Drinking Water Field Operations Branch Districts - Sonoma - 18

Forms and Documents

Section (Sortable) Name (Sortable) Form/Handout/Checklist (Sortable) Date Rev. (Sortable)

2017 Wildfires

2017 Wildfires - Return to Service Water Certification Form Form 11/2017
General Information Introduction to Regulatory Requirements for Public Water Systems (Handout 02) Handout 02 02/2016
General Information Annual Report Form and Submission Form
Bacteriological Collecting Bacteriological Water Samples (Handout 32) Handout 32 07/2014
Bacteriological Guidelines for Resolving Bacteriological Problems (Handout 33) Handout 33 07/2014
Bacteriological Helpful Tips for Avoiding Bacteriological Problems (Handout 34) Handout 34 07/2014
Bacteriological Small Surface Water System Bacteriological Sampling Plan (Form 36; Sonoma District Surface Water No Triggered Sampling) Form 36 01/2015
Bacteriological Small Water System Bacteriological Sampling Plan with Groundwater Rule Compliance (Form 36A; Sonoma District) Form 36A 01/2015
Bacteriological Large Water System Bacteriological Sampling Plan - GW triggered source (Form 37; Sonoma District) Form 37 02/2015
Bacteriological Large Water System Bacteriological Site Sampling Plan – Surface Water (Form 37a; Sonoma District) Form 37a 02/2015
CCR Tips for Completing Your CCR (Handout 15) Handout 15 02/2016
Cross Connection Program Cross Connection Control for Noncommunity Water Systems (Handout 67) Handout 67 08/2004
Cross Connection Program Cross Connection Control for Community Water Systems (Handout 68) Handout 68 11/2003
Cross Connection Program Example Cross Connection Control Ordinance for a Small Water System (Handout 69) Handout 69 01/2002
Disinfection Byproducts (DBP) - Stage 2 Stage 2 Disinfectants/Disinfection By products Monitoring Plan (Form 103-2) Form 103-2 12/2012
Disinfection Byproducts (DBP) - Stage 2 Stage 2 DBP Reporting Form (Form 103D) Form 103D
Disinfection Byproducts (DBP) - Stage 2 Stage 2 Bromate Reporting Form (Form 103G; See User's Document below for more information) Form 103G 06/2012
Disinfection Byproducts (DBP) - Stage 2 Stage 2 Bromate Reporting Form User's Document (Handout 103G) Handout 103G 07/2014
OEL Forms Operational Evaluation Reporting Form Form
OEL Forms Source Water Evaluation Checklist Checklist
OEL Forms Treatment Process Evaluation Checklist Checklist
OEL Forms Distribution System Evaluation Checklist Checklist
Drinking Water Source Assessment Program Drinking Water Source Assessment - New Well (Form 8-15) Form 8-15
Drinking Water Source Assessment Program Drinking Water Source Assessment - New Spring (Form 8-16) Form 8-16
Drinking Water Source Assessment Program Drinking Water Source Assessment - Cover Letter (Form 8-17) Form 8-17
Emergency Notification Plans (ENP) ENP (Form 21; Sonoma District) Form 21
Emergency Notification Plans (ENP) Example ENP Page 2 for Community Systems (Handout 22) Handout 22
Emergency Notification Plans (ENP) Example ENP Page 2 for Non-Community Systems (Handout 23) Handout 23
Example Operations Plans and Forms for Small Water Systems Operations Plan Small Groundwater System  
Example Operations Plans and Forms for Small Water Systems Operations Plan Small Groundwater System with Chlorination  
Example Operations Plans and Forms for Small Water Systems Surface Water Treatment Plant Operations Plan Form Form 11/2003
Lead and Copper Lead and Copper Rule Sampling Guidance (Handout 50) Handout 50 02/2016
Lead and Copper Lead and Copper Results Reporting Form (Form 52L) Form 52L 08/2017
