Drinking Water

Report

By: Christopher Vallier

&nb= sp;

= ;

Dri= nking Water Report

For

Waw= aitin Holiday Park

Prepared for:<= /span>

N= ORTHERN COLLEGE

Candice Kosick, Professor

<= span class=3DGramE>SSINVEST Northern Developments Inc.

Natalina Santos, Director

Prepared by:

Christopher Vallier, Student – Busi= ness Administration

March 27, 2006

Christopher Vallier

LT AL840 Wawaitin Falls

P.O. Box 1656

Timmins, Ontario

P4N 7W8

April 3, 200= 6.

SSINVEST Northern Developments Inc.

Mr. Tony Silva, = Chief Operating Officer

807 – 156 Enfield Place

Mississauga, ON= L5B 4L8

<= /o:p>

Dear Mr. Silva

Please find attached the compliance and procurement report discussed with the company’s corporate secretary in September, and for which we finalized the terms of reference on October 31, 2005.

The material= s used for research and analysis were primarily those you recommended. Additionally interviews were conducted and observations made during two site visits.

Your assista= nce and that of your staff was invaluable in the preparation of this report. Please express my thanks to everyone who helped.

I appreciate the opp= ortunity to have conducted this work on SSINVEST’s behalf. If you have any questions or require clarifications please contact = me. I look forward to working with you in the future.

= Cordially

Christopher Vallie= r

<= /o:p>

= Table of Contents

<= o:p>

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Executive Summary.. 1

Introduction.. 2

PURPOSE.. 3

SCOPE.. 3

SYSTEM BACKGR= OUND.. 3

DESCRIPTION OF REQUIREMENTS. 3

METHODOLOGY A= ND SOURCES. 4

DEFINTIONS. 4

PLAN OF PRESENTATION.. 4

CONCLUSIONS. 4

RECOMMENDATIO= NS. 5

Research and Analysis. 5

COMPARISON OF ONTARIO REGULATION 250/05 AND 170/03. 5

EVALUATION OF SOURCE AND DISTRIBUTION SYSTEM... 7

DISINFECTION OPTIONS. 7

U-V Treatment 7

Ozone Treatment 7

Chlorine Feed System.. 8

FILTRATION OP= TIONS. 9

Reverse Osmosis. 9

Ionized Carbon Filter. 10

Ion Exchange Resin Filter. 10

Table of Figures

Table 1:Comparative Regulations….=

Figure 1: Hypochlorite Generating System<= span style=3D'color:windowtext;display:none;mso-hide:all;text-decoration:none; text-underline:none'>.. 8

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Exe= cutive Summary

The water system at WHP which supplies its current operations does not fall under the definition of “public water works” as is it defined in the new Safe Drinking Water Act, S.O. 2002= and associated regulations to calendar year end 2005. It is a non-municipal seasonal residential drinking water system that does not serve designated facilities and is governed by regulation 252/05. see= Table 1

No treatment is required to the water made available to guests of WHP. While in operation, a testing program must be maintained. It is also recommended that an emergency chlorination system be installed to deal with the possibility of an adverse test result being obta= ined during the testing/operating season.

The planned expansion for the park may in= voke regulation 170/03, but only if the system extracts more than 50 000 liters = of water per day or ceases to be a seasonal operation (ex. not be closed for a minimum of 60 days in a 12 month period).

Total cost for an emergency chlorination = system is estimated at $1 500. Operating cost is next to nothing and yearly costs = for the testing program approximately $600.

For compliance with 170/03, complete inst= alled costs for Metcon Equipment $39 000. Yearly oper= ation and maintenance cost are estimated at $2 800 with additional costs for a testing program approximately $1 000.

Unless projected receivables warrant, it = is recommended that the park maintain its seasonal status.

Oversight of Reg. 252/05 is expected to be moved from the MOE’s water branch to local Health Units, in the fall of 2006.

Int= roduction

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PURPOSE

To prov= ide recommendations on the requirements for the provision of safe drinking wate= r to guests of a licensed tourism facility in accordance with Ontario’s Safe Drinking Water Ac= t, 2002.

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SCOPE

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To determine whether treatment is required for the drinking water supplied at = Wawaitin Holiday Park,

1. at current operat= ing capacity,

2. with expansion for overnight accommodations.

