DDW-2025-004627

Utah Department Of Environmental Quality
Division Of Drinking Water Sanitary Survey
Sanitary Survey
General System Information
Exception Granted: R309-550-7 | The basis for your request for an exception to R309-550-7 is that the existing water line at this location is
approximately 6-inch above the new sewer line. Your exception request noted the following:

1.The existing 8-inch C-900 PVC water line was installed in 2005 and is in good condition.
2.The new sewer line that is being installed is 12-inch SDR-35 PVC.
3.Raising the water line to obtain the 18-inches of clearance would place the water line above the frost line, increasing the possibility of freezing.
4.While the Stonegate area is known for high ground water, this crossing is near the north end with deeper ground water levels than in the southern
part of the project.
5.The sewer project includes a land drain under the sewer line to keep ground water levels below the sewer.
6.The water crosses the sewer at about a 30 degree angle. In evaluating whether to re-align the water to cross at 90 degrees you concluded that
the danger and cost of excavating more area in the partially water logged collapsible soils was greater than the public health benefit of a 90 degree
crossing.
Exception Granted: R309-550-7 | water/sewer crossings don't meet the 18-inch clearance water above sewer requirement in the following
locations: 400 EastWPP-0711+80, LagoonWPP-0915+90, LagoonWPP-0916+05, LagoonWPP-1020+85

Exception Granted: R309-550-5(5)(b) | Fire hydrants are spaced greater than 500 feet apart.

