[vc_row full_width=”stretch_row_content” css=”.vc_custom_1753449869868{padding-top: 100px !important;padding-bottom: 100px !important;background-image: url(https://deptest.nj.gov/watersupply/wp-content/uploads/sites/11/photosimages/bg-photos/sample-forms-banner.jpg?id=8168) !important;}”][vc_column][vc_custom_heading text=”Sampling & Regulatory Information” font_container=”tag:h1|font_size:50px|text_align:center|color:%23ffffff” use_theme_fonts=”yes” css=””][/vc_column][/vc_row][vc_row][vc_column][breadcrumb-shortcode][/vc_column][/vc_row][vc_row equal_height=”yes”][vc_column width=”2/3″][vc_message css=””]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@deptest.nj.gov 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@deptest.nj.gov, 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.[/vc_message][/vc_column][vc_column width=”1/3″][vc_custom_heading text=”Offline for an Entire Calendar Quarter” font_container=”tag:h2|font_size:16|text_align:center” use_theme_fonts=”yes” css=””][vc_message css=””]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@deptest.nj.gov
- subject: “PWSID, Offline Facility”
- FOOS Frequently Asked Questions
- For WQP use the WQP Biweekly Monitoring: Facility Out of Service Reporting Form
- For GWR use the GWR triggered well out of service form
[/vc_message][/vc_column][/vc_row][vc_row content_placement=”middle”][vc_column][vc_separator][vc_tta_tabs active_section=”1″ title=”General Information”][vc_tta_section title=”General” tab_id=”general”][vc_column_text css=””]
- 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
- Best Management Practices for the Control of Legionella in Public Community Water Systems
- 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).
[/vc_column_text][/vc_tta_section][vc_tta_section title=”Monitoring” tab_id=”monitoring”][vc_column_text css=””]
- 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
- LCR Sample Reduction Form (DEP_10-S_00061.1)
[/vc_column_text][/vc_tta_section][vc_tta_section title=”Electronic Reporting” tab_id=”electronic-reporting”][vc_column_text css=””]New Jersey Electronic Environmental (E2) Reporting System
- Electronic Environmental Reporting
- Electronic Environmental Reporting Quick Reference Guide [updated 10/2025]
- E2 DWR Sample Rejection Request (DEP_DWSG-O 00057.1) [updated 5/2025]
EN Suite
Forms
Presentations
- Electronic Reporting Overview
- Disinfection Residual and Precursor Reporting
- EN Suite: Account Types
- EN Suite: Lead Service Line Inventory Walkthrough
- SDWA June 2025 Update
- Licensed Operator Program IT Updates
- Upcoming IT Initiatives
[/vc_column_text][/vc_tta_section][vc_tta_section title=”Monthly Operator Reports” tab_id=”monthly-operator-reports”][vc_column_text css=””]
- Monthly Operators Report for Ground Water Systems (BSDW-40)
- Monthly Operating Report for Surface Water Treatment Plant/GWUDISW (BSDW-41)
[/vc_column_text][/vc_tta_section][/vc_tta_tabs][/vc_column][/vc_row][vc_row content_placement=”middle” css=”.vc_custom_1709583228256{padding-left: 0px !important;}”][vc_column][vc_custom_heading text=”Forms & Guidance Pertaining to Specific Rules” use_theme_fonts=”yes” css=”.vc_custom_1709583389584{padding-left: 30px !important;}”][vc_tta_tabs active_section=”1″ css=”.vc_custom_1709583349803{padding-left: 30px !important;}”][vc_tta_section title=”Surface or GUI Systems Using Membrane Filtration” tab_id=”surface-of-gui-systems”][vc_column_text css=””]
- Daily Integrity Testing (BSDW-103)
- Membrane Turbidity Monitoring (BSDW-104)
[/vc_column_text][/vc_tta_section][vc_tta_section title=”Revised Total Coliform” tab_id=”revised-total-coliform”][vc_column_text css=””]
- General Information/Factsheets
- Level Assessment Forms
- RTCR Assessment Factsheet
- Level 1 Assessment forms
- Level 2 Assessment forms
- Sample Siting Plan
- Seasonal Water Systems
[/vc_column_text][/vc_tta_section][vc_tta_section title=”Ground Water” tab_id=”ground-water”][vc_column_text css=””]
- 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
- Ground Water Rule Disinfectant Residual Compliance Monitoring Reporting Form (BSDW 101)
- Existing 4-log Virus Treatment Under the Ground Water Rule (DWS-GWR 4log)
[/vc_column_text][/vc_tta_section][vc_tta_section title=”Surface Water Treatment” tab_id=”surafce-water-treatment”][vc_column_text css=””]
- 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
