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Water

1 apologize for the slow responses. I've been pulled in many different directions over the past few days. Working with you and sampling the schools is my priority moving forward and my communications will be more prompt. Mike, | left you a voicemail yesterday afternoon when I received the message that you left earlier in the day. Sorry my response wasn't sooner, T'll be at my office by 8am tomorrow and I'd be happy to discuss anything. George, I have the professional sanitarian staff to collect water at schools, The GCHD financial people calculated $92/hr to cover costs. That didn't include 11/2 overtime pay. I can discuss this further. Thave the yellow copies of water (collection) forms used during our first round of sampling at the schools. I can fax, email or discuss them in detail. If you need details from discussions between GCHD staff and the school staff during the sampling, I can have my staff to sit in on a conference call, There seemed to be a lot of discrepancies regarding when/if and how long the fixtures were flushed. The sanitarian that sampled Freeman Elementary told me that the drinking fountains appeared to have been used prior to him collecting the samples (there was water in the basins). Keep in mind, this was after the schools had prohibited use of the fountains. He told me that he assumed that students were randomly pushing the drinking fountain buttons as they walked by because they were told not too use them. Steve, you made the expectations clear and detailed what everyone's role was with the first round. Of course some mistakes were expected, but the only consistency with flushing the water fixtures seemed to be the inconsistencies. For example; The central kitchen was not informed and the fixtures were not flushed previous to our sampling. However; we sampled a prep sink that had not been used that morning, but the kitchen manager couldn't recall the last time it had been used. I collected the samples at the school admin building and met with Tony Sitko. He wasn't sure, but thought the custodian flushed the drinking fountains and didn't know when they were flushed. There are many similar experiences that my staff reported back to me. I don't mean this critically and this just confirms that mistakes and will occur regardless of how clear the instructions. I think your approach to limiting the different parties involvement with sampling will help reduce mistakes. Thank Jim Sent from my phone xxxEND_PAGE:deq04_b580_7196_7564_126 Rennaker, Joanne (DEQ)

Flint Schools

Mike, do you have water results for Flint schools? Jim Henry RS, MBA Environmental Health Supervisor Genesee County Health Department w 630 S. Saginaw St., Suite 4 Flint, MI 48502-1540 Ww Phone {810} 257-3618 Fax (810) 257-3125 i 2crchel. us * NOTICE: This e-mail, including attachments, is intended for the exclusive use of the addressee and may contain proprietary, confidential or privileged information. If you are not the intended recipient, any disclosure, use, distribution, copying, or taking of any action in reliance of the contents of this e-mail is strictly prohibited. If you have received this e-mail in error, please notify me via e-mail and permanently delete the original and destroy all copies. ‘Thank you. For a copy of the Health Department’s Notice of Information Practices, contact the Health Department or visit the Health Department’s website al xxxEND_PAGE:deq16_b5_0892_4900_0133

FW: Public Health Emergency Declaration

i ie & £ [email protected] ged informaty 4. Sf you have ¢ use of the addressee and may o an prop action in reliance of th Wants af nd desiroy ali copies. Thank ant, any disclosu: if error, please notify me via For a cepy of the Health Department's Mos of information Practices, contact the Health Department or visit the Health Department's websil at hile fiw, gechid. us xxxEND_PAGE:deq16_b5_0892_4900_0144 fey Water Supply attire Weary Oacleration for: Puente Using the Fiiets e the Snacks: Te wet WLOLUMOLLOLLLLLA 3S B oA WMD is-coss yf GHENT “or Wie YES boporten' LLL LL EEE EEE xxxEND_PAGE:deq16_b5_0892_4900_0145 Suid be Sationay AUONS ara Hae SSNRS.IN WHOSEsoresA Use ACIS courdry, Uy Rese are many other potent ox @ “Rome temearias ane cow & Tamasnds ar Masiae e Bear oats s Cpystaldecanters Spunsl gs fhe Sey xxxEND_PAGE:deq16_b5_0892_4900_0146 xxxEND_PAGE:deq16_b5_0892_4900_0147

FW: FOIA Request

Hello Mike Will you please assist with obtaining the information requested in the attached FOIA? Below is the correspondence to the City on April 2" Thanks Jim Jira Henry RS, MBA Environmental Health Supervisor 430 S. Saginaw St, Suite 4 Flint, MI 48502-1540 3618 Fax (810) 257-3125 *NOTICE: This e-mail, including attachments, is intended for the exclusive use of the addressee and may contain proprietary, confidential or privileged information. If you are not the intended recipient, any disclosure, use, distribution, copying, or taking of any action in reliance of the contents of this e-mail is strictly prohibited. If you have received this e-mail in error, please notify me via e-mail and permanently delete the original and destroy all copies. ‘Thank you. For a copy of the Health Department’s Notice of Information Practices, contact the Health Department or visit the Health Department's website at fy

