HomeMy WebLinkAboutDDW-2024-010286Utah Department Of Environmental Quality
Division Of Drinking Water Sanitary Survey
Sanitary Survey
General System Information
Exception Granted: 309-550-7(1) | Minimum separation, vertical and horizontal, between culinary water and sanitary sewer pipelines.
Site Visit Date Surveyor Name
08/08/2024 David Heaton
EUREKA TOWN PWS ID: UTAH12004 Rating: Approved 10/02/2019 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: GREG
*Last Name: EVANS
*Organization:
*Address: Redacted
*City: EUREKA
*State: UT
*Zip: 84628
*Email: greg@eurekautah.org
*Phone: 801-608-4518
2 Legal Contact (LC) [ if no eMail address is available, enter NoeMail@utah.gov ]
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: EUREKA TOWN
*Address: PO BOX 156
*City: EUREKA
*State: UT
*Zip: 84628
*Email: eureka15@cut.net
*Phone: 435-433-6915
Emergency Phone: 435-610-6126
DEQ | Drinking Water
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3 Owner Contact (OW) [ if no eMail address is available, enter NoeMail@utah.gov ]
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: EUREKA TOWN
*Address: PO BOX 156
*City: EUREKA
*State: UT
*Zip: 84628
*Email: eureka15@cut.net
*Phone: 435-433-6915
Emergency Phone: 435-610-6126
4 Direct Operator in Charge (DO) [ if no eMail address is available, enter
NoeMail@utah.gov ]
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: JOE P
*Last Name: CARPENTER
*Organization:
*Address: Po Box 217
*City: EUREKA
*State: UT
*Zip: 84628
*Email: joe@eurekautah.org
*Phone: 435-433-6915
Emergency Phone: 801-381-5065
5 Does the system serve a Residential population?Y
5A Population - Residential 760
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 :70 (Notes: Residents of Mammoth, UT
purchase water from this system wholesale.)
9 Residential Connections:345
10 Commercial Connections:28
11 Industrial Connections:0
DEQ | Drinking Water
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Site Visit Info
Management and Operations
12 Agricultural Connections:1
13 Date of Survey (First Day of Field Work)08/08/2024
14 Date of Survey (Last Day of Field Work) ** this should match the Date of Survey in the
header **
08/08/2024
15 Date final report sent to system (questionnaire, deficiency report and capacity
spreadsheet)
08/21/2024
16 Water system representative present during the survey:Joe Carpenter
17 How much time was spent to prepare survey documents prior to field survey? (Round
up to nearest quarter hour)
1 hour.
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)
6 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)
2 hours
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?N
DEQ | Drinking Water
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Cross Connection and Operator Certification
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 your water system have an Emergency Response Plan?
MIN | 15pts | TR | TGR9 | R309-105-7, 8 & 18, R309-100 through 605 | Trigger for
regulatory followup to address concerns.
Y
31A Does your Emergency Response Plan include cybersecurity?
MIN | 15pts | TR | TGR9 | R309-105-7, 8 & 18, R309-100 through 605 | Trigger for
regulatory followup to address concerns.
Y
31B Does your water system use any computers, laptops, phones, tablets, or any other
computer systems to manage, operate, or maintain the PWS (SCADA or Industrial
Control Systems)? This includes any water sources, treatment, distribution or any
process related to operation function
Y
31C Does your water system use any computer systems in regular business operations
such as accounting, billing, payroll, human resources, or management?
Y
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
DEQ | Drinking Water
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General Maintenance and Environment
Distribution
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
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
DEQ | Drinking Water
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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
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
DEQ | Drinking Water
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General Disinfection
WS001 - BLUE ROCK WELL - Active
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
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 Is this facility Active or Inactive?I
50A Explain why this facility is Inactive (Is this facility in stand-by mode?)Facility is not connected to distribution
system. No plans to reconnect.
51 Operating Period (Start Date)01/01
52 Operating Period (Ending Date)12/31
53 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.
NA (Notes: Facility is inactive.)
DEQ | Drinking Water
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54 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.
NA (Notes: Facility is inactive.)
55 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
NA (Notes: Facility is inactive.)
