2020 award nomination guide...2020 award nomination form . nc awwa-wea . 2841 plaza place ste. 130 ....

2020 Award Nomination Guide NC AWWA-WEA 2841 Plaza Place Ste. 130 Raleigh, NC 27612 www.ncsafewater.org

NC AWWA-WEA members work every day to protect the public health and the environment. The organization’s awards program is designed to recognize individuals and organizations that go above and beyond expectations. With over 2,000 members across North Carolina, it is difficult for awards committees to know about the great work of every individual and organization, so NC AWWA-WEA depends on members to nominate co-workers and facilities that deserve recognition.

Awards Accepting Open Nominations A list of awards that accept open nominations is available on the following page. If you are aware of someone that fits the criteria of one or more award please complete the appropriate award application or contact the appropriate awards committee chair to make your nomination. Most award winners will be formally recognized at the NC AWWA-WEA Annual Conference in November. More information about these awards is available online at www.ncsafewater.org/about/awards.

The awards listed on this page are given by NC AWWA-WEA or recognized at an NC AWWA-WEA event, but do not accept open nomination.

Membership Awards Selected by Numbers The following awards are given by AWWA, WEF or NC AWWA-WEA as recognition for years of membership, years of service or number of new members recruited and are automatically generated by the associations. • AWWA Life Member: 30 years of

membership in AWWA and at least 65 years of age

• AWWA Silver/Gold Water Drop: 25/50 years of membership in AWWA

• Maffitt Membership Cup: Section member who

recruits the greatest number of AWWA members in the previous year

• WEF Life Member: 35 years of membership in WEF and 65 years of age

• William M. Piatt Award: Section member who recruits the greatest number of WEF members in the previous year

Awards from AWWA, WEF, and NC AWWA- WEA Selected by Committee The following awards are given by AWWA, WEF or NC AWWA-WEA and individual committees or national partners select recipients. Applications are not included in this packet. For a description of individual awards refer to www.ncsafewater.org/about/awards. • Arthur Sidney Bedell: Selected by the NC

AWWA- WEA Bedell Committee • Austin F. McCormack, Jr. Award: Application

submitted to AWWA • Donald E. Francisco Educator of the Year:

Selection rotates annually between by the Collection & Distribution School Committee, Plant Operations & Maintenance Committee, (Maintenance Tech), and Seminars & Workshops Committee.

• Kasey Monroe Outstanding Service: Selected by the NC AWWA-WEA Board of Trustees Chair

• Kenneth J. Miller Founders: Selected by the NC AWWA-WEA Water For People Committee

• Select Society of Sanitary Sludge Shovelers: Selected by 5S committee

• Special Recognition: Selected by the NC AWWA- WEA Board of Trustees Chair

• Wendell R. LaDue Utility Safety Award: Application submitted to AWWA

• William D. Hatfield: Selected by the NC AWWA- WEA Hatfield Committee

Send your award application and nominee photo to [email protected]. Applications are due by August 15, 2020.

Photos MUST be included and will be used in press release and award presentation PowerPoint slides.

http://www.ncsafewater.org/http://www.ncsafewater.org/about/awards/http://www.ncsafewater.org/about/awards/mailto:[email protected]?subject=Award%20Nomination

Awards with Open Nominations These awards welcome nomination from all sources by way of the applications on the following pages. Please refer to table below for information regarding complete application requirements for each award.

Award Title Application Deadline Information Contact

Disaster Preparedness Organizational Award

August 15 Complete Sections: 1, 2b, and 8 REQUIRED ADDITIONAL INFORMATION: Recommendation from supervisors and/or other professionals.

Perry Gayle AECOM Email: [email protected] Phone: (919)-461-1295

George Warren Fuller Individual Award

August 15 Complete Sections: 1, 2a, and 4

Jeff Cruickshank Hazen & Sawyer Email: [email protected] Phone: 336-478-3364

George W. Burke, Jr. Safety Organizational Award

August 15 Complete Sections: 1, 2b, and 9 REQUIRED ADDITIONAL INFORMATION: OSHA Form 300A “Summary of Work-Related Injuries and Illnesses”

Perry Gayle AECOM Email: [email protected] Phone: 919-461-1295

Golden Manhole Society Individual Award


Corey King Kimley-Horn Email: [email protected] Phone: 704-954-7477

Raymond E. “Red” Ebert Individual Award


Mac Merritt NCRWA Email: [email protected] Phone: 336-731-6963

Safewater Maintenance Technologist Excellence of the Year Individual Award


Scott Oliver Carotek Email: [email protected] Phone: 704-844-1100

Walter J. Courmon Safety Organizational Award

August 15 Complete Sections: 1, 2b, and 9 REQUIRED ADDITIONAL INFORMATION: OSHA Form 300A “Summary of Work-Related Injuries and Illnesses”

Perry Gayle AECOM Email: [email protected] Phone: 919-461-1295

Wastewater Collections Operator of the Year Individual Award


Glenn Walker Brunswick County Email:[email protected] Phone: 910-371-3490

Wastewater Collection System of the Year Organizational Award

August 12th Complete Sections: 1, 2b, and 11


Wastewater Laboratory Analyst Excellence Individual Award


Stephen Avent Town of Cary Email: [email protected] Phone: 919-779-0697

Wastewater Treatment Plant Operations & Maintenance Excellence Organizational Award

August 15 Complete Sections: 1, 2b, and 10 Nominations accepted on a continuous basis and will be held for consideration for two years.

