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UV Drinking Water Treatment Forms

Forms for public water systems that use UV treatment.

Contact

MassDEP Drinking Water Program

Phone

Program Director 617-292-5770

Online

MassDEP Drinking Water Program program.director-dwp@mass.gov

The Details

What you need

All public water systems must receive approval from MassDEP to use UV treatment. 

All UV applicants must complete the following forms:

  • UV-CAL
  • UV-OFF SPEC
  • UV-A

Applicants using the "Calculated Dose Approach" must also complete form UV-CDA.

Applicants using the "Intensity Setpoint Approach" must also complete form UV-ISA.

How to report

See details below.

Next steps

  1. Review the Instructions

    Form UV-CAL Instructions (PDF 248.37 KB)
    Form UV-OFF SPEC Instructions (PDF 260.18 KB)
    Form UV-A Instructions (PDF 365 KB)
    Form UV-CDA Instructions (PDF 395.29 KB)
    Form UV-ISA Instructions (PDF 379.12 KB)

  2. Complete the Report Forms

    UV Equipment Calibration Report (UV-CAL) (DOCX 42.17 KB)
    UV Reactor Monthly Off Specification Report, UV-OFF SPEC (DOCX 40.73 KB)
    Ultraviolet Disinfection Treatment Report (UV-A) (DOCX 40.12 KB)
    UV Reactor Report - Calculated Dose Approach, UV-CDA (DOCX 64.95 KB)
    UV Reactor Report - Intensity Setpoint Approach, UV-ISA (DOCX 49.06 KB)

  3. Submit the Report

    Submit the completed report forms by:

    • Mail - Print and mail the completed report forms to the appropriate MassDEP Regional Office (see listing below)
    MassDEP regional offices by community 

Contact

Address
MassDEP Boston
1 Winter Street, Boston, MA 02108
Directions 
Phone
Program Director 617-292-5770
Online
MassDEP Drinking Water Program program.director-dwp@mass.gov
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