HomeMy WebLinkAbout20260581 Resolution
Approve Federal Demonstration Partnership (FDP) Reciprocal Data Transfer and
Use Agreement for Survey of Private Well Stewardship in Colorado Communities,
and Authorize Chair to Sign — Colorado State University
Whereas, the Board of County Commissioners of Weld County, Colorado, pursuant to
Colorado statute and the Weld County Home Rule Charter, is vested with the authority of
administering the affairs of Weld County, Colorado, and
Whereas, the Board has been presented with a Federal Demonstration Partnership
(FDP) Reciprocal Data Transfer and Use Agreement for Survey of Private Well
Stewardship in Colorado Communities between the County of Weld, State of Colorado,
by and through the Board of County Commissioners of Weld County, on behalf of the
Department of Public Health and Environment, and the Board of Governors of the
Colorado State University System, acting by and through Colorado State University
(CSU), for the use and benefit of Environmental and Radiological Health Sciences,
commencing March 6, 2026, and ending March 5, 2028, with further terms and conditions
being as stated in said agreement, and
Whereas, after review, the Board deems it advisable to approve said agreement, a copy
of which is attached hereto and incorporated herein by reference.
Now, therefore, be it resolved by the Board of County Commissioners of Weld County,
Colorado, that the Federal Demonstration Partnership (FDP) Reciprocal Data Transfer
and Use Agreement for Survey of Private Well Stewardship in Colorado Communities
between the County of Weld, State of Colorado, by and through the Board of County
Commissioners of Weld County, on behalf of the Department of Public Health and
Environment, and the Board of Governors of the Colorado State University System, acting
by and through Colorado State University (CSU), for the use and benefit of Environmental
and Radiological Health Sciences, be, and hereby is, approved.
Be it further resolved by the Board that the Chair be, and hereby is, authorized to sign
said agreement.
cc- F-%L C 3G/ SF) 2026-0581
(31 laap HL0059
Federal Demonstration Partnership (FDP) Reciprocal Data Transfer and Use Agreement
for Survey of Private Well Stewardship in Colorado Communities — Colorado State
University
Page 2
The Board of County Commissioners of Weld County, Colorado, approved the above
and foregoing Resolution, on motion duly made and seconded, by the following vote on
the 16th day of March, A.D., 2026, nunc pro tunc March 6, 2026:
Scott K. James, Chair: Aye
Jason S. Maxey, Pro-Tem: Aye � ��L®P
•
Perry L. Buck: Aye I . 0Lynette Peppler: Aye `�
Kevin D. Ross: Ayetii4.9.4r
Approved as to Form: V
Bruce Barker, County Attorney
Attest:
Esther E. Gesick, Clerk to the Board
2026-0581
HL0059
c n vct ck I D 045Ct
BOARD OF COUNTY COMMISSIONERS
PASS-AROUND REVIEW
PASS-AROUND TITLE: Conduct a well water survey for Weld residents
DEPARTMENT: Public Health and Environment DATE: 3/10/26
PERSON REQUESTING: Jason Chessher, Executive Director
Brief description of the problem/issue:
The department seeks to partner with CSU to conduct a survey of well users within Weld County. The goal of
the survey is to glean information on well user knowledge and needs so we can better match services with
customer needs. The survey will also educate well users on lab services provided by the County.
Researchers at CSU have previously partnered with other county health departments to conduct similar surveys
and they are willing to partner with us. We have reviewed their survey,and included Weld specific amendments,
which provide us with the data that we need. In addition to being able to capture the data we are looking for,
CSU can provide incentives in the form of gift cards (at no cost to Weld County). Similar incentives have shown
to be effective in increasing response rates.
The department will conduct the mailings while CSU will collect the data which will then be shared with us. CSU
has a Data Transfer Use Agreement(DTAU)to ensure that roles are clearly defined.
What options exist for the Board?
Consequences: Completing the survey will help to ensure programing for our water lab is in line with
customer needs. By not completing the survey, the lab will continue to provide high level of customer
service but may miss out on overall needs as we deal with a subset of all well users within the county.
Impacts: This survey will help to ensure that lab programing is focused on what is most important to our
residents and community members.