Site Visit Date Surveyor Name
05/13/2025 Chris Bowles
ROOSEVELT CITY WATER
SYSTEM
PWS ID: UTAH07004 Rating: Approved 03/11/1980 Active
1 Admin Contact (AC) [ eMail address is REQUIRED ]
MIN | 15pts | SM | G004 | R309-100-4(5) | Rule requires a person or organization be
designated as the owner of the system and name, address and phone number of such
be supplied to the Division.
*First Name: JOSHUA
*Last Name: BAKE
*Organization:
*Address: Redacted
*City: ROOSEVELT
*State: UT
*Zip: 84066
*Email: [e-mail]
*Phone: [phone]
Emergency Phone: [phone]
DEQ | Drinking Water
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2 Legal Contact (LC) [ if no eMail address is available, enter [e-mail] ]
MIN | 15pts | SM | G004 | R309-100-4(5) | Rule requires a person or organization be
designated as the owner of the system and name, address and phone number of such
be supplied to the Division.
*First Name:
*Last Name:
*Organization: ROOSEVELT CITY
*Address: 255 S STATE
*City: ROOSEVELT
*State: UT
*Zip: 84066
*Email: [e-mail]
*Phone: [phone]
3 Owner Contact (OW) [ if no eMail address is available, enter [e-mail] ]
MIN | 15pts | SM | G004 | R309-100-4(5) | Rule requires a person or organization be
designated as the owner of the system and name, address and phone number of such
be supplied to the Division.
*First Name:
*Last Name:
*Organization: ROOSEVELT CITY
*Address: 255 S STATE
*City: ROOSEVELT
*State: UT
*Zip: 84066
*Email: [e-mail]
*Phone: [phone]
Emergency Phone: [phone]
4 Direct Operator in Charge (DO) [ if no eMail address is available, enter
[e-mail] ]
MIN | 15pts | SM | G004 | R309-100-4(5) | Rule requires a person or organization be
designated as the owner of the system and name, address and phone number of such
be supplied to the Division.
*First Name: Kirby
*Last Name: Wolfinjer
*Organization:
*Address: 255 S State
*City: ROOSEVELT
*State: UT
*Zip: 84066
*Email: [e-mail]
*Phone: [phone]
Emergency Phone: [phone]
5 Does the system serve a Residential population?Y
5A Population - Residential 8000
5B Operating Period (Start Date) - Residential 01/01
5C Operating Period (End Date) - Residential 12/31
DEQ | Drinking Water
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Site Visit Info
Management and Operations
6 Does the system serve a Transient population? (A transient population is a rotating
population that is served by a water system that does not remain in the jurisdiction of
the water system for long periods of time. Examples of a transient population include,
but are not limited to, campers at a campground, users of a highway rest stop, skiers
at a ski resort, guests at a hotel, or patrons of a restaurant or a shopping center.)
N
7 Does the system serve a Non-Transient population? (A non-transient population is a
population served by a water system that is the same population being served by the
system for at least six months of the year, but is not a resident in the system.
Examples of a non-transient population include, but are not limited to, employees of a
restaurant, shop, or ski resort; teachers and students at a school, day-care center, or
church; doctors, nurses, and other employees at a hospital or healthcare clinic.)
N
8 Population - Wholesale :0
9 Residential Connections:2389
10 Commercial Connections:268
11 Industrial Connections:65
12 Agricultural Connections:0
13 Date of Survey (First Day of Field Work)05/13/2025
14 Date of Survey (Last Day of Field Work) ** this should match the Date of Survey in the
header **
05/13/2025
15 Date final report sent to system (questionnaire, deficiency report and capacity
spreadsheet)
05/20/2025
16 Water system representative present during the survey:Y
17 How much time was spent to prepare survey documents prior to field survey? (Round
up to nearest quarter hour)
1
18 How much time was spent to complete the field survey (arrival to completion; include
travel time between water system facilities)? (Round up to nearest quarter hour)
8
19 How much time was spent traveling from the office to system and back again at the
end of the field survey? (Round up to nearest quarter hour)
3
20 How much time did it take to finish the Survey Report? (Round up to nearest quarter
hour)
3
21 Did you survey multiple water systems in one trip? ... if yes, answer the following
question(s)
Y
21A If yes, how many?4
22 For a community water system with water sources that require power to produce
sufficient flow, system is equipped with standby power option.
SIG | 25pts | SO | S033 | R309-515-6(2)(a) | Rule requires a community water system
without naturally flowing water sources, such as springs or flowing wells, to have one
or more of the system's sources equipped for operation during power outages. To
ensure continuous service when the primary power has been interrupted, a redundant
power supply is required. A redundant power supply may include a transfer switch for
auxiliary power such as a generator or a power supply service with coverage from two
independent substations. This significant deficiency must be corrected within 120 days
of notification or have a corrective action plan approved by DDW.
C
DEQ | Drinking Water
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23 There are no undocumented drinking water facilities (i.e. tanks, pump stations,
treatment facilities, etc.) or recent modifications that have not gone through or in
process of DDW review [LIST UNDOCUMENTED FACILITIES OR DESCRIBE
MODIFICATIONS, IF APPLICABLE] [undocumented sources are covered in a
different question]
SIG | 50pts | SM | G001 | R309-100-5(2), R309-500-6, R309-500-9, R309-500-9(2)
and (3) | Rule requires complete plans & specification for all public drinking water
projects to be approved in writing by the Director. Any facility found that has not
started DDW review shall be considered unapproved. This significant deficiency must
be corrected within 120 days of notification or have a corrective action plan approved
by DDW.
C
24 Are there any individual home booster pumps installed in the distribution system (not
for fire suppression)?
SIG | 50pts | SM | M008 | R309-550-11(3) | R309-550-11(3)
C
25 Does the system haul water?N
26 For a community system serving 100 or more connections, at least 2 water sources
are available.
SIG | 50pts | SO | TGR7 | R309-515-4(3) | Rule requires Community Water Systems
serving more than 100 connections to have a minimum of two sources except where
served by a water treatment plant. This significant deficiency must be corrected within
120 days of notification or have a corrective action plan approved by DDW.
C
27 Does system have a consecutive connection to another water system not listed in the
SOURCE section of Waterlink Report? If yes, answer the following question(s)
N
28 Does the system have a deficiency meeting the required source capacity? (USE
SPREADSHEET FOR CALCULATIONS) *IF YES, SELECT CORRECT STATEMENT
FROM THE FOLLOWING AND MARK "YES"; MARK ALL OTHER STATEMENTS
"NO."
N
29 Does the system have a deficiency meeting the required storage capacity DUE
SOLELY TO FIRE SUPPRESSION NEEDS? (USE SPREADSHEET FOR
CALCULATIONS) *IF YES, SELECT CORRECT STATEMENT FROM THE
FOLLOWING AND MARK "YES"; MARK ALL OTHER STATEMENTS "NO."
N
30 Does the system have a deficiency meeting the required equalization storage capacity
for indoor/outdoor demands (but not because of fire suppression needs)? (USE
SPREADSHEET FOR CALCULATIONS) *IF YES, SELECT CORRECT STATEMENT
FROM THE FOLLOWING AND MARK "YES"; MARK ALL OTHER STATEMENTS
"NO."
N
31 Does your water system have an Emergency Response Plan?
REC | 0pts | SM | M001 | R309-105-18 | All suppliers are advised to develop
contingency plans to cope with possible emergency situations. In many areas of the
state the possibility of earthquake damage shall be realistically considered.
Y
32 Does your Emergency Response Plan address cybersecurity? (only required for
systems over 3,300 population, otherwise mark NA)
MIN | 15pts | TR | TGR9 | R309-105-7, 8 & 18, R309-100 through 605 | Trigger for
regulatory followup to address concerns.
Y
33 Does your water system use SCADA? e.g. computers, laptops, phones, tablets, or any
other computer systems to manage, operate, or maintain the PWS?
Y
34 Does your water system use any computer systems in regular business operations
such as accounting, billing, payroll, human resources, or management?
Y
DEQ | Drinking Water
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Cross Connection and Operator Certification
35 For a community water system or a non-transient non-community water system, did
you make your initial service line inventory available to the public? (if a transient
system, enter NA)
REC | 0pts | MR | R006 | 40 CFR 141.84 | (a)(8)The rule requires that the service line
materials inventory be publicly accessible. (a)(8)(ii) The rule requires that water
systems serving greater than 50,000 persons make the publicly accessible inventory
available online. (a)(9) The rule requires that when a water system has no lead,
galvanized requiring replacement, or lead status unknown service lines (regardless of
ownership) in its inventory, it may comply with the requirements using a written
statement, in lieu of the inventory, declaring that the distribution system has no lead
service lines or galvanized requiring replacement service lines. The statement must
include a general description of all applicable sources used to make this
determination.
Y (Notes: 8000)
35A For a community or a non-transient non-community water system serving a population
greater than 50,000, is your service line inventory provided online? (mark NA for
systems less than 50,000) (If yes, provide the link in the comment box)?
REC | 0pts | MR | R006 | 40 CFR 141.84 | (a)(8)The rule requires that the service line
materials inventory be publicly accessible. (a)(8)(ii) The rule requires that water
systems serving greater than 50,000 persons make the publicly accessible inventory
available online. (a)(9) The rule requires that when a water system has no lead,
galvanized requiring replacement, or lead status unknown service lines (regardless of
ownership) in its inventory, it may comply with the requirements using a written
statement, in lieu of the inventory, declaring that the distribution system has no lead
service lines or galvanized requiring replacement service lines. The statement must
include a general description of all applicable sources used to make this
determination.
NA (Notes: 8000)
35B For a community water system or a non transient non-community water system
serving a population of less than 50,000, what method was used to make the inventory
publicly available?
O
36 Legally adopted authority statement
MIN | 15pts | SM | M003 | R309-105-12(2) | Rule requires each public water system to
have a cross connection control program that includes a legally adopted and functional
local authority to enforce the program (i.e., ordinance, bylaw, or policy).
C
37 Documentation of annual public awareness and/or employee training
MIN | 15pts | SM | M004 | R309-105-12(2) | Rule requires each public water system to
have a cross connection control program that includes providing public education or
awareness material or presentations.
C
38 Documentation of personnel trained to manage the program (ALL COMUNITY
WATER SYSTEMS REQUIRE A DDW CERTIFIED CCC PROGRAM
ADMINISTRATOR. ALL OTHER WATER SYSTEMS REQUIRE AT A MINIMUM
BACKFLOW 101 OR EQUIVALENT/ GREATER CCC TRAINING)
MIN | 15pts | SM | M005 | R309-105-12(2) | Rule requires each public water system to
have a cross connection control program that includes an operator with adequate
training in the area of cross connection control or backflow prevention.
C
DEQ | Drinking Water
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General Maintenance and Environment
Distribution
39 Does the water system have detailed records of cross connection control activities?
(inventories of backflow assemblies, devices, and air gaps installed within the system)
MIN | 15pts | SM | M006 | R309-105-12(2) | Rule requires each public water system to
have a cross connection control program that includes written records of cross
connection control activities.
C
40 Does the water system have records of on-going enforcement activities? (test history,
enforcement activities, hazard assessments)
MIN | 15pts | SM | M007 | R309-105-12(2) | Rule requires each public water system to
have a cross connection control program that includes test history and documentation
of on-going enforcement activities.
D (Notes: No documentation of Proactive
On-going just incidental and Backflow
testing being done has been voluntary thus
far)
41 Operator meets required level of certification for water system. ( IF NO CERTIFIED
OPERATOR IS REQUIRED MARK COMPLIANT )
SIG | 50pts | OC | C001 | R309-105-11, R309-300-5(3) | Rule requires every
community and NTNC water system and public water systems that utilize
treatment/filtration to have at least one operator certified at the classified grade of the
water system. Certification must be appropriate for the type of system operated
(treatment and/or distribution). This significant deficiency must be corrected within 120
days of notification or have a corrective action plan approved by DDW.
C
42 Certified operator is within 1 hour travel time of water system. ( IF NO CERTIFIED
OPERATOR IS REQUIRED MARK COMPLIANT )
MIN | 0pts | OC | C002 | R309-300-5(14) | Rule requires the operator to be within 1
hour travel time, under normal work and home conditions, of each drinking water
system for which he is considered in direct responsible charge.
C
43 Are there any visual indications of unsanitary conditions?
SIG | 50pts | SM | M017 | R309-200-6, R309-105-18, R309-215-4(3) | R309-200-6 The
Secondary Maximum Contaminant Levels for public water systems deals with
substances which affect the aesthetic quality of drinking water. They are presented
here as recommended limits or ranges and are not grounds for rejection. The taste of
water may be unpleasant and the usefulness of the water may be impaired if these
standards are significantly exceeded.
R309-105-18 The Director or the local health department shall be informed by
telephone by a water supplier of any "emergency situation". The term "emergency
situation...
R309-215-4(3) If the water fails to meet minimum standards, then certain public
notification procedures shall be carried out, as outlined in R309-220. Water suppliers
shall also keep analytical records in their possession, for a required length of time, as
outlined in R309-105-17.
D (Notes: Scum floating in Tanks, pictures
will be attached on follow up email. Advised
to overflow tanks to skim scum, flush and
take investigative samples. Photo's will be
sent on follow up email.)
44 No unprotected connection between the distribution system and a source of
contamination. (If there is an unprotected connection, describe the location in detail.)
SIG | 50pts | DS | D009 | R309-550-5(11) | R309-550-5(11)
C
45 Are air release/vacuum valves in the distribution system? ... if yes, answer the
following question(s)
Y
DEQ | Drinking Water
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45A Open end of vent line covered with #14 mesh screen
SIG | 25pts | DS | D004 | R309-550-6(6)(b) | Rule states the open end of the air relief
vent pipe from automatic valves shall be provided with a #14 mesh, non-corrodible
screen and a downward elbow, and where possible, be extended to at least one foot
above grade. This significant deficiency must be corrected within 120 days of
notification or have a corrective action plan approved by DDW.
C
45B For a valve in a chamber, open end of vent pipe is at least 12 inches above grade or
one foot above distribution line in a chamber that does not flood.
SIG | 25pts | DS | D006 | R309-550-6(6)(b) | Rule states the open end of the air relief
vent pipe from automatic valves shall be provided with a #14 mesh, non-corrodible
screen and a downward elbow, and where possible, be extended to at least one foot
above grade. This significant deficiency must be corrected within 120 days of
notification or have a corrective action plan approved by DDW.
C
45C Chamber has drain to daylight, gravel-filled adsorption pit if not subject to flooding, or
sump pump.
SIG | 25pts | DS | D007 | R309-550-6(6)(b) and (7)(b) | Rule states chambers shall be
provided with a drain to daylight, if possible. Where this is not possible, underground
gravel-filled absorption pits may be used if the site is not subject to flooding and
conditions will assure adequate drainage. Sump pumps may also be considered if a
drain to daylight or absorption pit is not feasible. This significant deficiency must be
corrected within 120 days of notification or have a corrective action plan approved by
DDW.
C
45D Open end of vent line down-turned.
SIG | 25pts | DS | D006 | R309-550-6(6)(b) | Rule states the open end of the air relief
vent pipe from automatic valves shall be provided with a #14 mesh, non-corrodible
screen and a downward elbow, and where possible, be extended to at least one foot
above grade. This significant deficiency must be corrected within 120 days of
notification or have a corrective action plan approved by DDW.
C (Notes: Vent not down turned but Hard
Cover is protecting screened riser.)
46 Water system has a program to maintain, operate, or control the use of fire hydrants.
REC | 0pts | DS | D012 | N/A | Fire hydrants provide a direct access to the water in the
distribution system. In order to protect the quality and integrity of the water, fire
hydrant access should be controlled.
C
47 Blow offs or air release valves are not directly connected to a sanitary sewer line.
SIG | 50pts | DS | D013 | R309-550-6(5)(a), R309-550-6(6)(c) and (7)(a) | Rule states
blow-offs or air relief valves shall not be connected directly to a sewer. This significant
deficiency must be corrected within 120 days of notification or have a corrective action
plan approved by DDW.
C
48 Blow offs or air release valves do not discharge below flood level in ditches or
streams.
SIG | 50pts | DS | D016 | R309-550-9(1) and (2), R309-550-13(2) | R309-550-9(1 & 3)
C
49 All water mains installed after 1995 that provide fire flow are at least 8 inches in
diameter.
MIN | 15pts | DS | D019 | R309-550-5(4) & (5) | Rule states that the minimum line size
serving a fire hydrant lateral shall be 8-inch diameter unless a hydraulic analysis
indicates that required flow and pressures can be maintained by 6-inch lines.
C
DEQ | Drinking Water
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General Disinfection
ST004 - 500,000 GALLON TANK ON R HILL ABANDONED - Inactive (AB - ABANDONED)
ST005 - STEEL TANK R HILL ABANDONED - Inactive (AB - ABANDONED)
TP015 - DURIGAN SP WELL CHLORINATOR - Inactive (AB - ABANDONED)
WS002 - CAMPBELL WELL 1 ABANDONED - Inactive (AB - ABANDONED)
WS003 - CAMPBELL WELL 2 ABANDONED - Inactive (AB - ABANDONED)
50 Distribution system capable of providing minimum pressure of 20 psi at all service
connections.
SIG | 50pts | DS | D003 | R309-105-9, R309-550-5(1) | Rule states the distribution
system shall maintain minimum pressures as required by R309-105-9 at all points of
connection under all flow conditions. This significant deficiency must be corrected
within 120 days of notification or have a corrective action plan approved by DDW.
C
51 Was the water system constructed or new portions added after January 1, 2007? ... if
yes, answer the following question(s)
Y
51A Distribution system capable of maintaining the following pressures at all service
connections: (a) 20 psi during fire flow and fire demand during peak day demand; (b)
30 psi during peak instantaneous demand; and (c) 40 psi during peak day demand.
SIG | 50pts | DS | D010 | R309-105-9, R309-550-5(1) | Rule states that unless
otherwise specifically approved by the Director, public water systems constructed after
January 1, 2007, shall be designed and shall meet the following minimum water
pressures at points of connection: (a) 20 psi during conditions of fire flow and fire
demand experienced during peak day demand; (b) 30 psi during peak instantaneous
demand; and (c) 40 psi during peak day demand. This significant deficiency must be
corrected within 120 days of notification or have a corrective action plan approved by
DDW.
C
52 Water system follows AWWA disinfection procedures for new, repaired, or
depressurized seasonal water mains and tanks.
SIG | 25pts | MR | D018 | R309-550-8(10) | All new and repaired water mains and
appurtenances shall be disinfected in accordance with AWWA Standard C651. This
significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
C
53 How often do you periodically disinfect any or all parts of your water system (i.e. batch
disinfection) other than for repairs or maintenance?
SIG | 50pts | SM | G006 | R309-105-6(1)(a), R309-500-6 | R309-105-6(1) Approval of
Engineering Plans and Specifications
R309-500-6 Plan Approval Procedure.
C
54 Does the water system still have physical access to this facility? Y/N Guidance:
Answer NO if sold and no longer have security access or the facility is demolished and
can not be inspected.
N (Notes: Abandoned)
55 Does the water system still have physical access to this facility? Y/N Guidance:
Answer NO if sold and no longer have security access or the facility is demolished and
can not be inspected.
N (Notes: Abandoned)
56 Does the water system still have physical access to this facility? Y/N Guidance:
Answer NO if sold and no longer have security access or the facility is demolished and
can not be inspected.
N (Notes: Abandoned)
57 Does the water system still have physical access to this facility? Y/N Guidance:
Answer NO if sold and no longer have security access or the facility is demolished and
can not be inspected.
N (Notes: Abandoned)
DEQ | Drinking Water
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WS004 - CAMPBELL WELL 3 ABANDONED - Inactive (AB - ABANDONED)
WS005 - HANCOCK COVE WELL 1 - Inactive (AB - ABANDONED)
WS006 - CAMPBELL WELL 4 ABANDONED - Inactive (AB - ABANDONED)
WS007 - CAMPBELL WELL 5 ABANDONED - Inactive (AB - ABANDONED)
WS008 - CAMPBELL WELL 6 ABANDONED - Inactive (AB - ABANDONED)
WS014 - HAYDEN WELL 5 ABANDONED - Inactive (AB - ABANDONED)
WS009 - HAYDEN WELL 1 - Active
58 Does the water system still have physical access to this facility? Y/N Guidance:
Answer NO if sold and no longer have security access or the facility is demolished and
can not be inspected.
N (Notes: Abandoned)
59 Does the water system still have physical access to this facility? Y/N Guidance:
Answer NO if sold and no longer have security access or the facility is demolished and
can not be inspected.
N (Notes: Abandoned)
60 Does the water system still have physical access to this facility? Y/N Guidance:
Answer NO if sold and no longer have security access or the facility is demolished and
can not be inspected.
N (Notes: Abandoned)
61 Does the water system still have physical access to this facility? Y/N Guidance:
Answer NO if sold and no longer have security access or the facility is demolished and
can not be inspected.
N (Notes: Abandoned)
62 Does the water system still have physical access to this facility? Y/N Guidance:
Answer NO if sold and no longer have security access or the facility is demolished and
can not be inspected.
N (Notes: Abandoned)
63 Does the water system still have physical access to this facility? Y/N Guidance:
Answer NO if sold and no longer have security access or the facility is demolished and
can not be inspected.
N (Notes: Abandoned)
64 Does the water system still have physical access to this facility? Y/N Guidance:
Answer NO if sold and no longer have security access or the facility is demolished and
can not be inspected.
N (Notes: Abandoned)
65 Is this facility Active or Inactive?A
66 Operating Period (Start Date)01/01
67 Operating Period (Ending Date)12/31
68 Undocumented sources shall not be physically connected to the drinking water
system. (IF SOURCE IS NOT IN SYSTEM INVENTORY MARK "DEFICIENT")
SIG | 200pts | SO | S001 | R309-515-6(5), R309-515-7(4), R309-500-9(2) and (3) |
R309-105-6(1) requires plans and specifications for all public drinking water projects to
be approved in writing by the Director prior to the commencement of construction. This
significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
C
69 Well casing is at least 18 inches above finished ground surface and 12 inches above
well house floor.
SIG | 25pts | SO | S003 | R309-515-6(6)(b)(vi), R309-515-6(12)(c)(ii), R309-515-
6(13)(a) | Rule requires the permanent well casing to project at least 18 inches above
the final ground surface and 12 inches above the pump house floor; at sites subject to
flooding, the top of the casing must terminate at least 3 feet above the 100-year flood
level or highest known flood elevation, whichever is higher. This significant deficiency
must be corrected within 120 days of notification or have a corrective action plan
approved by DDW.
C
DEQ | Drinking Water
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70 Wellhead is sealed to prevent contamination.
SIG | 50pts | SO | S013 | R309-515-6(6)(i) | R309-515-6(6)(i) and R309-515-
6(12)(b,c,d)require a sanitary seal be installed and maintained at the wellhead and
discharge piping. This significant deficiency should be corrected within 120 days of
notification or have a corrective action plan approved by
C
71 Is the well casing vented? ... if yes, answer the following question(s)Y
71A Vent screened with #14 mesh screen
SIG | 25pts | SO | S006 | R309-515-6(12)(d)(iii) | Guidance states provisions should be
made for venting the well casing, however if vented R309-515-6(12)(d)(iii) and R309-
550-6(6)(a)require vents be fitted with a #14 mesh or finer non-corrodible screen.
C
71B Vent down-turned
SIG | 25pts | SO | S007 | R309-515-6(12)(d)(iii) | Guidance states provisions should be
made for venting the well casing, however if vented R309-515-6(12)(d)(iii) and R309-
550-6(6)(b) requires vents be downturned or shielded to prevent the entrance of
surface water or rainwater.
C
71C Vent has adequate clearance to prevent contamination from entering the well
SIG | 25pts | SO | S008 | R309-515-6(12)(d)(iii) | Guidance states provisions should be
made for venting the well casing, however if vented R309-515-6(12)(d)(iii) and R309-
550-6(6)(b) requires vents be terminated with a discharge with an appropriate air gap.
C
72 Does the well have a pump to waste line? ... if yes, answer the following question(s)Y
72A Pump to waste line discharges with a minimum of 12-inch clearance to flood rim
SIG | 25pts | SO | S009 | R309-515-6(12)(d)(ix) | Rule requires a pump-to-waste line
connected to a sewer/storm drain to have a minimum 12-inch clearance to the flood
rim. This significant deficiency must be corrected within 120 days of notification or
have a corrective action plan approved by DDW.
C
72B Pump to waste line equipped with #4 non-corrodible mesh screen
SIG | 25pts | SO | S010 | R309-515-6(12)(d)(ix) | The discharge end of the pump-to-
waste line shall be covered with a No. 4 mesh corrosion-resistant screen. This
significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
C
72C Pump to waste line downturned if it discharges to sewer/storm drain or allowing
complete drainage if not downturned
SIG | 25pts | SO | S011 | R309-515-6(12)(d)(ix) | The discharge end of the pump-to-
waste line shall be downturned. This significant deficiency must be corrected within
120 days of notification or have a corrective action plan approved by DDW.
C
73 Water level is measured and recorded periodically
MIN | 5pts | SO | S015 | R309-515-6(12)(e ), R309-515-6(12)(c)(vi) | Rule requires
provisions be made to permit periodic measurement of water levels in the completed
well.
C
74 Wellhead secured to protect quality water
SIG | 25pts | SO | S002 | R309-105-10(5) | All water system facilities shall be secure.
This significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
C
DEQ | Drinking Water
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75 Well head or well house and equipment protected from flooding
SIG | 25pts | SO | S020 | R309-515-6(6)(b)(vi), R309-515-6(12)(d)(iii), R309-515-
6(13)(a) to (d) | Top of well casing shall terminate at least 18” above ground level or
12” above well house floor and for sites that flood at least 3’ above 100-year flood
level or highest known flood elevation. Well casing terminating in underground vault
shall have a drain to daylight and surface runoff directed away from vault access. Well
house floor shall be sloped for drainage, and have a drain to daylight unless highly
impractical. This significant deficiency must be corrected within 120 days of notification
or have a corrective action plan approved by DDW.
C
76 There are no unprotected cross-connections in well discharge piping.
SIG | 50pts | SO | S021 | R309-105-12(1), R309-515-6(12)(d)(iii) | Rule requires the
well discharge piping to be protected against the entrance of contamination. This
significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
C
77 Hose connections are equipped with a backflow prevention device
MIN | 15pts | SM | M007 | R309-105-12(2) | Rule requires each public water system to
have a cross connection control program that includes test history and documentation
of on-going enforcement activities.
C
78 No toxic chemicals, hazardous or flammable materials, or lubricants inside the well
house or near well head?
MIN | 15pts | TR | TGR9 | R309-105-7, 8 & 18, R309-100 through 605 | Trigger for
regulatory followup to address concerns.
C
79 Well discharge line has a smooth-nosed sampling tap, which samples the well water
before any chemical injection. (first item from the wellhead).
MIN | 5pts | SO | S023 | R309-515-6(12)(d)(iv) | Rule requires the discharge piping to
be equipped with a smooth nosed sampling tap, a check valve, a pressure gauge, a
means of measuring flow, and a shutoff valve. (smooth nosed sampling tap being the
first item from the well head and the shut-off valve as the last item)
C
80 Well discharge line has a check valve.
MIN | 5pts | SO | S024 | R309-515-6(12)(d)(iv) | Rule requires the discharge piping to
be equipped with (in order of placement from the wellhead) a smooth nosed sampling
tap, a check valve, a pressure gauge, a means of measuring flow, and a shutoff valve.
C
81 Well discharge line has a pressure gauge.
MIN | 5pts | SO | S025 | R309-515-6(12)(d)(iv) | Rule requires the discharge piping to
be equipped with (in order of placement from the wellhead) a smooth nosed sampling
tap, a check valve, a pressure gauge, a means of measuring flow, and a shutoff valve.
C
82 Well discharge line has a means to measure flow.
MIN | 5pts | SO | S026 | R309-515-6(12)(d)(iv) | Rule requires the discharge piping to
be equipped with (in order of placement from the wellhead) a smooth nosed sampling
tap, a check valve, a pressure gauge, a means of measuring flow, and a shutoff valve.
C
83 Well discharge line has a shut-off valve (last item from the well head).
MIN | 5pts | SO | S027 | R309-515-6(12)(d)(iv) | Rule requires the discharge piping to
be equipped with (in order of placement from the wellhead) a smooth nosed sampling
tap, a check valve, a pressure gauge, a means of measuring flow, and a shutoff valve.
C
DEQ | Drinking Water
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WS010 - HAYDEN WELL 2 - Active
84 Is there an air/vac valve on the well discharge line? If yes, answer the following
question(s)
Y
84A Air vacuum relief valve on well discharge piping downturned
SIG | 25pts | SO | S028 | R309-515-6(12)(d)(v) | Rule requires the exhaust/relief piping
on an air release/vacuum relief valve on the well discharge piping to be down-turned.
This significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
C
84B Air vacuum relief valve on well discharge piping screened with #14 mesh screen
SIG | 25pts | SO | S029 | R309-515-6(12)(d)(v) | Rule requires the exhaust/relief piping
on an air release/vacuum relief valve on the well discharge piping to be covered with a
#14 mesh corrosion-resistant screen. This significant deficiency must be corrected
within 120 days of notification or have a corrective action plan approved by DDW.
C
84C Air vacuum relief valve on well discharge piping has at least 6 inches of clearance
above floor
SIG | 25pts | SO | S030 | R309-515-6(12)(d)(v) | Rule requires the exhaust/relief piping
on an air release/vacuum relief valve on the well discharge piping to be at least 6
inches above the well house floor. This significant deficiency must be corrected within
120 days of notification or have a corrective action plan approved by DDW.
C
85 Wells that pump directly into a distribution system have means to release trapped air
from pump discharge piping (for example, pumps directly to a tank, has an air release
valve or pump to waste line)
MIN | 5pts | SO | SL01 | R309-515-6(12)(d)(v) | Rule requires a well that pumps
directly into the distribution system be equipped with an air release/vacuum relief valve
located upstream of the check valve, unless the wellhead valve and piping provide for
pumping to waste all trapped air before water is introduced into the distribution
system.
C
86 Does well require oil-lubrication?Y
86A Well shaft lubricants are food grade mineral oil?
SIG | 25pts | SO | S031 | R309-105-10(7), R309-515-6(6)(a) | Rules require all oil-
lubricated pumps for drinking water wells to utilize food-grade mineral oil suitable for
human consumption as determined by the Director. This significant deficiency must be
corrected within 120 days of notification or have a corrective action plan approved by
DDW.
<a href="https://www.youtube.com/watch?v=UABQMeeUz1g">Click here for addition
training</a>
D (Notes: Vegetable oil used.)
87 Is this facility Active or Inactive?A
88 Operating Period (Start Date)01/01
89 Operating Period (Ending Date)12/31
DEQ | Drinking Water
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90 Undocumented sources shall not be physically connected to the drinking water
system. (IF SOURCE IS NOT IN SYSTEM INVENTORY MARK "DEFICIENT")
SIG | 200pts | SO | S001 | R309-515-6(5), R309-515-7(4), R309-500-9(2) and (3) |
R309-105-6(1) requires plans and specifications for all public drinking water projects to
be approved in writing by the Director prior to the commencement of construction. This
significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
C
91 Well casing is at least 18 inches above finished ground surface and 12 inches above
well house floor.
SIG | 25pts | SO | S003 | R309-515-6(6)(b)(vi), R309-515-6(12)(c)(ii), R309-515-
6(13)(a) | Rule requires the permanent well casing to project at least 18 inches above
the final ground surface and 12 inches above the pump house floor; at sites subject to
flooding, the top of the casing must terminate at least 3 feet above the 100-year flood
level or highest known flood elevation, whichever is higher. This significant deficiency
must be corrected within 120 days of notification or have a corrective action plan
approved by DDW.
C
92 Wellhead is sealed to prevent contamination.
SIG | 50pts | SO | S013 | R309-515-6(6)(i) | R309-515-6(6)(i) and R309-515-
6(12)(b,c,d)require a sanitary seal be installed and maintained at the wellhead and
discharge piping. This significant deficiency should be corrected within 120 days of
notification or have a corrective action plan approved by
C
93 Is the well casing vented? ... if yes, answer the following question(s)Y
93A Vent screened with #14 mesh screen
SIG | 25pts | SO | S006 | R309-515-6(12)(d)(iii) | Guidance states provisions should be
made for venting the well casing, however if vented R309-515-6(12)(d)(iii) and R309-
550-6(6)(a)require vents be fitted with a #14 mesh or finer non-corrodible screen.
C
93B Vent down-turned
SIG | 25pts | SO | S007 | R309-515-6(12)(d)(iii) | Guidance states provisions should be
made for venting the well casing, however if vented R309-515-6(12)(d)(iii) and R309-
550-6(6)(b) requires vents be downturned or shielded to prevent the entrance of
surface water or rainwater.
C
93C Vent has adequate clearance to prevent contamination from entering the well
SIG | 25pts | SO | S008 | R309-515-6(12)(d)(iii) | Guidance states provisions should be
made for venting the well casing, however if vented R309-515-6(12)(d)(iii) and R309-
550-6(6)(b) requires vents be terminated with a discharge with an appropriate air gap.
C
94 Does the well have a pump to waste line? ... if yes, answer the following question(s)Y
94A Pump to waste line discharges with a minimum of 12-inch clearance to flood rim
SIG | 25pts | SO | S009 | R309-515-6(12)(d)(ix) | Rule requires a pump-to-waste line
connected to a sewer/storm drain to have a minimum 12-inch clearance to the flood
rim. This significant deficiency must be corrected within 120 days of notification or
have a corrective action plan approved by DDW.
C
DEQ | Drinking Water
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94B Pump to waste line equipped with #4 non-corrodible mesh screen
SIG | 25pts | SO | S010 | R309-515-6(12)(d)(ix) | The discharge end of the pump-to-
waste line shall be covered with a No. 4 mesh corrosion-resistant screen. This
significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
C
94C Pump to waste line downturned if it discharges to sewer/storm drain or allowing
complete drainage if not downturned
SIG | 25pts | SO | S011 | R309-515-6(12)(d)(ix) | The discharge end of the pump-to-
waste line shall be downturned. This significant deficiency must be corrected within
120 days of notification or have a corrective action plan approved by DDW.
C
95 Water level is measured and recorded periodically
MIN | 5pts | SO | S015 | R309-515-6(12)(e ), R309-515-6(12)(c)(vi) | Rule requires
provisions be made to permit periodic measurement of water levels in the completed
well.
C
96 Wellhead secured to protect quality water
SIG | 25pts | SO | S002 | R309-105-10(5) | All water system facilities shall be secure.
This significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
C
97 Well head or well house and equipment protected from flooding
SIG | 25pts | SO | S020 | R309-515-6(6)(b)(vi), R309-515-6(12)(d)(iii), R309-515-
6(13)(a) to (d) | Top of well casing shall terminate at least 18” above ground level or
12” above well house floor and for sites that flood at least 3’ above 100-year flood
level or highest known flood elevation. Well casing terminating in underground vault
shall have a drain to daylight and surface runoff directed away from vault access. Well
house floor shall be sloped for drainage, and have a drain to daylight unless highly
impractical. This significant deficiency must be corrected within 120 days of notification
or have a corrective action plan approved by DDW.
C
98 There are no unprotected cross-connections in well discharge piping.
SIG | 50pts | SO | S021 | R309-105-12(1), R309-515-6(12)(d)(iii) | Rule requires the
well discharge piping to be protected against the entrance of contamination. This
significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
C
99 Hose connections are equipped with a backflow prevention device
MIN | 15pts | SM | M007 | R309-105-12(2) | Rule requires each public water system to
have a cross connection control program that includes test history and documentation
of on-going enforcement activities.
C
100 No toxic chemicals, hazardous or flammable materials, or lubricants inside the well
house or near well head?
MIN | 15pts | TR | TGR9 | R309-105-7, 8 & 18, R309-100 through 605 | Trigger for
regulatory followup to address concerns.
C
DEQ | Drinking Water
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101 Well discharge line has a smooth-nosed sampling tap, which samples the well water
before any chemical injection. (first item from the wellhead).
MIN | 5pts | SO | S023 | R309-515-6(12)(d)(iv) | Rule requires the discharge piping to
be equipped with a smooth nosed sampling tap, a check valve, a pressure gauge, a
means of measuring flow, and a shutoff valve. (smooth nosed sampling tap being the
first item from the well head and the shut-off valve as the last item)
C
102 Well discharge line has a check valve.
MIN | 5pts | SO | S024 | R309-515-6(12)(d)(iv) | Rule requires the discharge piping to
be equipped with (in order of placement from the wellhead) a smooth nosed sampling
tap, a check valve, a pressure gauge, a means of measuring flow, and a shutoff valve.
C
103 Well discharge line has a pressure gauge.
MIN | 5pts | SO | S025 | R309-515-6(12)(d)(iv) | Rule requires the discharge piping to
be equipped with (in order of placement from the wellhead) a smooth nosed sampling
tap, a check valve, a pressure gauge, a means of measuring flow, and a shutoff valve.
C
104 Well discharge line has a means to measure flow.
MIN | 5pts | SO | S026 | R309-515-6(12)(d)(iv) | Rule requires the discharge piping to
be equipped with (in order of placement from the wellhead) a smooth nosed sampling
tap, a check valve, a pressure gauge, a means of measuring flow, and a shutoff valve.
C
105 Well discharge line has a shut-off valve (last item from the well head).
MIN | 5pts | SO | S027 | R309-515-6(12)(d)(iv) | Rule requires the discharge piping to
be equipped with (in order of placement from the wellhead) a smooth nosed sampling
tap, a check valve, a pressure gauge, a means of measuring flow, and a shutoff valve.
C
106 Is there an air/vac valve on the well discharge line? If yes, answer the following
question(s)
Y

