DDW-2024-012765

Utah Department Of Environmental Quality
Division Of Drinking Water Sanitary Survey
Sanitary Survey
General System Information
Exception Granted: N/A | N/A
Exception Granted: R309-600-11 | Private residence and septic tank is located within isolation zone.

Site Visit Date Surveyor Name
09/30/2024 Angela Jones
SOUTH DAVIS WATER
DISTRICT
PWS ID: UTAH06009 Rating: Approved 10/10/2018 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: JAKE MICHAEL
*Last Name: FERGUSON
*Organization:
*Address: Redacted
*City: BOUNTIFUL
*State: UT
*Zip: 84010
*Email: [e-mail]
*Phone: [phone]
2 Legal Contact (LC) [ if no eMail address is available, enter [e-mail] ]
MIN | 15pts | SM | G004 | R309-100-4(5) | Rule requires a person or organization be
designated as the owner of the system and name, address and phone number of such
be supplied to the Division.
*First Name:
*Last Name:
*Organization: SOUTH DAVIS COUNTY
WATER DISTRICT
*Address: PO BOX 140110
*City: SALT LAKE CITY
*State: UT
*Zip: 84114-0110
*Email: [e-mail]
*Phone: [phone]
DEQ | Drinking Water
Run Date: 10/30/2024 17:02:50 | Rating: Approved UTAH06009 SOUTH DAVIS WATER DISTRICT page 1 of 63
Site Visit Info
3 Owner Contact (OW) [ if no eMail address is available, enter [e-mail] ]
MIN | 15pts | SM | G004 | R309-100-4(5) | Rule requires a person or organization be
designated as the owner of the system and name, address and phone number of such
be supplied to the Division.
*First Name:
*Last Name:
*Organization: SOUTH DAVIS COUNTY
WATER DISTRICT
*Address: PO BOX 140110
*City: SALT LAKE CITY
*State: UT
*Zip: 84114-0110
*Email: [e-mail]
*Phone: [phone]
4 Direct Operator in Charge (DO) [ if no eMail address is available, enter
[e-mail] ]
MIN | 15pts | SM | G004 | R309-100-4(5) | Rule requires a person or organization be
designated as the owner of the system and name, address and phone number of such
be supplied to the Division.
*First Name: JAKE MICHAEL
*Last Name: FERGUSON
*Organization:
*Address: 2099 S 850 E
*City: BOUNTIFUL
*State: UT
*Zip: 84010
*Email: [e-mail]
*Phone: [phone]
5 Does the system serve a Residential population?Y
5A Population - Residential 10565
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 :43893
9 Residential Connections:3122
10 Commercial Connections:119
11 Industrial Connections:0
12 Agricultural Connections:0
DEQ | Drinking Water
Run Date: 10/30/2024 17:02:50 | Rating: Approved UTAH06009 SOUTH DAVIS WATER DISTRICT page 2 of 63
Management and Operations
13 Date of Survey (First Day of Field Work)09/30/2024
14 Date of Survey (Last Day of Field Work) ** this should match the Date of Survey in the
header **
09/30/2024
15 Date final report sent to system (questionnaire, deficiency report and capacity
spreadsheet)
10/30/2024
16 Water system representative present during the survey:Bill Davis (Notes: Jake Ferguson)
17 How much time was spent to prepare survey documents prior to field survey? (Round
up to nearest quarter hour)
1
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
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)
1
20 How much time did it take to finish the Survey Report? (Round up to nearest quarter
hour)
4
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
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
DEQ | Drinking Water
Run Date: 10/30/2024 17:02:50 | Rating: Approved UTAH06009 SOUTH DAVIS WATER DISTRICT page 3 of 63
Cross Connection and Operator Certification
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?
REC | 0pts | SM | M001 | R309-105-18 | All suppliers are advised to develop
contingency plans to cope with possible emergency situations. In many areas of the
state the possibility of earthquake damage shall be realistically considered.
Y
32 Does your Emergency Response Plan address cybersecurity? (required for systems
over 3,300 population)
MIN | 15pts | TR | TGR9 | R309-105-7, 8 & 18, R309-100 through 605 | Trigger for
regulatory followup to address concerns.
Y
33 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
N
34 Does your water system use any computer systems in regular business operations
such as accounting, billing, payroll, human resources, or management?
Y
35 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
36 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
37 Documentation of personnel trained to manage the program (ALL COMUNITY
WATER SYSTEMS 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
38 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
DEQ | Drinking Water
Run Date: 10/30/2024 17:02:50 | Rating: Approved UTAH06009 SOUTH DAVIS WATER DISTRICT page 4 of 63
General Maintenance and Environment
Distribution
39 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
40 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
41 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
42 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
43 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
44 Are air release/vacuum valves in the distribution system? ... if yes, answer the
following question(s)
N
45 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
DEQ | Drinking Water
Run Date: 10/30/2024 17:02:50 | Rating: Approved UTAH06009 SOUTH DAVIS WATER DISTRICT page 5 of 63
General Disinfection
ST004 - VAL VISTA HOLDING TANK ABANDONED - Inactive (AB - ABANDONED)
46 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
47 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
48 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
49 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
50 Was the water system constructed or new portions added after January 1, 2007? ... if
yes, answer the following question(s)
Y
50A 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
51 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
52 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
DEQ | Drinking Water
Run Date: 10/30/2024 17:02:50 | Rating: Approved UTAH06009 SOUTH DAVIS WATER DISTRICT page 6 of 63
ST005 - ODELL RESERVOIR - Inactive (AB - ABANDONED)
ST006 - 4A RESERVOIR - Inactive (AB - ABANDONED)
ST007 - STORAGE FACILITY ST007 - Inactive (AB - ABANDONED)
TP001 - ODELL SPRING CHLORINATOR-FLUORIDATOR - Inactive (AB - ABANDONED)
WS001 - DAGO SPRING -
53 Does the water system still have physical access to this facility? Y/N Guidance:
Answer NO if sold and no longer have security access or the facility is demolished and
can not be inspected.
N
54 Does the water system still have physical access to this facility? Y/N Guidance:
Answer NO if sold and no longer have security access or the facility is demolished and
can not be inspected.
N
55 Does the water system still have physical access to this facility? Y/N Guidance:
Answer NO if sold and no longer have security access or the facility is demolished and
can not be inspected.
N
56 Does the water system still have physical access to this facility? Y/N Guidance:
Answer NO if sold and no longer have security access or the facility is demolished and
can not be inspected.
N (Notes: Demolished)
57 Does the water system still have physical access to this facility? Y/N Guidance:
Answer NO if sold and no longer have security access or the facility is demolished and
can not be inspected.
N
58 Is this facility Active or Inactive? (Active status means used on a routine/seasonal
basis without long periods of inactivity and water quality samples are routinely
collected))
I
58A Explain why this facility is Inactive (Is this facility in stand-by mode and not used
regularly, has not been used for multiple years, does it have known water quality
concerns?)
Not connected to drinking water system.
Used for secondary water only.
59 Operating Period (Start Date)01/01
60 Operating Period (End Date)12/31
61 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
62 Area of equal or higher elevation within 50 feet of spring collection devices is fenced.
MIN | 15pts | SO | SS02 | R309-515-7(7)(e) | Rule requires a stock-tight fence around
the spring collection area.
D (Notes: Did not see the spring.)
63 Surface water runoff diverted away from spring by diversion channel or berm.
MIN | 15pts | SO | SS03 | R309-515-7(7)(g) | Rule requires a diversion channel or
berm, constructed immediately inside the fenced area, capable of diverting all
anticipated surface water runoff away from the spring collection area.
D (Notes: Did not see the spring.)
64 Spring box has a means to release overflow?
MIN | 15pts | SO | SS23 | R309-515-7(7)(d), R309-545-13(1) | All junction boxes and
collection boxes, must comply with R309-545 with respect to access openings,
venting, and tank overflow. Lids for these spring boxes shall be gasketed and the box
adequately vented.
N (Notes: Did not see the spring.)
DEQ | Drinking Water
Run Date: 10/30/2024 17:02:50 | Rating: Approved UTAH06009 SOUTH DAVIS WATER DISTRICT page 7 of 63
WS002 - COOPER SPRING -
65 Drain has minimum of 12 inch clearance above flood rim of receiving basin
SIG | 25pts | SO | SS14 | R309-515-7(7)(d), R309-545 | Overflow pipes on junction
and collection boxes shall comply with R309-545 and discharge a minimum of 12
inches above the ground surface or rim of the receiving basin. This significant
deficiency must be corrected within 120 days of notification or have a corrective action
plan approved by DDW.
D (Notes: Did not see the spring.)
66 Spring collection area graded and no evidence of water ponding or flow on surface?
SIG | 25pts | SO | SS06 | R309-515-7(7)(i) | Rule requires the spring to be developed
as thoroughly as possible to minimize the possibility of excess water ponding within
the collection area. This significant deficiency must be corrected within 120 days of
notification or have a corrective action plan approved by DDW.
D (Notes: Did not see the spring.)
67 If a liner is present, spring liner integrity is maintained.
SIG | 50pts | SO | SS19 | R309-515-7(7)(b)(iv) | If a liner is present, it shall be installed
to assure its integrity. No sharp-edged stones or stones two inches or larger shall be
located within two inches of the liner. This significant deficiency must be corrected
within 120 days of notification or have a corrective action plan approved by DDW.
D (Notes: Did not see the spring.)
68 No deep-rooted vegetation is within the 50 ft collection area.
SIG | 25pts | SO | SS07 | R309-515-7(7)(f) | All deep-rooted vegetation within the
fenced collection area shall be removed by a means not negatively affecting water
quality. This significant deficiency must be corrected within 120 days of notification or
have a corrective action plan approved by DDW.
D (Notes: Did not see the spring.)
69 No roots seen in collection boxes and junctions.
SIG | 25pts | SO | SS08 | R309-105-10(4)(a), R309-515-8(1)(a) | Spring collection
areas shall be periodically (preferably annually) cleared of deep-rooted vegetation to
prevent root growth from clogging collection lines. This significant deficiency must be
corrected within 120 days of notification or have a corrective action plan approved by
DDW.
D (Notes: Did not see the spring.)
70 Is a spring collection box present? ... if yes, answer the following question(s)
MIN | 5pts | SO | L014 | R309-515-7(7)(c) | Rule requires each spring collection area
to be provided with at least one collection box to permit spring inspection and testing.
N (Notes: Did not see the spring.)
71 Is a spring box vent present? ... if yes, answer the following question(s)
MIN | 5pts | SO | SS11 | R309-515-7(7)(d), R309-545-15 | Rule requires junction
boxes and collection boxes to comply with R309-545 with respect to venting.
Therefore, a junction or collection box requires a vent to be fitted with #14 mesh or
finer non-corrodible screen, be fitted with a protective heavy-gauge screen or covering
if 6 inches in diameter or greater, be down-turned and shielded to prevent the
