DDW-2024-009517

Utah Department Of Environmental Quality
Division Of Drinking Water Sanitary Survey
Sanitary Survey
General System Information
Site Visit Date Surveyor Name
09/18/2023 Ben Harker
MANTUA TOWN WATER
SYSTEM
PWS ID: UTAH02018 Rating: Approved 06/24/1996 Active
1 Admin Contact (AC) [ eMail address is REQUIRED ]
MIN | 15pts | SM | G004 | R309-100-4(5) | Rule requires a person or organization be
designated as the owner of the system and name, address and phone number of such
be supplied to the Division.
*First Name: HARPER LEON
*Last Name: JOHNSON
*Organization:
*Address: Redacted
*City: MANTUA
*State: UT
*Zip: 84324
*Email: [e-mail]
*Phone: [phone]
2 Legal Contact (LC) [ if no eMail address is available, enter [e-mail] ]
MIN | 15pts | SM | G004 | R309-100-4(5) | Rule requires a person or organization be
designated as the owner of the system and name, address and phone number of such
be supplied to the Division.
*First Name:
*Last Name:
*Organization: MANTUA
*Address: 409 N MAIN
*City: MANTUA
*State: UT
*Zip: 84324
*Email:
*Phone: [phone]
3 Owner Contact (OW) [ if no eMail address is available, enter [e-mail] ]
MIN | 15pts | SM | G004 | R309-100-4(5) | Rule requires a person or organization be
designated as the owner of the system and name, address and phone number of such
be supplied to the Division.
*First Name:
*Last Name:
*Organization: TOWN OF MANTUA
*Address: 409 N MAIN
*City: MANTUA
*State: UT
*Zip: 84324
*Email:
*Phone: [phone]
DEQ | Drinking Water
Run Date: 10/16/2023 19:51:28 | Rating: Approved UTAH02018 MANTUA TOWN WATER SYSTEM page 1 of 32
Site Visit Info
4 Direct Operator in Charge (DO) [ if no eMail address is available, enter
[e-mail] ]
MIN | 15pts | SM | G004 | R309-100-4(5) | Rule requires a person or organization be
designated as the owner of the system and name, address and phone number of such
be supplied to the Division.
*First Name: HARPER LEON
*Last Name: JOHNSON
*Organization:
*Address: 409 North Main
*City: MANTUA
*State: UT
*Zip: 84324
*Email: [e-mail]
*Phone: [phone]
5 Does the system serve a Residential population?Y
5A Population - Residential 1200
5B Operating Period (Start Date) - Residential 01/01
5C Operating Period (End Date) - Residential 12/31
6 Does the system serve a Transient population? (A transient population is a rotating
population that is served by a water system that does not remain in the jurisdiction of
the water system for long periods of time. Examples of a transient population include,
but are not limited to, campers at a campground, users of a highway rest stop, skiers
at a ski resort, guests at a hotel, or patrons of a restaurant or a shopping center.)
N
7 Does the system serve a Non-Transient population? (A non-transient population is a
population served by a water system that is the same population being served by the
system for at least six months of the year, but is not a resident in the system.
Examples of a non-transient population include, but are not limited to, employees of a
restaurant, shop, or ski resort; teachers and students at a school, day-care center, or
church; doctors, nurses, and other employees at a hospital or healthcare clinic.)
N
8 Population - Wholesale :0
9 Residential Connections:424
10 Commercial Connections:10
11 Industrial Connections:0
12 Agricultural Connections:3
13 Date of Survey (First Day of Field Work)09/18/2023
14 Date of Survey (Last Day of Field Work) ** this should match the Date of Survey in the
header **
09/18/2023
15 Date final report sent to system (questionnaire, deficiency report and capacity
spreadsheet)
10/16/2023
16 Water system representative present during the survey:Harper Johnson
17 How much time was spent to prepare survey documents prior to field survey? (Round
up to nearest quarter hour)
0.75 hours
18 How much time was spent to complete the field survey (arrival to completion; include
travel time between water system facilities)? (Round up to nearest quarter hour)
5.5 hours
19 How much time was spent traveling from the office to system and back again at the
end of the field survey? (Round up to nearest quarter hour)
0.75 hours
DEQ | Drinking Water
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Management and Operations
20 How much time did it take to finish the Survey Report? (Round up to nearest quarter
hour)
3 hours
21 Did you survey multiple water systems in one trip? ... if yes, answer the following
question(s)
N
22 For a community water system with water sources that require power to produce
sufficient flow, system is equipped with standby power option.
SIG | 25pts | SO | S033 | R309-515-6(2)(a) | Rule requires a community water system
without naturally flowing water sources, such as springs or flowing wells, to have one
or more of the system's sources equipped for operation during power outages. To
ensure continuous service when the primary power has been interrupted, a redundant
power supply is required. A redundant power supply may include a transfer switch for
auxiliary power such as a generator or a power supply service with coverage from two
independent substations. This significant deficiency must be corrected within 120 days
of notification or have a corrective action plan approved by DDW.
C
23 There are no undocumented drinking water facilities (i.e. tanks, pump stations,
treatment facilities, etc.) or recent modifications that have not gone through or in
process of DDW review [LIST UNDOCUMENTED FACILITIES OR DESCRIBE
MODIFICATIONS, IF APPLICABLE] [undocumented sources are covered in a
different question]
SIG | 50pts | SM | G001 | R309-100-5(2), R309-500-6, R309-500-9, R309-500-9(2)
and (3) | Rule requires complete plans & specification for all public drinking water
projects to be approved in writing by the Director. Any facility found that has not
started DDW review shall be considered unapproved. This significant deficiency must
be corrected within 120 days of notification or have a corrective action plan approved
by DDW.
C
24 Are there any individual home booster pumps installed in the distribution system (not
for fire suppression)?
SIG | 50pts | SM | M008 | R309-550-11(3) | R309-550-11(3)
C
25 Does the system haul water? ... if yes, answer the following question(s)N
26 For a community system serving 100 or more connections, at least 2 water sources
are available.
SIG | 50pts | SO | TGR7 | R309-515-4(3) | Rule requires Community Water Systems
serving more than 100 connections to have a minimum of two sources except where
served by a water treatment plant. This significant deficiency must be corrected within
120 days of notification or have a corrective action plan approved by DDW.
C
27 Does system have a consecutive connection to another water system not listed in the
SOURCE section of Waterlink Report? If yes, answer the following question(s)
N
28 Does the system have a deficiency meeting the required source capacity? (USE
SPREADSHEET FOR CALCULATIONS) *IF YES, SELECT CORRECT STATEMENT
FROM THE FOLLOWING AND MARK "YES"; MARK ALL OTHER STATEMENTS
"NO."
N
29 Does the system have a deficiency meeting the required storage capacity DUE
SOLELY TO FIRE SUPPRESSION NEEDS? (USE SPREADSHEET FOR
CALCULATIONS) *IF YES, SELECT CORRECT STATEMENT FROM THE
FOLLOWING AND MARK "YES"; MARK ALL OTHER STATEMENTS "NO."
N
30 Does the system have a deficiency meeting the required equalization storage capacity
for indoor/outdoor demands (but not because of fire suppression needs)? (USE
SPREADSHEET FOR CALCULATIONS) *IF YES, SELECT CORRECT STATEMENT
FROM THE FOLLOWING AND MARK "YES"; MARK ALL OTHER STATEMENTS
"NO."
N
31 Does the system serve greater than 3,300 persons? ... if yes, answer the following
question(s)
N
DEQ | Drinking Water
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Cross Connection and Operator Certification
General Maintenance and Environment
32 Legally adopted authority statement
MIN | 15pts | SM | M003 | R309-105-12(2) | Rule requires each public water system to
have a cross connection control program that includes a legally adopted and functional
local authority to enforce the program (i.e., ordinance, bylaw, or policy).
C
33 Documentation of annual public awareness and/or employee training
MIN | 15pts | SM | M004 | R309-105-12(2) | Rule requires each public water system to
have a cross connection control program that includes providing public education or
awareness material or presentations.
C
34 Documentation of personnel trained to manage the program (COMMUNITY WATER
SYSTEMS POPULATION 500 AND ABOVE REQUIRE A DDW CERTIFIED CCC
PROGRAM ADMINISTRATOR. ALL OTHER WATER SYSTEMS REQUIRE AT A
MINIMUM BACKFLOW 101 OR EQUIVALENT/ GREATER CCC TRAINING)
MIN | 15pts | SM | M005 | R309-105-12(2) | Rule requires each public water system to
have a cross connection control program that includes an operator with adequate
training in the area of cross connection control or backflow prevention.
C
35 Does the water system have detailed records of cross connection control activities?
(inventories of backflow assemblies, devices, and air gaps installed within the system)
MIN | 15pts | SM | M006 | R309-105-12(2) | Rule requires each public water system to
have a cross connection control program that includes written records of cross
connection control activities.
C
36 Does the water system have records of on-going enforcement activities? (test history,
enforcement activities, hazard assessments)
MIN | 15pts | SM | M007 | R309-105-12(2) | Rule requires each public water system to
have a cross connection control program that includes test history and documentation
of on-going enforcement activities.
C
37 Operator meets required level of certification for water system. ( IF NO CERTIFIED
OPERATOR IS REQUIRED MARK COMPLIANT )
SIG | 50pts | OC | C001 | R309-105-11, R309-300-5(3) | Rule requires every
community and NTNC water system and public water systems that utilize
treatment/filtration to have at least one operator certified at the classified grade of the
water system. Certification must be appropriate for the type of system operated
(treatment and/or distribution). This significant deficiency must be corrected within 120
days of notification or have a corrective action plan approved by DDW.
C
38 Certified operator is within 1 hour travel time of water system. ( IF NO CERTIFIED
OPERATOR IS REQUIRED MARK COMPLIANT )
MIN | 0pts | OC | C002 | R309-300-5(14) | Rule requires the operator to be within 1
hour travel time, under normal work and home conditions, of each drinking water
system for which he is considered in direct responsible charge.
C
DEQ | Drinking Water
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Distribution
39 Are there any visual indications of unsanitary conditions?
SIG | 50pts | SM | M017 | R309-200-6, R309-105-18, R309-215-4(3) | R309-200-6 The
Secondary Maximum Contaminant Levels for public water systems deals with
substances which affect the aesthetic quality of drinking water. They are presented
here as recommended limits or ranges and are not grounds for rejection. The taste of
water may be unpleasant and the usefulness of the water may be impaired if these
standards are significantly exceeded.
R309-105-18 The Director or the local health department shall be informed by
telephone by a water supplier of any "emergency situation". The term "emergency
situation...
R309-215-4(3) If the water fails to meet minimum standards, then certain public
notification procedures shall be carried out, as outlined in R309-220. Water suppliers
shall also keep analytical records in their possession, for a required length of time, as
outlined in R309-105-17.
C
40 No unprotected connection between the distribution system and a source of
contamination. (If there is an unprotected connection, describe the location in detail.)
SIG | 50pts | DS | D009 | R309-550-5(11) | R309-550-5(11)
C
41 Are air release/vacuum valves in the distribution system? ... if yes, answer the
following question(s)
Y
41A Open end of vent line covered with #14 mesh screen
