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Forms, Tools and Fact Sheets
Quick Links to "Forms, Tools and Fact Sheets" Webpage Content:
Monitoring & Report Formats
Coliform
Turbidity and Surface Water Treatment
Chemical Monitoring
Lead and Copper Corrosion Control
Lead and Copper Reporting and Monitoring Guidance
Public Notices
Data and Information Order Form
Fact Sheets, Interpretations and Techniques
Chemicals and Health Effects
Local County Health Department Information & Forms
Water System Surveys
Drinking Water Program Training
Water Hauling Guidelines for Oregon Drinking Water (pdf)
Drinking Water Laboratory Information:
Accredited and Certified Lab Lists, and Lab Reporting Forms
Direct Lab Reporting Procedure (Effective: April 1, 2006)
Domestic Well Testing:
Domestic Well Testing form (pdf)
Additional Domestic Well Testing information
Monitoring & Report Formats: These outline the testing requirements for the various types of water systems. To determine your water system type, use this flow chart (pdf)
Coliform:
A Small Systems Guide to the Total Coliform Rule (pdf)
Coliform Bacteria (pdf)
Coliform Bacteria and how to disinfect a well (pdf)
Coliform monitoring frequencies for all Systems (pdf)
Turbidity and Coliform monitoring frequencies for all Systems (pdf)
Proper Microbiological Sampling Techniques (pdf)
How to Interpret Coliform Test Results (pdf)
How to Develop a Coliform Sampling Plan --Spring 1994 Pipeline (pdf)
Coliform Sampling Plan Template for Small Systems (autofill doc) (pdf): Updated small system coliform sampling plan templates incorporate the source water monitoring requirements of the Ground Water Rule. Source water monitoring requirements are effective for Ground Water Systems beginning December 1, 2009.
Turbidity and Surface Water Treatment:
Turbidity and Coliform monitoring frequencies for all Systems (pdf)
Turbidity Monitoring and CT Summary Report (pdf)
Interim Enhanced Surface Water Treatment Rule: A Quick Reference Guide (pdf)
Long Term 1 Enhanced Surface Water Treatment Rule: A Quick Reference Guide (pdf)
Filter Backwash Recycling Rule: A Quick Reference Guide (pdf)
Tracer Study Parameter and Results Form (MS Excel)
Disinfection Byproducts:
EPA Quick Reference Guide (pdf)
EPA General M-DBP Fact Sheet (pdf)
EPA Stage 1 DBPR Fact Sheet (pdf)
DBP Outreach Plan (pdf)
EPA Chloramine Webpage
Maximum Residual Disinfectant Level Report Form (MRDL): Download and use this form to report MRDL samples collected in the distribution system to DHS-Drinking Water Program. Click here to download form.
Chemical Monitoring: *Note: New sampling requirements have been added for Disinfection Byproducts and Radionuclides that may effect your water system. Please consult the fact sheets below for further information:
Community and Non-Transient Water Systems (pdf)
Purchasing Community and Non-Transient Water Systems (pdf)
Transient/Non-community and State Regulated Water System (pdf)
Chemical Contaminants and Maximum Levels (pdf)
Chemical Monitoring Reduction Request Form (pdf)
SOC Use Waiver Guidance (pdf)
Arsenic
EPA Arsenic and Clarifications to Compliance and New Source Monitoring Rule: A Quick Reference Guide (pdf)
Radionuclides:
EPA Radionuclides in Drinking Water Web Page
EPA Radionuclides Rule: A Quick Reference Guide (pdf)
EPA Technical Fact Sheet: Final Rule (for Non-Radon) Radionuclides in Drinking Water (pdf)
Lead and Copper Public Education Requirements:
Updates to current Lead and Copper Public Education Rules (pdf)
Lead and Copper Corrosion Control Treatment (i.e. Lead and Copper Rule) Reporting Forms:
For Water System Entry Point (pdf)
For Water System Distribution (pdf)
Monitoring and Reporting Forms Instructions (pdf)
EPA Lead and Copper Rule Quick Reference (pdf)
EPA Revised Guidance Manual for Selecting Lead and Copper Control Strategies (pdf)
Lead and Copper Reporting and Monitoring Guidance: This is Form 141-A for certification of Lead and Copper sampling. Form submission is only required when there is a change in routine Lead/Copper sampling locations. Download two-page (pdf) form in document called EPA Lead and Copper Reporting and Monitoring Guidance for Public Water Systems (pp 99-100).
Lead Testing: EPA has a manual that describes how drinking water can be tested for lead, and how contamination problems can be corrected. This manual called Lead in Drinking Water in Schools and Non-Residential Buildings is intended for use by school officials responsible for the water system maintenance and/or safety. Revised technical guidance is available in EPA's 3Ts for Reducing Lead in Drinking Water in Schools. For more information about lead poisoning, contact DHS-Public Health Division, Lead Poisoning Prevention Program (ph. 971-673-0440) or click here.
EPA Revised Public Notification Rule: Now required by the 1996 Safe Drinking Water Act Amendments to make public notification easier and more effective. As a result, consumers will see notices much faster during emergencies, which are also easier to read and understand. Furthermore, regulators and water systems will now have more concise standard language and notices. Public notices are now divided up into three (3) categories based on public health risk:
Tier 1--Critical/Urgent (must issue within 24 hours)
Tier 2--Important (must issue within 30 days)
Tier 3--No immediate concern (must issue within one year)
EPA Revised Public Notification Rule Compliance Help: Compliance help for water system owners and operators can be obtained by clicking here: http://www.epa.gov/safewater/publicnotification/compliancehelp.html.
