Water Distribution 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 Any That Utility is Member Of)	AWWA WEF
SECTION 4
Distribution System Data Fill in the fields with information from the most recent fiscal year(s).
Miles of drinking water pipe in System
Population Served
Number of Metered Customers
Number of Storage Tanks
Number of Pump Stations
Number of Valves
Number of Total Water Distribution Staff
Number of Certified staff
Non Revenue Water (%)
Number of Water Quality Customer Complaints (Last year)
Number of Water Quality Customer Complaints (Last 3 years)
Number of Water Main Breaks/Leaks (Last year)
Number of Water Main Breaks/Leaks (Last 3 years)
Number of Service Breaks/Leaks (Last year)
Number of Service Breaks/Leaks (Last 3 years)
Number of coliform hits (Last year)
Number of coliform hits (Last 3 years)
Number of NOVs (Last year)
Number of NOVs (Last 3 years)
SECTION 5
Water Distribution System Management Activities Fill in the fields with information from the most recent fiscal year(s).
System-wide Hydraulic Model updated regularly?
Capital Improvement Plan adopted designating funding for short and long term reinvestment needs?
AMR program implemented?
Last date Design Standards Updated
Collect, document, and retain information on pipe coupons?
Work Order Management System in place for tracking maintenance?
Has a water audit been conducted?
SECTION 6
Annual Operations and Maintenance Activities Fill in the fields with information from the most recent fiscal year(s).
Routine review of inspection, maintenance, operational and complaint logs?
Number of Valves exercised (Past Year)
Leak Detection Program
Percentage of System covered by leak detection
How often is each tank inspected?
How often is each tank rehabilitated?
Pump station inspection program?
Annual flushing program?
Uni-directional flushing program?
Percentage of system flushed?
Documented Backflow/Cross Connection Prevention Program?
Dedicated program to maintain/exercise hydrants?
Tank Maintenance Program?
Number of Pump Stations with SCADA
SECTION 7
Annual Rehabilitation / Replacement Activities Fill in the fields with information from the most recent fiscal year, unless noted as last 3 years.
Miles of Pipe Renewal (Lined or Replaced) Last Year
Miles of Pipe Renewal (Lined or Replaced) Last 3 Years
Renewal Expenditures Last Year (Pipes lined or replaced)
Rehabilitation & Replacement Expenditures Last Year (Storage tanks only)
Rehabilitation & Replacement Expenditures Last Year (Pump Stations only)
SECTION 8
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