This part of the Utah Safe Drinking Water Act provides that public water supplies may not have fluorine added to or removed from the water supply without the approval of a majority of voters in an election in the area affected. An election shall be held:

(1) upon the filing of an initiative petition requesting the action,

(2) in the case of a municipal, local district, special service district, or county water system that is functionally separate from any other water system, upon the passage of a resolution by the legislative body or local district or special service district board representing the affected votes, submitting the question to the affected voters at a municipal general election, or

(3) in a county of the first or second class, upon the passage of a resolution by the county legislative body to place an opinion question relating to all public water systems within the county on the ballot at a general election.

The chapter provides that if a majority of voters on an opinion question approve the addition of fluorine to or the removal of fluorine from the public water supplies within the county, the local health departments shall require the addition of fluorine to or the removal of fluorine from all public water supplies within that county other than those systems:

(a) that are functionally separate from any other public water systems in that country; and

(b) where a majority of the voters served by the public water system voted against the addition or removal of fluorine on the opinion question.

The chapter provides that, in an election where a majority of the voters approve the addition to or removal of fluorine from the public water supplies, no election to consider removing fluorine from or adding fluorine to the public water supplies shall be held for a period of four years from the date of approval by the majority of voters. The chapter includes a special section on the provision of fluoridated water to a residence or business in a municipality located in two counties, one that has approved fluoridation and one that has not approved fluoridation. The provision of fluoridated water will be allowed:

(1) if the owner requests that the public water system supply water to the residence or business,

(2) no reasonable alternative water supply exists, and

(3) the owner’s request can be fulfilled without affecting other residences or businesses in the municipality or county that has not approved fluoridation.

The chapter also includes a section on the provision of fluoridated water to a municipality or county that has not approved fluoridation if, as a result of a short-term emergency, the only water available is from the public water system’s fluoridated inventory.

Utah Code Ann. § 19-4-111 Fluorine added to or removed from water — Election or shareholder vote required (Adopted 1981, last amended May 12, 2009).
Utah Code Ann. § 19-4-111.1. Provision of fluoridated water — Request of resident (Adopted May 6, 2002).
Utah Code Ann. § 19-4-111.2. Provision of fluoridated water — Emergency circumstances (Adopted May 6, 2002, amended May 12, 2009).

19-4-111. Fluorine added to or removed from water — Election or shareholder vote required.
(1) As used in this section:
(a) “Corporate public water system” means a public water system that is owned by a corporation engaged in distributing water only to its shareholders.
(b) “Corporation” is as defined in Section 16-4-102.
(c) “Fluorine” includes a derivative or compound of fluorine.
(d) “Removal” means ceasing to add fluorine to a public water supply, the addition having been previously approved by the voters of a political subdivision.
(2) (a) Except as provided in Subsection (7) or Subsection 19-4-104(1)(a)(i), public water supplies, whether state, county, municipal, or district, may not have fluorine added to or removed from the water supply without the approval of a majority of voters in an election in the area affected.
(b) An election shall be held:
(i) upon the filing of an initiative petition requesting the action in accordance with state law governing initiative petitions;
(ii) in the case of a municipal, local district, special service district, or county water system that is functionally separate from any other water system, upon the passage of a resolution by the legislative body or local district or special service district board representing the affected voters, submitting the question to the affected voters at a municipal general election; or
(iii) in a county of the first or second class, upon the passage of a resolution by the county legislative body to place an opinion question relating to all public water systems within the county, except as provided in Subsection (3), on the ballot at a general election.
(3) If a majority of voters on an opinion question under Subsection (2)(b)(iii) approve the addition of fluorine to or the removal of fluorine from the public water supplies within the county, the local health departments shall require the addition of fluorine to or the removal of fluorine from all public water supplies within that county other than those systems:
(a) that are functionally separate from any other public water systems in that county; and
(b) where a majority of the voters served by the public water system voted against the addition or removal of fluorine on the opinion question under Subsection (2)(b)(iii).
(4) Nothing contained in this section prohibits the addition of chlorine or other water purifying agents.
(5) Any political subdivision that, prior to November 2, 1976, decided to and was adding fluorine to the drinking water is considered to have complied with Subsection (2).
(6) In an election held pursuant to Subsection (2)(b)(i), (ii), or (iii), where a majority of the voters approve the addition to or removal of fluorine from the public water supplies, no election to consider removing fluorine from or adding fluorine to the public water supplies shall be held for a period of four years from the date of approval by the majority of voters beginning with elections held in November 2000.
(7) (a) A supplier may not add fluorine to or remove fluorine from a corporate public water system unless the majority of the votes cast by the shareholders of the corporate public water system authorize the supplier to add or remove the fluorine.
(b) If a corporate public water system’s shareholders do not vote to add fluorine under Subsection (7)(a), the supplier shall annually provide notice to a person who receives water from the corporate public water system of the average amount of fluorine in the water.
(c) A vote of the corporate public water system’s shareholders under Subsection (7)(a) does not require a supplier of another public water system, including a public water system that provides water to the corporate public water system, to add fluorine to or remove fluorine from the public water system.

19-4-111.1. Provision of fluoridated water — Request of resident.
A public water system in a county of the first or second class whose entire water inventory is fluoridated may supply water to a residence or business in a municipality that is located in two counties, one that has approved fluoridation and one that has not approved fluoridation in accordance with Subsection 19-4-111(1) if:
(1) the owner requests that the public water system supply water to the residence or business;
(2) no reasonable alternative water supply exists; and
(3) the owner’s request can be fulfilled without affecting other residences or businesses in the municipality or county that has not approved fluoridation.

19-4-111.2. Provision of fluoridated water — Emergency circumstances.
(1) A public water system that is simultaneously supplying water to a municipality or county that approved fluoridation in accordance with Section 19-4-111 and a municipality or county that has not approved fluoridation may provide water from its fluoridated inventory to a municipality or county that has not approved fluoridation if:
(a) as a result of a short-term emergency, the only water available is from the public water system’s fluoridated inventory;
(b) the public water system ceases providing fluoridated water to the municipality or county that has not approved fluoridation in accordance with Subsection 19-4-111(2) in a time consistent with repair times following best industrial practice; and
(c) where feasible provide prompt notice to the affected area.
(2) (a) A resident of an affected area that does not wish to receive fluoridated water during an emergency may contact the public water system to have delivery of fluoridated water to their residence or business terminated.
(b) The resident shall determine when to resume delivery of water and shall contact the public water system to have delivery of water resumed.