Costs(Current Fiscal Year/Ongoing or Subsequent Fiscal Years): One time cost(no ongoing costs)
of up to$3000(includes mailings, our incentive of 10 free water sampling tests, and possible advertising).
Recommendation: I recommend approval to conduct the well water survey and to place related DTAU on a
future Board agenda for formal consideration.
Support Recommendation Schedule
Place on BOCC Agenda Work Session Other/Comments:
Perry L. Buck _
Scott K. James
Jason S. Maxey - 1
Lynette Peppier
Kevin D. Ross
2026-0581
3/( 14L,0059
September 2020 FDP Reciprocal Data Transfer and Use Agreement Agreement ID.CSU.41996
FDP Reciprocal Data Transfer and Use Agreement ("Agreement")
Party 1:The Board of Governors o/the Colorado State Unwersity System,acting f Party 2:Weld County, Dept of Health and
by and through Colorado Slate university tCSU),for the use and benoRt of
Environmental and Radiological Health Sciences Environment
Party 1 Scientist Party 2 Scientist
Name:Lee,Debbie Name: Katrina Alsum
Email: debbie.lee@colostate.edu Email: kalsum@weid.gov
Party 1 Data Type: De-identified Data about Human Subjects Party 2 Data Type: Personally Identifiable Information-Common Rule only
Agreement Term Project Title: Private well stewardship in
Start Date: March 6,2026 Colorado communities
End Date: March 5,2028
Terms and Conditions
1) The Parties shall provide the data set(s)described on Attachment 1 (the"Data")to each other for the
research purpose set forth in Attachment 1 (the "Project"). Each Party is a Providing Party when providing Data
and a Receiving Party when receiving Data. Providing Party shall retain ownership of any rights it may have in
the Data, and Receiving Party does not obtain any rights in the Data other than as set forth herein.
2) Receiving Party shall not use the Data except as authorized under this Agreement. The Data will be used
solely to conduct the Project and solely by Receiving Party's Scientist and Receiving Party's faculty, employees,
fellows, students, and agents ("Receiving Party Personnel")and Third Party Personnel (as defined in Attachment
3)that have a need to use, or provide a service in respect of, the Data in connection with the Project and whose
obligations of use are consistent with the terms of this Agreement (collectively, "Authorized Persons").
3) Except as authorized under this Agreement or otherwise required by law, Receiving Party agrees to retain
control over the Data and shall not disclose, release, sell, rent, lease, loan, or otherwise grant access to the Data
to any third party, except Authorized Persons, without the prior written consent of Providing Party. Receiving
Party agrees to establish appropriate administrative, technical, and physical safeguards to prevent unauthorized
use of or access to the Data and comply with any other special requirements relating to safeguarding of the Data
as may be set forth in the applicable Attachment 2.
4) Receiving Party agrees to use the Data in compliance with all applicable laws, rules, and regulations,as well
as all professional standards applicable to such research.
5) The Parties are encouraged to make publicly available the results of the Project. Before either Party submits
a paper or abstract for publication or otherwise intends to publicly disclose information about the results of the
Project, the other Party will have thirty(30)days from receipt to review proposed manuscripts and ten (10)days
from receipt to review proposed abstracts to ensure that the Data is appropriately protected. The non-publishing
Party may request in writing that the proposed publication or other disclosure be delayed for up to thirty (30)
additional days as necessary to protect proprietary information. The Parties will together make decisions on
jointly authored publications. Authorship will be in accordance with academic and/or scholarly standards.
6) Receiving Party agrees to recognize the contribution of the Providing Party as the source of the Data in all
written, visual, or oral public disclosures concerning Receiving Party's research using the Data, as appropriate in
accordance with scholarly standards and any specific format that has been indicated in Attachment 1.
7) Unless terminated earlier in accordance with this section or extended via a modification in accordance with
Section 12, this Agreement shall expire as of the End Date set forth above. Either Party may terminate this
Agreement with thirty (30)days written notice to the other Party's Authorized Official as set forth below. Upon
expiration or early termination of this Agreement, Receiving Party shall follow the disposition instructions provided
in Attachment 1, provided, however,that Receiving Party may retain one (1)copy of the Data to the extent
necessary to comply with the records retention requirements under any law, and for the purposes of research
integrity and verification.
