CRS Help Tips

SURVEY 1: California Water and Wastewater Arrearage Payment Program (DUE DATE: 09.10.2021)

About: The purpose of this survey is to collect necessary data to allow the State Water Board to (1) determine the extent of Residential and Commercial drinking water arrearages and COVID-19 related water system revenue loss and establish eligibility; (2) collect the necessary paperwork to process direct payments to water systems for Residential and Commercial drinking water arrearages and COVID-19 related water system debt.

The information collected below is meant to reflect COVID-19 related Residential and Commercial customer debt and COVID-19 related revenue loss accrued between 03.04.2020 and 06.15.2021.

The data requested below pertains to the COVID-19 pandemic period between 03.04.2020 through 06.15.2021 and includes any customer billing period that contains these dates.

Survey Questions & Technical Assistance: The State Water Board may be able to provide technical assistance to help your water system complete this survey.

  1. WATER SYSTEM

    2. 0. Mandatory: Please select the option below that best describes your community water system. Most water systems will select option three.

    1. Community water system wholesaler that does NOT directly serve Residential or Commercial/Institutional customers.

    2. Community water system (may include wholesalers) with multiple water systems under the same umbrella organization/legal entity that directly serves Residential and/or Commercial/Institutional customers (an example would be a CPUC regulated company that has multiple systems; a special district or mutual water corporationthat has separate physical water systems; or a county with a county service areas etc.).

    3. A community water system that is not [1] or [2]

    If Option [1]; you are navigated to Question 1

    If Option [2]; you are navigated to Question 0.1

    If Option [3]; you are navigated to Question 1
    0.1 Mandatory if Question 0= "Option [2]": Would you prefer to complete this survey using aggregated data for all or some of the water systems that are under the same umbrella organization/legal entity?

    • Yes, I would like to complete this survey using aggregated data across the same umbrella organization/legal entity.

    • No, I want to complete an individual survey for each community water system I am reporting for.

    If "Yes"; you are navigated to Question 0.2

    If "No"; you are navigated to Question 1
    0.2 Mandatory if Question 0= "Option [2]" and Question 0.1 = "Yes": Please provide the name of the umbrella organization/legal entity.

    This will be used as a unique identify to group multiple PWSIDs together.
    0.3 Mandatory if Question 0= "Option [2]" and Question 0.1 = "Yes": Please use the text box below to provide the PWSIDs for all of the community water systems that are under the same umbrella organization/legal entity. Please separate each PWSID with a semicolon “ ; ”

    Example: CA#######; CA#######; CA#######; CA########
    0.4 Mandatory if Question 0= "Option [2]" and Question 0.1 = "Yes": Please use the text box below to provide the PWSIDs for all of the community water systems that you will be reporting data for in this survey regarding the Community Water System COVID-19 Debt Relief Program. These PWSIDs must be in the field above. You may provide a shorter list of systems here. Please separate each PWSID with a semicolon “ ; ”

    You may also complete this survey for an individual water system if desired.

    Example: CA#######; CA#######; CA#######; CA########
  2. COVID-19 FINANCIAL IMPACTS

    3. 1 Mandatory: Has your drinking water system accrued Residential drinking water arrearages, Commercial drinking water arrearages, and/or COVID-19 related drinking water revenue loss between 03.04.2020 through 06.15.2021? This includes any customer billing period that contains these dates.

    • Residential Drinking Water Arrearages: Active and inactiveResidential customers (single family and/or multi-family) that have accrued debt for drinking water serviced provided during the COVID-19 pandemic between 03.04.202 through 06.15.2021.

      • Residential Customers: water services are provided to customers that include single-family residences, multi-family residences, mobile homes, including, but not limited to, mobile homes in mobile home parks, or farmworker housing.

      • Inactive accounts: Customer accounts that are no longer being provided drinking water services and are not receiving drinking water charges.

    • Commercial Drinking Water Arrearages: Active and inactiveCommercial customers (retail, offices, gas stations, etc.) that have accrued debt for drinking water serviced provided during the COVID-19 pandemic between 03.04.202 through 06.15.2021.

      • Commercial Customers: water services are provided to commercial/institutional customers: hotels, motels, restaurants, office buildings, government and military facilities, gas stations, hospitals, educational institutions, retail establishments, dormitories, nursinghomes, churches, jails, prisons, mental health facilities, addiction recovery centers, farmworker housing, and campgrounds.

      • Commercial customers do NOT include: industrial (manufacturing, chemical, refineries, cooling towers, animal & food processing, etc.); agriculture irrigation (crops, aquaculture, etc.); and landscape irrigation (parks, golf courses, etc.).

    • COVID-19 Related Drinking Water Revenue Loss: Revenue loss accrued during the COVID-19 pandemic between 03.04.2020 through 06.15.2021. Revenue loss may be attributed to customer non-payment for drinking water services, reduction in fee or tax revenues, reduction in average annual demand (between fiscal years) etc.

    By marking 'No' it will be assumed that your water system was NOT financially impacted during the COVID-19 pandemic. Your system will NOT be eligible to receive aid through the Community Water System COVID-19 Relief Program.

    Systems that submit 'Yes' will be expected to provide documentation to support the amount requested. Please keep in mind that the amount requested will not necessarily reflect the amount of relief provided.
    1.1 If Question 1= "No": By selecting “No” to the previous question you have indicated that your water system has not experienced any Residential, Commercial, and/or COVID-19 related drinking water revenue loss. Your water system will not be eligible for the Community Water System COVID-19 Relief Program. Please select the “Submit” button below to save this information and exit this survey.
  3. CUSTOMERS

    4. 2 Mandatory, Auto-Filled from 2020 EAR: Does your water system charge customers for water (residential, commercial, industrial, or institutional water customers)?

