Water Testing Requirements for Crosswinds Campground, B. Everett Jordan Lake Project

DEPARTMENT OF THE ARMY
WILMINGTON DISTRICT, CORPS OF ENGINEERS
PO BOX 1890
WILMINGTON, NORTH CAROLINA 28402-1890

IN REPLY REFER TO
Project Management Branch

November 27, 1991

SUBJECT: Water Testing Requirements For Crosswinds Campground, B. Everett
Jordan Project

Mr. John N. Morris, Director
Division of Water Resources
North Carolina Department of Environment,
Health, and Natural Resources
Post Office Box 27687
Raleigh, North Carolina 27611-7687

Dear Mr. Morris:

Reference is made to the enclosed April 17, 1991, letter from Mr. Kevin
MacNaughton and my June 4, 1991, letter to you on the above subject matter.
The purpose of this letter is to officially transmit to the State the
test results for those tests performed on the water supply wells at the
Crosswinds Campground Recreation Area on June 17, 1991. These test results
were hand delivered to Mr. Mike Seigh and Mr. Fred Hagenberger on
November 13, 1991, at a site visit to the Crosswinds Campground Recreation
Area. These results should satisfy the request of Mr. MacNaughton in his
April 17 letter.

I am also enclosing a copy of a June 11, 1991, letter from Mr. William
T. Branager, Jr., to the State Division of Health Services transmitting
Permit No. 87-4007 and the Engineer's Statement for the Crosswinds
Campground Recreation Area Well Water System. This letter, along with the
above test results, should provide sufficient information for the Divsion of
Parks and Recreation to obtain an operating permit for the water supply
system at Crosswinds.

-2-

If you need any addition information or have any questions, please
contact me at [phone].

Sincerely,

Glenn McIntosh
Project Manager

Enclosures

Copy Furnished With Enclosures:

Dr. Philip K. McKnelly
Director, Parks and Recreation Division
North carolina Department of environment,
Health, and Natural resources
Post Office Box 27687
Raleigh, North Carolina 27611-7687

Mr. Tom Wells
Deputy Director, Parks and Recreation Division
North Carolina Department of Environment,
Health, and Natural Resources
Post Office Box 27687
Raleigh, North Carolina 27611-7687

Mr. Kevin MacNaughton
Chief, Design and Development Section
Parks and Recreation Division
12700 Bayleaf Church Road
Raleigh, North Carolina 27614

Mr. Mike Seigh
NC Division of Parks and Recreation
B. Everett Jordan
Route 2, Box 159
Apex, North Carolina 27502

State of North Carolina
Department of Environment, Health, and Natural Resources
Division of Parks and Recreation
512 North Salisbury Street • Raleigh, North Carolina 27611
James G. Martin, Governor Dr. Philip K. McKnelly
William W. Cobey, Jr., Secretary Director

April 17, 1991

Mr. Glen Macintosh
Department of the Army
Wilmington District Corps of Engineers
Post Office Box 1890
Wilmington, North Carolina 28402-1890

Dear Mr. Macintosh:

SUBJECT: Water Testing Requirements for Crosswinds Campground

Enclosed you will find a list of water tests required by the
Division upon acceptance of beneficial occupancy of this project.

If you have any further questions, please contact me at this
telephone number 919/846-9991.

Sincerely,

Kevin MacNaughton, P.E , Chief
Design and Development Section

KM/mb

Enclosure

cc: Tom R. Wells
James B. Hallsey
Howard Stewart
Mike Seigh

41/km

P.O. Box 27687, Raleigh, North Carolina 27611-7687 Telephone [phone]
An Equal Opportunity Affirmative Action Employer

DIVISION OF PARKS & RECREATION
March 28, 1991

MEMORANDUM

TO: Kevin MacNaughton

FROM: Mike Seigh

S UBJECT: Water Testing

This memo will serve to clarify what water and wastewater
system test results that the Division should require prior
to accepting the Crosswinds Campground.

1) Inorganic chemical test results - required every
three (3) years

2) Radiological tests - required every four (4) years

3) Source floride - once every ten (10) years

4) Corrosivity - one (1) time analysis

5) Regulated volatile organic chemicals - collect
four (4) consecutive quarterly samples every
three (3) years

6) Unregulated volatile organic chemicals - one sample
every (5) years

7) Letter from Department of Environmental Management
approving operating permit for the wastewater
treatment system

8) Letter for Division of Public Health Services
approving operation of water system

In the past, the Division has had to pay out the costs of these
test because the Corps of Engineers failed to do the initial
tests on the water system. I recommend that we request the
above testing be completed before we accept the area.

