Owner: - dms.psc.sc.gov

APPLICATIONFOR

ESTABLISHMENT OF A WATER SYSTEM

TO SERVEPINK HAVEN SUBDIVISION

(GARRETTS LANDING)

Owner:

January 25, 2010

APPLICATIONFOR

ESTABLISHMENT OF A WATER SYSTEM

TO SERVEPINE HAVEN SUBDIVISION

(GARRETTS LANDING)

Owner:__Vv

January 25, 2010

.' ..... 7

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INFORMATION TO BE FILED WITH THE PUBLIC SERVICE COMMISSIONAND THE OFFICE OF REGULATORY STAFF

FOR THE ESTABLISHMENT OF A WASTEWATER UTILITY

Company

1. Copy of articles of incorporation or partnership agreement.

2. Plat of proposed area to be served.

3. Copy of engineering plans and specifications designed or certified to be in accord withgood engineering practices by a professional engineer registered in South Carolina

4. Construction permits from the Department of Health and Environmental Control approvingengineering plans and specifications.

5. Schedule of proposed rates and charges and cost justifications, including tap fees withattached schedule depicting labor costs, materials costs, and miscellaneous costs.

6. Number of customers proposed to be served and capacity of system.

7. Financial statement showing proposed plant investment by categories.

8. Depreciation schedule by categories of plant or average service lives.

9. Pro-forma income and expense statement showing the effect of using the proposed ratesbased on plant capacity.

10. Filing of performance bond in accordance with 26 S.C. Code Regs. 103-512.3.

11. Statement by a professional engineer that the system was built and installed according toplans and specifications on file with the Commission and will furnish adequate service forthe area to be served.

12. Letter from the Department of Health and Environmental Control approving system foroperation, dated not more than six (6) months prior to date of application.

13. Customer bill form.

14. Other pertinent or relevant information determined necessary by the Commission.

Revised 01/12/05

Water/Wastewater Department ~ 1441 hAain Street, Suite 300 - PO Box 11263 ~ Columbia, SC 29201 - 803/737-0800

INFORMATION TO BE FILED WITH THE PUBLIC SERVICE COMMISSIONAND THE OFFICE OF REGULATORY STAFF

FOR THE ESTABLISHMENT OF A WASTEWATER UTILITY

Company.

XX

5.

"_ 7.

9

10.

_( 1I.

_( 12.

o

2.

3.

Copy of artic|es of incorporation or partnership agreement,

PLat of proposed area to be served.

Copy of engineering plans and specifications designed or certified to be in accord withgood engineering practices by a professional engineer registered in South CaroLina.

Construction permits from the Department of HeaLth and Environmental Control approvingengineering plans and specifications.

ScheduLe of proposed rates and charges and cost justifications, including tap fees withattached schedule depicting Labor costs, materials costs, and misceLLaneous costs.

Number of customers proposed to be served and capacity of system.

Financial statement showing proposed plant investment by categories.

Depreciation schedule by categories of plant or average service Lives.

Pro-forma income and expense statement showing the effect of using the proposed ratesbased on plant capacity.

Filing of performance bond in accordance with 26 S.C. Code Regs.103-512.3.

Statement by a professional engineer that the system was built and instaLLed according toplans and specifications on file with the Commission and wiLL furnish adequate service forthe area to be served.

Letter from the Department of HeaLth and Environmental Control approving system foroperation, dated not more than six (6) months prior to date of application.

Customer biLL form.

Other pertinent or relevant information determined necessary by the Commission.

Revised 01/12/05

Water/Wastewater Department • 1441 Main Street, Suite 300 - PO Box 11263 • Columbia, SC 29201 - 803/737-0800

1. ARTICLES OF INCORPORATION1. ARTICLES OF INCORPORATION

The water system that serves Pine Haven Subdivision isowned by Carrol Norman. See attached letter.The water system that serves Pine Haven Subdivision is

owned by Carrol Norman. See attached letter.

Carroll Norman767 Pine Haven CircleClover, S.C. 29710

Feb. 8, 2010

I Carroll Norman am sole owner of Pine Haven and Garrett Landing Water

System. Located on the corner of Tom Joye Rd. and Garrett Landen Dr. Clover, S.C.29710. I Carroll Norman am solely responsible for the operating and maintaining the

water system and for furnishing water to the residents of Pine Haven and Garrett's

Landing suddivision.

Sincerely,Carroll Norman

Carroll Norman

767 Pine Haven Circle

Clover, S.C. 29710

Feb. 8, 2010

I Carroll Norman am sole owner of Pine Haven and Garrett Landing Water

System. Located on the corner of Tom Joye Rd. and Garrett Landen Dr. Clover, S.C.

29710. I Carroll Norman am solely responsible for the operating and maintaining the

water system and for furnishing water to the residents of Pine Haven and Garrett's

Landing suddivision.

Sincerely, _ _

Carroll Norman

2. PLAT OF PROPOSED AREA TO BE SERVED.

MAP ATTACHED

2. PLAT OF PROPOSED AREA TO BE SERVED.

MAP ATTACHED

3. COPY OF ENGINEERING PLANS ANDSPECIFICATIONS DESIGNED OR CERTIFIED TOBE IN ACCORDANCE WITH GOOD ENGINEERINGPRACTICES.

o COPY OF ENGINEERING PLANS AND

SPECIFICATIONS DESIGNED OR CERTIFIED TO

BE IN ACCORDANCE WITH GOOD ENGINEERING

PRACTICES.

3. The original plans for the Pine Haven Subdivision wereprepared by Campco Engineering. A copy of a mapshowing the system layout is attached.

3. The original plans for the Pine Haven Subdivision were

prepared by Campco Engineering. A copy of a map

showing the system layout is attached.

4. CONSTRUCTION PERMITS4. CONSTRUCTION PERMITS

SOUTH CAROLINA DEPARTMENT OF HEALTHAND ENVIRONMENTAL CONTROL

Slms-Aycock Buildings

2000 Sull Street, Columbls, SC 20201

CONS TRUC TION PERM I T

Permission is Hereby Granted to:Mr. AT. Carroll NormanRoute 3, Box 76Clover, South Caroli na Z9710

for the construction of asystem in accordance wi thJanuary 26, 1982S. C. Registration No. :

potable water source, treatment and/or distributionplans, specifications and design calculations dated

William H. Armstrong P.E. r8384

PROJECT DESCRIPTIONrPine Haven Subdivision, constructions of a 6" well and approximately 1910 L.F.of 3" PVC water main, York County.