Lead and Copper Lead and Copper Results Worksheet - Modified (Form 52M) (Updated 5/2016) Form 52M 05/2016
Lead and Copper Lead and Copper Proof of Consumer Notification - Community Water Systems (Form 53A) Form 53A
Lead and Copper Lead and Copper Proof of Consumer Notification - Nontransient-Noncommunity Water Systems (Form 53B) Form 53B
Lead and Copper Lead and Copper Proof of Notification (Form 53) Form 53
Lead and Copper Lead and Copper Rule Collection Procedures - English & Spanish (Handout 54A) Handout 54A 07/2016
Lead and Copper Lead and Copper Text for Lead Public Education Program - Community Water Systems (Handout 55A) Handout 55A
Lead and Copper Lead and Copper Text for Lead Public Education Program - Nontransient - Noncommunity Water Systems (Handout 55B) Handout 55B
Lead and Copper Example Letter for Community WS Consumer Notification (Handout 55X) Handout 55X
Lead and Copper Example Letter for Nontransient-Noncommunity WS Consumer Notification (Handout 55Y) Handout 55Y
Lead and Copper Lead and Copper Initial WQP Monitoring (Form 56) Form 56 07/2014
Notification Templates Notification Templates  
Operational Handouts Well Surface Seal Requirements (Handout 60) Handout 60 01/2008
Operational Handouts Well Disinfection Procedures (Handout 61) Handout 61 07/2014
Operational Handouts Tank Disinfection Procedures (Handout 62) Handout 62 07/2014
Operational Handouts Steel Tank Coating Requirements (Handout 63) Handout 63 07/2014
Operational Handouts Chlorination Operational Requirements (Handout 64) Handout 64 07/2014
Operational Handouts Customer Complaint Form (Form 65) Form 65 07/2014
Operational Handouts Requirements for Drinking Water Additives (Handout 70) Handout 70 06/2009
Operational Handouts 4-log Virus Inactivation through Chlorine Disinfection (Handout 120) Handout 120 09/2018
Example Operations Plans and Forms for Small Water Systems 4-log Virus Inactivation Using Chlorination - Monitoring and Operations Plan Form (Handout 121) Handout 121
Permits SB1263 Handout Handout SB1263 06/2017
Permits Request a New Water Supply Permit Application (Form 7-00a) Form 7-00a 08/2018
Permits Request a Water Supply Permit Amendment Application
(Form 7-00b)
Form 7-00b 12/2016
Permits System Information Sheet (Form 7-03) Form 7-03 07/2014
Permits Water System Schematic Requirements (Form 7-09) Form 7-09
Permits Example: Water System Schematic (Form 7-09a) Form 7-09a 05/2013
Permits Water System Contacts Form (Form 7-18) Form 7-18 04/2017
Surface Water LT2 E. Coli Sampling Plan  
TMF (Technical, Managerial, Financial) TMF Assessment Forms Form
Wells 8-Hour Pumping Test for Wells in Alluvial Soils (Handout 9A) Handout 9A 01/2018
Wells Well Capacity Determination for Wells in Bedrock (Handout 9B) Handout 9B 03/2018
Wells Well Concrete Base or Pad Construction Requirements (Handout 60) Handout 60 01/2008
Wells 8-Hour, 72-Hour, and 10-Day Pump Test Form (See worksheet tabs for different durations) Form
Tank Inspection All Tank Inspection Form Form 08/2017
Tank Inspection Ground Level Concrete Tank Inspection Form Form 08/2017
Tank Inspection Ground Level Poly Tank Inspection Form Form 08/2017
Tank Inspection Ground Level Pressure Tank Inspection Form Form 08/2017
Tank Inspection Ground Level Redwood Tank Inspection Form Form 08/2017
Tank Inspection Ground Level Steel Tank Inspection Form Form 08/2017
Tank Inspection Underground Concrete Tank Inspection Form Form 08/2017
Tank Inspection Inspection Photograph Requirements (Required for all self-inspections)