    If the answer displayed in this question is incorrect and you would like to change it; please update your response to this question in the 2020 Electronic Annual Report (EAR). Once the answer has been updated in the EAR, it will automatically update in this survey.

    • Yes: Water system charges customers (residential or non-residential) for receiving drinking water services. Charges may be fixed or based on allocation/consumption levels. If a customer receives a bill at least once during the reporting year, the water system should select “Yes.”

    • No: Water system does not charge customers for receiving drinking water services. None of the water system’s customers received a bill throughout the reporting year.

    If "Yes" is selected the user navigates to question 3.

    If "No" is selected the user navigates to question 22.
    2A Mandatory – this question must be completed using aggregated informationfor the systems that you arereporting for. See guidance for question in the help tip above.
    3 Mandatory, Auto-Filled from 2020 EAR: Select applicable customer types:

    If the answer displayed in this question is incorrect and you would like to change it; please update your response to this question in the 2020 Electronic Annual Report (EAR). Once the answer has been updated in the EAR, it will automatically update in this survey.

    • Residential: water services are provided to customers that include single-family residences, multi-family residences, mobile homes, including, but not limited to, mobile homes in mobile home parks, or farmworker housing.

    • Non-Residential: all other customer types that are not residential. Typically, these include: Commercial (Retail, Offices, Gas Stations, etc.); Institutional (Schools, Hospitals, Hotels, etc.); Industrial (Manufacturing, Chemical, etc.); Landscape Irrigation (Parks, Gold Courses, etc.); and/or Agricultural Irrigation (Crops, Aquaculture, etc.)

    • Both: water system has both Residential and Non-Residential customers.

    If you select Residential or Both you will move to Question 3.1.

    If you select Non-Residential only you will move to Question 11.
    3A Mandatory – this question must be completed using aggregated information for the systems that you are reporting for. See guidance for question in the help tip above.
    3.1 Mandatory, Auto-Filled from 2020 EAR: Total Number of Residential Connections?

    If the answer displayed in this question is incorrect and you would like to change it; please update your response to this question in the 2020 Electronic Annual Report (EAR). Once the answer has been updated in the EAR, it will automatically update in this survey.

    • Residential: water services are provided to customers that include single-family residences, multi-family residences, mobile homes, including, but not limited to, mobile homes in mobile home parks, or farmworker housing.

    • Total Residential Service Connections is the sum of your total single-family residential service connections + total multi-family residential connections.
    3.1A Mandatory – this question must be completed using aggregated information for the systems that you are reporting for. See guidance for question in the help tip above.
    3.2 Mandatory, Auto-Filled from 2020 EAR: Total Number of Non-Residential Connections?

    If the answer displayed in this question is incorrect and you would like to change it; please update your response to this question in the 2020 Electronic Annual Report (EAR). Once the answer has been updated in the EAR, it will automatically update in this survey.

    • Non-Residential: all other customer types that are not residential. Typically, these include: Commercial (Retail, Offices, Gas Stations, etc.); Institutional (Schools, Hospitals, Hotels, etc.); Industrial (Manufacturing, Chemical, etc.); Landscape Irrigation (Parks, Gold Courses, etc.); and/or Agricultural Irrigation (Crops, Aquaculture, etc.)

    • Total Non-Residential Service Connections is the sum of the systems total Commercial service connections + total Industrial service connections+ total Landscape Irrigation service connections + total Agricultural Irrigation service connections.
    3.2A Mandatory – this question must be completed using aggregated information for the systems that you are reporting for. See guidance for question in the help tip above.
    3.2.1 Mandatory if Question 3 = "Both": Can your water system distinguish between Residential and Non-Residential accounts?

    • Residential: water services are provided to customers that include single-family residences, multi-family residences, mobile homes, including, but not limited to, mobile homes in mobile home parks, or farmworker housing.

    • Non-Residential: all other customer types that are not residential. Typically, these include: Commercial (Retail, Offices, Gas Stations, etc.); Institutional (Schools, Hospitals, Hotels, etc.); Industrial (Manufacturing, Chemical, etc.); Landscape Irrigation (Parks, Gold Courses, etc.); and/or Agricultural Irrigation (Crops, Aquaculture, etc.)

    Yes: My water system can distinguish between Residential and Non-Residential accounts.

    No: My water system can NOT distinguish between Residential and Non-Residential accounts.

    If your answer is “No,” please estimate the questions below related to Residential and Commercial Non-Residential accounts, using your best available data.
    3.3 Mandatory if Question 3 = "Non-Residential" or "Both", Auto-Filled from 2020 EAR: Total Number of Commercial Non-Residential Connections?

    If the answer displayed in this question is incorrect and you would like to change it; please update your response to this question in the 2020 Electronic Annual Report (EAR). Once the answer has been updated in the EAR, it will automatically update in this survey.

    • The State Water Board often distinguishes between Commercial and Institutional customer types. For the purposes of the Community Water System COVID-19 Relief Program; "Commercial Customers" will include Commercial and Institutional customers: hotels, motels, restaurants, office buildings, government and military facilities, gas stations, hospitals, educational institutions, retail establishments, dormitories, nursinghomes, churches, jails, prisons, mental health facilities, addiction recovery centers, farmworker housing, and campgrounds.