JMS:jlp

June 4, 1991

Project Management Branch

SUBJECT: Water Testing Requirements For Crosswinds Campground, B. Everett
Jordan Project

Mr. John N. Morris
Director, Water Resources Division
North Carolina Department of Environment,
Health and Natural Resources
Post Office Box 27687
Raleigh, North Carolina 27611-7687

Dear Mr. Morris:

Reference is made to the enclosed copy of an April 17, 1991, letter
from Mr. Kevin MacNaughton on the above subject matter. Our letter is to
advise you that procurement action has been initiated to have these tests
done and the results furnished to us by the end of June. We will then in
turn furnish them to you and Mr. MacNaughton.

Mr. MacNaughton's letter also requests that letters from the Department
of Environmental Management approving the operating permit for the
wastewater treatment system and the Division of Public Health Services
approving the operation of water system be furnished to the Division of
Parks and Recreations. Both of these organizations were contacted prior to
the pre-final inspection and both stated that they would not attend the pre-
final. Their only requirement was a letter from the Corps certifying that
both systems were constructed in accordance with the approved plans and
specifications. This letter will be furnished to both Division of
Enironmental Management and Division of Public Health Services once Mr. Bill
Branager furnishes us with this certification.

-2-

If you have any questions In regard to this matter, please do not
hesitate to call me at [phone].

Sincerely,

Glenn McIntosh
Project Manager

Enclosure

Copy Furnished:

Dr. Philip K. McKnelly
Director, Division of Parks and Recreation
North Carolina Department of Environment,
Health and Natural Resources
Post Office Box 27687
Raleigh, North Carolina 27611-7687

Mr. Tom Wells
Deputy Director, Div. of Parks and Recreation
North Carolina Department of Environment,
Health and Natural Resources
Post Office Box 27687
Raleigh, North Carolina 27611-7687

Mr. Kevin MacNaughton
Chief, Design and Development Section
NC Division of Parks and Recreation
12700 Bayleaf Church Road
Raleigh, North Carolina 27614

Mr. Mike Seigh
NC Division of Parks and Recreation
B. Everett Jordan
Route 2, Box 159
Apex, North Carolina 27502