SIG | 25pts | DS | D004 | R309-550-6(6)(b) | Rule states the open end of the air relief
vent pipe from automatic valves shall be provided with a #14 mesh, non-corrodible
screen and a downward elbow, and where possible, be extended to at least one foot
above grade. This significant deficiency must be corrected within 120 days of
notification or have a corrective action plan approved by DDW.
C
41B For a valve in a chamber, open end of vent pipe is at least 12 inches above grade or
one foot above distribution line in a chamber that does not flood.
SIG | 25pts | DS | D006 | R309-550-6(6)(b) | Rule states the open end of the air relief
vent pipe from automatic valves shall be provided with a #14 mesh, non-corrodible
screen and a downward elbow, and where possible, be extended to at least one foot
above grade. This significant deficiency must be corrected within 120 days of
notification or have a corrective action plan approved by DDW.
C
41C Chamber has drain to daylight, gravel-filled adsorption pit if not subject to flooding, or
sump pump.
SIG | 25pts | DS | D007 | R309-550-6(6)(b) and (7)(b) | Rule states chambers shall be
provided with a drain to daylight, if possible. Where this is not possible, underground
gravel-filled absorption pits may be used if the site is not subject to flooding and
conditions will assure adequate drainage. Sump pumps may also be considered if a
drain to daylight or absorption pit is not feasible. This significant deficiency must be
corrected within 120 days of notification or have a corrective action plan approved by
DDW.
C
DEQ | Drinking Water
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General Disinfection
41D Open end of vent line down-turned.
SIG | 25pts | DS | D006 | R309-550-6(6)(b) | Rule states the open end of the air relief
vent pipe from automatic valves shall be provided with a #14 mesh, non-corrodible
screen and a downward elbow, and where possible, be extended to at least one foot
above grade. This significant deficiency must be corrected within 120 days of
notification or have a corrective action plan approved by DDW.
C
42 Water system has a program to maintain, operate, or control the use of fire hydrants.
REC | 0pts | DS | D012 | N/A | Fire hydrants provide a direct access to the water in the
distribution system. In order to protect the quality and integrity of the water, fire
hydrant access should be controlled.
C
43 Blow offs or air release valves are not directly connected to a sanitary sewer line.
SIG | 50pts | DS | D013 | R309-550-6(5)(a), R309-550-6(6)(c) and (7)(a) | Rule states
blow-offs or air relief valves shall not be connected directly to a sewer. This significant
deficiency must be corrected within 120 days of notification or have a corrective action
plan approved by DDW.
C
44 Blow offs or air release valves do not discharge below flood level in ditches or
streams.
SIG | 50pts | DS | D016 | R309-550-9(1) and (2), R309-550-13(2) | R309-550-9(1 & 3)
C
45 All water mains installed after 1995 that provide fire flow are at least 8 inches in
diameter.
MIN | 15pts | DS | D019 | R309-550-5(4) & (5) | Rule states that the minimum line size
serving a fire hydrant lateral shall be 8-inch diameter unless a hydraulic analysis
indicates that required flow and pressures can be maintained by 6-inch lines.
C
46 Distribution system capable of providing minimum pressure of 20 psi at all service
connections.
SIG | 50pts | DS | D003 | R309-105-9, R309-550-5(1) | Rule states the distribution
system shall maintain minimum pressures as required by R309-105-9 at all points of
connection under all flow conditions. This significant deficiency must be corrected
within 120 days of notification or have a corrective action plan approved by DDW.
C
47 Was the water system constructed or new portions added after January 1, 2007? ... if
yes, answer the following question(s)
Y
47A Distribution system capable of maintaining the following pressures at all service
connections: (a) 20 psi during fire flow and fire demand during peak day demand; (b)
30 psi during peak instantaneous demand; and (c) 40 psi during peak day demand.
SIG | 50pts | DS | D010 | R309-105-9, R309-550-5(1) | Rule states that unless
otherwise specifically approved by the Director, public water systems constructed after
January 1, 2007, shall be designed and shall meet the following minimum water
pressures at points of connection: (a) 20 psi during conditions of fire flow and fire
demand experienced during peak day demand; (b) 30 psi during peak instantaneous
demand; and (c) 40 psi during peak day demand. This significant deficiency must be
corrected within 120 days of notification or have a corrective action plan approved by
DDW.
C
DEQ | Drinking Water
Run Date: 10/16/2023 19:51:28 | Rating: Approved UTAH02018 MANTUA TOWN WATER SYSTEM page 6 of 32
ST003 - 20 K TANK - Inactive (RL - REPLACED)
WS001 - GIRLS CAMP SPRING - Active
48 Water system follows AWWA disinfection procedures for new, repaired, or seasonal
water mains and tanks.
SIG | 25pts | MR | D018 | R309-550-8(10) | All new and repaired water mains and
appurtenances shall be disinfected in accordance with AWWA Standard C651. This
significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
C
49 How often do you periodically disinfect any or all parts of your water system (i.e. batch
disinfection) other than for repairs or maintenance?
SIG | 50pts | SM | G006 | R309-105-6(1)(a), R309-500-6 | R309-105-6(1) Approval of
Engineering Plans and Specifications
R309-500-6 Plan Approval Procedure.
C
50 Does the water system still have physical access to this facility? Y/N Guidance:
Answer NO if sold and no longer have security access or the facility is demolished and
can not be inspected.
Y
50A Is the facility incapable of allowing water or contamination to enter the drinking water
system? Yes(compliant) No(complete full question set for facility type and notify DDW)
SIG | 100pts | SM | A100 | R309-400-11 | If the water system does not comply with the
directive, the Director may assess 25 to 200 points to the water system. Points shall
be assessed based upon the severity of the non-compliance, the threat to public
health and the underlying basis for the original directive.
Y
50B Is the facility physically disconnected from supplying water to the distribution system?
Guidance: Is the equipment, pipe, etc, physically removed, disconnected.
Yes(compliant) No(complete full question set for facility type and notify DDW)
SIG | 50pts | SM | A075 | R309-400-11 | If the water system does not comply with the
directive, the Director may assess 25 to 200 points to the water system. Points shall
be assessed based upon the severity of the non-compliance, the threat to public
health and the underlying basis for the original directive.
Y
51 Is this facility Active or Inactive? (Active status means used on a routine/seasonal
basis without long periods of inactivity and water quality samples are routinely
collected))
A
52 Operating Period (Start Date)01/01
53 Operating Period (End Date)12/31
54 Undocumented sources shall not be physically connected to the drinking water
system. (IF SOURCE IS NOT IN SYSTEM INVENTORY MARK "DEFICIENT")
SIG | 200pts | SO | S001 | R309-515-6(5), R309-515-7(4), R309-500-9(2) and (3) |
R309-105-6(1) requires plans and specifications for all public drinking water projects to
be approved in writing by the Director prior to the commencement of construction. This
significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
C
55 Area of equal or higher elevation within 50 feet of spring collection devices is fenced.
MIN | 15pts | SO | SS02 | R309-515-7(7)(e) | Rule requires a stock-tight fence around
the spring collection area.
NA (Notes: As recorded in previous sanitary
survey by DDW, Not Applicable due to "No
grazing in the area, it is a steep side of the
hillside/mountain.")
DEQ | Drinking Water
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56 Surface water runoff diverted away from spring by diversion channel or berm.
MIN | 15pts | SO | SS03 | R309-515-7(7)(g) | Rule requires a diversion channel or
berm, constructed immediately inside the fenced area, capable of diverting all
anticipated surface water runoff away from the spring collection area.
C
57 Spring box has a means to release overflow?
MIN | 15pts | SO | SS23 | R309-515-7(7)(d), R309-545-13(1) | All junction boxes and
collection boxes, must comply with R309-545 with respect to access openings,
venting, and tank overflow. Lids for these spring boxes shall be gasketed and the box
adequately vented.
Y
57A Overflow screened with #4 mesh screen
SIG | 25pts | SO | SS04 | R309-515-7(7)(d), R309-545-13(3) | Overflow pipes on
junction and collection boxes shall comply with R309-545 and be screened with No. 4
mesh non-corrodible screens. This significant deficiency must be corrected within 120
days of notification or have a corrective action plan approved by DDW.
C
57B Overflow has a minimum of 12 inch clearance above flood rim of receiving basin
SIG | 25pts | SO | SS14 | R309-515-7(7)(d), R309-545 | Overflow pipes on junction
and collection boxes shall comply with R309-545 and discharge a minimum of 12
inches above the ground surface or rim of the receiving basin. This significant
deficiency must be corrected within 120 days of notification or have a corrective action
plan approved by DDW.
C
58 Drain has minimum of 12 inch clearance above flood rim of receiving basin
SIG | 25pts | SO | SS14 | R309-515-7(7)(d), R309-545 | Overflow pipes on junction
and collection boxes shall comply with R309-545 and discharge a minimum of 12
inches above the ground surface or rim of the receiving basin. This significant
deficiency must be corrected within 120 days of notification or have a corrective action
plan approved by DDW.
C
59 Spring collection area graded and no evidence of water ponding or flow on surface?
SIG | 25pts | SO | SS06 | R309-515-7(7)(i) | Rule requires the spring to be developed
as thoroughly as possible to minimize the possibility of excess water ponding within
the collection area. This significant deficiency must be corrected within 120 days of
notification or have a corrective action plan approved by DDW.
C
60 If a liner is present, spring liner integrity is maintained.
SIG | 50pts | SO | SS19 | R309-515-7(7)(b)(iv) | If a liner is present, it shall be installed
to assure its integrity. No sharp-edged stones or stones two inches or larger shall be
located within two inches of the liner. This significant deficiency must be corrected
within 120 days of notification or have a corrective action plan approved by DDW.
C
61 No deep-rooted vegetation is within the 50 ft collection area.
SIG | 25pts | SO | SS07 | R309-515-7(7)(f) | All deep-rooted vegetation within the
fenced collection area shall be removed by a means not negatively affecting water
quality. This significant deficiency must be corrected within 120 days of notification or
have a corrective action plan approved by DDW.
C
DEQ | Drinking Water
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62 No roots seen in collection boxes and junctions.
SIG | 25pts | SO | SS08 | R309-105-10(4)(a), R309-515-8(1)(a) | Spring collection
areas shall be periodically (preferably annually) cleared of deep-rooted vegetation to
prevent root growth from clogging collection lines. This significant deficiency must be
corrected within 120 days of notification or have a corrective action plan approved by
DDW.
D (Notes: Roots seen in collection line at the
bottom of the spring box. This was
remediated after the survey and will be
reflected on an IPS Deficiency Correction
Notice that will accompany the submission
of this Survey.)
63 Is a spring collection box present? ... if yes, answer the following question(s)
MIN | 5pts | SO | L014 | R309-515-7(7)(c) | Rule requires each spring collection area
to be provided with at least one collection box to permit spring inspection and testing.
Y
63A Spring box has shoe box type lid with 2 inch overlap around frame
