Colorado is one of a handful of states to allow water utilities to purify sewage for use as tap water and cities like Castle Rock are preparing to make it happen within a few years.
Right now, they just use the purified water to recharge the groundwater but said it is clean enough to drink.
Daniel McCurry, assistant professor of civil and environmental engineering at the University of Southern California, predicted at least half of states will adopt wastewater recycling in the next 20 years.
"Places that you wouldn't normally think of as dry or water-stressed at all are starting to build these plants," McCurry pointed out. "I think anywhere that's primarily reliant on groundwater is going to have water reuse in their future."
California's Orange County Water District, a leader in the field, already purifies 130 million gallons of wastewater per day and sends it down into the aquifer. Other cities use their recycled wastewater to irrigate fields and parks.
Darrin Polhemus, deputy director of the California State Water Resources Control Board, said efficiencies are worth exploring.
"We spend a lot of money and energy moving water from different parts of the state to Southern California, where it's used once and dumped in the ocean," Polhemus observed. "That's maybe not the smartest way to deal with a resiliency question."
David Sedlak, director of the Berkeley Water Center at the University of California-Berkeley, said the "yuck" factor can be challenging, so public outreach is key.
"They have to start building legitimacy from the ground up," Sedlak emphasized. "Sometimes that means changing the culture of transparency and openness. And sometimes that means working with the public and bringing them on board to see and understand it."
Arizona, Georgia, Texas, and Virginia also have large-scale programs to recycle wastewater.
This story is based on original reporting by Matt Vasilogambros and Kevin Hardy for Stateline.
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Watchdog groups said the West Virginia Department of Environmental Protection seems poised to allow coal company Keystone West Virginia to walk away from its obligation to treat acid mine drainage at a 160-acre surface mine near Marmet, in Kanawha County.
When a company is done mining and is done doing required reclamation work, it will ask the state to return the bond money given when it received its permit to mine. But in this case, the company has not done the cleanup.
Chad Cordell, coordinator for the Kanawha Forest Coalition, said the company has been involved in numerous complaints related to water pollution in Lens Creek.
"This is really a push where we're telling the DEP, not only do you need to not grant this bond release, but you really need to start enforcing the water quality laws and get this company to deal with this water pollution," Cordell outlined.
Keystone West Virginia has been plagued with regulatory problems and lawsuits. The mine the company is seeking for bond release has received 36 notices of violations and 12 cessation orders since it was first permitted, according to the coalition.
Cordell added decades of research and lived experience from residents show the high levels of heavy metals from acid mine drainage, which color the water a coppery brown, can cause permanent damage to drinking water quality, local infrastructure including bridges, public water and power plant supplies, and public health.
"There's really no debate about that at this point," Cordell contended. "We know that there are all sorts of health impacts from these mines. A lot of that is connected to the water impacts of these mines."
There are roughly 400 miles of freshwater trout streams in West Virginia that are impaired because of increased acidity levels from acid mine drainage, according to the West Virginia Water Research Institute.
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Many residents of southern West Virginia say the water flowing out of their taps is a brown or orange color and most continue to rely heavily on bottled water as a result.
Advocates want lawmakers to funnel more federal funds toward water and wastewater infrastructure projects in the region.
Natalia Rudiak, director of special projects for the nonprofit ReImagine Appalachia, said many residents drive miles to collect spring water or spend up to $100 a month on bottled water. She asserted Mountain State lawmakers are spending money distributed from the American Rescue Plan Act on other projects, instead of addressing the issue.
"That funding, millions of dollars, has gone into upgrading a baseball field at a university; it has gone to an entertainment center; it has gone to an out-of-state university in Ohio," Rudiak contended.
According to recent investigative reporting by the Gazette-Mail, the state's Water Development Authority has allowed more than $80 million of funds to be used for projects unrelated to water or sewage infrastructure.
An online petition by the West Virginia Rivers Coalition, the West Virginia Faith Collective and the coalfield advocacy group From Below is asking lawmakers to declare a state of emergency in order to provide residents with clean drinking water until proper infrastructure is in place.
Rudiak pointed out those who depend on well water or springs are also at risk.
"One of the health issues that we are seeing is people are getting sick from spring water that they're using," Rudiak observed.
The southern coalfields' water crisis has been exacerbated by recent storms and severe flooding. Rudiak pointed to recent flooding in which least two people died and tens of thousands were left without power.
"Unfortunately, the folks of southern West Virginia can't catch a break," Rudiak emphasized. "They've been hit by catastrophic flooding that is damaging main streets, and businesses, and homes."
According to a report from the West Virginia Office of Environmental Health Services, 65 water systems across the state are operating in marginal condition and 15 are classified as failing.
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Some Kentucky lawmakers want to weaken protections for waterways many residents depend on for drinking water.
Senate Bill 89, that would narrow the definition of which waters in Commonwealth are protected, has passed the Senate and is now in the Kentucky House.
A few years ago, the U.S. Supreme Court issued a ruling that severely weakened the federal government's abilities to regulate water bodies and wetlands.
Supporters of the Kentucky bill say it falls in line with that decision and would eliminate mining industry permitting barriers.
But it could also pose public health risks for drinking water, said Kentucky Sierra Club Chapter Director Julia Finch.
"So that's really what we're concerned about," said Finch. "We don't want to see any kind of restriction of that definition that would end protections for other water systems, including our groundwater."
According to the Kentucky Geological Survey, more than 1.5 million residents are served by public water systems that rely on groundwater, and about 416,000 rely on wells or springs for water.
Lacking guardrails, water treatment costs could potentially increase.
Finch explained that local public water systems depend on the state to regulate and monitor pollution in streams and rivers that are used for drinking water.
"If we're talking about drinking water," said Finch, "there could be additional water treatment that has to occur, then that cost could then go directly to customers."
Finch pointed out that Kentucky is home to several Superfund and other industrial sites, and noted that some of those sites would no longer have to consider groundwater protections during the cleanup process.
"That's really scary," said Finch, "because Superfund sites are some of our most polluted and deadliest sites."
Under the bill, dumping pollution into headwaters or rain-dependent streams - also known as ephemeral streams - would no longer be prohibited, and the state would lose its ability to limit water pollution or require sampling for these types of waters.
Around 65% of Kentucky's more than 79,000 miles of streams and rivers are ephemeral, according to Environmental Protection Agency data.
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