Submit a completed Permit Application Review form for Public Water Systems to the Environmental Health Services office.

Permit Application Review form for Public Water Systems

Domestic Water Supply Permit Application- State

Information to Accompany Applications for Public Water Systems 

Please be advised that Environmental Health Services invoices an hourly rate for the time spent permitting water systems which includes review of technical reports, TMFs, and all application plans and forms.  Please refer to our Fee Schedule for rates or contact our office at (805) 781-5544.

 

Well Location, Design, and Construction Information

Domestic water wells should be located a safe distance from sources of contamination and

comply with both the State Department of Health Services (DHS) and Department of Water

Resources (DWR) standards for well location.

• Existing Well

Submit well completion report, pump test, and Well Data Sheet.

Well Data Sheet

Water Quality Analysis

Water quality analysis must be performed by a State certified laboratory. Data should be no

more than three years old. General Water Testing Schedule by System Type

• Source Bacteriological (Coliform) Analyses Results

Submit recent total coliform and E.coli analysis results. If historical data is available, please submit that as well.

• Source Chemical Analyses Results

The requirements for chemical testing is dependent upon the water system classification. At a minimum, all systems must submit results of the source water general mineral, general physical, and inorganic (including nitrate) contaminants.

Submit source water information to the Environmental Health Services office for review and approval.

Once the Preliminary Technical report is approved, review the guidance documents for submitting a Technical Managerial and Financial (TMF) report:

TMF Assessment

TMF Capacity Guidance

Submit the report to the Environmental Health Services office for review and approval.

 

Complete and return the following plan documents:

Lead & Copper Sample Site Plan 

Bacteriological Site Sampling Plan

Emergency Notification Plan

Disinfection Byproduct Monitoring Plan (if applicable)

The following documents must be submitted and reviewed before the public water system permit can be approved:

California Environmental Quality Act (CEQA) Documents:

Please submit CEQA documents associated with the construction of the water system.

Cross-connection Control Survey:

Submit a completed Cross Connection Control Survey.  This survey must be completed by a certified cross connection control specialist or someone with relevant equivalent training or experience. This survey should be conducted by or with someone familiar with the distribution system.

Cross Connection Control Survey

Submit all applicable forms and documents from above to Environmental Health Services office.

Submit a completed Public Water System Permit Application (for the county) to the Environmental Health Services office.

Public Water System Permit Application (for the county)

Schedule a Site Inspection:

Once the system construction is complete and ready for operation, an inspection of the water system shall be conducted by Environmental Health Services staff prior to the water system permit issuance. Please contact (generic water program email) to schedule a system inspection.

Obtain the Services of a licensed Distribution and/or Treatment Operator:

Community and nontransient-noncommunity water systems are required to retain the services of a California Certified Distribution System Operator, Grade D-1 or above. All water systems with treatment are also required to have a California State Licensed Treatment Operator (except for chlorinators, which may be operated by a Distribution operator). Some water systems obtain the certification themselves while others opt to hire an operator. Prior to being issued a water supply permit, the water system must submit the name and certification number of the System Operator.

List of Certified Distribution and Treatment Operators 

Helpful Links:

General Water Testing Schedule by System Type

FAQs for Public Water Systems

Permitting Instructions for Public Water Systems

Supplemental Instructions for Public Water Systems