DDW-2025-005349

Utah Department Of Environmental Quality
Division Of Drinking Water Sanitary Survey
Sanitary Survey
General System Information
Site Visit Date Surveyor Name
06/04/2025 Luke Treutel
KANAB CITY PWS ID: UTAH13005 Rating: Approved 03/10/1980 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: JAKE AUSTIN
*Last Name: DUTTON
*Organization:
*Address: Redacted
*City: KANAB
*State: UT
*Zip: 84741
*Email: [e-mail]
*Phone: [phone]
Emergency Phone: [phone]
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: KANAB
*Address: 26 N 100 E
*City: KANAB
*State: UT
*Zip: 84741
*Email: [e-mail]
*Phone: [phone]
Emergency Phone: [phone]
DEQ | Drinking Water
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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: KANAB CITY
*Address: 26 N 100 E
*City: KANAB
*State: UT
*Zip: 84741
*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: JAKE AUSTIN
*Last Name: DUTTON
*Organization:
*Address: 369 W 300 N
*City: KANAB
*State: UT
*Zip: 84741
*Email: [e-mail]
*Phone: [phone]
Emergency Phone: [phone]
5 Does the system serve a Residential population?Y
5A Population - Residential 4925
5B Operating Period (Start Date) - Residential 01/01
5C Operating Period (End Date) - Residential 12/31
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.)
Y
6A Population - Transient 60
6B Operating Period (Start Date) - Transient 01/01
6C Operating Period (End Date) - Transient 12/31
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
DEQ | Drinking Water
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Site Visit Info
Management and Operations
9 Residential Connections:2378
10 Commercial Connections:257
11 Industrial Connections:2
12 Agricultural Connections:17
13 Date of Survey (First Day of Field Work)06/03/2025
14 Date of Survey (Last Day of Field Work) ** this should match the Date of Survey in the
header **
06/04/2025
15 Date final report sent to system (questionnaire, deficiency report and capacity
spreadsheet)
06/11/2025
16 Water system representative present during the survey:Jake Dutton
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)
7
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)
0
20 How much time did it take to finish the Survey Report? (Round up to nearest quarter
hour)
1.5
21 Did you survey multiple water systems in one trip? ... if yes, answer the following
question(s)
N
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
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
DEQ | Drinking Water
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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
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
DEQ | Drinking Water
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Cross Connection and Operator Certification
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: N/A - Population less than
50,000)
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?
H
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
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.
C
DEQ | Drinking Water
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General Maintenance and Environment
Distribution
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.
C
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
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
DEQ | Drinking Water
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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.
NA (Notes: N/A - Not located in chamber)
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.
NA (Notes: N/A - Not located in chamber)
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
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
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
DEQ | Drinking Water
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General Disinfection
WS022 - WEST FORK #5 - Proposed Source
ST001 - NORTH STEEL TANK - Inactive (RL - REPLACED)
ST002 - SOUTH STEEL TANK - Inactive (RL - REPLACED)
WS001 - CAVE LAKE(10) SPRINGS - Inactive (AB - ABANDONED)
WS006 - CHICKEN CANYON SPRING - Inactive (AB - ABANDONED)
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
62 Is this source in operation without an Operating Permit?
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.
N
62A When is the anticipated date to request an Operating Permit? Explain in comments...End of 2025 or early 2026.
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
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
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
DEQ | Drinking Water
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WS012 - R-3 SOLD - Inactive (SD - SOLD/TRANSFERRED)
WS013 - R-2 SOLD - Inactive (SD - SOLD/TRANSFERRED)
WS014 - R-1 SOLD - Inactive (SD - SOLD/TRANSFERRED)
WS017 - JOHNSON CANYON WELL - Inactive (AB - ABANDONED)
WS002 - MACE WELL #2 - Active
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
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
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
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
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
63 Is this facility Active or Inactive?A
64 Operating Period (Start Date)01/01
65 Operating Period (Ending Date)12/31
66 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
67 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
68 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
69 Is the well casing vented? ... if yes, answer the following question(s)N
70 Does the well have a pump to waste line? ... if yes, answer the following question(s)Y
DEQ | Drinking Water
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70A 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
70B 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
70C 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
71 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
72 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
73 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
74 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
75 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
DEQ | Drinking Water
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76 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
77 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
78 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
79 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
80 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
81 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
82 Is there an air/vac valve on the well discharge line? If yes, answer the following
question(s)
Y
82A 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
82B 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
82C 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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WS003 - WELL #9 - Active
83 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
84 Does well require oil-lubrication?N
85 Is this facility Active or Inactive?A
86 Operating Period (Start Date)01/01
87 Operating Period (Ending Date)12/31
88 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
89 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
90 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
91 Is the well casing vented? ... if yes, answer the following question(s)Y
91A 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
DEQ | Drinking Water
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91B 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
91C 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
92 Does the well have a pump to waste line? ... if yes, answer the following question(s)Y
92A 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
92B 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
92C 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
93 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
94 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
95 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
DEQ | Drinking Water
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96 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
97 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
98 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
99 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
100 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
101 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
102 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
103 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
104 Is there an air/vac valve on the well discharge line? If yes, answer the following
question(s)
Y

