DDW-2025-008852

Utah Department of Environmental Quality
Drinking Water
ATTN: Paul Wright
195 North 1950 West
Salt Lake City, UT 84116
[e-mail]

RE: CERTIFICATION OF RULE CONFORMANCE - Pine Valley Highway Water Line Extension
Project; Dixie Deer SSD, System #27003, File #15028

Project Name: Pine Valley Highway Water Line Extension
Project Location: Pine Valley Highway, Washington County, Utah
Date: September 17, 2025

Dear Paul Wright:

I, Steven Kamlowsky, a qualified professional engineer licensed in the State of Utah, do hereby
certify that the water line installation for the Pine Valley Highway Water Line Extension Project,
located in Washington County, Utah, has been designed, constructed, and tested in full
compliance with the applicable rules, regulations, and standards established by the State of
Utah and local authorities.

Furthermore, I affirm that the Pine Valley Highway Water Line Extension is constructed to meet
the relevant state and local regulations and is fit for public use as a potable water system in
conformance with rules R309-500 through 550 of the Utah Administrative Code.

This certification is valid as of the date above, subject to ongoing inspections and any necessary
future updates required by regulatory bodies.

Should you have any questions or require further information, please do not hesitate to contact
me.

Sincerely,

Steve Kamlowsky, PE
Civil Engineer
Brown Consulting Engineers, P.C.
435-628-4700
[e-mail]
DDW-Eng-0010 Page 1 of 1 12/8/2015
Utah Division of Drinking Water ― Checklist for Issuing Operating Permits
(Per Utah Administrative Code, Rule R309-500-9)
Water System Name: Dixie Deer SSD System Number: 27003
Project Description: Pine Valley Highway Water Line Extension File Number: 15028
Items 1 through 8 below must be submitted to the Division and found to be acceptable prior to operating
permit issuance. However, distribution lines without booster pumps may be placed into service prior to submitting all of the items if a professional engineer (PE) responsible for the entire water system has been identified to the Director and has received items 1 through 4 below. [In this case, a public water system will submit all items needed to obtain an Operating Permit for each distribution system project after the new water lines
have been placed into service as determined by the water system’s designated PE.]
☒ 1. Certification of Rule Conformance by a PE that all conditions of Plan Approval have been accomplished, and if applicable, changes made during construction were in conformance with rules R309-500 through 550
☒ 2. As-built or record drawings incorporating all changes to approved plans and specifications, unless no changes were made to the previously submitted and approved pre-construction drawings
☒ 3. Confirmation that as-built or record drawings have been received by the water system
☒ 4. Evidence that bacteriological samples have been collected to verify proper flushing and
disinfection in accordance with the appropriate ANSI/AWWA Standards:
☒ ANSI/AWWA C651-14 AWWA Standard for Disinfecting Water Mains
Two consecutive sample sets at least 16 hours apart, none positive (every 1200 feet, end-
of-line, each branch, etc.)
☐ ANSI/AWWA C652-11 AWWA Standard for Disinfection of Water-Storage Facilities
One or more samples, none positive
☐ ANSI/AWWA C653-13 AWWA Standard for Disinfection of Water Treatment Plants
Two consecutive samples per unit, none positive, no less than 30 minutes apart
☐ ANSI/AWWA C654-13 AWWA Standard for Disinfection of Wells
Two consecutive samples, none positive, no less than 30 minutes apart
☐ 5. Water quality data, where appropriate [Guidance: Include appropriate raw and finished water data
that demonstrate satisfactory performance of the new treatment facility. Storage tank water shall be analyzed for residual volatile organic compounds after tank interior painting or re-coating.]
☐ 6. If applicable, all other documentation that may have been required during the plan review
process
☐ 7. If applicable, confirmation that the water system owner has received the O&M manual for the
new facility
☐ 8. If applicable, location data of new storage tank, treatment facility, or source