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Drinking Water Forms & Reporting Formats
 

The forms on this page are for use by public drinking water systems and laboratories. DEP has implemented a paperless permitting process that will allow for the electronic submission of applications, forms, and requests for information; and following permit issuance the submission of required compliance forms.

In order to complete the following DEP electronic forms, you must have Adobe Reader 8.0 or higher.  If you do not have the capability or do not want to submit a form electronically, hard copies of the completed form with all required attachments and fees should be mailed to the appropriate offices indicated on each form.  Contact information for the Department offices is found on our Source and Drinking Water contacts page

Before submitting forms electronically, please refer to the Electronic Submission Instructions and please see the Electronic Submission Addresses (Email or FTP).

Form Number

Form Name

62-555.900(1) Application for a Specific Permit to Construct PWS Components
62-555.900(1) - Alternate Alternate Application for a Specific Permit to Construct PWS Components
62-555.900(3) Monthly Operation Report for PWSs Treating Raw Ground Water or Purchased Finished Water
62-555.900(3) -Alternate Alternate Monthly Operation Report for PWSs Treating Raw Ground Water or Purchased Finished Water
62-555.900(4) Monthly Operation Report for Consecutive Systems that Do Not Treat Water
62-555.900(5) Monthly Operation Report for PWSs Fluoridating Water
62-555.900(6) Monthly Operation Report for Consecutive Systems that Receive Purchased Finished Water from a Subpart H System
62-555.900(7) - Alternate Notice of Intent to Use the General Permit for Construction of Water Main Extensions for PWSs- Alternate
62-555.900(8) Application for Transfer of a PWS Construction Permit
62-555.900(9) Certification of Construction Completion and Request for Clearance to Place Permitted PWS Components into Operation
62-555.900(10) Asbestos-Free Certification or Asbestos Sampling Plan for PWSs
62-555.900(11) Monthly Operation Report for Summation of Finished-Water Production by CWSs that Have Multiple Treatment Plants
62-555.900(12) PWS Sampling Plan for Lead and Copper Tap Samples and Water Quality Parameters
62-555.900(13) Cross-Connection Control Program Annual Report
62-555.900(16) PWS Certification of Notification of Lead and Copper Tap Sample Results
62-555.900(17) Lead Public Education Program Report for PWSs
62-555.900(18) Notice of Intent to Use the General Permit for Construction of Lead or Copper Corrosion Control, or Iron or Manganese Sequestration, Treatment Facilities for Small or Medium PWSs
62-555.900(18) - Alternate Alternate Notice of Intent to Use the General Permit for Construction of Lead or Copper Corrosion Control, or Iron or Manganese Sequestration, Treatment Facilities for Small or Medium PWSs
62-555.900(19) Certification of Delivery of Consumer Confidence Report
62-555.900(19) - Alternate Alternate Certification of Delivery of Consumer Confidence Report
62-555.900(20) New Water System Capacity Development Financial and Managerial Operations Plan
62-555.900(20) - Alternate Alternate New Water System Capacity Development Financial and Managerial Operations Plan
62-555.900(21) Certification of Delivery of Consumer Confidence Information to Supplied Systems
62-555.900(22) Certification of Delivery of Public Notice
62-560.545(2) Reduced Monitoring Application Questionnaire for Synthetic Organic Contaminants

Laboratory Reporting Formats

Analytical results for samples taken pursuant to Chapter 62-550, Florida Administrative Code, shall be reported by the laboratory in a format which includes all of the required information described in the documents provided below. Laboratories may use computer generated versions of the formats provided such versions are identical in every respect other than print size, type, and spacing. If laboratory analysis reports are submitted without all of the required information, as set forth below, the submittal will be rejected. (Reference Rule 62-550.730, Florida Administrative Code)

Example Stage 1 D/DBPR Reporting Format

The following example reporting format was developed to assist PWSs in reporting parameters for the Stage 1 Disinfectants/Disinfection Byproducts Rule(D/DBPR).  PWSs are not required to use this example reporting format. PWSs can use any format they wish as long as the information required by 62-550.821(12), F.A.C. is provided.

Example Stage 2 D/DBPR Reporting Format

The following example reporting format was developed to assist PWSs in reporting parameters for the Stage 2 Disinfectants/Disinfection Byproducts Rule (D/DBPR). PWSs are not required to use the example reporting format. PWSs can use any format they wish as long as the information required by 40 CFR 141.629(a) is provided.

Example Stage 2 D/DBPR Monitoring Plan Formats

Stage 2 D/DBPR: The following format was developed to assist PWSs in preparing a Stage 2 Disinfectants/Disinfection Byproducts Rule (D/DBPR) monitoring plan. PWSs are not required to use this example monitoring plan format. PWSs can use any format they wish as long as the information required by the applicable federal regulations (40 CFR 141.622(a)(1)) is provided.

Example Monitoring Plan Formats

Stage 2 Example Operational Evaluation Level Reporting Format

Filter Backwash Recycling Rule (FBRR) Formats

Last updated: May 21, 2015

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