Technical Assistance Third Party Technical Assistance Providers Rural Community Assistance Corporation 1403 South Grand Blvd, Suite 203 S. Spokane, WA 99203 360-863-2419 509-860-7063 Evergreen Rural Water of Washington P.O. Box 2300 Shelton, WA 98584 360-462-9287 Washington State Department of Health Office of Drinking Water Town Center 3 (243 Israel Road SE, Tumwater) P.O. Box 47822 Olympia, WA 98504-7822 360-236-3100 or 800-521-0323 16201 E Indiana Ave, Suite 1500 Spokane Valley, WA 99216 509-329-2100 (Adams, Asotin, Benton, Chelan, Columbia, Douglas, Ferry, Franklin, Garfield, Grant, Kittitas, Klickitat, Lincoln, Okanogan, Pend Oreille, Spokane, Stevens, Walla Walla, Whitman and Yakima counties) 20435 72nd Ave. S., Suite 200 Kent, WA 98032 253-395-6750 (Island, King, Pierce, San Juan, Skagit, Snohomish and Whatcom counties) Town Center 3 ( 243 Israel Road SE, Tumwater) P.O. Box 47823 Olympia, WA 98504-7823 360-236-3030 (Clallam, Cowlitz, Clark, Grays Harbor, Jefferson, Kitsap, Lewis, Mason, Pacific, Skamania, Thurston and Wahkiakum counties) We designed this guidebook with internet access in mind This guidebook is available in electronic format only. You can download it or request a copy in CD format at the publications link below. Our publications are online at Our forms are online at For people with disabilities, this document is available on request in other formats. To submit a request, please call 1-800-525-0127 (TDD/TTY call 711).
Do you have a document that establishes the legal authority to make decisions for the system? For example, by-laws, resolutions, ordinances? Yes. If yes, attach a copy. No Do you have any insurance policies for the system? Yes. No. Who makes the major decisions? For example, who decides when to make improvements, how to finance improvements, when to allow additional connections. Single party Board (how many members) System customers or a representative subset of customers Commissioners (how many commissioners) Other How long are the terms of service for members of the body? How often do those responsible for making decisions meet? Monthly When necessary Annually Quarterly Other Are customers notified about these meetings? Yes No If yes, how are they notified? Is there an organizational chart? Yes. If yes, attach a copy. No Does the system have any paid employees? Yes No If yes, do you have personnel policies? Yes No Identify the persons or positions responsible for making financial transactions. For example, who maintains records, pays bills, and receives payments? Do you have a process to record and respond to customer complaints? Yes No. If yes, explain your process.
Table 2-5A Water Rights Self Assessment Existing Status Permit certificate or claim number Name on document Priority Date (List oldest first) Source Name and Number Any portion supplemental? (If yes, explain in footnote) Existing Water rights Existing consumption Current water right status (Excess/Deficiency) Maximum Instantaneous Flow Rate (Qi) Maximum Annual Volume (Qa) Maximum Instantaneous Flow Rate (Qi) Maximum Annual Volume (Qa) Maximum Instantaneous Flow Rate (Qi) Maximum Annual Volume (Qa) Permits/ Certificates 1. 2. 3. 4. Claims 1. 2. 3. 4. TOTAL Intertie name or Identifier Name of purveyor Providing water Existing limits on intertie use Existing consumption through intertie Current intertie supply status (Excess/Deficiency) Maximum Instantaneous Flow Rate (Qi) Maximum Annual Volume (Qa) Maximum Instantaneous Flow Rate (Qi) Maximum Annual Volume (Qa) Maximum Instantaneous Flow Rate (Qi) Maximum Annual Volume (Qa) 1. 2. 3. 4. TOTAL Pending water right application (New/Change) Name on application Date submitted Any portion supplemental? (If yes, explain in footnote) Pending water rights Maximum Instantaneous Flow Rate (Qi) Requested Maximum Annual Volume (Qa) Requested 1. 2. 3. 4.
Table 2-5B Water Rights Self Assessment 6 Year Forecast Permit certificate or claim # Name on document Priority Date (List oldest first) Source Name or Number Any portion supplemental? (If yes, explain in footnote) Existing Water rights Forecasted water use from sources (6-year Demand) Forecasted water right status (Excess/Deficiency) Maximum Instantaneous Flow Rate (Qi) Maximum Annual Volume (Qa) Maximum Instantaneous Flow Rate (Qi) Maximum Annual Volume (Qa) Maximum Instantaneous Flow Rate (Qi) Maximum Annual Volume (Qa) Permits/ Certificates 1. 2. 3. 4. Claims 1. 2. 3. 4. TOTAL Intertie name/ Identifier Name of purveyor Providing water Existing limits on intertie use Forecasted consumption through intertie Forecasted intertie supply status (Excess/Deficiency) Maximum Instantaneous Flow Rate (Qi) Maximum Annual Volume (Qa) Maximum Instantaneous Flow Rate (Qi) Maximum Annual Volume (Qa) Maximum Instantaneous Flow Rate (Qi) Maximum Annual Volume (Qa) 1. 2. 3. 4. TOTAL Pending water right application (New/Change) Name on application Date submitted Any portion supplemental? (If yes, explain in footnote) Pending water rights Maximum Instantaneous Flow Rate (Qi) Requested Maximum Annual Volume (Qa) Requested 1. 2. 3.