Onondaga County, NY · Onondaga County
Water Supply Improvement Completion Certification
A professional engineer completes this certification to report water supply improvement work and test results to the Onondaga County Health Department.
At a glance
- Issued by
- City of Onondaga County · Onondaga County, Onondaga County, New York
- Notarization
- Not required: file this form without a notary.
- Official source
- onondaga.gov
- Blank form
- Download the PDF
- Catalogued
- Machine-readable
- JSON record · about the forms index
What this form is
This form certifies that a water supply improvement was completed in conformance with approved plans and that reported information came from actual tests conducted under the engineer’s general supervision. It records project details, construction dates, pressure and disinfection test information, bacteriological samples, laboratory details, and sampling results. The form is for reporting completion of a water supply improvement to the Onondaga County Health Department.
Who needs it
A professional engineer responsible for supervising tests for a completed water supply improvement uses this form to certify the work and report results.
How to submit it
Mail the completed form to Onondaga County Health Department, Division of Environmental Health, 12th Floor, 421 Montgomery Street, Syracuse, New York 13202.
About notarization
This certification is signed without a notary; the form requires the professional engineer’s original ink seal and signature.
How to submit this form
- 1
Download the Form
Download the water supply improvement completion certification.
- 2
Complete the Project Details
Enter the project, construction, testing, laboratory, and sampling information requested on the form.
- 3
Gather Test Results
Include the attached results referenced by the form, if applicable.
- 4
Sign and Seal the Certification
The professional engineer must provide an original ink seal and signature.
- 5
Mail the Form
Mail it to the Onondaga County Health Department, Division of Environmental Health, at the address printed on the form.
Frequently asked questions
- Do I need a notary for the Water Supply Improvement Completion Certification?
- No. The form does not require notarization; it requires the professional engineer’s original ink seal and signature.
- Who completes this water supply improvement certification?
- A professional engineer certifies that the improvement was completed in conformance with approved plans and that the reported information came from tests conducted under their general supervision.
- What information does the certification request?
- It requests project and construction details, pressure and disinfection test information, bacteriological sample and laboratory details, and sampling results.
- How do I submit the water supply improvement certification?
- Mail the completed form to the Onondaga County Health Department, Division of Environmental Health, 12th Floor, 421 Montgomery Street, Syracuse, New York 13202.