded if there are certain issues, unless a variance is granted by the Director If any parts, requirements or limitations contained in this permit are unacceptable, the Permittee has the right to request an adjudicatory hearing upon written request within 30 days following receipt of this permit. This request shall be in the form of a written petition, conforming to Chapter 150B of the North Carolina General Statutes, and filed with the Office of Administrative Hearings at 6714 Mail AM., Service Center, Raleigh, NC 27699-6714. Unless such demands are made, this permit shall be final and binding. If you need additional information concerning this matter, please contact David Goodrich at (919) 715-6162 or david.goodrich&cdenr.gov. Sincerely, for Coleen H. Sullins cc: Durham County Health Department Raleigh Regional Office, Aquifer Protection Section Permit File WQ0005247 Notebook File WQ0005247 NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES RALEIGH WASTEWATER IRRIGATION SYSTEM PERMIT In accordance with the provisions of Article 21 of Chapter 143, General Statutes of North Carolina as amended, and other applicable Laws, Rules and Regulations PERMISSION IS HEREBY GRANTED TO NCDENR — Division of Parks and Recreation Durham County continued operation of a 9,990 GPD wastewater collection, spray irrigation treatment and disposal facility consisting of approximately 345 linear feet of eight inch gravity sewer, approximately 225 linear feet of six inch gravity sewer, a 2 hp pump station with duplex pumps and high water alarms, eight, 5 hp pump stations each with duplex pumps and high water alarms (as upgraded), two, 7.5 hp booster pump stations (as upgraded), each with duplex pumps and high water alarms, approximately 17,650 linear feet of 2, 3, and 4 inch force main, a 7 million gallon stabilization lagoon, a 5 million gallon storage lagoon, a tablet chlorinator, a 3,200 gallon chlorine contact chamber, a 150 GPM irrigation pump station with dual submersible pumps, and two 3.55 acre irrigation zones, ten pump stations at the Rollingview park, a grit chamber and piping to connect the existing shower at Pump Station 2, and wastewater collection facilities consisting of a septic tank, a pump station with duplex 22 GPM effluent pumps and high water alarms, and approximately 500 linear feet of two inch force main to discharge collected wastewater from the Superintendent's Residence to the existing wastewater facilities to serve Rolling View State Recreation Area, with no discharge of wastes to the surface waters, pursuant to the application received September 30, 2009, and subsequent additional information received by the Division of Water Quality (Division), and in conformity with the project plan, specifications, and other supporting data subsequently filed and approved by the Department of Environment and Natural Resources and considered a part of this permit. This permit shall be effective from the date of issuance until October 31, 2014, shall void Permit No. WQ0005247 issued December 21, 2007, and shall be subject to the following specified conditions and limitations: WQ0005247 Version 2.2 Shell Version 090806 Page 1 of 8 I. SCHEDULES 1. No later than six months prior to the expiration of this permit, the Permittee shall request renewal of this permit on official Division forms. Upon receipt of the request, the Division will review the adequacy of the facilities described therein, and if warranted, will renew the permit for such period of time and under such conditions and limitations as it may deem appropriate. Please note Rule 15A NCAC 02T .0105(d) requires an updated site map to be submitted with the permit renewal application. H. PERFORMANCE STANDARDS 1. The subject non -discharge facilities shall be effectively maintained and operated at all times so there is no discharge to surface waters, nor any contravention of groundwater or surface water standards. In the event the facilities fail to perform satisfactorily, including the creation of nuisance conditions due to improper operation and maintenance, or failure of the irrigation areas to adequately assimilate the effluent, the Permittee shall take immediate corrective actions including Division required actions, such as the construction of additional or replacement wastewater treatment or disposal facilities. 2. This permit shall not relieve the Permittee of their responsibility for damages to groundwater or surface water resulting from the operation of this facility. 3. All wells constructed for purposes of groundwater monitoring shall be constructed in accordance with 15A NCAC 02C .0 10 8 (Standards of Construction for Wells Other than Water Supply), and any other jurisdictional laws and regulations pertaining to well construction. 