EVALUATION

Of the

TENNESSEE WATER SUPPLY PROGRAM

Bureau of Water Hygiene
Environmental Protection Agency

Region IV
January 1971


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EPA

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EVALUATION
OF THE

TENNESSEE WATER SUPPLY PROGRAM

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®	US EPA

Headquarters and Chemical Libraries
c-O	EPA West BkJg Room 3340

Mailcode 3404T

4=P	1301 Constitution Ave NW

Washington DC 20004
202-566-0556

BUREAU OF WATER HYGIENE
ENVIRONMENTAL PROTECTION AGENCY
REGION IV

JANUARY 1971


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i

PREFACE

This report presents the Bureau of Water Hygiene's
findings, conclusions and recommendations, with
supporting data and explanatory text of the study
of the Tennessee drinking water supply program.

The information contained herein has been condensed
and the significance of the findings is further
discussed in a companion report EVALUATION OF THE
TENNESSEE WATER SUPPLY PROGRAM - SUMMARY. The
SUMMARY highlights important results and areas of
major need for all those who have an interest in
Tennessee's drinking water but who do not wish to
study the numerous details of the complete report.


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ii

TABLE OF CONTENTS

Page No.

PREFACE 		t

SUMMARY OF FINDINGS AND CONCLUSIONS 	 1

RECOMMENDATIONS 		9

INTRODUCTION 		13

SCOPE 		15

Water Supplies in Tennessee				15

Water Supplies Studied	!!!!!!	15

Figure 1 - Location of Water Supplies Surveyed .	17

Program Evaluation 	

EVALUATION CRITERIA		21

Water Quality		21

Facilities		*		22

surveillance	•••• .ill! 1!!!".!!!!! 1!!!!!!! 1! °!	24

other criteria	••!!!!!!!!!!!!!!!!!!!!!!!!!!!!	25

FINDINGS ;			27

Water Supply Status			 		27

water Quality	!!!!!!!!! !!!!!!!!!!!!!!!	27

Facilities 	!!.!!"**		29

Fluoride Practice	32

Operator Competence 				33

Surveillance.		!!!!!!	^

Water Supply Program			37

Authority	 					37

statute 		••~...!!!!!"!!!!****!****!!	37

Regulations			39

Policy		!!!!!!!!!!!!!!!!"!!!!	40

Resources 				41

organization 	!!!!!!!!!!!!!!!!!!!!!!!	41

Figure 2 - Tennessee Department of

Public Health 		42

Division of Sanitary Engineering 		41

Figure 3 - Division of Sanitary

Engineering Staff .........	43

Table I - Sanitary Engineerlag

Professional Staff Qualifications ....	45

Other Assistance 					47


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iii

TABLE OF CONTENTS

Page No.

FINDINGS (CONT'D)

Activities 				^8

Engineering	

Laboratory						|

Bacteriological 		^

Chemical 		56

DISCUSSION 		61

Public Health Risk		 •	61

Water Supply Deficiencies	• •••	61

Waterborne Disease 			62

Program Meeds 	..		63

Authority 							63

Statute 							63

Regulations 						68

Policy		73

Activities							73

Engineering 					73

Laboratory			...»		79

Bacteriological 				79

Chemical 	

Data Processing			

Resources ..........			»»«•	87

Organization 				87

Personnel Requirements 	

Figure 4 - Proposed Staffing Chart -

Division of Water Supply ••	9^

Budget Requirements 					91

Table II - Proposed Budget - Division

of Water Supply		9^

PARTICIPANTS 		96

ACKNOWLEDGEMENTS 		97

APPENDICES 				99

A.	Public Water Supply Survey Data 				

B.	Semi-Public Water Supply Report	• •••	^

C.	Individual Water Supply Data 		

D.	Fluoride Practice 			1-51

E.	Water Supply Code and Regulations 		171

F.	Bacteriological Laboratory Survey			183

G.	Waterborne Disease Occurrence			203

REFERENCES 							207


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SUMMARY OF FINDINGS AND CONCLUSIONS

Recognizing that the health of over 3.9 million people in Tennessee
is directly dependent upon the condition of their drinking water,
Dr. Eugene W. Fowinkle, Commissioner, Tennessee Department of Public
Health, requested that the Bureau of Water Hygiene evaluate the
Department*3 Water Supply Program. This report presents the Bureau
of Water Hygiene's findings, conclusions and recommendations, with
supporting data and explanatory text of that evaluation.

Approximately 3 million people in Tennessee are served by 445 public
water systems, Another 900,000 rural residents obtain their drinking
water from individual water systems* In addition, there are about
800 "semi-public11 systems at restaurants, service stations, recre-
ational facilities, amusement parks, etc. and as many as 3.8 million
residents and traveling public may be exposed to this water at one
time or another daring a year's tine*

The effectiveness of the Tennessee Water Supply Program was judged
primarily on the bases of drinking water quality, adequacy and
condition of water system facilities, and water supply surveillance.
Thirty-nine (39) public, 64 "semi-public" and 571 rural, individual
water supplies, representing a cross-section of water supply practice
in Tennessee, were selected for study. Theses a^eava,,	oypr

50 per cent of the State's population.


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2

The principal findings and conclusions of the study are:

WATER SUPPLY STATUS

Water Quality-Bacteriological

Thirty-one (31)^pejrecent of the public water
systems examined did not meet bacteriological
standards one or more of the past 12 months.

These systems serve approximately 28,730 people.

Fifty-nine (59) per cent of the rural, individual
supplies examined failed to meet bacteriological
standards and fecal contamination was confirmed
in three-fourths of these cases. These systems
serve approximately 1,680 people.

Nineteen (19) per cent of the "semi-public" systems
examined failed to meet bacteriological standards
and fecal contamination was confirmed in three-
fourths of these cases. It is estimated that as
many as 41,070 people (State residents and the
traveling public) may be exposed to this water durir
one year's time.

Water Quality-Chemical

Five (5) per cent of the public water systems
examined did not meet mandatory chemical
drinking water standards. These systems serve
approximately 179,800 people.


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3

Two (2) per cent of the rural, individual water
supplies examined failed to meet" one or more
mandatory chemical drinking water standards.

These supplies serve approximately 57 people.

Thirty-three (33) per cent of the public water
systems examined did not meet one or more of
the chemical drinking water standards. These
systems serve approximately 926,500 people
with less than desirable or aesthetically in-
ferior drinking water.

Twenty-six <26) per cent of the coral, individual
water systems failed to meet one or more of the
recommended chemical standards. These systems
serve approximately 74Q people.

Thirteen 1(13))ejrer cent;of thisVsemjLapub 1 ic'!ysystems
were judged to provide aesthetically inadeslsable
water. As many as 189,736 people	-rwn-aetits

and the traveling public) may be exposed to tkis
water during one year's time.

Facilities

Sixty-seven (67) per cent of the public water
systems needed additional treatment facilities
ana oz per cent neeaea important cnanges m kite


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operation of present facilities. Without these
additions and changes, continuous protection of
safe drinking water may not be maintained.

None of the 24 public water supply fluoridation
programs evaluated were fully acceptable. Only
50 per cent of the systems were fluoridating at
the proper level, thus significantly reducing
dental health benefits.

Thirty (30) per cent of the public supplies and
46 per cent of the "semi-public" supplies examined
which chlorinate did not provide a detectable chlorine
residual in all parts of the distribution system.
Unsatisfactory chlorination practice removes the
margin of safety against disease transmission
through drinking water.

Twenty-eight (28)r per-cent oft the public„K.a£e£ systems
examined had inadequate distribution system storage
and 21 per cent had inadequate water pressures in
some or all areas of the distribution system.
Seventy-two (72) per cent had inadequate cross-
connection control programs. Flawless treatment
avails nothing if the distribution system does not
deliver adequate water for essential health needs or
permits entrance of hazardous substances through
cross-connections or other system deficiencies.


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Eighty-four (84) per cent of the."semi-publie systems
rated overall less than "satisfactory" and 66 per cent
needed additional treatment. Nine (9) per cent had
visible sanitary defects, which clearly present the
potential for dangerous contamination.

Nearly every one of the rural, individual systems
examined had one or more facility deficiencies.

Very few of these systems were constructed to pre-
vent entrance of contamination.

Operator Competence

Thirty-one (31) per cent of the public water supplies
examined were maintaining inadequate operational records.

Thirty-six (36) per cent of the public water systems
evaluated had only part-time operators and 33 per cent
of public water supply operators were not certified
by the Tennessee Department of Public Health. Most
of these systems also had water quality problems
and/or facilities deficiencies.

Surveillance

Fifty-four (54) per cent of the public water systems
evaluated did not meet bacteriological surveillance
standards and 80 per cent had not had a chemical
evaluation during the past three years. Forty-one
(41) per cent had not been rated by a representative


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of the Tennessee Department of Public Health during
the previous twelve months. Without health agency
surveillance, hazardous conditions will persist
undetected and uncorrected.

Seventeen (17) per cent of the "semi-public" water
systems evaluated had not had a health agency visit in
the previous two years. These visits do not include a
full inspection of facilities and operational practices.

WATER SUPPLY PROGRAM

The funds expended for drinking water protection in Tennessee are
totally inadequate to support a comprehensive program. The Division
of Sanitary Engineering administers the program with a budget of only
$69,500. Even taking into consideration laboratory support provided
by other programs, less than 3-1/3 cents per capita per year is spent
to protect drinking water.

Staff limitations have prevented the Water Supply Program from ful-
filling its responsibilities. Evaluation of Tennessee water supply
practice indicates many supplies are deficient and present a high
risk to the public. Due to the fact that only 3-1/2 man years of
Professional Staff time is available, important Water Supply Program
activities are not being performed or are being performed only in a
cursory manner seriously reducing the effectiveness of the program.
A Water Supply Program conducted in this manner creates a false
sense of security.


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7

The Department of Public Health has been reluctant to issue compliance
orders for correction of water supply system deficiencies when such
deficiencies were found a menace to public health. The penalty for
violating the water supply code is insufficient.

Current Water Supply Regulations were issued by the Tennessee Department
of Public Health in 1945 and have not been updated since, except for a
special fluoride provision which was added in 1963. Raw and finished
water standards for bacteriological, chemical, and physical drinking
water quality are not specified in the regulations. No provision is
made for the orderly development of new public water supplies nor are
the general types of water systems which constitute a public supply
defined.

The Division of Sanitary Engineering's water supply policy is contained
in a number of publications and documents. The lack of a single, com-
plete policy document has caused problems for water supply program
staff and waterworks officials, alike.

Eighty-five (85) public water systems perform their own bacteriological
analyses. Only seven of these laboratories have been certified by the
Department of Public Health. Review of noncertified laboratories
revealed unacceptable laboratory procedures. These laboratories have
created a false sense of security and the effectiveness of overall
operational vigilance has been reduced as a result.

Operator training activities have reached a majority of the public
water supply operators. Nevertheless, system and operational


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8

deficiencies indicate that recommended waterworks practice and
public health protection are not being universally applied.

An immense quantity of data must be accumulated, processed and
analyzed for the successful management of a water supply program.

This important activity, now being done entirely by "hand" and
consequently too time consuming for experienced professional
personnel, is seldom given proper attention.

The Division of Sanitary Engineering, Tennessee Department of Public
Health, administers the State's Public Water Supply Program. However,
the Tennessee Camp Sanitation Act administered by the Department's
Division of Environmental Sanitation and the Tennessee Department of
Conservation's Divisions of Water Resources, and Hotel and Restaurant
Inspection have water supply responsibilities which parallel and
somewhat duplicate those delegated to the Division of Sanitary
Engineering.

*****

In summary, the Tennessee Water Supply Program is not providing the
health evaluation and engineering services necessary to fulfill its
responsibilities to protect the health of the citizens of Tennessee.
To properly provide such services, the following recommendations
are made.


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RECOMMENDATIONS

It is recommended that:

1.	The Water Supply Program be elevated to full Division status
in the Bureau of Environmental Health Services with a minimum
annual budget of $510,000. These funds should be used for:

a.	Water Supply Activities $384,000

b.	Laboratory Services	126,000

Total	$510,000

2.	The Division of Water Supply be initially staffed with a
minimum of 11 professionals, 4 sub-professionals and 7
secretaries.

3.	Water Supply activities be further decentralized by assign-
ment of an Assistant Director and staff of five to the
Knoxville Regional Office and establishment of a new Jackson
Regional Office with an Assistant Director and staff of two.

4. Two bacteriologists and one secretary be hired by the Division
of Water Supply and assigned to the Division of Laboratories
for certification of water laboratories. Similarly, three
chemists and one secretary be hired and assigned to the
Division of Stream Pollution Control Laboratory for drinking
water chemical analyses.


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The Water Supply Regulations be revised and expanded to
more comprehensively reflect current recommended water
supply practice. The following specific features should
be included:

a.	Quality standards for raw and finished drinking
water.

b.	Mandatory disinfection of all water systems
serving the public.

c.	Mandatory certification of all public water
supply operators.

d.	All water systems serving the public be desig-
nated a "Public Water Supply" subject to all
regulations pertaining thereto.

e.	Provide for orderly development of new supplies.

f.	Require that water system plans and specifica-
tions be prepared by registered professional
engineers.

g.	Require that an individual or group be desig-
nated legally responsible for each Public Water
Supply.

A single document be prepared and distributed which presents
all current Tennessee Water Supply Program Policy. Provi-
sion should be made for updating this document as policy
revisions occur.


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J. The Division of Water Supply increase and improve its
surveillance of Drinking Water Supplies to at least the
minimum levels set forth in the Public Health Service
Drinking Water Standards and Manual for Evaluating Public
Water Supplies. These activities should include, but not
necessarily be limited to:

a.	Thorough periodic sanitary surveys of each
system, setting priorities and time schedules
for improving those systems having deficiencies.

b.	Bacteriological surveillance sufficient to
check laboratory analyses provided by the larger
public water supplies, and in the case of small
systems without laboratories, bacteriological
surveillance sufficient to meet recommended
Standards.

c.	Complete routine chemical analyses of all
drinking water.

8. All water plant laboratories be certified by the Tennessee
Department of Public Health as to their capability of per-
forming "official" bacteriological analyses.

9. Automatic data processing techniques be employed for
storage, analysis, and retrieval of wat^r supply data.


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Provision be made for close coordination between the
Division of Water Supply and other State governmental
functions which may affect water supplies. These include:

a.	The Division of Water Resources and the
Division of Hotel and Restaurant Inspection,
Department of Conservation.

b.	Other Divisions of the Environmental Health
Services.

c.	Local health departments.

Regulations of other State agencies should reflect that
principal authority for regulation of public water sup-
plies rests with the Division of Water Supply.


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INTRODUCTION

This Evaluation was conducted to determine the effectiveness of the
Tennessee Water Supply Program, and if necessary, to recommend such
improvements as may be needed to assure safe, wholesome drinking
water for the residents of Tennessee.

The study was undertaken by the Bureau of Water Hygiene, Environ-
mental Protection Agency, at the request of Dr. Eugene V. Fowinkle,
Commissioner, Tennessee Department of Public Health, who recognized
the importance of water supplies to public health and suggested that
such an evaluation would render a useful service to the Department.

BACKGROUND

State Board of Health concern about public water supplies can be
traced back to an 1884 committee appointed by the Board to investi-
gate water supplies. A continuous water supply program began in
1919 with a Public Health Service Engineer on detail to Tennessee
and acting as State Sanitary Engineer. In 1921 the State General
Assembly established the Division of Sanitary Engineering for water
supply and sewerage control. The number of people served by pub-
lic water supplies multiplied in the ensuing years, and in 1945
the present Water Supply Code was adopted, which gave the Division
legal authority to conduct a water supply supervision program.

While other environmental health functions have been added to and
removed from the Division through several reorganizations, the Water


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Supply Program has remained. The latest reorganization, effective
July 1, 1968, created the Bureau of Environmental Health Services
with Sanitary Engineering one of its five Divisions,

PURPOSE OF EVALUATION

Specifically, this evaluation attempted:

1.	To ascertain the present condition of Tennessee's water supplies
through inspections of treatment plants and distribution systems
bacteriological, chemical, and radiochemical laboratory analyses
of water samples; and, examination of pertinent data recorded in
Department of Public Health files.

2.	To determine the adequacy of legal statutes, budget, manpower
resources, regulations and policies, laboratory support, surveil-
lance, and operator training.

3.	To review the effectiveness of the Water Supply Program in the
light of the present condition of the State's water supplies,
and to make recommendations as to what additions and revisions
should be made to assure adequate health protection for the
drinking water supplies of Tennessee.


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SCOPE

WATER SUPPLIES IN TENNESSEE

According to the 1970 census, 3,924,164 people reside in Tennessee.

About 3 million of these people are served by 445 public water
supplies. Many of the remaining 924,164 people live in rural areas
and obtain their drinking water from individual water systems. In
addition to the public supplies, there are an estimated 800 water
systems generally known as "semi-public" which may serve as many
as 3.8 million residents and traveling public at restaurants, ser-
vice stations, recreational facilities, amusement parks, trailer
courts, and other similar establishments.

WATER SUPPLIES STUDIED

In discussion with Mr. James L. Church, Jr., Assistant Commissioner
for Environmental Health Services and Mr. Julian R. Fleming, Director,
Division of Sanitary Engineering, it was agreed that the study would
generally follow the procedures used by the Bureau of Water Hygiene
in its National Community Water Supply Study. The principal objec-
tive was to evaluate the total Tennessee Water Supply Program, and,
if necessary, recommend improvements to assure safe, wholesome,
drinking water for the residents of Tennessee.

It was agreed that investigation of a representative number of water
supplies was sufficient to judge the effectiveness of the Tennessee
Water Supply Program. A sample of public, "semi-public" and individual


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water supplies was selected for study. The technique used for
selection was not intended to provide a perfect random sample.
However, the results are considered to reasonably represent water
supply practice in the State.

Five public water supplies were selected from each of the eight
State Comprehensive Health Planning Regions on the basis of size,
type of source, and treatment. These 40 supplies (later reduced
to 39*) provide a cross-section of the State's public water supply
practice and represent about one-tenth of all public supplies in
the State. It is estimated that these 39 systems serve over
1,725,000 people or about 58 per cent of all those served by public
water supplies. Five of the systems provide drinking water for
commercial passenger carriers operating interstate. The number
of interstate travelers so served is unknown. A list of the
systems surveyed is tabulated in Appendix A and their location is
shown in Figure 1.

Seventeen (17) of the 39 public water supplies selected for study
adjust the fluoride content of their water for dental health protec-
tion. A special fluoride study was made of these and seven other
systems, which were selected to provide a representative sample of
the fluoride practice in the State.

For the purpose of evaluating "semi-public" water systems, three
counties were selected for study, one in each of the geophysical

* One system deleted because extensive modifications were under
construction.


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1

LOCATION OF WATR SUPPLIES SURVEYED

¦AST

•a

\
t

/

•7 rJ

VZ7

•I

Rutherford

)

k

>39

• 34	)

»*r -i .n
•»

• Pubtc water supply surveyed (Sm table I, appendix A for supply nam* corresponding to number)

County surveyed in rural, individual supply investigation
County surveyed in semi-public supply investigation

§) Nashville-Water Supply Program Headquarters Office

(e) KnoxviHe Regional Office

0 Proposed Jackson Regional Office


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18

provinces of the State. The counties were Sevier in the east,
Wilson in the central, and Fayette in the western part of the
State. Sixty-four (64) "semi-public" water systems were surveyed,
and this represents approximately eight per cent of the estimated
800 supplies in this category.

It is estimated that perhaps as many as 3.8 million* residents and
travelers may drink water from this type of supply at some time
during the course of a year.

Rural-individual water supply practice was investigated in three
other counties, again one each in the State's three geophysical
provinces. The counties in which rural water supplies were
studied were Grainger in the east, Rutherford in the central, and
Haywood in the western part of the State. Five hundred and
seventy-one (571) individual water systems were surveyed. These
systems served approximately 2,850 people or about 0.3 per cent
of those served by individual water systems in the State.

PROGRAM EVALUATION

The basic water supply Statute, regulations, and program policies
were reviewed. The Water Supply Program's activities, responsive-
ness to water supply problems, and staffing were also examined. A

* The bases for this estimate may be found in Appendix B.


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19

two-day and a three-day waterworks operators training course were
monitored. Reported water-borne disease outbreaks were studied.
Additionally, many residents, waterworks personnel, municipal
officials, health officials and others were interviewed.

Four bacteriological laboratories were surveyed and evaluated.
These included the Department's Central Laboratory, a large
water treatment plant previously certified by the Health Depart-
ment, and two water treatment plant laboratories not previously
certified. The Department Water Chemistry Laboratory and its
chemical surveillance program were also studied.


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EVALUATION CRITERIA

The effectiveness of the Tennessee Water Supply Program was gauged
to a large degree on the bases of drinking water quality, adequacy
and condition of water system facilities, and water supply surveil-
lance.

Water Quality

Bacteriological quality of public water systems was judged by
comparing the previous 12 months bacteriological record filed
with or observed by the Health Department, with Public Health Ser-
vice Drinking Water Standards. Any system failing to meet the
bacteriological limits one or more of the past 12 months was con-
sidered to have failed the bacteriological standard. Since the
Water Supply Program does not routinely sample "semi-public"
and rural, individual water systems, they were judged on the
basis of bacteriological samples collected during the field
visit and examined by Health Department Laboratories. Any system
having total coliforms in concentrations of 4/100 ml or more and/or
having fecal coliform bacteria was considered to have failed the
bacteriological standard.

Chemical quality of public water supplies was judged on the basis
of water samples collected from the water treatment plant and from
two or more locations near the extremities of the distribution
system. Carbon filter and pesticide samples were also collected


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22

at treatment plants utilizing a surface water supply source. The
samples were analyzed by Bureau of Water Hygiene and Bureau of
Radiological Health Laboratories.

Each sample was compared singularly to the Public Health Service
Drinking Water Standards and determined as either:

1.	Meeting the Standards for all constituents, or

2.	Not meeting one or more "recommended" constituent limit
(some are aesthetic parameters), but meeting all "mandatory"
constituent limits, or

3.	Not meeting one or more "mandatory" constituent limit.

The chemical quality of rural, individual water systems was judged
on the basis of chemical samples collected at the time of the field
visit and analyzed by the Bureau of Water Hygiene Laboratory similar
to the procedure used for public water systems. Unfortunately, labo-
ratory resources were not available to run chemical analyses on the
"semi-public" water systems. These were judged primarily on the
basis of aesthetic acceptability (color, taste, odor, etc.)

Facilities

Public water supply source, treatment, operation and quality con-
trol were judged on the bases of the Manual for Evaluating Public
Drinking. Water Supplies and the Drinking Water Standards using the
same interpretation as in the Community Water Supply Study for
uniformity.


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23

Source

Quality of the source was judged where possible by chemical
analyses, and also by past experience of the treatment plant
operator. Quantity was judged by historical experience and
current water demands. Source protection was judged by the type
of source, and potential and/or actual problems.

Treatment

Treatment was judged on the bases of the facilities and their
operation (as observed on the day of the field visit), bacteriolo-
gical records and chemical analyses. Disinfection was judged
on the presence of a detectable free chlorine residual in all
parts of the distribution system.

Distribution System

Finished water storage was judged adequate if elevated or
non-pumped storage equaled or exceeded the system's average
daily demand. Pumped storage was considered only where on-site
internal conbustion or steam auxiliary powered pumping equipment
were available. A distribution system pressure of at least 20
psi in all parts of the system was considered adequate for the
purpose of this study. However, a minimum of 25 psi is considered
desirable to insure optimum operation of all plumbing fixtures.

Quality Control

Record keeping practices were judged by records maintained at
the water treatment plant or water treatment plant operator's


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24

office and available for inspection at the time of the field
visit. The cross-connection control program was judged from
the ordinance, program implementation and progress toward
eliminating hazards.

As shown in Table III, Appendix A, water system facilities
were divided into ten categories for examination and rating.

Each system was then assigned a Risk Factor ranging from 0 to
10 which reflects the number of facility deficiencies found.

Zero facility deficiencies ("0" Risk Factor) indicates least
or little risk. Ten facility deficiencies ("10" Risk Factor)
indicates most or high risk.

"Semi-public" and rural, individual water systems were judged
on the basis of the Manual of Individual Water Supply Systems in
addition to the references already cited. The adequacy of these
facilities was judged on the basis of a sanitary survey accom-
plished at the time of the field visit.

Surveillance

Water supply surveillance was judged on the bases of the Drinking
Water Standards and the Manual for Evaluating Public Drinking
Water Supplies. Bacteriological surveillance was considered
satisfactory if the average number of bacteriological samples
examined per month during the preceding 12 month period met the
minimum number specified by the Drinking Water Standards and


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25

monthly samples were routinely examined. Chemical surveillance
was considered satisfactory if chemical constituents (as dis-
tinguished from normal in plant operational checks) were examined
within the past three years and there was no record of significant
problems. For the purpose of this survey, a rating by Division
of Sanitary Engineering personnel sometime during the preceding
12 months was considered satisfactory. More frequent inspection,
however, is considered necessary for optimum surveillance.

Other Criteria

Bacteriological laboratories were judged on the basis of the
Public Health Service Manual entitled, Evaluation of Water
Laboratories and Standard Methods. Chemical laboratory
procedure was also judged by Standard Methods.

The adequacy of operator training was judged by the absence
or presence of operational and quality control deficiencies.


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27

FINDINGS
WATER SUPPLY STATUS

Water Quality

The bacteriological quality of Tennessee water supplies is reflected
by the following:

Thirty-one (31) per cent of the public water
systems examined did not meet bacteriological
standards one or more of the past 12 months;
some failed as many as three months. These
systems serve approximately 28,730 people.

Fifty-nine (59) per cent of the rural, individual
supplies examined failed to meet the bacteriological
standards and fecal contamination was confirmed in
approximately three-fourths of these cases. These
systems serve approximately 1,680 people.

Nineteen (19) per cent of the "semi-public" systems
examined failed to meet the bacteriological standard
and fecal contamination was confirmed in three-fourths
of these cases. It is estimated that as many as 41,070
people (State residents and the traveling public) may
be exposed to this water during one year's time.

Failure to meet bacteriological standards indicates a serious, potential
health hazard and calls for prompt corrective action. Additional details
and supporting data may be found in Appendices A, B, and C.


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2?

Chemical analyses of the water systems studied indicated that:

Five (5) per cent of the public water systems
examined failed to meet one or more of the
mandatory chemical standards. These systems
serve 179,800 people.

Two (2) per cent of the rural, individual water
supplies examined failed to meet one or more
mandatory chemical standards. These systems
serve approximately 57 people.

Drinking water must not contain any impurities which may be toxic or
otherwise hazardous to human health. Drinking water failing to meet
the mandatory chemical standards poses such a threat.

Thirty-three (33) per cent of the public water
systems examined failed to meet one or more of
the recommended chemical standards. These systems
serve over 926,500 people.

Twenty-six (26) per cent of the rural, individual
water supplies examined failed to meet one or more
recommended chemical standards. Approximately 740
people are served by these systems.

Thirteen (13) per cent of the "semi-public" water
supplies examined were judged to have aesthetically
undesirable chemical water quality. As many as


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29

189,736 people may be exposed to this water
during one year's time. Unfortunately, further
chemical analyses of the "semi-public" water
supplies was not possible at this time.

The recommended chemical standards are intended to assure that no
constituent is present in quantities which impart objectionable
taste, odor and/or undesirable physiological effects to drinking
water, rendering it less than desirable or aesthetically inferior.

Good quality drinking water should contain no impurity which would
cause offense to the sense of sight, taste or smell, and should have
chemical characteristics considerably better than the limiting values
established by the recommended standards. A large percentage of the
Tennessee supplies studied failed to meet these standards. See
Appendices A, Bt and C for additional details on chemical quality.

Facilities

Public Water Supplies

A sanitary survey of the water supply facilities of the
39 public water supplies studied revealed that:

(Sources)

Thirty-three (33) per cent had inadequate source
protection.

Ten (10) per cent of the sources were of insufficient
quantity.


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30

Five (5) per cent of the sources had unsatisfactory
raw water quality.

(Treatment)

Sixty-seven (67) per cent of the systems needed
additional treatment facilities.

Sixty-two (62) per cent of the systems needed
important changes in operation of present treat-
ment facilities.

Thirty (30) per cent of those chlorinating failed
to maintain chlorine residual in all parts of the
system.

(Distribution)

Twenty-eight (28) per cent of the systems had in-
adequate distribution storage.

Twenty-one (21) per cent had inadequate water
pressures in some or all areas of the distribution
system.

(Quality Control)

Thirty-one (31) per cent of the systems were not
maintaining adequate operational records.

Seventy-two (72) per cent of the systems were
found to have inadequate cross-connection control
programs.


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Only two of the public water supply systems were found to
meet the facilities evaluation criteria. The facilities
of 95 per cent of the public water supplies were found to
be deficient in one or more categories. One system had
nine deficiencies; many had four or five. The average
Risk Factor was 3.5 indicating a great potential hazard
to public health. See Appendix A for additional details
concerning public water systems.

Semi-Public Water Supplies

A sanitary survey of the 64 "semi-public" water supply
facilities revealed that:

Sixty-six (66) per cent of the systems needed
additional treatment.

Forty-six (46) per cent of the 26 systems
chlorinating were found to have no chlorine
residual.

Nine (9) per cent were observed to have a visible
sanitary defect.

Eighty-four (84) per cent were rated less than
"satisfactory".

"Semi-public" water systems serve a large number of people
in Tennessee and the deficiencies enumerated above indicate
a grave potential public health hazard. See Appendix B for
additional details concerning "semi-public" systems.


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32

Rural, Individual Water Supplies

A sanitary survey of the 571 rural, individual water systems
indicated that:

Nearly every system had one or more facility
deficiency.

Very few systems were constructed to prevent
entrance of contamination.

These findings are supported by the fact that 43 per cent of
the rural, individual systems were found to have fecal con-
tamination. This poses a serious public health problem for
the rural residents of Tennessee, Additional details may be
found in Appendix C.

Fluoride Practice

One hundred and nineteen (119) public water supplies in Tennessee
adjust the fluoride content of their water. These supplies serve
209 of the 445 public water systems. Approximately 46 per cent of
the population of Tennessee receive fluoridated drinking water.

A study of 24 of the public water systems fluoridating revealed that:

Not one system had a fully acceptable fluori-
dation program.

Only 50 per cent of the systems were fluoridating
at the proper level.


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33

Seventy-nine (79) per cent were deficient in
analytical control of fluoridation.

Seventy-five (75) per cent were deficient in
fluoridation equipment and facilities.

Sixty-three (63) per cent were deficient in
storage and handling of fluoride chemicals.

Seventeen (17) per cent of the operators were
unfamiliar with analytical testing equipment
and procedures.

Twenty-five (25) per cent of the operators did
not accept or were otherwise not interested in
fluoridation.

Operator Competence

Review of operator qualifications for the public water supplies
studied indicated that:

Thirty-six (36) per cent were only part-time
operators. One system did not have a designated
operator.

Thirty-three (33) per cent of the operators were
not certified by the Tennessee Department of
Public Health.


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Eleven (11) per cent of the operators had college
level training. Seventy-six (76) per cent had
received their waterworks training at State
sponsored short schools. Thirteen (13) per cent
of the operators had no formal waterworks training.