SPECIAL CONDITIONS:(Condi. ti ons attached)

Permit Number: 20468Z Date. February 16, 1982

EXPIRATION DATE: Unless construction j:'.s initiated prior to February 16, 1983

it will be necessary to reapply since this permit will no

longer be valid.

This is a permit for constructi on only and does not consti tute State Departmentof Health and Environmental Control approval, temporary or otherwise, to placethi s system in operati on.

Commi ssi onerYl k' E~M~v~, ~

Director, Pater Supply DivisionDCPrhpjcc: Mr. Ãi lli am H. Armstrong, P.E.

Mr. Al Wi 1li ams, Di st. Di rectorMr. K. Larry Baker, Dist. San. DirectorYork County Health Department

DHEC 1906 (4/81)

SOUTH CAROLINA DEPARTMENT OF HEALTHAND ENVIRONMENTAL CONTROL

CONS TRUC TION PERMI T

Slms-Aycock Buildings2800 Bull Street, Columbia, SC 29201

Permission is Herebg Granted to:

Mr. W. Carroll Norman

Route 3, Box 76

Clover, South Carolina 29710

for the construction of a potable water source, treatment andor distribution

system in accordance with plans• specifications and design calculations dated

January 26, 1982 , by William H. Armstrong , P.E.,

S. C. Registration No.: 8384

PROJECT DESCRIPTION:

Pine Haven Subdivision, constructions of a 6" well and approximately 1910 L.F.

of 3" PVC water main, York County.

SPECIAL CONDITIONS:

(Condi ,ions attached)

\

\

Permit Number: 204682 Date: February 16, 1982

EXPIRATION DATE: Unless construction is initiated prior to February 16 1983

it will be necessary to reapply since this permit will no

longer be valid.

This is a permit for construction only and does not constitute State Department

of Health and Environmental Control approval, temporary or otherwise, to place

this system in operation.

Commissioner

DCP:hpj

cc: Mr. William H. Armstrong, P.E.

Mr. A1 Williams, Dist. Director

Mr. K. Larry Baker, Dist. San. Director

York County Health Department

Director• Water Supplg Division

DHEC 1906 (4/81)

SPECIAL CONDZTZONS FOR CONSTRUCTZON PERMZT f204682

l. The chemical, physi cal, and bacteriological quali ty of the water must meetEPA primary and secondary standards or treatment may be required. The wa-ter from this well will be analyzed for radi ological quali ty by DHEC. Atthe end of one (1) year from the first radiological sampling, a final de-termination on the acceptabi lity of this well from the standpoint of ra-diologi cal quali ty, wi ll be made. The owner will be notified in writingof that determination.

2. The final determination of' the maximum number of taps to be served by thissystem will be based on the well pump capaci ty and storage.

3. Copies of all drillers records, logs, yield and drawdown test results mustbe submitted prior to final inspection.

4. The project time schedule as addressed in the Engineering Report is herebyapproved.

SPECIAL CONDITIONS FOR CONSTRUCTION PERMIT#204682

1.

2.

3o

4.

The chemical, physical, and bacteriological quality of the water must meet

EPA primary and secondary standards or treatment may be required. The wa-

ter from this well will be analyzed for radiological quality by DHEC. At

the end of one (i) year from the first radiological sampling, a final de-

termination on the acceptability of this well from the standpoint of ra-

diological quality, will be made. The owner will be notified in writing

of that determination.

The final determination of the maximum number of taps to be served by this

system will be based on the well pump capacity and storage.

Copies of all drillers records, logs, yield and drawdown test results must

be submitted prior to final inspection.

The project time schedule as addressed in the Engineering Report is hereby

approved.

Soulh CarolinaDeparlrnenl ofHealh andEnvironmenlaConlro

P. 0. Drawer 100Fort Lawn, ST C. 29714

July 17, 1985

BOARDJ. Lorln Mason, Jr. , M. D. , Chairman

Gerald A. Kaynard, Vice-ChairmanLeonard W. Douglas, M. D. , Secretary

Oren L. Brady, Jr.Moses H. Clarkson, Jr.

Barbara P. NuessleJames A. Spruill, Jr.

COMMISSIONERRobert S. Jackson, M. D.

2600 Bull StreetColumbia, S.C. 29201

Mr. Carroll NormanRoute 3, Box 291Clover, S. C. 29710

Re: Pine Haven Subdivision8 546037, York County

Dear Mr. Norman:

An inspection of your water system was conducted on April 5, ]985,by personnel of this office. At this time your system meets the minimumstandards set forth by the State of South Carolina for a.public water system.

Your continued cooperation in maintaining this system is greatlyappreciated.

If you have any questions, or if you need assistance, please contactthis office at 285-7461.

Sincerely,

Environmental Technician

RLSjlw

cc: Water Supply Division

Soul-hCarolinaDeparlmenlofHeallhandEnwonmenldConlrol

P. O. Drawer i00

Fort Lawn, S. C. 29714

July 17, 1985

BOARD

J. Lorln Mason, Jr., M.D., ChairmanGerald A. Kaynard, Vice-Chairman

Leonard W. Douglas, M. D., SecretaryOren L. Brady, Jr.

Moses H. Clarkson, Jr.Barbara P. Nuessle

James A. Spruill, Jr.

COMMISSIONER

Robert S. Jackson, M.D.2600 Bull Street

Columbia, S.C. 29201

Mr. Carroll Norman

Route 3, Box 291

Clover, S. C. 29710

Dear Mr. Norman:

Re: Pine Haven Subdivision

# 546037, York county

An inspection of your water system was conducted on April 5, 1985,by personnel of this office. At this time your system meets the minimum

standards set forth by the State of South Carolina for a public water system.

Your continued cooperation in maintaining this system is greatlyappreciated.

If you have any questions, or if you need assistance, please contactthis office at 285-7461.

