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HomeMy WebLinkAboutDDW-2025-005451Utah Department Of Environmental Quality Division Of Drinking Water Sanitary Survey Sanitary Survey General System Information Site Visit Date Surveyor Name 06/13/2025 Tom McOmie COTTONWOOD MUTUAL PWS ID: UTAH15013 Rating: Approved 09/01/2021 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: MICHAEL ROBERT *Last Name: JOHANSON *Organization: *Address: Redacted *City: MOUNTAIN GREEN *State: UT *Zip: 84050 *Email: mike@cottonwoodwater.com *Phone: 801-876-3895 Emergency Phone: 801-425-6558 2 Legal Contact (LC) [ if no eMail address is available, enter NoeMail@utah.gov ] 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: COTT0NWOOD MUTUAL WATER CO *Address: 4000 W OLD HWY RD *City: MORGAN *State: UT *Zip: 84050 *Email: mike@cottonwoodwater.com *Phone: 801-876-3895 DEQ | Drinking Water Run Date: 06/13/2025 16:32:26 | Rating: Approved UTAH15013 COTTONWOOD MUTUAL page 1 of 47 3 Owner Contact (OW) [ if no eMail address is available, enter NoeMail@utah.gov ] 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: COTTONWOOD MUTUAL WATER CO *Address: 4000 W OLD HWY RD *City: MORGAN *State: UT *Zip: 84050 *Email: MIKE@cottonwoodwater.com *Phone: 801-876-3895 4 Direct Operator in Charge (DO) [ if no eMail address is available, enter NoeMail@utah.gov ] 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: MICHAEL ROBERT *Last Name: JOHANSON *Organization: *Address: 4000 W Old Hwy Rd *City: MOUNTAIN GREEN *State: UT *Zip: 84050 *Email: mike@cottonwoodwater.com *Phone: 801-876-3895 Emergency Phone: 801-425-6558 5 Does the system serve a Residential population?Y 5A Population - Residential 2845 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.) N 7 Does the system serve a Non-Transient population? (A non-transient population is a population served by a water system that is the same population being served by the system for at least six months of the year, but is not a resident in the system. Examples of a non-transient population include, but are not limited to, employees of a restaurant, shop, or ski resort; teachers and students at a school, day-care center, or church; doctors, nurses, and other employees at a hospital or healthcare clinic.) N (Notes: THIS WAS CHANGED FROM 300 TO 0. THIS SYSTEM DOES NT HAVE A NON-TRANSIET POPULATION.) 7A Population - Non-Transient 300 7B Operating Period (Start Date) - Non-Transient 01/01 7C Operating Period (End Date) - Non-Transient 12/31 8 Population - Wholesale :0 9 Residential Connections:869 DEQ | Drinking Water Run Date: 06/13/2025 16:32:26 | Rating: Approved UTAH15013 COTTONWOOD MUTUAL page 2 of 47 Site Visit Info Management and Operations 10 Commercial Connections:43 11 Industrial Connections:0 12 Agricultural Connections:0 13 Date of Survey (First Day of Field Work)06/13/2025 14 Date of Survey (Last Day of Field Work) ** this should match the Date of Survey in the header ** 06/13/2025 15 Date final report sent to system (questionnaire, deficiency report and capacity spreadsheet) 06/13/2025 16 Water system representative present during the survey:Yes (Notes: Mike and John) 17 How much time was spent to prepare survey documents prior to field survey? (Round up to nearest quarter hour) 1 Hour 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) 3.5 Hours 19 How much time was spent traveling from the office to system and back again at the end of the field survey? (Round up to nearest quarter hour) 3 Hours 20 How much time did it take to finish the Survey Report? (Round up to nearest quarter hour) 2 Hours 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 25 Does the system haul water?N DEQ | Drinking Water Run Date: 06/13/2025 16:32:26 | Rating: Approved UTAH15013 COTTONWOOD MUTUAL page 3 of 47 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 Run Date: 06/13/2025 16:32:26 | Rating: Approved UTAH15013 COTTONWOOD MUTUAL page 4 of 47 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: NA for systems 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 Run Date: 06/13/2025 16:32:26 | Rating: Approved UTAH15013 COTTONWOOD MUTUAL page 5 of 47 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 Run Date: 06/13/2025 16:32:26 | Rating: Approved UTAH15013 COTTONWOOD MUTUAL page 6 of 47 45B For a valve in a chamber, open end of vent pipe is at least 12 inches above grade or one foot above distribution line in a chamber that does not flood. SIG | 25pts | DS | D006 | R309-550-6(6)(b) | Rule states the open end of the air relief vent pipe from automatic valves shall be provided with a #14 mesh, non-corrodible screen and a downward elbow, and where possible, be extended to at least one foot above grade. This significant deficiency must be corrected within 120 days of notification or have a corrective action plan approved by DDW. C 45C Chamber has drain to daylight, gravel-filled adsorption pit if not subject to flooding, or sump pump. SIG | 25pts | DS | D007 | R309-550-6(6)(b) and (7)(b) | Rule states chambers shall be provided with a drain to daylight, if possible. Where this is not possible, underground gravel-filled absorption pits may be used if the site is not subject to flooding and conditions will assure adequate drainage. Sump pumps may also be considered if a drain to daylight or absorption pit is not feasible. This significant deficiency must be corrected within 120 days of notification or have a corrective action plan approved by DDW. C 45D Open end of vent line down-turned. SIG | 25pts | DS | D006 | R309-550-6(6)(b) | Rule states the open end of the air relief vent pipe from automatic valves shall be provided with a #14 mesh, non-corrodible screen and a