OFFICIAL SITE OF THE STATE OF NEW JERSEYSampling & Regulatory Forms
Find necessary regulatory forms, permits, and documents
NOTE: Electronic reporting is required for most parameters including IOCs, VOCs, Radiologicals, and Total Coliform. Paper submission is required only for those forms listed on this page and can be submitted by the deadline via email to watersupply@njdepwptest.net with the name of the form in the subject line.
For a full list see the Electronic Environmental Reporting Quick Reference Guide
Please note that when submitting compliance sampling forms (DR, TU, etc.), whether on paper or by email to watersupply@njdepwptest.net, they should be submitted SEPARATELY from the Monthly Operator Report Forms. Sample results and Monthly Operator Forms are reviewed by different Units and submitting them separately will help to ensure that your forms are routed properly.
NOTE: If a facility is offline for an entire calendar quarter (i.e. January 1st – March 31st):
- Complete a Facility Out of Service Form
- Submit it to watersupply@njdepwptest.net
- subject: “PWSID, Offline Facility”
- For WQP use the WQP Biweekly Monitoring: Facility Out of Service Reporting Form
- For GWR use the GWR triggered well out of service form
General Information
- Systems General Contact Information Update Form
- Considerations When Purchasing Water Treatment Equipment for Small Community and Noncommunity Water Systems Factsheet
- Return to Compliance Guidance for Drinking Water Violations
- Water Filter Distribution Guidance
- Remedial Measures Report Form (BWSE-40)
- Corrective Actions Completion Certification (WSO-CA-01)
- Licensed Operator In Charge Employment Notification Form (DEP-065)
- Construction Permit Forms
- Sink for Dishwashing Only – Sign
- The Sink for Dishwashing Only sign may be used by facilities to indicate to customers that the tap is not to be used for other human consumption (e.g. drinking, cooking, making baby formula). Public water systems are still required to ensure compliance with all Federal and State Safe Drinking Water regulations at the posted tap(s).
- OQA Certified Labs
- Monitoring Reduction Request Form (DEP-S10-RRF.2)
- Missing WQPs
- RTCR Sample Reduction Form (DEP_10-S_00053.1) Updated 9/2024
Forms & Guidance Pertaining to Specific Rules
- Surface or GUI Systems Using Membrane Filtration
- Revised Total Coliform
- Ground Water
- Surface Water Treatment
- Disinfection Residuals
- Long Term 2 Enhanced Surface Water Treatment
- Stage 2 Disinfectants & Disinfection Byproducts
- Lead & Copper
- Construction Permits
- Public Notification
- Radiologicals
- Monitoring Waivers
- Asset Management/WQAA
- Additional Assistance
- CEHA Information
- Daily Integrity Testing (BSDW-103)
- Membrane Turbidity Monitoring (BSDW-104)
- General Information/Factsheets
- Level Assessment Forms
- RTCR Assessment Factsheet
- Level 1 Assessment forms
- Level 2 Assessment forms
- Sample Siting Plan
- Seasonal Water Systems
- Ground Water Rule Corrective Action Plan (DEP_10-F_00033.1) (New March 2023)
- GWR: Ground Water Source Tap Installation and Sampling for Public Water System (Revised November 19, 2018)
- Representative Source Water Monitoring Plan Summary Sheet
- Representative Source Water Monitoring Plan Certification
- Drinking Water Analysis – Ground Water Rule Assessment Monitoring Report Form (BSDW 100)
- Ground Water Rule Disinfectant Residual Compliance Monitoring Reporting Form (BSDW 101)
- Existing 4-log Virus Treatment Under the Ground Water Rule (DWS-GWR 4log)
- Disinfection Byproduct Precursor Compliance Report (BSDW-20)
- IESWTR Turbidity Report (BSDW-22)
- Instructions for IESWTR Turbidity Report (BSDW-22N)
- Individual Filter Exception Report (BSDW-23)
- Individual Filter Assessment Report (BSDW-24)
- Ground Water Under Direct Influence (GUDI) – Determination of Status form – Available upon request
- Ground Water Under Direct Influence (GUDI) – Preliminary Evaluation form (BSDW-110)
- Guidance for Understanding GUDI Workplan Requirements and Evaluating Data
- LT2 Cryptosporidium & Turbidity Report (BSDW-200)
- Bench Sheet for Method 1622
- Bench Sheet for Method 1623 and 1623.1
- LT2 E. coli Report (BSDW-201)
- Guidance for LT2 E. coli Report (BSDW-201N)
- Operational Evaluation Guidance Manual