104A 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
DEQ | Drinking Water
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WS004 - CHICKEN CANYON WELL #4 - Active

104B 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

104C 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
105 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
106 Does well require oil-lubrication?N
107 Is this facility Active or Inactive?A
108 Operating Period (Start Date)01/01
109 Operating Period (Ending Date)12/31
110 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
111 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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112 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
113 Is the well casing vented? ... if yes, answer the following question(s)Y

113A 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

113B 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

113C 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
114 Does the well have a pump to waste line? ... if yes, answer the following question(s)N
115 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
116 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
117 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
118 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
DEQ | Drinking Water
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119 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
120 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
121 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
122 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
123 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
124 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
125 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
126 Is there an air/vac valve on the well discharge line? If yes, answer the following
question(s)
Y

126A 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

126B 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
DEQ | Drinking Water
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WS005 - WELL #5 - Active

126C 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
127 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
128 Does well require oil-lubrication?N
129 Is this facility Active or Inactive?A
130 Operating Period (Start Date)01/01
131 Operating Period (Ending Date)12/31
132 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
133 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
134 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
135 Is the well casing vented? ... if yes, answer the following question(s)N
136 Does the well have a pump to waste line? ... if yes, answer the following question(s)Y
DEQ | Drinking Water
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136A 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

136B 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

136C 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
137 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
138 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
139 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
140 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
141 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
DEQ | Drinking Water
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142 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
143 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
144 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
145 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
146 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
147 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
148 Is there an air/vac valve on the well discharge line? If yes, answer the following
question(s)
Y

148A 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

148B 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

148C 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
Run Date: 06/11/2025 13:41:04 | Rating: Approved UTAH13005 KANAB CITY page 20 of 73
WS007 - WELL #12 - Active
149 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
150 Does well require oil-lubrication?Y

150A 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>
C
151 Is this facility Active or Inactive?A
152 Operating Period (Start Date)01/01
153 Operating Period (Ending Date)12/31
154 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
155 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
156 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
157 Is the well casing vented? ... if yes, answer the following question(s)Y
DEQ | Drinking Water
Run Date: 06/11/2025 13:41:04 | Rating: Approved UTAH13005 KANAB CITY page 21 of 73

157A 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

157B 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

157C 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
158 Does the well have a pump to waste line? ... if yes, answer the following question(s)Y

158A 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

158B 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

158C 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
159 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
160 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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161 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
162 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
163 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
164 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
165 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
166 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
167 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
168 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
169 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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WS008 - WELL #11 - Active
170 Is there an air/vac valve on the well discharge line? If yes, answer the following
question(s)
Y

170A 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

170B 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

170C 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
171 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
172 Does well require oil-lubrication?N
173 Is this facility Active or Inactive?A
174 Operating Period (Start Date)01/01
175 Operating Period (Ending Date)12/31
176 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
DEQ | Drinking Water
Run Date: 06/11/2025 13:41:04 | Rating: Approved UTAH13005 KANAB CITY page 24 of 73
177 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
178 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
179 Is the well casing vented? ... if yes, answer the following question(s)N
180 Does the well have a pump to waste line? ... if yes, answer the following question(s)Y

180A 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

180B 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

180C 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
181 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
182 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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183 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
184 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
185 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
186 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
187 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
188 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
189 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
190 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
191 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
Run Date: 06/11/2025 13:41:04 | Rating: Approved UTAH13005 KANAB CITY page 26 of 73
WS009 - WELL #13 - Active
192 Is there an air/vac valve on the well discharge line? If yes, answer the following
question(s)
Y