Sincerely,

Environmental Technician

RLS/Iw


South CcxolinaDepcxlrrenl ofl-leot, th ctnolEnvironmentalConti.ol

P. 0. Drawer 100Port La~~, S, C, 29714

November 4, 1983

g)a - ~~ -33~ '80ARD

William M. Wilson, Chairman

J, Lorln Meson, Jr„M,D. , Vice-ChairmanLeonard VVDougtas, M, D. , Secretary

Moses H. Ctsrkson, Jr.George G. Graham, D.D,S.

Barbara P. Nuessle

COMM t SSIONF R

Robert 8. Jackson, M. D.2800 Buli Street

Columbia, S,C, 2920t

PINAL CONSTRUCTION APPRDVAL

ISSUED TO: Hr. w. Carroll NormanRoute 3, Box 75Clover, S, C, 29710

for the operation of a water supply, treatment, or distribution systegL identifiedae follows:

a 6" well and approximately 1910 L7 of 3" PVC water main to serve Pine HavenSubdivision, York County.

Under the following s ecial conditions. "

The water from this 'we11 will be anal zed for radiolo ical ualit b theS, C. De artment of Health and Environmental Control. At the end of oneyear from the first radiolo ical sam lin a final determination on theacce tabilit of this well from t e stand oint of' radiolo ical ualit ' willbe made. The owner will be notified in writin of this determination.The existin well is to be ro erl abandoned within fort da s of the dateo this a grovel.

Max. number of services 32

This facility was constructed under permit 5 20/682 issue, d Pabruar 16 1982.

Based on the Engineer's letter of compliance signed by Nil. liam H, Armstrong, P. E. ,satisfactory bacteriological results and inspections performed by personnel of thisoffice, you may consider this facility approved by the S. C. Department of Healthand Environmental Control and ready to be placed in service.

Issued by;

'~h~+District EngineerCatawba District EQC

JSP/lw

cc: Mater Supply DivisionP. K,York County Bldg, Insp, Dept,

,...

SodhCorohaDepc IrnenPof.HealhandEnvi©nmenlaConlrol

P. O. Drawer I00

Fort La_, S, C. 29714

November 4, 1983

BOARDWilliam M. Wilson, Chairman

d. Lorln M_son, Jr., M.D., Vice-ahairmanLeonard W'TDouglas, 14, D., Secretary

Moses H. C,lark_on, dr.•Geotoe G. Grtham, O.D,S.

Bar_ra P. Nuessle

COMMISSIONER

Robert 8. Jeckson, M.D.2600 Bull Street

Columbia, 8,0. 29201

ISSUED TO:

FINAL CONSTRUCTION APPROVAL


Route 3, Box 75

Clover, S. C. 29710

for the operation of a water supply, treatme]_t, or distribution system identifiedas follows:

a 6" well an4 approximately 1910 LF of 3" PVC water maim to serve Pine Haven

Subdivision, YorkCounty.

Under the following Special conditions:

The water from this well will be analyzed for ra4iologlcal quality b_th.eS. C. Department of Health and Env%ronmental Control. A= the end of one

year from the first radiolo_i=al sampllmK_, a £1nal determination on the

_¢ceptabilltZ of this well from the _!._d_poi_t of radiol_leal Nual£ty, will.

be made. The owner will be notified in wrlt£ng of this determination. -

The exi_t_n_ well is _o be _r_erly abandoned within foKty days of the dateof th_8 approval.


This facility was constructed under permit ! 20_682 issued Fabruary_16_ ig82.

Based on _he Engineer's letter of compliance signed by William H. Armstrong, F. E.,

satisfactory bacteriological results and inspections performed by personnel of this

office, you may consider this facility approved by the S. C. Department of Eealth

and Environm_ntal Control and ready to be placed in service.

Issued by:

S. F_rls, Jr,

D_str_¢t Engineer

Catawba District EQC

JSF/Iw

co: Water Supply Division

P. E,

York County Bldg. Insp. Dept.

5. PROPOSED RATE SCHEDULE5. PROPOSED RATE SCHEDULE

PINE HAVEN SUBDIVISION WATER SYSTEMPROPOSAL RATE SCHEDULE

FLAT RATE OFSPRINKLER CHARGEPOOL CHARGERETURN CHECK CHARGERECONNECTION FEE

$40.00 PER MONTH10.00 PKR MONTH10.00 PER MONTH35.00 PER CHECK25.00 PER OCCURANCE

The "Sprinkler Charge' is applied to users with an in-ground irrigation

system with sprinkler heads or in-ground soaker pipes. The system shall be

controlled by a timer or manual controls. The charge is only applied for the

months of April through September.

The term pool shall apply to any above ground or in ground swimming pool

that has a filter system to maintain water quality. The Pool Charge is only

applied for the months of April through September which is the normal and

customary operation times for Pools .

Carroll Norman

PINE HAVEN SUBDIVISION WATER SYS_M

PROPOSAL RATE SCHEDULE

FLAT RATE OF

SPRINKLER CHARGE

POOL CHARGE

RETURN CHECK CHARGE

RECONNECTION FEE

$40.00 PER MONTH

10.00 PER MONTH

10.00 PER MONTH

35.00 PER CHECK

25.00 PER OCCURANCE

The" Sprinkler Charge' is applied to users with an in-ground irrigation

system with sprinkler heads or in-ground soaker pipes. The system shall be

controlled by a timer or manual controls. The charge is only applied for the

months of April through September.

The term pool shall apply to any above ground or in ground swimming pool

that has a filter system to maintain water quality. The Pool Charge is only

applied for the months of April through September which is the normal and

customary operation times for Pools.

Carroll Norman

6. NUMBER OF CUSTOMERS TO BE SERVED6. NUMBER OF CUSTOMERS TO BE SERVED

PINE HAVEN SUBDIVISIONSYSTEM CAPACITY

*SYSTEM PERMITTED FOR 32 SINGLE FAMILY UNITS

CURRENT USERS 29 SINGLE FAMILY UNITS

*SEEATTACHED PERMIT

PINE HAVEN SUBDIVISION

SYSTEM CAPACITY

*SYSTEM PERMITTED FOR 32 SINGLE FAMILY UNITS

CURRENT USERS 29 SINGLE FAMILY UNITS

*SEE ATTACHED PERMIT

Soulh CcxoinaDeporlmenl ofHeajhondEnvironmenlaConIIo

P. 0. Drawer 100Fort Lawn, S. C. 29714

November 4, 1983

BOARD

William M. Wilson, Chairman

J. Lorin Mason, Jr. , M. D. , Vice-ChairmanLeonard W. Douglas, M. D. , Secretary

Moses H. Clarkson, Jr.George G. Graham, D, D.S.

