Get Form Doh-360cuv - Water System Operation Report For Systems That Treat With Chlorine And/or

The Form DOH-360CUV serves as a critical documentation tool for water systems that utilize chlorine for treatment. This guide will provide you with step-by-step instructions to effectively complete the form, ensuring compliance and thorough reporting.

Follow the steps to accurately complete the Form DOH-360CUV

1. Press the ‘Get Form’ button to obtain the form and open it in an accessible format.
2. Fill in the public water system name to identify your system.
3. Enter the reporting month and year in the designated fields as MM YYYY.
4. Complete the date report submitted field in MM DD YYYY format.
5. Indicate the county where the water system is located.
6. Specify the town, village, or city associated with the water system.
7. Select the source water type(s) being utilized from the provided options.
8. Provide the public water system ID number in the specified format.
9. List the sources in use for your water system.
10. Input the treated water volume in gallons per day.
11. Detail the gaseous cylinder weight in pounds.
12. Provide the amount of chlorine used per day in pounds.
13. If applicable, document the liquid hypochlorite added to the crock in gallons or quarts.
14. Indicate the free chlorine residual at the entry point in mg/l.
15. Answer whether the UV unit is active by marking yes or no.
16. Confirm the intensity meter is above 70%.
17. Calculate the chlorine mix ratio with the specified amounts and concentrations.
18. Note the dates when the UV quartz sleeve was last cleaned and the UV lamp was replaced.
19. Indicate if there was alarm activation and, if yes, provide the date of activation.
20. Complete the report by filling in your name, title, certification number, and signature.
21. Finally, enter the date of report completion and operator grade level.
22. Once all sections are complete, review the document for accuracy, save your changes, and choose to download, print, or share the form as needed.

Ensure accurate compliance by completing the Form DOH-360CUV online today.