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.
to learn how to Modify, Add and Delete Contacts in the table below.
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 & ADDRESS | PHONE TYPE  | PHONE NO. | EMAIL | CONTACT TYPE (pick all that apply) |
| MCCLELLAN, MICHAEL |
Business
Home | 559-905-4578
|
michaelroy2001@msn.com
musickmeadows2@gmail.com |
|
|
| OPERATOR - Water Master |
Facsimile | |
|
|
P.O. Box 214
|
Mobile | |
|
|
| SHAVER LAKE
CA
93664 |
Emergency | |
|
|
| | |
|
| |
| GATSON, DENNIS L. |
Business
Home | 661-323-9400
|
dgatson@mcmorchlor.com
|
|
|
| CERTIFIED OPERATOR |
Facsimile | |
|
|
4700 District Blvd
|
Mobile | |
|
|
| BAKERSFIELD
CA
93313 |
Emergency | |
|
|
| | |
|
| |
| LEONARDO, JOSEPH |
Business
Home |
|
mike@thefcta.com
Nardo1895@yahoo.com |
|
|
| AC |
Facsimile | |
|
|
P.O. Box 102
|
Mobile | 559-298-5636 |
|
|
| SHAVER LAKE
CA
93664 |
Emergency | |
|
|
| | |
|
| |
| RAYMER, KIMI |
Business
Home | 559-250-3008
|
kimiraymer@gmail.com
musickmeadows2@gmail.com |
|
|
| SECRETARY |
Facsimile | |
|
|
P.O. Box 102
|
Mobile | |
|
|
| SHAVER LAKE
CA
93664 |
Emergency | |
|
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| | |
|
| |
| |
Business
Home |
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Facsimile | |
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Mobile | |
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Emergency | |
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Business
Home |
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Facsimile | |
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Mobile | |
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Emergency | |
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Business
Home |
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Facsimile | |
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Mobile | |
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Emergency | |
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Business
Home |
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Facsimile | |
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Mobile | |
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Emergency | |
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| | |
|
Add Additional Contact | (pick all that apply) |
| --Contact Name-- |
Business | (999) 999-9999 |
XXXXX@XXXXX.XXX
XXXXX@XXXXX.XXX |
|
|
| --Title-- |
Home | (999) 999-9999 |
|
|
--Address Line 1--
--Address Line 2-- |
Facsimile
Mobile | (999) 999-9999
|
|
|
| --City--
--ST--
99999 |
Emergency | (999) 999-9999 |
|
|
| | |
|
Add Additional Contact | (pick all that apply) |
| --Contact Name-- |
Business | (999) 999-9999 |
XXXXX@XXXXX.XXX
XXXXX@XXXXX.XXX |
|
|
| --Title-- |
Home | (999) 999-9999 |
|
|
--Address Line 1--
--Address Line 2-- |
Facsimile
Mobile | (999) 999-9999
|
|
|
| --City--
--ST--
99999 |
Emergency | (999) 999-9999 |
|
|
| | |
|
Add Additional Contact | (pick all that apply) |
| --Contact Name-- |
Business | (999) 999-9999 |
XXXXX@XXXXX.XXX
XXXXX@XXXXX.XXX |
|
|
| --Title-- |
Home | (999) 999-9999 |
|
|
--Address Line 1--
--Address Line 2-- |
Facsimile
Mobile | (999) 999-9999
|
|
|
| --City--
--ST--
99999 |
Emergency | (999) 999-9999 |
|
|
| | |
|
Add Additional Contact | (pick all that apply) |
| --Contact Name-- |
Business | (999) 999-9999 |
XXXXX@XXXXX.XXX
XXXXX@XXXXX.XXX |
|
|
| --Title-- |
Home | (999) 999-9999 |
|
|
--Address Line 1--
--Address Line 2-- |
Facsimile
Mobile | (999) 999-9999
|
|
|
| --City--
--ST--
99999 |
Emergency | (999) 999-9999 |
|
|
| | |
|
COMMENTS: |
2. POPULATION SERVED
| Population Type | Population  | Annual Operating Period  |
|---|
| Begin Date | End Date |
|---|
| MM | DD | MM | DD |
| Residential1 | 20 |
Method Used to Determine Population: |
01 |
01 |
12 |
31 |
| Transient2 | 25 | |
01 |
01 |
12 |
31 |
| Nontransient3 | 0 | |
01 |
01 |
12 |
31 |
MM = month, in 2-digit format DD = day, in 2-digit format
Descriptions:
1Residential
– report the number of persons who reside within the water system service area for more than half of the year (excludes
transient and nontransient populations). If year-round, the Begin Date would be 01/01 and the End Date would be 12/31.
