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

LARGE WATER SYSTEM
2015 ANNUAL REPORT TO THE DRINKING WATER PROGRAM
FOR YEAR ENDING DECEMBER 31, 2015
[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:


Water System Ownership Descriptions:

REPORT SUBMITTED BY:
Name: 
Title: 
Business phone: 
Cell phone: 
Email address: 


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).

NAME, TITLE & ADDRESSPHONE TYPEPHONE NO.EMAILCONTACT TYPE
(pick all that apply)
  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
 
 
  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
 
Add Additional Contact (pick all that apply)
Business



Home

Facsimile

Mobile

    Emergency
 
COMMENTS:


2. POPULATION SERVED

Permanent population or number of long-term residents*:
Please follow this LINK for instructions to determine population.

*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:


3. NUMBER OF SERVICE CONNECTIONS(as of December 31, 2015)

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, 2015 must be reported as either Unmetered or Metered for each Service Connection Type as appropriate.

 Potable WaterRecycled Water
TYPE

Do NOT report fire sprinkler connections and fire hydrants. These connections are not counted toward “service connections” for compliance purposes.
UnmeteredMeteredTotal*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
   
Industrial:
All manufacturing
   
Landscape Irrigation:
Parks, play fields, cemeteries, median strips, golf courses
   
Agricultural Irrigation:
Irrigation of commercially-grown crops
   

Total Active Connections*

 

 

 

 

 

 

Other:
Fire suppression, street cleaning, line flushing, construction meters, temporary meters
   

*Calculated field

B. Number of Inactive Connections (all types)

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

COMMENTS:

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

TypeTotal No.
Approved

(by permit)
Total No.
New/
Added in
2015
Total No.
Inactivated
in 2015
Total No.
Destroyed
in 2015
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 water sources metered?

1If a standby source was used in 2015, provide the following information.

Name of the Standby
Source
used in 2015:
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 otherwise isolated so that only an intentional act
by an operator can place the source in service.

COMMENTS:


5. WATER PRODUCED, PURCHASED AND SOLD

The Maximum Day is the day during 2015 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.

The Maximum Month is the month during 2015 with the highest total water usage. Provide the month in Column B,
then complete Columns C, D and E, indicating how much of the water during that month was from each source.

Units of Measure for this table:

Volumes are based on:

ABCDEFGHI
 Potable WaterNon-potable (exclude recycled)Recycled
 Date/
Month
Water Produced from
Groundwater (Wells)
Water Produced from
Surface Water2
Finished Water Purchased or Received from another PWS5Total Amount of Potable Water3*Water Sold to
Another PWS5
Maximum Day1  
Maximum Month  
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. To update, click below

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.

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

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

If recycled water was supplied to your 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:


6a. WATER RATES

If you have questions about completing this section of the report ONLY, please contact Kathy.Frevert@Waterboards.ca.gov or call (916) 322-5274.
For all other inquiries, please contact DRINC@waterboards.ca.gov.

Indicate the type of residential water rate structure used by your water system:

If tiered, what is the number of tiers?
Date of most recent update to the rate structure: MM/DD/YYYY
Describe the changes that were made in the update:
What is your billing frequency
What is your new connection fee?
Date of most recent update to the new connection fee: MM/DD/YYYY

Complete the table below providing specific water rates applied to your customers:

Connection TypeFLAT BASE RATEUNIFORM USAGE RATEVARIABLE BASE RATE (provide range)VARIABLE USAGE RATE (provide range)
$ (Base)$ per hcf $ Low$ High$ per hcf Low$ per hcf High
RESIDENTIAL
Single-family Residential
Multi-family Residential
Do you provide lifeline/low income subsidies?
If Yes, provide rates:
If yes, what percentage of residential customers receive this subsidy?
NON-RESIDENTIAL
Commercial/Institutional
Industrial
Landscape Irrigation
Agricultural Irrigation
Other
Do you have fire suppression surcharges?
If Yes, provide rates:
Do you have other surcharges?
What are the other surcharges?
If Yes, provide rates:


AVERAGE MONTHLY RESIDENTIAL CUSTOMER WATER BILL IN $/month USING:


a. 6 CCF
b. 12 CCF
c. 24 CCF


NOTE: If this is not a "Community" Water System; enter N/A. If individual customers do not pay a separate bill for water enter "0".