- Determining If I Have An Operational Evaluation Level (OEL) Exceedance
- Stage 2 Rule Operational Evaluation forms & checklists:
- Guide to Lead and Copper Rule Forms
- Lead and Copper Monitoring:
- Factsheets:
- PbCu Sample Location Spreadsheet
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- For New locations: BWSE-18N (bwse18n.xlsx)
- For Edits to existing locations: BWSE-18R bwse18r.xlsx
- Directions for PbCu Sample Location Spreadsheet revised May 2022
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- Lead and Copper Sample Site Change Form (BSDW 56)
- Non-Compliance Lead and Copper Tap Monitoring Form (BWSE-16) revised April 2019
- Instructions for Non-Compliance Monitoring Form – BWSE 16 revised April 2019
- CWS Customer Lead and Copper Sampling Refusal Form (DEP_10-S00018.1) new April 2022
- Lead Copper Sampling Suspension Form (BWSE-LC01)
- Water Quality Parameter Monitoring:
- Water Quality Parameter (WQP) Monitoring Bi-weekly periods
- Water Quality Parameter Biweekly Monitoring: Facility Out of Service Reporting Form (BSDW-OS)
- Factsheets:
- Initial WQP Monitoring
- Follow-Up WQP Monitoring
- Optimal WQP Monitoring
- Seasonal Sources
- Approved Person (Person Acceptable to the State)
- WQP Monitoring Report Form for Approved Party
- WQP Sample Site Change Form (BWSE 19)
- Optimal Water Quality Control Parameter Recommendation Form (BWSE-LC03)
- Corrosion Control Treatment:
- Source Water Treatment Recommendation
- Source Water Treatment Recommendation (BWSE-SOWTR-01) revised April 2021
- Lead Service Line Replacement
- For Community Water Systems:
- Lead Service Line (LSL) Inventory Report (DEP_10-S_00014.4) [previously BWSE-20] revised April 2024
- Lead Service Line (LSL) Inventory Report Instructions revised April 2024
- For Non-Transient Noncommunity Water Systems:
- NCWS Lead Service Line (LSL) Inventory Report (DEP_10-F_00048.2) revised June 2024
- NCWS Lead Service Line (LSL) Inventory Report Instructions revised June 2024
- Annual Lead Service Line Replacement Progress Report (DEP_10-S_00027.2) revised April 2024
- Annual Lead Service Line Replacement Progress Report Instructions revised April 2024
- Lead Service Line Notification Form (DEP_10-S_00028.1) new May 2022
- Factsheet
- Lead Service Line Replacement Frequently Asked Questions revised June 2024
- Customer Notice of Lead Service Line Material Template revised May 2024
- Customer Notice of Unknown Service Line Material Letter Template new May 2024
- Lead Service Line (LSL) Replacement Report for systems with an Action Level Exceedance per the LCR (BWSE-21) new February 2020
- Lead Service Line Replacement Contact Log new July 2022
- Resident Refusal Form new July 2022
- Webinar Resources
- LSL Law Webinar Slides (May 17, 2022)
- LSL Requirements: Notification Q&A Slides (February 3, 2022)
- LSL Replacement Webinar Slides (January 4, 2022)
- For Community Water Systems:
- Lead Service Line Replacement Plan Resources
- Lead Service Line Identification and Replacement Plan Template updated April 2024
- Guidance for Developing a Lead Service Line Replacement Plan new July 2022
- Predictive Modeling Rationale new November 2022
- Predictive Modeling Guidance new November 2022
- Lead Public Education
- A Public Water System’s Guide to Lead Public Education new November 2024
- CWS Lead Public Education Template revised November 2021
- NTNC Lead Public Education Template revised November 2021
- CWS Lead Public Education Brochure Template revised December 2021
- Lead Public Education Poster Template new November 2021
- Lead Public Education Water Bill Template new November 2021
- Lead Public Education Public Service Announcement Template new November 2021
- Initial Lead Public Education Certification Form (DEP_10-F_00006.2) revised August 2021
- Ongoing Lead Public Education Certification Form (DEP_10-F_00007.2) revised August 2021
- PE Press Release updated January 2022
- Lead Consumer Notice Resources
- Lead Consumer Notice Frequently Asked Questions (FAQ)
- Certification Form – Consumer Notice of Lead Tap Water Monitoring Results (BSDW 54)
- Consumer Notice of Tap Water Results – Lead Profile Sampling
- Community Water System (revised December 2021)
- Consumer’s Individual Result and Water System’s 90th Percentile Result Below Action Level