2Transient
– report the number of persons who are at the water system on the 60th busiest day of the year (excludes residential and nontransient
populations. Report the Begin Date and End Date if the Transient use is seasonal.
3Nontransient
– report the number of the persons who are at the water system for over 6 months per year (excludes residential and
transient populations). Report the Begin Date and End Date if the Nontransient use is seasonal.
| List the names of communities served by the system identifying both incorporated and unincorporated areas: |
| Musick Meadows 2 is a resort community with only a few year round residents. Homes are generally occupied on Holiday weekends and during the summer. |
COMMENTS: |
3. NUMBER OF SERVICE CONNECTIONS(as of December 31, 2017)
A. Active Service Connections:
| Total Active Potable Water Connections currently in Division of Drinking Water database: | 74 |
The total number of Service Connections as of December 31, 2017 must be reported as either Unmetered or Metered for each Service Connection Type as appropriate.
| | Potable Water | Recycled Water |
|---|
TYPE
Do NOT report fire sprinkler connections and fire hydrants. These connections are not counted toward “service connections” for compliance purposes. | Unmetered | Metered | Total* | Unmetered | Metered | Total* |
|---|
Single-family Residential: single family detached dwellings | 69 |
0 |
69 |
0 |
0 |
0 |
Multi-family Residential: Apartments, condominiums, town houses, duplexes and trailer parks | 0 |
0 |
0 |
0 |
0 |
0 |
Commercial/Institutional: Retail establishments, office buildings, laundries, schools, prisons, hospitals, dormitories, nursing homes, hotels | 5 |
0 |
5 |
0 |
0 |
0 |
Industrial: All manufacturing | 0 |
0 |
0 |
0 |
0 |
0 |
Landscape Irrigation: Parks, play fields, cemeteries, median strips, golf courses | 0 |
0 |
0 |
0 |
0 |
0 |
Agricultural Irrigation: Irrigation of commercially-grown crops | 0 |
0 |
0 |
0 |
0 |
0 |
Total Active Connections* | 74 |
0 |
74 |
0 |
0 |
0 |
*Calculated field
| | Potable Water | Recycled Water |
|---|
| TYPE | Unmetered | Metered | Total* | Unmetered | Metered | Total* |
|---|
Other: Fire suppression, street cleaning, line flushing, construction meters, temporary meters | 0 |
0 |
0 |
0 |
0 |
0 |
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.” | 7 |

C. Number of NON-residential customers required to have dedicated outdoor irrigation meters (excluding agricultural connections)  | |
COMMENTS: |
4. GROUNDWATER (GW) AND SURFACE WATER (SW) SOURCES
GROUNDWATER SOURCES (INCLUDING STANDBY SOURCES)
PSCode  | Name | Activity  |
| 1000061-004 | FCWWD #41 PURCHASED WATER | A |
| 1000061-002 | WELL 02 - FRONT OF HOUSING | A |
| 1000061-001 | WELL 01 - BACK OF HOUSING | A |
| 1000061-003 | WELL 03- INACTIVE | I |
| 1000061-005 | WELL 04 | A |
| | | |
Add sources not listed above. Describe changes to sources above under "Comments".
PSCode  | Name | Activity  | Comments |
| | | | |
| | | | |
| | | | |
| | | | |
| | | | |
| | | | |
SURFACE WATER INTAKES
PSCode  | Name | Activity  |
| | | |
| | | |
| | | |
| | | |
| | | |
| | | |
Add sources not listed above. Describe changes to sources above under "Comments".
PSCode  | Name | Activity  | Comments |
| | | | |
| | | | |
| | | | |
| | | | |
| | | | |
| | | | |
Are your water sources metered?