FW: FOIA Request

Good afternoon, Howard, Would you please look into the attached request? {sent it on April 2, 2015 and haven’t heard back. Mike/Howard, Would it be possible to arrange a meeting sometime soon, maybe the next time Mike conducts a site visit in Flint? Thanks Jim Jim Henry RS, MBA Environmental Health Supervisor Genesee County Health Department www.gchd.us 630 S, Saginaw St., Suite 4 Flint, MI 48502-1540 Phone (810) 257-3618 Fax (810) 257-3125 E-mail [email protected] xxxEND_PAGE:deq03_b604_2838_3252_081 *NOTIC are not the intended recipient, any disclosure, use, distribution, copying, or taking of any action in reliance of the contents of this e-mail is stricdly prohibited. Ul you have received this ¢-mail in error, please notify me via e-mail and permanently delete the original and destroy all copies. ‘Thank you. his e-mail, including attachments, is intended for the exclusive use of the addressee and may contain proprictary, confidential or privileged information. Ifyou For a copy of the Health Department’s Notice of Tnformation Practices, contact the Health Department or visit the Health Department's website at http://www. gchd.us/

FW: Questionnaire / FOIA

Importance: High Mike, | apologize for the delay regarding the attached FOIA’s and questionnaire. The information that you shared during the conference call last week was very helpful. | have not received a response yet from the April 2, FOIA. Thank you Jim Henry RS, MBA Environmental Health Supervisor 630 S. Saginaw St., Suite 4 Flint, MI 48502-1540 Phone (810) 257-3618 Fax (810) 257-3125 *NOTICE: This e-mail, including attachments, is intended for the exclusive use of the addressee and may contain proprietary, confidential or privileged information. If you are not the intended recipient, any disclosure, use, distribution, copying, or taking of any action in reliance of the contents of this e-mail is strictly prohibited. If you have received this e-mail in error, please notify me via e-mail and permanently delete the original and destroy all copies. Thank you. For a copy of the Health Department’s Notice of Information Practices, contact the Health Department or visit the Health Department’s website at hite://www.gehd.us/ xxxEND_PAGE:deq16_b5_0892_4900_0919 MDSS ID Legionellosis Questionnaire Genesee County, 2014-2015 Interviewer Identification Date of Interview: Interviewer’s Name: Health Dept.: Phone Number: E-mail: What was the patient’s outcome? [_RECOVERED [_] STILL ILL DIED [_] UNK Patient Contact Information Name: Age: Sex: |_JM F Street address: City: State: Zip: County: Daytime Phone: Evening Phone: Surrogate Contact Information <List surrogate contact information if patient is too unwell or has died> Name: Daytime Phone: Evening Phone: Relationship to Patient: Hello, my name is and I’m calling from (health department). We are investigating a cluster of respiratory illnesses in Genesee County. At this point, the source of these illnesses is still under investigation. We are hoping this interview will provide further information and answers about the illnesses. I’d like to ask you a few questions about your home and your exposures during the 2 weeks before you got sick. You do not have to answer any of the questions, but any assistance you can provide is appreciated. Do you have about 30 minutes to talk? If not now, when would be a good time for me to call back? <lf the case is from more than 1 month prior, the following text may be used: > It might be helpful for you to collect documents such as a calendar, receipts, credit card or bank statements to jog your memory about your activities and where you were in the 2 weeks prior to getting sick. The only information we would ask you to share from these are dates and locations. Would you like me to call you back after you have time to collect these materials? When would be a convenient day and time for me to call you back? | have that your first symptom started on <insert onset date> . Is this correct? [ves [JNo [_JNotsure If no, what was the first date you started feeling sick? / / List dates of exposure period: from vA L to vA ZL <The exposure period includes the 2 weeks before the date of illness onset> Page 1 of 6 xxxEND_PAGE:deq16_b5_0892_4900_0920 Illness Information 1.) During your illness, did you have any of the foll MDSS ID Diagnosis of pneumonia Fever If yes, highest temp: Chills Cough Nausea Vomiting Diarrhea Aches or muscle pains Chest pain Shortness of breath Sore throat Headaches Other symptoms (specify): Exposure Information 2.) How long have you lived at your current residence? <if they have moved since the listed exposure period, indicate that you are asking about the house they lived in prior to becoming sick> a.) If you moved after the exposure period/illness, what was your previous residence address? 