    • Non-Residential Commercial customers do NOT include industrial (manufacturing, chemical, refineries, cooling towers, animal & food processing, etc.); agriculture irrigation (crops, aquaculture, etc.); and landscape irrigation (parks, golf courses, etc.).
    3.3A Mandatory – this question must be completed using aggregated information for the systems that you are reporting for. See guidance for question in the help tip above.
  4. RESIDENTIAL CUSTOMER DEBT

    5. Question 4 through 11 are only revealed if the answer to Question 3 or 3A = "Both" or "Residential"

    4 Mandatory, Auto-Filled from 2020 EAR: Does your Residential customer bill include any non-drinking water charges (i.e. wastewater, stormwater, electricity, telecommunications, property tax etc.)?

    If the answer displayed in this question is incorrect and you would like to change it; please update your response to this question in the 2020 Electronic Annual Report (EAR). Once the answer has been updated in the EAR, it will automatically update in this survey.

    • Yes: If the water system’s customer bills include additional non-drinking water charges such as wastewater service charges; stormwater service charges; other utility charges (electricity, gas, internet, and/or telecommunications); garbage, recycling collection, property taxes, etc.

    • No: There are no additional non-drinking water related charges included on the water system’s customer’s bills.

    If “Yes” the user navigates to question 4.1.

    If “No” the user navigates to question 5.
    4A Mandatory – this question must be completed using aggregated information for the systems that you are reporting for. See guidance for question in the help tip above.
    4.1 Mandatory if Question 4 = "Yes": Can your accounting system distinguish between non-payment for drinking water services from non-payment for the other non-drinking water charges for Residential customers?

    • Yes: The water system’saccounting system can distinguish non-payment or partial payment for drinking water charges from non-payment or partial payment for non-drinking water charges. For example, if a customer has a bill that has a $30 charge for drinking water services and $50 for electricity and the customer only pays $20 for the total $80 bill. The water system’s accounting system can determine how much is still due for drinking water charges. The water system may allocate the $20 towards any outstanding chargehow it sees fit.

    • No: The water system’s accounting system cannot distinguish non-payment or partial payment for drinking water charges from non-payment or partial payment for non-drinking water charges. For example, if a customer has a bill that has a $30 charge for drinking water services and $50 for electricity and the customer only pays $20 for the total $80 bill. The water system’s accounting system can NOT determine how much is still due for drinking water charges because it only accounts for total outstanding debt.
    4.1.1 Mandatory if Question 4.1 = "No": What is the average annual (or fiscal year) percentage of drinking water charges on your annual average Residential bill (which included non-drinking water charges)?

    This will allow the State Water Board to estimate the total amount of drinking water arrearages excluding other non-drinking water service charges.

    Calculation Example:The total average Residential bill includes:
    • Wastewater Services = $600
    • Drinking Water Services = $360
    • Trash = $300
    • TOTAL AVERAGE ANNUAL BILL = $1,260

    The average annual percentage of drinking water charges is calculated by:

    [Average Annual Drinking Water Charges / Total Average Annual Bill ] x 100

    [ $360 / $1,260 ] x 100 = 28.57%
    5 Mandatory: What is the number of active and inactive Residential accounts (single-family, multi-family, and mixed use that include residential) that are currently missing one or more required full or partial bill paymentsfor drinking water services provided during a billing period that includes servicefrom 03.04.2020 through 06.15.2021?

    Accounts that are currently late on their most recent bill should not be included, only those that are missing payments that have resulted in an outstanding balance or unpaid bill as of the last billing period, i.e. “Amount Before Due.”

    Residential accounts that are late or have accrued debt are:

    • Based on your water system’s adopted policy on Residential customer arrearages; or
    • Residential accounts that have not fully paid their drinking water bill balance 60 days after the bill payment due date.

    If your water system bills residential customers annually or quarterly and cannot provide an exact number of residential accounts in arrears during this timeframe, please provide the number of accounts in arrears after the deadline for your last billing cycle.

    This field cannot be left blank.

    If your answer is 0 and you have commercial customers, then you will be navigated toquestion 12 and questions between 5.1 through 11will be hidden.

    If your answer is 0 and you do not have commercial customers, then you will be navigated to question 22 and questions 5.1 though 21 will be hidden.

    If your answer is greater than 0 you will be navigated to question 5.1.
    5.1 Mandatory: How many of your active and inactive Residential accounts in arrears have a past due balance $600 or greater for drinking water services provided from 03.04.2020 through 06.15.2021? This includes any customer billing period that contains these dates.

    If 0 accounts have a past due balance of $600 or greater, please enter 0.
    5.2 Mandatory: Is documented evidence available to support this number of active and inactive Residential accounts that are currently missing one or more required full or partial bill payments for drinking water services provided from 03.04.2020 through 06.15.2021?

    Yes: Documented evidence is available and may include:

    • Customer Account Number: Your systems financial information may be organized by individual accounts with their own unique identifier.
    • Initial missed billing period due date: The first billing period the residential account started to default for drinking water charges.
    • Past Due Amount: Total amount a residential customer owes.
    • Late Fee Amount: Late fees that have accrued during the COVID-19 pandemic.
    • Examples of Correspondence Indicating Customer Debt:Copies of emails or letters sent to the customer notifying them of debt accrual. Copies of correspondence with ALL customers in arrears will NOT be required.