192A 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

192B 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

192C 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
193 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
194 Does well require oil-lubrication?N
195 Is this facility Active or Inactive?A
196 Operating Period (Start Date)01/01
197 Operating Period (Ending Date)12/31
198 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
DEQ | Drinking Water
Run Date: 06/11/2025 13:41:04 | Rating: Approved UTAH13005 KANAB CITY page 27 of 73
199 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
200 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
201 Is the well casing vented? ... if yes, answer the following question(s)N
202 Does the well have a pump to waste line? ... if yes, answer the following question(s)Y

202A 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

202B 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

202C 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
203 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
204 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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205 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
206 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
207 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
208 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
209 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
210 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
211 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
212 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
213 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 - WELL #14 - Active
214 Is there an air/vac valve on the well discharge line? If yes, answer the following
question(s)
Y

214A 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

214B 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

214C 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
215 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
216 Does well require oil-lubrication?N
217 Is this facility Active or Inactive?A
218 Operating Period (Start Date)01/01
219 Operating Period (Ending Date)12/31
220 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
DEQ | Drinking Water
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221 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
222 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
223 Is the well casing vented? ... if yes, answer the following question(s)N
224 Does the well have a pump to waste line? ... if yes, answer the following question(s)Y

224A 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

224B 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

224C 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
225 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
226 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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227 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
228 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
229 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
230 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
231 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
232 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
233 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
234 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
235 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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WS011 - WELL #15 - Active
236 Is there an air/vac valve on the well discharge line? If yes, answer the following
question(s)
Y

236A 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

236B 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

236C 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
237 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
238 Does well require oil-lubrication?N
239 Is this facility Active or Inactive?A
240 Operating Period (Start Date)01/01
241 Operating Period (Ending Date)12/31
242 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
DEQ | Drinking Water
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243 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
244 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
245 Is the well casing vented? ... if yes, answer the following question(s)N
246 Does the well have a pump to waste line? ... if yes, answer the following question(s)Y

246A 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

246B 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

246C 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
247 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
248 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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249 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
250 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
251 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
252 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
253 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
254 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
255 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
256 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
257 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
Run Date: 06/11/2025 13:41:04 | Rating: Approved UTAH13005 KANAB CITY page 35 of 73
WS015 - WELL #10 -
258 Is there an air/vac valve on the well discharge line? If yes, answer the following
question(s)
Y

258A 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

258B 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

258C 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
259 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
260 Does well require oil-lubrication?N
261 Is this facility Active or Inactive?I

261A Explain why this facility is Inactive (Is this facility in stand-by mode?)Down for repair.
262 Operating Period (Start Date)01/01
263 Operating Period (Ending Date)12/31
264 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
DEQ | Drinking Water
Run Date: 06/11/2025 13:41:04 | Rating: Approved UTAH13005 KANAB CITY page 36 of 73
265 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
266 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
267 Is the well casing vented? ... if yes, answer the following question(s)Y

267A 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

267B 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

267C 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
268 Does the well have a pump to waste line? ... if yes, answer the following question(s)Y

268A 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

268B 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
DEQ | Drinking Water
Run Date: 06/11/2025 13:41:04 | Rating: Approved UTAH13005 KANAB CITY page 37 of 73

268C 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
269 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
270 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
271 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
272 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
273 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
274 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
275 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
DEQ | Drinking Water
Run Date: 06/11/2025 13:41:04 | Rating: Approved UTAH13005 KANAB CITY page 38 of 73
WS016 - WELL #3 -
276 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
277 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
278 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
279 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
280 Is there an air/vac valve on the well discharge line? If yes, answer the following
question(s)
Y

280A 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

280B 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

280C 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
281 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
282 Does well require oil-lubrication?N
DEQ | Drinking Water
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283 Is this facility Active or Inactive?I

283A Explain why this facility is Inactive (Is this facility in stand-by mode?)Down for repair.
284 Operating Period (Start Date)01/01
285 Operating Period (Ending Date)12/31
286 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
287 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
288 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
289 Is the well casing vented? ... if yes, answer the following question(s)Y

289A 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

289B 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

289C 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
290 Does the well have a pump to waste line? ... if yes, answer the following question(s)Y
DEQ | Drinking Water
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290A 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

290B 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

290C 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
291 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
292 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
293 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
294 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
295 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
DEQ | Drinking Water
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296 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
297 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
298 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
299 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
300 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
301 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
302 Is there an air/vac valve on the well discharge line? If yes, answer the following
question(s)
Y