Melinda Ward City of Eden Email: [email protected] Phone: 336-627-1009

Water Distribution Operator of the Year Individual Award


Mac Merritt NCRWA Email: [email protected] Phone: 336-731-6963

Water Distribution System of the Year Organizational Award

August 12th Complete Sections: 1, 2b, and 12


Send your award application and nominee photo to

[email protected]. Applications are due by August 15, 2020.

Photos MUST be included and will be used in press release and award presentation PowerPoint slides.

mailto:[email protected]?subject=Award%20Nomination

2020 Award Nomination Form NC AWWA-WEA 2841 Plaza Place Ste. 130 Raleigh, NC 27612 www.ncsafewater.org

For all nominations:

• Most award nominations are due August 15, and completed nominations should be sent to NC AWWA-WEA staff on or before the deadline.

• For all awards, additional pages may be attached to further answer questions or provide relevant information. • If you are submitting more than one nomination you must use a separate application for each nomination. Forms may be photocopied.

SECTION 1: Nominator Information

Name: Employer:

Address (include city, state and zip code):

Phone Number: Email:

SECTION 2: Nominee General Information

2a: Individual Nominee (Complete this section if the nominee is an individual and not an organization.)

Name: Employer:

Address (include city, state and zip code):

Phone Number: Email:

Professional Title:

Certifications Held (include type and level):

Professional Organization Memberships and Involvement (Indicate whether involvement was at national, local or state level):

AWWA Positions held:

Year Joined: Year required for Fuller award. WEF Positions held:

Year Joined::

NC AWWA-WEA Positions held: NC SLAM OR involvement with NC AWWA-WEA.

Other Positions held:

http://www.ncsafewater.org/

2b: Organizational Nominee (Complete this section if the nominee is an organization and not an individual.)

Facility Name: Utility Name:

Facility Type: Water Treatment Water Distribution Wastewater Collection Wastewater Treatment

Other (explain):

Facility Address (include city, state and zip code):

Facility Contact Person and Professional Title:

Contact Person Phone Number: Contact Person Email:

SECTION 3: Laboratory Analyst Excellence Award

This award, established in 1993, is presented each year to a wastewater laboratory analyst for outstanding performance, professionalism and contributions to the water quality analysis profession.

Recipient will be selected based on the following criteria. 1. The candidate must be employed at an educational facility laboratory, industrial laboratory, municipal laboratory or commercial laboratory that

performs wastewater related analysis and must have direct analytical responsibilities.2. Candidates are only eligible for this award.3. Selection criteria include:

• Membership and involvement in professional associations• Outstanding efforts in the area of wastewater and environmental aquatic analysis, including such items as innovative sampling techniques o

solutions to a treatment, analytical or environmental problem

• Involvement in community activities or public relations• Presentations at professional conferences, meetings, etc. relevant to water quality analysis• Professional certifications• Continuing education• Beneficial contributions to the candidate’s facility• Unusual initiative or performance “beyond the call of duty” in the area of wastewater analysis or environmental matters

Type of Laboratory: Municipal Commercial Industrial Other

Lab Experience:

Education/Continuing Education:

Address two or more of the following;

• Give examples of how this individual has gone “beyond the call of duty” in the wastewater analysis/environmental area.• Describe the nominee’s beneficial contributions to their facility.• Give examples of the nominee’s community or public relations involvement.• Give examples of any of the nominee’s innovative approaches to wastewater treatment or wastewater analytical problems. (Please feel free to

attach another document if more space is needed)

SECTION 4: George Warren Fuller Award (Continued on next page) This award, established in 1937, is given each year to members of the Association, designated by the Sections, for their distinguished service to the water supply field and in commemoration of the sound engineering skill, the brilliant diplomatic talent, and the constructive leadership of the members of the Association who exemplified the life of George Warren Fuller one of America’s most eminent engineers. Each Section, each year, may designate one of its members as a recipient of the George Warren Fuller Award. Such designation is presumed to recognize publicly the contribution toward advancement of water supply practice the member has made within the particular Section selecting them for the award. If two members have joined in a common project that the Section wishes to recognize, both participants may be jointly designated for the award. Education:

College: Degree: Graduation Year:



Brief Employment History:

Year joined AWWA:

Offices held (indicate whether section or Association-level):

Civic Organization Memberships (Lions, Kiwanis, school board, etc):

Professional organization memberships:

Professional Awards or Honors Received (Give year and identify awarding organization) :

Publications (List three major publications):

#1:

#2:

#3:

SECTION 4: George Warren Fuller Award (Continued from previous page)

Eligibility/Justification: Provide details of the nominee’s “distinguished service in the water supply field” which entitles them to this award.

