Forms and Report Templates

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Air Forms

The following are Ag BMP General Permit Record forms:

Water Forms 

• Notice of Termination (NOT) Application | View/Download Form > 

  • Consumer Confidence Report Mailing | Certification | Download > | Waiver | Download >
  • Consumer Confidence Report Template | Download >
  • DDBP Monitoring Plan | Download >
  • Drinking Water Analysis Reporting (DWAR) Forms
    With the transition to the Compliance Monitoring Data Portal (CMDP), many DWAR forms are no longer available in the following list. Those forms are no longer accepted via email and systems can now use the CMDP to complete reporting | Learn More >
    • 15 - Surface Water Treatment Plant Monitoring Requirements at a Glance | Download >
    • 15AB - Systems Using Surface Water - Direct, Conventional, and Membrane Filtration | Download >
    • 15AB - Systems Using Surface Water - Slow Sand, Diatomaceous Earth, or Cartridge/Bag Filtration | Download >
    • 15C - Surface Water Purchase Systems | Download >
    • 16D - Chlorine Dioxide - Chlorite | Download >
    • 17 - Total Organic Carbon/Alkalinity (TOCA) Analysis Reporting | Download >
    • 18A - MRDLs | Download >
    • 20 - Long Term 2 Monthly Reporting for Cryptosporidium, E. coli and Turbidity | Download >
    • 20BW - Schedule 4 System Long Term 2 Bi-weekly Reporting | Download >
    • 20C - Reporting for Schedule 4 Systems Monitoring for Cryptosporidium | Download >
    • 20M - Schedule 4 System Long Term 2 Monthly Reporting | Download >
    • 20UV - Disinfection Log Removal for Split UV Chemical Systems (Monthly Report) | Download >
    • 20UVBC - Disinfection and Bag/Cartridge Filter Verification | Download >
  • Drinking Water:
  • Emergency Operations Plan Template | Download >
  • Inorganic Chemical Waiver Application | Download >
  • LCR-B Lead & Copper Sampling Pool | Download >
  • LCR-C Lead & Copper Compliance Sampling:
  • Lead and Copper Sampling Procedures for Homeowners | Download >
  • Lead Consumer Notice | Download >
  • Lead Public Education Certification | Download >
  • Long Term 2 Monthly Reporting Form for Cryptosporidium, E. coli and Turbidity | Download >
  • Long Term 2 Notice of Intent to Provide Treatment for Cryptosporidium (Schedules 1 - 3 Only) | Download >
  • Long Term 2 Notice of Intent to Sample for Cryptosporidium (Schedule 4 Only) | Download >
  • Long Term 2 Sampling Location Worksheet | Download >
  • Long Term 2 Schematics 1 - 10 | Download >
  • Long Term 2 Source Water Sampling Plan Requirements Checklist | Download >
  • MRDL Monitoring Plan | Download >
  • Operations and Maintenance Manual Template | Download >
  • Optimal Corrosion Control Treatment for Systems Serving 50k or Fewer (Excel) | Download >
  • Optimal Corrosion Control Treatment for Systems Serving More Than 50k (Excel) | Download >
  • Reduced Monitoring Application | Download >
  • Revised Total Coliform Rule Level 1 Assessment Form | Download >
  • Revised Total Coliform Rule Level 2 Assessment Form | Download >
  • Revised Total Coliform Rule Microbiological Sample Siting Plan (1,000 or fewer) | Download >
  • Revised Total Coliform Rule Microbiological Sample Siting Plan (1,001 or more) | Download >
  • Revised Total Coliform Rule Seasonal Start-Up Procedures Certification | Download >
  • Routine Quarterly Monitoring Form | Download >
  • Stage 2 DBP Monitoring Plan & Summary Sheet Templates | Download >
  • Stage 2 DBP Operational Evaluation Level Template - Full Report | Download >
  • Stage 2 DBP Operational Evaluation Level Template - Limited Scope Report | Download >
  • Surface Water Treatment Rule - Comprehensive Performance Evaluation (CPE) Checklist | Download >
  • Surface Water Treatment Rule - Filter Profile Report for Individual Filters | Download >
  • Surface Water Treatment Rule - Self-Assessment Checklist | Download >
  • Synthetic Organic Chemical (SOC) Use Waiver Application | Download >
  • TOCA, Chlorine Dioxide and Bromate DBP Stage 1 Monitoring Plan | Download >
  • Total Organic Carbon/Alkalinity (TOCA) Calculations Spreadsheet (Excel) | Download >
  • Volatile Organic Chemical (VOC) Use Waiver Application | Download >

4.01 (Sewage Collection Systems)

  • Sewage Collection System Capacity | View >
  • Sewage Collection System Request for Discharge Authorization | View >  
  • Sewage Treatment Facility Capacity | View >
  • Sewer Notice of Intent Application | View >  
  • Sewer 4.01 Notice of Transfer | View > 

4.02 to 4.23 (Onsite Wastewater Treatment Systems)

  • 4.23 Annual Report Form | View > 
  • Report of Inspection | View >
  • Manufacturer’s Certificate of Conformance | View >
  • Notice of Closure | View >
  • Notice of Intent (0 GPD – Less than 24,000 GPD) | View >
  • Notice of Intent (24,000 GPD – less than 75,000 GPD) | View >
  • Notice of Transfer | View >
  • Request for Discharge Authorization | View >
  • Uniform Site Investigation | View >

Public/Semi-Public Swimming Pools

  • Pool/Spa Engineers Certificate of Completion | View >
  • Supplemental Spa Application | View >
  • Swimming Pool Approval to Construct Application | View > 

Other Public/Semi-Public Swimming Pools Supplemental Forms

  • Bathhouses Dressing Rooms | View >
  • Diving Areas and Equipment | View >
  • Overflow Collection Systems | View >
  • Special Use Pool | View >
  • Variance Approval | View >
  • Wading Pool | View >

Subdivisions

  • Subdivision Application | View > 

Other

  • Alternative Design (A312G) Request | View > 
  • Proprietary Product Listing | View >
  • Rule Clarification Request | View >
  • Type 2 Notice of Intent | View > 
  • Type 2 Permit Renewal | View >

Waste Forms

Notification for Advanced Recycling Facility | View >

Municipal Solid Waste Landfill

Non-Municipal Solid Waste Landfill

Regulatory Submittals

Checklists

Additional Forms

Reimbursement Request Forms