302A 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

302B 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

302C 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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WS018 - WEST FORK WELL #1 - Active
303 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
304 Does well require oil-lubrication?N
305 Is this facility Active or Inactive?A
306 Operating Period (Start Date)01/01
307 Operating Period (Ending Date)12/31
308 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
309 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
310 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
311 Is the well casing vented? ... if yes, answer the following question(s)Y

311A 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
DEQ | Drinking Water
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311B 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

311C 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
312 Does the well have a pump to waste line? ... if yes, answer the following question(s)Y

312A 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

312B 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

312C 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
313 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
314 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
315 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
DEQ | Drinking Water
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316 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
317 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
318 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
319 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
320 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
321 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
322 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
323 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
324 Is there an air/vac valve on the well discharge line? If yes, answer the following
question(s)
Y

324A 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
DEQ | Drinking Water
Run Date: 06/11/2025 13:41:04 | Rating: Approved UTAH13005 KANAB CITY page 45 of 73
WS019 - WEST FORK WELL #2 - Active

324B 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

324C 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
325 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
326 Does well require oil-lubrication?N
327 Is this facility Active or Inactive?A
328 Operating Period (Start Date)01/01
329 Operating Period (Ending Date)12/31
330 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
331 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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332 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
333 Is the well casing vented? ... if yes, answer the following question(s)Y

333A 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

333B 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

333C 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
334 Does the well have a pump to waste line? ... if yes, answer the following question(s)Y

334A 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

334B 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

334C 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
335 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
336 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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337 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
338 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
339 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
340 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
341 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
342 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
343 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
344 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
345 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
Run Date: 06/11/2025 13:41:04 | Rating: Approved UTAH13005 KANAB CITY page 48 of 73
WS020 - WEST FORK WELL #3 - Active
346 Is there an air/vac valve on the well discharge line? If yes, answer the following
question(s)
Y

346A 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

346B 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

346C 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
347 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
348 Does well require oil-lubrication?N
349 Is this facility Active or Inactive?A
350 Operating Period (Start Date)01/01
351 Operating Period (Ending Date)12/31
352 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
DEQ | Drinking Water
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353 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
354 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
355 Is the well casing vented? ... if yes, answer the following question(s)N
356 Does the well have a pump to waste line? ... if yes, answer the following question(s)Y

356A 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

356B 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

356C 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
357 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
358 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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359 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
360 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
361 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
362 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
363 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
364 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
365 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
366 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
367 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
Run Date: 06/11/2025 13:41:04 | Rating: Approved UTAH13005 KANAB CITY page 51 of 73
WS021 - WEST FORK WELL #4 - Active
368 Is there an air/vac valve on the well discharge line? If yes, answer the following
question(s)
Y

368A 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

368B 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

368C 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
369 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
370 Does well require oil-lubrication?N
371 Is this facility Active or Inactive?A
372 Operating Period (Start Date)04/01
373 Operating Period (Ending Date)09/30
374 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
DEQ | Drinking Water
Run Date: 06/11/2025 13:41:04 | Rating: Approved UTAH13005 KANAB CITY page 52 of 73
375 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
376 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
377 Is the well casing vented? ... if yes, answer the following question(s)Y

377A 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

377B 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

377C 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
378 Does the well have a pump to waste line? ... if yes, answer the following question(s)Y

378A 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

378B 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
DEQ | Drinking Water
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378C 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
379 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
380 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
381 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
382 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
383 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
384 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
385 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
DEQ | Drinking Water
Run Date: 06/11/2025 13:41:04 | Rating: Approved UTAH13005 KANAB CITY page 54 of 73
OT001 - SAND TRAP CL2 TANK - Active
386 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
387 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
388 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
389 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
390 Is there an air/vac valve on the well discharge line? If yes, answer the following
question(s)
Y

390A 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

390B 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

390C 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
391 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
392 Does well require oil-lubrication?N
DEQ | Drinking Water
Run Date: 06/11/2025 13:41:04 | Rating: Approved UTAH13005 KANAB CITY page 55 of 73
393 Is this facility Active or Inactive?A
394 Storage tank capacity in gallons (from SDWIS; if different explain why in the
comments)
10000
395 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
396 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
397 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
398 Are air vents present? ... if yes, answer the following question(s)Y

398A 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

398B 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

398C 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
Run Date: 06/11/2025 13:41:04 | Rating: Approved UTAH13005 KANAB CITY page 56 of 73

398D 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
399 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