8) EXCEPT AS PROVIDED BELOW OR PROHIBITED BY LAW,ANY DATA DELIVERED PURSUANT TO
THIS AGREEMENT IS UNDERSTOOD TO BE PROVIDED "AS IS." PROVIDING PARTY MAKES NO
REPRESENTATIONS AND EXTENDS NO WARRANTIES OF ANY KIND, EITHER EXPRESSED OR IMPLIED.
THERE ARE NO EXPRESS OR IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A
PARTICULAR PURPOSE, OR THAT THE USE OF THE DATA WILL NOT INFRINGE ANY PATENT,
COPYRIGHT, TRADEMARK, OR OTHER PROPRIETARY RIGHTS. Notwithstanding, Providing Party, to the
best of its knowledge and belief, has the right and authority to provide the Data to Receiving Party for use in the
Project.
2oZl�- d5'1
September 2020 FDP Reciprocal Data Transfer and Use Agreement Agrccmcnt ID-CSU.41996;
9) Each Receiving Party shall be liable for damages,losses,claims,and demands which may arise from its use,
storage, disclosure, or disposal of the Data except to the extent(a) prohibited by law and/or(b) caused by the
negligence,willful misconduct, or violation of applicable privacy or security laws and regulations by the Providing
Party. No indemnification for any damage, loss,claim,demand,or liability is intended or provided by either Party
under this Agreement.
10) Neither Party shall use the other Party's name,trademarks,or other logos in any publicity,advertising, or
news release without the prior written approval of an authorized representative of that Party. The Parties agree
that each Party may disclose factual information regarding the existence and purpose of the relationship that is
the subject of this Agreement for other purposes without written permission from the other Party provided that
any such statement shall accurately and appropriately describe the relationship of the Parties and shall not in any
manner imply endorsement by the other Party whose name is being used.
11) Unless otherwise specified,this Agreement and the below listed Attachments embody the entire
understanding between the Parties regarding the transfer of the Data for the Project:
I. Attachment 1: Project-specific Information
II. Party 1 Attachment 2: Data-specific Terms and Conditions
III. Party 2 Attachment 2: Data-specific Terms and Conditions
IV. Attachment 3: Identification of Permitted Third Parties(if any)
In the event of any conflict between the obligations set forth in the applicable Attachment 2 and this Agreement,
the obligations set forth in Attachment 2 shall prevail.
12) No modification or waiver of this Agreement shall be valid unless in writing and executed by duly authorized
representatives of both Parties.
13) The undersigned Authorized Officials of the Parties expressly represent and affirm that the contents of any
statements made herein are truthful and accurate and that they are duly authorized to sign this Agreement on
behalf of their institution.
By an Authorized Official of Party 1:
Digitally signed by Adam Donze,
�\ .._ Contracting Officer
"- Date:2026.03.09 17.05:17-06'00'
Name:Adam Donze Date
Title: Contracting Officer, OSP
Contact Information for Formal Notices: Contact Information for Formal Notices:
Name: Sponsored Programs Name: Katrina Alsum
Address: Campus Delivery 2002 Address: 1555 N. 17th Ave
Fort Collins,Colorado 80523-2002 Greeley,CO 80631
Email: OSP_MTA_NDA@ColoState.edu Email: kalsum@weld.gov
Phone: (970)491-6355 Phone: 970-400-2272
By an Aytyriz. cif f Party4 Board of County Commissioners
Attest:
GG��OOii WeldrCounty, Colorado
Clerk to the Board
By:
Deputy Clerk o the Board `; ott K.James, Chairist\s MAR 1 6
2026
<
ilti
1861 01114
440
2oz lc, -0581
September 2020 FDP Reciprocal Data Transfer and Use Agreement Agreement ID:CSU:41996;
Attachment 1
Reciprocal Data Transfer and Use Agreement
Project-specific Information
1. Description of Project:
This study aims to better understand the testing and treatment behaviors, concerns, and motivations of
private well users in Weld County through mixed methods (surveys, interviews, water testing). We will send
Katrina deidentified survey data after the survey is complete, including only zip code information
and removing all other identifiers. Water testing data generated by the county will be shared with
researchers in the project. Incentives for enrollment include 10 free water sample tests to be provided by the
county,where test recipients will be identified using survey responses. 10 random gift card winners will be
selected at the end of the survey and notified by CSU directly.