    Accepted Documentation Formats:

    • Electronic Spreadsheet (most preferred)
    • Other type of electronic accounting files
    • Physical Records/Non-electronic: ‘Paper’ records (e.g., copies of customer bills, past-due notices, emails to customers, etc.).

    No: Documented evidence is not available to support this number of active and inactive Residential accounts that are currently missing one or more required full or partial bill payments for drinking water services provided from 03.04.2020 through 06.15.2021.
    6 Mandatory: What is the sum of outstanding, uncollected Residential (single-family, multi-family, and mixed use that include residential) bills for drinking water services provided from 03.04.2020 through 06.15.2021 for both currently active and inactive accounts(DO NOT INCLUDE LATE FEES)?

    If non-drinking water charges are included in the total bill, please provide the total amount of bill debt that includes non-drinking water charges if you are unable to determine the drinking water debt separately.

    Charges that should NOT be included: late fees*, charges associated with non-drinking water services, taxes, fees, etc. that are on a customer’s bill that are not used to provided drinking water services. If your water system provided customer assistance and bill relief to customers during this time – please do NOT include that amount in this calculation.

    Please only provide the amount of unpaid debt for drinking water charges (fixed/base rates/fees and usage charges).

    * This information will be collected in question 7 below.

    Any numerical value is excepted here, but the field cannot be left blank.

    If answer is > $0; the user navigates to question 6.1.

    If answer is $0; the user navigates to question 7.
    6.1 Mandatory if 5.1> 0: Please provide the total amount of Residential arrearages for customers that have accrued debt of $600 or greater for drinking water services provided from 03.04.2020 through 06.15.2021 for both active and inactive accounts? This includes any customer billing period that contains these dates.

    This total should exclude any Residential accounts that have accrued arrears less than $600.
    6.2 Mandatory: Is documented evidence available to support this sum of outstanding, uncollected Residential bills for drinking water services provided from 03.04.2020 through 06.15.2021 for both currently active and inactive accounts? This includes any customer billing period that contains these dates.

    Yes: Documented evidence is available and may include:

    • Customer Account Number: Your systems financial information may be organized by individual accounts with their own unique identifier.
    • Initial missed billing period due date: The first billing period the residential account started to default for drinking water charges.
    • Past Due Amount: Total amount a residential customer owes.
    • Late Fee Amount: Late fees that have accrued during the COVID-19 pandemic.

    Accepted Documentation Formats:

    • Electronic Spreadsheet (most preferred)
    • Other type of electronic accounting files
    • Physical Records/Non-electronic: ‘Paper’ records (e.g., copies of customer bills, past-due notices, emails to customers, etc.).

    No: Documented evidence is not available to support this sum of outstanding, uncollected Residential bills for drinking water services provided from 03.04.2020 through 06.15.2021.
    7 Mandatory: What is the sum of outstanding, uncollected late fees associated with Residential accounts with outstanding water bills?

    This amount reflects the total outstanding accrued late fees associated with active and inactive Residential customer accounts in arrears. This sum shouldNOT include unpaid drinking water charges from past due water bills. This information is captured in question 6.
    8 Mandatory: How does your water system primarily track payment and non-payment for Residential water bills? Please select the option below that represents that most common format for the majority of information described above.

    • Electronic Database/Software: an online or desktop data tracking tool that manages customer accounts.

    • Spreadsheet (i.e. Excel, google sheets, etc.): This is different from an electronic database in that it is simply one or several files where information is manually tracked on a virtual form rather than a complex online or desktop database.

    • Paper files/ non-electronic: a physical record or collection of records that can verify the amount of payments vs non-payments. Ex: Bills, copies of receipts, invoices, letters/emails, etc.

    • No tracking system in place to document Residential payments/non-payments: no electronic or paper files exist to track Residential payments for drinking water services.
    9 Mandatory: Can your water system produce a spreadsheet with unique residential account numbers and the total outstanding drinking water debt per account for services provided from 03.04.2020 through 06.15.2021? This includes any customer billing period that contains these dates.

    • Yes, this can be completed within a week.
    • Yes, but it will take 2-3 weeks.
    • Yes, but will take a month or more.
    • Yes, but we will require outside assistance.
      • ‘Outside assistance’: If your system is unable to produce a spreadsheet without aide from another organization like a contractor, technical assistance provider, or government agency.
    • No, we don’t have the information needed to produce this spreadsheet.
    10 Mandatory: Does your water system provide payment plans for Residential customers in arrears?

    A payment plan is a revised billing solution which can be used when a customer has a temporary/sudden change in financial circumstance.

    Examples of payment plans may include:
    • Deferred or reduced payments
    • Alternative payment schedules
    • Revisions on payment agreements

    Requirements for payment plans are detailed in SB 998
    11 In the text box you may provide comments on Residential COVID-19 related debt. This information can help provide context to the State Water Board on how COVID-19 has impacted your customers.

    All information you provide will be available for disclosure through a public information request.
  5. NON-RESIDENTIAL COMMERCIAL CUSTOMER DEBT

    6. Question 12 through 21 are only revealed if the answer to Question 3 or 3A = "Both" or "Non-Residential"

    12 Can your water system distinguish between Non- Commercial Residential customers and other Non-Residential customers?*

    The State Water Board often distinguishes between Commercial and Institutional customer types. For the purposes of the Community Water System COVID-19 Relief Program; “Commercial Customers” will include Commercial and Institutional customers: hotels, motels, restaurants, office buildings, government and military facilities, gas stations, hospitals, educational institutions, retail establishments, dormitories, nursinghomes, churches, jails, prisons, mental health facilities, addiction recovery centers, farmworker housing, and campgrounds.

