Does Your Water System Disinfect the Water? YES NO (Go to 2.B) Days of Location Disinfectant Type of Volume Electricity Storage Disinfectant (Plant Used During an Disinfectant Stored Required to Feed (Emergency Name) Emergency? (Liquid/Gas) (gals or lbs) Disinfectant? Demand) YES NO YES NO YES NO YES NO YES NO YES NO Does Your Water System Provide Treatment Other Than Disinfection? YES NO (Go to 2.C) Days of Location Chemical Used Type of Volume Electricity Storage Chemical (Plant During an Chemical Stored Required to Feed (Emergency Name) Emergency? (Liquid/Gas) (gals or lbs) Chemical Demand) YES NO YES NO YES NO YES NO YES NO YES NO Does Your Water System Have Any Transfer Pump(s) In Your Treatment Plant(s)? (Do not include well or intake pumps) YES NO (Go to 3.A) Location Pump Used During Unit Preceding Unit Directly After Pump Pump Capacity (Plant Name) an Emergency? Pump Pump gpm YES NO gpm YES NO gpm YES NO DISTRIBUTION SYSTEM INFORMATION Does Your Water System Have Distribution Pumps? YES NO (Go to 3.B) Location (include Pump Used During Facility Preceding Facility Directly After Pump Pump Capacity pressure an Emergency? Pump Pump plane) gpm YES NO gpm YES NO gpm YES NO Does Your Water System Have Any Finished Water Storage/Pressurization Tanks? YES NO (Go to 4.A) Storage Tank Type Location (Elevated, (include Tank Used During Facility Preceding Facility Directly After Tank Capacity Hydropneumatic, pressure an Emergency? Tank Tank Ground or Stand) plane) YES NO gal YES NO gal YES NO gal PRESSURE PLANES
Does Your Water System Disinfect the Water? YES NO (Go to 2.B) Disinfectant Location (Plant Name) Disinfectant Used During an Emergency? Type of Disinfectant (Liquid/Gas) Volume Stored (gals or lbs) Days of Storage (Emergency Demand) Electricity Required to Feed Disinfectant? YES NO YES NO YES NO YES NO YES NO YES NO Does Your Water System Provide Treatment Other Than Disinfection? YES NO (Go to 2.C) Chemical Location (Plant Name) Chemical Used During an Emergency? Type of Chemical (Liquid/Gas) Volume Stored (gals or lbs) Days of Storage (Emergency Demand) Electricity Required to Feed Chemical YES NO YES NO YES NO YES NO YES NO YES NO Does Your Water System Have Any Transfer Pump(s) In Your Treatment Plant(s)? (Do not include well or intake pumps) YES NO (Go to 3.A) Pump Location (Plant Name) Pump Used During an Emergency? Unit Preceding Pump Unit Directly After Pump Pump Capacity YES NO gpm YES NO gpm YES NO gpm DISTRIBUTION SYSTEM INFORMATION Does Your Water System Have Distribution Pumps? YES NO (Go to 3.B) Pump Location (include pressure plane) Pump Used During an Emergency? Facility Preceding Pump Facility Directly After Pump Pump Capacity YES NO gpm YES NO gpm YES NO gpm Does Your Water System Have Any Finished Water Storage/Pressurization Tanks? YES NO (Go to 4.A) Storage Tank Type (Elevated, Hydropneumatic, Ground or Stand) Location (include pressure plane) Tank Used During an Emergency? Facility Preceding Tank Facility Directly After Tank Tank Capacity YES NO gal YES NO gal YES NO gal PRESSURE PLANES
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