Water supplies with lead or galvanized previously connected to lead (GPCL) service lines shall annually provide the department a summary of service line repairs or replacements. This form must be submitted by March 31st every year.
Water supplies that need to issue a public notice should contact EGLE Drinking Water staff to ensure content and delivery requirements are met.
Every community water supply must delivery a consumer confidence report (CCR) to consumers by July 1st annually. The report should include the most recent water quality data for the system within the last five (5) years.
Community water supplies must submit a certificate to your EGLE district office immediately following delivery of the annual consumer confidence report confirming that the CCR is correct and has been distributed as required.
Community water supplies must report annually by March 31st on the status of their cross connection program.
The cross connection report form is now available in MiEHDWIS! Please login to MiEHDWIS and find your supply's Cross Connection Report activity and complete and submit the form in the system. For water supplies not yet in MiEHDWIS, a downloadable version is available.
Cross connection report for municipal supplies
Cross connection report for systems serving only residential accounts (better for mobile home parks, condos, and apartments)
Community water supplies that serve disinfected water must have a monitoring plan detailing sampling locations, sampling dates, and compliance calculation procedures for disinfectants and disinfection byproducts monitoring.
Instructions for completing the form
DDBP monitoring plan for water plants treating surface water using conventional filtration
Public water supplies must file a written report with EGLE within 90 days of an emergency. An "emergency" includes situations that result in contamination, loss of pressure, lack of adequate water supply, or other condition that poses an imminent hazard or danger to public health.
This form replaces the contingency plan. Community water supplies must prepare plans and procedures and identify personnel and equipment that can be used in the event of an emergency. The emergency response plan outlines a program for rapid correction or mitigation of emergencies to significantly lessen the impact of the emergency on the public health and safety and supply of drinking water provided to the public. Water supplies with a contingency plan will transition to the emergency response plan according to the updated schedule contained in the contingency plan.
Water supplies must report lead and copper monitoring information within 10 days of the end of the monitoring period. This form should be used to meet this requirement. Use of Form A or B is dependent on whether a supply does or does not have lead service lines.
Form A: Supplies with lead service lines
Form B: Supplies without lead service lines
Template A (only): Supplies with lead service lines
Arabic | Bengali | Chinese | English | Spanish
Template B (only): Supplies without lead service lines
Arabic | Bengali | Chinese | English | Spanish
Water supplies must identify a pool of lead and copper sampling sites that targets high risk sites based on the tiering criteria in R325.10710a(1). This plan must contain at least the number of sites required for standard monitoring based on the supply's population. The plan is a living document and must be updated and submitted to EGLE as necessary.
Administrative Rule R 325.11905(1) requires water supplies to be under the supervision of an operator in charge (OIC), certified in the system classification. Please use this form to designate an OIC, back-up operator, or if appropriate, a back-up operations plan.
This form is intended to assist owners or administrators of community water systems in identifying and documenting the assignment of system operation and maintenance tasks. It will clarify the division of responsibilities. The system owner or administrator will remain the responsible party to ensure that all tasks are properly completed.
Public water supplies must report a certificate of distribution and a copy of the public notice that was distributed to EGLE within 10 days of notifying customers. The public notice certificate of distribution will aid in accomplishing the public notice distribution for Tier 2 and Tier 3 violations.
Tier 1 public notice certification of distribution
Tier 2 and Tier 3 public notice certification of distribution
Community water supplies that do not submit a monthly operation report must submit a report of annual water pumpage and usage by March 31st.
The pumpage/usage report form is now available in MiEHDWIS! Please login to MiEHDWIS and find your supply's Pumpage/Usage Report activity and complete and submit the form in the system. For water supplies not yet in MiEHDWIS, a downloadable version is available.
This form must be completed and submitted to your EGLE district office as soon as possible, but no later than 30 days after the Level 1 assessment is triggered.
Water supplies must have a current sample siting plan detailing sampling locations for routine and follow-up bacteriological monitoring. The SSP form is now available in MiEHDWIS! Please login to MiEHDWIS, create a Bacteriological Sample Site Plan activity, and enter the site information directly into the form in the system. For water supplies not yet in MiEHDWIS, a downloadable form is available.
The owner of a privately owned community water supply must stipulate to conditions required by the department to ensure the community water supply will meet the requirements of the acts and rules. The stipulation is required of owners of proposed water supplies, new owners of existing water supplies, and owners of water supplies whose classification is changed to community water supply. This stipulation is only one of the many requirements on privately owned community water supply. Contact the appropriate EGLE district office to discuss requirements.
Form A: Supplies not licensed by the State of Michigan
Form B: Supplies licensed by the State of Michigan (e.g. mobile home communities, health care facilities, etc.)
Water supplies must report water quality parameter (WQP) monitoring within 10 days of the end of the monitoring period. Since water quality parameter monitoring involves a mix of results that were collected in the field, done by benchtop analysis, or sent to a certified lad, a water supply can report lab results, their monthly operation report, or using these forms to meet this requirement. Use the form for supplies with corrosion control or without corrosion control based on the water system's treatment.
Form A: Systems with corrosion control treatment
Form B: Systems without corrosion control treatment