4. The wastewater collection facilities shall be properly maintained and operated at all times. The Permittee shall maintain compliance with an individual system -wide collection system permit for the operation and maintenance of these facilities in accordance with 15A NCAC 02T .0400. If an individual permit is not required, the following performance criteria shall be met as provided in 15A NCAC 02T .0403. a. The sewer system shall be effectively maintained and operated at all times to prevent discharge to land or surface waters, and any contravention of groundwater or surface water standards. b. A map of the sewer system shall be developed and actively maintained. c. An operation and maintenance plan shall be developed, implemented and maintained. d. Pump stations not connected to a telemetry system shall be inspected every day (i.e., 365 days per year). Pump stations connected to a telemetry system shall be inspected at least once per week. e. High -priority sewers shall be inspected at least once every six months. f. A general observation of the entire sewer system shall be conducted at least once per year. g. Overflows and bypasses shall be reported to the Raleigh Regional Office in accordance with 15A NCAC 02B .0506(a), and public notice shall be provided as required per North Carolina General Statute § 143-215.1 C. h. A grease control program shall be developed, implemented and maintained. i. Right-of-ways and easements shall be maintained. j. Inspection and maintenance records for Conditions IIA.a. through II.4.i. shall be maintained for a period of at least three years, except for Conditions IIA.b. and IIA.c., which shall be maintained .for the life of the system. 5. Effluent limitations shall not exceed those specified in Attachment A. 6. Application rates, whether hydraulic, nutrient or other pollutant, shall not exceed those specified in Attachment B. WQ0005247 Version 2.2 Shell Version 090806 Page 2 of 8 7. The compliance boundary for the disposal system shall be specified in accordance with 15A NCAC 02L .0107(b). This disposal system was individually permitted on or after December 30, 1983; therefore, the compliance boundary is established at either 250 feet from the effluent disposal area, or 50 feet within the property boundary, whichever is closest to the effluent disposal area. An exceedance of groundwater standards at or beyond the compliance boundary is subject to remediation action according to 15A NCAC 02L .0106(d)(2) as well as enforcement actions in accordance with North Carolina General Statute 143-215.6A through 143-215.6C. 8. In accordance with 15A NCAC 02L .0108, the review boundary is established midway between the compliance boundary and the effluent disposal area. Any exceedance of groundwater standards at the review boundary shall require action in accordance with 15A NCAC 02L .0106. 9. The Permittee shall apply for a permit modification to establish a new compliance boundary prior to any sale or transfer of property affecting a compliance boundary. 10. In accordance with 15A NCAC 02L .0107(d), no wells, excluding Division approved monitoring wells, shall be constructed within the compliance boundary except as provided for in 15A NCAC 02L .0107(g). 11. The facilities permitted herein shall be constructed according to the following setbacks: a. The setbacks for irrigation sites permitted prior to September 1, 2006 shall be as follows (all distances in feet): i. Any habitable residence or place of public assembly under separate ownership: 400 ii. Any habitable residence or place of public assembly owned by the Permittee: 200 iii. Any private or public water supply source: 100 iv. Surface waters: 100 v. Groundwater lowering ditches: 100 vi. Surface water diversions: 25 vii. Any well with exception of monitoring wells: 100 viii. Any property line: 150 ix. Top of slope of embankments or cuts of two feet or more in vertical height: 15 x. Any water line from a disposal system: 10 xi. Subsurface groundwater lowering drainage systems: 100 xii. Any swimming pool: 100 xiii. Public right of way: 50 xiv. Nitrification field: 20 xv. Any building foundation or basement: 15 b. The setbacks for storage and treatment units permitted prior to September 1, 2006 shall be as follows (all distances in feet): i. Any habitable residence or place of public assembly under separate ownership I Any private or public water supply source: iii. Surface waters: iv. Any well with exception of monitoring wells: v. Any property line: 100 100 50 100 50 WQ0005247 Version 2.2 Shell Version 090806 Page 3 of 8 M. OPERATION AND MAINTENANCE REQUIREMENTS 1. The facilities shall be properly maintained and operated at all times. The facilities shall be effectively maintained and operated as a non -discharge system to prevent the discharge of any wastewater resulting from the operation of this facility. The Permittee shall maintain an Operation and Maintenance Plan pursuant to 15A NCAC 02T .0507, which at a minimum shall include operational functions, maintenance schedules, safety measures and a spill response plan. 2. Upon the Water Pollution Control System Operators Certification Commission's (WPCSOCC) classification of the subject non -discharge facilities, in accordance with 15A NCAC 08G .0200 the Permittee shall designate and employ a certified operator in responsible charge (ORC) and one or more certified operator(s) as back-up ORC(s). The ORC or their back-up shall visit the facilities in accordance with 15A NCAC 08G .0200, and shall comply with all other conditions specified in the previously cited rules. 