EmailMe Form - GROUND WATER GRADE SHEET

Category

Ground Water
Plant *
Inspector (Note: Each Inspector Must Fill Out Their Own Form) *
Grade Sheet Submittal Options: *
If you prefer to upload a scan of your score sheets instead of filling out the online form, please do so here:
I. Chemicals
Adequacy of Equipment (Scales, Automatic Changeover, Ventilation Fan, Spare Parts, Pressure Gauges, Feeding Properly, etc.) *
Operating Condition (Pumps Working, Corrosion Due to Gas Leak, Lime Build Up, etc.) *
Maintenance (Operable Scales, Pump Packing Leaks, Cleaning, Lubrication, etc.) *
Overall Condition *
II. Pumping Equipment
Adequacy of Equipment (Duplicate Pumps, Well Level Monitoring Equipment, Pump to Waste Line, Pressure Gauges, Sample Taps, etc.) *
Operating Condition (Vibration, Pumping Air, Overheating, etc.) *
Maintenance (Lubrication, Packing Leak, Dirty Air Takes, etc.) *
Physical Appearance (Equipment Painted, Area Clean, etc.) *
Overall Condition *
III. Water Quality Performance

Ground Water

(Yes = 2 points, No = 0 points)

	Yes	No
Secondary Drinking Water Constituent Color Entering Distribution System Below MCL of 15 Color Units
Secondary Drinking Water Constituent pH Entering Distribution System Between MCL of 6.5-8.5
Secondary Drinking Water Constituent Iron Entering Distribution System Below MCL of 0.3 mg/L
Secondary Drinking Water Constituent Manganese Entering Distribution System Below MCL of 0.05 mg/L

(Yes = 2 points, No = 0 points)

	Yes	No
Produce Monthly Operating Reports for Previous Year
Produce Consumer Confidence Report for Previous Year
Has Unexpired Reagents on Hand
Uses EPA Approved Test Methods
Unaccounted for Water 15% or Less for Previous Year
Has Preventative Maintenance Schedule for Pumps
Has Pump Capacity Test Results
Has Distribution Flushing Schedule
Has Cross-Connection Policy
Can Produce Previous Year Bacteriological Results & Previous Year Chemical Results (VOC, SOC, Lead & Copper, etc.)
Has Current Sample Siteing Plan
Well Levels Recorded @ Each Site

V. Appearance & General Condition
Interior of Facilities *
Exterior of Facilities *
Overall Maintenance *
VI. Safety
(Yes = 1 point, No = 0 points) *

Yes No

Has Appropriate Danger Signs

Has Appropriate Safety Equipment on Hand
VII. Operators & AWPCA Affiliation
(Yes = 1 point, No = 0 points) *

Yes No

Has a Certified Operator

Has Attended AWPCA Short Course in the Last 3 Years

Has AWPCA Members
VIII. Operators & Employees
Overall Rating of Operators Knowledge of System *
IX. Bonus Point
(Yes = 1 point, No = 0 points) *

Yes No

Flouride Fed @ Facility & Maintained Between 0.5-0.9 mg/L
A Note on Scoring:
Due to limitations of the form, please save and resume when complete to see the valid score for the options selected. Sorry for the inconvenience while we look into better options.

	Yes	No
Has Appropriate Danger Signs
Has Appropriate Safety Equipment on Hand

	Yes	No
Has a Certified Operator
Has Attended AWPCA Short Course in the Last 3 Years
Has AWPCA Members

	Yes	No
Flouride Fed @ Facility & Maintained Between 0.5-0.9 mg/L