DDW-2024-006635

State ofUtah
GARY R HERBERT
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SPENCERJ COX
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Departrnent of
Environmental Quality
Alan Mathcson
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DIVIS10N OF DRINKINGヽ VATER
Maric E Owcns,PE
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October 19,2017
John Pitcher
Cornish Town Water System
4788 W 14300 N
Cornish, UT 84308
Subject: RTCR Sample Site Plan Approval for Cornish Town Water UTAH03005
Dear lИ r/ⅣIs.Cobum:
Thc cllrrent RTCR sample site plan for UTAH03005 is approved as submitted to the Division of
Drinking Watcr.If you have any questiOns or changcs that need to be rnade please feel free to
contact me at(801)536-4150 or Pkcersの utah:2Ωv
Sincerely,
Pete Keers
Environmental Scientist
Utah Division of Drinking Water
195 North 1950ヽ Vcst・ Salt Lよ c Ciり ,UT
Mailing Addrcss:P O Box 144830。Salt Lよ c Ciり ,UT 84114‐4830
Tclcphonc(801)5364200・ Fax(801)536‐4211・ TDD (801)5364414
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Printed on 100°O recycled papcr
DR:NK:NG
WATER
PO Box 144830
Salt Lake City, UT 84114-4830
Phone: [phone]
Fax: [phone]'1
Email : [e-mail]
www,drinkingwater.utah,gov
BACTERIOLOGICAL SAMPLE SITE PLAN
As part of the Revised Total Coliform Rule, the location from which samples are taken is to be varied. All water systems are
required to maintain a current bacteriological sample siting plan. The plan shows the locations of all sample sites from which
bacteriological iests are taken. Sample sites are to be representative of all pressure zones and each waler source of the
distribution system. The sample plan should be revised regularly and following any major construction proiect impacting the
distribution system.
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WATER SYSTEM INFORMAT10N
System \lgrng comlsh rown System#:∪TAHIo11311111。|卜 〕
Phone#: 435‐754・ 3067Street Addressi 14300 N 4800 W
Mailing Address: 4788 w 14300 N Emall:cornlshtownha∥Ogma∥∞mService Connectrons:Served:
SAMPLE COLLECT10N
samples collected by: John pver Pitcher
Name of Laboratory:Bear River Health Oepartmsnt
Malling Address:
State Lab Codel
85 East 1800 North North Logan,utah 84341
PhOne #: 43s-7e2.6s82 Fax #:
The Laboratory was sent a copy of this plan s1' et27tn17
Utah Division of Drinkinq Water was sent a copy of this plan on'.0et27t2017
Seasonal
ls the water operated seasonally?[l YES 〔7〕NO
Dates of operation: Open:Close:
Systems, which operale seasonally, are required to take an investigative sample prior to opening to the public, Where
will that sample be taken?
Location Date sampled:
MAP OF SYSTEM
Have you enclosed\attached a map of the dislribution system showing the source (well, spring, etc.), storage tanks,
treatment facilities, dislribution piping, routine sample locations, and
SAMPLE LOCAT10NS
The following describes each routine sample location, what months the location will be sampled, and where follow-up
(repeat) samples will be taken in the event of a "positive" routine sample.
Water samples wi∥be co∥ected from this bcalon du∥ng 3.13458N4500W
,he monthミ nf rrirrl。、ヽthe months of (circle):
Rou∥ne Sample Lccalo■:1 12200N5600W
(location name or address)
Description: -Outside
Faucet
(hOSe bib,Sink laucet,etc)
1"Qtr /」an. ‐ Feb. Mar.
2nd Qtr /Apr May Jun 4.
3rd Qtr /Jul. Aug Sep.
4th Qtr /Oct、 Nov. Dec.
Fol!ow・ up〔repeat)Sample Loca∥ons:
1 12200N5600W
(rOulne sam口 e5caじ 。n name oraddress)
2. 14300N4800W
(location name or addres ulstream)
(location name or address dorrn-stream)
lsource)
Rou∥ne Sample Loca∥on:
1 13458N4500W
(location namo or address)
Description: Sink Faucet
(hOSe bib,Sink faucel,etc)
lSI Qtr 」an. Feb. /Mar.
2nd Qt「 Apr. May l/Jun, 4.
3rd Qtr Jul Aug. /Sep.
4h Qt「 Oct Nov /Dec
Follow・ up(repeat)Sample Localons:
1 12200N5600W
(routine sample localion name or address)
2. 14000N4800W
(location name or address up-stream)
(location name or address dorrn-stream)
lsource)
Water samples will be collecled kom this location durinq
the mnnthc nf /rirnta\. - 3. 13459 N 4500 Wthe months of (circle):
Routine Sample Loca∥oni
l. 14300N4800W
(location name or address)
Description: Outsidefaucet
(hOSe bib.Sink laucet,etc)
lSI Qtr 」an /Feb Mar
2nd Qtr Apr /May Jun 4.
3rd Qtr 」u1 /Aug sep
40 Qt● Oct. /Nov. Dec
Folbw・ uo(repeat)Samde Localons:
1. 12200N5600W
(rOuttne sampに bcauon name Or address)
2. 14300N4800W
(location name or address up-strsam)
(location name or address do$rn-stream)
(source)
Water sam口 eS Wi∥be colttcted from thも bcalon dunng 3.13458N4500W
,ho mnnthc nfrrir.1。、.the months of (circle):
Report Prepared by:
Signature and Title:
Mishetl Gundersen
´で響 、C・ は :。9/27/2“7
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