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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


  • 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.

Guidance and Well Information

Contact Us

For more information, please e-mail or call us at 512-239-4691.