Citation: Provide a recommended citation of 40 words or less.

Attach additional information as necessary.

SECTION 5: Golden Manhole Society

Criteria for the Golden Manhole Society will be 3 or more of the following: 1. Years of experience and significant accomplishments in the design, education, training, certification, construction, operations,

maintenance, safety, or management of water distribution systems or wastewater collection systems 2. Innovative solutions to problems 3. Presentations and/or participation at conferences 4. Involvement in promoting the professional recognition of the Collection/Distribution Systems field 5. Papers or articles accepted by state, regional or national publications 6. Membership in WEF national collections system committee or AWWA national distribution systems committee 7. Membership in good standing with the NC AWWA-WEA 8. Active involvement with the NC AWWA-WEA Wastewater Collection/Water Distribution Committee 9. Any other reason why the Nominee deserves recognition

Induction will be decided by a vote of Collection and Distribution Systems Committee based on information provided on this application.

List the significant contributions the nominee has made that promote professionalism through the advancement of the systems design, education, training, certification, construction, operations, maintenance, and management of water distribution systems or wastewater collection systems.

I prefer to speak to a member of the Collection and Distribution System Committee about this nomination. My contact information is provided in the Nominator Information Section. When contacted, I am prepared to provide specific examples of the nominee’s commitment and contributions to the field.

In 1986, the NC AWWA-WEA established three new awards in order to recognize excellence in the industry for water distribution and wastewater collection employees.

Raymond E. (Red) Ebert Award - Demonstrate organizational leadership, or technical innovation, or facility improvement, or promoted and/or participated in training, or safety awareness and general knowledge that has led to the upgrading and advancement of the water distribution and/or wastewater collection systems. Water Distribution Operator of the Year - A full-time employee of superintendent grade or below (waived for towns with less than 5 utility employees) who has exhibited outstanding knowledge and innovation in the continuing operation of a water distribution system. Wastewater Collection Operator of the Year - A full-time employee of superintendent grade or below (waived for towns with less than 5 utility employees) who has exhibited outstanding knowledge and innovation in the continuing operation of a wastewater collection system.

Criteria for Awards: Membership in the NC AWWA-WEA is not required in order to be considered for these awards.

Considerations 1. Term of full-time service with the city or agency. 2. Extent of self-improvement. 3. Extent of taking advantage of training offered by employers

and others. 4. New ideas or improvements developed for existing facilities

and city or agency. 5. Ability to service the best interest of the community. 6. Character and previous recognition.

Requirements 1. The nominee must be a full-time employee of the city or agency. 2. The nominee must be a superintendent or below. This

requirement shall be waived in towns or agencies with less than 5 employees in utilities activities.

3. The nominee must be involved in water or wastewater activities. 4. The nomination must be endorsed by two or more

supervisors or other industry professionals. 5. The recipient shall be eligible for a recurring award.

This Application is for: Ebert Award Water Distribution OTY Award Wastewater Collection OTY

Length of FULL-TIME employment with current employer:

Extent of Self-improvement (job history, promotions, departmental growth, personal accomplishments, etc.):

The extent of taking advantage of training offered by employers and others (List courses completed, indicate interest in training of other employees, awareness of training offered by the City or other agency, initiative shown in seeking additional training):

New ideas or improvements developed for existing facility or city (efficient utilization of equipment, machinery modification, improved procedures, pride in workmanship, etc.):

Ability to serve the best interest of the community (awareness of public relations, concern for the public during construction of projects, concern for personal safety and that of other employees, personal discipline and loyalty to the chain of command, proper conduct while on the job, etc.):

SECTION 6: Raymond E. “Red” Ebert Award, Water Distribution Operator of the Year Award, and Wastewater Collection Operator of the Year Award

Character:

Previous Recognition:

Endorsed By: Endorsed By:

Employer: Employer:

Title: Title:

Phone: Phone:

Email: Email:

SECTION 7: Safewater Maintenance Technician of the Year Excellence Award

The selection will be based on an appropriate weighing following list of criteria in no particular order: 1. Maintenance certifications & training 2. Active membership in professional associations 3. Years of service 4. Recommendations from supervisors and/or other professionals 5. Professional accomplishments 6. Training & sharing of skills & abilities with other professionals 7. Other criteria as deemed appropriate by the committee

Years of service as a Maintenance Technician:

Training and sharing of skills and abilities with other professionals:

Professional Accomplishments:

List other reasons for this nomination:

Please provide separate sheets for recommendation from supervisors and/or other professionals.