[/vc_column_text][/vc_tta_section][vc_tta_section title=”Disinfection Residuals” tab_id=”disinfection-residuals”][vc_column_text css=””]
- Disinfectant Residuals Reporting Form (BSDW-25)
- Instructions for Chlorite & Chlorine Dioxide Report (BSDW-26N)
[/vc_column_text][/vc_tta_section][vc_tta_section title=”Long Term 2 Enhanced Surface Water Treatment” tab_id=”long-term-2-enhanced”][vc_column_text css=””]
- 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)
- Finished Water Reservoir Management Plan Guidance
[/vc_column_text][/vc_tta_section][vc_tta_section title=”Stage 2 Disinfectants & Disinfection Byproducts” tab_id=”stage-2-disinfectants”][vc_column_text css=””]
- Operational Evaluation Guidance Manual
- Determining If I Have An Operational Evaluation Level (OEL) Exceedance
- Stage 2 Rule Operational Evaluation forms & checklists:
[/vc_column_text][/vc_tta_section][vc_tta_section title=”Lead & Copper” tab_id=”lead-and-copper”][vc_column_text css=””]
- Guide to Lead and Copper Rule Forms
- Lead and Copper Monitoring:
- Factsheets:
- PbCu Sample Location Spreadsheet
- Lead and Copper Sample Site Change Form (BSDW 56)
- Non-Compliance Lead and Copper Tap Monitoring Form (BWSE-16) [updated 4/2019]
- Instructions for Non-Compliance Monitoring Form – BWSE 16 [updated 4/2019]
- CWS Customer Lead and Copper Sampling Refusal Form (DEP_10-S00018.1) [new 4/2022]
- Water Quality Parameter Monitoring:
- Water Quality Parameter (WQP) Monitoring Bi-weekly periods
- Water Quality Parameter Biweekly Monitoring: Facility Out of Service Reporting Form (DEP_10-S_00049.2) formerly (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) [updated 4/2021]
- Lead Service Line Replacement
- For Community Water Systems:
- Lead Service Line (LSL) Inventory Report (DEP_10-S_00014.4) [previously BWSE-20] [updated 4/2024]
- Lead Service Line (LSL) Inventory Report Instructions [updated 4/2024]
- For Non-Transient Noncommunity Water Systems:
- NCWS Lead Service Line (LSL) Inventory Report (DEP_10-F_00048.2) [updated 6/2024]
- NCWS Lead Service Line (LSL) Inventory Report Instructions [updated 6/2024]
- Annual Lead Service Line Replacement Progress Report (DEP_10-S_00027.2) [updated 4/2024]
- Annual Lead Service Line Replacement Progress Report Instructions [updated 4/2024]
- Lead Service Line Notification Form (DEP_10-S_00028.1) [new 5/2022]
- Factsheet
- Lead Service Line Replacement Frequently Asked Questions [updated 6/2024]
- Customer Notice of Known Lead Service Line Material Template [updated 7/2025]
- Customer Notice of Unknown Service Line Material Letter Template [new 5/2024]
- Lead Service Line (LSL) 7% Replacement Strategy [new 3/2025]
- Lead Service Line (LSL) Replacement Report for systems with an Action Level Exceedance per the LCR (BWSE-21) [updated 5/2025]
- Lead Service Line Replacement Contact Log [new 7/2022]
- Resident Refusal Form [new 7/2022]
- 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 4/2024]
- Guidance for Developing a Lead Service Line Replacement Plan [new 7/2022]
- Predictive Modeling Rationale [new 11/2022]
- Predictive Modeling Guidance [new 11/2022]
- Lead Public Education
- A Public Water System’s Guide to Lead Public Education [new 11/2024]
- CWS Lead Public Education Template [updated 7/2025]
- NTNC Lead Public Education Template [updated 7/2025]
- CWS Lead Public Education Brochure Template [revised 7/2025]
- Lead Public Education Poster Template [new 6/2025]
- Lead Public Education Water Bill Template [new 11/2021]
- Lead Public Education Public Service Announcement Template [new 11/2021]
- Initial Lead Public Education Certification Form (DEP_10-F_00006.2) [updated 8/2021]
- Ongoing Lead Public Education Certification Form (DEP_10-F_00007.2) [updated 8/2021]
- PE Press Release [updated 1/2022]
- 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
- 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 [updated 7/2025)
- 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 6/2020]
- Notice to Affected Household – Sample Template AL above 15 ppb [updated 7/2025]
- Notice to Affected Household – Sample Template AL below 15 ppb [updated 7/2025]
- Sampling Plan Guidance (Lead & Copper and Water Quality Parameter)
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- Water Sampling Analysis Form for Construction Permits and Temporary Approvals (BWSE-PA-101)
