Forms and Checklists for Submitting Plans or Specifications for Public Water Systems
For submitting plans or specifications for review, please use the following forms and checklists:
If you want to submit your plans for review, please see the Information on how to make your Plan Review Submittal for additional help.
Forms and Instructions
- Cementing Certificate (TCEQ-20842)
PDF /
Word - Core Data Form (for new systems) (TCEQ-10400)
- Public Water System Plan Review Submittal Form (TCEQ-10233)
PDF /
Word
- Financial Ability Form (TCEQ-20841)
PDF /
Word
- Sanitary Control Easement Form (TCEQ-20698)
PDF /
Word
- Microbial Report Form (TCEQ-10525) PDF
Checklists
- As-Built Plan Checklist
PDF /
Word
- Chemical Storage and Feed Facilities Checklist
PDF /
Word
- Chloramine Checklist
PDF /
Word
- Corrosivity Engineering Report PDF
- Disinfection Checklist
PDF /
Word
- Interconnection Between Two Public Water Systems Checklist
PDF /
Word
- Membrane Construction Checklist - Step 1
PDF /
Word
- Membrane Use Checklist - Step 2
PDF /
Word
- New Proposed Public Water System Checklist
PDF /
Word
- Pressure Tank Construction Checklist
PDF /
Word
- Proposed Public Water Supply Well/Spring - Step 1
PDF /
Word
- Surface Water Plant Checklist - Step 1
PDF /
Word
- Surface Water Plant Checklist - Step 2
PDF /
Word
- Surface Water Source and Intake Checklist
PDF /
Word
- Water Distribution Construction Checklist
PDF /
Word
- Water Hauler Use Checklist
PDF /
Word
- Water Storage Tank Construction Checklist
PDF /
Word
- New Version: Well Completion Data Checklist For Approval To Use - Step 2
PDF /
Word
Effective June 1, 2023, the Well Completion Data Checklist for Approval to Use (Step 2) requires raw water free ammonia sampling. Please refer to the checklist for additional information and guidance on sample analysis.
Suggested Construction Notes to Support Plan Review
Including these items will help you ensure your plans and specifications include all the necessary information and will reduce the likelihood that you will need to resubmit your plans.
- Hydropneumatic Pressure Tank
PDF /
Word
- Proposed Water Well
PDF /
Word
- Water Distribution System
PDF /
Word
- Water Storage Tank
PDF /
Word
Guidance and Well Information
- Evaluating Regionalization for Potential New Public Water Systems (RG-551)
- PE and Driller Requirements
- Pressure Cementing
- PVC Casing for Water Wells
- Restriction on the Use of Bentonite
- Required Bacteriological Samples when a Well Pump is Repaired or Replaced
Contact Us
For more information, please e-mail PTRS@tceq.texas.gov or call us at 512-239-4691.