Eighty (80) per cent of the systems with an
operator having no formal waterworks training
failed to meet Water Quality Standards and/or
had a Risk Factor of 3 or greater.

Seventy-nine (79) per cent of the systems with a
part-time operator failed to meet Water Quality
Standards and/or had a Risk Factor of 3 or greater.

Sixty-nine (69) per cent of the systems with a non-
certified operator failed to meet Water Quality
Standards and/or had a Risk Factor of 3 or greater.

Seventy-six (76) per cent of the systems with a
short school trained operator failed to meet Water
Quality Standards and/or had a Risk Factor of 3 or
greater.

Fifty (50) per cent of the systems with a college
trained operator failed to meet Water Quality
Standards and/or had a Risk Factor of 3 or greater.


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The operation of "semi-public" water systems varies widely with
type and size of the establishment served. Often the owner, manager
or person-in-charge also acts as water treatment operator. In some
cases operation of the water facilities was delegated to maintenance
personnel. Few, if any, of the "semi-public" water supply operators
have received formal waterworks training.

Operation of rural, individual water supplies rests primarily with
the homeowner or person(s) residing on the premises.

Surveillance

Of the 39 public water supply systems studied:

Fifty-four (54) per cent failed to meet
bacteriological surveillance standards.

Eighty (80) per cent had not had a chemical
evaluation during the past three years. ; The
chemical quality of two systems was last
checked 31 years ago. Several systems had no
record of ever being checked for chemical
quality.

Forty-one (41) per cent of the systems had
not been rated by a representative of the
Tennessee Department of Public Health during
the previous 12-month period.


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Review of the 64 "semi-public" water systems indicated that:

Seventeen (17) per cent had not had a health
agency visit in the previous two years. In
most cases, a visit consisted of collecting
a water sample and did not include a full
inspection of facilities and operational
practices.

In general, routine surveillance of "semi-
public" systems was provided by county sani-
tarians who are not fully trained in maintenance
and operation of water treatment facilities.

Bacteriological and chemical surveillance were
considered inadequate for systems serving the
public.

There is no routine surveillance of rural, individual water supplies
in Tennessee. Only those problems or complaints brought to the
attention of State and local health officials are investigated.

This places a heavy burden on the layman who obtains his drinking
water from a rural, individual supply for it is he who must
decide that a water supply problem exists and then seek assistance.


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WATER SUPPLY PROGRAM

Authority

The Tennessee Department of Public Health (hereafter designated
Department) administers the State Water Supply Program under
Sections 53-2001 - 53-2008 of the Tennessee Code Annotated (Acts
1945, Ch. 52, Section 1; C. Supp. 1950 Section 5826.1). This
Statute covers both public water supplies and sewerage systems.

Water Supply Regulations are promulgated by the Department's
Division of Sanitary Engineering to provide for the supervision of
public water supplies. The current Regulations were adopted by
the Public Health Council on May 17, 1945 on behalf of the Depart-
ment of Public Health.

In addition to the Statute and the Regulations, the Division of
Sanitary Engineering establishes policies and procedures for the
administration of the Public Water Supply Program.

Statute

The Public Water Supply and Sewer System Code (Appendix E)
provides the Department with broad powers to supervise con-
struction, operation and maintenance of public water supplies
Section 53-2001 defines a waterworks system as "the source of
supply and all structures used for the collection, treatment,
storage and distribution of water delivered to the consumers.
It specifically excludes waterworks systems for private


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38

residences or waterworks for industrial purposes not intended
for human consumption. A public water supply is defined as
"any waterworks system as defined above, whether privately or
publicly owned, where water is furnished to any community,
collection or number of individuals for a fee or charge or
any other waterworks system which on account of the people
who are or may be affected by the quality of the water is
classified as a public water supply by the Tennessee Department
of Public Health." (Emphasis added).

Section 53-2002 gives the Department authority to exercise
general supervision over construction of public water supplies.
Such general supervision includes all of the features of con-
struction of waterworks systems which do or may affect the
sanitary quality of the water supply. No new construction shall
be done nor shall any change be made to a water supply until
plans have been submitted to and approved by the Department.
The Department is empowered to adopt and enforce rules and
regulations governing the construction of public water supplies
and may require submission of water samples for examination.

Section 53-2003 authorizes the Department to investigate public
water supplies as often as necessary to exercise general super-
vision over the operation and maintenance of these supplies.

It may also adopt and enforce regulations governing such operation
and maintenance. Provision is made for the submission of any
necessary operating records and/or samples to the Department.


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39

Section 53-2004 provides the Department with the power to regulate
cross-connections, auxiliary intakes, by-pass connections or inter-
connections. Section 53-2005 states that if a public water supply
is found to be an actual or potential menace to health and effective
corrective measures are not carried out, the Department may issue
an order for correction and specify a time limit for compliance.
Section 53-2006 provides for a review of the necessity or reason-
ableness of any order issued by the Department.

Section 53-2007 provides that any person violating any provisions
of the Statute or failing to comply with any lawful order of the
Department, shall be guilty of a misdemeanor. Fines range from
$10.00 to $100.00 for each violation or each day of continued
violation. Section 53-2008 authorizes the Department to enforce
any standards, policies, general or specific orders, rules or
regulations to control public water supplies. It specifies that
the district attorney in whose jurisdiction a violation occurs
or the State Attorney General shall institute and prosecute
suits when the necessity has been shown by the Department.

Regulations

The Regulations for public water supplies currently in use by
the Department were originally issued on August 18, 1945 (See
Appendix E) and have not been updated. A special provision
covering fluoridation was added in April, 1963. The Regulations
designate the Division of Sanitary Engineering as responsible
for supervision of public water supplies and provides that the


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40

Director of the Division will act as the authorized agent of the
Commissioner.

Regulation W-l states that the definitions of terms as set
forth in Section 1, Chapter 52, Public Acts of 1945, shall be
used in the interpretation of the Regulations. Regulation W-2
provides for supervision of construction by requiring preliminary
plans, water samples, complete plans, plan revisions and conformity
with approved plans. Regulation W-3 covers operational supervi-
sion by requiring submission of records, reports, and water sam-
ples. Regulation W-4 covers cross-connections, interconnections,
etc. It specifically deals with non-potable water systems on
the same premise where a public supply is available and prohibits
cross-connections. It requires the labeling of the non-potable
system and the filing of a cross-connection statement by the
owner or operator of such a non-potable water supply. Regulation
W-5 covers investigations, reports, standards and special orders.

The regulations do not specify minimum acceptable Drinking
Water Quality Standards.

Policy

The Division of Sanitary Engineering's Water Supply Policy is
contained in a number of individual publications and documents.
The publications include: "Waterworks Operation Questions and
Answers"; "Filter Plant Operation"; "Bacteriological Examination
of Water"; and "Regulation of Reports, Plans and Specifications


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41

for Water Treatment Plants and Distribution Systems". Other
documents include: laboratory equipment lists; special letters
to all mayors, water superintendents and managers of utility
districts; special reports to new water supplies; and staff
meeting proceedings.

Resources

Organization

As discussed in the preceding section, the Tennessee Department
of Public Health is charged with protecting public health
through the administration of a Water Supply Program. The
Department is made up of two major Bureaus, the Bureau of
Personal Health Services and the Bureau of Environmental
Health Services. An organizational chart is shown in Figure 2.
The Division of Sanitary Engineering, Bureau of Environmental
Health Services, is reponsible for the Water Supply Program.

Division of Sanitary Engineering

The Division of Sanitary Engineering staff is presently com-
prised of a Director, an Assistant Director, and five sanitary
engineers. One sanitary engineering position is vacant. The
Division has four secretarial positions, one of which is vacant.
Figure 3 shows'.a "staffing chart ifor the Division.

The Division's activities are divided between supervision of
public water supplies and public sewerage systems. Since there
are no formal assignments of staff to either water or sewerage


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Figure 2.

TENNESSEE DEPARTMENT OF PUBLIC HEALTH

GOVERNOR

STAFF SERVICES

FISCAL » ADMINISTRATIVE SERVICES
PLANNING AND DEVELOPMENT

OFFICE OF COMPREHENSIVE HEALTH PLANNING
CENTER FOR HEALTH STATISTICS
STATISTICAL SERVICES
VITAL RECORD1!

HEALTH EDUCATION
PROGRAM PLANNING AND RESEARCH
LOCAL HEALTH ADMINISTRATION
PERSONNEL, RECRUITMENT 4 TRAINING
INTERNAL AUDIT SERVICES
LEGAL SERVICES

COMMISSIONER

ASSISTANT TO
THE COMMISSIONER

DEPUTY COMMISSIONER

4>
ro

f

PUBLIC HEALTH COUNCIL

--\ AIR POLLUTION CONTROL BOARD

BOARD OF TRUSTEES CHEST DISEASE HOSPITALS

4 HOSPITAL LICENSING BOARD

--I LICENSING BOARD FOR HEALING ARTS 	

•¦I CRIPPLED CHILDREN'S SERVICE ADVISORY COMMITTEE

¦A DENTAL ADVISORY COMMITTEE		

¦4 HOSPITAL ADVISORY COMMITTEE
LABORATORY ADVISORY CO»*MITTEE

H STATE

HEALTH PLANNING COUNCIL

•¦I STREAM POLLUTION CONTROL BOARD

BUREAU OF PERSONAL HEALTH SERVICES
(Assistant Coawissioner)

pivisI ON OF
AUXILIARY PERSONAL
HEALTH SERVICES

CERTIFICATION 4 LICENSURE
EMERGENCY HEALTH CARE
HEALTH CARE FACILITIES

SURVEY 4 CONSTRUCTION
VETERINARY MEDICINE

DIVISION OF
PREVENTIVE HEALTH
SERVICES

COMMUNICABLE DISEASE
CONTROL 
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43

FIGURE 3

DIVISION OF SANITARY ENGINEERING STAFF
1970

*Located in Knoxville
Regional Office


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activities, it is estimated that about one-half of the Division's
staff time is devoted to water supply activities. Based on this
estimate, the Water Supply Program is currently being administered
with approximately 3% engineers and secretaries.

The headquarters of the Division is located in Nashville, and
all Division personnel except one sanitary engineer operate from
this office. The western and central portions of the State are
covered from this location. On July 1, 1967, the Division
opened a Regional Office in Knoxville and permanently assigned
one sanitary engineer to the location. This office's area of
responsibility was established as all East Tennessee within the
Eastern Time Zone except Hamilton County (Chattanooga). East
Tennessee includes 29 counties and about one-third of all public
water supplies in the State. Because of limestone ground water
aquifers and surface water quality problems inherent to this
area, this region presents some of the State's most difficult
water supply problems.

Table I presents a summary: tai r the qualifications off" the
Sanitary Engineering professional staff. It is considered note-
worthy that all hold Masters' Degrees and that all hold Profes-
sional Engineers Licenses except the Sanitary Engineer II's,
who have not obtained sufficient experience to qualify for the
exaflM-nation.


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TABLE I

SANITARY ENGINEERING PROFESSIONAL STAFF QUALIFICATIONS

ENGINEER

CATEGORY

ANNUAL
SALARY

BACHELORS
DEGREE

MASTERS
DEGREE

PROF.
REGIS,

PREVIOUS EXPERIENCE

Fleming, Julian R.

Rosson, Harrell B.

Lashlee, Robert W.
Saucier, John W.

Dunn, C. Lamar
Glaus, C. Henry
Baumgartner, Wm. Z., Jr.

Env. E. V $18,240 U. Tenn. 1934

San. E. IV 17,040

San.	E.	Ill

San.	E.	Ill

San.	E.	Ill

San.	E.	II

San.	E.	II

15,350
14,820
13,740
11,760
11,760

U. Tenn. 1935
U. Iowa 1941

U. Tenn.

Miss. St. 1962
Tenn. Tech 1964
Tenn. Tech 1967
Vanderbilt 1966

Tenn.

Okla. St. 1952 Okla. St. 1953 Tenn.

ORla.

ruraue l^oi	Tenn.

U. Mich. 1965	Tenn.

Vanderbilt 1967	Tenn.

Okla. St. 1970	Tenn. EIT

Vanderbilt 1969	Tenn. EIT

Tennessee Eastman Corf
Greeley and Hansen

Engineers
Assoc. Prof. San. E.
U. of Tenn.

Infilco Corp.

Markwell & Hartz
Wallace & Tiernan Inc.

None

None

None

None

None

Ol


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The professional staff is well qualified and has displayed
an exemplary dedication to duty. During the six month period
from October 1969 through March 1970, two staff members who
keep day-to-day records of their activities worked an average
of 302 hours of non-compensated overtime. It is conservatively
estimated that the six-man staff (one member was on study leave
at the time) contributed approximately 1-1/2 man years of extra,
non-compensated overtime last year. This amounts to a 125 per
cent effort and no agency can expect its employees to perform
under these conditions indefinitely.

Current professional salaries are also shown on Table I. It
is noted^" that Tennessee ranks 15th among States in salary
paid to the Director of Public Health Engineering and 18th in
salary paid to beginning public health engineers.

The Division of Sanitary Engineering budget for Fiscal Year
1969-70, not counting a special program for on-the-job training
of sewage treatment plant operators, was $138,995. This amounts
to approximately 9.9 per cent of the total Bureau of Environmental
Health Services budget. Even though the Division's budget has
been increased by about $36,000 in the past ten years, this
amount was necessary to maintain salary levels, and no actual
growth occurred. Sanitary Engineering expenditures decreased
from 24.5 per cent of the amount spent for all environmental
health activities in 1960 to 21.8 per cent in 1965 and 9.9 per

/I State Salary Ranges, DHEW, Office of State Merit Systems


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47

cent in 1970. During this same period, the number of public
supplies requiring surveillance increased from 299 in 1960 to
445 in 1970, and the population served by these supplies in-
creased by over one-half million people.

Using the same equal division of resources between water supply
and sewerage activities as before, it is estimated that approx-
imately $69,500 was expended on the Water Supply Program for
FY 1969-70. This amounts to only about $107.50 for supervision
of each of the 445 public water supplies in Tennessee and only
about $27.00 each for the estimated 800 "semi-public" water systems
(on the premise that the average effort expended on a "semi-public"
supply should be about one-fourth that spent on a public system.)

Other Assistance

The Division of Laboratories, Bureau of Personal Health Services,
provides bacteriological laboratory support for the Water Supply
Program. Water bacteriological laboratories are located in
Chattanooga, Jackson, Johnson City, Knoxville, Memphis, and
Nashville. The Division of Laboratories also assists by eval-
uating and certifying the acceptability of procedures used by
other water bacteriological laboratories in the State which are
associated with interstate carrier water supplies.

The Division of Stream Pollution Control provides limited chemical
analysis of drinking water at its laboratory in Nashville. City
and county health departments may refer problems to the Division
of Sanitary Engineering and render assistance at the local level.


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48

Activities

Engineering

As stated previously, the engineering activities of the
Tennessee Water Supply Program are conducted by the Division
of Sanitary Engineering, Tennessee Department of Public
Health. Regulations prescribe that the following engineering
services will be provided:

1.	Engineering inspection of facilities and operation
of all public water supplies, including cross-
connection control.

2.	Review of plans and specifications for new construction
and modification of existing systems.

3.	Surveillance and final inspection of construction.

4.	Training of water plant operators.

5.	Promotion and supervision of fluoridation.

6.	Review of monthly operating reports from all
public water systems.

Advisory services to local health departments and other
services are also provided:

1.	Assistance to local health departments for
engineering surveillance of semi-public and
individual water systems.

2.	Assistance to other State agencies by engineering
surveillance of State-owned water supplies.


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To meet these responsibilities, the Water Supply Program has
adopted a policy that engineering inspection of all public
water supplies will be made twice per year. However, staff
limitations have never allowed this policy to be implemented.
In 1969, 196 public water systems (approximately 47 per
cent of the total in Tennessee at that time) were inspected
and rated. Of these inspected systems, 79 were rated "approved"
and 117 were rated "not approved". The remaining 220 public
water systems were not inspected in 1969 and included 48
systems which had never been rated by the Tennessee Water
Supply Program.

Essential to the engineering inspection activity is the
"rating" system. Following a field inspection, the water
system is assigned a numerical score to reflect the condition
of physical equipment, the type of operation and maintenance,
and the quality of water delivered, A copy of the Rating
Form is included in Appendix E. The ratings range between
zero and 100, and only those systems scoring 90 or better
receive an "approved" classification.

The field evaluation of 39 water systems revealed some
significant findings regarding the engineering inspection
and rating program. The Tennessee Water Supply Program had
inspected 59 per cent of these 39 water systems during the
past year. However, Bureau of Water Hygiene field evaluations
indicated that only 33 per cent of the 39 water systems had

/2 Public Water Supply Systems in Tennessee - 1969, Tennessee
Department of Public Health, 36 pp.


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a risk rating of less than three (3). A comparison of
the risk rating and the State's numerical rating is
presented in Table V, Appendix A. Of the twenty (20)
water systems that were rated "approved" by the State,
twelve (12) were found to have a high relative risk
rating of 3 or greater indicating that the ability of
these water systems to continually deliver safe drinking
water is suspect.

The review of 275 plans and specifications by the Water
Supply Program required approximately 1\ man-years of
professional time in Fiscal Year 1970. The review activity
is required by law and involves detailed calculations. A
concentrated effort has been made to carry out this activity
often at the sacrifice of other important activities. How-
ever, the related responsibility for supervision and in-
spection of the resultant construction projects is seldom
carried out.

The Water Supply Program conducts regional operator training
short schools and provides on-site training during water
system engineering inspections. In September 1969, it was
determined that this training program had certified operators
for 218 water systems or 52.4 per cent of the total public
water systems in Tennessee. During a six-months period
(October 1969 to March 1970) the Water Supply Program re-
ported that it had conducted eight water works operator


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51

schools. A total of 968 man-hours of engineering time
were devoted to short school training of 386 operators.

This evaluation's field survey of 39 water systems found
that 67 per cent had certified operators and that 76 per
cent of the operators had received State short school
training.

The Water Supply Program is also seeking a Department of
Labor grant for 1971 to provide on-the-job training for
150 water plant operators. Excellent experience with two
earlier grants for wastewater operators encouraged this
attempt, but because of funding limitations it is unlikely
this project will be initiated.

Advisory service to local health departments and other State
agencies has not been a priority activity. The Water Supply
Program has prepared an initial inventory of "semi-public"
water supplies and has provided some infrequent service to
these supplies. In 1969, an administrative study was made of
private water supplies ("semi-public" and rural) in Tennessee
based on review of bacteriological samples analyzed by the
Division of Laboratories during that year. Of 6,843 samples
examined in 1969, 47.5 per cent were positive for coliform
organisms. Of these 6,843 samples, 1,094 were from supplies
treated by chlorination, and 20.8 per cent of these 1,094
samples were reported positive. This information was


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52

substantiated by the laboratory results of the "semi-
public" water supply study (Appendix B) and the rural,
individual water supply study (Appendix G). Twenty (20)
per cent of the samples collected from "semi-public" water
supplies were positive for coliform (19 per cent failed
the bacteriological standard) and 59 per cent of the
samples collected from rural, individual water supplies
were positive for coliform organisms.

Laboratory

Laboratory surveillance of drinking water quality in Tennessee
is divided among many individuals and agencies. Sample collec-
tion may be done by Division of Sanitary Engineering personnel,
county sanitarians or water plant operators. Analyses may be
performed by the Division of Laboratories, Division of Stream
Pollution Control, private laboratories, or the water purveyor.
Only 41 per cent of the public water supplies surveyed in this
evaluation had collected a sufficient number of bacteriological
samples over the previous twelve months. Only 20 per cent had
a chemical analysis of the water within the past three years,
and this analysis did not include all constituents listed in
the Drinking Water Standards.

Bacteriological

The bacteriological laboratory services of the Department
of Public Health are provided by the Division of Labora-
tories, Bureau of Personal Health Services. The Division
of Laboratories operates a central laboratory in Nashville


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and branch laboratories in Chattanooga, Jackson, Johnson
City, Knoxville, and Memphis. This geographical spread
enables sample travel time to be maintained within the
30 hour limit prescribed in Standard Methods. The current
sampling policy of the Water Supply Program is that all
public water supplies must submit to the proper state
laboratory two (2) samples each month from the distribu-
tion system for bacteriological examinations. It has
also been recommended that all filtration or softening
plant systems (capacity > 0.2 mgd) and other systems
(capacity > 1.5 mgd) should maintain their own bacteriolo-
gical laboratory. Consequently, there are eighty-five (85)
water systems performing bacteriological analyses and
fourteen (14) other water plants which have the necessary
equipment but are not performing the analyses.

Samples collected by State, county or water works personnel
and submitted to the State laboratories are considered
"official" while samples analyzed at water plant labora-
tories are not considered "official" except where the
laboratory has been certified by the State. The informa-
tion reported in Table IV - Appendix A indicates that
the number of "official" samples examined for 21 of 39
water supplies was insufficient to meet requirements of
the PHS Drinking Water Standards.


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54

As part of the study of the Tennessee Water Supply Program,
the Central State Laboratory and three water plant labora-
tories were evaluated. (See Appendix F). One of the water
plant laboratories had been previously certified by the
State as an interstate carrier laboratory. The Central
State Laboratory was found to be in substantial compliance
with accepted procedures for bacteriological examinations
as was the previously certified water treatment plant
laboratory. The two water plant laboratories not previously
visited or certified by the laboratory certification officer
were found to be using unacceptable methods or procedures.
One was found to be in such noncompliance that it was recom-
mended that all previous data from the laboratory be marked
"void" and stricken from the record.

The PHS Drinking Water Standards specify that remedial
action for unsatisfactory bacteriological samples include
daily resampling and immediate active steps to locate and
eliminate the source of pollution. The Tennessee Water
Supply Program requires such actions. Whenever unsatis-
factory sample results are reported, two additional sample
bottles are sent to the operator along with the unsatis-
factory report that includes the following statement:

"Samples showing evidence of contamination require
repeated testing from the same location until two
successive negative results are obtained. Two bottles
are being forwarded for immediate daily sampling."


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A review of the records, however, show that this policy
is not being effectively implemented.

The data displayed in Table III, Appendix F, indicate
three points:

a.	The lack of resampling from the same location
on successive days until two negative results
are secured.

b.	The slow processing of positive results by the
Central Laboratory reporting section.

c.	A lack of understanding by some sample collectors
as to what constitutes the proper response to
positive laboratory results.

The problem at the Central Laboratory is apparently re-
lated to lack of staff and resources for record keeping
and reporting. This data handling delay has, in part,
defeated efforts of the laboratory to give a rapid
monitoring of water supplies. Results are available from
the membrane filter procedure within 24 hours, but an
average of five days was required before the water systems
was notified.

Similar inspection of records at two of the branch labora-
tories indicate that these laboratories are providing suf-
ficient response.


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Chemical

The water chemistry laboratory of the Tennessee State
Department of Public Health is operated by the Division
of Stream Pollution Control at the Central Office in
Nashville. In 1969, the laboratory analyzed 1,132
samples for Stream Pollution Control purposes and 178
for drinking water quality surveillance. About half of
these 178 analyses were of private wells, springs, or
cisterns and the remainder were of new public water
supplies. None were routine surveillance of previously
existing water supplies. According to a survey made by
by the Division of Sanitary Engineering in 1966,3 of 415
public water supplies in the State at that time, the
chemical quality of 81 had not been checked in the last
15 years and 60 had never been checked.

During the field surveillance activities of this study,
it was noted that only 20 per cent of the 39 water systems
had had a chemical analysis performed on their water during
the past three years. The majority of those performed
were done by the water supply laboratories of the larger
systems or by commercial laboratories.

As a part of this program evaluation, a special evaluation
of the Stream Pollution Control Laboratory was conducted.

/3 "Selected Chemical Content of Waters Used by Public
Supplies", Tennessee Department of Public Health.


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57

Analyses performed, methods, equipment, staffing, and
space requirements were examined. Routine chemical
analysis of drinking water, as currently practiced by
the laboratory, includes alkalinity, hardness, iron,
chloride, fluoride, pH, calcium, color, and turbidity.

Other constituents which are occasionally determined
are manganese, sulfates, nitrates, surfactants, and
zinc. This constitutes adequate surveillance for
operational purposes, but only a partial chemical
analysis of drinking water as compared with the extent
of analyses called for in the PHS Drinking Water Standards.
Trace metals, organics, and pesticides are not currently
being run for public water supplies, although the labora-
tory is equipped to run most of these constituents. The
laboratory does not normally run even such simple deter-
minations as total dissolved solids or conductivity.

The methods and procedures of the Stream Pollution Control
Laboratory were found to be in general conformance with
those outlined in Standard Methods. Laboratory equipment
was available to run most of the analyses that are essential
to surveillance of drinking water. There was an atomic
absorption spectrometer which could be used for the trace
metals analysis. There was also equipment for organic
contaminate determinations (carbon chloroform extractions)
and pesticide determinations which are currently run only


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for pollution control work. However, it was found that
the dionized water facilities in the laboratory were
not being monitored for quality and that the turbidimeter
used for water supply analysis did not have the sensitivity
necessary for drinking water supply work.

Space allocations of this laboratory appear to be adequate.
The quality of personnel is excellent. The staff includes
two chemists with master degrees, four with bachelor degrees
and one technician.

Chemical laboratory capability was found at 23 of the
39 water systems surveyed. The water purveyor does
not perform, and is not required by the State to perform
anything more than a partial chemical analysis, primarily
to monitor water treatment operations. These analyses
include alkalinity, CO2, turbidity, chlorine residual
and pH. Of the 23 water systems with chemical labora-
tories, only four had more than this capability, and
none had the ability to analyze the full range of
constituents listed in the Drinking Water Standards.

Several large water systems which treat water drawn
from the Tennessee River downstream from industrialized
areas are trying to develop the capability to analyze
for trace metals and exotic materials.

Analysis for radiochemical constituents has never been
routinely performed for drinking water supplies in


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59

Tennessee. The Tennessee Department of Public Health
has the competency and the equipment to perform this
function in their Division of Industrial Health and
Radiological Health.


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61

DISCUSSION
PUBLIC HEALTH RISK

Water Supply Deficiencies

Public health protection of drinking water supplies should assure that
each component of the production, storage and distribution process
function without risk or failure. Flawless treatment avails nothing
if the distribution system permits entrance of contamination through
faulty facilities or cross-connections. Similarly, excellent operation
of conventional water treatment and distribution facilities will not
protect public health if impurities are present in the raw water
source which are not amenable to treatment.

Documented incidents have shown that disease outbreaks resulted
when contamination of water and inadequate chlorination practices
occurred at the same time. As presented in the findings, not all
public and "semi-public" systems provide chlorination. Thirty (30)
per cent of the public and 46 per cent of the "semi-public" systems
which have chlorination facilities do not maintain chlorine residual
in all parts of the distribution system. In addition, 31 per cent
of the public supplies, 19 per cent of the "semi-publid'supplies,
and 59 per cent of the rural, individual supplies were found to
show evidence of bacteriological contamination. These conditions
present serious public health risks.

More industrial and agricultural chemicals, toxic to humans are finding
their way into our natural waters than ever before. Conventional water
treatment processes do not always remove these chemicals. Assurance


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that these substances are not present in drinking water can only
be given by (a) adequate protection of raw water sources, and
(b) a surveillance program providing routine complete chemical
analyses. It was found that 80 per cent of the supplies surveyed
had not had a chemical analysis during the previous three years,
and some had never been analyzed. Further, chemical surveillance
presently performed does not include analysis for many constituents
included in the Drinking Water Standards and others of known health
significance. Thirty-three (33) per cent of the supplies surveyed
failed to provide adequate protection for their raw water source,
indicating contamination by potentially dangerous substances may
be occurring undetected by water supply officials.

Tennessee drinking water supplies are vulnerable to enteric disease
transmission and are not providing sufficient protection against
other hazardous impurities.

Water-borne Diseases

Water-borne disease epidemics are documented to have occurred in
Tennessee in recent years. In addition, epidemiological records
indicate that potentially water-borne diseases occur each year.
(See Appendix G). While Tennessee has approximately two per cent
of the nation's population, about three per cent of the infectious
hepatitis, three per cent of the shigellosis, and five per cent of
the typhoid occurred in Tennessee. A portion of these cases, plus
an unknown number of unreported cases, may have been water-borne.


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63

In addition, body wastes from these diseased persons pose the
constant threat of contaminating drinking water supplies.

In essentially all documented water-borne epidemics, definite water
system deficiencies were shown to exist during the time when disease
was transmitted. Similar water systems deficiencies were noted
during this evaluation, and are discussed in the preceding section.
The requisites for repetition of the tragic epidemics of the past,
namely, vulnerable water supplies and persons infected with potentially
water-borne diseases, are still present in Tennessee. Greater
vigilance by health officials and the water supply industry is neces-
sary in order to minimize public health risk from drinking water.

PROGRAM NEEDS

Authority

Statute

The Statute appears to be generally well written and provides
the Tennessee Department of Public Health with broad regulatory
and investigative powers to supervise construction, operation
and maintenance of all public water supplies, and to issue
enforceable orders for correction of water system defects
which cause a health menace.

The Statute allows the Department to define which supplies are
to be considered as "public". It appears as though "semi-
public" (restaurants, motels, subdivisions, trailer courts,
parks, recreation areas, etc.) and industrial plant potable


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64

water supplies are covered by the act and could be placed
under surveillance by the Department at its option. How-
ever, the Statute definitions need to be strengthened and
clarified on this point.

No specific provision is included in the Statute for the
promotion and orderly development of new public water supplies.
Language similar to that discussed in the Public Health Service
Publication, Recommended State Legislation and Regulations
which provides for comprehensive community plans would be
helpful.

The definition of a cross-connection and Section 53-2004 should
specifically prohibit any physical connection or arrangement
between two otherwise separate piping systems, one of which
contains either water of unknown or questionable safety, or
stream, gas, or chemical, whereby there may be a flow from
one system to the other, the direction of flow depending on
the pressure differential between the two systems.

During the 25 years since the Department obtained the authority
to issue enforceable orders, four orders have been issued. The
events preceding the issuance of these orders were examined,
as were other situations where orders were considered, to
evaluate the Department's willingness to use all means under
law available to protect the public health.


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65

Only two orders were issued between 1945 and October 1970,
reflecting a definite reluctance on the part of the Department
to issue compliance orders. Files indicate, for example, that
this reluctance prevailed in spite of a Department Field
Epidemiologist's report which concluded ten persons had con-
tracted infectious hepatitis through a contaminated water
supply, and the Sanitary Engineering Division Director's
recommendations that the implicated water system be closed
down by Departmental Order.

One order was issued in October 1970, and another in November.
In both cases the supplies in question had been visited re-
peatedly over a period of several years by Department engineers
and had received correspondence which included strongly worded
recommendations to correct certain major deficiencies.

From the examination of the files, it appears that while the
Department has retained its strong preference for obtaining
progress through persuasion, it is now willing to resort to
legal techniques at its disposal when other means have failed.

This is considered a necessary and proper exercise of the
responsibility to protect the public health, and its continued
use, as prescribed by present law, is encouraged.