BCF:
CESAW-EN Files
CESAW-EN-DC
CESAW-CO-C
CESAW-CO-R
CESAW-CO-RJ
CESAW-RA

114 OAKMONT DRIVE
PHONE [phone]•0200

RSO. BOX 70P5r
Qi•IEEI VILLE:N.C• 21836.7066

BACTERIOLOGICAL ANALYSIS
LABORATORY I1)4# .; 3 7 7 15
WATER SYSTEM ID #

COUNTY: CIiATHAM
NAME OF SYSTEM : t3. EVERETT JUHnAN LAKE' AREA ,

SAMPLE TYPE : (ts ) (1-Routine; 2 • Repeat; 3 • Replacement; 4. Plan ApP./Q4; $ •, tiher)
COLLECTED ON: MATE: 0 S / 17 / D 1 (MMIDDIYY) TIME; 0 3':,a 0' • '• •(HH; MM AM or PM)
LOCATION WHERE COLLECTED: watt TW •- 3 2 CROSSWINDS 'A R E: P O :M C N C U R E, N. C.
LOCAi)QN-`YPE 5141 •:Entr Ta 2•-Ge ral Te ; 3'wE Ta « +
(• '• ), • ( y p ne p• rtd p; , t a iran/lnt;•5«kC7thwj
LOCATION CARE:
FOR REPEAT SAMPLE:
PrevloUe Positive Location Code: Original Sample Type; ( ) (1 • Routine;
Positive Collection Date: 2 - Repeat; 3 • Plan Apprayal; 4 'Other)
Time: M Original Collection Date: "
ProximIt if .) (1. Same; 2..Upstream; 3 ■ Do>:Nloatream) ' • Tlriwt •
•
•
Client Malting Address:.• • •' •
4
•
E r .
•
•
•
4.
I.
•
DILL' S 'WELL DRZLLXNa, INC.
800 MCARTHUR 'ROAD •
FAYETTEVILLE.' NC 2133111,'
•
•
Talaphone #:
•
4
•
•
•
•
•
•
19,) 4AF3•-3740
• • l• I •, •1 • ,.. ••Y • I y-n•••••YI•r. .v •
•
•
•
RESULT
•
COLLE6TE0BY:.. •THAt4A,: •••W...SXLi.'
FOR REPLACEMENT $AM{
Type of Supply:
4
•
•
•
•
;::..
•
•
•
•
•
•
•
•
M
Community ) NTNC
Non r itn'ty.:. • (; X ) Private
Type of Treatment: I ' • •
Chlorinated
Nonree hiorrinne Residual d
Total Chlorine Raalduai
•
• 1 •
1 1 I It } i I1• Iaim f
INVALID CODES
•
•
•
•
•
•
•
J
CONTAMINANT . - 'METHOD PRE •: Ash INVALID 1) CONFLq NT..Q(3Q j qH/NQ CONFORM FOUND
:.TOTAL COLIFORM ▪ • •: .3 la : • (° ) (_ X) { ) < 2) TNTC/N4 I tFQAM IrQUNR•`.: '.:
FECAL/E. COW • ( ) (. ) ( ) 3) TURBID GuLTLJRalNO Ctat.IFORM FOUND ` . ,-
HETEROTI PHIC P.G.
• • • 0 (number)
•
•
/ml
•
•
•
•
REPEAT SAMPLES REQUIRED ( )
*DATE ANALYSIS:t3EQUN: 0 5/ 2 8/ 9 t.
DATE ANALYSIS .COMPLETED: b G/ 2 9/ 9
LABORATORY LOG #: 8 9 9 9 -- 3 618 9 i •. P. n
r = -
COMMENTS:
•
i'
•
4) OVER 48 MOORS OLD. ':•::
5) IMPROPER 134MPI7E,G•R ANALYSIS
•
REPLACEMENT•SAMPLE REQUIRED (
TIME ANSYSIS SEGUN: • •• 012 s 3 H fi
TIME ANALYY$S CQ;A$PL.ETgR: .0 2: 4 5 p M
CERTIFIED BY:. L•S •
•
•
•
•
•
•
•
•
•
•
•
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•
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N\c:\•\ l;9S .5
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WHITE DHS COPY / YELLOW: CUSTOMER COPY ! PINK: LABORATORY COPY
•
•
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L 1U VLf%aJWUI1l WU Up U&UWWUtp,WUtUlUW'IM•
P,d. BOX 7085 • "w
QREENVILt9N.C, 2783b 7085.
1
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114 OAKMONT CHIVE
• PHONE [phone]
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. ' BACTERIOLOGICAL ANALYSIS
••:..1.' LABORATORY ID A1. : • 37 715 t.
WATER SYSTEM ID # :
•
11.1
•
•
•
•
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•
•
•
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•
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(...)':-P l `•, 1.: r:.. ...,w;.i:" •.\
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COUNTY: CHATHAM
NAME OF SYSTEM : t3 \ EVEFtETTE :JORDAN LAKE RECREATION ' : tit
SAMPLE TYPE :. (a ) (1-Routine; 2aRepeat; 3•. Replacement; 4-Plan ApprOvfi4; 6•.Other)
•
L I.;.• . .
•
•
•
COLLECTED ON: . DATE: 0 5 / 1 / / 91• (MMIDD/YY) TIME: • ?.;, 0 it II IIMH,;(vMM AM or PM)
LOCATION WHERE COLLECTED: TW4-33 CROSSWINDS AREA, I1ONCURE, NC '
LOCAttb_N' TYPE! (:5"e'PLY . '(t *tinny Tep;`2t«General rap; 3d.lErtd Tap; '4.r•cdir /intakk;:15-other) I.
.THPMA Sk D%LL
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}t;, FOR REPLACEMENT $AMPLE;'
Previous Positive. Location Code: Orl final Sample Tyype: ( ) (1.. Routing;
Positive Collection Date: • m Repeat; a. Fian Approval; 4 Other)'
Time: Orlglnel Collection Date;
Proximity: 4... ) (1- Same; 2 Pi Upstream; 3 M Downstream) • . Time:; . •• • M
•
•
LOCATION CODE:
FOR REPEAT SAMPLE!
Y
Client Mailing Address:
•
•
BLI•.L'S. WELL C712rl.t.T.Nif,INC,.
800 MCARTHUR RDAU
FAYETTEVILLE., 'NC 213311
Telephone #:
(919) 48B-3740
CONTAMINANT -
TOTAL GOLIFOAM
FECAL/E. 0OLI •
HETEROTROPHIQ P.C.
•
•
RESULT
METHOD PRESENT ASSENT
) t ).
/ml
.(number)
•
REPEAT SAMPLES REQUIRED ( )
DATE ANALYSIS BEGUN; 0 6 / 1 E3 / 91
DATE ANALYSIS COMPLETED: 06 / 19 /-9 3
LABORATORY LOG # 8999-•061.tt91.•6•ZZZ
COMMENTS:
COLLECTED BY:
•
Type of Supply: •
•
Community
Non•community
•
Type of Treatment: • ,
( j
Chlorinated
( x Non-chlorinated
ree hlorine Residual
Total Chlorine Residual
•
•
•
•
•
INVALID COUtS •
INVALID , 1) CONFLUI:NNTQROWi7•(INQCOLIPORMFOUND
2) TNTC/NQ CQMFORM POUND.,
3) TURBO CULTURE/NO 001.IFORM.FOUND :..
4) OVER 48 HOURS OLP• ;F1:4,
5) IMPROPER. SAMPLE QR. ANALYSIS
REPLACEMENT SAMPLE REQUIRED (- - j
TIME AN4Y$IB. SEQUN:4 . t3 21; 3 0 p M
TIME ANALYSIS Coop(.ETED.: • 02 s 4 5 P. M
CERTIFIED EY c S • •
•
NTNC .
. Private
•
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•
•
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•
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•
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•
FOAM 4003
• f ;
899h T , y,
WHITE: DHS COPY / YELLOW: CUSTOMER COPY / PINK: LABORA'tOBY Copy

