DDW-2025-002125

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Utah Division of Drinking Water
IPS Deficiency Correction Notice
Water System Name Syracuse City Water System
Water System ID #UTAH 06012
Instructions
Please use this form to report the correction of sanitary survey deficiencies identified on your
IPS report. List the individual Facility ID (where applicable), deficiency code, how deficiency
was corrected and the date of the correction below. You may attach a copy of your IPS report
with the date of the correction noted on the report. Pictures of corrections or a brief description
of the corrections are encouraged. Include the name of the facility and the correction date on any
documentation you provide.
Facility ID Deficiency Code How deficiency was corrected
DS001 S091
Date Corrected
Verification of System-Specific Sizing Mar 4. 2025
I certify that the information submitted with this report is true and accurate. You may
electronically sign this form by typing your name in the Signature block.
Angela Jones
Print Name
Corrections listed on attached IPS report☑
onisSignature
Mar 4. 2025
Date
Supportive documentation attached☑
DDW Approval Date//