2. Description of Party 1 Data:
Party 1 will provide Weld County with well water user survey data on testing and treatment behaviors,
concerns, and motivations in order for the county to perform their own analyses. These data will be
deidentified. Survey data will be sent after the survey is complete, including only zip code information and
removing all other identifiers.
3. Party 1 Disposition Requirements upon the termination or expiration of the Agreement
No disposition requirements. Party 2 may continue to store and use Party 1 Data upon the termination or
expiration of the Agreement.
4. For Party 1, send Data electronically to:
Name: Lee, Debbie
Email: debbie.lee@colostate.edu
Address:
Phone:
September 2020 FDP Reciprocal Data Transfer and Use Agreement Agreement ID: CSU:41996 ;
5. Description of Party 2 Data:
Party 2 will provide CSU with water quality data (results for nitrate, total coliform/E. coli, arsenic, cadmium,
iron, manganese, and uranium)for the 10 wells analyzed as incentive so that CSU can incorporate it into
water quality data from other counties. These data will be identified so CSU can connect it with responses to
the survey. Water quality data will be sent after analysis is complete.
6. Party 2 Disposition Requirements upon the termination or expiration of the Agreement
The Receiving Party is permitted to link Party 2 Data with other data sets, and this does not change at the
expiration or early termination of this Agreement.
7. For Party 2, send Data electronically to:
Name: Katrina Alsum
Email: kalsum@weld.gov
Address:
Phone:
FDP Data Transfer and Use Agreement
Agreement ID:
Attachment 2
Data Transfer and Use Agreement
Data-specific Terms and Conditions:
De-identified Data about Human Subjects
Additional Terms and Conditions:
1. The Data will not include personally identifiable information as defined in NIST Special Publication
800-122. If the Data being provided is coded, the Provider will not release, and the Recipient will not
request, the key to the code.
2. If Provider is a Covered Entity, the Data will be de-identified data, as defined by the Health
Insurance Portability and Accountability Act of 1996 ("HIPAA").
3. Recipient will not use the Data, either alone or in concert with any other information, to make any
effort to identify or contact individuals who are or may be the sources of Data without specific written
approval from Provider and appropriate Institutional Review Board (IRB) approval, if required
pursuant to 45 CFR 46. Should Recipient inadvertently receive identifiable information or otherwise
identify a subject, Recipient shall promptly notify Provider and follow Provider's reasonable written
instructions, which may include return or destruction of the identifiable information.
4. By signing this Agreement, Recipient provides assurance that relevant institutional policies and
applicable federal, state, or local laws and regulations (if any) have been followed, including the
completion of any IRB or ethics review or approval that may be required.
5. Recipient shall promptly report to the Provider any use or disclosure of the Data not provided for by
this Agreement of which it becomes aware.
February 2019 FDP Data Transfer and Use Agreement
Agreement ID: CSU:41996 ;
Attachment 2
Data Transfer and Use Agreement
Data-specific Terms and Conditions:
Personally Identifiable Information- Common Rule Only
Additional Terms and Conditions:
1. The Data is Personally Identifiable Information, as that is defined in OMB Memorandum M-07-16, and not
covered under HIPAA, FERPA, or similar laws or regulations governing personal information that require
the addition of special terms beyond those included in this Attachment 2.
D If checked,the Data is subject to the Federal Privacy Act of 1974, as amended, at 5 U.S.C. §552a.
❑ If checked,the Data is covered under a Certificate of Confidentiality,which must be asserted
against compulsory legal demands, such as court orders and subpoenas for identifying information or
characteristics of a research participant. See https://grants.nih.gov/grants/guide/notice-files/NOT-OD-
17-109.html for further information.
