HomeMy WebLinkAboutDDW-2025-009636Utah Division of Drinking Water
IPS Deficiency Correction Notice
Water System Name_________________________________________________
Water System ID #UTAH________
Instructions
Please use this form to report the correction of sanitary survey deficiencies identified on your
IPS report. List the individual Facility ID (where applicable), deficiency code, how deficiency
was corrected and the date of the correction below. You may attach a copy of your IPS report
with the date of the correction noted on the report. Pictures of corrections or a brief description
of the corrections are encouraged. Include the name of the facility and the correction date on any
documentation you provide.
Facility ID Deficiency Code How deficiency was corrected Date Corrected
I certify that the information submitted with this report is true and accurate. You may
electronically sign this form by typing your name in the Signature block.
Print Name Signature Date
Corrections listed on attached IPS report Supportive documentation attached
DDW Approval______________________________________ Date_____/_____/_____
Print Form
17036
WS001
WS001
ST001
Contractor added a #4 screen
Contractor added HBVB to hose bib
Contractor added a #4 screen
10/3/2025
10/3/2025
10/3/2025
Lance Anderson 10/7/2025Lance Anderson, P.E.
Eden Ranch Water Company
Submit by Email
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S u i t e 101
Cache Landmark
95 Golf Course Rd.
Logan, UT 84321
435.713.0099
Engineers
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Planners
APPROVED BY:
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SCALE:
CHECKED BY:
DESIGN BY:
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PROJECT NUMBER:
6 APRIL 2020
14012WIN
PROFESSIONAL ENGINEERLANCE ANDERSON
323733-2202
STATE OF UTAH
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SHEET:
SHEET DESCRIPTION:PROJECT TITLE:Cache Landmark
Engineers
Surveyors
Planners
95 West Golf Course Rd., Suite 101
Logan, UT 84321
435.713.0099
PROJECT #:DATE:NO.:DATE:DESCRIPTION:
DRAFTING BY:CHECKED BY:
APPROVED BY:
SCALE:
PROFESSIONAL ENGINEERLANCE ANDERSON
323733-2202
STATE OF UTAH10-7-2025
AUGUST 16, 2021
14012WIN
M-1.0
EDEN RANCH PUMP HOUSE MECHANICAL LAYOUT PLAN
4600 NORTH CISCO ROAD
LAKETOWN, UTAHD. AUSTIN L. ANDERSON
L. ANDERSON
NTS
RECORD DRAWINGS
SHEET:
SHEET DESCRIPTION:PROJECT TITLE:Cache Landmark
Engineers
Surveyors
Planners
95 West Golf Course Rd., Suite 101
Logan, UT 84321
435.713.0099
PROJECT #:DATE:NO.:DATE:DESCRIPTION:
DRAFTING BY:CHECKED BY:
APPROVED BY:
SCALE:
PROFESSIONAL ENGINEERLANCE ANDERSON
323733-2202
STATE OF UTAH10-7-2025
AUGUST 16, 2021
14012WIN
M-1.1
EDEN RANCH PUMP HOUSE MECHANICAL SECTIONS
4600 NORTH CISCO ROAD
LAKETOWN, UTAHD. AUSTIN L. ANDERSON
L. ANDERSON
NTS
RECORD DRAWINGS