downward elbow, and where possible, be extended to at least one foot above grade. This significant deficiency must be corrected within 120 days of notification or have a corrective action plan approved by DDW. C 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 Run Date: 06/13/2025 16:32:26 | Rating: Approved UTAH15013 COTTONWOOD MUTUAL page 7 of 47 General Disinfection WS010 - ROSE HILL WELL 2 REPL-1 (SUSPENDED) - Proposed Source WS011 - JOHNSON WELL #2 - Proposed Source ST004 - 250K GAILEY BENCH RESERVOIR - Proposed 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 59 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 59A When is the anticipated date to request an Operating Permit? Explain in comments...No time soon 60 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 60A When is the anticipated date to request an Operating Permit? Explain in comments...No time soon DEQ | Drinking Water Run Date: 06/13/2025 16:32:26 | Rating: Approved UTAH15013 COTTONWOOD MUTUAL page 8 of 47 ST008 - 400,000 GALLON UPPER TANK - Proposed TP001 - ROLLINS #1 & #2 CHLORINATOR (NOT EXIST) - Proposed TP002 - AIRPORT WELL CHLORINATOR (ABANDONED) - Inactive (AB - ABANDONED) WS003 - PARK WELL (ABANDONED) - Inactive (AB - ABANDONED) Exception Granted: R309-515-6(6)(i) | Well Grouting or the Park Well upto 100 ft not met WS006 - MIKE ROLLINS WELL (SAME AS WS007) - Inactive (SD - SOLD/TRANSFERRED) WS007 - ROLLINS #1 WELL (ABANDONED) - Inactive (AB - ABANDONED) 61 Is this facility in operation without an Operating Permit? 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. N 61A When is the anticipated date to request an Operating Permit? Explain in comments...No time soon 62 Is this facility in operation without an Operating Permit? 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. N 62A When is the anticipated date to request an Operating Permit? Explain in comments...No time soon 63 Is this facility in operation without an Operating Permit? 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. N 63A When is the anticipated date to request an Operating Permit? Explain in comments...No need at this time 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 Run Date: 06/13/2025 16:32:26 | Rating: Approved UTAH15013 COTTONWOOD MUTUAL page 9 of 47 WS008 - ROLLINS #2 WELL - Inactive (SD - SOLD/TRANSFERRED) WS001 - ROSE HILL WELL 1 - 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 64 Is this facility Active or Inactive?A 65 Operating Period (Start Date)01/01 66 Operating Period (Ending Date)12/31 67 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 68 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 69 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 70 Is the well casing vented? ... if yes, answer the following question(s)N 71 Does the well have a pump to waste line? ... if yes, answer the following question(s)N 72 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 73 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 Run Date: 06/13/2025 16:32:26 | Rating: Approved UTAH15013 COTTONWOOD MUTUAL page 10 of 47 74 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 75 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 76 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 77 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 78 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 79 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 80 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 81 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 82 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: 06/13/2025 16:32:26 | Rating: Approved UTAH15013 COTTONWOOD MUTUAL page 11 of 47 WS002 - ROSE HILL WELL 2 - Active 83 Is there an air/vac valve on the well discharge line? If yes, answer the following question(s) Y 83A 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 83B 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 83C 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 84 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 85 Does well require oil-lubrication?N 86 Is this facility Active or Inactive?A 87 Operating Period (Start Date)01/01 88 Operating Period (Ending Date)12/31 89 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: 06/13/2025 16:32:26 | Rating: Approved UTAH15013 COTTONWOOD MUTUAL page 12 of 47 90 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 91 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 92 Is the well casing vented? ... if yes, answer the following question(s)N 93 Does the well have a pump to waste line? ... if yes, answer the following question(s)Y 93A 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 93B 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 93C 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 94 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 95 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 Run Date: 06/13/2025 16:32:26 | Rating: Approved UTAH15013 COTTONWOOD MUTUAL page 13 of 47 96 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 97 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 98 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 99 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 100 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 101 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 102 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 103 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 104 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: 06/13/2025 16:32:26 | Rating: Approved UTAH15013 COTTONWOOD MUTUAL page 14 of 47 WS004 - AIRPORT WELL - Active 105 Is there an air/vac valve on the well discharge line? If yes, answer