2. Notwithstanding any statement herein to the contrary, Provider represents that it has full authority to share
the Data with the Recipient and has confirmed that the Project is consistent with such consents as
Provider may have obtained from individuals who are the subjects of the Data.
3. Unless otherwise required by law or legal process, Recipient shall not use or further disclose the Data
other than as permitted by this Agreement. If Recipient believes it is required by law or legal process to
use or disclose the Data, it will promptly notify Provider, to the extent allowed by law, prior to such use or
disclosure and will disclose the least possible amount of Data necessary to fulfill its legal obligations.
4. In the event Recipient becomes aware of any use or disclosure of the Data not provided for by this
Agreement, Recipient shall take any appropriate steps to minimize the impact of such unauthorized use or
disclosure as soon as practicable and shall notify Provider of such use or disclosure as soon as possible,
but no later than 5 business days after discovery of the unauthorized use or disclosure. Recipient shall
cooperate with Provider to investigate, correct, and/or mitigate such unauthorized use or disclosure.
Recipient acknowledges that Provider may have an obligation to make further notifications under
applicable state law and shall cooperate with the Provider to the extent necessary to enable Provider to
meet all such obligations.
5. Recipient will not use the Data, either alone or in concert with any other information,to make any effort to
contact individuals who are the subjects of the Data without appropriate Institutional Review Board (IRB)
approval, specific written approval from Provider, and informed consent from the individual, if required.
6. Recipient agrees to store Data with security controls adequate to protect Personally Identifiable
Information, to ensure that only Authorized Persons have access to the Data, and to maintain appropriate
control over the Data at all times.
7. Recipient agrees to remove and securely destroy or return, as directed by the Provider in Attachment 1,
the part or parts of the Data that identifies the individual who is the subject of the Data at the earliest time
at which removal and destruction or return can be accomplished, consistent with the purpose of the
Project.
8. By signing this Agreement, Recipient provides assurance that its relevant institutional policies and
applicable federal, state, or local laws and regulations(if any)have been followed, including the
completion of any IRB review or approval that may be required prior to Recipient's use of the Data. Upon
Provider's written request to the Recipient's Contact for Formal Notices identified in the signature block,
Recipient shall provide documentation of its IRB-Approved Protocol.
September 2020 FDP Reciprocal Data Transfer and Use Agreement Agreement ID:CSU:41996;
Attachment 3
Reciprocal Data Transfer and Use Agreement
Identification of Permitted Third Parties (if any)
For all purposes of this Agreement, the definition of"Third Party Personnel"checked below will pertain:
n"Third Party Personnel" means: None. No collaborators are permitted on the Project.
-OR-
I "Third Party Personnel"means as set forth below and agreed upon between the Parties:
Sample definition language for the drafter; delete if the first option is checked or after a final definition has
been agreed between the Parties:
"Third Party Personnel" means: faculty, employees,fellows, or students of[NAME OF THIRD PARTY
INSTITUTION], an academic institution, which institution (i)has agreed to collaborate in the Project, (ii)has
faculty, employees, fellows, or students who have a need to use or provide a service in respect of the Data in
connection with its collaboration in the Project, and (iii) has been made aware of the terms of this Agreement
and agreed to comply, and to cause its personnel to comply,with such terms.
An alternative option for(iii): "has executed an agreement that is substantially similar to this Agreement"
WELL OWNER SURVEY
WELD COUNTY DEPT OF PUBLIC HEALTH AND ENVIRONMENT
We at the Weld County Department of Public Health and Environment(WCDPHE) invite you to
participate in a survey so we can learn more about households that consume water from a private
well. Specifically, we want to know more about perceptions of water quality and motivations or
barriers to well testing, management, and treatment. All questions are optional, and all
responses are anonymous. All interested participants will be entered into a drawing for a
chance to win one of 10 $25 Amazon gift cards once the survey is closed. In addition, free water
testing will be offered to the first 10 interested participants to submit the survey who use well
water as their primary source of drinking water. If you do not use well water as your primary
source of drinking water, please do not complete this survey.
The survey will take about 10-15 minutes to complete.