While the fact that two orders were issued in 1970 is commended,
comment is appropriate regarding the interval of time between
full awareness of one situation meriting such action and actual


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66

execution of the order. Ori August 26, 1970, internal
correspondence of the Department documented that a certain
water supply presented a menace to health and had not made
satisfactory progress toward corrections. It cannot be
ascertained from the records whether an immediate decision
was made to issue the order or whether some time was spent
reaching this decision. It is significant, however, that an
order to correct a situation judged to constitute a health
menace was not issued until November 17, 1970. This delay,
which approaches three months, indicates either cumbersome
and unresponsive administrative procedures and/or lack of
resolve to act in the interest of public health on the part
of responsible officials.

The $10.00 to $100.00 penalty for violating the provisions of
the Act or directives of the Department appears to be very
minor in comparison to the potential public health problems
created by an improper public water supply. For example,
the Tennessee Stream Pollution Control Law, Section 70-317
provides for fines five (5) times as great as those specified
in the Water Supply Act. In view of the fact that stream
pollution has only an indirect health affect, whereas a water
supply has a direct and immediate effect on public health, the
penalty provisions of the Water Supply Act are considered in-
adequate. Under the present law only the District Attorney
or the State Attorney General shall institute and prosecute


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67

suits. The Department's role would be strengthened con-
siderably if it were authorized to bring suit in its own
right.

It is noted that authority conferred by Statute has been
extended to cover certain public drinking water by the
Tennessee Department of Conservation. The Division of
Water Resources, under the authority of Chapter 23 of
Title 70, Tennessee Code Annotated 70-2301 et. seq., licenses
water well drillers for the orderly development of the State's
underground water resources. This agency has developed rules
and regulations in order to protect groundwater resources
from contamination, to supply water of reasonable quality,
and to protect public health. Regulations governing water
supplies at restaurants and hotels have been promulgated by
the Division of Hotel and Restaurant Inspection, Tennessee
Department of Conservation, under statutory authority granted
in the Code of Tennessee 1932, and the Public Act of 1937.
Regulations pertaining to restaurants require use of public
water supplies if available. If an approved public supply
is not available, annual bacteriological testing is required,
and the laboratory report must be displayed. Provision is
made for arbitration of conflicts which may occur between
these regulations and City or County health agencies. No
mention is made, however, of State water supply regulations.
Regulations pertaining to hotels require only that "pure,
wholesome" drinking water be provided to guests.


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68

Section 53-3802, Tennessee Code Annotated, gives the
Commissioner, Tennessee Department of Public Health,
authority to adopt rules and regulations for the health
protection of persons using organized camps in the State.
Regulations issued under this authority specify general
water hygiene practice and require bacteriological samples,
one before camp opening each year and at least one during
camp operation.

It can be seen that programs administered by the Department
of Conservation and the Camp Sanitation Service of the
Department of Public Health parallel and somewhat duplicate
program for which the Division of Sanitary Engineering has
principal responsibility. None of the regulations specifi-
cally refer to the others. Closer coordination and cooperation
between these agencies is obviously necessary, and the regula-
tions of other agencies should reflect that principal authority
for regulation of public drinking water supplies has been given
to the Division of Sanitary Engineering.

Regulations

Clearly, the Department's Water Supply Regulations need to
be updated and strengthened. While the Division of Sanitary
Engineering is still a functional agency of the Department,
it has been largely superseded by the Bureau of Environmental
Health Services as the primary environmental health agency of


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69

the Department. The Regulations should recognize this
organizational change. Provision should also be made for
more and better coordination with other agencies of the
Bureau, such as Division of Stream Pollution, Division of
Environmental Sanitation, and the Solid Waste Section, since
the activities of these agencies have a direct bearing on
water supplies in the State.

As noted in the preceding section, no provision is made for
the promotion and orderly development of new public water
supplies. The Regulations do not specify that waterworks
design and/or the preparation of plans and specifications
must be by a professional engineer properly registered in
the State of Tennessee for this type of work. The provision
requiring all waterworks plans, specifications, and changes
in plans to be submitted for review and approval is important.
The suitability of proposed waterworks construction must be
determined in order that the public health may be properly
protected. The Regulations require the submission of such
plans at least two weeks prior to the date action is desired.

This is considered far too short a time to adequately review
all details of a complex design or proposal, particularly
when the design may be vague and/or incomplete. Only the
simplest waterworks improvement can be reviewed in two weeks.

In order to assure continued maintenance and safe operation
of all water supplies serving the public, it is mandatory


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70

that an individual or legally constituted group be designated
as responsible for the supply. Without such a designation,
proceedings to enforce elimination of menaces to public health
are ineffective.

The Regulations should specify the general types of water-
works which are considered public water supplies. Supplies
such as those serving restaurants, motels, service stations
and similar commercial establishments; trailer courts; Federal,
State, local and privately owned parks; recreational areas;
amusement parks; Federal, State, local and privately owned
institutions; industrial plant potable water systems; food
processing establishments; and all other similar water systems
which on account of the people who are or may be affected by
the quality of the water should be designated public water
supplies. It is suggested that such systems be classified
so that different types may be singled out or excluded from
certain provisions of the Regulations, depending upon their
particular significance.

Although not specifically granted in the Code, the Department's
authority for general supervision over construction of public
water supplies includes approval of the source of supply. In
order to adequately assess the suitability of a proposed water
source, water quality data should be compared to accepted water
quality standards. The Tennessee Stream Pollution Control Board


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71

has adopted water quality criteria for surface waters suitable
for use as domestic raw water supply. The Department's Water
Supply Regulations, however, do not include raw water standards.
Standards published in the Public Health Service's Manual for
Evaluating Public Drinking Water Supplies, and the Federal Water
Quality Administration's Water Quality Criteria are recommended.
No provision is made for the prohibition of bathing, water
skiing, boating or other activities in or near waters used as
a source of public water supply if evidence indicates that such
use may adversely affect the water supply. It is recommended
that this feature be included in future Regulations.

The adequacy of the water supply source in relation to current
and reasonable future demands should be ascertained and sub-
stantiated by geological, stream flow, weather or other records.
Location and restriction of well water sources should be covered.
Sealing of all abandoned or unsatisfactory wells should be re-
quired .

Finished water standards should be specified and bacteriological,
chemical, physical and radiochemical limits set. The Public
Health Service's latest Drinking Water Standards are recommended
as "minimum" standards for all public water supplies.

The bacteriological and chemical laboratory facilities considered
necessary for each type or class of water supply should be
specified as well as the type, number, and frequency of the


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raw and finished water examinations. The bacteriological
frequency specified for finished water in the PHS Drinking
Water Standards is recommended as "minimum".

Operator certification should be covered in the Regulations
and should specify the level of training and experience con-
sidered necessary to operate the various types and sizes of
waterworks. Mandatory certification is recommended.

Minimum acceptable water system pressures should be specified.
A minimum of 25 psi in all parts of the distribution system is
recommended. Mandatory chlorination is recommended. The
Regulations should require that a detectable free chlorine
residual be maintained in all parts of a water supply distri-
bution system serving the public and should specify the test
procedure to be used for monitoring chlorine residual.

Disinfection of all newly constructed waterworks, extensions,
modifications or major repair should be mandatory. Facilities
should be withheld from service until bacteriological samples
indicate that the disinfection was satisfactory.

4

The Ten States Standards are also suggested as a guide for
updating and revising the Tennessee Regulations.

/4 Recommended Standards for Water Works. Great Lakes - Upper
Mississippi River Board of State Sanitary Engineers.


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73

Policy

It is unfortunate that a single water supply policy document
is not available for the Division of Sanitary Engineering's
Water Supply Program.

Recently the Division instituted a procedure whereby Policy
is established or changed in staff meetings. Although the
minutes of these meetings are circulated, it would be much
better if each staff member had his own policy manual and
received insert sheets covering all policy changes. Even
with the very small staff, problems have arisen because the
staff was not familiar with the latest Division policy or
had forgotten that it had been changed during a recent staff
meeting. Exceptions to standard policy and special considera-
tions have not been recorded as well as perhaps they should.

Activities

Engineering

The findings of this evaluation, reviews by the State Depart-
ment of Public Health Comprehensive Health Planning Program,
and reports prepared by the Water Supply Program, all emphasize
that the Tennessee Water Supply Program is not providing the
engineering services necessary to fulfill its delegated
responsibilities. This conclusion was well stated in a
circular of the Division of Sanitary Engineering in April
1970, entitled, "Is that all?". It is appropriate here to


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74

restate the last four paragraphs of this article with

important phrases underlined.

"At the present time, there exist 270 public waste-
water systems and 441 public water systems in the
State of Tennessee. Actually, each of these systems
should be visited at least twice each year for a
routine investigation, but due to the lack of
sufficient personnel many of the systems have not
been visited since 1966. Many of the visits that
have been made were to deal with specific problems,
or those of an emergency nature.

"Presently, a substantial backlog of plans and specifi-
cations are awaiting the review of the engineering staff,
and according to State Law these much needed projects
cannot be placed under construction until the plans and
specifications have received the Department's approval.
Often, obvious mistakes are overlooked on the plans and
specifications because of the hurried nature in which
the review must be carried out.

"The Division does a negligible amount of construction
supervision. Also, the present operator training
programs are not adequate to provide the quality of
personnel necessary to operate public water and
wastewater facilities.


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"In short, the Division of Sanitary Engineering is
not providing the people of Tennessee the service
charged to it under TCA Sections 53-2001 through
53-2008 because of insufficient personnel."

These statements were shown to be correct by the findings of
the field survey phase of this evaluation. In addition to
lack of inspections, other significant findings included un-
protected sources of supply, deficient treatment facilities,
deficient treatment operation, low pressures, and inadequate
cross-connection control.

The primary need of the engineering phase of the Tennessee
Water Supply Program is sufficient personnel effectively
deployed throughout the State. Given sufficient personnel,
a secondary need would be to reevaluate and redirect existing
program activities. The lack of staff has necessitated com-
promises from optimum program practice which have accumulated
over the years to the point that the entire program has been
influenced. Not only are important program activities at
times not performed, but due to lack of resources much
work that is done lacks purpose and has become so routine as
to be ineffective. Many engineering inspections are no more
than "visits to the water plant". Return inspections to re-
view compliance with program directives are seldom made.
The problem extends beyond field visits and includes handling


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and follow-up of bacteriological reports, monthly operating
reports, and other activities. The Division's report to
the Environmental Health Committee, Tennessee State Health
Planning Council dated February 19, 1970, summed the situa-
tion quite well by stating, "Obviously, the staff is inade-
quate and many important duties can only be performed in a
perfunctory manner". Hence, the surveillance program as
presently conducted has established a false sense of security
regarding the reliability of water systems in Tennessee.

The engineering fluoridation control effort was also found
to be lacking in necessary surveillance. Major deficiencies
in facilities, equipment, and operational practices were found
in water systems thought to be providing a dental health
benefit to the people of Tennessee.

The attempt to establish a regional office for the eastern
one-third of the State has not been fully implemented. The
Knoxville Regional Office has never been equipped with ade-
quate staff, office space or facilities to carry forth an
effective regional program. This need has been documented
in the Region's annual Progress Reports.

The operator training activity has reached a major portion of
the water systems. Yet, field survey results show that many
of the systems operated by trained personnel have signifi-
cant deficiencies (See Appendix A, Table VI). Nine water


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77

systems (23 per cent of those surveyed) with short school
trained operators produced water which did not meet the
bacteriological standards at least once in the previous 12
months. Twenty-two (22) water systems (56 per cent of those
surveyed) with short school trained operators were found
to have Risk Factor of 3 or greater. Therefore, even with
the great amount time, effort, and popularity of short
school training, the program has not been effective in con-
veying the message of public health protection to the
water supplies.

Public Health Service experience indicates that it takes
an average of 1.2 man-days per public water supply to make a
comprehensive field survey of facilities and operation.

This time requirement for a single visit does not include
making arrangements for field work or preparation of written
reports of findings. Moreover, it does not include important
follow-up work with local officials, developing programs for
facilities improvement, or improving operator competence that
are necessary if the surveys are to be an effective tool in
securing adequate facilities and proper operation. It has
been estimated"' that, on the average, at least four man-days
per year are required for each public water supply for plans
review, meetings with governing bodies, surveys, report writing,

/5 Community Water Supply Survey. 1969, p. 62.


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78

training, etc. Cross-connection control activities are
excluded from this estimate because this activity is primarily
related to distribution system size. It is also estimated
that "semi-public" water systems require approximately
one-fourth as much time (one day per supply each year)
as is required for public water supply surveillance.

The following assumptions were used to estimate the personnel
requirements for the administration of an optimum water supply
program for Tennessee.

1.	445 public water supply systems.

2.	Four man-days/publie water supply/year.

3.	800 "semi-public" water systems.

4.	One man-day/"semi-publie" supply/year.

5.	Cross-connection control requirements for public

water systems based on the following:

Engineering Time
Population Served by System Man-Days/System/Year

100,000 and over

5

10,000 to 99,999

3

1,000 to 9,999

2

Less than 1,000

1

6. 220 man-days equals one man-year.


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79

Based on these assumptions, the annual personnel required are:

Public Water Supply: 445 systems x 4	= 1,780 man-days

"Semi-Public" Water Supply: 800 systems x 1	= 800 man-days

Cross-Connection Control:

Man-Days Man-Days
Population	No. Systems System Group

100,000 and over	4	5	20

10,000 to 99,999	40	3	120

1,000 to 9,999	233	2	466

Less than 1,000	168	1	168

445	774

The total annual personnel time for engineering activities is
3,354 man-days. This is equivalent to 15 man-years of pro-
fessional time for the Tennessee Water Supply Program. This
represents an increase of 11.5 man-years of professional time
over the present engineering staff.

Laboratory

Bacteriological

Bacteriological sampling is an essential part of the Water
Supply Program. The need for this activity in Tennessee
was supported by the bacteriological quality findings of
this study. Thirty-one (31) per cent of the supplies
studied did not meet the bacteriological quality require-
ments of the Drinking Water Standards.


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The primary needs of the bacteriological surveillance
program are:

a.	Consistent sampling of all public water supplies
at the level prescribed by the Drinking Water
Standards.

b.	Evaluation and certification of all bacteriological
laboratories that analyze drinking water.

c.	Improved remedial action on unsatisfactory samples.

Consistent bacteriological sampling was not demonstrated by
the findings of the study of water systems or the examination
of laboratory records. This is primarily due to the fact that
the Water Supply Program has not demanded that an adequate
bacteriological sampling frequency be maintained. While the
current program provides acceptable surveillance for small
supplies serving less than 2,500 people, it does not pro-
vide a satisfactory check system for the larger supplies.
Revision of the Water Supply Program's bacteriological
sampling policy is indicated. It is recommended that the

State laboratories examine monthly from each supply either

(a)	at least ten (10) per cent of the distribution system
samples required by the Drinking Water Standards, or

(b)	two (2) samples, whichever is greater. Remaining
samples required by the Drinking Water Standards should
be analyzed in treatment plant laboratories certified
by the State, or, in the case of small supplies without
laboratory capability, in State laboratories.


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81

Evaluation and certification of all laboratories
examining bacteriological quality of drinking
water is considered necessary for the proper operation
of the Water Supply Program (See Sections 3.13 and 3.14
of Drinking Water Standards). The number of "official"
samples could be increased by expanding the certification
of water system laboratories. The Tennessee Laboratory
Certification Program as provided by the Division of
Laboratories is a cooperative effort within the Tennessee
Department of Public Health. This program has certified
all the Department of Health laboratories and eight other
water system laboratories which are involved in the PHS
Interstate Carrier Program, These laboratories, together
with approximately one hundred (100) other laboratories
requiring certification, place a great burden on the
laboratory survey officer. This activity can only be
handled by trained microbiologists.

An active program covering all water supply laboratories
in the State will require the services of at least two
survey officers plus associated clerical and records
keeping staff. The Division of Laboratories has two
suxrvey officers who certify both water and milk labora-
tories. These officers, however, are not assigned full-
time to this function, and essential clerical and records
keeping staff are lacking. In order to examine and certify


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five State laboratories, LOO water plant laboratories,
and other hospital, university, or commercial laboratories,
it is essential that this be a full-time responsibility.

In order that the recommended bacteriological laboratory
evaluations and certifications may be accomplished within
a reasonable period of time, it is suggested that the State
Branch Laboratories be integrated into the laboratory
certification activity. The water treatment plant labora-
tories could be geographically grouped and initially visited
by the Branch Laboratory Director or his delegated micro-
biologist. A communications link with water plant labora-
tories within each region would be established and determina
tion of laboratories needing urgent attention could be made.
Training and corrective action would be the joint responsi-
bility of the Central and Branch Laboratories and would be
accomplished on a priority schedule established by the
initial screening. Once all existing bacteriological
laboratories are certified, the program could be reasonably
expected to be handled by the two Central Office Survey
Officers. However, the communications link between the
local laboratories and the branch laboratories should be
continued in case immediate assistance is needed and to
facilitate dissemination of new technical information.

Ineffective remedial action for unsatisfactory samples is
primarily the result of lack of records keeping and


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83

notification. This need could be satisfied by the
same clerical staff that assists the laboratory
evaluation service. It is highly desirable that the
time lag between laboratory results and notification be
decreased. Telephone communication between the laboratory,
the Water Supply Program, and the water supply appears to
be the most desirable choice. This tri-party communication
link is necessary in order that effective action can be
initiated (resampling, engineering inspection, and analysis).

Chemical

The primary problem with chemical surveillance of public
water supplies in Tennessee is the lack of laboratory
facilities and personnel. The dependence of the Water
Supply Program on the Stream Pollution Control Division
for chemical laboratory support precludes a comprehensive
drinking water surveillance program. The Stream Pollution
Control Division has administrative jurisdiction over the
laboratory, and its program will therefore be given top
priority. The Water Supply Program cannot expect to
accomplish its mission with a "we will do them if we have
time" agreement from the laboratory. This is not to question
the importance of the Stream Pollution Control Program, but
to assert that the Water Supply Program should be accorded
equal importance.


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84

The second major problem is two-fold:

a.	Water Supply Program regulations do not require
routine sampling of drinking water for chemical
quality.

b.	Analyses of drinking water as presently performed
do not include all constituents listed in the
PHS Drinking Water Standards.

The following actions are proposed for improvement of this
phase of the Water Supply Program:

a.	The Water Supply Program should hire three
chemists and one secretary to conduct the
laboratory analyses necessary for surveillance
of water supplies in Tennessee.

b.	The Water Supply Program should establish a
working agreement with the Stream Pollution
Control Division that this work can be performed
in the Stream Pollution Control Laboratory.

c.	A working agreement should be made with the
Division of Industrial Health and Radiological
Health to analyze for radiochemical constituents
in all water supplies.

d.	Chemical analyses should include the constituents
listed in the PHS Drinking Water Standards plus all
other substances which have health significance
(mercury and pesticides, for example).


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85

e.	Water samples from all drinking water supplies
should be collected and analyzed according to
the following recommended schedule unless more
frequent analyses are indicated by the presence

of excessive levels of certain harmful constituents:

(1)	Surface (river) - at least twice per year

(2)	Surface (lake) - at least once per year

(3)	Ground (well and spring) - at least once
every three years.

f.	The laboratory should provide more rigid quality
control for the demineralized water used in analyses.

g.	The laboratory should procure a more sensitive
turbidimeter (Hach Model 2100 or equal) for drinking
water analyses.

Data Processing

The successful administration of a water supply surveillance
program requires the accumulation, processing, analysis and
use of a vast quantity of information. In order to determine
the best method of data processing for the Tennessee Water
Supply Program, an estimation was made of the total amount of
information that must be handled in one year. Four major areas
of program responsibility were considered - bacteriological
quality, chemical quality, engineering inspections, and monthly
operating reports. It was assumed that each of these responsi-
bilities would be carried out in accord with the PHS Drinking


-------
86

Water Standards, As such, all 445 public water supplies
would be sampled for bacteriological quality at the frequency
consistent with Figure 1 of the Drinking Water Standards; all
445 public water supplies would be sampled for chemical quality
of all constituents of the Drinking Water Standards; engineering
inspections would be made on all 445 public water supplies using
the State's Public Water Supply Rating Form; and monthly operating
reports would be submitted by all 445 public water supplies.

Using the above assumptions and further assuming frequency of
chemical samples, engineering inspections, and completeness of
monthly operation reports based on water supply source and/or
treatment provided, it vas determined that the Tennessee Water
Supply Program must process 3.5 million items of information
each year. This is a conservative estimate and does not
include many other program aspects such as special water
quality samples, engineering plans review, or surveillance of
semi-public and individual water supplies.

The purpose of this discussion is to point out the immense
quantity data that must be handled for the successful manage-
ment of a Water Supply Program. If given proper attention,
this activity will demand a great deal in terms of personnel,
time, and space. Therefore, it appears evident that this
activity should be reorganized under a computerized system
and the services of a System Analyst should be secured.

This system should utilize the State's Computer Center and


-------
87

be operated on a time sharing plan with other Divisions

of the Tennessee State Department of Public Health. Automatic data

processing would provide an effective and efficient means

for evaluating water supply data. This important activity

is now considered too time consuming for the experienced

professional staff and is seldom given proper attention.

If the Water Supply Program is ever to be responsive to
problems before they become critical, it must have the
capability to define problems when they first become
detectable. A computer can perform this important but
time-consuming screening of data and can provide the pro-
fessional staff with a periodic summation which designates
potential problems. This will allow the engineering staff
to concentrate on problem areas and begin immediate
remedial action.

Resources

Organization

A few years ago the Division of Sanitary Engineering was the
principal environmental health agency in the Tennessee
Department of Public Health. At that time water supply
rightfully received emphasis as one of the important pro-
grams within the Division. During the intervening years,
however, a number of environmental program functions were
transferred or otherwise removed from the Sanitary Engineering


-------
88

Division, decreasing its overall prominence and the relative
importance of its programs. In 1968, the Bureau of Environmental
Health Services was created and superseded the Division of
Sanitary Engineering as the primary environmental health agency
of the Department. Under this organization, Air Pollution
Control, Stream Pollution Control, Environmental Sanitation,
and other important programs are also represented by Divisions
within the Bureau. The ultimate effect of this was further de-
emphasis of the Water Supply Program.

The importance of a strong Water Supply Program cannot be
escaped. The health and life of every Tennessee resident and
visitor depends upon the availability of safe drinking water.
Because protection of drinking water is so crucial to a healthful
environment, it should be elevated to its proper place as a
separate identifiable Division within the Bureau of Environmental
Health Services.

Personnel Requirements

Water Supply Program personnel requirements can be divided into
two categories: those assigned to the proposed Division of
Water Supply; and those assigned to supporting laboratory
functions.

Although separate water supply laboratory facilities are
desirable from an operation standpoint, in the interest of
efficient and economical use of laboratory facilities, it


-------
89

is proposed that the Water Supply Program fund several water
supply positions in the Division of Laboratories and in the
Division of Stream Pollution Control Laboratory. As discussed
in the preceding Activities Section, at least one secretarial
and two bacteriologist positions are necessary for bacterio-
logical laboratory certification and surveillance activities
by the Division of Laboratories. (This makes no allowance
for water analysis routinely performed by the Division of
Laboratories). In addition, one secretarial and three chemist
positions are necessary for water supply chemical surveillance
by the Division of Stream Pollution Control Laboratory.

The minimum staff considered necessary to administer the pro-
posed Division of Water Supply for an effective water supply
program is 15 professional and 7 secretarial positions. These
positions are recommended in addition to the 5 professional
and 2 secretarial positions assigned to laboratory functions
as discussed above. Also, it should be noted that this
staffing level is designed to meet present needs and makes no
allowance for increased needs of the future. In the interest
of economy and for efficient use of sanitary engineering talent,
engineering technician or other subprofessional personnel might
be substituted for some of the professional staff. However,
such substitution should be approached with caution and probably
should not exceed 25 per cent of the overall (professional-
subprofessional) staff*


-------
The Division of Sanitary Engineering estimated in 1965 that
establishment of a Knoxville Regional Office would save
$6,304 annually (based on 1964 costs). This saving was
based largely on travel expenses and personnel travel time
required to cover the East Tennessee area from Nashville.
Actually, benefits from decentralization amount to much more
than this figure would suggest. Time formerly spent by
central office staff prior to and during each trip in becoming
reacquainted with the facilities, problems, and people of a
distant location is largely saved. In addition, significant
improvement can be made in quality of service provided, and
in ability to quickly respond to problems and emergencies.

It is recommended that the proposed Division of Water Supply
be further decentralized by fully staffing the Knoxville
Regional Office and by establishing another Regional Office
in Jackson to serve West Tennessee. Because the water supply
problems in East Tennessee tend to be more difficult and more
numerous than those in the western part of the State, it is
recommended that the Knoxville Regional Office be staffed
with no less than 3 sanitary engineers, 1 engineering
technician, and 2 secretaries. It is recommended that the
Jackson Regional Office begin operations with not less than
one sanitary engineer, one engineering technician, and one
secretary. It is further suggested that those placed in
charge of the Regional Offices be appointed Assistant Directors


-------
91

A suggested staffing chart for the proposed Division of Water
Supply is shown in Figure 4 .

In order that there may be a focal point within the program
for coordination of important technical activities, it is
proposed that certain senior staff members be designated
technical consultants for specific subjects, such as Water
System Design, Manpower Development and Training, Water System
Operation, Distribution System Safety (cross-connection control),
and Data Analysis. These consultants would be charged with the
responsibility of keeping current in their respective specialities
and providing assistance, training, and coordination of their
particular activity throughout the State. They would be available
to supplement other staff members efforts in difficult field or
problem situations.

While Manpower Development could very well be a full-time job,
other specialists might also be assigned general staff functions.
Certain consultants could be stationed advantageously in one
of the Regional Offices, especially if the region's unique
problems demanded a disproportionate share of the consultants'
time.

Budget Requirements

Personnel costs of the recommended Water Supply Program are
estimated at approximately $330,000 based on current State
salary levels. Trave], space, equipment and supplies may


-------
92

FIGURE 4
PROPOSED STAFFING CHART
DIVISION OF WATER SUPPLY

D irector

Jackson
Office

Assistant Director
i - Engr. Technician

1 - Secretary

Central
Office

Assistant Director
5 - San. Engineers
2 - Engr. Technicians
4 - Secretaries

Knoxville
Office

Assistant Director
2 - San. Engineers

1	- Engr. Technician

2	- Secretaries

Other Related Water Supply Positions

Division of Laboratories

2 Bacteriologists and 1 Secretary

Division of Stream Pollution Control
3 Chemists and 1 Secretary


-------
93

cost as much as $54,000^ additional. These figures do not
include bacteriological laboratory costs or indirect chemical
laboratory costs but do include the new water supply positions
proposed for the Division of Laboratories and the Division of
Stream Pollution Control.

It is estimated that the Division of Laboratories examined
about 25,000 water samples for bacteriological contamination
in 1969. The cost of these analyses has never been calculated,
nor has any cost been charged to the Water Supply Program. The
analyses are conservatively estimated to have cost at least
$50,000. Bacteriological analyses for the proposed program
may number as high as 43,000 per year. This is about 18,000
more than are presently examined and could cost as much as
$36,000 more than the current program.

It is also estimated that about 575 complete chemical analyses
will be required each year for the proposed programs. Based
on an estimated cost of $150.00'^ per sample and deducting
chemical laboratory personnel costs already included above,
the chemical samples may cost as much as $40,000. This would
be about $33,000 more than is currently spent on these
analyses.

/6 Community Water Supply Study p. 62.
11 Community Water Supply Study p. 63.


-------
94

The total estimated cost of the proposed Water Supply Program
is summarized on the following table:

TABLE II
DIVISION OF WATER SUPPLY
PROPOSED BUDGET

Division of Water Supply Personnel

15 professional & subprofessional and 7 secretaries $253,000
Personnel assigned to Laboratories

5 professional and 2 secretaries	77,000

Travel, Space, Equipment and Supplies	54,000
Indirect Laboratory Costs

43,000 Bacteriological Samples	86,000

575 Chemical Samples	40,000

The cost of the current Water Supply Program is estimated as:

TOTAL

$510,000

Water Supply Activities

$ 69,500

Indirect Laboratory Costs

25,000 Bacteriological Analyses

50,000

175 partial chemical analyses

7,000

TOTAL

$126,500


-------
The proposed Water Supply Program amounts to a four-fold
increase over what is now being spent for water supply
protection. Viewed in another way, it may be said that the
current program could not even qualify as a "half-way"
measure, but only represents a "one-fourth" rate commit-
ment to the essential task of protecting Tennesseean's
drinking water.


-------
96

PARTICIPANTS

The following persons and/or agencies made a major contribution to the
successful completion of this study.

Study Director

G.	D. Hutchinson, Water Hygiene Representative

Study Advisors

H.	W. Chapman, Sanitary Engineer Director

J. A. Cofrancesco, Director, Division of Technical Operations

R. D. Lee, Chief, Community Water Supply Branch

W. N. Long, Deputy Director, Bureau of Water Hygiene

L. J. McCabe, Director, Division of Epidemiology & Biometrics

Field Evaluation

J.	M. Dennis, Chief, Water Hygiene Training Branch

E.	E. Geldreich, Principle Bacteriologist

J.	J. Healey, Staff Engineer

T.	N. Hushower, Fluoridation Engineer

C.	Johnson, Southern Regional Education Board Intern
P.	C. Karalekas, Jr., Programmer

E.	F. McFarren, Supervisor Chemist

F.	W. Norris, Jr., Water Resources Consultant

L.	Peppers, Southern Regional Education Board Intern

S.	Roach, Southern Regional Education Board Intern

D.	H. Taylor, Water Hygiene Engineer
W.	J. Whitsell, Ground Water Engineer

Laboratory Support

Bethesda Fluoride Laboratory, BWH
Cincinnati Water Hygiene Laboratory, BWH
Gulf Coast Water Hygiene Laboratory, BWH
S. E. Radiological Health Laboratory, BRH
Tennessee Department of Public Health Laboratories
(Knoxville, Nashville, and Memphis)

Epidemiological Evaluation

F.	E. Hamblet, Chief, Chronic Disease Section

Data Processing

Mrs. G. D. Bardo, Statistical Clerk
A. F. Hammonds, Computer Systems Analyst

G.	C. Kent, Chief, Water Quality Register Branch
P. C. Karalekas, Jr., Programmer

Report Preparation

Mrs. L. H. Hood, Secretary

Mrs. F. P. Matlock, Secretary

F. W. Norris, Jr., Water Resources Consultant

D. H. Taylor, Water Hygiene Engineer


-------
ACKNOWLEDGEMENTS

The assistance and cooperation of Mr. Julian R. Fleming, Director,
Division of Sanitary Engineering, Tennessee State Department of
Public Health, is gratefully acknowledged. The Division of Sanitary
Engineering Staff gave freely of their time and accompanied survey
officers on most field evaluations. The county sanitarians of
Fayette, Grainger, Haywood, Rutherford, Sevier and Wilson County
Health Departments also made a substantial contribution. The Division
of Laboratories, Nashville Central Laboratory and the Knoxville and
Memphis Branch Laboratories provided bacteriological analyses. And
finally, a special thanks is given to all the residents, waterworks
personnel and utility officials who provided information and otherwise
cooperated in the Study.