the following question(s) Y 105A 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 105B 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 105C 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 106 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 107 Does well require oil-lubrication?N 108 Is this facility Active or Inactive?A 109 Operating Period (Start Date)01/01 110 Operating Period (Ending Date)12/31 111 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: 06/13/2025 16:32:26 | Rating: Approved UTAH15013 COTTONWOOD MUTUAL page 15 of 47 112 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 113 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 114 Is the well casing vented? ... if yes, answer the following question(s)Y 114A 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 114B 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 114C 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 115 Does the well have a pump to waste line? ... if yes, answer the following question(s)Y 115A 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 115B 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: 06/13/2025 16:32:26 | Rating: Approved UTAH15013 COTTONWOOD MUTUAL page 16 of 47 115C 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 116 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 117 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 118 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 119 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 120 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 121 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 122 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: 06/13/2025 16:32:26 | Rating: Approved UTAH15013 COTTONWOOD MUTUAL page 17 of 47 WS005 - ROLLINS #3 WELL - Active 123 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 124 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 125 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 126 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 127 Is there an air/vac valve on the well discharge line? If yes, answer the following question(s) Y 127A 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 127B 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 127C 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 128 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 129 Does well require oil-lubrication?N DEQ | Drinking Water Run Date: 06/13/2025 16:32:26 | Rating: Approved UTAH15013 COTTONWOOD MUTUAL page 18 of 47 130 Is this facility Active or Inactive?A 131 Operating Period (Start Date)01/01 132 Operating Period (Ending Date)12/31 133 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 134 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 135 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 136 Is the well casing vented? ... if yes, answer the following question(s)Y 136A 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 136B 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 136C 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 137 Does the well have a pump to waste line? ... if yes, answer the following question(s)Y DEQ | Drinking Water Run Date: 06/13/2025 16:32:26 | Rating: Approved UTAH15013 COTTONWOOD MUTUAL page 19 of 47 137A 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 137B 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 137C 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 138 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 139 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 140 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 141 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 142 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 Run Date: 06/13/2025 16:32:26 | Rating: Approved UTAH15013 COTTONWOOD MUTUAL page 20 of 47 143 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 144 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 145 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 146 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 147 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 148 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 149 Is there an air/vac valve on the well discharge line? If yes, answer the following question(s) Y 149A 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 149B 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 149C 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: 06/13/2025 16:32:26 | Rating: Approved UTAH15013 COTTONWOOD MUTUAL page 21 of 47 WS009 - ROSE HILL WELL #3 - Active Exception Granted: R309-600-13(2)(d) | Land use agreement for property along Interstate 84 owned by UDOT within Zone Two. 150 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 151 Does well require oil-lubrication?N 152 Is this facility Active or Inactive?A 153 Operating Period (Start Date)01/01 154 Operating Period (Ending Date)12/31 155 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 156 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 157 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 158 Is the well casing vented? ... if yes, answer the following question(s)Y 158A 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 Run Date: 06/13/2025 16:32:26 | Rating: Approved UTAH15013 COTTONWOOD MUTUAL page 22 of 47 158B 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 158C 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 159 Does the well have a pump to waste line? ... if yes, answer the following question(s)Y 159A 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 159B 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 159C 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 