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SYSTEM BACKGROUND

The water system in use at the RV Park is operating and available to the public seasonally between May 1^st and October 3= 1^st each year. There are currently 18 sites with an estimated daily average consumption of 6 000 litres.

The expansion plans under development call for the pro= vision of an additional 30 sites and overnight accommodations for 48 guest in four= 2 bedroom cottages with kitchen and washroom and a motel type unit having 6 double rooms each with a washroom.

These additional facilities are estimated to increase = daily consumption by 34 000 litres per day.

WHP has implemented a testing program in collaboration= with Accuracy Environmental Laboratories Ltd and it has an MOE (Ministry of the Environment) drinking water system # 260058058.

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DESCRIPTION OF REQUIREMENTS

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To determine if the current water system at WHP is in compliance with the new government regulation 252/05, and if not what is required to rectify the situation. Also to advise as to the threshold crite= ria for invoking regulation 170//03.

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An evaluation of the source well and distribution system will be conducted aft= er a site visit and reported on with the aid of schematics, well records, and diagrams. This will be followed by a discussion of filtration and disinfect= ion options.

METHODOLOGY AND SOURCES

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P= rimary sources used in this report were company T.O.R., WHP well records, interview with property manager, S.O. Safe Drinking Water Act, 2002 and affiliated regulations. Inspection of existing source well and distribution system.

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S= econdary sources comprised mostly of published industry literature. It also included telephone interviews and correspondence with Porcupine Health Unit, Water Quality Branch of Ministry of Environment, and Metcon<= /span> Engineering.

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DEFINTIONS

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I. = ; Well means a public water supply well subject to Safe Drinking Water Act, S.O. 2002 c. 32 s. 1.

II. &nbs= p; Director means the Director of the Porcupine Health Unit and = or the Director of the Ministry of the Environment.

III. &n= bsp; Groundwater means well water that is not under the influence = of surface water.

PLAN OF PRESENTATION

The two main areas covered in this study are (1) is WH= P in compliance with the new government regulation and (2) an analysis of the co= sts of equipment and installations at WHP. This will be accomplished by Research and Analysis into the applicable Act and regulations, Options for Disinfect= ion and Filtration, and costs for any new required equipment.

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CONCLUSIONS

1. &= nbsp; &nbs= p; No treatment is required to supply safe drinking water to guests of WHP,

2. &= nbsp; &nbs= p; a mandatory testing program i= s required by O. Reg. 252/05 for the park’s current operations. The program in place appears to comply fully,

3. &= nbsp; &nbs= p; the existing filtration system = is capable of dealing with odor and cloudiness issues,

4. &= nbsp; &nbs= p; year round operations (not closi= ng for sixty days or more), and/or exceeding 50 000 liters per day usage will invo= ke O. Reg. 170/03,

5. &= nbsp; &nbs= p; the expansion plans as outlined= are not expected to exceed the daily extraction limit.

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RECOMMENDATIONS

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= ; Maintain current testing program,
= ; install emergency disinfection equipment,
= ; continue with current filtration program,
= ; remain a seasonal operation.

Table of Contents&nb= sp;

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Research and Analysis

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COMPARISON OF ONTARIO REGULATION 250/05 AND 170/03

B= oth of these regulations are designed to affectively provide the public with safe drinking water from small non-municipal systems.

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T= he primary differences between the two regulations are: (1) the availability of food services, (2) the daily maximum allowable consumption, and (3) the number of days open per calendar year. The foll= owing table summarizes these requirements:

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Table 1: Comparative Regulations

