Region of Waterloo Form

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Small Drinking Water Systems Opening Notification Form

(Ontario Regulation 319/08, S. 5)

*to be used for existing systems that have been closed for more than 60 days*

Facility Information

Facility Name

Facility #

Site Address

Phone Number

Site Email Address

Owner Information

Owner Name

Owner Address

Owner Phone Number

Owner Email Address

Designated Operator Information

Operator Name

Operator Address

Phone Number

Designated Operator Email Address

Opening Information/Details

Proposed Water Supply Date

Test Results Date

E.coli Results

T.C. Results

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:

A water sample is taken and tested for Escherichia coli and total coliforms
They are in receipt of the results of the water sample tests
The Medical Officer of Health of the health unit where the small drinking water system is located is notified in writing of:
- The proposed date on which the small drinking water system will begin to supply water to the users of the system
- The name and address of the owner and any operator of the small drinking water system
- The address that the small drinking water is located at and the name of the system, and
- The results of the tests conducted pursuant to this section. O. Reg. 319/08, s.5 (6).