entrance of contaminants, be located and sized to avoid blockage during winter, and
have the end of the vent discharge a minimum of 24 inches above the earth on buried
structures.
N (Notes: Did not see the spring.)
72 Spring has a permanent flow-measuring device.
MIN | 5pts | SO | SS01 | R309-515-7(7)(h) | Rule requires a spring to have a
permanent flow measuring device.
D (Notes: Did not see the spring.)
DEQ | Drinking Water
Run Date: 10/30/2024 17:02:50 | Rating: Approved UTAH06009 SOUTH DAVIS WATER DISTRICT page 8 of 63
73 Is this facility Active or Inactive? (Active status means used on a routine/seasonal
basis without long periods of inactivity and water quality samples are routinely
collected))
I
73A Explain why this facility is Inactive (Is this facility in stand-by mode and not used
regularly, has not been used for multiple years, does it have known water quality
concerns?)
The spring has been disconnected from the
drinking water system and is used for
irrigation only.
74 Operating Period (Start Date)01/01
75 Operating Period (End Date)12/31
76 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
77 Area of equal or higher elevation within 50 feet of spring collection devices is fenced.
MIN | 15pts | SO | SS02 | R309-515-7(7)(e) | Rule requires a stock-tight fence around
the spring collection area.
D (Notes: Did not see the spring)
78 Surface water runoff diverted away from spring by diversion channel or berm.
MIN | 15pts | SO | SS03 | R309-515-7(7)(g) | Rule requires a diversion channel or
berm, constructed immediately inside the fenced area, capable of diverting all
anticipated surface water runoff away from the spring collection area.
D (Notes: Did not see the spring)
79 Spring box has a means to release overflow?
MIN | 15pts | SO | SS23 | R309-515-7(7)(d), R309-545-13(1) | All junction boxes and
collection boxes, must comply with R309-545 with respect to access openings,
venting, and tank overflow. Lids for these spring boxes shall be gasketed and the box
adequately vented.
N (Notes: Did not see the spring)
80 Drain has minimum of 12 inch clearance above flood rim of receiving basin
SIG | 25pts | SO | SS14 | R309-515-7(7)(d), R309-545 | Overflow pipes on junction
and collection boxes shall comply with R309-545 and discharge a minimum of 12
inches above the ground surface or rim of the receiving basin. This significant
deficiency must be corrected within 120 days of notification or have a corrective action
plan approved by DDW.
D (Notes: Did not see the spring)
81 Spring collection area graded and no evidence of water ponding or flow on surface?
SIG | 25pts | SO | SS06 | R309-515-7(7)(i) | Rule requires the spring to be developed
as thoroughly as possible to minimize the possibility of excess water ponding within
the collection area. This significant deficiency must be corrected within 120 days of
notification or have a corrective action plan approved by DDW.
D (Notes: Did not see the spring)
82 If a liner is present, spring liner integrity is maintained.
SIG | 50pts | SO | SS19 | R309-515-7(7)(b)(iv) | If a liner is present, it shall be installed
to assure its integrity. No sharp-edged stones or stones two inches or larger shall be
located within two inches of the liner. This significant deficiency must be corrected
within 120 days of notification or have a corrective action plan approved by DDW.
D (Notes: Did not see the spring)
DEQ | Drinking Water
Run Date: 10/30/2024 17:02:50 | Rating: Approved UTAH06009 SOUTH DAVIS WATER DISTRICT page 9 of 63
WS003 - ODELL SPRING -
83 No deep-rooted vegetation is within the 50 ft collection area.
SIG | 25pts | SO | SS07 | R309-515-7(7)(f) | All deep-rooted vegetation within the
fenced collection area shall be removed by a means not negatively affecting water
quality. This significant deficiency must be corrected within 120 days of notification or
have a corrective action plan approved by DDW.
D (Notes: Did not see the spring)
84 No roots seen in collection boxes and junctions.
SIG | 25pts | SO | SS08 | R309-105-10(4)(a), R309-515-8(1)(a) | Spring collection
areas shall be periodically (preferably annually) cleared of deep-rooted vegetation to
prevent root growth from clogging collection lines. This significant deficiency must be
corrected within 120 days of notification or have a corrective action plan approved by
DDW.
D (Notes: Did not see the spring)
85 Is a spring collection box present? ... if yes, answer the following question(s)
MIN | 5pts | SO | L014 | R309-515-7(7)(c) | Rule requires each spring collection area
to be provided with at least one collection box to permit spring inspection and testing.
N (Notes: Did not see the spring)
86 Is a spring box vent present? ... if yes, answer the following question(s)
MIN | 5pts | SO | SS11 | R309-515-7(7)(d), R309-545-15 | Rule requires junction
boxes and collection boxes to comply with R309-545 with respect to venting.
Therefore, a junction or collection box requires a vent to be fitted with #14 mesh or
finer non-corrodible screen, be fitted with a protective heavy-gauge screen or covering
if 6 inches in diameter or greater, be down-turned and shielded to prevent the
entrance of contaminants, be located and sized to avoid blockage during winter, and
have the end of the vent discharge a minimum of 24 inches above the earth on buried
structures.
N (Notes: Did not see the spring)
87 Spring has a permanent flow-measuring device.
MIN | 5pts | SO | SS01 | R309-515-7(7)(h) | Rule requires a spring to have a
permanent flow measuring device.
D (Notes: Did not see the spring)
88 Is this facility Active or Inactive? (Active status means used on a routine/seasonal
basis without long periods of inactivity and water quality samples are routinely
collected))
I
88A Explain why this facility is Inactive (Is this facility in stand-by mode and not used
regularly, has not been used for multiple years, does it have known water quality
concerns?)
The spring has been disconnected from the
drinking water system and is used for
irrigation only.
89 Operating Period (Start Date)01/01
90 Operating Period (End Date)12/31
91 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
DEQ | Drinking Water
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92 Area of equal or higher elevation within 50 feet of spring collection devices is fenced.
MIN | 15pts | SO | SS02 | R309-515-7(7)(e) | Rule requires a stock-tight fence around
the spring collection area.
D (Notes: Did not see the spring)
93 Surface water runoff diverted away from spring by diversion channel or berm.
MIN | 15pts | SO | SS03 | R309-515-7(7)(g) | Rule requires a diversion channel or
berm, constructed immediately inside the fenced area, capable of diverting all
anticipated surface water runoff away from the spring collection area.
D (Notes: Did not see the spring)
94 Spring box has a means to release overflow?
MIN | 15pts | SO | SS23 | R309-515-7(7)(d), R309-545-13(1) | All junction boxes and
collection boxes, must comply with R309-545 with respect to access openings,
venting, and tank overflow. Lids for these spring boxes shall be gasketed and the box
adequately vented.
N (Notes: Did not see the spring)
95 Drain has minimum of 12 inch clearance above flood rim of receiving basin
SIG | 25pts | SO | SS14 | R309-515-7(7)(d), R309-545 | Overflow pipes on junction
and collection boxes shall comply with R309-545 and discharge a minimum of 12
inches above the ground surface or rim of the receiving basin. This significant
deficiency must be corrected within 120 days of notification or have a corrective action
plan approved by DDW.
D (Notes: Did not see the spring)
96 Spring collection area graded and no evidence of water ponding or flow on surface?
SIG | 25pts | SO | SS06 | R309-515-7(7)(i) | Rule requires the spring to be developed
as thoroughly as possible to minimize the possibility of excess water ponding within
the collection area. This significant deficiency must be corrected within 120 days of
notification or have a corrective action plan approved by DDW.
D (Notes: Did not see the spring)
97 If a liner is present, spring liner integrity is maintained.
SIG | 50pts | SO | SS19 | R309-515-7(7)(b)(iv) | If a liner is present, it shall be installed
to assure its integrity. No sharp-edged stones or stones two inches or larger shall be
located within two inches of the liner. This significant deficiency must be corrected
within 120 days of notification or have a corrective action plan approved by DDW.
D (Notes: Did not see the spring)
98 No deep-rooted vegetation is within the 50 ft collection area.
SIG | 25pts | SO | SS07 | R309-515-7(7)(f) | All deep-rooted vegetation within the
fenced collection area shall be removed by a means not negatively affecting water
quality. This significant deficiency must be corrected within 120 days of notification or
have a corrective action plan approved by DDW.
D (Notes: Did not see the spring)
99 No roots seen in collection boxes and junctions.
SIG | 25pts | SO | SS08 | R309-105-10(4)(a), R309-515-8(1)(a) | Spring collection
areas shall be periodically (preferably annually) cleared of deep-rooted vegetation to
prevent root growth from clogging collection lines. This significant deficiency must be
corrected within 120 days of notification or have a corrective action plan approved by
DDW.
D (Notes: Did not see the spring)
100 Is a spring collection box present? ... if yes, answer the following question(s)
MIN | 5pts | SO | L014 | R309-515-7(7)(c) | Rule requires each spring collection area
to be provided with at least one collection box to permit spring inspection and testing.
N (Notes: Did not see the spring)
DEQ | Drinking Water
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WS004 - ENOCH SPRING - Active
101 Is a spring box vent present? ... if yes, answer the following question(s)
MIN | 5pts | SO | SS11 | R309-515-7(7)(d), R309-545-15 | Rule requires junction
boxes and collection boxes to comply with R309-545 with respect to venting.
Therefore, a junction or collection box requires a vent to be fitted with #14 mesh or
finer non-corrodible screen, be fitted with a protective heavy-gauge screen or covering
if 6 inches in diameter or greater, be down-turned and shielded to prevent the
entrance of contaminants, be located and sized to avoid blockage during winter, and
have the end of the vent discharge a minimum of 24 inches above the earth on buried
structures.
N (Notes: Did not see the spring)
102 Spring has a permanent flow-measuring device.
MIN | 5pts | SO | SS01 | R309-515-7(7)(h) | Rule requires a spring to have a
permanent flow measuring device.
D (Notes: Did not see the spring)
103 Is this facility Active or Inactive? (Active status means used on a routine/seasonal
basis without long periods of inactivity and water quality samples are routinely
collected))
A
104 Operating Period (Start Date)01/01
105 Operating Period (End Date)12/31
106 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
107 Area of equal or higher elevation within 50 feet of spring collection devices is fenced.
MIN | 15pts | SO | SS02 | R309-515-7(7)(e) | Rule requires a stock-tight fence around
the spring collection area.
C
108 Surface water runoff diverted away from spring by diversion channel or berm.
MIN | 15pts | SO | SS03 | R309-515-7(7)(g) | Rule requires a diversion channel or
berm, constructed immediately inside the fenced area, capable of diverting all
anticipated surface water runoff away from the spring collection area.
C
109 Spring box has a means to release overflow?
MIN | 15pts | SO | SS23 | R309-515-7(7)(d), R309-545-13(1) | All junction boxes and
collection boxes, must comply with R309-545 with respect to access openings,
venting, and tank overflow. Lids for these spring boxes shall be gasketed and the box
adequately vented.
Y