160 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 161 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 162 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 Run Date: 06/13/2025 16:32:26 | Rating: Approved UTAH15013 COTTONWOOD MUTUAL page 23 of 47 163 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 164 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 165 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 166 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 167 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 168 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 169 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 170 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 171 Is there an air/vac valve on the well discharge line? If yes, answer the following question(s) Y 171A 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: 06/13/2025 16:32:26 | Rating: Approved UTAH15013 COTTONWOOD MUTUAL page 24 of 47 ST001 - ROSE HILL NO 1 STORAGE - Active 171B 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 171C 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 172 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 173 Does well require oil-lubrication?N 174 Is this facility Active or Inactive?A 175 Storage tank capacity in gallons (from SDWIS; if different explain why in the comments) 50000 176 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 177 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 178 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 179 Are air vents present? ... if yes, answer the following question(s)Y DEQ | Drinking Water Run Date: 06/13/2025 16:32:26 | Rating: Approved UTAH15013 COTTONWOOD MUTUAL page 25 of 47 179A 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 179B 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 179C 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 179D 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 180 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 180A 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 180B 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 180C Access opening lid properly gasketed SIG | 25pts | FW | V009 | R309-545-14(2) | Rule requires the access opening to a tank to be furnished with a gasket between the lid and frame. This significant deficiency must be corrected within 120 days of notification or have a corrective action plan approved by DDW. D (Notes: Needs new gasket.) DEQ | Drinking Water Run Date: 06/13/2025 16:32:26 | Rating: Approved UTAH15013 COTTONWOOD MUTUAL page 26 of 47 181 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 182 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 183 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 184 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 185 Are there cracks in the walls or roof of the storage tank? (if yes, select only one of the following options) N 186 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 186A 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 186B 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 186C 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 187 Are the drain line and overflow combined?Y DEQ | Drinking Water Run Date: 06/13/2025 16:32:26 | Rating: Approved UTAH15013 COTTONWOOD MUTUAL page 27 of 47 ST002 - ROSE HILL NO 2 STORAGE - Active 188 Is this facility Active or Inactive?A 189 Storage tank capacity in gallons (from SDWIS; if different explain why in the comments) 100000 190 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 191 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 192 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 193 Are air vents present? ... if yes, answer the following question(s)Y 193A 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 193B 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 193C 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: 06/13/2025 16:32:26 | Rating: Approved UTAH15013 COTTONWOOD MUTUAL page 28 of 47 193D 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 194 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 194A 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 194B 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 194C Access opening lid properly gasketed SIG | 25pts | FW | V009 | R309-545-14(2) | Rule requires the access opening to a tank to be furnished with a gasket between the lid and frame. This significant deficiency must be corrected within 120 days of notification or have a corrective action plan approved by DDW. D (Notes: Gasket needs to be replaced.) 195 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 196 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 197 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: 06/13/2025 16:32:26 | Rating: Approved UTAH15013 COTTONWOOD MUTUAL page 29 of 47 ST003 - 500K GRADE SCHOOL RESERVOIR - Active 198 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 199 Are there cracks in the walls or roof of the storage tank? (if yes, select only one of the following options) N 200 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 200A 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 200B 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 200C 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 201 Are the drain line and overflow combined?Y 202 Is this facility Active or Inactive?A 203 Storage tank capacity in gallons (from SDWIS; if different explain why in the comments) 500000 204 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 Run Date: 06/13/2025 16:32:26 | Rating: Approved UTAH15013 COTTONWOOD MUTUAL page 30 of 47 205 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 