Small Drinking Water Systems Notice and Designation Form

Ontario Regulation 319/08:  Small Drinking Water Systems

Section 5

  1. Every owner and every operator of a small drinking water system who intends to begin to supply water to the users of the system after any period of more than 60 days duration during which the system has not been supplying water to users shall ensure that,
    1. water sample is taken and tested for Escherichia coli and total coliforms;
    2. they are in receipt of the results of the water sample tests; and
    3. the medical officer of health of the health unit where the small drinking water system is located is notified in writing of,
      1. the proposed date on which the small drinking water system will begin to supply water to the users of the system,
      2. the name and address of the owner and any operator of the small drinking water system,
      3. the address that the small drinking water is located at and the name of the system, and
      4. the results of the tests conducted pursuant to this section.  O. Reg. 319/08, s. 5 (6).
  2. The owner and operator of a small drinking water system to which subsection (6) applies shall ensure that no water is supplied to a user of that system until the medical officer of health is notified.  O. Reg. 319/08, s. 5 (7).

Please complete this form and forward it by mail or fax to:

Windsor-Essex County Health Unit
Attn: Environmental Health Dept.
1005 Ouellette Avenue
Windsor, ON N9A 4J8
Fax: 519-258-8672

Section 1 - General Information
New Small Drinking Water System (SDWS) or Existing System:
Owner Address
SDWS Site Address
Please attach a copy of water sample results. O.Reg. 319/08, s.5(6) a.
Upload requirements

REQUIRED:  Copy of water sample results attached.  O.Reg. 319/08, s. 5(6) a

Changes made to the system:

Responsibilities of owners and operators:

O. Reg. 319/08, s. 6(1) requires the owner of a Small Drinking Water System to designate an operator who has primary responsibility to fulfill the requirements for sampling, testing, receipt of results, and submission of reports.

Details regarding responsibilities are described in the following sections of O. Reg. 319/08; 5 (6), 6 (2), 7 (4), 8, 9, 10, and 17 – 36.

“Fulfill” means perform, to do, achieve.

Section 2 - Designated Operator Information
I acknowledge as the owner that the information provided in this form is accurate and complete.