109A Overflow screened with #4 mesh screen
SIG | 25pts | SO | SS04 | R309-515-7(7)(d), R309-545-13(3) | Overflow pipes on
junction and collection boxes shall comply with R309-545 and be screened with No. 4
mesh non-corrodible screens. This significant deficiency must be corrected within 120
days of notification or have a corrective action plan approved by DDW.
C
DEQ | Drinking Water
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109B Overflow has a minimum of 12 inch clearance above flood rim of receiving basin
SIG | 25pts | SO | SS14 | R309-515-7(7)(d), R309-545 | Overflow pipes on junction
and collection boxes shall comply with R309-545 and discharge a minimum of 12
inches above the ground surface or rim of the receiving basin. This significant
deficiency must be corrected within 120 days of notification or have a corrective action
plan approved by DDW.
C
110 Drain has minimum of 12 inch clearance above flood rim of receiving basin
SIG | 25pts | SO | SS14 | R309-515-7(7)(d), R309-545 | Overflow pipes on junction
and collection boxes shall comply with R309-545 and discharge a minimum of 12
inches above the ground surface or rim of the receiving basin. This significant
deficiency must be corrected within 120 days of notification or have a corrective action
plan approved by DDW.
C
111 Spring collection area graded and no evidence of water ponding or flow on surface?
SIG | 25pts | SO | SS06 | R309-515-7(7)(i) | Rule requires the spring to be developed
as thoroughly as possible to minimize the possibility of excess water ponding within
the collection area. This significant deficiency must be corrected within 120 days of
notification or have a corrective action plan approved by DDW.
C
112 If a liner is present, spring liner integrity is maintained.
SIG | 50pts | SO | SS19 | R309-515-7(7)(b)(iv) | If a liner is present, it shall be installed
to assure its integrity. No sharp-edged stones or stones two inches or larger shall be
located within two inches of the liner. This significant deficiency must be corrected
within 120 days of notification or have a corrective action plan approved by DDW.
C
113 No deep-rooted vegetation is within the 50 ft collection area.
SIG | 25pts | SO | SS07 | R309-515-7(7)(f) | All deep-rooted vegetation within the
fenced collection area shall be removed by a means not negatively affecting water
quality. This significant deficiency must be corrected within 120 days of notification or
have a corrective action plan approved by DDW.
C
114 No roots seen in collection boxes and junctions.
SIG | 25pts | SO | SS08 | R309-105-10(4)(a), R309-515-8(1)(a) | Spring collection
areas shall be periodically (preferably annually) cleared of deep-rooted vegetation to
prevent root growth from clogging collection lines. This significant deficiency must be
corrected within 120 days of notification or have a corrective action plan approved by
DDW.
NA (Notes: Spring does not have a
collection box)
115 Is a spring collection box present? ... if yes, answer the following question(s)
MIN | 5pts | SO | L014 | R309-515-7(7)(c) | Rule requires each spring collection area
to be provided with at least one collection box to permit spring inspection and testing.
N (Notes: Spring does not have a collection
box)
DEQ | Drinking Water
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WS005 - VAL VISTA WELL 1 - Active
116 Is a spring box vent present? ... if yes, answer the following question(s)
MIN | 5pts | SO | SS11 | R309-515-7(7)(d), R309-545-15 | Rule requires junction
boxes and collection boxes to comply with R309-545 with respect to venting.
Therefore, a junction or collection box requires a vent to be fitted with #14 mesh or
finer non-corrodible screen, be fitted with a protective heavy-gauge screen or covering
if 6 inches in diameter or greater, be down-turned and shielded to prevent the
entrance of contaminants, be located and sized to avoid blockage during winter, and
have the end of the vent discharge a minimum of 24 inches above the earth on buried
structures.
N (Notes: Spring does not have a collection
box)
117 Spring has a permanent flow-measuring device.
MIN | 5pts | SO | SS01 | R309-515-7(7)(h) | Rule requires a spring to have a
permanent flow measuring device.
C
118 Is this facility Active or Inactive?A
119 Operating Period (Start Date)01/01
120 Operating Period (Ending Date)12/31
121 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
122 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
123 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
124 Is the well casing vented? ... if yes, answer the following question(s)N
125 Does the well have a pump to waste line? ... if yes, answer the following question(s)N
DEQ | Drinking Water
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126 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
127 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
128 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
129 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
130 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
131 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
132 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
133 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
134 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
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WS006 - VAL VISTA WELL 2 - Active
135 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
136 Is there an air/vac valve on the well discharge line? If yes, answer the following
question(s)
Y

136A Air vacuum relief valve on well discharge piping downturned
SIG | 25pts | SO | S028 | R309-515-6(12)(d)(v) | Rule requires the exhaust/relief piping
on an air release/vacuum relief valve on the well discharge piping to be down-turned.
This significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
C

136B Air vacuum relief valve on well discharge piping screened with #14 mesh screen
SIG | 25pts | SO | S029 | R309-515-6(12)(d)(v) | Rule requires the exhaust/relief piping
on an air release/vacuum relief valve on the well discharge piping to be covered with a
#14 mesh corrosion-resistant screen. This significant deficiency must be corrected
within 120 days of notification or have a corrective action plan approved by DDW.
C

136C Air vacuum relief valve on well discharge piping has at least 6 inches of clearance
above floor
SIG | 25pts | SO | S030 | R309-515-6(12)(d)(v) | Rule requires the exhaust/relief piping
on an air release/vacuum relief valve on the well discharge piping to be at least 6
inches above the well house floor. This significant deficiency must be corrected within
120 days of notification or have a corrective action plan approved by DDW.
C
137 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: Does not pump directly to
distribution.)
138 Does well require oil-lubrication?N
139 Is this facility Active or Inactive?A
140 Operating Period (Start Date)01/01
141 Operating Period (Ending Date)12/31
142 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
DEQ | Drinking Water
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143 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
144 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
145 Is the well casing vented? ... if yes, answer the following question(s)N
146 Does the well have a pump to waste line? ... if yes, answer the following question(s)N
147 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
148 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
149 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
150 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
151 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
DEQ | Drinking Water
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WS007 - VAL VISTA WELL 3 - Active
Exception Granted: R309-105-10(1) | We understand that the project will utilize chemical and mechanical cleaning
of accumulated scale from the casing and screened areas of the well. We
further understand that some of the chemicals you wish to use are
individually certified to NSF Standard 6

152 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
153 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
154 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
155 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
156 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
157 Is there an air/vac valve on the well discharge line? If yes, answer the following
question(s)
N
158 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: Does not pump directly to
distribution.)
159 Does well require oil-lubrication?N
160 Is this facility Active or Inactive?A
161 Operating Period (Start Date)01/01
162 Operating Period (Ending Date)12/31
DEQ | Drinking Water
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163 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
164 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.
D (Notes: Less than 12 inches from the
floor.)
165 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
166 Is the well casing vented? ... if yes, answer the following question(s)Y

166A 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

166B 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

166C 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
167 Does the well have a pump to waste line? ... if yes, answer the following question(s)N
168 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
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169 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
170 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
171 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
172 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
173 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)
D (Notes: No sampling tap near well head.)
174 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
175 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.
D (Notes: No pressure gauge on discharge
line)
176 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
177 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
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WS008 - BONA VISTA WELL - Active
178 Is there an air/vac valve on the well discharge line? If yes, answer the following
question(s)
Y

178A Air vacuum relief valve on well discharge piping downturned
SIG | 25pts | SO | S028 | R309-515-6(12)(d)(v) | Rule requires the exhaust/relief piping
on an air release/vacuum relief valve on the well discharge piping to be down-turned.
This significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
C

178B Air vacuum relief valve on well discharge piping screened with #14 mesh screen
SIG | 25pts | SO | S029 | R309-515-6(12)(d)(v) | Rule requires the exhaust/relief piping
on an air release/vacuum relief valve on the well discharge piping to be covered with a
#14 mesh corrosion-resistant screen. This significant deficiency must be corrected
within 120 days of notification or have a corrective action plan approved by DDW.
C

178C Air vacuum relief valve on well discharge piping has at least 6 inches of clearance
above floor
SIG | 25pts | SO | S030 | R309-515-6(12)(d)(v) | Rule requires the exhaust/relief piping
on an air release/vacuum relief valve on the well discharge piping to be at least 6
inches above the well house floor. This significant deficiency must be corrected within
120 days of notification or have a corrective action plan approved by DDW.
C
179 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: Does not pump directly to
distribution.)
180 Does well require oil-lubrication?N
181 Is this facility Active or Inactive?A
182 Operating Period (Start Date)01/01
183 Operating Period (Ending Date)12/31
184 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
DEQ | Drinking Water
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185 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
186 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
187 Is the well casing vented? ... if yes, answer the following question(s)N
188 Does the well have a pump to waste line? ... if yes, answer the following question(s)N
189 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
190 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
191 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
192 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
193 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
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194 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
195 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
196 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.
D (Notes: No pressure gauge)
197 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
198 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
199 Is there an air/vac valve on the well discharge line? If yes, answer the following
question(s)
Y

