Sol_140P1525Q0114_Amd_0002.pdf

(x)

140P1525Q0114 x x copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted ; or (c) By separate letter or electronic communication which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGEMENT TO BE

RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY RESULT IN REJECTION OF YOUR

OFFER. If by virtue of this amendment you desire to change an offer already submitted , such change may be made by letter or electronic communication, provided each letter or electronic communication makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

x

PIA

Flagstaff AZ 86001-2694 1824 S Thompson St, Ste 200 NPS, IMR - Arizona MABO

06/13/20250002

13. THIS ITEM ONLY APPLIES TO MODIFICATION OF CONTRACTS/ORDERS. IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

12. ACCOUNTING AND APPROPRIATION DATA (If required) is not extended.is extended, Items 8 and 15, and returning

Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended , by one of the following methods: (a) By completing

The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

FACILITY CODE CODE

10B. DATED (SEE ITEM 13)

10A. MODIFICATION OF CONTRACT/ORDER NO.

9B. DATED (SEE ITEM 11)

9A. AMENDMENT OF SOLICITATION NO.

CODE

8. NAME AND ADDRESS OF CONTRACTOR (No., street, county, State and ZIP Code)

7. ADMINISTERED BY (If other than Item 6)CODE 6. ISSUED BY

PAGE OF PAGES

4. REQUISITION/PURCHASE REQ. NO.3. EFFECTIVE DATE2. AMENDMENT/MODIFICATION NO. 5. PROJECT NO. (If applicable)

1. CONTRACT ID CODE

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

05/27/2025

CHECK ONE A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES (such as changes in paying office, C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER (Specify type of modification and authority) appropriation data, etc.) SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).

E. IMPORTANT: Contractor is not is required to sign this document and return __________________ copies to the issuing office.

ORDER NO. IN ITEM 10A.

14. DESCRIPTION OF AMENDMENT/MODIFICATION (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

Perform Inspection of 209 Backflow Prevention Assemblies.

Extension of Solicitation Due date to Jun 25. Still working the Q&A questions received.

Attached Grand Canyon National Park Cross Connection Control & Backflow Prevention Program that is called out in SOW and handed out at the site visit.

Question period regarding this solicitation is over.

CS: dennis_zoltak@nps.gov

Continued ...

16A. NAME AND TITLE OF CONTRACTING OFFICER (Type or print)15A. NAME AND TITLE OF SIGNER (Type or print)

15C. DATE SIGNED 16B. UNITED STATES OF AMERICA 15B. CONTRACTOR/OFFEROR 16C. DATE SIGNED

(Signature of person authorized to sign) (Signature of Contracting Officer)

Jessica Owens

STANDARD FORM 30 (REV. 11/2016)

Prescribed by GSA FAR (48 CFR) 53.243

Previous edition unusable

Except as provided herein, all terms and conditions of the document referenced in Item 9 A or 10A, as heretofore changed, remains unchanged and in full force and effect .

ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

NAME OF OFFEROR OR CONTRACTOR

2 41

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

(A) (B) (C) (D) (E) (F)

140P1525Q0114/0002

CO: jessica_owens@nps.gov

Period of Performance: 07/14/2025 to 11/14/2025

NSN 7540-01-152-8067 OPTIONAL FORM 336 (4-86)

Sponsored by GSA

FAR (48 CFR) 53.110

Grand Canyon National Park

Cross – Connection Control & Backflow Prevention Program

May 06, 2024

Developed By: _________________________________________________________________________________

Gary L. Lippard, GRCA - USRO / Cross-Connection Control Coordinator Specialists, Date

Reviewed By: __________________________________________________________________________________

Patrick Perry, GRCA - Deputy Chief of Facilities for Water Utilities Branch Date

Approved By: __________________________________________________________________________________

J. Treacy Stone, P.E. GRCA - Chief of Facility Management & Engineering Date

GRCA, Facility Management and Engineering Division, Water Utility Branch

P.O. Box 129, 1575 Shuttle Bus Road

Grand Canyon, AZ 86023

Public Water Supply System ID A0403702

Population served: 6,000 (est.)

Original document: 06/10/2015

Revised date: 05/06/2024

Table of Contents:

Introduction: Page, 3

Chapter 1: Overview Page, 4

Chapter 2: Responsibilities Page, 7

Chapter 3: Test Report Submission Page, 12

Chapter 4: Cross Connection Surveys and Inspections Page, 13

Chapter 5: Cross-Connection Hazards and Required Protections Page, 15

Chapter 6: Backflow Incident Investigation Page, 15

Chapter 7: Fire Sprinkler Systems Page, 16

Chapter 8: Boiler Systems Page, 16

Chapter 9: Removal Requirements Page, 16

Chapter 10: Discontinuance of Water Services Page, 17

Chapter 11: Sources of Information about Cross-Connection Control Page, 17

Chapter 12: Definitions and CCC Industry Terminology Page, 18

Appendix: A, Ariz. Admin. Code § 18-4-215, Current through Register Vol. 29, Page, 32

No. 5, February 3, 2023, Section R18-4-215 - Backflow Prevention

Appendix: B, List of NPS – GRCA – Backflow Repair / Tester Specialists and Page, 35

Testing Equipment - Certificates of Calibration.