SECTION 8: Disaster Preparedness Award The NC AWWA-WEA Disaster Preparedness Award is presented to utilities in acknowledgment of outstanding achievement in advancing disaster preparedness initiatives thereby strengthening our preparedness and increasing our resolve to prepare for, respond to, recover from, and mitigate the effects of natural disasters, man-made disasters, and acts of aggression against our locality, county, state, and nation.kn

Service Population (Based on USEPA Vulnerability Assessment Criteria): Greater than 50,000 10,000 - 49,999 Less than 10,000

Indicate which of the following the nominated utility has in place or has performed, or indicate when item is not applicable (N/A). Provide specific details when requested.

Water Vulnerability Assessment completed.

Water Emergency Operations Plan (EOP) completed.

Wastewater Vulnerability Assessment completed.

Wastewater Emergency Operations Plan completed.

All staff trained in EOP.

Drought management plan and/or water conservation plan

developed.

Written disaster response manual in the hands of all supervisors. (May be EOP if it is sufficiently usable at the first line supervisor level.)

Designated disaster preparedness person on staff. (Does not need to

be full time.) Name:

Departmental emergency call list maintained.

Parent agency (municipality or county) has executed the NC Local

Government Mutual Aid Agreement

Internal water incident tabletop exercise(s) conducted.

Emergency water interconnections with other systems in place. In discussion

At least one person in the utility has studied the EPA Response

Protocol Toolbox.

One or more staff is certified in the Incident Command System or National Incident Command System. Name:

Drafts of key possible notices to customers have been prepared

and are available.

Key facilities have been surveyed by one or more law enforcement agencies.

Disaster planning has been done with local police agency.

Disaster planning has been done with local fire department.

Communication is maintained with county health department.

Emergency electrical generators at facilities

All Most Some None

Has provided disaster intrastate mutual aid.

Specify event(s) and aid recipient(s):

Has provided disaster interstate mutual aid. Specify event(s) and aid recipient(s):

Major facilities have provisions to sustain staff in the event of “lock-down” or other disaster-induced immobility conditions.

Utility has capability of modeling water distribution system.

Other disaster preparedness/security initiatives:

SECTION 9: George W. Burke, Jr. and Walter J. Courmon Safety Awards (Continued on next page.)

These awards are given every year to encourage an active and effective safety program in municipal and industrial water and wastewater facilities. Documented and illustrated safety programs and safety records of the facility for the preceding calendar year are the primary criteria for the awards.

The George W. Burke Award is awarded to wastewater treatment plants and their collection systems. This award was established in 1982 in honor of George W. Burke, Jr. for his many years of service to the water pollution control field.

The Walter J. Courmon Award is awarded to water treatment plants and their distribution systems. The Courmon award was created in 2003 in memory of Mr. Walter J. Courmon, an employee of the City of Greensboro. Mr. Courmon was also an active member of the NC AWWA-WEA and was the Chair of the Safety Committee.

This Application is For: George W. Burke, Jr. Safety Award Walter J. Courmon Safety Award (If you are applying for both awards you must submit two separate applications.)

Facility Information:Number of Utility Department Employees Number of Treatment Plants Operated Number of Treatment Plant Employees

Accident and Injury Reporting: Please provide the OSHA Form 300A “Summary of Work-Related Injuries and Illness” with this application. Please only provide injury/illness information for nominated individual facility.

Safety Program: Please provide the following information about safety programs currently in place at the nominated facility.

Indicate the status of the following programs by checking a response in the columns to the right.

Program in Place (4 pts)

Program Being Developed (2 pts)

Program Not Applicable (0 pts)

Accident Prevention/Investigation Program

Blood borne Pathogen Exposure Control Plan and Training

Cranes/Hoists Training and Inspection Programs

Electrical Safety

Emergency Action Plan

Fire Prevention Plan

First Aid/CPR Training

Forklift Training and Inspection Program

Hazard Communication Program

Hazardous Waste Operations and Emer. Response

Hearing Protection and Training Program

Lockout/Tagout Program

Permit Required Confined Space Program

Personal Protective Equipment Program

Policy on Storage of Flammable/Combustible Liquids

Policy on Storage and Handling of LP Gas

Portable Fire Extinguisher Training

Process Safety Management

Respiratory Protection Program

Welding, Cutting and Brazing

Fall Protection Program

Risk Management Program

Job Hazard Analysis for each position/task

Machine Guarding

SECTION 9: George W. Burke, Jr. and Walter J. Courmon Safety Awards (Continued from previous page.)