If you have any questions, please contact the Weld County Dept. Public Health and Environment
Laboratory at 970-400-2278. We will be obtaining your consent to participate in this survey
through the following question. Do you agree with this statement:
"I have read (or someone has read to me) this consent form, and I am aware that I am being
asked to participate in a research study. I have had the opportunity to ask questions and have had
them answered to my satisfaction. I voluntarily agree to participate in this study. I am not giving
up any legal rights by providing consent. I will be given a copy of this consent form."
❑ Yes
❑ No - Survey Ends
Full name of participant:
We need your name to document consent. All individual participant data will be kept
confidential.
Thank you for agreeing to participate in this study. Please start the survey here:
Initial) Does your household use a private well for drinking water?
❑ Yes
❑ No (Do not complete this survey)
1) Which of the following best describes your relationship to the property?
❑ Primary home that I own
❑ Primary home that I rent
❑ Other(please specify):
2) How regularly is this well used for drinking water?
❑ Always
❑ Mostly
❑ Sometimes
❑ Never
3) Approximately how many people in the household drink water from the well?
❑ None
❑ 1-2
❑ 3 or more
❑ I don't know
4) Approximately how long have you been using water from this well?
❑ < 1 year
❑ 1-5 years
❑ 6-10 years
❑ More than 10 years
5) What, if any, concerns do you have about your well water? Please select all that apply.
❑ No concerns
❑ Bacteria, viruses, or parasites
❑ Lead
❑ Uranium/Radioactive Elements
❑ Other Metals (e.g., Arsenic, Copper, Iron, etc.)
❑ Nitrates
❑ Fluoride
❑ Hardness
❑ Pesticides
❑ Tastes Bad
❑ Smells Bad
❑ Volatile Organic Compounds (VOCs)
❑ Other(please specify):
❑ I don't know
6) Have you ever had your well water tested by a professional lab (for example:
WCDPHE)?
❑ Yes
❑ No - SKIP to Q13
❑ I don't know 4 SKIP to Q13
7) Which of the following are reasons that you had your well water tested? Please select all
that apply.
U To know if my well water is safe to drink.
❑ A local authority recommended I test my water.
❑ Issues with my water's taste, smell, appearance, etc.
O A private company contacted me offering well testing services.
❑ I heard about a local issue with well water quality.
❑ It was required for my real estate transaction.
❑ There are/were industrial activities in surrounding areas.
❑ I was drilling a new well.
❑ Other(please specify):
8) Approximately when was your well water last tested?
❑ Within the last year
❑ 1-5 years ago
❑ More than 5 years ago - SKIP to Q10
❑ I don't know 4 SKIP to Q10
9) Do you get your well water tested every year?
❑ Yes
❑ No
❑ I don't know
10) What have you tested your well water for? Please select all that apply.
❑ Bacteria(Total Coliform/E. co/i)
❑ pH
❑ Nitrate/Nitrite
❑ Lead
❑ Uranium/Radioactive Elements
❑ Other Metals (e.g., Arsenic, Copper, Iron, etc.)
❑ Hardness
❑ Fluoride
❑ Volatile Organic Compounds (VOCs)
❑ Total Dissolved Solids (TDS)
❑ Other(please specify):
❑ I don't know
11) Has previous well water testing ever shown a problem with the following? Please select
all that apply.
U No problems - SKIP to Q13
❑ Bacteria(Total Coliform/E. co/i)
❑ pH
❑ Nitrate/Nitrite
❑ Lead
❑ Uranium/Radioactive Elements
❑ Other Metals (e.g., Arsenic, Copper, Iron, etc.)
❑ Hardness
O Fluoride
❑ Volatile Organic Compounds (VOCs)
❑ Total Dissolved Solids (TDS)
❑ Other(please specify):
❑ I don't know -3 SKIP to Q14
12) When you received your water test results, did you do any of the following to help
understand and address the issue? Please select all that apply.
❑ I called the State Government/Colorado Department of Public Health and Environment.
❑ I called the local health department/Weld County Department of Public Health and
Environment.
❑ I called the lab that did the testing.
❑ I called a company offering well/water treatment services.
❑ I did research online.
❑ Other(please specify):
❑ I did nothing.
13) What are some of the reasons you might not test your well water regularly? Please
select all that apply.
