Utility District Survey Form
Utility Name:
Contact Name:
Phone Number:   xxx-xxx-xxxx
E-mail Address:
In what region of the state is your utility located?
What is the total number of employees of your utility?

Full Time

Part Time
Approximately how many miles of pipe?

Water

Wastewater

Gas
What is the largest (diameter) pipe you have installed in your system?

Water

 inches

Wastewater

 inches

Gas

 inches
How many storage tanks do you have?
What is the total capacity of your storage tanks.? gallons
Do you produce your own water?

If only part, what percent on average

 %

How million gallons per year do you produce?

 gallons

How million gallons per year do you purchase?

 gallons
What is the maximum amount of water that your utility has produced or sold within any month? gallons
How many meters do you serve Residential and Commercial?
What is the population (customers) that you serve in your Residential and Commercial area? Be sure to include population of any other system that your utility may serve. (You may use 3.2 persons-per-connection if you are unsure of your county population factor.)
How many major (employees over 50) industrial and commercial customers do you serve?

Please list names. (For example, Nissan Automotive Factory or Cool Springs Mall.)
What systems are you interconnected to? (Please list)
To how many municipalities do you provide service?
How many counties are in your service area?
What is the total value of your system (see audit “Statement of Net Assets” Investment of Capital Assets, Net of related debt. This should be largest figure in net assets.) $
What is the Yearly Revenue of your system? (see current audit) $
How many dollars per year does your utility spend on upgrading the system? (best estimate) $
How many dollars has your utility spent in the last 10 years to upgrade the system? (best estimate) $
How many miles or feet of pipe have you installed in the past year to service new customers (Include any new subdivision and industrial parks.) (best estimate)
How many miles or feet of pipe has your utility installed in the past 10 years, to service new customers? (Include any new subdivisions and industrial parks.) (best estimate)
How many new customers did you add in 2007?
How many new customers did you add in the last 10 years? (best estimate)
What percentage of your geographical service area (chartered boundaries) does your utility provide service to?  (best estimate) %
Does your utility serve customers outside of your chartered area?
Does your utility have a 5 year plan?

If so, what is estimated spending for system improvements over that time period?

 $
Does your utility have a 10 year plan?

If so, what is estimated spending for system improvements over that time period?

 $