62-555.900. Forms and Instructions

Effective on Monday, May 5, 2014
  • 1The forms used by the Department in the Public Water System Supervision Program are listed below by form number and name. Each form has been incorporated into the rule that references it. Copies of these forms may be obtained by writing to the Department of Environmental Protection, Source and Drinking Water Program, M.S. 3520, 2600 Blair Stone Road, Tallahassee, Florida 32399-2400. In addition, these forms are available at the Department of Environmental 73Protection’s district offices, at the Approved County Health Departments, and on the Department of Environmental Protection’s web site at www.dep.state.fl.us. Persons and public water systems shall report to the Department using the forms listed below or using computer-generated versions of the forms listed below provided such versions are identical to the forms listed below in every respect 130other than font type and style, font size, and character spacing.

    141(1) Application for a Specific Permit to Construct PWS Components, effective August 28, 2003.

    155(2) Monthly Operation Report for Subpart H Systems, effective October 14, 2004.

    167(3) Monthly Operation Report for PWSs Treating Raw Ground Water or Purchased Finished Water, effective August 28, 2003.

    185(4) Monthly Operation Report for Consecutive Systems that Do Not Treat Water, effective August 28, 2003.

    201(5) Monthly Operation Report for PWSs Fluoridating Water, effective August 28, 2003.

    213(6) Monthly Operation Report for Consecutive Systems that Receive Purchased Finished Water from a Subpart H System, effective April 3, 2003.

    234(7) Notice of Intent to Use the General Permit for Construction of Water Main Extensions for PWSs, effective August 28, 2003.

    255(8) Application for Transfer of a PWS Construction Permit, effective August 28, 2003.

    268(9) Certification of Construction Completion and Request for Clearance to Place Permitted PWS Components into Operation, effective August 28, 2003.

    288(10) Asbestos-Free Certification or Asbestos Sampling Plan for PWSs, effective August 28, 2003.

    301(11) Monthly Operation Report for Summation of Finished-Water Production by CWSs that Have Multiple Treatment Plants, effective August 28, 2003.

    321(12) PWS Sampling Plan for Lead and Copper Tap Samples and Water Quality Parameters, effective August 28, 2003.

    339(13) 340Form 34162-555.900(13), 342Cross-Connection Control Program Annual Report, effective 5-5-14, incorporated by reference in paragraph 35462-555.360(2)(b), 355F.A.C356.

    357(14) Deleted.

    359(15) Deleted.

    361(16) PWS Certification of Notification of Lead and Copper Tap Sample Results, effective October 1, 2010.

    377(17) Lead Public Education Program Report for PWSs, effective October 1, 2010.

    389(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, effective August 28, 2003.

    422(19) Form number 42562-555.900(19), 426Certification of Delivery of Consumer Confidence Report, effective April 10, 2003.

    437(20) New Water System Capacity Development Financial and Managerial Operations Plan, effective August 28, 2003.

    452(21) Form number 45562-555.900(21), 456Certification of Delivery of Consumer Confidence Information to Supplied Systems, effective April 10, 2003.

    470(22) Form number 47362-555.900(22), 474Certification of Delivery of Public Notice, effective 1-17-05.

    482Rulemaking Authority 484403.8055, 485403.861, 486403.861(9) FS. 488Law Implemented 490367.031, 491403.0877, 492403.861, 493403.8615 FS. 495History–New 1-18-89, Amended 1-3-91, Formerly 17-555.900, Amended 12-10-96, 9-22-99, 4-3-03, 4-10-03, 8-28-03, 10-14-04, 1-17-05, 10-1-10, 5-5-14.


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