Open a Small Drinking Water System

Use this form to notify Public Health of your intention to provide drinking water to your users.

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This field is for validation purposes and should be left unchanged.

Drinking water system information

Name of the small drinking water system(Required)

System ID number (The small drinking water system ID number can be found in your directive.)(Required)

Address(Required)

Street address City Postal code

Phone(Required)

Drinking water system operations

When is your small drinking water system in operation?(Required)

Year-round, continuously

Spring to fall operations

Winter operations

Planned summer opening date (leave blank if proposed open date is unknown)

Planned summer closing date (leave blank if proposed close date is unknown)

Owner information

An “owner” means a person who is the legal or beneficial owner of all or part of the small drinking water system. The owner may also be considered the operator unless a designate has been identified.

Name of legal entity(Required)

Name of registered owner(Required)

Contact number for registered owner(Required)

Designated operator information

Ontario Regulation 319/08 – Small Drinking Water Systems requires an operator is designated to fulfill the requirements of all sampling, testing, receipt of results, and submission of reports. An operator is defined as the individual(s) responsible for overseeing activities at the small drinking water system. There may be more than one operator, but the person listed below is the one who holds primary responsibility for fulfilling all necessary duties within the directive and regulation.

Is the registered owner the designated operator?(Required)

Yes

No. My designated operator’s information is listed below.

Name of designated operator(Required)

Phone number of the designated operator for the purpose of Public Health communication(Required)

Email for the purpose of Public Health communication (Orders)(Required)

Water sample results

Was the recent water sample result satisfactory?

Yes

By completing and submitting this form, you confirm that all preparations necessary to operate the above noted small drinking water system are in accordance with the regulation and will be completed before the proposed reopening date listed above.

Privacy

The personal information contained on this form is being collected in order to process your access to information request in compliance with the Municipal Freedom of Information and Protection of Privacy Act, R.S.O. 1990 and the Personal Health Information Protection Act, 2004, S.O. 2004. This information will be used to process the request for information and if necessary to complete statistical reporting required by the Information and Privacy Commission of Ontario. Questions about this collection should be directed to the Privacy Officer at Public Health Sudbury & Districts, 1300 Paris Street, Sudbury, ON, P3E 3A3, 705.522.9200 or by email at privacy@phsd.ca.