Yes No Check “Yes” or “No” to the following questions and provide additional information as necessary.

Are all of personnel; operators, mechanics, distribution, collections crew, etc. required to have and use approved safety glasses, hard hats, and safety footwear?

Are all personnel aware of the organization’s Safety & Health Manual?

Does each division of the organization have job specific Safety Policies and/or Procedures in place?

Does every employee attend regularly scheduled safety meetings?

Does the organization have a Safety Committee? If yes, please describe the Safety Committee philosophy.

Do employees understand management’s commitment to Safety and Health? Please Explain.

Does each new employee receive training from someone other than his or her immediate supervisor?

Was anyone disciplined during the year for a violation(s) of a safety rule(s)? Please explain.

Are employee driving records checked periodically?

Is there a Competent Person assigned to operate each backhoe assigned to a crew?

Does organization have a trenching and shoring program?

Does organization possess and train on the use of portable fire extinguishers?

Is there a Highway Work Zone Safety Program?

Are employees offered the Hepatitis B vaccines?

Are employees offered Tetanus vaccines? (If recommended by doctor)

Do all supervisors have first-aid/CPR training?

Are MSDS’s current, in order and located in each work area?

Is a baseline survey of the worksite conducted to identify hazards? Please Describe.

Are accidents and near misses promptly investigated in order to discover the root cause? Describe what actions are taken to investigate and prevent the accident from happening again.

Additional items about the Safety Program that should be considered in the selection of the NC AWWA-WEA Burke/Courmon Safety Award winners.

SECTION 10: Wastewater Treatment Plant Operations and Maintenance Excellence Award

The Professional Wastewater Operators (PWO) Committee is an outreach committee that fosters networking and professionalism for our state’s 3,000+ wastewater operators and other plant personnel, who are on the front lines of protecting our water environment.

To assist in these efforts, the committee shall annually recognize a plant in each region of our state with the Wastewater Treatment Plant Operation & Maintenance Excellence Award. It will be awarded to the most outstanding plant operation and maintenance (O&M) efforts, according to the best use of the resources available to that facility. An award may be given by each of the Professional Wastewater Operators Committee Regions (West, Central, and East). A plaque for each selected plant will be presented at the Association’s Annual Conference at an appropriate time and place in the program.

The award will honor the wastewater plant personnel that serve their community with a high level of professionalism and diligent work in the operation and maintenance of their wastewater treatment facility. The recipient’s plant staff make the most of their available resources, no matter how great or small.

The award committee will consist of at least four (but no more than eight) active members of each Region’s Professional Wastewater Operators Committee. The Region’s Chairperson will select the award committee members and also serve as the award committee’s chair.

Each regional award committee will nominate up to four plants during October or November for the award during the following year. The award committee will select the nominees from completed nomination forms and their general knowledge of O&M at plants in their region. Nominated plants will host a regional Professional Wastewater Operators Committee meeting so the award committee may visit the plant.

The award committee will strive to objectively rate each plant during the site visit. The rating will be according to the following 14 categories.

General Level of Plant Professionalism 0 - 10 Safety Practices & Programs 0 - 10

Apparent Level of Staff Training 0 - 5 Regulatory Compliance 0 - 10

Staff Certification Levels 0 - 5 Effluent Appearance 0 - 5

Observed Innovative O&M Practices 0 - 8 Plant odors & odor control efforts 0 - 5

Apparent Equipment Maintenance 0 - 8 Involvement in the Profession (outside own plant) 0 - 8

Housekeeping 0 - 8 Public & Community Education & Involvement 0 - 5

Use of Automation Systems 0 - 5 Overall Plant Appearance, Look & Feel 0 - 8

Under this rating system, a perfect score (highest rating in all 14 of the above categories) would equal 100. The rating will be obtained from discussion with the plant staff, as well as from general observations during the plant tour.

Even though the nominated plants may vary widely by plant and staff size, and scope of staff duties, the award committee will make every effort to judge each nominated plant fairly and evenly according to the resources available to them. The involvement of the plant’s staff in achieving outstanding operation and maintenance is of prime concern.

