https://drinc.ca.gov/ear/2019LWSHelp.htm

LARGE WATER SYSTEM
2019 ANNUAL REPORT TO THE DRINKING WATER PROGRAM
FOR YEAR ENDING DECEMBER 31, 2019
[Section 116530 Health & Safety Code]

WATER SYSTEM INFORMATION
Water System No.: 
Water System Name: 
Water System Ownership
(See descriptions below):
Physical location:
  (address line 1, address line 2, city, zip)
Note: NO P.O. Box


General Office Phone:
(with area code)
Web site address:

BOXES COLORED YELLOW ARE MANDATORY QUESTIONS AND MUST BE ANSWERED TO COMPLETE THIS REPORT

Water System Ownership Descriptions:


COMMUNITY WATER SYSTEMS ONLY

Your water system classification is:  

IF YOU ARE NOT A COMMUNITY WATER SYSTEM, SKIP THIS SECTION

CERTIFICATION FOR REDUCTION OF ANNUAL FEES FOR PUBLIC WATER SYSTEMS SERVING A DISADVANTAGED COMMUNITY (DAC)

By checking this box, you are a community water system who would like to request a fee reduction and is serving a DAC as defined in Title 22, Division 4, Chapter 14.5, section 64300 of the California Code of Regulations OR has previously submitted documentation to the State Water Resource Control Board certifying that you are serving a DAC.

To request a DAC fee reduction or to continue receiving a reduced annual fee you must complete a DAC certification form and upload the form to the “DAC” tab for the State Water Resources Control Board to review.

Click HERE for instructions on how to upload your completed DAC certification form. To upload a DAC Certification Form, click HERE

If you have questions about completing this section of the report, please contact the Program Liaison Unit at DDW-PLU@waterboards.ca.gov or call (916) 449-5158.

REPORT SUBMITTED BY:
Note: Your name and title, email address, and work phone number are disclosable report information that may be obtained through the Public Records Act.
Name: 
Title: 
Work phone: 
Cell phone: 
Email address: 


Please be aware that all comment boxes throughout this electronic annual report will be made publicly available WITH THE EXCEPTION of the comment box below. Only Waterboard staff and other people with your water system’s DRINC login credentials will have access to this comment box. You are encouraged to provide any comments that you believe may help improve this annual report process.

PRIVATE COMMENTS:


1. Public Water System Contacts

Click here to learn how to Modify, Add and Delete Contacts in the table below.

IMPORTANT: Each water system must have one and only one Administrative Contact AND one and only one Financial Contact. The same person may be both the Administrative and Financial Contacts.

Please provide an email address for the Administrative Contact as most email communication, particularly email blasts, from the Division of Drinking Water will be sent to the email address of the Administrative Contact.

PHONE TYPE: Home – if you use your home or personal phone number as your business number, use the HOME phone type instead and leave the BUSINESS phone type blank.
Only the BUSINESS phone type will appear in Drinking Water Watch (https://sdwis.waterboards.ca.gov/PDWW/), which can be viewed by the public, if the General Office phone number is not provided (see Water System Information section under the Intro tab).

EXISTING CONTACTS
NAME, TITLE & ADDRESSPHONE TYPE PHONE NO.EMAILCONTACT TYPE
(pick all that apply)
  Business

Home

This must be an email address





Facsimile

Mobile
    Emergency
 
 
  Business

Home







Facsimile

Mobile
    Emergency
 
 
  Business

Home







Facsimile

Mobile
    Emergency
 
 
  Business

Home







Facsimile

Mobile
    Emergency
 
 
  Business

Home







Facsimile

Mobile
    Emergency
 
 
  Business

Home







Facsimile

Mobile
    Emergency
 
 
  Business

Home







Facsimile

Mobile
    Emergency
 
 
  Business

Home







Facsimile

Mobile
    Emergency
 
NEW CONTACTS
Add Additional Contact (pick all that apply)
Business



Home

Facsimile

Mobile

    Emergency
 
Add Additional Contact (pick all that apply)
Business



Home

Facsimile

Mobile

    Emergency
 
Add Additional Contact (pick all that apply)
Business



Home

Facsimile

Mobile

    Emergency
 
Add Additional Contact (pick all that apply)
Business



Home

Facsimile

Mobile

    Emergency
 
COMMENTS (Note: Comments will be made publicly available):


2. POPULATION SERVED

Permanent population or number of long-term residents*:

*Long-term resident means someone who resides within the water system service area for more than half of the year.

Method used to determine population:

If permanent population is based on "Other" , identify the methods or sources of how it was estimated::


Seasonal Maximum Population (If applicable):

Provide season :

Begin DateEnd Date
MMDDMMDD


List the names of communities served by the system identifying both incorporated and unincorporated areas:

COMMENTS (Note: Comments will be made publicly available):


3. NUMBER OF SERVICE CONNECTIONS (as of December 31, 2019)

A. Active Service Connections:

Total Active Potable Water Connections currently in Division of Drinking Water database: 

The total number of Service Connections as of December 31, 2019 must be reported as either Unmetered or Metered for each Service Connection Type as appropriate.

 Potable Water
TYPE

Do NOT report fire sprinkler connections and fire hydrants. These connections are not counted toward “service connections” for compliance purposes.
UnmeteredMeteredTotal*
Single-family Residential:
single family detached dwellings
 
Multi-family Residential:
Apartments, condominiums, town houses, duplexes and trailer parks
 
Commercial/Institutional:
Retail establishments, office buildings, laundries, schools, prisons, hospitals, dormitories, nursing homes, hotels, churches, campgrounds
 
Industrial:
All manufacturing
 
Landscape Irrigation:
Parks, play fields, cemeteries, median strips, golf courses
 
Agricultural Irrigation:
Irrigation of commercially-grown crops
 

Total Active Connections*

 

 

 

*Calculated field

If the connection categories below include some portion of residential connections, please check the boxes below:

Commercial/Institutional

Industrial

Landscape Irrigation

B. Number of Inactive Connections (all types)

Include only service connections that have been physically disconnected (e.g., meter removed) from the water system. All other service connections should be considered as “Active.”

C. Outdoor or Indoor meters/submeter

Only Urban Water Suppliers answer the questions below

Does your water system keep records on outdoor irrigation meters or commercial, institutional, or industrial indoor submeters?

If “no”, skip questions C1-C4 in this section and question 6B2 in Section 6B, Deliveries.

C1. Number of NON-residential customers that have dedicated outdoor irrigation meters (excluding agricultural connections)

C2. Number of Single-Family Residential customers with dedicated outdoor irrigation meters?

C3. Number of Multi-Family Residential customers with dedicated outdoor irrigation meters?

C4. Number of Commercial, Institutional and Industrial customers with indoor submeters?

