Get Idph Non-community Public Water System Construction Application - Idph State Il

Filling out the IDPH Non-community Public Water System Construction Application is essential for obtaining the necessary permits for constructing, altering, or extending a drinking water system in Illinois. This guide provides clear, step-by-step instructions on how to complete the application accurately and efficiently.

Follow the steps to fill out the application correctly.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by identifying the purpose of the application by selecting whether you propose to construct, alter, or extend a water system. Indicate if it's for a new or existing facility and provide the facility identification number, if applicable.
3. In the 'Owner' section, enter the name, address, city/state/ZIP code, telephone number, and fax number of the owner. If the owner is a certified operator, indicate 'YES' and provide the certification number and the year certified.
4. Provide details for the individual responsible for system operation and water sample collection. This includes their name, address, city/state/ZIP code, telephone number, and fax number.
5. Fill in the 'Well Contractor' section with the name and license number of the well contractor, along with their mailing address, city/state/ZIP code, and telephone number.
6. Complete the 'Well Location' section by providing county, city, street, township, and the associated coordinates. Also, indicate if the system is within the setback zone of any community public water system, and if so, provide the name and distance from the CPWS.
7. List all known potential sources of contamination within 1,000 feet of the water system. For each site, provide the type and approximate distance from the well. If there are no contamination sources, indicate 'NONE'.
8. Describe the directions to the site using clear and concise language. If more space is needed, an additional sheet can be used.
9. In 'System Information', estimate the number of people served and daily water usage. Provide specific details about storage capacity, pump types, and distribution piping.
10. Describe the proposed construction materials and sizes. Attach any necessary diagrams or plans for clarity.
11. Complete the section specifically for non-transient non-community public water systems, addressing financial capacity, laboratory services, and emergency water supply arrangements. Provide full explanations as required.
12. Finally, certify the accuracy of the information provided by signing and dating the application form.
13. Once you have reviewed and completed the application, save any changes, and download or print a copy for your records. You may also share the form as needed.

Complete your IDPH Non-community Public Water System Construction Application online today to ensure a smooth permitting process.