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Home My WebLink AboutDDW-2024-006630Page 1 of 3 *Point Code Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Up WS001 Down WS001 Up WS001 Down WS001 Up WS001 Down WS001 Up WS001 Down WS001 Up WS001 Down WS001 Contact Person: Chemtech-Ford Laboratories 9632 S 500 W Sandy 84070 801-262-7299 Paul Ellingson Bacteria Sampling Laboratory Information: Laboratory Name: Address: City: Zip Code: Well #2 WS002 Source(s) Name:DDW Source or Group # All System Sources All Sources Well #1 WS001 Phone Number: 5 Unit #10b 5- DS001 Unit #11 Hose Bib Unit #9 X WS001 Unit #7 Kitchen Sink Unit #4 X X WS001 4 Unit #6 4- DS001 X3 Unit #10a 3- DS001 X X Unit #10b Kitchen Sink Unit #9 X WS001 Kitchen Sink Unit #1 X WS001 Routine Sample Point Description - hose bib, sink faucet, etc. Address 1 Unit #9 1- DS001 X Unit #10a Kitchen Sink Unit #8 X WS001 System Name:M & J Trailer Home Community System PDW #:UT02078 Monthly Routine Sample Sites (place an X in boxes below):Follow-up/Repeat Sample Sites (block or specific address) DDW Assigned # for Associated Source(s) 2 Unit #4 2- DS001 X X Unit #6 *When submitting a sample taken from a Routine sample site designated above, you must include the Point Code associated with that site on the laboratory paperwork. *Point Code Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Down Up Down Up Down Up Down Up Down Up Down Up Monthly Routine Sample Sites (place an X in boxes below):Follow (ran Address 1 123 N 500 W 1-DS001 X System Name:Waterville City System P X X 3 429 Maple St.3-DS001 X 2 678 S 200 E 2-DS001 X X X 5 5151 E 200 N 5-DS001 X41007 W 200 N 4-DS001 XX X64732 S 1500 W 6-DS001 Source(s) Name:DDW Source or Group #Bacteria Sampling All System Sources All Sources X Well 2 WS003 City: Zip Code: Example Springs WS001 Laboratory Name: Well 1 WS002 Address: Phone Number: Contact Person: All Sources All Sources All Sources All Sources All Sources All Sources WS001 WS001 WS002 WS002 WS003 WS003 12345 When complete, print this as a pdf and email as an attachment to ddwreports@utah.gov. w-up/Repeat Sample Sites nge or specific address) DDW Assigned # for Associated Source(s) Routine Sample Point Description - hose bib, sink faucet, etc. PDW #: 50 - 120 N 500 W All Sources Kitchen sink 125 -225 N 500 W 550 - 650 S 200 E All Sources Kitchen sink 680 - 780 S 200 E 320 - 420 Maple St.All Sources Hose bib 430 - 420 Maple St. 920 - 1000 W 200 N WS001 Hose bib 1010 - 1110 W 200 N 5050 - 5150 E 200 N WS002 Hose bib 5160 - 5210 E 200 N Hose bib 4740 - 4820 S 1500 W g Laboratory Information: 4650 - 4730 S 1500 W WS003 *When submitting a sample taken from a Routine sample site designated above, you must include the Point Code associated with that site on the laboratory paperwork.