DDW-2025-004516

April 17, 2025
Teresa Gray
Salt Lake City Water System
1530 S West Temple
Salt Lake City, Utah 84115
Dear Teresa Gray:
Subject: Public Drinking Water Requirements for Salt Lake City Water System, UTAH18026
According to the Division of Drinking Water’s records, Salt Lake City Water System is a
Community water system that now serves a population of about 741,828 people.
This population change results in the following changes to your system’s sampling requirements
as follows:
Bacteriological Sampling
The total number of bacteriological samples this system is now required to take has increased to
240 each month. It is still your responsibility to send a copy of all results to our office by the
10th of the following month. In the event of a coliform positive result, you are required to take
three repeat samples and a triggered source E.coli sample for each ground water source in service
at the time of the original positive sample. The system is required to submit an updated written
sample site plan that identifies sampling sites and sample collection schedules that are
representative of water throughout the distribution system. For any questions regarding the Total
Coliform rule or Groundwater rule, contact Sitara Federico at [phone] or
[e-mail]. This new sample schedule will take effect on June 1st, 2025.
195 North 1950 West • Salt Lake City, UT
Mailing Address: P.O. Box 144830 • Salt Lake City, UT 84114-4830
Telephone [phone] • Fax [phone] • T.D.D. [phone]
www.deq.utah.gov
Teresa Gray
Page 2 of 2
A current monitoring schedule for your system has been enclosed. If this letter is in error please
contact me at [phone] or [e-mail] within 30 days. Thank you for your efforts
in maintaining a safe drinking water system.
Sincerely,
Mark Berger
Monitoring and Standards Section Manager
Enclosure: Monitoring Schedule
Revised Total Coliform Rule (RTCR) Sample Site Plan
cc: Teresa Gray, [e-mail]
Rob Larson, Salt Lake County Health Department
Sitara Federico
Page 2 of 7
Contacts
Type: Administrative Contact
Name: TERESA GRAY
Office: 801-483-6744
Emergency:
Email:
[e-mail]
Site Information
Legal Contact: KETRELL, MARK
Address: 1530 S West Temple , SALT
LAKE CITY, UT 84115
Phone:
County: SALT LAKE COUNTY
System Type: Community
Certification Required: D4 T4
Total Population: 741828
Local Health District: Salt Lake Valley
Health Department
Site Updates
Last Inventory Update: 04/11/2025
Last Surveyor Update: 08/24/2023
Surveyor: SARAH ROMERO
Operating Period: 1/1 - 12/31
Last IPS Update: 04/16/2025 07:10:00
Political Districts
Legislative District Map
Water Usage Information per ERC
Standard as of: 04/01/2025
Peak Day Demand per ERC
(gal/day/ERC): 1307.0
Average Annual Demand per ERC
(gal/ERC): 195954.0
Equalization Storage per ERC
(gal/ERC): 703.0