106A Air vacuum relief valve on well discharge piping downturned
SIG | 25pts | SO | S028 | R309-515-6(12)(d)(v) | Rule requires the exhaust/relief piping
on an air release/vacuum relief valve on the well discharge piping to be down-turned.
This significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
C

106B Air vacuum relief valve on well discharge piping screened with #14 mesh screen
SIG | 25pts | SO | S029 | R309-515-6(12)(d)(v) | Rule requires the exhaust/relief piping
on an air release/vacuum relief valve on the well discharge piping to be covered with a
#14 mesh corrosion-resistant screen. This significant deficiency must be corrected
within 120 days of notification or have a corrective action plan approved by DDW.
C

106C Air vacuum relief valve on well discharge piping has at least 6 inches of clearance
above floor
SIG | 25pts | SO | S030 | R309-515-6(12)(d)(v) | Rule requires the exhaust/relief piping
on an air release/vacuum relief valve on the well discharge piping to be at least 6
inches above the well house floor. This significant deficiency must be corrected within
120 days of notification or have a corrective action plan approved by DDW.
C
DEQ | Drinking Water
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WS011 - HAYDEN WELL 3 - Active
107 Wells that pump directly into a distribution system have means to release trapped air
from pump discharge piping (for example, pumps directly to a tank, has an air release
valve or pump to waste line)
MIN | 5pts | SO | SL01 | R309-515-6(12)(d)(v) | Rule requires a well that pumps
directly into the distribution system be equipped with an air release/vacuum relief valve
located upstream of the check valve, unless the wellhead valve and piping provide for
pumping to waste all trapped air before water is introduced into the distribution
system.
C
108 Does well require oil-lubrication?Y

108A Well shaft lubricants are food grade mineral oil?
SIG | 25pts | SO | S031 | R309-105-10(7), R309-515-6(6)(a) | Rules require all oil-
lubricated pumps for drinking water wells to utilize food-grade mineral oil suitable for
human consumption as determined by the Director. This significant deficiency must be
corrected within 120 days of notification or have a corrective action plan approved by
DDW.
<a href="https://www.youtube.com/watch?v=UABQMeeUz1g">Click here for addition
training</a>
D (Notes: Vegetable Oil is currently used.)
109 Is this facility Active or Inactive?A
110 Operating Period (Start Date)01/01
111 Operating Period (Ending Date)12/31
112 Undocumented sources shall not be physically connected to the drinking water
system. (IF SOURCE IS NOT IN SYSTEM INVENTORY MARK "DEFICIENT")
SIG | 200pts | SO | S001 | R309-515-6(5), R309-515-7(4), R309-500-9(2) and (3) |
R309-105-6(1) requires plans and specifications for all public drinking water projects to
be approved in writing by the Director prior to the commencement of construction. This
significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
C
113 Well casing is at least 18 inches above finished ground surface and 12 inches above
well house floor.
SIG | 25pts | SO | S003 | R309-515-6(6)(b)(vi), R309-515-6(12)(c)(ii), R309-515-
6(13)(a) | Rule requires the permanent well casing to project at least 18 inches above
the final ground surface and 12 inches above the pump house floor; at sites subject to
flooding, the top of the casing must terminate at least 3 feet above the 100-year flood
level or highest known flood elevation, whichever is higher. This significant deficiency
must be corrected within 120 days of notification or have a corrective action plan
approved by DDW.
C
114 Wellhead is sealed to prevent contamination.
SIG | 50pts | SO | S013 | R309-515-6(6)(i) | R309-515-6(6)(i) and R309-515-
6(12)(b,c,d)require a sanitary seal be installed and maintained at the wellhead and
discharge piping. This significant deficiency should be corrected within 120 days of
notification or have a corrective action plan approved by
C
115 Is the well casing vented? ... if yes, answer the following question(s)Y
DEQ | Drinking Water
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115A Vent screened with #14 mesh screen
SIG | 25pts | SO | S006 | R309-515-6(12)(d)(iii) | Guidance states provisions should be
made for venting the well casing, however if vented R309-515-6(12)(d)(iii) and R309-
550-6(6)(a)require vents be fitted with a #14 mesh or finer non-corrodible screen.
C

115B Vent down-turned
SIG | 25pts | SO | S007 | R309-515-6(12)(d)(iii) | Guidance states provisions should be
made for venting the well casing, however if vented R309-515-6(12)(d)(iii) and R309-
550-6(6)(b) requires vents be downturned or shielded to prevent the entrance of
surface water or rainwater.
C

115C Vent has adequate clearance to prevent contamination from entering the well
SIG | 25pts | SO | S008 | R309-515-6(12)(d)(iii) | Guidance states provisions should be
made for venting the well casing, however if vented R309-515-6(12)(d)(iii) and R309-
550-6(6)(b) requires vents be terminated with a discharge with an appropriate air gap.
C
116 Does the well have a pump to waste line? ... if yes, answer the following question(s)Y

116A Pump to waste line discharges with a minimum of 12-inch clearance to flood rim
SIG | 25pts | SO | S009 | R309-515-6(12)(d)(ix) | Rule requires a pump-to-waste line
connected to a sewer/storm drain to have a minimum 12-inch clearance to the flood
rim. This significant deficiency must be corrected within 120 days of notification or
have a corrective action plan approved by DDW.
C

116B Pump to waste line equipped with #4 non-corrodible mesh screen
SIG | 25pts | SO | S010 | R309-515-6(12)(d)(ix) | The discharge end of the pump-to-
waste line shall be covered with a No. 4 mesh corrosion-resistant screen. This
significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
C

116C Pump to waste line downturned if it discharges to sewer/storm drain or allowing
complete drainage if not downturned
SIG | 25pts | SO | S011 | R309-515-6(12)(d)(ix) | The discharge end of the pump-to-
waste line shall be downturned. This significant deficiency must be corrected within
120 days of notification or have a corrective action plan approved by DDW.
C
117 Water level is measured and recorded periodically
MIN | 5pts | SO | S015 | R309-515-6(12)(e ), R309-515-6(12)(c)(vi) | Rule requires
provisions be made to permit periodic measurement of water levels in the completed
well.
C
118 Wellhead secured to protect quality water
SIG | 25pts | SO | S002 | R309-105-10(5) | All water system facilities shall be secure.
This significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
C
DEQ | Drinking Water
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119 Well head or well house and equipment protected from flooding
SIG | 25pts | SO | S020 | R309-515-6(6)(b)(vi), R309-515-6(12)(d)(iii), R309-515-
6(13)(a) to (d) | Top of well casing shall terminate at least 18” above ground level or
12” above well house floor and for sites that flood at least 3’ above 100-year flood
level or highest known flood elevation. Well casing terminating in underground vault
shall have a drain to daylight and surface runoff directed away from vault access. Well
house floor shall be sloped for drainage, and have a drain to daylight unless highly
impractical. This significant deficiency must be corrected within 120 days of notification
or have a corrective action plan approved by DDW.
C
120 There are no unprotected cross-connections in well discharge piping.
SIG | 50pts | SO | S021 | R309-105-12(1), R309-515-6(12)(d)(iii) | Rule requires the
well discharge piping to be protected against the entrance of contamination. This
significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
C
121 Hose connections are equipped with a backflow prevention device
MIN | 15pts | SM | M007 | R309-105-12(2) | Rule requires each public water system to
have a cross connection control program that includes test history and documentation
of on-going enforcement activities.
C
122 No toxic chemicals, hazardous or flammable materials, or lubricants inside the well
house or near well head?
MIN | 15pts | TR | TGR9 | R309-105-7, 8 & 18, R309-100 through 605 | Trigger for
regulatory followup to address concerns.
C
123 Well discharge line has a smooth-nosed sampling tap, which samples the well water
before any chemical injection. (first item from the wellhead).
MIN | 5pts | SO | S023 | R309-515-6(12)(d)(iv) | Rule requires the discharge piping to
be equipped with a smooth nosed sampling tap, a check valve, a pressure gauge, a
means of measuring flow, and a shutoff valve. (smooth nosed sampling tap being the
first item from the well head and the shut-off valve as the last item)
C
124 Well discharge line has a check valve.
MIN | 5pts | SO | S024 | R309-515-6(12)(d)(iv) | Rule requires the discharge piping to
be equipped with (in order of placement from the wellhead) a smooth nosed sampling
tap, a check valve, a pressure gauge, a means of measuring flow, and a shutoff valve.
C
125 Well discharge line has a pressure gauge.
MIN | 5pts | SO | S025 | R309-515-6(12)(d)(iv) | Rule requires the discharge piping to
be equipped with (in order of placement from the wellhead) a smooth nosed sampling
tap, a check valve, a pressure gauge, a means of measuring flow, and a shutoff valve.
C
126 Well discharge line has a means to measure flow.
MIN | 5pts | SO | S026 | R309-515-6(12)(d)(iv) | Rule requires the discharge piping to
be equipped with (in order of placement from the wellhead) a smooth nosed sampling
tap, a check valve, a pressure gauge, a means of measuring flow, and a shutoff valve.
C
127 Well discharge line has a shut-off valve (last item from the well head).
MIN | 5pts | SO | S027 | R309-515-6(12)(d)(iv) | Rule requires the discharge piping to
be equipped with (in order of placement from the wellhead) a smooth nosed sampling
tap, a check valve, a pressure gauge, a means of measuring flow, and a shutoff valve.
C
DEQ | Drinking Water
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WS012 - HANCOCK COVE WELL 2 -
128 Is there an air/vac valve on the well discharge line? If yes, answer the following
question(s)
Y

128A Air vacuum relief valve on well discharge piping downturned
SIG | 25pts | SO | S028 | R309-515-6(12)(d)(v) | Rule requires the exhaust/relief piping
on an air release/vacuum relief valve on the well discharge piping to be down-turned.
This significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
C

128B Air vacuum relief valve on well discharge piping screened with #14 mesh screen
SIG | 25pts | SO | S029 | R309-515-6(12)(d)(v) | Rule requires the exhaust/relief piping
on an air release/vacuum relief valve on the well discharge piping to be covered with a
#14 mesh corrosion-resistant screen. This significant deficiency must be corrected
within 120 days of notification or have a corrective action plan approved by DDW.
C