3. A suitable year round vegetative cover shall be maintained at all times, such that crop health is optimized, allows for even distribution of effluent and allows inspection of the irrigation system. 4. Adequate measures shall be taken to prevent effluent ponding in or runoff from the irrigation sites listed in Attachment B. 5. Irrigation shall not be performed during inclement weather or when the ground is in a condition that will cause ponding or runoff. 6. All irrigation equipment shall be tested and calibrated at least once per permit cycle. Calibration records shall be maintained at the facility for a period of no less than five years, and shall be made available to the Division upon request. 7. Only effluent from Rollingview State Recreation Area shall be irrigated on the sites listed in Attachment B. No automobiles or machinery shall be allowed on the irrigation sites except during equipment installation or while maintenance is being performed. 9. Public access to the irrigation sites and wastewater treatment facilities shall be prohibited. 10. The residuals generated from the wastewater treatment facilities shall be disposed or utilized in accordance with 15A NCAC 02T .1100. The Permittee shall maintain a residual management plan pursuant to 15A NCAC 02T .0508. 11. Diversion or bypassing of untreated or partially treated wastewater from the treatment facilities is prohibited. 12. Freeboard in the stabilization and storage lagoons shall not be less than two feet at any time. 13. A gauge to monitor waste levels in the stabilization and storage lagoons shall be provided. This gauge shall have readily visible permanent markings indicating the following elevations: maximum liquid level at the top of the temporary liquid storage volume; minimum liquid level at the bottom of the temporary liquid storage volume; and the lowest point on top of the dam. 14. A protective vegetative cover shall be established and maintained on all earthen embankments (i.e., outside toe of embankment to maximum allowable temporary storage elevation on the inside of the embankment), berms, pipe runs, erosion control areas, and surface water diversions. Trees, shrubs, and other woody vegetation shall not be allowed to grow on the earthen dikes or embankments. Earthen embankment areas shall be kept mowed or otherwise controlled and accessible. WQ0005247 Version 2.2 Shell Version 090806 Page 4 of 8 15. The Permittee shall provide for the pump station and force main the following items: Pump on/off elevations located so that 2-8 pumping cycles may be achieved per hour in the pump station, b. An air relief valve located at all high points along the force main, A screened vent for the wet well, d. Fillets located in the wet well at the intersection of the flooring and sidewalls, e. Three feet of cover (minimum) over the force main or the use of ferrous material where three feet cannot be maintained, f. Sufficient devices which will protect the pump station from vandals, and g. Flood protection if the pump station is located below the 100-year flood elevation IV. MONITORING AND REPORTING REQUIREMENTS 1. Any Division required monitoring (including groundwater, plant tissue, soil and surface water analyses) necessary to ensure groundwater and surface water protection shall be established, and an acceptable sampling reporting schedule shall be followed. 2. Per 15A NCAC 02H .0800, a Division certified laboratory shall conduct all laboratory analyses for the required effluent, groundwater or surface water parameters. 3. Flow through the treatment facility shall be continuously monitored, and daily average flow values shall be reported on Form NDMR. Flow may be estimated from water use records, provided the Permittee's water use is metered. Daily average flow values shall be calculated by dividing the monthly metered water usage by the number of days in the month. 4. The Permittee shall monitor the effluent from the subject facilities at the frequencies and locations for the parameters specified in Attachment A. 5. The Permittee shall maintain adequate records tracking the amount of effluent irrigated. At a minimum, these records shall include the following information for each irrigation site listed in Attachment B: a. Date of irrigation; b. Volume of effluent irrigated; c. Site irrigated; d. Length of time site is irrigated; e. Continuous weekly, monthly, and year-to-date hydraulic (inches/acre) loadings; f. Continuous monthly and year-to-date loadings for any non -hydraulic parameter specifically limited in Attachment B; g. Weather conditions; and h. Maintenance of cover crops. 