#  Using GIS and GPS as a Tool for Site Evaluations for On-Site Ground Absorption Wastewater Disposal Systems 

# 2006 - 2007

# Environmental Public Health Leadership Institute Fellow: 

# 

#  David M. Troutman, B.A., R.S.

*Director of Environmental Health,* Cabarrus Health Alliance

*1307 South Cannon Blvd., Kannapolis N.C. 28083 (704) 920-1211*

*dmtroutman@cabarrushealth.org*

# Mentor:

**Lisa Conti, DVM, MPH\
***Program Manager,* Florida Department of Health

# (Acknowledgements): 

# **Chrystal Swinger, B.S. R.S.** 

*Vector Control Specialist,* Cabarrus Health Alliance

**Dr. William F. Pilkington, D.P.A.**

*Chief Executive Officer and Director of Public Health,* Cabarrus Health
Alliance

# Mark Smith, Ph.D.

*Guilford County Heath Department,* Public Health Regional Surveillance
Team 5

# Steve Ramsey, R.S.

*Guilford County Heath Department,* Public Health Regional Surveillance
Team 5

# Information Technology Department

Cabarrus Health Alliance

![](media/image1.jpeg){width="1.3756944444444446in"
height="0.6368055555555555in"}

# EXECUTIVE SUMMARY:

The Cabarrus Health Alliance (CHA) is the local health department in
Cabarrus County North Carolina. Operating under the legal authority
granted to the local Health Department by North Carolina G.S. 130A-333
thru 130A-343 the Cabarrus Health Alliance performs site evaluations for
on-site ground absorption wastewater disposal systems*.* Section 15A
North Carolina Administrative Code 18A .1900 are the rules that are the
basis for all on-site ground absorption wastewater disposal systems
activities and are used to characterize the soil conditions and identify
any physical or legal characteristics of the property that may limit the
amount of space available to install a system. Physical characteristics
of the property that may limit available space include: shallow till or
limiting layers, seasonal high water table, evidence of fill or
excessive compaction, excessive slope, or lack of available space. Legal
characteristics that may limit available space include legal setbacks,
easements or other restrictions to full use of the property. Geographic
information systems (GIS) and global positioning systems (GPS) have been
increasingly used in public health settings since the 1990's with the
use of this technology growing at an astounding rate. This capacity
building project helps incorporate GIS/GPS technology into the
evaluation of sites for ground absorption wastewater treatment and
disposal systems (commonly known as septic tanks, private or individual
sewage systems). Given the increasing concern about the environment and
public health, it is necessary to provide an adequate tool to manage
such site specific information as land use, land contours, soil type,
streams, and topography, etc. The main use of GIS/GPS in this area is to
provide maps that are permanent, accurate and standardized that can be
created for a parcel/tract of land indicating which areas have been
evaluated for ground absorption waste water disposal systems. These maps
can be used for decision-making using information that may not normally
be linked, resulting in improved time and cost efficiency. It replaces
traditional paper-based field data collection methods with mobile GIS
applications. Project elements included procuring hardware and software,
conducting individualized and group training, developing data layers,
guiding the project development process and evaluating project
milestones.