COMMENTS (Note: Comments will be made publicly available):

4. GROUNDWATER (GW) AND SURFACE WATER (SW) SOURCES

TypeTotal No.
Active
Total No.
New/
Added in
2019
Total No.
Inactivated
in 2019
Total No.
Destroyed
in 2019
Active Groundwater Intakes (Wells)
Active Surface Water Intakes (Raw)
Active Purchased Water (GW) Connections
Active Purchased Water (SW) Connections
Standby Sources1
Emergency Interconnections
Inactive Sources2

Are your active water sources metered?
Do you routinely monitor the static water levels in your wells?
Do you routinely monitor the pumping water levels in your wells?
Are these levels recovering, declining or steady?:

1If a standby source was used in 2019, provide the following information.

Name of the Standby
Source
used in 2019:
No. of days
the Standby
Source was in
operation:
Were
customers
notified?
(Y/N)
Was the Division
of Drinking Water
notified?
(Y/N)
Describe the reason
the Standby Source
was used:
1 - 4 of 4

2Inactive sources are not approved as sources of supply and must be physically disconnected or similarly isolated.

COMMENTS (Note: Comments will be made publicly available):


5. WATER PRODUCED, PURCHASED AND SOLD

The Maximum Day is the day during 2019 with the highest total water usage. Provide the date for that day in Column B,
then complete Columns C, D and E, indicating how much of the water on that day was from each source.

Important Note Concerning Recycled Water Questions:

The California Water Code Section 10609(c)(4) states: “The state should identify opportunities for streamlined reporting, eliminate redundant data submissions, and incentivize open access to data collected by urban and agricultural water suppliers.”

It has come to the Division of Drinking Water’s attention that, between this Electronic Annual Report and other reports, some public water systems experience (at least some) redundant reporting of recycled water information to the Division of Drinking Water.

If some or all of the quantities are reported elsewhere, check this box: . Answer any questions below that are not reported elsewhere and leave the reported quantities blank in the table. Please note in the comments where these quantities were reported.

Leave recycled water cells blank ONLY IF it is reported elsewhere on other reports indicated below, otherwise enter zero or the actual figure.

Name of report(s) containing the information requested in this Electronic Annual Report for reporting year 2019:

Regulatory entity receiving the report(s), contact name, and phone number:

Units of Measure for tables in Section 5A:

Volumes are based on:

Table 5A: Water Produced, Purchased, and Sold

ABCDEFGHI
 Potable WaterNon-potable (exclude recycled)6Recycled7
 Date/
Month
Water Produced from
Groundwater (Wells)
Water Produced from
Surface Water2
Potable Water Received from another PWS5Total Amount of Potable Water3*Water Sold to
Another PWS5
Check here if no production for every month
Maximum Day1  
January  
February  
March  
April  
May  
June  
July  
August  
September  
October  
November  
December  
Annual Total*             
Percent Treated4

PWS = Public Water System

*Calculated field

Non-potable = water supplies, except recycled water, that do not enter the drinking water distribution system and are for non-potable uses only such as irrigation

Recycled = domestic wastewater which as a result of treatment is suitable for uses other than potable use such as irrigation or toilet flushing

1Only report Maximum Day if it is actually measured or determined from production records. It should not be the average day demand during
the maximum month of production.

2Do not include raw water purchased; report only volume of water that was treated.

3(F) Total Amount of Potable Water = Sum of Columns (C), (D) and (E), automatically calculated. Total water production includes water that is sold to another water system. To update, click below

6 Non-potable = water supplies, except recycled water, that do not enter the drinking water distribution system and are for non-potable uses only such as irrigation

7 Recycled = domestic wastewater which as a result of treatment is suitable for uses other than potable use such as irrigation or toilet flushing. The recycled water collected in this table should be the non-potable recycled water which is used to substitute potable water or untreated surface and well water. If the recycled were not available, potable or untreated surface and well water needs to be used. Example, a landscape used to be irrigated using potable water but now using recycled water.

4This is the percentage of the total annual volume for Groundwater produced that was provided treatment to meet drinking water standards other than precautionary disinfection and fluoridation.

5If water was Purchased/received from or Sold/delivered to another PWS, complete the table below:

Specify whether water
was Purchased or Sold or Transferred
Name of PWS
1 - 3 of 3

If recycled water was supplied to your water system’s customers , complete the table below:

Specify the level of treatment
(e.g., tertiary, disinfected secondary)
Name of Recycled Water supplier
1 - 3 of 3

COMMENTS (Note: Comments will be made publicly available):


6. WATER RATES, AFFORDABILITY, AND FINANCES

A. WATER RATES

Does your water system charge customers for water (residential, commercial, industrial, or institutional water customers)?

If yes, complete Section 6A. If no, explain why:

Comments (if “other” selected above):
If you do not have water rates, go to Section 6B, Deliveries.

If you have questions about completing this section of the report, please contact Mary.Yang@Waterboards.ca.gov, 916-322-6507

A1. RESIDENTIAL WATER RATES

Complete this section if you have residential water rates. If no, mark this box: and go to Section A6, Non-residential Water Rates.

If you are a water supplier without water rates, check this box , then move to Section 6B Water Deliveries.

A1.a. Indicate the type of residential water rate structure used by your water system (select those that apply):
  Base Rate – (Non-Volumetric Rates)
  Fixed Base Rate - Basic or fixed charge that is the same for all customers regardless of use.
  Variable Base Rate - Basic charge is different for customers depending on size of pipe, water meter, elevation, peak use, or other factors.
  Usage Rate (Volumetric Rates)
  Uniform Usage Rate - The charge per 100 cubic feet of water is the same regardless of use.
  Variable Usage Rate - Increasing Block or Tier Rate. The charge per 100 cubic feet or other increment of water increases as water use increases.
  Other Rates
  Flat Rate (often unmetered)- One rate for providing drinking water regardless of the volume of water used, not combined with a usage rate.
  If you have a Flat Rate, please skip questions A1.d, A1.e, A1.g, A1.h. Enter your flat rate in A3.
  Allocation Based
  Other rate structure (specify your rate structure in the comment box, provide a weblink 1j below)

A1.b. Comments on rate structure (Note: Comments will be made publicly available):

A1.c. What is your billing frequency?
A1.d. If charges change with different levels of water consumption or features, what is the number of tiers or levels of charges for single-family customers?
A1.e. If charges change with different levels of water consumption or features, what is the number of tiers or levels of charges for multi-family customers?
A1.f. Mark below any variances or factors used to determine or adjust residential water rates or water allocations.
  Agricultural use (non-commercial or commercial)
  Drought factor
  Elevation
  Evaporative Coolers
  Fire protection - water to irrigate vegetation
  Home-based business
  Livestock or large animals
  Lot size
  Medical needs
  Meter size
  Mitigation of high levels of total dissolved solids
  Occupancy (All-year)
  Occupancy (Seasonal)
  Pressure zone
  Soil compaction and dust control
  Supplement ponds and lakes to sustain wildlife
  Other :
  None of the above
A1.g. Units of Measure (UOM) for this table on Residential Water Rates:

A1.h. Table on Residential Water Rates, Single-family and Multi-family

If your water system uses an allocation or flat base rate structure, add a direct weblink to more information on your rate structure (A1.k or A1.l), provide information in the box “Comments on Residential Rate Structure”(A1.m), and leave this table blank.

