Drinking Water Forms & Reporting Formats

About the Forms

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 webpage.

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

Laboratory Reporting Formats

Analytical results for samples taken pursuant to Chapter 62-550, Florida Administrative Code (F.A.C.), shall be reported by the laboratory in a format that 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, F.A.C.).

• 62-550.730: Format to be used for reporting all drinking water bacteriological analysis results.
• 62-550.730: Format to be used for reporting all drinking water chemical analysis results except for lead and copper tap samples and water quality parameter samples.
• 62-550.730(4)(a): Lead and copper tap samples taken from the interior taps of private residences.
• 62-550.730(4)(c): Water quality parameter samples taken from the entry point to the distribution system and at points within the distribution system.
• Water Quality Parameter (WQP) Laboratory Reporting Format

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.

• Disinfectant Residual (Chlorine or Chloramines)

Example Stage 1 D/DBPR Chlorine/Chloramines Monitoring Plan Format/Example

The following example monitoring plan example was developed to assist PWSs in preparing a Stage 1 Disinfectants/Disinfection Byproducts Rule (D/DBPR) monitoring plan for chlorine and/or chloramines. PWSs are not required to use this example. PWSs can use any format they wish as long as the relevant information required by 62-550.821(11), F.A.C., is provided.

•  1 D/DBPR Chlorine/Chloramines Monitoring Plan Example

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 C.F.R. 141.629(a) is provided.

• Disinfection Byproducts (Total Trihalomethanes (TTHMs) and Haloacetic Acids Five (HAA5s)

Example Stage 2 D/DBPR Monitoring Plan Format

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 C.F.R. 141.622(a)(1)) is provided.

• Stage 2 D/DBPR Monitoring Plan Format

Stage 2 Example Operational Evaluation Level Reporting Format

• Operational Evaluation Level Reporting Format

Filter Backwash Recycling Rule (FBRR) Formats

• FBRR Recordkeeping Format (Adobe PDF)
• FBRR Recycling Notification Worksheet (Adobe PDF)

Ground Water Rule (Chapter 62-520, F.A.C.) Documents

• DEP Form # 62-520.900(1) Application For Monitoring Plan Approval
• DEP Form # 62-520.900(2) Ground Water Monitoring Report
• DEP Form # 62-520.900(3) Monitoring Well Completion Report

Example Cover Sheet for 4-Log Treatment Reporting Format

The following example reporting format was developed to assist PWSs in reporting information for the 4-log Treatment of Ground Water. PWSs are not required to use this example reporting format. PWSs can use any format they wish as long as pertinent information is provided.

• Cover Sheet 4-log inactivation