DDW-2024-006129

System Name:
System Number:
Address:
City, State, Zip:
495
Name:
Title:
Address:
City, State, Zip:
Phone No.:
E-mail Address:
Name:
Company:
Address:
City, State, Zip:
Phone No.:
E-mail Address:
Name:
Company:
Address:
City, State, Zip:
E-mail Address:
Name:
Duration (hrs):2
TBD
[e-mail]
Salt Lake City, UT 84123
4246 South Riverboat Rd
801-359-5565Phone No.:
8b. If YES, specify rule reference below [R309-511-4(1)(a)(i)-(iv)]:
Phone No.:435-247-2577
Tyler McKee
9. State or Federal Agency Funding:
8a. Is the project exempt from the Hydraulic Model Report requirement? [see
R309-511-4(1)(a)(i) through (iv)]
435-823-3392
TBD
3. Professional Engineer (PE) Responsible for System Oversight (if
applicable)
4. Professional Engineer (PE) Responsible for Design of this Project
Begin Construction:
Complete Construction:
7. Anticipated Construction Schedule (if applicable):
Advertise for Bids:
5. Local Fire Code Official & Required Fire Flow for Proposed Project
April 2024
2381 East 1000 South
For a new public water system (PWS) also complete a New PWS Application Form (see DDW website).
1. Public Water System (PWS) Information
Ballard Water Improvement District
24001
2. Name and Address for Official Correspondence (Mayor, Public Works
Director, Administrative Contact, etc.)
Submit (preferably by email) the completed PNF with plans and specifications to DDW.
Email completed form & documents to [e-mail] or mail to: Utah Division of Drinking Water
P.O. Box 144830, Salt Lake City, Utah 84114-4830, [phone]
Ballard, UT 84066
Req'd flow (gpm):1500
Loan #
City, State, Zip:Lapoint, UT84039
E-mail Address:
PROJECT NOTIFICATION FORM (PNF)
Utah Division of Drinking Water (DDW)
Present No. of ERCs system is obligated to serve:
No. of ERCs this project will add:
1005
0
Population Served:
6. Project Description (provide a unique facility name, location, and sufficient
details to specifically identify the project):
DDW - Plan Review File No.:
DDW - Date Received:
Please provide the following information for a proposed Public Drinking Water Project.
April 2024
[e-mail]
CRS Engineers Bid Opening:
https://deq.utah.gov/drinking-water/plan-review-program-tools
Checklists for use in preparing plans for review by DDW are available at:
This project includes the drilling of the new 7000 North Well for Ballard City located
at the intersection of 7000 North and 3500 East in Leeton. The well will be drilled to
300 feet below ground surface, with screens from 120 feet to 300 feet below
ground surface.
Ballard, UT 84066
Mark Chandler, PE
Ben Mower
2381 East 1000 South
Adminisitrative Contact
Yes No
Drinking Water Board (SRF or FSRF)
Community Impact Board (CIB)
None
Other (Specify)
DDW- Eng-0004 Page 1 of 1 3/22/2018
[ERC = Equivalent Residential Connection; SRF = State Revolving Fund]
DDW- Eng-0004 Page 1 of 1 3/22/2018