New Development Watermain Flushing Program
3rd Party Chlorine Residuals/Consumption
Date Time Sample location
Meter Read
Meter Read
Total Volume
Operator Name and
1. The date and time the sample was taken, the location where the sample was taken and the name of the person who took the sample
Chlorine Residuals
6-10. (1) The owner of a drinking water system and the operating authority for the system shall ensure that, for every sample required by this Regulation or by an approval, municipal
drinking water licence or order, including an OWRA order, a record is made of the following information:
*Operational standards for the City of Vaughan are as follows: Minimum combined chlorine residual = 0.30mg/L, Maximum combined chlorine residual = 2.75mg/L. If
these standards are exceeded, contact ACCESS VAUGHAN IMMEDIATELY at 905-832-2281
Consumption (m3)
Submit completed form within 1
week of sample date to
the combined chlorine reading is
outside the City's operational
standards listed below*
Flushing Contractor:
Consulting Engineering Firm (if known):
Developer (if known):
Site / Location:
Reporting Year:
* Once printed or data has been electronically populated, this form is no longer controllable.
Revised: March 21, 2019