Appendix: C, United States Environmental Protection Agency (USEPA) Cross- Page, 36

Connection Control Manual

Appendix: D, United States Environmental Protection Agency (USEPA) Cross- Page, 37

Connection Control; A Best Practices Guide

Appendix: E, American Water Works Association (AWWA) M-14 Backflow Page, 38

Cross-Connection Control; A Best Practices Guide

Appendix: F, United States Public Health Services, NPS – Office of Public Health, Page, 39

Cross-Connection and Recommended Backflow Prevention Devices

Field Guide and Manual, November 2021

Introduction

The legal authority (enabling legislation) that the US Department of Interior, National Park

Service (agency) has for the establishment of the Cross Connection Control / Backflow

Prevention Program. As outlined within the Federal Safe Drinking Water Act, Amendments of

1996. Then, based on this is the State of Arizona enactment that establishes the states privacy in the control of water within the State of Arizona. Cross-Connection Control is defined in the rules of the Arizona Department of Environmental Quality (ADEQ), of the State of Arizona, Title 18

Chapter 4, of the Arizona Administrative Code (AAC) as follows:

Means a physical connection between a Public Water System (PWS), and any source of water or other substance that may lead to pollution or contamination of the water provided by the Public

Water System (PWS) through backflow.

Consequently, either cross-connection or the chance of backflow must be eliminated to prevent degrading the high quality of water that the NPS - GRCA Facility Management and Engineering

Division, Water Utility Branch strives to maintain.

The following is the NPS - GRCA Facility Management and Engineering Division, Water Utility

Branch’s Policy on Cross-Connection Control / Backflow Prevention Program.

It is only through education and commitment can the NPS - GRCA Facility Management and

Engineering Division, Water Utility Branch can control the hazards presented by cross connections within its public drinking water supply. NPS - GRCA Facility Management and

Engineering Division, Water Utility Branch Services supports this policy and its enforcement and will offer its assistance to all who share the responsibility to provide and maintain safe drinking water.

Chapter 1 - Overview

Purpose

The purpose of this Policy is to protect the National Park Service, Grand Canyon National Park’s public potable water supply from the possibility of contamination or pollution. This policy is to promote the control and/or elimination of existing backflow / cross-connections, actual or potential, between its customers usage and the public water supply; and to provide for the maintenance of a continuing program of the backflow / cross-connection control which will systematically and effectively prevent the contamination of the potable water distribution system.

This Policy is intended to prevent delivered water (water that has passed beyond the public water system and into the private distribution systems of customers) from re-entering the public distribution system and being subsequently re-delivered to customers.

This allows persons active in piping design and installation to incorporate and install appropriate backflow prevention assemblies correctly.

The following is from United States Environmental Protection Agency (USEPA), Cross

Connection Control Manual. Public health officials have long been concerned about cross connections and backflow connections in plumbing systems and in public drinking water supply distribution systems. Such cross connections, which make possible the contamination of potable water, are ever present dangers. One example of what can happen is an epidemic that occurred in

Chicago, Illinois in 1933. Old, defective, and improperly designed plumbing and fixtures permitted the contamination of drinking water. As a result. 1,409 persons contracted amebic dysentery; there were 98 deaths. This epidemic, and others resulting from contamination introduce into a water supply through improper plumbing, made clear the responsibilities of public health officials and water purveyors for exercising controls over public water distribution systems and all plumbing systems connected to them. This responsibility includes advising and instructing plumbing installers in the recognition and elimination of cross connections.

• To protect the public potable water supply serving the Grand Canyon National Park

(GRCA) Water Utility from the possibility of contamination or pollution by isolating, at the source, such contaminants or pollutants which could backflow or back-siphon into the public water system.

• To promote the elimination or control of existing cross-connections, actual or potential, between potable water system, and non-potable water system.

• To provide for the maintenance of a continuing program of cross-connection control, which will systematically and effectively prevent the contamination or pollution of all potable water systems.

Causes of Backflow

The causes of backflow are not usually eliminated completely since backflow is often initiated by accident or unexpected circumstances. However, some causes of backflow can be partially controlled by good design and informed maintenance. Listed below are the major causes of backflow as outlined under the two types: backsiphonage and backpressure.

1. Backsiphonage – is caused by reduced or negative pressure being created in the supply piping. The principal causes of backsiphonage are:

a. Line repair or break which is lower than a service point. This will allow negative pressures to be created by water trying to flow to a lower point in the system.

b. Undersized piping – if water is withdrawn from a pipe at a very high velocity, the pressure in the pipe is reduced and the pressure differential created can cause water to flow into the pipe from a contaminated source.

c. Lowered pressure in water main due to a high-water withdrawal rate such as firefighting activities, water main flushing, water main breaks, etc.

d. Reduced main pressure on suction side of a booster pump.

2. Backpressure – may cause backflow to occur where a potable water system is connected to a non-potable system of piping, and the pressure in the non-potable system exceeds that in the potable system. The principal causes of back pressure are:

a. Booster pump systems designed without backflow prevention assemblies.

b. Potable water connections to Boilers, Fire Sprinkler (Suppression) and/or any other pressure systems, without backflow prevention assemblies.

c. Connections with other systems which may at times have a higher pressure.

d. Water stored in tanks or plumbing systems which, by virtue of their elevation, would create head pressures enough to cause backflow, if pressure were lowered in the public system.