199A Air vacuum relief valve on well discharge piping downturned
SIG | 25pts | SO | S028 | R309-515-6(12)(d)(v) | Rule requires the exhaust/relief piping
on an air release/vacuum relief valve on the well discharge piping to be down-turned.
This significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
C

199B Air vacuum relief valve on well discharge piping screened with #14 mesh screen
SIG | 25pts | SO | S029 | R309-515-6(12)(d)(v) | Rule requires the exhaust/relief piping
on an air release/vacuum relief valve on the well discharge piping to be covered with a
#14 mesh corrosion-resistant screen. This significant deficiency must be corrected
within 120 days of notification or have a corrective action plan approved by DDW.
C

199C Air vacuum relief valve on well discharge piping has at least 6 inches of clearance
above floor
SIG | 25pts | SO | S030 | R309-515-6(12)(d)(v) | Rule requires the exhaust/relief piping
on an air release/vacuum relief valve on the well discharge piping to be at least 6
inches above the well house floor. This significant deficiency must be corrected within
120 days of notification or have a corrective action plan approved by DDW.
C
DEQ | Drinking Water
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WS009 - VAL VERDA WELL -
200 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: Does not pump directly to
distribution.)
201 Does well require oil-lubrication?N
202 Is this facility Active or Inactive?A
203 Operating Period (Start Date)01/01
204 Operating Period (Ending Date)12/31
205 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
206 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
207 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
208 Is the well casing vented? ... if yes, answer the following question(s)Y

208A 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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208B 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

208C 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
209 Does the well have a pump to waste line? ... if yes, answer the following question(s)Y

209A 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

209B 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

209C 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
210 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
211 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
212 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
DEQ | Drinking Water
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213 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
214 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
215 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
216 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
217 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
218 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
219 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
220 Is there an air/vac valve on the well discharge line? If yes, answer the following
question(s)
Y

220A Air vacuum relief valve on well discharge piping downturned
SIG | 25pts | SO | S028 | R309-515-6(12)(d)(v) | Rule requires the exhaust/relief piping
on an air release/vacuum relief valve on the well discharge piping to be down-turned.
This significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
C

220B Air vacuum relief valve on well discharge piping screened with #14 mesh screen
SIG | 25pts | SO | S029 | R309-515-6(12)(d)(v) | Rule requires the exhaust/relief piping
on an air release/vacuum relief valve on the well discharge piping to be covered with a
#14 mesh corrosion-resistant screen. This significant deficiency must be corrected
within 120 days of notification or have a corrective action plan approved by DDW.
D (Notes: Missing screen)
DEQ | Drinking Water
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WS011 - NORTH CANYON WELL - Active

220C Air vacuum relief valve on well discharge piping has at least 6 inches of clearance
above floor
SIG | 25pts | SO | S030 | R309-515-6(12)(d)(v) | Rule requires the exhaust/relief piping
on an air release/vacuum relief valve on the well discharge piping to be at least 6
inches above the well house floor. This significant deficiency must be corrected within
120 days of notification or have a corrective action plan approved by DDW.
C
221 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
222 Does well require oil-lubrication?N
223 Is this facility Active or Inactive?A
224 Operating Period (Start Date)01/01
225 Operating Period (Ending Date)12/31
226 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
227 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
228 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
229 Is the well casing vented? ... if yes, answer the following question(s)N
230 Does the well have a pump to waste line? ... if yes, answer the following question(s)N
DEQ | Drinking Water
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231 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
232 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
233 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
234 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
235 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
236 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
237 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
238 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
239 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
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ST001 - 1A RESERVOIR - Active
240 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
241 Is there an air/vac valve on the well discharge line? If yes, answer the following
question(s)
Y

241A Air vacuum relief valve on well discharge piping downturned
SIG | 25pts | SO | S028 | R309-515-6(12)(d)(v) | Rule requires the exhaust/relief piping
on an air release/vacuum relief valve on the well discharge piping to be down-turned.
This significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
C

241B Air vacuum relief valve on well discharge piping screened with #14 mesh screen
SIG | 25pts | SO | S029 | R309-515-6(12)(d)(v) | Rule requires the exhaust/relief piping
on an air release/vacuum relief valve on the well discharge piping to be covered with a
#14 mesh corrosion-resistant screen. This significant deficiency must be corrected
within 120 days of notification or have a corrective action plan approved by DDW.
C

241C Air vacuum relief valve on well discharge piping has at least 6 inches of clearance
above floor
SIG | 25pts | SO | S030 | R309-515-6(12)(d)(v) | Rule requires the exhaust/relief piping
on an air release/vacuum relief valve on the well discharge piping to be at least 6
inches above the well house floor. This significant deficiency must be corrected within
120 days of notification or have a corrective action plan approved by DDW.
C
242 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: Does not pump directly to
distribution.)
243 Does well require oil-lubrication?N
244 Is this facility Active or Inactive?A
245 Storage tank capacity in gallons (from SDWIS; if different explain why in the
comments)
250000
246 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
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247 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
248 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
249 Are air vents present? ... if yes, answer the following question(s)Y

249A 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

249B 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

249C 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

249D 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
250 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

250A 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
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250B 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

250C 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: Gap in gasket)
251 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
252 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
253 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
254 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
255 Are there cracks in the walls or roof of the storage tank? (if yes, select only one of the
following options)
N
256 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

256A 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
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ST002 - 2A RESERVOIR - Active

256B 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

256C 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
257 Are the drain line and overflow combined?Y
258 Is this facility Active or Inactive?A
259 Storage tank capacity in gallons (from SDWIS; if different explain why in the
comments)
500000
260 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
261 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
262 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
263 Are air vents present? ... if yes, answer the following question(s)Y

263A 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
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263B 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

263C 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

263D 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
264 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

264A 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

264B 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

264C 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
265 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
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ST003 - 3A RESERVOIR (3057 S 100 W) - Active
266 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
267 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
268 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
269 Are there cracks in the walls or roof of the storage tank? (if yes, select only one of the
following options)
N
270 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

270A 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

270B 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

270C 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
271 Are the drain line and overflow combined?Y
272 Is this facility Active or Inactive?A
273 Storage tank capacity in gallons (from SDWIS; if different explain why in the
comments)
375000
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274 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
275 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
276 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
277 Are air vents present? ... if yes, answer the following question(s)Y

277A 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

277B 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

277C 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

277D 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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278 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

278A 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

278B 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

278C 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: Gap in gasket)
279 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
280 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
281 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
282 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
283 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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PF001 - OFFICE BOOSTER STATION -- Pump Stations -
284 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

284A 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.
D (Notes: Below receiving basin)

284B 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.
D (Notes: Could not see)

284C 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
285 Are the drain line and overflow combined?Y
286 Is this facility Active or Inactive?A
287 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
288 Pump Type (Centrifugal, Hand pump, Jet, Positive Displacement, Screw, Submersible,
Vertical turbine)
Centrifugal
289 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
DEQ | Drinking Water
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PF002 - VAL VISTA BOOSTER STATION -- Pump Stations - Active

289A 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
290 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
291 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
292 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
293 Does the pumping facility have an air relief valve located on the discharge piping? ... if
yes, answer the following question(s)
N
294 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
295 Is this facility Active or Inactive?A
296 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
297 Pump Type (Centrifugal, Hand pump, Jet, Positive Displacement, Screw, Submersible,
Vertical turbine)
Centrifugal
298 If the pump station is used to pressurize the distribution system, does it have at least
two functioning pumping units? ... if yes, answer the following question(s)
SIG | 25pts | PU | PS18 | R309-540-5(4)(b) | Rule states inline booster pumps,
withdrawing water directly from distribution lines without storage and feeding water
directly into distribution lines, shall have at least two pumping units. This significant
deficiency must be corrected within 120 days of notification or have a corrective action
plan approved by DDW.
NA (Notes: Not used to pressurize
distribution)
DEQ | Drinking Water
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PF003 - BONA VISTA BOOSTER STATION -- Pump Stations - Active
299 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
300 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
301 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
302 Does the pumping facility have an air relief valve located on the discharge piping? ... if
yes, answer the following question(s)
Y

302A 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

302B 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

302C 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
303 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
304 Is this facility Active or Inactive?A
305 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
306 Pump Type (Centrifugal, Hand pump, Jet, Positive Displacement, Screw, Submersible,
Vertical turbine)
Centrifugal
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TP009 - VAL VERDA WELL CHLORINATOR-FLUORIDATOR -- Treatment General - Active
307 If the pump station is used to pressurize the distribution system, does it have at least
two functioning pumping units? ... if yes, answer the following question(s)
SIG | 25pts | PU | PS18 | R309-540-5(4)(b) | Rule states inline booster pumps,
withdrawing water directly from distribution lines without storage and feeding water
directly into distribution lines, shall have at least two pumping units. This significant
deficiency must be corrected within 120 days of notification or have a corrective action
plan approved by DDW.
NA (Notes: Does not pressurize distribution
system)
308 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
309 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
310 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
311 Does the pumping facility have an air relief valve located on the discharge piping? ... if
yes, answer the following question(s)
Y

