Maine Drinking Water Program: Checklist for Review and Approval of a Treatment Process Change Form D

Form Template

Obtain a drawing of the existing system that shows the majors pieces of equipment (e.g., source, storage, existing treatment, and other major appurtenances) as well as how the proposed treatment will be integrated.

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How will the PWS routinely test/monitor for the chemical (manual/batch, automated/continuous)? How will the chemical be stored? Will there be secondary containment? Will the chemical be labeled properly (OSHA required Hazardous Material Information System - HMIS, or Globally Harmonized System - GHS). Will there be written procedures covering the chemical’s use? Has the chemical change proposed been shared with the PWS’s Primary Operator? (Drinking Water System Change Application [DWP0227] requires signoff or written approval of the Designated Operator) The Maine Drinking Water Program: Checklist for Review and Approval of a Treatment Process Change Form DWP 0161F mobile app allows you to replace your paper checklist with a mobile device. The mobile form includes fields to document items such as date, water program, location, engineer reviewer and captures engineer's signature. Once the mobile app is filled out a secure PDF is generated. The PDF is easy to share, and a copy is stored in your account for your water treatment records. You can also use the App Builder to personalize and customize this mobile form.

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