Summary of Requirements O. Reg’s. 170/03 & 252= /05
	<= span lang=3DEN-US style=3D'mso-ansi-language:EN-US'>Reg. 170/03	<= span lang=3DEN-US style=3D'mso-ansi-language:EN-US'>Reg. 252/05
Requirement=	Small Non-Municipal Non-Residential (e.g. church, mot= el, B&B, gas station, restaurant)	Non-Municipal Seasonal Residential (e.g. trailer par= k / campground, communal cottage system)
<= span lang=3DEN-US style=3D'font-size:9.0pt;font-family:Arial;color:black;mso-a= nsi-language: EN-US'>Testing	Drinking water samples must be sent to a laboratory licensed by MOE for testing. List of licensed labs
<= span lang=3DEN-US style=3D'font-size:9.0pt;font-family:Arial;color:black;mso-a= nsi-language: EN-US'>Installation of Treatment	Treatment equipment is required.	No treatment related requirements.
<= span lang=3DEN-US style=3D'font-size:9.0pt;font-family:Arial;color:black;mso-a= nsi-language: EN-US'>Corrective Action	Notify MOE Spills Action Centre at 1-800-268-6060 or (416)325-3000 and local Medical Officer of Health of adverse test results. Take corrective action as required by the regulation.
<= span lang=3DEN-US style=3D'font-size:9.0pt;font-family:Arial;color:black;mso-a= nsi-language: EN-US'>Record Keeping and Reporting	Records and documents retained as required by regulation. Annual reports required – Yes	Records and documents retained as required by regulation. Annual reports required – No
<= span lang=3DEN-US style=3D'font-size:9.0pt;font-family:Arial;color:black;mso-a= nsi-language: EN-US'>Microbiological Sampling in the Distribution System	Collect and submit samples to a licensed laboratory weekly or every 2 weeks, plus= one sample per month for each additional 100 hook-ups (E-coli / fecal coliforms, total coliforms and HPC testing	Collect and submit samples to a licensed laboratory every 2 weeks, plus one sample per month for each additional 100 hook-ups (E-coli and total coliforms only)
<= span lang=3DEN-US style=3D'font-size:9.0pt;font-family:Arial;color:black;mso-a= nsi-language: EN-US'>Microbiological sampling of the raw water supply	Collect and submit samples to a licensed laboratory monthly	Not Required
<= span lang=3DEN-US style=3D'font-size:9.0pt;font-family:Arial;color:black;mso-a= nsi-language: EN-US'>Sign Posting Option	Posting allowed, except for food service establishments	Posting not allowed (unless system is not using electricity)
Where sign posting is available MOE must be notified if signs are posted instea= d of testing. Notification to the Director of Posting Warning Notices
<= span lang=3DEN-US style=3D'font-size:9.0pt;font-family:Arial;color:black;mso-a= nsi-language: EN-US'>Chemical Sampling	Collect and submit samples to a licensed laboratory ranging from once every 3 mon= ths to once every 5 months	Not required

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T= he current testing program in affect at WHP is in compliance with O. Reg. 252/05 and no further action is required.

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O= wner / operators of non-municipal seasonal residential drinking water systems must: (1) obtain their own water from a well or surface water source, (2) not be municipally owned, (3) serve six or more communal cottages or campground wi= th six or more serviced hook up sites, (4) not operate the water supply for at least sixty consecutive days, and (5) not serve any designated facility (ex. Children’s camp, youth facility, private education facility, hostel or shelters).

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T= he testing requirements of O. Reg. 252/05 call for both oral and written notifications= of “an adverse water quality incident” (AWQI) to MOE Spills Action Center and the Director. The first, immediately after receipt = of adverse laboratory results, the latter in two parts, first, within 24 hours= of initial notice and second, within 7 days a report as to corrective action taken. The approved incident forms can be seen in Appendix C.=

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Table of Contents<= /a>

EVALUATION OF SOURCE AND DISTRIBUTION SYSTEM

A= n on site inspection of the ground water source and distribution systems revealed the following:

·<= /span> = The well head is well protected= at an elevation of 318 meters Datum,

·<= /span> = located at 48&d= eg; 20.270N 81° 29.224W,

·<= /span> = and approximately 83 feet East = of Kenogamissi Lake, a water reservoir on the Mattagammi<= /span> river.

·<= /span> = The distribution is housed in a= roofed facility and is comprised primarily of: (1) two 1000 liter pressure tanks, and (2) an Ion exchange resin filter.

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A= n analysis of the well record (see appendix A) revealed the following:

·<= /span> = three subsections of soils: (1) f= rom 0-30 feet sand and clay, (2) from 30-96 hard pan and boulders, and (3) from 96-1= 24 green rock,

·<= /span> = fresh water was found at 103 feet= and 118 feet,

· = six inch steel = well casing to 102 feet, well bottom at 124 feet, and submersible pump at 100 fe= et with continuous maximum pumping at 15 gallons per minute.

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DISINFECTION OPTIONS

There are three main types of disinfections options on the market today: (1) U-V treatment, (2) Ozone treatment, and (3) Chlorination.

Of the three options discussed, chlorination is the preferred treatment for the park.