Reason for Nomination (List any plant and staff improvements, innovations and achievements.):

SECTION 11: Collection System of the Year Award

The mission of the North Carolina Collection System of The Year Award is to identify and recognize the municipality that protects the public health and the natural beauty of the environment through pro-active practices of management, operations and maintenance beyond what is required of its NCDEQ collection system permit. To assist in these efforts, the Wastewater Collection and Water Distribution Systems committee shall annually recognize up to three wastewater collection systems in North Carolina based on the size of their collection system. Recipients of the awards will have demonstrated that they perform quality collection system maintenance procedures through the efficient use of labor, materials, equipment, and innovative methods to keep their collection system in good working condition to minimize health hazards and property damage that occur due to sanitary sewer over flows during both wet weather and dry weather conditions. The awards will honor the collection system personnel that serve their community with a high level of professionalism and diligent work in the operation and maintenance of their wastewater collection system facilities. The recipient’s staff make the most of their available resources, no matter how great or small. Collection systems will be categorized by the following sizes: large system = greater than 750 mi. of public collection system, medium system = 251-750 mi. of public collection system, and small system = 250 mi. of public collection system or less. The systems will be evaluated against all applicants in addition to the evaluation based on size. An overall winner, regardless of size, and the highest ranked systems in the two remaining size categories will be recognized. The award committee will review the applications; rank each collection system against the other applicants based on a normalization of the data on a per mile of gravity sewer basis. Members of the award committee may conduct interviews in order to review the data submitted and collect additional information as needed to determine the final winners.

Collection System Data Collection System Performance

Miles of Gravity Sewer in System Number of Dry Weather SSOs

Number of Service/Lateral Connections Number of Wet Weather SSOs

Number of Pump Stations Total Volume of SSOs Reported to DENR (gals)

Last Year

Miles of Sewer Force Main Total Volume of SSOs Reported to DENR (gals)

Prior Year

Number of Sewer Manholes Amount of Rainfall Last Year (inches)

Number of Force Main Air Release Valves Number of Gravity Sewer Cave-ins/Emergency

Repairs

Number of Food Service Establishments (FSEs) Number of Sewer Force Main Failures

Collection System Preventive Maintenance Activities (Most recent fiscal year, unless noted as last 3 years)

Number of Permanent Flow Monitors Number of Fats, Oils, and Grease Facility (FSE)

Inspections

Number of Temporary Flow Monitors Number of Pump Station Capacity Assessments

Performed

Number of Rainfall Monitoring Gauges Miles of Gravity Sewer Root Treatment/Root

Removal

Number of Temporary Flow Monitor Meter Months (Number of Meters times number of months installed)

Miles of Gravity Sewer Root Treatment/Root Removal Performed Last 3 years

Number of Temporary Flow Monitor Meter Months Last 3 Years

Number of Force Main Air Release Valve Inspections

Number of Gravity Sewer Preventive Maintenance Point Repairs

Miles of Force Main Inspected Last 3 Years

(internal inspection documented)

Annual Operations and Maintenance Activities (Most recent fiscal year, unless noted as last 3 years) Annual Review of Inspection, Maintenance, operational

and Complaint Logs yes/no Number of Manholes Inspected

(internal condition documented)

CCTV Defect Coding using PACP Rating System yes/no Number of Manholes Inspected Last 3 Years

Miles of Public Gravity Sewer CCTV Inspection Miles of Gravity Sewer Smoke Tested

Miles of Gravity Sewer Cleaned Miles of Gravity Sewer Smoke Tested Last 3 years

Miles of Gravity Sewer Cleaned Once

Number of Service/Lateral Inspected

(internal condition documented)

Annual Rehabilitation and Replacement Activities (Most recent fiscal year, unless noted as last 3 years)

Capital Improvement Plan adopted and designating funds for short and long-term reinvestment needs? yes/no

Rehabilitation and Replacement Expenditures (Collection System ,Force Mains, & Pump Stations

Only)

Routine pump station rehabilitation and replacement program implementation? yes/no

Rehabilitation and Replacement Expenditures Last 3 Years (Collection System, Force Mains, &

Pump Stations Only)

Miles of Gravity Sewer Rehabilitated/Replaced Number of Manholes Rehabilitated/Replaced Miles of Gravity Sewer Rehabilitated/Replaced Last 3

Years

Number of Manholes Rehabilitated/Replaced Last 3 Years

SECTION 12: Water Distribution System of the Year Award

The mission of the North Carolina Water Distribution System of The Year Award is to identify and recognize the municipality that protects the public health through pro-active practices of management, operations and maintenance of their water distribution system beyond minimum standards. To assist in these efforts, the Wastewater Collections and Water Distribution Systems committee shall annually recognize up to three water distribution systems in North Carolina. Recipients of the award will have demonstrated that it performs quality water system maintenance procedures through the efficient use of labor, materials, equipment, and innovative methods to keep its distribution system in good working condition to minimize health hazards. The award will honor the system personnel that serve their community with a high level of professionalism and diligent work in the operation and maintenance of their water distribution system facilities. The recipient’s staff make the most of their available resources, no matter how great or small. Awards will be given to one water distribution system in each of the three sizes; large system = greater than 750 miles of pipe, medium system = 251 – 750 miles of pipe, small system = 250 miles of pipe or less. The award committee will review the applications, rank each water distribution system against the other applicants. The systems will be evaluated against all applicants in addition to the evaluation based on size. An overall winner, regardless of size, and the highest ranked systems in the two remaining size categories will be recognized. Members of the award committee may conduct interviews in order to review the data submitted and collect additional information as needed to determine the final winners.

