DOH-360CUVEditable2ppSep2018 2026

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The document is a Water System Operation Report from the New York State Department of Health, detailing the operation and treatment processes of public water systems that utilize chlorine and/or ultraviolet radiation. It includes sections on chlorination, ultraviolet treatment, microbiological sampling, and compliance with health regulations. The report requires information on water treatment volumes, chlorine usage, sample collection for microbiological monitoring, and any violations or issues encountered during the reporting period.

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Click ‘Get Form’ to open the DOH-360CUVEditable2ppSep2018 in the editor.
Begin by entering your Public Water System ID and Name at the top of the form. Ensure accuracy as this information is crucial for identification.
Fill in the County, Town, Village, or City details along with the Reporting Month/Year and Date Report Submitted. Use the date picker for convenience.
In the Chlorination section, input data regarding treated water volume, cylinder weight, and chlorine used per day. Be precise to maintain compliance.
For Ultraviolet Radiation/Other Treatments, indicate free chlorine levels and check if the UV unit intensity sleeve was cleaned. Initials of the person checking should be added.
Complete microbiological sample sections by entering sample types, locations, dates, and results. This ensures thorough monitoring of water quality.
Finally, review all entries for accuracy before submitting. Utilize our platform’s features to save or share your completed form easily.

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Versions	Form popularity	Fillable & printable
2018	4.3 Satisfied (42 Votes)
2005	4.6 Satisfied (26 Votes)

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