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Division of Municipal Facilities Resources
Clean Water State Revolving Fund Program
Drinking Water Program
Drinking Water State Revolving Fund Program
Municipal Facilities Calendar
Municipal Facilities Forms
Municipal Facilities Publications
NDWPCC
Training and Exams
Lead in Schools
Backflow Prevention Program
PFAS
Municipal Facilities Forms
List of forms for the Division of Municipal Facilities.
Clean Water State Revolving Fund
Priority List
CWSRF Questionnaire for Potential Financial Assistance
Loan Application
Loan Application Packet
Facility Plan
Cost and Effectiveness Certification
Project Bid
Bid Document Submittal Checklist
Request for Payment
Request for Payment Form
Payment Request Form – Planning Assistance Reimbursement Contracts Only
Project Close-out
Final Document Checklist and Forms
Sample One Year Certification
Planning Assistance Reimbursement Engineer Certification of Services
Drinking Water Program
General
Arsenic Rule
Arsenic Sample Information Sheet and Sampling Instructions
Consumer Confidence Rule
CCR 2021 Certification Form
(≤ 500 people)
CCR 2021 Certification Form
(501-9,999 people)
CCR 2021 Certification Form
(≥ 10,000 people)
Fluoride Addition
Fluoride Sample Information Sheet and Operator Value Report Form
Lead & Copper Rule
Request for Lead and Copper Sample Site Plan Changes for Community Systems
Request for Lead and Copper Sample Site Plan Changes for Non-Transient Non-Community Systems
Consumer Notice of Tap Water Results Template (.docx)
Optimal Corrosion Control Treatment Evaluation Template for PWS serving ≤ 50,000 (.xlsx)
Optimal Corrosion Control Treatment Evaluation Template for PWS serving > 50,000 (.xlsx)
Nitrate-Nitrite
Nitrate and Nitrite Sample Information Sheet and Sampling Instructions
Individual Nitrate/Nitrite Sample Information Sheet and Sampling Instructions
(This form is to be used only if the combined nitrate and nitrite level is found to be elevated. Verification should be obtained from the DWP prior to sample collection.)
Operator Certification
2020 Spring Training Registration Form
Operator Certification Application
Operator Certification Contract
Operator Reimbursement
Operator Reimbursement Form
IRS W-9 Form
Public Notice Rule
Revised Total Coliform Rule
Sample Site Plans
RTCR Sample Site Plan (≤ 1000 people)
RTCR Sample Site Plan (≥ 1001 people)
Start-up Procedures
Seasonal Startup Procedures and Certification
Stage 2 Disinfectants/Disinfection ByProducts Rule
Chlorine Residual Reporting Form
Disinfectants and Disinfection ByProducts Rule (DBPR) Summary Form - Stage 2
Surface Water Treatment Rules
Conventional Treatment
Combined Filter Effluent Turbidity Monitoring Data
Distribution System Disinfectant Residual Monitoring Data
Exceptions Report for Individual Filter Monitoring
Individual Filter Turbidity Monitoring Summary
Long Term 1 - Enhanced Surface Water Treatment Rule Summary (with instructions)
Point of Entry Disinfectant Residual Monitoring Data
UV Reactor Monthly Reporting
Membrane Technology
Distribution System Disinfectant Residual Monitoring
Individual Unit Monitoring
Long Term 1 - Enhanced Surface Water Treatment Rule Summary Form (with instructions)
Long Term 1 - Enhanced Surface Water Treatment Rule Combined Effluent Turbidity Monitoring Form
Point-Of-Entry Disinfectant Residual Monitoring Form
Drinking Water State Revolving Fund
Intended Use Plan/Priority List
Project Questionnaire for the DWSRF
Loan Application
Loan Application Packet
Project Bid
Bid Document Submittal Checklist
Request for Payment
Request for Payment Form
Payment Request Form – Set Aside Contracts Only
Payment Request Form – Planning Assistance Reimbursement Contracts Only
Project Close-out
Final Document Checklist and Forms
Sample One Year Certification
Planning Assistance Reimbursement Engineer Certification of Services
Plan and Specification Review
Plans and Specifications Submittal Application
Drinking Water Design Standards
Water System Capacity Assessment Manual
Capacity Attribute Evaluation (Community and Non-Transient Non-Community)
Capacity Attribute Evaluation (Transient Non-Community)
Well Source Survey