EPA Revised Public Notification Handbook: Contains information on Public Notification Rule and violation types. Handbook also includes public notice templates, strategic planning concepts, standard and appropriate health effects language usage, and translated phrases in twenty-seven foreign languages (i.e. Arabic, Chinese, Farsi, Korean, Russian, Spanish, Thai, Ukrainian, Vietnamese and more). Download handbook here: http://www.epa.gov/safewater/publicnotification/pdfs/guide_publicnotification_pnhandbook.pdf.
Public Notice Templates: These are commonly used templates, procedures and forms for public water systems to utilize when exceeding a Maximum Contaminant Level (MCL); failing to complete required tests; failing to report the results; failing to meet treatment techniques; etc. Templates are available for download below (please consult "EPA Revised Public Notification Rule" section above for appropriate use criteria).
Total Coliform MCL (unresolved) (doc) (pdf)
Total Coliform MCL (resolved) (doc) (pdf)
Fecal Coliform or E. Coli MCL (doc) (pdf)
No Pressure Boil Water (Tier 1) (doc) (pdf)
Surface Water Treatment Technique--Turbidity-Boil Water (doc) (pdf)
Surface Water Treatment Technique--Turbidity (Tier 2) (doc) (pdf )
Surface Water Treatment Technique--Disinfection (Tier 2) (doc) (pdf)
Monitoring and/or Reporting failure (Coliform, surface water report, nitrate, etc.) (doc) (pdf)
Lead and Copper Rule Treatment Technique--Lead (pdf)
Lead and Copper Rule Treatment Technique--Copper (pdf)
Lead and Copper public education materials: Community water systems (doc) (pdf)
Lead and Copper public education materials: Non-transient non-community water systems (doc) (pdf)
Chemical or Radiological MCLs (Tier 2) (doc) (pdf)
Oregon Licensed Food Service Facilities: DHS-Public Health Division, Foodborne Illness Prevention Program has an emergency fact sheet related to licensed food service facilities and contaminated water supplies: Emergency Response Fact Sheet. For more information about licensed food service facilities and restaurant safety, call ph. 971-673-0451 or click here.
Boil Water Notices: Public water systems must immediately contact DHS-Drinking Water Program (ph. 971-673-0405) if issuing any boil water advisory. The document called Commonly Asked Questions Following a Boil Water Notice provides more information.
Fact Sheets, Interpretations and Techniques: Do you operate a public water system? Figure out what kind of system you have with this flow chart.
Chemicals and Health Effects: Bulletins below cover possible health effects of drinking water containing these chemicals. For more information on chemcials and health effects, please contact DHS-Public Health Divison, Toxicology Consultation (ph. 971-673-0440) or click here. All bulletins are in a downloadable (pdf) file format.
Ammonia
Arsenic
Benzene
Boron
Btex
Calcium Carbonate
Carbon Tetrachloride
Coliform Bacteria
Copper
Cryptosporidium
Dacthal
1,1 - Dichloroethane
1,1 - Dichloroethylene
1,2 - Dichloroethane
Cis 1,2 - Dichloroethylene
Trans-1,2 - Dichloroethylene
1,2 - Dichloropropane
Ethylbenzene
Ethylene Dibromide
Giardia
Haloacetic Acids
Lead
Methyl Chloride
Methy-Tertiary-Butyl-Ether
Nitrate
Nitrate - (Spanish version)
Paradichlorobenzene
PCBs and Submersible Pumps
Pentachlorophenol
Perchlorates
Picloram
Polychlorinated Biphenyls
Sodium
Sodium Carbonate
Sodium Hydroxide
Tetrachloroethylene
Toluene
Trans-1,2 - Dichloroethylene
Tributyltin
Trichloroethylene
1,1,1 - Trichloroethane
Trichlorofluorometh
Trihalomethanes
Uranium
Fluoride: Systems Adjusting Fluoride (pdf)
Oregon Water System Plan Review Requirements: Water system plans must be submitted to, and approved by, State Public Health Division, Drinking Water Program before the construction of a new system, or major additions or modifications to existing systems. For more details on requirements, land use statement, fee schedule, and waiver from construction standards, click here.
Local County Health Department Resources: Information and forms on inventory, contacts, and water system surveys are available for download below:
Data and Information Order Form: DHS-Drinking Water Program charges a small fee (usually $75.00) for 3rd-party data requests. To order data, click here to download order form (pdf), complete required information, and return with check and postage to the address listed on the form.
DHS-Drinking Water Program Training: Documents and files from past conferences, seminars and trainings are avilable below:
2009 Silver Falls Conference
2008 Fall/Regional Training
2008 Silver Falls Conference
2008 Drinking Water Program Orientation
2007 Fall/Regional Training
2007 Silver Falls Conference
2006 Fall/Regional Training
2006 Silver Falls Conference
Training Course
To request a CD (or alternative formats), please contact the DHS-Drinking Water Program (business hours: 8AM - 5PM, Mon-Fri), ph. 971-673-0405.
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