Public Water System Guidance and Forms
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This page includes links to guidance documents, publications and forms published by the Department of Health which are beneficial to Public Water Suppliers, Local Health Departments (LHD), and New York State Department of Health (NYSDOH) staff.
Lead and Copper Rule (LCR) and Lead and Copper Rule Revisions (LCRR) Compliance Guidance and Templates
- NYS Guidance for Complying with Lead and Copper Rule Revisions (PDF)
Public Education Templates (Microsoft Word)
- Community Water Systems (CWS)
- Non-transient Non-community Water Systems (NTNC)
Consumer and Public Notification
- Lead Action Level Exceedance Public Notice - Instructions and Template (MS Word)
- Instructions for Consumer Notification of Lead, Galvanized Requiring Replacement or Lead Status Unknown Service Line (MS Word)
- Consumer Notice of Lead Tap Sample Results - Instructions and Template (MS Word)
- Certification - Delivering Public Education Materials (PDF)
- Certification - Delivering Consumer Notification of Service Line Materials (PDF)
- Certification - Delivering Public Notification (PN) (PDF)
- Certification - Consumer Notice of Tap Sample Results (PDF)
Guidance on Preparing Service Line Inventory
Lead Service Line Inventory Templates (Microsoft Excel)
The Lead and Copper Rule Revisions require all community and non-transient non-community water systems to develop and submit a lead service line inventory by October 16, 2024. Water systems should use these templates to prepare their inventories.
Microsoft Excel templates are available to download:
- Template for Public Water Systems with a maximum of 500 service lines (43 KB)
- Template for Public Water Systems with a maximum of 5,000 service lines (98 KB)
- Template for Public Water Systems with a maximum of 20,000 service lines (289 KB)
- Template for Public Water Systems with a maximum of 50,000 service lines (676 KB)
- Template for Public Water Systems with a maximum of 120,000 service lines (1,561 KB)
- Template for Public Water Systems with more than 120,000 service lines (6,912 KB)
- Template with Longitude/Latitude for Public Water Systems with a maximum of 120,000 service lines (2,383 KB)
Lead and Copper Tap Sample and Water Quality Parameter Reporting Templates (Microsoft Excel)
The Lead and Copper Rule requires all community and non-transient non-community water systems to report tap sample monitoring results and the 90th percentile lead and copper concentrations to local health departments. Some water systems are also required to report applicable quality parameters. Water systems should use this template to report the results of their lead and copper tap samples and water quality parameters. Once lead and copper results are entered, the template will calculate the 90th percentile concentration of both lead and copper. The template includes five worksheets:
- a worksheet with instructions
- three worksheets to be used for reporting lead and copper sample results, separated based on the size of the population served
- a worksheet to report water quality parameters.
Fact Sheets and Downloadable Forms
Harmful Blue-green Algae
Information on Procedures and Operations for Public Water Suppliers
Interim Guidance on Removal of perfluorooctanoic acid (PFOA), perfluorooctane sulfonic acid (PFOS) and 1,4-Dioxane
- Interim Recommendations for Granular Activated Carbon (GAC) Installations (pdf)
- Interim Recommendations for Designing Treatment for the Removal of 1,4-dioxane - Pilot Testing of Advanced Oxidation Processes (AOP) (pdf)
This document is intended for use by local health departments (LHD) and New York State Department of Health (NYSDOH) engineering staff that review and approve granular activated carbon (GAC) treatment at public water systems (PWS). These recommendations are intended to be applicable to most GAC installations, but the LHD or NYSDOH should exercise best professional judgement during the review and approval process.
This document is intended for use by local health departments (LHD) and New York State Department of Health (Department) engineering staff to provide guidelines for piloting treatment for the removal of organic compounds such as 1,4-Dioxane from a Public Water Supply (PWS).