Provide information on residential water rates based on consumption. If a feature of your rate structure, (e.g., meter size, elevation, or other) affects water rates, provide the water rate associated with the most common situation. Enter zero “0” if not applicable. See examples

Single-family Rates

Multi-family Rates

Upper volume of water included
in base rate in Units of Measure (UOM)


If there is no base rate or volume of water
associated with a base rate, enter the
number zero “0”.
Cost per Billing Period (Dollars)Upper volume of water included
in base rate in Units of Measure (UOM)


If there is no base rate or volume of water
associated with a base rate, enter the
number zero “0”.
Cost per Billing Period (Dollars)
Base Rate (non-volumetric rates)

(Lower level instead of higher level)
The rows that follow do not include a base rate or fixed charge.
Usage Rate (volumetric rates)
Lower level of water volume
for each level in UOM
Cost per UOM (Dollars) Lower level of water volume
for each level in UOM
Cost per UOM (Dollars)
Rate Structure level 1
Rate Structure level 2
Rate Structure level 3
Rate Structure level 4
Rate Structure level 5
Rate Structure level 6
Rate Structure level 7

A1.i. Date of most recent update to the rate structure (this does not include regularly scheduled rate changes, rather actual changes to your rate structure): MM/DD/YYYY
A1.j. Describe the rate structure changes to rate changes that were made in the update:
A1.k. Provide a direct link to a web page that explains water rates and fees, if available.
A1.l. If a webpage with rate information is not available, Send an email (click here) with the document, subject line: PWSID CA_ _ _ _ _ _ _ and Rate Information
A1.m. Comments on Residential Rate Structure. Explain allocation rate, if applicable.

A2. RESIDENTIAL SERVICE CONNECTIONS

A2.a. Select the most common single-family residential meter size:
A2.b. Select the most common multi-family residential meter size:
A2.c. What is, approximately, the service connection fee for a single-family brand-new construction based on the most common meter size listed above ($)?
A2.d. Date of most recent update to the new connection fee for a single-family brand-new construction: MM/DD/YYYY
A2.e. What is the one-time fee or deposit needed to create a new water service account for an existing single-family home based on the most common meter size indicated above ($)?
A2.f. What is, approximately, the connection fee for a multi-family brand-new construction based on the most common meter size indicated above ($)?

A2.g. Check items included in new residential connection fees:

Existing infrastructure buy-in (e.g., water treatment/ conveyance/sewage treatment )
Upgrades to infrastructure (seismic retrofits, pipe replacements, etc.)
Storm water management system
Debt service charge
Development of new water supplies
Other :

A2.h. Comments on Residential Service Connections (publicly available):

A3. AFFORDABLE DRINKING WATER

For each amount of water delivered to a single-family residential customer shown below, what is charged (in dollars) to a customer?

For each of the three water volumes shown below, provide what would be the monthly water bill for a single-family residential customer. Enter the monthly Water Charges and Other Charges for each water volume. For example, if a single-family customer used 12 HCF in a month, the total bill would include water charges for using 12 HCF and other charges that are added to the bill. Other charges vary locally and may include property tax, city tax, utility users tax, services for fire suppression, waste water or sewer, stormwater or other non-water surcharges, electricity. If the “other charges” varies by certain features (e.g., by climate, lot size, landscaped area) use the lowest or most common charge in your calculation. Click the “Update Totals” button to automatically add the charges together to show a Total Monthly Water Bill that a residential customer would pay when its household used the specified amount of water.

For water systems with an allocation rate (also called “budget rates”) see additional guidance

To be consistent with California’s Human Right to Water Law and Conservation Law, the questions in this section ask for water charges associated with 6, 9, 12 and 24 hundred cubic feet (HCF) of water. Information on 9 HCF is new.

A3.a. 6 HCF
Drinking Water Charges (Fixed and variable water charges) Dollars/month
Other Charges (e.g., property tax, fire suppression, waste water, other) Dollars/month
Total Monthly Water Bill (Automatic sum of Water Charges and Other Charges)*  Dollars/month
A3.b. 9 HCF
Drinking Water Charges (Fixed and variable water charges) Dollars/month
Other Charges (e.g., property tax, fire suppression, waste water, other) Dollars/month
Total Monthly Water Bill (Automatic sum of Water Charges and Other Charges)*  Dollars/month
A3.b. 12 HCF
Drinking Water Charges (Fixed and variable water charges) Dollars/month
Other Charges (e.g., property tax, fire suppression, waste water, other) Dollars/month
Total Monthly Water Bill (Automatic sum of Water Charges and Other Charges)*  Dollars/month
A3.c. 24 HCF
Drinking Water Charges (Fixed and variable water charges) Dollars/month
Other Charges (e.g., property tax, fire suppression, waste water, other) Dollars/month
Total Monthly Water Bill (Automatic sum of Water Charges and Other Charges)*  Dollars/month

*If “Other Charges” varies, (e.g., by climate, lot size, landscaped area, or other features) use the lowest charge in your calculation.

Calculated field: To update calculated field, click button below

A3.e. Describe what is included in “Other Charges” (mark those that apply).

Property Tax
City Tax or Fee
Utility User Tax or Fee
Fire Suppression or Fire Protection Services Tax or Fee
Wastewater or Sewer Tax or Fee
Stormwater Tax or Fee
Electricity Tax or Fee
Other non-water charges and fees that are included on water bills, explain below:
Other:

A3.f. Comments on Affordable Drinking Water (publicly available):

A4. SHUT-OFFS

Completing this section will fulfill State Water Resources Control Board requirements of Senate Bill 998 – Discontinuation of residential water service, which are mandatory as of April 1, 2020.

Click the “Update Totals” button to automatically add the Single Family and Multifamily Accounts

Community Water Systems that have water rates and more than 200 connections must complete this section. If your community water system does not meet these criteria for completing this Section, then you must mark the boxes “did not collect information” below in order to avoid completion errors.

If a water supplier tracks the number of services connections but did not collect information on whether residences were occupied or unoccupied at the time of disconnection, put the total number of disconnections in the “unknown accounts” column in the tables in this section.
If a water supplier does not differentiate between single-family or multi-family, then enter all information as single-family.

Click the “Update Totals” button to automatically sum the Single Family and Multifamily Accounts.

For section A4, select the reporting year for your answers :

Residential Shut-offs and Reconnections

A4. This section has several questions on water services. Are you able to provide information on drinking water services alone, or are water services combined with non-water services (e.g., electricity, trash removal services) so your responses cover more than just water services?

A4.a.How many accounts for residential service connections had their water shut off once during the year due to failure to pay?

If this information is only available for accounts that had their water shut off at least once, then check this box and complete the table below and skip question A4.c

If there was no information collected for question A4.a, then mark this check box and skip below table.

Occupied
Accounts
Unoccupied
Accounts
Unknown
Accounts
Total*
Single-Family Accounts  
Multi-family Accounts  

A4.b. What is the average amount owed at the time of shut-off? $ Mark the box if unknown

A4.c. How many accounts for residential service connections had their water shut off more than once during the year due to failure to pay?