❑ I don't think it's important.
❑ I haven't had any issues with my well water.
❑ I forget to have my well water tested.
❑ I know my well water is safe.
❑ Well water testing is too expensive.
❑ Well water testing is inconvenient.
❑ I don't know where to test and what to test for.
❑ I am worried poor test results could impact the value of my property.
❑ I do test my water regularly.
❑ Other(please specify):
14) Would any of these programs motivate you to test your well water more often? Please
select all that apply.
❑ Free or discounted well water testing
❑ Water sample collection/drop off services
❑ Annual testing reminders
❑ Other(please specify):
❑ No, I'm not interested in testing my well water.
15) If a free program offering Weld County well owners educational resources and
technical support were developed,would you use it?
❑ Yes
❑ No
❑ I would need to know more about the program before deciding.
16) Do you support the development of additional resources and services aimed at
educating and assisting well owners in the management of their water wells and drinking
water?
❑ Yes
❑ No
❑ I don't know
17) Do you treat your well water? For example: filtration, water softener, reverse osmosis, etc.
❑ Yes
❑ No - SKIP to Q21
❑ I don't know -3 SKIP to Q21
18) What type of water treatment do you have in place? Please select all that apply.
❑ Pitcher-type water filter (for example: Brita)
❑ Refrigerator water filter
❑ Reverse osmosis
❑ Carbon filter (under sink)
❑ Carbon filter(whole home)
❑ Sediment filter(whole home)
❑ Water softener(whole home)
❑ Ion exchange system (whole home)
❑ Iron filter(whole home)
❑ UV treatment (whole home)
❑ Chlorination system (whole home)
❑ Other. Write in:
❑ I don't know
19) Why did you choose to treat your water this way? Please select all that apply.
❑ Results of laboratory test showing we needed treatment for: (write in)
❑ Didn't like the taste/smell/appearance
❑ To protect appliances
❑ Installed by previous house owner
❑ Other: (write in)
❑ I don't know
20) Do you perform routine maintenance on your treatment system?
For example- adding salt, changing filter cartridges, etc.
❑ Yes
❑ No
21) Which of the following would prompt you to install a water treatment system?
Please choose up to THREE that best apply
❑ A change in the taste, smell, or appearance of my water
❑ Getting test results that my well is contaminated
❑ Learning that some wells in my area are contaminated
❑ Learning that some of my neighbors are treating their wells
❑ A state or local requirement for water treatment
❑ A baby, child, pregnant woman, or immunocompromised person living in or visiting my
home
❑ Unexplained health problems
❑ Learning more about well water contaminants and their impact on health
❑ Learning more about which water treatment system is right for my home
❑ Finding a cost-effective water treatment system
❑ Finding a water treatment system that is easy to install
❑ Finding a water treatment system that is easy to maintain
❑ Not Applicable
The following section aims to better understand your thoughts on well water safety, testing,
and treatment. For the following questions, please select only one answer(22-29):
Mark the box that best matches DON'T STRONGLY STRONGLY
DISAGREE AGREE
how you feel on each statement KNOW DISAGREE AGREE
I have concerns about the safety O � O O O
of untreated (or unfiltered)well
water.
I believe that regular water
quality testing is important in O O O O O
making sure my well water is
safe to drink.
If a water quality test found an
issue with my well water, I
would take steps to address the O O O O O
issue, such as installing water
treatment or finding another
drinking water source.
I am confident I know how to O O O O O
select appropriate forms of water
treatment.
I feel confident in my ability to
make sure my well water is safe O O O O O
to drink following an emergency
situation(for example: power
outage,wildfire, flood, etc.).
I am interested in learning more O O O O O
about how to protect my well and
the safety of my drinking water.
I know where to find more
information about well O O O O O
management and water treatment. •
I know how to get my well water O O O O O
tested.
This section collects demographic information about you and your household so we can
better understand private-well households in Weld County. Your information is
anonymous, so none of your answers will be linked to your name or any identifying
information. Please remember that all questions are optional but that the more information
you provide, the better we can adapt our programs to the needs of residents.
30) What is your zip code?