128C Air vacuum relief valve on well discharge piping has at least 6 inches of clearance
above floor
SIG | 25pts | SO | S030 | R309-515-6(12)(d)(v) | Rule requires the exhaust/relief piping
on an air release/vacuum relief valve on the well discharge piping to be at least 6
inches above the well house floor. This significant deficiency must be corrected within
120 days of notification or have a corrective action plan approved by DDW.
C
129 Wells that pump directly into a distribution system have means to release trapped air
from pump discharge piping (for example, pumps directly to a tank, has an air release
valve or pump to waste line)
MIN | 5pts | SO | SL01 | R309-515-6(12)(d)(v) | Rule requires a well that pumps
directly into the distribution system be equipped with an air release/vacuum relief valve
located upstream of the check valve, unless the wellhead valve and piping provide for
pumping to waste all trapped air before water is introduced into the distribution
system.
C
130 Does well require oil-lubrication?Y

130A Well shaft lubricants are food grade mineral oil?
SIG | 25pts | SO | S031 | R309-105-10(7), R309-515-6(6)(a) | Rules require all oil-
lubricated pumps for drinking water wells to utilize food-grade mineral oil suitable for
human consumption as determined by the Director. This significant deficiency must be
corrected within 120 days of notification or have a corrective action plan approved by
DDW.
<a href="https://www.youtube.com/watch?v=UABQMeeUz1g">Click here for addition
training</a>
D (Notes: Vegetable Oil used.)
131 Is this facility Active or Inactive?I

131A Explain why this facility is Inactive (Is this facility in stand-by mode?)Not being used.
132 Operating Period (Start Date)07/01
133 Operating Period (Ending Date)09/30
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134 Undocumented sources shall not be physically connected to the drinking water
system. (IF SOURCE IS NOT IN SYSTEM INVENTORY MARK "DEFICIENT")
SIG | 200pts | SO | S001 | R309-515-6(5), R309-515-7(4), R309-500-9(2) and (3) |
R309-105-6(1) requires plans and specifications for all public drinking water projects to
be approved in writing by the Director prior to the commencement of construction. This
significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
C
135 Well casing is at least 18 inches above finished ground surface and 12 inches above
well house floor.
SIG | 25pts | SO | S003 | R309-515-6(6)(b)(vi), R309-515-6(12)(c)(ii), R309-515-
6(13)(a) | Rule requires the permanent well casing to project at least 18 inches above
the final ground surface and 12 inches above the pump house floor; at sites subject to
flooding, the top of the casing must terminate at least 3 feet above the 100-year flood
level or highest known flood elevation, whichever is higher. This significant deficiency
must be corrected within 120 days of notification or have a corrective action plan
approved by DDW.
C
136 Wellhead is sealed to prevent contamination.
SIG | 50pts | SO | S013 | R309-515-6(6)(i) | R309-515-6(6)(i) and R309-515-
6(12)(b,c,d)require a sanitary seal be installed and maintained at the wellhead and
discharge piping. This significant deficiency should be corrected within 120 days of
notification or have a corrective action plan approved by
C
137 Is the well casing vented? ... if yes, answer the following question(s)Y

137A Vent screened with #14 mesh screen
SIG | 25pts | SO | S006 | R309-515-6(12)(d)(iii) | Guidance states provisions should be
made for venting the well casing, however if vented R309-515-6(12)(d)(iii) and R309-
550-6(6)(a)require vents be fitted with a #14 mesh or finer non-corrodible screen.
C

137B Vent down-turned
SIG | 25pts | SO | S007 | R309-515-6(12)(d)(iii) | Guidance states provisions should be
made for venting the well casing, however if vented R309-515-6(12)(d)(iii) and R309-
550-6(6)(b) requires vents be downturned or shielded to prevent the entrance of
surface water or rainwater.
C

137C Vent has adequate clearance to prevent contamination from entering the well
SIG | 25pts | SO | S008 | R309-515-6(12)(d)(iii) | Guidance states provisions should be
made for venting the well casing, however if vented R309-515-6(12)(d)(iii) and R309-
550-6(6)(b) requires vents be terminated with a discharge with an appropriate air gap.
C
138 Does the well have a pump to waste line? ... if yes, answer the following question(s)Y

138A Pump to waste line discharges with a minimum of 12-inch clearance to flood rim
SIG | 25pts | SO | S009 | R309-515-6(12)(d)(ix) | Rule requires a pump-to-waste line
connected to a sewer/storm drain to have a minimum 12-inch clearance to the flood
rim. This significant deficiency must be corrected within 120 days of notification or
have a corrective action plan approved by DDW.
C
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138B Pump to waste line equipped with #4 non-corrodible mesh screen
SIG | 25pts | SO | S010 | R309-515-6(12)(d)(ix) | The discharge end of the pump-to-
waste line shall be covered with a No. 4 mesh corrosion-resistant screen. This
significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
C

138C Pump to waste line downturned if it discharges to sewer/storm drain or allowing
complete drainage if not downturned
SIG | 25pts | SO | S011 | R309-515-6(12)(d)(ix) | The discharge end of the pump-to-
waste line shall be downturned. This significant deficiency must be corrected within
120 days of notification or have a corrective action plan approved by DDW.
C
139 Water level is measured and recorded periodically
MIN | 5pts | SO | S015 | R309-515-6(12)(e ), R309-515-6(12)(c)(vi) | Rule requires
provisions be made to permit periodic measurement of water levels in the completed
well.
C
140 Wellhead secured to protect quality water
SIG | 25pts | SO | S002 | R309-105-10(5) | All water system facilities shall be secure.
This significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
C
141 Well head or well house and equipment protected from flooding
SIG | 25pts | SO | S020 | R309-515-6(6)(b)(vi), R309-515-6(12)(d)(iii), R309-515-
6(13)(a) to (d) | Top of well casing shall terminate at least 18” above ground level or
12” above well house floor and for sites that flood at least 3’ above 100-year flood
level or highest known flood elevation. Well casing terminating in underground vault
shall have a drain to daylight and surface runoff directed away from vault access. Well
house floor shall be sloped for drainage, and have a drain to daylight unless highly
impractical. This significant deficiency must be corrected within 120 days of notification
or have a corrective action plan approved by DDW.
C
142 There are no unprotected cross-connections in well discharge piping.
SIG | 50pts | SO | S021 | R309-105-12(1), R309-515-6(12)(d)(iii) | Rule requires the
well discharge piping to be protected against the entrance of contamination. This
significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
C
143 Hose connections are equipped with a backflow prevention device
MIN | 15pts | SM | M007 | R309-105-12(2) | Rule requires each public water system to
have a cross connection control program that includes test history and documentation
of on-going enforcement activities.
C
144 No toxic chemicals, hazardous or flammable materials, or lubricants inside the well
house or near well head?
MIN | 15pts | TR | TGR9 | R309-105-7, 8 & 18, R309-100 through 605 | Trigger for
regulatory followup to address concerns.
C
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145 Well discharge line has a smooth-nosed sampling tap, which samples the well water
before any chemical injection. (first item from the wellhead).
MIN | 5pts | SO | S023 | R309-515-6(12)(d)(iv) | Rule requires the discharge piping to
be equipped with a smooth nosed sampling tap, a check valve, a pressure gauge, a
means of measuring flow, and a shutoff valve. (smooth nosed sampling tap being the
first item from the well head and the shut-off valve as the last item)
C
146 Well discharge line has a check valve.
MIN | 5pts | SO | S024 | R309-515-6(12)(d)(iv) | Rule requires the discharge piping to
be equipped with (in order of placement from the wellhead) a smooth nosed sampling
tap, a check valve, a pressure gauge, a means of measuring flow, and a shutoff valve.
C
147 Well discharge line has a pressure gauge.
MIN | 5pts | SO | S025 | R309-515-6(12)(d)(iv) | Rule requires the discharge piping to
be equipped with (in order of placement from the wellhead) a smooth nosed sampling
tap, a check valve, a pressure gauge, a means of measuring flow, and a shutoff valve.
C
148 Well discharge line has a means to measure flow.
MIN | 5pts | SO | S026 | R309-515-6(12)(d)(iv) | Rule requires the discharge piping to
be equipped with (in order of placement from the wellhead) a smooth nosed sampling
tap, a check valve, a pressure gauge, a means of measuring flow, and a shutoff valve.
C
149 Well discharge line has a shut-off valve (last item from the well head).
MIN | 5pts | SO | S027 | R309-515-6(12)(d)(iv) | Rule requires the discharge piping to
be equipped with (in order of placement from the wellhead) a smooth nosed sampling
tap, a check valve, a pressure gauge, a means of measuring flow, and a shutoff valve.
C
150 Is there an air/vac valve on the well discharge line? If yes, answer the following
question(s)
Y

150A Air vacuum relief valve on well discharge piping downturned
SIG | 25pts | SO | S028 | R309-515-6(12)(d)(v) | Rule requires the exhaust/relief piping
on an air release/vacuum relief valve on the well discharge piping to be down-turned.
This significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
C

150B Air vacuum relief valve on well discharge piping screened with #14 mesh screen
SIG | 25pts | SO | S029 | R309-515-6(12)(d)(v) | Rule requires the exhaust/relief piping
on an air release/vacuum relief valve on the well discharge piping to be covered with a
#14 mesh corrosion-resistant screen. This significant deficiency must be corrected
within 120 days of notification or have a corrective action plan approved by DDW.
C

150C Air vacuum relief valve on well discharge piping has at least 6 inches of clearance
above floor
SIG | 25pts | SO | S030 | R309-515-6(12)(d)(v) | Rule requires the exhaust/relief piping
on an air release/vacuum relief valve on the well discharge piping to be at least 6
inches above the well house floor. This significant deficiency must be corrected within
120 days of notification or have a corrective action plan approved by DDW.
C
DEQ | Drinking Water
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WS013 - HAYDEN WELL 4 - Active
151 Wells that pump directly into a distribution system have means to release trapped air
from pump discharge piping (for example, pumps directly to a tank, has an air release
valve or pump to waste line)
MIN | 5pts | SO | SL01 | R309-515-6(12)(d)(v) | Rule requires a well that pumps
directly into the distribution system be equipped with an air release/vacuum relief valve
located upstream of the check valve, unless the wellhead valve and piping provide for
pumping to waste all trapped air before water is introduced into the distribution
system.
C
152 Does well require oil-lubrication?Y

152A Well shaft lubricants are food grade mineral oil?
SIG | 25pts | SO | S031 | R309-105-10(7), R309-515-6(6)(a) | Rules require all oil-
lubricated pumps for drinking water wells to utilize food-grade mineral oil suitable for
human consumption as determined by the Director. This significant deficiency must be
corrected within 120 days of notification or have a corrective action plan approved by
DDW.
<a href="https://www.youtube.com/watch?v=UABQMeeUz1g">Click here for addition
training</a>
D (Notes: Vegetable Oil)
153 Is this facility Active or Inactive?A (Notes: Submersible)
154 Operating Period (Start Date)01/01
155 Operating Period (Ending Date)12/31
156 Undocumented sources shall not be physically connected to the drinking water
system. (IF SOURCE IS NOT IN SYSTEM INVENTORY MARK "DEFICIENT")
SIG | 200pts | SO | S001 | R309-515-6(5), R309-515-7(4), R309-500-9(2) and (3) |
R309-105-6(1) requires plans and specifications for all public drinking water projects to
be approved in writing by the Director prior to the commencement of construction. This
significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
C
157 Well casing is at least 18 inches above finished ground surface and 12 inches above
well house floor.
SIG | 25pts | SO | S003 | R309-515-6(6)(b)(vi), R309-515-6(12)(c)(ii), R309-515-
6(13)(a) | Rule requires the permanent well casing to project at least 18 inches above
the final ground surface and 12 inches above the pump house floor; at sites subject to
flooding, the top of the casing must terminate at least 3 feet above the 100-year flood
level or highest known flood elevation, whichever is higher. This significant deficiency
must be corrected within 120 days of notification or have a corrective action plan
approved by DDW.
C
158 Wellhead is sealed to prevent contamination.
SIG | 50pts | SO | S013 | R309-515-6(6)(i) | R309-515-6(6)(i) and R309-515-
6(12)(b,c,d)require a sanitary seal be installed and maintained at the wellhead and
discharge piping. This significant deficiency should be corrected within 120 days of
notification or have a corrective action plan approved by
C
159 Is the well casing vented? ... if yes, answer the following question(s)N
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160 Does the well have a pump to waste line? ... if yes, answer the following question(s)Y

160A Pump to waste line discharges with a minimum of 12-inch clearance to flood rim
SIG | 25pts | SO | S009 | R309-515-6(12)(d)(ix) | Rule requires a pump-to-waste line
connected to a sewer/storm drain to have a minimum 12-inch clearance to the flood
rim. This significant deficiency must be corrected within 120 days of notification or
have a corrective action plan approved by DDW.
C

160B Pump to waste line equipped with #4 non-corrodible mesh screen
SIG | 25pts | SO | S010 | R309-515-6(12)(d)(ix) | The discharge end of the pump-to-
waste line shall be covered with a No. 4 mesh corrosion-resistant screen. This
significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
C

160C Pump to waste line downturned if it discharges to sewer/storm drain or allowing
complete drainage if not downturned
SIG | 25pts | SO | S011 | R309-515-6(12)(d)(ix) | The discharge end of the pump-to-
waste line shall be downturned. This significant deficiency must be corrected within
120 days of notification or have a corrective action plan approved by DDW.
C
161 Water level is measured and recorded periodically
MIN | 5pts | SO | S015 | R309-515-6(12)(e ), R309-515-6(12)(c)(vi) | Rule requires
provisions be made to permit periodic measurement of water levels in the completed
well.
C
162 Wellhead secured to protect quality water
SIG | 25pts | SO | S002 | R309-105-10(5) | All water system facilities shall be secure.
This significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
C
163 Well head or well house and equipment protected from flooding
SIG | 25pts | SO | S020 | R309-515-6(6)(b)(vi), R309-515-6(12)(d)(iii), R309-515-
6(13)(a) to (d) | Top of well casing shall terminate at least 18” above ground level or
12” above well house floor and for sites that flood at least 3’ above 100-year flood
level or highest known flood elevation. Well casing terminating in underground vault
shall have a drain to daylight and surface runoff directed away from vault access. Well
house floor shall be sloped for drainage, and have a drain to daylight unless highly
impractical. This significant deficiency must be corrected within 120 days of notification
or have a corrective action plan approved by DDW.
C
164 There are no unprotected cross-connections in well discharge piping.
SIG | 50pts | SO | S021 | R309-105-12(1), R309-515-6(12)(d)(iii) | Rule requires the
well discharge piping to be protected against the entrance of contamination. This
significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
C
165 Hose connections are equipped with a backflow prevention device
MIN | 15pts | SM | M007 | R309-105-12(2) | Rule requires each public water system to
have a cross connection control program that includes test history and documentation
of on-going enforcement activities.
C
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166 No toxic chemicals, hazardous or flammable materials, or lubricants inside the well
house or near well head?
MIN | 15pts | TR | TGR9 | R309-105-7, 8 & 18, R309-100 through 605 | Trigger for
regulatory followup to address concerns.
C
167 Well discharge line has a smooth-nosed sampling tap, which samples the well water
before any chemical injection. (first item from the wellhead).
MIN | 5pts | SO | S023 | R309-515-6(12)(d)(iv) | Rule requires the discharge piping to
be equipped with a smooth nosed sampling tap, a check valve, a pressure gauge, a
means of measuring flow, and a shutoff valve. (smooth nosed sampling tap being the
first item from the well head and the shut-off valve as the last item)
C
168 Well discharge line has a check valve.
MIN | 5pts | SO | S024 | R309-515-6(12)(d)(iv) | Rule requires the discharge piping to
be equipped with (in order of placement from the wellhead) a smooth nosed sampling
tap, a check valve, a pressure gauge, a means of measuring flow, and a shutoff valve.
C
169 Well discharge line has a pressure gauge.
MIN | 5pts | SO | S025 | R309-515-6(12)(d)(iv) | Rule requires the discharge piping to
be equipped with (in order of placement from the wellhead) a smooth nosed sampling
tap, a check valve, a pressure gauge, a means of measuring flow, and a shutoff valve.
C
170 Well discharge line has a means to measure flow.
MIN | 5pts | SO | S026 | R309-515-6(12)(d)(iv) | Rule requires the discharge piping to
be equipped with (in order of placement from the wellhead) a smooth nosed sampling
tap, a check valve, a pressure gauge, a means of measuring flow, and a shutoff valve.
C
171 Well discharge line has a shut-off valve (last item from the well head).
MIN | 5pts | SO | S027 | R309-515-6(12)(d)(iv) | Rule requires the discharge piping to
be equipped with (in order of placement from the wellhead) a smooth nosed sampling
tap, a check valve, a pressure gauge, a means of measuring flow, and a shutoff valve.
C
172 Is there an air/vac valve on the well discharge line? If yes, answer the following
question(s)
Y

172A Air vacuum relief valve on well discharge piping downturned
SIG | 25pts | SO | S028 | R309-515-6(12)(d)(v) | Rule requires the exhaust/relief piping
on an air release/vacuum relief valve on the well discharge piping to be down-turned.
This significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
C