206 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 207 Are air vents present? ... if yes, answer the following question(s)Y 207A 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 207B 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 207C 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 207D 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 208 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 208A 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: 06/13/2025 16:32:26 | Rating: Approved UTAH15013 COTTONWOOD MUTUAL page 31 of 47 208B 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 208C 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 209 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 210 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 211 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 212 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 213 Are there cracks in the walls or roof of the storage tank? (if yes, select only one of the following options) N 214 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 214A 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: 06/13/2025 16:32:26 | Rating: Approved UTAH15013 COTTONWOOD MUTUAL page 32 of 47 ST005 - 400,000 GAL ROSE HILL TANK #3 - Active 214B 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 214C 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 215 Are the drain line and overflow combined?Y 216 Is this facility Active or Inactive?A 217 Storage tank capacity in gallons (from SDWIS; if different explain why in the comments) 400000 218 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 219 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 220 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 221 Are air vents present? ... if yes, answer the following question(s)Y 221A 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 Run Date: 06/13/2025 16:32:26 | Rating: Approved UTAH15013 COTTONWOOD MUTUAL page 33 of 47 221B 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 221C 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 221D 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 222 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 222A 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 222B 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 222C 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 223 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: 06/13/2025 16:32:26 | Rating: Approved UTAH15013 COTTONWOOD MUTUAL page 34 of 47 ST006 - 250,000 GAL FOX HOLLOW TANK - Active 224 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 225 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 226 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 227 Are there cracks in the walls or roof of the storage tank? (if yes, select only one of the following options) N 228 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 228A 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 228B 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 228C 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 229 Are the drain line and overflow combined?Y 230 Is this facility Active or Inactive?A 231 Storage tank capacity in gallons (from SDWIS; if different explain why in the comments) 250000 DEQ | Drinking Water Run Date: 06/13/2025 16:32:26 | Rating: Approved UTAH15013 COTTONWOOD MUTUAL page 35 of 47 232 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 233 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 234 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 235 Are air vents present? ... if yes, answer the following question(s)Y 235A 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 235B 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 235C 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 235D Vent 6-inch diameter and larger protected with additional heavy-gauge screen or substantial covering. MIN | 5pts | FW | V035 | R309-545-15(5) | Rule requires vents that are 6-inch diameter or greater to be fitted with additional heavy gauge screen or substantial covering, which will protect the No. 14 mesh screen against vandalism or damage. C DEQ | Drinking Water Run Date: 06/13/2025 16:32:26 | Rating: Approved UTAH15013 COTTONWOOD MUTUAL page 36 of 47 236 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 236A 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 236B 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 236C 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 237 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 238 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 239 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 240 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 241 Are there cracks in the walls or roof of the storage tank? (if yes, select only one of the following options) N DEQ | Drinking Water Run Date: 06/13/2025 16:32:26 | Rating: Approved UTAH15013 COTTONWOOD MUTUAL page 37 of 47 ST007 - 1M GALLON TANK - Active 242 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 242A 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 242B 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 242C 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 243 Are the drain line and overflow combined?Y 244 Is this facility Active or Inactive?A 245 Storage tank capacity in gallons (from SDWIS; if different explain why in the comments) 1000000 246 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 247 Ladders, ladder guards, platform railings, or safely located entrance hatches are provided where applicable. MIN | 15pts | FW | V004 | R309-545-18 | Rule requires ladders, ladder