❑ Zip code:
31) What is your age?
❑ 18-28
❑ 29-44
❑ 45-64
❑ 65 or older
U Would prefer not to say
32) What is your race or ethnicity? Please select all that apply.
❑ White
U Hispanic or Latino
❑ Black or African American
U Asian
❑ American Indian or Alaska Native
❑ Middle Eastern or North African
❑ Native Hawaiian or Pacific Islander
❑ Other. Please specify:
❑ Would prefer not to say
33) What is the highest level of formal education that you completed?
❑ Some high school or less
❑ High school/GED
❑ Some college
❑ Technical/community college
❑ Associate degree
❑ Bachelor's degree
❑ Some graduate school
❑ Master's degree
❑ Doctoral degree
❑ Would prefer not to say
34) What was your approximate household income in 2025?
❑ Under$30,000
❑ $30,000-$74,999
❑ $75,000-$149,999
❑ $150,000 or over
❑ Would prefer not to say
35) Are there children who live in the home?
❑ Yes
❑ No
❑ Would prefer not to say
36) How did you find this survey?
❑ I received a letter from the county.
❑ I saw a post on social media.
❑ I received the link from the CSU Extension Office.
❑ Other:
37) Would you be interested in receiving free well water testing as part of this study?
❑ Yes
❑ No
38) Would you like to be entered into a drawing for a chance to win one of 10 $25 Amazon
gift cards?
❑ Yes
❑ No
39) Would you like to be contacted for follow-up questions or additional information?
❑ Yes
❑ No
40) If you answered 'Yes' to questions 37,38, or 39, please list your contact information
below. Please be advised that doing so will link your contact information to your survey
answers, and you will lose anonymity for this survey. Your contact information will remain
confidential and will not be released publicly with survey results.
Email address:
Phone number:
Thank you so much for your participation in this survey!
Contract Form
Entity Information
Entity Name* Entity ID* New Entity? Please use the job
COLORADO STATE UNIVERSITY SUP-2340 aid linked here to add a
❑supplier in Workday.
Contract Name* Contract ID Parent Contract ID
CONDUCT A WELL WATER SURVEY FOR WELD 10454
RESIDENTS WITH COLORADO STATE UNIVERSITY Requires Board Approval
Contract Lead* YES
Contract Status BFRITZ
CTB REVIEW Department Project#
Contract Lead Email
bfritz@weld.gov;Health-
Contracts@weld.gov
Contract Description*
CONDUCT A WELL WATER SURVEY FOR WELD RESIDENTS WITH COLORADO STATE UNIVERSITY
Contract Description 2
Contract Type* Department Requested BOCC Agenda Due Date
AGREEMENT HEALTH Date* 03/12/2026
03/16/2026
Amount* Department Email
$0.00 CM-Health@weld.gov Will a work session with BOCC be required?*
NO
Renewable* Department Head Email
NO CM-Health- Does Contract require Purchasing Dept. to be
DeptHead@weld.gov included?*
Automatic Renewal
NO
County Attorney
Grant GENERAL COUNTY
IGA ATTORNEY EMAIL
County Attorney Email
CM-
COUNTYATTORNEY@WEL
D.GOV
If this is a renewal enter previous Contract ID
If this is part of a MSA enter MSA Contract ID
Note: the Previous Contract Number and Master Services Agreement Number should be left blank if those contracts
are not in OnBase
Contract Dates
Effective Date Review Date* Renewal Date
02/01 /2028
Termination Notice Period Expiration Date*
Committed Delivery Date 03/15/2028
Contact Information
Contact Info
Contact Name Contact Type Contact Email Contact Phone 1 Contact Phone 2
Purchasing
Purchasing Approver Purchasing Approved Date
Approval Process
Department Head Finance Approver Legal Counsel
JASON CHESSHER CHRIS D'OVIDIO BYRON HOWELL
DH Approved Date Finance Approved Date Legal Counsel Approved Date
03/11 /2026 03/12/2026 03/12/2026
Final Approval
BOCC Approved Doc ID#
AG 031626
BOCC Signed Date
Originator
BOCC Agenda Date BERITZ
03/16/2026
Hello