311A 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

311B 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

311C 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
312 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
313 Is this facility Active or Inactive?A
DEQ | Drinking Water
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314 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
315 Operating Period (Start Date)01/01
316 Operating Period (Ending Date)12/31
317 What is the objective of the treatment process and how do you know it is working?
(e.g., surface water treatment, disinfection, arsenic removal, TDS removal etc.)
Fluoridation/chlorination
318 Walk me through the different process steps of your treatment plant. What is the
purpose of each step? Show me how you determine you are meeting your Treatment
Requirements.
Calculated dose report and monthly split
samples (Notes: Chlorine/fluoride residuals
at POE)
319 What Chemicals are used? Why?Sodium fluoride/gas chlorine (Notes:
fluoridation/secondary disinfection)
320 How is the chemical dose adjusted with flow and water quality? Prompts: What flow
rate is used for the adjustment (influent, effluent, CFE)? What water quality
parameters would make you change dose rate?
Influent
321 Does influent flow rate vary?N
322 Process control testing is consistent with the specific treatment process
MIN | 15pts | TR | TGR9 | R309-105-7, 8 & 18, R309-100 through 605 | Trigger for
regulatory followup to address concerns.
C
323 There is a means to accurately measure the quantities of chemicals used.
SIG | 25pts | TR | TD99 | R309-525-11(7)(d)(iv) | Provisions shall be made for
measuring the quantities of chemicals used. This significant deficiency must be
corrected within 120 days of notification or have a corrective action plan approved by
DDW.
C
324 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
325 Are liquid chemicals used? ... if yes, answer the following question(s)N
326 Treatment chemicals 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
DEQ | Drinking Water
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TP004 - NORTH CANYON CHLORINATOR -- Treatment - Chlorination General - Active
327 Are all chemical feeders properly verified for accuracy?
SIG | 25pts | TR | TG21 | R309-525-11(7)(a)(i) | Feeders shall supply, at all times, the
necessary amounts of chemicals at an accurately controlled rate, throughout the
anticipated range of feed. This significant deficiency must be corrected within 120
days of notification or have a corrective action plan approved by DDW.
C
328 Spare parts are available for all chemical feeders
MIN | 15pts | TR | TX09 | R309-525-11(7)(b)(i) and (ii) | R308-525-11(8)(b)(i) states
that a means consistent with the nature of the chemical solution shall be provided in a
solution tank to maintain a uniform strength of solution. Continuous agitation shall be
provided to maintain slurries in suspension. 2 dem
C
329 Incompatible chemicals stored separately
SIG | 25pts | TR | TG19 | R309-525-11(7)(a)(iv) | Rule prohibits chemicals that are
incompatible from being fed, stored, or handled together. This significant deficiency
must be corrected within 120 days of notification or have a corrective action plan
approved by DDW.
C
330 Daily operating records reflect chemical dosages and total quantities used
SIG | 25pts | MR | TG20 | R309-105-14(3)(a) | Rule requires all water system using
chemical addition or specialized equipment for the treatment of drinking water to
regularly complete operational reports. This significant deficiency must be corrected
within 120 days of notification or have a corrective action plan approved by DDW.
C
331 Raw water compliance samples are collected before any treatment. R309-215-4(4)
SIG | 25pts | TR | T006 | R309-525-15(10)(a)(i) | R309-525-15(10)(a)(i)
Y

331A If yes, was location shown?Yes
332 Where are finished water quality monitoring samples collected?right at well head
333 Does water system have a DEQ/DWQ (UPDES permit) discharge permit for the
proper disposal of treatment plant waste to land or water?
MIN | 15pts | SM | TGR3 | R309-105-6 | R309-105-6
NA (Notes: No waste)
334 Which parameters are watched when running treatment plant?n/a (Notes: This is not a treatment plant. It is
only used to fluoridate and chlorinate the
water)
335 What type of alarm system is used?SCADA notification
336 Does treatment plant have a SCADA system?Y

336A Can operators respond to all alarms in a normal day, or do they have to silence
legitimate alarms?
Yes

336B How are alarm set points adjusted and how are changes recorded?SCADA
337 Proper lab equipment on site to support required operations & maintenance of the
plant?
SIG | 25pts | TR | T019 | R309-525-17(1) | Sufficient laboratory equipment shall be
provided to assure proper operation and monitoring of the water plant. This significant
deficiency must be corrected within 120 days of notification or have a corrective action
plan approved by DDW.
NA (Notes: Not a treatment plant)
DEQ | Drinking Water
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338 Is this facility Active or Inactive?A
339 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
340 When chlorination is required, disinfection has operated uninterrupted during the past
year while supplying drinking water.
SIG | 50pts | TR | TD25 | R309-520-6 | Rule requires continuous disinfection of
groundwater sources that do not consistently meet bacteriological quality standards,
all surface water sources, and groundwater sources under the direct influence of
surface water. This significant deficiency must be corrected within 120 days of
notification or have a corrective action plan approved by DDW.
NA (Notes: Not required)
341 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
342 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.
NA (Notes: Gas chlorination)
343 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
344 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
345 Free chlorine residual test equipment on-site or available?
MIN | 15pts | TR | TD78 | R309-520-7(1)(j) | Rule requires chlorine residual test
equipment available capable of measuring residuals to the nearest 0.1 mg/l in the
range below 0.5 mg/l, to the nearest 0.3 mg/l between 0.5 mg/l and 1.0 mg/l and to the
nearest 0.5 mg/l above 1.0 mg/l.
C
346 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
347 Is chlorine chemical dose rate adjusted due to different water demand flow rates
and/or changing water quality?
Y

347A If yes, which water flow rate is used? e.g. influent flow, effluent flow, filter flow.Effluent
DEQ | Drinking Water
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TP005 - VAL VISTA WELL 1 CHLORINATOR-FLUORIDATOR -- Treatment - Chlorination General -
Active
348 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
349 POE is before first connection/customer?
SIG | 25pts | TR | T028 | R309-215 | R309-215 & R309-520-6(4)(d)
C
350 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

350A 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

350B Distribution chlorine residuals meet minimum concentration requirement
SIG | 25pts | TR | T028 | R309-215 | R309-215 & R309-520-6(4)(d)
C

350C "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 (Notes: 0.9 mg/L)

350D 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

350E 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
351 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
352 Daily operating records reflect chemical dosages and total quantities used
SIG | 25pts | MR | TG20 | R309-105-14(3)(a) | Rule requires all water system using
chemical addition or specialized equipment for the treatment of drinking water to
regularly complete operational reports. This significant deficiency must be corrected
within 120 days of notification or have a corrective action plan approved by DDW.
C
353 Is this facility Active or Inactive?A
354 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
DEQ | Drinking Water
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355 When chlorination is required, disinfection has operated uninterrupted during the past
year while supplying drinking water.
SIG | 50pts | TR | TD25 | R309-520-6 | Rule requires continuous disinfection of
groundwater sources that do not consistently meet bacteriological quality standards,
all surface water sources, and groundwater sources under the direct influence of
surface water. This significant deficiency must be corrected within 120 days of
notification or have a corrective action plan approved by DDW.
NA (Notes: Not required)
356 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
357 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.
NA (Notes: Gas chlorination)
358 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
359 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
360 Free chlorine residual test equipment on-site or available?
MIN | 15pts | TR | TD78 | R309-520-7(1)(j) | Rule requires chlorine residual test
equipment available capable of measuring residuals to the nearest 0.1 mg/l in the
range below 0.5 mg/l, to the nearest 0.3 mg/l between 0.5 mg/l and 1.0 mg/l and to the
nearest 0.5 mg/l above 1.0 mg/l.
C
361 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
362 Is chlorine chemical dose rate adjusted due to different water demand flow rates
and/or changing water quality?
Y

362A If yes, which water flow rate is used? e.g. influent flow, effluent flow, filter flow.Effluent
363 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
DEQ | Drinking Water
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TP009 - VAL VERDA WELL CHLORINATOR-FLUORIDATOR -- Treatment - Chlorination General - Active
364 POE is before first connection/customer?
SIG | 25pts | TR | T028 | R309-215 | R309-215 & R309-520-6(4)(d)
C
365 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

365A 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

365B Distribution chlorine residuals meet minimum concentration requirement
SIG | 25pts | TR | T028 | R309-215 | R309-215 & R309-520-6(4)(d)
C

365C "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 (Notes: 0.9 mg/L)

365D 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

365E 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
366 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
367 Daily operating records reflect chemical dosages and total quantities used
SIG | 25pts | MR | TG20 | R309-105-14(3)(a) | Rule requires all water system using
chemical addition or specialized equipment for the treatment of drinking water to
regularly complete operational reports. This significant deficiency must be corrected
within 120 days of notification or have a corrective action plan approved by DDW.
C
368 Is this facility Active or Inactive?A
369 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
370 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
DEQ | Drinking Water
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371 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
372 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.
NA (Notes: Gas chlorine)
373 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
374 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
375 Free chlorine residual test equipment on-site or available?
MIN | 15pts | TR | TD78 | R309-520-7(1)(j) | Rule requires chlorine residual test
equipment available capable of measuring residuals to the nearest 0.1 mg/l in the
range below 0.5 mg/l, to the nearest 0.3 mg/l between 0.5 mg/l and 1.0 mg/l and to the
nearest 0.5 mg/l above 1.0 mg/l.
C
376 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
377 Is chlorine chemical dose rate adjusted due to different water demand flow rates
and/or changing water quality?
Y

377A If yes, which water flow rate is used? e.g. influent flow, effluent flow, filter flow.Effluent
378 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
379 POE is before first connection/customer?
SIG | 25pts | TR | T028 | R309-215 | R309-215 & R309-520-6(4)(d)
C
380 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
DEQ | Drinking Water
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TP004 - NORTH CANYON CHLORINATOR -- Gaseous Chlorination - Active

380A 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

380B Distribution chlorine residuals meet minimum concentration requirement
SIG | 25pts | TR | T028 | R309-215 | R309-215 & R309-520-6(4)(d)
C

380C "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 (Notes: 0.9 mg/L)

380D 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

380E 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
381 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
382 Daily operating records reflect chemical dosages and total quantities used
SIG | 25pts | MR | TG20 | R309-105-14(3)(a) | Rule requires all water system using
chemical addition or specialized equipment for the treatment of drinking water to
regularly complete operational reports. This significant deficiency must be corrected
within 120 days of notification or have a corrective action plan approved by DDW.
C
383 Is this facility Active or Inactive?A
384 If disinfection is required, standby chlorination equipment of sufficient capacity is
available to replace the largest unit.
SIG | 25pts | TR | TD22 | R309-520-7(1)(k)(ii) | Where chlorination is required for
disinfection of the water supply, the rule requires standby equipment of sufficient
capacity to be available to replace the largest unit in the event of its failure. This
significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
NA (Notes: Not required)
385 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
386 If continuous disinfection is needed, automatic switch over of chlorine cylinders is
provided.
MIN | 15pts | TR | TD01 | R309-520-7(2)(a), R309-520-6(1) | Rule requires automatic
switch over of chlorine cylinders be provided if continuous disinfection is required.
NA (Notes: Not required)
DEQ | Drinking Water
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387 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
388 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
389 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
390 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
391 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
392 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
393 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
394 Is the chlorine cylinder 150 pounds in capacity? ... if yes, answer the following
question(s)
Y

394A 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

394B 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
DEQ | Drinking Water
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TP005 - VAL VISTA WELL 1 CHLORINATOR-FLUORIDATOR -- Gaseous Chlorination - Active