U @alrtiNWif 11D kVortip
P.O. BOX 7085
GREENVILLE, N.C. 27835.7085
Uilcc']
N EW WELL INORGANIC CHEMICAL ANALYSIS
114 OAKMONT DRIVE
PHONE [phone]
LABORATORY ID #
WATER SYSTEM ID # •
37715
COUNTY:
NAME OF SYSTEM: B. EVERETT JORDAN LAKE RECREATION AREA
TYPE OF SAMPLE: W = Source
COLLECTED ON:
06 / 17/ 91 (MM/DD/YY)
LOCATION WHERE COLLECTED: WELL # TW-32
COLLECTED BY:
MAIL RESULTS TO:
CONTAM
CODE
0100
1005
1010
1015
1016
1017
*1020
1022
1025
1028
1030
1031
1032
1035
1040
1045
1050
1052
1068
1095
1905
1915
1925
1927
THOMAS W. BILL
•
CHATHAM
TIME: 3 00 P M (HH:MM XM)
CROSSWINDS AREA, MONCURE, NC
SOURCE CODE:
BILL'S WELL DRILLING, INC.
800 McARTHUR RD.
FAYETTEVII T E, NC 28311
TELEPHONE # ( 919 ) 488-.3740
N AME
TURBIDITY, ntu
ARSENIC, mg/1
BARIUM, mg/I
CADMIUM, mg/I
CALCIUM mg/I
CHLORIDE, mg/I
CHROMIUM, mg/I
COPPER, mg/I
FLUORIDE, mg/I
IRON, mg/I
LEAD, mg/I
MAGNESIUM, mg/I
MANGANESE, mg/I
MERCURY, mg/I
N ITRATE, mg/I
SELENIUM, mg/I
S ILVER mg/I
SODIUM, mg/I
ACIDITY, mg/I
ZINC mgli
COLOR units
TOTAL HARDNESS, mg/I
pH, units
ALKALINITY, mg/I
SAMPLE UNSATISFACTORY ( )
1
DATE ANALYSES BEGUN: 06 / 18 / 91
COMMENTS: E-1 CLIENT ID# 5655
•
METHOD
CODE
001
125
125
125
101
128
125
101
107
125
125
101
:.125 ..
103
121 •
.125'
125
101
157
101
129
141
135
142
TYPE OF SUPPLY:
( ) COMMUNITY
( ) NTNC
( ) NON -COMMUNITY
( x ) PRIVATE
WATER SOURCE(S):
( x ) GROUND
RESULTS
6.19
<0.010
<0.100
<0.005
48,0
9
<0.010
<0.010
O .17
0.475
O .011
11 460
O .260
<0.0002
0.04
<0.00S
<0,050
91_0
15
1 _971
1n
1R5
7_A
173
RESAMPLE REQUESTED
ALLOWABLE
LIMITS
N/A
0.050
1.000
0.010
N/A
N/A
0.050
1.000
4.000
0.300
0.050
N/A
0 050
0002..:
10.00
0 010
0050
-N/A
N/A
5.000
1500
N/A
> 6.5
N/A
DATE ANALYSES COMPLETED: 07 / 09 / 91
CERTIFIED BY RS
•
WHITE' DHS COPY / YELLOW. CUSTOMER COPY / PINK: LABORATORY COPY