172B Air vacuum relief valve on well discharge piping screened with #14 mesh screen
SIG | 25pts | SO | S029 | R309-515-6(12)(d)(v) | Rule requires the exhaust/relief piping
on an air release/vacuum relief valve on the well discharge piping to be covered with a
#14 mesh corrosion-resistant screen. This significant deficiency must be corrected
within 120 days of notification or have a corrective action plan approved by DDW.
C

172C Air vacuum relief valve on well discharge piping has at least 6 inches of clearance
above floor
SIG | 25pts | SO | S030 | R309-515-6(12)(d)(v) | Rule requires the exhaust/relief piping
on an air release/vacuum relief valve on the well discharge piping to be at least 6
inches above the well house floor. This significant deficiency must be corrected within
120 days of notification or have a corrective action plan approved by DDW.
C
DEQ | Drinking Water
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WS015 - DURIGAN SP WELL 1 - Active
Exception Granted: R309-515-6(6)(i) and R309-600-13(2)(d) | Requested exception for land use agreements. Has been granted.
Only 20 feet of grout.
Exception Granted: R309-515-6(6)(i) | 100 feet of grout is not proposed

173 Wells that pump directly into a distribution system have means to release trapped air
from pump discharge piping (for example, pumps directly to a tank, has an air release
valve or pump to waste line)
MIN | 5pts | SO | SL01 | R309-515-6(12)(d)(v) | Rule requires a well that pumps
directly into the distribution system be equipped with an air release/vacuum relief valve
located upstream of the check valve, unless the wellhead valve and piping provide for
pumping to waste all trapped air before water is introduced into the distribution
system.
C
174 Does well require oil-lubrication?N
175 Is this facility Active or Inactive?A
176 Operating Period (Start Date)01/01
177 Operating Period (Ending Date)12/31
178 Undocumented sources shall not be physically connected to the drinking water
system. (IF SOURCE IS NOT IN SYSTEM INVENTORY MARK "DEFICIENT")
SIG | 200pts | SO | S001 | R309-515-6(5), R309-515-7(4), R309-500-9(2) and (3) |
R309-105-6(1) requires plans and specifications for all public drinking water projects to
be approved in writing by the Director prior to the commencement of construction. This
significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
C
179 Well casing is at least 18 inches above finished ground surface and 12 inches above
well house floor.
SIG | 25pts | SO | S003 | R309-515-6(6)(b)(vi), R309-515-6(12)(c)(ii), R309-515-
6(13)(a) | Rule requires the permanent well casing to project at least 18 inches above
the final ground surface and 12 inches above the pump house floor; at sites subject to
flooding, the top of the casing must terminate at least 3 feet above the 100-year flood
level or highest known flood elevation, whichever is higher. This significant deficiency
must be corrected within 120 days of notification or have a corrective action plan
approved by DDW.
C
180 Wellhead is sealed to prevent contamination.
SIG | 50pts | SO | S013 | R309-515-6(6)(i) | R309-515-6(6)(i) and R309-515-
6(12)(b,c,d)require a sanitary seal be installed and maintained at the wellhead and
discharge piping. This significant deficiency should be corrected within 120 days of
notification or have a corrective action plan approved by
C
181 Is the well casing vented? ... if yes, answer the following question(s)Y
DEQ | Drinking Water
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181A Vent screened with #14 mesh screen
SIG | 25pts | SO | S006 | R309-515-6(12)(d)(iii) | Guidance states provisions should be
made for venting the well casing, however if vented R309-515-6(12)(d)(iii) and R309-
550-6(6)(a)require vents be fitted with a #14 mesh or finer non-corrodible screen.
C

181B Vent down-turned
SIG | 25pts | SO | S007 | R309-515-6(12)(d)(iii) | Guidance states provisions should be
made for venting the well casing, however if vented R309-515-6(12)(d)(iii) and R309-
550-6(6)(b) requires vents be downturned or shielded to prevent the entrance of
surface water or rainwater.
C

181C Vent has adequate clearance to prevent contamination from entering the well
SIG | 25pts | SO | S008 | R309-515-6(12)(d)(iii) | Guidance states provisions should be
made for venting the well casing, however if vented R309-515-6(12)(d)(iii) and R309-
550-6(6)(b) requires vents be terminated with a discharge with an appropriate air gap.
C
182 Does the well have a pump to waste line? ... if yes, answer the following question(s)Y

182A Pump to waste line discharges with a minimum of 12-inch clearance to flood rim
SIG | 25pts | SO | S009 | R309-515-6(12)(d)(ix) | Rule requires a pump-to-waste line
connected to a sewer/storm drain to have a minimum 12-inch clearance to the flood
rim. This significant deficiency must be corrected within 120 days of notification or
have a corrective action plan approved by DDW.
C

182B Pump to waste line equipped with #4 non-corrodible mesh screen
SIG | 25pts | SO | S010 | R309-515-6(12)(d)(ix) | The discharge end of the pump-to-
waste line shall be covered with a No. 4 mesh corrosion-resistant screen. This
significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
C

182C Pump to waste line downturned if it discharges to sewer/storm drain or allowing
complete drainage if not downturned
SIG | 25pts | SO | S011 | R309-515-6(12)(d)(ix) | The discharge end of the pump-to-
waste line shall be downturned. This significant deficiency must be corrected within
120 days of notification or have a corrective action plan approved by DDW.
C
183 Water level is measured and recorded periodically
MIN | 5pts | SO | S015 | R309-515-6(12)(e ), R309-515-6(12)(c)(vi) | Rule requires
provisions be made to permit periodic measurement of water levels in the completed
well.
C
184 Wellhead secured to protect quality water
SIG | 25pts | SO | S002 | R309-105-10(5) | All water system facilities shall be secure.
This significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
C
DEQ | Drinking Water
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185 Well head or well house and equipment protected from flooding
SIG | 25pts | SO | S020 | R309-515-6(6)(b)(vi), R309-515-6(12)(d)(iii), R309-515-
6(13)(a) to (d) | Top of well casing shall terminate at least 18” above ground level or
12” above well house floor and for sites that flood at least 3’ above 100-year flood
level or highest known flood elevation. Well casing terminating in underground vault
shall have a drain to daylight and surface runoff directed away from vault access. Well
house floor shall be sloped for drainage, and have a drain to daylight unless highly
impractical. This significant deficiency must be corrected within 120 days of notification
or have a corrective action plan approved by DDW.
C
186 There are no unprotected cross-connections in well discharge piping.
SIG | 50pts | SO | S021 | R309-105-12(1), R309-515-6(12)(d)(iii) | Rule requires the
well discharge piping to be protected against the entrance of contamination. This
significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
C
187 Hose connections are equipped with a backflow prevention device
MIN | 15pts | SM | M007 | R309-105-12(2) | Rule requires each public water system to
have a cross connection control program that includes test history and documentation
of on-going enforcement activities.
C
188 No toxic chemicals, hazardous or flammable materials, or lubricants inside the well
house or near well head?
MIN | 15pts | TR | TGR9 | R309-105-7, 8 & 18, R309-100 through 605 | Trigger for
regulatory followup to address concerns.
C
189 Well discharge line has a smooth-nosed sampling tap, which samples the well water
before any chemical injection. (first item from the wellhead).
MIN | 5pts | SO | S023 | R309-515-6(12)(d)(iv) | Rule requires the discharge piping to
be equipped with a smooth nosed sampling tap, a check valve, a pressure gauge, a
means of measuring flow, and a shutoff valve. (smooth nosed sampling tap being the
first item from the well head and the shut-off valve as the last item)
C
190 Well discharge line has a check valve.
MIN | 5pts | SO | S024 | R309-515-6(12)(d)(iv) | Rule requires the discharge piping to
be equipped with (in order of placement from the wellhead) a smooth nosed sampling
tap, a check valve, a pressure gauge, a means of measuring flow, and a shutoff valve.
C
191 Well discharge line has a pressure gauge.
MIN | 5pts | SO | S025 | R309-515-6(12)(d)(iv) | Rule requires the discharge piping to
be equipped with (in order of placement from the wellhead) a smooth nosed sampling
tap, a check valve, a pressure gauge, a means of measuring flow, and a shutoff valve.
C
192 Well discharge line has a means to measure flow.
MIN | 5pts | SO | S026 | R309-515-6(12)(d)(iv) | Rule requires the discharge piping to
be equipped with (in order of placement from the wellhead) a smooth nosed sampling
tap, a check valve, a pressure gauge, a means of measuring flow, and a shutoff valve.
C
193 Well discharge line has a shut-off valve (last item from the well head).
MIN | 5pts | SO | S027 | R309-515-6(12)(d)(iv) | Rule requires the discharge piping to
be equipped with (in order of placement from the wellhead) a smooth nosed sampling
tap, a check valve, a pressure gauge, a means of measuring flow, and a shutoff valve.
C
DEQ | Drinking Water
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WS016 - HAYDEN WELL 5 REPLACEMENT - Active
194 Is there an air/vac valve on the well discharge line? If yes, answer the following
question(s)
Y

194A Air vacuum relief valve on well discharge piping downturned
SIG | 25pts | SO | S028 | R309-515-6(12)(d)(v) | Rule requires the exhaust/relief piping
on an air release/vacuum relief valve on the well discharge piping to be down-turned.
This significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
C

194B Air vacuum relief valve on well discharge piping screened with #14 mesh screen
SIG | 25pts | SO | S029 | R309-515-6(12)(d)(v) | Rule requires the exhaust/relief piping
on an air release/vacuum relief valve on the well discharge piping to be covered with a
#14 mesh corrosion-resistant screen. This significant deficiency must be corrected
within 120 days of notification or have a corrective action plan approved by DDW.
C

194C Air vacuum relief valve on well discharge piping has at least 6 inches of clearance
above floor
SIG | 25pts | SO | S030 | R309-515-6(12)(d)(v) | Rule requires the exhaust/relief piping
on an air release/vacuum relief valve on the well discharge piping to be at least 6
inches above the well house floor. This significant deficiency must be corrected within
120 days of notification or have a corrective action plan approved by DDW.
C
195 Wells that pump directly into a distribution system have means to release trapped air
from pump discharge piping (for example, pumps directly to a tank, has an air release
valve or pump to waste line)
MIN | 5pts | SO | SL01 | R309-515-6(12)(d)(v) | Rule requires a well that pumps
directly into the distribution system be equipped with an air release/vacuum relief valve
located upstream of the check valve, unless the wellhead valve and piping provide for
pumping to waste all trapped air before water is introduced into the distribution
system.
C
196 Does well require oil-lubrication?Y

196A Well shaft lubricants are food grade mineral oil?
SIG | 25pts | SO | S031 | R309-105-10(7), R309-515-6(6)(a) | Rules require all oil-
lubricated pumps for drinking water wells to utilize food-grade mineral oil suitable for
human consumption as determined by the Director. This significant deficiency must be
corrected within 120 days of notification or have a corrective action plan approved by
DDW.
<a href="https://www.youtube.com/watch?v=UABQMeeUz1g">Click here for addition
training</a>
D (Notes: Vegetable oil is used.)
197 Is this facility Active or Inactive?A
198 Operating Period (Start Date)01/01
199 Operating Period (Ending Date)12/31
DEQ | Drinking Water
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200 Undocumented sources shall not be physically connected to the drinking water
system. (IF SOURCE IS NOT IN SYSTEM INVENTORY MARK "DEFICIENT")
SIG | 200pts | SO | S001 | R309-515-6(5), R309-515-7(4), R309-500-9(2) and (3) |
R309-105-6(1) requires plans and specifications for all public drinking water projects to
be approved in writing by the Director prior to the commencement of construction. This
significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
C
201 Well casing is at least 18 inches above finished ground surface and 12 inches above
well house floor.
SIG | 25pts | SO | S003 | R309-515-6(6)(b)(vi), R309-515-6(12)(c)(ii), R309-515-
6(13)(a) | Rule requires the permanent well casing to project at least 18 inches above
the final ground surface and 12 inches above the pump house floor; at sites subject to
flooding, the top of the casing must terminate at least 3 feet above the 100-year flood
level or highest known flood elevation, whichever is higher. This significant deficiency
must be corrected within 120 days of notification or have a corrective action plan
approved by DDW.
C
202 Wellhead is sealed to prevent contamination.
SIG | 50pts | SO | S013 | R309-515-6(6)(i) | R309-515-6(6)(i) and R309-515-
6(12)(b,c,d)require a sanitary seal be installed and maintained at the wellhead and
discharge piping. This significant deficiency should be corrected within 120 days of
notification or have a corrective action plan approved by
C
203 Is the well casing vented? ... if yes, answer the following question(s)Y

203A Vent screened with #14 mesh screen
SIG | 25pts | SO | S006 | R309-515-6(12)(d)(iii) | Guidance states provisions should be
made for venting the well casing, however if vented R309-515-6(12)(d)(iii) and R309-
550-6(6)(a)require vents be fitted with a #14 mesh or finer non-corrodible screen.
C

203B Vent down-turned
SIG | 25pts | SO | S007 | R309-515-6(12)(d)(iii) | Guidance states provisions should be
made for venting the well casing, however if vented R309-515-6(12)(d)(iii) and R309-
550-6(6)(b) requires vents be downturned or shielded to prevent the entrance of
surface water or rainwater.
C

203C Vent has adequate clearance to prevent contamination from entering the well
SIG | 25pts | SO | S008 | R309-515-6(12)(d)(iii) | Guidance states provisions should be
made for venting the well casing, however if vented R309-515-6(12)(d)(iii) and R309-
550-6(6)(b) requires vents be terminated with a discharge with an appropriate air gap.
C
204 Does the well have a pump to waste line? ... if yes, answer the following question(s)Y

204A Pump to waste line discharges with a minimum of 12-inch clearance to flood rim
SIG | 25pts | SO | S009 | R309-515-6(12)(d)(ix) | Rule requires a pump-to-waste line
connected to a sewer/storm drain to have a minimum 12-inch clearance to the flood
rim. This significant deficiency must be corrected within 120 days of notification or
have a corrective action plan approved by DDW.
C
DEQ | Drinking Water
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204B Pump to waste line equipped with #4 non-corrodible mesh screen
SIG | 25pts | SO | S010 | R309-515-6(12)(d)(ix) | The discharge end of the pump-to-
waste line shall be covered with a No. 4 mesh corrosion-resistant screen. This
significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
D (Notes: Screen is damaged photo will be
on follow up email.)