- Consumer’s Individual Result and Water System’s 90th Percentile Result Above Action Level
- Consumer’s Individual Result Below Action Level and Water System’s 90th Percentile Result Above Action Level
- Consumer’s Individual Result Above Action Level and Water System’s 90th Percentile Result Below Action Level
- Noncommunity Water System (revised December 2021)
- Water Infrastructure Improvements for the Nation (WIIN) Act
The forms provided here are for convenience only. They are not DEP’s forms but are excerpts from EPA’s “Strategic Plan for Targeted Outreach to Populations Affected by Lead Water Infrastructure Improvements for the Nation (WIIN) Act.” Public water systems are advised to contact EPA directly. Additional information is available at https://www.epa.gov/dwreginfo/strategic-plan-targeted-outreach-populations-affected-lead.- Confirmation Sample Template new June 2020
- Notice to Affected Household – Sample Template AL above 15 ppb new June 2020
- Notice to Affected Household – Sample Template AL below 15 ppb new June 2020
- Sampling Plan Guidance (Lead & Copper and Water Quality Parameter)
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- Public Notification Templates
- Revised Total Coliform Rule
- RTCR Monitoring Waiver
- Public Notification Templates
- EC+
- TC+/EC-
- Ground Water Rule
- E. Coli in Source Water (BWA) [Updated 9/2022]
- E. Coli in Source Water (Consecutive Systems) [Updated 9/2022]
- Failure to collect source water samples
- Failure to submit a corrective action plan (Type 20)
- Failure to perform a corrective action (Type 48)
- Failure to submit a corrective action plan (Following a site visit/Type 20)
- Failure to perform corrective action (Following a site visit/Type 48)
- Failure to Maintain 4-log Treatment of Viruses (Tier 1) [8/2024]
- Failure to Maintain 4-log Treatment of Viruses (Tier 2) [8/2024]
- Revised Total Coliform Rule & Ground Water Rule
- E. coli in Source Water and Distribution System [Updated 9/2022]
- Nitrate
- Confirmed Nitrate MCL Exceedance [Updated 9/2022]
- Confirmed Nitrate MCL Exceedance & Failure to Maintain Treatment Violation (added 8/2020)
- Pending Nitrate Confirmation Sample (added 8/2020)
- Unconfirmed Nitrate MCL Exceedance [Updated 9/2022]
- Special Permission Nitrate MCL Exceedance (added 8/2020)
- Additional Nitrate Public Notice resources:
- Confirmed Nitrate MCL Exceedance in Spanish – Basic (added 10/2020)
- Instructions for Nitrate Public Notice Template (added 10/2020)
- PFAS
- Lead and Copper Rule
- Disinfection By-Products
- MCL Violation
- Miscellaneous
- Monitoring & Reporting
- Harmful Algal Blooms
- Public Notification Handbooks:
- Secondary Language Determination for PE and PN new 2/2022
- Public Notification Certification Form – Tiers 1, 2 & 3 (DEP_10-F_00054.1) formerly BSDW 53
- Request to Limit Tier 1 or Tier 2 Public Notification Distribution Form (DEP_10-S_00026.1)
- USEPA Best Practice Guide: Talking to Your Customers About Chronic Contaminants in Drinking Water
- Consumer Confidence Report (CCR)
- 2024 CCR Certification Form
- 2024 CCR Review Checklist (This document is used by NJDEP when reviewing CCRs for compliance with content requirements; CWS may refer to this as guidance when preparing a CCR for distribution to consumers.)
- SOC (Synthetic Organic Compounds)
- SOC Waivers for the 2023-2025 compliance period. To be considered for SOCs monitoring waiver for the 2023-2025 compliance period, systems must complete a NJ Well Vulnerability Survey for each well in use. Systems that do not submit survey(s) must conduct quarterly monitoring.
- Survey
- Asbestos:
- Monitoring and Waiver Determination Form (Asbestos Form #1)
- List of Municipalities Associated with Asbestos-Susceptible Geologic Formations (Attachment A to Asbestos Form #1)
- ACP/Aggressive Index Determination Form (Asbestos Form #2)
- Revised Total Coliform Rule Sampling Waiver Request (DEP_10-F00030.1)
- WQAA Annual Certification Form (DEP_10 S_00001.1) [Updated 10-2022]
- WQAA Annual Certification Form Submittal Instructions
- Capital Improvement Report Template Worksheet [Updated 1-2024]
For questions related to the WQAA, please contact the Department at WQAA@njdepwptest.net.
Note: Noncommunity System Inspections are only to be submitted via paper form when it is a new public water system or reactivation.