56 Is the well casing vented? ... if yes, answer the following question(s)N
57 Does the well have a pump to waste line? ... if yes, answer the following question(s)N
58 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.
NA (Notes: Facility is inactive.)
59 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.
NA (Notes: Facility is inactive.)
60 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.
NA (Notes: Facility is inactive.)
61 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.
NA (Notes: Facility is inactive.)
62 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 & 18, R309-100 through 605 | Trigger for
regulatory followup to address concerns.
NA (Notes: Facility is inactive.)
DEQ | Drinking Water
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WS002 - EUREKA HILL WELL - Active
63 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)
NA (Notes: Facility is inactive.)
64 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.
NA (Notes: Facility is inactive.)
65 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.
NA (Notes: Facility is inactive.)
66 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.
NA (Notes: Facility is inactive.)
67 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.
NA (Notes: Facility is inactive.)
68 Is there an air/vac valve on the well discharge line? If yes, answer the following
question(s)
N
69 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.
NA (Notes: Facility is inactive.)
70 Does well require oil-lubrication?N
71 Is this facility Active or Inactive?I
71A Explain why this facility is Inactive (Is this facility in stand-by mode?)Facility is not connected to distribution
system. No plans to reconnect.
72 Operating Period (Start Date)01/01
73 Operating Period (Ending Date)12/31
DEQ | Drinking Water
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74 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.
NA (Notes: Facility is inactive.)
75 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.
NA (Notes: Facility is inactive.)
76 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
NA (Notes: Facility is inactive.)
77 Is the well casing vented? ... if yes, answer the following question(s)N
78 Does the well have a pump to waste line? ... if yes, answer the following question(s)N
79 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.
NA (Notes: Facility is inactive.)
80 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.
NA (Notes: Facility is inactive.)
81 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.
NA (Notes: Facility is inactive.)
DEQ | Drinking Water
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WS003 - VULCAN WELL - Active
82 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.
NA (Notes: Facility is inactive.)
83 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 & 18, R309-100 through 605 | Trigger for
regulatory followup to address concerns.
NA (Notes: Facility is inactive.)
84 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)
NA (Notes: Facility is inactive.)
85 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.
NA (Notes: Facility is inactive.)
86 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.
NA (Notes: Facility is inactive.)
87 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.
NA (Notes: Facility is inactive.)
88 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.
NA (Notes: Facility is inactive.)
89 Is there an air/vac valve on the well discharge line? If yes, answer the following
question(s)
N
90 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.
NA (Notes: Facility is inactive.)
91 Does well require oil-lubrication?N
92 Is this facility Active or Inactive?A
DEQ | Drinking Water
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93 Operating Period (Start Date)01/01
94 Operating Period (Ending Date)12/31
95 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
96 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
97 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
D (Notes: Wellhead gasket needs to be
replaced.)
98 Is the well casing vented? ... if yes, answer the following question(s)Y
98A 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
98B 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
98C 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
99 Does the well have a pump to waste line? ... if yes, answer the following question(s)Y
99A 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
DEQ | Drinking Water
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99B 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
99C 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
100 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
101 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
102 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
103 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
104 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 & 18, R309-100 through 605 | Trigger for
regulatory followup to address concerns.
C
105 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
DEQ | Drinking Water
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WS004 - DOLINER WELL #3 -
106 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
107 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
108 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
109 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
110 Is there an air/vac valve on the well discharge line? If yes, answer the following
question(s)
N
111 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
112 Does well require oil-lubrication?N
113 Is this facility Active or Inactive?I
113A
Explain why this facility is Inactive (Is this facility in stand-by mode?)Facility is not connected to distribution
system. No plans to reconnect.
114 Operating Period (Start Date)01/01
115 Operating Period (Ending Date)12/31
116 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.
NA (Notes: Facility is inactive.)
DEQ | Drinking Water
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117 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.
NA (Notes: Facility is inactive.)
118 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
NA (Notes: Facility is inactive.)
119 Is the well casing vented? ... if yes, answer the following question(s)N
120 Does the well have a pump to waste line? ... if yes, answer the following question(s)N
121 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.
NA (Notes: Facility is inactive.)