    Other Non-Residential customers include: industrial (manufacturing, chemical, refineries, cooling towers, animal & food processing, etc.); agriculture irrigation (crops, aquaculture, etc.); and landscape irrigation (parks, golf courses, etc.).

    Yes: your water system can distinguish between Non- Commercial Residential customers and other Non-Residential customers

    No: your water system cannot distinguish between Non- Commercial Residential customers and other Non-Residential customers

    If your answer is "No", please estimate your responses to the following questions based on your best available information. You may estimate Commercial customers using meter sizes. Meters on Non-Residential customers that are 8 inches or less may be an alternative method for approximating Commercial customers.
    13 Mandatory: Does your Commercial Non-Residential customer bill include any non-drinking water charges (i.e. wastewater, stormwater, electricity, telecommunications, property tax etc.)?*

    • Yes: If the water system’s customer bills include additional non-drinking water charges such as wastewater service charges; stormwater service charges; other Utility charges (electricity, gas, internet, and/or telecommunications); garbage, recycling collection, property taxes, etc.

    • No: There are no additional non-drinking water related charges included on the water system’s customer’s bills.
    13.1 Mandatory if Question 13 = "Yes": Can your accounting system distinguish between non-payment for drinking water services from non-payment for the other non-drinking water charges?

    • Yes: The water system’saccounting system can distinguish non-payment or partial payment for drinking water charges from non-payment or partial payment for non-drinking water charges. For example, if a customer has a bill that has a $30 charge for drinking water services and $50 for electricity and the customer only pays $20 for the total $80 bill. The water system’s accounting system can determine how much is still due for drinking water charges. The water system may allocate the $20 towards any outstanding chargehow it sees fit.

    • No: The water system’s accounting system cannot distinguish non-payment or partial payment for drinking water charges from non-payment or partial payment for non-drinking water charges. For example, if a customer has a bill that has a $30 charge for drinking water services and $50 for electricity and the customer only pays $20 for the total $80 bill. The water system’s accounting system can NOT determine how much is still due for drinking water charges because it only accounts for total outstanding debt.
    13.1.1 Mandatory if Question 13.1 = "No": What is the average annual (or fiscal year) percentage of drinking water charges on your annual average Non-Residential Commercial bill (which included non-drinking water charges)?

    This will allow the State Water Board to estimate the total amount of drinking water arrearages excluding other non-drinking water service charges.

    Calculation Example:The total average Residential bill includes:
    • Wastewater Services = $600
    • Drinking Water Services = $360
    • Trash = $300
    • TOTAL AVERAGE ANNUAL BILL = $1,260

    The average annual percentage of drinking water charges is calculated by:

    [Average Annual Drinking Water Charges / Total Average Annual Bill ] x 100

    [ $360 / $1,260 ] x 100 = 28.57%
    14 Mandatory: What is the number of active and inactive Commercial Non-Residential accounts that are currently missing one or more required full or partial bill payments for drinking water services provided during a billing period that includes service from 03.04.2020 through 06.15.2021?

    Accounts that are currently late on their most recent bill should not be included, only those that are missing payments that have resulted in an outstanding balance or unpaid bill as of the last billing period, i.e. “Amount Before Due.”

    Residential accounts that are late or have accrued debt are:

    • Based on your water system’s adopted policy on Residential customer arrearages; or
    • Residential accounts that have not fully paid their drinking water bill balance 60 days after the bill payment due date.

    If your water system bills commercial customers annually or quarterly and cannot provide an exact number of residential accounts in arrears during this timeframe, please provide the number of accounts in arrears after the deadline for your last billing cycle.

    This field cannot be left blank. If your answer is 0, then you will be navigated to question 22 and questions between 14.1 through 22 will be hidden.
    14.1 Mandatory: How many of your active and inactive Commercial Non-Residentialaccounts in arrears have a past due balance $600 or greater for drinking water services provided from 03.04.2020 through 06.15.2021? Thisincludes any customer billing period that contains these dates.

    If 0 accounts have a past due balance of $600 or greater, please enter 0.
    14.2 Mandatory: Is documented evidence available to support this number of active and inactive Commercial Non-Residential accounts that are currently missing one or more required full or partial bill payments for drinking water services provided from 03.04.2020 through 06.15.2021?

    Yes: Documented evidence is available and may include:

    • Customer Account Number: Your systems financial information may be organized by individual accounts with their own unique identifier.
    • Initial missed billing period due date: The first billing period the commercial account started to default for drinking water charges.
    • Past Due Amount: Total amount a commercial customer owes.
    • Late Fee Amount: Late fees that have accrued during the COVID-19 pandemic.
    • Examples of Correspondence Indicating Customer Debt: Copies of emails or letters sent to the customer notifying them of debt accrual. Copies of correspondence with ALL customers in arrears will NOT be required.

    Accepted Documentation Formats:

    • Electronic Spreadsheet (most preferred)
    • Other type of electronic accounting files
    • Physical Records/Non-electronic: ‘Paper’ records (e.g., copies of customer bills, past-due notices, emails to customers, etc.).

