Drinking Water Program Forms and Tools

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Drinking Water Program

Department
- Human Services Department
- Divisions

WS Operator Tools and Forms
Monitoring & Report Formats
Coliform
Turbidity and Surface Water Treatment
Chemical Monitoring
Lead and Copper Corrosion Control
Public Notices
Order Form
Fact Sheets, Interpretations and Techniques
Health Effects
County Health Department
Sanitary Surveys
Training

Water Hauling Guidelines for Oregon Drinking Water (pdf)

Laboratories
Forms for Laboratories
Direct Lab Reporting - April 1

Domestic Well Testing
Domestic Well Testing form (pdf)
Additional Domestic Well Testing informations

Monitoring & Report Formats
These outline the testing requirements for the various types of water systems. To determine your water system type, use this flowchart (pdf)

Coliform
A Small Systems Guide to the Total Coliform Rule
Coliform Bacteria (pdf)
Coliform Bacteria and how to disinfect a well (pdf)
Turbidity and Coliform monitoring frequencies for all Systems (pdf)
Proper Microbiological Sampling Techniques (pdf)
How to Interpret Coliform Test Results (pdf)
How to Develop a Coliform Sampling Plan.--Spring 1994 Pipeline (pdf)
Coliform Sampling Plan Template for Small Systems (pdf)

Turbidity and Surface Water Treatment
Turbidity and Coliform monitoring frequencies for all Systems (pdf)
Turbidity Monitoring and CT Summary Report (pdf)
Interim Enhanced Surface Water Treatment Rule: A Quick Reference Guide (pdf)
Long Term 1 Enhanced Surface Water Treatment Rule: A Quick Reference Guide (pdf)
Filter Backwash Recycling Rule: A Quick Reference Guide (pdf)
Tracer Study Parameter and Results Form (MS Excel)

Disinfection Byproducts
Quick Reference Guide (pdf) (2 pages)
General M-DBP Fact Sheet (pdf) (5 pages)
Stage 1 DBPR Fact Sheet (pdf) (4 pages)
DBP Outreach Plan (pdf)
Chloramine Information

MRDL
Maximum Residual Disinfectant Level report form (doc)

Chemical Monitoring
*Note: New sampling requirements have been added for Disinfection Byproducts and Radionuclides that may effect your water system. Please consult the fact sheets below for further information.
Community and Non-Transient Water Systems (pdf)
Transient/Non-community and State Regulated Water System (pdf)
Chemical Contaminants and Maximum Levels (pdf)
Chemical Monitoring Reduction Request Form (pdf)
SOC Use Wavier Guidance (pdf)

Arsenic
Arsenic and Clarifications to Compliance and New Source Monitoring Rule: A Quick Reference Guide (pdf)

Radionuclides
Quick Reference Guide (pdf) (2 pages)
General Info Fact Sheet (www.epa.gov)
Detailed Fact Sheet on New Standard (www.epa.gov)

Lead and Copper Corrosion Control Treatment (Lead Copper Rule)
Reporting Forms
For Water System Entry Point (pdf)
For Water System Distribution (pdf)
Instructions (pdf)

LCR EPA Quick Reference (pdf)
Lead In Drinking Water In Schools and Non-Residential Buildings. EPA manual on how drinking water can be tested for lead and how contamination problems can be corrected if found. This manual is intended for use by officials responsible for the maintenance and/or safety of these facilities.
Revised Guidance Manual for Selecting Lead and Copper Control Strategies (pdf)

Public Notices
NEW PUBLIC NOTIFICATION RULE! LEARN MORE!
Revised as required by the 1996 Safe Drinking Water Act Amendments to make public notification easier and more effective. As a result, consumers will see notices much faster during emergencies, which are also easier to read and understand. Furthermore, regulators and water systems will now have more concise standard language and notices.