Cross-Connection Program Description

The National Park Service, Grand Canyon National Park’s Cross Connection Control / Backflow

Prevention Program is a containment program as defined by Arizona State Regulation, R18-4-

215 and the United States Environmental Protection Agency, Office of Water, Cross-Connection

Control Manual (4606M) EPA 816-R-03-022, United States Public Health Services, NPS -

Office of Public Health, Common Cross-Connections and Recommended Backflow Prevention

Devices, November 2021, Reference Manual 83-A (RM-83-A) . This program is housed within the GRCA Facility Management and Engineering Division, Water Utility Branch and has the following duties:

• Administer testing or handles contracts to test and maintain approximately 177

Park owned assemblies annually. Also handles the repairs via contract and/or inhouse of same devices.

• Track annual tests of 258 NPS-GRCA and Commercial Services / Partnerships

/ WASO - Albright Training Center, managed and maintained assemblies.

• Inspect service connections to ensure compliance with ordinances, rules, regulations, and laws, related to backflow devices.

• Review business surveys and enforce provisions of backflow rules.

• Prepare and submit reports of activities and findings.

1. NPS-GRCA, Commercial Services Division - Aramark, Bright Angel

Bike Shop and Café, Delaware North, Xanterra. Annual Testing and

Repair contract, Deadline August 31st of each year.

2. NPS-GRCA, Partnerships Services Division - Grand Canyon Unified

School District, Grand Canyon Conservatory. Annual Testing and

Repair contract, Deadline August 31st of each year.

3. NPS-WASO - Albright Training Center, Annual Testing and Repair contract, Deadline August 31st of each year.

4. NPS-GRCA - Buildings, Housing, Water Utilities Annual Testing and

Repair contract, Deadline August 31st of each year.

5. NPS-GRCA-FMD-CCC Program Testing / Repair / Program Review and ADEQ Reporting Deadline Oct 30th of the reporting year.

• Inspect existing cross connection control devices, to ensure proper, and adequate protection, and installation requirements.

• Develop and review, NPS - GRCA Facility Management and Engineering

Division, Water Utility Branch, standard details for the installation of backflow prevention assemblies; maintain current listings of approved backflow prevention assemblies.

• Maintain accurate database of all testing (digital-paper reports), testers, and certifications of third-party companies and NPS personnel.

• Maintain photograph documentation of testing devices; one side profile digital picture of location (Time and Date ID), one digital picture of device identification plate (Time and Date ID). This applies to all backflow device testing Park

(GRCA) wide.

• Review for compliance with State and/or Federal rules and recommends revisions to Grand Canyon National Park Cross – Connection Control & Backflow

Prevention Program, as appropriate (Annually Jan. to Dec. of each year) to conform to changes in State and/or Federal legislation.

• Review for compliance with State and/or Federal rules and recommends revisions to Grand Canyon National Park Cross – Connection Control & Backflow

Prevention Program - Emergency Incident Response Plan, as appropriate

(Annually Jan. to Dec. of each year) to conform to changes in State and/or Federal legislation.

• Meet and confer with other local and state agencies on rule making and compliance matters. (Networking / Training with other outside professional groups)

• Investigate backflow incidents and water quality complaints in conjunction with

Water Production / Distribution personnel.

Chapter 2 - Responsibilities

Cross Connection Control and Backflow Prevention Program

The responsibilities of Grand Canyon National Park Cross – Connection Control & Backflow

Prevention Program, in accordance with State Law R18-4-215, AAC are as follows:

1. To protect Grand Canyon National Park’s Public Water Supply, ADEQ - ID A0403702 from the possibility of contamination by isolating within the customers' Private Water

Systems, contaminants or pollutants which could, under adverse conditions, backflow through uncontrolled cross-connections, into the Public Water System (PWS).

2. To ensure the containment of Boiler, Fire Suppression, Water Softening Treatment

Systems, Livestock Water Tanks, Restaurants, RV Waste Disposal Stations, RV Water

Connections Stations Reclaim Water, and Irrigation backflow assemblies. That are located on Commercial, Park Operations and Housing properties, are correctly installed and functioning correctly.

3. To provide a continuing inspection program, of the cross-connection control / backflow, which will systematically and effectively control all actual or potential cross-connecting which may be installed in the future.

4. To educate customers / Park visitors about the dangers of possible cross-connects found on internal plumbing systems.

The GRCA Chief of Facility Management & Engineering shall be responsible for the protection of the public potable water distribution systems from contamination or pollution through the water service connection. If, in the judgment of the Chief of Facility Management & Engineering

(and/or Authorize Designees), the United States Public Health Service (USPHS)

(Recommendation), Coconino County Health Dept., or the Arizona Department of

Environmental Quality (ADEQ) (Regulatory Agency Requirements), an approved backflow prevention assembly is required for the safety of the water system. The GRCA Chief of Facility

Management & Engineering and/or designated representatives, shall give written notice to have an appropriate backflow prevention assembly installed. Failure to comply in a timely manner constitute a ground for discontinuing the water service until such device(s) has been properly installed.

Customers

The customers’ responsibility starts at the point of delivery from the public potable water system

(i.e., Water Meter or non-metered dedicated Fire Suppression line) and includes all their internal water systems. The customer, at their own expense, shall install, operate, test (digital-paper reports), and maintain approved backflow prevention assemblies, as directed by the Grand

Canyon National Park. The customer shall maintain accurate records of tests and repairs made to backflow prevention assemblies and provide Grand Canyon National Park with copies of such records.