SIG | 25pts | SO | SS09 | R309-515-7(7)(d), R309-545-14 (2) | Access openings shall
comply with R309-545 and be provided with a close-fitting, solid shoebox-type cover
that extends down around the frame at least 2 inches. This significant deficiency must
be corrected within 120 days of notification or have a corrective action plan approved
by DDW.
C
63B Spring box lid is gasketed
SIG | 25pts | SO | SS10 | R309-515-7(7)(d), R309-545-14 (2) | Access openings shall
comply with R309-545 and be provided with a cover furnished with a gasket between
the lid and frame. This significant deficiency must be corrected within 120 days of
notification or have a corrective action plan approved by DDW.
C
63C Spring box lid does not show evidence of a vacuum.
MIN | 5pts | SO | SS11 | R309-515-7(7)(d), R309-545-15 | Rule requires junction
boxes and collection boxes to comply with R309-545 with respect to venting.
Therefore, a junction or collection box requires a vent to be fitted with #14 mesh or
finer non-corrodible screen, be fitted with a protective heavy-gauge screen or covering
if 6 inches in diameter or greater, be down-turned and shielded to prevent the
entrance of contaminants, be located and sized to avoid blockage during winter, and
have the end of the vent discharge a minimum of 24 inches above the earth on buried
structures.
C
63D Spring box opening is at least 4 inches above the surface of the box or 18 inches
above an earthen cover if the box is buried.
MIN | 15pts | SO | SS12 | R309-515-7(7)(d), R309-545-14 (1), | Access openings shall
comply with R309-545 and be framed at least 4 inches above the surface of the spring
box roof at the opening or 18 inches above the ground surface on a buried spring box.
C
63E Spring box lid is locked
SIG | 25pts | SO | SS13 | R309-515-7(7)(d), R309-545-14 (3) | Access openings shall
comply with R309-545 and the lids to the openings shall be locked. This significant
deficiency must be corrected within 120 days of notification or have a corrective action
plan approved by DDW.
C
DEQ | Drinking Water
Run Date: 10/16/2023 19:51:28 | Rating: Approved UTAH02018 MANTUA TOWN WATER SYSTEM page 9 of 32
WS002 - FLUME HOLLOW SPRING - Active
63F All openings/penetrations in the spring collection box are sealed.
SIG | 50pts | SO | SS20 | R309-515-7(7)(d), R309-545-9(1) and (2) | All junction and
collection boxes shall comply with R309-545 and shall have suitable watertight roofs
and sidewalls that exclude birds, animals, insects, and excessive dust. All openings
shall be kept to a minimum and be watertight. Pipes that may contain water of lesser
quality than drinking water shall not penetrate the spring box. This significant
deficiency must be corrected within 120 days of notification or have a corrective action
plan approved by DDW.
C
64 Is a spring box vent present? ... if yes, answer the following question(s)
MIN | 5pts | SO | SS11 | R309-515-7(7)(d), R309-545-15 | Rule requires junction
boxes and collection boxes to comply with R309-545 with respect to venting.
Therefore, a junction or collection box requires a vent to be fitted with #14 mesh or
finer non-corrodible screen, be fitted with a protective heavy-gauge screen or covering
if 6 inches in diameter or greater, be down-turned and shielded to prevent the
entrance of contaminants, be located and sized to avoid blockage during winter, and
have the end of the vent discharge a minimum of 24 inches above the earth on buried
structures.
Y
64A Vent is down-turned.
SIG | 25pts | SO | SS16 | R309-515-7(7)(d), R309-545-15(1) | All vents on junction
and collection boxes shall comply with R309-545 and be downturned a minimum of 2
inches below any opening and shielded to prevent the entrance of contaminants. This
significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
C
64B Vent has #14 or finer non-corrodible mesh screen and a protective screen/covering if
6-inch diameter or greater.
SIG | 25pts | SO | SS17 | R309-515-7(7)(d), R309-545-15(4) and (5) | All vents on
junction and collection boxes shall comply with R309-545 and be fitted with No. 14 or
finer non-corrodible mesh screen. Vents 6-inch diameter or larger shall be fitted with
additional heavy gage screen or substantial covering to protect the No. 14 mesh
screen. This significant deficiency must be corrected within 120 days of notification or
have a corrective action plan approved by DDW.
C
64C End of vent has sufficient clearance to prevent ice/snow blockage or is at least 24
inches above the earthen cover
SIG | 25pts | SO | SS18 | R309-515-7(7)(d), R309-545-15(2) and (3) | All vents on
junction and collection boxes shall comply with R309-545 and shall be located and
sized to avoid blockage during winter. The end of a vent on a buried spring box shall
discharge a minimum of 24 inches above the ground. This significant deficiency must
be corrected within 120 days of notification or have a corrective action plan approved
by DDW.
C
65 Spring has a permanent flow-measuring device.
MIN | 5pts | SO | SS01 | R309-515-7(7)(h) | Rule requires a spring to have a
permanent flow measuring device.
C
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66 Is this facility Active or Inactive? (Active status means used on a routine/seasonal
basis without long periods of inactivity and water quality samples are routinely
collected))
A
67 Operating Period (Start Date)01/01
68 Operating Period (End Date)12/31
69 Undocumented sources shall not be physically connected to the drinking water
system. (IF SOURCE IS NOT IN SYSTEM INVENTORY MARK "DEFICIENT")
SIG | 200pts | SO | S001 | R309-515-6(5), R309-515-7(4), R309-500-9(2) and (3) |
R309-105-6(1) requires plans and specifications for all public drinking water projects to
be approved in writing by the Director prior to the commencement of construction. This
significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
C
70 Area of equal or higher elevation within 50 feet of spring collection devices is fenced.
MIN | 15pts | SO | SS02 | R309-515-7(7)(e) | Rule requires a stock-tight fence around
the spring collection area.
D (Notes: Still deficient, may qualify for a
variance/exception since no grazing takes
place in the area. Girl's Home currently has
an exception to this for the exact same
Spring......Exception Granted: 515-
7(7)ÿ¿ÿ¿ÿ¿ÿ¢ÿ¿ÿ¿ÿ¿
ÿ¿ÿ¿ÿ¿ÿ¿ÿ¬ | Fencing
around Flume Spring (On Girl's Home
Records).)
71 Surface water runoff diverted away from spring by diversion channel or berm.
MIN | 15pts | SO | SS03 | R309-515-7(7)(g) | Rule requires a diversion channel or
berm, constructed immediately inside the fenced area, capable of diverting all
anticipated surface water runoff away from the spring collection area.
C
72 Spring box has a means to release overflow?
MIN | 15pts | SO | SS23 | R309-515-7(7)(d), R309-545-13(1) | All junction boxes and
collection boxes, must comply with R309-545 with respect to access openings,
venting, and tank overflow. Lids for these spring boxes shall be gasketed and the box
adequately vented.
Y
72A Overflow screened with #4 mesh screen
SIG | 25pts | SO | SS04 | R309-515-7(7)(d), R309-545-13(3) | Overflow pipes on
junction and collection boxes shall comply with R309-545 and be screened with No. 4
mesh non-corrodible screens. This significant deficiency must be corrected within 120
days of notification or have a corrective action plan approved by DDW.
C
72B Overflow has a minimum of 12 inch clearance above flood rim of receiving basin
SIG | 25pts | SO | SS14 | R309-515-7(7)(d), R309-545 | Overflow pipes on junction
and collection boxes shall comply with R309-545 and discharge a minimum of 12
inches above the ground surface or rim of the receiving basin. This significant
deficiency must be corrected within 120 days of notification or have a corrective action
plan approved by DDW.
C
73 Drain has minimum of 12 inch clearance above flood rim of receiving basin
SIG | 25pts | SO | SS14 | R309-515-7(7)(d), R309-545 | Overflow pipes on junction
and collection boxes shall comply with R309-545 and discharge a minimum of 12
inches above the ground surface or rim of the receiving basin. This significant
deficiency must be corrected within 120 days of notification or have a corrective action
plan approved by DDW.
C
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74 Spring collection area graded and no evidence of water ponding or flow on surface?
SIG | 25pts | SO | SS06 | R309-515-7(7)(i) | Rule requires the spring to be developed
as thoroughly as possible to minimize the possibility of excess water ponding within
the collection area. This significant deficiency must be corrected within 120 days of
notification or have a corrective action plan approved by DDW.
C
75 If a liner is present, spring liner integrity is maintained.
SIG | 50pts | SO | SS19 | R309-515-7(7)(b)(iv) | If a liner is present, it shall be installed
to assure its integrity. No sharp-edged stones or stones two inches or larger shall be
located within two inches of the liner. This significant deficiency must be corrected
within 120 days of notification or have a corrective action plan approved by DDW.
C
76 No deep-rooted vegetation is within the 50 ft collection area.
SIG | 25pts | SO | SS07 | R309-515-7(7)(f) | All deep-rooted vegetation within the
fenced collection area shall be removed by a means not negatively affecting water
quality. This significant deficiency must be corrected within 120 days of notification or
have a corrective action plan approved by DDW.
C
77 No roots seen in collection boxes and junctions.
SIG | 25pts | SO | SS08 | R309-105-10(4)(a), R309-515-8(1)(a) | Spring collection
areas shall be periodically (preferably annually) cleared of deep-rooted vegetation to
prevent root growth from clogging collection lines. This significant deficiency must be
corrected within 120 days of notification or have a corrective action plan approved by
DDW.
C
78 Is a spring collection box present? ... if yes, answer the following question(s)
MIN | 5pts | SO | L014 | R309-515-7(7)(c) | Rule requires each spring collection area
to be provided with at least one collection box to permit spring inspection and testing.
Y
78A Spring box has shoe box type lid with 2 inch overlap around frame
SIG | 25pts | SO | SS09 | R309-515-7(7)(d), R309-545-14 (2) | Access openings shall
comply with R309-545 and be provided with a close-fitting, solid shoebox-type cover
that extends down around the frame at least 2 inches. This significant deficiency must
be corrected within 120 days of notification or have a corrective action plan approved
by DDW.
C
78B Spring box lid is gasketed
SIG | 25pts | SO | SS10 | R309-515-7(7)(d), R309-545-14 (2) | Access openings shall
comply with R309-545 and be provided with a cover furnished with a gasket between
the lid and frame. This significant deficiency must be corrected within 120 days of
notification or have a corrective action plan approved by DDW.
C
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78C Spring box lid does not show evidence of a vacuum.
MIN | 5pts | SO | SS11 | R309-515-7(7)(d), R309-545-15 | Rule requires junction
boxes and collection boxes to comply with R309-545 with respect to venting.
Therefore, a junction or collection box requires a vent to be fitted with #14 mesh or
finer non-corrodible screen, be fitted with a protective heavy-gauge screen or covering
if 6 inches in diameter or greater, be down-turned and shielded to prevent the
entrance of contaminants, be located and sized to avoid blockage during winter, and
have the end of the vent discharge a minimum of 24 inches above the earth on buried
structures.
C
78D Spring box opening is at least 4 inches above the surface of the box or 18 inches
above an earthen cover if the box is buried.
MIN | 15pts | SO | SS12 | R309-515-7(7)(d), R309-545-14 (1), | Access openings shall
comply with R309-545 and be framed at least 4 inches above the surface of the spring
box roof at the opening or 18 inches above the ground surface on a buried spring box.
C
78E Spring box lid is locked
