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Forms

To assist you in finding the forms you need, we have grouped them according to the Division. Use the search option to search by Form Name. If you're looking for a publication, please search the Publications page.



Form # Form Name Division Program Area Instructions Effective-Revision Date
62-550.817(11)(e)2 Adobe PDF Document File Icon FBRR Recordkeeping Format (Adobe PDF) Division of Water Resource Management Source & Drinking Water Program April 1, 2004
62-550.821(12)(b) Microsoft Word Document File Icon Disinfectant Residual (Chlorine or Chloramines) Division of Water Resource Management Source & Drinking Water Program January 1, 2012
62-550.822/40CFR141.626 Adobe PDF Document File Icon Operational Evaluation Level Reporting Format Division of Water Resource Management Source & Drinking Water Program May 16, 2012
62-555.900(1) Adobe PDF Document File Icon Application for a Specific Permit to Construct PWS Components Division of Water Resource Management Source & Drinking Water Program August 28, 2003
62-555.900(1) - Alternate Adobe PDF Document File Icon Alternate Application for a Specific Permit to Construct PWS Components Division of Water Resource Management Source & Drinking Water Program September 8, 2015
62-555.900(10) Adobe PDF Document File Icon Asbestos-Free Certification or Asbestos Sampling Plan for PWSs Division of Water Resource Management Source & Drinking Water Program August 28, 2003
62-555.900(11) Adobe PDF Document File Icon Monthly Operation Report for Summation of Finished-Water Production by CWSs that Have Multiple Treatment Plants Division of Water Resource Management Source & Drinking Water Program August 28, 2003
62-555.900(12) Adobe PDF Document File Icon PWS Sampling Plan for Lead and Copper Tap Samples and Water Quality Parameters Division of Water Resource Management Source & Drinking Water Program August 28, 2003
62-555.900(13) Adobe PDF Document File Icon Cross-Connection Control Program Annual Report Division of Water Resource Management Source & Drinking Water Program May 5, 2014
62-555.900(14) Adobe PDF Document File Icon Revised Total Coliform Rule Level 1 Assessment Form Division of Water Resource Management Source & Drinking Water Program March 2, 2016
62-555.900(16) Adobe PDF Document File Icon PWS Certification of Notification of Lead and Copper Tap Sample Results Division of Water Resource Management Source & Drinking Water Program October 1, 2010
62-555.900(17) Adobe PDF Document File Icon Lead Public Education Program Report for PWSs Division of Water Resource Management Source & Drinking Water Program October 1, 2010
62-555.900(18) Adobe PDF Document File Icon 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 Division of Water Resource Management Source & Drinking Water Program August 28, 2003
62-555.900(18) - Alternate Adobe PDF Document File Icon 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 Division of Water Resource Management Source & Drinking Water Program August 28, 2003
62-555.900(19) Adobe PDF Document File Icon Certification of Delivery of Consumer Confidence Report Division of Water Resource Management Source & Drinking Water Program April 10, 2003
62-555.900(19) - Alternate Adobe PDF Document File Icon Alternate Certification of Delivery of Consumer Confidence Report Division of Water Resource Management Source & Drinking Water Program February 1, 2013
62-555.900(20) Adobe PDF Document File Icon New Water System Capacity Development Financial and Managerial Operations Plan Division of Water Resource Management Source & Drinking Water Program August 28, 2003
62-555.900(20) - Alternate Adobe PDF Document File Icon Alternate New Water System Capacity Development Financial and Managerial Operations Plan Division of Water Resource Management Source & Drinking Water Program August 28, 2003
62-555.900(21) Adobe PDF Document File Icon Certification of Delivery of Consumer Confidence Information to Supplied Systems Division of Water Resource Management Source & Drinking Water Program April 10, 2003
62-555.900(22) Adobe PDF Document File Icon Certification of Delivery of Public Notice Division of Water Resource Management Source & Drinking Water Program January 17, 2005
62-555.900(3) Adobe PDF Document File Icon Monthly Operation Report for PWSs Treating Raw Ground Water or Purchased Finished Water Division of Water Resource Management Source & Drinking Water Program August 28, 2003
62-555.900(3) -Alternate Adobe PDF Document File Icon Alternate Monthly Operation Report for PWSs Treating Raw Ground Water or Purchased Finished Water Division of Water Resource Management Source & Drinking Water Program August 28, 2003
62-555.900(4) Adobe PDF Document File Icon Monthly Operation Report for Consecutive Systems that Do Not Treat Water Division of Water Resource Management Source & Drinking Water Program August 28, 2003
62-555.900(5) Adobe PDF Document File Icon Monthly Operation Report for PWSs Fluoridating Water Division of Water Resource Management Source & Drinking Water Program August 28, 2003