-------
99

APPENDICES

A.	Public Water Supply Survey Data

B.	Semi-Public Water Supply Report

C.	Individual Water Supply Data

D.	Fluoride Practice

E.	Water Supply Code and Regulations

F.	Bacteriological Laboratory Survey

G.	Waterborne Disease Occurrence


-------
APPENDIX A
TABLE I

PUBLIC WATER SYSTEMS STUDIED

NAME OF
SYSTEM

NO	

1	Belvidere U.D.

2	Calderwood

3	Camden

4	Cedar Grove

5	Chattanooga

6	Columbia

7	Cookeville

8	Cottage Grove

9	Daisy-Soddy U.D.

10	Dowelltown-Liberty

11	Dyersburg

12	East Kingsport U.D.

13	Eastside U.D.

14	Elizabethton

POPULATION
SERVED

AVERAGE DAILY
DEMAND (MGD)

n

SOURCE

TREATMENT

600
79
4,000
1,000
179,680
30,000
16,600
300
7,500

800
20,000
5,000

35,000

15,000

0.024
0.007
0.425
0.045
46.560
4.675
2.580
Unknown
0.480

0.040
3.000
0.200

3.230

2.500

Well
First Cr.

Tenn. R.
2-Wells
Tenn. R.

Duck R.

Falling Water R.

2-Wells

Tenn. R.

Wells

Well

3-Wells

Spring & Well
Kingsport

Spring
Chattanooga

Springs

D

FD

CSFDFl

ACSFD

CSFDFl

CSFDFl

CSFDFl

None

CSFD
D

D

ACSFDFl
D

D

DF1


-------
NAME OF	POPULATION

NO	SYSTEM	SERVED

15	Hallsdale-Powell	U.D.	20,000

16	Jackson	45,000

17	Johnson City	50,000

18	Rnox-Chapman U. D.	10,500

19	Knoxville	190,000

20	Lafayette	3,000

21	Memphis	620,000

22	Mercer U. D.	300

23	Mooresburg U. D.	250

24	Nashville	425,000

25	Orlinda	360

26	Orme	120

TABLE I (Cont'd)

AVERAGE DAILY

DEMAND (MGD)	SOURCE	TREATMENT

1.500 Springs	D

Beaver Cr. )	CSFD
Melton Res.)

5.500 10-Wells	ADLF1P

4-Wells	ACSFD
2-Wells	ADLA

6.500 Springs	D

Watauga R.	ACSFDF1

N. Indian Cr.	CSFDF1

0.680 French Broad R.	CSFD

29.000 Tenn. R.	CSFD

Third Cr.	CSFD

Wells & Spr.	CSFD

0.260 3-Springs	D

82.600 140 Wells	AFD

5-We	lis	ACSFDF1
4-Wells	AFDFl

0.006 Well	ADLA

0.030 Springs	D

60.000 Cumberland R.	ACSFDF1

0.050 Spr. & Well	D

Unknown Spring	None


-------
NO

27

28

29

30

31

32

33

34

35

36

37

38

39

40

TABLE I (Cont'd)

NAME OF	POPULATION	AVERAGE DAILY

SYSTEM

SERVED

DEMAND (MGD)

SOURCE

Pleasant Hill U. D.

400

0.020

Lake

River Road U. D.

400

0.016

Spr. & Lake

Rogersville

5,500

0.475

Big Creek

Sewanee

2,960

0.380

Lake

Smith U. D.

2,000

0.380

Caney Fk. R.

Spring Creek U. D.

220

0.015

2-Wells

Tri-Counties U. D.

400

0.240

Tenn. R.

Tullahoma

18,000

1.500

Spring

Turnbull U. D.

2,500

0.800

Turnbull Cr.

Union City

10,000

2.000

4-Wells

Walland

100

0.040

Well

Waverly (Deleted)







West Point U. D.

300

0.010

2-Wells

Whitwell

2,460

0.160

Sequatchie R.

1,725,329	148 gpcd Avg.

— A - Aeration	L -	Lime

C	- Coagulation	L^-	Soda Ash

S	- Sedimentation	Fl- Fluoridation

F	- Filtration	P -	Phosphates

D	- Disinfection


-------
;x?

10.

1

2

3

4

5

6

7

8

9

10

11

12

13

it.

0

0

0

0

(0

05;

0

0

0

0

0

0

0

0

APPENDIX A
TABLE II

WATER QUALITY - PUBLIC WATER SYSTEMS

MONTHS		CHEMICAL STANDARDS NOT MET*

BACTERIOLOGICAL 	RECOMMENDED	MANDATORY

STDS. NOT MET	Plant	Dist. Sys.	Plant	

10 0	0

0	Color (22.) Fe (0.540) Fe (0.630)	0

Turb. (7.10)

1	0 0	0

3 0 0	0

0 0 Fe (0.332)	0

Mn (0.105 & 0.084)

0 0 0	0

0 0 0	0

0 0 Fe (0.540)	0

0 0 0	0

0 0 0	0

0 Fe (0.465) Fe (0.560 & 0.650)	0

0 0 0	0

0 0 0	0


-------
TABLE II (Cont'd)

MONTHS	CHEMICAL STANDARDS NOT MET*

SYSTEM BACTERIOLOGICAL			RECOMMENDED			MANDATORY

NO.	STDS. NOT MET	Plant	Dist. Sys.	Plant	Dist. Sys.

14	1	0	0	0	0

15	0	0	0	0	0

16	0	Mn (0.110)	Fe (0.440)	0	0

Mn (0,240 & 0.390)

17	0 Color (20.) F (1.35)	0	0	0

Fe (0.570) Mn (0.069)

Turb. (20.)

18	0 0	0	0	0

19	0 0	0	0	0

20	0 0	0	0	0

21	0 F (1.35)	Fe (0.510)	0	0

22	1 0	0	0	0

23	3 Turb. (8.1)	0	0	0

24	0 0	0	0	0

25	0 Turb. (6.6)	Fe (0.424)	0	0

26	2 Turb. (6.3)	0 Cr (0.074)	0

o

vO


-------
TABLE II (Contl.d)

SYSTEM
NO.

MONTHS



CHEMICAL STANDARDS

NOT MET*



BACTERIOLOGICAL

RECOMMENDED



MANDATORY



STDS. NOT MET

Plant

Dist. Sys.

Plant

Dist. Sys.

27

1

CCE (0.237)

0

0

0

28

0

-

-

-

-

29

0

0

0

0

0

30

0

0

0

0

0

31

1

0

0

0

0

32

0

0

0

0

0

33

0

Turb. (9.0)

0

0

0

34

0

0

0

0

0

35

1

0

0

0

0

36

0

F (1.35)

0

0

0

37

1

0

0

0

0

38

-

-

-

-

-

39

0

0

0

0

0

40

1

0

0

0

0

No. Not Meet. Stds. 12 13	2

Per Cent 31% 33%	5,17<>

*Only those chemical constituents failing to meet Drinking Water Standards are shown.	Color and Turbidity are
expressed in Standard Units, all other constituents expressed as mg/1.


-------
APPENDIX A
TABLE III
FACILITIES - PUBLIC WATER SYSTEMS

SYSTEM
WO

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

SOURCE

TREATMENT

DISTRIBUTION

QUALITY
OK
OK
OK
OK
OK*

OK
OK
OK
OK
OK
OK
OK
OK
OK
OK
OK

QUANTITY
OK
OK
OK
OK
OK
OK
X
OK
OK
OK
OK
OK
OK
UC
OK
OK

PROTECTION
OK
OK
OK
OK
X
X
X
X
X

OK

OK

X

OK

OK

OK

X

FACILITIES
OK
X
X
X
UC
OK
X
X
X
OK
X
X
OK
X
X

OK

OPERATION
X
X
X
X
X
OK
X
X
X

OK

X

X

OK
X
X
X

STORAGE
OK
OK
OK
OK
X

OK
X

OK

OK

X

OK

OK

X

OK

X

PRESSURE
OK
X
X

OK

X

OK

OK

OK

OK

OK

OK

OK

OK

X

OK
OK

Cla RESIDUAL

X
X
X
X
X
X
OK

OK
OK
OK
OK
OK
OK
OK
X

RECORDS
OK
OK
OK
OK
OK
OK
OK
X

OK
OK
OK
X
OK
OK
OK
OK

QUALITY CONTROL

RISK

X-CONN, CONTROL FACTOR !'¦

X
P

X
X
X
p
X
X
X
P
p
X
X
X

OK

3

4

5

4
7

2

6

5

4
0

3

5

t_

6
2

4


-------
TABLE III (Cont'd)

SYSTEM	SOURCE	 	TREATMENT			DISTRIBUTION	 QUALITY CONTROL		RISK

MO	QUALITY QUANTITY	PROTECTION FACILITIES	OPERATION	STORAGE	PRESSURE	CI*. RESIDUAL	RECORDS X-CONN. CONTROL	FACTOR/1

17	OK*	OK	X	X	X	OKa	OK	X	OK	X	5

18	OK	OK	OK	OK	OK	OK	OR	OK	X	X	2

19	OK*	OK	OK	OK	OK	OK	X	OK	OK	OKI

20	OK	UC	OK	X	OK	X	OK	OK	OK	OK	3

21	OK	OK	OK	OK	X	OK	OK	OK	OK	X	2

22	OK	OK	OK	X	OK	OK*	OK	OK	X	X	3

23	OK	OK	OK	X	XX	OK	X	X	X	6

24	OK	OK	OK	OK	OK	OK*	OK	OK	OK	OK	0

25	OK	OK	OK	X	OK	OK	X	CKX	X	4

26	XXX	XXXX	-X	X	9

27	X	CSC	OK	X	OK	OK	OK	OK	OK	OK	2

28	OK	OK	OK	X	OK	OK	OK	OK	OK	X	2

29	OK	OK	OK	OK	X	OK	OK	OK	OK	X	2

30	OK	OK	X	X	X	X	OK	OK	X	X	6

31	OK*	OK	X	X	X	OK	OK	OK	OK	P	3

32	OK	OK	OK	OK	X	OK	OK	X	X	X	4

33	OK	OK	X	X	OK	OK	OK	OK	OK	X	3


-------
TABLE III (Cont'd)

SYSTEM
NO



SOURCE



TREATMENT





DISTRIBUTION

QUALITY CONTROL

RISK
FACTOR11

QUALITY

QUANTITY

PROTECTION

FACILITIES

OPERATION

STORAGE

PRESSURE

CI* RESIDUAL

RECORDS

X-CONN. CONTROL

34

OK

OK

OK

OK

OK

OK

OK

X

OK

X

2

35

OK

OK

OK

X

X

OK

OK

OK

OK

X

3

36

OK

OK

X

X

X

X

OK

OK

OK

X

5

37

OK

OK

OK

X

OK

X

OK

OK

X

X

4

38

-

-

-

-

-

-

-

-

-

-

-

39

OK

OK

OK

OK

OK

OK

OK

OK

X

X

2

40

OK

OK



X

X

OK

X

OK

X

X

5

TOTAL "X"

2

4

13

26

24

11

8

11

12

28



PER CENT

57.

107.

337.

677.

627.

287.

217.

307.

317.

727.



* - Subject to upstream pollution



















X - Deficient

/a - Conditional because of open reservoirs

P - Partial

UC - Under construction

/I Judged on the ten facility items - "0" Facility deficiencies 3 least risk

"10" Facility deficiencies » most risk


-------
IV I

1

2

3

4

5

6

7

8

9

10

11

12

APPENDIX A
TABLE IV

PUBLIC WATER SUPPLY SURVEILLANCE

BACT. LABS.

TYPE	CERTIFIED

NUMBER OF BACT. SAMPLES	MONTHS

REQUIRED 1./	 EXAMINED	WITH NO

Avg.^/ Range/Month SAMPLES

YEARS SINCE LAST
SHD SURVEY CHEMICAL ANAL.

SHD
SHD
SHD-WTP

SHD
SHD-WTP
SHD-WTP
SHD-WTP

SHD
SHD-WTP

SHD
SHD-WTP
SHD

Yes
Yes
SHD Only
Yes
Yes
SHD Only
SHD Only

Yes
SHD Only

Yes
SHD Only
Yes

2
2

4
2

160
35
20
2
8
2

24

5

2
2

28
2*
162
22
15

1
4

2

27
1

1-3
1-3
26-31

0-7
160-164

14-25
11-18

1-1

2-10
1-2

15-30
0-2

0
0
0
2
0
0
0
0
0
0

0

1

<	1
3
1

<	1

3
1

> 1
.< 1
1
1

1%

4

6

<	1
None
None

<	h

<	1

>	3
^ 31

>	8

11%

>	5

>	5

vO


-------
" w |

13

14

15

16

17

18

19

20

21

22

23

24

25

TABLE IV (Cont'd)

BACT. LABS.

TYPE	CERTIFIED

REQUIRED

NUMBER OF BACT. SAMPLES	MONTHS	YEARS SINCE LAST

EXAMINED	 WITH NO SHD SURVEY CHEMICAL ANAL.

Avg.il/ Range/Month SAMPLES

SHD
SHD
SHD-WTP
SHD-WTP
SHD-WTP
SHD-WTP
SHD-WTP

SHD
SHD-WTP
SHD
SHD
SHD-WTP
SHD

Yes
Yes
SHD Only
SHD Only

Yes
SHD Only
Yes
Yes
Yes®/
Yes
Yes
Yes
Yes

42
18
24
60
60
15
160
3
250
2
2
230
2

2

3

20
10
31

2

175
\\
422

3

1
414

2

2-2
1-11
16-20

26-63
1-.2
170-185

1-2
325-515

1-5
0-4—^

383-466

2-2

0
0
0
0
0
0
0
0
0
8
0
0

>	3
3%
1

<	1
3%

<	1

>	1

<	1
1
3

<	1

<	k

5

>	11

>	5

<	1

<	1
None

<	1
5

%

None

>	5
< 1

>	6

S3


-------
V t

26

27

28

29

30

31

32

33

34

35

36

37

38

TABLE IV (Cont'd)

BACT. LABS.

TYPE	CERTIFIED

NUMBER OF BACT. SAMPLES	MONTHS

REQUIRED*/	 EXAMINED	 WITH NO

Avg.— Range/Month SAMPLES

YEARS SINCE LAST
SHD SURVEY CHEMICAL ANAL.

SHD
SHD
SHD
SHD-WTP
SHD
SHD
SHD
SHD
SHD-WTP
SHD-WTP
SHD-WTP
SHD

Yes
Yes
Yes
SHD Only
Yes
Yes
Yes
Yes
SHD Only
SHD Only
SHD Only
Yes

2
2

2
6

3
2
2
2

20

4
13

2

%

2*

1
32

2
2

1

2
32

2
32
2

0-4
0-4

0-2
30-32

1-2
1-5

0-3

1-3
30-33

1-5
30-34
1-3

10

1
6
0
0
0

2
0
0
0
0
0

%

%

1

>	2

%

>	1

2

1

1%
1%

1

7

None
None

4

>	6

>	6
None

5

9
7

>	3

31

N>
LO


-------
TABLE IV (Cont'd)

SYSTEM BACT. LABS. NUMBER OF BACT. SAMPLES	MONTHS	YEARS SINCE LAST

NO. TYPE	CERTIFIED REQUIRED^	 EXAMINED		WITH NO	SHD SURVEY CHEMICAL ANAL,

Avg.	Range/Month	SAMPLES

39	SHD Yes 2 2 1-3 0	%	None

40	SHD Yes 3 2 1-3 0	h	None

^Deficient = 21	= 16	#> 3 = 31

54%	41%	80%

SHD - State Health Department

WTP - Water Treatment Plant

a/ - WTP only provisionally certified

b/ - Some samples were Special

* - See months with no samples

1_/ Minimum number of samples required

2_/ Average number of samples examined

to meet Drinking Water Standards,
per month during the 12 month period

preceding the study.	ro

l_n


-------
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

67

85

89

>t :

92

98

90

62

95

83

92

86

88

97

94

94

90

98

98

90

93

60

APPENDIX A
TABLE V

SUMMARY OF PUBLIC WATER SYSTEM DEFICIENCIES

WATER	RISK	SURVEILLANCE

QUALITY Ll	FACTOR Ll Bact. Chem. SHD

B	3	OK X. OK

C	4	OK OK X

B	5	OK X OK

B	4	X	X OK

C & C*	7	OK OK X

OK	2	X	OK OK

OK	6	XXX

C	5	X	X OK

OK	4	OK X OK

OK	0	OK X OK

C	3	OK X X

OK	5	XXX

OK	1	X	X OK

B	6	XXX

OK	2	XXX

C	4	X	OK OK

C	5	X	OK OK

OK	2	XXX

OK	1	OK OK OK

OK	3	XXX

C	2	OK OK OK

B

3	OK X OK


-------
129

TABLE V (Cont'd)

SYSTEM
NO

WATER
QUALITY H

RISK
FACTOR LI

SURVEILLANCE
Bact. Chem. SHD

23

24

25

26

27

28

29

30

31

32

33

34

35

36

37

38

39

40

TOTAL NO.
PER CENT

B & C
OK
C

B, C & C*
B & C
OK
OK
OK
B

OK
C

OK
B
C
B

OK
B

22

567o

6

0
4
9

2
2

2
6

3

4
3

2

3

5

4

2

5

37
95%

X

OK

OK

X

X

X

OK

X

OK

X

OK

OK

X

OK

OK

OK
X

20
51%

X

OK

X

X

X

x -

X
X
X
X
X
X
X
X
X

X
X

31
80%

X

OK

OK

OK

OK

OK

X

OK

X

X

X

OK

X

X

OK

OK
OK

16
41%

LAST
STATE
RATING 12

47
97
78
16
86

Not Rated
90
90
88

Not Rated
77
96
90
99
30

69
90

/1 B - Exceeded Bacteriological Standard at least once in 12 months.
C - Exceeded at least one "recommended" chemical limit.
C*- Exceeded at least one "mandatory" chemical limit.

/2 Judged on ten facilities items "0" deficiencies = least risk

"10" deficiencies - most risk

/3 Approved Water System = 90 rating or better.

X = Inadequate or deficient


-------
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

3

4

5

4

7

2

6

5

4

0

3

5

1

6

2

4

5

2

1

2

2

3

6

APPENDIX A
TABLE VI

PUBLIC WATER SUPPLY OPERATORS AND OPERATION

	OPERATOR		WATER

FULL TIME	TRAINING	CERTIFIED QUALITY

No	On-the-job	No	B

No.	Short School	No	C

Yes	Short School	No	B

No	On-the-job	No	B

Yes	College	Yes	C & C*

Yes	Short School	Yes	OK

Yes	Short School	Yes	OK

No	On-the-Job	No	C

Yes	Short School	Yes	OK

No	Short School	Yes	OK

Yes	Short School	Yes	C

Yes	Short School	Yes	OK

Yes	Short School	Yes	OK

Yes	Short School	Yes	B

Yes	Short School	No	OK

Yes	Short School	Yes	C

Yes	Short School	Yes	C

Yes	Short School	Yes	OK

Yes	College	Yes	OK

Yes	Short School	Yes	OK

Yes	College	Yes	C

No	Short School	No	B

No	Short School	No	B & C


-------
TABLE VI (Cont'd)

133

SYSTEM



OPERATOR



WATER

RISK

NO

FULL TIME

TRAINING

CERTIFIED

QUALITY

FACTO]

24

Yes

College

Yes

OK

0

25

No

Short School

Yes

C

4

26

None

	

	

B, C & C*

9

27

No

Short School

Yes

B & C

2

28

No

On-the-Job

No

OK

2

29

Yes

Short School

Yes

OK

2

30

Yes

Short School

Yes

OK

6

31

Yes

Short School

Yes

B

3

32

No

On-the-Job

No

OK

3

33

No

Short School

Yes

C

3

34

Yes

Short School

Yes

OK

2

35

Yes

Short School

Yes

B

3

36

Yes

Short School

Yes

C

5

37

No

Short School

No

B

4

38

-

	

	

	

	

39

No

Short School

No

OK

2

40

Yes

Short School

Yes

B

5

SUMMARY

14-No
36%

29 S.Sch.- 76%
5 Job - 13%
4 College-m

13-No
33%

22-Problems
56%

3.5 Average

/1 Judged on ten facilities items "0" deficiencies = least risk

"10" deficiencies - most risk

WATER QUALITY

B - Exceeded Bacteriological Standard at least once in 12 months.
C - Exceeded at least one "recommended" chemical limit.

C*- Exceeded at least one "mandatory" chemical limit.


-------
135

APPENDIX B
TENNESSEE SEMI-PUBLIC WATER SUPPLIES

Supervision of public water supplies by the Tennessee Department of
Public Health has been extended, under past administrative policies,
only to supplies with 25 or more connections. It is obvious, however,
that many supplies serving fewer than 25 customers could constitute
major threats to public health. There are also many water systems
serving the public at a variety of private and commercial establish-
ments, such as restaurants, motels, subdivisions, trailer courts,
parks, recreation areas, etc. The term "semi-public" water supply has
been used to describe these supplies which are not included in a for-
mal surveillance program. Little information was available in State
Health Department files regarding number of these supplies, number
of persons served, and extent of public health protection provided.
A recent compilation by the Department supplemented existing informa-
tion, but significant gaps in knowledge remained. Because it had
become apparent the"semi-publid'water supplies influenced the health
of many people, they were included in the Tennessee Water Supply
Study.

In order to evaluate the present condition of Tennessee1,semi-public"
water supplies and to ascertain if additional health agency surveil-
lance may be necessary to assure protection of the public health,
three counties were selected to be surveyed and sampled. These
counties were Sevier County in east Tennessee, Wilson County in


-------
136

mid-Tennessee, and Fayette County in west Tennessee. Although the
sample was admittedly small, it was felt that conclusions drawn from
these three counties could reasonably be extended to generally
describe the condition of 'feemi-publid' water supplies in Tennessee.

Sevier County consists of rolling to mountainous terrain, including
the Great Smoky Mountains and the extensive tourist development in
that vicinity. Wilson County is somewhat flatter and is bordered
on the northeast by Old Hickory Lake, an impoundment on the Cumberland
River. Fayette County is essentially flat and predominantly agricul-
tural.

"Semi-publid'water supplies in the three counties are largely depen-
dent on groundwater for source of supply. Wilson County, and to a
lesser degree Sevier County, are underlaid with limestone formations
which are subject to fracture and solution channels and which may
allow extensive movement of contaminated groundwater. This geologic
condition may cause properly constructed and operated wells to yield
contaminated water. Fayette County is underlaid with a massive sand
aquifer yielding water of excellent quality.

The study attempted to establish an estimate of the number of persons
affected by "semi-public*water supplies in the State. In many cases,
the number of persons actually served by a supply was not recorded.
In addition, the probability that water would be consumed differs
between guests at a motel and visitors at a day facility such as an
amusement park. Nevertheless, visitors to both facilities are


-------
137

dependent upon the water served as the only water available. All
visitors were included, therefore, in defining the population at
risk. Assumptions employed in obtaining the estimated population
at risk are included at the end of this Appendix.

Table I presents a tabulation of the principle features of the
"semi-public?1 water supplies surveyed in the three-county area. This
tabulation includes information on the number of people served, source,
treatment provided, surveillance by health agency, and quality of
water produced. Also included is a rating of the overall accept-
ability of the system from the public health standpoint. Obviously
some judgment was necessary to rate the adequacy of treatment and
freedom from sanitary defects. However, emphasis in rating the
systems was placed upon results of bacteriological testing and presence
of chlorinating equipment and chlorine residual. Sufficient data
were not assembled to evaluate adequately whether or not a particular
water supply could be operated safely without disinfection. In this
report, therefore, disinfection is necessary for a supply to be con-
sidered fully satisfactory. Supplies considered "satisfactory" in
all other respects except for the absence of chlorine equipment or
chlorine residual were considered "questionable11.

In order to provide satisfactory public health protection, it is the
policy of the Tennessee State Department of Public Health to require
disinfection of all public water supplies. The U. S. Public Health
Service also endorses disinfection of all public water supplies.


-------
u>
oo

TABLE I - SUMMARY OF PRINCIPLE FEATURES OF SUPPLIES SURVEYED



POPULATION SERVED



SOURCE



TREATMENT



SURVEILLANCE



QUALITY





RATING













Free From





















WILSON COUNTY

Est. Daily

Est. Annual





Visible

Equip,

Chlor.



Health Agcy.













SUPPLY

Pop. at

Pop. at

Adeq.



Sanitary

to

Resid.

Addit.*

Visit In

Total

Fecal

Esthetic









Risk

Risk

Otv.

Type

Defect

Chlor

Detect.

Treat.

Prev. 2 Yrs.

Coll.

Coli.

Accept.

Satis.

Que&

UnsatU

Bentleys Boat Dock

50

360

Yes

W

No

Yes

2.0

.

Yes

0

0

Yes



X



Boxwell Reservation

750

4,800

Yes

Surf

Yes

Yes

0

DCSF

Yes

0

0

Yes



X



Cedar Creek Club #1

52

52

Yes

W

Yes

Yes

0

Soft.

Yes

270

130

Yes





X

Cedar Creek Club #2

63

1,800

Yes

w

Yes

Yes

0

Soft.

Yes

23

4

Yes





X

Cherokee Resort

370

11,610

Yes

3 W

Yes

Yes

0.3

-

Yes

0

0

Yes

X





Easter Seal Camp

110

704

Yes

Surf

Yes

Yes

3.0

CSF

No

0

0

Yes

X





Maple Hill Trailer Park

6

6

Yes

H

No

Yes

0

-

No

20

4

Yes





X

Minit Burger

180

13,500

Yes

Surf

No

Yes

0

PP

Yes

670

10

Yes





X

Murphy Subdivision

50

50

Yes

Surf

Yes

Yes

0

DCSF

No

0

0

Yes



X



Pebble Point Subdivision

28

28

Yes

Surf

Yes

Yes

UK

FDFp

No

0

0

Yes

X





Rancho 70 Mobile Home Park

28

28

Yes

W

Yes

Yes

0.7

-

Yes

0

0

Yes

X





Ruilman Center

100

640

Yes

W

Yes

Yes

0

-

Yes

0

0

Yes



X



Spencers Creek Spa

184

5,400

Yes

W

No

Yes

0.2

FP

Yes

30

4

Yes





V

TOTAL

1,965

38,950



























FAYETTE COUNTY































SUPPLY































Ames Club House

300

1,200

Yes

w

Yes

No



-

No

0

0

Yes



X



Arlington Mobile Park

210

210

Yes

2 U

Yes

No



-

Yes

0

0

Yes



X



C & R Truck Stop

212

1,057

Yes

W

Yes

No



-

Yes

0

0

Yes



X



Camp Pine Crest

53

320

Yes

W

Yes

No



-

Yes

0

0

Yes



X



Drexel's Restaurant

247

18,000

Yes

W

Yes

No



-

Yes

0

0

Yes



X



E & E Restaurant

210

15,750

Yes

W

Yes

No



-

Yes

0

0

Yes



X



La Grange

210

210

Yes

2 W

Yes

No



-

No

0

0

Yes



X



Meadow Subdivision

35

35

Yes

W

Yes

No



-

No

0

0

Yes



X



Middlecoff Trailer Park

63

63

Yes

W

Yes

No



-

Yes

0

0

Yes



X



Pine Lake Mobile Estates

149

149

Yes

W

Yes

No



-

Yes

0

0

Yes



X



Uards Trailer Court

52

52

Yes

W

Yes

No



-

Yes

0

0

Yes



X



Ms, Jordan Subdivision

21

21

Yes

W

Yes

No



-

No

2

0

Yes



X



^	1,762	37,067

*See Explanation of Symbols Below


-------
TABLE I - SUMMARY OF PRINCIPLE FEATURES OF SUPPLIES SURVEYED

POPULATION SERVED 	SOURCE	 	TREATMENT	 SURVEILLANCE	QUALITY	 	RATING

Free From

SEVIER COUNTY

Est. Daily

Est. Annual





Visible

Equip.

Chlor,



Health Agcy.













SUPPLY

Pop. at

Pop. at

Adeq.



Sanitary

to

Resid.

Addit.*

Visit In

Total

Fecal

Esthetic









Risk

Risk

Qty.

Tjrpe

Defect

Chlor.

Detect.

Treat.

Prev. 2 Yrs.

Coli.

Coli.

Accept.

Sati&

Ques.

Unsatis.

Bible Presby. Camp

42

269

Yes

W

Yes

No



_

Yes

0

0

Yes



X



Buena Vista Estates #1

7

7

Yes

w

Yes

No



-

No

0

0

Yes





X

Buena Vista Estates #2

7

7

Yes

w

Yes

No



-

No

0

0

Yes



X



Camp Ba Yo Ca

125

800

Yes

w

Yes

No



-

Yes

0

0

Yes



X



Camp 'n' Air #1

80

3,200

Yes

w

Yes

No



-

Yes

12

0

Yes





X

Camp 'n' Air #2

80

3,200

Yes

w

Yes

No



-

Yes

0

0

Yes



X



Camp Pigeon Forge

104

4,160

Yes

w

Yes

Yes

0.2

-

Yes

0

0

Yes

X





Camp Smoky

230

9,200

Yes

V

Yes

No



-

Yes

0

0

Yes



X



Delozier Motel

27

1,295

Yes

w

Yes

Yes

0

-

Yes

0

0

Iron



X



Douglas Bait Center

40

4,500

Yes

w

Yes

Yes

0.3

-

Yes

0

0

Yes

X





Flat Branch Court

15

648

Yes

w

Yes

Yes

0.9

-

Yes

56

20

Iron

X





Gatlinburg Ski Corp.

1,500

180,000

Yes

w

Ho

No



-

Yes

0

0

Iron





X

Gatlinburg Tr. Pk. and Campgr.

154

6,160

Yes

Sp

Yes

Yes

0.3

-

Yes

4

0

Yes



X



Greenbriar Island Campgr.

230

9,200

Yes

w

Yes

No



-

Yes

0

0

Yes



X



Greenbriar Motel

14

1,296

Yes

w

Yes

Yes

0

-

Yes

0

0

Iron



X



Goldrush Junction

660

79,200

Yes

w

Yes

No



-

Yes

0

0

Yes



X



Hillside Motel

14

1,296

Yes

w

Yes

Yes

0.5

-

Yes

0

0

Sand

X





J. B. Whaley Store

60

450

Yes

w

Yes

Yes

0

-

Yes

20

4

Yes



X



L-Ranch Motel

20

1,782

Yes

V

Yes

No



-

Yes

0

0

Yes



X



Li11 Bit of Heaven #1

7

7

Yes

w

Mo

No



-

Yes

0

0

Iron





X

Li'l Bit of Heaven #2

10

10

Yes

w

Yes

No



-

Yes

0

0

Iron



X



Li'l Ponderosa

133

5,360

Yes

w

Yes

No



Fp

Yes

0

0

Yes



X



Mountain View Trailer Park

49

49

Yea

w

Yes

No



-

Yes

0

0

Yes



X



Norton Creek Club

14

14

Yes

Sp

Yes

No



-

Yes

700

2

Yes



X



Oak Hill Motel

9

972

Yes

w

Yes

No



-

Yes

0

0

Yes



X



Our Place Campground

86

3,440

Yes

w

Yes

No



-

Yes

96

2

Yes





X

Parkway Motel

24

1,790

Yes

w

Yes

Yes

0

-

Yes

0

0

Yes



X



River Edge Camp

170

6,800

Yes

w

Yes

No



-

Yes

0

0

Yes



X



Ski Mountain Motel

20

1,460

Yes

u

Yes

Yes

0

-

Yes

0

0

Yes



X



Smoky Mtn. Private Camp

44

1,600

Yes

w

Yes

No



-

Yes

0

0

Yes



X



u>


-------
TABLE I - SUMMARY OF PRINCIPLE FEATURES OF SUPPLIES SURVEYED

POPULATION SERVED 	SOURCE	 	TREATMENT	 SURVEILLANCE 	QUALITY	 	RATING

Free From

SEVIER COUNTY

Est. Dally

Est. Annual





Visible

Equip.

