Adding Chemicals to Water Supply - Permit

Permittee must comply with all requirements outlined in Section 141.011 of the NYC Health Code about the equipment used and the chemicals allowed, including sampling requirements. To view the Health Code, go to www.nyc.gov/healthcode and select Article 141.

Permittee must submit an Operation Status Change Form (Form PHE-ACW-01) that lists all devices or systems that it operates in NYC within 24 hours for each new activity that occurs including installation and commencement of treatment of a device or system and termination of treatment of a device or system. The required form can be requested and submitted by emailing PHE@health.nyc.gov.

Permittee must, for each device or system that was providing treatment at any time during the year, complete an Annual Compliance Report (Form PHE-ACW-02) by February 15th of each year for the preceding calendar year. The required form can be requested and submitted by emailing PHE@health.nyc.gov

Proof of Worker's Compensation and Disability Insurance, including the name of the insurance carrier, the policy number, and the expiration date must be submitted when you apply for a permit and when you renew. Or, if exempt, a copy of Form CE-200 stamped by the Worker's Compensation Board with the New York State-assigned Exemption Certificate Number. The certificate must list the New York City Department of Health and Mental Hygiene as the Certificate Holder.