3900 fm bsdw0033-2026

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The document is a form from the Pennsylvania Department of Environmental Protection for the inventory and brief description of public water systems (PWS) that either only disinfect or have no treatment. It includes sections for system identification, personnel data, source water information, treatment plant details, monitoring practices, storage facilities, and certifications of responsibility. The purpose is to ensure compliance with state and federal Safe Drinking Water Acts.

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Click ‘Get Form’ to open the 3900 fm bsdw0033 in the editor.
Begin by entering the Initial Survey Date and Updated On at the top of the form. This information is crucial for tracking changes.
Fill in the Public Water System (PWS) Name and ID #. Ensure accuracy as this identifies your system.
Indicate if it is a Transient System by selecting 'Y' or 'N'. Provide Owner Name and Ownership Type next.
Complete the Location Address, Mailing Address, City/State, Zip Code, Population Served, Number of Connections, and Production (GPD).
In the Personnel Data section, enter details for the Responsible Official and Water System Personnel including names, titles, addresses, and contact numbers.
Describe your water system in detail under General Description/Source Water Information. Attach any necessary sketches or maps as required.
Finally, complete the Certification of Responsibility section by typing names and titles before signing to certify accuracy.

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