Get Water System Operation Report - New York State Department Of - Health Ny

Filling out the Water System Operation Report accurately is crucial for compliance with New York State regulations. This guide will assist you in navigating the form online, ensuring that you provide all necessary information correctly and efficiently.

Follow the steps to complete the form online.

1. Click ‘Get Form’ button to obtain the form and open it in the designated online editor.
2. Begin by entering the public water system name in the allocated field. Ensure that this accurately reflects the name registered with the New York State Department of Health.
3. Select the source water types from the options provided. This may include surface water, ground water, GWUDI, or indicate if you purchase water with or without subsequent chlorination.
4. Fill in the reporting month and year. Use the format MM YYYY for consistency. Make sure the date report is submitted accurately in the given format.
5. Specify the county and the city, town, or village associated with the public water system.
6. In the treatment plant identification section, list all relevant facilities. For each plant, identify the fluoride compounds used, choosing from sodium fluoride, sodium fluorosilicate, or fluorosilicic acid.
7. Indicate the fluoride residual testing method in the designated field. This should detail the method you implemented for testing fluoride levels.
8. Provide the fluoride injection point location details, labeling each specific point used in the operation.
9. Fill in the date of fluoride split sample collection using the prescribed format; accurately note the specifics related to your water treatment.
10. Complete the daily monitoring section by recording the treated water volume and the amounts of chlorine used. Include detailed measurements for both liquid and gaseous chlorine as indicated.
11. Use the table provided to document microbiological samples and free chlorine residuals — including population served and monitoring sample requirements.
12. Check the boxes indicating whether any violations occurred. If violations are present, provide clear explanations for each situation addressed.
13. Include any necessary comments or additional information in the comments section at the end of the form, making sure to elaborate where required.
14. Once you have filled in all necessary fields, review your inputs for accuracy. You may then proceed to save changes, download, print, or share the completed form as required.

Complete your Water System Operation Report online today to ensure compliance with state regulations.