Total Ips Points: 0
Public Water System Water Monitoring ReportDEQ | Drinking Water
Salt Lake City Water System PWS ID: UTAH18026 Rating: Approved 06/05/1975 Status: Active

BACTERIOLOGICAL MONITORING
Sample Count Type Frequency Schedule Begin Schedule End Analyte Name
180 Routine Monthly 12/01/2017 COLIFORM (TCR)
DISINFECTION BYPRODUCT STAGE 2 MONITORING
Sample Count Type Frequency Sample Label
12 Routine Quarterly UTAH18026 DS001 Sample ID below
Sample ID Site Last Sampled Next Sample Due
MD207 SAPP BROTHERS CALIF AVE 01/14/2025 04/01/2025-06/30/2025
MD202 C.U.P. 4300 W 2100 S 01/14/2025 04/01/2025-06/30/2025
MD210 MCDONALDS 2300 E PARLEYS WAY 01/14/2025 04/01/2025-06/30/2025
MD203 AIRPORT SHUTTLE 01/14/2025 04/01/2025-06/30/2025
MD201 AG BODY 1220 S LEGACY STREET 01/14/2025 04/01/2025-06/30/2025
MD209 7800 S PUMP STA 01/14/2025 04/01/2025-06/30/2025
MD204 HAMPTON INN 307 N ADMIRAL BIRD DR 01/14/2025 04/01/2025-06/30/2025
MD205 WING POINTE GOLF COURSE 01/14/2025 04/01/2025-06/30/2025
MD212 UTAH HEALTH BLD 40 MEDICAL DR 01/14/2025 04/01/2025-06/30/2025
MD206 MAVERICK 1927 S 3200 W 01/14/2025 04/01/2025-06/30/2025
MD208 CHEVRON 1881 W CALIF AVE 01/14/2025 04/01/2025-06/30/2025
MD211 COMMON CENTS 700 N REDWOOD 01/14/2025 04/01/2025-06/30/2025
Sample during the following months: July, October, January, April
Page 2 of 7
OTHER DISTRIBUTION MONITORING
Analyte Name ID Sample Count Type Frequency Last Sampled Next Sample Due
LEAD AND COPPER DS001 50 Routine 3 Years 09/2024 06/01/2027-09/30/2027
ASBESTOS DS001 1 Routine 9 Years 01/2022 01/01/2029 - 12/31/2037
CHLORINE RESIDUAL MONITORING
ID Facility Name Sample Count Type Frequency Last Sampled Next Sample Due
DS001 UTAH18026 DISTRIBUTION SYSTEM 180 Routine Monthly --
EP017 POINT OF ENTRY FOR TP017 3 Routine Weekly --
Page 2 of 7
MONITORING REQUIREMENTS BY FACILITY
ID Name Facility Details
TP001 BIG COTTONWOOD WTP Hide Details
Name Sample Required Type Frequency Last Sample Next Sample Due
CARBON, TOTAL 1 Routine Monthly 03/31/2025 04/01/2025 - 04/30/2025
INORGANICS & METALS 1 Routine 9 Years 01/12/2024 01/01/2029 - 12/31/2037
NITRATE 1 Routine Yearly 01/12/2024 01/01/2025 - 12/31/2025
PESTICIDES¹2 Routine 3 Years 01/10/2025 04/01/2025-06/30/2025
RADS - COMPLIANCE 1 Routine 6 Years 01/10/2025 01/01/2026 - 12/31/2031
SULFATE,SODIUM,TDS 1 Routine 9 Years 01/12/2024 01/01/2029 - 12/31/2037
VOLATILE ORGANICS 1 Routine 3 Years 01/10/2025 01/01/2026 - 12/31/2028
TP002 PARLEYS WTP Hide Details
Name Sample Required Type Frequency Last Sample Next Sample Due
CARBON, TOTAL 1 Routine Monthly 03/31/2025 04/01/2025 - 04/30/2025
INORGANICS & METALS 1 Routine 9 Years 01/17/2025 01/01/2029 - 12/31/2037
NITRATE 1 Routine Yearly 01/17/2025 01/01/2026 - 12/31/2026
PESTICIDES¹2 Routine 3 Years 01/17/2025 01/01/2026-12/31/2028