SIG | 25pts | SO | SS13 | R309-515-7(7)(d), R309-545-14 (3) | Access openings shall
comply with R309-545 and the lids to the openings shall be locked. This significant
deficiency must be corrected within 120 days of notification or have a corrective action
plan approved by DDW.
C
78F All openings/penetrations in the spring collection box are sealed.
SIG | 50pts | SO | SS20 | R309-515-7(7)(d), R309-545-9(1) and (2) | All junction and
collection boxes shall comply with R309-545 and shall have suitable watertight roofs
and sidewalls that exclude birds, animals, insects, and excessive dust. All openings
shall be kept to a minimum and be watertight. Pipes that may contain water of lesser
quality than drinking water shall not penetrate the spring box. This significant
deficiency must be corrected within 120 days of notification or have a corrective action
plan approved by DDW.
C
79 Is a spring box vent present? ... if yes, answer the following question(s)
MIN | 5pts | SO | SS11 | R309-515-7(7)(d), R309-545-15 | Rule requires junction
boxes and collection boxes to comply with R309-545 with respect to venting.
Therefore, a junction or collection box requires a vent to be fitted with #14 mesh or
finer non-corrodible screen, be fitted with a protective heavy-gauge screen or covering
if 6 inches in diameter or greater, be down-turned and shielded to prevent the
entrance of contaminants, be located and sized to avoid blockage during winter, and
have the end of the vent discharge a minimum of 24 inches above the earth on buried
structures.
Y
79A Vent is down-turned.
SIG | 25pts | SO | SS16 | R309-515-7(7)(d), R309-545-15(1) | All vents on junction
and collection boxes shall comply with R309-545 and be downturned a minimum of 2
inches below any opening and shielded to prevent the entrance of contaminants. This
significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
C
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WS003 - (OLD) WELL NO 1 - Active
79B Vent has #14 or finer non-corrodible mesh screen and a protective screen/covering if
6-inch diameter or greater.
SIG | 25pts | SO | SS17 | R309-515-7(7)(d), R309-545-15(4) and (5) | All vents on
junction and collection boxes shall comply with R309-545 and be fitted with No. 14 or
finer non-corrodible mesh screen. Vents 6-inch diameter or larger shall be fitted with
additional heavy gage screen or substantial covering to protect the No. 14 mesh
screen. This significant deficiency must be corrected within 120 days of notification or
have a corrective action plan approved by DDW.
C
79C End of vent has sufficient clearance to prevent ice/snow blockage or is at least 24
inches above the earthen cover
SIG | 25pts | SO | SS18 | R309-515-7(7)(d), R309-545-15(2) and (3) | All vents on
junction and collection boxes shall comply with R309-545 and shall be located and
sized to avoid blockage during winter. The end of a vent on a buried spring box shall
discharge a minimum of 24 inches above the ground. This significant deficiency must
be corrected within 120 days of notification or have a corrective action plan approved
by DDW.
C
80 Spring has a permanent flow-measuring device.
MIN | 5pts | SO | SS01 | R309-515-7(7)(h) | Rule requires a spring to have a
permanent flow measuring device.
C
81 Is this facility Active or Inactive?A
82 Operating Period (Start Date)01/01
83 Operating Period (Ending Date)12/31
84 Undocumented sources shall not be physically connected to the drinking water
system. (IF SOURCE IS NOT IN SYSTEM INVENTORY MARK "DEFICIENT")
SIG | 200pts | SO | S001 | R309-515-6(5), R309-515-7(4), R309-500-9(2) and (3) |
R309-105-6(1) requires plans and specifications for all public drinking water projects to
be approved in writing by the Director prior to the commencement of construction. This
significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
C
85 Well casing is at least 18 inches above finished ground surface and 12 inches above
well house floor.
SIG | 25pts | SO | S003 | R309-515-6(6)(b)(vi), R309-515-6(12)(c)(ii), R309-515-
6(13)(a) | Rule requires the permanent well casing to project at least 18 inches above
the final ground surface and 12 inches above the pump house floor; at sites subject to
flooding, the top of the casing must terminate at least 3 feet above the 100-year flood
level or highest known flood elevation, whichever is higher. This significant deficiency
must be corrected within 120 days of notification or have a corrective action plan
approved by DDW.
C
86 Wellhead is sealed to prevent contamination.
SIG | 50pts | SO | S013 | R309-515-6(6)(i) | R309-515-6(6)(i) and R309-515-
6(12)(b,c,d)require a sanitary seal be installed and maintained at the wellhead and
discharge piping. This significant deficiency should be corrected within 120 days of
notification or have a corrective action plan approved by
C
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87 Is the well casing vented? ... if yes, answer the following question(s)N
88 Does the well have a pump to waste line? ... if yes, answer the following question(s)Y
88A Pump to waste line discharges with a minimum of 12-inch clearance to flood rim
SIG | 25pts | SO | S009 | R309-515-6(12)(d)(ix) | Rule requires a pump-to-waste line
connected to a sewer/storm drain to have a minimum 12-inch clearance to the flood
rim. This significant deficiency must be corrected within 120 days of notification or
have a corrective action plan approved by DDW.
C
88B Pump to waste line equipped with #4 non-corrodible mesh screen
SIG | 25pts | SO | S010 | R309-515-6(12)(d)(ix) | The discharge end of the pump-to-
waste line shall be covered with a No. 4 mesh corrosion-resistant screen. This
significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
C
88C Pump to waste line downturned if it discharges to sewer/storm drain or allowing
complete drainage if not downturned
SIG | 25pts | SO | S011 | R309-515-6(12)(d)(ix) | The discharge end of the pump-to-
waste line shall be downturned. This significant deficiency must be corrected within
120 days of notification or have a corrective action plan approved by DDW.
C
89 Provisions available to periodically measure water levels
MIN | 5pts | SO | S015 | R309-515-6(12)(e ), R309-515-6(12)(c)(vi) | Rule requires
provisions be made to permit periodic measurement of water levels in the completed
well.
C
90 Wellhead secured to protect quality water
SIG | 25pts | SO | S002 | R309-105-10(5) | All water system facilities shall be secure.
This significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
C
91 Well head or well house and equipment protected from flooding
SIG | 25pts | SO | S020 | R309-515-6(6)(b)(vi), R309-515-6(12)(d)(iii), R309-515-
6(13)(a) to (d) | Top of well casing shall terminate at least 18” above ground level or
12” above well house floor and for sites that flood at least 3’ above 100-year flood
level or highest known flood elevation. Well casing terminating in underground vault
shall have a drain to daylight and surface runoff directed away from vault access. Well
house floor shall be sloped for drainage, and have a drain to daylight unless highly
impractical. This significant deficiency must be corrected within 120 days of notification
or have a corrective action plan approved by DDW.
C
92 There are no unprotected cross-connections in well discharge piping.
SIG | 50pts | SO | S021 | R309-105-12(1), R309-515-6(12)(d)(iii) | Rule requires the
well discharge piping to be protected against the entrance of contamination. This
significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
C
93 No toxic chemicals, hazardous or flammable materials, or lubricants inside the well
house or near well head?
MIN | 15pts | TR | TGR9 | R309-105-7 & 8, R309-100 through 605 | Trigger for
regulatory followup to address concerns.
C
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WS004 - (NEW) WELL NO 2 - Active
94 Well discharge line has a smooth-nosed sampling tap, which samples the well water
before any chemical injection. (first item from the wellhead).
MIN | 5pts | SO | S023 | R309-515-6(12)(d)(iv) | Rule requires the discharge piping to
be equipped with a smooth nosed sampling tap, a check valve, a pressure gauge, a
means of measuring flow, and a shutoff valve. (smooth nosed sampling tap being the
first item from the well head and the shut-off valve as the last item)
C
95 Well discharge line has a check valve.
MIN | 5pts | SO | S024 | R309-515-6(12)(d)(iv) | Rule requires the discharge piping to
be equipped with (in order of placement from the wellhead) a smooth nosed sampling
tap, a check valve, a pressure gauge, a means of measuring flow, and a shutoff valve.
C
96 Well discharge line has a pressure gauge.
MIN | 5pts | SO | S025 | R309-515-6(12)(d)(iv) | Rule requires the discharge piping to
be equipped with (in order of placement from the wellhead) a smooth nosed sampling
tap, a check valve, a pressure gauge, a means of measuring flow, and a shutoff valve.
C
97 Well discharge line has a means to measure flow.
MIN | 5pts | SO | S026 | R309-515-6(12)(d)(iv) | Rule requires the discharge piping to
be equipped with (in order of placement from the wellhead) a smooth nosed sampling
tap, a check valve, a pressure gauge, a means of measuring flow, and a shutoff valve.
C
98 Well discharge line has a shut-off valve (last item from the well head).
MIN | 5pts | SO | S027 | R309-515-6(12)(d)(iv) | Rule requires the discharge piping to
be equipped with (in order of placement from the wellhead) a smooth nosed sampling
tap, a check valve, a pressure gauge, a means of measuring flow, and a shutoff valve.
C
99 Is there an air/vac valve on the well discharge line? If yes, answer the following
question(s)
N
100 Wells that pump directly into a distribution system have means to release trapped air
from pump discharge piping (for example, pumps directly to a tank, has an air release
valve or pump to waste line)
MIN | 5pts | SO | SL01 | R309-515-6(12)(d)(v) | Rule requires a well that pumps
directly into the distribution system be equipped with an air release/vacuum relief valve
located upstream of the check valve, unless the wellhead valve and piping provide for
pumping to waste all trapped air before water is introduced into the distribution
system.
C
101 Does well require oil-lubrication?N
102 Is this facility Active or Inactive?A
103 Operating Period (Start Date)01/01
104 Operating Period (Ending Date)12/31
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105 Undocumented sources shall not be physically connected to the drinking water
system. (IF SOURCE IS NOT IN SYSTEM INVENTORY MARK "DEFICIENT")
SIG | 200pts | SO | S001 | R309-515-6(5), R309-515-7(4), R309-500-9(2) and (3) |
R309-105-6(1) requires plans and specifications for all public drinking water projects to
be approved in writing by the Director prior to the commencement of construction. This
significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
C
106 Well casing is at least 18 inches above finished ground surface and 12 inches above
well house floor.
SIG | 25pts | SO | S003 | R309-515-6(6)(b)(vi), R309-515-6(12)(c)(ii), R309-515-
6(13)(a) | Rule requires the permanent well casing to project at least 18 inches above
the final ground surface and 12 inches above the pump house floor; at sites subject to
flooding, the top of the casing must terminate at least 3 feet above the 100-year flood
level or highest known flood elevation, whichever is higher. This significant deficiency
must be corrected within 120 days of notification or have a corrective action plan
approved by DDW.
C
107 Wellhead is sealed to prevent contamination.
SIG | 50pts | SO | S013 | R309-515-6(6)(i) | R309-515-6(6)(i) and R309-515-
6(12)(b,c,d)require a sanitary seal be installed and maintained at the wellhead and
discharge piping. This significant deficiency should be corrected within 120 days of
notification or have a corrective action plan approved by
C
108 Is the well casing vented? ... if yes, answer the following question(s)Y