122 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.
NA (Notes: Facility is inactive.)
123 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.
NA (Notes: Facility is inactive.)
124 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.
NA (Notes: Facility is inactive.)
125 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 & 18, R309-100 through 605 | Trigger for
regulatory followup to address concerns.
NA (Notes: Facility is inactive.)
DEQ | Drinking Water
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WS005 - EAGLE WELL - Active
126 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)
NA (Notes: Facility is inactive.)
127 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.
NA (Notes: Facility is inactive.)
128 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.
NA (Notes: Facility is inactive.)
129 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.
NA (Notes: Facility is inactive.)
130 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.
NA (Notes: Facility is inactive.)
131 Is there an air/vac valve on the well discharge line? If yes, answer the following
question(s)
N
132 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.
NA (Notes: Facility is inactive.)
133 Does well require oil-lubrication?N
134 Is this facility Active or Inactive?I
134A
Explain why this facility is Inactive (Is this facility in stand-by mode?)Facility is not connected to distribution
system. No plans to reconnect.
135 Operating Period (Start Date)01/01
136 Operating Period (Ending Date)12/31
DEQ | Drinking Water
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137 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.
NA (Notes: Facility is inactive.)
138 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.
NA (Notes: Facility is inactive.)
139 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
NA (Notes: Facility is inactive.)
140 Is the well casing vented? ... if yes, answer the following question(s)N
141 Does the well have a pump to waste line? ... if yes, answer the following question(s)N
142 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.
NA (Notes: Facility is inactive.)
143 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.
NA (Notes: Facility is inactive.)
144 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.
NA (Notes: Facility is inactive.)
DEQ | Drinking Water
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WS006 - EUREKA HILL REP WELL -
145 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.
NA (Notes: Facility is inactive.)
146 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 & 18, R309-100 through 605 | Trigger for
regulatory followup to address concerns.
NA (Notes: Facility is inactive.)
147 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)
NA (Notes: Facility is inactive.)
148 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.
NA (Notes: Facility is inactive.)
149 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.
NA (Notes: Facility is inactive.)
150 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.
NA (Notes: Facility is inactive.)
151 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.
NA (Notes: Facility is inactive.)
152 Is there an air/vac valve on the well discharge line? If yes, answer the following
question(s)
N
153 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.
NA (Notes: Facility is inactive.)
154 Does well require oil-lubrication?N
155 Is this facility Active or Inactive?I
DEQ | Drinking Water
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155A
Explain why this facility is Inactive (Is this facility in stand-by mode?)Facility is not connected to distribution
system. No plans to reconnect.
156 Operating Period (Start Date)01/01
157 Operating Period (Ending Date)12/31
158 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.
NA (Notes: Facility is inactive.)
159 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.
NA (Notes: Facility is inactive.)
160 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
NA (Notes: Facility is inactive.)
161 Is the well casing vented? ... if yes, answer the following question(s)N
162 Does the well have a pump to waste line? ... if yes, answer the following question(s)N
163 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.
NA (Notes: Facility is inactive.)
164 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.
NA (Notes: Facility is inactive.)
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165 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.
NA (Notes: Facility is inactive.)
166 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.
NA (Notes: Facility is inactive.)
167 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 & 18, R309-100 through 605 | Trigger for
regulatory followup to address concerns.
NA (Notes: Facility is inactive.)
168 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)
NA (Notes: Facility is inactive.)
169 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.
NA (Notes: Facility is inactive.)
170 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.
NA (Notes: Facility is inactive.)
171 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.
NA (Notes: Facility is inactive.)
172 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.
NA (Notes: Facility is inactive.)
173 Is there an air/vac valve on the well discharge line? If yes, answer the following
question(s)
N
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WS007 - TINTIC JUNCTION WELL 1 -
174 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.
NA (Notes: Facility is inactive.)
175 Does well require oil-lubrication?N
176 Is this facility Active or Inactive?A
177 Operating Period (Start Date)01/01
178 Operating Period (Ending Date)12/31
179 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
180 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
181 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
182 Is the well casing vented? ... if yes, answer the following question(s)Y
182A
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
DEQ | Drinking Water
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182B
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
182C
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
183 Does the well have a pump to waste line? ... if yes, answer the following question(s)Y
183A
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
183B
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
183C
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
184 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
185 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.