Annual Testing / Repair Records Package: For each individual device shall consist of fully completed Backflow Prevention Assembly Test form (digital-paper reports), (fail / passing with repairs / replacement listed, final passing) (2) two pictures (digital-paper reports) - (1) one picture of the device information plate, & (1) one picture side profile including #1 / #2 isolation valves.

All communication shall be conveyed through the NPS - GRCA Commercial Services Division -

Aramark, Bright Angel Bike Shop and Café, Delaware North, Xanterra, NPS - GRCA

Partnerships Division – Grand Canyon Unified School District, Grand Canyon Conservatory, and NPS – WASO Albright Training Center. They will communicate back and forth, all information to the GRCA Facility Management and Engineering Division, Deputy Chief of

Facilities for Water Utilities Branch.

In the event of accidental pollution or contamination of the public or customers’ potable water system due to backflow on or from customer's premises, the owner shall promptly take steps to confine further spread of pollution or contamination within the customers’ premises and shall immediately notify the Grand Canyon National Park, of the hazard. This is so that the

Emergency Incident Response Plan, can be implemented, and proper notifications to ADEQ can be made.

Backflow Prevention Assembly (Repairer) Installers

The installers’ responsibility is to properly install backflow prevention assemblies in accordance with the manufacturers’ installation instructions and any additional instructions approved by the

Grand Canyon National Park. All backflow devices shall be installed as close as possible to the water meter box with a heated enclosure (Hot Box) or heated structure, unless otherwise approved by Grand Canyon National Park.

The installation location shall be done in accordance with approved plans. Any revisions made to the locations of the backflow device, must be submitted to the Grand Canyon National Park, GRCA Facility Management and Engineering Division, Water Utility Branch, Cross Connection

Coordinator for approval. The installer is also responsible for ensuring an assembly is working properly, when it is installed and have a certified tester verify “passing” results.

Backflow Prevention Assembly Testers

Backflow testers are required to accurately report (digital-paper reports) the findings from the annual, installation, or repair test reports to the GRCA Facility Management and Engineering

Division, Utility Branch within 5 business days of completing the test. This applies to both

Contract Backflow Prevention Companies and NPS Certified Staff.

Tester Requirements:

All backflow testers must be certified by a recognized certifying authority. The GRCA Facility

Management and Engineering Division, Utility Branch recognizes the following certificates issued by:

• American Backflow Prevention Association (ABPA).

• Piping Industry Progress & Education Fund (PIPE).

• The International Association of Plumbing and Mechanical Officials (IAPMO)

• The American Society of Sanitary Engineers (ASSE).

• All American Backflow Prevention (AABP).

Tester Equipment:

Each backflow prevention assembly tester shall have properly calibrated and operating equipment to be used in the evaluation of the performance of the assembly they are testing. Each tester conducting test within the Grand Canyon National Park, shall provide the GRCA Facility

Management and Engineering Division, Utility Branch with Testing Device Calibration Report, documentation (digital-paper reports) annually.

Test equipment used on any system other than Potable Water backflow prevention assemblies, shall not be used to test such assemblies. All Reclaim Water backflow prevention devices, testing equipment, and reports, shall be identified as Non-Potable - Reclaim Water.

It is the responsibility of the tester to keep certification(s) and equipment calibration current and on file with the GRCA Facility Management and Engineering Division, Utility Branch – CCC

Office.

Backflow Protection:

GRCA Facility Management and Engineering Division, Water Utility Branch – CCC Office, is responsible for protecting the quality of public water supply. To prevent contamination of the public water supply by backflow and cross connection, the GRCA – FMD – WUB - CCC Office has identified types of developments requiring backflow prevention, and approved types of devices to prevent backflow.

Premises Requiring a Backflow Preventer:

(A) When any of the following items or activities are present or conducted on a premises served by the public potable water supply system, a potential hazard to the public potable water supply system shall be presumed, and the user shall insure that a backflow preventer or air gap, of the type specified for that item or activity herein, is in place at each service connection for that premises. The backflow prevention device should be located as close as possible to the water meter, and if necessary, installed in a hot box.

All backflow assemblies shall be installed above ground. Installation in a vault will be prohibited, in less equipped with an adequately sized floor drain.:

1. Aircraft service and repair shop: Reduced Pressure Principle Backflow Prevention

Assembly (RPA)

2. Animal veterinary / boarding facilities: RPA

Note: stock tanks with automatic filling devices are required to have an air gap, two times the diameter of the discharge. The measurement of air gap shall start from the top of the tank unrestricted overflow (Flood Level Rim) and the overflow must be two times the diameter of the water line discharge. At no time is the discharge point to be ever submerged and/or blocked (Water) in the tank. Main service line to facility as close as possible to the meter, an RP (located within a hot box, if necessary) will be required to be installed downstream from the meter.

