It's a New Day in Public Health.
The Florida Department of Health works to protect, promote & improve the health of all people in Florida through integrated state, county & community efforts.
Limited Use Wells
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This program deals with Limited Use Public Water Systems (public water systems which are not covered by the Safe Drinking Water Act), multi-family water systems, and private water systems. Definitions for these systems and statutory authorization are found in section 381.0062 of the Florida Statutes. Chapter 64E-8 of the Florida Administrative Code pdf (opens in new window, pdf <1mb) establishes the rules to implement the statutes. It includes setback standards for private water systems, construction standards for multi-family water systems, and construction and operation standards for limited use public water systems. The program is implemented at the local level by the county health departments.
Chapter 64E-8, FAC FORMS
Note: The fee schedules listed in the below applications only reflect the state fees. There may be additional city and/or county fees. Please contact your local county health department for complete details. All files in PDF and Word Doc format open in a new window:
DH Form 4092A Application for Limited Use Water System Operation- fillable pdf, 92kb
DH Form 4092B Water System Construction Permit Application - fillable pdf, 59kb
DH Form 4094 Water System Variance Application - fillable pdf, 31kb
DH Form 4095 Limited Use Commercial Water System Registration -fillable pdf, 36kb
DH Form 4113 Water System Data Sheet - fillable pdf, 151kb
DH Form 4020 Sanitary Survey & Inspection Report - gif, 206kb
The following are all in Microsoft Word Document format and open in a new window:
DH Form 4092A Application for Limited Use Water System Operation - Word, 64kb
DH Form 4092B Water System Construction Permit Application - Word, 59kb
DH Form 4094 Water System Variance Application - Word, 66kb
DH Form 4095 Limited Use Commercial Water System Registration Word, 62kb