Barbara P. Nuessle

COMMISSIONER

Robert S. Jackson, M D.2600 Bull St r ee t

Columbia, S.C, 29201

FINAL CONSTRUCTION .APPROVAL

ISSUED TO: Mr. W. Carroll NormanRoute 3, Box 76Clover, S. C. 29710

for the operation of a water supply, treatment, or distribution system identifiedas follows:

a 6" veil and approximately 1910 LF of 3" PVC water main to serve Pine HavenSubdivision, York County.

Under the following s ecial conditions:

The water from this well will be anal zed for radiolo ical ualit b theS. C. Department of Health and Environmental Control, At thc en' = or.eyear from the first radiological sam lin , a final determination on theacceptability of this well from the stand oint of radiolo ical ualit , willbe made. The owner vill be notified in vritin of this determination.The existin well is to be ro erl abandoned within fort da s of the dateof this a royal.


This facility was constructed under permit i/ 204682 issued Februar 16, 1982.

Based on the Engineer's letter of compliance signed by William H. Armstrong, P. E. ,satisfactory bacteriological results and inspections performed by personnel of thisoffice, you may consider this facility approved by the S. C. Department of Healthand Environmental Control and ready to be placed in service.

Joe S. Faris, Jr.Dist. rict EngineerCatawba District EgC

JSF/1w

cc: Water Supply DivisionP. E.York County Bldg. Insp. Dept.

oulh CorolinoDeparPrnenl ofHealhandEnvronrnenlaConlro/

P. O. Drawer i00


November 4, 1983


J. Lorin Mason, Jr., M.D., Vice-Chairman

Leonard W. Douglas, M.D., SecretaryMoses H. Clarkson, Jr.

George G. Graham, D.D.SBarbara P. Nuessle

COMMISSIONERRobert S. Jackson, MD.

2600 Bull StreetColumbia, S,C. 29201

ISSUED TO:



Route 3, Box 76

Clover, S. C. 29710


a 6" well and approximately 1910 LF of 3" PVC water main to serve Pine HavenSubdivision, York County.

Under the following special conditions:

The water from this well will be analyzed for radiological quality by the

S. C. Department of Health and Environmental Control° At the end _f one

year from the first radiological sampling, a final determination on the

acceptability of this well from the standpoint of radiological quality, will

be made. The owner will be notified in writing of this determination.

The existing well is to be properly abandoned within forty days of the darnof this approval.


This facility was constructed under permit # 204682 issued February 16, 1982.

B_sed on the Engineer's letter of compliance signed by William H. Armstrong, p. E.,

satisfactory bacteriological results and inspections performed by personnel of this

office, you may consider this facility approved by the S. C. Department of Healthand Environmental Control and ready to be placed in service.

Issued by:

Joe S. Faris, Jr.

District Engineer


JSF/lw


P. E.

York County Bldgo Insp. Dept0

7. FINANCIAL STATEMENT7. FINANCIAL STATEMENT

8. DEPRECIATION SCHEDULE8. DEPRECIATION SCHEDULE

PINE HAVEN SUBDIVISIONDEPRECIATION SCHEDULE

DECEMBER 2009

Wells

Tank

COST NKW

1 Well $10,000.00(82)

1 Hydropneumatic $6,000.00(82)(5,000 gallon tank)

USEFULLIFE

40 yrs

40 yrs

CURRENTVALUE

$ 3,250.00

$1,950.00

Service Lines $87,500.00(82) 40 yrs $28 437.00

$33,637.00


DEPRECIATION SCHEDULE

DECEMBER 2009

Wells

Tank

Service

1 Well

1 Hydropneumatic

(5,000 gallon tank)

Lines

COST NEW USEFUL CURRENT

LIFE VALUE

$10,000.00(82) 40 yrs $ 3,250.00

$ 6,000.00(82) 40 yrs $ 1,950.00

$87,500.00(82) 40 yrs $28_437.00

$33,637.00

9. PRO-FORMA INCOME AND EXPENSE STATEMENT9. PRO-FORMA INCOME AND EXPENSE STATEMENT

PINE HAVEN SUBDIVISIONSYSTEM PRO- FORMA

2010

Revenue:

28 Users x $40.00 /mo. x 12 months

3 Users x $10.00 mo. x 6 mo. Irrigation systems-

4 Users x $10.00 mo. x 6 mo. Pools

TOTAL ANNUAL REVENUE

$13,440.00

180.00

240.00

$13,860.00

EXPENSES:

Property taxes:Testing for lead and copper:Water Test- J 4 G EnvironmentalDHEC FeesWater Distribution License 4 TrainingMaint A RepairBilling 4 AdministrationPower

$480.00950.00

1,380.00850.00250.00

3,000.003,400.00

800.00

$11,110.00

RESERVE $2,750.00


SYSTEM PRO- FORMA

2010

Revenue:

28 Users x $40.00/mo. x 12 months

3 Users x $10.00 mo. x 6 mo. Irrigation systems -

4 Users x $10.00 mo. x 6 mo. Pools

TOTAL ANNUAL REVENUE

$13,440.00

180.00

240.00

$13,860.00

EXPENSES:

Property taxes :

Testing for lead and copper:Water Test- J & G Environmental

DHEC Fees

Water Distribution License & Training

Maim & Repair

Billing & Administration

Power

$480.00

950.00

1,380.00

850.00

250.00

3,000.00

3,400.00

800.00

$ 11,110.00

RESERVE $2,750.00

10. PERFORMANCE BOND10. PERFORMANCE BOND

10. TO THE BEST OF MY INFORMATION AND BELIEFA PERFORMANCE BOND IS NOT REQUIRED.

Carro 1 Norman

10. TO THE BEST OF MY INFORMATION AND BELIEF

A PERFORMANCE BOND IS NOT REQUIRED.