- Fact Sheet- Point of Entry Treatment Devices & Sampling in Public Water Systems (added 11/2021)
- Point of Use Treatment Device & Sampling in Public water systems (added 10/2021)
[/vc_column_text][/vc_tta_section][vc_tta_section title=”Public Notification” tab_id=”public-notification”][vc_column_text css=””]
-
- Public Notification Templates
- Revised Total Coliform Rule
-
- Failure to conduct an assessment or perform corrective action (Acute Level 2)
- Failure to conduct an assessment or perform corrective action (Level 1 or Chronic Level 2)
- Failure to perform correct start-up procedures [Updated 8/2025]
- Failure to conduct a Level 1 Assessment [Updated 8/2025]
- Failure to submit a Level Assessment by due date (4A) [Updated 8/2025]
- RTCR Monitoring Waiver [Updated 8/2025]
- EC+
- Failure to conduct a Level 2 Assessment (2B) [Updated 8/2025]
- Failure to perform corrective action (2C)
- Failure to conduct a Level 2 Assessment and perform corrective action (2B & 2C) [Updated 8/2025]
- E. coli Confirmed or Presumed in Distribution System [Updated 9/2022]
- TC+/EC-
- Ground Water Rule
- E. Coli in Source Water (BWA) [Updated 8/2025]
- E. Coli in Source Water (Consecutive Systems) [Updated 8/2025]
- Failure to collect source water samples [Updated 8/2025]
- 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) [Updated 8/2025]
- Failure to Maintain 4-log Treatment of Viruses (Tier 2) [Updated 8/2024]
- Revised Total Coliform Rule & Ground Water Rule
- E. coli in Source Water and Distribution System [Updated 8/2025]
- Nitrate
- Confirmed Nitrate MCL Exceedance [Updated 8/2025]
- Confirmed Nitrate MCL Exceedance & Failure to Maintain Treatment Violation [added 8/2025]
- Pending Nitrate Confirmation Sample [added 8/2025]
- Unconfirmed Nitrate MCL Exceedance [Updated 9/2025]
- Special Permission Nitrate MCL Exceedance [added 8/2025]
- 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
- Tier 1 Lead Action Level Exceedance [Updated 8/2025]
- Failure to Provide Public Education (LCR Lead ALE)
- Recordkeeping Violation (Type 9)
- Fail to Replace/Report LSLR (Type 64)
- Failure to Meet WQP Optimal Values [Updated 5/2025]
- Copper Water Bill Notification
- Disinfection By-Products
- MCL Violation
- Miscellaneous
- Monitoring & Reporting
-
- Tier 3 Monitoring and Reporting [Updated 8/2025]
- 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_00054.2) 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)
- 2026 CCR Certification Form
- 2026 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.)
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- Public Notification Templates
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[/vc_column_text][/vc_tta_section][vc_tta_section title=”Monitoring Waivers” tab_id=”monitoring-waivers”][vc_column_text css=””]
- SOC (Synthetic Organic Compounds)
- SOC Waivers for the 2026-2028 compliance period. To be considered for SOC monitoring waivers for the 2026-2028 compliance period, systems must complete a Well Vulnerability Survey for each well in use. Systems that do not submit survey(s) by the designated deadline will be placed on quarterly monitoring for all SOCs.
- 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)
[/vc_column_text][/vc_tta_section][vc_tta_section title=”Asset Management/WQAA” tab_id=”asset-management”][vc_column_text css=””]
- WQAA Annual Certification Form (DEP_10 S_00001.1) [Updated 10-2022]
- WQAA Annual Certification Form Submittal Instructions
- Capital Improvement Report Template Worksheet [Updated 2-2026]
For questions related to the WQAA, please contact the Department at WQAA@deptest.nj.gov.[/vc_column_text][/vc_tta_section][vc_tta_section title=”Additional Assistance” tab_id=”additional-assistance”][vc_column_text css=””]
- USEPA Quick Reference Guides
- USEPA Drinking Water Treatability Database
- DEP Water Compliance and Enforcement
- Office of Local Environmental Management
- Local Health Departments
- Childcare Certification Information
[/vc_column_text][/vc_tta_section][vc_tta_section title=”CEHA Information” tab_id=”ceha-information”][vc_column_text css=””]Note: Noncommunity System Inspections are only to be submitted via paper form when it is a new public water system or reactivation.
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OFFICIAL SITE OF THE STATE OF NEW JERSEY