D (Notes: Wellhead is out in the open next
to a public access dirt road. It is not inside of
the wellhouse or fenced.)
186 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
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WS008 - TINTIC JUNCTION WELL 2 - Active
187 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
188 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 & 18, R309-100 through 605 | Trigger for
regulatory followup to address concerns.
C
189 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
190 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
191 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
192 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
193 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
194 Is there an air/vac valve on the well discharge line? If yes, answer the following
question(s)
N
195 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
196 Does well require oil-lubrication?N
197 Is this facility Active or Inactive?A
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198 Operating Period (Start Date)01/01
199 Operating Period (Ending Date)12/31
200 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
201 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
202 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
203 Is the well casing vented? ... if yes, answer the following question(s)Y
203A
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
203B
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
203C
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
204 Does the well have a pump to waste line? ... if yes, answer the following question(s)Y
204A
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
DEQ | Drinking Water
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204B
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
204C
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
205 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
206 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
207 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
208 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
209 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 & 18, R309-100 through 605 | Trigger for
regulatory followup to address concerns.
C
210 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
DEQ | Drinking Water
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WS009 - TINTIC JUNCTION WELL #3 - Active
211 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
212 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
213 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
214 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
215 Is there an air/vac valve on the well discharge line? If yes, answer the following
question(s)
N
216 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
217 Does well require oil-lubrication?N
218 Is this facility Active or Inactive?I
218A
Explain why this facility is Inactive (Is this facility in stand-by mode?)Operator believes this well does not exist,
as there are only two Tintic Junction wells.
219 Operating Period (Start Date)01/01
220 Operating Period (Ending Date)12/31
221 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.
NA (Notes: Facility does not exist, or is
inactive.)
DEQ | Drinking Water
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222 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.
NA (Notes: Facility does not exist, or is
inactive.)
223 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
NA (Notes: Facility does not exist, or is
inactive.)
224 Is the well casing vented? ... if yes, answer the following question(s)N
225 Does the well have a pump to waste line? ... if yes, answer the following question(s)N
226 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.
NA (Notes: Facility does not exist, or is
inactive.)
227 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.
NA (Notes: Facility does not exist, or is
inactive.)
228 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.
NA (Notes: Facility does not exist, or is
inactive.)
229 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.
NA (Notes: Facility does not exist, or is
inactive.)
230 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 & 18, R309-100 through 605 | Trigger for
regulatory followup to address concerns.
NA (Notes: Facility does not exist, or is
inactive.)
DEQ | Drinking Water
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ST001 - STORAGE FACILITY ST001 - Active
231 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)
NA (Notes: Facility does not exist, or is
inactive.)
232 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.
NA (Notes: Facility does not exist, or is
inactive.)
233 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.
NA (Notes: Facility does not exist, or is
inactive.)
234 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.
NA (Notes: Facility does not exist, or is
inactive.)
235 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.
NA (Notes: Facility does not exist, or is
inactive.)
236 Is there an air/vac valve on the well discharge line? If yes, answer the following
question(s)
N
237 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.
NA (Notes: Facility does not exist, or is
inactive.)
238 Does well require oil-lubrication?N
239 Is this facility Active or Inactive?A
240 Storage tank capacity in gallons (from SDWIS; if different explain why in the
comments)
500000
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241 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
242 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
243 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
244 Are air vents present? ... if yes, answer the following question(s)Y
244A
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
244B
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
244C
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
244D
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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245 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
245A
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
245B
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
245C
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.
D (Notes: Gasket needs to be replaced.)
