DDW-2024-006645

Utah Division of Drinking Water
IPS Deficiency Correction Notice
Water System Name九趙橘 ノTOω に
Water System ID#UTAH 06013
1nstructions
Pleasc use this follll to rcport thc correction of sanitary survey deflciencies idcntifled on yollr
IPS report.List thc individual facility ID(whcrC applicablc),deflCiCncy code,how dcflciency
was correctcd and thc date of the correction below. You may attach a copy of your IPS rcport
with thc date of thc correction notcd on the rcport. Picturcs of corrections or a bricf description
ofthe corrcctions arc cncouragcd. Includc the namc ofthe facility and thc correction datc on any
documentation you provide
I certify that the information submitted with this report is true and accurate.
鉱 椛 rレ ん鷹傷疹 え//5/'7
Print Nalne Signature Date
Corrections listed on attached IPS report I Supportive documentation attache A {
/ /
Facility ID /
Description Code
How Deflcicncy Was Corrccted Date Corrected
/ML基 江 L並 動 と ____‐‐盾
/ /
/ /
DDW Approval
Page 1 0f l
/ /
/ /
/ ////// /
/ /
/ /
/ /
Bacteriological Sampling Site Plan
System Name: Newton Town System Number: 03013
Contact Person Information
System Owner: NeMon Town
Billing Address: PO Box 146 Newton UT 84327
System Manager: Matt Phillips
Manager Address: 240 West 300 South
Telephone #(s)(in case of bad sample) 435'760-2177
Email address information: [e-mail]
No.Name Address Location1
Newton Market l0 East Main Street2
Town Hall 5l South Center Street
Post Office 8 North Center Street4
Matt Phillips 240 West 300 South
Jed Woodward 64 South 200 East6789
10