DISCUSS CHANGES TO ABOVE SOURCES
If a STANDBY SOURCE was used in 2017, provide the following information.
Name of the Standby Source used in 2017: | No. of days the Standby Source was in operation: | Were customers notified? (Y/N) | Was DDW or Local County Staff notified? (Y/N) | Describe the reason the Standby Source was used: |
| | | | | |
| | | | | |
| | | | | |
| | | | | |
COMMENTS: |
5. WATER PRODUCED, PURCHASED AND SOLD
The Maximum Day is the day during 2017 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.

Units of Measure for the Maximum Day ONLY:
Mark this box if your water system does not have monthly production data.
If you do not have monthly production data to report, please report your Annual Total production in the row for January and leave all the other months blank.
Units of Measure for this table except for the Maximum Day:
Volumes are based on:
| A | B | C | D | E | F | G | H | I |
|---|
| | Potable Water | Non-potable (exclude recycled) | Recycled |
|---|
| | Date/ Month | Water Produced from Groundwater (Wells) | Water Produced from Surface Water2 | Finished Water Purchased or Received from another PWS5 | Total Amount of Potable Water3* | Water Sold to Another PWS5 |
|---|
| Maximum Day1 | |
|
|
|
0 |
|
| January | 130206 |
0 |
0 |
130206 |
0 |
0 |
0 |
| February | 150091 |
0 |
0 |
150091 |
0 |
0 |
0 |
| March | 125313 |
0 |
0 |
125313 |
0 |
0 |
0 |
| April | 114150 |
0 |
0 |
114150 |
0 |
0 |
0 |
| May | 118971 |
0 |
0 |
118971 |
0 |
0 |
0 |
| June | 144694 |
0 |
0 |
144694 |
0 |
0 |
0 |
| July | 220078 |
0 |
0 |
220078 |
0 |
0 |
0 |
| August | 166388 |
0 |
0 |
166388 |
0 |
0 |
0 |
| September | 132105 |
0 |
0 |
132105 |
0 |
0 |
0 |
| October | 166399 |
0 |
0 |
166399 |
0 |
0 |
0 |
| November | 98126 |
0 |
0 |
98126 |
0 |
0 |
0 |
| December | 100132 |
0 |
0 |
100132 |
0 |
0 |
0 |
| Annual Total* | 1666653 |
0 |
0 |
1666653 |
0 |
0 |
0 |
| 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
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 flouridation.
5If water was Purchased from or Sold to another PWS, complete the table below:
Specify whether water was Purchased or Sold | Name of PWS |
| | |
| | |
| | |
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 |
| | |
| | |
| | |
COMMENTS: |
6a. WATER RATES
If you have questions about completing this section of the report, please contact Kathy.Frevert@Waterboards.ca.gov or call (916) 322-5274.

Mark this box if your water system does not charge a water rate and skip the rest of Section 6a.
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 | 8/1/2016 |
| Describe the changes that were made in the update: | annual increase |
| What is your billing frequency |
What is your new connection fee?  | 750.00 |
Date of most recent update to the new connection fee: MM/DD/YYYY | 01/01/2000 |
Complete the table below providing specific water rates applied to your customers:
| Connection Type | FLAT BASE RATE (FBR) | If FBR + UUR, what is the volume allowed before UUR applies | UNIFORM 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 |
|---|
RESIDENTIAL  |
| Single-family Residential | 750.00 |
0 |
0 |
0 |
0 |
0 |
0 |
| Multi-family Residential | 0 |
0 |
0 |
0 |
0 |
0 |
0 |
| Do you provide lifeline/low income subsidies? | |
| If Yes, provide rates: | |
|
|
|
|
|
|
| If yes, what percentage of residential customers receives this subsidy? (Example: X %) | % |
NON-RESIDENTIAL  |
| Commercial/Institutional | 785.00 |
0 |
0 |
0 |
0 |
0 |
0 |
| Industrial | 0 |
0 |
0 |
0 |
0 |
0 |
0 |
| Landscape Irrigation | 0 |
0 |
0 |
0 |
0 |
0 |
0 |
| Agricultural Irrigation | 0 |
0 |
0 |
0 |
0 |
0 |
0 |
| Other | 240.00 |
|
|
|
|
|
|
| Do you have fire suppression surcharges? | |
| If Yes, provide rates: | |
|
|
|
|
|
|
| Do you have other surcharges? | |
| What are the other surcharges? | |
| If Yes, provide rates: | |
|
|
|
|
|
|
For each of the three water volumes shown below, provide what would be the monthly water bill for a single-family residential customer.