3. Automotive Repair / Service Shops, (with steam cleaners, acid cleaning equipment, or solvent facilities): RPA

4. Auxiliary water systems, public or private: RPA

5. Buildings greater than three stories in height or greater than 34 feet in height from curb level: Double Check Valve Backflow Prevention Assembly (DCVA)

6. Buildings used for commercial or industrial purposes where one service connection supplies more than on tenant or occupant of the building: RPA

7. Buildings where the user’s water supply system is in violation of the Uniform

Plumbing Code as adopted by the Park: RPA

8. Buildings with house pumps and or potable water storage tanks: DCVA

9. Buildings with landscape fountains, ponds, or baptismal tanks: RPA

10. Buildings with sewage ejectors: RPA

11. Car wash facilities: RPA

12. Cooling towers, boilers, chillers, and other heating and cooling systems utilizing potable water: RPA

13. Chemical storage facilities: RPA

14. Chemically treated (Water Softening) potable or non-potable (Reclaim Water) water systems: RPA

15. Commercial laundries: RPA

16. Fire hydrant / water meters connected to an irrigation system or any other use included in the Irrigation Systems Subsection: RPA

17. Fire hydrant / water meters, water tanker supply locations: RPA

18. Fire sprinkler systems connected to potable water systems only. No tanks or reservoirs.

No additives of any kind. In-line booster pumps are ok. DCVA

19. Fire systems with a storage tank: RPA***

20. Fire sprinkler systems connected to an auxiliary water supply or with FDC’s within 1,700 feet of an auxiliary supply: RPA***

21. fire systems with chemical additives: RPA***

*** This RP is to be installed on the fire line outside of the building not on the riser.

22. Government owned or operated facilities not open, for inspection (for LE security reasons) by the Water Utility: RPA

23. Hospitals and Clinics: RPA

24. Irrigation systems, except as described in Subparagraphs a.-e.: Pressure Vacuum

Breaker (PVB)

a. Premises where non-potable (Reclaim Water) water, is used for irrigation: RPA

b. Systems utilizing fertilizer or pesticide injection systems: RPA

c. Systems interconnected by more than one service connection: RPA

d. Systems using potable water with non-potable (Reclaim Water) water piping:

RPA

e. Systems designed and constructed capable of inducing backpressure at the service connection: RPA

25. Laboratories using toxic and/or nontoxic materials: RPA

26. Medical and dental buildings, behavioral health centers, engaged in the diagnosis, care or treatment of human illness: RPA

27. Mobile home parks served by master meters: DCVA

28. Multiple (Trailer Village) service connections (1) sanitary yard hydrants equipped with vacuum breaker on individual trailer connections) interconnected for potable uses: (1) on the main line: RPA

29. Oil and gas storage facilities: RPA

30. Portable insecticide or herbicide spray tanks: RPA or Air Gap (AG)

31. Premises served by water meters 3” or greater in size (vault meters): DCVA

32. Premises where a cross-connection is maintained or where a cross-connection previously occurred within a user’s premises: RPA

33. Restaurants: RPA

34. RV Dump Stations; (main water supply line) holding tank (Black and Gray Water) disposal: RPA

35. RV Dump Stations; (potable or non-potable water towers supply lines) holding tank

(Black and Gray Water) disposal: Atmospheric Vacuum Breaker (AVB)

36. Schools, colleges, and universities: RPA

37. Shopping centers served by master meters: RPA

38. Sewage collection or treatment facilities: RPA

39. Waterfront facilities: RPA

40. Water trucks, water tanks or hydraulic sewer cleaning equipment: RPA or AG

(B) When two or more of the items or activities listed in Subsection A are present or conducted on the same premises and served by the same service connection, the user shall install the most restrictive backflow preventer at the service connection.

For purposes of this Subsection the order of most restrictive to least restrictive backflow preventers shall be as follows:

1. Reduced Pressure Principle Backflow Prevention Assembly (RPA)

2. Pressure Vacuum Breaker Assembly (PVB)

3. Double Check Valve Backflow Prevention Assembly (DCVA)

(C) GRCA Facility Management and Engineering Division, Water Utility Branch – CCC Office shall perform site surveys of all new water users and existing water users to determine if the degree of hazard requires a backflow prevention assembly to be installed. If an assembly is required, the user shall comply with the standards set forth in this Chapter within a period of time as determined by the Water Utility Branch – CCC Office, based upon the degree of hazard.

(D) A change of type of use shall require the Water Utility Branch – CCC Office to conduct a new survey of use. If the survey determines a backflow prevention assembly is required, installation shall be completed by the user before the Park may grant the change.

Approved Backflow Prevention Devices:

The following types of backflow prevention devices are approved for use within the Grand

Canyon National Park, Facilities Maintenance Division, Water Utilities Branch service area:

• Reduced Pressure Principle Device, (RP)

• Reduced Pressure Principle - Detector Backflow Prevention Assembly (RPDA)

• Reduced Pressure Principle Detector Backflow Prevention Assembly – Type II (RPDA-

II)

• Double Check Valve Assembly, (DC)

• Double Check - Detector Backflow Prevention Assembly, (DCDA)

• Double Check - Detector Backflow Prevention Assembly – Type II, (DCDA-II)

• Air Gap Separation, (AG)

• Pressure Vacuum Breaker Backsiphonage Prevention Assembly, (PVB)

• Spill Resistant Vacuum Breaker Backsiphonage Prevention Assembly, (SVB)

• Atmospheric Vacuum Breaker Backsiphonage Prevention Assembly, (AVB)

Chapter 3 - Test Report Submission

It shall be the duty of the customer, at any commercial premises where approved backflow assemblies are installed, to have thorough inspections and operational tests made at least once a year, (Deadline: August 31st of each calendar year) or more often as directed by the GRCA

Facility Management and Engineering Division, Water Utility Branch. The tests shall be at the expense of the customer and be performed by a properly certified backflow tester.