399A 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

399B 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

399C 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
400 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
401 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
402 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
Run Date: 06/11/2025 13:41:04 | Rating: Approved UTAH13005 KANAB CITY page 57 of 73
ST003 - VERMILLION TANK - Active
403 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
404 Are there cracks in the walls or roof of the storage tank? (if yes, select only one of the
following options)
N
405 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.
NA (Notes: N/A - This is not a traditional
storage tank.)
406 Are the drain line and overflow combined?N

406A Drain line shall terminate at least 12 inches above ground or flood rim of receiving
basin
SIG | 25pts | FW | V016 | R309-545-10(1)(d) | If the local authority allows discharge to
a storm drain, the rule requires the drain discharge to have a physical clearance of at
least 12 inches between the discharge end of the pipe and the overflow 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.
C
407 Is this facility Active or Inactive?A
408 Storage tank capacity in gallons (from SDWIS; if different explain why in the
comments)
1000000
409 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
410 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
411 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
412 Are air vents present? ... if yes, answer the following question(s)Y
DEQ | Drinking Water
Run Date: 06/11/2025 13:41:04 | Rating: Approved UTAH13005 KANAB CITY page 58 of 73

412A 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

412B 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

412C 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

412D 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
413 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

413A 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

413B 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

413C 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
Run Date: 06/11/2025 13:41:04 | Rating: Approved UTAH13005 KANAB CITY page 59 of 73
414 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
415 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
416 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
417 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
418 Are there cracks in the walls or roof of the storage tank? (if yes, select only one of the
following options)
N
419 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

419A 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

419B 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

419C 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
420 Are the drain line and overflow combined?Y
DEQ | Drinking Water
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ST004 - STANSFIELD TANK - Active
421 Is this facility Active or Inactive?A
422 Storage tank capacity in gallons (from SDWIS; if different explain why in the
comments)
1000000
423 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
424 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
425 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
426 Are air vents present? ... if yes, answer the following question(s)Y

426A 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

426B 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

426C 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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426D 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
427 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

427A 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

427B 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

427C 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
428 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
429 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
430 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
Run Date: 06/11/2025 13:41:04 | Rating: Approved UTAH13005 KANAB CITY page 62 of 73
ST005 - NORTH TANK - Active
431 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
432 Are there cracks in the walls or roof of the storage tank? (if yes, select only one of the
following options)
N
433 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

433A 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

433B 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

433C 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
434 Are the drain line and overflow combined?Y
435 Is this facility Active or Inactive?A
436 Storage tank capacity in gallons (from SDWIS; if different explain why in the
comments)
2000000
437 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
DEQ | Drinking Water
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438 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
439 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
440 Are air vents present? ... if yes, answer the following question(s)Y

440A 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

440B 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

440C 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

440D 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
441 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

441A 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
DEQ | Drinking Water
Run Date: 06/11/2025 13:41:04 | Rating: Approved UTAH13005 KANAB CITY page 64 of 73

441B 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

441C 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
442 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
443 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
444 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
445 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
446 Are there cracks in the walls or roof of the storage tank? (if yes, select only one of the
following options)
N
447 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

447A 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
DEQ | Drinking Water
Run Date: 06/11/2025 13:41:04 | Rating: Approved UTAH13005 KANAB CITY page 65 of 73
ST006 - SOUTH TANK - Active

447B 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

447C 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
448 Are the drain line and overflow combined?Y
449 Is this facility Active or Inactive?A
450 Storage tank capacity in gallons (from SDWIS; if different explain why in the
comments)
2000000
451 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
452 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
453 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
454 Are air vents present? ... if yes, answer the following question(s)Y

454A 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
DEQ | Drinking Water
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454B 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

454C 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

454D 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
455 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

455A 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

455B 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

455C 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
456 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
DEQ | Drinking Water
Run Date: 06/11/2025 13:41:04 | Rating: Approved UTAH13005 KANAB CITY page 67 of 73
PF001 - EMERGENCY BOOSTER STATION -- Pump Stations - Active
457 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
458 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
459 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
460 Are there cracks in the walls or roof of the storage tank? (if yes, select only one of the
following options)
N
461 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