guards, platform railings, and safely located entrance hatches where applicable for water storage tanks and requires safety practices to conform to pertinent laws and regulations of the Utah Occupational Safety and Health Division. C DEQ | Drinking Water Run Date: 06/13/2025 16:32:26 | Rating: Approved UTAH15013 COTTONWOOD MUTUAL page 38 of 47 248 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 249 Are air vents present? ... if yes, answer the following question(s)Y 249A 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 249B 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 249C 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 249D 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 250 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 250A 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 250B Access opening shoe box type with at least 2 inches of overlap SIG | 25pts | FW | V010 | R309-545-14(2) | Rule requires the frame of an access opening to be provided with a close fitting solid shoebox type cover which extends down around the frame at least two inches and is furnished with a gasket(s) between the lid and frame. This significant deficiency must be corrected within 120 days of notification or have a corrective action plan approved by DDW. C DEQ | Drinking Water Run Date: 06/13/2025 16:32:26 | Rating: Approved UTAH15013 COTTONWOOD MUTUAL page 39 of 47 250C 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 251 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 252 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 253 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 254 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 255 Are there cracks in the walls or roof of the storage tank? (if yes, select only one of the following options) N 256 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 256A 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 256B Overflow line covered with #4 mesh non-corrodible screen SIG | 25pts | FW | V012 | R309-545-13(3) | Rule requires overflow pipes to be screened with #4 mesh non-corrodible screens installed at a location least susceptible to damage by vandalism. This significant deficiency must be corrected within 120 days of notification or have a corrective action plan approved by DDW. C DEQ | Drinking Water Run Date: 06/13/2025 16:32:26 | Rating: Approved UTAH15013 COTTONWOOD MUTUAL page 40 of 47 TP005 - ROLLINS #3 WELL IRON MN OXIDATION TRMT -- Treatment General - 256C 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 257 Are the drain line and overflow combined?N 257A 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 258 Is this facility Active or Inactive?I 258A Explain why this facility is Inactive (Is this facility in stand-by mode?)Nit needed at this time. 259 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 260 Operating Period (Start Date)01/01 261 Operating Period (Ending Date)12/31 262 What is the objective of the treatment process and how do you know it is working? (e.g., surface water treatment, disinfection, arsenic removal, TDS removal etc.) Inactive 263 Walk me through the different process steps of your treatment plant. What is the purpose of each step? Show me how you determine you are meeting your Treatment Requirements. Inactive 264 What Chemicals are used? Why?Inactive 265 How is the chemical dose adjusted with flow and water quality? Prompts: What flow rate is used for the adjustment (influent, effluent, CFE)? What water quality parameters would make you change dose rate? Inactive 266 Does influent flow rate vary?Y 266A If yes, why does influent flow rate vary?Inactive 266B If yes, does chemical dose rate adjust to remain compliant at different flow conditions?Inactive 267 Process control testing is consistent with the specific treatment process MIN | 15pts | TR | TGR9 | R309-105-7, 8 & 18, R309-100 through 605 | Trigger for regulatory followup to address concerns. C DEQ | Drinking Water Run Date: 06/13/2025 16:32:26 | Rating: Approved UTAH15013 COTTONWOOD MUTUAL page 41 of 47 268 There is a means to accurately measure the quantities of chemicals used. SIG | 25pts | TR | TD99 | R309-525-11(7)(d)(iv) | Provisions shall be made for measuring the quantities of chemicals used. This significant deficiency must be corrected within 120 days of notification or have a corrective action plan approved by DDW. C 269 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 270 Are liquid chemicals used? ... if yes, answer the following question(s)Y 270A Proper cross-connection control is provided on the service water lines that feed the solution tanks SIG | 50pts | TR | TG53 | R309-525-11(9)(b)(i) | Rule requires cross connection control to be provided to assure that the make-up waterlines discharging to solution tanks shall be properly protected from backflow as required by the Utah Plumbing Code. This significant deficiency must be corrected within 120 days of notification or have a compliance action plan approved by DDW. C 270B There are adequate spill containment provisions for acid and caustic liquids. MIN | 15pts | TR | TG59 | R309-525-11(6)(a)(iv)(B), R309-525-11(8)(b)(viii) | Rule requires liquid chemical storage tanks to have an overflow and receiving basin or drain capable of receiving accidental spills or overflows, and meeting all the requirements of R309-525-23. C 270C If there is a day tank, the bulk tank and day tanks have separate screened vents. MIN | 15pts | TR | TG60 | R309-525-11(8)(b)(vi) | Rule requires acid storage tanks to be vented to the outside atmosphere, but not through vents in common with day tanks. C 270D Solution tanks and tank refilling line entry points