108A
Vent screened with #14 mesh screen
SIG | 25pts | SO | S006 | R309-515-6(12)(d)(iii) | Guidance states provisions should be
made for venting the well casing, however if vented R309-515-6(12)(d)(iii) and R309-
550-6(6)(a)require vents be fitted with a #14 mesh or finer non-corrodible screen.
C

108B
Vent down-turned
SIG | 25pts | SO | S007 | R309-515-6(12)(d)(iii) | Guidance states provisions should be
made for venting the well casing, however if vented R309-515-6(12)(d)(iii) and R309-
550-6(6)(b) requires vents be downturned or shielded to prevent the entrance of
surface water or rainwater.
C

108C
Vent has adequate clearance to prevent contamination from entering the well
SIG | 25pts | SO | S008 | R309-515-6(12)(d)(iii) | Guidance states provisions should be
made for venting the well casing, however if vented R309-515-6(12)(d)(iii) and R309-
550-6(6)(b) requires vents be terminated with a discharge with an appropriate air gap.
C
109 Does the well have a pump to waste line? ... if yes, answer the following question(s)Y

109A
Pump to waste line discharges with a minimum of 12-inch clearance to flood rim
SIG | 25pts | SO | S009 | R309-515-6(12)(d)(ix) | Rule requires a pump-to-waste line
connected to a sewer/storm drain to have a minimum 12-inch clearance to the flood
rim. This significant deficiency must be corrected within 120 days of notification or
have a corrective action plan approved by DDW.
C
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109B
Pump to waste line equipped with #4 non-corrodible mesh screen
SIG | 25pts | SO | S010 | R309-515-6(12)(d)(ix) | The discharge end of the pump-to-
waste line shall be covered with a No. 4 mesh corrosion-resistant screen. This
significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
C

109C
Pump to waste line downturned if it discharges to sewer/storm drain or allowing
complete drainage if not downturned
SIG | 25pts | SO | S011 | R309-515-6(12)(d)(ix) | The discharge end of the pump-to-
waste line shall be downturned. This significant deficiency must be corrected within
120 days of notification or have a corrective action plan approved by DDW.
C
110 Provisions available to periodically measure water levels
MIN | 5pts | SO | S015 | R309-515-6(12)(e ), R309-515-6(12)(c)(vi) | Rule requires
provisions be made to permit periodic measurement of water levels in the completed
well.
C
111 Wellhead secured to protect quality water
SIG | 25pts | SO | S002 | R309-105-10(5) | All water system facilities shall be secure.
This significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
C
112 Well head or well house and equipment protected from flooding
SIG | 25pts | SO | S020 | R309-515-6(6)(b)(vi), R309-515-6(12)(d)(iii), R309-515-
6(13)(a) to (d) | Top of well casing shall terminate at least 18” above ground level or
12” above well house floor and for sites that flood at least 3’ above 100-year flood
level or highest known flood elevation. Well casing terminating in underground vault
shall have a drain to daylight and surface runoff directed away from vault access. Well
house floor shall be sloped for drainage, and have a drain to daylight unless highly
impractical. This significant deficiency must be corrected within 120 days of notification
or have a corrective action plan approved by DDW.
C
113 There are no unprotected cross-connections in well discharge piping.
SIG | 50pts | SO | S021 | R309-105-12(1), R309-515-6(12)(d)(iii) | Rule requires the
well discharge piping to be protected against the entrance of contamination. This
significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
C
114 No toxic chemicals, hazardous or flammable materials, or lubricants inside the well
house or near well head?
MIN | 15pts | TR | TGR9 | R309-105-7 & 8, R309-100 through 605 | Trigger for
regulatory followup to address concerns.
C
115 Well discharge line has a smooth-nosed sampling tap, which samples the well water
before any chemical injection. (first item from the wellhead).
MIN | 5pts | SO | S023 | R309-515-6(12)(d)(iv) | Rule requires the discharge piping to
be equipped with a smooth nosed sampling tap, a check valve, a pressure gauge, a
means of measuring flow, and a shutoff valve. (smooth nosed sampling tap being the
first item from the well head and the shut-off valve as the last item)
C
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ST001 - 150 K TANK - Active
116 Well discharge line has a check valve.
MIN | 5pts | SO | S024 | R309-515-6(12)(d)(iv) | Rule requires the discharge piping to
be equipped with (in order of placement from the wellhead) a smooth nosed sampling
tap, a check valve, a pressure gauge, a means of measuring flow, and a shutoff valve.
C
117 Well discharge line has a pressure gauge.
MIN | 5pts | SO | S025 | R309-515-6(12)(d)(iv) | Rule requires the discharge piping to
be equipped with (in order of placement from the wellhead) a smooth nosed sampling
tap, a check valve, a pressure gauge, a means of measuring flow, and a shutoff valve.
C
118 Well discharge line has a means to measure flow.
MIN | 5pts | SO | S026 | R309-515-6(12)(d)(iv) | Rule requires the discharge piping to
be equipped with (in order of placement from the wellhead) a smooth nosed sampling
tap, a check valve, a pressure gauge, a means of measuring flow, and a shutoff valve.
C
119 Well discharge line has a shut-off valve (last item from the well head).
MIN | 5pts | SO | S027 | R309-515-6(12)(d)(iv) | Rule requires the discharge piping to
be equipped with (in order of placement from the wellhead) a smooth nosed sampling
tap, a check valve, a pressure gauge, a means of measuring flow, and a shutoff valve.
C
120 Is there an air/vac valve on the well discharge line? If yes, answer the following
question(s)
Y

120A
Air vacuum relief valve on well discharge piping downturned
SIG | 25pts | SO | S028 | R309-515-6(12)(d)(v) | Rule requires the exhaust/relief piping
on an air release/vacuum relief valve on the well discharge piping to be down-turned.
This significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
C

120B
Air vacuum relief valve on well discharge piping screened with #14 mesh screen
SIG | 25pts | SO | S029 | R309-515-6(12)(d)(v) | Rule requires the exhaust/relief piping
on an air release/vacuum relief valve on the well discharge piping to be covered with a
#14 mesh corrosion-resistant screen. This significant deficiency must be corrected
within 120 days of notification or have a corrective action plan approved by DDW.
C

120C
Air vacuum relief valve on well discharge piping has at least 6 inches of clearance
above floor
SIG | 25pts | SO | S030 | R309-515-6(12)(d)(v) | Rule requires the exhaust/relief piping
on an air release/vacuum relief valve on the well discharge piping to be at least 6
inches above the well house floor. This significant deficiency must be corrected within
120 days of notification or have a corrective action plan approved by DDW.
C
121 Wells that pump directly into a distribution system have means to release trapped air
from pump discharge piping (for example, pumps directly to a tank, has an air release
valve or pump to waste line)
MIN | 5pts | SO | SL01 | R309-515-6(12)(d)(v) | Rule requires a well that pumps
directly into the distribution system be equipped with an air release/vacuum relief valve
located upstream of the check valve, unless the wellhead valve and piping provide for
pumping to waste all trapped air before water is introduced into the distribution
system.
C
122 Does well require oil-lubrication?N
DEQ | Drinking Water
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123 Is this facility Active or Inactive?A
124 There are no undocumented drinking water facilities (i.e. tanks, pump stations,
treatment facilities, etc.) or recent modifications that have not gone through DDW
review
SIG | 50pts | SM | G001 | R309-100-5(2), R309-500-6, R309-500-9, R309-500-9(2)
and (3) | Rule requires complete plans & specification for all public drinking water
projects to be approved in writing by the Director. Any facility found that has not
started DDW review shall be considered unapproved. This significant deficiency must
be corrected within 120 days of notification or have a corrective action plan approved
by DDW.
C
125 Storage tank capacity in gallons (from SDWIS; if different explain why in the
comments)
150000
126 Ladders, ladder guards, platform railings, or safely located entrance hatches are
provided.
MIN | 15pts | FW | V004 | R309-545-18 | Rule requires ladders, ladder guards,
platform railings, and safely located entrance hatches where applicable for water
storage tanks and requires safety practices to conform to pertinent laws and
regulations of the Utah Occupational Safety and Health Division.
C
127 Tank is vented.
SIG | 25pts | FW | VL02 | R309-545-15 | Rule requires drinking water storage tanks to
be vented. Overflows cannot be considered or used as vents. This significant
deficiency must be corrected within 120 days of notification or have a corrective action
plan approved by DDW.
C
128 Are air vents present? ... if yes, answer the following question(s)Y

128A
Vent is either down-turned or shielded from contaminants (at least 2 inches below the
bottom of the opening)
SIG | 25pts | FW | V005 | R309-545-15(1) | Rule requires inverted vents on water
storage tanks to be down-turned a minimum of 2 inches below any opening and
shielded to prevent the entrance of contaminants. This significant deficiency must be
corrected within 120 days of notification or have a corrective action plan approved by
DDW.
C

128B
End of vent terminates at least 24 inches above earthen cover (buried tank) and is
located and sized to avoid blockage during winter.
MIN | 15pts | FW | V006 | R309-545-15(2) | For buried structures, the rule requires the
end of the vent discharge to be a minimum of 24 inches above the earthen covering.
C

128C
Vent covered with #14 or finer non-corrodible mesh screen.
SIG | 25pts | FW | V007 | R309-545-15(4) | Rule requires a water storage tank vent to
be fitted with #14 mesh or finer non-corrodible screen and vents 6-inches or greater in
diameter to be fitted with additional heavy gauge screen or substantial covering to
protect the #14 mesh screen from vandalism or damage. This significant deficiency
must be corrected within 120 days of notification or have a compliance action plan
approved by DDW.
C
DEQ | Drinking Water
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128D
Vent 6-inch diameter and larger protected with additional heavy-gauge screen or
substantial covering.
MIN | 5pts | FW | V035 | R309-545-15(5) | Rule requires vents that are 6-inch diameter
or greater to be fitted with additional heavy gauge screen or substantial covering,
which will protect the No. 14 mesh screen against vandalism or damage.
C
129 Are access openings present? ... if yes, answer the following question(s)
MIN | 15pts | FW | VL03 | R309-545-14 and 14(1) | Rule requires drinking water
storage tanks to be designed with reasonably convenient access to the interior for
cleaning and maintenance.
Y