246 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
247 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
248 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
249 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
250 Are there cracks in the walls or roof of the storage tank? (if yes, select only one of the
following options)
N
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ST002 - SOUTH TANK - Active
251 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
251A
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
251B
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
251C
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
252 Are the drain line and overflow combined?Y
253 Is this facility Active or Inactive?A
254 Storage tank capacity in gallons (from SDWIS; if different explain why in the
comments)
317238
255 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
256 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
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257 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
258 Are air vents present? ... if yes, answer the following question(s)Y
258A
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
258B
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
258C
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
258D
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
259 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
259A
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
259B
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
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259C
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
260 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
261 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
262 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
263 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
264 Are there cracks in the walls or roof of the storage tank? (if yes, select only one of the
following options)
N
265 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
265A
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
265B
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
DEQ | Drinking Water
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PF002 - SOUTH TANK BOOSTER STATION -- Pump Stations - Active
265C
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
266 Are the drain line and overflow combined?Y
267 Is this facility Active or Inactive?A
268 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.
D (Notes: There are two active pump
stations. The South Tank/Beck Street pump
station (this one) and the Tintic pump
station.)
269 Pump Type (Centrifugal, Hand pump, Jet, Positive Displacement, Screw, Submersible,
Vertical turbine)
Submersible
270 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.
Y
270A
Demand is met by remaining pump(s) when largest pumping unit out of service
SIG | 25pts | PU | PS19 | R309-540-3(a) | Inline booster pumps shall have at least two
pumping units (such that with any one pump out of service, the remaining pump or
pumps shall be capable of providing the peak day demand of the specific portion of
the system serviced). This significant deficiency must be corrected within 120 days of
notification or have a corrective action plan approved by DDW.
C
271 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
272 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
DEQ | Drinking Water
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TP001 - TINTIC WELL GAS CHLORINATOR -- Treatment - Chlorination General - Active
273 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
274 Does the pumping facility have an air relief valve located on the discharge piping? ... if
yes, answer the following question(s)
Y
274A
End of air relief piping downturned
SIG | 25pts | PU | PS12 | R309-550-6(6)(b), R309-540-6(2) | The open end of the air
relief vent pipe from automatic valves shall be provided with a downward elbow. This
significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
C
274B
End of air relief piping covered with #14 mesh screen
SIG | 25pts | PU | PS10 | R309-550-6(6)(b), R309-540-6(2) | The open end of the air
relief vent pipe from automatic valves shall be provided 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
274C
End of air relief piping terminates at least 6 inches above floor
SIG | 25pts | PU | PS11 | R309-550-6(6)(b), R309-540-6(2) | Rule requires that an air
release valve discharge line terminate a minimum of 6 inches above the floor.
C
275 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
276 Is this facility Active or Inactive?A
277 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
278 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.
C
279 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
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280 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
281 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
282 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
283 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.
D (Notes: Operator keeps test equipment on
his truck, but does not have equipment at
each chlorinator.)
284 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
285 Is chlorine chemical dose rate adjusted due to different water demand flow rates
and/or changing water quality?
Y
285A
If yes, which water flow rate is used? e.g. influent flow, effluent flow, filter flow.Influent flow.
286 Is there a designated chlorine Point of Entry (POE) sample location?
MIN | 15pts | TR | TGR9 | R309-105-7, 8 & 18, R309-100 through 605 | Trigger for
regulatory followup to address concerns.
C
287 POE is before first connection/customer?
SIG | 25pts | TR | T028 | R309-215 | R309-215 & R309-520-6(4)(d)
D (Notes: There are five homes that receive
their water before chlorination.)
288 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
288A
System is sampling distribution residuals throughout entire distribution system
MIN | 15pts | TR | TGR9 | R309-105-7, 8 & 18, R309-100 through 605 | Trigger for
regulatory followup to address concerns.
C
288B
Distribution chlorine residuals meet minimum concentration requirement
SIG | 25pts | TR | T028 | R309-215 | R309-215 & R309-520-6(4)(d)
C
288C
"What is the maximum free chlorine residual measure? This value never exceeds 4.0
mg/L? "
MIN | 15pts | TR | TGR9 | R309-105-7, 8 & 18, R309-100 through 605 | Trigger for
regulatory followup to address concerns.
C
DEQ | Drinking Water
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TP003 - VULCAN WELL CHLORINATOR -- Treatment - Chlorination General - Active
288D
System collects at least three distribution chlorine residual samples a week?
MIN | 15pts | TR | TGR9 | R309-105-7, 8 & 18, R309-100 through 605 | Trigger for
regulatory followup to address concerns.