;$
ATi y4§T M,
AME OF SY$T
>_ TYPE OF .SAMPLE:
COLLECTED ON:
,` b;fiZVERE r: JORDAN LAKE RECREATION :AREA'-
4,Qurnp;
06117 / 91 tMM/DDIYY)
....-
LOCATION WHERE COLLECTED: WELL #IW'33 CROSSWINDS AREA.
COLLECTED BY: THOMAS W. BILL
MAIL RESULTS TO'
Yir
241
1 .
CONTAM
CODE
0100
1005
1010
,y'1015-
1010:
191;'_:
1020
1022
1025
1028
1030
1
BILLS WELL DRILLING, INC.
800 McARMUR RD.
FAYErI'EVIT LE, NC 28311
•
TELEPHONE # ( 919 ) 4884-3740
METHOD
NAME CODE
TURBIDITY, ntu
ARSENIC, ,pg/i
.BARIUM,. rngi: •
'CAQMIUM mgi1:: .
mg/
=cHI4RI04, mg/I
CHF QMIUM, mg(' .•
COPPER, mg/I
•-I`LUpRIQE, tng/I •:• ..
:} :IRON,. mg/1 .
LEAD, mg/i
jGANESE' tngli
Efi30URY; mg11•
NIT>ATg,
104.5 °"sgirrgNIUM • gall t .
>. SaLY
1052
1Qf >API()ITY.
21095
18D5.. Q0(PF.:1 `:units
r'S•
18257= pH, Jnit$ :. "
y. !R27 `= 1, kr.1Ni:TY• m 11
,
AMpI.E UNSATISFACTORY;
DATE ANALYSESBEGUN: 06 -/ 18 / 91
COMMENTS E,1I ID#,5655
4
•
•
•
001
125
125
125 .. ..:r.
101 .r
128
125.
101
107
125••
125
`101
103 'a
121
'125
r<125
.:157.;
101
120
141::
135
142.
•
•
RESAMPLE
•
•
144OAKMONT DRIVE
OtMI,P).7?sP8;., ''4> ;.
. t1
.1 '' `;'4'AA.M_ iNITY
3.06
<0:010-'
<O:100':
>'.<004
54: 9GiC
DATE ANALYSES CO
CERTIFIER BY.'
WHITE: DHS COPY / YELLOW: CUSTOMER COPY / PINK: LABORAT
•
•
'COMMUNITY
wag
`iatt):
r41.11; 1QWABLE
r,•
LIMITS
9 / 91..

June 11, 1991

Raleigh Area Office

SUBJECT: Permit No. 87-4007, U.S. Army Corps of Engineers, Crosswinds
Campgrounds, Well Water System, Contract No. DACW54-87-C-0037, B. Everett
Jordan Dam and Lake, Chatham County, North Carolina

State of North Carolina
Department of Human Resources
Division of Health Services
Post Office Box 2091
Raleigh, North Carolina 27602-2091

Gentlemen:

Enclosed is the Permit No. 87-4007 and the Engineer's Statement for
the subject project.

Do not hesitate to contact this office if you have any questions.

Sincerely,

William T. Branager, Jr.
Authorized Representative
of the Contracting Officer

Enclosure

CF: Mr. Kevin MacNaughton
CESAW-EN-R/Mr. Glenn McIntosh

Engineers Statement

I, William T. Branager, Jr., Area Engineer for the Raleigh Area
Office of the Wilmington District, U.S. Army Corps of Engineers, having
been authorized to observe periodically, the construction of the project:

Project: Contract No. DACW54-87-C-0037, Crosswinds Campgrounds

Name or Location: B. Everett Jordan Dam and Lake, Chatham County, North
Carolina

for the Permittee hereby state that, to the best of my abilities, due
care and diligence was used in the observation of the construction such
that the construction was observed to be built within substantial compliance
and intent of the approved plans and specifications.