U-V Treatment

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Ultra-violet (UV) treatment is the disinfection process of passing water by a special li= ght source immersed in the water in a protective transparent sleeve. The special light source emits UV waves that can inactivate harmful microorganisms.

Inactive microorganisms are not removed from the water source, UV treatment does not remove dirt and particles. The popularity of this sys= tem is basically that no chemicals are added to your ground water and distribut= ion system. Best use does not lend it to park use.

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Ozone Treatment<= /span>

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O= zone is an advanced technology for drinking water treatment by the US EPA . It is one of

the strongest disinfectants approved for potable water treatment capable of inactivating

bacteria, viruses, giardia and cryptosporidium. Ozo= ne is a relatively new treatment option which is most effective as can be seen be= low:

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· = Color, odor and= taste are reduced or eliminated,

· = efficient disinfection over a wide ra= nge of temperature and pH,

· = destruction of bacteria, viruses, spore= s, giardia and cryptosporidium with brief

contact<= /span> periods,

· = does not requir= e the on-site storage of other chemicals with the associated

hazards<= /span> and costs,

· = effective at reducing iron and mangan= ese,

· = reduces turbidi= ty and dissolved organic carbon by enhancing aerobic digestion

in filtration.

E= ven though a most effective disinfection method, it is most appropriate for large operations such as municipalities, therefore, not recommended for the park.=

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Chlorine Feed Sy= stem

Chlorination is a highly effective and the most widely used disinfec= tion system for human drinking water in the world. Its disinfectant properties k= ill virtual all microorganisms found in sources for drinking water. =

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An emergency chlorine injection system should be made available for short noti= ce use in the event of an adverse test result requiring immediate remedial act= ion. This system is available from Budget Water International Inc. and comprised= of three items: (1) PT4702-15 one series 100 kit including 220 VAC chlorine pu= mp, injector, and hoses, (2) PT4713 one 16 gallon chlorine solution tank, and (= 3) PT4713F one water flow control switch. The cost of the delivered product is nearly $1100 and incidental costs (installation and start up) are approxima= tely $400

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T= he equipment recommended by Metcon Engineering, co= nsists primarily of hypochlorite generating system with a chlorine injection capabilities, and an electronic panel with associated controls. (see in Appendix E). The quoted cost is $31 600 and the= re are additional on site preparation costs as well as training and certification costs of approximately $7 400.

Figure 1: Hypoc= hlorite Generating System

=

FILTRATION OPTIONS

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T= here are three primary means of filtration and each is best at the removal of varying substances. In the case of the park’s drinking water, there are two considerations that of iron removal and sulphur odors.

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T= hese three options are outlined below with the latter being recommended.

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Reverse Osmosis<= /span>

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Reverse osmosis systems purify water by forcing pressurized water through a very fi= ne, plastic membrane. During the initial filtration stage, water is pressurized= by what is called a booster pump which traps sand, silt, and sediments into a filter.

The second step, water is forced through a carbon filter removing the minerals = such as Iron, magnesium, and mercury. The pressured water then passes through the Reverse Osmosis module allowing only clean water through the membrane and into the storag= e tank where impurities are flushed out.

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F= inally, the water passes through another carbon filter to eliminate odors and smell= s. The reverse osmosis module is expensive and primarily used for large operat= ions and therefore, not recommended for the use at WHP.

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Ionized Carbon F= ilter

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T= here are two principal mechanisms by which activated carbon removes contaminants from water; absorption, and catalytic reduction, a process involving the attract= ion of negatively-charged contaminant ions to the positively-charged activated carbon. Organic compounds are removed by absorption and residual disinfecta= nts such as chlorine and chloramines are removed by catalytic reduction.

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A= ctivated carbon filtration is very common in residential water treatment systems. It= can be used as a standalone filter to reduce or eliminate bad tastes and odors, chlorine, and many organic contaminants in municipal (pre-treated or chlorinated) water supplies to produce a significantly improved drinking wa= ter.

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I= t is also very commonly used as a pre-treatment as part of a reverse osmosis system w= hich is are not being recommended. It is also not very effective in removing iron and heavy metals.

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Ion Exchange Res= in Filter

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I= on exchange resin filters can be used with most well water and can remedy two = of the most common problems being hydrogen sulphide smells and high iron content. This filtration type is one of the most effec= tive in moving suspended particles that cause water cloudiness.

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T= his is the recommended filtration option and the one currently used at WHP.