    No: : Documented evidence is not available to support this number of active and inactive Commercial Non-Residential accounts that are currently missing one or more required full or partial bill payments for drinking water services provided from 03.04.2020 through 06.15.2021.
    15 Mandatory: What is the sum of outstanding, uncollected Commercial Non-Residential bills for drinking water services provided from 03.04.2020 through 06.15.2021 for both currently active and inactive accounts(DO NOT INCLUDE LATE FEES)?

    If non-drinking water charges are included in the total bill, please provide the total amount of bill debt that includes non-drinking water charges if you are unable to determine the drinking water debt separately.

    Charges that should NOT be included: late fees*, charges associated with non-drinking water services, taxes, fees, etc. that are on a customer’s bill that are not used to provided drinking water services. If your water system provided customer assistance and bill relief to customers during this time – please do NOT include that amount in this calculation.

    Please only provide the amount of unpaid debt for drinking water charges (fixed/base rates/fees and usage charges).

    * This information will be collected in question 16 below.

    Any numerical value is excepted here, but the field cannot be left blank.

    If answer is > $0; the user navigates to question 15.1.

    If answer is $0; the user navigates to question 16.
    15.1 Mandatory if 14.1 > 0: Please provide the total amount of Commercial Non-Residential arrearages for customers that have accrued debt of $600 or greater for drinking water services provided from 03.04.2020 through 06.15.2021 for both active and inactive accounts? This includes any customer billing period that contains these dates.

    This total should exclude any Residential accounts that have accrued arrears less than $600.
    15.2 Mandatory: Is documented evidence available to support this sum of outstanding, uncollected Commercial Non-Residential bills for drinking water services provided from 03.04.2020 through 06.15.2021 for both currently active and inactive accounts? This includes any customer billing period that contains these dates.

    Yes: Documented evidence is available and may include:

    • Customer Account Number: Your systems financial information may be organized by individual accounts with their own unique identifier.
    • Initial missed billing period due date: The first billing period the commercial account started to default for drinking water charges.
    • Past Due Amount: Total amount a commercial customer owes.
    • Late Fee Amount: Late fees that have accrued during the COVID-19 pandemic.

    Accepted Documentation Formats:

    • Electronic Spreadsheet (most preferred)
    • Other type of electronic accounting files
    • Physical Records/Non-electronic: ‘Paper’ records (e.g., copies of customer bills, past-due notices, emails to customers, etc.).

    No: Documented evidence is not available to support this sum of outstanding, uncollected Commercial Non-Residential bills for drinking water services provided from 03.04.2020 through 06.15.2021.
    16 Mandatory: What is the sum of outstanding, uncollected late fees associated with Commercial Non-Residential accounts with outstanding water bills?

    This amount reflects the total outstanding accrued late fees associated with active and inactive Commercial Non-Residential customer accounts in arrears. This sum should NOT include unpaid drinking water charges from past due water bills. This information is captured in question 15.
    17 Mandatory: How does your water system primarily track payment and non-payment for Commercial Non-Residential water bills? Please select the option below that represents that most common format for the majority of information described above.

    • Electronic Database/Software: an online or desktop data tracking tool that manages customer accounts.

    • Spreadsheet (i.e. Excel, google sheets, etc.): This is different from an electronic database in that it is simply one or several files where information is manually tracked on a virtual form rather than a complex online or desktop database.

    • Paper files/ non-electronic: a physical record or collection of records that can verify the amount of payments vs non-payments. Ex: Bills, copies of receipts, invoices, letters/emails, etc.

    • No tracking system in place to document Residential payments/non-payments: no electronic or paper files exist to track Residential payments for drinking water services.
    18 Mandatory: Can your water system produce a spreadsheet with unique Commercial Non-Residential account numbers and the total outstanding drinking water debt per account for services provided from 03.04.2020 through 06.15.2021? This includes any customer billing period that contains these dates.

    • Yes, this can be completed within a week.
    • Yes, but it will take 2-3 weeks.
    • Yes, but will take a month or more.
    • Yes, but we will require outside assistance.
      • ‘Outside assistance’: If your system is unable to produce a spreadsheet without aide from another organization like a contractor, technical assistance provider, or government agency.
    • No, we don’t have the information needed to produce this spreadsheet.
    19 Mandatory: Does your water system provide payment plans for Commercial Non-Residential customers in arrears?

    A payment plan is a revised billing solution which can be used when a customer has a temporary/sudden change in financial circumstance.

    Examples of payment plans may include:
    • Deferred or reduced payments
    • Alternative payment schedules
    • Revisions on payment agreements

    Requirements for payment plans are detailed in SB 998
    20 Mandatory: The Governor’s Executive Order on the COVID-19 shut-off moratorium also applied to any business in the critical infrastructure sectors designated by the State Public Health Officer as critical to protect the health and well-being of all Californians that qualifies as a small business under 13 CFR Section 121.201 of the Small Business Administration’s regulations. Did your water system extend shut-off protection beyond this to include additional Commercial customers?

       - Select One -

    • No, we only extended shut-off protection to those included in the Executive Order.

    • Yes, we extended shut-off protection to some additional commercial customers.

    • Yes, we extended shut-off protection to all our commercial customers.
    21 In the text box you may provide comments on Commercial Non-Residential COVID-19 related debt. This information can help provide context to the State Water Board on how COVID-19 has impacted your customers.

    All information you provide will be available for disclosure through a public information request.
  6. WATER SYSTEM COVID-19 RELATED REVENUE LOSS

    7. 22 Did your water system experience COVID-19 related drinking water revenue loss between 03.04.2020 and 06.15.2021? This includes any customer billing period that contains these dates.