Include all fees and service charges associated with water services that this customer would pay when their household used the specified amount of water.
| Amount of water delivered to customer: | Bill amount (including all charges/fees associated with the amount of water used): |
| a. 6 HCF | 62.50 Dollars/month |
| b. 12 HCF | 62.50 Dollars/month |
| c. 24 HCF | 62.50 Dollars/month |
NOTE: If this is not a "Community" Water System or if individual customers do not pay a separate bill for water enter "0".
If bill amount would vary by season, use the month or time period with the highest water consumption.
HCF means “hundred cubic feet”. There are 748 gallons in 100 cubic feet. 
6b. WATER DELIVERIES

Mark this box if your water system does not have monthly water deliveries data and skip the rest of Section 6b.
Units of Measure for this table:
Provide monthly metered water deliveries in the table below.
PWS = Public Water System
*Calculated field
1Total Urban Retail = Sum of Columns (B) thru (G), automatically calculated. To update, click below
COMMENTS: |
7. WATER QUALITY
ANNUAL NITRATE SAMPLING
Regulations require a minimum of annual sampling for nitrate. If any nitrate result is >= 1/2 the MCL (Maximum Contaminant Level) of 10 mg/l as nitrogen (i.e., a result of >= 5 mg/l
as nitrogen) then quarterly monitoring must be initiated.
| Did your system conduct monitoring for nitrate during 2017 from each source? | |
NOTE: If there were any sources that were not monitored because they were offline during 2017, 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: | 01/01/2015 |
COMMENTS: |
8. WATER TREATMENT
| Treatment Plant | Required Treatment Plant Operator Classification |
| | |
| | |
| | |
| | |
If treatment was added or changed in any way in 2017, provide a brief description and identify the water source
TD = Treatment or Distribution operator at any level
NR, N/A, NA = There are no facilities subject to the Certified Treatment Plant Operator requirements
DIRECT ADDITIVES
Are all chemicals used NSF/ANSI Standard 60 certified?  | |
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: McMor, is the certified distribution operator and disinfection contact. |
9. CROSS-CONNECTION CONTROL
| Total Number in System | Number Installed in 2017 | Number Tested in 2017 | Number Failed in 2017 | Number Repaired/ Replaced |
|---|
Backflow Assemblies  on the Service Connections or Meter (Reduced Pressure Principle and Double Check Valve assemblies) | 74 |
0 |
0 |
0 |
0 |
Backflow Assemblies On-site but not on the Service Connections or Meter (Reduced Pressure Principle and Double Check Valve assemblies) | 0 |
0 |
0 |
0 |
0 |
Air-gap Separation | 0 |
0 | | | |
No. of Inactive Backflow Prevention Assemblies in water system in 2017 : | |
| Date of last cross-connection control survey done on the system: | 10/31/17 |
|
| Cross Connection Control Program Coordinator |
| Name: | |
| Certification Number: | |
| Business Phone: | (661)323-9400 |
Email Address: | |
| Certification or training received: |
Describe any cross-connection incidents
that occurred during 2017:
COMMENTS: |
10. CONSUMER CONFIDENCE REPORT
(does not apply to Transient Noncommunity water systems)
THE 2017 CCR MUST BE DISTRIBUTED TO YOUR CUSTOMERS AND A COPY SUBMITTED TO YOUR LOCAL REGULATORY AGENCY BY JULY 1, 2018. 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, 2018.
CERTIFICATION MUST BE SUBMITTED TO YOUR LOCAL REGULATORY AGENCY BY OCTOBER 1, 2018, STATING THAT THE 2017 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 2017 CCR was distributed or will be distributed to your customers: | 07/01/2018 mm/dd/yyyy |
COMMENTS: |
11. 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: There are no facilities subject to the Certified Treatment Plant Operator requirements
If you do not have a Certified Distribution System Operator, put "NONE" in each column of the first row.

