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TNC Applications, Forms and Tools

Operating Permit Application- individual (not general)

General Operating Permit Application

Summary of Requirements for General Operating Permit

Notice of Intent- General Operating Permit

Notice of Termination

Water System Officials Contact Form

Public Water Supply Survey Form

Construction Permit Application  UPDATED

TNC Source Water Permit Application

Certified Operator Application (Class 1A and 1B)

Statement regarding Child Support and VT Taxes

Public Notice Certification Form  

RTCR Forms & Examples

Revised Total Coliform Rule (RTCR) Introductory Fact Sheet  NEW

RTCR Coliform Sampling Plan & Guidance 1,000 or Under Population UPDATED  (formerly called bacteriological sampling plan)
RCTR Coliform Sampling Plan & Guidance Greater than 1,000 Population UPDATED  (formerly called bacteriological sampling plan

INSTRUCTIONAL VIDEO: RTCR Sampling Plan Form Training   NEW

Completed Examples:

PCWS - Greater than 1,000 Population

NTNC - School

TNC - Campground

TNC - Motel

TNC - Restaurant


Voluntary Coliform Response Assessment Form  NEW

Completed Examples:

Class 1A

Class 2

Class 3


Groundwater Seasonal Start-Up Form  NEW

Surface Water Seasonal Start-Up Form  NEW


Boil Water Notice Forms

Boil Water Notice Template for general use
Boil Water Notice Acute (E. coli) MCL template and Instructions
Boil Water Notice Non- Acute MCL Template and Instructions



Non-Boil Water Notice Forms

MCL Violation Non-Boil Template and Instructions
Tier 3 Public Notice Form & Guidance


Reporting Forms

Surface Water Monthly Report

Letter and Instructions for Filtered Surface Water Reporting

Groundwater Monthly Report




drinkingwater.vermont.gov   groundwater.vermont.gov   septic.vermont.gov wastewater.vermont.gov
VT DEC Drinking Water and Groundwater Protection Division 1 National Life Drive, Main Building, 2nd Floor  Montpelier, VT  05620-3521
Telephone 802-828-1535    Fax: 802-828-1541


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