C
288E
System is sampling distribution residuals in accordance with monitoring schedule
MIN | 15pts | TR | TGR9 | R309-105-7, 8 & 18, R309-100 through 605 | Trigger for
regulatory followup to address concerns.
C
289 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 (Notes: Housing and protection from
direct sunlight and excessive heat provided
for chlorination equipment.)
290 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.
D (Notes: Operator currently using a
monthly average for records.)
291 Is this facility Active or Inactive?A
292 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
293 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.
C
294 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
295 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
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296 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
297 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
298 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.
D (Notes: Operator keeps test equipment on
his truck, but does not have equipment at
each chlorinator.)
299 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
300 Is chlorine chemical dose rate adjusted due to different water demand flow rates
and/or changing water quality?
Y
300A
If yes, which water flow rate is used? e.g. influent flow, effluent flow, filter flow.Influent flow.
301 Is there a designated chlorine Point of Entry (POE) sample location?
MIN | 15pts | TR | TGR9 | R309-105-7, 8 & 18, R309-100 through 605 | Trigger for
regulatory followup to address concerns.
C
302 POE is before first connection/customer?
SIG | 25pts | TR | T028 | R309-215 | R309-215 & R309-520-6(4)(d)
C (Notes: There are no connections before
this chlorinator.)
303 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
303A
System is sampling distribution residuals throughout entire distribution system
MIN | 15pts | TR | TGR9 | R309-105-7, 8 & 18, R309-100 through 605 | Trigger for
regulatory followup to address concerns.
C
303B
Distribution chlorine residuals meet minimum concentration requirement
SIG | 25pts | TR | T028 | R309-215 | R309-215 & R309-520-6(4)(d)
C
303C
"What is the maximum free chlorine residual measure? This value never exceeds 4.0
mg/L? "
MIN | 15pts | TR | TGR9 | R309-105-7, 8 & 18, R309-100 through 605 | Trigger for
regulatory followup to address concerns.
C
303D
System collects at least three distribution chlorine residual samples a week?
MIN | 15pts | TR | TGR9 | R309-105-7, 8 & 18, R309-100 through 605 | Trigger for
regulatory followup to address concerns.
C
DEQ | Drinking Water
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TP001 - TINTIC WELL GAS CHLORINATOR -- Gaseous Chlorination - Active
303E
System is sampling distribution residuals in accordance with monitoring schedule
MIN | 15pts | TR | TGR9 | R309-105-7, 8 & 18, R309-100 through 605 | Trigger for
regulatory followup to address concerns.
C
304 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
305 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.
D (Notes: Operator currently using a
monthly average for records.)
306 Is this facility Active or Inactive?A
307 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.
C
308 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
309 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.
C
310 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
311 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
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312 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
313 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
314 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
315 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
316 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
317 Is the chlorine cylinder 150 pounds in capacity? ... if yes, answer the following
question(s)
Y
317A
Leak response/repair plan available
MIN | 15pts | TR | TGR9 | R309-105-7, 8 & 18, R309-100 through 605 | Trigger for
regulatory followup to address concerns.
C
317B
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
317C
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
318 Is the chlorine cylinder 1 ton in capacity? ... if yes, answer the following question(s)N
DEQ | Drinking Water
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TP003 - VULCAN WELL CHLORINATOR -- Gaseous Chlorination - Active
319 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 (Notes: Records in operator Joe
Carpenter's office.)
320 Is this facility Active or Inactive?A
321 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.
C
322 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
323 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.
C
324 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
325 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
326 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
327 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
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328 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
329 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
330 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
331 Is the chlorine cylinder 150 pounds in capacity? ... if yes, answer the following
question(s)
Y
331A
Leak response/repair plan available
MIN | 15pts | TR | TGR9 | R309-105-7, 8 & 18, R309-100 through 605 | Trigger for
regulatory followup to address concerns.
C
331B
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
331C
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
332 Is the chlorine cylinder 1 ton in capacity? ... if yes, answer the following question(s)N
333 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 (Notes: Records in operator Joe
Carpenter's office.)
DEQ | Drinking Water
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