If there was no information collected for question A4.c, mark this box and skip below table.

Occupied
Accounts
Unoccupied
Accounts
Unknown
Accounts
Total*
Single-Family Accounts  
Multi-Family Accounts  

A4.d. What is the residential fee, including all administrative and processing fees, to restore drinking water service due to failure to pay during operating hours?

Single-Family Accounts
Multi-family Accounts

A4.e. What is the residential fee, including all administrative and processing fees, to restore drinking water service due to failure to pay during non-operating hours?

Single-Family Accounts
Multi-Family Accounts

A4.f. What was the median duration of the shut-offs (in days) for continuously occupied residential service accounts?

If there was no information collected for question A4.f, mark the check box “Did not collect median duration of shut-offs (in days) for occupied residents" and skip below table.

Occupied
Accounts
Unoccupied
Accounts
Unknown
Accounts
Single-Family Accounts
Multi-Family Accounts

A 4.g How many of these shut-offs are returned to service within one-day (or 24-hours)?
This answer covers:

A4.h. If you offer an extended repayment or other customer payment assistance plan, how many continuously occupied residential customer accounts participated?

Single-Family Accounts
Multi-family Accounts
Total* 

A4.i. How many of the continuously occupied residential accounts were shut off at least once during the year and were enrolled in an extended repayment plan or other customer payment assistance plan at the time of the service disconnection?

Single-Family Accounts
Multi-family Accounts
Total* 

*Calculated field, to update calculated fields in this section, click button below

The Water Shutoff Protection Act (SB 998, 2018) requires community water systems that have more than 200 connections to have shutoff policies completed by April 1, 2020. Mark this box if your water system has less than 200 service connections

A4.j Provide a direct weblink to your shutoff policy as required by the Water Shutoff Protection Act:
If your water agency doesn’t have a website and for this reason is unable to post your shutoff policy, email your shutoff policy. Send an email (click here) with the document, Subject line: PWSID CA_ _ _ _ _ _ _ and Shutoff Policy

A4.k. What is the number of residential accounts (single-family, multi-family, and mixed use that include residential) that were missing one or more required water bill payments at the end of your year?

A4.l. For A4.k accounts, what is the sum of outstanding uncollected residential (single-family, multi-family, and mixed use that include residential) bills at the end of your most recent year? Not determined

A4.m. Comments on Shut-offs (publicly available):

A5. Affordable Drinking Water Assistance

For section A5, select the reporting year for your answers :

A5.a. Do you provide options for low-income assistance? If you selected “No”, skip questions A5b-A5h.
A5.b. If yes, how many residential accounts received the low-income subsidy?
A5.c. If yes, how was the program funded?
A5.d. How much funding was allocated to the program in 2019?

A5.e Does your program provide benefits to single-family only, or single-family and multi-family? (select answer)

A5.f. What was the average benefit amount for a single-family account in one month?
Amount and Unit of Measure:

A5g. What was the average benefit amount for a multi-family account in one month?
Amount and Unit of Measure:

A5.h If your system partners with an outside entity (e.g., United Way) to provide assistance to low income households, list the name of organization(s) and the amount of the benefit (in dollars) provided
Dollars provided: Time Period:

A5.i. OTHER FORMS OF ASSISTANCE TO ALL RESIDENTIAL CUSTOMERS. What type of bill assistance was provided? (Check all that are applicable)

Flexible or alterative Payment Terms Number of Accounts Average Bill $ Information Not Collected or Not Offered
Temporary Assistance Number of Accounts Average Bill $ Information Not Collected or Not Offered
Special Medical Need Number of Accounts Average Bill $ Information Not Collected or Not Offered
Other Please describe: Number of Accounts Average Bill $

A5.j Do you have a process that can offer bill forgiveness under certain circumstance?

If yes, Number of Accounts Average Bill $ Information Not Collected

A5.k Comments on Affordable Drinking Water Assistance (publicly available):

A6. NON-RESIDENTIAL WATER RATES

If you have non-residential water rates, complete this section. If no, mark this box: and go to Section 6B, Deliveries

A6.a. Select the most common non-residential meter size:

A6.b. What is your billing frequency for non-residential customers?

A6. c. Does your water system use an allocation rate for non-residential accounts?
If yes, skip table A6d. In the comment box A6.e provide a weblink to more information on the allocation rates.

A6.d. Complete the table below providing specific water rates applied to your non-residential customers:

Connection TypeBASE RATE
(BR)
If BR + UUR, what is the volume allowed before UUR appliesUNIFORM USAGE RATE
(UUR)
VARIABLE BASE RATE (provide range)
(VBR)
VARIABLE USAGE RATE (provide range)
(VUR)
$ (Base) HCF $ per HCF$ Low$ High$ per HCF Low$ per HCF High
Commercial
Institutional
Industrial
Landscape Irrigation
Agricultural Irrigation
Other


A6.e Comments on non-residential water rates (publicly available):

B. WATER DELIVERIES

Check this box if your water system does not have monthly water deliveries data and skip the rest of Section B.

Important Note Concerning Recycled Water Questions:

The California Water Code Section 10609(c)(4) states: “The state should identify opportunities for streamlined reporting, eliminate redundant data submissions, and incentivize open access to data collected by urban and agricultural water suppliers.”

It has come to the Division of Drinking Water’s attention that, between this Electronic Annual Report and other reports, some public water systems experience (at least some) redundant reporting of recycled water information to the Division of Drinking Water.

If some or all of the quantities are reported elsewhere, check this box: . Answer any questions below that are not reported elsewhere and leave the reported quantities blank in the table. Please note in the comments where these quantities were reported.

Leave recycled water cells blank ONLY IF it is reported elsewhere on other reports indicated above, otherwise enter zero or the actual figure.

Name of report(s) containing the information requested in this Electronic Annual Report for reporting year 2019:

Regulatory entity receiving the report(s), contact name, and phone number:

Units of Measure (UOM) for this table:

Provide monthly metered water deliveries for all water sources (potable and non-potable) in the table below. If you have partially metered or unmetered water deliveries, check the help tips for additional guidance as you may be able to provide information.

Table 6B Water Deliveries Before you begin, make sure that the water volume values entered in Section 5A Water Supplied and Section 6B Water Deliveries are consistent with each other and that they refer to the same population from Section 2 Population (“permanent population of number of long-term residents”).

ABCDEFGHIJ
 Single-family ResidentialMulti-family ResidentialCommercial/
Institutional
IndustrialLandscape IrrigationOtherTotal Retail1*AgriculturalOther PWS2
Check if no water is delivered or not applicable
January    
February    
March    
April    
May    
June    
July    
August    
September    
October    
November    
December    
Annual % recycled water
Annual % non-potable water
Total*                 

PWS = Public Water System

*Calculated field

1Total Retail = Sum of Columns (B) thru (G), automatically calculated. To update, click below

2 "Other PWS" values are prefilled from the Section 5 Table, Column G

B1. Mark boxes below:

If the delivery categories below include some portion of residential deliveries, please check the boxes below:

Commercial/Institutional

Industrial

Landscape Irrigation

If you have questions about this please contact State Water Board staff by email at: waterconservation@waterboards.ca.gov. This information is being asked at this time to help staff estimate the impacts of SB 606 and AB 1668, as required for the regulatory process.