394C 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
395 Is the chlorine cylinder 1 ton in capacity? ... if yes, answer the following question(s)N
396 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: On a sheet in pump house)
397 Is this facility Active or Inactive?A
398 If disinfection is required, standby chlorination equipment of sufficient capacity is
available to replace the largest unit.
SIG | 25pts | TR | TD22 | R309-520-7(1)(k)(ii) | Where chlorination is required for
disinfection of the water supply, the rule requires standby equipment of sufficient
capacity to be available to replace the largest unit in the event of its failure. This
significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
NA (Notes: Not required)
399 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
400 If continuous disinfection is needed, automatic switch over of chlorine cylinders is
provided.
MIN | 15pts | TR | TD01 | R309-520-7(2)(a), R309-520-6(1) | Rule requires automatic
switch over of chlorine cylinders be provided if continuous disinfection is required.
NA (Notes: Not required)
401 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
402 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
403 Chlorine vent line discharges outside and above grade and is screened with #14 mesh
screen.
SIG | 25pts | TR | TD13 | R309-520-7(2)(e) | Rule requires the chlorine vent line to
discharge outside, above grade, at a point least susceptible to vandalism, and to have
the end covered with a #14 mesh non-corrodible screen. This significant deficiency
must be corrected within 120 days of notification or have a corrective action plan
approved by DDW.
C
DEQ | Drinking Water
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TP009 - VAL VERDA WELL CHLORINATOR-FLUORIDATOR -- Gaseous Chlorination - Active
404 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
405 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
406 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
407 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
408 Is the chlorine cylinder 150 pounds in capacity? ... if yes, answer the following
question(s)
Y

408A 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

408B 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

408C 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
409 Is the chlorine cylinder 1 ton in capacity? ... if yes, answer the following question(s)N
410 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: On a sheet in the pump house)
411 Is this facility Active or Inactive?A
DEQ | Drinking Water
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412 If disinfection is required, standby chlorination equipment of sufficient capacity is
available to replace the largest unit.
SIG | 25pts | TR | TD22 | R309-520-7(1)(k)(ii) | Where chlorination is required for
disinfection of the water supply, the rule requires standby equipment of sufficient
capacity to be available to replace the largest unit in the event of its failure. This
significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
NA (Notes: Not required)
413 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
414 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
415 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
416 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
417 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
418 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
419 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
420 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
DEQ | Drinking Water
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TP009 - VAL VERDA WELL CHLORINATOR-FLUORIDATOR -- Filtration - General
421 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
422 Is the chlorine cylinder 150 pounds in capacity? ... if yes, answer the following
question(s)
Y

422A 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

422B 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

422C 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
423 Is the chlorine cylinder 1 ton in capacity? ... if yes, answer the following question(s)N
424 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: On sheet in pump room)
425 Instrumentation and controls for the process are operational, and in service
SIG | 25pts | TR | T021 | R309-100 - R309-600 | All instrumentation needed to verify
that treatment processes are sufficient shall be properly calibrated and maintained. At
a minimum, this shall include turbidimeters. This significant deficiency must be
corrected within 120 days of notification or have a corrective action plan approved by
DDW.
C
426 Is turbidity monitoring required? ... if yes, answer the following question(s)N
427 What is the maximum filtration rate throughout the year (in gpm/sf)?1.9872 (Notes: Dosage rate currently 0.0138
gpm x 12 gal. x 12 months)
428 What criteria are used to determine when a filter backwash is needed?NA (Notes: Inspected daily)
429 What criteria are used to determine filtration is functioning properly? (PSI, Turbidity,
Headloss, Flow rate, water quality parameter)
psi
430 Criteria is used to determine filter loading rate meets the manufacturers
recommendations? R309-525-15(2) Explain in comments...
MIN | 15pts | TR | TGR9 | R309-105-7, 8 & 18, R309-100 through 605 | Trigger for
regulatory followup to address concerns.
C
431 What criteria are used to determine if filter media needs to be replaced?visual inspection
DEQ | Drinking Water
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TP009 - VAL VERDA WELL CHLORINATOR-FLUORIDATOR -- Cartridge Filtration
TP005 - VAL VISTA WELL 1 CHLORINATOR-FLUORIDATOR -- Fluoridation - Active
432 Is backwash flow rate verified to determine it meets minimum requirements?
MIN | 15pts | TR | T076 | R309-525-15(7) | Rule requires that backwash systems be
designed and operated to
provide for adequate backwash with minimum media loss.
C
433 If system filters by Direct Filtration, the plant is configured to shut down automatically
when a source water exceeds 20 NTU for longer than 3 hours, or when the source
water turbidity exceeds 30 NTU at any time? R309-530-5(3)(g)
SIG | 25pts | TR | T021 | R309-100 - R309-600 | All instrumentation needed to verify
that treatment processes are sufficient shall be properly calibrated and maintained. At
a minimum, this shall include turbidimeters. This significant deficiency must be
corrected within 120 days of notification or have a corrective action plan approved by
DDW.
NA (Notes: This filter is only used to remove
sand.)
434 What filter is used in the cartridge?O (Notes: Stainless steel)
435 Is filter used for Surface Water/UDI log removal credits?N
436 What criteria is used to determine the filter is functioning according to manufacturer's
specifications?
n/a (Notes: Action #50 filter for sand
separator)
437 Is this facility Active or Inactive?A (Notes: .)
438 Background fluoride level before adding fluoride (in ppm):0.2 (Notes: .)
439 Target dose of fluoride added (in ppm):0.5 (Notes: .)
440 Typical fluoride level after adding fluoride (in ppm):0.7 (Notes: .)
441 Sampling location is present for measuring the final fluoride level (if compliant, answer
follow-up question)
MIN | 15pts | TR | TF44 | R309-535-5(2)(d)(iii) | A sampling point shall be provided
downstream of the fluoridation facility for measuring the fluoride level of treated water.
C (Notes: .)

441A Identify the sampling location of the measured final fluoride level:2997 S Vista Circle (Notes: .)
442 There is a means to measure the flow of water to be treated
SIG | 25pts | TR | TF11 | R309-535-5(2)(d)(i) | A means to measure the flow of treated
water shall be provided. This significant deficiency must be corrected within 120 days
of notification or have a corrective action plan approved by DDW.
C (Notes: .)
443 Fluoride concentrations, including chemical dosage and total water quantity, are
calculated daily. Daily operating records reflect chemical dosages and total quantities
used.
MIN | 15pts | TR | TF20 | R309-105-14(3) | R309-105-14(3) requires all water system
using chemical addition or specialized equipment for the treatment of drinking water
shall regularly complete operational reports. For a fluoridation facility that does not
calculate fluoride concentrations, include field and lab fluoride results.
C (Notes: .)
444 Fluoride testing instruments are properly verified (zeroed & recorded split samples) or
calibrated
MIN | 15pts | TR | TF21 | R309-525-25(4) | R309-525-25(4) states all instrumentation
needed to verify that treatment processes are sufficient shall be properly calibrated
and maintained.
C (Notes: .)
DEQ | Drinking Water
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445 Fluoride chemicals are stored in covered or unopened shipping containers inside a
building.
MIN | 15pts | TR | TF06 | R390-535-5(2)(b)(i) | Fluoride chemicals shall be stored in
covered or sealed containers, inside a building, and away from direct sunlight and a
source of heat.
C (Notes: .)
446 Fluoride injection point shall not be located upstream of lime-soda softening or ion
exchange softening process.
MIN | 15pts | TR | TF50 | R309-535-5(2)(g)(iii) | Added the following: The fluoride
injection point shall not be located upstream of lime softening, iron exchange, or other
processes that affect the fluoride level.
C (Notes: .)
447 Chemicals used for fluoridation meet the NSF/ANSI 60 standard or applicable AWWA
standards
SIG | 25pts | TR | TF04 | R309-535-5(2)(a)(i) | All chemicals used for fluoridation shall
be certified to comply 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 (Notes: .)
448 Electrical outlet and cord/plug for fluoride feed pump is a non-standard receptacle type
without using an adaptor and feed pump is interconnected with a well or a service
pump (to ensure that the fluoride feed pump is turned on only when the well or service
pump is on and water is flowing in the pipe)
SIG | 100pts | TR | TF22 | R309-535-5(2)(f) | Rule requires the electrical outlet used
for fluoride feed pump to have interlock protection by being wired with the well or
service pump, such that the feed pump is only activated when the well or service
pump is on. The rule also prohibits the feed pump from being plugged into a
continuously active ("hot") electrical outlet. This significant deficiency must be
corrected within 120 days of notification or have a corrective action plan approved by
DDW.
C (Notes: .)
449 Acid-resistant secondary containment is provided and adequately sized for corrosive
fluoride solutions.
SIG | 25pts | TR | TF26 | R309-535-5(2)(c )(i), (ii) and (iii) | Rule requires secondary
containment: for tanks containing corrosive fluoride solutions, to be sized to contain
the maximum volume of solution handled, and to be designed to be acid resistant.
This significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
C (Notes: .)
450 Vent for the chemical storage, injection and operating areas vents to outside
atmosphere and away from air intakes.
MIN | 15pts | TR | TF24 | R309-535-5(2)(j)(iii) | The fluoride operating area shall be
vented to outside atmosphere and away from air intakes.
C (Notes: .)
451 Incompatible chemicals are not stored in fluoride storage or injection areas.
MIN | 15pts | TR | TF28 | R309-535-5(2)(b)(i) - (iv) | Fluoride chemicals shall be stored
in covered or sealed containers, inside a building, away from direct sunlight and a
source of heat, and not be stored with incompatible chemicals. Bags or other
containers for dry materials shall be stored on pallets. Containers for dry materials
shall be kept closed to keep out moisture.
C (Notes: .)
452 Has any electrical or SCADA work been done recently that could affect the original
design or fluoride control settings?"... If the answer is yes, answer the next question.
N (Notes: .)
453 Is fluorosilicic acid used for fluoridation? ... if yes, answer the following questions N (Notes: .)
DEQ | Drinking Water
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TP006 - ENOCH SPRING FLUORIDATOR -- Fluoridation - Active
454 Is a saturator used for fluoridation? ... if yes, answer the following question(s)Y (Notes: .)

454A Chemicals are stored on pallets
MIN | 5pts | TR | TF36 | R309-535-5(2)(b)(iii) | Rule requires bags or other containers
for dry materials to be stored on pallets.
C (Notes: .)