are properly labeled to identify the chemicals or liquids MIN | 15pts | TR | TG03 | R309-525-11(8)(c)(vii) | Rule requires tanks to be properly labeled to designate the chemical contained. C 270E No direct connections exist between a sewer and drain or overflow from the feeder, solution chamber, or tank. SIG | 50pts | DS | M020 | R309-105-12(1) | Rule states that a water supplier shall not allow a connection to his system which may jeopardize its quality and integrity. Cross connections are not allowed unless controlled by an approved and properly operating backflow prevention assembly. This significant deficiency must be corrected within 120 days of notification or have a corrective action plan approved by DDW. C 270F Chemical storage tank access opening properly covered? MIN | 15pts | TR | TGR9 | R309-105-7, 8 & 18, R309-100 through 605 | Trigger for regulatory followup to address concerns. C DEQ | Drinking Water Run Date: 06/13/2025 16:32:26 | Rating: Approved UTAH15013 COTTONWOOD MUTUAL page 42 of 47 271 Treatment chemicals 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 272 Are all chemical feeders properly verified for accuracy? SIG | 25pts | TR | TG21 | R309-525-11(7)(a)(i) | Feeders shall supply, at all times, the necessary amounts of chemicals at an accurately controlled rate, throughout the anticipated range of feed. This significant deficiency must be corrected within 120 days of notification or have a corrective action plan approved by DDW. C 273 Spare parts are available for all chemical feeders MIN | 15pts | TR | TX09 | R309-525-11(7)(b)(i) and (ii) | R308-525-11(8)(b)(i) states that a means consistent with the nature of the chemical solution shall be provided in a solution tank to maintain a uniform strength of solution. Continuous agitation shall be provided to maintain slurries in suspension. 2 dem C 274 Incompatible chemicals stored separately SIG | 25pts | TR | TG19 | R309-525-11(7)(a)(iv) | Rule prohibits chemicals that are incompatible from being fed, stored, or handled together. This significant deficiency must be corrected within 120 days of notification or have a corrective action plan approved by DDW. C 275 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 276 Raw water compliance samples are collected before any treatment. R309-215-4(4) SIG | 25pts | TR | T006 | R309-525-15(10)(a)(i) | R309-525-15(10)(a)(i) Y 276A If yes, was location shown?Yes 277 Where are finished water quality monitoring samples collected?Yes 278 Does water system have a DEQ/DWQ (UPDES permit) discharge permit for the proper disposal of treatment plant waste to land or water? MIN | 15pts | SM | TGR3 | R309-105-6 | R309-105-6 C 279 Which parameters are watched when running treatment plant?Inactive 280 What type of alarm system is used?Inactive 281 Does treatment plant have a SCADA system?N 282 Proper lab equipment on site to support required operations & maintenance of the plant? SIG | 25pts | TR | T019 | R309-525-17(1) | Sufficient laboratory equipment shall be provided to assure proper operation and monitoring of the water plant. 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: 06/13/2025 16:32:26 | Rating: Approved UTAH15013 COTTONWOOD MUTUAL page 43 of 47 TP005 - ROLLINS #3 WELL IRON MN OXIDATION TRMT -- Treatment - Chlorination General - 283 Is this facility Active or Inactive?I 283A Explain why this facility is Inactive (Is this facility in stand-by mode?)Not needed at this time. 284 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 285 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: Inactive) 286 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 287 If chemical dilution or dissolution is needed, cross-connection control is provided on water lines feeding solution tanks. SIG | 50pts | TR | TX07 | R309-525-11(2)(c), R309-525-11(9)(b)(i) to (iv) | Cross connection control shall be provided on make-up water lines feeding solution tanks. This significant deficiency must be corrected within 120 days of notification or have a corrective action plan approved by DDW. C 288 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 289 Solution tanks and tank refilling line entry points are properly labeled to identify the chemicals MIN | 15pts | TR | TG03 | R309-525-11(8)(c)(vii) | Rule requires tanks to be properly labeled to designate the chemical contained. C 290 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 291 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 DEQ | Drinking Water Run Date: 06/13/2025 16:32:26 | Rating: Approved UTAH15013 COTTONWOOD MUTUAL page 44 of 47 TP005 - ROLLINS #3 WELL IRON MN OXIDATION TRMT -- Liquid Hypochlorination - 292 Is chlorine chemical dose rate adjusted due to different water demand flow rates and/or changing water quality? Y 292A If yes, which water flow rate is used? e.g. influent flow, effluent flow, filter flow.Influent Flow 293 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 294 POE is before first connection/customer? SIG | 25pts | TR | T028 | R309-215 | R309-215 & R309-520-6(4)(d) C 295 Chlorine residual records are maintained and available... if yes answer following SIG | 25pts | TR | T028 | R309-215 | R309-215 & R309-520-6(4)(d) NA (Notes: Inactive) 296 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 297 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 298 Is this facility Active or Inactive?I 298A Explain why this facility is Inactive (Is this facility in stand-by mode?)Not needed at this time. 299 Operational means provided to avoid injection of significantly decayed hypochlorite, such as solution strength testing and delivery records MIN | 5pts | TR | TD68 | R309-520-7(3)(b) | Rule requires the water system to provide an operational means, such as keeping records of the delivery date of the hypochlorite solution, to avoid the injection of significantly decayed hypochlorite solutions. C 300 Solution tank is covered to minimize corrosive vapors MIN | 5pts | TR | TD64 | R309-525-11(8)(b)(iii) | Chemical solutions shall be kept covered. C 301 Where concentrated hypochlorite solutions (5% or greater) are handled in containers LARGER than 55 gallons: emergency eyewash station and a safety shower present SIG | 25pts | TR | TD66 | R309-520-7(3)(a)(i) | Where hypochlorite solutions are used at remote locations or in quantities of 55 gallons or less on site, safety showers are not required and alternative emergency eyewash may be provided. 