Chlor.



Health Agcy.











SUPPLY

Pop. at

Pop. at

Adeq.



Sanitary

to

Resid.

Addit.*

Visit In

Total

Fecal

Esthetic







Risk

Risk

Otv.

Type

Defect

Chlor.

Detect;

Treat.

Prev. 2 Yrs.

Coli,

Coli.

Accept.

Satia

Ques.

Spring Valley Camp

154

6,160

Yes

W

Yes

Yes

0.2

-

Yes

0

0

Yes

X



Trout Creek Cam & Tr. Pk.

160

6,400

Yes

W

Yes

Yes

0.1

-

Yes

28

0

Yes



X

Venture Out

318

12,720

Yes

W

Yes

Yes

3.0

-

Yes

0

0

Yes

X



Village Mgmt - Alpendorf

262

262

Yes

H

Yes

No



-

No

0

0

Yes



X

Village Mgmt - Tyrolea

175

175

Yes

W

Yes

No



-

Yes

0

0

Yes



X

tfo-Floy Motel

48

5,184

Yes

W

Yes

No



-

Yes

0

0

Iron



X

baldens Creek Pres. Camp

400

2,560

Yes

W

Yes

No



-

Yes

0

0

Yes



X

faldens Creek Trailer Ct.

49

49

Yes

W

Yes

No



-

Yes

0

0

Yes



X

if ebb s Creek Camp

70

2,800

Yes

W

Yes

No



-

Yes

0

0

Yes



X

TOTAL

5,616

364,"482

























Treatment Symbols*

C - Chemical Coagulation
D - Prechlorination
F - Gravity Sand Filtration
Fp - Pressure Filtration
S - Sedimentation
UK - Information Unknown


-------
141

Since the differentiation between public and "semi-public" supplies has
been largely one of size, it is felt that public health requirements
for "semi-public" supplies should provide essentially the same level of
protection.

Conclusions

1.	Based on estimates derived from data obtained during the study,
approximately 800 "semi-public" water supplies are operating in
Tennessee. An estimated 3.8 million persons annually are depen-
dent in one or more instances on "semi-public" water supplies for
drinking water. This significant number of persons who are or
may be affected by the quality of the water requires that a
program for supervision of these supplies be established.

2.	Of 64 "semi-public" water supplies surveyed and sampled, a signi-
ficant percentage revealed the presence of bacteriological con-
tamination. Twenty (20) per cent showed the presence of coli-
form organisms (19 per cent failed the bacteriological standard),
and 14 per cent showed the presence of fecal coliform organisms.

3.	Only 16 per cent of the "semi-public" water supplies surveyed
and sampled could be given an overall "satisfactory" rating.

4.	Seventeen (17) per cent of the supplies surveyed had not been
visited by a health agency official in the previous two years.

Most health agency surveillance was provided by county sanitarians
who are not fully trained in maintenance and operation of water


-------
treatment facilities. In most cases, the visit consisted of
collection of a water sample and did not include significant
inspection of facilities or operational practices.

Recommendations

1.	Under authority granted in Section 53-2001, Tennessee Code
Annotated, include all supplies serving the public under present
and future public water supply programs.

2.	Provide minimum standards for construction, including protection
of source, size and type storage facility, disinfection equipment,
and distribution system.

3.	Provide for initial plan review and approval, inspections of
facilities and operations at least annually, and a bacteriologi-
cal sampling program which provides for submission of at least two
samples monthly for all supplies serving the public.

4.	Require mandatory disinfection of all water supplies serving
the public.

Assumptions for Calculating Annual Population at Risk

1.	Family campgrounds and travel trailer parks operate 120 days per
year at 50 per cent of capacity. Average length of stay is three
days per family with an average of four (4) visitors per family.

2.	Church camps and similar institutions operate eight sessions
at 80 per cent capacity.


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143

3.	Tourist and truck stop restaurants operate 300 days per year.

Daily customers average six times seating capacity and customers
average four visits per year.

4.	Lunch counters are open 300 days per year. Customers average
four times seating capacity and average 40 visits per year.

5.	Evening meal only restaurants located in recreation areas average
120 days per year operation. Daily customers average one per
seat capacity and customers return an average of four times per
year.

6.	Amusement parks operate 120 days a year at 30 per cent of peak day
patronage. No customers return.

7.	Trailer parks and subdivisions risk only residents.

8.	Motels operate 180 days a year at 60 per cent capacity. The
average customer (3 people) stays two days. (All motels in
study were tourist-oriented.)

9.	Club houses are occupied to capacity four times per year.
Calculations of Annual Population at Risk

In Sevier County, the estimated annual population at risk was divided
by the number of supplies surveyed, yielding approximately 9300 per-
sons at risk annually per supply. A similar calculation for Wilson
and Fayette Counties yields 3,000 and 3,100 persons at risk annually,
respectively. Averaging these three figures yields approximately


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144

5,000 persons annually at risk per "semi-publie" supply.

Based on the inventory of "semi-public" supplies assembled by the
Tennessee State Department of Public Health from lists submitted
by county sanitarians, there are an average of approximately 6.5
supplies per county. During the survey, it was found that approx-
imately 20 per cent more supplies were found than were included on
the county sanitarians' original listing. Based on this observation,
it is estimated that each county averages eight (8) "semi-public"
water supplies.

Ninety-five (95) counties with eight (8) supplies serving 5,000
persons annually comes to 3,800,000 persons whose health may be
affected by "semi-public" water supplies each year.


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APPENDIX C

INDIVIDUAL WATER SUPPLY SURVEY
STATE OF TENNESSEE
Summer 1970

PRELIMINARY ANALYSIS OF RESULTS
BACTERIOLOGICAL QUALITY OF WATER
Spri ngs:

Grainger County

Number of springs reported: 39

Number showing presence of fecal coliform: 33 (85%)
Number showing presence of total coliform in

concentrations of four or more/100ml: 38 (97%)

Rutherford County

Number of springs reported: 1 (positive for both
fecal and total coliform)

Haywood County

Number of springs reported: I (positive for both
fecal and total coliform)

Wei Is:

Grainger ~ County

Number of wells reported: 123

Number showing presence of fecal coliform: *+9 (*+0%)
Number showing presence of total coliform in

concentrations of four or more/lOOml: 57 C+6%)

Rutherford County

Number of wells reported: 192

Number showing presence of fecal coliform: 102 (53%)
Number showing presence of total coliform in

concentrations of four or more/lOOml: 160 l<>3%)

Haywood County

Number of wells reported: 199	_

Number showing presence of fecal coliform: Ho (2*4%)
Number showing presence of total coliform in

concentrations of four or more/lOOml: 68 (3***)


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146

Ci sterns;

Grainger County

Number of cisterns reported: 16

Number showing presence of fecal coliform: 9 (56%)

Number showing presence of total coliform in

concentrations of four or more/100ml: 11 (69%)

Rutherford County

Number of cisterns reported: 0

Haywood County

Number of cisterns reported: 0

Observations on bacteriological quality.

Haywood County's wells produce higher quality water because
of the unconsolidated formations (sand and gravel) in which they are
constructed. The effectiveness of sand as a barrier to bacterial
travel is not as apparent from the data above as It would be with
better well construction. The drilled wells produced much better
water, on the average, than the bored wells; the latter are seen
to be severely contaminated (see following paragraphs). It is
much easier to construct a safe well in unconsolidated formations
than in consolidated ones, such as the limestones of Rutherford
and Grainger Counties.

WELL CONSTRUCTION AND BACTERIOLOGICAL QUALITY.

Grainger County

Dug wells reported: 2

Number showing presence of fecal coliform; 2
Number showing presence of total coliform in
concentrations of four or more/lOOml;

Bored wells reported: 9

Number showing presence of fecal coliform: 4
Number showing presence of total col!form in
concentrations of four or more/lOOml:

Driven wells reported: 0

Drilled wells reported: 109

Number showing presence of fecal coliform: 43 (39%)
Number showing presence of total coliform in

concentrations of four or more/lOOml: 52 (48%)

Rutherford County

Dug wells reported: 1 (contaminated with both)

(100%)
2 (100%)

(44%)
6 (67%)

Bored wells reported; 0


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147

Driven wells reported: 0
Drilled welts reported: 186

Number showing presence of fecal col i form: 101 (5*4%)
Number showing presence of total coliform in

concentrations of four or more/IOOml: 159 (85%)

Well construction details and sanitary defenses. In addition to the
geology, factors which influence the safety of well source include:

1)	Method of construction (driven, bored, drilled, etc.)

2)	Quality and amount of casing installed.

3)	Kind and extent of sealing the casing into the formation—

especially in the upper layers.

*0 Presence of contaminant-proof well cover.

5)	Exposure of the well to flooding.

6)	Presence of a pit around the well.

7)	Kind of pump installation.

Generally speaking, quality of well construction in all three counties
is so poor, that one or more deficiencies threatening the safety of
the source could be found in nearly every well. Even in those wells
where a cement formation seal around the casing was reported (about
one well in four in Rutherford County), the method of placement and
the extent of sealing was unknown.

Common sense would seem to dictate that some effort should be made
at every well to prevent the entry of contaminants from the surface
either through the annular space around the casing, or directly into
the well at the top. Yet, the data show that very few wells have
both of these avenues effectively closed off. This is especially
true in the limestone rock formations of Rutherford and Grainger
Counties, where wells are particularly vulnerable to pollution
through an unsealed annular space around the casing.

The only analysis of data so far which has pointed to clues as to
the sources of contamination is one in which the twelve most highly
contaminated wells (using fecal contamination as the index) in
Rutherford County were compared with twelve of the wells from the
same county which showed no contamination whatever. These "safe"
wells were selected at random from the 2k "safe" wells for which
data were complete. This comparison showed that:

1)	the most contaminated wells without acceptable covers

were times more numerous than were the "safe" wells.

2)	there were five hand pumps used in the contaminated

group, compared with only one in the "safe" group.

In addition, the average depth of the highly contaminated wells
was 77 feet, while the average depth of the "safe" wells was 110
feet. This does not mean, of course, that safety can be obtained


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148

only by drilling deeper. Drilling deeper here could have meant
that more casing in the hole provided more probability that the
annular space would seal itself; or that the water source itself
was deeper, providing more natural filtration by the upper earth
formations.

The average age of the highly contaminated wells was estimated
at 20 years, while that for the "safe" wells was estimated at
15 years. If significant, this could mean that corrosion of
the casing is permitting contamination from the surface, or it
could simply reflect a better quality of workmanship and/or
casing in more recent years.

CHEMICAL QUALITY OF WATER
Springs:

Grainger County

Number of springs reported: 39

Number showing concentrations exceeding recommended

limits: 4 (Zn 1; Fe 2; and Mn 1)

Number showing concentrations exceeding mandatory
limits: none.

Rutherford County

Number of springs reported: one (no limits exceeded)

Haywood County

Number of springs reported: one (no limits exceeded)

Wells:

Grainger County

Number of wells reported: 123

Number showing concentrations exceeding recommended

limits: 31 (Fe 21; Mn 7; Zn 2; and Cu 1)
Number showing concentrations exceeding mandatory
limits: 3 (Ba 1; Fb 1; and Ag 1)

Rutherford County

Number of wells reported: 192

Number showing concentrations exceeding recommended

limits: 59 (Fe 40; Mn 17; and F 2)*

Number showing concentrations exceeding mandatory
limits: 5 (Cr 1; Fb 2; and Ag 2)


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149

Haywood County

Number of wells reported: 199

Number showing concentrations exceeding recommended

limits: 55 (Fe 35; Mn 12; NO^ 1; Zn 2; Cu 5)*
Number showing concentrations exceeding mandatory
limits: 3 (Pb 3)

Cisterns:

Grainger County

Number of cisterns reported: 16

Number showing concentrations exceeding recommended

limits: 2 (Fe 1; Mn 1)

Number showing concentrations exceeding mandatory
limits: none

Rutherford County

Number of cisterns reported: none

Haywood County

Number of cisterns reported: none

Summary:

Number of systems: 571**

Approximate number of people served: 2,850
Average Number of persons per supply: 5

Preliminary analysis of the rural, individual water supply data indicates
that the vast majority of people utilizing rural water systems in three
Tennessee counties are drinking water of inferior quality.

* Only 38 analyses run for fluoride and nitrate on the 571 sources.

** The actual number of water systems surveyed was 576. However, for
purposes of this preliminary report, complete data was available on
only 571.


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150

Fifty-nine (59) per cent of the rural systems had water
of poor bacteriological quality. The approximate exposed
population is 1,680.

Twenty-six (26) per cent of the rural systems had water of
aesthetically inferior chemical quality. The approximate
exposed population is 740.

Two (2) per cent of the rural systems had water of such
chemical quality to pose a direct threat to human health.
The approximate exposed population is 57.

There has been sufficient analysis to relate the quality of well construc-
tion with the poor bacteriological quality found in many rural systems.
Construction deficiencies were found in nearly every installation. Fur-
ther analysis is continuing on chemical quality and the other findings
of the study.

The study of rural, individual water systems in Tennessee is part of a
national study of rural water supplies by the Bureau of Water Hygiene.
A special report highlighting this important area of water supply will
be published at a later date.

(1)

(2)

(3)


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appendix D	1

TENNESSEE WATER SUPPLY PROGRAM EVALUATION

ADEQUACY OF FLUORIDATION AT SELECTED WATER SUPPLY SYSTEMS IN TENNESSEE

I n trod tic t i on

The Tennessee Department of Public Health recommends the fluoridation
of all public water supplies in the State to a level of 0.8 - 1.2 mg/1 as
an important public health measure for the prevention of tooth decay. The
Division of Sanitary Engineering of the Department of Public Health has been
charged with the responsibility to: "determine the adequacy of equipment
and proposed technical supervision," and to "advise local officials concerning
details of the treatment and laboratory procedures required" for approval of
a fluoridation installation by the State. In evaluating the adequacy of the
water fluoridation control program of the Division of Sanitary Engineering,
twenty-four public water supply systems in the State reported to be adding
fluorides were surveyed to determine the adequacy of the installations
operating under the approval of the Department of Public Health.

A total of 119 community water supply systems, serving 209 of the
communities supplied by public water systems in the State, were reported
adding fluorides when the evaluation survey was initiated. Twenty-four of
the 119 systems were *elected for rating as being representative of the
fluoridation installationsin operation. The selection of the twenty-four
supplies was based on the following criteria: georgraphical location, source
of water supply (ground or surface), population served, fluoride compound
used in fluoridation, type of feeder, and fluoride analysis method and test
instrument used. Three supplies were chosen in each of the eight Health
Planning Districts of the State to give representative geogrphical coverage.
Selection based on the other criteria noted was according to the same


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152

approximate percentages these criteria existed for all the 119 water supply
systems fluoridating (i.e., if 11% of the 119 installations in the State
were feeding hydrofluosi1icic acid as a source of fluoride ion, 11% of the
twenty-four or three water supply systems chosen for the study were feeding
hydrofluosi1icic acid). Figure i, Fluoridated Water Supply Systems Selected
for Study, locates the twenty-four installations evaluated and Table I
summarizes pertinent information on each facility.

A field inspection was conducted at each of the twenty-four installations
selected, a survey questionnaire form was completed at the facility'^, and
water samples for fluoride analysis were collected to support the conclusions
and recommendations in the report.

Summary of Findings

Data collected on the water supply systems fluoridating in the State
of Tennessee indicated only twelve of the twenty-four installations selected
for study, evidenced a fluoride content in the distribution system within
the established 0.8 - 1.2 tng/1 range recommended by the Department of Public
Health. Two of the twenty-four installations visited, Elizabethton and
Sewanee, had not been feeding fluorides for 51 and 29*+ days respectively
prior to the visit and were not rated. Of the remaining ten installations
that were not fluoridating within the established range, nine were under-
feeding. Tablell, Analysis of Samples From Selected Fluoridated Water Supply

Systems, tabulates the fluoride analysis results of the water samples collected

2)

at each installation surveyed. '

The actual level of fluoride in the distribution system is the single

most important factor in evaluating the adequacy of a community water

1)	A copy of the Tennessee Fluoridation Questionnaire used is appended.

2)	Fluoride samples were analyzed using the Electrode Method by Dr. Ervin
Bel lack, Chemist, Bureau of Water Hygiene, U. S. Public Health Service.


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Tennessee Water Supply Program Evaluation

Figure 1

FLUORIDATED WATER SUPPLY SYSTEMS SELECTED FOR STUDY

Region I: Northwest

1	- Camden

2	- Dyersburg

3	- onion City

Region II: Southwest
li - Brownsville
5> - Jackson
6 - Memphis

Region III: Mid-Cumberland

7	- Nashville

8	- New Johnsonville

9	- Turnbull U.D. (Burns)

Region 17: South Central

10	- Columbia

11	- Sewanee

12	- Tullahoma

Region V: Upper 'Cumberland
13 - Baxter
1U - Cookeville
15 - Smith U.D. (Carthage)

Region VI: Southeast
15 - Chattanooga

17	- Etowah

18	- Niota

Region VII: East Tennessee

19	- Jefferson City

20	- La Follette

21	- Lake City

Region VIII: I

22	- Elizabethten

23	- Johnson City
2k - Rcgersville

iri

Tennessee


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TENNESSEE WATER SUPPLY PROGRAM EVALUATION
TABLE I

FLUORIDATED WATER SUPPLY SYSTEMS SELECTED FOR STUDY

WATER SUPPLY SYSTEM

SOURCE OF SUPPLY

POPULATION
SERVED

AVG. FLOW

(mgd)

DATE
STARTED

FLUORIDE
COMPOUND

TYPE OF TEST
FEEDER METHOD

TEST

EQUIPMENT

Region I: Northwest

1.	Camden

2.	Dyersburg
3- Union City

Region II: Southwest
U. Brownsville

5.	Jackson

6.	Memphis

Region III: Mid-Cumberland
7> Nashville

8.	New Johnsonville

9.	TurnbulI U.D. (Burns)

Region IV: South Central

10.	Columbia

11.	Sewanee^')

12.	Tullahoma

Region V: Upper Cumberland

13.	Baxter

14.	Cookeviile

15.	Smith U.D. (Carthage)

Kentucky Lake	4,000	0.425

3-WeHs	20,000	3.000

4-Wells	10,000	2.000

'~-Wells	7,000	0.750

11-We11s	45.000	5.500

149-Wells	620,000	82.600

Cumberland River	425,000	SO.000

Kentucky Lake	950	0.100

TurnbulI Creek	9.500	0.800

Duck River	30,000	4.675

Lake 0'Donne 11	2,960	0.380

Short Springs	18,000	1.500

2-Springs	1,200	0.130

Falling Water River	18,300	2.580

Caney Fork River	2,000	0.380

8/65
3/57
2/56

6/51

11/62

2/70

2/53
7/66
1/67

6/60
7/59
6/60

6/54

12/52

3/69

VS
VS
VS

VS
VS
VA

VS
VS
VS

VS
VT
VS

VS
VS
VS

V-l
V-2
V-l

V-l
V-l
P-l

G-l
V-l
V-3

V-2
V-l
V-4

P-2
V-l
V-l

S

s

ss

ss
ss

E

ss
ss
ss

ss
ss
ss

s

ss
ss

T-l
T-2
T-3

T-4
T-3
T-5

T-3
T-3
T-3

T-3
T-3
T-3

T-l
T-3
T-3


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MATER SUPPLY SYSTEM

SOURCE OF SUPPLY

POPULATION AVG. FLOW DATE	FLUORIDE

SERVED	(MGO)	STARTED COHPOUNO

TYPE OF TEST	TEST

FEEDER METHOD EQUIPMENT

Region VI: Southeast

16.	Chattanooga

17.	Etowah

18.	Niota

Region VII: East Tennessee

19.	Jefferson City

20.	La Fol lette

21.	Lake City

Region VIII: First Tennessee

22.	Elizabethton (2)

23.	Johnson City

Watauga System
Unicoi System

2k. Rogersville

Tennessee River
Hiwsssee River
Ma I one Spring

Mossy Spring
011i s Spr i ng
1-Spring

Hampton Springs

Watauga River
2-Spr ings

Big Creek

250,000
7.000
1,800

7.500
10,000
2,500

I7.400
50,000

5,700

46.560
1.050
0.190

1.100
0.500
0.110

2.500
6.500

0.475

9/52
6/66
3/6 U

12/66

8/57

8/67

6/66
8/61

1/66

VA

vs

VT

VS
VS
VS

VS

VA
VS

VS

P-2

V-5
P-3

V-1
V-1
p-4

V-1

p-1
V-1

V-1

S

s

ss

ss
ss
ss

ss

ss
s

-6
-I

T-1

FIuor i de Compound:

VA - Hydrofluosi1ic Acid
VS - Sodium Si 1icofluoride
VT - Sodium Fluoride (Powder)

Test Method:

S - Spadns
SS - Scott-Sanchis
E - Electrode

(1)	Fluoridation discontinued 10/15/69-

shortage of chemicals reported

(2)	Fluoridation discontinued 8/3/70-

feeder repairs required

(3)	Fluoridation discontinued in Unicoi

System - chlorine accident

Type of Feeder:

V-1 Volumetric -WtT A-378 Roll Trt,c
V-2 Volumetric - W i- T A-690 Screw Type
V-3 Volumetric - BIF 23-02 Rotating Disk
V-4 Volumetric - BIF 50-A Rotating Disk
V-5 Volumetric - BIF 25-01 Helix
G-l Gravimetric - BIF 31-02 Loss-in-weight
P-1 Diaphragm Pump - BIF 1210 Chem-0-Feeder
P-2 Diaphragm Pump - W ( T A-7^7 Metering Pump
P-3 Diaphragm Pump - W fr T A-7^5 Metering Pump
P-h Plunger Pump - W ( T 222 Rocker Arm Pump

Test Equipment:

T-l Photometer - Hellige Aqua Analyzer

Model 950A
T-2 Photometer - Hach DR-A198
T-3 Color Comparator - Hellige Aqua

Testor #611-75 Disc
T-4 Color Comparator - Taylor Water

Analyzer, SIide
T-5 Expanded Scale pH Meter - Fisher Model
310 Accumet pH Meter

T-6 Spectrophotometer - Bausch 6 Lomb

Spectronic 20
T-7 Automatic Analyzer - Hach CR-2024

Ui
U1


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156

TENNESSEE WATER SUPPLY PROGRAM EVALUATION

TABLE II

ANALYSIS OF SAMPLES FROM SELECTED FLUORIDATED WATER SUPPLY SYSTEMS

(F1uor i de-Mg/1)

DATE OF RAW FINISHED WATER
WATER SUPPLY SYSTEM	SAMPLE WATER (OPERATOR) (PHS) DISTRIBUTION SYSTEM

|. Camden

7/23

0.15

1.0

0.9*+

0.90

0.93

Dyersburg

9/15

0.15

1.0

0.70

0.71

0.70

Union City

9/16

0.13

1.2

1.06

1 .20

1.25

1 1. Brownsvl1le

9/17

<0.1

1.0

1.10

1 .12

1.13

Jackson

7/22

0.08

0.8

0.51

0.48

0.51

Memphis - ( ' )









0.80

0.35

A1 1 en

9/14

0.12

1.0

0.94





Li chterman

9/14

0.07

0.9

0.85





McCord

9/14

0.11

0.8

0.79





Parkway

9/14

0.10

0.08

0.08





Sheahan

9/15

0.06

0.9

0.78





Nashv i1le

7/21

0.11

1.04

0.96

1.10

1.05

New Johnsonvi1le

9/16

0.17

1 .2

0.78

0.80

0.87

Turnbull U.D. (Burns)

7/24

0.12

0.9

1.01

1.02

0.97

Col limb i a

7/21

0.17

1.0

1.17

1 .19

1.18

Sewanee^

8/6

0.04

-

0.03

-

-

Tullahoma

8/7

0.05

1 .1

0.86

0.90

0.91

Baxter^

8/4

0.11

-

0.49

0.42

0.49

Cookevi1le

8/4

0.27

1.0

1.06

1.03

1.10

Smith U.D. (Carthage)

8/3

0.17

1 .0

1.30

0.85

1.04

Chattanooga

8/6

0.11

0.64

0.59

0.25

0.42

Etowah

8/5

0.02

1.06

0.54

0.62

0.62

Ni ota

8/5

0.15

0.9

1.01

0.97

0.68


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157

WATER SUPPLY SYSTEM

(F1uor i de-Mg/1)

DATE OF RAW FINISHED WATER

SAMPLE WATER (OPERATOR) (PHS) DISTRIBUTION SYSTEM

VII. Jefferson Ci ty

Lake City
VIII. Eli zabethton^
Johnson Clty^)

La Follette

9/21	0.15	1.2	1.00	1.00	1.02

9/22	0.14	0.9	1.02	1.05	1-05

9/22	0.36	1.0	0.46	0.46	0.45

9/24	0.11 - -	0.09	0.09

9/24 0.14 0.9 1.05 1.18

1.13

Rogersv i1le

9/23 0.16

1.0 0.80 0.30

0.41

(1)	Fluorides are added at five treatment plants. Parkway Plant under major
construction improvements during survey and not operating.

(2)	Fluoridation discontinued 10/15/69 ~ shortage of chemicals reported.

(3)	No fluoride analysis conducted by operator. Samples, 4/yr, sent to state.

(4)	Fluoridation discontinued 8/3/70 - feeder repairs required.

(5)	Watauga System. Fluoridation discontinued in Unicoi System - chlorine

accident.


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158

fluoridation effort and hence the State Water Fluoridation Control Program
responsible for approval of the installation. However, because two distri-
bution samples on one particular day may not give a true picture of day-to-day
operating conditions of the facility, the following questions were investigated:
I. Analytical Control of the Fluoride Level-

A.	Were the fluoride analysis conducted at the water plant accurate
within t 0.1 mg/1 of the value determined by the Public Health
Serv i ce?

B.	Were finished water samples analyzed daily or more frequent for
fluoride content?

C.	Were raw water samples analyzed regularly for fluoride content?

D.	Were laboratory equipment and facilities at the water plant
adequate to conduct a fluoride analysis?

E.	Was laboratory equipment clean and being given reasonable care?; and,

F.	Were complete records kept of the fluoridation operation?

Analytical control of the fluoride level by the plant operator or

chemist varied considerably. Only 48% of the fluoride analysis result?
reported at the water plant were within t 0.1 mg/1 of the sample
analyzed by the Public Health Service and, while 82% of the supplies
were conducting daily finished water fluoride sample analysis, only
50% were analyzing the raw water regularly for fluoride content. Only
one community was taking water samples from the distribution system
for analysis. Adequate laboratory equipment for fluoride analysis
was available at 95% of the installations visited but care of the
equipment was a problem at 2k% of the installations. Records of the
fluoridation operation were acceptable at only 59% of the water supply
systems surveyed.


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159

II.	Fluoride Feed Equipment and Facilities-

A.	Were the fluoride feed equipment and facilities adequate to
control the fluoride level in the finished water to the desired
leve1?

B.	Was positive protection provided against overfeeding, was

equipment location and point of fluoride application at the best practical
site and was the feed equipment site uncluttered?

C.	Was the fluoride feed installation operated continuously for
the past twelve months without an interruption of more than
one day?; and,

D.	Were the fluoride feed equipment and facilities maintained
sat i sfactor i1y?

Fluoride feed equipment and facilities deficiencies were found
in 23% of the installations visited and only 50% of the feeding
arrangements were rated acceptable, i.e. protected against over-
feeding, preferred point of feed application and good housekeeping
in the feeder area. Nineteen percent of the installations reported
one or more interruptions in fluoridation of one or more days
duration in the past twelve months and maintenance was found
satisfactory at only 36% of the installations surveyed.

III.	Fluoride Compound - Storage and Handling

A.	Was the fluoride chemical compound stored in a safe,
protected and orderly manner?

B.	Were safety equipment available and safe procedures followed
in handling the fluoride compound, and were dry compounds
tinted as required?; and,


-------
C. Were fluoride compound shipping containers disposed of
satisfactory or re-used only for fluoride storage?

Forty-one percent of the installations visited did not have
acceptable arrangements for storing the fluoride compound used.
Fifty-five percent of the facilities surveyed did not have or were
not using safety equipment in handling the fluoride compounds and/or
were not using tinted dry compounds as required by the State.
Twenty-one percent of the installations using dry compounds as a

source of fluoride ion were permitting re-use of the shipping
containers.

Operator Training and Interest

A.	Was the treatment plant operator well trained to operate the
fluoride feed equipment and facilities?

B.	Was the individual conducting the fluoride analysis knowledgeable
of his test equipment and standard procedures for analysis?

C.	Was the water plant official interviewed in favor of fluori-
dation and was he interested in adding fluorides to his water
system?

A trained operator with a genuine interest in feeding fluorides
is essential to the satisfactory operation of a fluoridation
installation. One of the twenty-two installations rated was under
the control of an operator not familiar with the fluoride feed
equipment and 18% of the operators interviewed were not completely
familiar with the test equipment and procedures used in conducting
a fluoride analysis. Twenty-seven percent of the water plant
officials interviewed did not favor feeding fluorides to public
water supply systems.


-------
161

V. Surve i11ance

A.	Were check samples for fluoride analysis submitted to the State
on a regular basis, four times per year?; and

B.	Had the water fluoridation installation surveyed been inspected
by the State in the past twelve months?

Surveillance of the water fluoridation install atiore by the
Department of Public Health must be conducted frequently, to assure
the facility is operating satisfactory. Quarterly check samples for
fluoride analysis by the State Laboratory were being submitted
regularly by 91% of the water systems surveyed as required; however,
77% of the installations rated had not received an inspection visit
by a representative of the Division of Sanitary Engineering in the
past twelve months. Inspection visits to the installations
fluoridating averaged approximately one visit in eighteen months.
To improve the general operating conditions observed, more frequent
check samples and a minimum of two inspected visits per year must
be i n i t i ated.

Figure 2 , Operating Conditions at Selected Fluoridated Water Supply
Systems, summarizes the operating conditions observed at the installations
inspected during the time of the survey. Conditions varied widely at
each installation and Tablelll, Adequacy of Fluoridation at Selected Water
Supply Systems, summarizes the adequacy of the operating conditions
observed at each installation surveyed.