454B Undissolved fluoride crystals above minimum mark on outside of the saturator tank
and an adequate level of fluoride crystals is in the saturator.
MIN | 15pts | TR | TF12 | R309-535-5(4)(b) | The minimum depth of undissolved
fluoride chemical required to maintain a saturated solution shall be marked on the
outside of the saturator tank.
C (Notes: .)

454C Backflow protection is on the dilution water supply line (a spring-opposed diaphragm
type anti-siphon device)
SIG | 50pts | TR | TF27 | R309-535-5(2)(k), R309-535-5(4)(d) | Rule requires cross
connection control be provided by an air gap or an approved and properly operating
backflow prevention assembly at all fluoridation installations. This significant deficiency
must be corrected within 120 days of notification or have a corrective action plan
approved by DDW.
C (Notes: .)

454D Disposal of empty bags, drums or barrels minimizes exposure to fluoride dusts.
MIN | 15pts | TR | TF41 | R309-535-5(5)(c)(i) | For dry-feed fluoride installations, the
rule requires that creation of fluoride dust be minimized during the transfer of dry
fluoride compounds when disposing of empty bags, drums, or barrels and while
cleaning.
C (Notes: .)

454E Emergency eyewash is provided.
SIG | 25pts | TR | TF10 | R309-535-5(4)(g), R309-535-5(5)(d) | For fluoride saturators
and dry feeders emergency eyewash shall be provided. This significant deficiency
must be corrected within 120 days of notification or have a corrective action plan
approved by DDW.
C (Notes: .)

454F A water meter is provided to measure the amount of fluoride solution being fed from
the saturator so the operator can track chemical usage
SIG | 25pts | TR | TF11 | R309-535-5(2)(d)(i) | A means to measure the flow of treated
water shall be provided. This significant deficiency must be corrected within 120 days
of notification or have a corrective action plan approved by DDW.
C (Notes: .)

454G Make-up water used for sodium fluoride dissolution has hardness less than 75 mg/l as
calcium carbonate.
MIN | 15pts | TR | TF37 | R309-535-5(4)(e)(i) | Rule requires make-up water used for
sodium fluoride saturators to be softened whenever the hardness exceeds 75 mg/L.
C (Notes: .)
455 Is fluoride dry feed equipment used?....if yes, answer the following questions N (Notes: .)
456 Appropriate personal protective equipment provided for operators (including NIOSH
approved respirator and chemical/dust-resistant safety goggles for saturators and dry
feeders, acid-resistant gloves, apron or coverall, and boots)
SIG | 25pts | TR | TF13 | R309-535-5(3)(f), R309-535-5(4)(h), R309-535-5(5)(e) | The
use of personal protective equipment (PPE) is required when handling fluorisilicic acid
and dry chemicals. This significant deficiency must be corrected within 120 days of
notification or have a corrective action plan approved by DDW.
C (Notes: .)
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457 Is this facility Active or Inactive?A (Notes: .)
458 Background fluoride level before adding fluoride (in ppm):0.2 (Notes: .)
459 Target dose of fluoride added (in ppm):0.5 (Notes: .)
460 Typical fluoride level after adding fluoride (in ppm):0.7 (Notes: .)
461 Sampling location is present for measuring the final fluoride level (if compliant, answer
follow-up question)
MIN | 15pts | TR | TF44 | R309-535-5(2)(d)(iii) | A sampling point shall be provided
downstream of the fluoridation facility for measuring the fluoride level of treated water.
C (Notes: .)

461A Identify the sampling location of the measured final fluoride level:151 W 3000 S (Notes: .)
462 There is a means to measure the flow of water to be treated
SIG | 25pts | TR | TF11 | R309-535-5(2)(d)(i) | A means to measure the flow of treated
water shall be provided. This significant deficiency must be corrected within 120 days
of notification or have a corrective action plan approved by DDW.
C (Notes: .)
463 Fluoride concentrations, including chemical dosage and total water quantity, are
calculated daily. Daily operating records reflect chemical dosages and total quantities
used.
MIN | 15pts | TR | TF20 | R309-105-14(3) | R309-105-14(3) requires all water system
using chemical addition or specialized equipment for the treatment of drinking water
shall regularly complete operational reports. For a fluoridation facility that does not
calculate fluoride concentrations, include field and lab fluoride results.
C (Notes: .)
464 Fluoride testing instruments are properly verified (zeroed & recorded split samples) or
calibrated
MIN | 15pts | TR | TF21 | R309-525-25(4) | R309-525-25(4) states all instrumentation
needed to verify that treatment processes are sufficient shall be properly calibrated
and maintained.
C (Notes: .)
465 Fluoride chemicals are stored in covered or unopened shipping containers inside a
building.
MIN | 15pts | TR | TF06 | R390-535-5(2)(b)(i) | Fluoride chemicals shall be stored in
covered or sealed containers, inside a building, and away from direct sunlight and a
source of heat.
C (Notes: .)
466 Fluoride injection point shall not be located upstream of lime-soda softening or ion
exchange softening process.
MIN | 15pts | TR | TF50 | R309-535-5(2)(g)(iii) | Added the following: The fluoride
injection point shall not be located upstream of lime softening, iron exchange, or other
processes that affect the fluoride level.
C (Notes: .)
467 Chemicals used for fluoridation meet the NSF/ANSI 60 standard or applicable AWWA
standards
SIG | 25pts | TR | TF04 | R309-535-5(2)(a)(i) | All chemicals used for fluoridation shall
be certified to comply 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 (Notes: .)
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468 Electrical outlet and cord/plug for fluoride feed pump is a non-standard receptacle type
without using an adaptor and feed pump is interconnected with a well or a service
pump (to ensure that the fluoride feed pump is turned on only when the well or service
pump is on and water is flowing in the pipe)
SIG | 100pts | TR | TF22 | R309-535-5(2)(f) | Rule requires the electrical outlet used
for fluoride feed pump to have interlock protection by being wired with the well or
service pump, such that the feed pump is only activated when the well or service
pump is on. The rule also prohibits the feed pump from being plugged into a
continuously active ("hot") electrical outlet. This significant deficiency must be
corrected within 120 days of notification or have a corrective action plan approved by
DDW.
C (Notes: .)
469 Acid-resistant secondary containment is provided and adequately sized for corrosive
fluoride solutions.
SIG | 25pts | TR | TF26 | R309-535-5(2)(c )(i), (ii) and (iii) | Rule requires secondary
containment: for tanks containing corrosive fluoride solutions, to be sized to contain
the maximum volume of solution handled, and to be designed to be acid resistant.
This significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
C (Notes: .)
470 Vent for the chemical storage, injection and operating areas vents to outside
atmosphere and away from air intakes.
MIN | 15pts | TR | TF24 | R309-535-5(2)(j)(iii) | The fluoride operating area shall be
vented to outside atmosphere and away from air intakes.
C (Notes: .)
471 Incompatible chemicals are not stored in fluoride storage or injection areas.
MIN | 15pts | TR | TF28 | R309-535-5(2)(b)(i) - (iv) | Fluoride chemicals shall be stored
in covered or sealed containers, inside a building, away from direct sunlight and a
source of heat, and not be stored with incompatible chemicals. Bags or other
containers for dry materials shall be stored on pallets. Containers for dry materials
shall be kept closed to keep out moisture.
C (Notes: .)
472 Has any electrical or SCADA work been done recently that could affect the original
design or fluoride control settings?"... If the answer is yes, answer the next question.
N (Notes: .)
473 Is fluorosilicic acid used for fluoridation? ... if yes, answer the following questions N (Notes: .)
474 Is a saturator used for fluoridation? ... if yes, answer the following question(s)Y (Notes: .)

474A Chemicals are stored on pallets
MIN | 5pts | TR | TF36 | R309-535-5(2)(b)(iii) | Rule requires bags or other containers
for dry materials to be stored on pallets.
C (Notes: .)

474B Undissolved fluoride crystals above minimum mark on outside of the saturator tank
and an adequate level of fluoride crystals is in the saturator.
MIN | 15pts | TR | TF12 | R309-535-5(4)(b) | The minimum depth of undissolved
fluoride chemical required to maintain a saturated solution shall be marked on the
outside of the saturator tank.
C (Notes: .)
DEQ | Drinking Water
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TP009 - VAL VERDA WELL CHLORINATOR-FLUORIDATOR -- Fluoridation - Active

474C Backflow protection is on the dilution water supply line (a spring-opposed diaphragm
type anti-siphon device)
SIG | 50pts | TR | TF27 | R309-535-5(2)(k), R309-535-5(4)(d) | Rule requires cross
connection control be provided by an air gap or an approved and properly operating
backflow prevention assembly at all fluoridation installations. This significant deficiency
must be corrected within 120 days of notification or have a corrective action plan
approved by DDW.
C (Notes: .)

474D Disposal of empty bags, drums or barrels minimizes exposure to fluoride dusts.
MIN | 15pts | TR | TF41 | R309-535-5(5)(c)(i) | For dry-feed fluoride installations, the
rule requires that creation of fluoride dust be minimized during the transfer of dry
fluoride compounds when disposing of empty bags, drums, or barrels and while
cleaning.
C (Notes: .)

474E Emergency eyewash is provided.
SIG | 25pts | TR | TF10 | R309-535-5(4)(g), R309-535-5(5)(d) | For fluoride saturators
and dry feeders emergency eyewash shall be provided. This significant deficiency
must be corrected within 120 days of notification or have a corrective action plan
approved by DDW.
C (Notes: .)

474F A water meter is provided to measure the amount of fluoride solution being fed from
the saturator so the operator can track chemical usage
SIG | 25pts | TR | TF11 | R309-535-5(2)(d)(i) | A means to measure the flow of treated
water shall be provided. This significant deficiency must be corrected within 120 days
of notification or have a corrective action plan approved by DDW.
C (Notes: .)

