Fillable DESIGNATED WATER PROVIDER 2019 ANNUAL REPORT DESIGNATION OF (Arizona Department of Water Resources)

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DESIGNATED WATER PROVIDER 2019 ANNUAL REPORT DESIGNATION OF (Arizona Department of Water Resources)

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U.S.A. forms for Arizona Department of Water Resources

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DESIGNATION OF ADEQUATE WATER SUPPLY
DESIGNATED WATER PROVIDER 2019 ANNUAL REPORT
WATER PROVIDER:
Address: _______ City, State, Zip code: _______
Owner name: Contact name:
Title: Phone: Email address: ______________________
PART I- TOTAL WATER WITHDRAWN, DIVERTED OR RECEIVED IN 2019, as reported by you
on the Community Water System (CWS) report (if you file CWS): _________ acre-feet
PART II - COMMITTED WATER DEMAND
Committed demand is the estimated future water demand at build out of all recorded lots or
parcels that are not yet served water within your service area. Estimate the future annual
demand in acre-feet for undeveloped, recorded lots or parcels that were located in your
service area as of December 31, 2019. Report demand for residential lots and non-residential
parcels separately as indicated below:
Annual demand per
residential lot
(acre-feet/year)
Total annual demand
(acre-feet/year)
Number of recorded
residential lots
Number: ________
Number or acres of
recorded
non-residential parcels
Number: ________
or
Acres: ___ __ __
Grand total (acre-feet)
DOUGLAS A. DUCEY
Governor
THOMAS BUSCHATZKE
Director
ARIZONA DEPARTMENT OF WATER RESOURCES
1110 W Washington Street, Suite 310
PHOENIX, ARIZONA 85007
(602) 771-8500
ARIZONA DEPARTMENT OF WATER RESOURCES
DESIGNATION OF ADEQUATE WATER SUPPLY ANNUAL REPORT
Explain how the non-residential demand was calculated. Use a separate sheet if necessary.
ARIZONA DEPARTMENT OF WATER RESOURCES
DESIGNATION OF ADEQUATE WATER SUPPLY ANNUAL REPORT
PART III - PROJECTED ANNUAL WATER DEMAND
P
roject the annual water demand in acre-feet for each year indicated. Calculate the increase in
demand for each year from the previous year. The projected demand in most cases will be greater
than the total water use for the current year. Current year demand should equal the total water
withdrawn, diverted and received for delivery in your service area for 2019 as reported in Part I.
Include all water sources used. To calculate GPCD (gallons per capita per day) divide the total
demand in gallons per day by the population in your service area.
Year
Projected
population
GPCD
Total Demand
(acre-feet/year)
Increase from previous year
(acre-feet/year)
2019
2020
2021
2022
2023
2024
2025
2026
2027
2028
2029
E
xplain how the population projection was made. Use a separate sheet if necessary.
P
ART IV - WATER QUALITY
A. I
s the water provider currently in compliance with the Arizona Department of Environmental
Quality’s state water quality standards and reporting requirements? _____ yes ______ no
I
f “no”, please provide an explanation on a separate sheet.
B. Have any new Superfund or WQARF sites been identified within the water provider’s service
ar
ea or have existing contaminant plumes migrated to be within one mile of any service area
wells? _____ yes ______ no
If “yes”, please provide an explanation on a separate sheet.
ARIZONA DEPARTMENT OF WATER RESOURCES
DESIGNATION OF ADEQUATE WATER SUPPLY ANNUAL REPORT
PART V - CERTIFICATION AND SIGNATURE
I hereby certify, under penalty of perjury, that the information contained in this report is, to the best of
my knowledge and belief, true, correct and complete.
Authorized Signature Date
Printed Name Title
Mail, email, or hand-deliver this report by June 1, 2020 to:
Arizona Department of Water Resources
Office of Assured and Adequate Water Supply
1110 W Washington Street, Suite 310
Phoenix, Arizona 85007
assuredadequate@azwater.gov
(602)771-8599, voice (602) 771-8689, fax
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Completed 12 August 2020

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