• All communication shall be conveyed through the NPS - GRCA – Commercial Services

Division and Partnerships Division. They will in turn communicate back and forth all information to the GRCA Facility Management and Engineering Division, Deputy Chief of Facilities for Water Utilities Branch.

Test Submission:

The tester shall submit the Annual Testing / Repair Records Packages to the GRCA Facility

Management and Engineering Division, Utility Branch, GRCA - Backflow / Cross-Connection

Control Coordinator, within 5 business days of test completion.

• Submit report to the GRCA Facility Management and Engineering Division, Utility

Branch, for entry into the database excel spreadsheet system. This will include temporary construction backflow tests reports. (Very detailed; typed or legible print)

• Test reports shall be filled out completely, with all necessary data as follows:

➢ Water Purveyor

➢ Assembly Service Street Address &

NPS - Inventory Location Identifier

➢ Backflow Location Notes

➢ Device; Annual Tests, New

Installation, Retest, Replacement

➢ Test Results; (PSID) and Repair

Information

➢ Additional comments

➢ Testers Certificate No. & Expiration

Date

➢ Two (2) pictures; One (1) of the Device

➢ Device Information: Service Type, (boiler, fire suppression, etc.) Device

Type, Serial No., Manufacturer, Model, Size, Water Meter Serial Number.

➢ Type of use and hazard

➢ Test Date

➢ Pass or Fail

➢ Test Company Information

➢ Testers Name (printed) & Signature

➢ Test Kit (Potable Water or Reclaim

Water) Model, Certification date, Serial

Number. The reclaim water backflow

Testing Notifications:

The Park will send out an 1st Annual Backflow Testing / Repair / Replacement (E-Mail) reminder by January 15th of each reporting year. On May 1st of each reporting year, the Park will send out a 2nd Annual Backflow Testing / Repair / Replacement (E-Mail) reminder. This will be the last reminder for the year.

The following is a four (4) stepped measured / escalation of enforcement for a Non-Compliance event.

1. If the Park, has not received the annual backflow testing / repair documentation by

August 31st the customer will be found in “Non-Compliance” with this policy. After the due date (August 31st) has passed, an “PASS DUE” notice will be sent out by E-Mail.

2. If the Park, has not received the annual backflow testing / repair documentation by

September 15th the customer will be found in “Delinquency” with this policy. After the

2nd Pass Due date (September 15th) has passed, an “2nd PASS DUE” notice will be sent out by E-Mail.

3. If the Park, has not received the annual backflow testing repair documentation by

September 25th the customer will be sent by E-mail, an “Final Notice - Water Service

Termination”. Should the customer / location fail to report test results, there will be an escalation of enforcement per this NPS - Grand Canyon National Park, Cross Connection

Control / Backflow Prevention Program. This will result in the termination (Locking Out or Water Meter Remove) of water service to the location. This is done in the Public

Health interest, State and Federal Regulations, and security of the Public Water Utility.

4. Upon notification of a backflow tester (to be scheduled with the GRCA - Cross

Connection Coordinator) on site, water service will be restored for testing purposes. If the device test results in a “Pass Report”, water service will be fully restored back to service.

Chapter 4 - Cross Connections Surveys and Inspections

Surveys

Due to changes in models or components of equipment, methods of manufacturing and additions to plants, buildings, etc., water use requirements undergo continual change. New cross-connections may be installed, and existing protection may be by-passed, removed, or become otherwise ineffective; therefore, a periodic site survey by GRCA Facility Management and

Engineering Division, Water Utility Branch, Cross Connection Coordinator, will be required.

Information Plate, & One (1) of the

Side Profile (Showing isolation valves

#1 & #2) of the location, in the room.

testing kit shall be marked with a label

“Reclaim Water” on the box.

These inspections will be on the customer’s premises and may consist of, but are not limited to:

1. Notifying customer, commercial services, partnership services, of an onsite inspection.

2. Visual check for Cross-connection. (actual or potential)

3. Verify that the proper device has been installed in relation to potential hazards, to the utility.

4. Verify backflow device is installed and working properly.

5. Verification of test results, NPS-GRCA may accompany the backflow prevention assembly tester during the time of testing. This would require advanced notification to the

GRCA Cross connection coordinator, of anticipated time of testing.

6. Assessment for installation of a backflow device, or if none is present.

7. Review all fire suppression systems and associated backflow prevention device requirements and proper application review.

8. Review all livestock watering tanks for proper backflow prevention device requirements and proper application review.

9. If in the judgment of the GRCA - Cross Connection Coordinator an approved backflow device is required to protect the Park Water Utility (Public Water System (PWS), from any contamination or pollution. GRCA - Cross Connection Coordinator, shall give notice in writing per email that the customer is to install the properly approved backflow prevention device within 90 days. And failure or refusal or inability on the part of the customer to install said device or devices within 90 days shall constitute grounds for discontinuing water service to the premise until such device or devices have been properly installed.

Proposed Construction

All new construction plans and specifications for commercial facilities, operations buildings, and housing shall be reviewed by GRCA Facility Management and Engineering Division, Water

Utility Branch, Cross Connection Coordinator, to determine the degree of potential cross-connection hazard. At the time of plan review, backflow prevention requirements in accordance with this policy will be made.