6b. WATER DELIVERIES

Units of Measure for this table:

Provide monthly metered water deliveries in the table below.

ABCDEFGHIJ
 Single-family ResidentialMulti-family ResidentialCommercial/
Institutional
IndustrialLandscape IrrigationOtherTotal Urban Retail1*AgriculturalOther PWS
Check if Recycled Water is included:  
January  
February  
March  
April  
May  
June  
July  
August  
September  
October  
November  
December  
Total*                 

PWS = Public Water System

*Calculated field

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



6c. WATER EFFICIENCY INFORMATION (Required for water suppliers listed HERE; optional for all others)

  1. What steps have you taken to implement the updated Model Water Efficient Landscape Ordinance?

    Provide the web link to the Landscape Ordinance that must be followed in your service area.
  2. Provide a calculation of the total irrigated area subject to the 0.8 of ET standard (existing landscape)
  3. Provide a calculation of the total irrigated area subject to the 0.55 of ET standard (existing landscape)
  4. What percentage of your residential customers used more than 80% of ET for outdoor irrigation during 2015?*
  5. What steps have you taken to implement SB 407 (2009)?
*Use 55 GPCD for indoor use. If you do not have household size data, use Census data. If your service area covers multiple ET zones and you do not have the ET data for each zone, use average ET for your service area.

COMMENTS:


20 largest urban water suppliers

  1. Anaheim, City of
  2. Bakersfield, City of
  3. California Water Service - Bakersfield
  4. Coachella Valley WD
  5. Cucamonga Valley WD
  6. East Bay MUD
  7. Eastern Municipal WD
  8. Fresno, City of
  9. Irvine Ranch WD
  10. Long Beach, City of
  11. Los Angeles County Public Works
  12. Los Angeles DWP
  13. Modesto, City of
  14. Rancho California WD
  15. Riverside, City of
  16. Sacramento, City of
  17. San Bernardino, City of
  18. San Diego, City of
  19. San Francisco PUC
  20. San Jose Water Company

7. WATER QUALITY

ANNUAL NITRATE SAMPLING

Regulations require a minimum of annual sampling for nitrate. If any nitrate result is >= 1/2 the MCL of 45 mg/l (i.e., a result of >= 23 mg/l nitrate)
then quarterly monitoring must be initiated.

Did your system conduct monitoring for nitrate during 2015 from each source?

NOTE: If there were any sources that were not monitored because they were offline during 2015,
you must contact your local regulatory agency to avoid an enforcement action for failure to monitor.

BACTERIOLOGICAL SAMPLE SITING PLAN

The coliform monitoring regulations require that an updated sample-siting plan be submitted at least every 10 years,
and at any time the plan no longer ensures representative monitoring of the system (Section 64422 of Title 22).

Date of current bacteriological sample siting plan:

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.

Name of
Chemical
Name of
Manufacturer
Purpose of
using chemical
Chemical is ANSI/NSF
Standard 60 certified
(Y/N)
Use initiated
in 2015
(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:


8. CROSS-CONNECTION CONTROL

Total
Number in
System
Number
Installed
in 2015
Number
Tested in
2015
Number
Failed in
2015
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

No. of Inactive Backflow Prevention Assemblies in water system in 2015 :
Date of last cross-connection control survey done on the system:
Cross Connection Control Program Coordinator
    Name:
    Certification Number:
    Business Phone: Email Address:
    Certification or training received:

Describe any cross-connection incidents that occurred during 2015:

COMMENTS:


9. CONSUMER CONFIDENCE REPORT (does not apply to Transient Noncommunity water systems)

THE 2015 CCR MUST BE DISTRIBUTED TO YOUR CUSTOMERS AND A COPY SUBMITTED TO YOUR LOCAL REGULATORY AGENCY BY JULY 1, 2016. IN ADDITION, PUBLIC WATER SYSTEMS THAT ARE ALSO REGULATED BY THE CALIFORNIA PUBLIC UTILITIES COMMISSION (PUC) MUST MAIL A COPY OF THEIR CCR TO THE PUC BY JULY 1, 2016.

CERTIFICATION MUST BE SUBMITTED TO YOUR LOCAL REGULATORY AGENCY BY OCTOBER 1, 2016, STATING THAT THE 2015 CCR HAS BEEN DISTRIBUTED
TO CUSTOMERS AND THAT THE INFORMATION IS CORRECT.