_c...I/-_._--.--,-----al:ro$1 l_orman

11. STATEMENT BY PROFESSIONAL ENGINEER THATSYSTEM WAS BUILT AND INSTALLEDACCORDING TO PLANS.

11. STATEMENT BY PROFESSIONAL ENGINEER THAT

SYSTEM WAS BUILT AND INSTALLED

ACCORDING TO PLANS.

JOEL E. WOOD & ASSOCIATES

PLANNING ~ ENGINEERING ~ MANAGEMENT

Main Office

2160 Filbert HighwayYork, SC 29?45

P.O. Box 296Clover, SC 29710

Tel. : (803) 684-3390Fax. : (803) 628-2891

The Honorable Charles L.A. TerreniChief Clerk R AdministratorPublic Service Commission of South Carolina

101 Executive Center DriveColumbia, SC 29210

February 25 2010

REF: PINE HAVEN SUBDIVISIONCARROLL NORMAN OWNER

Dear Mr. Terreni:

Kin s Mountain NC

104 N. Dilling St.Kings Mountain, NC28086


Tel. : (704) 739-2565Fax. : (704) 739-2565

As evidenced by certi6cations from Campco Engineering in 1983, issuance of a

"Permit to Operate" dated November 4, 1983 by the South Carolina Department

of Health and Environmental Control, (SCDHEC) and continued inspections by

SCDHEC the water system that serves Pine Haven Subdivision was constructed in

accordance with the SCDHEC "Permit to Construct" dated February 16, 1982. Tothe best of my information and belief, the water system that serves Pine Haven

Subdivision was constructed in substantial agreement with the construction plans

on ftle with SCDHEC.

Should you have any questions or need any additional information, please feel free

to contact me.

Sincerely,

JOEL E.WOOD & ASSOCIATES, L.L.C.

oel E. Wood, P.EManaging Partner.

JOEL E. WOOD & ASSOCIATES

PLANNING * ENGINEERING • MANAGEMENT

Main Office

2160 Filbert HighwayYork, SC 29745


Tel.: (803) 684-3390Fax.: (803) 628-2891

Kin,qs Mountain, NC

104 N. Dilling St.Kings Mountain, NC28086


Tel.: (704) 739-2565Fax.: (704) 739-2565

February 25, 2010

The Honorable Charles L.A. Terreni

Chief Clerk & Administrator

Public Service Commission of South Carolina

101 Executive Center Drive

Columbia, SC 29210

REF: PINE HAVEN SUBDMSION

CARROLL NORMAN OWNER

Dear Mr. Terreni:

As evidenced by certifications from Campco Engineering in 1983, issuance of a

"Permit to Operate" dated November 4, 1983 by the South Carolina Department

of Health and Environmental Control, (SCDHEC) and continued inspections by

SCDHEC the water system that serves Pine Haven Subdivision was constructed in

accordance with the SCDHEC "Permit to Construct" dated February 16, 1982. To

the best of my information and belief, the water system that serves Pine Haven

Subdivision was constructed in substantial agreement with the construction plans

on file with SCDHEC.

Should you have any questions or need any additional information, please feel free

to contact me.

Sincerely,

JOEL E. WOOD & ASSOC_TES, L.L.C.

/,/Joel E. Wood, P.E.

_/ Managing Partner.

12. LETTER FROM SCDHEC APPROVING SYSTEMFOR OPERATION.

12. LETTER FROM SCDHEC APPROVING SYSTEMFOR OPERATION.

D H E

PROMOTE PROTECT PROSPER

C.Eml ICnnrer, Commissioner

Pr~mO!ieieaPdPm!eZ(i' V~Amf'!h Oj&hePuMiS rrd theen", ~rOPSmZS!

November 25, 2009

Pinehaven SubdivisionAttn: C. Norman767 Pine Haven CircleClover SC 29710

Sanitary Survey: Pinehaven S/D

System Number: 4650037System Type: CSystem Operator: C. Norman

Dear Sir,

A sanitary survey of the drinking water system serving the above referenced site was conducted recently and a copy

of the survey report is enclosed for your records. The overall rating for the system is Satisfactory. It is necessa. ry

that you retain a copy of this report for a period of not less than ten years and make it available to DHEC or the

public upon request.

—Please continue to keep detailed weekly records of the checks performed on the system. The logs should contintle to

reflect all visits and repairs performed on the system. The system should review the procedure manual annually to be

sure all contact information is correct and make any needed modifications necessary to best reflect the actual

procedures used on the system. All records should be made available for surveys.

I will be happy to meet with you to discuss this agency's requirements for a public water system. Please let me know

if you have any questions or if I can be of further assistance. Thank you for your cooperation.

Sine ely

Hollon R. StillwellDistrict Drinking Water

QU f H CAROLINA DKPARTMKNT OP HKALTH AND KNVIRGNMKNPTAL CONTROLRegion 3

Serving Chester, Fairfield, Lancaster, Lexington, Net. berry, Richland and York Counties

Lancaster EQC Office 2475 DHEC Road Lancaster, SC 29720 Phone: (803)285-7461 ' Fax: (803)285-5594 ~ vow. scdhec. gov

)

D H E C

PROMOTE PROTECT PROSPER

C. _arl Hunter, Commissioner

P_r_m_i._cr a._d _mtectinfft'_ _et_t_h _hv _b_ic a_._ thcen._ir_nr_e'n._

November 25, 2009

Pinehaven Subdivision

Attn: C. Norman


Clover SC 29710

Sanitary Survey: Pinehaven S/D

System Number: 4650037

System Type: C

System Operator: C. Norman

Dear Sir,

A sanitary survey of the drinking water system serving the above referenced site was conducted recently and a copy

of the survey report is enclosed for your records. The overall rating for the system is Satisfactory. It is necessary

that you retain a copy of this report for a period of not less than ten years and make it available to DHEC or the

public upon request.

---Please continue to keep detailed weekly records of the checks performed on the system. The logs should continue toI 1._jreflect al visits and repairs performed on the system. The system should review the procedure manual annually _o besure all contact information is correct and make any needed modifications necessary to best reflect the actual

procedures used on the system. All records should be made available for surveys.