129A
Access opening framed at least 4 inches above roof surface or 18 inches above
earthen cover.
MIN | 15pts | FW | V008 | R309-545-14(1) | Rule requires tank access opening to be
framed at least 4 inches above the surface of the roof, or on a buried tank, to be at
least 18 inches above any earthen cover over the tank.
C

129B
Access opening shoe box type with at least 2 inches of overlap
SIG | 25pts | FW | V010 | R309-545-14(2) | Rule requires the frame of an access
opening to be provided with a close fitting solid shoebox type cover which extends
down around the frame at least two inches and is furnished with a gasket(s) between
the lid and frame. This significant deficiency must be corrected within 120 days of
notification or have a corrective action plan approved by DDW.
C

129C
Access opening lid properly gasketed
SIG | 25pts | FW | V009 | R309-545-14(2) | Rule requires the access opening to a tank
to be furnished with a gasket between the lid and frame. This significant deficiency
must be corrected within 120 days of notification or have a corrective action plan
approved by DDW.
C
130 Access opening locked
SIG | 25pts | FW | V029 | R309-545-14(3) | Rule requires the lid to any access
opening to have a locking device. This significant deficiency must be corrected within
120 days of notification or have a corrective action plan approved by DDW.
C
131 Roof or wall penetrations sealed
SIG | 100pts | FW | V017 | R309-545-6(1) and 545-9 | Rule requires openings in a
storage tank roof or top, designed to accommodate control apparatus or pump
columns, to be welded, gasketed, or curbed and sleeved and to have additional proper
shielding to prevent vandalism. This significant deficiency must be corrected within
120 days of notification or have a corrective action plan approved by DDW.
C
132 Area surrounding ground-level or buried storage tank is graded to prevent surface
water from standing within 50 feet.
SIG | 25pts | TR | V001 | R309-545-7(4) | Rule requires the area surrounding a
ground-level or buried water storage tank be graded in a manner to prevent surface
water from standing within 50 feet of the tank. This significant deficiency must be
corrected within 120 days of notification or have a corrective action plan approved by
DDW.
C
DEQ | Drinking Water
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ST002 - 500 K TANK - Active
133 Storage tank roof is sloped to prevent ponding
MIN | 15pts | FW | V003 | R309-545-9(4) | Rule requires drainage of storage tank roofs
to eliminate water ponding.
C
134 Are there cracks in the walls or roof of the storage tank? (if yes, select only one of the
following options)
N
135 Is a tank overflow present? ... if yes, answer the following question(s)
SIG | 25pts | FW | VL01 | R309-545-13 | Rule requires all storage tanks to be provided
with an overflow that discharges at an an elevation between 12 and 24 inches above
the ground surface or the rim of the receiving basin. This significant deficiency must
be corrected within 120 days of notification or have a corrective action plan approved
by DDW.
Y

135A
Overflow line discharges at least 12 inches above ground or the flood rim of receiving
basin?
SIG | 25pts | FW | V011 | R309-545-13 | Rule requires all water storage tanks to be
provided with an overflow that discharges at an elevation between 12 and 24 inches
above the ground surface or the rim of the receiving basin.
C

135B
Overflow line covered with #4 mesh non-corrodible screen
SIG | 25pts | FW | V012 | R309-545-13(3) | Rule requires overflow pipes to be
screened with #4 mesh non-corrodible screens installed at a location least susceptible
to damage by vandalism. This significant deficiency must be corrected within 120 days
of notification or have a corrective action plan approved by DDW.
C

135C
Overflow line connected or discharges to a sanitary sewer drain?
SIG | 50pts | FW | V013 | R309-545-13(5) | Rule prohibits overflow pipes from
connecting to, or discharging into, a sanitary sewer system. This significant deficiency
must be corrected within 120 days of notification or have a corrective action plan
approved by DDW.
C
136 Are the drain line and overflow combined?N

136A
Drain line shall terminate at least 12 inches above ground or flood rim of receiving
basin
SIG | 25pts | FW | V016 | R309-545-10(1)(d) | If the local authority allows discharge to
a storm drain, the rule requires the drain discharge to have a physical clearance of at
least 12 inches between the discharge end of the pipe and the overflow rim of the
receiving basin. This significant deficiency must be corrected within 120 days of
notification or have a corrective action plan approved by DDW.
C
137 Is this facility Active or Inactive?A
DEQ | Drinking Water
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138 There are no undocumented drinking water facilities (i.e. tanks, pump stations,
treatment facilities, etc.) or recent modifications that have not gone through DDW
review
SIG | 50pts | SM | G001 | R309-100-5(2), R309-500-6, R309-500-9, R309-500-9(2)
and (3) | Rule requires complete plans & specification for all public drinking water
projects to be approved in writing by the Director. Any facility found that has not
started DDW review shall be considered unapproved. This significant deficiency must
be corrected within 120 days of notification or have a corrective action plan approved
by DDW.
C
139 Storage tank capacity in gallons (from SDWIS; if different explain why in the
comments)
500000
140 Ladders, ladder guards, platform railings, or safely located entrance hatches are
provided.
MIN | 15pts | FW | V004 | R309-545-18 | Rule requires ladders, ladder guards,
platform railings, and safely located entrance hatches where applicable for water
storage tanks and requires safety practices to conform to pertinent laws and
regulations of the Utah Occupational Safety and Health Division.
C
141 Tank is vented.
SIG | 25pts | FW | VL02 | R309-545-15 | Rule requires drinking water storage tanks to
be vented. Overflows cannot be considered or used as vents. This significant
deficiency must be corrected within 120 days of notification or have a corrective action
plan approved by DDW.
C
142 Are air vents present? ... if yes, answer the following question(s)Y

142A
Vent is either down-turned or shielded from contaminants (at least 2 inches below the
bottom of the opening)
SIG | 25pts | FW | V005 | R309-545-15(1) | Rule requires inverted vents on water
storage tanks to be down-turned a minimum of 2 inches below any opening and
shielded to prevent the entrance of contaminants. This significant deficiency must be
corrected within 120 days of notification or have a corrective action plan approved by
DDW.
C

142B
End of vent terminates at least 24 inches above earthen cover (buried tank) and is
located and sized to avoid blockage during winter.
MIN | 15pts | FW | V006 | R309-545-15(2) | For buried structures, the rule requires the
end of the vent discharge to be a minimum of 24 inches above the earthen covering.
C

142C
Vent covered with #14 or finer non-corrodible mesh screen.
SIG | 25pts | FW | V007 | R309-545-15(4) | Rule requires a water storage tank vent to
be fitted with #14 mesh or finer non-corrodible screen and vents 6-inches or greater in
diameter to be fitted with additional heavy gauge screen or substantial covering to
protect the #14 mesh screen from vandalism or damage. This significant deficiency
must be corrected within 120 days of notification or have a compliance action plan
approved by DDW.
C

142D
Vent 6-inch diameter and larger protected with additional heavy-gauge screen or
substantial covering.
MIN | 5pts | FW | V035 | R309-545-15(5) | Rule requires vents that are 6-inch diameter
or greater to be fitted with additional heavy gauge screen or substantial covering,
which will protect the No. 14 mesh screen against vandalism or damage.
C
DEQ | Drinking Water
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143 Are access openings present? ... if yes, answer the following question(s)
MIN | 15pts | FW | VL03 | R309-545-14 and 14(1) | Rule requires drinking water
storage tanks to be designed with reasonably convenient access to the interior for
cleaning and maintenance.
Y

143A
Access opening framed at least 4 inches above roof surface or 18 inches above
earthen cover.
MIN | 15pts | FW | V008 | R309-545-14(1) | Rule requires tank access opening to be
framed at least 4 inches above the surface of the roof, or on a buried tank, to be at
least 18 inches above any earthen cover over the tank.
C

143B
Access opening shoe box type with at least 2 inches of overlap
SIG | 25pts | FW | V010 | R309-545-14(2) | Rule requires the frame of an access
opening to be provided with a close fitting solid shoebox type cover which extends
down around the frame at least two inches and is furnished with a gasket(s) between
the lid and frame. This significant deficiency must be corrected within 120 days of
notification or have a corrective action plan approved by DDW.
C

143C
Access opening lid properly gasketed
SIG | 25pts | FW | V009 | R309-545-14(2) | Rule requires the access opening to a tank
to be furnished with a gasket between the lid and frame. This significant deficiency
must be corrected within 120 days of notification or have a corrective action plan
approved by DDW.
C
144 Access opening locked
SIG | 25pts | FW | V029 | R309-545-14(3) | Rule requires the lid to any access
opening to have a locking device. This significant deficiency must be corrected within
120 days of notification or have a corrective action plan approved by DDW.
C
145 Roof or wall penetrations sealed
SIG | 100pts | FW | V017 | R309-545-6(1) and 545-9 | Rule requires openings in a
storage tank roof or top, designed to accommodate control apparatus or pump
columns, to be welded, gasketed, or curbed and sleeved and to have additional proper
shielding to prevent vandalism. This significant deficiency must be corrected within
120 days of notification or have a corrective action plan approved by DDW.
C
146 Area surrounding ground-level or buried storage tank is graded to prevent surface
water from standing within 50 feet.
SIG | 25pts | TR | V001 | R309-545-7(4) | Rule requires the area surrounding a
ground-level or buried water storage tank be graded in a manner to prevent surface
water from standing within 50 feet of the tank. This significant deficiency must be
corrected within 120 days of notification or have a corrective action plan approved by
DDW.
C
147 Storage tank roof is sloped to prevent ponding
MIN | 15pts | FW | V003 | R309-545-9(4) | Rule requires drainage of storage tank roofs
to eliminate water ponding.
C
148 Are there cracks in the walls or roof of the storage tank? (if yes, select only one of the
following options)
N
DEQ | Drinking Water
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PF003 - (OLD) WELL #1 BOOSTER PUMP -- Pump Stations - Active
149 Is a tank overflow present? ... if yes, answer the following question(s)
SIG | 25pts | FW | VL01 | R309-545-13 | Rule requires all storage tanks to be provided
with an overflow that discharges at an an elevation between 12 and 24 inches above
the ground surface or the rim of the receiving basin. This significant deficiency must
be corrected within 120 days of notification or have a corrective action plan approved
by DDW.
Y

149A
Overflow line discharges at least 12 inches above ground or the flood rim of receiving
basin?
SIG | 25pts | FW | V011 | R309-545-13 | Rule requires all water storage tanks to be
provided with an overflow that discharges at an elevation between 12 and 24 inches
above the ground surface or the rim of the receiving basin.
C

149B
Overflow line covered with #4 mesh non-corrodible screen
SIG | 25pts | FW | V012 | R309-545-13(3) | Rule requires overflow pipes to be
screened with #4 mesh non-corrodible screens installed at a location least susceptible
to damage by vandalism. This significant deficiency must be corrected within 120 days
of notification or have a corrective action plan approved by DDW.
C