# INTRODUCTION/BACKGROUND:

Historically, local health departments have captured data in mobile
environments through the use of ink pens and paper. Sometimes this
information is outdated or, because of scale, is inaccurately displayed
on a map. The precise distance between two on-site septic systems on a
countywide map, for instance, would be unclear. It is the goal of this
project to replace traditional methods for documenting on site septic
system data with accurate global positioning system (GPS). This type of
technology would make information more accessible, more accurate, and
more easily manipulated to produce predefined and customized reports.
Currently site visits are continually made to the same property over and
over again to identify areas that were found to be suitable and
unsuitable for ground absorption systems; this would be especially true
on larger tracts of land where accurate hand drawn field notes do not
exist. This situation is complicated by turnover in staff. It is easy to
read one's own field notes and make sense of them but someone else may
find them confusing. For example, an Environmental Health Specialist may
go out on a 20 acre tract of land where there are four house sites
proposed and maybe areas were found but there are not established
lot/property lines for each new lot. Some time later, maybe years, the
applicant may seek permits and provide us with new plats indicating the
property has been subdivided and the question is "Where were the areas
that were found to be suitable in relationship to the newly established
property lines? This happens all the time and what we have to do is to
go back on the site and try to establish where those areas are. To
complicate the matter the person that may have done the original
evaluations may not be on staff anymore and someone going out there cold
has a hard time finding those areas because he/she has never been there
before. For all intents and purposes it is starting over again. There
have been situations where property was evaluated years ago and existing
staff could not locate provisionally suitable areas that were indicated
on the field notes of other staff members that have retired or taken
other positions; this generates controversy and creates distrust. There
is no real way for existing staff to know exactly where previous
evaluations were done on the same tract of land. To complicate the issue
even more Cabarrus County N.C. it in the Piedmont of N.C. and has
predominantly bad clay soils that are unsuitable because of poor
drainage and expansive qualities; one whole side of the county is also
in the Carolina Slate Belt that has very shallow soils to the parent
rock material. The soils within the county are very dynamic and change
very fast and have the potential to change very fast over very short
distances. It costs the Cabarrus Health Alliance in man (or women)
hours; it costs the property owners, builders and real estate brokers
money in the way of fees; it costs the county itself because they cannot
provide any information to it citizens with regard if a property has
been evaluated by the Cabarrus Health Alliance and does not make full
use of the existing GIS data layers they (the county) maintain ; it may
not cost the state any money but it would create the foundation on which
other counties could use the "lessons learned" in Cabarrus to use this
technology themselves. This project proposes to use GPS in conjunction
with GIS to locate all factors that relate to on-site wastewater system
evaluations. The information about each on-site wastewater system
evaluation will be tied together with the tax map parcel number (which
is unique for each property) and will provide information about the
location of such things as soil evaluation auger borings, proposed
residence, property corners and lines (both real and proposed), roads
and any other information that has a geospatial relationship to the
property.

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####### ***Problem Statement:***

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Is there a way to record and report site evaluation data so that a
permanent, accurate and standardized map can be created for a
parcel/tract of land indicating which areas have been evaluated for
ground absorption waste water disposal systems?

####### ***Mental Models: What thinking allows the system to persist as it is?***

Mental models are the assumptions that we carry in our minds about
reality. They influence how we understand the world and the action that
we take. We are mostly unaware of these models and need to begin to
discover ways in which we view the world and learn to critically
evaluate them.

Change is often slowed by the wish of individuals and groups to remain
within the comfort zone. Harmony may be held in greater esteem than
innovation. Security and stability may be the priority (*Playing it
Safe*).

The application of familiar solutions to problems as they relate to
documentation that is needed to do the job. This is done mainly because
we like to stick with what we know best. In this century we are going to
need to look for new solutions to problems, rather than relying on ones
that worked before (*The easy way out usually leads back in*).

A problem often takes a while to manifest because the symptoms occur
long before the problem is known; this makes it hard to identify
problems early (*Cause and effect are not closely related in time and
space*).

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####### ***Behavior Over Time Graph:***

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####### ![](media/image2.png){width="7.376388888888889in" height="3.5527777777777776in"} 

####### ***Causal Loop Diagram and archetype:*** 

####### 

> **BACKFIRE**

####### ***10 Essential Environmental Public Health Services***

![](media/image3.png){width="4.581944444444445in" height="4.14375in"}

Figure 1: Relation of Essential Services to Core Functions developed by
Carl Osaki in Essential Services of Environmental Health ¹

