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In parallel with growing concerns, the concentration of trace organic compounds (TOrCs) has increased in wastewater streams as more people rely on these products for everyday uses. In addition, as nutrient total maximum daily loads continue to be developed for receiving waters, many wastewater treatment plants are facing more stringent limits, especially for phosphorus removal. The objective of this study was therefore to evaluate the performance of sand ballasted flocculation in combination with powdered activated carbon (PAC) for the removal of both a series of TOrCs and phosphorus. A pilot unit of Actiflo ® Carb was installed at the South Shore Water Reclamation Facility owned by Milwaukee Metropolitan Sewerage District and managed by Veolia Water North America. This study received financial support from Water Environment Research Federation and the Milwaukee Metropolitan Sewerage District.