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: 06/13/2025 16:32:26 | Rating: Approved UTAH15013 COTTONWOOD MUTUAL page 45 of 47 TP005 - ROLLINS #3 WELL IRON MN OXIDATION TRMT -- Hypochlorination (any type) - 302 Where concentrated hypochlorite solutions are handled in containers of 55 gallons or LESS: some method of emergency eyewash provided (a full eyewash station and shower is not required) SIG | 25pts | TR | TD66 | R309-520-7(3)(a)(i) | Where hypochlorite solutions are used at remote locations or in quantities of 55 gallons or less on site, safety showers are not required and alternative emergency eyewash may be provided. This significant deficiency must be corrected within 120 days of notification or have a corrective action plan approved by DDW. C 303 Hypochlorite solution storage area is protected from excessive heat and direct sunlight MIN | 5pts | TR | TD67 | R309-520-7(3)(a)(ii) | States Storage and injection areas shall be designed to minimize the decay in strength of concentrated hypochlorite solutions from excessive heat or direct sunlight. C 304 Records are kept to minimize the use of decayed hypochlorite solution MIN | 5pts | TR | TD68 | R309-520-7(3)(b) | Rule requires the water system to provide an operational means, such as keeping records of the delivery date of the hypochlorite solution, to avoid the injection of significantly decayed hypochlorite solutions. NA (Notes: Inactive) 305 There are adequate spill containment provisions for acid and caustic liquids. MIN | 15pts | TR | TG59 | R309-525-11(6)(a)(iv)(B), R309-525-11(8)(b)(viii) | Rule requires liquid chemical storage tanks to have an overflow and receiving basin or drain capable of receiving accidental spills or overflows, and meeting all the requirements of R309-525-23. C 306 Is this facility Active or Inactive?I 306A Explain why this facility is Inactive (Is this facility in stand-by mode?)Not needed at this time 307 Solution tank is covered to minimize corrosive vapors MIN | 5pts | TR | TD64 | R309-525-11(8)(b)(iii) | Chemical solutions shall be kept covered. C 308 Where concentrated hypochlorite solutions (5% or greater) are handled in containers LARGER than 55 gallons: emergency eyewash station and a safety shower present SIG | 25pts | TR | TD66 | R309-520-7(3)(a)(i) | Where hypochlorite solutions are used at remote locations or in quantities of 55 gallons or less on site, safety showers are not required and alternative emergency eyewash may be provided. This significant deficiency must be corrected within 120 days of notification or have a corrective action plan approved by DDW. C 309 Where concentrated hypochlorite solutions are handled in containers of 55 gallons or LESS: some method of emergency eyewash provided (a full eyewash station and shower is not required) SIG | 25pts | TR | TD66 | R309-520-7(3)(a)(i) | Where hypochlorite solutions are used at remote locations or in quantities of 55 gallons or less on site, safety showers are not required and alternative emergency eyewash may be provided. 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: 06/13/2025 16:32:26 | Rating: Approved UTAH15013 COTTONWOOD MUTUAL page 46 of 47 310 Hypochlorite solution storage area is protected from excessive heat and direct sunlight MIN | 5pts | TR | TD67 | R309-520-7(3)(a)(ii) | States Storage and injection areas shall be designed to minimize the decay in strength of concentrated hypochlorite solutions from excessive heat or direct sunlight. C 311 Records are kept to minimize the use of decayed hypochlorite solution MIN | 5pts | TR | TD68 | R309-520-7(3)(b) | Rule requires the water system to provide an operational means, such as keeping records of the delivery date of the hypochlorite solution, to avoid the injection of significantly decayed hypochlorite solutions. C 312 Is there on-site generation of hypochlorite solutions? ... if yes, answer the following questions Y 312A Make-up water is of drinking water quality SIG | 25pts | TR | TD70 | R309-520-7(1)(h)(i), R309-520-7(3)(c)(iii) | Rule requires make-up water used in on-site generation of hypochlorite solution to be of drinking water quality. This significant deficiency must be corrected within 120 days of notification or have a corrective action plan approved by DDW. C 312B Hydrogen gas from the electrolytic cell is vented upward and outside in a dedicated, unobstructed line SIG | 50pts | TR | TD71 | R309-520-7(3)(c)(iv) | Rule requires hydrogen gas generated in the electrolytic cell of the on-site generation system to be vented upward to the outside of the building in a dedicated, unobstructed line. This significant deficiency must be corrected within 120 days of notification or have a corrective action plan approved by DDW. C 313 Is a hypochlorite tablet process used? ... if yes, answer the following question(s)N DEQ | Drinking Water Run Date: 06/13/2025 16:32:26 | Rating: Approved UTAH15013 COTTONWOOD MUTUAL page 47 of 47