I will be happy to meet with you to discuss this agency's requirements for a public water system. Please let me know

if you have any questions or ifI can be of further assistance. Thank you for your cooperation.

Hollon R. Stillwell

District Drinking Water

_ )OUTH CAROLINA DEPARTMENT OF HEALTH AND ENVIRONMENTAL CONTROL

Serving Chester, Fairfield, Lancaster, Lexington, Newberry, Richland and York CountiesLancaster EQC Office • 2475 DHEC Road ° Lancaster, SC 29720 ° Phone: (803) 285-7461 ° Fax: (803) 285-5594 • w_,w.scdhec.gov

8-CDHEC

Bureau of Water

Public Water System Inventory Report Form

Site Name: P INEHAVEN S/D

system Number: 4650037

Fax Number: NONE

(A)dd, (M)edi(y, (R)eee m, (D)eiete:C'

Reason:

Today's Date: / 0DW Mailing Address:

Owner: PINEHAVEN S/D

Attn: C NORMAN

767 PINE HAVEN CIR

CLOVER, SC 29710

Owner Business Telephone: (803)222-3334

Owner Emergency Telephone: (803)222-3334

Site Info Address:

767 PINE HAVEN CIR

CLOVER, SC 29710

*Contact: NORMAN. CARROLL*Phone: /704)860-5333

email. NoneDW Mail Attention: C NORMANDW Contact Telephone: NONE

System Characteristics

System Type. . . , C

Owner Type. . . . . PRIV

Inact Code. .

Inact Date (mo/yr). . . .

Begin Date (mo/yr). . . 10/1980

Service Area. . . .

Counties Served:

46

R1 Season On (mo/day). . . . . . 01/01

Season Oft (mo/day). . . . . 12/31

Statistical Information

Source Use Information:

Percent Surface Water. . . . .

Percent Ground Water. . . . .-—,Percent Purchased Surface Water. . .

.~Percent Purchased Ground Water. . .

100

Number of Service Connections:

Residential. . . . . .Non Residential. . .Maximum Allowable. . .

Permitted. . .

25Total. . . 25

19

19

Total must equal 100%

Number of Surface Water Sources. . . 0

Number of Ground Water Sources. . . . 2

Purchased Suface Water Sources. . . . 0

Number of Permanent SW Sources. . . 0

Number of Emergency SW Sources. . .

Number of Permanent GW Sources. . .

Number of Emergency GW Sources. . .

Service Population:

Production (MGD):

Average. . . . . . .

Maximum Day. .

Capacity:

Total. . .

Emergency. . .

Storage:

Elevated (MG). . .

0.0000

.035

0.0000

0.000

Population. . . . . . . . . . .

Secondary Population. .

75 Ground (MG). . . .

Pressure (TG). . .

0.000

5.200

Comments

* Add/change contact name, address, phone and email info here. This information can be found in EFIS/Permits/Relations/type

DW Contact.

Signature:

October 16.2009 Page1 of1 dwinvent. rdf

SCDHEC

Bureau of Water

Public Water System Inventory Report FormJ..3, cjf .

._.Site Name: PINEHAVEN S/D

_ystem Number: 4650037

Fax Number: NONE

BW Mailing Address:

Owner: PINEHAVEN S/D

Attn: C NORMAN

767 PINE HAVEN CIR

CLOVER, SC 29710

Owner Business Telephone: (803)222-3334

Owner Emergency Telephone: (803)222-3334

(A)dd, (M)odify, (R)enum, (D)elete:

Reason: )' ._o

Today's Date: ff!,r3!o?Site Info Address:

767 PINE HAVEN ClR

CLOVER, SC 29710

*Contact: NORMAN. CARROLL*Phone: (704_860-5333

*email: NoneDW Mail Attention: C NORMAN

DW Contact Telephone: NONE

System Characteristics

System Type .... C

Owner Type ..... PRIV

Inact Code ..........

Inact Date (mo/yr) ....

Begin Date (mo/yr)... 10/1980

Service Area ....

Counties Served:

46

R1 Season On (too/day) ...... 01/01

Season Off (mo/day) ..... i2/31

Statistical Information

Source Use information:

Percent Surface Water ............. 0

Percent Ground Water ............. 100

-_\Percent Purchased Surface Water... 0

.__./Percent Purchased Ground Water .... 0

Total must equal 100%

Number of Surface Water Sources... 0

Number of Ground Water Sources .... 2

Purchased Suface Water Sources .... 0

Number of Permanent SW Sources... 0

Number of Emergency SW Sources... 0

Number of Permanent GW Sources... 1

Number of Emergency GW Sources... 0

Service Population:

Population ................

Secondary Population .......

Number of Service Connections:

Residential ............

Non Residential .........

Maximum Allowable .....

Permitted ..............

25._ Total... 25

0

19

19

Production (MGD):

Average ..............

Maximum Day ..........

0.0000

0

Capacity:

Total ............... ;. .035

Emergency ............ 0.0000

Storage:

Elevated (MG) ..........

75 Ground (MG) ...........

0 Pressure (-I'G) ..........

Comments

0.000

0.000

5.200

* Add/change contact name, address, phone and email info here. This information can be found in EFIS/Permits/RelatJonsltype

DW Contact.

)..j"

Signature:

October 16.2009 Page I of I dwinvent.rdf

Soulh CcxolinaDepai. tmenl ofHeathcndE~vironmen)cCoFI &0

P. O. Drawer 100Fort Lawn, S. C. 29714

November 4, 1983


J. Lorin Mason, Jr, , M. D. , Yice-ChairmanLeonard W. Oouglas, M. D. , Secretary

Moses H. Clarkson, Jr.George G. Graham, D.D.S.

Barbara P. Nuessle

COMMISSIONER

Robert S, Jackson, M. O .


FINAL CONSTRUCTION APPROUAL

ISSUED TO: Mr. V. Carroll NormanRoute 3, Box 76Clover, S. C. 29710



Under the following s ecial conditions:

The water from this yell vill be anal zed for radiolo ical ualit b theS. C. Department of Health and Environmental Control. At the end = oneyear from the first radiological sam lin , a final determination on theacceptability of this well from the stand oint of radiolo ical ualit , villbe made. The owner will be notified in writin of this determination.The existin well is to be ro erl abandoned within fort da s of the dateof this a royal.