461A 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

461B 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

461C 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
462 Are the drain line and overflow combined?Y (Notes: Shared with North Tank.)
463 Is this facility Active or Inactive?A
DEQ | Drinking Water
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464 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
465 Pump Type (Centrifugal, Hand pump, Jet, Positive Displacement, Screw, Submersible,
Vertical turbine)
Centrifugal
466 If the pump station is used to pressurize the distribution system, does it have at least
two functioning pumping units? ... if yes, answer the following question(s)
SIG | 25pts | PU | PS18 | R309-540-5(4)(b) | Rule states inline booster pumps,
withdrawing water directly from distribution lines without storage and feeding water
directly into distribution lines, shall have at least two pumping units. This significant
deficiency must be corrected within 120 days of notification or have a corrective action
plan approved by DDW.
NA (Notes: N/A - Emergency use only. Not
used to pressurize DS.)
467 Pump station building and equipment are protected from flooding.
MIN | 15pts | PU | PS13 | R309-540-5(1)(a)(ii), R309-540-5(2)(a)(iii) | Pump station
access shall be 6" above surrounding ground and located at least 3’ above 100-year
flood elevation or highest recorded flood elevation; station is accessible at all times
unless it can be taken out of service when inaccessible.
C
468 There are no unprotected cross-connections in the pump station.
SIG | 50pts | PU | PS15 | R309-105-12(1) | Cross connections are not allowed unless
controlled by an approved and properly operating backflow prevention assembly or
device. This significant deficiency must be corrected within 120 days of notification or
have a corrective action plan approved by DDW.
C
469 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
470 Discharge piping has a pressure gauge.
MIN | 15pts | PU | PS03 | R309-540-5 (6)(c)(i) | Rule requires that a standard pressure
gauge be installed on the pump discharge line.
C
471 Does the pumping facility have an air relief valve located on the discharge piping? ... if
yes, answer the following question(s)
Y

471A End of air relief piping downturned
SIG | 25pts | PU | PS12 | R309-550-6(6)(b), R309-540-6(2) | The open end of the air
relief vent pipe from automatic valves shall be provided with a downward elbow. This
significant deficiency must be corrected within 120 days of notification or have a
corrective action plan approved by DDW.
C
DEQ | Drinking Water
Run Date: 06/11/2025 13:41:04 | Rating: Approved UTAH13005 KANAB CITY page 69 of 73
TP001 - CAVE LAKE(10) SPRINGS CHLORINATOR -- Treatment - Chlorination General - Active

471B End of air relief piping covered with #14 mesh screen
SIG | 25pts | PU | PS10 | R309-550-6(6)(b), R309-540-6(2) | The open end of the air
relief vent pipe from automatic valves shall be provided 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

471C End of air relief piping terminates at least 6 inches above floor
SIG | 25pts | PU | PS11 | R309-550-6(6)(b), R309-540-6(2) | Rule requires that an air
release valve discharge line terminate a minimum of 6 inches above the floor.
C
472 Pump station properly secured
MIN | 15pts | PU | PS33 | R309-540-5(1)(a)(v) | The pump station is protected to
prevent vandalism and entrance by animals or unauthorized persons.
C
473 Is this facility Active or Inactive?A
474 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.
N
475 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.
NA (Notes: N/A - Chlorination is not
required)
476 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
477 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.
NA (Notes: N/A - Dilution/dissolution not
needed for gas chlorinator.)
478 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
479 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.
NA (Notes: N/A - Gas chlorinators do not
utilize solution tanks.)
DEQ | Drinking Water
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480 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
481 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
482 Is chlorine chemical dose rate adjusted due to different water demand flow rates
and/or changing water quality?
Y

482A If yes, which water flow rate is used? e.g. influent flow, effluent flow, filter flow.Influent flow
483 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
484 POE is before first connection/customer?
SIG | 25pts | TR | T028 | R309-215 | R309-215 & R309-520-6(4)(d)
C
485 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

485A 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

485B Distribution chlorine residuals meet minimum concentration requirement
SIG | 25pts | TR | T028 | R309-215 | R309-215 & R309-520-6(4)(d)
C

485C "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

485D 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

485E 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
486 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
DEQ | Drinking Water
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TP001 - CAVE LAKE(10) SPRINGS CHLORINATOR -- Gaseous Chlorination - Active
487 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
488 Is this facility Active or Inactive?A
489 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.
NA (Notes: N/A - Disinfection is not
required)
490 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
491 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
492 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
493 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
494 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
495 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
DEQ | Drinking Water
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496 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
497 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
498 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
499 Is the chlorine cylinder 150 pounds in capacity? ... if yes, answer the following
question(s)
Y

499A 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

499B 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

499C 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
500 Is the chlorine cylinder 1 ton in capacity? ... if yes, answer the following question(s)N
501 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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