3.) Where did you get your tap (drinking and other household use) water from between [ [ and [ [ ? <Exposure period from above> (Jt. City of Flint Water [_] 2. City of Flint Township Water in 3. Other municipal water system in 4. Private well CO] 5. Unknown O 6. Other 4.) During the last year, has the water pressure at your residence changed? Lyes Jno [Not sure a.) If yes, did the water pressure: EC] Increase in b). If yes, when did the water pressure change occur? Decrease Page 2 of 6 xxxEND_PAGE:deq16_b5_0892_4900_0921 MDSS ID 5.) During the last year, has the water quality (appearance, taste, smell) at your residence changed? L yes LINo []Not Sure a.) If yes, please describe the change in the water quality: b). If yes, when did the water quality change occur? 6.) Prior to your illness, did you make any recent plumbing changes or repairs at your residence? LJyes [_JNo [_JNotsure a.) If yes, please describe the changes/repairs and give the dates the work was done. 7.) Prior to your illness, were there any water main breaks or other water line issues that affected the water at your residence, including boil water advisories? L]Yes [_]No [_\Not sure a.) If yes, please describe the water main/line issues or boil water advisories and give the dates they occurred. I'd like to ask you some questions about what you did during the 2 weeks before you got sick. The time period I’m asking about is between i [ and [ / .<Exposure period> During this 2 week period, did you: 8.) Work or volunteer, either full or part time? Nes No |Not sure ) If yes, complete the following table: 9.) Spend any time in a hospital, doctor’s office, clinic, or dentist office as a patient, visitor, employee, or volunteer? [_]Yes No [_]Notsure a.) If yes, check all that apply: Inpatient [_] | Admission Discharge Outpatient [J Visitor C] Employee [_] Volunteer 10.) Visit, reside, or work in a long term care facility, nursing home, assisted living facility, or senior living facility? les No INot sure Page 3 of 6 xxxEND_PAGE:deq16_b5_0892_4900_0922 MDSS ID a.) If yes, complete the following table: 08 Resident L] Visitor ic Employee in 11.) In the 2 weeks before you before you gotsick(__ / = / _to /__{ ___),did you spend any nights away from home (excluding healthcare settings)? [Ves | No [JNot sure a.) If yes, complete the following table: <prompts: hotel, campground, cabin, cruise, second home, with family, etc.> 12.) Inthe 2 weeks before you before you gotsick(___/ —-/ _to /_{ _), did you visit any of the following community venues? Hote! (without | staying overnight — e.g. dinner, wedding) | Auditorium | | | Barbershop or Hair salon | Car wash | Casino Church or Place of. worship Gym or Work out facility Grocery store. Home improvement store Spa or Nail salon a Mall or Department store Movie theater Other (specify) 13.) In the 2 weeks before you before you got sick (___/ {to / {__), did you have exposure to any of the following water sources, either at home or while away from home? Page 4 of 6 xxxEND_PAGE:deq16_b5_0892_4900_0923 MDSS ID Shower Use a detachable shower head or. hose Hot tub, whirlpool spa, Jacuzzi tub Sat NEAR a working hot tub or whirlpool spa but did not get in Steam room or wet sauna Humidifier (whole house or If yes, specify type: portable) If yes, what type of water is used in device? uBottled uTap cOther: Respiratory therapy machine If yes, specify type: (e.g. nebulizer, CPAP, BiPAP, etc.) If yes, what type of water is used in device? uBottled oTap cOther: Other (specify) Shower at gym, work, other location Use a detachable shower head or hose Hot tub, whirlpool spa, Jacuzzi tub Sat NEAR a working hot tub or whirlpool spa but did not get in Humidifier (whole house or If yes, specify type: portable) If yes, what type of water is used in device? oBottled oTap cOther: Pool/splash pad/waterpark Recreational or cooling misters Steam room or wet sauna Decorative fountain Qutdoor watering hose or sprinkler Beach, lake, pond, river, creek, etc. Medical History Now I’m going to ask a few questions about your medical history and health behaviors. 14.) Have you ever been told by a healthcare provider that you had any of the following conditions: Page 5 of 6 xxxEND_PAGE:deq16_b5_0892_4900_0924 MDSS ID Chronic kidney disease Weakened immune system (due to cancer, chemotherapy , radiation therapy, immunosuppressive meds, HIV, organ transplant, etc.) Diabetes Chronic lung disease (COPD, emphysema) Asthma or chronic bronchitis Heart disease or congestive heart failure | Liver disease Other conditions (specify) 15.) Health behaviors: Are you currently a smoker? Are you a former smoker? Do you drink alcohol? 16.) Do you know anyone else with similar symptoms? [_]Yes [_]No [_]Not sure a.) If yes, complete the following table: Additional Comments Thank you so much for taking the time to answer these questions. Do you have any questions that | can help answer? If you have any questions or remember any further details later, please contact the (health department) at phone: Page 6 of 6 xxxEND_PAGE:deq16_b5_0892_4900_0925

