Forms for ECLS Programs

ECLS	Name of Form	Form Number
	Facility Update Form	583-D
	TRL Bypass Report Form	619-011
	TRL Monthly Operation Report	619-001
Soil Profilers	Name of Form	Form Number
	Certified Soil Profiler Application	641-011
	Certificate Bond for Certified Installers or Soil Profilers	641-001
	New Procedures (and Affidavit) for Obtaining Individual Licenses/Certifications
Certified Installers	Name of Form	Form Number
	Certificate Bond for Certified Installer	641-001
	Certification Examination Application	641-002
	New Procedures (and Affidavit) for Obtaining Individual Licenses/Certifications
	Compliance Report	641-003
	Notice of Deficiencies	IF 23
On-Site Sewage System	Name of Form	Form Number
	On-Site Sewage Treatment System Inspection Report	641-576A/S
	Soil Test On-Site Sewage Treatment Report	641-581SP
	Perc Test On-Site Sewage Treatment Report	641-581P
	Certification Document Form	641-581Cert
	Supplemental Application for an Alternative On-Site Sewage Disposal System	641-581Supp
	Request for Authorization/Permit to Construct an On-Site Sewage Disposal System	641-575
	Existing On-site Sewage Treatment System Report	641-525
	Individual Sewage Treatment Investigative Report	641-526
	Soil Profilers Compliance Report	641-527
Small Public Water Supplies	Name of Form	Form Number
	Application for a Permit to Construct a Minor Water System	624-001
	Final Inspection Request for Minor Water System	624-003
	Wellhead Protection Checklist for Minor Water Systems	624-002
Request for Services	Name of Form	Form Number
	Request for Services	641-005
	Customer Performance Survey	No number

Septage Pumpers and Transporters	Name of Form	Form Number
	The septage pumper and transporter forms are currently under construction. If you would like apply for a license today please contact Janet Zotigh at 405-702-6191.



Storm Water (Construction/Industrial)	Name of Form	Form Number
	Annual Comprehensive Site Complaince Evaluation Report for Industrial Facilities	605-006
	No Exposure Certification of Storm Water Discharges Associated with Industrial Activity	605-004
	Notice of Intent for Storm Water Discharges Associated with Construction Activity	605-002A
	Notice of Intent for Storm Water Discharges Associated with Industrial Activity	605-002B
	Inspection Request for Storm Water Discharges Associated with Construction Activity	605-008
	Notice of Termination for Storm Water Discharges Associated with Industrial or Construction Activity	640-572
Environmental Complaints	Name of Form	Form Number
	Complaint Form and Instructions	No number
	Customer Performance Survey	1-800-522-0206

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Forms for ECLS Programs