It is thought that the strength of the environmental public health
system lies in its ability to deliver the ten essential services shown
above in Figure 1. As a whole, these ten essential services provide an
overall perspective of the responsibilities of a local environmental
health program. This project seeks to enhance the agency's ability to
provide the essential service of being able to enforce laws and
regulations that protect health and ensure safety. The Cabarrus Health
Alliance is the local regulatory authority for ground absorption
wastewater disposal enforcement activities. As stated in the executive
summary "The Cabarrus Health Alliance (CHA) is the local health
department in Cabarrus County North Carolina. Operating under the legal
authority granted to the local Health Department by North Carolina G.S.
130A-333 thru 130A-343 the Cabarrus Health Alliance performs site
evaluations for on-site ground absorption wastewater disposal systems*.*
Section 15A North Carolina Administrative Code 18A .1900 are the rules
that are the basis for all on-site ground absorption wastewater disposal
systems activities" This project also has an assessment component that
ensures limited resources are used effectively by increasing the
agency's ability to compile relevant information when needed as well as
provide the knowledge of where to go to obtain the information
(information gathering).

####### 

####### 

####### ***National Goals Supported*** 

One of the CDC Health Protection Goals² is to create a public health
workforce that is committed to protecting the population from
infectious, environmental, and terrorist threats **(**People Prepared
for Emerging Health Threats). Funding for this project was secured as
part of CDC Project 516, funded by a CDC grant under the Bioterrorism
Act of 2002, and provided ESRI ArcView9.1, ArcPad, ArcPad StreetMap and
ArcPad Application Builder software; hardware; and application training.
One of the goals of the project is to create capacity building and be a
model for other local health departments to incorporate GIS/GPS
technology and mobile data collection into daily operations and in the
process build and train core staff on the use of this equipment so that
they are well beyond the learning curve when it comes time to put it
into use to collect and analyze field data more efficiently and rapidly
following natural disasters, disease outbreaks, or other emergent public
health events. The emphasis of the program is to create within
environmental health a group of personnel who have a solid understanding
of GIS software. Through regular and consistent use of the hardware and
software in the field, they could then take that knowledge and apply it
to disaster epidemiology which includes rapid needs assessment, disease
control strategies, assessment of the availability and use of health
services, surveillance systems for both descriptive and analytic
investigations of disease and injury, and research on risk factors
contributing to disease, injury, or death. This project also supports
the National Strategy to Revitalize Environmental Public Health
Services³ goals by providing Cabarrus Health Alliance environmental
public health program an opportunity to train personnel in the use of
new technologies.