Only answer question B2 if your system is an Urban Water Supplier with dedicated outdoor irrigation meters

B2. What is the annual volume of outdoor irrigation water used on landscape areas with dedicated irrigation meters in connection with commercial, institutional, and industrial (CII) water use?

a. Unit of Measure

b. Volume of water

c. Water system does not collect this information (mark box if applies)

Comments

B3. If known, indicate what percentage of total annual urban water deliveries (see column H in Table 6B) is used for irrigation of:

a. Developed and natural parklands

b. Publicly maintained urban trees (outside of parklands)

c. Water system does not collect this information (mark box if applies)

COMMENTS (Note: Comments will be made publicly available):

7. WATER QUALITY


Date of Emergency Notification Plan:
Is the Emergency Notification Plan up to date?
If no is selected, please upload a revised WQENP.

DIRECT ADDITIVES

Pursuant to Section 64590, Title 22 of the California Code of Regulations, (effective January 1, 1994), all chemicals or products, including chlorine,
added directly to the drinking water as part of a treatment process must meet the ANSI/NSF Standard 60. Please complete the following table
for each chemical used by this water system. If you are not sure whether a chemical you are using meets this standard, contact the manufacturer
or distributor of the chemical.

If you do not use any direct additives, put “NONE” in each column of the first row.

*Click here to upload an Excel spreadsheet of your water system's Water Quality Direct Additives.*
Name of
Chemical
Name of
Manufacturer
Purpose of
using chemical
Chemical is ANSI/NSF
Standard 60 certified
(Y/N)
Use initiated
in 2019
(Y/N)
1 - 4 of 4

INDIRECT ADDITIVES

As of March 9, 2008, a water system shall not use any chemical, material, lubricant, or product in the production, treatment or distribution
of drinking water that comes in contact with the drinking water that does not have certification of meeting NSF/ANSI standard 61.

Does your water system have procedures to ensure all future equipment and materials meet this standard?

If you have any questions on the requirements related to indirect additives, you may contact your local regulatory agency.

COMMENTS (Note: Comments will be made publicly available):


8. CROSS-CONNECTION CONTROL

Total
Number in
System
in 2019 ¹
Number
Installed
in 2019
Number
Tested in
2019 ²
Number
Failed in
2019
Number
Repaired/
Replaced
Backflow Assemblies
on the Service Connections or Meter
(Reduced Pressure Principle and
Double Check Valve assemblies)
Backflow Assemblies On-
site but not on the Service
Connections or Meter
(Reduced Pressure Principle and
Double Check Valve assemblies)
Air-gap Separation

Notes:

¹ Total Number in System in 2019 – Total number of active Backflow Prevention Assemblies including new devices installed in 2019, but excluding inactive devices.
² Number Tested in 2019 – includes all active devices that were tested in 2019 and either passed or failed.

No. of Inactive Backflow Prevention Assemblies in water system in 2019 :
Date of last cross-connection control survey done on the system:
If ongoing, enter the last day of the year, e.g., 12/31/2019
Cross Connection Control Program Coordinator
    Name:
    Certification Number:
    Business Phone: Email Address:
    Certification or training received:

Describe any cross-connection incidents that occurred during 2019:

COMMENTS (Note: Comments will be made publicly available):


9. OPERATOR CERTIFICATION

A. Please list the State certified Water Treatment Plant Operators employed by your water system that supervise and direct the operation
of your water treatment plants, beginning with the chief operator(s) .

Your Highest Treatment System Classification is:  

Check this box if your public water system has designated a Chief Treatment Operator.

Name of Chief Treatment Operator (First name Last name):
Grade of Chief Treatment Operator (1, 2, 3, 4 or 5):
Treatment Operator Number (4 or 5 digits):
Treatment Certification Expiration Date (MM/DD/YYYY):
*Click here to upload an Excel spreadsheet of your water system’s certified water treatment operators.*
Treatment Operator Name
(First name Last name)
Grade of Treatment
Operator
(1, 2, 3, 4, or 5)
Chief or
Shift1
(C, S or X)
Treatment Operator
Number
(4 or 5 digits)
Treatment Certification
Expiration Date
(MM/DD/YYYY)
1 - 4 of 4

1Use “C” for Chief Operator and “S” for Shift Operator. If neither, put an "X". Do not leave blank.

Do your Chief and Shift Treatment Plant Operators have the minimum level required?

B. Please list the State certified Water Distribution System Operators employed by your water system that supervise and direct the operation
of your distribution systems, beginning with the chief operator(s) .

Your Distribution System Classification is:  

Check this box if your public water system has designated a Chief Distribution Operator.

Name of Chief Distribution Operator (First name Last name):
Grade of Chief Distribution Operator (1, 2, 3, 4 or 5):
Distribution Operator Number (4 or 5 digits):
Distribution Certification Expiration Date (MM/DD/YYYY):
*Click here to upload an Excel spreadsheet of your water system's certified distribution operators.*
Distribution Operator Name
(First name Last name)
Grade of Distribution
Operator
(1, 2, 3, 4, or 5)
Chief or
Shift1
(C, S or X)
Distribution Operator
Number
(4 or 5 digits)
Distribution Certification
Expiration Date
(MM/DD/YYYY)
1 - 4 of 4

1Use “C” for Chief Operator and “S” for Shift Operator. If neither, put an "X". Do not leave blank.

Do your Chief and Shift Distribution System Operators have the minimum level required?

COMMENTS (Note: Comments will be made publicly available):


10. WATER SYSTEM IMPROVEMENTS

The California Waterworks Standards (Section 64556) require an amended permit for any of the following improvements or modifications:

If your water system made any improvements or modifications during 2019 for which a permit was not obtained, please describe
the improvements or modifications below.

Indicate any planned improvements or modifications for 2020.

COMMENTS (Note: Comments will be made publicly available):


11. COMPLAINTS REPORTED (WRITTEN OR VERBAL)

Type of ComplaintNo. of
Complaints
Reported by
Customers
No. of
Complaints
Investigated
No. of
Complaints
reported to
the Division of
Drinking Water
or Local
County Staff
Brief Description of
Cause and Corrective
Action taken
Taste and Odor
Color
Turbidity
Visible Organisms
Pressure (High or Low)
Water Outages1
Illnesses
(Waterborne)
Other (Specify)
Total No. of
Complaints*
      
1These are customer complaints of a water outage and not necessarily the same as the water outages reported under “System Problems” in the Distribution Section of the EARDWP.
*Calculated field

COMMENTS (Note: Comments will be made publicly available):


12. RECYCLED WATER USE

Does your water system have recycled water in its service area (provided by your water system or another utility)? If no, skip the questions below in this section and move to the next section.

Important Note Concerning Recycled Water Questions:

The California Water Code Section 10609(c)(4) states: “The state should identify opportunities for streamlined reporting, eliminate redundant data submissions, and incentivize open access to data collected by urban and agricultural water suppliers.”

