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BK 00025 PG <br />Division of Public Health <br />Agreement Addendum ` <br />FY 12 -13 <br />Page 1 of 4 <br />Lee County Health Department <br />Local Health Department Legal Name <br />Environmental Health Section/ <br />Food Protection and Facilities Branc <br />DPH Section/Branch Name <br />Larry Michael, (919) 707 -5872 <br />874 Food and Lodging larry.michaeI( dhhs.nc.gov <br />Activity Number and Description DPH Program Contact Name, Telephone <br />Number (with area code) and Email <br />04/01 /2013 — 05/3 1/2013 <br />Service Period DPH Program Signature Date <br />(only required for negotiable agreement <br />addendum) <br />05/01/2013 — 06/30/2013 <br />Payment Period <br />® Original Agreement Addendum <br />❑ Agreement Addendum Revision # ,_,- (Please do not put the Aid to County BE revision # here.) <br />I. Ba und <br />In order to fund a portion of local expenditures created by State - mandated Food, Lodging and Institution <br />sanitation programs and activities, the legislature established a State Inspections Statistics and Fees <br />Program within the Environmental Health Section. This program centralizes public health data, invoices <br />regulated facilities, and distributes the funds in accordance with GS 130A 248(d). The receipts collected <br />are redistributed to local environmental health programs in the form of aid to counties. <br />R. Purpose <br />The Agreement Addendum allows for the Local Health Department's environmental health program to <br />implement State - required sanitation regulations. The funds from this Agreement Addendum are to be used <br />to support local food, lodging and institution programs and activities. The disbursement and fund purpose <br />are described in GS 130A- 248(d) and 15A NCAC 18A.2901. <br />GS 130A- 248(d) The Department shall charge each establishment subject to this section, except <br />nutrition programs for the elderly administered by the Division of Aging and Adult Services of the <br />Department of Health and Human Services, establishments that prepare and sell meat food products <br />or poultry products, and public school cafeterias, a fee of seventy -five dollars ($75.00) for each <br />24 6 � ZZ 3 /;w <br />Health Director Si ature (use blue ink) Dafe <br />Loral Health Department to complete: LHD program contact name: Pte"\ <br />(If follow up information is needed by DPH) Phone number with area code: <br />Email address: Fxg� Qrire_ - )(J 1eeL U y�S . ate✓ <br />SWaature on this page signifies you have read and accented all oases of this document. <br />Revised 9/26/11 <br />