####### ***Project Logic Model:***

+----------+------------------+----------------+---------+-----------+
| **RES    | **ACTI           | **OUTPUTS**    | **IM    | **LONG    |
| OURCES** | VITIES/PROCESS** |                | MEDIATE | TERM**    |
|          |                  |                | OUT     |           |
|          |                  |                | COMES** | **O       |
|          |                  |                |         | UTCOMES** |
+----------+------------------+----------------+---------+-----------+
| Cabarrus | **a**. Meet with | Download data  | Proc    | Make      |
| County   | and establish a  | from county    | urement | in        |
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| De       | that there can   | site specific  | h       | more      |
| partment | be a mutual      | and tied to    | ardware | ac        |
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| Cabarrus | the types of     | parcel number, | so      | more      |
| Health   | data sets the    | which is       | ftware; | accurate, |
| Alliance | County can       | unique for     | funding | and more  |
| (CHA)    | provide and what | each property. | was     | easily    |
| Envir    | is needed to     | Information    | p       | ma        |
| onmental | access them for  | such as        | rovided | nipulated |
| Health   | field            | dimensions,    | as part | to        |
| (EH)     | applications.    | shape,         | of a    | produce   |
| Staff    | Input from this  | easements,     | CDC     | p         |
|          | department needs | topography,    | Project | redefined |
| Cabarrus | to be solicited  | bodies of      | 516     | and       |
| Health   | because they     | water and      | Grant,  | c         |
| Alliance | will be the main | aerial         | funded  | ustomized |
| IT Staff | provider of all  | photography    | by a    | reports   |
|          | GIS information  | would be       | CDC     | to help   |
| PHRST 5  | to be used.      | available in   | grant   | to        |
| Project  |                  | the field to   | under   | identify  |
| 516      | **b.** Ask for   | EH staff.      | the     | areas     |
| Sta      | input and        |                | Biote   | that were |
| ff/Earth | feedback from    | Replace        | rrorism | found to  |
| R        | "proposed users" | traditional    | Act of  | be        |
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|          | clear            | accurate       | ArcView | a         |
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|          | what is needed   | positioning    | http:// | systems,  |
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|          | training needs   | Create         | oftware | e         |
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|          | experience       | and mobile     | [       | land      |
|          | create a culture | data           | ArcPad] | where     |
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|          |                  | into daily     | /www.es | hand      |
|          | **c**. Meet with | operations and | ri.com/ | drawn     |
|          | IT staff for     | in the process | softwar | field     |
|          | their input into | build and      | e/arcgi | notes do  |
|          | what is needed   | train core     | s/arcpa | not       |
|          | from our agency  | staff on the   | d/index | exist.    |
|          | to be able to    | use of this    | .html), |           |
|          | download GIS     | equipment      | [ArcPad | Create    |
|          | Data sets from   | software in    | St      | within    |
|          | the county. CHA  | the field and  | reetMap | envi      |
|          | IT will be the   | then take that | ](http: | ronmental |
|          | main technical   | knowledge and  | //www.e | health,   |
|          | support for      | apply it to    | sri.com | personnel |
|          | Environmental    | disaster       | /softwa | who have  |
|          | Health and the   | epidemiology   | re/arcg | a solid   |
|          | liaison between  |                | is/arcp | unde      |
|          | Environmental    |                | ad-stma | rstanding |
|          | Health and the   |                | p/index | of GIS    |
|          | county GIS       |                | .html), | software. |
|          | department       |                | and     | Take that |
|          |                  |                | [ArcPad | knowledge |
|          | **d.** Pick up   |                | Appl    | and teach |
|          | hardware and     |                | ication | other     |
|          | software awarded |                | B       | public    |
|          | to CHA through   |                | uilder] | health    |
|          | the Project 516  |                | (http:/ | staff so  |
|          | Grant. Attend    |                | /www.es | it can be |
|          | the two training |                | ri.com/ | applied   |
|          | workshops where  |                | softwar | to        |
|          | grant recipients |                | e/arcgi | disaster  |
|          | are taught       |                | s/arcpa | epid      |
|          | hardware use and |                | d-appbl | emiology  |
|          | software         |                | dr/inde | which     |
|          | applications.    |                | x.html) | includes  |
|          |                  |                | so      | rapid     |
|          |                  |                | ftware; | needs     |
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|          |                  |                | rdware; | sessment, |
|          |                  |                | and     | disease   |
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|          |                  |                | aining. | a         |
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|          |                  |                | Partn   | of the    |
|          |                  |                | erships | ava       |
|          |                  |                | are     | ilability |
|          |                  |                | created | and use   |
|          |                  |                | with    | of health |
|          |                  |                | the     | services, |
|          |                  |                | County  | sur       |
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|          |                  |                | Dept.   | systems   |
|          |                  |                | &ERSI   | for both  |
|          |                  |                | Te      | de        |
|          |                  |                | chnical | scriptive |
|          |                  |                | support | and       |
|          |                  |                | & PHRST | analytic  |
|          |                  |                | 5 staff | inves     |
|          |                  |                |         | tigations |
|          |                  |                | CHA     | of        |
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|          |                  |                | staff   | and       |
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|          |                  |                | in the  | or death  |
|          |                  |                | op      |           |
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|          |                  |                | of the  |           |
|          |                  |                | h       |           |
|          |                  |                | ardware |           |
|          |                  |                | and     |           |
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+----------+------------------+----------------+---------+-----------+

# PROJECT OBJECTIVES/DESCRIPTION/DELIVERABLES:

####### ***Program Goal***

To record and report site evaluation data so that a permanent, accurate
and standardized map can be created for a parcel/tract of land
indicating which areas have been evaluated for ground absorption.