149C
Overflow line connected or discharges to a sanitary sewer drain?
SIG | 50pts | FW | V013 | R309-545-13(5) | Rule prohibits overflow pipes from
connecting to, or discharging into, a sanitary sewer system. This significant deficiency
must be corrected within 120 days of notification or have a corrective action plan
approved by DDW.
C
150 Are the drain line and overflow combined?Y
151 Is this facility Active or Inactive?A
152 There are no undocumented drinking water facilities (i.e. tanks, pump stations,
treatment facilities, etc.) or recent modifications that have not gone through DDW
review
SIG | 50pts | SM | G001 | R309-100-5(2), R309-500-6, R309-500-9, R309-500-9(2)
and (3) | Rule requires complete plans & specification for all public drinking water
projects to be approved in writing by the Director. Any facility found that has not
started DDW review shall be considered unapproved. This significant deficiency must
be corrected within 120 days of notification or have a corrective action plan approved
by DDW.
C
153 Pump Type (Centrifugal, Hand pump, Jet, Positive Displacement, Screw, Submersible,
Vertical turbine)
Centrifugal
154 If the pump station is used to pressurize the distribution system, does it have at least
two functioning pumping units? ... if yes, answer the following question(s)
SIG | 25pts | PU | PS18 | R309-540-5(4)(b) | Rule states inline booster pumps,
withdrawing water directly from distribution lines without storage and feeding water
directly into distribution lines, shall have at least two pumping units. This significant
deficiency must be corrected within 120 days of notification or have a corrective action
plan approved by DDW.
NA (Notes: not used to pressurize
distribution system)
DEQ | Drinking Water
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TP001 - GIRLS CAMP SPRING CHLORINATOR -- Treatment - Chlorination General - Active
155 Pump station building and equipment are protected from flooding.
MIN | 15pts | PU | PS13 | R309-540-5(1)(a)(ii), R309-540-5(2)(a)(iii) | Pump station
access shall be 6" above surrounding ground and located at least 3’ above 100-year
flood elevation or highest recorded flood elevation; station is accessible at all times
unless it can be taken out of service when inaccessible.
C
156 There are no unprotected cross-connections in the pump station.
SIG | 50pts | PU | PS15 | R309-105-12(1) | Cross connections are not allowed unless
controlled by an approved and properly operating backflow prevention assembly or
device. This significant deficiency must be corrected within 120 days of notification or
have a corrective action plan approved by DDW.
C
157 Discharge piping has a pressure gauge.
MIN | 15pts | PU | PS03 | R309-540-5 (6)(c)(i) | Rule requires that a standard pressure
gauge be installed on the pump discharge line.
C
158 Does the pumping facility have an air relief valve located on the discharge piping? ... if
yes, answer the following question(s)
N
159 Pump station properly secured
MIN | 15pts | PU | PS33 | R309-540-5(1)(a)(v) | The pump station is protected to
prevent vandalism and entrance by animals or unauthorized persons.
C
160 Is this facility Active or Inactive?A
161 Is system required to provide primary disinfection? Prompt - If system knows they are
required to chlorinate based on water quality issues and/or knows they are required to
provide a minimum CT then follow-up by DDW is needed.
N
162 When chlorination is required, disinfection has operated uninterrupted during the past
year while supplying drinking water.
SIG | 50pts | TR | TD25 | R309-520-6 | Rule requires continuous disinfection of
groundwater sources that do not consistently meet bacteriological quality standards,
all surface water sources, and groundwater sources under the direct influence of
surface water. This significant deficiency must be corrected within 120 days of
notification or have a corrective action plan approved by DDW.
NA (Notes: not required.)
163 Chlorine (gas & hypochlorite solution, tablets, granules, ) and chemicals used to
generate chlorine solutions and chlorine dioxide meet ANSI/NSF 60.
SIG | 50pts | TR | TD90 | R309-525-11(5), R309-520-6(2) | All chemicals added to
drinking water, including chlorine, chloramines and chemicals used to generate
hypochlorite solutions and chlorine dioxide, shall be certified as complying with
ANSI/NSF Standard 60. This significant deficiency must be corrected within 120 days
of notification or have a corrective action plan approved by DDW.
C
164 If chemical dilution or dissolution is needed, cross-connection control is provided on
water lines feeding solution tanks.
SIG | 50pts | TR | TX07 | R309-525-11(2)(c), R309-525-11(9)(b)(i) to (iv) | Cross
connection control shall be provided on make-up water lines feeding solution tanks.
This significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
C
DEQ | Drinking Water
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165 Water flow rate is measured to control chemical feed?
SIG | 25pts | TR | TD79 | R309-525-11(7)(d)(ii) and (iii), R309-525-11(7)(a)(i) |
Chemical feed rates shall be proportional to flows and a means to measure water flow
rate shall be provided. This significant deficiency must be corrected within 120 days of
notification or have a corrective action plan approved by DDW.
C
166 Solution tanks and tank refilling line entry points are properly labeled to identify the
chemicals
MIN | 15pts | TR | TG03 | R309-525-11(8)(c)(vii) | Rule requires tanks to be properly
labeled to designate the chemical contained.
C
167 Free chlorine residual test equipment on-site or available?
MIN | 15pts | TR | TD78 | R309-520-7(1)(j) | Rule requires chlorine residual test
equipment available capable of measuring residuals to the nearest 0.1 mg/l in the
range below 0.5 mg/l, to the nearest 0.3 mg/l between 0.5 mg/l and 1.0 mg/l and to the
nearest 0.5 mg/l above 1.0 mg/l.
C
168 Spare parts are available to replace parts subject to wear and breakage
MIN | 15pts | TR | TD75 | Standard Method 334.0 Determination of Residual Chlorine
in Drinking Water Using an Online Chlorine Analyzer. [EPA 815-B-09-013 September
2009 11.1.1.2 Page 13] | Spare parts shall be provided and maintained for all
chlorinators to repair parts subject to wear and breakage.
C
169 Is chlorine chemical dose rate adjusted due to different water demand flow rates
and/or changing water quality?
Y

169A
If yes, which water flow rate is used? e.g. influent flow, effluent flow, filter flow.Influent Flow
170 Is there a designated chlorine Point of Entry (POE) sample location?
MIN | 15pts | TR | TGR9 | R309-105-7 & 8, R309-100 through 605 | Trigger for
regulatory followup to address concerns.
C
171 POE is before first connection/customer?
SIG | 25pts | TR | T028 | R309-215 | R309-215 & R309-520-6(4)(d)
C
172 Chlorine residual records are maintained and available... if yes answer following
SIG | 25pts | TR | T028 | R309-215 | R309-215 & R309-520-6(4)(d)
Y

172A
System is sampling distribution residuals throughout entire distribution system
MIN | 15pts | TR | TGR9 | R309-105-7 & 8, R309-100 through 605 | Trigger for
regulatory followup to address concerns.
C

172B
Distribution chlorine residuals meet minimum concentration requirement
SIG | 25pts | TR | T028 | R309-215 | R309-215 & R309-520-6(4)(d)
C

172C
"What is the maximum free chlorine residual measure? This value never exceeds 4.0
mg/L? "
MIN | 15pts | TR | TGR9 | R309-105-7 & 8, R309-100 through 605 | Trigger for
regulatory followup to address concerns.
C

172D
System collects at least three distribution chlorine residual samples a week?
MIN | 15pts | TR | TGR9 | R309-105-7 & 8, R309-100 through 605 | Trigger for
regulatory followup to address concerns.
C
DEQ | Drinking Water
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TP002 - WELL 2 CHLORINATOR -- Treatment - Chlorination General - Active

172E
System is sampling distribution residuals in accordance with monitoring schedule
MIN | 15pts | TR | TGR9 | R309-105-7 & 8, R309-100 through 605 | Trigger for
regulatory followup to address concerns.
C
173 Treatment plant properly secured to protect the quality of the treated water. R309-520-
7(2)(f)
SIG | 25pts | SM | A050 | R309-400-11 | If the water system does not comply with the
directive, the Director may assess 25 to 200 points to the water system. Points shall
be assessed based upon the severity of the non-compliance, the threat to public
health and the underlying basis for the original directive.
C
174 Daily operating records reflect chemical dosages and total quantities used
SIG | 25pts | MR | TG20 | R309-105-14(3)(a) | Rule requires all water system using
chemical addition or specialized equipment for the treatment of drinking water to
regularly complete operational reports. This significant deficiency must be corrected
within 120 days of notification or have a corrective action plan approved by DDW.
C
175 Is this facility Active or Inactive?A
176 Is system required to provide primary disinfection? Prompt - If system knows they are
required to chlorinate based on water quality issues and/or knows they are required to
provide a minimum CT then follow-up by DDW is needed.
N
177 When chlorination is required, disinfection has operated uninterrupted during the past
year while supplying drinking water.
SIG | 50pts | TR | TD25 | R309-520-6 | Rule requires continuous disinfection of
groundwater sources that do not consistently meet bacteriological quality standards,
all surface water sources, and groundwater sources under the direct influence of
surface water. This significant deficiency must be corrected within 120 days of
notification or have a corrective action plan approved by DDW.
NA (Notes: not required.)
178 Chlorine (gas & hypochlorite solution, tablets, granules, ) and chemicals used to
generate chlorine solutions and chlorine dioxide meet ANSI/NSF 60.
SIG | 50pts | TR | TD90 | R309-525-11(5), R309-520-6(2) | All chemicals added to
drinking water, including chlorine, chloramines and chemicals used to generate
hypochlorite solutions and chlorine dioxide, shall be certified as complying with
ANSI/NSF Standard 60. This significant deficiency must be corrected within 120 days
of notification or have a corrective action plan approved by DDW.
C
179 If chemical dilution or dissolution is needed, cross-connection control is provided on
water lines feeding solution tanks.
SIG | 50pts | TR | TX07 | R309-525-11(2)(c), R309-525-11(9)(b)(i) to (iv) | Cross
connection control shall be provided on make-up water lines feeding solution tanks.
This significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
C
180 Water flow rate is measured to control chemical feed?
SIG | 25pts | TR | TD79 | R309-525-11(7)(d)(ii) and (iii), R309-525-11(7)(a)(i) |
Chemical feed rates shall be proportional to flows and a means to measure water flow
rate shall be provided. This significant deficiency must be corrected within 120 days of
notification or have a corrective action plan approved by DDW.
C
DEQ | Drinking Water
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181 Solution tanks and tank refilling line entry points are properly labeled to identify the
chemicals
MIN | 15pts | TR | TG03 | R309-525-11(8)(c)(vii) | Rule requires tanks to be properly
labeled to designate the chemical contained.
C
182 Free chlorine residual test equipment on-site or available?
MIN | 15pts | TR | TD78 | R309-520-7(1)(j) | Rule requires chlorine residual test
equipment available capable of measuring residuals to the nearest 0.1 mg/l in the
range below 0.5 mg/l, to the nearest 0.3 mg/l between 0.5 mg/l and 1.0 mg/l and to the
nearest 0.5 mg/l above 1.0 mg/l.
C
183 Spare parts are available to replace parts subject to wear and breakage
MIN | 15pts | TR | TD75 | Standard Method 334.0 Determination of Residual Chlorine
in Drinking Water Using an Online Chlorine Analyzer. [EPA 815-B-09-013 September
2009 11.1.1.2 Page 13] | Spare parts shall be provided and maintained for all
chlorinators to repair parts subject to wear and breakage.
C
184 Is chlorine chemical dose rate adjusted due to different water demand flow rates
and/or changing water quality?
Y

