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Collection Systems Award Nomination

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To be eligible, the following nomination must be submitted, along with supporting documentation, by July 13, 2017.

Fields marked with an (*) are required.

Section A: General Information

Organization(*)
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Mailing Address(*)
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City(*)
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State(*)
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Zip(*)
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Nominated By
Full Name(*)
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Phone(*)
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Title(*)
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Email(*)
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Alternate Contact(*)
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Alternate Phone(*)
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Section B: System Information

Average daily flow in millions of gallons(*)
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Maximum peak daily flow in millions of gallons(*)
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Total miles of sewer maintained (estimated)(*)
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Date original collection system was constructed(*)
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Date of latest collection system improvements(*)
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Total number of manholes (estimated)(*)
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Total number of lift stations(*)
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Number of collection system employees (including supervisor)(*)
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Total number of collection system employees who are members of KWEA(*)
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Section C: Award Information

Number of personnel with ABC collection systems certification(*)
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Average number, per employee, of training hours and/or seminars for collection systems personnel(*)
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Number of reported system overflow discharge(s)(*)
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Does organization have a comprehensive plan for I&I and capacity issues?(*)
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Does organization have a collection system maintenance program?(*)
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Collection system O&M budget in dollars(*)
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Number of backups that were the responsibility of the municipality(*)
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Number of man hours lost due to injuries and/or accidents(*)
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Amount of Systems Inspected Annually:
Television(*)
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length/quantity

Lamp(*)
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length/quantity

Smoke (testing)(*)
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length/quantity

Manhole observation/inspection(*)
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length/quantity

Flow monitoring conducted(*)
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Corrective Maintenance Used:
Rodding/cleaning(*)
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length/quantity

Installation of trenchless technology(*)
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length/quantity

Foaming/root control(*)
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length/quantity

Line replacement/sewer relief(*)
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length/quantity

Manhole adjustments/rehabilitation(*)
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length/quantity

Line repairs(*)
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length/quantity

Lines flushed annually(*)
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length/quantity

Other
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length/quantity

Lift Stations
Number of times checked per week(*)
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Check the items that apply to your lift stations(*)

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Safety
Check the safety items that are available and/or apply to your collection system operation(*)

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Other
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Supporting Documentation

Please provide documentation and supporting information detailing outstanding and significant contribution in wastewater collection.

Accepted file formats: doc, docx, pdf, txt, jpg, ppt, pptx. Max 2MB per file.

Documentation / Supporting Info
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