Revised 09/2016
Public Water Supply Section
Water System-Supplied Information
Information on this page must be updated on an annual basis
Data provided by: _______________________________________( name) Date provided:_________________________________
Position: ____________________________________________________________________________________________________
Number of current connections in water system
_________________connections
Approved number of connections in water system
_________________connections
□ N/A – local government system
Current average and maximum daily demand of existing system. Average day demand is the one day
average demand for the latest calendar year.
_________________average gpd
_________________maximum gpd
Current maximum daily treated water supply of existing system
Maximum daily treated water supply is the maximum quantity of treated water that can be produced
and/or purchased by the system.
_________________maximum gpd
Total elevated storage capacity of existing system
Total ground storage capacity of existing system
Total hydropneumatic storage capacity of existing system
Contractual storage with other system(s) Attach a copy of the agreement with the providing system
_________________gallons
_________________gallons
_________________gallons
_________________gallons
Systems > 300 connections:
• Total storage volume is at least half the average annual daily demand (Rule .0805(c))
• For municipalities, at least 75,000 gallons elevated storage and at least half the average day
demand combined elevated and ground finished water storage (Rule .0805(b))
Systems with hydropneumatic storage tanks up to 300 connections:
• Volume of hydropneumatic storage tank is sufficient to meet peak demands based on Rule .0802 and
calculations in Appendix B, Figure 6
• For residential community systems, volume of hydropneumatic storage tank is at least 40 times the
number of connections or 500 gallons, whichever is greater (Rule .0803)
• For mobile home park systems, volume of hydropneumatic storage tank is at least 25 times the number
of connections or 500 gallons, whichever is greater (Rule .0803)
• For campground systems, volume of hydropneumatic storage tank is at least 10 times the number of
connections or 500 gallons, whichever is greater (Rule .0803)
□ Yes □ No
□ Yes □ No □ N/A
□ Yes □ No
□ Yes □ No □ N/A
□ Yes □ No □ N/A
□ Yes □ No □ N/A