6. Freeboard (i.e., waste level to the lowest embankment elevation) in the stabilization shall be recorded weekly. Weekly freeboard records shall be maintained at the facility for a period of no less than five years, and shall be made available to the Division upon request. WQ0005247 Version 2.2 Shell Version 090806 Page 5 of 8 7. Three copies of all monitoring data (as specified in Conditions IV.3. and IVA.) on Form NDMR for each PPI and three copies of all operation and disposal records (as specified in Conditions IV.5 and IV.6.) on Form NDAR-1 for every site in Attachment B shall be submitted on or before the last day of the following month. If no activities occurred during the monitoring month, monitoring reports are still required documenting the absence of the activity. All information shall be submitted to the following address: Division of Water Quality Information Processing Unit 1617 Mail Service Center Raleigh, North Carolina 27699-1617 8. A record shall be maintained of all residuals removed from this facility. This record shall be maintained at the facility for a period of no less than five years, and shall be made available to the Division upon request. At a minimum, this record shall include: a. Name of the residuals hauler; b. Non -Discharge permit number authorizing the residuals disposal, or a letter from a municipality agreeing to accept the residuals; c. Date the residuals were hauled; and d. Volume of residuals removed. A maintenance log shall be maintained at this facility. This log shall be maintained at the facility for a period of no less than five years, and shall be made available to the Division upon request. At a minimum, this log shall include: a. Visual observations of the plant and plant site; and b. Record of preventative maintenance (e.g., changing of equipment, adjustments, testing, inspections and cleanings, etc.). 10. An annual representative soils analysis (i.e., Standard Soil Fertility Analysis) shall be conducted on each irrigation site listed in Attachment B. These results shall be maintained at the facility for a period of no less than five years, and shall be made available to the Division upon request. At a minimum, the Standard Soil Fertility Analysis shall include the following parameters: Acidity Exchangeable Sodium Percentage Phosphorus Base Saturation (by calculation) Magnesium Potassium Calcium Manganese Sodium Cation Exchange Capacity Percent Humic Matter Zinc Copper pH 11. Noncompliance Notification: The Permittee shall report by telephone to the Raleigh Regional Office, telephone number (919) 791- 4200, as soon as possible, but in no case more than 24 hours, or on the next working day following the occurrence or first knowledge of the occurrence of any of the following: a. Any occurrence at the facility resulting in the treatment of significant amounts of wastes that is abnormal in quantity or characteristic, including the known passage of a hazardous substance. b. Any process unit failure (e.g., mechanical, electrical, etc.), due to known or unknown reasons, rendering the facility incapable of adequate wastewater treatment. c. Any facility failure resulting in a by-pass directly to receiving surface waters. d. Any time self -monitoring indicates the facility has gone out of compliance with its permit limitations. e. Ponding in or runoff from the irrigation sites. WQ0005247 Version 2.2 Shell Version 090806 Page 6 of 8 Any emergency requiring immediate reporting (e.g., discharges to surface waters, imminent failure of a storage structure, etc.) outside normal business hours shall be reported to the Division's Emergency Response personnel at telephone number (800) 662-7956, (800) 858-0368, or (919) 733-3300. Persons reporting such occurrences by telephone shall also file a written report in letter form within five days following first knowledge of the occurrence. This report shall outline the actions taken or proposed to be taken to ensure the problem does not recur. V. INSPECTIONS 1. The Permittee shall provide adequate inspection and maintenance to ensure proper operation of the wastewater treatment and disposal facilities. 2. The Permittee or their designee shall inspect the wastewater treatment and disposal facilities to prevent malfunctions, facility deterioration and operator errors resulting in discharges, which may cause the release of wastes to the environment, a threat to human health or a public nuisance. The Permittee shall maintain an inspection log that includes, at a minimum, the date and time of inspection, observations made, and any maintenance, repairs, or corrective actions taken. The Permittee shall maintain this inspection log for a period of five years from the date of the inspection, and this log shall be made available to the Division upon request. 3. Any duly authorized Division representative may, upon presentation of credentials, enter and inspect any property, premises or place on or related to the wastewater treatment and disposal facilities permitted herein at any reasonable time for the purpose of determining compliance with this permit; may inspect or copy any records required to be maintained under the terms and conditions of this permit, and may collect groundwater, surface water or leachate samples. VI. GENERAL CONDITIONS 1. Failure to comply with the conditions and limitations contained herein may subject the Permittee to an enforcement action by the Division in accordance with North Carolina General Statutes 143- 215.6A to 143-215.6C. 2. This permit shall become voidable if the permitted facilities are not constructed in accordance with the conditions of this permit, the Division approved plans and specifications, and other supporting documentation. 