474G Make-up water used for sodium fluoride dissolution has hardness less than 75 mg/l as
calcium carbonate.
MIN | 15pts | TR | TF37 | R309-535-5(4)(e)(i) | Rule requires make-up water used for
sodium fluoride saturators to be softened whenever the hardness exceeds 75 mg/L.
C (Notes: .)
475 Is fluoride dry feed equipment used?....if yes, answer the following questions N (Notes: .)
476 Appropriate personal protective equipment provided for operators (including NIOSH
approved respirator and chemical/dust-resistant safety goggles for saturators and dry
feeders, acid-resistant gloves, apron or coverall, and boots)
SIG | 25pts | TR | TF13 | R309-535-5(3)(f), R309-535-5(4)(h), R309-535-5(5)(e) | The
use of personal protective equipment (PPE) is required when handling fluorisilicic acid
and dry chemicals. This significant deficiency must be corrected within 120 days of
notification or have a corrective action plan approved by DDW.
C (Notes: .)
477 Is this facility Active or Inactive?A (Notes: .)
478 Background fluoride level before adding fluoride (in ppm):0.2 (Notes: .)
479 Target dose of fluoride added (in ppm):0.5 (Notes: .)
480 Typical fluoride level after adding fluoride (in ppm):0.7 (Notes: .)
481 Sampling location is present for measuring the final fluoride level (if compliant, answer
follow-up question)
MIN | 15pts | TR | TF44 | R309-535-5(2)(d)(iii) | A sampling point shall be provided
downstream of the fluoridation facility for measuring the fluoride level of treated water.
C (Notes: .)
DEQ | Drinking Water
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481A Identify the sampling location of the measured final fluoride level:63 W 3600 S (Notes: .)
482 There is a means to measure the flow of water to be treated
SIG | 25pts | TR | TF11 | R309-535-5(2)(d)(i) | A means to measure the flow of treated
water shall be provided. This significant deficiency must be corrected within 120 days
of notification or have a corrective action plan approved by DDW.
C (Notes: .)
483 Fluoride concentrations, including chemical dosage and total water quantity, are
calculated daily. Daily operating records reflect chemical dosages and total quantities
used.
MIN | 15pts | TR | TF20 | R309-105-14(3) | R309-105-14(3) requires all water system
using chemical addition or specialized equipment for the treatment of drinking water
shall regularly complete operational reports. For a fluoridation facility that does not
calculate fluoride concentrations, include field and lab fluoride results.
C (Notes: .)
484 Fluoride testing instruments are properly verified (zeroed & recorded split samples) or
calibrated
MIN | 15pts | TR | TF21 | R309-525-25(4) | R309-525-25(4) states all instrumentation
needed to verify that treatment processes are sufficient shall be properly calibrated
and maintained.
C (Notes: .)
485 Fluoride chemicals are stored in covered or unopened shipping containers inside a
building.
MIN | 15pts | TR | TF06 | R390-535-5(2)(b)(i) | Fluoride chemicals shall be stored in
covered or sealed containers, inside a building, and away from direct sunlight and a
source of heat.
C (Notes: .)
486 Fluoride injection point shall not be located upstream of lime-soda softening or ion
exchange softening process.
MIN | 15pts | TR | TF50 | R309-535-5(2)(g)(iii) | Added the following: The fluoride
injection point shall not be located upstream of lime softening, iron exchange, or other
processes that affect the fluoride level.
C (Notes: .)
487 Chemicals used for fluoridation meet the NSF/ANSI 60 standard or applicable AWWA
standards
SIG | 25pts | TR | TF04 | R309-535-5(2)(a)(i) | All chemicals used for fluoridation shall
be certified to comply 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 (Notes: .)
488 Electrical outlet and cord/plug for fluoride feed pump is a non-standard receptacle type
without using an adaptor and feed pump is interconnected with a well or a service
pump (to ensure that the fluoride feed pump is turned on only when the well or service
pump is on and water is flowing in the pipe)
SIG | 100pts | TR | TF22 | R309-535-5(2)(f) | Rule requires the electrical outlet used
for fluoride feed pump to have interlock protection by being wired with the well or
service pump, such that the feed pump is only activated when the well or service
pump is on. The rule also prohibits the feed pump from being plugged into a
continuously active ("hot") electrical outlet. This significant deficiency must be
corrected within 120 days of notification or have a corrective action plan approved by
DDW.
C (Notes: .)
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489 Acid-resistant secondary containment is provided and adequately sized for corrosive
fluoride solutions.
SIG | 25pts | TR | TF26 | R309-535-5(2)(c )(i), (ii) and (iii) | Rule requires secondary
containment: for tanks containing corrosive fluoride solutions, to be sized to contain
the maximum volume of solution handled, and to be designed to be acid resistant.
This significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
C (Notes: .)
490 Vent for the chemical storage, injection and operating areas vents to outside
atmosphere and away from air intakes.
MIN | 15pts | TR | TF24 | R309-535-5(2)(j)(iii) | The fluoride operating area shall be
vented to outside atmosphere and away from air intakes.
C (Notes: .)
491 Incompatible chemicals are not stored in fluoride storage or injection areas.
MIN | 15pts | TR | TF28 | R309-535-5(2)(b)(i) - (iv) | Fluoride chemicals shall be stored
in covered or sealed containers, inside a building, away from direct sunlight and a
source of heat, and not be stored with incompatible chemicals. Bags or other
containers for dry materials shall be stored on pallets. Containers for dry materials
shall be kept closed to keep out moisture.
C (Notes: .)
492 Has any electrical or SCADA work been done recently that could affect the original
design or fluoride control settings?"... If the answer is yes, answer the next question.
N (Notes: .)
493 Is fluorosilicic acid used for fluoridation? ... if yes, answer the following questions N (Notes: .)
494 Is a saturator used for fluoridation? ... if yes, answer the following question(s)Y (Notes: .)

494A Chemicals are stored on pallets
MIN | 5pts | TR | TF36 | R309-535-5(2)(b)(iii) | Rule requires bags or other containers
for dry materials to be stored on pallets.
C (Notes: .)

494B Undissolved fluoride crystals above minimum mark on outside of the saturator tank
and an adequate level of fluoride crystals is in the saturator.
MIN | 15pts | TR | TF12 | R309-535-5(4)(b) | The minimum depth of undissolved
fluoride chemical required to maintain a saturated solution shall be marked on the
outside of the saturator tank.
C (Notes: .)

494C Backflow protection is on the dilution water supply line (a spring-opposed diaphragm
type anti-siphon device)
SIG | 50pts | TR | TF27 | R309-535-5(2)(k), R309-535-5(4)(d) | Rule requires cross
connection control be provided by an air gap or an approved and properly operating
backflow prevention assembly at all fluoridation installations. This significant deficiency
must be corrected within 120 days of notification or have a corrective action plan
approved by DDW.
C (Notes: .)

494D Disposal of empty bags, drums or barrels minimizes exposure to fluoride dusts.
MIN | 15pts | TR | TF41 | R309-535-5(5)(c)(i) | For dry-feed fluoride installations, the
rule requires that creation of fluoride dust be minimized during the transfer of dry
fluoride compounds when disposing of empty bags, drums, or barrels and while
cleaning.
C (Notes: .)
DEQ | Drinking Water
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TP009 - VAL VERDA WELL CHLORINATOR-FLUORIDATOR -- Ion Exchange

494E Emergency eyewash is provided.
SIG | 25pts | TR | TF10 | R309-535-5(4)(g), R309-535-5(5)(d) | For fluoride saturators
and dry feeders emergency eyewash shall be provided. This significant deficiency
must be corrected within 120 days of notification or have a corrective action plan
approved by DDW.
C (Notes: .)

494F A water meter is provided to measure the amount of fluoride solution being fed from
the saturator so the operator can track chemical usage
SIG | 25pts | TR | TF11 | R309-535-5(2)(d)(i) | A means to measure the flow of treated
water shall be provided. This significant deficiency must be corrected within 120 days
of notification or have a corrective action plan approved by DDW.
C (Notes: .)

494G Make-up water used for sodium fluoride dissolution has hardness less than 75 mg/l as
calcium carbonate.
MIN | 15pts | TR | TF37 | R309-535-5(4)(e)(i) | Rule requires make-up water used for
sodium fluoride saturators to be softened whenever the hardness exceeds 75 mg/L.
C (Notes: .)
495 Is fluoride dry feed equipment used?....if yes, answer the following questions N (Notes: .)
496 Appropriate personal protective equipment provided for operators (including NIOSH
approved respirator and chemical/dust-resistant safety goggles for saturators and dry
feeders, acid-resistant gloves, apron or coverall, and boots)
SIG | 25pts | TR | TF13 | R309-535-5(3)(f), R309-535-5(4)(h), R309-535-5(5)(e) | The
use of personal protective equipment (PPE) is required when handling fluorisilicic acid
and dry chemicals. This significant deficiency must be corrected within 120 days of
notification or have a corrective action plan approved by DDW.
C (Notes: .)
497 Salt used for the brine solution is certified to meet the ANSI/NSF 60 standard
SIG | 25pts | TR | T080 | R309-525-11(5), R309-525-25(1), R309-535-11(5)(d) | Rule
requires that all chemicals added to water being treated for use in a public water
system for human consumption comply with ANSI/NSF Standard 60. This significant
deficiency must be corrected within 120 days of notification or have a compliance
action plan approved by DDW.
C
498 Make-up water inlet is protected from back-siphonage
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
499 Overflows are protected with corrosion resistant screens and terminate with a down
turned discharge with at least 6 inches of clearance from the floor
SIG | 50pts | TR | TX08 | R309-525-11(8)(b)(v), R309-525-11(9)(b)(iii) | R309-525-
11(9)(b) For an ion exchange facility where the overflow discharge piping is not
protected with a corrosion resistant screen or is not terminated with a downturned
bend with adequate clearance to prevent cross connection 10 points shall be assess
C
500 There is a brine measuring tank or a means of metering proper dilution
MIN | 15pts | TR | TX09 | R309-525-11(7)(b)(i) and (ii) | R308-525-11(8)(b)(i) states
that a means consistent with the nature of the chemical solution shall be provided in a
solution tank to maintain a uniform strength of solution. Continuous agitation shall be
provided to maintain slurries in suspension. 2 dem
C
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501 Does media type require regeneration or periodic replacement?Y

501A If yes, what criteria is used to determine when to regenerate or replace the media?grains per gallon treated

501B If yes, what is the time interval between media regeneration/replacement?80,000 grains
502 Operational differential pressure is monitored and recorded?
SIG | 25pts | TR | T021 | R309-100 - R309-600 | All instrumentation needed to verify
that treatment processes are sufficient shall be properly calibrated and maintained. At
a minimum, this shall include turbidimeters. 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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