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): | |
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) |
| none | 0 | 0 | 0 | 0 |
| | | | | |
| | | | | |
| | | | | |
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: D1
If you do not have a Certified Distribution System Operator, put "NONE" in each column of the first row.

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): | |
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) |
| Dennis Gatson | 2 | C | 36709 | 10/01/2018 |
| | | | | |
| | | | | |
| | | | | |
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: |
12. WATER SYSTEM IMPROVEMENTS
The California Waterworks Standards (Section 64556) require an amended permit for any of the following improvements or modifications:
- Addition of a new distribution reservoir with a capacity of 100,000 gallons or more
- Modification or extension of the existing distribution system using an alternative to the requirements of the California Waterworks Standards
(see Sections 64570 through 64578) - Modification of the water supply by:
- Adding a new source
- Changing the status of an existing source (for example, active to standby) or
- Changing or altering a source, such that the quality or quantity of water supply could be affected
- Any addition or change in treatment, including
- Expansion of the existing service area by 20 percent or more of the number of service connections specified in your current permit.
If your water system made any improvements or modifications during 2017 for which a permit was not obtained, please describe the improvements
or modifications below.
Drilled well and was approved
Indicate any planned improvements or modifications for 2018.
Install remote read meter heads so we can start monitoring individual usage
COMMENTS: |
13. COMPLAINTS REPORTED (WRITTEN OR VERBAL)
| Type of Complaint | No. 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 Outages | |
|
|
|
Illnesses (Waterborne) | |
|
|
|
| Other (Specify) | |
|
|
|
Total No. of Complaints* | 0 |
0 |
0 | |
*Calculated field
COMMENTS: |
14. SYSTEM PROBLEMS
| Type of Problem | No. 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 | 4 |
|
|
Power company hit lines; Repaired, disinfected and brought back into service |
Water Outages | |
|
|
|
| Boil Water Orders | 1 |
|
1 |
E. coli occurence; notified the Division and residents; Installed 4 backflow devices |
| Total* | 5 |
0 |
1 | |
COMMENTS: |
15. ONGOING WATER SYSTEM VIOLATIONS
| Is your water system operating under USEPA, Division or LPA enforcement for a continuous violation? | |
If yes, respond to the following:
| Type of violation (for example, specify “Nitrate MCL” violation if your wells exceeds the nitrate MCL of 45 mg/L |
|
| Dates in 2017 that public notification was provided to users |
|
| Corrective action taken in 2017 |
|
| Was bottled water provided to users? | |
| If yes, how was bottled water provided, for example, direct delivery? |
|
| Describe anticipated schedule to return to compliance |
|
COMMENTS: |
16. WATER CONSERVATION AND DROUGHT PREPAREDNESS
| Date of your revised Drought Preparedness Plan or Water Shortage Contingency Plan, if any: | |
Units of Measure for this section:  | |
| If you experienced water shortages in 2017, please estimate the amount of shortfall in units selected for this section: | |
| How many water-shortage response stages are in your drought plan? For “non-applicable”, enter zero. | |
| Did drought conditions cause you to activate emergency standby wells in 2017? | |
Do you project water shortages in the current calendar year?  | |
| Did you implement NEW water conservation measures in 2017? | |
If you implemented NEW water conservation measures in 2017, please estimate how much water was conserved: volume of water in units selected for this section
% 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: |
17. CLIMATE CHANGE ADAPTATION AND RESILIENCY FOR WATER UTILITIES

ONLY FOR COMMUNITY WATER SYSTEMS
Your water system classification is: Community Water System 
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)?  |
| 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 Depletion | Decreased 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 snowmelt | Choose an item |
Region relies on water diverted from the Delta, imported from the Colorado River, or other climate-sensitive area | Choose an item |
| Water Quality Degradation | Salt-water intrusion into aquifers | Choose 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 species | Choose an item |
| Flooding | Sea Level Rise | High flow events and flooding | Choose an item |
| Inundation due to sea level rise, high tides, and/or coastal storm surges | Choose an item |