RADS - COMPLIANCE 1 Routine 6 Years 01/17/2025 01/01/2026 - 12/31/2031
SULFATE,SODIUM,TDS 1 Routine 9 Years 01/17/2025 01/01/2029 - 12/31/2037
VOLATILE ORGANICS 1 Routine 3 Years 01/17/2025 01/01/2026 - 12/31/2028
TP003 CITY CREEK WTP Hide Details
Name Sample Required Type Frequency Last Sample Next Sample Due
CARBON, TOTAL 1 Routine Monthly 03/31/2025 04/01/2025 - 04/30/2025
INORGANICS & METALS 1 Routine Yearly 01/10/2025 01/01/2026 - 12/31/2026
NITRATE 1 Routine Quarterly 01/10/2025 04/01/2025 - 06/30/2025
PESTICIDES¹2 Routine 3 Years 01/10/2025 04/01/2025-06/30/2025
RADS - COMPLIANCE 1 Routine 9 Years 01/21/2022 01/01/2029 - 12/31/2037
SULFATE,SODIUM,TDS 1 Routine Yearly 01/10/2025 01/01/2026 - 12/31/2026
VOLATILE ORGANICS 1 Routine 3 Years 01/10/2025 01/01/2026 - 12/31/2028
WS001 BIG COTTONWOOD INTAKE Hide Details
Name Sample Required Type Frequency Last Sample Next Sample Due
TOC AND ALKALINITY 1 Routine Monthly 03/31/2025 04/01/2025 - 04/30/2025
WS002 PARLEYS INTAKE - MOUNTAIN DELL RESERVOIR Hide Details
Name Sample Required Type Frequency Last Sample Next Sample Due
TOC AND ALKALINITY 1 Routine Monthly 03/31/2025 04/01/2025 - 04/30/2025
WS003 CITY CREEK INTAKE Hide Details
Name Sample Required Type Frequency Last Sample Next Sample Due
TOC AND ALKALINITY 1 Routine Monthly 03/31/2025 04/01/2025 - 04/30/2025
WS006 UPPER BOUNDARY SPRING Hide Details
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ID Name Facility Details
Name Sample Required Type Frequency Last Sample Next Sample Due
INORGANICS & METALS 1 Routine 9 Years 02/21/2025 01/01/2029 - 12/31/2037
NITRATE 1 Routine Yearly 02/21/2025 01/01/2026 - 12/31/2026
PESTICIDES¹2 Routine 3 Years 02/21/2025 04/01/2025-06/30/2025
RADS - COMPLIANCE 1 Routine 9 Years 12/08/2023 01/01/2029 - 12/31/2037
SULFATE,SODIUM,TDS 1 Routine 9 Years 02/21/2025 01/01/2029 - 12/31/2037
WS008 EMIGRATION TUNNEL Hide Details
Name Sample Required Type Frequency Last Sample Next Sample Due
INORGANICS & METALS 1 Routine 3 Years 02/21/2025 01/01/2026 - 12/31/2028
NITRATE 1 Routine Yearly 02/21/2025 01/01/2026 - 12/31/2026
PESTICIDES¹2 Routine 3 Years 02/21/2025 04/01/2025-06/30/2025
RADS - COMPLIANCE 1 Routine 3 Years 02/21/2025 01/01/2026 - 12/31/2028
SULFATE,SODIUM,TDS 1 Routine 3 Years 02/21/2025 01/01/2026 - 12/31/2028
VOLATILE ORGANICS 1 Routine 3 Years 02/21/2025 01/01/2026 - 12/31/2028
WS010 NILA WAY WELL Hide Details
Name Sample Required Type Frequency Last Sample Next Sample Due
INORGANICS & METALS 1 Routine 9 Years 08/02/2024 01/01/2029 - 12/31/2037
NITRATE 1 Routine Yearly 08/02/2024 01/01/2025 - 12/31/2025
PESTICIDES¹2 Routine 3 Years 08/02/2024 04/01/2025-06/30/2025
RADS - COMPLIANCE 1 Routine 9 Years 07/03/2019 01/01/2020 - 12/31/2028
SULFATE,SODIUM,TDS 1 Routine 9 Years 08/02/2024 01/01/2029 - 12/31/2037