####### ***Health Problem***

Septic systems that are not properly sited can cause ground water
contamination and or expose sewage to the public when they fail creating
the potential for disease transmission.

####### ***Outcome Objective***

By January 31, 2007 all site evaluations will incorporate a GIS/GPS
produced map.

####### ***Determinant***

Hand drawn field notes with little or no standardization create problems
in properly siting approved areas for ground absorption waste water
disposal systems and delineating unsuitable areas.

####### ***Impact Objective***

By January 31, 2007 all (100%) site evaluations will incorporate a
GIS/GPS produced map that will accurately denote the exact location of
the approved area for the drain field as well as areas that have been
evaluated and determined to be unsuitable.

####### ***Contributing Factors***

Using pen and paper are the traditional way of making field notes; staff
turnover creates situations where one is reading someone else's notes;
ownership of property changes and information given to original
applicant does not matter.

####### ***Process Objectives***

Acquisition of hardware and software to create accurate maps using
GPS/GIS. Acquire parcel data sets from county; train staff on the use of
equipment and software; build partnerships for technical support.

# METHODOLOGY:

####### ***Events and Activities***

**Activities:**

February 15, 2006- awarded CHA is awarded one of seven Project 516
Grants

April 7, 2006 "Start Up" meeting for initial orientation.

May 10-12, 2006 Training on use of hardware, software and workshop on
"form" and application building;

July 11, 2006 Distribution of hardware and additional training in
"form"building.

August 8 & 9, 2006 participate in disaster exercise as part of grant
requirements.

August 28, 2006 begin in the field use and hands on training.

Hold monthly meetings to evaluate status and receive feedback on project

# RESULTS:

Our goal was to apply a mobile GIS field data collection system to a
program in which we will gain experience and build expertise through
daily use of the system. Skills and experience gained would be
transferred to key Public Health Preparedness and Response staff,
Communicable Disease Staff and Environmental Health staff through
planned training.

A strength that Cabarrus Health Alliance has is its highly qualified
in-house Information Technology Department. Therefore, Cabarrus Health
Alliance is well positioned to develop, implement, maintain, and expand
new technologies.

The Environmental Health section is geared to employ mobile GIS/GPS
technology in its on-site wastewater program. Environmental Health
Specialists have been trained to use field computers, mobile GIS/GPS
during on-site soil evaluations to pinpoint site locations and soil
sampling areas, to aid in accurate and efficient data collection, and to
provide analysis of captured data. Property data is transferred from
Cabarrus Health Alliance's central database to the handheld unit before
conducting each site visit. Data is collected on soil structure and
texture, soil depth, topography, landscape position, restrictive
horizons, and available space. The results of the analysis dictate if a
permit for an on-site ground absorption wastewater system can be
obtained and if it will be denied. Environmental Health has the ability
to quickly input all descriptive data onto a customized form located on
a handheld unit. After returning to the office, data collected during
the site evaluation is uploaded to the agency's computers and imported
into ArcView. ArcView enables us to compose maps displaying coordinates
in relation to their descriptive characteristics.

It is anticipated that through daily use, Environmental Health
Specialists will become expert users of the technology enabling them to
also apply the technology in the case of food-borne or other disease
outbreak investigations and to train other departments within Cabarrus
Health Alliance in its use. We are not at the point where we would
consider ourselves experts; learning any new skill set takes time and
becoming an "expert" takes even longer.

