Wastewater Collection System of the Year Award

SECTION 1
Nominator Information Please complete the following information for the person completing this nomination.
Nominator Full Name *
Nominator Organization *
Nominator Professional Title
Nominator Address (Include City, State, and Zip) *
Nominator Phone *
Nominator Email Address *
SECTION 2
Organization General Information Complete the following fields related to the organization being nominated for the award.
Facility Name
Utility Name
Facility Type	Water Treatment Water Distribution Wastewater Collection Wastewater Treatment
Facility Address (Include City, State, and Zip)
Facility Contact Person and Professional Title
Contact Person Phone Number
Contact Person Email
SECTION 3
Utility Memberships Please indicate which (if any) the organization has a membership with.
Memberships (select all that apply)	AWWA WEF
SECTION 4
Collection System Data Fill in the fields regarding the organizations collection system.
Collection System Data

Miles of Gravity Sewer in System
Number of Service/Lateral Connections
Number of Pump Stations
Number of Sewer Manholes
Miles of Sewer Force Main
Number of Force Main Air Release Valves
Number of Food Service Establishments (FSEs)
SECTION 5
Collection System Performance Fill in the fields regarding the organizations collection system.
Number of Dry Weather SSOs
Number of Wet Weather SSOs
Total Volume of SSOs Reported to DENR (gals) Last Year
Total Volume of SSOs Reported to DENR (gals) Prior Year
Amount of Rainfall Last Year (inches)
Number of Gravity Sewer Cave-ins/Emergency Repair
Number of Sewer Force Main Failures
SECTION 6
Collection System Preventative Maintenance Activities Fill in the fields with information from the most recent fiscal year, unless noted as last 3 years.
Number of Permanent Flow Monitors
Number of Temporary Flow Monitors
Number of Rainfall Monitoring Gauges
Number of Temporary Flow Monitor Meter Months (Number of Meters times number of months installed)
Number of Temporary Flow Monitor Meter Months Last 3 Years
Number of Gravity Sewer Preventive Maintenance Point Repairs
Number of Fats, Oils, and Grease Facility (FSE) Inspections
Number of Pump Station Capacity Assessments Performed
Miles of Gravity Sewer Root Treatment/Root Removal
Miles of Gravity Sewer Root Treatment/Root Removal Performed Last 3 years
Number of Force Main Air Release Valve Inspections
Miles of Force Main Inspected Last 3 Years (internal inspection documented)
SECTION 7
Annual Operations and Maintenance Activities Fill in the fields with information from the most recent fiscal year, unless noted as last 3 years.
Annual Review of Inspection, Maintenance, operational and Complaint Logs	Yes No
CCTV Defect Coding using PACP Rating System	Yes No
Miles of Public Gravity Sewer CCTV Inspection
Miles of Gravity Sewer Cleaned
Miles of Gravity Sewer Cleaned Once
Number of Manholes Inspected (internal condition documented)
Number of Manholes Inspected Last 3 Years
Miles of Gravity Sewer Smoke Tested
Miles of Gravity Sewer Smoke Tested Last 3 years
Number of Service/Lateral Inspected (internal condition documented)
SECTION 8
Annual Rehabilitation and Replacement Activities Fill in the fields with information from the most recent fiscal year, unless noted as last 3 years.
Capital Improvement Plan adopted and designating funds for short and long-term reinvestment needs?	Yes No
Routine pump station rehabilitation and replacement program implementation?	Yes No
Miles of Gravity Sewer Rehabilitated/Replaced
Miles of Gravity Sewer Rehabilitated/Replaced Last 3 Years
Rehabilitation and Replacement Expenditures (Collection System ,Force Mains, & Pump Stations Only)
Rehabilitation and Replacement Expenditures Last 3 Years (Collection System, Force Mains, & Pump Sta
Number of Manholes Rehabilitated/Replaced
Number of Manholes Rehabilitated/Replaced Last 3 Years
SECTION 9
Uploading Supporting Documents If you would like to upload responses to open-ended questions, or additional materials, please convert them to PDF format and merge all documents into a clearly labeled file.
Upload any supporting documents here