VOLATILE ORGANICS 1 Routine 3 Years 08/02/2024 01/01/2026 - 12/31/2028
WS013 NEFFS DRAW WELL Hide Details
Name Sample Required Type Frequency Last Sample Next Sample Due
INORGANICS & METALS 1 Routine 9 Years 05/17/2024 01/01/2029 - 12/31/2037
NITRATE 1 Routine Yearly 05/17/2024 01/01/2025 - 12/31/2025
PESTICIDES¹2 Routine 3 Years 05/17/2024 04/01/2025-06/30/2025
RADS - COMPLIANCE 1 Routine 3 Years 08/02/2022 01/01/2023 - 12/31/2025
SULFATE,SODIUM,TDS 1 Routine 9 Years 05/17/2024 01/01/2029 - 12/31/2037
VOLATILE ORGANICS 1 Routine Yearly 05/17/2024 01/01/2025 - 12/31/2025
WS014 4280 S 2700 E WELL Hide Details
Name Sample Required Type Frequency Last Sample Next Sample Due
INORGANICS & METALS 1 Routine 3 Years 07/03/2024 01/01/2026 - 12/31/2028
NITRATE 1 Routine Yearly 07/03/2024 01/01/2025 - 12/31/2025
PESTICIDES¹2 Routine 3 Years 07/03/2024 04/01/2025-06/30/2025
RADS - COMPLIANCE 1 Routine 3 Years 06/11/2021 01/01/2023 - 12/31/2025
SULFATE,SODIUM,TDS 1 Routine 3 Years 07/03/2024 01/01/2026 - 12/31/2028
VOLATILE ORGANICS 1 Routine 3 Years 07/03/2024 01/01/2026 - 12/31/2028
WS020 13TH EAST WELL Hide Details
Page 2 of 7
ID Name Facility Details
Name Sample Required Type Frequency Last Sample Next Sample Due
INORGANICS & METALS 1 Routine 9 Years 07/05/2024 01/01/2029 - 12/31/2037
NITRATE 1 Routine Yearly 07/05/2024 01/01/2025 - 12/31/2025
PESTICIDES¹2 Routine 3 Years 07/05/2024 04/01/2025-06/30/2025
RADS - COMPLIANCE 1 Routine 6 Years 06/25/2019 01/01/2020 - 12/31/2025
SULFATE,SODIUM,TDS 1 Routine 9 Years 07/05/2024 01/01/2029 - 12/31/2037
VOLATILE ORGANICS 1 Routine 3 Years 07/05/2024 01/01/2026 - 12/31/2028
WS023 900 E 4800 S WELL Hide Details
Name Sample Required Type Frequency Last Sample Next Sample Due
INORGANICS & METALS 1 Routine 9 Years 07/23/2024 01/01/2029 - 12/31/2037
NITRATE 1 Routine Yearly 07/23/2024 01/01/2025 - 12/31/2025
PESTICIDES¹2 Routine 3 Years 07/23/2024 04/01/2025-06/30/2025
RADS - COMPLIANCE 1 Routine 9 Years 07/23/2024 01/01/2029 - 12/31/2037
SULFATE,SODIUM,TDS 1 Routine 9 Years 07/23/2024 01/01/2029 - 12/31/2037
VOLATILE ORGANICS 1 Routine 3 Years 07/23/2024 01/01/2026 - 12/31/2028
WS024 BRINTON SPRING WELL Hide Details
Name Sample Required Type Frequency Last Sample Next Sample Due
INORGANICS & METALS 1 Routine 9 Years 06/14/2024 01/01/2029 - 12/31/2037
NITRATE 1 Routine Yearly 06/14/2024 01/01/2025 - 12/31/2025
PESTICIDES¹2 Routine 3 Years 09/13/2024 01/01/2026-12/31/2028
RADS - COMPLIANCE 1 Routine 9 Years 06/20/2017 01/01/2020 - 12/31/2028
SULFATE,SODIUM,TDS 1 Routine 9 Years 06/14/2024 01/01/2029 - 12/31/2037
VOLATILE ORGANICS 1 Routine 3 Years 06/14/2024 01/01/2026 - 12/31/2028
WS025 5400 S EDGEWOOD WELL Hide Details
Name Sample Required Type Frequency Last Sample Next Sample Due
INORGANICS & METALS 1 Routine 3 Years 07/05/2024 01/01/2026 - 12/31/2028