    Revenue loss includes total drinking water revenue declines when comparing revenues before the COVID-19 pandemic to revenue collected during the COVID-19 pandemic, ending in 06.15.2021.

    Revenue declines may be attributed to unpaid customer charges (Residential and Non-Residential) and decreased demand compared to average demand before the COVID-19 pandemic. Community water systems that do not charge customers directly for water may have experienced COVID-19 related revenue declines (i.e. reduced fees, rent, and other sources of income).

    Yes: My community water system did experience COVID-19 related drinking water revenue loss between 03.04.2020 and 06.15.2021.

    No: My community water system did experience COVID-19 related drinking water revenue loss between 03.04.2020 and 06.15.2021.

    If "No" you will be navigated to question 29.

    If "Yes" you will be navigated to question 23.
    23 Mandatory: What was your water system’s total 2019 (fiscal or calendar year) revenue?

    Any numerical value is excepted here, but the field cannot be left blank. Field cannot accept non-numerical values such as a negative sign.

    This amount will be used as a basis to determine general revenue loss compared to previous years.
    23.1 Mandatory: Is this for the fiscal or calendar year?

    • 2019 calendar year
    • 2019 fiscal year

    Fiscal year: a one-year period of time that your water system uses for accounting purposes and preparation of its financial statements.

    If your water system's fiscal year is based on the calendar year (Jan 1 to Dec 31), then select "2019 calendar year" for this question.

    If you select 2019 fiscal year, you will be navigated to question 23.1.1.

    If you select 2019 calendar year, you will be navigated to question 24.
    23.1.1 Mandatory if 23.1 = "2019 fiscal year": Please select fiscal year start date.

    Ex: A fiscal year starting on July 1, 2018, and ending on June 30, 2019, refers to the fiscal year 2019, or FY 2019.
    24 Mandatory: What were your total 2019 (fiscal or calendar, consistent with your revenue time period) expenses for operating your drinking water system and maintaining drinking water services? Please exclude any large capital/infrastructure expenses that were made during this time (i.e. construction of a new well).

    The value provided must be greater than $0.

    Expenses should include:

    • Operations and Maintenance Expenses: expenses incurred during the system’s normal operation during the reporting year. It may include salaries, benefits for employees, utility bills, system repair and maintenance, supplies (e.g., treatment chemicals), insurance, water purchased for resale etc.

    • Finance-related Expenses: Expenses incurred from retirement of long-term debt, purchase of securities, interest expenses etc.

    Please exclude:

    • Large Investing and Capital Expenditures: expenses incurred from purchase of property and equipment; construction of new assets (i.e. treatment, distribution etc.) and any other expenditures related towards expanding and/or improving the water system.

    The purpose of this question is to estimate the average annual expenditures the water system incurred before the COVID-19 pandemic.
    25 Mandatory [pulled from 2020 EAR]: Total 2020 (fiscal or calendar year) revenue?

    This information is required and was collected in the 2020 Electronic Annual Report (EAR). If the figure below is missing, this means you did not complete this required data field in your 2020 EAR. You must provide this information in the 2020 EAR to be eligible for this funding. You may re-open your EAR to complete this data field.

    If the answer displayed in this question is incorrect and you would like to change it; please update your response to this question in the 2020 Electronic Annual Report (EAR). Once the answer has been updated in the EAR, it will automatically update in this survey.

    Auto-Calculated; Total Annual Revenue for the Reporting Year.

    This field will auto-calculate using the values provided in the previous questions.

    Total Annual Revenue for the Reporting Year = Residential Water Rate Revenue (B1.1) + Non-Residential Water Rate Revenue (B1.2) + Residential Fees and Charges Revenue (B1.3) + Non-Residential Fees and Charges Revenue (B1.4) + Interfund or Governmental Revenue (B1.5.2) – Interfund or Government Revenue Lost (B1.6) + Other Revenue (B1.7)
    25A Mandatory – this question must be completed using aggregated information for the systems that you are reporting for. See guidance for question in the help tip above.
    25.1 Mandatory: Is this for the fiscal or calendar year?

    • 2020 calendar year
    • 2020 fiscal year

    Fiscal year: a one-year period of time that your water system uses for accounting purposes and preparation of its financial statements.

    If your water system's fiscal year is based on the calendar year (Jan 1 to Dec 31), then select "2020 calendar year" for this question.

    If you select 2020 fiscal year, you will be navigated to question 25.1.1.

    If you select 2020 calendar year, you will be navigated to question 26.
    25.1.1 Mandatory if 25.1 = "2020 fiscal year": Please select fiscal year start date.

    Ex: A fiscal year starting on July 1, 2019, and ending on June 30, 2020, refers to the fiscal year 2020, or FY 2020.
    26 Mandatory: Please estimate your lost customer derived revenue from 01.01.2021 to 06.15.2021 due to the COVID-19 pandemic for drinking water services. This sum may include unpaid customer charges (Residential and Non-Residential) and decreased demand compared to average demand before the COVID-19 pandemic.

    Do not include other revenues such as interest income, depreciation, or any income not directly associated with customers. Do not include any incurred expenses in this calculation.

    If you operate on a fiscal year calendar that includes these dates, and this information is included in your response to question 25, please enter 0.