New and Existing Facilities

In order to determine the degree of hazard to the public potable water system, a survey will be made of the customers’ presently installed water system. This survey does not need to be a detailed inspection of the location or disposition of the water mains but can be confined to establishing the water uses on the premises for the existence of cross-connections, and the availability of auxiliary or non-potable (Reclaim Water) water supplies. On-site inspections are done on new and existing facilities and should any devices or plumbing change be required. A notification will be sent, and a follow-up inspection will be completed, at a later date.

Chapter 5 - Cross-Connection Hazards and Required Protections

Type of Backflow Protection Required

An approved backflow prevention assembly of the type designated shall be installed on each water service connection to commercial, operations buildings, and housing facilities. The GRCA

Facility Management and Engineering Division, Water Utility Branch uses the most current edition (10th) of the USC-FCCCHR Manual of Cross-Connection Control for list of approved assemblies.

Parallel Installations

All backflow prevention assemblies with test cocks are required to be tested annually. Testing requires a water shutdown usually lasting five (5) to twenty (20) minutes. For facilities that require an uninterrupted supply of water, provisions shall be made for a "parallel installation" of backflow prevention assemblies.

During testing, one assembly is left on while the other is being tested. GRCA Facility

Management and Engineering Division, Utility Branch will not accept an unprotected bypass around a backflow assembly when the assembly needs testing, repair, or replacement.

Chapter 6 - Backflow Incident Investigation

The GRCA Facility Management and Engineering Division, Water Utility Branch shall submit a written cross-connection incident report to ADEQ, Coconino Health Dept., and the USPHS, within 5 business days after a cross-connection problem occurs that results in contamination of the public water system.

If a backflow incident were to occur, ADEQ, Coconino Health Dept., and the USPHS, must be notified (Ariz. Admin. Code § R18-4-211-A) within five (5) business days with the following information:

1. Date/Time of discovery of the cross-connection incident,

2. Nature of the cross-connection incident,

3. Affected area,

4. Cause of the cross-connection incident,

5. Public health impact,

6. Date and text of any public health advisory issued,

7. Corrective action taken, and

8. Date of completion of each corrective action.

Internally, the practice will be to follow these steps:

• Locate the source,

• Contact Water Distribution Supervisor / Crew, to isolate source to protect the water distribution system from further contamination,

• Notify the GRCA - Backflow / Cross-Connection Control Coordinator, Management, and the GRCA - Regulatory Compliance Office, Management will contact ADEQ,

• Determine the extent of the spread,

• Notification of the public, if necessary,

• Take corrective action to remove hazard from the distribution system,

• Restore service to the customers.

Chapter 7 - Fire Sprinkler Systems

Plans and permits for fire sprinkler (suppression) systems are processed through the GRCA

Facility Management and Engineering Division, Utility Branch, and the GRCA Fire Department.

Commercial properties are required to have a testable backflow assembly, if the GRCA Fire

Department deems a sprinkler system necessary. The GRCA Fire Department will do a rough and final fire sprinkler (suppression) systems inspection on new construction and/or remodeling construction. This inspection is to verify that the construction complies with state of Arizona fire codes and NPS specifications.

GRCA - Cross Connection Coordinator performs the rough and final inspection of the related backflow prevention device. Before the system can be placed into service a backflow prevention tester has to complete a backflow prevention assembly test form (Passing) with two pictures.

Backflow prevention devices are required to be installed between the potable water main and the fire sprinkler (suppression) systems, commercial and housing units.

Chapter 8 - Boiler Systems

All commercial, Park operations, and housing utilizing boiler systems for heating require a

Reduce Pressure Principle Backflow Prevention Assembly, (RP) for water supply line to the unit.

The device size will be determined by the supply line to the boiler.

Chapter 9 - Removal Requirements

It shall be unlawful for any person to alter, modify, bypass, or remove a backflow preventer without the written approval of GRCA Facility Management and Engineering Division, Water

Utility Branch - Cross Connection Coordinator. The property owner must contact the GRCA

Facility Management and Engineering Division, Water Utility Branch prior, to removing the backflow assembly. A site survey will be completed to assess the actual or potential for cross-connections if the backflow were to be removed. If none are found, the GRCA Facility

Management and Engineering Division, Water Utility Branch - Cross Connection Coordinator, will issue a written report documenting the findings.

If the property owner has already removed the backflow, a site survey must be completed to assess the water usage and the status of the removal. The device and piping shall be removed as close as possible to the main service connection. Under no circumstances shall the GRCA

Facility Management and Engineering Division, Water Utility Branch, give approval if only the device has been removed and the water lines are open to the air. Grand Canyon National Park has the right to require the backflow device be reinstalled to protect the Park’s potable water distribution system.

Once the removal is completed to the satisfaction of the Park, it can be removed from the database. If there has been a change in owner/tenant or a water use change, the Park can require a backflow device to be reinstalled.

Chapter 10 - Discontinuance of Water Services

As stated in Chapter 3, a reminder E-mail will be sent on September 26th. The Park will then generate and send by email, a “Final Notice - Water Service Termination”. This email notification will be sent to the business/property owner as part of the escalating enforcement. If the deadline has passed without communication, a “Notice of Violation” (NOV) will be issued to the legal authority for the business/owner of the property. The GRCA - Chief of Facility

Management & Engineering, will be notified of the violation and the possibility of water disconnect.