| Aging flood protection infrastructure (levees), or insufficient impoundment capacity | Choose an item |
| Extreme Heat | Peak demand volume surges (due to extreme heat, temperature trends, etc.) | Choose an item |
| Increases in agricultural water demand or energy sector needs | Choose an item |
| Fire | Other Impacts | Increased fire risk and altered vegetation, e.g., wildfires | Choose an item |
| Disruption of power supply | Choose an item |
| Other |
Choose an item |
| C. ADAPTATION MEASURES |
Identify measures to reduce current vulnerability, or make future modifications based on identified sensitivity of the water system. Indicate status for all projects that your organization has completed, or plan to implement to increase resiliency of the water system to climate change? 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 capacity | Choose 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 facilities | Choose 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, partnerships | Choose an item |
| Alternative or backup energy supply | Choose an item |
| On-site energy generation | Choose an item |
| Enhance monitoring program, budget for additional testing and treatment, chemicals | Choose an item |
| Other |
Choose an item |
18. LEAD SERVICE LINE REPLACEMENT

ONLY FOR COMMUNITY WATER SYSTEMS
Your water system classification is: Community Water System
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 (CWS) to compile an inventory of known partial or total lead user service lines in use in its distribution system by July 1, 2018. The inventory must include all user service lines that are active and those that are reasonably expected to become active in the future. Also, Section 116885 requires that CWS identify areas that may have lead user service lines in use, and/or identify any areas within the CWS distribution system that the CWS cannot identify the material that is being used for the service line.
For additional information, 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.
| Date lead service line inventory was completed (MM/DD/YYYY): | 07/17/2018 |
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 Material | Estimated Number of Service Lines (Enter “0” if none) | Estimated Total Length of Service Lines (In feet), if applicable |
|---|
| A. Lead | 0 |
|
| B. Unknown material | 0 |
|
| C. Copper | 0 |
| D. Cast iron (ductile pipe) | 0 |
| E. Ductile iron | 0 |
| F. Galvanized steel | 0 |
| G. Polyvinyl chloride (PVC) | 0 |
| H. Polyethylene (PE) | 0 |
| I. High density polyethylene (HDPE) | 73 |
| J. Polybutylene (PB) | 0 |
| K. Transite/asbestos cement | 0 |
| L. Other materials not listed above: | |
| Identify material 1 | |
0 |
| Identify material 2 | |
0 |
| Identify material 3 | |
0 |
| Identify material 4 | |
0 |
| Total number of service lines inventoried* (calculated field) | 73 |
| Total number of service connections from Section 3 of the EAR | 73 |
Fittings or fittings connecting a water main: | | | M. Lead fittings NOT on a lead pipe(e.g., goosenecks, pigtails, and corporation stops) | 0 |
| N. Lead fittings ON a lead pipe (e.g., goosenecks, pigtails, and corporation stops) | 0 |
| O. Fittings of unknown material (e.g., goosenecks, pigtails, and corporation stops) | 0 |
| Total number of lead service lines** (calculated field) | 0 |
*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. PRINT THIS INVENTORY FORM FOR YOUR SIGNATURE
I certify under penalty of perjury under the laws of the State of California that the foregoing [including any uploaded documents] is true and correct to the best of my knowledge.
| Signature: |
| Name: | Joseph M. Leonardo |
| Title: | Board President |
| Phone number: | 559-260-8620 |
| Date signed (MM/DD/YYYY): | 7/17/18 |
| PWS Name: | MUSICK MEADOWS #2 |
| PWS No.: | CA1000061 |
Print this completed form by clicking “Print” below, sign and scan. This is your certified form.
Print
D. UPLOAD SIGNED INVENTORY FORM AND MAP(S) IDENTIFYING AREAS WITH LEAD SERVICE LINES OR SERVICE LINES CONSTRUCTED OF UNKNOWN MATERIAL
Click HERE to upload the certified form if no lead service lines or service lines constructed of unknown material were identified.
OR
Click HERE to upload the maps (only .shp, .kml or .kmz, and .pdf in order of preference) only if you have areas with lead service lines or service lines constructed of unknown material and upload the certified form.
Disclosure: Be advised that Sections 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 purposes of compliance may be liable for a civil penalty not to exceed
five thousand dollars ($5,000) for each separate violation 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 the violation, or be imprisoned in county jail
not to exceed one year, or both the fine and imprisonment.