Doh 5025 form-2026

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  1. Click ‘Get Form’ to open the doh 5025 form in the editor.
  2. Begin by entering the Public Water System Name in the designated field. This is crucial for identifying your project.
  3. Fill in the Project Location, specifying the City, Town, or Village where the project is situated.
  4. Indicate whether this is a Drinking Water State Revolving Fund (DWSRF) Project by selecting 'Yes' or 'No'. If 'Yes', provide the DWSRF Project Number.
  5. Check all applicable boxes regarding plans approved by NYSDOH BWSP, including options for Regional Office and District Office.
  6. Enter both the Construction Start Date and Substantial Construction Completion Date accurately.
  7. Provide a brief Project Description that outlines key details of your public water improvement project.
  8. Affix your NYS Engineer's Seal and Signature at the bottom of the form after certifying completion according to approved plans.
  9. If there are any deviations from approved plans, document them in the provided section or attach additional sheets as necessary.

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2012 4.8 Satisfied (37 Votes)
2011 4.3 Satisfied (55 Votes)
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