NITRATE 1 Routine Yearly 07/05/2024 01/01/2025 - 12/31/2025
PESTICIDES¹2 Routine 3 Years 07/05/2024 04/01/2025-06/30/2025
RADS - COMPLIANCE 1 Routine 9 Years 09/08/2021 01/01/2029 - 12/31/2037
SULFATE,SODIUM,TDS 1 Routine 3 Years 07/05/2024 01/01/2026 - 12/31/2028
VOLATILE ORGANICS 1 Routine 3 Years 07/05/2024 01/01/2026 - 12/31/2028
WS026 DIAGONAL WELL Hide Details
Name Sample Required Type Frequency Last Sample Next Sample Due
INORGANICS & METALS 1 Routine 9 Years 08/16/2024 01/01/2029 - 12/31/2037
NITRATE 1 Routine Yearly 08/16/2024 01/01/2025 - 12/31/2025
PESTICIDES¹2 Routine 3 Years 08/16/2024 04/01/2025-06/30/2025
RADS - COMPLIANCE 1 Routine 9 Years 06/22/2022 01/01/2029 - 12/31/2037
SULFATE,SODIUM,TDS 1 Routine 9 Years 08/16/2024 01/01/2029 - 12/31/2037
VOLATILE ORGANICS 1 Routine 3 Years 08/16/2024 01/01/2026 - 12/31/2028
WS027 FONTAINE BLEU WELL Hide Details
Page 2 of 7
ID Name Facility Details
Name Sample Required Type Frequency Last Sample Next Sample Due
INORGANICS & METALS 1 Routine 9 Years 07/03/2024 01/01/2029 - 12/31/2037
NITRATE 1 Routine Yearly 07/03/2024 01/01/2025 - 12/31/2025
PESTICIDES¹2 Routine 3 Years 07/03/2024 04/01/2025-06/30/2025
RADS - COMPLIANCE 1 Routine 9 Years 05/19/2016 01/01/2020 - 12/31/2028
SULFATE,SODIUM,TDS 1 Routine 9 Years 07/03/2024 01/01/2029 - 12/31/2037
VOLATILE ORGANICS 1 Routine 3 Years 07/03/2024 01/01/2026 - 12/31/2028
WS030 GREENFIELD VILLAGE WELL Hide Details
Name Sample Required Type Frequency Last Sample Next Sample Due
INORGANICS & METALS 1 Routine 9 Years 07/23/2024 01/01/2029 - 12/31/2037
NITRATE 1 Routine Yearly 07/23/2024 01/01/2025 - 12/31/2025
PESTICIDES¹2 Routine 3 Years 07/23/2024 04/01/2025-06/30/2025
RADS - COMPLIANCE 1 Routine 3 Years 06/11/2021 01/01/2023 - 12/31/2025
SULFATE,SODIUM,TDS 1 Routine 9 Years 07/23/2024 01/01/2029 - 12/31/2037
VOLATILE ORGANICS 1 Routine 3 Years 07/23/2024 01/01/2026 - 12/31/2028
WS032 ELLISON WELL Hide Details
Name Sample Required Type Frequency Last Sample Next Sample Due
INORGANICS & METALS 1 Routine 9 Years 06/14/2024 01/01/2029 - 12/31/2037
NITRATE 1 Routine Yearly 06/14/2024 01/01/2025 - 12/31/2025
PESTICIDES¹2 Routine 3 Years 06/14/2024 04/01/2025-06/30/2025
RADS - COMPLIANCE 1 Routine 3 Years 06/14/2024 01/01/2026 - 12/31/2028
SULFATE,SODIUM,TDS 1 Routine 9 Years 06/14/2024 01/01/2029 - 12/31/2037
VOLATILE ORGANICS 1 Routine 3 Years 06/14/2024 01/01/2026 - 12/31/2028
WS033 WALKER LANE WELL Hide Details
Name Sample Required Type Frequency Last Sample Next Sample Due
INORGANICS & METALS 1 Routine 3 Years 06/07/2024 01/01/2026 - 12/31/2028
NITRATE 1 Routine Yearly 06/07/2024 01/01/2025 - 12/31/2025
PESTICIDES¹2 Routine 3 Years 06/07/2024 04/01/2025-06/30/2025
RADS - COMPLIANCE 1 Routine 9 Years 06/29/2016 01/01/2020 - 12/31/2028