    If your water system did not experience any revenue declines during this time period, please enter 0.
    27 Mandatory: Approximately how much lost customer derived revenue accrued during the entire COVID-19 pandemic for drinking water services provided from 03.04.2020 through 06.15.2021? This includes any customer billing period that contains these dates. This sum may include unpaid customer charges (Residential and Non-Residential) and decreased demand compared to average demand before the COVID-19 pandemic.

    Do not include other revenues such as interest income, depreciation, or any income not directly associated with customers. Do not include any incurred expenses in this calculation.

    Water system that do not directly charge customers for water may include revenue loss associated from declines in intergovernmental transfers of funds* and other types of revenue associated with customers/drinking water recipients.

    Example: A mobile home park that does not directly charge for water, but water is included in the rent and customers are behind on rent payments. Please provide an estimate of revenue loss due to reduced rent income.

    * intergovernmental transfers of funds - Typically this takes the form of a transfer of funds from a City or County general fund to the drinking water system. The source of these funds may be from other utilities (wastewater, stormwater, energy etc.) or revenues from property taxes/fees, sales taxes/fees, and/or other charges not directly charges by the drinking water system.

    If your water system did not experience any revenue declines during this time period, please enter 0.
    28 In the text box you may provide comments on COVID-19 related drinking water system debt. This information can help provide context to the State Water Board on how COVID-19 has impacted your system.

    All information you provide may be available for disclosure through a public information request.
  7. ESTIMATED DRINKING WATER FUNDING REQUEST

    8. 29 Mandatory: Based on the information provided in this survey, approximating how much support do you anticipate requesting from this funding program for drinking water?

    This is an estimation of how much your water system may apply for through the Community Water System COVID-19 Relief Program.

    This information will not be used for your official application request for funding.
    30 Voluntary: Comments on estimated funding request.

    In the text box you may provide comments on your estimated funding request.

    All information you provide may be available for disclosure through a public information request.
    31 Mandatory: The information provided in this survey will be used to make important eligibility and allocation decisions for this program, please certify that the information provided is true and accurate under penalty of perjury.

    The water system reporter must certify that the information provided is true and accurate under penalty of perjury.

    The State Water Board recognizes that some community water systems may not be able to provide verified or exact answers to some of the questions in this survey.Community water systems must make every reasonable effort to determine the answers using the best available information and answer all questions truthfully and accurately to the best of its abilities under penalty of perjury.
    32 Voluntary: The State Water Bord may be able to provide technical assistance to help your water system complete a funding application when the application window opens.

    Please select the checkbox below if you are interested in receiving assistance in compiling the application materials to submit an application.

    Technical Assistance Request Form: https://www.waterboards.ca.gov/drinking_water/docs/ta_request_form_arrears.pdf

    Please email TA request form to DFA-TARequest@waterboards.ca.gov
  8. PRE-APPLICATION MATERIALS

    9. In order for the State Water Board to process a payment, your water system must submit the following form which contains your water system’s Tax ID.

    You may upload the form to this survey if you are able to complete it before the survey deadline. Or you may email it to communitywatersystemscovidrelief@waterboards.ca.gov if you cannot complete it by the survey deadline.

    33 Mandatory: Tax Filing Status

    Your ‘Tax Filing Status’ is based on your water system’s ownership type. This information is imported directly from your 2020 Electronic Annual Report (EAR) for question Water System Information: Water System Ownership.

    Ownership types by filing status:

    Government

    • Local Government: e.g., city, county, or special district, local school district, junior colleges, county or community parks, etc.

    • State or Federal Government: e.g., state or national park, BLM, USFS and COE campgrounds and recreation facilities, or District Fairs and Expositions, Caltrans rest stop, military base, other state or federal facility

    Non-Government

    • Privately Owned, PUC Regulated, For Profit: investor-owned water utilities as listed by CPUC’s water division: https://www.cpuc.ca.gov/water/

    • Privately owned, non-PUC-regulated (Community Water System): e.g., mobile home park, apartment or condominium

    • Privately Owned, Mutual Water Company or Association: Any public water system meeting the definition per California Corporations Code Section 14300, https://law.onecle.com/california/corporations/14300.html

    • Privately owned business (non-community): e.g., church, private school, restaurant, amusement park, RV park/campground, motel, ranch/farm, factory, other business establishment

    If the answer displayed in this question is incorrect and you would like to change it; please update your response to this question in the 2020 EAR. Once the answer has been updated in the EAR, it will automatically update in this survey.
    33A Mandatory – this question must be completed using aggregated information for the systems that you are reporting for. See guidance for question in the help tip above.
    34 Mandatory if you have not done so already: You must download and complete the form provided below. Completed and signed forms must be emailed to communitywatersystemscovidrelief@waterboards.ca.gov

    This form must be signed by your water system’s authorized signatory - Administrative Contact or authorized fiscal representative. The authorized signatory or authorized fiscal representative is required to provide a wet signature (physically sign) the form and attach a copy of the form. Forms with electronic signatures will not be accepted.

    Government Tax Filing Status: https://fiscal.ca.gov/wp-content/uploads/2019/08/GovtTINForm_000.pdf

    Non-Government Tax Filing Status: https://www.documents.dgs.ca.gov/dgs/fmc/pdf/std204.pdf


    • Instructions are available on each form to assist with filling them out.
    • Note that the entity’s name and Taxpayer Identification Number provided on the form must match the information on file with the Internal Revenue Service to be accepted.
    • Authorized signatories or authorized fiscal representatives must include their title (e.g., President, General Partner, etc.) as it relates to the organization to demonstrate authority to sign on behalf of the organization.