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<br />EXHIBIT F
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<br />CDH.WQcO
<br />DRINKING WATEH SECTION
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<br />ANNUAL INSPECTION-PUBLIC WATER SUPPLY
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<br />OWNERSHIP ~
<br />PWSID..l..L i'... q 0 n ,COUNTY (lO.'. ! I / I: .t:'C~ NON,COM
<br />DATE~I()'X "-SYSTEM NAME ~~ k ,L<!..L:>. wL.C...____,__
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<br />OWNER BUSINESS ADDRESS p, 0 . I:').L::Jl~__i:L.k....-
<br />CITY "~'V 1--.,>\.11 ~ ____,STATE_ CO _zIP.5Ll.Lf:.L
<br />BUSINESS PHONE L-> {, 7? - :'i'.. CJ <-EMERGENCY PHONE <--J ,t, 77- - ../ / !2.Q
<br />PLANT ADDRESS (PHY LOCATIONl ~ Iv~ll~ ~~f.u.o. c ,1:f ..Lm.U1.L__,
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<br />LEGAL OWNER NAME (ENTITYIINDJ
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<br />II.
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<br />DESIGN DATA
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<br />POPULATIO'" SERVED: RESIDENT I ,--, 0 <:> NO~J.I~E5IDENT
<br />IS TRANSIE~IT POPULATION SEASONAe8~)-- EXf'LAIN ~ \ ,.". ~
<br />III. TREATMENT/O&M
<br />TREATMENT ADEQUATE-f<:;ES~O} , __. .
<br />BRI~F PROCESS DESCRIPT1(~~rlC~LORIN~ TION, FLOCCULA TION, COAGULATION. etcJ ~___~
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<br />COMMENTS:
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<br />MECHANICAL FAILURES (YES/NO) EXPLAIN: _ _
<br />FREE CL2 RESIDUAL ~ DISINFECTION WAIVER (Y~;;~
<br />PLANT CLAS51FICA TION D __:::: OPERATOR AT PROPER LEVEL (VES/NO)
<br />OPERATOR NAME k'. co_ k.. }/I)Q. J I ~1 cl. .,__
<br />OPERATOR CLASS/LICENSE NUMBER ,) , ~:z..{~~__.
<br />CHANGE IN SOURCE FROM LAST INSPECTION? (YEeXPL.AIN IN COMMENTS.
<br />POTENTIAL HAZARDSlUPSET CONDITIONS \ \ ~~._._
<br />PROCESS SIZING ADEOUAT(~~O) EXPLAIN: _____.___
<br />EST TIME TO FACILITY CAPA~ "?. (, D 0 _
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<br />IV. REGULATED CONTAMINANT LEVELS
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<br />ANY CONTAMINANT LEVELS EXCEEDED FROM LAST INSPECTION (V/Nl WHEN
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<br />TYPE CONTAMINANT f) C) '-':..-. /GIVE DATES OF LAST SAMPLES SUBMITTED TO THE STATE:
<br />ORGANICS }\,/ ,/1" THMs ,U lic' IN~ICS_"+-S-:.LRAC"OLOGICAL_LL Is"
<br />TURBIDITY (REO'O) I\} I,;' I rORROSIVITY (FORM SUBMITTED] II " I ,.:., !
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<br />BACTERIOLOGICAL: NUMBER OF REQUIRED SAMPLESlMONTH _ ^<-
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<br />BACT IN COMPLlANC~;~ES'O): MCL V MONITOF:lNG _ (..
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<br />V. ENfORCEMENT ORDERS _, .
<br />is THE SYSTEM IN COMPLlANC0YES,'~1 EXPLAIN: ___
<br />UNDER AN ENFORCEMENT ORDER?'~ ) L-() __.___
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<br />WILL THE SYSTEM MEET COMPLIANCE SCHEDULE? EXPLAIN '-"";
<br />PERSON INTERVIEWED 1._, c k l; I- I.. /! I Y':GJ~_
<br />CDH ENGINEER~.,.- d l--..J,':') Y)l..<:30-J
<br />COMMENTS:
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