It has come to the Division of Drinking Water’s attention that there is (at least some) redundant reporting of recycled water information occurring, for at least for some public water systems in this Electronic Annual Report to the Division of Drinking Water. If some or all of the recycled water questions are reported elsewhere, check this box: . Answer any questions below that are not reported elsewhere and leave the reported quantities blank in the table. Please note in the comments where these quantities were reported.

Name of report(s) containing the information requested in this Electronic Annual Report for reporting year 2019:

Regulatory entity receiving the report(s), contact name, and phone number:

If only some of the recycled water questions in this Electronic Annual Report section are reported elsewhere, complete the information above and answer the questions below that are not reported elsewhere. Leave recycled water cells blank ONLY IF it is reported elsewhere on other reports indicated above, otherwise enter zero or the actual figure.

Recycled Water (RW)
Use Sites
Total No. of
Approved Sites as of
Dec. 31, 2019
No. of New
Sites Approved in 2019
No. of Sites
Proposed for 2020
Irrigation, Agriculture
Irrigation, Landscape
Industrial
Dual-plumbed
(In-building)
Dual-plumbed
(Single-family lot)
Cooling Towers
Other
Total*     

Name of the recycled water coordinator:
Business Phone:
Email address:
How many inspections of recycled water use sites were conducted in 2019?
How many pressure/shutdown tests were performed in 2019?
Do all of your recycled water uses sites have an on-site supervisor?
How many recycled water uses sites do not have an on-site supervisor?

COMMENTS (Note: Comments will be made publicly available):


13. SYSTEM OPERATION - TREATMENT

A. GROUNDWATER TREATMENT (respond only if groundwater treatment is provided, exclude chlorination treatment)

Groundwater
Treatment Plant
Name
Treatment
Process
Date of
Operations Plan
Is Operations
Plan Current?
(Y/N)
Contaminant
Removed
1 - 6 of 6

Describe any plant problems, process failures, major shutdowns, etc., which occurred in 2019 and substantially affected the plant performance AND/OR
any significant modifications or maintenance provided to the plant(s):

B. SURFACE WATER TREATMENT (respond only if surface water treatment is provided)

Surface water
Treatment Plant
Name
Date of
Operations Plan
Is Operations
Plan Current?
(Y/N)
1 - 6 of 6

Describe any plant problems, process failures, major shutdowns, etc., which occurred in 2019 and substantially affected the plant performance AND/OR
any significant modifications or maintenance provided to the plant(s):

TD = Treatment or Distribution operator at any level

NR, N/A, NA = There are no facilities subject to the Certified Treatment Plant Operator requirements

Date of current Emergency Disinfection Plan (EDP)*:
*As required under Section 64660(c)(2). The EDP may be included in your water system’s Emergency Response Plan or Operations Plan. If so, provide the Name and Date of those plans below:.
Name of Document that includes the Emergency Disinfection Plan:
Date of document that includes the Emergency Disinfection Plan:
Date of last watershed sanitary survey report :
Date planned to complete next watershed sanitary survey report*:
*As required under Section 64665, each watershed sanitary survey shall be updated at least every 5 years.

COMMENTS (Note: Comments will be made publicly available):


14. SYSTEM OPERATION – DISTRIBUTION

A1. DEAD-END FLUSHING PROGRAM

Total No.
in System
No. with
Blowoffs
No. Flushed
in 2019
Frequency of
Flushing

Comments on DEAD-END FLUSHING PROGRAM (publicly available):

A2. ALL FLUSHING OPERATIONS

Units of Measure for total volume reported below:
Total Volume in units of measure selected above; include all types of flushing,
not just dead-end flushing:

Comments on ALL FLUSHING OPERATIONS (publicly available):

B. VALVE EXERCISE PROGRAM

Size Range of
Valves
Total No. in SystemNo. Exercised in 2019Frequency of Valve Exercising

Comments on VALVE EXERCISE PROGRAM (publicly available):

C. STORAGE TANK/RESERVOIR INSPECTION/CLEANING PROGRAM

(Do not include pressure tanks)

*Click here to upload an Excel spreadsheet of your water system's Storage Tank/Reservoir Inspection/Cleaning Program.*
Tank nameCapacity
(in million
gallons, MG)
Year
installed
Date of last
inspection
Date of last
cleaning
Date re-lined
or coated
Corrosion
protection(*)
Material of
construction
1 - 6 of 6

*Coatings and linings do not count as corrosion protection for table Subsection C.

D. SYSTEM PROBLEMS

Type of ProblemNo. of
Problems
No. of
Problems
Investigated
No. of
Problems
Reported to
the Division of
Drinking Water
or Local
County Staff
Brief Description of
Cause and Corrective Action Taken
Service Connection
Breaks/ Leaks
Main Breaks/Leaks
Water Outages
Boil Water Orders
Total*      

Comments on SYSTEM PROBLEMS (publicly available):

E. INFRASTRUCTURE AND PRESSURE

Pipe Material in Distribution System

1. Which materials does your distribution system pipe consist of? Please check all that apply:

Plastic (Including Poly Vinyl Chloride and HDPE)
Steel
Cast Iron
Galvanized Iron
Ductile Iron
Cement Concrete
Asbestos Cement

Pipeline MaterialPercentage of distribution pipe system
composed of the materials selected above
Average Age
(in years)
Plastic
Steel
Cast Iron
Galvanized Iron
Ductile Iron
Cement Concrete
Asbestos Cement
other:

COMMENTS (Note: Comments will be made publicly available):


15. EMERGENCY PREPAREDNESS & RESPONSE, AND WATER PARTNERSHIPS

A. EMERGENCY RESPONSE PLANS

PUBLIC WATER SYSTEMS WITH AT LEAST 3,300 OR MORE PERSONS SHOULD REVIEW AND REVISE THEIR EMERGENCY
RESPONSE PLAN TO ENSURE THAT THE PLANS ARE SUFFICIENT TO ADDRESS POSSIBLE DISASTER SCENARIOS.

Do you have an Emergency Response Plan (ERP) that addresses the procedures
for the restoration of water service for your water system?
Date of your current Emergency Response Plan:
Date ERP was last exercised with a tabletop or other activity:

Are you registered in your local energy utility’s Public Safety Power Shutoff notification plan?

B. AUXILIARY POWER SUPPLY

Does your water system have backup power for:
      1. Sources:
      2. Pumping Stations:
      3. Water Treatment Plants:
If your system has backup power, how many times per year is it exercised?
Can your system maintain system pressure in all pressure zones either by backup power or by gravity fed storage during power outages for each of the following number of hours?
24 hours
48 hours
72 hours
Is your backup power system automatic or manual start?:

COMMENTS (Note: Comments will be made publicly available):


16. WATER CONSERVATION AND DROUGHT PREPAREDNESS

1. Date of your revised Drought Preparedness Plan or Water Shortage Contingency Plan, if any:
Water system does not have a current drought or water shortage plan, mark box if applies:
2. Did your water system experience water shortages in 2019?
If yes, please estimate the amount of shortfall in units selected for this section Volume of water:
Units of Measure:
3. How many water-shortage response stages are in your drought plan? For “non-applicable”, enter zero.
4. Did drought conditions cause you to activate emergency standby wells in 2019?
5. Do you project water shortages in the current calendar year?
6. Does your water system anticipate having to go to mandatory restrictions in the upcoming year?