Conclusions and Recommendations

1. 119 community water supply systems serving 209 of the M*5 communities
supplied by public water systems in Tennessee were reported to be


-------
TENNESSEE WATER SUPPLY PROGRAM EVALUATION

FIGURE 2

OPERATING CONDITIONS AT SELECTED FLUORIDATED WATER SUPPLY SYSTEMS

% of Fluoridated Water Supply Systems Surveyed



(0

PARAMETER EVALUATED

f-> r\

III I I * I I F





-A-

10D

Fluoride content in the distribution system
Fluoride level 0.8-1.2 mg/1
Fluoride level <0.8 mg/1
Fluoride level >1.2 mg/1

Analytical control of the fluoride level . .
Operator analysis t 0.1 mg/1 PHS value' '
Daily finished water fluoride analysis
Regular raw water fluoride analysis
Adequate analytical equip. £- facilities^'
Adequate care for laboratory equipment^2'
Adequate records

Fluoride feed equipment and facilities

Adequate feeding equipment £• facilities
Adequate feeding arrangements
Feed interrupted <1-day in past 12-mos.
Adequate maintenance

Fluoride compound - storage and handling
Adequate storage arrangements
Acceptable safe handling provisions
Satisfactory disposal of shipping containers

Operator training and interest

Adequately trained to operatre feed equip.
Knowledgeable of test equip. & procedures
Accepts and interested in fluoridation

Survei1 lance

Quarterly check samples to State Lab			

Installation inspected by State in past 12-mos.	-

(1)	Twenty-two installations were rated. Two of the twenty-four water supply systems selected for the
survey were not fluoridating at the time of the field visit.

(2)	Twenty-one installations were rated. One of the water systems fluoridating was not conducting fluoride
analysis regularly.


-------
TENNESSEE WATER SUPPLY PROGRAM EVALUATION
TABLE III

ADEQUACY OF FLUORIDATION AT SELECTED WATER SUPPLY SYSTEMS

PARAMETER EVALUATED













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f-4



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5



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3





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s

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c

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5



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(0

H

4J

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u

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o

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>

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i-i

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X

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•H



c

u

0

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p

o

0)



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O

s

p

p

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Z

Z

H



C/5

H

«

w

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60
O
O

c

<0
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s s

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4

4J

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u

4)

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J=

0)
.O

«d

N

w

U

c

X
o
*1

4)
00

o

Fluoride content in the distribution system

















































Fluoride level 0.8-1.2 mg/1

OK





OK





OK

OK

OK

OK



OK



OK

OK







OK

OK





OK



Fluoride level 0.8 mg/1



X





X

X













X





X

X

X





X





X

Fluoride level 1.2 mg/1





X











































Analytical control of the fluoride level

















































Operator analysis +0.1 mg/1 PHS value

OK

X

OK

OK

X

OK

OK

X

OK

X



X

(4)

OK

X

OK

X

OK

X

OK

X



X

X

Daily finished water fluoride analysis

X

OK

OK

X

OK

OK

OK

OK

OK

OK



OK

X

OK

OK

OK

OK

OK

OK

OK

X



OK

OK

Regular row water fluoride analysis

X

OK

X

X

OK

X

OK

OK

OK

X



OK

X

X

X

OK

OK

X

OK

X

OK



OK

X

Adequate analytical equip, and facilities

OK

OK

OK

OK

OK

OK

OK

OK

OK

OK



OK

N/A

OK

OK

OK

OK

X

OK

OK

OK



OK

OK

Adequate care for1 laboratory equipment

OK

OK

OK

OK

X

OK

OK

X

OK

OK



OK

N/A

X

OK

OK

OK

X

OK

OK

X



OK

OK

Adequate records

X

OK

X

X

OK

OK

CMC

OK

OK

X



OK

X

OK

OK

OK

OK

X

OK

X

X



OK

X

Fluoride feed equipment and facilities

















































Adequate feeding euipment & facilities

OK

X

X

OK

OK

OK

OK

X

OK

OK



OK

OK

OK

OK

OK

OK

X

OK

OK

X



OK

OK

Adequate feeding arrangements

X

X

X

OK

X

OK

OK

OK

X

OK



OK

OK

X

OK

X

OK

X

X

X

X



OK

OK

Feed interrupted 1-day in past 12-mos.

OK

OK

OK

OK

OK

(5)

OK

OK

OK

OK



OK

X

OK

X

X

OK

X

OK

OK

OK



OK

OK

Adequate maintenance

OK

X

X

X

X

OK

X

OK

X

OK



OK

X

X

OK

X

OK

X

X

X

OK



X

X

Fluoride compound - storage and handling

















































Adequate storage arrangements

X

OK

X

OK

X

OK

X

OK

X

X



OK

X

OK

OK

OK

OK

X

OK

X

OK



OK

OK

Acceptable safe handling provisions

OK

OK

X

X

OK

OK

OK

OK

X

X



OK

X

X

X

OK

OK

X

X

X

X



OK

Y

Satisfactory disposal of shipping containers

X

OK

OK

OK

OK

N/A

OK

OK

X

OK



OK

OK

X

OK

N/A

OK

X

OK

OK

OK



N/A

OK

Operator Training and interest

















































Adequately trained to operate feed equipment

OK

OK

OK

OK

OK

OK

OK

OK

OK

OK



OK

X

OK

OK

OK

OK

OK

OK

(X

OK



OK

OK

Knowledgeable of test equip. & procedures

X

OK

OK

OK

OK

OK

OK

OK

OK

OK



OK

X

OK

OK

OK

OK

X

OK

OK

X



OK

OK

Accepts and interested in fluoridation

OR

OK

OK

OK

OK

OK

OK

X

X

OK



OK

X

OK

OK

X

OK

X

OK

OK

(X



OK

X

h

c

I


-------


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U
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4)

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4)

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Q

§



i—i



5



*H



*£3

M

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u

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X

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3

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h-1

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P4

Surveillance

















































Quarterly check samples to State Lab

OR

OK

OK

OK

OK

OK

OK

OK

OK

OK



OK

OK

OK

OK

OK!

OK

X

OK

OK

OK



X

OK

Installation Inspected by State in past 12-months

X

X

X

X

OK

OK

OK

X

X

OK



X

X

X

X

X

X

X

X

X

X



OK

X

(1)	Fluoridation discontinued 10/15/69 - shortage of chemicals reported

(2)	Fluoridation discontinued 8/3/70 - feeder repairs required

(3)	Watauga System, Fluoridation discontinued in Unicoi System

(4)	Ho fluoride analysis conducted by operator

(5)	Fluoridation Initiated February 1970
X	Deficiency


-------
165

fluoridating. Since no dentally significant concentrations of natural
fluorides are known in any of the public water supplies in the State, only
h7% of the community water supply systems are attempting to supply
fluoridated water.

Recommendation:

The Tennessee Department of Public Health should more actively promote
fluoridation in Tennessee and strengthen their financial assistance program
to institute controlled fluoridation throughout the State. The adoption
of a State Law requiring the fluoridation of all public water supplies in
Tennessee as now exists in several other states should be pursued.

2.	Fifty-four percent of the water supply system reported fluoridating
contained fluoride levels within the 0.8 - 1.2 mg/1 range recommended by
the Department of Public Health. Only 48% of the fluoride analysis results
reported were within t 0.1 mg/1 of the sample analysis value reported by
the Public Health Service.

Recommendation:

The Department of Public Health, Division of Sanitary Engineering
should concentrate their effort in water fluoridation to assist the water
plant operator at fluoridation instal1 atioif to control the fluoride level
in the distribution system within the recommended range, and conduct
fluoride analysis within * 0.1 mg/1 of the State check sample value.
Mandatory daily distribution sample fluoride analysis, regular raw water
sampling for fluoride, adequate laboratory equipment and care of equipment
and complete records should be required at all installations.

3.	Fluoride feed equipment and facilities to control the distribution system
fluoride levels to between 0.8 and 1.2 mg/1 and satisfactory arrangements


-------
166

for feeding fluorides did not exist at all the installations surveyed.
Maintenance conditions were satisfactory at only 36% of the facilities
surveyed.

Recommendati on:

The Department of Public Health Division of Sanitary Engineering
should provide design assistance to all communities proposing to install
fluoridation facilities, review all proposed installations before the
operation is approved and assist the operator as needed during the'fetart-up"
period of fluoridation. Fluoride saturators should be considered at the
smaller systems in preference to batch-type feed systems. Four visits to
a new installation should be required during the first year to assure
satisfactory operation of the facility. A preventative maintenance
program should be established by the Division of Sanitary Engineering for
each system and closely followed for the installation to receive continued
approval.

k. Storage arrangements and safety precautions for handling the fluoride

compounds used were judged inadequate at k]% and 55% of the installations
surveyed respectively.

Recommenda t i on:

The Department of Public Health Division of Sanitary Engineering
should develop and adopt an acceptable arrangement for storing fluoride
compounds and a safety procedure for handling the compounds. Installations
not complying with the requirements should not be approved. The Division
of Sanitary Engineering should require that all fluoride compounds used
meet AWWA Specifications.


-------
167

5.	A trained water plant operator with a genuine interest in feeding
fluorides is essential to the satisfactory operation of a fluoridation
installation. Training deficiencies were noted in the water plant
operators knowledge of his fluoride feed equipment and particularly
his acquaintance with the test equipment and procedures used in
conducting fluoride analysis.

Recommendation:

The Department of Public Health Division of Sanitary Engineering
should expand their short school training program to include a
training course in fluoride determinations in water and equipment
operation for the operators of the fluoridated water supply systems.
Satisfactory completion of the course should be a mandatory require-
ment of the plant operator for approval of his installation to feed
f1uor ides.

6.	Frequent check samples of fluoride levels in the distribution system
and regular inspection visits to the water fluoridation installation
by a representative of the Division of Sanitary Engineering must be
conducted to assure the facility is operating satisfactory. Inspection
visits to the installations fluoridating averaged one visit every
eighteen months.

Recommendation:

The Department of Public Health, Division of Sanitary Engineering
should require a minimum of one check sample per month from each
installation fluoridating and should conduct two field inspection per
year of the facility. A field staff of approximately double the
personnel now conducting water supply program evaluations is estimated
to be needed.


-------
168

T^NNESSEK FLUORIDATION SURVEY

Water System:

Population Served:	Average Flow:

Date Fluoridation Started:

Source of Supply:

Treatment:

Natural Fluoride:

Fluoridation Equipment -
Manufacturer:

Tyue:

Model:

Location:

Voint of application:

Condition of equipment:

Operational problems:

Overfeeding safeguards:

Remarks:


-------
Fluoride Compound -

Chemical:	Cost:

Source:

Form of shipment:

Storage facilities:

Quantity used:

Safety provisions:

Remarks:

Control of Fluoridation -

Frequency of sampling:

Raw water:	Finished water

Sampling point:

Test method:

Test instrument:

Records:

Interruptions:

Remarks:


-------
170

Operator Qualifications -
Experience:

Training:

Interest:

Remarks:

Surveillance -
Check saranles:

Last visit by State:

Availability of technical assistance:
Remarks:

Comments -


-------
171

APPENDIX E

REGULATIONS - PUBLIC WATER SUPPLIES

Tennessee Department of Public Health
Division of Sanitary Engineering

Under Sections 2 and23, Chapter 52, Public Acts of 1945, author-
izing the Tennessee Department of Public Health to exercise supervision
over the construction, operation, and maintenance of public water supplies
and public sewerage systems, the following regulations have been officially
adopted by the Public Health Council on this the 17th day of May, 1945.

These regulations will have the full force of law from the date of adoption,
and all previously promulgated regulations of the Department relating to
public water supplies which are in conflict with these regulations are
hereby repealed.

The Division of Sanitary Engineering will be responsible for
the supervision of public water supplies and the Director of this Division
will be the authorized agent of the Commissioner.

REGULATION W-l. TERMS USED

Definition of terms as set forth in Section 1, Chapter 52, Public
Acts of 1945, shall be used in the interpretation of these regulations.

REGULATION W-2. SUPERVISION OVER CONSTRUCTION OF PUBLIC
WATER SUPPLIES

(a)	Preliminary Plans. Whenever any new construction or any
major change of an existing system is contemplated/"3. statement concern-
ing the proposed construction or change together 
-------
172

construction or major change of an existing system, complete plans and
specifications and cost estimates, together with such additional data as
may be required to determine the suitability of the works, shall be sub-
mitted to the Tennessee Department of Public Health, and no part of the
work shall be commenced until the Department has given its written
approval. All such plans shall be submitted at least two weeks prior
to the date upon which action of the Department is desired.

(d)	Revision of Plans. In case it is necessary or desirable to
make any material change in the approved plans and specifications, revised
plans and specifications, together with a statement of the reasons for the
changes, shall be submitted to the Tennessee Department of Public Health
for review and no part of the work affected by the change or changes shall
be commenced until the Department has given its written approval.

(e)	Work in Conformity with Plans and Specifications. All work
on new construction or changes of existing systems shall be done in con-
formity with approved plans and specifications. The Department may re-
quire reports and make investigations during and following the completion
of any construction to determine whether or not work is being done or has
been done in conformity with approved plans.

(f)	Records of Existing Works. Whenever there is a question
concerning the suitability of existing structures or other parts of the
system to insure the safety of the water supply, the Department may require
the submission of plans or other data necessary to ascertain the details

of such works in relation to their possible direct or indirect effect on
the sanitary quality of the public water supply.

REGULATION W-3. SUPERVISION OVER OPERATION OF PUBLIC
WATER SUPPLIES

(a)	Records and Reports. Daily records of operation of water
works systems shall be kept, and these data shall be submitted to the
Tennessee Department of Public Health on forms supplied by the Department.
Reports may be required either weekly, monthly, or as deemed necessary to
ascertain the continuous production of a safe water.

(b)	Water Samples. Samples of water shall be submitted to the
Tennessee Department of Public Health when and in such manner as the De-
partment may direct. Samples for bacteriological examinations hhall be
collected in regulation bottles furnished by the Department and mailed

or brought to the Central Laboratory or one of the branch laboratories as
designated. Samples may be requested for chemical and physical examina-


-------
173

tion at any time and such samples shall be collected and mailed or other-
wise delivered to the Department in accordance with instructions.

(c) Supervision and Operation. The supervision, operation, and
maintenance shall be of such character as in the opinion of the Tennessee
Department of Public Health will produce a satisfactory water at all times
as judged by the current standards of the Department. Evidence of compe-
tence may be required if and when deemed necessary by the Commissioner
to insure proper operation and maintenance of any public water supply.

REGULATION W-4. CROSS-CONNECTIONS, AUXILIARY INTAKES, BY-
PASSES, AND INTER-CONNECTIONS.

(a)	Cross - Connection. No connection between the distribution
system of any public water supply and that of any other water supply shall
be permitted unless the quality of such other water supply, the arrange-
ment for connecting, and the operation of the two supplies have been
approved in writing by the Tennessee Department of Public Health. Also,
both supplies must be continuously under the supervision of the Department
and the responsible official or officials of the Public Water supply.

Records of such approved connections must be submitted to the Department
as often and in such detail as directed. Two public water supplies may

be cross-connected provided the construction, operation, and maintenance
of both are satisfactory to the Tennessee Department of Health and the
arrangement and responsibility for such connection is jointly agreed upon
and submitted in writing to the Department for approval.

(b)	Auxiliary Intakes. No auxiliary intake for a public water
supply shall be permitted unless the source and use of such auxiliary supply
and the location and arrangement of the intake have been approved by the
Tennessee Department of Public Health. Plans for an auxiliary intake
must be submitted to the Department in the same manner as for a new supply
or a new source.

(c)	By-Pass. No by-pass shall be permitted at any water
treatment plant of a public water supply unless such by-pass is approved
by the Tennessee Department of Public Health. Plans and other data
necessary for the Department to assure itself that htere is no direct

or indirect danger to the water quality must be submitted along with any
request for approval of a by-pass.

(d)	Inter -connections. No system of piping or other arrangement
whereby a potable water supply is connected directly with a sewer, drain,
conduit or other device which does or may carry sewage or other waste


-------
174

which would be capable of imparting contamination to the public water
supply shall be permitted. If such a connection is suspected, the De-
partment may require the submission of such data as necessary to positively
ascertain that there is no chance of sewage or other waste finding its
way into any part of the public water supply system.

(e) Non-Potable Water. Whenever a public water supply is avail-
able on any premises having a non-potable supply which is used for industrial,
fire protection, or other purposes, such non-potable supply shall be dis-
tributed through an independent piping system having no cross-connection
with the potable supply. Such non-potable supply shall be labeled in such
manner as may be directed and shall not be available for drinking or other
personal or domestic uses. The owner or operator of such non-potable
supply shall file a statement with the official responsible for the public
water supply stating that there are no cross-connections with the non-
potable supply and that none will be permitted.

REGULATION W-5. INVESTIGATIONS, REPORTS, RECOMMENDATIONS,
STANDARDS AND ORDERS.

(a)	Investigations. The Commissioner through the Division of
Sanitary Engineering shall arrange for such investigations, either routine
or special as in his judgment may be necessary to insure proper construc-
tion, operation and maintenance of public water supplies and to insure
compliance with these regulations.

(b)	Reports. Reports of investigations together with recommen-
dations regarding improvements or other matters relating to any public
water supply shall be prepared and forwarded to the official responsible

for such system as often as deemed necessary by the Director of the Division.

(c)	Standards. The Department shall prepare and disseminate
such information concerning public water supplies as it mayddeem necessary
or desirable to insure the production and distribution of safe water. It
shall prepare, adopt or utilize such standards as necessary to properly
interpret the sanitary quality of water being produced by any public

water supply of Tennessee.

(d)	Special Orders. Whenever it is the judgment of the Ten-
nessee Department of Public Health, based upon investigation, that a
public water supply is an actual or potential menace to public health,
because of faulty design, inadequacy, improper supervision or inefficient
operation, and that effective measures are not being carried out to correct
these defects, the Department may issue an order for its correction, and
such order or orders shall be complied with within the time limit specified
in the order.

8/18/45


-------
175

SPECIAL REGULATION - PUBLIC WATER SUPPLIES

Tennessee Oepartment of Public Health

Division of Sanitary Engineering

PoIicyr Procedure and Requirements for

FIuor i dat ion of Pub Iic Water Sudd Iles

Under Title 53, Chapter 20 Tennessee Code Annotated 53-2001-2016
authorizing the Tennessee Department of Public Health to exercise
supervision over the construction, operation and maintenance of public
water supplies and public sewerage systems, the following special regu-
lations have been officially adopted by the Public Health Council on
this the eighth day of April, 1963.

POLICY:

Inasmuch as a wealth of evidence has been gathered to show
the dental benefits of controlled fluoridation of public water supplies,
the Tennessee Department of Public Health encourages all cities, towns,
and utility districts with an approved water supply to consider seriously
the adoption of this very important preventive health measure.

Prior to approval, the Division of Sanitary Engineering will
determine the adequacy of the equipment and proposed technical super-
vision, and engineers of the Division will advise local officials con-
cerning details of the treatment and laboratory procedures required.
Written approval of the Division is necessary before fluoridation
equipment is installed, and an engineer from the Division must be
present when the fluoride is first added to the water supply* The
water supply must be Approved.

Procedure for Obta i ni na AporovaI:

1.	The governing body will authorize, by passage of a suitable
ordinance, the fluoridation of the water supply and instruct the respon-
sible water department officials to prepare the necessary plans for
obtaining approval of the State Health Department.

2.	Detailed plans showing the method and point of application
of fluoride and storage facilities for stock chemical will be forwarded
to the Division of Sanitary Engineering for review and approval.


-------
Special ReguI ation-PubIic Water Supplies

Genera I Regu i rements for ApprovaI:

1.	Reliable feeding equipment with an accuracy within 5% will
be provided to feed the desired dosage of fluoride. The rate of feed
shall be such as to give a fluoride content of 0.8 to 1.2 ppm. in the
treated water. The point of application will be selected so that the
fluoride will be adequately mixed with the water before leaving the
treatment plant.

2.	if solution feed equipment is to be used, at least two
solution tanks and accurate means for weighing the stock chemical and
measuring the water for the solution are to be provided.

3.	Special precautions must be taken to protect the operators
from inhaling the fluoride. These precautions will vary with the type
of installation but the minimum will be the provision of a toxic-dust
respirator for each operator involved.

4.	Laboratory facilities must be provided for the determina-
tion of the fluoride content of the water in accordance with the procedure
out Ii ned i n the Iatest ed i t i on of Standard Methods for the Examination of
Water and Wastewater.

5.	Samples of raw water must be tested occasionally and plant
effluent samples at least once daily and the results included on the
reguIar operation report submitted to the State Health Department.

Samples from the distribution system are to be sent to the Sanitary
Engineering Division at weekly intervals until otherwise requested.

This regulation is in addition to Public Water Supply Regula-
tions officially adopted by the Public Health Council A/lay 17, 1945.

Approved both as to form and legality, April 23, 1963.

S/Georqe F. McCanless

Seorge F. McCanless, Attorney General

Adopted, April 19, 1963

S/R. H. Hutcheson

R. H. Hutcheson, Commissioner of Health

Filed, ApriI 29, 1963

S/Joe C. Carr	

Joe C. Carr, Secretary of State

SE-63-9
(completed)


-------
177

PUBLIC WATER SUPPLY AND SEWER SYSTEM
Tennessee Code Annotated - Sections 53-2001 - 53-2008

SECTION.

53-2001. Definitions.

53-2002. Department exercising general supervi-
sion over construction of public water
supplies and public sewerage systems.

53-2003. Operation and Maintenance supervised by
Department.

53-2004. Cross-connections, auxiliary intakes,
by-pass or interconnections to be ap-
proved--Drain lines or conduits carrying
wastes not to enter water supply.

53-2005. Defects in water supply or sewerage or-
dered corrected when health menace.

53-2006. Review of order to correct--Procedure.

53-2007. Violation of provisions a misdemeanor--
Penalty.

53-2008. Standards, orders, rules and regulations
enforced by Department.

53-2001, Definitions--The terms used In
55 53-2001--53-2008 are defined as follows:

"Waterworks system" - The source of supply
and all structures and appurtenances used for
the collection, treatment, storage and distribu-
tion of water delivered to the consumers. This
shall not include waterworks systems for private
residences or dwellings or waterworks systems
for industrial purposes not intended for human
consumption.

"Public water supply" - Any waterworks sys-
tem as defined above, whether privately or
publicly owned, where water is furnished to any
community, collection or number of Individuals
for a fee or charge or any other waterworks
system which on account of the people who are or
may be affected by the quality of the water, is
classified as a public water supply by the
Tennessee Department of Public Health,

"Department" - The Tennessee Department of
Public Health through its executive officer, the
commissioner of public health, or his legally
designated representative.

"Commissioner" - The Commissioner of the
Tennessee Department of Public Health or his
authorized agent.

"Potable water supply" - Any public or other
water supply, the quality of which is approved
by the Tennessee Department of Public Health for
human consumption.

"Cross connection" - Any physical connection
whereby a potable water supply system is connect-
ed with any other water supply system, whether
public or private, either inside or outside of
any building or buildings, in such manner that a
flow of water into the potable water supply is
possible, either through the manipulation of
valves or because of ineffective check or back
pressure valves.

"Auxiliary intake" - Any piping connection or
other device whereby water may be secured from a
source other than that normally used.

"By-pass" - Any system of piping or other
arrangement whereby the water may be diverted
around any part or portion of a water purifica-
tion plant.

"Interconnection" - Any system of piping or
other arrangement whereby a potable water supply
is connected directly with a sewer, drain, con-
duit or other device which does or may carry sew-
age or other liquid or waste which would be
capable of imparting contamination to the potable
water supply.

"Public sewerage system" - Hie conduits, sew-
ers, and all devices and appurtenances by means
of which sewage is collected, pumped, treated or
disposed of finally. This shall not include
systems for private residences or dwellings.

"Sewage" - All water-carried human and house-
hold wastes from residences, buildings, institu-
tions or industrial establishments, together with
such ground, surface, or storm water as may be
present.

"Person" - Any and all persons, natural or
artificial, including any individual. fir» or
association and any municipal or private corpo-
ration organized or existing under the laws of
this or any other state or country. (Acts 1945,
ch. 52, 5 1; C. Supp. 1950, 5 5826. 1.)

53-2002. Department exercising general super-
vision over construction of public water supplies
and public sewerage systems.--The department

shall exercise general supervision over the
construction of public water supplies and public
sewerage systems throughout the state. Such gen-
eral supervision shall include all of the fea-
tures of construction of waterworks systems which


-------
178

do or may affect the sanitary quality of the
water supply and all features of construction of
sewerage systems which do or may affect the
proper collection, treatment, or disposal of
sewage. No new construction shall be done nor
shall any change be made in any public water
supply or public sewerage system until the plans
for such new construction or change have been
submitted to and approved by the department. In
granting approval of such plans the department
may specify such modifications, conditions, and
regulations as may be required for the protec-
tion of the public health. The department is
authorized to investigate the public water sup-
plies and public sewerage systems throughout the
state as often as is deemed necessary by the
commissioner. The department is empowered to
adopt and enforce rules and regulations govern-
ing the construction of public water supply and
public sewerage systems, and may require the
submission of samples of water or sewage for
examination. Records of construction including
plans and descriptions of existing works shall
be made available to the department upon request.
The person in charge of the public water supply
or public sewerage system shall promptly comply
with such request. (Acts 1945, ch. 52, $ 2; C.
Supp. 1950, $ 5826.2)

33-2003. Operation and maintenance super-
vised by department. --The department shall exer-
cise general supervision over the operation and
maintenance of public water supply and public
sewerage systems throughout the state. Such
general supervision shall include all of the
features of operation and maintenance which do
or may affect the sanitary quality of the water
supply and all of the features of operation and
maintenance which do or may affect the proper
treatment or disposal of sewage. For exercising
such general supervision over the operation and
Maintenance of public water supply and public
sewerage system the department is authorized to
investigate the public water supplies and public
sewerage systems as often as is deemed necessary
by the commissioner, and may adopt and enforce
regulations governing the operation and mainten-
ance of public water supply and public sewerage
systems. Records of operation of public water
supplies and of public sewerage systems shall
be kept on blanks furnished by the department
and this data shall be submitted to the depart-
ment at such times and intervals as the depart-
ment may direct. Samples of water or sewage shall
be submitted to the department when and In such
¦anner as the department may direct. When the
department shall have required the submission of
such records or reports of operation and sanples
of water or sewage the person in charge of the
public water supply or public sewerage system

shall promptly comply with such request. (Acts
1945, ch. 52. $ 3; C. Supp. 1950, $ 5826.3.)

33-2004. Cross connections, auxiliary in-
t(*es, by-pass or interconnections to be approv-
ed--drain lines or conduits carrying wastes not
to enter water supply.--No person shall install,
permit to be installed, or maintain any cross
connection, auxiliary intake, by-pass, or inter-
connection, unless the source and quality of
water from the auxiliary supply, the method of
connection, and the use and operation of such
cross connection, auxiliary intake, by-pass or
interconnection has been approved by the depart-
ment. The arrangement of sewer, soil, or other
drain lines or conduits carrying sewage or other
wastes in such manner that the sewage or waste
may find its way into any part of the public
water supply system is prohibited. (Acts 1945,
ch. 52, § 4; C. Supp. 1950, $ 5826.4.)

33-2005. Defects in water supply or sewerage
system ordered corrected when health menace.-•

When the commissioner finds upon investigation
that a public water supply or public sewerage
system is an actual or potential menace to health
because of improper location, quality of the
source in case of public water supplies, inade-
quacy, faulty design, improper supervision, or
inefficient operation, and that effective meas-
ures are not being carried out to correct these
defects, the department may issue an order for
their correction, and this order shall be com-
plied with within the time limit specified in
the order. Such notice shall be made by personal
service or shall be sent by registered mail to
the person responsible for the operation of the
public water supply or public sewerage system.
Investigations made in accordance with this sec-
tion may be made at the initiative of the com-
missioner. (Acts 1945, ch. 52, $ 5; C. Supp.
1930, * 3826.5.)

93-2006. Review of order to correct - pro-
cedure. -- Any person against whom an order is
issued may secure a review of the necessity for
or reasonableness of any order of the department
by filing with the department a sworn petition,
setting forth the grounds and reasons for his
objections and asking for a hearing of the matter
involved. The department shall thereupon fix the
time and place for such hearing and shall notify
the petitioner thereof. At such hearing, the
petitioner, and any other interested party, may
appear, present witnesses, and submit evidence.
Following such hearing the final order of deter-
mination of the department shall be conclusive,
provided that such final order of determination
may be reviewed in any court of competent Juris-
diction upon petition therefor, filed within


-------
179

fifteen (15) days after such final order of
determination has been issued. All such hearings
shall be held in the county where the waterworks
and/or sewerage system affected is located and if
such system be located within any incorporated
town than such hearing shall be held at a public
place in such town, and the hearing shall be a
public hearing.

The chancery court of the county wherein such
system is located shall have exclusive original
jurisdiction of all review proceedings instituted
under the authority and provisions of $$ 53-2001-
53-2008, whether such proceedings shall be insti-
tuted by the department of health, the waterworks
system, the sewerage system or any company,
corporation, municipality, or individual author-
ized to institute such review proceedings. (Acts
1945, ch. 52, § 6; C. Supp. 1950, $ 5826.?.)

S3-2007. Violation of provisions a aisde-
¦eanor - Penalty.--Any person violating any of
the provisions of $$ 53-2001--53-2008, or failing,
neglecting or refusing to comply with any order
of the department lawfully issued, shall be
guilty of a misdemeanor and, upon conviction,

shall be liable to a fine of not less than ten
dollars ($10.00) nor more than one hundred
dollars ($100) for each violation within the dis-
cretion of the court, and each day of continued
violation after conviction shall constitute a
separate offense. (Acts 1945, ch. 52. $ 7; C.
Supp. 1950, $ 5826.7.)

33-2008. standards, orders, rules and regu-
lations enforced by department. --The department

may clause the enforcement of any standards,
policies, general or special orders, rules or
regulations issued by it to control public water
supplies and public sewerage systems. Such suit
or suits as may be necessary to effectually
carry out the provisions of$$ 53-2001--53-2008
may be instituted, brought and prosecuted, in
any court of competent jurisdiction. The district
attorney-general in whose jurisdiction a viola-
tion of 53-2001--53-2008 occurs or the attor-
ney-general of the state — either or both as
indicated—shall institute and prosecute such
suits when necessity therefor has been shown
by those herein clothed with power of investi-
gation. (Acts 1945, ch. 52, $ 8; C. Supp.
1950, * 5826.8.)


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WATER

	 _	181

FIELD INVESTIGATION REPORT — DIVISION OF SANITARY ENGINEERING

Tmmum Department of Public Health

Location		Date		 19

PERSON CONTACTED

NAME

INTERVIEWED

REPORT

COPY

Mayor









Recorder









City Manager









Superintendent









Operator





























CHD









Sample Record

["organisms /
j	/ 100 ML.