Distribution System Data (Most Recent Fiscal Year(s))

Miles of drinking water pipe in System ________ Number of Water Quality Customer Complaints (Last year) ______

Population Served ________ Number of Water Quality Customer Complaints (Last 3 years) ________

Number of Metered Customers ________ Number of Water Main Breaks/Leaks (Last year) ________

Number of Storage Tanks ________ Number of Water Main Breaks/Leaks (Last 3 years) ________

Number of Pump Stations ________ Number of Service Breaks/Leaks (Last year) ________

Number of Valves ________ Number of Service Breaks/Leaks (Last 3 years)

Number of Total Water Distribution Staff ________ Number of coliform hits (Last year) ________

Number of Certified staff ________ Number of coliform hits (Last 3 years) ________

Non Revenue Water (%) ________ Number of NOVs (Last year) ________

Number of NOVs (Last 3 years) ________

Water Distribution System Management Activities (Most Recent Fiscal Year)

System-wide Hydraulic Model updated regularly? Yes / No Collect, document, and retain information on

pipe coupons? Yes / No

Capital Improvement Plan adopted designating funding for short and long term reinvestment needs? Yes / No

Work Order Management System in place for tracking maintenance? Yes / No

AMR program implemented? Yes / No Has a water audit been conducted? Yes / No

Last date Design Standards Updated ________

Annual Operations and Maintenance Activities (Most Recent Year)

Routine review of inspection, maintenance, operational and complaint logs?

Yes / No

Annual flushing program? Yes / No

Number of Valves exercised (Past Year) __________ Uni-directional flushing program? Yes / No

Leak Detection Program Yes / No Percentage of system flushed? _________

Percentage of System covered by leak detection __________ Documented Backflow/Cross Connection Prevention Program?

Yes / No

How often is each tank inspected? __________ Dedicated program to maintain/exercise hydrants? Yes / No

How often is each tank rehabilitated? __________ Tank Maintenance Program? Yes / No

Pump station inspection program? Yes / No Number of Pump Stations with SCADA __________

Annual Rehabilitation/Replacement Activities (Most Recent Fiscal Year unless noted as last 3 years)

Miles of Pipe Renewal (Lined or Replaced) Last Year _________ Rehabilitation & Replacement Expenditures Last Year (Storage tanks only)

________

Miles of Pipe Renewal (Lined or Replaced) Last 3 Years _________

Rehabilitation & Replacement Expenditures Last Year (Pump Stations only) ________

Renewal Expenditures Last Year (Pipes lined or replaced) _________

Awards from AWWA, WEF, and NC AWWA- WEA Selected by CommitteeFor all nominations:NC AWWA-WEA Positions held:ConsiderationsRequirementsLength of FULL-TIME employment with current employer:Character:Facility Information:

