Get Doh-5025 2012-2026

The DOH-5025 form is a vital document for certifying the completion of public water improvement projects in New York State. This guide provides users with step-by-step instructions to successfully fill out and submit the form online.

Follow the steps to complete the DOH-5025 online.

1. Press the ‘Get Form’ button to access the DOH-5025 form and open it in the editing interface.
2. Enter the public water system name in the designated field.
3. Fill in the PWSID number, ensuring that the number is accurate.
4. Indicate the project location by providing the city, town, or village.
5. Specify whether the project is a Drinking Water State Revolving Fund (DWSRF) project.
6. Check 'Yes' or 'No' regarding the approval of plans by the NYSDOH Bureau of Water Supply Protection.
7. If applicable, enter the DWSRF Project Number and NYSDOH BWSP Project Log Number.
8. Provide the construction start date.
9. Indicate the substantial construction completion date and attach a copy of the notice to proceed.
10. Write a brief project description that summarizes the key elements of the project.
11. Review the statement regarding the certification of project completion, and prepare to affix your seal and signature.
12. If there are any deviations from the approved plans, document them in the space provided or attach additional sheets as necessary.
13. Enter the name of the engineering firm and print the contact person's name.
14. Complete the contact phone number and date signed fields, then affix the NYS Engineer's seal and signature.
15. Based on your answers, determine the appropriate address to send the completed form, whether to NYSDOH BWSP or another regional or district office.

Complete your DOH-5025 form online and ensure a smooth submission process.