SULFATE,SODIUM,TDS 1 Routine 3 Years 06/07/2024 01/01/2026 - 12/31/2028
VOLATILE ORGANICS 1 Routine 3 Years 06/07/2024 01/01/2026 - 12/31/2028
WS042 ARTESIAN BASIN WELL #2 Hide Details
Name Sample Required Type Frequency Last Sample Next Sample Due
INORGANICS & METALS 1 Routine 9 Years 12/11/2024 01/01/2029 - 12/31/2037
NITRATE 1 Routine Yearly 12/11/2024 01/01/2025 - 12/31/2025
PESTICIDES¹2 Routine 3 Years 12/11/2024 04/01/2025-06/30/2025
RADS - COMPLIANCE 1 Routine 9 Years 08/06/2021 01/01/2029 - 12/31/2037
SULFATE,SODIUM,TDS 1 Routine 9 Years 12/11/2024 01/01/2029 - 12/31/2037
VOLATILE ORGANICS 1 Routine 3 Years 12/11/2024 01/01/2026 - 12/31/2028
Page 2 of 7
¹To fulfill the two pesticide sample requirements, systems are to submit the second pesticide sample in the quarter following the quarter in which the first sample was
collected.
GROUPED SOURCE SAMPLING STATIONS
Sample Group ID Sample Group Facility Details
8053 S28-UTAH18026UTAH18103 Hide Details
Source ID Source Name Sample Group Details System
WS005 MT OLYMPUS SPRING ABND UTAH18026 SALT LAKE CITY WATER SYSTEM
WS001 MT OLYMPUS SPRING UTAH18103 MOUNT OLYMPUS WATERS
8085 S29-UTAH18026UTAH18050 Hide Details
Source ID Source Name Sample Group Details System
WS007 LOWER BOUNDARY SPRING TSFR UTAH18026 SALT LAKE CITY WATER SYSTEM
WS001 LOWER BOUNDARY SPRING UTAH18050 BOUNDARY SPRING WATER CO
8193 S30-UTAH18026UTAH18028 Hide Details
Source ID Source Name Sample Group Details System
WS039 RICHARDS DITCH WELL [DISCONNECTED]IGNORE THIS ONE UTAH18026 SALT LAKE CITY WATER SYSTEM
WS027 RICHARDS DITCH WELL (SOLD/TRANSFERRED)UTAH18028 SANDY CITY WATER SYSTEM
7956 S63-UTAH18026UTAH18028 Hide Details
Source ID Source Name Sample Group Details System
WS031 7901 S HIGHLAND WELL TSFR UTAH18026 SALT LAKE CITY WATER SYSTEM
WS026 LITTLE COTTONWOOD WELL UTAH18028 SANDY CITY WATER SYSTEM
OPEN COMPLIANCE SCHEDULES
Type Required Activities Severity Created Due
TEMPORARY EXCEPTION GWR CORRECT DEFICIENCY 120 DAYS SIG 02/07/2024 04/01/2027
TEMPORARY EXCEPTION GWR CORRECT DEFICIENCY 120 DAYS SIG 02/07/2024 04/01/2027
Water Use Data WUD STANDARD SET, RESET DUE IN 3 YEARS 03/31/2021 03/31/2024
CCR SCHEDULES Submit Consumer Confidence Report 01/01/2025 07/01/2025
CCR SCHEDULES Submit CCR Certification Letter 01/01/2025 10/01/2025
ERROR:PFAS SUBMIT PFAS INITIAL MONITORING SAMPLES 04/26/2024 04/26/2027
Utah Division of Drinking Water
Bacteriological Sample Site Plan
All public water systems are required under the Revised Total Coliform Rule (RTCR) to submit a Bacteriological
Sample Site Plan. The purpose of the wrien sample site plan is to ensure the collecon of samples from points in
the distribuon system that best represent the quality of water served to customers, to idenfy repeat sampling
locaons, and to establish a sampling schedule.