3. This permit is effective only with respect to the nature and volume of wastes described in the permit application, Division approved plans and specifications, and other supporting documentation. No variances to applicable rules governing the construction or operation of the permitted facilities are granted, unless specifically requested and approved in this permit pursuant to 15A NCAC 02T .0105(n). 4. The issuance of this permit does not exempt the Permittee from complying with any and all statutes, rules, regulations, or ordinances, which may be imposed by other jurisdictional government agencies (e.g., local, state, and federal). Of particular concern to the Division are applicable river buffer rules in 15A NCAC 02B .0200; erosion and sedimentation control requirements in 15A NCAC Chapter 4 and under the Division's General Permit NCGO10000; any requirements pertaining to wetlands under 15A NCAC 02B .0200 and 02H .0500; and documentation of compliance with Article 21 Part 6 of Chapter 143 of the General Statutes. WQ0005247 Version 2.2 Shell Version 090806 Page 7 of 8 5. In the event the permitted facilities change ownership or the Permittee changes their name, a formal permit modification request shall be submitted to the Division. This request shall be made on official Division forms, and shall include appropriate property ownership documentation and other supporting documentation as necessary. The Permittee of record shall remain fully responsible for maintaining and operating the facilities permitted herein until a permit is issued to the new owner. The Permittee shall retain a set of Division approved plans and specifications for the life of the facilities permitted herein. 7. The Permittee shall maintain this permit until all permitted facilities herein are properly closed or permitted under another permit issued by the appropriate permitting authority pursuant to 15A NCAC 02T .01050). 8. This permit is subject to revocation or unilateral modification upon 60 days notice from the Division Director, in whole or part for the requirements listed in 15A NCAC 02T .0110. 9. Unless the Division Director grants a variance, expansion of the permitted facilities contained herein shall not be granted if the Permittee exemplifies any of the criteria in 15A NCAC 02T .0120(b). 10. The Permittee shall pay the annual fee within 30 days after being billed by the Division. Failure to pay the annual fee accordingly shall be cause for the Division to revoke this permit pursuant to 15A NCAC 02T .0105(e) (3). Permit issued this the 5 h day of November 2009 NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION C H. Sullins, Director Division of Water Quality By Authority of the Environmental Management Commission WQ0005247 Version 2.2 Shell Version 090806 Page 8 of 8 ,k ATTACHMENT A - LIMITATIONS AND MONITORING REQUIREMENTS PPI 001— WWTF Effluent Permit Number: WQ0005247 Version: 2.2 EFFLUENT CHARACTERISTICS EFFLUENTLIMITS MONITORING REQUIREMENTS Parameter Description - PCS Code Monthly Average" Monthly Geometric Mean Daily Minimum'Measurement Daily Maximum Frequency Sample Type Flow. in conduit or thru treatment plant — 50050 9.990 gpd Monthly Estimate pi I — 00400 Weekly Grab Coliform, Fecal MF. M-FC 13roth,44.5C — 31616 n 3 X year` Grab Chlorine. Total Residual — 50060 Weekly d Grab Nitrogen, Nitrate Total (as N) — 00620 3 X year` Grab Phosphorous, Total (as P)— 00665 3 X year' Grah Solids. Total Suspended — 00530 3 X year` Grab 1301), 5-Day (20 Deg. C) — 00310 3 X year` Grab Nitrogen, Ammonia Total (as N) — 00610 3 X year` Grab Nitrogen. Kjeldahl, 'total (as N) — 00625 3 X year` Grab Monthly averages for all but fecal coliform shall be the arithmetic mean oral[ samples collected during the reporting period. Geometric mean for fecal coli form shall be the geometric mean of all samples collected during the reporting period. Daily maximum shall he the maximum value of all samples collected during the reporting period. d Monitoring for pl I and Total Residual Chlorine shall be performed weekly from March 1 through September 30. and during each spray event from October I through February 29. 3 X year sampling shall be conducted dining March. July and September. WQ0005247 Version 2.2 Attachment A Page I of 2 THIS PAGE BLANK WQ0005i 1ersion 2.2 Attachment A e 2 of A� ATTACHMENT B - APPROVED LAND APPLICATION SITES AND LIMITATIONS Permit Number: WQ0005247 Version: 2.2 NCDENR (Division of Parks and Recreation) — Rollingview State Recreation Area IRRIGATION AREA INFORMATION APPLICATION LIMITATIONS Basin / Owner County Latitude Longitude Net Dominant Parameter Hourly Yearly Units Field Acreage Soil Series Rate Max I S NCDGNR Rollingview State Durham 36000'27" 78043'38" 3.55 01284 — Application Surface Irrigation 0.2 31.2 Inches Recreation l)PR NCDGNR Rollingview State Durham 36027'27" 78043'38" 3.55 01284 — Application Surface Irrigation 0.2 31.2 Inches Recreation Totals 7.10 W000##### Version f.# Attachment C Page I of I