Name: Employer: Address include city state and zip code: Phone Number: Email: Name_2: Employer_2: Address include city state and zip code_2: Phone Number_2: Email_2: Professional Title: Certifications Held include type and level: Year Joined: Positions held 1: Year Joined_2: Positions held 1_2: Positions held 1_3: Positions held 1_4: Facility Name: Utility Name: Other explain: Facility Address include city state and zip code: Facility Contact Person and Professional Title: Contact Person Phone Number: Contact Person Email: Address two or more of the following Give examples of how this individual has gone beyond the call of duty in the wastewater analysisenvironmental area Describe the nominees beneficial contributions to their facility Give examples of the nominees community or public relations involvement Give examples of any of the nominees innovative approaches to wastewater treatment or wastewater analytical problems Please feel free to attach another document if more space is neededRow1: College: Degree: Graduation Year: College_2: Degree_2: Graduation Year_2: College_3: Degree_3: Graduation Year_3: Brief Employment History: Year joined AWWA: Offices held indicate whether section or Associationlevel: Civic Organization Memberships Lions Kiwanis school boardetc: Professional organization memberships: Professional Awards or Honors Received Give year and identify awarding organization Row1: them to this award 1: Citation Provide a recommended citation of 40 words or less 1: Water Distribution OTY Award: Extent of Selfimprovement job history promotions departmental growth personal accomplishments etc 1: other employees awareness of training offered by the City or other agency initiative shown in seeking additional training 1: procedures pride in workmanship etc 1: concern for personal safety and that of other employees personal discipline and loyalty to the chain of command proper conduct while on the job etc 1: Character 1: Previous Recognition 1: Endorsed By: Endorsed By_2: Employer_3: Employer_4: Title: Title_2: Phone: Phone_2: Email_3: Email_4: Years of service as a Maintenance Technician: Name_3: Name_4: Specify events and aid recipients 2: Specify events and aid recipients 2_2: Other disaster preparednesssecurity initiatives: Are all personnel aware of the organization s Safety Health Manual: Does each division of the organization have job specific Safety Policies andor Procedures in place: Does every employee attend regularly scheduled safety meetings: Does the organization have a Safety Committee If yes please describe the Safety Committee philosophy: Does each new employee receive training from someone other than his or her immediate supervisor: Was anyone disciplined during the year for a violations of a safety rules Please explain: Are employee driving records checked periodically: Is there a Competent Person assigned to operate each backhoe assigned to a crew: Does organization have a trenching and shoring program: Does organization possess and train on the use of portable fire extinguishers: Is there a Highway Work Zone Safety Program: Are employees offered the Hepatitis B vaccines: Are employees offered Tetanus vaccines If recommended by doctor: Do all supervisors have firstaidCPR training: Are MSDSs current in order and located in each work area: Is a baseline survey of the worksite conducted to identify hazards Please Describe: Additional items about the Safety Program that should be considered in the selection of the NC AWWAWEA BurkeCourmon Safety Award winners 1: Reason for Nomination List any plant and staff improvements innovations and achievements: Number of Rainfall Monitoring Gauges: Removal: Number of Meters times number of months installed: Removal Performed Last 3 years: Years: Inspections_2: Repairs_2: internal inspection documented: internal condition documented: Number of Manholes Inspected Last 3 Years: Miles of Public Gravity Sewer CCTV Inspection: Miles of Gravity Sewer Smoke Tested: Miles of Gravity Sewer Cleaned: Miles of Gravity Sewer Smoke Tested Last 3 years: Miles of Gravity Sewer Cleaned Once: internal condition documented_2: Only: Pump Stations Only: Miles of Gravity Sewer RehabilitatedReplaced: Number of Manholes RehabilitatedReplaced: Years_2: 3 Years: undefined_3: 1_3: 2_3: 1_4: 2_4: 1_5: 2_5: 3_2: 4_2: Number of Water Main BreaksLeaks Last year: undefined_4: undefined_5: undefined_6: 1_6: 2_6: 1_7: 2_7: 3_3: 4_3: Yes No_3: Yes No_4: undefined_8: Miles of Pipe Renewal Lined or Replaced Last Year: undefined_9: undefined_10: Rehabilitation Replacement Expenditures Last: undefined_11: Check Box1: OffCheck Box2: OffCheck Box3: OffCheck Box4: OffCheck Box5: OffCheck Box6: OffCheck Box7: OffCheck Box8: OffCheck Box9: OffCheck Box10: OffCheck Box11: OffCheck Box12: OffCheck Box13: OffText14: Text15: Text16: Text17: Check Box18: OffCheck Box19: OffCheck Box20: OffCheck Box21: OffText22: Text23: Text24: Check Box25: OffCheck Box26: OffCheck Box27: OffCheck Box28: OffCheck Box29: OffCheck Box30: OffCheck Box31: OffCheck Box32: OffCheck Box33: OffCheck Box34: OffCheck Box35: OffCheck Box36: OffCheck Box37: OffCheck Box38: OffCheck Box39: OffCheck Box40: OffCheck Box41: OffCheck Box42: OffCheck Box43: OffCheck Box44: OffCheck Box45: OffCheck Box46: OffCheck Box47: OffCheck Box48: Offdiscussion: Check Box49: OffCheck Box50: OffCheck Box51: OffCheck Box52: OffCheck Box53: OffCheck Box54: OffCheck Box55: OffNumber of Treatment Plant Employees: Number of Treatment Plants Operated: Number of Utility Department Employees: Check Box56: OffCheck Box57: OffCheck Box58: OffCheck Box59: OffCheck Box60: OffCheck Yes or No to the following questions and provide additional information as necessary: Text61: Text62: Check Box64: OffCheck Box63: OffPerformed: Number of Temporary Flow Monitors: Inspections: Number of Permanent Flow Monitors: Number of Sewer Force Main Failures: Number of Food Service Establishments FSEs: Repairs: Number of Force Main Air Release Valves: Amount of Rainfall Last Year inches: Number of Sewer Manholes: Prior Year: Miles of Sewer Force Main: Last Year: Number of Pump Stations: Number of Wet Weather SSOs: Number of ServiceLateral Connections: Number of Dry Weather SSOs: Miles of Gravity Sewer in System: Group65: OffText66: undefined_7: Group111: YesGroup611: OffGroup622: Off1111: Off2222: Off3333: Off4444: Off222: Off333: Off777: Off7777: Off888: Off99: Off0000: Offaa: Offaaa: Offaaaa: Off

2020 award nomination guide...2020 award nomination form . nc awwa-wea . 2841 plaza place ste. 130 ....

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