204C Pump to waste line downturned if it discharges to sewer/storm drain or allowing
complete drainage if not downturned
SIG | 25pts | SO | S011 | R309-515-6(12)(d)(ix) | The discharge end of the pump-to-
waste line shall be downturned. This significant deficiency must be corrected within
120 days of notification or have a corrective action plan approved by DDW.
C
205 Water level is measured and recorded periodically
MIN | 5pts | SO | S015 | R309-515-6(12)(e ), R309-515-6(12)(c)(vi) | Rule requires
provisions be made to permit periodic measurement of water levels in the completed
well.
C
206 Wellhead secured to protect quality water
SIG | 25pts | SO | S002 | R309-105-10(5) | All water system facilities shall be secure.
This significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
C
207 Well head or well house and equipment protected from flooding
SIG | 25pts | SO | S020 | R309-515-6(6)(b)(vi), R309-515-6(12)(d)(iii), R309-515-
6(13)(a) to (d) | Top of well casing shall terminate at least 18” above ground level or
12” above well house floor and for sites that flood at least 3’ above 100-year flood
level or highest known flood elevation. Well casing terminating in underground vault
shall have a drain to daylight and surface runoff directed away from vault access. Well
house floor shall be sloped for drainage, and have a drain to daylight unless highly
impractical. This significant deficiency must be corrected within 120 days of notification
or have a corrective action plan approved by DDW.
C
208 There are no unprotected cross-connections in well discharge piping.
SIG | 50pts | SO | S021 | R309-105-12(1), R309-515-6(12)(d)(iii) | Rule requires the
well discharge piping to be protected against the entrance of contamination. This
significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
C
209 Hose connections are equipped with a backflow prevention device
MIN | 15pts | SM | M007 | R309-105-12(2) | Rule requires each public water system to
have a cross connection control program that includes test history and documentation
of on-going enforcement activities.
C
210 No toxic chemicals, hazardous or flammable materials, or lubricants inside the well
house or near well head?
MIN | 15pts | TR | TGR9 | R309-105-7, 8 & 18, R309-100 through 605 | Trigger for
regulatory followup to address concerns.
C
DEQ | Drinking Water
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211 Well discharge line has a smooth-nosed sampling tap, which samples the well water
before any chemical injection. (first item from the wellhead).
MIN | 5pts | SO | S023 | R309-515-6(12)(d)(iv) | Rule requires the discharge piping to
be equipped with a smooth nosed sampling tap, a check valve, a pressure gauge, a
means of measuring flow, and a shutoff valve. (smooth nosed sampling tap being the
first item from the well head and the shut-off valve as the last item)
C
212 Well discharge line has a check valve.
MIN | 5pts | SO | S024 | R309-515-6(12)(d)(iv) | Rule requires the discharge piping to
be equipped with (in order of placement from the wellhead) a smooth nosed sampling
tap, a check valve, a pressure gauge, a means of measuring flow, and a shutoff valve.
C
213 Well discharge line has a pressure gauge.
MIN | 5pts | SO | S025 | R309-515-6(12)(d)(iv) | Rule requires the discharge piping to
be equipped with (in order of placement from the wellhead) a smooth nosed sampling
tap, a check valve, a pressure gauge, a means of measuring flow, and a shutoff valve.
C
214 Well discharge line has a means to measure flow.
MIN | 5pts | SO | S026 | R309-515-6(12)(d)(iv) | Rule requires the discharge piping to
be equipped with (in order of placement from the wellhead) a smooth nosed sampling
tap, a check valve, a pressure gauge, a means of measuring flow, and a shutoff valve.
C
215 Well discharge line has a shut-off valve (last item from the well head).
MIN | 5pts | SO | S027 | R309-515-6(12)(d)(iv) | Rule requires the discharge piping to
be equipped with (in order of placement from the wellhead) a smooth nosed sampling
tap, a check valve, a pressure gauge, a means of measuring flow, and a shutoff valve.
C
216 Is there an air/vac valve on the well discharge line? If yes, answer the following
question(s)
Y

216A Air vacuum relief valve on well discharge piping downturned
SIG | 25pts | SO | S028 | R309-515-6(12)(d)(v) | Rule requires the exhaust/relief piping
on an air release/vacuum relief valve on the well discharge piping to be down-turned.
This significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
C

216B Air vacuum relief valve on well discharge piping screened with #14 mesh screen
SIG | 25pts | SO | S029 | R309-515-6(12)(d)(v) | Rule requires the exhaust/relief piping
on an air release/vacuum relief valve on the well discharge piping to be covered with a
#14 mesh corrosion-resistant screen. This significant deficiency must be corrected
within 120 days of notification or have a corrective action plan approved by DDW.
C

216C Air vacuum relief valve on well discharge piping has at least 6 inches of clearance
above floor
SIG | 25pts | SO | S030 | R309-515-6(12)(d)(v) | Rule requires the exhaust/relief piping
on an air release/vacuum relief valve on the well discharge piping to be at least 6
inches above the well house floor. This significant deficiency must be corrected within
120 days of notification or have a corrective action plan approved by DDW.
C
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ST001 - 300,000 GALLON TANK - Active
217 Wells that pump directly into a distribution system have means to release trapped air
from pump discharge piping (for example, pumps directly to a tank, has an air release
valve or pump to waste line)
MIN | 5pts | SO | SL01 | R309-515-6(12)(d)(v) | Rule requires a well that pumps
directly into the distribution system be equipped with an air release/vacuum relief valve
located upstream of the check valve, unless the wellhead valve and piping provide for
pumping to waste all trapped air before water is introduced into the distribution
system.
C
218 Does well require oil-lubrication?Y

218A Well shaft lubricants are food grade mineral oil?
SIG | 25pts | SO | S031 | R309-105-10(7), R309-515-6(6)(a) | Rules require all oil-
lubricated pumps for drinking water wells to utilize food-grade mineral oil suitable for
human consumption as determined by the Director. This significant deficiency must be
corrected within 120 days of notification or have a corrective action plan approved by
DDW.
<a href="https://www.youtube.com/watch?v=UABQMeeUz1g">Click here for addition
training</a>
D (Notes: Vegetable oil is used.)
219 Is this facility Active or Inactive?A
220 Storage tank capacity in gallons (from SDWIS; if different explain why in the
comments)
300000
221 There are no undocumented drinking water facilities (i.e. tanks, pump stations,
treatment facilities, etc.) or recent modifications that have not gone through DDW
review
SIG | 50pts | SM | G001 | R309-100-5(2), R309-500-6, R309-500-9, R309-500-9(2)
and (3) | Rule requires complete plans & specification for all public drinking water
projects to be approved in writing by the Director. Any facility found that has not
started DDW review shall be considered unapproved. This significant deficiency must
be corrected within 120 days of notification or have a corrective action plan approved
by DDW.
C
222 Ladders, ladder guards, platform railings, or safely located entrance hatches are
provided where applicable.
MIN | 15pts | FW | V004 | R309-545-18 | Rule requires ladders, ladder guards,
platform railings, and safely located entrance hatches where applicable for water
storage tanks and requires safety practices to conform to pertinent laws and
regulations of the Utah Occupational Safety and Health Division.
C
223 Tank is vented.
SIG | 25pts | FW | VL02 | R309-545-15 | Rule requires drinking water storage tanks to
be vented. Overflows cannot be considered or used as vents. This significant
deficiency must be corrected within 120 days of notification or have a corrective action
plan approved by DDW.
C
224 Are air vents present? ... if yes, answer the following question(s)Y
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224A Vent is either down-turned or shielded from contaminants (at least 2 inches below the
bottom of the opening)
SIG | 25pts | FW | V005 | R309-545-15(1) | Rule requires inverted vents on water
storage tanks to be down-turned a minimum of 2 inches below any opening and
shielded to prevent the entrance of contaminants. This significant deficiency must be
corrected within 120 days of notification or have a corrective action plan approved by
DDW.
C

224B End of vent terminates at least 24 inches above earthen cover (buried tank) and is
located and sized to avoid blockage during winter.
MIN | 15pts | FW | V006 | R309-545-15(2) | For buried structures, the rule requires the
end of the vent discharge to be a minimum of 24 inches above the earthen covering.
C

224C Vent covered with #14 or finer non-corrodible mesh screen.
SIG | 25pts | FW | V007 | R309-545-15(4) | Rule requires a water storage tank vent to
be fitted with #14 mesh or finer non-corrodible screen and vents 6-inches or greater in
diameter to be fitted with additional heavy gauge screen or substantial covering to
protect the #14 mesh screen from vandalism or damage. This significant deficiency
must be corrected within 120 days of notification or have a compliance action plan
approved by DDW.
C

224D Vent 6-inch diameter and larger protected with additional heavy-gauge screen or
substantial covering.
MIN | 5pts | FW | V035 | R309-545-15(5) | Rule requires vents that are 6-inch diameter
or greater to be fitted with additional heavy gauge screen or substantial covering,
which will protect the No. 14 mesh screen against vandalism or damage.
C
225 Are access openings present? ... if yes, answer the following question(s)
MIN | 15pts | FW | VL03 | R309-545-14 and 14(1) | Rule requires drinking water
storage tanks to be designed with reasonably convenient access to the interior for
cleaning and maintenance.
Y

225A Access opening framed at least 4 inches above roof surface or 18 inches above
earthen cover.
MIN | 15pts | FW | V008 | R309-545-14(1) | Rule requires tank access opening to be
framed at least 4 inches above the surface of the roof, or on a buried tank, to be at
least 18 inches above any earthen cover over the tank.
C

225B Access opening shoe box type with at least 2 inches of overlap
SIG | 25pts | FW | V010 | R309-545-14(2) | Rule requires the frame of an access
opening to be provided with a close fitting solid shoebox type cover which extends
down around the frame at least two inches and is furnished with a gasket(s) between
the lid and frame. This significant deficiency must be corrected within 120 days of
notification or have a corrective action plan approved by DDW.
C

225C Access opening lid properly gasketed
SIG | 25pts | FW | V009 | R309-545-14(2) | Rule requires the access opening to a tank
to be furnished with a gasket between the lid and frame. This significant deficiency
must be corrected within 120 days of notification or have a corrective action plan
approved by DDW.
C
DEQ | Drinking Water
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226 Access opening locked
SIG | 25pts | FW | V029 | R309-545-14(3) | Rule requires the lid to any access
opening to have a locking device. This significant deficiency must be corrected within
120 days of notification or have a corrective action plan approved by DDW.
C
227 Roof or wall penetrations sealed
SIG | 100pts | FW | V017 | R309-545-6(1) and 545-9 | Rule requires openings in a
storage tank roof or top, designed to accommodate control apparatus or pump
columns, to be welded, gasketed, or curbed and sleeved and to have additional proper
shielding to prevent vandalism. This significant deficiency must be corrected within
120 days of notification or have a corrective action plan approved by DDW.
C
228 Area surrounding ground-level or buried storage tank is graded to prevent surface
water from standing within 50 feet.
SIG | 25pts | TR | V001 | R309-545-7(4) | Rule requires the area surrounding a
ground-level or buried water storage tank be graded in a manner to prevent surface
water from standing within 50 feet of the tank. This significant deficiency must be
corrected within 120 days of notification or have a corrective action plan approved by
DDW.
C
229 Storage tank roof is sloped to prevent ponding
MIN | 15pts | FW | V003 | R309-545-9(4) | Rule requires drainage of storage tank roofs
to eliminate water ponding.
C
230 Are there cracks in the walls or roof of the storage tank? (if yes, select only one of the
following options)
N
231 Is a tank overflow present? ... if yes, answer the following question(s)
SIG | 25pts | FW | VL01 | R309-545-13 | Rule requires all storage tanks to be provided
with an overflow that discharges at an an elevation between 12 and 24 inches above
the ground surface or the rim of the receiving basin. This significant deficiency must
be corrected within 120 days of notification or have a corrective action plan approved
by DDW.
Y

231A Overflow line discharges at least 12 inches above ground or the flood rim of receiving
basin?
SIG | 25pts | FW | V011 | R309-545-13 | Rule requires all water storage tanks to be
provided with an overflow that discharges at an elevation between 12 and 24 inches
above the ground surface or the rim of the receiving basin.
C

231B Overflow line covered with #4 mesh non-corrodible screen
SIG | 25pts | FW | V012 | R309-545-13(3) | Rule requires overflow pipes to be
screened with #4 mesh non-corrodible screens installed at a location least susceptible
to damage by vandalism. This significant deficiency must be corrected within 120 days
of notification or have a corrective action plan approved by DDW.
D (Notes: Screen is damaged and needs to
be replaced. Photo will be sent on follow up
email.)

231C Overflow line connected or discharges to a sanitary sewer drain?
SIG | 50pts | FW | V013 | R309-545-13(5) | Rule prohibits overflow pipes from
connecting to, or discharging into, a sanitary sewer system. This significant deficiency
must be corrected within 120 days of notification or have a corrective action plan
approved by DDW.
C
232 Are the drain line and overflow combined?Y
DEQ | Drinking Water
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ST002 - 2,000,000 GALLON TANK - Active
233 Is this facility Active or Inactive?A
234 Storage tank capacity in gallons (from SDWIS; if different explain why in the
comments)
2000000
235 There are no undocumented drinking water facilities (i.e. tanks, pump stations,
treatment facilities, etc.) or recent modifications that have not gone through DDW
review
SIG | 50pts | SM | G001 | R309-100-5(2), R309-500-6, R309-500-9, R309-500-9(2)
and (3) | Rule requires complete plans & specification for all public drinking water
projects to be approved in writing by the Director. Any facility found that has not
started DDW review shall be considered unapproved. This significant deficiency must
be corrected within 120 days of notification or have a corrective action plan approved
by DDW.
C
236 Ladders, ladder guards, platform railings, or safely located entrance hatches are
provided where applicable.
MIN | 15pts | FW | V004 | R309-545-18 | Rule requires ladders, ladder guards,
platform railings, and safely located entrance hatches where applicable for water
storage tanks and requires safety practices to conform to pertinent laws and
regulations of the Utah Occupational Safety and Health Division.
C
237 Tank is vented.
SIG | 25pts | FW | VL02 | R309-545-15 | Rule requires drinking water storage tanks to
be vented. Overflows cannot be considered or used as vents. This significant
deficiency must be corrected within 120 days of notification or have a corrective action
plan approved by DDW.
C
238 Are air vents present? ... if yes, answer the following question(s)Y

238A Vent is either down-turned or shielded from contaminants (at least 2 inches below the
bottom of the opening)
SIG | 25pts | FW | V005 | R309-545-15(1) | Rule requires inverted vents on water
storage tanks to be down-turned a minimum of 2 inches below any opening and
shielded to prevent the entrance of contaminants. This significant deficiency must be
corrected within 120 days of notification or have a corrective action plan approved by
DDW.
C

238B End of vent terminates at least 24 inches above earthen cover (buried tank) and is
located and sized to avoid blockage during winter.
MIN | 15pts | FW | V006 | R309-545-15(2) | For buried structures, the rule requires the
end of the vent discharge to be a minimum of 24 inches above the earthen covering.
C

238C Vent covered with #14 or finer non-corrodible mesh screen.
SIG | 25pts | FW | V007 | R309-545-15(4) | Rule requires a water storage tank vent to
be fitted with #14 mesh or finer non-corrodible screen and vents 6-inches or greater in
diameter to be fitted with additional heavy gauge screen or substantial covering to
protect the #14 mesh screen from vandalism or damage. This significant deficiency
must be corrected within 120 days of notification or have a compliance action plan
approved by DDW.
C
DEQ | Drinking Water
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238D Vent 6-inch diameter and larger protected with additional heavy-gauge screen or
substantial covering.
MIN | 5pts | FW | V035 | R309-545-15(5) | Rule requires vents that are 6-inch diameter
or greater to be fitted with additional heavy gauge screen or substantial covering,
which will protect the No. 14 mesh screen against vandalism or damage.
C
239 Are access openings present? ... if yes, answer the following question(s)
MIN | 15pts | FW | VL03 | R309-545-14 and 14(1) | Rule requires drinking water
storage tanks to be designed with reasonably convenient access to the interior for
cleaning and maintenance.
Y

239A Access opening framed at least 4 inches above roof surface or 18 inches above
earthen cover.
MIN | 15pts | FW | V008 | R309-545-14(1) | Rule requires tank access opening to be
framed at least 4 inches above the surface of the roof, or on a buried tank, to be at
least 18 inches above any earthen cover over the tank.
D (Notes: This Hatch is being replaced in
next couple of months. Photo's will be sent
on follow up email.)