Reports Submitted
Remarks	

Certified Operator

Recommendations

Report

Engineer
Title	


-------
182 PUBLIC WATER SUPPLY RATING FORM—DIVISION OF SANITARY ENGINEERING

Tennessee Department of Public Health

Location	Date			

PHYSICAL EQUIPMENT

1.	Source ol supply (10)—Adequacy ( ) Standby ( ) Pollu tion hazards ( ) Spring supply intake ( ) Well
supply protection ( ) Suction or gravity mains ( ) Raw water quality ( )				 ( )

2.	Equipment, buildings <£ grounds (5)—Low lift pumping equipment ( ) High lift pumping equipment ( )

All water works buildings & grounds ( ) Master meter ( ) Other equipment or structures ( )	

	( )

3.	Treatment facilities (10)—Aerators ( ) Chemical feeders ( ) Mixing devices ( ) Sedimentation

units ( ) Filters & appurtenances ( ) Disinfection equipment ( )____	 ( )

4.	Laboratory facilities (5)—Chemical & physical ( ) Bacteriological ( ) Space adequate for laboratory
work ( )					 ( )

5.	Potable water storage facilities (5)—Ground level reservoir ( ) Elevated tanks ( ) Location & construc-
tion details ( )	( )

6.	Distribution system piping (2)-—-Kind, size & location of mains ( ) Valves, hydrants & blow-offs ( ) Extent
of service ( )			( )

7.	Existing cross connections (5)—With unsafe source ( ) With reservoir or tank ( ) Between two approved
sources ( ) Ordinance or policy filed with Health Department ( )	( )

OPERATION

8.	Certified operator (9)—Chief operator or superintendent ( ) Distribution system superintendent ( )	

	( )

9.	Maintenance of equipment, buildings & grounds (5)—Protective works at the source ( ) Low <5, high lift
pumping equipment ( ) All buildings & grounds or other structures ( ) Cleanliness ( ) Maintenance of
treatment units ( )	_( )

10.	Operation & laboratory control o£ treatment works (10)—Systematic operation of all treatment facilities
( ) Laboratory control of treatment ( ) Bacteriological analysis ( )			 ( )

11.	Operation of distribution system, reservoirs 4 tanks (4)—Maintenance of valves, hydrants & other appur-
tenances ( ) Routine flushing of dead ends ( ) Disinfection of new works or existing works subjected
to contamination ( ) Maintenance of reservoirs or tanks ( )		( )

12.	Cross connection policy (5)—Signed statement to Health Department ( ) Satisfactory administration of
regulations ( )	( )

13.	Cooperation with Department (5)—Submission of reports ( ) Submission of plans & specifications for
approval ( ) General attitude of cooperation ( )			( )

WATER QUALITY

14.	Physical characteristics (5)—Turbidity more than 5 p.p.m. ( ) Color more than 15 p.p.m. ( ) Taste &
odor ( )	—		__( )

15.	Chemical characteristics (5)—Calcium carbonate equilibrium ( ) Iron ( ) Manganese ( ) Fluoride ( )
Hardness (	)

16.	Bacteriological quality (10)—Samples submitted in 12 months ( ) Positive samples ( )
	( )

Note: Defects marked with a cross (X)	Total score	

Signed						

Title


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183

APPENDIX F

Report of a Survey of the
Tennessee Department of Public Health
Division of Laboratories
Central Laboratory
Cor dell Hull Building
6th Ave., North
Nashville, Tennessee 37219
on Sept. 15-16, 1970

by

Edwin E. Geldreich, Chief Bacteriologist
Bureau of Water Hygiene
U. S. Public Health Service
Cincinnati, Ohio 45213

The equipment and procedures employed in the bacteriological analysis of
water by the laboratory conformed with the provisions of "Standard Methods
for the Examination of Water and Wastewater" (12th edition, 1965) and
with the provisions of the Interstate Quarantine Drinking Water Standards,
except for items marked with a cross, "X", on the accompanying form
PHS 875 (Rev. 1-66). Items marked with a "U" could not be determined
at the time of the survey. Items marked "O" do not apply to the procedures
programmed in the laboratory. Specific deviations are described with
appropriate remedial action for compliance in the following recommendations^

1. Sampling Requirements

Sampling frequency for municipal supplies was examined from the records
of the Central Laboratory (Nashville) and the two branch laboratories in
Jackson and Knoxville with some observations presented in Table 1.


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184

Table 1. Sampling Frequency for Selected Small Supplies

Municipal

Sample

Coliforms

Supply

Location

per 100 ml

Central Laboratory Records, Nashville





Collinwood Jan. 20, '69

Unknown

< 1

Feb.

— _ —

	*

Mar. 18

Unknown

< 1

April

o..

	*

May 6

Unknown

< 1

May 27

fl

< 1

June 24

II

< 1

July



	#

Aug. 5

Unknown

< 1

Aug. 12

M

< 1

Sept.

_ _

— mm aw "f

Oct. 6

Unknown

< 1

Oct. 14

Unknown

< 1

Oct. 20

Unknown

54

Oct. 27

Unknown

< 1

Oct. 2 9

Dixon residence

< 1

Nov. 18

Beauty shop

< 1

Dec. 12

Barber shop

< 1

Knoxville Branch Laboratory Records





Sneedville Utility District





Jan. 1, '70

— _ #>!<

	*>:<

Jan. 13

Service Plant

60

Jan. 16

(i

< 1

Jan. 16

M 1!

< 1

Feb. to Sept.

	***

	***

First Utility District of Knox Co.





April 2, '70

Northshore-Cowan Pk,

Positive

May to Sept.

	***

>*<

Pleasant Hill Utility District





July 15, '70

Unknown

78

July 20

M

< 1

Aug. - Sept.



— _

*No samples collected during the month
**Sample too old in transit

other samples to date, Sept. 29, 1970
other samples taken at this location to date, Sept. 29, 1970


-------
185

Apparently some small supplies were not sampled every month (Collin-
wood, Sneedville Utility District, and First Utility District of Knox Co. ),
location of samples were not recorded making evidence of resampling
difficult to detect, and some evidence that sampling locations that did yield
unsatisfactory results were not monitored again after one negative result
was reported (Pleasant Hill Utility District).

Some effort was made, by a random cross section analysis, to study the
sampling frequency for "Official Samples" submitted each month to the
Division of Laboratories. The information reported in Table 2 indicates
the number of "Official Samples" submitted by supplies serving populations
over 5, 000 is approximately 10 percent or less of the requirements speci-
fied in the Public Health Service Drinking Water Standards, Revised 1962.
Sampling of the Gatlinburg municipal supply was also observed to remain
at two per month during the summer months, regardless of the large influx
of population related to the tourist season.

	Table 2. Monthly Sampling Frequency for Public Water Supplies	

Municipal	Samples per Month

Supply

Population

"Official

Recommended



Served

Samples"*

Frequency*

Collinwood

596

1

2

Alexandria

599

2

2

Dandridge

829

2

2

Oliver Springs

1, 163

2

2

Gatlinburg

1, 764

2

2

Lake City

1, 914

2

2

Joelton Water U. D.

4, 000

4

4

La Follette

7, 130

2

8

Knox- C hapman

7, 780

2

8

Northeast Knox U. D.

10, 000

2

14

Maryville

10, 348

2

14

Athens

12,103

2

15

Oak Ridge

30, 000

4

41

Knoxville

212, 000

10

160

Nashville

261, 000

18

180

^-'"Official Samples" includes those samples sent to either the Central

Laboratory, the regional Branch Laboratory or both.
'""Recommended Frequency of sampling based on population served
(PHS Drinking Water Standards, Revised 1962).


-------
186

3. Dechlorination

All sample bottles are prepared with the dechlorinating compound, sodium
thiosulfate plus a chelation agent EDTA for possible metal ion toxicities
that might be present in a given water source. These two agents are added
in a mixed solution, 1 ml per sample bottle prior to bottle sterilization.
Although the final concentration of 100 mg. sodium thiosulfate per liter is
correct, the stock solution should be increased in concentration so that
only 0. 5 ml of the mixed EDTA plus dechlorinating agent are needed per
bottle. The one ml quantity does not evaporate to a dry residual in the
sterile bottles and therefore may be lost through spill-out during inversion
of bottles to get positioned under some faucet openings in confined spaces.

5. Remedial action for unsatisfactory samples

As recommended in the laboratory evaluation report of Dec. 5-6, 1967,
whenever an unsatisfactory sample result is detected for municipal supplies,
two additional sample bottles are sent to the operator with the report that
includes the following statement:

"Samples showing evidence of contamination require repeated
testing from the same location until two successive negative
results are obtained. Two sample bottles are being forwarded
for immediate daily sampling. "

Inspection of the laboratory reports in current files for 1969 revealed the
following response from Joelton Water Utility District on repeat sampling
requirements (Table 3).

Table 3. A Study of Response to Reports of Unsatisfactory Samples
Public	Date

Water	0	,	0 , T j.-	Coliforms Date

Sampled	Sample Location	^	„ . ,

Supply	per 100 ml Rptd.

Joelton Water May 21, '69
Utility District May 26
June 5

Clay Lick Road

11	II	M

H	II	! |

(No other sampling in 1969)
Ashland City Highway

13

5

< 1

June 3
June 3

June

12

Master Meter

< 1





Aug.

12

Bailey Scott Grocery

2

Sept.

25

Aug.

22

Master Meter

24

Sept.

25

Sept.

12

Bailey Scott Grocery

2

Sept.

30

Sept.

25

Bailey Scott Grocery

< 1

Sept.

30

Sept.

25

Master Meter

2

Sept.

30


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187

Table 3. (Continued)

Public
Water
Supply

Date
Sampled

Sample Location

Coliforms
per 100 ml

Date
Rptd.

Joelton Water





Ashland City Highway





Sept.

26

Master Meter

2



Sept.

30

Bailey Scott Grocery

< 1



Oct.

9

Master Meter

2

Oct. 15

Oct.

10

Bailey Scott Grocery

TNTC

Oct. 15

Oct.

13

Bailey Scott Grocery

< 1

--

Oct.

13

Master Meter

< 1



Oct.

21

Master Meter

< 1



Nov.

6

Bailey Scott Grocery

TNTC

Nov. 12





(No other sampling in 1969)





Aug.

10

Knight Road

54

Sept. 25

Sept.

13

II II

12

Oct. 15

Sept.

25

M M

< 1

--

Oct. 8

13

Oct. 15

(No other sampling in 1969)

These data illustrate the lack of consecutive sampling from the same loca-
tion on successive days till two negative results were secured. The table
also illustrates the apparent slow processing of positive results by the
Central laboratory reporting section. This backlog on filing has, in part,
defeated efforts of the laboratory to give a rapid monitoring of water supplies
through use of the faster membrane filter procedure. Inspection of the
records in the Jackson and Knoxville Branch laboratories indicates record
filing and reporting in these comparatively smaller laboratories to be current.
Data in table 1 also indicate a lack of understanding by some sample collectors
as to what constitutes the proper response to positive laboratory results.

9. Incubator

Incubator temperature control is not consistently meeting the ± 1. 0°C tolerance
at 35°C. It is suggested that an outboard electronic temperature regulator
switch be installed for control within ± 1. 0°C tolerance if the bimetalic strip
in the incubator can not be stabilized. The accidental reduction in incubation
temperature below 35° C will increase the problem of interference and false
positives associated with non-coliform organisms common to unchlorinated
supplies, well waters, lakes and some small streams. On the MF, Para-
colobacterium species occur as the most frequent false positive, producing


-------
188

sheen reaction as a result of the partial breakdown of lactose. In general,
we find these organisms grow better at temperatures below 35°C. False
positive results in the multiple tube confirmed test may originate from
several sources including anaerobic spore-formers of the Clostridium
welchii type, spore-bearing aerobic forms related to Bacillus subtillfr
and to the symbiotic action of two different organisms.

State Water Laboratory Evaluation Program

Mr. Kenneth Whaley, Supervising Microbiologist for Water and Milk, has
been the designated bacteriological survey officer of the Division of Labora-
tories for approximately 10 years. A review of this program activity
indicates branch laboratories are evaluated every two years and the pro-
gram has been expanded in recent years to include periodic visits to water
plant laboratories at Alcoa, Chattanooga, Johnson City, Knoxville, Memphis,
Nashville and Kingsport Consolidated Utility District.

With increasing activity in laboratory evaluation service, Mr. Whaley con-
cluded it was desirable to train Mr. James Scott, Microbiologist, as an
additional survey officer. Initial training included a joint survey of the
Chattanooga Branch Laboratory on August 19, 1969. As part of the re-
quested in-depth study of laboratories and their procedures, Mr. Scott
participated in two joint (Federal-State) reviews of the bacteriological
procedures used at the Knoxville Utilities Board, Mark B. Whitteker water
plant, September 2 9, 1970 and the Knox-Chapman Utilities District water
plant, September 30, 1970.

Mr. Scott is familiar with coliform detection methods, laboratory apparatus,
media requirements, and analysis of laboratory records for compliance of
sampling to meet Public Health Service requirements in water quality
standards. During my two-day conference on laboratory procedures at the
Central Laboratory and in our joint visit to two water plant laboratories in
the Knoxville area, Mr. Scott demonstrated the qualities of temperament
desirable to obtain the cooperation of laboratory personnel in improving
their procedures where necessary, without incurring a feeling of resent-
ment.

The current evaluation status for water laboratories by the Tennessee
Department of Public Health is given in Table 4.


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189

Table 4. Current Evaluation Status for Water Laboratories in Tennessee

Laboratory and Location

Survey Officer

Jackson Branch Laboratory
Jackson, Tenn. 38301

Johnson City Branch Lab.
Johnson City, Tenn. 37601

Knoxville Branch Laboratory
Knoxville, Tenn. 37902

Memphis Branch Laboratory
Memphis, Tenn. 38103

Water Plant Laboratories
Alcoa Water Plant

Chattanooga Water Plant

Johnson City Water and
Sewerage Treatment

Knoxville Utilities Board

Knox-Chapman Utilities

Nashville Water Plant

Consolidated Utility District,
Kingsport

K. Whaley
K. Whaley
K. Whaley
K. Whaley

K. Whaley
K. Whaley
K. Whaley

E. Geldreich & J. Scott
J. Scott & E. Geldreich
K. Whaley
K. Whaley

Survey
Date

Tennessee Branch Laboratories
Chattanooga Branch Laboratory J. Scott & K. Whaley
Chattanooga, Tenn. 37403

8/19/69
11/10, 13/69
5/13-15/70
10/23/69
2/4-5/70

12/4-5/69
5/26/70
10/25/66

9/29/70
9/30/70
2/1, 15/67
2/8/67

Water plants that are known to be performing some bacteriological exami-
nations of their water supplies for quality control but which have never been
evaluated are listed in Table 5.


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190

Table 5.

Water Plant Laboratories in Tennessee that Have Never Been Evaluated

Water	Bacteriological

Water Plant	County	Connections Procedures

Athens

McMinn

3, 926

MF

Big Creek U. D.

Grundy

803

MF

Bloomingdale

Sullivan

2, 000

MF

Bolivar

Hardeman

1, 250

MF

Bristol

Sullivan

7, 800

MF

Bristol-Bluff City U. D.

Sullivan

975

MPN

Camden

Benton

1, 250

MF

Carthage

Smith

750

MF

Cleveland

Bradley

8, 041

MF

Clinton

Anderson

1, 550

MF

Cocke Co. U. D.

Cocke

550

MF

Columbia

Maury

7, 094

MPN

Cooke rville

Putnam

4, 000

MF

Crossville

Cumberland

1, 535

MF

Cumberland Water Co.

Davidson

1, 350

MPN

Daisy-Soddy Falling

Hamilton

2, 250

MF

Water U. D.







Dickson

Dickson

2, 000

MPN

Dunlap

Sequatchie

675

MF

Dyersburg

Dyer

4, 568

MPN

Dyersburg Sub. Cons.

Dyer

684

MPN

U.D.







Erwin

Unicoi

2, 800

MF

Etowah

McMinn

1, 809

MPN

Fayetteville

Lincoln

3, 000

MPN

Franklin

Williamson

3, 400

MPN

Gallatin

Sumner

4, 000

MF

Gatlinburg

Sevier

1, 068

MF

Greeneville

Greene

5, 000

MF

Hallsdale-Powell U. D.

Knox

4, 345

MF

Harpeth Valley U. D.

Davidson

768

MF

Harriman

Roane

2, 875

MPN

Hartsville

Trousdale

683

MF

Huntington

Carroll

1, 200

MF

Jefferson City

Jefferson

1, 425

MF

Kingsport

Sullivan

12, 500

MF

Kingston

Roane

1, 304

MPN


-------
Table 5. (Continued)

191

Water Plant	County	„ Wat"	Bacteriological

Connections	Procedures

LaFollette

Campbell

2

300

MF

Lawrenceburg

Lawrence

3

100

MPN

Lebanon

Wilson

4

048

MPN

Lenoir City

Loudon

1

770

MF

Lewisburg

Marshall

2

800

MF

Lexingt on

Henderson

1

000

MF

Livingston

Overton

1

150

MF

Madison Sub. U.D.

Davidson

11

000

MPN

Manchester

Coffee

1

900

MPN

Martin

Weakley

2

000

MF

Maryville

Blount

4

617

MF

McMinnville

Warren

3

904

MF

Memphis

Shelby

160

000

MPN

Millington

Shelby

1

800

MPN

Morriston

Hamblen

6

916

MF

Murfreesboro

Rutherford

6

398

MF

New Providence U.D.

Montgomery

2

600

MF

North Anderson Co. U.D.

Anderson

1

509

MF

Northeast Knox U. D.

Knox

2

500

MF

Oak Ridge

Anderson

17

000

MPN

Old Hickory U. D.

Davidson

1

300

MF

Oneida

Scott



775

MF

Paris

Henry

3

771

MPN

Pulaski

Giles

2

489

MPN

Rockwood

Roane

2

100

MF

Rogersville

Hawkins

1

500

MF

Sevierville

Sevier



760

MF

Shelbyville

Bedford

4

083

MPN

Smyrna

Rutherford

1

200

MF

South Cheatham U. D.

Cheatham



550

MF

Sparta

White

2

300

MF

Springfield

Robertson

2

900

MF

Sweetwater

Monroe

1

600

MF

Tullahoma

Coffee

4

300

MPN

Turnbull U. D.

Dickson



300

MF

Union City

Obion

3

850

MF

West Knox U. D.

Knox

2

096

MF

West Wilson Co. U.D.

Wilson

1

013

MPN

White House U.D.

Robertson

1

450

MPN

Whitehaven U.D.

Shelby

10

700

MF

Winchester

Franklin

2

000

MPN

Woodbury

Cannon



761

MF


-------
192

In an effort to obtain a cross section review of bacteriological procedures
in water plant laboratories, three specific categories described in Table 6
were chosen and evaluations were performed in September 1970.

Table 6. Tennessee Water Plant Laboratories Evaluated

Name	Service Connections Evaluation by State

Jackson Water Utility

14, 050

None

Knoxville Utilities Board

53, 000

Dec. 3, 1969

Knox-Chapman Utilities District

1, 945

None

Evaluation of the procedures used in the Jackson water plant laboratory
(Jackson Water Utility) revealed that no dechlorination agent was ever
added to sample bottles. Chlorine residual was reported to average 0. 1
mg/liter in distribution samples. The frequency of sampling water plant
finished water and sampling the distribution system water quality was

by collecting only finished waters for three days and distribution
samples only on the other two days. The technician (1 year of college) was
taught to use the MF procedure by the water plant operator. The water
plant operator gained his knowledge of the MF technique from a one day
demonstration course given by the Millipore Filter Corporation regional
representative. The Jackson Branch laboratory of the Tennessee Depart-
ment of Health has never been consulted by the water plant personnel on
MF methods nor has any effort been made by this state laboratory staff to
visit the filter plant laboratory in the past.

The Knoxville Utilities Board (Mark B. Whitteker Water Plant) laboratory
is well equipped and is staffed by two graduate chemists and a technician
with previous laboratory experience. Their laboratory procedures have
been previously evaluated and found to be acceptable by Mr. Whaley in his
evaluation, December 1969. Our laboratory evaluation indicated that the
deviations noted by Mr. Whaley had either been corrected immediately or
as soon as specified equipment was obtained.

The Knoxville-Chapman Utilities District does perform a limited number of
chemical and bacteriological tests on the raw water, treatment processes
and the finished product. All tests are performed by the water plant oper-
ator whose knowledge has been acquired from several water plant operator
courses and by reference to an outline of laboratory procedures prepared
in 1957 by the Tennessee Department of Public Health. There has never
been an effort made by the State water laboratory evaluation service to
examine the procedures, equipment and staff ability of the numerous small
water plants that desire to test water for their needs in control processing.


-------
193

The need for further training in laboratory procedures by some personnel
at small water plants can be illustrated from our observations at the Knox-
Chapman water plant. Study of plant records indicates no coliforms have
been reported in the finished water for a period of years. Inspection of the
MPN procedures shows the reason to be related to use of nutrient broth in
the presumptive test instead of lactose broth. Nutrient broth does not con-
tain a fermentable carbohydrate thus no gas will ever be found in these
fermentation tubes. What was more remarkable was the record of positive
results using the same medium on raw samples. Apparently the operator is
convinced that these raw water MPN results must be positive and is recording
results as such. I saw no positive cultures among any of the MPN tubes
being incubated beyond 24 hours during the day of our visit. Inquiry made
at the Knoxville Branch Laboratory of the Tennessee Division of Labora-
tories indicated Mr. Shipe had made a short visit to the Knox-Chapman water
plant some five or six years ago but no formal evaluation of procedures was
ever made prior to our visit September 30, 1970.

A cross-section study of water plant laboratories demonstrates the need for
a more comprehensive laboratory evaluation service. Every effort should
be made by designated state laboratory survey officers to up-grade methods
and equipment used in small water plant laboratories. This could be accom-
plished by recommending procedural improvements that would lead to in-
creased test sensitivity; assisting with on-site training when feasible; en-
couraging visits to the State laboratory for an on-the-job training period of
several days; and establishing a direct communication link between personnel
of these two levels of laboratory competencies. Although the personnel of
these small laboratories may not have a background of scientific training,
per se, they are eager to learn and to perform the bacteriological control
testing properly.

Legal responsibility for the Tennessee State Laboratory Survey Program is
with the Division of Sanitary Engineering. As a cooperative effort, evalua-
tions are done by a designated microbiologist in the Division of Laboratories
who also supervises the water and milk laboratory. Any expansion of the
evaluation service will require the use of two approved survey officers and
this problem has been solved in the selection and certification of both Mr.
Kenneth Whaley and Mr, James Scott. There is also a recognized need for
clerical help specifically assigned to the water and milk laboratory to type
laboratory evaluation reports, record and report laboratory results on
water examinations sent to the Central Laboratory, and to type corres-
pondence generated with water plants under the proposed expansion of this
state service.


-------
194

Since there are approximately 85 laboratories that have never been evalu-
ated, it is proposed that the grouping be sorted by counties covered by the
State Branch Laboratory service. All initial visits should be made by the
Branch Laboratory Director or his delegated microbiologist to establish a
communication line within his region and to determine which laboratories
need urgent priority attention to up-grade major problems in procedures,
equipment needs and personnel knowledge.

Coverage of all laboratories that examine potable water should eventually
include not only all municipal water plant laboratories but any hospital,
university, or commercial laboratories in Tennessee that examine potable
waters for compliance with PHS Drinking Water Standards and State regu-
lations.

Remarks

Space

The laboratory bench space will have to be increased if the monitoring of
water, milk and food is increased as anticipated. Currently water and milk
samples must be scheduled to use the same limited available bench space
in one laboratory during different times in the day. Part of a second
assigned laboratory room is used for clerical work by the staff micro-
biologists who spend several hours each day recording "PK" testing results.
When clerical help is made available for the laboratory evaluation service,
this same office personnelcould be trained to do the "PK" recording and
report filing, thus releasing the microbiologists for use in the projected
increase in environmental monitoring service.

Distilled Water

Distilled water used in the water and milk laboratory is brought by carboy
from the fourth floor to the preparation rooms and laboratory. The central
distilled water system in the building has been modified for delivery of
demineralized water through the relatively new block tin lines. The water
and milk laboratory has examined the biological suitability of the demineralized
water and found it to be in a toxic range of 0. 35 to 0. 2. Double distilled
water used to prepare media and dilution blanks has been shown to be of
excellent quality (0. 8 to 1. 0) in terms of the distilled water suitability test.

For purposes of supplying a good quality distilled water for use by all
laboratory activities, it is recommended that the central still be inserted in
the output of the demineralizer and this product water be distributed through
the central distribution lines of block tin. Availability of a good quality
distilled water does require monitoring. Some laboratory staff member


-------
195

should be assigned responsibility to maintain the distilled water quality
through daily checks of conductivity, periodic recharging of the demineral-
izer, control of production capacity to have a reservoir supply available,
yearly inspection of valves, electrical heating elements, storage tank and
distribution lines for defects plus a yearly suitability test to measure the
biological suitability of the distilled water quality. This biological pro-
cedure should be done by the staff microbiologists in the water and milk
program.

Water Bath

Expanding use of the fecal coliform procedure for use in monitoring natural
bathing waters during the summer months has created the need for a suit-
able water bath capable of maintaining water temperature at 44. 5°C ± 0. 2°C.
The available water bath is small and is difficult to maintain any closer than
± 0. 5° C when adjusted for the required elevated temperature incubation.

There are several circulating water baths available commercially that will
hold the ± 0. 2° C tolerance at 44. 5° C. Blueprints of an excellent unit
developed by personnel of the Alabama State Health Department can be
obtained in a request to Dr. Hosty, Director of Laboratories. If local shop
metal workers are experienced in stainless steel construction, a copy of the
Alabama water bath may be constructed at some saving in cost and fully
meet the needs of such a unit in water and food examinations.

Mrs. Dianne Brown, Mrs. Helen Nelson, Mr. Robert Ball and Mr. James
Scott, Microbiologist in the water and milk laboratory are approved for
the application of the total coliform and fecal coliform membrane filter
and multiple tube procedures to the bacteriological examination of both
potable water and natural bathing water quality measurements.

The procedures and equipment in use at the time of the survey complied in
general with the provisions of Standard Methods for the Examination of
Water and Wastewater (12th Edition, 1965) and the Public Health Service
Drinking Water Standards and with correction of deviations listed, it is
recommended that the results be accepted for the bacteriological exgttlfr~
nation of potable waters under interstate regulations.

Personnel Approved

Conclusions

Consulting Bacteriologist


-------
department of health, education, and welfare

ml Lie H1M.TH HRVtCI

Survey Form for Water Labordlorlas
( Bacteriological)

, q7 WWI

<-7 1 (Rev. I-M)

indiemttmg conformity with Public Health Service Drmking
Wmter Standards

SURVEY BY

Edwin E, Qeldreieh

X=DEVIATION UsUNDBTBRMINED OsNOT USID

laboratory Tennessee Dept. of Public Rttfelfh
Division Of Lafror»toriee. Central

«.ocatIOn Cordell Hull Building
	Nftfihyffle. Tenn. 37219

DATS

Sept. 15-16.197C

Smmpfatf 				

Rapresantetive point* throughout distribution system

Location and frequency of sampling adequete 			 X

Minimum number monthly adaquata for population 			 "X"

Repetitive samplet from designated pointt at wall at othart to

estebiish bactariological quality throughout tyttem
Proportionataly mora temples -from iqnatl population a ran .

		

Volume necettary for all tetts		

Minimum tampla not leu than .lOOjn^	

Ample air space shall ba left in bottla to feciUtete mixing
Representative sample collected without contamination
Tap sample collactad from tap connected diractly to main by

service pipa 	

Do not collact tampla from tap connactad to itoraga tanli 	

Tap allowed to waste water until tervice line hat been cleared ....

River, stream, lake, or reservoir tampla collactad by plunging'

opened bottla with neck downward balow surface	

Collect with mouth and toward currant (or away from hand)....

Pump allowed towette water 5 m»n before taking temple

Promptly Identify sample legibly and indelibly 	

Complete and accurate datik accompanies sample 	

S.

ir

Sodium thiosulfate used for dechlorination 	

Added before iteriiiietion of bottla 	

Concant ration appaoximetely J00 m®/1 		

4.	Tr—»p"	mat ltai|i			

Temperature maintained at dote at possible to tha water tem-
perature et time of collection 	*s

Initiate examination at toon at pottible after collection 	 _

Recommended time within I hr after collection 	_			 _

Time between collection and examination not exceeding 30 hr	 _

Establith field procedure where time exceeds 24 hr	 _

Time and temperature of storage recorded 			, _

5.	AcHm for ItaMrtkfKtery Saaspl*	_

Ifgitaae or mere potitive tubet par .tart, or 			 _

fuel or mora coliformi par 100 ml by membrane filter	 _

Daily templet from point promptly examined until two eontecu-

~ive temples are tatisfactory 		 _

«. Imm4 M>w*>ry tMMlMtlMM 			

Results attembled and available for Impaction 	 -

Consistent compliance with water qualify standard*		 ,r

Laboratory methods and technical competence of local govern-'
ment, waterworks, and commercial laboratories approved by
reporting agency 				—• -

LABOtATOKY APPARATUS
7. Sample BoHlet .4. 02, (l?5..nil)

Glass res's+ant to solvent action of watert 	

£ajtijjjmglek»ttlet which mey be sterilized end yield no toxic

substancei 	

Holds sufficient sample with air space for all necessary bac-
tariological tests, meinteint tampla uncontaminated 	

Cloture: 	

a.	Glass stopper, covered, before tteriliiation, with metel foil,
rubberized cloth, or heavy impermeable paper 	

b.	Metal or jtostie tcrew cap with leak-proof liner, provided

	

both are free from toxic tubttances on steriliietion

Accuracy checked with thermometer certified by National Bu-
raeu of Standards, or one of equivalent eccuracy 		 	

?. tMaknr mfeQ.Mpdel.MQ		

Maintain uniform tamparatura in all parti (±1-0* C) 	 ^

Either water-jacket (filled) or anhydric type, with low-tempera-
ture, thermostatically controlled electric heating unitt properly

insulated and located in or adjacent to wallt or floor	 	

Provided with thelvet to spaced at to assure uniformity of

temperature 		 	

Sufficient tiie (provide I-in. space between wallt, dishes, or

baskets) 		

Accurate thermometer with bulb immersed in liquid on each

thelf 	 ,

Dally record of temperature, or			 	

Optionally use automatic devices of predetermined accuracy for

recording temperatures 	 	 	

Unless recording thermometer! are in continuout operetlon, pref-
erably Install meximel and minimal registering thermometer on
middle shelf to record tempereture variation! over 24-hr

period 	 	

At interveli determine tempereture variation! within incubator

when filled to maximal capacity 		 ——-

Keep where temperaturai do not very excessively (50-80*F)	—-

l»Mktw laaa 		—Q.

Optionally use walk-in roomt, well iniulated, equipped with prop-
erly distributed heating unit! and forced-air circulation

Provided erees conform to desired temperature limits 	

Record daily range in temperature in areas used for plates ....
II. HsfcAIr HarMhtaf Ores Precision
Slie sufficient to prevent crowding of interior
Constructed to give uniform end edequete sterilising tempera-
tures (check tempereture variations within oven)

Equipped with thermometer registering accurately et 160-140* C..
Recording thermometer (optional) 	 			

i* ahmIwm	Caatla	

Site sufficient to prevent crowding of inferior 	

Constructed to provide uniform temperetures up to end including

121* C	-	

Equipped with eccurete thermometer with bulb properly located
to register minimal temperature within chamber 	

¦a -lite, i


-------
fHS*75
(Kev. 1-M)

198

Laboratory App«r«(«i (coetleeed)

Recording thermometer (optional) 	..............	.........	..	....

