Water Program and Well Forms
Small Public Water Systems
- Complete SSP (Sample Siting Plan) - Updated 07/05/2022
- Request for Reclassification & Certification Form - Updated 07/05/2022
- Domestic Water Supply Permit Application - Updated 07/05/2022
- Emergency Notification Plan Form for Small Water Systems - Updated 07/07/2022
- Small Water Systems Certified Operator List - Updated 06/24/2025
- Water Testing Laboratories - Updated 07/07/2022
Wells
- Damaged or Missing Wells Updated 09/24/2021
Well Application and Permit Forms
- Cathodic Protection & Geothermal Wells
- Compliance Bulletin: Exploratory Borings Updated 09/29/2021
- Compliance Bulletin: Submittal of Well Completion Reports Updated 09/29/2021
- Destruction Water Supply & Monitoring Wells
- Attachment for Multiple Well Destructions (If there is more than 1 well to be destroyed, use this form for additional wells)
- Important Notice: Water Well Rehabilitations Updated 11/25/2020
- Monitoring Wells & Soil Borings
- Permanent & Temporary Conductor Casings Guidance Document Updated 07/12/2022
- Property Owner's Authorization Letter Updated 06/18/2025
- Water Supply Well/Well Repair/Pump Repair & Replacement (Updated 01/22/2025)
- Water Well Disinfection Stages I and II Updated 07/12/2022
- Well Driller's Authorization Letter Updated 06/18/2025
- Well Driller's List Updated 12/09/2020
- Well Inactivation
Cross Connection Control (Backflow Prevention)
- Certified Backflow Prevention Assembly Tester List Updated 04/14/2014
- Cross Connection Water Supplier Contact List Updated 03/01/2011
- Sacramento County Water Purveyors Map
Cross Connection Approved Backflow Prevention Assembly Lists
The approved list of backflow prevention assemblies is available from the University of Southern California’s Foundation for Cross-Connection Control and Hydraulic Research website located at http://fccchr.usc.edu/
Please contact our office should you have any questions.
Cross Connection Ordinance (Sacramento County Code Chapter 6.30) - Final, Adopted April 13, 2010