7. Identify the method your water system uses to discourage excessive water use when in drought, in support of SB 814 (2016) (Check as applicable)

7e. COMMENTS REGARDING SB 814 (Note: Comments will be made publicly available) :

8. To identify data streamlining opportunities, are there other government agencies, aside from the Department of Water Resources, that require reports on the same information found in the Electronic Annual Report? If yes, please describe (include the title of the report, which agency receives it, and the type of information it includes):

Only complete the questions below if you are an Urban Retail Water Supplier

Conservation legislation (AB 1668 and SB 606, 2018) requires that the Department of Water Resources recommend standards to calculate water use objectives (targets representing efficient water use) for each urban retail water supplier. The State Water Board will use those recommendations to adopt regulations in July 2022. The questions below help inform this process.

9. What conservation activities occurred in your service area in 2019?

a. Provide a direct link to a web page that summarizes conservation activities in your service area, if available.

b. If a webpage is not available, send an email (click here) with the document, Subject line: PWSID CA_ _ _ _ _ _ _, Water Conservation Activities

10. Have you tracked how much your water system spent on conservation and efficiency programs in the last fiscal year?

a. If known, enter those expenditures $

b. If detailed in a document, provide a direct link to a web page with information:

11. Have you tracked how much water was saved as a result of those programs?

a. If known, enter those savings: b. Units of measure:

b. If detailed in a document, provide a direct link to a web page with information:

12. Have you estimated the “saturation” or percentage of water efficient appliances and fixtures already in your service area?

a. If yes, provide a direct link to a web page with information:

b. Alternatively, if a webpage is not available, send an email (click here) with the document, Subject line: PWSID CA_ _ _ _ _ _ _ , water efficiency of appliances and fixtures

13. Do you currently use imagery to evaluate demand for outdoor use? Comment:

14. Does your water system have a variance or adjustment process that either 1) allows customers to request a greater volume of water than what would otherwise be budgeted for that customer type or 2) signals customers to reduce water use under particular circumstances? For examples of variances and adjustments, see the drop-down boxes below. If no, skip this question and go to question 16 below.

a. How many types of adjustments or variances do you provide?

Variance 1 How is the amount of the variance or adjustment determined?
Significance to water demand for the water system?
Variance 2 How is the amount of the variance or adjustment determined?
Significance to water demand for the water system?
Variance 3 How is the amount of the variance or adjustment determined?
Significance to water demand for the water system?
Variance, Other: How is the amount of the variance or adjustment determined?
Significance to water demand for the water system?

15. Do you intend to use the potable reuse water bonus incentive explained in CWC 10609.20(d))?

(If you have questions about this please contact State Water Board staff by email at: waterconservation@waterboards.ca.gov. State Water Board staff will follow up with those suppliers who answer “yes”. This information is being asked at this time to help staff estimate the impacts of SB 606 and AB 1668, as required for the regulatory process)

16. COMMENTS (Note: Comments will be made publicly available):


17. CLIMATE CHANGE ADAPTATION AND RESILIENCY FOR WATER UTILITIES

Per Waterboard Resolution 2017-0012, dated 3/7/17, water system inspections are required to address climate change impacts & concerns.


ONLY FOR COMMUNITY WATER SYSTEMS

Your water system classification is:  

If you have questions about completing this section of the report, please contact Joseph.Crisologo@waterboards.ca.gov or call (818) 551-2046.

A. CLIMATE THREATS

What climate-related impacts are of concern for your water system (check all that apply)?

Drought Groundwater Depletion Water Quality Degradation Flooding Sea Level Rise
Extreme Heat Fire Other None or N/A
B. SENSITIVITY AND MAGNITUDE OF IMPACTS

Qualitatively assess climate change sensitivity of your facilities, and criticality or consequence of disruption. Consider identified climate threats using past experience, and expert judgement based on the magnitude of expected change and extreme events in the future. You do not need numeric answers. USEPA provides a risk assessment tool, called CREAT, to help utilities identify which environmental changes can impact water supply: https://www.epa.gov/crwu/build-resilience-your-utility. More resources are available that may help you complete this section.

Drought | Groundwater DepletionDecreased water storage (low lake and reservoir levels)Choose an item
Groundwater depletion (increased extraction, reduced groundwater recharge, etc.)Choose an item
Change in seasonal runoff and/or loss of snowmeltChoose an item
Region relies on water diverted from the Delta, imported from the Colorado River, or other climate-sensitive areaChoose an item
Water Quality DegradationSalt-water intrusion into aquifersChoose an item
Altered water quality during storm events (turbidity shifts, debris flows)Choose an item
Surface water quality issues related to eutrophication, algal blooms, invasive speciesChoose an item
Flooding | Sea Level RiseHigh flow events and floodingChoose an item
Inundation due to sea level rise, high tides, and/or coastal storm surgesChoose an item
Aging flood protection infrastructure (levees), or insufficient impoundment capacityChoose an item
Extreme HeatPeak demand volume surges (due to extreme heat, temperature trends, etc.)Choose an item
Increases in agricultural water demand or energy sector needsChoose an item
Fire | Other ImpactsIncreased fire risk and altered vegetation, e.g., wildfiresChoose an item
Disruption of power supplyChoose an item
Other Choose an item
C. ADAPTATION MEASURES

Identify measures to increase resiliency and reduce vulnerabilities based on identified water system sensitivities. Indicate status for all projects that your organization has completed or plans to implement to increase resiliency of the water system to climate change? Adaptation measures planned or achieved for reasons other than climate change should be put in the “Other” box along with the reason for the measure. USEPA’s Adaptation Strategies Guide for Water Utilities provides examples of adaptation: https://www.epa.gov/crwu/learn-how-plan-extreme-weather-events

Install new and deeper drinking water wells, or modify existing wells to increase pumping capacityChoose an item
Develop local supplemental water supply, enhanced treatment, or increased storage capacity (e.g. recycled water, storm runoff for groundwater recharge, desalination, new reservoir)Choose an item
Interconnection with other utilities (transfers, mutual aid agreements with neighboring utilities)Choose an item
Relocate facilities, construct or install redundant facilitiesChoose an item
Modify facilities (e.g., install barrier or levee, raise a wall, seal a door, elevate construction)Choose an item
Conservation measures (demand management, enhanced communication and outreach)Choose an item
Fire prevention – brush management, partnershipsChoose an item
Alternative or backup energy supply Choose an item
On-site energy generationChoose an item
Enhance monitoring program, budget for additional testing and treatment, chemicalsChoose an item
Other Choose an item

COMMENTS (Note: Comments will be made publicly available):


18. LEAD SERVICE LINE REPLACEMENT


ONLY FOR COMMUNITY WATER SYSTEMS

Your water system classification is:  

Section 116885 of the California Health and Safety Code, Lead Service Lines in Public Water Systems, added to the Health and Safety Code by Senate Bill 1398 (2016) and amended by Senate Bill 427 (2017), requires all community water systems (CWSs) to compile an inventory of known partial or total lead user service lines in use in its distribution system by July 1, 2018. DDW is utilizing the electronic annual report (eAR) to gather and update this information.