What to include in the plan:
1. The following should be submied for the Bacteriological Sample Site Plan:
a. The plan must include a MAP of the distribuon system. Excepons are small systems such as
restaurants, schools, office buildings, and some small industries.
b. Bacteriological Sample Site Plan form.
2. The map should show locaons of all distribuon lines, sources, treatment, storage tanks and sampling
sites. Idenfy each sampling site by street address and a numeric point code. Give a brief descripon of
the site. For example: 201 Main Street, 1. DS001, outside house tap, or Maintenance Facility, 1. DS001,
men’s restroom sink. The sampling site Numeric Point Code should begin with the number 1 and then
connue in sequenal numeric order. Use the numeric point code, along with DS001, when subming
samples to the laboratory.
3. Locate sample sites so they represent all areas of the distribuon system. You may wish to include
comments on your plan showing the reason(s) for selecng each site. Such as populaon density,
industrial areas, pressures zones, areas vulnerable to potenal contaminaon, dead-end lines, and
purchased source entry points. Alternate sampling locaons through different locaons of the water
system.
4. Do NOT indicate the raw water tap or sources as sampling sites for roune or repeat coliform samples.
These are “triggered source” sampling locaons under the Groundwater Rule (GWR). Indicate the
associated source (by DDW assigned source codes) for each sample locaon. For example: “WS001”,
“WS002 and WS004”, or “All Sources” supply this specific locaon.
5. Include the locaon for “Repeat” sample sites. Repeat samples must be collected at the following
locaons within 24 hours of a total coliform or E coli posive sample:
- The tap where the original posive coliform sample was collected,
- A tap within five (5) service connecons upstream, and
- A tap within five (5) service connecons downstream.
6. Alternave fixed repeat locaons may be idenfied at locaons that best verify and determine the extent
of potenal contaminaon in the distribuon system based on a specific situaon.
7. For system with only one or two service connecons (suitable sampling taps), collect all three repeat
samples in one day from the limited number of sampling taps. The sample site plan should show which
taps(s) are in use for mulple samples.
8. The number of roune coliform samples collected each month is based on the populaon of the water
system. For a table indicang the number of samples required see Secon R309-210-5.
9. Include a schedule for selecon of the samples. Systems using only groundwater and serving less than
4,900 people (five samples required per month or fewer) may collect all required sample on a single day.
Systems with greater than five samples per month must collect a poron of the samples at regular
intervals throughout the month with the total number being the number required.
revised 2/3/2021
S UBMITTAL
Mail the completed form to:
Or Email:
Division of Drinking water
An: Sitara Federico
195 N 1950 W
PO BOX 144830
Salt lake City, UT 84114
[e-mail]
This applicaon and related environmental informaon are available online: DrinkingWater.utah.gov
revised 2/3/2021
Bacteriological Sample Site Plan
B ASIC W ATER S YSTEM I NFO
Water System Name: Water System #:
S ITE S ELECTION I NFO
Monthly Roune Sample Sites (mark an “X” in boxes below): Follow-up/Repeat Sample (range
or specific address)
DDW Assigned #
for Associated
Roune Sample Point
Descripon
(horse bib, sink faucet, etc.) Address Point
ID
JA
N
FE
B
MA
R
AP
R
MA
Y
JU
N
JU
L
AU
G
SE
P
OC
T
NO
V
DE
C
1-DS00
1 Down Up
2-DS00
1 Down Up
3-DS00
1 Down Up
4-DS00
1 Down Up
5-DS00
1 Down Up
6-DS00
1 Down Up
S OURCE INFO
C ERTIFICATION
Samples Collected by: Plan Submitted by: Date Submitted:
revised 2/3/2021
Source(s) Name: DDW Source
or Group # Bacteria Sampling Laboratory Information:
Laboratory:
Address:
City:
Zip Code:
Phone
Number:
Contact Name:
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