Drinking Water Forms

Drinking Water Permitting and Engineering

Application and Modification Forms

• Click Here for More Information on Drinking Water Permitting Processes
• Application for a Permit to Operate a Public Water System (MS Word) [Revised April 2024]
• Drinking Water Project Submittal [Revised April 2017]
• Wellhead Protection: New Well / Spring Application [Revised Feb. 2024] 
• Public Water System Water Conservation Questionnaire (MS Word) [Revised Jan 2004]
• Business Plan For Public Water Systems (Appendix A) [Revised Jan. 2000]
• Well Completion Data Form [Revised November 2014]

• Surface Water Checklist #1 - New Surface Water Treatment Plant *NEW*

• Surface Water Checklist #2 - Submission of Engineering Report *NEW*

• Surface Water Checklist #3 - Submission of Pilot Studies *NEW*

• Surface Water Checklist #4 - Submission of Engineering Plans *NEW*

• Northern Groundwater and Purchase Water System Permitting Checklist  [Revised June 2023]

• Southern Groundwater and Purchase Water System Permitting Checklist  [Revised June 2023]

• High Rate Study Data Submittal Form *NEW FORM*

• Step Dose Tracer Test Data *NEW FORM*

• Tracer Study  Report *NEW FORM*

Drinking Water Laboratory Services

• Drinking Water Analyses Terms and Conditions (effective 7/1/2023)
• Analytical Fee Schedule (effective 7/1/2023)
• Request to Change Water System Inventory or Laboratory Services Form
• Water Sample Shipping Case Request

Drinking Water Compliance

Application Forms

• Chemical Monitoring Report Form [Updated Dec 2016]

Revised Total Coliform Rule (RTCR) Forms

• Level I Assessment Form [Effective April 1, 2016]
• Level II Assessment Form [Effective April 1, 2016]
• Seasonal System Start-Up Procedure and Checklist [Effective April 1, 2016]

Sanitary Survey for Public Water Systems

• Surface Water Sanitary Survey for Public Water Systems [Revised May 2001]
• Surface Water System Description (Part B) Sanitary Survey for Public Water Systems [Revised May 2001]
• Ground/Purchased Water Sanitary Survey for Public Water Systems [Revised January 2017]

Treatment Plant Monthly Operating Report Forms

• Surface Water Treatment Plant Monthly Operating Report Forms (Excel Format) [Revised Nov 2005]
• Ground Water Treatment Plant Monthly Operating Report Forms (Excel Format) [Revised Nov 2022]
• Membrane Plant Monthly Operating Report Forms (Excel Format) [Revised June 2008]
• Purchased Water Treatment Plant Monthly Operating Report Forms (Excel Format) [Revised Nov 2022]

Disinfection Byproducts (TTHM & HAA5) Report Forms

• Stage 2 DBP Monitoring Plan {Revised Jan. 2015]
• Compliance Determination: Treatment Technique for DBP Precursor Removal (TOC Removal Report) [Revised Dec 2003]
• Stage 2 DBPR Operational Evaluation Guidance Manual
• Stage 2 DBPR Operational Evaluation Report for Ground Water Systems
• Stage 2 DBPR Operational Evaluation Report for Surface Water Systems
• Stage 2 DBPR Operational Evaluation Report for Consecutive Systems
• Operational Evaluation Level Calculation Form

Certifications for Drinking Water

• Consumer Confidence Report Certification [Revised August 2023] *Updated*
• Certification of Public Notice

Laboratory Certification

• Application for Reciprocity
• Application for In-State Microbiology Certification
• Guide to Georgia's Laboratory Certification Program

Lead and Copper Forms for Drinking Water Systems

• Lead and Copper Consumer Notice Certification Form
• Georgia’s Lead and Copper Summary of Materials Survey Form 2016
• Georgia’s Lead and Copper Final Targeted Sample Sites Form 2020
• Lead Consumer Notice for Non-Contracted PWSs 2016
• Lead Consumer Notice Certification Form for Non-Contracted PWSs 2022