Public notices are now divided up into three (3) categories based on public health risk:
Tier 1--critical/urgent (must issue within 24 hours)
Tier 2--important (must issue within 30 days)
Tier 3--no immediate concern (must issue within one year)

Public Notice Handbook and information on the new Public Notification Rule
http://www.epa.gov/safewater/pn.html

Public Notice Fact Sheet
http://www.epa.gov/safewater/publicnotification/index.html

Public Notice Templates for all violation types including translated phrases in foreign languages (Spanish, French, Vietnamese, Chinese, and Korean).
http://www.epa.gov/safewater/publicnotification/index.html

Foodborne Illness Prevention Program Emergency Response Fact Sheet for Licensed Facilities

Commonly Asked Questions Following a Boil Water Notice

Commonly used templates (consult info above for use criteria), procedures and forms that public water systems use when they exceed an MCL (Maximum Contaminant Level), fail to complete required tests and/or report the results, fail to meet treatment techniques, etc:

Total Coliform MCL (unresolved) (fillable doc) (pdf )
Total Coliform MCL (resolved) (fillable doc) (pdf )
Fecal Coliform/E. Coli MCL (fillable doc) (pdf )
No Pressure Boil Water (Tier 1) (pdf)
Surface Water Treatment Technique--Turbidity-Boil Water (fillable doc) (pdf )
Surface Water Treatment Technique--Turbidity (Tier 2) (fillable doc) (pdf )
Surface Water Treatment Technique--Disinfection (Tier 2) (fillable doc) (pdf )
Monitoring and/or Reporting failure (Coliform, surface water report, nitrate, etc.) (pdf)
Lead and Copper Rule Treatment Technique--Lead (pdf)
Lead and Copper Rule Treatment Technique--Copper (pdf)
Lead & Copper public education materials for community water systems (doc) (pdf)
Lead & Copper public education materials for non-transient non-community water systems (doc) (pdf )

Fact Sheets, Interpretations and Techniques
Do you operate a public water system? Figure out what kind of system you have with this flow chart

Fact Sheet: Recommendations for Arsenic Removal from Private Drinking Water Wells in Oregon
Fact Sheet: Creating a Water System Operations Manual
Fact Sheet: Coliform Sampling Plans
Fact Sheet: Home Water Treatment Devices
Fact Sheet: Preparing for Water System Survey

Data order form
The Oregon Drinking Water Program charges a small fee for 3rd party data requests. This is usually $75.
Download our orderform (pdf) and mail with a check.

Fluoride
Systems Adjusting Fluoride (pdf)

HealthEffects Information
Bulletins that cover the health effects of drinking water containing these chemicals.

Ammonia (pdf)
Arsenic (pdf)
Benzene (pdf)
Boron (pdf)
Btex (pdf)
Calcium Carbonate (pdf)
Carbon Tetrachloride (pdf)
Coliform Bacteria (pdf)
Copper (pdf)
Cryptosporidium (pdf)
Dacthal (pdf)
1,1 - Dichloroethane (pdf)
1,1 - Dichloroethylene (pdf)
1,2 - Dichloroethane (pdf)
Cis 1,2 - Dichloroethylene (pdf)
Trans-1,2 - Dichloroethylene (pdf)
1,2 - Dichloropropane (pdf)
Ethylbenzene (pdf)
Ethylene Dibromide (pdf)
Giardia (pdf)
Lead (pdf)
Methyl Chloride (pdf)
Methy-Tertiary-Butyl-Ether (pdf)
Nitrate (pdf)
Paradichlorobenzene (pdf)
PCBs and Submersible Pumps (pdf)
Pentachlorophenol (pdf)
Perchlorates (pdf)
Picloram (pdf)
Polychlorinated Biphenyls (pdf)
Sodium (pdf)
Sodium Carbonate (pdf)
Sodium Hydroxide (pdf)
Tetrachloroethylene (pdf)
Toluene (pdf)
Tributyltin (pdf)
Trichloroethylene (pdf)
1,1,1 - Trichloroethane (pdf)
Trichlorofluorometh (pdf)
Trihalomethanes (pdf)
Uranium (pdf)

Plan Review Requirements

County Health Department Forms

Inventory Updates
Plan Review Routing Form
Source Info
Water System Information
Entry Structure Diagram
Chemical Monitoring Schedule Change Form

PWS Contact Forms
Contact Report/Assistance Actions (autofill doc)
Contact Report/Assistance Actions (doc)
SNC Investigation Report   (autofill doc)
SNC Investigation Report   (manual form doc)
SNC Resolution Report   (autofill doc)
SNC Resolution Report   (manual form doc)

Sanitary Survey Forms

Sanitary Survey Manual Part 1 (pages 1 - 94)

Page updated: May 14, 2008

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