184A
If yes, which water flow rate is used? e.g. influent flow, effluent flow, filter flow.Influent Flow
185 Is there a designated chlorine Point of Entry (POE) sample location?
MIN | 15pts | TR | TGR9 | R309-105-7 & 8, R309-100 through 605 | Trigger for
regulatory followup to address concerns.
C
186 POE is before first connection/customer?
SIG | 25pts | TR | T028 | R309-215 | R309-215 & R309-520-6(4)(d)
C
187 Chlorine residual records are maintained and available... if yes answer following
SIG | 25pts | TR | T028 | R309-215 | R309-215 & R309-520-6(4)(d)
Y

187A
System is sampling distribution residuals throughout entire distribution system
MIN | 15pts | TR | TGR9 | R309-105-7 & 8, R309-100 through 605 | Trigger for
regulatory followup to address concerns.
C

187B
Distribution chlorine residuals meet minimum concentration requirement
SIG | 25pts | TR | T028 | R309-215 | R309-215 & R309-520-6(4)(d)
C

187C
"What is the maximum free chlorine residual measure? This value never exceeds 4.0
mg/L? "
MIN | 15pts | TR | TGR9 | R309-105-7 & 8, R309-100 through 605 | Trigger for
regulatory followup to address concerns.
C

187D
System collects at least three distribution chlorine residual samples a week?
MIN | 15pts | TR | TGR9 | R309-105-7 & 8, R309-100 through 605 | Trigger for
regulatory followup to address concerns.
C

187E
System is sampling distribution residuals in accordance with monitoring schedule
MIN | 15pts | TR | TGR9 | R309-105-7 & 8, R309-100 through 605 | Trigger for
regulatory followup to address concerns.
C
DEQ | Drinking Water
Run Date: 10/16/2023 19:51:28 | Rating: Approved UTAH02018 MANTUA TOWN WATER SYSTEM page 29 of 32
TP001 - GIRLS CAMP SPRING CHLORINATOR -- Gaseous Chlorination - Active
188 Treatment plant properly secured to protect the quality of the treated water. R309-520-
7(2)(f)
SIG | 25pts | SM | A050 | R309-400-11 | If the water system does not comply with the
directive, the Director may assess 25 to 200 points to the water system. Points shall
be assessed based upon the severity of the non-compliance, the threat to public
health and the underlying basis for the original directive.
C
189 Daily operating records reflect chemical dosages and total quantities used
SIG | 25pts | MR | TG20 | R309-105-14(3)(a) | Rule requires all water system using
chemical addition or specialized equipment for the treatment of drinking water to
regularly complete operational reports. This significant deficiency must be corrected
within 120 days of notification or have a corrective action plan approved by DDW.
C
190 Is this facility Active or Inactive?A
191 If disinfection is required, standby chlorination equipment of sufficient capacity is
available to replace the largest unit.
SIG | 25pts | TR | TD22 | R309-520-7(1)(k)(ii) | Where chlorination is required for
disinfection of the water supply, the rule requires standby equipment of sufficient
capacity to be available to replace the largest unit in the event of its failure. This
significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
NA (Notes: not required.)
192 Is the chlorinator room heated and has the ability to be protected from excessive heat?
MIN | 15pts | TR | TD08 | R309-520-7(1)(l) | Rule requires chlorinator buildings to be
heated, lighted, and ventilated as necessary to assure proper operation of the
equipment and safety of the operators.
C
193 If continuous disinfection is needed, automatic switch over of chlorine cylinders is
provided.
MIN | 15pts | TR | TD01 | R309-520-7(2)(a), R309-520-6(1) | Rule requires automatic
switch over of chlorine cylinders be provided if continuous disinfection is required.
NA (Notes: not required.)
194 Exhaust fan takes suction near the floor as far as practical from the door and air inlet,
and discharges outside away from air inlets.
MIN | 15pts | TR | TD09 | R309-520-7(2)(d)(iii) | Rule requires a chlorine room exhaust
fan to take suction inside the chlorine room near the floor, as far as practical from the
door and air inlet, and discharge air outside of the building away from air inlets.
C
195 Air inlets are located near the ceiling and fitted with louvers.
MIN | 15pts | TR | TD10 | R309-520-7(2)(d)(iv) | Rule requires chlorine room air inlets
to be through wall louvers near the ceiling.
C
196 Chlorine vent line discharges outside and above grade and is screened with #14 mesh
screen.
SIG | 25pts | TR | TD13 | R309-520-7(2)(e) | Rule requires the chlorine vent line to
discharge outside, above grade, at a point least susceptible to vandalism, and to have
the end covered with a #14 mesh non-corrodible screen. This significant deficiency
must be corrected within 120 days of notification or have a corrective action plan
approved by DDW.
C
DEQ | Drinking Water
Run Date: 10/16/2023 19:51:28 | Rating: Approved UTAH02018 MANTUA TOWN WATER SYSTEM page 30 of 32
TP002 - WELL 2 CHLORINATOR -- Liquid Hypochlorination - Active
197 Separate switches for chlorine room fans and lights are located near the entrance to
the room (or are located outside the chlorine room if housed in a water treatment
plant).
MIN | 15pts | TR | TD12 | R309-520-7(2)(d)(v) | Rule requires separate switches for
the chlorine room fans and lights to be located near the entrance to the room and to
be protected from vandalism. The switches are required to be located outside the
chlorine room if housed in a water treatment plant.
C
198 Chlorine cylinder is restrained in position to prevent upset.
SIG | 25pts | TR | TD15 | R309-520-7(2)(h) | Rule requires chlorine cylinders to be
restrained in position to prevent upset. This significant deficiency must be corrected
within 120 days of notification or have a corrective action plan approved by DDW.
C
199 Chlorine cylinder is not stored in direct sunlight or exposed to excessive heat.
SIG | 25pts | TR | TD17 | R309-520-7(2)(f)(ii) | Rule prohibits chlorine cylinders from
being stored in direct sunlight or exposed to excessive heat. This significant deficiency
must be corrected within 120 days of notification or have a corrective action plan
approved by DDW.
C
200 Weight scale is provided for weighing chlorine gas cylinders/containers.
SIG | 25pts | TR | TD02 | R309-520-7(2)(i) | Rule requires scales to be provided for
determining chlorine cylinder weight. This significant deficiency must be corrected
within 120 days of notification or have a corrective action plan approved by DDW.
C
201 Is the chlorine cylinder 150 pounds in capacity? ... if yes, answer the following
question(s)
Y

201A
Leak response/repair plan available
MIN | 15pts | TR | TGR9 | R309-105-7 & 8, R309-100 through 605 | Trigger for
regulatory followup to address concerns.
C

201B
Bottle of ammonium hydroxide (56 % ammonia solution) is available for chlorine leak
detection
MIN | 15pts | TR | TD14 | R309-520-7(2)(l)(i) | Rule requires a bottle of ammonium
hydroxide (56% ammonia solution) to be available for leak detection.
C

201C
Immediate access to NIOSH respirator available
SIG | 25pts | TR | TD04 | R309-520-7(2)(k)(ii) | Where 150 pound chlorine cylinders
are used, a respirator recommended the National Institute of Occupational Safety and
Health must be available. This significant deficiency must be corrected within 120 days
of notification or have a corrective action plan approved by DDW.
C
202 Is the chlorine cylinder 1 ton in capacity? ... if yes, answer the following question(s)N
203 Is the (daily) scale weight or volume data recorded? Explain where in the comments...
SIG | 25pts | TR | TD02 | R309-520-7(2)(i) | Rule requires scales to be provided for
determining chlorine cylinder weight. This significant deficiency must be corrected
within 120 days of notification or have a corrective action plan approved by DDW.
C
204 Is this facility Active or Inactive?A
DEQ | Drinking Water
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205 Operational means provided to avoid injection of significantly decayed hypochlorite,
such as solution strength testing and delivery records
MIN | 5pts | TR | TD68 | R309-520-7(3)(b) | Rule requires the water system to provide
an operational means, such as keeping records of the delivery date of the hypochlorite
solution, to avoid the injection of significantly decayed hypochlorite solutions.
C
206 Solution tank is covered to minimize corrosive vapors
MIN | 5pts | TR | TD64 | R309-525-11(8)(b)(iii) | Chemical solutions shall be kept
covered.
C
207 Where concentrated hypochlorite solutions (5% or greater) are handled in containers
LARGER than 55 gallons: emergency eyewash station and a safety shower present
SIG | 25pts | TR | TD66 | R309-520-7(3)(a)(i) | Where hypochlorite solutions are used
at remote locations or in quantities of 55 gallons or less on site, safety showers are not
required and alternative emergency eyewash may be provided. This significant
deficiency must be corrected within 120 days of notification or have a corrective action
plan approved by DDW.
NA (Notes: Not larger than 55 gallons)
208 Where concentrated hypochlorite solutions are handled in containers of 55 gallons or
LESS: some method of emergency eyewash provided (a full eyewash station and
shower is not required)
SIG | 25pts | TR | TD66 | R309-520-7(3)(a)(i) | Where hypochlorite solutions are used
at remote locations or in quantities of 55 gallons or less on site, safety showers are not
required and alternative emergency eyewash may be provided. This significant
deficiency must be corrected within 120 days of notification or have a corrective action
plan approved by DDW.
C
209 Hypochlorite solution storage area is protected from excessive heat and direct sunlight
MIN | 5pts | TR | TD67 | R309-520-7(3)(a)(ii) | States Storage and injection areas shall
be designed to minimize the decay in strength of concentrated hypochlorite solutions
from excessive heat or direct sunlight.
C
210 Records are kept to minimize the use of decayed hypochlorite solution
MIN | 5pts | TR | TD68 | R309-520-7(3)(b) | Rule requires the water system to provide
an operational means, such as keeping records of the delivery date of the hypochlorite
solution, to avoid the injection of significantly decayed hypochlorite solutions.
C
211 There are adequate spill containment provisions for acid and caustic liquids.
MIN | 15pts | TR | TG59 | R309-525-11(6)(a)(iv)(B), R309-525-11(8)(b)(viii) | Rule
requires liquid chemical storage tanks to have an overflow and receiving basin or drain
capable of receiving accidental spills or overflows, and meeting all the requirements of
R309-525-23.
C
DEQ | Drinking Water
Run Date: 10/16/2023 19:51:28 | Rating: Approved UTAH02018 MANTUA TOWN WATER SYSTEM page 32 of 32