Pressure gages and properly adjusted safety valve 	

Connected with saturated-steam line, or to gas or electrically

heated steam generator 	g	

Reach sterilizing temperature in Sfrmin 			—		

Small pressure cookers may be substituted only in emergencies
and only where satisfactory results have been demonstrated....
And provided pressure cooler has pressure gage and thermometer"
with bulb I in. above water level 	

13.	C*4«ity Canter 			

Quebec colony counter, darlc-field model preferred
Or one providing equivalent magnification and visibility 	

14.	pH tqrip—* ...Bec|^an.J5er<^MiS	

Electrometric pH meter shall be used for pH of media 	

IB. kl«MM 	 .T.O.r.si,Qii....B.ailftnfte.				

a.	Balance with sensitivity of 2 g at 150-g load shall be uted ....
Appropriate weights of good quality 	

b.	Analytical balance with sensitivity of I mg at 10-g load 	

Appropriate analytical grade weights 					

Used for weighing quantities less than 2 g 	

16.	Ma4ta Preparation Utensils 				

8oro»ilicate glass 			

Stainless steel 	

Other noncorrostve utentil 	

Clean and free from foreign residues or dried agar	

Free from toxic or foreign materials which may contaminate

media (such as detergents, chlorine, copper, line, antimony, or
chromium) 	

17.	Mp««s ..Kimax	

Deliver accurately and quickly 				

Calibration error not exceeding 2.5% 	

Tips unbroken, graduation distinctly marked 	

Mouth end plugged with cotton (optional) 	

Pi pet i conforming to APHA specifications (S. M. Exam. Dairy

Prod. Ilth ed.) may be used (optional) 	

It. ft|Mrt Caatataan 		 		

Bok, aluminum or stainless steel, 2-3 x 16 in	

Paper wrappings of good quality sulfite paper (optional) 	

Copper cans or boxes prohibited 	

19. Mlatlaa BaMa* or Tab**			

Borosilicate or other noncorrosive glass 	

Glass stopper or	 rubtoeiLrattail	

Screw cap with leak-proof liner free from toxic 	 -

substances on sterilization 	

Cotton plugs prohibited" -"v-		-y	 -

Graduation level indelibly marked on side of bottle or tube	 -

Non-toxic plastic bottles may be substituted 	 -

tO. Petri Dittos 	 -

Clear bottom, free from bubbles and scratches 	

Diameter 100 mm x 15 mm high (60 x 15 mm for M.P.) 	 -

Bottom flat for medium of uniform thh Container* 		 -

U',ed to orotsct and handle before and after sterilization 	 _

A'uminjm or stainless stee! (not copper) cans with covers,
coarsely woven wire baskets or char-resistant pajsar

W'JOJiTIS	- 			

22.	Pel iiiantuUon Tnfcat 		

Sufficient size to conform with requirements for concentration of
nutrient ingredients and sample as described subwquently

PREPARATION

23.	ta ..'.'better .		

Thoroughly washed with suitable detergent and hot water

(i60* f) Tennessee State Industries	

Rinsed in clean water at 180 *F to remove detergent 	

Rinsed with distilled water 		

Freedom from any residue on drying 	

Free from acidity or alkalinity 			

Detergent leaves no toxic residue 		

24.	Storllfartloii ef frlaiswar* 		

Heat glassware not in metal containers for not less than 60 min

at i7o* c . ,.2 hrs. .at.lT5°C	

Optionally use 160* C for 60 min with constant temperature

recording device if oven temperatures are uniform 	 -

Heat glassware in metal containers for not less than 2 hr at

170* C 	 -

Non-plastic sample bottle as above, or		

Autoclave at 121* C for fir min .N.O-S.team .exhaUSt... -
Plastic sample bottles that distort on eutoclaving sterlllied by

low-temperature ethylene oxide gas 	 	 _

28. Baffarad Dilation Watar 	-

Stock phosphate buffer solution at pH 7.2 	

Freshly prepared when stock solution shows trace of turbidity 	 -

Optionally autoclave stock buffer and store in refrigerator 	 -

1.25 ml of stock buffer added to I liter distilled water 	 _

Dispense to give 99± 2 ml or 9± 0^after autocleving	 -

Sterilized in autoclave at 121* C for Hi min 		 -

Quantity after sterilization with 2% or less deviation 	 -

Dilution volumes of 9 ml may be measured aseptically 		 -

MROIA — MATMIALS ANO PROCIDURM

24.	Wa«ar 	

Distilled or demineraliied water used for media, reagents, blanks,

etc. 	

Free from traces of dissolved metals or chlorine 	

Neutralize distilled water if free chlorine is present 	

Free from bactericidal compounds as measured by bacteriological
suitability tost using Aerobdct&r aerogenes 		

27. Madia Ingradlanti 		

Beef extract 	

Yeast extract 			

Peptone 		

Sugars 	

Agar			

Above preparations demonstrated to give satisfactory reiulH for
bacteriological purposes 				

25.	•aaaral Cbaailealt 	

Reagent or ACS grade 	

19. Dyai 	

Certified by the Biological Stain Commission for uie In media	

30. Staraga 	

Dehydrated media stored tightly in dark (low humidity) at lets

then 30* C 	'		

Not used if discolored or caked 		

Culture media stored in clean, dry space free from contamination
and excessive evapoi*tiMl				

~TT


-------
Survey Form for Water Laboratories
(Bacteriological)

X=DEVIATION

199

U - UNDETERMINED

NCU1-132 (C1 ll)
(5-68)

0=:NOT USED

laboratory Tennessee Dept. of Public Health,
Division of Laboratories, Central T .ahr.-rgtr.i~y

location Cordell Hull Building
Nashville, Tenn. 37219

DATE

Sept, 15-16, 197

Media — Materials and froctdvrci (contlmrod)

Batches used in less then I week 	 	

Protected from strong light 			 	

Fermentation tubes stored at room temperature not over I week..
Fermentation tubes stored at tow temperatures must be incubated
overnight and tubes with air bubbles discarded 	 	

31.	Ad|vctm«ttt of Reaction 		 ,

Expressed in concentration of hydrogen ions (pH) 		

Determine decrease in pH of individual medium in the autoclave

used "for its sterilisation 			 	

Potentiometric method recommended for accurate determirtation..

Appropriate standard buffer used to calibrate pH meters 	 	

Colonmgtric method not used with Madia containing dyes 	

Indicator solution prepared to match color standards 	 	

Calibrated against standard buffer 	pJ5L.T»...Q	 	

FoHow standard procedure, using a comparator 		

32.	St»rllii«tien of Medio 	 —

All medio, except sugar broths, autoclaved at 121® C for 15 min.. 	

Timing starts when autoclave reaches. 121° C temperature 	 	

Media removed and cooled as soon as possible after steriltietion.. 	

Tubes packed loosely in baskets for uniform-heating-and cooling.... 	

Carbohydrate broths sterilized as above *or 10 min 	„	 .—

Optionally add sterilized carbohydrate solution aseptically to

sterile media 		 	

Incubate tubes so prepared at 35° C. for. 24 hr before use 	 	

Total exposure of carbohydrate media to heat not over w min		

33.	Clarification 	 -J2-

Use filtration, sedimentation, or centrifugation as needed 	 		

Do not clarify with nutrient substances such as egg albumen 	

CULTURE MfiDlA —SWiCWCATIONS

34.	C«wt Solution 			.

Use grams solute per 100 ml of solution 				

35.	Nutrient Broth ....			O

Correct composition, sterility, and pH {6.8-7,0) 		„		

34. Lactoso Broth 		 -		¦. .

Correct composition, sterility, end pH (6.9±0J) 		.

^ubed in proper sized tube with inverted vial 				—

Total time of exposure to any heat not more than 30 min 				w	-

When quantities greater than I ml are planted, composition after

planting will contain 0.013 g per ml of dry ingredients 			

Not less than 10 ml medium per tube 				

Dehydrated medium used. Brand .J^ifCO.„ Lot No, 42.6838	

37.	Lcwryl Tryj»to». Broth 		—Q—

Correct composition, sterility, and pH (6.8 ± 0.1) 		- ...

Complies with general requirement! described above 		_

When quantities greater than I m( are planted, compoiition after

planting will contain 0.0356 g permt of dry ingredients			—	

Dehydrated medium uted. Brtind ¦	 Lot No				

38.	brilliant Green Lactose Bllo BrotH 		

Cnrrnct composition. Brand		 Lot No, 428855	

Dfjhydi-flt^d ox ^i^ll only u'.ed in medium ;		

Or 'tvI -.o'utl'cn (10% ,n dfs+i!!ed water) has pH of

A "Id i"?/) 'T,i 0.1% so'ii*:o^ bril'Ian* green/1 of medium

Sterile medium has pH of 7.1 to 7.4 (electrometric method only)	

39.	Elide Medium 	 _Q_

Formula I used or 					

Formula II used 		 				

Correct composition, sterility, and pH (7.4 ±0.1) 		

Proper reaction when seeded with conforms 					

Dehydrated medium used. Brand 	 Lot No		

40.	Eosln Methylene Bloo Afar	 O ¦

Correct composition, sterility, and pH (7.1 0.1)

Proper reaction when seeded with coliforms 	

Medium contains no sucrose. Catalog No.

Dehydrated medium used. Brand 			 Lot No, 			—

41.	Tryptono Glacote Beef Ixtroct Agar 		-X

Tryptone Glncoie Toast fxtract Agar 		—

Correct composition, productivity, sterility, and pH (7.0 :fc 0.1). 		

Sterile medium not remelted a second time after sterilization	 	

Free from precipitate 			 	

Dehydrated medium used. Brand O.lfCO.., Lot No. 5.34456

42.	M>Endo Mediant 			 		—--

Correct composition. Brand		 Lot No. 5.38132 	

Prepare in clean presterilized borosilicote glassware 	 	

Reconstituted in distilled water containing 2% ethyl alcohol. .. 	

Heated to boiling point {do not boil or submit to steam pressure)	—

pH between 7.1 and 7.3 		—

Stored in dark at 2-10' C 	'.....	

Unused medium discarded after 96 hr 	

43.	M>Rndo A«|«r Medlem 	

Correct composition. Brand 	 Lot No	

Reconstituted in distilled water containing 2% ethyl alcohol....

Heated to boiling point (do not boil or submit to steam pretsur.)..

pH between 7.1 and 7.3 	-

Cool to 45-50* C and dispense 4 ml in 60-mm dishes 	

Keep plates in dark at 2-10* C (may store 2 weeks)

TESTS FOR PRESENCE OP MEMBERS OP COUPOiM «ltOW
BY MULTIPLE>TUBE FERMENTATION TECHNIQUE

44.	PrwMiptiv* T«t . y.se only, on turbid samples—

Lactose broth or 		— ¦	—^—

Lauryl tryptose broth 							

Before planting portions arrange tubes in order, number sample,	- , ,

or otherwise identify 	-	-			.

Shake sample vigorously 25 times before removing portions 	

Inoculate fermentation tubes with appropriate quantities 		^

Ule 5 standard portions, either 10 or 100 ml					——

Concentration of ingredients conform to items 36 or 37 					-—.

Quantities inoculated: 10 ml .. .5	 I ml 0.1 ml	¦ ¦¦ ¦ -

Incubate tubei at 35 ± 0.5° C for 24 ± 2 Hr			

Examine for gas — any gas bubble positive 	—-

Return negative tubes to incubator 						—

Examine for gas at 48 3 hr from original incubation 			

Sl_

Record presence or absence of gas at each examination			 — —

Gas in any quantity in 48 2 hr is positive Presumptive Test — ... —...

No gas in 48 ± 3 hr it negative test		 	

Do not record gas produced after 51 hr of incubation 			

3


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NCtl 1-132 (Cin) 200

(5-68)	TmIi far Praeaaca «f Mnnktn if Cdlfcrn ®roep

45. Confirmed Taet 	 ——

Promptly submit all presumptive tubes showing gas production
before of at 24-hr and 48-hr periods to Confirmed Te»t 		 	

a.	Brilliant qraea lactose Ml fcreth 		 ——

Gently shake tube or mi* by rotating 		 	

Transfer one loopful of positive broth to brilliant green bile.... —		

Using sterile loop of 24-gage wite not lets then '3 mm diameter	

incubate for 48 ± 3 hr at 3S* ± 0.5° C 	 —	.

Formation of any gas in the inverted vial within 48 ±: 3 hr
constitutes a positive Confirmed Test 	 	

b.	Me or eosln methylene Mm agar plates	 	_Q_

Streak on® or more plates with inoculum from positive primary

fermentation tube(s) 			

Use inoculating needle slightly curved at tip 	 — .

Tap and incline tube to avoid ony scum 	 ——.....

Insert needle approximately 5 mm 	 	

Streak agar surface with curved section 	 ¦

To obtain discrete colonies separated by at least 0.5 cm ...... ¦

Incubate at 35° ± 0.5* C for 24 :£ 2 hr 		 -— —

!f typical nucleated colonies with or without sheen develop,

the Confirmed Test is positive 	..		

If atypical, unnudeated pink colonies develop, result is doubtful

and Completed Test must be applied 		

If no colonies or only colorless colonies without mucoid char-
acteristics, the Confirmed Teit is negative 	 —-——

c.	Alternate application with multiple portions and dilutions .... —

Optional only with three or more decimal dilutions 	 	

Submit to Confirmed Test all positive tubes of two highest

dilutions (smallest volumes) occurring in 24 hr.t				

Record any tube showing gas in 24 hr which has not been con-
firmed as positive Confirmed Test 	——

Submit to confirmation ell tubes negative at 24 hr end positive

in 48 hr (no exception) 	 	—.

44. Cawplnted Tost 	 		

Appliod to positive Confirmed Teit fermentation tubes or 	 			

To doubtful appearing colonies on differential plate medivm 	 	

If from liquid medium, streak as in Item 45b 	 	 	

Fish one or more typical colonies to transfer to lactose or leuryl

tryptose broth tube and to an agar slant or 		 		

Fish two or more atypical colonies as described above 	' 		

Choose colonies separated by 0.5 cm 		 	

Incubate at 35* db 0.5* C for 24 ^ 2 or 48 ± 3 hr			 	

Examine agar slant with Gram-stain if corresponding secondary

lactose broth showed gas in 24 or 48 hr		-	 	

Gram-negative rods without spores and gas in lactose tube is

positive Completed Test 		 		

Absence of gas In lactota tube In 48 hr — negative test 			

Only Gram-positive bacteria in stein — negative test 			 		,

47. Application af Tatts ,te ftMrtkn fiamlnatlan 		,,

a.	Prasamptlva Tart applied to: 							i

Samples not being considered for drinking water 			,

Routine raw water quality where applicable in plant 			 	—

b.	Confirmed Test applied to: 							¦¦

Waters to which Presumptive Teft it not applicable 				*

Routine samples of drinking water, process or finished watar.... 		„

Chlorinated sewage effluents 					

Bathing waters 		 	-

c.	Completed Ttrt applied to: 	-	 	¦¦¦ —

£xam-*a*'on of water sempfes where results are to be used for

; -or:Tro' of qua'i5"-' of raw or of finished waters		,

I)

by Mnttlpla-tvfca Nmantatlan Technlqne <«nt

If not; eppJied to all such samples, then applied to such a pro-
portion as to establish beyond reasonable doubt the value
of the Confirmed Test in determining their sanitary quality.. —¦
48. Hmmbmr of Torta Par Yaar •	—

Presumptive Total 	 	 4- 	— —— ¦ ¦¦-

Confirmed Total 	 + 	 — -				

Completed Total 	 +		 —	 — 	

TtSTS POR PKRSINCft OF MiMtlRS OF COUWIM *ROUI>
BY MCMBAANS FILTKR TICHHlQUI
4f, Application As Standard Ta»t		—

Use as a standard test for determining po+ability of water after
demonstration by parallel testing that it yields information

equal to that from the multiple-tube fermentation procedure . - 	¦

Examine not less than 50-ml sample 		

50.	Laboratory App*rat«i (See items 7, 17-21)		

Graduated cylinders accurate within 2.S% and 	 	

Openings covered withw^effil &il^oy,lRpsj?tu^e before sterilization 		.—

Use glass containers for culture medium 	

Filtration unit — ,any type that can be sterilized 		

Filters all the sample through the membrane	 		 		

Vacuum source (water trap to protect pump desirable) 		 	

Funnel and filter receptacle wrapped separately for sterilization

and storage 									

51.	Filter Membraaai M.^Pore 		

Full bacterial retention, satisfactory speed of filtration 	-

Stable in use, glycerin free, free from substances 'oxic to growth -	-

Preferably grid marked, non-toxic ink 		

Adequately protected during sterilization from recontamination ——•—
Autoclaved at 121* C for 10 win (or presteriliied)	 		

52.	Abiarbant Pad*		 ———

Filter peper free from growth inhibitory substances 			 	

Approximately 48 mm diameter 			 . —	

Thickness will permit absorbing 1.8 - 2.2 ml medium 	 		

Sterilized before using in test (121* C for 10 min) 	 	

53.	PerMp* 		___

Round tipped, without corrugations 			____

Membrenes end pads handled with sterile (alcohol flamed)

forceps 	 ___

84. Mlcraiaapa mti liny		 _____

Preferably binocular wide field. 10 to 15 diameters magnification ... -

Fluorescent light, edjacent, above, perpendicular to filter plane. 	

Other optical device giving equivalent results 		

SS. PIKratlM 	 	

Suitably dilinfect bench lurface, ellow to dry 	 	

Filter holding unit sterile et stert of series 		

Use support for Inverted funnel between samples (optlonel) . 	

Place iterlle membrane on porous plete, secure funnel 	

Apply vacuum, filter appropriate sample volume (number of teits

uncountable not eicesilva) and rinse funnel 		 	

By filtering ] volumes of 20-30 ml of sterila buffered water 		.

Remove filter with sterile forceps 					

U. Stamford Tart — Slaffa Step		 _____

a. Brett—Sterile pad placed in culture dish 			 ¦

Saturated with M-6ndo medium (42) 					 . . ..

Allow to stand a few minutes before pouring off excess 	

Prepared filter (SS) rolled (grid side up) onto pad....	

h. Afar—Use culture dilh previously prepared (43) .... 	

Prepared filter (55) pieced on agar with rolling
motion 								 i


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Survey Form for Water Laboratories

(Bacteriological)

Tennessee Dept. of Public Health,

X=DEVIATION

201

U UiVDI-TEHMlNED

NCUI-132 fCIn)
(5-58)

Or-NOT USED

location Cordell Hull Buildii

Nashville, Tenn. 372!S

LABORATORY

Division of Laboratories, Central Laboratory

Te«t« for Pretence of Members of Coliform Group by Membrane Pllter Technique (continued)
57. Standard Te«t — with Snrichment 			 O

I DATE

{Sept.

15-16,197<

pi»d placed *n cui'ure dish 		

5ft*uratod wi^h approximatoly 1.8 mI enrichmenr medium «")	

Car©fully remove *ny excess liquid 	 	

Prepared filter (55) placed on pad 	

Incubata inverted filter at 35° zt 0 5' C for -1/2*2 hr .

Remove dif.h from incubator and remove top 	

Bi'Otfc— With sterile forceps lift1 paa 3pd fi'ter i~> +op of dish
Place now sterile pad on bottom and saturate with

'vedu'm [42 j
Transfer fiitgr to now pad land discard used pad)

b. A^or— With 1eriio *orcepr. strip -ffl*er from pad	

-Rr.il o^Lo surface of previously prepared agar (43)....
Optionally leave used pad '•	to maintain

humidify		 	 	

50. inciabrtSofl ... 			 ¦ • 			

Irt sa-vrated humidity, with dish inverted ..		

A'- 3 V ± 0.5* C, *or 22-2* hr	

Incubate anrich^d vcr? ti'ntrrncdiatftiy bo* ' removing portion

f:ach dr'^tion shaken 25 times 			

All. Hating 			

Appr-..:-riatp. qi.:.tnt;ty of sample per plate 		

i,. hfv p-v!ur-;-d water: u:-> d:,uti.jns in sterile dilution water 	

n,V .-'.ore than ' or less '•Hon 0.1 m' (sample or dilution)
/i jr> 'n	di'.h 10 '""i or morp liquefied agar medium 	

Ai	or	C ...		

rr.edi'im srornd for to more fHan 3 hr, 43-45° C 	

Ii'''	p<^:i cird mivf^ro spread eve^lv 		

Al:ow tti xo'idity f/^hin S 10 mr on level surface 			

¦ i/«rt I'.inif?--; c!ay top? re used) ^nci promptly incubate 	

I\!' ' m.;r« th/in 20 min between meaiurino sampie and pouring...

•M	..

^ach p'«Ao or pile separated by at iees+ ' In. from
pl!rt5, ansi from top and walls of ch-amb&r ... 		

!r--ub* + e a*	0.Sg C tor ?** .TT 2 hr, or . . . 		 -		

A i 7r)'J +¦ 0.5" C for w ±: 3 hr 	

Any devi,ihoi	in repoH 					 	

f-'c" shetl'Ish trtr,-.jba*$ 49. d" 3 hr at 35° C 	

Ii»9 ....		

,1(	1 o'".r \i '* 1 r>' ss'rtpl^ en 30
ouptina aid-

than 30 colcnle
3^0 colonie* .

-- t

Raise second digit from left by ! whnn third diglr is 5 or more ....

Record as "standi" ' - ::c ¦; i~ ^ -'A 3L"' C (or 20rt Cj"	 -

OIFFIP.S^TIAI PROCSOURES

66.	Elevated Temperature T««t* NaturaJ ba.t.hmg.,.wate£S_

Inoculate fermenta":or; tubo of EC medium ('3 mm loop) 			

Placed in water bo'h -w^hin 30 nvn 						 — 	

Hold «t 44.5s ± 0.5° C. for 24 Hr .M~ ?..C...Q.i?CO #53, 65_fi.§_

Gas p'cdi1 *.tjon :s por.i'Iv© tes+ (indicating fecal origin)

Absence aas is negative reaction inon-fecaj orig.n) ..

Used only as confirmatory test 	

67.	Different!o) T#it* ?Ten*otiy«? 					

o. Indole te«t* 	

Tryptophane 8ro*h (35e C, 24 2 hr) 			

Satisfactory reagent [pH < 6.0) 		

Procedure satisfactory .		

b.	Methyl red tej?		

Buffered glucose broth (35° C, 5 days) 		

Satisfactory indicator 		

Procedure satisfactory 	

c.	Vogei-Proufcdtter test 			

Buffered or salt peptone glucose broth (35° C, 48 hr)

tt-napthoi solution fresh dally 	

Procedure satisfactory 	

d.	Sodlom citrate test 		

Koser's citrate bro+h f'35° C, 3-4 days} or 		

Simmon's citrate agar {35* C, 48 hr) 			

Procedure satisfactory 	


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203

APPENDIX G
WATER-BORNE DISEASE OCCURRENCE

Since the middle of the nineteenth century, when Dr. John Snow did his
classical study on the transmission of cholera through a water supply,
it has been generally recognized that disease epidemics can, and do,
result from consumption of water containing pathogenic microorganisms.
Diseases most commonly associated with drinking water are cholera,
typhoid fever, dysentery, and infectious hepatitis. Spread of these
diseases occurs most commonly when body wastes from the infected per-
sons are ingested. While person-to-person contact is recognized as
the more common method of transmission for low incidence levels cur-
rently found in this country, the potential for catastrophic epidemics
transmitted by drinking water supplies which serve thousands of people
remains and demands constant vigilance.

In recent years, concern has also been directed to the possible chronic
diseases which may result from use of water containing certain chemicals.
These potentially dangerous chemicals include heavy metals, pesticides,
and other toxic industrial products. Although few clinical cases are
recorded, health agency statistics are usually limited to communicable
diseases and affected individuals may have unrecognized symptons.
Increased reuse of water by municipal, agricultural, and industrial
users indicates vigilance against chemical contamination must be
maintained.


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204

Human body wastes from infected person(s), when present in inadequately
treated drinking water, have caused widespread disease in Tennessee.
In 1945, an outbreak of gastroenteritis occurred in Tazewell, which
was soon followed by a typhoid epidemic involving 100 cases. This
tragic incident was caused by an improperly treated drinking water
supply, according to Tennessee Department of Public Health reports.
In I960, ten persons living in Lyons Park subdivision in Hawkins
County contacted infectious hepatitis within a two-week period. This
and other epidemiological evidence indicated water-borne transmission.
The drinking water supply serving this subdivision was found to
violate many health protection measures. More recently, there has
been at least one case of typhoid at Top of the World in Blount
County and a large outbreak of unidentified infectious disease in
Brentwood, both of which have been associated with drinking water
supplies. Although evidence is inconclusive, investigation revealed
serious deficiencies in the health protection provided by the drinking
water supplies serving these victims.

While epidemiological records do not generally show widespread inci-
dence of water-borne disease, this may actually reflect incomplete
reporting, inaccurate diagnosis and the fact that much enteric
illness is not treated by physicians. This has led some authorities to
suggest that cases of such diseases as gastroenteritis and infectious
hepatitis may actually be as many as 100 times the number reported.


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205

Table I presents a tabulation of significant potentially water-borne
diseases and a comparison of the number of cases occurring in Tennessee
versus the number occurring nationwide for the past eight years. While
Ternessee has approximately two per cent of the nation's population, about
three per cent of the reported infectious hepatitis cases occurred in
Tennessee, about three per cent of the shigellosis occurred in Tennessee,
and about five per cent of the typhoid occurred in Tennessee. The
data in the Table are not intended to imply that all reported cases
were water-borne. It is intended, however, to point out that a por-
tion of these cases, plus an unknown number of unreported cases, may
have been water-borne. In addition, it is significant to note that
body wastes from these diseased persons pose the constant threat of
contaminating public drinking water with pathogenic microorganisms.

In essentially all documented cases of water-borne illness, it has been
shown that definite deficiencies existed in the water supply systems
during the time when disease was transmitted. Furthermore, these
deficiencies were either unrecognized because of inadequate surveillance
for public health hazards, or were recognized but not remedied due to
ineffective persuasion or enforcement by health officials. Deficiencies
similar to those believed responsible for epidemics still are found in
the water supplies of Tennessee. The requisites for repetition of the
tragic epidemics of the past, namely deficient health protection of
public water supplies and presence of diseased individuals in the State,
are still present in Tennessee. Greater vigilance by health officials
and the water supply industry is indicated in order to minimize risk
from drinking water supplies.


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206

TABLE I

INCIDENCE OF WATER-BORNE DISEASE

Year	Amebiasis	Hepatitis

1962

Reported Tenn, Cases	11	2,039

Reported U. S. Cases	3,048	53,016

Percent in Term.	0.4	3.8

1963

Reported Term. Cases	20	1,459

Reported U. S. Cases	2,886	42,974

Percent in Tenn.	0.7	3.4

1964

Reported Tenn. Cases	36	910

Reported U. S. Cases	3,304	37,740

Percent in Tenn.	1.1	2.4

1965

Reported Tenn. Cases	51	805

Reported U. S. Cases	2,768	33,856

Percent in Tenn.	1.8	2.4

1966

Reported Tenn. Cases	46	1,015

Reported U. S. Cases	2,921	34,356

Percent in Tenn.	1.6	3.0

1967

Reported Tenn. Cases	33	860

Reported U. S. Cases	3,157	41,367

Percent in Tenn.	1.1	2,1

1968

Reported Tenn. Cases	47	1,058

Reported U. S. Cases	3,005	50,722

Percent in Tenn.	1.6	2.1

1969

Reported Tenn, Cases	83	1,097

Reported U. S. Cases	2,915	54,325

Percent in Tenn.	2.9	2.0

TOTALS

Reported Tenn. Cases	327	9,243

Reported U. S. Cases	24,004	348,356

Percent in Tenn,	1.4	2.6

Salmonellosis	Shigellosis	Typhoid

124	389	30

9,680	12,443	608

1.3	3.1	4.9

148	379	30

15,390	13,009	566

1.0	2.9	5.3

220	488	21

17,144	12,984	501

1.3	3.8	4.2

191	369	18

17,161	11,027	454

1.1	3.3	4.0

229	312	20

16,841	11,888	378

1.4	2.6	5.3

436	322	12

18,120	13,474	396

2.4	2.4	3.0

313	273	20

16,514	12,180	395

1.9	2.2	5.1

277	336	22

18,419	11,946	364

1.5	2.8	1.0

1,938	2,868	173

129,269	98,951	3,662

1.5	2.9	4.7


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207

REFERENCES

Community Water Supply Study - Analysis of National Survey Findings.
Bureau of Water Hygiene, July, 1970, 111 pp.

Evaluation of Water Laboratories, Public Health Service Publication
No. 999.EE-1, Superintendent of Documents, Government Printing
Office, Washington, D. C. 20402, 1966, 54 pp.

"List of Public Water Supplies In Tennessee," Division of Sanitary
Engineering, Tennessee Department of Public Health, Nashville,
Tennessee, April, 1970, 31 pp.

Manual for Evaluating Public Drinking Water Supplies, Public Health
Service Publication No. 1820, Superintendent of Documents,
Government Printing Office, Washington, D. C. 20402, 1969,

62 pp.

Manual of Individual Water Supply Systems, Public Health Service
Publication No. 24, Superintendent of Documents, Government
Printing Office, Washington, D. C. 20402, 1962, 121 pp.

1962 Public Health Service Drinking Water Standards, Public Health
Service Publication No. 956, Superintendent of Documents,
Government Printing Office, Washington, D. C. 20402, 61 pp.

Public Water Systems In Tennessee - 1969, Office of Comprehensive

Health Planning, Tennessee Department of Public Health, Nashville,
Tennessee, July, 1970, 36 pp.

Recommended Standards for Water Works, Great Lakes - Upper Mississippi
River Board of Sanitary Engineers, Health Education Service,
P. 0. Box 7283, Albany, N. Y., 12224, 1968, 87 pp.

Recommended State Legislation and Regulations, DHEW, Division of

Environmental Engineering and Food Protection, Superintendent
of Documents, Government Printing Office, Washington, D. C. 20402,
July, 1.965, 109 pp.

"Selected Chemical Content of Waters Used By Public Supplies," Division
of Sanitary Engineering, Tennessee Department of Public Health,
Nashville, Tennessee, January, 1966, 18 pp.

Standard Methods for Examination of Water and Wastewater, 12th Edition,
APHA, AWWA, and WPCF, American Public Health Association, New
York, New York, 1965, 796 pp.

State Salary Ranges, DHEW, Office of State Merit Systems, Government
Printing Office, Washington, D. C. 20204, July 1, 1970.


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208

Tennessee Morbidity Statistics - 1969, Tennessee Department of Public
Health, Nashville, Tennessee, 1970, 47 pp.

Tucker, Farrell, Dodd and Purdam, "An Outbreak of Typhoid Fever At

Tazewell, Tennessee," Division of Preventable Diseases and Division
of Sanitary Engineering, Tennessee Department of Public Health
Nashville, Tennessee, 1945, 10 pp.

Tucker, Owen and Farrell, "An Outbreak of Infectious Hepatitis Apparently
Transmitted Through Water," Southern Medical Journal, Journal of
the Southern Medical Association, Birmingham, Alabama, Volume 47,
Number 8, August, 1954, pp. 734-740.

Water Quality Criteria - Report of the National Technical Advisory

Committee to the Secretary of the Interior, Federal Water Pollution
Control Administration, Superintendent of Documents, Government
Printing Office, Washington, D. C. 20402, April 1, 1968, 234 pp.

"Water Systems in Tennessee Distributing Fluoridated Water," Division
of Sanitary Engineering, Tennessee Department of Public Health,
Nashville, Tennessee, April 1, 1969, 10 pp.


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