Forms are available in electronic format only (Word or PDF). You cannot order hard-copies through our offices or through our online publication ordering system. If you have questions concerning a form, contact your regional office.
Eastern Regional Office—Spokane Valley: 509-329-2100
Northwest Regional Office—253-395-6750
Southwest Regional Office—Tumwater: 360-236-3030
Consumer Confidence Report
331-203—Consumer Confidence Report Certification Form (PDF)
Drinking Water State Revolving Fund
For information about Drinking Water State Revolving Fund forms, please visit the DWSRF page.
Engineering and Planning Submittals
331-149—Project Approval Application, WA State Dept. of Health (Word)
331-568—Local Government Consistency Determination Form (Word)
Water Rights Self Assessment
331-370—Small Water System Management Program-- Water Rights Self Assessment (Word)
331-372—Water System Plan - Water Rights Self Assessment--10 and 20 Year Forecast (Word)
Groundwater Under the Direct Influence of Surface Water
331-493—Drinking Water Warning: Loss of Pressure (Word)
331-495—Drinking Water Warning: Backflow Incident (Word)
- 331-691 Spanish (PDF)
- 331-691 Russian (PDF)
- 331-691 Tagalog (PDF)
- 331-691 Ukrainian (PDF)
- 331-691 Vietnamese (PDF)
Sanitary Survey Forms
331-487—Third-Party Sanitary Survey Checklist (Word)
331-638—Public Water System Well Site Inspection Form (Word)
Surface Water Treatment Forms
Monthly Report Workbooks
You will need Microsoft Excel 97 or a later version on your computer to use these forms. They include:
- Water Treatment Plant Monthly Report.
- SWTR Disinfection Monthly Report.
- Surface Water Treatment Plant Monthly Report Summary.
Each Excel file includes a Contact Time (CT) look up table. For each technology listed in the Monthly Report Workbooks below, three forms are contained in one Excel workbook file. After opening the file, note the four tabs at the bottom. The first tab (Cover Page and Notes) contains the directions on use of the forms. Open and read it first, then click on the other tabs to access the forms.
- 331-513-F Bag Cartridge Filtration (Excel)
- 331-514-F Diatomaceous Earth Water Treatment (Excel)
- 331-517-F Low Pressure Membrane Filtration (Excel)
- 331-522-F Slow Sand (Excel)
- 331-527-F Rapid Rate (Excel)
Other Surface Water Treatment Forms
331-319-F—Coliform Bacteria Analysis Form (Word) (Note: Regular size form 11 in x 4 in.)
331-320-F—Coliform Bacteria Analysis Form (Word) (Note: Same form as 331-319-F but 5 in. x 8 in. and designed to fit into a window envelope.)
Completing the above forms
- Save the templates to your computer.
- Text in "Red" can be deleted so you can add your name, address, and your Ecology-accredited Method Code.
Printing the form: The forms are designed to print 100%. Page scaling options are available by selecting "file" and then "print."
Public notification templates
- Boil Water Door Hanger—English and Spanish (Word) | (PDF)
- Drinking Water Warning—Community (Word) | (PDF)
- Drinking Water Warning—Noncommunity (Word) | (PDF)
The two organizations below can help you complete these forms.
Epichlorohydrin and Acrylamide
- 331-496—Fluoridation Monthly Operations Report Form for Sodium Fluoride Saturators (Excel) | (PDF)
- 331-497—Fluorosilicic Acid Sodium Fluorosilicate (Excel) | (PDF)
Water Use Efficiency
Annual Water Use Efficiency Performance Report—new online reporting form.