239B Access opening shoe box type with at least 2 inches of overlap
SIG | 25pts | FW | V010 | R309-545-14(2) | Rule requires the frame of an access
opening to be provided with a close fitting solid shoebox type cover which extends
down around the frame at least two inches and is furnished with a gasket(s) between
the lid and frame. This significant deficiency must be corrected within 120 days of
notification or have a corrective action plan approved by DDW.
C

239C Access opening lid properly gasketed
SIG | 25pts | FW | V009 | R309-545-14(2) | Rule requires the access opening to a tank
to be furnished with a gasket between the lid and frame. This significant deficiency
must be corrected within 120 days of notification or have a corrective action plan
approved by DDW.
D (Notes: Gasketed, but opening is formed
concrete with a polyurethane coating on top.
Hatch being upgraded on project in next
couple of months. Photo's of Hatch will be
sent on follow up email.)
240 Access opening locked
SIG | 25pts | FW | V029 | R309-545-14(3) | Rule requires the lid to any access
opening to have a locking device. This significant deficiency must be corrected within
120 days of notification or have a corrective action plan approved by DDW.
C
241 Roof or wall penetrations sealed
SIG | 100pts | FW | V017 | R309-545-6(1) and 545-9 | Rule requires openings in a
storage tank roof or top, designed to accommodate control apparatus or pump
columns, to be welded, gasketed, or curbed and sleeved and to have additional proper
shielding to prevent vandalism. This significant deficiency must be corrected within
120 days of notification or have a corrective action plan approved by DDW.
D (Notes: Conduit junction box lid missing
and conduit has came apart and is
Damaged, conduit runs across and drops
into tank. Tank is being rehabbed, and
repaired on project in next couple of months.
Photo's will be sent on follow up email.)
242 Area surrounding ground-level or buried storage tank is graded to prevent surface
water from standing within 50 feet.
SIG | 25pts | TR | V001 | R309-545-7(4) | Rule requires the area surrounding a
ground-level or buried water storage tank be graded in a manner to prevent surface
water from standing within 50 feet of the tank. This significant deficiency must be
corrected within 120 days of notification or have a corrective action plan approved by
DDW.
C
DEQ | Drinking Water
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ST003 - 1MG PAGE BENCH TANK - Active
243 Storage tank roof is sloped to prevent ponding
MIN | 15pts | FW | V003 | R309-545-9(4) | Rule requires drainage of storage tank roofs
to eliminate water ponding.
C
244 Are there cracks in the walls or roof of the storage tank? (if yes, select only one of the
following options)
Y

244A Mild deterioration or spalling?
MIN | 15pts | FW | V021 | R309-545-6(1) and 545-9(1) | Rule requires all water
storage tanks to have suitable watertight roofs and sidewalls that shall also exclude
birds, animals, insects, and excessive dust.
N

244B Severe deterioration or spalling?
SIG | 50pts | FW | V022 | R309-545-6(1) and 545-9(1) | Rule requires all water storage
tanks to have suitable watertight roofs and sidewalls that shall also exclude birds,
animals, insects, and excessive dust. This significant deficiency must be corrected
within 120 days of notification or have a corrective action plan approved by DDW.
Y (Notes: Being repaired in next couple of
months)
245 Is a tank overflow present? ... if yes, answer the following question(s)
SIG | 25pts | FW | VL01 | R309-545-13 | Rule requires all storage tanks to be provided
with an overflow that discharges at an an elevation between 12 and 24 inches above
the ground surface or the rim of the receiving basin. This significant deficiency must
be corrected within 120 days of notification or have a corrective action plan approved
by DDW.
Y

245A Overflow line discharges at least 12 inches above ground or the flood rim of receiving
basin?
SIG | 25pts | FW | V011 | R309-545-13 | Rule requires all water storage tanks to be
provided with an overflow that discharges at an elevation between 12 and 24 inches
above the ground surface or the rim of the receiving basin.
C

245B Overflow line covered with #4 mesh non-corrodible screen
SIG | 25pts | FW | V012 | R309-545-13(3) | Rule requires overflow pipes to be
screened with #4 mesh non-corrodible screens installed at a location least susceptible
to damage by vandalism. This significant deficiency must be corrected within 120 days
of notification or have a corrective action plan approved by DDW.
C

245C Overflow line connected or discharges to a sanitary sewer drain?
SIG | 50pts | FW | V013 | R309-545-13(5) | Rule prohibits overflow pipes from
connecting to, or discharging into, a sanitary sewer system. This significant deficiency
must be corrected within 120 days of notification or have a corrective action plan
approved by DDW.
C
246 Are the drain line and overflow combined?Y
247 Is this facility Active or Inactive?A
248 Storage tank capacity in gallons (from SDWIS; if different explain why in the
comments)
1000000
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249 There are no undocumented drinking water facilities (i.e. tanks, pump stations,
treatment facilities, etc.) or recent modifications that have not gone through DDW
review
SIG | 50pts | SM | G001 | R309-100-5(2), R309-500-6, R309-500-9, R309-500-9(2)
and (3) | Rule requires complete plans & specification for all public drinking water
projects to be approved in writing by the Director. Any facility found that has not
started DDW review shall be considered unapproved. This significant deficiency must
be corrected within 120 days of notification or have a corrective action plan approved
by DDW.
C
250 Ladders, ladder guards, platform railings, or safely located entrance hatches are
provided where applicable.
MIN | 15pts | FW | V004 | R309-545-18 | Rule requires ladders, ladder guards,
platform railings, and safely located entrance hatches where applicable for water
storage tanks and requires safety practices to conform to pertinent laws and
regulations of the Utah Occupational Safety and Health Division.
C
251 Tank is vented.
SIG | 25pts | FW | VL02 | R309-545-15 | Rule requires drinking water storage tanks to
be vented. Overflows cannot be considered or used as vents. This significant
deficiency must be corrected within 120 days of notification or have a corrective action
plan approved by DDW.
C
252 Are air vents present? ... if yes, answer the following question(s)Y

252A Vent is either down-turned or shielded from contaminants (at least 2 inches below the
bottom of the opening)
SIG | 25pts | FW | V005 | R309-545-15(1) | Rule requires inverted vents on water
storage tanks to be down-turned a minimum of 2 inches below any opening and
shielded to prevent the entrance of contaminants. This significant deficiency must be
corrected within 120 days of notification or have a corrective action plan approved by
DDW.
C

252B End of vent terminates at least 24 inches above earthen cover (buried tank) and is
located and sized to avoid blockage during winter.
MIN | 15pts | FW | V006 | R309-545-15(2) | For buried structures, the rule requires the
end of the vent discharge to be a minimum of 24 inches above the earthen covering.
C

252C Vent covered with #14 or finer non-corrodible mesh screen.
SIG | 25pts | FW | V007 | R309-545-15(4) | Rule requires a water storage tank vent to
be fitted with #14 mesh or finer non-corrodible screen and vents 6-inches or greater in
diameter to be fitted with additional heavy gauge screen or substantial covering to
protect the #14 mesh screen from vandalism or damage. This significant deficiency
must be corrected within 120 days of notification or have a compliance action plan
approved by DDW.
C

252D Vent 6-inch diameter and larger protected with additional heavy-gauge screen or
substantial covering.
MIN | 5pts | FW | V035 | R309-545-15(5) | Rule requires vents that are 6-inch diameter
or greater to be fitted with additional heavy gauge screen or substantial covering,
which will protect the No. 14 mesh screen against vandalism or damage.
C
DEQ | Drinking Water
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253 Are access openings present? ... if yes, answer the following question(s)
MIN | 15pts | FW | VL03 | R309-545-14 and 14(1) | Rule requires drinking water
storage tanks to be designed with reasonably convenient access to the interior for
cleaning and maintenance.
Y

253A Access opening framed at least 4 inches above roof surface or 18 inches above
earthen cover.
MIN | 15pts | FW | V008 | R309-545-14(1) | Rule requires tank access opening to be
framed at least 4 inches above the surface of the roof, or on a buried tank, to be at
least 18 inches above any earthen cover over the tank.
C

253B Access opening shoe box type with at least 2 inches of overlap
SIG | 25pts | FW | V010 | R309-545-14(2) | Rule requires the frame of an access
opening to be provided with a close fitting solid shoebox type cover which extends
down around the frame at least two inches and is furnished with a gasket(s) between
the lid and frame. This significant deficiency must be corrected within 120 days of
notification or have a corrective action plan approved by DDW.
C

253C Access opening lid properly gasketed
SIG | 25pts | FW | V009 | R309-545-14(2) | Rule requires the access opening to a tank
to be furnished with a gasket between the lid and frame. This significant deficiency
must be corrected within 120 days of notification or have a corrective action plan
approved by DDW.
C
254 Access opening locked
SIG | 25pts | FW | V029 | R309-545-14(3) | Rule requires the lid to any access
opening to have a locking device. This significant deficiency must be corrected within
120 days of notification or have a corrective action plan approved by DDW.
C
255 Roof or wall penetrations sealed
SIG | 100pts | FW | V017 | R309-545-6(1) and 545-9 | Rule requires openings in a
storage tank roof or top, designed to accommodate control apparatus or pump
columns, to be welded, gasketed, or curbed and sleeved and to have additional proper
shielding to prevent vandalism. This significant deficiency must be corrected within
120 days of notification or have a corrective action plan approved by DDW.
C
256 Area surrounding ground-level or buried storage tank is graded to prevent surface
water from standing within 50 feet.
SIG | 25pts | TR | V001 | R309-545-7(4) | Rule requires the area surrounding a
ground-level or buried water storage tank be graded in a manner to prevent surface
water from standing within 50 feet of the tank. This significant deficiency must be
corrected within 120 days of notification or have a corrective action plan approved by
DDW.
C
257 Storage tank roof is sloped to prevent ponding
MIN | 15pts | FW | V003 | R309-545-9(4) | Rule requires drainage of storage tank roofs
to eliminate water ponding.
C
258 Are there cracks in the walls or roof of the storage tank? (if yes, select only one of the
following options)
N
DEQ | Drinking Water
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ST006 - 2 MILLION GALLON VICTORY TANK - Active
259 Is a tank overflow present? ... if yes, answer the following question(s)
SIG | 25pts | FW | VL01 | R309-545-13 | Rule requires all storage tanks to be provided
with an overflow that discharges at an an elevation between 12 and 24 inches above
the ground surface or the rim of the receiving basin. This significant deficiency must
be corrected within 120 days of notification or have a corrective action plan approved
by DDW.
Y

259A Overflow line discharges at least 12 inches above ground or the flood rim of receiving
basin?
SIG | 25pts | FW | V011 | R309-545-13 | Rule requires all water storage tanks to be
provided with an overflow that discharges at an elevation between 12 and 24 inches
above the ground surface or the rim of the receiving basin.
C

259B Overflow line covered with #4 mesh non-corrodible screen
SIG | 25pts | FW | V012 | R309-545-13(3) | Rule requires overflow pipes to be
screened with #4 mesh non-corrodible screens installed at a location least susceptible
to damage by vandalism. This significant deficiency must be corrected within 120 days
of notification or have a corrective action plan approved by DDW.
C

259C Overflow line connected or discharges to a sanitary sewer drain?
SIG | 50pts | FW | V013 | R309-545-13(5) | Rule prohibits overflow pipes from
connecting to, or discharging into, a sanitary sewer system. This significant deficiency
must be corrected within 120 days of notification or have a corrective action plan
approved by DDW.
C
260 Are the drain line and overflow combined?Y
261 Is this facility Active or Inactive?A
262 Storage tank capacity in gallons (from SDWIS; if different explain why in the
comments)
2000000
263 There are no undocumented drinking water facilities (i.e. tanks, pump stations,
treatment facilities, etc.) or recent modifications that have not gone through DDW
review
SIG | 50pts | SM | G001 | R309-100-5(2), R309-500-6, R309-500-9, R309-500-9(2)
and (3) | Rule requires complete plans & specification for all public drinking water
projects to be approved in writing by the Director. Any facility found that has not
started DDW review shall be considered unapproved. This significant deficiency must
be corrected within 120 days of notification or have a corrective action plan approved
by DDW.
C
264 Ladders, ladder guards, platform railings, or safely located entrance hatches are
provided where applicable.
MIN | 15pts | FW | V004 | R309-545-18 | Rule requires ladders, ladder guards,
platform railings, and safely located entrance hatches where applicable for water
storage tanks and requires safety practices to conform to pertinent laws and
regulations of the Utah Occupational Safety and Health Division.
C
DEQ | Drinking Water
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265 Tank is vented.
SIG | 25pts | FW | VL02 | R309-545-15 | Rule requires drinking water storage tanks to
be vented. Overflows cannot be considered or used as vents. This significant
deficiency must be corrected within 120 days of notification or have a corrective action
plan approved by DDW.
C
266 Are air vents present? ... if yes, answer the following question(s)Y

266A Vent is either down-turned or shielded from contaminants (at least 2 inches below the
bottom of the opening)
SIG | 25pts | FW | V005 | R309-545-15(1) | Rule requires inverted vents on water
storage tanks to be down-turned a minimum of 2 inches below any opening and
shielded to prevent the entrance of contaminants. This significant deficiency must be
corrected within 120 days of notification or have a corrective action plan approved by
DDW.
C

266B End of vent terminates at least 24 inches above earthen cover (buried tank) and is
located and sized to avoid blockage during winter.
MIN | 15pts | FW | V006 | R309-545-15(2) | For buried structures, the rule requires the
end of the vent discharge to be a minimum of 24 inches above the earthen covering.
C

266C Vent covered with #14 or finer non-corrodible mesh screen.
SIG | 25pts | FW | V007 | R309-545-15(4) | Rule requires a water storage tank vent to
be fitted with #14 mesh or finer non-corrodible screen and vents 6-inches or greater in
diameter to be fitted with additional heavy gauge screen or substantial covering to
protect the #14 mesh screen from vandalism or damage. This significant deficiency
must be corrected within 120 days of notification or have a compliance action plan
approved by DDW.
C

266D Vent 6-inch diameter and larger protected with additional heavy-gauge screen or
substantial covering.
MIN | 5pts | FW | V035 | R309-545-15(5) | Rule requires vents that are 6-inch diameter
or greater to be fitted with additional heavy gauge screen or substantial covering,
which will protect the No. 14 mesh screen against vandalism or damage.
C
267 Are access openings present? ... if yes, answer the following question(s)
MIN | 15pts | FW | VL03 | R309-545-14 and 14(1) | Rule requires drinking water
storage tanks to be designed with reasonably convenient access to the interior for
cleaning and maintenance.
Y

267A Access opening framed at least 4 inches above roof surface or 18 inches above
earthen cover.
MIN | 15pts | FW | V008 | R309-545-14(1) | Rule requires tank access opening to be
framed at least 4 inches above the surface of the roof, or on a buried tank, to be at
least 18 inches above any earthen cover over the tank.
C

267B Access opening shoe box type with at least 2 inches of overlap
SIG | 25pts | FW | V010 | R309-545-14(2) | Rule requires the frame of an access
opening to be provided with a close fitting solid shoebox type cover which extends
down around the frame at least two inches and is furnished with a gasket(s) between
the lid and frame. This significant deficiency must be corrected within 120 days of
notification or have a corrective action plan approved by DDW.
C
DEQ | Drinking Water
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267C Access opening lid properly gasketed
SIG | 25pts | FW | V009 | R309-545-14(2) | Rule requires the access opening to a tank
to be furnished with a gasket between the lid and frame. This significant deficiency
must be corrected within 120 days of notification or have a corrective action plan
approved by DDW.
C
268 Access opening locked
SIG | 25pts | FW | V029 | R309-545-14(3) | Rule requires the lid to any access
opening to have a locking device. This significant deficiency must be corrected within
120 days of notification or have a corrective action plan approved by DDW.
C
269 Roof or wall penetrations sealed
SIG | 100pts | FW | V017 | R309-545-6(1) and 545-9 | Rule requires openings in a
storage tank roof or top, designed to accommodate control apparatus or pump
columns, to be welded, gasketed, or curbed and sleeved and to have additional proper
shielding to prevent vandalism. This significant deficiency must be corrected within
120 days of notification or have a corrective action plan approved by DDW.
C
270 Area surrounding ground-level or buried storage tank is graded to prevent surface
water from standing within 50 feet.
SIG | 25pts | TR | V001 | R309-545-7(4) | Rule requires the area surrounding a
ground-level or buried water storage tank be graded in a manner to prevent surface
water from standing within 50 feet of the tank. This significant deficiency must be
corrected within 120 days of notification or have a corrective action plan approved by
DDW.
C
271 Storage tank roof is sloped to prevent ponding
MIN | 15pts | FW | V003 | R309-545-9(4) | Rule requires drainage of storage tank roofs
to eliminate water ponding.
C
272 Are there cracks in the walls or roof of the storage tank? (if yes, select only one of the
following options)
N
273 Is a tank overflow present? ... if yes, answer the following question(s)
SIG | 25pts | FW | VL01 | R309-545-13 | Rule requires all storage tanks to be provided
with an overflow that discharges at an an elevation between 12 and 24 inches above
the ground surface or the rim of the receiving basin. This significant deficiency must
be corrected within 120 days of notification or have a corrective action plan approved
by DDW.
Y

273A Overflow line discharges at least 12 inches above ground or the flood rim of receiving
basin?
SIG | 25pts | FW | V011 | R309-545-13 | Rule requires all water storage tanks to be
provided with an overflow that discharges at an elevation between 12 and 24 inches
above the ground surface or the rim of the receiving basin.
C

273B Overflow line covered with #4 mesh non-corrodible screen
SIG | 25pts | FW | V012 | R309-545-13(3) | Rule requires overflow pipes to be
screened with #4 mesh non-corrodible screens installed at a location least susceptible
to damage by vandalism. This significant deficiency must be corrected within 120 days
of notification or have a corrective action plan approved by DDW.
C
DEQ | Drinking Water
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ST007 - HAYDEN TANK - Active

273C Overflow line connected or discharges to a sanitary sewer drain?
SIG | 50pts | FW | V013 | R309-545-13(5) | Rule prohibits overflow pipes from
connecting to, or discharging into, a sanitary sewer system. This significant deficiency
must be corrected within 120 days of notification or have a corrective action plan
approved by DDW.
C
274 Are the drain line and overflow combined?Y
275 Is this facility Active or Inactive?A
276 Storage tank capacity in gallons (from SDWIS; if different explain why in the
comments)
2000000
277 There are no undocumented drinking water facilities (i.e. tanks, pump stations,
treatment facilities, etc.) or recent modifications that have not gone through DDW
review
SIG | 50pts | SM | G001 | R309-100-5(2), R309-500-6, R309-500-9, R309-500-9(2)
and (3) | Rule requires complete plans & specification for all public drinking water
projects to be approved in writing by the Director. Any facility found that has not
started DDW review shall be considered unapproved. This significant deficiency must
be corrected within 120 days of notification or have a corrective action plan approved
by DDW.
C
278 Ladders, ladder guards, platform railings, or safely located entrance hatches are
provided where applicable.
MIN | 15pts | FW | V004 | R309-545-18 | Rule requires ladders, ladder guards,
platform railings, and safely located entrance hatches where applicable for water
storage tanks and requires safety practices to conform to pertinent laws and
regulations of the Utah Occupational Safety and Health Division.
C
279 Tank is vented.
SIG | 25pts | FW | VL02 | R309-545-15 | Rule requires drinking water storage tanks to
be vented. Overflows cannot be considered or used as vents. This significant
deficiency must be corrected within 120 days of notification or have a corrective action
plan approved by DDW.
C
280 Are air vents present? ... if yes, answer the following question(s)Y