62-555.900(6) Adobe PDF Document File Icon Monthly Operation Report for Consecutive Systems that Receive Purchased Finished Water from a Subpart H System Division of Water Resource Management Source & Drinking Water Program April 3, 2003
62-555.900(7) - Alternate Adobe PDF Document File Icon Notice of Intent to Use the General Permit for Construction of Water Main Extensions for PWSs- Alternate Division of Water Resource Management Source & Drinking Water Program August 28, 2003
62-555.900(8) Adobe PDF Document File Icon Application for Transfer of a PWS Construction Permit Division of Water Resource Management Source & Drinking Water Program August 28, 2003
62-555.900(9) Adobe PDF Document File Icon Certification of Construction Completion and Request for Clearance to Place Permitted PWS Components into Operation Division of Water Resource Management Source & Drinking Water Program August 28, 2003
62-560.545(2) Adobe PDF Document File Icon Reduced Monitoring Application Questionnaire for Synthetic Organic Contaminants Division of Water Resource Management Source & Drinking Water Program March 20, 2014
62-582.900 (3) Adobe PDF Document File Icon Construction/Clearance Permit Application for Class V Division of Water Resource Management Aquifer Protection Program - UIC February 9, 2017
62-602.900(1) Adobe PDF Document File Icon Certification Application Division of Water Resource Management Certification and Restoration Program February 14, 2017
62-602.900(1) Adobe PDF Document File Icon Treatment Plant License Application Division of Water Resource Management Certification and Restoration Program February 14, 2017
62-602.900(2) Adobe PDF Document File Icon Treatment Plant Operator Examination Division of Water Restoration Assistance Water Supply Restoration February 14, 2017
62-602.900(3) Adobe PDF Document File Icon Distribution System Operator License Application Division of Water Resource Management Certification and Restoration Program February 14, 2017
62-602.900(4) Adobe PDF Document File Icon Distribution System Operator Examination Division of Water Resource Management Certification and Restoration Program February 14, 2017
62-604.300(3)(a) Adobe PDF Document File Icon Notification/Application For Constructing A Domestic Wastewater Collection/Transmission System Division of Water Resource Management Domestic Wastewater Program October 4, 2021
62-604.300(3)(b) Adobe PDF Document File Icon Notification of Completion of Construction for a Domestic Wastewater Collection/Transmission System Division of Water Resource Management Domestic Wastewater Program October 4, 2021
62-606.400(4)(a) Adobe PDF Document File Icon Gambling Vessel Registration Form Division of Water Resource Management Domestic Wastewater Program April 4, 2010
62-606.400(4)(b) Adobe PDF Document File Icon Gambling Vessel Verification of Marine Waste Treatment System Division of Water Resource Management Domestic Wastewater Program April 4, 2010
62-620.910(1) Adobe PDF Document File Icon Wastewater Facility or Activity Permit Application - General Information - Form 1 Division of Water Resource Management Industrial Wastewater Program July 30, 2010
62-620.910(1) Adobe PDF Document File Icon Wastewater Facility or Activity Permit Application-General Information-Form 1 Division of Water Resource Management Domestic Wastewater Program July 30, 2010
62-620.910(11) Adobe PDF Document File Icon Application for Transfer of a Wastewater Facility or Activity Permit Division of Water Resource Management Industrial Wastewater Program October 23, 2000
62-620.910(11) Adobe PDF Document File Icon Application for Transfer of a Wastewater Facility or Activity Permit Division of Water Resource Management Domestic Wastewater Program October 23, 2000
62-620.910(12) Adobe PDF Document File Icon Notification of Completion of Construction for Wastewater Facilities or Activities Division of Water Resource Management Industrial Wastewater Program October 23, 2000
62-620.910(12) Adobe PDF Document File Icon Notification of Completion of Construction for Wastewater Facilities or Activities Division of Water Resource Management Domestic Wastewater Program October 23, 2000
62-620.910(13) Adobe PDF Document File Icon Notification of Availability of Record Drawings and Final Operation and Maintenance Manuals Division of Water Resource Management Industrial Wastewater Program October 23, 2000
62-620.910(13) Adobe PDF Document File Icon Notification of Availability of Record Drawings and Final Operation and Maintenance Manuals Division of Water Resource Management Domestic Wastewater Program October 23, 2000
62-620.910(14) Adobe PDF Document File Icon Application for Permit to Operate a Non-Discharge/Closed Loop Recycle System - Form 2CR Division of Water Resource Management Industrial Wastewater Program November 29, 1994
62-620.910(16) Adobe PDF Document File Icon Request for Approval of Monitoring Plans for Discharge of Domestic Wastewater to Wetlands Division of Water Resource Management Domestic Wastewater Program August 15, 1986
62-620.910(17) Adobe PDF Document File Icon NEX NOI Division of Water Resource Management NPDES Stormwater Program February 17, 2009

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