Hurricane Florence made landfall on the North Carolina coast in early September 2018. In response, the North Carolina EOC was activated to alleviate potential impacts from the hurricane. Due to potential water sector impacts, the state requested assistance at the EOC from EPA Region 4 water division personnel. Quick activation at the EOC was made possible from day-to-day relationships between EPA Region 4 and the North Carolina Department of Environmental Quality (NCDEQ). These pre-event personal and professional relationships strengthened communication and collaboration in the early phases of the response. Once the EOC was activated, daily summary reports were provided by NCDEQ to EPA on water utilities and were used for the U.S. Army Corps of Engineers and the Department of Homeland Security daily situation reports.

In addition to EOC activation, water sector mutual aid organizations shared emergency capabilities during the response. NCWaterWARN and the NC Rural Water Association (NCRWA) were provided a workspace in the state's EOC during the response to ensure coordination of aid to affected facilities. Throughout the response, NCRWA generated a list of facilities they were assisting and provided the list to EPA and NCDEQ. These mutual aid networks provided water and wastewater line repair staff, generators, fuel and other forms of aid through their members. As a result, very few resource requests for the water sector were made of the state EOC, and even fewer federal resources were deployed to assist the water sector.