CWSs that reported in the table below the existence of lead user service lines (A) or unknown material user service lines (B) or lead/unknown fittings associated with user service lines (M or O), need to submit to a timeline for replacement of those user service lines or fittings to DDW by July 1, 2020. Please include the updated information on your user service line inventory below so DDW can track the progress of your system. If you have identified user service lines in A, B, M or O below, you will need to upload a timeline, including a spreadsheet listing the locations and replacement schedules and a letter or short report contain the justification for the dates of the replacement, for approval by DDW. Please utilize the spreadsheet template located on DDW’s lead service line webpage to document the replacement schedules. For the suggested contents of the letter or report, please check the Fact Sheet on DDW’s lead service line webpage. Water systems that previously reported service lines of unknown materials, that have now identified those materials and can certify that no lead or unknown service lines exist, must upload a certification form under the LSLR tab in place of a timeline report or letter.

For additional information including the spreadsheet template, certification form and Facts Sheet, please visit

https://www.waterboards.ca.gov/drinking_water/certlic/drinkingwater/lead_service_line_inventory_pws.html

If you have questions about completing this section of the report, please contact David.Pimentel@Waterboards.ca.gov or call (916) 323-0572.

IMPORTANT: In the 2017 and 2018 electronic Annual Reports, all CWSs were required to submit the lead service line inventory to the DDW. The inventory will be prefilled with the 2018 EAR data for this section. Please review the table below and take this opportunity to make changes and update your inventory. Do not leave entry spaces blank. You must enter zero in any yellow fields which are not populated, otherwise errors will be generated at the end of the eAR report.

If your water system is a wholesaler and contains no user service lines, you are not required to complete this form: Please check this box:

Date lead service line inventory was completed (MM/DD/YYYY):

A. User service line inventory:

"User service line" means the pipe, tubing, and fittings connecting a water main to an individual water meter or service connection.

Pipe MaterialEstimated Number of Service Lines
(Enter “0” if none)
Estimated Total Length of Service Lines
(In feet), if applicable
A. Lead
B. Unknown material
C. Copper
D. Cast iron (ductile pipe)
E. Ductile iron
F. Galvanized steel
G. Polyvinyl chloride (PVC)
H. Polyethylene (PE)
I. High density polyethylene (HDPE)
J. Polybutylene (PB)
K. Transite/asbestos cement
L. Other materials not listed above:
Identify material 1
Identify material 2
Identify material 3
Identify material 4
Total number of service lines inventoried* (calculated field) 
Total number of service connections from Section 3 of the EAR
Fittings or fittings connecting a water main:
M. Lead fittings NOT on a lead pipe(e.g., goosenecks, pigtails, and corporation stops)
N. Lead fittings ON a lead pipe (e.g., goosenecks, pigtails, and corporation stops)
O. Fittings of unknown material (e.g., goosenecks, pigtails, and corporation stops)
Total number of lead service lines** (calculated field) 

*Total number of service lines inventoried (calculated field) = Sum of A through L

**Total number of lead service lines (calculated field) = Sum of A and M

To Update calculated field, click button below

B. Method(s) used to prepare the lead service line inventory in Part A (check all that apply):

Tap Cards or tickets from initial service installation
Plans from water main installation, rehabilitation, and replacement
Records indicating when buildings were constructed
Meter replacement records
Distribution maps, drawings, or GIS
Visual confirmation of pipe material by plumbers or utility crews during maintenance or installation activities
Interviews with water system personnel and/or past employees
Field investigations
Other (describe below):

C. COMPLIANCE WITH LEAD SERVICE LINE REPLACEMENT REQUIREMENT - NEW

Select one of the following options which applies to all community water system:

  1. If the CWS completed the requirement by reporting no lead or no unknown service lines or fittings in the 2017, 2018, and 2019 EAR (2017, 2018, and 2019 EAR LSLR inventory table in subsection A. have rows A, B, M and O equal to 0), Check the box below to indicate you have completed the requirement. Click OK in the two pop-up windows that open after the box is checked. No further action is required.

    No lead and no unknown material service lines or fittings.

  2. If the CWS reported lead or unknown material service lines or fittings in the 2017 and/or 2018 EAR LSLR section AND have since replaced or identified the materials (2019 EAR LSLR inventory table in subsection A. has rows A, B, M and O equal to 0), complete the LSLR certification form (the template can be found at the webpage linked below) then click HERE to upload the completed form. When you click on the HERE link, a new browser tab will open to the Replacement Timeline LTR or Certification Form upload page, after you have uploaded the document navigate back to this browser tab to complete the Finalize section of the EAR.

    The LSLR certification form template and FAQs can be found on the Lead Service Line Inventory Requirement for Public Water Systems webpage in the Resource and supplemental material section (bottom of page) at: https://www.waterboards.ca.gov/drinking_water/certlic/drinkingwater/lead_service_line_inventory_pws.html

  3. If the CWS reported lead or unknown material service lines or fittings in the 2019 EAR LSLR section (rows A, B, M and/or O are NOT equal to 0), a Replacement Timeline letter and spreadsheet must be submitted. The completed letter and spreadsheet (Replacement Timeline LTR and SS) should be uploaded at the links provided in 3.a. and 3.b. When you click on the HERE link below in 3.a., a new browser tab will open which has the Replacement Timeline LTR upload location, after you have uploaded the document navigate back this browser tab and click the HERE link in 3.b. for a new browser tab to open with the upload page for the Replacement Timeline SS. You will need to return to this browser tab to complete the Finalize section of the EAR after the uploads are completed.

    1. Click HERE to upload the Replacement Timeline LTR
    2. Click HERE to upload the Replacement Timeline SS

    The timeline spreadsheet template and FAQs on this requirement can be found on the Lead Service Line Inventory Requirement for Public Water Systems webpage in the Resource and supplemental material section (bottom of page) at: https://www.waterboards.ca.gov/drinking_water/certlic/drinkingwater/lead_service_line_inventory_pws.html

If you are not able to upload the Replacement Timeline documents before the 2019 EAR is due, submit the 2019 EAR report on or before the report due date. After the EAR is reviewed, District or LPA Staff will return the EAR for revisions to allow you to upload the required documents by the July 1, 2020 deadline. You can request your District or LPA Office return the EAR for revision if you are ready to upload the documents before the review is completed.

Please indicate the total number of hours spent to complete this report. This information will be utilized to characterize the level of effort required to complete this report

By checking this box you acknowledge that any information submitted in this report is publicly accessible and may be used by the State of California to determine compliance with applicable laws and regulations. Knowingly submitting false information in this report is a misdemeanor, and by submitting this information you certify that the contents are, to the best of your knowledge, complete and correct.