Guide Drinking Water Forms

Find permit applications and reporting forms for operator certification. These forms include:

  • consumer confidence reporting forms,
  • emergency response forms and information,
  • the Ground Water Rule forms, and
  • many other drinking water forms.

Drinking Water Forms

Certified Operators Forms

Consumer Confidence Reports Forms

  • Consumer Confidence Report Certification  

    Community water systems use this form to certify to MassDEP that their annual Consumer Confidence Reports have been distributed in accordance with the provisions of the Massachusetts Drinking Water Regulations.  Rev. February 2016.

Cross Connections Forms

  • BRP WS 10 - Cross Connection Certification

    EEA ePLACE permitting application for the certification or certification renewal for backflow prevention device testers or cross connection surveyors. New and existing applicants must register for an account in the new portal. Users will be able to renew, amend , and pay for fees associated with their certification.

Distribution System Modifications Forms

Emergency Response Forms

General / Administration Forms

  • Contact Information / Notification Registration Form  

    Use this form if you need to update your contact information with the MassDEP Drinking Water Program (DWP).  You may also use this form if you are interested in subscribing, or unsubscribing, to DWP email and autodialer notifications, as well as any of our electronic newsletters.  Rev. October 2015.

Ground Water Rule Forms

Ground Water Under the Direct Influence of Surface Water (GWUDI) Forms

Laboratory Analytical Forms

           A guideline to assist Massachusetts certified laboratories and interested parties on how to approach the conversion of uranium activity to mass units.

Lead and Copper Forms

Lead Service Line Replacement Program Forms

Monitoring Waivers Forms

  • Asbestos in Distribution System Exemption Form  

    May be submitted by water suppliers who are able to certify that their distribution systems do not contain any asbestos-cement pipe and/or asbestos-cement vinyl lined pipe.

  • Groundwater Under the Influence of Surface Water - Community Groundwater Exemption Application  

    Community public water systems must complete this application to determine if their groundwater source is exempt from microscopic particulate analysis testing and the requirements of the Surface Water Treatment Rule.  Rev. March 2010.

  • Monitoring Waiver Application for 2017-2019 Compliance Period

    Cover letter, information sheet, and application for the 2017 to 2019 Monitoring Period can be found here. This information was emailed out to all community and nontransient noncommunity public water systems on July 13, 2016. Waivers can be requested for each source for VOCs, SOCs, and IOCs, including arsenic and perchlorate. The deadline to apply for the 2017-2019 waiver period is September 30, 2016.

Monthly And Daily Reporting Forms

New Source Approvals Forms

New Technology Approvals Forms

Public Notification Certification Forms

Public Notification Tier 1 Templates

Public Notification Tier 2 Templates

  • Public Notification Template for Tier 2 Violations of Drinking Water Regulations  

    Instructions and templates for Tier 2 Public Notices for notifying consumers of outbreaks or violations. The Tier 2 templates include:  Resolved and Unresolved Total Coliform, Chemical or Radiological MCLs Notice, Fluoride MCL, SWTR Failure to Filter,  SWTR Turbidity Exceedance, SWTR Disinfection Treatment, LCR Failure to Install Corrosion Control, and LCR Failure to Maintain Corrosion Control. Updated May 2017. 

Public Notification Tier 3 Templates

Public Notification: Templates for Non-Community Public Water Systems

Public Water System Modifications Forms (Land, Source, or System)

Source Protection Forms

Statistical Reporting Forms

Underground Injection Control Forms

Vending Machines Forms

Water Management Act Forms

  • Water Management Act Forms

    Water Management Act withdrawal permits, reporting, seasonal demand management plans, water audits, and water conservation forms.

Water Treatment Plants Forms

Well Drillers Forms

  • Well Completion Report Correction & Change Request  

    Request to change information on a previously submitted Well Completion Report.  Rev. March 2012.

  • Well Driller Recertification

    Renewal letters are sent to MassDEP registered drillers near the end of October each year. The completed form and fee for renewal and rig renewal (if any) needs to be received by the end of the calendar year. Registrations run from January to December. If you are a driller not previously certified in Massachusetts, please contact Steve Hallem at 617-292-5681 or by email to stephen.hallem@state.ma.us.

Well Drillers Forms - eDEP Online Filing

 

 

Zone 2 Determinations Forms

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