Once the “Notice of Violation” (NOV) deadline has passed, a call will be placed to the NPS legal authority that the water service to the address will be discontinued. The Park’s Commercial

Services Supervisor and the FMD Chief of Facilities will be notified of the discontinuance. The

Cross Connection Coordinator will place a door hanger at the address notifying the occupant of the discontinuance to happen in 24 hours. If Commercial Services Division and/or GRCA

Facility Management and Engineering Division, Water Utility Branch is not contacted within the time period, the water will be shut off until the violation is resolved.

Chapter 11 – Sources of Information about Cross-Connection

Control

American Society of Sanitary Engineering

ASSE International Office

901 Canterbury, Suite A

Westlake, OH 44145

(440) 835-3040

American Backflow Prevention Association (ABPA)

100 N. 20th Street, Suite 200

Philadelphia, PA 19103

(979) 846-7606

American Water Works Association

6666 West Quincy Ave.

Denver, CO 80235-3098

(800) 366-0107

University of Southern California, Foundation for Cross-Connection Control and Hydraulic

Research

KAP – 200 University Park MC-2531

Los Angeles, CA 90089-2531

(866) 545-6340

Chapter 12 – Definitions and Cross-Connection Control Industry

Terminology

Absolute Pressure:

Is the total combination of gage pressure and atmospheric pressure.

Accessible:

Assemblies must be installed having access for testing, maintenance, and repair.

Administrative Authority:

The official office, board, department, or agency authorized by law to administer and enforce regulation and or code requirements. This includes a duly authorized representative of the

Administrative Authority. The state administrative authority sets the minimum standards for a

Cross-Connection Control Program.

Air Gap (AG)

The unobstructed vertical distance through the free atmosphere between the lowest opening from any pipe or faucet supplying water to a tank, plumbing fixture, or other device and the flood level rim of the vessel. An approved air gap shall be at least double the diameter of the supply pipe, measured vertically, above the overflow rim of the vessel; by physical separation and in no case less than one inch. The relief valve on a RP assembly must be piped to a drain through an air gap. Examples: (Kitchen faucet, bathroom faucet, drains going into a floor sink)

Approved:

Accepted by the GRCA Chief of Facility Management & Engineering as meeting an applicable specification stated or cited in this ordinance, or as suitable for the proposed use. (Meeting certain standards like USC, ABPA, or ASSE)

As-built Drawings:

Blueprint drawings that are modified to reflect the actual piping, configuration and location.

Aspirator:

The means by which liquids are sucked into a piping system. It’s the velocity of liquid in the pipe that creates a vacuum or low pressure on the sides of the pipe which allows backsiphonage to occur. (Small tee inlet, water main break)

Assembly:

An assemblance of one or more approved body components, including approved, shutoff valves, test cocks and check valves. A Y configured reduced pressure assembly has less head loss than an inline assembly.

Atmospheric Pressure:

Is the pressure exerted by the earth’s atmosphere at sea level (14.7 psi)

Atmospheric vacuum breaker (AVB): the AVB consists of a float check, a check seat, and an air inlet port. A shutoff valve immediately upstream may or may not be an integral part of the device. The AVB is designed to allow air to enter the downstream water line to prevent backsiphonage. This unit may never be subjected to a backpressure condition, have a downstream shutoff valve, or be installed where it will be in continuous operation for more than

12 hours in a 24-hour period. (AVB’s must be installed a minimum of 6 inches above all downstream piping. AVB’s are used on lab sinks, janitor sinks, hose bibs, they are not approved, for service protection. AVB’s can only be assumed as working by taking it apart and inspecting)

Authority having Jurisdiction:

The agency, organization, office or individual responsible for approving materials, equipment, work installation, or procedure. (Local authorities: NPS, United

States Public Health Service (USPHS)(Recommendation), Coconino County Health Dept., or the

Arizona Department of Environmental Quality (ADEQ) (Regulatory Agency Requirement)

Auxiliary Water Supply (Reclaim Water):

Any water supply on or available to the premises, other than the National Park Service approved potable water system, will be considered an auxiliary water supply. These auxiliary waters may include water from another purveyor’s public potable water supply or any natural source(s) such as a well, spring, river, lake, stream, etc., or “Reclaim Water” or “recycled” or “used water” or

“industrial fluids”. These waters may be contaminated or polluted, or they may be objectionable and constitute an unacceptable water source over which the National Park Service has no sanitary control. Water users that maintain an auxiliary water supply must provide backflow protection.

Backflow:

The reversal of the normal flow of a liquid, gas, or other substance in a potable water distribution piping system because of a cross connection. This can be caused by either backpressure or backsiphonage. The #1 cause of a backflow, cross connection is the common garden hose.

Backflow Preventer:

An assembly, device, or method that prohibits the backflow of water into the potable water supply systems. The primary reason for installing a BPA is to prevent backflow. A bypass around a BPA installation is not allowed under any circumstance without the same backflow protection. (Assembly low rates differ with the size and type)

Back Pressure:

The flow of water or other liquids, mixtures, or substances under pressure into the pipes of a potable water supply from any source(s) other than the intended source. This backpressure, that would be higher on the water user’s side than on the supply side may be caused by a pump, elevated tank, boiler, air or steam pressure, pressure sprayers, high-rise buildings. (Back pressure is one form of backflow)

Backsiphonage:

The flow of water or other liquids, mixtures, or substances into the distribution pipes of a potable water supply from any source(s) other than its intended source caused by the reduction of pressure in the potable water supply system. This backflow caused by negative, sub atmospheric or reduced pressure in the supply piping.