The CCR guidance, CCR template, and the certification form can be obtained from the Division of Drinking Water web site
at:http://www.waterboards.ca.gov/drinking_water/certlic/drinkingwater/CCR.shtml

Indicate the date your 2015 CCR was distributed or will be distributed to your customers: mm/dd/yyyy

PUBLIC WATER SYSTEMS THAT SERVE 100,000 OR MORE PERSONS ARE REQUIRED TO POST THEIR CCR ON THE INTERNET.

If your water system serves 100,000 or more persons, indicate the date the CCR was or will be posted to the Internet:

If applicable, please provide the URL link to the CCR posted on the Internet:

COMMENTS:


10. 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:  

If you do not have a Certified Treatment Plant Operator, put "NONE" in each column of the first row.

NameGrade of
Operator
Chief or
Shift1 (C/S)
Operator
Number
Expiration Date
1 - 4 of 4

1Use “C” for Chief Operator and “S” for Shift Operator. If neither, put an "X".

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

B. Please list the State certified Water Distribution 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:  

If you do not have a Certified Distribution System Operator, put "NONE" in each column of the first row.

NameGrade of
Operator
Chief or
Shift1 (C/S)
Operator
Number
Expiration Date
1 - 4 of 4

1Use “C” for Chief Operator and “S” for Shift Operator. If neither, put an "X".

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

COMMENTS:


11. 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 2015 for which a permit was not obtained, please describe
the improvements or modifications below.

Indicate any planned improvements or modifications for 2016.

COMMENTS:


12. 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:


13. RECYCLED WATER USE

Do you have recycled water in your service area (provided by you or another utility)?

Recycled Water (RW)
Use Sites
Total No. of
Approved Sites as of
Dec. 31, 2015
No. of New
Sites Approved in 2015
No. of Sites
Proposed for 2016
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 2015?
How many pressure/shutdown tests were performed in 2015?
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:


14. SYSTEM OPERATION - TREATMENT

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

Groundwater
Treatment Plant
Name
Treatment
Plant
Classification
Capacity
(MGD)
Type of
Treatment
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 2015 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
Treatment
Plant
Classification
Capacity
(MGD)
Type of
Treatment
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 2015 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:


15. SYSTEM OPERATION – DISTRIBUTION

A. DEAD-END FLUSHING PROGRAM

Total No.
in System
No. with
Blowoffs
No. Flushed
in 2015
Frequency of
Flushing

B. VALVE EXERCISE PROGRAM

Size Range of
Valves
Total No. in SystemNo. Exercised in 2015Frequency of Valve Exercising

C. STORAGE TANK/RESERVOIR INSPECTION/CLEANING PROGRAM

(Do not include pressure tanks)

Tank nameCapacity
(in million
gallons, MG)
Year
installed
Date of last
inspection
Date of last
cleaning
Date re-lined
or coated
1 - 6 of 6

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:


16. EMERGENCY PREPAREDNESS AND RESPONSE

A. EMERGENCY RESPONSE PLANS

PUBLIC WATER SYSTEMS WITH AT LEAST 3,300 OR MORE PERSONS ARE REQUIRED TO 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:

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 either by backup power or by storage
during power outages of 2 hours or less?
Is your backup power system automatic or manual start?:

COMMENTS:


17. WATER CONSERVATION AND DROUGHT PREPAREDNESS

Date of your revised Drought Preparedness Plan, if any:
If you experienced water shortages in 2015, please estimate the amount of shortfall in millions of gallons:
Did drought conditions cause you to activate emergency standby wells in 2015?
Do you project water shortages in the current calendar year?
Did you implement NEW water conservation measures in 2015?
If you implemented NEW water conservation measures in 2015, please estimate how much water was conserved in millions of gallons:
      (MG)
      % reduction in demand
Do you anticipate having to go to mandatory rationing in the upcoming year?
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?:

Please list any other long term actions you are considering or planning:

COMMENTS:


Disclosure: Be advised that Section 116725 and 116730 of the California Health and Safety Code
states that any person who knowingly makes any false statement on any report or document
submitted for the purpose of compliance may be liable for a civil penalty not to exceed
five thousand dollars ($5,000) for each separate violations for each day that the violation
continues. In addition, the violators may be prosecuted in criminal court and upon conviction, be
punished by a fine of not more than $25,000 for each day of violation, or be imprisoned in county jail
not to exceed one year, or both the fine and imprisonment.