280A Vent is either down-turned or shielded from contaminants (at least 2 inches below the
bottom of the opening)
SIG | 25pts | FW | V005 | R309-545-15(1) | Rule requires inverted vents on water
storage tanks to be down-turned a minimum of 2 inches below any opening and
shielded to prevent the entrance of contaminants. This significant deficiency must be
corrected within 120 days of notification or have a corrective action plan approved by
DDW.
C

280B End of vent terminates at least 24 inches above earthen cover (buried tank) and is
located and sized to avoid blockage during winter.
MIN | 15pts | FW | V006 | R309-545-15(2) | For buried structures, the rule requires the
end of the vent discharge to be a minimum of 24 inches above the earthen covering.
C
DEQ | Drinking Water
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280C Vent covered with #14 or finer non-corrodible mesh screen.
SIG | 25pts | FW | V007 | R309-545-15(4) | Rule requires a water storage tank vent to
be fitted with #14 mesh or finer non-corrodible screen and vents 6-inches or greater in
diameter to be fitted with additional heavy gauge screen or substantial covering to
protect the #14 mesh screen from vandalism or damage. This significant deficiency
must be corrected within 120 days of notification or have a compliance action plan
approved by DDW.
C

280D Vent 6-inch diameter and larger protected with additional heavy-gauge screen or
substantial covering.
MIN | 5pts | FW | V035 | R309-545-15(5) | Rule requires vents that are 6-inch diameter
or greater to be fitted with additional heavy gauge screen or substantial covering,
which will protect the No. 14 mesh screen against vandalism or damage.
C
281 Are access openings present? ... if yes, answer the following question(s)
MIN | 15pts | FW | VL03 | R309-545-14 and 14(1) | Rule requires drinking water
storage tanks to be designed with reasonably convenient access to the interior for
cleaning and maintenance.
Y

281A Access opening framed at least 4 inches above roof surface or 18 inches above
earthen cover.
MIN | 15pts | FW | V008 | R309-545-14(1) | Rule requires tank access opening to be
framed at least 4 inches above the surface of the roof, or on a buried tank, to be at
least 18 inches above any earthen cover over the tank.
C

281B Access opening shoe box type with at least 2 inches of overlap
SIG | 25pts | FW | V010 | R309-545-14(2) | Rule requires the frame of an access
opening to be provided with a close fitting solid shoebox type cover which extends
down around the frame at least two inches and is furnished with a gasket(s) between
the lid and frame. This significant deficiency must be corrected within 120 days of
notification or have a corrective action plan approved by DDW.
C

281C Access opening lid properly gasketed
SIG | 25pts | FW | V009 | R309-545-14(2) | Rule requires the access opening to a tank
to be furnished with a gasket between the lid and frame. This significant deficiency
must be corrected within 120 days of notification or have a corrective action plan
approved by DDW.
C
282 Access opening locked
SIG | 25pts | FW | V029 | R309-545-14(3) | Rule requires the lid to any access
opening to have a locking device. This significant deficiency must be corrected within
120 days of notification or have a corrective action plan approved by DDW.
C
283 Roof or wall penetrations sealed
SIG | 100pts | FW | V017 | R309-545-6(1) and 545-9 | Rule requires openings in a
storage tank roof or top, designed to accommodate control apparatus or pump
columns, to be welded, gasketed, or curbed and sleeved and to have additional proper
shielding to prevent vandalism. This significant deficiency must be corrected within
120 days of notification or have a corrective action plan approved by DDW.
C
DEQ | Drinking Water
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TP009 - HAYDEN CHLORINATOR -- Treatment - Chlorination General - Active
284 Area surrounding ground-level or buried storage tank is graded to prevent surface
water from standing within 50 feet.
SIG | 25pts | TR | V001 | R309-545-7(4) | Rule requires the area surrounding a
ground-level or buried water storage tank be graded in a manner to prevent surface
water from standing within 50 feet of the tank. This significant deficiency must be
corrected within 120 days of notification or have a corrective action plan approved by
DDW.
C
285 Storage tank roof is sloped to prevent ponding
MIN | 15pts | FW | V003 | R309-545-9(4) | Rule requires drainage of storage tank roofs
to eliminate water ponding.
C
286 Are there cracks in the walls or roof of the storage tank? (if yes, select only one of the
following options)
N
287 Is a tank overflow present? ... if yes, answer the following question(s)
SIG | 25pts | FW | VL01 | R309-545-13 | Rule requires all storage tanks to be provided
with an overflow that discharges at an an elevation between 12 and 24 inches above
the ground surface or the rim of the receiving basin. This significant deficiency must
be corrected within 120 days of notification or have a corrective action plan approved
by DDW.
Y

287A Overflow line discharges at least 12 inches above ground or the flood rim of receiving
basin?
SIG | 25pts | FW | V011 | R309-545-13 | Rule requires all water storage tanks to be
provided with an overflow that discharges at an elevation between 12 and 24 inches
above the ground surface or the rim of the receiving basin.
C

287B Overflow line covered with #4 mesh non-corrodible screen
SIG | 25pts | FW | V012 | R309-545-13(3) | Rule requires overflow pipes to be
screened with #4 mesh non-corrodible screens installed at a location least susceptible
to damage by vandalism. This significant deficiency must be corrected within 120 days
of notification or have a corrective action plan approved by DDW.
C

287C Overflow line connected or discharges to a sanitary sewer drain?
SIG | 50pts | FW | V013 | R309-545-13(5) | Rule prohibits overflow pipes from
connecting to, or discharging into, a sanitary sewer system. This significant deficiency
must be corrected within 120 days of notification or have a corrective action plan
approved by DDW.
C
288 Are the drain line and overflow combined?Y
289 Is this facility Active or Inactive?A
290 Is system required to provide primary disinfection? Prompt - If system knows they are
required to chlorinate based on water quality issues and/or knows they are required to
provide a minimum CT then follow-up by DDW is needed.
Y

290A If yes, no new connections have been added prior to approved first connection that
would change the disinfection CT calculation.
SIG | 50pts | TR | TD26 | R309-505-7(2), R309-520-4 and 6(4) | Point of application of
disinfectants shall be at a location that will achieve the required disinfection CT prior to
the first service connection. This significant deficiency must be corrected within 120
days of notification or have a corrective action plan approved by DDW.
C
DEQ | Drinking Water
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291 When chlorination is required, disinfection has operated uninterrupted during the past
year while supplying drinking water.
SIG | 50pts | TR | TD25 | R309-520-6 | Rule requires continuous disinfection of
groundwater sources that do not consistently meet bacteriological quality standards,
all surface water sources, and groundwater sources under the direct influence of
surface water. This significant deficiency must be corrected within 120 days of
notification or have a corrective action plan approved by DDW.
C
292 Chlorine (gas & hypochlorite solution, tablets, granules, ) and chemicals used to
generate chlorine solutions and chlorine dioxide meet ANSI/NSF 60.
SIG | 50pts | TR | TD90 | R309-525-11(5), R309-520-6(2) | All chemicals added to
drinking water, including chlorine, chloramines and chemicals used to generate
hypochlorite solutions and chlorine dioxide, shall be certified as complying with
ANSI/NSF Standard 60. This significant deficiency must be corrected within 120 days
of notification or have a corrective action plan approved by DDW.
C
293 If chemical dilution or dissolution is needed, cross-connection control is provided on
water lines feeding solution tanks.
SIG | 50pts | TR | TX07 | R309-525-11(2)(c), R309-525-11(9)(b)(i) to (iv) | Cross
connection control shall be provided on make-up water lines feeding solution tanks.
This significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
C
294 Water flow rate is measured to control chemical feed?
SIG | 25pts | TR | TD79 | R309-525-11(7)(d)(ii) and (iii), R309-525-11(7)(a)(i) |
Chemical feed rates shall be proportional to flows and a means to measure water flow
rate shall be provided. This significant deficiency must be corrected within 120 days of
notification or have a corrective action plan approved by DDW.
C
295 Solution tanks and tank refilling line entry points are properly labeled to identify the
chemicals
MIN | 15pts | TR | TG03 | R309-525-11(8)(c)(vii) | Rule requires tanks to be properly
labeled to designate the chemical contained.
C
296 Free chlorine residual test equipment on-site or available?
MIN | 15pts | TR | TD78 | R309-520-7(1)(j) | Rule requires chlorine residual test
equipment available capable of measuring residuals to the nearest 0.1 mg/l in the
range below 0.5 mg/l, to the nearest 0.3 mg/l between 0.5 mg/l and 1.0 mg/l and to the
nearest 0.5 mg/l above 1.0 mg/l.
C
297 Spare parts are available to replace parts subject to wear and breakage
MIN | 15pts | TR | TD75 | Standard Method 334.0 Determination of Residual Chlorine
in Drinking Water Using an Online Chlorine Analyzer. [EPA 815-B-09-013 September
2009 11.1.1.2 Page 13] | Spare parts shall be provided and maintained for all
chlorinators to repair parts subject to wear and breakage.
C
298 Is chlorine chemical dose rate adjusted due to different water demand flow rates
and/or changing water quality?
Y

298A If yes, which water flow rate is used? e.g. influent flow, effluent flow, filter flow.influent
299 Is there a designated chlorine Point of Entry (POE) sample location?
MIN | 15pts | TR | TGR9 | R309-105-7, 8 & 18, R309-100 through 605 | Trigger for
regulatory followup to address concerns.
C
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TP009 - HAYDEN CHLORINATOR -- Gaseous Chlorination - Active
300 POE is before first connection/customer?
SIG | 25pts | TR | T028 | R309-215 | R309-215 & R309-520-6(4)(d)
C
301 Chlorine residual records are maintained and available... if yes answer following
SIG | 25pts | TR | T028 | R309-215 | R309-215 & R309-520-6(4)(d)
Y

301A System is sampling distribution residuals throughout entire distribution system
MIN | 15pts | TR | TGR9 | R309-105-7, 8 & 18, R309-100 through 605 | Trigger for
regulatory followup to address concerns.
C

301B Distribution chlorine residuals meet minimum concentration requirement
SIG | 25pts | TR | T028 | R309-215 | R309-215 & R309-520-6(4)(d)
C

301C "What is the maximum free chlorine residual measure? This value never exceeds 4.0
mg/L? "
MIN | 15pts | TR | TGR9 | R309-105-7, 8 & 18, R309-100 through 605 | Trigger for
regulatory followup to address concerns.
C

301D System collects at least three distribution chlorine residual samples a week?
MIN | 15pts | TR | TGR9 | R309-105-7, 8 & 18, R309-100 through 605 | Trigger for
regulatory followup to address concerns.
C

301E System is sampling distribution residuals in accordance with monitoring schedule
MIN | 15pts | TR | TGR9 | R309-105-7, 8 & 18, R309-100 through 605 | Trigger for
regulatory followup to address concerns.
C
302 Treatment plant properly secured to protect the quality of the treated water. R309-520-
7(2)(f)
SIG | 25pts | SM | A050 | R309-400-11 | If the water system does not comply with the
directive, the Director may assess 25 to 200 points to the water system. Points shall
be assessed based upon the severity of the non-compliance, the threat to public
health and the underlying basis for the original directive.
C
303 Daily operating records reflect chemical dosages and total quantities used
SIG | 25pts | MR | TG20 | R309-105-14(3)(a) | Rule requires all water system using
chemical addition or specialized equipment for the treatment of drinking water to
regularly complete operational reports. This significant deficiency must be corrected
within 120 days of notification or have a corrective action plan approved by DDW.
C
304 Is this facility Active or Inactive?A
305 If disinfection is required, standby chlorination equipment of sufficient capacity is
available to replace the largest unit.
SIG | 25pts | TR | TD22 | R309-520-7(1)(k)(ii) | Where chlorination is required for
disinfection of the water supply, the rule requires standby equipment of sufficient
capacity to be available to replace the largest unit in the event of its failure. This
significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
C
306 Is the chlorinator room heated and has the ability to be protected from excessive heat?
MIN | 15pts | TR | TD08 | R309-520-7(1)(l) | Rule requires chlorinator buildings to be
heated, lighted, and ventilated as necessary to assure proper operation of the
equipment and safety of the operators.
C
DEQ | Drinking Water
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307 If continuous disinfection is needed, automatic switch over of chlorine cylinders is
provided.
MIN | 15pts | TR | TD01 | R309-520-7(2)(a), R309-520-6(1) | Rule requires automatic
switch over of chlorine cylinders be provided if continuous disinfection is required.
C
308 Exhaust fan takes suction near the floor as far as practical from the door and air inlet,
and discharges outside away from air inlets.
MIN | 15pts | TR | TD09 | R309-520-7(2)(d)(iii) | Rule requires a chlorine room exhaust
fan to take suction inside the chlorine room near the floor, as far as practical from the
door and air inlet, and discharge air outside of the building away from air inlets.
C
309 Air inlets are located near the ceiling and fitted with louvers.
MIN | 15pts | TR | TD10 | R309-520-7(2)(d)(iv) | Rule requires chlorine room air inlets
to be through wall louvers near the ceiling.
C
310 Chlorine vent line discharges outside and above grade and is screened with #14 mesh
screen.
SIG | 25pts | TR | TD13 | R309-520-7(2)(e) | Rule requires the chlorine vent line to
discharge outside, above grade, at a point least susceptible to vandalism, and to have
the end covered with a #14 mesh non-corrodible screen. This significant deficiency
must be corrected within 120 days of notification or have a corrective action plan
approved by DDW.
C
311 Separate switches for chlorine room fans and lights are located near the entrance to
the room (or are located outside the chlorine room if housed in a water treatment
plant).
MIN | 15pts | TR | TD12 | R309-520-7(2)(d)(v) | Rule requires separate switches for
the chlorine room fans and lights to be located near the entrance to the room and to
be protected from vandalism. The switches are required to be located outside the
chlorine room if housed in a water treatment plant.
C
312 Chlorine cylinder is restrained in position to prevent upset.
SIG | 25pts | TR | TD15 | R309-520-7(2)(h) | Rule requires chlorine cylinders to be
restrained in position to prevent upset. This significant deficiency must be corrected
within 120 days of notification or have a corrective action plan approved by DDW.
C
313 Chlorine cylinder is not stored in direct sunlight or exposed to excessive heat.
SIG | 25pts | TR | TD17 | R309-520-7(2)(f)(ii) | Rule prohibits chlorine cylinders from
being stored in direct sunlight or exposed to excessive heat. This significant deficiency
must be corrected within 120 days of notification or have a corrective action plan
approved by DDW.
C
314 Weight scale is provided for weighing chlorine gas cylinders/containers.
SIG | 25pts | TR | TD02 | R309-520-7(2)(i) | Rule requires scales to be provided for
determining chlorine cylinder weight. This significant deficiency must be corrected
within 120 days of notification or have a corrective action plan approved by DDW.
C
315 Is the chlorine cylinder 150 pounds in capacity? ... if yes, answer the following
question(s)
Y

315A Leak response/repair plan available
MIN | 15pts | TR | TGR9 | R309-105-7, 8 & 18, R309-100 through 605 | Trigger for
regulatory followup to address concerns.
C (Notes: Fire department)
DEQ | Drinking Water
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315B Bottle of ammonium hydroxide (56 % ammonia solution) is available for chlorine leak
detection
MIN | 15pts | TR | TD14 | R309-520-7(2)(l)(i) | Rule requires a bottle of ammonium
hydroxide (56% ammonia solution) to be available for leak detection.
C

315C Immediate access to NIOSH respirator available
SIG | 25pts | TR | TD04 | R309-520-7(2)(k)(ii) | Where 150 pound chlorine cylinders
are used, a respirator recommended the National Institute of Occupational Safety and
Health must be available. This significant deficiency must be corrected within 120 days
of notification or have a corrective action plan approved by DDW.
C
316 Is the chlorine cylinder 1 ton in capacity? ... if yes, answer the following question(s)N
317 Is the (daily) scale weight or volume data recorded? Explain where in the comments...
SIG | 25pts | TR | TD02 | R309-520-7(2)(i) | Rule requires scales to be provided for
determining chlorine cylinder weight. This significant deficiency must be corrected
within 120 days of notification or have a corrective action plan approved by DDW.
C
DEQ | Drinking Water
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