# 

# 

# CONCLUSIONS:

Although GIS/GPS technology has the potential to save resources and
reduce error the initial investment in equipment is substantial. This
project would not have been possible without the Project 516 grant. As
equipment becomes more user-friendly and costs decrease, GIS/GPS will
become more of a routine tool for public health and no doubt new and
innovative uses will evolve. Cabarrus Health Alliance foresees the
development and use of this technology in several areas other than to
provide maps that are permanent, accurate and standardized indicating
which areas have been evaluated for ground absorption waste water
disposal systems. Some of those uses are (but not limited to):

[Surveillance and Investigation]{.underline} -- The technology would be
used as a data collection tool for surveillance and investigation should
there be a communicable disease or food-borne illness outbreak in the
county. Field assessments could be performed in schools, businesses, or
other sites in the community.

[Mass vaccination/mass dispensing]{.underline} -- Mobile data collection
technology would be used as a registration tool for mass dispensing/mass
vaccination clinics. For example, this would be exercised in Cabarrus
Health Alliance's annual fall flu clinics. Over the past two years, the
agency has worked to develop an efficient "drive-up" service for the
delivery of vaccines. Handheld technology would enhance the efficiency
of the registration process.

[Rapid assessment]{.underline} -- Mobile GIS could be used as a tool to
quickly identify the needs of the community's population if they were to
be re-located to a shelter or in a quarantine situation. This would
expedite the process of identifying the need for and/or securing
equipment and services. The most likely need for this would be in the
event of an ice storm or similar event when special needs shelters would
be opened. However, rapid assessments could also be used in data
collection in schools, businesses, or other identified populations in
the county to identify and quantify community health needs.

[Monitoring infant mortality indicators]{.underline} - The maternal
health section will consider the use of this technology for data
collection during postpartum home visits to capture indicators of Infant
Morbidity and Mortality. Monthly analysis could provide an opportunity
to easily identify at-risk populations and provide information for
establishing concentrated educational programs as well as to support
future grant opportunities.

# 

# 

# 

# 

# LEADERSHIP DEVELOPMENT OPPORTUNITIES:

####### ***David M. Troutman, R.S.***

As I reflect on all I have learned the past year I am very thankful for
the opportunity to participate in EPHLI. I am extremely thankful for all
the help and knowledge that I have received as a result of that
participation. It has been a great chance to meet new people and build
relationships, compare and discuss issues of common interest as well as
develop and share ideas. One thing that I have become immensely aware of
is that improvement requires change and improving yourself as a leader
requires you to change. Perhaps my greatest accomplishment is that I
have a greater understanding that holding strongly to one\'s opinion
(and even defending it vigorously) is not incompatible to listening to
another position and respecting and liking the person holding it. To be
a real leader one needs to be able to influence people to make the
changes needed to achieve results and in order to do that we need to
examine where we are coming from and release our need to be right and
acknowledge all parties have needs and commit to a process to achieve a
mutually satisfactory solution. I know I am a better person and I think
(time will tell) that I am a better leader.

 

# ABOUT THE EPHLI FELLOW

David M. Troutman currently serves as the Director of Environmental
Health for the Cabarrus Health Alliance, the Public Health Authority for
Cabarrus County North Carolina. He began his career in environmental
public health in 1978 as a summer intern in the Solid Waste and Vector
Control Branch of what was then The Cabarrus Health Department. He
received his undergraduate degree from the University of North Carolina
at Charlotte in 1979. He became a Registered Sanitarian with the N.C.
Board of Sanitarian Examiners in 1984. He graduated with a Certificate
in Community Preparedness and Disaster Management from the University of
North Carolina School of Public Health in 2005. Mr. Troutman is the
current chairman for the Cabarrus County Local Emergency Planning
Commission (LEPC).

# REFERENCES

1)  Carl Osaki, RS, MSPH, Northwest Center for Public Health Practice,
    10 Essential Environmental Health Services.

2)  CDC NOW: Health Protection Goals Fact Sheet-Goals for the 21^st^
    Century, <http://www.cdc.gov/about/goals/default.htm>

3)  CDC National Strategy to Revitalize Environmental Public Health
    Services,
    <http://www.cdc.gov/nceh/ehs/Docs/nationalstrategy2003.pdf>