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- This page, Drinking Water Permits, Forms, and Templates, is offered by
- Massachusetts Department of Environmental Protection
Drinking Water Permits, Forms, and Templates
Table of Contents
Autodialer & Contact Information
Certified Operators Forms
Consumer Confidence Reporting Forms & Templates
Cross Connections Forms
Distribution System Modifications Forms
Emergency Response Forms
Revised February 2024. Log sheet, available in PDF and Word, for PWS to log results from testing water treatment controls and alarms. The log must be maintained and kept on-site for at least five years for inspection by MassDEP/DWP when requested.
Revised February 2024. Log sheet, available in PDF and Word, for PWS to log results from testing water treatment controls and alarms. The log must be maintained and kept on-site for at least five years for inspection by MassDEP/DWP when requested.
Form to be used when a Non-Community Public Water System (TNC, NTNC) has to temporarily close due to a declared State of Emergency.
Form to be used when a Non-Community Public Water System (TNC, NTNC) has to temporarily close due to a declared State of Emergency.
This form must be completed if PWS determines that it does not have operational technology (OT) cybersecurity risks.
Ground Water Rule Forms
Ground Water Under the Direct Influence of Surface Water (GWUDI) Forms
Laboratory Analytical Forms
List of sampling location numbers for all Public Water Systems. Last Updated: January 2, 2025
List of school and childcare facility orgcodes. Last Updated: January 2, 2025
List of sampling location codes for the LCCA Program. Last Updated: Jan. 17, 2025
Version 8.0.3 (Jan. 11, 2024)
Lead and Copper Forms & Templates
Monitoring Waiver Forms
Monthly and Daily Reporting Forms
New Source Approval Forms
New Technology Approvals Forms
Public Notification Forms & Templates
Public Water System Modifications Forms
Source Water Protection Forms & Templates
Statistical Reporting Forms
Common issues that eDEP users encounter during the ASR filing process and how to work through those problems
Surveys and Questionnaires
Questionnaire conducted approximately every five years to determine the extent of the use of mercury-containing products at public water systems.
Underground Injection Control Forms
Vending Machines Forms
Water Management Act (WMA)
Water Treatment Plant Forms
Well Drillers Forms
WIIN Act
For households where the public water system's 90th percentile level in their most recent sampling round is below the action level and the household's lead sample result is greater than 15 ppb.
For households where the public water system's 90th percentile level in their most recent sampling round and the household's lead sample results are greater then 15 ppb.
The Confirmation Form is for public water system (PWS) to confirm distribution of the required information to EPA, MassDEP, and the Local Board of Health.
Zone II Determinations Forms
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