This facility was constructed under permit f3 204682 issued Februar 16, 1982.

Based on the Engineer's letter of compliance signed by William H. Armstrong, P. E. ,satisfactory bacteriological results and inspections performed by personnel of thisoffice, you may consider this facility approved by the S. C. Department of Healthand Environmental Control and ready to be placed in service.

Joe S. Faris, Jr.District EngineerCa tawba Dis t ric t EgC

JSF/lv

cc: Mater Supply DivisionP. E.York County Bldg. Insp. Dept.

SoulhCoroho..: DeparPrnenl of

Heal[hanoiEnvironrnenlo

, Conlro/P. O. Drawer i00


November 4, 1983


J, Lorin Mason, Jr., M.D., Vice-Chairman

Leonard W. Douglas, M.D., SecretaryMoses H. Clarkson, Jr.

George G. Graham, D.D.S.•Barbara P. Nuessle

COMMISSIONERRobert S. Jackson, M.D.


ISSUED TO:



Route 3, Box 76

Clover, S. C. 29710

for the operation of a water supply, treatment or distribution system identifiedas follows:


Under the following special conditions:

The water from this well will be analyzed for radiolo ical ualit b theS. C. Department of Health and Environmental Control _ the end _ _=,

_ar--fr--_--mt-_ f-irs_r-_ogical samlin__ final determinationacceptability of this _ f-_om t_e s__-_ ---7 _=u_ir_at_°n on,the

_=_y__u_u o_ raololo ical ualit , willbe made. The owner will be notified in writing of this determination.

The existing well is to be tO--abandoned within fort_ of the dateof thisar_.


This facility was constructed under permit # 204682 issued February 16, 1982.

B_sed on the Engineer's letter of compliance signed by William

satisfactory bacteriological results and inspections performed H. Armstrong, p. E.,by personnel of this

office, you may consider this facility approved by the S. C. Department of Healthand Environmental Control and ready to be placed in service.

Issued by:

Joe S. Faris, Jr.

District Engineer


JSF/lw

cc: Water Supply DivisionP. E.

York County Bldgo Insp. Dept.

13. CURIWNT BILL FORM13. CURRENT BILL FORM

PINE HAVEN SUBDIVISIONWATER SYSTEM

767 PINK HAVEN CIRCLECLOVER, SC 29710

(S03) 222-3334

UTILITY BILL

CUSTOMERNAME NUMBER

BILLING ADDRESS

To

PAST DUE BALANCEWATER CHARGE From TQ

SPRINKLER CHARGE FromPOOL CHARGE From TQ

RECONNECTION CHARGETOTAL BALANCE DUE

PAYMENT DUE BY

A copy of the "Rate Schedule" is available upon request by contacting Pine HavenSubdivision Water System at the address shown above (803-222-3334).

Mail Payment to: Carroll Norman767 Pine Haven CircleClover, SC 29710


WATER SYSTEM

767 PINE HAVEN CIRCLE

CLOVER, SC 29710

(803) 222-3334

UTILITY BILL

CUSTOMER

NAME NUMBER

BILLING ADDRESS

PAST DUE BALANCE

WATER CHARGE From To

SPRINKLER CHARGE From To

POOL CHARGE From To

RECONNECTION CHARGE

TOTAL BALANCE DUE

$

$

$

PAYMENT DUE BY

A copy of the "Rate Schedule" is available upon request by contacting Pine Haven

Subdivision Water System at the address shown above (803-222-3334).

. Mail Payment to: Carroll Norman


Clover, SC 29710

TY'PE.' [ t 9/stet" f J Sewer I' J Both

CERTIFICATED CGMPANY INFORMATION

Corn PMy N 8Mp pine Haven S~W Ca oil Norman Owner )

767 Pine Haven CircleMaiiing Address

Clover, SC 29710City, State, Zip Code

767 Pine Haven CircleBusiness l ovation

Clover SC 29710City, State, Zip Code

803-222-3334Telephone

York

Registered Agerit:' Carroll »rman

MailingAddress 767 Pine Haven circle

Dty, State, Zip Code; clover sc 29710

I'uriumnt to the Commission'e rules and re uiatiorie rint Or e cpm n contact for the foIIovAn:

A. R&gUlatOry Office[", Carroll Norman

803-222-3334 / N A / A

Telephone Number / Facsimile Number / E-mail Address

B, Customer Relatiore (Cornplairtz):

803—222—3334 / N/A / N/A

Telephone Number / Facsimile Number / 6-mail Address

C. Eaginm. ring. QQaratiorts:

803-222-3334 / N A / N A

Page I of2

AUTHORIZED UTILITY REPRESENTATIVE FORM

TYPE: [ ] Water [ ] Sewer [ ] Both

CERTIFICATED COMPANY INFORMATION

CompanyName Pine Haven Subdivision

..W_ CaI-_oll No_..( ._,Qg_er)

Dba/_a


803-222-3334

Telephone

Mailing Address

Clover, sc 2971 0

City, State, Zip Code


Business Location

Clover, SC 29710 York

City, State, Zip Code County

REGISTERED AGENT INFORMATION

Registered Agent: "Carroll Norman

MailingAddress: 767 Pine Haven Circle

City,State,_p Code: Clover, SC 2971 0

Pursuant to the Commission's rules and .requlations, print or type company contact for th%,f.,oltowtn.q:

A, Regulatory Officer: Carroll Norman

803-222-3334

Telephone Number

B. Customer Relations (Complaints): _. Carroll Norman

/ .N_/A t N/A ....

t Facsimile Number 1E.mail Address

803-222-3334 / N/A t N/A

C,

Telephone Number I Facsimile Number

Engi,_,_dn_j..Qpe,.rations: Carroll _ormaq

803-222-3334 [ N/A

/ E-m_i1Address

/ N/APzgs I of 2

Telephone Number t Facsimile Number t E-maii Address

D. TBSl and Repel l". Carroll Norman

803-222-3334 t N/A t N/A

Telephone Number t Facsimile Number t E-mail Address

E. Emergencies: Carroll Norman(Dunng Non-Offic Hours)

803-222-3334 j N/A t N/. A

Telephone Number t Facsirriile Number / E-mail Address

Financial'. Carroll Norman

803—222 —3334 / N/A j N/a

Telephone Number t Facsimile Number l E-maii Address

Customer Contact fTol! Free Number): 803-222-3334

Carroll Norman

This form was completed by Iprint riame}

Owner

Sigriature

RETURN COMPLETED FORM TO.'