Bibliography

=

Sa= fe Drinking Water Act, S.O. 2002 c.32

Ontario Regu= lation 170/03

Ontar= io Regulation 252/05

Accuracy Labs - aelabs.ca

Prices for emergency disinfe= ction system - watertreatmentsup= ply.com

Prices for emergency disinfection system - budgetwater.c= om

Patricia Osterling - patriciao@metcomeng.com

Wojtek<= /span> Sawick= i, B. Eng. - wojtechs@metcomeng.com<= /a>

Natalin= a Santos - SSINVEST Corporate Secretary

JC Santos - WHP Property Manager

Sarah Momy - Sarah.= Momy@ene.on.ca

Ministry of Environment - Safe Drinking = Water Branch

Table of Contents

Appendix A

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Appendix B

Non-Residential and Non-Municipal Seasonal Residential Systems That Do Not Serve Designated Facilities Regulation O. Reg. 252/05

&nb= sp;

Notice of Adverse Test Results and Other Problems =

&nb= sp;

S= ECTION 1 –WRITTEN NOTICE BY LABORATORY

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Indicators of Adverse Water Quality	Microbiological ٱ	Physical/Chemical ٱ CofA/Or= der ٱ
Oral Notification to SPILLS ACTION CENTRE=
Person Contacted:	Date:	Time:
Person Notifying:	AWQI Notification No (s)
Laboratory Name:	Laboratory Emergency Contact Name
Address	Position
Telephone # of Lab( )	Phone #( )	Fax # ( )
Drinking-Water System (DWS) Name	DWS Emergency Contact
DWS (Waterworks) #	Name
Location	Position
Telephone # of DWS ( )	Phone #( )	Fax # ( )
Oral Notification to Drinking-Water System Owner=	Oral Notification to Local Medical Officer of He= alth or Director
Person Contacted	Person Contacted
Position	Position
Date	Time	Date	Time
Laboratory Written Notification Prepared by: (Lab Results must be attached using Section3of t= his form)
Signature	Date

(PI= BS 5140e Version June, 2005)

Non-Residential and Non-Municipal Seasonal Residential Systems That = Do Not Serve Designated Facilities Regulation O. Reg. 252/05

S= ECTION 2(A)–WRITTEN NOTICE BY DRINKING-WATER SYSTEM OWNER

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Indicators = of adverse water quality	*Microb= iological*	*Physic= al/Chemical C of A/Order*
= Was a Warning Notice Posted if E. coli result: = Yes No	Details of adverse result (parameter of conc= ern and amount):
AWQI Notifi= cation # (s)
Drinking-water system(waterworks) na= me	Corrective action(s) taken or to be taken by owner/accredited operating authority(Staff informed of required corrective action(s)):
Drinking-water system(waterworks) # =	Resample & test	Yes No
Oral Notification to Medical Officer of Health	= Disinfectant restored/increased	Yes No
Person Contacted	Mains/pipes flushed	Yes No
Position	Users advised to boil water/seek alternate source	Yes No
Date	Time	Other corrective actions(example: prescribed by medical officer <= /p> of health and/or other actions taken= or to be taken) describe:
Phone #	Fax #	Additional information attached□
DWS person providing oral notificati= on
Oral Notification to Spills Action Centre=	DWS Emergency Contact
Person Contacted	Name
Date	Time	Position
DWS person providing oral notificati= on	Phone #	Fax #
DWS written notification prepared by= :	Alternate Phone # (if applicable)
Signature	Date	Phone #

SECTION 2(B) – NOTICE OF ISSUE RESOLUTION (Sect. 4-7 O. Reg. 252/05) <= /b>

Date Resolved:

Date Resolution Notice Provided:

Summary of Action taken and Results Achieved (include test results showing water quality is no longer adverse) =

Prepared by:

Signature:

Date:

=

=

=

=

Notice of Issue Resolution at O. Reg. 252= /05 Drinking Water Systems (PIBS 5140e Version June, 2005)

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Appendix= C



Appendix D

CLORTEC

T es

♦ Eliminate safety hazards

♦ Reduce operating costs

♦ Improved water quality

♦ Low raw material usage

♦ RMP & PSM exempt

♦ Guaranteed performance

♦ Superior warranty

♦ NSF 61 Certified

Introduction

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O= n-site sodium hypochlorite generation is unparalleled in safety and cost efficienc= y. CLORTEC on-site systems generate 0.8% sodium hypochlorite by combining thre= e

common consumables: salt, water and electricity NaCl += H2O +2e =3DNaOCl +H2 (Salt +Water Power =3DSodium Hypochlorite +Hydrogen) CLORTEC T systems easily control sodium hypochlorite production and provide a powerful disinfection method for any application. T systems meet requirements for 2 to 36 ppd (0.9 = to 16 kg) chlorine equivalent. Applications include potable water, wastewater, odor and corrosion control, cooling towers, oxidation = and swimming pool disinfection.