Information Request and Documentation e

Hello everyone, - The Genesee County Health Department has made several written and verbal requests for specific information since October, 2014, including a Freedom of Information Act Request on January 27, 2015. The information still has not been received and the city’s lack of cooperation continues to prevent my office from performing our responsibilities. The Genesee County Health Department has the responsibility to conduct Illness Investigations and consider all potential sources, this Is not optional. In 2014, Genesee County experienced a significant increase of confirmed Legionella illnesses relative to previous years. Legionella can be a deadly, waterborne disease that typically affects the respiratory s' (stem. The increase of the illnesses closely corresponds with the timeframe of the switch to Flint ’ River water. ‘The majority of the cases reside or have an association with the city. Also, McLaren Hospital identified and mitigated Legionella in their water system: This is rather _ glaring information and it needs to be looked into now, prior to the warmer summer months “when Legionella is at its peak and we are potentially faced with a crisis. < This situation has been explicitly explained to MDEQ-and many of the city’s officials. | want to make sure, in writing that there are no misunderstandings regarding this significant and urgent public health issue. The Trihalomethane issues “pale i in comparison” to the poteniial public ai risks of Legionella. _lam subnilting ‘the attached FOIA request again and requesting that the legal. obligations of the request are met. If the information is not available, please let me know. In the past, | \ have requested to meet with the water plant staff dnd MDEQ regarding Legionella concerns. | did'not receive a response from the water plant staff and MDEQ declined. | think it is in the: best Interest for all stakeholders that we meet and discuss the Issues. Respectfully, Jim xxxEND_PAGE:deq26_b240_1890_2019_015 Jim Henty RS, MBA Environmental Health Supervisor, Genesee County Health Depariment veww.gchd us 630 S. Saginaw St., Suite 4. Flint, MI 48502-1540 Phone (810) 257-3618 Fax (810) 257-3125 E-mail [email protected] — xxxEND_PAGE:deq26_b240_1890_2019_016

Information Request and Documentation

Hello everyone, The Genesee County Health Department has made several written and verbal requests for specific information since October, 2014, including a Freedom of Information Act Request on January 27, 2015. The information still has not been received and the city’s lack of cooperation continues to prevent my office from performing our responsibilities. The Genesee County Health Department has the responsibility to conduct illness investigations and consider all potential sources, this is not optional. In 2014, Genesee County experienced a significant increase of confirmed Legionella illnesses relative to previous years. Legionella can be a deadly, waterborne disease that typically affects the respiratory system. : The increase of the illnesses closely corresponds with the timeframe of the switch to Flint River water. The majority of the cases reside or have an association with the city. Also, McLaren Hospital identified and mitigated Legionella in their water system. This is rather glaring information and it needs to be looked into now, prior to the warmer summer months when Legionella is at its peak and we are potentially faced with a crisis. xxxEND_PAGE:deq28_b161_0869_0871_2 This situation has been explicitly explained to MDEQ and many of the city’s officials. | want to make sure, in writing that there are no misunderstandings regarding this significant and urgent public health issue. The Trihalomethane issues “pale in comparison” to the potential public health risks of Legionella. | am submitting the attached FOIA request again and requesting that the legal obligations of the request are met. !f the information is not available, please let me know. In the past, | have requested to meet with the water plant staff and MDEQ regarding Legionella concerns. | did not receive a response from the water plant staff and MDEQ declined. | think it is in the best interest for all stakeholders that we meet and discuss the issues. Respectfully, Jim Jim Henry Jim Henry RS, MBA Environmental Health Supervisor Genesee County Health Department www.gchd.us 630 S. Saginaw St., Suite 4 Flint, MI 48502-1540 Phone (810) 257-3618 Fax (810) 257-3125 E-mail [email protected] xxxEND_PAGE:deq28_b161_0869_0871_3