Pubk Service Commission pf 8CDocketing DepartmentPost Office Drawer 11649Columbia, South Carolina 29211

And

QNce of Regulatory StaffAttn: Jeanne Gordon1401 Main Street, Suite 900Columbia, South Carolina 29201

(Rev, Psc Q3(t20Q9)

Page 2 of2

D,

t FacsimileNumber

Carroll Norman

! E-mail AddressTete#honeNumber

Test and ReRair:

803-222-3334 l N/A t N/A

Telephone Number ! Facsimile Number. l E-mail Address

Emergencies: Carroll Norman

(Dur;ngNon-OfficeHours)

803-222-3334 / N/A I N/A

Telephone Number / FacsimileNumber / E-mail Address

Financial: Carroll Norman

803-222-3334 / N/A / N/a

E,

F,

G.

Telephone Number f FacsfmileNumber I E-mailAddress

Customer Contact (Toll Free Number): 803-222-3334

Carroll Norman

Thfs form was completed by (printname)

Crw-ner

Titre

STgnature

Date

RETURNCOMPLETED FORM TO:

I=ublicServiceCommission of SC

Docketing DepartmentPostOfficeDrawert1649

Columbia,SouthCarolina 29211

And

Office of RegulatoryStaffAttn: Jeanne Gordon1401 MainStreet, Suite 900

Columbia,South Carolina29201

Page Z o_2

BEFORE

THE PUBLIC SERVICE COMMISSION OF

SOUTH CAROLINA

DOCKET NO. 2009-278-W

Petition of the Office of Regulatory Staff fora Declaratory Order against Carroll Normanand/or Pine Haven Water System RequiringCertification as a Water Utility and thePosting of a Performance Bond

)) NOTICE OF APPEARANCE) OF COUNSEL))))

YOU WILL PLEASE TAKE NOTICE that C. Lessie Hammonds and Jeffrey M. Nelson give notice

of appearance as counsel for the Office of Regulatory Staff in the above-captioned matter. Pursuant to S.C.

Code Ann. Section 58-4-10 (Supp. 2008), the Office of Regulatory Staff is a party of record in all filings,

applications, and proceedings before the Public Service Commission of South Carolina. Any further

information or correspondence filed with the Public Service Commission of South Carolina should also be

served on the undersigned as counsel for the Office of Regulatory Staff.

C. LessigHam'monds, EsqurieJeffrey. M. Nelson, EsquireOFFI'OK OF REGULATORY STAFF1401 Main Street, Suite 900Columbia, South Carolina 29201Phone: (803) 737-0803Fax: (803) 737-0895lhammon re staff. sc. ov'nelson re staff. sc. ov

September 25, 2009Columbia, South Carolina

BEFORE

THE PUBLIC SERVICE COMMISSION OF

SOUTH CAROLINA


1NRE:

Petition of the Office of Regulatory Staff for

a Declaratory Order against Carroll Norman

and/or Pine Haven Water System Requiring

Certification as a Water Utility and the

Posting of a Performance Bond

NOTICE OF APPEARANCE

OF COUNSEL

YOU WILL PLEASE TAKE NOTICE that C. Lessie Hammonds and Jeffrey M. Nelson give notice

of appearance as counsel for the Office of Regulatory Staff in the above-captioned matter. Pursuant to S.C.

Code Ann. Section 58-4-10 (Supp. 2008), the Office of Regulatory Staff is a party of record in all filings,

applications, and proceedings before the Public Service Commission of South Carolina. Any further

information or correspondence filed with the Public Service Commission of South Carolina should also be

served on the undersigned as counsel for the Office of Regulatory Staff.

f

'_ _ ,4/ .' ......•___ -.II,_,_L". / .".-._,.-....

c.L. 'H onds,Esq eJe,ffre_, N. Nelson, EsquireOFFri_'E OF REGULATORY STAFF

/

1N01 Main Street, Suite 900

Columbia, South Carolina 29201

Phone: (803) 737-0803

Fax: (803) 737-0895

lhammon@regstaff, sc. gov

[email protected]

September 25, 2009

Columbia, South Carolina

BEFORE

THE PUBLIC SERVICE COMMISSION

OF SOUTH CAROLINA

DOCKET NO. 2009-27S-W

Petition of the Office of Regulatory Staff for aDeclaratory Order against Carroll Norman

and/or Pine Haven Water System RequiringCertification as a Water Utility and thePosting of a Performance Bond

))) CERTIFICATE OF) SERVICE)))

This is to certify that I, Chrystal L. Morgan, have this date served one (1) copy of the NOTICE

OF APPEARANCE OF COUNSEL in the above-referenced matter to the person(s) named below by

causing said copy to be deposited in the United States Postal Service, first class postage prepaid and

affixed thereto, and addressed as shown below:

Carroll Norman767 Pine Haven Circle

Clover, SC, 29710

Chryst L. Morgan

September 25, 2009Columbia, South Carolina

BEFORE

THE PUBLIC SERVICE COMMISSION

OF SOUTH CAROLINA


INRE:

Petition of the Office of Regulatory Staff for a

Declaratory Order against Carroll Norman

and/or Pine Haven Water System Requiring

Certification as a Water Utility and the

Posting of a Performance Bond

CERTIFICATE OF

SERVICE

This is to certify that I, Chrystal L. Morgan, have this date served one (1) copy of the NOTICE

OF APPEARANCE OF COUNSEL in the above-referenced matter to the person(s) named below by

causing said copy to be deposited in the United States Postal Service, first class postage prepaid and

affixed thereto, and addressed as shown below:

Carroll Norman


Clover, SC, 29710

September 25, 2009

Columbia, South Carolina

c_

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Owner: - dms.psc.sc.gov