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T= he CLORTEC T Series is component based and consists of a modular configuration. This design allows for ease in serviceability and expansion potential. The prima= ry components may be arranged to optimize available space and systems may be custom designed for unique applications.

Appendix E

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ON-SITE SODIUM HYPOCHLORITE INJECTION/GENERATING SYSTEM

QUOTATION NO#: E22-6652-WS/DH-2

Metcon= Sales and Engineering Limited is pleased to submit a quotation for = the supply of the equipment

described herein:

ITEM#1 – ON-SITE SODIUM HYPOCHLORITE GENERATING SYSTEM

System Includes:

Item# A – STS T-SERIES GENERATING SYSTEM

Description:

- Qty One (1) 6PPD titanium electrodes with sight glass, brine proportioning pump and

mounting shelf, temp/level sensors and hydrogen vent mounted on a PVC board<= /span>

- Qty One (1) Control cabinet with:

o Powder coated carbon steel, NEMA12 enclosure

o Two line alpha numer= ic display

o GE OCS PLC

o Power supply<= /p>
o All necessary I/O po= ints

o Safety Interlocks

- Qty One (1) 20 Micron 10” inli= ne filter in clear PVC housing

- Qty One (1) Electric water heater

- Qty One (1) Spare electrolytic cell level and temp. switch assembly

- Qty One (1) 300L brine tank
- Qty One (1) 500L hypochlorite storage tank

- Qty One (1) Water Softener (automatic regenerating)

Item# B – CHEMICAL FEED SY= STEM

QUANTITY ONE (1) HIGH DENSITY PO= LYETHYLENE METERING PUMP PANEL, PREMOUNTED,

PRE-PIPED FOR LOW FLOW CHLORINAT= ION, PRE-WIRED AND PRESSURE

TESTED (24 HRS), WITH ONE CHEMICAL INJECTION POINT, = AS SUPPLIED BY METCON

SALES AND ENGINEERING=

INCLUDING THE FOLLOWING COMPONEN= TS:

ITEM A Metering Pumps=

Qty One (1) ProMi= nent Model GALa1008NPB9, Solenoid Driven, Diaphragm Metering Pumps

- Microprocessor based electronics

- LCD display of operating status

- 4-20 mA External Analog Control

- Rated 6.3 LPH at max back pressure 145 psi

- Auto-degassing Liquid End

- Fault annunciating relay

- On/Off Keypad

- Remote on off capability

- Manual stroke length adjustment 0-100 % electrical readout

- Diaphragm of PTFE faced EPDM with nylon reinforcement and steel core

- LCD display that shows flow rate, frequency, stroke rate and stroke length

- Includes Foot Valve, Injection Valve and 2 M control Cable

ITEM B Accessories Package

- Qty One (1) Backpressure valve

- Qty One (1) Pressure relief valves

- Qty One (1) Lot of Isolation ball valves

- Qty One (1) Pressure gauge, with diaphragm isolators, pre-mounted

- Qty One (1) 100 ml Calibration column, pre-mounted

- Qty One (1) Corporation stop, to be installed at injection point

- Qty One (1) Flow monitor for continuous chemical feed ability.

METCON SALES= AND ENGINEERING LIMITED

Wojtek Sawicki, B. Eng.

Inside Technical Sales

METCON SALES & ENGINEERING<= /p>
905-738-2355 x289

wojciechs@metconeng.com

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Table of Co= ntents

RECEIVED

SSINVEST Northern Developments Inc.

Date:   November 14, 2005 Name and Signature:

Per:

        Tony Silva

=

Date Resolved:	Date Resolution Notice Provided:
Summary of Action taken and Results Achieved (include test results showing water quality is no longer adverse) =
Prepared by:	Signature:	Date:
=	=	=	=