FOR THE UNITED STATES OF AMERICA:

Signature
Authorized Represent
the Contracting Office

Date: 11 June 1991

Permit No. 87-4007

North Carolina Department of Human Resources
Division of Health Services
P.O. Box 2091 Raleigh, North Carolina 27602.2091
James G. Martin, Governor Ronald H. Levine, M.D. M.P.H.
David T. Flaherty, Secretary State Health Director

Apri 27, 1987

Mr. Jaman Vithalani
U.S. Army Corps of Engineers, Wilmington District
P. O. Box 1890
Wilmington, North Carolina 28402

Re: Well Water System
Crosswinds Campground
B. Everett Jordan Dam and Lake
Chatham County

Dear Mr. Vithalani:

Plans and specifications for the references project prepared by Thompson-
Gordon-Shook Engineers, Incorporated have been reviewed by engineers of this section.
The plans call for the installation of a 32 gpm well #32 with 5 hp submersible well
pump, a 32 gpm well #33 with 5 hp submersible well pump and well house with well
head piping assembly on both wells; water treatment and storage building with three
(3) 13 gpm capacity each greensand filters (Kisco Model AMG-24), potassium permagnate
solution feeding system and gas chlorination system with apparatus; one 4,000 gallon
ASME coded hydropneumatic tank with automatic air-water volume controls, air compressor
and other accessories; 4-inch, 3-inch and 2-inch distribution water mains, valves and
other appurtenances to serve Crosswinds Campground. These plans and specifications are
approved under Division of Health Services serial number 87-4007, dated April 24, 1987.

One copy of the "Application for Approval..." is enclosed. One copy of the plans
and specifications bearing the Division of Health Services stamp of approval is being
fowarded under separate cover. One copy of each is being forwarded to the Chatham
County Health Department. The third copy is being retained in our permanent files.

If we can be of further service, please call on us at [phone].

Very truly yours,

James F. Stamey, Chief
Environmental Health Section

enclosures

CC: Frank Morris, Regional Engineer
Chatham County Health Department
Thompson-Gordon-Shook Engineers
Earl Eaton
N.C. Div. of Parks and Rec.

Department of Human Resources
Division of Health Services

Application For Approval of Plans
And Specifications For Water Supply
Systems

DATE April 24, 1981

SERIAL NO.
(DHS Use Only) (OHS Use Only)

To The Division of Health Services
Department of Human Resources:
The US Army Corps of Engineers
(name of board or council, authorized official and title, or owner)
of Wilmington District
(name of city, town, corporation, sanitary district, water company, or other)
in the County of New Hanover State of North Carolina authorized by law to
act for the said Wilmington District
(name of city town, corporation, sanitary district, water company. or other
and to expend its funds for the water project described below, herewith submit for the counsel and service
of the Division of Health Services plans and specifications prepared by Thompson- Gordon-Shook
Engineers Incorporated of 1215 Franklin Road, Raleigh, NC 27606
for the installation or construction of Groundwater Supply, Treatment and Distribution at
(describe project)
Crosswinds Campground, B. Everett Jordan Dam and Lake in
(location of project)
Chatham and herewith make application to the Division of Health Services
(county)
for the approval of such feature of said plans and specifications as relate to public health and the protection
of public water supplies.

These plans have been approved and accepted by the applicant.

This application is made under>and in full accord with the provisions cif Chapter 180A17 of the North
Carolina General Statutes, and such other statutes as relate to water systems. The applicant agrees that no
change or deviation from the plans and specifications approved by the Division of Health Services will be
made except with the written consent and approval of the Division of Health Services or its authorized
representative.

Remarks:

(Signature of Owner, Manager, Mayor or Chairman)

JAMAN VITHALANI
(Type or Print Name Signed Above)
PO Box 1890
(Street or Box Number)
Wilmington, NC 28402

These plans and specifications cited in the foregoing application are hereby approved insofar as the
protection of public health is concerned as provided in the regulations, standards and criteria adopted
under the authority of Chapter 130A-317 of the General Statutes, with the following provisos:

This approval is given with the understanding that upon installation of such works, its operation shall
be placed under the care of a competent person, and the operation shall be carried out according to best
accepted practice and in accordance with the recommendations of the Division of Health Services.

The official copies of plans and specifications accompanying this application have been sealed and
stamped with the serial number of this application 87-4007. Only such plans and specifications
are included in this approval and any erasures, additions or alterations of the proposed improvements will
make such approval null.and void.

Signed
James F. Stamey
Title: Chief. Environments Health Section

DHS 2136 (Revised 1/85)
ENGINEERING PLANNING